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OBJECTIVE: To determine the prevalence, epidemiological profile, and clinical characteristics of Oral or Oropharyngeal Mucosal Lesions (OOPML) in patients attended at the Otorhinolaryngology Service of the Evandro Chagas National Institute of Infectious Diseases (INI-FIOCRUZ) from 2005 to 2017. METHODS: Statistical analysis of descriptive data from medical records (gender, age, education level, skin color, origin, smoking, alcoholism, HIV co-infection, time of disease evolution, first symptom, and OOPML location) was performed. RESULTS: Of 7551 patients attended at the service, 620 (8.2%) were included in the study. OOPML were classified into developmental anomalies (n = 3), infectious diseases (non-granulomatous n = 220; granulomatous n = 155), autoimmune diseases (n = 24), neoplasms (benign n = 13; malignant, n = 103), and unclassified epithelial/soft tissue diseases (n = 102). OOPML of infectious diseases (60.5%) and neoplasms (18.7%) were the most frequent. The predominant demographics of patients with OOPML were: males (63.5%), white (53.5%), and those in the fifth to sixth decades of life (43.3%). Local pain (18.1%) and odynophagia (15%) were the most reported first symptoms, and the most frequent OOPML sites were the palatine tonsil (28.5%), hard palate (22.7%), and tongue (20.3%). The median evolution time was three months. CONCLUSIONS: Infectious OOPML were the most frequent, as expected in a reference center for infectious diseases, and thus, they are likely to be less frequent in general care and/or dental services. Underreporting of OOPML is possible, as oral/oropharyngeal examination is often not included in the routine medical examination. Oral cavity/oropharynx examination should be performed by specialists, such as dentists and otorhinolaryngologists, who have the expertise in identifying OOPML, even in incipient/asymptomatic cases. Given the numerous diseases in which OOPML can present, diagnosis could be facilitated by multidisciplinary teams, potentially enabling the early treatment of diseases, and thus, reduce morbidity and improve prognosis. The use of standardized medical records for oral/oropharyngeal systematic examination could provide relevant tools for differential diagnoses and information for new clinical-epidemiological studies. LEVEL OF EVIDENCE: Level 3.

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Abstract Several topics related to the oral cavity are briefly addressed in this article, from anatomical variations that, when recognized, avoid unnecessary investigations, to diseases that affect exclusively the mouth, mucocutaneous diseases, as well as oral manifestations of systemic diseases. A complete clinical examination comprises the examination of the mouth, and this approach facilitates clinical practice, shortening the path to diagnosis in the outpatient clinic as well as with in-hospital patients. The objective of this article is to encourage the examination of the oral cavity as a useful tool in medical practice, helping to recognize diseases in this location.

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Several topics related to the oral cavity are briefly addressed in this article, from anatomical variations that, when recognized, avoid unnecessary investigations, to diseases that affect exclusively the mouth, mucocutaneous diseases, as well as oral manifestations of systemic diseases. A complete clinical examination comprises the examination of the mouth, and this approach facilitates clinical practice, shortening the path to diagnosis in the outpatient clinic as well as with in-hospital patients. The objective of this article is to encourage the examination of the oral cavity as a useful tool in medical practice, helping to recognize diseases in this location.

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Abstract Objective To determine the prevalence, epidemiological profile, and clinical characteristics of Oral or Oropharyngeal Mucosal Lesions (OOPML) in patients attended at the Otorhinolaryngology Service of the Evandro Chagas National Institute of Infectious Diseases (INI-FIOCRUZ) from 2005 to 2017. Methods Statistical analysis of descriptive data from medical records (gender, age, education level, skin color, origin, smoking, alcoholism, HIV co-infection, time of disease evolution, first symptom, and OOPML location) was performed. Results Of 7551 patients attended at the service, 620 (8.2%) were included in the study. OOPML were classified into developmental anomalies (n = 3), infectious diseases (non-granulomatous n = 220; granulomatous n = 155), autoimmune diseases (n = 24), neoplasms (benign n = 13; malignant, n = 103), and unclassified epithelial/soft tissue diseases (n = 102). OOPML of infectious diseases (60.5%) and neoplasms (18.7%) were the most frequent. The predominant demographics of patients with OOPML were: males (63.5%), white (53.5%), and those in the fifth to sixth decades of life (43.3%). Local pain (18.1%) and odynophagia (15%) were the most reported first symptoms, and the most frequent OOPML sites were the palatine tonsil (28.5%), hard palate (22.7%), and tongue (20.3%). The median evolution time was three months. Conclusions Infectious OOPML were the most frequent, as expected in a reference center for infectious diseases, and thus, they are likely to be less frequent in general care and/or dental services. Underreporting of OOPML is possible, as oral/oropharyngeal examination is often not included in the routine medical examination. Oral cavity/oropharynx examination should be performed by specialists, such as dentists and otorhinolaryngologists, who have the expertise in identifying OOPML, even in incipient/asymptomatic cases. Given the numerous diseases in which OOPML can present, diagnosis could be facilitated by multidisciplinary teams, potentially enabling the early treatment of diseases, and thus, reduce morbidity and improve prognosis. The use of standardized medical records for oral/oropharyngeal systematic examination could provide relevant tools for differential diagnoses and information for new clinical-epidemiological studies. Level of evidence: Level 3.

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The gold standard for the diagnosis of oral cancer is the microscopic analysis of specimens removed preferentially through incisional biopsies of oral mucosa with a clinically detected suspicious lesion. This dataset contains captured histopathological images of oral squamous cell carcinoma and leukoplakia. A total of 237 images were captured, 89 leukoplakia with dysplasia images, 57 leukoplakia without dysplasia images and 91 carcinoma images. The images were captured with an optical light microscope, using 10x and 40x objectives, attached to a microscope camera and visualized through a software. The images were saved in PNG format at 2048 × 1536 size pixels and they refer to hematoxylin-eosin stained histopathologic slides from biopsies performed between 2010 and 2021 in patients managed at the Oral Diagnosis project (NDB) of the Federal University of Espírito Santo (UFES). Oral leukoplakias were represented by samples with and without epithelial dysplasia. Since the diagnosis considers socio-demographic data (gender, age and skin color) as well as clinical data (tobacco use, alcohol consumption, sun exposure, fundamental lesion, type of biopsy, lesion color, lesion surface and lesion diagnosis), this information was also collected. So, our aim by releasing this dataset NDB-UFES is to provide a new dataset to be used by researchers in Artificial Intelligence (machine and deep learning) to develop tools to assist clinicians and pathologists in the automated diagnosis of oral potentially malignant disorders and oral squamous cell carcinoma.

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Epidemiological data on the distribution of oral and maxillofacial diseases present in early childhood are scarce in the literature. This study analyzed the frequency of lesions biopsied in this region in children aged 0 to 3 years and sent for histopathological analysis in a reference oral pathology laboratory . Histopathological diagnostic data, lesion location, sex, and age were collected. Of the total of 93,950 records, 250 cases (0.27%) belonged to the age group from 0 to 3 years old. The most frequently diagnosed oral alterations were: mucocele (34/250; 13.6%); papilloma (11/250; 4.4%), giant cell fibroma (6/250; 2.4%), pyogenic granuloma (5/250; 2%) and hemangioma (3/250; 1.2%). The lip was the most affected site, followed by the gingiva and the tongue. These results generate information on the lesions most frequently diagnosed in early childhood, which facilitates the process of diagnosis and, consequently, treatment.

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The aim of this systematic review and network meta-analysis (NMA) of randomized controlled trials was to evaluate the effectiveness of treatments for pain relief of burning mouth syndrome (BMS). Five databases and gray literature were searched. Independent reviewers selected studies, extracted data, and assessed the risk of bias. The primary outcome was pain relief or burning sensation, and the secondary outcomes were side effects, quality of life, salivary flow, and TNF-α and interleukin 6 levels. Four comparable interventions were grouped into different network geometries to ensure the transitivity assumption for pain: photobiomodulation therapy, alpha-lipoic acid, phytotherapics, and anxiolytics/antidepressants. Mean difference (MD) and 95% CI were calculated for continuous outcomes. The minimal important difference to consider a therapy beneficial against placebo was an MD of at least -1 for relief of pain. To interpret the results, the GRADE approach for NMA was used with a minimally contextualized framework and the magnitude of the effect. Forty-four trials were included (24 in the NMA). The anxiolytic (clonazepam) probably reduces the pain of BMS when compared with placebo (MD, -1.88; 95% CI, -2.61 to -1.16; moderate certainty). Photobiomodulation therapy (MD, -1.90; 95% CI, -3.58 to -0.21) and pregabalin (MD, -2.40; 95% CI, -3.49 to -1.32) achieved the minimal important difference of a beneficial effect with low or very low certainty. Among all tested treatments, only clonazepam is likely to reduce the pain of BMS when compared with placebo. The majority of the other treatments had low and very low certainty, mainly due to imprecision, indirectness, and intransitivity. More randomized controlled trials comparing treatments against placebo are encouraged to confirm the evidence and test possible alternative treatments (PROSPERO CRD42021255039).

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OBJECTIVE: EstomatoNet is an online service driven by primary health care professionals to support diagnosis and decision-making for oral lesions. This study aimed to describe the experience of the service, depicting use cases and its impact on the referral to specialised services. MATERIALS AND METHODS: Patient/applicant demographics and information related to their oral lesions and/or complaints were retrieved from the service's cloud-based platform. The differential diagnosis provided by the applicants, their level of satisfaction and the teleconsultant's opinion in terms of diagnosis and management were also reported. The teleconsultant's suggestion was cross-referenced with the data from the regulation system to verify the avoidance of referral. RESULTS: Out of 2,002 teleconsultations, most patients were women (55.1%) and 50.1% were aged between 20 and 59 years. Applicants (96.5%) generally considered the service very satisfying/satisfying. Potentially malignant disorders were reported in 19.6% of cases and 7.7% were suspected to be malignant. The referral of 37.3% of patients was avoided after the suggestion of keeping the patient in the primary health care system (k = 0.234; p < 0.001; 62.2% agreement). CONCLUSION: The use of EstomatoNet for oral mucosal lesions improves support for primary health care professionals in the management of lesions and reduces referral to specialised services.

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OBJECTIVES: To describe the clinical features and location of oral lesions in patients with human monkeypox. METHODS: A systematic scoping review was accomplished by implementing the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping reviews. The analysis incorporated varied databases and the gray literature. Keywords were implemented to search publications in all languages until July 2022. RESULTS: The initial electronic exploration included 889 reports, of which 843 studies were eliminated. Reading the full text occasioned the omission of 27 additional investigations. Finally, 19 publications were included. These reports analyzed 1256 patients with monkeypox, mostly described in Europe. Most of them were men who have sex with men. The study population consisted mainly of adults but children were also infected. The oral lesions of monkeypox patients were observed in different parts of the oral mucosa, including lips and tongue, but mainly in the tonsils (15 cases). The oral lesions manifested as papules, vesicles, pustules, and ulcers. Erythema, edema, enanthema, and severe pain were also observed, accompanied by tonsillar enlargement. Sore throat was also reported. Monkeypox is accompanied by a significant number of systemic manifestations, mainly including multiple skin lesions throughout the body, as well as lymphadenopathy, fever, headache, myalgia, and fatigue, among others. The symptoms associated with monkeypox were managed with different antiretroviral and antimicrobial therapies and medications to control pain and fever principally. Seventeen deaths were informed. CONCLUSION: Most monkeypox-associated oral lesions are seen in different parts of the oral mucosa, mainly in the tonsils manifested as papules, vesicles, pustules, and ulcers.

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Paracoccidioidomycosis is a progressive, chronic, systemic disease which is the second most common form of mycosis in South America, affecting approximately 10million people in this region. It occurs most commonly in adult male farmers and mainly affects the lungs. Oral paracoccidioidomycosis is the second most frequent chronic presentation. We report the case of an immunocompetent female patient whose oral mucosae was infected with paracoccidium and discuss oral paracoccidium.

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RESUMEN Introducción: las afecciones bucales consecuentes al uso de prótesis dental en el adulto mayor son un problema de salud pública de alta prevalencia. Con el uso de dentaduras artificiales pueden aparecer factores de riesgo que condicionan las afecciones bucales, su frecuencia en este grupo poblacional motivó la realización del presente estudio. Objetivo: establecer el comportamiento de las afecciones bucales y factores de riesgo presentes en adultos mayores portadores de prótesis dental. Métodos: se realizó un estudio descriptivo, retrospectivo de corte transversal en el período 2018-2020. Universo: 3 884 pacientes portadores de prótesis dental, de 60 años o más, pertenecientes a la Clínica Estomatológica "Antonio Briones Montoto" de Pinar del Río. Muestra: 250 pacientes seleccionados por muestreo aleatorio simple. Se empleó estadística descriptiva mediante frecuencias absolutas y relativas. Resultados: predominaron pacientes femeninas (54 %) y el grupo de 80-84 años (38,8 %). Las lesiones más frecuentes fueron estomatitis subprótesis (40,4 %) y úlcera traumática (22,9 %) en portadores de prótesis totales. El hábito de fumar, la higiene bucal deficiente y la placa dentobacteriana incidieron en la ocurrencia de estas afecciones. Conclusiones: las afecciones bucales consecuentes al uso de prótesis dental y los factores de riesgo presentes en el adulto mayor, se asociaron con deficientes estilos de vida como la inadecuada higiene bucal, la ausencia de medidas preventivas, la mala calidad del aparato protésico y la necesidad de confeccionar y reinstalar nuevas prótesis.

ABSTRACT Introduction: oral diseases resulting from the wear of dental prostheses in older adults continue to be a highly prevalent public health problem. With the use of artificial dentures, risk factors can appear that condition oral diseases. The frequency of these conditions in this age group encouraged the present study. Objective: to establish the behavior of oral diseases and risk factors present in older adults who wear dental prostheses. Methods: a descriptive, retrospective, cross-sectional study was carried out in the period 2018-2020. Target group: 3884 patients with dental prostheses, 60 years or older, belonging to Antonio Briones Montoto dentistry clinic in Pinar del Rio. Sample: 250 patients chosen by simple random sampling. Descriptive statistics was applied by means of absolute and relative frequencies. Results: female patients predominated (54 %) and the age group 80-84 reaching a 38,8 %. The most frequent lesions were subprosthetic stomatitis (40,4%) and traumatic ulcer (22,9 %) in total prosthesis wearers. Smoking, poor oral hygiene and dentobacterial plaque had an impact on the occurrence of these conditions. Conclusions: the oral diseases resulting from the wear of dental prostheses and the risk factors present in older adults were associated with poor lifestyles such as inadequate oral hygiene, the absence of preventive measures, the poor quality of the prosthetic appliance and the need to make and reinstall new dental prostheses.

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RESUMEN Introducción: los cambios hormonales que experimentan las mujeres gestantes acentúa la respuesta gingival y causa un cuadro clínico diferente, se considera un factor modificador en la enfermedad periodontal. Objetivo: valorar la prevalencia de la enfermedad periodontal en gestantes atendidas en la Clínica Estomatológica José Martí en el período de septiembre 2018 a enero 2020. Métodos: se realizó un estudio observacional, descriptivo y transversal en 83 pacientes gestantes, en el período comprendido de septiembre del 2018 a enero 2020. La información de interés se obtuvo de las historias clínicas individuales de servicios básicos de estomatología y de periodoncia. Todos los pacientes dieron su consentimiento informado y los resultados se obtuvieron con la utilización del análisis estadístico que incluyó el porcentaje y la razón. Resultados: predominaron pacientes enfermas con un 82 % sobre las sanas con 18 %. La gingivitis fue la enfermedad más frecuente en el 35 % de las gestantes estudiadas. Las formas menos graves de la enfermedad se presentaron con mayor frecuencia en el grupo de 27 a 36 años para el 43,7 %, y las periodontitis fueron más frecuentes en las gestantes de 37 a 45 años para un 33,3 %. El nivel de conocimientos fue regular para un 37,3 % seguido del bueno para un 36,2 %. Conclusiones: la frecuencia de la enfermedad periodontal fue alta con predominio de la forma leve de esta.

ABSTRACT Introduction: the hormonal changes experienced by pregnant women accentuate the gingival response and cause a different clinical picture, being considered a modifying factor in periodontal disease. Objective: to assess the prevalence of periodontal disease in pregnant women attended at Jose Marti Dentistry Clinic in the period from September 2018 to January 2020. Methods: an observational, descriptive and cross-sectional study was conducted in 83 pregnant women, in the period from September 2018 to January 2020. The information of interest was collected from individual medical records of basic dentistry and Periodontics services. All patients provided an informed consent and the results were processed using statistical analysis including percentage and ratio. Results: sick patients predominated with 82 % over healthy patients with 18 %. Gingivitis was the most frequent disease in the 35 % of pregnant women studied. Less severe forms of the disease were more frequent in the age group 27 to 36 years for 43,7 %, and periodontitis was more frequent in pregnant women aged 37 to 45 years for 33,3 %. The level of knowledge was fair for 37,3 % followed by good for 36,2 %. Conclusions: the frequency of periodontal disease was high with a predominance of mild periodontal disease.

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OBJECTIVE: To evaluate the prevalence of oral mucosal lesions (OML) and oral self-examination and their associated factors among pregnant women from the 2015 Pelotas Birth Cohort Study, Brazil. METHODS: Pregnant women who would deliver babies in 2015 were included in the antenatal study. Data related to demographic, socio-economic and behavioural conditions were collected using questionnaires. Participants were also clinically assessed for oral health outcomes. The outcomes were the presence of OMLs and oral self-examination. Size, location, time of onset and symptomatology of the lesions were collected. Descriptive and bivariate analysis, and Poisson regression were performed. p-Value <0.05 was set to indicate statistical significance. RESULTS: Data from 2481 pregnant women were analysed. Four hundred and nine (16.5%) had at least one OML. The most prevalent lesions were exostosis (80/16.6%), coated tongue (70/14.5%) and benign oral brownish pigmentation (68/14.1%). Non-white skin colour was associated with a higher prevalence of OMLs (PR 1.3; 95% CI 1.1-1.6), while daily use of dental floss was positively associated with the prevalence of oral self-examination (PR 1.4; 95% CI 1.2; 1.5). CONCLUSIONS: Almost 20% of pregnant women presented OML, which were more prevalent in non-white individuals. Women with better oral care were more likely to perform oral self-examination.

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O objetivo desta revisão sistemática de ensaios clínicos randomizados (ECRs) foi avaliar a eficácia dos tratamentos para o alívio da dor da síndrome da ardência bucal (SAB). Cinco bases de dados e literatura cinzenta foram pesquisadas e as listas de referências dos estudos incluídos foram pesquisadas manualmente. Revisores independentes selecionaram estudos, extraíram dados e avaliaram o risco de viés através da ferramenta Revised Cochrane risk-of-bias tool for randomized trials (RoB 2.0). O principal desfecho foi o alívio da dor. Os desfechos secundários foram efeitos adversos, qualidade de vida, fluxo salivar, níveis de TNF-α e interleucina (IL-6), quando relatados por estudos. Para a meta análise em rede (network meta-analysis - NMA), foram agrupadas quatro intervenções comparáveis em diferentes geometrias para garantir o pressuposto da transitividade: terapia de fotobiomodulação (PBMT), ácido alfa-lipóico (ALA), fitoterápicos e ansiolíticos/antidepressivos. As estimativas de efeitos para dor foram: diferença de média (DM) para desfechos contínuos pois os estudos usaram escalas comparáveis variando de 0 a 10 para dor; e risco relativo (RR) para desfechos binários. Para qualidade de vida, a diferença de média padronizada (DMP) foi calculada pois os estudos usaram escalas diferentes. Para calcular a DM, usou-se a média e desvio padrão (DP) em baseline e no último momento de cada intervenção. Para ambas todas as estimativas, foram calculados os correspondentes intervalos de confiança (IC) de 95%. A certeza da evidência foi avaliada usando a abordagem GRADE para NMA. Para a certeza da evidência, foi avaliado ser havia problemas de risco de viés, inconsistência, evidência indireta, viés de publicação, intransitividade, imprecisão e incoerência. Para imprecisão, foi considerada a diferença mínima importante (minimal importante difference - MID) necessária para tomada de decisão de tratamento comparando intervenção e placebo, sendo este último o comparador. Para dor relatada como DM, o MID foi -1 ou 1, e 0,32 ou 1,68 para RR. A classificação de Cohen foi usada para determinar um MID de grande efeito para a qualidade de vida (DMP): < -0,8 ou >0,8. Para otimizar a interpretação dos resultados da NMA e a aplicabilidade clínica, foram usadas a abordagem GRADE minimamente contextualizada para dor e o parcialmente contextualizada para qualidade de vida. O ansiolítico (clonazepam) provavelmente reduz a dor da SAB quando comparado ao placebo (DM: - 1,88; IC 95%: -2,61; -1,16, certeza moderada). A DM do fluxo salivar aumentou ligeiramente em -0,20 tanto para o ansiolítico quanto para o placebo. A DM, para os níveis de IL-6 e TNF-α, foi maior para PBMT do que placebo, o que significa uma diminuição mais pronunciada nesses níveis para PBMT. Apesar de PBMT, pregabalina e fitoterápicos apresentarem superioridade quando comparados ao placebo, a certeza da evidência foi baixa ou muito baixa. A maioria dos demais tratamentos teve baixa e muito baixa certeza, principalmente devido à imprecisão e evidência indireta. Nenhum tratamento causou impacto na qualidade de vida. Os efeitos adversos foram pouco reportados e não influenciaram o curso dos tratamentos. Mais ECRs comparando tratamentos com placebo são encorajados para confirmar a evidência. Até o momento, o melhor tratamento para SAB é o ansiolítico clonazepam. No entanto, a aplicabilidade relacionada à eficácia, efeitos adversos e qualidade de vida são limitados à 120 dias.

This systematic review of randomized controlled trials (RCTs) aimed to assess the effectiveness of treatments for pain relief of burning mouth syndrome (BMS). Five databases and grey literature were searched, and the reference lists of included studies were hand-searched. Independent reviewers selected studies, extracted data, and assessed the risk of bias (RoB 2.0). The main outcome was pain relief. The secondary outcomes were adverse effects, quality of life, salivary flow, TNF-α and interleukin (IL-6) levels, when reported by trials. For the network meta-analysis (NMA), four comparable interventions were grouped into different geometries to ensure the transitivity assumption: photobiomodulation therapy (PBMT), alpha-lipoic acid (ALA), phytotherapics, and anxiolytics/antidepressants. The effect estimate was a mean difference (MD) for continuous outcomes instead of the standardized mean difference (SMD), as studies used comparable scales varying from 0 to 10 for pain; and risk ratio (RR) for binary outcomes. The SMD was calculated for quality of life as studies used different scales. To calculate MD, we used mean and standard deviation (SD) at the baseline and at the last time point of each intervention. For both estimates, corresponding 95% confidence intervals (CI) were calculated. The GRADE approach for NMA was used to assess the certainty of the evidence. We rated down the certainty of evidence if there were problems due to the risk of bias, inconsistency, indirectness, publication bias, intransitivity, imprecision, and incoherence. We considered the minimal important difference (MID) necessary to a treatment decision comparing intervention and placebo (comparator) to rate imprecision. For pain reported as MD, the MID was -1 or 1, and 0.32 or 1.68 for RR. The Cohen classification was used to determine a MID of large effect for the quality of life (SMD): < -0.8 or >0.8 To optimize the interpretation of results of NMA and clinical applicability, we followed the GRADE minimally contextualized framework for pain and the partially contextualized framework for quality of life. The anxiolytic (clonazepam) probably reduces pain of BMS compared to placebo (MD: - 1.88; 95% CI: -2.61; -1.16, moderate certainty). The MD of salivary flow slightly increased in -0.20 for both the anxiolytic and placebo (Heckmann et al. 2012). The MD for IL-6 and TNF-α levels was higher for PBMT than placebo, which means a more pronounced decrease in these levels for PBMT. Although PBMT, pregabalin and phytotherapics showed superiority compared to placebo, the certainty was low or very low. The majority of the other treatments had low and very low certainty, mainly due to imprecision and indirectness. No treatment improved the quality of life. Adverse effects were rarely reported and did not influence the course of treatments. More RCTs comparing treatments against placebo are encouraged to confirm the evidence. So far, the anxiolytic clonazepam is the best treatment for BMS. However, the applicability of effectiveness, adverse effects and quality of life are limited to 120 days.

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Abstract This study evaluated the presence of oral lesions in patients with COVID-19 hospitalized in an intensive care unit (ICU). Data included demographic, clinical, and laboratory information. Clinical assessment of the oral cavity was performed on the 2 nd and 5 th days of orotracheal intubation. Thirty-eight patients were evaluated and 16 (42.1%) presented oral lesions during their ICU stay. The median age and length of stay were 75 years and 15 days, respectively. Among the patients with oral lesions, ulcerative oral lesions were reported in 14 (87.5%) patients, of which 11 (78.6%) were found on the lips. This study highlights the importance of oral examination for patients admitted to the ICU with COVID-19.

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RESUMEN Introducción: El envejecimiento es un proceso biológico, dinámico, irre versible, inevitable y progresivo que cursan todos los seres humanos. En la actualidad constituye un problema sociodemográfico serio, donde sus altas cifras cada vez más crecientes de adultos mayores, constituyen un desafío para el sistema de salud. Objetivo: Actualizar los conocimientos sobre la relación que existe entre las enfermedades sistémicas y las enfermedades bucales en el adulto mayor. Métodos: Se realizó una revisión de la literatura entre abril y julio de 2021. Se revisaron artículos disponibles en las bases de datos SciELO, BVS, PudMed, Scopus, LILACS, en el motor de búsqueda Google Scholar y revistas de la Web of Sciences, resultando un total de 30 referencias bibliográficas utilizadas, donde el 50 % y 83,3 % se circunscribió a literatura de los últimos tres y cinco años respectivamente. Como estrategia de búsqueda de información se utilizaron frases claves como: adulto mayor; cavidad bucal; enfermedades sistémicas; enfermedades degenerativas; enfermedades bucales. Se tuvo presente su relevancia y novedad en correspondencia sobre el tema. Resultados: El envejecimiento es marcado por la ocurrencia de numerosos cambios que hacen más propensos a los adultos mayores a presentar enfermedades sistémicas y bucales, donde son numerosos los trabajos publicados que demuestran que una de ellas puede influir siendo causa o consecuencia en el desarrollo de la otra. Conclusiones: Es importante conocer la relación bidireccional entre las enfermedades sistémicas y las enfermedades bucales en el adulto mayor, donde se precisa de un mayor cuidado y una atención sistemática en estos pacientes.

ABSTRACT Introduction: Aging is an inevitable and progressive process that currently constitutes a serious sociodemographic problem, where its high numbers constitute a challenge for the health system. Objective: To update knowledge about the relationship between systemic diseases and oral diseases in the elderly. Methods: A literature review was conducted between April and July 2021. Articles available in the SciELO, BVS, PudMed, Scopus, LILACS databases, in the Google Scholar search engine and Web of Sciences journals were reviewed, resulting in a total of 30 bibliographic references used, where 50 % and 83.3 % were limited to literature from the last three and five years respectively. Its relevance and novelty were taken into account in correspondence on the subject. Results: Aging is marked by the occurrence of systemic and oral diseases, where there are numerous published works that show that one of them can influence, being a cause or a consequence, in the development of the other. Conclusions: It is important to know the bidirectional relationship between systemic diseases and oral diseases in the elderly, requiring greater care and systematic attention in these patients.

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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.

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Resumen El estado de salud bucal y la atención odontológica en sujetos con Trastornos del Espectro Autista (TEA), amerita atención, dada las características específicas en su fisiopatología bucal y algunos factores comportamentales que influyen el progreso de enfermedades bucales como la caries dental y la enfermedad periodontal. El objetivo de la presente revisión fue describir la evidencia referente a salud bucal, así como consideraciones relevantes para la atención odontológica en sujetos con TEA. Se realizó búsqueda sistemática de la literatura empleando los buscadores de información: EBSCOhost, ScienceDirect, y Scopus. Los descriptores empleados fueron: Trastorno del Espectro Autista, Salud Bucal, Caries dental, Enfermedades Periodontales, Atención Odontológica (DeCS-Bireme), sus combinaciones y equivalencias en inglés Autism Spectrum Disorder, Oral health, Dental caries, Periodontal Diseases, Dental care (MeSH-Database). Considerando artículos publicados entre 2014 y septiembre de 2019. Inicialmente, se revisaron los títulos y aplicaron criterios de elegibilidad para la descripción de evidencia incluida, correspondiente a 46 artículos, considerando su enfoque, tipología, idioma y año de publicación y luego se plantea un análisis de la información. Concluyendo que la evidencia sigue siendo controversial y limitada con tendencia a destacar deficiencias en la higiene bucal que se realiza en los hogares de sujetos con TEA, la presencia de caries dental, enfermedad periodontal y algunos hallazgos que condicionan la fisiología oral y progreso de enfermedades bucales. Así mismo, se resalta la dificultad en la atención odontológica a causa de la cuestionable preparación del personal de odontología y los consecuentes temores en los padres que puede limitar la asistencia a la consulta de manera oportuna y en edades tempranas para lograr una buena adaptación. Por todo lo anterior, la atención odontológica se convierte en un desafío que deberá orientar sus acciones con empatía para atender esta población con participación de la familia, profesores y otros miembros de instituciones especializadas, con carácter holístico y de medicina familiar.

Abstract Oral health status and dental care in subjects with Autism Spectrum Disorders (ASD) deserves attention, given the specific characteristics of their oral pathophysiology and some behavioral factors that influence the progress of oral diseases such as dental caries and periodontal disease. The objective of the present review was to describe the evidence regarding oral health as well as relevant considerations for dental care in subjects with ASD. Therefore, a systematic search of the literature was carried out using the information seekers: EBSCOhost, ScienceDirect, and Scopus. The descriptors used were: Trastorno del Espectro Autista, Salud Bucal, Caries dental, Enfermedades Periodontales, Atención Odontológica (DeCS-Bireme), their combinations and equivalents in English: Autism Spectrum Disorder, Oral health, Dental caries, Periodontal Diseases, Dental care (MeSH-Database). Considering articles published between 2014 and September 2019. Initially, the titles were reviewed and eligibility criteria were applied for the description of the included evidence, corresponding to 46 articles, considering their focus, typology, language and year of publication, and then an analysis of the information was proposed. Concluding that the evidence remains controversial and limited, with a tendency to highlight deficiencies in oral hygiene performed in the homes of individuals with ASD, the presence of dental caries, periodontal disease, and some findings that condition oral physiology and the progress of oral diseases. Likewise, the difficulty in dental care is highlighted due to the questionable preparation of the dental staff and the consequent fears in parents that may limit attendance at the consultation in a timely manner and at an early age to achieve a good adaptation. Due to all the above, dental care becomes a challenge that should guide its actions with empathy to serve this population with the participation of the family, teachers and other members of specialized institutions, with a holistic and family medicine nature.

Resumo O estado da saúde bucal e da assistência odontológica em indivíduos com Transtornos do Espectro do Autismo (TEA) merece atenção, dadas as características específicas de sua fisiopatologia bucal e alguns fatores comportamentais que influenciam no progresso de doenças bucais, como cárie dentária e doença periodontal. O objetivo da presente revisão foi descrever as evidências sobre a saúde bucal, bem como considerações relevantes para o cuidado odontológico em indivíduos com TEA. Portanto, uma busca sistemática da literatura foi realizada usando os motores de busca de informações: EBSCOhost, ScienceDirect e Scopus. Os descritores usados ​​foram: Trastorno del Espectro Autista, Salud Bucal, caries dental, Enfermedades Periodontales, Atención Odontológica (DeCS-Bireme), suas combinações e equivalentes em inglês Autism Spectrum Disorder, oral health, dental caries, Periodontal Diseases, dental care (MeSH-Database). Considerando os artigos publicados entre 2014 e setembro de 2019. Inicialmente, os títulos foram revisados ​​e os critérios de elegibilidade aplicados para a descrição das evidências incluídas, correspondendo a 46 artigos, considerando seu foco, tipologia, idioma e ano de publicação, para então uma análise é proposta das informações. Concluindo que as evidências permanecem controversas e limitadas, com tendência a evidenciar deficiências na higiene bucal realizada nas residências de indivíduos com TEA, a presença de cárie dentária, doença periodontal e alguns achados que condicionam a fisiologia oral e o progresso das doenças bucais. Da mesma forma, destaca-se a dificuldade no atendimento odontológico devido ao preparo questionável da equipe odontológica e os consequentes temores dos pais que podem limitar o comparecimento à consulta em tempo hábil e em idade precoce para uma boa adaptação. Por tudo isso, a assistência odontológica torna-se um desafio que deve nortear suas ações com empatia para atender essa população com a participação da família, professores e demais membros de instituições especializadas, com caráter holístico e de medicina de família.

RESUMO

RESUMEN Introducción: las enfermedades oncológicas, entre ellas el cáncer bucal, constituyen el objeto de estudio de diversas instituciones, de ahí que sea necesario analizar el comportamiento de esta ciencia publicada. Objetivo: analizar la producción científica sobre cáncer bucal en la Web of Science en el periodo 2000 a 2020. Métodos: se realizó un estudio bibliométrico de los artículos sobre cáncer bucal publicados en la Core Collections de la Web of Science. Las matrices de co-ocurrencia para el análisis de las redes fueron pre-procesados en Bibexel, y se empleó VOSviewer v1.6.15 para analizar. Se analizaron indicadores de visibilidad, impacto y cooperación. Resultados: se analizaron 10 349 documentos, donde el 76,50 % fueron originales. Se recibieron 198 302 citas, para un promedio de 19,99 citas por artículos. La tasa de variación en cuanto al número de artículos fue del 82,91 %. Las publicaciones redactadas en idioma inglés constituyeron el 98,96 %. Estados Unidos resultó el país más productivo, con el 23,92 %. Los documentos se publicaron en 1 416 recursos y se firmaron por 5 160 instituciones, de ellas 138 colaboraron al menos en 1un artículo. Conclusiones: existe un interés creciente en la investigación sobre el cáncer bucal, concentrada en un pequeño número de países, los que exhiben genuinas capacidades de liderazgo en este campo. Se evidenció un avance en cuanto a la colaboración internacional. El análisis de la co-ocurrencia de términos refleja el interés de la comunidad científica internacional en función de la prevención, diagnóstico y tratamiento de esta enfermedad a nivel global.

ABSTRACT Introduction: oncological diseases, including oral cancer, are the object of study of various institutions; for this reason it is necessary to analyze the behavior of this published science. Objective: to analyze the scientific production on oral cancer in the Web of Science in the period 2000 to 2020. Methods: a bibliometric study of the articles on oral cancer published in the Core Collections of Web of Science was conducted. The co-occurrence matrices for the analysis of the networks were pre-processed in Bibexel, and VOSviewer v1.6.15 was used its analysis. Visibility, impact and cooperation indicators were analyzed. Results: the documents analyzed (10349), where 76,50 % were original articles. The citations received were 198 302, for an average of 19, 9 citations per article. The variation rate in terms of the number of articles was 82,91 %. Publications written in English language reached 98,96 %. The United States was the most productive country, with 23,92 %. The documents were published in 1416 resources and signed by 5160 institutions; at least 138 collaborated on one article. Conclusions: there is an increasing interest in research on oral cancer, concentrated in a small number of countries which exhibit genuine leadership capabilities in this field. Progress was evidenced in terms of international collaboration. The analysis of the co-occurrence of terms reflects the interest of the international scientific community in the prevention, diagnosis and treatment of this disease at a global level.

RESUMO

RESUMEN Introducción: el ozono por su amplia gama de propiedades es útil para tratar afecciones bucales como la gingivitis crónica. Objetivo: demostrar efectividad de la ozonoterapia en el tratamiento de la gingivitis crónica en adolescentes en el Policlínico "Pedro Borrás Astorga", del municipio Pinar del Río, en el período comprendido entre enero y septiembre de 2019. Métodos: se realizó un estudio observacional, analítico, longitudinal, de casos y control. La muestra quedó conformada por 50 pacientes seleccionados por el método no probabilístico intencionado, teniendo en cuenta los criterios de inclusión y exclusión. Para un mejor estudio se formaron dos grupos, uno de estudio tratado con oleozón y otro de control tratado con propóleos al 5 %, con 25 pacientes cada uno. Se utilizaron métodos teóricos, empíricos, y se aplicó la prueba de Chi cuadrado con un nivel de significación de p=0.05. Resultados: se demostró la efectividad de la aplicación del oleozón en la muestra seleccionada al presentar una evaluación terapéutica de los pacientes más favorable con respecto a los tratados con propóleos al 5%, alcanzando la mayor cantidad de pacientes curados y con éxito en el tratamiento de la gingivitis crónica, la que fue más presentada por adolescentes masculinos de 13 años, prevaleció en su forma moderada, y la higiene bucal deficiente fue el factor de riesgo de mayor incidencia en su aparición. Conclusiones: la ozonoterapia resultó ser un tratamiento efectivo para la gingivitis crónica en los adolescentes estudiados.

ABSTRACT Introduction: the ozone due to its ample range of properties is useful to treat oral diseases as chronic gingivitis. Objective: to demonstrate the effectiveness of ozone-therapy in the treatment of chronic gingivitis in adolescents at Pedro Borras Astorga Polyclinic, Pinar del Rio municipality, during the period between January and September 2019. Methods: an observational, analytical, longitudinal study of case and control. The sample comprised 50 patients chosen by intentional non-probabilistic method, considering the criteria of inclusion and exclusion. To carry out a better study two groups were included, a study group treated with oil-ozone and a control one treated with propolis at 5 %, with 25 patients each of the group. Theoretical and empirical methods were applied, and the chi-squared test with a significance level of p=0.05. Results: the effectiveness of the application of oil-ozone was demonstrated in the sample chosen when presenting a more favorable therapeutic evaluation of the patients, respect to those treated with propolis at 5 %, reaching the greatest quantity of cured patients and with success in the treatment of chronic gingivitis, which was more frequent in male adolescents (13 years old), its moderate type prevailed, a deficient oral hygiene was the risk factor of highest incidence in its onset. Conclusions: the ozone-therapy resulted in an effective treatment for chronic gingivitis in the studied adolescents.