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Osteomyelitis With Proliferative Periostitis: A Case Report With 18 Months of Follow-Up
ORAL AND MAXILLOFACIAL PATHOLOGY e74 Abstracts PCC-251 - OSTEORADIONECROSIS HANDLING WITH LOW-LEVEL LASER THERAPY SUPPORT. LILIANE JANETE GRANDO, MARIANA COMPAROTTO MINAMISAKO, GUILHERME HENRIQUE RIBEIRO, MARIA INÊS MEURER, YASMIM GUTERRES, CARLA GIRARDI. UNIVERSIDADE FEDERAL DE SANTA CATARINA. Osteoradionecrosis of the jaw (ORNJ) is a radiotherapyassociated side effect of oral cancer. The combination of decreased bone repair and local trauma or dental infection can cause ORNJ, which results in morbidity. Three patients with ORNJ in different stages had been treated with antibiotics, chlorhexidine mouth rinse, bone debridement, low-level laser therapy, and photodynamic therapy in intraoral exposed bone and fistulous pathway. There was complete resolution in the first case; significant improvement in the second; and stabilization but still a risk of mandibular fracture in the third. None of the patients reported pain, and all 3 were under treatment for 24 months. Because the healing of ORNJ is complex, a combination of techniques is required in order to stabilize the lesion. Laser and photodynamic therapies are important tools to improve patient quality of life.
PCC-252 - ORAL ULCERS INDUCED BY ACETAMINOPHEN: DIFFICULTIES TO PERFORM ITS DIAGNOSIS. MARCELO DADALT RODRIGUES, MARIA FERNANDA BARTHOLO SILVA, JOSÉ DIVALDO PRADO, RODRIGO NASCIMENTO LOPES, LETICIA OLIVEIRA TONIN, ANA PAULA MOLINA VIVAS, FÁBIO DE ABREU ALVES. AC CAMARGO CANCER CENTER. Acetaminophen is widely used as an analgesic. Although acetaminophen is considered safe, cutaneous hypersensitivity reactions have been reported. A 65-year-old male presented with a 20-day history of painful oral ulcers. In the anamnesis, the patient reported frequent use of acetaminophen for headache. Intraoral examination showed thick, white areas of erythema, as well as multiple ulcers, on the buccal mucosa, tongue, inferior gingiva, and lower lip. Infectious diseases were suspected. However, serological tests for herpes, Epstein-Barr virus, and syphilis were negative. Allergic reaction to acetaminophen was then hypothesized. The acetaminophen was changed to another analgesic class, which resulted in complete regression of the lesions. This case shows that some details obtained during the anamnesis can be essential to the diagnosis.
PCC-253 - OSTEOMYELITIS WITH PROLIFERATIVE PERIOSTITIS: A CASE REPORT WITH 18 MONTHS OF FOLLOW-UP. ANA RAQUEL ROCHA CORREIA VILELA, LUCIANO LEOCÁDIO TEIXEIRA NOGUEIRA FILHO, EDVAL SANTOS SOUZA JÚNIOR, GLAUBER JOSÉ DE MELO CAVALCANTI MANSO, JOSÉ RICARDO MIKAMI, JANAINA ANDRADE LIMA SALMOS BRITO, RICARDO VIANA BESSA NOGUEIRA. CENTRO UNIVERSITÁRIO CESMAC. Osteomyelitis with proliferative periostitis (or Garré’s osteomyelitis) is described as a productive, proliferative inflammatory response of the periosteum to infection or other irritation. It generally appears during childhood, when the number of osteoblastic cells is abundant in the periosteum. When it affects the jaw, Garré’s osteomyelitis generally originates from an infection of low virulence, such as dental decay, mild periodontitis, dental eruption, or previous dental extraction in the affected area. A 7-year-old patient presented with a facial swelling (right side) associated with a decayed deciduous tooth. Conventional radiography showed a thin radiopaque line at the lower mandibular
OOOO August 2015 border associated with a radiolucent image at the alveolar socket. Cone-beam computed tomography was performed in order to complement the initial findings. The patient was treated with antibiotics, and eruption of the permanent teeth was monitored for 18 months, during which time no recurrence was reported.
PCC-254 - ORAL MANIFESTATIONS OF INTESTINAL INFLAMMATORY DISEASES: 2 CASE REPORTS. MANOELA SEADI PEREIRA, MARCO ANTONIO TREVIZANI MARTINS, MANOELA DOMINGUES MARTINS, MARIA CRISTINA MUNERATO. UNIVERSIDADE FEDERAL DO RIO GRANDE DO SUL. Crohn’s disease (CD) and ulcerative rectocolitis (UR) are chronic intestinal inflammations in which immunological, genetic, and environmental etiologies are possibly involved. These disorders can have oral manifestations, appearing as lesions similar to recurrent aphthous ulcerations. A 16-year-old male, diagnosed with CD at the age of 8, presented recurrent ulcerations of the oral mucosa. An improvement in the oral ulcers was seen after topical application of clobetasol; and the administration of prednisone, azathioprine, zinc and adalimumab seemed to be effective against CD. Another patient, a 32-year-old male, also presented recurrent ulcerations of the oral mucosa. He had a history of chronic diarrhea and ophthalmic lesions, which had led to blindness. Colonoscopy findings were suggestive of CD or UR. The oral ulcers disappeared after treatment with dexamethasone elixir, and the diarrhea was reduced by treatment with mesalazine. When dealing with a patient with oral ulcerations, the dentist needs to know how to identify intestinal inflammatory diseases, thus facilitating early treatment and improving patient quality of life.
PCC-255 - ORAL HAIRY LEUKOPLAKIA ASSOCIATED WITH SYSTEMIC LUPUS ERYTHEMATOSUS DIAGNOSED BY CYTOPATHOLOGY. LILIAN MACHADO DE SOUSA ALMEIDA, ELIANE PEDRA DIAS, ELOÁ BORGES LUNA, RAQUEL MACHADO DE ANDRADE, ARLEY SILVA JUNIOR, ADRIANNA MILAGRES, KARIN SOARES GONÇALVES CUNHA. UNIVERSIDADE FEDERAL FLUMINENSE. Oral hairy leukoplakia (OHL) is a benign lesion caused by the Epstein-Barr virus (EBV) and usually affects immunosuppressed individuals. Systemic lupus erythematosus (SLE) is an autoimmune disease that can have several systemic manifestations, including impaired renal function, dermatological lesions, and hematological alterations. A 42-year-old female diagnosed with SLE, associated with impaired renal function, severe anemia, and leukopenia, was referred to a stomatologist because of an oral lesion. Intraoral examination revealed a necrotic area in the gingiva. Cytopathological examination of the tongue was performed, and the gingival necrosis was treated by curettage and laser therapy. The cytopathological examination demonstrated the cytopathic effects of EBV, and the results were consistent with a diagnosis of OHL. Although SLE is an autoimmune disease, few cases of OHL associated with SLE have been reported. Cytopathology is a test that is easily performed, affordable and non-invasive, making it the method of choice for the diagnosis of OHL.
PCC-256 - TRAUMATIC EOSINOPHILIC GRANULOMA: A CASE REPORT. LAURA PRISCILA BARBOZA DE CARVALHO, LAUDENICE LUCENA PEREIRA, DIEGO DANTAS MOREIRA DE PAIVA, KAROLINE GOMES DA SILVEIRA, GUILHERME COSTA GUEDES PEREIRA, MARCOS ANTÔNIO FARIAS DE PAIVA. UNIVERSIDADE FEDERAL DA PARAÍBA.
PCC-252 - ORAL ULCERS INDUCED BY ACETAMINOPHEN: DIFFICULTIES TO PERFORM ITS DIAGNOSIS. MARCELO DADALT RODRIGUES, MARIA FERNANDA BARTHOLO SILVA, JOSÉ DIVALDO PRADO, RODRIGO NASCIMENTO LOPES, LETICIA OLIVEIRA TONIN, ANA PAULA MOLINA VIVAS, FÁBIO DE ABREU ALVES. AC CAMARGO CANCER CENTER. Acetaminophen is widely used as an analgesic. Although acetaminophen is considered safe, cutaneous hypersensitivity reactions have been reported. A 65-year-old male presented with a 20-day history of painful oral ulcers. In the anamnesis, the patient reported frequent use of acetaminophen for headache. Intraoral examination showed thick, white areas of erythema, as well as multiple ulcers, on the buccal mucosa, tongue, inferior gingiva, and lower lip. Infectious diseases were suspected. However, serological tests for herpes, Epstein-Barr virus, and syphilis were negative. Allergic reaction to acetaminophen was then hypothesized. The acetaminophen was changed to another analgesic class, which resulted in complete regression of the lesions. This case shows that some details obtained during the anamnesis can be essential to the diagnosis.
PCC-253 - OSTEOMYELITIS WITH PROLIFERATIVE PERIOSTITIS: A CASE REPORT WITH 18 MONTHS OF FOLLOW-UP. ANA RAQUEL ROCHA CORREIA VILELA, LUCIANO LEOCÁDIO TEIXEIRA NOGUEIRA FILHO, EDVAL SANTOS SOUZA JÚNIOR, GLAUBER JOSÉ DE MELO CAVALCANTI MANSO, JOSÉ RICARDO MIKAMI, JANAINA ANDRADE LIMA SALMOS BRITO, RICARDO VIANA BESSA NOGUEIRA. CENTRO UNIVERSITÁRIO CESMAC. Osteomyelitis with proliferative periostitis (or Garré’s osteomyelitis) is described as a productive, proliferative inflammatory response of the periosteum to infection or other irritation. It generally appears during childhood, when the number of osteoblastic cells is abundant in the periosteum. When it affects the jaw, Garré’s osteomyelitis generally originates from an infection of low virulence, such as dental decay, mild periodontitis, dental eruption, or previous dental extraction in the affected area. A 7-year-old patient presented with a facial swelling (right side) associated with a decayed deciduous tooth. Conventional radiography showed a thin radiopaque line at the lower mandibular
OOOO August 2015 border associated with a radiolucent image at the alveolar socket. Cone-beam computed tomography was performed in order to complement the initial findings. The patient was treated with antibiotics, and eruption of the permanent teeth was monitored for 18 months, during which time no recurrence was reported.
PCC-254 - ORAL MANIFESTATIONS OF INTESTINAL INFLAMMATORY DISEASES: 2 CASE REPORTS. MANOELA SEADI PEREIRA, MARCO ANTONIO TREVIZANI MARTINS, MANOELA DOMINGUES MARTINS, MARIA CRISTINA MUNERATO. UNIVERSIDADE FEDERAL DO RIO GRANDE DO SUL. Crohn’s disease (CD) and ulcerative rectocolitis (UR) are chronic intestinal inflammations in which immunological, genetic, and environmental etiologies are possibly involved. These disorders can have oral manifestations, appearing as lesions similar to recurrent aphthous ulcerations. A 16-year-old male, diagnosed with CD at the age of 8, presented recurrent ulcerations of the oral mucosa. An improvement in the oral ulcers was seen after topical application of clobetasol; and the administration of prednisone, azathioprine, zinc and adalimumab seemed to be effective against CD. Another patient, a 32-year-old male, also presented recurrent ulcerations of the oral mucosa. He had a history of chronic diarrhea and ophthalmic lesions, which had led to blindness. Colonoscopy findings were suggestive of CD or UR. The oral ulcers disappeared after treatment with dexamethasone elixir, and the diarrhea was reduced by treatment with mesalazine. When dealing with a patient with oral ulcerations, the dentist needs to know how to identify intestinal inflammatory diseases, thus facilitating early treatment and improving patient quality of life.
PCC-255 - ORAL HAIRY LEUKOPLAKIA ASSOCIATED WITH SYSTEMIC LUPUS ERYTHEMATOSUS DIAGNOSED BY CYTOPATHOLOGY. LILIAN MACHADO DE SOUSA ALMEIDA, ELIANE PEDRA DIAS, ELOÁ BORGES LUNA, RAQUEL MACHADO DE ANDRADE, ARLEY SILVA JUNIOR, ADRIANNA MILAGRES, KARIN SOARES GONÇALVES CUNHA. UNIVERSIDADE FEDERAL FLUMINENSE. Oral hairy leukoplakia (OHL) is a benign lesion caused by the Epstein-Barr virus (EBV) and usually affects immunosuppressed individuals. Systemic lupus erythematosus (SLE) is an autoimmune disease that can have several systemic manifestations, including impaired renal function, dermatological lesions, and hematological alterations. A 42-year-old female diagnosed with SLE, associated with impaired renal function, severe anemia, and leukopenia, was referred to a stomatologist because of an oral lesion. Intraoral examination revealed a necrotic area in the gingiva. Cytopathological examination of the tongue was performed, and the gingival necrosis was treated by curettage and laser therapy. The cytopathological examination demonstrated the cytopathic effects of EBV, and the results were consistent with a diagnosis of OHL. Although SLE is an autoimmune disease, few cases of OHL associated with SLE have been reported. Cytopathology is a test that is easily performed, affordable and non-invasive, making it the method of choice for the diagnosis of OHL.
PCC-256 - TRAUMATIC EOSINOPHILIC GRANULOMA: A CASE REPORT. LAURA PRISCILA BARBOZA DE CARVALHO, LAUDENICE LUCENA PEREIRA, DIEGO DANTAS MOREIRA DE PAIVA, KAROLINE GOMES DA SILVEIRA, GUILHERME COSTA GUEDES PEREIRA, MARCOS ANTÔNIO FARIAS DE PAIVA. UNIVERSIDADE FEDERAL DA PARAÍBA.