O hemangioma é uma neoplasia benigna que se caracteriza por proliferação endotelial anormal. Acomete a região maxilofacial com predileção pelos lábios, língua e mucosa jugal. O tratamento pode ser realizado por diferentes formas terapêuticas, desde corticoterapia até a excisão cirúrgica. Neste trabalho, descrevemos um caso clínico de hemangioma lingual, no qual se optou pela utilização de oleato de monoetanolamina a 5% - ethamolin®, obtendo-se total involução da lesão em 3 aplicações, além de nenhum sinal de recidiva após 15 meses.
Objective: Performing an in vitro evaluation of the biological effects on cell growth and viability of fibroblasts in PLGA membranes with and without simvastatin. Methods: Two groups of resorbable synthetic polymeric membranes were used: PLGA, with and without simvastatin, cut into a suitable format to fit to 24 thermometric wells. Fibroblasts were grown on resorbable membranes and evaluated for proliferation and viability at 24, 48 and 72 hours after the beginning of cultivation, being the tests performed in triplicate. For the cell growth analysis, the Trypan blue exclusion method was applied, while cell viability was observed by the MTT test. The results were statistically analyzed applying the Two-Way ANOVA, followed by the Bonferroni test, with 95% confidence interval and P value smaller than 0.05 was accepted as statistically significant. Results: Statistical difference (p <0.01) was seen between the control group (2.16x104 ± 0.51 cells) and the PLGA group with simvastatin (1.58x104 ± 0.36 cells) in the 48-hour period. After 72 hours, statistical differences (p <0.001) were observed between the PLGA group with simvastatin (1.66x104 ± 0.49 cells) and the PLGA group without simvastatin (2.25x104 ± 0.2 cells) when compared to the control group (2.81x104 ± 0.33 cells) for cell proliferation. Statistical differences (p <0.05) were observed between the control group (0.27 ± 0.05) and the PLGA group with simvastatin (0.21 ± 0.03). Likewise, a statistical difference (p <0.001) was seen between the PLGA group without simvastatin (0.19 ± 0.02) and the control group after 24 hours. In the 48 – 72-hour period, statistical differences (p <0.001) were observed between the control group (0.36 ± 0.09 and 0.55 ± 0.05, after 48 and 72 hours respectively) and the PLGA group without simvastatin (0.26 ± 0.05 and 0.34 ± 0.07, after 48 and 72 hours respectively), as well as in the PLGA group with simvastatin (0.27 ± 0.04 and 0.31 ± 0, 04, after 48 and 72 hours respectively) for the cell viability test. Conclusion: The association of simvastatin to PLGA membranes had an inhibitory effect on fibroblast proliferation, as well as induced a reduction in cell viability. Thus, the use of PLGA along with simvastatin may assist in guided bone regeneration.
INTRODUÇÃO: A remoção cirúrgica dos terceiros molares impactados é um dos procedimentos que fazem parte da rotina clínica dos cirurgiões bucomaxilofaciais. Comumente, estão relacionados a possíveis complicações como as lesões em nervos e o deslocamento de dentes para dentro de espaços adjacentes. A presença de corpos estranhos nos seios paranasais é considerada rara pela literatura, sendo o seio maxilar normalmente o mais acometido. Diversos fatores estão relacionados com a ocorrência desses tipos de agravos, no entanto, sua etiologia está diretamente relacionada com a íntima relação dos terceiros molares às estruturas nobres e a inexperiência do cirurgião, contribuindo para a incidência dos casos. O presente trabalho busca relatar um caso clínico de tratamento de uma complicação cirúrgica de um terceiro molar deslocado para o interior do seio maxilar. MÉTODO: Paciente M.P.M, 40 anos, sexo feminino compareceu ao ambulatório de Cirurgia e Traumatologia Buco-Maxilo-Facial do Hospital Geral de Fortaleza (HGF, Fortaleza, Ceará, Brasil) com dor, eritema e aumento de volume em hemiface direita. Na anamnese foi relatado da tentativa de exodontia do dente 18, onde o dente foi deslocado para o interior do seio maxilar direito. Após exame clínico, somado à observância de cortes tomográficos, constatou-se a presença do elemento 18 no interior do seio maxilar direito, sendo assim programada a remoção do mesmo. DISCUSSÃO E CONCLUSÃO: Para avaliar a relação entre o seio maxilar e os terceiros molares superiores a radiografia panorâmica e a Tomografia Computadorizada de Feixe Cônico (TCFC) são essenciais na tomada de decisão cirúrgica e planejamento preciso do caso, tendo a técnica de Calldwel-Luc possibilitando poucas complicações e permitindo um amplo acesso. O deslocamento de dentes para dentro do seio maxilar compõe parte das complicações de exodontias de elementos dentários superiores, portanto, o cirurgião buco-maxilo-facial deve estar apto a diagnosticar e tratá-la adequadamente.
Introduction:
The McCune–Albright syndrome (MAS) is a complex congenital disorder caused by the embryonic post-zygotic somatic activating mutations in the GNAS1 gene. In such syndrome, phenotypes are heterogeneous and comprised polyostotic/monostotic fibrous dysplasia, café au lait macules, and hyperfunctioning endocrinopathies as the excess growth hormone. Likewise, acromegaly, as a manifestation of the endocrine hyperfunction, is unusual and affects about 20% of patients with MAS.
Case Presentation:
This research study describes a case of a 31-year-old female subject presenting polyostotic fibrous dysplasia with severe facial involvement, along with acromegaly and the MAS. The case was satisfactorily managed by surgical re-alignment and presented no clinical signs of relapse in a 12-year follow-up period. Finally, a literature review was conducted to discuss the standard protocols and the controversies when treating such cases.
Conclusion:
Patients with craniomaxillofacial fibrous dysplasia associated with acromegaly may present significant facial deformities that can be satisfactorily treated by cosmetic treatment, especially in patients with psychological problems and severe social acceptance.
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