(1) Background: Hypersensitivity reactions to metals may arise in predisposed patients chronically exposed to metallic materials, including dental implants made of titanium alloys. The purpose of this article was to systematically review titanium allergy manifestations in patients treated with dental implants and report a clinical case; (2) Methods: A systematic electronic search was performed for articles published in the English language until July 2021. The following eligibility criteria were adopted: (1) Population: individuals undergoing titanium and/or titanium alloy implant-supported rehabilitations; (2) Exposure: peri-implant soft tissue reactions attributable to implant insertion; (3) Outcome: evidence of titanium allergy, diagnostic methods, and forms of resolution; (3) Results: The included studies, in summary, presented evidence that titanium should not be considered an inert material, being able to trigger allergic reactions, and may be responsible for implant failure. A 55-year-old male patient received 3 implants in the posterior region of the left mandible and presented an epulis-like lesion developed from the peri-implant mucosa. The immunohistochemical analysis of the biopsy specimen confirmed the initial diagnosis of allergic reaction to titanium; (4) Conclusions: Although the evidence is weak, and titanium allergy has a low incidence, hypersensitivity reactions should not be underestimated. A rapid and conclusive diagnosis is mandatory to prevent further complications.

Oral desmoplastic melanoma mimicking inflammatory hyperplasiaIntroduction: Desmoplastic melanoma (DM) arising in the oral cavity is a rare neoplasm that may be confused with a variety of non-melanocytic benign or malignant lesions. Objectives: To present a case of DM in the oral mucosa mimicking fibrous inflammatory hyperplasia, discusses the difficulties involved in the diagnosis and offers a literature review on the clinicopathologic and immunohistochemincal aspects of this neoplasm. Case report: A 62-year-old white male, smoker, was referred with a chief complaint of pain and swelling in the palate. The oral examination revealed multiple brown-to-black patches and a non-pigmented sessile nodule located on the mucosa of the hard palate. The clinical diagnosis of the pigmented lesions was either oral melanosis or melanoma. The nodular lesion was clinically diagnosed as fibrous inflammatory hyperplasia. Incisional biopsy was performed on the pigmented lesion and the microscopic sections revealed a melanotic macule. The nodular lesions histologically revealed an amelanotic desmoplastic melanoma. Conclusions: Reactive lesions close to a pigmented area should be investigated with great care.

No abstract

Introduction: Ameloblastoma is a locally invasive, slowly growing odontogenic epithelium, which can reach large proportions. It is preferentially located in the region of mandibular molars. The most indicated treatment is resection with safety margin, since its potential for recurrence is high. Objective: To report a case of recurrence the ameloblastoma. Case report: A 60-year-old female patient came to the hospital with difficulty speaking and eating because of the mass inside the mouth and earaches. The extra-buccal physical examination had an increase in volume in the jugal and right temporal regions. At the intra-buccal physical examination there was a nodule approximately 5X6X7 cm, firm at palpation with normal overlying mucosa in color and continuity. The patient reported that 30 years ago she had undergone a surgical procedure to remove an ameloblastoma in the region of the right mandibular body. Imaging revealed a wide extension of the lesion, extending from the symphysis to the cranial base, in the middle cranial fossa region. Previous incisive biopsy revealed the diagnosis of follicular ameloblastoma. Conclusion: Ameloblastoma should be followed for a long period of time because it is a locally infiltrative benign neoplasm that, even when treated with surgery and safety margin, may recur late. The approach taken was the removal of the lesion associated with mandibular reconstruction.

O cementoblastoma é uma neoplasia odontogênica benigna, rara, responsável por 1% dos tumores odontogênicos. A localização mais comum é a região do primeiro molar inferior. Ela afeta principalmente a segunda e terceira décadas de vida, com crescimento lento, pode causar abaulamento cortical. Radiograficamente apresenta-se como uma lesão radiopaca, circunscrita por uma fina área radiolúcida, envolvendo a raiz dentária. Histologicamente, pode-se observar uma massa mineralizada, com aspecto cementóide, aderida às raízes do dente. Casos que apresentam expansão da cortical óssea aos exames clínico e imaginológico requerem tratamento cirúrgico por meio da curetagem da lesão e remoção do elemento dentário associado. Paciente do sexo feminino, leucoderma, 30 anos, procurou atendimento sem queixa de dor, apresentando abaulamento do osso cortical na região inferior esquerda do primeiro molar. Exames de imagem mostraram lesão radiopaca associada à raiz do elemento dentário 36, circunscrita com halo radiolúcido. A tomografia computadorizada mostra uma massa radiopaca na região apical do elemento. Biópsia excisional e exodontia do dente 46 foram realizadas. Material foi enviado para análise histopatológica e o diagnóstico foi cementoblastoma. A paciente está em proservação.Descritores: Diagnóstico; Neoplasias; Tumores Odontogênicos.