Avaliação do budding tumoral em biópsias incisionais de carcinoma epidermóide de boca e sua associação com a expressão imuno-histoquímica das proteínas Podoplanina e Osteopontina

TCC (graduação) - Universidade Federal de Santa Catarina. Centro de Ciências da Saúde. Odontologia.O budding tumoral (BT) é um marcador morfológico associado a perda de adesão celular, invasão tumoral e possivelmente a transição epitélio-mesenquimal. As proteínas podoplanina e osteopontina são biomarcadores associados ao desenvolvimento, progressão e metástase de tumores, e ambos parecem desempenhar um papel na descoesão e migração celular. Com isso, este estudo teve como objetivo avaliar a intensidade do BT em amostras de biópsias de carcinoma epidermóide de boca (CEB) e sua associação com as proteínas podoplanina e osteopontina. A seleção final da amostra incluiu 98 casos de CEB dos quais foram selecionados blocos de parafinas e cortes histológicos para a realização da técnica imuno-histoquímica, para avalição do BT foi utilizado o anticorpo pan-citoceratina (AE1/AE3) e anti-podoplanina e antiosteopontina para avaliação das proteínas. O teste Qui-quadrado foi utilizado para analisar a associação entre a intensidade do BT e a expressão de podoplanina e osteopontina. O teste de McNemar foi empregado para identificar diferenças entre a expressão de podoplanina e osteopontina nas áreas de alta intensidade de BT e fora da área de BT e o teste exato de Fisher foi usado para avaliar a associação entre o BT e a localização anatômica. Não foi observada associação entre BT e a expressão de podoplanina e osteopontina. Nos tumores com BT de alta intensidade, a expressão de podoplanina foi menor nas áreas de BT do que nas áreas externas ao BT. Foram observadas diferenças entre a intensidade do BT e a localização anatômica, sendo que 53,6% dos tumores em língua apresentaram alta intensidade de BT, enquanto apenas 6,3% dos tumores em lábios apresentavam essa característica. No CEB, o BT de alta intensidade não foi associada à expressão de podoplanina e osteopontina. Além disso, a podoplanina foi menos expressa nas áreas de BT do que em áreas fora desteTumor budding (TB) is a morphologic marker associated with cellular detachment, tumor invasion, and possibly epithelial-mesenchymal transition. Podoplanin and Osteopontin are biomarkers associated with tumor development, progression, and metastasis and both appear to have a role in cellular detachment and cell migration. Thus, this study aimed to evaluate the intensity of TB in biopsy samples of oral squamous cell carcinoma (OSCC) and its association with podoplanin and osteopontin immunoexpression. Immunohistochemistry was employed in 98 cases of OSCC to detect pancytokeratin (AE1/AE3), in order to identify epithelial tumor cells in TB evaluation. Antibodies against podoplanin and osteopontin were also used to identify these proteins. A Chi-square test was used to analyze the association between the intensity of TB and the expression of podoplanin and osteopontin. McNemar’s test was employed to identify differences between podoplanin and osteopontin expression in the budding area and outside the TB area. The Fisher exact test was used to evaluate the association between TB and anatomical location of the OSSC. No association was observed between TB and podoplanin and osteopontin expression. In tumors with high-intensity TB, podoplanin expression was lower in tumor buds areas than areas outside the budding. Differences were observed between TB intensity and anatomical location, with 53.6% of tongue tumors presenting high-intensity TB, and only 6.3% of lips tumors showing this characteristic. In OSCC, high-intensity TB was not associated with podoplanin and osteopontin expression and podoplanin were less expressed in tumor buds than in areas outside the budding

Labels and descriptions of dental behaviour support techniques: A scoping review of clinical practice guidelines

Introduction: There is no agreed taxonomy of the techniques used to support patients to receive professional oral healthcare. This lack of specification leads to imprecision in describing, understanding, teaching and implementing behaviour support techniques in dentistry (DBS). Methods: This review aims to identify the labels and associated descriptors used by practitioners to describe DBS techniques, as a first step in developing a shared terminology for DBS techniques. Following registration of a protocol, a scoping review limited to Clinical Practice Guidelines only was undertaken to identify the labels and descriptors used to refer to DBS techniques. Results: From 5317 screened records, 30 were included, generating a list of 51 distinct DBS techniques. General anaesthesia was the most commonly reported DBS (n = 21). This review also explores what term is given to DBS techniques as a group (Behaviour management was most commonly used (n = 8)) and how these techniques were categorized (mainly distinguishing between pharmacological and non‐pharmacological). Conclusions: This is the first attempt to generate a list of techniques that can be selected for patients and marks an initial step in future efforts at agreeing and categorizing these techniques into an accepted taxonomy, with all the benefits this brings to research, education, practice and patients

Behaviour support in dentistry: A Delphi study to agree terminology in behaviour management

Objectives: Dental behaviour support (DBS) describes all specific techniques practiced to support patients in their experience of professional oral healthcare. DBS is roughly synonymous with behaviour management, which is an outdated concept. There is no agreed terminology to specify the techniques used to support patients who receive dental care. This lack of specificity may lead to imprecision in describing, understanding, teaching, evaluating and implementing behaviour support techniques in dentistry. Therefore, this e‐Delphi study aimed to develop a list of agreed labels and descriptions of DBS techniques used in dentistry and sort them according to underlying principles of behaviour. Methods: Following a registered protocol, a modified e‐Delphi study was applied over two rounds with a final consensus meeting. The threshold of consensus was set a priori at 75%. Agreed techniques were then categorized by four coders, according to behavioural learning theory, to sort techniques according to their mechanism of action. Results: The panel (n = 35) agreed on 42 DBS techniques from a total of 63 candidate labels and descriptions. Complete agreement was achieved regarding all labels and descriptions, while agreement was not achieved regarding distinctiveness for 17 techniques. In exploring underlying principles of learning, it became clear that multiple and differing principles may apply depending on the specific context and procedure in which the technique may be applied. Discussion: Experts agreed on what each DBS technique is, what label to use, and their description, but were less likely to agree on what distinguishes one technique from another. All techniques were describable but not comprehensively categorizable according to principles of learning. While objective consistency was not attained, greater clarity and consistency now exists. The resulting list of agreed terminology marks a significant foundation for future efforts towards understanding DBS techniques in research, education and clinical care

Crianças e adolescentes com transtornos do neurodesenvolvimento e a evidência científica em odontologia: uma coletânea de revisões

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Odontologia, Florianópolis, 2022.A Odontologia para pacientes com necessidades especiais é uma área ampla e que abrange indivíduos com qualquer condição limitante, seja ela emocional, comportamental, cognitiva, de desenvolvimento, mental ou física. Evidências indicam que crianças e adultos sem deficiência experienciam as mesmas condições bucais que seus pares não deficientes, embora pessoas com deficiência tenham desfechos piores. Dessa forma, o objetivo deste trabalho foi conduzir uma serie de revisões relacionadas a crianças e adolescentes com transtornos do neurodesenvolvimento (TN) e a evidência disponível na Odontologia. Primeiramente, uma revisão bibliométrica (RB) foi conduzida para elaborar um levantamento dos 100 artigos mais citados referentes a crianças e adolescente com TN na odontologia. Posteriormente, uma revisão sistemática (RS) sobre a prevalência de bruxismo/ranger dos dentes nesse grupo de pacientes foi realizada. Por fim, uma revisão de escopo (RE) com a finalidade de mapear a literatura sobre qualidade de vida relacionada a saúde bucal foi elaborada. Em relação a RB, a maioria dos estudos incluídos foram observacionais, focando na epidemiologia de condições bucais e referente a pessoas com síndrome de Down e transtorno do espectro do Autismo. O número de citações variou de 30 a 106 por estudo. Em relação a RS, 77 estudos foram incluídos e a prevalência de bruxismo oscilou de acordo com a deficiência e os resultados apresentaram alta heterogeneidade. Por último, dos 15 estudos incluídos na RE, oito foram do Brasil, sobre pessoas com Paralisia Cerebral e utilizaram o P-CPQ para avaliação da qualidade de vida relacionada a saúde bucal. Os resultados desses trabalhos não são importantes somente com desenvolvimento científico e clínico, mas também para garantir uma odontologia inclusiva e baseada em evidências para os paciente, garantindo aos cirurgiões?dentistas acesso a diferentes artigos que sintetizam a vasta literatura disponível atualmente.Abstract: Dentistry for patients with special needs is a broad area that encompasses individuals with any limiting condition, be it emotional, behavioral, cognitive, developmental, mental or physical that requires medical treatment. Evidence indicates that children and adults without disabilities experience the same oral conditions as their non-disabled peers, although people with disabilities have worse outcomes. Thus, the objective of this work was to conduct a series of reviews related to children and adolescents with neurodevelopmental disorders (ND) and dentistry. First, a bibliometric review (BR) was conducted to create a survey of the 100 most cited articles referring to children and adolescents with ND in dentistry. Subsequently, a systematic review (SR) on the prevalence of bruxism/teeth grinding in this group of patients was performed. Finally, a scoping review (ScR) with the purpose of mapping the literature on quality of life related to oral health was elaborated. Regarding BR, most of the studies included were observational, focusing on the epidemiology of oral conditions and referring to people with Down syndrome and Autism Spectrum Disorder. The number of citations ranged from 30 to 106 per study. Regarding the SR, 77 studies were included and the prevalence of bruxism varied according to the disability and the results showed high heterogeneity. Finally, of the 15 studies included, eight were from Brazil, about people with Cerebral Palsy and used the P-CPQ to assess the quality of life related to oral health in the ScR. The results of these works are not only important for scientific and clinical development, but also for ensuring an inclusive and evidence-based dentistry for patients, guaranteeing dentists access to different articles that synthesize the vast literature currently available