A typical case of Fahr's syndrome is described in a 76-year-old Brazilian female who underwent a total thyroidectomy three decades ago. Six years before the current admission, she started with generalized tonic-clonic seizures. Associated disorders involved extra-pyramidal, cognitive, nocturnal terror and mood changes. With suspicion of hypocalcemia due to secondary hypoparathyroidism, laboratory determinations confirmed the diagnoses. Furthermore, imaging studies of the central nervous system detected multiple calcifications, with characteristic distribution of Fahr's syndrome. Clinical management was successful.
O aumento dos índices de violência interpessoal tem gerado um grande impacto na sociedade mundial, principalmente pelo número de vítimas acometidas por ferimentos causados por projéteis de arma de fogo (PAF). Levando-se em consideração a gravidade desse tipo de lesão, a necessidade de intervenção cirúrgica e o aumento significativo de mulheres vitimizadas, destaca-se a importância do conhecimento, por parte do cirurgião bucomaxilofacial, do procedimento técnico cirúrgico e do acolhimento da vítima. Este trabalho tem como objetivo destacar a problemática social envolvendo o feminicídio e relatar de maneira descritiva um caso, no qual a paciente foi vítima de uma tentativa de homicídio, necessitando, dessa forma, de intervenção cirúrgica para redução e fixação de uma fratura cominutiva em região mandibular. A paciente encontra-se com 8 anos de pós-operatório, apresentando estabilidade da osteossínte e da oclusão, realizando normalmente todas as funções do sistema estomatognático. Mostrando assim sucesso da abordagem cirúrgica escolhida.
Kissing Molars is a term used to describe impacted teeth that contact occlusal surfaces in a single follicular space. The occurrence of this phenomenon is extremely rare and of unknown etiology. Therefore, the present study aimed to present a case report of Kissing Molars associated with dentigerous cyst where a surgical procedure was needed under general anesthesia due to the atrophied jaw. On the left side, of the mandible, and fracture after the removal of the impacted teeth happened and a 2.4 mm reconstruction plate was installed. After the extraction of impacted molars, the lesion with a cystic aspect was removed and sent to histopathological analysis which confirmed the diagnostic hypothesis of dentigerous cyst. Thus, it was concluded that despite the rare impaction and unknown etiology, with a little report in the literature, clinically the case behaves like any impacted tooth, and inflammation may occur if it partially erupts. Radiographically, it presents with the occlusal surfaces in contact and a single follicle, usually associated with the dentigerous cyst.
Surgical management of impacted third molars is a treatment performed by dentists and its indicated for various conditions, among the indications has the prevention of mandibular fracture, but this is a factor that has been discussed and is controversial. Fractures caused by a third molar can occur, and on the other hand, the fractures after or during the management of impacted third molar are a possible complication. Surgical planning as the indication to the surgery has to be performed to avoid complications as the fracture. Thus this study aims to report a case about a mandible fracture after third molar extraction, presenting edema, pain, and restriction in mandible mobility in 01-day follow-up. A 27-year-old female was referred to the oral and maxillofacial surgery service of the Santa Casa Hospital of Araçatuba (Araçatuba, Brazil), reporting dental history of third molar removal, with immediately chief complaints. In the assessment, the patient presented edema, pain, malocclusion, and restriction in mandible mobility, and the panoramic X-ray showed a mandible fracture with displacement. The patient underwent surgery under general anesthesia to open reduction with internal fixation (ORIF) through an intraoral approach. On the follow-up, the patient showed an improvement in mouth opening and mandibular mobility without pain or infection signs. The panoramic X-Rays showed us the bone fracture healing.
An old patient with recent diagnosis of classic seminoma is reported. The tumor of left testicle was heralded by tenderness about 30 days before medical attention and enlarged testis confirmation. There was antecedent of left testis hypotrophy treated with testosterone and a surgery for varicocele at 15 years of age. Clinical hypothesis of testicular tumor was strengthened by ultrasonography images and elevated tumor markers (lactate dehydrogenase, a-fetoprotein, and b-hCG). Radical orchiectomy was performed and a classic seminoma (pT1pNx) was diagnosed. Active waiting was the first choice for management, but six months later a retroperitoneal mass with lymph node enlargement were found, and he underwent four sessions of carboplatin (AUC 5), bleomycin and etoposide (BEP regimen). Asymptomatic, he was referred to outpatient surveillance on Oncology. Population-based studies about frequency and outcome of early-stage testis seminoma in elderly are scarce. Case studies might contribute to the knowledge about this condition.
Fracture of an endodontic instrument within the root canal system can occur due to incorrect use of instruments, and clinicians are confronted with a few removal options when considering this situation. The purpose of this article is to present the removal of a fractured endodontic file from the periapical region of the right upper central incisor, that caused a nasal floor perforation and otorhinolaryngological symptoms, with the aid of a dental operating microscope (DOM) and cone bean computed tomography (CBCT). Success was achieved when the fragment was visible and removed from the nasal fossa. The standardized techniques of removal or bypassing fracture file were not effective, and success was obtained with the aid of CBCT that made possible the visualization of the broken file inside the nasal fossa.
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