BackgroundBisphosphonate-related osteonecrosis of the jaw (BRONJ) is a clinical condition characterized by the presence of exposed bone in the maxillofacial region. Its pathogenesis is still undetermined, but may be associated with risk factors such as rheumatoid arthritis (RA). The aim of this paper is to report two unpublished cases of BRONJ in patients with RA and to conduct a literature review of similar clinical cases with a view to describe the main issues concerning these patients, including demographic characteristics and therapeutic approaches applied.MethodsTwo case reports of BRONJ involving RA patients were discussedResultsBoth patients were aging female taking alendronate for more than 3 years. Lesions were detected in stage II in posterior mandible with no clear trigger agent. The treatment applied consisted of antibiotics, oral rinses with chlorhexidine, drug discontinuation and surgical procedures. Complete healing of the lesions was achieved.ConclusionsThis paper brings to light the necessity for rheumatologists to be aware of the potential risk to their patients of developing BRONJ and to work together with dentists for the prevention and early detection of the lesions. Although some features seem to link RA with oral BRONJ and act as synergistic effects, more studies should be developed to support the scientific bases for this hypothesis.
Hemangiomas are benign tumors of infancy and childhood, characterized by a phase of fast growth with endothelial cell proliferation, occurring in 10-12% of children at 1 year of age. It is known that hemangiomas of infancy are most commonly located on the head and neck region (around 60% of cases) and occur more frequently in the lips, tongue, and palate. Approximately 50% of hemangiomas have complete resolution, and 90% of them are resolved up to the age of 9. Complications occur in only 20% of the cases, the most common problem being ulceration with or without infection. The treatment depends on lesion location, size and evolution stage, and the patient's age. Surgery is usually indicated when there is no response to systemic treatments, or even for esthetic reasons, being performed as a simple excision in combination or not with plastic surgery. This paper reports a case of lip cavernous hemangioma in a 4-year-old child, who was submitted to 3 sessions of vascular sclerosis due to the size of the lesion, before undergoing simple excision of the hemangioma. Two years of postoperative clinical follow-up shows treatment success with no recurrence of the lesion.
This literature review aims to evaluate the epidemiologic profile of patients with rheumatoid arthritis (RA) that developed a bisphosphonate-related osteonecrosis that affect the jaws (BRONJ), including demographic aspects, as well as clinical and therapeutic issues. A search of PUBMED/MEDLINE, Scopus, and Cochrane databases from January 2003 to September 2011 was conducted with the objective of identifying publications that contained case reports regarding oral BRONJ in RA patients. Patients with RA who develop oral BRONJ are usually women above 60 years taking steroids and long-term alendronate. Most of them have osteoporosis, and lesions, triggered by dental procedures, are usually detected at stage II in the mandible. Although there is no accepted treatment protocol, these patients seem to have better outcomes with conservative approaches that include antibiotic therapy, chlorhexidine, and drug discontinuation.
RESUMO A disseminação da doença por COVID-19 (SARS-CoV-2, coronavírus 2019, novo Coronavírus ou o coronavírus 2 da síndrome respiratória aguda grave), surgida em dezembro de 2019, já alcançou os critérios epidemiológicos declarados como pandemia. Uma das primeiras medidas tomadas e impostas foi fechamento temporário de instituições de ensino em todos os níveis educacionais. Dessa forma, instituições odontológicas de ensino também foram afetadas. Nesse cenário, a utilização de meios virtuais e recursos Web para continuar a educação na odontologia se tornou uma possibilidade. O objetivo deste estudo é realizar uma revisão bibliográfica narrativa sobre a utilização dos recursos Web na educação em Odontologia durante a pandemia da Covid-19. Foi realizada uma busca nos sites oficiais do governo e nas plataformas SciELO e Google acadêmico, utilizando Descritores em Ciências da Saúde. Foram encontrados artigos sobre as estratégias educacionais através de recursos Web na Odontologia e as recomendações do Ministério da Educação para o período da pandemia. Com o cenário de isolamento social, as ferramentas tecnológicas e ambientes virtuais apresentam uma grande aplicabilidade como ferramentas educacional complementar na Odontologia, embora ainda apresentem uma limitação em relação à acessibilidade.
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