Lesions in the floor of the mouth can be a challenging diagnosis due to the variety of pathological conditions that might be found in this area. Within a broad range of lesions, attention has to be addressed to those that require specific management, such as a dermoid cyst (DC) and a ranula. Especially in pediatric patients, in whom the failure of diagnosis can postpone the correct treatment and cause sequelae later in life. DC, a developmental anomaly, is managed primarily by surgical resection. On the other hand, ranula is a pseudocyst that may be treated by marsupialization. This article reports a large and painful lesion in the floor of the mouth in a pediatric patient. With a diagnostic hypothesis of ranula, two surgical interventions were performed, but there were recurrences of the lesion. Subsequently, the patient was referred to the Oral and Maxillofacial Surgery Unit for re-evaluation. Computed tomography showed a semi-transparent image suggesting a cystic formation. Another surgical procedure was performed where the lesion was completely removed. Anatomopathological analysis confirmed the diagnosis of DC. The five-year follow-up showed no signs of recurrence. This article indicates that although DC in the floor of the mouth is rare, it should be considered in the differential diagnosis of other diseases in this area. This precaution may be particularly important in the following circumstances: 1) Similar lesions that have different therapeutic approaches and, 2) To prevent future sequelae in pediatric patients.

45% of patients did not come back for chemodenervation. Treatment cost can be a reason for the high dropout rate (Fig. 1).Other treatment options for unilateral lower lip palsy include selective neurectomy of the healthy contralateral side. Another reconstructive option is reconstruction of the lower lip depressor activity with digastric muscle transfer.Patients with CULLP have high level of concern regarding their mouth symmetry during speech and smiling. Chemodenervation treatment resulted with higher patient satisfaction with speech in comparison to smiling. One possible reason can be the anatomy of the smile as explained by Rubin et al in 1974. 10 There are there 3 types of smile, namely ''Mona Lisa,'' canine and full denture smile. The only smile affected by lower lip palsy is the full denture smile, therefore it can be speculated patients that have the other smile patterns are not affected as much. Whereas unilateral lower lip palsy almost always causes serious asymmetry during speech, especially while pronouncing sounds that incorporate i and e.Although this study was carried out in CULLP patients only, results are also applicable to other DLI related asymmetries. Contralateral DLI chemodenervation is also a very valid option for patients with acquired unilateral lower lip palsy such as Bell palsy, iatrogenic marginal mandibular palsy. CONCLUSIONMost CULLP patients are concerned regarding their asymmetric appearance while smiling or speaking. Chemodenervation of the contralateral DLI muscle reduces concern levels and has high patient satisfaction. Chemodenervation of the contralateral healthy DLI muscle is a valid, practical treatment option.

OBJECTIVE: This article presents a case of ossifying fibroma (OF), including its diagnosis, treatment, and 15-month clinical and radiographic follow-up as well as a review of the literature about this pathology. CASE REPORT: A routine panoramic radiograph of a 27-year-old, systemically healthy, white woman revealed a radiolucent lesion with well-defined sclerotic margins of approximately 3 × 2 cm in the mandible. The histopathological diagnosis revealed it was an OF. Lower Right Canine and Lower Right First Premolar teeth were endodontically treated for later surgical removal of the tumor. There was no history of trauma in the region. CONCLUSION: OF is a benign fibro-osseous tumor of the craniofacial bones commonly involving the jaws, especially the mandible. The diagnosis is based on a combination of clinical, radiographic and histologic criteria. Conservative treatment is an effective option that reduces morbidity and simplifies postoperative rehabilitation. We emphasize the importance of properly documenting individual cases and interpreting postoperative radiographic images along with the patients in order to avoid possible confusion between areas of bone repair and of potentially suspicious lesions in the future.Key words: Surgery, Oral; Pathology, Oral; Fibroma, Ossifying Fibroma ossificante -diagnóstico, tratamento e acompanhamento: relato de caso e revisão da literatura RESUMO OBJETIVO: Este artigo apresenta um caso de fibroma ossificante (OF), incluindo seu diagnóstico, tratamento e acompanhamento clínico e radiográfico de 15 meses, bem como uma revisão da literatura sobre esta patologia. RELATO DO CASO: Uma radiografia panorâmica de rotina de uma mulher branca de 27 anos, sistemicamente saudável, revelou uma lesão radiolúcida com margens escleróticas bem definidas de aproximadamente 3 × 2 cm na mandíbula. O diagnóstico histopatológico revelou que era um FO. O Canino Inferior Direito e o Pré-Molar Inferior Direito foram tratados endodonticamente para posterior remoção cirúrgica do tumor. Não havia história de trauma na região. CONCLUSãO: O FO é um tumor fibro-ósseo benigno dos ossos craniofaciais que comumente envolve os ossos maxilares, especialmente a mandíbula. O diagnóstico é baseado em uma combinação de critérios clínicos, radiográficos e histológicos. O tratamento conservador é uma opção eficaz que reduz a morbidade e simplifica a reabilitação pós-operatória. Ressaltamos a importância de uma adequada documentação dos casos, bem como do esclarecimento sobre a evolução das imagens radiográficas pós-operatórias junto aos pacientes, de modo a evitar possíveis confusões entre as áreas de reparo ósseo e suspeitas de novas lesões no futuro.

Objective: To determine the impact of Burning mouth syndrome (BMS) on the quality of life of patients by means of the World Health Organization Abbreviated Instrument for Quality of Life Assessment (WHOQOL-26). Methods: A total of 116 patients were selected, 58 with BMS and 58 controls. Individuals with changes in the hemogram and in the blood levels of glucose, iron, folic acid and vitamin B 12 were excluded, as well as those who used antidepressant and/or anxiolytic drugs or who showed a salivary flow rate of less than 0.1 mL/min. Results: The overall score of the WHOQOL-26 was significantly lower in the group with the disorder (P<0.001). The patients with BMS also displayed significantly lower scores when compared to controls in relation to the psychological and physical domains of the instrument (P=0.005 and P<0.001, respectively). There was no significant difference between BMS and control patients with respect to scores of the social and environment domains. Conclusions: BMS interferes with the quality of life of patients in a negative way, and therefore, its management is a challenge for the clinicians, who should treat the individual with this disorder in a broader context.

No abstract