Possible adverse effects of low-level laser on oral and oropharyngeal cancer cells: A scope review.

BACKGROUND: The effects of laser therapy on normal cells are well known and accepted, but the impact of this therapy on malignant cells are not yet fully understood. This review aims to map and outline what the scientific literature addresses on the effects of laser therapy on malignant cells. METHODS: This review article followed the guidelines of the PRISMA-ScR protocol, being all the search, analysis, and selection of articles based on it. RESULTS: After all application of the predetermined criteria, five studies were included, dated between the years 2013 and 2021. With the complete reading of the selected studies, 100% of the articles were classified as category III of the Agency for Healthcare as Research and Quality classification. Similar themes among the papers included were investigated and compared. In these five studies, the visible red and near infrared wavelengths were used, and energy densities varied between 1 and 5 J/cm2 . It was observed that low-level laser could alter the expression of cell proliferation and migration proteins, such as cyclin D1, E-cadherin, and ß-catenin. In addition, changes related to increased cell viability and metabolism were also identified. CONCLUSION: The low-level laser seems to positively regulate the proliferative, migratory, and viability capacity of neoplastic cells, depending on the protocol used. All these studies included in the review are equivalent to in vitro studies; the cells are not in such a complex environment as is an organized tissue, making it necessary to carry out more complex tests, such as in vivo research.

Diagnostic accuracy of immunohistochemistry compared with molecular tests for detection of BRAF V600E mutation in ameloblastomas: Systematic review and meta-analysis.

OBJECTIVE: The objective of this systematic review with meta-analysis was to critically evaluate the available data on sensitivity and specificity of IHC compared with molecular tests in the detection of BRAF V600E mutation in ameloblastomas. MATERIALS AND METHODS: This systematic review was performed based on the PRISMA statement and registered in Prospero (CRD42021259117). PubMed, Web of Science, Scopus, and Cochrane Library databases were searched for observational studies to answer the question "What is the diagnostic accuracy of immunohistochemistry compared with molecular tests for the diagnosis of BRAF V600E mutation in ameloblastomas?". Methodological quality and risk of bias assessment of the selected studies were based on the QUADAS-2. Meta-analysis based on hierarchical SROC curve model and summary measures for sensitivity and specificity were computed. RESULTS: A total of 226 records were found, but only 05 articles met the inclusion criteria, with 277 FFPE specimens of ameloblastoma included in the quantitative analysis. The sensitivity of the IHC compared to molecular tests ranged from 0.71 to 1.00, while all of the included studies showed perfect specificity (1.00). Pooled measures for sensitivity and specificity were 0.95 [95% CI 0.89, 1.00] and 1.00 [95% CI 0.95, 1.00], respectively. The diagnostic odds ratio was 4.05, and the AUC for SROC curve was calculated as 0.979. CONCLUSIONS: BRAF V600E-specific IHC using VE1 antibody showed extremely high sensitivity and specificity when compared with molecular tests in the detection of the mutation in ameloblastomas.

Access to information on oral hygiene and mothers' practices of children with microcephaly caused by Zika virus.

OBJECTIVE: To verify whether access to information about oral hygiene influenced the practices of caregivers of children with microcephaly caused by Zika virus (ZIKV). METHODS: A case series study was developed at the Mens Sana Rehabilitation Center, in the municipality of Arcoverde, Pernambuco, Brazil. The study universe included the mothers of 32 children with microcephaly caused by Zika virus. Data collection took place in June 2018 and was carried out through a structured questionnaire. The variables studied comprised socioeconomic issues, habits, diet, and knowledge about oral hygiene. Fisher's Exact and Pearson's Chi-square tests were used with a significance level of 5%. RESULTS: Out of 32 individuals eligible to participate in the study, only 27 were selected. Most mothers reported receiving information about oral hygiene from their infants (63.0%). Fisher's Exact and Pearson's Chi-square tests showed that access to oral hygiene information was associated with mother's education, family income, regular visits to the dentist, frequency of tooth brushing, age at which the infant started brushing, and brushing time (p < 0.05). CONCLUSION: Access to information about oral hygiene positively influenced the oral health care of mothers with their children with microcephaly caused by ZIKV.

Surgical versus non-surgical treatment of actinic cheilitis: A systematic review and meta-analysis.

OBJECTIVE: The aim of this systematic review was to compare outcomes between surgical and non-surgical treatment of actinic cheilitis (AC). MATERIALS AND METHODS: A systematic review and meta-analysis based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses guideline were performed. A search of PubMed/MEDLINE, Web of Science, and Cochrane Library databases was conducted. Articles were selected based on the inclusion criteria: randomized clinical trials, prospective/retrospective studies, and case series with at least 10 patients, with a minimum follow-up period of 6 months. A weighted remission rate (RER) and recurrence rate (RR) with a 95% confidence interval was performed. Data analysis was performed using a comprehensive meta-analysis software. RESULTS: A total of 283 ACs in 10 studies were included. About 2.5% surgically treated cases underwent malignant transformation. The weighted remission rate was higher for surgical (92.8%) compared to non-surgical treatment (65.9%). The recurrence rate was lower for surgical (8.4%) compared to non-surgical treatment (19.2%). CONCLUSION: In this systematic review, the surgical treatment was more favorable than non-surgical for AC. Meanwhile, further studies are needed that should maximize methodological standardization and have greater rigor of the data collection process.

Comparison of two suture techniques on the inflammatory signs after third molars extraction-A randomized clinical trial.

PURPOSE: Wound closure technique is an operative factor that influences early post-operative complications after third molar surgery. This study investigates and compared the effectiveness of two closure techniques, primary closure and healing by second intention of the oblique incision on postsurgical discomfort after mandibular third molar surgery. MATERIALS AND METHODS: This is a prospective, randomized, double-blind, split mouth controlled trial. Surgical sites were divided into two groups Control group received simple sutures in both alveolar crest incision and oblique incision and intervention group received simple sutures in alveolar crest incision, while the oblique incision healed by second intention. All the patients were instructed to measure pain according to visual analogue scale (VAS) in postoperative period, swelling, mouth opening was assessed at 72h and 7 days after surgery. The wound healing was assessed on day 7. RESULTS: Thirty-five patients, who had bilateral impacted third molars of similar surgical difficulty, were recruited. Thirty-one successfully completed the study. Patients in the second intention group had significantly less pain at 24h (p < 0.27). and 48h (< 0.001), had significantly less swelling (< 0.001) and trismus (< 0.001) and patients submitted to primary closure had a better evaluation of the Landry index (p < 0.001). CONCLUSION: Healing by second intention of the oblique relaxing incision by partial surgical wound closure, in our study, were superior to the primary closure in reduction of post-operative pain, swelling and trismus. TRIAL REGISTRATION: This trial is registered at Brazilian Registry of Clinical Trials-ReBEC -UTN: RBR-5fxbqsf (https://ensaiosclinicos.gov.br/rg/RBR-5fxbqsf).

A Systematic Review of the Granular Cell Odontogenic Fibroma and Report of a New Case.

BACKGROUND: Granular Cell Odontogenic Fibroma (GCOF) is a rare odontogenic neoplasm reported over time with different names. The purpose of this study is to review all available data on the GCOF in the scientific literature, with a summary of all reported cases and a report of a new case. METHODS: This review was conducted following the PRISMA guidelines. An electronic search was performed up to November 2022. RESULTS: Thirty-nine studies reporting fifty-three cases were included. GCOF is a rare neoplasm among the odontogenic tumors, with a higher prevalence in women of the middle-aged and white population. This lesion occurs mostly on the posterior region of the mandible. Furthermore, based on clinical, radiographic, and histopathologic features, conservative treatment was the most reported choice with recurrence reported in two cases. CONCLUSION: GCOF remains controversial due to the still unsolved histogenesis.

Clinical pathological analysis of nine cases of aneurysmal bone cyst of the jaws in a Brazilian population.

Aneurysmal bone cysts (ABCs) are benign osteolytic lesions that occur rarely in the jaws. The aim of this study was to investigate the clinical, radiographical and pathological features of ABCs of the jaws. A retrospective analysis of the content of a 39-year database, including nine cases of ABCs of the jaws diagnosed from the archives of the Oral Pathology Service. Nine patients (3 males and 6 females), ranging in age from 5 to 33 years were included. Seven (7/9) lesions were located in the mandible and two (2/9) in the maxilla. A painful swelling was the most common clinical finding (n = 4, 4/9). Radiologically, the lesions frequently presented as multilocular (5/9), well defined (4/9), bone expansion and perforation (2/9). Pathological analysis revealed that two cases were associated with central ossifying fibroma and one case with central giant cell lesion. Histomorphology showed a predominance of the solid type (5/9) and of sinusoidal pseudocystic spaces (4/9). Giant cells, osteoid material, calcified material, blood vessels and hemosiderin deposits were observed in 6/9, 7/9, 8/9, 9/9 and 7/9, respectively. The patients with ABCs presented clinical and radiographical features, which often posed a diagnostic dilemma. Knowledge about the most common characteristics of ABCs may contribute to the establishment of a more accurate diagnosis.

The Importance of Cone-Beam Computed Tomography in Endodontic Treatment of a Mandibular Premolar With Atypical Anatomy: A Case Report.

The objective of this case study is to report the endodontic treatment of a mandibular premolar with a C-shaped root canal configuration based on the use of cone-beam computed tomography (CBCT) as a diagnostic aid and in treatment planning. A 14-year-old patient was referred for endodontic treatment of tooth No. 21. Upon examination of the CBCT, C-shaped canal anatomy was verified. The chemical-mechanical preparation was carried out with a rotary file system (rotary files 25.08, 30.05, and 35.05) and the use of 2.5% sodium hypochlorite as an auxiliary chemical substance. Clinical and radiographic follow-up was performed 6 months and 1 year after endodontic treatment. A periapical radiolucency revealed a progressive reduction, suggesting the evolution of tissue repair. This case study confirms that to achieve a favorable prognosis of endodontic treatment, in-depth knowledge of the internal anatomy of the root canal system, along with its variations, is necessary. In this regard, CBCT is an important tool to assist in obtaining the correct diagnosis and understanding the anatomical complexity to be treated. Variations of C-shaped canals are challenging due to difficulties encountered during the stages of chemical-mechanical preparation and filling. Thus, means of enhancing disinfection are needed.

Epidemiology and correlation of the clinicopathological features in oral epithelial dysplasia: analysis of 173 cases.

Oral epithelial dysplasias (OEDs) are potentially malignant disorders characterized by diverse degrees of cellular atypia. The early and careful diagnosis has extreme importance, allowing prevention of the progression to the oral squamous cell carcinoma. This study aimed to determine the epidemiology and then correlate it with the clinicopathological features of OED. One hundred seventy-three cases of oral lesions retrieved from the files of a Service of Pathological Anatomy, covering a 38-year period, were submitted to descriptive statistical analysis through the Pearson χ(2) test. The majority of cases were from affected females (57.9%), with a peak of occurrence in the age group of 41 and 55 years (37.3%), white patients (64.8%), and those with lesions located on the gingiva/alveolar ridge (25.1%). The lesions predominantly presented with white color (56.8%) and were described as nodules (27.4%), with a rough surface (76.7%), an exophytic growth (79.1%), and a sessile base (95.6%). The majority of the lesions with degree of mild (34.6%) and moderate (34.9%) OED had clinical diagnosis of leukoplakia, whereas 33.3% of the lesions with degree of severe had clinical diagnosis of squamous cell carcinoma (P < .05). Tobacco use was the risk habit more related with OED (42.6%) (P > .05). The knowledge of OED epidemiology and clinical features provide a better understanding of the factors that possibly are associated with the malignant transformation of OED. Furthermore, these results contribute to supporting a prompt and accurate recognition of these lesions in clinical practice.

Epidemiological study of 534 biopsies of oral mucosal lesions in elderly Brazilian patients.

BACKGROUND: The number of elderly people in Brazil has increased during the last few decades. Oral lesions are very common in this age group, but few studies have examined the prevalence of these conditions worldwide and, particularly, in Brazil. PURPOSE: This study aimed to evaluate the frequency of oral lesions in an elderly Brazilian population. MATERIALS AND METHODS: A total of 534 cases of oral lesions retrieved from the files of the Oral Pathology Laboratory of the School of Dentistry, University of Pernambuco, between 1991 and 2008, were descriptively and qualitatively evaluated. RESULTS: In this study, the oral mucosal lesions cases preferentially affected women (n=357; 66.8%), white persons (n=253; 47.3%), in the seventh decade of life (n=361; 67.6%), and with lesions predominantly located on the gingival/alveolar ridge (n=102; 19.1%). The non-neoplastic lesions (n=353; 66.1%) were more prevalent than benign neoplasms (n=85; 15.9%), oral cancers (n=56; 10.4%) and potentially malignant lesions (n=40; 7.4%). The five most predominant diseases were fibrous hyperplasia, non-specific chronic inflammatory processes, oral squamous cell carcinoma, non-specified odontogenic cysts and epithelial dysplasia. CONCLUSIONS: Our results may be helpful in understanding the distribution of oral diseases in this very specific age group that requires special attention.

Morphological analysis and immunohistochemical expression in restorations with self-adhesive resin: A randomized split-mouth design-controlled study.

BACKGROUND: To evaluate the morphology and immunohistochemical expression of MMP-9, TIMP-3, COL-I, TNF-alfa and COX-2 in the dentinopulp complex of restorations with self adhesive composite (Vertise Flow/Kerr) compared with conventional resin composite with self-etching adhesive (Filtek Z250/3M ESPE and Clearfil SE Bond/Kuraray-Noritake). MATERIAL AND METHODS: A randomized, controlled, double-blind, split-mouth, two-arm clinical trial was conducted. Twenty-seven volunteers with third molars indicated for extraction received two deep class I restorations, one with each material. The morphology and immunohistochemical expression were measured at 15 days after the restorative procesures. The data were submitted to the Fisher`s Exct test (α=0.05). RESULTS: Through morphological analysis, a slight disorganization of the odontoblastic layer was visualized, along with a slight inflammatory infiltrate in the VERT and CSEB groups (p< 0.05). In immunohistochemical analysis, TNF-alpha, MMP-9, TIMP-3 and COX-2 demonstrated more cases of positive pulp labeling. CONCLUSIONS: Self-adhesive resin composite and conventional resin composite with a self-etching bonding agent promoted slight alterations in the dentin-pulp complex, indicating a repair ability and reversibility of the inflammatory process against aggressions of the adhesive restorative procedure. Key words:Immunohistochemistry, inflammation, randomized clinical trial, self-adhering composite, dentistry.

Chondrosarcoma of the Temporomandibular Joint: Systematic Review and Survival Analysis of Cases Reported to Date.

The purpose of this systematic review was to summarize the available data on TMJ chondrosarcomas and to perform a survival analysis of cases reported to date. This review was conducted in accordance with the PRISMA. Two authors performed an electronic search of case reports of TMJ chondrosarcoma published until August 02, 2020. Forty-seven studies reporting 53 cases were included. Chondrosarcomas of the TMJ were more prevalent in women, with a male:female ratio of 1:1.4. Survival curves were significantly associated with histological diagnosis (p = 0.004), reconstructive surgery (p = 0.024), recurrence (p < 0.001), and distant metastasis (p = 0.001). Only distant metastasis was independently associated with survival (p = 0.017). TMJ chondrosarcomas presented with low recurrence and higher survival rates than other chondrosarcomas. Synovial subtype, absence of reconstructive surgery, and presence of local recurrence or distant metastasis were associated with poorer prognosis.

Comparison of the biocompatibility of calcium silicate-based materials to mineral trioxide aggregate: Systematic review.

The objective of this systematic review was to evaluate the biocompatibility and interaction of bioceramic materials with animal and human mesenchymal cells in vitro and in vivo and to compare them with mineral trioxide aggregate (MTA). Two independent researchers conducted PubMed/Medline, Web of Science, and Scopus searches to identify studies published in English, without restrictions on year of publication using the following keywords: "root canal sealer," "root repair material," "cytotoxicity," and "bioceramics." The articles were selected following the PRISMA statement. A total of 1486 titles were identified in the initial search. However, only 18 studies met the inclusion and exclusion criteria. The results showed that bioceramic materials have biological properties similar to those of MTA, including low cytotoxicity as well as promoting cell proliferation and adhesion, low expression of inflammatory cytokines, and reduced pulp inflammation. This systematic review therefore suggests that the choice of repair bioceramic materials or MTA based on biocompatibility should be the professional's decision.

Endodontic Treatment of Complex Dens Invaginatus Teeth with Long Term Follow-Up Periods.

Dens invaginatus is characterized by invagination of enamel and dentin in the dental papilla prior to tissue calcification. This malformation commonly occurs in the maxillary lateral incisors. The present study reports two complex endodontic treatments in Oehlers' type II and III dens invaginatus, with periapical lesion and presence of bone resorption. In the reported cases, conventional endodontic therapy was successful and sufficient enough to eliminate the infectious process, allowing periapical bone neoformation and absence of symptomatology. Dens invaginatus is a relatively easy-to-diagnose dental malformation. However, it is necessary to know its radiographic aspects. The treatment results demonstrated that, although the cases of dens invaginatus of high complexity are challenging, an accurate diagnosis accompanied with proper endodontic treatment can avoid unnecessary surgical intervention and allow great chances of favorable prognosis in long term.

Florid cemento-osseous dysplasia and peripheral giant cell granuloma in a patient with neurofibromatosis 1.

We report a 35-year-old mulatto female patient with neurofibromatosis Type 1 who presented with facial asymmetry. The patient had two lesions: florid cemento-osseous dysplasia associated with peripheral giant cell granuloma. She was referred for surgical treatment of the peripheral giant cell granuloma and the florid cemento-osseous dysplasia was treated conservatively by a multidisciplinary team. So far, no changes have been observed in the patient's clinical status. We observed no recurrence of peripheral giant cell granuloma. To the best of our knowledge, the present case is the first report of a patient with neurofibromatosis Type 1 associated with a giant cell lesion and florid cemento-osseous dysplasia.

Racial disparity and prognosis in patients with mouth and oropharynx cancer in Brazil

Background: Oral and oropharyngeal cancer (OPC) is an important cause of morbidity and mortality worldwide.Populations in situations of social vulnerability tend to have higher incidences of cancer, a higher proportion oflate diagnosis, greater difficulties in accessing health services, and, consequently, worse prognosis. The aim ofthis study was to evaluate the relationship between race/skin color and OPC prognosis in Brazil.Material and Methods: This is a cross-sectional epidemiological study using OPC data from the National CancerInstitute between the years 2000 and 2019. The selected variables were: gender, race/skin color, age, education,smoking and alcohol consumption, stage of the disease and disease status at the end of the 1st treatment.Results: 154,214 cases were recorded. Black men, in the 6th decade of life, were the most affected population.Blacks had a lower level of education when compared to non-blacks (p<0.001). Blacks were more exposed tosmoking and alcohol consumption (p<0.001). At the time of diagnosis, the black population was at the most advanced stage when compared to non-blacks (p<0.001). At the end of the 1st treatment, more black patients haddisease in progression, as well as more black patients died (p<0.001). Conclusions: Blacks had a worse prognosisfor OPC in Brazil. Despite the limitations, these results are important to elucidate the scenario of health disparitiesin relation to the race/skin color of the Brazilian population. (AU)

Doença cardiovascular e periodontite: análise de série de casos avaliando níveis de Proteína C-Reativa / Cardiovascular disease and periodontitis: case series analysis evaluating C-Reative Protein levels

As periodontopatias podem ser dos principais fatores para o agravamento de doenças, como alterações cardiovasculares. Microrganismos e produtos bacterianos encontrados nessas condições provocam intensa produção de mediadores inflamatórios, incluindo a proteína C-reativa (PCR), marcador para cardiopatias. Avaliou-se a relação dos níveis plasmáticos de PCR em pacientes com doenças cardiovasculares (DCV) e periodontite. Uma série de quatro casos acompanhados/ concluídos na referida clínica (idade entre 24 e 61 anos, todos homens). Constatada a condição de periodontite, o periograma do sextante comprometido foi realizado, junto à requisição de exames para dosagem dos níveis plasmáticos de PCR, antes e após sessão de raspagem e alisamento radicular. Em 21 a 30 dias, um periograma reavaliativo foi realizado para análise comparativa das pro fundidades de sondagem e níveis de PCR antes e após a sessão de instrumentação. Houve redução de 13,7% (paciente "A") e até 2 mm na perda de inserção (pacientes "A" e "C") dos sítios avaliados; não houve nenhuma mudança significativa nas novas dosagens dos níveis de PCR. Conclui-se que não foi possível demonstrar uma correlação entre os níveis de PCR em pacientes que apresentam concomitantemente DCV e periodontite, nesta série de casos... (AU)

Periodontal diseases are one of the main factors for aggravation of diseases, such as cardiovascular alterations. Microorganisms and bacterial products found under these conditions provoke intense production of inflammatory mediators, including C-reactive protein (CRP), a marker for cardiovascular disease. It was evaluated the relationship of plasma levels of CRP in patients with Cardiovascular Diseases (CVD) and periodontitis in the dental clinic of the UPE campus Arcoverde. A series of four cases followed at the clinic (24 to 61 years old, all men). Condition of periodontitis confirmed, the periogram of the compromised sextant was performed, together with the requisition of tests for the determination of plasma levels of CRP, before and after scaling and root planing sessions. Around 21-30 days a re-evaluating periogram was performed for comparative analysis of depths of probing and CRP levels before and after the instrumentation. There was a reduction of 13.7% (patient "A") and up to 2 mm in the loss of insertion (patients "A" and "C") of the evaluated sites; there wasn't significant change in the new doses of CRP levels. It's concluded was not possible to demonstrate a correlation between CRP levels in patients with concomitant CVD and periodontitis in this case series... (AU)