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Photodynamic therapy: treatment of choice for actinic cheilitis?
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Abstracts
differential diagnosis of bullous lesions. Despite this, the test can often be false-negative. In such cases, clinical and histological findings usually allow institution of appropriate therapy for these patients.
MICRO-COMPUTED TOMOGRAPHY ASPECTS OF CLINICALLY INCIPIENT RADIATION-RELATED CARIES Faria KM1, Santos-Silva AR1, Ribeiro ACP2, Brandão LG3, Cernea CR3, Lopes MA1, Brandão TB2 - 1PIRACICABA DENTAL SCHOOL UNIVERSITY OF CAMPINAS, PIRACICABA, SÃO PAULO, BRAZIL - ORAL DIAGNOSIS/SEMIOLOGY, 2INSTITUTO DO CÂNCER DO ESTADO DE SÃO PAULO OCTAVIO FRIAS DE OLVEIRA, SÃO PAULO, BRASIL. - SERVIÇO DE ODONTOLOGIA ONCOLÓGICA, 3 INSTITUTO DO CÂNCER DO ESTADO DE SÃO PAULO OCTAVIO FRIAS DE OLVEIRA, SÃO PAULO, BRASIL. SERVIÇO DE CIRURGIA DE CABEÇA E PESCOÇO Diffuse brown discoloration of teeth has been recently described as incipient manifestation of radiation-related caries (RRC). Objectives: To analyze the patterns of RRC progression by using conventional radiography (CR) and micro-computed tomography (MCT). Study design: Fifteen teeth affected by incipient RRC were placed in a standard position for CR and MCT (coronal, transaxial and sagittal sections) images acquisition. Lesions were classified according to the depth of invasion and relationship with enamel, dentin and pulp. Results: CR detected 20% of the lesions restricted to enamel, 73% compromising both enamel and dentin and no case of pulp invasion. In MCT, no case was restricted to enamel, 87% affected both enamel and dentin and 13% presented extension to the pulp. Conclusion: MCT was more accurate to demonstrate that incipient RRC may behave more aggressively than the clinical aspects suggest and post-radiation brown discoloration of teeth should be promptly treated.
PHOTODYNAMIC THERAPY: TREATMENT OF CHOICE FOR ACTINIC CHEILITIS? Fontes KBFC1,2, Teixeira MKS1, Takahama Júnior A1, Azevedo RS1, Camisasca DRB1, Kurachi C3 - 1UNIVERSIDADE FEDERAL FLUMINENSE FORMAÇÃO ESPECÍFICA, 2UNIVERSIDADE FEDERAL FLUMINENSE - PROGRAMA DE PÓS-GRADUAÇÃO EM PATOLOGIA, 3UNIVERSIDADE DE SÃO PAULO - INSTITUTO DE FÍSICA Photodynamic Therapy (PDT) is a promising treatment for actinic cheilitis (AC). We report four patients with clinically severe AC who were submitted to one or two sessions of PDT. The lower lip was curetted and a thick layer of 5-aminolevulinic acid methyl ester (PDT-pharma) cream was applied. The lip was covered with an occlusive dressing and aluminum foil for 3 hours. The fluorescence was confirmed and the lip was irradiated for 8 minutes in three distinct areas, with LED red light source (630nm, 40 J/cm and 100mW) (Lince, MMoptics). All patients showed a significant improvement in physical exam and some patients showed alteration in the gradation of epithelial dysplasia (ED) after PDT. In one patient, severe ED changed for no ED, two patients with moderate ED changed for mild ED and one
October 2012 mild ED did not changed. Further studies are needed for assessment of the efficacy of PDT in AC.
MALIGNANT PERIPHERAL NERVE SHEATH TUMOR OF THE LOWER LIP: CASE REPORT Díaz KP1, Agostini M2, Valiati R3, de Almeida OP1, Romañach MJ2 - 1PIRACICABA DENTAL SCHOOL, UNIVERSITY OF CAMPINAS (UNICAMP) - ORAL DIAGNOSIS, 2FEDERAL UNIVERSITY OF RIO DE JANEIRO (UFRJ) - ORAL PATHOLOGY, 3UNIVERSITY OF PLANALTO CATARINENSE (UNIPLAC) ORAL SURGERY Malignant peripheral nerve sheath tumor (MPNST) is a malignant tumor that exhibits nerve sheath differentiation with poor prognosis. We would like to present a case of a MPNST affecting the lower lip of a 67-year-old male patient without association to NF-1. Intraoral examination revealed a painful multilobulated whitish swelling in the lower lip mucosa, measuring 3 ⫻ 3 cm in the greatest diameter. The patient was submitted to an incisional biopsy and microscopical features revealed spindle tumor cells with wavy nuclei, exhibiting dense fascicles in a plexiform pattern, mitotic figures and nuclear pleomorphism. Tumor cells were immunopositive for S-100 protein, CD56 and Ki-67 (20%). The final diagnosis was of MPNST. The patient was submitted to the surgical excision of the tumor and no recurrence was detected after 2 years of follow-up. MPNST is a rare aggressive soft tissue tumor that might sporadically affects the oral cavity of non-syndromic patients.
ORAL SQUAMOUS CELL CARCINOMA IN 14 YEARS OLD PATIENT: CASE REPORT Pavanello KC1, Guimarães DM1, Brazão-Silva MT1, Pontes FSC2, Pontes HAR2 1 FOUSP - ESTOMATOLOGIA, 2UFPA - HOSPITAL UNIVERSITÁRIO JOAO DE BARROS BARRETO Oral cancer is the sixth most common in the world, including oral carcinoma cell thorny (OSCC) is the most prevalent, totaling 95% of cases. It occurs more in developing countries, has a higher incidence in males and its etiology is related to smoking and excessive alcohol consumption. On the other hand a small group of young people, approximately 1:1000 develop this cancer, it is believed that this tumor is completely different because the main etiological factors are not involved. The literature is controversial and there are few published by the rarity of this disease in young, but many clinicians believe that this tumor is more aggressive and is associated with a worse prognosis for the patient. This work report a case of OSCC in 14 years old boy which presented painless ulcerated lesion in left side of hard palate with 3 months of evolution and after 6 months of surgery and radiotherapy no signs of recurrence.
PHENYTOIN AND PHENOBARBITAL INDUCED RIDGE OVERGROWTH WITHOUT DENTURE WEAR: A CASE REPORT Dhingra K1, Prakash S2 - 1N.S.V.K SRI VENKATESHWARA DENTAL COLLEGE, BANGALORE, KARNATAKA, INDIA - PERIODONTICS, 2COLLEGE OF DENTAL SCIENCES, DAVANGERE, KARNATAKA, INDIA PERIODONTICS Objective: This report highlights the case findings of a 60-year-old female who presented to Department of Periodontics reporting generalized gingival overgrowth and mobility of teeth,
e120
Abstracts
differential diagnosis of bullous lesions. Despite this, the test can often be false-negative. In such cases, clinical and histological findings usually allow institution of appropriate therapy for these patients.
MICRO-COMPUTED TOMOGRAPHY ASPECTS OF CLINICALLY INCIPIENT RADIATION-RELATED CARIES Faria KM1, Santos-Silva AR1, Ribeiro ACP2, Brandão LG3, Cernea CR3, Lopes MA1, Brandão TB2 - 1PIRACICABA DENTAL SCHOOL UNIVERSITY OF CAMPINAS, PIRACICABA, SÃO PAULO, BRAZIL - ORAL DIAGNOSIS/SEMIOLOGY, 2INSTITUTO DO CÂNCER DO ESTADO DE SÃO PAULO OCTAVIO FRIAS DE OLVEIRA, SÃO PAULO, BRASIL. - SERVIÇO DE ODONTOLOGIA ONCOLÓGICA, 3 INSTITUTO DO CÂNCER DO ESTADO DE SÃO PAULO OCTAVIO FRIAS DE OLVEIRA, SÃO PAULO, BRASIL. SERVIÇO DE CIRURGIA DE CABEÇA E PESCOÇO Diffuse brown discoloration of teeth has been recently described as incipient manifestation of radiation-related caries (RRC). Objectives: To analyze the patterns of RRC progression by using conventional radiography (CR) and micro-computed tomography (MCT). Study design: Fifteen teeth affected by incipient RRC were placed in a standard position for CR and MCT (coronal, transaxial and sagittal sections) images acquisition. Lesions were classified according to the depth of invasion and relationship with enamel, dentin and pulp. Results: CR detected 20% of the lesions restricted to enamel, 73% compromising both enamel and dentin and no case of pulp invasion. In MCT, no case was restricted to enamel, 87% affected both enamel and dentin and 13% presented extension to the pulp. Conclusion: MCT was more accurate to demonstrate that incipient RRC may behave more aggressively than the clinical aspects suggest and post-radiation brown discoloration of teeth should be promptly treated.
PHOTODYNAMIC THERAPY: TREATMENT OF CHOICE FOR ACTINIC CHEILITIS? Fontes KBFC1,2, Teixeira MKS1, Takahama Júnior A1, Azevedo RS1, Camisasca DRB1, Kurachi C3 - 1UNIVERSIDADE FEDERAL FLUMINENSE FORMAÇÃO ESPECÍFICA, 2UNIVERSIDADE FEDERAL FLUMINENSE - PROGRAMA DE PÓS-GRADUAÇÃO EM PATOLOGIA, 3UNIVERSIDADE DE SÃO PAULO - INSTITUTO DE FÍSICA Photodynamic Therapy (PDT) is a promising treatment for actinic cheilitis (AC). We report four patients with clinically severe AC who were submitted to one or two sessions of PDT. The lower lip was curetted and a thick layer of 5-aminolevulinic acid methyl ester (PDT-pharma) cream was applied. The lip was covered with an occlusive dressing and aluminum foil for 3 hours. The fluorescence was confirmed and the lip was irradiated for 8 minutes in three distinct areas, with LED red light source (630nm, 40 J/cm and 100mW) (Lince, MMoptics). All patients showed a significant improvement in physical exam and some patients showed alteration in the gradation of epithelial dysplasia (ED) after PDT. In one patient, severe ED changed for no ED, two patients with moderate ED changed for mild ED and one
October 2012 mild ED did not changed. Further studies are needed for assessment of the efficacy of PDT in AC.
MALIGNANT PERIPHERAL NERVE SHEATH TUMOR OF THE LOWER LIP: CASE REPORT Díaz KP1, Agostini M2, Valiati R3, de Almeida OP1, Romañach MJ2 - 1PIRACICABA DENTAL SCHOOL, UNIVERSITY OF CAMPINAS (UNICAMP) - ORAL DIAGNOSIS, 2FEDERAL UNIVERSITY OF RIO DE JANEIRO (UFRJ) - ORAL PATHOLOGY, 3UNIVERSITY OF PLANALTO CATARINENSE (UNIPLAC) ORAL SURGERY Malignant peripheral nerve sheath tumor (MPNST) is a malignant tumor that exhibits nerve sheath differentiation with poor prognosis. We would like to present a case of a MPNST affecting the lower lip of a 67-year-old male patient without association to NF-1. Intraoral examination revealed a painful multilobulated whitish swelling in the lower lip mucosa, measuring 3 ⫻ 3 cm in the greatest diameter. The patient was submitted to an incisional biopsy and microscopical features revealed spindle tumor cells with wavy nuclei, exhibiting dense fascicles in a plexiform pattern, mitotic figures and nuclear pleomorphism. Tumor cells were immunopositive for S-100 protein, CD56 and Ki-67 (20%). The final diagnosis was of MPNST. The patient was submitted to the surgical excision of the tumor and no recurrence was detected after 2 years of follow-up. MPNST is a rare aggressive soft tissue tumor that might sporadically affects the oral cavity of non-syndromic patients.
ORAL SQUAMOUS CELL CARCINOMA IN 14 YEARS OLD PATIENT: CASE REPORT Pavanello KC1, Guimarães DM1, Brazão-Silva MT1, Pontes FSC2, Pontes HAR2 1 FOUSP - ESTOMATOLOGIA, 2UFPA - HOSPITAL UNIVERSITÁRIO JOAO DE BARROS BARRETO Oral cancer is the sixth most common in the world, including oral carcinoma cell thorny (OSCC) is the most prevalent, totaling 95% of cases. It occurs more in developing countries, has a higher incidence in males and its etiology is related to smoking and excessive alcohol consumption. On the other hand a small group of young people, approximately 1:1000 develop this cancer, it is believed that this tumor is completely different because the main etiological factors are not involved. The literature is controversial and there are few published by the rarity of this disease in young, but many clinicians believe that this tumor is more aggressive and is associated with a worse prognosis for the patient. This work report a case of OSCC in 14 years old boy which presented painless ulcerated lesion in left side of hard palate with 3 months of evolution and after 6 months of surgery and radiotherapy no signs of recurrence.
PHENYTOIN AND PHENOBARBITAL INDUCED RIDGE OVERGROWTH WITHOUT DENTURE WEAR: A CASE REPORT Dhingra K1, Prakash S2 - 1N.S.V.K SRI VENKATESHWARA DENTAL COLLEGE, BANGALORE, KARNATAKA, INDIA - PERIODONTICS, 2COLLEGE OF DENTAL SCIENCES, DAVANGERE, KARNATAKA, INDIA PERIODONTICS Objective: This report highlights the case findings of a 60-year-old female who presented to Department of Periodontics reporting generalized gingival overgrowth and mobility of teeth,