The Impact of a Pandemic on a Military Oral and Maxillofacial Pathology Biopsy Service.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) and the resulting societal reaction presented new challenges to the medical community by limiting patient access to care in 2020 and 2021. The Navy Postgraduate Dental School (NPDS) oral and maxillofacial pathology biopsy service is dependent on in-office physician or dentist appointments and patient biopsies. The purpose of this study was to understand the regulatory and societal impacts of COVID-19 restrictions on biopsy service submissions by assessing NPDS biopsy submission quantities and disease distribution. MATERIALS AND METHODS: All NPDS oral and maxillofacial pathology biopsy submissions from calendar years 2015 to 2016 and 2019 to 2021 were evaluated, and patient demographics and biopsy diagnoses were recorded in a biopsy registry. Data collected included age, sex, biopsy site, and diagnosis. Data from 2015, 2016, and 2019 were defined as pre-COVID and 2020 and 2021 as COVID. Biopsy reports for each year were organized in quarters. Diagnoses were categorized as malignant, pre-malignant, or benign. Categorical and continuous data were evaluated and presented as counts with percentages and means or medians with standard deviations, respectively. Significant differences in proportions or means were assessed using chi-square analysis or Student t-test, respectively. Cases were aggregated by quarter and year and assessed for temporal trends using linear regression analysis. RESULTS: The study evaluated 9,351 biopsy submission reports. The annual pre-COVID count mean (± standard deviation) and yearly counts for 2020 and 2021 were 2,063 ± 33.3, 1,421, and 1,742, respectively. The mean (± standard deviation) percentage of diagnoses classified as malignant from pre-COVID, 2020, and 2021 were 2.46 ± 0.005%, 3.59%, and 3.04%, respectively. Case counts and representation as a percentage of all biopsy diagnoses for Human Papillomavirus (HPV)-associated squamous cell carcinoma increased significantly during COVID compared to pre-COVID years (P < .05). CONCLUSIONS: Overall, preventative COVID-19 health measures and protocols resulted in a reduction in biopsy submission frequency, particularly during the second quarter (April to June) of 2020. However, case counts for malignant biopsies remained consistent between pre-COVID and COVID time intervals, suggesting that the identification and analysis of cases requiring follow-on care were unaffected by COVID-19 protocols.

Bibliometric analysis and evaluation of the journal Medicina Oral Patología Oral y Cirugía Bucal (2008-2018)

BACKGROUND: In 2008 the journal Medicina Oral Patología Oral y Cirugía Bucal was included in Journal Citation Reports. To appraise its evolution and current status, this study carried out a bibliometric analysis and evaluation of the journal for the period 2008-2018. MATERIAL AND METHODS: From the Web of Science, Journal Citation Reports we obtained the indicators Journal Impact Factor (JIF), 5-year JIF, JIF without self-cites, Eigenfactor score and Article Influence score (2010-2017); and from the Core Collection database the following variables: number and article types, institutions and countries of origin of the authors (2008-2018), and the variable cited and citing journal data in 2017. Twelve articles/year (n = 132) were randomly selected to gather: the time between submittal and acceptance of an article, number of authors/article, representation of each section, gender of first author, and funding. RESULTS: The journal occupied the third quartile of the JCR from 2010 to 2017, when it moved up to the second quartile. From 2008 to 2018 it published a total of 1,518 documents, 90% articles and 9.5% reviews. Sixty countries were represented, 48.68% of the documents coming from Spain, and overall 1,293 institutions were involved. Between submittal and acceptance of articles, the average time was 134.42 days, without differences between years. The mean of authors/article was 5.15, increasing over time. The sections most represented were Oral Medicine and Pathology, and Oral Surgery. There were no differences regarding the gender of the first author, and in general the authors did not provide information about funding received. CONCLUSIONS: The bibliometric results indicate a steadily improving position of this journal, along with a tendency to reduce self-citation. The time between reception of an article and its acceptance was very stable, the number of authors per article showed an increase, and there was a nearly equal representation of males and females as the first autor

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The Spectrum of Histological Findings in Oral Biopsies

Aim: To undertake a retrospective analysis of the use of a diagnostic pathology service, to determine the source of oral biopsies submitted for histological analysis, and to examine the range and frequencies of histologically diagnosed oral lesions in an Irish population. Methods: A retrospective analysis was carried out on all oral biopsies submitted for histological analysis to an oral and maxillofacial diagnostic pathology service from June to December 2015. Results: In total 724 oral biopsies were submitted. The majority of diagnoses were benign (80.3%) and the remaining diagnoses were made up of malignancies (6.7%) and potentially malignant disorders (PMDs), histologically characterised by epithelial dysplasia (13%). Less than 1% of biopsies were submitted from general dentists in primary care. Conclusion: This study showed that oral biopsies are not submitted from the primary care setting, but rather from hospital-based specialist units or referral-based specialist practitioners. There was a broad range of histological diagnoses, the majority of which were benign.

A retrospective study of 51,781 adult oral and maxillofacial biopsies.

BACKGROUND: Few studies have compared patient and anatomic characteristics across the broad scope of oral and maxillofacial disease seen in dental clinics. The authors conducted a study to make these comparisons by surveying a large sample of histologically diagnosed oral and maxillofacial lesions in a US adult population. METHODS: A total of 51,781 specimens biopsied from 51,781 adult patients were received by an oral pathology service over 13 years (2001-2015) and analyzed. A description of patients' sex and age at diagnosis, as well as the anatomic site of biopsy was given for diagnoses of 10 oral disease types, including malignant neoplasm, benign neoplasm, infectious, reactive, potentially malignant, developmental, healthy tissue, immune dysfunction, physical trauma, and other. RESULTS: The authors reported reactive lesions were the most prevalent disease type found in the sample (74.9%). Malignant diagnoses comprised 1.97% of all biopsies. The 3 most prevalent diagnoses in this study included benign keratosis, chronic apical periodontitis, and radicular cyst. Different anatomic sites, patient age groups, and sexes show different distributions of disease. CONCLUSIONS: Certain disease types and diagnoses were found to have a higher prevalence by sex, among particular age groups, and in certain anatomic sites. PRACTICAL IMPLICATIONS: This information provides clinicians with a detailed and broad scope of the variety of oral and maxillofacial lesions processed at an oral pathology service and may assist practitioners in forming clinical impressions and differential diagnoses.

Análise das patologias bucais e maxilofaciais de uma população brasileira durante um período de 15 anos / Analysis of oral and maxillofacial pathologies of a brazilian population over a period of 15 years

O propósito desta pesquisa foi analisar o banco de dados de diagnósticos histopatológicos de lesões bucais biopsiadas na Clínica Odontológica Universitária da Universidade Estadual de Londrina (UEL) e que estão armazenados no Laboratório de Anatomia Patológica do Hospital Universitário - UEL, no período de 01 de janeiro de 1998 a 31 de dezembro de 2012, correspondendo a 15 anos de pesquisa. A coleta de dados envolveu ano do exame, idade e gênero do paciente, localização anatômica da lesão e diagnóstico histopatológico. Obteve-se 3.991 casos, os quais foram separados em 11 categorias diagnósticas: patologia da mucosa bucal, patologia das glândulas salivares exceto neoplasias, miscelânea, neoplasias benignas incluindo tumores de glândulas salivares, cistos odontogênicos e não odontogênicos, patologia gengival e periodontal, neoplasias malignas, tumores odontogênicos, doenças infecciosas e parasitárias, patologia dental, patologia óssea. A maioria das lesões é de carácter benigno, sendo a hiperplasia fibrosa inflamatória o diagnóstico histopatológico mais prevalente com 38,76% do total, seguida da mucocele (9,8%). As décadas de vida mais acometidas são a 5ª e 6ª e o sítio anatômico mais comumente afetado é o rebordo alveolar. O carcinoma espinocelular representa 81,7% das neoplasias malignas, com uma razão masculino : feminino (M:F) de 6:1, idade média de ocorrência de 55,7 anos e se apresenta mais frequente que a leucoplasia. Tal fato pode sugerir que a falha no reconhecimento, na identificação, na abordagem ou no acompanhamento das leucoplasias pode estar ocorrendo, permitindo que consequências mais sérias, como a transformação maligna destas, ocorra e que o número de carcinomas, desta forma, exceda o número de casos de leucoplasias. A necessidade do diagnóstico precoce do câncer bucal deve novamente ser salientada...

A 10-year study of specimens submitted to oral pathology laboratory analysis: lesion occurrence and demographic features

The purpose of the present paper was to describe the range of lesions histologically diagnosed in an oral pathology laboratory in southern Brazil. A retrospective study of 8,168 specimen analyses recorded between 1995 and 2004 was conducted. The records were retrieved from the Oral Pathology Laboratory, School of Dentistry, Federal University of Rio Grande do Sul, RS, Brazil. A total of 6,831 valid cases (83.63%) were examined. Of these, inflammatory lesions were the most common occurrences (n = 4,320; 63.24%). Benign and malignant tumors accounted for 7.66% (n = 523) and 1.9% (n = 130) of the occurrences, respectively. Significant associations were observed between nonneoplastic proliferative disorders and benign mesenchymal tumors in females, and between squamous cell carcinoma and leukoplakia in males. Most diagnoses were benign in nature and had an inflammatory etiology. The association of some demographic characteristics with the occurrence of lesions suggests that these characteristics should be considered in performing differential diagnoses.

A 10-year study of specimens submitted to oral pathology laboratory analysis: lesion occurrence and demographic features.

The purpose of the present paper was to describe the range of lesions histologically diagnosed in an oral pathology laboratory in southern Brazil. A retrospective study of 8,168 specimen analyses recorded between 1995 and 2004 was conducted. The records were retrieved from the Oral Pathology Laboratory, School of Dentistry, Federal University of Rio Grande do Sul, RS, Brazil. A total of 6,831 valid cases (83.63%) were examined. Of these, inflammatory lesions were the most common occurrences (n = 4,320; 63.24%). Benign and malignant tumors accounted for 7.66% (n = 523) and 1.9% (n = 130) of the occurrences, respectively. Significant associations were observed between nonneoplastic proliferative disorders and benign mesenchymal tumors in females, and between squamous cell carcinoma and leukoplakia in males. Most diagnoses were benign in nature and had an inflammatory etiology. The association of some demographic characteristics with the occurrence of lesions suggests that these characteristics should be considered in performing differential diagnoses.

Analysis of demographic data obtained from pathology records.

INTRODUCTION: Pathologists commonly analyse patient data obtained from pathology records. Such information is useful in that it might provide an indication of changing patterns of disease, or of the aetio-pathogenesis of a disease process, but such data is seldom standardised. AIM: To determine to what extent the lack of standardisation may influence the resultant data and the conclusions drawn. MATERIALS AND METHODS: Pathology reports of all cysts diagnosed from 1994 to 2004 were retrieved. The diagnosis and site of the cyst, and the age, gender and race of patient were analysed. Comparative data from 1958 to 1992 was obtained from the text "Cysts of the oral regions". The data from the different periods was statistically compared. Only the four most common cysts were included: radicular, dentigerous, odontogenic keratocyst and nasopalatine duct cysts. RESULTS: There was no difference in frequency and site of cysts or in age of patients. Statistically significant differences were found in the gender and race comparisons. CONCLUSION: Do the differences reflect a changing pattern of disease or are they due to changes in the demographics of the patient pool from which the surgical specimens were obtained? We favour the latter. Awareness of the fact that data from either survey is not reliable due to lack of standardisation is pertinent to avoid drawing fundamental conclusions from such data.

Patterns of second-opinion diagnosis in oral and maxillofacial pathology.

OBJECTIVES: Several studies have documented the beneficial effect of second opinions in diagnostic pathology. Among disease sites, the head and neck can be a particularly problematic area for pathologists, prompting frequent second opinions. However, the effect of second opinion requests made by physician pathologists (PPs) to oral and maxillofacial pathologists (OMPs) has not been well studied and might identify disease and subsites that pose diagnostic challenges. The objectives of this study were to study the referral patterns of PPs to a referral center for oral and maxillofacial pathology and to assess changes in diagnosis following second opinion. STUDY DESIGN: We retrospectively reviewed 142 consecutive pathology consultation requests over a 2-year period. The submitted report and matched second opinion report were reviewed to extract predetermined demographic, clinical, and pathologic data. Each diagnosis was reviewed to determine if there was agreement, minor disagreement, or major disagreement between the original and the second opinion. RESULTS: The most common diagnostic categories sent for second opinion were dysplasia/carcinoma, odontogenic cysts, and odontogenic tumors. In the 135 cases where agreement could be assessed, there were a total of 46 cases (34.1%) with differences in diagnostic opinion. Minor disagreements occurred in 24 cases (17.8%) and major disagreements in 22 cases (16.3%). Importantly, major disagreements identified here would have resulted in significant differences in patient evaluation and management. CONCLUSIONS: This study supports the positive impact of second-opinion surgical pathology for lesions in the maxillofacial complex and supports the role of OMPs in subspecialty diagnostic pathology.

A retrospective analysis of referral patterns for oral radiologic consultation over 3 years in Ontario, Canada.

OBJECTIVES: To determine the types of practitioners who most commonly refer and the film type and diagnostic entities that are most frequently submitted for oral radiologic consultation in Ontario, Canada. STUDY DESIGN: A total of 430 referral letters and responses from 2 Ontario oral radiologists from 2003 to 2005 were analyzed. Data collected included the specialty of the referring practitioner, the film type(s) submitted, the radiographic density of the entity of interest, and the interpretation by the radiologist. RESULTS: General practitioners (58.9%) and oral surgeons (21.5%) were the most frequently referring practitioner types, representing 1.2% and 17.1% respectively of each group practicing in Ontario. Also, 18.2% of oral pathologists referred. Panoramic radiographs (79.5%) were included in referrals more often than intraoral radiographs (46.0%). Of the entities, 37.0% were radiopacities, 27.4% were radiolucencies, and 13.5% had mixed radiopaque-radiolucent density. The radiologists interpreted normal features (55.6%) most often. CONCLUSION: Panoramic radiographs with normal findings were submitted to oral radiologists for consultation most frequently in Ontario.

Scope of practice, referral patterns and lesion occurrence of an oral medicine service in Australia.

AIM: The purpose of this study was to examine the scope of practice, lesion occurrence and utilisation of referral-based hospital and private practice oral medicine and oral pathology (OMP) services in Australia. MATERIALS AND METHODS: Clinical records of patients referred to a hospital (n=500) and private (nbequals;1104) OMP clinic were audited. For each patient, the following parameters were recorded: age, gender, source of referral, reason for referral, site of lesion/condition if applicable, medical and drug history, diagnostic services utilised, clinical and histopathological diagnoses rendered, medications prescribed and further treatment required. RESULTS: A majority of the referrals were generated by general dental practitioners. The most commonly seen problems were epithelial hyperplasia/hyperkeratosis, oral candidosis, oral lichen planus, xerostomia, recurrent aphthous ulcers and burning mouth syndrome. OMP specialists requested diagnostic imaging for 13% of hospital and 9.42% of private patients, diagnostic biopsies were required for 18.4% of hospital and 19.3% of private patients, blood tests were ordered for 14.4% of hospital and 12.13% of private patients, while medications were prescribed for approximately 36% of hospital and 51% of private patients. CONCLUSIONS: This study is the first to detail the scope of practice, lesion occurrence and utilisation of services offered by OMP specialists in Australia. The demand for OMP services is strong.

Review of oral pathology service, Medlab Dental, University of Otago, 2002-2005.

The School of Dentistry of the University of Otago operates a diagnostic oral pathology service, Medlab Dental, as a joint venture with the private pathology service Medlab South. This report reviews the use of the service in 2005 and provides information on current activities that highlights the importance of oral pathology diagnostic services in patient management.

Efecto de los tratamientos antirretrovirales en las manifestaciones orales de los pacientes VIH+ / Effects of antiretoviral treatments on oral manifestations in HIV+ patients

El presente trabajo es un estudio para valorar el efecto de los tratamientos antirretrovirales en pacientes seropositivos al VIH, visitados en el dispensario de enfermedades infecciosas del Hospital Vall D´Hebron de Barcelona. Se visitaron 90 pacientes, 51 varones (56,7%) y 39 mujeres (43,3%), siendo la edad media de los pacientes de 36,2 años con una desviación de ±17,8 años y una moda de 35 años. Las visitas fueron realizadas desde enero a diciembre del año 1999. Estos pacientes recibían tratamiento antirretroviral de uno o más fármacos y algunos de ellos (32,2% ) estaban sometidos a tratamiento antirretroviral de alta actividad (TAAA). Asimismo, en estos pacientes se valoró el recuento de CD4 y carga viral de forma bimodal, al inicio del proceso y en el momento de la visita. La exploración de la cavidad oral se realizó en este momento, buscando las lesiones asociadas al Sida según la clasificación de Pindborg y cols., de 1989. La patología más prevalente encontrada en este estudio fue la sensación de boca seca o xerostomía en un 47,8%, seguida por orden de frecuencia de policaries (34,4%) y candidiasis eritematosa (31,1%). Otras manifestaciones orales son muy poco frecuentes, en comparación con los resultados de otros autores en la etapa previa a la utilización de los inhibidores de la proteasa (IP). Así, por ejemplo, se observó un solo caso de leucoplasia vellosa, tan característica antes del año 1996 (AU)

We evaluate the effects of antiretroviral treatments in HIV seropositive patients, who were seen in the Clinic for Infectious Diseases in the Vall D´Hebron Hospital, Barcelona. 90 patients were seen, 51 males (56.7%) and 39 females (43.3%), the mean age of the patients was 36.2 years with a deviation of ±17.8, and a mode of 35 years. The visits were carried out between January and December 1999. These patients were receiving antiretroviral treatment with one or more drugs and some of them (32.2%) were subjected to high activity antiretroviral treatment (HAART). Also, in these patients the CD4 count and bimodal viral load was measured, at the start of the disease process and at the time of visit. Theoral cavity was examined at this time, in search of lesions associated with AIDS according to the classification by Pindborg et al, 1989. The most prevalent pathology found in this study was the sensation of dry mouth or xerostomia in 47.8%, followed by, in order of frequency, multiple caries (34.4%) and erythematous candidiasis (31.1%). Other oral manifestations are very rare, in comparison with the results of other authors in the time before the use of protease inhibitors (PI). There is, for example, only one case of leukoplakia, so characteristic before 1996 (AU)

Proyección del estudiante de Patología y Clínica Estomatológica desde el ámbito del claustro de la Facultad al Hospital Público: Registro retrospectivo de las patologías observadas / Projection of oral pathology and clinical stomatology student from faculty class room to public hospital: retrospective analyse of the observed diseases

Estableciendo las bases del proceso Enseñanza/Aprendizaje de la Estomatología para alumnos del último nivel de la currícula de Odontología, y en especial de la Asignatura Patología y Clínica Estomatológica, se ha diseñado este estudio. El mismo se ha llevado a cabo teniendo en cuenta los siguientes Objetivos: 1) La observación del desempeño de los estudiantes en un hospital público, en donde han realizado su trabajo en terreno. 2) Un relevamiento de las lesiones y enfermedades que se han presentado con la observación y guía por el personal docente y la resolución de los casos clínicos. Material y Métodos: los alumnos del nivel quinto de la Asignatura de Patología y Clínica Estomatológica de la Facultad de Odontología de la Plata, año tras año han sido citados, por comisiones pequeñas (no más de 7alumnos por cada una) con el fin de observar y participar de la tarea hospitalaria que realiza un equipo docente de Estomatología dentro del funcionamiento del Servicio de Odontología de un Hospital de Agudos. Se tomaron los datos correspondientes a un tiempo estimado en horas de 1.800 horas paciente/docente-alumno. De 495 pacientes fueron evaluados los datos de edad, sexo, ocupación, estado civil, hábitos y factores ambientales. Se registraron los datos correspondientes a las lesiones y enfermedades y se realizó el análisis estadístico de los mismos. Resultados: 1) Los alumnos demostraron interés y entusiasmo al concurrir a la Unidad Hospitalaria. Este resultado se midió por la cantidad de alumnos que solicitaron poder concurrir al Hospital fuera de las horas de clases en forma voluntaria: 40%. 2) Del estudio del relevo de datos, las micosis superficiales fueron las más prevalentes seguidas por aftas, líquenes atípicos y carcinomas a células escamosas. Conclusiones: 1) Se observa que el Hospital docente asistencial pareciera brindar al mecanismo de Enseñanza/Aprendizaje, la posibilidad de insertar al alumno en la realidad de la salud pública del medio ambiente al cual pertenece. 2) Las demás especialidades, integradas al Servicio de Odontología/Estomatología, permitirían una acción en conjunto del equipo sanitario, por un fenómeno de retroalimentación. 3) Coincidiendo con otros datos de diversos Servicios Asistenciales y otras Facultades del país, la Candidiasis oral resultó la lesión más frecuentemente observada. 4) La incidencia de Cáncer bucal nos lleva a insistir sobre su diagnóstico temprano y la importancia del reconocimiento de las enfermedades precancerosa y establecer estrategias contra el hábito del tabaquismo, en nuestro medio de referencia (AU)

This study was designed in order to establish basement of Teaching/Learning process in Stomatology, for students of the last step of Curricula in Odontology and, very specially for Patology and Stomatological Clinic’ attenden. Objectives were: 1) Observation of students behaviour in a public hospital, were it takes place, their «work in situ». 2) To stand out diagnosticated lesions and diseases with the guide of experimental teachers and, resolution of clinic cases. Material and methods: Students of the last level of Patology and Clinical Stomatology Asignature, of the Odontology Faculty of La Plata City, year by year were sending in small groups (no more than seven students each), to a Public Hospital, to Odontology Unit, to participate in an equipment composed by Docents of the Faculty that works in this hospitalry Service and in relationship with other medical units of the same Hospital. For this study, data was assesed taking 1.800 hours/patient. 495 patients were evaluated and sex, age, civil state, ocupation, habits and factors of the enviroment were tabulated. Screaning of lesions and diseases were made and an statistic analyse was performed. Results: 1) Students demostrated, most of the time, really interesting and entusiassm. This result was calculated in a frequence of 40% of them, who wanted to state longer overthere and to come back, out of their own study classes and obligations. 2) From lesions and diseases data study, superficial mycosis was the most prevalent disease that it was founded, followed by major afthous and carcinomas of squamous cells. Conclusions: 1) Its was observed that Assistant/Docent/ Hospital educational method woul offer to Teaching/ Learning mechanism, the possibility to insert the students inside their real public health medium. 2) Other medical specialities integrated with Stomatology seems to allow a common sanitary equipment by a retronutritionary phenomem. 3) In agreement with other data of asistant services and other faculties of our country, Oral Candidiasis was the most observed disease. 4) Incidence of Oral cancer advices us to insist about its early diagnosis, the importance of pre-malignant lesions recognition and to improve strategies againts nicotinism, in our environment (AU)

A survey of oral and maxillofacial pathology specimens submitted by general dental practitioners over a 30-year period.

OBJECTIVES: To determine the range and frequency of diagnoses in specimens submitted for histopathological examination by general dental practitioners (GDPs). METHODS: A retrospective analysis was carried out of all cases submitted by GDPs for the period 1974-2003, using a Foxpro Windows database. The data were collated into 10 diagnostic categories each comprising number of diagnoses, percentage of each diagnosis within a diagnostic category and each diagnosis as a percentage of total cases. RESULTS: GDPs submitted 6,666 cases out of a total of 53,474 for this period. While the total number of specimens increased four-fold over the 30-year period, specimens from GDPs increased from 7% to 17%. The range of diagnoses increased from 18 to 45. Of the 617 GDPs who submitted material, 279 (45%) submitted less than two specimens each in 30 years. Nine malignant neoplasms were diagnosed. Other significant pathology included 320 benign neoplasms as well as diagnoses ranging from mucosal lesions such as lichen planus to odontogenic cysts. CONCLUSIONS: It is clear that GDPs have provided an increased number of biopsy specimens over the last three decades. This reflects an increasing demand by GDPs for a diagnostic oral histopathology service and their use of this service should be encouraged.

Estudo epidemiológico de urgências odontológicas / Epidemiologic study of urgencies in dentistry

O objetivo deste estudo retrospectivo foi determinar a razão da procura de atendimento de urgência na Faculdade de Odontologia da Universidade de Pernambuco, no segundo semestre de 2000, e relacionar o diagnóstico dos casos com o tratamento proposto, gênero e idade dos pacientes. Foram utilizados 227 prontuários de pacientes de ambos os gêneros, com idade variando de 11 a 81 anos. De posse dos dados, foram realizados as estatísticas descritivas e inferencial. A amostra consistiu de 70,5% de pacientes do gênero feminino e 29,5% do masculino. A idade média foi de 29 anos (DP = 11,75 anos). Dos casos atendidos, 33% tiveram como diagnóstico pulpite irreversível sintomática, seguida de 17,2% de pulpite reversível. A abertura coronária doi indicada nos casos de pulpite irreversível sintomática, abcesso dentoalveolar agudo e periodontite apical aguda, correspondendo a 55,1% dos tratamentos realizados. Conclui-se que o alto percentual de urgências endodônticas reflete o perfil de saúde bucal da população atendida, exibindo um alto padrão cariogênico que necessita ser revertido

Patología oral en niños con anemia aplásica / Oral pathology in kids with aplastic anemia

El presente trabajo de investigación tuvo como objetivo identificar las diferentes patologías orales de tipo ulcerativo, micótico, hemorrágico e inflamatorio, presentes en la cavidad oral de pacientes con anemia aplásica. La población estuvo conformada por 36 pacientes que acudieron a consulta externa durante los meses de consulta externa durante los meses de marzo a mayo del año 2003 en el servicio de hematología clínica de instituto de salud del niño (ISN). Se evaluó la frecuencia de patologías orales clasificación a los pacientes de acuerdo con la edad, sexo, grado de anemia aplásica (moderada o severa), procedencia y año de diagnóstico de la enfermedad. Los resultados obtenidos muestran que la patología que se presentó con mayor frecuencia en la cavidad oral fue la gingivitis. Al aplicar la prueba estadística chi cuadrado, no se encontró diferencias significativas en la presencia de patología orales de acuerdo con las clasificaciones realizadas. Finalmente, concluimos que del 100 por ciento de pacientes evaluados, 94 por ciento presentó por lo menos una patología en la cavidad oral durante nuestro estudio. Esto indica que las manifestaciones orales en los niños con anemia aplásica son muy frecuentes, por lo tanto, el odontólogo debe realizar el diagnóstico y tratamiento adecuado en estos pacientes, evitando alteraciones que compliquen su estado general y puedan causar al muerte

The investigation aim was identify the different oral pathologies of type ulcerative, micotic, hemorrhagic and inflammatory, present in the oral cavity of patient with aplastic anemia, the population was confirmed by 36 patients that went to external consulation during the months of March to may 2003 in the service of clinical hematology of the instituto de salud del niño (ISN). The frequency of oral pathologies was evaluated, classifying the patients according to the age, sex, grade of aplastic anemia (moderate or severe), origin and year of diagnostic of the illness. The abstained results show that the pathology that was presented with more frequency in the oral cavity was the gingivitis. When the chi square test was applied. They were not significant differences in the presence of oral pathologies according to the carried out classifications. Finally we conclude that o 100 per cent of evaluated patients 94 per cent presented at least a pathology in the oral cavity during our study, with indicates that those oral manifestation in the children with aplastic anemia are very frequent, the appropiate diagnosis and treatment in the these patients, avoiding alterations that complicate its general condition and could cause the death.

Referral patterns, lesion prevalence, and patient care parameters in a clinical oral pathology practice.

OBJECTIVE: The purpose of this study was to determine the following parameters in a referral-based private practice oral and maxillofacial pathology clinic: (1) sources of clinical referrals; (2) types of problems referred; and (3) clinical effectiveness of treatment. STUDY DESIGN: Clinical charts were reviewed for a cohort of 362 patients seen over a 2 1/2-year period (1993-1995). From these charts, we determined the source of referral and the final diagnosis for each patient. In addition, 50 patients were randomly selected and surveyed by telephone; each was asked a series of questions to determine the following: (1) the number of health care practitioners previously seen with regard to the patient's condition; (2) the length of time that the condition had been present before the patient came to the oral and maxillofacial pathology clinic; (3) the costs associated with medications and office visits that had been incurred before the patient came to the oral and maxillofacial pathology clinic; (4) the costs associated with medications and office visits that were incurred at the oral and maxillofacial pathology clinic; and (5) the patient's level of satisfaction with the oral and maxillofacial pathology clinic. RESULTS: Fifty-five percent of the referrals came from dentists, and 45% came from physicians. The 3 problems most commonly seen were candidiasis (12%), burning mouth syndrome (10%), and lichen planus (8%). For the 50 patients who were interviewed, the mean number of health care practitioners seen previously was 2.2 (range, 1-9). The mean time from initial symptoms to evaluation by an oral pathologist was 15 months. The mean approximate cost of medications and office visits before evaluation by an oral pathologist was $350 (range, $30-$4,000; median, $100); this compared with a cost of $94 (range, $50-$300; median, $70) for the patient visit and medications associated with the oral pathology appointment. The difference was statistically significant (P < or = .001). CONCLUSIONS: This preliminary study suggests that the clinical evaluation of oral lesions by an oral pathologist appears to be cost-effective and should be an integral part of a comprehensive health management system. These results should be corroborated by similar multicenter studies.