Subset of CD8+ and FOXP3 + T cells in lichen planus associated with chronic hepatitis C infection.

OBJECTIVE: To verify whether there are differences between populations of CD8 + and FoxP3 + T cells in lesions of oral lichen planus associated with hepatitis C virus chronic infection (OLP-HCV) and lesions of idiopathic oral lichen planus (OLP-I). MATERIALS AND METHODS: A case-control study was performed using a convenience sample of 11 paraffin-embedded tissue blocks of OLP-HCV and 19 of OLP-I. Histological sections stained with haematoxylin and eosin were used to classify the intensity of inflammatory infiltrate. Immunohistochemistry was used to identify CD8 + and FoxP3 + T cells. The count of positive cells was compared between the two groups and correlated to clinical and demographic data (p < 0.05). RESULTS: There were no statistically significant differences in the distribution of CD8 + and FoxP3 + T cells regarding the inflammatory infiltrate in lesions of OLP-HCV and OLP-I. Atrophic/erosive lesions showed a higher relationship between counts of CD8/FoxP3 T cells per mm2 (p = 0.018) and counts of CD8 + T cells per mm2 (p = 0.034) in OLP-HCV group compared to OLP-I group. CONCLUSION: Overall, no difference was found between cell populations in the lesions of OLP-HCV and OLP-I. However, atrophic/erosive lesions of OLP-HCV had a higher amount of CD8 + T cells and lower FoxP3 expression.

Salivary evaluation in radioactive I131 treated patients with thyroid carcinoma.

BACKGROUND AND OBJECTIVE: radioiodine treatment (I131) used to treat thyroid carcinomas produces side effects (sialadenitis, xerostomia, dysphagia and caries susceptibility) reflecting in a poor patient quality of life. This study aimed to evaluate the effect of I131 on salivary function and possible oral impairment. MATERIAL AND METHODS: Thirty-seven patients undergoing I131 were submitted to oral examination, answer questions regarding xerostomia/hyposalivation and collect saliva at three moments (M1: 30-45 days before I131, M2: 1-2 days after I131 and M3: 7-10 days after treatment). Saliva was assayed for flow rate and calcium/phosphate concentrations. RESULTS AND CONCLUSIONS: significant difference in calcium/phosphate concentration was shown between M1 and M2, with evident decrease at M2. Flow rate reduced right after treatment with 41% of patients returning to previous rate at M3 (no statistical difference). A higher number of patients related xerostomia and difficulty in swallowing food at M2. The results showed that xerostomia/hyposalivation, dysphagia and calcium/phosphate concentration decrease may be considered early radioiodine side effects.

A Rare Case of Mucoepidermoid Carcinoma ex Pleomorphic Adenoma arising in Minor Salivary Gland: Histopathological and Immunohistochemical Analysis.

Mucoepidermoid carcinoma ex pleomorphic adenoma (MCxPA) is a rare salivary gland tumor predominantly found in major salivary glands. A case of MCxPA involving the soft tissue and bone of the retromolar region of a 26-year-old man is presented. The histopathological features revealed a neoplasm with predominance of pleomorphic adenoma (PA) elements, and presence of mucoepidermoid carcinoma malignant epithelial cells in several areas. Histochemical and immunohistochemical studies were positive for periodic acid Schiff, alcian blue, cytokeratins 7, 13, 14, and 19, Bcl-2, c-erbB-2, FGF-2 and maspin in the malignant areas. The patient underwent a partial resection of the left side of the mandible with neck dissection and MCxPA diagnosis was confirmed.

Mucormycosis causing oral and nasal osteonecrosis in a case of acute myeloid leukemia.

AIMS: Mucormycosis is a rare and aggressive fungal infection with a high mortality rate because of its rapidly progressive and destructive nature. The oral cavity is often affected under opportunistic conditions. We report a 34-year-old woman diagnosed with acute myeloid leukemia complained of slight swelling on the right side of her face with toothache and gingival swelling. An incisional biopsy was performed, and the specimen analysis revealed broad aseptate hyphae with a ribbon-like appearance, which is characteristic of opportunistic Mucorales infection. METHODS AND RESULTS: The oral lesion worsened, and invasion of the fungal infection into the maxillary sinus, nasal cavity, ethmoidal air cells, and sphenoid and frontal sinuses was observed. Partial maxillectomy was performed concomitantly with the ongoing chemotherapy for leukemia. A maxillofacial prosthesis was used for functional rehabilitation. CONCLUSION: Successful management requires a multimodal approach. In this case, the patient required different systemic approaches for treating leukemia and the fungal infection as well as rehabilitation with an obturator prosthesis.

DNA-ICM as an adjuvant method applied on oral cytological specimens.

OBJECTIVE: This study aimed to evaluate cytology diagnosis accuracy using adjuvant methods in clinical routine for oral cancer. STUDY DESIGN: This prospective study was conducted on 98 patients with clinically potentially malignant or malignant oral cavity lesions. One oral lesion smear was taken from each patient using a cytobrush before biopsy and stored at PreservCyt Thinprep. Samples were cytologically analyzed, and DNA ploidy measurement was performed on the same slide. The diagnostic methods' accuracy was then calculated. RESULTS: In clinical inspection, 61 patients had suspicious lesions for malignancy, whereas 37 had potentially malignant disorders. Cytology associated with DNA image cytometry presented a sensitivity of 81.2% and specificity of 90.9%. When analyzing lesions located in high-risk sites to oral malignancies individually, cytology associated with DNA image cytometry presented a sensitivity of 88.2%, specificity of 100.0%, accuracy of 90.0%, and Kappa value of 0.77 (CI 95%: 0.48-1.00). CONCLUSIONS: Association between cytology and DNA image cytometry is an objective and non-invasive diagnostic method that demonstrated high sensitivity and specificity in diagnosing malignant epithelial squamous cell transformation in the oral cavity.

Diagnostic accuracy of a telediagnosis service of oral mucosal diseases: A multicentric survey.

OBJECTIVE: The aim of this multicentric study was to assess the diagnostic accuracy of a telediagnosis service for oral mucosal disorders. STUDY DESIGN: This study included 100 patients seen at the oral medicine outpatient clinic of 3 Brazilian Dental Schools (University of Campinas, Federal University of Pernambuco, and Federal University of Santa Catrina) from March 2019 to October 2019. In addition to the face-to-face assistance provided by graduate students and the final diagnosis validated by the professors of these institutions, a remote evaluation was requested for these patients through the EstomatoNet/TelessaúdeRS platform. RESULTS: The sensitivity and specificity of telediagnosis were compared with those of the face-to-face approach and found to be 100% and 97.4%, respectively. The concordance between the examiners was 95%, and case management was relatively simple in approximately 60% of cases. CONCLUSIONS: Based on the results, telediagnosis for oral diseases can be considered a reliable method, representing a promising alternative for the clinical support of health professionals, particularly in remote locations.

Cell-block as ancillary tool for the diagnosis of cystic and cyst-like jaw lesions.

BACKGROUND: The cell-block technique is a cytological diagnostic method that decreases cellular dispersion; however, its usefulness regarding intraosseous lesions is underexplored. Therefore, this study aimed to assess the diagnostic usefulness of cell-block for cystic and cyst-like jaw lesions. METHODS: Individuals with cystic or cyst-like jaw lesions who underwent aspiration biopsy were considered eligible. Aspiration of luminal content was prepared and processed by the cell-block technique. Cytological evaluations were blindly performed by two trained PhD students (in a single evaluation) and one oral and maxillofacial pathologist (OMP). Cohen's kappa statistic was used to measure inter-rater agreement. RESULTS: The sample was composed of 52 lesions, represented by 25 radicular cysts (RC), 17 odontogenic keratocysts (OKC), 5 idiopathic bone cavities (IBC), and 5 unicystic ameloblastomas (UA). The kappa coefficient of cell-block compared to histopathological diagnosis was 0.390 (95% confidence interval [95%CI], 0.195-0.585) for PhD students and 0.612 (95%CI, 0.433-0.791) for the OMP. The highest concordance rates between cell-block and histopathological diagnosis were observed for RC (PhD = 76.0%; OMP = 80.0%) and OKC (PhD = 58.8%; OMP = 76.5%). Conflicting results were found regarding IBC (PhD = 40.0%; OMP = 80.0%) and UA, that presented the overall lowest concordance rates (PhD = 20.0%; OMP = 40.0%). CONCLUSION: The cell-block technique presented a high diagnostic usefulness for detecting RC and OKC and, if associated with clinical and radiographic characteristics, might be sufficient for final diagnosis of these diseases. Regarding IBC and UA, an analysis with a higher number of cases is recommended to determine the true usefulness of the cell-block as ancillary tool for the diagnosis of these lesions.

Diagnostic Challenge and Clinical Management of Juvenile Mandibular Chronic Osteomyelitis.

Juvenile mandibular chronic osteomyelitis (JMCO) is a rare, idiopathic disease of chronic bone inflammation without suppuration, sinus tract formation, or sequestration. As the name suggests, this condition predominately affects children. The few cases of JMCO reported in the literature describe different treatments, and thus a standard therapy protocol has not yet been established. The aim of this paper is to report a clinical case in a 9-year-old girl that was misdiagnosed and unsuccessfully treated for 1 year. After experiencing persistent symptoms, a correct diagnosis was subsequently rendered based on the physical and radiographic examination as well as successful treatment with non-steroidal anti-inflammatory drugs (NSAIDs). The patient received drug therapy followed by periods of remission over a 4 year follow-up period. Diagnosis and treatment of JMCO is a challenge given the rarity and nonspecific signs and symptoms of this condition. Treatment with NSAIDs and regular follow-up is a conservative option for these patients.

Incidence of reactive hyperplastic lesions in the oral cavity: a 10 year retrospective study in Santa Catarina, Brazil.

INTRODUCTION: Reactive hyperplastic lesions develop in response to a chronic injury simulating an exuberant tissue repair response. They represent some of the most common oral lesions including inflammatory fibrous hyperplasia, oral pyogenic granuloma, giant cell fibroma, peripheral ossifying fibroma, and peripheral giant cell lesions. OBJECTIVE: The incidence of those lesions was investigated in an oral pathology service, and the clinical characteristics, associated etiological factors, concordance between the clinical and histopathological diagnostic was determined. METHODS: A total of 2400 patient records were screened from 2006 to 2016. Clinical features were recorded from biopsy reports and patients' files. RESULTS: A total of 534 cases of reactive hyperplastic lesions were retrieved and retrospectively studied, representing 22.25% of all diagnoses. The most frequent lesion was inflammatory fibrous hyperplasia (72.09%), followed by oral pyogenic granuloma (11.79%), giant cell fibroma (7.30%), peripheral ossifying fibroma (5.24%), and peripheral giant cell lesions (3.55%). Females were predominantly affected (74.19%), the gingiva and alveolar ridge were the predominant anatomical site (32.89%), and chronic traumatism was presented as the main etiological factor. The age widely ranges from the 1st decade of life to the 7th. Clinically, the reactive hyperplastic lesions consisted of small lesions (0.5-2cm) and shared a strong likeness in color to the oral mucosa. The concordance between the clinical and histopathological diagnostic was high (82.5%). CONCLUSION: Reactive hyperplastic lesions had a high incidence among oral pathologies. The understanding of their clinical features helps to achieve a clearer clinical and etiological diagnosis, and the knowledge of factors related to their development. This may contribute to adequate treatment and positive prognosis.

Impacto na deglutição e manejo da mucosite hipofaríngea em pacientes submetidos à quimiorradioterapia na região de cabeça e pescoço: uma revisão integrativa da literatura / Management of hypopharyngeal mucositis in patients undergoing chemoradiotherapy in the head and neck region and its impact on swallowing: an integrative literature review

RESUMO Objetivo Investigar o impacto da mucosite hipofaríngea quimiorradioinduzida na deglutição e o seu manejo, a partir de uma revisão integrativa de literatura. Estratégia de pesquisa A busca e a seleção dos artigos foram realizadas nas seguintes bases de dados: PubMed, Embase, Scopus, ScienceDirect e LILACS. Critérios de seleção Os termos de busca utilizados foram ''Pharyngeal Mucositis", ''Radiotherapy" e ''Esophagitis", com auxílio do operador booleano (AND). A equação de busca utilizada foi: ''Pharyngeal Mucositis" AND "Radiotherapy" AND "Esophagitis". A seguinte questão central orientou o estudo: "Qual a forma de avaliação e manejo da mucosite hipofaríngea induzida pela radiação na região de cabeça e pescoço e seu impacto na deglutição?". Resultados Foram identificados 75 estudos, sendo que 6 foram excluídos devido à duplicidade e 60 foram excluídos por não se encaixarem nos critérios de inclusão; os artigos restantes foram lidos na íntegra e 4 foram selecionados para fazerem parte desta revisão integrativa da literatura. Conclusão Apesar da escassa literatura e das poucas informações sobre os métodos de avaliação da mucosite hipofaríngea, os artigos apontam que, independentemente da dose de radiação, a radioterapia na região cervical causa mucosite hipofaríngea. A mucosite hipofaríngea provoca grande impacto na deglutição, resultando na necessidade de uso de via alternativa de alimentação. Além da ausência de informações quanto à avaliação e graduação da mucosite hipofaríngea, os estudos não discutem o tratamento direto ou a prevenção desse tipo de doença.

ABSTRACT Purpose To investigate the impact of chemoradiation-induced hypopharyngeal mucositis on swallowing and its management, based on an integrative literature review. Research strategy Two researchers were responsible for the search and selection of articles, within the following databases: PubMed, Embase, Scopus, Science Direct, and Lilacs. Selection criteria The search terms used were "Pharyngeal Mucositis", "Radiotherapy" and "Esophagitis", with the aid of the Boolean operator (AND). The search equation used was "Pharyngeal Mucositis" AND Radiotherapy AND Esophagitis. The following central question guided the study: "What is the assessment and management of radiation-induced hypopharyngeal mucositis in the head and neck region and its impact on swallowing?" Results 75 studies were identified, of which 6 were excluded due to duplicity and 60 were excluded for not meeting the inclusion criteria; the remaining articles were read in full and 4 were selected to be part of the integrative literature review. Conclusion Despite the scarce literature and little information on methods for evaluating hypopharyngeal mucositis, the articles point out that, regardless of the radiation dose, radiotherapy in the cervical region causes hypopharyngeal mucositis. Hypopharyngeal mucositis causes a great impact on swallowing, resulting in the need to use an alternative feeding route. In addition to the lack of information regarding the assessment and grading of hypopharyngeal mucositis, the studies do not discussitsdirect treatment or prevention.

Influence of self-etching adhesive on the bond strength of irradiated teeth / Influência do adesivo autocondicionante na resistência de união em dentes submetidos à radiação

ABSTRACT This study aimed to conduct a literature review about the influence of self-etching adhesives on the bond strength of restorative procedures for irradiated teeth. The search for articles was carried out on six databases (PubMed, Scopus, Web of Science, Embase, LILACS, Cochrane). Gray literature (Google Scholar) and reference lists of included studies were evaluated. The keywords used were: "Radiotherapy" OR "Radiation Therapy" OR "Radiation Treatment" OR "Radiation Effects" OR "Radioterapia" OR "Terapia por radiação" OR "Tratamento por radiação" OR "Efeitos da Radiação" OR "Terapia por Radiación" OR "Tratamiento por Radiación" OR "Efectos de Radiación" AND "Dentin-Bonding agent" OR "Adesivos Dentinários" OR "Recubrimientos Dentinarios". The inclusion criteria were laboratory and clinical studies, dissertations, literary and systematic reviews, and no time and language restrictions. Three hundred and eighteen studies were identified in the databases, 30 in the gray literature, and 5 from the reference list of included articles. 40 were excluded for being duplicates. After reading the title and abstract, 28 articles remained for complete analysis. In the end, 21 articles were included in this study. Self-etching could be a good option for irradiated teeth restorations. However, further clinical studies are needed.

RESUMO O objetivo deste trabalho foi realizar uma revisão integrativa da literatura sobre a influência de adesivos autocondicionantes na resistência de união de restaurações de dentes submetidos à radiação. A busca da literatura foi realizada em seis bases de dados (PubMed, Scopus, Web of Science, Embase, LILACS, Cochrane). A literatura cinza (Google Scholar) e as listas de referências dos estudos incluídos foram avaliadas. A pesquisa foi realizada com as palavras-chave: "Radiotherapy" OR "Radiation Therapy" OR "Radiation Treatment" OR "Radiation Effects" OR "Radioterapia" OR "Terapia por radiação" OR "Tratamento por radiação" OR "Efeitos da Radiação" OR "Terapia por Radiación" OR "Tratamiento por Radiación" OR "Efectos de Radiación" AND "Dentin-Bonding agent" OR "Adesivos Dentinários" OR "Recubrimientos Dentinarios". Os critérios de inclusão foram estudos in vitro e clínicos, dissertações, revisões sistemáticas e literárias, sem restrições de período e de idiomas. Foram identificados 318 estudos nas diferentes bases de dados, 30 na literatura cinzenta e 5 da lista de referências dos artigos incluídos, dos quais 40 foram excluídos por serem duplicatas. Após a leitura do título e do resumo, permaneceram 28 artigos para análise completa. Ao final, 21 artigos foram incluídos neste trabalho. Os adesivos autocondicionantes podem ser uma boa alternativa em restaurações de dentes submetidos à radiação. Todavia, ainda existem poucos trabalhos sobre o tema e ratifica-se a necessidade de mais estudos clínicos.

Osteoradionecrosis of the jaws: case series treated with adjuvant low-level laser therapy and antimicrobial photodynamic therapy.

BACKGROUND: Osteoradionecrosis of the jaw (ORNJ) is the most severe and complex sequel of head and neck radiotherapy (RT) because of the bone involved, it may cause pain, paresthesia, foul odor, fistulae with suppuration, need for extra oral communication and pathological fracture. We treated twenty lesions of ORNJ using low-level laser therapy (LLLT) and antimicrobial photodynamic therapy (aPDT). The objective of this study was to stimulate the affected area to homeostasis and to promote the healing of the oral mucosa. METHODS: We performed aPDT on the exposed bone, while LLLT was performed around the bone exposure (red spectrum) and on the affected jaw (infrared spectrum). Monitoring and clinical intervention occurred weekly or biweekly for 2 years. RESULTS: 100% of the sample presented clinical improvement, and 80% presented complete covering of the bone exposure by intact oral mucosa. CONCLUSION: LLLT and aPDT showed positive results as an adjuvant therapy to treat ORNJ.

A comparative study of the breathing pattern and amount of nasopharynx obstruction by the pharyngeal tonsil in HIV infected and non infected children.

AIM: the goal of the present investigation was to study the association between breathing pattern and pharyngeal tonsil size in 122 children (60 HIV infected and 62 without such infection). MATERIAL AND METHODS: The children were analyzed as to their breathing pattern, nasal flow and pharyngeal tonsil obstruction seen in side cephalometric x-rays, by means of a computerized analysis. RESULTS: The pattern that most occurred in both groups was the mixed type. Most of the children presented oral or mixed type breathing and there was no association between the type of breathing and HIV presence (p=0.091). Nasal flow was mainly medium in both groups. Children without prior history of HIV infection had medium to large nasal flow and most of the HIV-infected children had medium nasal airflow. There was a positive association between nasal flow and HIV infection (p<0.0001). The average percentage of nasopharynx obstruction by the pharyngeal tonsil was high in both groups, and there was no statistically significance difference between them. Children from both groups had a moderate or large size of pharyngeal tonsil, and there was no association between tonsil size and HIV (p=0.21).

The use of tools to support oral lesion description in oral medicine referrals.

Poor description of oral lesions jeopardize the prioritization of appointments in Oral Medicine. The present study investigated whether the use of support tools changes the quality of descriptions focusing on health care prioritization. Two oral lesions (A and B) were described by 64 dental students and 48 dentists using three methods: (a) without support tools (free); (b) using the oral examination form from the Specialties Manual in Oral Health/Brazilian Ministry of Health (SMOH form); and (c) using the OralDESC guideline. The descriptions were compared with a gold standard and percentage of agreement was analyzed by the Kruskal-Wallis and Dunn's tests (p<0.05). Descriptions with the OralDESC presented higher information quality. Considering items essential for prioritization, the OralDESC demonstrated better performance for lesion A; for lesion B, free descriptions and descriptions using the OralDESC were of higher quality than those using SMOH form. Therefore, the OralDESC offered greater support for the description of oral lesions for health care prioritization in Oral Medicine.

Proliferative verrucous leukoplakia: diagnosis, management and current advances.

INTRODUCTION: Proliferative verrucous leukoplakia is a multifocal and progressive lesion of the oral mucosa, with unknown etiology, and commonly resistant to all therapy attempts with frequent recurrences. It is characterized by a high rate of oral squamous cell carcinoma and verrucou carcinoma transformations. OBJECTIVE: To analyze the studies about Proliferative verrucous leukoplakia and develop a concise update. METHODS: A Pubmed search identifying studies (laboratory research, case series and reviews of literature) that examined patients with Proliferative verrucous leukoplakia was realized. RESULTS: There are not enough studies about Proliferative verrucous leukoplakia in the literature. The few found studies not present a consensus about its etiology and diagnosis criteria. Although several treatment strategies have been proposed, most of them still show a high recurrence rate. CONCLUSION: More research about Proliferative verrucous leukoplakia is necessary to understand and treat this disease.

Qualidade de vida relacionada à deglutição em pacientes com câncer de cabeça e pescoço / Quality of life related to swallowing in patients with head and neck cancer / Calidad de vida relacionada con la deglución en pacientes con cáncer de cabeza y cuello

Introdução: No câncer de cabeça e pescoço (CCP), as sequelas relacionadas aos tratamentos e à própria localização do tumor podem trazer alterações físicas e funcionais, com impacto na qualidade de vida (QV) destes pacientes. Objetivo: mensurar o impacto do câncer de boca sobre a qualidade de vida relacionada à deglutição e saúde bucal em pacientes com câncer de cabeça e pescoço, após tratamento médico com radioterapia e/ou cirurgia. Métodos: participaram do estudo dez pacientes em pós-tratamento médico para o CCP e que foram submetidos aos questionários de qualidade de vida M.D. Anderson Dysphagia Inventory (MDAD),Oral Health Impact Profile (OHIP-14) e Questionário de Qualidade de Vida da Universidade de Washington(UW-QOL). Resultados: Os resultados dos domínios emocional e funcional do protocolo MDADI demonstraram médias positivas, enquanto o domínio físico apresentou médias que demonstraram baixo funcionamento do dia-a-dia e qualidade de vida. A partir do questionário OHIP-14, verificou-se que 40% dos participantes foram classificados com alto índice de impacto na saúde bucal. As dimensões ''desconforto psicológico'' e ''deficiência'' impactam negativamente na QV dos pacientes. "Atividade'' e "saliva" foram os problemas mais relatados, mostrando que, ''saliva'', ''humor'' e ''mastigação'' foram os três domínios mais importantes na visão dos pacientes, verificado a partir do protocolo UW-QOL. Conclusão: Apesar do número reduzido de pacientes e da heterogeneidade de localização dos tumores, os resultados demonstram que o CCP e as sequelas de seu tratamento podem impactar de maneira significativa a QV dos pacientes em diversos domínios.

Introducción: En el cáncer de cabeza y cuello (CCC), las secuelas relacionadas con el tratamiento y la propia localización del tumor pueden traer cambios físicos y funcionales, con impacto en la calidad de vida (CV) de estos pacientes. Objetivo: medir el impacto del cáncer bucal en la calidad de vida relacionada con la deglución y la salud bucal en pacientes con cáncer de cabeza y cuello después del radioterapia y/o cirurgía. Metodos: participaron del estudio diez pacientes en postratamiento médico por cáncer de cabeza y cuello y fueron sometidos a cuestionarios de calidad de vida M.D. Anderson Dysphagia Inventory (MDADI), Oral Health Impact Profile (OHIP-14) y cuestionario de calidad de vida de la Universidad de Washington (UW-QOL). Resultados: Los resultados de los dominios emocional y funcional del protocolo MDADI mostraron medias positivas, mientras que el dominio físico mostró medias que evidenciaron bajo funcionamiento cotidiano y calidad de vida. Del cuestionario OHIP-14 se encontró que 40% de los participantes fueron clasificados como de alto impacto en la salud bucal. Las dimensiones "malestar psicológico" y "discapacidad" tienen un impacto negativo en la calidad de vida de los pacientes. "Actividad" y "saliva" fueron los problemas más reportados, mostrando que "saliva", "estado de ánimo" y "masticar" eran los tres dominios más importantes en la opinión de los pacientes verificado a partir del protocolo UW-QOL. Conclusión: A pesar del pequeño número de pacientes y la heterogeneidad de la localización del tumor, los resultados demuestran que el CCP y las secuelas de su tratamiento pueden impactar significativamente la calidad de vida de los pacientes en varios dominios.

Introduction: In head and neck cancer (HNC), the sequelae related to the treatment and the location of the tumor itself can bring physical and functional changes, with an impact on the quality of life (QoL) of these patients. Objective: measure the impact of oral cancer on quality of life related to swallowing and oral health in patients with head and neck cancer after radiotherapy and/or surgery. Methods: 10 patients participated on study in medical post-treatment for head and neck cancer and they were submitted the quality of life questions M.D. Anderson Dysphagia Inventory, Oral Health Impact Profile (OHIP-14) and University of Washington quality of life questionnaire (UW-QOL). Results: The results of the emotional and functional domains of the MDADI protocol showed positive means, while the physical domain showed low day-to-day functioning and quality of life means. From the OHIP-14 questionnaire, it was found that 40% of participants were hated with a high index of impact on oral health. The dimensions "psychological discomfort" and "deficiency" negatively impact on patients QOL. "Activity" and "spittle" were the problems most reported, showing that, "spittle", "humor" and "chewing" were the three most important domains on patient's view verified from the UW-QOL protocol. Conclusion: Despite the small number of patients and the heterogeneity of tumor location, the results demonstrate that the CCP and the sequelae of its treatment can significantly impact the QoL of patients in several domains.

Aspiration and cytological evaluation of idiopathic bone cavities of the jaw.

The idiopathic bone cavity (IBC) is an intraosseous pseudocyst devoid of epithelial lining. Clinically, IBCs of the jaw are asymptomatic and normally found in routine radiographic exams. Although the literature regarding the content of IBCs is controversial, the final diagnosis is usually aided by the discovery of an empty cavity upon surgical exploration. The aim of this study was to perform cytological and histological analysis of IBC contents. Cytological analysis of nine cases of IBC was performed after puncture and processed by the cell block technique. Histological analysis was performed in six cases in which it was possible to collect enough material by curettage of bone walls. Remarkably, cell block analysis revealed the presence of fibrin, often arranged as a net; erythrocytes; and inflammatory cells, with a predominance of lymphocytes as well as some macrophages and neutrophils. Histological analysis showed the presence of scant connective tissue, bone trabeculae, hemorrhagic foci, and hemosiderin. Only two cases presented scattered multinucleated giant cells. Cytological evaluation of IBC content by the cell block technique might represent a useful diagnostic tool, especially in cases in which there is no available material for curettage in the cavity.

Medication-Related Osteonecrosis of Jaws: A Low-Level Laser Therapy and Antimicrobial Photodynamic Therapy Case Approach.

Medication-related osteonecrosis of the jaws (MRONJ) can be considered an inability of the alveolar bone to respond to an injury, which frequently leads to severe local and systemic complications. Once the problem is installed, dentist must use all therapeutic approaches recommended. This manuscript reports a successful management of MRONJ handled with antibiotics, conservative debridement, low-level laser therapy (LLLT), and photodynamic therapy (PDT) up to 12 months. As healing of MRONJ may be very slow, combined therapeutic approaches are required. Besides the recommended conventional treatment protocol, LLLT and PDT are important tools to contribute to healing and improvement of patient's quality of life.