Salivary protein candidates for biomarkers of oral disorders in people with a crack cocaine use disorder

Abstract The use of cocaine and its main derivative, crack, can cause some systemic effects that may lead to the development of some oral disorders. Objective To assess the oral health of people with a crack cocaine use disorder and identify salivary protein candidates for biomarkers of oral disorders. Methodology A total of 40 volunteers hospitalized for rehabilitation for crack cocaine addiction were enrolled; nine were randomly selected for proteomic analysis. Intraoral examination, report of DMFT, gingival and plaque index, xerostomia, and non-stimulated saliva collection were performed. A list of proteins identified was generated from the UniProt database and manually revised. Results The mean age (n=40) was 32 (±8.88; 18-51) years; the mean DMFT index was 16±7.70; the mean plaque and gingival index were 2.07±0.65 and 2.12±0.64, respectively; and 20 (50%) volunteers reported xerostomia. We identified 305 salivary proteins (n=9), of which 23 were classified as candidate for biomarkers associated with 14 oral disorders. The highest number of candidates for biomarkers was associated with carcinoma of head and neck (n=7) and nasopharyngeal carcinoma (n=7), followed by periodontitis (n=6). Conclusions People with a crack cocaine use disorder had an increased risk of dental caries and gingival inflammation; less than half had oral mucosal alterations, and half experienced xerostomia. As possible biomarkers for 14 oral disorders, 23 salivary proteins were identified. Oral cancer and periodontal disease were the most often associated disorders with biomarkers.

No association between dopamine D2 receptor (DRD2) alleles and crack/cocaine dependence in Brazilians

INTRODUCTION: The causal mechanisms behind crack/cocaine use are still unknown, but genetic influences are suggested. OBJECTIVE: To investigate the relationship between the genetic polymorphism TaqI (rs1800497) in the dopamine D2 receptor (DRD2) gene and susceptibility to crack/cocaine dependence in a group of addicts to crack/cocaine and a non-addicted group. METHODS: The case group (n=515) was composed of crack/cocaine-dependent men and the control group (n=106) comprised men who were considered not dependent on crack/cocaine. The oral hygiene habits, decayed, missing, and filled teeth index, gingival index, and plaque index were evaluated. The reference single nucleotide polymorphism (rs1800497 C/T) of the DRD2 gene was genotyped by a real-time polymerase chain reaction technique. Student's t-tests for independent samples or the non-parametric Mann-Whitney test were used to compare groups regarding quantitative variables. RESULTS: The case group showed a mean time of 9.91±7.03 years of crack use, and 61.06±92.96 stones/week. The socio-demographic profile of the sample was White, single men, with basic education, blue-collar worker, smoker, and reporting alcohol use. There was a high frequency of gingival inflammation, plaque accumulation, and caries experience. For all genetic models tested, there was no significant difference in the genotypic frequency in rs1800497 of the DRD2 gene, between case and control groups (p>0.05). CONCLUSION: The genetic variant in the DRD2 did not increase the vulnerability to develop crack/cocaine dependence. The complex genetic nature of crack/cocaine dependence and a large variation of DRD2 allele frequencies, depending on the population group sampled, could be one explanation for the no association.

Double Retromolar Canal: a Case Report / Canal Retromolar Duplo: Relato de Caso Clínico

The retromolar canal is an anatomical variation of the mandibular canal. Its neurovascular bundle may extend to areas of the temporalis tendon, and areas of buccinator muscle insertion in the alveolar process at lower third molar region, beside the retromolar fossa. The observation of the retromolar canal in conventional radiographs is limited by the presence of increased bone condensation in the region due to overlapping anatomical structures. The use of three-dimensional imaging techniques, such as cone beam computed tomography can contribute significantly for the treatment planning. Some complications may occur in surgical procedures involving the retromolar area when the retromolar canals are present, such as hemorrhage, failure in anesthesia and injuries to nerve branches. This study reported an unusual case of a double retromolar canal on the left side of the mandible, that led to the change of the treatment planning in a 54-year-old male patient. Furthermore, the clinical and surgical consequences of these findings in oral rehabilitation were discussed. The cone beam computed tomography was an important diagnostic tool in the observation of the presence and the exact location of retromolar canal. Retromolar canals may be detected on a panoramic radiograph. However, more precise information about the anatomical variation can be shown on cross sectional cone beam computed tomography images. (AU)

O canal retromolar é uma variação anatômica do canal da mandíbula. Seu feixe vásculo-nervoso pode se estender para áreas do tendão do músculo temporal, áreas de inserção do músculo bucinador e no processo alveolar na região do terceiro molar inferior, além da fossa retromolar. A observação do canal retromolar em radiografias convencionais é limitada pela presença de condensação óssea com sobreposição de estruturas anatômicas. Devido a esse fato o uso de técnicas de imagem tridimensionais, como a tomografia computadorizada de feixe cônico, contribuem significativamente para o planejamento do tratamento. Algumas complicações podem ocorrer em procedimentos cirúrgicos envolvendo a região retromolar quando o canal retromolar está presente, como hemorragia, falha na anestesia e lesões aos ramos nervosos. Este estudo relatou um caso incomum de canal retromolar duplo, do lado esquerdo da mandíbula, causando alterações no planejamento clínico do tratamento de um paciente do sexo masculino de 54 anos de idade. Além disso, as consequências clínicas e cirúrgicas desses achados na reabilitação bucal foram discutidas. A tomografia computadorizada de feixe cônico apresentou-se como importante ferramenta diagnóstica na observação da presença e localização exata do canal retromolar. Canais retromolares podem ser detectados em uma radiografia panorâmica. No entanto, informações mais precisas sobre esta variação anatômica podem ser mostradas em imagens de tomografia computadorizada de feixe cônico. (AU)

The impact of nonsyndromic cleft lip with or without cleft palate on oral health-related quality of life

Abstract Nonsyndromic cleft lip with or without cleft palate (NSCL±P) compromises oral health, leading to missing or malformed teeth, and hampering oral hygiene. Apart from anatomic damages, NSCL±P also culminates in an impact on the routine quality of life with social privation and psychological embarrassment. Objective To evaluate the impact of NSCL±P on oral health-related quality of life. Material and Methods The study was classified as exploratory and descriptive, with quantitative approach. Patients with NSCL±P treated between August 2013 and September 2014 at the Cleft Lip and Palate Integral Care Center (CAIF), Curitiba, Brazil, were invited to participate. Age and sex-related data were collected, as well as level of education, financial income, type of orofacial cleft, use of orthodontic and prosthetic appliances, and number of previous orofacial surgeries. Selected patients were asked to answer the Oral Impact on Daily Performance (OIDP) questionnaire designed to measure the impact of oral health on daily performances. Results The sample was composed of 103 (44.59%) women and 128 (55.41%) men, with mean age of 19.74 ± 10.20 (7-65) years. The OIDP values ranged from 1 to 175 in 114 (49.35%) patients (mean: 22.38), whereas 117 patients (50.65%) presented total OIDP value equal to zero. High negative impact of NSCL±P on daily performances was detected when associated with the female sex (p=0.037). Daily performances related to phonetics (OIDP2; 2.63) and aesthetics (OIDP5; 2.48) presented the highest average values when compared to other daily performances, except OIDP6. The main symptoms and reported oral problems comprised the aesthetic dissatisfaction. Conclusions Almost half of the patients evaluated in this study showed negative impact of NSCL±P in the performance of daily activities.

Acinar autolysis and mucous extravasation in human sublingual glands: a microscopic postmortem study

Although some morphological investigations on aged human sublingual glands (HSG) found eventual phenomena identified as autolysis and mucous extravasation, the exact meaning of these findings has not been elucidated.Objective The aim of this work is to investigate whether acinar autolysis and mucous extravasation are related to the aging process in human sublingual glands. We also speculate if autolytic changes may assist forensic pathologists in determining time of death.Material and Methods 186 cadavers’ glands were allocated to age groups: I (0–30 years); II (31–60), and III (61–90). Time and mode of death were also recorded. Acinar autolysis and mucous extravasation were classified as present or absent. Ultrastructural analysis was performed using transmission electron microscopy (TEM). Data were compared using Mann-Whitney U, Spearman’s correlation coefficient, Kruskal-Wallis, and Dunn tests (p<0.05).Results There was correlation between age and acinar autolysis (r=0.38; p=0.0001). However, there was no correlation between autolysis and time of death. No differences were observed between genders. TEM showed mucous and serous cells presenting nuclear and membrane alterations and mucous cells were more susceptible to autolysis.Conclusion Acinar autolysis occurred in all age groups and increased with age while mucous extravasation was rarely found. Both findings are independent. Autolysis degrees in HSG could not be used to determine time of death.

Phenotype and cell proliferation activity of duct-like structures in human sublingual glands: a histological and immunohistochemical study

There are several age-related microscopic changes in the salivary glands, including the increase in the number of duct-like structures (DLS). However, the true origin and the phenotype of the DLS are not known. Objective To evaluate the phenotype and the cell proliferation index of the DLS of human sublingual glands. Material and Methods Sixty sublingual glands obtained from human cadavers were divided into two groups - 0-30 and 61-90 years old. The phenotype was estimated by immunostaining for cytokeratin 19 (CK 19) and the S-100 protein as well as by the presence of mucin and glycogen. The cell proliferation index was determined by the Ki-67 antibody. The histochemical techniques used periodic acid-Schiff (PAS) and Alcian Blue. In each captured microscopic field, the DLS were counted to establish a percentage for the staining profile. The statistical analysis was accomplished using Student's t-test, the Mann-Whitney test and Pearson's correlation coefficient (p<0.05). Results Comparing both groups, only CK 19 showed a statistically significant difference (p=0.033), with the strongest expression in the elderly group. There was no significant difference between PAS and Alcian Blue (p=0.270). In both groups, the immunostaining for CK 19 was stronger than that for S-100 (p=0.004;p<0.001), but there was no correlation between the two immunomarkers (ρ=-0.163; p=0.315). There was no immunostaining for Ki-67. Conclusions DLS demonstrate a ductal phenotypic profile and do not present cell proliferation activity. DLS may represent a regressive process arising from acini or represent the result of metaplasia. .

Arnica montana does not affect mast cell populations in experimentally induced oral ulcers in rats / Arnica montana não afeta populações de mastócitos em úlceras orais induzidas experimentalmente em ratos

BACKGROUND: Studies have shown that Arnica montana shows anti-inflammatory and antioxidant activities. It has been used in traditional medicine for the treatment of several disorders. The aim of this study was to investigate the effect of Arnica montana on mast cells during the wound healing of oral ulcers. METHOD: An ulcerated lesion was chemically induced on the tongue of 75 male albino rats and, then, treated topically for seven days using saline solution (control), Arnica montana gel or tincture. The animals were killed after 2nd, 7th, 14th, 21th and 42th day of treatment. The tongues were removed and subjected to routine laboratory (0.2% toluidine blue staining). The numbers of mast cell were determined in two regions: superficial and submucosa. RESULTS: The numbers of mast cells were significantly increased for all groups in the region of the deeper tissue when compared to the superficial region. No statistical difference was observed in mast cell numbers for each group. CONCLUSION: This study revealed that Arnica montana tincture and gel were unable to change mast cell population during wound healing of oral ulcer of rats. According to these results, the anti-inflammatory effects of Arnica montana were not related to inhibition of mast cell degranulation.

OBJETIVO: Sabe-se que a Arnica montana mostra atividade anti-inflamatória e anti-oxidante e tem sido usada em medicina tradicional para o tratamento de vários distúrbios. O objetivo deste estudo foi investigar o efeito da Arnica montana em mastócitos durante a cicatrização de feridas de úlceras orais. MÉTODO: Uma úlcera foi quimicamente induzida na língua de 75 ratos albinos machos e, em seguida, tratada topicamente durante sete dias, utilizando solução salina (controle), gel ou tintura de Arnica montana. Os animais foram sacrificados após 2, 7, 14, 21 e 42º dia de tratamento. As línguas foram removidas e submetidas a rotina de laboratório (coloração com 0,2% de azul de toluidina). A densidade de mastócitos foi determinada em duas regiões: superficial e submucosa. RESULTADOS: O número de mastócitos aumentou nitidamente para todos os grupos na região mais profunda do tecido peri-ulceroso, quando comparada à região superficial. Nenhuma diferença estatística foi observada no número de mastócitos entre os grupos. CONCLUSÃO: Este estudo revelou que a tintura ou o gel de Arnica montana foram incapazes de interferir na população de mastócitos durante a cicatrização da úlcera oral de ratos. De acordo com estes resultados, os efeitos anti-inflamatórios de Arnica montana não foram relacionados à inibição da degranulação dos mastócitos.

Morphology and morphometry of the human sublingual glands in mouth floor enlargements of edentulous patients

Asymptomatic mouth floor enlargements may be observed in edentulous patients. These masses, which protrude from the mouth floor, may complicate the fitting of dentures and require surgery. Whether this "entity" may be considered an anatomical variation of the mouth floor or represent specific alterations in the sublingual gland is not known. Objective: The aim of this work is to investigate the morphological and morphometric aspects of the sublingual glands of edentulous patients with mouth floor enlargements and compare the glands of these patients with the sublingual glands of human cadavers. Material and Methods: Microscopic evaluation was performed on human sublingual glands from edentulous patients with mouth floor enlargements (n=20) and edentulous cadavers (n=20). The patients and cadavers were of similar ages. The data were compared using Mann-Whitney U, Fisher's exact and Student's t tests (p<0.05). Results: Acinar atrophy, duct-like structures, mononuclear infiltrates, replacement of parenchyma with fibrous/adipose tissue, mucous extravasation and oncocytosis were similar between the groups (p>0.05). Only the variables "autolysis" and "congested blood vessels" presented statistical difference between groups (p=0.014; p=0.043). The morphometric study revealed that the volume densities of acini, ducts, stroma and adipose tissue were similar between the groups (p>0.05). CONCLUSION: The microscopic characteristics of the sublingual glands in mouth floor enlargements in edentulous patients correspond to characteristics associated with the normal aging process. The glands are not pathological and represent an age-related alteration that occurs with or without the presence of the mouth floor enlargements. .

Cytological analysis of epithelial cells in adolescents with type 1 diabetes mellitus / Análise citológica das células epiteliais de adolescentes com diabetes mellitus tipo 1

Type 1 diabetes mellitus is a chronic metabolic disorder condition, which may causes oral mucosa changes in adolescents. The effect of glycemic control on the oral tissues has been scarcely reported as well as the low number of oral mucosal lesions found in this population. The goal of this study is to evaluate cytopathological changes in oral epithelial cells of adolescents with type 1 diabetes mellitus (DM1) and assess the glycemic control. Materials and methods: Oral smears were collected from normal mucosa by exfoliative cytology in 40 healthy adolescents and 40 with DM1. Cell morphology and cellularity were analyzed. Nuclear area (NA) and cytoplasmic area (CA) were measured; nuclear/cytoplasmic area ratio (NA/CA) was calculated. Time elapsed from the diagnosis of diabetes and glycated hemoglobin levels (HbA1c) were recorded. Results: There was no significant difference to NA, CA, NA/CA for both groups and also in relation to HbA1c (P > 0.05). No morphological differences were found among the groups (P > 0.05). There was a predominance of nucleated cells of the superficial layer in smears of both groups. Class I and Class II smears were predominant in both groups. Conclusion: This study revealed that type 1 diabetes mellitus and the glycemic control were unable to induce significant changes on oral epithelial cells in adolescents...

A diabetes mellitus do tipo 1 é uma doença metabólica crônica que pode causar alterações nas células do epitélio da mucosa bucal. O estudo do efeito do controle glicêmico nos tecidos bucais tem sido pouco relatado e o baixo número de lesões da mucosa bucal encontrada nesta população também. O objetivo deste estudo foi avaliar as alterações citológicas nas células epiteliais bucal de adolescentes com diabetes mellitus tipo 1 (DM1) e avaliar o controle glicêmico. Materiais e métodos: Esfregaços da mucosa normal foram coleta¬dos por citologia esfoliativa em 40 adolescentes com DM1 e 40 saudáveis. A morfologia celular e a celularidade foram analisadas. A área nuclear (NA) e área do citoplasma (CA) foram medidas, e a relação de área de núcleo/ citoplasma (NA/CA) foi calculada. O tempo decorrido desde o diagnóstico da diabetes e os níveis de hemoglobina glicada (HbA1c) foram registrados. Resultados: Não houve diferença significativa para NA, CA, NA/CA para ambos os grupos e também em função da HbA1c (P > 0,05). Não foram encontradas diferenças morfológicas entre os grupos (P > 0,05). Houve um predomínio de células nucleadas da camada superficial em esfregaços de ambos os grupos. Esfregaços classe I e classe II foram predominantes em ambos os grupos. Conclusão: Este estudo revelou que o diabetes mellitus tipo 1 e o controle glicêmico não foram capazes de induzir alterações significativas nas células epiteliais da mucosa bucal de adolescentes...

Características da função mastigatória em indivíduos com mordidacruzada posterior unilateral / Masticatory function characteristics in individuals with unilateralposterior crossbite

Objetivo: Analisar as características da função mastigatória em indivíduos com mordida cruzada posterior unilateral. Material e métodos: A amostra foi dividida em 2 grupos: grupo 1, composto por 12 indivíduos com mordida cruzada posterior unilateral; e grupo 2, com 11 indivíduos com oclusão normal. Os participantes do estudo foram examinados por ortodontista e fonoaudióloga para identificar as características clínicas da oclusão bem como da função mastigatória e de hábitos de sucção e deglutição. Resultados: No Grupo 1, 5 (41,67%) pacientes apresentaram maloclusão Classe I de Angle; 6 (50%), maloclusão Classe II; e 1 (8,33%), Classe III. Não houve diferença estatisticamente significante entre os grupos para as variáveis uso de chupeta e/ou hábitos bucais, posição de língua durante a deglutição e trituração total do bolo alimentar (p ≥ 0,05). Houve diferença estatisticamente significante entre os grupos para a dificuldade de mastigar alimentos fibrosos (p = 0,0033). Conclusão: A mordida cruzada posterior unilateral foi observada em pacientes com os três tipos de classificação oclusal sagital. Esteve associada à dificuldade de mastigar alimentos fibrosos, não alterando, entretanto, o resultado final da trituração do bolo alimentar.

Objective: To analyze masticatory function characteristics in subjects with unilateral posterior crossbite. Materials and methods: The sample was divided in two groups: group 1, comprised of 12 subjects with unilateral posterior crossbite; and group 2, with 11 subjects with normal occlusion. They were examined by orthodontist and speech therapist to identify clinical characteristics of occlusion, masticatory function, and sucking and swallowing habits. Results: In Group 1 it was observed that 5 (41.67%) patients had Angle Class I malocclusion, 6 (50%), Class II malocclusion, and 1 (8.33%), Class III. There was no statistically significant difference between groups for the following variables: use of pacifier and/or oral habits, tongue position during swallowing and total crushing the bolus (p ≥ 0.05). There was statistically significant difference between groups for difficulty in chewing fibrous foods (p = 0.0033). Conclusion: The unilateral posterior crossbite was observed in patients with three types of sagittal occlusal classification. It was associated with difficulty in chewing fibrous foods, not changing, however, the final result of crushing the bolus.

Utilização de brocas trefina para a confecção de tissue microarray / Use of trephine drills for the production of tissue microarray

Objetivos: Descrever e validar uma técnica alternativa econômica e eficiente para a confecção de amostras teciduais com arranjo matricial (tissue microarrays, TMA). Materiais e métodos: Utilizou-se um motor, um micromotor, um contra-ângulo redutor 16:1 e brocas trefina de aço inoxidável para osso. Análise histomorfométrica do volume das células acinares de glândulas parótidas foi realizada. Para testar marcadores imunoistoquímicos para células mioepiteliais, acinares e ductais das parótidas foram utilizados calponina e PCNA. Resultados: Na análise macroscópica e microscópica das lâminas, não foi encontrada perda total do tissue e nem mesmo deslocamento (parcial e/ou total) deste, sendo as perdas teciduais observadas apenas parciais. Das 90 lâminas analisadas, 59 (65%) obtiveram de 50% a 100% do tissue com ausência de artefato, deslocamento ou perda de tecido. Conclusão: O equipamento proposto pelos autores para a confecção deamostras teciduais com arranjo matricial representa uma alternativa econômica e eficiente.

Objectives: To describe and validate an inexpensive and efficient alternative for the production of tissue microarrays (TMA). Materials and methods: An electric-motor, a hand-piece, a reducing contra-angle hand-piece 16:1 and trephine stainless steel drills for bones were used in this study. A histomorphometric assessment of the volume of the acinar cells of parotid glands was performed. Calponin and PCNA were used to test the immunohistochemical markers for myoepithelial, acinar and ductal cells of parotid glands. Results: During the macroscopic and microscopic analysis, total loss of sections was not observed in any slide as well as artifactual ungluing (total and/or partial) of the sections. The loss of sections was partial. Fifty nine (65%) out of 90 slides showed 50%-100% of the tissue without technical artifact, artifactual ungluing or loss of the section. Conclusion: The equipment proposed by the authors for the production of arrays represents an inexpensive and efficient alternative.

Prevalência das lesões de glândulas salivares em laudos histopatológicos do Laboratório de Patologia Experimental da PUCPR no período de 1999-2008 / Prevalence of salivary glands lesions from histopathologic diagnosis of Experimental Pathology Laboratory of PUCPR in the period of 1999-2008

Introdução: As lesões que acometem as glândulas salivares representam um grupo de entidades clínicas que variam desde alterações patológicas locais até a manifestação de doenças sistêmicas. Objetivo: Este estudo objetivou levantar a prevalência de casos de lesões em glândulas salivares nos pacientes atendidos na clínica odontológica da Pontifícia Universidade Católica do Paraná (PUCPR). Material e métodos: Um total de 1.990 laudos de exames histopatológicos foi consultado nos registros do Laboratório de Patologia Experimental da PUCPR no período de 1999 a 2008. Foram analisados 73 casos referentes a lesões de natureza de glândula salivar, de acordo com as variáveis sexo, idade e diagnóstico histopatológico. Resultados: A mucocele foi a lesão mais comum, com 58 casos (2,9%). Outras enfermidades foram diagnosticadas, tais como: adenoma pleomórfico (0,3%), carcinoma adenoide cístico (0,1%), sialoadenite (0,1%), carcinoma mucoepidermoide (0,05%), síndrome de Sjõgren (0,05%), rânula (0,05%) e hiperplasia adenomatoide (0,05%). Não foi observada nenhuma predileção com relação ao sexo dos indivíduos, entretanto essas doenças ocorreram principalmente durante as três primeiras décadas de vida. Conclusão: Esses achados reforçam a ideia de que a ocorrência de lesões associadas às glândulas salivares é muito baixa quando comparada a de outras lesões bucais. As entidades patológicas mais comuns que afetam as glândulas salivares são associadas a agentes traumáticos e acometem pacientes adultos jovens e do sexo masculino.

Introduction: Lesions that affect salivary glands are a group of clinicentities ranging from local pathological alterations to the manifestationof systemic diseases. Objective: The aim of this study was to observethe prevalence of cases of lesions regarding salivary glands in patientsof dental clinic of the Pontifícia Universidade Católica do Paraná(PUCPR). Material and methods: A total of 1990 histopathologicreports was analyzed in data of Experimental Pathology Laboratory ofthe Pontifícia Universidade Católica do Paraná, in the period of 1999to 2008. Seventy-three cases of salivary glands diseases were analyzed,according to sex, age and histopathologic diagnosis. Results: Mucocelewas the most prevalent lesion, with 58 cases (2.9%). Others diseaseswere diagnosed, such as: pleomorphic adenoma (0.3%), cystic adenoidcarcinoma (0.1%), sialoadenitis (0.1%), mucoepidermoid carcinoma(0.05%), Sjögren’ssyndrome (0.05%), ranula (0.05%) and adenomatoidhyperplasia (0.05%). No predilection for sex was observed, but themajority of diseases occurred principally during the three first lifedecades. Conclusion: These findings reinforce that the occurrence oflesions associated to the salivary glands is low when compared to othersoral diseases. The more common pathological entities that affectsalivary glands are associated to traumatic agents and affect adult maleyoung patients.