Fernanda Aragão Felix

Orofacial pain is a multifactorial condition that severely impacts basic functions and overall quality of life in patients, underscoring the need for non-opioid therapeutic strategies. Targeting the Transient Receptor Potential Vanilloid 1 (TRPV1) pathway has emerged as a biologically plausible approach, given its central role in nociceptive transduction and peripheral sensitization. Capsaicin, a selective TRPV1 agonist, induces receptor desensitization and has shown potential in chronic pain modulation; however, its efficacy in orofacial conditions remains unclear. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of capsaicin in managing orofacial pain, compared to placebo or other pharmacological interventions. Following PRISMA guidelines, a comprehensive search of five databases (PubMed, Scopus, Web of Science, CDSR, and LILACS) was conducted without language or date restrictions. Studies involving human participants with orofacial pain treated with capsaicin were included. The protocol was registered in PROSPERO (CRD420251004538). Risk of bias was assessed using the RoB2, RoB2 crossover trial and ROBINS-I checklist, and meta-analyses were performed using random-effects models. Nine studies enrolling a total of 164 participants met the eligibility criteria and encompassed temporomandibular disorders, burning mouth syndrome, oral mucositis, trigeminal neuralgia, and neuropathic facial pain. Although placebo-controlled comparisons showed a trend toward pain reduction that did not reach statistical significance (MD = –1.87; [95% CI: –3.94, 0.19]; p = 0.08; I² = 86%), and no significant difference was found between capsaicin concentrations (MD = 0.46; [95% CI: –2.67, 3.60]; p = 0.77, I² = 66%), pre–post analyses of uncontrolled (single-arm) studies demonstrated a significant and clinically meaningful reduction in pain following capsaicin treatment (MD = –6.39; [95% CI: –7.40, –5.38; p < 0.001, I² = 0%). Capsaicin also showed an acceptable safety profile: although adverse events were significantly more frequent than with control (OR = 19.84; [95% CI: 4.32–91.21]; p < 0.001, I² = 0%), these were mild, localized, and self-limited. Capsaicin may provide clinically meaningful pain relief in selected orofacial conditions, particularly burning mouth syndrome, where uncontrolled evidence was most consistent (I² = 0%); evidence for temporomandibular disorders was more heterogeneous and did not reach significance in pooled placebo-controlled analyses.

Background: Sjögren disease (SjD) and non-Sjögren sicca (nSS) individuals exhibit symptoms of oral dryness. However, studies investigating factors influencing oral health-related quality of life (OHRQoL) in these groups remain scarce. Purpose: To evaluate OHRQoL in SjD and nSS patients and identify factors influencing its perception. Methods: A cross-sectional study was conducted. The short version of the Oral Health Impact Profile-14 (OHIP-14) questionnaire was administered. Bivariate analyses were performed to examine associations between independent variables and OHRQoL. Statistical significance was set at p < 0.05. Results: A total of 116 individuals were evaluated, including 79 with SjD and 37 with nSS. Hyposalivation was more frequent in SjD (55.7%) than in nSS (27.0%). The median overall OHIP-14 score was higher in nSS (30.0) than in SjD (22.0) ( p = 0.027), indicating poorer OHRQoL among nSS individuals. In SjD, hyposalivation significantly worsened OHIP-14 across five domains, whereas this association was absent in nSS. A negative correlation between unstimulated salivary flow rate and clinical oral dryness score, and a positive correlation between decayed, missing, and filled teeth index and OHIP-14, were observed only in nSS. Conclusion: OHRQoL impairment was greater in nSS, but salivary dysfunction exerted stronger effects in SjD, underscoring distinct determinants in sicca conditions.

The Wnt/β-catenin signaling pathway is tightly controlled under typical physiological conditions, being involved in teeth developmental processes. Its dysregulation and the abnormal activation of downstream target genes can result from mutations in essential pathway components. These dysregulations might ultimately foster odontogenic cysts and tumors onset and progression. In this review, we retrieve the main alterations reported in the Wnt/β-catenin signaling pathway in the context of odontogenic cysts and tumors. Increasing evidence supports the involvement of the Wnt/β-catenin pathway disruption in the biology of calcifying odontogenic cyst, odontoma, adenoid ameloblastoma, and ghost cell-containing odontogenic tumors. A deeper understanding of these molecular mechanisms may contribute to improved diagnostic and therapeutic strategies in the future.

The Wnt/β-catenin signaling pathway is tightly controlled under typical physiological conditions, being involved in teeth developmental processes. Its dysregulation and the abnormal activation of downstream target genes can result from mutations in essential pathway components. These dysregulations might ultimately foster odontogenic cysts and tumors onset and progression. In this review, we retrieve the main alterations reported in the Wnt/β-catenin signaling pathway in the context of odontogenic cysts and tumors. Increasing evidence supports the involvement of the Wnt/β-catenin pathway disruption in the biology of calcifying odontogenic cyst, odontoma, adenoid ameloblastoma, and ghost cell-containing odontogenic tumors. A deeper understanding of these molecular mechanisms may contribute to improved diagnostic and therapeutic strategies in the future.

Background: Salivary glands are the reservoir for severe acute respiratory syndrome Coronavirus 2 virus (SARS‐CoV‐2). It is known that SARS‐CoV‐2 uses angiotensin‐converting enzyme 2 (ACE2), transmembrane serine protease 2 (TMPRSS2) and FURIN to infect cells. Salivary glands express these entry factors, and it is unclear if these molecules are expressed in salivary glands from primary Sjögren's disease (pSjD). This study assessed ACE2, TMPRSS2, and FURIN gene expression by RT‐qPCR in pSjD compared to normal salivary gland and pleomorphic adenoma.Methods: An integrated study of ACE2, TMPRSS2, and FURIN gene expression across pSjD, pleomorphic adenoma, and normal salivary gland by RT‐pPCR was performed. The association between gene expression and clinicopathological data was also examined.Results: pSjD showed ACE2 upregulation compared with normal salivary gland and pleomorphic adenoma (p < 0.05). TMPRSS2 and FURIN mRNA levels are also higher in pSjD compared to pleomorphic adenoma (p < 0.05). ACE2 expression levels were associated with anti‐SSA/SSB positivity (p < 0.05). A strong correlation was observed between TMPRSS2 and FURIN in pSjD (r = 0.768; p = 0.001).Conclusion: Our analysis revealed a high expression of ACE2 in pSjD. ACE2, TMPRSS2, and FURIN mRNA levels are increased in pSjD in comparison to pleomorphic adenomas. Neither ACE2, TMPRSS2, nor furin was consistently associated with SARS‐CoV‐2 positivity in pSjD. These findings may guide future investigations on the effects of SARS‐CoV‐2 in a subset of salivary gland diseases.

The study aims to describe six subgemmal neurogenous plaque (SNP) cases and compile the previously available data on SNP. Searches on PubMed, Web of Science, Embase, Scopus, and a two-step study selection were performed to compile data from case reports/series of SNP published in English literature. Our six patients (range 29–63 years) had SNP in the posterior lateral border of the tongue. Four of them were associated with lymphoepithelial cysts. A total of 15 studies, comprising 116 patients, were included in this overview. There was a slight predilection for female patients (56.0%) in the 5th (22.4%) and the 7th (23.9%) decades. The lateral border of the tongue (66.4%) was the most common anatomical location. The major manifestation was nodule/papule. Histologically, the presence of taste buds (n = 40/ 34.5%), superficial neural plexus (n = 32/ 27.6%), deep nerve fascicles (n = 32/ 27.6%), ganglion cells (n = 41/ 35.3%), and lymphoid tissue (n = 22/ 19.0%) was mainly reported. Surgical removal was the primary approach, with a low recurrence rate. Although largely unknown, SNP is a regular and likely frequent structure located in the tongue. The findings emphasize the importance of describing clinicopathological patterns of SNP as a differential diagnosis of neural lesions that affect the tongue.

The aim of this study was to analyze the expression of mast cell markers toluidine blue, c-kit, and tryptase and presence of mononuclear inflammatory cells in oral lichen planus (OLP) and oral lichenoid lesions related to dental amalgam. Nineteen specimens of OLP, OLLC, and healthy oral mucosa were selected. Mononuclear inflammatory cells were analyzed. Histochemical and immunohistochemical analyses were performed using toluidine blue, anti-c-kit and anti-tryptase reagents, and the results were quantified in areas A and B of connective tissue. Mast cells of all OLP and OLLC samples were positive for toluidine blue, c-kit, and tryptase. The density of toluidine blue+, c-kit+ and tryptase+ mast cells was higher in tissue with OLP and OLLC compared with healthy controls (p < 0.05). No difference was noted in mast cells density between OLP and OLLC (p > 0.05). The density of tryptase+ mast cells was higher in the subepithelial region (area A) than the region below it (Area B) in OLLC (p = 0.047). The mononuclear inflammatory cell density was higher in OLLC compared to OLP, but without statistical significance (p > 0.05). A positive statistical correlation was found between mononuclear immune cells and density of c-kit+ and tryptase+ mast cells in OLP (r = 0.943 and r = 0.886, respectively). Our data demonstrate that the etiopathogenesis process of OLP and OLLC modulates the expansion and degranulation of mast cells; mast cells density, however, was similar between OLP and OLLC. The distribution of mast cells appears to vary along the lamina propria.

Objectives This multicenter study aimed to evaluate cases of non-syndrome and syndromic odontogenic keratocyst, as well as cases of recurrence within these two groups. Methods This descriptive, analytical, retrospective cross-sectional study evaluated the sex, age and presence of multiple lesions in 1,169 individuals seen at 10 Brazilian oral and maxillofacial pathology centers. Of these, 1,341 odontogenic keratocysts were analyzed regarding clinical diagnosis, size, site, imaging appearance, signs and symptoms, type of biopsy, treatment, and recurrence. Results There was a similar distribution by sex. The median age of non-syndromic and syndromic patients was 32 and 17.5 years, respectively. The posterior mandible was the site most affected by small and large lesions in both groups and in recurrent cases. Unilocular lesions were more frequent, also in recurrent cases. Mainly small lesions showed this imaging appearance. Signs and symptoms were absent in most cases. Conservative treatment was the most frequent modality in all age groups, regardless of the patient’s condition and recurrence. Recurrences were uncommon. Conclusion This study showed a higher frequency of non-syndromic keratocysts in the population. Clinicopathological features related to the involvement of multiple sites, age, and recurrence may differ between syndromic and non-syndromic cases. Furthermore, we found an association between lesion size and some clinical features and between the time interval to recurrence and the syndromic spectrum. Clinical relevance To contribute to a better understanding of the distribution and association between clinical, imaging, and sociodemographic characteristics in each spectrum of the lesion.