Atypical Location of Oral Metastasis as the First Manifestation of Renal Carcinoma. Case Report / Localización Atípica de Metastasis Oral como Primera Manifestación de Carcinoma Renal. Reporte de Caso

Oral cavity metastatic tumors derived from primary tumors from other corporal regions are rare, representing barely 1 % of all malignant tumors. Differential diagnosis of these lesions is challenging due to the wide spectrum of lesions with similar clinical presentation and especially when the presence of a primary tumor goes undetected. We present the case of a 55-year-old male with a painless tumor in the anterior maxillary region, vestibular gingiva and palate, with a 2-month evolution. Anatomopathological diagnosis was malignant clear cell tumor, highly suggestive of clear cell renal carcinoma metastasis, and the oral lesion constituted the first sign of illness.

Los tumores metastásicos de cavidad oral derivados de tumores primarios de otras regiones corporales son raros, representando apenas el 1 % de todos los tumores malignos. El diagnóstico diferencial de estas lesiones es desafiante debido al amplio espectro de lesiones con presentación clínica similar y especialmente cuando la presencia de un tumor primario pasa desapercibida. Presentamos el caso de un varón de 55 años con una tumoración indolora en región maxilar anterior, encía vestibular y paladar, de 2 meses de evolución. El diagnóstico anatomopatológico fue de tumor maligno de células claras, altamente sugestivo de metástasis de carcinoma renal de células claras, y la lesión bucal constituyó el primer signo de enfermedad.

Validation of the WHOQOL-BREF Quality of Life Questionnaire in an Urban Sample of Older Adults in a Neighbourhood in Zaragoza (Spain).

BACKGROUND: Nowadays, the increase in life expectancy needs to be matched by an increase in the wellbeing of older adults. A starting point is the definition of what is understood by health-related quality of life and its measurement in different contexts. Our research translates these international priorities to a local base. OBJECTIVE: To evaluate the psychometric characteristics of the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF) in a sample of older adults from a Spanish urban community (Casablanca). METHODS: In collaboration with the local health centre, we designed and implemented the health neighbourhood survey. Interviews took place at subjects' homes with 212 women and 135 men over the age of 60, who were residents in Casablanca. With the results, we evaluated the psychometric characteristics of WHOQOL-BREF and tested its reliability and validation. RESULTS: The instrument has a high internal consistency with a Cronbach's Alpha of 0.9. The items with higher correlation value were: ability to carry out activities in daily life, enough energy for daily life. The scale contributions of Physical Health dimension (0.809) and Psychological Health dimension (0.722) were notable. CONCLUSIONS: As with other studies, the instrument proved to be an integral evaluation of the diverse domains that condition the wellbeing of older adults.

"Célula de Patología Oral - Hospital Digital": una estrategia de teleodontología para reducir desigualdades en el acceso a la atención odontológica en la especialidad de patología oral y maxilofacial en Chile

En junio 2020, en un escenario de confinamiento por cuarentenas y con restricción de la atención odontológica por la pandemia del COVID-19, comienza la implementación en Chile de una herramienta basada en la generación de interconsultas electrónicas asincrónicas a un especialista en patología oral y maxilofacial geográficamente distante, bajo la dirección de Hospital Digital de Ministerio de Salud. Esta nueva herramienta de teleodontología, denominada "Célula de Patología Oral", tiene como objetivo fortalecer la Red Asistencial de salud con un modelo de atención a distancia enfocado en la persona, permitiendo mejorar el acceso y oportunidad en la atención de salud en la especialidad de Patología Oral y Maxilofacial a través Tecnología de Información y Comunicaciones. La Célula de Patología Oral ha demostrado contribuir a la accesibilidad y reducir las desigualdades en la atención de la salud bucal, en una de las especialidades odontológicas implicadas en el diagnóstico de lesiones graves como son el cáncer oral y otras lesiones orales de alta prioridad durante la pandemia por la enfermedad debido a SARS-CoV2.

In June 2020, in a confinement scenario and with restriction of dental care due to the COVID-19 pandemic in Chile, a tool based on the generation of asynchronous electronic consultations by a geographically distant specialist in oral and maxillofacial pathology was implemented under the direction of the Digital Hospital of the Ministry of Health. This new dentistry tool, called " Célula de Patología Oral", aims to strengthen the Health Assistance Network with a remote care model focused on the patient, allowing the improvement of health care access and opportunity in the specialty of Oral and Maxillofacial Pathology, through Information and Communication Technology. The "Célula de Patología Oral" has proven to contribute to accessibility and to reduce inequalities in oral health care, in a dental specialty involved in the diagnosis of serious disease such as oral cancer and other high-priority oral diseases during the SARS-CoV2 pandemic.

Cistoadenoma de glándula salival menor en paladar: Reporte de dos casos y revisión de la literatura

El cistoadenoma es un tumor epitelial benigno de baja frecuencia en glándulas salivales, que habitualmente se presenta como una masa de crecimiento lento. En glándulas salivales menores se localiza habitualmente en labio, paladar y mucosa yugal, cuyo diagnóstico diferencial representa un desafío desde el punto de vista clínico. El propósito de este reporte es presentar 2 casos de cistoadenoma en paladar, con énfasis en sus características clínicas y diagnóstico diferencial.

Cystadenoma is an uncommon benign epithelial tumor of the salivary glands, which usually appears as a slow-growing mass. In minor salivary glands, it is usually located in the lip, palate and buccal mucosa, whose differential diagnosis is a clinical challenge. The purpose of this report is to present 2 cases of palate cystadenoma, with emphasis on their clinical characteristics and differential diagnosis.

Hypovitaminosis D, oral potentially malignant disorders, and oral squamous cell carcinoma: a systematic review

Background: Oral squamous cell carcinoma (OSCC) and potentially malignant oral disorders (OPMDs) could be associated with low levels of vitamin D. This systematic review aimed to determine the relationship between serum levels of vitamin D with OPMDs and OSCC. Material and Methods: This review was conducted according to Cochrane guidelines (PROSPERO CRD42020207382) on literature retrieved from the PubMed, Cochrane, and Web of Science databases. The antecedents extracted were study design, methodology, sample (country, number of patients, age, and sex), oral manifestations (type of lesion, location, prevalence, and follow-up), serum vitamin D levels or use of vitamin D supplements, results, and conclusions. Results: Twelve articles were selected. Some of the most relevant findings were alterations in vitamin D could favor the progress of OPMDs to OSCC. Higher levels of vitamin D can increase levels of anti-inflammatory mediators, CD4+ T lymphocytes and CD8+ T lymphocytes and CD3+ T lymphocytes in intratumoral tissue. The normalization of vitamin D levels in patients with OSCC can increased cytotoxic activity of natural killer cells, favoring antitumor immune response. Vitamin D supplemented can lower adverse effects associated with chemotherapy like mucositis and pain. Tobacco can increase risk of developing OSCC altering vitamin D levels. Conclusions: Hypovitaminosis D could increase risk of developing OSCC from OPMDs, thus altering the immune response and it is associated with a lower survival rate in patients with OSCC, a greater recurrence of tumors in patients who underwent surgical treatment, and an increase in adverse reactions to chemotherapy. The use of vitamin D supplements can be a complement to primary therapy to prevent the recurrence of lesions and reduce adverse events associated with treatment.(AU)

Frecuencia de Patologías y Condiciones de Lengua Observadas en Población Pediátrica

RESUMEN: Las patologías y condiciones linguales constituyen una proporción considerable del total de lesiones de la mucosa oral. Los estudios epidemiológicos que describen su frecuencia en la población pediátrica son escasos y variables. El objetivo de este estudio fue establecer la frecuencia de patologías y condiciones de lengua en niños atendidos en la Facultad de Odontología de la Universidad de Chile. Se realizó un estudio observacional, descriptivo y de corte transversal donde se examinaron pacientes pediátricos de 4 a 13 años de ambos sexos. De un total de 179 pacientes, un 53 % presentó al menos una patología o condición lingual. El rango etario de 11 a 13 años presentó un mayor OR de presentar lesiones y/o condiciones linguales al ser comparado con los otros rangos etarios (valor p<0,05). La patología o condición lingual más frecuente fue la lengua saburral (39 %), seguida por la lengua fisurada (15 %), la hipertrofia de papilas linguales (5 %) y la lengua geográfica (3 %). La ubicación más frecuente fue la base lingual con un 59 % del total de ubicaciones registradas. En base a la escasa evidencia que existe y a la alta frecuencia encontrada en esta investigación, se debe destacar la importancia del conocimiento de las patologías y condiciones linguales en niños. A través de este estudio, se sientan bases para futuras investigaciones que ayuden a odontólogos a reconocer, diagnosticar y tratar estas condiciones cuando sea necesario.

ABSTRACT: Lingual pathologies and conditions constitute a considerable proportion of the total lesions of the oral mucosa.The epidemiological studies that describe its frequency in the pediatric population are limited and variable. The objective of this study was to establish the frequency of pathologies and lingual conditions in children attended at the Faculty of Dentistry of the University of Chile. An observational, descriptive and cross-sectional study was carried out where pediatric patients between 4 and 13 years of both sexes were examined. Of a total of 179 patients, 53 % had at least one pathology or lingual condition. The age range of 11 to 13 years presented a higher OR of presenting lesions and/or lingual conditions when compared with the other age ranges (p value <0.05). The most frequent pathology or lingual condition was coated tongue (39 %), fast due to the fissured tongue (15 %), the hypertrophy of the lingual papillae (5 %) and the geographic tongue (3 %). The most frequent location was the lingual base with 59 % of the total frequency registered. Based on the little evidence that exists and the high frequency found in this research, the importance of knowledge of pathologies and lingual conditions in children should be highlighted. Through this study, foundations are laid for future investigations that help dentists recognize, diagnose, and treat these conditions when necessary.

Sobrevida de carcinoma oral de células escamosas: reporte de la Universidad de Chile / Survival of oral squamous cell carcinoma: report of the University of Chile

RESUMEN: El carcinoma oral de células escamosas es la neoplasia maligna más frecuente en la cavidad oral. Sin embargo, los estudios sobre supervivencia general en pacientes con cáncer oral son escasos en Chile. Objetivo: Determinar las características sociodemográficas y la supervivencia general de pacientes diagnosticados con carcinoma en labio y cavidad oral en el Servicio de Anatomía Patológica de la Facultad de Odontología, Universidad de Chile. Material y métodos: Se seleccionaron los casos de carcinoma oral de células escamosas diagnosticados entre los años 2000-2012. Se incluyeron sólo los primeros diagnósticos y las recidivas fueron excluidas. Resultados: De 134 casos registrados, 120 cumplían los criterios de inclusión. El 60% correspondió a hombres (razón hombre-mujer 1,3:1) y la media de edad fue 63 años. La supervivencia general a dos años fue 48,3% y a cinco años 33,9% según estimación de Kaplan-Meier. Se detectó una mayor supervivencia en el grupo de pacientes que tenían menos de 55 años (p<0,05). 79,2% de los casos fallecidos registra como causa de muerte cáncer oral. Conclusiones: El mayor porcentaje de personas diagnosticadas fueron hombres y adultos mayores. La supervivencia general a cinco años fue menor a lo determinado en reportes nacionales previos. Los adultos de 55 años y mayores presentaron una menor supervivencia general.

ABSTRACT: Oral squamous cell carcinoma is the most common malignant neoplasm of oral cavity. Research about general survival rates in patients with oral cancer is limited in Chile. Objective: To determine the sociodemographic characteristics and general survival of patients diagnosed with lip and oral carcinoma in the Pathological Anatomy Service at the School of Dentistry, University of Chile. Material and methods: All cases of oral squamous cell carcinoma selected were diagnosed between the years 2000 and 2012. All cases included in this study corresponded to the first diagnosis and tumor recurrence was excluded. Results: The 134 registered cases, 120 were selected with inclusion criteria. 60% were men (male and female ratio of 1.3: 1) and median age 63 year-old. Overall survival at two years was 48.3% and at five years 33.9%, according to Kaplan-Meier estimate. A higher survival was detected in the group of patients younger than 55 years old (p <0.05). In 79.2% of dead patients, the cause of death was registered as oral cancer. Conclusions: The highest percentage of patients diagnosed was men and elders. Five-year survival was lower than previously reported in national reports. Adults aged 55 years and older had a lower overall survival.

Efecto de miconazol sobre el recuento de levaduras en candidiasis asociada a estomatitis protésica / Effect of miconazole on the yeast count in candidiasis associated with denture stomatitis

RESUMEN: Introducción: Estomatitis Subprotésica, proceso inflamatorio crónico de la mucosa adyacente a prótesis removible. 71,4% de los sujetos con esta condición es portador de Candida y la severidad se relaciona con la presencia de esta levadura. Para su tratamiento se indica antimicóticos tópicos de la familia de polienos o de azoles. El propósito del estudio fue determinar el recuento de levaduras del género Candida en adultos mayores con candidiasis oral, antes y después de ser tratados con miconazol. Materiales y métodos: Se consignaron antecedentes sistémicos y locales en 32 adultos mayores con estomatitis subprotésica. Se determinó recuento de levaduras del género Candida en saliva, antes y después del tratamiento tópico con Miconazol 2%. Se aceptaron diferencias estadísticamente significativas con un error alfa igual o menor a 0.05%. Resultados: Los recuentos de levaduras del inicio del estudio disminuyeron significativamente a los días 8 y 15 después del tratamiento (mediana 6.800, 163, 60, respectivamente). 56,2% de los individuos presentó persistencia de levaduras después del tratamiento; 21,8% de ellos con recuentos superiores a 400 UFC/ml de saliva. Conclusiones: En el 56,2% de los individuos del estudio se observó persistencia de levaduras del género Candida luego de 2 semanas de tratamiento con miconazol al 2%.

ABSTRACT: Introduction: Denture stomatitis is a chronic inflammatory process of the mucosa adjacent to removable prosthesis. 71.4% of the subjects with this condition are carriers of Candida and the severity is related to the presence of this yeast. Topical antimycotics belonging to the polyene or azole family are indicated for its treatment. Efficacy of miconazole is reported to be from 80% to 100%, although resistance is described in isolates of Candida. The purpose of the study was to determine the count of Candida in older adults with oral candidiasis, before and after being treated with miconazole. Methodology: Systemic and local antecedents were recorded in 32 elderly adults with denture stomatitis. Differences in number of the colony forming units of Candida yeast, were determined before and after topical treatment with Miconazole 2%. Statistical significances were set at a value of p < 0.05. Results: Yeast counts at the start of the study significantly decreased 8 and 15 days after treatment (median 6,800, 163, 60, respectively). 56.2% of the subjects presented persistence of yeasts after treatment; 21.8% of them with counts higher than 400 CFU / ml saliva. Conclusion: In 56.2% of the study subjects, persistence of Candida yeasts was observed after 2 weeks of treatment with 2% miconazole.

Pseudogota tofacea de articulación temporomandibular: reporte de un caso / Tophaceous pseudogout of the temporomandibular joint: report of a case

La pseudogota tofacea es una enfermedad articular que generalmente aparece en rodillas, caracterizada por el depósito de cristales de pirofosfato de calcio en el cartílago articular o fibrocartílago. Se presenta el caso de una mujer de 62 años con aumento de volumen a nivel de articulación temporomandibular derecha, de 2 años de evolución. En la tomografía axial computarizada se observó una gran masa de radioopacidad mixta que rodea la cabeza del cóndilo. Se realizó la exéresis total de la lesión. Con el estudio histopatológico y antecedentes clínicos se obtiene el diagnóstico de pseudogota tofacea. La paciente se encuentra 2 años después de la cirugía en buenas condiciones y sin signos de recidiva. La baja incidencia de esta enfermedad y su rara localización en la articulación temporomandibular pueden hacer difícil el diagnóstico, por lo que estudios específicos se requieren para dar un diagnóstico acertado (AU)

Tophaceous pseudogout is a joint disease in which there is deposition of crystals of calcium pyrophosphate in articular cartilage or fibrocartilage, and usually occurs in the knees. The case is presented of a 62-year-old woman with increase in volume in the right temporomandibular joint of 2 years onset. A large mass of mixed radio-opacity surrounding the head of the condyle was observed on the computerized axial tomography. Total excision of the lesion was performed. The diagnosis of tophaceous pseudogout was obtained, by means of the histopathological examination and medical history. Two years after surgery, the patient is in good condition without signs of recurrence. The low incidence of this disease and its rare location in the temporomandibular joint can it difficult to diagnosis, thus specific studies are required to make an accurate diagnosis (AU)

Illness Experiences in Women with Oral Dryness as a Result of Sjögren's Syndrome: The Patient Point of View.

BACKGROUND: Sjögren's syndrome and the associated dryness can have multiple consequences. The aim of the present qualitative study was to give an in-depth account of the life experiences of women with primary Sjögren's syndrome (pSS) and health-related behaviours, and to summarize these experiences in an integrated model. METHODS: Twelve women diagnosed with pSS who regularly attended the Hospital of the University of Chile participated in detailed interviews. The data were analysed using qualitative methods based on the principles of grounded theory. RESULTS: Selective coding identified three categories: illness experience, social interaction and psychological response. An integrated model was developed connecting these dynamic aspects and suggesting how they could lead to a life cycle crisis in cases of maladjustment. We found that problem-solving strategies, reconstruction of identity, acceptance and a social support may prevent this life cycle crisis. DISCUSSION: Xerostomia and other consequences of pSS can have a profound influence on daily life. However, the severity of the consequences depends on individual experiences with the illness, social influences and the psychological responses of the patient. Physicians, dentists and other healthcare professionals can help the patient by listening to their problems and exploring solutions based on a psychological approach.

Oral health practices and beliefs among caregivers of the dependent elderly.

BACKGROUND: Caregivers deal with oral health care of the dependent elderly; however, this has a low priority among them, and their education in daily oral care is deficient. Therefore, studying the oral care practices as well as their oral health beliefs is important as these affect the quality of the oral care they perform. OBJECTIVE: To compare formal and informal caregivers' oral care practices and oral health beliefs when taking care of severely dependent elderly. MATERIAL AND METHODS: A cross-sectional study was conducted on a convenience sample of 21 formal caregivers from a long-term residence and 18 informal caregivers from a local primary health care domiciliary programme. Caregivers were surveyed using a questionnaire designed to elicit oral care practices and oral health beliefs. The nursing Dental Coping Beliefs Scale questionnaire was translated and validated in Chile. RESULTS: Significant differences were observed between formal and informal caregivers' performance of some oral health care practices. There were no significant differences between formal and informal caregivers' oral health beliefs. CONCLUSIONS: Although there are some differences in formal and informal caregivers' oral health care practices, we cannot state that one caregiver's performance is better than the other, in fact, negative oral health beliefs were found in both groups.

[Spanish translation and validation of the nursing dental coping beliefs scale]. / Traducción al español y validación del cuestionario de creencias en salud bucal para cuidadores (DCBS-SP).

BACKGROUND: Caregivers of disable and dependent people, institutionalized elderly and hospitalized, must provided oral health care for the patients under their care, for that reason, it is necessary to have a valid instrument in Spanish to measure oral health beliefs among caregivers. The aim of the study was to translate to Spanish the Nursing Dental Coping Beliefs Scale (Nursing DCBS) and validate this questionnaire to be used on Hispanic caregivers. METHODS: The nursing DCBS was translated to Spanish and revised for linguistic adaptation. A group of experts revised their content and face validity. A pilot study of the questionnaire in Spanish, was held in a group of 118 nurse assistant students from two professional institutes. The reliability of the instrument, was evaluated by its internal consistency with Cronbach's Alpha and the measurement stability, through intraclass correlation coefficient (ICC). RESULTS: The questionnaire was validated by its appearance and content. The internal consistency for the questionnaire through Cronbach's Alpha was 0.64 and the stability of the instrument 0.5 for ICC. CONCLUSIONS: The Spanish version of the nursing Dental Coping Beliefs Scale is a questionnaire that has an internal consistency to be used as an instrument to measure oral health beliefs among caregivers, however, future investigations must re-evaluate there psychometric characteristics, specially its stability as an instrument.

Traducción al español y validación del cuestionario de creencias en salud bucal para cuidadores (DCBS-SP) / Spanish translation and validation of the nursing dental coping beliefs scale

Fundamentos: Los cuidadores de personas discapacitadas, dependientes, de adultos mayores institucionalizados y hospitalizados deben proveer el cuidado bucal de los pacientes a su cargo, por lo que es necesario contar con un instrumento en español que permita medir las creencias en salud bucal de los cuidadores. El objetivo de esta investigación fue traducir al español el Cuestionario Nursing Dental Coping Belifes Scale (Nursing DCBS) y validarlo para su uso en cuidadores de habla hispana. Métodos: El Cuestionario Nursing DCBS fue traducido al español y realizada su adaptabilidad lingüística. Un grupo de expertos realizó su validación por apariencia y contenido. Se llevó a cabo una prueba piloto del cuestionario en español en un grupo de 118 estudiantes de la carrera de técnico en asistente de enfermería de dos institutos profesionales. Se analizó la confiabilidad del instrumento mediante la consistencia interna con el Alfa Cronbach y su estabilidad mediante el Coeficiente de Correlación Intraclase (CCI). Resultados: La evaluación de su consistencia interna mostró valores Alfa para el cuestionario completo de 0,64 y la evaluación de su estabilidad de medición mostró un valor de CCI de 0,5. Conclusiones: El DCBS-Sp para cuidadores es un cuestionario que presenta una consistencia interna que permite recomendarlo como instrumento de medición de creencias en salud bucal de personas que desempeñen el rol de cuidadores. Sin embargo, futuras investigaciones deben reevaluar sus características psicométricas, en especial su estabilidad como instrumento(AU)

Background: Caregivers of disable and dependent people, institutionalized elderly and hospitalized, must provided oral health care for the patients under their care, for that reason, it is necessary to have a valid instrument in Spanish to measure oral health beliefs among caregivers. The aim of the study was to translate to Spanish the Nursing Dental Coping Beliefs Scale (Nursing DCBS) and validate this questionnaire to be used on Hispanic caregivers. Methods: The nursing DCBS was translated to Spanish and revised for linguistic adaptation. A group of experts revised their content and face validity. A pilot study of the questionnaire in Spanish, was held in a group of 118 nurse assistant students from two professional institutes. The reliability of the instrument, was evaluated by its internal consistency with Cronbach´s Alpha and the measurement stability, through intraclass correlation coefficient (ICC). Results: The questionnaire was validated by its appearance and content. The internal consistency for the questionnaire through Cronbach`s Alpha was 0.64 and the stability of the instrument 0.5 for ICC. Conclusions: The Spanish version of the nursing Dental Coping Beliefs Scale is a questionnaire that has an internal consistency to be used as an instrument to measure oral health beliefs among caregivers, however, future investigations must re-evaluate there psychometric characteristics, specially its stability as an instrument(AU)

Evaluación del grado de queratinización y el recuento de AgNORs en citología exfoliativa de mucosa oral normal de individuos fumadores y no fumadores / Evaluation of keratinization and AgNORs count in exfoliative cytology of normal oral mucosa from smokers and non-smokers

Objetivos. En individuos fumadores con mucosa oral clínicamente sana, se han observado cambios citológicos como una mayor queratinización, existiendo también reportes de un mayor grado de actividad nucleolar. En estos estudios, las células para frotis se han obtenido por medio de espátula de madera. Nuestro objetivo es evaluar la profundidad de muestras citológicas de mucosa oral obtenidas con cepillo para frotis (endobrush) y comparar el grado de queratinización y la actividad nucleolar en pacientes fumadores y no fumadores. Diseño del estudio. Se obtuvieron frotis de mucosa oral de borde de lengua clínicamente normal de 30 individuos fumadores y 30 no fumadores, utilizando espátula de madera y endobrush. Las muestras fueron teñidas con Papanicolaou y con la tinción AgNORs. Resultados. Con la espátula de madera se obtuvo un mayor porcentaje de células epiteliales superficiales anucleadas (P= 0.016) y con el endobrush se obtuvieron células más profundas (tipo intermedias) (P= 0.035). Los individuos fumadores presentaron un mayor porcentaje de células superficiales anucleadas con ambas técnicas, diferencia que fue estadísticamente significativa con la técnica endobrush (P=0.005). El promedio de AgNORs en las células nucleadas fue mayor en los individuos fumadores (3.83) que en los no fumadores (2.79) (P= 0.003). Conclusiones. El endobrush permite obtener células de estratos más profundos. Los individuos fumadores con mucosa clínicamente normal presentan un mayor porcentaje de células queratinizadas y una mayor actividad nucleolar, sugiriendo que el consumo de cigarrillo influye en la actividad celular de la mucosa del borde de lengua (AU)

Objetive.In smokers with clinically normal buccal mucosa, cytological changes such as increased keratinization, and higher nucleolar activity have been observed. In these studies the cells for cytological smears were obtained with a wooden spatula. Our objectives were to evaluate the depth of cytological smears of oral mucosa obtained with both a brush (endobrush) and a wooden spatula, and to compare the degree of keratinization and the nucleolar activity in smokers and non-smokers. Design. We obtained cytological smears of clinically normal lateral tongues of 30 smokers and 30 non-smokers using both a wooden spatula and endobrush. The samples were dyed with Papanicolaou and the AgNORs. Results. With the wooden spatula we found a greater percentage of enucleated superficial epithelial cells (P = 0.016) and deeper cells were obtained with an endobrush (intermediate cells) (P = 0.035). The smokers showed a greater percentage of enucleated superficial cells with both techniques, however this difference was significantly greater with Endobrush (P=0.005). The average of AgNORs in the nucleated cells was greater in smokers (3.83) than in non-smokers (2.79) (P=0.003). Conclusion. The Endobrush allows the clinician to obtain deeper cells of buccal mucosa. Smokers with clinically normal mucosa show a greater percentage of keratinized cells and a greater nucleolar activity, suggesting that cigarette smoking influences the cellular activity of the mucosa of the lateral tongue (AU)

Evaluation of keratinization and AgNORs count in exfoliative cytology of normal oral mucosa from smokers and non-smokers.

OBJECTIVE: In smokers with clinically normal buccal mucosa,cytological changes such as increased keratinization, and higher nucleolar activity have been observed. In these studies the cells for cytological smears were obtained with a wooden spatula. Our objectives were to evaluate the depth of cytological smears of oral mucosa obtained with both a brush (endobrush) and a wooden spatula, and to compare the degree of keratinization and the nucleolar activity in smokers and non-smokers. DESIGN: We obtained cytological smears of clinically normal lateral tongues of 30 smokers and 30 non-smokers using both a wooden spatula and endobrush. The samples were dyed with Papanicolaou and the AgNORs. RESULTS: With the wooden spatula we found a greater percentage of enucleated superficial epithelial cells (P = 0.016) and deeper cells were obtained with an endobrush (intermediate cells) (P = 0.035). The smokers showed a greater percentage of enucleated superficial cells with both techniques, however this difference was significantly greater with Endobrush (P = 0.005). The average of AgNORs in the nucleated cells was greater in smokers(3.83) than in non-smokers (2.79) (P = 0.003). CONCLUSION: The Endobrush allows the clinician to obtain deeper cells of buccal mucosa. Smokers with clinically normal mucosa show a greater percentage of keratinized cells and a greater nucleolar activity, suggesting that cigarette smoking influences the cellular activity of the mucosa of the lateral tongue.