RESUMEN
OBJECTIVE: To evaluate the levels of oxidative stress markers in the saliva of patients with oral lichen planus (OLP). METHODS: A cross-sectional study was conducted with 22 patients diagnosed both clinically and histologically with OLP (reticular or erosive) and 12 individuals without OLP. Non-stimulated sialometry was performed and oxidative stress (myeloperoxidase - MPO and malondialdehyde - MDA) and antioxidant (superoxide dismutase - SOD and glutathione - GSH) markers were determined in the saliva. RESULTS: Among the patients with OLP, most were women (n = 19; 86.4%) and reported to have experienced menopause (63.2%). Patients with OLP were mostly in the active stage of the disease (n = 17; 77.3%) and the reticular form was predominant (n = 15; 68.2%). No statistically significant differences were observed when comparing SOD, GSH, MPO and MDA values between individuals with and without OLP, as well as between erosive and reticular forms of OLP (p > 0.05). Patients with inactive OLP presented higher SOD when compared to those with active disease (p = 0.031). CONCLUSION: Oxidative stress markers in the saliva of patients with OLP were similar to those found in people without OLP, which can be related to the high exposure of the oral cavity environment to several physical, chemical and microbiological stimuli, important generators of the oxidative stress.
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Liquen Plano Oral , Saliva , Humanos , Femenino , Masculino , Liquen Plano Oral/patología , Estudios Transversales , Biomarcadores/metabolismo , Estudios de Casos y Controles , Estrés Oxidativo , Glutatión , Superóxido DismutasaRESUMEN
Cheilitis Glandularis (CG) is a chronic inflammatory disorder with no specific etiology that affects the minor salivary glands of the lips. The main characteristic of this condition consists of the exit of thick saliva or mucopurulent secretion through the dilated ducts present in the vermilion border of the lip, associated to varying degrees of macrocheilia. In this article we report the case of a male patient, leucoderma, 48 years old, that exhibited actinic cheilitis and glandular cheilitis. We emphasized the clinical management, diagnosis criteria and treatment, taking into consideration that GC is a rare condition and makes a differential diagnosis with other entities that may occur on lips. Although a diagnosis of CG is not difficult, its treatment is a challenge, considering the unknown etiology that hinders the development of more specific and effective treatments.
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Queilitis , Sialadenitis , Humanos , Masculino , Persona de Mediana Edad , Glándulas Salivales MenoresRESUMEN
Stafne bone defect (SBD) is a bone cavity in the lingual surface of the mandible normally filled by salivary gland tissue. In conventional radiographs, SBD typically resembles a radiolucent unilocular lesion with welldefined margins, localized under the inferior alveolar canal. The diagnosis of SBD is often incidental due to the asymptomatic nature. The aim of this study was to investigate the prevalence of SBDs in a Brazilian population and to describe the radiographic features of the cases reported. This retrospective study evaluated 17,180 digital panoramic radiographs of patients with an indication of radiography for dental treatment seen at three centers located in the three Brazilian states. In each center, two researchers evaluated the images for establishment of the consensual diagnosis of SBD. In the case of disagreement, a third researcher was consulted to reach a final consensus. To assess the prevalence of SBDs, sex and age of patients were considered, and SBDs were classified according to their form and location. Data were submitted to descriptive analysis. Among the 17.180 patients, only 15 (0.08 %) had SDB, including 3 women and 12 men. The age range of the patients with SDB was 30-69 years (mean: 49.2). Fourteen cases were located in the posterior region of the mandibular body and one case in the ascending ramus. Stafne bone defect is a rare developmental anomaly that more commonly affects middle-aged men. The condition has a typical radiographic appearance and panoramic radiography is a valuable tool for its diagnosis.
El defecto óseo de Stafne (DOS) es una cavidad ósea en la superficie lingual de la mandíbula, normalmente llena de tejido glandular salival. En las radiografías convencionales, el DOS generalmente se asemeja a una lesión unilocular radiotransparente con bordes bien definidos, ubicada debajo del canal alveolar inferior. El diagnóstico de DOS a menudo es accidental debido a su naturaleza asintomática. El objetivo de este estudio fue investigar la prevalencia de DOS en una población brasileña y describir las características radiográficas de los casos reportados. Este estudio retrospectivo evaluó 17.180 radiografías panorámicas digitales de pacientes con indicación radiográfica para tratamiento dental atendidos en tres centros ubicados en tres estados brasileños. En cada centro, dos investigadores evaluaron las imágenes para establecer un diagnóstico consensuado de DOS. En caso de desacuerdo, se consultó a un tercer investigador para llegar a un consenso final. Para evaluar la prevalencia de DOS, se consideraron el sexo y la edad de los pacientes, y se clasificaron según su forma y ubicación. Los datos fueron sometidos a análisis descriptivo. Entre los 17.180 pacientes, solo 15 (0,08 %) tenían DOS, incluidos 3 mujeres y 12 hombres. El rango de edad de los pacientes con DOS fue de 30 a 69 años (media: 49,2). Catorce casos se ubicaron en la región posterior del cuerpo mandibular y un caso en la rama ascendente. Los defectos óseos de Stafne son una anomalía rara del desarrollo que afecta más comúnmente a los hombres de mediana edad. La condición tiene una apariencia radiográfica típica y la radiografía panorámica es una herramienta valiosa para su diagnóstico.
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Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Enfermedades Mandibulares/epidemiología , Enfermedades Mandibulares/diagnóstico por imagen , Brasil/epidemiología , Radiografía Panorámica , Prevalencia , Estudios RetrospectivosRESUMEN
BACKGROUND: Few studies regarding the distribution of pediatric oral diseases are available. Thus, the aim of this study was to investigate the incidence and demographic profile of neoplasms and non-neoplastic lesions among children and adolescents (0-19 years old). METHODS: A retrospective descriptive cross-sectional study was performed and data regarding gender, age, anatomical location, and histopathological diagnosis were collected and categorized. Biopsy records were obtained from the archives of a Brazilian referral center between 1980 and 2016. RESULTS: A total of 2.114 pediatric patient biopsy records were analyzed, where most cases were diagnosed in patients aged 10 to 19 years old (80.7%). Females were more affected (n = 1180) and the lip (n = 507) was the most common anatomical site. Reactive and inflammatory lesions (n = 942) were the most prevalent non-neoplastic pathologies, followed by cysts (n = 308). Benign neoplasms were the most frequent among neoplasms (n = 346) and malignant cases were very rare (n = 11). CONCLUSIONS: An increase in the prevalence of lesions in the second decade of life was observed, where reactive and inflammatory lesions, cysts, and benign neoplasms were most frequent. CLINICAL RELEVANCE: Biopsy data allows for the real characterization of the incidence of oral and maxillofacial lesions and, thus, permits Brazilian dentists and pediatricians to diagnose these diseases.
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Enfermedades de la Boca , Neoplasias de la Boca , Adolescente , Adulto , Biopsia , Brasil , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Enfermedades de la Boca/diagnóstico , Neoplasias de la Boca/diagnóstico , Estudios Retrospectivos , Adulto JovenRESUMEN
The aim of this study was to evaluate the efficacy of low-level laser therapy (LLLT) and alpha-lipoic acid (ALA) in the treatment of burning mouth syndrome (BMS) and secondary oral burning (SOB) by unstimulated sialometry, symptom assessment, and measurement of salivary TNF-α levels. Forty-four patients were randomized into four treatment groups: BMS/laser (n = 10), BMS/ALA (n = 5), SOB/laser (n = 15), and SOB/ALA (n = 14). The control group consisted of eight healthy female subjects. Unstimulated salivary flow was measured before and after treatment, and the collected saliva was stored at - 20 °C for the analysis of TNF-α. Symptoms were evaluated before and after treatment using a pain visual analog scale. Most patients were women (81.8%) during menopause (72.2%). LLLT and ALA were efficient in increasing salivary flow only in BMS but provided symptom relief in both conditions. TNF-α levels did not differ between patients with BMS and SOB or between those patients and the control group. No differences were observed in posttreatment TNF-α levels in either condition. The results of this study suggest that LLLT and ALA are efficient therapies in reducing burning mouth symptoms, with LLLT being more efficient than ALA.
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Síndrome de Boca Ardiente/tratamiento farmacológico , Síndrome de Boca Ardiente/radioterapia , Terapia por Luz de Baja Intensidad , Ácido Tióctico/uso terapéutico , Terapia Combinada , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Saliva/metabolismo , Factor de Necrosis Tumoral alfa/metabolismo , Escala Visual AnalógicaRESUMEN
OBJECTIVE: Actinic cheilitis (AC) is a potentially malignant lesion caused by prolonged exposure to ultraviolet light. The aim of this research was to analyze the efficacy of diclofenac sodium 3% gel in the treatment of this condition, through clinical follow-up. METHODS: Thirty-one patients diagnosed with AC were instructed to perform a topical application of the gel three times a day for a period of 90 days. In each visit, a digital photography was obtained for verified progress and response to treatment. Two researchers evaluated all images after treatment was completed and assigned the following scores regarding clinical aspect of the lip: 1, complete improvement; 2, partial improvement; 3, no changes; 4, worsening of the clinical condition. In addition, the patients' tolerability to the drug and their satisfaction after treatment were evaluated. RESULTS: Twelve cases abandoned the treatment for reasons unrelated to the study. Ten participants showed total remission of all clinical features of the lesion and three had partial improvement of the characteristics. One participant presented worsening of clinical condition, and in five cases, treatment was discontinued due to development of mild adverse effects at the site of gel application. Regarding satisfaction analyses and tolerability to the drug, from 14 patients who completed treatment without adverse effects or complications, most agreed fully that they were satisfied with the therapy (n = 11) and that the drug was not irritating to the mouth (n = 9). Patients are being monitored without clinical signs of recurrence and/or progression of the lesions. CONCLUSION: Topical application of the drug has provided a convenient and well tolerated in most cases. CLINICAL RELEVANCE: Diclofenac sodium gel (3%) may be a promising alternative for treatment of actinic cheilitis.
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Antiinflamatorios no Esteroideos/uso terapéutico , Queilitis/tratamiento farmacológico , Diclofenaco/uso terapéutico , Administración Tópica , Adulto , Anciano , Anciano de 80 o más Años , Antiinflamatorios no Esteroideos/administración & dosificación , Diclofenaco/administración & dosificación , Femenino , Geles , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Resultado del TratamientoRESUMEN
OBJECTIVE: To determine the incidence of potentially malignant oral lesions, and evaluate and correlate their clinical and pathological aspects. METHODS: The sample consisted of cases clinically diagnosed as oral leukoplakia, oral erythroplakia, erythroleukoplakia, actinic cheilitis, and oral lichen planus treated at a diagnostic center, between May 2012 and July 2013. Statistical tests were conducted adopting a significance level of 5% (p≤0.05). RESULTS: Out of 340 patients, 106 (31.2%) had potentially malignant oral lesions; and 61 of these (17.9%) were submitted to biopsy. Actinic cheilitis was the most frequent lesion (37.5%) and the lower lip was the most affected site (49.6%). Among 106 patients in the sample, 48 (45.3%) reported nicotine consumption, 35 (33%) reported alcohol intake and 34 (32.1%) sun exposure while working. When clinical and histopathological diagnoses were compared, oral erythroplakia and atypical ulcer were the lesions that exhibited greater compatibility (100% each). CONCLUSION: In most cases, clinical and histopathological diagnoses were compatible. An association between the occurrence of erythroplakia, leukoplakia and erythroleukoplakia with smoking was observed. Similarly, an association between actinic cheilitis and sun exposure was noted. Erythroleukoplakia presented the highest malignancy grade in this study. Finally, dental surgeons should draw special attention to diagnosis of potentially malignant oral lesions, choose the best management, and control the lesions to avoid their malignant transformation.
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Queilitis/patología , Eritroplasia/patología , Leucoplasia Bucal/patología , Neoplasias de la Boca/patología , Lesiones Precancerosas/patología , Adulto , Anciano , Anciano de 80 o más Años , Brasil/epidemiología , Queilitis/epidemiología , Estudios Transversales , Eritroplasia/epidemiología , Femenino , Humanos , Incidencia , Leucoplasia Bucal/epidemiología , Liquen Plano Oral/epidemiología , Liquen Plano Oral/patología , Masculino , Persona de Mediana Edad , Neoplasias de la Boca/epidemiología , Lesiones Precancerosas/epidemiología , Estudios Retrospectivos , Factores de Riesgo , Fumar , Adulto JovenRESUMEN
Granular cell tumor (GCT) is an uncommon benign soft tissue neoplasm, which usually presents as a solitary nodule, appearing especially in the tongue. There are few cases of multiple oral GCT in the English-language literature, with only three cases reported in the last 20 years. This report describes a case of two oral GCT in a young patient and provides a literature review from 1995 to 2015. Clinical characteristics of the reviewed cases were retrieved and compared with the present case. Exceptionally, the current case was the only one that occurred in an adolescent and solely affected the oral cavity. Besides the oral cavity, the other cases also observed GCT lesions in the skin. Although rare, it is important to know multiple oral GCT clinical and histopathological characteristics so they can be correctly diagnosed, treated and followed up.
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Tumor de Células Granulares/patología , Neoplasias Primarias Múltiples/patología , Neoplasias de la Lengua/patología , Niño , Femenino , Tumor de Células Granulares/cirugía , Humanos , Neoplasias Primarias Múltiples/cirugía , Neoplasias de la Lengua/cirugíaRESUMEN
OBJECTIVE: The objective of this study was to evaluate the association between psychological, hormonal, and genetic factors with the development of burning mouth syndrome (BMS) and secondary oral burning (SOB) in order to provide a better characterization and classification of these conditions. DESIGN: Cross sectional study. SETTING: Patients with complaints of mouth burning registered at the Oral Diagnostic Service of the Federal University of Rio Grande do Norte between 2000 and 2013. SUBJECTS: The sample consisted of 163 subjects divided into a group of patients with BMS (n = 64) and a group of subjects with SOB (n = 99). METHODS: The following variables were analyzed: passive and stimulated saliva flow, stress levels and phase, depression, anxiety, serum cortisol and dehydroepiandrosterone (DHEA) levels, and the presence of polymorphisms in the interleukin 6 (IL-6) gene. RESULTS: The results showed significant differences in the presence of xerostomia (p = 0.01), hyposalivation at rest (p < 0.001) and symptoms of depression (p = 0.033) between the two groups, which were more prevalent in the BMS group. DHEA levels were lower in the BMS group (p = 0.003) and were sensitive and specific for the diagnosis of this condition. Genetic analysis revealed no significant association between the polymorphisms analyzed and the development of BMS. CONCLUSION: These results suggest a possible role of depression, as well as of reduced DHEA levels, as associated factors for development of BMS.
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Síndrome de Boca Ardiente/metabolismo , Síndrome de Boca Ardiente/psicología , Enfermedades de la Boca/metabolismo , Enfermedades de la Boca/psicología , Adulto , Anciano , Síndrome de Boca Ardiente/genética , Estudios Transversales , Deshidroepiandrosterona/sangre , Depresión/complicaciones , Femenino , Genotipo , Humanos , Masculino , Persona de Mediana Edad , Enfermedades de la Boca/genética , Reacción en Cadena en Tiempo Real de la PolimerasaRESUMEN
BACKGROUND: To investigate whether the immunohistochemical expression of GLUT-1 and HIF-1α is related to the diagnosis and pathogenesis of oral vascular lesions. STUDY METHODS: Thirty cases each of pyogenic granuloma (PG) and hemangioma were studied. Antibodies against GLUT-1 and HIF-1α were detected by immunoperoxidase staining in 3-µm histological sections, and the results were analyzed qualitatively and quantitatively, respectively. Positive and negative cells were counted, and the mean number of positive cells was calculated for each case. RESULTS: The initial diagnosis of hemangioma was maintained in only 7 (23%) of the 30 cases studied, which were positive for GLUT-1. The remaining 23 cases were reclassified as vascular malformation (VM) (n = 13) and PG (n = 10) due to the absence of staining. The endothelium of blood vessels was negative for GLUT-1 in all cases initially diagnosed as PG (n = 30). The percentage of HIF-1α-positive cells was higher in cases of PG, followed by hemangiomas and VMs (P = 0.005). CONCLUSIONS: Histological features are not sufficient to establish the correct diagnosis of oral hemangiomas, and an accurate anamnesis is essential in these cases. In addition, these findings demonstrate that vascular lesions express mediators of angiogenesis, HIF-1α, and suggest that his process may play a role in the pathogenesis of vascular.
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Transportador de Glucosa de Tipo 1/análisis , Granuloma Piogénico/diagnóstico , Hemangioma/diagnóstico , Subunidad alfa del Factor 1 Inducible por Hipoxia/análisis , Enfermedades de la Boca/diagnóstico , Neoplasias de la Boca/diagnóstico , Adulto , Inductores de la Angiogénesis/análisis , Biomarcadores/análisis , Biomarcadores de Tumor/análisis , Diagnóstico Diferencial , Endotelio Vascular/patología , Granuloma Piogénico/etiología , Granuloma Piogénico/patología , Hemangioma/etiología , Hemangioma/patología , Humanos , Técnicas para Inmunoenzimas , Enfermedades de la Boca/etiología , Enfermedades de la Boca/patología , Neoplasias de la Boca/etiología , Neoplasias de la Boca/patología , Estudios Retrospectivos , Malformaciones Vasculares/diagnóstico , Malformaciones Vasculares/etiología , Malformaciones Vasculares/patologíaRESUMEN
Peripheral ameloblastoma is an uncommon, extraosseous counterpart of solid ameloblastoma, which occurs in the soft tissues overlying tooth-bearing areas or the alveolar mucosa of the mandible and maxilla. In this paper, the authors report a case of peripheral ameloblastoma located in the maxillary gingiva of a 54-year-old woman and review the literature regarding clinicopathological features, differential diagnosis and therapeutic management of peripheral ameloblastomas.
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Ameloblastoma/diagnóstico , Neoplasias Gingivales/diagnóstico , Biopsia , Núcleo Celular/patología , Diagnóstico Diferencial , Células Epiteliales/patología , Epitelio/patología , Femenino , Estudios de Seguimiento , Humanos , Hiperplasia , Maxilar/patología , Persona de Mediana EdadRESUMEN
BACKGROUND: Florid cemento-osseous dysplasia (FCOD) has been described as a condition that characteristically affects the jaws of middle-aged black women. Radiographically, FCOD appears as dense, lobulated masses, often symmetrically located in various regions of the jaws. FCOD is usually asymptomatic. In severe cases, focal expansion may occur due to infection. Management of the symptomatic patient is more difficult due to the avascular nature of the lesion which contributes to susceptibility severe infection, bone sequestration, and osteomyelitis when surgery is performed. CASE REPORT: This paper presents a rare case of severe FCOD; the black woman patient was diagnosed based on clinical and radiographic findings and treated conservatively. The examination of panoramic radiographs revealed a multiple sclerotic masses with radiolucent borders, found in the mandible and maxilla which were symmetrical at presentation. The patient continuous with the follow-up. DISCUSSION: This report confirms that a diagnosis can be made with accurate clinical and radiographic assessment. The correct selection of treatment for FCOD depends on this information.
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Infecciones Bacterianas/diagnóstico por imagen , Cementoma/diagnóstico por imagen , Cementoma/terapia , Cemento Dental , Neoplasias Mandibulares/diagnóstico por imagen , Neoplasias Mandibulares/terapia , Neoplasias Maxilares/diagnóstico por imagen , Neoplasias Maxilares/terapia , Neoplasias Primarias Múltiples/diagnóstico por imagen , Neoplasias Primarias Múltiples/terapia , Radiografía Panorámica , Infecciones Bacterianas/terapia , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Higiene BucalRESUMEN
OBJECTIVE: The aim of this study was to evaluate oral epithelial cells by exfoliative cytology in burning mouth syndrome (BMS). MATERIAL AND METHODS: Oral smears were collected from clinically normal-appearing mucosa by liquid-based exfoliative cytology in 40 individuals (20 BMS patients and 20 healthy controls matched for age and gender) and analysed for cytological and cytomorphometric techniques. RESULTS: Mean values of nuclear area (NA) for experimental and control groups were, respectively, 67.52 and 55.64 µm² (p < 0.05). Cytoplasmic area (CA) showed the following mean values: 1258.0 (experimental) and 2069.0 µm² (control). Nucleus-to-cytoplasm area ratio for the experimental group was 0.07, besides the control group was 0.03 (p < 0.05). Morphologically, oral smears exhibited normal epithelial cells in both experimental and control groups. There was a significant predominance of nucleated cells of the superficial layer in the smears of BMS patients (p = 0.00001). CONCLUSION: This study revealed that oral mucosa of BMS patients exhibited significant cytomorphometric changes in the oral epithelial cells. These changes probably are associated with epithelial atrophy and a deregulated maturation process that may contribute to the oral symptoms of pain and discomfort in BMS.
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Síndrome de Boca Ardiente/patología , Mucosa Bucal/patología , Adulto , Anciano , Anciano de 80 o más Años , Atrofia , Estudios de Casos y Controles , Núcleo Celular/ultraestructura , Forma de la Célula , Colorantes , Citodiagnóstico/instrumentación , Citodiagnóstico/métodos , Citoplasma/ultraestructura , Células Epiteliales/patología , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Masculino , Persona de Mediana Edad , Lengua/patologíaRESUMEN
Sialolipoma is a rare benign neoplasm characterized by a well-circumscribed mass composed of neoplastic mature adipose tissue and non-neoplastic salivary gland elements. A 72-year-old woman presented with a painless swelling located in the hard palate, which had been identified 15 days earlier. Microscopically, the tumor was well-circumscribed consisting of lobular proliferation of the lipomatous tissue with thin fibrous tissue septa containing clustered salivary gland elements. Both the glandular and adipose components were found in almost equal proportion. No atypia in the adipose tissue was observed. The definitive diagnosis was sialolipoma. The patient showed no signs of recurrence 8 months after surgical excision. Including the present case, 35 cases of sialolipoma have been reported in the English literature. Of these 35 cases, 16 cases were located in minor salivary glands. Gender was identified in 14 of these cases with 4 males (28.5%) and 10 females (71.5%). The age distribution was from 27 to 84 years (mean, 61.6 years) and the tumor size ranged from 0.9 to 4 cm (mean, 1.7 cm). The most frequently reported clinical presentation was of a painless swelling (56.3%).
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Lipoma/patología , Neoplasias de las Glándulas Salivales/patología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Lipoma/cirugía , Masculino , Persona de Mediana Edad , Neoplasias de las Glándulas Salivales/cirugía , Glándulas Salivales Menores/patología , Glándulas Salivales Menores/cirugía , Resultado del TratamientoRESUMEN
This study evaluated the expression of fibronectin, tenascin and type I collagen in ameloblastomas and adenomatoid odontogenic tumors (AOTs) aiming to contribute with the comprehension of the differences in the biological behavior of these tumors. Immunohistochemical technique was performed in 20 cases of ameloblastoma (16 solid and 4 desmoplastic) and in 10 cases of AOT. All tumors presented moderate fibronectin expression in the stroma. Solid ameloblastomas showed intense expression of fibronectin at the epithelial-mesenchymal interface, whereas desmoplastic ameloblastomas revealed no immunoexpression of fibronectin at this site. Ameloblastomas presented stronger immunoreactivity to tenascin than AOTs, especially at the epithelial-mesenchymal interface. AOTs and desmoplastic ameloblastomas showed intense labeling for type I collagen. The patterns of expression of the proteins studied agree with the locally more invasive behavior of ameloblastomas in comparison to AOTs. Our results might suggest a less invasive behavior of desmoplastic ameloblastoma in comparison to solid ameloblastoma.