Resumption of brazilian oral medicine health care during the second period of the COVID-19 pandemic

Aim: This present study aims to compare the data from the Brazilian Unified Health System on the number of clinical consultations of Oral Medicine from the first 6 months (March-August 2020) of the COVID-19 pandemic in Brazil with the last 6 months (September-February 2020/2021) to update the data, verify the measures' effectiveness to return clinical activities in the following months. Methods: perform a literature review of recent articles that report the impact of the COVID-19 pandemic on Oral Medicine. Results: There was an increase in the number of Oral Medicine clinical consultations in the second half of the pandemic throughout Brazil (+64.2%), representing over 9,235 appointments in this period. Conclusion: measures for the return of health assistance and the practice of Telemedicine proved to be effective after the second period of the pandemic. Even so, strengthening security measures against the coronavirus is essential to ward off a new wave since the Omicron variant emerged in the country and, consequently, possible new lockdowns that might affect healthcare in Brazil

Students' perception to an interactive web-based response system in oral and maxillofacial pathology teaching

Abstract This study evaluated dental students' perceptions and adherence to an interactive web-based response system in the teaching of Oral and Maxillofacial Pathology. Between 2018 and 2019, students from a single Brazilian dental school used the Poll Everywhere® app to answer questions on subjects taught during an Oral and Maxillofacial Pathology course. At the end of the academic semester, the students completed a questionnaire containing 10 questions regarding the app's use. The study included 123 students. Regarding the devices used to answer the questions on the app, 117 (95.1%) students used a smartphone and 3 (2.4%) used a laptop. Almost all students (121; 98.4%) agreed that this interactive web-based response system provided the teacher with a better overview of students' understanding and improved their self-assessment of the acquired knowledge of the subjects. Most students (118; 95.9%) preferred classes using this technology and 122 (99.2%) stated that using the app made them feel more engaged in classes. In addition, all students agreed that the app improved student-teacher interactions. Most students (119; 96.7%) considered the digital interactive method more attractive than the conventional teaching approach, and 99 (80.5%) did not have any negative comments regarding the app. In conclusion, the Poll Everywhere® app provides a more dynamic and attractive educational environment for Oral and Maxillofacial Pathology teaching.

Contribution of public oral pathology services to the diagnosis of oral and oropharyngeal cancer in Brazil

Abstract This study aimed to evaluate the contribution of oral and maxillofacial pathology laboratories (OMPLs) in Brazilian public universities to the diagnosis of lip, oral cavity, and oropharyngeal squamous cell carcinoma (SCC). A cross-sectional study was performed using biopsy records from a consortium of sixteen public OMPLs from all regions of Brazil (North, Northeast, Central-West, Southeast, and South). Clinical and demographic data of patients diagnosed with lip, oral cavity, and oropharyngeal SCC between 2010 and 2019 were collected from the patients' histopathological records. Of the 120,010 oral and maxillofacial biopsies (2010-2019), 6.9% (8,321 cases) were diagnosed as lip (0.8%, 951 cases), oral cavity (4.9%, 5,971 cases), and oropharyngeal (1.2%, 1,399 cases) SCCs. Most cases were from Brazil's Southeast (64.5%), where six of the OMPLs analyzed are located. The predominant profile of patients with lip and oral cavity SCC was Caucasian men, with a mean age over 60 years, low schooling level, and a previous history of heavy tobacco consumption. In the oropharyngeal group, the majority were non-Caucasian men, with a mean age under 60 years, had a low education level, and were former/current tobacco and alcohol users. According to data from the Brazilian National Cancer Institute, approximately 9.9% of the total lip, oral cavity, and oropharyngeal SCCs reported over the last decade in Brazil may have been diagnosed at the OMPLs included in the current study. Therefore, this data confirms the contribution of public OMPLs with respect to the important diagnostic support they provide to the oral healthcare services extended by the Brazilian Public Health System.

Awareness of patients receiving bisphosphonates: a cross-sectional study

Abstract The aim of this study was to evaluate the awareness of patients using bisphosphonates (BP) regarding their risks and benefits. Sixty-five patients using BP were included. Each participant completed a self-administered questionnaire consisting of 13 questions, including sociodemographic and general information on BP. Data were analyzed using descriptive statistics, and a binomial test was used to assess patient knowledge about BP, considering a 5% significance level. Fifty-nine (90.2%) patients were unaware or had never heard of BP drugs and only 3 (4.6%) knew their indications. Only 6 patients (9.2%) said they knew about the oral complications caused by BP. Sixty-three patients (96.9%) said they were not referred to the dentist before starting BP treatment. Patients using BP do not have satisfactory knowledge regarding the risks and benefits of BP. Physicians and dentists must be prepared to inform and counsel BP users about their adverse effects and possible risk factors. Our results emphasize the importance of public policies, whether individual or collective, to be taken to increase knowledge about BP to avoid medication-related osteonecrosis of the jaw.

Mandible lymphoma: an aggressive osteolytic lesion

Background: Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-hodgkin's lymphoma. In oral cavity represents approximately 2% of all malignancies. Case presentation: This report describes a rare mandibular involvement of DLBCL. A 56 year-old man was referred for evaluation of left mandible pain. In the anamnesis, the patient informed to be treating tooth pain in lasting 6 months. On oral evaluation, an intense mobility of the left mandibular second molar and a swelling in posterior left mandible were observed. Computed tomography showed a large osteolytic lesion affecting both mandibular body and ramus. An incisional biopsy was performed and according to histopathological and imumnohistochemical features, DLBCL was diagnosed. The treatment consisted of 8 cycles of R-CHOP and adjuvant radiotherapy. He is asymptomatic after 6 years. Conclusion: This case showed a rare bone presentation of DLBCL and such tumor should be considered as differential diagnosis of osteolytic lesion of the mandible.

Diagnóstico histopatológico de lesões orais provenientes da mesorregião agreste do estado de Pernambuco / Diagnóstico histopatológico de lesiones orales de la mesorregión agreste del estado de Pernambuco / Histopathological diagnosis of oral lesions from the agreste mesoregion of Pernambuco state

Resumo Introdução e Objetivos: Os laboratórios de patologia oral de universidades têm procurado caracterizar e quantificar a prevalência de lesões que são obtidas nas biópsias, para que assim, seja possível estabelecer o perfil dos casos do acervo deste serviços. O presente trabalho objetivou analisar os diagnósticos histológicos de biópsias solicitados por profissionais estabelecidos e serviços localizados na região do agreste meridional do estado de Pernambuco ao laboratório de patologia oral da UFPE. Materiais e métodos: Tratou-se um estudo retrospectivo em que foram analisadas todas as fichas de requisição de exames anatomopatológicos e seus respectivos laudos emitidos pelo Laboratório de Patologia Oral da Universidade Federal de Pernambuco no período de 17 anos - março de 2000 a março de 2017. Resultados: Das 6000 fichas clínicas, 11,4% provieram da mesorregião do Agreste Pernambucano. 42% destas peças foram provenientes da cidade Caruaru, sendo os processos proliferativos não neoplásicos o grupo de lesão mais frequente (43,9%), seguido pelo grupo de patologia inflamatória das glândulas salivares (12%) e lesões cancerizáveis (7,3%). O sexo feminino foi o mais afetado em 64,7% dos casos, com média de idade dos pacientes de 45 anos. Conclusão: A mesorregião agreste de Pernambuco carece de laboratórios especializados no diagnóstico histológico de lesões orais. Na amostra estudada, mulheres e processos proliferativos não neoplásicos foram os mais prevalentes.

Resumen Introducción y objetivo: Los laboratorios de patología oral de las universidades han tratado de caracterizar y cuantificar la prevalencia de las lesiones que se obtienen en las biopsias, de modo que sea posible establecer el perfil de los casos a partir de la recopilación de estos servicios. Este estudio tuvo como objetivo analizar los diagnósticos histológicos de biopsias solicitados por profesionales y servicios establecidos ubicados en la región agreste del estado de Pernambuco al laboratorio de patología oral de la UFPE. Materiales y métodos: Este fue un estudio retrospectivo que analizó todos los archivos de solicitud de exámenes patológicos y sus respectivos informes emitidos por el Laboratorio de Patología Oral de la Universidad Federal de Pernambuco de 17 años, del marzo de 2000 al marzo de 2017. Resultados: De los 6000 registros clínicos, el 11,4% provino de la mesorregión agreste de Pernambucano. El 42% de estas piezas provienen de la ciudad de Caruaru, siendo los procesos proliferativos no neoplásicos el grupo de lesiones más frecuente (43,9%), seguido por el grupo de patología inflamatoria de las glándulas salivales (12%) y el grupo de lesiones com potencial de cancerización (7,3%). Las mujeres fueron las más afectadas en el 64,7% de los casos, con una edad media de 45 años. Conclusión: La mesorregión agreste de Pernambuco carece de laboratorios especializados en el diagnóstico histológico de lesiones orales. En la muestra estudiada, las mujeres y los procesos proliferativos no neoplásicos fueron los más prevalentes.

Abstract Introduction and Objective: The oral pathology laboratories of universities have sought to characterize and quantify the prevalence of lesions that are obtained on biopsies, in aim to analyze the histological diagnoses of biopsies requested by established professionals and services located in agreste region of Pernambuco state demanded by the oral pathology laboratory of UFPE. Materials and methods: This was a retrospective study that analyzed all the request files for pathological exams and their respective reports issued by the Oral Pathology Laboratory of the Federal University of Pernambuco from 17 years - March 2000 to March 2017. Results: Of the 6000 clinical records, 11.4% came from the agreste mesoregion from Pernambuco. 42% of these pieces came from Caruaru, with non-neoplastic proliferative processes being the most frequent lesion group (43.9%), followed by the salivary glands inflammatory pathology group (12%) and cancerous lesions group (7.3%). Females were the most affected in 64.7% of cases, with a mean age of 45 years. Conclusion: The agreste mesoregion of Pernambuco lacks specialized laboratories in the histological diagnosis of oral lesions. In the sample studied, women and non-neoplastic proliferative processes were the most prevalent.

COVID-19 Pandemic: Oral Repercussions and its Possible Impact on Oral Health

Abstract Many viral infections cause oral manifestations, including disorders in odontogenesis, resulting in dental malformations. In this review, based on current knowledge, we will discuss the likely dental and oral consequences of COVID-19. In this article, we review currently available data associated with vertical transmission of COVID-19 and odontogenesis, oral manifestations, and the impact of COVID-19 pandemic on a diagnosis of oral diseases. Owing to the severity of the pandemic, the population's anxiety and fear of becoming infected with COVID-19 may underestimate the signs and symptoms of serious illnesses, besides discourage patients from seeking health, medical or dental services to determine the diagnosis of oral lesions. Thus, the COVID-19 pandemic could be an additional and aggravating factor for the delay of serious illness diagnosis, such as oral squamous cell carcinoma resulting in higher morbidity and worse prognosis. Several changes and oral lesions have been described as oral manifestations of COVID-19, such as dysgeusia, oral ulcers, petechiae, reddish macules, desquamative gingivitis, among others. Besides, it can cause major systemic changes and predispose opportunistic infections. As with other viral infections, oral manifestations, including dental anomalies, can occur as a direct result of SARS-CoV-2 infection. However, further studies are needed to guide and clarify possible oral changes.

Neoplasias orofaciais em crianças e adolescentes / Orofacial neoplasms in children and adolescents

Objetivo:Este trabalho analisou os casos de neoplasias orofaciais em crianças e adolescentes, diagnosticadas pelo Laboratório de Patologia Oral da Universidade Federal de Pernambuco no período de março de 2000 a março de 2019. Métodos: Tratou-se de um estudo retrospectivo das neoplasias mais prevalentes diagnosticada no serviço. Os dados foram tabulados e analisados através do programa Statistical Package for the Social Sciences(SPSS) na versão 24.0. Resultados:Dos 6.766 casos diagnosticados, 101 foram de neoplasias, destes 52,5% foram no sexo feminino. A média de idade entre os pacientes foi de 12,6 anos. Em relação ao tipo de biópsia, a excisional foi mais prevalente e em 71,3% dos casos os diagnósticos histopatológicos confirmaram as hipóteses diagnósticas clínicas. A neoplasia benigna não odontogênica mais comum foi o papiloma oral com 30 casos (29,7%). Entre os tumores benignos de origem odontogênica, os odontomas foram os mais prevalentes com 16 casos (15,8%). Foram diagnosticados apenas dois tipos de neoplasias malignas: o carcinoma adenoide cístico e o leiomiossarcoma. Conclusão:Levantamentos epidemiológicos de lesões orofaciais são importantes para determinar a sua prevalência, além de contribuir com a determinação das características na população estudada, fornecendo ao cirurgião-dentista uma base sólida para o diagnóstico e manejo clínico das neoplasias nesses indivíduos.

Aim:To analyze the cases of orofacial neoplasms in children and adolescents, diagnosed by the Oral Pathology Laboratory of the Federal University of Pernambuco from March 2000 to March 2019. Methods: Treatment of a retrospective study of the most prevalent neoplasms diagnosed at the laboratory. Data were tabulated and analyzed using the Statistical Package for Social Sciences (SPSS), version 24.0. Results:Of the 6,766 cases diagnosed, 101 were neoplasms, 52.5% of these were not female. The average age among the patients was 12.6 years. Regarding the type of biopsy, tooth extractions were more prevalent, and in 71.3% of the cases, the histopathological diagnoses confirmed the clinical diagnostic hypotheses. The most common non-odontogenic benign neoplasm was the oral papilloma, found in 30 cases (29.7%). Among the benign tumors of odontogenic origin, the odontomas were the most prevalent in 16 cases (15.8%). Only two types of malignant neoplasms were diagnosed: adenoid cystic carcinoma and leiomyosarcoma. Conclusion:Epidemiological surveys of orofacial lesions are important to determine their prevalence and aid in defining the characteristics in the studied population, providing the dentist with a continuous basis for the diagnosis and clinical treatment of neoplasms in these individuals.

COVID-19 pandemic and the impact on dental education: discussing current and future perspectives

Abstract Due to the COVID-19 pandemic crisis, many dental schools and instructors are rethinking the way they teach and interact with students. New perspectives regarding a change in face-to-face activities, social isolation and the reformulation of clinical activities result in a transition toward e-learning and e-teaching processes. In this review, we discuss some favorable aspects and difficulties associated with virtual teaching and learning, searching for available tools and techniques as well as new perspectives.

Oral squamous cell carcinoma: a clinicopathological study on 194 cases in northeastern Brazil. A cross-sectional retrospective study

ABSTRACT BACKGROUND: Only a few studies have evaluated the clinicopathological features of oral squamous cell carcinoma (SCC) in Brazil, and most were conducted in the most industrialized region of the country, i.e. the southeastern region. The aim of this study was to evaluate the clinicopathological features of this malignant neoplasm in northeastern Brazil. DESIGN AND SETTING: Retrospective study performed in an oral pathology laboratory in Recife, Brazil. METHODS: All cases of oral SCC that occurred between 2000 and 2015 were studied. Clinical data were recorded and histological slides were reviewed. Statistical analysis was performed using the chi-square test (P ≤ 0.05). RESULTS: A total of 194 cases were evaluated. The male-to-female ratio was 1.5:1. The mean age was 65.4 years, and only 6.6% of the cases occurred in patients younger than 41 years. Most tumors consisted of well-differentiated SCC (54.6%). CONCLUSIONS: The findings of this study highlight the higher prevalence of oral SCC among women and the increasing number of cases among young patients. Thus there is no specific risk group for oral SCC, as in the past. This fact needs to be taken into consideration in clinical routine care, so that apparently innocuous malignant lesions do not go unnoticed in these individuals.

Cemento-Osseous Dysplasias: Imaging Features Based on Cone Beam Computed Tomography Scans

Abstract Imaging exams have important role in diagnosis of cemento-osseous dysplasia (COD). Cone beam computed tomography (CBCT) stands out for allowing three-dimensional image evaluation. This study aimed to assess the prevalence of cases diagnosed as COD on CBCT scans, as well identify the main imaging features related to these lesions. An analysis was performed in a database containing 22,400 radiological reports, in which all cases showing some type of COD were initially selected. These CBCT exams were reevaluated to confirm the radiographic diagnosis and determine the prevalence and distribution of the types of COD with regard to gender, age and preferred location, while describing its most common imaging aspects. Data were presented using descriptive analyses. There were 82 cases diagnosed as COD in the CBCT images (prevalence of 0.4%). The distribution of patients was 11 (13.4%) male and 71 (86.6%) female, with a mean age of 49.8 years (age-range 17-85 years). There were 47 (57.3%) cases of periapical COD, 23 (28%) of focal COD and 12 (14.6%) of florid COD. The mandible was more affected than the maxilla. In most cases, the lesions were mixed or hyperdense. All COD had well-defined limits and there were no cases of tooth displacement. In conclusion, periapical COD was the most common type and the most affected bone was the mandible. Imaging evaluation is critical for diagnosis and dentists should bear in mind all possible radiographic presentations of COD in order to prevent misleading diagnoses and consequently, inadequate treatments.

Resumo Os exames por imagem têm papel importante no diagnóstico da displasia cemento-óssea (DCO). A tomografia computadorizada por feixe cônico (TCFC) se destaca por permitir a avaliação tridimensional da imagem. O objetivo neste estudo foi avaliar a prevalência de casos diagnosticados como DCO nos exames de TCFC, bem como identificar as principais características de imagem relacionadas a essas lesões. Uma análise foi realizada em um banco de dados contendo 22.400 laudos radiológicos, no qual todos os casos que apresentavam algum tipo de DCO foram inicialmente selecionados. Estes exames foram reavaliados para confirmar o diagnóstico radiográfico e determinar a prevalência e distribuição dos tipos de DCO em relação ao sexo, idade e localização preferencial, além de descrever seus aspectos imaginológicos mais comuns. Os dados foram apresentados por meio de análise descritiva. Oitenta e dois casos foram diagnosticados como DCO nas imagens de TCFC (prevalência de 0,4%). A distribuição dos pacientes foi de 11 (13,4%) homens e 71 (86,6%) mulheres, com idade média de 49,8 anos (faixa etária de 17 a 85 anos). Houve 47 (57,3%) casos de DCO periapical, 23 (28%) de DCO focal e 12 (14,6%) de DCO florida. A mandíbula foi mais afetada que a maxila. Na maioria dos casos, as lesões foram mistas ou hiperdensas. Todas as DCO apresentaram limites bem definidos e não houve casos de deslocamento dentário. Em conclusão, a DCO periapical foi o tipo mais comum e o osso mais afetado foi a mandíbula. A avaliação da imagem é crítica para o seu diagnóstico e os dentistas devem ter em mente todas as possíveis apresentações radiográficas da DCO, a fim de prevenir diagnósticos enganosos e, conseqüentemente, tratamentos inadequados.

Effects of Zoledronic Acid in Experimental Periapical Lesions in Rats: An Imaging and Histological Analysis

Abstract The aim of this study was to assess the imaging and histological features of experimental periapical lesions, including the adjacent alveolar bone, in rats under zoledronic acid treatment. The study used 40 male Wistar rats distributed into 8 groups of 5 animals each: G1: induction of periapical lesion (PL) and weekly intraperitoneal administration (WIPA) of saline solution (0.9% NaCl) for 4 weeks; G2: PL induction and WIPA of zoledronic acid (0.15 mg/kg/week) for 4 weeks; G3: PL induction and WIPA of saline solution for 8 weeks; G4: PL induction and WIPA of zoledronic acid for 8 weeks; G5:WIPA of saline solution for 4 weeks and subsequent PL induction; G6: WIPA of zoledronic acid for 4 weeks and subsequent PL induction; G7: WIPA of saline solution for 8 weeks and subsequent PL induction; G8: WIPA of zoledronic acid for 8 weeks and subsequent PL induction. The administration of zoledronic acid or saline solution continued after PL induction until the euthanasia. Thus, cone beam computed tomography and histological analysis were performed. Statistical analyzes were performed by ANOVA and Kruskal-Wallis test. Groups treated with zoledronic acid showed significantly smaller size of PL than the groups treated with 0.9% NaCl (p<0.05). PLs were formed by chronic inflammation ranging from mild to moderate, with no difference between groups. In all specimens, no mandibular necrosis was observed. In conclusion, the presence of PLs apparently does not represent an important risk factor for the development of bisphosphonate-related osteonecrosis of the jaws.

Resumo O objetivo deste estudo foi avaliar as características histológicas e de imagem de lesões periapicais experimentais, incluindo o osso alveolar adjacente, em ratos sob tratamento com ácido zoledrônico. O estudo utilizou 40 ratos Wistar, machos, distribuídos em 8 grupos de animais cada: G1: indução de lesão periapical (LP) e administração intraperitoneal semanal (AIS) de solução salina (NaCl 0.9%) por 4 semanas; G2: indução de LP e AIS de ácido zoledrônico (0,15 mg/kg/week) por 4 semanas; G3: indução de LP e AIS de solução salina por 8 semanas; G4: indução de LP e AIS de ácido zoledrônico por 8 semanas; G5- AIS de solução salina por 4 semanas e subsequente indução de LP; G6- AIS de ácido zoledrônico por 4 semanas e subsequente indução de LP; G7: AIS de solução salina por 8 semanas e subsequente indução de LP; G8: AIS de ácido zoledrônico por 8 semanas e subsequente indução de LP. A administração de ácido zoledrônico ou solução salina continuou após indução de LP até a eutanásia. Após isso, tomografia computadorizada de feixe cônico e análise histológica foram realizadas. Análises estatísticas foram realizadas por ANOVA e teste de Kruskal-Wallis. Os grupos tratados com ácido zoledrônico mostraram LPs significativamente menores que os grupos tratados com NaCl 0.9% (p <0.05). LPs eram formadas por inflamação crônica variando de leve a moderada, sem diferença entre os grupos. Em todos os espécimes, necrose mandibular não foi observada. Em conclusão, a presença de LPs aparentemente não representa um fator de risco importante para o desenvolvimento de osteonecrose relacionada ao uso de bisfosfonatos.

Fluoxetine effects on periodontogenesis: histomorphometrical and immunohistochemical analyses in rats

Abstract Reports have indicated that serotonin plays an important role in cell migration and differentiation during the organogenesis of several tissues, including the oral types. Administration of selective serotonin reuptake inhibitor (SSRI) drugs during pregnancy could affect the delivery of serotonin to embryonic tissues altering its development. Objective This study aimed to assess the effects of fluoxetine, a selective serotonin reuptake inhibitor, on the formation of the periodontal ligament during pregnancy and lactation in rat pups. Material and Methods Twelve pregnant rats of Wistar lineage were divided into four study groups. In the control group, 0.9% sodium chloride solution was administered orally, throughout the entire period of the 21 days of pregnancy (CG group) and in the CGL group, it was administrated during pregnancy and lactation (from day 1 of pregnancy to the 21st day after birth). Fluoxetine was administered orally at the dose of 20 mg/kg in a group treated during pregnancy only (FG group), and during pregnancy and lactation (FGL group). Histometrical, histochemical and immunohistochemical analysis of the maxillary first molar periodontium region of the 24 rat pups was made under light microscopy, and periodontal ligament collagen was qualitatively evaluated under a polarizing light microscope. Results The quantity of fibroblasts (p=0.006), osteoblasts (p=0.027) and cementoblasts (p=0.001) was reduced in pups from the rats that received fluoxetine during pregnancy and lactation. No alterations were seen in the collagen fibers. Conclusion These findings suggest that periodontal tissue may be sensitive to fluoxetine, and its interference in reducing periodontal cells depends on exposure time during lactation.

Extensa fibromatose gengival idiopática: relato de caso / Extensive Idiopathic Gingival Fibromatosis: A Case Report

A Fibromatose Gengival (FG) é descrita como uma condição bucal rara, clinicamente manifestada por um crescimento lento, progressivo, difuso e benigno dos tecidos gengivais. Essa condição pode se manifestar de forma isolada, em associação a outras doenças sistêmicas ou como componente de síndromes. A FG pode ter uma etiologia identificável ou ser idiopática. Em função da severidade de cada caso, pode acarretar transtornos funcionais e estéticos significativos, sobretudo, relacionado à dificuldade de higienização, fala e deglutição, devido à formação de grandes massas teciduais na gengiva. O presente trabalho propõe a revisão dos aspectos clínicos, diagnósticos e terapêuticos da Fibromatose Gengival e relata um caso severo desta doença que foi tratada cirurgicamente... (AU)

The Gingival Fibromatosis (GF) is described as a rare oral condition, clinically manifested by a slow, progressive, diffuse, and benign growth of gingival tissues. This condition can manifest itself in isolation, in combination with other systemic diseases or as a component of syndromes. GF may have an identifiable etiology or be idiopathic. Depending on the severity of each case, GF may result in significant functional and aesthetic disorders, mainly related to the difficulty of cleaning, speech and swallowing due to formation of large gingival tissue masses. This paper proposes a review of the clinical features, diagnosis and treatment of gingival fibromatosis and reports a severe case of this condition that was surgically treated... (AU)

PADRÃO DAS BIÓPSIAS E FICHAS DE SOLICITAÇÃO DE EXAME HISTOPATOLÓGICO ENCAMINHADOS PARA O LABORATÓRIO DE PATOLOGIA ORAL DA UNIVERSIDADE FEDERAL DE PERNAMBUCO / STANDARDS OF BIOPSIES AND RECORDS OF HISTOPATHOLOGIC TEST REQUESTS SENT TO THE UFPE ORAL PATHOLOGY LABORATORY

O objetivo geral deste trabalho foi realizar um levantamento quali-quantitativo das fichas de solicitações de exame histopatológico enviadas ao laboratório de histopatologia oral da UFPE, no período de outubro de 2011 até agosto de 2013, com a finalidade de conhecer a origem das demandas e situar o papel deste serviço dentro do Sistema Único de Saúde (SUS). A maioria das fichas clínicas enviadas ao serviço estavam dentro do padrão estabelecido pelas normas postas na literatura. Porém, foi observado pouca demanda dos Centros de Especialidades Odontológica (CEO) e das Unidades de Saúde da Família (USF) para o laboratório, indicando que políticas de inclusão e de credenciamento de serviços de diagnóstico disponíveis para a rede sus é de fundamental importância para garantir a integralidade do cuidado.

The aim of this study was to perform qualitative and quantitative survey of the records of requests sent to the histopathology laboratory of oral histopathology UFPE, from October 2011 until August 2013, with the purpose of knowing the origin of the demands and situate the role of the service within the unified health system (SUS). Most clinical records were sent to the service within the standard set by the rules put in literature. However, little demand centers of dental specialties (CEO) and units of family (USF) health to the laboratory was observed, indicating that inclusion policies diagnostic services available for sus network is of critical importance to ensure comprehensive care.

Mixed Periapical Lesion: An Atypical Radicular Cyst with Extensive Calcifications

The radicular cyst is an inflammatory odontogenic cyst of endodontic origin. Radiographically, the lesion appears as a periapical radiolucent image. This report describes a very rare case of a mixed periapical radiographic image diagnosed as a radicular cyst. A 37-year-old female patient presented a mixed, well-circumscribed image located in the periapical region of the left maxillary central incisor, which presented unsatisfactory endodontic treatment. Microscopic examination revealed a cavity lined by non-keratinized squamous epithelium and extensive calcifications in the cystic lumen and lining epithelium. Diagnosis of radicular cyst with extensive calcifications was established. Endodontic retreatment was performed and no radiographic signs of recurrence were observed 18 months after treatment. Although very rare, a radicular cyst should be considered in the differential diagnosis of a mixed periapical image associated to teeth with pulp necrosis.

O cisto radicular é um cisto odontogênico inflamatório de origem endodôntica. Radiograficamente, a lesão se apresenta como uma imagem radiolúcida periapical. Este relato descreve um caso muito raro de uma imagem radiográfica periapical mista diagnosticada como cisto radicular. Uma paciente de 37 anos de idade, do gênero feminino, apresentava uma imagem mista, bem circunscrita, localizada na região periapical do incisivo central superior esquerdo, que apresentava tratamento endodôntico insatisfatório. Avaliação microscópica revelou uma cavidade revestida por epitélio escamoso não-queratinizado e calcificações extensas na cavidade cística e revestimento epitelial. O diagnóstico de cisto radicular com extensas calcificações foi estabelecido. Retratamento endodôntico foi realizado e não foram observados sinais radiográficos de recorrência da lesão após 18 meses de tratamento. Embora muito raro, um cisto radicular deve ser considerado no diagnóstico diferencial de uma imagem periapical mista associada a dentes com necrose pulpar.

Ossifying Fibroma of the Jaws: A Clinicopathological Case Series Study

The aim of this study was to assess the clinical, radiographic and microscopic features of a case series of ossifying fibroma (OF) of the jaws. For the study, all cases with OF diagnosis from the files of the Oral Pathology Laboratory, University of Ribeirão Preto, Ribeirão Preto, SP, Brazil, were reviewed. Clinical data were obtained from the patient files and the radiographic features were evaluated in each case. All cases were reviewed microscopically to confirm the diagnosis. Eight cases were identified, 5 in females and 3 in males. The mean age of the patients was 33.7 years and most lesions (7 cases) occurred in the mandible. Radiographically, all lesions appeared as unilocular images and most of them (5 cases) were of mixed type. The mean size of the tumor was 3.1 cm and 3 cases caused displacement of the involved teeth. Microscopically, all cases showed several bone-like mineralized areas, immersed in the cellular connective tissue. From the 8 cases, 5 underwent surgical excision and 1 patient refused treatment. In the remaining 2 cases, this information was not available. In conclusion, OF occurs more commonly in women in the fourth decade of life, frequently as a mixed radiographic image in the mandible. Coherent differential diagnoses are important to guide the most adequate clinical approach. A correlation between clinical, imaginological and histopathological features is the key to establish the correct diagnosis.

O objetivo deste estudo foi analisar as características clínico-radiográficas e microscópicas de uma série de casos de fibroma ossificante (FO). Para o estudo, todos os casos com diagnóstico de FO do arquivo do Laboratório de Patologia Bucal da Universidade de Ribeirão Preto, Ribeirão Preto, São Paulo, Brasil, foram estudados. Os dados clínicos foram coletados das fichas de encaminhamento das lesões ao Laboratório. As características radiográficas foram avaliadas em cada caso. Todos os casos foram revisados microscopicamente para confirmação do diagnóstico. Oito casos foram identificados, 5 em mulheres e 3 em homens. A idade média dos pacientes foi de 33,7 anos e a maioria das lesões (7 casos) ocorreu na mandíbula. Radiograficamente todas as lesões se apresentavam como imagens uniloculares e a maioria (5 casos) se mostravam como imagem mista. O tamanho médio do tumor foi de 3,1 cm e 3 casos causavam deslocamento dos dentes envolvidos. Microscopicamente, todos os casos apresentavam várias áreas mineralizadas semelhantes a osso, imersas em um tecido conjuntivo celularizado. Dos 8 casos, 5 foram submetidos a excisão cirúrgica da lesão e 1 paciente recusou tratamento. Nos outros 2 casos, essa informação não estava disponível. Conclui-se que o FOs ocorrem mais comumente na mandíbula de pacientes do gênero feminino durante a quarta década de vida e se apresentam frequentemente como uma imagem radiográfica mista. Diagnósticos diferenciais coerentes são importantes para guiar a conduta clínica mais adequada. A correlação entre as características clínicas, imaginológicas e histopatológicas é a chave para estabelecer o diagnóstico correto.