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Abstract This study aimed to evaluate the contribution of oral and maxillofacial pathology laboratories (OMPLs) in Brazilian public universities to the diagnosis of lip, oral cavity, and oropharyngeal squamous cell carcinoma (SCC). A cross-sectional study was performed using biopsy records from a consortium of sixteen public OMPLs from all regions of Brazil (North, Northeast, Central-West, Southeast, and South). Clinical and demographic data of patients diagnosed with lip, oral cavity, and oropharyngeal SCC between 2010 and 2019 were collected from the patients’ histopathological records. Of the 120,010 oral and maxillofacial biopsies (2010-2019), 6.9% (8,321 cases) were diagnosed as lip (0.8%, 951 cases), oral cavity (4.9%, 5,971 cases), and oropharyngeal (1.2%, 1,399 cases) SCCs. Most cases were from Brazil’s Southeast (64.5%), where six of the OMPLs analyzed are located. The predominant profile of patients with lip and oral cavity SCC was Caucasian men, with a mean age over 60 years, low schooling level, and a previous history of heavy tobacco consumption. In the oropharyngeal group, the majority were non-Caucasian men, with a mean age under 60 years, had a low education level, and were former/current tobacco and alcohol users. According to data from the Brazilian National Cancer Institute, approximately 9.9% of the total lip, oral cavity, and oropharyngeal SCCs reported over the last decade in Brazil may have been diagnosed at the OMPLs included in the current study. Therefore, this data confirms the contribution of public OMPLs with respect to the important diagnostic support they provide to the oral healthcare services extended by the Brazilian Public Health System.

https://doi.org/10.1590/1807-3107bor-2023.vol37.0126

Clinicopathologic analysis of oral dermoid and epidermoid cysts: a Brazilian multicenter study
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CUNHA, John Lennon Silva

; ANDRADE, Allany de Oliveira

; CAVALCANTE, Israel Leal

; BARROS, Caio César da Silva

; SOUSA NETO, Sebastião Silvério de

; BARROS, Joyce Magalhães de

; LEITE, Larissa Sandy da Silva

; FÉLIX, Fernanda Aragão

; TURATTI, Eveline

; CARVALHO, Francisco Samuel Rodrigues

; SOUSA, Sílvia Ferreira de

; MENDONÇA, Elismauro Francisco de

; ANBINDER, Ana Lia

; PIRES, Fábio Ramoa

; ALVES, Pollianna Muniz

; NONAKA, Cassiano Francisco Weege

; ANDRADE, Bruno Augusto Benevenuto de

Brazilian Oral Research

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2023, Volume 37 elocation e107

Abstract: En | Text: En | PDF: En

Abstract Dermoid cysts (DCs) and epidermoid cysts (ECs) are uncommon developmental cysts affecting the oral cavity. This study aims to evaluate patients with oral DCs and ECs and their demographic and clinicopathologic features. A retrospective descriptive cross-sectional study was performed. A total of 105,077 biopsy records of oral and maxillofacial lesions from seven Brazilian oral pathology centers were analyzed. All cases diagnosed as oral DCs and ECs were reviewed, and clinical, demographic, and histopathological data were collected. The series comprised 32 DCs (31.4%) and 70 ECs (68.6%). Most of the DCs occurred on the floor of the mouth (n = 14; 45.2%) of women (n = 17; 53.1%) with a mean age of 34.6 ± 21.6 years. All DCs were lined partially or entirely by stratified squamous epithelium (100%). Chronic inflammatory cells, melanin pigmentation, multinucleated giant cell reaction, and cholesterol clefts were observed in the fibrous capsule . Most of the ECs affected the labial mucosa (n = 20; 31.7%) of men (n = 39; 56.5%) with a mean age of 48.0±19.8 years. Microscopically, most ECs (n = 68; 97.1%) were lined entirely by stratified squamous epithelium. Two cysts (2.9%) showed areas of respiratory metaplasia. Chronic inflammatory cells, melanin pigmentation, multinucleated giant cell reaction, and cholesterol clefts were also observed in the fibrous capsule. Conservative surgical excision was the treatment of choice in all cases. Oral DCs and ECs are uncommon and often clinically misdiagnosed lesions. Clinicians should consider DCs and ECs in the differential diagnosis of soft tissue lesions in the oral cavity, mainly located on the floor of the mouth and labial mucosa.

https://doi.org/10.1590/1807-3107bor-2023.vol37.0107

Clinical features of oral lichen planus and oral lichenoid lesions: an oral pathologist’s perspective
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Netto, Juliana de Noronha Santos

; Pires, Fábio Ramoa

; Costa, Karen Hurtado Andrade

; Fischer, Ricardo Guimarães

Brazilian Dental Journal

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sep 2022, Volume 33 N. 3 Pages 67 - 73

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Os achados clinico-patológicos que caracterizam de forma precisa o líquen plano oral (LPO) e as lesões liquenoides orais (LLO) ainda representam um desafio. O objetivo do presente estudo foi analisar, pela perspectiva do patologista oral, os achados clínicos do LPO e das LLO. Espécimes preenchendo os critérios histológicos para o diagnóstico de LPO e LLO, e também aqueles compatíveis com LPO (LPO-C), foram selecionados e as informações clínicas foram obtidas a partir das requisições laboratoriais. A amostra final foi composta de 221 casos, incluindo 119 LPO (53.8%), 65 LPO-C (29.4%) e 37 LLO (16.7%). As mulheres foram mais acometidas nos três grupos, mas o número de homens acometidos foi maior nas LLO. A média de idade foi menor no LPO (52.3 anos) em comparação com as LLO (57.9 anos) (p=0.020). O envolvimento da mucosa jugal e da língua foi mais frequente no LPO; o envolvimento gingival foi incomum nas LLO. O padrão reticular foi mais frequentemente encontrado no LPO, enquanto a associação dos padrões reticular e atrófico/erosivo/ulcerado foi mais comum no LPO-C e nas LLO (p=0.025). Em conclusão, o gênero e a média de idade dos pacientes, assim como a localização anatômica e a manifestação clínica das LLO são diferentes do LPO, e podem ajudar a melhor caracterizar este grupo de condições. Espécimes diagnosticados como LPO-C mostraram parâmetros clínicos mais próximos ao LPO.

Abstract The clinicopathological features that precisely characterize oral lichen planus (OLP) and oral lichenoid lesions (OLL) still represent a challenge. The aim of the present study was to analyze, from an oral pathologist perspective, the clinical features from OLP and OLL. Specimens fullfilling the histological criteria for OLP and OLL, and also compatible with OLP (OLP-C), were selected and clinical information was retrieved from the laboratory forms. The final sample was composed by 221 cases, including 119 OLP (53.8%), 65 OLP-C (29.4%) and 37 OLL (16.7%). Females were more affected in the three groups, but the number of males was higher in OLL. Mean age was lower in OLP (52.3 years) in comparison with OLL (57.9 years) (p=0.020). Buccal mucosa and tongue involvement was more frequent in OLP; gingival involvement was uncommon in OLL. The reticular pattern was more frequently found in OLP, while the association of reticular and atrophic/erosive/ulcerated patterns was more common in OLP-C and OLL (p=0.025). In conclusion, gender and mean age of the patients, and anatomical location and clinical manifestation of OLL are different from OLP, and could help to better characterize this group of conditions. Specimens diagnosed as OLP-C showed clinical parameters close to OLP.

https://doi.org/10.1590/0103-6440202204426

Expression of epithelial growth factors and of apoptosis-regulating proteins, and presence of CD57+ cells in the development of inflammatory periapical lesions
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Valente, Walter Arthur Silva

; Barrocas, Déborah

; Armada, Luciana

; Pires, Fábio Ramôa

Journal of Applied Oral Science

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2022, Volume 30 elocation e20210413

Abstract: En | Text: En | PDF: En

Abstract The mechanisms that stimulate the proliferation of epithelial cells in inflammatory periapical lesions are not completely understood and the literature suggests that changes in the balance between apoptosis and immunity regulation appear to influence this process. Objective: To evaluate the expression of the epidermal growth factor (EGF), its receptor (EGFR) and of the keratinocyte growth factor (KGF), the presence of CD57+ cells, the epithelial cell proliferation index, and the expression of the Bcl-2 protein in inflammatory periapical lesions (IPL) at different stages of development. Methodology: Our sample was composed of 52 IPLs (22 periapical granulomas - PG - and 30 periapical cysts - PC), divided into three groups: PGs, small PCs, and large PCs. Specimens were processed for histopathologic and immunohistochemical analyses. Sections were evaluated according to the amount of positive staining for each antibody. Results: We found no significant differences among the groups regarding Bcl-2 (p=0.328) and Ki-67 (p>0.05) expression or the presence of CD57+ cells (p=0.748). EGF (p=0.0001) and KGF (p=0.0001) expression was more frequent in PCs than in PGs, and CD57+ cells were more frequent in IPLs with intense inflammatory infiltrates (p=0.0001). We found no significant differences in KGF (p=0.423), Bcl-2 (p=0.943), and EGF (p=0.53) expression in relation to inflammatory infiltrates or to the type of PC epithelial lining, but observed greater KGF expression (p=0.0001) in initial PCs. EGFR expression was similar among the groups (p>0.05). Conclusion: More frequent EGF and KGF expression in PCs and the greater presence of CD57+ cells in lesions with intense inflammatory infiltrates suggest that these factors influence IPL development. The greater KGF expression in initial PCs suggests its importance for the initial stages of PC formation.

https://doi.org/10.1590/1678-7757-2021-0413

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

; Machado, Renato Assis

; Martelli, Daniella Reis Barbosa

; Cruz Perez, Danyel Elias da

; Pires, Fábio Ramôa

; Martelli Júnior, Hercílio

Pesquisa Brasileira em Odontopediatria e Clínica Integrada

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2021, Volume 21 elocation e210018

Abstract: En | Text: En | PDF: En

ABSTRACT 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.

https://doi.org/10.1590/pboci.2021.160

Pro-inflammatory and anti-inflammatory cytokine expression in post-treatment apical periodontitis
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Dessaune Neto, Nilton

; Porpino, Mariana Teixeira Maneschy

; Antunes, Henrique dos Santos

; Rodrigues, Renata Costa Val

; Perez, Alejandro Ron

; Pires, Fábio Ramôa

; Siqueira Jr, José Freitas

; Armada, Luciana

Journal of Applied Oral Science

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2018, Volume 26 elocation e20170455

Abstract: En | Text: En | PDF: En

Abstract Objective: This study evaluated the expression of pro-inflammatory (IL-1β, IL-6, IFN-γ and TNF-α) and anti-inflammatory (IL-4 and TGF-β) cytokines in apical periodontitis lesions. Correlations between these cytokines and clinical and cone-beam computed tomographic (CBCT) data were also assessed. Material and Methods: Apical periodontitis lesions’ data were obtained from 27 patients subjected to periradicular surgery. Specimens were processed for histopathologic and immunohistochemical analysis. Sections were evaluated according to the amount of positive staining for each antibody. Expression levels of the target mediators were compared with clinical and CBCT data. Results: Twenty lesions were diagnosed as granuloma and 7 as cyst. In granulomas, IL-4 expression was significantly higher than IL-6 (p=0.001) and TNF-α (p=0.001). There was a significant relationship between high levels of TNF-α and lesions <5 mm (p=0.017). In cysts, IL-6 expression was significant lower than IL-4 (p=0.001) and IFN-γ (p=0.004). There was a significant relationship between high levels of TGF-β and endodontic treatment performed ≤4 years before (p=0.045). In general, IL-4 was the most expressed mediator in both cysts and granulomas. Conclusions: There was a balance between the expression of pro-inflammatory and anti-inflammatory cytokines associated with the chronic periradicular inflammatory process. TNF-α and TGF-β were related to some clinical and CBCT data.

https://doi.org/10.1590/1678-7757-2017-0455 2201 downloads

Histologic and Tomographic Findings of Bone Block Allografts in a 4 Years Follow-up: A Case Series
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Deluiz, Daniel

; Oliveira, Luciano Santos

; Fletcher, Paul

; Pires, Fábio Ramôa

; Tinoco, Justine Monnerat

; Tinoco, Eduardo Muniz Barretto

Brazilian Dental Journal

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dec 2016, Volume 27 N. 6 Pages 775 - 780

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo O objetivo deste artigo é relatar achados histológicos e tomográficos de aloenxertos ósseos em bloco com implantes dentários em oclusão funcional em um acompanhamento de longo prazo. Quatro pacientes com implantes funcionalmente carregados por 4 anos em rebordos alveolares enxertados, que necessitaram de cirurgia mucogengival ou instalação de implantes adicionais foram incluídos nesta série de casos. Imagens de tomografia cone-beam foram comparados volumetricamente entre o momento inicial (instalação do implante original) e imagens atuais. Biópsias dos enxertos foram coletadas e enviadas para análise histológica. A redução volumétrica dos enxertos variou entre 2,1-7,7%. A avaliação histológica demonstrou enxertos bem incorporados com diferentes graus de remodelação. Embora os dados apresentados neste relato sejam de uma amostra pequena e não permitam conclusões definitivas, as biópsias dos sítios enxertados apresentaram características muito similares ao osso nativo. A remodelação da porção cortical dos aloenxertos parece levar mais tempo do que a porção esponjosa. A presença de remanescentes do enxerto não incorporado não demonstrou impacto no sucesso dos implantes ou na saúde dos tecidos circunjacentes. Este é o primeiro relato com dados histológicos e tomográficos em longo prazo de enxertos ósseos alógenos disponível na odontologia.

Abstract The aim of this paper is to report histologic and tomographic findings of fresh frozen bone block allografts bearing dental implants in functional occlusion in a long-term follow-up. Four patients with implants functionally loaded for 4 years on augmented ridges requiring additional mucogingival surgery or implant placement were included in this case series. Cone-beam tomography scans were compared volumetrically between the baseline (first implant placement) and current images. Biopsies of the grafts were retrieved and sent to histological analysis. Volumetric reduction of the grafts varied from 2.1 to 7.7%. Histological evaluation demonstrated well-incorporated grafts with different degrees of remodeling. While data presented in this report are from a small sample size and do not allow definitive conclusions, the biopsies of the grafted sites were very similar to the host's native bone. Remodeling of the cortical portion of the allografts seems to take longer than the cancellous portion. The presence of unincorporated graft remains did not impair the implant success or the health of the surrounding tissues. This is the first time histologic and tomographic long term data of bone allograft have been made available in dentistry.

https://doi.org/10.1590/0103-6440201601100 1785 downloads

Oral squamous cell carcinoma: clinicopathological features from 346 cases from a single Oral Pathology service during an 8-year period
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Pires, Fabio Ramoa

; Ramos, Amanda Barreto

; Oliveira, Jade Bittencourt Coutinho de

; Tavares, Amanda Serra

; Luz, Priscilla Silva Ribeiro da

; Santos, Teresa Cristina Ribeiro Bartholomeu dos

Journal of Applied Oral Science

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sep 2013, Volume 21 N. 5 Pages 460 - 467

Abstract: En | Text: En | PDF: En

Epidemiological data from oral squamous cell carcinoma (OSCC) is mostly derived from North American, European and East Asian populations. OBJECTIVE: The aim of this study was to report the demographic and clinicopathological features from OSCC diagnosed in an Oral Pathology service in southeastern Brazil in an 8-year period. MATERIAL AND METHODS: All OSCC diagnosed from 2005 to 2012 were reviewed, including histological analysis of all hematoxylin and eosin stained slides and review of all demographic and clinical information from the laboratory records. RESULTS: A total of 346 OSCC was retrieved and males represented 67% of the sample. Mean age of the patients was 62.3 years-old and females were affected a decade older than males (p<0.001). Mean time of complaint with the tumors was 10 months and site distribution showed that the border of the tongue (37%), alveolar mucosa/gingiva (20%) and floor of mouth/ventral tongue (19%) were the most common affected sites. Mean size of the tumors was 3.4 cm, with no differences for males and females (p=0.091) and males reported both tobacco and alcohol consumption more frequently than females. Histological grade of the tumors revealed that 27%, 40% and 21% of the tumors were, respectively, classified as well-, moderately- and poorly-differentiated OSCC, 26 cases (7.5%) were microinvasive OSCC and 17 cases were OSCC variants. OSCC in males mostly affected the border of tongue, floor of mouth/ventral tongue and alveolar mucosa/gingival, while they were more frequent on the border of tongue, alveolar mucosa/gingival and buccal mucosa/buccal sulcus in females (p=0.004). CONCLUSIONS: The present data reflect the epidemiological characteristics of OSCC diagnosed in a public Oral Pathology laboratory in southeastern Brazil and have highlighted several differences in clinicopathological features when comparing male and female OSCC-affected patients.

https://doi.org/10.1590/1679-775720130317 5425 downloads Cited 5 times in SciELO

Lingual Cortical Mandibular Bone Depression: Frequency and Clinical-Radiological Features in a Brazilian Population
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Mourão, Carlos Fernando de Almeida Barros

; Miranda, Águida Maria Menezes Aguiar

; Santos, Eduardo José da Costa

; Pires, Fábio Ramôa

Brazilian Dental Journal

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apr 2013, Volume 24 N. 2 Pages 157 - 162

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo O objetivo deste estudo foi relatar a frequência e os achados clínico-radiográficos dos casos de depressão cortical mandibular lingual diagnosticados em radiografias panorâmicas e em tomografias computadorizadas realizadas pela técnica de feixe cônico consecutivas em uma população brasileira. A metodologia incluiu uma análise retrospectiva de radiografias panorâmicas consecutivas, dos registros dos pacientes da clínica de estomatologia e tomografias computadorizadas consecutivas realizadas pela técnica do feixe cônico. Todos os casos com diagnóstico de depressão cortical mandibular lingual foram selecionados e as informações clínico-radiográficas foram obtidas a partir dos prontuários dos pacientes e da análise dos exames imaginológicos. Um total de 20 casos de depressão cortical mandibular lingual foi diagnosticado em 18 pacientes, incluindo 2 casos em 3.000 radiografias panorâmicas (0,07%), 6 em 2.421 pacientes da clínica de Estomatologia (0,25%) e 10 em 1.684 pacientes do grupo submetido a tomografia computadorizada (0,59%). Os 18 pacientes mostraram uma média de idade de 51,5 anos e 13 eram do gênero masculino. Dois pacientes apresentaram imagens bilaterais. Quatorze imagens (70%) foram classificadas como bem definidas; dezoito acometeram a região posterior da mandíbula e dois casos acometeram a região anterior da mandíbula. O tamanho das lesões foi maior em pacientes mais jovens. Em conclusão, existe uma considerável heterogeneidade na expressão radiográfica das imagens e parece haver uma diminuição do tamanho das imagens com o aumento da idade dos pacientes.

The aim of this study was to report the frequency and clinical-radiological features of cases of lingual cortical mandibular bone depressions (LCMBD) diagnosed in consecutive panoramic radiographs and cone-beam computed tomography (CBCT) scans from a Brazilian population. The methods included a retrospective analysis of consecutive panoramic radiographs, charts from the Oral Medicine clinic and consecutive CBCT scans. All cases diagnosed as LCMBD were selected and clinical-radiological data were retrieved from the clinical charts and by the analysis of the image exams. Twenty LCMBD cases diagnosed in 18 patients were found, including 2 from 3,000 consecutive panoramic radiographs (0.07%), 6 from 2,421 Oral Medicine patients (0.25%) and 10 from 1,684 CBCT scans (0.59%). The 18 patients had a mean age of 51.5 years and 13 were males. Two patients presented bilateral lesions. Fourteen images (70%) were classified as well-defined. Eighteen affected the posterior area of the mandible and two affected the anterior mandible. Size of the lesions was larger in younger patients. In conclusion, there seemed to be a considerable radiological heterogeneity when comparing the LCMBD cases and it seemed that the images decreased in size with the increase of patient's age.

https://doi.org/10.1590/0103-6440201302091 3880 downloads

10.

Authors' reply
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Amaral, Simone Macedo

; Côrtes, Antonieta de Queiróz

; Pires, Fábio Ramôa

Jornal Brasileiro de Pneumologia

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apr 2010, Volume 36 N. 2 Pages 272 - 273

Abstract: En | Text: En | PDF: En

897 downloads

11.

Pneumonia nosocomial: importância do microambiente oral
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Amaral, Simone Macedo

; Cortês, Antonieta de Queiróz

; Pires, Fábio Ramôa

Jornal Brasileiro de Pneumologia

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nov 2009, Volume 35 N. 11 Pages 1116 - 1124

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

A pneumonia nosocomial, em especial aquela associada à ventilação mecânica, é uma infecção frequente nas UTIs. Seus principais fatores etiológicos incluem bactérias colonizadoras e oportunistas da cavidade oral. Manobras de higiene oral, com o uso de antissépticos orais, como a clorexidina, têm se mostrado úteis na diminuição de sua incidência. O objetivo deste trabalho foi revisar a literatura sobre a importância do microambiente oral no desenvolvimento da pneumonia nosocomial.

Nosocomial pneumonia, especially ventilator-associated pneumonia, is a common infection in ICUs. The main etiologic factors involve colonizing and opportunistic bacteria from the oral cavity. Oral hygiene measures, including the use of oral antiseptic agents, such as chlorhexidine, have proven useful in reducing its incidence. The objective of this article was to review the literature on the importance of the oral environment in the development of nosocomial pneumonia.

91204 downloads Cited 4 times in SciELO

12.

Cholesterol granuloma of the maxillary sinus
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Almada, Cinthya Bessa da Motta

; Fonseca, Debora Rodrigues

; Vanzillotta, Rachel Rego

; Pires, Fábio Ramôa

Brazilian Dental Journal

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2008, Volume 19 N. 2 Pages 171 - 174

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Granuloma de colesterol (GC) é uma reação de corpo estranho a deposição de cristais de colesterol, usualmente encontrado em associação com doenças crônicas do ouvido médio, sendo bastante incomum nos seios paranasais. O objetivo deste artigo é relatar um caso de GC no seio maxilar de um homem de 22 anos de idade, manifestando-se como aumento de volume na maxila direita, associado a dor e obstrução nasal. Cortes de tomografia computadorizada (TC) mostraram opacificação completa do seio maxilar direito com expansão e destruição do osso cortical. A biópsia revelou uma massa sólida ocupando o seio maxilar e o exame histológico mostrou uma reação de corpo estranho aos cristais de colesterol. Os achados microscópicos associados à vitalidade dos dentes, imagens em TC e ausência de cavidade durante o procedimento cirúrgico foram compatíveis com o diagnóstico de GC do seio maxilar. A excisão cirúrgica completa da massa sob anestesia geral foi sugerida, mas o paciente não retornou para concluir o tratamento. O GC deve ser incluído no diagnóstico diferencial das doenças que causam opacificação dos seios paranasais, especialmente as sinusites e lesões císticas e tumorais.

Cholesterol granuloma (CG) is a foreign body reaction to the deposition of cholesterol crystals, usually found in association to chronic middle ear diseases, being highly uncommon in the paranasal sinuses. This article reports a case of CG in the maxillary sinus of a 22-year-old man, manifesting as a swelling on the right maxilla associated with pain and nasal obstruction. Computed tomography (CT) imaging showed complete opacification of the right maxillary sinus with cortical bone expansion and destruction. Incisional biopsy showed a solid mass filling the sinus and histological examination showed foreign body reaction to cholesterol crystals. The microscopic findings associated to tooth vitality, CT images and absence of a cavity during the surgical procedure were compatible with the diagnosis of CG of the maxillary sinus. Complete surgical excision of the mass under general anesthesia was suggested, but the patient did not return to conclude the treatment. CG must be included in differential diagnosis of diseases that cause opacification on the paranasal sinuses, especially sinusitis, and cystic and tumoral lesions.

6010 downloads

13.

Colonização e espécies de Candida em pacientes submetidos à radioterapia cervicofacial
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Bonan, Paulo Rogério Ferreti

; Pires, Fábio Ramoa

; Lopes, Márcio Ajudarte

; Di Hipólito Júnior, Osvaldo

Jornal Brasileiro de Patologia e Medicina Laboratorial

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dec 2007, Volume 43 N. 6 Pages 407 - 412

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Os objetivos deste estudo foram investigar a colonização por Candida associada à redução do fluxo salivar e identificar as espécies antes, durante e após a radioterapia em 20 pacientes portadores de carcinomas de células escamosas, comparando com dados obtidos em dois grupos-controle, um formado por 24 pacientes saudáveis e o outro, por nove pacientes submetidos à radioterapia por pelo menos um ano. A saliva total de todos os pacientes foi coletada pelo método não-estimulado. As unidades formadoras de colônia de Candida foram quantificadas e identificadas pelos testes bioquímicos, CHROMagar e Api 20 Aux. Os resultados evidenciaram, no grupo de estudo, redução progressiva do fluxo salivar entre a primeira e a terceira coleta (p = 0,001) e aumento da positividade de espécies, com predominância das espécies C. albicans e C. tropicalis, bem como de sua diversificação. Houve correlação significativa entre redução do fluxo salivar e colonização por Candida (p = 0,009). Após 12 meses, o fluxo salivar apresentavase baixo e houve maior incidência das espécies C. albicans e C. tropicalis. Em suma, os pacientes irradiados com doses tumoricidas em campos cervicofaciais apresentaram redução do fluxo salivar, aumento na colonização fúngica e diversificação das espécies durante e no final do tratamento.

The aims of this study were to investigate Candida carriage associated with reduced salivary flow and to identify Candida species in 20 patients with squamous cell carcinoma before, during and after head and neck radiotherapy, comparing with 2 control groups, one compounded by 24 healthful patients and the other, by nine patients submitted to head and neck radiotherapy one year at least. Whole non stimulated saliva were collected from all patients. Candida unit form colonies were quantified and identified using biochemistry tests, CHROMagar and API 20 Aux. The results showed progressive reduction of salivary flow during radiotherapy (p = 0.001) and increased Candida carriage, mainly C. tropicalis and C. albicans, with species diversification. The correlation between reduced salivary flow and increased Candida carriage was statistically demonstrated (p = 0.009). After 12 months of the radiotherapy, the patients showed higher incidence of C. albicans and C. tropicalis. In conclusion, head and neck irradiated patients showed reduced salivary flow during radiotherapy, increasing of Candida colonization and higher variety of Candida species on saliva than non irradiated patients during and after radiotherapy.

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14.

Dental management of low socioeconomic level patients before radiotherapy of the head and neck with special emphasis on the prevention of osteoradionecrosis
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Bonan, Paulo Rogério Ferreti

; Lopes, Márcio Ajudarte

; Pires, Fábio Ramoa

; Almeida, Oslei Paes de

Brazilian Dental Journal

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2006, Volume 17 N. 4 Pages 336 - 342

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Pacientes portadores de carcinomas espinocelulares em cabeça e pescoço necessitam receber tratamento odontológico antes da radioterapia. Mesmo pacientes que visitam regularmente consultórios odontológicos requerem especial atenção incluindo profilaxias e tratamentos curativos. Os objetivos desse estudo foram avaliar a condição odontológica de 40 pacientes de baixo nível sócio-econômico antes da radioterapia em cabeça e pescoço e discutir o tratamento odontológico realizado. Os pacientes foram acompanhados durante o tratamento oncológico. Antes da radioterapia, 28 pacientes eram dentados e doze edêntulos, sendo que todos esses apresentavam péssimas condições sistêmicas e higiene oral deficiente. O tratamento mais comumente empregado foi a extração dentária e 23 pacientes tiveram a média de 8,6 dentes extraídos (Grupo I). Um em 9 (11,1%) pacientes desenvolveram cárie por radiação e 5 em 23 (21,73%) osteorradionecrose, sendo um caso associado a extrações dentárias prévias à radioterapia e outros de origem multifatorial. Pacientes de baixo nível socioeconômico com carcinoma espinocelular em cabeça e pescoço receberam múltiplas extrações dentárias devido à condição dentária precária e má higienização. O tratamento odontológico não preveniu a osteorradionecrose, que apresenta origem multifatorial na maioria dos casos.

Head and neck cancer patients need to receive dental care previously to radiotherapy. Even patients who regularly visit dental offices need special attention including profilatic and curative treatments. The purposes of this study were to evaluate the dental status of Brazilian head and neck squamous cell carcinoma patients with low socioeconomic level as well as to discuss the dental treatment performed and the oral side effects of radiotherapy. Forty patients with head and neck squamous cell carcinoma received dental care and dental extractions prior to radiotherapy and were were followed up for a mean period of 28.7 months after the cancer treatment. Before radiotherapy, 28 patients were dentulous and 12 edentulous, and all of them had poor oral health and hygiene. The most common treatment performed were dental extraction and 23 patients had 8.6 teeth extracted on average. One out of 9 (11.1%) patients developed radiation caries and 5 out of 23 cases (21.3% - Group I) developed osteoradionecrosis, being only 1 case associated with previous dental extraction. Brazilian low-socioeconomic level patients with head and neck cancer were submitted to multiple dental extractions due to poor dental condictions and inadequate oral care. The dental treatment did not prevent osteoradionecrosis, which presumably presented a multifactorial etiology in most cases.

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15.

Candida in saliva of Brazilian hemophilic patients
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Pereira, Claudio Maranhão

; Pires, Fábio Ramôa

; Corrêa, Maria Elvira Pizzigatti

; di Hipólito Júnior, Osvaldo

; Almeida, Oslei Paes de

Journal of Applied Oral Science

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dec 2004, Volume 12 N. 4 Pages 301 - 306

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Hemofilia é uma alteração hemorrágica hereditária comum, entretanto pouco se sabe a respeito da microbiota oral destes indivíduos. O objetivo deste estudo foi quantificar a presença de Candida e identificar as suas espécies na saliva de hemofílicos, correlacionando os resultados com fatores clínicos que possam influenciar a presença deste fungo. Foram avaliados 86 hemofílicos do Hemocentro/UNICAMP e 43 indivíduos saudáveis. Todos os pacientes foram submetidos a anamnese, exame clínico intra-oral e coleta de saliva de forma não estimulada. A quantificação e identificação das espécies de Candida foram realizadas nas amostras de saliva. Candida estava presente em 64% dos hemofílicos e em 44% dos indivíduos saudáveis. C. albicans representou 65% e 68% das espécies identificadas, nos hemofílicos e grupo controle respectivamente, e C. tropicalis foi a segunda espécie mais comum. Estes resultados sugerem que pacientes hemofílicos albergam mais freqüentemente Candida na cavidade bucal e em maiores quantidades que os indivíduos do grupo controle, independentemente dos parâmetros clínicos analisados, como infecção viral, próteses dentárias, transfusões de hemoderivados e fluxo salivar.

Hemophilia is a common hereditary hemorrhagic disorder, however little is known about the oral microflora of hemophilic patients. The aim of this study was to quantify the Candida and identify its species in non-stimulated saliva of hemophilic patients, and consider its relationship with clinical factors influencing Candida carriage. This study comprised evaluation of 86 hemophilic patients of the Hematology Center/UNICAMP and 43 healthy subjects as controls. All patients were submitted to anamnesis, intraoral examination and unstimulated saliva collection. Candida counts and species identification were performed in salivary samples. Candida was present in 64% of the hemophilic patients and in 44% of the healthy controls. C. albicans represented 65% and 68% of the isolated species, in hemophiliacs and control group respectively, and C. tropicalis was the second most common species in both groups. These results indicate that hemophilic patients carry Candida more frequently and in higher counts than healthy controls, independently of oral clinical parameter considered, as viral infections, complete dentures, transfusions of hemoderivatives, and salivary flow.

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