Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 57
Braz. oral res. (Online) ; 35: e033, 2021. tab
Article in English | LILACS, BBO | ID: biblio-1153604


Abstract The aim of this study was to investigate the epidemiological and clinical characteristics of chronic inflammatory periapical diseases in different regions of Brazil and to compare with data from the literature. A multicenter study was carried out in four Brazilian referral centers in oral diagnosis. Histopathological records were reviewed, and all cases diagnosed microscopically as periapical granuloma, radicular cyst, and periapical abscess were included. Demographic and clinical data were collected. Descriptive statistics and Pearson's chi-square test were performed. A total of 10,381 cases of chronic inflammatory periapical diseases were found (13.8% of 74,931 archived specimens) over a period of 65 years. Radicular cysts were the most common lesion (59.9%). Women (56.1%) with a mean age of 37.01 years old (range 13 to 100 ± 14.42) and people of white skin color (59.2%) were the most affected individuals by chronic inflammatory periapical diseases. The lesions were generally asymptomatic (28.1%), located in the maxilla (60.1%), and posterior region (49.8%). The radicular cysts were larger when compared to periapical granulomas (p < 0.001). The disagreement between the clinical and histopathological diagnoses was higher when the final diagnosis was a periapical granuloma (p < 0.001). Chronic inflammatory periapical diseases continue to be common lesions affecting mainly adults. This should be a consequence of the burden of untreated caries in permanent teeth. Women are more affected and radicular cyst was the most common lesion.

Humans , Female , Adolescent , Adult , Young Adult , Periapical Abscess/epidemiology , Periapical Diseases/epidemiology , Periapical Granuloma/epidemiology , Radicular Cyst/epidemiology , Brazil/epidemiology , Chronic Disease , Multicenter Studies as Topic
Article in English | LILACS, BBO | ID: biblio-1287504


ABSTRACT Objective: To compare salivary and serum biochemical levels in patients with chronic renal failure undergoing hemodialysis. Material and Methods: The sample was composed of 57 patients treated in Hemodialysis Reference Centers, from a state of Northeastern Brazilian, with age ≥21 years old with at least 3 months of hemodialysis treatment time. Serum data were obtained from records. Unstimulated and stimulated saliva were collected. Flow rate (mL/min) was measured. Spectrophotometry was performed for the measurement of salivary levels of calcium (570 nm), urea (340 nm), and creatinine (510 nm). Statistical analysis used Mann Whitney and Kruskal-Wallis tests (p<0.05). Results: Unstimulated and stimulated salivary flow rates were 0.43 mL/min and 1.69 mL/min, respectively. There was significant difference (p<0.001) of levels of calcium (5.41 mg/dL and 9.70 mg/dL), urea (118.03 mg/dL and 183.22 mg/dL) and creatinine (0.59 mg/dL and 9.20 mg/dL) between saliva and serum, respectively. Concerning the time of hemodialysis, salivary and serum calcium not exhibited significant association; however, serum urea (p=0.012) and serum creatinine (p=0.025) showed significant association to the time of hemodialysis. Conclusion: Salivary biochemical levels of urea, creatinine and calcium can indicate the presence of a possible chronic renal failure and the saliva demonstrated to be a potential auxiliary biofluid for clinical monitoring renal alterations.

Humans , Male , Female , Adult , Middle Aged , Aged , Saliva/immunology , Spectrophotometry/methods , Renal Dialysis/instrumentation , Creatinine , Renal Insufficiency, Chronic/pathology , Brazil/epidemiology , Medical Records , Calcium , Cross-Sectional Studies/methods , Statistics, Nonparametric
Braz. dent. j ; 31(3): 290-297, May-June 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1132302


Abstract Chloride intracellular channel-4 (CLIC4) is regulated by p53 and tumor necrosis factor-α (TNF-α), it is linked to the increase of transforming growth factor-β (TGF-β), and myofibroblastic differentiation in skin carcinogenesis. This study analyzed the immunoexpression of CLIC4, p53, TGF-β, TNF-α, and α-SMA in 50 actinic cheilitis (AC) and 50 lower lip squamous cell carcinoma (LLSCC). AC and LLSCC immunoexpression were categorized as score 1 (<5% positive cells), 2 (5-50%) or 3 (>50%). For CLIC4, nuclear and cytoplasmic immunostaining of epithelial cells was considered individually. For morphologic analysis, the World Health Organization criteria were used to epithelial dysplasia grade of ACs, and Bryne grading of malignancy system was applied for LLSCC. Higher nuclear CLIC4 (CLIC4n) and TGF-β were observed in ACs with low-risk of transformation, while cytoplasmic CLIC4 (CLIC4c), p53 and TNF-α were higher in the high-risk cases (p<0.05). In LLSCCs, CLIC4c was higher in cases with lymph node metastasis, advanced clinical stages, and histological high-grade malignancy. p53 expression was higher in high-grade LLSCCs, whereas TGF-β decreased as the clinical stage and morphological grade progressed (p<0.05). ACs showed an increased expression of CLIC4n and TGF-β, while CLIC4c and α-SMA were higher in LLSCCs (p<0.0001). Both lesions showed negative correlation between CLIC4n and CLIC4c, while in LLSCCs, negative correlation was also verified between CLIC4c and p53, as well as CLIC4c and TGF-β (p<0.05). Change of CLIC4 from the nucleus to cytoplasm and alterations in p53, TGF-β, TNF-α, and α-SMA expression are involved in lip carcinogenesis.

Resumo O canal intracelular de cloreto 4 (CLIC4) é regulado pela p53 e fator de necrose tumoral α (TNF-α) e está relacionado ao aumento do fator de crescimento transformador β (TGF-β) e na diferenciação miofibroblástica na carcinogênese cutânea. Este estudo analisou a imunoexpressão de CLIC4, p53, TGF-β, TNF-α e α-SMA em 50 queilites actínicas (QA) e 50 carcinomas de células escamosas de lábio inferior (CCELI). A imunoexpressão da QA e CCELI foram categorizadas em escore 1 (<5% de células positivas), 2 (5-50%) ou 3 (>50%). Para CLIC4, a imunomarcação nuclear e citoplasmática das células epiteliais foi considerada separadamente. Para análise morfológica, foram utilizados os critérios da Organização Mundial da Saúde para a gradação das displasias epiteliais nas QAs, e o sistema de gradação de malignidade de Bryne foi utilizado para os casos de CCELIs. Alta imunoexpressão de CLIC4 nuclear (CLIC4n) e TGF-β foi observada em QA de baixo risco de transformação, enquanto CLIC4 citoplasmática (CLIC4c), p53 e TNF-α foram elevadas nos casos de alto risco (p<0.05). No CCELI, a imunoexpressão de CLIC4c foi maior em caos com metástase linfonodal, estágio clínico avançado e alto grau histológico de malignidade. A expressão de p53 foi elevada em CCELI de alto grau, enquanto o TGF-β diminuiu à medida que o estádio clínico e o grau morfológico progrediram (p<0.05). QAs exibiram uma elevada expressão de CLIC4n e TGF-β, enquanto o CLIC4c e α-SMA foram elevados em CCELIs (p<0.0001). Ambas as lesões mostraram correlação negativa entre CLIC4n e CLIC4c, enquanto nos CCELIs, também se verificou correlação negativa entre CLIC4c e p53, assim como entre CLIC4c e TGF-β (p<0.05). Alteração do CLIC4 do núcleo para o citoplasma e alterações na expressão de p53, TGF-β, TNF-α, e α-SMA estão envolvidas na carcinogênese labial.

Humans , Lip Neoplasms , Transforming Growth Factor beta , Tumor Suppressor Protein p53 , Tumor Necrosis Factor-alpha , Chloride Channels , Myofibroblasts , Carcinogenesis , Lip
Braz. oral res. (Online) ; 34: e096, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1132722


Abstract Regulatory T (Treg) cells can suppress antitumor immune response, but little is known about possible age-related differences in the number of these cells in the microenvironment of oral tongue squamous cell carcinoma (OTSCC). The aim of this study was to determine the number of FoxP3+ Treg cells in the microenvironment of OTSCC in young (≤ 45 years) and older (≥ 60 years) patients, and to correlate the findings with clinicopathological parameters (sex, tumor size/extent, regional lymph node metastasis, clinical staging, and histopathological grade of malignancy). Forty-eight OTSCCs (24 diagnosed in young patients and 24 diagnosed in older patients) were selected. Lymphocytes exhibiting nuclear immunopositivity for FoxP3 were quantified at the tumor invasive front and the results were analyzed statistically using the non-parametric Mann-Whitney test. FoxP3+ lymphocytes were observed in all cases assessed. The number of FoxP3+ lymphocytes in OTSCC tended to be higher in older patients (p = 0.055). Analysis of OTSCC in males and in early clinical stages revealed a higher number of Treg cells in older patients than in young ones (p < 0.05). In older patients, the number of Treg cells tended to be higher in smaller tumors (p = 0.079). Tumors with intense inflammatory infiltrate exhibited a larger number of Treg cells, both in young (p = 0.099) and older patients (p = 0.005). The results suggest a greater participation of Treg cells in immunoinflammatory responses in the microenvironment of OTSCC in older patients, particularly in males and in early stages.

Humans , Male , Tongue Neoplasms , Carcinoma, Squamous Cell , T-Lymphocytes, Regulatory , Forkhead Transcription Factors , Tumor Microenvironment , Neoplasm Staging
Article in English | LILACS, BBO | ID: biblio-1135565


Abstract Objective: To perform an in vitro analysis of antibacterial and antifungal potential of an alcoholic extract from the leaves of Guapira Graciliflora Mart. against oral microorganisms and determine its chemical composition. Material and Methods: A hydroalcoholic extract of the leaves form G. graciliflora was obtained through maceration, vacuum concentration and freeze-drying. Antibacterial and antifungal activities were evaluated against Streptococcus mutans, Streptococcus salivarius, Streptococcus oralis, Streptococcus parasanguinis, Streptococcus mitis and strains of Candida albicans using broth microdilution method. Phytochemical analysis determined the total phenolic compounds, protein concentration and total of sugars present in the extract. Results: G. Graciliflora demonstrated antifungal activity against the LM 11 and LM 410 clinical isolates of C. albicans (MIC 0.5 mg/mL and 2 mg/mL, respectively). The other microorganisms tested were resistant to the extract. The phytochemical analysis revealed 3% proteins, 13% total sugars and 17% phenolic compounds. Conclusion: G. Graciliflora has antifungal activity against clinical strains of C. albicans and exhibits proteins, sugars and phenolic compounds in its chemical composition.

Plants, Medicinal , In Vitro Techniques , Plant Extracts/pharmacology , Anti-Infective Agents , Anti-Bacterial Agents , Candida albicans , Microbial Sensitivity Tests , Streptococcus oralis , Streptococcus mitis , Streptococcus salivarius , Antifungal Agents
Rev. Ciênc. Méd. Biol. (Impr.) ; 18(2): 210-216, nov 07, 2019. fig, tab, ilus
Article in Portuguese | LILACS | ID: biblio-1292078


Introdução: as escovas dentais possuem como principal função a limpeza dos tecidos bucais. Objetivo: analisar as características micro e macroscópicas de escovas dentais de uso infantil e adulto. Metodologia: foram selecionadas 11 escovas dentais (cinco de uso infantil e seis de uso adulto). Dois pesquisadores treinados analisaram aspectos microcoscópicos e macroscópicos, de acordo com os parâmetros da Portaria n° 97/SVS (ANVISA). Os dados foram tabulados e analisados utilizando-se o Microsoft Excel, sendo apresentados por meio de estatística descritiva. Resultados: foram encontradas cerdas arredondadas em 40% das escovas de uso infantil e em 66,7% de uso adulto, com farpas em 60% das escovas de uso infantil e em 50% de uso adulto, com a parte ativa ovalada em 60% das escovas de uso infantil e em 50% de uso adulto e com as cerdas macias em 80% das escovas de uso infantil e em 50% de uso adulto. O comprimento e a largura da parte ativa das de uso infantil variaram de 19,14 a 25,03 mm e de 8,82 a 13,98 mm respectivamente, enquanto, nas de uso adulto, o comprimento variou de 25,77 a 37,02 mm e a largura de 12,57 a 15,40 mm. As escovas de uso infantil possuíam comprimento total entre 137,91 e 163,82 mm e as de uso adulto entre 180,08 mm e 195,42 mm. Conclusão: a maioria das escovas dentais analisadas não estão adequadas aos parâmetros estabelecidos na legislação brasileira, sendo essencial que o cirurgião-dentista oriente individualmente o paciente acerca de qual escova é a mais indicada.

Introduction: toothbrushes have the main function of cleaning the oral tissues. Objective: to analyze the micro and macroscopic characteristics of children's and adult's toothbrushes. Methodology: eleven toothbrushes were selected (five for children and six for adults). Two trained researchers analyzed microscopic aspects and macroscopic aspects of the brushes, according to the parameters of Ordinance Number 97/SVS (ANVISA). Data were tabulated and analyzed by using Microsoft Excel and were presented by using descriptive statistics. Results: rounded bristles were found in 40% of the children's brushes and 66.7% of the adult, with barbs in 60% of the children's brushes and 50% of the adult, with the active part oval in 60% of the children's brushes and 50% adult brushes and soft bristles on 80% of the children's brushes and 50% of the adult. The length and width of the active part of the children's brushes ranged from 19.14 to 25.03 mm and from 8.82 to 13.98 mm respectively, while the adult brushes ranged from 25.77 to 37.02 mm in length and from 12.57 to 15.40 mm in width. The children's brushes had a total length between 137.91 and 163.82 mm and the adult brushes were between 180.08 mm and 195.42 mm. Conclusion: most of the toothbrushes analyzed are not adequate by the parameters established by the Brazilian legislation, so it is essential that the dentist individually guide the patient as to which toothbrush is the most suitable.

Pesqui. bras. odontopediatria clín. integr ; 19(1): 4348, 01 Fevereiro 2019. tab
Article in English | LILACS, BBO | ID: biblio-998004


Objective: To evaluate self-medication for toothache and its associated factors in children and adolescents. Material and Methods: A cross-sectional study was carried out with 252 children/adolescents aged 6-16 years. A questionnaire was applied with questions related to demographic and socioeconomic characteristics; experience of, and self-medication for, toothache; as well as aspects related to the condition. Descriptive and inferential statistical analyses (Pearson's Chi-square test and Fisher's exact test) were performed, with a 5% significance level. Results: The prevalence of toothache was 41.7%. In 96 cases analyzed, there was prevalence of 69.8% of self-medication for toothache. There were no statistically significant associations between self-medication for toothache and variables related to the children/adolescents (gender and age), their parents or guardians (age and schooling), socioeconomic characteristics (family income and number of people in the household) and aspects related to toothache (fever, crying and school absenteeism) (p>0.05). The most commonly used drug was paracetamol (60.7%), whose choice was based to its previous use by the study population for conditions not related to toothache (47.8%). Conclusion: There was a high prevalence of self-medication for toothache in the study population. No independent variable was associated with self-medication practice.

Humans , Male , Female , Child , Adolescent , Drug Prescriptions , Self Medication , Toothache/etiology , Child , Adolescent , Absenteeism , Brazil , Chi-Square Distribution , Cross-Sectional Studies/methods , Surveys and Questionnaires , Statistics, Nonparametric
Rev. odontol. UNESP (Online) ; 48: e20190005, 2019. tab
Article in English | LILACS, BBO | ID: biblio-1043177


Abstract Introduction Actinic cheilitis is a inflammatory condition affecting mainly the lower lip and it is caused by chronic and excessive exposure of the lips to the ultraviolet radiation in sunlight. Objective Identifying clinical and histopathologic characteristics in 40 cases histopathologically diagnosed as actinic cheilitis. In addition, to investigate possible associations between these aspects. Method Defined as an observational, transversal, retrospective and descriptive study, it registered data regarding age, gender, occupation, symptomatology, records of sun exposure, frequency of sunblock use, tabagism, skin color, clinical aspect and histopathological classification. The data was submitted to the chi square test of Pearson (p<0.05). Result There was a predominance of male gender, leucodermia, and ages ranging between 50 and 60 years. The most common occupation was farming. From our sample, 85% had history of chronic sun exposure, in which 50% reported the use of some type of sunblock and only 25% were smokers. The main clinical condition was non-ulcerated leukoplakia and in the histopathological study, the hyperkeratosis were more common. A correlation between the degree of tissue alteration verified in the histopathological diagnosis and the studied clinical variables was not established (p=0.112). Conclusion The clinical aspect of the wound can conceal tissue alterations in different stages, emphasizing the importance of a premature diagnosis.

Resumo Introdução A queilite actínica e uma condição de natureza inflamatória que acomete o lábio inferior, e é causada pela exposição prolongada e crônica dos lábios à radiação ultravioleta proveniente dos raios solares. Objetivo Identificar as características clínicas e histopatológicas em uma série de 40 casos diagnosticados histopatologicamente como queilite actínica. Além disso, investigar possíveis associações entre estes aspectos. Método Caracterizado como um estudo observacional, transversal, retrospectivo e descritivo. Foram registrados dados a respeito da idade, gênero, ocupação, sintomatologia, histórico de exposição ao sol, uso de proteção solar, tabagismo, cor da pele, aspecto clínico e classificação histopatológica. Os dados foram submetidos ao teste de Qui-Quadrado de Pearson (p<0,05). Resultado Houve uma prevalência do gênero masculino, leucodermas, com faixa etária entre 50 e 60 anos e a ocupação mais presente foi a de agricultor. Da amostra, 85% apresentou histórico de exposição crônica ao sol, onde 50% relatou uso de algum tipo de proteção solar e apenas 25% era tabagista. A principal apresentação clínica foi leucoplasia não ulcerada, e no estudo histopatológico as hiperceratoses foram as mais presentes. Não foi possível correlacionar o grau de alteração tecidual verificada no diagnóstico histopatológico com as variáveis clínicas estudadas (p=0,112). Conclusão Não foi possível correlacionar o grau de alteração tecidual verificada no diagnóstico histopatológico com os aspectos clínicos observados. O aspecto clínico da lesão pode mascarar alterações teciduais em diversos estágios, o que enaltece a importância do diagnóstico precoce.

Humans , Male , Female , Adult , Middle Aged , Aged , Precancerous Conditions/pathology , Cheilitis , Clinical Study , Pathology, Clinical , Clinical Diagnosis
Einstein (Säo Paulo) ; 17(1): eRC4610, 2019. graf
Article in English | LILACS | ID: biblio-984362


ABSTRACT Spindle cell squamous cell carcinoma of the tongue is a rare variant of squamous cell carcinoma. This paper reports the case of a spindle cell squamous cell carcinoma of the tongue, in a 64-year-old male patient, and presents a review of the etiopathogenesis, clinicopathological and immunohistochemical features and treatment of the malignancy. The patient presented for evaluation of a painful swelling on his tongue. Extraoral examination revealed palpable submandibular and superior cervical lymph nodes. Based on the presumptive diagnoses of squamous cell carcinoma or malignant salivary gland neoplasm, an incisional biopsy was performed. Histopathological analysis showed a proliferation of atypical spindle cells, exhibiting extensive pleomorphism. Tumor cells were positive for vimentin, P53 and alpha-smooth muscle actin, focally positive for epithelial membrane antigen and P63, and negative for pan-cytokeratin (AE1/AE3), CK7, CD138, CD34, CD56, and S-100. The positivity index for Ki-67 was approximately 40%. The diagnosis of spindle cell squamous cell carcinoma was established and the patient was referred to a head and neck surgery service. In the oral cavity, spindle cell squamous cell carcinoma of the tongue is an aggressive variant of squamous cell carcinoma, which usually presents as an exophytic mass located on the tongue of elderly males. Due to its distinct histopathological characteristics, immunohistochemistry is a valuable and helpful tool to establish the diagnosis of spindle cell squamous cell carcinoma of the tongue.

RESUMO O carcinoma de células escamosas de células fusiformes da língua, é uma variante rara do carcinoma de células escamosas. Este trabalho relata o caso de um paciente do sexo masculino de 64 anos de idade com carcinoma de células escamosas de células fusiformes da língua. Foi feita uma revisão dos aspectos relacionados a etiopatogenia, características clinicopatológicas e imuno-histoquímicas, além do tratamento dessa neoplasia. O paciente procurou atendimento para avaliação de tumefação dolorosa na língua. O exame extraoral revelou linfonodos cervicais submandibulares e cervicais superiores palpáveis. Foi realizada biópsia incisional com base nas hipóteses diagnósticas de carcinoma de células escamosas ou neoplasia maligna de glândula salivar. A análise histopatológica demonstrou proliferação de células fusiformes atípicas, exibindo extenso pleomorfismo. As células tumorais foram positivas para vimentina, p53 e alfa-actina de músculo liso, focalmente positivas para antígeno de membrana epitelial e P63, e negativas para pancitoqueratina (AE1/AE3), CK7, CD138, CD34, CD56 e S-100. O índice de positividade para o Ki-67 foi de aproximadamente 40%. Foi feito o diagnóstico de carcinoma de células escamosas, de células fusiformes, e o paciente foi encaminhado para um serviço de cirurgia de cabeça e pescoço. Na cavidade oral, o carcinoma de células escamosas de células fusiformes da língua, é uma variante agressiva do carcinoma de células escamosas, que geralmente se apresenta como massa exofítica localizada na língua de homens idosos. Devido às suas distintas características histopatológicas, a imuno-histoquímica é uma ferramenta valiosa e útil para estabelecer o diagnóstico de carcinoma de células escamosas de células fusiformes da língua.

Humans , Male , Middle Aged , Tongue Neoplasms/pathology , Carcinoma, Squamous Cell/pathology , Immunohistochemistry , Diagnosis, Differential , Middle Aged
Braz. oral res. (Online) ; 33: e085, 2019. tab, graf
Article in English | LILACS | ID: biblio-1019611


Abstract The aim of this study was to evaluate the immunoexpression of human leukocyte antigen-DR (HLA-DR) in actinic cheilitis (AC) and lower lip squamous cell carcinoma (LLSCC), and to correlate the findings with clinical (tumor size/extent, regional lymph node metastasis, and clinical stage) and histopathological (grade of epithelial dysplasia and inflammatory infiltrate for AC and histopathological grade of malignancy for LLSCC) parameters. Twenty-four AC and 48 LLSCC cases (24 with regional nodal metastasis and 24 without regional nodal metastasis) were selected. The scores of immunopositive cells for HLA-DR in the epithelial component of the lesions were assessed and the results were analyzed statistically using the nonparametric Mann-Whitney test. Epithelial expression of HLA-DR was observed in only five (20.8%) cases of AC (two low-grade and three high-grade lesions), with a very low median score of immunopositivity. By contrast, expression of HLA-DR was found in most LLSCC (97.9%), with a relatively high median score of positive cells. The score of HLA-DR-positive cells tended to be higher in tumors with regional lymph node metastasis, tumors in advanced clinical stages, and low-grade tumors, but the difference was not statistically significant (p > 0.05). In addition, there was a tendency towards higher expression of HLA-DR in highly/moderately keratinized tumors, and tumors with little/moderate nuclear pleomorphism (p > 0.05). The results suggest a potential role of HLA-DR in lip carcinogenesis, particularly in the development and progression of LLSCC. The expression of this protein can be related to the degree of cell differentiation in these tumors.

Humans , Male , Female , Adult , Aged , Aged, 80 and over , Lip Neoplasms/immunology , HLA-DR Antigens/immunology , Cheilitis/immunology , Squamous Cell Carcinoma of Head and Neck/immunology , Lip Neoplasms/pathology , Lip Neoplasms/secondary , Cheilitis/pathology , Neoplasm Grading , Carcinogenesis/immunology , Squamous Cell Carcinoma of Head and Neck/pathology , Squamous Cell Carcinoma of Head and Neck/secondary , Inflammation/pathology , Lymphatic Metastasis/pathology , Middle Aged , Neoplasm Staging
Rev. cir. traumatol. buco-maxilo-fac ; 18(1): 30-33, jan.-mar. 2018. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1255058


O ceratocisto odontogênico (CO) é um cisto de origem odontogênica, cujo diagnóstico final é dado com base nos aspectos clínicos, radiográficos e histopatológicos. O tratamento mais comum consiste na enucleação cirúrgica. O objetivo do presente estudo foi relatar um caso de CO em região posterior de mandíbula, abordando as características clínico-patológicas e a terapia para essa lesão. Paciente do sexo feminino, 69 anos de idade, apresentou um tumor, de superfície ulcerada, na região retromolar inferior do lado direito. O exame radiográfico da região afetada revelou a presença de uma imagem radiolúcida com limites bem definidos. Após dois meses da primeira consulta e de ter feito ajuste de sua prótese mal adaptada, a paciente retornou apresentando uma lesão tumoral, sem a presença de úlcera, na mesma região. Sob as hipóteses diagnósticas de CO e de cisto residual, foi realizada biópsia excisional. Os achados histopatológicos foram compatíveis com CO. Dezoito meses após a remoção da lesão, não foram identificados sinais de recidiva. O CO possui achados clínicos e radiográficos característicos, bem como diferentes possibilidades terapêuticas, sendo estas abordagens agressiva ou conservadora. Em todos os casos, faz-se necessário o acompanhamento periódico, considerando as altas taxas de recorrência da doença... (AU)

The odontogenic keratocyst (OK) is a cyst of odontogenic origin, which final diagnosis is given from the clinical, radiological and histopathological findings. The most common treatment is surgical enucleation. The objective of the present study was to report a case of OK in the posterior mandible, approaching the clinicopathological features and treatment for this lesion. A 69-year-old female patient presented a tumor lesion of ulcerated surface in the retromolar region of the right side. Radiographic examination of the affected region revealed the presence of radiolucent image with well-defined limits. After two months of the first appointment and after having made adjustments to her poorly adapted prosthesis, the patient returned presenting a tumor lesion, without the presence of ulcers, in the same region. Under the diagnostic hypotheses of OK and residual cyst, excisional biopsy was performed. The histopathologic findings were consistent with OK. Eighteen months after the removal of the lesion there were not identified clinical and radiographic signs of recurrence. The OK has characteristic clinical and radiographic findings, as well as different therapeutic possibilities, being these approaches aggressive or conservative. In all cases, periodic follow-up is necessary, taking into account the high recurrence rates of the disease... (AU)

Humans , Female , Aged , Jaw Diseases , Odontogenic Cysts , Mandible , Neoplasms , Wounds and Injuries , Biopsy
Einstein (Säo Paulo) ; 16(2): eRC4025, 2018. graf
Article in English | LILACS | ID: biblio-891469


ABSTRACT Melanotic neuroectodermal tumor of infancy is a rare and fast-growing neoplasm. In this study, we describe the case of a 6-month-old female patient, who presented swelling in the anterior maxilla. Tomographic reconstruction showed an unilocular hypodense and expansive area associated with the upper right central primary incisor. The presumptive diagnoses were dentigerous cyst, adenomatoid odontogenic tumor, melanotic neuroectodermal tumor of infancy and rhabdomyosarcoma, and an incisional biopsy was performed. Microscopically, the lesion revealed a biphasic cell population, consisting of small, ovoid, neuroblastic-like cells and epithelioid cells containing melanin. Immunohistochemically, the melanocyte-like component was strongly and diffusely positive for HMB-45 and Melan-A, but weakly positive for S100. Based on these findings, definitive diagnosis of melanotic neuroectodermal tumor of infancy was established. Then, enucleation of the lesion was performed by careful curettage. After 2 year follow-up, no clinical or radiographical evidence of recurrence was verified. The present case highlights the importance of early diagnosis and therapeutic intervention at the appropriate time to achieve a favorable outcome for the patient.

RESUMO O tumor neuroectodérmico melanocítico da infância é uma neoplasia rara e de crescimento rápido. Neste estudo, relata-se o caso de uma paciente do sexo feminino de 6 meses de idade, que apresentou tumefação na região anterior de maxila. A reconstrução tomográfica revelou área unilocular hipodensa e expansiva associada ao incisivo central superior direito decíduo. Realizou-se biópsia incisional, considerando as hipóteses diagnósticas de cisto dentígero, tumor odontogênico adenomatoide, tumor neuroectodérmico melanocítico da infância e rabdomiossarcoma. Microscopicamente, a lesão revelou população celular bifásica, consistindo de células pequenas, ovoides, de aparência neuroblástica, e de células epitelioides, contendo melanina. A análise imuno-histoquímica demonstrou que o componente celular contendo melanina era positivo de forma intensa e difusa para HMB-45 e Melan-A, mas levemente positivo para S100. Com base nestes achados, foi estabelecido o diagnóstico definitivo de tumor neuroectodérmico melanocítico da infância. Em seguida, foi realizada a enucleação da lesão com curetagem cuidadosa. Após 2 anos de acompanhamento, não foram verificadas evidências clínicas ou radiográficas de recorrência. O presente caso destaca a importância do diagnóstico precoce e da intervenção terapêutica no momento apropriado, a fim de alcançar um desfecho favorável para o paciente.

Humans , Female , Infant , Maxillary Neoplasms/pathology , Neuroectodermal Tumor, Melanotic/pathology , Biopsy , Immunohistochemistry , Maxillary Neoplasms/diagnosis , Tomography, X-Ray Computed , Neuroectodermal Tumor, Melanotic/diagnosis , Early Detection of Cancer
RGO (Porto Alegre) ; 65(4): 376-379, Oct.-Dec. 2017. graf
Article in English | LILACS, BBO | ID: biblio-896046


ABSTRACT Orthokeratinized odontogenic cysts are developmental odontogenic cysts, presenting with low frequency, low rate of recurrence and their ethiopathogenesis is unknown. Radiographically, they show a radiolucent area in the mandibular posterior region. The aim of this report is to describe an unusual case of orthokeratinized odontogenic cysts, radiographically exhibiting radiopaque areas with an aspect of calcifications in the lesion. Based on this, the clinical hypothesis of ameloblastic fibro-odontoma was suggested. After incisional biopsy and microscopic analysis, the conclusive diagnosis was orthokeratinized odontogenic cysts. The radiopaque foci were observed to be associated with a foreign body reaction. The patient was submitted to surgery under local anesthesia, with intraoral access for complete excision of the lesion and to re-establish esthetics. After follow-up of 24 months there were no signs of recurrence. Knowledge of this type of reaction is important because of the risk that the lesion may mimic a potentially more aggressive lesion, affecting the choice of treatment.

RESUMO Os cistos odontogênicos ortoceratinizados são cistos de desenvolvimento de origem odontogênica, de baixa frequência, etiopatogenia desconhecida e baixa taxa de recorrência. Radiograficamente, apresenta-se como uma área radiolúcida em região posterior de mandíbula. O objetivo deste artigo é descrever um caso não usual de cistos odontogênicos ortoceratinizados, que exibia, radiograficamente, focos radiopacos semelhantes à calcificações, no interior da lesão, sugerindo diagnóstico clínico de fibro-odontoma ameloblástico. Após a biópsia incisional e análise microscópica, o diagnóstico conclusivo foi de cistos odontogênicos ortoceratinizados. Observou-se que os focos radiopacos estavam associados, microscopicamente, a presença de uma reação de células gigantes multinucleadas por corpo estranho. O paciente foi tratado cirurgicamente, sob anestesia local, com acesso intrabucal para remoção total da lesão, com o restabelecimento da estética e sem sinais de recidiva após 24 meses. A importância do conhecimento deste tipo de reação dar-se pelo risco de mimetizar uma lesão potencialmente mais agressiva, direcionando a escolha do tratamento da lesão.

ROBRAC ; 26(79): 9-15, out./dez. 2017. tab
Article in English | LILACS-Express | LILACS | ID: biblio-906015


Purpose: The aim of the present case-control study was to investigate whether there was any association between occupation and oral squamous cell carcinoma (OSCC) in a Brazilian population. Methods: This population-based study investigated an occupation that was classified according to the International Standard Classification of Occupations. The sample consisted of 665 individuals, of whom 133 were cases of OSCC, selected from reference hospitals for cancer in Paraíba; and 532 were part of a control group, paired by age, gender, place and smoking habit, who participated in the study. Results: There was statistically significant association between OSCC and occupation (p<0.001), alcohol consumption (p<0.001) and marital status (p=0.003). The variables marital status, occupation, alcoholism and smoking were shown to be statistically associated with the development of cancer of the oropharynx with Odds Ratio (OR) ranging from 1.8 to 11.2 Conclusion: Occupational exposure to chemical and physical carcinogenic substances, as well as the condition of living with a partner may be raised as possible risk factors for the development of cancer of the mouth and oropharynx.

Objetivo: O presente estudo de caso-controle teve como objetivo investigar se existe associação entre ocupação e carcinoma de células escamosas orais (OSCC) em uma população brasileira. Métodos: Este estudo populacional investigou a ocupação que foi classificada de acordo com a Norma Internacional de Classificação de Ocupações. Foram incluídos 665 indivíduos, sendo 133 casos de OSCC, selecionados de hospitais de referência para câncer na Paraíba e 532 participantes do grupo controle, pareados por idade, sexo, local e tabagismo. Resultados: Houve associação estatisticamente significativa entre ocupação (p<0,001), consumo de álcool (p<0,001) e estado civil (p=0,003). As variáveis estado civil, ocupação, alcoolismo e tabagismo mostraram-se estatisticamente associadas ao desenvolvimento de câncer da orofaringe com Odds Ratio (OR) entre 1,8 e 11,2. Conclusão: A exposição ocupacional às substâncias químicas e físicas cancerígenas, bem como a condição de viver com um parceiro podem aumentar a possibilidade de fatores de risco para o desenvolvimento de câncer de boca e orofaringe.

Braz. dent. j ; 28(2): 256-261, mar.-Apr. 2017. graf
Article in English | LILACS | ID: biblio-839137


Abstract Teratomas are tumors composed by tissues derived from the three germ cell layers, and they are relatively uncommon in head and neck. The term epignathus has been applied to teratomas from the oropharynx. This paper reports the case of a giant epignathus teratoma discovered at birth, which was successfully managed and followed up for 7 years. A newborn boy presented a polypoid tumor mass exteriorizing through the mouth over a length of 9 cm, with some surface areas resembling skin and others exhibiting hair. Computed tomography showed that the mass arose deep from the left hemiface. Alpha-fetoprotein (AFP) levels were high (316,000 ng/mL). Surgery was performed and microscopic analysis confirmed the diagnosis of mature teratoma. Because of residual tumor and high AFP levels, the patient was submitted to chemotherapy, resulting in complete regression of the lesion and normalization of AFP levels. Surgical repair of a cleft palate was performed at 5 years of age. At 7 years of age, the patient was in good general health and showed no clinical signs of recurrence. Although epignathus is a rare condition, it should be diagnosed in the fetus as early as possible. Prenatal care provides unquestionable benefits, providing the early diagnosis of anomalies that can jeopardize the life of the fetus and contributing to the indication of cases that require treatment before birth.

Resumo Teratomas são tumores constituídos por tecidos derivados das três camadas de células germinativas e são relativamente incomuns em cabeça e pescoço. O termo epignathus tem sido utilizado para designar teratomas que se originam na orofaringe. Este artigo relata o caso de um teratoma epignathus gigante descoberto ao nascimento, o qual foi tratado com sucesso e proservado por 7 anos. Um menino recém-nascido apresentou uma massa tumoral polipoide que se exteriorizava através da boca por uma extensão de 9 cm, com regiões da superfície semelhantes à pele e outras exibindo pelos. Exame de tomografia computadorizada revelou que a massa se originava profundamente na hemiface esquerda. Os níveis de alfa-fetoproteína (AFP) se apresentavam elevados (316.000 ng/mL). Foi realizada cirurgia e a análise microscópica confirmou o diagnóstico de teratoma maduro. Por apresentar lesão residual e altos níveis de AFP, o paciente foi submetido à quimioterapia, resultando em regressão completa da lesão e normalização dos níveis de AFP. Correção cirúrgica de uma fenda palatina foi realizada aos 5 anos de idade. Aos 7 anos de idade, o paciente apresentava um bom estado de saúde geral, sem sinais clínicos de recorrência da lesão. Embora o epignathus seja uma condição rara, seu diagnóstico no feto deve ser realizado o mais precocemente possível. O cuidado pré-natal proporciona benefícios inquestionáveis, permitindo o diagnóstico precoce de anomalias que podem comprometer a vida do feto e contribuindo para a indicação de casos que requerem tratamento antes do nascimento.

Humans , Male , Infant, Newborn , Mouth Neoplasms/pathology , Teratoma/pathology , Follow-Up Studies , Mouth Neoplasms/diagnostic imaging , Teratoma/diagnostic imaging
Pesqui. bras. odontopediatria clín. integr ; 17(1): e3331, 13/01/2017. tab, ilus
Article in English | LILACS, BBO | ID: biblio-914241


Objective: To compare the rate of cell proliferation and expression of antiapoptotic protein Bcl-2 between drug-induced gingival overgrowth (DIGO) and clinical healthy gingiva (CHG) and to establish associations with histopathological features. Material and Methods: Twenty specimens of DIGO and 20 CHG specimens were submitted to morphological and immunohistochemical analysis by light microscopy. Cell proliferation (Ki-67) and the expression of Bcl-2 were evaluated in epithelial cells and spindle-shaped mononuclear cells of the connective tissue by establishing the labeling index (LI). Results: In epithelial tissue, the mean LI for Ki-67 was 17.2% in DIGO and 21.71% in CHG (p = 0.137). The mean LIs for Bcl-2 in epithelial tissue were 14.67% and 10.24% in DIGO and CHG, respectively (p = 0.026). In connective tissue, DIGO and CHG specimens exhibited low LIs for Ki-67 and Bcl-2, with mean values of less than 0.5% in both groups. No significant differences in the LIs for Ki-67 or Bcl-2 in epithelial tissue were observed according to the degree of collagenization, degree of vascularization and intensity of inflammatory infiltration (p > 0.05). No significant correlations were observed between the LIs for Ki-67 and Bcl-2 (p > 0.05). Conclusion: The present results suggest that the pathogenesis of DIGO does not involve increased proliferation or decreased apoptosis of fibroblasts. On the other hand, the morphological pattern of elongated epithelial cristae observed in DIGO could mainly be due to the inhibition of keratinocyte apoptosis and not to increased proliferation of these cells.

Cell Proliferation , Fibromatosis, Gingival/pathology , Genes, bcl-2 , Immunohistochemistry/methods , Ki-67 Antigen , Brazil , Statistics, Nonparametric
Pesqui. bras. odontopediatria clín. integr ; 17(1): e3235, 13/01/2017. tab
Article in English | LILACS, BBO | ID: biblio-914261


Objective: To evaluate the anti-Candida effect of eugenol and its antimicrobial interaction with nystatin. Material and Methods: The antimicrobial potential was assessed by microdilution technique (M27A3 reference method), by determining the minimum inhibitory concentration (MIC) and the minimum fungicidal concentration (MFC) against C. albicans (ATCC 90028). The possible action of eugenol on the fungal cell wall was evaluated with the assistance of the osmotic protector sorbitol (0.8 M). The antimicrobial interaction with nystatin was assessed through the checkerboard method. All tests were performed in triplicate. Results: All groups showed reductions in PI and GBI values and improvements in oral health knowledge, but IG1 and IG2 showed statistically significant differences in these variables compared to CG. Conclusion: The eugenol has antifungal activity against C. albicans and its mechanism of action is probably not related to damage to the fungal cell wall. Association between eugenol and nystatin was not found to be an advantageous possibility for growth inhibition of C. albican.

Anti-Bacterial Agents , Candida albicans , Drug Synergism , Eugenol , Brazil , In Vitro Techniques
Pesqui. bras. odontopediatria clín. integr ; 17(1): e3732, 13/01/2017. tab
Article in English | LILACS, BBO | ID: biblio-914466


Objective: To investigate if an association exists between diet and oral squamous cell carcinoma (OSCC) in a Brazilian population. Material and Methods: This populationbased study investigated food groups intaken by means of a quantitative food frequency questionnaire (QFFQ) validated for use in Brazil. It was included 665 individuals, being 133 cases of OSCC, selected from reference hospitals for cancer in Paraíba and 532 being part of a control group, paired by age, gender, place and smoking habit took part in the study. Food consumption related to cases and control groups were evaluated by QFFQ. The Chi-square test was carried out in order to verify if there was association between the categorical variables. The level of significance was 5%. Conditional logistic regression was performed by the Enter method in order to verify the odds ratio of independent variables that predict OSCC. Results: It was found statistical association between OSCC and: processed and variety meats (p=0.048), dairy products (p<0.001), oils and fats (p<0.001) and alcoholic beverages (p<0.001). The high consumption of cereals and tubers (OR=0.53; CI95%: 0.29-0.96; p=0.0039) acted as protection factor for OSCC. Conclusion: Data of the present research suggest that the ingestion of animal fat, food rich in salt and refined carbohydrates were associated with OSCC cases.

Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Carcinoma, Squamous Cell/pathology , Case-Control Studies , Diet/methods , Mouth Diseases/pathology , Brazil , Chi-Square Distribution , Eating , Logistic Models , Surveys and Questionnaires
Braz. oral res. (Online) ; 31: e34, 2017. tab, graf
Article in English | LILACS | ID: biblio-839511


Abstract The aim of this study was to evaluate the immunoexpression of glucose transporters 1 (GLUT-1) and 3 (GLUT-3) in keratocystic odontogenic tumors associated with Gorlin syndrome (SKOTs) and non-syndromic keratocystic odontogenic tumors (NSKOTs), and to establish correlations with the angiogenic index. Seventeen primary NSKOTs, seven recurrent NSKOTs, and 17 SKOTs were selected for the study. The percentage of immunopositive cells for GLUT-1 and GLUT-3 in the epithelial component of the tumors was assessed. The angiogenic index was determined by microvessel count. The results were analyzed statistically using the nonparametric Kruskal-Wallis test and Spearman’s correlation test. High epithelial immunoexpression of GLUT-1 was observed in most tumors (p = 0.360). There was a higher frequency of negative cases for GLUT-3 in all groups. The few GLUT-3-positive tumors exhibited low expression of this protein in epithelial cells. No significant difference in the angiogenic index was observed between groups (p = 0.778). GLUT-1 expression did not correlate significantly with the angiogenic index (p > 0.05). The results suggest that the more aggressive biological behavior of SKOTs when compared to NSKOTs may not be related to GLUT-1 or GLUT-3 expression. GLUT-1 may play an important role in glucose uptake by epithelial cells of KOTs and this process is unlikely related to the angiogenic index. GLUT-1 could be a potential target for future development of therapeutic strategies for KOTs.

Humans , Basal Cell Nevus Syndrome/pathology , Glucose Transporter Type 1/analysis , Glucose Transporter Type 3/analysis , Neovascularization, Pathologic/pathology , Odontogenic Cysts/pathology , Odontogenic Tumors/pathology , Basal Cell Nevus Syndrome/metabolism , Epithelial Cells/pathology , Immunohistochemistry , Odontogenic Cysts/chemistry , Odontogenic Tumors/chemistry , Paraffin Embedding , Reference Values , Statistics, Nonparametric
Int. j. odontostomatol. (Print) ; 10(3): 513-520, dic. 2016. ilus
Article in English | LILACS | ID: biblio-841003


This study aimed to assess the immunoexpression of cell proliferation markers (Ki-67 and Mcm-2) in oral tongue cancer, correlating it with patients' age and prognostic indicators. Sample was composed of 22 cases under 40 years and 22 over 50 years of age. Clinical staging and histological grade of malignancy were obtained. Cell proliferation was evaluated through labeling indices. Statistical analysis was performed (p<0.05 for statistical significance). Most young patients were stages III/IV (n=13/65 %) and most older patients were stages I/II (n=11/61.1 %) (p>0.05). Mean Ki-67-LI in young and older patients was 42.4 % and 44.15 %, respectively (p>0.05). Mean Mcm-2-LI was higher in older (63.6 %) than in young patients (55.75 %) (p<0.05). We found that young patients presented more aggressive lesions in comparison to older patients, however Mcm-2 expression was significantly higher in older than in young patients. SCC of tongue can be more aggressive in young patients, and this may not be related to cell proliferation. Our findings for Mcm-2 LI and Ki-67 LI suggests that Mcm-2 could be a more sensitive marker for cell proliferation.

Este estudio tuvo como objetivo evaluar la inmunoexpresión de marcadores de proliferación celular (Ki-67 y Mcm-2) en el cáncer de lengua oral, correlacionándolo con la edad de los pacientes y los indicadores pronósticos. La muestra estuvo compuesta por 22 personas menores de 40 años y 22 personas mayores de 50 años. Se identificaron los estadios clínicos y el grado histológico de malignidad. La proliferación celular se evaluó mediante índices de marcado. Se realizó análisis estadístico (p <0,05 para significación estadística). La mayoría de los pacientes jóvenes eran estadios III / IV (n = 13/65 %) y la mayoría de los pacientes mayores eran estadios I / II (n = 11 / 61,1 %) (p> 0,05). La media de Ki-67-LI en pacientes jóvenes y mayores fue 42,4% y 44,15%, respectivamente (p> 0,05). La media de Mcm-2-LI fue mayor en pacientes mayores (63,6 %) que en pacientes jóvenes (55,75 %) (p <0,05). Se encontró que los pacientes jóvenes presentaron lesiones más agresivas en comparación con los pacientes mayores, sin embargo la expresión de Mcm-2 fue significativamente mayor en pacientes mayores que en pacientes jóvenes. SCC de la lengua puede ser más agresivo en pacientes jóvenes, y esto no puede estar relacionado con la proliferación celular. Nuestros hallazgos para Mcm-2 LI y Ki-67 LI sugieren que Mcm-2 podría ser un marcador más sensible para la proliferación celular.

Humans , Male , Female , Adult , Middle Aged , Carcinoma, Squamous Cell/immunology , Ki-67 Antigen/metabolism , Mouth Neoplasms/immunology , Age Factors , Biomarkers, Tumor/metabolism , Cell Proliferation , Immunohistochemistry , Minichromosome Maintenance Complex Component 2/metabolism , Mouth Neoplasms/metabolism , Prognosis , Tongue Neoplasms/metabolism