Challenges in the assessment of epithelial dysplasia in oral lichen planus and oral lichenoid lesion: Inter and intra-observer variability of the WHO criteria and binary system.

Background: Assessment of oral epithelial dysplasia is the gold standard for investigating the risk of malignant progression. The World Health Organization (WHO) methods and the binary system have limitations. This study assess the inter- and intra-observer variability of the architectural and cytological criteria and the classification of the presence and degree of epithelial dysplasia in oral lichen planus (OLP) and oral lichenoid lesion (OLL), using both the 2017 WHO criteria and the binary system. Material and Methods: The sample consisted of 65 biopsies from lesions classified as OLP and OLL according to the American Academy of Oral and Maxillofacial Pathology (AAOMP) criteria. The histological slides were reevaluated by two oral pathologists. Results: The individual alterations with most inter-observer disagreement were atypical mitotic figures (43.1%), loss of cohesion between epithelial cells (38.5%) and drop shape rete ridges ridges (38.5%). Inter-observer agreement analysis did not show statistically significant agreement regarding the classification of epithelial dysplasia grade by WHO criteria, only regarding the binary system classification (k=0.257; p=0.035). Intra-observer agreement analysis by evaluator 1 showed that the classification of epithelial dysplasia grade according to both methods had statistically significant agreement (k=0.546; p=0.004, k=0.861; p<0.001). Considering evaluator 2, only the evaluation of the WHO system classification showed statistically significant agreement (k=0.593; p=0.010). Conclusions: The evaluation of epithelial dysplasia is subjective and focal changes and inflammatory infiltrate, characteristic of OLP and OLL, can increase the degree of disagreement among evaluators. The binary system presents better inter-observer agreement, while the WHO system presents better intra-observer agreement. Key words:Oral lichen planus, oral lichenoid lesion, oral lichenoid disease, dysplasia, inter-observer variation.

Oral lichenoid lesion in association with chemotherapy treatment for non-Hodgkin lymphoma or lichen planus? Review of the literature and report of two challenging cases.

BACKGROUND: The diagnosis of oral lichenoid lesions (OLL) remains a challenge for clinicians and pathologists. Although, in many cases, OLL cannot be clinically and histopathologically distinguishable from oral lichen planus (OLP), one important difference between these lesions is that OLL has an identifiable etiological factor, e.g. medication, restorative material, and food allergy. The list of drugs that can cause OLL is extensive and includes anti-inflammatory drugs, anticonvulsants, antihypertensives, antivirals, antibiotics, chemotherapeutics, among others. This work aimed to perform a literature review of OLL related to chemotherapy drugs and to report two cases of possible OLL in patients with B-cell and T-cell non-Hodgkin lymphomas in use of chemotherapy and adjuvant medications. We also discuss the challenge to clinically and histopathologically differentiate OLL and OLP. CASE PRESENTATION: In both cases, oral lesions presented reticular, atrophic, erosive/ulcerated, and plaque patterns. The diagnosis of OLL was initially established in both cases by the association of histopathology and history of onset of lesions after the use of medications. Although the patients have presented a significant improvement in the oral clinical picture for more than 2 years of follow-up, they still have some lesions. CONCLUSION: A well-detailed anamnesis associated with the drug history, temporal relationship of the appearance of the lesions, and follow-up of patients are fundamental for the diagnosis of OLL related to drugs. Nevertheless, its differentiation from OLP is still a challenge.

Congenital sebaceous choristoma of the tongue: A rare case report.

The most common oral choristomas are consisted of thyroid tissue and bone. The presence of sebaceous glands in the oral mucosa, especially in the buccal mucosa and labial mucosa, is often considered a normal anatomical variation since they are observed in about 80% of the population and are called ectopic sebaceous glands or Fordyce's granules. However, the presence of these glands on the tongue is rare, with only 11 cases in the dorsum of the tongue reported in the English literature, and it is considered a choristoma. This paper aims to report the third case in the literature of a congenital sebaceous choristoma on the tongue. An 11-year-old white male patient presented a firm sessile papule, without color alteration, measuring 0.4 cm x 0.3 cm in diameter, in the middle third of the dorsum of the tongue with a slight increased size in the last months. Histopathological examination showed an invagination of the epithelium into the connective tissue, forming a ductal structure covered by stratified squamous epithelium. The deeper areas had normal well-differentiated sebaceous glands, with ducts connected to the central duct. Considering clinical and histopathological findings the diagnosis was sebaceous choristoma. Despite being rare, sebaceous choristomas should also be considered in the differential diagnosis of tongue abnormalities or lesions. Although the pathogenesis is not well understood, the present report, as a congenital choristoma case in the midline, reinforces the hypothesis of a disorder with embryological origin and a possible relationship with thyroglossal duct remnants. Key words:Choristoma, Oral Mucosa, Tongue.

An integrative review of oral manifestations in patients with COVID-19: signs directly related to SARS-CoV-2 infection or secondary findings?

We conducted an integrative review on oral manifestations in patients with COVID-19 based on the current available literature evidence. A bibliographic search was carried out on March 11, 2021, among published studies in the years 2019-2021 in the PubMed database and based on the search strategy ("COVID-19" AND "oral lesions" OR "oral mucositis" OR "oral manifestation"). After applying the inclusion and exclusion criteria, 29 articles were considered suitable for this review. A total of 110 cases of patients with COVID-19 who had oral manifestations were reported. The presence of ulcerated lesions was the most common finding, having a herpetiform and aphthous clinical pattern observed in most cases. Macules, petechiae, hemorrhagic blisters, pustular enanthem, mucositis, and halitosis were also among the most frequently described oral manifestations. The tongue was the most commonly affected site, followed by the palate and lip. Most of the reported cases were diagnosed only by the clinical aspect of the lesion associated with a positive SARS-CoV-2 test or the presence of other COVID-19 symptoms. Current scientific evidence still could not affirm that most of the oral lesions observed in patients with COVID-19 are related to the virus's direct or indirect action on the oral mucosa. To confirm this association, prospective and longitudinal studies are further needed, together with a larger number of patients, complemented by histopathological examination of these lesions. Additionally, molecular techniques, such as immunohistochemistry and in situ hybridization, may be necessary to perform the differential diagnosis with other oral lesions.

Dentinogenic ghost cell tumor with focal atypical features suggesting ghost cell odontogenic carcinoma: Report of a challenging diagnosis.

Dentinogenic ghost cell tumor (DGCT) represents a rare benign odontogenic neoplasm that can appear in a central or peripheral form and may rarely undergo malignant transformation to ghost cell odontogenic carcinoma (GCOC). We aim to report a case of a central DGCT with focal cytological malignant aspects. A 24-year-old woman exhibited a painful enlargement and dental mobility in the left posterior maxilla for about one year, which appeared as an expansive well-defined hypodense maxillary image with hyperdense foci invading ipsilateral maxillary sinus. Incisional biopsy showed a predominantly solid hyperchromatic basaloid epithelium presenting cellular pleomorphism and mitotic activity, admixed with abundant ghost cell aggregates and dentinoid material. The lesion was immunopositive for p53 and had 21% of Ki-67 proliferation index (PI). These microscopic features suggested initially a GCOC diagnosis. Partial left maxillectomy was performed without complications. The surgical specimen presented an exuberant variation of the epithelial parenchyma, including ameloblastomatous, fusiform, and cribriform areas, with numerous ghost cells and dentinoid material, lacking any signs of malignancy. The final diagnosis was DGCT. The patient is in a strict regular follow-up for over two years, and there are no signs of recurrence.

Comparative Analysis Between Dentinogenic Ghost Cell Tumor and Ghost Cell Odontogenic Carcinoma: A Systematic Review.

Dentinogenic ghost cell tumor (DGCT) and ghost cell odontogenic carcinoma (GCOC) form a spectrum of rare benign and malignant odontogenic neoplasms, respectively. The aim of this study was to perform a comparative systematic review of the clinicopathological, genetic, therapeutic, and prognostic features of DGCT and GCOC. The electronic search was performed until December 2020 on seven electronic databases. Case reports, series, and research studies with enough histopathological criteria for diagnosis and all genomic studies were included. Both DGCT and GCOC showed a male prevalence (p = 0.043), with mandibular and maxillary predilections, respectively (p = 0.008). Peripheral DGCT (DGCTp) affected most elderly people (p < 0.001), and central DGCT (DGCTc) and GCOC occurred mainly in younger individuals. Unilateral enlargement of maxilla or mandible was the most common clinical sign associated with a radiolucent or mixed image. Ameloblastomatous epithelium was often present in both neoplasms. Basaloid and large cells with vesicular nuclei were also frequently seen in GCOC. ß-catenin expression and mutations (CTNNB1 gene) were found in DGCT and GCOC. Conservative surgery was mostly used for DGCTp, while radical resection was chosen for DGCTc and GCOC. High recurrence rates were found in DGCTc and GCOC. Metastasis occurred in 16.7% of GCOC cases and the 5-year survival rate was 72.6%. DGCT and GCOC share numerous clinicopathological features and demand a careful histopathological evaluation, considering the overlap features with other odontogenic tumors and the possibility of malignant transformation of DGCT. A strict regular post-operative follow-up is mandatory due to high recurrence rates and metastatic capacity in GCOC.

Recomendações para o Manejo e a Mitigação do Aerossol Produzido pelo Uso de Instrumentos Rotatórios de Alta Velocidade Durante Epidemia da COVID-19: Revisão Integrativa / Recommendations for Management and Mitigation of Aerosol Generated by the Use of High-Speed Rotary Instruments During the COVID-19 Epidemic: An Integrative Review

Objetivo: sistematizar a produção bibliográfica sobre as recomendações para o manejo e a mitigação do aerossol produzidos por instrumentos rotatórios de alta velocidade em tempos de epidemia pela COVID-19. Método: foi realizada uma busca bibliográfica no em bases bibliográficas eletrônicas brasileiras e internacionais (Lilacs, SciELO, MEDLINE e PubMed). Após aplicados critérios de inclusão e exclusão dos documentos, 21 estudos foram selecionados para a realização da revisão. Resultado: foi construída uma proposta com recomendações para reduzir a contaminação durante procedimentos geradores de aerossol provenientes de instrumentos rotatórios de alta velocidade. Conclusão: recomenda-se a utilização de equipamentos de proteção individual completo, incluindo respiradores N95, PFF2, PFF3 ou similar, o emprego de barreiras mecânicas, a aspiração através de bomba de alta eficiência, a constante renovação do ar ambiente através de sistemas de exaustão ou pressurização da sala de trabalho e a limpeza e desinfecção criteriosa do ambiente de trabalho após cada atendimento

Objective: To systematize the bibliographic production on the recommendations for management and mitigation of aerosol generated by high-speed rotary instruments in times of COVID-19 epidemic. Material and Methods: A bibliographic search was carried out on Brazilian and international electronic bibliographic databases (Lilacs, SciELO, MEDLINE and PubMed). After applying criteria for inclusion and exclusion of articles, 21 studies were selected to carry out the review. Results: A proposal was designed with recommendations to reduce contamination during aerosol-generating procedures with high-speed rotary instruments. Conclusion: It is recommended to use complete personal protective equipment, including N95, FFP2, FFP3 or similar respirators, mechanical barriers, suction through high volume evacuator, constant renewal of the ambient air through exhaust systems or workroom pressurization, and careful cleaning and disinfection of the work environment after each patient

Odontologia em Tempos de COVID-19: Revisão Integrativa e Proposta de Protocolo para Atendimento nas Unidades de Saúde Bucal da Polícia Militar do Estado do Rio de Janeiro - PMERJ / Dentistry During the COVID-19 Pandemic: Integrative Review and Proposed Protocol for the Rio de Janeiro State Military Police Dental Care Units

Objetivo: sistematizar a produção bibliográfica sobre as recomendações, práticas e cuidados adotados no atendimento odontológico em tempos de COVID-19, assim como, propor um protocolo de atendimento odontológico nas unidades de saúde bucal da Polícia Militar do Estado do Rio de Janeiro a partir das evidências encontradas na literatura. Material e Métodos: foi realizada uma busca bibliográfica no dia 11 de abril de 2020 em bases bibliográficas eletrônicas brasileiras e internacionais (Portal Regional da Biblioteca Virtual em Saúde, Web of Science e Pubmed), a partir da estratégia de busca ("COVID-19" AND "dentistry"), entre estudos publicadas nos anos de 2019 e 2020. Após aplicados os critérios de inclusão e exclusão dos documentos, 18 estudos foram considerados elegíveis para a realização da revisão. Resultados: a partir das evidências científicas encontradas nos estudos, foi construída uma proposta de protocolo para o atendimento odontológico nas unidades de saúde da Polícia Militar do Estado do Rio de Janeiro, assim como em qualquer outra unidade de saúde bucal. Conclusão: durante o período de surto epidêmico os atendimentos devem restringir-se às urgências e emergências odontológicas. O Cirurgião-Dentista deve redobrar a atenção à rotina de biossegurança como: lavagem rigorosa das mãos com água e sabão e/ou 'álcool gel a 70%', uso correto de todo equipamento de proteção individual e sua troca a cada paciente. Recomenda-se o tempo de 3 horas entre os atendimentos quando houver produção de aerossol, a higienização de todas as superfícies do consultório com hipoclorito de sódio a 0,1% ou 'álcool 70%', esterilização de todo instrumental e o descarte adequado dos resíduos.

Objective: to collate the literature that contains recommendations, best practices, and infection control measures for dental health care during the COVID-19 pandemic and, based on this evidence, to propose a protocol for use at the Rio de Janeiro State Military Police dental health care units. Materials and Methods: search of the regional VHL Network Portal, Web of Science, and Pubmed databases using the search query ("covid19" AND "dentistry") to retrieve studies published in 2019 and 2020. After applying the inclusion and exclusion criteria, 18 were found to be eligible for the review. Results: from the scientific evidence reported in the retrieved documents, an infection control protocol was proposed for use at the Rio de Janeiro State Military Police dental care units, which could be applied to any dental health setting. Conclusion: while the epidemic continues, only urgent and emergency dental care should be provided. The dental surgeon should adopt enhanced biosecurity measures, namely: rigorous hand sanitizing with soap and water and/or 70% alcohol hand sanitizer; correct use of complete personal protective equipment (PPE), and discarding of PPE after each patient; allowing three hours to elapse between patients after aerosol-generating procedures; cleaning of all surfaces with 0.1% sodium hypochlorite or 70% ethanol; sterilization of all instruments; and adequate disposal of all waste.

Uso dos Equipamentos de Proteção Individual no Atendimento Odontológico Durante Surto da COVID-19 e Alternativas em Períodos de Desabastecimento: Revisão Integrativa / Use of Personal Protective Equipment in Dental Care During COVID-19 Outbreaks and Options During Supply Shortages: An Integrative Review

Objetivo: sistematizar a produção bibliográfica sobre as recomendações para uso, uso prolongado, reuso e descontaminação de equipamentos de proteção individual (EPI) no atendimento odontológico em período de surto epidêmico da COVID-19 a partir das evidências encontradas na literatura. Material e Métodos: foi realizada uma busca bibliográfica no dia 1 de maio de 2020 em bases bibliográficas eletrônicas brasileiras e internacionais (Portal Regional da Biblioteca Virtual em Saúde, Web of Science e Pubmed), a partir da estratégia de busca ("individual protective equipment" AND "covid-19"), entre estudos publicados nos anos de 2015 a 2020. Foram também analisados documentos de órgãos de vigilância sanitária de diferentes países e recomendações da Associação Americana de Odontologia. Após aplicados os critérios de inclusão e exclusão dos documentos, 20 estudos foram considerados elegíveis para a realização da revisão. Resultados: Há uma escassez de publicações que relacionem a odontologia e o uso de EPI durante a pandemia. O uso prolongado/reuso limitado de respiradores (N95, PFF2, PFF3) pode ser recomendado em períodos de grave desabastecimento de EPIs desde que a sua integridade e capacidade de vedação estejam mantidas. Os aventais de tecido não tecido, máscaras cirúrgicas, luvas e gorros são considerados equipamentos de uso único. Os protetores oculares podem ser reusados após limpeza e desinfecção. Conclusão: Em períodos de surtos epidêmicos da SARS-CoV-2 recomendamos para atendimento odontológico com geração de aerossol o uso de respiradores do tipo N95, PFF2, PFF3 ou equivalente, protetor facial que pode ser reusado após limpeza e desinfecção e o uso de avental impermeável, luvas e gorro que devem ser descartados a cada paciente

Objective: to collate the recommendations on the use, extended use, reuse, and decontamination of personal protective equipment (PPE) in dental care during the COVID-19 outbreak, based on evidence found in the literature. Materials and Methods: searches were made of the following Brazilian and international databases on May 1, 2020: the Virtual Health Library Regional Portal, the Web of Science, and PubMed. The search strategy was based on the query ("individual protective equipment" AND "COVID-19") and retrieved publications from 2015 to 2020. Oficial infection prevention and control documents from different countries were also analyzed, as well as the recommendations of the American Dental Association. After applying the inclusion and exclusion criteria, a total of 20 studies were found to be eligible for the review. Results: there is a dearth of publications relating dentistry and PPE use during the pandemic. The extended use and reuse of respirators (N95, FFP2, FFP3) may be recommended during severe shortages, provided they are not damaged and they seal adequately. Nonwoven fabric gowns, surgical masks, gloves, and caps are singleuse PPE. Eye protection may be reused after cleaning and disinfection. Conclusion: during the epidemic of SARS-CoV-2 we recommend wearing a N95, FFP2, FFP3 or equivalent respirator during aerosol-generating procedures, a face shield, which may be reused after cleaning and disinfection, and an impermeable gown, gloves, and cap, which should be discarded between patients

Computerized Evaluation of the Immunoexpression of Ki-67 Protein in Odontogenic Keratocyst and Dentigerous Cyst.

Evaluation and comparison of odontogenic keratocysts and detigerous cysts immunoexpression and immunostaining intensities of Ki-67 antigen by assessing the whole extent of the epithelium (all epithelium layers in combination) and each layer individually. Ki-67 immunoexpression was evaluated in 15 odontogenic keratocysts and 6 dentigerous cysts using automated methods and the Aperio Technologies Inc. computer system. No statistically significant differences were observed in immunoexpression nor in immunostaining intensities between both lesions. Also, no statistically significant differences were found between odontogenic keratocysts from maxilla versus mandible nor primary versus recurrent. However, odontogenic keratocyst showed a significantly higher cellular proliferation index in the suprabasal layers compared to the basal layer. Assessment of the cellular proliferation index through a computerized system enabled the evaluation of all epithelial tissue without field selection. The increased Ki-67 immunoexpression in suprabasal layers of odontogenic keratocyst suggests a different biological behavior and more aggressive proliferation potential when compared to dentigerous cyst. The same result was found in recurrent odontogenic keratocysts when compared with primary ones. The odontogenic keratocysts of the maxilla and mandible have similar Ki-67 immunoexpression. The evaluation of cellular proliferation only by immunohistochemical analysis with Ki-67 antigen does not provide enough data to elucidate the biological behavior of odontogenic keratocyst.

Análise do índice de proliferação celular com o anticorpo Antí-Ki-67 e Ceratocistos Odontogênicos: uma revisão sistemática / Analysis of cell proliferation index using the Ki-67 Antigen in odontogenic keratocyst: a systematic review

Objetivo: analisar artigos científicos sobre o índice de proliferação celular usando o anticorpo anti-Ki-67 em ceratocistos odontogênicos e comparar esses trabalhos para estimar um índice médio para essa lesão. Material e Métodos: dois pesquisadores realizaram a busca literária de forma independente na base de dados MEDLINE/PubMed e 28 artigos contendo dados relevantes foram selecionados. Resultados: a análise imuno-histoquímica utilizada nos artigos avaliados mostrou-se muito variável, não apresentando metodologias claras e unificadas, tornando a comparação entre os diferentes resultados difícil. Conclusão: Considerando o ceratocisto odontogênico uma lesão de comportamento clínico incomum, uma classificação adequada é necessária, assim como um tratamento apropriado com um bom prognostico deve ser estabelecido para o paciente de acordo com sua natureza. Dessa forma, um protocolo de análise imuno-histoquímica deve ser estabelecido para que possamos obter dados confiáveis sobre essa lesão

Objective: this review aims to analyze scientific articles about cell proliferation index using Ki-67 in odontogenic keratocyst and compare these papers to estimate the average index of this lesion. Material and Methods: two researchers performed a literature search independently in the MEDLINE/PubMed database and 28 articles containing relevant data were selected. Results: the immunohistochemical analysis methodology showed great variability among all the papers, with unclear and unified methodologies, making the comparison among different studies difficult. Conclusion: considering odontogenic keratocyst as a lesion with an uncommon clinical behavior, an adequate classification for it is necessary, so an appropriate treatment with a good prognosis for the patient can be established according to its nature. A standardization is needed so immunohistochemical analyses will find reliable data to classify properly this lesion

Primordial Odontogenic Tumor: Report of a New Case and Literature Review.

Primordial odontogenic tumor (POT) was recently recognized in the 2017 World Health Organization (WHO) Classification as a distinct mixed odontogenic tumor most commonly observed in the posterior mandible of young patients. POT appears as an expansile radiolucency associated to an unerupted tooth. The aim of the present study was to perform a retrospective microscopic evaluation of pediatric odontogenic tumors diagnosed in an Oral Pathology Laboratory from Rio de Janeiro-Brazil, in order to reclassify potential cases as POT. From 150 cases of odontogenic tumors in children diagnosed in the last 50 years, one case filled the criteria for POT, being therefore better diagnosed as such. The patient was in the first decade of life and presented a well-defined expansile tumor in the posterior mandible, which had been initially diagnosed as immature complex odontoma. To the best of our knowledge, only 12 cases of POT have been reported in the English-language literature. We herein present an additional case of POT and review of its clinicopathological findings is offered.

Conhecimento e importância atribuída a conteúdos curriculares de Patologia Oral por estudantes de Odontologia e cirurgiões-dentistas / Knowledge and importance attached to curricular contents of Oral Pathology by Dentistry

O objetivo desta pesquisa foi avaliar o conhecimento e a importância atribuída a conteúdos curriculares de Patologia Oral por cirurgiões-dentistas e estudantes. A amostra foi constituída de 113 cirurgiões-dentistas e 55 estudantes de graduação em Odontologia no Rio de Janeiro/Brasil. Questionários e um formulário-teste com dez questões de múltipla escolha foram aplicados aos alunos e dentistas. As respostas foram analisadas em perspectiva descritiva. Os conteúdos curriculares de Patologia Oral apontados como mais relevantes pelos respondentes durante sua vida acadêmica e profissional foram as infecções bacterianas e virais, as alterações de desenvolvimento dos dentes e das estruturas orais e as patologias da polpa e do periápice.

The intraoral video camera: a diagnostic tool in the exam of patient with ncreased oral cancer risk / A vídeo-câmera intraoral como instrumento auxiliar no exame dos pacientes com risco aumentado para câncer bucal

OBJECTIVE: To compare the findings of the clinical examination of the oral cavity with and without theaid of an intraoral video camera (“videoroscopy”) with the purpose of diagnosing epithelial precursorlesions (leukoplakia, erythroplakia and actinic cheilitis) and precancerous conditions (lichen planus).MATERIALS AND METHODS: Both forms of examination were performed in 100 patients withincreased risk of oral cancer. All patients were examined without the aid of any enlargement apparatusbefore the intraoral video camera was used. After each of the exams, the presence or absence of epithelialprecursor lesions or lichen planus was recorded. In the event a lesion was found, a digital picture was takena toluidine blue staining test was performed and then a biopsy was done. RESULTS: Of the patients withepithelial precursor lesions or lichen planus, 80% of the lesions had been observed in both of the examinationswhile 7% only had been diagnosed the after the videoroscopy. The results of the histopathological analysisand the toluidine blue staining tests are also presented. CONCLUSIONS: In this study videoroscopy issuggested for use on a regular basis in patients with an increased risk of oral cancer in an attempt to diagnoseearly lesions, select of the best area to be biopsied and during the following up of these lesions.

OBJETIVO: Comparar os achados do exame clínico da boca com e sem auxílio da vídeo-câmeraintrabucal (videoroscopia) com o propósito de diagnosticar lesões epiteliais precursoras(leucoplasia, eritroplasia, eritroleucoplasia e queilite actínica) e condições pré-cancerosas (líquen plano). MATERIAL E MÉTODOS: Os exames foram realizados em 100 pacientes com riscoaumentado para câncer oral. Todos os pacientes foram examinados sem o auxílio de qualqueraparelho de aumento antes que a vídeo-câmera intrabucal fosse usada. Após cada exame, a presençaou ausência de lesões epiteliais precursoras ou líquen plano foram anotadas. Nos casos em quelesões foram diagnosticadas, fotografaram-se as lesões, bem como o teste do azul de toluidina ea biópsia. RESULTADOS: Dos pacientes com lesão epitelial precursora ou líquen plano, 80%das lesões foram observadas em ambos os exames, enquanto 7% foram somente diagnosticadasapós a videoroscopia. Os resultados histopatológicos e dos testes com azul de toluidina foramtambém discutidos. CONCLUSÕES: Sugere-se a utilização regular da videoroscopia nos pacientescom risco aumentado para o câncer de boca, para auxiliar o diagnóstico de lesões precoces, naseleção da melhor área para a biópsia e acompanhamento dessas lesões.

A utilização da videoroscopia na investigação de lesões orais / The use of videoroscopy for the oral lesions investigation

A avaliação clínica nem sempre é suficiente para garantir o diagnóstico da lesão. O objetivo deste estudo foi avaliar a utilização da vídeo-câmera oral no diagnóstico de lesões. A amostra constituiu-se de 180 pacientes; 105 lesões identificadas foram documentadas e submetidas à biópsia. As lesões biopsiadas foram agrupadas e o padrão-ouro foi a histopatologia. Houve concordância de 89% entre o diagnóstico histopatológico e videoroscopia auxiliada pela oroscopia. Foi concluído que a videoroscopia auxilia a visualização das lesões orais principalmente em locais de difícil acesso, em lesões incipientes, com pouca espessura e/ou de pequeno tamanho.

Cisto odontogênico calcificante associado a odontoma composto: relato de caso / Calcifying odontogenic cyst associated to compound odontoma: report of a case

O cisto odontogênico calcificante (COe) é um tumor odontogênico, que comumente pode apresentar-se associado a um odontoma. O diagnóstico radiográfico de odontoma faz muitos cirurgiões não enviarem a peça cirúrgica para exame anatomopatológico. Tal conduta pode levar o profissional a ignorar o devido diagnóstico e realizar procedimento inadequado. Neste trabalho relata-se um caso de paciente de 16 anos, onde a única manifestação clínica era a ausência do dente 33. Em exame radiográfico foi detectada lesão radiolúcida, com imagens radiopacas no seu interior. Após a hipótese clínico-radiográfica de odontoma composto, foi realizada a biópsia excisional com preservação do dente 33. O resultado histopatológico foi de COC associado à odontoma composto. O paciente está sendo tratado por ortodontia, sem recidiva da lesão. Será enfatizada ainda a importância da associação de um exame clínico-radiográfico criterioso ao exame histopatológico, para obtenção de um diagnóstico final preciso.

The calcifying odontogenic cyst (COC) is an odontogenic tumor, which is commonly associated to odontomas. However, the radiographic diagnosis of an odontoma might lead the dentist not to send the surgical specimen to microscopic analysis. Such behavior might lead the dentists to ignore a proper post-surgical follow-up in cases of COC. In this paper, a case of a calcifying odontogenic cyst associated to an odontoma in a 16 years-old male patient whose only clinical manifestation was the absence of the tooth 33 is reported. In the radiographic examination a radiolucence was detected with radiopaque signs inside. With clinical and radiographic hypothesis of compound odontoma, an excisional biopsy was performed with preservation of the tooth 33. The histopathological result was COC associated to compound odontoma. The patient has been submitted to orthodontic treatment without recurrence. In this paper, it will be emphasized the importance of an association of a proper clinical and radiographic examinations to the histopatological analysis to obtain an accurate definitive diagnosis.

Epithelial Precursor Lesions and Squamous Cell Carcinoma Prevalence for a Period of 10-years in the Anatomic Pathology Service of the Antonio Pedro University Hospital, Fluminense Federal University

Oral squamous cell carcinoma represents approximately 90% of all oral malignancies and in some cases can be preceded by lesions considered epithelial precursor lesions. Early diagnosis of these lesions and intervention at an early stage constitute keys to reduce mortality, morbity and expenses with oral cancer treatment. The objective of this paper is to present the prevalence of epithelial precursor lesions and oral squamous cell carcinoma at the Anatomic Pathology Service of Antônio Pedro University Hospital, Fluminense Federal University in the last ten years. Considered data were sex, age, race, location, addictions, clinical and histological aspects. A total of 3,752 oral lesions were found and evaluated. The epithelial precursor lesions represented 4.23% of the oral biopsies, while the squamous cell carcinoma represented 4.21%. Leukoplakia was the most prevalent clinical aspect among the epithelial precursor lesions. The white women in their sixties were the mostaffected and the buccal mucosa was the most common anatomic localization. The most frequent histological finding was the epithelial hyperplasia without dysplasia. The squamous cell carcinoma showed up clinically as an ulceration in 80.3% of the cases. The white men in their sixties were the most affected. The tongue was the most affected area. In relation to the histological classification, the most frequent type was the moderately differentiated squamous cell carcinoma. The patientswith epithelial precursor lesions and with squamous cell carcinoma were smokers in its majority.

Tabagismo: pesquisa entre alunos e professores de Odontologia / Tobaccoism: a research among students and professors of Dentistry

Foi avaliado o comportamento de alunos e professores de Odontologia com relação ao tabagismo e ao conhecimento de suas consequências. Do total de pesquisados, 70% eram não fumantes, 19% fumantes, 11% ex-fumantes, sendo o tipo de fumo mais utilizado o cigarro (82,5%). A maioria fuma há menos de cinco anos (42,1%), e de 5 a 10 cigarros por dia (42,1%). Do total de fumantes, 70,2% tentaram parar de fumar, sendo que 90% destes voltaram a fumar. Apenas um pesquisado não sabia que o fumo pode causar câncer de boca