RESUMO
Intravascular papillary endothelial hyperplasia (IPEH) represents an uncommon reactive endothelial hyperplastic proliferation. A 46-year-old man experienced increased volume in the right maxilla, elevation of the nasal ala, and swelling of the hard palate with a reddish hue for 3 months. Computed tomography revealed an expansive hypodense region and cortical bone destruction associated with an impacted supernumerary tooth and an endodontically treated tooth. Under the differential diagnoses of a radicular cyst, dentigerous cyst, and ameloblastoma, an exploratory aspiration and incisional biopsy were performed. This revealed the formation of blood vessels of various diameters lined by endothelium, forming intravascular papillae positive for CD-34. The definitive diagnosis was IPEH, and the patient was treated by embolization and surgery. Histological analysis confirmed the presence of IPEH associated with an odontogenic cyst. After 12 months of follow-up, no recurrence was observed. Also, we reviewed case reports of IPEH affecting the maxilla and mandible. Fourteen intraosseous cases were reported in the maxilla and mandible, with a preference for males and affecting a wide age range. Complete surgical excision was the treatment of choice, and recurrences were not reported. The pathogenesis of IPEH is controversial and may originate from trauma or inflammatory processes. To the best of our knowledge, this is the first report of an association of IPEH with an odontogenic cyst. The importance of IPEH in the differential diagnosis of intraosseous lesions in the jaws is emphasized, and preoperative semiotic maneuvers are needed to prevent surgical complications.
Assuntos
Hiperplasia , Cistos Odontogênicos , Humanos , Masculino , Pessoa de Meia-Idade , Cistos Odontogênicos/patologia , Cistos Odontogênicos/complicações , Diagnóstico Diferencial , Maxila/patologia , Maxila/cirurgia , Biópsia , Resultado do Tratamento , Tomografia Computadorizada por Raios X , Doenças Maxilares/patologia , Doenças Maxilares/complicações , Doenças Maxilares/cirurgia , Embolização TerapêuticaRESUMO
La histiocitosis de células de Langerhans es una enfermedad poco frecuente, caracterizada por la proliferación clonal de células dendríticas mieloides CD1a positivas, asociada a un componente inflamatorio significativo. El compromiso óseo es común; en niños, las lesiones líticas más frecuentes son en la cúpula craneal y son raras las lesiones en la órbita. Se presenta a un lactante de 18 meses que consultó por edema periorbitario y proptosis del ojo derecho de dos meses de evolución. Al momento del examen físico, no se encontraron otras alteraciones. Se realizó una tomografía y una resonancia magnética, que mostraron una masa tumoral en el seno maxilar de crecimiento expansivo y erosión del techo de la órbita. La biopsia confirmó la proliferación CD1a positiva; recibió tratamiento con prednisona y vinblastina, con evolución favorable. Un tratamiento precoz puede evitar secuelas significativas en los pacientes cuando son sensibles al tratamiento. Es una entidad poco frecuente que requiere un alto índice de sospecha y un manejo multidisciplinario.
The Langerhans cell histiocytosis is a rare disease characterized by the clonal proliferation of CD1a + myeloid dendritic cells associated with a significant inflammatory component. The localized form of the disease is called eosinophilic granuloma. Bone involvement is common; in children, lytic lesions are most frequently found in the cranial dome being rare in the orbit. We present an 18-month-old infant who consulted due to periorbital edema and proptosis of the right eye, with two months of evolution. The computed tomography and the magnetic resonance imaging showed a maxillary sinus tumor mass of expansive growth and erosion of the roof of the orbit. The biopsy confirmed CD1a+ proliferation; it was treated with prednisone and vinblastine with favorable evolution. It is a rare entity that requires a high index of suspicion and multidisciplinary management. Early diagnosis and treatment leads to a favorable prognosis for the patient.
Assuntos
Humanos , Masculino , Lactente , Doenças Orbitárias/etiologia , Doenças Maxilares/complicações , Histiocitose de Células de Langerhans/complicaçõesRESUMO
The Langerhans cell histiocytosis is a rare disease characterized by the clonal proliferation of CD1a + myeloid dendritic cells associated with a significant inflammatory component. The localized form of the disease is called eosinophilic granuloma. Bone involvement is common; in children, lytic lesions are most frequently found in the cranial dome being rare in the orbit. We present an 18-month-old infant who consulted due to periorbital edema and proptosis of the right eye, with two months of evolution. The computed tomography and the magnetic resonance imaging showed a maxillary sinus tumor mass of expansive growth and erosion of the roof of the orbit. The biopsy confirmed CD1a+ proliferation; it was treated with prednisone and vinblastine with favorable evolution. It is a rare entity that requires a high index of suspicion and multidisciplinary management. Early diagnosis and treatment leads to a favorable prognosis for the patient.
La histiocitosis de células de Langerhans es una enfermedad poco frecuente, caracterizada por la proliferación clonal de células dendríticas mieloides CD1a positivas, asociada a un componente inflamatorio significativo. El compromiso óseo es común; en niños, las lesiones líticas más frecuentes son en la cúpula craneal y son raras las lesiones en la órbita. Se presenta a un lactante de 18 meses que consultó por edema periorbitario y proptosis del ojo derecho de dos meses de evolución. Al momento del examen físico, no se encontraron otras alteraciones. Se realizó una tomografía y una resonancia magnética, que mostraron una masa tumoral en el seno maxilar de crecimiento expansivo y erosión del techo de la órbita. La biopsia confirmó la proliferación CD1a positiva; recibió tratamiento con prednisona y vinblastina, con evolución favorable. Un tratamiento precoz puede evitar secuelas significativas en los pacientes cuando son sensibles al tratamiento. Es una entidad poco frecuente que requiere un alto índice de sospecha y un manejo multidisciplinario.
Assuntos
Histiocitose de Células de Langerhans/complicações , Doenças Maxilares/complicações , Doenças Orbitárias/etiologia , Humanos , Lactente , MasculinoAssuntos
Edema/etiologia , Granuloma Piogênico/complicações , Doenças Maxilares/complicações , Doenças da Boca/etiologia , Idoso , Biópsia , Diagnóstico Diferencial , Edema/diagnóstico , Edema/cirurgia , Granuloma Piogênico/diagnóstico , Granuloma Piogênico/cirurgia , Humanos , Masculino , Doenças Maxilares/diagnóstico , Doenças Maxilares/cirurgia , Doenças da Boca/diagnóstico , Doenças da Boca/cirurgia , Procedimentos Cirúrgicos Bucais/métodosRESUMO
The aim of this study was to evaluate the long-term success rate of immediate occlusal loading of extrasinus zygomatic implants after an 8-year follow-up. From 62 patients who needed implant treatment in 2003, 25 patients who presented with maxillary atrophy met the inclusion criteria and agreed to participate in the study. All patients received fixed dentures under immediate occlusal loading supported by extrasinus zygomatic implants associated with anterior standard implants. No bone grafting procedures were performed. During the 8-year follow-up period, 21 patients underwent clinical evaluation and radiographic examinations every 6 months. This study conforms to the STROBE guidelines regarding prospective cohort studies. 40 extrasinus zygomatic and 74 anterior standard implants were evaluated. All patients were clinically free of signs and symptoms of sinus disturbance at all follow-up appointments. After 8 years, the success rates of extrasinus zygomatic implants, standard anterior implants and definitive prostheses were 97.5%, 95.9% and 95.2%, respectively. Within the limits of this study, immediate occlusal loading of extrasinus zygomatic implants presents a predictable treatment option for the atrophic maxilla.
Assuntos
Implantação Dentária Endóssea/métodos , Prótese Dentária Fixada por Implante , Prótese Total Superior , Carga Imediata em Implante Dentário , Zigoma/cirurgia , Perda do Osso Alveolar/complicações , Estudos de Coortes , Implantação Dentária Endóssea/instrumentação , Implantes Dentários , Retenção de Dentadura , Seguimentos , Humanos , Doenças Maxilares/complicações , Estudos ProspectivosRESUMO
Crystal-storing histiocytosis is a rare manifestation of plasma cell dyscrasia/monoclonal gammopathies and lymphoproliferative disorders, characterized by cytoplasmic accumulation of crystallized immunoglobulins in histiocytes. Nevertheless, some reported cases of crystal-storing histiocytosis raise the possibility that this lesion may also be reactive. Crystal-storing histiocytosis in the oral cavity is extremely rare; only one case affecting the tongue has been reported in the English-language literature. In this report, we discuss the case of a 38-year-old man who presented a persistent periapical lesion affecting the maxillary left lateral incisor. Histopathological analysis showed numerous crystal-laden histiocytes associated with a mild plasma cell infiltrate within a fibrous stroma. The plasma cells failed to show clonal light-chain restriction, and the patient had no associated hematologic disorder or systemic disease. Thus, this lesion was probably the result of hypersecretion of immunoglobulins by polyclonal plasma cells found in the periapical lesion. Crystal-storing histiocytosis should be considered in the differential diagnosis of periapical lesions.
Assuntos
Biomarcadores Tumorais/metabolismo , Histiocitose/patologia , Doenças Maxilares/patologia , Doenças Periapicais/patologia , Adulto , Cristalização , Diagnóstico Diferencial , Histiócitos/patologia , Histiocitose/complicações , Histiocitose/diagnóstico por imagem , Humanos , Imunoglobulinas/metabolismo , Masculino , Doenças Maxilares/complicações , Doenças Maxilares/diagnóstico por imagem , Boca/patologia , Doenças Periapicais/complicações , Doenças Periapicais/diagnóstico por imagem , Plasmócitos/patologia , RadiografiaRESUMO
Juvenile ossifying fibroma is an uncommon, benign, bone-forming neoplasm that is distinguished from other fibro-osseous lesions primarily by its age of onset, clinical presentation, and potential behavior. It mainly occurs in juveniles and has a slight male predilection and more aggressive behavior than a common ossifying fibroma. There are 2 distinct histopathological variants of this lesion: (1) psammomatoid pattern and (2) trabecular pattern. An aneurysmal bone cyst may occur in association with other bone lesions, such as fibrous dysplasia, ossifying fibroma, and giant cell lesion. The clinical management and prognosis of juvenile ossifying fibroma is somewhat uncertain, and this tumor has high rates of recurrence. Such behavior may be related to younger patient age and the concurrent development of aneurysmal bone cyst. The purpose of this paper was to report a case of trabecular juvenile ossifying fibroma in a 9-year-old girl associated with an aneurysmal bone cyst, presenting an aggressive behavior, and causing significant facial asymmetry.
Assuntos
Cistos Ósseos Aneurismáticos/complicações , Fibroma Ossificante/complicações , Doenças Maxilares/complicações , Neoplasias Maxilares/complicações , Cistos Ósseos Aneurismáticos/patologia , Criança , Assimetria Facial/etiologia , Feminino , Fibroma Ossificante/patologia , Humanos , Doenças Maxilares/patologia , Neoplasias Maxilares/patologia , Recidiva Local de NeoplasiaRESUMO
The purpose of this study was to analyze the electromyographic (EMG) activity and the maximal molar bite force in women diagnosed with osteoporosis in the maxillary and mandibular regions, considering the habits and conditions that lead to development of generalized skeletal bone loss, including on face bones, can disturb the functional harmony of the stomatognathic system. Twenty-seven women with mandibular and maxillary osteoporosis and 27 healthy controls volunteered to participate in the study. A 5-channel electromyographer was used. Muscle activity was evaluated by means of EMG recordings of the masticatory musculature (masseter and temporalis muscles, bilaterally) during the following clinical conditions: rest (5 s); right and left lateral excursions (5 s); protrusion (5 s); maximal dental clenching on Parafilm (4 s) and maximal voluntary contraction (4 s). This latter clinical condition was used as the normalization factor of the sample data. It was observed that individuals with osteoporosis presented greater EMG activity when maintaining mandible posture conditions and less activity during dental clenching and when obtaining maximal molar bite force. It may be concluded that facial osteoporosis can interfere on the patterns of masticatory muscle activation and maximal bite force of the stomatognathic system.
Assuntos
Força de Mordida , Doenças Mandibulares/fisiopatologia , Músculos da Mastigação/fisiopatologia , Doenças Maxilares/fisiopatologia , Osteoporose/complicações , Idoso , Estudos de Casos e Controles , Estudos de Coortes , Oclusão Dentária , Eletromiografia , Feminino , Lateralidade Funcional , Humanos , Doenças Mandibulares/complicações , Doenças Mandibulares/patologia , Análise por Pareamento , Doenças Maxilares/complicações , Doenças Maxilares/patologia , Pessoa de Meia-Idade , Contração Muscular/fisiologia , Osteoporose/patologia , Osteoporose/fisiopatologia , Valores de ReferênciaRESUMO
The purpose of this study was to analyze the electromyographic (EMG) activity and the maximal molar bite force in women diagnosed with osteoporosis in the maxillary and mandibular regions, considering the habits and conditions that lead to development of generalized skeletal bone loss, including on face bones, can disturb the functional harmony of the stomatognathic system. Twenty-seven women with mandibular and maxillary osteoporosis and 27 healthy controls volunteered to participate in the study. A 5-channel electromyographer was used. Muscle activity was evaluated by means of EMG recordings of the masticatory musculature (masseter and temporalis muscles, bilaterally) during the following clinical conditions: rest (5 s); right and left lateral excursions (5 s); protrusion (5 s); maximal dental clenching on Parafilm (4 s) and maximal voluntary contraction (4 s). This latter clinical condition was used as the normalization factor of the sample data. It was observed that individuals with osteoporosis presented greater EMG activity when maintaining mandible posture conditions and less activity during dental clenching and when obtaining maximal molar bite force. It may be concluded that facial osteoporosis can interfere on the patterns of masticatory muscle activation and maximal bite force of the stomatognathic system.
Este estudo teve como objetivo analisar a atividade eletromiográfica e a força de mordida molar máxima de indivíduos diagnosticados com osteoporose na região maxilar e mandibular, visto que os hábitos e condições que provocam o desenvolvimento de uma perda óssea generalizada no esqueleto, inclusive no esqueleto facial, podem causar distúrbios na harmonia funcional do sistema mastigatório. Vinte e sete indivíduos portadores de osteoporose na mandíbula e maxila e 27 voluntários sem a doença participaram deste estudo. Um eletromiógrafo de 5 canais foi utilizado. A avaliação da atividade muscular foi realizada por meio de registros eletromiográficos da musculatura mastigatória (músculos masseter e temporal, bilateralmente) durante as seguintes condições clínicas: Repouso (5 s); Lateralidades direita e esquerda (5 s); Protrusão (5 s); Apertamento dental máximo com parafilme (4 s) e a contração voluntária máxima (4 s), sendo que esta condição clínica foi utilizada como fator de normalização dos dados da amostra. Verificou-se que os indivíduos com osteoporose apresentaram maior atividade eletromiográfica durante a manutenção das condições posturais da mandíbula e menor atividade durante o apertamento dental e na obtenção da força de mordida molar máxima. Conclui-se que a osteoporose na região dos ossos da face pode interferir nos padrões de ativação da musculatura mastigatória e na força de mordida máxima do sistema estomatognático.
Assuntos
Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Força de Mordida , Doenças Mandibulares/fisiopatologia , Músculos da Mastigação/fisiopatologia , Doenças Maxilares/fisiopatologia , Osteoporose/complicações , Estudos de Casos e Controles , Estudos de Coortes , Oclusão Dentária , Eletromiografia , Lateralidade Funcional , Análise por Pareamento , Doenças Mandibulares/complicações , Doenças Mandibulares/patologia , Doenças Maxilares/complicações , Doenças Maxilares/patologia , Contração Muscular/fisiologia , Osteoporose/patologia , Osteoporose/fisiopatologia , Valores de ReferênciaAssuntos
Síndrome do Nevo Basocelular/diagnóstico , Doenças Mandibulares/diagnóstico , Doenças Maxilares/diagnóstico , Cistos Odontogênicos/diagnóstico , Síndrome do Nevo Basocelular/complicações , Humanos , Masculino , Doenças Mandibulares/complicações , Doenças Mandibulares/diagnóstico por imagem , Doenças Maxilares/complicações , Doenças Maxilares/diagnóstico por imagem , Pessoa de Meia-Idade , Cistos Odontogênicos/complicações , Cistos Odontogênicos/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
Determining the causative factors of dental abscesses continues to tax the diagnostic skills of clinicians. A case is discussed of an unusually presenting chronic periodontal abscess involving the bifurcation of the upper left first premolar.