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A glandular odontogenic cyst (GOC) has an intriguing, aggressive behaviour whose mechanisms have not yet been clarified.To conduct a collaborative cross-sectional study on the clinical, demographic, microscopic and immunohistochemical characteristics of GOCs, emphasizing the histopathological characteristics and expression of proteins related to invasiveness.Twenty-two cases of GOC from three oral and maxillofacial pathology services in Brazil were selected from 1988 to 2018. Clinical and demographic data were collected. Histopathological features were evaluated in detail. Sixteen cases of GOC were also submitted to immunohistochemistry to detect MT1-MMP, TKS4, TKS5 and cortactin, the key regulators of invadopodia formation.Glandular odontogenic cysts were primarily seen in men over 40 years of age, in the posterior mandible and the anterior maxilla as a unilocular, radiolucent lesion. All cases presented hobnail cells, clear cells and variable thickness of the lining epithelium, 3 of the 10 key histopathological parameters to be evaluated in GOCs. Immunohistochemistry revealed a greater expression of the studied proteins in the GOCs than in the controls (p 0.0001).Overexpression of proteins that regulate cell invasiveness was identified, and the present study's findings suggest that invadopodia activity is a possible mechanism used by GOCs to promote local invasion, which could partly explain its intriguing biological behaviour.

Background Burning mouth syndrome (BMS) it is characterized by burning and uncomfortable sensations with no clinical alterations or laboratory findings. The evaluation of the salivary characteristics of people with BMS can help the understanding of the pathogenesis of this condition. This case-control study aimed to trace the salivary profile of women with burning mouth syndrome (BMS). Material and Methods 40 women with BMS and 40 control women were recruited. Unstimulated salivary flow rate (uSFR), pH, salivary cortisol levels, salivary viscosity, and oral health impact profile (OHIP-14 questioner) were determined. P< 0.05 was considered statistically significant. Results For uSFR, mean values obtained for BMS and for control group respectively were 0.35 and 0.61 mL/min; for pH, 7.23 and 7.34; for cortisol levels, 0.36 and 0.15 μg/dL; for viscosity values, 31.1 and 45.01 mPas and for OHIP-14 scores, 21.7 and 5.7. To uSFR, cortisol levels, viscosity values and OHIP-14 scores, differences were statistically significant. Salivary cortisol levels and OHIP-14 scores were correlated positively (rho = 0.624; p< 0.05). Conclusions BMS women have lower uSFR and salivary viscosity and higher salivary cortisol levels that were associated with worse quality of life, compared with the control group. Key words:Xerostomia, Burning mouth syndrome, Viscosity.

Objectives: To evaluate (1) the effect of a salivary substitute prepared using chamomile (Matricaria chamomilla L.) flower and flax (Linum usitatissimum L.) seed to relieve Primary burning mouth sy...

Data on the occurrence and clinicopathological characteristics of actinic cheilitis (AC) and lip squamous cell carcinoma (LSCC) are well studied; however, they are based on studies limited to a single centre. Herein, we described the frequency of AC and LSCC submitted to microscopic examination from representative geographic regions of Brazil. A retrospective multicentre study was performed on biopsies obtained from 1953 to 2018 at 10 Brazilian oral and maxillofacial pathology centres. A total of 198,709 biopsy specimens were surveyed. Sociodemographic data and clinicopathologic characteristics were analysed. A total of 2017 cases of ACs (1.0%) and 850 cases of LSCCs (0.4%) were recorded. A strong fair-skinned (> 87%) male (> 70%) predilection was observed in both conditions. The mean age was 54.8 ± 18.7 for individuals with AC and 57.8 ± 19.0 for individuals with LSCC. The most commonly affected site was the lower lip (> 90%). This is a large multicentre study of AC and LSCC from Brazil. The frequency and clinicopathological features of AC and LSCC were similar to those described worldwide. This study provides robust and representative epidemiological data of these conditions for the scientific community.

We present the frequency of cases of isolated odontogenic keratocysts submitted to microscopic examination at 10 Brazilian referral centres in Oral and Maxillofacial Pathology. In a retrospective (1953-2017) analysis, data on clinicoradiographic features and treatment of these lesions were collected and analysed descriptively. Among the 258,867 cases retrieved, 2,497 (0.96%) were isolated odontogenic keratocysts. In summary, an overview of individuals affected with isolated odontogenic keratocysts is reported herein. This lesion showed predilection for the posterior mandible of young adult men.

The aim of this study was to determine the presence of immature CD1a+ and mature CD83+ dendritic cells in oral squamous cell carcinoma, to compare immunoreactivity between smokers and nonsmokers, and to correlate the results with histopathological grading. In this observational study, twenty-eight paraffin-embedded biopsies of oral squamous cell carcinoma were retrospectively retrieved and submitted to immunohistochemistry for immature CD1a+ and mature CD83+. Descriptive and statistical analyses were performed. The sample consisted of 18 man (64.3%) and 10 women (35.7%), with a mean age of 64.6 years in the nonsmoker group and 53.2 years in the smoker group. The tongue (11 cases, 39.2%) was the most commonly affected anatomical site, followed by gingiva (6 cases, 21.4%). Histopathological grading revealed 7 low-grade and 7 high-grade malignancy cases in each group, and no correlation with the number of positive DCs. The number of immature CD1a+ was not significantly different between smoker and nonsmoker groups, while a lower number of mature CD83+ was detected in the smoker group (p = 0.001). Smoking changes the oral immune system and decreases the ability to activate and mature dendritic cells, which may influence the development and progression of oral squamous cell carcinoma.

To evaluate the impact of the COVID-19 pandemic on the number of diagnoses of oral and maxillofacial lesions in public laboratories after one year of COVID-19 outbreak in Brazil.This is a cross-sectional study. Biopsies submitted to histopathologic examination from March 2019 to February 2020 (pre-pandemic period) and from April 2020 to March 2021 (pandemic period) in nine Brazilian public oral pathology laboratories were retrieved and the number of diagnoses, types of lesion, and percentage changes during both periods were analyzed.There were 7389 diagnoses in the pre-pandemic period and 2728 in the pandemic era, indicating a reduction of 63.08%. The reduction was 64.23% for benign lesions and 49.48% for malignant lesions, with a 50.64% reduction in squamous cell carcinoma. The largest decreases were observed in April 2020 and January 2021.An important reduction in the diagnoses of benign and malignant lesions was noted in the Brazilian public oral pathology laboratories during the first year of the COVID-19 pandemic.

Objective This study aimed to evaluate tumor budding (TB) and quantify the neutrophilic and lymphocytic infiltration in the invasive front of lip squamous cell carcinomas. In addition, the associations between these features and the histopathological grading in the invasive front were analyzed. Design A total of 43 lip squamous cell carcinoma surgical specimens were included and classified in accordance with a histological invasive front grading system. Immunohistochemistry was performed for CD66b and CD3 for the evaluation of neutrophils and T lymphocytes, respectively, in the invasive front of the tumors. Tumor budding was evidenced by AE1/AE3 staining. Results Thirty-six (83.7%) of the tumors were well-differentiated tumors. Eleven (25.6%) of the cases exhibited high-intensity tumor budding. There were low neutrophil and high T lymphocyte infiltrations in the invasive front, leading to a low neutrophil/T lymphocyte ratio in the same region. Moreover, we found an association between tumor budding and the pattern of invasion, and between the CD3+ cell count and the inflammatory infiltrate (p Conclusions The low neutrophil and high T lymphocyte infiltration in the invasive front, and the few high-intensity tumor budding cases are in accordance with the histopathological features of well-differentiated lip tumors. If these characteristics remain in lip squamous cell carcinomas with more aggressive histopathological features, it deserves to be investigated.

Background & aims: Diet quality has been inversely associated with depression, but less is known about its association with anxiety and about the mechanisms involved in the association between diet and mental health. This study aimed to assess the associations of diet quality with major depressive disorder (MDD) and generalized anxiety disorder (GAD) in young adults, and to explore whether inflammation, indexed by interleukin-6 (IL-6) and C-reactive protein (CRP), and body mass index (BMI) mediate this association.Methods: We used data of 3331 participants from the 1993 Pelotas Birth Cohort (Brazil). Data on dietary intake and inflammatory markers were assessed at 18 years, and information on mental disorders was obtained at both 18 and 22 years. A food frequency questionnaire was used to assess dietary intake, and diet quality was estimated using the Brazilian Healthy Eating Index – Revised (BHEI-R). The occurrence of MDD and GAD was assessed using the Mini International Neuropsychiatric Interview (MINI), conducted by psychologists. The associations of diet quality, BMI and inflammatory markers with mental disorders were explored using logistic regression. The mediation analysis was performed using structural equation modelling.Results: A one standard deviation increase in the diet quality score at age 18 years was associated with both lower levels of CRP (−0.06 mg/L) at 18 years and 23% lower odds of MDD at 22 years. No association was found between diet quality score and both BMI and GAD. Obesity was associated with higher odds of MDD, but CRP and IL-6 were not associated with MDD or GAD. Our results provide no evidence that inflammatory markers and BMI mediate the association between diet quality and MDD in young adults.Conclusions: A better diet quality is associated with lower occurrence of MDD among young adults, but we did not find evidence that inflammatory markers and BMI mediate this association.Keywords: Mental health; Diet; Young adults; Cohort studies

Occurrences of rare oral complications following herpes zoster (HZ) infection have been reported. In the present case, a 57-year-old man was referred for periodontal evaluation due to gingival bleeding. His medical history included diagnoses of chronic lymphocytic leukemia and HZ infection. Intraoral examination revealed necrosis and alveolar bone exposure around the mandibular left lateral incisor, and the patient reported spontaneous exfoliation of the maxillary and mandibular left central incisors. Conservative surgical and antibiotic therapies were provided to the patient, and a diagnosis of osteonecrosis of the jaw following HZ infection was established. There were no signs of recurrence in 17 months of follow-up. Clinicians should be aware of unusual complications related to a previous HZ infection.

The objective of this study was to investigate intergenerational breastfeeding practices according to parental sex and age at delivery in the 1993 Pelotas (Brazil) birth cohort study. This is a prospective birth cohort study, and at the 22‐year follow‐up, a substudy with all children of the cohort members who had become parents was conducted (93Cohort‐II). First generation breastfeeding data were collected at 3 months and 4‐year‐old follow‐ups. In the 93Cohort‐II, parents answered a questionnaire about their children's breastfeeding practices. Adjusted Tobit and Poisson regression models with robust variance were applied to estimate the association between predominant parental breastfeeding duration and exclusive breastfeeding duration of the children at 3 and 6 months. Out of 3,810 cohort participants, 955 (25%) had delivered at least one live‐born infant, and 1,222 children were assessed. Fifty‐four percent of parents were ≤19 years old. Direct effects of predominant parental breastfeeding duration on exclusive breastfeeding duration of their children were only observed when data were stratified by parental age: children born to parents aged ≥20 years old and who were predominantly breastfed for at least 3 months presented higher exclusive breastfeeding duration and higher prevalence of being exclusively breastfed for at least 3 months. When analyses were stratified by mothers and fathers, the result remained significant only among mothers. Longer predominant breastfeeding duration in the first generation was associated with longer exclusive breastfeeding duration in the second generation, but only among older mothers. Education and social support surrounding breastfeeding should be intensified among fathers and younger parents to create a positive environment supportive of breastfeeding.

Background intravascular papillary endothelial hyperplasia is an unusual vascular lesion characterized by the proliferation of endothelial cells. The aim of this study was to determine the frequency and general features of this lesion. Methods biopsy records of three oral pathology services were reviewed for intravascular papillary endothelial hyperplasia cases from 1959 to 2020. In addition, a systematic review of case reports and case series was carried out in eight electronic databases. Results of the 65,205 retrieved cases, 20 (0.03%) were diagnosed as intravascular papillary endothelial hyperplasia. Mean patient age was 46.55 years, and females (12 cases/60%) were more affected. The lower lip (9 cases/47.36%) was the most commonly affected site, and the lesions were generally asymptomatic (7 cases/63.63%). Clinically, 90% of the lesions presented (18 cases) as a nodule, with a mean size of 1.13cm. The clinical diagnostic hypotheses most frequently raised were mucocele (6 cases/37.50%) and hemangioma (5 cases/31.25%). An excisional biopsy was chosen in all cases for treatment. Forty-nine studies of the systematic review were included, yielding 105 cases. The literature showed similarity in all variables. Conclusion despite the uncommon frequency, clinicians and oral pathologists should familiarize themselves with the similarities between intravascular papillary endothelial hyperplasia and some other lesions in terms of clinical and histological features.

Resumo Este estudo teve como objetivo avaliar o efeito de fatores demográficos e socioeconômicos, de doenças crônicas e do recebimento de orientações em saúde no padrão alimentar de idosos. O consumo alimentar foi avaliado por meio de questionário de frequência alimentar reduzido aplicado a 1.426 idosos residentes em Pelotas, RS, Brasil e os padrões alimentares foram obtidos por análise de componentes principais. Dois padrões foram identificados: saudável (alimentos integrais, frutas, legumes/verduras e leite) e ocidental (doces, frituras, alimentos congelados, embutidos e “fast food”). Mulheres, não fumantes e não dependentes alcoólicos aderiam mais ao padrão saudável, enquanto que homens, fumantes, dependentes alcóolicos e indivíduos com sobrepeso aderiam mais ao padrão ocidental. Maior renda e escolaridade estiveram associadas à maior adesão de ambos os padrões e a presença de doenças crônicas não esteve associada a nenhum padrão. O recebimento de orientações para hábitos saudáveis esteve associado à maior adesão ao padrão saudável e menor ao padrão ocidental. Há necessidade do fortalecimento de orientações eficazes sobre hábitos saudáveis nos serviços de saúde, com especial atenção para idosos do sexo masculino, tabagistas, dependentes alcoólicos e indivíduos com sobrepeso. Abstract This cross-sectional study sought to assess the effect of demographic and socioeconomic factors, chronic diseases, and health counseling on dietary patterns of the elderly. Food consumption was assessed by means of a reduced eating frequency questionnaire distributed to 1,426 elderly residents in Pelotas, State of Rio Grande do Sul, Brazil, and dietary patterns were obtained using main component analysis. Two dietary patterns were identified: healthy diet (wholegrain food, fruits, vegetables, and milk) and Western diet (sweet snacks, fried foods, frozen foods, processed meats, and fast food). Females, non-smokers, and alcohol-free individuals tended more toward the healthy diet, whereas males, smokers, alcohol-dependent, and overweight individuals tended more toward the Western diet. Higher income and schooling were associated with a higher tendency toward both diets, and chronic diseases were not associated with either diet. Receiving counseling for adopting healthy habits was associated with a higher tendency toward a healthy diet and a lower tendency toward the Western diet. There is a need to increase effective guidance on healthy habits by health services to promote healthier eating practices, with special attention to elderly males, smokers, alcohol-dependent and overweight individuals.

Background: Peripheral Calcifying Epithelial Odontogenic Tumors (CEOT) rich in clear cells are a rare entity in the oral cavity, with only 14 previous case reports in the English literature. None have discussed recommended treatment approaches for extraosseous CEOT. Objective: This brief descriptive review describes a treatment approach for peripheral CEOT including the clear cell variant. Study design: A complete review of all well-documented extraosseous case reports with an emphasis on the treatment was performed. Additionally, the present article reports a case of a 21-year-old woman with an asymptomatic swelling in the gingiva finally diagnosed as peripheral CEOT abundant in clear cells. Results: Twenty-four cases of peripheral CEOT were described; conservative surgery was the first treatment approach in approximately 80% of cases, with only one recurrence. Discussion: Clear cell finding was not associated with more aggressive behavior. Conclusion: Conservative surgery may be an advantageous approach for this group of peripheral lesions with or without clear cells, with a recurrence rate of approximately 4%.

Objective The 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 (≥60 years). Background Few studies describe the distribution of oral lesions in older people. Materials and methods A 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. Results A 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 (n = 268), ameloblastoma (n = 51) and salivary duct cyst (n = 21), respectively. Overall, women were more affected (n = 351, mean age: 68 years). Intraosseous lesions were more common in the mandible (n = 342), and soft tissue cysts occurred more in the lip (n = 13). Conclusion Odontogenic cysts were relatively common, whereas odontogenic tumours and non-odontogenic cysts were rarer among the older people studied in the present investigation.

Background Odontogenic myxoma (OM) is an uncommon neoplasm of the jaws. Considering the importance of defining the relative incidence and demographic profile of these lesions in South America, the aim of this study was to analyze the clinical and imagiological features of OM from three South American oral pathology services and to discuss these findings in light of the literature. Methods Data regarding age, gender, anatomic site and imagiological features from 85 cases of OM were collected. Additionally, we did a review of OM studies published in three electronic databases. Results Among 63,450 oral biopsies, 1,178 (1.85%) were odontogenic tumors (World Health Organization - 2017), of which 85 (7.21%) met the criteria of OM. The mean age was 30.7 years (range: 10-61 years; SD: 12.22). Forty-five (52.9%) cases occurred in females and 40 (47.1%) in males (ratio: 1:1.12). Maxilla was affected in 44 cases (53%) and mandible in 39 (47%). Of the 41 informed cases (48.2%), all of them were radiolucent lesions. The literature review indicated a majority of mean ages in third decade and a predilection for females, mandible and multilocular radiolucent lesions. Conclusions The features of OM samples have strong similarity to that reported in studies from other continents. It is possible to infer that geographic variation does not help to explain some differences observed in the clinical features of OM. This article is protected by copyright. All rights reserved.

The aim of this study was to evaluate the demographic and clinical profile of the oral squamous cells carcinoma (OSCC) cases registered in a center of oral diagnosis in southern Brazil. Eight hundred and six individuals with OSCC from 1959 to 2012 were included in this study. The variables recorded were: sex, age, occupation according to workplace, alcohol and tobacco consumption, skin color, tumor location, histological type, clinical appearance, size, evolution time, presence of pain and lymph node metastasis. Descriptive analysis was performed and the associations between variables were assessed using the chi-square and Fisher’s exact test, with a confidence level of 5%. OSSC was more common in males (76.6%) aged between 51 to 70 years (53.9%). The most frequent sites were lower lip vermilion (23.3%), tongue (20.2%) and gingiva/alveolar ridge (18.1%). There was a strong association between outdoor occupation and white skin color with lip squamous cell carcinoma (LSCC). OSCC intraoral lesions were commonly more painful, larger than 2 cm and presented lymphatic metastasis. In conclusion, most of the results confirm the data from literature about sex, age, tumor location and occupation. Moreover, the positive correlations between LSCC and occupation, between LSCC and white skin color, and between bigger lesions and presence of pain/cervical metastasis also corroborate the literature data.

Objectives The aim of this study was to investigate the prevalence of oral and maxillofacial lesions among older adults (≥60 years) from representative regions in Brazil. Design Retrospective descriptive cross-sectional study. Setting Biopsy records were obtained from the archives of four Brazilian referral centers of oral diagnosis between 2000 and 2016. Participants A total of 45,506 biopsy records of all patients were analyzed, of these 7,259 persons aged 60 and older were selected. Measurements Data such as gender, age, race, anatomical location, and histopathological diagnosis were collected and categorized. Pearson's chi-square test (P < .005) was used to evaluate differences in the frequency of the several groups of oral lesions. Results Oral and maxillofacial lesions were diagnosed in 7,259 older people, including 59.4% women (P < .001) and 61.3% white patients (P = .07). The most commonly affected sites were the cheek mucosa (20.3%) and mandible (8.9%) (P < .001). Reactive and inflammatory lesions were the most common lesions, followed by neoplasms. Oral squamous cell carcinoma was the most prevalent neoplasm (83.4%) (P < .001). Conclusion Knowledge of oral diseases obtained from biopsy records provides more accurate data about the diagnosis and oral health of elderly patients. These indicators thus support the development of specific health policies for the prevention and treatment of oral and maxillofacial lesions that affect this population.

Objective To investigate the frequency of dentinogenic ghost cell tumor (DGCT) that has been submitted to microscopic examination from representative geographic regions of Brazil and to compare it with literature data. Study Design A retrospective study was conducted on biopsy results obtained from 1953-2016 at 6 Brazilian oral and maxillofacial pathology services. A total of 84,668 biopsy specimens were analyzed. Demographic data and histopathologic diagnosis were evaluated descriptively. A literature search was performed in PubMed/MEDLINE for articles about DGCT published from 1933-2017. Results A total of 10 cases of DGCT were identified across the sample. Most individuals were male patients (60%) and ranged in age from 12 to 64 years (mean, 27.6 years). The most frequent location was the mandible (66.3%), and most of patients were asymptomatic (62.5%). The literature review showed a higher frequency in Asia and North America, mainly affecting men in the fifth decade of life. Conclusion DGCT is an extremely rare lesion. Data regarding age of the Brazilian patients reported here differ with findings from cases reported elsewhere. Support: FAPEMIG

A 37-year-old woman was referred to the School of Dentistry, Brazil, in April 2018, complaining of a radiographic finding noted by her dentist. The intra- and extraoral examination did not present any abnormalities. The panoramic radiograph revealed 2 different radiolucent images associated with the unerupted tooth 48. By mesial was suggestive of dentigerous cyst and by distal presented no defined limits, measuring about 2 cm, with an initial hypothesis of ameloblastoma. An incisional biopsy (distal image) with extraction of tooth 48 was carried out. The histopathology analysis of distal image showed hypercellular, hematopoietic bone marrow characterized by erythroid, granulocytic, and lymphocytic series. A few dilated vascular channels were also observed. There was no abnormality in the morphology of the hematopoietic cells and no evidence of malignant cells. The diagnosis of focal osteoporotic marrow defect was made. The mesial image revealed a dentigerous cyst. Currently, there is no evidence of disease.

Background Jaw pseudocysts are benign osseous lesions of unclear etiology. Among these, the simple bone cyst (SBC) and aneurysmal bone cyst (ABC) are intriguing bone pathologies still rarely studied together. This retrospective study aimed to present the long-term case series of patients with jaw pseudocysts focusing on the clinical, radiographic, and transoperative aspects. Material and Methods A retrospective case series of patients with SBC and ABC was performed. Clinical, radiographic, and transoperative aspects of both pseudocysts were reviewed from the histopathological archives of 20,469 cases between 1959-2012. All descriptive data were summarized. Results Of 354 (15.25%) bone pathologies, 54 cases of jaw pseudocysts were found, with 42 (11.86%) SBC and 12 (3.39%) ABC cases. For both lesions, most of the sample were young Caucasian women with an asymptomatic posterior mandible lesion with undetermined time of evolution and none trauma history. A unique radiolucent scalloped lesion presenting an empty cavity were also observed for both conditions. However, some atypical findings were found for SBC including: the expansion of bone cortical, tooth resorption, displacement of the mandibular canal, and recurrence. The absence of painful symptoms and the lack of classical blood-filled cavity were observed in some cases of ABC. Conclusions The SBC and ABC are bone pathologies with few retrospective studies, no previous studies on the two conditions, varied nomenclature, and atypical aspects in some cases. Therefore, the knowledge of clinical, imaging, and transoperative features of such pseudocysts are clinically valuable as diagnosis hypothesis of radiolucent lesions of the jaws. Key words:Simple bone cyst, aneurysmal bone cyst, pseudocysts, jaws.

OBJECTIVES: To explore the association between adiposity, major depressive disorder and generalized anxiety disorder, and to assess the role of inflammation, diet quality and physical activity in this association. METHODS: We used data from 2,977 individuals from the 1993 Pelotas Cohort (Brazil) who attended the 18- and 22-year follow-ups. We assessed general obesity using body mass index, fat mass index, and abdominal obesity using waist circumference. Major Depressive Disorder and generalized anxiety disorder were assessed using the mini-international neuropsychiatric interview. C-reactive protein and interleukin-6 (IL-6) levels were used as a measure of inflammation; diet quality was estimated using the revised diet quality index, and physical activity was assessed by the International physical activity questionnaire (IPAQ, min/day). The association between adiposity and major depressive disorder and generalized anxiety disorder was assessed using logistic regression, and the natural indirect effect via the mediators was estimated using G-computation. RESULTS: General obesity assessed by body mass index (OR: 2.3; 95% CI:1.13; 4.85), fat mass index (OR: 2.6; 95%CI: 1.37; 4.83), and abdominal obesity (OR: 2.5; 95%CI: 1.18; 5.39) were associated with higher odds of major depressive disorder, whereas major depressive disorder was only associated with obesity assessed by body mass index (OR=1.9; 95% CI: 1.09; 3.46). Obesity and generalized anxiety disorder were not associated. C-reactive protein, diet quality and physical activity did not mediate the effect of obesity on major depressive disorder, and C-reactive protein mediated about 25% of the effect of major depressive disorder on adiposity. CONCLUSIONS: Depression, but not generalized anxiety disorder, is associated with adiposity in both directions, with a stronger evidence for the direction obesity-depression. Inflammation explains part of the effect of major depressive disorder on obesity but not the other way around. Further research should explore other mechanisms that could be involved in the association between obesity and depression.

The aim of this study was to analyze the clinical features of BSCC in the oral cavity, diagnosed over 31 years of service in oral pathology, and make comparisons with the data reported in the literature. Data regarding gender, age, clinical presentation, anatomical location, symptoms, evolution time, size of lesion, and use of alcohol and tobacco from cases of BSCC were collected. Additionally, we conducted a review of BSCC studies from searches in three electronic databases. Among 24,570 oral biopsies, 7 (0.03%) were BSCC and represented 0.8% of oral squamous cell carcinoma (n = 875). All cases occurred in males, and the prevalent affected age was the sixth decade (60%). Ulcers occurred in all cases, with the majority showing no symptoms (71.4%). The tongue (30.8%), alveolar ridge/gingiva (30.8%), and floor of the mouth (23.1%) were the anatomical locations affected. The literature review indicated a total of fifteen publications, reporting 214 cases of BSCC. Males (76.7%) in the seventh (53.3%) decade of life were most affected. According to the cases with adequate information, symptomatic (90.0%) ulcers (80.0%) in the floor of the mouth (42.1%), with a mean size of 2 cm and the mean evolution time of 1.5 to 18 months were the most seen. Association with tobacco and alcohol use, when noted, was 50.0%. The features presented in this study are more similar than different when compared with the literature data.

To evaluate in vivo the bone tissue response of rats to varying amounts of infected and noninfected dentine debris.Bone tissue reactions were evaluated histologically in 42 Wistar rats after 7, 30 and 60 days. For each animal, three surgical cavities were prepared on the femur and filled with varying amounts (5, 10 or 20 mg) of infected or noninfected dentine debris pellets. In the negative control group, the surgical cavities were not filled. At the end of each experimental period, the animals were euthanized. The samples were processed histologically and analysed using a light microscope. The presence and the severity of inflammatory reaction, as well as hard tissue deposition were evaluated. Data were subjected to statistical analysis and the effects of the dependent variables calculated using nonparametric tests Kruskal-Wallis and Mann-Whitney U with due Bonferroni corrections at P = 0.05.At 7 days, the presence of infected debris significantly increased the histopathological scores for neutrophils (P 0.05), and abscess formation (P 0.05). Noninfected debris scored significantly higher for lymphocyte infiltrate compared with the control group and infected debris (P 0.05). Both infected and noninfected debris equally triggered eosinophil cells compared with no-dentine (P 0.05). As for giant cells and macrophages, no difference was detected amongst the dentine groups (P 0.05). Hard tissue deposition was similar regardless of the presence or the bacteriological status of the dentine (P = 1.00). None of the above histopathological parameters was significantly influenced by the amount of debris (P 0.05). For all parameters evaluated, at 7 days of analysis, the inflammatory response was significantly more intense compared with 30 and 60 days (P 0.05). Inflammatory parameters were scored similarly for the evaluated groups after 30 and 60 days (P 0.05). However, hard tissue deposition has significantly increased after 30 days (P 0.05). No difference was seen between 30 and 60 days of analysis (P = 1.00) for all histological parameters evaluated.The assumption that the amount of extruded debris may negatively affect the inflammatory response of bone tissue was not validated in the present in vivo animal study. Infected dentine may trigger acute inflammatory parameters especially during the first 7 days of contact with the tissue; however, in the long term, these negative effects are mitigated.

This study aimed to evaluate tumor budding (TB) and quantify the neutrophilic and lymphocytic infiltration in the invasive front of lip squamous cell carcinomas. In addition, the associations between these features and the histopathological grading in the invasive front were analyzed.A total of 43 lip squamous cell carcinoma surgical specimens were included and classified in accordance with a histological invasive front grading system. Immunohistochemistry was performed for CD66b and CD3 for the evaluation of neutrophils and T lymphocytes, respectively, in the invasive front of the tumors. Tumor budding was evidenced by AE1/AE3 staining.Thirty-six (83.7%) of the tumors were well-differentiated tumors. Eleven (25.6%) of the cases exhibited high-intensity tumor budding. There were low neutrophil and high T lymphocyte infiltrations in the invasive front, leading to a low neutrophil/T lymphocyte ratio in the same region. Moreover, we found an association between tumor budding and the pattern of invasion, and between the CD3The low neutrophil and high T lymphocyte infiltration in the invasive front, and the few high-intensity tumor budding cases are in accordance with the histopathological features of well-differentiated lip tumors. If these characteristics remain in lip squamous cell carcinomas with more aggressive histopathological features, it deserves to be investigated.

Reports of rare oral complications as osteonecrosis and spontaneous exfoliation of teeth have been reported after herpes zoster (HZ) infection. A 57-year-old male patient was referred for periodontal evaluation because of gingival bleeding. The patient’s medical history included a diagnosis of chronic lymphocytic leukemia and previous HZ infection. Intraoral examination revealed a redness around the left anterior inferior gingiva and necrosis and alveolar bone exposure around tooth 32. Alveolar bone exposure with spontaneous tooth exfoliation of tooth 21 was noted. Radiographically, the radiolucent area surrounding the tooth 32 and the outline of the socket of the exfoliated tooth 21 were visible. Conservative surgical and antibiotic therapy were performed. The diagnosis of osteonecrosis of the jaw following HZ infection was established. The patient is in follow-up for 1.5 years without signs of recurrence. Clinicians should be aware of unusual complication related to the previous infection of HZ.

Objective This study aimed to describe the morphologic characteristics of lip squamous cells carcinomas focusing in the invasive front and its association with tumor budding, and the presence of neutrophils and T lymphocytes. Study Design We included 43 surgical specimens of lip squamous cells carcinoma and classified them in accordance with a histologic invasive front grading system. Immunohistochemistry was performed for CD66b and CD3 for evaluation of neutrophils and T lymphocytes, respectively, in the invasive front of the tumors. Tumor budding was evidenced by AE1/AE3 staining. Results Thirty-six (83.7%) tumors were well-differentiated tumors. Eleven (25.6%) cases exhibited high-intensity tumor budding. There were low neutrophil and high T lymphocyte infiltrations in the invasive front, leading to a low neutrophil to T lymphocyte ratio in the same region. Moreover, we found an association between tumor budding and pattern of invasion, and also between CD3+ cell count and inflammatory infiltrate (P Conclusions The few cases showing high-intensity tumor budding, as well as the low neutrophil and high T-lymphocyte infiltration in the invasive front, are in accordance with the histopathological features of well-differentiated tumors. These morphologic parameters should be adjunct tools in the evaluation of lip squamous cell carcinomas. Support: FAPEMIG.

Objectives The aim of this study was to integrate the available data published on intravascular papillary endothelial hyperplasia (IPEH) into a comprehensive analysis of their clinic, radiographic, and imaginologic features, treatment, and recurrence. Methods An electronic search was undertaken in April 2018 in 3 databases, including cases reports and cases series of IPEH. Eligibility criteria included publications having enough clinical, radiologic, and histopathologic information to confirm a definite diagnosis of the lesion. Results Thirty studies were included in the systematic review with 86 cases of IPEH. The mean age was 46 years—with a predilection for females (55%). Asymptomatic (88%) lesions on the lower lip (39%), with a clinical presentation of firm nodular lesion, bluish, or reddish coloration and mean size of 1.6 cm were the most observed. When intraosseous, the radiographic features were multilocular radiolucent area. Of informed cases, treatment chosen was excisional biopsy (96%) and no recurrence was observed. The diagnostic hypothesis most prevalent was hemangioma, in 27 cases (31%). Conclusions The features presented in this study are more similar to than different from those reported in the literature.

Oral metastatic tumors are rare and usually indicate late stage of the disease. A 50-year-old female patient with previous medical history of treatment for colon adenocarcinoma 2 years earlier was referred for evaluation of an asymptomatic lesion with 1 month of evolution. Additionally, the patient was under investigation of bone metastasis. Extraoral examination did not detect lymph nodes. Intraoral examination revealed a pedunculated reddish-purple nodule measuring around 3.0 × 2.0 cm in the gingiva of the posterior left maxilla with bleeding to palpation. Cone beam computed tomography showed bone loss surrounding the molar region. An excisional biopsy was performed, and according to the microscopic and immunohistochemistry findings, the final diagnosis of colon adenocarcinoma metastasis was established. Metastasis in L2 vertebra also was confirmed. A palliative radiotherapy/chemotherapy was established; however, the patient died 1 month after the diagnosis. Metastatic tumors should be considered as differential diagnosis of oral lesions in patients with history of malignant neoplasms.

Objectives To analyze the clinical and radiographic features of focal osteoporotic marrow defect (FOMD) from 2 Brazilian oral pathology services and to discuss these findings in light of the literature. Study Design Data regarding age, sex, anatomic location, symptoms, radiographic features, size of lesion, and diagnostic hypotheses from cases of FOMD were collected. Additionally, an electronic search was undertaken in April 2018, including cases reports and cases series of FOMD. Results Among 61,754 oral biopsies, 28 (0.04%) were FOMD. The mean age was 39.6 years and 20 (74.1%) cases occurred in females. An asymptomatic (75.0%) radiolucent (87.5%) lesion, with a mean size of 1.3 cm in the posterior mandible (77.8%) was the most common characteristic found. Fifteen cases were obtained on systematic review. The mean age was 50.1 years—with a predilection for females (73.3%). Asymptomatic (66.7%) lesions on the posterior mandible (80.0%), with a radiolucent aspect (93.3%) and a mean size of 2.3 cm were more observed. FOMDs were present in diagnostic hypotheses in 15.8% and 14.3% of multicenter cases and systematic reviews, respectively. Conclusions The features presented in this study have more similarities than differences when compared to those reported in the literature. Support: FAPEMIG.

To evaluate bone tissue reactions in rats to an MTA-based endodontic sealer with and without the addition of various concentrations of C3A or C3A + Ag.Bone tissue reactions were evaluated in 45 Wistar rats after 7, 30 and 90 days (n = 5 per period). Three surgical cavities were prepared on the right femur and filled with 0.2 mL MTA Fillapex, MTA Fillapex + C3A and C3A + Ag at various concentrations: AH Plus (Dentsply DeTrey GmbH, Konstanz, Germany), EndoSequence BC (Brasseler USA, Savannah, GA, USA) or no sealer (negative control). By the end of each experimental period, animals were randomly euthanized. The samples were histologically processed and analysed using a light microscope. The presence of inflammatory cells, fibres and hard tissue barrier formation was evaluated. Data were analysed statistically using nonparametric tests to compare the differences between groups. Multiple groups were compared using the Kruskal-Wallis and Mann-Whitney U-tests with a Bonferroni correction at P = 0.05.The inflammatory response significantly decreased from 30 to 90 days (P 0.05). Fibre condensation was similar amongst the groups at 07 and 30 days after intervention (P 0.05). At 90 days, however, fibres were absent in most specimens of EndoSequence BC Sealer, AH Plus, MTA Fillapex and the control group, whilst they were still observed in samples of the modified sealers (P 0.05). At 90 days, all specimens of AH Plus, EndoSequence BC Sealer and control group had complete formation of hard tissue barrier. In the MTA Fillapex group, as well as in the modified sealers groups, partial deposition of mineralized tissue was noticed.The hypothesis tested that the incorporation of C3A and C3A + Ag particles to MTA Fillapex would improve bone tissue repair was partially accepted, since modified MTA Fillapex did not have the same repair potential as the commercial bioceramic material.

OBJECTIVE To evaluate the prevalence and demographic, socioeconomic, behavioral and health factors associated with depressive symptomatology in rural residents. METHODS This is a population-based, cross-sectional study with a representative sample of 1,453 residents aged 18 years or over of the rural area of the city of Pelotas, State of Rio Grande do Sul, Brazil. We used the Edinburgh Postnatal Depression Scale to evaluate depressive symptomatology, considering the cutoff point ≥ 8 points. We evaluated the association between the outcome and the independent variables using Poisson regression. RESULTS The prevalence of depressive symptomatology was 35.4% (95%CI 31.5–39.3). After adjustment, the depressive symptomatology was higher among women (PR = 1.77, 95%CI 1.46–2.15), individuals with low education level (0–4 years of study) (PR = 1.62, 95%CI 1.22–2.16), worse socioeconomic conditions (classes D or E) (PR = 1.49, 95%CI 1.22–1.83), and with chronic diseases (PR = 1.74, 95%CI 1.24–2.45). CONCLUSIONS The high prevalence of depressive symptomatology in rural residents indicates the relevance of depression as an important public health problem in this population. Specific attention should be aimed at the subgroups that presented the highest prevalence of symptomatology. RESUMO OBJETIVO Avaliar a prevalência e os fatores demográficos, socioeconômicos, comportamentais e de saúde associados à sintomatologia depressiva em moradores na zona rural. MÉTODOS Estudo transversal de base populacional realizado com amostra representativa de 1.453 residentes na zona rural do município de Pelotas, RS, com 18 anos ou mais. Utilizou-se a Escala de Depressão Pós-Natal de Edimburgo para avaliar a sintomatologia depressiva, considerando ponto de corte ≥ 8 pontos. A associação entre o desfecho e as variáveis independentes foi avaliada por regressão de Poisson. RESULTADOS A prevalência de sintomatologia depressiva foi de 35,4% (IC95% 31,5–39,3). Após o ajuste, a sintomatologia depressiva foi maior entre as mulheres (RP = 1,77; IC95% 1,46–2,15), indivíduos com baixa escolaridade (0–4 anos completos de estudo) (RP = 1,62; IC95% 1,22–2,16), pior condição socioeconômica (classes D ou E) (RP = 1,49; IC95% 1,22–1,83) e com doenças crônicas (RP = 1,74; IC95% 1,24–2,45). CONCLUSÕES A alta prevalência de sintomatologia depressiva em moradores rurais indica a relevância da depressão como importante problema de saúde pública também nessa população. Atenção específica deve ser direcionada aos subgrupos que apresentaram as maiores prevalências de sintomatologia.

Resumo Objetivo: estimar a prevalência de incapacidade funcional para atividades básicas e instrumentais da vida diária e sua associação com características socioeconômicas, demográficas, comportamentais e de saúde em idosos. Métodos: estudo transversal de base populacional realizado em Pelotas, Rio Grande do Sul, Brasil, em 2014; as escalas de Katz e de Lawton foram utilizadas para definição dos desfechos; empregou-se regressão de Poisson. Resultados: foram incluídos 1.451 idosos; a prevalência de incapacidade funcional foi de 36,1% para atividades básicas, 34,0% para instrumentais e 18,1% para ambas; maiores prevalências de incapacidade funcional foram observadas em idosos ≥80 anos (RP=3,01; IC95% 2,17;4,18), que não trabalhavam (RP=2,02; IC95% 1,13;3,60)) e com múltiplas morbidades (RP=3,28; IC95% 1,38;7,79); e menores naqueles com ≥12 anos de estudo (RP=0,40; IC95% 0,24;0,66), e que eram ativos no lazer (RP=0,42; IC95% 0,21;0,82). Conclusão: as incapacidades funcionais associaram-se a maior idade, menor escolaridade e multimorbidades. Resumen Objetivo: estimar la prevalencia de discapacidad funcional para actividades básicas e instrumentales de la vida diaria en ancianos y evaluar su asociación con características socioeconómicas, demográficas, conductuales y de salud. Métodos: estudio transversal de base poblacional realizado en Pelotas, Brasil, en 2014; las escalas de Katz y Lawton fueron empleadas para evaluar discapacidades; fue utilizada regresión de Poisson. Resultados: fueron incluidos 1.451 ancianos; la prevalencia de discapacidad fue 36,1% para actividades básicas, 34,0% para instrumentales y 18,1% para ambas; la prevalencia de discapacidad funcional fue mayor entre individuos ≥80 años (RP=3,01; IC95% 2,17;4,18), que no trabajaban (RP=2,02; IC95% 1,13;3,60) y con múltiples morbilidades (RP=3,28; IC 95% 1,38;7,79); y menores entre individuos con ≥12 años de escolaridad (RP=0,40; IC95% 0,24;0,66), y que eran activos físicamente (RP=0,42; IC95% 0,21;0,82). Conclusión: la discapacidad funcional estuvo asociada a mayor edad, menor escolaridad y múltiples morbilidades. Abstract Objective: to estimate the prevalence of disability related to basic and instrumental activities of daily living and its association with socioeconomic, demographic, behavioral and health characteristics in the elderly. Methods: population-based cross-sectional study in Pelotas, Brazil, in 2014; Katz and Lawton scales were used to assess the outcomes using Poisson regression. Results: the study included 1.451 elderly individuals; the prevalence of disability for basic and instrumental activities was 36.1% and 34.0%, respectively, and 18.1% in both; higher prevalence of functional disability were observed individuals ≥80 years (PR=3.01; 95%CI 2.17;4.18), not working (PR=2.02; 95%CI 1.13;3.60) and those with multiple morbidities (PR=3.28; 95%CI 1.38;7.79); and lower in individuals with ≥12 years of schooling (PR=0.40; 95%CI 0.24;0.66), and that were physically active (PR=0.42; 95%CI 0.21;0.82). Conclusion: functional disability was associated to individuals older than 80, with less schooling years and affected by multiple morbidities.

The aim of this study was to describe 40 cases of acquired oral syphilis (AOS) and to discuss the distribution of demographic characteristics, clinical features, and differential diagnosis of the disease. A retrospective study was conducted covering a 17-year period at a single institution in southern Brazil. Moreover, a literature review was performed through a search of the PubMed database for articles on AOS published between 1955 and March 2018. Data were analyzed descriptively. The predominant group within the case series was male patients in their twenties. The vast majority of cases (92.5%) were in the secondary stage of the disease. The lips were the most commonly affected site, with greyish-white mucous patches and reddish ulcers. In the literature review, the largest number of reported cases came from North America. Male patients in the third and fourth decades of life were most affected. AOS occurred more commonly as mucous patches and ulcers on the tongue and palate. Similarities regarding the distribution by sex, age, and anatomical location were found in the present study when compared to cases reported elsewhere. Clinicians, oral pathologists, and maxillofacial surgeons should familiarize themselves with the variable spectrum of signs and symptoms of AOS in their clinical practice to improve diagnosis and management.