Pierre Fauchard's Contribution to Oral Medicine and Oral and Maxillofacial Pathology: An historical essay.

Pierre Fauchard, considered the father of dentistry, contributed to the development of different fields of dentistry that we know today. However, the contribution of this important individual to the fields of oral medicine and oral and maxillofacial pathology is unknown. This study aimed to identify Pierre Fauchard's contribution to these areas of dentistry. We focused on "Le Chirurgien Dentiste, or Traité des Dents" in both French and English, looking for information about the oral diseases diagnosed and treated by Fauchard. Information on patient history, disease description, treatment applied, and clinical follow-up was collected. A contemporary analysis of the diseases was performed, and the collected data were systematized, reported, and analyzed descriptively, according to the current literature on the addressed topics. Information on conditions such as scurvy, parulides, epulides, oral ulcers, dentoalveolar abscesses, dental alterations, and post-exodontia incidents were elucidated. Findings indicated that Pierre Fauchard described, diagnosed, and treated different soft and hard tissue diseases of great interest to the fields of oral medicine and oral and maxillofacial pathology.

Modalidades de radioterapia empregadas para o câncer de cabeça e pescoço / Radiotherapy modalities used for head and neck cancer

O câncer de cabeça e pescoço (CCP) refere-se ao grupo de tumores que atingem a laringe, cavidade nasal, nasofaringe, orofaringe, cavidade oral e glândulas salivares. A radioterapia no paciente com CCP representa uma terapia para manutenção do órgão, através da destruição das células neoplásicas malignas. O objetivo do presente estudo foi identificar estratégias radioterápicas aplicadas ao paciente com CCP e seus respectivos efeitos colaterais em cavidade oral, além de investigar as principais modalidades utilizadas nos sistemas de saúde do Brasil. Tratou-se de uma revisão narrativa da literatura com busca ativa das bases eletrônicas PUBMED, LILACS e SCIELO. Após todas as etapas de refinamento, um total de 58 artigos foram incluídos na presente revisão. A radioterapia possui papel de destaque no tratamento do CCP. No entanto, por não ser um método terapêutico com alta especificidade, resulta em efeitos adversos ao tratamento como mucosite oral, trismo e disfunção salivar, que findam por reduzir a qualidade de vida do paciente. Dentre as principais técnicas radioterapêuticas utilizadas no Brasil, a IMRT e VMAT caracterizam-se como as formas mais avançadas da terapia em 3D, proporcionando doses equivalentes para cada área da lesão tumoral, poupando áreas teciduais circunvizinhas que não necessitam de irradiação. Além da toxicidade reduzida, uma maior sobrevida pode ser observada em pacientes tratados com essas técnicas. Um dos maiores desafios atuais na radioterapia contra o CCP é a proteção de tecidos saudáveis. Nesse sentido, a IMRT e VMAT apresentam superioridade em relação às demais técnicas.

Head and neck cancer (CCP) refers to the group of tumors that affect the larynx, nasal cavity, nasopharynx, oropharynx, oral cavity and salivary glands. Radiotherapy in patients with CCP represents a therapy for organ maintenance, through the destruction of malignant neoplastic cells. The aim of this study was to identify radiotherapy strategies applied to patients with CCP and their respective side effects in the oral cavity, and to investigate the main modalities used in health systems in Brazil. It was a narrative review of the literature with active search of electronic databases PUBMED, LILACS and SCIELO. After all stages of refinement, a total of 58 articles were included in this review. Radiotherapy has a prominent role in the treatment of CCP. However, because it is not a therapeutic method with high specificity, it results in adverse effects to treatment such as oral mucositis, trismus and salivary dysfunction, which end up reducing the quality of life of the patient. Among the main radiotherapeutic techniques used in Brazil, IMRT and VMAT are characterized as the most advanced forms of 3D therapy, providing equivalent doses for each area of the tumor sparing surrounding tissue areas that do not require irradiation. In addition to reduced toxicity, greater survival can be observed in patients treated with these techniques. One of the biggest current challenges in radiation therapy against CCP is the protection of healthy tissues. In this sense, the IMRT and VMAT present superiority in relation to the other techniques.

Gingival neoplasms: a multicenter collaborative study of 888 patients in Brazil

Background: To evaluate the prevalence and clinicopathological features of a large series of gingival neoplasms in Brazil. Material and methods: All gingival benign and malignant neoplasms were retrieved from the records of six Oral Pathology Services in Brazil, during a 41-year period. Clinical and demographic data, clinical diagnosis, and histopathological data were collected from the patients' clinical charts. For statistical analysis, the chi-square, median test of independent samples and the U Mann-Whitney tests were used, considering a significance of 5%. Results: From 100,026 oral lesions, 888 (0.9%) were gingival neoplasms. There were 496 (55.9%) males, with a mean age of 54.2 years. Most cases (70.3%) were malignant neoplasms. Nodules (46.2%) and ulcers (38.9%) were the most common clinical appearance for benign and malignant neoplasms, respectively. Squamous cell carcinoma (55.6%) was the most common gingival neoplasm, followed by squamous cell papilloma (19.6%). In 69 (11.1%) malignant neoplasms, the lesions were clinically considered to be inflammatory or of infectious origin. Malignant neoplasms were more common in older men, appeared with larger size, and with a time of complaint shorter than benign neoplasms (p<0.001). Conclusions: Benign and malignant tumors may appear as nodules in gingival tissue. In addition, malignant neoplasms, especially squamous cell carcinoma, should be considered in the differential diagnosis of persistent single gingival ulcers. (AU)

Clinicopathological study and survival outcomes of sialoblastoma: A systematic review.

Sialoblastoma is a rare malignant salivary gland tumor. The aim of this study was to review the available published data on sialoblastoma in a comprehensive analysis of its clinicopathologic characteristics, treatment, and outcomes. An unrestricted electronic search was performed in the following databases: MEDLINE/PubMed, EMBASE, Scopus, Web of science, and gray literature databases. Eligibility criteria included publications with sufficient clinical, imaging, and histopathological information to confirm the diagnosis of sialoblastoma. Data were evaluated descriptively and analytically. A total of 52 studies met the eligibility criteria. In total, 62 patients were evaluated. There was no gender predilection, with the parotid being the most affected primary site (n = 28; 45.2%). In the log-rank test, there was a significant increase in disease-associated survival in patients younger than 1 year of age (82.8% vs. 44.4%; p = 0.003), individuals with lesions in major salivary glands (79.4% vs. 38.5%; p = 0.005), patients without metastases (77.8% vs. 14.3%; p = 0.011), encapsulated lesions (85.7% vs. 0%; p < 0.0001), congenital lesions (83.3% vs. 25.0%; p < 0.0001), and lesions that do not show perineural invasion (89.5% vs. 40%; p = 0.035). Kaplan-Meier curves estimated overall survival and disease-free survival at 5 years of 95.5% and 68.1%, respectively. In the multivariate Cox regression model, only the presence of metastasis was identified as an independent prognostic factor (hazard ratio [HR] = 9.81; p = 0.010). Although sialoblastoma presents good prognosis, the tumor has a high recurrence rate.

Oral hyperpigmentation as an initial clinical aspect of hand foot syndrome.

Hand-foot syndrome (HFS) is a common adverse effect of anticancer therapy. It is known to cause dermatological symptoms including acral erythema and dysesthesia of the palms and soles of the feet, swelling, pain, itching, and scaling. Some drugs, like capecitabine, are known to trigger this condition. However, pigmentation of the oral mucosa is a rare adverse effect. This study aims to report a case of oral mucosa hyperpigmentation caused by capecitabine therapy before the clinical diagnosis of HFS. A 58-year-old female, diagnosed with invasive breast duct carcinoma, had the central nervous system, liver, skin, and lung metastasis, using capecitabine every day for 14 cycles. Oral examination revealed multifocal black macules on the hard palate, bilateral buccal mucosa, gingival mucosa, and dorsum of the tongue. The clinical hypothesis was oral mucosa hyperpigmentation by capecitabine use and only periodic follow-up was necessary. Hyperpigmentation of oral mucosa by capecitabine is a rare consequence of neoplastic therapy and your association with HFS is unclear, and poorly reported. The report of these events is important to alert oncology health teams about the individual tolerance to capecitabine therapy.

Oral hyperpigmentation as an initial clinical aspect of hand foot syndrome

Abstract Hand-foot syndrome (HFS) is a common adverse effect of anticancer therapy. It is known to cause dermatological symptoms including acral erythema and dysesthesia of the palms and soles of the feet, swelling, pain, itching, and scaling. Some drugs, like capecitabine, are known to trigger this condition. However, pigmentation of the oral mucosa is a rare adverse effect. This study aims to report a case of oral mucosa hyperpigmentation caused by capecitabine therapy before the clinical diagnosis of HFS. A 58-year-old female, diagnosed with invasive breast duct carcinoma, had the central nervous system, liver, skin, and lung metastasis, using capecitabine every day for 14 cycles. Oral examination revealed multifocal black macules on the hard palate, bilateral buccal mucosa, gingival mucosa, and dorsum of the tongue. The clinical hypothesis was oral mucosa hyperpigmentation by capecitabine use and only periodic follow-up was necessary. Hyperpigmentation of oral mucosa by capecitabine is a rare consequence of neoplastic therapy and your association with HFS is unclear, and poorly reported. The report of these events is important to alert oncology health teams about the individual tolerance to capecitabine therapy.

Resumo A síndrome mão-pé (SMP) é um efeito adverso comum da terapia anticâncer. Sabe-se que causa sintomas dermatológicos, incluindo eritema acral e disestesia das palmas das mãos e solas dos pés, inchaço, dor, coceira e descamação. Alguns medicamentos como a capecitabina são conhecidos por desencadear essa condição. No entanto, a pigmentação da mucosa oral é um efeito adverso raro. Este trabalho tem como objetivo relatar um caso de hiperpigmentação da mucosa oral causada pela terapia com capecitabina antes do diagnóstico clínico de SMP. Mulher de 58 anos, com diagnóstico de carcinoma invasivo de ducto mamário, apresentou metástase no sistema nervoso central, fígado, pele e pulmão, em uso de capecitabina todos os dias por 14 ciclos. O exame oral revelou máculas negras multifocais no palato duro, mucosa bucal bilateral, mucosa gengival e dorso de língua. A hipótese clínica foi de hiperpigmentação da mucosa oral pelo uso de capecitabina e apenas o acompanhamento periódico foi necessário. A hiperpigmentação da mucosa oral pela capecitabina é uma consequência rara da terapia neoplásica e sua associação com SMP não é clara e pouco relatada. O relato desses eventos é importante para alertar as equipes de saúde oncológica sobre a tolerância individual à terapia com capecitabina.