High-frequency Ultrasound in the Assessment before and after Applying HArmonyCa™.

AIM: To describe a clinical case of ultrasound (US) used to evaluate, before, post-immediately, and after 4 months, the facial application of a volumizing and biostimulating substance. BACKGROUND: Detecting the behavior of injected filler materials with high-frequency US-guided application is the future of natural facial rejuvenation with more predictable and satisfactory results. TECHNIQUE: A patient indicated for orofacial harmonization (OFH) procedures through volumizing and biostimulating material application was invited to participate. The technique was performed by applying HArmonyCa™ (Allergan Aesthetics, Irvine, CA, USA) in the gonial, preauricular, and bilateral lateral zygomatic angle regions. The first evaluations used the US images before and after product application with a Logiq e® high-frequency US device (GE Healthcare, Chicago, IL, USA) with a probe/linear transducer of 18 MHz. About 4 months after the procedure, a new assessment with the same initial acquisition pattern was performed. The first evaluation showed normal-looking anatomical structures without the esthetic material. Immediately after the procedure and 4 months later, the assessments presented semi-permanent esthetic fillers as dispersed lobulated hyperechogenic areas with a cloud aspect. CONCLUSION: High-frequency US was efficient in the static evaluation of HArmonyCa™ behavior on the facial skin. CLINICAL SIGNIFICANCE: The US-guided application of injectable products in specific areas has minimal side effects and contributes to more predictable and satisfactory results. How to cite this article: Gouveia RSA, Tostes LLL, Bezerra FV, et al. High-frequency Ultrasound in the Assessment before and after Applying HArmonyCa™. J Contemp Dent Pract 2024;25(1):10-14.

Low-level Laser Therapy in the Management of Oral Mucositis Induced by Radiotherapy: A Randomized Double-blind Clinical Trial.

AIM: The present study evaluated the effect of LLLT at red and infrared wavelengths associated with therapeutic measures from the Mucositis Study Group of the Multinational Association of Supportive Care of Cancer and International Society of Oral Oncology (MASCC/ISOO) for preventing and treating RT-induced oral mucositis (OM). MATERIALS AND METHODS: For the study, 80 subjects diagnosed with head and neck cancer (HNC) undergoing treatment were randomized into three groups to apply different photobiomodulation protocols for 42 days, as follows: Group I-LLLT of 660 nm; Group II-LLLT of 810 nm; and Group III-association of wavelengths of 660 and 810 nm. The treatments were performed by properly trained professionals and with equipment calibrated for the intervention. RESULTS: Different OM scores were noted for the groups studied, and the third group had lower scores than Groups I and II (p = 0.012). No difference was noted in the pain score analyzing the groups (p = 0.49). CONCLUSION: The LLLT was effective for OM lesions in individuals treated with radiotherapy associated or not with chemotherapy. When combined, the red and infrared lasers reduce OM scores. CLINICAL SIGNIFICANCE: OM is one of the main adverse effects of antineoplastic therapy in head and neck cancer patients. The evidence supporting the validity of LLLT for OM can improve patients' quality of life.

Evaluation of the Genotoxicity of Tobacco and Alcohol in Oral Mucosa Cells: A Pilot Study.

AIM AND OBJECTIVE: To define the genotoxic potential of tobacco and alcohol in the oral mucosa through a micronuclei (MN) test. MATERIALS AND METHODS: Samples of exfoliative cells from oral mucosa were collected using superficial scraping of the right- and left-cheek mucosa of 83 patients divided into four groups, namely: (G1) 24 individuals abstaining from tobacco and alcoholic beverages; (G2) 23 individuals who smoke and abstain from alcoholic beverages; (G3) 24 smokers and alcoholics; and (G4) 12 individuals who consume alcohol and abstain from tobacco. The samples were stained with Giemsa-Wright, and the frequencies of MN, binucleated cells, and metanuclear changes were recorded in the samples of each group (1,000 cells per patient). RESULTS: Analysis of variance (ANOVA) showed a difference between groups for changes concerning karyorrhexis (p = 0), pycnosis (p = 0.002), karyolysis (p = 0.003), and binucleated cells (p = 0.046). As for the total number of changes, G3, G2, and G4, respectively, were significantly higher than G1. CONCLUSION: It is suggested that the influence of smoking and drinking on exfoliating cells of oral mucosa may cause metanuclear changes due to genetic changes that these products cause, and the MN test is effective in detecting and monitoring such changes. CLINICAL SIGNIFICANCE: MN test may work for constantly monitoring the oral mucosa of smokers and/or alcoholic patients, so that early cell changes may be diagnosed, preventing the genesis of oral cancer.

Evaluation of a Series of Overdentures Made in a Higher Education Dental Institution in Southern Brazil.

AIM AND OBJECTIVE: This study aimed to evaluate the epidemiological profile, oral health self-perception index, and level of satisfaction of users of complete implant-supported overdentures that had been used for at least 1 year and were made at the School of Dentistry of the University of Passo Fundo, Rio Grande do Sul, Brazil (FO/UPF), between 2014 and 2019. MATERIALS AND METHODS: The sample consisted of 30 patients with overdentures, who were selected from the dental records filed at the institution. Data on general health and the dental implants involved (brand, type of prosthetic connection, number of implants, and additional overdenture retention system) were collected from the medical records. The 30 patients were invited to answer the Oral Health Impact Profile-14 (OHIP-14) and visual analog scale (VAS) questionnaires, and due to the coronavirus disease 2019 pandemic, it was possible to contact 15 patients. RESULTS: Most of the prostheses studied were mandibular overdentures, and 66.66% of the cases were retained by the O-ring system. As for the oral health self-perception of the individuals, it was concluded that male patients had a lower mean overall score (p = 0.047) and functional domain (p = 0.042) in the OHIP-14. The number of implants and the installation arch interfered with functional domain and psychological capacity (p <0.05). The VAS showed that women have greater esthetic satisfaction with prostheses (p = 0.048) and that the bar-clip retention system is more satisfactory than the O-ring (p = 0.017). CONCLUSION: Despite the limitations of overdentures, it was noted that, when properly indicated, they are a viable option for oral rehabilitation on implants. CLINICAL SIGNIFICANCE: Oral rehabilitation well-indicated with overdentures, especially those retained by the bar-clip system, results in an improvement in the patients' quality of life.

Histopathological Classifications of Oral Leukoplakia and its Relation to Cell Proliferative Activity: A Case Series.

AIM: This study relates the average number of nucleolar organizing regions (NORs) obtained in a series of cases of oral leukoplakia, with three methods of histopathological classification of such lesion. MATERIALS AND METHODS: This is a histopathological-histochemical laboratory cross-sectional study. The 18 cases of leukoplakia analyzed were filed at Pathology Service of the Biological Sciences Institute of the University of Passo Fundo, Rio Grande do Sul, Brazil (SDH/ICB/UPF) (2017 and 2018), from which epidemiological data were extracted. New histological sections were performed for impregnation by the argyrophilic nucleolar organizer regions (AgNOR) technique. The histopathological slides were analyzed by photon microscopy (1,000×), and the nuclei of 100 epithelial cells were photographed to count the number of NORs. Three methods were used for the lesions' histopathological classification [World Health Organization (WHO), Brothwell, and binary system]. The means of NORs were compared with the three histopathological classifications by means of the t or analysis of variance (ANOVA) statistical tests, at a significance level of 5%. RESULTS: According to the WHO classification method, most cases (11-61.1%) had a moderate classification. Evaluations by the Brothwell method showed moderate and mild classification in 50 and 38.9% of cases, respectively. According to the binary system, most cases (10-55.6%) had low risk. The average NORs found in 100 nuclei of each of the 18 lesions ranged from 2 to 4. When crossing the average NORs with the histopathological classification methods of the lesions by means of the t test or ANOVA, no significant relationship was noted. CONCLUSION: The average of NORs is not associated with the histological classifications of leukoplakias. Thus, the AgNOR method should be used with caution when differentiating different histological grades of leukoplakias. CLINICAL SIGNIFICANCE: The AgNOR method should be used with caution to determine the clinical treatment of oral leukoplakias, since no agreement was observed between this method and the histopathological classifications available for such lesion.

Oral Lesions found in a Dental School in Southern Brazil.

OBJECTIVE: This study aimed to perform an epidemiological survey of the cases of oral lesions diagnosed in a Brazilian dental school. MATERIALS AND METHODS: An epidemiological survey was carried out at the Faculty of Dentistry of the University of Passo Fundo (FOUPF), Rio Grande do Sul, Brazil, between March 2015 and June 2017, characterizing the patients in terms of gender, age, and ethnicity. A total of 3,200 records were evaluated, from which 716 presented information on oral lesions diagnosed and treated at the clinics of the FOUPF. The data were evaluated by descriptive statistics of frequency. RESULTS: The most frequent change was the coated tongue (13.83%). The majority of the patients were female (56%), white (31.57%), in the sixth decade of life (21.65%). Regarding the classification of lesions, the most frequent group was developmental changes (25%). CONCLUSION: It is considered that the sample studied presented a significant index of oral lesions and normality changes, considering that 716 (22.38%) patients studied showed some type of change in the oral cavity. CLINICAL SIGNIFICANCE: The sample studied presents peculiar characteristics regarding the number of oral lesions/conditions diagnosed. It is also considered that Schools of Dentistry are valuable environments for carrying out epidemiological surveys in stomatology, providing the diagnostic exercise, as long as the students are stimulated for this purpose.

Evaluation of Cellular Proliferative Activity in Patients with Actinic Cheilitis through Silver-stained Nucleolar Organizer Region Method.

Introduction: Actinic cheilitis (AC) is a lesion potentially malignant that affects the lips after prolonged exposure to solar ultraviolet (UV) radiation. The present study aimed to assess and describe the proliferative cell activity, using silver-stained nucleolar organizer region (AgNOR) quantification proteins, and to investigate the potential associations between AgNORs and the clinical aspects of AC lesions. Materials and methods: Cases diagnosed with AC were selected and reviewed from Center of Histopathological Diagnosis of the Institute of Biological Sciences, Passo Fundo University, Brazil. Clinical data including clinical presentation of the patients affected with AC were collected. The AgNOR techniques were performed in all recovered cases. The different microscopic areas of interest were printed with magnification of *1000, and in each case, 200 epithelial cell nuclei were randomly selected. The mean quantity in each nucleus for NORs was recorded. One-way analysis of variance was used for statistical analysis. Results: A total of 22 cases of AC were diagnosed. The patients were aged between 46 and 75 years (mean age: 55 years). Most of the patients affected were males presenting asymptomatic white plaque lesions in the lower lip. The mean value quantified for AgNORs was 2.4 ± 0.63, ranging between 1.49 and 3.82. No statistically significant difference was observed associating the quantity of AgNORs with the clinical aspects collected from the patients (p > 0.05). Conclusion: The present study reports the lack of association between the proliferative cell activity and the clinical aspects observed in patients affected by AC through the quantification of AgNORs. Clinical significance: Knowing the potential relation between the clinical aspects of AC and the proliferative cell activity quantified by AgNORs could play a significant role toward the early diagnosis of malignant lesions in the clinical practice. Keywords: Actinic cheilitis, Proliferative cell activity, Silver-stained nucleolar organizer regions.

Most Frequent Oral Lesions in Patients with Type 2 Diabetes Mellitus.

AIM: Type 2 diabetes mellitus (DM2) is a chronic disease caused by the underproduction of insulin in the organism and it is considered a risk factor to periodontal disease. MATERIALS AND METHODS: This study performed a cross-sectional research on the main oral changes in patients with DM2 and nondiabetics, in Passo Fundo, Rio Grande do Sul, Brazil. The sample included 116 patients examined at the Diabetes Outpatient Clinic of the School of Medicine of the University of Passo Fundo (UPF) and 134 nondiabetic patients examined at the Examinations, Triage, and Emergency Sector of the School of Dentistry of UPF. Inclusion criteria for the study were patients over 35-years old, diagnosed with DM2 for more than 2 years. The same criteria were used for the control group, except for the presence of diabetes. Data collected were analyzed by Statistical Package for the Social Sciences 18.0 for Windows™ software and the Chi-square test at 5% significance. This study showed that, overall, oral lesions were more prevalent in diabetic patients. RESULTS: The stomatological manifestations observed more frequently in such patients were pseudomembranous candidia-sis, lichen planus, lingual varices, xerostomia, and prosthetic stomatitis (p > 0.001). CONCLUSION: Therefore, based on the sample investigated, it is concluded that patients with DM2 present higher prevalence of oral lesions when compared with nondiabetics. CLINICAL SIGNIFICANCE: It is important for the dentist to know about oral lesions because they may allow either early diagnosis in patients unaware of this condition or help diagnosing a potential decompensation. Moreover, oral lesions may represent a potential gateway for infectious agents, and the dentist may restrain this condition by performing treatment as early as possible.

Influence of Age on Factors associated with Peri-implant Bone Loss after Prosthetic Rehabilitation over Osseointegrated Implants.

INTRODUCTION: To verify the influence of age on factors associated with peri-implant bone loss after prosthetic rehabilitation over osseointegrated implants. MATERIALS AND METHODS: This is an analytical, observational, and longitudinal study with initial 23 participants. Patients presenting with osseointegrated implants with their respective prostheses installed were included, and they could be carriers of chronic and degenerative diseases, such as diabetes, osteoporosis, hypothyroidism, cardiovascular disease (CVD), and systemic arterial hypertension. Thus, 18 participants with 57 implants were selected and followed up from 2009 to 2013. For statistical analysis, chi-square or Fisher's exact test was used for the association of systemic conditions and bone loss. Student's t-test was used for mean comparisons of age and number of total upper and lower implants. RESULTS: The average age of the sample studied was 71.05 years (65-80). The average implant per person was 3.2. Smoking had an influence on both mesial and distal bone loss, and the latter was significant (p = 0.0370). The association between bone loss and gender was also significant (p < 0.05). Moreover, male gender and upper implants were factors significantly associated with bone loss. The systemic conditions, when isolated, did not have significant influence on implant survival. CONCLUSION: Age is not a factor that, alone, contraindicates implant-rehabilitating therapy. On the contrary, smoking has a significant influence on dental implant survival. Systemic diseases, such as osteoporosis, hypothyroidism, diabetes, hypertension, and heart diseases, when controlled, are not contraindication factors. CLINICAL SIGNIFICANCE: This study is relevant for assessing peri-implant bone loss in elderly patients, right after implant installation and over time. Therefore, it was possible to verify that age is not a limiting factor for this procedure. Controlled systemic diseases do not contraindicate implant installation, but smoking is a factor that affects implant survival.