Extranodal natural killer/T cell lymphoma nasal type simulating osteoradionecrosis with metachronic B lymphoma in the pelvis: Case report.

Extranodal Natural Killer/T Cell Lymphoma Nasal Type (EN-NK/T-CL-NT) is a non-Hodgkin extranodal lymphoma of unfavorable prognosis due to its aggressive nature. This neoplasm mainly affects the paranasal sinuses, nasopharynx, oropharynx, oral cavity, palate, and rarely intestinal, gastric and skin regions. 50-year-old female with a history of lymphoma in nasal and pelvic region. At four years of tumors-free, has facial asymmetry, accompanied by sub-palpebral, nasal and lip edema. Intraoral examination revealed a large ulceration suggestive of osteoradionecrosis. Gum biopsy shows Extranodal NK/T Cell Lymphoma Nasal Type (EN-NK/T-CL-NT). In this case we highlight the characteristics of EN-NK/T-CL-NT with a presentation of osteoradionecrosis-like. Unfortunately, the nature of this tumor led to the patient's death. Clinical follow-up of patients with cancer is imperative to mend and/or decrease treatment complications, as well as to identify second primary tumors or the spread of the underlying disease.

Healing of Recurrent Aphthous Stomatitis by Non-Thermal Plasma: Pilot Study.

Recurrent aphthous stomatitis (RAS) is a common disease in the oral cavity characterized by recurrent ulcers (RU). Usually, these cause acute pain without definitive treatment. The present study determines the efficacy of non-thermal plasma (NTP) for treating RU. NTP is applied to the patient's RU using a radiofrequency generator connected to a point reactor. The power density applied to the ulcer is 0.50 W/cm2, less than 4 W/cm2, which is the maximum value without biological risk. Each patient received two treatments of three minutes each and spaced 60 min apart at a distance of 5 mm from the RU. From a sample of 30 ulcers in patients treated for RU with an average age of 37 years, they stated that the pain decreased considerably and without the need for ingestion of analgesics and antibiotics. Regeneration took place in an average of three days. The NTP proved to be an excellent therapeutic alternative for the treatment of RU since it has a rapid effect of reducing pain and inflammation, as well as adequate tissue regeneration.

Use of liquid-based cytology samples reveals genomic instability and cell death in patients undergoing orthodontic treatment.

PURPOSE: To examine the use of liquid-based exfoliative cytology to determine the presence of genomic instability and cell death in the oral mucosa of patients with orthodontic appliances. METHODS: Fifty-four oral mucosa samples were collected from 18 patients and divided into three stages: T0, before fixation of orthodontic appliances; T1, 25 days after appliance fixation; T2, 90 days after appliance fixation. All samples were Papanicolaou-stained and observed by microscopy (1,000 cells/sample) to ascertain the frequency of micronucleated cells (MN) and nuclear abnormalities (nuclear buds (NB), binucleated (BN), condensed chromatin (CC), karyorrhexis (KR), and karyolysis (KL)). Differences were analyzed statistically using the Mann-Whitney, Wilcoxon, Kruskal-Wallis and chi-squared tests. RESULTS: After placement of orthodontic appliances, significant differences were observed for genomic instability biomarkers (MN and NB) and cell death (CC, KR and KL) (P < 0.05). Female patients and older patients exhibited a higher frequency of MN. CONCLUSION: Liquid-based cytology has revealed that orthodontic appliances induce genomic instability and cell death in epithelial tissue of the oral mucosa, facilitating sample preservation and yielding more than one preparation per sample. Future studies should investigate whether such cell damage can be reversed through cell repair or whether cell alterations evolve and lead to disease.

Enhancement of fluoride release in glass ionomer cements modified with titanium dioxide nanoparticles.

BACKGROUND: Several efforts have been made to improve the glass ionomer cements (GICs) properties with nanotechnology. Fluoride release in once of most beneficial properties of GICs. The purpose of this study was to evaluate the fluoride release, recharge, and cytotoxicity in GICs reinforced with titanium dioxide nanoparticles (TiO2N). OBJECTIVE: Evaluate the fluoride release, recharge, and cytotoxicity in GICs reinforced with TiO2N. METHODS: Four GICs, FUJI IX EXTRA (G1c), KETAC MOLAR (G2c), IONOFILL MOLAR (G3c), and FUJI IX (G4c) were combined with TiO2N (G1e, G2e, G3e, and G4e) and divided into blocks of 5-mm width and 1-mm thickness 10 each. A total of 80 samples were arranged as follows: GICs alone as negative control (n = 40) and GICs + TiO2N as experimental groups (n = 40). The fluoride release was determined for periods of 1, 2, 6, 10, 31, 90, 180, 240, and 300 days. On days 30 and 179, samples were recharged by submerging in 1 mL of 20,000 ppm sodium fluoride gel. Cytotoxic activity was carried out with gingival fibroblasts, using 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide cell viability assay. RESULTS: The experimental groups obtained the highest and more constant fluoride released when compared to control groups. After the first recharge, experimental groups (G1e, G3e, and G4e) showed statistically significant results (P = .001, 0.010, and 0.001 respectively) enhancing their recharge ability regarding control groups. The second recharge showed better results in G1e concerning the rest of the groups. No cytotoxic activity was observed in all experimental groups, although significant differences were observed in G3e and G4e regarding control group. CONCLUSION: The incorporation of TiO2N enhance the fluoride release in glass ionomers with a noncytotoxic effect on human gingival fibroblasts.

Mechanical Properties and Antibacterial Effect on Mono-Strain of Streptococcus mutans of Orthodontic Cements Reinforced with Chlorhexidine-Modified Nanotubes.

Recently, several studies have introduced nanotechnology into the area of dental materials with the aim of improving their properties. The objective of this study is to determine the antibacterial and mechanical properties of type I glass ionomers reinforced with halloysite nanotubes modified with 2% chlorhexidine at concentrations of 5% and 10% relative to the total weight of the powder used to construct each sample. Regarding antibacterial effect, 200 samples were established and distributed into four experimental groups and six control groups (4 +ve and 2 -ve), with 20 samples each. The mechanical properties were evaluated in 270 samples, assessing microhardness (30 samples), compressive strength (120 samples), and setting time (120 samples). The groups were characterized by scanning electron microscopy and Fourier transform infrared spectroscopy, and the antibacterial activity of the ionomers was evaluated on Streptococcus mutans for 24 h. The control and positive control groups showed no antibacterial effect, while the experimental group with 5% concentration showed a zone of growth inhibition between 11.35 mm and 11.45 mm, and the group with 10% concentration showed a zone of growth inhibition between 12.50 mm and 13.20 mm. Statistical differences were observed between the experimental groups with 5% and 10% nanotubes. Regarding the mechanical properties, microhardness, and setting time, no statistical difference was found when compared with control groups, while compressive strength showed higher significant values, with ionomers modified with 10% concentration of nanotubes resulting in better compressive strength values. The incorporation of nanotubes at concentrations of 5% and 10% effectively inhibited the presence of S. mutans, particularly when the dose-response relationship was taken into account, with the advantage of maintaining and improving their mechanical properties.

Antimicrobial Activity of Biogenic Silver Nanoparticles from Syzygium aromaticum against the Five Most Common Microorganisms in the Oral Cavity.

Syzygium aromaticum (clove) has been used as a dental analgesic, an anesthetic, and a bioreducing and capping agent in the formation of metallic nanoparticles. The main objective of this study was to evaluate the antimicrobial effect in oral microorganisms of biogenic silver nanoparticles (AgNPs) formed with aqueous extract of clove through an ecofriendly method "green synthesis". The obtained AgNPs were characterized by UV-Vis (ultraviolet-visible spectroscopy), SEM-EDS (scanning electron microscopy-energy dispersive X-ray spectroscopy), TEM (transmission electron microscopy), and ζ potential, while its antimicrobial effect was corroborated against oral Gram-positive and Gram-negative microorganisms, as well as yeast that is commonly present in the oral cavity. The AgNPs showed absorption at 400-500 nm in the UV-Vis spectrum, had an average size of 4-16 nm as observed by the high-resolution transmission electron microscopy (HR-TEM), and were of a crystalline nature and quasi-spherical form. The antimicrobial susceptibility test showed inhibition zones of 2-4 mm in diameter. Our results suggest that AgNPs synthesized with clove can be used as effective growth inhibitors in several oral microorganisms.

Mesiodens en dentición temporal y mixta: informe de casos / Mesiodens in primary and mixed dentition: case reports

Objetivo: Presentar una serie de casos clínicos de me- siodens en niños con dentición temporal y mixta, su trata- miento y seguimiento. Casos clínicos: Se muestra el manejo clínico de tres casos de mesiodens en dentición temporal y un caso en den- tición mixta, los cuales fueron diagnosticados en un examen radiográfico de rutina (AU)

Aim: To present a series of clinical cases of mesiodens in children with primary and mixed dentition, their treatment and follow-up. Clinical cases: This paper describes the clinical man- agement of three cases of mesiodens in primary dentition and one case in mixed dentition which were diagnosed in routine radiographic examinations (AU)

Spongiotic hyperplasia of the oral mucosa: case series and immunohistochemical analysis.

The localized juvenile spongiotic gingival hyperplasia (LJSGH) mainly affects the maxillary vestibular attached gingiva of juvenile patients, without sex predilection. Similar lesions involving extragingival sites have not been reported to date. Here, we report 2 cases of extragingival soft tissue lesions with similar clinicopathological features to those reported in LJSGH and 12 cases of intraoral reactive soft tissue lesions microscopically showing LJSGH-like focal areas. The 2 cases were adult patients, affecting the maxillary alveolar ridge (55-year-old female) and hard palate (78-year-old male), which were diagnosed as "spongiotic hyperplasia of the oral mucosa." The 12 intraoral reactive soft tissue lesions (6 men and 6 women; mean age, 49.5 years) were diagnosed as inflammatory fibrous hyperplasia (n = 6), peripheral ossifying fibroma (n = 3), and pyogenic granuloma (n = 3), each of them presenting LJSGH-like focal areas. By immunohistochemistry, the spongiotic hyperplasia areas showed positivity for CK19, CK14, CK34ßE12, and CAM5.2 (weak/focal), while CK4 was negative. Considering the anatomical locations (extragingival) of these 2 cases, the term "spongiotic hyperplasia of the oral mucosa" is suggested. Moreover, LJSGH-like focal areas can be detected when microscopically assessing common intraoral reactive soft tissue lesions.

Effect of Human Development Index and other socioeconomic factors on mortality-to-incidence ratio of lips and oral cavity cancer in Mexican states: an ecological study.

OBJECTIVES: To assess the association between the Human Development Index (HDI) and covariates on the mortality-to-incidence ratio (MIR) of lips and oral cavity cancer (LOCC) in Mexico. DESIGN: Ecological study. SETTING: Data from 32 Mexican states for year 2019. PARTICIPANTS: Data set of male and female populations from Mexico. EXPOSURES: Socioeconomic conditions based on HDI and covariates related to healthcare system capacity (total health spending per capita, school dropout and ratio of medical personnel in direct contact with patients). PRIMARY AND SECONDARY OUTCOME MEASURES: MIR of LOCC by state and sex was calculated from the Global Burden of Disease Study website for year 2019. Data for calculating HDI 2019 by state and covariates were obtained from the National Institute of Statistics and Geography. A multiple regression model was constructed to measure the effects of HDI and covariates on LOCC-MIR. RESULTS: Among the states with the highest HDI (>0.780), Colima had the highest aged-standardised rates per 100.000 in men for incidence (5.026) and mortality (3.118). The greatest burden of the disease was found on men, with the highest Men:Women MIR in Colima (3.10) and Baja California Sur (2.73). The highest MIR (>0.65) was found among the states with the lowest HDI (Oaxaca and Chiapas). For each unit of increase of the HDI there was a decrease in the LOCC- MIR of -0.778, controlling for the covariates. The most suitable regression model explained the 57% (F (p): 0.000) of the variance. CONCLUSIONS: Men were most affected by LOCC in Mexican states. The highest MIRs of LOCC were found in the states with the highest HDI. But a worse prognosis of the disease, expressed as a higher MIR, is expected in contexts with lower HDI in the country, even with lower MIRs.

COVID-19 pandemic accelerated virtual transformation in dental education: a multicenter review of remote teaching and teledentistry / Transformação virtual acelerada pela pandemia de COVID-19 na educação odontológica: uma revisão multicêntrica do ensino à distância e da teleodontologia

ABSTRACT Although prior to the pandemic there was some resistance to the virtualization of dental education, the COVID-19 pandemic is providing us a unique opportunity to overcome several barriers that previously blocked the adoption of remote teaching and teledentistry. Thanks to the extended availability of telecommunications, digital technologies, and platforms, remote education and teledentistry appear to be the preferred choice to maintain dental education and patient care active under this pandemic, without contamination risks. In this paper, we review valid remote education strategies and possible alternatives useful in virtual transformation in dental education. Furthermore, the role of teledentistry and its advantages and challenges are also revised. Under the current pandemic context, as dental educators, we are called to be creative and flexible. Every dental school should adapt and use remote education as much as possible until clinical attention can be readopted. The evidence presented in this review supports our position that under this pandemic, remote education and telemedicine/teledentistry may be "the virtual convenient solution", to adapt and improve the hitherto classic way of teaching dentistry through tele-education.

RESUMO Embora antes da pandemia houvesse alguma resistência à virtualização da educação odontológica, a pandemia COVID-19 está nos fornecendo uma oportunidade única de superar várias barreiras que anteriormente bloqueavam a adoção do ensino à distância e teledontologia. Graças à ampla disponibilidade de telecomunicações, tecnologias digitais e plataformas, a educação à distância e a teledontologia parecem ser a escolha preferida para manter a educação odontológica e o atendimento ativo aos pacientes durante a pandemia, sem riscos de contaminação. Neste artigo, revisamos estratégias válidas de educação a distância e possíveis alternativas úteis na transformação virtual na educação odontológica. Além disso, o papel do teleodontologia e suas vantagens, assim como também os desafios. No atual contexto pandêmico, como educadores odontológicos, somos chamados a ser criativos e flexíveis. Cada escola de odontologia deve se adaptar e usar a educação à distância, tanto quanto possível, até que a atenção clínica possa ser readotada. As evidências apresentadas nesta revisão corroboram nossa posição de que, sob esta pandemia, a educação a distância e a telemedicina / teleodontologia podem ser "a solução virtual conveniente", para adaptar e aprimorar a forma até então clássica de ensino de odontologia, agora por meio da teleducação.

Evaluation of the release of nickel and titanium under orthodontic treatment.

The metal alloys used in dentistry are made mainly of nickel (Ni), titanium (Ti), and other elements such as molybdenum (Mo), zirconium (Zr), iron (Fe), tin (Sn), chrome (Cr), carbon (C), copper (Cu) and niobium (Nb) which can release metal ions in unstable environments. The aim of this work was determine the salivary pH before and during orthodontic treatment; evaluate the release of metal ions, mainly Ni and Ti, in urine and saliva using Inductively Coupled Plasma Optical Emission Spectroscopy (ICP-OES); and evaluate the corrosion using Scanning Electronic Microscopy (SEM). In this study, we selected 35 individuals under orthodontic treatment, from whom saliva and urine samples were collected in 3 stages: (a) basal, (b) at 3 and (c) 6 months after the placement of the fixed appliances. SEM analyzed the Ni-Ti (0.016″) and stainless steel (SS) (0.016 × 0.022″) archs after 1 month of being in contact with the oral cavity. Statistical analysis was performed with Stata using the ANOVA model of repeated measures with a p < 0.05. A statistically significant difference in the concentration of Ni in saliva were found between 3 and 6 months of intervention and Ti in urine was found 3 and 6 months.

Strategies and operational procedures in oral radiology to mitigate potential SARS-CoV-2 transmission / Estrategias y procedimientos operacionales en Radiología Oral para mitigar transmisión de SARS-CoV-2

SUMMARY Coronavirus disease (COVID-19) is highly transmissible through respiratory droplets, saliva, and aerosol particles. Infection can lead to severe acute respiratory syndrome and trigger multi-organ failure and death. Most clinical dental procedures involve contact with saliva or the generation of aerosols with saliva and blood. These airborne particles increase the risk of transmission by COVID-19 between dentists and patients. Thus, dentistry must adopt procedures to reduce transmission during dental procedures. Although these strategies may not be directly applicable to all institutions due to cultural, social, geographical, and economic differences, the underlying principles and implemented strategies remain relevant and can be adopted or modified by the institutions dealing with the current COVID-19 outbreak. The purpose of this article is to discuss one of the principal sources of COVID-19 transmission: saliva, the biofluid most frequently handled in a radiology environment. The authors also recommend strategies and operational procedures to decrease the spread of COVID-19 in a radiological routine.

RESUMEN La enfermedad por coronavirus (COVID-19) se transmite fácilmente a través de gotitas respiratorias, saliva y partículas de aerosol. La infección puede desencadenar un síndrome respiratorio agudo severo, insuficiencia multiorgánica y, en algunos casos, la muerte. Los procedimientos clínicos dentales determinan el contacto con saliva o la generación de aerosoles con saliva y sangre, lo que implica un alto riesgo de transmisión por COVID-19 entre odontólogos y pacientes. Por ello, la práctica odontologica debe adoptar medidas para detener la propagación durante los procedimientos dentales. En este artículo se revisan las estrategias para mitigar el riesgo de transmisión de COVID-19. Si bien estas estrategias pueden no ser directamente aplicables a todas las instituciones debido a diferencias culturales, sociales, geográficas y económicas inherentes, los principios subyacentes y las estrategias implementadas siguen siendo relevantes y pueden ser adoptados o modificados por las instituciones que se ocupan del brote actual de COVID-19. El propósito de este artículo es discutir una de las principales fuentes de transmisión de COVID-19: la saliva, el biofluido que se maneja con mayor frecuencia en un entorno radiológico. Los autores también recomiendan estrategias y procedimientos operativos para disminuir la propagación de COVID-19 en una rutina radiológica.

Erratum to "Relationship between the Human Development Index and its Components with Oral Cancer in Latin America" [J Epidemiol Global Health 9(4), 2019, 223-232].

DOI of original article: https://doi.org/10.2991/jegh.k.191105.001.

Relationship between the Human Development Index and its Components with Oral Cancer in Latin America.

To evaluate the relationship between the Human Development Index (HDI) and its components with oral cancer (OC) in Latin America. Ecological study in 20 Latin American countries in 2010 and 2017, which evaluated the relationship between the Age-Standardized Rates (ASRs) of incidence and mortality from oral cancer and the following indicators: HDI, with its components (income, education, and health indexes); and the Gini and Theil-L indexes. Among the countries with the highest HDI, men from Brazil and Cuba had the highest incidence and mortality ASRs per 100,000 inhabitants (ASR incidence >7.5 and mortality >4.5). Among those with the lowest HDI, Haiti was the most affected country (ASR incidence >4.1 and mortality >3.0). The highest male:female ratio was in Paraguay in both years (incidence >3.5 and mortality >4.0). Mortality from oral cancer is negatively related to the global HDI in both years, with regression coefficients (95% confidence interval) being -5.78 (-11.77, 0.20) in 2010 and -5.97 (-11.38, -0.56) in 2017; and separate (independent) from the income [-4.57 (-9.92, 0.77) in 2010 and -4.84 (-9.52, -0.17) in 2017] and health indexes [-5.81 (-11.10, -0.52) and -6.52 (-11.32, -1.72) in 2017] (p < 0.05) in the countries with lower HDI. Oral cancer incidence and mortality rates vary both among and within Latin American countries according to sex, with a greater burden on men. The HDI is negatively related to mortality from oral cancer in the countries of medium and low HDI.

[Effect of risk factor control policies on oral cancer mortality in Latin America]. / Efecto de las políticas de control de factores de riesgo sobre la mortalidad por cáncer oral en América Latina.

OBJECTIVE: Mortality from oral cancer, the prevalence of the main risk factors and the implementation of policies to control current trends and the distribution of data among the countries of Latin America. The objective of this study was to describe the trends of mortality from oral cancer between 2000 and 2017, by sex, in 20 countries in Latin America, and to know the effect of measures to control tobacco consumption and alcohol consumption on the Mortality from oral cancer. METHODS: Ecological study that evaluates the relationship between the rates standardized by the age of cancer by oral sex, the prevalence of tobacco consumption and alcohol consumption, and the implementation of control policies. To calculate the annual percentage change of the rates, the Prais-Winsten regression was used; and the effect of measures of control of risk factors on oral cancer mortality is assessed by Spearman correlations. RESULTS: The greatest decreases in oral cancer mortality were in men in Brazil (APC -7.83, -14.25,-0.93). Mortality from cancer the oral relationship between men and the prevalence of tobacco consumption and alcohol consumption (r = 0.358, r 0.537) (p <0.01), and between the non-implementation of control policies of smoking (r = 0.738) (p= 0.003), the restrictions on the hours and days of sale of alcohol (r = 0.777, p = 0.001), and the states on sponsorship and promotion of alcohol sales (r =0.739 , p =0.040). CONCLUSIONS: The effect of the implementation of control policies is evidenced by a greater relationship with oral cancer mortality in the countries with the least progress in their execution.

OBJETIVO: La mortalidad por cáncer oral, la prevalencia de los principales factores de riesgo y la implementación de las políticas para su control presentan tendencias y distribución desiguales entre los países de América Latina. El objetivo de este trabajo fue describir las tendencias de la mortalidad por cáncer oral entre 2000 y 2017, según sexos, en 20 países de América Latina, y conocer el efecto de las medidas de control del consumo de tabaco y el consumo de alcohol sobre la mortalidad por cáncer oral. METODOS: Estudio ecólogico que evaluó la relación entre las tasas estandarizadas por edad del fallecimiento por cáncer oral según el sexo, la prevalencia del consumo de tabaco y del consumo de alcohol,y la implementación de las políticas de control. Para calcular la variación porcentual de cambio anual de las tasas, se usó la regresión Prais-Winsten; y el efecto de las medidas de control de los factores de riesgo sobre la mortalidad por cáncer oral se evalúo mediante correlaciones de Spearman. RESULTADOS: Los mayores descensos en la mortalidad por cáncer oral fueron en los hombres de Brasil (APC -7,83; -14,25; -0,93). La mortalidad por cáncer oral mostró relación positiva entre hombres y la prevalencia del consumo de tabaco y del consumo de alcohol (r=0,358, r=0,537) (p<0,01), y entre la no implementación de las políticas de control de tabaquismo (r=0,738) (p=0,003), las restricciones en los horarios y días de venta de alcohol (r=0,737, p=0,001), y los reglamentos sobre patrocinio y promoción de venta de alcohol (r=0,739, p=0,040). CONCLUSIONES: El efecto de la implementación de las políticas de control se evidencia en una mayor relación con la mortalidad por cáncer oral en los países con menor avance en su ejecución.

Tendencias de la mortalidad por cáncer oral y el efecto de las políticas públicas de prevención en América Latina / Trends in oral cancer mortality and the effect of preventive policies across Latin America

OBJETIVO: Describir las tendencias de la mortalidad por cáncer oral entre 2000 y 2017 por sexos en 20 países de América Latina, e identificar los efectos de las políticas implementadas para controlar de los factores de riesgo. MATERIALES Y MÉTODOS: Se realizó un estudio ecólogico que evaluó la relación entre las tasas estandarizadas por edad de mortalidad por cáncer oral según el sexo, la prevalencia de tabaquismo y consumo de alcohol y la implementación de las políticas públicas de control. RESULTADOS: Los hombres de Cuba y Brasil muestran las más altas tasas de mortalidad en la región. Los descensos más importantes se presentan en los hombres de Brasil y en las mujeres de Panamá. Son pocas las tendencias al aumento, aunque éstas se evidencian especialmente entre las mujeres. La implementación de las medidas de control de factores de riesgo, en cuanto a tabaco, alcohol, infecciones virales, programas de detección temprana y tratamiento, muestra avances desiguales entre los países. Se observó una mayor relación entre la mortalidad por cáncer oral con el consumo de tabaco en los contextos de menor implementación de las políticas, y el consumo de alcohol en los escenarios de mayor avance. CONCLUSIÓN: La mortalidad por cáncer oral afecta especialmente a los hombres de la región, lo que se puede asociar a la distribución de los factores etiológicos y avances desiguales de los países en la implementación de las medidas preventivas. Se requiere profundizar en investigación subnacional de seguimiento, y fortalecer la prevención y tratamiento con estrategias validas para cada contexto.

OBJECTIVE: To describe the trends in oral cancer mortality between 2000 and 2017 by sex in 20 countries in Latin America, and identify the effects of the policies that were implemented to control associated risk factors. MATERIALS AND METHODS: An ecological study was conducted to evaluate the relationship between age-standardized rates of oral cancer mortality by sex, the prevalence of smoking and alcohol consumption, and the implementation of public control policies. RESULTS: Men in Cuba and Brazil show the highest mortality rates in the region. The most important decreases occurred among Brazilian men and Panamanian women. There are only a few cases of increasing trends, although these are especially evident among women. The implementation of risk factor control measures, in terms of tobacco, alcohol, viral infections, early detection programs and treatment, have progressed unevenly in different countries. A strong relationship was observed between oral cancer mortality and tobacco consumption in countries with limited policy implementation; and with alcohol consumption in countries with advanced implementation. CONCLUSION: Oral cancer mortality especially affects men in the region, which can be associated with the distribution of etiological factors and unequal advances in countries in the implementation of preventive measures. It is necessary to further develop subnational follow-up research and strengthen prevention and treatment measures with valid strategies, adapted for each context.

Efecto de las políticas de control de factores de riesgo sobre la mortalidad por cáncer oral en América Latina / Effect of risk factor control policies on oral cancer mortality in Latin America

OBJETIVO: La mortalidad por cáncer oral, la prevalencia de los principales factores de riesgo y la implementación de las políticas para su control presentan tendencias y distribución desiguales entre los países de América Latina. El objetivo de este trabajo fue describir las tendencias de la mortalidad por cáncer oral entre 2000 y 2017, según sexos, en 20 países de América Latina, y conocer el efecto de las medidas de control del consumo de tabaco y el consumo de alcohol sobre la mortalidad por cáncer oral. MÉTODOS: Estudio ecólogico que evaluó la relación entre las tasas estandarizadas por edad del fallecimiento por cáncer oral según el sexo, la prevalencia del consumo de tabaco y del consumo de alcohol,y la implementación de las políticas de control. Para calcular la variación porcentual de cambio anual de las tasas, se usó la regresión Prais-Winsten; y el efecto de las medidas de control de los factores de riesgo sobre la mortalidad por cáncer oral se evalúo mediante correlaciones de Spearman. RESULTADOS: Los mayores descensos en la mortalidad por cáncer oral fueron en los hombres de Brasil (APC -7,83; -14,25; -0,93). La mortalidad por cáncer oral mostró relación positiva entre hombres y la prevalencia del consumo de tabaco y del consumo de alcohol (r=0,358, r=0,537) (p<0,01), y entre la no implementación de las políticas de control de tabaquismo (r=0,738) (p=0,003), las restricciones en los horarios y días de venta de alcohol (r=0,737, p=0,001), y los reglamentos sobre patrocinio y promoción de venta de alcohol (r=0,739, p=0,040). CONCLUSIONES: El efecto de la implementación de las políticas de control se evidencia en una mayor relación con la mortalidad por cáncer oral en los países con menor avance en su ejecución

OBJECTIVE: Mortality from oral cancer, the prevalence of the main risk factors and the implementation of policies to control current trends and the distribution of data among the countries of Latin America. The objective of this study was to describe the trends of mortality from oral cancer between 2000 and 2017, by sex, in 20 countries in Latin America, and to know the effect of measures to control tobacco consumption and alcohol consumption on the Mortality from oral cancer. METHODS: Ecological study that evaluates the relationship between the rates standardized by the age of cancer by oral sex, the prevalence of tobacco consumption and alcohol consumption, and the implementation of control policies. To calculate the annual percentage change of the rates, the Prais-Winsten regression was used; and the effect of measures of control of risk factors on oral cancer mortality is assessed by Spearman correlations. RESULTS: The greatest decreases in oral cancer mortality were in men in Brazil (APC -7.83, -14.25,-0.93). Mortality from cancer the oral relationship between men and the prevalence of tobacco consumption and alcohol consumption (r = 0.358, r 0.537) (p <0.01), and between the non-implementation of control policies of smoking (r = 0.738) (p= 0.003), the restrictions on the hours and days of sale of alcohol (r = 0.777, p = 0.001), and the states on sponsorship and promotion of alcohol sales (r =0.739 , p =0.040). CONCLUSIONS: The effect of the implementation of control policies is evidenced by a greater relationship with oral cancer mortality in the countries with the least progress in their execution