Hybrid Neurofibroma/Schwannoma of the Oral Cavity: A Rare Case Report and Literature Review.

Hybrid peripheral nerve sheath tumors show combined features of more than one type of conventional benign peripheral nerve sheath tumors. There are few cases reported of hybrid peripheral nerve sheath tumors in the head and neck region. A 68-year-old female patient was referred for evaluation of an oral swelling lasting five years. Intraoral examination revealed a small mobile nodule located in the lower vestibule. The patient underwent excisional biopsy and microscopic evaluation showed typical features of neurofibroma enclosing areas with palisading nuclei compatible with Antoni A pattern, which are seen in schwannomas. These regions showed strong and diffuse immunoreactivity for S100 protein and moderate positivity in the neurofibroma area. CD34 was positive in the neurofibroma area and entrapped axons were positive for neurofilament. The final diagnosis was oral hybrid neurofibroma-schwannoma tumor. Hybrid peripheral nerve sheath tumors, although extremely rare, may arise within the oral cavity. To the best of our knowledge, this is the first neurofibroma-schwannoma tumor reported in the oral cavity. Recognizing hybrid peripheral nerve sheath tumors as a distinct clinicopathological entity is important because they may also be associated with syndromic disorders.

Tongue hamartomas in pediatric patients: an international case series and literature review.

This study reports 9 additional tongue hamartomas in children paired with a literature review. A retrospective analysis was performed from 3 Oral Pathology laboratories. Additionally, a literature review was conducted through 5 electronic databases and gray literature. A total of 9 cases were identified in the retrospective analysis. Females outnumbered males with a ratio of 1.25:1. The age of presentation ranged from 2 weeks to 7 years. The posterior dorsum tongue was the most affected subsite (n = 4). One case was seen in a patient with oro-facial-digital syndrome, 2 cases in patients with cleft palates, and one case with an encephalocele. The most common predominant component was salivary gland tissue (n = 4). A literature search included 79 pediatric patients presenting with 95 tongue hamartomas. A slight female (n = 47) predilection was observed, with ages varying from 15 hours to 19 years. The posterior tongue dorsum (n = 31) was the most affected site. Seven cases were seen in association with syndromes. The most common predominant component was smooth muscle (n = 35). Although hamartomas are rare in the oral cavity, they should be considered in the differential diagnosis of masses involving the posterior tongue dorsum in children.

Acquired oral syphilis: A multicenter study of 339 patients from South America.

OBJECTIVE: To report the clinicopathologic features of acquired oral syphilis cases in South American countries. MATERIALS AND METHODS: Clinical data were retrospectively collected from the records of 18 oral diagnostic services in Argentina, Brazil, Chile, Colombia, Venezuela, Uruguay, and Peru. Serologies of nontreponemal and treponemal tests were used for diagnosis. RESULTS: The series comprised 339 cases of acquired oral syphilis. Secondary syphilis ranked as the most common stage (86.7%). Lesions were more frequent among males (58.0%) and young adults with a mean age of 33.3 years. Individuals aged 20-29 years were most affected (35.3%). The most commonly involved sites were the tongue (31.6%), lip/labial commissure (25.1%), and hard/soft palate (20.4%). Clinically, acquired oral syphilis usually presented as mucous patches (28.4%), papules (25.7%), and ulcers (18.1%). Skin manifestations occurred in 67.7% of individuals, while lymphadenopathy and fever were observed in 61.3% and 11.6% of all subjects, respectively. Most patients were treated with the benzathine penicillin G antibiotic. CONCLUSION: This report validates the spread of acquired oral syphilis infection among young adults in South America. Our directives include accessible diagnostic tools for proper disease screening, surveillance, and counselling of affected individuals, especially in low- and middle-income countries.

Central odontogenic fibroma: an international multicentric study of 62 cases.

OBJECTIVE: The aim of this study was to report the clinicopathologic features of 62 cases of central odontogenic fibroma (COdF). STUDY DESIGN: Clinical and radiographic data were collected from the records of 13 oral pathology laboratories. All cases were microscopically reviewed, considering the current World Health Organization classification of tumors and were classified according to histopathologic features. RESULTS: There were 43 females and 19 males (average age 33.9 years; range 8-63 years). Clinically, COdF lesions appeared as asymptomatic swellings, occurring similarly in the maxilla (n = 33) and the mandible (n = 29); 9 cases exhibited palatal depression. Imaging revealed well-defined, interradicular unilocular (n = 27), and multilocular (n = 12) radiolucencies, with displacement of contiguous teeth (55%) and root resorption (46.4%). Microscopically, classic features of epithelial-rich (n = 33), amyloid (n = 10), associated giant cell lesion (n = 7), ossifying (n = 6), epithelial-poor (n = 3), and granular cell (n = 3) variants were seen. Langerhans cells were highlighted by CD1a staining in 17 cases. Most patients underwent conservative surgical treatments, with 1 patient experiencing recurrence. CONCLUSIONS: To the best of our knowledge, this study represents the largest clinicopathologic study of COdF. Most cases appeared as locally aggressive lesions located in tooth-bearing areas in middle-aged women. Inactive-appearing odontogenic epithelium is usually observed within a fibrous/fibromyxoid stroma, occasionally exhibiting amyloid deposits, multinucleated giant cells, or granular cells.

Uso de enxaguatórios bucais em pacientes portadores de câncer de boca e orofaringe / Mouthrinse use in patients with oral and oropharyngeal cancer

O câncer de boca é atualmente um grave problema de saúde mundial. A incidência varia amplamente todo o mundo. Vários fatores de risco têm sido associados com cânceres da cavidade oral, tais como o fumo, consumo de bebidas alcoólicas, pobre saúde bucal e infecção pelo papiloma vírus humano. O mecanismo pelo qual bebidas alcoólicas provocam câncer oral é desconhecido, mas provavelmente envolve exposição tópica. Diferentes estudos têm sido conduzidos por muitos anos, a fim de esclarecer a possível relação entre o uso crônico de enxaguatórios bucais com álcool e câncer oral. O objetivo desse estudo foi avaliar o uso de enxaguatórios bucais em pacientes com câncer de boca e orofaringe. Foram entrevistados 53 pacientes por meio de um questionário específico de dois centros de referência para o diagnóstico e tratamento do câncer. O grupo caso foi constituído por 33 pacientes, com diagnóstico final de carcinoma epidermóide de boca e orofaringe com sítios nas seguintes localizações anatômicas: face interna dos lábios, língua, gengiva, assoalho da boca, palato e úvula, mucosa oral, vestíbulo da boca, área retromolar, outras partes e partes não especificadas da boca, amígdala e orofaringe. O grupo controle foi constituído por 20 pacientes atendidos em outros ambulatórios dos mesmos hospitais e serviços não ligados a oncologia...

Oral cancer is a major problem worldwide nowadays. The incidence varies widely throughout the world. A great variety of risks have been associated with oral and oropharyngeal cancers,such as tobacco and alcohol consumption, poor oral health, and human papilloma virus infection. The mechanism through which alcohol contributes to oral cancer is unknown, but it probably involves topical and systemic exposition. Different studies aiming to clarify a possible association between alcoholic mouthwashes and oral cancer have been conducted for many years. The objective of this study was to evaluate oral hygiene habits and the use of mouthwashes in oral and oropharyngeal cancer patients. Fifty-three patients from two cancer centers were interviewed by means of a specific questionnaire. The case group comprised 33 patients diagnosed with squamous cell carcinoma located at the following anatomical sites: lips, tongue, gingiva, floor of the mouth, buccal mucosa, palate, uvula, pharyngeal tonsil, oropharynx, and other non-specified parts. The control group comprised 20 patients with non-neoplastic treatments. The results showed that 42.4% the of case group patients presented tongue lesions, 16 patients were classified at stageIV...

Parameters in panoramic radiography for differentiation of radiolucent lesions.

OBJECTIVE: The aims of this study were to establish parameters in panoramic radiography for interpretation of unilocular radiolucent lesions, and to compare the accuracy of diagnoses given by examiners before and after using these parameters. MATERIAL AND METHODS: In Part I, 12 specialists analyzed 24 images and the diagnostic criteria used by each examiner to make correct diagnoses were used to build a list of basic radiographic parameters for each pathology (ameloblastoma, keratocystic odontogenic tumor, dentigerous cyst, and idiopathic bone cavity). In Part II, this list was used by 6 undergraduate students (Un), 8 recently graduated dentists (D), 3 oral pathologists, 3 stomatologists, 3 oral radiologists, and 3 oral surgeons to diagnose the corresponding pathologies in the other set of 24 panoramic radiographs (T2). The same analysis occurred without using this list (T1). The method of generalized estimating equations (GEE) was used in order to estimate the probability of making a correct diagnosis depending on the specialty of the examiner, type of lesion, and moment of the evaluation, T1 or T2 (before or after they had access to the list of parameters, respectively). RESULTS: Higher values were obtained for the probability (GEE) of making a correct diagnosis on T2; the group Un presented the highest improvement (14.6 %); no differences between the probabilities were observed either between Un and D, or among the different groups of specialists. CONCLUSIONS: The use of panoramic radiographic parameters did allow improving the diagnostic accuracy for all groups of examiners.

Parameters in panoramic radiography for differentiation of radiolucent lesions

OBJECTIVE: The aims of this study were to establish parameters in panoramic radiography for interpretation of unilocular radiolucent lesions, and to compare the accuracy of diagnoses given by examiners before and after using these parameters. MATERIAL AND METHODS: In Part I, 12 specialists analyzed 24 images and the diagnostic criteria used by each examiner to make correct diagnoses were used to build a list of basic radiographic parameters for each pathology (ameloblastoma, keratocystic odontogenic tumor, dentigerous cyst, and idiopathic bone cavity). In Part II, this list was used by 6 undergraduate students (Un), 8 recently graduated dentists (D), 3 oral pathologists, 3 stomatologists, 3 oral radiologists, and 3 oral surgeons to diagnose the corresponding pathologies in the other set of 24 panoramic radiographs (T2). The same analysis occurred without using this list (T1). The method of generalized estimating equations (GEE) was used in order to estimate the probability of making a correct diagnosis depending on the specialty of the examiner, type of lesion, and moment of the evaluation, T1 or T2 (before or after they had access to the list of parameters, respectively). RESULTS: Higher values were obtained for the probability (GEE) of making a correct diagnosis on T2; the group Un presented the highest improvement (14.6 percent); no differences between the probabilities were observed either between Un and D, or among the different groups of specialists. CONCLUSIONS: The use of panoramic radiographic parameters did allow improving the diagnostic accuracy for all groups of examiners.

Epilepsia: uma abordagem odontológica / Epilepsia: an oral approach

A epilepsia é uma doença provocada pelo descontrole do SNC, podendo ser classificada de acordo com a região cerebral afetada. A incidência é alta nas duas primeiras décadas de vida e depois dos 50 anos, sendo necessário um tratamento para controle dos ataques, muitas vezes com uso de uma combinação de medicações que acabam por provocar diversas alterações na cavidade bucal, como a hiperplasia gengival. Além disso, as ações dos medicamentos anti-convulsionantes podem ser influenciadas por várias medcações de uso corriqueiro em Odontologia...

Epilepsy is a disease caused by the disarray of the CNS an can be classified inagreement with the affected area. The incidence is high in the first two decades of life and after the fith. A treatment is necessary to control the attacks and many times uses a combination of medications that brings several implications to the oral cavity tissues, such as gengival hyperplasia. These medcations can also be influeced by many medications prescribed by the dentistry...

Detalhes arquitetônicos para o atendimento odontológico a deficientes físicos: medidas simples que conquistam espaço no mercado de trabalhoArchitectural / Architectural details for dental treatment of physical handicapped patients: simple actions that conquer space in the labor market

Ao entrar no século 21, as pesquisas demográficas mostram que o número de deficientes físicos aumenta a cada dia. Evidentemente, a procura desses pacientes por tratamento odontológico também tem crescido e, apesar disso, pouco são os cirurgiões-dentistas que se sentem preparados ou possuem instalações físicas que permitam um bom atandimento a eles. O atendimento odontológico a pacientes com distúrbios físicos, em especial o motor, praticamente em nada difere do atendimento a pacientes considarados normais, a não ser pela eliminação de barreiras físicas. Este trabalho mostra que com o uso de medidas arquitetônicas simples, enumeradas no decorrer do texto, pode-se conquistar um vasto mercado de trabalho inexplorado pela Odontologia.