Manifestações orais da sífilis

The past decade has shown a significant rise in the prevalence of infective syphilis in the developed world, and striking increases in its frequency have occurred in Eastern Europe, particularly the UK, and in the US. Although oral manifestations of syphilis are most likely to be observed during secondary disease, all stages of the disease can give rise to oral lesions. Significant oral lesions such as gumma-associated bony destruction and a possible predisposition to oral squamous cell carcinoma are associated with tertiary disease. Since the prevalence of infective syphilis in heterosexuals has been increasing, there has now been a gradual rise in the number of children born with congenital syphilis. Consequently, the congenital disease gives rise to dental anomalies as well as bone, skin, and neurological anomalies of the face. The aim of this report is to review syphilis-related oral lesions, as well as to summarize the relations between human immunodeficiency virus (HIV) and syphilis.A última década tem mostrado um aumento importante na prevalência de sífilis infecciosa nos países desenvolvidos e epidemias surgiram na Europa ocidental, particularmente no Reino Unido, bem como nos EUA. Embora as manifestações orais da sífilis sejam mais freqüentes na fase secundária da doença, todos os estágios podem apresentar lesões orais. A fase terciária da doença está associada a lesões orais significativas tais como destruição óssea associada à goma sifilítica e uma possível predisposição ao carcinoma espinocelular. Com o aumento da prevalência da sífilis infecciosa, há também um aumento gradual de crianças nascidas com sífilis congênita. Consequentemente esta patologia leva a anomalias faciais de ordem dentária, óssea, dermatológica e neurológica. O objetivo deste artigo é revisar as lesões orais associadas á sífilis, bem como discorrer brevemente sobre a relação entre a infecção pelo vírus da imunodeficiência humana (human immunodeficiency virus - HIV) e a sífilis

Quality Assessment of PBM Protocols for Oral Complications in Head and Neck Cancer Patients: Part 1

Radiotherapy and chemotherapy are frequently employed in head and neck cancer (HNC) patients causing significant side effects that impair life quality and prognosis. Photobiomodulation (PBM) has become a growing approach to managing such oral complications. Despite its proven efficacy and absence of contraindications, there is still a lack of universally accepted disease-specific PBM protocols

Angioleiomyoma affecting the lips : report of 3 cases and review of the literature

Angioleiomyoma is an uncommon benign soft tissue tumor usually found in the lower extremities and rarely observed in oral tissues. It is microscopically characterized as a proliferation of smooth muscle cells intermingled with abundant vascular channels. Oral angioleiomyomas affect mostly the lips, palate, buccal mucosa and tongue, and appears as a submucosal painless nodule. Upper lip is seldom affected and only few cases have been reported. We report three additional cases of angioleiomyoma affecting the lips of elderly patients. All lesions were asymptomatic and presented as submucosal nodules of approximately 1cm. Microscopic analysis on H and E sections revealed similar pattern in all cases, showing well-circumscribed and encapsulated tumors characterized by proliferation of smooth muscle cells and large amount of wide vascular spaces of varying sizes. Most tumor cells were immunoreactive for ?-smooth muscle actin, desmin and HHF-35. CD34 was also positive on the endothelial cells. All patients were surgically treated and no recurrence was observed so far. The oral pathologists and clinicians should consider this entity when assessing nodular lesions on upper lip. © Medicina Oral S. L

Association between periodontal disease, aterosclerosis and thickness of the intimate-medium carotid layer / Associação entre doença periodontal, aterosclerose e espessura da camada carotídea íntima-média

A doença coronariana tem grande impacto na saúde global, potencial morbidade e mortalidade, e assim como a doença periodontal apresenta alta prevalência. Além disso, as duas condições compartilham fatores de risco comuns, como tabagismo, diabetes melitus e idade. O objetivo deste estudo foi avaliar a associação entre doença periodontal, aterosclerose e espessura da íntima-média da carótida. Trata-se de um estudo observacional transversal realizado no Hospital de Urgência da Universidade de Pernambuco (PROCAPE) com amostra de 92 pacientes com idade entre 19 e 82 anos. Foi realizada anamnese e avaliação periodontal através do índice de placa, índice de sangramento, profundidade de sondagem, recessão gengival. A espessura da íntima-média da artéria carótida foi obtida por ultrassom. A prevalência de índice de periodontite foi de 74,2% e 11,8% de gengivite. Na análise bivariada houve correlação estatisticamente significativa entre doença periodontal e a presença de placa de ateroma, mas essa relação não se manteve na análise multivariada. A presença de placas de ateroma foi maior em pacientes com doença periodontal moderada a grave. Houve correlação estatisticamente significativa entre a presença de doença periodontal e a presença de placas de ateroma, bem como, aumento da espessura médio-intimal carotídea. No entanto, essa associação não foi verificada nas análises multivariadas

The need for communication between clinicians and pathologists in the context of oral and maxillofacial diseases

Good communication between clinicians and pathologists is a vital element in the diagnostic process, and poor communication can adversely affect patient care. There is a lack of research about communication in diagnostic oral and maxillofacial pathology. This narrative review explores different aspects of the quality of communication between clinicians and oral pathologists, with a focus on the diagnosis of oral and maxillofacial diseases. An electronic search was carried out in MEDLINE through the PubMed, Scopus, and Embase databases up to April 2021. No studies reporting communication, its adequacy or the required skills between clinicians and pathologists in oral diagnosis were found. According to studies published in medicine, strategies for improving communication skills include clinicianpathologist collaboration; a well-formatted, clear and thorough report; training in communication skills; and patient-centered care. Further studies evaluating the current practices and quality in oral and maxillofacial pathology are required to identify barriers and encourage optimal communication to facilitate diagnosis, as well as patient safety.The Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES), the Brazilian National Council for Scientific and Technological Development, CNPq and a PhD scholarship from the São Paulo State Research Foundation.https://www.scielo.br/j/bordm2022Oral Pathology and Oral Biolog

Clinicopathologic characteristics, cell proliferation markers and myofibroblast expression in oral squamous cell carcinoma carcinoma of the tongue

Orientador: Marcio Ajudarte LopesTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: O carcinoma espinocelular oral é a principal neoplasia maligna da boca, sendo a língua o local mais acometido. Recentemente tem sido relatado que tumores deste local apresentam características clínicas e comportamento biológico distintos dos demais tumores orais. O objetivo do presente trabalho foi avaliar as características clínicas, histopatológicas e expressão de marcadores de proliferação celular e actina de músculo liso (AML) em carcinomas espinocelulares (CECs) de língua. Para tanto, foram retrospectivamente analisados 63 casos de lesões de língua sem tratamento prévio e sem metástase à distância ao diagnóstico. As informações clínicas foram obtidas dos prontuários do Hospital do Câncer A.C. Camargo e as características histopatológicas observadas segundo os critérios de Anneroth e Bryne, sendo feitas reações imunoistoquímicas para Ki-67, mcm-2, geminina e AML. O tumor foi mais prevalente em homens, com 51 casos (80,95%) e apenas 12 em mulheres (19,05%), com idade variando de 31 a 92 anos, e média de 57,6 anos (dp = 11,81). Maior parte dos pacientes era fumante (85,7%) e consumia bebidas alcoólicas regularmente (82,5%). Com relação à gradação histológica, verificou-se que um escore de Anneroth maior que 15 esteve associado a etilismo (p=0,05), tipo de tratamento (p=0,05), tamanho do tumor (p=0,05), presença de êmbolos tumorais em vasos sanguíneos (p=0,003), comprometimento nodal (p=0,05), ruptura de cápsula nodal (p=0,016) e desenvolvimento de metástase à distância (p=0,002). Por outro lado, um escore maior que 12 segundo a gradação de Bryne apresentou associação com ruptura de cápsula (p=0,02) e desenvolvimento de metástase à distância (p=0,002), além de sobrevida global (p=0,03) e sobrevida livre de doença (p=0,05). O Ki-67 se mostrou capaz de prever metástase cervical (p=0,06). A expressão de mcm-2 correlacionou-se com idade (p=0,03) e metástase cervical (p=0,008) e a expressão de geminina com gênero feminino (p=0,02) e presença de invasão neural (p=0,05). Alta expressão de AML no estroma tumoral apresentou associação com estádio N maior ou igual a 1 (p=0,01), estadiamento clínico III e IV (p=0,03) e evolução com metástase nodal após o tratamento (p=0,07). Com base nestes resultados, sugere-se que os critérios de Bryne, associados à utilização de marcadores de proliferação celular e de miofibroblastos, podem ser importantes na avaliação do comportamento biológico de CECs de língua.Abstract: The aim of this study was to evaluate the clinical and histopathological features as well as proliferation markers and smooth muscle actin (SMA) immunohistochemical expression in tongue squamous cell carcinomas. Sixty three cases of tongue lesions with no previous treatment and no distant metastasis were selected. Clinical informations were retrieved from the clinical files of A.C. Camargo Cancer Hospital and the tumors were graded according to Anneroth et al. (1987) and Bryne et al. (1992) grading systems. Immunohistochemical reactions to Ki-67, mcm-2, geminin and SMA were performed. A male predilection could be noted since the sample was composed by 51 men (80,95%) and 12 women (19,05%). Age ranged from 31 to 92 years, with a mean age of 57,6 years (sd=11,81) and a median age of 58 years. Most of the patients were smokers (85,7%) and regular consumers of alcoholic beverages (82,5%). A total Anneroth score was related to regular consumption of alcoholic beverages (p=0,05), treatment (p=0,05), tumor size (p=0,05), tumoral embolization of blood vessels (p=0,003), nodal metastasis (p=0,05), nodal capsule rupture (p=0,016) and distant metastasis (p=0,002). On the other hand, total Bryne score above 12 was related to nodal capsule rupture (p=0,02) and distant metastasis (p=0,002), as well as overall survival (p=0,03) and disease-specific survival (p=0,05). Ki-67 was capable of predicting nodal metastasis (p=0,06). Immunohistochemical evaluation of mcm-2 revealed a relation between expression and age (p=0,03) and nodal metastasis (p=0,008). Geminin expression was related to female gender (p=0,02) and neural invasion (p=0,05). High levels of SMA were related to N stage (p=0,01), clinical stage III and IV (p=0,03) and nodal metastasis after treatment (p=0,07). It could be concluded that Bryne score together with proliferation and myofibroblast markers expression can be useful for evaluating the biological behavior of tongue squamous cell carcinomas.DoutoradoEstomatologiaDoutor em Estomatopatologi

Oral manifestations of syphilis

The past decade has shown a significant rise in the prevalence of infective syphilis in the developed world, and striking increases in its frequency have occurred in Eastern Europe, particularly the UK, and in the US. Although oral manifestations of syphilis are most likely to be observed during secondary disease, all stages of the disease can give rise to oral lesions. Significant oral lesions such as gumma-associated bony destruction and a possible predisposition to oral squamous cell carcinoma are associated with tertiary disease. Since the prevalence of infective syphilis in heterosexuals has been increasing, there has now been a gradual rise in the number of children born with congenital syphilis. Consequently, the congenital disease gives rise to dental anomalies as well as bone, skin, and neurological anomalies of the face. The aim of this report is to review syphilis-related oral lesions, as well as to summarize the relations between human immunodeficiency virus (HIV) and syphilis

Subgemmal Neurogenous Plaque: Clinical And Microscopic Evaluation Of 7 Cases.

Subgemmal neurogenous plaques (SNPs) are biphasic neural structures found on the posterolateral border of the tongue. Fewer than 40 cases have been reported and only a few were symptomatic. The present report details the features of 7 cases of SNP retrieved from the files of a single institution. Clinical and histopathological data were reviewed and immunohistochemical analysis was performed for S100, CD56, neuron-specific enolase, epithelial membrane antigen, CK7, CK8, CK14, and CK20. All cases showed similar morphological and immunohistochemical characteristics. Neural markers highlighted the biphasic pattern and CK7, CK8, and CK20 were detected on taste buds confined to the epithelium adjacent to the SNPs. Five patients presented pain/discomfort as the main symptom. Symptomatic SNPs seems to be more common than previously reported, presenting as focal burning on the posterolateral border of the tongue.108920-