ABSTRACT Hemangiolymphangioma is a very rare vascular malformation that develops as a combination of dilated venous and lymphatic vessels. We describe an unusual case of hemangiolymphangioma of the tongue affecting an adult man who complained of an uncomfortable, slowly progressing exophytic irregular dark red-violaceous nodular mass on his tongue that impaired speech and swallowing for two weeks. The clinical differential diagnoses were Kaposi’s sarcoma and a COVID-19-related lesion. A complete blood count and serology for HIV-1 and 2 and RT-PCR for COVID-19 were requested and results were negative. An incisional biopsy was performed. Microscopically, the lesion exhibited several dilated vessels lined by normal-appearing endothelial cells, some filled with prominent intravascular erythrocytes and others containing proteinaceous eosinophilic material resembling lymphatic vessels, in close association with hyperkeratosis, papillomatosis, and acanthosis. From immunohistochemical analysis, most vessels were found to be CD34 positive, some highlighted by α-SMA, whereas D2-40 was focal. Positive staining for some lymphatic and blood vessel markers, i.e., D2-40 and CD34, respectively, indicates a mixed derivation of the lesion. HHV-8 was negative. Clinical features, the congested blood vessels with ectasia in intimate association with hyperplastic epithelium, and the immunohistochemical profile supported the final diagnosis of oral hemangiolymphangioma. The patient underwent minimally invasive surgical excision with no intercurrences. After 18 months of follow-up, there were no signs of relapse.

ResumoObjetivoAlguns parâmetros clínicos de saúde periodontal foram avaliados comparativamente em pacientes que utilizavam braquetes convencionais e linguais.Material e métodoUm examinador treinado registrou as frequências de placa bacteriana visível (PB) e sangramento à sondagem (SS), bem como dos índices higiene oral simplificado (IHO-S) e gengival modificado (IGM), em 83 pacientes de duas clínicas. Os efeitos dos tratamentos ortodônticos na saúde periodontal foram analisados por regressão logística (α=0,05).ResultadoNo grupo convencional, a frequência de placa bacteriana foi significativamente mais elevada nas superfícies vestibulares dos dentes anteriores (OR = 12,5) e posteriores superiores (OR = 3,6), p < 0,01. O SS nos dentes posteriores também foi mais frequente neste grupo, p < 0,05. O grupo lingual apresentou frequência mais alta de placa bacteriana nas superfícies linguais dos dentes anteriores (OR = 4,3; p = 0,0034). O grupo convencional apresentou frequências significativamente elevadas de gengivite leve nas regiões vestibulares dos dentes anteriores (OR = 9,0) e posteriores superiores (OR = 16,7), p < 0,05, e de papilas anteriores (OR = 9,0 p = 0,0003). Por outro lado, o grupo lingual evidenciou gengivite leve mais frequentemente nas superfícies linguais dos dentes anteriores (OR = 54,5), p < 0,01.ConclusãoCom base nos resultados deste estudo, as condições clínicas de saúde periodontal podem ser consideradas razoáveis em pacientes que utilizavam braquetes convencionais e linguais.

AbstractObjectiveSome clinical periodontal health parameters were assessed comparatively in patients using conventional and lingual brackets.Material and methodA trained examiner registered the frequencies of visible plaque (VP), bleeding on probing (BOP), as well as the simplified oral hygiene (OHI-S) and modified gingival (MGI) indices in 83 subjects from two clinics. The effects of orthodontic treatments on periodontal health were analyzed using logistic regression (α = 0.05).ResultIn the conventional group, the frequency of visible plaque was significantly higher on the buccal surfaces of anterior (OR = 12.5) and maxillary posterior (OR = 3.6) teeth, p < 0.01. BOP in posterior teeth was also more frequent in this group, p < 0.05. The lingual group presented higher frequency of visible plaque on the lingual surfaces of anterior teeth (OR = 4.3; p = 0.0034). The conventional group had significantly higher frequencies of mild gingivitis in the buccal regions of anterior (OR = 9.0) and maxillary posterior (OR = 16.7) teeth, p < 0.05, and anterior papillae (OR = 9.0; p = 0.0003). On the other hand, the lingual group evidenced mild gingivitis more often in the lingual regions of anterior teeth (OR = 54.5), p < 0.01.ConclusionBased on the results of this study, the clinical periodontal health conditions may be considered acceptable for patients using both conventional and lingual brackets.

AIM: To investigate the associations between nutritive and non-nutritive sucking habits and the prevalence of anterior open bite, in children from Aragua-Venezuela and São Paulo-Brazil. METHODS: Seven calibrated examiners (κ = 0.89-1.0) performed clinical assessments in Venezuelans (N = 809) and Brazilians (N = 1,377) aged 3-6 years. Sucking habits were investigated using questionnaires answered by the mothers. Data were analyzed using logistic regression models (α = 0.05). RESULTS: Among 380 children with anterior open bite, 309 were Brazilians. Approximately 65% of Brazilians with pacifier-sucking habit lasting beyond 3 years of age had this malocclusion. Brazilians who prolonged pacifier and digit-sucking habits beyond 3 years of age have, respectively, 68.5 and 14.5 times more chances of presenting anterior open bite than children without sucking habits (p < 0.001). In Venezuelans with open bite, 37.7% had digit-sucking habits beyond 3 years of age, resulting in a high odds ratio (9.3; p < 0.001) when compared to children without this habit. No significant effect was found for bottle feeding. However, non-breastfed Venezuelan children or those breastfed for periods shorter than 6 months have a two-fold higher chance of presenting anterior open bite than children who were breastfed for longer periods, p = 0.008. CONCLUSIONS: Infant feeding had some effect on Venezuelan children, since insufficient breastfeeding was related to a higher prevalence of anterior open bite. Pacifier-sucking was more prevalent in Brazilians, corresponding to pronounced chances (8-68 times greater) of diagnosing anterior open bite in pacifier users compared to non-users. Among Venezuelans, on the other hand, digit-sucking effect surpassed that of pacifier use and was associated with far higher chances (6-9 times) for this malocclusion.

AIM: This experimental study investigated the association between masticatory hypofunction and mandibular morphological dimensions and internal bone characteristics. METHODS: Twentyfour 21-day-old male Wistar rats were randomly divided into two groups, according to the diet consistency. The control group (CG) was fed a solid diet (pellets) and the experimental group (EG) received a powdered diet during 50 days. All animals were euthanized and their mandibles removed and processed for histomorphometric analysis. A calibrated examiner performed linear and angular measurements (mandibular body length and height, mandibular lengths, ramus depth and height, mandibular base depth, mandibular head and gonial angle) on photographs, estimated bone density in the mandibular ramus region on digital radiographs and assessed the area of cortical and trabecular bone tissue in the second molar region, in 5-µm-thick serial cuts stained with Cason's Trichrome. Measurements for the study groups were compared using Mann-Whitney test (α=0.05). larvae to induce experimental candidiasis, and after 24 hours, the survival rate was assessed. RESULTS: some of the macroscopic dimensions evaluated on photographs were significantly smaller in EG compared to CG, specifically mandibular ramus height (10.77 mm vs. 11.11 mm, p=0.0375), mandibular body length (21.67 mm vs. 22.36 mm, p=0.0165) and height (4.24 mm vs. 4.54 mm, p=0.0016), as well as mandibular base depth (1.24 mm vs. 1.47 mm, p=0.0325). The relative mineral bone density was significantly decreased in EG (1.04) compared to CG (1.25), p<0.001. Rats in the EG also presented smaller trabecular and cortical bone area (2.36 mm²) than those in CG (3.16 mm²), p<0.001. CONCLUSIONS: Based on the above-mentioned measurements, it may be concluded that masticatory hypofunction induced by a powdered diet affected mandibular morphology and was associated with significantly reduced bone content.

Enhancement filters are potentially supposed to improve the diagnostic performance of digital images. Thus, the aim of this study was to compare the performance of digital radiography with and without enhancement filters for the detection of induced proximal caries lesions. The total sample consisted of 120 sound human teeth (40 premolars, 80 molars). Enamel subsurface demineralization was induced in one of the proximal surfaces of 60 teeth. Standardized radiographs of all teeth were acquired after the demineralization phase using the Digora-Optime® system. Four radiologists examined the digital radiographs and applied the following filters provided by the Digora® for Windows 2.6 package: Negative, Sharpen and both (Negative plus Sharpen). Validation of radiographic diagnosis was carried out by Knoop cross-sectional micro-hardness profiling on the proximal surfaces. Intraobserver agreement was estimated using Kappa statistics (k). Sensitivity, specificity and over-all accuracy were compared using ANOVA/Tukey test (α = 5%). Intraobserver agreement ranged from good to very good/optimal (k: 0.65–0.83). Although not statistically significant, the highest sensitivity (0.68 ± 0.22) and accuracy (0.76 ± 0.16) values were observed using the Sharpen filter as opposed to the Negative filter, which presented the lowest performance indices (0.57 ± 0.13 and 0.70 ± 0.10, respectively). Specificity ranged from 0.84 to 0.85, considering all imaging modalities (p > 0.05). Insofar as the Sharpen filter had the highest performance indices, it may be considered a useful adjunct for detecting subtle proximal caries lesions.

AIM: Knowledge of enamel thickness is relevant to perform stripping during orthodontic treatment. Thus, proximal enamel measurements of human permanent teeth were compared in this study. METHODS: The measurements were previously obtained on cut sections of mandibular central (n = 30) and lateral (n = 30) incisors, canines (n = 20), first (n = 40) and second (n = 40) premolars; maxillary central (n = 20) and lateral (n = 20) incisors, canines (n = 20), first (n = 40) and second (n = 42) premolars. Comparisons between thicknesses by arch side and proximal surface were carried out using Student's t-tests (α = 0.05). Teeth were compared according to the mesial and distal thicknesses by ANOVA and Tukey's test. RESULTS: No significant differences were found between right and left teeth. For the mesial surface, the mandibular second premolar presented the highest mean value (1.376 mm ± 0.198; p<0.001). The mandibular central incisor had the smallest thickness in relation to the other teeth (0.675 mm ± 0.144), although not significant compared with the mandibular lateral incisor and canine (0.734-0.781 mm). The mandibular second premolar also presented the higher distal thickness in relation to the others (1.450 mm ± 0.172), although not significant compared with the maxillary first premolar (1.322 mm ± 0.195). Mandibular incisors had the lowest means for distal thickness (0.872-0.879 mm), although not statistically different compared with maxillary incisors and mandibular canine (1.002-1.015 mm). Distal thickness was greater than mesial (p<0.001). CONCLUSIONS: Interproximal stripping should be less marked in incisors and mesial surfaces.