Concordancia clínica e histopatológica de lesiones blancas en cavidad bucal

Introducción: Las lesiones blancas en cavidad bucal constituyen un problema de salud que responde a causas diversas y afectan a una cifra considerable de personas a nivel mundial. Las condiciones y resultados del diagnóstico clínico de las lesiones sin un basamento histopatológico solo exhiben deducciones empíricas basadas en la experiencia clínica acumulada, que pueden concordar o no con la real naturaleza de la enfermedad diagnosticada. El estudio de su concordancia permite evidenciar la certeza del diagnóstico clínico. Objetivo: Determinar la concordancia clínica e histopatológica de lesiones blancas presentes en cavidad bucal. Métodos: Se realizó un estudio observacional descriptivo de corte transversal en 193 pacientes con lesiones blancas en cavidad bucal seleccionados mediante muestreo no probabilístico de tipo intencionado, que acudieron al Servicio de Estomatología del Policlínico Arturo Puig Ruiz de Villa del municipio Minas, provincia Camagüey, en el período comprendido de enero de 2020 a enero de 2022. Se realizó biopsia de las lesiones para correlacionar el diagnóstico clínico y el diagnóstico histopatológico. Se evaluó la concordancia de los resultados mediante el índice de Kappa. Resultados: Predominó el grupo de edades de 40-49 años, los pacientes más afectados correspondieron al sexo femenino y el color de piel blanca, la lesión que predominó fue la leucoplasia con displasia, el subsitio anatómico más afectado es la mucosa del carrillo y más de la mitad de los pacientes se relacionaron con el tabaquismo como factor de riesgo. La fuerza de concordancia de la leucoplasia fue muy buena respecto al liquen plano y la candidiasis crónica hiperplásica (buena). El carcinoma espinocelular tuvo un nivel de concordancia moderado. Conclusión: Se promediaron los resultados de concordancia para las lesiones blancas presentes en cavidad bucal en los 193 pacientes de la investigación y de manera general el estudio mostró buena concordancia.

Introduction: White lesions in the oral cavity constitute a health problem that responds to diverse causes and affects a considerable number of people worldwide. The conditions and results of the clinical diagnosis of lesions without a histopathological basis only show empirical deductions based on accumulated clinical experience, which may or may not agree with the real nature of the clinically diagnosed entity. The study of their concordance allows evidencing the certainty of the clinical diagnosis. Objective: To determine the clinical and histopathological concordance of white lesions present in the oral cavity. Methods: A cross-sectional descriptive observational study was carried out in 193 patients with white lesions in the oral cavity selected by non-probabilistic purposive sampling who attended the Department of Dentistry of the Arturo Puig Ruiz de Villa Polyclinic from January 2020 to January 2022. The lesions were biopsied to correlate the clinical diagnosis and histopathological diagnosis. The concordance of the results was evaluated using the Kappa index. Results: The predominant age group was 40-49 years, the most affected patients were female and white skin color, the predominant lesion was leukoplakia with dysplasia, the most affected anatomical subsite was the cheek mucosa and more than half of the patients were related to smoking as a risk factor. The concordance strength of leukoplakia was very good with respect to lichen planus and hyperplastic chronic candidiasis (good). Squamous cell carcinoma had a moderate level of concordance. Conclusion: The concordance results for white lesions present in the oral cavity in the 193 patients of the study were averaged and in general the study showed a good concordance.

Nivel de conocimientos sobre el tabaquismo y su relación con la cavidad bucal / Level of knowledge about smoking and its relationship with the oral cavity

Introducción: El tabaquismo es una enfermedad adictiva crónica la cual constituye la causa de muerte prevenible más importante en los países desarrollados y la de mayor morbilidad y mortalidad antes que cualquier otra enfermedad crónica (hipertensión arterial, diabetes mellitus). Se considera una epidemia de carácter universal y es una gravosa carga para el individuo, la familia y la sociedad. Objetivo: Determinar el nivel de conocimientos sobre el hábito de fumar, relacionado con la cavidad bucal en adultos fumadores. Métodos: Se realizó un estudio descriptivo transversal con 55 pacientes fumadores de ambos sexos. Se aplicó un cuestionario para realizar un diagnóstico de conocimientos sobre el daño que ocasiona el tabaquismo en la cavidad bucal. Resultados: El 76,33 por ciento de los sujetos presentaron un nivel de conocimiento insuficiente, el 92,72 por ciento conocían la relación con el cáncer bucal, el 72,72 por ciento los beneficios de abandonar el hábito y el 53,36 por ciento la relación con los dientes, sin embargo el 83,63 por ciento presentó un nivel de conocimiento insuficiente en relación con los tejidos periodontales. Conclusiones: El nivel de conocimientos en la población estudiada fue insuficiente(AU)

Introduction: Smoking is a chronic addictive disease which is the most important preventable cause of death in developed countries and the one with the highest morbidity and mortality before any other chronic disease (hypertension, diabetes mellitus). It is considered an epidemic of universal character and is a burden for the individual, the family and society. Objective: To determine the level of knowledge about smoking habit, related to the oral cavity in adult smokers. Methods: A cross-sectional descriptive study was conducted with 55 smokers patients of both sexes. A questionnaire was applied to make a diagnosis of knowledge about the damage caused by smoking in the oral cavity. Results: 76.33 percent of the subjects presented an insufficient level of knowledge, 92.72 percent knew the relationship with oral cancer, 72.72 percent the benefits of quitting and 53.36 percent the relationship with teeth, however, 83.63 percent presented an insufficient level of knowledge in relation to periodontal tissues. Conclusions: The level of knowledge in the population studied was insufficient(AU)

La prótesis estomatológica como factor de riesgo de lesiones premalignas y malignas en la cavidad bucal / The dental prosthesis as a risk factor for premalignant and malignant lesions in the oral cavity

RESUMEN Fundamento: la ubicación de cualquier tipo de prótesis dental en la boca provoca inevitables variaciones en el medio bucal, que obliga a los tejidos a reaccionar para adaptarse ante nuevas situaciones donde puede llegar a originarse lesiones consideradas como malignas o premalignas. Objetivo: describir la influencia de las prótesis estomatológicas como factor de riesgo para la aparición de lesiones premalignas y malignas en la cavidad bucal. Métodos: se realizó un estudio descriptivo transversal en el Policlínico Docente Manuel Antonio de Varona Miranda del municipio Sibanicú, provincia Camagüey en el periodo de enero 2016 hasta abril 2018. El universo de estudio estuvo constituido por 88 pacientes portadores de prótesis totales y parciales acrílicas remitidos con sospechas de lesiones premalignas o malignas. Resultados: el 57,9 % de las lesiones premalignas o malignas se desarrollaron en el reborde alveolar residual. De las prótesis en uso el 77,2 % se encontraban desajustadas y el 23,8 % presentó algún tipo de fractura. Solo el 18,7 % de los aparatos protésicos se estaban higienizados y el 43,7 % de los pacientes de la muestra usaban sus prótesis durante 24 horas. Conclusiones: la mayoría de las lesiones se desarrollaron en el reborde alveolar residual. Una gran parte de los aparatos protésicos en uso no se higienizaban bien, se usaban durante 24 horas y presentaban un estado técnico inadecuado.

ABSTRACT Background: the location of any type of dental prosthesis in the mouth causes unavoidable variations in the oral environment, which forces the tissues to react to adapt to new situations and it may cause lesions considered malignant or premalignant. Objective: to describe the influence of dental prostheses as a risk factor for the appearance of premalignant and malignant lesions in the oral cavity. Methods: a cross-sectional descriptive study was carried out in the Manuel Antonio de Varona Miranda Teaching Polyclinic of the Sibanicú municipality, in Camagüey province, from January 2016 to April 2018. The universe of study consisted of 88 patients with total and partial acrylic prostheses, referred with suspicion of premalignant or malignant lesions. Results: 57.9 % of premalignant or malignant lesions developed in the residual alveolar ridge. Of the prostheses in use, 77.2 % were out of adjustment and 23.8 % had some type of fracture. Only 18.7 % of the prosthetic devices were properly sanitized and 43.7 % of the patients in the sample used their prostheses for 24 hours. Conclusions: the majority of the lesions were developed in the residual alveolar ridge. A large part of the prosthetic devices in use were not sanitized well, they were used for 24 hours and had an inadequate technical condition.

Queimadura elétrica labial em criança relato de caso e revisão de literatura / Electrical burns of the lip in child: case report and review of the literature

Queimaduras elétricas em lábios são raras (5,6% – 7% dos casos de queimadura elétrica),mesmo em crianças, sendo o sexo masculino duas vezes mais atingido. Por serem incomuns,são de difícil e contraditório manejo no atendimento inicial e no tratamento das sequelas.No presente trabalho é descrito um caso de queimadura elétrica em lábio em uma pacientede 2 anos. Foi submetida a tratamento cirúrgico 10 dias após a queimadura e apresentouresultado estético e funcional satisfatório após 8 meses de evolução.

Electric burn injuries in lips are rare (5.6% – 7% are the range of occurrences), even inchildren, never the less statistics shows that male patients are two times more likely to sufferthis burns. Due to the fact, that this cases are uncommon they often have difficult andcontradictory first aid protocols, as well as in the following treatment. This text reports atwo-year-old-female patient who had a lip burn injury. The patient had suffered a surgicalproceeding 10 days after the burn took place and also had presented a satisfactory functionalevolution, 8 months later.

O papel da matriz extracelular na cicatrização de feridas bucais / Extracellular matrix role on the wound healing of oral lesions

A matriz extracelular (MEC) é uma estrutura complexa que proporciona o arcabouço que sustenta as células nos tecidos de todos os mamíferos. Uma contínua reconstrução e mudança nos constituintes da MEC ocorrem normalmente durante o processo de reparo de uma ferida. Assim, pode-se afirmar que a cicatrização é uma integração dinâmica que envolve células, MEC e mediadores solúveis. Dessa maneira, a cicatrização depende não só das células e polipeptídeos disponíveis, mas do microambiente da matriz extracelular (MEC). Devido à imensa gama de fatores de origem local ou sistêmica, exógena ou endógena, certamente ocorrem modificações muito mais complexas e profundas nos componentes da MEC e suas inter-relações com as células envolvidas no processo de reparação de feridas bucais, o que influencia a qualidade e quantidade de tecido reparador em cada tipo de ferimento.

Extracellular matrix (ECM) is a complex structure which supports and maintains all the cells organized in tissues in mammalians. A continuous reconstruction and change of the ECM components normally occur during the repair of injured tissue. Thus, it can be affirmed that wound healing is a dynamic integration among cells, ECM and soluble mediators. So it depends not only on the available polypeptides and cells, but especially on the micro environment of the ECM. Because of the enormous endogenous and exogenous, local and systemic factors related, many complex and profound modifications certainly occur in the components of the ECM and also in their relation with all the cells involved in oral lesion repair. These factors influence the quality and quantity of the repairing tissue in each type of lesion.