RESUMO
This case report highlights the delay in the diagnosis of oral squamous cell carcinoma (OSCC) and the inappropriate use of low-level laser therapy (LLLT) in dentistry. OSCC is a malignant neoplasm that affects the oral cavity and can have severe consequences if not diagnosed and treated appropriately and promptly. The patient presented with a persistent oral lesion that was initially diagnosed as a traumatic injury and treated with LLLT, which led to a delay in the correct diagnosis of OSCC. The case emphasizes the importance of early detection and proper management of oral lesions to prevent the progression of malignant conditions. It also emphasizes the need for professional knowledge regarding the applicability of LLLT in dental practice. Dental professionals should be vigilant in recognizing suspicious oral lesions and promptly refer patients for further evaluation and appropriate treatment to ensure optimal outcomes.
Este informe de un caso destaca el retraso en el diagnóstico del carcinoma espinocelular oral (CEC) y el uso inapropiado de la terapia con láser de baja potencia (LBP) en odontología. El CEC es una neoplasia maligna que afecta la cavidad oral y puede tener graves consecuencias si no se diagnostica y trata de manera adecuada y oportuna. La paciente presentó una lesión oral persistente que inicialmente se diagnosticó como lesión traumática y se trató con LBP, lo que llevó a un retraso en el diagnóstico correcto del CEC. El caso enfatiza la importancia de la detección temprana y el manejo adecuado de las lesiones orales para prevenir la progresión de condiciones malignas. También resalta los riesgos asociados con el uso inapropiado de la LBP en la práctica odontológica. Los profesionales de la odontología deben estar atentos a las lesiones orales sospechosas y remitir a los pacientes de manera oportuna para una evaluación adicional y un tratamiento adecuado, con el fin de garantizar mejores resultados.
RESUMO
The oral cancer is responsible for approximately 3 % of cases of cancer in Brazil. Epidemiological studies have associated low folate intake with an increased risk of epithelial cancers, including oral cancer. Folic acid has a key role in DNA synthesis, repair, methylation and this is the basis of explanations for a putative role for folic acid in cancer prevention. The role of folic acid in carcinogenesis may be modulated by polymorphism C677T in MTHFR and tandem repeats 2R/3R in the promoter site of TYMS gene that are related to decreased enzymatic activity and quantity and availability of the enzyme, respectively. These events cause a decrease in the synthesis, repair and DNA methylation, which can lead to a disruption in the expression of tumor suppressor genes as TP53. The objective of this study was investigate the distribution of polymorphisms C677T and tandem repeats 2R/3R associated with the development of oral squamous cell carcinoma (OSCC). 53 paraffin-embedded samples from patients who underwent surgery but are no longer at the institution and 43 samples collected by method of oral exfoliation by cytobrush were selected. 132 healthy subjects were selected by specialists at the dental clinics of the Faculdade de Odontologia de Pernambuco-FOP. The MTHFR genotyping was performed by PCR-RFLP, and the TYMS genotyping was performed by conventional PCR. Fisher's Exact test at significant level of 5 %. Odds ratios (ORs) and 95 % confidence intervals (CIs) were used to measure the strength of association between genotype frequency and OSCC development. The results were statistically significant for the tandem repeats of the TYMS gene (p = 0.015). The TYMS 2R3R genotype was significantly associated with the development of OSCC (OR = 3.582; 95 % CI 1.240-10.348; p = 0.0262) and also the genotype 3R3R (OR = 3.553; 95 % CI 1.293-9.760; p = 0.0345). When analyzed together, the TYMS 2R3R + 3R3R genotypes also showed association (OR = 3.518; 95 % CI 11.188-10.348; p = 0.0177). No differences for the MTHFR C677T polymorphisms distribution were found between the oral cancer patients and controls subjects in our study (p = 0.499). Therefore, these data suggest that determination of TYMS tandem repeats could provide information on the comprehension of the risk factors and prevention of the OSCC.