- Email: [email protected]
PREVENTION PROTOCOL FOR BISPHOSPHONATE-RELATED OSTEONECROSIS OF THE JAWS IN A PATIENT WITH HIV
OOOO Volume 129, Number 1 the professional/student. As the user creates interest in the topics covered, it is expected that they seek to deepen their knowledge in the available bibliography. Conclusion: Given the great adhesion to smartphones by the general population, this tool serves as a source of research and contributes to the dissemination of specialized content, making it possible to generate faster and more accurate diagnoses.
TRENDS IN MORTALITY DUE TO ORAL AND OROPHARYNGEAL CANCERS IN URUGUAY FROM 1997 TO 2014. MARIA LAURA COSETTI, AMANDA RAMOS DA CUNHA, TAIANE SCHAEDLER PRASS, MARCO ANTONIO TREVIZANI MARTINS, VINICIUS COELHO CARRARD, FERNANDO NEVES HUGO and, MANOELA DOMINGUES MARTINS Objective: To analyze the trend of oral and oropharyngeal cancer mortality in Uruguay between 1997 and 2014 and the rates by age, sex, and departments of the country. Study Design: A time-series ecological study with secondary data. To establish an estimation of the mortality trend of the historical series, by sex, anatomic site, and age groups, linear regressions were generated by the Prais-Winsten procedure. Results: Between 1997 and 2014, there were 1696 deaths from oral cancer and oropharyngeal cancer in Uruguay. The male to female ratio was 3.23:1. Malignant neoplasm of tongue presented the highest mortality rate. The mortality rate was relatively stable (total and by sex) in all age groups studies. Means of the annual coefficients were higher for the age groups between 50 and 79 years. In women, the trend remained stable in the different departments of the country, except in Lavalleja and Maldonado where there was an increase, while in men a decrease in Artigas and Rivera was observed. Conclusion: The mortality for oral and oropharyngeal cancer in Uruguay has remained constant for the period of 1997 to 2014. Prevention strategies and early diagnosis are necessary to improve survival.
ORAL HEALTH, HEALTH-RELATED QUALITY OF LIFE, AND WORK ABILITY AMONG PATIENTS WITH CHRONIC LIVER DISEASE. LARISSA SOUZA SANTOS, FERNANDO MARTINS CARVALHO, VIVIANE ALMEIDA SARMENTO, LIANA CODES, MARIA AUXILIADORA EVANGELISTA, ALESSANDRA DE OLIVEIRA CASTRO and, LILIANE LINS Oral infections are common causes of morbidity and mortality among patients with chronic liver diseases (CLD). Objective: To evaluate health-related quality of life (HRQoL), work ability, and oral health among patients with CLD. Study Design: Cross-sectional study with 25 patients on the transplantation waiting list (group 1) and 25 patients with CLD (group 2) attended in a university hospital in Salvador, Brazil. HR-QoL and work ability were evaluated using standardized questionnaires (36-Item Short-Form Health Survey [SF-36] and Wok Ability Index [WAI], respectively). Oral health (DMFT index and periodontal disease) was evaluated using World Health Organization protocol. Mean differences were compared using t tests for independent samples. Results: The mental component summary of HR-QoL was lower in group 1 than in group 2 when WAI was low/moderate (43.3 § 9.1 vs 51.8 § 7.5, respectively; P = .003) or when
ABSTRACTS
e131
gingivitis occurred (42.7 § 9.3 vs 50.4 § 3.6; P = .001); the physical component summary of HR-QoL was lower when periodontitis occurred (35.7 § 10.2 vs 48.8 § 6.4; P = .003). The groups presented similar DMFT index (19.1 § 8.3 vs 18.7 § 7.9; P = .86). Conclusions: Compared with patients with CLD, patients with CLD on the transplant waiting list presented lower HR-QoL because of its mental component when low work ability and gingivitis occurred; periodontitis was associated with low HR-QoL because of its physical component.
POLYMORPHISMS ASSOCIATED WITH ORAL CLEFTS AS POSSIBLE MARKERS OF SUSCEPTIBILITY FOR BREAST CANCER AND ORAL CANCER. EDIMILSON MARTINS DE FREITAS, RENATO ASSIS MACHADO, EDILMAR DE MOURA SANTOS, FELIPE RODRIGUES DE MATOS, ROSEANA DE ALMEIDA FREITAS, RICARDO D. COLETTA and, HERCILIO MARTELLI JUNIOR Objective: To evaluate the association of single nucleotide polymorphisms (SNPs) in the genes/loci IRF6, WNT3 A, GSK3 B, 8 q24, and WNT11, representing regions consistently altered in nonsyndromic oral clefts with breast and oral cancers in the Brazilian population. Study Design: We performed a case-control study with association of SNPs rs642961 (IRF6), rs708111 (WNT3 A), rs9879992 (GSK3 B), rs987525 (8 q24), and rs1533767 (WNT11) in 159 samples from breast cancer patients and 79 patients with oral squamous cell carcinoma. A total of 121 female controls (breast controls) and 130 oral cancer controls were used. Logistic regression analysis was used to adjust for confounding factors. A value of P < .05 was considered statistically significant. The study was approved by the ethics committees of the hospitals affiliated to the study. Results: Although our results have not demonstrated association between frequencies of SNP genotypes in IRF6, WNT3 A, GSK3 B, 8 q24, and WNT11 and the risk of breast and oral cancers, gene-gene interactions were associated. Conclusion: Our data revealed an association between gene-gene interactions in IRF6, WNT3 A, GSK3 B, 8 q24, and WNT11 at risk of breast cancer and oral squamous cell carcinoma in a Brazilian population. Additional experiments and large-scale independent studies in other ethnic populations are needed to confirm our results.
PREVENTION PROTOCOL FOR BISPHOSPHONATE-RELATED OSTEONECROSIS OF THE JAWS IN A PATIENT WITH HIV. NATHALIA DE ALMEIDA FREIRE, FERNANDA VIEIRA HEIMLICH, MARIA ELIZA BARBOSA RAMOS, SARAH APARECIDA ^ e ISRAEL FERREIRA ANTERO and, MONICA SIMOES Objective: To describe a preventive dental protocol for medication-related osteonecrosis of the jaw (MRONJ) in patients with HIV before and after bisphosphonate therapy. Study Design: Development of the protocol was based on literature review of articles, book chapters, and theses in the last 10 years. Results: The proposed protocol focuses on 3 groups of patients with HIV: Patients diagnosed as having osteoporosis who have not started treatment with bisphosphonates; patients at
ABSTRACTS
e132
OOOO January 2020
risk for developing MRONJ, and stage 0 patients. It should be noted that certain features of the preventive protocol stages, such as the shorter breaks between appointments and the early application of low-power laser therapy, take into account the possibility of greater severity and/or fastness in MRONJ signs and symptoms in patients with HIV. Conclusion: Although the steps of the protocol are simple, they require technical-scientific knowledge by the dentist and the application of laser therapy, a particularity that may constitute a challenge for the adoption of such protocol in the Brazilian public health service. The role of dentistry in the multidisciplinary approach of patients with HIV still lacks on the AIDS protocols and guidelines offered by the Brazilian Ministry of Health. Because these documents may influence medical opinions and behaviors, it seems appropriate to emphasize this gap on such system.
differentiated carcinomas (group 1) and moderately/poorly differentiated (group 2). For analysis of TATE, the histologic slides were stained with Congo red, and stromal eosinophils were counted in 5 consecutive high-power fields using Image J 1.45 s. The SE count was performed by XE-2100 D Sysmex automated system after venous puncture. Of the 113 patients, 83 were from group 1 and 30 were from group 2. Most of the patients were white, smokers, alcoholics, and manual workers. Stage II of the disease predominated in both groups, and 8 patients died. There was no statistical difference between the groups in relation to TATE or SE (P = .16 and P = .19, respectively). However, there was a positive correlation between the TATE and SE (r = + 0.417, P = .048). TATE is directly associated with SE in OSCC patients, having no association with tumor aggressiveness, survival, or other clinical parameters.
VARIATION OF SALIVARY FLOW RATE IN DIFFERENT ANTINEOPLASTIC TREATMENTS. JULIANA BORGES DE LIMA e BISPO, HAYANA RAMOS DANTAS, MAYARA SIMOES LIMA, ALENA RIBEIRO ALVES PEIXOTO MEDRADO, ^ MANOELA CARRERA, ELISANGELA DE JESUS CAMPOS and, GABRIELA BOTELHO MARTINS
SECRETORY CARCINOMA OF SALIVARY GLANDS: WHERE ARE WE?. THAYANA ALVES, LEANDRO DE SOUZA THIAGO, LUIZ HENRIQUE DE LIMA ARAUJO, HELITON SPINDOLA ANTUNES, ANDREIA CRISTINA DE MELO, LUIZ CLAUDIO SANTOS THULER and, DANIEL COHEN GOLDEMBERG
Objective: To investigate salivary flow changes during the treatment of patients submitted to head and neck radiotherapy (HNR) and/or exclusive chemotherapy. Study Design: Prospective cross-sectional study with 61 patients divided into 2 groups: GT1 (n = 20)—individuals with malignant neoplasms in any region of the body, except head and neck, submitted to exclusive chemotherapy; GT2 (n = 41)—individuals in HNR associated or not with chemotherapy. Salivary flow examination was performed by an interval of 7 days among them: 3 samples for GT1 (baseline, 7 and 14 days after first infusion) and 5 for GT2 (baseline, 6th, 12th, 18th, and 24th HNR sessions). The GT2 group was subdivided based on the irradiation fields in 3 subgroups: face, neck, and face/neck. Results: There was an increase in the salivary flow of the GT1 group and a negative D for the GT2 group, which represented a statistical difference for the salivary flow variations between the treatment groups (P < .001). However, it was not possible to verify differences between the evaluated irradiated fields. Conclusion: HNR was able to reduce salivary flow rate significantly, whereas chemotherapy did not seem to influence salivary production.
Secretory carcinoma, described as mammary analog secretory carcinoma, is a recently described tumor of salivary glands that is defined by its histologic, immunophenotypic, and genetic similarities to the secretory breast carcinoma and is characterized by ETV6 translocation. The first description of mammary analog secretory carcinoma was reported by Skalova et al. in 2010. Retrospective studies showed that some tumors of salivary glands such as acinic cell carcinoma, low-grade salivary duct carcinoma, adenocarcinoma/cystadenocarcinoma not otherwise specified (NOS), and low-grade mucoepidermoid carcinoma were misdiagnosed. The purpose of this study is to review the literature showing the differential characteristics among these tumors and secretory carcinoma, highlighting how to perform the correct diagnosis, giving the patients the right treatment and improving their prognosis. Potential target therapy is also approached.
SERUM EOSINOPHILS AND TUMOR-ASSOCIATED TISSUE EOSINOPHILIA IN PATIENTS WITH ORAL SQUAMOUS CELL CARCINOMA. ROGERIO GONDAK, HANNAH KARYN DA SILVA, GEORGIA MARTINI, NATALIA CRISTINA TRENTIN BORDIGNON and, FERNANDA VIVIANE MARIANO The aim of this study was to evaluate the clinical and pathologic findings of patients with oral squamous cell carcinoma (OSCC) and compare them with the tumor-associated tissue eosinophilia (TATE) and serum eosinophilia (SE) quantifications. Clinical and anatomopathologic data were obtained from the medical records between 2006 and 2016. Tumors were classified according to histologic grade into 2 groups: well-
IMMUNOHISTOCHEMISTRY EVALUATION OF DENDRITIC CELLS IN ORAL PAPILLOMA AND TONSILLAR CARCINOMA. ANA GUADALUPE GAMA CUELLAR, FERNANDA VIVIANE MARIANO, ALBINA ALTENAMI and, ROGERIO GONDAK Objective: To quantify the number of mature and immature dendritic cells (DCs) in oral papilloma (OP) and tonsillar carcinoma (TC) and its relation to human papilloma virus. Study Design: A total of 21 cases of OP, 21 cases of TC, and 12 control cases of healthy oral mucosa samples were used. Immunohistochemical reactions against CD1 and CD83 were performed to identify immature and mature DCs respectively. Detection of the virus was made with p16 antibody. Quantitative and semiquantitative analysis using Image J 1.45 s software was applied for determination of immunopositivity. Results: In the epithelium, CD1 a + DCs were significantly decreased in TC compared with morphologically normal tissue (P = .02) and OP (P = .005). In the connective compartment, CD83 + DCs were significantly decreased in OP and TC
TRENDS IN MORTALITY DUE TO ORAL AND OROPHARYNGEAL CANCERS IN URUGUAY FROM 1997 TO 2014. MARIA LAURA COSETTI, AMANDA RAMOS DA CUNHA, TAIANE SCHAEDLER PRASS, MARCO ANTONIO TREVIZANI MARTINS, VINICIUS COELHO CARRARD, FERNANDO NEVES HUGO and, MANOELA DOMINGUES MARTINS Objective: To analyze the trend of oral and oropharyngeal cancer mortality in Uruguay between 1997 and 2014 and the rates by age, sex, and departments of the country. Study Design: A time-series ecological study with secondary data. To establish an estimation of the mortality trend of the historical series, by sex, anatomic site, and age groups, linear regressions were generated by the Prais-Winsten procedure. Results: Between 1997 and 2014, there were 1696 deaths from oral cancer and oropharyngeal cancer in Uruguay. The male to female ratio was 3.23:1. Malignant neoplasm of tongue presented the highest mortality rate. The mortality rate was relatively stable (total and by sex) in all age groups studies. Means of the annual coefficients were higher for the age groups between 50 and 79 years. In women, the trend remained stable in the different departments of the country, except in Lavalleja and Maldonado where there was an increase, while in men a decrease in Artigas and Rivera was observed. Conclusion: The mortality for oral and oropharyngeal cancer in Uruguay has remained constant for the period of 1997 to 2014. Prevention strategies and early diagnosis are necessary to improve survival.
ORAL HEALTH, HEALTH-RELATED QUALITY OF LIFE, AND WORK ABILITY AMONG PATIENTS WITH CHRONIC LIVER DISEASE. LARISSA SOUZA SANTOS, FERNANDO MARTINS CARVALHO, VIVIANE ALMEIDA SARMENTO, LIANA CODES, MARIA AUXILIADORA EVANGELISTA, ALESSANDRA DE OLIVEIRA CASTRO and, LILIANE LINS Oral infections are common causes of morbidity and mortality among patients with chronic liver diseases (CLD). Objective: To evaluate health-related quality of life (HRQoL), work ability, and oral health among patients with CLD. Study Design: Cross-sectional study with 25 patients on the transplantation waiting list (group 1) and 25 patients with CLD (group 2) attended in a university hospital in Salvador, Brazil. HR-QoL and work ability were evaluated using standardized questionnaires (36-Item Short-Form Health Survey [SF-36] and Wok Ability Index [WAI], respectively). Oral health (DMFT index and periodontal disease) was evaluated using World Health Organization protocol. Mean differences were compared using t tests for independent samples. Results: The mental component summary of HR-QoL was lower in group 1 than in group 2 when WAI was low/moderate (43.3 § 9.1 vs 51.8 § 7.5, respectively; P = .003) or when
ABSTRACTS
e131
gingivitis occurred (42.7 § 9.3 vs 50.4 § 3.6; P = .001); the physical component summary of HR-QoL was lower when periodontitis occurred (35.7 § 10.2 vs 48.8 § 6.4; P = .003). The groups presented similar DMFT index (19.1 § 8.3 vs 18.7 § 7.9; P = .86). Conclusions: Compared with patients with CLD, patients with CLD on the transplant waiting list presented lower HR-QoL because of its mental component when low work ability and gingivitis occurred; periodontitis was associated with low HR-QoL because of its physical component.
POLYMORPHISMS ASSOCIATED WITH ORAL CLEFTS AS POSSIBLE MARKERS OF SUSCEPTIBILITY FOR BREAST CANCER AND ORAL CANCER. EDIMILSON MARTINS DE FREITAS, RENATO ASSIS MACHADO, EDILMAR DE MOURA SANTOS, FELIPE RODRIGUES DE MATOS, ROSEANA DE ALMEIDA FREITAS, RICARDO D. COLETTA and, HERCILIO MARTELLI JUNIOR Objective: To evaluate the association of single nucleotide polymorphisms (SNPs) in the genes/loci IRF6, WNT3 A, GSK3 B, 8 q24, and WNT11, representing regions consistently altered in nonsyndromic oral clefts with breast and oral cancers in the Brazilian population. Study Design: We performed a case-control study with association of SNPs rs642961 (IRF6), rs708111 (WNT3 A), rs9879992 (GSK3 B), rs987525 (8 q24), and rs1533767 (WNT11) in 159 samples from breast cancer patients and 79 patients with oral squamous cell carcinoma. A total of 121 female controls (breast controls) and 130 oral cancer controls were used. Logistic regression analysis was used to adjust for confounding factors. A value of P < .05 was considered statistically significant. The study was approved by the ethics committees of the hospitals affiliated to the study. Results: Although our results have not demonstrated association between frequencies of SNP genotypes in IRF6, WNT3 A, GSK3 B, 8 q24, and WNT11 and the risk of breast and oral cancers, gene-gene interactions were associated. Conclusion: Our data revealed an association between gene-gene interactions in IRF6, WNT3 A, GSK3 B, 8 q24, and WNT11 at risk of breast cancer and oral squamous cell carcinoma in a Brazilian population. Additional experiments and large-scale independent studies in other ethnic populations are needed to confirm our results.
PREVENTION PROTOCOL FOR BISPHOSPHONATE-RELATED OSTEONECROSIS OF THE JAWS IN A PATIENT WITH HIV. NATHALIA DE ALMEIDA FREIRE, FERNANDA VIEIRA HEIMLICH, MARIA ELIZA BARBOSA RAMOS, SARAH APARECIDA ^ e ISRAEL FERREIRA ANTERO and, MONICA SIMOES Objective: To describe a preventive dental protocol for medication-related osteonecrosis of the jaw (MRONJ) in patients with HIV before and after bisphosphonate therapy. Study Design: Development of the protocol was based on literature review of articles, book chapters, and theses in the last 10 years. Results: The proposed protocol focuses on 3 groups of patients with HIV: Patients diagnosed as having osteoporosis who have not started treatment with bisphosphonates; patients at
ABSTRACTS
e132
OOOO January 2020
risk for developing MRONJ, and stage 0 patients. It should be noted that certain features of the preventive protocol stages, such as the shorter breaks between appointments and the early application of low-power laser therapy, take into account the possibility of greater severity and/or fastness in MRONJ signs and symptoms in patients with HIV. Conclusion: Although the steps of the protocol are simple, they require technical-scientific knowledge by the dentist and the application of laser therapy, a particularity that may constitute a challenge for the adoption of such protocol in the Brazilian public health service. The role of dentistry in the multidisciplinary approach of patients with HIV still lacks on the AIDS protocols and guidelines offered by the Brazilian Ministry of Health. Because these documents may influence medical opinions and behaviors, it seems appropriate to emphasize this gap on such system.
differentiated carcinomas (group 1) and moderately/poorly differentiated (group 2). For analysis of TATE, the histologic slides were stained with Congo red, and stromal eosinophils were counted in 5 consecutive high-power fields using Image J 1.45 s. The SE count was performed by XE-2100 D Sysmex automated system after venous puncture. Of the 113 patients, 83 were from group 1 and 30 were from group 2. Most of the patients were white, smokers, alcoholics, and manual workers. Stage II of the disease predominated in both groups, and 8 patients died. There was no statistical difference between the groups in relation to TATE or SE (P = .16 and P = .19, respectively). However, there was a positive correlation between the TATE and SE (r = + 0.417, P = .048). TATE is directly associated with SE in OSCC patients, having no association with tumor aggressiveness, survival, or other clinical parameters.
VARIATION OF SALIVARY FLOW RATE IN DIFFERENT ANTINEOPLASTIC TREATMENTS. JULIANA BORGES DE LIMA e BISPO, HAYANA RAMOS DANTAS, MAYARA SIMOES LIMA, ALENA RIBEIRO ALVES PEIXOTO MEDRADO, ^ MANOELA CARRERA, ELISANGELA DE JESUS CAMPOS and, GABRIELA BOTELHO MARTINS
SECRETORY CARCINOMA OF SALIVARY GLANDS: WHERE ARE WE?. THAYANA ALVES, LEANDRO DE SOUZA THIAGO, LUIZ HENRIQUE DE LIMA ARAUJO, HELITON SPINDOLA ANTUNES, ANDREIA CRISTINA DE MELO, LUIZ CLAUDIO SANTOS THULER and, DANIEL COHEN GOLDEMBERG
Objective: To investigate salivary flow changes during the treatment of patients submitted to head and neck radiotherapy (HNR) and/or exclusive chemotherapy. Study Design: Prospective cross-sectional study with 61 patients divided into 2 groups: GT1 (n = 20)—individuals with malignant neoplasms in any region of the body, except head and neck, submitted to exclusive chemotherapy; GT2 (n = 41)—individuals in HNR associated or not with chemotherapy. Salivary flow examination was performed by an interval of 7 days among them: 3 samples for GT1 (baseline, 7 and 14 days after first infusion) and 5 for GT2 (baseline, 6th, 12th, 18th, and 24th HNR sessions). The GT2 group was subdivided based on the irradiation fields in 3 subgroups: face, neck, and face/neck. Results: There was an increase in the salivary flow of the GT1 group and a negative D for the GT2 group, which represented a statistical difference for the salivary flow variations between the treatment groups (P < .001). However, it was not possible to verify differences between the evaluated irradiated fields. Conclusion: HNR was able to reduce salivary flow rate significantly, whereas chemotherapy did not seem to influence salivary production.
Secretory carcinoma, described as mammary analog secretory carcinoma, is a recently described tumor of salivary glands that is defined by its histologic, immunophenotypic, and genetic similarities to the secretory breast carcinoma and is characterized by ETV6 translocation. The first description of mammary analog secretory carcinoma was reported by Skalova et al. in 2010. Retrospective studies showed that some tumors of salivary glands such as acinic cell carcinoma, low-grade salivary duct carcinoma, adenocarcinoma/cystadenocarcinoma not otherwise specified (NOS), and low-grade mucoepidermoid carcinoma were misdiagnosed. The purpose of this study is to review the literature showing the differential characteristics among these tumors and secretory carcinoma, highlighting how to perform the correct diagnosis, giving the patients the right treatment and improving their prognosis. Potential target therapy is also approached.
SERUM EOSINOPHILS AND TUMOR-ASSOCIATED TISSUE EOSINOPHILIA IN PATIENTS WITH ORAL SQUAMOUS CELL CARCINOMA. ROGERIO GONDAK, HANNAH KARYN DA SILVA, GEORGIA MARTINI, NATALIA CRISTINA TRENTIN BORDIGNON and, FERNANDA VIVIANE MARIANO The aim of this study was to evaluate the clinical and pathologic findings of patients with oral squamous cell carcinoma (OSCC) and compare them with the tumor-associated tissue eosinophilia (TATE) and serum eosinophilia (SE) quantifications. Clinical and anatomopathologic data were obtained from the medical records between 2006 and 2016. Tumors were classified according to histologic grade into 2 groups: well-
IMMUNOHISTOCHEMISTRY EVALUATION OF DENDRITIC CELLS IN ORAL PAPILLOMA AND TONSILLAR CARCINOMA. ANA GUADALUPE GAMA CUELLAR, FERNANDA VIVIANE MARIANO, ALBINA ALTENAMI and, ROGERIO GONDAK Objective: To quantify the number of mature and immature dendritic cells (DCs) in oral papilloma (OP) and tonsillar carcinoma (TC) and its relation to human papilloma virus. Study Design: A total of 21 cases of OP, 21 cases of TC, and 12 control cases of healthy oral mucosa samples were used. Immunohistochemical reactions against CD1 and CD83 were performed to identify immature and mature DCs respectively. Detection of the virus was made with p16 antibody. Quantitative and semiquantitative analysis using Image J 1.45 s software was applied for determination of immunopositivity. Results: In the epithelium, CD1 a + DCs were significantly decreased in TC compared with morphologically normal tissue (P = .02) and OP (P = .005). In the connective compartment, CD83 + DCs were significantly decreased in OP and TC