RESUMO
El nevus blanco esponjoso (NBE) es una rara condición autosómica dominante, caracterizada por placas blancas bilaterales en la mucosa, de aspecto esponjoso, blandas a la palpación y que pueden escamarse. Los tratamientos son paliativos; y el uso de antibióticos, en especial la tetraciclina, ha demostrando buenos resultados en su control. Este trabajo presenta tres casos clínicos de una familia afectada por NBE, donde se discuten los posibles diagnósticos diferenciales y conductas terapéuticas indicadas. Un paciente masculino de 52 años de edad acudió a la clínica aquejado de lesiones blancas bilaterales. El paciente notó las lesiones 30 años antes, sin lograr un diagnóstico final de las mismas. Después de la anamnesis y del examen clínico fue realizada una biopsia incisional. La reunión de los datos clínicos e histopatológicos llevó al diagnóstico de NBE. Se le solicitó al paciente que indagase entre sus familiares con respecto a lesiones semejantes. Se detectó que el hijo de 19 años y la hija de 25 eran portadores de placas blancas en la mucosa yugal. Como no había afectación estética, se optó por no intervenir en las lesiones. El nevus blanco esponjoso es una lesión genética que debe ser diferenciada de otras patologías localizadas y sistémicas importantes, que tienen repercusiones serias para el individuo. Como no hay un tratamiento curativo para el NBE, el papel del cirujano dentista es diagnosticar esta lesión, aclarar al paciente sobre la naturaleza benigna y autolimitante del NBE y si fuera necesario desde el punto de vista estético, aplicar diferentes modalidades terapéuticas(AU)
The aim of present paper is to introduce three clinical cases from a family affected from nevus spongiosus albus (NSA) and also to discuss the possible differential diagnoses as well as the therapeutical behaviors to be adopted. Clinical case: A man aged 52 seen in our clinic due to bilateral white lesions noted 30 years ago without achieve a final diagnosis of lesions. After anamnesis and physical examination an incision biopsy was taken. The clinical and histopathological data collection allows making the NSA diagnosis. Thus, it was necessary to inquire again into the patient's relatives regarding the existence of similar lesions proving the presence of white plaques in oral mucosa in a son aged 19 and a daughter aged 25. The nevus spongiosus albus is an uncommon genetic lesion that must to be differentiated from other significant localized and systemic pathologies with serious repercussions for the subjects. Since there is not a curative treatment for the NSA, the role of the surgeon-dentist is to diagnose that lesion, to explain clearly to patient on the benign and self-limiting origin of this entity and if it is necessary from the aesthetic point of view, to apply the different therapeutical modalities to control the plaques(AU)
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Tetraciclinas/uso terapêutico , Diagnóstico Diferencial , Leucoceratose da Mucosa Hereditária/terapia , Doenças da Boca/fisiopatologiaRESUMO
PURPOSE: To evaluate the rates of periodontal examination in private dental practices in Brazil. METHODS: 235 dentists, 117 female and 118 males (mean age 33.1 years), presenting different levels of experience (mean: 11.2 years) were audited. In each dental practice, a team of two trained auditors evaluated dental examination kits for the presence of a periodontal probe, and checked whether there was any specific diagram to record the periodontal status of the patient in the model of clinical charts. The dentists were then asked whether or not they performed periodontal probing and radiographic examination of periodontal structures in all their patients. The degree of association between variables was evaluated using Chi-square or correlation tests. RESULTS: The dentists, 117 female and 118 males, were from 22 to 62 years old (mean age, 33.1 years), and presented 0.5 to 40 years of experience (mean of 11.2 years). Of the 235 clinicians, 19.3% performed periodontal probing in all their patients, and 17.5% of them record the periodontal examination, 48.9% of the professionals occasionally performed periodontal probing while 31.8% did not perform periodontal probing at all. Specialists in prosthodontics, and dentists having more than two specialties, excluding periodontists, performed periodontal probing more frequently than other specialists.