Oral/Perioral Reactions to Injectable Soft Tissue Fillers: A Clinicopathological Multicentric Study.

OBJECTIVE: To analyze the characteristics of a series of oral reactions to injectable soft tissue fillers. MATERIALS AND METHODS: Cases diagnosed as oral reactions to injectable soft tissue fillers were selected from eight Pathology laboratories. Information was retrieved from the laboratory charts and from the review of the hematoxylin and eosin-stained histological slides. RESULTS: The 151 patients showed a mean age of 54.9 years, and 136 (90.1%) were females. Mean time of onset was 20.4 months, and the lips were the most frequent location (72.8%). Most cases presented as asymptomatic isolated nodules, with a mean size of 17.4 mm. Silicone (38.5%), polymethylmetacrylate (33%), and hyaluronic acid (11.9%) were the three most common fillers. Granulomas, foamy macrophages, and multinucleated giant cells were observed in 44%, 51.5%, and 65.3% of the cases, respectively. Time of onset was shorter for males (p = 0.033), and symptoms were common in the upper lip, buccal mucosa, and lower vestibule (p = 0.010). Foamy macrophages were more common in association with silicone and collagen (p < 0.001), whereas multinucleated giant cells were more common in association with polymethylmetacrylate, hydroxiapatite, and polylactic acid (p = 0.012). CONCLUSION: Clinicians should consider reactions to injectable soft tissue fillers when evaluating asymptomatic submucosal nodules affecting the lips of adult/older females.

TeleCleft: Development and Evaluation of a Mobile Application for Monitoring Cleft Patients.

OBJECTIVE: Development and evaluation of a mobile application for remote monitoring and guidance of pediatric patients diagnosed with cleft lip and/or palate (CL ± P) and their caregivers. DESIGN: This is a pilot cross-sectional, applied, and quantitative study. SETTING: The study was conducted in two tertiary care treatment centers in Brazil. PARTICIPANTS: The participants included 20 caregivers and infants undergoing treatment with nasoalveolar molding (NAM) for CL ± P. INTERVENTIONS: The intervention involved using the TeleCleft mobile application for remote monitoring and guidance of caregivers and infants during NAM treatment. MAIN OUTCOME MEASURE(S): The main outcome measures included usability and satisfaction of users with the TeleCleft application. RESULTS: The results showed high usability and satisfaction ratings among users of the TeleCleft application. Most participants found remote monitoring to be effective and expressed positive opinions about its convenience and usefulness. CONCLUSION: TeleCleft could be a viable tool for remote monitoring and guidance, reducing the need for patients and caregivers to travel to treatment centers, which could potentially alleviate the burden of care faced by families during the journey of CL ± P treatment.

Digital resources in the monitoring of patients with cleft lip and palate: protocol for a scoping review.

INTRODUCTION: Cleft lip and/or palate (CL+/-P) is a congenital malformation affecting the lip and palate, requiring long-term treatment due to potential associated complications. For this reason, it is important for the patient to be continuously monitored and followed for health promotion and prevention, as well as improving the quality of life. The aim of this scoping review protocol is to identify and map the available evidence regarding the application of digital resources and technologies in the monitoring and follow-up of patients with CL+/-P. METHODS AND ANALYSIS: This scoping review protocol follows the guidelines recommended by the Joanna Briggs Institute Manual, employing the PCC acronym (Patient/Concept/Context). Searches will be conducted, in May 2024, of PubMed, Web of Science, Scopus, Latin American and Caribbean Health Sciences Literature, ScienceDirect, as well as grey literature indexed in ProQuest Open Access Dissertations & Theses and Google Scholar. The review will consider all types of published studies, including grey literature, in English, Portuguese and Spanish languages, and will consider studies regardless of publication date. Exclusions will apply to studies that do not address the use of digital resources and technologies in CL+/-P monitoring and follow-up. ETHICS AND DISSEMINATION: As this is a scoping review, no ethics committee approval is required. After completion, the plan is to publish results in scientific journals on craniofacial malformations. STUDY REGISTRATION: Open Science Framework, DOI:10.17605/OSF.IO/Y6AG8.

Oral Lymphatic Malformations: A 21-Year Retrospective Study in a Single Institution.

Introduction. Oral lymphatic malformations are uncommon lesions. This study assessed the clinicopathological and sociodemographic features of oral lymphatic malformations in a Brazilian oral pathology service. Methods. Between 2000 and 2021, all oral lymphatic malformations diagnosed in a single oral pathology service were selected for the study. Clinical data, such as age, sex, site of the lesion, clinical presentation, diagnosis clinical, and the type of biopsy were recorded from the patient's clinical charts. Results. From 7554 oral lesions, 17 (0.22%) were oral lymphatic malformations. This lesion similarly affected both sexes, and the mean age of the patients was 16.5 years. The tongue was the most common site (n = 13; 76%). The mean size of the lesions was 17 mm. Oral lymphatic malformations were asymptomatic for 29% of the patients. Clinically, most lesions appeared as a reddish, sessile nodule, with a pebbly surface. In addition, the clinical and histopathological diagnoses agreed for most lesions (n = 11; 64%). The type of biopsy performed was excisional in 41% of lesions. Conclusions. In summary, oral lymphatic malformations present a low prevalence among the oral lesions diagnosed in an oral pathology service. Moreover, they affect equally both sexes, especially young patients, and usually appear as an asymptomatic or symptomatic nodular swelling on the tongue.

Telehealth in oral medicine: A cross-sectional evaluation based on a mobile application.

BACKGROUND: Teledentistry is considered a good tool in the diagnostic process. In oral medicine, there is a low number of trained professionals and dentists have difficulty in diagnosing and treating oral lesions. OBJECTIVE: We aimed to perform a cross-sectional evaluation based on the mobile application for oral diagnosis using a mobile application in a Brazilian State. METHODS: This is a retrospective, cross-sectional, observational study of the data of the "Telehealth in Stomatology in Paraíba" carried out between May 2021 and November 2022. RESULTS: The app has a team of 16 consultants (Ph.D. professors, postgraduate students, residents, and dentists). In addition, there are 289 registered professionals, with a mean age of 33.7 years, predominantly female (70.2%), working in primary care (79.2%), and general practitioners (42.6%). Regarding the cases, the app has 194 cases, and reactive lesions are the most suggested hypotheses reported by dentists (24.5%) and consultants (22.3%). We had an overall concordance rate of 64.1%. CONCLUSION: The application is easily accessible and has an assistance network that helps with early diagnosis. In addition, it has good coverage with users in more than 50% of the cities in the state. Thus, applications that provide specialized care to distant areas are important for better public health.

Solitary fibrous tumor: Two cases report with a focus on the differential diagnosis / Tumor Fibroso Solitário: Relato de dois casos com foco no diagnóstico diferencial

Solitary fibrous tumor (SFT) is a neoplasm of fibroblastic/myofibroblastic origin with intermediate biological behavior. We report here two cases of SFT affecting an unusual anatomical site in 58-year-old and 40-year-old female patients and discuss the differential diagnosis of this lesion. In case 01, the lesion showed the clinical appearance of an asymptomatic "blister" with normal color, rubbery consistency, measuring 0.3 cm, and affected the lower lip; while in case 02, a symptomatic red nodular lesion with a soft consistency and measuring 0.5 cm affected the floor of the mouth. Excisional biopsies were performed. Microscopically, two well-delimited benign neoplasms were observed, exhibiting the proliferation of ovoid to spindle-shaped mesenchymal cells, vascular spaces with staghorn arrangement, and the absence of mitosis figures. Immunohistochemistry was performed in case 01 to assist in the diagnosis. Weak and diffuse immunostaining was observed for α-SMA and intense and diffuse immunopositivity for Bcl-2 and CD34. Based on histopathological and immunohistochemical features, a diagnosis of SFT was rendered in both cases. The low occurrence and nonspecific clinical features of oral SFT may make its clinical diagnosis difficult. Also, morphological and immunohistochemical are essential for differential diagnosis with other mesenchymal neoplasms.(AU)

O tumor fibroso solitário (TFS) é uma neoplasia de origem fibroblástica/miofibroblastica com comportamento biológico intermediário. Nesse artigo relatamos dois casos de TFS afetando sítios anatômicos incomuns em pacientes do sexo feminino de 58 anos e 40 anos e discutir os seus diagnósticos. No caso 01 clinicamente a lesão apresentou um aspecto de "bolha" assintomática, coloração normal da mucosa, consistência borrachoide medindo 0,3 cm, em região de lábio inferior, enquanto que no caso 02, como uma lesão sintomática, vermelha, nodular com consistência mole e medindo 0,5 cm afetando o assoalho bucal. As biópsias excecionais foram realizadas. Microscopicamente, observamos duas lesões neoplásicas bem delimitadas exibindo uma proliferação de células mesenquimais variando de ovoides a fusiformes, vasos sanguíneos em formato de "chifre de veado", com ausência de figuras de mitoses. No caso 01 foi realizado análise imuno-histoquímica para auxiliar no diagnóstico. Foi observado uma marcação fraca e difusa de α-SMA e uma intensa e difusa imunopositividade para o Bcl-2 e CD34.Baseado nos achados histopatológicos e imuno-histoquímicos o diagnóstico de TFS foi estabelecido em ambos os casos. A baixa ocorrência e os achados clínicos inespecíficos do TFS oral podem dificultar o diagnóstico clínico. Além disso, as análises morfológicas e imuno-histoquimicas são essenciais para realização do diagnóstico diferencial com outras neoplasias mesenquimais.(AU)_

Risk factors for oral alterations in intensive care unit patients: A pilot cohort study.

BACKGROUND: Several studies evidenced the presence of oral alterations in ICU patient. However, data about identification of their risk factors in ICU patients is scarce, especially due to the lack of longitudinal prospective studies. Here, we evaluate the risk factors for the development of oral alterations in a group of ICU patients through a prospective longitudinal cohort. METHODS: During May-December 2019, 43 ICU patients in a tertiary hospital in Brazil were evaluated. Medical record reviews and oral examinations of each patient were made by 3 dentists in five distinct moments. RESULTS: Among all patients, 53.5% (n = 23) were female, with a mean age of 59.8 years (±17.4). The incidence of oral alterations was 51.2% (35.6%-66.8%) and among these (n = 22), hyposalivation (n = 9; 40.9%), and lingual biofilm accumulation (n = 9; 40.9%) were the most common. The mean age of the group with oral alterations (66.9 years) was higher compared to the group without alterations (52.3 years). Furthermore, male patients (p = 0.02), older than 60 years (p = 0.004) and treated with mechanical ventilator (p = 0.03) had a higher risk of oral alterations. CONCLUSIONS: Systemic parameters, as age and mechanical ventilator, could influence the oral environment of ICU patients.

Odontogenic Myxoma: Follow-Up of 13 cases after conservative surgical treatment and review of the literature.

BACKGROUND: We aim to report a serie of odontogenic myxoma over a 40-year period. MATERIAL AND METHODS: We conducted a retrospective and sectional review of OM cases. The clinical, radiographic and treatment data were collected from clinical records included cases whose medical records contained clinical, radiographic, histopathological, follow-up data of at least six months. RESULTS: There was a mild preference for the male with a mean age of 22.8 years. Seventy-seven percent of the lesions occurred in the posterior region of the mandible, presenting a multilocular radiolucent aspect (54%) with one presenting symptomatology. Conservative treatment was performed in all patients initially and recurrence was observed in two cases. CONCLUSIONS: Odontogenic myxoma has a well-defined clinical profile and the choice of treatment should consider aspects such as patient's age, lesion size, and location. Key words:Myxoma, odontogenic tumors, diagnosis, treatment.

Primary Intraosseous Squamous Cell Carcinoma Involving the Jaw Bones: A Systematic Review and Update.

Primary intraosseous oral squamous cell carcinoma (PIOSCC) is a rare malignant neoplasm that affects the jaws. Despite its aggressive biological behavior, there are no studies that evaluated the clinicopathological features of this tumor and parameters associated with its prognosis. The objective of the present study was to conduct a systematic review of the available data on oral and maxillofacial PIOSCC in order to determine its clinicopathological characteristics and biological behavior. We conducted a systematic review in May 2020 in multiple databases using a specific search strategy. Cases diagnosed as PIOSCC in the oral cavity and maxillofacial complex that had sufficient histopathological data, absence of ulceration in the oral mucosa, a negative result for a distant primary tumor, and radiographic evidence of an osteolytic lesion that was entirely or mostly surrounded by the jaw bones were included. A total of 109 published articles were included in our systematic review, corresponding to 257 cases. PIOSCC showed a male predilection (69.3%) and a preference for the mandible (7:1), with the posterior region being the most commonly affected site. The mean age at diagnosis was 57.3 years. Cortical expansion, pain, and lip/facial paresthesia were the most common clinical features. Regarding histopathological features, most PIOSCC were well-differentiated and the solid subtype was the most common. Statistical analysis showed that PIOSCC located in the mandible (p = 0.03) and recurrence (p < 0.01) were significantly associated with a higher mortality rate. PIOSCC has a poor prognosis, with high rates of mortality.

YouTube™ and oral lichen planus: an appraisal of the educational quality of information.

The objective of this study was to analyze the quality of videos on oral lichen planus (OLP) available in YouTube™. A cross-sectional analytical study was conducted by searching the video sharing platform YouTube™. Videos aimed at clarifying the etiological and clinical characteristics, diagnostic criteria, treatment, and prognosis of OLP were included. A total of 481 videos were retrieved and 37 were included in the study according to the selection criteria established. Most of the videos evaluated (86.5%; n = 32) were produced by independent users. The average reliability was 1.8 and quality assessment classified only three videos (8.1%) as having good/excellent quality. A significant correlation was observed between the length of the video analyzed and its quality and reliability (p < 0.05), as well as between the reliability and usefulness of the video (p = 0.03). YouTube™ has become a leading source of information for the general population. However, a significant number of these videos have a low quality. Students, professionals, and healthcare providers must be more actively involved in providing clear, accurate, and reliable evidence-based information in an accessible language in order to enable significant improvement in patient care delivery.

Sialolithiasis of minor salivary gland in labial mucosa: a clinical finding / Sialolitíase de glândula salivar menor na mucosa labial: um achado clínico

Introduction: sialolithiasis is the most common form of obstructive sialadenitis caused by a mixture of different calcium phosphates and an organic matrix. It is one of the most common salivary gland diseases, often attributed to the submandibular gland, with no relation to age or gender. However, it is rarely reported in the minor salivary glands. Objective: the present study aims to report auncommon clinical finding case of a sialolithiasisof minor salivary gland in labial mucosa. Case report: a 43-year-old female patient presented with a single, yellow and asymptomatic nodule in the labial mucosa at clinical examination. The clinical hypotheses were lipoma and fibrous hyperplasia. The lesion was biopsied, and the histopathological analysis showed a mineralized tissue. The final diagnosis was sialolithiasis and the patient remained under follow-up (8 months) without relapse. Conclusion: this case shows that sialolithiasis should be included in the diagnostic hypotheses when occur in a minor salivary glands area and emphasizes the importance of a complete clinical examination since it was not complaint of the patient.(AU)

Introdução: a sialolitíase é a forma mais comum de sialadenite obstrutiva causada por um composto de diferentes produtos, como fosfato de cálcio e matriz orgânica. É uma das doenças mais comuns das glândulas salivares, geralmente atribuídas à glândula submandibular, sem relação com idade ou sexo. No entanto, raramente é relatada nas glândulas salivares menores. Objetivo: reportar um achado clínico incomum de sialolitíase em glândula oral menor na mucosa labial. Relato de caso: uma paciente do sexo feminino, de 43 anos, apresentou nódulo único, amarelo e assintomático na mucosa labial durante o exame clínico. As hipóteses clínicas foram lipoma e hiperplasia fibrosa. A lesão foi encaminhada para biópsia e a análise histopatológica mostrou um tecido mineralizado. O diagnóstico final foi de sialolitíase e o paciente permaneceu em acompanhamento por 8 meses sem recidiva. Conclusão: este caso mostra que a sialolitíase deve ser incluída nas hipóteses diagnósticas de lesões em áreas de glândulas salivares menores e enfatiza a importância de um exame clínico completo, pois não se tratava da queixa principal da paciente.(AU)

Clinicopathologic Analysis of Oral and Maxillofacial Solitary Fibrous Tumor.

OBJECTIVES: The aim of this systematic review was to provide an overview of the oral and maxillofacial solitary fibrous tumor (SFT) in order to determine its clinicopathologic characteristics and biological behavior. METHODS: We conducted a systematic review in May 2019 in multiple databases. Cases diagnosed as SFT in the oral cavity and maxillofacial complex were included. RESULTS: Seventy-three published articles were included in our systematic review, corresponding to a total of 154 cases. SFT showed a slight female predilection (53.2%), and the cheek mucosa/cheek, tongue, and palate were the most affected anatomical sites. The mean size of SFT in the oral cavity and maxillofacial region at diagnosis was 1.4 cm. Histologic features of malignancy by morphologic analysis (P < .001) were significantly associated with a larger tumor size. Surgical excision was the most frequent therapeutic modality. Recurrence and metastasis were uncommon findings in our sample. CONCLUSIONS: Histologic features of malignancy can be important parameters of tumor behavior. Adequate surgical treatment and long-term follow-up are required for these cases.

Fatores de risco para o aparecimento de alterações bucais em pacientes internados em UTI: estudo de coorte / Risk factors for the appearance of oral changes in ICU patients: cohort study

Introdução: A unidade de terapia intensiva (UTI) é um setor da área hospitalar em que se presta assistência ao paciente em estado crítico, o qual pode apresentar alterações bucais que podem interferir no status sistêmico. Objetivo: Avaliar os fatores de risco para o desenvolvimento de alterações bucais em um grupo de pacientes atendidos em Unidade de Terapia Intensiva. Materiais e métodos: Trata-se de um estudo de campo, do tipo coorte, prospectivo, realizado entre maio a dezembro/2019 com 43 pacientes na UTI da Liga Contra o Câncer/RN. Os dados foram coletados por 03 avaliadores que incluíram os principais desfechos (alterações bucais com maior frequência e morbidade) e dados referentes aos pacientes (sexo, idade, tempo de internação, alta ou óbito, doenças de base, condição fisiorrespiratória e exames hematológicos). Foram realizados os testes de Mann Whitney (U), Quiquadrado de Pearson com correção de continuidade e Teste Exato de Fisher. O nível de significância adotado foi de 0.05. Resultados: Entre os 43 pacientes incluídos, 53.5% (n=23) eram do sexo feminino com idade média de 59.8 anos (.±17.4). Em relação aos grupos, a média de idade do grupo que apresentou alterações bucais (66.9 anos) foi maior que o grupo sem alterações (52.3 anos), além de maior tempo de hospitalização (15.3 dias) e maiores níveis de proteína C reativa. A incidência dessas alterações nos pacientes internados na UTI foi de 51,2% (35,6%-66,8%). Entre os pacientes com alterações bucais (n=22), a hipossalivação (n = 9; 40.9%) e biofilme lingual (n = 9; 40.9%) foram as mais comuns. Foi observado que os pacientes do sexo masculino (p=0.02), maiores de 60 anos (p=0.004) e que utilizam a ventilação mecânica (p<0.05) apresentaram maior risco para o desenvolvimento de lesões bucais. Conclusões: A idade e o sexo foram importantes fatores de risco para o desenvolvimento de alterações bucais nos pacientes analisados. O uso do tubo orotraqueal e da ventilação mecânica ao longo da internação também devem ser considerados. Além disso, devido a mais de 50% dos pacientes internados apresentarem alterações, é importante a presença do CD de forma integral para a prevenção, diagnóstico e tratamento dos problemas bucais (AU).

Introduction: The intensive care unit (ICU) is a sector of the hospital area where care is provided to patients in critical condition, which may present oral alterations that can interfere the systemic condition. Objective: To evaluate the risk factors for the development of oral alterations in a group of patients seen in the Intensive Care Unit. Materials and methods: This is a prospective cohort field study carried out between May and December 2019 with 43 patients in the ICU of the League Against Cancer / RN. Data were collected by 03 evaluators who included the main outcomes (oral alterations with greater frequency and morbidity) and data related to patients (sex, age, length of hospital stay, discharge or death, underlying diseases, physio-respiratory condition and hematological exams). Mann Whitney (U), Pearson's Chi-square tests with continuity correction and Fisher's Exact Test were performed. The level of significance adopted was 0.05. Results: Among the 43 patients included, 53.5% (n = 23) were female, with a mean age of 59.8 years (. ± 17.4). In relation to the groups, the mean age of the group that presented oral alterations (66.9 years) was higher than the group without alterations (52.3 years), in addition to longer hospital stay (15.3 days) and higher levels of C-reactive protein. The incidence of these changes in patients admitted to the ICU was 51.2% (35.6% -66.8%). Among patients with oral changes (n = 22), hyposalivation (n = 9) and lingual biofilm (n = 9; 40.9%) were the most common. It was observed that male patients (p = 0.02), older than 60 years (p = 0.004) and who use mechanical ventilation (p <0.05) had a higher risk for the development of oral lesions. Conclusions: Age and sex were important risk factors for the development of oral changes in the patients analyzed. The use of the orotracheal tube and mechanical ventilation throughout hospitalization should also be considered. In addition, due to more than 50% of hospitalized patients showing changes, it is important to have the DC fully in the ICU for the prevention, diagnosis and treatment of oral problems (AU).