- Email: [email protected]
Mandibular Odontogenic Myxoma: From Resection to Rehabilitation: Case Report
OOOO Volume 117, Number 2 PE-201 - MANAGEMENT OF CHERUBISM WITH CALCITONIN AND TRIAMCINOLONE ACETONIDE: CLINICAL CASE REPORT. VANESSA CHIDIAC JORNADA, MARIA NOEL MARZANO RODRIGUES PETRUZZI, LILIANE SOARES YURGEL, FERNANDA GONÇALVES SALUM, MARIA ANTONIA ZANCANARO DE FIGUEIREDO, KAREN CHERUBINI. PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO GRANDE DO SUL.
Cherubism is a benign disorder characterized by “raised-toheaven” eyes, painless jawbone enlargement, abnormal dentition, and intra-osseous central giant cell granuloma-like lesions. Since the disease presents a tendency toward spontaneous remission, treatment need raises controversy. However, aggressive lesions might require clinical intervention. Young woman, 17, was referred to the department of stomatology with dental impaction, agenesis, and tooth mobility associated with swelling in the mental region plus buccal cortical bone thinning. Clinicohematological, radiographic, and histopathological findings contributed to the diagnosis of cherubism. To prevent tooth loosening and pathological bone fracture, the patient has been treated for 6 months with calcitonin (200 IU) every other day via nasal passage and intralesional injections of triamcinolone acetonide (20 mg/ml) diluted with lidocaine (10 mg/ml). Despite the unpredictable prognosis, favorable results are being achieved. The proposed management is well tolerated and should be considered as a noninvasive treatment alternative for cherubism lesions.
PE-202 - MANAGEMENT OF DENTAL PATIENTS USING BISPHOSPHONATES: CASE REPORT. INÁCIO LIMA SILVA AGUIAR, ANTONIO FERNANDO PEREIRA FALCÃO, VIVIANE ALMEIDA SARMENTO, PATRICIA LEITE RIBEIRO LAMBERTI, DAVI SILVA CARVALHO CURI, ANDRÉ LUCAS D’ALMEIDA LYRIO DOS SANTOS, THAMIRES SILVA SOUZA. UFBA. Bisphosphonates have an affinity for bone tissue and are used in the treatment of bone disorders. However, they have been associated with osteonecrosis of the jaws, dentists should be aware of how to prevent this disease. Man, 44, was diagnosed with multiple myeloma for which he was undergoing chemotherapy. During therapy, he developed hypercalcemia after receiving a dose of pamidronate. He was referred for dental treatment before continuing the treatment. Studies have shown that cases of osteonecrosis are directly associated with dental procedures, but the causes remain unclear. Because of the morbidity of this condition, performing needed dental treatment before beginning bisphosphonates is essential to reduce potential sources of infection.
PE-203 - MANDIBULAR FRACTURE-INDUCED OSTEORADIONECROSIS. RODRIGO MONTEZANO DA CUNHA, TAIANE BERGUEMAIER DE LIMA, KÍVIA LINHARES FERRAZZO, MÁRCIA RODRIGUES PAYERAS. FRANCISCAN UNIVERSITY CENTEReUNIFRA - SANTA MARIA/ BRAZIL. Osteoradionecrosis is the collateral effect of radiotherapy in the head and neck and is of great clinical significance. A case of mandibular fracture-induced osteoradionecrosis was reported. Man, 52, sought dental care with a history of oral cancer and radiotherapy. Examination revealed extraoral
ABSTRACTS Abstracts e171 fistula in the left jaw, limited mouth opening, and an area of intraoral exposed bone. The clinical diagnosis was osteoradionecrosis. The panoramic radiograph revealed fracture of the left mandibular body. Clindamycin plus daily mouthwash with chlorhexidine gluconate 0.12% for 15 days was prescribed, resulting in the closure of intraoral and extraoral fistulae. The mandibular fracture remains, with the patient awaiting further intervention. We highlight the importance of integration between medical and dental teams in preventing and treating side effects of oral cancer therapy with the goal of avoiding debilitating consequences that affect the quality of life of these patients.
PE-204 - MANDIBULAR METASTASIS OF DUCTAL BREAST CARCINOMA: CASE REPORT. THAYANA KARLA GUERRA DOS SANTOS, PATRÍCIA MEIRA BENTO, DANIELA PITA DE MELO, DALIANA QUEIROGA CASTRO GOMES, GUSTAVO PINA GODOY, CASSIANO FRANCISCO WEEGE NONAKA, POLLIANNA MUNIZ ALVES. UNIVERSITY OF PARAÍBA (UEPB). Breast cancer is the most common malignant disease in women. About 60% of patients with breast cancer have advanced disease and develop bone metastases, but these are rare in the maxillofacial region. Woman, 66, complained of symptomatic swelling in the left posterior mandible that had increased rapidly. Four years previously she was treated for breast cancer using radiotherapy and chemotherapy. Panoramic radiograph demonstrated radiolucency with cortial bone rupture; scintigraphy showed hyperintense signal in the left posterior mandible. The preliminary diagnosis was osseous metastases. An incisional biopsy was performed, and microscopic examination revealed a malignant neoplasm exhibiting proliferating atypical and undifferentiated cells. Immunohistochemistry results were positive for estrogen receptor and negative for progesterone receptor and C-erbB2. The definitive diagnosis was mandibular metastasis of ductal breast carcinoma. This case shows the essential role dentists play in diagnosing maxillofacial metastases and possibly prolonging survival and improving the quality of life of patients.
PE-205 - MANDIBULAR ODONTOGENIC MYXOMA: FROM RESECTION TO REHABILITATION: CASE REPORT. ANDERSON DA SILVA MACIEL, BRAULIO CARNEIRO JUNIOR, ROBERTO ALMEIDA DE AZEVEDO, VIVIANE ALMEIDA SARMENTO. UFBA. Odontogenic myxoma is a benign tumor but can be locally aggressive. The mandible is the most often affected site. Myxoma promotes the painless expansion of cortical bone and can displace teeth. When small, the tumor may not produce abnormalities except on radiographic examination, which shows a unilocular or multilocular radiolucency with irregular margins. The defect may contain thin residual bone tissue arranged at right angles to one another, described as a “stepladder pattern.” The treatment of choice to minimize recurrence is extensive resection, so rehabilitation of patients can be quite challenging for surgeons. Microvascular reconstruction techniques, osseous free flaps, and other procedures such as distraction osteogenesis, when associated with osseointegrated implants and prosthetics, allow the recovery of both function and aesthetics. This paper reports a case of a patient diagnosed with myxoma and its oral rehabilitation.
Cherubism is a benign disorder characterized by “raised-toheaven” eyes, painless jawbone enlargement, abnormal dentition, and intra-osseous central giant cell granuloma-like lesions. Since the disease presents a tendency toward spontaneous remission, treatment need raises controversy. However, aggressive lesions might require clinical intervention. Young woman, 17, was referred to the department of stomatology with dental impaction, agenesis, and tooth mobility associated with swelling in the mental region plus buccal cortical bone thinning. Clinicohematological, radiographic, and histopathological findings contributed to the diagnosis of cherubism. To prevent tooth loosening and pathological bone fracture, the patient has been treated for 6 months with calcitonin (200 IU) every other day via nasal passage and intralesional injections of triamcinolone acetonide (20 mg/ml) diluted with lidocaine (10 mg/ml). Despite the unpredictable prognosis, favorable results are being achieved. The proposed management is well tolerated and should be considered as a noninvasive treatment alternative for cherubism lesions.
PE-202 - MANAGEMENT OF DENTAL PATIENTS USING BISPHOSPHONATES: CASE REPORT. INÁCIO LIMA SILVA AGUIAR, ANTONIO FERNANDO PEREIRA FALCÃO, VIVIANE ALMEIDA SARMENTO, PATRICIA LEITE RIBEIRO LAMBERTI, DAVI SILVA CARVALHO CURI, ANDRÉ LUCAS D’ALMEIDA LYRIO DOS SANTOS, THAMIRES SILVA SOUZA. UFBA. Bisphosphonates have an affinity for bone tissue and are used in the treatment of bone disorders. However, they have been associated with osteonecrosis of the jaws, dentists should be aware of how to prevent this disease. Man, 44, was diagnosed with multiple myeloma for which he was undergoing chemotherapy. During therapy, he developed hypercalcemia after receiving a dose of pamidronate. He was referred for dental treatment before continuing the treatment. Studies have shown that cases of osteonecrosis are directly associated with dental procedures, but the causes remain unclear. Because of the morbidity of this condition, performing needed dental treatment before beginning bisphosphonates is essential to reduce potential sources of infection.
PE-203 - MANDIBULAR FRACTURE-INDUCED OSTEORADIONECROSIS. RODRIGO MONTEZANO DA CUNHA, TAIANE BERGUEMAIER DE LIMA, KÍVIA LINHARES FERRAZZO, MÁRCIA RODRIGUES PAYERAS. FRANCISCAN UNIVERSITY CENTEReUNIFRA - SANTA MARIA/ BRAZIL. Osteoradionecrosis is the collateral effect of radiotherapy in the head and neck and is of great clinical significance. A case of mandibular fracture-induced osteoradionecrosis was reported. Man, 52, sought dental care with a history of oral cancer and radiotherapy. Examination revealed extraoral
ABSTRACTS Abstracts e171 fistula in the left jaw, limited mouth opening, and an area of intraoral exposed bone. The clinical diagnosis was osteoradionecrosis. The panoramic radiograph revealed fracture of the left mandibular body. Clindamycin plus daily mouthwash with chlorhexidine gluconate 0.12% for 15 days was prescribed, resulting in the closure of intraoral and extraoral fistulae. The mandibular fracture remains, with the patient awaiting further intervention. We highlight the importance of integration between medical and dental teams in preventing and treating side effects of oral cancer therapy with the goal of avoiding debilitating consequences that affect the quality of life of these patients.
PE-204 - MANDIBULAR METASTASIS OF DUCTAL BREAST CARCINOMA: CASE REPORT. THAYANA KARLA GUERRA DOS SANTOS, PATRÍCIA MEIRA BENTO, DANIELA PITA DE MELO, DALIANA QUEIROGA CASTRO GOMES, GUSTAVO PINA GODOY, CASSIANO FRANCISCO WEEGE NONAKA, POLLIANNA MUNIZ ALVES. UNIVERSITY OF PARAÍBA (UEPB). Breast cancer is the most common malignant disease in women. About 60% of patients with breast cancer have advanced disease and develop bone metastases, but these are rare in the maxillofacial region. Woman, 66, complained of symptomatic swelling in the left posterior mandible that had increased rapidly. Four years previously she was treated for breast cancer using radiotherapy and chemotherapy. Panoramic radiograph demonstrated radiolucency with cortial bone rupture; scintigraphy showed hyperintense signal in the left posterior mandible. The preliminary diagnosis was osseous metastases. An incisional biopsy was performed, and microscopic examination revealed a malignant neoplasm exhibiting proliferating atypical and undifferentiated cells. Immunohistochemistry results were positive for estrogen receptor and negative for progesterone receptor and C-erbB2. The definitive diagnosis was mandibular metastasis of ductal breast carcinoma. This case shows the essential role dentists play in diagnosing maxillofacial metastases and possibly prolonging survival and improving the quality of life of patients.
PE-205 - MANDIBULAR ODONTOGENIC MYXOMA: FROM RESECTION TO REHABILITATION: CASE REPORT. ANDERSON DA SILVA MACIEL, BRAULIO CARNEIRO JUNIOR, ROBERTO ALMEIDA DE AZEVEDO, VIVIANE ALMEIDA SARMENTO. UFBA. Odontogenic myxoma is a benign tumor but can be locally aggressive. The mandible is the most often affected site. Myxoma promotes the painless expansion of cortical bone and can displace teeth. When small, the tumor may not produce abnormalities except on radiographic examination, which shows a unilocular or multilocular radiolucency with irregular margins. The defect may contain thin residual bone tissue arranged at right angles to one another, described as a “stepladder pattern.” The treatment of choice to minimize recurrence is extensive resection, so rehabilitation of patients can be quite challenging for surgeons. Microvascular reconstruction techniques, osseous free flaps, and other procedures such as distraction osteogenesis, when associated with osseointegrated implants and prosthetics, allow the recovery of both function and aesthetics. This paper reports a case of a patient diagnosed with myxoma and its oral rehabilitation.