Prevalence of Oral Lesions Diagnosed at a Pathology Institute: A Four-year Analysis

Abstract Objective: To identify the most prevalent oral lesions based on reports from a pathology institute's reports and associations between malignant and oral potentially malignant disorders with patient's demographic variables and the anatomical location. Material and Methods: All 1,298 histopathological reports of oral lesions recorded in the database were reviewed. Demographic variables, anatomical location of the lesion, histopathological diagnosis of the lesions, and their biological behavior were analyzed. Results: Regarding the biological behavior of the identified lesions, benign lesions were predominant (70%), followed by lesions of undetermined behavior (14.3%), malignant lesions (14.2%), absence of histological alteration (1.2%), and finally, oral potentially malignant disorders (0.5%). The anatomical locations of the most prevalent oral lesions potentially malignant disorders and malignant were in the following structures of the oral cavity: gums, buccal mucosa, floor of the mouth and hard palate (p=49.2%), and tongue (p=48.7%). Conclusion: The probability of malignant and premalignant lesions was higher among males (PR= 4.21; 95% CI 2.08-6.22), the increase in age (PR = 1.06; 95% CI 1.05-1.08), and in the tongue region (PR = 5.48; 95% CI 1.67; 17.92). Identification of malignant and potentially malignant oral conditions is higher in older men and in tongue specimens.

Child abuse and neglect: oral and dental signs and the role of the dentist.

Historically, the law, dental and forensic literature has included numerous articles concerning abused children. The orofacial structures are injured frequently in the maltreated child. Injuries of the neck, head, face, and oral cavity represent the most affected areas of the victim's body that routinely sustain physical trauma in child maltreatment cases. This literature review aimed to report the state of art of child abuse from the point of view of the dentist with focus on studies in dental aspects of child abuse and neglect of the last ten years. Considering the time slot, 20 papers were included with the following inclusion criteria: papers published in English, all keywords included in the title, articles available on PubMed. Many of the injuries are within the scope of dentistry or easily observed by the dental professional during routine dental treatment, and it is essential that the dentist recognizes them. Concerning neglect, it is appropriate to make a distinction between deliberate parental behavior that has the consequence of unavoidable and voluntary neglect towards their children and those conditions of involuntary carelessness determined by socio-economic and cultural factors such as family isolation, lack of finances, parental ignorance, or lack of perceived value of oral health. Therefore, it is relevant that the dentist pays attention to the cases to report and those that only need help.

Oral lesions after infection by SARS CoV 2: two case reports / Lesiones bucales posteriores a infección por SARS CoV 2 presentación de dos casos

Introduction: The SARS CoV 2 infection has resulted in several health, economic, and social crises in all areas. The disease shows a substantial biological diversity in humans causing a series of sequels in the trans- or post-infection period in the entire organism. Case Report: The manifestations that occur in the oral cavity and pharynx have not been evaluated. In this study, two clinical cases are reported. The first patient, a 67-year-old male, presents erosive lesions on the dorsal surface of his tongue after SARS CoV 2 infection. Results: Therapy consisting of reinforcing oral cleaning, use of antifungal solutions, mouthwashes containing superoxidation solution and B complex was given to the patient. The reported lesions improved satisfactorily. The second case, a 47-year-old male patient, presented vesiculobullous lesions on the lingual and labial mucosa accompanied by severe painful symptoms after SARS CoV 2 infection. An incisional biopsy was performed. The histopathological result was compatible with pemphigus vulgaris, and the treatment protocol was started with 0.1% topical mometasone and 2g miconazole gel, observing adequate involution of the lesions after 20 days. Conclusions: The aim of this study is to report on the lesions affecting the oral cavity and pharynx in post-COVID patients with the aim of carrying out a thorough intraoral examination, establishing a clinical or histopathological diagnosis to implement a specific treatment plan in each case to improve the health and quality of life of the patients. Keywords: SARS-CoV-2; Oral manifestations; Oral ulcer; Pemphigus; Mouth; Mucous membrane.

Introducción: La infección por virus de SARS CoV 2 ha dejado a su paso una estela de crisis en materia de salud, económica, social y en todos los ámbitos a la fecha seguimos realizando la observación del comportamiento de la enfermedad en los seres humanos con una diversidad biológica importante y que ha traído como consecuencia una serie de secuelas que se presentan en el periodo trans o posterior a la infección en toda la economía corporal. Reporte de Caso: Se ha evaluado poco las manifestaciones que se presentan en la cavidad bucal y faringe; se presentan dos casos clínicos el primero paciente masculino de 67 años de edad posterior a la infección por SARS CoV 2 presenta diluciones de continuidad en bordes laterales de la lengua se indica terapia y refuerza limpieza bucal, antimicótico, colutorios con solución de superoxidación y complejo B, las úlceras involucionan de manera satisfactoria. Resultados: El segundo caso masculino de 47 años posterior a la infección por SARS CoV 2 debuta con lesiones vesículo-ampollosas en mucosa lingual, labial con sintomatología dolorosa severa, se realiza biopsia incisional donde el resultado histopatológico es compatible con pénfigo vulgar, se inicia protocolo de tratamiento con mometasona tópica al 0.1% y miconazol gel 2g observándose una adecuada involución de las lesiones a los 20 días. Conclusiones: El objetivo de este trabajo es poner en contexto de la comunidad médica y científica las lesiones concernientes a la cavidad bucal y faringe que están presentando los pacientes postcovid con el objetivo de realizar una exhaustiva exploración intraoral, establecer un diagnóstico clínico o histopatológico y con base en esto instaurar un plan de tratamiento específico en cada caso en particular con el fin fundamental de mejorar la salud y calidad de vida del paciente.

Tumores vasculares de interesse odontológico: aspectos clínicos e formas de tratamento / Vascular tumors of dental interest: clinical aspects and forms of treatment

Os hemangiomas são neoplasias benignas dos tecidos moles. São lesões caracterizadas pela proliferação de células endoteliais. Objetivos: O objetivo deste trabalho é demonstrar por meio de uma revisão da literatura os principais hemangiomas de interesse odontológico e suas características clínicas e abordagens terapêuticas. Revisão de literatura: O estudo mostrou prevalência de até 6% na população geral, sendo o tumor mais comum na infância. Essas lesões apresentam rápido crescimento pós-natal, que pode levar meses a dois anos em média, mas geralmente após esse período ocorre sua involução. O diagnóstico é comumente baseado nas características clínicas e na história do paciente. É importante entender que o estudo histopatológico pode ser necessário nos casos em que o diagnóstico é incerto, para diferenciá-lo de outras neoplasias graves. Destacam-se as principais complicações relacionadas a lesões, ulcerações e hemorragias, além de infecções secundárias que podem causar alto índice de morbidade. Assim, é fundamental que o dentista reconheça essas patologias e tenha capacidade para tratá-las. Considerações finais: Foi possível observar que os hemangiomas são manifestações vasculares incomuns para o cirurgião-dentista, porém o profissional deve saber diagnosticá-los e tratá-los. Dentre as áreas acometidas, essas lesões são frequentes na cavidade oral e o tratamento consiste em acompanhamento com intervenções conservadoras(AU)

Hemangiomas are benign soft tissue neoplasms. These are lesions characterized by the proliferation of endothelial cells. Objectives: The objective of this work is to demonstrate through a literature review about the main hemangiomas of dental interest and clinical characteristics and therapeutic approaches. Literature review: The study showed a prevalence of up to 6% in the general population, being the most common tumor in childhood. These lesions presents a rapid postnatal growth, which may take months until two years on average, but usually after this period their involution occurs. The diagnosis is commonly based on clinical characteristics and patient's history. It is important to understand that the histopathological study may be necessary in cases that the diagnostic is uncertainty, in order to differentiate it from other serious neoplasms. Main complications related to injuries, ulceration and hemorrhage can be highlighted, in addition to secondary infections that can cause a high rate of morbidity. Thus, it is essential that dentists recognize such pathologies and be able to treat them. Final considerations: Was possible do observe that hemangiomas are uncommon vascular manifestations for the dental surgeon, however, the professional must know to diagnose and treat them. Among the affected areas, these lesions are frequently seen in the oral cavity and the treatment consists of following up with conservative interventions(AU)

Traumatismos bucodentales en la práctica del rugby: a propósito de un caso / Oral trauma in rugby practice: about a case

Introducción: La participación en el rugby se ha visto incrementada con el paso de los años, especialmente en países donde la práctica de este deporte no era habitual, lo que ha arrojado como consecuencia un aumento en la incidencia de lesiones, dada la naturaleza de alto impacto del mismo. Diversos estudios epidemiológicos han evaluado la incidencia de traumatismos bucodentales como consecuencia de accidentes deportivos, en los que se hace referencia a las fracturas dentarias como aquellas más comúnmente producidas dentro de la práctica de este tipo de deportes. Descripción del caso clínico: Se presenta el caso clínico de un paciente varón de 18 años de edad, sin antecedentes médicos de interés, remitido al servicio de Cirugía Bucal del Hospital Viamed Virgen de la Paloma de Madrid, quién presentaba una lesión de tejidos blandos, además de luxación palatina del sector dentario anterosuperior, como consecuencia de un traumatismo durante un partido de rugby, para el cual se prescribió tratamiento farmacológico combinado con una ferulización, permitiéndose así la cicatrización espontánea de los tejidos. Discusión y conclusiones: Se observa una alta incidencia de lesiones producidas durante la práctica del rugby debido al escaso equipamiento protector usado por los jugadores, donde la cara y sus tejidos blandos constituyen las zonas con mayor frecuencia de afectación, pudiendo considerarse como el deporte de alto impacto con mayor prevalencia de lesiones de cabeza y cuello. (AU)

Introduction: Participation in rugby has increased over the years, especially in countries where the practice of this sport was not common, which has resulted in an increase in the incidence of injuries given its high-impact nature. Various epidemiological studies have evaluated the incidence of oral trauma as a result of sports accidents, in which dental fractures are referred to as those most commonly produced within the practice of this type of sports. Description of the clinical case: We present the clinical case of an 18-yearold male patient, with no relevant medical history, referred to the Oral Surgery Service of the Virgen de la Paloma Viamed Hospital in Madrid, who presented a soft tissue lesion in addition to a palatal dislocation of the dental sector anterosuperior as a result of trauma during a rugby match, for which drug treatment combined with splinting was prescribed, thus allowing spontaneous tissue healing. Discussion and conclusions: A high incidence of injuries produced during rugby practice is observed due to the scarce protective equipment used by the players, where the face and its soft tissues constitute the areas with the highest frequency of affectation and can be considered as the high-impact sport with the highest prevalence of head and neck injuries. (AU)

Granuloma piógeno oral. Serie de casos / Oral pyogenic granuloma. Case series

RESUMEN El granuloma piógeno es una lesión que se manifiesta en la piel y en la cavidad oral, relacionado con diversas causas, como irritación crónica, trauma y cambios hormonales. Clínicamente se muestra como una lesión hiperplásica altamente vascularizada, con un tamaño de 1-3 cm, de base pedunculada o sésil y de crecimiento lento. Predomina en el sexo femenino y tiende a aparecer, sobre todo, en la encía, con muy pocos casos reportados en zonas edentes, motivo por el que se realizó el reporte de tres casos de granuloma piógeno oral en pacientes femeninas, comprendidas entre 30 y 40 años de edad. Se presentaron lesiones que diferían en cuanto a su localización y apariencia clínica (AU).

ABSTRACT Pyogenic granuloma is a lesion that arises in the skin and oral cavity, related to various causes, such as chronic irritation, trauma and hormonal changes. Clinically it looks like a highly vascularized hyperplastic lesion, sized 1-3 cm, with a pedunculated or sessile base and slow growing. It predominates in the female sex and tends to appear, above all, in the gum, with very few cases reported in edentulous areas; that is why the authors reported three cases of oral pyogenic granuloma in female patients, aged between 30 and 40 years. The lesions differed in their location and clinical appearance (AU).

What is the frequency of floor of the mouth lesions? A descritive study of 4016 cases / ¿Cuál es la frecuencia de las lesiones del suelo de la boca? Un estudio descriptivo de 4016 casos

Background: The aim of this study was to investigate the frequency of oral lesions in the floor of the mouth fromrepresentative oral pathology centres in Latin America.Material and Methods: This study was conducted on biopsies obtained from January of 1978 to December of 2018at nine Latin America oral and maxillofacial pathology centres. Gender, age and histopathological diagnosis wereevaluated. Data were analysed using descriptive methods. Chi-square test was used for pairwise comparisons.Results: From 114,893 samples, 4,016 lesions (3.49%) occurred in the floor of the mouth. Brazil showed 3,777 cases(94%), Mexico 182 cases (4.5%) and Argentina 57 cases (1.4%). Benign lesions represented 65.1% (2,617 cases),followed by 34.9% (1,404 cases) of malignant disorders. Lesions of epithelial origin were more frequent (1,964) cases; 48.9%), followed by salivary glands (1,245 cases; 31%) and soft tissue lesions (475 cases; 11.7%). The mostcommon histological subtypes were oral squamous cell carcinoma (1,347 cases; 33.5%), ranula (724 cases; 18%), oralleukoplakia (476 cases; 11.8%) and inflammatory fibrous hyperplasia (239 cases; 5.9%). The lesion affected males in2,129 cases and females in 1,897 cases.Conclusions: In the current study, lesions in the floor of the mouth represented 3.49% of biopsies submitted to oralpathology services and oral squamous cell carcinoma, ranula and leukoplakia were the most common lesions.(AU)

Relación causa - efecto entre manifestaciones bucales y pacientes con la COVID-19 / Cause - effect relationship between the oral manifestations and the patients with COVID-19

Las manifestaciones clínicas en los pacientes con la COVID-19 han sido notificadas en numerosas investigaciones; sin embargo, respecto a la cavidad bucal es escasa la información. En este artículo se abordan las manifestaciones bucales más frecuentes y su localización. Asimismo, se considera que no puede establecerse la relación causa - efecto entre la infección por coronavirus y la aparición de lesiones bucales, puesto que estas lesiones pueden estar relacionadas con la inmunosupresión; además, se presentan como coinfecciones y manifestaciones secundarias con múltiples aspectos clínicos.

The clinical signs in patients with COVID-19 have been notified in numerous investigations; however, there is lack of information regarding the oral cavity. The most frequent oral manifestations and their localization are approached in this work. Also, it is considered that the cause-effect relationship between the infection by coronavirus and the emergence of oral lesions cannot be established, since these lesions can be related to the immunosupression; also, they are presented as coinfections and secondary signs with multiple clinical aspects.

The use of customized mouthguards during the training produced protective effects on salivary factors of young athletes.

AIM: Custom-made mouthguards have many advantages compared to the stock and ready-made types, but sport treatments with custom made mouthguards involve changes in ecological factors of the oral cavity. In the present study we investigated the potential protective role of salivary factors, such as pH value, volume, prostaglandin E2 (PGE2) and 8-iso-prostaglandin F2? (8-iso-PGF2?) levels during training with customised mouthguards. MATERIALS AND METHODS: A total of 80 subjects were selected: 40 athletes, of whom 20 practice volleyball and 20 basketball (test group), and 40 subjects who attend a gym at a non-competitive level (control group). The athletes (test group) were analyzed at baseline (T0), pre-training (T1), post-training with custom-made Ethylene-Vinyl-Acetate (EVA) mouthguards (T2), post-training without mouthguards (T3). The control group was analyzed only at baseline (T0). On each player, in the 4 time points, and on the control group at T0, we stimulated saliva for determining PGE2 and 8-iso-PGF2? levels by radioimmunoassay and pH value by a pH meter and volume/ml. Saliva pH was calculated with a pH meter. RESULTS: We observed an inhibition of 8-iso-PGF2? salivary release induced by physical exercise and by use of custom-made mouthguard, while we found an increase in PGE2 salivary level in athletes after training and wearing the mouthguard. Furthermore, in the test of the volume of saliva produced in 5 minutes, a significant inhibition of saliva production emerged in the athletes who did not use the mouthguard during sports activities. CONCLUSION: Sports activity could lead to a reduction in oxidative stress and the use of mouth guards seems even more effective for athletes.

Liquen plano pigmentoso en la cavidad oral / Lichen planus pigmentosus in oral cavity

Introducción: El liquen plano pigmentoso es una lesión autoinmune de etiología desconocida, aunque tiene mayor incidencia en mujeres de mediana edad, a las que afecta principalmente la cara y el cuello y, en menor medida, la cavidad oral. Objetivo: Describir las características clínicas e histopatológicas de un caso de liquen plano pigmentoso en la cavidad oral. Presentación del caso: Mujer de 21 años, negra, que acudió al servicio quejándose de una mancha en la cavidad oral. Las lesiones presentaban un mes de evolución, crecimiento radial y sin síntomas dolorosos. Consistían en placas ennegrecidas de contorno regular con estrías blanquecinas en su periferia, forma redondeada, bordes afilados, en mucosa yugal bilateral, que medían aproximadamente 25 mm en el derecho y 13 mm en el lado izquierdo. Después de la biopsia incisional y el análisis histopatológico, se confirmó la sospecha de liquen plano pigmentoso oral. El tratamiento propuesto para las lesiones fue conservador mediante un estricto seguimiento clínico. Conclusiones: El diagnóstico del liquen plano pigmentoso, debido a su baja ocurrencia en la cavidad oral y sus características clínicas atípicas y semejantes a otras lesiones orales, es complejo. En este contexto, se ratifica la relevancia del examen histopatológico y se destaca la necesidad de otros estudios para aclarar los factores etiológicos involucrados en esta lesión(AU)

Introduction: Pigment lichen planus is an autoimmune lesion of unknown etiology, with preference for middle-aged women, which mainly affects the face and neck, being rare in the oral cavity. Objective: To report a case of pigment lichen planus in the oral cavity, with emphasis on its clinical and histopathological characteristics. Case report: 21 years old woman, black, who came to the service complaining about a spot in the oral cavity. The lesions presented a month of evolution, radial growth and no painful symptoms. They consisted of blackened plates of regular contour with whitish stretch marks on their periphery, rounded shape, sharp edges, on bilateral jugular mucosa, which measured approximately 13 mm on the left side and 25 mm on the right. After the incisional biopsy and histopathological analysis, the suspicion of oral pigment lichen planus was confirmed. The proposed treatment for the lesions was conservative through strict clinical follow-up. Conclusion: The importance and difficulty of the diagnosis of pigment lichen planus is emphasized, especially due to its low occurrence in the oral cavity and its atypical clinical characteristics and similar to other oral lesions. In this context, the relevance of the histopathological examination is ratified and the need for further studies to clarify the etiological factors involved in this pathology is highlighted(AU)

Anthocyanin complex niosome gel accelerates oral wound healing: In vitro and clinical studies.

An anthocyanin complex (AC), composed of extracts of purple waxy corn and blue butterfly pea petals, and AC niosomes, bilayered vesicles of non-ionic surfactants, were compared in in vitro and clinical studies. Cultured fibroblasts subjected to a scratch wound were monitored for cell viability, cell migration, nuclear morphology and protein expression. Scratched cells showed accelerated wound healing activity, returning to normal 24 h after treatment with AC niosomes (0.002 mg/mL). Western blots and immunocytochemistry indicated upregulation of type I, III and IV collagens, fibronectin and laminins in AC niosome-treated scratched cells. A randomized block placebo-controlled double-blind clinical trial in 60 volunteers (18-60 years old) with oral wounds indicated that AC niosome gel accelerated wound closure, reduced pain due to the oral wounds and improved participants' quality of life more than AC gel, triamcinolone gel and placebo gel. These data are consistent with enhanced delivery of AC to fibroblasts by use of niosomes. AC niosomes activated fibroblasts within wounded regions and accelerated wound healing, indicating that AC niosomes have therapeutic potential.

Prevalência de lesões bucais em tecidos mole e duro diagnosticadas em idosos em um serviço histopatológico de referência / Prevalence of oral lesions in soft and hard tissue in elderly patients in a single histopathological service / Prevalencia de lesiones bucales en tejido blando y duro enancianos diagnosticadas en un servicio de referencia histopatológico

O envelhecimento populacional é um fenômeno mundial, sendo percebido também no estado do Amazonas. Com a alta expectativa de vida, o enfoque na saúde geral e bucal impactam diretamente a qualidade de vida da pessoa. Desta forma, os levantamentos acerca da população geriátrica não devem ser restritos às alterações fisiológicas da idade, devendo abordar também as manifestações patológicas, retratando assim quais são as lesões bucais mais recorrentes. O trabalho em questão visa levantar o número de lesões bucais prevalentes em tecido mole e duro em idosos. Sendo feito a partir de um levantamento das lesões bucais prevalentes em tecido mole e duro que acometeram os idosos registrados nos laudos do Serviço de Patologia Oral e Maxilofacial da Universidade do Estado do Amazonas, SEPAT-UEA, entre os anos de 2012 a 2018. Segundo os dados coletados, a categoria de neoplasias de tecido mole (28,94%) teve o maior número de casos, em que a lesão mais prevalente, sendo esta do mesmo grupo, foi a hiperplasia fibrosa inflamatória (14,04%). Teve maior acometimento em mulheres (54,91%), pessoas com 60-69 anos (74,77%), usuários de próteses removíveis (15,56%) e a mandíbula (17,28%) foi a localização mais comum. Com as informações adquiridas, a partir de um serviço de referência do estado do Amazonas, é possível ter um melhor direcionamento dos recursos para a população geriátrica tendo um maior enfoque para as lesões mais prevalentes visando assim uma melhor saúde bucal e consequentemente uma melhor qualidade de vida(AU)

Population aging is a worldwide phenomenon, and is also noticed in the state of Amazonas. According to the high life expectancy, the focus on general health and the oral impact directly on the person's quality of life. Thus, surveys about thegeriatric population should not be restricted as physiological changes in age, but should also be addressed as pathological manifestations, thus portraying which are the most recurrent oral lesions. The aim of the study is to raise the frequency of the most prevalent of oral lesions in soft and hard tissue in the elderly. Being made from a survey of oral lesions in soft and hard tissue that affected the elderly registered in the reports of the Oral and Maxillofacial Pathology Service of the Amazonas State University, SEPAT-UEA, between the years 2012 to 2018. According to collected data, the category of soft tissue neoplasms (28.94%) had the highest number of cases, in which the most prevalent lesion, being the same group, for an inflammatory fibrous hyperplasia (14.04%). It was more recurrent in women (54.91%), elderly in 60-69 years (74.77%), users of removable prosthesis (15.56%) and the mandible (17.28%) was the most common location. With the information acquired, from a reference service in the state of Amazonas, it is possible to have a better targeting of resources for the geriatric population, with agreater focus on the most prevalent injuries, thus better oral health and consequently a better quality of life care(AU)

El envejecimiento de la población es un fenómeno mundial, se percibe también en el estado de Amazonas. Con la alta expectativa de vida, el enfoque en la salud general y bucal impactan directamente la calidad de vida de la persona. De esta forma, las encuestas sobre la población geriátrica no deben restringir a los cambios fisiológicos de la edad, sino que deben abordar también las manifestaciones patológicas, describiendo así cuáles son las lesiones bucales más recurrentes. El trabajo en cuestión tiene por objeto levantar el número de lesiones bucales prevalentes en tejido blando y duro en ancianos. Se realiza a partir de um estudio de las lesiones bucales prevalentes que han afectado a los ancianos registrados en los informes del Servicio de Patología Oral y Maxilofacial de la Universidad del Estado de Amazonas, SEPAT-UEA, entre los años 2012 a 2018. Según los datos recogidos, la categoría de neoplasias de tejidos blandos (28,94%) presentó el mayor número de casos, en la que la lesión más prevalente fue la hiperplasia fibrosa inflamatoria (14,04%). Fue más afectado por mujeres (54,91%), personas de 60 a 69 años (74,77%), usuarios de prótesis removibles (15,56%) y la mandíbula (17,28%) fue la localización más común. Con la información adquirida, de un servicio de referencia en el estado de Amazonas, es posible tener una mejor focalización de recursos para la población geriátrica, con un mayor enfoque en las lesiones más prevalentes, apuntando así a una mejor salud bucal y consecuentemente una mejor calidad de vida(AU)

Oral mucositis. Is it present in the immunotherapy of the immune checkpoint pd1/pd-l1 against oral cancer? A systematic review / Mucositis bucal. ¿Está presente en la inmunoterapia del punto de control inmunológico pd1/pd-l1 contra el cáncer oral? Una revisión sistemática

Background: Oral mucositis (OM) is a painful lesion that takes place in the mucosa of the oral cavity, usually itsetiology is associated with drug therapies in cancer patients. It is presented as well-defined ulcers whose painfulsymptomatology sometimes implies the suspension of oncological treatment or parenteral feeding, being there-fore an important adverse effect, marking the evolution of these types of therapies against cancer. The presentwork aim is to know the prevalence of oral mucositis in oral cancer immunotherapy compared to its prevalencein standard therapy.Material and Methods: A protocol was developed for a systematic review following PRISMA® guidelines and afocused question (PICO) was constructed. A comprehensive literature search was conducted on electronic data-bases including PubMed, the SCOPUS database, the Cochrane library and the Web of Science (WOS).Results: Six clinical trials were included that met the different inclusion criteria. In these articles, a discrepancybetween the prevalence of OM in patients treated with chemotherapy and patients treated with immunotherapyrelated to the immune checkpoint PD-1/PD-L1 (Nivolumab and Pembrolizumab) was observed. Conclusions: The prevalence of oral mucositis is lower in new immunotherapy with monoclonal antibodies againstoral cancer than drugs used so far (chemotherapy drugs [methotrexate, cisplatin] as well as cetuximab). However,more studies should be carried out to confirm these data.(AU)

Asociación entre los niveles de linfocitos T CD4 y lesiones bucales de portadores del VIH/sida / Association between CD4 T lymphocyte levels and oral lesions in HIV/AIDS patients

Introducción: Las enfermedades de la cavidad bucal en los pacientes con VIH/sida pueden verse agravadas dependiendo de la respuesta inmunitaria del paciente y los niveles de linfocitos. Objetivo: Relacionar los niveles de linfocitos T CD4 y las principales lesiones bucales en pacientes con el VIH/sida del Hospital Nacional Hipólito Unanue (Lima, Perú), durante el 2018. Métodos: Se realizó un estudio analítico y de corte transversal, entre julio y octubre del 2018, en 65 pacientes hospitalizados, a los cuales se realizó un examen clínico de la cavidad bucal. Se evaluó la presencia de manifestaciones bucales asociadas al VIH/sida; también se clasificó el nivel de linfocitos T CD4 en tres categorías (> 500 cel/mm3, entre 200-500 cel/mm3 y < 200 cel/mm3). Resultados: Un 70,8 por ciento de los pacientes no se encontraba con tratamiento antirretroviral al momento del examen. El nivel promedio de linfocitos T CD4 fue 237,65 cel/mm3, con mayor prevalencia en mujeres. El 56,9 por ciento de los pacientes presentaron lesiones bucales, el sexo masculino fue el más afectado (91 por ciento). La lesión más frecuente fue la candidiasis bucal (44,6 por ciento) y la categoría que presentó mayor frecuencia de lesiones bucales fue la < 200 cel/mm3 (38,5 por ciento; p < 0,05). Conclusiones: El sexo masculino presentó la mayor cantidad de lesiones bucales asociadas a bajos niveles de linfocitos T CD4. La mayor parte de lesiones bucales se presentaron en un nivel de linfocitos T CD4 < 200 cel/mm3. La candidiasis bucal fue la lesión que más se evidenció al momento de realizar el examen clínico(AU)

Introduction: Oral diseases may be aggravated in HIV/AIDS patients depending on their immune response and lymphocyte levels. Objective: Describe the relationship between CD4 T lymphocyte levels and the main oral lesions in HIV/AIDS patients from Hipólito Unanue National Hospital in Lima, Peru, during the year 2018. Methods: An analytical cross-sectional study was conducted of 65 hospitalized patients from July to October 2018. The patients underwent oral clinical examination. Evaluation was performed of the presence of HIV/AIDS-related oral manifestations, and CD4 T lymphocyte levels were classified into three categories: > 500 cell/mm3, 200-500 cell/mm3 and < 200 cell/lmm3. Results: Of the total patients studied, 70.8 percent were not under antiretroviral treatment at the moment of the examination. Average CD4 T lymphocyte level was 237.65 cell/mm3, with higher results among women. 56.9 percent of the patients had oral lesions. Males were more commonly affected (91 percent). The most frequent lesion type was oral candidiasis (44.6 percent), whereas the category presenting the highest frequency of oral lesions was < 200 cell/mm3 (38.5 percent; p < 0.05). Conclusions: Male patients presented the largest number of oral lesions associated to low CD4 T lymphocyte levels. Most of the oral lesions were found at a CD4 T lymphocyte level < 200 cell/mm3. Oral candidiasis was the lesion most commonly found by the clinical examination(AU)

Manifestación oral de la sífilis / Oral manifestation of syphilis

Introduction: syphilis is a sexually transmitted disease with an annual incidence of 12 million people worldwide. In Brazil, there are increasing rates of infant mortality and incidence due to this disease. Objective: to report a case of primary syphilis with manifestation in the mouth. Case report: patient 50-years-old, male, homosexual with a complaint of an asymptomatic lesion on the lower left lip for about 2 months. In the intraoral physical examination, it was observed ulcerated lesion, with white-yellowish pseudomembrane, non-suppurative with hardened, elevated and badly-delimited edges measuring approximately 3 cm on the lower left lip. An incisional biopsy of the lesion was carried out and it was prescribed high doses of prednisolone, but without success. During follow-up, erythematous lesions target-shaped appeared in the palmar region and the resulting histopathological report showed ulcerated lichenoid cheilitis. Hematological exams confirmed positive for syphilis in the VDRL test. The treatment was penicillin G benzathine for 3 weeks. Conclusions: in the present case, the syphilitic lesion has clinical characteristics common to other diseases. Thus, dentists should know their clinical manifestations, that would aid in early diagnosis and treatment(AU)

Introducción: La sífilis es una enfermedad de transmisión sexual con una incidencia anual de 12 millones de personas en el mundo. En Brasil, hay crecientes tasas de incidencia y mortalidad infantil por esa enfermedad. Objetivo: Describir un caso de sífilis primaria con manifestación en cavidad oral. Presentación del caso: Paciente masculino de 50 años de edad, homosexual, con queja de lesión sin dolor en el labio inferior izquierdo que había comenzado aproximadamente dos meses antes de asistir a la consulta. En la inspección clínica intraoral se observó lesión ulcerada, que medía aproximadamente 3 cm en el labio inferior izquierdo, con seudomembrana blanco-amarillenta, no supurativa, con bordes indurados, elevados y mal delimitados. Se tomó una biopsia de la lesión y se prescribieron altas dosis de prednisolona, pero sin éxito. Durante el seguimiento, lesiones eritematosas en "tiro al blanco" aparecieron en la región palmar y el estudio histopatológico reveló queilitis liquenoide ulcerada. Los exámenes hematológicos confirmaron positividad para sífilis en la prueba VDRL. El tratamiento fue penicilina G benzatínica por tres semanas. Conclusiones: En el presente caso la lesión sifilítica tenía características clínicas comunes a otras enfermedades. Por lo tanto, los dentistas deben conocer sus manifestaciones clínicas, que ayudarían en el diagnóstico y tratamiento tempranos(AU)