Clinical and hystopathological dilemmas in diagnosis of epitheloid hemangioma of maxillae-case report
Epithelioid hemangioma (EH) is a rare benign tumor involving the blood vessels and surrounding epithelioid cells. Epitheloid hemangioma, also called histiocytoid hemangioma, angiolymphoid hyperplasia with eosinophilia (ALHE), is a very rare benign tumor in maxillofacial region. There is a controversy in regards to correct diagnosis of an epithelioid hemangioma (EH), particularly when arising in skeletal locations, because of aggressive clinical characteristics, including multifocal presentation and occasional lymph node involvement. Specifically, its distinction from epithelioid hemangio-endothelioma (EHE) has been controversial. In literature we did not find a case where EH involves maxilla. However, there are few cases reported in which EH involved maxillary sinus and nasal cavity. We will present a case of 21 year old male, who came to our Department with a lesion in frontal maxillary region. He underwent surgery four times, wide excision, and with four different histopathology results. The last result was ephiteloid hemangioma with metaplastic bone formation – a very rare benign lesion in oral region, but clinically with very aggressive nature.
Selection of Angiogenic Markers that Predict the Transition from Bisphosphonate Exposure to MRONJ in a Rat Model
Medication related osteonecrosis of the jaw (MRONJ) is a disorder characterized by loss of blood supply to the jaws and death to the bone. In our previous work, we created a rat model of MRONJ by two injections of 60ug/Kg zoledronic acid (a powerful bisphosphonate abbreviated as ZA) via tail vein followed by extraction of a single first molar. We have shown in this model (ZA-treated rats plus molar extraction) a decrease in the vasculature of the jaws and a delay in bone healing beyond 4 weeks. Purpose: The current study identified angiogenic factors from the jaws of our MRONJ model where expression was altered independent of exposure to ZA alone. Methods: Using RT-PCR arrays containing 84 different gene sequences related to angiogenesis, we screened RNA isolated from the jaws of Control, ZA-treated rats, and our MRONJ rat model (ZA-treated plus first molar extraction), 3 and 6 weeks after extraction. Heat maps of gene expression were analyzed to identify genes where expression was either maximal or lost in MRONJ rats relative to ZA-treated rats without extraction. Results: Our study demonstrates the loss or gain of expression for 22 genes in the MRONJ rat model relative to rats treated with ZA alone. In MRONJ rats, the loss of expression was seen for 10 genes after 3 weeks and 3 additional genes (13 total) after 6 weeks where maximal expression was seen in rats treated with ZA-alone. This study also identified 5 genes that were maximally expressed in MRONJ rats after 3 weeks and an additional 4 genes (9 total) after 6 weeks that were not expressed in rats treated with ZA alone. Conclusions: Our study identifies genes that predict the transition from asymptomatic bisphosphonate exposure to MRONJ.
Introduction: Crouzon syndrome is a genetic disease characterized by cranial and facial deformities, as well as several dental dysfunctions. Objectives: The main objective of the review is to analyze and highlight factors associated with oral, facial and dental development as consequences in the life of people with Crouzon Syndrome, highlighting its development, functional and aesthetic changes in addition to their respective treatments and results. Methodology: The LILACS, MEDLINE and SciELO databases were used as a methodology, and the terms “Crouzon syndrome”, “dental consequences”, “functional” and “aesthetic” were applied to the research. Results: Based on the research, it was found that the patients with the syndrome had several oral and facial manifestations that significantly interfered in their lives, requiring specific attention and care so that their clinical conditions did not worsen. Conclusion: Therefore, follow-up and surgical and orthodontic treatments, with multiprofessional performance, should be performed even in the infancy of these people in order to obtain better results and a good evolution.
Introduction – Eagle`s syndrome refers to calcification and hardening of the stylohyoid ligament, which connects the hyoid bone to the temporal bone. The classic symptomatology includes craniofacial pain, limitation in the movements of the head and the neck and continuous pain in the pharynx that worsens during the deglutition. The diagnosis is based on clinical and radiological examination, and the treatment of the pathology can be clinical or surgical, occurring depending on the intensity of the symptoms. Objectives – This work aims to review studies related to Eagle`s Syndrome, thus having a greater knowledge about it`s unique causes, symptoms and effective treatments in order to deal with, if not all, the most of manifestations among them dysphagia, odynophagia, otalgia, headache, tinnitus and trismus. Methodology – This review of Eagle`s syndrome was performed with a search of books and scientific articles on several digital platforms. Results – The results show that, although the etiology of Eagle`s Syndrome is not known, the disease has symptoms such as headaches and swallowing difficulties, and can be treated through drugs or surgical procedures. Conclusion – In this way, we conclude that from radiological examinations it is possible to diagnose Eagle`s Syndrome, making possible the submission of patients to the treatment appropriate to their degree of danger.
Apert’s syndrome, better known as acrocephalosyndactyly, is a pathology that is associated with the Fibroblast Growth Factor Receptor 2 (FGFR2) gene mutation. However, some cases may be related to new sporadic mutations associated with elevated paternal age. Objective: The main objective of this study is to show the oral manifestations, such as maxillary hypoplasia, in which compression of the dental sac is observed, causing irregular positioning of the teeth and marked thickening of the alveolar process, gingival hypertrophy, high susceptibility to cavities proliferation and dental breakdown, as well as their treatments. Methodology: The method used was referenced from scientific articles and clinical case studies. Results and Discussion: It was possible to observe that the occurrence of this syndrome is extremely rare (case for one hundred thousand to one hundred and sixty thousand births). In addition, it became clear that a higher incidence of bacterial plaque in patients with the syndrome due to poor oral hygiene, which is a consequence of syndactyly – because it is a limiting motor factor.
Introduction: The Acquired Immunodeficiency Syndrome (AIDS) is an advanced clinical manifestation of human immunodeficiency virus (HIV) infection. It is characterized by host immunosuppression, manifested by a wide variety of clinical signs and symptoms, many of which are observed in the oral cavity. Objectives: The objective of this study was to evaluate oral manifestations among HIV positive patients and to identify factors associated with such manifestations. Methodology: This article was elaborated from a literature review, firstly, carrying out a bibliographical survey about the chosen theme from scientific articles, from 1990 to 2017 and then selecting the articles that fit the pre-established objectives. Results: Candidiasis and Periodontitis were the oral manifestations found more often. On the other hand, Leukoplasia, herpes and Kaposi’s sarcoma were not found as much as the others. In this analysis, there was a greater risk among patients with low schooling, smokers, with a longer time of HIV infection and higher viral load. Conclusion: The studies confirm the high prevalence of opportunistic oral manifestations due to the infection that compromises the immune system, which causes depletion in the immunological function of the oral mucosa, making it susceptible to several diseases.
Introduction: A Pierre Robin syndrome occupies an important space in front of the odontological field, especially for its peculiar characteristics determined by a series of anomalies. Objective: The main objective of the study is to present a literary review about the characteristics of the syndrome and its various possibilities of treatment. Methodology: The method used in the preparation of this work was the analysis of articles available in digital platforms, selection of contents related to the theme, obtaining a broader and interdisciplinary view of the syndrome. Results and Discussion: Although there is no specific treatment defined for the syndrome, it is possible through surgical methods or procedures (mandibular distraction, nasopharyngeal intubation, postural treatment, among others) to achieve a significant improvement in the patient’s quality of life when he is treated according to your individual needs. Conclusion: Therefore, in the Pierre Robin sequence, although there is no cure for the pathology, we conclude that with the appropriate treatments is possible to reduce some symptoms, so providing a better quality of life for the patient.