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The association between periodontitis and myocardial infarction remains unclear in the literature. Few studies have addressed periodontitis exposure as a predisposing factor for the development of myocardial infarction. Therefore, the present systematic review aims to analyze the association between periodontitis and myocardial infarction. This meta-analysis systematically searched MEDLINE, EMBASE, The Cochrane Controlled Trials Register, SCIELO, LILACS, CINAHL, Scopus, Web of Science and grey literature for studies estimating the association between periodontitis and myocardial infarction. Quality of evidence was assessed for all studies. The meta-analysis was conducted using random-effects models. Four of the six studies selected were included in the meta-analysis, including 1,035,703 subjects. The association between periodontitis and myocardial infarction was: RR: 5.99 (95% CI: 1.17-30.68), but with high heterogeneity (I2 = 100%; p

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.

Xerostomia and hyposalivation are frequent conditions in patients undergoing head and neck radiotherapy, which usually lead to a worsening of quality of life. This study aimed to assess whether photobiomodulation (PBM) can minimize hyposalivation, xerostomia and qualitative changes on saliva and improve quality of life in patients undergoing radiotherapy in short-term follow-up. Twenty-one patients were randomly divided into two groups: sham group (SG) and laser group (LG). A diode laser was used for intra- (660 nm, 10 J/cm2, 0.28 J per point, 40 mW) and extra-oral (810 nm, 25 J/cm2, 0.7 J per point, 40 mW) applications over the salivary glands, three times a week, during the entire radiotherapy period. In SG, the tip of the instrument was sealed with blue rubber to prevent the passage of light. Xerostomia and pH were evaluated and unstimulated and stimulated salivary flow was determined before the start of radiotherapy (T1), after the 15th session (T2), after the end of radiotherapy (T3) and 60 days after radiotherapy (T4). Concentrations of calcium, total proteins, chloride, sodium, potassium and amylase and catalase activities were evaluated in stimulated saliva samples. Quality of life was assessed at times T1 and T4. Generalized estimating equations were used to assess differences in the outcome between times and groups. All patients showed worsening in unstimulated (p = .003) and stimulated (p

Oral cavity metastases are rare events and occur mainly in the jaws compared with the soft tissues. A 69-year-old Caucasian woman was referred to the stomatology service complaining of a bleeding oral lesion, which developed 4 months before the appointment. The patient had a renal adenocarcinoma, which was treated with right radical nephrectomy and chemotherapy. Immunotherapy with nivolumab was started 1 month before the lesion appearance. On examination, we observed an erythematous, pediculated mass, about 1.5 cm in diameter, with ulcerative surface on the right buccal mucosa. An incisional biopsy was performed, and the microscopic exam revealed the presence of clear epithelial cells and intense vascular neoformation. Immunohistochemical analysis was positive for cytokeratins AE1 and AE3 and PAX8, confirming the diagnosis of metastatic clear cell from the renal adenocarcinoma. The patient died in the same year, as the result of the disease progression.

Multiple myeloma is a multifocal plasma cell proliferation in the bone marrow. Its occurrence in the jaws is frequent; however, oral lesions rarely appear as a primary manifestation of the disease. A 66-year-old man complained of a painful swelling in his mouth, which had evolved over 4 months. At the examination, an extensive lesion in the left mandibular region was observed. The computed tomography demonstrated an osteolytic lesion measuring 4 × 2.5 cm, associated with a pathologic fracture of the mandible body. A biopsy revealed a malignant neoplasia with proliferation of lymphoid and plasmacytoid cells. Immunohistochemical examination was positive for antibodies CD138, CD56, Ki-67, and lambda light chains. Confirmation of the diagnosis of multiple myeloma occurred with the observation of osteolytic areas in multiple regions of the skull. The patient was referred to the oncology department; however, he died before starting the treatment.

A 70-year-old Caucasian female presented with multiple small, firm, yellowish nodules in the mucosa of the lower and upper lips, buccal mucosa, and dorsal and ventral surfaces of the tongue. Medical history of the patient included carpal tunnel syndrome surgery, systemic arterial hypertension, osteoarthritis, osteoporosis, and hypercholesterolemia. Laboratory tests showed serum levels of thyroid-stimulating hormone (TSH) at 6.56 UI/µmL, leukocyte count of 3,400/mm³, and erythrocyte sedimentation rate of 36 mm/1 h. A biopsy of the oral lesions was performed, and the histopathologic examination revealed connective tissue with deposits compatible with amyloid material, which was also observed in the Congo red examination. Concurrently, chest radiograph, serum protein electrophoresis, C-reactive protein, urea and creatinine, and urinalysis were performed and did not reveal any alterations. The patient was referred to the rheumatologist and is now undergoing follow-up.

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.

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.