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INTRODUCTION: Medication-associated osteonecrosis of the jaws (MRONJ) is characterized by the presence of exposed bone or an intraoral or extraoral fistula in the maxillofacial region in patients with a history of treatment with anti-resorptive and anti-angiogenic drugs, such as monoclonal antibodies, and without a history of radiotherapy or metastatic diseases in the area. OBJECTIVE: The aim of this study is to report a case of a pathological mandibular fracture in an area of MRONJ in a patient diagnosed with Crohn's disease treated with infliximab. CASE REPORT: A 53-year-old male patient, an active smoker for 35 years, diagnosed with Crohn's disease, undergoing intravenous administration of infliximab 300 mg for 1 year and 3 months, with no previous history of anti-angiogenic or anti-resorptive medication, presenting with an extraoral fistula in the submandibular region for 4 months, with painful symptoms, diagnosed as MRONJ. He was initially treated conservatively, using antimicrobial photodynamic therapy (aPDT), antibiotic therapy, and the PENTO protocol. However, the patient evolved with a pathological fracture in the mandibular parasymphysis, requiring surgical reconstruction. FINAL CONSIDERATIONS: Pathological fracture of the mandible is a complication of MRONJ that compromises the patient's quality of life. The management of patients with MRONJ is complex and challenging.

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OBJECTIVE: Assess the impact of photobiomodulation therapy (PBMT) on xerostomia, salivary flow rate (SFR) and composition in patients undergoing radiotherapy (RT) for head and neck cancer (HNC). STUDY DESIGN: Thirty patients undergoing RT (65 Gy) for HNC were enrolled. Saliva and xerostomia evaluations collected pre- and post-PBMT-RT. PBMT involved irradiation of extra and intraoral points, 15-20 sessions, 2-3 times/week. SFR, trace elements, total protein, alkaline phosphatase, xerostomia, and pH were analyzed. RESULTS: The average age was 60.7 years. After treatment, there was not a significant reduction in SFR and there was no difference on xerostomia. Significant reductions in Al, Cd, Fe, Ni, P, and Sb concentrations were observed, along with a significant increase in Mg concentration. Sample data were organized into 3 groups based on a self-organizing map. Low concentrations of Al, As, Co, Cr, Cu, Fe, Mn, Mo, S, Sr, and Zn were the primary discriminatory factors for group A, while group B consisted of post-PBMT-RT samples with high concentrations of Ca, K, Mg, Na, and S. CONCLUSIONS: PBMT prevented a significant reduction in SFR and xerostomia induced by radiation therapy. These findings suggest that PBMT prevents salivary gland damage minimizing the decline in salivary flow.

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MYH9 disease is a rare genetic disorder in which there is a mutation in the gene for the non-muscle myosin heavy chain IIA. It initially causes macrothrombocytopenia followed by other clinical manifestations. When the patient reaches adulthood, he can develop chronic kidney failure. Thus, the risk of suffering a hemorrhage, difficulty in repairing and, infections increases in individuals with this disease. In addition, the use of drugs in these patients should be carefully evaluated. An adult patient sought dental care with a complaint associated with a tooth with advanced dental caries. He had severe thrombocytopenia (7000 platelets/mm3 ), hearing loss, and chronic kidney failure. The diagnosis of MYH9 disease was confirmed through genotyping. After clinical examination, extraction was planned. Local and systemic procedures were used to prevent hemorrhage, especially postoperatively. Although the patient had an infection at the surgical wound site and no episode of postoperative bleeding, the repair process occurred normally. The purpose of this article is to report the surgical management of a patient with MYH9 disease.

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PURPOSE: To evaluate implant osseointegration in grafted autogenous bone blocks fixed with cyanoacrylate-based adhesive and screws. Also, grafted bone fixed either with an adhesive or screw was evaluated. MATERIALS AND METHODS: Two surgical defects in the parietal region of rabbits (n = 12) were performed in each animal. Autogenous bone blocks obtained were fixed anteriorly with a screw or cyanoacrylate-based adhesive. After 30 and 45 days of grafting procedures, implants were placed in bone blocks. Histomorphometric and microcomputed tomography (micro-CT) analyses of the implant area were performed at 30 days after implant surgery in the screw (n = 6) and adhesive (n = 6) groups. Histomorphometric analyses of bone-grafted areas were performed at 60 and 75 days in the screw (n = 6) and adhesive (n = 6) groups. Histomorphometric evaluations were carried out in implant and grafted bone areas. The micro-CT parameters evaluated were bone-to-implant contact, bone area fraction occupancy, bone volume fraction, trabecular thickness, trabecular separation, and trabecular number. RESULTS: No differences were observed in the micro-CT parameters for the screw and adhesive groups in all experimental periods. However, an increased quantity of immature bone volume was observed on the adhesive group in the grafted area after 75 days. The grafted area in the screw group (75 days) presented a decrease in the volume density of the immature bone compared with the screw group (60 days). There were no differences in both groups and experimental periods in soft tissue in the grafted area. CONCLUSION: No differences were observed in the osseointegration of implants placed in grafted autogenous bone blocks fixed with cyanoacrylate-based adhesive and screws. Therefore, osseointegration in autogenous bone fixed with cyanoacrylate-based adhesive is viable.

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Parameter reproducibility in photobiomodulation therapy (PBMT) is still scarce in literature for the management of oral mucositis (OM). This study aimed to identify the most used PBMT dosimetry parameters (DP) and their efficacy in OM management after preconditioning for hematopoietic stem cell transplantation (HSCT). This research was conducted according to the PRISMA guidelines. The search for primary studies was in PubMed/MEDLINE, Web of Science, Embase, BVS, and Cochrane Library. Gray literature was verified on BDTD-Ibict and Open Gray. A total of 1044 studies were identified. Nine met the eligibility criteria for qualitative assessment and 7 for meta-analysis. The studies involved 396 patients submitted to preconditioning for HSCT, 211 with PBMT and 185 without PBMT in the OM management. The WHO scale was the most used to assess OM degree. The most used parameters were 660-nm wavelength, 40-mw power, 0.16-J energy, 1-W/cm2 power density, 4-J/cm2 energy density, and 0.04-cm2 spot size. The meta-analysis demonstrated that PBMT decreased the severity of OM, with a protection factor 20% higher than the control group (without PBMT), and when the parameters are similar to the DP mentioned, the protection factor increases to 94%. These most used DP with similarity seem to be a therapeutic strategy for the management of OM in this population.

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BACKGROUND: Viral reactivation in patients undergoing immunosuppressive therapy after hematopoietic stem cell transplantation (HSCT) is a serious complication associated with significant morbidity and mortality. Infections caused by human herpes viruses such as herpes simplex virus (HSV), cytomegalovirus (CMV), and Epstein-Barr virus (EBV) can result in oral lesions. CASE PRESENTATION: A 40-year-old male patient who had undergone HSCT presented with ulcerated lesions in different areas of the mouth, for 7 months. The lesions had evolved to painful exophytic nodules with an erythematous, ulcerated surface. They were present on the tongue margins and soft and hard palate. Histological, immunohistochemical (IHC), and polymerase chain reaction analyses were performed, and the results were compatible with HSV-1 and -2 and CMV infections. Treatment comprised five sessions of antimicrobial photodynamic therapy (aPDT) and oral valganciclovir. Thirty days after combined antiviral therapy and aPDT, the lesions were completely resolved. Patient was followed up for 12 months without recurrence. CONCLUSION: Diagnosis and treatment of atypical oral infections in immunosuppressed patients is challenging. Assessment of both clinical and laboratory findings is mandatory for a conclusive diagnosis. The use of local antimicrobial and systemic therapies contributes to positive clinical response in such cases.

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BACKGROUND: Schizophrenia (SCZ) presents complex challenges related to diagnosis and clinical monitoring. The study of conditions associated with SCZ can be facilitated by using potential markers and patterns that provide information to support the diagnosis and oral health. METHODS: The salivary composition of patients diagnosed with SCZ (n = 50) was evaluated and compared to the control (n = 50). Saliva samples from male patients were collected and clinical parameters were evaluated. The concentration of total proteins and amylase were determined and salivary macro- and microelements were quantified by ICP OES and ICP-MS. Exploratory data analysis based on artificial intelligence tools was used in the investigation. RESULTS: There was a significant increase in the salivary concentrations of Al, Fe, Li, Mg, Na, and V, higher prevalence of caries (p < 0.001), periodontal disease (p < 0.001), and reduced salivary flow rate (p = 0.019) in SCZ patients. Also, samples were grouped into six clusters. As, Co, Cr, Cu, Mn, Mo, Ni, Se, and Sr were correlated with each other, while Fe, K, Li, Ti, and V showed the highest concentrations in the samples distributed in the clusters with the highest association between SZC patients and controls. CONCLUSIONS: The results obtained indicate changes in salivary flow, organic composition, and levels of macro- and microelements in SCZ patients. Salivary concentrations of Fe, Mg, and Na may be related to oral conditions, higher prevalence of caries, and periodontal disease. The exploratory analysis showed different patterns in the salivary composition of SCZ patients impacted by associations between oral health conditions and the use of medications. Future studies are encouraged to confirm the results investigated in this study.

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Natal teeth are infrequent at birth. Dental extraction is the most recommended treatment to avoid complications. Reactive soft tissue lesions associated to natal tooth or its incomplete removal are rare. A five-month-old female presented natal teeth #71 and #81 which were removed the day after the birth. The baby evolved with two nodules in the region of #71 and #81, pedunculated, 10 and 9 mm, respectively, covered by a pink mucosa, firm in consistency. Periapical radiography showed two radiopaque areas, suggestive of root fragments. After 30 days the nodule located in the region of #81 became purple in color and ulcerated. Both lesions were removed with high intensity diode laser. Histopathological analysis was compatible with inflammatory fibrous hyperplasia (#71) and pyogenic granuloma (#81). Early diagnosis of oral lesions in newborns by means of histopathological examination and a minimum invasive treatment, such as laser surgery, should be of primary concern.

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AIMS: The aim of this study was to compare individuals with and without schizophrenia through the characteristics of the palate, such as width, length, depth, palate shape, and upper dental arch shape. METHODS AND RESULTS: The sample was divided into one case group (n = 45) and two control groups (n = 90; 45 individuals each group). Groups were paired by variables: sex, age, and malocclusion type. All analyses were performed on upper dental arch plaster models. All individuals were male and the mean age was 28.56 (SD: 7.82) years. The frequency of the malocclusion type observed was 54.1% (Class I), 22.2% (Class II), and 23.7% (Class III). Statistically significant difference was observed between the case and control groups for the variables palate shape (P = .004) and upper dental arch shape (P = .003). The case group had a higher frequency of the deep or grooved palate shape (57.8%) and parabolic dental arch shape (48.9%). There was no statistically significant difference for the palate width, length, and depth (P > .05). CONCLUSIONS: There was an evidence that the deep or grooved palate shape and parabolic dental arch shape are morphological characteristics of the palate in men with schizophrenia.

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PURPOSE: The purpose of this study was to evaluate bone repair with two bone substitutes, deproteinized bovine bone and biphasic calcium phosphate ceramics, associated with autogenous bone. MATERIALS AND METHODS: The experimental groups were as follows: autogenous bone only (AB), autogenous bone/deproteinized bovine bone (1:1), and autogenous bone/biphasic calcium phosphate ceramic (1:1). After 30, 60, and 90 days, animals were euthanized and samples were collected for microcomputed tomography (micro-CT), histologic, histomorphometric, and expression analyses of VEGFA, RUNX2, ALP, COL1A1, OCN, PHEX, RANKL, and OPG genes by real-time polymerase chain reaction (PCR) array. RESULTS: Histomorphometric analysis showed no difference in the amount of immature bone between AB and AB/biphasic calcium phosphate ceramic at 30 and 60 days. There was less mature bone formation in the AB/deproteinized bovine bone at 60 days compared with AB/biphasic calcium phosphate ceramic and AB, and a lower amount of immature bone in the AB/deproteinized bovine bone at 30 and 60 days compared with the AB (P ≤ .05). Micro-CT analysis showed higher immature bone volume (BVI) in the AB/biphasic calcium phosphate ceramic at 60 days and lower BVI at 90 days (P ≤ .05). Molecular analysis showed a lower expression of all genes in the AB/deproteinized bovine bone and AB/biphasic calcium phosphate ceramic compared with AB at all time points. A greater expression of RANKL was found in the AB/deproteinized bovine bone compared with AB/biphasic calcium phosphate ceramic at 30 days (P ≤ .05), and a lower expression of the OC, RUNX2, and ALP genes in AB/deproteinized bovine bone and AB/biphasic calcium phosphate ceramic was found compared with AB at all time points (P ≤ .05). CONCLUSION: The use of biphasic calcium phosphate ceramic resulted in greater immature bone formation than deproteinized bovine bone at an early assessment. The studied bone regeneration genes were downregulated in comparison to the control.

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Objective: To evaluate the effects of alendronate (AL), a bisphosphonate, on visual bone density by means of a radiographic analysis. Material and methods: Sixty-two Wistar rats were divided into four groups: Group AA (AL with autogenous graft); group AW (AL without autogenous graft) both receiving AL on alternate days for 4 weeks before surgery; control group CA (with autogenous graft); group CW (without autogenous graft) both receiving saline solution before surgery. Experimental periods of evaluation were 2 weeks and 4 weeks postsurgery. Conventional and digital radiographs were obtained, and a 5-point grading system (score) was used to assess visual radiographic bone density. Results: There were no statistical differences between CA and AA groups at 2 and 4 weeks. The AA group had a higher mean score of bone density than the CW and AW groups at 2 weeks (P < 0.05). The CA and AA groups had higher scores of bone density than the CW and AW groups at 4 weeks (P < 0.05). Conclusions: Treatment with AL did not affect radiographic bone density at 2 and 4 weeks after surgery. The presence of an autograft resulted in higher scores of bone density. (AU)

Objetivo: Avaliar os efeitos do alendronato (AL), um bisfosfonato, na densidade óssea através de uma análise radiográfica. Material e métodos: Sessenta e dois ratos Wistar foram divididos em quatro grupos: Grupo AA (AL com enxerto ósseo autógeno); grupo AW (AL sem enxerto ósseo autógeno); ambos receberam AL em dias alternados durante 4 semanas antes da cirurgia; grupo controle CA (com enxerto ósseo autógeno); grupo CW (sem enxerto ósseo autógeno) ambos receberam solução salina antes da cirurgia. Os tempos experimentais de avaliação foram 2 e 4 semanas após a cirurgia. Radiografias convencionais e digitais foram realizadas, e um sistema de escore de 5 pontos foi utilizado para avaliar a densidade óssea radiográfica visualmente. Resultados: Não houve diferença estatisticamente significativa entre os grupos CA e AA em 2 e 4 semanas. O grupo AA apresentou maior escore de densidade óssea do que os grupos CW e AW em 2 semanas (p < 0.05). Os grupos CA e AA apresentaram maior escore de densidade óssea do que os grupos AW e CW em 4 semanas (p < 0.05). Conclusões: O tratamento com AL não interferiu na densidade óssea radiográfica em 2 e 4 semanas após cirurgia. A presença do enxerto resultou em maior escore de densidade óssea. (AU)

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OBJECTIVES: The aim of this study was to verify the likely influence of presurgical administration of low doses of alendronate sodium in craniofacial bone repair and correlate the histological frame found on reparative tissue to the immunohistochemical presence of IGF1, IGF2, and osteopontin (OP). MATERIALS AND METHODS: In total, 120 rats were randomly allocated into four groups: group C (control), group OA (autogenous bone), group B (bisphosphonates), and group OA-B (autogenous bone + bisphosphonates). Groups B and OA-B received alendronate sodium (ALN) 0.01 mg/kg subcutaneously on alternate days for 4 weeks. Groups C and OA received saline solution. Critical 5-mm defects were created in rat calvaria, which were filled with blood clot in groups C and B and with autogenous bone in groups OA and OA-B. The animals were euthanized at 15 or 30 days postoperatively. Histological analysis and immunohistochemistry of IGF1, IGF2, and OP proteins was performed. Immunohistochemistry evaluated the expression in cells and extracellular matrix. RESULTS: Groups C and B revealed healing predominantly characterized by connective tissue. In groups OA and OA-B, healing of connective tissue and neoformation of compact bone was observed. Expression of IGF1 an OP was present in all specimens. IGF1 expression in cells was more pronounced in groups OA and OA-B 15 days postoperatively. The expression of IGF2 was only observed in groups OA and OA-B, with greater intensity in group OA-B 30 days postoperatively. OP expression was only observed in cells and not in the extracellular matrix and was more pronounced in group OA 15 days postoperatively. CONCLUSIONS: The application of systemic ALN at a dose of 0.01 mg/kg did not improve cranial bone matrix deposition. Nevertheless, the expression of IGF1 and OP and a slight marking of IGF2 were observed especially in groups OA and OA-B in the wound healing process. Future studies should assess higher doses of ALN to verify its influence on bone repair. CLINICAL RELEVANCE: The systemic use of ALN 0.01 mg/kg on alternate days 4 weeks prior to surgery did not interfere with bone repair.

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INTRODUCTION: Bone graft is a very common procedure that is performed when bone volume needs to be increased before a dental implant. Screws and miniplates are the clinical standards for osteosynthesis. However, some disadvantages for this method have been reported, including artifacts on radiological images, infection, screw loosening, and the need to remove screws that interfere with the dental implants. Bone adhesives are a promising alternative for bone graft surgery. PURPOSE: The aim of this study was to compare the shear bond strength of two cyanoacrylate-based adhesives and titanium screws for bone graft fixation. METHODS: Pig jaw samples were cut into rectangular bars (2 × 6 × 20 mm) and bonded with a 5-mm overlap of N-butyl cyanoacrylate and ethyl cyanoacrylate, and 1.5-mm titanium screws were inserted into the center of the contact area. The blocks were fixed on a shear bond strength device that was coupled to a universal testing machine. The maximum force (N) was recorded on a computer and divided by the bonded area (in mm(2)) in order to calculate the bond strength (MPa). The data were statistically analyzed with ANOVA and Tukey's test (α = 0.05). RESULTS: The shear bond strengths of the screws were significantly higher than both cyanoacrylate adhesives, which presented statistically similar bond strength means, and have the biomechanical potential to be used for bone fixation. CONCLUSIONS: Ethyl cyanoacrylate is an inexpensive adhesive that has multiple purposes and can be considered as an alternative for bone fixation.

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Xanthoma is a very rare bone tumor, especially in the mandible, that can be associated with metabolic diseases such as hyperlipidemia. A 14-year-old girl presented with a non-corticated unilocular radiolucent lesion observed on panoramic radiography. The lesion was located between the roots of the left first and second premolar teeth, extending from the cervical to the apical region, measuring approximately 1 cm in greatest dimension. An excisional biopsy revealed foam cells and occasional nonfoamy mononuclear macrophage-like cells spread among a discrete fibrous stroma. Immunohistochemically, the xanthomatous cells were CD68 and vimentin positive, focally positive for S100, CD1a, and CD3 and negative for AE1/AE3, CD20, CD117, and HMB45. Hematologic and biochemical investigations ruled out systemic disease.

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BACKGROUND: This study evaluated the osteoconductive effect of an autograft, in the presence or absence of the L-PRP, using histomorphometric analysis of the bone formed, and we compared the results in the presence of TGF-ß1, Wnt10b and CD34 detected by immunohistochemistry. MATERIALS AND METHODS: Two bone defects were produced in the calvaria of 20 rabbits. The defects were treated with autograft and autograft combined with L-PRP. The animals were euthanized at 15 and 40 days post-surgery. Data were analyzed by Student-Newman-Keuls (p ≤ 0.05) test for histomorphometric and immunohistochemical interpretation. RESULTS: The results revealed that the presence of bone matrix was significantly less in the defects treated with L-PRP. These results coincided with changes of the immunolocalization of the TGF-ß1. In the L-PRP-free groups the TGF-ß1 was restricted to bone matrix while the CD34 was scarce and the Wnt10b occurred in peritrabecular cells. In contrast, in defects that received L-PRP the presence of TGF-ß1 occurred in cells, which occupied whole area of defect. These TGF-ß1+ cells also were co-expressed to Wnt10b and CD34. CONCLUSION: These results suggest that L-PRP induces a cross-reaction between TGF-ß1 and Wnt10b, which stimulates the self-renewal and maintenance of CD34+ stem cells immunophenotype, impairing the osteoconductivity properties of the autograft.

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The aim of this study was to evaluate the osteocalcin immunoexpression during the bone repair treated with subcutaneous adipose tissue in rats and rabbits. Fourteen rats and 14 rabbits were used in the study. A critical-sized calvarial defect was created in each animal. The animals were divided into 4 experimental groups: RC (rat control), RbC (rabbit control), RAT (rat adipose tissue), RbAT (rabbit adipose tissue). In the groups RC and RbC the defect was filled with a blood clot. In groups RAT and RbAT, the defect was filled with macerated subcutaneous adipose tissue. The euthanasia was performed at 30 days (RC and RAT) and 40 days (RbC and RbAT). Histological analysis and immunohistochemical analysis of osteocalcin protein expression were performed. Data were submitted to descriptive statistical analysis (mode). Osteocalcin immunoexpression was detected in the experimental models. Notwithstanding, RbAT showed higher positivity, especially in the adipocytes, than the group RAT group. In groups RC and RbC, the surgical wound was filled by collagen fibers. In Group RAT, the defect was composed by collagen fibers and adipocytes in the reparative sites. Similarly, in RbAT, the defect also was partially filled by collagen fibers and presence of adipocytes dispersed among the fibers. Additionally, chronic inflammatory process and areas of bone matrix deposition were observed. It may be concluded that in both animal models the adipose tissue demonstrated low osteogenic capacity. However, the rabbit animal model exhibited a more evident osteocalcin immunoexpression and a greater amount of newly formed bone matrix.

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Objective : This study analyzed the influence of autogenous white adipose tissue on bone matrix development in critical-size defects created in rabbit calvaria. Materials and methods : A 15-mm-diameter defect was created in the calvaria of 42 rabbits. Twenty-one rabbits were treated with 86 mm(3) of immediate transplant of fragmented white subcutaneous adipose tissue (WSAT); the others constituted the control group (sham). The animals were euthanized at 7, 15, and 40 days postsurgery (n = 7), and the histological data were analyzed by histomorphometry and immunohistochemistry using the anti-adiponectin and parathyroid hormone 1-receptor (PTH1R) antibodies. Results : The calvariae treated with fragmented WSAT demonstrated significant bone formation. These results coincided with the significant presence of immunopositivity to adiponectin and PTH1R in loci, which in turn coincided with the increase in bonelike matrix deposited both in fat tissue stroma and adipocytes' cytoplasm. In contrast, the control group revealed a small amount of bone-matrix deposition and presented scarce PTH1R expression and a lack of immunostain for adiponectin. Conclusion : These results indicate that transplant of fragmented white subcutaneous adipose tissue may be an alternative to treatment of craniofacial bone deformities because adipose tissue suffers from osseous metaplasia and exhibits immunoexpression of the adiponectin and PTH1R, which are proteins associated with bone metabolism.

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BACKGROUND: Detection and quantification of human papillomavirus (HPV) may help in predicting the evolution of HPV infection and progression of associated lesions. OBJECTIVES: We propose a novel protocol using consensus primers GP5+/6+ in a SYBR Green quantitative real-time (Q-RT) polymerase chain reaction (PCR). The strategy permits screening for HPV infection and viral load quantification simultaneously. STUDY DESIGN: DNA from 153 archived cervical samples, previously tested for HPV detection by GP5+/6+ PCR and typed by EIA-RLB (enzyme immunoassay-reverse line blot) or sequence analysis, was analysed using SYBR Green Q-RT PCR. Melting temperature assay (T(m)) and cycle threshold (C(t)) were used to evaluate HPV positivity and viral load. The T(m) in the range of 77-82 degrees C was considered to be positive for HPV-DNA. HPV results generated through GP5+/6+ conventional PCR were considered the gold standard against which sensitivity and specificity of our assay were measured. RESULTS: Out of 104 HPV positive samples, 100 (96.2%) were also determined as positive by SYBR Green Q-RT PCR; of the 49 HPV-negative samples, all were determined as negative. There was an excellent positivity agreement (kappa=0.94) between the SYBR Green Q-RT and the previous methods employed. The specificity and sensitivity were 100% and 96.2%, respectively. Comparison of SYBR Green Q-RT and TaqMan oligo-probe technologies gave an excellent concordance (rho(c)=0.95) which validated the proposed strategy. CONCLUSIONS: We propose a sensitive and easy-to-perform technique for HPV screening and viral load quantification simultaneously.

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Bell"s palsy is a neuropathy of the peripheral seventh cranial nerve, resulting from traumatic, compressive, infective, inflammatory or metabolic abnormalities or it can be idiopathic. HIV, Epstein-Barr virus and hepatitis B virus have been suspected as initiating organisms, but herpes simplex virus is the most frequently implicated. This report describes 2 cases of Bell"s palsy in children that were managed with antiviral agents. Both patients experienced complete recovery within 28 days; after 1 year follow-up, no recurrence was observed and both patients have normal facial movement. Differential diagnosis is essential to guide the treatment plan in Bell"s palsy. Special attention should be given to children with respect to prescription of medications that can cause important side effects.

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