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Abstract The aim of this study was to describe the prevalence, clinicopathological, and prognostic features of acinic cell carcinoma (AciCC) of the oral and maxillofacial region. AciCC cases were retrospectively retrieved from 11 pathology centers of three different countries. Medical records were examined to extract demographic, clinical, pathologic, and follow-up information. A total of 75 cases were included. Females (65.33%) with a mean age of 45.51 years were mostly affected. The lesions usually presented as an asymptomatic (64.28%) nodule (95.66%) in the parotid gland (70.68%). The association of two histopathological patterns was the most common finding (48.93%) and the tumors presented mainly conventional histopathological grades (86.11%). Surgical treatment was performed in the majority of the cases (59.19%). Local recurrence was observed in 20% of the informed cases, regional metastasis in 30.43%, and distant metastasis in 12.50%. The statistical analysis showed that the cases with a solid histopathological pattern (p=0.01), high-grade transformation (p=0.008), recurrence (p=0.007), and regional metastasis (p=0.03) were associated with poor survival. In conclusion, high histopathological transformation, presence of nodal metastasis, and recurrence were prognostic factors for AciCC of the oral and maxillofacial region.

https://doi.org/10.1590/1807-3107bor-2023.vol37.0050

Contribution of public oral pathology services to the diagnosis of oral and oropharyngeal cancer in Brazil
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LOUREDO, Brendo Vinicius Rodrigues

; CURADO, Maria Paula

; PENAFORT, Paulo Victor Mendes

; DE ARRUDA, José Alcides Almeida

; ABREU, Lucas Guimarães

; MESQUITA, Ricardo Alves

; PINTO-JÚNIOR, Décio dos Santos

; ABRAHÃO, Aline Corrêa

; ANDRADE, Bruno Augusto Benevenuto de

; AGOSTINI, Michelle

; MORAES, Renata Mendonça

; ANBINDER, Ana Lia

; DOURADO, Pedro Henrique Silva

; SANTOS, Teresa Cristina Ribeiro Bartholomeu dos

; PIRES, Fábio Ramoa

; BORDIGNON, Natalia Cristina Trentin

; GONDAK, Rogério Oliveira

; DE OLIVEIRA, Marcia Gaiger

; CARRARD, Vinicius Coelho

; MARTINS, Manoela Domingues

; SOUSA-NETO, Sebastião Silvério

; ARANTES, Diego Antônio Costa

; MENDONÇA, Elismauro Francisco

; CIESLAK-SANCHES, Silvia Roberta

; ANTUNES, Daniella Moraes

; AMARAL-SILVA, Gleyson Kleber do

; MANIERI, Patricia Rubia

; RAMALHO, Luciana Maria Pedreira

; DOS SANTOS, Jean Nunes

; LEONEL, Augusto César Leal da Silva

; PEREZ, Danyel Elias da Cruz

; VERHEUL, Hannah Carmem Carlos Ribeiro Silva

; BARROSO, Keila Martha Amorim

; RODRIGUES, Flávia Luiza Santos

; GONZAGA, Amanda Katarinny Goes

; FERNANDES, Romana Renery

; DE SOUZA, Lélia Batista

; SOUZA, Lucas Lacerda de

; PONTES, Flávia Sirotheau Corrêa

; PONTES, Hélder Antônio Rebelo

; SILVA, Caroline Alfaia

; CÂMARA, Jeconias

; LIBÓRIO-KIMURA, Tatiana Nayara

; SANTOS-SILVA, Alan Roger

; LOPES, Márcio Ajudarte

; ALMEIDA, Oslei Paes de

; ROMAÑACH, Mário José

; VARGAS, Pablo Agustin

Brazilian Oral Research

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2023, Volume 37 elocation e126

Resumo: En | Texto: En | PDF: En

Abstract This study aimed to evaluate the contribution of oral and maxillofacial pathology laboratories (OMPLs) in Brazilian public universities to the diagnosis of lip, oral cavity, and oropharyngeal squamous cell carcinoma (SCC). A cross-sectional study was performed using biopsy records from a consortium of sixteen public OMPLs from all regions of Brazil (North, Northeast, Central-West, Southeast, and South). Clinical and demographic data of patients diagnosed with lip, oral cavity, and oropharyngeal SCC between 2010 and 2019 were collected from the patients’ histopathological records. Of the 120,010 oral and maxillofacial biopsies (2010-2019), 6.9% (8,321 cases) were diagnosed as lip (0.8%, 951 cases), oral cavity (4.9%, 5,971 cases), and oropharyngeal (1.2%, 1,399 cases) SCCs. Most cases were from Brazil’s Southeast (64.5%), where six of the OMPLs analyzed are located. The predominant profile of patients with lip and oral cavity SCC was Caucasian men, with a mean age over 60 years, low schooling level, and a previous history of heavy tobacco consumption. In the oropharyngeal group, the majority were non-Caucasian men, with a mean age under 60 years, had a low education level, and were former/current tobacco and alcohol users. According to data from the Brazilian National Cancer Institute, approximately 9.9% of the total lip, oral cavity, and oropharyngeal SCCs reported over the last decade in Brazil may have been diagnosed at the OMPLs included in the current study. Therefore, this data confirms the contribution of public OMPLs with respect to the important diagnostic support they provide to the oral healthcare services extended by the Brazilian Public Health System.

https://doi.org/10.1590/1807-3107bor-2023.vol37.0126

Virtual learning object about oral ulcerative lesions: controlled educational intervention study
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ZIEGER, Renata de Almeida

; HUGO, Fernando Neves

; THIEME, Stéfanie

; JARDIM, Luisa Comerlato

; KUPSTAITIS, Lorenzo Costa

; FRICHEMBRUDER, Karla

; WAGNER, Vivian Petersen

; CARRARD, Vinicius Coelho

; MARTINS, Manoela Domingues

; MARTINS, Marco Antonio Trevizani

Brazilian Oral Research

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2023, Volume 37 elocation e118

Resumo: En | Texto: En | PDF: En

Abstract The aim of this study was to develop a virtual learning object (VLO) to teach undergraduate dental students about the diagnostic and therapeutic approaches to oral ulcerative lesions. The VLO was developed with information on the diagnostic process, lesion classification, and clinical-surgical management of oral ulcerative lesions. The VLO content was initially validated by a group of specialists. Learning was evaluated in a sample of 58 undergraduate dental students, divided into control group (conventional theoretical class, n = 29) and intervention group (interaction with VLO, n = 29). All students answered a pre-test and post-test questionnaire. The VLO group also answered a specific questionnaire on the evaluation of the VLO. Both quantitative and qualitative descriptive analyses were performed. The validation showed that professors and students considered the VLO adequate. The use of the VLO was recommended by 100% of professors and 86.6% of students. In the intervention group, the results showed a significantly higher number of correct answers in the post-test (p < 0.01). In conclusion, the VLO proved to be a useful tool for teaching oral medicine, contributing significantly to the knowledge of ulcerated lesions in the mouth.

https://doi.org/10.1590/1807-3107bor-2023.vol37.0118

Investigation of oral and general health status and IL-1β gene polymorphism as risk factors for oral mucositis in hematopoietic stem cell transplantation patients
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Curra, Marina

; Baldin, Julianna Joanna Carvalho Moraes de Campos

; Martins, Marco Antonio Trevizani

; Schuch, Lauren Frenzel

; Carvalho, Ana Luísa Saraiva Homem de

; Gaio, Eduardo José

; Rösing, Cassiano Kuchenbecker

; Bittencourt, Rosane Isabel

; Gregianin, Lauro José

; Paz, Alessandra Aparecida

; Daudt, Liane Esteves

; Martins, Manoela Domingues

Brazilian Oral Research

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2022, Volume 36 elocation e016

Resumo: En | Texto: En | PDF: En

Abstract: The aim of the present study was to analyze the relationship of OM with possible risk factors such as oral health condition, immunological status and IL-1β profile in patients submitted to hematopoietic stem cell transplantation (HSCT). Fifty-four individuals submitted to HSCT were included. All patients received previous dental treatment and photobiomodulation (PBM) as the institutional OM preventive protocol. OM scores, immune status, and IL-1β levels were determined during the conditioning period and at D+3 and D+8 after HSC infusion. IL-1β gene polymorphism was also analyzed during conditioning. Possible associations of OM with risk factors were analyzed using conditional Fisher's exact test. OM was observed in 34 patients (62.9%) classified as Grade 1 (13 patients/24.1%), Grade 2 (14 patients/25.9%), Grade 3 (3 patients/5.5%), and Grade 4 (4 patients/7.4%). Allogeneic HSCT individuals exhibited a higher OM grade than autologous subjects. Moreover, an association was observed between severe OM and severe gingivitis (p = 0.01), neutropenia (p = 0.03), and leukopenia (p = 0.04). A significant association between OM and lower IL-1β levels was detected at three time points, i.e., conditioning (p = 0.048), D+3 (p = 0.01), and D+8 (p = 0.005). The results showed that IL-1β gene polymorphism was not associated with OM. Our study provided important insights into the scope of OM risk factors in the setting of HSCT. Patients submitted to HSCT with severe gingivitis prior to chemotherapy and with severe neutropenia and leukopenia exhibited a higher OM grade. Further investigation will be necessary to better understand the exact role of IL-1β in the context of OM pathobiology and to validate cytokine analysis in larger cohorts.

https://doi.org/10.1590/1807-3107bor-2022.vol36.0016

Prognostic factors from squamous cell carcinoma of the hard palate, gingiva and upper alveolar ridge
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Kovalski, Luan Nathiel Santana

; Zanella, Virgilio Gonzalez

; Jardim, Luisa Comerlato

; Só, Bruna Barcelos

; Girardi, Fabio Muradás

; Kroef, Ricardo Gallicchio

; Barra, Marinez Bizarro

; Carrard, Vinicius Coelho

; Martins, Manoela Domingues

; Martins, Marco Antonio Trevizani

Brazilian Oral Research

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2022, Volume 36 elocation e058

Resumo: En | Texto: En | PDF: En

Abstract: The purpose of this study was to evaluate the clinicodemographic characteristics and treatment protocol as prognostic factors in patients with oral squamous cell carcinoma (OSCC) of the hard palate, upper gingiva, and alveolar ridge (HPUGAR). This retrospective cohort study collected data of patients treated in two head and neck surgery departments in southern Brazil between 1999 and 2021. Information on clinicodemographic data, habits, site, size, clinical aspect, clinical staging, cervical metastasis, treatment, and survival was collected. Associations between independent variables and outcomes were assessed using Pearson's chi-square test and binary regression. Kaplan–Meier test was employed to compare the survival between the neck approaches. Forty-one patients were included; most were male (61%), with a mean age of 68.8 (± 13.9) years. The consumption of tobacco (p = 0.003) and alcohol (p = 0.02) was significantly higher in male than in female patients. The main clinical features observed in the study sample were lesions larger than 2 cm (48.7%), no cervical (90.2%), or distant metastasis (90.2%). Surgery alone was the main treatment approach (48.8%). The watch-and-wait strategy was adopted in 34 cases (83.0%), while elective neck dissection was applied in five (12.2%). Only two patients with cN0 disease (4.9%) presented with cervical metastasis at follow-up. Eight patients (12.2%) died of the disease. Clinicodemographic variables, habits, surgical margins, and histological subtype were not significantly associated with cervical metastasis or survival. Cervical metastasis (p = 0.004) was associated with poor survival. No difference was detected in survival between different neck approaches (p = 0.28). Cervical metastasis and local recurrence are negative prognostic factors for HPUGAR OSCC.

https://doi.org/10.1590/1807-3107bor-2022.vol36.0058

Distance learning course improves primary care dentists’ diagnosis and self-efficacy in the management of oral lesions
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CARDOSO, Fernanda Brochier

; WAGNER, Vivian Petersen

; CORRÊA, Ana Paula Borngräber

; MARTINS, Marco Antônio Trevizani

; MARTINS, Manoela Domingues

; D’ÁVILA, Otávio Pereira

; GONÇALVES, Marcelo Rodrigues

; HARZHEIM, Erno

; UMPIERRE, Roberto Nunes

; CARRARD, Vinicius Coelho

Brazilian Oral Research

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2022, Volume 36 elocation e101

Resumo: En | Texto: En | PDF: En

Abstract Oral cancer represents a public health issue because of its high mortality rate, resulting mainly from diagnostic delays. Insufficient training in oral diagnosis is usually perceived by dentists. Distance learning could be used as an auxiliary tool to bridge that gap. This study evaluated the impact of a distance learning course on oral mucosal lesion diagnosis offered to public healthcare dentists. Participants of an online course answered a pretest/posttest comprising clinical images of 30 clinical cases. Participants were questioned about the diagnosis and informed their decision on the cases (referring the cases to a specialist or managing them themselves), as a parameter of perceived self-efficacy. A total of 442 dentists enrolled in the course. Their pass rate was 97%. Classification of the nature of the lesions, diagnostic hypotheses, sensitivity, and specificity improved by 13.4%, 10.0%, 13.4%, and 6.6%, respectively (p<0.01, Wilcoxon test). Regarding management, there was a 16.6% reduction in the intention to refer cases, while confidence in the diagnosis of benign lesions increased by 40%. A distance learning course may be useful in continuing education actions for primary care dentists, improving their diagnostic abilities and encouraging them in the management of oral lesions. Moreover, this strategy could contribute to disseminating knowledge to remote regions, particularly among primary health care professionals.

https://doi.org/10.1590/1807-3107bor-2022.vol36.0101

Risk factors for jaw osteoradionecrosis: a case control study
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GIRARDI, Fábio Muradás

; WAGNER, Vivian Petersen

; MARTINS, Manoela Domingues

; ABENTROTH, Aliende Lengler

; HAUTH, Luiz Alberto

; KRAETHER NETO, Leo

; MERGEN, Cristian

; MATIELLO, Juliana

Brazilian Oral Research

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2022, Volume 36 elocation e132

Resumo: En | Texto: En | PDF: En

Abstract There are divergences among studies regarding features associated to increased risk of osteoradionecrosis (ORN). Our objective was to identify factors that predispose to the development of ORN of the jaw. This was a retrospective, hospital-based, case-control study involving patients with head and neck cancer who had been treated with ≥ 60 Gy external radiotherapy (RT) to the jaw. A total of 19 cases of ORN and 43 controls were included. The patients’ demographic data, tumor type, staging, treatment and outcome information, and pre-treatment oral status were collected. Univariate analysis showed that the oral cavity/oropharynx sites were associated with 9.77-fold increased risk of ORN development compared to other sites (p = 0.005). Being an active smoker was associated with 3.95-fold increased risk of ORN development (p = 0.01). A tendency towards increased risk of ORN was observed particularly when tooth extraction occurred after RT (odds ratio (OR): 3.04; p = 0.08). Multivariable analysis showed that tumor site was the only significant risk factor (OR: 21.03, p = 0.01). The oral and oropharyngeal primary site is an important risk factor for ORN. Dental extraction, which did not occur in 28% of the sample, was not an essential event for ORN development.

https://doi.org/10.1590/1807-3107bor-2022.vol36.0132

Preservation of immunoexpression of type I collagen, BSP and BMP4 in the dentin-pulp complex of head and neck cancer patients after radiotherapy
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FONSÊCA, Jéssica Montenegro

; MARTINS, Manoela Domingues

; VARGAS, Pablo Agustin

; SILVA, Wagner Gomes

; NORMANDO, Ana Gabriela Costa

; PALMIER, Natália Rangel

; RIBEIRO, Ana Carolina Prado

; BRANDÃO, Thaís Bianca

; LOPES, Márcio Ajudarte

; GOES, Mário Fernando de

; SANTOS-SILVA, Alan Roger

Brazilian Oral Research

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2022, Volume 36 elocation e012

Resumo: En | Texto: En | PDF: En

Abstract This study tested the hypothesis that head and neck radiotherapy (HNRT) impacts the immunoexpression of type I collagen, bone sialoprotein (BSP) and bone morphogenetic protein 4 (BMP4), thereby leading to micromorphological changes in the dentin-pulp complex (DPC), and promoting the onset and progression of radiation caries (RC). Twenty-two demineralized sections of carious teeth (a group of 11 irradiated teeth and a control group of 11 non-irradiated teeth) extracted from 19 head and neck cancer patients were analyzed by conventional optical microscopy and immunohistochemistry to investigate the micromorphology (cellular layer hierarchy, blood vessels, odontoblasts, fibroblasts, extracellular matrix, calcification, necrosis, reactionary dentin formation, and chronic inflammation), and the patterns of staining/immunolocalization of type I collagen, BSP and BMP4 in the dental pulp of irradiated and control samples. No significant differences attributable to the direct impact of radiotherapy were detected in DPC micromorphology between the groups. In addition, the patterns of immunohistochemical staining and immunolocalization of the proteins studied did not differ between the irradiated and the control samples for type I collagen, BSP or BMP4. This study rejected the hypothesis that HNRT directly damages dentition by changing the organic components and the microstructure of the DPC, ultimately leading to RC.

https://doi.org/10.1590/1807-3107bor-2022.vol36.0012

Factors associated with incomplete surgical margins in basal cell carcinoma of the head and neck
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Girardi, Fábio Muradás

; Wagner, Vivian Petersen

; Martins, Manoela Domingues

; Abentroth, Aliende Lengler

; Hauth, Luiz Alberto

Brazilian Journal of Otorhinolaryngology

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Nov 2021, Volume 87 Nº 6 Páginas 695 - 701

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Introdução: A recorrência do carcinoma basocelular (CBC) cutâneo está associada a margens cirúrgicas inadequadas. A frequência e os fatores associados a margens cirúrgicas comprometidas ou inadequadas no carcinoma basocelular de cabeça e pescoço variam. Objetivo: Avaliar os fatores clínicos e patológicos associados a margens cirúrgicas inadequadas no carcinoma basocelular de cabeça e pescoço. Método: Conduzimos um estudo transversal que abrangeu todos os pacientes submetidos à resseçcão de carcinoma basocelular de cabeça e pescoço de janeiro de 2017 a dezembro de 2019. Dados sobre idade, sexo, topografia na cabeça e pescoço, achados histopatológicos e estadiamento foram recuperados e comparados. Cada tumor foi considerado como um caso individual. As margens comprometidas e próximas foram denominadas ‘‘inadequadas’’ ou ‘‘incompletas’’. As variáveis que foram significantemente associadas à presença de margens incompletas foram avaliadas adicionalmente por regressão logística. Resultados: Foram incluídos 605 tumores de 389 pacientes. No geral, 16 casos (2,6%) foram classificados como comprometidos, 52 (8,5%) como próximos e 537 (88,7%) como margens livres. Presença de esclerodermia (p = 0,005), nível de Clark mais elevado (p < 0,001), variantes agressivas (p < 0,001), invasão além do tecido adiposo (p < 0,001), estágio T mais avançado (p < 0,001), invasão perineural (p = 0,002), sítio primário (p = 0,04), multifocalidade (p = 0,01) e diâmetro do tumor (p = 0,02) mostraram associação com margens inadequadas. Após a regressão logística, a multifocalidade, o nível de Clark e a profundidade de invasão foram considerados fatores de risco independentes para margens inadequadas. Conclusão: O exame clínico macroscópico pode ser suficiente para determinar baixa prevalência de margens cirúrgicas inadequadas no tratamento do carcinoma basocelular de cabeça e pescoço em centros oncológicos altamente experientes. Multifocalidade, nível de Clark e profundidade de invasão foram considerados fatores de risco independentes para margens incompletas.

Abstract Introduction: Cutaneous basal cell carcinoma recurrence is associated with inadequate surgical margins. The frequency of and the factors associated with compromised or inadequate surgical margins in head and neck basal cell carcinoma varies. Objective: The purpose of this study was to evaluate the clinical and pathological factors associated with inadequate surgical margins in head and neck basal cell carcinoma. Methods: We developed a cross-sectional study comprising all patients who had undergone resection of head and neck basal cell carcinoma from January 2017 to December 2019. Data on age, sex, head and neck topography, histopathological findings, and staging were retrieved and compared. Each tumor was considered an individual case. Compromised and close margins were termed ‘‘inadequate’’ or ‘‘incomplete’’. Variables that were significantly associated with the presence of incomplete margins were further assessed by logistic regression. Results: In total, 605 tumors from 389 patients were included. Overall, sixteen cases (2.6%) were classified as compromised, 52 (8.5%) as close, and 537 (88.7%) as free margins. Presence of scleroderma (p = 0.005), higher Clark level (p < 0.001), aggressive variants (p < 0.001), invasion beyond the adipose tissue (p < 0.001), higher T stage (p < 0.001), perineural invasion (p = 0.002), primary site (p = 0.04), multifocality (p = 0.01), and tumor diameter (p = 0.02) showed association with inadequate margins. After Logist regression, multifocality, Clark level and depth of invasion were found to be independent risk factors for inadequate margins. Conclusion: Gross clinical examination may be sufficient for determining low prevalence of inadequate surgical margins when treating head and neck basal cell carcinoma in highly experienced oncologic centers. Multifocality, Clark level and depth of invasion were found to be independent risk factors for incomplete margins.

https://doi.org/10.1016/j.bjorl.2020.02.007 1 downloads

10.

Better outcome for parotid versus neck metastasis of head and neck cutaneous squamous cell carcinoma: a new report on reemerging data
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Girardi, Fábio Muradás

; Wagner, Vivian Petersen

; Martins, Manoela Domingues

; Abentroth, Aliende Lengler

; Hauth, Luiz Alberto

Brazilian Journal of Otorhinolaryngology

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Jul 2021, Volume 87 Nº 4 Páginas 389 - 395

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Introdução As metástases regionais do carcinoma espinocelular cutâneo de cabeça e pescoço ocorrem em aproximadamente 5% dos casos, sendo esse o fator prognóstico mais importante na sobrevida, atualmente sem distinção entre metástases de parótida e cervicais. Objetivo Avaliar as características prognósticas em pacientes com carcinoma espinocelular cutâneo de cabeça e pescoço com metástase regional. Método Foi feita uma análise retrospectiva de pacientes com carcinoma espinocelular cutâneo submetidos à parotidectomia e/ou esvaziamento cervical entre 2011 e 2018 em um único centro terciário de uma única instituição. Dados demográficos dos pacientes, informações clínicas, cirúrgicas e patológicas, tratamentos adjuvantes e desfechos no último acompanhamento foram coletados. Os desfechos incluíram recorrência e morte devido à doença. O valor prognóstico das características clínico-patológicas associadas à sobrevida específica da doença foi obtido. Resultados Foram identificados 38 casos de carcinoma espinocelular cutâneo de cabeça e pescoço com metástase de parótida e/ou pescoço. No geral, 18 (47,3%) pacientes apresentaram metástase da parótida isolada, 12 (31,5%) apresentaram metástase cervical isolada e 8 (21,0%) apresentaram ambos. Um tumor primário na região da parótida (Hazard ratio [HR] = 5,53; p = 0,02) foi associado a melhor sobrevida específica. Pior sobrevida específica foi observada em pacientes com maior diâmetro do tumor primário (HR = 1,54; p = 0,002), maior profundidade de invasão (HR = 2,89; p = 0,02), invasão além da gordura subcutânea (HR = 5,05; p = 0,002), metástase cervical na primeira apresentação (HR = 8,74; p < 0,001), conforme maior número de linfonodos positivos (HR = 1,25; p = 0,004) e estágios TNM mais elevados (HR = 7,13; p = 0,009). Os pacientes que apresentaram metástase da parótida isolada durante todo o acompanhamento apresentaram melhor sobrevida específica do que aqueles com metástase cervical ou ambos (HR = 3,12; p = 0,02). Conclusão Os casos de carcinoma espinocelular cutâneo de cabeça e pescoço com metástase intraparotídea demonstraram melhores desfechos do que aqueles com metástase cervical.

Abstract Introduction Regional metastases of cutaneous head and neck squamous cell carcinoma occur in approximately 5 % of cases, being the most important prognostic factor in survival, currently with no distinction between parotid and neck metastasis. Objective The purpose of this study was to evaluate the prognostic features among patients with head and neck cutaneous squamous cell carcinoma exhibiting regional metastasis. Methods A retrospective analysis of patients with cutaneous squamous cell carcinoma who underwent parotidectomy and/or neck dissection from 2011 to 2018 at a single institution tertiary center was performed. Patient demographics, clinical, surgical and pathological information, adjuvant treatments, and outcome at last follow-up were collected. Outcomes included disease recurrence and death due to the disease. Prognostic value of clinic pathological features associated with disease-specific survival was obtained. Results Thirty-eight cases of head and neck cutaneous squamous cell carcinoma with parotid and/or neck metastasis were identified. Overall, 18 (47.3 %) patients showed parotid metastasis alone, 12 (31.5 %) exhibited neck metastasis alone and 8 (21.0 %) had both. A primary tumor in the parotid zone (Hazard Ratio ‒ HR = 5.53; p = 0.02) was associated with improved disease-specific survival. Poorer disease-specific survival was observed in patients with higher primary tumor diameter (HR = 1.54; p = 0.002), higher depth of invasion (HR = 2.89; p = 0.02), invasion beyond the subcutaneous fat (HR = 5.05; p = 0.002), neck metastasis at first presentation (HR = 8.74; p < 0.001), number of positive lymph nodes (HR = 1.25; p = 0.004), and higher TNM stages (HR = 7.13; p = 0.009). Patients presenting with isolated parotid metastasis during all follow-ups had better disease-specific survival than those with neck metastasis or both (HR = 3.12; p = 0.02). Conclusion Head and neck cutaneous squamous cell carcinoma with parotid lymph node metastasis demonstrated better outcomes than cases with neck metastasis.

https://doi.org/10.1016/j.bjorl.2019.10.007 55 downloads

11.

Immunohistochemical expression of OCT4 and CD44 in major and minor salivary gland neoplasms
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Moura, Jamile Marinho Bezerra de Oliveira

; Gonzaga, Amanda Katarinny Goes

; Queiroz, Salomão Israel Monteiro Lourenço

; Martins, Manoela Domingues

; Pinto, Leão Pereira

; Souza, Lélia Batista de

Brazilian Oral Research

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2021, Volume 35 elocation e073

Resumo: En | Texto: En | PDF: En

Abstract The aim of this study was to identify tumor parenchyma cells exhibiting immunohistochemical profile of stem cells by evaluating the immunoreactivity of OCT4 and CD44 in a number of cases of salivary gland neoplasms. The sample consisted of 20 pleomorphic adenomas, 20 mucoepidermoid carcinomas, and 20 adenoid cystic carcinomas located in major and minor salivary glands. The expression of OCT4 and CD44 was evaluated by the percentage of positive cells and the intensity of expression. All studied cases showed positive expression of OCT4 and CD44 and higher values than the control groups. For OCT4, luminal and non-luminal cells were immunostained in the case of pleomorphic adenomas and adenoid cystic carcinomas. Moreover, the immunoreactivity of CD44 was particularly evident in the non-luminal cells of these lesions. In mucoepidermoid carcinomas, there was immunoreactivity for both markers in squamous and intermediate cells and absence of staining in mucous cells. For both markers, a significantly higher immunostaining was verified in neoplasms located in the major salivary glands compared with lesions in minor salivary glands (p<0.001). In the total sample and in minor salivary glands, malignant neoplasms exhibited higher immunoreactivity for OCT4 than pleomorphic adenoma. A significant moderate positive correlation (r = 0.444 and p ≤ 0.001) was found between OCT4 and CD44 immunoexpression in the total sample. The high expression of OCT4 and CD44 may indicate that these proteins play an important role in identifying tumor stem cells.

https://doi.org/10.1590/1807-3107bor-2021.vol35.0073 163 downloads

12.

Analysis of referrals to the stomatology service in a Southern Brazilian hospital: a retrospective study
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ZIGMUNDO, Gisele Corrêa de Oliveira

; SCHMIDT, Tuany Rafaeli

; SILVEIRA, Felipe Martins

; NEVES, Matheus

; MARTINS, Marco Antônio Trevizani

; CARRARD, Vinicius Coelho

; MARTINS, Manoela Domingues

Brazilian Oral Research

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2021, Volume 35 elocation e072

Resumo: En | Texto: En | PDF: En

Abstract This paper intends to describe the demand for referrals to the stomatology service requested by the medical teams for inpatients in a reference hospital in the south of Brazil. This research is a retrospective cross-sectional descriptive study focusing on data collection and assessment of information about referrals to the stomatology unit carried out from January 2008 to December 2018. All information was obtained from the hospital management software database, then transferred and analyzed individually for descriptive statistics. A total of 4433 cases were referred to the stomatology team, with an average of 403 cases by year. Hematology/hemato-oncology (37.3%) was the specialty asking for the majority of the referrals, followed by Oncology (20.4%) and Pneumology (8.2%). The mean patients’ profile was males (55.5%), receiving a diagnosis of oral mucositis (43.5%), and with the first and second decades of life being the most prevalent ones (34.9%), with a mean age of 34.8±22.3 years. The most common treatment performed by the stomatology team was the photobiomodulation therapy (44.8%). This retrospective study demonstrated the important profile of the stomatological care in hospitalized patients from a specific hospital, especially referred by the hematology/hemato-oncology team. These results evidenced the importance of the stomatology specialty in the hospital environment.

https://doi.org/10.1590/1807-3107bor-2021.vol35.0072 124 downloads

13.

BMI-1 expression increases in oral leukoplakias and correlates with cell proliferation
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KLEIN, Isadora Peres

; MEURER, Luise

; DANILEVICZ, Chris Krebs

; SQUARIZE, Cristiane Helena

; MARTINS, Manoela Domingues

; CARRARD, Vinicius Coelho

Journal of Applied Oral Science

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2020, Volume 28 elocation e20190532

Resumo: En | Texto: En | PDF: En

Abstract Oral leukoplakia (OL) is a white lesion of an indeterminate risk not related to any excluded (other) known diseases or disorders that carry no increased risk for cancer. Many biological markers have been used in an attempt to predict malignant transformation; however, no reliable markers have been established so far. Objective To evaluate cell proliferation and immortalization in OL, comparing non-dysplastic (Non-dys OL) and dysplastic OL (Dys OL). Methodology This is a cross-sectional observational study. Paraffin-embedded tissue blocks of 28 specimens of Non-dys OL, 33 of Dys OL, 9 of normal oral mucosa (NOM), 17 of inflammatory hyperplasia (IH), and 19 of oral squamous cell carcinomas (OSCC) were stained for Ki-67 and BMI-1 using immunohistochemistry. Results A gradual increase in BMI-1 and K-i67 expression was found in oral carcinogenesis. The immunolabeling for those markers was higher in OSCC when compared with the other groups (Kruskal-Wallis, p<0.05). Ki-67 expression percentage was higher in OL and in IH when compared with NOM (Kruskal-Wallis/Dunn, p<0.05). Increased expression of BMI-1 was also observed in OL when compared with NOM (Kruskal-Wallis/Dunn, p<0.05). No differences were observed in expression of both markers when non-dysplastic and dysplastic leukoplakias were compared. A significant positive correlation between Ki-67 and BMI-1 was found (Spearman correlation coefficient, R=0.26, p=0.01). High-grade epithelial dysplasia was associated with malignant transformation (Chi-squared, p=0.03). Conclusions These findings indicate that BMI-1 expression increases in early oral carcinogenesis and is possibly associated with the occurrence of dysplastic changes. Furthermore, our findings indicate that both Ki-67 and BMI-1 are directly correlated and play a role in initiation and progression of OSCC.

https://doi.org/10.1590/1678-7757-2019-0532 1012 downloads

14.

Mortality due to oral and oropharyngeal cancer in Uruguay from 1997 to 2014
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Cosetti-Olivera, Maria Laura

; Cunha, Amanda Ramos da

; Prass, Taiane Schaedler

; Martins, Marco Antonio Trevizani

; Hugo, Fernando Neves

; Martins, Manoela Domingues

Journal of Applied Oral Science

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2020, Volume 28 elocation e20190166

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Abstract Oral and oropharyngeal cancer is considered a public health problem in several countries due to its high incidence and mortality rate. Objective: This study aimed to analyze oral and oropharyngeal cancer mortality in Uruguay from 1997 to 2014 by age, sex and country region. Methodology: A time series ecological study using secondary data was performed. Data on mortality due to oral and oropharyngeal cancers were obtained from the Vital Statistics Department of Uruguay's Ministry of Public Health. Results: The cumulative mortality rate due to oral and oropharyngeal cancer over the study period was of 19.26/100,000 persons in women and 83.61/100.000 in men, with a mean annual rate of 1.75/100,000 in women and 7.60/100,000 in men. Mortality rate from both sites during the study period was 4.34 times higher in men than in women. Malignant neoplasms of other parts of the tongue and base of tongue showed the highest mortality rate. The means of the annual coefficients of deaths were higher for the age groups between 50 and 69 years. Higher mortality rates of oral and oropharyngeal cancer were observed in Artigas (4.63) and Cerro Largo (3.75). Conclusions: Our study described a high mortality rate for oral and oropharyngeal cancer in Uruguay from 1997 to 2014. According to the country's health department, men, tongue cancer, and oral cavity had higher mortality rates, with some variation. Prevention strategies with control of risk factors and early diagnosis are necessary to improve survival in the Uruguayan population.

https://doi.org/10.1590/1678-7757-2019-0166 1809 downloads

15.

Influence of photobiomodulation therapy on root development of rat molars with open apex and pulp necrosis
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ZACCARA, Ivana Maria

; JARDINE, Alexander Pompermayer

; MESTIERI, Letícia Boldrin

; QUINTANA, Ramiro Martins

; JESUS, Luciano

; MOREIRA, Maria Stella

; GRECCA, Fabiana Soares

; MARTINS, Manoela Domingues

; KOPPER, Patrícia Maria Poli

Brazilian Oral Research

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2019, Volume 33 elocation e084

Resumo: En | Texto: En | PDF: En

Abstract This study aimed to evaluate the role of photobiomodulation (PBM) in apexification and apexogenesis of necrotic rat molars with an open apex. Rat molars were exposed to the oral environment for 3 weeks. Canals were rinsed with 2.5% NaOCl and 17% EDTA, filled with antibiotic paste and sealed. After 7 days, canals were rinsed and divided into six groups (n=6): mineral trioxide aggregate (MTA); blood clot (BC); human dental pulp stem cells (hDPSC); MTA+PBM; BC+PBM; and hDPSC+PBM. In hDPSC groups, a 1% agarose gel scaffold was used. Two groups were not exposed: healthy tooth+PBM (n = 6), healthy tooth (n = 3); and one was exposed throughout the experiment: necrotic tooth (n = 3). In PBM groups, irradiation was performed with aluminum gallium indium phosphide (InGaAlP) diode laser for 30 days within 24-h intervals. After that, the specimens were processed for histological and immunohistochemical analyses. Necrotic tooth showed greater neutrophil infiltrate (p < 0.05). Necrotic tooth, healthy tooth, and healthy tooth+PBM groups showed absence of a thin layer of fibrous condensation in the periapical area. All the other groups stimulated the formation of a thicker layer of fibers (p < 0.05). All groups formed more mineralized tissue than necrotic tooth (p < 0.05). PBM associated with MTA, BC, or hDPSC formed more mineralized tissue (p < 0.05). MTA+PBM induced apexification (p < 0.05). Rabbit polyclonal anti-bone sialoprotein (BSP) antibody confirmed the histological findings of mineralized tissue formation, and hDPSC groups exhibited higher percentage of BSP-positive cells. It can be concluded that PBM improved apexification and favored apexogenesis in necrotic rat molars with an open apex.

https://doi.org/10.1590/1807-3107bor-2019.vol33.0084 1476 downloads

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