Worldwide prevalence of geographic tongue in adults: A systematic review and meta-analysis.

To identify the prevalence of geographic tongue in patients >18 years. A systematic literature review was performed in search of population-based observational studies. Searches were performed using five main databases: Embase, LILACS, PubMed, Scopus and Web of Science; and three gray literature sources: Google Scholar, ProQuest, and OpenGrey. In addition, a manual search in the reference list and consultation with experts on the topic studied were performed. Methodological quality was assessed using the Joanna Briggs Institute's checklist for prevalence studies. Ratio meta-analyses were performed using JAMOVI. Initially, 3046 studies were identified. After a two-phase selection, 11 studies were included for quantitative synthesis. Two studies were classified as of low methodological quality, five studies as of moderate quality, and four as of high quality. Two types of prevalence were analyzed: by period and point. Three studies were included in the period prevalence meta-analysis, and the prevalence was 3% (Confidence interval [CI]: 0.4%-5.5%, n = 9813). Eight studies were included in the point-prevalence meta-analysis, and the prevalence was 3% (CI: -0.2% to 5.5%, n = 10,967). Although there are phases of exacerbation and remission in geographic tongue, prevalence and period prevalence were similar. Approximately one in 30 adults has a geographic tongue.

Prevalence of oral mucosal disorders during pregnancy: A systematic review and meta-analysis.

OBJECTIVE: To assess the prevalence of oral mucosal disorders during pregnancy. METHODS: Observational studies were selected by two reviewers in a two-phase process. Search strategies were applied at CINAHL, LILACS, LIVIVO, PubMed, Scopus, Web of Science, Google Scholar, OpenGrey, and ProQuest. The risk of bias was assessed using the Joanna Briggs Institute's Critical Appraisal Checklist for Studies Reporting Prevalence Data. Synthesis of results was calculated by the software R Statistics version 3.5.1 (The R Foundation, Vienna, Austria). Confidence in cumulative evidence was assessed by using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. RESULTS: Fifteen studies met the eligibility criteria and were selected for qualitative synthesis and meta-analysis, of which 5935 participants were enrolled. The overall prevalence of oral mucosal disorders was 11.8%. Gingival hyperplasia (17.1%), morsicatio buccarum (10%), oral candidiasis (4.4%), pyogenic granuloma (3%), and benign migratory glossitis (2.8%) were the most prevalent lesions. The overall risk of bias was considered moderate, and the quality of evidence was very low. CONCLUSION: Disorders of the oral mucosa were present in approximately 1 out of 10 pregnant women. Gingival hyperplasia was the most prevalent lesion. Further studies should apply homogeneous methodology to improve the quality of evidence.

Severe manifestation of oral pemphigus.

This article describes a case of pemphigus vulgaris in a relatively young patient with exacerbated characteristics, widespread lesions, and rapid evolution. A 40-year-old woman sought treatment, complaining about severe oral pain and dysphagia. Intraoral inspection revealed ulcerated lesions on the lips, buccal mucosa, and floor of the mouth. The number of lesions quickly increased and resembled erythema multiforme. She also presented blistering lesions on the back, abdomen, neck, and eyes. Incisional oral biopsy revealed pemphigus vulgaris. This report emphasizes the importance of early diagnosis of an oral biopsy in systemic diseases and the management of the lesions.

Chronic maxillary sinusitis associated with dental impression material.

A 62-year-old man was referred for routine treatment of hyperplasia of the mucosa in the anterior lower jaw. An oroantral fistula was detected in the right superior alveolar ridge. The patient had no complaints. Plain radiographs showed a radiopaque foreign body in the posterior region associated with opacification of the maxillary sinus. Computed tomography showed the same hyperdense foreign body located in the posterior lower part of the sinus and an abnormal soft tissue mass in the entire right maxillary sinus. When asked about sinusitis, the patient mentioned occasional episodes of pus taste and intermittent crises of headache lasting for one week. The patient has been edentulous for 20 years. Sinus debridement was performed and the oroantral fistula was closed. The clinical suspicion of the presence of zinc oxide-eugenol paste was confirmed by microscopical and chemical analysis. After 6 months of follow-up, the fistula continued to be closed and sinusitis did not recur. This clinical case of maxillary chronic sinusitis illustrates a different odontogenic origin.

Atypical clinical manifestation of mucoepidermoid carcinoma in the palate.

A 62-year-old woman sought treatment for a red macule in her hard palate. Examination of the oral cavity revealed an ovoid-shaped erythematous macule on the right side of the hard palate. The patient was edentulous and used a poorly adapted maxillary denture. The initial diagnosis was chronic atrophic candidosis and trauma; however, when the lesion did not heal following removal of the prosthesis and application of topical antifungal medication, an incisional biopsy was performed, resulting in a final diagnosis of low-grade mucoepidermoid carcinoma. The patient was referred to a head and neck surgeon and the tumor was excised.

Effects of sclerosing agents on head and neck hemangiomas: A systematic review.

BACKGROUND: The aim of this study was to systematically review the literature for studies that investigated the effects of sclerosing agents on head and neck hemangiomas. MATERIAL AND METHODS: Clinical trials, cohort studies, and descriptive studies were considered eligible and selected in a two-phase process. Six main electronic databases, in addition to three grey literature databases, were searched. Risk of bias (RoB) was assessed using the "Meta-Analysis of Statistics Assessment and Review Instrument" checklist. From fifty-six considered eligible, five were finally included. RESULTS: One article were judged at low, one at moderate, and three at high RoB. The sclerosing agents investigated were sodium tetradecyl sulphate (n=2), ethanolamine oleate (n=1), pingyangmycin (n=1) and bleomycin (n=1). Overall, good results were achieved on the treatment of head and neck hemangiomas with intralesional sclerotherapy. Most commonly reported adverse effects included pain, swelling, fever, necrosis, transient facial palsy, and anorexia. CONCLUSIONS: Considering the limited number of included studies, intralesional sclerotherapy on the management of HN hemangiomas presented overall good results with minor adverse reactions, especially in regards to smaller lesions. Key words:Sclerotherapy, sclerosing solutions, vascular neoplasms, hemangioma.

Oral health assessment for users of marijuana and cocaine/crack substances.

The objective of this study was to assess the oral health status of users of illicit drugs such as marijuana and cocaine/crack and compare it with individuals not using these chemical substances. Questionnaires were applied to 35 illicit drugs users to gather information on demographic status, general health, and use of drugs. Then, a clinical assessment of the oral health condition was performed to collect data on decayed, missing and filled teeth (DMFT) index, salivary flow rate (SFR), and mucosal lesions. The control group was composed of 35 non-illicit drug users. In the experimental group, 91.43% were males, 80% were smokers, and 42.85% were alcoholics. Cocaine was the most common drug used (77.15%), followed by marijuana (68.6%), and crack (51.4%). The average DMFT index was 9.8 and the SFR was reduced in 60% of subjects. Mucosal alterations were detected, but no potentially malignant disorders or oral cancer were diagnosed. Compared to control group, significantly higher values for gender (40%, p = 0.0001), smoking (22.86%) and heavy drinking (5.7%) habits (p = 0.0001), SFR (31.4%; p = 0.0308), and oral lesions (p = 0.0488) were found for the experimental group, although significantly higher values were found in the control group for DMFT index (p = 0.0148). It can be concluded that the use of illicit drugs contributed to an increased prevalence of oral mucosa lesions. In addition, a decline on SFR and a reduced DMFT index was observed for illicit drug users.

Radiographic analysis of root canal fillings: influence of two sealers on the perception of voids.

The aim of this ex vivo was to investigate if two radiopaque root canal sealers with different formulations would influence the radiographic perception of root canal fillings. The root canals of 48 extracted maxillary canines were prepared and randomly assigned to 3 groups of 16 specimens each. In each group, the root canals were filled by lateral condensation of gutta-percha and one of the tested sealers: Endométhasone, Sealer 26, or a non-radiopaque sealer. A through-and-through void was simulated in half of the specimens from each group (n=8). The buccolingual radiographic images obtained were randomly interpreted for voids existence by a radiologist and an endodontist. The differences in sensitivity and specificity between groups and examiners were compared using, respectively, Fisher's Exact and McNemar tests at 5% significance level. Both radiopaque sealers caused a significant decrease in sensitivity at the coronal part of fillings. The use of Endométhasone increased specificity values for both coronal and apical portions of the root canal fillings. In conclusion, the tested sealers influenced the radiographic perceptions of laterally condensed root canal fillings in a different way.

Radiographic analysis of root canal fillings: influence of two sealers on the perception of voids

The aim of this ex vivo was to investigate if two radiopaque root canal sealers with different formulations would influence the radiographic perception of root canal fillings. The root canals of 48 extracted maxillary canines were prepared and randomly assigned to 3 groups of 16 specimens each. In each group, the root canals were filled by lateral condensation of gutta-percha and one of the tested sealers: Endométhasone, Sealer 26, or a non-radiopaque sealer. A through-and-through void was simulated in half of the specimens from each group (n=8). The buccolingual radiographic images obtained were randomly interpreted for voids existence by a radiologist and an endodontist. The differences in sensitivity and specificity between groups and examiners were compared using, respectively, Fisher's Exact and McNemar tests at 5 percent significance level. Both radiopaque sealers caused a significant decrease in sensitivity at the coronal part of fillings. The use of Endométhasone increased specificity values for both coronal and apical portions of the root canal fillings. In conclusion, the tested sealers influenced the radiographic perceptions of laterally condensed root canal fillings in a different way.

O propósito deste estudo ex vivo foi investigar se dois cimentos obturadores de fórmulas diferentes influenciariam a percepção radiográfica de obturações de canais radiculares. Os canais radiculares de 48 caninos superiores extraídos foram preparados e divididos em 3 grupos. Em cada grupo os canais foram preenchidos através da condensação lateral da guta-percha e de um dos cimentos testados (Endométhasone, Sealer 26 e cimento não-radiopaco), e um defeito de ponta a ponta foi simulado em metade dos espécimes de cada grupo (n=8). As imagens radiográficas vestíbulo-linguais obtidas foram aleatoriamente interpretadas quanto à existência de defeitos por um radiologista e um endodontista. As diferenças em sensibilidade e especificidade entre os grupos e examinadores foram comparadas respectivamente usando-se os testes Exato de Fisher e McNemar ajustados ao nível de significância de 5 por cento. Ambos os cimentos radiopacos ocasionaram uma redução significativa da sensibilidade na parte cervical das obturações. O uso do Endométhasone aumentou os valores de especificidade para as porções cervical e apical das obturações dos canais radiculares. Concluiu-se que os cimentos testados influenciaram de maneira distinta a percepção radiográfica de obturações endodônticas executadas com condensação lateral.

Effect of calcium hydroxide-based dressing on apical sealing in immature teeth filled with MTA / Efeito da medicação à base de hidróxido de cálcio no selamento apical de dentes imaturos obturados com MTA

OBJECTIVES: To evaluate the effects of a calcium hydroxide-based intracanal dressing on the initialapical adaptation and leakage of fillings performed with mineral trioxide aggregate (MTA) in teeth withopen apices. STUDY DESIGN: A total of 24 canals were manually prepared and randomly divided intotwo groups (n = 12). In the experimental group, root canals were dressed with calcium hydroxide-basedpaste for 21 days; in the control group, no medication was applied prior to the filling of root canalswith mineral trioxide aggregate. Apical sealing was evaluated on the basis of rhodamine B penetrationand the detection of microscopic apical defects at the filling interface (SEM). The data obtained werecompared by means of t- and Fisher’s Exact tests (á = 0.05). RESULT S: The difference in mean dyeleakage between the experimental (5.03±1.97 mm) and control (4.14±1.13 mm) groups was not statisticallysignificant (ñ < 0.05). The number of microscopic fissures at the experimental group interface (2/12)was significantly lower than that observed for the control group (9/12) (ñ < 0.05). CONCLUSIONS:The use of a calcium hydroxide-based intracanal dressing did not interfere with the initial apical sealingof immature teeth filled with MTA.

OBJETIVOS: Avaliar os efeitos da medicação intracanal à base de hidróxido de cálcio sobre a adaptação apical inicial e selamento de obturações realizadas com agregado de trióxido mineral (MTA) em dentes com ápice aberto. PLANEJAMENTO DO ESTUDO: Um total de 24 canais foram manualmente preparados e aleatoriamente divididosem dois grupos (n = 12). No grupo experimental, canais radiculares foram preenchidos com pasta à base de hidróxido de cálcio por 21 dias; no grupo controle, nenhuma medicação foi aplicada antes da obturação dos canais com agregado de trióxido mineral. O selamento apical foi avaliado com base na penetração de rodamina B e na detecção microscópica de defeitos apicais na interface das obturações (MEV). Os dados obtidos foram comparados por intermédio dos testes “t” e Exato de Fisher (α = 0,05). RESULTADOS: A diferença nos níveis médios de infiltraçãoentre os grupos experimental (5.03±1.97 mm) e controle (4.14±1.13 mm) não se mostrou estatisticamente significante (ρ < 0,05). O número de fendas microscópicas na interface das obturações do grupo experimental (2/12) apresentou-se estatisticamente inferior ao detectado para o grupo controle (9/12) (ρ < 0,05). CONCLUSÕES: O uso de medicação intracanal à base de hidróxido de cálcio não interferiu no selamento apical inicial de dentes imaturos obturados com MTA.

Von Recklinghausen's disease - diagnosis from oral lesion: neurofibromatosis I / Enfermedad de Von Recklinghausen: diagnóstico desde la lesión oral: neurofibromatosis I

A 35 years-old male patient was referred to your Institution due to a nodule on the palate with more than 15 years of evolution. In general physical examination noticed the presence of papules and café au lait (coffee with milk) pigmentation in many parts of the body. Intra oral examination found a swelling in the hard palate and resilient on palpation, asymptomatic with three centimeters of diameter. Incisional biopsy was performed and the diagnosis was neurofibroma. Complete resection of the lesion was performed confirming the initial diagnosis. The general clinical findings and the presence of neurofibroma confirmed the diagnosis of Von Recklinghausen's disease. This paper emphasizes the important role of the dentist in diagnostic and follow-up of the Von Recklinghausen's disease.

Un paciente hombre de 35 años de edad fue remitido a la Institución, debido a un nódulo en el paladar con más de 15 años de evolución. En el examen físico general, notaron la presencia de pápulas y pigmentaciones café au lait (café con leche) en muchas partes del cuerpo. Al examen oral intra se encontró un aumento de volúmen en el paladar duro resistente a la palpación, asintomático, con tres centímetros de diámetro. Se realizó la biopsia incisional, y el diagnóstico fue neurofibroma. La resección completa de la lesión confirma el diagnóstico inicial. Las conclusiones clínicas generales y la presencia de neurofibroma confirmó el diagnóstico de la enfermedad de Von Recklinghausen. Este trabajo destaca el importante papel del odontólogo en el diagnóstico y seguimiento de la enfermedad de Von Recklinghausen.

Efeitos do tampão apical no potencial selador das obturações com agregado de trióxido mineral em dentes com rizogênese incompleta / The apical plug effects on sealing potential of mineral trioxide aggregate root canal fillings performed in teeth with incomplete root formation

OBJETIVOS: Investigar os efeitos da presença de um tampão apical na qualidade do preenchimento e selamento conferidos pelas obturações de agregado de trióxido mineral (MTA) aos dentes com rizogênese incompleta. MATERIAL E MÉTODO: Vinte e quatro canais de dentes com ápice aberto foram manualmente preparados e aleatoriamente divididos em dois grupos (n=12). No grupo experimental confeccionou-se uma barreira apical de hidróxido de cálcio; no grupo controle nenhum tratamento adicional precedeu a obturação dos canais com agregado de trióxido mineral (MTA). Os espécimes foram radiografados e imediatamente imersos em rodamina B. O número de defeitos radiolúcidos de preenchimento dos canais e os níveis médios de infiltração apical do marcador entre os grupos foram analisados de forma cega e comparados por meio do teste qui-quadrado e teste “t”, respectivamente, ambos ajustados ao intervalo de confiança de 95%. RESULTADOS: O número de defeitos no terço apical das obturações e o nível médio de infiltração do corante detectados para o grupo experimental apresentaram-se estatisticamente inferiores aos do grupo controle. CONCLUSÕES: O uso de uma barreira apical de hidróxido de cálcio melhorou a qualidade de preenchimento e selamento dos canais de dentes com rizogênese incompleta obturados com agregado de trióxido mineral.

OBJECTIVES: To investigate the effects of an apical barrier on the filling quality and sealing of root canal fillings performed with mineral trioxide aggregate on teeth with immature root formation. MATERIAL AND METHOD: Twenty four root canals were manually prepared and divided in two groups (n=12). In the experimental group an apical plug of calcium hydroxide was performed, while in the control group no procedures preceded the root canal filling of all specimens with mineral trioxide aggregate. The specimens were radiographed in a bucco-lingual direction and immediately immersed on rodhamine B. The number of radiolucent filling voids and the mean level of apical microleakage between groups were compared by means of the Chi-square Test and “t” test, respectively, both adjusted at the 95% confidence interval. RESULTS: The number of voids at the apical third of fillings and the mean dye leakage level at specimens of experimental group were statistically lower than the ones observed for the control group. CONCLUSIONS: The use of a calcium hydroxide apical barrier improved the filling quality and sealing of obturations performed with mineral trioxide aggregate in teeth with immature root formation.

Avaliação radiográfica, biomecânica e microscópica de enxerto ósseo xenogênico associado a implantes de titânio em mandíbula de coelhos / Radiographic, biomechanical and microscopic evaluation of xenogenic bone graft associated to titanium implants in rabbits mandible

O propósito deste trabalho foi avaliar a interação de matriz óssea bovina inorgânica, (Gen-ox®) como material de enxerto e implantes de titânio em mandíbula de coelhos. A amostra constituiu-se de 32 coelhos da raça Botucatu de aproximadamente 4kg. Os incisivos inferiores destes animais foram extraídos e foi realizada um defeito de aproximadamente 4mm de diâmetro. Um dos lados foi mantido apenas com coágulo (grupo controle) e o outro lado (grupo experimental) recebeu o enxerto do material proposto. Após 60 dias foram instalados implantes bilateralmente na região do defeito. Os animais foram eutanaziados imediatamente após a instalação dos implantes e após 1, 2 e 6 meses (n=6) para o grupo microscópico a após 2 e 6 meses para o grupo do teste biomecânico (n=4). A análise constituiu de medidas da distância da crista óssea alveolar à plataforma do implante, da densidade radiográfica em valores de pixel ma região do alvéolo, de teste biomecânico de torque de remoção e microscópico através de medidas de contato osso-implante (BIC) (em µm e %) e área de osso (em µm² e %). Os resultados demonstraram que não houve diferenças significantes nem durante o tempo e nem entre os grupos na analise de distancia entre crista óssea alveolar e plataforma do implante. Na medida de densidade óssea, não houve variação significante ao longo do tempo, mas houve diferença estatisticamente significante entre os grupos, sendo maior no grupo experimental. Para o teste biomecânico também não houve variação significante do torque de remoção ao longo do tempo e nem houve diferença significante entre os grupos. Na análise de contato osso implante (BIC) não houve variação significante ao longo do tempo, mas houve diferença estatisticamente significante entre os ...

The aim of this study was to evaluate the interaction of an inorganic bovine bone matrix (Gen-ox®) as bone graft and titanium implants in rabbits mandible. Thirty-two Botucatu rabbits weighting about 4kg were used on this experiment. The mandible incisives were extracted and a defect of 4 mm of diameter was performed. One socket and defect was filled with experimental material. The opposite site was left to heal naturally and served as control. After 60 days, the implants were installed on the defect region. The animals were killed immediately after the implant installation and after 1, 2 and 6 months. Vertical bone height, bone density, biomechanical test, bone implant contact (BIC) and bone area near to implant threads were evaluated. The results showed that there was no significant differences on the distance between the alveolar bone crest to the implant platform (vertical bone height) along the time, neither between groups. On the bone density (pixel value) there was no significant difference along the time, but there was significant difference between groups, being the experimental group higher. For the biomechanical test there was no significant difference along the time, neither between groups. There was no significant differences on the bone implant contact (BIC) measures along the time, but there was significant difference between groups, being the experimental groups higher and there was interaction between time and groups. On bone area evaluation, there was no significant difference along the time, neither between the groups during the analyzed time. The graft behavior observed by the authors was similar to that of the control group, suggesting high acceptance of the material as graft option associated to titanium implants.