tissue necrosis in hiv-positive patient taking chemotherapy for acute lymphoblastic leukemia subtype...

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diagnostic aid of an intensier image to guarantee the precise location for foreign body removal, which proceeded uneventfully. This diagnostic method has the advantages of providing dynamic intraoperative images quickly and at varying angles. PE-316 - TISSUE NECROSIS IN HIV-POSITIVE PATIENT TAKING CHEMOTHERAPY FOR ACUTE LYMPHO- BLASTIC LEUKEMIA SUBTYPE 3: DENTAL APPROACH. CAROLINE ZIMMERMANN, LILIANE JANETE GRANDO, JOANITA ANGELA GONZAGA DEL MORAL, AIRA MARIA BONFIM SANTOS, LUCIANA GOULART MEDEIROS, CÍNTIA LOCKS, MARIA INÊS MEURER. UNIVERSIDADE FEDERAL DE SANTA CATARINA. Acute lymphoblastic leukemia (ALL) subtype 3 (Burkitts leukemia) is an aggressive cancer of B cells. It may be associated with human immunodeciency virus (HIV) infection, and its treatment can induce stomatotoxicity. Man, 33, with ALL subtype 3 and HIV infection started chemotherapy and antiretroviral treatment and developed grade II oral mucositis and necrotic ulcer in the mucosa that progressed to bone necrosis (anterior mandibular region, teeth #32 to #42). The dental measures adopted included antibiotic therapy based on culture of the necrotic bone, photodynamic therapy with low-power laser (red), mouthwash with chamomile iced tea during drug infusions, strict oral hygiene care, and subsequent bone surgery. The patient experienced some hospital stays, discharges, and readmissions, and ultimately passed away. Patients with ALL require highly complex treatment and a multidisciplinary approach. Hospital dental monitoring is essential to improve the patients quality of life through the use of preventive, curative, and palliative approaches. PE-317 - TOPICAL CLOBETASOL PROPIONATE ASSO- CIATED WITH ANTIFUNGAL IN THE TREATMENT OF SYMPTOMATIC ORAL LICHEN PLANUS. RONAIRO ZAIOSC TURCHIELLO, ARTHUR PIAS SALGUEIRO, MÁRCIA RODRIGUES PAYERAS, KÍVIA LINHARES FERRAZZO. FRANCISCAN UNIVERSITY CENTER - UNIFRA - SANTA MARIA/RS. Oral lichen planus is a chronic inammatory disease of autoimmune character and unknown origin. Erosive lichen planus can cause painful symptoms and manifest as atrophic erythema- tous areas with ulceration. Woman, 65, complained of burning mouth. Her medical history revealed hypertension and daily use of losartan. Intraoral and histopathological examination results were compatible with erosive oral lichen planus. Initial treatment with topical steroids (dexamethasone elixir) for 4 weeks produced a slight improvement. The drug was replaced by clobetasol pro- pionate (0.05%) plus nystatin, which led to a signicant reduction of lesions and pain in the rst week. Therapy was continued for more 3 weeks, until the disappearance of pain and most of the lesions. The patient is being followed up. Despite clobetasol being a potent topical corticosteroid and the rst-line treatment for oral lichen planus, total remission of lesions does not always occur. PE-318 - TRANSIENT LINGUAL PAPILLITIS RELATED TO FOOD ALLERGY. ANNA PAULA NIGRI, ALINE ARAÚJO SILVA, NATHÁLIA ALMEIDA, SARAH APARECIDA ANTERO, MARIA ELIZA BARBOSA RAMOS, ROSEMIRO DE MENEZES MACIEL, MÔNICA ISRAEL. UERJ. Transient lingual papillitis (TLP) is an inammatory condi- tion that has an uncertain pathogenesis and has been associated with several different factors. It affects the fungiform papillae of the tongue and is most common in women. White man, 30, described a burning sensation and pain on the lateral portion of the tongues dorsum present for about a week. The physical ex- amination revealed focally localized erythematous and hyper- trophied papillae. After a meticulous history was obtained, an association between food hypersensitivity and the patients clinical features was noticed. Because TLP has no precise pathogenesis, the history assumes a vital role in correlating symptoms and causation and is indispensable to reaching the correct diagnosis. PE-319 - TRAUMATIC DENTOALVEOLAR INJURY WITH TOOTH IMPACTION MIMICKING MIXED ODONTOGENIC LESION: CASE REPORT. CAROLINE SIVIERO DILLENBURG, JOSÉ LUÍS NICOLAU GHENO, MARCO ANTONIO TREVIZANI MARTINS, MANOELA DOMINGUES MARTINS, MARIA CRISTINA MUNERATO. HOSPITAL DE CLÍNICAS DE PORTO ALEGRE, UNI- VERSIDADE FEDERAL DO RIO GRANDE DO SUL. Man, 84, came to the stomatology service with a stula in the left submental region present for 6 months. He reported sponta- neous purulent drainage. Intraoral examination showed mild bone irregularity in the region of the lower alveolar ridge. The patient stated that at age 13 years he suffered a mule kick that caused chin trauma with multiple fractures and loss of teeth. Panoramic radiography indicated a mixed image with well-dened edges and central calcied spots surrounded by a radiolucent area measuring about 2.0 1.5 cm. Possible diagnoses included various odon- togenic lesions. Based on the clinical and radiographic charac- teristics, surgical exploration was performed and the lesion was excised. Several tooth fragments were removed, consistent with the history of traumatic dentoalveolar injury. Histopathological analysis showed chronic suppurative inammation. After surgery, the extraoral stula resolved completely. The patient continues to attend clinical and radiographic follow-up with no signs of recurrence. PE-320 - TRAUMATIC NEUROMA: REPORT OF TWO CASES. MARCOS ANTONIO NUNES COSTA SILAMI, DANIELLE RESENDE CAMISASCA, MARCIA DUARTE SOTHER, REBECA DE SOUZA AZEVEDO, SILVIA PAULA DE OLIVEIRA. ODONTOCLÍNICA CENTRAL DO EXÉRCITO (OCEX). Traumatic neuroma is a reactive lesion of neural origin that develops in a nerve bundle after trauma. In the repair process, axon growth occurs to reestablish neural connections, but sometimes a mass resembling an ordinary reactive lesion de- velops at the site of injury. Two cases of traumatic neuroma are reported. Woman, 61, had a white lesion associated with a mandibular removable partial denture clip in the alveolar mu- cosa corresponding to the inferior left canine. It was sensitive to touch. Man, 67, revealed multiple normochromic papules in the apical tongue present for 1 year. Sensitivity associated with smoking and drinking was present. In both cases, excisional biopsy was performed and the nal diagnosis was traumatic neuroma. No recurrences developed. The reported traumatic neuromas are common and show consistent symptoms, although the clinical presentation differs from the typical nodular pattern described. OOOO ABSTRACTS Volume 117, Number 2 Abstracts e193

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Page 1: Tissue Necrosis in HIV-Positive Patient Taking Chemotherapy For Acute Lymphoblastic Leukemia Subtype 3: Dental Approach

OOOO ABSTRACTS

Volume 117, Number 2 Abstracts e193

diagnostic aid of an intensifier image to guarantee the preciselocation for foreign body removal, which proceeded uneventfully.This diagnostic method has the advantages of providing dynamicintraoperative images quickly and at varying angles.

PE-316 - TISSUE NECROSIS IN HIV-POSITIVE PATIENTTAKING CHEMOTHERAPY FOR ACUTE LYMPHO-BLASTIC LEUKEMIA SUBTYPE 3: DENTAL APPROACH.CAROLINE ZIMMERMANN, LILIANE JANETE GRANDO,JOANITA ANGELA GONZAGA DEL MORAL, AIRA MARIABONFIM SANTOS, LUCIANA GOULART MEDEIROS,CÍNTIA LOCKS, MARIA INÊS MEURER. UNIVERSIDADEFEDERAL DE SANTA CATARINA.

Acute lymphoblastic leukemia (ALL) subtype 3 (Burkitt’sleukemia) is an aggressive cancer of B cells. It may be associatedwith human immunodeficiency virus (HIV) infection, and itstreatment can induce stomatotoxicity. Man, 33, with ALL subtype3 and HIV infection started chemotherapy and antiretroviraltreatment and developed grade II oral mucositis and necroticulcer in the mucosa that progressed to bone necrosis (anteriormandibular region, teeth #32 to #42). The dental measuresadopted included antibiotic therapy based on culture of thenecrotic bone, photodynamic therapy with low-power laser (red),mouthwash with chamomile iced tea during drug infusions, strictoral hygiene care, and subsequent bone surgery. The patientexperienced some hospital stays, discharges, and readmissions,and ultimately passed away. Patients with ALL require highlycomplex treatment and a multidisciplinary approach. Hospitaldental monitoring is essential to improve the patient’s qualityof life through the use of preventive, curative, and palliativeapproaches.

PE-317 - TOPICAL CLOBETASOL PROPIONATE ASSO-CIATED WITH ANTIFUNGAL IN THE TREATMENTOF SYMPTOMATIC ORAL LICHEN PLANUS. RONAIROZAIOSC TURCHIELLO, ARTHUR PIAS SALGUEIRO,MÁRCIA RODRIGUES PAYERAS, KÍVIA LINHARESFERRAZZO. FRANCISCAN UNIVERSITY CENTER -UNIFRA - SANTA MARIA/RS.

Oral lichen planus is a chronic inflammatory disease ofautoimmune character and unknown origin. Erosive lichen planuscan cause painful symptoms and manifest as atrophic erythema-tous areas with ulceration. Woman, 65, complained of burningmouth. Her medical history revealed hypertension and daily useof losartan. Intraoral and histopathological examination resultswere compatible with erosive oral lichen planus. Initial treatmentwith topical steroids (dexamethasone elixir) for 4 weeks produceda slight improvement. The drug was replaced by clobetasol pro-pionate (0.05%) plus nystatin, which led to a significant reductionof lesions and pain in the first week. Therapy was continued formore 3 weeks, until the disappearance of pain and most of thelesions. The patient is being followed up. Despite clobetasolbeing a potent topical corticosteroid and the first-line treatmentfor oral lichen planus, total remission of lesions does not alwaysoccur.

PE-318 - TRANSIENT LINGUAL PAPILLITIS RELATEDTO FOOD ALLERGY. ANNA PAULA NIGRI, ALINEARAÚJO SILVA, NATHÁLIA ALMEIDA, SARAHAPARECIDA ANTERO, MARIA ELIZA BARBOSA RAMOS,ROSEMIRO DE MENEZES MACIEL, MÔNICA ISRAEL.UERJ.

Transient lingual papillitis (TLP) is an inflammatory condi-tion that has an uncertain pathogenesis and has been associatedwith several different factors. It affects the fungiform papillae ofthe tongue and is most common in women. White man, 30,described a burning sensation and pain on the lateral portion ofthe tongue’s dorsum present for about a week. The physical ex-amination revealed focally localized erythematous and hyper-trophied papillae. After a meticulous history was obtained, anassociation between food hypersensitivity and the patient’sclinical features was noticed. Because TLP has no precisepathogenesis, the history assumes a vital role in correlatingsymptoms and causation and is indispensable to reaching thecorrect diagnosis.

PE-319 - TRAUMATIC DENTOALVEOLAR INJURYWITH TOOTH IMPACTION MIMICKING MIXEDODONTOGENIC LESION: CASE REPORT. CAROLINESIVIERO DILLENBURG, JOSÉ LUÍS NICOLAU GHENO,MARCO ANTONIO TREVIZANI MARTINS, MANOELADOMINGUES MARTINS, MARIA CRISTINA MUNERATO.HOSPITAL DE CLÍNICAS DE PORTO ALEGRE, UNI-VERSIDADE FEDERAL DO RIO GRANDE DO SUL.

Man, 84, came to the stomatology service with a fistula in theleft submental region present for 6 months. He reported sponta-neous purulent drainage. Intraoral examination showed mild boneirregularity in the region of the lower alveolar ridge. The patientstated that at age 13 years he suffered a mule kick that causedchin trauma with multiple fractures and loss of teeth. Panoramicradiography indicated a mixed image with well-defined edges andcentral calcified spots surrounded by a radiolucent area measuringabout 2.0 � 1.5 cm. Possible diagnoses included various odon-togenic lesions. Based on the clinical and radiographic charac-teristics, surgical exploration was performed and the lesion wasexcised. Several tooth fragments were removed, consistent withthe history of traumatic dentoalveolar injury. Histopathologicalanalysis showed chronic suppurative inflammation. After surgery,the extraoral fistula resolved completely. The patient continuesto attend clinical and radiographic follow-up with no signs ofrecurrence.

PE-320 - TRAUMATIC NEUROMA: REPORT OF TWOCASES. MARCOS ANTONIO NUNES COSTA SILAMI,DANIELLE RESENDE CAMISASCA, MARCIA DUARTESOTHER, REBECA DE SOUZA AZEVEDO, SILVIAPAULA DE OLIVEIRA. ODONTOCLÍNICA CENTRAL DOEXÉRCITO (OCEX).

Traumatic neuroma is a reactive lesion of neural origin thatdevelops in a nerve bundle after trauma. In the repair process,axon growth occurs to reestablish neural connections, butsometimes a mass resembling an ordinary reactive lesion de-velops at the site of injury. Two cases of traumatic neuroma arereported. Woman, 61, had a white lesion associated with amandibular removable partial denture clip in the alveolar mu-cosa corresponding to the inferior left canine. It was sensitive totouch. Man, 67, revealed multiple normochromic papules in theapical tongue present for 1 year. Sensitivity associated withsmoking and drinking was present. In both cases, excisionalbiopsy was performed and the final diagnosis was traumaticneuroma. No recurrences developed. The reported traumaticneuromas are common and show consistent symptoms, althoughthe clinical presentation differs from the typical nodular patterndescribed.