Psychological profile and α-amylase levels in oral lichen planus patients: A case-control preliminary study.

OBJECTIVE: To investigate psychological (anxiety, depression, and stress) and salivary (flow and concentration of α-amylase) profile associated with oral lichen planus. MATERIALS AND METHODS: A case-control preliminary study with oral lichen planus patients and age-gender matched controls was conducted. The participants underwent psychological tests (Beck depression and anxiety inventories and perceived stress scale) and saliva collection to determine the unstimulated salivary flow and α-amylase levels at three moments along the day. The data were analyzed statistically using Mann-Whitney, McNemar chi-square and Friedman tests, and the Spearman correlation coefficient. The significance level adopted was 5%. RESULTS: A total of 46 case-control pairs were recruited. There was a significant correlation between anxiety, depression, stress, and oral lichen planus, as well as the stress and decline of salivary α-amylase levels. Higher concentrations of this biomarker were found in the case group thirty minutes post-awakening. CONCLUSION: The applied psychological tests indicated that factors such as anxiety, depression, and stress were associated with oral lichen planus. Salivary analyses demonstrated a higher concentration of α-amylase thirty minutes post-awakening on individuals with the disease and its decline correlated with stress, suggesting the role of α-amylase as a promising biomarker for future studies.

Salivary biomarkers to evaluate psychological disorders in oral lichen planus: A systematic review with meta-analysis.

OBJECTIVE: To analyze the use of salivary biomarkers to identify psychological disorders (anxiety, depression, and stress) in individuals with oral lichen planus (OLP). MATERIALS AND METHODS: The search was made in Medline/Pubmed, Scopus, Web of Science, Virtual Health Library, ProQuest, and by cross-reference. Original case-control, cross-sectional, and cohort studies, in human subjects (age ≥18 years) with clinical and histopathological diagnosis, with or without the use of psychometric scales, published until June 2021, were included. Random-effects meta-analyses, subgroup analyses, and sensitivity were performed. Publication bias was measured using the Egger test and visual inspection of the funnel plot. RESULTS: A total of 67 articles were found, of which 12 were included in the meta-analysis. Among the different biomarkers identified, it was only possible to perform a meta-analysis for cortisol. The mean difference between salivary cortisol levels in patients with OLP compared to controls was 3.43 ng/ml (95% CI: 1.20-5.65) with I2  = 98.9%. Studies considered outliers were removed and based on sensitivity analyses, results did not change, therefore, being stable. CONCLUSION: The studies analyzed demonstrated that cortisol was the most quantified biomarker to identify psychological disorders; however, DHEA, IgA, adiponectin, and α-amylase were also evaluated.

Oral Lichen Planus and Oral Squamous Cell Carcinoma share key oncogenic signatures.

To investigate similarities in the gene profile of Oral Lichen Planus and Oral Squamous Cell Carcinoma that may justify a carcinogenic potential, we analyzed the gene expression signatures of Oral Lichen Planus and Oral Squamous Cell Carcinoma in early and advanced stages. Based on gene expression data from public databases, we used a bioinformatics approach to compare expression profiles, estimate immune infiltrate composition, identify differentially and co-expressed genes, and propose putative therapeutic targets and associated drugs. Our results revealed gene expression patterns related to processes of keratinization, keratinocyte differentiation, cell proliferation and immune response in common between Oral Lichen Planus and early and advanced Oral Squamous Cell Carcinoma, with the cornified envelope formation and antigen processing cross-presentation pathways in common between Oral Lichen Planus and early Oral Squamous Cell Carcinoma. Together, these results reveal that key tumor suppressors and oncogenes such as PI3, SPRR1B and KRT17, as well as genes associated with different immune processes such as CXCL13, HIF1A and IL1B are dysregulated in OLP.

Uso dos laminados cerâmicos como alternativa restauradora para solucionar a presença de espaços negros no sorriso / Use of ceramic veneers as an alternative to solve the presence of black spaces in smile

Os avanços alcançados no desenvolvimento dos materiais restauradores e procedimentos adesivos têm possibilitado a realização de procedimentos minimamente invasivos nas reabilitações orais. Neste contexto, os laminados cerâmicos tornaram-se uma alternativa viável para a resolução de diversos problemas que acometem a função e estética. Assim, este trabalho apresentou como objetivo relatar um caso clínico de reabilitação estética do sorriso com o fechamento de espaços negros, originados a partir de um trauma, seguido de movimentação ortodôntica, através da utilização de laminados cerâmicos. Neste foram descritas as etapas clínicas de diagnóstico, planejamento e execução do procedimento restaurador, observando que o tratamento proposto foi uma alternativa conservadora e eficaz na resolução dos espaços negros existentes, reestabelecendo a estética do sorriso e devolvendo a auto-estima do paciente(AU)

The advances achieved in the development of restorative materials and adhesive procedures have made possible to perform minimally invasive procedures in oral rehabilitation. In this context, ceramic veneers have become a viable alternative for solving several problems that affect function and aesthetics. Thus, this study aimed to report a clinical case of aesthetic smile rehabilitation with the closure of black spaces, originated from trauma, followed by orthodontic movement, through the use of ceramic veneers. In this, the clinical stages of diagnosis, planning and execution of the restorative procedure were described, noting that the proposed treatment was a conservative and effective alternative in the resolution of existing black spaces, reestablishing the aesthetic of the smile and restoring the patient's selfesteem(AU)

Anti-inflammatory and wound healing effect of Copaiba oleoresin on the oral cavity: A systematic review.

Copaiba oleoresin has been related to properties including healing and anti-inflammatory effects, making it a potential candidate to treat oral lesions. We aimed to define the benefits related to the anti-inflammatory and healing capacity of Copaiba-based formulations on the oral cavity. This is a systematic review, conducted in PubMed, Web of Science, Scopus, Embase, Scielo, Cochrane Library, BVS, and Google Scholar databases selecting full articles in English, Portuguese, or Spanish, until March 3rd, 2021. Pre-clinical, clinical, or randomized clinical trials, cohort and case-control in vivo studies were included; studies with other designs, in vitro, and those that did not match the PICO question were excluded (PROSPERO: CRD42021244938). Data was collected and synthesized descriptively through a specific form. The risk of bias was evaluated by SYRCLE's RoB Tool. So, five studies were included. Two reported beneficial wound healing effects, such as early reduction in the wound area and greater immature bone formation in the rats' mandibles; and two related benefic anti-inflammatory effects, like reduced acute inflammatory reaction and more advanced tissue repair stage, early formation of collagen fibrils, with greater quantity, thickness and better organization, and more expressive anti-inflammatory activity, reduction of the edema intensity and the CD68 + macrophages concentration. Based on the articles, benefits related to the wound healing and anti-inflammatory effects in the oral cavity of rats treated with Copaiba oleoresin were suggested. However, due to the limited data, future studies are necessary, especially clinical ones.

Adenocarcinoma of mammary origin in the maxillary gingiva: a case report and brief literature review.

Maxillofacial metastases are rare but represent advanced disease progression and a poor prognosis. The primary purpose of this article is to describe a patient with previously diagnosed and treated invasive ductal breast carcinoma who developed a metastatic lesion in the maxillary gingiva. In addition, this article presents a brief literature review of case reports on metastatic breast cancer manifestations in the gingiva. In the present case, a 68-year-old woman had been diagnosed and treated for invasive ductal breast carcinoma. At the 6-month follow-up after treatment for breast cancer, she complained of pain in the right leg and spine, swelling in the right arm associated with redness, and a nodular growth in the maxillary gingiva that was painful, friable, and associated with tooth mobility. Imaging examinations and microscopic analysis of an oral biopsy specimen revealed disease progression to the oral cavity, femur, lung, and brain. Because of the advanced disease, the patient died within a few weeks. The literature review identified 6 articles that reported varied clinical presentations of metastatic breast cancer in the gingiva. Invasive ductal carcinoma was the most common histologic type. Routine dental follow-up of patients with cancer is essential for the identification and diagnosis of oral lesions to ensure early intervention for lesions that may be distant metastases mimicking benign lesions.

Toxicidades orales de la terapia contra el cáncer en niños y adolescentes: un estudio descriptivo / Toxicidades orais da terapia oncológica em crianças e adolescentes: um estudo descritivo / Oral toxicities of oncology therapy in children and adolescents: a descriptive study

Resumen Introducción y objetivo: El cáncer es la segunda causa de muerte entre niños y adolescentes en Brasil. Evaluar la prevalencia de toxicidades orales derivadas del tratamiento oncológico en niños y adolescentes atendidos en el Hospital Estadual da Criança, de 2016 a 2017. Materiales y métodos: Se trata de un estudio descriptivo con datos obtenidos de historias clínicas. Se estudiaron variables relacionadas con la neoplasia, el portador, las toxicidades orales y el tratamiento oncológico, las cuales fueron analizadas de forma descriptiva y se realizó la prueba de la χ2 de Fisher para algunas de ellas. Resultados: Se identificaron 58 pacientes, en su mayoría mujeres (53%) y con edades entre 3 y 5 años (28%), con una media de 6,62 años. La neoplasia más común fue la leucemia linfoide aguda (38%), siendo la quimioterapia sola, la modalidad terapéutica más utilizada (67%), especialmente con el uso de citarabina (60%) y vincristina (56%). Veintitrés (40%) de los niños y adolescentes presentaron alguna toxicidad oral durante la terapia oncológica, por lo que a 4 (17,4%) se les interrumpió el tratamiento antineoplásico. La mucositis oral (70%) fue la toxicidad más común, afectando los labios en el 55% y fue asociada a dolor en el 64% de los casos. Dieciocho (78,2%) pacientes recibieron tratamiento por toxicidad oral, prescribiéndose nistatina en el 88,9% de los casos. Además, hubo una asociación significativa entre el estado de supervivencia y el lugar de residencia (p=0,03). Conclusiones: Entre los 58 niños y adolescentes estudiados, el 40% presentó toxicidades orales y 4 tuvieron interrumpido el tratamiento antineoplásico por este motivo. Así, se refuerza la importancia y la necesidad de la actuación del odontólogo en el equipo multidisciplinario en oncología.

Abstract Introduction and objective: Cancer is the second leading cause of death among children and adolescents in Brazil. To evaluate the prevalence of oral toxicities resulting from cancer treatment in children and adolescents treated at the Hospital Estadual da Criança, from 2016 to 2017. Material and methods: This is a descriptive study with data obtained from medical records. Variables related to neoplasia, carrier, oral toxicities and cancer treatment were studied, which were analyzed descriptively and thFisher χ2 test was performed for some of them. Results: Fifty eigth patients were identified, mostly female (53%) and aged between 3 and 5 years (28%), with an average of 6.62 years. The most frequent neoplasm was acute lymphoid leukemia (38%), with chemotherapy alone being the most used therapeutic modality (67%), especially with the use of cytarabine (60%) and vincristine (56%). Twenty-three (40%) of the children and adolescents exhibited some oral toxicity during cancer therapy, and for this reason, 4 (17.4%) had their antineoplastic treatment interrupted. Oral mucositis (70%) was the most common toxicity, affecting the lips in 55% and being associated with pain in 64% of cases. Eighteen (78.2%) patients received treatment for oral toxicities, with nystatin being prescribed in 88.9% of cases. In addition, there was a significant association between survival status and place of residence (p=0.03). Conclusions: Among the 58 children and adolescents studied, 40% had oral toxicities and 4 had their antineoplastic treatment interrupted for this reason. Thus, the importance and the need for the performance of the dentist in the multidisciplinary team in oncology is reinforced.

Resumo Introdução e objetivo: O câncer é a segunda maior causa de morte entre crianças e adolescentes no Brasil. Avaliar a prevalência de toxicidades orais decorrentes do tratamento oncológico em crianças e adolescentes atendidos no Hospital Estadual da Criança, no período de 2016 a 2017. Materiais e métodos: Trata-se de um estudo descritivo com dados obtidos de prontuários médicos. Foram estudadas variáveis relacionadas à neoplasia, ao portador, às toxicidades orais e ao tratamento oncológico, que foram analisadas descritivamente e o teste χ2 de Fisher foi aplicado para algumas delas. Resultados: Foram identificados 58 pacientes, com maioria do sexo feminino (53%) e idade entre 3 e 5 anos (28%), com média de 6,62 anos. A neoplasia maligna mais frequente foi a leucemia linfóide aguda (38%), sendo a quimioterapia isolada a modalidade terapêutica mais empregada (67%), especialmente com uso de citarabina (60%) e vincristina (56%). Vinte e três (40%) das crianças e adolescentes exibiram alguma toxicidade oral durante a terapia oncológica, e por esta razão, 4 (17,4%) tiveram o tratamento antineoplásico interrompido. A mucosite oral (70%) foi a toxicidade mais comum, acometendo os lábios em 55% e estando associada a dor em 64% dos casos. Dezoito (78,2%) pacientes receberam tratamento para as toxicidades orais, sendo a nistatina prescrita em 88,9% dos casos. Ademais, observou-se associação significante entre status de sobrevida e local de residência (p=0.03). Conclusões: Dentre as 58 crianças e adolescentes estudadas, 40% apresentou toxicidades orais e 4 tiveram o tratamento antineoplásico interrompido por esta razão. Desta forma, reforça-se a importância e a necessidade da atuação do cirurgião-dentista na equipe multiprofissional em oncologia.

Reabilitação com prótese oculopalpebral após exenteração de órbita: relato de caso / Rehabilitation with oculopalpebral prosthesis after orbit exenteration: a case report / Rehabilitación com prótesis oculopalpebral después de la exenteración de la órbita: reporte de un caso

Introdução: A ressecção cirúrgica de tumores em região de cabeça e pescoço é um tratamento eficaz, mas que implica em significativa desfiguração facial dependendo da localização da lesão. Aqueles pacientes considerados curados precisam ser reabilitados estética e funcionalmente para que possam ser reintegrados às funções sociais. A prótese maxilofacial é um artefato de baixo custo, que pode resolver essa necessidade. Relato de caso: Esse artigo relata o caso de uma paciente de 19 anos submetida à exenteração de órbita para tratamento de Tumor Fibroso Solitário Retrorbitário que, após a cirurgia e radioterapia adjuvante, foi reabilitada por meio de prótese óculopalpebral em silicone. Conclusão: O caso foi considerado um sucesso e ressalta a importância do cirurgião dentista na equipe oncológica e o positivo impacto psicológico e social da reabilitação(AU)

Introduction: Surgical resection of head and neck tumors is an effective treatment, but it implies significant facial disfigurement depending on the location of the lesion. Those patients considered cured need to be rehabilitated aesthetically and functionally so that they can be reintegrated into social functions. The maxillofacial prosthesis is an artifact of low cost, which can solve thisneed. Case Report: This article reports the case of a 19-year-old patient who underwent orbit exanteration for the treatment of Solitary Retrorbital Fibrous Tumor, which, after surgery and adjuvant radiotherapy, was rehabilitated using an oculopebral prosthesis made of silicone. Conclusion: The case was considered a success and highlights the importance of the dental surgeon in the oncology team and the positive psychological and social impact of rehabilitation(AU)

Introducción: La resección quirúrgica de los tumores de cabeza y cuello es un tratamiento eficaz, pero implica una desfiguración facial significativa según la ubicación de la lesión. Aquellos pacientes considerados curados necesitan ser rehabilitados estética y funcionalmente para que puedan reintegrarse a las funciones sociales. La prótesis maxilofacial es un artefacto de bajo costo que puede resolver esta necesidad. Reporte del caso: Este artículo informa el caso de una paciente de 19 años que se sometió a una exenteración de órbita para el tratamiento del tumor fibroso retrorbital solitario, que, después de la cirugía y la radioterapia adyuvante, fue rehabilitada con una prótesis oculopalpebral de silicona. Conclusión: El caso se consideró un éxito y destaca la importancia del cirujano dental en el equipo de oncología y el impacto psicológico y social positivo de la rehabilitación(AU)

Secretory carcinoma of salivary glands at the National Cancer Institute: A 20-year retrospective clinical, pathological, immunohistochemical and molecular study.

OBJECTIVES: This study aim was to review cases of acinic cell carcinoma (the main differential diagnosis of secretory carcinoma) that were diagnosed and treated at the National Cancer Institute of Brazil (INCA) between 1996 and 2016. The primary objective was to identify underdiagnosed cases of secretory carcinoma via a clinical, immunopathological and molecular reassessment. MATERIALS AND METHODS: This is a cross sectional study, with retrospective data collection from medical records and histological specimen review, with staining for periodic acid-Schiff (PAS) and PAS with diastase, immunohistochemistry for S-100, mammaglobin, and DOG-1, and droplet digital RT-PCR for ETV6-NTRK3. The Research Ethics Committee approved this study, and the patients allowed their participation through informed consent. RESULTS: Eighty-three cases of acinic cell carcinoma were diagnosed and treated in the specified period at INCA, of which, seven had their diagnosis changed to secretory carcinoma. CONCLUSION: The present study adds seven cases of secretory carcinoma to the literature, contributing to a better understanding of the epidemiological, histological, immunohistochemical and molecular characteristics of this recently described tumor. Also, the use of a comprehensive diagnostic approach, including immunohistochemical and molecular methods, along with classical morphological studies, allowed the reclassification of acinic cell carcinoma to secretory carcinoma.

A systematic review of secretory carcinoma of the salivary gland: where are we?

OBJECTIVE: The aim of this systematic review was to describe the epidemiology, diagnostic criteria, differential diagnosis, treatment, prognostic factors, and treatment outcomes of secretory carcinoma. STUDY DESIGN: A comprehensive search of Lilacs, PubMed, Science Direct, and Web of Science databases was conducted to identify all case reports, letter to the editor, and histopathologic reclassifications regarding salivary gland secretory carcinoma published in English, Spanish, French, and Portuguese. RESULTS: The final analysis included 119 studies, which totaled 642 secretory carcinoma diagnoses, with 239 case reports and 403 diagnostic reclassifications, mostly in the United States. The age range was 5 to 87 years, and cases were predominantly in males (58.7%) and mostly affecting the parotid glands (73.7%). The disease usually presents as a slow-growing, painless mass. The main differential diagnosis is acinic cell carcinoma, and the tumor is usually treated with surgery. The prognosis is considered favorable, although there have been reports of local recurrences, distant metastases, and deaths. CONCLUSIONS: It is important that clinicians become aware of this salivary gland neoplasm and report clinical data, clinical course, management and long-term follow-up. There is an urgent need to conduct more clinical trials, especially on tropomyosin receptor kinase (TRK) inhibitors and other potential target therapy modalities.

Panorama Atual dos Programas de Residência Multiprofissional em Oncologia para Cirurgiões-Dentistas do Brasil / Current Portrait of Multiprofessional Residency Programs in Oncology for Dentist in Brazil / Panorama Actual de los Programas de Residencia Multiprofesional en Oncología para Cirujanos-Dentistas en Brasil

Introdução: Os Programas de Residência Multiprofissional constituem-se uma estratégia fundamental para a ampliação da capacidade para o enfrentamento do câncer. Objetivo: Analisar o panorama atual dos Programas de Residência Multiprofissional em Oncologia para cirurgiões- -dentistas no Brasil, bem como o número de profissionais egressos desses cursos, a partir de dados informados pelo Ministério da Educação (MEC). Método: Trata-se de um estudo quantitativo, exploratório. A primeira fase consistiu na solicitação à Equipe Técnica da Residência Multiprofissional do MEC do Brasil da relação de todos os Programas de Residência Multiprofissional em Oncologia que incluíssem a categoria profissional da odontologia. Adicionalmente, foi realizada busca manual. Na segunda fase, realizaram-se contato por e-mail e busca pelos editais disponíveis na Internet dos casos em que não houve resposta. Os dados investigados foram a presença de Programa ativo, inclusão da categoria profissional da odontologia, número de vagas ofertadas e de egressos para cada ano entre 2010 e 2020, que foram analisados descritivamente. Resultados:Foram identificados 13 Programas de Residência Multiprofissional em Oncologia para cirurgiões-dentistas, distribuídos em 12 centros, situados em dez cidades de oito Estados brasileiros, sobretudo, na Região Sudeste. Seis Programas foram implementados em 2010, seis em 2016 e um em 2020. No cenário Brasileiro, entre 2010 e 2020, foram ofertadas 216 vagas e formados pouco mais de 114 profissionais especializados nessa área. Conclusão: Ressalta-se a necessidade do incremento de centros, Programas e vagas para Residências Multiprofissionais em Oncologia para cirurgiões-dentistas no Brasil, bem como do reconhecimento da Oncologia como uma especialidade odontológica.

Introduction: Multiprofessional Residency programs represent a fundamental strategy to increase the capacity of cancer management. Objective: To analyze the current portrait of Multiprofessional Residency programs in oncology for dental surgeons in Brazil, as well as the number of professionals graduating from these courses, based on data reported by the Ministry of Education (MEC). Method: Quantitative, exploratory study. The first phase consisted in requesting to the Brazilian MEC Technical Team of Multiprofessional Residency to list all the Multiprofessional Residency Programs in Oncology that included the professional category of dentistry. Additionally, a manual search was performed. In the second phase, a contact was made by e-mail and a search in the available Internet public notices of the unanswered cases was conducted. The data searched and analyzed descriptively consisted in the existence of an active program, inclusion of the professional dentistry category, number of vacancies offered and graduates for each year between 2010 and 2020. Results: Thirteen Multiprofessional Residency programs in oncology for dental surgeons were identified, distributed in 12 centers, located in ten cities in eigtht Brazilian states, mainly in the Southeast region. Six programs were implemented in 2010, six in 2016 and one in 2020. In the Brazilian scenario, between 2010 and 2020, a total of 216 vacancies were offered and just over 114 professionals specialized in this area completed the academic formation. Conclusion: It is emphasized the necessity to increase the quantity of centers, programs and vacancies for Multiprofessional Residencies in Oncology for dental surgeons in Brazil, as well as the recognition of oncology as a dental specialty

Introducción: Los Programas de Residencia Multiprofesional constituyen una estrategia fundamental para expandir la capacidad de enfrentar el cáncer. Objetivo:Analizar el panorama actual de los Programas de Residencia Multiprofesional en oncología para cirujanos-dentistas en Brasil, así como el número de profesionales que concluyeron estos cursos, con base en datos reportados por el Ministerio de Educación (MEC). Método: Este es un estudio cuantitativo exploratorio. La primera fase consistió en pedirle al Equipo Técnico de Residencia Multiprofesional del MEC del Brasil que enumerara todos los Programas de Residencia Multiprofesional en Oncología que incluían la categoría profesional de odontología. Además, se realizó una búsqueda manual. En la segunda fase, se contactó por correo electrónico y se buscaron los avisos disponibles en Internet de los casos en que no hubo respuesta. Los datos investigados fueron la presencia de Programa activo, inclusión de la categoría profesional odontología, número de vacantes ofrecidas y número de graduados para cada año entre 2010 y 2020, que fueron analizados descriptivamente. Resultados: Se identificaron 13 Programas de residencia multiprofesional en oncología para cirujanos dentistas, distribuidos en 12 centros, ubicados en diez ciudades de ocho estados brasileños, principalmente en la región Sudeste. Se implementaron seis Programas en 2010, seis en 2016 y uno en 2020. En el escenario brasileño, entre 2010 y 2020, se ofrecieron 216 vacantes y se capacitaron poco más de 114 profesionales especializados en esta área. Conclusión: Se enfatiza la necesidad de aumentar el número de centros, Programas y vacantes para residencias multiprofesionales en oncología para dentistas en Brasil, así como del reconocimiento de la oncología como especialidad odontológica

Abordagem Cirúrgica de Osteorradionecrose Mandibular Causada por Fratura Idiopática / Surgical Approach of Mandible Osteoradionecrosis Caused by Idiopathic Fracture / Abordaje Quirúrgico de Osteorradionecrosis Mandibular Causada por Fractura Idiopática

Introdução: A osteorradionecrose acomete de 1% a 6% dos pacientes submetidos à radioterapia e é considerada a complicação oral mais grave advinda dessa modalidade terapêutica. Relato do caso: Trata-se de um homem, 65 anos, com diagnóstico de carcinoma de células escamosas em assoalho bucal esquerdo, tratado com cirurgia e radioterapia adjuvante. Na avaliação odontológica inicial, não foram observadas alterações clínicas ou radiográficas. Duas semanas após o término da radioterapia, o paciente relatou ter acordado com dor intensa em mandíbula, sem relato de trauma ou queda. A radiografia panorâmica evidenciou fratura no corpo mandibular esquerdo, sugerindo fratura idiopática durante o sono. Após dez dias, houve exposição óssea intraoral do coto distal e preconizou-se tratamento conservador com analgesia, osteotomia superficial sob anestesia local e antibioticoterapia profilática. O paciente evoluiu com secreção purulenta, fístula extraoral e eliminação de sequestro ósseo, após cinco meses, confirmando o diagnóstico de osteorradionecrose. Diante desse quadro, após 11 meses do diagnóstico da fratura, optou-se pela intervenção cirúrgica de mandibulectomia redutora de coto distal. Depois de sete meses de acompanhamento pós-cirúrgico, o paciente encontra-se sem evidências clínicas e radiográficas de osteorradionecrose. Conclusão: O tratamento da osteorradionecrose é considerado desafiador para os dentistas que lidam com essa sequela da radioterapia. Portanto, destaca-se a importância da capacitação do dentista para atuar em todas as etapas do tratamento oncológico

Introduction: Osteoradionecrosis of the jaws affects 1% to 6% of patients undergoing radiotherapy and is considered the most severe oral complication resulting from this therapeutic modality. Case report: This is a 65-year-old man diagnosed with squamous cell carcinoma in the left oral floor, treated with surgery and adjuvant radiotherapy. In the dental evaluation, no clinical or radiographic changes were observed. Two weeks after the radiotherapy, the patient reported severe pain in the mandible, with no report of trauma or fall. The panoramic radiograph showed a fracture in the left mandibular body, suggesting an idiopathic fracture while asleep. After ten days, there was intraoral bone exposure of the distal portion of the mandible and conservative treatment with analgesia, superficial osteotomy under local anesthesia and prophylactic antibiotic therapy was performed. The patient evolved with purulent secretion, extraoral fistula and elimination of bone sequestration, after five months, confirming the diagnosis of osteoradionecrosis. Thereby, 11 months after the fracture diagnosis, the patient underwent a surgical intervention with partial mandibulectomy of the distal portion. After seven months of post-surgical follow-up, the patient presents neither clinical or radiographic evidence of osteoradionecrosis. Conclusion: The treatment of osteoradionecrosis is considered challenging for dentists who deal with this side effect of radiotherapy. Therefore, the importance of training the dentist to work in all stages of cancer treatment is highlighted.

Introducción: La osteorradionecrosis afecta del 1% al 6% de los pacientes sometidos a radioterapia y se considera la complicación oral más grave resultante de esta modalidad terapéutica. Relato del caso: Hombre, 65 años, diagnosticado con carcinoma de células escamosas en el suelo de boca izquierdo, tratado con cirugía y radioterapia adyuvante. La evaluación odontológica no presentó alteraciones clínicas o radiográficas. Dos semanas después de concluir la radioterapia, él informó haber despertado con un fuerte dolor en la mandíbula, sin historia de trauma o caída. La radiografía panorámica mostró una fractura en el cuerpo mandibular izquierdo, lo que sugirió una fractura idiopática durante el sueño. Diez días después, hubo exposición ósea intraoral del muñón distal y fue empleado tratamiento conservador con analgesia, osteotomía superficial bajo anestesia local y antibiótico profiláctico. El paciente evolucionó con secreción purulenta, fístula extraoral y eliminación de secuestro óseo, pasados cinco meses, confirmando el diagnóstico de osteorradionecrosis. Así, pasados 11 meses del diagnóstico de fractura, fue indicada intervención quirúrgica de mandibulectomía reductora del muñón distal. Después de siete meses de la cirugía, no hay evidencias clínicas o radiográficas de osteorradionecrosis. Conclusión: El tratamiento de la osteorradionecrosis se considera un desafío para los dentistas que se ocupan de esta secuela de la radioterapia. Por lo tanto, se destaca la importancia de capacitar al dentista, para que trabaje en todas las etapas del tratamiento oncológico

Sobrevida de adultos jovens com carcinoma de células escamosas oral em uma população do Brasil / Survival of young adults with oral squamous cell carcinoma in a brazilian population / Supervivencia de adultos jóvenes con carcinoma de células escamosas orales en una población de Brasil

RESUMO Objetivo Analisar o perfil e a sobrevida de adultos jovens com carcinoma de células escamosas oral, atendidos entre 2010 a 2016 na Unidade de Alta Complexidade em Oncologia de Feira de Santana, Brasil. Métodos Coorte retrospectiva, realizada através das informações dos prontuários de todos os pacientes jovens atendidos no referido centro. Foi realizada análise descritiva das variáveis, teste exato de Fisher, curva de Kaplan-Meier e teste log rank. Resultados Um total de 35 pacientes foram registrados. A maioria era do sexo masculino, fumantes e etilistas. Os tumores estavam localizados predominantemente em língua, diagnosticados tardiamente e classificados como bem diferenciado, tendo como tratamento de escolha cirurgia associada a radioterapia e quimioterapia. O tempo mediano de sobrevida foi de 31 meses e 22,8% dos pacientes foram a óbito. As variáveis que apresentaram significância estatística em relação ao tempo de sobrevida foram a localização do tumor e o tipo de tratamento. Conclusão O perfil e o baixo tempo de sobrevida refletem a necessidade de uma maior atenção à doença nesta população.(AU)

ABSTRACT Objective To analyze the profile and survival in young adults with oral squamous cell carcinoma, attended at the High Complexity in Oncology of Feira de Santana, Brazil, between 2010 and 2016. Methods Retrospective cohort, performed through the information of the medical records of all young patients attended in the referred center. Descriptive analysis of the variables, Fisher's exact test, Kaplan-Meier curve and log-rank test were performed. Results A total of 35 patients were registered. The majority were male, smokers and former alcoholics. Tumors were predominantly localized in the tongue, diagnosed at late stages, classified as well differentiated and treated mainly with surgery associated to radiotherapy and chemotherapy. The median survival time was 31 months and 22.8% of the patients died. The variables that presented statistical significance in relation to the survival time were the tumor site and the type of treatment. Conclusion The profile and low survival time reflect the need for greater attention to the disease in this population.(AU)

RESUMEN Objetivo Analizar el perfil y la supervivencia de adultos jóvenes con carcinoma de células escamosas atendidos en el Centro de Alta Complejidad en Oncología de Feira de Santana (Brasil), durante el periodo 2010-2016. Métodos cohorte retrospectivo realizado mediante la información de registros médicos de todos los pacientes jóvenes atendidos en el centro médico mencionado. Asimismo, se hizo un análisis descriptivo de las variables, test exacto de Fisher, curva de Kaplan-Meier y una prueba de rango logarítmico. Resultados Se registró un total de 35 pacientes: la mayoría, hombres fumadores y exalcohólicos. Gran parte de los tumores fueron hallados en la lengua y diagnosticados en la última fase; asimismo, se clasificaron, se diferenciaron y se trataron con cirugía apoyada en radioterapia y quimioterapia. El tiempo promedio de supervivencia fue de 31 meses. El 22,8% de los pacientes fallecieron. Las variables que demostraron una gran significancia estadística en relación con el tiempo de supervivencia fueron la ubicación del tumor y el tipo de tratamiento. Conclusión El perfil y el escaso tiempo de supervivencia demuestran que es necesaria una mejor atención de la enfermedad que padece esta población.(AU)

Perfil clínico-demográfico de los carcinomas de células escamosas bucales en una población del nordeste de Brasil / Clinical and demographic profile of oral squamous cell carcinoma in a northeast population of Brazil

Objetivo: Describir el perfil clínico-demográfico e identificar los factores de riesgo presentes en individuos portadores de carcinoma oral de células escamosas, que asistieron a un centro de referencia del nordeste de Brasil, de 2007 a 2015. Materiales y métodos: En este estudio descriptivo y retrospectivo, los datos fueron recopilados de las historias clínicas de individuos con diagnóstico histológico de carcinoma oral de células escamosas. Resultados: De los 104 casos analizados, el 72,12% eran hombres; el 53,84%, mayores de 60 años, y el 38,9%, de tez morena. La mayoría de los individuos eran alcohólicos y/o fumadores (95%). En cuanto a las lesiones, en su mayoría eran: ulceradas (58,70%), rojas (47,42%), de superficie arrugada (92,39%), duras (78,02%), con crecimiento endofítico (56,12%) y estaban localizadas en el borde lateral de la lengua (27,62%). Conclusiones: En este estudio, el carcinoma oral de células escamosas fue diagnosticado principalmente en hombres de tez morena, mayores de 60 años. Las lesiones más frecuentes fueron úlceras en la lengua. El consumo de tabaco y alcohol fueron las características de comportamiento de mayor ocurrencia (AU)

Aim: Describe the clinical-demographic profile and identify risk factors present in individuals with oral squamous cell carcinoma, attending a reference center in Northeastern Brazil from 2007 to 2015. Materials and methods: The present descriptive and retrospective study evaluated data collected from the dental records of individuals with histological diagnosis of oral squamous cell carcinoma. Results: Of the 104 cases analyzed, 72.12% were men, 53.84% were over 60 years old and 38.9% were of brown complexion. Most of the individuals were alcoholics and/or smokers (95%). The clinical characteristics were: ulcerated (58.70%), red (47.42%), rough (92.39%), hard consistency (78.02%), endophytic growth (56.12%) and located in the lateral of the tongue (27.62%). Conclusions: In this study, the oral squamous cell carcinoma was diagnosed mainly in men, brown and over 60 years. In the majority of cases, the lesions presented as ulcers in the tongue. Tobacco and alcohol consumption were the most frequent behavioral characteristics (AU)

[Survival of young adults with oral squamous cell carcinoma in a brazilian population]. / Sobrevida de adultos jovens com carcinoma de células escamosas oral em uma população do Brasil.

OBJECTIVE: To analyze the profile and survival in young adults with oral squamous cell carcinoma, attended at the High Complexity in Oncology of Feira de Santana, Brazil, between 2010 and 2016. METHODS: Retrospective cohort, performed through the information of the medical records of all young patients attended in the referred center. Descriptive analysis of the variables, Fisher's exact test, Kaplan-Meier curve and log-rank test were performed. RESULTS: A total of 35 patients were registered. The majority were male, smokers and former alcoholics. Tumors were predominantly localized in the tongue, diagnosed at late stages, classified as well differentiated and treated mainly with surgery associated to radiotherapy and chemotherapy. The median survival time was 31 months and 22.8% of the patients died. The variables that presented statistical significance in relation to the survival time were the tumor site and the type of treatment. CONCLUSION: The profile and low survival time reflect the need for greater attention to the disease in this population.

Fibrolipoma en cavidad oral / Fibrolipoma in the mouth

Resumen: El fibrolipoma es la más prevalente de las variaciones histológicas del lipoma. Clínicamente, se asemeja mucho al lipoma y por eso muchas veces es subdiagnosticado. Es una lesión de comportamiento benigno, que raras veces se desarrolla en la cavidad oral y que suele ser asintomática. Estos factores asociados contribuyen para que la mayoría de los pacientes sólo busquen tratamiento cuando las lesiones presentan grandes dimensiones, están ulceradas y/o causan dificultades en la masticación y deglución. El objetivo de este estudio es relatar tres casos de fibrolipoma en cavidad oral. Los tres casos relatados son de mujeres, con edades entre 38 y 49 años, que presentaban una lesión nodular, indolora, en región de mucosa yugal y con dimensiones variables entre 1 y 2 cm. En todos los casos las sospechas diagnósticas iniciales fueron de fibroma o lipoma, pero el análisis histopatológico concluyó que se trataban de fibrolipomas. Los fibrolipomas son lesiones raras en la cavidad oral y presentan características clínicas semejantes a diversas lesiones, de modo que suelen ser diagnosticados como una de estas entidades. De este modo, se resalta la importancia de la ejecución del estudio histopatológico, para que se pueda realizar un correcto diagnóstico de esta patología.

Abstract: Fibrolipoma is the most frequent histological variation of all lipoma lesions. From a clinical point of view, it is very similar to lipoma, for this reason it is frequently misdiagnosed. It is an asymptomatic lesion of benign behavior, rarely found in the oral cavity. These associated factors contribute to drive the patient to only seek treatment when lesions have reached great dimensions, are ulcerated and/or cause deglutition and mastication difficulties. The aim of the present study was to relate three cases of fibrolipoma in the mouth. All three reviewed cases were of 38-49 year old females, who exhibited a nodular, painless lesion in the region of the oral mucosa, with sizes varying 1-2 cm. In all cases, initial suspected diagnosis was fibroma or lipoma, nevertheless, histopathological analysis revealed they were fibrolipoma. Fibrolipoma are rare lesions in the mouth, exhibiting clinical characteristics which are similar to many lesions, thus it is oftentimes diagnosed as one of these entities. Thus, importance of conducting histopathological studies is stressed so that this condition can be accurately diagnosed.