Introduction and importance Fibrous Dysplasia (FD) is a benign fibro-osseous lesion, characterized by replacement with fibrous connective tissue instead of normal bone. The best treatment option for the condition has not yet been established, although several therapeutic approaches have been reported. The present case report describes the clinical, imaging and therapeutic aspects of an atypical bilateral presentation of FD in the mandible. Case presentation A 26-year-old afro-descendent woman, who had previously undergone surgery to remove FD in the right hemimandible, complained of asymptomatic swelling in the left hemimandible. Imaging analysis showed an ipsilateral extensive multilocular mandibular lesion, with thinning of the cortical bone. After diagnosis of FD, complete surgical removal was performed, associated with immediate local reconstruction with xenograft and covering membrane, with primary wound closure. Clinical discussion Bilateral presentation of FD is uncommon, and its diagnosis by means of clinical data, imaging and histopathological analysis, is relevant in order to establish the correct therapy. Conclusion Complete surgical removal associated with immediate local bone reconstruction, has shown satisfactory clinical results, when adequate follow-up is performed.
Rhabdomyosarcoma (RMS), a malignant tumor derived from the neoplastic proliferation of striated skeletal muscle cells, is the most common pediatric soft tissue sarcoma. Its treatment is mainly based on neoadjuvant chemotherapy (QT+), surgical resection, and adjuvant radiotherapy (RT+). RT+ has shown satisfactory results for locoregional control of the disease, in spite of promoting local side effects. The present case report was aimed at describing the clinical and therapeutic characteristics and the management of complications resulting from multimodal therapy in a patient with an atypical presentation of RMS in the sinonasal tract. A 20-year-old Afro-descendant man complained of an expansive tumor lesion, with left eye proptosis that reduced visual acuity and caused severe regional pain. Imaging analysis showed an extensive and infiltrative lesion in the periorbital region, sinonasal tract, left maxilla, and orbital roof. According to the histopathological analysis, the diagnosis was established corresponding to parameningeal alveolar RMS that was unresectable. Treatment was initiated with three cycles of QT+ which showed partial response and later RT+. After completing half of the RT+ sessions, the patient showed a complete response with reduction in tumor volume and improvement in pain and local conditions. Side effects such as alopecia and dermatological changes induced by radiation were observed. Moreover, painful erythematous areas were observed in the region of the hard and soft palate, uvula, and oropharynx, compatible with Grade 2 mucositis lesions. After the cytological swab test, some of them were diagnosed as herpes simplex lesions; thickening and decrease in salivary flow were also found. A local drug therapy approach was instituted, and photobiomodulation was performed to manage oral complications. RT+ was shown to be effective in locoregional control of the disease; however, the early management of its undesirable effects on the surrounding tissues was required.
A pesquisa teve como objetivo avaliar o conhecimento dos acadêmicos do curso de medicina do Centro Universitário FAMINAS, localizada na cidade de Muriaé, no estado de Minas Gerais, a respeito dos aspectos que se relacionam à saúde bucal e suas implicações sistêmicas e, em seguida, apresentar uma revisão de literatura sobre sua relevância e seus aspectos. Delimitou-se como amostra as respostas dos acadêmicos de medicina obtidas através de questionário estruturado e produzido mediante utilização da plataforma Google Forms e encaminhado via rede social e e-mail para os graduandos do curso em questão. Em seguida, os dados foram tabulados em planilhas do Microsoft Excel e utilizados para as análises e conclusão da pesquisa. Concluiu-se que os acadêmicos do curso de medicina compreendem a relevância do tema estudado, bem como a importância da odontologia hospitalar e da presença de um dentista no âmbito do hospital. Entretanto existem algumas lacunas a serem melhoradas.
Resumo: Vários estudos vêm demonstrando que a resposta imunológica exacerbada em infecção pela SARS-COV2, chamada de tempestade de citocinas em pacientes, onde seu estágio de infecção da COVID-19 é avançado. Tendo assim, uma maior dificuldade na escolha de tratamento e elevando o risco desses indivíduos a evoluir para um quadro grave e complexo, dificultando a melhora e escolha terapêutica adequada. Devido a sua variedade fisiopatológica, vários mecanismos homeostáticos estão envolvidos, um deles é a deficiência de Colecalciferol, mais conhecida como vitamina D, tendo essa uma função muito importante na modulação do sistema imunológico, a mesma vem sendo apontado em vários estudos e que pacientes que apresentam níveis baixos dessa vitamina, tem tido resultados negativos, levando-os a ajuda de terapias intensivas. Foi realizada uma revisão de literatura, com artigos selecionados de acordo com o tema, usando como base a Scientific Electronic Library Online (SCIELO), Google Acadêmico, Pubmed, Revistas eletrônicas e livros. Essas bases de dados foram escolhidas devido ao conhecimento na esfera cientifica e por dispor de um grande acervo para pesquisa. Artigos publicados entre os anos de 2019 e 2021, nos idiomas português e inglês, artigos com disponibilidade de acesso online e relacionado ao tema. Considerando-se como critério de exclusão: idiomas não citados na inclusão, publicações com mais de 10 anos, artigos que não estivessem de acordo com o tema. Após a busca na base de dados, realizou-se a leitura dos artigos encontrados. A infecção causada pela COVID-19 vem sendo um grande desafio para a ciência na busca de cura ou tratamento adequado. Tentar minimizar o máximo de sofrimento ao paciente tem sido algo quase impossível, devido a sua complexidade fisiopatológica muitas vezes leva o individuo á óbito.Vários estudos vêm sendo realizados na busca da terapia ideal, mas ainda estamos um pouco longe de encontrar o tratamento adequado, é necessário investir em pesquisas, principalmente em um tratamento que tenha custo benefício onde toda população tenha acesso, a terapia apresentada nesse artigo, seria viável, uma vez que se trata de um suplemento barato e de fácil acesso a todos. Porém, é necessário mais pesquisas comprovando a eficácia da vitamina D como terapia coadjuvante.
Calcifying epithelial odontogenic tumor (CEOT) is a rare benign neoplasm, with slow, localized, invasive, and asymptomatic growth. The involvement of the maxillary sinus by the neoplasm is rare, with its treatment controversial. The aim of this study was to describe the clinical, imaging, and therapeutic characteristics of a CEOT with maxillary sinus extension, as well as a literature review of therapeutic approaches and the prognoses obtained from cases of the same extension. In this case report, we report the case of a female patient, 49 years old, Caucasian, with mild asymmetry of the middle third of the face. Clinical and imaging examinations showed an intraosseous tumor in the posterior region of the left hemimaxillary, with imprecise limits and extension of 44×24×32 mm, compromising the alveolar process, maxillary posterior teeth, posterior hemipalatal region, left maxillary sinus, and orbital floor, associated with local expansion, tooth mobility, maxillary sinusopathy, and nasal obstruction. Calcifying epithelial odontogenic tumor diagnosis was obtained from incisional biopsy and histopathological examination. Surgical therapy of partial maxillectomy was performed from the Weber Ferguson Access with subsequent prosthetic rehabilitation. There were no postoperative complications. This case presented had satisfactory success with the therapy performed. The use of invasive therapies such as partial maxillectomies associated with transfacial approaches is an effective treatment for CEOT involving the maxillary sinus. Long-term follow-up is essential to avoid recurrences.
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