Bernardo da Fonseca Orcina

Central giant cell granuloma (CGCG) is a benign osteolytic lesion that may display non-aggressive or aggressive behavior. This report describes a 27-year-old male with a mandibular CGCG initially classified as non-aggressive due to its radiographic features and absence of cortical perforation or root resorption. Initial treatment with intralesional corticosteroid injections and enucleation failed to control the lesion, which progressed rapidly, reaching 7 cm and causing buccal cortical perforation. A new biopsy confirmed aggressive features, prompting surgical management via segmental osteotomy with curettage and cryotherapy, preserving the lingual cortex. Immediate reconstruction was performed using an autogenous iliac bone graft and titanium plate fixation. Postoperative healing was uneventful, with good functional and aesthetic outcomes. After 9 years and 7 months of follow-up, no recurrence was observed. This case highlights the potential for behavioral shift in CGCG and emphasizes the need for individualized treatment and timely surgical intervention when conservative therapy fails.

Background: Central giant cell granuloma (CGCG) is a benign and locally confined osteolytic lesion that occasionally exhibits aggressive behavior, while the peripheral giant cell granuloma (PGCG) is a reactive lesion with localized proliferation. Both lesions present similar histological characteristics.Objective: To compare the immunoexpression of the main invadopodia‐related proteins in CGCG and PGCG in the jaws.Methods: 30 CGCG and 12 PGCG biopsied at the oral and maxillofacial pathology departments of three universities were evaluated. The expression of cortactin, MT1‐MMP, TKS4, and TKS5, in spindle‐shaped and polygonal mononuclear cells (SPMC) and multinucleated giant cells (MGC) was observed through immunohistochemistry, and the labeled areas were semi‐automatically detected by an image processing software equipped with an efficient color detection plugin. The percentages of labeled areas in MGC and SPMC for both lesions were statistically compared at a significance level of p < 0.05.Results: The expressions of all evaluated proteins in MGC were significantly higher for CGCG than PGCG (p < 0.05). Regarding SPMC, only the expressions of cortactin and TKS5 were significantly higher expressed in CGCG than in PGCG (p < 0.05).Conclusion: The significantly higher expressions of cortactin (MGC, SPMC), TKS4 (MGC), TKS5 (MGC, SPMC), and MT1‐MMP (MGC) in CGCG may partially explain its greater invasiveness/aggressiveness.

Objectives: This study aimed to evaluate the association between nutritional status and oral health-related quality of life (OHRQoL) in older adults from population-based studies of two cities in southern Brazil. Methods: A total of 569 community-dwelling individuals aged 60 years and older were included. Sociodemographic, dental, and behavioral data were collected. Nutritional status was evaluated using the Mini Nutritional Assessment (MNA). OHRQoL, the primary outcome, was measured using the Oral Health Impact Profile-14 (OHIP-14) questionnaire. Poisson regression with robust variance was applied in crude and adjusted analyses to evaluate the impact of nutritional status on OHIP-14 outcomes. Results: The prevalence of risk of malnutrition was 31.6%, while the mean OHIP-14 was 4.86 ± 7.55. Individuals with malnutrition risk (7.44 ± 9.95) showed overall OHIP-14 scores significantly higher than those with normal nutrition (3.65 ± 5.76) (p < 0.001). A similar trend in results was detected in all domains of OHIP-14 (p < 0.05). In the adjusted analysis, individuals at risk of malnutrition had a 66% higher prevalence ratio (PR) (95% confidence interval [95% CI]: 1.23–2.23) of having poorer OHRQoL. Associations were also observed for the severity (PR: 1.69; 95% CI: 1.31–2.19) and extent (PR: 2.33; 95% CI: 1.55–3.49) of OHIP-14. Conclusions: In conclusion, poorer nutritional status is significantly associated with a higher impact on OHRQoL in older adults.

This study presents a case report of a patient with chronic kidney disease (CKD) with secondary hyperparathyroidism and the presence of manifestations in the oral-maxillofacial complex with Renal osteodystrophy (ROD). Also, a literature review in the PubMed was carried out using the MeSH Terms descriptors (((jaws) AND (treatment)) AND (secondary hyperparathyroidism)) AND (case reports). The search was limited to articles written in English and published in the last 10 years. Also, this article presented the clinical case of a 49- year-old caucasian female patient, with volumetric increase in jaws after dental extraction. The patient reported having CKD for 10 years. Clinical examination of the patient revealed enlargement of the alveolar bone ridge in the maxilla and mandible. The maxilla showed an evident loss of palatal concavity, and the mandible loss of space at the bottom of the vestibular groove. The diagnosis of ROD was consolidated after the analysis of imaging tests, laboratory tests and histopathological evaluation of the bone tissue. The manifestation of systemic diseases in the face demands a systemic look, to establish treatments with the best prognosis. We reinforce the need for multidisciplinary work for the correct diagnosis and management of patients with systemic diseases.

This study aimed to report sociodemographic, clinicopathologic and radiological features of 12 cases of aggressive neoplasms that were clinically diagnosed as chronic endodontic lesions. The series comprised seven females (58.33%) and five males (41.67%), with a mean age of 48.9 ± 19.19 years (range: 16–75 years). In six cases (50%), the posterior maxillary region was involved. Internal appearance was radiolucent density ( n = 12/100%). Eleven cases (91.67%) exhibited well‐defined borders, while one (8.33%) showed ill‐defined borders. Histopathologic diagnoses included metastasis ( n = 4/33.33%), squamous cell carcinoma ( n = 3/25%), mucoepidermoid carcinoma ( n = 2/16.68%), acinic cell carcinoma ( n = 1/8.33%), Ewing's sarcoma ( n = 1/8.33%) and Langerhans cell histiocytosis ( n = 1/8.33%). Survival status was retrieved for three patients (25.00%), all of whom were alive at the time of reporting. This study identified seven distinct histological types of aggressive neoplasms that mimic chronic periapical lesions. Given that such lesions often lack clinical or radiological signs of aggressive behaviour, it is imperative that all excised tissue undergo histopathological examination.

The aim of this case report is to show the hospital dental approach to a patient with Niemann-Pick disease (NPD) type B. After her caregivers reported poor oral health, a 10-year-old girl was referred to a hospital. She was diagnosed with NPD type B 4 years ago, with involvement of the brain, nerves, liver, spleen, bone marrow, and lungs. A dental physical examination revealed chronic carious lesions in ten teeth, as well as four residual roots and poor oral hygiene. We chose a surgical block treatment based on the altered complementary exams, dental demands, and the systemic compromise caused by NPD type B. All decayed elements were restored with glass ionomer cement, and residual roots were extracted. The patient had no clinical signs of infection or hemorrhage after 20 days of post-surgical follow-up. Although rare, the presence of patients with NPD type B in the dental routine can occur, necessitating the development of an individualized and multidisciplinary treatment plan.

Objetivo: Descrever um Procedimento Operacional Padrão para a higiene bucal de pacientes em internação hospitalar sob posição prona. Métodos: Um grupo de cirurgiões-dentistas atuantes no âmbito hospitalar, seguindo outros protocolos de operacionalização e a literatura referente a este tema, produziu uma sugestão de padronização da higiene bucal para este tipo de paciente. Conclusão: A produção deste Procedimento Operacional Padrão auxiliará na execução da higiene oral de pacientes sob posição prona, reduzindo as complicações sistêmicase bucais decorrentes da ausência desse cuidado.Palavras-chave: COVID-19, Decúbito ventral, Infecções nosocomiais, Antissépticos bucais, Assistência odontológica. Objective: The goal of this study was to describe a Standard Operating Procedure (SOP) for oral hygiene in prone patients admitted to the hospital. Methods: A group of dentists working in a hospital environment developed a suggestion for standardizing oral hygiene for this type of patient based on previous operational standards and literature connected to this topic. Conclusion: The development of this SOP will aid in the execution of oral hygiene for patients in the prone position, minimizing systemic and oral problems caused by a lack of care.Keywords: COVID-19, Prone position, Nosocomial infection, Mouthwashes, Dental care.

Em março de 2020, a doença causada pelo novo coronavírus (SARS-CoV-2) foi caracterizada como uma pandemia. Em decorrência da magnitude que a doença alcançou e seu caráter inédito, um crescente interesse científico sobre a mesma surgiu, com buscas para se encontrarem novos métodos diagnósticos, aumentando a velocidade para a obtenção dos resultados dos testes e, consequentemente, um melhor mapeamento epidemiológico da doença. Esta revisão integrativa tem como objetivo analisar as principais evidências científicas sobre a utilização da saliva como método diagnóstico da Covid-19. Na presente revisão integrativa, foram realizadas buscas em quatro bases de dados eletrônicas, em março de 2022, sendo elas: PubMed, em que foram inclusos resultados exclusivamente em inglês, e nas plataformas Google acadêmico, SciELO e Biblioteca Virtual de Saúde (BVS), havendo a inclusão dos resultados restritamente em português. Foram utilizadas diferentes palavras-chave de acordo com a linguagem dominante das bases de dados, sendo no PubMed em língua inglesa escolhidos ‘’SARS-CoV-2´´, ‘’saliva’’, ‘’diagnosis’’, ‘’viral load’’ e ‘’coronavirus Covid-19’’ e nas demais plataformas, em língua portuguesa ‘’saliva’’, ‘’covid’’ e ‘’diagnósticos’’. Dentre os 45 artigos incluídos e analisados, mais da metade classificaram a saliva como um método diagnóstico alternativo ou complementar. Ainda, apenas três artigos do número total classificaram a saliva como uma amostra inviável para os testes de diagnóstico. Dessa forma, a saliva mostrou resultados positivos como uma opção de diagnóstico e para o acompanhamento e monitoramento da Covid-19. No entanto, apesar das limitações dos estudos, a amostra salivar em pacientes pediátricos sugere ter baixa sensibilidade.

Purpose This study identifies the impact of the absence of dental support for patients with cancer whose clinical dental care was interrupted by the coronavirus disease 2019 (COVID-19) pandemic. Methods Individuals with oncologic diseases were selected from a telephone list of a Clinical Research Center (CRC) that specialized in the care of patients with cancer at the Bauru School of Dentistry, University of São Paulo (FOB/USP). The convenience sample comprised 280 patients (aged > 18 years) with a history of cancer that underwent dental treatment at the FOB/USP CRC in 2019 and did not receive care in 2020 owing to the pandemic. The participants completed a questionnaire sent via email or a text messaging application. Individuals receiving treatment or who were already treated for cancer were divided into two groups for data tabulation. Statistical analyses were performed using Fisher’s and chi-square tests. Results Of the 280 patients, 104 answered the questionnaire, and 75 (72.1%) were women. Among the women, 45 (60.0%) were receiving antineoplastic treatment, and 30 (40.0%) had already been treated. Among the men, 15 (51.7%) were receiving antineoplastic treatment, and 14 (48.3%) had already been treated. Regarding oral problems that arose during the pandemic, dental pain when eating hot or cold food or drinks (57.0%), muscle pain (53.8%), and difficulties when chewing (51.0%) were the most common reported among patients. Furthermore, most individuals reported not having received any type of remote dental follow-up, before being contacted by our team, which could contribute to reducing these oral problems. Conclusion It is impossible to say whether the absence of dental support in cancer patients during the coronavirus disease 2019 (COVID-19) pandemic had a negative impact on oral issue rates.