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Objetivo: establecer la relación entre el diagnóstico histopatológico de sacos foliculares de terceros molares y la medida radiográfca estandarizada en radiografía panorámica digital. Métodos: se llevó a cabo un estudio descriptivo en el que se incluyeron 28 sacos foliculares de terceros molares. Dos observadores midieron la radiolucidez pericoronal en radiografías panorámicas digitales usando un método estandarizado y se calculó el índice de correlación intraclase. Se estableció un diagnóstico radiográfco según la medida del saco, con <2.5 mm como el límite para sacos foliculares normales. Dicho diagnóstico fue comparado con el respectivo diagnóstico histopatológico. Se calculó sensibilidad y especifcidad; se aplicó la prueba de chi-cuadrado, exacta de Fisher y, fnalmente, el índice Kappa. Resultados: se obtuvo un alto grado de acuerdo entre los observadores. La prueba radiográfca tuvo una baja sensibilidad (0.27) y especifcidad (0.6) y no se encontró diferencia estadísticamente signifcativa entre estos. Conclusiones: la ausencia de hallazgos radiográfcos no implica ausencia de enfermedad. Además, no se puede establecer relación entre la presencia de quistes dentígeros y radiolucidez ≥ 2.5 mm en radiografía panorámica digital.
Objective: To establish the relationship between the histopathological diagnosis of follicular sacs of third molars and the standardized radiographic measurement in digital panoramic radiography. Methods: This was a descriptive study in which 28 follicular sacs of third molars were included. In digital panoramic radiographs two observers measured the pericoronal radiolucency using a standardized method and the intraclass correlation index was calculated. A radiographic diagnosis was established according to the size of the sac, with <2.5mm being the limit for normal follicular sacs. This diagnosis was compared with the respective histopathological diagnosis. Sensitivity and specifcity were calculated; the chi-square test, Fisher's exact test and fnally the Kappa index were applied. Results: A high degree of agreement was obtained among the observers. The radiographic test had a low sensitivity (0.27) and specifcity (0.6) and no statistically signifcant diference was found between these. Conclusions: The absence of radiographic fndings does not imply absence of disease, furthermore, no relationship can be established between the presence of dentigerous cysts and radiolucency ≥ 2.5 mm in digital panoramic radiography.
Subject(s)
Humans , Adult , Dentigerous Cyst , Molar, Third , Pathology , Radiography, Panoramic , CystsABSTRACT
ABSTRACT The dental follicle is characterized as a radiolucent area around an impacted tooth. It is believed that these follicles can originate cysts and tumors. The aim of this study was to report a clinical case of a 15-year-old female, normosystemic patient, with an increased dental follicle involving the crown of the tooth 48, which was removed and referred for histopathological examination. The diagnosis hypothesis was dentigerous cyst, but the histopathological report describes a definitive diagnosis of dental follicle. After six months of postoperative follow-up the patient presented no signs of relapse or complaints in the region.
RESUMEN El folículo pericoronario se caracteriza por un área radiolúcida alrededor de un diente no erupcionado. Se cree que eses folículos puedan desarrollar quistes y tumores. El objetivo de este trabajo es reportar el caso clínico de un paciente de género femenino, de 15 años de edad, buen estado general, que presentaba un folículo dilatado, cubriendo la corona del diente 48, lo cual ha sido removido y enviado para estudio histopatológico. La hipótesis diagnóstica fue de quiste dentígero, pero el informe histopatológico logró establecer como diagnóstico definitivo folículo pericoronario. En los primeros seis meses del período postoperatorio, no hay señales de recidiva o quejas en la región.
RESUMO O folículo pericoronário caracteriza-se como uma área radiolúcida em volta de um dente incluso. Acredita-se que esses folículos podem originar cistos e tumores. O objetivo deste trabalho foi relatar o caso clínico de um paciente do gênero feminino, 15 anos de idade, normossistêmica, que apresentava folículo pericoronário aumentado, envolvendo a coroa do dente 48, o qual foi removido e encaminhado para exame histopatológico. A hipótese diagnóstica foi cisto dentígero, mas o laudo histopatológico teve como diagnóstico definitivo folículo pericoronário. A paciente encontra-se com seis meses de pós-operatório sem sinais de recidiva ou queixas na região.
ABSTRACT
Abstract The aim of this study was to investigate the effects of low-intensity pulsed ultrasound (LIPUS) on the osteogenic differentiation of dental follicle cells (DFCs) in vitro and on the regenerative effects of DFC-OsteoBoneTM complexes in vivo. DFCs were isolated and characterized. In the in vitro study, DFCs were cultured in an osteogenic medium in the presence or absence of LIPUS. The expression levels of ALP, Runx2, OSX, and COL-I mRNA were analyzed using real-time polymerase chain reaction (RT-PCR) on day 7. Alizarin red staining was performed on day 21. The state of the growth of the DFCs that were seeded on the scaffold at 3, 5, 7, and 9 days was detected by using a scanning electron microscope. In our in vivo study, 9 healthy nude mice randomly underwent subcutaneous transplantation surgery in one of three groups: group A, empty scaffold; group B, DFCs + scaffold; and group C, DFCs + scaffold + LIPUS. After 8 weeks of implantation, a histological analysis was performed by HE and Mason staining. Our results indicate that LIPUS promotes the osteogenic differentiation of DFCs by increasing the expression of the ALP, Runx2, OSX, and COL-I genes and the formation of mineralized nodules. The cells can adhere and grow on the scaffolds and grow best at 9 days. The HE and Mason staining results showed that more cells, fibrous tissue and blood vessels could be observed in the DFCs + scaffold + LIPUS group than in the other groups. LIPUS could promote the osteogenic differentiation of DFCs in vitro and promote tissue regeneration in a DFCs-scaffold complex in vivo. Further studies should be conducted to explore the underlying mechanisms of LIPUS.
Subject(s)
Animals , Osteogenesis/radiation effects , Ultrasonic Therapy/methods , Bone Regeneration/radiation effects , Dental Sac/cytology , Ultrasonic Waves , Time Factors , Microscopy, Electron, Scanning , Random Allocation , Ceramics , Reproducibility of Results , Rats, Sprague-Dawley , Dental Sac/radiation effects , Real-Time Polymerase Chain Reaction , Flow Cytometry , Mice, NudeABSTRACT
Las imágenes radiolúcidas periapicales que involucran dientes primarios traumatizados se pueden confundir entre sí y dar lugar a diagnósticos erróneos y tratamiento. Por lo tanto, es importante identi-ficar las características radiográficas de las imágenes radiolúcidas periapicales en los incisivos prima-rios traumatizados, principalmente debido al hecho de que la superposición de imágenes se produce en esta región. Además, es frecuente observar la expansión del folículo haciendo que el diagnóstico radiográfico sea aún más difícil. El objetivo de este estudio fue describir, a través de una revisión de la literatura, las características radiográficas de las imágenes periapicales asociadas con los incisivos primarios traumatizados.
Periapical radiolucencies involving traumatized primary teeth can be confused with each other and lead to misdiagnosis and treatment. Therefore, it is important to identify radiographic characteristics of periapical radiolucent images in traumatized primary incisors, mainly due to the fact that overla-pping of images occurs in this region. Besides, it is frequent to observe follicle expansion making the radiographic diagnosis even more difficult. The objective of this study was to describe, through a literature review, the radiographic characteristics of periapical images associated with traumatized primary incisors.
As radioluscências periapicais envolvendo dentes decíduos traumatizados podem ser confundidas entre si e levar a um erro de diagnóstico e tratamento. Por isso, é importante identificar características radiográficas de imagens radiolúcidas periapicais em incisivos decíduos traumatizados, principalmente pelo fato que nesta região ocorre sobreposição de imagens e, é frequente observar expansão do folículo, dificultando ainda mais o diagnóstico radiográfico. O objetivo deste trabalho foi descrever através de uma revisão de literatura as características radiográficas de imagens periapicais associadas a incisivos decíduos traumatizados.
Subject(s)
Periapical Granuloma , Tooth, Deciduous , Radiography, Dental , Radicular Cyst , Tooth Injuries , Dental Sac , Patient Escort Service , Tooth Germ , Dental Pulp Necrosis , Medical Errors , Diagnosis, OralABSTRACT
Introdução: O Folículo Pericoronário envolve a coroa do germe dental durante seu desenvolvimento. Quando o dente permanece incluso, alterações do folículo podem originar doenças, como cistos e tumores odontogênicos. Objetivo: Analisar as alterações histológicas no tecido mole circundante a terceiros molares inclusos e semi-inclusos, independentemente de alterações patológicas aparentes em suas radiografias correspondentes, além de relacionar o diagnóstico histológico com o diagnóstico radiográfico dos casos. Material e Método: A partir de terceiros molares extraídos de 26 pacientes, foram analisados espécimes histológicos de folículos pericoronários por dois examinadores calibrados. O diagnóstico histopatológico obtido foi relacionado ao radiográfico, sendo este realizado por meio de radiografias periapicais e, quando necessário, complementado por radiografias panorâmicas. Resultado: Dos 37 folículos pericoronários avaliados, 30% mostraram alterações histológicas compatíveis com cistos dentígeros; 51% eram folículos normais, e 19% continham apenas fragmentos de mucosa. Radiograficamente, 100% dos casos demonstraram características de folículos sem alterações. Conclusão: Esses dados exemplificam que anormalidades podem estar presentes nos tecidos pericoronários sem que haja evidências clínicas e radiográficas. O exame histopatológico provê um diagnóstico mais preciso e deve ser considerado para a construção do diagnóstico definitivo. .
Introduction: Dental follicles remain adjacent to the crown of an unerupted or impacted tooth. Changes in dental follicles can occur and form a solitary cyst around the crown of the tooth, deemed dentigerous cysts. Objective: The aim of this study was to determine the incidence of soft tissue changes around unerupted or impacted third molars. Material and Method: Pericoronal tissue of patients who were referred to our clinic for removal of third molars for a variety of reasons was examined histopathologically. Follicular spaces were measured from periapical and panoramic radiographs by each author independently. Result: Of the 37 specimens submitted for histopathologic examination, 19 normal follicular tissues (51%), 11 arrangements typical of a cyst (30%) and 7 normal tissues of oral mucous (11%) were found. Conclusion: Cystic changes may be encountered in the histopathologic examination of radiographically normal unerupted or impacted third molar follicles. .
Subject(s)
Tooth, Unerupted , Radiography, Dental , Radiography, Panoramic , Odontogenic Cysts , Odontogenic Tumors , Dental Sac , Molar, ThirdABSTRACT
BACKGROUND:During in vitro culture, dental folicle cels are easy to loss self-renewal capacity and become aging, and they are also very difficult to be purified and amplified in quantity, which limits the application of dental folicle cels in periodontal tissue engineering. OBJECTIVE:To study the osteogenic effect of immortalized rat dental folicle cels. METHODS:pSSR69-pAmpho plasmids containing SV40T-Ag were used to transfect 293 cels. Rat dental folicle cels were transfected with virus supernatant and screened by hygromycin to establish immortalized rat dental folicle cels (experimental group). Untransfected cels served as controls. RT-PCR was used to detect the osteogenic related factors (alkaline phosphatase, osteocalcin, bone morphogenetic protein 2, and Runx2) in the experimental group and control group. RESULTS AND CONCLUSION:The results showed no statistical differences between the experimental group and the control group in the expressions of alkaline phosphatase, bone morphogenetic protein 2 and Runx2 (P > 0.05). The expression of osteocalcin was significantly higher in the experimental group than the control group (P < 0.05). These findings suggest that in the late osteogenesis differentiation, immortalized rat dental folicle cels may promote the secretion of osteocalcin and then make osteoblasts early entry into the bone calcification stage.
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BACKGROUND:Bone morphogenetic protein 9 is proved to promote the osteogenic differentiation of various kinds of stem cel s, but whether it can induce the osteogenic differentiation of dental fol icle cel s in vitro is yet unclear. OBJECTIVE:To investigate whether bone morphogenetic protein 9 can induce the osteogenic differentiation of rat dental fol icle cel s in vitro. METHODS:Purified rat dental fol icle cel s at passage 3 were transfected with bone morphogenetic protein 9 adenovirus. Then, alkaline phosphatase activity, calcium deposition and expression of osteogenesis-related factors at mRNA and protein levels were detected in the dental fol icle cel s. RESULTS AND CONCLUSION:After transfection with bone morphogenetic protein 9, the dental fol icle cel s showed continuously enhanced alkaline phosphatase activities and obviously enhanced calcium deposition. Real-time PCR results demonstrated that the mRNA expressions of alkaline phosphatase, osteocalcin, bone sialoprotein, osteopontin and core binding factor were increased significantly. The western blot assay showed that the expression of osteopontin enhanced in the dental fol icle cel s after transfection with bone morphogenetic protein 9. In summary, bone morphogenetic protein 9 can induce the osteogenic differentiation of dental fol icle cel s.
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Os objetivos deste estudo foram o isolamento e diferenciação de células da polpa (hDPCs) e do folículo (hDFCs) dentário de terceiros molares humanos e utilização para avaliação da citotoxicidade e bioatividade de novos cimentos endodônticos. (Capítulo 1) - Após a obtenção das culturas primárias foram realizados os ensaios vermelho de Alizarina, atividade da enzima fosfatase alcalina (ALP). A expressão gênica de proteína morfogenética óssea (bmp7), sialofosfoproteína dentinária (dspp) e alp foi avaliada. Os ensaios de bioatividade demonstraram maior atividade para hDPCs, além de maior expressão de dspp e alp; a expressão de bmp7 foi semelhante nas duas linhagens. Conclui-se que hDPCs demonstram maior capacidade de diferenciação em células com potencial de mineralização, quando comparadas com hDFCs. (Capítulo 2) Foram utilizadas linhagens primárias (hDPCs e hDFCs), em comparação com linhagens imortalizadas (células osteoblásticas humanas Saos-2, e do ligamento periodontal de ratos mPDL) para análise dos materiais: 1) Cimento Portland branco (CP); 2) MTA; 3) CP/ óxido de nióbio microparticulado (Nb2O5?); 4) CP/ óxido de nióbio nanoparticulado (Nb2O5n). A citotoxicidade foi avaliada pelos ensaios MTT e Azul de Trypan e a bioatividade pela atividade da ALP. Viabilidade celular foi observada em todas as linhagens; e a atividade de ALP apresentou maior resposta na linhagem Saos-2. Conclui-se que as diferentes linhagens celulares são similares para avaliação da citotoxicidade; entretanto, para avaliação da bioatividade o uso de uma linhagem celular osteoblástica é mais indicado. Além disso, observa-se que materiais à base de Nb2O5? e Nb2O5n mostram potencial como radiopacificador alternativo no MTA
The aims of this study were to isolate and differentiate pulp (hDPCs) and follicle (hDFCs) cells obtained from human third molars and to use them in cytotoxicity and bioactivity assays of new dental materials. (Chapter 1) - After obtaining the stem cultures, Alizarin Red, alkaline phosphatase (ALP) activity and gene expression by Real Time PCR of bone morphogenetic protein (BMP7), dentin sialophosphoprotein (DSPP) and ALP were performed. The bioactivity asssays showed greater activity for hDPCs, and increased expression of dspp and alp; the expression of bmp7 was similar in both cell lines. We conclude that hDPCs demonstrate greater ability to differentiate into cells with mineralization potential when compared with hDFCs. (Chapter 2) - stem lineages (hDPCs and hDFCs) were used, compared to immortalized lineages (human osteoblastic cells Saos-2, and periodontal ligament of mice cells mPDL) for analysis of the following materials: 1) white Portland cement (PC); 2) MTA; 3) C/ microparticulated of niobium oxide (Nb2O5µ); 4) CP/nanoparticulated niobium oxide (Nb2O5n). Cytotoxicity was performed by MTT and Trypan Blue assays and bioactivity by ALP activity assay. Cell viability was observed in all cell lines, and ALP activity showed greater response in Saos-2. We conclude that the different cell lines are similar in cytotoxicity, however, to evaluate the bioactivity, using an osteoblastic cell line is more appropriate. Moreover, it is observed that materials based on Nb2O5µ and Nb2O5n show potential for alternative use to MTA
Subject(s)
Cell Survival , Silicate Cement , Niobium , Dental Pulp , Dental SacABSTRACT
This study investigated the immunodetection of PCNA in epithelial components of dental follicles associated with impacted third molars without radiographical and morphological signs of pathosis. A total of 105 specimens of dental follicles associated with impacted third molars with incomplete rhizogenesis (between Nolla's stage 6 and 9) were surgically removed from 56 patients. Epithelial cell proliferating was determined by using immunohistochemical labeling. Statistical analysis was performed using the Fisher exact test. Of the 105 dental follicles collected, 6 were PCNA-positive ( 6 percent). The specimens with squamous metaplasia and epithelial hyperplasia had higher rates of positivity for PCNA, as well as those with proliferative remnants of odontogenic epithelium. In conclusion, this study shows that dental follicles at this stage of development have low proliferative potential, but suggests that squamous metaplasia, hyperplasia of the epithelial lining and presence of proliferative odontogenic epithelial rests in the connective tissue may be early signs of developing lesions of odontogenic origin.
Se investigó la inmunodetección de PCNA en los componentes epiteliales de los folículos dentales asociados a terceros molares retenidos sin signos radiográficos y morfológicos de la patología. Fueron extraídos quirúrgicamente, de 56 pacientes, 105 muestras de folículos dentales asociados a terceros molares retenidos con rizogénesis incompleta (entre los estadíos de Nolla 6 y 9) La proliferación de células epiteliales se deteminó mediante inmunohistoquímica. El análisis estadístico se realizó mediante la prueba exacta de Fisher. De los 105 folículos dentales recogidos, 6 fueron PCNA-positivos ( 6 por ciento). Las muestras con metaplasia escamosa e hiperplasia epitelial tuvieron mayores tasas de positividad para PCNA, así como aquellos con restos de proliferación del epitelio odontogénico. En conclusión, este estudio mostró que los folículos dentales en esta etapa del desarrollo tienen un potencial proliferativo bajo, pero sugiere que la metaplasia escamosa, la hiperplasia del epitelio y la presencia de restos epiteliales odontogénicos, en proliferación en el tejido conectivo, pueden ser signos tempranos de lesiones en el desarrollo de origen odontogénico.
Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Proliferating Cell Nuclear Antigen/analysis , Dental Sac/pathology , Molar, Third/pathology , Tooth, Impacted , Immunohistochemistry , Radiography, Panoramic , Dental Sac/diagnostic imaging , Molar, Third/diagnostic imagingABSTRACT
Objective To study the effect of different concentration of tumor necrosis factor-? (TNF-?) on expression of the receptor activator of nuclear factor-kappa B ligand (RANKL) and osteoprotegerin (OPG) mRNA on human dental follicle cells in vitro, and investigate the role of TNF-? in osteoclast formation during tooth eruption. Methods The 5th passage of primary cultured human dental follicle cells were treated with 0 (control group), 5, 10, 25, 50 and 100ng/ml TNF-?, respectively, for 6 hours. Total RNA was then isolated from human dental follicle cells and subjected to RANKL and OPG mRNA assay by reverse transcription-polymerase chain reaction (RT-PCR) technique. The relative expression levels of RANKL and OPG mRNA were normalized to ?-actin gene expression. Results The mRNA expression of OPG in human dental follicle cells with 5ng/ml TNF-? treatment was down regulated significantly compared with that in control group (P