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Language Medicina oral, patología oral y cirugía bucal. Ed inglesa. 2022. Vol. 27, no. 4
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- Racial disparity and prognosis in patients with mouth and oropharynx cancer in Brazil(2022) Ramos, Letícia Francine Silva; Sobrinho, Adriano Referino da Silva; Ribeiro, Lucas Nascimento; Martins-de-Barros, Allan Vinícius; Maurício, Herika Arruda; Ferreira, Stefânia Jerônimo; Carvalho, Marianne-de VasconcelosOral and oropharyngeal cancer (OPC) is an important cause of morbidity and mortality worldwide. Populations in situations of social vulnerability tend to have higher incidences of cancer, a higher proportion of late diagnosis, greater difficulties in accessing health services, and, consequently, worse prognosis. The aim of this study was to evaluate the relationship between race/skin color and OPC prognosis in Brazil. This is a cross-sectional epidemiological study using OPC data from the National Cancer Institute between the years 2000 and 2019. The selected variables were: gender, race/skin color, age, education, smoking and alcohol consumption, stage of the disease and disease status at the end of the 1st treatment. 154,214 cases were recorded. Black men, in the 6th decade of life, were the most affected population. Blacks had a lower level of education when compared to non-blacks (p<0.001). Blacks were more exposed to smoking and alcohol consumption (p<0.001). At the time of diagnosis, the black population was at the most advanced stage when compared to non-blacks (p<0.001). At the end of the 1st treatment, more black patients had disease in progression, as well as more black patients died (p<0.001). Blacks had a worse prognosis for OPC in Brazil. Despite the limitations, these results are important to elucidate the scenario of health disparities in relation to the race/skin color of the Brazilian population.
- Influence of root width and dentin wall thickness evaluated by endoscopy upon the outcome of periapical surgery. A cohort study(2022) Glera-Suárez, Pablo; Pallarés Serrano, Antonio; Soto-Peñaloza, David; Tarazona Álvarez, Beatriz; Peñarrocha Diago, Miguel; Peñarrocha Oltra, DavidAn analysis was made of the correlation between root width, the thickness of the remaining dentinal wall as determined by endoscopy, and the outcome of periapical surgery. A retrospective cohort study was carried out involving patients subjected to periapical surgery between 2017 and 2019 at the University of Valencia (Valencia, Spain). One year after surgery, cone-beam computed tomography (CBCT) was used to evaluate healing against the preoperative volumes. The maximum root width was measured on the postoperative CBCT scan at the apical section of the treated root. This measurement was transferred to the intraoperative endoscopic image, where the minimum root width, peripheral dentin thickness, and minimum dentin thickness were recorded. Root measurements, and the position (maxillary or mandibular) and type of tooth (roots of incisors, canines, premolars or molars) were further correlated to periapical surgery outcome. A total of 51 patients, comprising 52 teeth and 62 roots, were included in the study. The mean measurements were: maximum root width (4.13±0.84 mm), minimum root width (2.46±0.72 mm), peripheral dentin thickness (0.77±0.2 mm) and minimum dentin thickness (0.4±0.2 mm). The success rate was 82.2%. Premolar roots showed a greater minimum dentin thickness (0.58±0.25 mm) (p<0.003) than incisor roots. No significant association was found between the different measurements and the healing rate at one year, though the roots that failed to heal showed smaller minimum dentin thickness values than the roots that healed correctly. The position and type of tooth did not influence healing outcome. The root width and thickness of the remaining dentin wall did not significantly influence healing. However, the roots that failed to heal showed smaller minimum dentin thickness values than the roots that healed correctly.
- Ameloblastomas mimicking apical periodontitis:a case series(2022) Soimu, Giuliana; Netto, Juliana-de Noronha-Santos; Miranda, Águida-Maria-Menezes-Aguiar; Perez, Danyel Elias da Cruz; Armada, Luciana; Pires, Fábio-RamôaAmeloblastomas are benign odontogenic tumors that can eventually mimic the clinical and radiological features of apical periodontitis. The aim of the present study was to evaluate the clinical, radiological and histological characteristics from a series of ameloblastomas mimicking apical periodontitis diagnosed in a 14-year period. all cases histologically diagnosed as ameloblastomas from 2005 to 2018 presenting a clinical diagnosis of periapical lesion of endodontic origin were selected for the study. Clinical, radiological and histological characteristics from all cases were tabulated and descriptively and comparatively analyzed. Twenty cases composed the final sample, including 18 solid and 2 unicystic ameloblastomas. Mean age of the affected patients was in the fifth decade with predilection for males (72%). The most common anatomical location was the posterior mandible (55%) and most cases presented a radiolucent unilocular (80%) well-defined (95%) image. Most cases were asymptomatic, but the presence of local swelling and bone cortical rupture were common. Ameloblastomas mimicking periapical lesions of endodontic origin are mostly diagnosed in adult males as well-defined radiolucent unilocular lesions producing local swelling and bone cortical rupture.
- Predictors of health-related quality of life in Serbian patients with head and neck cancer(2022) Cankovic, Milos; Tesic, Milan; Jevtic, Marija; Stevanovic, Dejan; Jovanovi?, Milan B; Kosti?, Dejan; Anti?, Jadranka; Trivi?, Sanja Krejovi?The aim of this study was to identify predictors of the Health-Related Quality of Life (HRQoL) in patients with head and neck cancers (HNCs). In total, 345 patients with HNCs were interviewed. A self-report questionnaire was administered to collect data about demographic characteristics, health status, smoking, alcohol consumption habits, and HRQoL. It were used the EORTC Instruments - Quality of Life Questionnaire-Core 30-questions (QLQ-C30), Quality of Life Questionnaire - Head and Neck Module 35-questions (QLQ-H&N 35) and OHIP-14 instrument for HRQoL assessments. Clinical information and treatment data were collected from medical records. Five groups of HRQoL predictors were identified: demographic, socioeconomic, behavioral, psychophysical, and clinical/treatment. These HRQoL predictors had a strong (i.e., age, level of social support and social contact, level of education, depression, fatigue, presence of gastrostomy, comorbidities, and use of pain medications and supplements), a moderate (i.e., marital status, smoking, sexuality problems, time since diagnosis, presence of tracheostomy, and side effects outcomes of radio and chemotherapy) and a small impact (i.e., employment/financial difficulties, tumor site and stage, and surgical procedure). Study identified nineteen predictors that had significant, moderate and small impact on the HRQoL of patients with HNCs. Some of the predictors, like levels of social support and social contact, depression, and comorbidities could be targets for innervations to improve HRQoL.
- Connexin 43, Bcl-2, Bax, Ki67, and E-cadherin patterns in oral squamous cell carcinoma and its relationship with GJA1 rs12197797 C/G(2022) Segura, Ignacio González; Secchi, Dante Gustavo; Galíndez, María Fernanda; Carrica, Andrés; Bologna Molina, Ronell; Brunotto, Mabel; Centeno, VivianaTo our knowledge, there is no useful and accurate prognostic biomarker or biomarkers for patients with oral squamous cell carcinoma (OSCC), a tumor with uncertain biological behavior, and unpredicTable clinical progress. The purposes of this study were: a) to determine the expresión profile of Connexin 43, Bcl-2, Bax, E-cadherin, and Ki67 in patients with OSCC; b) identify the GJCA1 rs12197797 genotypic composition. A cross-sectional study using genomic DNA and biopsy samples extracted from the oral mucosa with/without OSCC, older than 18 years, both genders, attended at Facultad de Odontología, Universidad Nacional Córdoba. Immunostaining for Cx43, Bcl-2, Bax, E-cadherin, and Ki67 and genotyping GJA1 rs12197797 by RFLP were performed. Odds Ratio (95% CI), Spearman Coefficient were estimated. Mann-Whitney test was applied to analyze immunostaining between controls/cases (p <0.05 was set for statistical significance). GG (mutant) was the most frequent genotype in patients with OSCC diagnosis (53.2%) in relation to CC ?healthy? genotype (p=0.00487; OR=7.33; CI95% [1.1-54.7]). And, the allele G (mutant) had a presence in 75.5% of OSCC patients. However, no significant association was observed between alleles C/G and diagnosis (p=0.0565). The heterozygous genotype was the most frequent in the patients of both groups Cx43 and E-cadherin markers were lower in OSCCs in relation to controls. Ki67 and Bcl-2 immunolabeling were high on OSCC, and Bax immunomarker was diminished in OSCC. We hypothesized that the oral epithelium losses Connexin 43 and E-cadherin in the membrane, which modifies cell differentiation. The Ki67 and Bcl2 overexpression would increase the cell density in the tissue, by promoting proliferation and decreasing apoptosis. And, this study shows evidence that patients who carry on allele G of GJA1rs12197797 could be at risk of developing OSCC.
- Prognostic and clinicopathological significance of tumor-stroma ratio in head and neck squamous cell carcinoma:a systematic review(2022) de Morais, Everton Freitas; Morais, Hannah Gil de Farias; Martins, Hélder-Domiciano-Dantas; Carlan, Leonardo Magalhães; Costa, Antônio de Lisboa Lopes; Freitas, Roseana A.Analysis of the tumor microenvironment has been proposed as a strategy for the treatment and prognosis of different neoplastic processes. A grading system based on the tumor-stroma ratio (TSR), which evaluates the proportion of stroma in relation to neoplastic parenchyma at the invasion front, has shown a strong prognostic value in different neoplastic processes. The aim of the present systematic review was to understand the role of the TSR in head and neck squamous cell carcinoma (HNSCC), evaluating its correlation with clinical and prognostic parameters. An electronic search was performed in PubMed/Medline, Web of Science, Science Direct, Scopus, Embase, and the Cochrane Collaboration Library. Publications assessing the relationship between TSR and prognosis in cases of HNSCC were eligible. The quality of the studies was assessed independently by four evaluators using the Newcastle-Ottawa scale. After application of the previously es+lished inclusion/exclusion criteria, nine articles were included in the qualitative synthesis. With regards to quality on the Newcastle-Ottawa scale, an overall value of 4.55 was obtained. This systematic review demonstrated a strong association between TSR and prognosis in esophageal and oral squamous cell carcinomas. Histopathological analysis of the TSR can optimize the analysis of the prognosis of cases diagnosed with HNSSC. In addition, the TSR is a reliable and simple parameter that can be evaluated in hematoxylin/eosin-stained slides during routine laboratory examinations, showing high inter- and intraobserver agreement.
- Oral manifestations in SARS-CoV-2 infection(2022) Tüter, Gülay; Yerebakan, Mukaddes; Celik, Bulent; Kara, GulsahWe aimed to evaluate the prevalence of predisposing factors and oral manifestations in SARS-CoV-2 infection. 204 SARS-CoV-2 positive patients were included in the study. Questions regarding the systemic, periodontal health, oral hygiene habits, common symptoms and, oral manifestations of COVID-19 such as oral lesions, and dry mouth were included in the survey. The Visual Analogue Scale (VAS) was used. 47.5% of individuals had various systemic diseases. Dry mouth (44.2%) and oral lesions (22.4%) were the most common oral manifestations in COVID-19 patients. Also, dry mouth had the highest VAS score. The most common oral lesion locations were buccal mucosa (15.2%) and tongue (10.8%). The majority of participants (142 patients) were affected by taste disorders. Patients who received periodontal treatment before SARS-CoV-2 infection reported fewer oral complaint and manifestations than those who did not receive periodontal therapy (p=0.032). There was no statistically significant difference between males and females on the presence of any oral manifestations, and taste disorders. Our results showed that SARS-CoV-2 could cause oral manifestations. However various predisposing factors may be part of the etiology and promote oral findings.
- The evaluation of changes in maxillofacial bones using cone beam tomography in acromegaly(2022) Dogruel, Fatma; Canger, Emin Murat; Gonen, Zeynep Burcin; Asantogrol, Firdevs; Sahin, Ali; Bayram, FahriThe aim of the study was to evaluate the changes in craniofacial dimensions of newly diagnosed and untreated acromegaly patients, patients with non-functional pituitary adenoma and healthy individuals on Cone Beam Computed Tomography (CBCT). 50 newly diagnosed acromegaly patients who did not receive any treatment for acromegaly were included in the study (Group A). Twenty patients with nonfunctional pituitary adenoma (Group B) and 30 healthy individuals were included (Group C). Linear, angular and volumetric measurements were performed. Mandibular length showed significant difference in acromegaly patients, and maxillar length statistically significant difference was found between the A-B and B-C (p> 0,05), no difference was found between the A-C (p<0,05). SNB and ANB angle was statistically different in all groups, while SNA angle was statistically different between group A-C and B-C. In volumetric measurements, a statistically significant difference was found between groups a-c and groups A-B (p< 0,05), no difference was found between groups B-C (p>0,05). CBCT measurements showed that mandibular volume and length were increased in the acromegaly group compared to the group B-C. Present study is the first research that compares acromegaly patients in respect to changes in maxillofacial dimensions.
- Endoscopic findings in periapical surgery. A cross-sectional study of 206 roots(2022) Glera-Suárez, Pablo; Pallarés Serrano, Antonio; Soto-Peñaloza, David; Tarazona Álvarez, Beatriz; Peñarrocha Diago, Miguel; Peñarrocha Oltra, DavidA study is made of the findings of high-magnification rigid endoscopy at the root end surface following apicoectomy of teeth subjected to periapical surgery. A cross-sectional study was made of patients subjected to periapical surgery at the Unit of Oral Surgery and Implantology (University of Valencia, Valencia, Spain) between 2011 and 2019. Following apicoectomy, the root end surfaces were inspected, with the evaluation of untreated canals, isthmuses, craze lines, crack lines, opaque dentin and gaps. Likewise, an analysis was made of the association between patient age and the tooth type and restoration and the presence of craze lines, cracks, opaque dentin and gaps. The final sample consisted of 168 patients subjected to periapical surgery, with 177 operated teeth and 206 roots. Untreated canals were observed in 14 roots (6.8%). Isthmuses were identified in 74 roots (35.9%), particularly in the mesial root of the lower first molar (94.1%). In turn, craze lines were identified in 8.3% of the roots, cracks in 3.9%, and gaps in 53.4%. The prevalence of opaque dentin was 78.3%, with a greater presence in posterior teeth (90.3% in premolars and 86.2% in molars) than in anterior teeth (50.6%) (p<0.001). Patient age and tooth restoration showed no correlation to the studied parameters. Craze lines and crack lines were observed in less than 10% of the roots, though opaque dentin was identified in 73% of the roots, particularly in posterior teeth, and gaps were found in over half of the canals.
- Risk factors for oral mucositis during chemotherapy treatment for solid tumors:a retrospective STROBE-guided study(2022) Martins, Joyce Ohana de Lima; Fontes-Borges, Marcela Maria; Malta, Cássia Emanuella Nóbrega; Carlos, Anna Clara Aragão Matos; Crispim, André Alves; de Moura, José Fernando Bastos; Silva-Fernandes, Isabelle Joyce de Lima; Silva, Paulo-Goberlânio-de BarrosThis study retrospectively analyzed the risk factors for transchemotherapy oral mucositis (OM). Before each chemotherapy cycle, patients were routinely evaluated for the presence/severity of OM based on the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 scale for adverse effects and graded as follows: However, specific conditions such as mucositis are graded on a five-point scale: 0, absence of mucositis, grade 1 (Asymptomatic or mild), 2 (Presence of pain and moderate ulceration, without interference with food intake), 3 (severe pain with interference with food intake) or 4 (Life-threatening with the need for urgent intervention). Information from 2 years of evaluations was collected and patient medical records were reviewed to obtain data on chemotherapy cycle, sex, age, body mass index, body surface area, primary tumor, chemotherapy protocol, and history of head and neck radiotherapy. The X² test and multinomial logistic regression were used for statistical analysis (SPSS 20.0, p<0.05). Among 19,000 total evaluations of 3,529 patients during 5.32±4.7 chemotherapy cycles (CT) the prevalence of OM was 6.3% (n=1,195). Chemotherapy duration (p<0.001), female sex (p=0.001), adjuvant intention (p=0.008) and the use of carboplatin (p=0.001), cisplatin (p=0.029), docetaxel (p<0.001) and bevacizumab (p=0.026) independently increased the risk of mucositis. In head and neck tumors, 2018 year (p=0.017), chemotherapy duration (p=0.018), BMI>30 (p=0.008), radiotherapy (p=0.037) and use of carboplatin (p=0.046) and cyclophosphamide (p=0.010) increased this prevalence. Cycles of chemotherapy, sex, cytotoxicity drugs, bevacizumab and head and neck radiotherapy increase the risk of OM in solid tumors.
- Validity and reliability of the Turkish version of the orthognathic quality of life questionnaire in patients with dentofacial deformity(2022) Turna, Duygu; Benlidayi, Emre; Güney, Ayça Üstdal; Sertdemir, Ya?arDue to the lack of a specific quality of life (QoL) survey on dentofacial deformities (DFD) for Turkish speakers, the present research aimed to perform a translation of the English version of the Orthognathic Quality of Life Questionnaire (OQLQ) into Turkish (the OQLQ-TR) and provide cultural adaptation to the Turkish population. The process of this cross-cultural adaptation followed the six stages given in the guidelines that were proposed by Beaton et al. (2000), which comprised the following: 1) performing the initial translation, 2) synthesizing the translation, 3) performing the back translation, 4) presenting it to the expert committee, and 5) testing the prefinal version. Throughout the process of validating the Turkish version, the results of the OQLQ were compared with the Oral Health Impact Scale-14 (OHIP-14) and Short Form-36 (SF-36) questionnaires and the Visual Analogue Scale (VAS), which were previously validated in Turkish. All of these Turkish questionnaires (OHIP-14, SF-36, OQLQ) were applied to 69 patients at the Çukurova University Faculty of Dentistry. Analysis of the internal consistency of the OQLQ-TR exhibited good correlations for the domains. Moreover, the test-retest reliability also exhibited intra-class correlation coefficients that were excellent. The correlation between the OQLQ-TR and SF-36 was weak and negative. The OQLQ-TR exhibited good correlations with the OHIP-14 and VAS. The OQLQ-TR was found to be valid, reliable, and reproducible. Thus, it has become a useful instrument for assessing the quality of life of Turkish-speaking patients with dentofacial deformity.
- Actinic cheilitis:proposal of a clinical index(2022) Medeiros, Cristianne Kalinne Santos; Lopes, Maria-Luiza-Diniz-de Sousa; Dantas da Silveira, Ericka Janine; Costa de Lima, Kenio; de Oliveira, Patrícia TeixeiraActinic cheilitis is a potentially malignant lesion most commonly found in the lower lip of individuals with chronic exposure to ultraviolet radiation. The aim of this study was to develop and to test a clinical index that can be used to assess the severity of actinic cheilitis. The clinical index of actinic cheilitis was applied to 36 patients. An incisional biopsy was obtained to grade oral epithelial dysplasias following the World Health Organization (WHO) and binary systems, and to evaluate their association with clinical characteristics by Fisher?s exact test (P<0.05). The accuracy of the index was evaluated based on sensitivity, specificity, positive and negative predictive values, and receiver operating curve. The blurring between the border of the lip and the skin was significantly associated with cases without dysplasia/mild epithelial dysplasia (P=0.041) and with low risk of malignancy (P=0.005). Ulcers and crusts were significantly associated with moderate/severe epithelial dysplasia (P=0.002 and P=0.012, respectively) and high risk of malignancy (P=0.005 and P=0.045, respectively). Erosion showed a significant association only with high-risk cases of malignancy (P=0.024). The cut-off values of the diagnostic test showing the best performance were 10 for the WHO grading system and 11 for the binary system. The index cut-offs with the highest accuracy were considered indicators for a biopsy. Erosion, ulceration and crusts were associated with more severe oral epithelial dysplasias.
