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OZONOTHERAPY IN JAW OSTEONECROSIS RELATED TO RADIOTHERAPY AND BISPHOSPHONATE: A CASE REPORT
ABSTRACTS
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JAFFE-LICHTENSTEIN SYNDROME ASSOCIe ATED WITH SIMPLE BONE CYST. JOAO e CESAR GUIMARAES HENRIQUES, FABIO FRANCESCHINI MITRI, LUIZ FERNANDO BARBOSA DE PAULO, GABRIELLA LOPES DE REZENDE BARBOSA, JONAS DANTAS BATISTA, SERGIO VITORINO CARDOSO and, ADRIANO MOTA LOYOLA Fibrous dysplasia is a fibroosseous lesion with single or multiple manifestations. The polyostotic variant is rare and may involve 2 syndromes: McCune-Albright or Jaffe-Lichtenstein. Patient C.P.G., 42 years old, white, went to the stomatology department with a complaint of swelling in the mandible. The extraoral examination revealed right mandibular swelling, as well as an underdeveloped arm and leg on the same side. Intraoral exam showed an expansion of vestibular and lingual cortex. Imaging examinations exhibited craniofacial bones with a "ground-glass" appearance and a probable simple bone cyst in the swollen area. Skin pigmentations were identified and the patient denied any sexual precocity during adolescence. New imaging tests revealed altered bones at several sites, such as the humerus and femur. An incisional mandibular biopsy confirmed the hypothesis of a fibroosseous lesion and a curettage of the bone cavity resulted in bone formation, proving the association of Jaffe-Lichtenstein syndrome with simple bone cyst.
OZONOTHERAPY IN JAW OSTEONECROSIS RELATED TO RADIOTHERAPY AND BISPHOSPHONATE: A CASE REPORT. JULIANA BORGES DE LIMA DANTAS, MANOELA ^ CARRERA, ANTONIO MARCIO TEIXEIRA MARCHIONNI, DANILO DE PAULA RIBEIRO BORGES, SILVIA REGINA DE ALMEIDA REIS, LAIS BASTOS e and, ALENA PEIXOTO MEDRADO GUIMARAES Several antineoplastic treatments disturb wound repair and may even contribute to bone necrosis development. The present study aims to report a case of osteoradionecrosis in the mandible, and how its sequels were controlled by ozonotherapy. A 73-yearold female patient with a history of infiltrative ductal breast carcinoma with mandibular metastasis underwent chemotherapy and radiotherapy in head and neck region. Three years later, she was diagnosed with right hemimandibular osteoradionecrosis that exhibited communication with buccal cavity presenting as a chronic, suppurative, and persistent infection. Adjuvant therapy with ozone was applied through the cutaneous fistula and the exposed necrotic bone. Additionally, nonvital bone debridement was performed. The patient is nonsymptomatic after 1-year follow-up. It is proposed that ozone therapy, due to its antibacterial and immunoregulatory mechanism of action, was an important therapeutic agent for improving the patient’s quality of life.
TREATMENT OF MUCOUS MEMBRANE PEMPHIGOID WITH LOW-LEVEL LASER THERAPY. ISIS OLIVEIRA GOMES, HELENO OLIVEIRA DE MORAIS, WAGNER PINTO DAS CHAGAS, CARLA RENATA PETILLO, SARAH APARECIDA ^ e ISRAEL and, ROSEMIRO DE ANTERO, MONICA SIMOES MENEZES MACIEL Pemphigoid of the mucous membranes represents a group of subepithelial blistering diseases of autoimmune origin. The
OOOO January 2020 radiation emitted by the low-level laser affects the metabolic processes of the target cells, producing biostimulants that act in the process of regeneration of the tissues. A 34-year-old female patient presented clinically with an erythematous gingiva that was blistering and scaling, with painful and burning symptomatology. An excisional biopsy was performed, sent for histopathologic examination, confirming the diagnosis of mucous membrane pemphigoid. Treatment included low-level laser therapy at the wavelength 630 to 700 nm, following the 1 J protocol for interdental papilla, with an area of approximately 1 cm2 per point, and use of steroids. The objective of this study is to demonstrate how laser therapy functions in the treatment of oral lesions of mucous membrane pemphigoid.
MULTIPLE ORAL FISTULA AND TRISMUS LEADING TO A SURPRISING DIAGNOSIS. TIAGO NOVAES PINHEIRO, ALESSANDRA VALLE SALINO, HUGO FELIPE DO VALE, ROMAN e CARLOS and, RODRIGO LEITAO We report a rare case of late diagnosis of malignant osteopetrosis due to clinical investigation of multiple intraoral fistulae and trismus in a 35-year-old male patient. The patient reported history of various complicated dental extractions during his life, facial scars that he could not attribute with certainty to old external fistulas, but besides his blindness, present since his childhood, he never had any other significant disease previously diagnosed. A computerized scanning tomography was performed and revealed a marblelike sclerotic pattern of all cranial bones, thickened parietal bone, and a narrowing of the encephalic space and optic canal. Further laboratorial and imaging studies revealed complete sclerosed bone of the chest and pelvis, anemia, reticulocitosis, extramedullary hematopoiesis, altered lactate dehydrogenase, and acid phosphatases. An interdisciplinary treatment was started with medical and dental care monitoring, and the patient is still under follow-up care after 1 year.
A RARE CASE OF PRIMARY INTRAOSSEOUS CARCINOMA OF THE MAXILLA ARISING FROM AN ODONTOGENIC KERATOCYST. JUSSARA MARIA GON¸CALVES, LUIZ HENRIQUE MAROLA, DANIELLA SERAFIN COUTO VIEIRA, GUSTAVO PHILIPPI DE LOS SANTOS, JORGE ESQUICHE LEON, FILIPE MODOLO and, ROGERIO GONDAK A 47-year-old man was referred to treatment of a lesion located on the left maxilla with 5 months of evolution. Intraoral examination revealed a perforation in the vestibular cortical bone. The computerized tomography (CT) showed an extensive, well-delineated, radiolucent lesion, extending from the alveolar ridge up to the nasal cavity. Microscopically, a cystic lesion consistent with odontogenic keratocyst (OKC) was observed. Decompression to posterior enucleation was performed. After 3 months, the patient returned presenting with a significant increase of the vestibular cortical perforation. A destructive lytic lesion involving the maxilla and surpassing the medium line was evident on the CT. The second incisional biopsy presented as an epithelial neoplasia composed of islands and projections toward the surface with abundant keratin deposition forming pearls and keratin plugging. Diagnosis of primary intraosseous carcinoma arising from an OKC was confirmed and the patient underwent
e26
JAFFE-LICHTENSTEIN SYNDROME ASSOCIe ATED WITH SIMPLE BONE CYST. JOAO e CESAR GUIMARAES HENRIQUES, FABIO FRANCESCHINI MITRI, LUIZ FERNANDO BARBOSA DE PAULO, GABRIELLA LOPES DE REZENDE BARBOSA, JONAS DANTAS BATISTA, SERGIO VITORINO CARDOSO and, ADRIANO MOTA LOYOLA Fibrous dysplasia is a fibroosseous lesion with single or multiple manifestations. The polyostotic variant is rare and may involve 2 syndromes: McCune-Albright or Jaffe-Lichtenstein. Patient C.P.G., 42 years old, white, went to the stomatology department with a complaint of swelling in the mandible. The extraoral examination revealed right mandibular swelling, as well as an underdeveloped arm and leg on the same side. Intraoral exam showed an expansion of vestibular and lingual cortex. Imaging examinations exhibited craniofacial bones with a "ground-glass" appearance and a probable simple bone cyst in the swollen area. Skin pigmentations were identified and the patient denied any sexual precocity during adolescence. New imaging tests revealed altered bones at several sites, such as the humerus and femur. An incisional mandibular biopsy confirmed the hypothesis of a fibroosseous lesion and a curettage of the bone cavity resulted in bone formation, proving the association of Jaffe-Lichtenstein syndrome with simple bone cyst.
OZONOTHERAPY IN JAW OSTEONECROSIS RELATED TO RADIOTHERAPY AND BISPHOSPHONATE: A CASE REPORT. JULIANA BORGES DE LIMA DANTAS, MANOELA ^ CARRERA, ANTONIO MARCIO TEIXEIRA MARCHIONNI, DANILO DE PAULA RIBEIRO BORGES, SILVIA REGINA DE ALMEIDA REIS, LAIS BASTOS e and, ALENA PEIXOTO MEDRADO GUIMARAES Several antineoplastic treatments disturb wound repair and may even contribute to bone necrosis development. The present study aims to report a case of osteoradionecrosis in the mandible, and how its sequels were controlled by ozonotherapy. A 73-yearold female patient with a history of infiltrative ductal breast carcinoma with mandibular metastasis underwent chemotherapy and radiotherapy in head and neck region. Three years later, she was diagnosed with right hemimandibular osteoradionecrosis that exhibited communication with buccal cavity presenting as a chronic, suppurative, and persistent infection. Adjuvant therapy with ozone was applied through the cutaneous fistula and the exposed necrotic bone. Additionally, nonvital bone debridement was performed. The patient is nonsymptomatic after 1-year follow-up. It is proposed that ozone therapy, due to its antibacterial and immunoregulatory mechanism of action, was an important therapeutic agent for improving the patient’s quality of life.
TREATMENT OF MUCOUS MEMBRANE PEMPHIGOID WITH LOW-LEVEL LASER THERAPY. ISIS OLIVEIRA GOMES, HELENO OLIVEIRA DE MORAIS, WAGNER PINTO DAS CHAGAS, CARLA RENATA PETILLO, SARAH APARECIDA ^ e ISRAEL and, ROSEMIRO DE ANTERO, MONICA SIMOES MENEZES MACIEL Pemphigoid of the mucous membranes represents a group of subepithelial blistering diseases of autoimmune origin. The
OOOO January 2020 radiation emitted by the low-level laser affects the metabolic processes of the target cells, producing biostimulants that act in the process of regeneration of the tissues. A 34-year-old female patient presented clinically with an erythematous gingiva that was blistering and scaling, with painful and burning symptomatology. An excisional biopsy was performed, sent for histopathologic examination, confirming the diagnosis of mucous membrane pemphigoid. Treatment included low-level laser therapy at the wavelength 630 to 700 nm, following the 1 J protocol for interdental papilla, with an area of approximately 1 cm2 per point, and use of steroids. The objective of this study is to demonstrate how laser therapy functions in the treatment of oral lesions of mucous membrane pemphigoid.
MULTIPLE ORAL FISTULA AND TRISMUS LEADING TO A SURPRISING DIAGNOSIS. TIAGO NOVAES PINHEIRO, ALESSANDRA VALLE SALINO, HUGO FELIPE DO VALE, ROMAN e CARLOS and, RODRIGO LEITAO We report a rare case of late diagnosis of malignant osteopetrosis due to clinical investigation of multiple intraoral fistulae and trismus in a 35-year-old male patient. The patient reported history of various complicated dental extractions during his life, facial scars that he could not attribute with certainty to old external fistulas, but besides his blindness, present since his childhood, he never had any other significant disease previously diagnosed. A computerized scanning tomography was performed and revealed a marblelike sclerotic pattern of all cranial bones, thickened parietal bone, and a narrowing of the encephalic space and optic canal. Further laboratorial and imaging studies revealed complete sclerosed bone of the chest and pelvis, anemia, reticulocitosis, extramedullary hematopoiesis, altered lactate dehydrogenase, and acid phosphatases. An interdisciplinary treatment was started with medical and dental care monitoring, and the patient is still under follow-up care after 1 year.
A RARE CASE OF PRIMARY INTRAOSSEOUS CARCINOMA OF THE MAXILLA ARISING FROM AN ODONTOGENIC KERATOCYST. JUSSARA MARIA GON¸CALVES, LUIZ HENRIQUE MAROLA, DANIELLA SERAFIN COUTO VIEIRA, GUSTAVO PHILIPPI DE LOS SANTOS, JORGE ESQUICHE LEON, FILIPE MODOLO and, ROGERIO GONDAK A 47-year-old man was referred to treatment of a lesion located on the left maxilla with 5 months of evolution. Intraoral examination revealed a perforation in the vestibular cortical bone. The computerized tomography (CT) showed an extensive, well-delineated, radiolucent lesion, extending from the alveolar ridge up to the nasal cavity. Microscopically, a cystic lesion consistent with odontogenic keratocyst (OKC) was observed. Decompression to posterior enucleation was performed. After 3 months, the patient returned presenting with a significant increase of the vestibular cortical perforation. A destructive lytic lesion involving the maxilla and surpassing the medium line was evident on the CT. The second incisional biopsy presented as an epithelial neoplasia composed of islands and projections toward the surface with abundant keratin deposition forming pearls and keratin plugging. Diagnosis of primary intraosseous carcinoma arising from an OKC was confirmed and the patient underwent