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Language Journal of Clinical and Experimental Dentistry. 2014. Vol. 6, no. 3
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- Conflict of interest reporting in dentistry meta-analyses: a systematic review(2014) Beyari, Mohammed M.; Strain, Dan; Li, Chuan Silvia; Lamfon, Hanadi A.Objectives: The issue of reporting conflicts of interest (COI) in medical research has come under scrutiny over the past decade. Absolute transparency is important when dealing with conflicts of interest to provide readers with all essential information required to make an informative decision of the results. The key objective of this study was to examine the prevalence of reporting conflicts of interest in therapeutic dental meta-analyses of Randomized Control Trials (RCTs), and to investigate possible associations with other categorical variables. Study Design: We conducted an extensive literature search across multiple databases to search for relevant review articles for this study. We utilized pre-determined key words, and relied on three reviewers to test and review the use of a data extraction form that was used for the meta-analyses. Data regarding study characteristics, direction of results, and the significance of the results from each meta-analysis were extracted. Results: There were 129 meta-analyses used in this review, and the reporting on conflict of interest was low with only 50 (38.8%) of the articles possessing a conflict of interest statement (either confirming of denying COI). Of these 50 articles, there were only 4 (8%) studies that reported an actual conflict of interest. A statement of conflicts of interest was found in 29 (35.3%) of the papers that reported significant findings, whereas 35% of the papers that reported positive results reported on conflict of interest. Prior to 2009, only 17 (25%) papers reported conflicts of interest, but since 2009, 54.1% of papers collected had a conflict of interest statement. Conclusions: Meta-analyses published in the field of dentistry do not routinely report author conflicts of interest. Although few conflicts appear to exist, the field of dentistry should continue to ensure that best evidence reports provide clear and transparent reporting of potential conflicts of interest in academic journals.
- Parry Romberg Syndrome with localized scleroderma: a case report(2014) Khan, Mohsin; Khan, Mubeen; Negi, Raju; Gupta, NikitaParry Romberg syndrome(PRS) is a rare acquired poorly understood neurocutaneous syndrome of unknown etiology characterized by slow progressive atrophic changes commonly affecting one half of the face. The exact incidence and etiology towards the syndrome remains unclear. Apart from the multifactorial etiology proposed, the possible primary cause is mainly attributed to the cerebral disturbance of the fat metabolism. The syndrome over - laps with "en coup de sabre" morphea, with an ill defined relationship existing between the two. Parry Romberg Syndrome is an invalidating lesion that may be associated with different neurological, cutaneous, ocular, dental and autoimmune abnormalities. This report presents one rare case of 22 years old female patient with Parry Romberg syndrome associated with localized scleroderma, accompanied by a brief review of literature with classical clinical, radiographic, histological findings and the treatment of progressive hemifacial atrophy.
- Comparative study of mandibular linear measurements obtained by cone beam computed tomography and digital calipers(2014) Tarazona Álvarez, Pablo; Romero Millán, Javier; Peñarrocha Oltra, David; Fuster Torres, Mª Ángeles; Tarazona Álvarez, Beatriz; Peñarrocha Diago, MiguelObjectives: Cone beam computed tomography (CBCT) is an innovative dental of imaging system characterized by rapid volumetric imaging with patient exposure to a single dose of radiation. The present study was carried out to compare the linear measurements obtained with CBCT and digital caliper in 20 mandibles from human cadavers. Study design: A total of 4800 linear measurements were measured between different mandibular anatomical po - ints with CBCT and digital caliper. The real measurements were defined as those obtained with the digital caliper. Posteriorly, the mandibles were scanned to obtain the CBCT images, with software-based measurements of the distances. Results: The measurements obtained with the digital caliper were greater. The CBCT technique underestimated distances greater than 100 mm. Conclusions: CBCT allows to obtain linear mandibular anatomical measurements equivalent to those obtained with digital caliper. The differences existing between both methods were clinically acceptable.
- Correlation between mutans streptococci counts of parents and their children residing in Chandigarh, India(2014) Pannu, Parampreet; Chawla, H. S.; Tewari, Amrit; Gauba, K.; Sujlana, Amrita; Gambhir, Ramandeep SinghObjectives: To determine the prevalence of Mutans Streptococci (MS) in children and to evaluate the relationship between the salivary levels of MS in children and their parents. Material and Methods: 100 children aged 3-6 years along with their parents (100 mothers and fathers each) were included in the study. The children were segregated depending upon their age and level of caries experience. The children were examined clinically on an ordinary chair in natural daylight using the Møller's index criteria. Assays for Mutans Streptococci (MS) were done for both the children and their parents using the Dentocult SM strip mu - tans test. Collected data was assessed using SPSS software. Results: The overall prevalence of MS in the children was 83%. A statistically significant correlation (p<0.05) was observed between salivary MS counts of children and their mothers. No significant correlation was seen with the fathers. Conclusions: The findings conclude that if primary caregivers harbour high levels of MS in their saliva, it is likely that their children will have the same.
- Hand skeletal maturity and its correlation with mandibular dental development(2014) Bagherpour, Ali; Pousti, Maryam; Adelianfar, ElaheObjectives: Assessment of pubertal status and pubertal growth spurt in orthodontic patients has a considerable impact on the diagnosis, treatment plan and the outcome of orthodontic treatments. Hand-wrist radiography is routinely used to evaluate skeletal development. Some studies have shown that there is an association between bone development and different stages of dental calcification; therefore, the stages of dental calcification can be used as the first tool for diagnosis, in case there is an association. This study was performed with the aim to evaluate the association between the phases of dental development and the stages of skeletal maturity. Study design: In this study, a total of 52 patients (26 males and 26 females), referring to Mashhad School of Den - tistry for orthodontic treatment, were evaluated; the subjects were within the age range of 9-14 years. Hand-wrist radiographic evaluation of skeletal maturation was performed using Fishman method. Also, the Demirjian method was used to identify the stages of dental calcification by panoramic radiographs. Independent t-test and Spearman correlation coefficient were used for data analyses. Results: The mean age of males and females was 11.05 ± 1.05 and 10.62 ± 1.12 years, respectively (p=0.156). The Spearman correlation coefficients between skeletal maturity indicators (SMIs) and developmental stages of mandi - bular left and right canines and second molars were significant in males only (p<0.05). Also, correlation coefficients were significant between adductor sesamoid ossification and mandibular right and left canines developmental sta - ges in males (p<0.05). Conclusions: Findings of this study showed that the correlation between dental developmental stages and skeletal maturity only were significant in males; thus, different skeletal maturity patterns in males and females might be perceptible.
- Traumatic neuroma of the mandible: a case report with spontaneous remission(2014) Jham, Bruno C.; Costa, N.L; Batista, Aline Carvalho; Mendonça, Elismauro FranciscoTraumatic neuroma is a well-known disorder involving peripheral nerves, which occurs following trauma or sur - gery. The lesion develops most commonly in the soft tissues of the mental foramen area, lower lip and tongue. Intra- osseous lesions arising in jawbones are very uncommon. In this paper, we report a new case of an intra-osseous traumatic neuroma, discovered incidentally on a panoramic radiograph obtained for orthodontic documentation. In addition, the case herein described developed spontaneous remission, a situation not previously reported in the literature. Finally, we discuss relevant demographic, clinical, microscopic, immunohistochemical and treatment aspects of traumatic neuromas.
- Lowering of the mouth floor and vestibuloplasty to support a mandibular overdenture retained by two implants: a case report(2014) Cortell Ballester, Isidoro; Figueiredo, Rui; Gay Escoda, CosmeIn Oral Implantology most of the procedures are predictable and have high success rates. The use of osseointegrated implants as a therapeutic option for the rehabilitation of patients with severe mandibular atrophy has decreased the need for pre-prosthetic surgery Nevertheless, complications may occur during implant surgery and also once the prosthesis has been placed. This paper describes the case of a totally edentulous patient with an upper complete removable denture and an implant-retained overdenture with two implants in the intermentonian region. During clinical examination, the implant abutments were totally covered by soft tissue since the floor of the mouth was elevated. The panoramic radiography showed severe mandibular atrophy. Vestibuloplasty was performed together with the lowering of the floor of the mouth under general anesthesia and nasotracheal intubation to expose the implants. A new prosthesis was fabricated for the patient to prevent recurrence and improve the patient's chewing ability as it formed a physical barrier against soft tissue migration on prosthetic attachments.
- Iatrogenic salivary duct injury in head and neck cancer patients: report of four cases and review of the literature(2014) Kulyapina, Alena; López de Atalaya, Javier; Ochandiano Caicoya, Santiago; Navarro Cuéllar, C.; Navarro Vila, C.Introduction: The lesions of the salivary ducts may be idiopathic, post- traumatic, or iatrogenic and lead to sialocele formation with persistent painful facial swelling or cutaneous fistula formation. No consensus on treatment of this condition exists: the options of treatment include needle aspiration, pressure dressings, antisialogogue therapy, radiotherapy, botulinum toxin and surgical approaches as duct repair, diversion, ligation, different drainage systems and even parotidectomy/submaxilectomy. The management and special features of iatrogenic salivary duct injury in patients with oral cancer who underwent head and neck reconstructive surgery has not been described yet. Material and Methods: We present four cases of iatrogenic lesions of salivary ducts and its management in patients with oral cancer. Conclusions: The iatrogenic lesions of salivary ducts are to be taken into account in patients with oral cancer as the distal ends of salivary ducts could be involved in the margins of surgical resection. Different options of treatment of this complication are described.
- Sialolithiasis. Proposal for a new minimally invasive procedure: piezoelectric surgery(2014) Pastor Ramos, Victoria; Cuervo Díaz, Alfonso; Aracil Kessler, LuisSialolithiasis is the presence of stones in the ducts of the salivary glands. Most episodes are unique, and 60-80% are located exclusively in the main excretory duct. The main clinical manifestations are swelling and pain typically before, during or after meals that decreases if the obstruction is not complete. The highest prevalence of lithiasis is in the submandibular gland -87%-, whose secretion is more viscous, followed by the parotid gland -10%- and finally the sublingual gland -3%-. The most significant consequences are caused by the prolonged blockage of the duct by a stone, which can produce a persistent ductal dilatation with a swelling that does not subside, and could lead to the complete degeneration of the parenchyma, becoming a hot spot where secondary infections may occur, leading to acute bacterial sialadenitis or glandular abscesses. Treatment options range from a single probing extraction, extraction with sialographic control using the sialoen - doscope, LASER intraductal lithotripsy, lithotripsy extracorporeal shock wave (ESWL), to the surgical techniques combining open duct with endoscopic or glandular removal. We propose, with regard to a case, the use of a simple piezoelectric device which, tunnelling through the glandular channel by the ostium, allows stone fragmentation, wi - thout damaging the surrounding soft tissue. Stone removal by this less invasive method reduces the need for more complex and expensive techniques. The postoperative course without retraction of the ostium, and the regaining of functionality is favourable.
- Clinical evaluation of subepithelial connective tissue graft and guided tissue regeneration for treatment of Miller's class 1 gingival recession: comparative, split mouth, six months study(2014) Trivedi, Sakshee R.; Bhavsar, Neeta V.; Dulani, Kirti; Trivedi, RahulObjectives: The present study aims to clinically compare and evaluate subepithelial connective tissue graft and the GTR based root coverage in treatment of Miller's Class I gingival recession. Study Design: 30 patients with at least one pair of Miller's Class I gingival recession were treated either with Sube - pithelial connective tissue graft (Group A) or Guided tissue regeneration (Group B). Clinical parameters monitored included recession RD, width of keratinized gingiva (KG), probing depth (PD), clinical attachment level (CAL), attached gingiva (AG), residual probing depth (RPD) and % of Root coverage(%RC). Measurements were taken at baseline, three months and six months. A standard surgical procedure was used for both Group A and Group B. Data were recorded and statistical analysis was done for both intergroup and intragroup. Results: At end of six months % RC obtained were 84.47% (Group A) and 81.67% (Group B). Both treatments resulted in statistically significant improvement in clinical parameters. When compared, no statistically significant difference was found between both groups except in RPD, where it was significantly greater in Group A. Conclusions: GTR technique has advantages over subepithelial connective tissue graft for shallow Miller's Class I defects and this procedure can be used to avoid patient discomfort and reduce treatment time.
- How much incisor decompensation is achieved prior to orthognathic surgery?(2014) McNeil, Calum; McIntyre, Grant T.; Laverick, SeanObjectives: To quantify incisor decompensation in preparation for orthognathic surgery. Study design: Pre-treatment and pre-surgery lateral cephalograms for 86 patients who had combined orthodontic and orthognathic treatment were digitised using OPAL 2.1 [http://www.opalimage.co.uk]. To assess intra-observer reproducibility, 25 images were re-digitised one month later. Random and systematic error were assessed using the Dahlberg formula and a two-sample t-test, respectively. Differences in the proportions of cases where the maxillary (110 0 +/- 6 0 ) or mandibular (90 0 +/- 6 0 ) incisors were fully decomensated were assessed using a Chi-square test (p<0.05). Mann-Whitney U tests were used to identify if there were any differences in the amount of net decompen - sation for maxillary and mandibular incisors between the Class II combined and Class III groups (p<0.05). Results: Random and systematic error were less than 0.5 degrees and p<0.05, respectively. A greater proportion of cases had decompensated mandibular incisors (80%) than maxillary incisors (62%) and this difference was statis - tically significant (p=0.029). The amount of maxillary incisor decompensation in the Class II and Class III groups did not statistically differ (p=0.45) whereas the mandibular incisors in the Class III group underwent statistically significantly greater decompensation (p=0.02). Conclusions: Mandibular incisors were decompensated for a greater proportion of cases than maxillary incisors in preparation for orthognathic surgery. There was no difference in the amount of maxillary incisor decompensation between Class II and Class III cases. There was a greater net decompensation for mandibular incisors in Class III cases when compared to Class II cases.
- Proposed new grading of oral submucous fibrosis based on cheek flexibility(2014) Santosh, Patil; Maheshwari, SnehaObjectives: Oral submucous fibrosis (OSMF) is a potentially malignant disorder of oral cavity, pharynx and upper digestive tract, characterized by progressive inability to open the mouth. Based on clinical and/or histopathological features, various classifications and grading systems have been put forth till date. The aim of the present study was to study the variance in cheek flexibility in OSMF patients, the observance of which led to the introduction of a new grading for the condition. Material and Methods: The study included 412 patients with OSMF attending to the Department of Oral Medicine and Radiology during the period from December 2008 to June 2013. A detailed history and examination of the patients was performed with special emphasis on measuring cheek flexibility. Statistical analysis was done using Chi-square test and p<0.05 was considered to be statistically significant. Results: The most common etiological factor was tobacco (73.3%). All the patients reported with burning sensation of the mouth and blanching of the mucosa. Malignancy was reported in only 4.6% patients. 60.4% patients showed cheek flexibility of 30mm and above, while 29.6% patients showed cheek flexibility between 20-30mm and 10% patients showed less than 30mm of cheek flexibility. Conclusion: The observations of the present study have led to the proposal of a new grading of OSMF based on cheek flexibility which could assist in the categorization of the condition by the clinicians.
- The role of topical simvastatin on bone regeneration: a systematic review(2014) Montero, Javier; Manzano Martínez, Guillermo; Albaladejo Martínez, AlbertoObjectives: The aim of this systematic review was to summarize the results concerning the use of simvastatin for promoting bone regeneration and to discuss the level of scientific evidence supporting such findings. Material and Methods: A Pubmed search using "Simvastatin"[Mesh] AND "Bone Regeneration"[Mesh] as Boolean operators was constrained to the last 10 years and only included papers written in English. Results: Of the 41 relevant papers reviewed, most of them (76.2%) have been published in the last 5 years, and most of them address animal studies (66.6%) performed on rats or rabbits in extraoral regions. Only 4 randomized controlled trials (RCTs) assessed the role of topical simvastatin in periodontal patients. Conclusions: A large part of the evidence concerning the role of topical simvastatin on bone regeneration comes from animal studies (mainly rats) focusing on extraoral bone defects. Only the use of subgingival simvastatin after root scaling has been properly supported by RCT.
- Association of chronic periodontitis with white blood cell and platelet count: a Case Control Study(2014) Kumar, Balmuri Praveen; Khaitan, Tanya; Ramaswamy, Pachigolla; Sreenivasulu, Pattipati; Uday, Ginjupally; Velugubantla, Ragha GeethikaObjectives:The objective of the study was to determine whether plasma levels of white blood corpuscles (WBCs) and platelets were altered in patients with chronic periodontitis compared to healthy controls. Study Design:A total of 120 subjects, 60 with chronic periodontitis and 60 with healthy periodontium of age group 30-50 years were selected for the study. Oral hygiene status and pocket probing depth were measured. During cli - nical evaluation, venous blood samples were taken to analyze the WBC and platelet counts. Statistical analysis was utilized to compare differences across various groups. Results:The WBC count was higher in patients with chronic periodontitis when compared with controls whereas the platelet count was lower in the case group. Conclusions:Elevated WBC count plays a key role in chronic periodontitis and in turn a risk factor for cardiovas - cular diseases. However, there is no significant role of platelets in periodontal infection even though it has a major role in atherogenesis.
- Gingival recession: prevalence and risk indicators among young greek adults(2014) Chrysanthakopoulos, Nikolaos AndreasObjectives: The aim of the current research was to assess the prevalence of gingival recession and to investigate possible associations among this condition, periodontal and epidemiological variables in a sample of young Greek adults in a general dental practice. Material and Methods: A total of 1,430 young adults was examined clinically and interviewed regarding several periodontal and epidemiological variables. Collected data included demographic variables, oral hygiene habits and smoking status. Clinical examination included the recording of dental plaque, supragingival calculus presence, gingival status and buccal gingival recession. Multivariate logistic regression analysis model was performed to access the possible association between gingival recession and several periodontal and epidemiological variables as potential risk factors. Results: The overall prevalence of gingival recession was 63.9%. The statistical analysis indicated that higher edu - cational level [OR= 2.12, 95% CI= 0.53-8.51], cigarette smoking [OR= 1.97, 95% CI= 1.48-7.91], frequent tooth brushing [OR= 0.98, 95% CI= 0.56-1.96], presence of oral piercing [OR= 0.92, 95% CI= 0.38-1.58], presence of gingival inflammation [OR= 4.54, 95% CI= 1.68-7.16], presence of dental plaque [OR= 1.67, 95% CI= 0.68-2.83] and presence of supragingival calculus [OR=1.34, 95% CI= 0.59-1.88], were the most important associated factors of gingival recession. Conclusions: The observations of the current research supported the results from previous authors that several periodontal factors, educational level and smoking were significantly associated with the presence of gingival re - cession, while presence of oral piercing was a new factor that was found to be associated with gingival recession.
- Comparative study of the efficacy of herbal antioxdants oxitard and aloe vera in the treatment of oral submucous fibrosis(2014) Santosh, Patil; Halgatti, Vishal; Maheshwari, Sneha; Santosh, BSObjectives: Oral submucous fibrosis (OSMF) is a potentially malignant disorder predominantly seen in the Indian subcontinent due to areca nut, tobacco and their products. The aim of the present study was to compare the efficacy of oxitard and aloe vera in the management of OSMF. Material and Methods: 120 subjects with OSMF were included in the study. The patients were clinico-pathologi - cally diagnosed and divided equally in 2 groups, Group A (oxitard group) and Group B (aloe vera group). Group A was administered 2 oxitard capsules twice daily and Group B was given 5 mg aloe vera gel to be applied topically thrice daily for 3 months. Different clinical parameters were evaluated at regular intervals. Data was analyzed using the Student's paired t test and Chi-square test. P-value <0.001 was considered to be statistically significant. Results: Clinical improvements in mouth opening and tongue protrusion was significant in the oxitard group (p=0.0005). Subjective symptoms of pain associated with the lesion (p=0.0003), difficulty in swallowing (p=0.0000) and speech (p=0.0001) also significantly improved in the Group A. The improvement in burning sensation was not statistically significant between the 2 groups (p=0.002). There was a mild to moderate decrease in the size of the lesion. Conclusions: Though there is no definitive treatment for the condition however, overall assessment of symptoms like mouth opening, tongue protrusion, difficulty in swallowing and speech and pain associated with the lesion showed that oxitard capsules can bring about significant clinical improvements than aloe vera gel in the treatment of OSMF.
- Parotid gland solitary fibrous tumor with mandibular bone destruction and aggressive behavior(2014) Alonso Rodríguez, Estefanía; González Otero, Teresa; Castro Calvo, A.; Ruiz Bravo, ElenaIntroduction: Solitary fibrous tumor is associated with serosal surfaces. Location in the salivary glands is extremely unusual. Extrathoracic tumors have an excellent prognosis associated with their benign clinical behavior. We report an aggressive and recurrent case of this tumor. We review the clinical presentation, inmunohistochemical profiles and therapeutic approaches. Case Report: A 73-years-old woman presented a mass in her right parotid gland. She had a past history of right superficial parotidectomy due to a neurilemoma. FNAB and magnetic resonance were non-specific. After a tumor resection, microscopic findings were spindled tumor cells with reactivity to CD34, bcl-2 and CD99 and the tumor was diagnosed as Solitary Fibrous Tumor. The patient suffered two recurrences and the tumor had a histological aggressive behavior and a destruction of the cortical bone of the mandible adjacent to the mass. A marginal mandi - bulectomy with an alveolar inferior nerve lateralization was performed. Conclusions: Solitary fibrous tumor is a very rare tumor. Usually, they are benign, but occasionally they can be aggressive. Complete resection is the most important prognostic factor and no evidence supports the efficacy of any therapy different to surgery. Due to the unknown prognosis and to the small number of cases reported, a long-term follow-up is guaranteed.
- Influence of adhesive systems on microtensile bond strength of resin-based endodontic sealers to the root dentin(2014) Rodríguez Martínez, Juan Bautista; González Rodríguez, Paloma; Gonzalez Lopez, Santiago; Ferrer Luque, Carmen MaríaObjective: The aim of this study was to determine the microtensile bond strength to root dentin of AH PlusTM and EndoREZ® with Clearfil Liner Bond 2V and Optibond SoloTM Plus adhesive systems. Study Design: The coronal and middle thirds of six single rooted bovine teeth was split longitudinally in a mesio- distal direction. The two halves were joined with AH Plus or EndoREZ, with and without the use of Clearfil Li - ner Bond 2V and Optibond SoloTM Plus adhesive systems. Build-ups were vertically sectioned into quadrangular (?1mmx1mm) compound bars and subjected to tensile tests at a constant crosshead speed (1 mm/min) until debon - ding. Results: Optibond ® Solo PlusTM in combination with AH PlusTM and EndoREZ ® showed the highest mean micro - tensile bond strength values, in both coronal and middle thirds. The lowest results were seen in the groups where no dentine adhesive was applied, and in those where the self-etching adhesive Clearfil Liner Bond 2V was used. Conclusion: The microtensile bond strength to root dentin of AH PlusTM and EndoREZ may be increased with the use of a total-etch adhesive.
- The craniofacial necrotizing fasciitis after a minor trauma in an elderly white woman(2014) Modlinska, Aleksandra; Osowicka, Magdalena; Buss, Tomasz; Lichodziejewska-Niemierko, MonikaThe term necrotizing fasciitis /NF/ was probably first described by Jones in 1871 as "hospital gangrene". NF, with its fast spreading from the local infection to massive necrosis of the underlying tissues, ie. superficial fascia and subcutaneous layers, is a potentially fatal disease, unless diagnosed early and properly treated. NF is more frequent in frail patients with chronic debilitating illnesses, immune deficiencies or from a poor social background. Sixty percent of NF cases occur in females. Here we present a case of necrotizing fasciitis of the head and neck region after a minor trauma (phenol blocks due to severe neuropathic pain) in an 82-year-old female with the history of trigeminal neuralgia.
- Occurrence of Contralateral Lymph Neck Node Metastasis in Patients with Squamous Cell Carcinoma of the Oral Cavity(2014) Donaduzzi, Liziane Cattelan; De Conto, Ferdinando; Kuze, Luana Soares; Rovani, Gisele; Flores, Mateus Ericson; Pasqualotti, AdrianoIntroduction: Squamous cell carcinoma represents about 90% of malignancies of the mouth and about 38% of the head and neck tumors. The behavior of the cancer is very aggressive, presenting early cervical metastasis and, often contralateral ranging from 0.9 to 36%. Objectives: This study aims to analyze clinical and pathological factors that may influence metastasis of squamous cell carcinoma in cervical lymph nodes and relate this occurrence in the contralateral primary tumor, with disease prognosis and the interference of this type of metastasis in the survival rate of patients with this pathology. Material and Metohds: It was conducted a retrospective study from medical records of patients with Squamous Cell Carcinomas with homolateral lymph node metastasis and contralateral attended at the clinic of Head and neck surgery of Hospital São Vicente de Paulo in Passo Fundo - RS - Brazil, from 2000 to 2008. Results: Analyzing the charts of patients with metastatic and metastatic contralateral side it was observed that pa - tients with initial stage presented a higher survival with statistical significance (p=0,035). Conclusions: The occurrence of metastases in lymph nodes of contralateral position to the primary lesion was not the main fator that influenced the survival of the group.
