Introduction: Brown tumor is a focal lesion of giant cells that develops in association with hyperparathyroidism. Objective: To report a case of brown tumor that occurred in the mandibular symphysis region, associated with secondary hyperparathyroidism. Case report: A 45-year-old male patient with chronic renal failure exhibited increased volume with comorbid local paresthesia in the mandibular symphysis region. Radiographs showed a unilocular radiolucent area with partially defined edges in the anterior mandible region. The histopathological findings revealed connective tissue, rich in oval, notched cells and giant cells with hemosiderin pigments. Laboratory tests showed increased serum levels of parathyroid hormone. An attempt to control the hormone levels with medication while the patient awaited a kidney transplant was unsuccessful. Therefore, as a transplant was not imminent and injury continued to develop, the lesion was surgically excised. Three years later, the lesions recurred in the paranasal region. Following partial removal of the lesions, the patient is now under follow-up care. Conclusion: Correct diagnosis and effective treatment of brown tumor requires correlation of biochemical data with the patient's clinical, imaging, and histological profile.

Introduction: Oral implants rehabilitation has increased in the recent years. In order to reduce failures, some studies have been published pointing the risk factors and using antibiotic prophylaxis as an alternative to prevent infections in patients submitted to implant surgery, despite the fact it is still controvertial in the literature. Objective: Answer the following question: "Does antibiotic prophylaxis reduce the rates of postoperative infection or implant loss?" Methodology: Only randomized controlled clinical trials which analyzed implant loss or postoperative infection in patients undergoing surgery for single or multiple implants, without graft association, were selected. Results: Four randomized controlled trials were included. A total of 827 patients and 1.320 implants were used. The studies had different surgical approaches. Two of them showed multiple implant surgeries and the other two showed single implants. The first parameter assessed was the presence of postoperative complications, which were different between groups. Pain was the parameter present in all of them; The second parameter was implant stability which was evaluated by the studies around the 4 th month after surgery, using mobility as the main criteria of implant loss, although other criteria have been used in association. All studies evaluated the administration of amoxicillin 1h prior to the surgery and a placebo group. The most used protocol was 2 g of amoxicillin (3 studies); only one study used 3g of amoxicillin. This review was submitted to a meta-analysis of three parameters: implant survivor after a minimum period of 2 months, rate of postoperative infection per patient and rate of postoperative infection per implant. The results showed that there were no statistically significant differences between the groups. Conclusion: There is still no consistent evidence that antibiotic prophylaxis plays a beneficial role in preventing postoperative infections.

INTRODUÇÃO: O uso de antibióticos em Implantodontia é amplamente empregado a fim de prevenir a infecção pós-operatória e perda do implante. No entanto, sua necessidade e eficácia não são consensuais na literatura. OBJETIVO: estre trabalho visa verificar a necessidade de profilaxia antibiótica em pacientes submetidos à cirurgia de implantes osseointegrados. MATERIAIS E MÉTODOS: buscou-se publicações sobre a temática nas bases de dados LILACS, SCIELO e PUBMED, nos idiomas português e inglês. RESULTADOS: a análise de literatura mostrou que a profilaxia antibiótica está indicada para pacientes com risco de endocardite infecciosa, imunodeprimidos, quando sítio cirúrgico esteja previamente infectado, em procedimentos extensos que necessitem de grande quantidade de implantes e/ou uso de biomateriais. Os ensaios clínicos randomizados publicados na literatura não têm padronização na metodologia, tipo de antibiótico, protocolos de posologia, procedimentos envolvidos, quantidade de implantes instalados por paciente, controle e falta de padronização dos operadores, que dificulta estabelecer um protocolo. CONCLUSÃO:o índice de sucesso dos implantes osseointegrados não está associado com a prescrição pré ou pós-operatória de antibióticos, mas sim com a correta indicação, planejamento, adequada técnica cirúrgica e aos procedimentos pré e pós-cirúrgicos eficientes. A profilaxia antibiótica deve ser indicada para pacientes que possuam alguma condição sistêmica que justifique seu uso. Em pacientes saudáveis, deve ser realizada uma rigorosa assepsia local, correta manipulação dos tecidos e utilização de técnica adequada para proporcionar ao paciente um excelente pós-operatório e igualmente, sucesso no tratamento.

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