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Background: The ability of coronavirus SARS-CoV-2 to spread is one of the determinants of the COVID-19 pandemic status. Until June 2020, global COVID-19 cases surpassed 10 million. Asymptomatic patients, with no respiratory impairment, are believed to be responsible for more than 80% of the transmission. Other viruses have been consistently detected in periodontal tissues. Objective: The aim of this study was to investigate the presence of SARS-CoV-2 in periodontal tissue. Methods: We conducted video-endoscope minimally invasive post-mortem biopsy in seven fatal cases of COVID-19, using a regular endoscope video system associated with a smartphone to locate periodontal tissue. We analyzed the samples using RT-PCR, to identify the SARS-CoV-2 RNA and histopathological analysis. Results: The seven studied autopsies with positive laboratory tests for COVID-19 included 57.14% of female patients at the average age of 47.4 (range 8 to 74). In five cases, periodontal tissue was positive for SARS-CoV-2 (RT-PCR). Histopathologic analyses showed morphologic alterations in the keratinocytes of the junctional epithelium, a vacuolization of the cytoplasm and nucleus and nuclear pleomorphism. Conclusion: We presented a biomolecular analysis obtained from minimally invasive autopsies. This is the first study to demonstrate the presence of SARS-CoV-2 in periodontal tissue in COVID-19 positive patients.

Introduction Medication-related osteonecrosis of the jaws is a severe complication of the use of antiresorptive and antiangiogenic therapy, with limited treatment options and great impact on patient’s quality pf life. Objective The aim of this study was to assess the risk factors associated with medication-related osteonecrosis of the jaws in oncologic patients undergoing bisphosphonate treatment. In addition, salivary levels of interleukin-6, IL-6, were measured to investigate their association with severity and risk of medication-related osteonecrosis of the jaws. Methods Case-control study with 74 patients with bone metastases from solid tumors and multiple myeloma was included. Patients were divided into three groups: 1) those undergoing bisphosphonate treatment with medication-related osteonecrosis of the jaws; 2) those undergoing bisphosphonate without medication-related osteonecrosis of the jaws; and 3) those with bisphosphonate pretreatment. The demographic and medical data of the patients were collected to assess risk. The clinical evaluation was performed to diagnose medication-related osteonecrosis of the jaws and unstimulated saliva was collected for quantification of IL-6. Results As result, it was observed that patients diagnosed with medication-related osteonecrosis of the jaws were submitted to higher number of bisphosphonate doses (p = 0.001) and monthly infusion protocol (p = 0.044; OR = 7.75). Patients who did not have routine followup with specialized dentists during therapy with bisphosphonate and smoking were associated with medication-related osteonecrosis of the jaws (p = 0.019; OR = 8.25 and p = 0.031; OR = 9.37 respectively). Group 1 had a higher frequency of treatment with chemotherapy and corticosteroids concomitant with bisphosphonate, and surgical dental procedures (p = 0.129). Salivary IL-6 levels showed no statistically significant difference between the groups (p = 0.571) or association with medication-related osteonecrosis of the jaws severity (p = 0.923). Conclusion A higher number of bisphosphonate cycles, monthly infusion protocol, no dental follow-up for oral health maintenance and smoking were associated with medication-related osteonecrosis of the jaws. Specialized dental follow up during bisphosphonate treatment has been shown to be an important factor in preventing this complication.

A escolha do tratamento em pacientes com lesões orais malignas depende do estadiamento preciso no pré-tratamento, particularmente, a detecção de linfonodos comprometidos. Portanto, o estadiamento da região cervical deve ser o mais preciso possível. O objetivo do presente estudo é revisar e discutir a literatura sobre a utilização de ressonância magnética para detecção de metástases de carcinoma epidermoide em linfonodos cervicais. Foi pesquisado no MEDLINE, através do PubMed, artigos publicados até 2018, restritos a publicações em inglês. Os critérios de inclusão englobaram artigos originais que analisaram ou discutiram o uso de imagens de ressonância magnética na avaliação de carcinomas de células escamosas da cavidade bucal (SCCOC) e metástases à distância em humanos. Um total de 30 estudos foram considerados elegíveis para inclusão nesta revisão de literatura e reunidos para discussão. Previamente à cirurgia, o exame de ressonância magnética deveria ser aliado ao de PET-CT para uma detecção mais precisa das metástases linfonodais relacionadas ao SCCOC e esses exames deveriam ser repetidos no primeiro dia de pós-operatório. A ressonância magnética tem uma boa resolução para os tecidos moles, portanto, ajuda na determinação do tamanho do tumor, o que pode ser um fator preditivo de metástase. Como os índices de sensibilidade e especificidade ainda não são ideais, a análise histopatológica dos linfonodos ainda é necessária para confirmação da presença de metástases e correto estadiamento da doença.