ABSTRACT
Abstract The aim of this study was to describe the prevalence, clinicopathological, and prognostic features of acinic cell carcinoma (AciCC) of the oral and maxillofacial region. AciCC cases were retrospectively retrieved from 11 pathology centers of three different countries. Medical records were examined to extract demographic, clinical, pathologic, and follow-up information. A total of 75 cases were included. Females (65.33%) with a mean age of 45.51 years were mostly affected. The lesions usually presented as an asymptomatic (64.28%) nodule (95.66%) in the parotid gland (70.68%). The association of two histopathological patterns was the most common finding (48.93%) and the tumors presented mainly conventional histopathological grades (86.11%). Surgical treatment was performed in the majority of the cases (59.19%). Local recurrence was observed in 20% of the informed cases, regional metastasis in 30.43%, and distant metastasis in 12.50%. The statistical analysis showed that the cases with a solid histopathological pattern (p=0.01), high-grade transformation (p=0.008), recurrence (p=0.007), and regional metastasis (p=0.03) were associated with poor survival. In conclusion, high histopathological transformation, presence of nodal metastasis, and recurrence were prognostic factors for AciCC of the oral and maxillofacial region.
ABSTRACT
ABSTRACT Regenerative therapies have been widely developed in dentistry and it is important to incorporate dentists' knowledge of these new therapies into the dental clinic routine. This study reviewed the literature on regenerative therapies and clinical applications. Tissue engineering has contributed to changes in the paradigm of restorative health sciences. Its pillars underpin the techniques of tissue and organ regeneration. Despite the majority of studies in this field being in vitro, a range of preclinical studies and methodologies has been formed using these principles and they are already being used on humans. The use of platelet-rich plasma and platelet-rich fibrin in surgery as natural scaffolds for the reestablishment of bone and periodontal tissue are often reported in the literature and clinical trials using this approach have shown promising results. Stem cells from autologous dental pulp have been successfully applied in bone tissue regeneration using natural collagen scaffold in humans. In addition, revascularization of the root canal already appears in the literature as a promising alternative to apexification. The principle behind this therapy is the use of the blood clot as a scaffold and the migration of stem cells of the apical papilla to regenerate the dental pulp organ. Final considerations: Although still in the early stages, regenerative therapies can now be used in dental practice. Knowledge of the principles governing these therapies should be understood by the dentist for use in clinical practice.
RESUMO Terapias regenerativas vem sendo amplamente desenvolvidas na odontologia e o conhecimento destas novas terapias por parte dos dentistas é importante para que elas sejam incorporadas na rotina clínica odontológica. Assim, este estudo revisou a literatura acerca das terapias regenerativas e suas aplicações clínicas. A engenharia tecidual tem contribuído na mudança do paradigma restaurador das ciências da saúde. Seus pilares embasam as técnicas de regeneração de tecidos e órgãos. Apesar da grande maioria dos estudos neste campo ser in vitro, uma gama de metodologias pré-clínicas foi consolidada e estudos utilizando estes princípios já estão sendo empregados em humanos. A utilização de plasma rico em plaquetas e plasma rico em fibrina como scaffolds naturais em cirurgias para reestabelecimento de tecido ósseo e periodontal são frequentemente relatadas na literatura e ensaios clínicos utilizando esta abordagem demonstram resultados promissores. Células-tronco da polpa dental autólogas já foram aplicadas com sucesso na regeneração de tecido ósseo utilizando scaffold naturais de colágeno em humanos. Além disto, a revascularização do canal radicular já aparece na literatura como uma alternativa promissora frente a opção de apecificação do canal radicular. Esta terapia utiliza como princípio o coágulo sanguíneo como scaffold e a migração das células-tronco da papila apical para regenerar o órgão pulpar. Considerações finais: Apesar de incipientes, as terapias regenerativas já podem ser utilizadas na prática clínica odontológica. O conhecimento dos princípios que regem estas terapias deve ser compreendido pelo dentista para que sejam utilizadas na prática clínica.