Methotrexate delayed wound healing of a pyogenic granuloma in a child with juvenile idiopathic arthritis / Metotrexato atrasou a cicatrização de um granuloma piogênico em criança com artrite idiopática juvenil

A nine-year-old girl with of juvenile idiopathic arthritis (JIA) in use of methotrexate complained of a self-bleeding ulcerated lesion exhibiting a red surface in the lower lip. Pyogenic granuloma was confirmed by histopathological analysis. After the 7th and 15th days, the lip where biopsy had been done exhibited a deficient healing. The case was discussed with the physician for temporary suspension of methotrexate. Complete wound healing of the biopsied site occurred after temporary interruption of the medication. Wound healing after methotrexate temporary suspension allowed concluding that the drug delayed surgical wound healing was a consequence of drug cytotoxicity. (AU)

Uma menina de nove anos de idade com artrite idiopática juvenil (AIJ) em uso de metotrexato queixou-se de lesão ulcerada com sangramento espontâneo que exibia superfície avermelhada em lábio inferior. O granuloma piogênico foi confirmado pelo exame histopatológico. Após o 7º e 15º dias, a região do lábio onde a biópsia foi realizada exibiu cicatrização deficiente. O caso foi discutido com o médico e foi realizada a suspensão temporária do metotrexato que resultou em cicatrização completa. A cicatrização da ferida após a suspensão temporária do metotrexato permitiu concluir que o medicamento retardou a cicatrização da ferida cirúrgica como consequência da citotoxicidade da droga. (AU)

Elastic band causing exfoliation of the upper permanent central incisors.

Objective. This study reports a case in which elastic band use culminated in the loss of the incisors. Case Report. An 11-year-old white girl was seen complaining of pain, with purulent discharge and severe tooth mobility. The bone destruction detected radiographically in the region, despite its single location and absence in posterior quadrants of the maxilla and/or mandible, was similar to that observed in Langerhans cell disease. To our surprise, an elastic band involving the midportion of the roots of the two upper central incisors was found during biopsy. The debris was removed and a metal wire was placed in permanent maxillary right and left incisors. The patient was followed up, but no improvement in tooth mobility was observed. Bone loss increased, and internal resorption and root exposure occurred, which culminated in the extraction of permanent maxillary right and left incisors. Conclusion. The present case highlights the fact that professionals sometimes are confronted by anamnestic reports never seen before.

Emotional assessment of patients with oral lichen planus.

BACKGROUND: Oral lichen planus is a chronic immune-mediated disease with an estimated prevalence of 0.5-2.5% in the general population. Patients with oral lichen planus are often emotionally unstable and anxious and may develop concomitant systemic disorders. The objective of this study was to evaluate emotional characteristics of patients with oral lichen planus. METHODS: Two groups were studied: the first group consisted of 48 patients with a diagnosis of oral lichen planus, and the second group consisted of controls without the disease matched for age and gender at a proportion of 1:1. The emotional state of the patients was evaluated using the State-Trait Anxiety Inventory, SF-36 generic quality of life questionnaire, and the Self Reporting Questionnaire-20. RESULTS AND CONCLUSIONS: The present investigation demonstrated the presence of anxiety and depression in patients with oral lichen planus and a negative impact of the disorder on the patient's quality of life as indicated by impairment of the physical aspect, vitality, mental health, and social aspect domains. This could indicate that associated psychological treatment may be important in the follow-up of these patients.

Correlation of clinical, cytological and histological findings in oral squamous cell carcinomas.

The present study aimed to investigate the efficiency of exfoliative cytology by correlating the clinical lesions of oral squamous cell carcinoma (OSCC) with exfoliative cytology and histopathological findings. Cases of OSCC diagnosed between 1984 and 2010 were analyzed. The inclusion criteria for the present study were the availability of detailed clinical findings and a diagnosis of the disease through exfoliative cytology and histopathology. The cases were assessed and assigned scores, which were then submitted to modal expression analysis, which considers the higher frequency scores, thus relating the variables. The cytological findings demonstrated that the majority of the cases had malignant potential. Exfoliative cytology should be used as a supplementary tool for the diagnosis of OSCC, as it enables the early detection of these lesions. However, cytology should not be used as a substitute for histopathological examination.

Immunohistochemical features of multifocal melanoacanthoma in the hard palate: a case report.

BACKGROUND: Melanoacanthoma (MA) has been described in the oral mucosa as a solitary lesion or, occasionally, as multiple lesions. MA mainly affects dark skinned patients and grows rapidly, showing a plane or slightly raised appearance and a brown to black color. The differential diagnosis includes oral nevi, amalgam tattoos, and melanomas. We report here the case of a 58-year-old black woman who presented multiple pigmented lesions on the hard palate. CASE PRESENTATION: Based on the differential diagnosis of melanoma, a punch biopsy (4 mm in diameter) was performed. The material was fixed in 10% formalin, embedded in paraffin, and stained with hematoxylin-eosin or submitted to immunohistochemical analysis. Immunohistochemistry using antibodies against protein S-100, melan-A, HMB-45, MCM-2, MCM-5, Ki-67 and geminin was performed. Immunohistochemical analysis revealed strong cytoplasmic immunoreactivity of dendritic melanocytes for proteinS-100, HMB-45 and melan-A.Positive staining for proliferative markers (MCM-2, MCM-5, Ki-67) was only observed in basal and suprabasal epithelial cells, confirming the reactive etiology of the lesion. The diagnosis was oral Melanoacanthoma (MA). CONCLUSION: The patient has been followed up for 30 months and shows no clinical alterations. MA should be included in the differential diagnosis of pigmented lesions of the oral cavity.

Cytokeratin profile in exfoliative cytology of smokers.

OBJECTIVE: To compare the expression of cytokeratins (CKs) 6, 16, 19 and pan-cytokeratin (PAN) in oral mucosa cells between smokers and nonsmokers to determine the proliferative activity and expression indicative of a potential for malignant transformation. STUDY DESIGN: Smears were obtained from the left lateral border of the tongue with a cytobrush from 25 smokers and 20 nonsmokers seen at the clinics of São José dos Campos Dental School, São Paulo State University, São José dos Campos, São Paulo, Brazil, and processed for immunohistochemistry. Conventional microscopy was used for qualitative analysis. Proportions were compared statistically by the z-test and Fisher's exact test. RESULTS: The expression of CK6 (p = 0.002), CK16 (p = 0.003), CK19 (p = 0.0001) and PAN (p = 0.008) was higher in oral mucosa smears from smokers compared to nonsmokers. CONCLUSION: The expression of CK6 and CK16 demonstrated increased epithelial proliferation in the oral mucosa of smokers, and expression of CK19 indicated alterations in epithelial maturation. The expression of PAN indicates the need for the investigation of other types of CK in further studies.

Lateral periodontal cyst: a case report and literature review.

BACKGROUND: The lateral periodontal cyst is considered a developmental odontogenic cyst with unusual occurrence. In most cases it is preliminary diagnosed as a radiographic finding, presenting as well circumscribed or as a round or teardrop-shaped radiolucent area. Due to its location it can easily be misdiagnosed as a lesion of endodontic origin. Final diagnosis should be based on histopatological examination. The purpose of this paper is to report a classic case of lateral periodontal cyst located in the anterior region of mandible and to review the relevant literature which describes the clinical, radiological and histopathological features of lateral periodontal cysts. METHODS: A 50 years female patient complained of an asymptomatic gingival swelling in the region between the left mandibular lateral incisor and canine. Radiographic examination revealed a well circumscribed radiolucency with approximately 0.5 cm diameter with a radiopaque margin between the roots of the left mandibular lateral incisor and canine. The adjacent teeth had vital pulp. RESULTS: A total enucleation of the lesion was performed, and intraoperative examination showed a single lesion with no communication between the cyst's cavity and the oral environment. Histological examination revealed that the lesion was "lateral periodontal cyst of developmental origin". There was no recurrence or complications for 24 months follow-up. CONCLUSIONS: The lateral periodontal cyst can be considered in the differential diagnosis when a radioloucent lesion appears adjacent to the roots of vital teeth. The treatment of choice is surgical removal and subsequent histological evaluation to confirm the diagnosis. Relapses are infrequent.

Exfoliative cytology of the oral mucosa: comparison of two collection methods.

This study compared the sampling efficacy of a cytobrush and metal spatula for exfoliative cytology of the oral mucosa. Thirty students with no detectable oral alterations upon clinical examination were submitted to exfoliative cytology of the lateral border of the tongue, using a metal spatula on the left side and a cytobrush on the right side. The smears were stained using the Papanicolaou technique and evaluated for cellularity, cell type, cell distribution, homogeneity, and cellular distortion, as well as the presence of mucus, inflammatory infiltrate, and hemorrhage. A statistical test (Z-test) with a 95% confidence interval (CI) showed a significant difference between the metal spatula and cytobrush in terms of cellularity (p = 0.02) and homogeneity (p = 0.01). No difference between the two methods was observed regarding cell type (p = 0.4, Z-test) or cell distribution for the 95% confidence interval (p = 0.2, Fisher's test). Cell distortion and the presence of mucus were observed in five cases that used the metal spatula and in two cases that used the cytobrush. No hemorrhage or inflammatory infiltrate was detected in any of the slides. Based on the results of this study, the cytobrush produced qualitatively better smears in terms of cellularity and homogeneity compared to the metal spatula.

Spectral region optimization for Raman-based optical biopsy of inflammatory lesions.

OBJECTIVE: The biochemical alterations between inflammatory fibrous hyperplasia (IFH) and normal tissues of buccal mucosa were probed by using the FT-Raman spectroscopy technique. The aim was to find the minimal set of Raman bands that would furnish the best discrimination. BACKGROUND: Raman-based optical biopsy is a widely recognized potential technique for noninvasive real-time diagnosis. However, few studies had been devoted to the discrimination of very common subtle or early pathologic states as inflammatory processes that are always present on, for example, cancer lesion borders. METHODS: Seventy spectra of IFH from 14 patients were compared with 30 spectra of normal tissues from six patients. The statistical analysis was performed with principal components analysis and soft independent modeling class analogy cross-validated, leave-one-out methods. RESULTS: Bands close to 574, 1,100, 1,250 to 1,350, and 1,500 cm(-1) (mainly amino acids and collagen bands) showed the main intragroup variations that are due to the acanthosis process in the IFH epithelium. The 1,200 (C-C aromatic/DNA), 1,350 (CH(2) bending/collagen 1), and 1,730 cm(-1) (collagen III) regions presented the main intergroup variations. This finding was interpreted as originating in an extracellular matrix-degeneration process occurring in the inflammatory tissues. The statistical analysis results indicated that the best discrimination capability (sensitivity of 95% and specificity of 100%) was found by using the 530-580 cm(-1) spectral region. CONCLUSIONS: The existence of this narrow spectral window enabling normal and inflammatory diagnosis also had useful implications for an in vivo dispersive Raman setup for clinical applications.

Papiloma escamoso bucal e condiloma acuminado: relato de caso clínico / Oral squamous papilloma and condyloma accuminattum: a case report

Objetivos: O presente artigo relata um caso clínico de papiloma em ventre lingual associado à história pregressa de condiloma acuminado em região peniana. Materiais e métodos: Paciente do gênero masculino, leucoderma, 28 anos, foi encaminhado à clínica de Propedêutica Estomatológica. O paciente relatou queixa de "condiloma bucal" (sic). O mesmo informou que havia notado uma "bolinha na base da língua" e que havia cauterizado uma lesão peniana há sete meses, com diagnóstico de condiloma acuminado. Ao exame clínico intrabucal notou-se lesão nodular pediculada, papilomatosa, assintomática, de coloração semelhante à mucosa adjacente, localizada em região de freio lingual, medindo aproximadamente 0,5 cm no maior diâmetro. Foi realizada biópsia excisional e o material enviado para exame histopatológico. Resultados: O exame histológico mostrou lesão proliferativa epitelial benigna, constituída por numerosas projeções papíliferas revestidas por epitélio pavimentoso estratificado, que mostrava áreas de espessura aumentada, exibindo várias células com vacuolização citoplasmática, halos perinucleares e/ou aspecto coilocitótico, recebendo diagnóstico de papiloma escamoso. Conclusão: No caso clínico relatado, o papiloma escamoso bucal sugere inter-relação com a história pregressa de condiloma acuminado em região peniana do paciente. Cabe ao cirurgião dentista minuciosa observação clínica e atenta anamnese visando favorecer o diagnóstico, o tratamento, a orientação, e o esclarecimento ao paciente quanto aos riscos e as medidas profiláticas a serem tomadas.

Objectives: This article reports a case of oral papilloma in the ventral tongue associated to previous penile Condyloma acuminatum. Materiais and methods: A white male, 28 years old, was referred to the Propaedeutic Stomatology University Clinic claiming of a nodule at the base of the tongue. He had a penile lesion removed seven months before, with diagnosis of Condyloma acuminatum. Clinical exarnination showed a 0.5 cm intraoral pedunculated nodular papillomatous asymptomatic lesion, located in the tongue frenulum. Excisional biopsy was performed. Results: Histological examination showed a benign epithelial proliferative lesion, presenting numerous long papillary projections with thinned extremities, lined by stratified epithelium, with areas of increased thickness and severa I coilocytotic cells characterized by cytoplasmic vacuolization and perinuclear halos, receiving the diagnosis of squamous papilloma. Conclusion: The oral squamous papilloma, in this case, suggests inter-relationship with the penile Condyloma acuminatum. Dental professionals must be able to make a good clinical examination and anamnesis in order to promote the patients diagnosis, treatment and orientation about the risks and prophylactic measures regarding this lesion.

Cytogenetic damage of oral mucosa by consumption of alcohol, tobacco and illicit drugs.

BACKGROUND: The aim of the present study was to quantitatively evaluate micronuclei (MN) in the mucosa of users of alcohol, tobacco and illicit drugs in a Brazilian population. METHODS: Patients were divided: (i) experimental group - 24 patients users of alcohol, tobacco and illicit drugs from the Center of Psychosocial Care for Alcohol and other Drugs (CAPSad), São José dos Campos city, and (ii) control group: 24 patients attending the clinics of the São José dos Campos Dental School FOSJC-UNESP. Criterion for inclusion in the two groups was no visible clinical alteration in the oral mucosa. Exfoliative cytology specimens were obtained from the left side of the border of the tongue. Feulgen staining was used and 600 cells per subject were evaluated by light microscopy. RESULTS: The frequency of MN and micronucleated cells was analysed statistically using the Kruskal-Wallis and Mann-Whitney tests. The incidence of MN was 3.08 +/- 3.20 in the CAPSad group and 2.08 +/- 1.93 in the control group. The frequency of micronucleated cells was 2.38 +/- 2.57 in the CAPSad group and 1.42 +/- 1.25 in the control group. CONCLUSION: The results showed a higher frequency of MN and micronucleated cells in the CAPSad group, but the difference compared with the control group was not significant.

Cherubism: clinicoradiographic features and treatment.

OBJECTIVES: Cherubism is a congenital childhood disease of autosomal dominant inheritance. This disease is characterized by painless bilateral enlargement of the jaws, in which bone is replaced with fibrous tissue. The condition has sui generis clinical, radiographic and histological features, of which the clinician should be aware for a better differential diagnosis in the presence of a fibro-osseous lesion affecting the bones of the maxillomandibular complex. The purpose of present paper was to review the literature and to report the most important aspects of cherubism in order to facilitate the study of this disease. MATERIAL AND METHODS: Literature was reviewed about cherubism, emphasizing the relevant clinicoradiographic features and treatment. Literature was selected through a search of PubMed and Scielo electronic databases. The keywords used for search were adolescent, cherubism, cherubism/physiopathology, cherubism/treatment, cherubism/radiography. A manual search of the reference lists of the identified articles and the authors' article files and recent reviews was conducted to identify additional publications. Those studies that described new features about cherubism were included in this review. RESULTS: In total 44 literature sources were obtained and reviewed. Studies that described new features about cherubism physiopathology, diagnostics and treatment were reviewed. CONCLUSIONS: Despite the exceptions, cherubism is a clinically well-characterized disease. In cases of a suspicion of cherubism, radiographic examination is essential since the clinical presentation, the location and distribution of the lesions may define the diagnosis. Histopathological examination is complementary. Nowadays, genetic tests should be used for final diagnosis of cherubism.

Gingival squamous cell carcinoma: a case report.

BACKGROUND: Squamous cell carcinoma is a malignant epithelial neoplasm characterized by variable clinical manifestations. When located in the gingiva, this neoplasm may mimic common inflammatory lesions. The aim of this study was to report a case of atypical squamous cell carcinoma, in which the patient had no risk factors for the development of this neoplasm. METHODS: A 61 year old Caucasian female was seen with a 3 month history of a rapidly growing, painful nodule in the gingiva adjacent to tooth #11. Clinical examination revealed a proliferative lesion in the vestibular marginal gingiva of teeth #11 and #12, presenting with purulent exudation. Thus, in view of the clinical symptoms and differential diagnosis of an infectious granulomatous process and malignant neoplasm, an incisional biopsy was obtained from the lesion. RESULTS: The diagnosis of squamous cell carcinoma was made and fourteen days after incisional biopsy, healing was found to be unsatisfactory. The patient was referred for treatment consisting of surgical excision of the tumour. A removable partial denture was fabricated for rehabilitation, one month after surgery of the maxilla; the patient was submitted to dissection of the regional lymph nodes and radiotherapy for an additional 3 months. Three years after the end of treatment, the patient continues to be followed-up and does not show any sign of recurrence. CONCLUSIONS: Gingival squamous cell carcinoma is a condition which chance of cure is higher when carcinomatous lesions are diagnosed and treated early. In this instance dentists play an important role in early detection of gingival squamous cell carcinoma.

Oral exfoliative cytology for the diagnosis of paracoccidoidomycosis in a patient with human immunodeficiency virus: a case report.

BACKGROUND: Paracoccidioidomycosis is not the most common fungal disease in patients infected with human immunodeficiency virus (HIV), except for endemic regions in Latin America countries. CASE: A 33-year-old man with HIV presented with mulberry-like lesions on the palate. The diagnosis was made by exfoliative cytology and Papanicolaou staining. Microscopic analysis revealed fungal structures with birefringent walls and exosporulation conferring an airplane radial motor appearance, or even bowel-like or goblet-like forms compatible with Paracoccidioides brasiliensis. CONCLUSION: This process spares the immunosuppressed patient from undergoing invasive biopsy procedures.

Estudo comparativo entre planigrafia convencional, planigrafia digital e ressonância magnética da ATM em pacientes com disfunção temporomandibular / Comparative study between TMJ conventional planigraphy, digital planigraphy and magnetic resonance imaging of temporomandibular disorder patients

A proposta deste trabalho foi analisar as alterações ósseas da ATM de 75 pacientes com desordens temporomandibulares, por meio de imagens de planigrafia convencional, planigrafia digital e ressonância magnética. O índice temporomandibular foi usado para selecionar os pacientes com alterações intra-articulares, excluindo-se aqueles com somente alterações musculares. Os pacientes foram divididos em três grupos de 25 sujeitos; o grupo 1 foi submetido à planigrafia convencional, o grupo 2 à planigrafia digital e o grupo 3 à ressonância magnética. O teste do qui-quadrado (χ2 ) foi usado para se comparar o número de alterações ósseas da ATM visto nos três grupos, divididas tais alterações em cinco aspectos: espaço articular anterior, cabeça da mandíbula, eminência articular, movimento e posição da cabeça da mandíbula. A planigrafia convencional e a digital tiveram a qualidade de suas imagens analisada pelo programa Aeroimagem 1.0 (Instituto de Estudos Avançados, IEAv, FAB , São José dos Campos, SP, Brasil). O grupo 2 mostrou mais alterações ósseas da ATM do que os grupos 1 (p=0,012) e 3 (p=0,00). Os grupos 1 e 3 não diferiram significativamente entre si (p=0,018). As imagens de planigrafia digital mostraram maior número e melhor distribuição dos níveis de cinza que as de planigrafia convencional pelo programa Aeroimagem 1.0. A planigrafia digital mostrou maior número de alterações ósseas da ATM do que a planigrafia convencional e a ressonância magnética. A planigrafia convencional e a ressonância não diferiram entre si neste aspecto. A planigrafia digital ofereceu maior quantidade de informações e qualidade de imagem que a convencional

The purpose of this study was to analyze TMJ bone alterations in 75 temporomandibular joint disorders patients through conventional planigraphy, digital planigraphy and magnetic resonance imaging. Temporomandibular Index (Pehling et al., 2002) was used to select those patients with intra-articular alterations, excluding those with only muscle alterations. Patients were divided in three groups of 25 each: group 1 was submitted to conventional planigraphy, group 2 to digital planigraphy and group 3 to magnetic resonance imaging. Bone alterations were divided into five aspects: anterior joint space, condyle, articular eminence, condyle position and movement. Statistical χ2 test compared the number of TMJbone alterations among imaging techniques. Digital and conventional planigraphy had their imaging quality analysed by Aeroimagem 1.0 software program. Digital planigraphy showed more TMJ bone alterations than conventional planigraphy (p=0,012) and magnetic resonance imaging (p=0,00). Conventional planigraphy and MRI showed similar number of TMJ bone alterations (p=0,018). Digital planigraphy had a greater number and a better gray level distribution than conventional one, according to Aeroimagem 1.0 program. MRI presented significant more normal cases than the two other techniques, but only in the condyle position aspect. Digital planigraphy showed greater TMJ bone alterations than conventional planigraphy and MRI. Digital planigraphy also offered greater amount of information and better imaging quality than conventional planigraphy

Incontinentia pigmenti presenting as hypodontia in a 3-year-old girl: a case report.

INTRODUCTION: Incontinentia pigmenti or Bloch-Sulzberger syndrome is a rare X-linked dominant disease that mainly affects the skin, eyes, hair, central nervous system and teeth. The disease is predominant among women. Although dermatologic manifestations are among the most important aspects for the diagnosis of the syndrome, they are less damaging to the patient and do not require treatment. However, oral involvement characterized by hypodontia of deciduous and permanent teeth is important for the diagnosis and treatment of the patient. CASE PRESENTATION: We report the case of a 3-year-old girl with ophthalmologic and neurologic disturbances, cutaneous manifestations and hypodontia. Since the patient did not present more damaging manifestations such as neurologic and/or ophthalmologic problems, her most severe complications were related to dental anomalies. The importance of integrated dental treatment, which combines pediatric dentistry, orthodontics and conventional prosthesis, is emphasized. CONCLUSION: Hypodontia is a frequent finding in incontinentia pigmenti, and dentists should be aware of this condition in order to help with the diagnosis.

Imprint cytology of osteosarcoma of the jaw: a case report.

INTRODUCTION: Osteosarcomas are highly malignant bone-forming neoplasms that account for about 20% of all sarcomas. In light of their aggressive behavior, early diagnosis is crucial for determining adequate treatment. Dental professionals may be the first to detect jaw osteosarcomas in their initial stages. The aim of this case report is to draw attention to the possibility of diagnosing this tumor based on clinical, radiographical and cytological characteristics before confirmation by histology. CASE PRESENTATION: A 24-year-old Afro-Brazilian man presented with swelling and pain on the left side of the mandible in the region of the third molar (tooth 38). Radiography showed a poorly delimited intraosseous lesion with radiolucent and radiopaque areas. The cytological aspects were consistent with the diagnosis of osteosarcoma, which was confirmed by biopsy. CONCLUSION: Imprint cytology was found to be a reliable, rapid and easy complementary examination. An early diagnosis of osteosarcoma of the jaw is fundamental to the early determination of an adequate treatment.

Avaliação da importância do exame clínico para os alunos do curso de graduação da Faculdade de Odontologia de São José dos Campos - UNESP / Evaluation of the importance of clinical examination for the undergraduate course students at São José dos Campos School of Dentistry - UNESP

O exame físico e a anamnese são etapas primordiais, além de fundamentais em qualquer área de saúde, visando diagnósticos precisos e tratamentos adequados. O objetivo desse estudo foi avaliar a importância dada pelos alunos, quanto ao processo diagnóstico. 150 alunos voluntários foram avaliados através de um questionário, considerando a importância dada ao exame físico pormenorizado e à anamnese. Os resultados foram analisados por estatística descritiva. 45,6% dos voluntários deixaram de fazer algum tipo de pergunta; 3,88% dos alunos do Noturno e 26,21% do Integral não costumam explicar aos seus pacientes a importância da anamnese; sendo que 66,99% dos alunos costumam avaliar o sistema estomatognático como um todo; e somente 47,57% destes sentem-se motivados a realizar o exame físico extra e intrabucal completo nas clínicas. Frente aos resultados verifica-se a necessidade de novos estudos utilizando outros métodos de avaliação, incluindo avaliações da prática clínica, para o aperfeiçoamento do processo ensinos/ aprendizado (AU).

Physical examination and anamnesis are foremost and fundamental in any health area in order to obtain precise diagnosis and suitable treatment. The objective of this study was to evaluate the importance given by the students to the diagnosis process. A total of 150 volunteer students were evaluated through a questionnaire taking into consideration the importance given to detailed physical examination and anamnesis. The results were analyzed by descriptive statistics: 45.6% of the volunteers failed to ask some kind of question; 3.88% of the students from the night course and 26% from the comprehensive course are not used to explaining the importance of anamnesis to their patients; 66.99% of the students are used to evaluating the stomatognathic system as a whole; and only 47.57% of the students feel motivated to perform the complete extra- and intra-oral physical examination in the clinic. In view of the results, we can see that there is a need for new studies using other evaluation methods, including evaluation of clinical practice, in order to improve the teaching/learning processes (AU).