ORAL AND MAXILLOFACIAL PATHOLOGY OOOO

e142 Abstracts February 2014

biopsy was done with a safety margin of tissue having normalclinical appearance. It is unusual to develop a recurrence of basalcell carcinoma when they are treated properly and metastases arerare. In patients whose disease invades vital structures, cancerspread is uncontrollable and the result is death, but this is an un-usual situation because of the current advances in early diagnosis.

PE-049 - BILATERAL MANDIBULAR PREMOLARS WITHTOOTH SHAPE DEVIATION. GILLIENE BATISTAFERREIRA DA COSTA, ROBERTA NATALIE DE ANDRADESANTOS, FLÁVIA MARIA DE MORAES RAMOS-PEREZ,JUREMA FREIRE LISBOA DE CASTRO, DANYEL ELIASDA CRUZ PEREZ. UNIVERSIDADE FEDERAL DEPERNAMBUCO.

Tooth shape deviations are a rare dental anomaly described inpremolars and are characterized by simultaneous increasedmesiodistal and decreased buccolingual dimension compared withother normal teeth. Man consulted the dentist with a complaintof misaligned teeth and requested orthodontic evaluation. Afteranalysis of the plaster study models, it was noted that bothmandibular first premolars presented a crown with an irregularshape (tooth shape deviation), larger mesiodistal measurement(11 mm), and discreetly smaller buccolingual measurement(8 mm) than the conventional premolars. Teeth are susceptible todevelopmental alterations, which may be primary or arisesecondarily because of environmental influences. Along with al-terations in size and shape, tooth shape deviation can also occur.These deviations alter the arch perimeter, leading to retention ofthe permanent canines and tooth crowding.

PE-050 - BILATERAL MULTIFOCAL CANALICULARADENOMA OF THE UPPER LIP. REPORT OF TWOCASES. CARLA SILVA SIQUEIRA, KARIN SÁ FERNANDES,ANA PAULA MOLINA VIVAS, DÉCIO DOS SANTOS PINTO-JÚNIOR, SUZANA CANTANHEDE ORSINI MACHADO DESOUSA. UNIVERSIDADE DE SÃO PAULO.

Canalicular adenoma is an uncommon benign salivary glandtumor that mostly occurs in the upper lip, may present multiplenodules, and can involve multifocal microscopic growth. Themicroscopic appearance can be mistaken for a polymorphous low-grade adenocarcinoma or basal cell adenoma. Immunohistochem-istry can be helpful in differentiating these disorders. Two cases ofcanalicular adenoma showing tumor foci are described. Bothoccurred in the upper lip of white women aged 72 and 79 years,respectively. Besides the histological multifocal aspect, one patienthad bilateral nodules. Histological examination of lesions revealedinterconnecting and branching canal-like structures composed ofuniform columnar and sometimes cuboidal cells that were partiallyencapsulated. Immunohistochemical analysis showed intenseexpression of cytokeratins 7 and 13, weak reaction to 14, and anegative reaction to vimentin. Once they were diagnosed, the lesionswere excised. It is important to properly diagnose canalicular ade-noma and differentiate its multifocal aspect frommalignant behavior.

PE-051 - BIPHOSPHONATE-ASSOCIATED OSTEONEC-ROSIS OF THE JAWS: TWO SUCCESSFUL CLINICALFOLLOW-UPS. SILVIA PAULA DE OLIVEIRA, JULIAHONORATO, DANIELLE RESENDE CAMISASCA,MÁRCIA DUARTE SOTHER. ODONTOCLÍNICA CEN-TRAL DO EXÉRCITOeOCEX.

Bisphosphonates are used as therapy to reduce bone resorp-tion. At head and neck sites, one of consequences of this use is

osteonecrosis of the jaws (BRONJ). BRONJ affects quality of lifeand produces significant morbidity. Two cases of BRONJ treatedwithout surgical intervention were reported. Both developed aftertooth extraction in patients treated with bisphosphonates. In bothcases, conservative treatment was undertaken, involving antibi-otics, chlorhexidine, and periodic monitoring. The clinical courseof the cases were quite favorable but seemed to vary based on theuse of vitamin D. BRONJ can be prevented in patients takingbisphosphonates. Vitamin D seems to accelerate bone regenera-tion. Dental surgeons should be aware of patients who usebisphosphonates. Proper oral hygiene and conservative treatmentmay be the best approach to avoid complications.

PE-052 - BISPHOSPHONATE-ASSOCIATED OSTEO-NECROSIS: SURGICAL THERAPEUTIC APPROACH.MARÍLIA CUNHA MARONEZE, LUISA MACHADO BARIN,FERNANDA MAIA PILLUSKY, JULIANA DA SILVA MORO,CARLOS ALBERTO BAZAGLIA ESCOBAR, CRISTIANECADEMARTORI DANESI. UNIVERSIDADE FEDERAL DESANTA MARIA (UFSM).

Bisphosphonates (BFS) have been associated with a debili-tating complication that affects the gnathic bones. Bisphospho-nate-associated osteonecrosis (BON) is defined by the presence ofnecrotic bone tissue in the oral cavity. Man, 69, complained aboutexposed bone in his oral cavity. During the history, the patientreported using BFS for a year, as cancer therapy. Oroscopy foundan exposed bone on the lingual surface of the lower right molarextending to the retromolar trigone region. Histopathologicalreport was conclusive for osteonecrosis. Treatment consisted ofsurgical removal of the necrotic bone area with the involvedtooth. The cicatrization process followed a normal course, and thepatient remains under observation. The treatment of BON isvariable, challenging, and controversial because there is still noeffective protocol. This case emphasizes surgical therapy as astrong determinant of BON outcomes.

PE-053 - BISPHOSPHONATE-ASSOCIATED OSTEO-NECROSIS AND TRAUMA CAUSED BY PROSTHE-SIS. GILBERTO MARCUCCI, MARCELO MARCUCCI.CLINICA MARCUCCI.

The osteonecrosis associated with bisphosphonates (OAB) isusually triggered by surgical manipulation in the oral cavity, butmay also be related, to a lesser extent, to the trauma of havingprostheses on the alveolar ridge. Woman, 75, complained ofinjury under the mandibular removable partial dentures installed 3months previously. The medical history revealed her use ofalendronate 70 mg for 5 years. Intraoral examination showedbony exposure in the alveolar ridge in the area of tooth #46. Theadjacent mucosa was erythematous and slightly edematous nearits contact with the acrylic prosthesis. Imaging revealed anosteolytic lesion with central bone fragment and adjacent scleroticreaction. Pathological examination showed chronic inflammationwith areas of acute and granulation tissue. Patients takingbisphosphonates and using prostheses with mucosal supportshould be informed of the risks and monitored to minimizetrauma causing OAB.

PE-054 - BONE-OBSCURED BREAST CANCERMETASTASIS IN PATIENT WITH BISPHOSPHONATE-ASSOCIATED OSTEONECROSIS OF JAW. ISADORALUANA FLORES, ERIKA GRAF PEDROSO, WILFREDOALEJANDRO GONZALEZ ARRIAGADA, RODRIGO