Subgemmal neurogenous plaque: a series of six cases and a literature overview.

The study aims to describe six subgemmal neurogenous plaque (SNP) cases and compile the previously available data on SNP. Searches on PubMed, Web of Science, Embase, Scopus, and a two-step study selection were performed to compile data from case reports/series of SNP published in English literature. Our six patients (range 29-63 years) had SNP in the posterior lateral border of the tongue. Four of them were associated with lymphoepithelial cysts. A total of 15 studies, comprising 116 patients, were included in this overview. There was a slight predilection for female patients (56.0%) in the 5th (22.4%) and the 7th (23.9%) decades. The lateral border of the tongue (66.4%) was the most common anatomical location. The major manifestation was nodule/papule. Histologically, the presence of taste buds (n = 40/ 34.5%), superficial neural plexus (n = 32/ 27.6%), deep nerve fascicles (n = 32/ 27.6%), ganglion cells (n = 41/ 35.3%), and lymphoid tissue (n = 22/ 19.0%) was mainly reported. Surgical removal was the primary approach, with a low recurrence rate. Although largely unknown, SNP is a regular and likely frequent structure located in the tongue. The findings emphasize the importance of describing clinicopathological patterns of SNP as a differential diagnosis of neural lesions that affect the tongue.

ALDH1 immunoexpression in epithelial and stromal cells of oral lichen planus and lesions with lichenoid inflammatory infiltrate

Background: Oral Lichen Planus is a potential malignant disorder and shares clinical and histopathological features with other similar lesions. ALDH1 is a specific biomarker for stem cells identification, however its role in stromal cells of immune inflammatory infiltrate has not been explored. The aim of this study was to investigate the ALDH1 immunoexpression in epithelial and stromal cells of Oral Lichen Planus and other lesions with lichenoid inflammatory infiltrate. Material and Methods: 64 samples of Oral Lichen Planus, Oral Lichenoid Lesions, Oral Leukoplakia and Unspecific Chronic Inflammation were included. ALDH1 was evaluated in both epithelium and stromal cells. ALDH1+ cells ≥ 5% were considered positive in epithelium. Stromal cells were evaluated semi quantitatively. Fields were ranked in scores, according to criteria: 1 (0 to 10%); 2 (11 to 50%) and 3 (>50%). The mean value of the sum of the fields was the final score. Statistical differences among groups were investigated, considering p < 0.05. Results: ALDH1 expression in epithelium was low in all groups without difference among them. ALDH1+ cells in the lamina propria were higher for Lichen Planus [2.0], followed by Leukoplakia [1.3], Lichenoid lesions [1.2] and control [1.1] (p<0.05). Conclusions: ALDH1 immunoexpression in epithelium of lichenoid potential malignant disorders did not show a contributory tool, however ALDH1 in stromal cells of lichen planus might be involved in the complex process of immune regulation associated with the pathogenesis of this disease. (AU)

Scales to graduate oral mucositis: What are the limitations?

Oral mucositis is a common acute complication of a head and neck squamous cell carcinoma treatment. Multiple scales can be used to diagnose and grade this lesion, but they all have some limitation regarding this group of patients. Most of these issues are associated with the hardness to differentiate signs and symptoms from oral mucositis vs. the inherent neoplasm. This study highlights the importance of a specifically developed scale for patients with head and neck squamous cell carcinoma.

Chronic inflammatory periapical diseases: a Brazilian multicenter study of 10,381 cases and literature review.

The aim of this study was to investigate the epidemiological and clinical characteristics of chronic inflammatory periapical diseases in different regions of Brazil and to compare with data from the literature. A multicenter study was carried out in four Brazilian referral centers in oral diagnosis. Histopathological records were reviewed, and all cases diagnosed microscopically as periapical granuloma, radicular cyst, and periapical abscess were included. Demographic and clinical data were collected. Descriptive statistics and Pearson's chi-square test were performed. A total of 10,381 cases of chronic inflammatory periapical diseases were found (13.8% of 74,931 archived specimens) over a period of 65 years. Radicular cysts were the most common lesion (59.9%). Women (56.1%) with a mean age of 37.01 years old (range 13 to 100 ± 14.42) and people of white skin color (59.2%) were the most affected individuals by chronic inflammatory periapical diseases. The lesions were generally asymptomatic (28.1%), located in the maxilla (60.1%), and posterior region (49.8%). The radicular cysts were larger when compared to periapical granulomas (p < 0.001). The disagreement between the clinical and histopathological diagnoses was higher when the final diagnosis was a periapical granuloma (p < 0.001). Chronic inflammatory periapical diseases continue to be common lesions affecting mainly adults. This should be a consequence of the burden of untreated caries in permanent teeth. Women are more affected and radicular cyst was the most common lesion.

Chronic inflammatory periapical diseases: a Brazilian multicenter study of 10, 381 cases and literature review

Abstract The aim of this study was to investigate the epidemiological and clinical characteristics of chronic inflammatory periapical diseases in different regions of Brazil and to compare with data from the literature. A multicenter study was carried out in four Brazilian referral centers in oral diagnosis. Histopathological records were reviewed, and all cases diagnosed microscopically as periapical granuloma, radicular cyst, and periapical abscess were included. Demographic and clinical data were collected. Descriptive statistics and Pearson's chi-square test were performed. A total of 10,381 cases of chronic inflammatory periapical diseases were found (13.8% of 74,931 archived specimens) over a period of 65 years. Radicular cysts were the most common lesion (59.9%). Women (56.1%) with a mean age of 37.01 years old (range 13 to 100 ± 14.42) and people of white skin color (59.2%) were the most affected individuals by chronic inflammatory periapical diseases. The lesions were generally asymptomatic (28.1%), located in the maxilla (60.1%), and posterior region (49.8%). The radicular cysts were larger when compared to periapical granulomas (p < 0.001). The disagreement between the clinical and histopathological diagnoses was higher when the final diagnosis was a periapical granuloma (p < 0.001). Chronic inflammatory periapical diseases continue to be common lesions affecting mainly adults. This should be a consequence of the burden of untreated caries in permanent teeth. Women are more affected and radicular cyst was the most common lesion.

Características clínicas e demográficas das malformações linfáticas orais: estudo multicêntrico no Brasil e revisão de literatura / Clinical and demographic characteristics of oral lymphatic malformations: a Brazilian multicenter study and literature review

As malformações linfáticas orais são anomalias vasculares incomuns. Portanto, compreender suas principais características clínicas e demográficas pode auxiliar o entendimento e diagnóstico dessas lesões. A partir de um estudo multicêntrico e revisão de literatura, este trabalho avaliou a ocorrência e analisou as características demográficas e clínicas de malformações linfáticas orais. O estudo multicêntrico foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal de Minas Gerais (parecer nº 3.313.870 e CAAE 10723019.0.1001.5149) e replicado para os Comitês de Ética dos demais centros. Foram acessados os arquivos de biópsia de sete laboratórios brasileiros de Patologia Oral e Bucomaxilofacial, compreendendo 228.150 laudos, os quais eram datados entre o ano de inauguração do centro e 2018. Foram selecionados os casos com diagnóstico histopatológico de malformação linfática oral. Adicionalmente, foi realizada uma revisão de literatura sobre o tema. Nesta, a partir de uma estratégia de busca estruturada, foram selecionados os casos de malformação linfática oral reportados em língua inglesa. Posteriormente foram extraídos dados similares aos do estudo multicêntrico, permitindo sua comparação. A análise dos dados foi realizada no programa estatístico SPSS versão 22.0. Para estatísticas analíticas o nível de significância foi estabelecido em p<0,05. No total, o estudo multicêntrico compreendeu 208 casos, representando 0,09% de todo o arquivo investigado, e a revisão de literatura 1035 casos. Em ambos houve concordância de que há distribuição semelhante entre os sexos e a maioria acomete a língua. O estudo multicêntrico e os estudos de relato de casos apresentaram idade mediana de 22 e 10 anos, respetivamente. Já o tamanho das lesões e proporção de pacientes sintomáticos foi maior entre os casos da revisão de literatura. Ao avaliar tais divergências, foi observado que em ambos houve associação estatisticamente significativa (p<0,05) entre idade e tamanho de lesão, em que pacientes mais jovens tiveram lesões maiores. O presente estudo multicêntrico conta com a maior amostra de malformações linfáticas orais até o momento e revelou que este diagnóstico foi incomum em todos os centros participantes. O estudo multicêntrico e a revisão de literatura mostraram que homens e mulheres são afetados igualmente, o sítio preferencial de acometimento é a língua e há relação entre idade do paciente e tamanho da lesão.

Oral lymphatic malformations are uncommon vascular anomalies. Thus, recognizing the main demographical and clinical characteristics of oral lymphatic malformation can help to understand and diagnose these lesions. This multicenter study and literature review assessed the occurrence, clinical and demographic characteristics of oral lymphatic malformation. The multicenter study was approved by the Research Ethics Committee from Universidade Federal de Minas Gerais (CAAE 10723019.0.1001.5149) and replicated to the Ethics Committees of the other centers. The biopsy files from seven Oral and Bucomaxilofacial Pathology Services were acessed. All cases with histopathological diagnosis of lymphatic malformation dated from 1953 to 2018 were selected. Additionally, was performed a literature review, based on a structured search strategy. Were selected cases of oral lymphatic malformation in the English language. Data extracted were similar to those from the multicenter study, allowing their comparison. Data analysis was performed with the software Statistical Package for the Social Sciences (SPSS), version 22.0 (SPSS Inc., Armonk, USA). The level of significance was set at p< 0.05 for analytical statistics. The multicenter study retrieved 208 cases, representing 0.09% of the total sample. The literature review retrieved 1035 cases. Both affected male and female individuals equally and most cases were at tongue. The multicenter study and the case report studies showed median age of 22 and 10 years, respectively. On the other hand, the lesion size and proportion of symptomatic patients were higher among cases from the literature review. Cases, in both multicenter study and the literature review, revealed an association (p<0.05) among age and lesion size, showing young patients with larger lesions. This multicenter study represented the larger sample of oral lymphatic malformations to date and evidenced that this is an uncommon diagnosis in Brazilian Oral and Bucomaxilofacial Pathology Services. The multicenter study and the literature review showed that men and women are affected equally, the main location site is the tongue and patient age is related to the lesion size.

Uso do laser de diodo de alta intensidade para realização de frenectomia e bridectomia pré-protética para aumento de retenção em prótese total removível em paciente diabético - relato de caso / Uso do laser de diodo de alta intensidade para realização de frenectomia e bridectomia pré-protética para aumento de retenção em prótese total removível em paciente diabético - relato de caso

Previamente à confecção de próteses totais mucossuportadas, o cirurgião dentista deve observar se o paciente possui características em seu rebordo alveolar e tecidos moles que ocasionariam diminuição de sua retenção e, a partir de então, avaliar a necessidade e possibilidade de realizar uma cirurgia pré-protética para correção. Este trabalho traz o relato de caso de uma paciente atendida na clínica de prótese total da FO-UFMG, de sexo feminino, idosa, melanoderma, desdentada total e portadora de diabetes melittus tipo II controlada. Ao exame clínico, foi observada presença de freio labial superior proeminente, bem como bridas. Ambos diminuiriam a área de suporte da prótese a ser confeccionada, culminando em sua retenção insuficiente. Portanto, fez-se necessária a remoção cirúrgica desses tecidos moles. A frenectomia e bridectomia foram realizadas com laser de diodo de alta intensidade e o pós-operatório ocorreu sem maiores intercorrências. Após uma semana, a cicatrização encontrava-se quase completa, a cirurgia foi considerada satisfatória e a paciente não relatou sintomatologia dolorosa, possibilitando a realização de moldagem para iniciar a confecção da prótese. A prótese total mucossuportada foi instalada após 42 dias, sem queixas de perda de retenção pela paciente (AU).

Before the manufacture of total dentures, the dentist must observe if the patient has features in his alveolar ridge and soft tissues that would cause a reduction in retention of the denture and, after, evaluate the need and possibility of performing surgery for correction. This paper presents the case report of a patient attended at the Clinic of Complete Denture of FO-UFMG, female, elderly, black, total edentulous and with type II diabetes mellitus controlled. At the clinical examination, the presence of prominent upper labial frenum was observed. This would reduce the area of support of the prosthesis to be made, culminating in its insufficient retention. Therefore, the surgical removal of these soft tissues was required. The frenectomy and bridectomy were performed with high-intensity diode laser and the postoperative occurred without major intercurrences. After one week the healing was almost complete, the surgery was considered satisfactory and the patient did not report painful symptomatology, allowing the accomplishment of molding to begin the preparation of the prosthesis. The complete denture was installed after 42 days, without complaints of loss of retention by the patient (AU).