E-CADERIN, N-CADERIN, SLUG, SNAIL, and TWIST contribute to epithelial-mesenchymal transition in salivary gland tumors.

BACKGROUND: Transcription factors are important in the epithelial-mesenchymal transition process and are possibly related to the development of a more invasive tumor phenotype. Thus, the objective of this study was to analyze the expression and identify the localization of cellular markers related to the epithelial-mesenchymal transition process in salivary gland tumors. STUDY DESIGN: The expression and localization of E-CADERIN, N-CADERIN, SLUG, SNAIL, and TWIST were evaluated, using immunohistochemistry, in 48 salivary gland tumors, being 17 pleomorphic adenomas (PA), 14 adenoid cystic carcinomas (ACC), and 17 mucoepidermoid carcinomas (MEC). these proteins were compared to clinical and histopathologic parameters. normal gland tissues were included for immunohistochemical comparisons. RESULTS: ACC and MEC cases showed higher expression of SNAIL compared to PA. MEC showed high expression of SLUG and TWIST. Low expression of N-CADHERIN, SNAIL, and TWIST in ACC was frequent in T3 and T4. High expression of TWIST in MEC was more frequent at age ≥ 40 years A positive correlation was only observed between N-cadherin/SNAIL in ACC, between SNAIL/TWIST in MEC, and between SLUG/TWIST in PA. CONCLUSION: This study provided insight into EMT-related proteins (E-cadherin, N-cadherin, SNAIL, SLUG, and TWIST) and their contribution to the maintenance of morphogenesis and the development of the salivary gland tumors and showed a positive correlation among N-CADHERIN/SNAIL in ACC and SNAIL/TWIST in MEC.

Epidemiologic profile and prevalence of live births with orofacial cleft in Brazil: a descriptive study / Perfil epidemiológico e prevalência de nascidos vivos com fissura orofacial no Brasil: um estudo descritivo

ABSTRACT Objective: To describe the epidemiological profile and prevalence of live births with orofacial clefts in Brazil between 1999 and 2020. Methods: Descriptive study. The population corresponded to live births with isolated orofacial clefts in Brazil registered in the Live Birth Information System between 1999 and 2020. Descriptive variables were selected according to their availability and grouped into socioeconomic and demographic, maternal and child health care, and biological variables. Data were submitted to a descriptive analysis using the Software for Statistics and Data Science (STATA). Results: During the period, 33,699 children were born with orofacial clefts, and 82.1% (27,677) of them were isolated clefts. Regarding these cases, the majority were cleft lip and palate (9,619 or 34.7%), followed by cleft palate (9,442 or 34.1%), and by cleft lip (8,616 or 31.3%). Conclusions: Live births with orofacial clefts in Brazil were male, white, with birthweight ≥2,500 g and gestational age ≥37 weeks, born by cesarean section, and with Apgar scores ≥7. The cases were more frequent among mothers who were in their first and single pregnancy and had seven or more prenatal appointments. The mothers were 20 and 29 years old, had eight to ten years of study, and were single. The national prevalence of clefts was 4.24/10,000. The South and Southeast regions of Brazil had the highest prevalence, while the lowest prevalence was recorded in the Northeast and North regions. For the Federative Units, the highest and lowest prevalences were found, respectively, in Paraná and Acre.

RESUMO Objetivo: Descrever o perfil epidemiológico e a prevalência dos nascidos vivos com fissuras orofaciais no Brasil entre 1999 e 2020. Métodos: Estudo descritivo. A população correspondeu aos nascidos vivos com fissuras orofaciais isoladas no Brasil registrados no Sistema de Informação de Nascidos Vivos entre 1999 e 2020. As variáveis descritivas foram selecionadas de acordo com a sua disponibilidade e agrupadas em variáveis socioeconômicas e demográficas, de atenção à saúde materno-infantil e biológicas. Os dados foram submetidos a análise descritiva utilizando o Software for Statistics and Data Science (STATA). Resultados: No período, 33.699 indivíduos nasceram com fissura orofacial no Brasil, e 82,1% (27.677) deles foram fissuras isoladas. Com relação a esses casos, a maioria foi de fissuras de lábio e palato (9.619 ou 34,7%), seguidas por fissura de palato (9.442 ou 34,1%) e por fissura de lábio (8.616 ou 31,1%). Conclusões: O perfil epidemiológico dos nascidos vivos com fissuras orofaciais no Brasil foi de nascidos do sexo masculino, da raça/cor branca, por parto cesáreo, com peso ao nascer ≥2,500 g, idade gestacional ≥37 semanas e com índices de Apgar ≥7. Os casos foram mais frequentes entre mães que estavam na primeira gestação, única e que haviam realizado sete ou mais consultas de pré-natal. As mães, com maior frequência, tinham entre 20 e 29 anos, apresentavam oito ou mais anos de estudo, eram solteiras e residiam em cidades do interior. A prevalência nacional de fissuras foi de 4,24/10.000. As Regiões Sul e Sudeste apresentaram as maiores prevalências, enquanto as menores foram registradas nas Regiões Nordeste e Norte. Para as Unidades Federativas, as maiores e menores prevalências foram encontradas, respectivamente, no Paraná e no Acre.

Evaluation of the presence of Th1 response through T-bet and IFN-gamma immunohistochemical expression in lower lip and oral tongue squamous cell carcinomas.

INTRODUCTION: Evaluate the immunohistochemical expression of T-bet and IFN-γ in lower lip (LLSCC) and oral tongue squamous cell carcinoma (OTSCC), verifying the presence of Th1 responses in lesions with different clinical conditions. METHODS AND MATERIALS: Thirty OTSCC and 30 LLSCC were analyzed by immunohistochemistry. T-bet was quantitatively assessed by parenchyma cell and stroma quantification, and IFN-γ was semi-quantitatively analyzed: 1:0-25%; 2:26-50%; 3:51-75%; 4:> 75% immunopositive cells. Histological differentiation degrees were categorized as well differentiated (WD), moderately differentiated (MD), or poorly differentiated (PD). RESULTS: OTSCC presented the highest number of T-bet+, parenchyma (p: 0.006), stroma (p: 0.156), parenchyma/stroma (p: 0.015), with no relationship to histological malignancy grade. IFN-γ higher concentrations in LLSCC were detected in parenchyma, stroma and in parenchyma/stroma (p: 0.000), as well as greater immunoreactivity in WD and MD (p: 0.001). In OTSCC, a positive and statistically significant correlation was observed between T-bet+ in parenchyma and IFN-γ in stroma(r: 0.388; p: 0.034), in addition to a statistically significant positive correlation between T-bet in parenchyma compared to stroma(r: 0.411; p: 0.024) and for IFN-γ in both parenchyma and stroma(r: 0.775; p: 0.000) in LLSCC. Higher T-bet+ was observed in OTSCCs, although higher IFN-γ was detected in LLSCCs. CONCLUSION: Thus, we suggest that, even though LLSCC presented lower T-bet+, the favorable microenvironment in these lesions led to an expressive activation of IFN-γ by T-bet+, considerably acting on Th1 differentiation and in antitumor activity, which, admittedly, present less aggressive behavior, reinforcing once again the important role of this cytokine and its use in strategy to fight cancer.

DNA-ICM as an adjuvant method applied on oral cytological specimens.

OBJECTIVE: This study aimed to evaluate cytology diagnosis accuracy using adjuvant methods in clinical routine for oral cancer. STUDY DESIGN: This prospective study was conducted on 98 patients with clinically potentially malignant or malignant oral cavity lesions. One oral lesion smear was taken from each patient using a cytobrush before biopsy and stored at PreservCyt Thinprep. Samples were cytologically analyzed, and DNA ploidy measurement was performed on the same slide. The diagnostic methods' accuracy was then calculated. RESULTS: In clinical inspection, 61 patients had suspicious lesions for malignancy, whereas 37 had potentially malignant disorders. Cytology associated with DNA image cytometry presented a sensitivity of 81.2% and specificity of 90.9%. When analyzing lesions located in high-risk sites to oral malignancies individually, cytology associated with DNA image cytometry presented a sensitivity of 88.2%, specificity of 100.0%, accuracy of 90.0%, and Kappa value of 0.77 (CI 95%: 0.48-1.00). CONCLUSIONS: Association between cytology and DNA image cytometry is an objective and non-invasive diagnostic method that demonstrated high sensitivity and specificity in diagnosing malignant epithelial squamous cell transformation in the oral cavity.

Polymorphisms associated with oral clefts as potential markers for oral pre and malignant disorders.

OBJECTIVE: To investigate whether genes in the Wnt pathway, which have been previously associated with both oral clefts and oral squamous cell carcinoma, are also associated with oral potentially malignant disorders (leukoplakia, erythroplakia and lichen planus). MATERIALS AND METHODS: Case-control study: Dataset consisted of clinical information linked to DNA samples from affected subjects diagnosed with oral potential malignant disorders and oral cancer and their matched controls. Individual samples, clinical history, and potential risk factors were obtained through the Dental Registry and DNA Repository project of the School of Dental Medicine, University of Pittsburgh. The rs1533767 (WNT11), rs9879992 (GSK3B), and rs3923087 (AXIN2) were tested. After genomic DNA had been extracted, genotyping was performed blindly to clinical diagnosis status. Representation of genotypes and alleles in affected subjects in comparison to the unaffected individuals was determined using PLINK. Additional analysis was performed to investigate associations between environmental (socioeconomic/lifestyle) risk factors and the oral pathologies studied using STATA. RESULTS: Two of the SNPs tested (rs9879992 in GSK3B and rs3923087 in AXIN2) were statistically, significantly associated with the pathologies studied (p = 0.039 and 0.038, respectively). CONCLUSION: Single-nucleotide polymorphisms in genes in the Wnt pathway were associated with oral potentially malignant disorders.

Coast-or Inland Residence and Differences in the Occurrence of Cleft Lip and Cleft Palate.

OBJETIVE: To analyze if differences in lifestyle and environment between coastal and inland areas are associated with differences in frequency of orofacial cleft types. DESIGN: Populational cross-sectional study. SETTING: All live borns with orofacial cleft registered at Brazilian Live Birth Information System between 1999 and 2020. PARTICIPANTS: 33,699 live borns with orofacial cleft. INTERVENTION: Data from borns with orofacial cleft were collected at Brazilian Live Birth Information System. MAIN OUTCOME MEASURE: Differences in frequencies between the cleft types and covariates were determined using chi-square. Bivariate analysis was done to obtain the prevalence ratio of types of clefts by geographic origin. Multiple logistic regression analysis was used to determine adjusted odds ratios, controlling for covariates, establishing a significance level of p value <0.05. RESULTS: The frequency of cleft types was statistically significant different according to geographic origin (inland x coast). For syndromic clefts, the prevalence ratio for cleft lip with/without palate was 3.6 times higher inland (p value = 0.000). Regarding non-syndromics, the prevalence ratio for cleft lip with/without palate was two times higher inland (p value = 0.000). Logistic regression suggested cleft lip with/without palate was 6.33 more likely to occur in inland regions (p value = 0.000). CONCLUSION: Geographic origin was associated with the type of cleft in Brazil, with a higher prevalence of cleft lip with/without palate in inland areas, compared to cleft palate, which was higher in the coast.

Epidemiologic profile and prevalence of live births with orofacial cleft in Brazil: a descriptive study.

OBJECTIVE: To describe the epidemiological profile and prevalence of live births with orofacial clefts in Brazil between 1999 and 2020. METHODS: Descriptive study. The population corresponded to live births with isolated orofacial clefts in Brazil registered in the Live Birth Information System between 1999 and 2020. Descriptive variables were selected according to their availability and grouped into socioeconomic and demographic, maternal and child health care, and biological variables. Data were submitted to a descriptive analysis using the Software for Statistics and Data Science (STATA). RESULTS: During the period, 33,699 children were born with orofacial clefts, and 82.1% (27,677) of them were isolated clefts. Regarding these cases, the majority were cleft lip and palate (9,619 or 34.7%), followed by cleft palate (9,442 or 34.1%), and by cleft lip (8,616 or 31.3%). CONCLUSIONS: Live births with orofacial clefts in Brazil were male, white, with birthweight ≥2,500 g and gestational age ≥37 weeks, born by cesarean section, and with Apgar scores ≥7. The cases were more frequent among mothers who were in their first and single pregnancy and had seven or more prenatal appointments. The mothers were 20 and 29 years old, had eight to ten years of study, and were single. The national prevalence of clefts was 4.24/10,000. The South and Southeast regions of Brazil had the highest prevalence, while the lowest prevalence was recorded in the Northeast and North regions. For the Federative Units, the highest and lowest prevalences were found, respectively, in Paraná and Acre.

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.

Salivary biomarkers to evaluate psychological disorders in oral lichen planus: A systematic review with meta-analysis.

OBJECTIVE: To analyze the use of salivary biomarkers to identify psychological disorders (anxiety, depression, and stress) in individuals with oral lichen planus (OLP). MATERIALS AND METHODS: The search was made in Medline/Pubmed, Scopus, Web of Science, Virtual Health Library, ProQuest, and by cross-reference. Original case-control, cross-sectional, and cohort studies, in human subjects (age ≥18 years) with clinical and histopathological diagnosis, with or without the use of psychometric scales, published until June 2021, were included. Random-effects meta-analyses, subgroup analyses, and sensitivity were performed. Publication bias was measured using the Egger test and visual inspection of the funnel plot. RESULTS: A total of 67 articles were found, of which 12 were included in the meta-analysis. Among the different biomarkers identified, it was only possible to perform a meta-analysis for cortisol. The mean difference between salivary cortisol levels in patients with OLP compared to controls was 3.43 ng/ml (95% CI: 1.20-5.65) with I2  = 98.9%. Studies considered outliers were removed and based on sensitivity analyses, results did not change, therefore, being stable. CONCLUSION: The studies analyzed demonstrated that cortisol was the most quantified biomarker to identify psychological disorders; however, DHEA, IgA, adiponectin, and α-amylase were also evaluated.

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

Oral Lichen Planus: Associations Between Histomorphometric Characteristics and White and Red Lesions.

Histomorphometry seems to provide more rigid quantitative elements for histological analysis and to bring less subjectivity to the diagnosis of oral lichen planus lesions (OLP). This study aimed to verify the association between white and red lesions and histomorphometric characteristics of OLP lesions. This retrospective cross-sectional study assessed 48 hematoxylin- and eosin-stained histological sections from incisional biopsies obtained from OLP cases. A single previously calibrated evaluator performed the light microscopy analyses to evaluate morphological and morphometric parameters. Analyses of associations among variables were performed using the Fisher's exact test. Morphometric variables were assessed using the Mann-Whitney non-parametric test. Comparisons among the three groups (age range) were performed using the Kruskal-Wallis test. In this study, 81.2% of the participants were women aged < 50 years. Keratosis, acanthosis, and inflammatory infiltrates were noted in 10.4, 10.4, and 37.5% of moderate/severe cases, respectively. Inflammatory infiltrate (52.1%), papillary projections (54.2%), saw teeth (12.5%), basal layer degeneration (39.6%), and Civatte bodies (68.8%) were also observed. There was no significant association between lesion type and clinicopathological variables (p > 0.05) or between lesion type and histological (p > 0.05) and morphometric variables (p > 0.05). Furthermore, the morphometric variables analyzed did not differ between white and red lesions (p > 0.05) or in their associations with clinicopathological variables (p > 0.05). The results of this investigation showed no associations between white and red OLP lesions and the histomorphometric characteristics evaluated.

Perfil Epidemiológico e Fatores Relacionados ao Câncer de Cavidade Oral em Adultos Jovens Brasileiros e sua Relação com o Óbito, 1985-2017 / Epidemiological Profile and Factors Related to Oral Cavity Cancer in young Brazilian Adults and its Relationship with Death, 1985-2017 / Perfil Epidemiológico y Factores Relacionados con el Cáncer de Cavidad Oral en Adultos Jóvenes Brasileños y su Relación con la Muerte, 1985-2017

Introdução: A incidência do câncer de cavidade oral entre adultos jovens tem crescido ao longo dos últimos anos, não estando clara a etiologia e a patogênese da neoplasia nesse grupo. Objetivo: Descrever o perfil dos adultos jovens brasileiros diagnosticados com carcinoma de células escamosas (CCE) em cavidade oral e a relação com o óbito entre 1985 e 2017. Método: Estudo transversal de base hospitalar, com indivíduos de 19 a 40 anos, diagnosticados com CCE a partir dos Registros Hospitalares de Câncer do Brasil. Foi realizada a análise descritiva e calculados o teste qui-quadrado, a razão de prevalência (RP) e a regressão logística com intervalo de confiança de 95%. Resultados: Foram elegíveis 1.761 casos de CCE em adultos jovens no período em estudo. O maior número de casos se concentrou na faixa etária de 31≥40 anos (79,80%), homens (71,90%), brancos (50,20%), moradores da Região Sudeste (36,40%), sem companheiro (58,00%) e com o ensino fundamental completo (63,40%). A maioria apresentava hábitos tabagistas (61,60%) e etilistas (56,70%), 18,50% eram profissionais da agricultura/aquicultura e 40,70% relataram histórico familiar de câncer. Foram diagnosticados em estádio avançado 68,10% e 25,50% dos casos foram a óbito. Os casos diagnosticados na língua foram os mais frequentes (42,40%) e apresentaram RP=2,638 (IC95% 2,050-3,394) vezes maior para óbito em relação aos casos no lábio e após ajuste, a odds ratio para esse local aumentou para 7,832 (IC95% 2,625-23,374, p<0,0001). Conclusão: O CCE nessa população necessita de maior atenção para reduzir a incidência e a letalidade desse problema de saúde pública

Introduction: The incidence of oral cavity cancer among young adults has grown over the past few years, and the etiology and pathogenesis of the neoplasm in this group is unclear. Objective: To describe the profile of Brazilian young adults diagnosed with squamous cell carcinoma (SCC) in the oral cavity and the relationship with death between 1985 and 2017. Method: Hospital-based cross-sectional study with individuals, aged 19 to 40, diagnosed with SCC from the Brazilian Cancer Hospital Records. Descriptive analysis was performed and chi-square test, prevalence ratio (PR) and logistic regression were calculated with 95% confidence interval. Results: 1,761 cases of SCC in young adults were retrieved during the study period. The highest number of cases was concentrated in the age group of 31≥40 years (79.80%), males (71.90%), white (50.20%), residents of the Southeast region (36.40%), without partner (58.00%) and completed elementary education (63.40%). 61.60% were smokers, 56.70%, alcoholics, 18.50%, agriculture/aquaculture professionals and 40.70% reported family cancer history. 68.10% were diagnosed at an advanced stage and about 25.50% of the cases died. Cases in the tongue were the most frequent (42.40%) with PR=2.638 (95%CI 2.050-3.394) times higher for death compared to cases in the lip and after adjustment, the odds ratio increased to 7.832 (CI95% 2.625-23.374, p<0.0001). Conclusion: It is necessary to pay more attention to the population with SCC, in order to reduce the incidence and lethality of this public health problem

Introducción: La incidencia de cáncer de cavidad oral entre adultos jóvenes ha aumentado en los últimos años y la etiología y patogenia de la neoplasia en este grupo no está clara. Objetivo: Describir el perfil de los jóvenes adultos brasileños diagnosticados de carcinoma epidermoide (CCE) en la cavidad oral y la relación con la muerte entre 1985 y 2017. Método: Estudio transversal hospitalario con individuos de 19 a 40 años, diagnosticados de CCE a partir de los registros hospitalarios oncológicos de Brasil. Se realizó análisis descriptivo, y se calculó la prueba de chi-cuadrado, razón de prevalencia (RP) y regresión logística con un intervalo de confianza del 95%. Resultados: Un total de 1.761 casos de CCE en adultos jóvenes fueron elegibles durante el período de estudio. El mayor número de casos se concentró en el grupo de edad de 31≥40 años (79,80%), hombres (71,90%), blancos (50,20%), residentes del Sureste (36,40%), sin pareja (58,00%) y con educación básica (63,40%). La mayoría (61,60%) tenía hábito de fumar y beber (56,70%), el 18,50% eran profesionales de la agricultura/acuicultura y el 40,70% referían antecedentes familiares de cáncer. El 68,10% fueron diagnosticados en estadio avanzado y alrededor del 25,50% de los casos fallecieron. Los casos con localización en la lengua fueron los más frecuentes (42,40%) y presentaron RP=2,638 (IC 95% 2,050-3,394) veces mayor para muerte en comparación con los casos en el labio y luego del ajuste, la odds ratio para esta localización aumentó 7,832 (IC95% 2,625 ­23,374, p<0,0001). Conclusión: El CCE en esta población necesita más atención para reducir la incidencia y la letalidad de este problema de salud pública

Presence of Civatte Bodies in an oral lichen planus incisional biopsy sample / Presença de corpos de Civatte em uma amostra de biópsia incisional de líquen plano oral

ABSTRACT Objective: Civatte bodies are colloid bodies of apoptotic keratinocytes located at the dermoepidermal junction and are common in several dermatoses, including lichen planus lesions. The present study aimed to determine the presence of Civatte bodies in a sample of incisional biopsies obtained from patients diagnosed with oral lichen planus. Methods: A retrospective cross-sectional study, carried out with 34 slides stained with hematoxylin-eosin from the archive of an Oral Pathology Laboratory of a Higher Education Institution. The sample obtained was classified into white and red lesions from the available clinical data. Histological analyses were performed under a light microscope, with 10x and 40x objectives, identifying the presence or absence of Civatte bodies. Results: Colloid bodies were present in 73.5% the total sample studied and in 74.2% white lesions. Conclusion: The Civatte bodies were frequent in all samples analysed and should thus be considered a criterion for histological diagnosis in lesions of Oral Lichen Planus.

RESUMO Objetivo: Corpos de Civatte são corpos coloidais de queratinócitos apoptóticos localizados na junção dermoepidérmica e que são frequentes em várias dermatoses, inclusive as lesões de líquen plano. O objetivo do presente trabalho foi determinar a presença de corpos de Civatte em uma amostra de biópsias incisionais obtidas a partir de pacientes com diagnóstico de líquen plano oral (LPO). Métodos: Tratou-se de um estudo transversal retrospectivo, realizado com 34 casos cujas lâminas foram coradas pela hematoxilina-eosina, pertencentes ao arquivo de um Laboratório de Patologia Oral de Instituição de Ensino Superior. A amostra obtida foi classificada em lesões brancas e vermelhas a partir dos dados clínicos disponíveis. As análises histológicas foram realizadas em microscópio de luz, nas objetivas de 10x e 40x, com identificação dos corpos de Civatte como presentes ou ausentes. Resultados: Os corpos colóides estavam presentes em 73,5% da amostra total estudada e em 74,2% das lesões brancas. Conclusão: Os corpos de Civatte foram frequentes em todas as amostras analisadas e não devem ser negligenciados como critério de diagnóstico histopatológico em lesões de LPO.

In vitro determination of potentially bioavailable fluoride in diet and toothpaste after ingestion

Aim: To propose a new method to determine in vitro potentially bioavailable fluoride (F) in diet and toothpaste after ingestion. Methods: Diet samples (D) were obtained from 15 portions of a meal served to children in a day care centre. To simulate the ingestion of toothpaste during brushing after meals, a specific amount of toothpaste was added to the diet samples (D + T). F was determined in D and D + T after incubation in a solution that simulated "gastric juice" (0.01 M hydrochloric acid) at 37oC for 30, 60 and 120 min. Microdiffusion facilitated by HMDS was used to determine the total F concentrations in samples D and D + T. The analyses were performed using an ion specific electrode. Results: For D samples, incubation in "gastric juice" for 30, 60 and 120 min resulted in F concentrations (µg F/mL) of 0.75 ± 0.06c, 0.77 ± 0.07c and 0.91 ± 0.09b, corresponding to 75.3, 77.3 and 90.7% of the total F (1.02 ± 0.12a), respectively (p = 0.0001; ANOVA + Tukey). For D + T samples, these values of F concentrations (µg F/mL) were 2.55 ± 0.46b, 2.83 ± 0.44ab and 3.15 ± 0.37a, corresponding to 86.9, 94.8 and 106.7% of the total F (2.99 ± 0.34a), respectively (p = 0.0023; ANOVA + Tukey). Conclusion: Then, it can be concluded that the proposed method of "gastric juice" is a promising protocol for determining potentially bioavailable fluoride in the diet and toothpaste after ingestion. However, additional studies are desirable

Toxicidades orales de la terapia contra el cáncer en niños y adolescentes: un estudio descriptivo / Toxicidades orais da terapia oncológica em crianças e adolescentes: um estudo descritivo / Oral toxicities of oncology therapy in children and adolescents: a descriptive study

Resumen Introducción y objetivo: El cáncer es la segunda causa de muerte entre niños y adolescentes en Brasil. Evaluar la prevalencia de toxicidades orales derivadas del tratamiento oncológico en niños y adolescentes atendidos en el Hospital Estadual da Criança, de 2016 a 2017. Materiales y métodos: Se trata de un estudio descriptivo con datos obtenidos de historias clínicas. Se estudiaron variables relacionadas con la neoplasia, el portador, las toxicidades orales y el tratamiento oncológico, las cuales fueron analizadas de forma descriptiva y se realizó la prueba de la χ2 de Fisher para algunas de ellas. Resultados: Se identificaron 58 pacientes, en su mayoría mujeres (53%) y con edades entre 3 y 5 años (28%), con una media de 6,62 años. La neoplasia más común fue la leucemia linfoide aguda (38%), siendo la quimioterapia sola, la modalidad terapéutica más utilizada (67%), especialmente con el uso de citarabina (60%) y vincristina (56%). Veintitrés (40%) de los niños y adolescentes presentaron alguna toxicidad oral durante la terapia oncológica, por lo que a 4 (17,4%) se les interrumpió el tratamiento antineoplásico. La mucositis oral (70%) fue la toxicidad más común, afectando los labios en el 55% y fue asociada a dolor en el 64% de los casos. Dieciocho (78,2%) pacientes recibieron tratamiento por toxicidad oral, prescribiéndose nistatina en el 88,9% de los casos. Además, hubo una asociación significativa entre el estado de supervivencia y el lugar de residencia (p=0,03). Conclusiones: Entre los 58 niños y adolescentes estudiados, el 40% presentó toxicidades orales y 4 tuvieron interrumpido el tratamiento antineoplásico por este motivo. Así, se refuerza la importancia y la necesidad de la actuación del odontólogo en el equipo multidisciplinario en oncología.

Abstract Introduction and objective: Cancer is the second leading cause of death among children and adolescents in Brazil. To evaluate the prevalence of oral toxicities resulting from cancer treatment in children and adolescents treated at the Hospital Estadual da Criança, from 2016 to 2017. Material and methods: This is a descriptive study with data obtained from medical records. Variables related to neoplasia, carrier, oral toxicities and cancer treatment were studied, which were analyzed descriptively and thFisher χ2 test was performed for some of them. Results: Fifty eigth patients were identified, mostly female (53%) and aged between 3 and 5 years (28%), with an average of 6.62 years. The most frequent neoplasm was acute lymphoid leukemia (38%), with chemotherapy alone being the most used therapeutic modality (67%), especially with the use of cytarabine (60%) and vincristine (56%). Twenty-three (40%) of the children and adolescents exhibited some oral toxicity during cancer therapy, and for this reason, 4 (17.4%) had their antineoplastic treatment interrupted. Oral mucositis (70%) was the most common toxicity, affecting the lips in 55% and being associated with pain in 64% of cases. Eighteen (78.2%) patients received treatment for oral toxicities, with nystatin being prescribed in 88.9% of cases. In addition, there was a significant association between survival status and place of residence (p=0.03). Conclusions: Among the 58 children and adolescents studied, 40% had oral toxicities and 4 had their antineoplastic treatment interrupted for this reason. Thus, the importance and the need for the performance of the dentist in the multidisciplinary team in oncology is reinforced.

Resumo Introdução e objetivo: O câncer é a segunda maior causa de morte entre crianças e adolescentes no Brasil. Avaliar a prevalência de toxicidades orais decorrentes do tratamento oncológico em crianças e adolescentes atendidos no Hospital Estadual da Criança, no período de 2016 a 2017. Materiais e métodos: Trata-se de um estudo descritivo com dados obtidos de prontuários médicos. Foram estudadas variáveis relacionadas à neoplasia, ao portador, às toxicidades orais e ao tratamento oncológico, que foram analisadas descritivamente e o teste χ2 de Fisher foi aplicado para algumas delas. Resultados: Foram identificados 58 pacientes, com maioria do sexo feminino (53%) e idade entre 3 e 5 anos (28%), com média de 6,62 anos. A neoplasia maligna mais frequente foi a leucemia linfóide aguda (38%), sendo a quimioterapia isolada a modalidade terapêutica mais empregada (67%), especialmente com uso de citarabina (60%) e vincristina (56%). Vinte e três (40%) das crianças e adolescentes exibiram alguma toxicidade oral durante a terapia oncológica, e por esta razão, 4 (17,4%) tiveram o tratamento antineoplásico interrompido. A mucosite oral (70%) foi a toxicidade mais comum, acometendo os lábios em 55% e estando associada a dor em 64% dos casos. Dezoito (78,2%) pacientes receberam tratamento para as toxicidades orais, sendo a nistatina prescrita em 88,9% dos casos. Ademais, observou-se associação significante entre status de sobrevida e local de residência (p=0.03). Conclusões: Dentre as 58 crianças e adolescentes estudadas, 40% apresentou toxicidades orais e 4 tiveram o tratamento antineoplásico interrompido por esta razão. Desta forma, reforça-se a importância e a necessidade da atuação do cirurgião-dentista na equipe multiprofissional em oncologia.

Fatores comportamentais desenvolvidos na adolescência e sua influência na etiologia do câncer de cavidade oral / Behavioral factors developed in adolescence and its influence on oral cavity cancer etiology

Introdução: o sistema de saúde brasileiro enfrenta um importante desafio com o aumento da incidência e taxa de letalidade das doenças crônicas não transmissíveis. Entre elas encontra-se o câncer de cavidade oral que se desenvolve com a interação de múltiplos fatores, especialmente de ordem ambiental, evitáveis, que são instalados muitas vezes durante a adolescência. Objetivo: realizar revisão de literatura referente à prevalência, em adolescentes, de fatores comportamentais de risco que podem levar ao desenvolvimento do câncer oral. Metodologia: foi realizada revisão narrativa a fim de levantar os principais trabalhos referentes à temática. O levantamento bibliográfico foi conduzido através de bases de dados on-line, referente ao período de 2008 a 2018, utilizando os descritores: fatores de risco comportamentais, adolescentes, câncer oral, tabaco, álcool, HPV, e dieta de forma combinada, nos idiomas português e inglês. Foram incluídos aqueles documentos que apresentaram as expressões utilizadas nas buscas no título ou palavras-chave, ou tinham explícito no resumo que o texto estava relacionado ao tema, dentro da temporalidade especificada. Resultados e Discussão: foram identificados 12 artigos sobre o tema que apontaram como principais fatores comportamentais desenvolvidos na adolescência o tabagismo, o alcoolismo, e os comportamentos sexuais e alimentares, os quais representam importantes fatores de riscos na instalação do câncer oral. Conclusão: é consenso na literatura a necessidade, na maioria dos casos, de acumulação temporal dos fatores etiológicos desta doença, tendo assim a adolescência como uma fase promissora para o estabelecimento de hábitos saudáveis ou nocivos para a saúde do indivíduo.

Introduction: the Brazilian health system faces an important challenge with the increasing incidence and case fatality rate of c chronic diseases. These include oral cavity cancer that develops through the interaction of multiple, especially environmental, preventable factors that often develop during adolescence. Objective: to review the literature regarding the prevalence in adolescents of behavioral risk factors that may lead to the development of oral cancer. Metodology: narrative review was performed in order to survey the main works related to the theme. The literature review was conducted through online databases, from 2008 to 2018, using the descriptors: behavioral risk factors, adolescents, oral cancer, tobacco, alcohol, HPV, and diet in a combined manner, in Portuguese and English. We included those documents that presented the expressions used in the search in the title or keywords, or had explicit in the abstract that the text was related to the theme, within the specified temporality. Results and Discussion: twelve articles on the topic were identified that pointed as the main behavioral factors developed in adolescence, smoking, alcoholism, and sexual and eating behaviors, which represent important risk factors in the onset of oral cancer. Conclusion: there is a consensus in the literature on the need, in most cases, for the temporal accumulation of the etiological factors of this disease, thus having adolescence as a promising phase for the establishment of healthy or harmful habits for the individual's health.

Acurácia do diagnóstico clínico de lesões orais malignas em um Centro de Referência do Nordeste Brasileiro / Accuracy of clinical diagnosis of oral malignant lesions in a Northeastern Brazilian Reference Center

Objetivo: avaliar a acurácia do diagnóstico clínico comparando com o diagnóstico histopatológico de lesões malignas analisadas no Laboratório de Patologia Oral do Centro de Referências de Lesões Orais da Universidade Estadual de Feira de Santana. Metodologia: foi realizado um estudo de validade de diagnóstico em uma amostra composta por 1.926 casos que foram submetidos à biópsias orais no período de 2005 a 2017. Resultados: observou-se que a sensibilidade do diagnóstico clínico na detecção de lesões malignas foi de 75% e a especificidade foi de 97%. O valor preditivo positivo foi de 77% e o valor preditivo negativo foi de 95%. O valor da acurácia foi de 95%, correspondendo assim a uma acurácia alta. Os indivíduos com lesões malignas eram do sexo masculino (65,9%) e acima de 40 anos (93,2%). Ao analisar as características clínicas das lesões, foi observado que a localização mais frequente foi a língua (29,4%), com coloração vermelha (54,9%), sendo a úlcera (50%) a lesão fundamental mais comum. As lesões se apresentaram maiores que 10cm (72,7%) e 54,4% das lesões estiveram presentes há mais de 12 meses na cavidade oral. Conclusões: o exame clínico demonstrou uma alta precisão na identificação de lesões malignas em cavidade oral, demonstrando assim a importância do conhecimento prévio das características das lesões por estudantes e profissionais da Odontologia. Entretanto, apesar de sua validade, não se deve abrir mão do exame histopatológico para a confirmação da suspeita clínica.

Purpose: to evaluate the accuracy of the clinical diagnosis comparing with the histopathological diagnosis of malignant lesions analyzed in the Laboratory of Oral Pathology of the Center of Reference of Oral lesions of the State University of Feira de Santana. Methodology: a diagnostic validity study was performed in a sample of 1,926 oral biopsies cases from 2005 to 2017. Results: it was observed that the sensitivity of the clinical diagnosis in the detection of malignant lesions was 75% and the specificity was 97%. The positive predictive value was 77% and the negative predictive value was 95%. The value of the accuracy was 95%, thus corresponding to a high accuracy. The individuals with malignant lesions were male (65.9%) and over 40 (93.2%). The clinical characteristics of the lesions were analyzed and it was observed that the most frequent location was the tongue (29.4%), with a red color (54.9%), and ulcer (50%) was the most common fundamental lesion. The lesions were larger than 10cm (72.7%) and 54.4% of the lesions were present for more than 12 months in the oral cavity. Conclusions: the clinical examination demonstrated a high validity in the identification of malignant lesions in the oral cavity, thus demonstrating the importance of prior knowledge of the characteristics of the lesions by students and dental professionals. However, despite its reliability, the histopathological examination should not be dismissed, due to confirm the clinical suspicion.

Relationship of psychological factors with salivary flow rate and cortisol levels in individuals with oral lichen planus: A case-control study.

OBJECTIVE: The objective of this study was to analyze the relationship between psychological factors and salivary flow rate and cortisol levels in individuals with oral lichen planus. STUDY DESIGN: A case-control study of 21 individuals with clinical and histopathological diagnosis of oral lichen planus and 21 individuals without the disease (controls), matched by sex and age, was performed. The Beck Anxiety and Depression Inventories and Perceived Stress Scale were administered, and the salivary flow rate and salivary cortisol secretion pattern were determined. Data were statistically analyzed using Mann-Whitney U, McNemar's χ2, and Student's t tests and the Spearman correlation coefficient. The significance level adopted was 5%. RESULTS: Individuals with oral lichen planus had higher anxiety (P = .001), depression (P = .005), and perceived stress (P = .026) scores, but no association was found between the disease and salivary flow rate (P = .29) or with the pattern of salivary cortisol secretion (at awakening: P = .98; 30 min post-awakening: P = .95; at bedtime: P = .97). CONCLUSION: An association was observed between oral lichen planus and anxiety, depression, and stress scores through psychological tests but not in relation to salivary flow rate and the pattern of salivary cortisol secretion.

Perfil clínico-epidemiológico das fissuras orofaciais em um centro de referência do nordeste do Brasil / Clinical-epidemiological profile of orofacial fissures in a reference center from northeast Brazil / Perfil clinico-epidemiológico de las fisuras orofaciales en un centro de referencia en el noreste de Brasil

RESUMO Objetivo Descrever o perfil clínico-epidemiológico dos portadores de fissuras orofaciais, atendidos em um Centro de Referência do Nordeste do Brasil. Métodos Estudo descritivo, baseado em dados secundários de prontuários médicos. Informações sociodemográficas do portador e da mãe, uso de medicamentos durante a gestação, aspectos clínicos e cirúrgicos relacionados às fissuras, histórico familiar da malformação e consanguinidade dos pais foram investigadas. Os dados foram analisados descritivamente, com o uso do programa estatístico SPSS (Statistical Package for te Social Sciences), no qual foram obtidas medidas de frequência, média e desvio padrão. Resultados 51,1% dos portadores de fissuras orofaciais eram do sexo feminino, 46,2% menores de um ano e 54,4% eram procedentes na zona urbana. A maioria das mães encontrava-se na faixa etária entre 16 a 25 anos durante o período gestacional e relatou uso de medicação em 59,2% dos casos. A fissura transforame incisivo foi a mais diagnosticada (34,4%). No momento de cadastro ao Centro de Reabilitação de Anomalias Craniofaciais, 90,5% dos indivíduos ainda não haviam realizado tratamento cirúrgico. História familiar de fissura foi observada em 29,8% dos casos estudados e em apenas 7,1% desses foi reportado consanguinidade entre os pais. Conclusão Os fatores socioeconômicos e genéticos podem exercer influência sobre o desenvolvimento de fissuras orofaciais, o que exige uma maior atenção governamental assim como novos estudos para melhor investigação.(AU)

ABSTRACT Objective To describe the clinical-epidemiological profile of patients with orofacial fissures treated at a reference center from northeast Brazil. Materials and Methods Descriptive study, based on secondary data obtained from medical records. Sociodemographic information of patients and their mothers, use of medication during pregnancy, clinical and surgical aspects related to fissures, family history of malformation, and consanguinity among the parents were investigated. Data were analyzed descriptively using the SPSS (Statistical Package for Social Sciences) statistical program to obtain frequency, mean and standard deviation measures. Results 51.1% of the patients with orofacial fissures were female, 46.2% were under one year of age and 54.4% lived in urban areas. The majority of mothers were between the ages of 16 and 25 during the gestational period, and 59.2% reported the use of medication. Cleft lip and palate were the most prevalent types of fissures (34.4%). On admission to the Craniofacial Anomaly Rehabilitation Center, 90.5% of the individuals had not yet undergone surgical treatment. Family history of fissure was found in 29.8% of the cases studied, but inbreeding among parents was reported in only 7.1% of them. Conclusion Socioeconomic and genetic factors can influence the development of orofacial fissures; this requires greater governmental attention as well as new studies for better investigation.(AU)

RESUMEN Objetivo Describir el perfil clínico-epidemiológico de los portadores de fisuras orofaciales, atendidos en un Centro de Referencia del Nordeste de Brasil. Métodos Estudio descriptivo, basado en datos secundarios de pronóstico médicos. La información sociodemográfica del portador y de la madre, uso de medicamentos durante la gestación, aspectos clínicos y quirúrgicos relacionados con las fisuras, historia familiar de la malformación y consanguinidad de los padres fueron investigadas. Los datos fueron analizados descriptivamente, con el uso del programa estadístico SPSS (Statistical Package for te Social Sciences), en el cual se obtuvieron medidas de frecuencia, media y desviación estándar. Resultados 51,1% de los portadores de fisuras orofaciales eran del sexo femenino, 46,2% menores de un año y 54,4% eran procedentes en la zona urbana. La mayoría de las madres se encontraban en el grupo de edad entre 16 a 25 años durante el período gestacional y relató uso de medicación en el 59,2% de los casos. La fisura transforam incisiva fue la más diagnosticada (34,4%). En el momento de la inscripción en el Centro de Rehabilitación de Anomalías Craneofaciales, el 90.5% de los individuos aún no se habían sometido a tratamiento quirúrgico. La historia familiar de fisura fue observada en el 29,8% de los casos estudiados y en apenas el 7,1% de esos fue reportado consanguinidad entre los padres. Conclusión Los factores socioeconómicos y genéticos pueden influir en el desarrollo de fisuras orofaciales, lo que exige una mayor atención gubernamental así como nuevos estudios para una mejor investigación.

Perfil clínico-demográfico de los carcinomas de células escamosas bucales en una población del nordeste de Brasil / Clinical and demographic profile of oral squamous cell carcinoma in a northeast population of Brazil

Objetivo: Describir el perfil clínico-demográfico e identificar los factores de riesgo presentes en individuos portadores de carcinoma oral de células escamosas, que asistieron a un centro de referencia del nordeste de Brasil, de 2007 a 2015. Materiales y métodos: En este estudio descriptivo y retrospectivo, los datos fueron recopilados de las historias clínicas de individuos con diagnóstico histológico de carcinoma oral de células escamosas. Resultados: De los 104 casos analizados, el 72,12% eran hombres; el 53,84%, mayores de 60 años, y el 38,9%, de tez morena. La mayoría de los individuos eran alcohólicos y/o fumadores (95%). En cuanto a las lesiones, en su mayoría eran: ulceradas (58,70%), rojas (47,42%), de superficie arrugada (92,39%), duras (78,02%), con crecimiento endofítico (56,12%) y estaban localizadas en el borde lateral de la lengua (27,62%). Conclusiones: En este estudio, el carcinoma oral de células escamosas fue diagnosticado principalmente en hombres de tez morena, mayores de 60 años. Las lesiones más frecuentes fueron úlceras en la lengua. El consumo de tabaco y alcohol fueron las características de comportamiento de mayor ocurrencia (AU)

Aim: Describe the clinical-demographic profile and identify risk factors present in individuals with oral squamous cell carcinoma, attending a reference center in Northeastern Brazil from 2007 to 2015. Materials and methods: The present descriptive and retrospective study evaluated data collected from the dental records of individuals with histological diagnosis of oral squamous cell carcinoma. Results: Of the 104 cases analyzed, 72.12% were men, 53.84% were over 60 years old and 38.9% were of brown complexion. Most of the individuals were alcoholics and/or smokers (95%). The clinical characteristics were: ulcerated (58.70%), red (47.42%), rough (92.39%), hard consistency (78.02%), endophytic growth (56.12%) and located in the lateral of the tongue (27.62%). Conclusions: In this study, the oral squamous cell carcinoma was diagnosed mainly in men, brown and over 60 years. In the majority of cases, the lesions presented as ulcers in the tongue. Tobacco and alcohol consumption were the most frequent behavioral characteristics (AU)