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Background The aim of this retrospective, cross-sectional and observational study was to perform a survey of the stomatological conditions of elderly patients seen in a period of 40 years at a Stomatology Service in Southern Brazil. Material and Methods A total of 24,347 medical records were reviewed, of which 5,063 belonged to elderly patients aged 60 to 97 years. The stomatological conditions, systemic conditions, and smoking and alcohol drinking habits as well were recorded. Results The mean age of the patients was 69.29 years, 67.1% were female and 32.9% were male. Variations of normality accounted for 44.5% of the cases. The most prevalent disorders were fungal infections (26.1%), reactive inflammatory lesions (24.6%), burning mouth syndrome (14.9%), benign neoplasms (12.4%), autoimmune disorders (12.3%), premalignant lesions (10.2%) and malignant epithelial neoplasms (7.2%). Regarding biopsied lesions, squamous cell carcinoma was the most prevalent at 30.2%, followed by hyperplasic lesions (28.2%). Conclusions Knowledge of these physiological and pathological conditions in the oral cavity of the older people is essential for early diagnosis and preventive and therapeutic measures when necessary. Key words:Oral mucosa, aged, oral medicine, elderly, oral lesions.

Head and neck radiotherapy can cause hypofunction of the salivary glands. Many studies report that laser photobiomodulation (PBM) is able to minimize radiation-induced hyposalivation, yet there is no consensus about its effects.To carry out a meta-analysis of controlled clinical trials that used PBM to prevent radiation-induced hyposalivation.A systematic search was performed through Embase, Medline/PubMed, Cochrane, EBSCO, Scopus, LILACS and Web of Science databases. The strategy included comparisons of the effect of PBM with placebo/clinical follow-up on unstimulated and/or stimulated salivary flow in patients undergoing head and neck radiotherapy.Six clinical trials were included, five of which were used for meta-analysis. Evidence was observed between the use of PBM and increased unstimulated salivary flow (MD 0.20 mL/min, 95 % Cl 0.10-0.30, I² = 96 %, p0.00001) and in stimulated salivary flow (MD 0.27 mL/min, 95 % CI 0.08-0.46, I² = 95 %, p0.00001).PBM appears to minimize radiation-induced hyposalivation.

The aim of this paper was to review the current literature with regard to the use of chlorhexidine and povidone-iodine in the treatment of oral wounds.Oral mucosa is continuously subjected to physical or chemical injuries, where it becomes a common site for the occurrence of ulcerated lesions. These lesions are susceptible to infections that may delay healing.A search of the medical and dental literature was conducted in Medline/Pubmed and Scielo using a combination of the terms oral ulcer, oral wound, wound healing, povidone-iodine and chlorhexidine, to review their mechanism of action and their use in the healing of oral wounds.The use of chlorhexidine and povidone-iodine is effective in the control of local infection in a concentration-dependent manner, exerting a positive influence on the tissue repair process. Oral antiseptics appear be a good alternative in the management of these lesions, since there is a low risk of systemic toxicity and allergies, and less clinical evidence of bacterial resistance.

Objective To evaluate the effect of topical application of 10% chamomile extract and 2% curcumin gel in the oral ulcers of the rats. Study Design Thirty-nine Wistar rats were divided into 3 groups: the chamomile group, the curcumin group, and the control group. A 5-mm circular excision wound was made with sterile punch in the tongue of rats; Chamomile extract, curcumin, and vehicle gel were applied 2 times per day for 5 days on the oral ulcers, all animals were euthanized on the sixth day postoperatively. Results There was no significant difference between the groups in relation to area of residual ulcer (P = .20), newly formed epithelium (P = .97), and intensity of inflammatory infiltrate (P = .724). Conclusions Chamomile and curcumin had no effect on accelerating the healing of oral ulcers or reducing the inflammatory process.

Uremic stomatitis represents an unusual condition associated with uremia in patients with renal failure. A 29-year-old man with chronic renal failure on hemodialysis was referred by nephrology service because of complaint of multiple painful oral lesions. The patient had been hospitalized for fever associated with severe pancytopenia and elevated levels of creatinine and urea (16.10 mg/dL and 251 mg/dL, respectively). On physical examination, the patient presented with whitish plaques interspersed by reddish areas of atrophy and epithelial erosion and few ulcerated areas dispersed in the upper and lower labial mucosa, bilateral buccal mucosa, bilateral tongue border, ventral surface of tongue, floor of the mouth, labial commissures, soft palate, and lower lip vermillion. Chlorhexidine 0.12% mouthwash was prescribed to assist in oral antisepsis. Laser therapy was performed periodically for local analgesia. The oral lesions regressed spontaneously as the serum levels of urea decreased with hemodialysis.

Objective This study investigated the effect of topical application of 0.12% chlorhexidine, 10% povidone-iodine, and 50% erythromycin on the optimization of healing process of traumatic ulcers made on tongue of rats. Study Design Forty-eight Wistar rats were divided into 4 groups: control, chlorhexidine (Chx), povidone-iodine (PvI), and erythromycin (Er). An ulcer of 5 mm in diameter was made on the ventral tongue of the animals. After 24 hours, a microbiologic sample was taken and daily application of the substances started. Six animals from each group were euthanized at 4 days and the others at 8 days postoperative. Before euthanasia, a new microbiologic collection was performed. Results The experimental groups showed less area of residual ulcer. A significant difference was seen between the PvI and Chx in relation to the control after 3 days of treatment. Er exhibited the lowest inflammation scores after 7 days of treatment. PvI showed reduction of microorganisms at both times and under aerobic and microaerophilic conditions. Er significantly reduced the count of microorganisms in aerobic condition compared with control group. Conclusions All drugs promoted reduction of the microorganisms at the site of the injury, which may have a direct effect on the tissue repair process.

A 63-year-old white female patient who underwent renal transplant was referred by the oral surgeon to the oral medicine unit. She complained of discomfort on the left maxilla evolving for 3 months. She was taking mycophenolate mofetil prescribed by the nephrologist. As a previous treatment of the lesion, tooth 24 was treated endodontically, but no improvement was noted. Intraoral physical examination showed yellowish ulcerated lesion of firm consistency on the hard palate (region 23 to 26) with superficial necrosis. The presence of a submucosal nodule in the vestibule (region 43 to 45) was also observed. Clinically, the palatine lesion was compatible with neoplasia and the submucosal nodule with salivary retention cyst. Imaging and preoperative examinations were requested for posterior incisional biopsy of the 2 lesions. Histopathologic diagnosis (hematoxylin and eosin and immunohistochemistry) was double non-Hodgkin´s lymphoma. She was referred for treatment at the oncology department.

The increasing demand for cosmetic procedures in the orofacial area results in a growing number of complications, including the development of foreign body granulomas. A 55-year-old woman presented with submucosal and subcutaneous nodules that were firm on palpation, which had arisen approximately 30 days earlier in the right buccal mucosa and in the face (cervical, submentonian, and submandibular regions). The diagnostic hypothesis was lymphoma, but after the clinical examination, the patient reported having undergone facial filling procedure 1 year before. Ultrasonography showed nodular images suggestive of reactive granulomas. Preoperative tests were requested, and incisional surgical biopsy was performed. Histologic analysis showed granulomatous reactions associated with the use of hyaluronic acid (accumulation of amorphous basophilic material) and polymethylmethacrylate (refringent material, without dye impregnation). The patient was unaware of the facial filling with polymethylmethacrylate.

This study investigated the effect of topical application of 0.12% chlorhexidine, 10% povidone-iodine and 50% erythromycin on the optimization of healing process of traumatic ulcers made on ventral tongue of rats.Forty-Eight Wistar rats were randomly divided into four groups: control, chlorhexidine (Chx), povidone-iodine (PvI) and erythromycin (Er). An ulcer of 5 mm in diameter was made on the ventral tongue of the animals. After 24 h, a microbiological sample was taken and daily application of the substances started. Six animals each group were euthanized at 4 days and the others at 8 days postoperative, totaling three and seven days of treatment. Prior to euthanasia, a new microbiological collection was performed.The experimental groups showed less area of residual ulcer. A significant difference was seen between the PvI and Chx in relation to the control after three days of treatment (p 0.05). Although the experimental groups displayed greater newly formed epithelial area, there was no significant difference compared to the control (p 0.05). Er exhibed the lowest inflammation scores after seven days of treatment (p 0.05). PvI showed reduction of microorganisms at both times and under aerobic (p 0.01 at 3 days and p 0.001 at 7 days) and microaerophilic (p 0.05) conditions. Er significantly reduced the count of microorganisms in aerobic condition when compared to control group (p 0.05 at 3 days and p 0.01 at 7 days).All drugs promoted reduction of the microorganisms at the site of the injury, which may have a direct effect on the tissue repair process.