Introduction The aim of this case report is to present a distinct subtype of gingival inflammatory hyperplasia, providing information to avoid diagnostic mistakes and overtreatment. Also, an unexpected progression of the lesion is shown. Furthermore, a review of the literature to discuss the pathogenesis, diagnosis, treatment, and the need for new therapeutic approaches is presented. Case Series The authors report four cases of localized juvenile spongiotic gingival hyperplasia involving the anterior maxillary gingiva with distinct clinical features. The patients were followed for a period of 1 to 9 years, and the evolution of the lesions was documented. Surgical excision or therapy by topical steroids was used to treat the lesions. Conclusions The long‐term follow‐up provides important information for clinicians not to eliminate older patients for lesion diagnosis. Although surgical excision should not be recommended for all cases, considering the risk of esthetic problems, the treatment modality using topical steroids was not permanently effective in the authors’ cases. Investigations about new esthetic treatment modalities for lesions are needed.

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Aim: In this study we described the causes of mortality in Brazil, its 5 geographic regions, and in the most populated cities of Sao Paulo State in order to contribute for development of prevention and intervention strategies. Methods: Data on causes of death and age distribution of the populations were collected from online public databases and then submitted to the 2001 World Health Organization age standardization of rates for better assessment. Results: Data showed that the main causes of death in Brazil and in all 5 geographic regions were diseases of the circulatory system. Neoplasms were the second most frequent cause of death in Brazil and in 3 regions (South, Southeast and Midwest). However, in the other 2 regions (North and Northeast) the second most common was associated to external causes, being neoplasms the third most often. Additionally, in the South and Southeast the third cause of deaths were from diseases of the respiratory system and from the external causes occupied the fourth position. Analyzing the most populated cities of Sao Paulo State it was observed that all of them have the same profile of the country. On the other hand, as speculated previously, in Piracicaba city, the most common cause of mortality was neoplasm. Conclusions: These findings showed that Brazil has a large spectrum of causes of death and methods to decrease the mortality rates should be implemented in a local scenario rather than a nation-wide approach, where each location has to focus on its most urging problem.

Oral cancer is a public health problem worldwide with approximately 300,000 new cases diagnosed every year and more than 170,000 deaths annually. Squamous cell carcinoma (SCC) accounts for approximately 90% of all oral malignancies and it is frequently preceded by lesions known as oral potentially malignant disorders (OPMDs). Screening programs for early detection of oral lesions have been conducted. Therefore, the objective of this research was to carry out an active search in a screening program in the city of Piracicaba, Brazil. High-risk patients were identified at the city's health center through their medical records and referred for dental consultation. Other patients who opportunistically sought dental care were also seen and if they did not present risk factors for SCC, they were considered low-risk. A total of 756 patients were examined, and 445 met the criteria for the high-risk group and 311 for the low-risk group. It was possible to diagnose 27 OPMDs and six SCCs -21 OPMDs and six SCCs occurred in high-risk patients and six OPMDs in low-risk patients. A chi-square test was applied and a statistically significant value (p = 0.006) was obtained for the detection of OPMD and SCC in patients of the high-risk group. Screening of high-risk patients through active search proved to be an effective program for diagnosing OPMD and SCC. Therefore, we encourage its implementation on a large scale to reduce the current scenario of this disease.

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