Manejo cirúrgico de ferimento auto-infligido por arma de fogo em região maxilofacial / Surgical management of self-inflicted injury by gun in the maxillofacial region

INTRODUÇÃO: O manejo dos pacientes vítimas de PAF possui vertentes divergentes a respeito do tratamento cirúrgico, que pode ser realizado de forma imedata ou tardia. Em lesões auto-infligidas, a distância entre a arma e a região acometida é menor, causando consequências estéticas e funcionais mais devastadoras. Aliado ao fato desse tipo de trauma criar uma ferida suja devido à comunicação com a cavidade oral e seios paranasais, o manejo das lesões representam um desafio mesmo à cirurgiões experientes. OBJETIVO: Estre trabalho relata o manejo cirúrgico de uma ferida auto-infligida por arma de fogo que resultou em avulsão dos tecidos moles na região maxilofacial. DESCRIÇÃO DO CASO: Paciente do sexo masculino, 35 anos, vítima de projétil de arma de fogo auto-infligido em região maxilofacial, cursando com extenso ferimento em região de língua e mento. Clinicamente, o paciente não apresentava sinais de fratura em ossos da face. Ambos os ferimentos apresentavam secreção purulenta e o paciente manifestava disfonia devido a grande destruição tecidual. CONSIDERAÇÕES FINAIS: O tratamento de ferimentos por arma de fogo não só é um grande desafio para o cirurgião, como para toda a equipe multidisciplinar requerida para tais casos, visto que não há protocolos bem definidos para o tratamento dessas lesões(AU)

INTRODUCTION: The management of patients who are victims of FAP has divergent aspects regarding surgical treatment, which can be performed immediately or late. In self-inflicted injuries, the distance between the weapon and the affected region is smaller, causing more devastating aesthetic and functional consequences. Allied to the fact that this type of trauma creates a dirty wound due to the communication with the oral cavity and paranasal sinuses, the management of injuries represents a challenge even for experienced surgeons. OBJECTIVE: This paper reports the surgical management of a self-inflicted gunshot wound that resulted in soft tissue avulsion in the maxillofacial region. CASE DESCRIPTION: Male patient, 35 years old, victim of a self-inflicted firearm projectile in the maxillofacial region, coursing with extensive injury in the region of the tongue and chin. Clinically, the patient did not show signs of facial bone fractures. Both wounds had purulent secretion and the patient had dysphonia due to extensive tissue destruction. FINAL CONSIDERATIONS: The treatment of gunshot wounds is not only a great challenge for the surgeon, but also for the entire multidisciplinary team required for such cases, since there are no well-defined protocols for the treatment of these injuries(AU)

Influência da via hippo em carcinomas de células escamosas de língua oral / Influence of the hippo pathway on oral tongue squamous cell carcinomas

O carcinoma de células escamosas de língua oral (CCELO) apresenta altas taxas de morbidade e mortalidade. Apesar dos progressos alcançados nesta área, os pesquisadores continuam em busca de biomarcadores moleculares que tenham valor preditivo no prognóstico dos pacientes e que possibilitem o desenvolvimento de novas estratégias terapêuticas. Neste contexto, várias pesquisas têm destacado o papel da via Hippo com esta finalidade. Portanto, esta pesquisa teve como objetivo avaliar se as proteínas relacionadas à Via Hippo, LATS2 e YAP1, exercem alguma influência sobre o comportamento biológico dos CCELOs. A amostra foi constituída por 26 casos de CCELO e 8 casos de mucosa oral normal como controle. Para avaliar a morfologia dos CCELOs foram utilizadas as gradações propostas pela OMS (2005) e por Almangush et al. (2014). O perfil imunoistoquímico de LATS2 e YAP1 foi avaliado por escores (0-3), com base na sua imunoexpressão em localização intracelular (núcleo e/ou citoplasma) e distribuição epitelial. Para a análise entre os parâmetros estudados foram realizados os testes estatísticos Qui-quadrado de Pearson e Exato de Fisher. A análise de sobrevida foi realizada através do método de Kaplan Meier e do teste log-rank. Para todas as avaliações foram considerados valores significativos com p<0,05. Foi observada alta expressão da LATS2 tanto em mucosa oral normal (100%) quanto na maioria dos CCELOs (73,1%), sem diferença estatística significativa (p=0,160). Foi possível evidenciar o aumento da imunoexpressão da YAP nos casos de CCELO em comparação à mucosa oral normal (p<0,001). Verificou-se ainda que a baixa expressão da LATS2 foi associada com menores taxas de sobrevida livre da doença (p=0,039). Além disso, constatou-se que a elevada expressão da YAP foi associada à classificação de alto risco do modelo BD (p=0,034), sugerindo que a imunoexpressão desta proteína pode estar associada a TEM e invasão celular em CCELO. A elevada expressão de ambas as proteínas, na maioria dos CCELOs, sugere que outras vias de sinalização, além da regulação através da LATS2, podem estar induzindo a expressão nuclear de YAP nestes tumores. Portanto, conclui-se que a via Hippo pode influenciar o comportamento biológico dos CCELOs (AU).

Oral tongue squamous cell carcinoma (OTSCC) has high morbidity and mortality rates. Despite the progress made in this area, researchers continue to search for molecular biomarkers that have predictive value in the prognosis of patients and allow the development of new therapeutic strategies. In this context, several studies have highlighted the role of the Hippo pathway for this purpose. Therefore, this research aimed to evaluate whether the proteins related to the Hippo pathway, LATS2 and YAP1, have some influence on the OTSCC biological behavior. The sample consisted of 26 OTSCC cases and 8 normal oral mucosa cases as control. For the morphological assessment of OTSCC, the gradations proposed by the WHO (2005) and by Almangush et al. (2014) were performed. The immunohistochemical profile of LATS2 and YAP1 was evaluated by scores (0-3), based on their immunoexpression in intracellular location (nucleus and/or cytoplasm) and epithelial distribution. Pearson's Chi-square and Fisher's Exact statistical tests were performed for the analysis of the studied parameters. Survival analysis was performed using the Kaplan-Meier method and the log-rank test. For all evaluations, values with p<0.05 were considered significant. High expression of LATS2 was observed both in normal oral mucosa (100%) and in most OTSCC (73,1%), with no statistically significant difference (p=0,160). It was possible to observe the increase in YAP immunoexpression in cases of OTSCC compared to the normal oral mucosa (p<0.001). It was also found that the LATS2 low expression was associated with lower rates of disease-free survival (p=0.039). Furthermore, YAP high expression was found associated with the BD model's high-risk classification (p=0.034), suggesting this protein immunoexpression may be associated with EMT and cell invasion in OTSCC. The high expression of both proteins in most OTSCC suggests that other signaling pathways, in addition to regulating through LATS2, may be inducing the nuclear YAP expression in these tumors. Therefore, it is concluded that the Hippo pathway can influence the OTSCC biological behavior (AU).

Utilização da morfometria celular no microambiente neoplásico e sua relação com a imunoexpressão da interleucina-4 / Use of cellular morphometry in the neoplastic microenvironment and its relationship with the immunoexpression of interleukin-4

A morfometria celular é um tipo de análise quantitativa que utiliza as medidas geométricas para obter informações acerca da morfologia nuclear, citoplasmática e outras medidas gerais das células, sendo que estes parâmetros podem estar alterados devido a processos fisiológicos e patológicos que modificam a morfologia celular normal, sendo uma análise relevante no prognóstico de diversas lesões. Os ceratinócitos possuem morfologia poliédrica com núcleos ovoides, mas podem sofrer alterações com eventos patológicos e fisiológicos, por exemplo, no núcleo. Essas alterações podem estar presentes em neoplasias malignas, como, no carcinoma epidermoide. A interleucina-4 (IL-4) é uma citocina secretada por diversos tipos de células, estando envolvida no desenvolvimento e diferenciação de células Th2, atuando na resposta antiinflamatória e sua expressão parece estar relacionada com o desenvolvimento de algumas neoplasias, incluindo o câncer oral. O objetivo da pesquisa foi realizar análise morfométrica celular (compartimentos nuclear e citoplasmático), identificação de irregularidades nucleares de ceratinócitos malignos e comparar com a imunoexpressão da IL-4 e profundidade de invasão nos casos de Carcinoma Epidermoide de Lábio Inferior (CELI) e Língua Oral (CELO). Foram analisados 30 casos de cada lesão. Para morfometria celular foram analisados 16 ceratinócitos malignos por caso; a imunoexpressão de IL-4 foi analisada no parênquima e estroma das lesões, utilizando softwares de análises de imagens. Foram aplicados os testes estatísticos de Análise de Variância, Kruskal-Wallis e Correlação de Spearman. A imunoexpressão de IL-4 no parênquima foi maior nos casos de CELI em todos os campos analisados (p<0,05); Houve correlação positiva entre área celular total e profundidade de invasão (p=0,038) e negativa entre imunoexpressão da IL-4 no parênquima superficial e perímetro nuclear superficial (p=0,007). Portanto, sugere-se que exista uma relação protetora da imunoexpressão IL-4 com as lesões analisadas, bem como alterações morfométricas dos ceratinócitos malignos com a imunoexpressão da IL-4 nessas lesões (AU).

Cell morphometry is a type of quantitative analysis that uses geometric measurements of cells to obtain information about the nuclear, cytoplasmic and general morphology of cells. Such parameters may be altered due to physiological and pathological processes that modify normal cell morphology, being a relevant analysis in the prognosis of several injuries. Keratinocytes have a polyhedral morphology with ovoid nuclei, but may undergo changes with pathological and physiological events, for example, in the nucleus. These changes may be present in malignant neoplasms, such as squamous cell carcinoma. Interleukin-4 (IL-4) is a cytokine secreted by several types of cells, being involved in the development and differentiation of Th2 cells, acting in the anti-inflammatory response and its expression seems to be related to the development of some neoplasms, including the oral cancer. The objective of the research was to perform cellular morphometric analysis (nuclear and cytoplasmic compartments), identification of nuclear irregularities of malignant keratinocytes and compare with the immunoexpression of IL-4 and depth of invasion in cases of Epidermoid Carcinoma of the Lower Lip (CELI) and Oral Tongue. (CELLO). Thirty cases of each lesion were analyzed. For cell morphometry, 16 malignant keratinocytes were analyzed per case; IL-4 immunoexpression was analyzed in the parenchyma and stroma of the lesions, using image analysis software. The statistical tests of Analysis of Variance, Kruskal-Wallis and Spearman's Correlation were applied. The immunoexpression of IL-4 in the parenchyma was higher in cases of CELI in all analyzed fields (p<0,05); There was a positive correlation between total cell area and depth of invasion (p=0.038) and a negative correlation between IL-4 immunoexpression in the superficial parenchyma and superficial nuclear perimeter (p=0.007). Therefore, it is suggested that there is a protective relationship between IL-4 immunoexpression and the lesions analyzed, as well as morphometric alterations of malignant keratinocytes with IL-4 immunoexpression in these lesions (AU).

Associação da imunoexpressão das proteínas Ecaderina, SHH e GLI-1 com parâmetros clinicopatológicos em Carcinoma Epidermóide de Língua Oral / Association of immunoexpression of Ecadherin, SHH and GLI-1 proteins with clinicopathological parameters in Oral Tongue Squamous Cell Carcinoma

O potencial de invasão do carcinoma epidermoide requer modifcações fenotípicas nas células parenquimatosas de forma que essas adquiram capacidade de sobreviver e invadir o microambiente tumoral. Esse processo de modificação fenotípica é denominado de transição epitélio-mesenquimal (TEM), cujo as células epiteliais perdem parte de suas características e adquirem outras inerentes às células mesenquimais, de forma controlada por diversos fatores de transcrição indutores destas alterações, conferindo além das habilidades citadas, características de célula tronco, de resistência ao tratamento antineoplásico e angiogênese. O objetivo do presente estudo foi investigar associações da expressão imunoistoquímica das proteínas E-caderina, Shh e Gli-1, sinalizadoras da TEM, com caraterísticas clinicopatológicas de carcinomas epidermoides de língua oral (CELO). A imunoexpressão dessas proteínas foi analisada em 42 casos de CELO, de forma semiquantitativa, nas células neoplásicas do front de invasão tumoral e nos brotamentos tumorais. Os CELOs foram classificados como de baixa e alta expressão proteíca. As gradações de Almangush et al. (2015) e de Boxberg et al. (2017) mostraram categorização semelhante para os casos de CELOs, todavia, a gradação de Almangush et al. (2015) apresentou melhor associação com os parâmetros clínicos, destacando o tamanho do tumor (p=0,013) e o desfecho de óbito (p<0,01). A análise imunoistoquímica revelou predomínio de baixa expressão membranar da E-caderina, apresentando associação significativa com o comprometimento linfonodal (p=0,042). A expressão do Shh foi bem variável e não mostrou associações significativas. A expressão do Gli-1 foi predominantemente alta, mostrando relações significativas com parâmetros clinicopatológicos, como comprometimento linfonodal (p=0,024), estágio clínico do tumor (p=0,016), profundidade de invasão (p=0,015), atividade de brotamentos tumorais (p=0,033), menor tamanho do ninho tumoral (p=0,020) e o grau de diferenciação (p=0,033), sendo estes quatro últimos associados com os brotamentos tumorais. A análise estatística evidenciou ausência de associações significativas entre as variáveis imunoistoquímicas e indicadores de prognóstico do CELO. Os resultados deste estudo indicam que os sistemas de gradação morfológica analisados mostraram-se eficazes na identificação de casos de CELOs mais agressivos, com maior destaque para o proposto por Almangush et al (2015) e, em relação aos achados imunoistoquímicos, os resultados sugerem que a menor expressão membranar da E-caderina e a alta expressão nuclear/citoplasmática de Gli-1 associaram-se ao parâmetro clínico de pior prognóstico, referente ao comprometimento nodal. Diante do modelo do estudo, não se observou associação da imunoexpressão das proteínas estudadas com a sobrevida dos pacientes (AU).

The potential for squamous cell carcinoma invasion requires phenotypic modifications in the parenchymal cells so that they acquire the ability to survive and invade the tumor microenvironment. This process of phenotypic modification is called epithelialmesenchymal transition (EMT), which is crucial for the acquisition of this aggressive malignant phenotype. In this process, the epithelial cells lose part of their characteristics and acquire others inherent to the mesenchymal cells, in a controlled manner, inducing by various transcription factors, conferring, in addition to the aforementioned abilities, stem cell characteristics, resistance to anti-neoplastic treatment and angiogenesis. The aim of the present study was to investigate associations between the immunohistochemical expression of E-cadherin, Shh e, Gli-1 proteins, signaling TEM, with clinicopathological characteristics of oral tongue squamous cell carcinoma (OTSCC). The immunoexpression of these proteins was analyzed in 42 cases of OTSCC, in a semiquantitative way, in the neoplastic cells of the tumor invasion front and in the cells that make up the tumor budding. OTSCCs were classified as low and high protein expression. Aiming at the association of immunohistochemical findings with clinicopathological variables and survival rates, cases were classified into low expression and high expression categories. Initially, statistical differences between the histopathological gradations of malignancy by Almangush et al. (2015) and that of Boxberg et al. (2017) regarding clinical parameters. Both, the gradations showed similar categorization for OTSCC cases, were able to categorize the tumors, however, the gradation by Almangush et al. (2015) showed a better association with clinical parameters, highlighting tumor size (p=0.013) and the outcome of death (p<0.01). The immunohistochemical analysis revealed a predominance of low membrane expression of E-cadherin, with a statistically significant association with lymph node involvement (p=0.042). The expression of Shh was quite variable and had no statistically significant associations. Gli-1 had a prevalence of high expression, showing significant relationships with clinicopathological parameters, such as the occurrence of lymph node involvement (p=0.024), clinical stage of the tumor (p=0.016), depth of invasion (p=0.015), activity of tumor budding (p=0.033), smaller size of the tumor nest (p=0.020) and degree of differentiation (p=0.033), the last four being associated with tumor budding. Some correlations between markers were found, such as the positive correlation between the cytoplasmic expression of E-cadherin with Shh (p=0.030) and the immunoexpression of Gli-1 in the cytoplasm/nucleus with Shh (p=0.041). Statistical analysis evidenced the absence of significant associations between immunohistochemical variables and OTSCC prognostic indicators. The findings of this study suggest the expression pattern of E-cadherin, Shh and Gli-1 in OTSCC, in addition to indicating a better clinicopathological association with the malignancy gradation of Almangush et al. (2015). However, the expression of these biomarkers may not be related to patient survival. In addition, no significant differences were observed between the expression of the proteins studied in tumor budding when other cells in the invasion front were evaluated, suggesting a similar cell phenotype for both. The results of this study indicate that the analyzed morphological grading systems proved to be effective in identifying cases of more aggressive OTSCC, with greater emphasis on the one proposed by Almangush et al (2015) and, in relation to the immunohistochemical findings, the results suggest that the lower membrane expression of E-cadherin and the high nuclear/cytoplasmic expression of Gli-1 were associated with the clinical parameter of worse prognosis (AU).

Analysis of Tongue Color-Associated Features among Patients with PCR-Confirmed COVID-19 Infection in Ukraine

ABSTRACT Objective: To evaluate and systematize tongue color-related manifestations among patients with PCR-confirmed COVID-19 infection. Material and Methods: This retrospective study included analysis of tongue images obtained from patients with PCR-confirmed COVID-19 infection. Evaluation of coronavirus disease severity (mild, moderate, severe, critical) was provided, considering clinical symptomatology and results of laboratorial and instrumental diagnostic methods. Each picture was analyzed considering the parameters of color of the tongue and color of the tongue plaque by two dental specialists. Cochran-Armitage test for trend was used to evaluate associations between the tongue color and tongue plaque color, and coronavirus disease severity. Results: The most prevalent tongue colors were pale pink, red and dark red (burgundy color). A total of 64.29% of patients with mild disease demonstrated pale pink color of the tongue. Patients with moderate coronavirus disease were characterized with the adverse trend: 62.35% of them presented with red-colored tongue, while in 37.64% of cases, the tongue was pale pink. Severe COVID-19 patients, almost in 90% of the cases, had either red or burgundy color of the tongue. Conclusion: SARS-COV-2 infection is not manifested by tongue-targeted or tongue-specific signs and features; however, coronavirus disease itself provokes changes within the tongue color and tongue plaque color similar to those registered during other internal pathologies.

Correlation between the cephalometric measurements and acoustic properties of /s/ sound in Turkish

Abstract Objectives To evaluate the acoustic properties of the /s/ sound in individuals with different occlusion types and to investigate relationships between these properties and cephalometric measurements. Methodology Sixty patients were divided into three groups based on malocclusion. Group 1 included 20 patients (mean age: 14.85±2.01 years) with Class I skeletal and dental relationships. Group 2 included 20 patients (mean age: 13.49±1.78 years) with Class II skeletal and dental relationships. Group 3 included 20 patients (mean age: 12.46±2.62 years) with Class III skeletal and dental relationships. Cephalometric tracings were obtained from cephalometric radiographs. All included patients were native speakers of Turkish. The /s/ sound was selected for center of gravity analysis. Correlations between cephalometric values and acoustic parameters were also investigated. Results The center of gravity of the /s/ sound had the lowest value in Group 2 (p<0.05). For the /s/ sound in Group 3, moderate positive correlations were found between center of gravity and Sella-Nasion to Gonion-Gnathion angle (p<0.05, r=0.444) Lower incisor to Nasion-B point (p<0.023, r=0.505), and Lower incisor to Nasion-B point angle (p<0.034; r=0.476). No correlation was found in other cephalometric measurements. Conclusions The /s/ sound was affected by malocclusion due to the changing place of articulation. Therefore, referral to an orthodontist for malocclusion treatment especially patients with class III in the early period is suggested for producing acoustically ideal sound.

Tongue function and swallowing in individuals with temporomandibular disorders

Abstract The tongue participates in the oral phase of swallowing by pushing the food bolus toward the oropharynx. This relationship between tongue function and swallowing is little addressed addressed in individuals with temporomandibular dysfunction (TMD). Objective: To analyze the association of functional tongue conditions on swallowing in individuals with TMD. Methodology: After approval by the Institutional Review Board, the study was conducted on 30 individuals of both sexes, aged 18 to 28 years, with TMD, and not treated for the disorder. Tongue function was assessed as to the mobility, pressure, and oral motor control. Swallowing was analyzed by clinical assessment during ingestion of solid (wafer biscuit) and liquid (water). Data regarding mobility and swallowing were collected using the orofacial myofunctional evaluation protocol. Tongue pressure was measured by the Iowa Oral Performance Instrument, during elevation, protrusion, swallowing, and resistance test. The oral motor control was assessed by the oral diadochokinesis (DDK) test by rapid and repeated emissions of syllables "ta" and "ka". Data were statistically analyzed by the Spearman correlation coefficient, at a significance level of 5%. Results: Relationships were found between tongue function and swallowing for the following aspects: mobility (r=0.741), pressure in protrusion (r=-0.366), swallowing of saliva (r=-0.499), mean DDK rate in emissions "ta" (r=-0.424) and "ka" (r=-0.446), and mean DDK period in emissions "ta" (r=0.424) and "ka" (r=0.446). Thus, the greater the change in tongue mobility, the lower the tongue pressure in protrusion and swallowing of saliva, the lower the emissions per second, the longer the mean time between vocalizations, and the worse the swallowing of individuals with TMD. Conclusion: The functional conditions of the tongue regarding mobility, pressure, and oral DDK were associated with swallowing in individuals with TMD.

Bacterial Colonization and Dental Implants: A Microbiological Study

Abstract Objective: To compare colony forming unit (CFU) of oral bacterial from buccal mucosa and lingual buccal tongue among patients with a dental implant and normal oral hygiene individuals without a dental implant. Material and Methods: Twenty-six individuals with a dental implant and twenty-six individuals without dental implants were included in this study. The samples were sent to the laboratory to culture with Brain Heart Infusion Broth (BHI), prepared serial dilution and then spread to the blood agar. CFU was counted when a single layer of bacteria is formed on the blood agar at any dilution level. An independent-T test was used to compare the means different of CFU oral bacterial between control and test groups from buccal mucosa and lingual buccal mucosa, respectively. Results: Buccal mucosa control group (186.19 ± 5.61) and test group (186.65 ± 6.24) (p>0.05). The result from the lingual buccal tongue control group (198.38 ± 6.12) and test group (197.96 ± 6.50) (p>0.05). There was no significant difference between the control group and test group CFU bacterial load. Conclusion: The presence of implants in the oral cavity do not interfere or worsen the oral condition; nevertheless, the effect of implants surrounding oral flora is similar to natural teeth.

Carcinoma verrucoso en lengua de paciente geriátrica. Informe de caso clínico / Verrucous carcinoma in the tongue of a geriatric patient. Clinic case report

Resumen Se informa el caso de un paciente femenino de 80 años de edad, la cual presenta un crecimiento exofítico en el borde lateral izquierdo de la lengua con dolor a la masticación y deglución de alimentos y bebidas; es referida por el odontólogo del Hospital Primario del municipio de Villanueva, departamento de Chinandega, Nicaragua, al área de Diagnóstico en Patología Bucal de la Facultad de Odontología de la Universidad Nacional Autónoma de Nicaragua, León (UNAN-León). A la exploración clínica se observa lesión exofítica en la zona posterior del borde lateral izquierdo de la lengua de aspecto papilomatoso, y ocupa además el reborde alveolar del mismo lado. El diagnóstico definitivo histopatológico fue carcinoma verrucoso.

Abstract We report the case of an 80-year-old female patient, who presents an exophytic growth on the left lateral border of the tongue with pain when chewing and swallowing food and drinks; who is referred by the Dentist of the Primary Hospital of the municipality of Villanueva, department of Chinandega, Nicaragua to the area of Oral Pathology Diagnostics of the National Autonomous University of Nicaragua, Dental School León (UNAN-León). An exophytic lesion was observed in the posterior area of the left lateral border of the papillomatous aspect of the tongue, occupying in addition the alveolar ridge on the same side. The definitive histopathological diagnosis was Verrucous carcinoma.

Tumor de células granulares em criança: relato de caso / Granular cell tumor in a child: Case report

Introdução: O Tumor de células granulares é uma lesão, que foi descrita pela primeira vez em 1926, por Abrikosoff, ocorrendo geralmente entre a segunda e a quinta década de vida, predominantemente em mulheres negras, sendo raro o acometimento em crianças. A característica clínica é de uma lesão séssil, não sangrante, coloração da mucosa, indolor, tamanho aproximado de 1,0 cm, firme à palpação. Relato de caso: Este trabalho tem por objetivo apresentar um relato de caso de um tumor de células granulares localizado no dorso da língua de uma criança. Foi realizado excisão cirúrgica. O paciente segue em acompanhamento de 3 anos, sem recidiva. Consideracões finais: É importante relatar que o TCG é uma lesão incomum em crianças. Apresenta-se como um tumor benigno, sendo raro o aparecimento da variante maligna. Recidiva é incomum. A remoção cirúrgica é o tratamento indicado... (AU)

Introduction: Granular cell tumor is an injury that was described for the first time in 1926 by Abrikosoff, a histologically similar tumor with skeletal muscle fibers. It is suggested that this lesion originates from the skeletal muscles, this type of lesion usually occurs between the second and fifth decade of life, occurs predominantly in women and blacks, and is uncommon in children, presents as a sessile, non-bleeding, painless mucosal color lesion, approximately 1.0 cm in size, firm the palpation and the skin covering the lesion remain intact without ulcerations. Case report: Thus, this work aims to present a case report of a surgical excision of a granular cell tumor located on the back of a child's tongue after incisional biopsy and with the histopathological result confirming that it was a granular cell tumor. Surgical excision was performed under general anesthesia, where it goes through 3 years of follow-up without relapse. Final considerations: It is important to report that GCT is an uncommon injury in children. It presents as a benign tumor, being rare the appearance of the malignant variant. Relapse is uncommon. Surgical removal is the indicated treatment... (AU)

Análise imuno- histoquímica das proteínas BRCA1 e Acetil Histona H3 no carcinoma de células escamosas oral / Immunohistochemical analysis of BRCA1 and Acetyl Histone H3 proteins in oral squamous cell carcinoma

O carcinoma de células escamosas da região de cabeça e pescoço é o 4° tipo de câncer mais comum em homens no mundo. A Carcinogênese oral é caracterizada por uma heterogeneidade clínica, patológica e biológica, gerando instabilidade genômica e ocasionando a progressão e desenvolvimento de uma desordem potencialmente maligna. O mecanismo DDR (DNA damage response) age como um mecanismo de autodefesa responsável pela manutenção da integridade da cromatina. Sua eficácia é dependente de seu acesso ao local do dano pelas proteínas envolvidas no processo, como as histonas (proteínas que compõem os nucleossomos e que auxiliam no desempacotamento da cromatina). O desequilíbrio da acetilação e deacetilação das histonas em regiões promotoras contribui para a desregulação da expressão gênica e tem sido associado à carcinogênese e à progressão do câncer. O mecanismo DDR é composto por diversas vias de sinalização interconectadas, como as vias do BRCA1. A proteína BRCA1 regula a transcrição, o remodelamento da cromatina, a ubiquitinação e o reparo da quebra de fita dupla de DNA, entre outras funções. Sua identificação tem sido relacionada à quimiorresistência e pior prognóstico, principalmente, em carcinomas de mama e ovário. Assim, o objetivo do estudo foi avaliar a imunoexpressão das proteínas BRCA1 e Acetil Histona H3 em espécimes de biópsia incisional de carcinomas de células escamosas oral (CCEO) em língua móvel, e correlacionar sua expressão com dados epidemiológicos e com a gradação histopatológica dos tumores. Biopsias incisionais de 43 CCEO de língua móvel foram submetidas a análise imuno-histoquímica para os anticorpos BRCA1 e AcH3. As amostram foram microscopicamente subdividas em bem diferenciado (BD) e pouco diferenciado (PD) Todos os casos de CCEO apresentaram marcação nuclear positiva para a ACH3 e não houve correlação estatisticamente significativa entre este anticorpo e a gradação histológica (p=0.391). Todos os casos foram também positivos para a proteína BRCA1. O grupo PD apresentou uma expressão aberrante do BRCA1, com a maioria dos casos possuindo menos que 10% da marcação nuclear (p<0.01). Todos os casos do grupo PD apresentaram marcação citoplasmática (p=0.034). O grupo dos BD mostrou uma expressão majoritariamente nuclear com a maioria dos casos expressando mais de 50% das células positivas (p<0.01). Nossos resultados mostraram que as proteínas AcH3 e BRCA1 foram encontradas expressas em todos os casos de CCEO. Em geral, casos de CCEO apresentaram-se hipoacetilados. Houve uma diminuição significante na expressão da proteína BRCA1 no grupo PD em comparação ao BD. Além disso, a imunomarcação do BRCA1 nos casos PD foi exclusivamente citoplasmática. Nossos estudos corroboram com os achados de trabalhos anteriores para imuno-histoquímica de ambas proteínas BRCA1 e AcH3 em CCEO. O status hipoacetilado do CCEO evidencia a importância das mudanças epigenéticas na carcinogênese oral e na progressão tumoral como sendo um campo de investigação promissor. A imunoexpressão da proteína BRCA1 mostrou um declínio significativo nos casos PD com a proteína, em sua maioria, sendo encontrada no citoplasma. Apesar do estudo ter usado espécimes de biópsia incisional, nosso BRCA1 reproduziu o mesmo observado nos CCEO e em outras neoplasias, sugerindo a possibilidade de seu uso como um marcador prognóstico. (AU)

Oral squamous cell carcinoma (OSCC) is the most common cancer of the head and neck region and is the fourth most prevalent cancer in men worldwide. The oral carcinogenesis is characterized by a clinical, pathological and biological heterogeneity, causing genomic instability with the progression and development of potentially malignant disorders. The DDR (DNA damage response) pathway acts as a mechanism of self-defense responsible for the detection of the chromatin integrity. Its efficacy is dependent on its access to the site of damage by the proteins involved in the process, such as the histones (proteins that constitute the nucleosomes and assist the packing of the chromatin). The instability of histone acetylation or deacetylation in promoter regions contribute for the dysregulation of the gene expression and has been associated to the carcinogenesis and cancer progression. The DDR mechanism is composed of several interconnected signaling pathways, such as BRCA1 pathways. The BRCA1 protein regulates transcription, chromatin remodeling and repair of double strand DNA breaks and other functions. Its identification has been related to chemoresistance and poor prognostic, especially in mama and ovarian carcinoma. The aim of the study was to evaluate the immunoexpression profile of BRCA1 and AcH3 proteins in fragments of incisional biopsy oral squamous cell carcinomas of the mobile tongue and correlate with the epidemiological data and histopathological gradation of the tumors. Incisional biopsy samples of 43 oral squamous cell carcinoma of the mobile tongue were submitted to immunohistochemical for AcH3 and BRCA1 antibodies. Samples were microscopically graded in well differentiated and the poor differentiated. All OSCC cases showed AcH3 positive nuclear expression and there was no correlation between AcH3 and histological grading (p=0.391). All the OSCC cases were positive for BRCA-1 expression. The PD group showed an aberrant expression of the BRCA1 protein, with most of the cases with less than 10% of nuclear staining (p<0.01). Moreover, all PD cases showed cytoplasmatic staining (p=0.034). The WD cases showed nuclear staining with most of the cases showing more than 50% of positive cells (p<0.01). Our results pointed that the AcH3 and BRCA1 protein were found to be expressed in all OSCC. In general, OSCC cases were hypoacetylated. There was a significant decrease in BRCA1 protein expression in the poor differentiated group in comparison to the well differentiated. Also, BRCA1 immunostaining was cytoplasmatic in the poor differentiated cases. Our results corroborate the few previous studies for both AcH3 and BRCA1 protein immunohistochemistry findings in OSCC. The hypoacetylated status of OSCC highlights the importance of epigenetics changes in oral carcinogenesis and tumor progression as a promising field of investigation. The BRCA1 protein imunnoexpression showed a significant decrease in the PD cases and the protein was mostly found into the cytoplasm. Although the present study used biopsy specimens, our BRCA1 results were the same observed not only in OSCC but in other cancers suggesting it as a promising prognostic marker.

A new technique for tongue brushing and halitosis reduction: the X technique

Abstract The tongue is one of the primary sources of halitosis. The manual or mechanical removal of biofilm is known to decrease oral malodor. Objective: To evaluate a new tongue hygiene technique hereby referred to as "the X technique" and its effects on both halitosis and the number of microorganisms based on microbiological parameters and diagnostic features of the breath. Material and Methods: The study included thirty patients divided into a control group (patients without systematized guidelines of lingual hygiene, but who performed the mechanical cleaning of tongue dorsum, each in its own way), the 3R group (instructed to perform the movements of the X technique for 3 repetitions at each brushing), and the 6R group (instructed to perform 6 repetitions of the technique at each brushing). After two weeks, a new data collection was performed. Results: Patients in the 6R group presented the lowest score on the organoleptic assessment scale at the second consultation, followed by the 3R group and the controls. Regarding the self-perception of breath by the method of Visual Analog Scale (VAS), the control group did not perceive improvements in oral malodor; the results of the 3R group and the 6R group were similar. Conclusion: These results indicate that the X technique improves both measurements and perceptions of halitosis. Microbiological analyses revealed greatest reduction in the 6R group. The findings show that the X technique reduces both organoleptic scores and the number of bacterial colonies, and improves users' perceptions of their breath.

Effect of Polyethylene Terephthalate Tongue Scraper on Oral Levels of Volatile Sulfur Compounds: a randomized clinical trial / Efeito do raspador de língua de polietilenotereftalato nos níveis orais de compostos sulfurados voláteis: um ensaio clínico randomizado

Objective: To evaluate the effect of Polyethylene Terephthalate (PET) tongue scraper on the volatile sulfur compound (VSC) levels. Material and Methods: A randomized, controlled, parallel design was used in this study. Out of the 48 volunteers from Dentistry Department of the Federal University of Sergipe, 40 subjects who met the inclusion criteria were randomly divided into 4 groups (n=10): G1 (control), rinsing of distilled water solution (WS); G2, WS and tongue coating removal (TCR) with toothbrush; G3, WS and TCR with a commercial tongue scraper; and G4, WS and TCR with PET tongue scraper. PET bottles were cut with a rectangular shape (1.0 cm wide x 20 cm long) to obtain PET tongue scraper. The VSC measurements were performed before (T0) and immediately after (T1) each therapy by portable sulfide monitor. Data (ppb) were submitted to Wilcoxon test (α=0.05). The differences between T0 and T1 were calculated and percentage values were assigned. Data (percentage) were submitted to ANOVA and Tukey test (α=0.05). Results: All 40 selected subjects completed the study. All groups reduced significantly the VSC levels after therapy (P<0.01). ANOVA indicated a significant difference among groups (P<0.001). The Tukey test showed that G1 (reduction of 21%) was similar to G2 (31%); G2 was similar to G3 (42%) and different from G4 (52%); G3 and G4 were similar. Conclusion: PET tongue scraper was similar to commercial tongue scraper and provided higher reductions of VSC levels than the toothbrush. (AU)

Objetivo: Avaliar o efeito do raspador de língua de polietilenotereftalato (PET) nos níveis de compostos sulfurados voláteis (CSVs). Material e Métodos: Um desenho paralelo, controlado e randomizado foi empregado neste estudo. Dos 48 voluntários do Departamento de Odontologia da Universidade Federal de Sergipe, 40 atenderam ao critério de inclusão e foram distribuídos aleatoriamente em 4 grupos (n=10): G1 (controle), bochecho com solução de água destilada (SA); G2, SA e remoção da saburra lingual (RSL) com escova dental; G3, SA e RSL com um raspador de língua comercial; e G4, SA e RSL com raspador de língua PET. Garrafas PET foram recortadas com uma forma retangular (1,0 cm de largura x 20 cm de comprimento) para obtenção dos raspadores de língua PET. As mensurações de CSVs foram realizadas antes (T0) e imediatamente após (T1) cada terapia usando um monitor portátil de enxofre. Os dados (ppb) foram submetidos ao teste de Wilcoxon (α=0,05). As diferenças entre T0 e T1 foram calculadas e transformadas em valores percentuais de redução. Os dados (percentuais) foram submetidos à ANOVA e ao teste de Tukey (α=0,05). Resultados: Todos os 40 indivíduos selecionados completaram o estudo. Em todos os grupos houve redução significante dos níveis de CSVs após terapia (P<0,01). ANOVA indicou uma diferença significante entre grupos (PP<0,001). O teste de Tukey mostrou que G1 (redução de 21%) foi semelhante a G2 (31%); G2 foi semelhante a G3 (42%) e diferente de G4 (52%); G3 e G4 foram semelhantes. Conclusão: O raspador de língua PET foi semelhante ao raspador de língua comercial e proporcionou maiores reduções de CSVs do que a escova dental. (AU)

Relationship between acetaldehyde concentration in mouth air and characteristics of microbiota of tongue dorsum in Japanese healthy adults: a cross-sectional study

Abstract Acetaldehyde, associated with consumption of alcoholic beverages, is known to be a carcinogen and to be related to the tongue dorsum. Objective The aim of this study was to investigate the relationship between acetaldehyde concentration in mouth air and bacterial characteristics on the tongue dorsum. Methodology Thirty-nine healthy volunteers participated in the study. Acetaldehyde concentrations in mouth air were evaluated by a high-sensitivity semiconductor gas sensor. A 16S rRNA gene sequencing technique was used to compare microbiomes between two groups, focusing on the six samples with the highest acetaldehyde concentrations (HG) and the six samples with lowest acetaldehyde concentrations (LG). Results Acetaldehyde concentration increased in correlation with the increase in bacterial count (p=0.048). The number of species observed in the oral microbiome of the HG was higher than that in the oral microbiome of the LG (p=0.011). The relative abundances of Gemella sanguinis, Veillonella parvula and Neisseria flavescens in the oral microbiome of the HG were higher than those in the oral microbiome of the LG (p<0.05). Conclusion Acetaldehyde concentration in mouth air was associated with bacterial count, diversity of microbiome, and relative abundance of G. sanguinis, V. parvula, and N. flavescens.

Retalho miomucoso de língua para fechamento de fístula complexa em palato: relato de caso / Myomucosal tongue flap for closure of complex fistula in palate: case report

As fissuras labiopalatais são malformações congênitas faciais resultantes da falha no mecanismo de fusão dos processos frontonasais laterais com os processos mediais maxilares entre a oitava e a décima segunda semana de vida intrauterina, apresentando uma etiologia multifatorial. O presente estudo teve como objetivo apresentar a utilização de um retalho miomucoso de língua para o tratamento de fístula complexa em palato duro, secundária ao insucesso de uma palatoplastia primária. Paciente do sexo masculino, 15 anos de idade, portador de fissura labial bilateral transforame, apresentou-se ao Hospital Santo Antônio das Obras Sociais Irmã Dulce para tratamento de fístula em região de palato. Após preparo pré-operatório, o paciente foi submetido a procedimento cirúrgico, sob anestesia geral, para fechamento da fístula utilizando-se um retalho pediculado de língua com base na porção anterior da mesma. O retalho foi mantido pediculado cerca de 01 mês, período imprescindível para integração do enxerto na área receptora. Após esse período, realizou-se novo procedimento para soltar o pedículo e moldar o enxerto de tecido mole ao palato. Observou-se no pós-operatório da segunda intervenção, boa integração do enxerto de língua ao palato, fechamento da fístula palatina, permanecendo apenas um pequeno orifício residual comunicando com a cavidade nasal. Constatou-se ainda melhora de funções como dicção das palavras, deglutição e do som anasalado da fala do paciente, e, consequentemente, da sua qualidade de vida. A técnica mostrou-se uma opção efetiva para a reabilitação das grandes fístulas palatinas e exige uma atuação interdisciplinar para execução do protocolo de tratamento(AU)

The labiopalatal fissures are congenital facial badly formations resulting from the failure of the fusion mechanism of the lateral frontonasal processes with the maxillary medial processes between the eighth and tenth week of intrauterine life, presenting a multifactorial etiology. The present study aimed to present the use of a tongue myomucosal flap for the treatment of complex fistula in the hard palate, secondary to the failure of a primary palatoplasty. A 15-year-old male patient with transforame bilateral cleft lip, presented to Hospital Santo Antônio das Obras Sociais Irmã Dulce for treatment of fistula in the palate region. After preoperative preparation, the patient underwent a surgical procedure, under general anesthesia, to close the fistula using a pedicled tongue flap based on the anterior portion of the same. The flap was kept pediculated around 30 days, an essential period for graft integration in the recipient area. After this period, a new procedure was accomplished to drop the pedicle and to shape the soft tissue graft to the palate. In the second intervention, postoperative period, a good integration of the tongue graft to the palate was observed, closing the palatine fistula, remaining only a small residual orifice communicating with the nasal cavity. There was also an improvement in functions such as word diction, swallowing, and the patient's speech nasal sound. The technique proved to be an effective option for the closure of the large palatine fistulas, providing an excellent rehabilitation and, consequently, an improvement in the patient's quality of life(AU)

Correção cirúrgica de macroglossia: relato de caso / Macrogloss surgical correction: case report

Macroglossia é uma doença ou manifestação de etiologia múltipla, classificada como verdadeira ou relativa, podendo ser congênita ou adquirida. A redução cirúrgica da língua é um procedimento incomum, indicado para correção de alterações funcionais ou estéticas. Pode estar associada à mordida aberta anterior, a protrusão bimaxilar e a instabilidade no tratamento ortodôntico e orto-cirúrgico. O presente trabalho, tem como objetivo promover uma revisão de literatura sobre o assunto e relatar o caso de uma paciente (18 anos), do sexo feminino, melanoderma, com diagnostico de macroglossia verdadeira, a qual impossibilitava a descompensação ortodôntica prévia para cirurgia ortognática, tratada com glossectomia parcial pela técnica de Morgan. O resultado do tratamento foi satisfatório com melhoras da fonação, deglutição e quadro ortodôntico.

Macroglossy is a disease or manifestation of multiple etiology, classified as true or relative, and may be congenital or acquired. Surgical reduction of the tongue is an uncommon procedure, indicated for the correction of functional or aesthetic changes. It may be associated with anterior open bite, bimaxillary protrusion and instability in orthodontic and ortho-surgical treatment. The present study reports a case of patient (18 years), female, melanodermic, with diagnosis of true macroglossy, which prevented the previous orthodontic decompensation for orthognathic surgery, treated with partial glossectomy by the Morgan technique. The treatment outcome was satisfactory with improvements in phonation, swallowing and orthodontic conditions.

Effects of orofacial myofunctional therapy on masticatory function in individuals submitted to orthognathic surgery: a randomized trial

Abstract Objectives: The esthetic and functional results of orthognathic surgery of severe dentofacial deformities are predictable, however there are differences regarding the effects on stomatognathic system. The aim was to investigate the effects of orofacial myofunctional therapy (OMT) on the masticatory function in individuals with dentofacial deformity submitted to orthognathic surgery (OGS). Material and Methods: Forty-eight individuals (18-40 years) were evaluated, 14 undergoing OMT (treated group-TG), 10 without this treatment (untreated group-UTG) and 24 in a control group with normal occlusion; for clinical aspects the data of an individual was missed (n=46). Chewing was performed using the Expanded protocol of orofacial myofunctional evaluation with scores (OMES-E). Muscle tone and mobility were also analyzed before (P0), three (P1) and six months (P2) after OGS. Surface electromyography of the masseter and temporalis muscles was performed, considering the parameters amplitude and duration of act and cycle, and the number of masticatory cycles. The OMT consisted of ten therapeutic sessions along the postoperative period. The results were compared using parametric and non-parametric tests. Results: TG showed higher scores in P1 and P2 than P0; for the masticatory type the scores in P2 were significantly higher than P0. In addition, the proportion of individuals with adequate tone of lower lip and adequate tongue mobility for TG increased significantly from P1 and P2 in relation to P0. The EMG results showed a decrease in act and cycle duration in P2 in relation to P0 and P1 for the TG; furthermore the values were close to controls. An increase in the number of cycles from P0 to P2 was also observed, indicating faster chewing, which may be attributed to an improvement of balanced occlusion associated with OMT. Conclusion: There were positive effects of OMT on the clinical and electromyography aspects of chewing in individual submitted to orthognathic surgery.

Educational program in oral health for caregivers on the oral hygiene of dependent elders / Programa educacional em saúde bucal para cuidadores sobre a higiene oral de idosos dependentes

Objective: Due increased number of elders living in long-term care institutions, actions designs to improve their oral health are essential. Thus, the aim of this study was to evaluate the impact of an educational program for the caregivers through the assessment of the oral hygiene of institutionalized elders. Material and method: The education program consisted in lectures to caregivers about oral health that were performed once a month. The subjects were 40 functionally dependent institutionalized elders and 14 caregivers. Hygiene habits, plaque index, and tongue coating/discoloration of the elders were measured before the educational program (baseline- T0) and after 6 (T1), 12 (T2), 18 (T3) and 24 months (T4). Caregivers answered questions about their knowledge, doubts and implementation of dental care (T0 to T4). Result: After analyzing the data (Friedman, Chi-square and Spearman α = 0.05), a gradual improvement in the oral hygiene of the subjects was observed, with an increased frequency of brushing (p=0.0005), a change in the brush type (p=0.0065) and a reduction in the plaque index (p<0.05) and tongue coating (p<0.05). Caregivers showed a marked improvement in their dental care knowledge. Conclusion: It was concluded that the educational program for caregivers had a positive impact in the oral health of institutionalized elderly observed by the increased in the effectiveness of oral hygiene parameters such as plaque index and tongue coating, contributing to the knowledge gain in hygiene by caregivers.

Objetivo: Devido ao aumento do número de idosos que vivem em instituições de longa permanência são essenciais projetos de ações para melhorar a saúde bucal. Assim, o objetivo deste estudo foi avaliar o impacto de um programa educacional para os cuidadores de idosos institucionalizados por meio da avaliação da higiene bucal. Material e método: O programa de educação consistiu em palestras para cuidadores sobre saúde bucal que foram realizadas uma vez por mês. Foram avaliados 40 idosos institucionalizados dependentes funcionalmente e 14 cuidadores. Os hábitos de higiene, o índice de placa e o revestimento/descoloração da língua dos idosos foram avaliados antes do programa educacional (T0) e após 6 (T1), 12 (T2), 18 (T3) e 24 meses (T4). Os cuidadores responderam perguntas sobre seus conhecimentos, suas dúvidas e sobre a implementação de cuidados bucais (T0 a T4). Resultado: Após análise dos dados (Friedman, Qui-quadrado e Spearman, α = 0,05), observou-se melhora gradual na higiene oral dos idosos, com maior freqüência de escovação (p = 0,0005), alteração do tipo de escova (p = 0,0065) e redução do índice de placa (p <0,05) e revestimento da língua (p <0,05). Os cuidadores mostraram uma melhoria acentuada no seu conhecimento sobre saúde bucal. Conclusão: Concluiu-se que o programa educacional para cuidadores teve um impacto positivo na saúde bucal dos idosos institucionalizados observado pelo aumento na eficácia dos parâmetros de higiene bucal, como índice de placa e revestimento da língua, contribuindo para o ganho de conhecimento em higiene pelos cuidadores.

Clinical characteristics and therapeutic response in patients with Burning Mouth Syndrome: accompanying 2 years / Características clínicas e resposta terapêutica em pacientes portadores da Síndrome de Ardência Bucal: acompanhamento de 2 anos

Introduction: Burning Mouth Syndrome (BMS) is a condition characterized by burning symptom of the oral mucosa in the absence of clinical signs. Its etiology is still unknown and, and to date there is no effective treatment. Purpose: The aim of this study was to evaluate patients with BMS profile and the therapies results in a retrospective study. Material and method: Clinical and therapeutic data were collected from records of patients with BMS diagnosed between January 2013 to April 2015 at the Clinic of Stomatology Clinic, Faculdade de Odontologia of Universidade de São Paulo, according to the criteria established by the International Headache Society in 2013. The therapies used for BMS control were also evaluated. Result: Twelve patients were diagnosed with BMS at this period. All of them were women with a mean age of 61.18 years and the apex of the tongue was the most common affected site and the duration of the burning sensation ranged from 6 months to 25 years. Many therapies were prescribed for BMS control, such as topical capsaicin, topical clonazepan, low level laser therapy and homeopathy. Among the established therapies, capsaicin has immediate effect in reducing symptoms. Conclusion: The present study showed that the challenges towards an effective treatment for BMS are varied and are mainly related to the lack knowing of the pathogenesis of this disease. The demographic profile of patients studied here was similar to that described in the available literature, however, the variables represented by secondary symptoms (medical history, anxiety and depression levels) may be modifying factors of therapeutic response and the pathogenesis of the disease itself.

Introdução: A Síndrome de Ardência Bucal (SAB) é uma condição caracterizada pelo sintoma de ardência na mucosa oral na ausência de qualquer sinal clínico. Sua etiologia ainda é desconhecida e, até o momento, não dispõe de tratamento efetivo. Objetivo: Avaliar o perfil do paciente portador de SAB, as terapias instituídas e seus resultados em estudo retrospectivo. Material e método: Foram coletados os dados clínicos e terapêuticos dos prontuários de pacientes diagnosticados com SAB, no período de janeiro de 2013 a abril de 2015, no Ambulatório da Disciplina de Estomatologia Clínica da Faculdade de Odontologia da Universidade de São Paulo. Os critérios para o diagnóstico utilizados se basearam nos estabelecidos pela International Headache Society em 2013 e foram observadas as terapêuticas empregadas e seus resultados. Resultado: Doze pacientes foram diagnosticadas com SAB neste período, todas do sexo feminino, média de idade 61,18 anos, e a principal região acometida pelo sintoma de ardor foi o ápice de língua. O tempo de duração deste sintoma variou de 6 meses a 25 anos. As terapias utilizadas para o controle de sintomas da SAB foram capsaicina, clonazepan tópico, laserterapia e homeopatia. Dentre as terapias instituídas, a capsaicina apresentou efeito imediato na redução dos sintomas. Conclusão: O presente estudo demonstrou que os desafios que circundam a obtenção de um tratamento efetivo para a SAB são diversos e estão principalmente relacionados ao desconhecimento da etiopatogenia da doença. O perfil demográfico dos pacientes aqui estudados foi semelhante ao descrito na literatura disponível, entretanto, as variáveis representadas por sintomas secundários (história médica, níveis de ansiedade e depressão) podem constituir fatores modificadores da resposta terapêutica e da própria etiopatogenia da doença.