Publications by authors named "Natalia Rangel Palmier"

Objective: Evaluate the sociodemographic, clinical, and lifestyle characteristics at head and neck squamous cell carcinoma (HNSCC) diagnosis and their impact on overall survival (OS) across different anatomical sites.

Materials And Methods: A retrospective cohort study (2011-2021) at Instituto do Câncer do Estado de São Paulo, involving 3052 HNSCC patients. Survival analyses utilized the Kaplan-Meier method and Cox proportional hazard ratios with 95% confidence intervals, incorporating significant variables from univariate analysis.

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The dental treatment of patients with oral cavity and oropharyngeal squamous cell carcinoma (OOPSCC) may be challenging for dentists. This study aimed to characterize systemic changes in patients with OOPSCC undergoing dental treatment prior to cancer therapy, with a specific focus on laboratory assessments. The primary objectives included identifying potential adverse events, such as infections or bleeding, resulting from dental procedures.

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Aims: Radiation caries (RC) is a highly prevalent and chronic complication of head and neck radiotherapy (HNRT) and presents a challenge for clinicians and patients. The present study aimed to assess the impact of RC on the morbidity and mortality outcomes of head and neck squamous cell carcinoma (HNSCC) patients.

Methods And Results: Patients were divided into three groups: (1) RC (n = 20), (2) control (n = 20), and (3) edentulous (n = 20).

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Objective: This systematic review investigated the dosimetric parameters used in preclinical studies.

Study Design: Searches were performed in 3 databases (PubMed, Scopus, and Embase) and gray literature to identify studies for review. In vitro and ex vivo studies that examined the effect of radiation on human permanent teeth were included.

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Objective: We performed a systematic review dedicated to pooling evidence for the associations of clinical features with malignant transformation (MT) and recurrence of 3 oral potentially malignant disorders (OPMDs) (actinic cheilitis [AC], oral leukoplakia [OL], and proliferative verrucous leukoplakia [PVL]).

Study Design: We selected studies that included clinical features and risk factors (age, sex, site, size, appearance, alcohol intake, tobacco use, and sun exposure) of OL, PVL, and AC associated with recurrence and/or MT.

Results: Based on the meta-analysis results, non-homogeneous OL appears to have a 4.

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This study tested the hypothesis that head and neck radiotherapy (HNRT) impacts the immunoexpression of type I collagen, bone sialoprotein (BSP) and bone morphogenetic protein 4 (BMP4), thereby leading to micromorphological changes in the dentin-pulp complex (DPC), and promoting the onset and progression of radiation caries (RC). Twenty-two demineralized sections of carious teeth (a group of 11 irradiated teeth and a control group of 11 non-irradiated teeth) extracted from 19 head and neck cancer patients were analyzed by conventional optical microscopy and immunohistochemistry to investigate the micromorphology (cellular layer hierarchy, blood vessels, odontoblasts, fibroblasts, extracellular matrix, calcification, necrosis, reactionary dentin formation, and chronic inflammation), and the patterns of staining/immunolocalization of type I collagen, BSP and BMP4 in the dental pulp of irradiated and control samples. No significant differences attributable to the direct impact of radiotherapy were detected in DPC micromorphology between the groups.

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Article Synopsis
  • The study aimed to evaluate the safety and effectiveness of a preventive treatment called extraoral photobiomodulation (PBM) for reducing oral and oropharyngeal mucositis (OM) in patients with oral and throat cancer undergoing radiation therapy (RT).
  • Patients were randomly assigned to receive either PBM or a placebo; results showed that the PBM group had a delayed onset of OM, lower pain scores, and reduced need for pain and anti-inflammatory medications, along with improved quality of life.
  • Despite these benefits, there was no significant difference in overall survival rates between the two groups after one year, suggesting that while PBM may help with symptoms, it doesn't affect long-term cancer
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Objectives: Radiation-related caries (RRC) is one of the most aggressive complications of radiotherapy (RT) in survivors of head and neck cancer (HNC). Lack of RRC awareness may contribute to the occurrence of this oral cavity complication. RRC may be considered a "forgotten oral complication" by patients with HNC, oncologists, and dentists.

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Statement Of Problem: Established restorative protocols for patients after head and neck radiotherapy are lacking, increasing the failure rates of dental adhesive restorations.

Purpose: The purpose of this systematic review and meta-analysis was to analyze the evidence regarding the impact of head and neck radiotherapy on the longevity of dental adhesive restorations.

Material And Methods: A search was performed using PubMed, Scopus, and Embase in May 2018 (updated in November 2020).

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Purpose: To identify and summarize the evidence on the cost-effectiveness of photobiomodulation (PBM) therapy for the prevention and treatment of cancer treatment-related toxicities.

Methods: This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA) and Meta-analysis Of Observational Studies in Epidemiology (MOOSE). Scopus, MEDLINE/PubMed, and Embase were searched electronically.

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Aims: Evaluate the abundance of the selected targets, alpha-1-antitrypsin (A1AT) and macrophage migration inhibitory factor (MIF), and correlate these findings with the risk of developing severe oral mucositis (OM).

Materials And Methods: Head and neck squamous cell carcinoma (HNSCC) patients submitted to radiotherapy (RT) or chemoradiotherapy (CRT) were assessed. OM grade and pain were evaluated daily during treatment.

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Article Synopsis
  • The study aimed to assess the effects of prophylactic photobiomodulation therapy (PBMT) on oral mucositis (OM) in patients with advanced oral squamous cell carcinoma (OSCC).
  • It found that OM most commonly affected the lateral border of the tongue, buccal mucosa, and labial mucosa, with peak severity at weeks 5 to 7 and a cumulative severe OM occurrence of 23%.
  • Results indicated that PBMT led to less severe mucositis, reduced pain levels, less use of analgesics, and lowered need for feeding support, suggesting its effectiveness in mitigating OM symptoms during treatment.
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Background: The aim of this work was to evaluate the microscopic characteristics through polarized light microscopy, scanning electron microscopy and the mineral content of circumpulpal dentin of irradiated (IT) and non-irradiated teeth (NIT), with deep caries that reached the root canal.

Material And Methods: A total of 25 IT were analyzed macroscopically, and radiographed. 5 NIT were used as controls.

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Objective And Study Design: This narrative review summarizes the current state of art of radiation-related caries (RC), an aggressive disease that affects approximately 30% of post-head and neck radiotherapy (HNRT) patients.

Results: RC mainly affects the tooth cervical areas and incisal/cuspal tips and develops 6 to 12 months after HNRT. Early RC signs include black/brownish tooth discoloration and enamel cracks, which progress to enamel delamination, exposing underlying dentin to a highly cariogenic oral environment and rapid tooth destruction/dental crown amputation.

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Background: Incidence and mortality rates of childhood cancer represent a global public health issue, however, the worldwide prevalence of head and neck cancer in pediatric patients (HNCPP) is still unknown. Therefore, this study aimed to describe the frequency and distribution of HNCPP worldwide.

Methods: A specific search strategy was performed using MEDLINE, Scopus, and EMBASE to include studies based on hospital records, national cancer registries, and pathology files.

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Radiation-related caries (RRC) is a disease with a high potential for destruction of the dentition, which impairs quality of life in head-and-neck (HN) cancer (HNC) patients who undergo radiotherapy. In light of the recently described "clustering of oral symptoms theory," the present systematic review (PROSPERO CRD42019132709) aims to assess HN and gastrointestinal (GI) symptom clusters among HNC patients and discusses how these indirect effects of cancer therapy play a pivotal role in the pathophysiology of RRC. The search was performed at PubMed, Scopus, and Embase and resulted in 11 studies that met the inclusion criteria.

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Objectives: To evaluate cancer treatment-related toxicities in young head and neck cancer (HNC) patients.

Material And Methods: A total of 44 patients were included in the present retrospective cohort study, which was designed to access oral toxicities of cancer treatment in young (< 45 years of age, Group I, n = 22) and old (> 58 years of age, Group II, n = 22) HNC patients with similar tumor stage and treatment protocols. Oral mucositis (OM), xerostomia, dysphagia, dysgeusia, trismus, and radiodermatitis were assessed during days 7th, 21st, and 35th of head and neck radiotherapy (HNRT) according to previously validated scales (World Health Organization criteria and the National Cancer Institute and Common Terminology Criteria for Adverse Events version 4.

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Purpose: The objective of this multicentre study was to verify the relationship between the scores of quality of life (QoL) and the decayed, missing and filled teeth (DMFT) and radiation caries (RC) in patients treated with radiation therapy (RT) for head and neck cancer, and through this to determine if RC is capable of causing a significant decrease in the QoL.

Methods: One hundred patients were divided into 2 groups: patients with at least 1 year of RT completion who developed RC (study group, n = 50); and patients with at least 1 year of RT completion who did not develop RC (control group, n = 50). All patients answered the Brazilian-Portuguese version of the University of Washington quality of life (UW-QoL) questionnaire, which was divided into physical and social-emotional functioning domains and evaluated the DMFT index score.

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A 31-year-old woman was referred for the evaluation of persistent lower lip numbness following endodontic treatment of tooth #36. Imaging examinations showed a large amount of radiopaque/hyperdense material spread in an angiographic distribution in the left mandibular body region. Laboratory analyses of tooth #36 and adjacent periapical tissue, surgically extracted in an external Service due to acute pain following endodontic treatment, identified chronic inflammatory reaction and birefringent crystalloid foreign bodies rich in barium and sulphur, leading to the diagnosis of alveolar nerve injury due to accidental extrusion of intracanal dressing material composed of calcium hydroxide [Ca(OH) ] paste incorporated with barium sulphate.

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Photobiomodulation therapy (PBMT), also known as low-level laser therapy (LLLT), has been increasingly used for the treatment of toxicities related to cancer treatment. One of the challenges for the universal acceptance of PBMT use in cancer patients is whether or not there is a potential for the light to stimulate the growth of residual malignant cells that evaded oncologic treatment, increasing the risk for tumor recurrences and development of a second primary tumor. Current science suggests promising effects of PBMT in the prevention and treatment of breast cancer-related lymphedema and oral mucositis, among other cancer treatment toxicities.

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Background: Radiation-related caries (RRC) is one of the most significant oral toxicities of head and neck radiotherapy (HNRT); however, the potential of radiation to directly cause harmful dentin and pulpal effects and impair response to caries progression is controversial.

Material And Methods: Therefore, the aim of this study was to characterize the reactions of the dentin-pulp complex in teeth affected by RRC. Patients and methods: Twenty-two carious teeth extracted from 22 head and neck cancer (HNC) patients were divided into control (conventional caries; n=11) and irradiated (RRC; n=11) groups and paired matched by dental homology, clinical patterns of caries progression following the Post-Radiation Dental Index (PRDI) and microscopic depth of carious invasion.

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Validation studies of whole slide imaging (WSI) systems produce evidence regarding digital microscopy (DM). This systematic review aimed to provide information about the performance of WSI devices by evaluating intraobserver agreement reported in previously published studies as the best evidence to elucidate whether DM is reliable for primary diagnostic purposes. In addition, this review delineates the reasons for the occurrence of discordant diagnoses.

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Objectives: The aim of this study was to assess the presence of enamel craze lines (ECLs), part of the spectrum of the so-called cracked tooth syndrome, on the surface of teeth irradiated in vivo.

Study Design: Forty teeth extracted from patients with head and neck cancer were paired, matched, and equally divided into 4 groups: noncarious irradiated (G1); noncarious control (G2); radiation-related caries (RRC) (G3), and carious control (G4). Samples were examined for ECL detection with a fiberoptic transillumination device and photographed, and ECL mean size, number, and patterns of topographic distribution in tooth crown were determined.

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Whole slide imaging (WSI) systems are being increasingly used in educational and professional settings, highlighting the value of digital microscopy and favouring its acceptance for use in primary diagnosis. There has been a reluctance to introduce diagnostic applications due to a lack of validation and regulation of these devices. This study aims to provide information regarding the performance of WSI and to validate it for use in the diagnosis of oral diseases, using the intraobserver variability as the primary form of analysis.

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