Introduction Ameloblastomas are neoplasms that have inspired great controversy and clinical interest; their incidence, radiographic features, treatment and behavior are still discussed quite often in the literature. In 2017, the classification of these lesions underwent modifications in terminology with the introduction of prospective views based on updates in current genetic studies. Objective To describe the most important features of the new classification, as well as to evaluate the prevalence and the clinical and radiographic characteristics of 136 ameloblastomas. Methodology The clinical-pathological characteristics of 136 patients diagnosed with ameloblastoma in two large hospitals in São Paulo were analyzed. All the hematoxylin-eosin (HE) stained slides were reviewed using an optical microscope (Olympus Cover) and tumors were classified according to the new WHO criteria (2017). Two independent evaluators analyzed the slides; in cases where there was disagreement a third evaluator was used and the result was established in consensus. Results 71% of the lesions were of the conventional type, the predominant histopathological pattern being plexiform (40%), 72% of the tumors showed cortical expansion, and 84% had a radiographic pattern of the multilocular type. The treatment of choice in most cases was segmental resection (45%) and recurrence was present in 13% of the cases. Conclusion Studies with clinical-pathological correlations will be necessary in the near future, in order to provide new therapies that are more effective and conservative, improving the quality of life of patients effected.
Our findings suggest that the expression patterns of important Shh pathway proteins can represent valuable markers for early diagnosis of NBCCS-associated OKCs, as the major criterion for the diagnosis of NBCCS is currently based on the late appearance of basal cellular carcinomas. Thus, standardizing a new diagnostic tool for diagnosis of NBCCS could be of great importance in the identification of therapeutic targets. We therefore suggest, as based on our findings, that OKCs showing high expression of Shh, Smo, and Gli1 are potentially associated with NBCCS.
Sickle cell anemia (SCA) is a hemoglobin disorder that occurs more commonly among Afro-descendants. The authors report the case of a 28-year-old Afro-descendent male patient with the diagnosis of homozygotic sickle cell disease (SCD) referred for evaluation of mandibular lesions. The patient’s main complaints included pain and bilateral teeth mobility. An intraoral examination revealed gingiva recession affecting the lower molars with extensive root exposure. A panoramic x-ray showed two radiolucent symmetrical periapical lesions evolving both the first and the second lower molars, bilaterally. The diagnostic hypotheses comprised odontogenic infection, among others. Besides antimicrobial therapy, the two molars of both sides were extracted and bone was collected for histopathological and microbiological analyses. Osteomyelitis was diagnosed, and Streptococcus viridans was recovered from the culture media. Mandibular osteomyelitis should be considered as a diagnosis in patients with SCD. The present case offers an alert to clinicians about the importance of knowing jaw lesions related to SCA.
The purpose of this study was to analyze the effectiveness of Nd: YAG laser photocoagulation in the treatment of vascular malformations in the oral and perioral area; 93 patients (104 lesions) were evaluated in an Ambulatory of Oral Medicine (2006-2013). The sample consisted of 57 women (61%) and 36 men (39%), aged 8 to 85 years. The lesion size was smaller than 3 cm in most patients. The lesions were located on the lips, jugal mucosa, tongue, palate, gingiva, and retromolar trigone. All patients were treated on an outpatient basis using local anesthesia and Nd: YAG laser (Power Laser C ) with a wavelength of 1064 nm and a fiber optic diameter of 400 μm. After treatment no patients had complications, however, in patients of deep lesions, 2 or more irradiations were required to treat the lesions. Finally, the authors conclude that the clinical and aesthetic satisfactory results of the 93 patients treated with Nd: YAG laser suggest that this type of laser is effective and safe in the treatment of oral and perioral vascular malformations.
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