Oral Mucosa and Saliva Alterations Related to Vape.

OBJECTIVES: Electronic nicotine delivery systems (e-cigarette, pod, and vape) are currently among the tobacco consumption of adolescents and young adults. The aim is to show oral mucosa and saliva alterations related to vape. MATERIAL AND METHODS: A vape-user patient, presenting a white plaque in the posterior region of the hard palate, underwent clinical examination, sialometry, pH evaluation, and excisional biopsy of the white lesion. Molecular changes in saliva and vape liquid were analyzed by vibrational spectroscopy. RESULTS: The histopathological analyses showed hyperparakeratosis without dysplasia. Formaldehyde, ketones, and aromatic hydrocarbon species were identified in e-cig liquid by the FTIR. CONCLUSIONS: The use of vape may be related to the development of hyperkeratotic lesions in the oral mucosa as well as significantly modify the patient's salivary patterns as the vape liquid presents carcinogenic and cytotoxic components in its composition.

Evaluation of micronuclei, cytomorphometric and cytologic changes of the oral mucosa in hookah and cigarette smokers.

OBJECTIVE: To analyze the effect of hookah and cigarettes on the oral mucosa of smokers through the use of exfoliative cytology. STUDY DESIGN: Smear samples were collected by exfoliative cytology from the tongue of 33 hookah smokers, 22 cigarette smokers, and 30 non-smokers. The selected analyses include micronuclei (MN), metanuclear anomalies, epithelial maturation, and cytomorphology (nuclear area [NA], cytoplasmic area [CA], and NA/CA ratio). RESULTS: The largest differences observed for MN and metanuclear anomalies were between cigarette smokers and the control group (notably 1 MN P = .04; total cells with MN P = .039; total MN P = .042; karyorrhexis and binucleation, P = .0001). The hookah group, compared with the control group, showed the greatest differences for karyolysis (P = .0023), binucleation (P = .0003), and broken egg (P = .008). Significant differences were found between the smokers and the control groups regarding changes in the superficial cell without nucleus, perinuclear halo, vacuolization, color change, mucus, and keratohyalin granules. There was a significant increase in the NA and NA/CA ratio in the smoker groups. CONCLUSION: This study showed that a combined analysis of exfoliative cytology associated with other diagnostic methods is a useful tool for studying oral carcinogenesis. Hookah and cigarettes showed similar effects in terms of displaying substantial cytogenetic and cytotoxic damage.

HOXA1 3'UTR Methylation Is a Potential Prognostic Biomarker in Oral Squamous cell Carcinoma.

BACKGROUND: HOXA1 is a prognostic marker and a potential predictive biomarker for radioresistance in head and neck tumors. Its overexpression has been associated with promoter methylation and a worse prognosis in oral squamous cell carcinoma (OSCC) patients. However, opposite outcomes are also described. The effect of the methylation of this gene on different gene regions, other than the promoter, remains uncertain. We investigated the methylation profile at different genomic regions of HOXA1 in OSCC and correlated differentially methylated CpG sites with clinicopathological data. METHODS: The HOXA1 DNA methylation status was evaluated by analyzing data from The Cancer Genome Atlas and three Gene Expression Omnibus datasets. Significant differentially methylated CpG sites were considered with a |∆ß| ≥ 0.10 and a Bonferroni-corrected p-value < 0.01. Differentially methylated CpGs were validated by pyrosequencing using two independent cohorts of 15 and 47 OSCC patients, respectively. RESULTS: Compared to normal tissues, we found significantly higher DNA methylation levels in the 3'UTR region of HOXA1 in OSCC. Higher methylation levels in tumor samples were positively correlated with smoking habits and patients' overall survival. CONCLUSIONS: Our findings suggest that HOXA1 gene body methylation is a promising prognostic biomarker for OSCC with potential clinical applications in patient monitoring.

Knowledge of Brazilian dentists about bisphosphonate-associated osteonecrosis of the jaw / Conhecimento de dentistas brasileiros sobre a osteonecrose dos maxilares associada ao uso de bisfosfonatos

Osteonecrosis of the jaw associated with bisphosphonate use is a matter of utmost importance in clinical practice for the safe treatment of patients using this medication. Objective: The aim of this study was to evaluate the level of knowledge of dentists who carry out clinical practice about bisphosphonate-associated jaw osteonecrosis. Material and Methods: The methodology used in the present research consisted of a non-probability sampling approach for the selection of participants. To conduct the study, a questionnaire created on the Google Forms platform was sent via Direct on Instagram to the professionals who agreed to participate. The data were sent for analysis, using the frequency for each response, and the professionals were divided into subcategories according to their time of professional practice. Results: Participants were familiar with the purpose of the medication (65%) or had heard of it (34%); regarding the professionals' opinion on their knowledge and practice about bisphosphonate-related osteonecrosis a significant percentage (93.24%) responded positively regarding the existence of side effects resulting from the therapeutic use of bisphosphonates and 48.65% self-evaluated their level of knowledge on the subject as insufficient. Conclusion: The study reveals that almost all participating dentists have good knowledge about the effects caused by bisphosphonates, but some of them still do not feel specifically confident about the management and knowledge of jaw osteonecrosis (AU)

A osteonecrose dos maxilares associada ao uso de bisfosfonatos é um assunto de suma importância na prática clínica para o atendimento seguro dos pacientes que fazem uso terapêutico do medicamento. Objetivo: O objetivo deste trabalho foi avaliar o nível de conhecimento de cirurgiões dentistas que realizam atendimento clínico acerca da osteonecrose dos maxilares associada ao uso dos bisfosfonatos. Material e Métodos: A metodologia utilizada na presente pesquisa consistiu em uma abordagem de amostragem não probabilística para a seleção dos participantes. Para conduzir o estudo, enviamos um questionário criado na plataforma Google Forms via Direct no Instagram para os profissionais que concordaram em participar. Os dados foram enviados para análise, usando a frequência para cada resposta, sendo que os profissionais foram divididos em subcategorias por tempo de formação. Resultados: Os participantes estavam familiarizados com a finalidade do medicamento (65%) ou já haviam ouvido falar deles (34%); em relação à opinião dos profissionais sobre seu conhecimento e prática acerca da osteonecrose relacionada aos bisfosfonatos, observou-se que 48,65% autoavaliaram seu nível de conhecimento sobre o assunto como insuficiente e uma parcela expressiva (93,24%) respondeu positivamente em relação à existência de efeitos colaterais decorrentes ao uso terapêutico dos bisfosfonatos. Conclusão: O estudo revela que quase todos os dentistas participantes possuem um bom conhecimento acerca dos efeitos causados pelos bisfosfonatos, mas que parte deles ainda não se sentem seguros especificamente em relação ao manejo e conhecimento da osteonecrose dos maxilares (AU)

Preliminary Findings on the Salivary Metabolome of Hookah and Cigarette Smokers.

The aim of the study was to evaluate the salivary metabolomic profile of patients who habitually smoke hookah and cigarettes. The groups consisted of 33 regular and exclusive hookah smokers, 26 regular and exclusive cigarette smokers, and 30 nonsmokers. Unstimulated whole saliva was collected for the measurement of salivary metabolites by gas chromatography coupled with tandem mass spectrometry (GC-MS/MS). The MetaboAnalyst software was used for statistical analysis and evaluation of biomarkers. 11 smoking salivary biomarkers were identified using the area under receiving-operator curver criterion and threshold of 0.9. Xylitol and octadecanol were higher in cigarette smokers compared to controls; arabitol and maltose were higher in controls compared to cigarette smokers; octadecanol and tyramine were higher in hookah smokers compared to controls; phenylalanine was higher in controls compared to hookah smokers; and fructose, isocitric acid, glucuronic acid, tryptamine, maltose, tyramine, and 3-hydroxyisolvaleric acid were higher in hookah smokers compared to cigarettes smokers. Conclusions: The evaluation of the salivary metabolome of hookah smokers, showing separation between the groups, especially between the control versus hookah groups and cigarette versus hookah groups, and it seems to demonstrate that the use of hookah tobacco is more damaging to health.

Hidden colon adenocarcinoma diagnosed from mouth metastasis: case report and literature review.

BACKGROUND: We report an unusual case of metastatic colon adenocarcinoma to the maxilla as an initial clinical sign of the disease, this being the second case reported in the palate. In addition, we show an extensive review of the literature, with clinical cases of adenocarcinoma with metastasis to the mouth. CASE PRESENTATION: An 80-year-old man complained of "swelling on the palate" with a 3-week evolution time. He reported suffering from constipation and high blood pressure. The intraoral examination revealed a pedunculated, red, and painless nodule on the maxillary gingiva. Under the diagnostic hypotheses of squamous cell carcinoma and malignant neoplasm of the salivary gland, an incisional biopsy was performed. Microscopically, the columnar epithelium was observed forming papillary areas, neoplastic cells with prominent nucleoli, hyperchromatic nuclei, atypical mitotic figures, and mucous cells, being positive for CK 20, suggesting the provisional diagnosis of metastatic adenocarcinoma, probably of gastrointestinal origin. The patient was submitted to endoscopy and colonoscopy exams, and a lesion in the sigmoid region of the colon was observed. After a colon biopsy, a moderately differentiated adenocarcinoma was confirmed, establishing the final diagnosis of metastatic neoplasia of colon adenocarcinoma to the oral lesion. The literature review revealed 45 clinical cases of colon adenocarcinoma with metastasis to the oral cavity. To the best of our knowledge, it is the second case on the palate. CONCLUSIONS: Colon adenocarcinoma with metastasis to the oral cavity is rare but should be included in the differential diagnosis of neoplasms of the oral cavity, even when there are no known primary tumors in some cases, and this may be the first indication of the presence of a tumor.

The Effect of Nicotine Lozenge Over Teeth Bleaching During Cigarette's Addiction Treatment

The aim of this study was to evaluate the effect of nicotine lozenge on teeth staining with/without bleaching in animal model study. A total of 15 Wistar rats were exposed in an acrylic container to 10 cigarettes smoke three times a day for 8 minutes per time, and sacrificed after 60 days. A total of 30 incisor teeth were treated (n=10) as the following: Group-1: in-office bleaching, at-home bleaching and immersion in artificial saliva; group-2: in-office bleaching, at - home bleaching and immersion in nicotine lozenge solution and in artificial saliva; group-3: immersion in nicotine lozenge solution and in artificial. The specimens of all groups were photographed using a stereomicroscope at T1) immediately after the extraction and before any treatment; T2) after one month of the treatment; and T3) after two months of the treatment. Four equidistant points of each specimen were analyzed using CMYK shade guide. The data were analyzed one-way ANOVA test followed by Tukey test for multiple comparisons with (a ≤ 0.05). In group-1, there was a significant difference of the color saturation of specimens between T1 and T2, and between T1 and T3 readings (P<0.0001). In group-2, there was a significant difference of the color saturation of specimens between T1 and T2, between T2 and T3 readings (P<0.0001). In group-3, there was a significant difference of the color saturation of specimens between T1 and T2, and between T1 and T3 readings (P<0.0001). The usage of nicotine lozenge promotes teeth lighting with/without bleaching.

El objetivo de este estudio fue evaluar el efecto de comprimidos de nicotina sobre la tinción de los dientes con/sin blanqueamiento en un estudio de modelo animal. Un total de 15 ratas Wistar fueron expuestas en un recipiente acrílico al humo de 10 cigarrillos tres veces al día durante 8 minutos por vez, y sacrificadas después de 60 días. Se trataron un total de 30 dientes incisivos (n=10) de la siguiente manera: Grupo-1: blanqueamiento en consultorio, blanqueamiento en casa e inmersión en saliva artificial; grupo-2: blanqueamiento en consultorio, blanqueamiento en casa e inmersión en solución de comprimidos de nicotina y en saliva artificial; grupo-3: inmersión en solución de nicotina en comprimidos y en artificial. Los especímenes de todos los grupos fueron fotografiados utilizando un microscopio estereoscópico en T1) inmediatamente después de la extracción y antes de cualquier tratamiento; T2) después de un mes del tratamiento; y T3) a los dos meses del tratamiento. Se analizaron cuatro puntos equidistantes de cada espécimen utilizando la guía de colores CMYK. Los datos se analizaron con la prueba ANOVA unidireccional seguida de la prueba de Tukey para comparaciones múltiples con (a ≤ 0,05). En el grupo 1, hubo una diferencia significativa de la saturación de color de las muestras entre T1 y T2, y entre las lecturas T1 y T3 (P<0,0001). En el grupo 2, hubo una diferencia significativa de la saturación de color de las muestras entre T1 y T2, entre las lecturas de T2 y T3 (P<0.0001). En el grupo 3, hubo unadiferencia significativa de la saturación de color de las muestras entre T1 y T2, y entre las lecturas T1 y T3 (P<0,0001). El uso de comprimidos de nicotina promueve la iluminación de los dientes con/sin blanqueamiento.

Unlocking the secrets of saliva: the promising potential of salivary biomarkers for evaluating crack use / Desvendando os segredos da saliva: o potencial promissor dos biomarcadores salivares para avaliar o uso de crack

The forthcoming letter will encompass the following highlights: Crack cocaine use involves smoking a highly addictive form of cocaine, which is a significant concern in Brazil, particularly in urban areas. This addiction is linked to various health problems, including cardiovascular issues, sexually transmitted infections (STIs) like AIDS and syphilis, tuberculosis, and a notable increase in mortality, largely due to violent causes. Furthermore, crack cocaine users are particularly vulnerable to dental caries, gingival inflammation, oral mucosa lesions, and xerostomia (AU)

A próxima carta incluirá os seguintes destaques: O uso de crack envolve fumar uma forma altamente viciante da cocaína, o que é uma preocupação significativa no Brasil, especialmente em áreas urbanas. Esta dependência está ligada a vários problemas de saúde, incluindo problemas cardiovasculares, infecções sexualmente transmissíveis (IST), como a AIDS e a sífilis, a tuberculose e um aumento notável da mortalidade, devido, em grande parte, a causas violentas. Além disso, os usuários de crack são particularmente vulneráveis a cáries dentárias, inflamação gengival, lesões na mucosa oral e xerostomia (AU)

The Fagerström and AUDIT Tests as Probable Screening Tools in Oral Cancer and Their Correlation with CYP1A1, GSTM1, GSTP1, and GSTT1 Gene Expression.

BACKGROUND: Cancer is currently a major public health problem worldwide, with a marked increase of about 70% in the number of expected diagnosed cases over the next two decades. The amount of tobacco and alcohol consumed is calculated based on the subjective information provided by the user. Tobacco exposure can be assessed using the Fagerström Test for Cigarette Dependence (FTCD) and alcohol consumption by the Alcohol Use Disorder Identification Test (AUDIT). MATERIALS AND METHODS: Forty-eight subjects answered the Fagerström, and AUDIT tests and we studied them as likely screening tools for oral cancer and their correlation with the expression of CYP1A1, GSTM1, GSTP1, and GSTT1 genes by the RT-qPCR method. RESULTS: There were significant differences in the AUDIT score and CYP1A1 expression between cancer and control groups. Participants in advanced stages, whether due to tumor size or regional metastasis, showed significant differences in the duration of tobacco use, FTCD, AUDIT score, and CYP1A1 expression when compared to patients in early stages. Among subjects without cancer, we found a significant correlation between participant age and GSTP1 expression. Furthermore, the expression of GSTP1 was significantly correlated with the number of cigarettes smoked per day, duration of tobacco use, and FTCD. CONCLUSIONS: Questionnaires designed to evaluate the degree of tobacco and alcohol exposure and dependence combined with gene expression tests can be useful to assess the risk of developing oral cancer. Furthermore, raising the awareness of individuals regarding their degree of dependence and encouraging them to participate in cessation programs are important educational measures for the prevention of tobacco-related malignancies.

Micro-Fourier-transform infrared reflectance spectroscopy as tool for probing IgG glycosylation in COVID-19 patients.

It has been reported that patients diagnosed with COVID-19 become critically ill primarily around the time of activation of the adaptive immune response. However the role of antibodies in the worsening of disease is not obvious. Higher titers of anti-spike immunoglobulin IgG1 associated with low fucosylation of the antibody Fc tail have been associated to excessive inflammatory response. In contrast it has been also reported that NP-, S-, RBD- specific IgA, IgG, and IgM are not associated with SARS-CoV-2 viral load, indicating that there is no obvious correlation between antibody response and viral antigen detection. In the present work the micro-Fourier-transform infrared reflectance spectroscopy (micro-FTIR) was employed to investigate blood serum samples of healthy and COVID-19-ill (mild or oligosymptomatic) individuals (82 healthcare workers volunteers in "Instituto de Infectologia Emilio Ribas", São Paulo, Brazil). The molecular-level-sensitive, multiplexing quantitative and qualitative FTIR data probed on 1 µL of dried biofluid was compared to signal-to-cutoff index of chemiluminescent immunoassays CLIA and ELISA (IgG antibodies against SARS-CoV-2). Our main result indicated that 1702-1785 [Formula: see text] spectral window (carbonyl C=O vibration) is a spectral marker of the degree of IgG glycosylation, allowing to probe distinctive sub-populations of COVID-19 patients, depending on their degree of severity. The specificity was 87.5 % while the detection rate of true positive was 100%. The computed area under the receiver operating curve was equivalent to CLIA, ELISA and other ATR-FTIR methods ([Formula: see text]). In summary, overall discrimination of healthy and COVID-19 individuals and severity prediction as well could be potentially implemented using micro-FTIR reflectance spectroscopy on blood serum samples. Considering the minimal and reagent-free sample preparation procedures combined to fast (few minutes) outcome of FTIR we can state that this technology is suitable for fast screening of immune response of individuals with COVID-19. It would be an important tool in prospective studies, helping investigate the physiology of the asymptomatic, oligosymptomatic, or severe individuals and measure the extension of infection dissemination in patients.

MALDI-TOF mass spectrometry of saliva samples as a prognostic tool for COVID-19.

BACKGROUND: The SARS-CoV-2 infections are still imposing a great public health challenge despite the recent developments in vaccines and therapy. Searching for diagnostic and prognostic methods that are fast, low-cost and accurate are essential for disease control and patient recovery. The MALDI-TOF mass spectrometry technique is rapid, low cost and accurate when compared to other MS methods, thus its use is already reported in the literature for various applications, including microorganism identification, diagnosis and prognosis of diseases. METHODS: Here we developed a prognostic method for COVID-19 using the proteomic profile of saliva samples submitted to MALDI-TOF and machine learning algorithms to train models for COVID-19 severity assessment. RESULTS: We achieved an accuracy of 88.5%, specificity of 85% and sensitivity of 91.5% for classification between mild/moderate and severe conditions. When we tested the model performance in an independent dataset, we achieved an accuracy, sensitivity and specificity of 67.18, 52.17 and 75.60% respectively. CONCLUSION: Saliva is already reported to have high inter-sample variation; however, our results demonstrates that this approach has the potential to be a prognostic method for COVID-19. Additionally, the technology used is already available in several clinics, facilitating the implementation of the method. Further investigation using a larger dataset is necessary to consolidate the technique.

Influence of nicotine dependence, current smoking status and gender on CYP1A1, CYP1B1 and CYP2A6 expression in oral squamous cell carcinoma / Influência da dependência nicotínica, parâmetros de consumo de tabaco e gênero na expressão de CYP1A1, CYP1B1 e CYP2A6 em carcinoma de células escamosas oral

Objective: Tobacco smoke is composed of cancer-causing chemicals referred to as carcinogens. These carcinogens are metabolized by the enzymes of the cytochrome P450 (CYP) family. Our objective was to evaluate the correlation of tobacco consumption parameters with CYP1A1, CYP1B1 and CYP2A6 expression using qRT-PCR in samples of oral squamous cell carcinoma (OSCC). Material and Methods: The sample was divided into 2 groups: Cancer (36 subjects) and non-Cancer (12 subjects). The smokers' participants (36) were evaluated regarding their Nicotine dependence (ND) was assessed by the Fagerström test for cigarette dependence (FTCD). Questions regarding tobacco consumption like the number of cigarettes/day (CPD), duration of use, and pack-years were also evaluated. The Mann-Whitney and Spearman correlation tests were used at a significance level of 5%. Results: 48 participants were included, 32 men (66.7%), 36 smokers (75%) and 27 smokers with OSCC (56.3%). Samples of OSCC expressed more CYP1A1, CYP1B1, and CYP2A6. Especially, the CYP1B1 gene was significantly expressed in OSCC samples, regardless gender or tobacco use. No women expressed CYP2A6, as well as, non-smokers did not express the CYP1A1 and CYP2A6 genes. CYP1A1 gene was higher among men (P = 0.021). Conclusion: Lack of exposure to tobacco may justify the absence of CYP1A1 and CYP2A6 expression in non-smokers. The CYP1B1 gene was significantly expressed in the cancer presence despite gender or tobacco use. The assessment of ND and quantification of tobacco consumption are important instruments in monitoring smokers with benign oral lesions and, especially, in the presence of cancer.(AU)

Objetivo: A fumaça do tabaco é composta de substâncias químicas cancerígenas conhecidas como carcinógenos. Esses carcinógenos são metabolizados pelas enzimas da família do citocromo P450 (CYP). Nosso objetivo foi avaliar a correlação dos parâmetros do consumo de tabaco com a expressão de CYP1A1, CYP1B1 e CYP2A6 por qRT-PCR em amostras de carcinoma de células escamosas bucal (CCEB). Material e Métodos: A amostra foi dividida em 2 grupos: Câncer (36 indivíduos) e sem Câncer (12 indivíduos). Os participantes fumantes (36) foram avaliados quanto à dependência nicotínica (DN) pelo teste de Fagerström para dependência de cigarro (TFDC). Questões relacionadas ao consumo de tabaco como número de cigarros / dia (CPD), tempo de uso e anos-maço também foram avaliadas. Os testes de correlação de Mann-Whitney e Spearman foram utilizados com nível de significância de 5%. Resultados: foram incluídos 48 participantes, 32 homens (66,7%), 36 fumantes (75%) e 27 fumantes com CCEB (56,3%). Amostras de CCEB expressaram mais CYP1A1, CYP1B1 e CYP2A6. Especialmente, o gene CYP1B1 foi significativamente expresso em amostras de CCEB, apesar do sexo ou uso de tabaco. Nenhuma mulher expressou CYP2A6, assim como, não fumantes não expressaram os genes CYP1A1 e CYP2A6. O gene CYP1A1 foi maior entre os homens (P = 0,021). Conclusão: A falta de exposição pode justificar a ausência da expressão dos genes CYP1A1 e CYP2A6 entre não fumantes. O gene CYP1B1 foi significativamente expresso na presença de câncer, independentemente do sexo ou do uso de tabaco. A avaliação da DN e a quantificação do consumo de tabaco são importantes instrumentos no acompanhamento de fumantes com lesões bucais benignas e, principalmente, na presença de câncer (AU)

Identification of Possible Salivary Metabolic Biomarkers and Altered Metabolic Pathways in South American Patients Diagnosed with Oral Squamous Cell Carcinoma.

Oral squamous cell carcinoma (OSCC) represents 90% of oral malignant neoplasms. The search for specific biomarkers for OSCC is a very active field of research contributing to establishing early diagnostic methods and unraveling underlying pathogenic mechanisms. In this work we investigated the salivary metabolites and the metabolic pathways of OSCC aiming find possible biomarkers. Salivary metabolites samples from 27 OSCC patients and 41 control individuals were compared through a gas chromatography coupled to a mass spectrometer (GC-MS) technique. Our results allowed identification of pathways of the malate-aspartate shuttle, the beta-alanine metabolism, and the Warburg effect. The possible salivary biomarkers were identified using the area under receiver-operating curve (AUC) criterion. Twenty-four metabolites were identified with AUC > 0.8. Using the threshold of AUC = 0.9 we find malic acid, maltose, protocatechuic acid, lactose, 2-ketoadipic, and catechol metabolites expressed. We notice that this is the first report of salivary metabolome in South American oral cancer patients, to the best of our knowledge. Our findings regarding these metabolic changes are important in discovering salivary biomarkers of OSCC patients. However, additional work needs to be performed considering larger populations to validate our results.

E-cig might cause cell damage of oral mucosa.

OBJECTIVE: The aim of this study was to investigate cytogenetic and cytotoxic damage through the evaluation of micronuclei (MN) and metanuclear anomalies in the oral mucosa of electronic cigarette (e-cig) users. STUDY DESIGN: The patients were recruited into 4 groups: e-cig users, smokers, former smokers, and nonsmokers (control). The samples were collected by means of exfoliative cytology of the lateral region of the tongue and the floor of the mouth. The smears obtained were fixed and stained by the Feulgen method for investigation of MN and metanuclear anomalies. RESULTS: A significant difference was observed for MN frequency only between the smoker and control groups. As for metanuclear anomalies, significant differences were observed: karyolysis between: smokers and control, e-cig and control, as well as former smokers; karyorrhexis: between smoker and control; binucleation: between e-cig and former smoker, as well as control; broken eggs: between e-cig and all other groups; nuclear bud: between e-cig and former smokers, as well as control. CONCLUSIONS: E-cig and alcohol users presented genotoxicity and cytotoxicity in the oral mucosa cells. The use of e-cigs and alcohol by former smokers can cause more damage to the cells of the oral mucosa compared to those who have not used e-cigs.

Immediate placement of denture over undiagnosed ameloblastoma / Instalação de prótese total imediata sobre ameloblastoma não diagnosticado

Ameloblastoma is an odontogenic tumor that affects the bones of the jaw, often affecting posterior region of the mandible. It is a benign neoplasm and is frequently associated to an unerupted tooth. The purpose of this article is to report a case of failure in making an immediate full denture in a patient that had an ameloblastoma. A female patient aged 67 years complained of a hard swelling in the right mandible at the premolar region, that she noted after teeth extraction and confection of an immediate denture. Intraoral examination showed buccal and lingual cortical plate expansion and radiograph examination showed multilocular radiolucency with a well-defined margin. Aspiration was nonproductive and the provisional diagnosis was ameloblastoma. An incisional biopsy was performed and the histopathological report was conclusive of an acanthomatous ameloblastoma. The patient was sent for surgical excision of the lesion and after three years, the patient returned reporting that she was operated elsewhere in the past year and had an unsuccessful bone graft. She was sent to a prosthodontist to make a complete denture. In the present case the ameloblastoma was diagnosed only after the teeth extraction and immediate denture (AU)

O ameloblastoma é um tumor odontogênico que afeta os ossos maxilares, geralmente a região posterior de mandíbula. É uma neoplasia benigna frequentemente associada a um dente não irrompido. O objetivo deste artigo é relatar um caso de prótese total imediata confeccionada para uma paciente com ameloblastoma na região anterior da mandíbula. Paciente do sexo feminino, 67 anos, queixou-se de aumento de volume na região de pré-molares inferiores do lado direito após extração dentária e confecção de prótese total imediata. Ao exame clínico intrabucal foi observada expansão da cortical vestibular e lingual e o exame radiográfico revelou radiolucência multilocular com margem bem definida. A punção aspirativa não foi produtiva e o diagnóstico provisório foi de ameloblastoma. Foi realizada biópsia incisional e o laudo histopatológico foi conclusivo para ameloblastoma acantomatoso. A paciente foi encaminhada para ressecção cirúrgica da lesão e não retornou. Depois de três anos procurou atendimento e relatou que tinha sido submetida a cirurgia com colocação de enxerto ósseo para implante sem sucesso. O enxerto ósseo foi perdido e a paciente necessitava de nova prótese total. Ela foi encaminhada a um protesista. No presente caso, o diagnóstico de ameloblastoma foi feito somente após a instalação da prótese total imediata, quando a paciente notou aumento de volume (AU).

Quality of life in a smoking cessation program: lifestyle, anxiety, and depression / Qualidade de vida em um programa de cessação do tabagismo: estilo de vida, ansiedade e depressão

Objective: Tobacco dependence is quite variable among individuals because it includes many aspects such as psychological, emotional, behavioral, and cultural perspectives. This study aimed to evaluate the social and emotional issues of patients in a smoking cessation program through the generic and specific quality of life questionnaires. Material and Methods: Two generic questionnaires (SF36 and Fantastic Lifestyle) and two specific (SRQ-20 for depression and STAI s/t for levels of state and anxiety trait) were applied at the first meeting and after three months of treatment. Data were statistically analyzed by the Pearson correlation coefficient (significance level of 5%). Results: In total, 15 participants (10 men, 5 women), with mean age of 60 and 56, respectively. The mean of the smoking intake was 65.88±34.37 for men and 35.66±11.17 for women. SRQ20 and STAI s/t indicated that poor improvement in depression and anxiety was related to relapse; SF36 questionnaire indicated improvement in the domains of physical aspect limit, pain, social and emotional aspects; Fantastic Lifestyle indicated improvement according to its scale, being in a first moment "Regular" (53 points), and later, "Good" (55.67 points). Conclusion: In conclusion, smoking cessation treatment is correlated to the decrease in anxiety and depression levels and improvement of the general quality of life (AU)

Objetivo: A dependência do tabaco é bastante variável entre os indivíduos porque inclui muitos aspectos, como perspectivas psicológicas, emocionais, comportamentais e culturais. Este estudo teve como objetivo avaliar as questões sociais e emocionais de pacientes em um programa de cessação tabagágica por meio de questionários genéricos e específicos de qualidade de vida. Material e Métodos: Dois questionários genéricos (SF36 e Estilo de Vida Fantástico) e dois específicos (SRQ-20 para depressão e IDATE s/t para níveis de estado e traço de ansiedade) foram aplicados no primeiro encontro e após três meses de tratamento. Os dados foram analisados estatisticamente pelo coeficiente de correlação de Pearson (nível de significância de 5%). Resultados: No total, 15 participantes (10 homens, 5 mulheres), com média de idade de 60 e 56 anos, respectivamente. A média do consumo tabágico foi de 65,88 ± 34,37 para homens e 35,66 ± 11,17 para mulheres. SRQ20 e IDATE s/t indicaram que a fraca melhora na depressão e ansiedade estava relacionada à recaída; o questionário SF36 indicou melhora nos domínios limite do aspecto físico, dor, aspectos sociais e emocionais; Estilo de Vida Fantástico indicou melhora de acordo com sua escala, sendo em um primeiro momento "Regular" (53 pontos), e posteriormente, "Bom" (55.67 pontos). Conclusão: Em conclusão, o tratamento para cessação do tabagismo está correlacionado à diminuição dos níveis de ansiedade e depressão e à melhora da qualidade de vida geral (AU)

Multicentre retrospective study of 97 cases of intraoral lipoma.

BACKGROUND: Lipomas are benign neoplasms derived from adipose tissue that are unfrequently found in the oral cavity. The objective of this study is to identify the main clinicopathological characteristics of this tumour in a case series of oral lipomas (OL) in a population from Spain and Brazil. MATERIAL AND METHODS: A multicentre retrospective observational study was conducted in collaboration with the Oral Pathology Unit of the São Paulo State University (UNESP), São José dos Campos, in Brazil, and the Oral Medicine and Pathology Units of the University of Santiago de Compostela (USC) and the University of the Basque Country (UPV/EHU) in Spain. RESULTS: This multicentre series consists of a total of 97 of OL cases, 31 (32%) of which correspond to Spain, and 66 (68%) to Brazil with an overall prevalence of 0.33%. The average age of the patients is 56.44 years old, with a range of 10-92 (SD = 15.52). Buccal mucosa was the most frequent location (42.3%). Cases from Spain coexisted with other lesions in a significant number of cases, 12.9%, vs Brazil, 1.5% (P = 0.018). According to the progression time, Brazil has an average of 60.35 months (CI: 27.20-93.51), compared to 5.41 months in Spain (CI: 3.17-7.65) (P = 0.022). Average size is 12.55 mm (SD = 11.06), ranging from 2 to 75 mm. A positive correlation is also seen between the increase in the lesion size and a greater progression time (CC = 0.367; P = 0.008). CONCLUSIONS: Correct differential diagnosis of the clinical lesion is key, followed by a good histopathological study, to achieve the final diagnosis.

Methotrexate delayed wound healing of a pyogenic granuloma in a child with juvenile idiopathic arthritis / Metotrexato atrasou a cicatrização de um granuloma piogênico em criança com artrite idiopática juvenil

A nine-year-old girl with of juvenile idiopathic arthritis (JIA) in use of methotrexate complained of a self-bleeding ulcerated lesion exhibiting a red surface in the lower lip. Pyogenic granuloma was confirmed by histopathological analysis. After the 7th and 15th days, the lip where biopsy had been done exhibited a deficient healing. The case was discussed with the physician for temporary suspension of methotrexate. Complete wound healing of the biopsied site occurred after temporary interruption of the medication. Wound healing after methotrexate temporary suspension allowed concluding that the drug delayed surgical wound healing was a consequence of drug cytotoxicity. (AU)

Uma menina de nove anos de idade com artrite idiopática juvenil (AIJ) em uso de metotrexato queixou-se de lesão ulcerada com sangramento espontâneo que exibia superfície avermelhada em lábio inferior. O granuloma piogênico foi confirmado pelo exame histopatológico. Após o 7º e 15º dias, a região do lábio onde a biópsia foi realizada exibiu cicatrização deficiente. O caso foi discutido com o médico e foi realizada a suspensão temporária do metotrexato que resultou em cicatrização completa. A cicatrização da ferida após a suspensão temporária do metotrexato permitiu concluir que o medicamento retardou a cicatrização da ferida cirúrgica como consequência da citotoxicidade da droga. (AU)