RESUMO
The aim of this systematic review and network meta-analysis (NMA) of randomized controlled trials was to evaluate the effectiveness of treatments for pain relief of burning mouth syndrome (BMS). Five databases and gray literature were searched. Independent reviewers selected studies, extracted data, and assessed the risk of bias. The primary outcome was pain relief or burning sensation, and the secondary outcomes were side effects, quality of life, salivary flow, and TNF-α and interleukin 6 levels. Four comparable interventions were grouped into different network geometries to ensure the transitivity assumption for pain: photobiomodulation therapy, alpha-lipoic acid, phytotherapics, and anxiolytics/antidepressants. Mean difference (MD) and 95% CI were calculated for continuous outcomes. The minimal important difference to consider a therapy beneficial against placebo was an MD of at least -1 for relief of pain. To interpret the results, the GRADE approach for NMA was used with a minimally contextualized framework and the magnitude of the effect. Forty-four trials were included (24 in the NMA). The anxiolytic (clonazepam) probably reduces the pain of BMS when compared with placebo (MD, -1.88; 95% CI, -2.61 to -1.16; moderate certainty). Photobiomodulation therapy (MD, -1.90; 95% CI, -3.58 to -0.21) and pregabalin (MD, -2.40; 95% CI, -3.49 to -1.32) achieved the minimal important difference of a beneficial effect with low or very low certainty. Among all tested treatments, only clonazepam is likely to reduce the pain of BMS when compared with placebo. The majority of the other treatments had low and very low certainty, mainly due to imprecision, indirectness, and intransitivity. More randomized controlled trials comparing treatments against placebo are encouraged to confirm the evidence and test possible alternative treatments (PROSPERO CRD42021255039).
Assuntos
Síndrome da Ardência Bucal , Clonazepam , Humanos , Metanálise em Rede , Síndrome da Ardência Bucal/tratamento farmacológico , Qualidade de Vida , DorRESUMO
BACKGROUND: The aim of this study was to investigate the frequency of oral lesions in the floor of the mouth from representative oral pathology centres in Latin America. MATERIAL AND METHODS: This study was conducted on biopsies obtained from January of 1978 to December of 2018 at nine Latin America oral and maxillofacial pathology centres. Gender, age and histopathological diagnosis were evaluated. Data were analysed using descriptive methods. Chi-square test was used for pairwise comparisons. RESULTS: From 114,893 samples, 4,016 lesions (3.49%) occurred in the floor of the mouth. Brazil showed 3,777 cases (94%), Mexico 182 cases (4.5%) and Argentina 57 cases (1.4%). Benign lesions represented 65.1% (2,617 cases), followed by 34.9% (1,404 cases) of malignant disorders. Lesions of epithelial origin were more frequent (1,964 cases; 48.9%), followed by salivary glands (1,245 cases; 31%) and soft tissue lesions (475 cases; 11.7%). The most common histological subtypes were oral squamous cell carcinoma (1,347 cases; 33.5%), ranula (724 cases; 18%), oral leukoplakia (476 cases; 11.8%) and inflammatory fibrous hyperplasia (239 cases; 5.9%). The lesion affected males in 2,129 cases and females in 1,897 cases. CONCLUSIONS: In the current study, lesions in the floor of the mouth represented 3.49% of biopsies submitted to oral pathology services and oral squamous cell carcinoma, ranula and leukoplakia were the most common lesions.
Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Doenças da Boca , Neoplasias Bucais , Feminino , Humanos , Leucoplasia Oral , Masculino , Doenças da Boca/epidemiologia , Mucosa Bucal , Neoplasias Bucais/epidemiologia , Estudos RetrospectivosRESUMO
BACKGROUND: Among the oral potentially malignant disorders, leukoplakia stands out as the most prevalent. The purpose of this study was to analyse the clinical-pathological features of oral leukoplakia in groups of patients from three major pathology centers in two different regions of Brazil, in order to determine which factors would be associated to the clinical risk of malignant transformation. MATERIAL AND METHODS: A total of 148 patients was analyzed, and data regarding gender, age, site, classification of the clinical subtype, harmful habits such as use of tobacco and alcohol, time of evolution and presence of dysplasia were collected. The association between risk factors and malignant transformation was investigated using the chi-square test and Fischer's exact test for correlation of variables. A significance level of 5% (p≤0.05) was used. RESULTS: The mean age of the patients was 60 years, and 56% were female. Most of the lesions (34,5%) were located in the lateral and ventral regions of the tongue. Of the 148 patients, ninety had clinical follow-up. Malignant transformation occurred in 13 patients (8.8%), with an average of 44 months of follow up. CONCLUSIONS: Non-smoker, nonhomogeneous clinical presentation, location at the tongue, and the presence of high degree of dysplasia were statistically relevant factors associated with a higher risk of transformation transformation.
Assuntos
Transformação Celular Neoplásica , Leucoplasia Oral , Brasil/epidemiologia , Feminino , Humanos , Leucoplasia Oral/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de RiscoRESUMO
OBJECTIVE: The aim of this study was to evaluate the association of IL17A G197A polymorphism and serum levels with oral lichen planus (OLP) susceptibility and clinical presentation. SUBJECTS AND METHODS: Eighty-three individuals diagnosed with OLP and 99 healthy controls (C) were consecutively recruited. All participants had desquamating oral mucosal cells collected and DNA isolated for IL17A (G197A) genotyping. Blood samples of 42 OLP individuals and 23 healthy controls were collected for evaluation of IL17A serum levels. RESULTS: IL17A G197A genotypes were associated with an increased chance of having OLP (GA/AA × GG, OR = 3.44, 95% CI = 1.87-6.33, p < .001). Overall A carriers (GA or AA) were more common in OLP (38.1%) than in C (20.2%; OR = 2.43, 95% CI = 1.53-3.87, p < .001). Serum levels of IL17A were higher among patients with OLP than in healthy controls (reticular, p = .0003; erosive, p < .001), but no difference was found among the disease types. CONCLUSIONS: IL17A G197A is associated with a higher susceptibility of developing OLP and these patients seem to present a considerable increase in IL17A serum levels. These findings suggest that Th17 cells, and IL17A in particular, may play a pivotal role in OLP pathogenesis.
Assuntos
Interleucina-17/sangue , Interleucina-17/genética , Líquen Plano Bucal/sangue , Líquen Plano Bucal/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Predisposição Genética para Doença/genética , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Adulto JovemRESUMO
OBJECTIVES: DNA methylation is an important mechanism of gene control expression, and it has been poorly addressed in odontogenic tumours. On this basis, we aimed to assess the methylation pattern of 22 apoptosis-related genes in solid ameloblastomas. MATERIALS AND METHODS: Ameloblastoma fresh samples (n = 10) and dental follicles (n = 8) were included in the study. The percentage fraction of methylated and unmethylated DNA promoter of 22 apoptosis-related genes was determined using enzymatic restriction digestion and quantitative real-time PCR (qPCR) array. The relative expressions of the genes that showed the most discrepant methylation profile between tumours and controls were analysed by reverse-transcription quantitative PCR (RT-qPCR). RESULTS: Lower methylation percentages of TNFRSF25 (47.2%) and BCL2L11 (33.2%) were observed in ameloblastomas compared with dental follicles (79.3% and 59.5%, respectively). The RT-qPCR analysis showed increased expression of BCL2L11 in ameloblastomas compared with dental follicles, in agreement with the methylation analysis results, while there was no difference between the expression levels of TNFRSF25 between both groups. CONCLUSIONS: On the basis of our results, the transcription of the apoptosis-related gene BCL2L11 is possibly regulated by promoter DNA methylation in ameloblastoma. The biological significance of this finding in ameloblastoma pathobiology remains to be clarified.
Assuntos
Ameloblastoma/genética , Proteína 11 Semelhante a Bcl-2/genética , Metilação de DNA , Expressão Gênica , Neoplasias Maxilomandibulares/genética , Membro 25 de Receptores de Fatores de Necrose Tumoral/genética , Adulto , Apoptose/genética , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Regiões Promotoras Genéticas , Adulto JovemRESUMO
BACKGROUND: The amalgam-associated oral lichenoid lesion (AAOLL) shows clinical and histopathological features similar to oral lichen planus (OLP). Molecular researches to improve knowledge of pathogenesis and clinical behavior of AAOLL are still scarce. OBJECTIVE: We investigated for the first time the use of loss of heterozygosity (LOH) as a molecular approach for genetic characterization of AAOLL in comparison with OLP and evaluated the cell proliferation index. MATERIALS AND METHODS: The sample comprised nine AAOLLs, 10 OLPs, and eight NOMs matched by patients' gender and age. LOH was assessed using polymorphic microsatellite markers at chromosomes 9p (D9S157, D9S162, D9S171), 11q (D11S1369), and 17p (TP53, AFM238WF2). Cell proliferation was assessed by immunohistochemical expression of Ki-67 (MIB-1). The association between LOH and Ki-67 was investigated. RESULTS: Loss of heterozygosity occurred in 5/9 AAOLLs and in 2/10 OLPs in at least one marker each, while NOM showed no LOH. Cell proliferation index in AAOLL ranged from 2 to 23%. There was no association between cell proliferation and LOH, independent of the marker. CONCLUSION: Our study shows that the profile of molecular changes in AAOLL and OLP, evaluated by LOH and Ki-67 expression, is similar. Additional studies including larger samples should be performed to confirm or to refute our findings.
Assuntos
Amálgama Dentário/efeitos adversos , Erupções Liquenoides/etiologia , Perda de Heterozigosidade , Doenças da Boca/etiologia , Mucosa Bucal/fisiopatologia , Adulto , Idoso , Estudos de Casos e Controles , Proliferação de Células , Feminino , Humanos , Imuno-Histoquímica , Antígeno Ki-67/metabolismo , Líquen Plano Bucal/genética , Líquen Plano Bucal/fisiopatologia , Erupções Liquenoides/genética , Erupções Liquenoides/fisiopatologia , Masculino , Repetições de Microssatélites , Pessoa de Meia-Idade , Doenças da Boca/genética , Doenças da Boca/fisiopatologia , Polimorfismo GenéticoRESUMO
Two experiments were done to evaluate the effect of increasing levels of dietary digestible methionine (Met) and Met:cysteine (Met:Cys) ratio on the productivity of Hy-Line W-36 laying hens fed sorghum- and soybean meal-based diets. In Exp. 1, 160 hens from 68 to 75 weeks of age were assigned to four dietary levels of digestible Met (0.20 0.24, 0.28 and 0.32%). The digestible total sulfur amino acids:Lysine (TSAA:Lys) ratios were: 62, 68, 76 and 84%. In Exp. 2, 192 hens from 76-83 weeks of age were assigned to four dietary digestible Met:Cys ratios (160, 116.7, 85.7 and 62.5%). The digestible TSAA:Lys ratio was kept constant across diets (80%). Results were subjected to ANOVA and linear regression analyses. In Exp. 1, optimal egg production, egg mass, and feed efficiency responses were observed at 0.30 and 0.50% of dietary digestible Met and TSAA, respectively (quadratic effect, p 0.05). Live performance was maximized with digestible Met and TSAA in takes of 288 and 478 mg/hen/d, respectively. In Exp. 2, optimal egg production and feed efficiency responses were observed at 151 and 150% of dietary digestible Met:Cys ratios, respectively (quadratic effect, p 0.05). The digestible Met, Cys and TSAA intake to maximize egg production and feed efficiency were 313, 207 and 510 mg/hen/d, respectively. The requirements for sulfur AA in Hy-Line W-36 hens from 68 to 83 weeks of age fed sorghum- and soybean meal-based diets fell inside the range of the requirements previously estimated in hens fed corn-soybean meal based diets.(AU)
Assuntos
Animais , Feminino , Galinhas/crescimento & desenvolvimento , Galinhas/metabolismo , Ração Animal/análise , Ração AnimalRESUMO
Two experiments were done to evaluate the effect of increasing levels of dietary digestible methionine (Met) and Met:cysteine (Met:Cys) ratio on the productivity of Hy-Line W-36 laying hens fed sorghum- and soybean meal-based diets. In Exp. 1, 160 hens from 68 to 75 weeks of age were assigned to four dietary levels of digestible Met (0.20 0.24, 0.28 and 0.32%). The digestible total sulfur amino acids:Lysine (TSAA:Lys) ratios were: 62, 68, 76 and 84%. In Exp. 2, 192 hens from 76-83 weeks of age were assigned to four dietary digestible Met:Cys ratios (160, 116.7, 85.7 and 62.5%). The digestible TSAA:Lys ratio was kept constant across diets (80%). Results were subjected to ANOVA and linear regression analyses. In Exp. 1, optimal egg production, egg mass, and feed efficiency responses were observed at 0.30 and 0.50% of dietary digestible Met and TSAA, respectively (quadratic effect, p 0.05). Live performance was maximized with digestible Met and TSAA in takes of 288 and 478 mg/hen/d, respectively. In Exp. 2, optimal egg production and feed efficiency responses were observed at 151 and 150% of dietary digestible Met:Cys ratios, respectively (quadratic effect, p 0.05). The digestible Met, Cys and TSAA intake to maximize egg production and feed efficiency were 313, 207 and 510 mg/hen/d, respectively. The requirements for sulfur AA in Hy-Line W-36 hens from 68 to 83 weeks of age fed sorghum- and soybean meal-based diets fell inside the range of the requirements previously estimated in hens fed corn-soybean meal based diets.
Assuntos
Feminino , Animais , Galinhas/crescimento & desenvolvimento , Galinhas/metabolismo , Ração Animal , Ração Animal/análiseRESUMO
AIM: To investigate whether single nucleotide polymorphisms (SNPs) within the interleukin-1 gene cluster (IL1) are associated with the occurrence and severity of inflammatory external root resorption (IERR) after replantation of avulsed permanent teeth. METHODOLOGY: Indexes of IERR were radiographically assessed in 182 mature replanted permanent teeth from 146 patients at the onset of endodontic therapy. DNA was extracted from buccal mucosa cells and genotyped using TaqMan probes-based assays for the SNPs IL1A -889C/T (rs 180058), IL1B +3954C/T (rs1143634) and IL1RN +2018C/T (rs419598). Teeth were grouped into two categories: IERR absent to mild (indexes ≤ 4) and moderate to severe IERR (indexes > 4). Genetic variations in the IL1 gene cluster were tested for their effect on the occurrence and extension of IERR using the GEE model (generalized estimation equation). Patient's age at the moment of injury, timing of pulpectomy, extra-alveolar period and storage condition of the avulsed teeth was included as possible confounders. RESULTS: No association was found between SNPs IL1A -889C/T, IL1B +3954C/T (rs1143634) and IL1RN +2018C/T (rs419598) and IERR indexes. Timing of pulpectomy (OR 3.5 IC 95% 2.0-6.2 P < 0.001) and patient's age at the moment of trauma (OR 0.29 IC 95% 0.12-0.67 P = 0.004) significantly affected the risk of developing severe IERR. CONCLUSIONS: While timing of pulpectomy and patient's age at the moment of trauma were confirmed as important risk factors, SNPs within the IL1 gene cluster did not affect the susceptibility for IERR after replantation of permanent teeth.
Assuntos
Interleucina-1/genética , Reabsorção da Raiz/genética , Reimplante Dentário/métodos , Adolescente , Adulto , Fatores Etários , Brasil , Criança , Feminino , Seguimentos , Humanos , Masculino , Família Multigênica , Polimorfismo de Nucleotídeo Único , Pulpectomia , Fatores de Risco , Reabsorção da Raiz/etiologia , Fatores de Tempo , Avulsão Dentária/terapiaRESUMO
OBJECTIVE: Graft-versus-host disease is a major complication after allogenic hematopoietic stem cell transplantation. Interferon gamma is an important pro-inflammatory cytokine involved in this disease. Cytokine gene polymorphisms are associated with functional differences in cytokine expression and can alter the clinical course of graft-versus-host disease. This study aimed to investigate the association between IFN-γ levels in saliva, blood, and IFNG polymorphisms, as well as the occurrence of acute graft-versus-host disease in allogenic HSCT. SUBJECTS AND METHODS: Fifty-eight consecutive allogenic hematopoietic stem cell transplantation recipients and their donors were prospectively studied. IFN-g levels in saliva and blood were assessed by ELISA. Samples were collected weekly from 7 days before transplantation (day -7) to 100 days after allogenic HSCT (day +100) or until death. Saliva and/or blood samples were obtained from the recipients and donors to determine IFNG gene polymorphisms. RESULTS: Increased saliva and blood IFN-g levels were observed in patients that had developed aGVHD. In the saliva, the peak levels of IFN-g could be found one week before aGVHD diagnosis, while in the blood, peak levels of IFN-g could be only observed upon diagnosis. A significant association could be identified between the recipients'IFNG genotypes and the IFN-g levels in their blood, at +14 days after HSCT. No association could be observed between IFNG gene polymorphisms and the aGVHD. CONCLUSION: The present study shows that the genetic background of recipients can influence the production of IFN-g. Moreover, as IFN-g levels in the saliva and blood were found to be associated with aGVHD development, this cytokine may be a useful predictor of acute graft-versus-host disease.