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1.
Arch. pediatr. Urug ; 93(1): e306, jun. 2022. ilus
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1383647

ABSTRACT

La hiperplasia de glándulas sebáceas es un hallazgo benigno y transitorio, común en el período neonatal. Secundariamente al estímulo hormonal androgénico se produce un hipercrecimiento de las glándulas, con mayor frecuencia en nariz y mejillas, donde existen en mayor densidad. La hiperplasia de glándulas en una localización ectópica, llamada gránulos de Fordyce (GF), es excepcional en el período neonatal. Se han reportado en aproximadamente 1% de los recién nacidos, y con frecuencia se localizan en la mucosa oral. Los GF se describen como lesiones papulares de aspecto vesiculoso blanco amarillentas de 1-3 mm2, que podrían confundir al neonatólogo o al pediatra con entidades infecciosas, dando lugar a pruebas invasivas y tratamientos innecesarios. Se describen tres casos clínicos de neonatos con diagnóstico de hiperplasia sebácea ectópica localizada en mucosa oral, con el objetivo de revisar la etiología, las características clínicas, los diagnósticos diferenciales y la evolución de esta entidad benigna. Conclusiones: la hiperplasia sebácea ectópica en mucosa oral de neonatos es un hallazgo benigno autolimitado que se presenta con baja frecuencia. El reconocimiento clínico de esta entidad es importante para evitar diagnósticos incorrectos y tratamientos innecesarios.


Sebaceous gland hyperplasia is a common transient and benign finding in neonates. After androgenic hormonal stimulation, there is a gland overgrowth mainly in the nose and cheeks where there is a greater density of glands. Ectopic sebaceous gland hyperplasia, called Fordyce's Granules (FG), is exceptional in neonates and it is reported in approximately 1% of newborns and frequently located in the oral mucosa. FGs are described as 1-3mm2 yellowish-white papular and vesicular lesions. Neonatologists or pediatricians may confuse these clinical features with infectious diseases, leading to invasive tests and unnecessary treatment. We describe three clinical cases of neonates with diagnosis of ectopic sebaceous gland hyperplasia located in the oral mucosa, with the aim of reviewing the etiology, clinical characteristics, differential diagnoses and evolution of this benign entity. Conclusions: ectopic sebaceous gland hyperplasia of the lips is a self-limited benign finding occurring infrequently in newborns. The clinical recognition of this entity is important to avoid inaccurate diagnoses or unnecessary treatment.


A hiperplasia das glândulas sebáceas é um achado benigno e transitório comum nos neonatos. Secundário ao estímulo hormonal androgênico, há um hipercrescimento das glândulas com mais frequência no nariz e nas bochechas onde há uma maior densidade das glândulas. A hiperplasia das glândulas num local ectópico, chamado Fordyce Granules (FG), é excepcional no período neonatal, e ela é relatada em aproximadamente 1% dos recém-nascidos e muitas vezes está localizada na mucosa oral. Os FGs são descritos como lesões vesiculares brancas amareladas de 1-3mm2, o que poderia confundir o neonatologista ou pediatra com entidades infecciosas, levando a testes invasivos e tratamentos desnecessários. Descrevemos três relatos clínicos de recém-nascidos com diagnóstico de hiperplasia sebácea ectópica localizada na mucosa oral, com o objetivo de rever a etiologia, características clínicas, diagnósticos diferenciais e evolução desta entidade benigna. Conclusões: hiperplasia sebácea ectópica na mucosa oral de recém-nascidos é um achado benigno autolimitante que ocorre com baixa frequência. O reconhecimento clínico desta entidade é importante para evitar diagnósticos incorretos e tratamentos desnecessários.


Subject(s)
Humans , Male , Infant, Newborn , Streptococcal Infections/diagnosis , Streptococcus agalactiae , Herpes Simplex/diagnosis , Hyperplasia/diagnosis , Mouth Mucosa/pathology , Diagnosis, Differential
2.
Autops. Case Rep ; 12: e2021360, 2022. tab, graf
Article in English | LILACS | ID: biblio-1360154

ABSTRACT

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.


Subject(s)
Humans , Female , Aged , Xanthomatosis/complications , Lichen Planus, Oral/complications , Immunohistochemistry , Xanthomatosis/pathology , Lichen Planus, Oral/pathology , Mouth Mucosa/pathology
3.
Rev. ADM ; 78(6): 361-364, nov.-dic. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1357715

ABSTRACT

El lipoma es un tumor benigno derivado de tejido adiposo maduro que se presenta con poca frecuencia en la cavidad oral, pero de interés para el clínico estomatológico por su distintiva presentación en esta región. A continuación se reportan dos casos clínicos de lipoma simple localizados en la mucosa vestibular y piso de boca que fueron tratados mediante eliminación quirúrgica (AU)


Lipoma is a benign neoplasm derived of mature adipose tissue that occurs infrequently in the oral cavity, but of interest to the stomatologic clinician for its distinctive presentation in this region. Next, two cases of simple lipoma located in the vestibular mucosa and floor of the mouth that were treated by surgical excision are presented (AU)


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Oral Surgical Procedures , Lipoma , Mouth Mucosa/pathology , Schools, Dental , Neoplasms, Adipose Tissue , Age and Sex Distribution , Mexico
4.
Rev. ADM ; 78(3): 167-175, mayo-jun. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1254949

ABSTRACT

La actual pandemia de COVID-19 provocada por el virus SARS-CoV-2 es un problema de salud que afecta a la población globalmente. Su desarrollo puede ser asintomático o exhibir manifestaciones clínicas moderadas o severas dependiendo en gran medida de la respuesta inmune de quien la padece. Esta enfermedad afecta principalmente a los pulmones a través del desarrollo del síndrome respiratorio agudo severo (SRAS), tanto como por la «tormenta de citocinas¼, una respuesta inflamatoria exacerbada que podría provocar una falla multisistémica y, en casos severos, la muerte. Se conoce que la enzima convertidora de angiotensina 2 (ECA-2), presente en diversos tejidos del cuerpo, actúa como receptor funcional del virus SARS-CoV-2 facilitando la entrada de éste a las células. Se ha demostrado la presencia de dicho receptor en varios tejidos orales, por lo que se puede considerar a la cavidad bucal como una vía latente de infección por dicho coronavirus, ya que su mecanismo de transmisión es a través de la inhalación de partículas virales, ya sea por vía nasal u oral. Así mismo, la presencia de carga vírica en la saliva y algunos de los síntomas de la COVID-19, por ejemplo la ageusia, pueden indicar la presencia de contagio viral en etapas tempranas. La presente revisión muestra evidencia que sugiere que diversos tejidos en la cavidad oral podrían ser considerados sitios potenciales de contagio por el SARS-CoV-2, teniendo un papel importante en el mecanismo de transmisión y en el desarrollo de coinfecciones (AU)


The COVID-19 pandemic caused by the SARS-CoV-2 virus is currently a global healthcare problem. The onset of this disease can exhibit several clinical manifestations ranging from mild to severe symptoms, depending on the individual's immune response. COVID-19 primarily affects the lungs by developing the Severe Acute Respiratory Syndrome (SARS) and the «cytokine storm¼, an exacerbated inflammatory reaction that can lead to multiorgan failure and consequently death. The angiotensin-converting enzyme 2 (ACE-2), present in several tissues in the human body, is known to act as the functional receptor of the SARS-CoV-2 germ facilitating its entrance into the cells. Such receptor is also present in diverse oral cavity tissues, indicating a latent route of infection due to its influence in the transmission mechanism by inhalation, either oral or nasal, of virus particles. Also, viral load in saliva and taste disorder symptoms like ageusia could indicate a viral infection in its early stages. This article presents evidence suggesting that several tissues in the oral cavity can be considered potential sites of SARS-CoV-2 infection, thus playing an essential role in the transmission mechanism and development of co-infections (AU)


Subject(s)
Humans , SARS-CoV-2 , COVID-19 , Mouth Mucosa/pathology , Oral Manifestations , Signs and Symptoms , Taste Disorders , Peptidyl-Dipeptidase A , Viral Load , Inflammation
5.
Medisan ; 25(1)ene.-feb. 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1154846

ABSTRACT

Introducción: Las lesiones paraprotésicas son alteraciones de la mucosa bucal asociadas al uso de prótesis dental, las cuales pueden provocar complicaciones graves. Objetivo: Identificar los factores de riesgo relacionados con las lesiones paraprotésicas en pacientes portadores de prótesis removibles. Métodos: Se realizó un estudio observacional y descriptivo de 180 pacientes con lesiones paraprotésicas, atendidos en la Clínica Estomatológica Provincial Docente Mártires del Moncada de Santiago de Cuba, desde febrero del 2019 hasta mayo del 2020. Se seleccionaron las siguientes variables: edad, sexo, factor de riesgo y tipo de lesión paraprotésica. Resultados: Predominaron los pacientes de 60 años y más, la estomatitis subprótesis (52,7 %) y factores de riesgo, tales como prótesis mucosoportada, mayor tiempo de uso, así como hábito de dormir con la prótesis. Conclusiones: La lesión paraprotésica más frecuente fue la estomatitis subprótesis debido a la persistencia de los mismos factores de riesgo, que incidieron en la población a través del tiempo.


Introduction: Paraprosthetic lesions are alterations of the oral mucosa associated with the use of dental prosthesis, which can cause serious complications. Objective: To identify the risk factors related to the paraprosthetic lesions in patients with removable prosthesis. Method: An observational and descriptive study of 180 patients with paraprosthetic lesions was carried out; they were assisted in Mártires del Moncada Teaching Provincial Stomatological Clinic in Santiago de Cuba, from February, 2019 to May, 2020. The following variables were selected: age, sex, risk factor and type of paraprosthetic lesion. Results: There was a prevalence of the 60 years and over patients, sub prosthesis stomatitis (52.7 %) and risk factors, such as mucosoported prosthesis, longer time using it, as well the habit of sleeping with the prosthesis. Conclusions: The most frequent paraprosthetic lesion was the sub prosthesis stomatitis due to the persistence of the same risk factors that impacted in the population through the time.


Subject(s)
Dental Prosthesis/adverse effects , Mouth Mucosa/pathology , Risk Factors
6.
Acta toxicol. argent ; 28(2): 36-44, Sept. 2020. graf
Article in English | LILACS | ID: biblio-1278221

ABSTRACT

Abstract This research aimed to conduct a systematic review and metanalysis to compare the frequency of cell damage in crack users and nonusers, through Micronucleous (MN) test in buccal mucosa cells. A comprehensive search was carried out on MEDLINE via PubMeb, Web of Science, LILACS and the grey literature without restrictions. It was included case-control studies that report the frequency of micronuclei in the oral mucosa of adult crack users and nonusers. A review protocol was registered with PROSPERO (CRD42018115672), and conducted in accordance with the PRISMA guidelines for the report of this systematic review. Furthermore, study quality was evaluated using an adapted Newcastle-Ottawa Scale for cross-sectional studies.The original search yielded 27 references, after eligibility criteriaonly five articles were included. The number of micronuclei was higher in crack users compared to nonusers. Also, secondary outcomes: binucleated cells, nuclear buds, pyknosis, karyorrhexis and karyolysis had higher prevalence in crack users.Crack use is associated with genotoxic and mutagenic effects because there is a higher frequency of micronuclei in exfoliated cells of crack users. In addition, MN test proved to be a goodbiomarker to assess the mutagenic impact of crack use in oral epithelium.


Resumen Esta investigación tuvo como objetivo realizar una revisión sistemática y un meta-análisis para comparar la frecuencia de daño celular en usuarios de crack y sin crack, a través de la prueba de micronúcleos (MN) en células de la mucosa bucal. Se realizó una búsqueda exhaustiva en MEDLINE a través de PubMeb, Web of Science, LILACS y la literatura gris sin restricciones. Se incluyeron estudios de casos y controles que informaron la frecuencia de micronúcleos en la mucosa oral de usuarios adultos de crack y sin crack. Se registró un protocolo de revisión con PROSPERO (CRD42018115672), y se realizó de acuerdo con las pautas de PRISMA para el informe de esta revisión sistemática. Además, la calidad del estudio se evaluó mediante una escala Newcastle-Ottawa adaptada para estudios transversales. La búsqueda original arrojó 27 referencias, después de los criterios de elegibilidad se incluyeron un total de cinco artículos. El número de micronúcleos fue mayor en los usuarios de crack en compa ración con los usuarios sin crack. Además, los resultados secundarios de células binucleadas, yemas nucleares, picnosis, cario- rrexis y cariólisis tuvieron una mayor prevalencia en los usuarios de crack. El uso de crack se asocia con efectos genotóxicos y mutagénicos porque hay una mayor frecuencia de micronúcleos en las células exfoliadas de los usuarios de crack. Además, la prueba de MN demostró ser un buen biomarcador para evaluar el impacto mutagénico del uso de crack en el epitelio oral.


Subject(s)
Humans , Adolescent , Adult , Young Adult , Crack Cocaine , Cocaine-Related Disorders/pathology , Mouth Mucosa/pathology , Micronucleus Tests/methods , Mutagens
7.
Rev. otorrinolaringol. cir. cabeza cuello ; 80(2): 166-171, jun. 2020. graf
Article in Spanish | LILACS | ID: biblio-1115831

ABSTRACT

El tumor glómico es una neoplasia vascular originada de las células del músculo liso del componente neuromioarterial, responsable del control del flujo sanguíneo microvascular. Representa el 1,6% de todos los tumores de tejidos blandos, localizándose principalmente en la zona subungüeal y clínicamente muy doloroso. Su diagnóstico puede ser tardío debido a su pequeño tamaño, manifestaciones clínicas inespecíficas y localizaciones anatómicas inusuales. El tratamiento principalmente es quirúrgico, el cual es curativo, permitiendo además la confirmación histopatológica. Se presenta el reporte de caso de una paciente de 13 años de edad con un tumor glómico de localización inusual en mucosa bucal.


The glomus tumor is a vascular neoplasm originating from smooth muscle cells of neuromyoarterial component, responsible for the control of microvascular blood flow. It represents 1.6% of all soft tissue tumors, being located mainly in the subungual area and clinically very painful. Diagnosis may be delayed because of their small size, nonspecific clinical manifestations and unusual anatomical locations. Treatment is primarily surgical, which is healing, also allowing the histopathologic confirmation. The case report of a 13-year-old patient with an unusual-located glomus tumor in the oral mucosa is presented.


Subject(s)
Humans , Female , Adolescent , Mouth Neoplasms/pathology , Glomus Tumor/pathology , Mouth Neoplasms/diagnosis , Glomus Tumor/diagnosis , Mouth Mucosa/pathology
8.
Rev. Asoc. Odontol. Argent ; 108(1): 14-18, ene.-abr. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1096370

ABSTRACT

Los lipomas son tumores benignos compuestos por adipocitos maduros. Si bien representan la neoplasia más común en el cuerpo humano, su aparición en la región de la cabeza y el cuello es relativamente rara. No muestra predilección por sexo y afecta a individuos en la cuarta década de vida. Clínicamente, puede observarse un aumento de volumen nodular, de consistencia blanda y superficie lisa. Su etiopatogenia aún es desconocida, aunque algunos autores han sugerido factores endócrinos, inflamatorios, hereditarios y traumáticos. El diagnóstico se realiza a través de la evaluación clínica, con la ayuda de pruebas de imagen como la tomografía computarizada y la resonancia magnética. Sin embargo, solo puede ser confirmado mediante análisis histopatológico de la lesión, considerado el examen por excelencia. El tratamiento de los lipomas y todas sus variantes consiste en la extirpación quirúrgica total, con lo cual se disminuye la posibilidad de recidivas, que es rara de por sí. El objetivo de esta publicación es informar un caso clínico de lipoma localizado en la región de la mucosa yugal, con extirpación quirúrgica completa de la lesión de manera ambulatoria (AU)


Lipomas are benign tumors composed of mature adipo- cytes. Although they represent the most common neoplasia in the human body, their occurrence in the head and neck region is relatively rare. Regardless of gender, they affect individu- als from the fourth decade of life on. Clinically, an increase of the nodular volume with softened consistency and smooth surface can be observed. Although its etiopathogenesis is still uncertain, some authors have suggested endocrinal, inflam- matory, hereditary and traumatic factors. The diagnosis is made through clinical evaluation, with the aid of imaging ex- aminations, such as computerized tomography and magnetic resonance. However, it can only be confirmed through the histopathological analysis of the lesion, which is considered the gold standard examination. The treatment of the lipomas and all their variations consists of complete surgical exci- sion, thus diminishing the possibility of recurrence, which in turn is rare. The aim of this publication is to report a clin- ical case of lipoma, located in the jugal mucosa region and treated through complete surgical removal of the lesion on an outpatient basis (AU)


Subject(s)
Humans , Female , Middle Aged , Neoplasms, Adipose Tissue , Lipoma/surgery , Lipoma/diagnostic imaging , Mouth Mucosa/pathology , Brazil , Histological Techniques , Oral Surgical Procedures , Ambulatory Surgical Procedures
9.
Article in English | LILACS, BBO | ID: biblio-1135489

ABSTRACT

Abstract Objective: To compare colony forming unit (CFU) of oral bacterial from buccal mucosa and lingual buccal tongue among patients with a dental implant and normal oral hygiene individuals without a dental implant. Material and Methods: Twenty-six individuals with a dental implant and twenty-six individuals without dental implants were included in this study. The samples were sent to the laboratory to culture with Brain Heart Infusion Broth (BHI), prepared serial dilution and then spread to the blood agar. CFU was counted when a single layer of bacteria is formed on the blood agar at any dilution level. An independent-T test was used to compare the means different of CFU oral bacterial between control and test groups from buccal mucosa and lingual buccal mucosa, respectively. Results: Buccal mucosa control group (186.19 ± 5.61) and test group (186.65 ± 6.24) (p>0.05). The result from the lingual buccal tongue control group (198.38 ± 6.12) and test group (197.96 ± 6.50) (p>0.05). There was no significant difference between the control group and test group CFU bacterial load. Conclusion: The presence of implants in the oral cavity do not interfere or worsen the oral condition; nevertheless, the effect of implants surrounding oral flora is similar to natural teeth.


Subject(s)
Humans , Oral Hygiene/education , Bacteria , Dental Implants , Dental Materials , Mouth Mucosa/pathology , Tongue , Control Groups , Statistics, Nonparametric , Agar , Bacterial Load , Malaysia/epidemiology
10.
J. appl. oral sci ; 28: e20190020, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1056587

ABSTRACT

Abstract Objective: This study sought to identify the differences between the oral changes presented by patients with solid and hematologic tumors during chemotherapeutic treatment. Methodology: This is an observational, prospective and quantitative study using direct documentation by follow-up of 105 patients from 0 to 18 years using the modified Oral Assessment Guide (OAG). Of the 105 patients analyzed, 57 (54.3%) were boys with 7.3 years (±5.2) mean age. Hematologic neoplasms accounted for 51.4% of all cases. Results: Voice, lips, tongue, and saliva changes were not significantly different (p>0.05) between patients with solid or hematologic tumors and during the follow-up. From the 6th until the 10th week of chemotherapeutic treatment alterations in swallowing function, in the mucous membrane (buccal mucosa and palate), in the labial mucosa, and in the gingiva occurred and were distributed differently between the two tumors groups (p<0.05). The main alterations were observed in patients with hematologic tumors. Conclusion: It was concluded that the oral changes during the chemotherapeutic treatment occurred especially in swallowing function, in the mucous membrane, in the labial mucosa and in the gingiva, and these alterations were found mainly in patients with hematologic tumors.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Mouth Diseases/chemically induced , Neoplasms/drug therapy , Antineoplastic Agents/adverse effects , Deglutition Disorders/chemically induced , Prospective Studies , Longitudinal Studies , Hematologic Neoplasms/complications , Hematologic Neoplasms/drug therapy , Mouth Diseases/classification , Mouth Mucosa/pathology , Antineoplastic Agents/therapeutic use
11.
J. appl. oral sci ; 28: e20190532, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1101257

ABSTRACT

Abstract Oral leukoplakia (OL) is a white lesion of an indeterminate risk not related to any excluded (other) known diseases or disorders that carry no increased risk for cancer. Many biological markers have been used in an attempt to predict malignant transformation; however, no reliable markers have been established so far. Objective To evaluate cell proliferation and immortalization in OL, comparing non-dysplastic (Non-dys OL) and dysplastic OL (Dys OL). Methodology This is a cross-sectional observational study. Paraffin-embedded tissue blocks of 28 specimens of Non-dys OL, 33 of Dys OL, 9 of normal oral mucosa (NOM), 17 of inflammatory hyperplasia (IH), and 19 of oral squamous cell carcinomas (OSCC) were stained for Ki-67 and BMI-1 using immunohistochemistry. Results A gradual increase in BMI-1 and K-i67 expression was found in oral carcinogenesis. The immunolabeling for those markers was higher in OSCC when compared with the other groups (Kruskal-Wallis, p<0.05). Ki-67 expression percentage was higher in OL and in IH when compared with NOM (Kruskal-Wallis/Dunn, p<0.05). Increased expression of BMI-1 was also observed in OL when compared with NOM (Kruskal-Wallis/Dunn, p<0.05). No differences were observed in expression of both markers when non-dysplastic and dysplastic leukoplakias were compared. A significant positive correlation between Ki-67 and BMI-1 was found (Spearman correlation coefficient, R=0.26, p=0.01). High-grade epithelial dysplasia was associated with malignant transformation (Chi-squared, p=0.03). Conclusions These findings indicate that BMI-1 expression increases in early oral carcinogenesis and is possibly associated with the occurrence of dysplastic changes. Furthermore, our findings indicate that both Ki-67 and BMI-1 are directly correlated and play a role in initiation and progression of OSCC.


Subject(s)
Humans , Animals , Male , Adult , Middle Aged , Aged , Aged, 80 and over , Leukoplakia, Oral/pathology , Mouth Neoplasms/pathology , Carcinoma, Squamous Cell/pathology , Ki-67 Antigen/analysis , Polycomb Repressive Complex 1/analysis , Mouth Mucosa/pathology , Immunohistochemistry , Cross-Sectional Studies , Risk Factors , Statistics, Nonparametric , Disease Progression , Cell Proliferation , Carcinogenesis/pathology
12.
J. oral res. (Impresa) ; 8(6): 505-509, dic. 28, 2019. ilus, graf, tab
Article in English | LILACS | ID: biblio-1224479

ABSTRACT

Objectives: A systematic review was conducted to evaluate effectiveness and safety of beta carotenes for the treatment of oral leukoplakia regarding clinical resolution and prevention of malignant transformation. Material and Methods: The systematic search was conducted in three electronic databases and the study's selection was performed according to pre-set eligibility criteria. Four studies evaluating the efficacy of beta carotenes in oral leukoplakia compared to placebo were included in the review; three of which were assigned for quantitative analysis. Data were extracted, tabulated, quality assessed and statistically analyzed. Results: The meta-analysis revealed that when comparing clinical resolution the beta carotene group favored was favored compared to placebo, with statistically significant difference. However, a meta-analysis comparing beta carotene and placebo groups regarding malignant transformation as a primary outcome failed to show any significant benefit. Furthermore, results showed evidence of beta carotene safety. Conclusion: the overall quality of evidence about efficacy of beta carotene in oral leukoplakia treatment was not high. However, given the obvious safety of this agent, data suggests it could have a promising effect in clinical improvement of oral leukoplakia lesions. However, no evidence supporting its benefits in reducing risk of malignant transformation in these lesions was found. Therefore, further long term, well designed randomized clinical trials are highly recommended.


Introducción: el cáncer oral es un problema grave con alta mortalidad y morbilidad, a pesar de la disponibilidad de los mejores tratamientos. Uno de los factores más importantes para una mortalidad tan alta es su diagnóstico tardío. La mejor manera de enfrentar un problema de este tipo es evitar su aparición creando conciencia entre la población y tenendo un diagnóstico más temprano. El cáncer oral es una enfermedad multifactorial, donde el daño genómico tiene un papel. Se ha demostrado que los micronúcleos (MNi) son un biomarcador importante y en este estudio se utilizó como una herramienta para crear conciencia sobre el riesgo de cáncer oral. Objetivo: evaluar y comparar la frecuencia de MNi en fumadores sin ninguna lesión oral visible (Grupo I) y no fumadores sanos (Grupo II). Materiales y métodos: se obtuvieron citoestimuladores de fumadores sauditas (n = 15, Grupo I) sin ninguna lesión oral visible y no fumadores sanos (n = 15, control, Grupo II) y se tiñeron con hemotoxilina y eosina para evaluar la frecuencia de MNi y las observaciones fueron sometidas a análisis estadístico utilizando la prueba t de Student. Resultados: La frecuencia media de MNi en el Grupo I fue significativamente mayor (p<0.05) que en el Grupo II. El estudio ayuda a educar, motivar y crear conciencia, alentando así a los pacientes a dejar de fumar, y evitando así el cáncer oral antes de su inicio.


Subject(s)
Humans , Mouth Neoplasms/genetics , Micronucleus Tests , Mouth Mucosa/pathology , Saudi Arabia , DNA Damage , Leukoplakia, Oral , Biomarkers , Delayed Diagnosis , Smokers , Non-Smokers
13.
An. bras. dermatol ; 94(4): 449-451, July-Aug. 2019. tab, graf
Article in English | LILACS | ID: biblio-1038316

ABSTRACT

Abstract: Benign migratory glossitis or geographic tongue is a benign condition that usually manifests as asymptomatic erythematous and migratory circinate patches, involving the lateral and dorsal aspects of the tongue. Extra-lingual lesions uncommonly occur and are mainly located on labial and buccal mucosae, lips and floor of the mouth. The present report describes one patient with a geographic lesion on the hard palate associated with lingual lesions and another patient who had multiple geographic lesions both in the hard and soft palate without lingual lesions. We found 64 cases in the English literature of ectopic locations with 22 palate involvement. No case of simultaneous involvement of the hard and the soft palate was found.


Subject(s)
Humans , Male , Female , Palate/pathology , Stomatitis/pathology , Glossitis, Benign Migratory/pathology , Tongue/pathology , Middle Aged , Mouth Mucosa/pathology
14.
Braz. j. otorhinolaryngol. (Impr.) ; 85(4): 399-407, July-Aug. 2019. tab, graf
Article in English | LILACS | ID: biblio-1019582

ABSTRACT

Abstract Introduction Reactive hyperplastic lesions develop in response to a chronic injury simulating an exuberant tissue repair response. They represent some of the most common oral lesions including inflammatory fibrous hyperplasia, oral pyogenic granuloma, giant cell fibroma, peripheral ossifying fibroma, and peripheral giant cell lesions. Objective The incidence of those lesions was investigated in an oral pathology service, and the clinical characteristics, associated etiological factors, concordance between the clinical and histopathological diagnostic was determined. Methods A total of 2400 patient records were screened from 2006 to 2016. Clinical features were recorded from biopsy reports and patients' files. Results A total of 534 cases of reactive hyperplastic lesions were retrieved and retrospectively studied, representing 22.25% of all diagnoses. The most frequent lesion was inflammatory fibrous hyperplasia (72.09%), followed by oral pyogenic granuloma (11.79%), giant cell fibroma (7.30%), peripheral ossifying fibroma (5.24%), and peripheral giant cell lesions (3.55%). Females were predominantly affected (74.19%), the gingiva and alveolar ridge were the predominant anatomical site (32.89%), and chronic traumatism was presented as the main etiological factor. The age widely ranges from the 1st decade of life to the 7th. Clinically, the reactive hyperplastic lesions consisted of small lesions (0.5-2 cm) and shared a strong likeness in color to the oral mucosa. The concordance between the clinical and histopathological diagnostic was high (82.5%). Conclusion Reactive hyperplastic lesions had a high incidence among oral pathologies. The understanding of their clinical features helps to achieve a clearer clinical and etiological diagnosis, and the knowledge of factors related to their development. This may contribute to adequate treatment and positive prognosis.


Resumo Introdução As lesões hiperplásicas reativas se desenvolvem em resposta a uma lesão crônica que estimula uma resposta acentuada de reparo tecidual. Elas representam uma das lesões orais mais comuns, inclusive hiperplasia fibrosa inflamatória, granuloma piogênico oral, fibroma de células gigantes, fibroma periférico ossificante e lesão periférica de células gigantes. Objetivo A incidência dessas lesões foi investigada em um serviço de patologia bucal e as características clínicas, os fatores etiológicos associados e a concordância entre os diagnósticos clínico e histopatológico foram determinados. Método Foram selecionados 2.400 registros de pacientes entre 2006 e 2016. As características clínicas foram registradas a partir de laudos de biópsia e dos prontuários dos pacientes. Resultados Um total de 534 casos de lesões hiperplásicas reativas foram recuperados e retrospectivamente estudados, representando 22,25% de todos os diagnósticos. A lesão mais frequente foi hiperplasia fibrosa inflamatória (72,09%), seguida por granuloma piogênico oral (11,79%), fibroma de células gigantes, (7,30%), fibroma periférico ossificante (5,24%) e lesão periférica de células gigantes (3,55%). O sexo feminino foi predominante (74,19%), a gengiva e a crista alveolar foram o local anatômico predominante (32,89%) e o traumatismo crônico foi demonstrado como o principal fator etiológico. A idade variou desde a 1ª década de vida até a 7ª. Clinicamente, as LHR consistiram em pequenas lesões (0,5 a 2 cm) que apresentaram uma forte semelhança de cor com a mucosa oral. A concordância entre o diagnóstico clínico e histopatológico foi alta (82,5%). Conclusão As lesões hiperplásicas reativas apresentaram alta incidência entre as patologias bucais. A compreensão das características clínicas ajuda na realização de um diagnóstico clínico e etiológico mais claro, bem como determinar os fatores relacionados ao seu desenvolvimento. Dessa forma contribui para um tratamento adequado e um prognóstico positivo.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Young Adult , Hyperplasia/pathology , Mouth/pathology , Mouth Diseases/pathology , Giant Cells/pathology , Retrospective Studies , Granuloma, Pyogenic/congenital , Granuloma, Pyogenic/pathology , Fibroma, Ossifying/etiology , Fibroma, Ossifying/pathology , Fibroma/etiology , Fibroma/pathology , Hyperplasia/classification , Hyperplasia/etiology , Mouth Diseases/classification , Mouth Diseases/diagnosis , Mouth Diseases/etiology , Mouth Mucosa/pathology
15.
Arq. bras. oftalmol ; 82(3): 242-244, May-June 2019. graf
Article in English | LILACS | ID: biblio-1001307

ABSTRACT

ABSTRACT A 12-year-old girl presented with recurrent crusty debris and dandruff at the base of both eyelashes despite having completed different medical treatments. She had had a hoarse voice since her early childhood. Upon anterior segment examination of the eyes, we found yellow-white, bead-like papules on the margins of the eyelids. An otolaryngologist detected multiple nodules on the vocal cords and buccal mucosa. Ultrasonography revealed salivary stones in the main parotid ducts. And a dermatological examination revealed thickened skin lesions on the elbows and knees with a biopsy showing histopathological findings of lipoid proteinosis. We diagnosed the patients as having Urbach-Wiethe syndrome or lipoid proteinosis, a rare autosomal recessive multisystem disorder with variable manifestations vary that difficult the diagnosis. The ocular manifestations are not well known among ophthalmologists, but the typical lid lesions are pathognomonic and ophthalmologists should be aware of this presentation to identify patients with Urbach-Wiethe syndrome.


RESUMO Uma menina de 12 anos apresentava restos crostosos e caspa recorrente na base de ambos os cílios, apesar de ter completado diferentes tratamentos médicos. Ela tinha uma voz rouca desde a infância. No exame do segmento anterior dos olhos, encontramos pápulas amarelo-esbranquiçadas nas margens das pálpebras. Um otorrinolaringologista detectou múltiplos nódulos nas cordas vocais e na mucosa bucal. A ultrassonografia revelou cálculos salivares nos principais ductos parotídeos. Um exame dermatológico revelou lesões cutâneas espessas nos cotovelos e joelhos com uma biópsia mostrando os achados histopatológicos de proteinose lipoide. Diagnosticamos os pacientes da síndrome de Urbach-Wiethe ou proteinose lipoide, um distúrbio multissistêmico autossômico recessivo raro, com manifestações variáveis, que dificultam o diagnóstico. Manifestações oculares não são bem conhecidas entre oftalmologistas, mas as lesões típicas da pálpebra são patognomônicas e os oftalmologistas devem estar atentos a essa apresentação para identificar pacientes com síndrome de Urbach-Wiethe.


Subject(s)
Humans , Female , Child , Blepharitis/diagnosis , Blepharitis/pathology , Lipoid Proteinosis of Urbach and Wiethe/diagnosis , Lipoid Proteinosis of Urbach and Wiethe/pathology , Skin/pathology , Vocal Cords/pathology , Biopsy , Diagnosis, Differential , Hyalin , Mouth Mucosa/pathology
16.
Rev. Assoc. Med. Bras. (1992) ; 65(6): 870-879, June 2019. tab, graf
Article in English | LILACS | ID: biblio-1012994

ABSTRACT

SUMMARY This study aimed to assess the prevalence of medical and nonmedical use of psychiatric medication among undergraduate students of health sciences from a public university in Brasil. Another objective was to determine the frequency of nuclear morphological abnormalities in the buccal mucosa of students using psychiatric drugs. A cross-sectional study based on a Web survey was carried out with 375 health sciences undergraduate students from schools of Pharmacy, Physical Education, Nutrition, and Medicine. Additionally, spontaneous genetic damages in exfoliated cells of the buccal mucosa of 41 individuals by counting micronucleus (MN) and binucleated (BN) cells frequencies were evaluated. The results showed 76 (20.3%) of students reported the use of psychotropic drugs after enrolling in university. The majority of these students were from Pharmacy and Medicine programs, females, aged between 18-25 years old, nonsmokers, alcohol addicts, and with a family history of mental illness. In addition, Medical students, individuals with high-income, who live alone and are in the last period of the program are more likely to use psychotropic drugs. Moreover, exposure to psychiatric medication was able to increase the number of binucleated cells. These results provide evidence that the use of psychoactive drugs is increased in the academic context and may be related to the failure of the cell cycle.


RESUMO O objetivo deste estudo foi avaliar a prevalência de uso médico e não médico de medicação psiquiátrica entre estudantes de graduação em Ciências da Saúde de uma universidade pública do Brasil. Outro objetivo foi determinar a frequência de anormalidades nucleares morfológicas na mucosa bucal desses estudantes. Realizou-se um estudo transversal baseado na Web com 375 estudantes de graduação em Ciências da Saúde das escolas de Farmácia, Educação Física, Nutrição e Medicina. Adicionalmente, danos genéticos espontâneos em células esfoliadas da mucosa bucal de 41 indivíduos foram analisados para estudo da frequência de micronúcleos e células binucleadas. Os resultados mostraram que 76 (20,8%) dos estudantes relataram que usaram drogas psicotrópicas após se matricularem na universidade. O uso desses medicamentos foi maior entre estudantes de cursos de Farmácia e Medicina, sexo feminino, idade entre 18 e 25 anos, não tabagistas, alcoolistas e histórico familiar de doença mental. Além disso, estudantes de Medicina, indivíduos com alta renda, que moram sozinhos e estão no último período do curso são mais propensos a usar drogas psicotrópicas. Ademais, a exposição à medicação psiquiátrica foi capaz de aumentar o número de células binucleadas. Esses resultados fornecem evidências de que o uso de drogas psicotrópicas aumenta no contexto acadêmico e pode estar relacionado à falha do ciclo celular.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Psychotropic Drugs/therapeutic use , Students, Health Occupations/statistics & numerical data , Drug Misuse/statistics & numerical data , Mouth Mucosa/drug effects , Mouth Mucosa/pathology , Socioeconomic Factors , Universities , Brazil , Micronucleus Tests , Cross-Sectional Studies , Surveys and Questionnaires , Risk Factors
17.
Rev. Odontol. Araçatuba (Impr.) ; 40(2): 43-47, maio/ago. 2019. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1006564

ABSTRACT

O objetivo deste estudo é descrever o diagnóstico e conduta clínica no tratamento do Fibroma Traumático (FT). O FT é uma lesão proliferativa de natureza benigna que surge na cavidade bucal devido à traumas de repetição, que desencadeiam reações inflamatórias em tecido conjuntivo, causando uma hiperplasia tecidual, geralmente assintomática, podendo interferir na mastigação e na fala causando desconforto ao paciente. Sua prevalência é alta, geralmente em mucosa jugal, linha oclusal, mucosa labial, língua e gengiva. O tratamento consiste na excisão cirúrgica e a confirmação do diagnóstico é dado através de envio para exame histopatológico. Paciente do gênero masculino, 46 anos de idade, procurou atendimento por apresentar nódulo único, exofítico, unilateral de aproximadamente 3 cm em seu diâmetro, localizado na mucosa jugal do lado direito, com bordas regulares e indolor a palpação, apresentando há cerca de 12 meses. Foi submetido a remoção cirúrgica total da lesão e encaminhamento ao laboratório para análise histopatológica para confirmação diagnóstica, além de proservação do caso em 7, 30 e 60 dias. Desta forma, foi possível concluir que a excisão cirúrgica da lesão promove maior conforto, melhora na fala e mastigação, além de um bom reparo tecidual, devolvendo assim, condições de saúde a mucosa bucal e mínimas chances de recidiva(AU)


The objective of this study is to describe the diagnosis and clinical management in the treatment of Traumatic Fibroma (FT). FT is a proliferative lesion of benign nature that arises in the buccal cavity due to repetitive traumas, which trigger inflammatory reactions in connective tissue, causing a tissue hyperplasia, usually asymptomatic, that can interfere in chewing and speech causing discomfort to the patient. Its prevalence is high, usually in jugal mucosa, occlusal line, labial mucosa, tongue and gingiva. The treatment consists of surgical excision and confirmation of the diagnosis is given by sending for histopathological examination. A 46-year-old male patient sought care for having a single, exophytic, unilateral nodule of approximately 3 cm in diameter, located on the right side of the jugal mucosa, with regular borders and painless palpation, presenting about 12 months. He was submitted to total surgical removal of the lesion and sent to the laboratory for histopathological analysis for diagnostic confirmation, in addition to case proservation at 7, 30 and 60 days. In this way, it was possible to conclude that the surgical excision of the lesion promotes greater comfort, improvement in speech and chewing, besides a good tissue repair, thus returning health conditions to the oral mucosa and minimal chances of relapse(AU)


Subject(s)
Humans , Male , Middle Aged , Fibroma/surgery , Surgery, Oral , Fibroma , Fibroma/diagnosis , Fibroma/therapy , Hyperplasia , Mouth Mucosa/pathology
18.
Rev. Odontol. Araçatuba (Impr.) ; 40(1): 52-55, jan.-abr. 2019. tab, graf
Article in Portuguese | LILACS, BBO | ID: biblio-995188

ABSTRACT

A grande quantidade de patologias com características clínicas semelhantes possibilita a coexistência de vários diagnósticos diferenciais frente a uma única lesão na mucosa bucal. Muitas vezes a realização de exames complementares, como a biópsia, torna-se mandatória para confirmação do diagnóstico sugestivo. Realizar levantamento dos laudos histopatológicos provenientes de biópsias executadas em uma clínica-escola odontológica no período entre 2011 e 2018. A partir dos prontuários odontológicos, as informações foram coletadas e tabuladas. Foram determinadas a frequência de cada lesão em relação ao total e ao seu próprio grupo de doenças e as características dos indivíduos. Um total de 106 diagnósticos de 105 pacientes (idade média 47,5 anos), sendo a maioria do sexo feminino (68 indivíduos - 64,8%) e leucoderma (67 indivíduos - 63,8%), foram avaliados. Em relação aos grupos de doenças, o mais representativo foi o das neoplasias benignas epiteliais ou mesenquimais (35 casos - 33%), seguido pelo dos processos proliferativos não neoplásicos (30 casos - 28,3%). Quanto aos diagnósticos, foram observados 25 diferentes, nos quais se destacaram o fibroma (30 casos - 28,3%) e a hiperplasia fibrosa inflamatória (22 casos - 20,8%). Não foi constatada nenhuma patologia maligna. Traçar o perfil epidemiológico de certo grupo de indivíduos pode muitas vezes facilitar os diagnósticos, além de auxiliar na implementação de medidas de prevenção e na orientação dos assuntos a serem abordados nos cursos das instituições de ensino superior(AU)


A large number of pathologies with similar clinical features may allow coexistence of several differential diagnoses in a single lesion on the buccal mucosa. According to the clinical picture, complementary exams such as biopsy are often mandatory to confirm the suggestive diagnosis. To carry out a survey of histopathological diagnoses from biopsies performed in a dental school clinic in the period from 2011 to 2018. Information from dental records was gathered and tabulated. The frequency of each lesion was determined in relation to the total and its own group of diseases as well as the epidemiological characteristics of the individuals. A total of 106 diagnoses from 105 patients (mean age 47.5 years) were evaluated, being the majority of them female (68 individuals - 64.8%) and white (67 individuals - 63.8%). In relation to the groups of diseases, epithelial or mesenchymal benign neoplasms (35 cases - 33%) were the most representative, followed by nonneoplastic proliferative processes (30 cases - 28.3%). Regarding the diagnoses, 25 different ones were observed, in which fibroma (30 cases - 28.3%) and inflammatory fibrous hyperplasia (22 cases - 20.8%) were more prevalent. No malignant pathology was found. To describe the epidemiological profile of a population can often facilitate diagnoses, besides assisting in the implementation of preventive measures and in the definition of graduate and post-graduate courses' scope(AU)


Subject(s)
Stomatognathic Diseases/pathology , Mouth Mucosa/injuries , Mouth Mucosa/pathology , Biopsy , Stomatognathic Diseases/epidemiology
19.
Rev. Assoc. Med. Bras. (1992) ; 65(3): 330-332, Mar. 2019. graf
Article in English | LILACS | ID: biblio-1003036

ABSTRACT

SUMMARY Vitiligo is the most common depigmenting, chronic acquired disease of the skin and mucosa. However, vitiligo of an unclassified type and mucosal subtype affecting only one area of the mucosa is considered quite uncommon. The diagnosis of vitiligo, regardless of its type, is clinical. Nonetheless, a device that allows the visualization of the tissue fluorescence may be useful for confirming the diagnosis. We present the use of wide-field optical fluorescence device for complementary examination and diagnosis of unusual cases of mucosal vitiligo located only in angles of the mouth.


RESUMO O vitiligo é a doença crônica adquirida despigmentante mais comum da pele e/ou da mucosa. Entretanto, o vitiligo do tipo não classificado e subtipo de mucosa afetando apenas uma área da mucosa é considerado bastante incomum. O diagnóstico de vitiligo, independentemente do seu tipo, é clínico. No entanto, o uso de um dispositivo que permite a visualização da fluorescência tecidual pode ser útil para a confirmação do diagnóstico de vitiligo. Apresentamos o uso do dispositivo de exame complementar de fluorescência óptica de campo amplo para o diagnóstico de um caso incomum de vitiligo de mucosa localizado apenas em ângulos da boca.


Subject(s)
Humans , Male , Vitiligo/diagnostic imaging , Optical Imaging/methods , Mouth Diseases/diagnostic imaging , Mouth Mucosa/diagnostic imaging , Vitiligo/pathology , Optical Imaging/instrumentation , Fluorescence , Middle Aged , Mouth Diseases/pathology , Mouth Mucosa/pathology
20.
Braz. j. otorhinolaryngol. (Impr.) ; 85(1): 11-16, Jan.-Feb. 2019. tab, graf
Article in English | LILACS | ID: biblio-984044

ABSTRACT

Abstract Introduction: Oral verrucous carcinoma is a special form of well-differentiated squamous cell carcinoma which possesses specific clinical, morphologic and cytokinetic features that differ from other types of oral cancers and hence diagnosis requires immense experience in histopathology. Hence it is certainly important to distinguish such a lesion from other oral tumors as treatment strategies vary widely between them. Objective: In search of a critical diagnostic marker in distinguishing oral verrucous carcinoma from oral squamous cell carcinoma, Notch4 receptor, one of the key regulatory molecules of the Notch signaling family has been aberrantly activated in the progression of several types of tumors. However its function in oral verrucous carcinoma remains unexplored. Thus the present study aims in determining the differential expression pattern of Notch4 in oral verrucous carcinoma and oral squamous cell carcinoma. Methods: Ten patients reported positive for oral cancer (5 patients with oral verrucous carcinoma and 5 patients with oral squamous cell carcinoma). Five normal tissue samples were also obtained and evaluated for clinicopathological parameters and immunohistochemistry, western blotting and real time polymerase chain reaction for Notch4 expression. Results: Our results reveal that the expression of Notch4 was considerably high in oral squamous cell carcinoma lesions compared to normal tissue, whereas in oral verrucous carcinoma, irrespective of the clinicopathological features, complete regulação descendente of Notch4 was observed. Conclusions: These preliminary findings strongly support the fact that Notch4 is downregulated in oral verrucous carcinoma and could be considered as a suitable prognostic marker in distinguishing oral verrucous carcinoma from oral squamous cell carcinoma. This distinguishing marker can help in improving therapeutic options in patients diagnosed with oral verrucous carcinoma.


Resumo Introdução: O carcinoma verrucoso de cavidade oral é uma forma especial de carcinoma de células escamosas bem diferenciada que tem características clínicas, morfológicas e citocinéticas específicas que diferem de outros tipos de cânceres orais. Por essa razão, o diagnóstico requer grande experiência em histopatologia. Portanto, é certamente importante distingui-lo de outros tumores orais, pois as respectivas estratégias de tratamento variam muito. Objetivo: Em busca de um marcador de diagnóstico crítico na distinção entre o carcinoma verrucoso e o carcinoma de células escamosas de cavidade oral, o receptor Notch4, uma das principais moléculas reguladoras da família de sinalizadores Notch, foi ativado de maneira anormal na progressão de vários tipos de tumores. No entanto, sua função no carcinoma verrucoso permanece inexplorada. Assim, o presente estudo tem como objetivo determinar o padrão de expressão diferencial de Notch4 no carcinoma verrucoso e de células escamosas de cavidade oral. Método: Dez pacientes tiveram resultado positivo para câncer oral (cinco pacientes com carcinoma verrucoso e cinco pacientes com carcinoma de células escamosas) e cinco amostras normais foram também obtidas. Além da avaliação dos parâmetros clínico-patológicos, foram feitos análise imuno-histoquímica, Western Blot e reação de polimerase em cadeia em tempo real para a expressão de Notch4. Resultados: Nossos resultados revelam que a expressão de Notch4 foi consideravelmente alta em carcinomas de células escamosas em comparação com os tecidos normais, enquanto que no carcinoma verrucoso, independentemente das características clínico-patológicas, observou-se regulação descendente completa de Notch4. Conclusão: Esses achados preliminares apoiam fortemente o fato de que Notch4 estava regulado para baixo no carcinoma verrucoso oral e poderia ser considerado um marcador prognóstico adequado para distinguir entre carcinoma verrucoso e carcinoma de células escamosas de cavidade oral. Esse marcador distintivo pode ajudar a melhorar as opções terapêuticas em pacientes com diagnóstico de carcinoma verrucoso oral.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Mouth Neoplasms/pathology , Carcinoma, Squamous Cell/pathology , Carcinoma, Verrucous/pathology , Receptor, Notch4/analysis , Prognosis , Reference Values , Mouth Neoplasms/chemistry , Immunohistochemistry , Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/chemistry , Biomarkers, Tumor/analysis , Down-Regulation , Blotting, Western , Carcinoma, Verrucous/diagnosis , Carcinoma, Verrucous/chemistry , Reverse Transcriptase Polymerase Chain Reaction , Diagnosis, Differential , Mouth Mucosa/pathology
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