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Adenoid cystic carcinoma (ACC) is a malignant epithelial tumor of the salivary glands that commonly affects the minor salivary glands, and the palate is the most recurrent site. Treatment is challenging because this tumor tends to recur with distant metastases and poor prognosis. A 50-year-old woman complained of numbness in the upper left hemimaxilla, extended to the labial region, nose wing, and nasolabial sulcus, with clinical intra-oral alterations similar to an endodontic fistula tooth 25 palatal mucosa and discrete periapical rarefaction on radiologic evaluation. Endodontic treatment was provided with laser therapy administered for persistent numbness. After 3 months a palate volume increase and small ulcerated region were noted encompassing the region of teeth 24 to 27. The panoramic and tomographic examination was performed showing extensive bone destruction, and the patient underwent a biopsy followed by microscopic and immunohistochemistry evaluation and diagnosis as ACC. The patient was forwarded to a head and neck surgeon.

Objective: Define prevalence of radiolucent periapical lesions (RLP) in patients with primary Sjogren syndrome (SSP) and characterize the teeth associated with RLP. Methods: The radiographs were analyzed using Image J software by a radiologist. A socioeconomic questionnaire was applied. The salivary flow was evaluated through the collection of nonstimulated saliva. Mean and standard deviation (SD) for the quantitative variables and absolute and relative frequency of the qualitative variables was calculated. The χ2 test (95% CI) compared the difference between proportions of the qualitative variables, and the Student t test compared means of quantitative variables between patients with and without periapical lesions. Results: All 24 patients were female, aged between 20 and 71 years, with xerostomia, and 80% had hyposalivation. At least 1 RLP was found in 70.8% of patients. The mean number of teeth per patient was 23.3 ± 3.1 with a prevalence of RLP in the teeth of 7.86% of patients. The teeth with RLP had a higher percentage of root-fillings and caries located more in the central superior sextant (P

This study reported a clinical case about the use of salmon calcitonin in treatment of cherubism. A 12-year-old male melanoderm patient had bilateral expansion of the mandible and maxilla firm by palpation. The sclera below the iris showed the "look to the sky" classic description. The intrabuccal examination showed diastema, crowding, dental absences, and mobility of the lower central incisors. The radiologic examination showed multilocular radiolucent lesions in the maxillary tuberosities, paranasal region, and entire mandible, except the condyle. The treatment consisted of the daily administration of salmon calcitonin 200 UI nasal spray. Biochemical markers of calcium, phosphorus, and parathyroid remain within the reference values, while alkaline phosphatase has been elevated throughout the treatment. After 30 months of therapy, stabilization of the active bone lesion was observed without remission. The child is under periodic clinical and radiographic follow-up to evaluate the long-term therapy.

Gardner syndrome (GS) is an autosomal dominant disease characterized by adenomatous intestinal polyps, and if not treated, shows a great chance of becoming malignant. Multiple osteomas in the skull, maxilla, and mandible, along with multiple cutaneous and subcutaneous masses are also characteristics of GS. A 30-year-old woman reported an epidermoid cyst on the frontal bone and a scar on the left shoulder due to osteoma removal. Tooth absence, malocclusion, and osteoma in the palatal region were observed in the intraoral exam. A panoramic radiography analysis revealed permanent teeth retention, supernumerary teeth, and radiopaque areas suggestive of osteomas. Although there were Gardner syndrome manifestations, only after our evaluation, a colonoscopy examination was ordered and intestinal polyps were removed with a diagnosis of tubular adenoma with low grade dysplasia. Today, the patient is under follow-up with a gastroenterologist and oral and maxillofacial surgeons, orthodontists, and stomatology experts with a common goal of function, esthetic, and quality of life improvements.

Osteolipoma is an extremely rare histologic variant of lipoma that contains mature lamellar bone. We report a case of a 27-year-old man with history of a small, rounded lesion in the right cheek that started in childhood, without symptomatology, but with continuous growing. On the examination, facial asymmetry was observed, without lymph node enlargement. A firm nodule of about 2.5 cm was seen involving his right buccal mucosa. A panoramic radiograph showed radiopaque irregular shapes in the region of the first upper and lower right molars. The lesion was excised, and pathologic examination of the specimen showed fragments of trabecular bone between adipocytes. Definitive pathologic diagnosis was osteolipoma. There was no recurrence at 7 months’ follow-up. Although osteolipoma is very rare, it is important to keep it in the differential diagnosis of nodules with a firm consistency in the oral mucosa and when noting a radiopaque image on panoramic exam.

Objective To determine whether the use of a metal artifact reduction (MAR) algorithm improves the detection of peri-implant fenestrations and dehiscences on cone beam computed tomography scans. Study Design One hundred titanium fixtures were implanted into bovine ribs after the creation of defects simulating fenestrations and dehiscences. Images were acquired using four different protocols, namely, A2 (MAR on, voxel 0.2 mm), A3 (MAR on, voxel 0.3 mm), B2 (MAR off, voxel 0.2 mm), and B3 (MAR off, voxel 0.3 mm). For all protocols, receiver operating characteristic (ROC) curves were determined. Values for the areas under the ROC curves (Az) were subjected to analysis of variance. Results Az values were not statistically different among protocols regardless of the defect type ( P > .05). Conclusions The MAR algorithm tested by us did not improve the diagnosis of peri-implant fenestrations and dehiscences with use of either the 0.2 mm or the 0.3 mm voxel sizes.

To investigate whether cone beam computed tomography filters would improve periimplant dehiscence detection.A hundred titanium implants were placed in bovine ribs in which defects simulating periimplant dehiscence had previously been created. After images acquisition, three oral radiologists assessed them with and without the following filters: Angio Sharpen high 5 × 5, Shadow, Sharpen 3 × 3, Sharpen Mild, and Smooth. The McNemar test verified the disagreement between all images versus the reference standard and original images versus images with filters; P.05 was considered statistically significant.Dehiscence detection using the original images and the Shadow filter disagreed from the reference standard (P.05), as well as when using the filters instead of the original images (P.05).All the filters tested, with the exception of the Shadow, improved periimplant dehiscence detection. The Sharpen 3 × 3 filter was considered best for this task.