ORAL AND MAXILLOFACIAL PATHOLOGY OOOO

e152 Abstracts February 2014

PE-101 - DENTAL MANAGEMENT OF PATIENTS WITHTOXIC EPIDERMAL NECROLYSIS: CASE REPORTS. DAVISILVA CARVALHO CURI, ANDRÉ LUCAS D ALMEIDALYRIO DOS SANTOS, THAMIRES SILVA SOUZA,PATRÍCIA LEITE RIBEIRO LAMBERTI, ANTÔNIOFERNANDO PEREIRA FALCÃO, VINICIUS RABELOTORREGROSSA, VIVIANE ALMEIDA SARMENTO. FED-ERAL UNIVERSITY OF BAHIA.

Rare and extremely serious, toxic epidermal necrolysis(TEN) usually comes as a hypersensitivity response to drugadministration. Affecting more than 30% of the body surface, thisdisease has a high rate of morbidity and mortality. The oralmucosa is frequently affected, requiring participation of the sto-matologist on the multidisciplinary team that assists the patient.Two cases of patients with TEN were admitted to the intensivecare unit of the Hospital of the Federal University of Bahia,Salvador, Bahia, Brazil. Woman, 22, had taken antibiotic, anti-inflammatory, and analgesic treatment for 2 days and haddisseminated erythematous rash that developed into painful blis-ters. Young woman, 17, came after a month of using an anti-convulsant treatment and had bullous lesions and diffuse painfulsores on the lips and oral mucosa. The role of the dental team waspresented and discussed.

PE-102 - DENTAL TWINNING OF MAXILLARY CEN-TRAL INCISORS ASSOCIATEDWITH AGENESIS OF THEHOMOLOGOUS TOOTH: CASE REPORT. CAROLINEFARIAS LEMOS, LUCIANA DUARTE CALDAS,BERNARDO FERREIRA BRASILEIRO, MARTA RABELLOPIVA, NAYANE CHAGAS CARVALHO. UNIVERSIDADEFEDERAL DE SERGIPE.

Dental anomalies are common but very important alterationsoccurring in dental practice. Early detection of these anomaliescan significantly affect the prognosis of the affected teeth. Twoexamples are agenesis and twinning, which are characterized,respectively, by the congenital absence of a tooth germ and bytwo teeth attempting to develop from a single germ cell. Twinnedteeth, often incisors, have a large bifid clinical crown, a singleroot, and a single root canal. However, besides compromisingaesthetics, given the presence of a diastema, these teeth causemesiodistal discrepancies between the upper and lower teeth thatcause dental malocclusion. Boy, 12, had twinning of teeth #11and #21 plus agenesis of the homologous tooth. The occlusalchanges generated by the presence of these abnormalities and themultidisciplinary treatment employed in this case are alsodescribed.

PE-103 - DENTIGEROUS CYST INVOLVING MULTIPLEPERMANENT TEETH: REPORT OF AN UNUSUALCASE. AMANDA LUCIO DO Ó SILVA, TONY SANTOSPEIXOTO, ROBERIA LÚCIA DE QUEIROZ FIGUEIREDO,JOZINETE VIEIRA PEREIRA, PATRÍCIA MEIRA BENTO,GUSTAVO PINA GODOY, CASSIANO FRANCISCOWEEGE NONAKA. UNIVERSIDADE ESTADUAL DAPARAÍBA.

Dentigerous cyst (DC) is a developmental odontogeniccyst that encloses the crown of an unerupted tooth at thecementoenamel junction. DCs most often develop in associa-tion with mandibular third molars and maxillary canines.Involvement of multiple permanent teeth by DC is unusual,

with only a few reported cases. Young woman, 13, wasreferred for evaluation of a painless swelling in the leftmaxilla. Intraoral examination disclosed persistence of decid-uous teeth #51, #52, and #53. Panoramic radiographs andcomputed tomography showed a large cystic lesion involvingimpacted permanent teeth #11, #12, and #13. Dentigerouscyst was provisionally diagnosed, prompting an incisionalbiopsy. Histopathological examination revealed a cystic cavitylined by thin, non-keratinized stratified squamous epitheliumwithout rete ridges. The fibrous capsule exhibited hemorrhagicareas and discrete inflammatory infiltrate. A definitive diag-nosis of dentigerous cyst was made, and total enucleation ofthe lesion was performed. The patient remains under closefollow-up.

PE-104 - DENTINOGENESIS IMPERFECTA: FAMILYCASE. VIVIANE PALMEIRA DA SILVA, JULIANAANDRADE CARDOSO, SUELLEN DA GUARDA, MARIAPALMA BARRETO, ARIANA GONÇALVES CARNEIRO,JENER GONÇALVES DE FARIAS. UNIME.

Dentinogenesis imperfecta is considered a developmentalgenetic disorder of dentin that can occur with no systemicalteration. This autosomal-dominant disorder can be causedby mutations in the dentin sialophosphoprotein gene (DSPP).The diagnosis must be made carefully and with close atten-tion to detail because of the difficulty differentiating it fromother anomalies. Therefore the authors present a brief litera-ture review and report on the diagnostic method of a family’scase of dentinogenesis imperfecta, discussing the clinical,radiographic, epidemiologic, and differential diagnostic vari-ables.

PE-105 - DENTOFACIAL CHANGES OF NOONANSYNDROME: REPORT OF TWO CLINICAL CASES.CAROLINE FARIAS LEMOS, LUCIANA DUARTE CALDAS,BERNARDO FERREIRA BRASILEIRO, NAYANE CHAGASCARVALHO, MARTA RABELLO PIVA. UNIVERSIDADEFEDERAL DE SERGIPE.

Noonan syndrome (NS) is a dominant autosomal geneticsyndrome that affects both genders with an estimated incidenceranging from 1:1000 to 1:2500. It is an important differentialdiagnosis in patients with short stature, facial dismorphism,delayed puberty, and cryptorchidism. Among the facialchanges typical of NS patients are ocular hypertelorism, eyelidptosis, external palpebral fissure diverted downward, low im-plantation and incomplete rotation of the auricle, mandibularmicrognathia, short and webbed neck, and a triangular-shapedface. Dental changes include maxillary atresia, which hindersproper tongue positioning, often causing posterior crossbiteand occasionally anterior open bite. Moreover, because ofmandibular micrognathia, these patients present with AngleClass II malocclusions. Two cases of SN patients are presentedalong with a description of their similarities in terms of den-tofacial changes and the therapeutic procedures adopted foreach case.

PE-106 - DERMOID CYST WITH EVOLUTION OF 30YEARS IN SUBLINGUAL REGION: CASE REPORT.RAFAEL FERANDES DE ALMEIDA NERI, CAETANOGUILHERME CARVALHO PONTES, CLARISSE SAMARA

OOOO ABSTRACTS

Volume 117, Number 2 Abstracts e153

DE ANDRADE, DIEGO TOSTA SILVA, VIVIANE ALMEIDASARMENTO, ROBERTO ALMEIDA DE AZEVEDO,BRAULIO CARNEIRO JÚNIOR. UNIVERSIDADE FED-ERAL DA BAHIA.

Dermoid cyst is a rare entity and it is characterized byepithelium surrounded by adnexal structures, with numeroussebaceous glands, sweat glands, hair follicles or nails.Woman, 36, had a sublingual lesion of 30 years’ duration thatwas causing tongue elevation and speech and swallowingproblems. Surgical removal via intraoral access was achieved,and histopathological analysis revealed dermoid cyst. Thepatient is now 6 months past her surgery. The clinical, im-aging, and pathological aspects were discussed along withthe surgical treatment. When the supramylohyoid region isinvolved, dermoid cyst can cause tongue movement andphonetic and airway problems. Its treatment consists of sur-gical removal.

PE-107 - DESMOPLASTIC FIBROBLASTOMA (COLLAG-ENOUS FIBROMA): CASE REPORT AND IMMUNOHIS-TOCHEMICAL STUDY. MILENA RAYANE DE ANDRADETEIXEIRA, MARIA CÁSSIA FERREIRA DE AGUIAR,GUSTAVO PINA GODOY, DALIANA QUEIROGA CASTROGOMES, JOZINETE VIEIRA PEREIRA, TONY SANTOSPEIXOTO, POLLIANNA MUNIZ ALVES. UNIVERSIDADEESTADUAL DA PARAÍBAeUEPB.

Desmoplastic fibroblastoma is a rare benign neoplasm ofthe oral cavity usually found in subcutaneous and muscletissue. The literature reports only seven cases. Woman, 20,had an asymptomatic nodular lesion of the right buccalmucosa measuring about 2.5 cm. It showed evidence ofsubmucosal implantation and rubbery consistency. The pre-liminary diagnosis was dermal cyst. An excisional biopsywas done, and microscopy revealed benign mesenchymalneoplasm hypocellularized with scant fibroblasts of varyingformats immersed in a highly collagenous stroma and with alight inflammatory infiltrate peripherally. Immunohistochem-ical analysis was positive for AML, factor XIIIa, and CD68but negative for S-100. The histopathological diagnosis wasdesmoplastic fibroblastoma. The patient has been disease-freefor 8 months with no sign of recurrence. The development ofthis rare lesion in the oral cavity demonstrates the need tocarefully formulate a correct diagnosis leading to appropriatetreatment.

PE-108 - DIAGNOSIS OF SECONDARY SYPHILISTHROUGH ORAL LESIONS IN A PATIENT WITHOUTHUMAN IMMUNODEFICIENCY VIRUS INFECTION.BRUNA LAVINAS SAYED PICCIANI, VANESSA DE CARLABATISTA DOS SANTOS, FELIPE LEAL MANHÃES DE SÁ,DANIELA OTERO, KARIN GONÇALVES SOARES CUNHA,ARLEY SILVA JÚNIOR, ELIANE PEDRA DIAS. UNI-VERSIDADE FEDERAL FLUMINENSE.

Syphilis is a sexually transmitted infection caused by Trep-onema pallidum. Oral lesions can be the first clinical manifesta-tion. Particularly in human immunodeficiency virus (HIV)�positive individuals, false-negative serologic tests and delayeddiagnosis of syphilis may occur. This study presents a case ofsyphilis in non-HIV�infected patient who was diagnosed throughoral lesions. Woman, 29, complained of oral lesions present for

1 month. Laboratory tests were negative for VDRL, FTA-ABSand HIV. Extraoral examination was normal; the oral examinationrevealed erythematous patches on the labial and buccal mucosa.An incisional biopsy of the buccal mucosa was performed and anew VDRL test requested. Histopathological evaluation sug-gested syphilis, and the VDRL test was positive. After treatment,the oral lesions resolved completely. This case demonstrated thechallenge of making a syphilis diagnosis in non-HIV�positivepatients and the importance of oral manifestations in making thediagnosis.

PE-109 - DIAGNOSIS OF UNICYSTIC AMELO-BLASTOMA AFTER JAW FRACTURE IN A PEDIATRICPATIENT. HANNA JANYNE MEIRA E. MELLO LUIZANTONIO PORTELA GUERRA, ALÍPIO MIGUEL DAROCHA NETO, PRISCILLA FLORES SILVA, LUCASALEXANDRE DE MORAIS SANTOS, VANESSA DECARVALHO MELO, FÁBIO LUIZ NEVES GONÇALVES.FACULDADE DE ODONTOLOGIA DE PERNAMBUCO- UPE.

The progressive expansion of cortical cone caused by intra-bony lesions can lead to pathological bone fracture. Boy, 11, wasseen after he suffered a cycling accident and was complaining ofpain and dental malocclusion. Clinical examination showed facialasymmetry due to a hardened swelling of the jaw, pronouncedmobility, and absence of the second mandibular molar on thesame side. Panoramic radiography and computed tomographyshowed ectopic inclusion of the second and third molars dis-placed by a radiolucent unilocular lesion in the mandibular bodyand ramus with loss of bone continuity. Because of the fracture,excisional biopsy and removal of the associated teeth was per-formed under general anesthesia, followed by bone fixation withtitanium plates. Histopathological diagnosis was consistent withunicystic ameloblastoma. After 1 year of follow up, the patientwas asymptomatic, with stable occlusion and no signs of facialasymmetry. The control radiograph demonstrates satisfactorybone healing.

PE-110 - DIAGNOSTICALLY CHALLENGING CLEARCELL ODONTOGENIC CARCINOMA. LIA PONTESARRUDA PORTO, MARCUS MELLO BORBA, LUCIANAMARIA PEDREIRA RAMALHO, CARINA MAGALHÃESESTEVES DUARTE, SUZANA CANTANHEDE ORSINIMACHADO DE SOUSA, JEAN NUNES DOS SANTOS,FLÁVIA CALÓ DE AQUINO XAVIER. FEDERAL UNIVER-SITY OF BAHIA.

Clear cell odontogenic carcinoma (CCOC) is an aggressiveodontogenic tumor with distinctive behavior. Woman, 27, had anasymptomatic swelling on the left side of the mandible of3 months’ duration. Intraorally the lesion showed lingual-vestibular expansion but no mucosal ulceration. Orthopanto-mography showed an osteolytic radiolucence in the molar areaextending to the anterior region. Samples from an incisional bi-opsy analyzed histologically showed malignant epithelial islandsrich in clear cells in a collagenous and hyaline stroma, consideredto be carcinoma. The patient underwent hemimandibulectomywith left neck dissection. Immunohistochemical analysis waspositive for AE1/AE3, EMA, CK7, CK8, CK14, CK18, CK19,and S-100 and negative for TTF-1, CEA, Cerb B-2, vimentin,GFAP, CK10, and CK20. Histological and immunohistochem-ical correlations suggested CCOC. Adjuvant radiotherapy and