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OP - RENAL OSTEODYSTROPHY WITH ORAL INVOLVEMENT: REPORT OF TWO CASES
OOOO Volume 123, Number 2 OP - INTRALESIONAL TRIAMCINOLONE FOR TREATMENT OF CENTRAL GIANT CELL LESION OF MANDIBLE: A 10-YEAR FOLLOW-UP. PAULO ANDRÉ GONÇALVES DE CARVALHO, RODRIGO NASCIMENTO LOPES, ESDRAS FAÇANHA CARVALHO, GUSTAVO DAVI RABELO, ANA PAULA MOLINA VIVAS, GRAZIELLA CHAGAS JAGUAR, FABIO ABREU ALVES. C CAMARGO CANCER CENTER. Central giant cell lesion (CGCL) is a benign bone lesion of unknown etiology that primarily affects the jaws, with a predilection for younger women. The CGCL clinical behavior ranges from a slow-growing asymptomatic swelling to an aggressive lesion that presents with pain, local bone destruction, root resorption and tooth displacement. Extensive resection is a treatment option, but this procedure results in large surgical defects. Nonsurgical treatment methods, such as intralesional corticosteroid injections and systemic calcitonin or interferon-a, are increasingly being used. This study aimed to report the case of a 9-year old girl with an expansive CGCL crossing the mandibular midline, which was treated with intralesional triamcinolone injections for a period of 10 weeks. There was gradual osseous neoformation. After 10-years follow-up, clinical and radiographic success of treatment were observed. The panoramic radiograph showed areas of new bone formation. Thus far, no recurrence or side effects of the medication have been detected. In conclusion, the administration of intralesional corticosteroid injections is an alternative in CGCL treatment, especially in children.
ABSTRACTS Abstracts e37 diagnosis in the elderly and immunosuppressed patients even with negative staining, because Ziehl-Neelsen technique efficiency is low (7.8%) in oral specimens due to the scarcity of microorganisms in this site.
OP - BILATERAL REPORT OF NECROTIZING SIALOMETAPLASIA. NATHALIA DE ALMEIDA FREIRE, JULIANA TRISTÃO WERNECK, FERNANDA GUIMARÃES, FELIPE BAARS DE MIRANDA, ADRIANNA MILAGRES, ELIANE PEDRA DIAS, ARLEY SILVA, JUNIOR. UNIVERSIDADE FEDERAL FLUMINENSE. Necrotizing sialometaplasia is a benign, self-limiting, and rare inflammatory disease of the minor salivary glands. The exact etiology is unknown; however, many authors suggest that ischemic changes could lead to the salivary gland infarction followed by necrosis. This study aimed to report an atypical case of a bilateral sialometaplasia on hard palate. A 53-year-old woman, heavy smoker, reporting daily alcohol consumption with bilateral palatal painful lesions with three days of development, which on the third day became into two deep ulcerations. The edges of the lesions were flat and soft, and the base revealed an exposed bone. No radiographic changes were observed. An incisional biopsy was performed and the histopathological findings were coagulation necrosis, inflammation, and squamous metaplasia consistent with necrotizing sialometaplasia. The ulcers resolved after topical desoxyribonuclease fibrinolysin treatment within 8 weeks. The importance of this case is to report an atypical clinical aspect.
OP - DIAGNOSTIC ASPECTS OF ORAL TUBERCULOSIS MANIFESTATION: A CASE REPORT. WELLINGTON HIDEAKI YANAGUIZAWA, CAMILLA VIEIRA ESTEVES DOS SANTOS, VANESSA JULIANA GOMES CARVALHO, MARÍLIA TRIERVEILER MARTINS, OSLEI PAES DE ALMEIDA, NORBERTO NOBUO SUGAYA, CAMILA DE BARROS GALLO. SCHOOL OF DENTISTRY, UNIVERSITY OF SAO PAULO, DENTISTRY SCHOOL, STATE UNIVERSITY OF CAMPINAS.
OP - RENAL OSTEODYSTROPHY WITH ORAL INVOLVEMENT: REPORT OF TWO CASES. RAFAEL NETTO, MARIA ELISA RANGEL JANINI, VALDIR MEIRELLES, JÚNIOR, PEDRO HENRIQUE MATTOS DE CARVALHO, ALINE CORRÊA ABRAHÃO, HERNANDO VALENTIM DA ROCHA, JÚNIOR, THAIS GOMES AMARAL. UNIVERSIDADE FEDERAL DO RIO DE JANEIRO, HOSPITAL FEDERAL DE BONSUCESSO, RIO DE JANEIRO.
A 61-year-old Caucasian female patient was attended at the Stomatology Department presenting a lesion in the gingiva that has been painful for 1 month. Clinical examination revealed a 20-mm, irregular, deep ulcer in both vestibular and lingual gingival mucosa, without bone involvement in the intraoral periapical radiograph. In addition, the patient also reported fever, weight loss and pneumonia. An incisional biopsy was performed with the clinical hypotheses of histoplasmosis, tuberculosis (TB) and oral squamous cell carcinoma. Histopathological examination showed ulceration with mixed inflammatory infiltrate and areas of necrosis. PAS and Ziehl-Neelsen staining were negative. Despite the lack of detection of microorganisms, malignant features were absent and the hypothesis of infectious disease was not disregarded. Ziehl-Neelsen staining was repeated in a new biopsy specimen showing positive result for TB. The patient died from complications of pulmonary infection later diagnosed as tuberculosis. Oral manifestations of tuberculosis are unusual; nevertheless, they should be considered in the differential
Renal osteodystrophy is characterized by bone mineralization deficiency, a direct result of the electrolyte and endocrine derangements that accompany chronic kidney disease (CKD). Renal osteodystrophy is thought to be the result of hyperparathyroidism secondary to hyperphosphatemia combined with hypocalcemia, both of which are due to decreased excretion of phosphate by the damaged kidney. Low activated vitamin D3 levels result from the damaged kidneys inability to convert this vitamin into its active form, calcitriol, and lead to further hypocalcemia. We report two cases of hyperparathyroidism secondary to chronic renal insufficiency in 2 patients presenting maxillary lesions. The first patient was a 35-year-old woman with CKD, with an 8-month history of swelling in the maxilla and hard palate. The second patient was a 42-year-old man with CKD and an identical dental history since 6 months. Chest, pelvic, long bones, and hand radiographies showed osseous changes. Incisional maxillary biopsies were obtained in both cases, confirming the clinical diagnosis of renal osteodystrophy. The patients started dialysis and osteoplastic procedures are being discussed.
ABSTRACTS Abstracts e37 diagnosis in the elderly and immunosuppressed patients even with negative staining, because Ziehl-Neelsen technique efficiency is low (7.8%) in oral specimens due to the scarcity of microorganisms in this site.
OP - BILATERAL REPORT OF NECROTIZING SIALOMETAPLASIA. NATHALIA DE ALMEIDA FREIRE, JULIANA TRISTÃO WERNECK, FERNANDA GUIMARÃES, FELIPE BAARS DE MIRANDA, ADRIANNA MILAGRES, ELIANE PEDRA DIAS, ARLEY SILVA, JUNIOR. UNIVERSIDADE FEDERAL FLUMINENSE. Necrotizing sialometaplasia is a benign, self-limiting, and rare inflammatory disease of the minor salivary glands. The exact etiology is unknown; however, many authors suggest that ischemic changes could lead to the salivary gland infarction followed by necrosis. This study aimed to report an atypical case of a bilateral sialometaplasia on hard palate. A 53-year-old woman, heavy smoker, reporting daily alcohol consumption with bilateral palatal painful lesions with three days of development, which on the third day became into two deep ulcerations. The edges of the lesions were flat and soft, and the base revealed an exposed bone. No radiographic changes were observed. An incisional biopsy was performed and the histopathological findings were coagulation necrosis, inflammation, and squamous metaplasia consistent with necrotizing sialometaplasia. The ulcers resolved after topical desoxyribonuclease fibrinolysin treatment within 8 weeks. The importance of this case is to report an atypical clinical aspect.
OP - DIAGNOSTIC ASPECTS OF ORAL TUBERCULOSIS MANIFESTATION: A CASE REPORT. WELLINGTON HIDEAKI YANAGUIZAWA, CAMILLA VIEIRA ESTEVES DOS SANTOS, VANESSA JULIANA GOMES CARVALHO, MARÍLIA TRIERVEILER MARTINS, OSLEI PAES DE ALMEIDA, NORBERTO NOBUO SUGAYA, CAMILA DE BARROS GALLO. SCHOOL OF DENTISTRY, UNIVERSITY OF SAO PAULO, DENTISTRY SCHOOL, STATE UNIVERSITY OF CAMPINAS.
OP - RENAL OSTEODYSTROPHY WITH ORAL INVOLVEMENT: REPORT OF TWO CASES. RAFAEL NETTO, MARIA ELISA RANGEL JANINI, VALDIR MEIRELLES, JÚNIOR, PEDRO HENRIQUE MATTOS DE CARVALHO, ALINE CORRÊA ABRAHÃO, HERNANDO VALENTIM DA ROCHA, JÚNIOR, THAIS GOMES AMARAL. UNIVERSIDADE FEDERAL DO RIO DE JANEIRO, HOSPITAL FEDERAL DE BONSUCESSO, RIO DE JANEIRO.
A 61-year-old Caucasian female patient was attended at the Stomatology Department presenting a lesion in the gingiva that has been painful for 1 month. Clinical examination revealed a 20-mm, irregular, deep ulcer in both vestibular and lingual gingival mucosa, without bone involvement in the intraoral periapical radiograph. In addition, the patient also reported fever, weight loss and pneumonia. An incisional biopsy was performed with the clinical hypotheses of histoplasmosis, tuberculosis (TB) and oral squamous cell carcinoma. Histopathological examination showed ulceration with mixed inflammatory infiltrate and areas of necrosis. PAS and Ziehl-Neelsen staining were negative. Despite the lack of detection of microorganisms, malignant features were absent and the hypothesis of infectious disease was not disregarded. Ziehl-Neelsen staining was repeated in a new biopsy specimen showing positive result for TB. The patient died from complications of pulmonary infection later diagnosed as tuberculosis. Oral manifestations of tuberculosis are unusual; nevertheless, they should be considered in the differential
Renal osteodystrophy is characterized by bone mineralization deficiency, a direct result of the electrolyte and endocrine derangements that accompany chronic kidney disease (CKD). Renal osteodystrophy is thought to be the result of hyperparathyroidism secondary to hyperphosphatemia combined with hypocalcemia, both of which are due to decreased excretion of phosphate by the damaged kidney. Low activated vitamin D3 levels result from the damaged kidneys inability to convert this vitamin into its active form, calcitriol, and lead to further hypocalcemia. We report two cases of hyperparathyroidism secondary to chronic renal insufficiency in 2 patients presenting maxillary lesions. The first patient was a 35-year-old woman with CKD, with an 8-month history of swelling in the maxilla and hard palate. The second patient was a 42-year-old man with CKD and an identical dental history since 6 months. Chest, pelvic, long bones, and hand radiographies showed osseous changes. Incisional maxillary biopsies were obtained in both cases, confirming the clinical diagnosis of renal osteodystrophy. The patients started dialysis and osteoplastic procedures are being discussed.