Mast cells in oral lichen planus and oral lichenoid lesions related to dental amalgam contact

Abstract The aim of this study was to analyze the expression of mast cell markers toluidine blue, c-kit, and tryptase and presence of mononuclear inflammatory cells in oral lichen planus (OLP) and oral lichenoid lesions related to dental amalgam. Nineteen specimens of OLP, OLLC, and healthy oral mucosa were selected. Mononuclear inflammatory cells were analyzed. Histochemical and immunohistochemical analyses were performed using toluidine blue, anti-c-kit and anti-tryptase reagents, and the results were quantified in areas A and B of connective tissue. Mast cells of all OLP and OLLC samples were positive for toluidine blue, c-kit, and tryptase. The density of toluidine blue+, c-kit+ and tryptase+ mast cells was higher in tissue with OLP and OLLC compared with healthy controls (p < 0.05). No difference was noted in mast cells density between OLP and OLLC (p > 0.05). The density of tryptase+ mast cells was higher in the subepithelial region (area A) than the region below it (Area B) in OLLC (p = 0.047). The mononuclear inflammatory cell density was higher in OLLC compared to OLP, but without statistical significance (p > 0.05). A positive statistical correlation was found between mononuclear immune cells and density of c-kit+ and tryptase+ mast cells in OLP (r = 0.943 and r = 0.886, respectively). Our data demonstrate that the etiopathogenesis process of OLP and OLLC modulates the expansion and degranulation of mast cells; mast cells density, however, was similar between OLP and OLLC. The distribution of mast cells appears to vary along the lamina propria.

Evaluation of peripheral nerve fibers and mast cells in burning mouth syndrome

Abstract Emerging evidence has revealed a cross-talk in the etiopathogenesis of burning mouth syndrome (BMS) related to peripheral nerve fibers (NF) and neuropeptides secreted by mast cells. Here, we investigated the S-100+ density and PGP 9.5+ integrity of peripheral NF and the tryptase+ mast cell density in the oral mucosa of BMS patients and healthy individuals. A total of 23 oral mucosa specimens (12 BMS and 11 controls) were evaluated. The clinical diagnosis of BMS was based on a careful examination, excluding other local and systemic causes. Samples were taken from an incisional biopsy of the tongue mucosa of individuals with symptomatic BMS, while the margins of the non-neoplastic tongue biopsy served as controls of healthy individuals. Immunohistochemistry was performed to determine the density/mm2 of S-100+, PGP 9.5+ peripheral NF, and tryptase+ mast cells. Similar densities of S-100+, PGP 9.5+ peripheral NF, and tryptase+ mast cells were found in cases of BMS, with a median value of 3.70, 0.70, and 29.24/mm2, respectively, and in the control group, with a median value of 2.60, 0.80, and 26.01/mm2, respectively (p > 0.05). Moreover, the relationship between S100+ and PGP 9.5+ peripheral NF was the same in both groups (p = 0.70). This study demonstrated that there were no alterations in the density and integrity of peripheral NF in the tongue of symptomatic BMS patients. However, the sensitization of peripheral NF in this disease may not depend on mast cell density.

Acinic cell carcinoma of the oral and maxillofacial region: an international multicenter study

Abstract The aim of this study was to describe the prevalence, clinicopathological, and prognostic features of acinic cell carcinoma (AciCC) of the oral and maxillofacial region. AciCC cases were retrospectively retrieved from 11 pathology centers of three different countries. Medical records were examined to extract demographic, clinical, pathologic, and follow-up information. A total of 75 cases were included. Females (65.33%) with a mean age of 45.51 years were mostly affected. The lesions usually presented as an asymptomatic (64.28%) nodule (95.66%) in the parotid gland (70.68%). The association of two histopathological patterns was the most common finding (48.93%) and the tumors presented mainly conventional histopathological grades (86.11%). Surgical treatment was performed in the majority of the cases (59.19%). Local recurrence was observed in 20% of the informed cases, regional metastasis in 30.43%, and distant metastasis in 12.50%. The statistical analysis showed that the cases with a solid histopathological pattern (p=0.01), high-grade transformation (p=0.008), recurrence (p=0.007), and regional metastasis (p=0.03) were associated with poor survival. In conclusion, high histopathological transformation, presence of nodal metastasis, and recurrence were prognostic factors for AciCC of the oral and maxillofacial region.

Contribution of public oral pathology services to the diagnosis of oral and oropharyngeal cancer in Brazil

Abstract This study aimed to evaluate the contribution of oral and maxillofacial pathology laboratories (OMPLs) in Brazilian public universities to the diagnosis of lip, oral cavity, and oropharyngeal squamous cell carcinoma (SCC). A cross-sectional study was performed using biopsy records from a consortium of sixteen public OMPLs from all regions of Brazil (North, Northeast, Central-West, Southeast, and South). Clinical and demographic data of patients diagnosed with lip, oral cavity, and oropharyngeal SCC between 2010 and 2019 were collected from the patients' histopathological records. Of the 120,010 oral and maxillofacial biopsies (2010-2019), 6.9% (8,321 cases) were diagnosed as lip (0.8%, 951 cases), oral cavity (4.9%, 5,971 cases), and oropharyngeal (1.2%, 1,399 cases) SCCs. Most cases were from Brazil's Southeast (64.5%), where six of the OMPLs analyzed are located. The predominant profile of patients with lip and oral cavity SCC was Caucasian men, with a mean age over 60 years, low schooling level, and a previous history of heavy tobacco consumption. In the oropharyngeal group, the majority were non-Caucasian men, with a mean age under 60 years, had a low education level, and were former/current tobacco and alcohol users. According to data from the Brazilian National Cancer Institute, approximately 9.9% of the total lip, oral cavity, and oropharyngeal SCCs reported over the last decade in Brazil may have been diagnosed at the OMPLs included in the current study. Therefore, this data confirms the contribution of public OMPLs with respect to the important diagnostic support they provide to the oral healthcare services extended by the Brazilian Public Health System.

Indices in dental image exams for bone mineral density evaluation of aromatase inhibitor users

Abstract We evaluated the accuracy of radiomorphometric indices (RI) and fractal dimension (FD) for screening bone mineral density (BMD) in postmenopausal patients who had breast cancer and were using aromatase inhibitors (AI). The sample consisted of 40 participants. Digital panoramic radiography (DPR) and cone beam computed tomography (CBCT) were evaluated along with dual-energy X-ray absorptiometry (DXA), which is the gold standard for detecting low BMD. According to the T-scores of DXA, the subjects were assigned into two groups: with normal BMD and with low BMD (osteopenia and osteoporosis). The area under the curve (AUC), sensitivity, and specificity with their respective confidence intervals were determined for DPR and CBCT. For DPR indices, AUC ranged from 52.6 to 75.8%. The mandibular cortical width (MCW) had the highest AUC. For FD, the total trabecular index had the highest sensitivity, while the index anterior to the mental foramen (MF) had the highest specificity. In CBCT, the AUC ranged from 51.8 to 62.0%. The indices with the highest AUC were the molar (M) and anterior (A). The symphysis (S) index had the highest sensitivity and the posterior (P) index had the highest specificity. Sensitivity and specificity were adequate for the computed tomography index (Inferior; CTI [I]). Therefore, MCW, FD of the mandible angle, and total trabecular ROI in DPR and the CTI (I), M, P, and A indices in CBCT proved to be promising tools in distinguishing individuals with low BMD. Cutoff point for these indices could be a useful tool to investigate low BMD in postmenopausal women taking AI.

Does smoking habit affect dendritic cell expression in oral squamous cell carcinoma?

Abstract: The aim of this study was to determine the presence of immature CD1a+ and mature CD83+ dendritic cells in oral squamous cell carcinoma, to compare immunoreactivity between smokers and nonsmokers, and to correlate the results with histopathological grading. In this observational study, twenty-eight paraffin-embedded biopsies of oral squamous cell carcinoma were retrospectively retrieved and submitted to immunohistochemistry for immature CD1a+ and mature CD83+. Descriptive and statistical analyses were performed. The sample consisted of 18 man (64.3%) and 10 women (35.7%), with a mean age of 64.6 years in the nonsmoker group and 53.2 years in the smoker group. The tongue (11 cases, 39.2%) was the most commonly affected anatomical site, followed by gingiva (6 cases, 21.4%). Histopathological grading revealed 7 low-grade and 7 high-grade malignancy cases in each group, and no correlation with the number of positive DCs. The number of immature CD1a+ was not significantly different between smoker and nonsmoker groups, while a lower number of mature CD83+ was detected in the smoker group (p = 0.001). Smoking changes the oral immune system and decreases the ability to activate and mature dendritic cells, which may influence the development and progression of oral squamous cell carcinoma.

Toxicity of Carnoy's solution toward human keratinocytes: an in vitro study

Abstract: The present study aimed to characterize the chemical elements and cytotoxicity of Carnoy's solution (CS) by comparing two different trademarked products (one Brazilian [NCS] and another imported [ICS]) using inductively coupled plasma mass spectrometry (ICP-MS) and human keratinocyte (HaCaT) cultures. For performing ICP-MS, the solutions were diluted according to calibration curves, and the chemical elements were analyzed with a spectrometer. HaCaT cells were exposed to CS concentrations ranging from 0.10% to 20% for 3 or 5 min. Cell viability was evaluated immediately (T0), 24 h (T1), and 7 days (T2) after exposure to CS using 3-(4,5-dimethylthiazol-2-yl)-2, 5-diphenyl-tetrazolium bromide (MTT) reduction assay. Data were analyzed using a t-test for ICP-MS and analysis of variance followed by Tukey's post-hoc test for MTT assay, both considering statistical significance at p<0.05. ICP-MS results revealed that ICS presented significantly lower concentrations of 12 chemical elements than NCS. The results of MTT assay revealed that at T0, ICS was more cytotoxic than NCS regardless of the time of exposure (p < 0.05). At T1, the only difference between the groups was at a concentration of 0.10% after 5 min of exposure. At T2, at a concentration of 0.5%, ICS resulted in a significant reduction in cell viability compared to NCS (p < 0.05). Thus, the results showed that ICS was more cytotoxic than NCS. Collectively, our findings suggest that the individual compositions of different CS formulations should be investigated.

Cross-Sectional Study of Mandibular Canal Branching in Regions Affected by Dental Inflammation with Cone Beam Computed Tomography / Estudio Transversal de la Ramificación del Canal Mandibular en Regiones Afectadas por Inflamación Dental con Tomografía Computarizada de Haz Cónico

ABSTRACT: The present study aimed to investigate the occurrence of mandibular canal alterations in regions with dental inflammation by means of cone beam computed tomography (CBCT). A database of 2,484 CBCTs was reviewed for identifying dental inflammation in mandibular alveolar ridges. The final sample consisted of 150 CBCTs, including 91 females and 59 males, with ages ranging from 13 to 89 years (mean age of 47.06; ± SD=18.722). The presence and location of dental inflammation, gender, age, as well as presence and location of mandibular canal branching (MCB) were evaluated. The Kolmogorov-Smirnov, Chi-square, and T-test were applied to verify the statistical relationship of the data. There were 178 images of dental inflammation on 150 CBCTs, mainly located at molars' region (75 %). Apical lesions were the most common type of dental inflammation found (79 or 44.4 % of the sample), followed by pericoronitis (32; 18.0 %). This study identified 135 mandibular canal branches in the exams that presented dental inflammation. The MCB were also most commonly located at molars' region (74.07 %). No statistical difference was identified regarding the distribution of mandibular canal branching in relation to the sites with dental inflammation (p=0.370).The MCB found were mostly single (86 or 63.7 % of the total). Sex had no influence on mandibular canal branching occurrence (p=0.308), not did age (p=0.728). A high prevalence of mandibular canal branching was observed in the regions where dental inflammation were identified, most commonly found in the molar region.

RESUMEN: El presente estudio tuvo como objetivo investigar la ocurrencia de ramificación del canal mandibular (RCM) en regiones con inflamación dental mediante tomografía computarizada de haz cónico (TCHC). Se revisó una base de datos de 2.484 TCHC para identificar la inflamación dental en las crestas alveolares mandibulares. La muestra final consistió en 150 TCHC, incluidas 91 mujeres y 59 hombres, con edades comprendidas entre 13 y 89 años (edad media de 47,06 ± DE = 18,722). Se evaluaron el sexo, la edad, la presencia y la ubicación de la inflamación dental, así como la presencia y ubicación de RCM. KolmogorovSmirnov, Chi-cuadrado y prueba-T se aplicaron para verificar la relación estadística de los datos. Hubo 178 imágenes de inflamación dental en 150 TCHC, ubicados principalmente en la región de los molares (75 %). Las lesiones apicales fueron el tipo más común de inflamación dental encontrada (79 o 44,4 % de la muestra), seguidas por pericoronitis (32; 18,0 %). Este estudio identificó 135 ramas del canal mandibular en las regiones que presentaron inflamación dental. El RCM también se localizó con mayor frecuencia en la región de los molares (74,07 %). No se identificaron diferencias estadísticas con respecto a la distribución de la ramificación del canal mandibular en relación con los sitios con inflamación dental (p = 0,370). Las RCM encontrados fueron en su mayoría solteros (86 o 63,7 % del total). El sexo no tuvo influencia en la ocurrencia de la ramificación del canal mandibular (p = 0,308), no la edad (p = 0,728). Se observó una alta prevalencia de ramificación del canal mandibular en las regiones donde se identificó la inflamación dental, que se encuentra con mayor frecuencia en la región molar.

Mast cell degranulation in periodontal disease from HIV-infected individuals

Aim: The objective was to compare the density and degranulation of mast cells on specimens obtained from individuals diagnosed with gingivitis or chronic periodontitis who were either non-HIV-infected or HIV-infected patients treated with highly active antiretroviral therapy (HAART). Methods: Gingival samples were taken from 16 non-HIV-infected individuals and 17 HIV-infected individuals diagnosed with gingivitis and chronic periodontitis. The samples were processed and tained with 0.3 percent o-toluidine blue. Densities (cells/mm²) and percentages of intact and degranulated mast cells were obtained. Results: No statistically significant differences were observed in the mast cell density and the percentage of degranulated mast cells between non-HIV-infected and HIV-infected individuals diagnosed with gingivitis and chronic periodontitis. Mononuclear inflammatory infiltrate was weakly correlated with the percentage of mast cells degranulated for both groups. Conclusions: There are no differences of the density and degranulation of mast cells in gingival tissue between non-HIV-infected and HIV-infected patients undergoing HAART, both groups with diagnosis of gingivitis or chronic periodontitis. This may be a result of the recovery of the immunologic system by HAART treatment.

The use of social networks in scientific research with questionnaires

Aim: The aim of this study was to determine the response rate of the SF-36 quality of life questionnaire sent and received by mail and over a social network to caregivers of individuals with epidermolysis bullosa (EB) in Brazil. Methods: All volunteers were first-degree relatives of patients with EB that directly spent time helping them with their basic activities of daily living. A maximum of two caregivers per patient could answer the questionnaire. Volunteers were divided into two groups: for group 1, questionnaires were sent to 53 members of a support association for the disease by mail, and for group 2, 798 members of the Facebook™ page of friends and relatives of patients with EB were invited to participate using an access link to Google Drive™ to gain access to the questionnaire. The data from both groups were analyzed 150 days after the start the study. Descriptive analysis was performed by EpiInfo8 and the return of questionnaires was evaluated according to age, sex, and time of return using the Chi-squared and Fisher's exact test. Results: After 150 days, 30 questionnaires were returned, 17 (56.7%) of which from group 1 and 13 (43.3%) from group 2. Approximately 12 questionnaires were returned by mail and 11 over the social network. Conclusions: The data collection of the SF-36 quality of life questionnaire from caregivers of individuals with EB over a social network seems to be efficient mainly when it is necessary to collect results within a short timeframe, highlighting the importance of social networks as a means for conducting this type of research. However, in our study, the most efficient method was distributing the questionnaires by mail

Hyaluronic acid accelerates bone repair in human dental sockets: a randomized triple-blind clinical trial

Abstract This study evaluated the effects of hyaluronic acid (HA) on bone repair of human dental sockets. Thirty-two lower first premolars were extracted from 16 patients (2 per patient) for orthodontic reasons. Following the extractions, one socket was randomly filled with 1% HA gel, while the other was allowed to naturally fill with blood clot. After 30 and 90 days of surgery, patients underwent cone beam computed tomography. Five central orthoradial slices were captured from each socket. The gray intensity was measured in each image and results were reported as mean percentage of bone formation. The buccolingual alveolar ridge width was measured and dimensional changes were compared between the postoperative intervals. The pattern of alveolar trabecular bone was evaluated through the fractal dimension. Treated sockets showed a higher percentage of bone formation and fractal dimension values (58.17% and 1.098, respectively) compared with controls (48.97% and 1.074, respectively) in the 30-day postoperative period (p < 0.05). After 90 days, there was no significant difference between groups. Additionally, no significant difference was found between groups regarding the alveolar dimensions (p > 0.05). Use of 1% HA gel after tooth extraction accelerates bone repair in human dental sockets.

Dentists' perceptions of HIV/AIDS: psychometric properties of a first questionnaire for dentistry

Aim: The present study outlines the testing the first questionnaire to the field of dentistry to evaluate dentists' perceptions of HIV/AIDS, and its psychometric properties. Methods: A first questionnaire developed to evaluate dentists' perceptions of HIV/AIDS at this cross-sectional study contained 33 items in its original version. Randomly subsample of 251 Argentine dentists was invited to participate in the study. A four-factor structure (Transmission, Oral Manifestations, Dentists' practice, and Infection Controls) was tested through exploratory and confirmatory factor analysis, as well reliability was assessed. Results: The deletion of eight items from the original questionnaire improved the goodness of fit for the instrument. The retained 25 items revealed an acceptable reliability (internal consistency of 0.68), while the four factors revealed a Cronbach's alpha coefficient of 0.53 for Transmission factor items, 0.71 for Oral Manifestations factor items, 0.59 for Dentists' Practice factor items, and 0.48 for Infection Controls factor items. Higher scores were observed on the Oral Manifestations factor items, but convergent and discriminant validity was compromised for the others factors. Conclusions: The findings presented here demonstrate the value of this first questionnaire with 25 items as a starting point for further inquiry. However, it would be desirable to add more items and a replication of the questionnaire is suggested to determine the stability of its psychometric properties

A multicenter study of biopsied oral and maxillofacial lesions in a Brazilian pediatric population

Abstract The aim of this study was to investigate the prevalence of oral and maxillofacial lesions among children from representative regions of Brazil. A retrospective descriptive study was conducted. Biopsy records comprising the period from 2000 to 2015 were obtained from the archives of three Brazilian oral pathology referral centers. A total of 32,506 biopsy specimens were analyzed, and specimens from 1,706 children aged 0-12 years were selected. Gender, age, anatomical location and histopathological diagnosis were evaluated. Descriptive statistics was carried out. Likelihood ratio tests were used to evaluate the association between the categorical variables. The level of significance was set at 0.05. The post-hoc test was used to identify the subgroups that significantly differed from one another, and the Bonferroni correction was applied. A total of 1,706 oral and maxillofacial lesions were diagnosed in pediatric patients, including 51.9% girls. Oral mucocele was the most prevalent reactive/inflammatory lesion (64%). The most commonly affected sites were the lips (34.5%) and mandible (19.9%). A significant association was observed between age and the group of lesions of the oral cavity (p < 0.001), and between age and anatomical location (p < 0.001). Pediatric oral and maxillofacial lesions were frequent and showed wide diversity, with the prevalence of mucocele. Knowledge of oral lesions is important for pediatric dentists worldwide, since it provides accurate data for the diagnosis and oral health of children.

Comparative study of oral and salivary parameters in patients with and without loss of bone mass

Abstract Osteoporosis is an insidious and increasingly prevalent disease that can cause fractures and affect patients' quality of life. The current study comparatively evaluates patients with and without loss of bone mass in terms of salivary calcium, viscosity, and pH. A controlled cross-sectional study was conducted in two groups of 32 postmenopausal women subjected to a bone densitometry scan and later referred for dental management at the Federal University of Minas Gerais, Brazil. The patients were assigned to two groups: Group 1 - patients with low bone mineral density (BMD) and Group 2 - patients without bone mineral changes. The following salivary parameters were evaluated: calcium concentration, flow rate, viscosity, pH, and average total protein. An oral examination was performed for assessment of DMFT variables and tongue coating. Data were analyzed using descriptive and inferential statistics, adopting a p-value < 0.05. The patients' mean age was 60 years (± 7.35). Salivary flow, pH, and viscosity were similar among the groups. Average total protein was 14.8 mg/mL and 19.0 mg/mL in Groups 1 and 2, respectively. Tongue coating and salivary calcium levels were significantly higher in Group 1 (p < 0.001). Salivary calcium is an important screening tool and may eventually be used for the diagnosis of bone mineral changes.

Development of questionnaire on dentists' knowledge of HIV/AIDS / Desenvolvimento de um questionário sobre HIV/AIDS para dentistas

Aim: This study aimed to construct and evaluate the cross-cultural adaptation of DK-HIV-Q in an Argentine Spanish version. Methods: A translation and back translation of the DK-HIV-Q questionnaire were completed, as the original questionnaire had been formulated in Portuguese by a Brazilian researcher. The DKHIV- Q was tested in two pilot studies conducted with Argentine dentists. Results: The committee of experts, consisting of three bilingual dentists, an epidemiology dentist, a general clinical dentist, and an oral pathology specialist, fully agreed on the conceptual relevance of the general domain and the 4-domain structure for the DK-HIV-Q, such as the declarative knowledge of the transmission of HIV/AIDS, the declarative knowledge of oral manifestations of HIV/AIDS, the procedural knowledge of proper dental practice, and the procedural knowledge of infection control measures. A final version of the DK-HIV-Q showed a satisfactory degree of semantic accuracy and semantic equivalence with the original version, and proved to be satisfactorily conceptual and useful as an initial indicator for a subsequent study of construct validity. Conclusion: This study described the specific details of the construction of the DK-HIV-Q and aspects of the content validity process, which is one of the main procedures to be considered by healthcare researchers and professionals who are interested in using reliable and appropriate measurements and instrument scales for given population groups, such as HIV/AIDS patients.

Objetivo: O objetivo deste estudo foi construir o DK-HIV-Q na versão espanhola Argentina e avaliar sua adaptação transcultural. Materiais e Métodos: Foi realizada a tradução e a retro-tradução, porque o DK-HIV-Q foi feito em português pela pesquisadora brasileira. O DK-HIV-Q foi testado em dois estudospiloto entre dentistas argentinos. Resultados: O comitê de especialistas, composto por três cirurgiõesdentistas bilíngues, um epidemiologista, um clínico geral e um especialista em patologia oral, concordaram completamente com a relevância conceitual do domínio geral e com a estrutura de quatro domínios para o DK-HIV-Q, que foram conhecimento declarativo dos métodos de transmissão do HIV, conhecimento declarativo das manifestações orais de HIV/AIDS, conhecimento processual de práticas gerais odontológicas, e conhecimento processual de controle de infecção. A versão final do DKHIV- Q mostrou um grau satisfatório de precisão e de equivalência semânticas com a versão original e provou ser satisfatoriamente conceitual e útil como um indicador inicial para realizar um estudo posterior de validade de construto. Conclusão: Este estudo descreveu detalhes da construção do DK-HIV-Q e aspectos do processo de validade de conteúdo, um dos procedimentos a serem considerados por pesquisadores de saúde e profissionais que estão interessados em usar medidas confiáveis e adequadas e escalas de instrumentos para determinados grupos de população, tais como pacientes com HIV/AIDS.

Development of questionnaire on dentists’ knowledge of HIV/AIDS

Aim: This study aimed to construct and evaluate the cross-cultural adaptation of DK-HIV-Q in an Argentine Spanish version. Methods: A translation and back translation of the DK-HIV-Q questionnaire were completed, as the original questionnaire had been formulated in Portuguese by a Brazilian researcher. The DKHIV-Q was tested in two pilot studies conducted with Argentine dentists. Results: The committee of experts, consisting of three bilingual dentists, an epidemiology dentist, a general clinical dentist, and an oral pathology specialist, fully agreed on the conceptual relevance of the general domain and the 4-domain structure for the DK-HIV-Q, such as the declarative knowledge of the transmission of HIV/AIDS, the declarative knowledge of oral manifestations of HIV/AIDS, the procedural knowledge of proper dental practice, and the proceduralknowledge of infection control measures. A final version of the DK-HIV-Q showed a satisfactory degreeof semantic accuracy and semantic equivalence with the original version, and proved to be satisfactorilyconceptual and useful as an initial indicator for a subsequent study of construct validity. Conclusion: Thisstudy described the specific details of the construction of the DK-HIV-Q and aspects of the content validity process, which is one of the main procedures to be considered by healthcare researchers and professionals who are interested in using reliable and appropriate measurements and instrument scales for given populationgroups, such as HIV/AIDS patients.

Tratamento da mucocele com a técnica da micromarsupialização modificada / Treatment of mucocele with the upgraded micro-marsupialisation technique

O objetivo deste trabalho é descrever o relato de um caso clínico da mucocele selecionada, tratada com a técnica da micromarsupialização modificada. Esta técnica baseia-se na transfixação da lesão com fios cirúrgicos e possui a finalidade de promover uma epitelização ao redor das suturas, formando novos canais excretores e permitindo, assim, o esvaziamento do muco e a regressão da lesão. Paciente de 36 anos, gênero feminino, compareceu à clínica de Especialização em Estomatologia da Faculdade de Odontologia da Universidade Federal de Minas Gerais (UFMG). No exame intraoral observou-se lesão cujo diagnóstico clínico foi de mucocele e a forma de tratamento proposta foi a micromarsupialização modificada, descrita na literatura. A paciente retornou para controle de 7 em 7 dias e, após 30 dias, apresentava-se sem sinais clínicos da lesão, quando as suturas foram removidas. No caso relatado, modificações da técnica descritas na literatura foram adotadas, a saber: utilização de fio de sutura seda 3.0, realização de movimentos de "vai e vem" e remoção completa do muco. A paciente está em acompanhamento por 24 meses e sem sinais clínicos de recidiva. A partir deste relato de caso sugere-se que a técnica de micromarsupialização modificada seja eficaz no tratamento da mucocele selecionada.

The aim of this study is to describe a case report of selected mucocele treated with the upgraded micromarsupialisation technique. This technique is based on the puncture of the lesion with a silk suture and aims to promote epithelisation of the mucosa around the suture in turn leading to several new path tract formations, allowing the drainage of total mucus and regression of the lesion. A 36-year-old woman was referred to the Oral Medicine Clinic of the School of Dentistry at the Universidade Federal Minas Gerais (UFMG). Intraoral examination demonstrated a mucocele and the choice of the treatment was the upgraded micromarsupialisation. The patient underwent a weekly follow-up period and after 30 days showed no clinical signs of recurrence. In this time, the sutures were removed. In this case report, the modifications of the technique describe on literature were: the use of a 3.0 silk suture, the mechanical enlargement of the pathways performed by a to-and-fro movement and the clearance of total mucus. The patient had 24 months of follow-up and it was free-disease. From this case report suggests that the upgraded micro-marsupialisation technique is effective in the treatment of selected mucocele.

Morphometric evaluation of keratocystic odontogenic tumor before and after marsupialization

The aim of the present study was the morphometric evaluation of the epithelial lining and fibrous capsule in histological specimens of keratocystic odontogenic tumors (KOTs) before and after marsupialization. Histological sections from six KOTs that had undergone marsupialization followed by enucleation were photographed. The thickness and features of the capsule and of the epithelial lining of the tumor were evaluated upon marsupialization and upon subsequent enucleation using Axion Vision software. The histological specimens taken upon marsupialization presented an epithelial lining that is typical of KOTs. After marsupialization, the enucleated specimens had a modified epithelial lining and a fibrous capsule that both presented a greater median thickness (p = 0.0277 and p = 0.0212, respectively), morphological changes, and significant enlargement. These modifications can facilitate full surgical treatment and may well be related to a low KOT recurrence rate.

Cellular proliferation markers in peripheral and central fibromas: a comparative study

ABSTRACT Objective: To perform a comparative study of the cellular proliferation in the peripheral and central fibromas. Material and Methods: Immunohistochemistry for PCNA and the AgNOR technique were performed in 9 cases of peripheral odontogenic fibroma (POF), in 4 cases of odontogenic fibroma (OdF), in 8 cases of peripheral ossifying fibroma (PEOF) and 7 cases of ossifying fibroma (OsF). The Kruskal-Wallis and Mann-Whitney tests were used for the statistical analyses. Results: Mesenchymal component of the central lesions presented a higher mean number of AgNOR per nucleus and PCNA index than did the peripheral lesions (P≤0.05). The mean number of AgNOR per nucleus in the epithelial component proved to be higher in the OdF than in the POF (P≤0.05). The mesenchymal and epithelial components presented similar mean numbers of AgNOR per nucleus and PCNA index in the OdF, as well as a similar mean number of AgNOR per nucleus in the POF. Conclusions: The mesenchymal component may well play a role in the differences between the biological behaviour of the central lesions as compared to the peripheral lesions. Moreover, considering that the epithelial and mesenchymal components in odontogenic fibromas presented a similar proliferation index, more research is warranted to understand the true role of the epithelial components, which are believed to be inactive in nature, as well as in the development and biological behaviour of these lesions. .

Avaliação do infiltrado inflamatório na gengivite crônica de indivíduos fumantes e não fumantes / Assessment of inflammatory infiltrate in chronic gingivitis of smoker and non-smoker individuals

O tabagismo tem sido considerado pela literatura um dos principais fatores de risco associado à doença periodontal. Substâncias como a nicotina podem afetar a vascularização, o sistema imunológico humoral e celular. Alterações no número de células inflamatórias podem ser observadas também em indivíduos com gengivite crônica. Neste estudo, foram avaliadas 27 amostras de tecidos gengivais que foram agrupadas em 10 amostras de indivíduos com gengivite e não fumantes (GNF), 10 amostras de indivíduos com gengivite e fumantes (GF) e 7 amostras controle (C) formada por indivíduos sem gengivite e não-fumantes. As biópsias foram coradas em hematoxilina-eosina e as células do infiltrado inflamatório foram contadas e expressas suas densidades em células/mm². O infiltrado inflamatório mononuclear foi maior no grupo GNF (137,60 ± 53,18) e GF (91,70 ± 42,59) quando comparado com o grupo C (12,43 ± 4,24), (p=0,0001 e p=0,002 respectivamente). Quando os grupos com gengivite foram comparados, observou-se um menor número de células inflamatórias no grupo GF (p=0,04). Conclui-se que o infiltrado inflamatório aumenta no tecido gengival de indivíduos com gengivite crônica, porém, em indivíduos fumantes, observa-se diminuição dessas células.

The smoking habit has been considered by the literature as one of the major risk factors associated to the periodontal diseases. Substances such as nicotine can affect the vascularization, the humoral and cellular immune system. Changes in the number of inflammatory cells can also be observed in patients with chronic gingivitis. In this study we have evaluated 27 samples of gingival tissues that were divided in three groups: the first one contained 10 samples from nonsmokers patients with gingivitis (GNF), the second contained 10 samples from smokers patients with gingivitis (GF) and the last group contained 07 control samples (C) of nonsmoker patients without gingivitis. The biopsies were stained with hematoxylin-eosin and the inflammatory cells were counted and showed the density in cells/mm². The mononuclear cell infiltration was higher in the GNF (137.60 ± 53.18) and GF (91.70 ± 42.59) when compared with group C (12.43 ± 4.24) (p=0.0001 e p=0.002 respectively). When groups with gingivitis were compared to each other, there was a smaller number of inflammatory cells in the group GF (p=0.04). We conclude that there is an increase of the inflammatory infiltrate in the gingival tissue of patients with chronic gingivitis, however, in smokers patients, there in a decrease of those cells.