Clinical and Research Activities of the Brazilian Productivity Fellows in Oral Medicine and Oral Pathology during the COVID-19 Era

Objective: To evaluate the effect of the COVID-19 impacts on the activities of researchers in the field of Oral Medicine (OM) and Oral Pathology (OP). To assess the research activities and training of human resources by Brazilian productivity fellows in research (BPFR) in OM and OP in the COVID-19 Era . Material and Methods: Thirty-six BPFR in OM and OP areas, funded by National Council for Scientific and Technological Development (CNPq), received a virtual structured questionnaire by e-mail, on the Google Forms (Google®) platform, with questions regarding research activities and training of human resources (supervision of undergraduate and postgraduate students), during the COVID-19 pandemic. From the thirty-six BPFR in OM and OP, twenty-seven (75.0%) answered the questionnaire. Results: Most of them were males (n=20; 74.1%) and were distributed in four Brazilian regions and ten states of the federation, including the Federal District. Twenty-four (88.9%) BPFR reported having suspended clinical activities, while sixteen (59.3%) answered that histopathology practices are suspended. Twenty-five (92.6%) BPFR mentioned difficulties in conducting research projects and 55.5% stated having no difficulties in the supervision of undergraduates, master’s and PhD students . Conclusion: The current scenario may significantly impact the diagnosis of oral diseases in Brazil. Moreover, a decrease in the scientific production of BPFR in OM and OP in the coming years is also considered

Specialized Dental Care in the Brazilian Unified National Health System (SUS)

Objective: To analyze specialized dental care through access, demand and the work processes provided by the CEO\u27s, using secondary data from the cycles of the PMAQ-CEO. Material and Methods: Cross-sectional study using public domain data. Variables of interest were selected from the external evaluation instrument data matrices and were grouped in categories. The categories were geographic distribution, structural, human resources, work processes and access and coordination. Results: The total of 932 CEO’s were evaluated in 2014 and 1,042 in 2016, most of them type II, present in the Northeast region. In both cycles, the highest average of dentists worked in the endodontic specialty (2.4 professionals per CEO) and the lowest in oral medicine (0.8 professionals per CEO). Of the two cycles, 91.5% of the CEO’s had a manager, 79.5% performed action planning activities and 74.5% realized internal self-assessment processes. There was an increase in the mean number of days to be seen at the CEO in all analyzed specialties (p<0.001) and 85.2% of the CEO\u27s managers reported that there is a reference for oral cancer confirmed cases. Conclusion: Between the PMAQ-CEO cycles the number of CEO has increased, but there are still a big pent-up demand and the presence of care gaps. However, an expansion and improvement of the CEO’s actions was evidenced, mainly related to the work processes

Rare Diseases and COVID-19: How are the Patients?

Dear Editor, When searching the scientific literature COVID-19-associated syndromes in addition to syndromes middle eastern respiratory syndrome (MERS), severe acute respiratory syndrome (SARS), some cardiovascular syndromes and post intensive care syndrome [1,2], we found the syndromes of Guillain-Barré, Miller Fisher, polyneuritis cranialis, Kawasaki, Inflammatory multisystem syndrome, and syndrome of inappropriate antidiuretic hormone secretion [3-29]. Of these, only Guillain-Barré syndrome and Miller Fisher syndrome, Kawasaki diseases and Inflammatory multisystem syndrome have currently present cranio-facial manifestation (Table 1), but possibly others will become know when the damage of COVID-19 becomes known.Although there is no standardized definition of rare diseases, the classification of rare diseases is closely related to a definition according to point prevalence in the current political and legislative context, and such definitions are based on a prevalence threshold directly or implied. According to the World Health Organization (WOS) and adopted by the Ministry of Health of Brazil, a rare disease affects up to 65 per 100,000 individuals [30]. Each rare disease, taken separately, affects a limited number of people. Considering, however, that there are up to 8,000 types of rare diseases worldwide, when grouped under a single category, their epidemiological impact may become quite significant. About 80% of those are caused by genetic factors, and the rest by other factors, such as environmental, infectious and immunologicalones [31]. Thus, rare diseases are a global challenge that must be overcome. A multi-professional and interdisciplinary team, including pediatric dentistry, oral medicine and pathology, is essential for success throughout the process

COVID-19 pandemic: oral repercussions and its possible impact on oral health

Many viral infections cause oral manifestations, including disorders in odontogenesis, resulting in dental malformations. In this review, based on current knowledge, we will discuss the likely dental and oral consequences of COVID-19. In this article, we review currently available data associated with vertical transmission of COVID-19 and odontogenesis, oral manifestations, and the impact of COVID-19 pandemic on a diagnosis of oral diseases. Owing to the severity of the pandemic, the population's anxiety and fear of becoming infected with COVID-19 may underestimate the signs and symptoms of serious illnesses, besides discourage patients from seeking health, medical or dental services to determine the diagnosis of oral lesions. Thus, the COVID-19 pandemic could be an additional and aggravating factor for the delay of serious illness diagnosis, such as oral squamous cell carcinoma resulting in higher morbidity and worse prognosis. Several changes and oral lesions have been described as oral manifestations of COVID-19, such as dysgeusia, oral ulcers, petechiae, reddish macules, desquamative gingivitis, among others. Besides, it can cause major systemic changes and predispose opportunistic infections. As with other viral infections, oral manifestations, including dental anomalies, can occur as a direct result of SARS-CoV-2 infection. However, further studies are needed to guide and clarify possible oral changes20

Non-syndromic oral clefts and risk of cancer: a systematic review

Objective: To discuss the risk of cancer among relatives of individuals with cleft lip and palate (CL/P), as well as the risk of CL/P among relatives of individuals with cancer, since studies published currently have suggested  an increased risk of cancer among relatives of cleft individuals. Design: A systematic literature review was carried out in accordance with the Cochrane Collaboration Group protocol, including literature search strategy, selection of papers through the inclusion and exclusion criteria, data extraction and quality assessment. PubMed, Scopus and ISI - Web of Science databases were systematically searched using the fallowing search strings: “cleft lip and palate” AND “cancer”, “oral clefts” AND “cancer” and “orofacial clefts” AND “cancer”. Results: From 653 studies accessed, 8 comprised the final sample: 6 investigating CL/P index cases and their family history of cancer and 2 investigating individuals with cancer and their family history for CL/P. The sample sizes were not homogeneous. Oral clefts, the type of cancer and the degree of kinship family were not categorized in all studies. Leukemia, breast cancer and colon cancer were the most cited types, even as first-and-second degree relatives. Conclusions: An increased risk of cancer among relatives of cleft individuals could not be entirely confirmed. However, studies with this specific purpose suggest that first-and-second degrees relatives of cleft individuals have some types of cancer more often than unexposed families, highlighting that future studies should expand their samples to investigate possible common molecular mechanisms that allow relating oral clefts and cancer

Hereditary gingival fibromatosis: clinical and ultrastructural features of a new family

Objective: This article describes the diagnosis, clinical and microscopic (histopathology and ultrastructural) features and treatment of a new family with hereditary gingival fibromatosis (HGF) and highlights the importance of this genetic condition. Study Design: To characterize the pattern of inheritance and the clinical features, members of a new family with HGF were examined. The pedigree was reliably constructed including the four latest generations of family. Hematoxylin and eosin staining and ultrastructural analysis were performed with the gingival tissue. Results: Examination of the family pedigree revealed that the patient III-2 represent the index patient of this family (initial patient with a mutation), which was transmitted to her daughter through an autosomal dominant mode of inheritance. The affected patients showed a generalized gingival overgrowth. The patient was treated with surgical procedures of gingivectomy and gingivoplasty. The diagnosis was confirmed by histopathology examination that showed a well-structured epithelium with elongated and thin papillae inserted in fibrous connective tissue with increased amount of collagen. The ultrastructural aspects of the tissue show collagen fibrils exhibiting their typically repeating banding pattern with some fibrils displaying loops at their end. Moreover, it was possible to seen in some regions fibrillar component presenting tortuous aspects and loss of the alignment among them. Conclusions: This HGF frequently resulted in both esthetic and functional problems. The genetic pattern of this Brazilian family suggested a new mutation, which was later transmitted by an autosomal dominant trait