Florid cemento-osseous dysplasia is a subtype of fibrous-osseous lesion that commonly appears in the jaws of middle-aged black women. Clinically, the florid cemento-osseous dysplasia is asymptomatic. The radiographic aspect shows a radiolucent area with several masses of radiopaque structures, typically found in the toothbearing areas. Usually, the diagnosis is made during routine radiographic examination. The treatment is required when infection occurs due to exposure of the lesion in the oral cavity. In these severe cases, pain and facial deformity may be present. Commitment oral hygiene and routine dental visits for check-up are recommended for individuals affected. The objective of this study was to present a clinical case of a 24-year-old white woman with florid cemento-osseous dysplasia, who had been under surveillance for 13 years. Some changes in the radiographic pattern were observed as the orthodontic treatment was carried out in a private service. No tooth extraction was performed. This change is expected because florid cemento-osseous dysplasia has different radiographic aspects that correspond to the different developmental stages of the lesion. It is suggested, however, that the presence of florid cemento-osseous dysplasia did not preclude the success of the orthodontic treatment.Indexing terms: Oral pathology. Orthodontics. Radiography.
RESUMOA displasia cemento-óssea florida é um subtipo de lesão fibro-óssea que geralmente aparece nos ossos gnáticos de mulheres negras de meia idade. Clinicamente a displasia cemento-óssea florida é assintomática. Os aspectos radiográficos mostram uma área radiolucente
Objective:
To assess the frequency of orofacial outcomes in adolescents with perinatally infected HIV in treatment with antiretroviral therapy (ART).
Design:
A Brazilian institution-based retrospective study analyzing medical charts and medication dispensing data.
Methods:
Medical records of 137 adolescents were reviewed. HIV viral load, CD4+ T-cell count (CD4+), ART regimen, nonadherence events, and prolonged ART discontinuation were recorded. The frequency of each outcome was determined. Associations between the most frequent outcomes and both records of undetectable viral load and CD4+ at least 500 cells/μl were carried out. Associations of lymphadenitis, Group 1 orofacial manifestations and Group 2 orofacial manifestations with records of Center for Disease Control and Prevention (CDC) category C illness were also performed. Odds ratio (OR), confidence intervals (CI) and P values were provided.
Results:
Cervical and submandibular lymphadenitis (45.25%), dental caries (32.84%) and periodontal issues (11.67%) were the most frequent orofacial outcomes. A detectable viral load (OR = 2.61, 95% CI 1.16--5.88) and CD4+ less than 500 cells/μl (OR = 2.34, 95% CI 1.13--4.82) were associated with a greater risk of lymphadenitis. Orofacial outcomes associated with HIV were found in adolescents with longer ART discontinuation and a greater number of ART discontinuation events (P < 0.05). No association was found between records of CDC category C illness and group 1 orofacial manifestations, group 2 manifestations or lymphadenitis (P > 0.05).
Conclusion:
Orofacial outcomes, in particular, cervical and submandibular lymphadenitis were common among the adolescents assessed. Long-term ART and long-term exposure to HIV virus may have altered the orofacial outcome profile in adolescents perinatally infected by HIV.
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