Necrotizing sialometaplasia: systematic review and meta analyses over the past 46 years

Objectives: The aim of this study was to characterize the main characteristics of this disease in relation to diagnosis, clinical aspects, progression and treatment as well as correlating them with remission time. Material and Methods: A systematic search was performed following the guidelines given by PRISMA and the Joanna Briggs Institute. PubMed, Web of Science and Scopus were the databases used. Results: The final analysis resulted in 108 articles with 173 clinical cases. The longest remission time for signs and symptoms (>7 weeks) was registered among male patients (p = 0.02) and outside the oral cavity; however no significant correlation was observed (p>0.05). A high risk of bias was the most common rating among the articles analyzed (55%); followed by moderate (27%) and low (18%). The lack of standardization in clinical case report descriptions made it difficult to gain a thorough knowledge of the essential characteristics of the NS patho-logical processes. Conclusion: It is recommended that publications follow the standards recommended by the literature; in addition, studies using advanced technologies to better understand NS's pathological path are recommended so as to propose effective treatments for this disease. (AU)

Contribution of public oral pathology services to the diagnosis of oral and oropharyngeal cancer in Brazil.

This study aimed to evaluate the contribution of oral and maxillofacial pathology laboratories (OMPLs) in Brazilian public universities to the diagnosis of lip, oral cavity, and oropharyngeal squamous cell carcinoma (SCC). A cross-sectional study was performed using biopsy records from a consortium of sixteen public OMPLs from all regions of Brazil (North, Northeast, Central-West, Southeast, and South). Clinical and demographic data of patients diagnosed with lip, oral cavity, and oropharyngeal SCC between 2010 and 2019 were collected from the patients' histopathological records. Of the 120,010 oral and maxillofacial biopsies (2010-2019), 6.9% (8,321 cases) were diagnosed as lip (0.8%, 951 cases), oral cavity (4.9%, 5,971 cases), and oropharyngeal (1.2%, 1,399 cases) SCCs. Most cases were from Brazil's Southeast (64.5%), where six of the OMPLs analyzed are located. The predominant profile of patients with lip and oral cavity SCC was Caucasian men, with a mean age over 60 years, low schooling level, and a previous history of heavy tobacco consumption. In the oropharyngeal group, the majority were non-Caucasian men, with a mean age under 60 years, had a low education level, and were former/current tobacco and alcohol users. According to data from the Brazilian National Cancer Institute, approximately 9.9% of the total lip, oral cavity, and oropharyngeal SCCs reported over the last decade in Brazil may have been diagnosed at the OMPLs included in the current study. Therefore, this data confirms the contribution of public OMPLs with respect to the important diagnostic support they provide to the oral healthcare services extended by the Brazilian Public Health System.

Twenty-year analysis of photobiomodulation clinical studies for oral mucositis: a scoping review.

OBJECTIVE: Our objective was to review the first 20 years of photobiomodulation (PBM) clinical studies for oral mucositis (OM) mitigation. STUDY DESIGN: A scoping review screened controlled clinical studies. The PBM devices, protocols, and clinical outcomes were analyzed. RESULTS: Seventy-five studies met the inclusion criteria. The first study dated from 1992, and the term "PBM" was first published in 2017. Public services, placebo-controlled randomized trials, and patients with head and neck chemoradiation were predominant among included studies. Prophylactic red intraoral laser protocols were mostly used. Comparing the outcomes of all protocols was unfeasible due to missing treatment parameters and nonhomogeneous measurements. CONCLUSIONS: The main barrier to optimizing clinical protocols of PBM for OM was the lack of standardization in clinical studies. Although PBM use is now globally present in oncology settings and generally marked by good outcomes reported, additional randomized clinical trials with well-described methods are necessary.

Expression and degranulation of mast cells in laser photobiomodulated mucositis chemo-induced: pilot study in hamsters.

This study aimed to evaluate the influence of laser photobiomodulation on the expression and degranulation of mast cells in chemo-induced oral mucositis (OM) lesions in hamsters. Twelve adult male Syrian hamsters (Mesocricetus auratus), golden lineage, were submitted to OM induction. They were divided into three groups: control-OM without treatment (C), OM treated with red laser (RL), OM treated with infrared laser (IL) and analyzed in the experimental time of 7 days. Three and 4 days after the intraperitoneal injection of the chemotherapy drug fluorouracil, the OM lesions were induced by making grooves in the right cheek pouch. Immediately after chemoinduction, the hamsters were submitted to photobiomodulation every 48 h for 7 days. The specimens were processed and stained using the hematoxylin-eosin and toluidine blue techniques. There was a predominance of mild chronic inflammation in the experimental groups and a greater persistence of neutrophils in the control group (C), although not statistically significant. The group irradiated with red laser (RL) had the highest mean mast cell expression (38.28 ± 19.05) (p < 0.001). As for the degranulation activity in mast cells, the control group (C) showed a greater number of fields with more than 50% of degranulated cells, presenting statistical significance when comparing it with the RL (p < 0.009) and IL (p = 0.036) group. It can be concluded that photobiomodulation, at both wavelengths, decreased mast cell degranulation, accelerating the inflammatory process. The use of infrared laser provided, in addition to less degranulation, the quantitative reduction of mast cells.

Contribution of public oral pathology services to the diagnosis of oral and oropharyngeal cancer in Brazil

Abstract This study aimed to evaluate the contribution of oral and maxillofacial pathology laboratories (OMPLs) in Brazilian public universities to the diagnosis of lip, oral cavity, and oropharyngeal squamous cell carcinoma (SCC). A cross-sectional study was performed using biopsy records from a consortium of sixteen public OMPLs from all regions of Brazil (North, Northeast, Central-West, Southeast, and South). Clinical and demographic data of patients diagnosed with lip, oral cavity, and oropharyngeal SCC between 2010 and 2019 were collected from the patients' histopathological records. Of the 120,010 oral and maxillofacial biopsies (2010-2019), 6.9% (8,321 cases) were diagnosed as lip (0.8%, 951 cases), oral cavity (4.9%, 5,971 cases), and oropharyngeal (1.2%, 1,399 cases) SCCs. Most cases were from Brazil's Southeast (64.5%), where six of the OMPLs analyzed are located. The predominant profile of patients with lip and oral cavity SCC was Caucasian men, with a mean age over 60 years, low schooling level, and a previous history of heavy tobacco consumption. In the oropharyngeal group, the majority were non-Caucasian men, with a mean age under 60 years, had a low education level, and were former/current tobacco and alcohol users. According to data from the Brazilian National Cancer Institute, approximately 9.9% of the total lip, oral cavity, and oropharyngeal SCCs reported over the last decade in Brazil may have been diagnosed at the OMPLs included in the current study. Therefore, this data confirms the contribution of public OMPLs with respect to the important diagnostic support they provide to the oral healthcare services extended by the Brazilian Public Health System.

Florid cemento-osseous dysplasia-related osteonecrosis: A series of cases.

OBJECTIVE: The aim of this study was to assess the clinicopathological features of florid cemento-osseous dysplasia (FCOD)-related osteonecrosis highlighting their histopathological aspects and bone structure. METHODS: Twenty-two FCOD-related osteonecrosis cases were evaluated retrospectively. Osteonecrosis, osteomyelitis, bacterial colonization, bone resorption, reactive bone, osteon-like structure, lamellar bone, and basophilic lines were analyzed. Specific staining and fluorescence and polarized light microscopy analyses were also performed. RESULTS: The mandible was more affected by FCOD-related osteonecrosis. There was a predominance of African-Brazilian women in the fifth and seventh decades of life. Osteomyelitis was present in 82 % of cases whereas bone resorption and bacterial colonization were present in 100 % of FCOD-related osteonecrosis cases. Thick basophilic lines were seen in all cases (100 %). Actinomycosis and osteoclasts were not often. CONCLUSIONS: This study showed female adult preference, mandibular location, and some findings such as osteomyelitis, bone resorption, and bacterial colonization were histopathological features more frequent in FCOD-related osteonecrosis. In the absence of a close clinical and radiographic correlation, the morphology of the necrotized bone similar to cementum could help to recognize FCOD.

Necrotizing sialometaplasia: a case report of a non-ulcerated histopathological presentation.

A 27-year-old woman presented with the chief complaint of severe pain in the palate region, which had been present for two months. Upon examination, she was found to have a firm, non-ulcerated nodule measuring about 2.5cm at the palatal junction. Incisional biopsy was recommended because the clinical differential diagnosis was mucoepidermoid carcinoma or squamous cell carcinoma. Anatomopathological examination revealed squamous metaplasia of the salivary gland ducts with preservation of the lobular architecture. Immunohistochemistry showed metaplastic ducts with low reactivity for p53 and Ki67, as well as positivity for CK AE1/AE3, CK7, p63, S-100, and SMA. The final diagnosis was necrotizing sialometaplasia. No treatment is required for this disease. Thirty-nine days after biopsy, total remission was observed with no signs of relapse after two years.

Escleroterapia como tratamento conservador para hemangioma oral: relato de caso / Sclerotherapy as a conservative approach for oral hemangioma: case report

Introdução: o hemangioma é um tumor benigno vascular de origem endotelial, definido por crescimento anormal dos vasos sanguíneos. Essa lesão pode atingir qualquer parte do corpo, porém a região de cabeça e pescoço tem uma incidência de 60% dos casos; na cavidade oral, ela pode se apresentar na língua, na mucosa bucal, no palato, nos lábios. O tratamento é multimodal, incluindo laser, crioterapia, excisão cirúrgica, agentes quimioterápicos e escleroterapia. Objetivo: apresentar um relato de caso de escleroterapia em hemangioma de dorso de língua, tratado com dose única de oleato de monoetanolamina. Metodologia: paciente do sexo feminino, 35 anos, branca, apresentou-se a um consultório particular queixando-se de lesão pigmentada na língua, assintomática, notada após contato com aparelho ortodôntico lingual. Ao exame clínico intrabucal foi observada lesão nódulo papular, de coloração vermelha, localização em dorso de língua, com 0.5 cm de diâmetro e inserção séssil com diagnóstico de hemangioma oral. Tratado em dose única com oleato de monoetanolamina a 0.4ml na proporção de 50%, diluído na solução anestésica local de lidocaína com adrenalina 1\100.000 no centro da lesão. Resultados: a lesão apresentou regressão total da lesão e sem recidiva após uma sessão do tratamento. Conclusão: escleroterapia é um tratamento conservador, eficiente e com resultado estético positivo, nos casos de hemangioma, porém vale ressaltar que esta deve ser devidamente indicada, analisando sempre as suas limitações e os seus benefícios.

Introduction: hemangioma is a benign vascular tumor of endothelial origin defined by abnormal growth of blood vessels. This injury can affect any part of the body, but the head and neck region has an incidence of 60% of cases. In the oral cavity it may be present in the tongue, buccal mucosa, palate, lips. Treatment is multimodal including laser, cryotherapy, surgical excision, chemotherapeutic agents and sclerotherapy. Objective: to present a case report of sclerotherapy in tongue dorsal hemangioma treated with a single dose of monoethanolamine oleate. Methodology: a 35-year-old white female patient presented to a private practice complaining of asymptomatic pigmented tongue injury noted after contact with the lingual orthodontic appliance. Clinical examination revealed a red papular nodule lesion, located on the back of the tongue, 0.5 cm in diameter and sessile insertion diagnosed with Oral Hemangioma. The nodule was treated in the lesion center with a single dose of 0.4 ml monoethanolamine oleate, at a proportion of 50% dilution in 1\100,000 local anesthetic solution of lidocaine with adrenaline. Results: total regression of the lesion and no recurrence was presented after 01 treatment session. Conclusion: sclerotherapy is a conservative treatment, efficient and with positive aesthetic result in cases of Hemangioma, but it is worth mentioning that it should be properly indicated always considering its limitations and its benefits.

Análise comparativa entre a coloração do azul de toluidina e a imunoexpressão da ciclina D1 em leucoplasias da mucosa bucal com diferentes graus de atipia / Comparative analysis between the coloring of toluidine blue and the immunoexpression of cyclin D1 in leucoplakias of the bucal mucosa with different degrees of atipia

O câncer de boca ocupa uma posição de destaque em relação ao número total de casos registrados no Brasil. A displasia epitelial (DE) oral é um achado histopatológico associado a um risco aumentado de transformação maligna do epitélio oral. A falha nos mecanismos de sinalização celular, no controle do ciclo celular ou nos mecanismos para reparar danos celulares pode favorecer a processos que culminam com a progressão para o câncer. Objetivo: avaliar comparativamente a resposta clínica da marcação do azul de toluidina (AT) e a imunoexpressão da proteína ciclina D1, uma proteína nuclear de grande importância como regulador da transição da fase G1 para fase S do ciclo celular, em leucoplasias oral (LO). Metodologia: avaliamos 12 pacientes que apresentavam, na cavidade bucal, lesões com diagnóstico clínico de LO. O estudo se desenvolveu em duas etapas: clínica e laboratorial. Foi feita marcação com AT e avaliação Imuno-histoquímica, respectivamente. Após análise quantitativa das lâminas, os dados obtidos foram analisados pelo programa BIOESTAT 2.0, por meio dos testes de Spearman e pelo teste de correlações múltiplas de Pearson. Resultados: não foi observada relação entre a marcação clínica do AT, o grau de displasia da lesão e a imunoexpressão da Ciclina D1 em LO. Conclusão: 82% das lesões apresentaram DE em graus variados, confirmando a necessidade de se realizar o diagnóstico histopatológico das LO e o acompanhamento clínico posterior dos pacientes.

Mouth cancer occupies a prominent position in relation to the total number of cases registered in Brazil. Oral epithelial dysplasia (ED) is a histopathological finding associated with an increased risk of malignant transformation of oral epithelium. The failure in the mechanisms of cell signaling, cell cycle control mechanisms or to repair cell damage can favor processes that culminate with the progression to cancer. Objective: evaluate comparatively the clinical response of the toluidine blue marking (TB) and immuno-expression of cyclin D1 protein, a nuclear protein of great importance as a factor regulating the transition from G1 phase to S phase of the cell cycle, in oral leukoplakia (OL). Methodology: we evaluated 12 patients who presented lesions in the oral cavity with clinical diagnosis of OL. The study was developed in two stages: Clinical and Laboratorial. Marking was made with TB and immunohistochemical evaluation, respectively. After quantitative analysis of blades, the data obtained were analyzed by BIOESTAT program 2.0 through Spearman tests and by Pearson multiple correlation test. Results: no relation was observed between clinical marking of TB, the degree of dysplasia of the lesion and the immuno-expression of Cyclin D1 in OL. Conclusion: 82% of the lesions presented DE in varying degrees, confirming the need to perform histopathological diagnosis of the OL and the subsequent clinical monitoring of the patients.