José Miguel Amenábar

Anxiety and salivary cortisol levels in patients with burning mouth syndrome: case-control study

OBJECTIVE The objective of this study was to evaluate the anxiety and salivary cortisol levels in patients with burning mouth syndrome. STUDY DESIGN A case-control ed into 2 groups: BMS, with diagnosis of the syndrome, and control, without any complaint of burning mouth. Anamnesis, oral examination, sialometry, the application anxiety inventory, and 3 saliva samples for cortisol analysis were done in every patient. RESULTS Statistical difference for subjective xerostomia was found on the BMS group (P = .01), but salivary flow rate was normal in both groups. BMS group presented higher anxiety (P = .001) and salivary cortisol levels (P = .003) when compared with the control group. CONCLUSION Higher anxiety and salivary cortisol levels were positively associated with the presence of BMS.

Micro-marsupialization as an alternative treatment for mucocele in pediatric dentistry.

BACKGROUND Mucocele is a common oral lesion in children and adolescents. Different techniques have been described for the treatment; however, all of them are invasive. AIM This work studied the efficacy of micro-marsupialization for the treatment for mucoceles in paediatric patients. DESIGN A retrospective review was performed using the clinical records of patients aged between 0 and 18 years with a clinical diagnosis of mucocele. The following data were obtained: age, gender, location and size of the lesion, duration of mucocele development, and type of treatment and its results. RESULTS The mean age of the patients was 11.1 ± 3.95 years. Mucoceles were found in the lower lip (83.7%), buccal mucosa (11.6%), and tongue (4.7%). From the overall cohort of 86 cases, 33 were treated by micro-marsupialization, of which five developed a recurrence that required surgical excision. The other 53 cases were treated by surgical excision, and three of these had recurrent disease. No statistically significant difference was found between the treatment methods. CONCLUSIONS Micro-marsupialization can be used to treat mucoceles in paediatric dentistry. It is simpler to perform, minimally invasive, requires no local infiltration of anaesthesia, has a lower postoperative complications rate, and is well-tolerated by patients.

[Minor salivary gland tumours: a 10-year study].

Salivary gland tumours represent between 2 % and 6.5 %, approximately, of all head and neck tumours. The aim of this paper was to identify the frequency of minor salivary gland tumours among patients in the Oral Medicine Clinic of the Federal University of Paraná during the period from 1997 to 2007. A retrospective study was conducted on 1,923 histopathological analyses of oral lesions. Fourteen cases of salivary gland tumours were found, of which 7 were benign and 7 malignant. The lesions were localized mainly in the palate (71.5 %). By histological type, 50 % of the lesions were characterized as pleomorphic adenoma, 28.6 % mucoepidermoid carcinoma, 14.3 % cystic adenoid carcinoma and 7.1 % as polymorphous adenocarcinoma. These findings suggest that salivary gland tumours have a low incidence in the population and that the pleomorphic adenoma is the most common type of tumour, followed by mucoepidermoid carcinoma.

Oral leukoplakia in patients with Fanconi anaemia without hematopoietic stem cell transplantation

Fanconi anaemia is a genetic disease characterized by congenital abnormalities, progressive bone marrow failure, and a higher predisposition of oral squamous cell carcinoma. The purpose of this study was to evaluate the prevalence of oral mucosa lesions in patients with Fanconi anaemia without hematopoietic stem cell transplantation (HSCT).

Salivary detection of periodontopathic bacteria in Fanconi's anemia patients.

Fanconis anemia (FA) is characterized by bone marrow failure and can lead to infections such as periodontal disease. The aim of this study was to compare the prevalence of four periodontopathic bacteria including Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Fusobacterium nucleatum and Treponema denticola in saliva samples from children with and without FA. Paraffin-stimulated saliva samples were collected from 71 children and adolescents, aged 6-18 years old. The samples were divided in three groups: FA without HSCT (n = 25), FA with HSCT (n = 23) and Non-FA (n = 24). The test bacteria were identified using a 16S rRNA-based PCR analysis. P. gingivalis was the most frequent species in all groups and T. denticola the less frequent. P. gingivalis was also common species in combinations in all groups. No statistically difference was observed between the groups for single bacteria, pair or triple combination. The combination of the four species was detected in one saliva sample of the FA without HSCT group and in five samples of the Non-FA group, with statistical difference between them (p < 0.05, Fisher exact test). Systemic alterations found in FA subjects did not affect the salivary distribution of the four bacteria analyzed.

Oral squamous cell carcinoma in two siblings with Fanconi anemia after allogeneic bone marrow transplantation

Fanconi Anemia patients are a high risk group for solid and hematologic malignancies. The risk seems to be influenced by age, chronic graft versus host disease and immunosuppressive drug regimens. Reports of oral malignant transformation in Fanconi Anemia after hematopoietic stem cell transplantation (HSCT) are increasing probably because of longer survival rates. This is the report of an 18- and her 28-year old sister who developed a post-HSCT oral squamous cell carcinoma. There were significant differences regarding time to malignant transformation, marrow donor characteristics and graft versus host disease evolution and treatment. The report reinforce the need for a routine head and neck screening for cancer in this particular syndrome and suggest that familial history should also be considered in Fanconi anemia patients at risk for oral malignancy after HSCT.

Neoplasias de glándulas salivales menores: estudio de 10 años

Resumen Las neoplasias de las glandulas salivales representan aproximadamente un 2-6,5 % de todos los tumores de la cabeza y cuello. El objetivo de este trabajo es identificar la frecuencia de neoplasias de glandulas salivales menores en pacientes de Medicina Oral de la Universidad Federal de Parana atendidos de 1997 a 2007. Se realizo un estudio retrospectivo mediante el analisis de 1.923 laudos histopatologicos, y se hallo 14 casos de neoplasias de glandulas salivales. Las lesiones encontradas fueron 7 tumores benignos y 7 malignos. Las alteraciones, en su mayoria, se encontraban en la mucosa palatina (71,5 %). En cuanto al tipo histologico, el 50 % se caracterizo como adenoma pleomorfo; el 28,6 %, como carcinoma mucoepidermoide; el 14,3 %, como carcinoma adenoide quistico, y el 7,1 %, como adenocarcinoma polimorfo. Estos resultados permiten concluir que las neoplasias de glandulas salivales tienen una baja incidencia en la poblacion y que el adenoma pleomorfo es el tipo de neoplasia mas comun, seguido del carcinoma mucoepidermoide.

Oral cancer in Fanconi anemia: Review of 121 cases.

Fanconi anemia (FA) is a rare autosomal recessive genetic disorder characterized by aplastic anemia, progressive pancytopenia, congenital anomalies, and increased risk of cancer development. After hematopoietic stem cell transplant (HSCT), patients have an estimated 500-fold increase in the risk of developing head and neck cancer compared to a non-affected, and the oral cavity is affected in one-third of cases. Thus, this study aimed to better understand the natural history of oral cavity cancer in patients affected by FA. After conducting a keyword search on MEDLINE, we found 121 cases of oral cavity cancer in patients who had been affected by FA. In conclusion, HSCT may increase the risks of oral cancer development, especially after 5 years after the transplant. In the normal population, the tongue is the most affected area. FA patients should be informed of the risks of oral malignant transformation and encouraged to be undergo medical surveillance.

Oral and Maxillofacial Complex Lesions in Adolescents: A Retrospective Study of 20 Years

Los estudios que evaluan la prevalencia de lesiones orales muestran que entre el 5,2% hasta el 12,8% de las muestras de biopsia corresponden a ninos y adolescentes. En Brasil, hay pocos estudios que hayan analizado la distribucion de las lesiones orales enesa poblacion. Por lo tanto, el objetivo de este estudio fue evaluar la distribucion de las lesiones orales y maxilofaciales de adolescentes, ingresados en el Servicio de Diagnostico Oral de la Universidad Federal de Parana (UFPR) entre 1994 a 2013. Se llevo a cabo la revision de historias clinicas y las lesiones halladas fueron clasificadas en 11 categorias: enfermedad de glandulas salivales, patologia dental, patologia gingival y periodontal, quistes odontogenicos, tumores odontogenicos, quistes no odontogenicos, patologia osea, patologia de la mucosa, patologia del tejido conectivo, tumores malignos y otras patologias. Tambien se evaluaron otras variables como edad, genero, etnia, diagnostico y localizacion de la lesion. Luego del analisis, se identificaron 376 lesiones, la mayoria en ninas (51,9%), siendo el 77,1% de los pacientes de raza blanca. La localizacion mas frecuente fue el labio inferior seguida de la encia. El mucocele fue la lesion mas comun (27,6%), seguido de hiperplasia fibroepitelial (8,2%) y granuloma piogeno (5,3%). Aunque existe una amplia serie de patologias que pueden ocurrir en la cavidad oral, las lesiones traumaticas son las mas comunes en este grupo de edad.

Oral health status in children and adolescents with Fanconi anemia

OBJECTIVE The aim of the study was to investigate the caries experience, dental care level, and oral hygiene in children and adolescents with Fanconi anemia. METHODS Decay-missing-filled teeth index, restorative index and simplified oral hygiene index were examined in two groups of children and adolescents: FA, diagnosed with Fanconi anemia (n = 35) and a healthy control group, non-FA (n = 35). Oral hygiene habits were assessed through questionnaires completed by parents. RESULTS FA group presents higher decay-missing-filled teeth index values, dental care index, oral hygiene index. Nevertheless, no statistical difference was observed between the groups. Frequency of visits to the dentist was higher in the non-FA group. Frequency of tooth brushing was higher in FA group and it was performed by the subjects without the help of their parents. CONCLUSIONS No difference was observed in caries experience, dental care level, and oral hygiene in children and adolescents with FA when compare with non-FA.