Neurofibromas are benign neoplasms of the peripheral nerve sheath, characterized by the proliferation of Schwann cells, perineural cells and endoneural fibroblasts.Their occurrence in the oral and maxillofacial complex is uncommon. This study aimed to evaluate the clinical and histopathological characteristics of neurofibromas of the oral and maxillofacial complex excised at our institution over a 48-year period.Using light microscopy, two previously trained oral pathologists re-evaluated all hematoxylin and eosin slides. From a total of 15,375 cases diagnosed at a referred Oral Pathology Service, 24 cases were diagnosed as neurofibromas. Eighteen neurofibroma patients were female, with a mean age of 39.1 years. Three patients presenting neurofibromas exhibited neurofibromatosis type I. Clinically, most of the lesions presented as asymptomatic nodules, and the most frequent sites were the tongue (n = 6; 25.0%), gingiva (n = 6; 25.0%) and intraosseous maxillary bone region (n = 3; 12.5%). Histopathologically, the lesions were predominantly well delimited, exhibiting interlocking bundles of spindle-shaped cells that usually displayed wavy nuclei, associated with delicate collagen fibers. Thus, knowledge of their clinical and histopathological features by dentists and oral pathologists is essential for the correct diagnosis of these lesions.
K E Y W O R D Sdiagnosis, mouth neoplasms, nerve sheath neoplasms, pathology
Objective: Evaluate the influence of head and neck radiotherapy dose on periodontal tissue for to understanding of its adverse effects, and consequently to propose strategies to reduce its severity. Methodology: An observational, longitudinal and prospective study with intraoral clinical examinations performed before radiotherapy (T0) and immediately after the end of radiation therapy. The clinical data collected regarding oral and periodontal hygiene conditions were visible plaque index (VPI), gingival bleeding index (GBI), probing depth (PD), gingival recession area, clinical attachment level (CAL), degree of mobility and presence or absence of suppuration. In addition, data such as radiation dose, fractionation and duration of radiotherapy were reported. Results: Fourteen patients were evaluated, of which 11 had periodontitis after the radiotherapy, and 9 had poor oral hygiene conditions after the radiotherapy. Seven of the 11 subjects with periodontitis presented tumors in the oral cavity. There was a decrease in visible plaque index (VPI) and gingival bleeding index (GBI). The research was unable to establish a significant association between radiation therapy and oral hygiene condition and periodontitis. Conclusion: Poor oral hygiene conditions predominated in the sample, which can be associated with the presence of debilitating conditions. Direct radiation on the oral cavity may have an influence on the development of periodontitis. The development of gingivitis only and periodontitis was not influenced by dose, fraction or duration of radiotherapy in the study period.
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