Actinic cheilitis:proposal of a clinical index

Actinic 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

A retrospective 11-year study on lip lesions attended at an oral diagnostic service

The objective of this study was to describe the upper and lower lip lesion occurrence in an oral diagnostic service. Retrospective descriptive sectional study was performed. Clinical records were obtained from the archives of an Oral Diagnostic Service referral center between 2006 and 2016. Data such as gender, age, anatomical location, and diagnosis were collected and categorized. The collected data were submitted to a descriptive analysis and Pearson's chi-square test (p ? 0.05). A total of 587 patient records of lip lesions were analyzed. Most lesions were diagnosed in female (52.1%) and adults (56.9%) patients in the lower lip (76.2%). Among all lip lesions, the reactive/inflammatory lesions (n = 238; 40.5%) and oral potentially malignant disorders (n = 164; 28%) were the most frequent group lesions. Mucocele (n = 147; 25%), actinic cheilitis (n = 136; 23.1%) and vascular lesions (n = 51; 8.7%) were the most frequent lesion in the sample. Actinic cheilitis was significant in relation to gender (p < 0.001), all three most frequent lesions were significant in concerning to age group and anatomical site. Mucocele was the most common lower lip lesion in all age groups, followed by actinic cheilitis and vascular lesions, which mainly affected adults and the elderly

Lipoma bilateral em região de trígono retromolar: relato de caso / Bilateral lipoma in retromolar trigone region: case report

O lipoma é a neoplasma mesenquimal mais comum de tecidos moles. Seu acometimento ocorre, em maioria, no tronco e na porção proximal das extremidades, enquanto que na região oral os lipomas são muito menos frequentes. Objetivo: Relatar um caso de lipoma bilateral em paciente do sexo feminino, 71 anos, apresentou lesões bilaterais nodulares, assintomáticas, de consistência amolecida em região de trígono retromolar. A lesão em lado direito apresentava-se pedunculada e normocrômica enquanto que a lesão em lado esquerdo era séssil e amarelada. No exame histopatológico sob microscopia de luz, foi observado presença de neoplasia benigna constituída de adipócitos maduros, sem presença de atipias celulares, circundados por uma cápsula de tecido conjuntivo fibroso denso. Como a paciente não apresentava clinicamente massas lipomatosas na região superior do tórax e região cervical e apresentava, microscopicamente, a presença de uma cápsula fibrosa, descartou-se a doença de Madelung. Logo então, o diagnóstico de lipoma em ambos os lados foi confirmado. Conclusão: Os lipomas em região oral são menos frequentes do que em outras regiões do corpo e, quando presentes simetricamente, devem ser investigados se está associado a alguma desordem proliferativa rara

Técnica de restauração atraumática: revisão da literatura

O tratamento restaurador atraumático envolve restaurações atraumáticas e procedimentos educativos-preventivos. Trata-se de uma forma simplificada de atendimento, que consiste na remoção do tecido cariado, com instrumentação manual. Este estudo tem como objetivo realizar uma revisão de literatura sobre as principais evidencias da técnica de restauração atraumática em lesões cariosas na odontopediatria. Foi realizada uma revisão bibliográfica nas bases de dados, PubMed, SciELO e Periódicos CAPES. A maioria dos estudos sobre a eficácia do ART demonstraram um bom resultado, isso é explicado pela praticidade da técnica e baixo custo, sendo apropriada a todo e qualquer segmento sócioeconômico, e não apenas a populações de baixa renda. A técnica é baseada em mínima intervenção, assim, a ART tem um enfoque preventivo-terapêutico e não somente restaurador, sendo uma opção na odontopediatria para contribuir para a redução da necessidade de tratamentos invasivos. Estudos usando o ART em crianças tem mostrando resultados promissores

Verruciform xanthoma associated with lichen planus

Verruciform xanthoma (VX) is a rare benign lesion of unknown etiology, with a rough or papillary aspect, painless, sessile, well-defined, most lesions do not exceed 2 cm in their largest diameter, the degree of keratinization of the surface influences color, varying white to red, affecting mainly the gingiva and alveolar mucosa, and can also be seen in skin and genital. Herein, we present a report a clinical case of oral verruciform xanthoma in the buccal mucosa associated with the lichen planus lesion, as well as the morphological and immunohistochemical characteristics of the lesion. The clinical diagnostic hypothesis of oral lichen planus of the white reticular lesions on the buccal mucosa and on the tongue was confirmed by histopathology before a subepithelial connective tissue exhibiting intense inflammatory infiltrate in a predominantly lymphocytic band. In contrast, the hypothesis of the verrucous lesion in the left buccal mucosa was leukoplakia, with histopathological evidence showing exophytic and digitiform proliferations with parakeratin plugs between the papillary projections. Subepithelial connective tissue was characterized by macrophages with foamy cytoplasm (xanthoma cells). An immunohistochemical examination was performed, showing positivity for CD68, a macrophage marker, in addition to testing by Schiff's periodic acid (PAS) with diastasis, which was detected the presence of lipids inside these macrophages. The patient is free of recurrences of verruciform xanthoma and is being monitored due to the presence of lesions of oral lichen planus