SM was found at a high frequency in oral and vascular samples, even in edentulous patients, and its presence in atherosclerotic plaques suggests the possible involvement of this bacterium in the disease progression.

The aim of this study is to share the experience of implementing a network for the diagnosis of oral cancer by integrating primary, secondary, and tertiary oral health care centers and identifying the possible weaknesses of the process. The study also investigated the risks of exposure to the main risk factors for oral and lip cancer and their most common potentially malignant lesions (PML). A quantitative cross-sectional study was conducted in two different regions, with patients seen at a primary health care facility from August 2010 to July 2011. Patients with oral lesions were referred to dental specialty centers for biopsy. Patients with PML were treated in dental specialty centers, and patients with squamous cell carcinoma (SCC) were referred to tertiary health care facilities. The dentists' knowledge of PML and SCC was assessed by an objective questionnaire. A total of 3,965 individuals were examined, 296 lesions were found, and 73 biopsies were performed, of which 13.7% were diagnosed as PML and 9.6% as SCC. Tobacco use and sunlight exposure were associated with SCC (85.7%) and PML (80%), respectively. In total, 55 dentists were assessed. The lesions most commonly recognized as PML were leukoplakia (74%), erythroplakia (57%), and actinic cheilosis (56%). Most dentists (74%) felt incapable of performing biopsies, most likely because of an anxiety towards oral cancer, and 57% had never performed one. The integration of primary and secondary health care enables the diagnosis of PML and SCC and establishes a diagnosis network. However, the inability of most primary care dentists to identify PML and perform biopsies is a weakness of the diagnostic process.

Primary cardiac angiosarcoma is an extremely rare malignant tumor. Distant metastases are common at the time of diagnosis but have never been reported in the jaw. A 45-year-old female patient with primary cardiac angiosarcoma was referred for dental care due to pain in the mandibular alveolar ridge. Oral examination revealed a red-violet lesion that was soft on palpation and had been present for 3 months. Histological analysis confirmed the diagnosis of metastatic cardiac angiosarcoma. The patient died of multiple metastases.

FOP is a rare disease dentists must familiarize themselves with to provide adequate, personalized treatment, which minimizes traumas that may exacerbate the disease.

Aim: To present the clinical findings of a patient with Fibro dysplasia Ossificans Progressiva (FOP), highlighting peculiari ties of dental treatment in patients with this condition. Background: FOP is a rare genetic disease characterized by skeletal malformations and ectopic ossifications in skeletal muscles, tendons, ligaments and aponeurosis. Exacerbation of these ossifications can be caused by dental treatment, resulting in disease progression. Case description: A 26yearold male patient with a diagnosis of FOP was referred to our service for dental treatment. The patient presented decreased mobility in peripheral joints (knees and elbows), postural disability (ankylosis of the vertebral column), lateral deviation and shortness of the hallux, as well as heterotopic ossifications on the hands and back. The implementation of conservative dental procedures, such as oral hygiene instructions and recurrent topical fluoride applications, were performed in addition to endodontic and restorative treatments. Brief dental appointments were conducted without using regional anesthesia or dental dam clamps. The dental chair was positioned at 45° to provide more comfort and to avoid exacerbating the disease. The patient has now completed 6 months of followup and is free of heterotopic ossifications resulting from dental treatment. Conclusion: The dental treatment modifications implemented for the present case were sufficient to establish good oral health and to prevent the formation of heterotopic ossifications in the maxillofacial region. Clinical significance: FOP is a rare disease dentists must familiarize themselves with to provide adequate, personalized treatment, which minimizes traumas that may exacerbate the disease.