Acinic cell carcinoma of the oral and maxillofacial region: an international multicenter study

Abstract The aim of this study was to describe the prevalence, clinicopathological, and prognostic features of acinic cell carcinoma (AciCC) of the oral and maxillofacial region. AciCC cases were retrospectively retrieved from 11 pathology centers of three different countries. Medical records were examined to extract demographic, clinical, pathologic, and follow-up information. A total of 75 cases were included. Females (65.33%) with a mean age of 45.51 years were mostly affected. The lesions usually presented as an asymptomatic (64.28%) nodule (95.66%) in the parotid gland (70.68%). The association of two histopathological patterns was the most common finding (48.93%) and the tumors presented mainly conventional histopathological grades (86.11%). Surgical treatment was performed in the majority of the cases (59.19%). Local recurrence was observed in 20% of the informed cases, regional metastasis in 30.43%, and distant metastasis in 12.50%. The statistical analysis showed that the cases with a solid histopathological pattern (p=0.01), high-grade transformation (p=0.008), recurrence (p=0.007), and regional metastasis (p=0.03) were associated with poor survival. In conclusion, high histopathological transformation, presence of nodal metastasis, and recurrence were prognostic factors for AciCC of the oral and maxillofacial region.

Clinicopathologic analysis of oral dermoid and epidermoid cysts: a Brazilian multicenter study

Abstract Dermoid cysts (DCs) and epidermoid cysts (ECs) are uncommon developmental cysts affecting the oral cavity. This study aims to evaluate patients with oral DCs and ECs and their demographic and clinicopathologic features. A retrospective descriptive cross-sectional study was performed. A total of 105,077 biopsy records of oral and maxillofacial lesions from seven Brazilian oral pathology centers were analyzed. All cases diagnosed as oral DCs and ECs were reviewed, and clinical, demographic, and histopathological data were collected. The series comprised 32 DCs (31.4%) and 70 ECs (68.6%). Most of the DCs occurred on the floor of the mouth (n = 14; 45.2%) of women (n = 17; 53.1%) with a mean age of 34.6 ± 21.6 years. All DCs were lined partially or entirely by stratified squamous epithelium (100%). Chronic inflammatory cells, melanin pigmentation, multinucleated giant cell reaction, and cholesterol clefts were observed in the fibrous capsule . Most of the ECs affected the labial mucosa (n = 20; 31.7%) of men (n = 39; 56.5%) with a mean age of 48.0±19.8 years. Microscopically, most ECs (n = 68; 97.1%) were lined entirely by stratified squamous epithelium. Two cysts (2.9%) showed areas of respiratory metaplasia. Chronic inflammatory cells, melanin pigmentation, multinucleated giant cell reaction, and cholesterol clefts were also observed in the fibrous capsule. Conservative surgical excision was the treatment of choice in all cases. Oral DCs and ECs are uncommon and often clinically misdiagnosed lesions. Clinicians should consider DCs and ECs in the differential diagnosis of soft tissue lesions in the oral cavity, mainly located on the floor of the mouth and labial mucosa.

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

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

Effects of a mucoadhesive formulation containing Curcuma longa L. on oral wound healing

Introduction: The aim of this study was to investigate the effects of a topical mucoadhesive formulation with Curcuma longa L. extract (MFC) on oral wound healing. Methods: Seventy-two Wistar rats were randomly assigned to 3 groups: Control, Vehicle, and MFC. Traumatic ulcers were made on the dorsum of the tongue with a 3-mm diameter punch. Vehicle and MFC groups received application of the products twice a day, while animals in the control group were cared for in identical conditions but received no product application. Six rats in each group were euthanized at days 3, 5, 10, and 14. Percentage of repair was calculated based on wound area. HE-stained histological sections were obtained for semi-quantitative analysis of re-epithelization and inflammation. Results: Clinical findings revealed that at days 3 and 5, animals from the MFC group exhibited a significantly higher percentage of wound repair. At day 5, animals from this group also demonstrated a significant increase in the degree of re-epithelization and inflammation. Conclusions: MFC is capable of accelerating oral wound repair in an in vivo model by modulating the inflammatory process and stimulating epithelial proliferation. (AU)

Chondroblastic osteosarcoma mimicking periapical abscess

Abstract Lesions of non-endodontic origin may mimic periapical abscess. Osteosarcoma is a rare malignant lesion. Case report The present report describes a case of chondroblastic osteosarcoma in the periapical region of teeth #29, #30, and #31 of an 18-year-old male. Clinical history showed self-reported discomfort in the right posterior gingiva for over a month. Physical examination showed a small expansion and redness of the right mandibular buccal and lingual cortical plates, but no signs of pain or inflammation were observed. All the teeth responded positively to pulp sensibility. Periapical and panoramic radiographs showed slight periapical radiolucency in the roots of teeth #29 and #30, clear periodontal ligament space widening, and evident loss of lamina dura. Incisional biopsy was performed, and based on microscopic findings the diagnosis of chondroblastic osteosarcoma was confirmed. Conclusions Non-endodontic diseases associated with tooth root apex, such as chondroblastic osteosarcoma, should be included in differential diagnosis of jaw lesions that resemble periapical abscess.

Epidermoid cyst: highlights on diagnosis and magnetic resonance imaging features / Cisto epidermóide: processo de diagnóstico e características das imagens por ressonância magnética

Purpose: Epidermoid and dermoid cysts are extremely rare developmental cysts of a benign nature, which may occur anywhere in the body, although about 7% are found in the head and neck. This article reports a clinical case of a patient who had an epidermoid cyst and its magnetic resonance imaging (MRI) features. Case report: This case discusses an epidermoid cyst in a 36-year-old woman complaining about speech difficulty. Clinical examination revealed an extensive swelling on the floor of the mouth. MRI findings showed a cystic homogenous lesion located underneath the mylohyoid muscle which was removed by surgery. Histological examination of the mass confirmed the diagnosis of an epidermoid cyst. Conclusion: We concluded that MRI was considered useful for a more accurate diagnosis prior to treatment.

Proposta: Cistos epidermóide e dermóide são cistos de desenvolvimento extremamente raros, de natureza benigna, que podem ocorrer em qualquer região do corpo e somente 7% são encontrados na região de cabeça e pescoço. Este artigo apresenta o caso clínico de uma paciente que possuía um cisto epidermóide juntamente com as características das imagens por ressonância magnética. Descrição do caso: Paciente do gênero feminino, 36 anos, apresentou-se com queixa de dificuldade de fonação e deglutição. O exame clínico intrabucal revelou uma extensa tumefação em soalho bucal. As imagens por ressonância magnética indicaram uma lesão de natureza cística, homogênea, de conteúdo sólido e localizada abaixo do músculo milohiódeo. A lesão foi enucleada e encaminhada para exame anatomopatológico, cujo diagnóstico foi compatível com cisto epidermóide. Conclusão: A imagem por ressonância magnética foi essencial para determinar as características da lesão de acordo com a sua localização anatômica.

O papel do laser de baixa intensidade e da cloredidina 0, 12% no tratamento da mucosite bucal em crianças leucêmicas submetidas à quimioterapia / The utilization of the low energy laser and chlorexidine 0, 12% in the management of oral mucositis due to chemotherapy unn children with leukemia

No tratamento das leucemias é utilizada a quimioterapia, que apresenta vários efeitos colaterais. A mucosite bucal é a principal causa de dor durante a quimioterapia e a complicação mais comum dotratamento para neoplasias hematológicas. Esse estudo teve o objetivo de avaliar o uso do laser debaixa intensidade e da clorexidina 0,12% no tratamento da mucosite bucal decorrente de quimioterapiaem crianças leucêmicas. A amostra foi constituída por 10 crianças (Grupo Experimental) com leucemia aguda submetidas à quimioterapia e portadoras de mucosite bucal Graus I, II ou III, atendidas noHospital Araújo Jorge da Associação de Combate ao Câncer em Goiás. Também fazia parte da amostra, dados de 24 prontuários de pacientes infantis com leucemia aguda, tratados no mesmo hospital, que apresentaram mucosite bucal como intercorrência do tratamento de quimioterapia. Os pacientes do Grupo Experimental foram aleatoriamente distribuídos para receber o tratamento 1 (clorexidina 0,12%) ou 2 (laser). A presença e o grau de mucosite eram avaliados pelo mesmo examinador. Para comparação, os dados de prontuários de pacientes previamente tratados foram registrados, sendo que para estes, era utilizado apenas o tratamento sintomático da mucosite bucal. Os registros, da mesma forma, eram anotados quanto à presença e grau de mucosite. A mucosite bucal foi menos freqüente e teve menor tempo de duração no grupo que recebeu tratamento (clorexidina ou laser) do que no gruposem tratamento. A associação das várias formas de tratamento (higiene bucal, clorexidina e laser) leva à redução do número de episódios de mucosite bem como menor duração das lesões

Chemotherapy, which presents several side effects, is used in the management of leukemia. Oral mucositis is the main cause of pain during chemotherapy and is the most common complication in the management of hematological cancer. The aim of the current study was to investigate the utilization of the low-energy laser and the use of chlorexidine 0,12% in the management of oral mucositis due to chemotherapy in children with leukemia. The study group was composed of 10 children with acute leukemia, who developed oral mucositis grade I, II, or III, and who underwent chemotherapy at the Araújo Jorge Hospital at the Combat Cancer Association of Goias. 24 case records of infant patients with acute leukemia, who were managed at the already mentioned hospital, and who developed oral mucositis as intercurrence of chemotherapy, were also included. The patients in the Study Group were randomized tobe treated with 1 (chlorexidine 0,12%) or 2 (laser). The presence and the degree of mucositis being evaluated by the same examiner. For comparison, data in the charts of patients previously treated were registered. For these patients, just the symptomatic treatment of the oral mucositis was used. The data about the presence and degree of mucositis were equally logged. Oral mucositis was less frequent and had a shorter period of duration in the treated group (chlorexidine or laser) than in the untreated group. The association of various forms of treatment (oral hygiene, chlorhexidine and laser) decreases the number of mucositis occurrences and shortens duration of the lesions

Complicações bucais da quimioterapia e radioterapia no tratamento do câncer / Oral complications of chemotherapy and radiotherapy in cancer treatment

O câncer em geral tem apresentado uma alta incidência no decorrer dos anos. O seu tratamento consiste em inibir a proliferação excessiva de células neoplásicas, podendo incluir cirurgia, quimioterapia e/ou radioterapia. Esses dois últimos métodos acarretam efeitos colaterais, vários deles na cavidade bucal. É importante ressaltar que a irradiação provoca alterações bucais apenas quando atinge a região de cabeça e pescoço. Dentre estas, destacam-se: mucosite, xerostomia, neurotoxicidade, hipogeusia, trismo muscu-lar, osteorradionecrose, sangramento gengival, candidose, herpes labial e queilite angu-lar. Portanto, não só o câncer bucal afeta a boca, mas também a terapia dos diversos tipos de câncer. Assim, o objetivo desse trabalho é, através de uma ampla revisão de literatura, orientar o cirurgião-dentista no acompanhamento do paciente submetido à quimioterapia e/ou radioterapia na região de cabeça e pescoço e ressaltar a importância de sua participação numa equipe multidisciplinar para prevenir, diagnosticar, controlar e tratar os efeitos colaterais na boca. Dessa forma, pode-se oferecer qualidade de vida e aumentar as possibilidades de sucesso do tratamento, não só através do uso de medicamentos, mas também por meio da motivação do paciente, aprimorando suas habilidades para higienização e os cuidados com a saúde bucal. Observa-se que não há um protocolo padrão para o controle dessas complicações bucais, pela variedade de métodos e substâncias estudados e pesquisados para este fim.

Programa de de prevençäo do câncer bucal no município de Goiânia / Program of prevention of the oral cancer in the municipal district of Goiânia

No ano de 1996, foi desenvolvido no município de Goiânia um programa de prevençäo contra o câncer bucal cujas informaçöes eram transmitidas, à populaçäo em geral, através dos meios de comunicaçäo, palestras, painés o auto-exame bucal. Os pacientes eram examinados, conscientizados e, quando necessário, encaminhados para as clínicas da Faculdade de Odontologia - UFG e do Hospital Araújo Jorge. Os resultados mostraram que os pacientes ainda säo pouco informados sobre as consequências das neoplasias e que a eficácia e o sucesso de um programa de prevençäo contra o câncer bucal necessita, fundamentalmente, da ajuda dos programas de saúde bucal desenvolvido no Estado de Goiás

Cisto ósseo traumático: relato de caso / Traumatic bone cyst: case report

Os autores relataram um caso de cisto ósseo traumático localizado na regiäo de corpo mandibular direito em um paciente de 16 anos de idade. O tratamento instituído consistiu numa abordagem cirúrgica para exposiçäo da cavidade óssea e estabelecimento de sangramento em seu interior. Após 1 ano de "follow-up" houve completa neoformaçäo óssea na área.

Tumor odontogênico adenomatóide associado a pré-molar retido / Adenomatois odontogenic tumour associated to impacted premolar

Os autores apresentam um caso clínico de tumor odontogênico adenomatóide associado ao 1§ pré-molar superior retido e discutem alguns pontos referentes a origem desse tumor no complexo maxilo-mandibular

Estudo do processamento e da exaustäo com filme periapical Ektaspeed, processado nas soluçöes Kodak (convencional) e Inodon (monobanho), através da análise subjetiva e das densidades ópticas e de volume de prata / Study of processing and of exhaustion with Ektaspeed periapical film, processed in Kodak solutions (conventional) and Inodon (monobth), across subjective analysis and of optical density and of silver volume

Para esta pesquisa foi selecionado o filme Ektaspeed (EP-21) processado nas soluçöes Kodak (convencional) e Inodon (monobanho), tendo como meios de avaliaçäo métodos consagrados em radiologia odontológica, tais como densidade óptica, avaliaçäo subjetiva, medidas de pH e cor, utilizando ainda metodologia introduzida recentemente, que é a quantificaçäo de prata metálica na emulsäo radiográfica pela densidade de volume. Os propósitos básicos deste trabalho foram, verificar o tempo de processamento adequado e a atividade química (exaustäo) das soluçöes utilizando a quantidade de 25 ml. O tempo de processamento adequado quando a temperatura era mantida em 22ºC em ambas as soluçöes foi de 4 minutos, embora com tempos de 2 e 3 minutos, obteve-se radiografias com qualidade satisfatória para o diagnóstico. Os resultados de densidade óptica permitiram a representaçäo gráfica através de um traçado característico e serviram para controle e comparaçäo com a densidade de volume de prata, tanto no experimento de processamento, quanto para o teste com fins de verificar a exaustäo destas soluçöes. Com referência à ativiadde química das soluçöes (exaustäo), a soluçäo Kodak foi a que apresentou resultados mais satisfatórios quando comparada à Inodon, provavelmente devido à perda muito rápida da atividade fixadora da soluçäo monobanho. Verificamos que na 45ª radiografia do simulador de mandíbula no processamento Kodak já mostrava sinais indicativos de exaustäo pelo aparecimento de estrias na imagem radiográfica. No processamento da soluçäo Inodon, a partir da 10ª radiografia do simulador percebia-se uma certa dificuldade de fixaçäo da imagem e ainda uma boa atividade de revelaçäo do líquido monobanho. Através da análise microscópica dos filmes radiográficos foram constatadas alteraçöes morfológicas e quantitativas de prata metálica formada em funçäo do tempo de exposiçäo, tempo de processamento e exaustäo das soluçöes empregadas neste estudo...