To perform a systematic review of the literature on the control of oral biofilms and the incidence of nosocomial pneumonia, in addition to assessing and classifying studies as to the grade of recommendation and level of evidence. The review was based on PubMed, LILACS, and Scopus databases, from January 1st, 2000 until December 31st, 2012. Studies evaluating oral hygiene care related to nosocomial infections in patients hospitalized in intensive care units were selected according to the inclusion criteria. Full published articles available in English, Spanish, or Portuguese, which approached chemical or mechanical oral hygiene techniques in preventing pneumonia, interventions performed, and their results were included. After analysis, the articles were classified according to level of evidence and grade of recommendation according to the criteria of the Oxford Centre for Evidence-Based Medicine. A total of 297 abstracts were found, 14 of which were full articles that met our criteria. Most articles included a study group with chlorhexidine users and a control group with placebo users for oral hygiene in the prevention of pneumonia. All articles were classified as B in the level of evidence, and 12 articles were classified as 2B and two articles as 2C in grade of recommendation. It was observed that the control of oral biofilm reduces the incidence of nosocomial pneumonia, but the fact that most articles had an intermediate grade of recommendation makes clear the need to conduct randomized controlled trials with minimal bias to establish future guidelines for oral hygiene in intensive care units.
Lipomas are very common benign slow-growing soft tissue neoplasms composed of
mature adipose tissue mostly diagnosed in the fifth decade of life. These tumors
rarely present in the oral cavity, representing less than approximately 5% of
all benign mouth tumors. They are usually less than 2cm in size and etiology
remains unclear. We report a young male patient presenting with a giant lipoma
in the buccal mucosa. Histopathology revealed a large area of mature fat cells
consistent with conventional lipoma and an area of the mucosal lining of the
lesion suggestive of morsicatio buccarum. In the present
article, we emphasize the clinicopathological features and differential
diagnosis of the disease.
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