Biological role of the bidirectional interaction between epithelial-mesenchymal transition and PD-L1 expression in head and neck squamous cell carcinomas: A systematic review

Background: Squamous cell carcinoma (SCC) is the most common head and neck malignant neoplasm. Despite progress in antineoplastic treatment for SCC, there are still high morbidity and mortality rates. Over the years, several tumor biomarkers have been suggested to predict the prognosis of patients with oral SCC. Studies point to a bidirectional association between the epithelial-mesenchymal transition (EMT) and the expression of PD-L1 with the aggressive biological behavior of the neoplastic cell. Thus, this systematic review aimed to explore the biological roles and mechanisms underlying the interaction between EMT and PD-L1 expression in head and neck SCC-derived cell lines. Material and methods: An electronic search was performed in the PubMed/Medline, Web of Science, Science Direct, Scopus, Embase, and Cochrane Collaboration Library databases. Articles evaluating the in vitro relationship between EMT/PD-L1 interaction and the biological behavior of head and neck SCC cell lines were selected for this systematic review. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. Results: After applying the previously established inclusion/exclusion criteria, 9 articles were included in the qualitative synthesis. The present systematic review suggests the existence of a bidirectional interaction between EMT and PD-L1 expression, which is related to alterations in the cell cycle, proliferation, apoptosis, and cell survival, affecting the migration and invasion ability of tumor cells. Conclusions: Combined targeting of the two pathways may be potentially effective for immunotherapy in head and neck SCC. (AU)

Immunohistochemical analysis of SHH, SMO and GLI-1 proteins in epithelial odontogenic lesions.

The present study analyzed the expression of proteins involved in the sonic hedgehog signaling pathway (SHH, SMO, and GLI-1) in benign epithelial odontogenic lesions (odontogenic keratocyst - OKC, ameloblastoma - AB, and adenomatoid odontogenic tumor - AOT) in order to identify the role of these proteins in the pathogenesis of these lesions. The sample consisted of 20 OKCs, 20 ABs, and 10 AOTs. The Kruskal-Wallis, Mann-Whitney U, and Spearman's (r) tests were used for statistical analysis, with the level of significance set at 5% (p < 0.05). The membrane/cytoplasmic expression of SHH was significantly higher in AB compared to AOT (p = 0.022) and OKC (p = 0.02). No differences were found in the membrane/cytoplasmic expression of SMO between the lesions studied. Regarding GLI-1, significant differences were observed at the nuclear level for AB and OKC compared to AOT (p < 0.0001). In addition, significant positive correlations were found between cytoplasmic and nuclear GLI-1 in AB (r = 0.482; p = 0.031) and OKC (r = 0.865; p < 0.0001), and between membrane/cytoplasmic SMO and cytoplasmic GLI-1 in AOT (r = 0.667; p = 0.035) and OKC (r = 0.535; p = 0.015). The results of this study confirm the participation of the sonic hedgehog signaling pathway in the pathogenesis of the lesions studied. Overexpression of SHH in ABs and nuclear expression of GLI-1 in ABs and OKCs indicate that these proteins contribute to the more aggressive behavior of these two lesions when compared to AOT.

Immunohistochemical analysis of SHH, SMO and GLI-1 proteins in epithelial odontogenic lesions

Abstract The present study analyzed the expression of proteins involved in the sonic hedgehog signaling pathway (SHH, SMO, and GLI-1) in benign epithelial odontogenic lesions (odontogenic keratocyst - OKC, ameloblastoma - AB, and adenomatoid odontogenic tumor - AOT) in order to identify the role of these proteins in the pathogenesis of these lesions. The sample consisted of 20 OKCs, 20 ABs, and 10 AOTs. The Kruskal-Wallis, Mann-Whitney U, and Spearman's (r) tests were used for statistical analysis, with the level of significance set at 5% (p < 0.05). The membrane/cytoplasmic expression of SHH was significantly higher in AB compared to AOT (p = 0.022) and OKC (p = 0.02). No differences were found in the membrane/cytoplasmic expression of SMO between the lesions studied. Regarding GLI-1, significant differences were observed at the nuclear level for AB and OKC compared to AOT (p < 0.0001). In addition, significant positive correlations were found between cytoplasmic and nuclear GLI-1 in AB (r = 0.482; p = 0.031) and OKC (r = 0.865; p < 0.0001), and between membrane/cytoplasmic SMO and cytoplasmic GLI-1 in AOT (r = 0.667; p = 0.035) and OKC (r = 0.535; p = 0.015). The results of this study confirm the participation of the sonic hedgehog signaling pathway in the pathogenesis of the lesions studied. Overexpression of SHH in ABs and nuclear expression of GLI-1 in ABs and OKCs indicate that these proteins contribute to the more aggressive behavior of these two lesions when compared to AOT.

Resumo O presente estudo analisou a expressão de proteínas envolvidas na via de sinalização Sonic Hedgehog (SHH, SMO e GLI-1) em lesões benignas do epitélio odontogênico de comportamento biológico distintos, tais como ceratocistos odontogênicos (CO), ameloblastomas (AMB) e tumores odontogênicos adenomatoides (TOA), com o intuito de identificar o papel destas proteínas na patogênese destas lesões. A amostra foi constituída de 20 CO, 20 AMB e 10 TOA, analisada pela técnica da imuno-histoquímica de forma semiquantitativa por compartimento celular, onde foi feita uma análise da membrana e citoplasma das células nas proteínas SHH e SMO, enquanto que para a proteína GLI-1, foi feita uma análise nuclear e/ou citoplasmática. Para análise estatística, foram utilizados os testes de Kruskal-Wallis (KW), Mann-Whitney (U) e Spearman (r), com o nível de significância estabelecido em 5% (p < 0,05). Ao analisar a proteína SHH, observou-se que o AMB demonstrou expressão membranar/citoplasmática significativamente maior em comparação ao TOA (p = 0,022) e CO (p = 0,020). Com relação à análise membranar/citoplasmática da SMO, não foram identificadas diferenças entre as lesões estudadas. Para a proteína GLI-1, foram constatadas diferenças estatisticamente significativas, em nível nuclear, para o AMB e CO em comparação ao TOA (p< 0,0001). Além disso, foram observadas correlações positivas com significância estatística entre GLI-1 citoplasmático e GLI-1 nuclear para o AMB (r = 0,482; p = 0,031) e CO (r = 0,865; p< 0,0001), e entre o SMO membranar/citoplasmático e o GLI-1 citoplasmático para o TOA (r = 0,667; p = 0,035) e o CO (r = 0,535; p = 0,015). Os resultados deste estudo confirmam a participação da via de sinalização Sonic Hedgehog na patogênese das lesões estudadas e, a superexpressão de SHH em AMBs e GLI-1 nuclear em AMBs e COs, indica que estas proteínas contribuem com o comportamento biológico mais agressivo destas duas lesões quando comparado ao TOA.

Prognostic and clinicopathological significance of tumor-stroma ratio in head and neck squamous cell carcinoma: A systematic review

Background: Analysis of the tumor microenvironment has been proposed as a strategy for the treatment and prognosis of different neoplastic processes. A grading system based on the tumor-stroma ratio (TSR), which evaluates theproportion of stroma in relation to neoplastic parenchyma at the invasion front, has shown a strong prognostic valuein different neoplastic processes. The aim of the present systematic review was to understand the role of the TSR inhead and neck squamous cell carcinoma (HNSCC), evaluating its correlation with clinical and prognostic parameters.Material and Methods: An electronic search was performed in PubMed/Medline, Web of Science, Science Direct,Scopus, Embase, and the Cochrane Collaboration Library. Publications assessing the relationship between TSRand prognosis in cases of HNSCC were eligible. The quality of the studies was assessed independently by fourevaluators using the Newcastle-Ottawa scale.Results: After application of the previously es+lished inclusion/exclusion criteria, nine articles were included inthe qualitative synthesis. With regards to quality on the Newcastle-Ottawa scale, an overall value of 4.55 was obtained. This systematic review demonstrated a strong association between TSR and prognosis in esophageal andoral squamous cell carcinomas.Conclusions: Histopathological analysis of the TSR can optimize the analysis of the prognosis of cases diagnosedwith HNSSC. In addition, the TSR is a reliable and simple parameter that can be evaluated in hematoxylin/eosinstained slides during routine laboratory examinations, showing high inter- and intraobserver agreement. (AU)

Biomarcadores da transição epitélio-mesenquimal em desordens potencialmente malignas e carcinoma de células escamosas de língua oral / Biomarkers of epithelial-mesenchymal transition in potentially malignant disorders and squamous cell carcinoma of the oral tongue

Durante a carcinogênese oral, as células malignas adquirem um fenótipo agressivo que resulta em aumento da motilidade individual e na capacidade para invadir tecidos circunvizinhos. Para tanto, as células epiteliais malignas desenvolvem um processo regulatório e programado denominado transição epitélio-mesenquimal (TEM), que é crucial para aquisição deste fenótipo maligno agressivo. O objetivo do presente estudo foi investigar o papel da expressão imunoistoquímica de proteínas sinalizadoras da TEM em displasias epiteliais orais e em carcinomas de células escamosas de língua oral (CCELO), avaliando suas respectivas associações com parâmetros clínico-patológicos e de prognóstico. Inicialmente, objetivando obter uma compreensão aprofundada sobre o tema proposto, foram desenvolvidas duas revisões sistemáticas de literatura avaliando o papel da TEM como possível marcador de prognóstico em casos diagnosticados como displasia epitelial oral e o papel dos fatores de transcrição nuclear associados ao processo de TEM na regulação da plasticidade celular e no compartamento biológico em linhagens celulares de carcinoma de células escamosas em região de cabeça e pescoço. Para o estudo imunoistoquímico, foram selecionados 47 casos de displasias epiteliais orais e 41 casos diagnosticados como CCELO, nos quais foram analisados a imunoexpressão das proteínas Twist1, Snail1, E-caderina e N-caderina. Foram investigadas possíveis associações entre o padrão de expressão destas proteínas com a gradação histopatológica das displasias epiteliais e com os aspectos clínico-patológicos, recidiva e sobrevida em CCELO. Foram observados diferentes padrões de marcação entre os grupos analisados, observando-se uma perda significativa da expressão da E-caderina membranar em casos de CCELO em comparação aos casos de displasias epiteliais orais (p = <0.0001). Foi observado uma pior sobrevida global em casos com baixa expressão da E-caderina membranar (HR = 0.27; p = 0.033) e alta expressão do Twist1 citoplasmático (HR = 3.19; p = 0.010). Ao analisar isoladamente o parâmetro intensidade de expressão, foi observada associação entre a alta intensidade da N-caderina citoplasmática com a sobrevida global (HR = 4.93; p = 0.006). Nossos achados sugerem que a perda da expressão da E-caderina e o aumento da expressão da N-caderina e dos fatores de transcrição nuclear Twist1 e Snail1 estão associados ao desenvolvimento e progressão da carcinogênese oral. Isoladamente, a perda da expressão membranar da E-caderina e o aumento da expressão citoplasmática do Twist1 e da N-caderina foram associados a uma pior sobrevida (AU).

During oral carcinogenesis, malignant cells acquire an aggressive phenotype that results in increased individual motility and the ability to invade surrounding tissues. Therefore, malignant epithelial cells develop a regulatory and programmed process called epithelial-mesenchymal transition (EMT), which is crucial for the acquisition of this aggressive malignant phenotype. The aim of the present study was to investigate the role of immunohistochemical expression of EMT signaling proteins in oral epithelial dysplasias and oral squamous cell carcinomas of the tongue (OTSCC), evaluating their respective associations with clinicopathological and prognostic parameters. Initially, aiming to obtain a deeper understanding of the proposed topic, two systematic literature reviews were developed evaluating the role of EMT as a possible prognostic marker in cases diagnosed as oral epithelial dysplasia and the role of nuclear transcription factors associated with the MET process in regulation of cellular plasticity and biological behavior in head and neck squamous cell carcinoma cell lines. For the immunohistochemical study, 47 cases of oral epithelial dysplasias and 41 cases diagnosed with OTSCC were selected, in which the immunoexpression of Twist1, Snail1, E-cadherin and Ncadherin proteins were analyzed. Possible associations between the expression pattern of these proteins and the histopathological grading of epithelial dysplasias and with the clinicopathological aspects, recurrence and survival in OTSCC were investigated. Different staining patterns were observed between the analyzed groups, with a significant loss of membrane E-cadherin expression in cases of OTSCC compared to cases of oral epithelial dysplasias (p = <0.0001). Worse overall survival was observed in cases with low membrane E-cadherin expression (HR = 0.27; p = 0.033) and high cytoplasmic Twist1 expression (HR = 3.19; p = 0.010). When analyzing the expression intensity parameter alone, an association was observed between high cytoplasmic N-cadherin intensity and overall survival (HR = 4.93; p = 0.006). Our findings suggest that loss of E-cadherin expression and increased expression of N-cadherin and nuclear transcription factors Twist1 and Snail1 are associated with the development and progression of oral carcinogenesis. Alone, loss of membrane expression of E-cadherin and increased cytoplasmic expression of Twist1 and N-cadherin were associated with worse survival (AU).

YouTube™ and oral lichen planus: an appraisal of the educational quality of information.

The objective of this study was to analyze the quality of videos on oral lichen planus (OLP) available in YouTube™. A cross-sectional analytical study was conducted by searching the video sharing platform YouTube™. Videos aimed at clarifying the etiological and clinical characteristics, diagnostic criteria, treatment, and prognosis of OLP were included. A total of 481 videos were retrieved and 37 were included in the study according to the selection criteria established. Most of the videos evaluated (86.5%; n = 32) were produced by independent users. The average reliability was 1.8 and quality assessment classified only three videos (8.1%) as having good/excellent quality. A significant correlation was observed between the length of the video analyzed and its quality and reliability (p < 0.05), as well as between the reliability and usefulness of the video (p = 0.03). YouTube™ has become a leading source of information for the general population. However, a significant number of these videos have a low quality. Students, professionals, and healthcare providers must be more actively involved in providing clear, accurate, and reliable evidence-based information in an accessible language in order to enable significant improvement in patient care delivery.

Immunohistochemical expression of DNA repair proteins in oral tongue and lower lip squamous cell carcinoma.

The DNA repair system involves genes and proteins that are essential for the maintenance of genome integrity and the consequent control of various cellular processes. Alterations in these genes and proteins play a role in tumor development and progression and might be associated with prognosis. The aims of this study were to analyze the immunoexpression of two DNA repair proteins, XPF and XRCC1, in lower lip squamous cell carcinoma (LLSCC) and oral tongue squamous cell carcinoma (OTSCC), and to investigate possible associations with clinical and histopathological parameters. The immunohistochemical expression of XPF and XRCC1 was analyzed semi-quantitatively in 40 cases each of LLSCC and OTSCC. The chi-squared test or Fisher's exact test, when appropriate, was used to investigate the association between expression of the proteins and clinicopathological characteristics. The cytoplasmic immunoexpression of XPF was high in OTSCC (95% of the cases analyzed) but low in LLSCC (52.5%). Among the clinicopathological parameters evaluated, a statistically significant association was observed between high nuclear expression of XRCC1 and the absence of regional lymph node metastasis in patients diagnosed with OTSCC (p=0.006). The high protein expression of XPF and XRCC1 in OTSCC and LLSCC suggests an important role in the development and progression of these tumors. Our study found an association between high nuclear expression of XRCC1 and the absence of loco-regional metastasis in cases diagnosed as OTSCC, suggesting a role of this protein in tumor progression.

Estomatite protética associada a candidíase pseudomembranosa em paciente geriátrico: relato de caso / Prosthetic stomatitis associated with pseudomembranus candidiasis in geriatric patient: case report

As próteses removíveis são consideradas facilitadoras em potencial da estomatite protética, caracterizada por aspectos hiperplásicos e eritematosos na mucosa de suporte. Este trabalho tem como objetivo relatar as principais manifestações orais da estomatite protética em um paciente geriátrico associada a candidíase oral pseudomembranosa. Paciente do gênero masculino, setenta e quatro anos, apresentava uma lesão exofítica, na região de palato com dois centímetros de extensão, além da presença de candidíase pseudomembranosa, fazia o uso de uma prótese parcial superior removível há aproximadamente dez anos. Foi levantada a hipótese diagnóstica de estomatite protética associada a candidíase pseudomembranosa. A terapêutica instituída consistiu no uso de antifúngico por um período de quinze dias e biópsia incisional. O exame histopatológico confirmou o diagnóstico de hiperplasia fibrosa inflamatória. Foi recomendado a confecção de uma nova prótese para que fosse evitado a recorrência da lesão, e o paciente também foi instruído quanto a sua higiene oral evitando-se desta forma a recorrência da candidíase. O cirurgião-dentista deve ser capaz de reconhecer e diagnosticar a estomatite protética em sua prática diária e tratar o paciente de acordo com a sua etiologia, oferecendo desta forma para o paciente um maior conforto e melhores condições de vida(AU)

Removable total dentures are considered potential facilitators of prosthetic stomatitis, characterized by hyperplastic and erythematous aspects in the supporting mucosa. This paper aims to report the main oral manifestations of prosthetic stomatitis in an elderly patient associated with pseudomembranous oral candidiasis. A seventyseven-year-old male patient presented with an exophytic lesion in the palate region of two centimeters in length, in addition to the presence of pseudomembranous candidiasis, and had been using a removable upper partial denture for approximately ten years. The diagnostic hypothesis of prosthetic stomatitis associated with pseudomembranous candidiasis was raised. The therapy instituted consisted of the use of antifungal for a period of fifteen days and incisional biopsy. Histopathological examination confirmed the diagnosis of inflammatory fibrous hyperplasia. It was recommended to make a new prosthesis to avoid recurrence of the lesion, and the patient was also instructed as to its oral hygiene, thus avoiding the recurrence of candidiasis. The dentist should be able to recognize and diagnose prosthetic stomatitis in his daily practice and treat the patient according to its etiology, thus offering the patient greater comfort and better living conditions(AU)

Prognostic value of the immunohistochemical detection of epithelial-mesenchymal transition biomarkers in oral epithelial dysplasia: A systematic review

BACKGROUND: Oral potentially malignant disorders (OPMDs) comprise a range of clinical-pathological alterations that are frequently characterized as architectural and cytological derangements upon histological analysis. Epithelial-mesenchymal transition (EMT) has been proposed as a critical mechanism for the acquisition of the malignant phenotype in neoplastic epithelial processes. This study aims to systematically review the current findings on the immunohistochemical expression of epithelial-mesenchymal transition markers in oral potentially malignant disorders and to evaluate their possible application as biomarkers associated with the progression of oral epithelial dysplasias. MATERIAL AND METHODS: A systematic search was performed in the following databases: PubMed, EMBASE, Chinese BioMedical Literature Database, and Cochrane Library. Articles that evaluated the relationship between the expression of EMT markers and the degree of oral epithelial dysplasia were selected for the systematic review. The quality of each eligible study was evaluated by independent reviewers that used operationalized prognostic biomarker reporting guidelines (REMARK). RESULTS: Seventeen articles met all inclusion criteria and were selected. The EMT markers analyzed exhibited an important association with the prognosis of the cases evaluated. The results showed a progressive increase in the expression of nuclear transcription factors and markers of mesenchymal differentiation, as well as negative regulation of epithelial and cell adhesion markers, according to the stage of oral epithelial dysplasia. CONCLUSIONS: The dysregulation of expression of important EMT components in oral dysplastic epithelium is a potential prognostic marker in OPMDs

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Immunoexpression of DNA base excision repair and nucleotide excision repair proteins in ameloblastomas, syndromic and non-syndromic odontogenic keratocysts and dentigerous cysts.

OBJECTIVE: To evaluate the immunoexpression of DNA base excision repair (BER) [apurinic/apyrimidinic endonuclease 1 (APE-1), X-ray repair cross complementing 1 (XRCC-1)] and nucleotide excision repair (NER) [xeroderma pigmentosum complementation group (XPF)] proteins in benign epithelial odontogenic lesions with different biological behaviors. DESIGN: Thirty solid ameloblastomas, 30 non-syndromic odontogenic keratocysts (NSOKCs), 29 syndromic odontogenic keratocysts (SKOCs), 30 dentigerous cysts (DCs) and 20 dental follicles (DFs) were evaluated quantitatively for APE-1, XRCC-1 and XPF through immunohistochemistry. RESULTS: Nuclear expression of APE-1 was significantly higher in NSOKCs, SOKCs, and ameloblastomas in comparison to DCs (p < 0.001). Nuclear expression of XRCC-1 was higher in NSOKCs and SOKCs than in DCs (p < 0.05). At the nuclear level, XPF expression was higher in NSOKCs and SOKCs than in DCs and ameloblastomas (p < 0.05). A statistically significant higher expression of APE-1 (nuclear), XRCC-1 (nuclear), and XPF (nuclear and cytoplasmic) was found in all odontogenic lesion samples as compared to DFs (p < 0.05). For all lesions, there was a positive correlation between nuclear expression of APE-1 and XRCC-1 or XPF (p < 0.05). CONCLUSIONS: Our results suggest a potential involvement of APE-1, XRCC-1 and XPF proteins in the pathogenesis of benign epithelial odontogenic lesions, especially in those with more aggressive biological behavior, such as ameloblastomas, NSOKCs, and SOKCs. We also showed that the expression of APE-1 was positively correlated with the nuclear expression of XRCC-1 and XPF, which may suggest an interaction between the BER and NER pathways in all odontogenic lesions studied herein.

Immunohistochemical expression of DNA repair proteins in oral tongue and lower lip squamous cell carcinoma

Abstract The DNA repair system involves genes and proteins that are essential for the maintenance of genome integrity and the consequent control of various cellular processes. Alterations in these genes and proteins play a role in tumor development and progression and might be associated with prognosis. The aims of this study were to analyze the immunoexpression of two DNA repair proteins, XPF and XRCC1, in lower lip squamous cell carcinoma (LLSCC) and oral tongue squamous cell carcinoma (OTSCC), and to investigate possible associations with clinical and histopathological parameters. The immunohistochemical expression of XPF and XRCC1 was analyzed semi-quantitatively in 40 cases each of LLSCC and OTSCC. The chi-squared test or Fisher's exact test, when appropriate, was used to investigate the association between expression of the proteins and clinicopathological characteristics. The cytoplasmic immunoexpression of XPF was high in OTSCC (95% of the cases analyzed) but low in LLSCC (52.5%). Among the clinicopathological parameters evaluated, a statistically significant association was observed between high nuclear expression of XRCC1 and the absence of regional lymph node metastasis in patients diagnosed with OTSCC (p=0.006). The high protein expression of XPF and XRCC1 in OTSCC and LLSCC suggests an important role in the development and progression of these tumors. Our study found an association between high nuclear expression of XRCC1 and the absence of loco-regional metastasis in cases diagnosed as OTSCC, suggesting a role of this protein in tumor progression.

Avaliação clínica e radiográfica de intrusão dentária na dentição decídua: relato de caso / Clinical and radiographic evaluation of dental intrusion in the decidualdentition: case report

Introdução:A intrusão resulta no deslocamento do dente no sentido axial para o interior do osso alveolar, podendo causar injúrias à estrutura periodontal e ao tecido pulpar através do esmagamento e ruptura das fibras do ligamento periodontal e do aporte vascular.Objetivo:abordar a ocorrência de um traumatismo dentário do tipo intrusivo, na dentição decídua, descrevendo aspectos relacionados ao diagnóstico, tratamento e proservação da unidade dentária. Relato de caso:Paciente, quatro anos de idade, gênero feminino, apresentou traumatismo dentário condizente com o diagnóstico de luxação intrusiva, foi estabelecido um tratamento conservador, preservando o elemento dentário no arco até que ocorresse a esfoliação do mesmo. No presente caso, obteve-se um bom prognóstico, visto que foi percebida a reerupção do elemento dentário no período de dois meses.Conclusões:O conhecimento das técnicas de manipulação dos traumatismos dento-alveolares e dos tecidos moles é imprescindível para a realização de um tratamento adequado dessas condições. Desta maneira, é importante o cirurgião-dentista ter habilidades no manejo da criança para um correto diagnóstico, estabelecendo um adequado tratamento, para melhor prognostico da unidade dentária (AU).

Introduction:Intrusion results in axial displacement of the tooth into the alveolar bone and may cause damage to the periodontal structure and pulp tissue by crushing and rupturing the periodontal ligament fibers and vascular input.Objective:To address the occurrence of intrusive dental trauma in the deciduous dentition, describing aspects related to the diagnosis, treatment and proservation of the dental unit. Case report:Patient, four years old, female, had dental trauma consistent with the diagnosis of intrusive dislocation, a conservative treatment was established, preserving the dental element in the arch until exfoliation occurred. In the present case, a good prognosis was obtained, since it was noticed the re-erection of the dental element in the period of two months. Conclusions:The knowledge of the techniques of manipulation of dento-alveolar and soft tissue trauma is essential for the adequate treatment of these conditions. In this way, it is important for the dental surgeon to have skills in the management of the child for a correct diagnosis, establishing an appropriate treatment, for a better prognosis of the dental unit (AU).

Aspectos clínico-patológicos de queilite granulomatosa: relato de caso / Clinical and pathological aspects of Granulomatosis Queilite: Case Report

Introdução:A queilite granulomatosa (QG) é uma lesão oral rara, apresentando clinicamente inchaço de aspecto granulomatoso no lábio.Objetivo:O presente estudo, tem como objetivo apresentar um relato de caso de QG, tendo em vista, a dificuldade do diagnóstico e tratamento de condições inflamatórias com etiologias desconhecidas que acometem a cavidade oral.Relato de caso:Paciente do sexo feminino, apresentou aumento de volume no lábio superior exibindo sintomatologia dolorosa, porém, sem relatar associações com alterações sistêmicas. Durante o exame clínico notou-se que o lábio superior apresentava fissuras profundas, observando tambémedema que se estendia da comissura labial, atravessando a linha média. Levantou-se então, a hipótese diagnóstica de QG. Foi realizada uma biópsia incisional para confirmação do diagnóstico. A análise histopatológica evidenciou, presença de granulomas não caseosos e infiltrado inflamatório linfoplasmocitário perivascular. De acordo com os dados clínicos e análise histopatológica foi dado o diagnóstico inicial de QG. Após o diagnóstico inicial de QG, a paciente foi encaminhada para uma avaliação médica, a fim de avaliar possíveis alterações intestinais que pudessem caracterizar a síndrome de Melkersson-Rosenthal ou Cronh, como também possível reação de hipersensibilidade tardia. Conclusões:O cirurgião-dentista deve estar preparado para diagnosticar aumentos de volume significativos nos lábios, a fim de manejar corretamente o tratamento do paciente, estabelecendo desta forma, prognósticos favoráveis para essas condições (AU).

Introduction:Granulomatous cheilitis (HQ) is a rare oral lesion, presenting clinically granulomatous swelling on the lip. Objective: This study aims to present a case report of HG, considering the difficulty of diagnosis and treatment of inflammatory conditions with unknown etiologies that affect the oral cavity.Objective:This study aims to present a case report of HG, considering the difficulty of diagnosis and treatment of inflammatory conditions with unknown etiologies that affect the oral cavity.Case report:A female patient presented increased volume in the upper lip showing painful symptoms, but without reporting associations with systemic alterations. During the clinical examination it was observed that the upper lip presented deep fissures, also observing edema that extended from the labial commissure, crossing the middle line. The diagnostic hypothesis of GQ was then raised. An incisional biopsy was performed to confirm the diagnosis. Histopathological analysis revealed the presence of non-caseous granulomas and perivascular lymphoplasmacytic inflammatory infiltrate. According to the clinical data and histopathological analysis the initial diagnosis of GH was given. After initial diagnosis of HG, the patient was referred for medical evaluation to evaluate possible intestinal changes that could characterize Melkersson-Rosenthal syndrome or Cronh, as well as possible late hypersensitivity reactions.Conclusions:The dentist should be prepared to diagnose significant volume increases in the lips in order to correctly manage the patient's treatment, thus establishing favorable prognoses for these conditions (AU).

Osteomielite crônica associada a trauma pós-exodontia: relato de caso / Osteomyelitis associated with post-extraction trauma: case report

Introdução: Relatar um caso de osteomielite crônica associada a trauma pós-exodontia, localizado em região posterior de mandíbula. Relato de caso: Paciente do sexo masculino, 44 anos, compareceu à clínica odontológica e foi submetido à extração dos dentes 36 e 38. No alvéolo do 36, foi deixado um fragmento da raiz distal, e, quase dois meses após a data da extração, o paciente retornou à clínica com um abscesso extraoral, com um período de evolução de 2 semanas. Foi observado um aumento de volume do lado esquerdo na região mandibular, o qual não exibia sintomatologia, não era móvel à palpação e continha secreção. Ao exame intraoral, apresentava uma fístula. Dessa forma, foi prescrito penicilina para combater a infecção, e, após uma semana, foi realizada a reabertura, curetagem e drenagem da região. Considerações Finais: A osteomielite dos maxilares está sendo melhor entendida e tratada devido ao acesso do paciente a procedimentos diagnósticos. Por outro lado, o desenvolvimento de microrganismos resistentes a antibióticos comumente usados, a presença de um maior número de indivíduos clinicamente comprometidos e a falta de experiência e recursos diagnósticos por alguns clínicos ainda têm tornado difícil o controle e a prevenção dessa patologia... (AU)

Introduction: To report a case of osteomyelitis associated with post-extraction trauma, located in the posterior region of mandible. Case report: A 44-year-old male patient attended at dental clinic was submitted to extraction of teeth 36 and 38, a fragment of distal root was left in the alveolus of 36, almost two months after extraction date, this patient returned to clinic with an extra oral abscess with an evolution period of 2 weeks. An increase in left side volume was observed in mandibular region, which showed no pain symptoms, but it was palpable and contained secretion. On intraoral examination, he had a fistula. Thus, penicillin was prescribed to combat infection and after one week, reopening, curettage and region drainage were performed. Final considerations: Osteomyelitis of jaws is being better understood and treated, due to patient's access to diagnostic procedures. On the other hand, the development of commonly used antibiotic resistant microorganisms, presence of a greater number of clinically compromised individuals, lack of experience and diagnostic resources by some clinicians have made it difficult to control and prevent this pathology... (AU)

Perfil clínico-epidemiológico do carcinoma epidermoide bucal em pacientes adultos jovens dos 20 aos 45 anos: revisão sistemática / Clinical and epidemiological profile of oral squamous cell carcinoma in young adult patients aged 20 to 45 years: systematic review

Objetivo: identificar e descrever o perfil clínico e epidemiológico do carcinoma epidermoide bucal (CEB) em pacientes adultos jovens. Revisão da literatura: realizou-se uma revisão sistemática, utilizando-se como fontes de buscas as bases de dados eletrônicas Lilacs, SciELO, PubMed e Portal de Periódicos Capes, por meio dos descritores: câncer bucal, carcinoma de células escamosas oral, epidemiologia e paciente jovem, nos idiomas português, inglês e espanhol, no período de janeiro de 2003 a janeiro de 2016. Foram identificados 348 artigos, sendo 171 no Portal de Periódicos Capes, 126 no PubMed, 26 no Lilacs e 2 no SciELO. Após análise dos estudos localizados, oito artigos foram selecionados para a presente revisão sistemática. Considerações finais: são necessários mais estudos para a identificação das características clínicas e epidemiológicas do tumor na população em questão, bem como a padronização da faixa etária referente ao termo adulto jovem, visto que esses esclarecimentos podem refletir no seu controle e possibilitar o desenvolvimento de um programa de prevenção primária para o CEB em pacientes jovens. (AU)

Objective: to identify and describe the clinical and epidemiological profile of oral squamous cell carcinoma in young adult patients. Literature Review: a systematic review was performed using the Lilacs, SciELO, PubMed, and Periódicos Capes electronic databases as search sources, through the following descriptors: oral cancer, oral squamous cell carcinoma, epidemiology, and young patient, in English, Spanish, and Portuguese, from January 2003 to January 2016. A total 348 articles were identified, from which 171 were found in Periódicos Capes, 126 in PubMed, 26 in Lilacs, and 2 in SciELO. After analyzing the studies found, eight articles were selected for the present systematic review. Final considerations: further studies are required to identify the clinical and epidemiological characteristics of the tumor in this population and to standardize the age regarding the term young adult, considering these explanations may reflect in its control and allow developing of a primary prevention program for oral squamous cell carcinoma in young patients. (AU)

Efeito de diferentes colutórios sobre a microdureza de resinas compostas fotopolimerizáveis / Effect of different mouthwashes on microhardness of photopolymerizable composite resins

Introdução: Na Odontologia, as resinas são utilizadas como materiais restauradores, para o restabelecimento da estética, da função e da forma dos dentes. Objetivo: Avaliar in vitro a microdureza das resinas Filtek Z350 XT® e Filtek Z250 XT®, submetidas ao contato direto quando expostas a colutórios. Material e método: Dez corpos de prova foram confeccionados em uma matriz de náilon, em dois incrementos, e foram fotoativados por 20 s. A homogeneidade da amostra foi verificada através dos testes Mann-Whitney e Kruskal-Wallis, e uma variância paramétrica foi realizada (ANOVA) para a análise de significância, aplicando-se o teste de Tukey a fim de comparar os resultados (α=5%). Resultado: O maior valor médio foi apresentado pelo grupo G1 (Filtek Z350 XT- água destilada- controle) - 138,22(±21,8) e os menores valores foram do grupo G9 (Filtek Z250 XT- Solução de Camomila) - 87,12(±4,39) e do grupo G10 (Filtek Z250 XT- Solução de Romã) - 99,32(±11,10). A resina Filtek Z350 XT foi superior à resina Filtek Z250 XT (p=0,015). Conclusão: A resina Filtek Z350 XT apresentou melhores resultados quando estes foram comparados aos resultados da Filtek Z250 XT.

Introduction: In dentistry, resins are used as restorative materials for the reconstruction of aesthetics, function and shape of teeth. Aim: To evaluate in vitro the microhardness of Filtek Z350 XT® and Filtek Z250 XT® resins subjected to direct contact when exposed to mouthwashes. Material and method: Ten specimens were prepared in a nylon matrix in two increments and photoactivated for 20s. The homogeneity of the sample was verified through the Mann-Whitney and Kruskal-Wallis tests and a parametric variance was performed (ANOVA), and for Tukey significance analysis (α=5%). Result The highest mean value was presented by group G1 (Filtek Z350 XT- distilled water- control) - 138.22 (±21.8), and the least values ​​were from group G9 (Filtek Z250 XT- Chamomile Solution) - 87.12 (±4.39) and the G10 group (Filtek Z250 XT - Pomegranate solution) - 99.32 (±11.10). Filtek Z350 XT resin was superior to Filtek Z250 XT (p=0.015). Conclusion Filtek Z350 XT resin presented better results than Filtek Z250 XT.

Avaliação do Efeito Carcinogênico do Papilomavírus Humano em Cavidade Oral e Orofaringe: Uma Revisão Sistemática / Evaluation The Effect Carcinogenic of Human Papillomavirus In Oral Cavity And Oropharynx: A Sistematic Review

O carcinoma epidermoide corresponde a 90% das lesões malignas da cavidade oral e orofaringe. Entre os fatores de risco para o câncer de boca pode-se destacar o tabagismo e o etilismo. Além disso, vírus oncogênicos estão sendo relacionados ao desenvolvimento do câncer ral e de orofaringe. Entre estes vírus, destaca-se o papilomavírus humano. Avaliar o efeito carcinogênico do papilomavírus humano em cavidade oral e orofaringe. Uma busca sistemática de artigos científicas publicados entre janeiro de 2000 a maio de 2016 foi executada nas bases de dados PubMed/Medline, Scopus e Science Direct através dos descritores: Câncer Oral e de Orofaringe, Carcinoma Epidermoide, papiloma vírus Humano. Após análise completa das publicações, seis artigos preencheram todos os critérios de inclusão. Em nossa revisão sistemática, o subtipo 16 foi o mais frequentemente localizado em cavidade oral nos pacientes com carcinoma epidermoide em todos os estudos, sendo de acordo com a literatura científico um subtipo de alto risco para o desenvolvimento neoplásico. O papilomavírus humano pode apresentar-se como um fator etiológico para o desenvolvimento do câncer de orofaringe, assim como para um subgrupo de carcinoma epidermoide, essencialmente em casos de infecção pelo subtipo de risco papilomavírus humano 16. (AU)

The Squamous cell carcinoma accounts for 90% of malignant lesions of the oral cavity and oropharynx. Among the risk factors for oral cancer can highlight smoking and alcohol consumption. In addition, oncogenic viruses are related to the development of oral cancer and oropharyngeal. To evaluate the carcinogenic effect of human papillomavirus in oral cavity and oropharynx. A systematic search of scientific articles published from January 2000 to May 2016 was performed in the databases PubMed / Medline, Scopus and Science Direct through the descriptors: Oral and oropharynx cancer, squamous cell carcinoma, Human Papilloma Virus. After complete analysis of publications, six articles met all inclusion criteria. In our systematic review, subtype 16 was most often located in the oral cavity in patients with squamous cell carcinoma in all studies, and according to the scientific literature a high risk subtype for neoplastic development. Human papilloma vírus can be presented as an etiological factor for the development of oropharyngeal cancer as well as squamous cell carcinoma subgroup, mainly in cases of infection risk subtype of human papilloma vírus 16. (AU)

Matrix metalloproteinase-8 analysis in patients with periodontal disease with prediabetes or type 2 diabetes mellitus: A systematic review.

OBJECTIVES: The objective of this systematic review was to evaluate information on the levels of MMP-8 in patients diagnosed with prediabetes or type 2 diabetes mellitus with periodontal disease, analyzing its validity as a possible biomarker for the diagnosis and progression of periodontal disease (PD). METHODS: A systematic search of the following databases was performed: PubMed/Medline, CENTRAL (The Cochrane Library), EMBASE and Web of Science. Studies involving the evaluation of MMP-8 in patients with prediabetes or patients presenting type 2 diabetes mellitus concomitantly with PD were selected. The evaluation of the methodological quality of the selected studies was based on the methodological bias risk analysis (QUADAS-2). RESULTS: Eight of the initially identified 2683 articles were selected. In all the selected studies, evaluator calibration and the use of clear methods for patient diagnosis with periodontal disease were present. Studies have demonstrated significantly higher MMP-8 concentrations in PD patients compared to controls, as well as in patients presenting more advanced stages of PD. However, controversies regarding MMP-8 levels in prediabetes/diabetes type 2 patients with PD. CONCLUSIONS: Higher MMP-8 levels in patients with PD compared to controls imply the potential use of MMP-8 in the diagnosis of PD. The influence of patient glycemic state, as well as medications these patients make use of, are factors that possibly contribute to the modulation of MMP-8 concentrations in patients with diabetes and should be analyzed, aiming at a better understanding of the relationship between glycemic state and MMP-8 levels in patients with PD.

Avaliação do efeito carcinogênico do papilomavírus humano em cavidade oral e orofaringe: Uma revisão sistemática / Evaluation the effect carcinogenic of human papillomavirus in oral cavity and oropharynx: A sistematic review

O carcinoma epidermoide corresponde a 90% das lesões malignas da cavidade oral e orofaringe. Entre os fatores de risco para o câncer de boca, pode-se destacar o tabagismo e o etilismo. Além disso, vírus oncogênicos estão sendo relacionados ao desenvolvimento do câncer oral e de orofaringe. Entre estes vírus, destaca-se o papilomavírus humano. Avaliar o efeito carcinogênico do papilomavírus humano em cavidade oral e orofaringe. Uma busca sistemática de artigos científicos publicados entre janeiro de 2000 a maio de 2016 foi executada nas bases de dados PubMed/Medline, Scopus e Science Direct utilizando-se os descritores: Câncer Oral e de Orofaringe, Carcinoma Epidermoide, papiloma vírus Humano. Após análise completa das publicações, seis artigos preencheram todos os critérios de inclusão. Em nossa revisão sistemática, o subtipo 16 foi o mais frequentemente localizado em cavidade oral nos pacientes com carcinoma epidermoide em todos os estudos, sendo, de acordo com a literatura científica, um subtipo de alto risco para o desenvolvimento neoplásico. O papilomavírus humano pode apresentar-se como um fator etiológico para o desenvolvimento do câncer de orofaringe, assim como para um subgrupo de carcinoma epidermoide, essencialmente em casos de infecção pelo subtipo de risco papilomavírus humano 16.

The squamous cell carcinoma accounts for 90% of malignant lesions of the oral cavity and oropharynx. Among the risk factors for oral cancer can highlight smoking and alcohol consumption. In addition, oncogenic viruses are related to the development of oral cancer and oropharyngeal. To evaluate the carcinogenic effect of human papillomavirus in oral cavity and oropharynx. A systematic search of scientific articles published from January 2000 to May 2016 was performed in the databases PubMed / Medline, Scopus and Science Direct through the descriptors: Oral and oropharynx cancer, squamous cell carcinoma, Human Papilloma Virus. After complete analysis of publications, six articles met all inclusion criteria. In our systematic review, subtype 16 was most often located in the oral cavity in patients with squamous cell carcinoma in all studies, and according to the scientific literature a high risk subtype for neoplastic development. Human papilloma virus can be presented as an etiological factor for the development of oropharyngeal cancer as well as squamous cell carcinoma subgroup, mainly in cases of infection risk subtype of human papilloma virus 16.

Chlorhexidine to treat oral mucositis in patients with acute leukemia: systematic review / Uso da clorexidina no tratamento da mucosite oral em pacientes com leucemia aguda: revisão sistemática

ABSTRACTBACKGROUND AND OBJECTIVES:Leukemias impair hematopoietic stem-cells shunting and promote a proliferation of malignant cells without functional competence. Studies point that oral manifestations such as pain, hyperplasia and gum bleeding may be one of the first signs in leukemia patients. In light of the above, this study aimed at carrying out a systematic analysis of articles published in the last 15 years, with regard to chlorhexidine to treat and prevent mucositis in acute leukemia children under chemotherapy.CONTENTS:A systematic search of articles published between January 2000 and January 2015 was carried out in Pubmed/Medline, Science Direct and LILACS databases. After systematic search, 6 articles have fulfilled all methodological inclusion criteria. Chlorhexidine is an important means of preventing and treating oral mucositis and studies refer that 0.12% chlorhexidine gluconate effectiveness is probably related to its bactericide action. Adequate oral hygiene is important to prevent mucositis and other therapeutic modalities have shown to be effective to treat and prevent oral mucositis.CONCLUSION:Chlorhexidine gluconate does not totally eliminate oral mucosa injuries, but is able to decrease their frequency and intensity without significant noxious effects. However, other drugs compared to chlorhexidine in this study may present better results.

RESUMOJUSTIFICATIVA E OBJETIVOS:As leucemias comprometem a derivação das células-tronco hematopoiéticas e promovem uma proliferação de células malignas sem competência funcional. Estudos apontam que manifestações orais como dor, hiperplasia e sangramento gengival podem ser um dos primeiros sinais em pacientes com leucemia. Diante do exposto, o objetivo deste estudo foi realizar uma análise sistemática de artigos publicados nos últimos 15 anos, no que diz respeito ao uso da clorexidina no tratamento e prevenção da mucosite em crianças com leucemia aguda em quimioterapia.CONTEÚDO:Uma busca sistemática de artigos publicados entre janeiro de 2000 e janeiro de 2015 foi feita nas bases de dados Pubmed/Medline, Science Directe LILACS. Após pesquisa sistemática 6 artigos preencheram todos os critérios de inclusão metodológica. A clorexidina é um importante meio de prevenção e tratamento da mucosite oral e estudos referem que a efetividade do gluconato de clorexidina a 0,12% está provavelmente relacionada à sua ação bactericida. A correta higienização oral tem importante papel na prevenção da mucosite e outras formas terapêuticas demonstram ser eficazes no tratamento e prevenção da mucosite oral.CONCLUSÃO:O gluconato de clorexidina não elimina totalmente as lesões de mucosa oral, mas é capaz de diminuir sua frequência e intensidade sem apresentar efeitos deletérios significativos no paciente. Entretanto, outros fármacos comparados à clorexidina neste estudo podem apresentar melhores resultados.