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Abstract The aim of this study is to report an original case series of synchronous jawbone diseases. Data of patients seen over 13 years were extracted from the files of three Oral Radiology and Pathology diagnostic centers in Brazil. The clinical, radiographic, and laboratory characteristics were tabulated and analyzed by the authors; the patients were described according to lesion type. Seventy-two synchronous jawbone diseases were included in this study. Florid osseous dysplasia, Gorlin-Goltz syndrome, and cherubism were the most frequent disorders reported in this case series. In addition, the posterior mandible area was the main site of manifestation. Florid osseous dysplasia and Gorlin-Goltz syndrome represented two-thirds of our samples. With the utilization of adequate demographic, clinical, and radiologic information, it is possible to diagnose most of the synchronous lesions of jawbones. Sometimes, however, we need complementary exams, such as histopathologic and biochemical analysis or dosing of calcium, phosphorus, and alkaline phosphatase.

https://doi.org/10.1590/1807-3107bor-2023.vol37.0011

Contribution of public oral pathology services to the diagnosis of oral and oropharyngeal cancer in Brazil
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LOUREDO, Brendo Vinicius Rodrigues

; CURADO, Maria Paula

; PENAFORT, Paulo Victor Mendes

; DE ARRUDA, José Alcides Almeida

; ABREU, Lucas Guimarães

; MESQUITA, Ricardo Alves

; PINTO-JÚNIOR, Décio dos Santos

; ABRAHÃO, Aline Corrêa

; ANDRADE, Bruno Augusto Benevenuto de

; AGOSTINI, Michelle

; MORAES, Renata Mendonça

; ANBINDER, Ana Lia

; DOURADO, Pedro Henrique Silva

; SANTOS, Teresa Cristina Ribeiro Bartholomeu dos

; PIRES, Fábio Ramoa

; BORDIGNON, Natalia Cristina Trentin

; GONDAK, Rogério Oliveira

; DE OLIVEIRA, Marcia Gaiger

; CARRARD, Vinicius Coelho

; MARTINS, Manoela Domingues

; SOUSA-NETO, Sebastião Silvério

; ARANTES, Diego Antônio Costa

; MENDONÇA, Elismauro Francisco

; CIESLAK-SANCHES, Silvia Roberta

; ANTUNES, Daniella Moraes

; AMARAL-SILVA, Gleyson Kleber do

; MANIERI, Patricia Rubia

; RAMALHO, Luciana Maria Pedreira

; DOS SANTOS, Jean Nunes

; LEONEL, Augusto César Leal da Silva

; PEREZ, Danyel Elias da Cruz

; VERHEUL, Hannah Carmem Carlos Ribeiro Silva

; BARROSO, Keila Martha Amorim

; RODRIGUES, Flávia Luiza Santos

; GONZAGA, Amanda Katarinny Goes

; FERNANDES, Romana Renery

; DE SOUZA, Lélia Batista

; SOUZA, Lucas Lacerda de

; PONTES, Flávia Sirotheau Corrêa

; PONTES, Hélder Antônio Rebelo

; SILVA, Caroline Alfaia

; CÂMARA, Jeconias

; LIBÓRIO-KIMURA, Tatiana Nayara

; SANTOS-SILVA, Alan Roger

; LOPES, Márcio Ajudarte

; ALMEIDA, Oslei Paes de

; ROMAÑACH, Mário José

; VARGAS, Pablo Agustin

Brazilian Oral Research

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2023, Volume 37 elocation e126

Resumo: En | Texto: En | PDF: En

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

Oral health assessment in school program health: who and how?
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OLIVEIRA, Erick Ely Gomes de

; ARANTES, Diandra Costa

; NASCIMENTO, Liliane Silva do

; PONTES, Flávia Sirotheau Correa

RGO - Revista Gaúcha de Odontologia

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Jun 2018, Volume 66 Nº 2 Páginas 154 - 159

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

RESUMO A saúde bucal apresenta-se como um direito constitucional, sendo condição relevante à integralidade de saúde. Este artigo objetivou compreender como a avaliação e ações de saúde bucal são contempladas no âmbito do Programa Saúde na Escola, através de pesquisa com abordagem qualitativa no município de Belém, Pará, utilizando roteiro semiestruturado com amostra de três categorias do Programa Saúde na Escola, selecionadas por conveniência e com base no critério de saturação: enfermeiros, professores e pais. A análise resultou três categorias distintas e inter-relacionadas que ressaltam a discussão acerca da necessidade de empoderamento para compreensão dos significados da saúde bucal dentro do PSE e ampliação de sua especificidade no cenário de trabalho transdisciplinar. Para o efetivo funcionamento da articulação escola/saúde, faz-se necessário reconhecer a aplicabilidade da política do Programa Saúde na Escola, buscando cada vez mais implementá-la nas escolas de modo a otimizar a interligação entre os envolvidos. Verificou-se a constante necessidade acerca do aperfeiçoamento de habilidades dos atores deste cenário de modo a atuar munidos de atitudes/comportamentos adequados para a melhoria da qualidade de vida do escolar.

ABSTRACT Oral health is a constitutional right, with its own national policy which guides the relevance of its interrelation to general health within the integrality principles. This manuscript aims at understanding how oral health assessment and actions are observed within the School Program Health, through a qualitative study performed in the city of Belém, State of Pará, Brazil. The sample criterion consisted of 5 nurses, 5 teachers and 5 parents. A semi-structured script was used, written and transcribed with subsequent thematic analysis. The analysis revealed three thematic categories emphasizing the need for policy empowerment and practice in order to understand the meanings of oral health within the SHP as well as to enlarge its specificity in the interdisciplinary work scenario. Thus, it is clear that for the effective functioning of the school / health relationship, it is of utmost importance that SHP policy is applied and recognized while continuously seeking to strengthen the principle of integrality and extended clinic. The study also highlights permanent education and constant need for the participants’ skill improvement so that both students’ health care and life quality can be fully promoted.

https://doi.org/10.1590/1981-863720180002000083416 1005 downloads

Nuclear metallothionein in oral squamous cell carcinoma: clinicopathological parameters and patient survival
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BEZERRA, Girlene Maria do Rego

; PONTES, Flávia Sirotheau Corrêa

; CONTE NETO, Nicolau

; NASCIMENTO, Liliane Silva do

; SOUZA, Lucas Lacerda de

; PINTO JUNIOR, Décio dos Santos

; PONTES, Hélder Antônio Rebelo

Brazilian Oral Research

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2018, Volume 32 elocation e105

Resumo: En | Texto: En | PDF: En

Abstract The aim of this study was to identify the immunoexpression of methallothionein in oral squamous cell carcinoma as well as to address the correlation with clinical features, histological grade and patient survival. Samples were collected from 93 patients with tongue squamous cell carcinoma who presented for follow-up. Immunohistochemical expression of methallothionein in all groups was performed. The scoring system has previously been published by Tsurutani in 2005, which is based on intensity and distribution of staining. We used Kappa index to evaluate the degree of observers’ agreement under metallothionein immunostaining and histological grade. Associations between methallothionein expression and clinical parameters (age, gender, smoking, tumor size, lymph node metastasis and disease stage) were examined for statistical significance using the chi-squared test. The overall survival rates were estimated by the Kaplan-Meier method and the relationship between protein expression and survival was compared using the log-rank test (p < 0.05). Our results showed no statistically significant association between methallothionein immunostaining and the selected clinicopathological variables. Immunohistochemistry results showed positive nuclear immunostaining for metallothionein in 62,37% (58/93) and negative for metallothionein 37,63% (35/93). The degree of examiners agreement by Kappa varied from substantial to perfect and both metallothionein immunostaining and histological grade were explored. The present study suggests that positive methallothionein expression found in tongue squamous cell carcinoma may not help to predict survival in the analyzed samples, as well as no relation between the protein and histological grade and clinical features was observed. In conclusion, the present study suggests that metallothionein is not associated with tongue squamous cell carcinoma clinicopathological characteristics and aggressiveness.

https://doi.org/10.1590/1807-3107bor-2018.vol32.0105 647 downloads

Ki-67 protein predicts survival in oral squamous carcinoma cells: an immunohistochemical study
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LOPES, Verena Karla Monteiro

; JESUS, Adriana Souza de

; SOUZA, Lucas Lacerda de

; MIYAHARA, Ligia Akiko Ninokata

; GUIMARÃES, Douglas Magno

; PONTES, Helder Antônio Rebelo

; PONTES, Flavia Sirotheau Correa

; CARVALHO, Pedro Luiz de

Brazilian Oral Research

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2017, Volume 31 elocation e66

Resumo: En | Texto: En | PDF: En

Abstract The aim of this study was to identify the expression of Ki-67 and MCM3 in oral squamous cell carcinoma (OSCC) as well as to address the correlation with patient survival and clinical features. Samples were collected from 51 patients with OSCC who presented for follow-up. Immunohistochemical expression of Ki-67 and MCM3 in all groups was performed. The scoring system was previous published by Tsurutani in 2005. We used Kappa index to evaluate observers agreement degree. The associations between protein expression and clinical variables were examined for statistical significance using the chi-squared test. The overall survival rates were estimated by the Kaplan-Meier method and the relationship between protein expression and survival was compared using the log-rank test (p < 0.05). The overall survival time for a patient with positive immunostaining for Ki-67 is shorter than for a patient with negative immunostaining, (log-rank test, p = 0.00882). Patients with tumor size T3 and T4 showed a statistically significant relationship with Ki-67 immunoexpression (log-rank test, p = 0.0174). The relationship between Ki-67 expression and the relation between age, gender, smoking, tumor site, lymph node metastasis and disease stage was not significant. The examiners agreement degree by Kappa presented p value < 0.05. There was not a significant correlation when we evaluated MCM3 expression regarding clinical characteristics and survival rate. From these results, the present study suggests that positive Ki-67 expression found in OSCC patients may contribute to predict the survival in OSCC samples, as well as the relation between the protein and the tumor size.

https://doi.org/10.1590/1807-3107bor-2017.vol31.0066 1924 downloads

Copaiba oil effect on experimental jaw defect in Wistar rats
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Silva, Priscilla Flores

; Brito, Marcus Vinicius Henriques

; Pontes, Flávia Sirotheau Correa

; Ramos, Suzana Rodrigues

; Mendes, Laís Cordeiro

; Oliveira, Louize Caroline Marques

Acta Cirúrgica Brasileira

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Fev 2015, Volume 30 Nº 2 Páginas 120 - 126

Resumo: En | Texto: En | PDF: En

PURPOSE: To evaluate the effects of copaiba oil on jaw defects repair in Wistar rats treated with bioglass or adipose tissue. METHODS: A jaw defect was randomly created in forty-two rats and filled with bioglass or adipose tissue. The two groups (Gbio and Gcell) were subdivided in three subgroups with seven animals each according to gavage administration: control (distillated water), oil (copaiba oil) and melox (meloxicam). Euthanasia was performed after forty post-operative days. The bone formation was analyzed regarding the histological aspects. RESULTS: The osteoclasts activity was observed only in four subgroups (p=0.78). Regarding the osteoblasts presence, it was very similar between the subgroups, the difference was due to Gcell-melox (p=0.009) that presented less osteoblastic activity. The inflammatory cells were more evident in Gcell-melox subgroup, however, there was no difference in comparison with the other subgroups (p=0.52). Bone formation was observed in all subgroups, just two animals showed no bone formation even after 40 days. More than 50% of bone matrix mineralization was observed in 56% (23 animals) of the analyzed areas. The bone matrix mineralization was not different between subgroups (p=0.60). CONCLUSIONS: The subgroups that received copaiba oil showed bone repair, although not statistically significant in comparison to subgroups treated whit meloxicam or controls. Copaiba oil administered by gavage had no effect on bone repair in this experimental model.

https://doi.org/10.1590/S0102-86502015002000006 2690 downloads

Extranodal Nasal NK/T-Cell Lymphoma: A Rare Oral Presentation and FASN, CD44 and GLUT-1 Expression
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Pontes, Helder Antonio Rebelo

; Pontes, Flavia Sirotheau Correa

; Silva, Brunno Santos de Freitas

; Fonseca, Felipe Paiva

; Andrade, Bruno Augusto Benevenuto de

; Rizo, Victor Hugo Toral

; Romanach, Mario Jose

; Leon, Jorge Esquiche

; Almeida, Oslei Paes de

Brazilian Dental Journal

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Jun 2013, Volume 24 Nº 3 Páginas 284 - 288

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

O linfoma de células natural killers (NK)/T extranodal é um tumor maligno agressivo com características clinicopatológicas distintas, caracterizadas por invasão e destruição vasculares, necrose proeminente, fenótipo linfocítico citotóxico e uma forte associação com o vírus Epstein-Barr. Relatamos aqui um caso de linfoma de células NK/T nasal extranodal, envolvendo o seio maxilar, assoalho de órbita, e interessantemente estendendo-se para a cavidade oral através do osso alveolar e mucosa vestibular, preservando o palato, levando a um diagnóstico inicial equivocado de doença periodontal agressiva. Ainda, nós investigamos pela primeira vez a expressão imunoistoquímica das proteínas Fatty acid sinthase (FASN) e glucose transporter 1 (GLUT-1) nesta neoplasia. FASN revelou uma forte expressão citoplasmática nas células neoplásicas, enquanto GLUT-1 e CD44 foram negativas. Estes achados sugerem que a expressão de FASN e a perda de CD44 podem estar envolvidas na patogênese do linfoma de células NK/T nasal extranodal, e que GLUT-1 não deve participar da adaptação das células tumorais ao ambiente de hipóxia. Estudos adicionais com séries maiores são necessários para confirmar nossos resultados iniciais.

Extranodal natural killer (NK)/T-cell lymphoma is an aggressive malignant tumor with distinctive clinicopathological features, characterized by vascular invasion and destruction, prominent necrosis, cytotoxic lymphocyte phenotype and a strong association with Epstein-Barr virus. Here is reported an extranodal nasal NK/T-cell lymphoma case, involving the maxillary sinus, floor of the orbit, and interestingly extending to the oral cavity through the alveolar bone and buccal mucosa, preserving the palate, leading to a primary misdiagnosis of aggressive periodontal disease. Moreover, this work investigated for the first time the immunohistochemical expression of fatty acid synthase (FASN) and glucose transporter 1 (GLUT-1) proteins in this neoplasia. FASN showed strong cytoplasmatic expression in the neoplastic cells, whereas GLUT-1 and CD44 were negative. These findings suggest that the expression of FASN and the loss of CD44 might be involved in the pathogenesis of the extranodal nasal NK/T-cell lymphoma, and that GLUT-1 may not participate in the survival adaptation of the tumor cells to the hypoxic environment. Further studies with larger series are required to confirm these initial results.

https://doi.org/10.1590/0103-6440201302202 3577 downloads

Effect of andiroba oil on periodontitis in Wistar rats
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Carmona, Glaucia Babeto

; Teixeira, Renan Kleber Costa

; Brito, Marcus Vinicius Henriques

; Pontes, Flavia Sirotheau Correa

; Andrade, Eloisa Helena Aguiar

; Fonseca, Felipe Paiva

; Costa, Ricardo Miranda Brito

; Carvalho, Francideise Martins

Acta Cirúrgica Brasileira

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Jun 2013, Volume 28 Nº 6 Páginas 430 - 434

Resumo: En | Texto: En | PDF: En

PURPOSE: To evaluate the effects of andiroba oil on the periodontitis in rats. METHODS: The periodontitis was induced by the placement of cotton ligatures around the cervix of the second upper molars on fifteen rats, and waiting fifty days. The animals were randomly distributed into three groups: saline group, andiroba oil group and meloxican group, differentiated by substance used in the treatment of periodontitis. The groups received the respective substance by gavage for seven days, after the periodontitis induced. It was analyzed the score of inflammatory cells and the measurement from the cemento-enamel junction to the bone crest. RESULTS: The andiroba oil group (p=0.008) and meloxican group (p=0.0347) show a less score of inflammatory cells than saline group, however there weren't difference between them (p=0.2754). Regarding the analysis of measurement from the cemento-enamel junction to the bone crest, there was no difference between groups studied (p=0.3451). CONCLUSION: Andiroba oil decreased the quantity of inflammatory cells, however, it didn't have an effect on the measurement of alveolar bone loss, like the treatment with Meloxican®.

3647 downloads Citado 1 vez em SciELO

Intraosseous lipoma of the mandible: A diagnostic challenge
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Silva, Brunno Santos de Freitas

; Yamamoto, Fernanda Paula

; Pontes, Flávia Sirotheau Corrêa

; Fonseca, Felipe Paiva

; Pontes, Hélder Antônio Rebelo

; Pinto Júnior, Décio dos Santos

Revista Odonto Ciência

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2011, Volume 26 Nº 2 Páginas 182 - 186

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OBJETIVO: Relatar um caso raro de lipoma intra-ósseo em mandíbula e discutir os aspectos mais importantes desta lesão, enfatizando a desafio diagnóstico que esta entidade pode representar para cirurgiões dentistas e radiologistas. DESCRIÇÃO DO CASO: Paciente do sexo masculino, 18 anos de idade apresentava uma lesão radiolúcida assintomática na mandíbula na região dos dentes 43 e 44 sem qualquer alteração clínica. Após a biópsia incisional, o exame histopatológico evidenciou uma lesão encapsulada composta majoritariamente por tecido adiposo benigno e algumas áreas de calcificações distróficas confirmando o diagnóstico de lipoma intra-ósseo. A lesão foi cirurgicamente removida e nenhum sinal de recorrência foi observado após seis meses de acompanhamento. CONCLUSÃO: Devido às características clínicas e radiográficas inespecíficas e à sua raridade, o lipoma intra-ósseo de mandíbula pode representar um desafio diagnóstico para cirurgiões dentistas e radiologistas. Portanto, o exame histopatológico é fundamental para o correto diagnóstico da lesão.

PURPOSE: To report a rare case of intraosseous lipoma of the mandible and to discuss the most important features of the lesion, emphasizing the diagnostic pitfall that this entity may represent for general dentists and radiologists. CASE DESCRIPTION: An 18-year-old male patient presented an asymptomatic radiolucent lesion in the mandible in the region of the teeth 43 and 44 with no clinical alteration. After the incisional biopsy the histopathological exam revealed a capsulated lesion predominantly composed of mature adipose tissue and some areas of dystrophic calcification confirming the diagnosis of intraosseous lipoma. The lesion was surgically removed and no signs of recurrence could be observed after six months of follow-up. CONCLUSION: Due to the unspecific clinical and radiographic features and its rarity the intraosseous lipoma of the mandible may be a diagnostic challenge for general dentists and radiologists. Therefore, the histopathological examination is required for the correct diagnosis of the lesion.

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Computed tomography and scintigraphy exams for diagnosis and treatment planning of the condylar osteochondroma: a case report
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Yamamoto, Fernanda Paula

; Silva, Brunno Santos de Freitas

; Modes, Ricardo Wagner

; Fonseca, Felipe Paiva

; Pontes, Flávia Sirotheau Corrêa

; Sousa, Suzana Cantanhede O. M. de

Revista Odonto Ciência

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Dez 2010, Volume 25 Nº 4 Páginas 422 - 426

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OBJETIVO: Relatar um caso incomum de osteocondroma afetando o côndilo mandibular de uma paciente jovem e ilustrar as importantes contribuições dos diferentes exames por imagem para o diagnóstico e plano de tratamento desta lesão. DESCRIÇÃO DO CASO: Paciente do sexo feminino, 24 anos, com queixa principal de uma crescente assimetria facial e dor na região pré-auricular esquerda, além de apresentar redução da abertura bucal, desvio de mandíbula e mordida cruzada posterior, por um período de 18 meses. A radiografia panorâmica revelou um aumento do côndilo esquerdo, enquanto secções de tomografia computadorizada e reconstrução 3D exibiram um crescimento ósseo bem definido originando-se do côndilo. O exame de cintilografia revelou uma atividade osteogênica anormal na região de articulação tempormandibular esquerda. O côndilo foi cirurgicamente removido e após 18 meses de acompanhamento a radiografia panorâmica e a tomografia computadorizada não revelaram nenhum sinal de recorrência. CONCLUSÃO: Apesar de o osteocondroma ser um tumor ósseo benigno que raramente surge na região crânio maxilofacial, ele deve ser considerado como diagnóstico diferencial para massas de crescimento lento na área temporomandibular e o uso de diferentes exames por imagem contribuem significativamente para o correto diagnóstico e plano de tratamento desta condição patológica.

PURPOSE: To report an uncommon case of osteochondroma affecting the mandibular condyle of a young patient and to illustrate the important contributions of different imaging resources to the diagnosis and treatment planning of this lesion. CASE DESCRIPTION: A 24-year-old female patient with the chief complaint of an increasing facial asymmetry and pain in the left pre-auricular region, revealing a reduced mouth opening, mandibular deviation and posterior cross-bite over a period of 18 months. Panoramic radiography revealed an enlargement of the left condyle, whereas computed tomography (CT) sections and three-dimensional CT showed a well-defined bone growth arising from condylar neck. The scintigraphy exam showed an abnormal osteogenic activity in the left temporomandibular joint. The condyle was surgically removed and after 18 months follow-up the panoramic radiography and CT scans showed no signs of recurrence. CONCLUSION: Although osteochondroma is a benign bone tumor that rarely arises in cranial and maxillofacial region, it should be considered in the differential diagnosis of slow-growing masses of the temporomandibular area and the use of different imaging exams significantly contribute to the correct diagnosis and treatment planning of this pathological condition.

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