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Abordagem em medicina dentária na prevenção da malignização da eritroplasia oral: revisão scoping
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| Projeto de pós-graduação_41577 | 1.15 MB | Adobe PDF |
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Introdução: A eritroplasia oral é uma das lesões orais potencialmente malignas mais preocupantes devido ao seu elevado risco de transformação maligna. Apesar da sua baixa prevalência, a eritroplasia oral apresenta-se frequentemente já associada a displasia grave ou carcinoma in situ no momento do diagnóstico. O papel do médico dentista é crucial no rastreio em cuidados primários, mas os métodos de diagnóstico continuam a apresentar limitações.
Objetivo: Esta scoping review pretende identificar as características clínicas e histopatológicas da eritroplasia oral, analisar as estratégias atuais de rastreio, diagnóstico e tratamento/acompanhamento, reforçando o papel do médico dentista na deteção precoce.
Metodologia: Foi realizada uma scoping review seguindo a metodologia PRISMA. A pesquisa foi efetuada nas bases de dados PubMed, Web of Science e B-on, de artigos publicados entre 2015 e 2025 em língua portuguesa, inglesa e francesa. Foram aplicados termos relacionados com eritroplasia oral, diagnóstico, tratamento e abordagem clínica. Dos 2448 artigos inicialmente identificados, 9 cumpriram os critérios de inclusão e foram analisados de forma descritiva.
Resultados: Estudos confirmam que a eritroplasia oral apresenta frequentemente displasia epitelial grave, carcinoma in situ ou carcinoma invasivo aquando do diagnóstico. A biópsia com exame histopatológico mostrou-se o método mais indicado para o diagnóstico da eritroplasia. Métodos complementares, como a coloração vital com azul de toluidina, imagiologia por banda estreita (NBI), colposcopia oral, e inteligência artificial, demonstraram utilidade para orientar o local da biópsia e melhorar a deteção precoce. A excisão cirúrgica constitui o tratamento de eleição, reduzindo em mais de 50% o risco de transformação maligna, mas não elimina a necessidade de vigilância clínica rigorosa e biópsias repetidas.
Conclusões: A eritroplasia oral, apesar de rara, não deve ser desvalorizada, dado a sua elevada taxa de transformação maligna. Para além da biopsia histopatológica, o desenvolvimento ou a consolidação de novas abordagens diagnósticas, a uniformização dos protocolos e o reforço do papel preventivo do médico dentista no rastreio em cuidados primários, constituem uma prioridade para reduzir significativamente a prevalência do cancro oral e melhorar o prognóstico dos pacientes com eritroplasia oral.
Introduction: Oral erythroplakia is one of the most worrisome potentially malignant oral lesions due to its high risk of malignant transformation. Despite its low prevalence, oral erythroplakia is often already associated with severe dysplasia or carcinoma in situ at the time of diagnosis. The role of the dentist is crucial in screening in primary care, but diagnostic methods continue to have limitations. Objective: This scoping review aims to identify the clinical and histopathological characteristics of oral erythroplakia, analyze current strategies for screening, diagnosis and treatment/follow-up, and reinforcing the role of the dentist in early detection. Methodology: A scoping review was carried out according to the PRISMA methodology. The search was carried out in the PubMed, Web of Science and B-on databases, including articles published between 2015 and 2025 in Portuguese, English, and French. Terms related to oral erythroplakia, diagnosis, treatment and clinical approach were applied. Of the 2448 articles initially identified, 9 met the inclusion criteria and were analyzed descriptively. Results: Most studies confirm that most oral erythroplakia patients frequently present with severe epithelial dysplasia, carcinoma in situ, or invasive carcinoma at diagnosis. Biopsy with histopathological examination shows that is the most indicate to erythroplakia diagnosis, although complementary methods such as vital stains with toluidine blue, narrowband imaging (NBI), oral colposcopy, salivary biomarkers, and artificial intelligence have been shown to be useful in guiding the biopsy site and improving early detection. Surgical excision is the treatment of choice, reducing the risk of malignant transformation by more than 50%, but it does not eliminate the need for close clinical surveillance and repeated biopsies. Conclusions: Oral erythroplakia, although rare, should not be underestimated, given its high rate of malignant transformation. In addition to histopathological biopsy, the development or consolidation of new diagnostic approaches, the standardisation of protocols and the reinforcement of the preventive role of dentists in primary care screening are priorities for significantly reducing the prevalence of oral cancer and improving the prognosis of patients with oral erythroplasia.
Introduction: Oral erythroplakia is one of the most worrisome potentially malignant oral lesions due to its high risk of malignant transformation. Despite its low prevalence, oral erythroplakia is often already associated with severe dysplasia or carcinoma in situ at the time of diagnosis. The role of the dentist is crucial in screening in primary care, but diagnostic methods continue to have limitations. Objective: This scoping review aims to identify the clinical and histopathological characteristics of oral erythroplakia, analyze current strategies for screening, diagnosis and treatment/follow-up, and reinforcing the role of the dentist in early detection. Methodology: A scoping review was carried out according to the PRISMA methodology. The search was carried out in the PubMed, Web of Science and B-on databases, including articles published between 2015 and 2025 in Portuguese, English, and French. Terms related to oral erythroplakia, diagnosis, treatment and clinical approach were applied. Of the 2448 articles initially identified, 9 met the inclusion criteria and were analyzed descriptively. Results: Most studies confirm that most oral erythroplakia patients frequently present with severe epithelial dysplasia, carcinoma in situ, or invasive carcinoma at diagnosis. Biopsy with histopathological examination shows that is the most indicate to erythroplakia diagnosis, although complementary methods such as vital stains with toluidine blue, narrowband imaging (NBI), oral colposcopy, salivary biomarkers, and artificial intelligence have been shown to be useful in guiding the biopsy site and improving early detection. Surgical excision is the treatment of choice, reducing the risk of malignant transformation by more than 50%, but it does not eliminate the need for close clinical surveillance and repeated biopsies. Conclusions: Oral erythroplakia, although rare, should not be underestimated, given its high rate of malignant transformation. In addition to histopathological biopsy, the development or consolidation of new diagnostic approaches, the standardisation of protocols and the reinforcement of the preventive role of dentists in primary care screening are priorities for significantly reducing the prevalence of oral cancer and improving the prognosis of patients with oral erythroplasia.
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Palavras-chave
Eritroplasia oral Lesões orais potencialmente malignas Diagnóstico precoce Medicina dentária Prevenção Oral erythroplakia Potentially malignant oral lesions Early diagnosis Dentistry Prevention