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This systematic review purposed to investigate reports of oral lesions in confirmed COVID-19 patients summarizing clinical characteristics, histological findings, treatment and correlation of oral lesions and COVID-19 severity. Electronic search was conducted on November 2021 using seven databases to identify case reports/series describing lesions in oral mucosa in COVID-19 confirmed cases. A total of 5,179 studies were found, being 39 eligible from 19 countries, totalling 116 cases. It was observed only COVID-19 non-vaccinated cases and no sex or age predilection. The oral lesions presentation was mostly single location (69.8%), commonly in the tongue, lips, and palate, being ulcer the main clinical presentation. According to severity index for COVID-19, the reports were more frequent in patients with mild and moderate symptoms, being 75.8% in acute phase. The oral lesion appearance in post-acute COVID-19 were described after 14 to two months after patient recovery. Histologically, keratinocytes with perinuclear vacuolization, thrombosis and mononuclear inflammatory infiltrate were also described with the presence of the virus in keratinocytes, endothelial cells, and minor salivary glands. In conclusion, health care professionals should consider COVID-19 association when patient present ulcerated oral lesions and mild to moderate symptoms for COVID-19 or had acute-COVID-19.

A metastatic giant cell–rich osteosarcoma (GCRO) to the jaws is an exceedingly rare neoplasm. To date, fewer than 10 cases have been reported in the English language literature. In this article, we describe an additional case of a metastatic GCRO that presented the diagnostic challenge of a painless mass in the posterior mandible of a 19-year-old girl who exhibited rapid and aggressive local growth. The lesion was confirmed radiologically as an ill-defined expansive osteolytic mass showing cortical perforation. Microscopically, the presence of osteoclast-like giant cells permeated with atypical oval and rounded mesenchymal cells in a fibrovascular stroma, cellular atypia, and scarce osteoid formation were observed. Immunohistochemistry revealed the Ki-67 proliferative index in 50% of positive cells, positivity for vimentin and CD68, as well as scarce positivity for CDK4. The patient's medical history involved a GCRO in the proximal ulna. This report highlights the aggressive behavior of GCRO and its high capacity for metastasis to different parts of the body. Clinicians, pathologists, and surgeons should be aware of the giant cell–rich variant of osteosarcoma of the jaws, an imminent “wolf in a sheep's skin”, because its indolent but unrelenting growth and dissemination, with radiographic and histologic characteristics that may represent a diagnostic pitfall regarding aggressive central giant cell lesions of the jaws.

The adenomatoid odontogenic tumor (AOT) has a prevalence of 3% to 7% among odontogenic tumors and 3 described variants: Follicular, extrafollicular, and peripheral (or gingival). We reported a case of extrafollicular AOT in a 31-year-old melanoderm woman. An increase in volume was observed in the lower left third of the face associated with bulging of the buccal and lingual cortices in the region of elements 34 to 32. The imaging revealed a well-defined unilocular radiolucent area with sclerotic margin, involving periapices of elements 34, 33, and 32, rupture of the vestibular bone cortex in the region, and mild root resorption of units 33 and 32. Histopathologic examination revealed presence of fibrovascular capsule and epithelial cells forming structures such as ductus and solid patter. The treatment was an excisional biopsy. Follow-up of 7 and 15 days with satisfactory postoperative period was performed. Provision will be made every 6 months.

Introduction: The use of the mobile device is based on radiofrequency waves, a type of electromagnetic wave, formed by a magnetic and electric field. This technology uses radio transmitters and receivers, operating in the microwave range, and therefore, ends up being an emitter and receiver of nonionizing energy. Objective: To evaluate whether the nonionizing radiation emitted by smartphones cause genotoxic and/or cytotoxic effects on the cells present in the oral mucosa, and to compare the different brands. Study design: A total of 30 adults were divided into 2 groups according to 2 mobile phone brands. The material was collected by smearing the jugal mucosa bilaterally with a spatula, and it was evaluated by means of the micronucleus test. This test analyzed the shape, borders, changes within the cytoplasm, and the chromatin structure, color, and texture. Statistical analysis was performed using the Wilcoxon test, with a significance level of 5%. Results: For micronuclei, there was no statistically significant difference between exposed and nonexposed sides (P = .251); however, for the other alterations, there was a statistically significant difference (P = .024). Regarding the comparison between the marks, there was no statistically significant difference (P = .47). Conclusion: The different brands of smartphones do not appear to offer risks of inducing genotoxicity. However, both brands showed cytotoxicity. Funding: CNPq.

Statement of problem Different instruments have been developed to improve crown finish lines after conventional preparation with diamond rotary instruments. However, more evidence on the effectiveness of these instruments is required. Purpose of study The purpose of this in vitro study was to assess the effectiveness of 4 different instruments used for cervical margin finishing in regard to the external line angle (ELA). Material and methods Forty-eight freshly extracted third molar teeth with similar dimensions were conventionally prepared for crowns and randomly allocated into 4 groups (n=12) according to the finishing instrument: hand trimmer (HT), tungsten carbide bur (TCB), ultrasonic instrument (UI), and diamond rotary instrument (DRI) mounted in a contra angle handpiece with reduced speed. Photomicrographs from the margin profiles of each tooth were obtained with scanning electron microscopy (×40) before and after finishing procedures. The images were qualitatively analyzed (scores 1-4) by 9 experienced dental professionals. Average results were assessed with the paired t test and repeated measures ANOVA followed by Tukey HSD test (α=.05). Results HT, TCB, and UI demonstrated no significant differences between unfinished and finished mean ELA scores. DRI was the only group to demonstrate a significantly improved ELA ( P P =.989), all the other groups demonstrated statistically significant different ELA scores. Conclusion DRI mounted in a contra angle handpiece was the only finishing instrument capable of significantly improving the ELA, while TCB and UI produced nonsignificant improvement, and HT was detrimental to the ELA.

The use of the mobile device is based on radiofrequency waves, an electromagnetic wave type. To verify if cellular damage occurs, the micronucleus test was developed, aiming to identify an increase in the frequency of mutations in cells that are exposed to a varied range of agents. Objective: This study aims to answer the following question: "Could the nonionizing radiation emitted by mobile telephone devices cause genotoxic and/or cytotoxic effects in the cells present in the oral mucosa, from microscopic observation by the micronucleus test?" Study Design: Three stages were followed: defining the objective, tracing the search method (PICO), selecting articles, and extracting data. The databases consulted were: MEDLINE, PubMed (AllDatabases, MeSH), Scopus, LILACS, Google academic, PROSPERO, and COCHRANE using the Boolean operators Persons, Smartphone, Mutagenicity Tests, and Mouth, based on MeSH terms. Results: A total of 396 articles were found, 323 abstracts were analyzed, 312 abstracts were excluded, and w6 full texts and 6 studies were included, according to the table of scientific evidence (grade 5). Conclusion: Our study revealed that there is no occurrence of genotoxic effects; nonetheless, there is a suggestion of occurrence of cytotoxic effects caused by exposure to electromagnetic fields of radiofrequency emitted by mobile phones, especially in case of prolonged exposure.

Objective: To develop and evaluate a smartphone application with web application tool, content management, that enables the study of radiographic anatomy. Study Design: Face-to-face meetings and design thinking activities were carried out to better understand the proposed problem by the research group. The application, completed in the beta version, provided satisfaction and usability questionnaires to 51 students of the dentistry course. Results: A total of 50% of students use the Android operating system; 100% of the students feel that applications can aid in the teaching of radiology, 93.20% prefer to study by photos, and 86.40% study with the cell phone connected. Regarding the satisfaction questionnaire, with the APPOLO app (app of learning on line), Cronbach alpha coefficient was applied, obtaining values above 0.7; therefore, the questionnaire is reliable. In addition, 98.04% affirmed that it the content that is made available is certainly important. A total of 64.69% of the students considered the quantity of the images satisfactory. The majority, 68.62%, feel very motivated to complement their study with this type of methodology. As for the usability of the application, 66.66% found its handling very easy. Conclusion: The APPOLO application proved to be practical and easy to understand, navigate, and use; further, it can assist in the teaching support of students of dental radiology.

Objectives: The odontogenic adenomatoid tumor (AOT) has a prevalence of 3% to 7% among odontogenic tumors. There are 3 variants of AOT: follicular, extrafollicular, and peripheral. The present study aims to trace the clinical and epidemiologic profile of extrafollicular AOT, based on a review of case reports. Study Design: Using the adenomatoid and extrafollicular descriptors, a search was performed in the PubMed database. Fifty-one articles were obtained as a result. The following exclusion criteria were adopted: by title, by case report, by the summary, and by the series of cases. At the end, 10 articles were used as sources for the present study. Results: Ten cases were published between 2009 and 2019, with the following most prevalent characteristics: Asian ethnicity (90%), no gender preference, and mandible location (60%). Imaging presentation included well-defined borders (80%); root displacement (50%); presence of cortical perforation (30%); and root resorption (30%). The mean time of the cases was 4 months, with a maximum of 2 years, and no recurrence was observed in any of the cases. Conclusion: Extrafollicular odontogenic adenomatoid tumor is uncommon. It does not present a predominant profile, exhibiting a diversity of clinical manifestations, with slow to fast and locally aggressive growth.

Cleidocranial dysostosis (CCD) is an inherited autosomal dominant syndrome due to the heterozygous mutation of the RUNX2 gene, which is often the same in men and women. The diagnosis is based on clinical and radiographic features, which include images of the skull, thorax, pelvis, and hands. The present study aims to present a case report of CCD in a 29-year-old feoderm woman. During intraoral examination permanent nonerupted teeth, deep palate, prominent mandible, maxillary hypoplasia, and vertical occlusion dimension were observed. Panoramic radiographs and computed tomography scan of the conical bundle showed several nonerupted teeth and multiple supernumerary teeth. Wormian bones and persistent open sutures were observed on the lateral radiograph of the head. The shoulder radiograph shows the absence of right and left clavicles. In view of the complexity of the treatment an interdisciplinary discussion is necessary, taking into account age and economic condition.

Fibrous dysplasia (FD) is a benign fibro-osseous lesion that accounts for 2.5% of bone lesions. Herein, we present an 11-year-old female patient presented to examination with an increase in volume on the right side of the face with indeterminate evolution time. Intraoral clinical examination revealed a hardened region, with no alteration in the mucosa, that suggests a bone etiology lesion. Radiographic examination showed a mixed, circumscribed lesion with a pediculated and poorly delimited aspect in relation to healthy bone tissue, extending from the right coronary process to the lateral region of the ipsilateral jaw. Histopathologically the presence of trabeculae of immature bone tissue dispersed in a cellular fibrous stroma and absence of cellular atypia was observed. The diagnosis was FD. The treatment was the total exeresis of the lesion, performed to avoid relapses and due to aesthetic and functional impairment. The patient has been in follow-up for 9 months without recurrence.

In this manuscript, we present a rare case report of giant complex odontoma in the maxillary sinus, where the applied therapy included complete excision of the lesion with a conservative approach. Odontomas are also called benign growth abnormalities or hamartomas. They represent a more common type of odontogenic tumor and are related to various disorders such as bad dental placements, expansion, increased volumetric bone, and no eruption of permanent teeth. Usually they have an asymptomatic evolutionary course. The etiologic factors, although obscure, are related to local trauma, infection, and genetic factor. The structural composition of an odontoma consists of mature dental tissues. Odontomas can be differentiated according to their anatomical presentations: Compound odontoma-clusters of several denticles and complex odontoma-well defined tumefaction mass. The diagnosis can be performed by radiographic examination.

This study evaluated the microhardness of two resin cements and a low-viscosity resin composite when light-cured under different ceramic thicknesses. A total of 20 samples (10.0 × 1.0 mm) of each material were polymerized by means of a LED light source with an intensity of 1,100 mW/cm2 for 20 seconds. For each experimental group, different ceramic thicknesses (0.5 mm, 1.0 mm, and 1.5 mm) were applied to each sample. For the control group, the samples were polymerized without the presence of ceramics. Each material was then stored in dry vials that inhibited the passage of light for a period of 24 hours. After that time, each sample underwent Vickers hardness test (HMV, Shimadzu: 25 g/10 seconds). The data were collected and analyzed using analysis of variance and Tukey test (P < .05). For the control group, RelyX Veneer (3M ESPE), Filtek Flow Z350XT (3M ESPE), and Allcem Veneer (FGM) showed mean microhardness values and standard deviations of 44.42 ± 4.9, 44.25 ± 2.4, and 31.71 ± 2.4, respectively. The lowest microhardness value (24.13) was found when the greatest ceramic thickness (1.5 mm) was used on the Allcem Veneer cement (P < .01). The microhardness of resin-based materials was affected when the 1.5-mm-thick ceramic material was interposed during photoactivation.

Background Cone beam computed tomography (CBCT) has become an important diagnostic tool in dentistry but has the disadvantage of exposing the patient to ionizing radiation, which may induce base damage, single- and double-strand breaks, and DNA protein crosslinks. Objective The aim of this study was to assess cytologic evidence of genotoxicity and cytotoxicity of x-rays in the oral exfoliated cells of adults subjected to partial and total (stitching module) CBCT by determining micronuclei frequency, associated with counting of degenerative nuclear alterations (pyknosis, karyolysis, karyorrhexis, buds, and broken eggs), and comparing partial and total (stitching module) CBCT in search of possible differences in the nature and/or intensity of the effects. Methods Thirty adults who were referred for total or partial CBCT were selected. Material collection was performed immediately before scanning and 10 days later, by scraping the vestibular mucosa with a plastic spatula. Statistical analysis was performed by using the paired t test for intragroup analysis and Student's t test for the intergroup data, with a significance level of 5%. Results No statistically significant difference was noted in the mean frequency of micronucleated cells before and after partial CBCT (P = .403). However, there was a significant difference in micronucleus frequency before and after total CBCT (P = .003). With regard to cytotoxicity, there was a statistically significant difference between partial and total acquisitions (P = .007 and P Discussion/Conclusions Only total CBCT seems to have a risk of inducing genetic damage, although both forms of CT scanning have promoted the induction of cytotoxic nuclear alterations.

Background: To compare the diagnostic accuracy of three different imaging systems: Direct digital radiography system (DDR-CMOS), four types of filtered images, and a priori and a posteriori registration of digital subtraction radiography (DSR) in the diagnosis of proximal defects. Materials and Methods: The teeth were arranged in pairs in 10 blocks of vinyl polysiloxane, and proximal defects were performed with drills of 0.25, 0.5, and 1 mm diameter. Kodak RVG 6100 sensor was used to capture the images. A posteriori DSR registrations were done with Regeemy 0.2.43 and subtraction with Image Tool 3.0. Filtered images were obtained with Kodak Dental Imaging 6.1 software. Images (n = 360) were evaluated by three raters, all experts in dental radiology. Results: Sensitivity and specificity of the area under the receiver operator characteristic (ROC) curve (Az) were higher for DSR images with all three drills (Az = 0.896, 0.979, and 1.000 for drills 0.25, 0.5, and 1 mm, respectively). The highest values were found for 1-mm drills and the lowest for 0.25-mm drills, with negative filter having the lowest values of all (Az = 0.631). Conclusion: The best method of diagnosis was by using a DSR. The negative filter obtained the worst results. Larger drills showed the highest sensitivity and specificity values of the area under the ROC curve.

Background: To evaluate the diagnostic accuracy of different radiographic methods in the assessment of proximal alveolar bone loss (ABL). Materials and Methods: ABL, the distance between cement-enamel junction and alveolar bone crest, was measured in 70 mandibular human teeth - directly on the mandibles (control), using conventional periapical radiography with film holders (Rinn XCP and Han-Shin), digital periapical radiography with complementary metal-oxide semiconductor sensor, conventional panoramic, and cone-beam computed tomography (CBCT). Three programs were used to measure ABL on the images: Image tool 3.0 (University of Texas Health Sciences Center, San Antonio, Texas, USA), Kodak Imaging 6.1 (Kodak Dental Imaging 6.1, Carestream Health ® , Rochester, NY, USA), and i-CAT vision 1.6.20. Statistical analysis used ANOVA and Tukey′s test at 5% significance level. Results: The tomographic images showed the highest means, whereas the lowest were found for periapical with Han-Shin. Controls differed from periapical with Han-Shin (P < 0.0001). CBCT differed from panoramic (P = 0.0130), periapical with Rinn XCP (P = 0.0066), periapical with Han-Shin (P < 0.0001), and digital periapical (P = 0.0027). Conventional periapicals with film holders differed from each other (P = 0.0007). Digital periapical differed from conventional periapical with Han-Shin (P = 0.0004). Conclusions: Conventional periapical with Han-Shin film holder was the only method that differed from the controls. CBCT had the closest means to the controls.