This systematic review evaluated the efficacy of the morning fasting serum C-terminal telopeptide (CTX) test in predicting the development of bisphosphonate-related osteonecrosis of the jaw (BRONJ). A comprehensive search of studies published up to March 2016, and listed in the PubMed/MEDLINE, Web of Science, and Cochrane Library databases, was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. This review has been registered in the PROSPERO international prospective register of systematic reviews (CRD42016036717). The search identified 542 publications; eight studies were finally deemed eligible for inclusion according to the study criteria. These studies included a total 1442 patients (mean age 66.7 years). The most prescribed drug was alendronate, with osteoporosis being the most frequent indication for the prescription of bisphosphonates. Tooth extraction was the most common trigger for BRONJ. Of all patients evaluated after bisphosphonate treatment, only 24 (1.7%) developed BRONJ. All eight of the selected studies found that CTX levels were not predictive of the development of BRONJ. In conclusion, this systematic review indicates that the CTX test has no predictive value in determining the risk of osteonecrosis in patients taking bisphosphonates.

Pemphigus vulgaris (PV) is a rare and potentially lethal autoimmune disease that affects the skin and mucous membranes. Injuries caused by the disease cause pain, risk of infection, and other complications that result in a high mortality rate. Frequently, management of the PV requires intensive care and a multidisciplinary approach. Oral lesions of PV are usually the first clinical signs of the disease and the last lesions to heal, requiring treatment by a specialized dental team. The aim of this study was to report two clinical cases of PV with involvement of the oral mucosa. The patients were admitted to an intensive care unit, and underwent multidisciplinary management of their condition along with low-level laser therapy. Both cases demonstrated the importance of specialized dental care in improving the quality of life of patients with PV.

Pyogenic granuloma is a common cause of growth of soft tissue in the oral cavity, especially in the gingiva. It is mainly associated with local and chronic irritants besides hormonal changes during pregnancy. Here, the authors present an unusual patient of an extra-gingival pyogenic granuloma with large dimensions and displacing teeth arising in a male patient. This is an interesting patient to be reported due to its exacerbated and atypical clinical features.

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O tratamento odontológico consiste na reabilitação da saúde bucal do paciente e na preservação da integridade do sistema estomatognático. Por isso, é imprescindível realizar a adequação do meio bucal, estabelecendo um ambiente favorável à paralisação da cárie e outras doenças/alterações, de forma que elas sejam corrigidas ou eliminadas. O objetivo deste estudo foi relatar um caso com a adequação de meio bucal através de abordagem multidisciplinar. Após os exames iniciais, foram realizados profilaxia, raspagem, alisamento e polimento supragengival, orientação de higiene, restaurações provisórias com cimento de ionômero de vidro e tratamento endodôntico em múltiplos dentes. Foi concluído que a adequação de meio bucal é essencial e envolve um conjunto de procedimentos multidisciplinares da odontologia. Ao ser realizada a adequação, pôde-se observar o controle e a prevenção de infecções e o restabelecimento da forma e função dos dentes resultando em saúde bucal.

Toxic epidermal necrolysis (TEN) is a mucocutaneous disorder characterized by the detachment of epidermal and mucous tissues and areas of necrosis, resulting from hypersensitivity reactions to different drugs. We report a clinical case of a 19-year-old male patient diagnosed with TEN, with 90% involvement of the body surface and severe oral involvement. The patient was monitored by dentists from the multidisciplinary team of an intensive care unit, where adjuvant treatment was performed through photobiomodulation to control pain and regenerate the oral mucosa. The case represents the importance of early performance in oral TEN injuries and the role of the multidisciplinary team for comprehensive treatment.