Leni Verônica de Oliveira Silva

A multicenter study of malignant oral and maxillofacial lesions in children and adolescents

OBJECTIVESnTo investigate the frequency of malignant oral and maxillofacial lesions among children and adolescents from representative geographic regions of Brazil.nnnMATERIALS AND METHODSnA retrospective study was conducted on biopsies obtained from 1990 to 2016 at six Brazilian oral and maxillofacial pathology referral centers. A total of 85,105 biopsy specimens from children and adolescents were analyzed. Gender, age, anatomical location, symptomatology and histopathological diagnosis were evaluated. Data were analyzed using descriptive statistical methods.nnnRESULTSnFifty-eight (0.06%) malignant oral and maxillofacial lesions were diagnosed in children (19%) and adolescents (81%). The lesions were more frequent among females (60.3%) and adolescents. The most prevalent lesions were mucoepidermoid carcinomas (22.4%), osteosarcomas (13.8%), squamous cell carcinomas (12.1%), and Burkitts lymphomas (12.1%). The most commonly affected sites were the palate (19%), mandible (13.8%), and maxilla (13.8%). Almost half the patients were asymptomatic.nnnCONCLUSIONnPediatric oral and maxillofacial malignant lesions were infrequent and showed wide diversity, with a prevalence of mucoepidermoid carcinomas. Analysis of malignant lesions in children and adolescents helps pediatric dentists and oncologists to obtain a better understanding of such lesions and to reduce the time for diagnosis, with a consequent improvement of prognosis.

Odontogenic carcinosarcoma: A systematic review

The aim of this study was to integrate the available data published on odontogenic carcinosarcoma into a comprehensive analysis of their features, treatment and recurrence. An electronic search with no publication date or language restriction was undertaken in March 2018 in the following databases: Medline Ovid, PubMed, Web of Science, Scopus and LILACS. Eligibility criteria included publications having enough clinical, imaginological and histopathological information to confirm a definite diagnosis of the neoplasm. Data were evaluated descriptively and statistically using the MedCalc software. The Kaplan-Meier method was used for survival analysis. The systematic review detected nine articles from eight countries. Six cases with no age predilection occurred in male individuals complaining of painful swelling in the posterior mandible. Radiographically, the lesions were large, with expansive radiolucency and with ill-defined borders and seven cases were associated with preexisting odontogenic lesions. Radical surgery was the treatment of choice in the majority of cases. Recurrences (nu202f=u202f6), metastasis (nu202f=u202f4) and death (nu202f=u202f4) were frequently observed in many cases. Odontogenic carcinosarcoma is a very aggressive neoplasm with a poor prognosis. This study provides knowledge that could help surgeons, oncologists, otorhinolaryngologists and oral maxillofacial pathologists with the diagnosis and management of these lesions.

A multicentre study of oral paracoccidioidomycosis: Analysis of 320 cases and literature review

OBJECTIVESnTo investigate the frequency of oral paracoccidioidomycosis from representative geographical regions of Brazil and to compare the data with a literature review.nnnMATERIALS AND METHODSnA retrospective study was conducted on 108,304 biopsies obtained from 1953 to 2016 at six Brazilian oral and maxillofacial pathology services. Demographic data and clinical and histopathological diagnosis of oral paracoccidioidomycosis were evaluated. A literature review of oral paracoccidioidomycosis studies published in three electronic databases was carried out. Data were analysed descriptively.nnnRESULTSnA total of 320 cases of oral paracoccidioidomycosis were surveyed (0.3% of the oral lesions at the centres studied). The lesions were more frequent among male patients. The gingiva/alveolar ridge was the most affected site. Mean age of affected individuals was 51.3xa0years (±11.7). The literature review showed a higher incidence of oral paracoccidioidomycosis in the south-east and south regions of Brazil. Male individuals and individuals between 50 and 59xa0years were most affected.nnnCONCLUSIONSnOral paracoccidioidomycosis is an uncommon lesion observed in oral biopsy samples. The differences in the relative frequency of oral paracoccidioidomycosis are related to geographical variations. Men between 50 and 59xa0years are more affected. This study provides helpful information for clinicians in the diagnosis of oral paracoccidioidomycosis.

A multicentre study of 268 cases of calcifying odontogenic cysts and a literature review

OBJECTIVESnTo investigate the frequency of calcifying odontogenic cysts (COCs) that have been submitted for microscopic examination from representative geographic regions of Brazil and to compare it with literature data.nnnMATERIALS AND METHODSnA retrospective study was conducted on biopsies obtained from 1953 to 2016 at 10 Brazilian oral and maxillofacial pathology centres. A total of 198,350 biopsy specimens were analysed. Demographic data and histopathological diagnosis were evaluated descriptively and statistically. In addition, a literature review of case series was carried out in four electronic databases.nnnRESULTSnA total of 268 cases of COC were surveyed, representing 0.1% of the oral lesions at the centres studied. Female patients in their second decade of life and the maxilla were more affected. The mean lesion size of symptomatic individuals was larger than that of cases without symptoms (pxa0=xa00.026). The literature review showed a higher frequency in Asia and Europe, mainly affecting men in the third decade of life.nnnCONCLUSIONSnCOC is a rare lesion. Novel data on the clinicopathological features of 268 cases have been added to the literature. Data regarding gender and age of the Brazilian patients reported herein contrast with findings of case series and retrospective studies reported elsewhere.

Calcifying epithelial odontogenic tumours: Collaborative study of 32 cases and review of literature

OBJECTIVESnTo analyse the occurrence of calcifying epithelial odontogenic tumours (CEOT) based on biopsy records from different Brazilian geographic regions and to contrast the data with a review of the literature.nnnMATERIALS AND METHODSnA 2-step study was conducted. Step 1 consisted of a collaborative study of biopsies obtained from 1953 to 2017 at six Brazilian oral and maxillofacial pathology centres. Evaluation of 86,268 biopsy records was performed. Demographic and histopathological diagnosis data were assessed. In Step 2, a review of the literature of case reports and cases series of CEOT identified across five electronic databases was conducted.nnnRESULTSnIn the collaborative study, 32 cases of CEOT were evaluated. This figure represented 0.03% of the oral and maxillofacial lesions and 1.7% of all odontogenic tumours across the centres. Women in the fourth decade of life were more affected. CEOT occurred more in the mandible than in the maxilla (ratio 1.9:1). The review of the literature showed that Asian individuals were more affected by this neoplasm.nnnCONCLUSIONSnUseful knowledge on the epidemiology, treatment and follow-up of CEOT has been provided. Demographic data and clinical features of the cases presented in this collaborative study were quite similar to those of studies reported worldwide.

Calcifying odontogenic cyst, dentinogenic ghost cell tumor, and ghost cell odontogenic carcinoma: A systematic review

BACKGROUNDnThe aim of this study was to integrate the available data published on calcifying odontogenic cyst (COC), dentinogenic ghost cell tumor (DGCT), and ghost cell odontogenic carcinomas (GCOCs) into a comprehensive analysis of their clinicoradiological features, treatment, and recurrence.nnnMATERIALS AND METHODSnAn electronic search with no publication date restriction was undertaken in October 2017 in the following databases: PubMed, Medline Ovid, Web of Science, and Scopus. Eligibility criteria included publications containing enough clinical, radiological, and histopathological information to confirm a definite diagnosis of these lesions. Data were evaluated descriptively.nnnRESULTSnThe literature review indicated a total of 234 publications reporting 367 COCs, 55 DGCTs and 44 GCOCs. These lesions have a predilection for Asian males. COCs mainly affect the mandible and patients in the second decade of life, DGCTs mostly affect the mandible and patients in the fourth decade of life, and GCOCs mostly affect the maxilla and patients in the fifth decade of life.nnnCONCLUSIONnConservative surgery was the most common therapy for COCs and DGCTs, while radical surgery was most common for GCOCs. This study provides important and interesting data that could help clinicians and surgeons as well as oral and maxillofacial pathologists with the diagnosis and management of these lesions.

Nonsyndromic cleft lip and/or palate: A multicenter study of the dental anomalies involved

Background Nonsyndromic cleft lip and/or palate (NSCL/P) is the most common craniofacial malformation. Due to the anatomical defect present in the alveolar process, these patients tend to exhibit more dental anomalies. The aim of this study was to identify the prevalence of dental anomalies in patients with NSCL/P by obtaining orthodontic documentation from Brazilian Centers for cleft lip and palate treatment. Material and Methods A retrospective analysis (2000-2014) was conducted on orthodontic archives, radiographs and medical records of NSCL/P of 524 patients under orthodontic treatment. Panoramic radiographs and intra-oral photographs were examined to identify these anomalies. Categorical variables were expressed in terms of frequencies and percentages and analyzed using the Chi-Square test. The level of significance was set at p≤0.05 in all analyses. Results Approximately 83.3% of the individuals had at least one dental anomaly. Tooth agenesis was the most common abnormality found in those patients (87.8%) (p<0.001). Also, the largest number of dental anomalies was detected in the group of unilateral left clefts. The prevalence of dental anomalies in the present sample of NSCL/P patients was high and reached the highest levels in patients with alveolar bone clefts. Conclusions This study describes the most common dental anomalies observed in patients with NSCL/P. These abnormalities can cause significant problems that may be solved or minimized by early diagnosis and treatment. Key words:Cleft lip and/or palate, dental care for children, epidemiology, craniofacial abnormalities.

A retrospective multicentre study of cystic lesions and odontogenic tumours in older people

OBJECTIVEnThe aim of this study was to investigate the frequency and some characteristics of odontogenic tumours, odontogenic cysts and non-odontogenic cysts in an elderly population (≥60xa0years).nnnBACKGROUNDnFew studies describe the distribution of oral lesions in older people.nnnMATERIALS AND METHODSnA retrospective descriptive cross-sectional study was performed. Biopsy records were obtained from the archives of four Brazilian referral centres between 2000 and 2016. Data such as gender, age, anatomical location, symptomatology and histopathological diagnosis were collected and categorised. Statistical analyses were performed adopting a P-value of ≤.05 and a 95% confidence interval.nnnRESULTSnA total of 7259 biopsy records of elderly participants were analysed; 642 cases were cystic lesions and odontogenic tumours, 491 of which being classified as odontogenic cysts (76.5%), 75 as odontogenic tumours (11.7%) and 76 as non-odontogenic cysts (11.8%). The most frequent lesions in each group were radicular cyst (nxa0=xa0268), ameloblastoma (nxa0=xa051) and salivary duct cyst (nxa0=xa021), respectively. Overall, women were more affected (nxa0=xa0351, mean age: 68xa0years). Intraosseous lesions were more common in the mandible (nxa0=xa0342), and soft tissue cysts occurred more in the lip (nxa0=xa013).nnnCONCLUSIONnOdontogenic cysts were relatively common, whereas odontogenic tumours and non-odontogenic cysts were rarer among the older people studied in the present investigation.

A multicenter study of biopsied oral and maxillofacial lesions in a Brazilian pediatric population

The aim of this study was to investigate the prevalence of oral and maxillofacial lesions among children from representative regions of Brazil. A retrospective descriptive study was conducted. Biopsy records comprising the period from 2000 to 2015 were obtained from the archives of three Brazilian oral pathology referral centers. A total of 32,506 biopsy specimens were analyzed, and specimens from 1,706 children aged 0-12 years were selected. Gender, age, anatomical location and histopathological diagnosis were evaluated. Descriptive statistics was carried out. Likelihood ratio tests were used to evaluate the association between the categorical variables. The level of significance was set at 0.05. The post-hoc test was used to identify the subgroups that significantly differed from one another, and the Bonferroni correction was applied. A total of 1,706 oral and maxillofacial lesions were diagnosed in pediatric patients, including 51.9% girls. Oral mucocele was the most prevalent reactive/inflammatory lesion (64%). The most commonly affected sites were the lips (34.5%) and mandible (19.9%). A significant association was observed between age and the group of lesions of the oral cavity (p < 0.001), and between age and anatomical location (p < 0.001). Pediatric oral and maxillofacial lesions were frequent and showed wide diversity, with the prevalence of mucocele. Knowledge of oral lesions is important for pediatric dentists worldwide, since it provides accurate data for the diagnosis and oral health of children.

Odontalgia não odontogênica: levantamento e revisão da literatura atual

Introducao: Apesar da maior compreensao acerca da dor orofacial nos ultimos anos, o diagnostico preciso da dor ainda e um desafio na odontologia contemporânea. Muitos disturbios na regiao de cabeca e pescoco sao reconhecidos para se referir a dor de estruturas dentarias ou que simulam a odontalgia. Objetivo: O objetivo desse estudo foi realizar uma revisao de literatura atual de series e/ou relatos de casos de pacientes portadores de odontalgia de natureza nao odontogenica a fim de contribuir na elucidacao dos diagnosticos diferenciais e discutir os principais achados clinicos. Material e Metodo: A revisao da literatura foi elaborada em Agosto de 2017 com base em artigos publicados na lingua inglesa, do banco de dados Medline (PubMed). Foram utilizadas pesquisas do periodo compreendido entre 1968 e 2016 para determinar o mapeamento dos casos dos pacientes. Os dados foram arquivados em ano da publicacao, idade, genero, numero de casos, localizacao anatomica e diagnostico diferencial. Resultados: Vinte e quatro artigos foram analisados. Diferentes diagnosticos e condutas foram tomadas nas odontalgias nao odontogenicas. Conclusao: E pertinente concluir que o diagnostico diferencial entre a odontalgia e as doencas de natureza nao odontogenica e imprescindivel a fim de promover aos pacientes tratamentos conservadores, quando possiveis e melhores prognosticos evitando sobremaneira a mutilacao dos dentes, tratamentos endodonticos desnecessarios e terapeuticas tardias nos casos de neoplasias malignas. Descritores: Odontalgia; Dor facial; Diagnostico.