Metástase em cavidade oral: uma revisão para o dentista / Metastasis in the oral cavity: a review for the dentist

Metástase é o crescimento de células cancerígenas em sítios distantes do órgão de onde se originaram, e a sua ocorrência indica um prognóstico ruim. Em cavidade oral são raras. Podem ocorrer nos tecidos moles, nos maxilares ou em ambos, e são de expressiva importância clínica, pois indicam um estágio disseminado de um câncer, e podem ser o único sintoma de uma malignidade subjacente ainda não diagnosticada. Desse modo, é essencial que o cirurgião-dentista esteja familiarizado com o aspecto clínico e achados radiográficos mais associados a essa patologia. O objetivo desta revisão narrativa de literatura é compilar os principais aspectos sobre as metástases orais para a atuação do clínico. A patogenia das metástases para a cavidade oral é complexa e não totalmente compreendida. Os sítios primários mais frequentes são o câncer de mama, para as metástases nos ossos maxilares; e o câncer de pulmão, para os depósitos nos tecidos moles orais. As regiões orais mais acometidas são a área posterior de mandíbula e a gengiva. As metástases em osso são mais prevalentes do que em tecidos moles. De maneira geral, os homens são mais acometidos, especialmente na quinta a sétima década de vida, e o aspecto clínico das metástases é variável, lembrando lesões inflamatórias ou hiperplásicas, mas com crescimento rápido. Os achados radiográficos são inespecíficos, e podem apresentar características como osso "roído por traças" e aumento irregular dos espaços da membrana periodontal. Conclui-se com essa revisão que é fundamental que o cirurgião-dentista conheça e inclua lesões metastáticas no diagnóstico diferencial das patologias orais, tendo em vista o seu grau elevado de relevância clínica.

Metastasis is the growth of cancer cells in sites distant from the organ from which they originated, and its occurrence indicates a poor prognosis. In the oral cavity they are rare. They can occur in the soft tissues, jaws or both, and are of significant clinical importance, as they indicate a disseminated stage of cancer, and may be the only symptom of an underlying malignancy that has not yet been diagnosed. Therefore, it is essential that the dental surgeon is familiar with the clinical aspect and radiographic findings most associated with this pathology. The aim of this narrative literature review is to compile the main aspects about oral metastases for the clinician's work. The pathogenesis of metastases to the oral cavity is complex and not fully understood. The most frequent primary sites are breast cancer, for metastases in the jaw bones; and lung cancer, for deposits in oral soft tissues. The most affected oral regions are the posterior area of the jaw and the gingival tissue. Metastases in bone are more prevalent than in soft tissues. In general, men are more affected, especially in the fifth to seventh decade of life, and the clinical appearance of metastases is variable, resembling inflammatory or hyperplastic lesions, but with rapid growth. Radiographic findings are nonspecific and may present characteristics such as "moth-eaten" bone and irregular increase in periodontal membrane spaces. This review concludes that it is essential for the dentist to know and include metastatic lesions in the differential diagnosis of oral pathologies, given their high degree of clinical relevance.

Carcinoma oral de células escamosas y su posible asociación con la higiene bucal / Oral squamous cell carcinoma and possible association with oral hygiene

El cáncer se caracteriza por la falta de diferenciación citológica, autonomía de la homeostasis local y general; el cáncer bucal ocupa el sexto sitio de frecuencia de todas las áreas del cuerpo. Alrededor de 90% de los tipos histológicos de cáncer en cavidad bucal corresponden a carcinoma bucal de células escamosas (COCE) (AU)

Cancer is characterized by a lack of cytological differentiation, autonomy of local and general homeostasis, and oral cancer ranks sixth frequency site of all areas of the body. About 90% of histologic types of oral cavity cancer are OSCC (AU)

Nivel de información sobre cáncer bucal en estudiantes preuniversitarios. Morón, 2022-2023

Fundamento: El cáncer bucal constituye un problema de salud mundial; en este sentido, se hace necesaria la identificación de las necesidades de aprendizaje en la población desde edades tempranas. Objetivo: Caracterizar el nivel de información sobre cáncer bucal en estudiantes preuniversitarios. Métodos: Se realizó un estudio descriptivo, en estudiantes de la escuela preuniversitaria Roberto Rodríguez, del municipio de Morón, provincia de Ciego de Ávila, en el periodo comprendido entre enero de 2022 a enero de 2023. Se trabajó con la totalidad del universo (N= 183). Como medidas de resumen de la información se utilizaron las frecuencias absolutas y relativas, así como medidas de tendencia central y dispersión. Resultados: Existió ligero predominio del sexo femenino (51,9 %) y de los que cursaban el duodécimo grado (35,0 %). El hábito de fumar resultó el factor de riesgo más frecuente (30,6 %). En la calificación global 104 (56,8 %) estudiantes fueron evaluados de inadecuado. El 44,8 % de los jóvenes identificó a los medios de difusión masiva como vías de obtención de la información. Conclusiones: Se identificaron inadecuados niveles de información en la mayoría de las categorías de la encuesta, lo cual demuestra la necesidad de realizar estrategias educativas relacionadas con el cáncer bucal, con la finalidad de incrementar el nivel cognoscitivo sobre esta enfermedad.

Foundation: Oral cancer is a global health problem; in this sense, it is necessary to identify the population's learning needs from an early age. Objective: To characterize the information level about oral cancer in college prep students. Methods: A descriptive study was carried out on students from the Roberto Rodríguez college prep school, in the Morón municipality, Ciego de Ávila province, from January 2022 to January 2023. The entire universe was (N= 183). Absolute and relative frequencies, as well as measures of central tendency and dispersion, were used as measures to summarize the information. Results: There was a slight predominance of the female sex (51.9%) and those who were in twelfth grade (35.0%). Smoking was the most common risk factor (30.6%). In the overall rating, 104 (56.8%) students were evaluated as inadequate. 44.8% of young people identified the mass media as ways to obtain information. Conclusions: Inadequate levels of information were identified in most of the survey categories, which demonstrates the need to carry out educational strategies related to oral cancer, with the aim of increasing the cognitive level about this disease.

Perfil de morbimortalidade por câncer de boca e orofaringe em Montes Claros ­ MG no período de 2008 a 2018 / Morbidity and mortality profile due to mouth and oropharyngeal cancer in Montes Claros ­ MG in the period from 2008 to 2018

Introdução: Neoplasias malignas que afetam a cavidade oral e a orofaringe representam um problema de saúde pública. Sua incidência e prevalência é alta sendo consideradas de elevada mortalidade, podendo variar de região para região do Brasil. Objetivo: Caracterizar o índice de internações e óbitos por câncer de boca e orofaringe no município de Montes Claros (MG) entre 2008 e 2018. Material e Métodos: Estudo retrospectivo, transversal, de delineamento quantitativo. O universo da pesquisa foi a base de dados do Sistema de Informações Hospitalares do Sistema Único de Saúde referente à taxa de internações e óbitos por câncer de boca e orofaringe no município de Montes Claros, no período de 2008 a 2018. Resultados: Foram registrados 2.460 casos de internações e uma média de 224 por ano. Houve predomínio do sexo masculino (76,1%), entre a faixa etária de 50 a 69 anos (55,9%), pardos (76,9%), internados em caráter de urgência (65,1%), em regime privado (68,7%), com média de permanência maior no regime público (11,4 dias). O setor privado é responsável por maior parte dos gastos: 5,54 milhões de reais (55,5%). A taxa média de mortalidade por câncer de boca e orofaringe foi de 7,85%, sendo que foi maior no sexo masculino, mais expressiva em pacientes com idade 0 a 9 anos (16,67%) e acima dos 80 anos (13,48%). Conclusão: Ao avaliar, as taxas de internações e óbitos por câncer de boca e orofaringe no município de Montes Claros (MG) no período analisado, verificou-se que o público masculino é o mais atingido, tanto em termos de diagnóstico deste tipo de condição clínica quanto em taxas de internação e mortalidade.

Introduction: Malignant neoplasms affecting the oral cavity and oropharynx represent a public health problem. Its incidence and prevalence is high and is considered to have a high mortality rate, which may vary from region to region of Brazil. Objective: To characterize the rate of hospitalizations and deaths due to mouth and oropharyngeal cancer in the city of Montes Claros ­ (MG) between 2008 and 2018. Material and Methods: Retrospective, cross-sectional, quantitative study. The research universe was the database of the Hospital Information System of the Unified Health System regarding the rate of hospitalizations and deaths due to mouth and oropharyngeal cancer in the municipality of Montes Claros, from 2008 to 2018. Results: A total of 2460 hospitalizations were recorded, with an average of 224 per year. There was a predominance of males (76.1%), aged 50-69 years (55.9%), brown (76.9%), hospitalized as an emergency (65.1%), in the private sector (68.7%), with a longer average stay in the public sector (11.4 days). The private sector is responsible for most of the expenditure 5.54 million reais (55.5 The average mortality rate for mouth and oropharyngeal cancer was 7.85%, which was higher in males, more significant in patients aged 0 to 9 years (16.67%), over 80 years of age (13.48%). Conclusion: When evaluating the rates of hospitalizations and deaths due to mouth and oropharyngeal cancer in the municipality of Montes Claros (MG) in the specific period, it was transferred that the male public is the most affected, both in terms of diagnosis of this type of clinical condition as well as internationality and mortality rates.

Congruencia Diagnóstica Clínica-Histopatológica de Lesiones en Cavidad Oral, en la Faculta de Odontología, Universidad de Costa Rica, en el Período 2016-2019 / Clinical-Histopathological Diagnostic Consistency of Lesions in the Oral Cavity, at the Faculty of Dentistry, Universidad de Costa Rica, in the 2016-2019 Period

El conocimiento de la patología oral, y su correcto diagnóstico es fundamental en Odontología, puesto que un diagnóstico tardío, particularmente en casos de lesiones premalignas o malignas, pueden conducir a serias consecuencias para el paciente. El objetivo de este trabajo fue establecer la congruencia diagnóstica clínica - histopatológica de lesiones en cavidad oral en pacientes que asistieron a la Facultad de Odontología, Universidad de Costa Rica, y a quienes se les realizó biopsia de la lesión, durante el período 2016-2019. El estudio fue descriptivo y retrospectivo, basado en datos de reportes histopatológicos en la población mencionada, por presentar alguna lesión, de tejidos blandos o duros, en cavidad oral. La muestra estadística fue por conveniencia, no probabilística y no aleatoria. Las técnicas estadísticas utilizadas fueron descriptivas para el análisis de la información, el cual se basó en la distribución de frecuencias y cruce de variables. El procesamiento estadístico de los datos se diseñó en una base de datos creada en Excel. La muestra comprendió 160 reportes histopatológicos de los cuales se excluyeron 14. La edad promedio de los pacientes fue 42 años (rango 2 - 78 años). La proporción hombre: mujer correspondió 1:1.4, predominado el sexo femenino en 58,9 %. La congruencia del diagnóstico histopatológico con el diagnóstico clínico correspondió a 55,8 %. La congruencia de los diagnósticos demuestra el conocimiento del profesional en identificar la lesión clínicamente de forma correcta, lo que permite actuar en el momento preciso y confirmar la impresión clínica diagnóstica de una patología mediante el estudio histopatológico, el cual es el estándar oro. El problema radica en aquellos casos en que hay discrepancia diagnóstica, pues exige conocer los factores responsables de esta discrepancia, exige la búsqueda de soluciones y exige reforzar y redireccionar la formación académica del profesional y de los estudiantes para reconocer y describir estas lesiones.

Knowledge of oral pathology and its correct diagnosis is fundamental in Dentistry, since a late diagnosis, particularly in cases of premalignant or malignant lesions, can lead to serious consequences for the patient. The objective of this study was to establish the clinical- histopathological diagnostic consistency of lesions in the oral cavity in patients who attended the Faculty of Dentistry, Universidad de Costa Rica, and who underwent a biopsy of the lesion, during the period 2016-2019. The study was descriptive and retrospective, based on data from histopathological reports in the mentioned population, due to presenting some lesion, soft or hard tissue, in the oral cavity. The statistical sample was for convenience, non- probabilistic nor random. The statistical techniques used were descriptive for the analysis of the information, which was based on frequency distribution and crossing of variables. The statistical processing of the data was designed in a database created in Excel. The sample collects 160 histopathological reports, of which 14 were excluded. The average age of the patients was 42 years (range between 2 - 78 years old).The male:female ratio corresponded to 1:1.4, with a predominance of the female sex at 58.9 %.The congruence of the histopathological diagnosis with the clinical diagnosis corresponded to 55.8 %. Diagnostic consistency demonstrates knowledge of the professional in correctly identifying the lesion clinically, which allows acting at the precise moment and confirming the diagnostic clinical impression of the pathology via histopathological study which is the gold standard. The problem lies in those cases in which there is a diagnostic discrepancy, since it requires having knowledge of the underlying factors and therefore, requires searching for solutions, reinforcing and redirecting the academic training of professionals and students to recognize and describe these lesions.

Intervención educativa sobre cáncer bucal y su prevención en estudiantes preuniversitarios

Fundamento el aumento de la incidencia del cáncer bucal constituye un problema de salud mundial, por ello surge la necesidad de realizar acciones educativas que tributen a la prevención de la enfermedad desde edades tempranas. Objetivo evaluar la efectividad de una intervención educativa sobre cáncer bucal y su prevención en estudiantes de un centro preuniversitario. Métodos se realizó un estudio preexperimental, de intervención educativa, con diseño preprueba/posprueba, en el periodo comprendido entre noviembre de 2021 a mayo de 2022. Se trabajó con la totalidad del universo, el cual estuvo constituido por 125 estudiantes de la escuela Roberto Rodríguez, del municipio Morón, Ciego de Ávila. Se utilizó estadística descriptiva e inferencial. Resultados el 52,0 % de los participantes perteneció al sexo femenino. La media de edad para ambos sexos fue de 15,86 ± 1,053 años. El 36,8 % cursaba el onceno grado. Se determinaron inadecuados niveles de información en la etapa diagnóstica en cuanto a: generalidades (96,0 %), factores de riesgo (91,2 %), autoexamen bucal (96,0 %) y medidas de promoción y prevención (95,2 %). Después de aplicada la intervención se logró elevar el nivel cognoscitivo hasta un 97,6 %, 99,2 %, 96,8 % y 99,2 % respectivamente. El test de McNemar arrojó resultados significativos (p = 0,000; p < 0,05). Conclusiones se logró una modificación estadísticamente significativa de la información en cada uno de los encuestados, por lo que se pudo inferir que la intervención educativa resultó efectiva.

Foundation the increase in the incidence of oral cancer constitutes a global health problem, there is a need to carry out educational actions that contribute to the prevention of the disease from an early age. Objective to evaluate the effectiveness of an educational intervention on oral cancer and its prevention in students from a pre-university center. Methods a pre-experimental educational intervention study was carried out, with a pre-test/post-test design, from November 2021 to May 2022. The entire universe was studied, 125 students from the Roberto Rodríguez School in Morón municipality, Ciego de Ávila. Descriptive and inferential statistics were used. Results 52.0% of the participants were female. The mean age for both sexes was 15.86 ± 1.053 years. 36.8% were in eleventh grade. Inadequate levels of information were determined in the diagnostic stage in terms of: generalities (96.0%), risk factors (91.2%), oral self-examination (96.0%) and promotion and prevention measures (95.2%). %). After applying the intervention, the cognitive level was raised to 97.6%, 99.2%, 96.8% and 99.2% respectively. The McNemar test showed significant results (p = 0.000; p < 0.05). Conclusions a statistically significant modification of the information was achieved in each of the respondents, so it could be inferred that the educational intervention was effective.

Caracterización de lesiones orales premalignas diagnosticadas en un servicio de Estomatología en Pinar del Río

Fundamento: las lesiones premalignas son aquellas que presentan alteraciones celulares, generan células sanguíneas anormales y pueden afectar los tejidos bucales del paciente. Suelen manifestarse inicialmente en la cavidad bucal, o luego de la diseminación desde otras partes del cuerpo por medio de sistemas linfáticos y sanguíneos. Objetivo: caracterizar las lesiones orales premalignas presentes en pacientes adultos. Métodos estudio descriptivo, de corte transversal, en pacientes pertenecientes al Policlínico Docente Universitario Luis Augusto Turcios Lima, del municipio de Pinar del Río, en el período enero-diciembre de 2022. Del universo integrado por 5259 pacientes atendidos en consulta de Servicios Básicos Estomatológicos, se tomó una muestra de 53, seleccionada mediante un muestreo simple aleatorio. Los resultados fueron representados en tablas de frecuencias absolutas y porcentajes, como medidas de resumen. Resultados la mayoría de los pacientes con lesiones orales premalignas pertenecieron al sexo masculino (78,5 %) y al grupo de 60 y más años (58,5 %). El factor de riesgo más frecuente fue el hábito de fumar (86,8 %). Prevaleció la leucoplasia (69,8 %), con mayor frecuencia de localización en los labios (43,4 %). El tratamiento más empleado fue el medicamentoso-quirúrgico (58,5 %). Conclusiones las lesiones premalignas de la cavidad bucal en la serie de pacientes en estudio, se caracterizaron por su predominio en el sexo masculino, mayores de 60 años, y fumadores. La leucoplasia resultó la lesión más frecuente, y los labios el sitio más afectado. El tratamiento medicamentoso-quirúrgico fue el más empleado.

Foundation premalignant lesions are those that present cellular alterations, generate abnormal blood cells and can affect the patient's oral tissues. They usually manifest initially in the oral cavity, or after spreading from other parts of the body through lymphatic and blood systems. Objective to characterize premalignant oral lesions present in adult patients. Methods descriptive, cross-sectional study, in patients belonging to the Luis Augusto Turcios Lima University Teaching Polyclinic, in the Pinar del Río municipality, from January to December 2022. From the universe made up of 5,259 patients treated in the Basic Stomatological Services consultation, a sample of 53 was taken, selected through simple random sampling. The results were represented in absolute frequencies and percentages charts, as summary measures. Results the majority of patients with premalignant oral lesions belonged to the male sex (78.5%) and to the group aged 60 and over (58.5%). The most frequent risk factor was smoking (86.8%). Leukoplakia prevailed (69.8%), with a greater frequency of location on the lips (43.4%). The most used treatment was medication-surgical (58.5%). Conclusions premalignant lesions of the oral cavity in the series of patients under study were characterized by their predominance in males, over 60 years of age, and smokers. Leukoplakia was the most common lesion, and the lips were the most affected site. Medication-surgical treatment was the most used.

The protective effect and mechanism of tea polyphenols on oral cancer in mice / 中国医师杂志

Objective:To explore the protective mechanism of tea polyphenols (TP) on mouse oral cancer.Methods:A total of 50 mice were divided into control group, model group, TP group, Selisistat group, TP+ Selisistat group, with 10 mice in each group. The control group was gavaged with physiological saline, while the model group, TP group, Selisistat group, and TP+ Selisistat group were gavaged with 300 mg/L 4-NQO to establish a mouse oral cancer model. Physiological saline, 200 mg/kg TP, 0.01 mg/kg Selisistat, and 200 mg/kg TP+ 0.01 mg/kg Selisistat were gavaged respectively. The weight changes of each group of mice were compared; HE staining was used to observe the morphology of mouse oral tumor tissue; Enzyme linked immunosorbent assay was used to detect the levels of malondialdehyde (MDA) and superoxide dismutase (SOD) in serum; Immunoblotting and immunohistochemistry were used to detect the expression of silencing information regulatory factor (Sirt1) and nuclear factor E2 related factor 2 (Nrf2) proteins in mouse oral tissues.Results:Compared with the control group, the model group mice had a decrease in body weight [(23.19±1.36)g], a decrease in serum SOD level [(91.64±8.75)U/ml], an increase in MDA level [(5.18±0.46)nmol/ml], a decrease in Sirt1 (0.38±0.05) and Nrf2 (0.36±0.05) protein expression in oral tissue, and an increase in Nrf2 acetylation level (0.84±0.11) (all P<0.05). Compared with the model group, the TP group mice had an increase in body weight [(25.28±1.25)g], elevated serum SOD levels [(121.24±10.68)U/ml], decreased MDA levels [(3.89±0.42)nmol/ml], increased expression of Sirt1 (0.61±0.09) and Nrf2 (0.58±0.06) proteins in oral tissue, and decreased Nrf2 protein acetylation levels (0.39±0.05); The Selisistat group mice showed a decrease in body weight [(21.41±1.07)g], a decrease in serum SOD levels [(72.16±7.43)U/ml], an increase in MDA levels [(5.87±0.41)nmol/ml], a decrease in Sirt1 (0.23±0.04) and Nrf2 protein (0.24±0.03) expression in oral tissue, and an increase in Nrf2 acetylation levels (1.12±0.14) ( P<0.05). The body weight [(23.32±1.27)g], serum SOD levels [(92.58±8.13)U/ml], and oral Sirt1 (0.41±0.06) and Nrf2 (0.38±0.05) protein expression in the TP+ Selisistat group mice were higher than those in the Selisistat group, while MDA [(5.11±0.38)nmol/ml] and Nrf2 acetylation levels (0.82±0.09) were lower than those in the Selisistat group (all P<0.05). Conclusions:Tea polyphenols can alleviate oral tissue damage and alleviate oxidative stress in mice with oral cancer, and their mechanism may be related to the upregulation of the Sirt1/Nrf2 pathway.

Progress in clinical application of 125I seeds brachytherapy in the treatment of oral and maxillofacial malignant tumors / 中华核医学与分子影像杂志

Oral and maxillofacial malignant tumors threaten the life and health of patients, and seriously affect their swallowing, language function and face. 125I seeds brachytherapy for oral and maxillofacial malignant tumors has been widely concerned and studied because of its advantages such as less surgical trauma, large and uniform dose distribution in the target tissue, little damage to the surrounding normal tissue, and reducing radiation exposure of medical staff. Low-dose brachytherapy with 125I seeds can effectively reduce the tumor volume and prolong the survival time of patients. This article reviews the clinical application of 125I seeds brachytherapy in oral and maxillofacial malignant tumors.

Polypoid non-neural granular cell tumor of the oral cavity: case report and literature review

To report a case of non-neural granular cell tumor (NN-GCT), an uncommon neoplasm, with only six studies worldwide describing cases involving the oral cavity. Methods: A 26-year-old male patient with an erythematous, firm, polypoid nodule in the floor of the mouth that exhibited areas of ulceration and mild bleeding to the touch. A biopsy was performed to aid in the diagnosis. Results: Based on the histopathological and immunohistochemical results (vimentin +, CD68 +, S100 -), the diagnosis was compatible with S100-negative (primitive polypoid non-neural) granular cell tumor. No recurrence was observed over two years of follow-up. Conclusion: The diagnosis of NN-GCT is extremely challenging because this tumor shares histological and immunophenotypic features with many benign and malignant tumors. Although oral NN-GCT may exhibit unusual and atypical histological features, it has an indolent behavior. Thus, until more cases of oral involvement are reported, complete resection and close follow-up are recommended

Creation of a self-guided course about oral cancer for Community Health Workers: A Teleeducation experience / Criação de um curso autoinstrucional sobre câncer de boca para Agentes Comunitários de Saúde: uma experiência de telemedicina

Abstract Objective: To report the experience of creating and providing a self-instructional course about oral cancer, in a Telehealth platform, to Community Health Workers, and to analyze the participants' clinic and demographic profile. Methods: Descriptive cross-sectional study of development and implementing experience of a course carried on a virtual learning environment, based on ADDIE, an Instructional Design model. The Kolmogorov-Smirnov test was applied, with 95% confidence level for quantitative variables. Results: The initial stage consisted of constructing the online course. In the second stage, the course was provided in a virtual learning environment. The course "Abre a boca, meu povo! - O que você precisa saber sobre o câncer de boca" was provided to the target audience with a student's guide, initial survey, four modules with video lessons, initial and final knowledge test, satisfaction evaluation and certificate. Simplicity, clarity and objectivity have been prioritised in the transmission of knowledge. The final sample comprised 205 Community Health Workers. The predominant profile consisted of professionals aged between 40 and 49 years, female, with more than 10 years of career. Conclusions: The course achieved its objectives, revealing a satisfactory number of professionals in its first edition.

Resumo Objetivo: Relatar a experiência da criação e disponibilização de curso autoinstrucional sobre câncer de boca, em plataforma de Telessaúde, para Agentes Comunitários de Saúde, e analisar o perfil clínico-demográfico dos participantes. Metodologia: Estudo transversal descritivo da experiência de implantação e desenvolvimento de curso realizado em ambiente virtual de aprendizagem, baseado em ADDIE, um modelo de Design Instrucional. Foi aplicado teste de normalidade de Kolmogorov-Smirnov, com 95% de confiança para variáveis quantitativas. Resultados: A primeira fase consistiu na construção do curso on-line. Na segunda fase, o curso foi disponibilizado em ambiente virtual de aprendizagem. O curso "Abre a boca, meu povo! - O que você precisa saber sobre o câncer de boca" foi disponibilizado ao público-alvo com um manual do aluno, enquete inicial, quatro módulos com videoaulas, testes de conhecimentos inicial e final, avaliação de satisfação e certificado. Simplicidade, clareza e objetividade foram priorizadas na transmissão dos conhecimentos. A amostra final foi composta por 205 Agentes Comunitários de Saúde. O perfil predominante foi de profissionais com idade entre 40 e 49 anos, do sexo feminino, com mais de 10 anos de carreira. Conclusões: O curso atingiu os objetivos propostos, revelando um quantitativo satisfatório de profissionais, em sua primeira edição.

Effect of low-level laser therapy in the treatment of oral mucositis in patients with head and neck cancer: a scoping review

Aim: This article aims to evaluate, using the best sources of evidence, the contribution of low-level lasers in treating oral mucositis in patients with oral cancer. Methods: This review, including the entire process of the selection of studies and preparation of results, complied with the PRISMA-ScR protocol guidelines. At the end of the predefined analyses (title, abstract, and full text), 02 studies were included that correctly fit the eligibility criteria. These were published in 2015 and 2019 and were classified according to level II of the Agency for Healthcare of Research and Quality (AHRG). After critically reading the study, the common topics addressed in this scoping review were defined. Results: Two works brought considerations about the laser therapy protocol, the use of the visible red wavelength, and energy densities between 3 and 4 J/cm². In addition, positive correlations were identified between painful symptoms and nutritional status with oral mucositis, as low-level laser therapy reduced pain and weight loss and improved the nutritional quality of cancer patients. Conclusion: Photobiomodulation proved effective in treating mucositis at higher degrees. Scientific evidence on this topic is still being developed, but it will be promising and valid if more research is conducted.

Oral cancer over six decades: a multivariable analysis of a clinicopathologic retrospective study

Abstract Studies have reported changes in the epidemiological profile of patients with oral cancer in recent decades, especially regarding gender and age. This study aimed to evaluate a historical series of oral malignant lesions prevalence over six decades and define characteristics associated with the occurrence, mainly, of oral squamous cell carcinoma (OSCC). A retrospective review of histopathological records from 1953 to 2019 was conducted in three oral pathology laboratories in South Brazil about age, sex, anatomical site, clinical aspect, and histopathological diagnosis. Descriptive and analytical analyses were performed comparing the histopathological diagnoses with other variables. Multivariable logistic regression was applied to determine the associated predictors of OSCC. Of the 53,065 records available in the institutions, 986 were oral malignant tumors (including all malignant neoplasms), representing 1.86% of all diagnoses. The occurrence of OSCC in the 1960's was 80.0%, decreasing over time reaching the lowest percentage of cases in the 1990's (75.8%) and significantly increasing to 88.7% in the 2010s. Females had a lower chance than males of having OSCC independently of the decade (odds ratio=0.30, p<0.001). This was the same for older individuals compared to those younger than 40 years. No interactions between sex, age, and decade were observed. The number of diagnoses of oral malignant lesions increased over time, and the occurrence of OSCC varied. Older individuals and males had higher chances of having OSCC independently of the decade. Therefore, in this study sample, no changes were observed in the epidemiological profile over the years concerning these predictors.

Resumo Alguns estudos relataram mudanças no perfil epidemiológico dos pacientes com câncer bucal nas últimas décadas, principalmente quanto ao gênero e a idade. Este estudo teve como objetivo avaliar, em uma série histórica, a prevalência de todas as lesões malignas bucais ao longo de seis décadas e definir características associadas na ocorrência, principalmente, de carcinoma espinocelular (CEC). Um levantamento retrospectivo dos registros histopatológicos de 1953 a 2019 foi realizado em três laboratórios de Patologia Bucal no Sul do Brasil em relação à idade, gênero, sítio anatômico, aspecto clínico e diagnóstico histopatológico. Análises descritivas e analíticas foram realizadas comparando-se os diagnósticos histopatológicos com as outras variáveis. A regressão logística multivariada foi aplicada para determinar os possíveis preditores associados ao CEC. Dos 53.065 prontuários disponíveis nas instituições, 986 eram tumores malignos bucais (incluindo todas as neoplasias malignas), representando 1,86% de todos os diagnósticos. A ocorrência de CEC na década de 1960 foi de 80,0%, diminuindo ao longo do tempo, atingindo o menor percentual de casos na década de 1990 (75,8%) e aumentando significativamente para 88,7% na década de 2010. As mulheres tiveram menor risco de desenvolver CEC do que os homens, independentemente da década (OR=0,30, p<0,001). Este foi o mesmo para indivíduos com idade mais avançada em comparação com aqueles com menos de 40 anos de idade. Não foram observadas interações entre gênero, idade e década. O número de diagnósticos de lesões malignas bucais aumentou ao longo das décadas e a ocorrência de CEC variou. Indivíduos com mais de 40 anos e do sexo masculino tiveram maiores chances de ter CEC, independentemente da década analisada. Portanto, nessa amostra estudada, não foram observadas mudanças no perfil epidemiológico ao longo dos anos com relação a esses preditores.

Differential Diagnosis of Oral Metastases / Diagnóstico Diferencial de las Metástasis Orales

Metastatic lesions in the mouth can resemble common inflammatory lesions. Therefore, we set out to investigate oral metastases whose clinical and imaging characteristics mimicked those of harmless lesions, confusing and delaying the diagnosis. For this, a systematic review was carried out from case reports, case series, and cross-sectional studies in the PubMed/Medline, Scopus, Embase-via Elsevier, Virtual Health Library, Web of Science, and gray literature, using PICO strategy without period restriction. We assessed the quality of studies using the Joanna Briggs Institute assessment tool. A narrative synthesis of the data was carried out. Association analyses using chi-square and Fisher's exact tests were performed, with statistical significance at p<0.05. Most of the lesions came from the lung, breast, kidneys, liver, and thyroid. They affected mainly the mandibles of men, between the fifth and seventh decades of life, causing osteolysis. In soft tissue, there were firm swellings, associated with bleeding. Limitations regarding the heterogeneity of the included studies and the absence of clinic pathological descriptions of the tumors substantially reduced the chance of statistical analysis of the data. Knowing the different possibilities of clinical presentation of oral and maxillofacial metastases is important for the diagnost ic suspicion to occur and diagnostic errors to be avoided. Thus, treatment is instituted and survival can be extended. Protocol registration: PROSPERO CRD42020200696.

Las lesiones metastásicas en la cavidad oral pueden parecer similares a lesiones inflamatorias comunes. Por ello, nos propusimos investigar metástasis orales cuyas características clínicas e imagenológicas simularan las de lesiones inofensivas, confundiendo y retrasando el diagnóstico. Para ello, se realizó una revisión sistemática a partir de reportes de casos, series de casos y estudios transversales en PubMed/Medline, Scopus, Embase-vía Elsevier, Virtual Health Library, Web of Science y literatura gris, utilizando la estrategia PICO sin restricción de periodo. La calidad de los estudios se evaluó mediante la herramienta de evaluación del Instituto Joanna Briggs. Se realizó una síntesis narrativa de los datos. Se realizaron análisis de asociación mediante chi-cuadrado y prueba exacta de Fisher, con significancia estadística en p<0,05. La mayoría de las lesiones procedían de pulmón, mama, riñones, hígado y tiroides. Afectan principalmente a las mandíbulas de los hombres, entre la quinta y la séptima década de la vida, provocando osteólisis. En los tejidos blandos, había hinchazones firmes, asociadas con sangrado. Las limitaciones con respecto a la heterogeneidad de los estudios incluidos y la ausencia de descripciones clinicopatológicas de los tumores redujeron sustancialmente la posibilidad de realizar un análisis estadístico de los datos. Conocer las diferentes posibilidades de presentación clínica de las metástasis orales y maxilofaciales es importante para que se produzca la sospecha diagnóstica y se eviten errores diagnósticos. Por lo tanto, se instituye el tratamiento y se puede prolongar la supervivencia. Registro de protocolo: PROSPERO CRD42020200696.

Desarrollo de la habilidad en el diagnóstico precoz del cáncer bucal durante las prácticas preprofesionales de Estomatología / Development of the competence in oral cancer early diagnosis during pre-professional training in Dentistry i: en

Introducción: La creciente aparición del cáncer bucal en etapas avanzadas revela la necesidad de egresar profesionales preparados que contribuyan a su prevención y diagnóstico precoz. Objetivo: Evaluar un sistema de tareas docentes para el desarrollo de la habilidad en el diagnóstico precoz del cáncer bucal. Métodos: Se realizó un preexperimento en 32 estudiantes y 10 profesores vinculados al proceso de enseñanza-aprendizaje de la asignatura Atención Integral a la Población de la carrera de Estomatología en la Universidad de Ciencias Médicas de Guantánamo, en el curso escolar 2022-2023. A tal efecto, se determinó la variable el desarrollo de la habilidad para el diagnóstico precoz del cáncer bucal, con sus dimensiones e indicadores, y se comprobó la significación de un sistema de tareas docentes para este fin a través de la prueba de Wilcoxon. Resultados: De acuerdo con los rangos de Wilcoxon, el sistema de tareas docentes resultó confiable para contribuir al desarrollo de la habilidad objeto de estudio (p<0,05). Los estudiantes consideraron que dicho sistema constituye la vía idónea para su preparación en el tema; de igual forma, todos los profesores coincidieron en cuanto a su pertinencia, factibilidad, efectividad, utilidad práctica y relevancia. Conclusiones: El sistema de tareas docentes aplicado durante la práctica preprofesional de los estudiantes de estomatología demostró ser factible para el desarrollo de la habilidad en el diagnóstico precoz del cáncer bucal.

Introduction: The increasing appearance of advanced oral cancer reveals the need of graduating professionals, prepared to contribute to its prevention and early diagnosis. Objective: To evaluate a system of teaching tasks for the development of competence in oral cancer early diagnosis. Methods: A pre-experiment was carried out with 32 students and 10 professors, who were involved in the teaching-learning process of the subject Comprehensive Dental Care for the Population of Dentistry degree in the University of Medical Sciences from Guantánamo, in the 2022-2023 academic year. For this purpose, the development of competence in oral cancer early diagnosis was determined as the variable, with its dimensions and indicators, and the significance of a system of teaching tasks for this objective was verified through the Wilcoxon test. Results: According to the Wilcoxon ranks, the teaching task system was reliable in contributing to the development of the competence under study (p<0.05). The students considered that this system is the ideal way for their training on the subject; in the same way, all teachers agreed regarding the relevance, feasibility, effectiveness, and practical utility of the teaching task system. Conclusions: The teaching task system applied during pre-professional practice of dentistry students proved to be feasible for the development of competence in oral cancer early diagnosis.

Tumor volume as a prognostic factor on the median survival in locally advanced oral cancer treated with definitive chemoradiotherapy

Background: Surgery has been the mainstay treatment for oral cancer. Patients who do not receive surgery are generally treated with concurrent chemoradiotherapy (CCRT). Many factors play a role in patients� survival; tumor volume might be one of those factors. This study aims to determine the effect of the pre-treatment tumor volume on the survival of oral cancer. Methods: Retrospective study of patients with histological confirmed squamous cell carcinoma, stage III朓V oral cancer, who received definitive CCRT. Tumor volume from pre-treatment computed tomography (CT) scans were reviewed and analyzed. The optimal cut-off tumor volume was evaluated by receiver operating characteristic (ROC) curve analysis. Results: Among 67 patients, half of the primary tumor sites were oral tongue. The median total tumor volume (TTV) was 73.25 cm3, while the median survival was 12.5 months (95% confidence interval: 10.9-20.3). The optimal cut-off TTV ?52.9 cm3 (P < 0.0001). The median survival of the patients, who had tumor volume <52.9 cm3 were 34.4 months, and for tumor volume ?52.9 cm3 were 8.6 months (P < 0.0001). Multivariate analysis showed that TTV ?52.9 cm3, and intensity-modulated radiotherapy (IMRT) or volumetric-modulated arc therapy (VMAT) technique had significantly influenced the overall survival. Conclusion: TTV had an influence on the overall survival of locally advanced oral cancer. In addition, TTV may be considered as a factor in selecting the appropriate treatment option for these patients.

Avaliação do conhecimento e da percepção de cirurgiões-dentistas e estudantes de odontologia acerca de desordens potencialmente malignas / Knowledge assessment and perception among dentists and dental students about potentially malignant disorders

Introdução: As desordens potencialmente malignas (DPM) são condições da cavidade oral que apresentam risco significativo para o desenvolvimento do câncer. Desse modo, o diagnóstico precoce torna-se essencial no prognóstico de lesões orais. Para isso, analisar o perfil de conhecimento acerca dessas desordens é fundamental ao identificar lacunas na educação e promover alternativas para melhorar a qualidade no diagnóstico. Objetivo: Avaliar a percepção de cirurgiões-dentistas (CDs) e estudantes de Odontologia brasileiros acerca de seu conhecimento e capacidade de identificar DPM. Métodos: Foi realizado um estudo transversal através de aplicação de questionário online. Foram aplicados dois questionários com 24 questões, um para estudantes e outro para CDs, divididos em três seções: dados demográficos e acadêmicos, treinamento, atitudes e autopercepção sobre DPM e conhecimento de DPM. A análise estatística envolveu os testes de Pearson, Mann-Whitney e Kruskal-Wallis. Resultados: O estudo foi composto por 209 participantes, 76 CDs e 133 estudantes de odontologia. A maioria dos participantes nunca realizou curso que envolvia o diagnóstico de desordens potencialmente malignas. A pontuação sobre o conhecimento de DPM variou de 0 a 10 pontos, sendo a média entre estudantes de 6,29±1,77 e entre CDs de 7,01±1,82. A maior taxa de acertos foi para as questões que discutiam a conduta clínica e a definição das desordens. Já as questões com menor taxa de acertos foram sobre lesões que não são consideradas potencialmente malignas, potencial de malignização e definição de Carcinoma in Situ. Conclusão: Há lacunas no conhecimento de estudantes de odontologia e CDs na identificação das desordens potencialmente malignas. Logo, essa deficiência reforça a necessidade de mais treinamentos e investimentos em educação, bem como de acompanhamento periódico de pacientes com tais desordens, a fim de prevenir potenciais transformações malignas.

Introduction: Potentially malignant disorders (PMD) are conditions of the oral cavity that present a significant risk for the development of cancer. Thus, early diagnosis becomes essential in the prognosis of oral lesions. Therefore, assessing the knowledge profile of these disorders is essential to identify gaps in education and to promote alternatives to improve the quality of their diagnosis. Objective: Evaluate the perception of brazilian dentists and dental students about their knowledge and ability to identify PMD. Methods: A cross-sectional study was carried out using an online questionnaire. Two questionnaires with 24 questions were applied, one for students and other for dentists, divided into three sections: demographic and academic data, training, attitudes and self-perception about potentially malignant disorders and knowledge of potentially malignant disorders. Statistical analysis involved Pearson, Mann-Whitney and Kruskal-Wallis tests. Results: The study consisted of 209 participants, 76 dentists and 133 dentistry students. Most participants never attended a course that involved the diagnosis of potentially malignant disorders. The score of knowledge about potentially malignant disorders ranged from 0 to 10 points, with a mean of 6.29±1.77 among students and 7.01±1.82 among dentists. The highest rate of correct answers was for questions that discussed clinical management and the definition of disorders. The questions with the lowest rate of correct answers were about lesions that are not considered potentially malignant, malignancy potential and the definition of Carcinoma in Situ. Conclusion: There are gaps in the knowledge of dental students and dentists in the identification of potentially malignant disorders. Therefore, this deficit reinforces the needed of more training and investments in education, as well as more training and investments in education and periodic follow-up of patients with such disorders are needed in order to prevent potential malignant transformations.

Fatores associados ao atraso no diagnóstico e tratamento do câncer bucal: revisão integrativa de literatura / Factors associated with delay in the diagnosis of bucal cancer: integrative literature review

Introdução: O câncer bucal é apontado como um problema de saúde relevante e apresenta alta taxa de incidência e mortalidade. O consumo de tabaco e álcool são considerados os principais fatores de risco para sua ocorrência. Apesar dos avanços relacionados a detecção, diagnóstico e tratamento, grande parte dos pacientes ainda é diagnosticada com a doença em estágio avançado. Objetivo: Estabelecer os principais fatores associados ao atraso no diagnóstico do câncer bucal. Material e Métodos: Foram pesquisados artigos nas bases de dados MEDLINE/PubMed, SciELO e Lilacs, com os descritores: delayed oral cancer; delayed diagnosis oral cancer; oral cancer young patients; e HPV oral cancer patients. Como critérios de inclusão, foram delimitados artigos completos e disponíveis integramente. Publicações não relacionadas a delimitação do tema e ao objetivo do estudo foram excluídas. Resultados: Foram encontrados 513 artigos, dos quais 118 foram lidos na íntegra e 96 por fim selecionados, conforme critérios de inclusão e exclusão. Os dados indicaram que o atraso no diagnóstico do câncer bucal é frequente e relacionado ao atraso pelo paciente, atraso pelo profissional de saúde e atraso no tratamento, com destaque ao atraso pelo paciente. Conclusão: O diagnóstico precoce é o meio mais eficaz de reduzir as taxas de mortalidade e melhorar o prognóstico e qualidade de vida de pacientes com câncer bucal. Dessa forma, estratégias que objetivam a redução de diagnósticos realizados tardiamente devem ser consideradas.

Introduction: Oral cancer is identified as a relevant health problem and has a high incidence and mortality rate. Tobacco and alcohol consumption are considered the main risk factors for its occurrence. Despite advances related to detection, diagnosis and treatment, a large proportion of patients are still diagnosed with the disease at an advanced stage. Objective: To establish the main factors associated with delays in the diagnosis of oral cancer. Material and Methods: Articles were searched in the MEDLINE/PubMed, SciELO and Lilacs databases, with the descriptors: delayed oral cancer; delayed diagnosis of oral cancer; oral cancer young patients; and oral HPV cancer patients. As inclusion criteria, complete and fully available articles were delimited. Publications not related to the delimitation of the topic and the objective of the study were excluded. Results: 513 articles were found, of which 118 were read in full and 96 were finally selected, according to inclusion and exclusion criteria. The data indicated that delays in diagnosing oral cancer are frequent and related to delays by the patient, delays by healthcare professionals and delays in treatment, with emphasis on delays by the patient. Conclusion: Early diagnosis is the most effective way to reduce mortality rates and improve the prognosis and quality of life of patients with oral cancer. Therefore, strategies that aim to reduce late diagnoses should be considered.

Regulação do acesso ao tratamento do câncer de boca no estado do Rio de Janeiro / Study of the regulation system for access to oral cancer treatment in the state of Rio de Janeiro

Objetivos: Descrever o perfil das solicitações de vaga para tratamento do câncer de boca e analisar o tempo entre a solicitação e o agendamento. Métodos. Pesquisa com dados secundários do Sistema Estadual de Regulação do Estado do Rio de Janeiro, entre setembro de 2015 e junho de 2018. Incluiu-se as solicitações para "Oncologia Ambulatório de 1ª vez- Cirurgia de Cabeça e Pescoço" classificadas como câncer de boca e excluiu-se as com status "cancelada". Resultados. Foram exportados 5802 registros, sendo 1663 elegíveis. A idade média foi de 61 anos, com um desvio padrão de 12,3 anos. O tempo médio de espera foi de 19 dias com um desvio padrão de 16,6 dias. 19% dos agravos referiram-se as "Neoplasia maligna de outras partes e partes não especificadas da língua". Conclusão. O perfil dos pacientes corrobora o encontrado na literatura e o tempo de espera para o atendimento é considerado aceitável.

Objectives: To describe the profile of vacancy requests for treatment of oral cancer and to analyze the time between the request and the schedule. Methods. Research with secondary data from the State Regulation System of the State of Rio de Janeiro, between September 2015 and June 2018. Included were requests for "First-time Ambulatory Oncology - Head and Neck Surgery" classified as oral cancer and those with "canceled" status were excluded. Results. 5,802 records were exported, of which 1663 were eligible. The average age was 61 years, with a standard deviation of 12.3 years. The average waiting time was 19 days with a standard deviation of 16.6 days. 19% of the complaints referred to "Malignant neoplasm from other parts and unspecified parts of the tongue". Conclusion. The profile of patients corroborates that found in the literature and the waiting time for care is considered acceptable.

The impact of the Covid-19 pandemic on a reference oral medicine service in Brazil

The COVID-19 pandemic in 2020 had a global impact on healthcare services, leading to a decrease and delay in diagnosing various diseases and initiating treatment. Dentistry was quickly recognized as a high-risk area for contamination, resulting in a reduction in the number of consultations conducted. The objective of this study was to identify the main characteristics of consultations at the Oral Medicine Outpatient Clinic from our institution, comparing the number of consultations and diagnoses performed during re-gular years from 2016 to 2019 with the years of the COVID-19 pandemic. Materials and Methods: Data were collected and analyzed from clinical records of all patients seen at the Oral Medicine Outpatient Clinic from March 2016 to May 2021. Sociodemographic data and the diagnosis stablished for these patients were collected. In the pre-pandemic period, an average of 324 patients per year were treated. In the pandemic period average was 248.5 per year, indicating a 23.3% reduction in the number of patients treated at the service. When comparing the number and overall percentage of diagnosis stablished, a higher number of malignant neoplasms were identified during the pandemic, despite the reduction in services provided. Thus, we conclude that the COVID-19 pandemic had a negative impact on the total number of new patients admitted to our service but we were able to continue diagnosing cases of malignant neoplasms. This reinforces the importance of maintaining the service, considered essential to the population, during this critical period we have gone through. (AU)