Evandro Guimarães de Aguiar

Denture stomatitis presents as a chronic disease in denture-bearing patients, especially under maxillary prosthesis. Despite the existence of a great number of antifungal agents, treatment failure is observed frequently. Propolis, a natural bee product, possesses well-documented antifungal and anti-inflammatory activities. The purpose of this study was to evaluate the clinical efficacy of a new Brazilian propolis gel formulation in patients diagnosed with denture stomatitis. Thirty complete-denture wearers with denture stomatitis were enrolled in this pilot study. At baseline, clinical evaluation was performed by a single clinician and instructions for denture hygiene were provided. Fifteen patients received Daktarin (Miconazole gel) and 15 received Brazilian propolis gel. All patients were recommended to apply the product four times a day during one week. Clinical evaluation was repeated by the same clinician after treatment. All patients treated with Brazilian propolis gel and Daktarin had complete clinical remission of palatal edema and erythema. This new Brazilian propolis gel formulation had efficacy comparable to Daktarin and could be an alternative topical choice for the treatment of denture stomatitis.

This study evaluated the susceptibility of oral pathogenic microorganisms Candida albicans, Streptococcus mutans, Staphylococcus aureus, and Aggregatibacter actinomycetemcomitans to Brazilian medicinal plant extracts of Schinus terebinthifolius (aroeira), Croton campestris (velame), Lafoensia pacari (pacari), Centaurium erythraea (centáurea), Stryphnodendron adstringens (barbatimão), and Anacardium humile (cajuzinho-docerrado), as compared to standardized antimicrobial agents (nystatin, chloramphenicol and tetracycline hydrochloride). Ethanol, hexane and butane fractions from stem barks, rinds, leaves, and/or roots were extracted and tested. Antimicrobial diffusion agar test and MIC were performed according to CLSI. After 24 h of incubation at 37 °C, the diameter of inhibition zones and spectrophotometer readings were measured and compared. The results were reported as means ± standard deviation (M ± SD). With the exception of five extracts that showed no antimicrobial activity, all the extracts tested showed antimicrobial activity, in different levels. This study suggests that extracts from the plants tested could be an alternative therapeutic option for infectious conditions of the oral cavity, such as denture stomatitis, dental caries, and periodontitis.

Oral Myiasis is a rare pathology in humans and is associated with poor oral hygiene, alcoholism, senility, suppurating lesions, severe halitosis and others conditions. The treatment is a mechanical removal of the maggots one by one but a systemic treatment with Ivermectin, a semi-synthetic macrolide antibiotic, have been used for treatment for oral myiasis. We present a case report of a 32-year-old man indigent, alcohol-dependent with an extensive necrotic area and acute swelling in upper lip and fetid odor. The patient's management included topic use of gentian violet, oral therapy with ivermectin (6 mg orally), surgical exploration to remove the larvae and necrotic tissue. After the complete larvae removal the swelling and the wounds were healing normally, the patients was referred to plastic surgery to repair tissue damage. The prevention of human myiasis is by education, but unfortunately in the developing countries some people live in low social condition, predisposing the occurrence of the infestation.

Tonsillolith is a rare dystrophic calcification as a result of chronic inflammation of the tonsils. Three asymptomatic cases of tonsillolith are reported, incidentally discovered through panoramic radiographs, which showed different sizes of radiopaque images, varying from 2 to 5 mm; cases I and III images did not overlap the mandible ramus, which led to a probable diagnosis of soft tissue calcification. Case II had radiopaque unilateral images, with osseous tissue density, overlapping the mandibular ramus, leading to a benign intra-osseous lesion, which was considered as differential diagnosis. No symptoms were reported in any case. Only case I had clinical characteristics, showing highly consistent white plaques partially visible through the mucosa. Computed tomography of the maxillofacial region/head and neck were requested to find out the exact location of these images, since most of the overlapping radiopaque images in the mandibular ramus were very similar to intra-osseous abnormalities. The computed tomography showed hyperdense images in the palatine tonsils, confirming the diagnosis of tonsillolith. The patients are currently under follow-up. No treatment is required if there is no symptom. In conclusion, tonsillolith might show images on panoramic radiographs similar to intra osseous abnormalities. The diagnosis is relatively easy when computed tomography is requested, although the images are not pathognomonic. Therefore, clinicians should consider other pathologies as differential diagnosis.