Aim: Keratocystic odontogenic tumor (KOT) is a benign odontogenic neoplasm with locally aggressive behavior and high recurrence rates. It is associated with nevoid basal cell carcinoma syndrome which usually has a more rapid growth. The aim of the study is to report the experience of our service on diagnosis and treatment of KOT. Materials and methods:Twenty-five cases of KOT were diagnosed between the years of 1989 and 2006. Demographic data was collected as well as diagnose and treatment.Results: Fifty-six percent were female with a mean age of 33 years old. Seventy percent occurred in mandibula and all received surgical treatment, associate or not with adjuvant therapy, such as cryotherapy and Carnoy's solution. Recidive was observed in 48% of cases with a mean period of time of 18 months. Conclusion:Our data analysis showed the importance of previous diagnosis before enucleation procedure and long-term follow-up for recurrence early detection. Recurrence incidence is more frequent on first year after diagnosis.Clinical significance: KOT is a benign tumor with local aggressive behavior and therefore its treatment must consider the high index of recidive. Reports of protocol treatment should raise new discussion to decrease recurrence rates.

Summary Introduction: Radiotherapy (RT) of head and neck neoplasms often damages the salivary glands. Aim: To examine the pattern of morphologic changes resulting from RT of the head and neck region in minipig parotid glands in a clinical and experimental research setting. Methods: Twelve 18-month-old male Brazilian minipigs weighing 30–40 kg were selected. Eight minipigs were assigned to the experimental group (group 1) and 4 to the control group (group 2). The RT was performed under general anesthesia at Erasto Gaertner Hospital, Curitiba, Brazil, using an á/â ratio of 2.5. The minipigs from group 1 underwent 3 sessions of irradiation with Cobalt 60 of the head and neck, bilaterally, with 3 exposures of 8 Gy each at 7-day intervals for a total dose of 24 Gy. The animals were sacrificed 12 weeks post-RT. Results: The irradiated parotid glands displayed reductions in the size and number of acini as well as loss of secretory granules. The presence of fibrosis and loss of parenchyma relative to non-irradiated glands were observed, with an average reduction in volume of 54%. Conclusions: Our results demonstrate that this model for parotid gland damage resulting from an RT regimen appears to be useful for preclinical large animal studies of RT-induced damage and testing novel potential treatment options. Although recent advances in radiation therapy, such as intensity-modulated radiation therapy, have reduced the dose and limited the field of radiation, considerable salivary gland injury still occurs and can greatly impact the patient's quality of life after cancer treatment.

ResumoO ameloblastoma é um tumor local invasivo que se origina do remanescente da lâmina dentinária e do epitélio odontogênico. O objetivo deste trabalho é apresentar um caso de ameloblastoma multicistico tratado com ressecção óssea ampla e reconstrução imediata que sofreu complicações pós-operatórias. Paciente do sexo masculino, 32 anos, foi atendido no Pronto-Socorro do Hospital e Maternidade do Município de São José dos Pinhais -PR relatando parestesia na região de mandíbula direita. No exame físico, observou-se tumefação indolor na região dos molares de coloração similar aos tecidos adjacentes. A radiografia panorâmica mostrava lesão radiolúcida multilocular em mandíbula direita, com aproximadamente 4 centímetros de diâmetro. Foi realizada biópsia incisional e o exame histopatológico foi compatível com ameloblastoma multicistico. O tratamento definitivo proposto foi ressecção ampla e reconstrução com enxerto de crista ilíaca. Após 60 dias, o paciente voltou relatando dor e edema na área operada. Na radiografia panorâmica observou-se deslocamento do enxerto no coto e do material de osteossíntese. Paciente informou ter sido preso nesse período e negligenciado os cuidados pós-operatórios. Foi programada nova intervenção cirúrgica. O enxerto não foi fixado novamente devido contaminação da região. O mesmo retornou após 1 semana sem os elásticos e referiu que não irá realizar o tratamento proposto. Cirurgias radicais geralmente acarretam aos pacientes sérias complicações. Entretanto, o ameloblastoma tem alta incidência de recidiva quando não removido adequadamente, tornando a ressecção cirúrgica do tumor, o tratamento de escolha para esse tipo de lesão. Porém, a adesão do paciente ao tratamento proposto é fator decisivo para controle efetivo da lesão e para a boa evolução do quadro. Descritores: Ameloblastoma; Unidade Hospitalar de Odontologia; Procedimentos Cirúrgicos Bucais. AbstractAmeloblastoma is invasive local tumor, that may arise from rests of the dental lamina and epithelial lining of a odontogenic cyst. The aim of this article is to present a case report of multicystic ameloblastoma treated with a broad bone resection followed by reconstruction that suffered postoperative complications. A 32-year-old male patient was treated at the Emergency Room of the Hospital and Maternity Hospital of the Municipality of São José dos Pinhais -PR, reporting paraesthesia in the right jaw region. At the physical examination, painless swelling was observed in the region of molars similar to adjacent tissues. The panoramic radiograph showed multilocular radiolucent lesion in the right mandible, approximately 4 centimetres in diameter. An incisional biopsy was performed and histopathological examination was compatible with multicystic ameloblastoma. The proposed definitive treatment was extensive resection and reconstruction with iliac crest graft. After 60 days, the patient returned to report pain and edema in the operated area. In the panoramic radiograph, graft displacement was observed in the stump and in the osteosynth...

No abstract