Collagen quantification in peri-implant soft tissues in human peri-implantitis lesions / Cuantificación de colágeno en tejidos blandos periimplantarios en lesiones de periimplantitis en humanos

SUMMARY: Peri-implantitis is an inflammatory lesion of bacterial etiology characterized by inflammation of the mucosa and bone loss. Chronic inflammation is characterized by neovascularization and collagen neoformation. Mast cells have been shown to participate in the inflammatory process by releasing mediators and proteases such as chymase and tryptase, important in the collagen neoformation process. Although a higher percentage of collagen has been described in periodontal disease, the literature is scarce about the percentage of collagen in peri-implantitis. The aim of this study was to quantify the percentage of collagen fibers present in the peri- implant soft tissue of patients with peri-implantitis lesions. A descriptive observational cross-sectional study was performed. Samples of peri-implant soft tissue were collected from eleven patients with peri-implantitis and then processed by Masson's Trichrome Technique. In microscopic analysis, collagen fibers were observed in all samples, with an average percentage of 39.89 %, standard deviation of 17.02 %, with a minimum value of 8.99 % and a maximum value of 75.65 % density. From these results, it can be concluded that in human peri-implantitis lesions with bone loss greater than 50 %, there is an important percentage of collagen fibers, which is interpreted as connective tissue in a permanent process of reparative response, in the presence of inflammatory infiltrate.

RESUMEN: La periimplantitis es una lesión inflamatoria de etiología bacteriana caracterizada por inflamación de la mucosa y pérdida ósea. La inflamación crónica se caracteriza por neovascularización y neoformación de colágeno. Se ha demostrado que los mastocitos participan en el proceso inflamatorio liberando mediadores y proteasas como quimasa y triptasa, importantes en el proceso de neoformación del colágeno. Aunque se ha descrito un mayor porcentaje de colágeno en la enfermedad periodontal, la literatura sobre el porcentaje de colágeno en la periimplantitis es escasa. El objetivo de este estudio fue cuantificar el porcentaje de fibras de colágeno presentes en el tejido blando periimplantario de pacientes con lesiones de periimplantitis. Se realizó un estudio observacional descriptivo transversal. Se recogieron muestras de tejido blando periimplantario de once pacientes con periimplantitis y luego se procesaron mediante la técnica tricrómica de Masson. En el análisis microscópico, se observaron fibras de colágeno en todas las muestras, con un porcentaje promedio de 39,89 %, desviación estándar de 17,02%, con un valor mínimo de 8,99 % y un valor máximo de 75,65% de densidad. De estos resultados se puede concluir que en las lesiones de periimplantitis humana con pérdida ósea superior al 50 %, existe un porcentaje importante de fibras de colágeno, que se interpreta como tejido conectivo en un proceso permanente de respuesta reparadora, en presencia de infiltrado inflamatorio.

Hallazgos Histopatológicos del Tejido Pericoronario de Terceros Molares Incluidos Sanos / Histopathological Findings of Pericoronary Tissue in Healthy Third Molars

RESUMEN: Este estudio se realizó para evaluar la presentación de cambios histopatológicos tempranos en sacos pericoronarios de terceros molares incluidos sanos. Sesenta y un tejidos pericoronarios de terceros molares incluidos, clínicamente asintomáticos y sin evidencia radiográfica de anomalía del saco pericoronario, se extrajeron por diferentes razones. Las muestras se fijaron y procesaron de forma rutinaria y se tiñeron con hematoxilina-eosina antes de la evaluación. Se estandarizaron los diagnósticos concluyendo que toda muestra que presente metaplasia escamosa del epitelio reducido del órgano del esmalte (EEE) se considerará cambio quístico temprano. De las muestras presentadas, el 28 % mostró metaplasia escamosa sugerente de cambio quístico temprano. Esta variación histológica del tejido pericoronario fue significativamente mayor en los pacientes menores de 20 años de edad, sexo femenino, terceros molares mandibulares, en inclusión ósea y en pacientes que no informaron sintomatología local previa (P = 0,05). Estos hallazgos sugieren que la ausencia de semiología clínica y radiográfica en terceros molares incluidos no necesariamente indica ausencia de alteraciones en el tejido pericoronario de los mismos.

ABSTRACT: This study was performed to evaluate the presentation of early histopathological changes in pericoronal healthy third molars. Sixty-one pericororonitis tissues third molars, without radiographic evidence of abnormality in pericoronary sack, extracted for various reasons. The samples were fixed and processed routinely and stained with hematoxylin-eosin before evaluation. Diagnostic standardized concluding that all this shows that squamous metaplasia of the reduced enamel organ (EEE) is considered cystic epithelium were early change. Of the samples submitted, 28 % showed squamous metaplasia early suggestive of cystic change. This histological tissue pericoronary variation was significantly higher in patients under 20 years of age, female gender, mandibular third molars, including in bone and in patients who reported no previous local symptoms (P = 0.05). These findings suggest that the absence of clinical and radiographic semiology third molars does not necessarily indicate the absence of alterations in tissue pericoronary thereof.

Estudio Retrospectivo: Características Clínicas de la Esclerosis Sistémica en Pacientes de los Hospitales Vicente Corral Moscoso y José Carrasco Arteaga. Enero 2008 ­ Junio 2015 / Retrospective Research: Clinical Features of Systemic Sclerosis in Patients from Vicente Corral Moscoso and José Carrasco Arteaga Hospitals. January 2008 - June 2015

INTRODUCCIÓN: La esclerosis sistémica es una patología crónica del tejido conectivo; de etiología desconocida y caracterizada por presentar vasculopatía, autoinmunidad y fibrosis. Genera importantes repercusiones socio sanitarias y hasta la actualidad no tiene cura. El objetivo de la presente investigación fue determinar las características clínicas de esa enfermedad en la población local. MÉTODOS: Se realizó un estudio de tipo descriptivo retrospectivo. El universo incluyó a 58 pacientes diagnosticados de esclerosis sistémica en el Hospital Vicente Corral Moscoso y José Carrasco Arteaga durante el período comprendido entre Enero 2008 ­ Julio 2015. La información fue recopilada de las historias clínicas digitales y se realizó estadística descriptiva utilizando el programa SPSS versión 20.0. RESULTADOS: La esclerosis sistémica fue más común en el sexo femenino (relación hombre ­ mujer: 1/8.6), el subtipo limitado fue la forma de presentación principal. Las manifestaciones clínicas más frecuentes fueron las cutáneas (93.1%), seguidas de las osteomusculares (84.5%) y el fenómeno de Raynaud (81%). Los anticuerpos antinucleares fueron positivos en más del 70% de los pacientes. CONCLUSIÓN: La esclerosis sistémica es una enfermedad crónica con afección multiorgánica. El conocimiento de las distintas manifestaciones clínicas de esta patología en la población local, facilitará el diagnóstico oportuno y la instauración de un tratamiento apropiado, con el objetivo de mejorar la calidad de vida del paciente y prevenir complicaciones.(au)

BACKGROUND: Systemic sclerosis is a chronic connective tissue disease; of unknown etiology and characterized by vasculopathy, autoimmunity and fibrosis. The aim of this study was to determine the clinical features of this pathology in local population. METHODS: A retrospective descriptive study was performed. The universe included 58 patients with systemic sclerosis at Vicente Corral Moscoso Hospital and Hospital of Specialties José Carrasco Arteaga during January 2008 - July 2015. The information was compiled from medical records; descriptive statistics were performed using the statistical program SPSS version 20.0. RESULTS: Systemic sclerosis was more common in the females (male - female ratio: 1/8.6), the limited subtype was the main presentation form. The most frequent clinical features were skin disorders (93.1%), followed by osteomuscular manifestations (84.5%) and Raynaud's syndrome (81%). Antinuclear antibodies were positive in more than 70% of patients. CONCLUSION: Systemic sclerosis is a chronic entity with multisystem involvement. The knowledge of the different clinical manifestations will facilitate the opportune diagnosis and the establishment of an appropriate treatment; with the purpose of improve the quality of life and preventing complications.(au)

Action of vanillin (Vanilla planifolia) on the morphology of tibialis anterior and soleus muscles after nerve injury / Ação da vanilina (Vanilla planifolia) sobre a morfologia dos músculos tibial anterior e sóleo após lesão nervosa

ABSTRACT Objective To evaluate the action of vanillin (Vanilla planifolia) on the morphology of tibialis anterior and soleus muscles after peripheral nerve injury. Methods Wistar rats were divided into four groups, with seven animals each: Control Group, Vanillin Group, Injury Group, and Injury + Vanillin Group. The Injury Group and the Injury + Vanillin Group animals were submitted to nerve injury by compression of the sciatic nerve; the Vanillin Group and Injury + Vanillin Group, were treated daily with oral doses of vanillin (150mg/kg) from the 3rd to the 21st day after induction of nerve injury. At the end of the experiment, the tibialis anterior and soleus muscles were dissected and processed for light microscopy and submitted to morphological analysis. Results The nerve compression promoted morphological changes, typical of denervation, and the treatment with vanillin was responsible for different responses in the studied muscles. For the tibialis anterior, there was an increase in the number of satellite cells, central nuclei and fiber atrophy, as well as fascicular disorganization. In the soleus, only increased vascularization was observed, with no exacerbation of the morphological alterations in the fibers. Conclusion The treatment with vanillin promoted increase in intramuscular vascularization for the muscles studied, with pro-inflammatory potential for tibialis anterior, but not for soleus muscle.

RESUMO Objetivo Avaliar a ação da vanilina (Vanilla planifolia) sobre a morfologia dos músculos tibial anterior e sóleo após lesão nervosa periférica. Métodos Ratos Wistar foram divididos em quatro grupos, com sete animais cada, sendo Grupo Controle, Grupo Vanilina, Grupo Lesão e Grupo Lesão + Vanilina. Os animais dos Grupos Lesão e Grupo Lesão + Vanilina foram submetidos à lesão nervosa por meio da compressão do nervo isquiático, e os Grupos Vanilina e Grupo Lesão + Vanilina foram tratados diariamente com doses orais de vanilina (150mg/kg) do 3o ao 21o dia após a indução da lesão nervosa. Ao término do experimento, os músculos tibial anterior e sóleo foram dissecados e seguiram o processamento de rotina em microscopia de luz, para posterior análise morfológica. Resultados A compressão nervosa promoveu alterações morfológicas características de denervação, sendo que o tratamento com vanilina foi responsável por respostas distintas nos músculos estudados. Para o tibial anterior, houve aumento do número de células satélites, núcleos centrais e atrofia das fibras, bem como desorganização fascicular. Já no sóleo, houve apenas aumento da vascularização, sem exacerbação das alterações morfológicas nas fibras. Conclusão O tratamento com vanilina promoveu o aumento da vascularização intramuscular para os músculos estudados, com potencial pró-inflamatório para o tibial anterior, o que não ocorreu no músculo sóleo.

Síndrome de Ehlers-Danlos, variante sculocontractural. Informe de un caso / Ehlers-Danlos syndrome, musculocontractural variant. A case report / Síndrome de Ehlers-Danlos, variante musculocon-tractural. Informe de um caso

El síndrome de Ehlers-Danlos comprende un conjunto de trastornos hereditarios que comparten hiperextensibilidad de la piel, hipermovilidad articular y fragilidad tisular manifiesta como disminución de la fuerza de tensión y de la integridad de la piel y las articulaciones. La frecuencia de este síndrome, para todas las variantes combinadas, se ha estimado en 1 en 5000 a 1 en 10 000 personas. Sin embargo, se desconocen la prevalencia e incidencia exactas. Entre las variantes descritas de Ehlers-Danlos se incluye la musculocontractural, cuyas principales características son las siguientes: dismorfismo craneofacial típico, contracturas congénitas de los pulgares y los dedos, pie equinovaro, cifoescoliosis, hipotonía muscular, piel fina hiperextensible, facilidad para el desarrollo de equimosis, cicatrices atróficas, acrogeria, hipermovilidad de las articulaciones y problemas oculares. Se presenta un caso de dicha variante y se hace una breve revisión de la literatura.

Ehlers-Danlos syndrome comprises a group of hereditary disordes that share skin hyperextensibility, joint hipermobility and tissular fragility manifested as diminished tensile strenght and integrity of skin and joints. The estimated frequency, for the whole group, is 1 in 5.000 to 1 in 10.000 people. Nevertheless, the exact prevalence and incidence are unknown.One of the described subtypes of Ehlers-Danlos is the musculocontractural, whose primary characteristics include typical craneofacial dysmorphism, congenital thumb and fingers contractures, club foot, kyphoscoliosis, muscular hypotony, thin hyperextensible skin, easy bruising, atrophic scaring, acrogeria, joint hypermobility, and ocular problems. We present a case of this variant and a brief literature review.

A síndrome de Ehlers-Danlos compreende um conjunto de transtornos hereditários que compartilham hiperextensibilidade da pele, hipermobilidade articular e fragilidade tissular manifesta como diminuição da força de tensão e da integridade da pele e as articulações. A frequência desta síndrome, para todas as variantes combinadas, se há estimado em 1 em 5.000 a 1 em 10.000 pessoas. Embora, se desconhecem a prevalência e incidência exatas. Entre as variantes descritas de Ehlers-Danlos se inclui a musculocontractural, cujas principais características são as seguintes: dimorfismo craniofacial típico, contraturas congénitas dos polegares e os dedos, pé equinovaro, cifoescoliose, hipotonia muscular, pele fina hiperextensível, facilidade para o desenvolvimento de equimoses, cicatrizes atróficas, acrogeria, hipermobilidade das articulações e problemas oculares. Se apresenta um caso de dita variante e se faz uma breve revisão da literatura.

Alterações do sistema miofuncional orofacial na síndrome de Parry-Romberg: revisão crítica da literatura / Alterations of the myofunctional orofacial system in the Parry-Romberg syndrome: a critical literature review

INTRODUÇÃO Esta revisão qualitativa da literatura analisou publicações científicas internacionais sobre possíveis alterações miofuncionais orofaciais em pacientes acometidos pela Síndrome de Parry-Romberg, por meio da base de dados PubMed. MÉTODOS: O levantamento realizado limitou-se a seres humanos, de qualquer faixa etária, no idioma inglês, entre os anos 2002 e 2012. As publicações sem acesso completo, repetidas por sobreposição das palavras-chave, revisões de literatura, cartas ao editor e as não relacionadas diretamente ao tema foram excluídas. RESULTADOS: Foram identificados 719 estudos, sendo 21 dentro dos critérios estabelecidos. Com base nos estudos selecionados, pacientes acometidos pela Síndrome de Parry-Romberg podem apresentar alterações dos tecidos mole e duro, tais como atrofia dos músculos esternocleidomastoideo, masseter e pterigoideos; atrofia na região da bochecha e depressão da prega nasolabial; desvio dos lábios e nariz; atrofia unilateral da língua; atrofia do ângulo da boca; reabsorção progressiva do osso da maxila e da mandíbula; atrofia do arco zigomático, do osso frontal e assimetria facial; desenvolvimento atrófico das raízes ou reabsorção patológica dos números de dentes permanentes; redução da mandíbula e erupção atrasada dos dentes superiores e inferiores. CONCLUSÃO: Apesar do crescente interesse pelo diagnóstico e pela descrição sintomatológica de indivíduos com Síndrome de Parry-Romberg, a escassez de publicações que abordem tratamentos funcionais e interdisciplinares é evidente. Verifica-se a necessidade da realização de estudos mais específicos que visem à melhoria da qualidade de vida desses pacientes.

INTRODUCTION This qualitative literature review analyzed international scientific publications on possible orofacial myofunctional alterations in patients with Parry-Romberg syndrome by using PubMed. METHODS: The survey was conducted in English, between 2002 and 2012, and was limited to human beings of any age. Publications without full access, duplicated by overlapping keywords, literature reviews, letters to the editor, and those not directly related to the research topic were excluded. RESULTS: We identified 719 studies, of which 21 were within the established criteria. Based on the selected studies, patients with Parry-Romberg syndrome may show changes in soft and hard tissues such as atrophy of the sternocleidomastoid, masseter, and pterygoid muscles; atrophy in the cheek region and depression of the nasolabial fold; deviation of the lips and nose; unilateral tongue atrophy; atrophy of the mouth angle; progressive resorption of the maxilla and mandible bone; atrophy of the zygomatic arch and frontal bone, and facial asymmetry; atrophic root development or pathological resorption of permanent tooth numbers; and jaw reduction and delayed eruption of the upper and lower teeth. CONCLUSION: Despite the growing interest in the diagnosis and symptomatic description of individuals with Parry-Romberg syndrome, publications that address functional and interdisciplinary treatments are scarce. Therefore, specific studies aimed at improving the quality of life of these patients are needed.

Exuberant Vasculoconnective Component in Mediastinal Mixed Germ Cell Tumors

We aimed to evaluate the histologic components of primary mediastinal mixed germ cell tumors. A total of 221 patients diagnosed with a mediastinal germ cell tumor (GCT) were retrospectively reviewed. Among them, 14 patients underwent surgical resection after chemotherapy and 8 patients were diagnosed with mixed GCT, who were then selected for further evaluation. Clinical chart review and histologic review of biopsy and surgical specimens of 8 patients were performed. All 8 patients were young males and showed a mature teratoma or a mature teratoma with a focal immature teratoma in the resected specimens. Serum alpha-feto protein was variably elevated. Seven patients experienced an increase in tumor size after the chemotherapy. In 5 patients, a variable amount of vasculoconnective tissue was found along with the mature teratoma occupying average 66.3% of resected mass, and 3 of them showed an identical vasculoconnective component on biopsy before chemotherapy. We suggest that vasculoconnective tissue might be the intrinsic component of primary mediastinal mixed GCT. When vasculoconnective tissue is obtained on small biopsy of an anterior mediastinal mass of a young male, the possibility of underlying mixed GCT should be considered and further clinical work up should be performed.

[Apoptosis of gingival connective tissue cells in diabetic individuals with chronic periodontitis]

Apoptosis or programmed cell death plays an important role in the pathogenesis of many diseases. Previous studies suggest that apoptosis is involved in the pathogenesis of periodontal disease. On the other hand, it is also suggested that diabetes mellitus enhances apoptosis of connective tissue cells. Thus, we measured expression of proteins which are relevant to apoptosis in the gingival tissue of diabetic patients with chronic periodontitis in comparison to non diabetic individuals. 25 patients with diabetes and chronic periodontitis and 16 non diabetic controls with chronic periodontitis were included in this study. 4 weeks after scaling and root planning and oral hygiene instructions, periodontal surgery was done and gingival tissues obtained during surgery, were sent to lab to investigate expression of Fas, P53, Bcl-2 and Survivin using real-time PCR technique. Data were analyzed using Mann-Whitney and Chi-squared. Pro-apoptotic proteins [Fas, P53] were significantly [P<0.05] higher in gingival tissues of diabetics [9.5x10[-6], 2.4x10[-6], respectively] in comparison to non diabetics [9.4x10[-7], 5.6x10[-7]], whereas the difference in expression of anti-apoptotic proteins [Bcl-2, Survivin] between 2 groups was not significant [9.7x10[-8], 3.5x10[-7] in comparison to 1.4x10[-7], 3.1x10[-7], respectively] [P=0.91, P=0.29 respectively]. Apoptosis was increased in gingival connective tissue of diabetic patients with chronic periodontitis in comparison with non diabetic ones. Therefore, intervention in expression or function of pro-apoptotic proteins [Fas, P53] could be a new goal in the treatment of periodontal disease of diabetic patients.

Is radiographic appearance a reliable indicator for the absence or presence of pathology in impacted third molars.

In dental practice, impacted third molar teeth are a common finding. The dentists usually remove them if they are associated with some radiographic finding suggestive of a cyst or a tumor or if they cause pain or resorption of the adjacent teeth. It has been found that, in many cases, even the radiographically and clinically asymptomatic impacted mandibular third molars are associated with some pathology. This paper brings into the light two cases with clinically and radiographically normal impacted third molar teeth associated with dentigerous cyst, thus highlighting that the radiographic appearance is not a reliable indicator of the absence or presence of pathology associated with the impacted third molars.

Peripheral squamous odontogenic tumor.

A case of peripheral squamous odontogenic tumor is described in a 60-year-old female who presented with a sessile growth in the right posterior mandible. Radiographic examination revealed no evidence of a central lesion in bone. With the characteristic histopathological picture of benign-appearing islands of squamous epithelium scattered randomly against a background of mature fibrous connective tissue, the tumor was diagnosed as peripheral squamous odontogenic tumor (PSOT). The epithelial islands showed peripheral cuboidal or flattened cells, microcyst formation, individual cell keratinization, and keratin pearl formation.

Exploring anorganic bovine bone granules as osteoblast carriers for bone bioengineering: a study in rat critical-size calvarial defects

It is known that current trends on bone bioengineering seek ideal scaffolds and explore innovative methods to restore tissue function. In this way, the objective of this study was to evaluate the behavior of anorganic bovine bone as osteoblast carrier in critical-size calvarial defects. MC3T3-E1 osteoblast cells (1x10(5) cells/well) were cultured on granules of anorganic bovine bone in 24-well plates and after 24 h these granules were implanted into rat critical-size calvarial defects (group Biomaterial + Cells). In addition, other groups were established with different fillings of the defect: Blood Clot (negative control); Autogenous Bone (positive control); Biomaterial (only granules) and Cells (only MC3T3-E1 cells). After 30 days, the animals were euthanized and the calvaria were technically processed in order to allow histological and morphometric analysis. It was possible to detect blood vessels, connective tissue and newly formed bone in all groups. Particularly in the Biomaterial + Cells group, it was possible to observe a profile of biological events between the positive control group (autogenous bone) and the group in which only anorganic bovine granules were implanted. Altogether, the results of the present study showed that granules of anorganic bovine bone can be used as carrier to osteoblasts and that adding growth factors at the moment of implantation should maximize these results.

Sabe-se que uma das atuais tendências na bioengenharia óssea é procurar um carreador ideal e explorar métodos inovadores para restaurar a função do tecido. Desta forma, nosso objetivo foi avaliar o comportamento do osso bovino inorgânico como carreador de osteoblastos em defeitos ósseos de tamanho crítico em calvária de ratos. Osteoblastos da linhagem MC3T3-E1 (1x10(5) células/poço) foram cultivadas em grânulos de osso bovino inorgânico sob placas de 24 poços e após 24 h esses grânulos foram implantados em defeitos ósseos de tamanho crítico em calvária de ratos. Além deste grupo experimental (Biomaterial + Células), foram estabelecidos outros grupos com diferentes preenchimentos do defeito crítico: coágulo sanguíneo (controle negativo); osso autógeno (controle positivo); Biomaterial (apenas grânulos) e Células (apenas células MC3T3-E1). Após 30 dias, os animais foram eutanasiados e as calvárias foram processadas histotecnicamente, a fim de permitir a análise histológica e morfometria. Nossos resultados mostraram que em todos os grupos avaliados foi possível detectar vasos sanguíneos, tecido conjuntivo e osso neoformado. Em especial para o grupo tratado com Biomaterial + Células, foi possível observar um perfil de eventos biológicos intermediário ao grupo controle positivo (osso autógeno) e o grupo de biomaterial (apenas grânulos inorgânico bovino). Ao todo, nossos resultados mostraram que os grânulos de osso bovino inorgânico podem ser usados como carreador de osteoblastos e que a adição de fatores de crescimento no momento em que ocorre o implante deve maximizar os resultados.

Changes in peripheral innervation and nociception in reticular type and erosive type of oral lichen planus.

Background: Oral lichen planus (OLP) is a chronic inflammatory lesion in oral mucosa. Reticular (OLP-R) and erosive (OLP-E) types of OLP are the common forms that have been found in dental clinics. The aim of this investigation is to determine the correlation between neurogenic inflammation and nociception associated with OLP-R and OLP-E. Materials and Methods: The oral mucosal lesions from six patients with OLP-E, four with OLP-R and three with noninflamed oral mucosa, which represent normal mucosa, were identified by morphometric analysis of nerve fibers containing immunoreactive protein gene product (PGP) 9.5. The level of inflammation was measured with hematoxylin and eosin staining and the level of nociception was analyzed with visual analog scale measurement. Results: We found that 1) an increase in peripheral innervation was related to the size of the area of inflammatory cell infiltration from both OLP-R and OLP-E; 2) the pattern of PGP 9.5-immunoreactivity among OLP-R and OLP-E was not significantly different (P=0.23); and 3) the correlation between nociception and an increase in PGP 9.5-immunoreactivity was not found in OLP-E and in OLP-R. Conclusions: Our findings suggest that an increase in peripheral innervation may lead to increased inflammation, which is part of the immunopathogenesis of OLP. Differences in nociception between OLP-R and OLP-E arise from the pathogenesis of each lesion, not from the differences in peripheral innervation.

Ameloblastic fibro-odontoma masquerading as odontoma.

Ameloblastic fibro-odontoma (AFO) is a rare, benign epithelial mixed odontogenic tumor. It occurs as an intraosseous lesion, generally asymptomatic and more prevalent in children and adolescent. AFO is found on radiographic evaluation of patients with unerupted or impacted teeth in many cases. Histological examination reveals a fibrous soft tissue, islands of odontogenic epithelium and a disordered mixture of dental tissues. The treatment modality in most cases involves conservative surgery with enucleation. We present a case of 13-year-old boy with a missing right central incisor, mimicking-like odontoma on radiograph but proved to be AFO and treated with enucleation with preservation of impacted tooth. There was no recurrence after one year of follow-up. This report discusses the clinical, radiographical, histological features and surgical assessment to preserve the impacted tooth associated with AFO.

Glandular odontogenic cyst: Report of an unusual bilateral occurrence.

Glandular odontogenic cyst (GOC) is a recently recognized rare developmental odontogenic cyst having an aggressive behavior and accounting for 0.012% to 1.3% of all jaw cysts. GOC usually presents as a painless, slow-growing swelling that tends to affect the anterior part of the jaws. It chiefly occurs in the fourth and fifth decades of life and presents as an expansion of jaws with or without pain or paresthesia. Aggressive nature of the lesion has been reported, as supported by the fact that 25 to 55% of cases recur following curettage. So far only just over 113 cases of GOC have been reported in the literature. Here, we report a case of bilateral GOC in the posterior region of the maxilla, in a 29-year-old male patient, which is unique, being the first case of bilateral GOC to be reported in the literature.

Subcutaneous connective tissue response to primary root canal filling materials

This study evaluated the response of the subcutaneous connective tissue of BALB/c mice to root filling materials indicated for primary teeth: zinc oxide/eugenol cement (ZOE), Calen paste thickened with zinc oxide (Calen/ZO) and Sealapex sealer. The mice (n=102) received polyethylene tube implants with the materials, thereby forming 11 groups, as follows: I, II, III: Calen/ZO for 7, 21 and 63 days, respectively; IV, V, VI: Sealapex for 7, 21 and 63 days, respectively; VII, VIII, IX: ZOE for 7, 21 and 63 days, respectively; X and XI: empty tube for 7 and 21 days, respectively. The biopsied tissues were submitted to histological analysis (descriptive analysis and semi-quantitative analysis using a scoring system for collagen fiber formation, tissue thickness and inflammatory infiltrate). A quantitative analysis was performed by measuring the area and thickness of the granulomatous reactionary tissue (GRT). Data were analyzed by Kruskal-Wallis, ANOVA and Tukey's post-hoc tests (?=0.05). There was no significant difference (p>0.05) among the materials with respect to collagen fiber formation or GRT thickness. However, Calen/ZO produced the least severe inflammatory infiltrate (p<0.05). The area of the GRT was significantly smaller (p<0.05) for Calen/ZO and Sealapex. In conclusion, Calen/ZO presented the best tissue reaction, followed by Sealapex and ZOE.

Neste estudo avaliou-se a resposta do tecido conjuntivo subcutâneo de camundongos BALB/c a materiais obturadores de canal radicular de dentes decíduos: óxido de zinco/eugenol (OZE), pasta Calen® espessada com óxido de zinco (Calen/OZ) e cimento Sealapex®. Os camundongos (n=102) receberam implantes de tubos de polietileno??? e foram divididos em grupos: I, II, III - Calen/OZ (7, 21 e 63 dias, respectivamente); IV, V, VI - Sealapex (7, 21 e 63 dias, respectivamente); VII, VIII, IX - OZE (7, 21 e 63 dias, respectivamente); X, XI - tubo vazio (7 e 21 dias, respectivamente). Os tecidos foram submetidos ao processamento e análise histopatológica descritiva e por meio de escores do fibrosamento, espessura tecidual e infiltrado inflamatório. Para a análise quantitativa mensurou-se a área e a espessura do tecido granulomatoso reacional (TGR). Os resultados foram analisados pelos testes de Kruskal-Wallis, ANOVA e pós-teste de Tukey (?=0,05). Não houve diferença significante (p>0,05) entre os materiais, com relação ao fibrosamento e à espessura do TGR. Contudo, Calen/OZ apresentou infiltrado inflamatório de menor intensidade (p<0,05). A área do TGR foi menor (p<0,05) para Calen/OZ e Sealapex. Pôde-se concluir que Calen/OZ foi o material que apresentou a melhor compatibilidade tecidual, seguido pelos cimentos Sealapex e OZE.

Repair of critical-size defects with autogenous periosteum-derived cells combined with bovine anorganic apatite/collagen: an experimental study in rat calvaria

The aim of this study was to evaluate the bone repair using autogenous periosteum-derived cells (PDC) and bovine anorganic apatite and collagen (HA-COL). PDC from Wistar rats (n=10) were seeded on HA-COL discs and subjected to osteoinduction during 6 days. Critical-size defects in rat calvarias were treated with blood clot (G1), autogenous bone (G2), HA-COL (G3) and HA-COL combined with PDC (G4) (n=40), and then analyzed 1 and 3 months after surgeries. Radiographic analysis exhibited no significant temporal change. G1 and G2 had discrete new marginal bone, but the radiopacity of graft materials in G2, G3 and G4 impaired the detection of osteogenesis. At 3 months, histopathological analysis showed the presence of ossification islets in G1, which was more evident in G2, homogeneous new bone around HA-COL in G3 and heterogeneous new bone around HA-COL in G4 in addition to moderate presence of foreign body cells in G3 and G4. Histomorphometric analysis showed no change in the volume density of xenograft (p>0.05) and bone volume density in G2 was twice greater than in G1 and G4 after 3 months (p<0.05), but similar to G3. The PDC did not increase bone formation in vivo, although the biomaterial alone showed biocompatibility and osteoconduction capacity.

O objetivo deste estudo foi avaliar o reparo ósseo usando células derivadas de periósteo (PDC) e apatita inorgânica e colágeno bovinos (HA-COL). PDC de ratos Wistar (n=10) foram semeadas sobre discos de HA-COL e osteoinduzidas por 6 dias. Defeitos de tamanho crítico em calvárias de ratos foram tratados com coágulo sanguíneo (G1), osso autógeno (G2), HA-COL (G3) ou HA-COL associado a PDC (G4) (n=40) e analisados em 1 e 3 meses após as cirurgias. Análise radiográfica não exibiu mudança temporal significante, G1 e G2 tiveram aumento discreto de novo osso marginal, entretanto a radiopacidade dos materiais de enxerto em G2, G3 e G4 prejudicou a detecção de osteogênese. Análise histopatológica mostrou em 3 meses ilhotas de ossificação em G1 que foi maior em G2, novo osso homogêneo ao redor de HA-COL em G3 e novo osso heterogêneo ao redor de HA-COL em G4 além da presença moderada de células gigantes de corpo estranho em G3 e G4. Análise histomorfométrica mostrou a densidade de volume inalterada do xenoenxerto (p>0,05) e a densidade de volume de novo osso em G2 duas vezes maior que G1 e G4 após 3 meses (p<0,05), mas similar a G3. PDC não aumentaram a formação óssea in vivo apesar do biomaterial sozinho ter apresentado biocompatibilidade e capacidade osteocondutora.

Ação da matriz óssea bovina desmineralizada na neoformação óssea em ratos submetidos ao alcoolismo experimental: avaliação histológica e histométrica / Action of demineralized bovine bone matrix on bone neoformation in rats submitted to experimental alcoholism: histological and histometric evaluation

O etanol inibe a proliferação de células osteoblásticas, gerando baixa massa óssea e aumento na prevalência de fraturas na população alcoólatra. A quantidade de defeitos ósseos criados cirurgicamente, e pelos vários tipos de acidentes, tem aumentado atualmente e existe uma preocupação muito grande na descoberta de substâncias que acelerem a neoformação óssea que preencham essas cavidades. Baseado no exposto anteriormente resolveu-se realizar este trabalho com o objetivo de observar se a matriz óssea bovina desmineralizada (Genox ®) altera a neoformação óssea em ratos submetidos ao alcoolismo experimental, usando para isso análise histológica e histométrica. Para isso foram utilizados 40 ratos machos (Rattus norvegicus), separados em 2 grupos de 20 animais cada, assim distribuídos: Grupo E1, que recebeu álcool etílico a 25%, diluído em água de torneira, e cavidade cirúrgica preenchida somente por coágulo sanguíneo, e Grupo E2, que recebeu álcool etílico a 25%, diluído em água de torneira, e cavidade cirúrgica preenchida por Gen-ox®. Após um período de 3 semanas de adaptação gradativa ao álcool, os animais receberam dieta alcoólica de 25% por um período de 90 dias. Decorrido esse período, a tíbia esquerda de todos os animais foi submetida a uma cirurgia onde se produziu uma cavidade cirúrgica experimental, que no Grupo E1 ficou preenchida por coágulo sanguíneo, e no Grupo E2 preenchida por Gen-ox®. Cinco animais de cada grupo foram sacrificados em períodos de 10, 20, 40 e 60 dias contados a partir do dia da cirurgia experimental, para retirada de parte da tíbia, onde a cavidade cirúrgica foi realizada. Os blocos retirados foram processados histologicamente e submetidos à coloração por Tricrômico de Masson, para estudo histomorfológico e histométrico da área total do defeito, quantidade de tecido conjuntivo presente e quantidade de tecido ósseo neoformado. Os resultados mostraram que a reorganização da medula óssea e reparação total da...

Ethanol inhibits the proliferation of osteoblastic cells, leading to low bone mass and increased prevalence of fractures in the alcoholic population. The amount of bone defects surgically created, and various types of accidents has increased and there is currently a great concern in the discovery of substances that accelerate new bone formation to fill those cavities. Based on the foregoing it was decided to undertake this work in order to see whether demineralized bovine bone (Gen-ox®) alters bone formation in rats subjected to experimental alcoholism, using it for histological and histometric analysis. For this we used 40 male rats (Rattus norvegicus) separated in two groups of 20 animals each one, distributed as follows: Group E1, which received 25% ethanol, diluted in tap water, and the surgical cavity filled only by a blood clot, and Group E2, which received 25% ethanol, diluted in tap water, and the surgical cavity filled with Gen-ox®. After a period of three weeks of gradual adaptation to alcohol, the animals received 25% alcohol diet for a period of 90 days. After this period, the left tibia of all animals underwent a surgery where it produced an experimental surgical cavity, which in Group E1 was filled by blood clot, and in Group E2 filled with Gen-ox®. Five animals from each group were sacrificed on days 10, 20, 40 and 60 days from the day of experimental surgery to remove part of the tibia, where the sinus surgery was done. The blocks were removed and processed histologically stained by Masson trichrome, for histomorphological and histometric study of the total area of the defect, amount of connective tissue and amount of new bone. The results showed that the reorganization of the bone marrow and full repair of the surgical cavity in Group E1 had occurred in a shorter time than in Group E2. It was also noted that in the final period, the animals in Group E2 showed areas of connective tissue and thick bone...

Ação da matriz óssea bovina desmineralizada na neoformação óssea em ratos submetidos ao alcoolismo experimental: avaliação histológica e histométrica / Action of demineralized bovine bone matrix on bone neoformation in rats submitted to experimental alcoholism: histological and histometric evaluation

O etanol inibe a proliferação de células osteoblásticas, gerando baixa massa óssea e aumento na prevalência de fraturas na população alcoólatra. A quantidade de defeitos ósseos criados cirurgicamente, e pelos vários tipos de acidentes, tem aumentado atualmente e existe uma preocupação muito grande na descoberta de substâncias que acelerem a neoformação óssea que preencham essas cavidades. Baseado no exposto anteriormente resolveu-se realizar este trabalho com o objetivo de observar se a matriz óssea bovina desmineralizada (Genox ®) altera a neoformação óssea em ratos submetidos ao alcoolismo experimental, usando para isso análise histológica e histométrica. Para isso foram utilizados 40 ratos machos (Rattus norvegicus), separados em 2 grupos de 20 animais cada, assim distribuídos: Grupo E1, que recebeu álcool etílico a 25%, diluído em água de torneira, e cavidade cirúrgica preenchida somente por coágulo sanguíneo, e Grupo E2, que recebeu álcool etílico a 25%, diluído em água de torneira, e cavidade cirúrgica preenchida por Gen-ox®. Após um período de 3 semanas de adaptação gradativa ao álcool, os animais receberam dieta alcoólica de 25% por um período de 90 dias. Decorrido esse período, a tíbia esquerda de todos os animais foi submetida a uma cirurgia onde se produziu uma cavidade cirúrgica experimental, que no Grupo E1 ficou preenchida por coágulo sanguíneo, e no Grupo E2 preenchida por Gen-ox®. Cinco animais de cada grupo foram sacrificados em períodos de 10, 20, 40 e 60 dias contados a partir do dia da cirurgia experimental, para retirada de parte da tíbia, onde a cavidade cirúrgica foi realizada. Os blocos retirados foram processados histologicamente e submetidos à coloração por Tricrômico de Masson, para estudo histomorfológico e histométrico da área total do defeito, quantidade de tecido conjuntivo presente e quantidade de tecido ósseo neoformado. Os resultados mostraram que a reorganização da medula óssea e reparação total da...

Ethanol inhibits the proliferation of osteoblastic cells, leading to low bone mass and increased prevalence of fractures in the alcoholic population. The amount of bone defects surgically created, and various types of accidents has increased and there is currently a great concern in the discovery of substances that accelerate new bone formation to fill those cavities. Based on the foregoing it was decided to undertake this work in order to see whether demineralized bovine bone (Gen-ox®) alters bone formation in rats subjected to experimental alcoholism, using it for histological and histometric analysis. For this we used 40 male rats (Rattus norvegicus) separated in two groups of 20 animals each one, distributed as follows: Group E1, which received 25% ethanol, diluted in tap water, and the surgical cavity filled only by a blood clot, and Group E2, which received 25% ethanol, diluted in tap water, and the surgical cavity filled with Gen-ox®. After a period of three weeks of gradual adaptation to alcohol, the animals received 25% alcohol diet for a period of 90 days. After this period, the left tibia of all animals underwent a surgery where it produced an experimental surgical cavity, which in Group E1 was filled by blood clot, and in Group E2 filled with Gen-ox®. Five animals from each group were sacrificed on days 10, 20, 40 and 60 days from the day of experimental surgery to remove part of the tibia, where the sinus surgery was done. The blocks were removed and processed histologically stained by Masson trichrome, for histomorphological and histometric study of the total area of the defect, amount of connective tissue and amount of new bone. The results showed that the reorganization of the bone marrow and full repair of the surgical cavity in Group E1 had occurred in a shorter time than in Group E2. It was also noted that in the final period, the animals in Group E2 showed areas of connective tissue and thick bone...

Clinical investigation of mucosal thickness stability after soft tissue grafting around implants: A 3-year retrospective study.

Purpose: To assess the long-term stability of gingival grafts placed around dental implants at the time of second surgery uncovering and to further investigate the association between mucosal thickness (MTh) by demographic variables and clinical investigation. Materials and Methods: Fourteen patients with submerged dental implants covered by inadequate keratinized mucosa were studied. The subjects underwent a periimplant plastic surgery (PPS) at the second-stage dental implant surgery and free gingival autograft orsubepithelial connective tissue graft were used according to the patients' clinical situation. Clinical measurement of MTh was assessed by bone sounding with a periodontal probe using customized acrylic stents andthe values were recorded at baseline (day of graft) and at 0.5, 1.5, 4, 12, 24 and 36 months after grafting. Results: At 12 months postoperatively, the mean MTh was 2.89 mm, with a mean additional increase of 1.75 mm when compared with baseline (P=0.0001). No statistically significant differences in MTh were found between the 12- and the 36-month observations (P=0.09). In addition, at 36 months, a thin mucosa was associated with a greater increase in the MTh compared with a thick mucosa (2.14 and 0.64 mm, respectively, P=0.006). Similarly, the mandibular sites were associated with a greater increase in the MTh in comparison with the maxillary sites (2.17 and 0.81 mm, respectively; P=0.02). Conclusions: Within the limitations of this investigation, the data suggest that PPS at the second-stage dental implant surgery could results in additional increases in MTh, especially when it is performed in areas where the mucosa is of a thin biotype.

Evaluation of biocompatibility of Targis Dentin and Artglass by using subcutaneous implantation test.

Introduction: Biocompatibility of a crown-bridge material is as important as its physical and mechanical properties. It is also one of the most important factors for the long-lasting clinical success of that restoration. It directly contacts the vital prepared tooth and that is the reason it has to be nontoxic to the local tissues, such as the pulp, gingiva, or the rest of the body. Materials with different physical properties are used in the conventional fixed prosthodontic restorations. Recently, metal-free systems that are reinforced with fibers have been improved for crown and bridge restorations. These new composite systems have the advantages of both ceramic and polymer chemistry. Materials and Methods: In this research, biocompatibility of two ceramic-polymer-based prosthetic materials (Targis Dentin® and Artglass Dentin® ) was studied using a subcutaneous implantation test on rats. Initially (15 th day) mild inflammatory reactions were observed in tissues, which directly contacted the Artglass, Targis, and control tubes. These probably originated from the surgical traumas. After the 90th day of implantation, these reactions resolved and healthy, well-organized fibrous connective capsules were seen around the implants. Results: Initially (15 th day) mild inflammatory reactions were observed in tissues, which directly contacted the Artglass, Targis, and control tubes. These probably originated from the surgical traumas. After the 90 th day of implantation, these reactions resolved and healthy, well-organized fibrous connective capsules were seen around the implants. Conclusion: At the end of the study, according to the FDI and ISO-7405 standards, Targis and Artglass indicated biocompatibility with the subcutaneous connective tissue of the rat.