Variations of oral anatomy and common oral lesions

Abstract Several topics related to the oral cavity are briefly addressed in this article, from anatomical variations that, when recognized, avoid unnecessary investigations, to diseases that affect exclusively the mouth, mucocutaneous diseases, as well as oral manifestations of systemic diseases. A complete clinical examination comprises the examination of the mouth, and this approach facilitates clinical practice, shortening the path to diagnosis in the outpatient clinic as well as with in-hospital patients. The objective of this article is to encourage the examination of the oral cavity as a useful tool in medical practice, helping to recognize diseases in this location.

Oral conditions of children with microcephaly associated with congenital Zika syndrome: a cross-sectional study

Abstract The aim of the present study was to compare the oral conditions of children with congenital Zika syndrome (CZS)-associated microcephaly, non-CZS-associated microcephaly, and normotypical children, as well as to characterize their sociodemographic aspects and medical history. A paired cross-sectional study was carried out on 14 children with CZS-associated microcephaly and 24 age-matched controls, in Belo Horizonte, in southeastern Brazil. Children's oral conditions were assessed: dental caries experience (dmft/DMFT indices); developmental defects of enamel (DDE) index; dental anomalies; mucosal changes; lip sealing, and malocclusion (overjet, overbite, and/or posterior crossbite alterations). The quality of oral hygiene was analyzed by the simplified oral hygiene index. The children's mothers also answered a questionnaire about sociodemographic and medical history data. The variables were analyzed descriptively. Female participants were more prevalent (60.5%), and the mean age of the participants was 4.9 years (±1.4) (range: 2-8 years) and 92.1% of their exhibited some oral condition. All participants with CZS-associated microcephaly showed absence of lip sealing and had malocclusion (100.0%). When compared to the other groups, children with CZS had a higher percentage of dental anomalies (35.7%), mucosal changes (71.4%), and unsatisfactory oral hygiene (64.3%). In a sample composed mainly of female participants aged less than 5 years, the prevalence of oral conditions and unsatisfactory oral hygiene was higher in the group with CZS-associated microcephaly, followed by the group with non-CZS-associated microcephaly. Normotypical children had the highest percentage of dental caries experience.

Laparoscopic ventral onlay ureteroplasty with buccal mucosa graft for complex proximal ureteral stricture

ABSTRACT Introduction: There is lack of papers dedicated to the laparoscopic buccal mucosa graft (BMG) ureteroplasty of the complex upper ureteral stricture. The aim of this study is to evaluate the results of laparoscopic BMG ureteroplasty in patients with complex proximal ureteral stricture. Material and methods: Twenty-four patients underwent laparoscopic ventral onlay BMG ureteroplasty for long or recurrent proximal ureteral stricture not amenable to uretero-ureteral anastomosis over 2019-2022. Patient demographics, operative time, estimated blood loss, length of stay, follow-up, intra- and postoperative complication rate and percentage of stricture-free at last visit were analyzed. Results: The mean stricture length was 3.6 cm. The mean operative time was 208.3 min, while mean blood loss was 75.8 mL. The length of hospital stay was 7.3 days. No intraoperative complications were observed. Postoperatively, seven patients developed complications (29.2%). Five patients experienced a Grade II (according to Clavien nomenclature). Two patients developed a Grade IIIa complication, which included leakage of the anastomosis site. The mean follow-up was on the 22 months with stricture free rate 87.5%. Conclusion: Patients with proximal ureteral strictures could be effectively treated by laparoscopic ventral onlay ureteroplasty with a buccal mucosa graft.

Láser de baja frecuencia para aftas mayores recurrentes. Caso Clínico / Low frequency laser for major recurrent aphthous stomatitis. Clinical case

La estomatitis aftosa recurrente (menor, mayor o herpética) es una de las enfermedades bucodentales más frecuentes, de etiología multifactorial y con predisposición genética. Para esta patología su diagnóstico es clínico, y tomando como base la historia clínica se puede discriminar con otras patologías ulcerativas. La terapia con láser de baja potencia (LLLT) se propone como un tratamiento no invasivo, actuando como un fotomodulador celular, por lo que reduce el dolor, la inflamación, y estimula la regeneración tisular, previniendo daños. En el presente artículo se reporta a un niño de 11 años con una herida dolorosa de 4 meses en el borde posterior de la lengua que apareció tras una mordedura, en el que a la exploración clínica se encontró una lesión amarillenta con zonas enrojecidas, rodeada de un halo blanquecino de bordes redondeados. Para el tratamiento se utilizó LLLT, luego de una semana disminuyó el dolor, el paciente comenzó a comer correctamente, a los 15 días se observó una reducción de los bordes rojizos de la lesión, pasado el mes la lesión había remitido casi por completo. La LLLT se describe como un tratamiento eficaz, no invasivo, reduciendo los síntomas, y mejorando la calidad de vida del paciente al promover la curación de las lesiones.

Recurrent aphthous stomatitis (minor, major or herpetic) is one of the most frequent bucodental diseases, of multifactorial etiology and with genetic predisposition. The diagnosis of this pathology is clinical, and based on the clinical history it can be discriminated with other ulcerative pathologies. Low power laser therapy (LLLT) is proposed as a non-invasive treatment, acting as a cellular photo modulator, which reduces pain, inflammation, and stimulating tissue regeneration, preventing damage. This article reports an 11-year-old boy with a 4-month-old painful wound on the posterior edge of the tongue that appeared after a bite, in which clinical examination revealed a yellowish lesion with reddened areas, surrounded by a whitish halo with rounded edges. LLLT was used for the treatment, after one week the pain decreased, the patient started to eat properly, after 15 days a reduction of the reddish edges of the lesion was observed, after one month the lesion had almost completely remitted. LLLT is described as an effective, non-invasive treatment, which reduces symptoms and improves the patient's quality of life promoting the healing of the lesions.

Manifestaciones clínicas e histopatológicas de la eritroplasia bucal en pacientes fumadores de tabaco

Fundamento la eritroplasia es la lesión precancerosa más agresiva de la cavidad oral, con un gran potencial de transformación maligna. Al momento de practicar la biopsia y analizar la muestra, puede aparecer una displasia severa o un carcinoma invasivo. Objetivo describir las manifestaciones clínicas e histopatológicas de la eritroplasia bucal en pacientes fumadores activos de tabaco. Métodos se realizó un estudio descriptivo y transversal, con 12 fumadores diagnosticados clínica e histopatológicamente con eritroplasia bucal, atendidos en la consulta estomatológica del Policlínico de Especialidades del Hospital Saturnino Lora Torres, de Santiago de Cuba. Para la recolección del dato primario se confeccionó una encuesta con las variables: edad, sexo, diagnóstico clínico, tiempo en el hábito de fumar, diferentes formas de consumir tabaco, localización anatómica y estudio histopatológico de la enfermedad. Resultados prevaleció el sexo masculino, el grupo etario de 60 y más años, y los fumadores convencionales de 21 y más años. El infiltrado inflamatorio crónico intenso y la displasia epitelial severa resultaron los cambios hísticos más comunes. Los signos displásicos tisulares mayormente implicados fueron la alteración de los clavos interpapilares, pérdida de la polaridad de las células basales e hiperplasia de las células del estrato basal; mientras que los displásicos citológicos más relevantes resultaron la hipercromasia de núcleos y nucleolos, el pleomorfismo nuclear y el aumento de la relación núcleo-citoplasma, siendo el paladar blando el sitio más frecuente. Conclusiones todos los pacientes fumadores mostraron lesiones eritroplásicas al examen clínico bucal, lo cual fue confirmado por estudio histopatológico.

Foundation erythroplasia is the most aggressive precancerous lesion in the oral cavity, with great potential for malignant transformation. At the time of performing the biopsy and analyzing the sample, severe dysplasia or invasive carcinoma may appear. Objective to describe the clinical and histopathological manifestations of oral erythroplasia in patients who are active tobacco smokers. Methods a descriptive and cross-sectional study was carried out, with 12 smokers clinically and histopathologically diagnosed with oral erythroplasia, attended in the Specialties Polyclinic stomatological consultation of the Saturnino Lora Torres Hospital, in Santiago de Cuba. For the collection of the primary data, a survey was made with the variables: age, sex, clinical diagnosis, time in the smoking habit, different ways of consuming tobacco, anatomical location and histopathological study of the disease. Results the male sex, the age group of 60 years old and over, and conventional smokers of 21 and over prevailed. Intense chronic inflammatory infiltrate and severe epithelial dysplasia were the most common tissue changes. The tissue dysplastic signs most involved were alteration of the interpapillary nails, loss of polarity of the basal cells, and hyperplasia of the basal layer cells; while the most relevant cytological dysplastics were hyperchromasia of nuclei and nucleoli, nuclear pleomorphism and increased nucleus-cytoplasm ratio, with the soft palate being the most frequent site. Conclusions all the smoking patients showed erythroplastic lesions on oral clinical examination, which was confirmed by histopathological study.

Is colorectal mucosa a reasonable graft alternative to buccal grafts for urethroplasty?: A comparison of graft histology and stretch

ABSTRACT Objective: To compare the histological properties and stretch of colorectal mucosal grafts (CMG) and buccal mucosal grafts (BMG) and to evaluate the impact of age, medical comorbidity and tobacco use on these metrics. Materials and Methods: Samples of BMGs from patients undergoing augmentation urethroplasty were sent for pathologic review. CMGs were collected from patients undergoing elective colectomy. CMGs were harvested fresh, at full thickness from normal rectum/sigmoid. Patients with inflammatory bowel disease, prior radiation, or chemotherapy were excluded. Results: Seventy two BMGs and 53 CMGs were reviewed. While BMGs and CMGs were both histologically composed of mucosal (epithelium + lamina propria) and submucosal layers, the mucosal layer in CMG had crypts. The outer epithelial layers differed significantly in mean thickness (BMG 573μm vs. CMG 430μm, p=0.0001). Mean lamina propria thickness and submucosal layer thickness also differed significantly (BMG 135μm vs. CMG 400μm, p<0.0001; BMG 1090μm vs. CMG 808μm, p = 0.007, respectively). Mean delta stretch, as to length and width, was greater for CMG (118% x 72%) compared to BMGs (22% x 8%), both p<0.001. Conclusion: CMGs and BMGs significantly differ histologically in layer composition, width and architecture, as well as graft stretch. Given its elastic properties, CMG may be useful in covering large surface areas, but its thin epithelium, thick lamina propria and additional muscularis mucosal layer could impact graft take and contracture.

Cytogenetic changes in oral mucosal cells of human immunodeficiency virus-infected children and adolescents undergoing antiretroviral treatment

SUMMARY OBJECTIVE: The objective of this study was to evaluate possible cytogenetic changes in children and adolescents with human immunodeficiency virus on antiretroviral therapy, through the micronucleus test in oral mucosa. METHODS: This was a prospective study consisted of 40 individuals, of whom 21 comprised the human immunodeficiency virus group and 19 comprised the control group. Children and adolescents with human immunodeficiency virus were enrolled. The inclusion criteria were <18 years old and consent in participating in the study. The exclusion criteria were the presence of numerous systemic comorbidities, oral lesions, the habit of smoking, alcohol consumption, and X-rays or CT scans taken within 15 days prior to sample collection. A gentle scraping was performed on the inner portion of the jugal mucosa on both sides. A total of 2,000 cells per slide were analyzed for the determination of mutagenicity parameters as follows: micronuclei, binucleation, and nuclear buds. For measuring cytotoxicity, the following metanuclear changes were evaluated: pyknosis, karyolysis, and karyorrhexis, in a double-blind manner. The repair index was also evaluated in this setting. RESULTS: The human immunodeficiency virus group showed high frequencies of micronuclei (p=0.05), binucleated cells (p=0.001), and nuclear buds (p=0.03). In the cytotoxicity parameters, represented by the cell death phases, there was an increase with statistical difference (p≤0.05) in the karyorrhexis frequency (p=0.05). Additionally, repair index was decreased in the human immunodeficiency virus group. CONCLUSION: These results indicate that human immunodeficiency virus -infected individuals undergoing antiretroviral therapy have cytogenetic changes in oral mucosal cells.

The use of micronucleus assay in exfoliated oral cells in patients undergoing fixed orthodontic therapy: a systematic review with meta-analysis

Abstract The aim of this systematic review was to evaluate published papers regarding the micronucleus assay in oral mucosal cells of patients undergoing orthodontic therapy (OT). A search of the scientific literature was made in the PubMed, Scopus, and Web of Science databases for all data published until November, 2021 using the combination of the following keywords: "fixed orthodontic therapy," "genetic damage", "DNA damage," "genotoxicity", "mutagenicity", "buccal cells", "oral mucosa cells," and "micronucleus assay". The systematic review was designed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Nine studies were retrieved. Some authors demonstrated that OT induces cytogenetic damage in oral mucosal cells. Out of the nine studies included, two were classified as strong, five as moderate, and two as weak, according to the quality assessment components of the Effective Public Health Practice Project (EPHPP). Meta-analysis data revealed no relationship between mutagenicity in oral cells and OT in different months of treatment. At one month, the SMD = 0.65 and p = 0.08; after three months of OT, the SMD = 1.21 and p = 0.07; and after six months of OT, the SMD = 0.56 and p = 0.11. In the analyzed months of OT, I2 values were >75%, indicating high heterogeneity. In summary, this review was not able to demonstrate that OT induces genetic damage in oral cells. The study is important for the protection of patients undergoing fixed OT, given that mutagenesis participates in the multi-step process of carcinogenesis.

Cytogenetic changes in oral mucosa cells from individuals submitted to oral human immunodeficiency virus pre-exposure prophylaxis use

SUMMARY OBJECTIVE: The objective of this study was to evaluate cytogenetic changes in individuals submitted to oral human immunodeficiency virus pre-exposure prophylaxis use through the micronucleus test in oral mucosa. METHODS: This study consisted of 37 individuals, of whom 17 comprised the pre-exposure prophylaxis group and 20 comprised the control group. A total of 2,000 cells per slide were analyzed for the determination of micronuclei, binucleation, nuclear buds, and cytotoxicity parameters: pyknosis, karyolysis, and karyorrhexis (KR), in a double-blind manner. The repair index was also evaluated in this setting. RESULTS: In the mutagenicity parameters, the pre-exposure prophylaxis group showed increased frequencies of micronuclei (p=0.0001), binucleation (p=0.001), and nuclear buds (p=0.07). Regarding the cytotoxicity parameters, there was an increase with a statistical difference (p≤0.05) in the karyorrhexis frequency (p=0.001). Additionally, the repair system efficiency decreased in the pre-exposure prophylaxis group. CONCLUSION: These results indicate that individuals undergoing pre-exposure prophylaxis use have geno- and cytotoxicity in oral mucosal cells.

Evaluation of Wiping Edible Sesame Oils in the Oral Cavities of Hospitalised Older Patients Who Resist Oral Hygiene Management

Context: One of the causes of aspiration pneumonia is poor oral hygiene. We need care methods that caregivers can quickly, safely and inexpensively implement for convalescents with inadequate self?care. Edible sesame oil containing sesamin or sesaminol has already been shown to inhibit bacterial and fungal growth and have a vasodilating effect. Aims: The aim of this study is to evaluate the usefulness of using edible sesame oils for oral hygiene management. Settings and Design: This study evaluates an oral hygiene management method using two types of sesame oils in elderly hospitalised patients resistant to oral hygiene management. Methods and Material: The inpatients received oral care for 90 days. In the intervention groups, nurses brushed and wiped the oral cavity with roasted sesame oil (RSO) or sesame salad oil, while in the control group, care with tap water alone and brushing were done. Bacteria and Candida counts from tongue swabs, water content from the tongue’s surface and cheek mucosa, oral health assessment tool (OHAT) and cytology of the cheek mucosa were assessed every 30 days before and after the intervention. Results: RSO showed a tendency to reduce the number of bacteria and Candida. There was an improvement in the OHAT scores with both oils. The water content or cytology was not changing. Conclusions: Sesame oils may improve oral hygiene and maintain health in older patients.

Transmission electron microscopy in oral cytopathology: a pilot study / Microscopia eletrônica de transmissão em citopatologia bucal: um estudo piloto

Introduction: Cytopathology is a collection method that allows cell analysis through the different techniques. The oral mucosa exfoliated cells observation demonstrates morphological, biochemical and/or molecular aspects depending on the type of processing of the sample. Aim: This study tested the use of oral cytopathology associated with transmission electron microscopy (TEM) to observe the morphology of cells, mainly in relation to the cell nucleus, the cytoplasmic membrane, and cell junctions. Materials and Methods: Exfoliated epithelial cells from the oral mucosa were analyzed by TEM from individuals exposed to tobacco and alcohol, with leukoplakia or with a histopathological diagnosis of squamous cell carci-noma. Results: The cytoplasmic cell-cell junctions in the malignant samples lost the characteristic irregular pattern formed by the numerous interdigitations and the junctional process of normal cells and started to present a straight cytoplasmic surface. The nuclei of cells from leukoplakia and squamous cell carcinoma samples showed heterogeneous staining, while non-lesional cells were homogeneous. Discussion: The analysis of oral cytopathological smears by TEM contributes to the un-derstanding of the changes that occur during the process of malignancy of the oral mucosa, especially with regard to the cytoplasmic membrane and intercellular junctions. Conclusion: TEM may be a good analytical method to investigate morphological changes in exfoliated cells of the oral epithelium.

Introdução: A citopatologia é um método de coleta que permite a análise celular por meio de diferentes técnicas. A observação das células esfoliadas da mucosa bucal demonstra aspectos morfológicos, bioquímicos e/ou moleculares dependendo do tipo do processamento empregado. Objetivo: Este estudo testou o emprego da técnica de citopatologia bucal associada à microscopia eletrônica de transmissão (MET) para observar a morfologia das células, principalmente com relação à membrana citoplasmática, as junções celulares e ao núcleo da célula. Materiais eMétodos: Células epiteliais esfoliadas da mucosa bucal foram analisadas por MET de indivíduos expostos a tabaco e álcool, apresentando leucoplasia ou com diagnóstico de carcinoma espinocelular. Resultados:As junções citoplasmáticas célula-célula nas amostras malignas perderam o padrão irregular característico formado pelas inúmeras interdigitações e o processo juncional das células normais e passaram a apresentar uma superfície citoplasmática reta. O núcleo das células das amostras de leucoplasia e do carcinoma espinocelular apresentou coloração heterogênea, enquanto as células não lesionais foram homogêneas. Discussão: A análise de esfregaços citopatológicos bucais por MET contribui para o entendimento das alterações que ocorrem durante o processo de malignidade da mucosa bucal, principal-mente no que diz respeito à membrana citoplasmática e as junções intercelulares. Conclusão: A MET pode ser um bom método analítico para investigar alterações morfológicas em células esfoliadas do epitélio bucal.

The assessment of periimplant soft tissue condition with morse taper abutment connection: a rapid review

Aim: This study aims to evaluate the clinical assessment results of periimplant soft tissue with morse taper (internal abutment connection). Methods: The study was conducted using a rapid review by searching the articles from PubMed NCBI and Cochrane by using keywords. All articles were selected by the year, duplication, title, abstract, full-text, and finally, all selected articles were processed for final review. Following clinical parameters were included; Periimplant Probing Pocket Depth (PPD), Plaque Score (PS), modified Plaque Index (mPI), Mucosal Thickness (MTh), Gingival Height (GH), periimplant mucosal zenith, Pink Esthetic Score (PES), Bleeding On Probing (BOP), Sulcus Bleeding Index (SBI), and modified Gingival Index (mGI). Results: 9 selected articles were obtained from the initial literature searching count of 70 articles. The overall samples included 326 morse taper implants. Based on the evaluation, 3 out of 4 articles reported pocket depth < 4 mm, no bleeding was reported in 2 out of 4 articles. 4 out of 4 articles reported low plaque accumulation, low soft tissue recession was reported in 3 out of 3 articles, and 4 out of 4 articles reported acceptable PES values. Conclusion: The evaluations indicate that the morse taper (internal abutment connection) has favorable assessment results based on various clinical parameters

Does systemic anticancer gemcitabine compromise oral soft tissue wound healing? / ¿La gemcitabina anticancerígena sistémica compromete la cicatrización de heridas en tejidos blandos orales?

Background: Numerous types of cancer are of substantial medical and social concern, posing a major challenge to modern medicine. Chemotherapeutic drugs include the use of nucleosides, which are composed of nucleic acid and sugar. Objective: This study aims to assess the impact of systemic chemotherapeutic drugs at a therapeutic dose on the wound healing process of the oral mucosa. Material and Methods: 30 healthy rats were randomly divided into two main groups based on the study material, 15 rats in each group. Group A (control) was given a single dose of normal saline (1ml/kg, intraperitoneal), and Group B (study) a single injection of gemcitabine (50 mg /Kg, intraperitoneal). After anesthesia, a full-thickness soft tissue incision (0.5 cm length) on the right side of the buccal mucosa was made in the animals of both groups. Each group was subdivided according to the time of sacrifice into 3, 7, 14 days after surgery, at the end of the experimental periods, specimens were collected for histopathological study, and samples of blood were obtained from retro-orbital venous plexus and collected in microfuge tubes and levels of antioxidant enzymes were measured by ELISA. The data were analyzed statistically at a 0.05 level of significance. Results: Gemcitabine delayed the onset of wound cascade (inflammation and re-epithelization) which lead to worsening healing of the oral tissue; it also resulted in a decrease of the antioxidant activity of glutathione peroxidase and catalase, as well as activated caspase 3, which induces cell apoptosis. Conclusion: Gemcitabine showed negative feedback on oral tissue wound healing through delayed wound healing cascade and by inducing apoptosis.

Antecedentes: numerosos tipos de cáncer son motivo de gran preocupación médica y social, lo que representa un gran desafío para la medicina moderna. Los fármacos quimioterapéuticos incluyen el uso de nucleósidos, que están compuestos de ácido nucleico y azúcar. Objetivo: Este estudio tiene como objetivo evaluar el impacto de los fármacos quimioterapéuticos sistémicos a una dosis terapéutica en el proceso de cicatrización de heridas de la mucosa oral. Material y Métodos: 30 ratas sanas se dividieron aleatoriamente en dos grupos principales según el material de estudio, 15 ratas en cada grupo. Al grupo A (control) se le administró una dosis única de solución salina normal (1 ml/kg, intraperitoneal) y al grupo B (estudio) una inyección única de gemcitabina (50 mg/kg, intraperitoneal). Después de la anestesia, se realizó una incisión de tejido blando de espesor total (0,5 cm de longitud) en el lado derecho de la mucosa bucal en los animales de ambos grupos. Cada grupo se subdividió de acuerdo al tiempo de sacrificio en 3, 7, 14 días después de la cirugía, al final de los períodos experimentales se colectaron especímenes para estudio histopatológico, se obtuvieron muestras de sangre del plexo venoso retroorbitario y se recolectaron en tubos de microcentrífuga y los niveles de enzimas antioxidantes se midieron por ELISA. Los datos se analizaron estadísticamente a un nivel de significación de 0,05. Resultados: La gemcitabina retrasó el inicio de la cascada de heridas (inflamación y reepitelización) que condujo a un empeoramiento de la cicatrización del tejido oral; también resultó en una disminución de la actividad antioxidante de la glutatión peroxidasa y la catalasa, así como de la caspasa 3 activada, que induce la apoptosis celular. Conclusión: La gemcitabina mostró retroalimentación negativa sobre la cicatrización de heridas del tejido oral a través de una cascada de cicatrización retardada y mediante la inducción de apoptosis.

Lesiones de la mucosa asociadas al uso de prótesis estomatológica en pacientes adultos mayores / Mucosal lesions associated with the use of dental prostheses in elderly patients

RESUMEN Fundamento: La calidad de la prótesis dental y su papel en la aparición de las lesiones bucales, sobre todo en el adulto mayor, resulta de especial interés para la comprensión de la etiología de estas enfermedades y la recomendación de estrategias preventivas. Objetivo: caracterizar la población geriátrica con lesiones en la mucosa bucal asociadas al uso de prótesis estomatológicas. Métodos: estudio descriptivo, que incluyó a todos los pacientes (N=48) portadores de prótesis dental que presentaron lesión de la mucosa, los cuales acudieron a la consulta de prótesis estomatológica, en la Clínica Estomatológica de Especialidades, de Cienfuegos, en el periodo de enero a junio de 2020. Se analizaron las variables: edad, sexo, lesiones bucales, tiempo de uso de la prótesis, hábito de uso y estado técnico. Resultados: predominaron las lesiones en mujeres, con un 70,9 %. El grupo etario más afectado, el de 65-69 años, con 45,4 %. La estomatitis subprótesis representó el 90,2 %, de todas las lesiones, seguida por el épulis fisurado (7,8 %). La presencia de lesión se asoció en un 54,5 % de los casos con el tiempo de uso de 5-9 años. El uso continuo y presencia de prótesis desajustada se evidenciaron en mayor frecuencia, representados en un 76,4 % y 70,9 %, respectivamente. Conclusión: c uestiones como el tiempo de uso prolongado, prótesis desajustada y uso continuo de estas, son características en este grupo poblacional, las cuales guardan una lógica relación con la presencia de lesiones de la mucosa.

ABSTRACT Background The quality of the dental prosthesis and its role in the appearance of oral lesions, especially in the elderly, is of special interest for the etiology understanding of these diseases and the preventive strategies recommendation. Objective to characterize the geriatric population with lesions in the oral mucosa associated with the use of dental prostheses. Methods descriptive study, which included all patients (N=48) with dental prostheses who presented mucosal lesions, who attended the dental prosthesis consultation, at the Specialty Stomatology Clinic, in Cienfuegos, from January to June 2020. The analyzed variables were: age, sex, oral lesions, time of use of the prosthesis, habit of use and technical status. Results lesions in women predominated, with 70.9%. The most affected age group, 65-69 years, with 45.4%. Subprosthesis stomatitis represented 90.2% of all lesions, followed by fissured epulis (7.8%). The presence of injury was associated in 54.5% of cases with a time of use of 5-9 years. The continuous use and presence of maladjusted prostheses were evidenced more frequently, represented in 76.4% and 70.9%, respectively. Conclusion issues such as prolonged use time, maladjusted prosthesis and continuous use of these are characteristic in this population group, which are logically related to the presence of mucosal lesions.

Ventral onlay glanuloplasty for treatment of fossa navicularis strictures

ABSTRACT Purpose: Management of fossa navicularis (FN) strictures balances restoring urethral patency with adequate cosmesis. Historically, FN strictures are managed via glans cap or glans wings, and in severe cases, multi-stage procedures. Ventral onlay glanuloplasty (VOG) is an easily reproducible technique that involves a single-stage augmentation with buccal mucosal graft. We have been applying this technique for several years and present early promising outcomes of this novel approach. Materials and Methods: We retrospectively reviewed all patients with FN strictures who underwent VOG at our institution. Treatment success was designated by the absence of extravasation on voiding cystourethrogram and no need for further urethral instrumentation on follow up. Glans cosmesis was assessed by patients providing binary (yes/no) response to the satisfaction in their appearance. We also noted stricture length, stricture etiology, demographic characteristics and any post-operative complications and reported median, interquartile range (IQR) and count, frequency (%), accordingly. Results: Ten patients underwent VOG and fit our inclusion criteria. Median stricture length was 2.0 cm (IQR 1.6 -2). Success rate was 90% (9/10) with a median follow up of 30 months (IQR 24.3 - 36.8). The one recurrence was treated by dilation combined with triamcinolone injection at 419 days post-op. Stricture etiology included primarily iatrogenic causes such as transurethral prostate resection (4/10), greenlight laser vaporization (2/10), cystolitholapaxy (1/10), and traumatic catheterization (3/10). All patients were satisfied with penile cosmesis. Conclusion: VOG is a simple technique for treating FN strictures. Based on our preliminary series, VOG provides sustained distal urethral patency and patients are pleased with the appearance.

El hábito de fumar y su relación con afecciones bucales en adolescentes / Smoking and its relationship with oral conditions in adolescents

RESUMEN Introducción: El hábito de fumar está asociado a una gran variedad de cambios perjudiciales en la cavidad bucal, pues altera su microambiente y lo predispone para que se presenten diversas afecciones. Objetivo: Determinar la posible relación del hábito de fumar con las afecciones bucales en adolescentes. Método: Se realizó un estudio observacional en adolescentes del Centro Mixto «Pepito Tey» de San Diego del Valle, Cifuentes, en el período comprendido entre septiembre de 2016 y octubre de 2018. La población de estudio, conformada por 208 adolescentes, se organizó en dos estratos: grupo estudio y grupo control. Se seleccionaron dos muestras probabilísticas por muestreo aleatorio simple (60 adolescentes en cada grupo). Resultados: Predominaron adolescentes de 12 años, fumadores leves, del sexo masculino, con inicio del hábito entre 14-15 años y práctica de este hábito de menos de 6 meses. Se asociaron al hábito de fumar: la caries dental, la enfermedad periodontal, las manchas dentales, las lesiones de la mucosa bucal y la halitosis. Conclusiones: Predominaron adolescentes fumadores masculinos de 12 años. La gran mayoría de los fumadores fueron clasificados como leves, con inicio del hábito entre los 14-15 años de edad, y con práctica desde hace menos de seis meses. Existió asociación significativa entre el hábito de fumar y las afecciones bucales (enfermedad periodontal, caries dental, mancha dental, halitosis y lesión de la mucosa bucal).

ABSTRACT Introduction: smoking is associated with a wide variety of harmful changes in the oral cavity, since it alters its microenvironment and predisposes it to the occurrence of various conditions. Objective: to determine the possible relationship between smoking and oral conditions in adolescents. Method: an observational study was carried out in adolescents from "Pepito Tey" Mixed Center, in San Diego del Valle, Cifuentes between September 2016 and October 2018. The study population, made up of 208 adolescents, was organized into two strata: study group and control ones. Two probabilistic samples were selected by simple random sampling (60 adolescents in each group). Results: 12-year-old male light smokers, who started smoking between 14 and 15 years of age and practiced this habit for less than 6 months, predominated. Dental caries, periodontal disease, dental stains, oral mucosal lesions and halitosis were associated with smoking. Conclusions: 12-year-old male adolescent smokers predominated. Most smokers were classified as light, started smoking between 14 and 15 years of age and practiced this habit for less than 6 months. There was a significant association between smoking and oral conditions (periodontal disease, dental caries, dental stains, halitosis and oral mucosal lesions).

Verruciform xanthoma associated with lichen planus

Verruciform xanthoma (VX) is a rare benign lesion of unknown etiology, with a rough or papillary aspect, painless, sessile, well-defined, most lesions do not exceed 2 cm in their largest diameter, the degree of keratinization of the surface influences color, varying white to red, affecting mainly the gingiva and alveolar mucosa, and can also be seen in skin and genital. Herein, we present a report a clinical case of oral verruciform xanthoma in the buccal mucosa associated with the lichen planus lesion, as well as the morphological and immunohistochemical characteristics of the lesion. The clinical diagnostic hypothesis of oral lichen planus of the white reticular lesions on the buccal mucosa and on the tongue was confirmed by histopathology before a subepithelial connective tissue exhibiting intense inflammatory infiltrate in a predominantly lymphocytic band. In contrast, the hypothesis of the verrucous lesion in the left buccal mucosa was leukoplakia, with histopathological evidence showing exophytic and digitiform proliferations with parakeratin plugs between the papillary projections. Subepithelial connective tissue was characterized by macrophages with foamy cytoplasm (xanthoma cells). An immunohistochemical examination was performed, showing positivity for CD68, a macrophage marker, in addition to testing by Schiff's periodic acid (PAS) with diastasis, which was detected the presence of lipids inside these macrophages. The patient is free of recurrences of verruciform xanthoma and is being monitored due to the presence of lesions of oral lichen planus.

Alteration of mucosa cell maturation pattern after exposure to different radiographic imaging methods

Aim: Dental imaging has been widely used for diagnosis in dentistry. However, dental X-ray may induce cytotoxicity leading to apoptosis in oral mucosa cells. The present study aimed to observe the maturation pattern of buccal and gingival cells after exposure to X-ray radiation from analog/digital panoramic scanning and cone beam computed tomography (CBCT). Methods: The research samples were 40 subjects who fulfilled the inclusion and exclusion criteria. The subjects were divided into the exposed (patients who received analog/digital panoramic radiography or CBCT) and controlled (patients who had no radiography examinations) groups, with 10 subjects in each group. Exfoliative cytology smears were obtained from buccal mucosa and gingiva before exposure (or on day 0 for the control group) and 10 days later. The cells were stained with the Papanicolaou method. Then, the superficial, intermediate, and parabasal cells were counted in each glass slide. Results: No significant differences (p > 0.05) were observed among all cell types between day 0 and 10 in the control group. Meanwhile, after exposure to three kinds of radiography examinations, the frequency of intermediate cells in buccal mucosa and gingiva increased (p < 0.05), but that of superficial cells decreased (p < 0.05) significantly. No significant difference was found in the parabasal cells (p > 0.05). The frequency differences between intermediate and superficial cells showed no significant difference between the buccal mucosa and gingiva. Conclusion: Analog/digital panoramic radiography and CBCT exposure can induce cytotoxicity by altering the maturation pattern of buccal mucosa cells and gingiva, so it is strongly recommended to only perform these procedures if necessary and avoid repeated exposure to the same patient

A new double graft technique in urethroplasty for complex urethral stenosis: preliminary findings

ABSTRACT The management of complex urethral stenosis may involve different surgical techniques. As retraction of the graft may account for surgical failure, this risk increases in patients with more extensive stenosis requiring a graft of greater diameter. Although double grafts have already been used to maximize success in these cases, we propose a modified technique for urethroplasty with longitudinal urethral incision. The hypothesis was that this technique would increase the lumen by using only a urethral incision on the dorsal surface. Two patients presenting with recurrent urethral stenosis underwent urethroplasty using a double graft of oral mucosa that preserves the integrity of the spongy tissue and allows ventral inlay graft fixation using a midline relaxing incision in the portion of the urethra with stenosis. In both cases, the urethrocystoscopy and uroflowmetry performed after surgery showed a pervious and complacent urethra. After four and six months of follow-up, the postoperative outcomes were satisfactory for both patients. Further studies involving larger numbers of patients and long-term follow-up are required to evaluate the effectiveness of this method.

Efectividad de ozonoterapia en tratamiento de gingivitis en adolescentes, Pinar del Río 2019 / Effectiveness of ozone-therapy in the treatment of gingivitis in adolescents, Pinar del Rio 2019

RESUMEN Introducción: el ozono por su amplia gama de propiedades es útil para tratar afecciones bucales como la gingivitis crónica. Objetivo: demostrar efectividad de la ozonoterapia en el tratamiento de la gingivitis crónica en adolescentes en el Policlínico "Pedro Borrás Astorga", del municipio Pinar del Río, en el período comprendido entre enero y septiembre de 2019. Métodos: se realizó un estudio observacional, analítico, longitudinal, de casos y control. La muestra quedó conformada por 50 pacientes seleccionados por el método no probabilístico intencionado, teniendo en cuenta los criterios de inclusión y exclusión. Para un mejor estudio se formaron dos grupos, uno de estudio tratado con oleozón y otro de control tratado con propóleos al 5 %, con 25 pacientes cada uno. Se utilizaron métodos teóricos, empíricos, y se aplicó la prueba de Chi cuadrado con un nivel de significación de p=0.05. Resultados: se demostró la efectividad de la aplicación del oleozón en la muestra seleccionada al presentar una evaluación terapéutica de los pacientes más favorable con respecto a los tratados con propóleos al 5%, alcanzando la mayor cantidad de pacientes curados y con éxito en el tratamiento de la gingivitis crónica, la que fue más presentada por adolescentes masculinos de 13 años, prevaleció en su forma moderada, y la higiene bucal deficiente fue el factor de riesgo de mayor incidencia en su aparición. Conclusiones: la ozonoterapia resultó ser un tratamiento efectivo para la gingivitis crónica en los adolescentes estudiados.

ABSTRACT Introduction: the ozone due to its ample range of properties is useful to treat oral diseases as chronic gingivitis. Objective: to demonstrate the effectiveness of ozone-therapy in the treatment of chronic gingivitis in adolescents at Pedro Borras Astorga Polyclinic, Pinar del Rio municipality, during the period between January and September 2019. Methods: an observational, analytical, longitudinal study of case and control. The sample comprised 50 patients chosen by intentional non-probabilistic method, considering the criteria of inclusion and exclusion. To carry out a better study two groups were included, a study group treated with oil-ozone and a control one treated with propolis at 5 %, with 25 patients each of the group. Theoretical and empirical methods were applied, and the chi-squared test with a significance level of p=0.05. Results: the effectiveness of the application of oil-ozone was demonstrated in the sample chosen when presenting a more favorable therapeutic evaluation of the patients, respect to those treated with propolis at 5 %, reaching the greatest quantity of cured patients and with success in the treatment of chronic gingivitis, which was more frequent in male adolescents (13 years old), its moderate type prevailed, a deficient oral hygiene was the risk factor of highest incidence in its onset. Conclusions: the ozone-therapy resulted in an effective treatment for chronic gingivitis in the studied adolescents.