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Oral leukoplakia and erythroplakia in young patients: a southern Brazilian multicenter study patients
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SOARES, Alini Cardoso

; GOMES, Ana Paula Neutzling

; CALDERIPE, Camila Barcellos

; SALUM, Fernanda Gonçalves

; CHERUBINI, Karen

; MARTINS, Manoela Domingues

; SCHUCH, Lauren Frenzel

; KIRSCHNICK, Laura Borges

; ABREU, Lucas Guimarães

; SANTOS-SILVA, Alan Roger

; VASCONCELOS, Ana Carolina Uchoa

Brazilian Oral Research

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2024, Volume 38 elocation e069

Abstract: En | Text: En | PDF: En

Abstract The objective of the present study was to investigate the frequency of oral leukoplakia and oral erythroplakia among young patients from three Brazilian reference centers in Oral and Maxillofacial Pathology. A retrospective study was carried out from 2011 to 2021 on 861 patients diagnosed with oral leukoplakia and oral erythroplakia. Demographic and clinicopathological data were evaluated. Fisher’s exact test was used to evaluate the association among sex, age, anatomical location, and histopathological diagnosis. A total of 83 (9.64%) cases involved young patients (aged <40 years). Among these, biopsy records were included in 31 (37.34%) cases, all of which received a clinical diagnosis of oral leukoplakia. Seventeen (54.84%) patients were female, mostly in their fourth decade of life (n = 22/70.97%), and their mean age at diagnosis was 32.61(± 5.21) years. Among informed cases, seven (22.58%) patients were smokers. The lateral border of the tongue (n = 9/29.03%) was the most affected site. In 13 (41.94%) cases, oral leukoplakias showed a homogeneous appearance. The mean size of the lesions was 1.47 cm (0.2–3.0 cm) and the mean time of disease progression was 64.37 (± 65.90) months. The histopathological analysis showed that 11 cases (35.48%) exhibited some degree of epithelial dysplasia. Acanthosis and/or hyperkeratosis were observed in 20 cases (64.52%). No significant associations were observed between sex and anatomical location, age and anatomical location, nor between sex and histological diagnosis (p > 0.05). Oral leukoplakia and oral erythroplakia are uncommon diseases in young patients. In this population, oral leukoplakia shows a slight predilection for women aged between 30 and 39 years. Pathology 201 202 86 evaluated Fishers Fisher s location 8 9.64% 964 9 64 (9.64% 40 <4 years . years) these 3 37.34% 3734 37 34 (37.34% 54.84% 5484 54 84 (54.84% female n 22/70.97%, 227097 22/70.97% , 22 70 97 22/70.97%) 32.61± 3261 32.61 ± 32 61 32.61( 5.21 521 5 21 22.58% 2258 58 (22.58% smokers 9/29.03% 92903 29 03 site 1 41.94% 4194 41 94 (41.94% appearance 147 47 1.4 0.2–3.0 0230 0 2 (0.2–3. 6437 64.3 ( 65.90 6590 65 90 months 35.48% 3548 35 48 (35.48% dysplasia andor or 64.52%. 6452 64.52% 52 (64.52%) p 0.05. 005 0.05 05 0.05) population 9.64 96 6 (9.64 4 < 37.34 373 (37.34 54.84 548 (54.84 22709 22/70.97 7 326 32.6 5.2 22.58 225 (22.58 9/29.03 9290 41.94 419 (41.94 14 1. 0.2–3. 023 (0.2–3 643 64. 65.9 659 35.48 354 (35.48 645 64.52 (64.52% 00 0.0 9.6 (9.6 37.3 (37.3 54.8 (54.8 2270 22/70.9 32. 5. 22.5 (22.5 9/29.0 929 41.9 (41.9 0.2–3 02 (0.2– 65. 35.4 (35.4 64.5 (64.52 0. 9. (9. 37. (37. 54. (54. 227 22/70. 22. (22. 9/29. 92 41. (41. 0.2– (0.2 35. (35. (64.5 (9 (37 (54 22/70 (22 9/29 (41 0.2 (0. (35 (64. (3 (5 22/7 (2 9/2 (4 (0 (64 22/ 9/ (6

https://doi.org/10.1590/1807-3107bor-2024.vol38.0069

Impact of an educational intervention regarding tobacco counseling on dentists and dental students
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Herpich, Tiago Luís

; Mendes, Eduarda Martins

; Roxo-Gonçalves, Michelle

; Katz, Natan

; Almeida, Janete Dias

; Martins, Manoela Domingues

; Romanini, Juliana

; Carrard, Vinicius Coelho

Brazilian Oral Research

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2024, Volume 38 elocation e102

Abstract: En | Text: En | PDF: En

Abstract: The present study aimed to assess the knowledge, attitudes, and perceptions of dental professionals and students regarding tobacco cessation counseling (TCC) after their participation in a continuing education activity (CEA) entitled "Smoking cessation: How does the dentist participate in this decision?" at the Oral Cancer Seminar: Projeto Maio Vermelho 2021. This study utilized a pre-/post-intervention design, including a pre-intervention questionnaire with 20 close-ended questions, an educational intervention, and a post-intervention questionnaire with nine close-ended questions. Descriptive and statistical analyses were performed using SPSS 25 and GraphPad Prism 8 software. The significance level was set at p = 0.05. A total of 94 participants answered the pre-intervention questionnaire and 52 answered both the pre- and post-intervention questionnaires. Most participants reported regularly asking about smoking status (96.8%), providing advice on tobacco risks (96.8%), and offering some counseling to help patients stop smoking (84.0%). Although participants habitually ask about cigarette use, other forms of tobacco consumption are frequently overlooked. Most participants reported never having attended TCC training during their undergraduate studies (67.0%) or after graduation (71.2%). However, 96.2% showed interest in attending TCC training. The perception that motivational counseling by dentists can encourage patients to stop smoking rose from 87.5 to 98.2% (p<0.05) after the educational intervention. In addition, participants’ self-confidence in conducting TCC increased from 8.9% to 23.3% (p<0.01). The brief CEA on TCC showed favorable outcomes, enhancing the perception of dentists and undergraduate dental students regarding the effectiveness of counseling for smoking cessation and boosting their self-confidence in providing tobacco counseling. Abstract knowledge attitudes (TCC (CEA Smoking decision decision? Seminar 2021 pre/postintervention prepostintervention pre /post intervention post design preintervention 2 closeended close ended questions postintervention software 005 0 05 0.05 9 5 questionnaires 96.8%, 968 96.8% , 96 (96.8%) 84.0%. 840 84.0% . 84 (84.0%) use overlooked 67.0% 670 67 (67.0% 71.2%. 712 71.2% 71 (71.2%) However 962 96.2 875 87 87. 982 98 98.2 p<0.05 p005 (p<0.05 addition selfconfidence self confidence 89 8.9 233 23 3 23.3 p<0.01. p001 p<0.01 01 (p<0.01) outcomes 202 00 0.0 96.8 (96.8% 84.0 (84.0% 67.0 6 (67.0 71.2 7 (71.2% 96. 98. p<0.0 p00 (p<0.0 8. 23. (p<0.01 0. (96.8 84. (84.0 67. (67. 71. (71.2 p<0. p0 (p<0. (96. (84. (67 (71. p<0 (p<0 (96 (84 (6 (71 p< (p< (9 (8 ( (7 (p

https://doi.org/10.1590/1807-3107bor-2024.vol38.0102

Oral cancer immunology: state of the art and future perspectives immunology
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GIRARDI, Fábio Muradás

; SCHUCH, Lauren Frenzel

; MARTINS, Manoela Domingues

Brazilian Oral Research

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2024, Volume 38 elocation e129

Abstract: En | Text: En | PDF: En

Abstract Oral cancer is a multifactorial disease involving genetic, epigenetic, and environmental factors. The literature indicates that inflammatory cells at the advancing front of the tumor induce a host immune response, preventing the spread of the tumor. However, cancer cells adopt various continued strategies to circumvent this immune surveillance. The complexity of immune mechanisms suggests that there must be virtually individual patterns of anti-tumor immune responses. Due to this important interaction of cancer with the immune system, the objective of the present study was to provide an up-to-date overview of immuno-oncology focused on oral cancer, summarizing the basic immunology, the classic risk factors, immunotherapy, and future treatment and prognostic perspectives. genetic epigenetic factors response However surveillance antitumor anti responses system uptodate up date immunooncology immuno oncology immunology immunotherapy perspectives

https://doi.org/10.1590/1807-3107bor-2024.vol38.0129

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

Abstract: En | Text: 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. (OMPLs SCC. . (SCC) crosssectional cross sectional North, North (North Northeast CentralWest, CentralWest Central West, West Central-West South. South South) 201 120010 120 010 120,01 20102019, 20102019 , (2010-2019) 69 6 9 6.9 8,321 8321 8 321 (8,32 0.8%, 08 0 (0.8% 95 cases, 4.9%, 49 4 (4.9% 5971 5 971 5,97 1.2%, 12 1 2 (1.2% 1399 399 1,39 Brazils s 64.5%, 645 64.5% 64 (64.5%) located men years level consumption group nonCaucasian non formercurrent former users Institute 99 9.9 Therefore System (SCC 20 12001 01 120,0 2010201 (2010-2019 6. 8,32 832 32 (8,3 0.8% (0.8 4.9% (4.9 597 97 5,9 1.2% (1.2 139 39 1,3 64.5 (64.5% 9. 1200 120, 201020 (2010-201 8,3 83 3 (8, 0.8 (0. 4.9 (4. 59 5, 1.2 (1. 13 1, 64. (64.5 20102 (2010-20 8, (8 0. (0 4. (4 1. (1 (64. (2010-2 ( (64 (2010- (6 (2010 (201 (20 (2

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

Acinic cell carcinoma of the oral and maxillofacial region: an international multicenter study region
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KIRSCHNICK, Laura Borges

; SILVEIRA, Felipe Martins

; SCHUCH, Lauren Frenzel

; VASCONCELOS, Ana Carolina Uchoa

; GOMES, Ana Paula

; SANTOS, Jean Nunes dos

; SANTANA, Dandara Andrade

; FONSECA, Felipe Paiva

; MESQUITA, Ricardo Alves

; MENDONÇA, Elismauro Francisco de

; SOUSA-NETO, Sebastião Silvério

; PONTES, Hélder Antônio Rebelo

; ROBINSON, Liam

; HEERDEN, Willie van

; CARLOS-BREGNI, Román

; TAGER, Elena María José Román

; SILVA, Luan César da

; ZANELLA, Virgílio Gonzales

; RIVERO, Luis Fernando

; BITTENCOURT, Raquel

; MARTINS, Marco Antonio Trevizani

; LOPES, Márcio Ajudarte

; WAGNER, Vivian Petersen

; VARGAS, Pablo Agustin

; MARTINS, Manoela Domingues

Brazilian Oral Research

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2023, Volume 37 elocation e050

Abstract: En | Text: En | PDF: En

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. prevalence clinicopathological (AciCC region 1 countries demographic clinical pathologic followup follow up information 7 included 65.33% 6533 65 33 (65.33% 4551 45 51 45.5 affected 64.28% 6428 64 28 (64.28% 95.66% 9566 95 66 (95.66% 70.68%. 7068 70.68% . 70 68 (70.68%) 48.93% 4893 48 93 (48.93% 86.11%. 8611 86.11% 86 (86.11%) 59.19%. 5919 59.19% 59 19 (59.19%) 20 3043 30 43 30.43% 1250 12 50 12.50% p=0.01, p001 p p=0.01 , 0 01 (p=0.01) highgrade grade p=0.008, p0008 p=0.008 008 (p=0.008) p=0.007, p0007 p=0.007 007 (p=0.007) p=0.03 p003 03 (p=0.03 survival conclusion 65.33 653 6 3 (65.33 455 4 5 45. 64.28 642 2 (64.28 95.66 956 9 (95.66 706 70.68 (70.68% 48.93 489 (48.93 861 86.11 8 (86.11% 591 59.19 (59.19% 304 30.43 125 12.50 p00 p=0.0 (p=0.01 p000 p=0.00 00 (p=0.008 (p=0.007 (p=0.0 65.3 (65.3 64.2 (64.2 95.6 (95.6 70.6 (70.68 48.9 (48.9 86.1 (86.11 59.1 (59.19 30.4 12.5 p0 p=0. (p=0.00 (p=0. 65. (65. 64. (64. 95. (95. 70. (70.6 48. (48. 86. (86.1 59. (59.1 30. 12. p=0 (p=0 (65 (64 (95 (70. (48 (86. (59. p= (p= (6 (9 (70 (4 (86 (59 (p ( (7 (8 (5

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

Virtual learning object about oral ulcerative lesions: controlled educational intervention study lesions
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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

Abstract: En | Text: 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. (VLO process classification clinicalsurgical clinical surgical specialists 5 conventional class 29 interaction 29. . pretest pre test posttest post performed adequate 100 866 86 6 86.6 p 0.01. 001 0.01 0 01 0.01) conclusion medicine mouth 2 10 8 86. 00 0.0 1 0.

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

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

Abstract: En | Text: 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

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

Abstract: En | Text: 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

Abstract: En | Text: 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

10.

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

Abstract: En | Text: 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

11.

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

Abstract: En | Text: 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

12.

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 N. 6 Pages 695 - 701

Abstract: Pt En | Text: 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

13.

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 N. 4 Pages 389 - 395

Abstract: Pt En | Text: 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

14.

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

Abstract: En | Text: 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

15.

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

Abstract: En | Text: 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

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