ABSTRACT
e28 Abstracts
AN EXTENSIVE ORAL MELANOMA LESION:
A CASE REPORT Oldeir Digno Ribeiro de
SOUZA, Victor TIEGHI Neto, Vivian Palata
VIOLA, Ana Luiza Ribeiro de Oliveira AVI, Daniele
Moraes LOSADA, Carlos Roberto dos SANTOS, and
F

abio Luiz CORACIN
Malignant melanoma of the oral cavity is a rare condition,
accounting 0.5 % of all oral malignancies and 1-2% of all mela-
nomas. A 74-year-old male patient presented a black lesion in
the palate with a six-month evolution, associated with painful
symptoms and difficulty in swallowing. Incisional biopsy was
performed with results suggestive of compound nevus. Due to
lesion progression, a new biopsy was performed, with final diag-
nosis of malignant melanoma. Additional immunohistochemical
markers were positive for HMB-45,Mart-1 and Tyrosinase lead-
ing to final diagnosis of oral melanoma. Upon physical examina-
tion, an extensive lesion was seen occupying almost the entirety
of the palate, extending to the right cheek mucosa with imprecise
limits. Computed tomography revealed an ill-defined infiltrative
lesion in half-posterior right hard palate, infiltrating the midline.
Treatment included surgery in association with radiotherapy.
The patient is still alive as of the last follow-up.
LOW-LEVEL LASER THERAPY FOR XERO-
STOMIA IN A PATIENT WITH SJOGREN’S
SYNDROME: A CASE REPORT Joao Pedro
Santos NASCIMENTO, Mariela Dutra Gontijo de
MOURA, Laura Casc~ ao LOPES, Mariana Silveira SOUZA,
Anna Carolina Machado VIEIRA, Rodrigo Villamarim
SOARES, and Soraya de Mattos Camargo GROSSMANN
A 58-year-old woman presenting xerostomia was diagnosed
with Sj€ogren
s Syndrome at our service. Low-lever laser therapy
(LLLT - 100mW) was used to irradiate the parotid, submandibu-
lar, and sublingual glands, once a week for 15 weeks. Each irra-
diation point received a dose of 2 J/cm2. The salivary flow rate
was measured and a questionnaire for xerostomia were applied
before LLLT (0.58mL/min), after 10 sessions (0.62 mL/min),
after 15 sessions (0.65 mL/min), after one month from the end of
treatment (0.25 mL/min), and then after five months (0.23 mL/
min). Increase of salivary flow and the dry mouth symptoms
improved during LLLT. However, after therapy stopped, she
reported that her mouth was not moistened as when she was dur-
ing LLLT. This case shows a beneficial effect of LLLT on sali-
vary gland function, alleviating the symptoms and influencing
the patients’ quality of life, although they are not permanent.
MAXILLARY METASTASIS OF BREAST CAN-
CER Liliana Wolf BRAUN, Douglas Rodrigues
Gonçalves, J

ulia Candido Le~
ao, Alexandra
Cauduro Ponso Fernandes, Marco Antonio Trevizani
Martins, Manoela Domingues Martins, and Vinicius
Coelho Carrard
Metastatic tumor in the oral cavity represents approximately
1% of all oral tumors and usually affects soft tissues or jawbones.
A 45-year-old female sought an oral medicine service due to a
painful well-defined ulcerated lesion with oroantral communica-
tion in the hard palate. The lesion measured 1.5 £ 1.0cm and had
a 21-day history. The patient reported headache, dysphagia, and
left breast sectorectomy three years earlier for treating triple-neg-
ative breast cancer positive for BRCA2 mutation. The diagnostic
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July 2023
hypotheses included metastatic lesion of breast adenocarcinoma,
necrotizing sialometaplasia, and malignant salivary gland tumor.
A partial biopsy was performed and the histopathological and
immunohistochemistry analyses confirmed the mammary origin
of the tumor. The patient was referred to the medical team for
managing the recurrence of the disease. Further evaluation
showed metastatic lesions in the skin, lungs, bones, liver and
brain. Considering the disease was disseminated and uncon-
trolled, the patient was referred to palliative care.
PLASMA CELL MUCOSITIS IN ORAL CAV-
ITY: CASE REPORT Thiago Salvador de Lima
YAMADA, Claudia Perez Trindade FRAGA,


Ophir RIBEIRO JUNIOR, Amanda Almeida LEITE, Karen
Patr
ıcia Domingues GALLAGHER, Pablo Agostin
VARGAS, and Marcelo MARCUCCI
Plasma cell mucositis is a rare benign disease of unknown
etiology, histologically characterized by plasmacyte infiltration
in the upper aerodigestive tract submucosa. Affects mostly adults
and may be associated with immunological disorders. Oral
lesions may appear erythematous with papillomatosis, nodular,
or granulomatous. A 21-year-old male patient with celiac disease
was referred to the stomatology clinic for evaluation of an oral
lesion. On physical examination, there is an ulcerated lesion on
the left cheek mucosa, extending to the bottom of the sulcus and
alveolar mucosa, with dimensions of approximately 4 to 5 cm in
its longest axis, with a hardened consistency and painless on pal-
pation, with the presence of bleeding to the touch. An incisional
biopsy was performed, which revealed a chronic perineural and
perivascular plasma cell inflammatory process, confirming the
diagnosis of plasma cell mucositis. The patient underwent intra-
lesional corticosteroid therapy with marked remission of the
lesion.
MACHINE LEARNING IN THE DIAGNOSIS
OF FOLLICULAR LYMPHOMA Lucas Lacerda
de SOUZA, Anna Luiza Damaceno ARAUJO,
Viviane Mariano da SILVA, Alan Roger Santos-Silva,
Marcio Ajudarte Lopes, Matheus Cardoso Moraes, and
Pablo Agustin Vargas
Objective: To implement a machine-learning (ML)
model to assist pathologists in the differentiation of follicular
hyperplasia (FH) and follicular lymphoma (FL).
Study Design: Whole slide images from 10 patients with
FH and 10 patients with FL were manually annotated and frag-
mented into 21,585 patches (FH=13,399 and FL=8,186) of
299 £ 299 pixels. The convolutional neural network (CNN)
VGGNet was re-trained using Python 3.6 and other open-source
libraries for machine learning and image processing (Tensor-
Flow, Keras, Scikit-Learn, and OpenCV). The training and vali-
dation were carried out for 10 epochs until accuracy stabilized
and validation loss reduced its variation.
Results: The total processing time for the CNN train-
ing was 753s. Different metrics could be obtained through
the confusion matrix, emphasizing a high training accuracy
of 98% and F1-score of 82%. Sensitivity and specificity were
74.8% and 91.8%, respectively. The receiver operating char-
acteristic curve of 94% showed the fine class separation abil-
ity of the CNN.
Conclusion: The ML model used in this study is feasible
to differentiate FH and FL. Additional CNN training and
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Volume 136, Number 1
validation in bigger/multicenter datasets may generate AI-
assisted tools to aid FL diagnosis.
EVALUATION OF TERT PROMOTER HOT-
SPOT MUTATIONS IN AMELOBLASTOMA
AND AMELOBLASTIC CARCINOMA Maria
Carolina Silva Versieux MAGALHAES, e Let
ıcia Martins
GUIMARAES,e Jean Nunes dos SANTOS, Luiz Armando
DE MARCO, Ricardo Santiago GOMEZ, Carolina
Cavali

eri GOMES, and S
ılvia Ferreira DE SOUSA
Ameloblastoma is a benign, locally destructive, and infiltra-
tive neoplasm. Ameloblastic carcinoma (AC) is a rare malignant
tumor that arises either de novo or from a pre-existing ameloblas-
toma. The gene telomerase reverse transcriptase (TERT) encodes
the enzyme telomerase, responsible for preventing replicative
senescence. Detectable telomerase activity has been reported in
ameloblastoma. TERT promoter (TERTp) mutation is one of the
mechanisms that lead to increased enzyme activity. The coexis-
tence of TERTp mutations with BRAFV600E is reported in
some tumors as papillary thyroid carcinoma or cutaneous mela-
noma, and it is associated with aggressiveness. Ameloblastoma
and AC harbor BRAFV600E, however, it remains unknown
whether these odontogenic tumors also show mutations in TERT
promoter. Objective: To investigate TERTp hotspot mutations in
ameloblastoma and AC. Study Design: Genomic DNA of paraf-
fin-embedded ameloblastomas (n=6) and AC (n=3) were Sanger-
sequenced to assess the hotspot mutations C228T and C250T
TERTp. Results: None of the samples harbored TERTp muta-
tions. Conclusion: The results suggest that the mutations C228T
and C250T in TERT promoter are not a common event in amelo-
blastoma and AC. Whether other genetic or epigenetic events in
TERT promoter play a role in the tumorigenesis of these odonto-
genic tumors remains to be elucidated. SUPPORT: FAPEMIG
PROBIC.
EFFECTS OF SMOKING NARGHILE ON
ORAL HEALTH: A COMPARATIVE CROSS-
SECTIONAL STUDY Ana Carolina Elias
HANNA, Thi^

essy Tamylla Freitas LUCIO, Camila Alves
COSTA, Ricardo Nat~ a Fonseca SILVA, Virg
ılio Moreira
RORIZ, and N
adia doLago COSTA
Objective: To comparatively evaluate the prevalence of
lesions in the oral mucosa and periodontal status in chronic nar-
ghile users and non-users.
Study Design: Chronic narghile users (n=40) and non-
users (control group) (n=40), paired by age and sex, participated
in this cross-sectional study. Characteristics of narghile use and
data on demographic and socioeconomic factors were obtained
through structured forms. The degree of dependence was
assessed using the Fagerstrom dependence test. Intraoral exami-
nation and periodontal status were evaluated with intraoral clini-
cal examination.
Results: The mean age of the participants was 24.9
(§6.3) years in the narghile users and 25 (§6.6) in the control
group, with a predominance of males (80%, n=32). It was
observed that the mean bleeding on probing was 28.2% (§23.8)
and 22.2% (§11.9) in the narghile users and control group
(p=0.799), respectively. There was a higher occurrence of peri-
odontitis in narghile users (n=19; 47.5%), compared to control
group (n=3; 7.5%) (p<0.001). A direct association was observed
between the degree of dependence and periodontal attachment
ABSTRACT
Abstracts e29
loss (p=0.002) in the narghile group. In narghile users, 17
(42.5%) lesions were observed, 2 of which were leukoplakia.
Conclusion: Narghile users are more susceptible to peri-
odontal disease and potentially malignant lesion manifestations
than non-users.
ASSESSMENT OF LABIAL AND ORAL DRY-
NESS, ORAL ULCERATIONS IN HOSPITAL-
IZED PATIENTS UNDER PALLIATIVE CARE
Nayara Flores MACEDO, Bianca Cardoso WEIDNER,
Bruno Jassek de OLIVEIRA, Gabriela Leite BAGGIO,
Luciana Reis Azevedo ALANIS, Paulo Henrique Couto
SOUZA, and Soraya de Azambuja Berti COUTO
Objective: To evaluate the frequency of lip and oral dry-
ness as well as the presence of oral ulcerations in hospitalized
patients under palliative care, and correlate them with their sys-
temic diseases.
Study Design: A cross-sectional and observational study
comprising 38 patients, 14 women and 24 men, 59.4 § 10.3
years-old, under palliative care was conducted at a University
Hospital from Curitiba, Brazil. Data collection was performed in
two stages: firstly, the study of hospital records to collect data
such as the basal disease and secondly, the clinical examination
for the diagnosis of lip and oral dryness and oral ulcerations.
Results: The chi-square statistical test did not show a
significant correlation between lip and oral dryness, as well as
the presence of oral ulcerations, when correlated to the presence
of systemic diseases, specifically head and neck cancer (N=15)
(p>0.05).
Conclusion: Although there was no statistical correla-
tion between lip and oral dryness and oral ulcerations with sys-
temic diseases, these oral alterations were diagnosed
predisposing a significant oral discomfort. Therefore, the impor-
tance of dental care for patients under palliative care during the
hospitalization is fundamental to relieving their suffering and
improving their quality of life.
QUALITY OF INFORMATION ABOUT MEDI-
CATION-ASSOCIATED OSTEONECROSIS OF
THE JAWS AVAILABLE ON GOOGLE, YOU-
TUBE, AND INSTAGRAM Kamilla PASSOS, Pollyana
SANTOS, Augusto LEONEL, Jurema DE CASTRO, Vit

oria
CRUZ, Elaine CARVALHO, and Danyel PEREZ
Objective: To evaluate the quality of information about
medication-associated osteonecrosis of the jaws (MRONJ) avail-
able on Google, YouTube, and Instagram.
Study Design: The keywords "medication-related osteo-
necrosis of the jaws" and "medication-related osteonecrosis of
the jaw" were used on Google, Youtube, and Instagram, #mronj
and #osteonecrosedosmaxilares. The contents evaluated were in
Brazilian Portuguese and English languages. Websites and Insta-
gram were evaluated using the JAMA benchmarks, Discern
instrument, and the Flesch Index. The existence of HONcode has
only been recorded on websites. Videos were ranked according
to their usefulness score.
Results: A total of 26 Instagram posts, 11 websites, and
82 YouTube videos were evaluated. Regarding the JAMA bench-
marks, all sites and posts included at least two criteria. Regarding
the Flesch index, 9.1% of the sites were classified as "difficult"
and 90.9% "very difficult." From Instagram, 50% of the posts
were rated as "very difficult," 46.2% as "difficult," and 3.8% as