Diode laser on excision of giant peripheral odontogenic myxoma: a rare case report and literature review.

It was to report a rare case of peripheral odontogenic myxoma removed with high-power diode laser and to do an extensive review of studies of odontogenic cysts and tumors treated with high-power laser (HPL). This is a rare case of a 63-year-old male patient with a peripheral odontogenic myxoma measuring approximately 10 cm in the attached gingiva region of tooth 16 removed with a high-power diode laser (808 nm, 3 W, in continuous mode, under constant suction, with 400-µm optical fiber). A literature review was also carried out looking for articles that involved the use of HPL in the treatment of odontogenic cysts and tumors, without restriction of year or language. In the present case, there was no need for suturing, no postoperative discomfort, and minimal bleeding during the procedure. In a 12-month follow-up period, there were no signs of recurrence. Only two cases of intra-osseous odontogenic myxomas treated with HPL and 10 cases involving other odontogenic cysts and tumors were found. All studies showing HPL to be effective in treating these lesions. Despite the different types of lasers used and different parameters, it is observed that lasers are effective in the treatment of odontogenic lesions.

Survival and prognostic factors in patients with oral squamous cell carcinoma / Supervivencia y factores pronósticos en pacientes con carcinoma oral de células escamosas

Background: This study aimed to evaluate sociodemographic and clinical factors influencing overall survival(OS) in patients with oral squamous cell carcinoma (OSCC).Material and Methods: Medical charts of 547 patients with OSCC from a public hospital in northeastern Brazilseen between 1999 and 2013 were evaluated. Survival analysis was performed using the Kaplan-Meier method.The influence of age, sex, ethnicity, clinical stage, anatomical location, type of treatment, and comorbidities on thepatients’ prognosis was evaluated. Cox proportional hazards regression model was used to identify independentprognostic factors.Results: The 5-year OS was 39%. Multivariate analysis showed that age < 40 years (HR = 2.20; 95%CI: 1.02-4.72)and a single treatment modality (HR = 1.91; 95%CI: 1.37-2.67) were associated with a poor prognosis, while earlyclinical stage resulted in better outcomes (HR = 0.38; 95%CI: 0.25-0.58).Conclusions: OSCC patients in advanced clinical stages, diagnosed at a younger age, and submitted to a singletherapeutic modality have a poorer prognosis.(AU)

Uso de laser de alta potência para remoção de granuloma piogênico em palato: relato de um caso / Use of high power laser to remove piogenic granuloma in the palate: a case report

A laserterapia na área odontológica oferece ao paciente e ao profissional uma alternativa terapêutica em relação a métodos convencionais. O uso do laser de alta potência em procedimentos cirúrgicos apresenta inúmeras vantagens, uma vez que reduz o sangramento durante a diérese, proporciona uma boa visão do campo operatório e torna mais curto e conveniente o tempo do procedimento. O objetivo deste trabalho é relatar um caso de remoção cirúrgica de granuloma piogênico em palato mole com Laser de diodo de alta potência. A paciente do sexo feminino com 75 anos foi encaminhada à Clínica Escola de Odontologia com lesão em palato, com hipótese diagnóstica de granuloma piogênico. O tratamento de escolha foi a exérese da lesão com o Laser de diodo Thera Lase surgery (DMC equipamentos, São Carlos/SP, Brasil) 808nm, meio ativo de Gallium-Indium-Arsenide (InGaAs), 3500mW, 4J e frequência contínua, a amostra foi encaminhada para o Laboratório de Histopatologia oral para análise histopatológica, sendo confirmado como granuloma piogênico fibrosado. O Laser cirúrgico utilizado foi eficaz na excisão da lesão, permitindo excelente hemostasia, acesso cirúrgico à lesão e fácil manuseio, não ocorrendo intercorrências trans- e/ou pós-operatórias. Após 3 anos de acompanhamento periódico, não houve recidiva da lesão... (AU)

Laser therapy in the dental field offers the patient and the professional an alternative to conventional methods. The use of high-powered laser in surgical procedures has numerous advantages, since it reduces bleeding during the incision, provides a good view of the operative field, the procedure time becomes shorter and more convenient. The objective of this work is to report a case of surgical removal of pyogenic granuloma in the soft palate with a high-power diode laser. The 75 year old female patient was referred to the Dental School Clinic with a palate lesion, with a diagnostic hypothesis of pyogenic granuloma. The treatment of choice was the excision of the lesion with the Thera Lase surgery diode laser (DMC equipment, São Carlos / SP, Brazil) 808 nm, active medium Gallium-Indium-Arsenide (InGaAs), 3500mW, 4J and continuous frequency, the sample was sent to the Oral Histopathology Laboratory for histopathological analysis, being confirmed as fibrous pyogenic granuloma. The surgical laser used was effective in excising the lesion, hemostasis was satisfactory, handling was practical, easy access to the area to be excised, there was no intraoperative complication and no postoperative complications were reported. The patient after about 3 years of periodic follow-up is healthy and has no recurrence of the lesion... (AU)

Epidemiological profile of young patients with squamous cell carcinoma in northeast Brazil.

AIM: The aim of the present study was to delineate the epidemiological profile of young patients with squamous cell carcinoma (SCC) treated at a healthcare service in northeastern Brazil. METHODS: A cross-sectional study was performed involving the quantitative analysis of 51 medical records from patients diagnosed with SCC between 1998 and 2013. All patients aged ≤50 years were included in the study. Statistical analysis involved Pearson's χ2 -test, Fisher's exact test, and the Mann-Whitney U-test, with the level of significance set at 5% (P < .05). RESULTS: The mean age was 46 ± 7.94 years, and males accounted for 80.4% of the sample. The tongue was the most affected site (37.3%). Most tumors were classified as stage III (26.3%) or IV (42.1%). Surgery associated with chemotherapy was the most common therapeutic approach (39.3%). Female patients had a lower mean age (P = .013) and less advanced clinical staging (P = .022). Smoking was more associated with male sex (P = .043). CONCLUSION: SCC in young patients is more common in males aged 46 ± 7.94 years, with the tongue being the most affected anatomic site. Important differences were found in clinical-epidemiological features between young men and women.

Prospective evaluation of quality of life in patients with head and neck cancer.

OBJECTIVES: This study aimed to evaluate, prospectively, the quality of life of patients with head and neck cancer. STUDY DESIGN: A quantitative, longitudinal, and prospective study was conducted. The survey instrument was the University of Washington quality of life questionnaire. The sample consisted of 47 patients. For data analysis, paired t test, McNemar test, Student t test, and 1-way analysis of variance tests were used. The significance level was 5% (P < .05). RESULTS: Mood (68.89 ± 35.41) and anxiety (70.22 ± 32.99) domains were the most affected at the time of diagnosis. Chewing (71.11 ± 39.15) and speech (76.22 ± 33.72) domains were the most affected in the revaluation of the questionnaire, after 3 months. In the temporal assessment of the domains at diagnosis and after 3 months, it was observed that domains that improved quality of life were pain (P = .013) and mood (P = .039). Swallowing (P = .017), chewing (P = .024), speech (P = .048), and saliva (P = .004) domains produced a worse quality of life. CONCLUSIONS: The parameters that influence quality of life differ when the the University of Washington quality of life questionnaire is applied at the time of diagnosis and 3 months after diagnosis.

Quality of Life of Paediatric Oncology Patients

Objective: To evaluate the indicators of quality of life (QoL) of children and adolescents with cancer and to evaluate the QoL of participants regarding oral health. Material and Methods: The modified Autoquestionnaire Qualité de Vie Enfant Imagé (AUQEI), with scores ranging from 0 to 78 and a cut-off value of 48, was the instrument used in this study. Questions were added regarding oral health, with scores ranging from 0 to 18. The study consisted of two groups: group 1 (case) consisted of 24 children and adolescents with cancer, and group 2 (control) consisted of 30 healthy children and adolescents aged 6 to 15 years old. A chi-square test was performed using the SPSS program, version 18.0, to determine whether health conditions were related to QoL. Results: We observed that 69.25% of participants had scores representing a satisfactory QoL, with a mean score of 54.3 (51.7 for the group of children and adolescents with cancer and 56.5 for the healthy group). The results of the present study showed a value of p=0.016, suggesting that the disease condition is related to lower QoL scores. The Mann-Whitney test showed that the healthy group showed significantly better indicators in the oral health domain. Conclusion: The children and adolescents under study showed satisfactory overall QoL standards; however, when comparing the cancer group to the healthy group, we observed that cancer is associated with lower QoL indicators.

Neoplasias de Glândulas Salivares: Estudo Retrospectivo de 134 casos numa população do Nordeste do Brasil / Salivary gland neoplasms: a retrospective study of 134 cases in a population from the northeast of Brazil

Objetivo: determinar a prevalência de neoplasias das glândulas salivares diagnosticadas no Hospital Dr. Napoleão Laureano, em João Pessoa-PB. Metodologia: Realizou-se um estudo retrospectivo dos laudos emitidos entre 1996 e 2003. Resultados: Cento e trinta e quatro casos recuperados dos arquivos foram considerados para análise, 94 (70,1%) benignos e 40 (29,9%) malignos. Os pacientes apresentavam idades entre 9 e 97 anos (média de 44,7), sendo que a maioria estava na faixa etária de 50 a 59 anos (25,2%). As formas malignas foram mais frequentes na sexta década (11%), e as benignas, na quinta década (15,4%). Noventa e um pacientes (67,1%) eram mulheres, e houve predominância feminina para as neoplasias benignas (74,5%) e malignas (52,5%). Na parótida, ocorreram 76 casos (60,3%), sendo 63 (82,8%) benignos e 13 (17,2%) malignos. O adenoma pleomórfico foi o mais comum dos tumores benignos (83%), enquanto o carcinoma adenoide cístico prevaleceu entre os malignos (60%). Conclusão: Mulheres na faixa etária entre 40 e 60 anos foram as mais acometidas por tumores de glândulas salivares, que se configuraram, principalmente, como adenomas pleomórficos, dentre os benignos, e como carcinomas adenoides císticos, dentre os malignos, tendo sido a glândula parótida a mais afetada.

Aim: The aim of this study was to analyze the prevalence of salivary gland neoplasms diagnosed at Dr. Napoleão Laureano Hospital in João Pessoa-PB. Methods: The case files of patients diagnosed with salivary gland neoplasms between 1996 and 2003 were reviewed. Results: One hundred and thirty-four cases retrieved from the files were considered for analysis. Ninety-four neoplasms (70.1%) were benign and 40 (29.9%) were malignant. The patients' ages ranged from 9 to 97 years (mean, 44.1 y), and the largest proportion (25.2%) was in the 50-59 y age group. The malignant forms were most frequent in those aged 50-59 y and the benign ones in those aged 40-49 y. Ninety-one patients (67.9%) were women, with a female predominance for both benign (74.5%) and malignant (52.5%) neoplasms. The majority (82.9%) of the 76 tumors located in the parotid glands were benign. Pleomorphic adenoma was the most common benign neoplasm (83%), while adenoid cystic carcinoma was the most prevalent malignant one (60%). Conclusion: Women aged between 40 and 60 years were the most affected by salivary gland tumors, particularly pleomorphic adenomas among the benign ones and adenoid cystic carcinomas among the malignant ones, the parotid being the most affected gland.

Líquen plano oral em paciente jovem: relato de caso / Oral lichen planus in a young patient: case report

Objetivo: o presente trabalho teve o objetivo de relatar um caso incomum de líquen plano oral em paciente jovem. Relato de Caso: paciente do sexo masculino, leucoderma que procurou diagnóstico diante da queixa de "feridas embaixo da língua, bochechas e no lábio inferior". Ao exame clínico evidenciaram-se múltiplas lesões eritematosas com estrias esbranquiçadas de aspecto reticulado, e lesões ulceradas e placas leucoplásicas localizadas em ambos os lados da mucosa jugal, região retromolar e gengiva inserida e língua. Não havia relato de lesões semelhantes na derme. A hipótese clínica foi de líquen plano oral, a qual confirmou-se após biópsia incisional de uma das lesões. O exame anatomopatológico confirmou a suspeita clínica de líquen plano oral onde foram evidenciadas características microscópicas típicas. Após 45 dias com tratamento convencional a base de corticóides, observou-se regressão parcial das lesões em gengiva inserida e mucosa jugal esquerda. O paciente foi encaminhado para tratamento com dermatologista e encontra-se sob proservação. Conclusão: apesar da falta de consonância com a literatura, o líquen plano oral pode ser verificado em pacientes jovens, do sexo masculino e afetando múltiplos locais da mucosa oral. O aumento do nível de estresse, entre outras condições inerentes ao cotidiano dessa faixa etária, pode estar relacionado ao aparecimento de líquen plano oral em pacientes jovens.

Objective: the presented paper aims to report a lichen planus case in a young patient. Case report: white male patient which was referred to an Oral Medicine Service of a Public University, with the main complaint of sore lesions underneath of the tongue and low lip. Intraoral examination revealed multiples erythemous lesions with a white lace-like pattern on buccal mucosa, and both some ulcerations' areas and leukoplastic plaques located on the tongue, bilateral involvement of buccal mucosa, retromolar trigone and attached gingivae. Based on the clinical findings, the case was diagnosed as oral lichen planus, which was confirmedafter incisional biopsy of the tongue. The histopathologic examinations revealed typical features of lichen planus. The conventional treatment with topic corticosteroid did not resulted in regression of the lesion through 45 days. The patient was referred to a Dermatologist and is underpreservation. Conclusion: Despite the lesion in question might not represent an incidence range of oral lichen planus, it can be found as well as a multiples lesion and the conditions can affects young patients and men. The increase of stress level and another's conditions typical of the teenagers' environment and life stile may explain the oral lichen planus occurrence in young people.

Informação e comportamento de cirurgiões-dentistas do Programa Saúde da Família de Aracaju a respeito de câncer bucal / Knowledge and behavior of the dentists of the Family Health Program of Aracaju regarding oral cancer

Introdução: O câncer bucal no Brasil ainda apresenta altos níveis de incidência e prevalência, com baixa taxa de sobrevida, devido principalmente ao retardo no diagnóstico. Aumentar o conhecimento dos profissionais de saúde sobre essa doença é uma importante ação na reversão deste quadro epidemiológico. Objetivo: Identificar o nível de informação e de comportamento preventivo que os cirurgiões-dentistas do Programa Saúde da Família de Aracaju/SE possuíam a respeito de câncer bucal. Métodos: Foram realizadas entrevistas estruturadas com 47 cirurgiões-dentistas do Programa Saúde da Família, utilizando-se roteiro de entrevista construído para este fim. Resultados: Esses profissionais desconheciam ou possuíam informações inadequadas sobre lesões cancerizáveis e tipo histológico de câncer bucal mais prevalente. No entanto, forneceram informações corretas sobre localização, apresentação clínica, fatores de risco e ações para prevenção/diagnóstico precoce do câncer bucal. Os entrevistados não faziam um exame clínico adequado e não realizavam educação em saúde sobre câncer bucal em mais de 50% dos usuários atendidos por eles. Conclusão: Verificou-se que os cirurgiões-dentistas do Programa Saúde da Família de Aracaju apresentaram médio nível de informação e demonstraram baixo nível de comportamento preventivo sobre câncer bucal.

Introduction: Oral cancer in Brazil still presents high incidence and prevalence levels with low 5-year survival rates, mainly because of the diagnostic delay. Enhance the knowledge of health care professionals regarding oral cancer is an important action to revert this epidemiologic picture. Objective: To identify the level of information and of preventive behavior that dentists of Family Health Care Program of Aracaju regarding oral cancer. Methods: Forty-seven dentists of the Family Health Care Program were interviewed. Results: They ignored or possessed inadequate information about cancerous lesions and histological type of the most prevalent oral cancer. However, they supplied correct information about location, clinical presentation, risk factors and actions for prevention/precocious diagnosis of oral cancer. The dentists did not make an appropriate clinical exam and they did not accomplish to provide proper information about health on oral cancer in more than 50% of the users assisted by them. Conclusions: The dentists of the Family Health Care Program of Aracaju presented medium level of information and demonstrated low level of preventive behavior regarding oral cancer.

A Odontologia e o Programa Saúde da Família: novos desafios e perspectivas / Dentistry and the Family Health Program: new challenges and perspectives

o presente trabalho objetiva abordar, através de revisão da literatura, os desafios e as perspectivas originadas pela inserção da Odontologiano Programa Saúde da Família (PSF). Para tanto, inicialmente procurou-se analisar a origem do Programa, em que contexto, por que e para quem foi criado, seguindo-se de um breve relato sobre o mercado de trabalho odontológico e o paradoxo epidemiológico da situação de saúde bucal da população brasileira. Posteriormente, são discutidas as contradições entre a formação do cirurgiã0-dentista e as exigências do referido Programa, avançando até as perspectivas proporcionadas pelo PSF quanto às oportunidades de emprego por ele criadas, questionando-se a compatibilidade entre a projeção de vagas a serem oferecidas e a quantidade de novos profissionais formados a cada ano. Por fim, procurou-se sintetizar a essência do que se abordou, através da construção de considerações finais acerca da inserção da odontologia no PSF e de suas repercussões sobre as condições de saúde bucal da população, a formação profissional e o mercado de trabalho.

Alterações Estomatológicas Diagnósticadas na Clínica de Odontopediatria / Stomatological Alterations in the Pediatric Dentistry Clinic

Objetivo: Determinar a prevalência de alterações estomatológicas em crianças atendidas na Clínica de Odontopediatria da Universidade Federal da Paraíba - Brasil, no período de julho a outubro de 2002. Material e Métodos: Após obtenção do consentimento livre e esclarecido dos respectivos responsáveis, as crianças foram examinadas por um único profissional e os dados foram anotados em ficha clínica elaborada para essa pesquisa. Lesões cariosas e patologias ósseas foram excluídas, sendo o diagnóstico fundamentado na observação clínica. Resultados: Um total de 151 crianças foi examinado: 67 (44,37 por cento) do gênero masculino e 84 (55,63 por cento) do gênero feminino. O grupo étnico mais prevalente foi o branco (48,34 por cento, n=73) e a maioria das crianças se encontrava entre 7 e 9 anos de idade (62,25 por cento, n=94). Foram diagnosticadas 221 alterações em 115 pacientes (76,16 por cento), sendo as mais freqüentes a pigmentação melânica (30,78 por cento, n=68), a petéquia (14,48 por cento, n=32), a parúlide (9,50 por cento, n=21) e a língua saburrosa (8,60 por cento, n=19). Na análise univariada não houve associação estatisticamente significativa entre a presença de alteração e o gênero (x²=0,140; p>0,05) ou faixa etária (x²=3,118; p>0,05), evidenciando-se tal associação quando se pesquisou o grupo étnico (x²=11,118; p<0,05). Conclusão: As alterações estomatológicas foram frequentes na população estudada e a pigmentação melânica foi a mais prevalente, constatando-se associação significativa à etnia mestiça