Radiation-induced Oral Mucositis in Brazilian Patients: Prevalence and Associated Factors.

Aim: To determine the prevalence of radiation-induced oral mucositis (OM) and associated factors. PATIENTS AND METHODS: A cross-sectional retrospective study was performed at a reference dental care center. The medical records of patients submitted to radiotherapy for the treatment of head and neck cancer were used to collect clinical and demographic variables. The data were submitted to descriptive analysis and multivariate Poisson regression with robust variance [p<0.05; 95% confidence intervaI (CI)]. RESULTS: Four hundred and thirteen patients were analyzed. The mean age was 55±14 years. The prevalence of OM in the overall sample was 41.9% and was higher among males (78.2%). The following variables were significantly associated with the outcome: radiation dose [prevalence ratio (PR)= 1.04; 95% CI=1.02-1.06]; concomitant chemotherapy (PR=1.48, 95% CI=1.05-2.08); oral candidiasis (PR=1.97, 95% CI=1.44-2.68); and osteoradionecrosis (PR=1.51, 95% CI=1.10-2.06). CONCLUSION: Radiation-induced OM was associated with radiation dose, concomitant chemotherapy, oral candidiasis and osteoradionecrosis. The rate of OM underscores the importance of adequate oral care prior to treatment for head and neck cancer.

Mandibular buccal bifurcation cyst: Case report and literature review.

The present study reports a case of a mandibular buccal bifurcation cyst (MBBC) associated with a partially erupted mandibular first molar. The intraoral examination revealed vestibular swelling in the right mandibular permanent first molar region. Panoramic radiography and cone-beam computed tomography (CBCT) showed a well-delimited radiolucent image involving the roots and part of the crown of the right mandibular permanent first molar with bulging and areas of buccal cortical bone resorption. An incisional biopsy was performed and the diagnosis was MBBC. The lesion was surgically removed by enucleation and curettage. Bone repair was observed seven months after the surgical procedure.

Osteoradionecrosis prevalence and associated factors: A ten years retrospective study

BACKGROUND: Osteoradionecrosis (ORN) is one of the most serious complications of head and neck radiotherapy and is considered a public health problem worldwide. This study aims to determine the prevalence and associated factors of ORN in patients undergoing radiotherapy for head and neck malignancy. MATERIAL AND METHODS: A cross-sectional retrospective study was conducted, in which all medical records of patients undergoing head and neck radiation in the period between 2006 to 2015 (10 years) were examined. Clinical and demographic data were extracted. Multivariate Poisson regression analysis with robust variance was employed to access the relationship between ORN and independent variables (p < 0.05; 95% CI). RESULTS: The sample comprised 413 medical records of patients undergoing radiotherapy. The prevalence of ORN was 9.7 %. Most participants were males (78.2%). The mean age of subjects was 55 years (± 14 years). The mandible was the main site of occurrence of ORN (85.0%). The following variables were associated with ORN: presence of oral mucositis (PR = 3.03; 95% CI: 1.30-7.03), history of smoking (PR = 0.23; 95% CI: 0.07-0.74), number of teeth removed before radiotherapy (PR = 1.06; 95% CI: 1.01-1.11) and visit to the dentist before radiation (PR = 0.08; 95% CI: 1.02-1.11). CONCLUSIONS: The prevalence of ORN was low and was associated with the presence of oral mucositis and the number of removed teeth before radiation. Visiting the dentist before radiotherapy and stopping smoking were protective factors for ORN

Oral paracoccidioidomycosis: Retrospective analysis of 55 Brazilian patients.

Paracoccidioidomycosis (PCM) is a rare fungal infection in the world, but endemic and acquired exclusively in Latin America, with the highest prevalence in South America and Brazil, particularly. Changes in oral cavity are common and constitute the first clinical manifestation in many patients. The aim of this study was to describe the prevalence of oral PCM and analyse the profile of the disease and patients. Retrospective research, consisting of information present in the medical records in the period 1998-2015, whose histopathological diagnosis was oral PCM. Fifty-five oral PCM cases were confirmed. Of these patients, 90.9% were males and 9.1% were females. The average age was 49.66 years and the most reported occupation was rural workers. The painful symptomatology was present in 61.82% of patients. Erythematous lesions were predominant in 73% of them. In single lesions (22 cases), the most common locations were jugal mucosa and tongue. In multiple involvement (30 cases), the most affected regions were lips, jugal mucosa and alveolar ridge. Epidemiology of PCM, was similar to several other studies, especially in Brazil. This is the most important fungal infection in Latin America and the recognition of oral lesions is extremely important, as is often the first and in many cases the only manifestation of the disease.

Oral candidiasis: A retrospective study of 276 Brazilian patients.

BACKGROUND: Although oral candidiasis (OC) is a very common fungal infection of oral cavity, clinical features of affected patients and their demographic profile are not well documented. OBJECTIVE: The objective of the study was to assess the demographic profile of patients diagnosed with OC and its clinical features in an import Brazilian center of oral and maxillofacial pathology. MATERIALS AND METHODS: A retrospective study consisted of 276 patients diagnosed with OC by cytopathology Periodic Acid-Schiff (PAS) staining, during the period of 20 years. The variables related to patients were gender, age and skin color. Regarding infection, the data collected were location, color, symptoms, early manifestation, or recurrent and associated factors. RESULTS: Male and female were equally affected, and the median age was 43 years. The majority of lesions were of primitive origin, asymptomatic and affecting only one site of oral cavity. The most affected site was the palate followed by tongue. More than a half of the patients (56.2%) had red lesions. The main associated factors related were the use of removable prostheses, bone marrow transplantation and AIDS. CONCLUSIONS: OC affects predominantly adults and elderly, without difference between sex and skin color. Although clinical findings are crucial, cytopathology tests are important complementary examinations to reach a definitive diagnosis. PAS staining seems to be more used in cases of erythematous candidiasis since white lesions are easier to diagnose clinically.

Avaliação in-vitro da atividade antifúngica e da citotoxicidade da própolis de copaíba contra espécies do gênero Candida spp / In-vitro evaluation of the antifungal activity and cytotoxicity of copaiba propolis against Candida spp

OBJETIVOS: verificar a atividade antifúngica e a citotoxicidade da própolis de copaíba e de um protótipo de enxaguante bucal contra espécies do gênero Candida spp. METODOLOGIA: o perfil cromatográfico do extrato de própolis foi realizado por Cromatografia Líquida de Ultraeficiência em Fase Reversa (RP-UPLC). A atividade antifúngica do extrato de própolis de copaíba (EPC) e do seu protótipo de enxaguante bucal contra C. albicans, C. tropicalis e C. krusei foi avaliada por microdiluição em caldo e discodifusão em ágar. A citotoxicidade foi verificada pelo ensaio de MTT em fibroblastos 3T3 ¿ L1. RESULTADOS: Fenóis foram os principais compostos encontrados, sendo identificados dentre eles o ácido caféico (ácido fenólico) e canferol (flavonóide). Os valores de CIM foram 156 ug/ml, 312 ug/ml e 625 ug/ml para C. albicans, C. tropicalis e C. krusei respectivamente, indicando atividade antifúngica presente, mas moderada. Os valores das zonas de inibição verificaram inibição do crescimento das leveduras e sugeriram uma atividade fungistática do enxaguante bucal. Em relação aos testes de citotoxicidade, o EPC exerce, em baixas concentrações, um efeito dose dependente sobre a proliferação de fibroblastos 3T3-L1 e pode exercer um efeito regenerador de tecidos. CONCLUSÕES: a própolis investigada apresenta potencial antifúngico moderado contra Candida spp., podendo ser o enxaguante bucal uma opção terapêutica no combate da candidíase oral, já que o seu tratamento é baseado no controle e não na erradicação das leveduras. Estudos futuros sobre a caracterização dos seus compostos químicos, aperfeiçoamento do produto e ensaios clínicos deverão ser realizados

Objectives: verify the antifungal activity and cytotoxicity of copaiba propolis and its mouthwash prototype against Candida spp. Methodology: the chromatographic profile of the propolis extract was perpormed by Reverse Phase Ultra-efficiency Liquid Chromatography (RP-UPLC)....

Infecções odontogênicas complexas e seu perfil epidemiológico / Severe odontogenic infections and its epidemiological profile

Infecções odontogênicas complexas são aquelas, que se disseminam para espaços faciais subjacentes, podendo provocar complicações graves, como a Angina de Ludwig. Seu diagnóstico precoce e uma avaliação precisa das complicações são extremamente importantes para o sucesso do tratamento. O objetivo deste estudo foi conhecer o perfil epidemiológico de 50 pacientes internados com infecção odontogênica complexa em um hospital público de Belo Horizonte-MG, no intervalo de um ano. Dentre eles, 26 eram mulheres e 24 homens, com a média de idade de 31,04 anos. O período de internação foi, em média, de 6,9 dias, e o intervalo entre o início da infecção e a internação foi de 4,80 dias em média. Apenas 6% eram portadores de Diabetes Mellitus. Em 56%, os dentes causadores foram segundos e terceiros molares inferiores. Um total de 54% possuía baixa renda, mas apenas 4% eram analfabetos. Dentre os pacientes, 47 fizeram uso de algum tipo de medicamento prévio ao momento da internação hospitalar e 32,0% relataram-se automedicado. Concluiu-se que a infecção odontogênica pode atingir indivíduos de variadas faixas etárias, independente do sexo, classe econômica ou nível de instrução. A prevenção e a abordagem precoce dos casos são a melhor estratégia de tratamento... (AU)

Severe odontogenic infections are those that spread to spaces underlying facial and may cause severe complications such as Ludwig's angina. Early diagnosis and precise evaluation of complications is extremely important for successful treatment. The objective of this study was to understand the epidemiology of 50 patients admitted with severe odontogenic infection in a public hospital in Belo Horizonte, Minas Gerais within one year. Among them, 26 were women and 24 men, with a mean age of 31.04 years. The hospital stay averaged 6.9 days and the interval between the onset of infection and hospitalization was 4.80 days on average. Only 6% were diabetic patients. In 56%, the causing teeth were second and third molars. A total of 54% had low income, but only 4% were illiterate. Among the patients, 47 had used some kind of drug prior to the time of hospitalization and 32.0% reported having self-medicated. It was concluded that the odontogenic infection can affect individuals of different age groups, regardless of gender, economic class or education level. The prevention and early treatment of cases are the best treatment strategy... (AU)

Osteonecrose de mandíbula associada ao uso de bisfosfonato após instalação de implantes: relato de caso / Osteonecrosis of the jaw associated with bisphosphonate use after implant placement: case report

A reabilitação bucal de pacientes com perdas dentárias múltiplas ou unitárias com implantes osseointegrados tem se tornado um tratamento com altas taxas de sucesso. Apesar disso, uma séria complicações pode afetar a sobrevida desses implantes, como a osteonecrose dos maxilares associada ao uso de bisfosfonatos. Os bisfosfonatos são uma classe de medicamentos que têm por função a inibição da atividade dos osteoclastos, interferindo na remodelação e no turnover ósseo. São indicados para retardar o envolvimento ósseo em algumas condições malignas, como em mielomas múltiplos e metástase do câncer de mama e próstata, no tratamento da doença de Paget e da osteoporose. Clinicamente, as BRONJ (Bisphosphonated Related Osteonecrosis of the Jaw) aparecem como perda da continuidade da mucosa bucal com exposição do osso subjacente, podendo ser extremamente dolorosas, persistentes e não responder aos tratamentos convencionais. Assim, o objetivo do presente trabalho é revisar a literatura sobre o tema apresentado e relatar um caso clínico de BRONJ em mandíbula após a fixação de implantes.

Oral rehabilitation of patients with unit or multiple tooth loss with dental implants has become a treatment with high success rates. Nevertheless, a serious complication can affect the survival of these implants: osteonecrosis of the jaws associated with the use of bisphosphonates. Bisphosphonates are a class of drugs that has the function of inhibiting the activity of osteoclasts, interfering with remodeling and bone turnover. Are shown to slow bone involvement in some malignancies such as multiple myeloma and metastatic breast cancer and prostate cancer, in the treatment of Paget's disease and osteoporosis. Clinically the BRONJ appear as loss of continuity of the oral mucosa with exposure of the underlying bone and can be extremely painful, persistent and do not respond to conventional treatments. The objective of this paper is to review the literature on the subject and report of a case in BRONJ after implant fixation.