Da biópsia para o microscópio: processamento tecidual em odontologia

Objetivo: O objetivo desta revisão de literatura é descrever as etapas fundamentais do processamento tecidual para microscopia óptica com coloração de hematoxilina e eosina (HE) de interesse na odontologia. Revisão de Literatura: O processamento tecidual para coloração com HE é constituída basicamente por 7 etapas sequenciais. Imediatamente após a biópsia, o espécime é fixado em formol a fim de interromper a autólise tecidual. Em seguida, na etapa de clivagem, a peça sofre redução de tamanho para facilitar a penetração do agente fixador. Caso a amostra seja dente ou tecido ósseo, ela passa por um processo de descalcificação prévio à clivagem. Nas etapas de processamento e inclusão ocorre remoção de líquidos do interior das células para que em seu lugar entre parafina, e o tecido é incluido em um molde para formar um bloco rígido de parafina, o qual será cortado na fase de microtomia. Finas secções teciduais são então aderidas a uma lâmina, coloridas e seladas. Conclusão: Um ótimo resultado na obtenção de lâminas histológicas depende da execução correta de todas as etapas do processamento tecidual, sendo também influenciado pelos cuidados do cirurgião-dentista com a amostra a ser enviada ao laboratório.

Aim: The aim of this literature review is to describe the fundamental steps of tissue processing for optical microscopy with hematoxylin and eosin (HE) staining of interest in dentistry. Literature Review: Tissue processing for HE staining basically consists of 7 sequential steps. Immediately after the biopsy, the specimen is fixed in formaldehyde to stop tissue autolysis. Then, in the cleavage stage, it undergoes size reduction to facilitate the penetration of the fixing agent. If the sample is a tooth or bone tissue, it goes through a decalcification process prior to cleavage. In the processing and inclusion stages, liquids are removed from the interior of the cells so that paraffin enters in its place, and the tissue is included in a mold to form a rigid block of paraffin, which will be cut in the microtomy phase. Thin tissue sections are then adhered to a slide, colored and sealed. Conclusion: An excellent result in obtaining histological slides depends on the correct execution of all stages of the tissue processing, and is also influenced by the dentist's care with the sample to be sent to the laboratory.

O papel da infecção e inflamação na etiopatogênese da osteonecrose dos maxilares induzida por medicamentos / The role of infection and inflammation in the etiopathogenesis of medication-related osteonecrosis of the jaw

Objetivo: O objetivo desta revisão de literatura é evidenciar o papel da infecção e inflamação na etiopatogenia da osteonecrose dos maxilares induzida por medicamentos (MRONJ). Revisão da literatura: A MRONJ é uma condição rara e grave que impacta negativamente a vida dos pacientes afetados. Sua etiopatogenia é multifatorial e ainda não foi totalmente compreendida. Uma das hipóteses propostas para explicá-la sugere que, além da inibição do turnover ósseo pelos medicamentos antirreabsortivos, a infecção associada à exodontia e a inflamação local desempenham papel decisivo no desencadeamento da condição. O entendimento da etiopatogenia da MRONJ permite ao cirurgião-dentista a identificação dos pacientes com risco maior para a doença, assim como o auxilia no monitoramento e escolha do manejo mais adequado. No campo da pesquisa, ele pode aprimorar estudos pré-clínicos e aprofundar a investigação de biomarcadores para diagnóstico precoce de MRONJ. Considerações finais: Conhecer a contribuição da infecção e inflamação na etiopatogênese da MRONJ é fundamental para orientar a pesquisa e a adoção de estratégias preventivas para os pacientes em risco, e de manejo e monitoramento adequado para aqueles já acometidos. (AU)

Aim: The aim of this literature review is to highlight the role of infection and inflammation in the etiopathogenesis of drug-induced osteonecrosis of the jaw (MRONJ). Literature review: MRONJ is a rare and serious condition that negatively impacts the lives of affected patients. Its etiopathogenesis is multifactorial and has not yet been fully understood. One of the hypotheses proposed to explain it suggests that, in addition to the inhibition of bone turnover by antiresorptive drugs, the infection associated with tooth extraction and local inflammation play a decisive role in triggering the condition. Understanding the etiopathogenesis of MRONJ allows the dentist to identify patients at higher risk for the disease, as well as assisting in monitoring and choosing the most appropriate management. In research, it can improve preclinical studies and deepen the investigation of biomarkers for early diagnosis of MRONJ. Conclusion: Knowing the contribution of infection and inflammation in the etiopathogenesis of MRONJ is essential to guide research and the adoption of preventive strategies for patients at risk, and adequate management and monitoring for those already affected.(AU)

Zinc and Manganese Imbalances in BALB/c Mice Experimentally Infected with Leishmania (Leishmania) amazonensis.

PURPOSE: The clinical progression of Leishmania (Leishmania) amazonensis infection depends on multiple factors, including immunological status of the host and their genotypic interaction. Several immunological processes depend directly on minerals for an efficient performance. Therefore, this study used an experimental model to investigate the alterations of trace metals in L. amazonensis infection associate with clinical outcome, parasite load, and histopathological lesions, and the effect of CD4 + T cells depletion on these parameters. METHODS: A total of 28 BALB/c mice were divided into 4 groups: 1-non-infected; 2-treated with anti-CD4 antibody; 3-infected with L. amazonensis; and 4-treated with anti-CD4 antibody and infected with L. amazonensis. After 24 weeks post-infection, levels of calcium (Ca), iron (Fe), magnesium (Mg), manganese (Mn), Cu, and Zn were determined by inductively coupled plasma optical emission spectroscopy using tissue samples of the spleen, liver, and kidneys. Additionally, parasite burdens were determined in the infected footpad (inoculation site) and samples of inguinal lymph node, spleen, liver, and kidneys were submitted to histopathological analysis. RESULTS: Despite no significant difference was observed between groups 3 and 4, L. amazonensis-infected mice had a significant reduction of Zn (65.68-68.32%) and Mn (65.98 to 82.17%) levels. Presence of L. amazonensis amastigotes was also detected in the inguinal lymph node, spleen, and liver samples in all infected animals. CONCLUSION: The results showed that significant alterations in micro-elements levels occur in BALB/c mice experimentally infected with L. amazonensis and may increase the susceptibility of individuals to the infection.

Bone cells and their role in physiological remodeling.

PURPOSE: This work compiles the characteristics of bone cells involved in the physiological bone remodeling. METHODS: A narrative review of the literature was performed. RESULTS: Remodeling is a different process from modeling. Remodeling allows old or damaged bone tissue to be renewed, ensuring the maintenance of bone fracture resistance, as well as maintaining calcium and phosphorus homeostasis. We present the role of osteoclasts, a multinucleated cell with hematopoietic origin responsible for resorbing bone. The formation of osteoclasts depends on the cytokines macrophage colony stimulating factor (M-CSF) and receptor activator of NF-kB ligand (RANKL) and can be blocked by osteoprotegerin. Furthermore, this review highlights the features of osteoblasts, polarized cubic cells of mesenchymal origin that deposit bone and also covers osteocytes and bone lining cells. This review presents the five fundamental phases of bone remodeling and addresses aspects of its regulation through hormones and growth factors. CONCLUSIONS: Knowledge of the current concepts of physiological bone remodeling is necessary for the study of the different pathologies that affect the bone tissue and thus helps in the search for new therapies.

Diagnosis of juvenile idiopathic arthritis with asymptomatic involvement of the temporomandibular joint: A case report.

Juvenile idiopathic arthritis (JIA) is a broad term that describes a group of heterogeneous rheumatologic diseases, mainly characterized by inflammation in the joints of children and young people up to 16 years of age. Its etiology is still not well understood and the diagnosis, essentially clinical, begins with the exclusion of other joint diseases. When the disease affects the temporomandibular joint, diagnosis is a challenge, as many patients are asymptomatic. The objective of this paper is to present a case of JIA with severe involvement of the temporomandibular joint and to discuss the clinical, radiographic, laboratory findings and the importance of early diagnosis. The lack of diagnosis of active arthritis in the temporomandibular joint in patients with JIA can cause irreversible effects such as micrognathia, malocclusion and reduced maximum mouth opening. Early diagnosis of temporomandibular joint involvement in JIA is important and needs to be investigated early in the clinical manifestation of systemic disease. Laboratory tests and clinical history are important to define treatment and prognosis, but not to predict temporomandibular joint arthritis. Imaging exams are important diagnostic tools to identify morphological changes in soft and hard tissues of the temporomandibular joint.

Sensitivity and specificity of salivary pipecolic acid in head and neck squamous cell carcinoma

Aim: The aim of the present preliminary case-control study was to test the sensitivity and specificity of salivary pipecolic acid in predicting head and neck squamous cell carcinoma (HNSCC). Methods: High-performance liquid chromatography was used for the analysis of non-stimulated saliva samples from 40 individuals: 20 in the case group (recently diagnosed with untreated HNSCC) and 20 in the control group (individuals without cancer). Both groups included patients taking daily oral hypoglycemic drugs (comorbidity). The case and control groups were matched at a proportion of 1:1 for sex and comorbidity. Results: Mean salivary levels of pipecolic acid were 169.38 ng/ mL in the case group and 114.66 ng/mL in the control group (p<0.001). Individuals who took oral hypoglycemic drugs had higher levels of pipecolic acid in both the case and control groups (p<0.001). The receiver operating characteristic curve analysis revealed 90% sensitivity and 65% specificity for head and neck cancer, with an area under the curve of 0.838 between the case and control groups. Conclusions: Pipecolic acid had high sensitivity for the diagnosis of HNSCC but low specificity in the sample analyzed. Our findings suggest that salivary pipecolic acid levels are associated with glucose homeostasis. Studies with larger samples are required to evaluate the specificity of this metabolite

In silico and in vivo protective effect of Morus nigra leaves on oxidative damage induced by iron overload.

Morus nigra L. is a plant popularly known as 'amoreira preta', very used in folk medicine. Iron overload (hemochromatosis) is a clinical condition that causes damage to various tissues due to oxidative stress. Therapy to control iron overload is still unsatisfactory. The protective effect on oxidative stress induced by iron overload was verified. Phytochemical characterization was evaluated by UHPLC-MS/MS. The in silico toxicity predictions of the main phytochemicals were performed via computer simulation. To induce iron overload, the animals received iron dextran (50 mg/kg/day). The test groups received doses of 500 and 1000 mg/kg of M. nigra extract for six weeks. Body weight, organosomatic index, serum iron, hepatic markers, cytokines, interfering factors in iron metabolism, enzymatic and histopathological evaluations were analyzed. Vanillic acid, caffeic acid, 6-hydroxycoumarin, p-coumaric acid, ferulic acid, rutin, quercitrin, resveratrol, apigenin and kaempferol were identified in the extract. In addition, in silico toxic predictions showed that the main compounds presented a low probability of toxic risk. The extract of M. nigra showed to control the mediators of inflammation and to reduce iron overload in several tissues. Our findings illustrate a novel therapeutic action of M. nigra leaves on hemochromatosis caused by iron overload.

Tucumã (Astrocaryum aculeatum) extract: phytochemical characterization, acute and subacute oral toxicity studies in Wistar rats.

Natural products are often used by the population to treat and/or prevent several disorders. Tucumã is an Amazonian fruit widely consumed by local population and no in vivo toxicity studies regarding its safety are available in the literature to date. Therefore, the phytochemical characterization, acute and repeated dose 28-day oral toxicities of crude extract of tucumã's pulp (CETP) in Wistar rats were evaluated. For the CETP preparation, tucumã pulp was crushed and placed into sealed amber glass jars containing absolute ethanol solution for extraction. CETP phytochemical analyses evidenced the presence of carotenoids, flavonoids, unsaturated and satured fatty acids, and triterpenes. In the acute toxicity, female rats from the test group were treated with CETP at single dose of 2000 mg/kg. For the repeated dose toxicity, CETP was administered to male and female rats at doses of 200, 400 and 600 mg/kg, for 28 days. Body weight was recorded during the experiment and blood, liver and kidney were collected for further analysis. No mortality or toxicity signs were observed during the studies. CETP was classified as safe (category 5, OECD guide), in acute toxicity. In repeated dose study was observed alterations in some biochemical parameters, as well as in oxidative damage and enzymatic activity. Histopathological findings showed renal damage in male rats at higher dose. The data obtained suggest that CETP did not induced toxicity after exposure to a single or repeated doses in female rats. However, in males may be considered safe when given repeatedly in low doses.

Preclinical safety assessment of the crude extract from Sida rhombifolia L. aerial parts in experimental models of acute and repeated-dose 28 days toxicity in rats.

Sida rhombifolia (Malvaceae) is popularly used as a treatment for several pathological conditions; however, there is a lack of studies that identify its compounds and that evaluate comprehensively the safety of its consumption. Therefore, the aim of this study was to determinate the phytochemical constitution of the crude extract of Sida rhombifolia (CESR), and its safety in models of acute and repeated doses (28 days) toxicity. The tested dose for the model of acute toxicity was 2000 mg/kg doses for the repeated dose model were 150, 300 e 600 mg/kg. Hematological, biochemical, histopathological and oxidative markers were investigated. HPLC-DAD-MS analysis evidenced the presence of caffeic acid, coumarin, and rutin. In the acute toxicity model the only altered parameters were tissue ROS, and AST and BUN in serum. As for the repeated dose experiment both hematological and biochemical markers remained within the values of reference for the species. Obtained results demonstrate that the CESR did not present significant toxic effects when administrated orally to male and female rats in acute and repeated doses.

Prevalence of hyposalivation and associated factors in survivors of head and neck cancer treated with radiotherapy.

Hyposalivation and sensation of dry mouth (xerostomia) are one of the most common adverse effects in the treatment of patients with head and neck cancer. OBJECTIVE: This study evaluates the prevalence of late hyposalivation and associated factors in survivors of squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx treated with radiotherapy with or without concomitant chemotherapy. METHODOLOGY: A cross-sectional study was conducted with 88 patients who had concluded radiotherapy at least three months before the study, at a referral center for the treatment of head and neck cancer in the Southern region of Brazil. Hyposalivation was evaluated based on the stimulated salivary flow rate using the spitting method. Multivariate analysis using binary logistic regression was performed to determine the associations between hyposalivation and clinical and demographic variables. RESULTS: Hyposalivation was found in 78.41% of the sample and the mean radiation dose was 63.01 Gy (±9.58). In the crude model of the multivariate analysis, hyposalivation was associated with higher doses of radiation (p=0.038), treatment with concomitant radiotherapy and chemotherapy (p=0.005), and time elapsed since the end of radiotherapy (p=0.025). In the adjusted model of the multivariate analysis, hyposalivation was only associated with dose and time elapsed. Patient who received higher doses of radiation had a 4.25-fold greater chance of presenting hyposalivation, whereas a longer time elapsed since the end of radiotherapy exerted a 75% protective effect against the occurrence of hyposalivation. CONCLUSION: Hyposalivation is a highly prevalence late-onset side effect of radiotherapy in patients treated for head and neck cancer, with a greater chance of occurrence among those who received higher doses of radiation and those who ended therapy less than 22 months before our study. Concomitant chemotherapy and radiotherapy does not seem to increase the chances of hyposalivation compared to radiotherapy alone.

Association between trismus and dysphagia-related quality of life in survivors of head and neck cancer in Brazil.

OBJECTIVES: The aim of this study was to evaluate the association between trismus and other radiation-associated conditions with dysphagia-related quality of life in patients who have undergone radiotherapy of the head and neck. STUDY DESIGN: This cross-sectional study included 88 patients who had squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx and had been treated with 3-dimensional (3-D) conformal radiotherapy, which had been completed at least 3 months earlier. Clinical data were obtained from medical records. Trismus, hyposalivation, and radiation caries were evaluated clinically. Dysphagia-related quality of life (DRQoL) was investigated by using the M. D. Anderson Dysphagia Inventory (MDADI). Binary logistic regression was performed to determine associations between DRQoL and both demographic and clinical variables. RESULTS: The mean total MDADI score was 67.33 ± 15.47, and the physical domain was the most affected (60.28 ± 19.00). Patients with cancer of the mouth and oropharynx had worse scores (P = .001). Trismus was associated with poorer DRQoL in all domains of the MDADI (P = .001) and with a greater chance of moderate to profound swallowing limitation (P = .024). CONCLUSIONS: Trismus and tumors located in the mouth and oropharynx were associated with poor swallowing function, exerting a negative impact on DRQoL.

Histological and inflammatory analysis to diagnostic method of proximal gingivitis by flossing.

OBJECTIVES: The aim of this study was to assess with histological and inflammatory analysis the use of flossing as a diagnostic method for detecting proximal gingivitis. MATERIAL AND METHODS: This is a diagnostic accuracy paper composed of two different studies. In the first study, three groups were identified based on papilla status: bleeding (+) with both methods (N = 26); bleeding (+) with dental floss, but no bleeding (-) with probing (N = 26); and no bleeding (-) with either method (N = 26). One papilla from all 78 participants was biopsied and analyzed for the determination of inflammatory infiltrate and percentage of collagen fibers. Sensibility, specificity, positive and negative predictive, and accuracy values were analyzed. In the second study, the volume of gingival crevicular fluid (GCF) was analyzed in 49 participants with flossing+/probing- and flossing-/probing- at contralateral proximal sites. The GCF volume was compared between these sites (n = 172). RESULTS: Significantly greater frequencies of moderate/intense inflammation were found in the flossing+/probing+ (100%) and flossing+/probing- (92.3%) groups compared to those in the flossing-/probing- (0%) group. Significantly different percentages of collagen fibers were found among the three groups (flossing+/probing+ (40.90 ± 3.68); flossing+/probing- (45.78 ± 4.55); flossing-/probing- (60.01 ± 36.66)) (P < 0.001). Dental floss increased the balance between sensitivity and specificity values and showed highest positive predictive (100%) and accuracy (97%) values. Among the 172 sites evaluated, positive bleeding sites had a significantly greater volume of GCF (38 (27-68)) than negative sites (25 (16-51)) (P < 0.001). CONCLUSIONS: The findings suggest that flossing can be used as a diagnostic method for proximal gingivitis in subjects with no history of periodontitis. CLINICAL RELEVANCE: Dental floss can be used as a complementary diagnostic method for proximal gingivitis in adults without clinical attachment loss in clinical practice as well as epidemiology studies.

Tissue engineering perspectives in dentistry: review of the literature / Perspectivas da engenharia tecidual na Odontologia: revisão de literatura

ABSTRACT Tooth losses due to pathological processes continue to be a reality in daily clinical dentistry, inducing functional and psychological complications in patients. In view of this, a new option for the management of this problem - tissue engineering - has been studied in Dentistry. This field, considered multidisciplinary, uses three key elements for tissue regeneration: scaffolds (extracellular matrices) - natural or synthetic; cells, and growth factors. In this sense, combination of these three elements may induce regeneration of the dental pulp, bone and periodontal tissue, among others. Therefore, the aim of this study was to conduct a literature review, describing the main elements of tissue engineering and their applicability in Dentistry, as a means of updating dental surgeons about this subject.

RESUMO As perdas dentárias, devido aos processos patológicos, ainda são uma realidade na clínica odontológica diária, induzindo complicações funcionais e psicológicas ao paciente. Diante disso, uma nova opção para o manejo desse problema vem sendo estudada na Odontologia, a engenharia tecidual. Essa área, considerada multidisciplinar, utiliza três elementos chaves para a regeneração dos tecidos: os scaffolds (matriz extracelular) naturais ou sintéticos, as células e os fatores de crescimento. Nesse sentido, a combinação desses três elementos pode induzir a regeneração da polpa dentária, tecido ósseo e periodontal, entre outros. Portanto, o objetivo deste estudo é realizar uma revisão da literatura, descrevendo e atualizando os cirurgiões-dentistas sobre os principais elementos da engenharia tecidual e sua aplicabilidade na Odontologia.

Study of Pathological Changes in the Dental Follicle of Disease-Free Impacted Third Molars.

BACKGROUND: The prophylactic extraction of third molars is a common practice in dental offices, but divergent opinions are found in the literature regarding the indication of this procedure. The aim of the present study was to determine the prevalence of pathological changes associated with the pericoronal tissue of asymptomatic impacted third molars that could justify prophylactic extraction. MATERIALS AND METHODS: A cross-sectional observational study was conducted in which 109 pericoronal tissues with no radiographic evidence of pathology were histopathologically analyzed. The specimens were fixed in 10% formalin, embedded in paraffin, stained with hematoxylin and eosin and analyzed individually by two pathologists. RESULT: The frequency of inflammatory infiltrate in the dental follicle of patients older than 20 years of age was significantly higher than that of younger patients (p = 0.004), demonstrating an association between inflammation in the dental follicle and patient age. The occurrence of squamous metaplasia was also greater in patients older than 20 years (p = 0.042), demonstrating that the prevalence of squamous metaplasia increases with age. A significant association was also found between inflammation and squamous metaplasia (p < 0.001). CONCLUSION: Pathological changes may be present in the dental follicle of impacted third molars even in the absence of clinical or radiographic signs of disease.

Oral and oropharyngeal cancer: epidemiology and survival analysis.

OBJECTIVE: To evaluate the epidemiological profile and survival rate of oral and oropharyngeal cancer patients seen at a university hospital. METHODS: A cross-sectional study was carried out by means of the pathological reports of patients with oral and oropharyngeal cancer, seen at a university hospital of the Southern Region, between January 2004 and December 2014. Information was collected on patients and tumors. The mortality rate was gathered from the patient death registry in the Mortality Information System. Data were analyzed using the Kaplan-Meier survival curve and the log-rank test to compare variables. RESULTS: The 5- and 10-year survival rates were 42% and 38%, respectively. The anatomical location had a significant association with survival rate (p=0.001), with the rates were better in the lips (p=0.04), and worse in the oropharynx (p=0.03). There were no statistically significant differences between survival rates according to age, sex, ethnicity, schooling level and histologic grade. CONCLUSION: The survival rates of oral and oropharyngeal cancer were and associated with the anatomical site of the tumor.

Reação liquenoide oral ao amálgama: uma lesão ainda vista / Oral lichenoid reaction to amalgam: a lesion still seen

O amálgama dental ainda é amplamente utilizado na prática odontológica, apesar do acordo assinado na Convenção de Minamata, na qual 140 países comprometeram-se a reduzir o uso do mercúrio. O uso desse material restaurador pode desencadear reações liquenoides orais (RLO) cujas lesões apresentam semelhanças clínicas e histológicas com líquen plano oral (LPO), dificultando o diagnóstico. Aqui relatamos o caso de uma paciente do sexo feminino, de 72 anos, que foi encaminhada com uma lesão na mucosa bucal esquerda, com 10 meses de evolução e queixa de dor. A lesão era adjacente ao segundo molar inferior esquerdo que tinha uma restauração de amálgama. A paciente não apresentava doença sistêmica ou hábitos deletérios e não estava usando drogas continuamente. O diagnóstico clínico presuntivo foi RLO versus LPO. Sessenta dias após a substituição da restauração do amálgama, observou-se a regressão completa da lesão e o diagnóstico final de RLO foi realizado. A avaliação clínica associada aos resultados obtidos após a substituição do material suspeito pode ser suficiente para estabelecer o diagnóstico, embora em alguns casos seja necessária a avaliação histopatológica.

Dental amalgam is still widely used in dental practice, despite the agreement signed at the Minamata Convention, in which 140 countries have committed to reducing the use of mercury. The use of this restorative material may trigger oral lichenoid reactions (OLR) whose lesions show clinical and histological similarities with oral lichen planus (OLP), making diagnosis difficult. Here we report the case of a female patient, 72-year-old, who was referred with a lesion in the left buccal mucosa, with 10 months of evolution and complaint of pain. The lesion was adjacent to the second lower left molar which had an amalgam restoration. The patient had no systemic disease or deleterious habits and was not using drugs continuously. The presumptive clinical diagnosis were OLR versus OLP. Sixty days after the replacement of amalgam restoration the complete regression of the lesion was observed and the final diagnosis of OLR was done. Clinical assessment associated with the results obtained after the replacement of suspect material may be sufficient to establish the diagnosis, although in some cases it may be necessary histopathological evaluation.

Oral and oropharyngeal cancer: epidemiology and survival analysis / Câncer de boca e orofaringe: epidemiologia e análise da sobrevida

ABSTRACT Objective To evaluate the epidemiological profile and survival rate of oral and oropharyngeal cancer patients seen at a university hospital. Methods A cross-sectional study was carried out by means of the pathological reports of patients with oral and oropharyngeal cancer, seen at a university hospital of the Southern Region, between January 2004 and December 2014. Information was collected on patients and tumors. The mortality rate was gathered from the patient death registry in the Mortality Information System. Data were analyzed using the Kaplan-Meier survival curve and the log-rank test to compare variables. Results The 5- and 10-year survival rates were 42% and 38%, respectively. The anatomical location had a significant association with survival rate (p=0.001), with the rates were better in the lips (p=0.04), and worse in the oropharynx (p=0.03). There were no statistically significant differences between survival rates according to age, sex, ethnicity, schooling level and histologic grade. Conclusion The survival rates of oral and oropharyngeal cancer were and associated with the anatomical site of the tumor.

RESUMO Objetivo Avaliar o perfil epidemiológico e a taxa de sobrevida do câncer de boca e orofaringe de pacientes atendidos em um hospital universitário. Métodos Foi realizado um estudo transversal por meio dos laudos anatomopatológicos dos pacientes com câncer de boca e orofaringe atendidos em um hospital universitário, na Região Sul, entre janeiro de 2004 a dezembro de 2014. A partir destes laudos, foram coletadas informações sobre o paciente e o tumor. A taxa de mortalidade foi obtida do registro de óbitos dos pacientes no Sistema de Informações sobre Mortalidade. Os dados foram analisados utilizando a curva de sobrevida pelo método de Kaplan-Meier e o teste de log-rank para a comparação das variáveis. Resultados As taxas de sobrevida em 5 e 10 anos foram 42% e 38%, respectivamente. A localização anatômica apresentou associação significativa com a taxa de sobrevida (p=0,001), sendo que, em lábio, os índices foram melhores (p=0,04) e, em orofaringe, piores (p=0,03). Não houve diferenças estatisticamente significantes entre as taxas de sobrevida de acordo com idade, sexo, etnia, nível educacional e grau histológico. Conclusão As taxas de sobrevida do câncer de boca e orofaringe foram baixas e associadas à localização anatômica do tumor.

Antimicrobial photodynamic therapy with photosensitizer in ethanol improves oxidative status and gingival collagen in a short-term in periodontitis.

BACKGROUND: This study evaluated the antimicrobial photodynamic therapy (aPDT) effects using the methylene blue (MB) in ethanol 20% on systemic oxidative status and collagen content from gingiva of rats with periodontitis. METHODS: Rats were divided into five experimental groups: NC (negative control; no periodontitis); PC (positive control; periodontitis without any treatment); SRP (periodontitis and scaling and root planing), aPDT I (periodontitis and SRP+aPDT+MB solubilized in water), and aPDT II (periodontitis and SRP+aPDT+MB solubilized in ethanol 20%). After 7days of removal of the ligature, the periodontal treatments were performed. At 7/15/30days, gingival tissue was removed for morphometric analysis. The erythrocytes were used to evaluate systemic oxidative status. RESULTS: PC group showed higher lipoperoxidation levels at 7/15/30days. aPDT indicated a protective influence in erythrocytes at 15days observed by the elevation in levels of systemic antioxidant defense. aPDT II group was the only one that restored the total collagen area in 15days, and recovered the type I collagen area at the same time point. CONCLUSIONS: aPDT as an adjunct to the SRP can induce the systemic protective response against oxidative stress periodontitis-induced and recover the gingival collagen, thus promoting the healing periodontal, particularly when the MB is dissolved in ethanol 20%.

Antifungal activity of synthetic antiseptics and natural compounds against Candida dubliniensis before and after in vitro fluconazole exposure.

INTRODUCTION:: This study evaluated the susceptibilities of oral candidiasis-derived Candida albicans, fluconazole-resistant (FR) Candida dubliniensis, and fluconazole-susceptible (FS) C. dubliniensis to synthetic antiseptics [chlorhexidine gluconate (CHX), cetylpyridinium chloride (CPC), and triclosan (TRC)] and natural compounds (carvacrol, eugenol and thymol). METHODS:: Susceptibility tests were performed based on the M27-A3 reference method. The fluconazole-resistant C. dubliniensis strains were obtained after prolonged in vitro exposure to increasing fluconazole concentrations. The geometric mean values for minimum inhibitory concentrations and minimum fungicidal concentrations were compared among the groups. RESULTS:: Fluconazole-susceptible C. dubliniensis was more sensitive to CPC and TRC than FR C. dubliniensis and C. albicans were. However, eugenol and thymol were more active against FR C. dubliniensis. The fungicidal activities of CHX and TRC were similar for the three groups, and FR C. dubliniensis and C. albicans had similar sensitivities to CPC. CONCLUSIONS:: The resistance of C. dubliniensis to fluconazole affects its sensitivity the synthetic antiseptics and natural compounds that were tested.

Antifungal activity of synthetic antiseptics and natural compounds against Candida dubliniensis before and after in vitro fluconazole exposure

ABSTRACT INTRODUCTION: This study evaluated the susceptibilities of oral candidiasis-derived Candida albicans, fluconazole-resistant (FR) Candida dubliniensis, and fluconazole-susceptible (FS) C. dubliniensis to synthetic antiseptics [chlorhexidine gluconate (CHX), cetylpyridinium chloride (CPC), and triclosan (TRC)] and natural compounds (carvacrol, eugenol and thymol). METHODS: Susceptibility tests were performed based on the M27-A3 reference method. The fluconazole-resistant C. dubliniensis strains were obtained after prolonged in vitro exposure to increasing fluconazole concentrations. The geometric mean values for minimum inhibitory concentrations and minimum fungicidal concentrations were compared among the groups. RESULTS: Fluconazole-susceptible C. dubliniensis was more sensitive to CPC and TRC than FR C. dubliniensis and C. albicans were. However, eugenol and thymol were more active against FR C. dubliniensis. The fungicidal activities of CHX and TRC were similar for the three groups, and FR C. dubliniensis and C. albicans had similar sensitivities to CPC. CONCLUSIONS: The resistance of C. dubliniensis to fluconazole affects its sensitivity the synthetic antiseptics and natural compounds that were tested.