This study aimed to investigate the presence of BRAF V600E mutation in mandibular ameloblastoma by comparing the results of molecular detection and immunohistochemical analysis. A 128 cases of mandibular ameloblastoma and 30 cases of dentigerous cyst (control group) were selected for analysis. Detection of BRAF V600E mutation was performed with immunohistochemistry (IHC) and polymerase chain reaction techniques. Clinico-pathologic data were collected in order to investigate possible associations with the mutation. Of the 128 cases submitted to IHC, 81.2% (108 cases) showed positivity for anti-BRAF V600E antibody, whereas 24 were negative (18.8%). Molecular analysis of the BRAF V600E mutation by polymerase chain reaction was possible in 116 cases due to DNA quality. Of these cases, 96 were positive (82.8%) and 20 negative (17.2%). All cases of dentigerous cyst were negative for BRAF V600E mutation in both techniques. Considering the sequencing as a gold standard method, the receiver operating characteristics curve analysis showed sensitivity of 0.99 and specificity of 1 (area under the curve=0.995, standard error=0.006; P<0.001; 95% confidence interval=0.983 to 1). We also tested the agreement between the techniques by using the Cohen’s κ coefficient, with κ being 0.97 (P<0.001). IHC is a reliable test for identifying the BRAF V600E mutation in ameloblastomas, presenting advantages such as being more frequently used in surgical pathology laboratories and requiring fewer critical steps for paraffin-embedded tissue compared with molecular biology techniques.
Introduction Medication-related osteonecrosis of the jaws (MRONJ) is a complication that develops in patients who use or have used antiresorptive or antiangiogenic medications for the treatment of bone metabolic disease and bone metastases. Clinically, MRONJ is characterized by the appearance of an inflammation in soft tissues and exposure of necrotic bone tissue in mandible or maxilla, for a period of 8 weeks, in patients with no history of head and neck radiotherapy that were being or are being treated with antiresorptive and/or antiangiogenic agents. The fibrin-rich platelets and leukocytes (L-PRF) membrane has been used as an alternative for MRONJ prevention. The aim of this study was to evaluate the use of L-PRF in prevention and treatment of bone necrosis. Material and MethodsThe patients included had MRONJ diagnosis confirmed after clinical and radiographic examination and patients whose only therapeutic option was dental extraction. Results Twenty patients were included in the study and were divided in three groups. Two patients were removed from the study due to previous history of pentoxifylline and tocopherol use. The result of surgical treatment was successful in 57% in group 1 (control/MRONJ prevention), 100% in group 2 (MRONJ prevention), and 80% in group 3 (MRONJ treatment). Conclusion L-PRF is an autologous biomaterial that allows the release of growth factors for a prolonged time, resulting in a better healing, reducing the risk contamination, edema, and postoperative pain, being a great ally in the prevention and treatment of MRONJ because it returns to these patients, mainly quality of life, reducing pain, and recurrent infections commonly seen in the processes of bone necrosis of the jaws.Keywords Bisphosphonate-associated osteonecrosis of the jaw • Platelet-rich fibrin • Treatment outcome
Os anestésicos locais permitem um melhor e adequado controle da dor em pacientes que se submetem a tratamentos dentários. A farmacologia dos anestésicos locais é muito complexa, por isso é importante saber selecionar a droga correta para cada procedimento a ser realizado. Sendo assim, observamos a necessidade e a importância de um artigo como revisãode literatura para reunir as informações atuais e importantes sobreos anestésicos locais mais utilizados na área da odontologia.
The mandibular defects caused by mandibulectomies can involve esthetic and functional sequelae in patients. The fibula presents positive aspects and can be used as an option for mandibular reconstruction after tumor resections or extensive traumas. Furthermore, this retrospective study of the patients who have passed through a mandibular reconstruction with a microvascular fibular flap over the last 17 years describes the experience of the Oral and Maxillofacial SurgeryService at the ErastoGaertner Hospital, Curitiba/PR. The use of this flap type has a complication rate of 32.3%, which includes the fixation material exposure, flap resorptions, fistulas, pathological fractures, tumor recurrence, infections, seromas, and thrombocytopenia. Most of them are associated with patients who have received radiotherapy and/or chemotherapy. These data suggest a high frequency of complications when a reconstruction plate fixation is used. Minor complications are usual and they should not be overlooked because they can lead to devastating consequences.
Abstract:Introduction: Of unknown aetiology, the schwannoma is a benign tumor that originates
ResumoSífilis é uma doença sexualmente transmissível causada por bactérias gram-negativas do grupo das espiroquetas, Treponema pallidum. Ela pode ser congênita ou adquirida. Seus sinais e sintomas podem variar dependendo do seu estádio. Foi relatado o caso clínico de uma paciente de 25 anos que ao exame físico apresentou múltiplas placas brancas, rugosas em mucosa bucal e orofaringe, com diagnóstico após exames laboratoriais e anatomopatológico de sífilis secundária. Paciente foi encaminhada ao Serviço de Infectologia, para tratamento clínico com penicilina G benzatina. Para descartar a existência de gravidez, foi solicitado exame Beta-HCG, o qual foi negativo. A paciente foi orientada sobre educação sexual, DSTs e a evitar gravidez até liberação pelo médico infectologista, devido ao risco de o bebê ser contaminado. Porém, antes de iniciar o tratamento, enquanto aguardava a liberação da medicação, a paciente engravidou. No seu retorno com a equipe odontológica, informou aos profissionais que estava gestante de 11 semanas. Clinicamente apresentou remissão total das lesões orais. Conclui-se que, apesar de muito ser discutido acerca da necessidade de novos testes diagnósticos que sejam mais práticos, rápidos e acessíveis para facilitar a detecção da doença, torna-se essencial educar a população desde a época escolar sobre as DSTs. Descritores: Sífilis; Boca; Gravidez. AbstractSyphilis is a sexually transmitted disease caused by gram-negative bacteria of the spirochete group, Treponema pallidum. It may be congenital or acquired. Your signs and symptoms may vary depending on your stage. The clinical case of a 25-year-old female patient who on physical examination presented multiple white plaques, wrinkled in the buccal mucosa and oropharynx, with diagnosis after laboratory and anatomopathological examination of secondary syphilis. Patient was referred to the Infectology Service, for clinical treatment with benzathine penicillin G. To rule out the existence of pregnancy, Beta-HCG examination was requested, which was negative. The patient received instruction about sex education, STIs and to avoid pregnancy until released by the infectious disease physician due to the risk of the baby being contaminated. However, before beginning treatment, while awaiting the release of the medication, the patient became pregnant. On her return with the dental team, she informed the professionals that she was pregnant for 11 weeks. Clinically, the patient presented total remission of oral lesions. It is concluded that, although much is discussed about the need for new diagnostic tests that are more practical, fast and accessible to facilitate the detection of the disease, it is essential to educate the population from school time about STDs. Descriptors: Syphilis; Mouth; Pregnancy. ResumenLa sífilis es una enfermedad de transmisión sexual causada por bacterias gram-negativas del grupo de espiroquetas, Treponema pallidum. Puede ser congénita o adquirida. Sus signos y síntomas pueden variar dependiendo de su estadio. Se informará el caso...
<p>Tooth impaction results from a mechanical blocking that prevents the tooth from erupt. This situation is frequently associated to permanent tooth as wisdom teeth and canines. Impaction of a primary tooth can be associated to systemic or local etiologic factors. Treatment options could include dental extraction, removal of lesion associated without removing the primary tooth and others. The aim of this article is to present a rare case report of an impacted primary tooth in a 42 year-old man, with no complain of swelling. Extra oral examination revealed no alteration of normality. The panoramic radiograph showed a primary tooth impacted in the left body of the mandible. Most of the time the cause for non-eruption of primary tooth is the presence of a mechanical obstacle, not anatomical, in its trajectory. The surgical intervention is a possibility, but it can stay unaltered with no problems related to the impacted tooth. Many times the professional experience and the activity together in various areas of knowledge are the most important and wise conduct to be taken in health care.</p><p><strong>Keywords</strong></p><p>Mandible; Impacted tooth; Oral surgery.</p><p>Key-words: mandible; impacted tooth; oral surgery</p>
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