Aim The aim of the present preliminary case-control study was to test the sensitivity and specificity of salivary pipecolic acid in predicting head and neck squamous cell carcinoma (HNSCC). Methods High-performance liquid chromatography was used for the analysis of non-stimulated saliva samples from 40 individuals: 20 in the case group (recently diagnosed with untreated HNSCC) and 20 in the control group (individuals without cancer). Both groups included patients taking daily oral hypoglycemic drugs (comorbidity). The case and control groups were matched at a proportion of 1:1 for sex and comorbidity. Results Mean salivary levels of pipecolic acid were 169.38 ng/mL in the case group and 114.66 ng/mL in the control group (p<0.001). Individuals who took oral hypoglycemic drugs had higher levels of pipecolic acid in both the case and control groups (p<0.001). The receiver operating characteristic curve analysis revealed 90% sensitivity and 65% specificity for head and neck cancer, with an area under the curve of 0.838 between the case and control groups. Conclusions Pipecolic acid had high sensitivity for the diagnosis of HNSCC but low specificity in the sample analyzed. Our findings suggest that salivary pipecolic acid levels are associated with glucose homeostasis. Studies with larger samples are required to evaluate the specificity of this metabolite.

Abstract Hyposalivation and sensation of dry mouth (xerostomia) are one of the most common adverse effects in the treatment of patients with head and neck cancer. Objective: This study evaluates the prevalence of late hyposalivation and associated factors in survivors of squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx treated with radiotherapy with or without concomitant chemotherapy. Methodology: A cross-sectional study was conducted with 88 patients who had concluded radiotherapy at least three months before the study, at a referral center for the treatment of head and neck cancer in the Southern region of Brazil. Hyposalivation was evaluated based on the stimulated salivary flow rate using the spitting method. Multivariate analysis using binary logistic regression was performed to determine the associations between hyposalivation and clinical and demographic variables. Results: Hyposalivation was found in 78.41% of the sample and the mean radiation dose was 63.01 Gy (±9.58). In the crude model of the multivariate analysis, hyposalivation was associated with higher doses of radiation (p=0.038), treatment with concomitant radiotherapy and chemotherapy (p=0.005), and time elapsed since the end of radiotherapy (p=0.025). In the adjusted model of the multivariate analysis, hyposalivation was only associated with dose and time elapsed. Patient who received higher doses of radiation had a 4.25-fold greater chance of presenting hyposalivation, whereas a longer time elapsed since the end of radiotherapy exerted a 75% protective effect against the occurrence of hyposalivation. Conclusion: Hyposalivation is a highly prevalence late-onset side effect of radiotherapy in patients treated for head and neck cancer, with a greater chance of occurrence among those who received higher doses of radiation and those who ended therapy less than 22 months before our study. Concomitant chemotherapy and radiotherapy does not seem to increase the chances of hyposalivation compared to radiotherapy alone.

RESUMO As perdas dentárias, devido aos processos patológicos, ainda são uma realidade na clínica odontológica diária, induzindo complicações funcionais e psicológicas ao paciente. Diante disso, uma nova opção para o manejo desse problema vem sendo estudada na Odontologia, a engenharia tecidual. Essa área, considerada multidisciplinar, utiliza três elementos chaves para a regeneração dos tecidos: os scaffolds (matriz extracelular) naturais ou sintéticos, as células e os fatores de crescimento. Nesse sentido, a combinação desses três elementos pode induzir a regeneração da polpa dentária, tecido ósseo e periodontal, entre outros. Portanto, o objetivo deste estudo é realizar uma revisão da literatura, descrevendo e atualizando os cirurgiões-dentistas sobre os principais elementos da engenharia tecidual e sua aplicabilidade na Odontologia.

ABSTRACT Tooth losses due to pathological processes continue to be a reality in daily clinical dentistry, inducing functional and psychological complications in patients. In view of this, a new option for the management of this problem - tissue engineering - has been studied in Dentistry. This field, considered multidisciplinary, uses three key elements for tissue regeneration: scaffolds (extracellular matrices) - natural or synthetic; cells, and growth factors. In this sense, combination of these three elements may induce regeneration of the dental pulp, bone and periodontal tissue, among others. Therefore, the aim of this study was to conduct a literature review, describing the main elements of tissue engineering and their applicability in Dentistry, as a means of updating dental surgeons about this subject.

RESUMO Objetivo Avaliar o perfil epidemiológico e a taxa de sobrevida do câncer de boca e orofaringe de pacientes atendidos em um hospital universitário. Métodos Foi realizado um estudo transversal por meio dos laudos anatomopatológicos dos pacientes com câncer de boca e orofaringe atendidos em um hospital universitário, na Região Sul, entre janeiro de 2004 a dezembro de 2014. A partir destes laudos, foram coletadas informações sobre o paciente e o tumor. A taxa de mortalidade foi obtida do registro de óbitos dos pacientes no Sistema de Informações sobre Mortalidade. Os dados foram analisados utilizando a curva de sobrevida pelo método de Kaplan-Meier e o teste de log-rank para a comparação das variáveis. Resultados As taxas de sobrevida em 5 e 10 anos foram 42% e 38%, respectivamente. A localização anatômica apresentou associação significativa com a taxa de sobrevida (p=0,001), sendo que, em lábio, os índices foram melhores (p=0,04) e, em orofaringe, piores (p=0,03). Não houve diferenças estatisticamente significantes entre as taxas de sobrevida de acordo com idade, sexo, etnia, nível educacional e grau histológico. Conclusão As taxas de sobrevida do câncer de boca e orofaringe foram baixas e associadas à localização anatômica do tumor.

ABSTRACT Objective To evaluate the epidemiological profile and survival rate of oral and oropharyngeal cancer patients seen at a university hospital. Methods A cross-sectional study was carried out by means of the pathological reports of patients with oral and oropharyngeal cancer, seen at a university hospital of the Southern Region, between January 2004 and December 2014. Information was collected on patients and tumors. The mortality rate was gathered from the patient death registry in the Mortality Information System. Data were analyzed using the Kaplan-Meier survival curve and the log-rank test to compare variables. Results The 5- and 10-year survival rates were 42% and 38%, respectively. The anatomical location had a significant association with survival rate (p=0.001), with the rates were better in the lips (p=0.04), and worse in the oropharynx (p=0.03). There were no statistically significant differences between survival rates according to age, sex, ethnicity, schooling level and histologic grade. Conclusion The survival rates of oral and oropharyngeal cancer were and associated with the anatomical site of the tumor.

ABSTRACT INTRODUCTION: This study evaluated the susceptibilities of oral candidiasis-derived Candida albicans, fluconazole-resistant (FR) Candida dubliniensis, and fluconazole-susceptible (FS) C. dubliniensis to synthetic antiseptics [chlorhexidine gluconate (CHX), cetylpyridinium chloride (CPC), and triclosan (TRC)] and natural compounds (carvacrol, eugenol and thymol). METHODS: Susceptibility tests were performed based on the M27-A3 reference method. The fluconazole-resistant C. dubliniensis strains were obtained after prolonged in vitro exposure to increasing fluconazole concentrations. The geometric mean values for minimum inhibitory concentrations and minimum fungicidal concentrations were compared among the groups. RESULTS: Fluconazole-susceptible C. dubliniensis was more sensitive to CPC and TRC than FR C. dubliniensis and C. albicans were. However, eugenol and thymol were more active against FR C. dubliniensis. The fungicidal activities of CHX and TRC were similar for the three groups, and FR C. dubliniensis and C. albicans had similar sensitivities to CPC. CONCLUSIONS: The resistance of C. dubliniensis to fluconazole affects its sensitivity the synthetic antiseptics and natural compounds that were tested.

ABSTRACT This study evaluated the clinical diagnosis of proximal gingivitis by comparing two methods: dental flossing and the gingival bleeding index (GBI). One hundred subjects (aged at least 18 years, with 15% of positive proximal sites for GBI, without proximal attachment loss) were randomized into five evaluation protocols. Each protocol consisted of two assessments with a 10-minute interval between them: first GBI/second floss, first floss/second GBI, first GBI/second GBI, first tooth floss/second floss, and first gum floss-second floss. The dental floss was slid against the tooth surface (TF) and the gingival tissue (GF). The evaluated proximal sites should present teeth with established point of contact and probing depth ≤ 3mm. One trained and calibrated examiner performed all the assessments. The mean percentages of agreement and disagreement were calculated for the sites with gingival bleeding in both evaluation methods (GBI and flossing). The primary outcome was the percentage of disagreement between the assessments in the different protocols. The data were analyzed by one-way ANOVA, McNemar, chi-square and Tukey’s post hoc tests, with a 5% significance level. When gingivitis was absent in the first assessment (negative GBI), bleeding was detected in the second assessment by TF and GF in 41.7% (p < 0.001) and 50.7% (p < 0.001) of the sites, respectively. In the absence of gingivitis in the second assessment (negative GBI), TF and GF detected bleeding in the first assessment in 38.9% (p = 0.004) and 58.3% (p < 0.001) of the sites, respectively. TF and GF appears to be a better diagnostic indicator of proximal gingivitis than GBI.

Abstract Revascularization of immature teeth with necrotic pulps traditionally involves the use of triple antibiotic paste, which may sometimes lead to undesirable complications. The objective of this study was to assess tissue repair in immature dog teeth with apical periodontitis subjected to revascularization, comparing two different pastes used for root canal disinfection. Apical periodontitis was induced in 30 dog premolars. Teeth were randomly divided into three experimental groups: root canals filled with triple antibiotic paste (n = 10); root canals filled with 1% propolis paste (n = 10); and no medication (n = 10). An additional group (n = 10, no intervention) was used as control. After 7 months, the jaws were histologically evaluated for the following variables: newly formed mineralized tissue (present/absent); vital tissue in the canal space (absent/periodontal ligament-like/pulp-like); apical extension of root (present/absent); and severity of inflammatory process (absent/mild/moderate/severe). There were no statistically significant differences among the experimental groups in new mineralized tissue formation and apical root development. The formation of vital tissue in the canal space, in turn, was statistically different between the triple paste and propolis groups: vital tissues were present in all revascularized teeth disinfected with propolis paste (100%), compared to 71% of those disinfected with the triple paste. Severity of inflammatory process was different between the triple paste and no medication groups. The new tissues formed onto canal walls and in the root canal space showed characteristics of cementum and periodontal ligament, respectively. Propolis may have some advantages over the triple paste for the revascularization of immature teeth.

O objetivo deste estudo foi avaliar a prevalência de lesões bucais entre pacientes HIV positivos e identificar fatores associados a tais lesões. Foi realizado estudo transversal que coletou dados mediante entrevista, exame clínico e consulta aos prontuários médicos de pacientes adultos atendidos no Serviço de HIV-AIDS do Hospital Universitário da Universidade Federal do Rio Grande, Rio Grande do Sul, Brasil, sendo considerados fatores sócio-demográficos, imunológicos e terapêuticos. Foi utilizada a regressão de Poisson num modelo hierárquico de análise. Entre abril de 2006 a janeiro de 2007 foram observados 300 pacientes, sendo 51% do sexo masculino e média de idade de 40 anos; 39% apresentaram lesões bucais, sendo a candidíase a mais freqüente (59,1%), seguida de leucoplasia pilosa (19,5%). As mulheres apresentaram um risco menor, com observância de uma associação inversa com o CD4. Houve um risco maior entre aqueles pacientes com menor escolaridade, menor renda, tabagistas, dependentes do álcool, com maior tempo de infecção pelo HIV e carga viral mais elevada. Os dados confirmaram a elevada prevalência das manifestações bucais oportunistas e evidenciaram a sua relação com a situação social, assim como sua relação com determinados hábitos e costumes passíveis de modificação.

The aim of the study was to assess the prevalence of oral lesions in AIDS patients and identify associated factors. A cross-sectional study collected data from interviews, clinical examination, and a review of medical records for adult patients treated at the HIV/AIDS clinic in the University Hospital of the Federal University in Rio Grande, Rio Grande do Sul State, Brazil, focusing on socio-demographic, immune status, and treatment factors. Poisson regression was used in a hierarchical analytical model. From April 2006 to January 2007, 300 patients were observed (51% males; mean age 40 years). Of the total, 39% presented oral lesions, with candidiasis as the most frequent (59.1%), followed by hairy leukoplakia (19.5%). Women showed a lower risk of oral lesions, and there was an inverse association with CD4 count. Increased risk was associated with lower schooling, low income, smoking, alcohol addiction, time since HIV seroconversion, and higher viral load. The data confirm the increased prevalence of opportunistic oral lesions and show their relationship to socioeconomic conditions and modifiable habits and customs.

O objetivo deste estudo foi avaliar a prevalência de lesões bucais entre pacientes HIV positivos e identificar fatores associados a tais lesões. Foi realizado estudo transversal que coletou dados mediante entrevista, exame clínico e consulta aos prontuários médicos de pacientes adultos atendidos no Serviço de HIV-AIDS do Hospital Universitário da Universidade Federal do Rio Grande, Rio Grande do Sul, Brasil, sendo considerados fatores sócio-demográficos, imunológicos e terapêuticos. Foi utilizada a regressão de Poisson num modelo hierárquico de análise. Entre abril de 2006 a janeiro de 2007 foram observados 300 pacientes, sendo 51% do sexo masculino e média de idade de 40 anos; 39% apresentaram lesões bucais, sendo a candidíase a mais freqüente (59,1%), seguida de leucoplasia pilosa (19,5%). As mulheres apresentaram um risco menor, com observância de uma associação inversa com o CD4. Houve um risco maior entre aqueles pacientes com menor escolaridade, menor renda, tabagistas, dependentes do álcool, com maior tempo de infecção pelo HIV e carga viral mais elevada. Os dados confirmaram a elevada prevalência das manifestações bucais oportunistas e evidenciaram a sua relação com a situação social, assim como sua relação com determinados hábitos e costumes passíveis de modificação.

The aim of the study was to assess the prevalence of oral lesions in AIDS patients and identify associated factors. A cross-sectional study collected data from interviews, clinical examination, and a review of medical records for adult patients treated at the HIV/AIDS clinic in the University Hospital of the Federal University in Rio Grande, Rio Grande do Sul State, Brazil, focusing on socio-demographic, immune status, and treatment factors. Poisson regression was used in a hierarchical analytical model. From April 2006 to January 2007, 300 patients were observed (51% males; mean age 40 years). Of the total, 39% presented oral lesions, with candidiasis as the most frequent (59.1%), followed by hairy leukoplakia (19.5%). Women showed a lower risk of oral lesions, and there was an inverse association with CD4 count. Increased risk was associated with lower schooling, low income, smoking, alcohol addiction, time since HIV seroconversion, and higher viral load. The data confirm the increased prevalence of opportunistic oral lesions and show their relationship to socioeconomic conditions and modifiable habits and customs.