Comparative analysis of photobiomodulation therapy and transcutaneous electrical nerve stimulation for burning mouth: a randomized clinical trial.

OBJECTIVE: To compare the effect of photobiomodulation (PBM) and transcutaneous electrical nerve stimulation (TENS) in the treatment of burning mouth. MATERIALS AND METHODS: Randomized clinical trial of 25 patients with burning mouth treated by TENS (n=12) and PBM (n=13). The patients were treated weekly for 8 weeks. Two-factor ANOVA was used to determine whether the two interventions promoted significant differences in symptoms (measured with a visual analogue scale), unstimulated salivary flow, xerostomia, and dysgeusia between T0 (baseline), T1 (after the 4th treatment session), T2 (after the 8th treatment session), and T3 (30 days after the end of treatment). RESULTS: Intragroup comparison of VAS scores for pain showed a significant difference between T0xT1, T0xT2, and T0xT3 in the TENS group and between T0xT2 and T0xT3 in the PBM group (p˂0.001). Intergroup comparison of VAS scores for pain between T2xT3 showed a better response to PBM than to TENS (p=0.003). Patients of the TENS group showed an increase in salivary flow between T1 and T2 (p=0.052). There were no expressive variations in xerostomia or dysgeusia in the two groups analyzed. CONCLUSION: TENS and PBM were effective in reducing the symptoms of burning mouth during and after treatment. The PBM group showed a better response during follow-up. TRIAL REGISTRATION: This clinical trial was registered at http://clinicaltrials.gov (Number: NCT05816200). CLINICAL RELEVANCE: TENS was found to be a safe and effective therapy for burning mouth. Trial registration number (TRN) and date of registration: This clinical trial was registered at http://clinicaltrials.gov (Number: NCT05816200; date: May 08, 2023).

The potential impact of vegetarian diet on the oral mucosa: A preliminary cytopathological study.

BACKGROUND/PURPOSE: Actually, many individuals have opted for the vegetarian diet. The objective of this study was to evaluate the impact of the vegetarian diet on the oral epithelium through cytopathology. METHODS: Oral smears of the tongue and buccal mucosa of 60 adult subjects (30 vegetarians and 30 controls) were collected. Smears were analyzed morphologically and for three morphometric variables: nucleus area (NA), cytoplasm area (CA) and nucleus/cytoplasm ratio. RESULTS: Vegetarians were classified as ovolactovegetarian (53.3%), vegans (30%) and strict vegetarians (16.7%). The NA and CA of the epithelial cells of vegetarian individuals were smaller when compared to controls both in the region of the buccal mucosa and tongue. However, there was no statistically significant difference according to the Student's t-test. For the NA/CA ratio, cells in the oral mucosa region were larger for vegetarians compared to controls. For the tongue, both groups had the same value and the Mann-Whitney U test confirmed that there is no difference between the groups for this cytomorphometric variable. RESULTS: Vegan individuals had a smaller (but not larger) area of CA when compared to controls for the tongue (vegan = 2604.2 ± 179.2 versus control = 3256.7 ± 463.8 p = 0.013). Most smears showed normal epithelial cells and some individuals had changes of an inflammatory nature, mainly in the tongue. CONCLUSION: Despite the small sample size, the results of this study raise the hypothesis that the vegetarian diet (especially the vegan diet) can compromise the thickness of the oral epithelium of the tongue.

Oral Reactive Lesions Associated to Incomplete Removal of Natal Teeth: Case Report.

Natal teeth are infrequent at birth. Dental extraction is the most recommended treatment to avoid complications. Reactive soft tissue lesions associated to natal tooth or its incomplete removal are rare. A five-month-old female presented natal teeth #71 and #81 which were removed the day after the birth. The baby evolved with two nodules in the region of #71 and #81, pedunculated, 10 and 9 mm, respectively, covered by a pink mucosa, firm in consistency. Periapical radiography showed two radiopaque areas, suggestive of root fragments. After 30 days the nodule located in the region of #81 became purple in color and ulcerated. Both lesions were removed with high intensity diode laser. Histopathological analysis was compatible with inflammatory fibrous hyperplasia (#71) and pyogenic granuloma (#81). Early diagnosis of oral lesions in newborns by means of histopathological examination and a minimum invasive treatment, such as laser surgery, should be of primary concern.

Conformational and constitutional analysis of dental caries following radiotherapy for head and neck cancer.

BACKGROUND: This study aimed to investigate the morphology and chemical composition of dental caries related to ionizing radiation (DCIR), an aggressive and progressive disease that affects dental hard tissues. MATERIALS AND METHODS: Eight human teeth with DCIR were paired with sixteen control teeth (8 teeth with conventional caries and 8 without caries) and included in this study. An analysis of the morphology of the lesions was performed using the following techniques: periapical radiography, cone beam computed tomography, computed microtomography, and scanning electron microscopy. The chemical composition was assessed using X-ray dispersive spectroscopy. RESULTS: There was more demineralization in DCIR lesions when compared to conventional dental caries, even though there was no cavitation in the cervical region of the teeth. The superficial roughness and topography of DCIR lesions were similar to those of healthy teeth. On the other hand, lesions of conventional dental caries showed greater surface and topographic irregularity when compared to DCIR and healthy teeth (p = 0.001). Calcium (Ca) and phosphorus (P) levels were lower in DCIR lesions when compared to controls. However, higher levels of carbon (C) have been observed in DCIR lesions. There was a greater loss of the mineral matrix in DCIR followed by conventional caries. The reduction in the mineral matrix (Ca and P) was compatible with the imaging patterns observed in teeth with DCIR and conventional caries. CONCLUSION: Despite their rapid evolution, DCIR presents an irregular, apparently intact surface with significant changes in the amount of Ca, P, and C.

Cytopathological Changes Induced by the Crack Use in Oral Mucosa.

AIMS: To evaluate cytological alterations, inflammation, and microbial charge of the oral mucosa epithelium in crack users in in terms of the amount and duration of use. METHODS: Two hundred thirty four crack users (case group) and 120 non-users (control group) participated in this study. Clinically healthy epithelial cells were collected from the posterior mouth floor, using the conventional exfoliative cytology. Some of the aspects evaluated were as follows: Papanicolaou classification, nuclear area (NA), cytoplasmic area (CA), nuclear/cytoplasmic area ratio (NA/CA), inflammation, microbial charge, keratinization, enucleated superficial cells, and binucleation. RESULTS: The average time of crack consumption was 9.8 years (±7.1) and the average quantity of use was 13.97 g/week (±18.5). The average NA values and NA/CA ratio were increased and CA values were decreased in the case group compared to those in the controls (p < 0.05). Papanicolaou class II, intense inflammation, and intense microbial charge were more prevalent in the case group than in the controls (p < 0.05). There was a significant association between high quantity of smoked crack rocks per week and increased CA values, absence of keratinization, and presence of enucleated superficial cells (p < 0.05). CONCLUSION: Crack use seemed to induce inflammatory alterations and early indicators of malignant transformation on the oral mucosa epithelium.

Prevalence of bifid mandibular canals in panoramic radiographs: a maxillofacial surgical scope.

PURPOSE: The present study aims to estimate the prevalence of bifid mandibular canals in patients treated at the Dental Clinic of the Federal University of Paraná, Brazil. METHODS: The sample consisted of 3,024 panoramic radiographs from male (n = 1,155) and female (n = 1,869) patients (mean age 30 years). An experienced radiologist analyzed the panoramic radiographs according to the study of Langlais et al. (J Am Dental Assoc 110:923-926, 1985), which classifies bifid mandibular canals into four different types. RESULTS: Sixty patients (1.98 %) presented bifid mandibular canals. Specifically, 50 patients revealed bifid mandibular canals type I, while 10 patients revealed bifid mandibular canals type II. All the variations were unilateral. In addition, statistically significant results were not observed for gender distribution. CONCLUSION: The present findings indicate a low prevalence of morphologic alterations of the mandibular canal in the studied population. However, the present outcome highlights the clinical relevance of investigating the radiologic morphology of the mandibular canal prior to surgical interventions.

Radiographic Assessment of Different Autogenous Bone Grafts in the Alveolar Cleft: A Retrospective Longitudinal Study.

Objectives: To assess feasibility and maintenance of bone after alveolar cleft reconstructions using graft from iliac crest and mandibular symphysis. Methods: 51 alveolar clefts grafted with iliac crest and 51 ones grafted with mandibular symphysis bones were selected from patients aged between 7 and 12 years. At three (T1) and 12 months (T2) after surgeries, periapical radiographs were performed to measure the height of the grafted bone based on the modified Bergland scale. Chi-square and Mann-Whitney-Wilcoxon tests compared differences between T1 and T2 according to each bone graft. Results: From the clefts grafted with mandibular symphysis bone, 47 were classified as type I (92.5%) and 04 as type II (7.84%) at T1. At T2, 36 were classified as type II (25.49%) and 02 as type III (3.92%). In the analysis of the clefts grafted with iliac crest at T1, 48 were classified as type I (94.11%) and three as type II (5.88%). At T2, 37 classifieds as type I (72.54%), 12 as type II (23.52%) and two as type III (3.92%). There was no statistically significant difference between treatments. Conclusions: It was concluded that iliac crest and mandibular symphysis are adequate areas from which bone grafts can be obtained for reconstruction of alveolar cleft.

The surgical management of a patient with chronic renal failure and macrothrombocytopenia related to the MYH9 gene mutation: A case report.

MYH9 disease is a rare genetic disorder in which there is a mutation in the gene for the non-muscle myosin heavy chain IIA. It initially causes macrothrombocytopenia followed by other clinical manifestations. When the patient reaches adulthood, he can develop chronic kidney failure. Thus, the risk of suffering a hemorrhage, difficulty in repairing and, infections increases in individuals with this disease. In addition, the use of drugs in these patients should be carefully evaluated. An adult patient sought dental care with a complaint associated with a tooth with advanced dental caries. He had severe thrombocytopenia (7000 platelets/mm3 ), hearing loss, and chronic kidney failure. The diagnosis of MYH9 disease was confirmed through genotyping. After clinical examination, extraction was planned. Local and systemic procedures were used to prevent hemorrhage, especially postoperatively. Although the patient had an infection at the surgical wound site and no episode of postoperative bleeding, the repair process occurred normally. The purpose of this article is to report the surgical management of a patient with MYH9 disease.

Cytological analysis of the epithelial cells in patients with oral candidiasis.

The aim of this study was to evaluate oral epithelial cells of the oral mucosa infected by Candida albicans using exfoliative cytology. Oral smears were collected from clinically normal-appearing mucosa by liquid-based exfoliative cytology of 60 individuals (30 patients with oral candidiasis and 30 healthy controls matched for age and gender) and analysed for morphologic and cytomorphometric technique. Morphologically, candida-infected epithelial cells exhibited nuclear enlargement, perinuclear rings, discrete orangeophilia, and cytoplasmic vacuoles. The cytomorphometric analysis demonstrated that the cytoplasmic area (CA) of the epithelial cells was diminished in patients undergoing candidiasis as compared to the non-infected controls. In addition, there was an augmentation in nuclear area (NA) and NA/CA area ratio. This study revealed that oral mucosa of patients undergoing candidal infection exhibited significant changes in the size and shape of the oral epithelial cells.

Exfoliative cytology of the oral mucosa in burning mouth syndrome: a cytomorphological and cytomorphometric analysis.

OBJECTIVE: The aim of this study was to evaluate oral epithelial cells by exfoliative cytology in burning mouth syndrome (BMS). MATERIAL AND METHODS: Oral smears were collected from clinically normal-appearing mucosa by liquid-based exfoliative cytology in 40 individuals (20 BMS patients and 20 healthy controls matched for age and gender) and analysed for cytological and cytomorphometric techniques. RESULTS: Mean values of nuclear area (NA) for experimental and control groups were, respectively, 67.52 and 55.64 µm² (p < 0.05). Cytoplasmic area (CA) showed the following mean values: 1258.0 (experimental) and 2069.0 µm² (control). Nucleus-to-cytoplasm area ratio for the experimental group was 0.07, besides the control group was 0.03 (p < 0.05). Morphologically, oral smears exhibited normal epithelial cells in both experimental and control groups. There was a significant predominance of nucleated cells of the superficial layer in the smears of BMS patients (p = 0.00001). CONCLUSION: This study revealed that oral mucosa of BMS patients exhibited significant cytomorphometric changes in the oral epithelial cells. These changes probably are associated with epithelial atrophy and a deregulated maturation process that may contribute to the oral symptoms of pain and discomfort in BMS.

Fresh-frozen bone allografts in maxillary ridge augmentation: histologic analysis.

Bone allograft has become an alternative to autogenous bone due to its decreased operative trauma and the almost unlimited supply of reconstructive material. The aim of the present study was to histologically evaluate the suitability of fresh-frozen bone graft (test group) used in maxillary ridge augmentation, comparing it to autogenous bone (native maxilla: control group). During the re-entry procedures, 9 months after the fresh-frozen allogeneic bone blocks were placed in the atrophic maxillary ridges, bone cores were removed with a trephine bur from test and control treatments in the same patient. Routine histologic processing using hematoxylin and eosin and Picrosirius staining was performed. Mature and immature collagen area and density analysis were carried out for both groups under polarization. The results of Student's t test for paired samples (P > .05) showed no statistically significant difference in mature and immature collagen area or density percentage between test and control groups. Histologically similar bone formation patterns were observed in both groups. We concluded that fresh-frozen bone allograft is a biologically acceptable alternative for augmentation of the deficient alveolar ridge, showing a similar collagen pattern to that of autogenous bone.

Relationship between taste perception and use of upper complete dentures.

AIMS: The aim of the present study was to evaluate the taste perception in patients with upper complete dentures. METHODS AND RESULTS: One hundred seventy male and female patients (45-83 years old) upper denture wearers were evaluated for their gustatory function by the paper strips technique in relation to the four basic tastes. The taste test was performed with and without the presence of the denture on the palate. Through Shapiro-Wilk and Kolmogorov-Smirnov tests, the results were analyzed by their normal distribution. The t-test for paired samples was used to evaluate if there was a statistical difference on the taste perception and itself revealed that there is a significant difference (p < 0.01) when the taste perception was analyzed for the absence and presence of the prosthesis (alone and compared) (p < 0.01). The results revealed that patients with dentures had great difficulty to recognize the bitter taste, followed by the salty, sweet, and sour. CONCLUSION: The presence of the denture was able to modify the perception of taste when compared to its absence, especially for the bitter taste.

Oral health, organic and inorganic saliva composition of men with Schizophrenia: Case-control study.

BACKGROUND: Schizophrenia (SCZ) presents complex challenges related to diagnosis and clinical monitoring. The study of conditions associated with SCZ can be facilitated by using potential markers and patterns that provide information to support the diagnosis and oral health. METHODS: The salivary composition of patients diagnosed with SCZ (n = 50) was evaluated and compared to the control (n = 50). Saliva samples from male patients were collected and clinical parameters were evaluated. The concentration of total proteins and amylase were determined and salivary macro- and microelements were quantified by ICP OES and ICP-MS. Exploratory data analysis based on artificial intelligence tools was used in the investigation. RESULTS: There was a significant increase in the salivary concentrations of Al, Fe, Li, Mg, Na, and V, higher prevalence of caries (p < 0.001), periodontal disease (p < 0.001), and reduced salivary flow rate (p = 0.019) in SCZ patients. Also, samples were grouped into six clusters. As, Co, Cr, Cu, Mn, Mo, Ni, Se, and Sr were correlated with each other, while Fe, K, Li, Ti, and V showed the highest concentrations in the samples distributed in the clusters with the highest association between SZC patients and controls. CONCLUSIONS: The results obtained indicate changes in salivary flow, organic composition, and levels of macro- and microelements in SCZ patients. Salivary concentrations of Fe, Mg, and Na may be related to oral conditions, higher prevalence of caries, and periodontal disease. The exploratory analysis showed different patterns in the salivary composition of SCZ patients impacted by associations between oral health conditions and the use of medications. Future studies are encouraged to confirm the results investigated in this study.

Salivary flow rate, calcium, urea, total protein, and amylase levels in fanconi anemia.

OBJECTIVES: Fanconi anemia (FA) is a genetic disease characterized by a chromosomal instability that develops a progressive pancitopenia, leukemia, and/or solid tumors. Nevertheless, it is unknown if this illness induces changes on the salivary gland parenchyma and function. The aim of this study was to assess the stimulated salivary flow rate (SSFR) and calcium, urea, total protein, and amylase levels in saliva of FA patients. METHODS: Stimulated whole saliva was collected from 34 randomly selected FA patients and 34 age-matched and sex-matched controls. Both samples were analyzed for salivary flow rate, calcium, urea, total proteins, and amylase. The SSFR was analyzed by gravimetric method and calcium, urea, total protein, and amylase concentrations were realized by chemistry tests. RESULTS: Mean values of SSFR for experimental and control groups were, respectively, 0.5 mL/min and 0.8 mL/min (P<0.05). Calcium concentration was 36% (P<0.05) and urea concentration was 21% (P<0.01) lower in the FA group saliva compared with saliva from the controls. The saliva concentration of amylase was almost equal in both groups. CONCLUSIONS: FA patients may exhibit significant changes in SSFR, calcium, and urea concentration of saliva.

Radiographic analysis of dental maturation in children with amelogenesis imperfecta: A case-control study.

AIMS: To assess dental maturation in children with amelogenesis imperfecta (AI) and compare their estimated dental age with the age of non-AI children. METHODS AND RESULTS: Panoramic radiographs of children with (n = 27) and without (n = 54) AI were retrospectively collected in the ratio of 1:2. The former consisted of case group, while the latter figured as control group. Both groups were paired by sex and age (P > .05). Dental maturation was assessed in each radiograph using Demirjian's staging technique and Willems' method. Intra- and interexaminer reproducibility reached >0.8. The mean estimated dental age in subjects with AI was 12.5 ± 2.69 years, while in subjects without AI it was 11.73 ± 2.48 years (P = .21). The comparison of mean chronological (12.26 ± 2.6 years) and estimated dental age (12.5 ± 2.69 years) in subjects with AI did not reveal statistically significant differences (P = .38). CONCLUSION: This study highlights the similarity of dental maturation between subjects with and without AI from the radiographic perspective of crown-root formation.

The characteristics of palate and upper dental arch can be an anatomical marker for men with schizophrenia? Case-control study: Palate can be a marker for schizophrenia?

AIMS: The aim of this study was to compare individuals with and without schizophrenia through the characteristics of the palate, such as width, length, depth, palate shape, and upper dental arch shape. METHODS AND RESULTS: The sample was divided into one case group (n = 45) and two control groups (n = 90; 45 individuals each group). Groups were paired by variables: sex, age, and malocclusion type. All analyses were performed on upper dental arch plaster models. All individuals were male and the mean age was 28.56 (SD: 7.82) years. The frequency of the malocclusion type observed was 54.1% (Class I), 22.2% (Class II), and 23.7% (Class III). Statistically significant difference was observed between the case and control groups for the variables palate shape (P = .004) and upper dental arch shape (P = .003). The case group had a higher frequency of the deep or grooved palate shape (57.8%) and parabolic dental arch shape (48.9%). There was no statistically significant difference for the palate width, length, and depth (P > .05). CONCLUSIONS: There was an evidence that the deep or grooved palate shape and parabolic dental arch shape are morphological characteristics of the palate in men with schizophrenia.

Salivary flow, amylase, and total protein in hospitalized patients with HIV infection / AIDS complications.

BACKGROUND: Saliva is a complex secretion produced daily by the salivary glands. Saliva consists mainly of water, enzymes, ions and amino acids and performs several important functions in oral health. OBJECTIVE: The aim of this study was to investigate the flow rate and concentrations of amylase and total proteins in the saliva of hospitalized patients due to AIDS complications. METHODS: Ninety-three men and women (20-64 years of age) were divided into two groups (46 HIV-infected patients and 47 controls) and had salivary flow rate and levels of amylase enzyme and total proteins evaluated. RESULT: The mean salivary flow rate was lower in individuals with HIV when compared to controls (P < 0.05). No significant difference between amylase enzyme levels and total proteins were observed in the saliva of patients with HIV infection when compared to controls. CONCLUSION: Individuals with HIV / AIDS infection (in hospital treatment) suffer no interference in levels of amylase and total salivary proteins, but they have significantly reduced salivary flow.

Morphologic, Structural, and Chemical Properties of Pulp Stones in Extracted Human Teeth.

INTRODUCTION: Pulp stones are mineral structures that develop in the pulp tissue triggered by several clinical conditions. The exact biochemical process behind the occurrence of pulp stones is uncertain. This study aimed to perform a structural and crystallographic characterization of pulp stones and dentin from extracted human teeth. METHODS: The sample consisted of 13 erupted and unerupted permanent human teeth diagnosed with pulp stones. The teeth were analyzed with scanning electron microscopy with secondary and backscattered electrons, energy-dispersive spectroscopy, micro-Raman spectroscopy, micro-X-ray diffraction, and inductively coupled plasma atomic emission spectroscopy. RESULTS: The pulp stones revealed a heterogeneous morphology and structure compared with each other. Compared with the adjacent dentin, the pulp stones had a similar structure. From a chemical point of view, oxygen, calcium, carbon, and phosphorus were the most prevalent chemical elements in the inner part of the stones, whereas on the surface carbon, nitrogen, sulfur, chlorine, aluminum, potassium, zinc, copper, and lead were the most prevalent. Copper, iron, and zinc were higher in the stones than the dentin (P < .05). Statistically significant differences between the chemical structure of stones from erupted and unerupted teeth were not detected (P > .05). CONCLUSIONS: Pulp stones have structural and chemical properties that are similar to dentin. Variations in morphology are common.

Morphology of the palate, palatal rugae pattern, and dental arch form in patients with schizophrenia.

AIMS: This study aimed to investigate the morphology of the palate, palatal rugae pattern, and dental arch form in patients with schizophrenia. METHODS AND RESULTS: An observational case-control study was designed following the STROBE statement and checklist. The sample consisted of 132 patients (39 diagnosed with schizophrenia and 93 controls). Dental casts of the patients were classified based on the pattern of their palatal rugae, their dental arch form, and the area of their palate. The palatal rugae in patients with schizophrenia had a more random distribution and shape compared to the control group (P = .027). Oval dental arches were the most prevalent in both groups (P = .473). The palate area was slightly larger in the control group (3.2318 ± 0.549 mm2 ) compared with the group of patients with schizophrenia (3.060 ± 0.470 mm2 ) (P = .090). CONCLUSION: Palatal rugae pattern may feature as a potential minor physical anomaly for schizophrenia. Additional studies with alternative sampling and classification systems are necessary to understand this finding and its applications in practice.

Oral manifestations of celiac disease. A case report and review of the literature.

Celiac disease is a chronic intestinal disease caused by intolerance to gluten associated with poor digestion and absorption of the majority of nutrients and vitamins, which may affect both developing dentition and oral mucosa. The aim of this study is to make a brief review of the literature about celiac disease and to report on a clinical case, showing the impact it may have on the general and oral health. A 39-year-old woman reported the presence of diarrhea, nauseas, flatulence, colic, difficulty with falling asleep, lack of appetite and loose of 18 Kg in the last two years. She also noted the appearance of symptomatic lesions in the mouth. These lesions had a mean duration of a month and occurred in any region of the oral mucosa, particularly on the tongue. Multiples ulcerations were found in the sublingual caruncula region, at the vestibular fornix and at the lingual apex. Topical treatment was instituted for the oral lesions with immediately relief of the symptoms. The diagnosis of celiac disease was established by means of medical clinical exam, biopsy of the small intestine, and by the presence of specific antibodies in the blood. The patient has been instructed to follow a gluten-free diet. Multiprofessional action with the involvement of a gastroenterologist and other health professionals, such as dentists, is important for diagnosing the disease and guiding the patient with celiac disease to achieve a good quality of life.