Occupational Exposure to Domestic Waste and Oral Mucosal Lesions: a Cross-Sectional Study / Exposição Ocupacional a Resíduos Domésticos e Lesões de Mucosa Oral: Estudo Transversal

This study aimed to evaluate the occurrence of oral mucosal lesions (OML) in domestic waste collectors and their association with occupational exposure to domestic waste. This cross-sectional study included 295 adult men who worked in a waste management company: 129 men were exposed to domestic waste during their labor of waste collection, and 166 were not. The waste collectors used personal protective equipment. The lips, buccal mucosa and sulcus, gum, alveolar ridge, tongue, the floor of the mouth, and soft and hard palate were evaluated. The chi-square or Fisher's exact test assessed the variables associated with OML (P ≤ 0.05). Twenty-five OMLs were observed in 22 volunteers, 8 in the exposed and 17 in the non-exposed group. Actinic cheilitis in the lips and candidiasis were the most common lesions in both groups. OML was not associated with waste exposure (OR= 0.72, 95% CI = 0.29-1.77, P = 0.47). There was no association between domestic waste exposure and actinic cheilitis (OR = 0.70, 95% CI= 0.23-2.15, P = 0.37), candidiasis (OR = 0.42, 95% CI= 0.08-2.12, P = 0.24) or leukoplakia (OR = 0.99, 95% CI= 0.97-1.01, P = 0.32). Actinic cheilitis in the lips and candidiasis were the most common lesions in both exposed and non-exposed groups. Occupational exposure to domestic waste was not related to OML. Proper use of personal protective equipment may have prevented the development of OML in domestic waste collectors. (AU)

Este estudo teve como objetivo avaliar a ocorrência de lesões de mucosa oral (LMO) em coletores de lixo doméstico e sua associação com a exposição ocupacional a resíduos domésticos. Este estudo transversal incluiu 295 homens adultos que trabalhavam numa empresa de gestão de resíduos: 129 homens foram expostos a resíduos domésticos durante o seu trabalho de coleta de resíduos e 166 não. Os coletores de lixo usavam equipamentos de proteção individual. Foram avaliados lábios, mucosa bucal e vesticulo, gengiva, rebordo alveolar, língua, assoalho da boca e palato mole e duro. O teste qui-quadrado ou exato de Fisher avaliou as variáveis associadas à LMO (P ≤ 0,05). Vinte e cinco LMO foram observadas em 22 voluntários, 8 no grupo exposto e 17 no grupo não exposto. Queilite actínica nos lábios e candidíase foram as lesões mais comuns em ambos os grupos. A LMO não foi associada à exposição a resíduos (OR = 0,72, IC 95% = 0,29-1,77, P = 0,47). Não houve associação entre exposição a resíduos domésticos e queilite actínica (OR = 0,70, IC 95% = 0,23-2,15, P = 0,37), candidíase (OR = 0,42, IC 95% = 0,08-2,12, P = 0,24) ou leucoplasia ( OR = 0,99, IC 95% = 0,97-1,01, P = 0,32). A queilite actínica nos lábios e a candidíase foram as lesões mais comuns nos grupos expostos e não expostos. A exposição ocupacional a resíduos domésticos não esteve relacionada com LMO. O uso adequado de equipamentos de proteção individual pode ter evitado o desenvolvimento de LMO em coletores de lixo doméstico. (AU)

Polypoid non-neural granular cell tumor of the oral cavity: case report and literature review

To report a case of non-neural granular cell tumor (NN-GCT), an uncommon neoplasm, with only six studies worldwide describing cases involving the oral cavity. Methods: A 26-year-old male patient with an erythematous, firm, polypoid nodule in the floor of the mouth that exhibited areas of ulceration and mild bleeding to the touch. A biopsy was performed to aid in the diagnosis. Results: Based on the histopathological and immunohistochemical results (vimentin +, CD68 +, S100 -), the diagnosis was compatible with S100-negative (primitive polypoid non-neural) granular cell tumor. No recurrence was observed over two years of follow-up. Conclusion: The diagnosis of NN-GCT is extremely challenging because this tumor shares histological and immunophenotypic features with many benign and malignant tumors. Although oral NN-GCT may exhibit unusual and atypical histological features, it has an indolent behavior. Thus, until more cases of oral involvement are reported, complete resection and close follow-up are recommended

The use of micronucleus assay in exfoliated oral cells in patients undergoing fixed orthodontic therapy: a systematic review with meta-analysis.

The aim of this systematic review was to evaluate published papers regarding the micronucleus assay in oral mucosal cells of patients undergoing orthodontic therapy (OT). A search of the scientific literature was made in the PubMed, Scopus, and Web of Science databases for all data published until November, 2021 using the combination of the following keywords: "fixed orthodontic therapy," "genetic damage", "DNA damage," "genotoxicity", "mutagenicity", "buccal cells", "oral mucosa cells," and "micronucleus assay". The systematic review was designed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Nine studies were retrieved. Some authors demonstrated that OT induces cytogenetic damage in oral mucosal cells. Out of the nine studies included, two were classified as strong, five as moderate, and two as weak, according to the quality assessment components of the Effective Public Health Practice Project (EPHPP). Meta-analysis data revealed no relationship between mutagenicity in oral cells and OT in different months of treatment. At one month, the SMD = 0.65 and p = 0.08; after three months of OT, the SMD = 1.21 and p = 0.07; and after six months of OT, the SMD = 0.56 and p = 0.11. In the analyzed months of OT, I2 values were >75%, indicating high heterogeneity. In summary, this review was not able to demonstrate that OT induces genetic damage in oral cells. The study is important for the protection of patients undergoing fixed OT, given that mutagenesis participates in the multi-step process of carcinogenesis.

Evaluation of remote teaching in master programs in the Oral Pathology and Oral Medicine during the COVID-19 pandemic. Brazilian multicentric study

Background: With the COVID-19 pandemic, there was a need to adopt online teaching methods in a generalized and sudden way, a situation that led to unprecedented changes in the routine of post-graduate students and research development. This study aimed to analyze the evaluation of remote teaching by graduates of master's degrees and advisors in master's programs in the Oral Pathology and Oral Medicine who needed to adapt to a remote teaching methodology in the pandemic. Material and Methods: This quantitative study evaluated the remote teaching in the perception of master's graduates and advisors from postgraduate programs in Oral Pathology and Oral Medicine. Data were collected through an online Google forms® questionnaire. Results: Participated in the study 14 master graduates and 14 master's advisors. Master graduates evaluated that the professors had a good performance (p=0.001), that the duration of the classes was adequate (p=0.015), that the interaction with professors was satisfactory (p=0.007), that they had good interaction with the advisor (p=0.001), that they were satisfied with the remote guidance process (p=0.038) and that face-to-face practical activities were missed (p=0.002). Master's advisors reported satisfaction with remote teaching, good adaptation (p=0.018) and motivation for remote teaching (p=0.016), they evaluated that students were cooperative in activities (p=0.019) and that face-to-face practical activities were missed (p=0.002). Conclusions: Despite the difficulties, remote teaching proved to be an effective alternative to face-to-face teaching. (AU)

Using the Response Surface Methodology for Periodontitis Diagnosis / Uso da Metodologia de Superfície de Resposta para Diagnóstico de Periodontite

Response surface methodology (RSM) consists of mathematical and statistical techniques to develop models which help to understand the influence of various factors on a dependent variable of interest. The feasibility of RSM use to detect cases of periodontitis and its correlated factors has not yet been evaluated. This study developed mathematical models for periodontitis diagnosis independent of periodontal probing using the RSM. Demographic, socioeconomic, behavioral, systemic, local factors, and periodontitis were assessed in 176 volunteers. Periodontitis case was defined according to three different definitions: 1) ≥3 sites with clinical attachment level (CAL) ≥4 mm; 2) at least one site with CAL ≥4 mm and bleeding on probing; 3) ≥2 proximal sites with CAL ≥3 mm and ≥2 proximal sites with probing depth (PD) ≥4 mm (not on the same tooth) OR 1 site with PD ≥5 mm. 4th-degree polynomial equations showed high coefficients of determination (R²= 1) and were used to represent the mathematical models of periodontitis cases. According to definition 1, the diagnosis of periodontitis was accurate by including in the model: age, sex, education level, plaque index (PI), number of missing teeth, previous hygiene instructions, and body mass index (BMI). According to definition 2, the diagnosis of periodontitis was accurate by including in the model: age, sex, education level, income, PI, previous oral hygiene instructions, frequency of brushing and type of toothbrush, and use of mouthwash in the model. For an accurate diagnosis of periodontitis according to definition 3, the model included: age, education level, IP, number of missing teeth, previous oral hygiene instruction, BMI, and diabetes. The multifactorial mathematical models were able to diagnosis periodontitis according to different periodontitis case definitions using only variables of easy evaluation and non-invasive. (AU)

A metodologia de superfície de resposta (MSR) consiste em técnicas matemáticas e estatísticas para desenvolver modelos que ajudam a entender a influência de vários fatores em uma variável dependente de interesse. A viabilidade do uso da MSR para detectar casos de periodontite e seus fatores correlacionados ainda não foi avaliada. Este estudo desenvolveu modelos matemáticos para diagnóstico de periodontite independente da sondagem periodontal usando a MSR. Fatores demográficos, socioeconômicos, comportamentais, sistêmicos, locais e periodontite foram avaliados em 176 voluntários. O caso de periodontite foi definido de acordo com três definições diferentes: 1) ≥3 locais com nível de inserção clínica (NIC) ≥4 mm; 2) Um local com NIC ≥4 mm e sangramento à sondagem; 3) ≥2 locais proximais com NIC ≥3 mm e ≥2 locais proximais com profundidade de sondagem (PS) ≥4 mm (não no mesmo dente) OU 1 local com PS ≥5 mm. Equações polinomiais de 4º grau apresentaram altos coeficientes de determinação (R²= 1) e foram utilizadas para representar os modelos matemáticos dos casos de periodontite. De acordo com a definição 1, o diagnóstico de periodontite foi preciso ao incluir no modelo: idade, sexo, escolaridade, índice de placa (IP), número de dentes perdidos, instruções de higiene anteriores e índice de massa corporal (IMC). De acordo com a definição 2, o diagnóstico de periodontite foi preciso ao incluir no modelo: idade, sexo, escolaridade, renda, IP, instruções prévias de higiene bucal, frequência de escovação e tipo de escova dental e uso de enxaguatório bucal no modelo. Para um diagnóstico preciso de periodontite de acordo com a definição 3, o modelo incluiu: idade, escolaridade, IP, número de dentes perdidos, instrução prévia de higiene oral, IMC e diabetes. Os modelos matemáticos multifatoriais foram capazes de diagnosticar a periodontite de acordo com diferentes definições de casos de periodontite usando apenas variáveis de fácil avaliação e não invasivas. (AU)

Gingival neoplasms: a multicenter collaborative study of 888 patients in Brazil

Background: To evaluate the prevalence and clinicopathological features of a large series of gingival neoplasms in Brazil. Material and methods: All gingival benign and malignant neoplasms were retrieved from the records of six Oral Pathology Services in Brazil, during a 41-year period. Clinical and demographic data, clinical diagnosis, and histopathological data were collected from the patients' clinical charts. For statistical analysis, the chi-square, median test of independent samples and the U Mann-Whitney tests were used, considering a significance of 5%. Results: From 100,026 oral lesions, 888 (0.9%) were gingival neoplasms. There were 496 (55.9%) males, with a mean age of 54.2 years. Most cases (70.3%) were malignant neoplasms. Nodules (46.2%) and ulcers (38.9%) were the most common clinical appearance for benign and malignant neoplasms, respectively. Squamous cell carcinoma (55.6%) was the most common gingival neoplasm, followed by squamous cell papilloma (19.6%). In 69 (11.1%) malignant neoplasms, the lesions were clinically considered to be inflammatory or of infectious origin. Malignant neoplasms were more common in older men, appeared with larger size, and with a time of complaint shorter than benign neoplasms (p<0.001). Conclusions: Benign and malignant tumors may appear as nodules in gingival tissue. In addition, malignant neoplasms, especially squamous cell carcinoma, should be considered in the differential diagnosis of persistent single gingival ulcers. (AU)

Acinic cell carcinoma of the oral and maxillofacial region: an international multicenter study.

The aim of this study was to describe the prevalence, clinicopathological, and prognostic features of acinic cell carcinoma (AciCC) of the oral and maxillofacial region. AciCC cases were retrospectively retrieved from 11 pathology centers of three different countries. Medical records were examined to extract demographic, clinical, pathologic, and follow-up information. A total of 75 cases were included. Females (65.33%) with a mean age of 45.51 years were mostly affected. The lesions usually presented as an asymptomatic (64.28%) nodule (95.66%) in the parotid gland (70.68%). The association of two histopathological patterns was the most common finding (48.93%) and the tumors presented mainly conventional histopathological grades (86.11%). Surgical treatment was performed in the majority of the cases (59.19%). Local recurrence was observed in 20% of the informed cases, regional metastasis in 30.43%, and distant metastasis in 12.50%. The statistical analysis showed that the cases with a solid histopathological pattern (p=0.01), high-grade transformation (p=0.008), recurrence (p=0.007), and regional metastasis (p=0.03) were associated with poor survival. In conclusion, high histopathological transformation, presence of nodal metastasis, and recurrence were prognostic factors for AciCC of the oral and maxillofacial region.

Dental Prosthesis Needs and Associated Factors in Native Brazilian Kiriri Indians: a CrossSectional Study / Necessidades de Próteses Dentárias e Fatores Associados em Índios Kiriri Nativos Brasileiros: um Estudo Transversal

This study evaluated the dental prosthesis needs and associated factors in indigenous Brazilian adults from Northeastern Brazil. Dental prosthesis needs were assessed in a representative sample of 225 Indians. Edentulous area and current indication for tooth extraction according to periodontal status or non-restorable condition were registered in a clinical chart. Bivariate and logistic analyses were applied to assess associations of dental prosthesis needs and prosthesis type with age, sex, income, education, smoking, moderate or severe periodontitis, plaque index, dental caries experience, and previous dental visit. Prosthetic treatment was necessary in 83% of the participants. These individuals required 339 dental prostheses, including removable partial dentures (60.2%), fixed (33.6%), and complete dentures (6.2%). Regression analysis showed that age ≥35 years [odds ratio (OR) 5.95, 95% confidence interval (CI) 1.97­17.91, p=0.002] and caries experience ≥3 [OR 4.01, 95%CI 1.78­9.02, p=0.001] were significantly associated with prosthesis needs. The type of prosthesis required was associated with sex, age, educational level, periodontitis, caries experience, and plaque index (p≤0.03). In conclusion, the need for prosthetic rehabilitation was high in this population, and sociodemographic factors, dental plaque level, caries experience, and periodontitis were associated with the required type of prosthesis. These data can be used to plan the allocation of resources to promote preventive and curative strategies in this population.(AU)

Este estudo avaliou as necessidades de prótese dentária e fatores associados em adultos indígenas brasileiros do Nordeste do Brasil. As necessidades de prótese dentária foram avaliadas em uma amostra representativa de 225 índios. A área edêntula e a indicação para extração dental, de acordo com o estado periodontal ou condição não restaurável, foram registradas em um prontuário clínico. Análises bivariadas e logísticas foram aplicadas para avaliar as associações das necessidades de prótese dentária e tipo de prótese com idade, sexo, renda, escolaridade, tabagismo, periodontite moderada ou grave, índice de placa, experiência de cárie dentária e consulta odontológica anterior. O tratamento protético foi necessário em 83% dos participantes. Esses indivíduos necessitaram de 339 próteses dentárias, incluindo próteses parciais removíveis (60,2%), fixas (33,6%) e próteses totais (6,2%). A análise de regressão mostrou que idade ≥35 anos [odds ratio (OR) 5,95, intervalo de confiança de 95% (IC) 1,97­17,91, p=0,002] e experiência de cárie ≥3 [OR 4,01, IC 95% 1,78­9,02, p=0,001] foram significativamente associados às necessidades de prótese. O tipo de prótese necessária foi associado ao sexo, idade, escolaridade, periodontite, experiência de cárie e índice de placa (p≤0,02). Em conclusão, a necessidade de reabilitação protética foi alta nesta população e fatores sociodemográficos, nível de placa dentária, experiência de cárie e periodontite foram associados ao tipo de prótese necessária. Estes dados podem ser usados para planejar a alocação de recursos para promover estratégias preventivas e curativas nessa população.(AU)

Foreign body reactions related to orofacial esthetic fillers: A systematic review.

The aim of this study was to systematically review the clinicopathological data regarding foreign body reactions (FBR) related to esthetic procedures in the orofacial region. Electronic searches were performed in six databases and in gray literature using PEO acronym for the review question. Case series and case reports describing FBR related to esthetic procedures in the orofacial region were included. The JBI Critical Appraisal Checklist-University of Adelaide tool was used for measuring the risk of bias. Eighty-six studies reporting 139 cases of FBR were identified. The mean age at diagnosis was 54.12 years (14-85 years), with most of the cases reported in America, North America (n = 42/30.70%) and Latin America (n = 33/23.60%), mainly occurring in women (n = 131/94.40%). Asymptomatic (n = 60/43.40%) nodules (n = 71/50.60%) were the main clinical characteristics. The lower lip represented the most affected anatomical location (n = 28/22.20%), followed by the upper lip (n = 27/21.60%). Surgical removal was the treatment of choice (n = 53/35.70%). Twelve different dermal fillers were reported in the study, and the microscopic characteristics of the cases varied according to the material used. The results based on case series and case reports showed that nodule and swelling were the main clinical characteristics of FBR related to orofacial esthetic fillers. The histological characteristics depended on the type of the filler material used.

Whole-exome sequencing of oral epithelial dysplasia samples reveals an association with new genes.

The genetic basis of oral epithelial (OED) is unknown, and there is no reliable method for evaluating the risk of malignant transformation. Somatic mutations are responsible for the transformation of dysplastic mucosa to invasive cancer. In addition, these genomic variations could represent objective markers of the potential for malignant transformation. We performed whole-exome sequencing of 10 OED samples from Brazilian and Chilean patients. Using public genetic repositories, we identified 41 deleterious variants that could produce high-impact changes in the amino acid structures of 38 genes. In addition, the variants were filtered according to normal skin and Native American genome profiles. Finally, 13 genes harboring 15 variants were found to be exclusively related to OED. High-grade epithelial dysplasia samples showed a tendency to accumulate highly deleterious variants. We observed that 62% of 13 OED genes identified in our study were also found in head and neck squamous cell carcinoma. Among the shared genes, eight were not identified in oral squamous cell carcinoma. To our knowledge, we have described for the first time 13 genes that are found in OED in a Latin American population, of which five genes have already been observed in oral squamous cell carcinoma. Through this study, we identified genes that may be related to basal biological functions in OED.

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.

Acinic cell carcinoma of the oral and maxillofacial region: an international multicenter study

Abstract The aim of this study was to describe the prevalence, clinicopathological, and prognostic features of acinic cell carcinoma (AciCC) of the oral and maxillofacial region. AciCC cases were retrospectively retrieved from 11 pathology centers of three different countries. Medical records were examined to extract demographic, clinical, pathologic, and follow-up information. A total of 75 cases were included. Females (65.33%) with a mean age of 45.51 years were mostly affected. The lesions usually presented as an asymptomatic (64.28%) nodule (95.66%) in the parotid gland (70.68%). The association of two histopathological patterns was the most common finding (48.93%) and the tumors presented mainly conventional histopathological grades (86.11%). Surgical treatment was performed in the majority of the cases (59.19%). Local recurrence was observed in 20% of the informed cases, regional metastasis in 30.43%, and distant metastasis in 12.50%. The statistical analysis showed that the cases with a solid histopathological pattern (p=0.01), high-grade transformation (p=0.008), recurrence (p=0.007), and regional metastasis (p=0.03) were associated with poor survival. In conclusion, high histopathological transformation, presence of nodal metastasis, and recurrence were prognostic factors for AciCC of the oral and maxillofacial region.

Whole-exome sequencing of oral epithelial dysplasia samples reveals an association with new genes

Abstract The genetic basis of oral epithelial (OED) is unknown, and there is no reliable method for evaluating the risk of malignant transformation. Somatic mutations are responsible for the transformation of dysplastic mucosa to invasive cancer. In addition, these genomic variations could represent objective markers of the potential for malignant transformation. We performed whole-exome sequencing of 10 OED samples from Brazilian and Chilean patients. Using public genetic repositories, we identified 41 deleterious variants that could produce high-impact changes in the amino acid structures of 38 genes. In addition, the variants were filtered according to normal skin and Native American genome profiles. Finally, 13 genes harboring 15 variants were found to be exclusively related to OED. High-grade epithelial dysplasia samples showed a tendency to accumulate highly deleterious variants. We observed that 62% of 13 OED genes identified in our study were also found in head and neck squamous cell carcinoma. Among the shared genes, eight were not identified in oral squamous cell carcinoma. To our knowledge, we have described for the first time 13 genes that are found in OED in a Latin American population, of which five genes have already been observed in oral squamous cell carcinoma. Through this study, we identified genes that may be related to basal biological functions in OED.

The use of micronucleus assay in exfoliated oral cells in patients undergoing fixed orthodontic therapy: a systematic review with meta-analysis

Abstract The aim of this systematic review was to evaluate published papers regarding the micronucleus assay in oral mucosal cells of patients undergoing orthodontic therapy (OT). A search of the scientific literature was made in the PubMed, Scopus, and Web of Science databases for all data published until November, 2021 using the combination of the following keywords: "fixed orthodontic therapy," "genetic damage", "DNA damage," "genotoxicity", "mutagenicity", "buccal cells", "oral mucosa cells," and "micronucleus assay". The systematic review was designed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Nine studies were retrieved. Some authors demonstrated that OT induces cytogenetic damage in oral mucosal cells. Out of the nine studies included, two were classified as strong, five as moderate, and two as weak, according to the quality assessment components of the Effective Public Health Practice Project (EPHPP). Meta-analysis data revealed no relationship between mutagenicity in oral cells and OT in different months of treatment. At one month, the SMD = 0.65 and p = 0.08; after three months of OT, the SMD = 1.21 and p = 0.07; and after six months of OT, the SMD = 0.56 and p = 0.11. In the analyzed months of OT, I2 values were >75%, indicating high heterogeneity. In summary, this review was not able to demonstrate that OT induces genetic damage in oral cells. The study is important for the protection of patients undergoing fixed OT, given that mutagenesis participates in the multi-step process of carcinogenesis.

Survival of young and elderly adults with oral squamous cell carcinoma in a population in northeastern Brazil

To compare the profile and overall survival of young adults and elderly people diagnosed with SCC. Methods: A retrospective study was carried out at a High Complexity Oncology Unit, between 2010 and 2016. A descriptive analysis, a bivariate analysis using the chi-square and Fisher's exact test and the Kaplan-Meier estimator were performed. The predictor variables were tested using the log-rank test and those with statistical significance and the literature were maintained for the Cox regression model. Results: 282 cases of SCC were recorded, with only 12.4% diagnosed in young adults. The profile was similar between groups, with the majority of cases of the disease occurring in males, smokers and alcohol consumers. The lesions predominantly located on the tongue and were diagnosed in an advanced stage of the disease, resulting in 35.7% of deaths. The median survival time was 30 months in the elderly and 31 months in young people. In the multivariate analysis, age was not statistically significant, only staging and treatment were predictors of reduced overall survival. Conclusion: Tumor staging, and treatment were prognostic factors for the disease

Calcifying odontogenic cyst with AOT-like features: a case report and literature review / Cisto odontogênico calcificante com características adenomatóides: relato de caso e revisão de literatura

Odontogenic lesions are a heterogeneous group of diseases that presents differences in their biological behavior and the occurrence of variable inductive interactions. Calcifying odontogenic cyst (COC), or Gorlin's cyst, is a well-recognized example of these lesions. We describe a case of COC with AOT-like areas and highlights its morphological diversity. A 60-year-old pheoderma man presented with a large swelling in the anterior buccal region of the mandible. Panoramic radiography revealed a well-defined, unilocular, radiolucent lesion associated with important root resorption. Complete enucleation of the lesion was performed and the histopathological findings met the criteria for the diagnosis of COC, although the cyst exhibited unusual AOT-like features. The patient has been recurrence free for 6 months after surgery. COCs with AOT-like features are rare, and reflect the multipotentiality and complexity of the inductive effects of the odontogenic epithelium with the ectomesenchyme. Enucleation seems to be the most indicated treatment, similar to classical COC (AU)

As lesões odontogênicas são um grupo heterogêneo de patologias que apresentam diferenças no seu comportamento biológico, e ocorrência de interações indutivas variáveis. O cisto odontogênico calcificante (COC), ou cisto de Gorlin, é um exemplo bem conhecido destas lesões. Descrevemos um caso de COC com áreas adenomatóides e destacamos a sua diversidade morfológica. Paciente do sexo masculino, 60 anos de idade, apresentou um aumento de volume na região anterior da mandíbula. A radiografia panorâmica revelou uma lesão bem definida, unilocular e radiolúcida associada a uma reabsorção radicular importante. A enucleação completa da lesão foi realizada e os achados histopatológicos preencheram os critérios para o diagnóstico de COC, embora o cisto exibisse características adenomatóides pouco usuais. O paciente permanece livre de recidivas durante 6 meses após a cirurgia. Os COCs com características adenomatóides são raros, e refletem a multipotencialidade e complexidade dos efeitos indutivos do epitélio odontogênico com o ectomesênquima. A enucleação parece ser o tratamento mais indicado, semelhante ao COC clássico. (AU)

Assessment of the relationship between tooth inclination and gingival and alveolar bone dimensions using computed tomography of the maxillary anterior teeth: a cross-sectional study.

OBJECTIVE: The present study aimed to investigate the relationship between tooth inclination and gingival and bone dimensions in maxillary anterior teeth. METHODS: This cross-sectional study included cone-beam computed tomography (CBCT) images of 160 maxillary anterior teeth (30 individuals). Tooth inclination, gingival and bone thickness, and distances from cementoenamel junction to alveolar bone crest and gingival margin were measured in the labial surface. The correlations were analyzed using Pearson and partial correlation tests (p≤0.05). RESULTS: In the central incisors, tooth inclination was positively and significantly related to apical bone thickness (R = 0.34, p= 0.001). In the canines, tooth inclination was negatively and significantly related to cervical bone thickness (R = - 0.34, p= 0.01) and positively associated to apical bone thickness (R = 0.36, p= 0.01) and to gingival margin-cementoenamel junction distance (R = 0.31, p= 0.03). In the lateral incisors, tooth inclination was not associated with gingival or bone dimensions. CONCLUSIONS: In the central incisors, the greater the labial tooth inclination, the greater is the apical bone thickness. In the canines, the greater the labial tooth inclination, the smallest is the cervical bone thickness, the greater is the apical bone thickness, and the greater is the gingival margin. Gingival and bone dimensions should be assessed when planning orthodontic treatment involving buccal movement of central incisors and canines.

Florid cemento-osseous dysplasia-related osteonecrosis: A series of cases.

OBJECTIVE: The aim of this study was to assess the clinicopathological features of florid cemento-osseous dysplasia (FCOD)-related osteonecrosis highlighting their histopathological aspects and bone structure. METHODS: Twenty-two FCOD-related osteonecrosis cases were evaluated retrospectively. Osteonecrosis, osteomyelitis, bacterial colonization, bone resorption, reactive bone, osteon-like structure, lamellar bone, and basophilic lines were analyzed. Specific staining and fluorescence and polarized light microscopy analyses were also performed. RESULTS: The mandible was more affected by FCOD-related osteonecrosis. There was a predominance of African-Brazilian women in the fifth and seventh decades of life. Osteomyelitis was present in 82 % of cases whereas bone resorption and bacterial colonization were present in 100 % of FCOD-related osteonecrosis cases. Thick basophilic lines were seen in all cases (100 %). Actinomycosis and osteoclasts were not often. CONCLUSIONS: This study showed female adult preference, mandibular location, and some findings such as osteomyelitis, bone resorption, and bacterial colonization were histopathological features more frequent in FCOD-related osteonecrosis. In the absence of a close clinical and radiographic correlation, the morphology of the necrotized bone similar to cementum could help to recognize FCOD.

Long term dental transversal stability of Class II division 1 treated with cervical headgear.

INTRODUCTION: In several conditions, outcome stability is a great challenge for Orthodontics. Previous studies have reported that relapse commonly occurs along the years after orthodontic treatment finishing. OBJECTIVE: The aim of the present study was to evaluate in the long-term transversal dental arch changes of Class II division 1 patients treated with cervical headgear and fixed appliance. METHODS: Plaster study casts of 20 patients treated with cervical headgear without dental extractions were 3D-scanned and evaluated in three distinct times: initial (T1), immediate post-treatment (T2) and long-term retention (T3 - minimum 20 years). Transversal teeth distance of maxillary and mandibular canines, premolars and first molars were measured. RESULTS: A statistically significant increase during treatment was observed for all maxillary teeth transversal distances (p< 0.05). In turn, a significant reduction was observed in the long term (p< 0.05). For the mandibular teeth, canine transversal distance presented statistically significant constriction in the retention period (p< 0.05). Mandibular first molars distance was significantly expanded by treatment (p< 0.05) and remained stable in the long term. The changes observed for the other teeth or other times were considered not statistically relevant. CONCLUSIONS: For the accessed sample, transversal changes occurred during treatment and retention phases in Class II division 1 patients treated with cervical headgear and fixed appliance. Relapse was considered statistically relevant, even with the institution of a retention protocol.