ORAL AND MAXILLOFACIAL PATHOLOGY e192 Abstracts PE-311 - SQUAMOUS CELL CARCINOMA OF THE TONGUE WITH OSTEOCLAST-LIKE GIANT CELL REACTION: CASE REPORT. RAFAELLA BASTOS LEITE, ROBERIA LÚCIA DE QUEIROZ FIGUEIREDO, JOZINETE VIEIRA PEREIRA, DALIANA QUEIROGA DE CASTRO GOMES, POLLIANNA MUNIZ ALVES, GUSTAVO PINA GODOY, CASSIANO FRANCISCO WEEGE NONAKA. UNIVERSIDADE ESTADUAL DA PARAÍBA. Osteoclast-like giant cell (O-LGC) reaction in intimate association with human malignancies is an uncommon phenomenon that is usually reported in high-grade carcinomas. Tumors with O-LGC reactions have been identified at several anatomic locations, including breast, pancreas, liver, gallbladder, and skin. In the oral cavity, O-LGC reaction is only rarely reported with squamous cell carcinoma (SCC). Nonsmoking woman, 50, required evaluation of a painful reddish nodule on the lateral surface of the tongue that was found about 6 months earlier. Extraoral examination showed no palpable lymph nodes. Because SCC was suspected, an incisional biopsy was performed. Histopathological examination revealed moderately differentiated invasive SCC with numerous O-LGCs closely associated with the neoplastic epithelial cells. Immunohistochemical analysis disclosed positive reactions for cytokeratin 14 (epithelial cells) and CD68 (O-LGCs). The definitive diagnosis was SSC with O-LGC reaction. The patient was referred to a head and neck surgical service.
PE-312 - SYNCHRONOUS OCCURRENCE OF JUVENILE OSSIFYING FIBROMA OF THE MANDIBLE AND MAXILLA: CASE REPORT. TARCÍSIO OLIVEIRA DONATO FERNANDES, JEAN NUNES DOS SANTOS, CLARISSA ARAUJO SILVA GURGEL, BRUNO BOTTO DA SILVEIRA, FATIMA KAROLINE ARAUJO ALVES DULTRA, JOAQUIM ALMEIDA DULTRA, ÁGUIDA CRISTINA GOMES HENRIQUES. FACULDADE DE ODONTOLOGIA UNIVERSIDADE FEDERAL DA BAHIA.
Juvenile ossifying fibroma (JOF) is an uncommon, benign, bone-forming neoplasm distinguished from other fibro-osseous lesions primarily by its age of onset, clinical presentation, aggressive behavior, and high tendency to recur. An atypical case is presented. Man, 26, manifested synchronous JOF lesions, with one in the left mandible measuring 10 cm and one in the left maxilla measuring 5 cm with a multilocular radiolucent radiographic appearance. The lesions were treated by hemimandibulectomy and curettage, respectively. Microscopically, the lesions were composed of cell-rich fibrous stroma associated with bony trabeculae exhibiting different degrees of mineralization and spherical ossicles showing basophilic centers and peripheral eosinophilia. Synchronous presentation of this neoplasm in the maxilla and mandible is rare. JOF can share clinicopathological features with other fibro-osseous lesions and bone neoplasms. Clinicoradiologic and histopathological criteria for JOF are discussed, along with suggestions to guide early diagnosis, suggest appropriate treatment, and, especially, provide long-term followup of patients.
PE-313 - TEMPOROMANDIBULAR ANKYLOSING SPONDYLITIS: A RARE MANIFESTATION: CASE REPORT. JESSICA OLIVEIRA MELO SILVA, SINTIQUE PRISCILA ALVES LUZ, LAIRA RENATA LEMOS SANTOS, PATRICIA LEITE RIBEIRO LAMBERTI, MILENA PEREIRA SOUZA PAIXÃO, ADRIANA BORGES OLIVEIRA. UFBA.
OOOO February 2014 Ankylosing spondylitis is an inflammatory chronic rheumatic disease that affects the joints of genetically predisposed individuals. It primarily affects the spine, but the temporomandibular joint (TMJ) is involved in 4% of cases, or only 1% of the general population, making this a rare manifestation. Ankylosing spondylitis produces generalized joint stiffness through the development of fibrous scar tissue that ossifies, subsequently leading to progressive loss of mobility. Treatment is designed to induce the remission of symptoms, which reduces pain, joint stiffness, inflammation, and the consequent functional incapacity. The dentist should know about this condition to guide a multidisciplinary team approach with the goal of improving the patient’s quality of life. This report documents a case of bilateral TMJ ankylosis secondary to ankylosing spondylitis, in a lightskinned man, age 37 years, who came to the Stomatology Clinic of FOUFBA.
PE-314 - EFFICACY OF LOW-LEVEL LASER THERAPY FOR HYPOSALIVATION: REPORT OF TWO CASES. TAIANA CAMPOS LEITE, RAFAELA ELVIRA ROZZA DE MENEZES, KARLA BIANCA FERNANDES DA COSTA FONTES, ELIANE PEDRA DIAS, RAQUEL RICHELIEU LIMA DE ANDRADE, ARLEY SILVA JÚNIOR, KARIN SOARES GONÇALVES CUNHA. UNIVERSIDADE FEDERAL FLUMINENSE. Hyposalivation is often neglected and may cause negative consequences for the patient’s health. This report outlines the hyposalivation protocol of our service and shows the results of treatment of two patients with xerostomia. Both patients underwent clinical and cytopathological examinations and a sialometry test. They presented low non-stimulated (0.02 mL/min; 0.12 mL/min) and low stimulated sialometry values (0.35 mL/ min; 0.34 mL/min) and were treated with low-level laser therapy (LLLT) given in doses designed to increase salivation. Weekly irradiation with GaAlAs diode laser (808 nm, 4 J, 142 J/cm2, 100 mW) was done at three points in each parotid and submandibular gland, and two points in each sublingual gland. After 10 sessions of LLLT, both patients had improved xerostomia and salivary flow rates: non-stimulated (0.28 mL/min; 0.36 mL/ min) and stimulated (0.7 mL/min for both). LLLT is beneficial for hyposalivation, but the literature still lacks reports of clinical trials and protocols.
PE-315 - USE OF INTENSIFIER IMAGE AS A METHOD FOR LOCATING DIAGNOSTIC NEEDLE IN PTERYGOMANDIBULAR SPACE. RENNAN LUIZ OLIVEIRA DOS SANTOS, LUCAS ALEXANDRE DE MORAIS SANTOS, PRISCILLA FLORES SILVA, ANTONIO FIGUEIREDO CAUBI, FÁBIO LUIZ NEVES GONÇALVES, MARIA LUÍSA SOARES, RAFAEL DE QUEIROZ MOURA. FOPeUPE. The decision to remove or maintain fractured needles after local anesthesia remains controversial because surgical manipulation without identifying the exact location may cause more harm than benefit. Woman, 41, complained of severe pain in the right pterygomandibular region 3 months after having a tooth extracted. Clinically, no facial or intraoral abnormalities were compatible with the symptoms. Computed tomography was done to ensure greater diagnostic accuracy and showed a semi-circular suture needle in the pterygomandibular region on the right side that was in intimate contact with the mandibular foramen. Removal was performed under general anesthesia with the
OOOO Volume 117, Number 2 diagnostic aid of an intensifier image to guarantee the precise location for foreign body removal, which proceeded uneventfully. This diagnostic method has the advantages of providing dynamic intraoperative images quickly and at varying angles.
PE-316 - TISSUE NECROSIS IN HIV-POSITIVE PATIENT TAKING CHEMOTHERAPY FOR ACUTE LYMPHOBLASTIC LEUKEMIA SUBTYPE 3: DENTAL APPROACH. CAROLINE ZIMMERMANN, LILIANE JANETE GRANDO, JOANITA ANGELA GONZAGA DEL MORAL, AIRA MARIA BONFIM SANTOS, LUCIANA GOULART MEDEIROS, CÍNTIA LOCKS, MARIA INÊS MEURER. UNIVERSIDADE FEDERAL DE SANTA CATARINA. Acute lymphoblastic leukemia (ALL) subtype 3 (Burkitt’s leukemia) is an aggressive cancer of B cells. It may be associated with human immunodeficiency virus (HIV) infection, and its treatment can induce stomatotoxicity. Man, 33, with ALL subtype 3 and HIV infection started chemotherapy and antiretroviral treatment and developed grade II oral mucositis and necrotic ulcer in the mucosa that progressed to bone necrosis (anterior mandibular region, teeth #32 to #42). The dental measures adopted included antibiotic therapy based on culture of the necrotic bone, photodynamic therapy with low-power laser (red), mouthwash with chamomile iced tea during drug infusions, strict oral hygiene care, and subsequent bone surgery. The patient experienced some hospital stays, discharges, and readmissions, and ultimately passed away. Patients with ALL require highly complex treatment and a multidisciplinary approach. Hospital dental monitoring is essential to improve the patient’s quality of life through the use of preventive, curative, and palliative approaches.
PE-317 - TOPICAL CLOBETASOL PROPIONATE ASSOCIATED WITH ANTIFUNGAL IN THE TREATMENT OF SYMPTOMATIC ORAL LICHEN PLANUS. RONAIRO ZAIOSC TURCHIELLO, ARTHUR PIAS SALGUEIRO, MÁRCIA RODRIGUES PAYERAS, KÍVIA LINHARES FERRAZZO. FRANCISCAN UNIVERSITY CENTER UNIFRA - SANTA MARIA/RS. Oral lichen planus is a chronic inflammatory disease of autoimmune character and unknown origin. Erosive lichen planus can cause painful symptoms and manifest as atrophic erythematous areas with ulceration. Woman, 65, complained of burning mouth. Her medical history revealed hypertension and daily use of losartan. Intraoral and histopathological examination results were compatible with erosive oral lichen planus. Initial treatment with topical steroids (dexamethasone elixir) for 4 weeks produced a slight improvement. The drug was replaced by clobetasol propionate (0.05%) plus nystatin, which led to a significant reduction of lesions and pain in the first week. Therapy was continued for more 3 weeks, until the disappearance of pain and most of the lesions. The patient is being followed up. Despite clobetasol being a potent topical corticosteroid and the first-line treatment for oral lichen planus, total remission of lesions does not always occur.
PE-318 - TRANSIENT LINGUAL PAPILLITIS RELATED TO FOOD ALLERGY. ANNA PAULA NIGRI, ALINE ARAÚJO SILVA, NATHÁLIA ALMEIDA, SARAH APARECIDA ANTERO, MARIA ELIZA BARBOSA RAMOS, ROSEMIRO DE MENEZES MACIEL, MÔNICA ISRAEL. UERJ.
ABSTRACTS Abstracts e193 Transient lingual papillitis (TLP) is an inflammatory condition that has an uncertain pathogenesis and has been associated with several different factors. It affects the fungiform papillae of the tongue and is most common in women. White man, 30, described a burning sensation and pain on the lateral portion of the tongue’s dorsum present for about a week. The physical examination revealed focally localized erythematous and hypertrophied papillae. After a meticulous history was obtained, an association between food hypersensitivity and the patient’s clinical features was noticed. Because TLP has no precise pathogenesis, the history assumes a vital role in correlating symptoms and causation and is indispensable to reaching the correct diagnosis.
PE-319 - TRAUMATIC DENTOALVEOLAR INJURY WITH TOOTH IMPACTION MIMICKING MIXED ODONTOGENIC LESION: CASE REPORT. CAROLINE SIVIERO DILLENBURG, JOSÉ LUÍS NICOLAU GHENO, MARCO ANTONIO TREVIZANI MARTINS, MANOELA DOMINGUES MARTINS, MARIA CRISTINA MUNERATO. HOSPITAL DE CLÍNICAS DE PORTO ALEGRE, UNIVERSIDADE FEDERAL DO RIO GRANDE DO SUL. Man, 84, came to the stomatology service with a fistula in the left submental region present for 6 months. He reported spontaneous purulent drainage. Intraoral examination showed mild bone irregularity in the region of the lower alveolar ridge. The patient stated that at age 13 years he suffered a mule kick that caused chin trauma with multiple fractures and loss of teeth. Panoramic radiography indicated a mixed image with well-defined edges and central calcified spots surrounded by a radiolucent area measuring about 2.0 1.5 cm. Possible diagnoses included various odontogenic lesions. Based on the clinical and radiographic characteristics, surgical exploration was performed and the lesion was excised. Several tooth fragments were removed, consistent with the history of traumatic dentoalveolar injury. Histopathological analysis showed chronic suppurative inflammation. After surgery, the extraoral fistula resolved completely. The patient continues to attend clinical and radiographic follow-up with no signs of recurrence.
PE-320 - TRAUMATIC NEUROMA: REPORT OF TWO CASES. MARCOS ANTONIO NUNES COSTA SILAMI, DANIELLE RESENDE CAMISASCA, MARCIA DUARTE SOTHER, REBECA DE SOUZA AZEVEDO, SILVIA PAULA DE OLIVEIRA. ODONTOCLÍNICA CENTRAL DO EXÉRCITO (OCEX). Traumatic neuroma is a reactive lesion of neural origin that develops in a nerve bundle after trauma. In the repair process, axon growth occurs to reestablish neural connections, but sometimes a mass resembling an ordinary reactive lesion develops at the site of injury. Two cases of traumatic neuroma are reported. Woman, 61, had a white lesion associated with a mandibular removable partial denture clip in the alveolar mucosa corresponding to the inferior left canine. It was sensitive to touch. Man, 67, revealed multiple normochromic papules in the apical tongue present for 1 year. Sensitivity associated with smoking and drinking was present. In both cases, excisional biopsy was performed and the final diagnosis was traumatic neuroma. No recurrences developed. The reported traumatic neuromas are common and show consistent symptoms, although the clinical presentation differs from the typical nodular pattern described.