A comparative study to evaluate the effects of antibiotics, plant extracts and fluoride-based toothpaste on the oral pathogens isolated from patients with gum diseases in Pakistan / Um estudo comparativo para avaliar os efeitos de antibióticos, extratos vegetais e creme dental à base de flúor sobre os patógenos orais isolados de pacientes com doenças gengivais no Paquistão

Oral diseases caused by various microorganisms are common around the world. Scientific research has now been focusing on novel medicines to overcome bacterial resistance and antibiotics side effects; therefore, the current study was designed to assess the efficacy of certain antibiotics, toothpaste, and medicinal plant extracts (Ajuga bracteosa and Curcuma longa) versus the bacterial pathogens isolated from the human oral cavity. A total of 130 samples were collected from Khyber Teaching Hospital Peshawar, Pakistan, among those 27 species isolated, and eight bacterial species were identified from the samples. Among all the bacterial species, Staphylococcus aureus (29.62%) and Proteus mirabilis (22.2%) were found to be more prevalent oral pathogens. In comparison, the least pervasive microbes were Proteus vulgaris, Shigella sonnei, Escherichia coli and Aeromonas hydrophila. The study also suggested that dental problems were more prevalent in males (41-50 years of age) than females. Among the eight antibiotics used in the study, the most promising results were shown by Foxicillin against A. hydrophila. The survey of TP1 revealed that it showed more potent antagonist activity against Proteus vulgaris as compared TP2 and TP3 that might be due to the high content of fluoride. The Curcuma longa showed more significant activity than Ajuga bracteosa (Stem, leaves and root) extracts. The data obtained through this study revealed that antibiotics were more effective for oral bacterial pathogens than toothpaste and plant extracts which showed moderate and low activity, respectively. Therefore, it is suggested that the active compounds in individual medicinal plants like Curcuma longa and Ajuga bracteosa could replace the antibiotics when used in daily routine as tooth cleansers or mouth rinses.

As doenças bucais causadas por vários microrganismos são comuns em todo o mundo. A pesquisa científica agora tem se concentrado em novos medicamentos para superar a resistência bacteriana e os efeitos colaterais dos antibióticos; portanto, o presente estudo foi desenhado para avaliar a eficácia de certos antibióticos, pasta de dente e extratos de plantas medicinais (Ajuga bracteosa e Curcuma longa) contra os patógenos bacterianos isolados da cavidade oral humana. No total, 130 amostras foram coletadas do Khyber Teaching Hospital Peshawar, Paquistão, entre essas, 27 espécies foram isoladas e oito espécies bacterianas foram identificadas a partir das amostras. Entre todas as espécies bacterianas, Staphylococcus aureus (29.62%) e Proteus mirabilis (22.2%) foram os patógenos orais mais prevalentes. Em comparação, os micróbios menos difundidos foram Proteus vulgaris, Shigella sonnei, Escherichia coli e Aeromonas hydrophila. O estudo também sugeriu que os problemas dentários eram mais prevalentes em homens (41-50 anos de idade) do que em mulheres. Entre os oito antibióticos usados no estudo, os resultados mais promissores foram mostrados pelo Foxicillin contra A. hydrophila. A pesquisa de TP1 revelou que ele mostrou atividade antagonista mais potente contra Proteus vulgaris em comparação a TP2 e TP3, o que pode ser devido ao alto teor de flúor. A Curcuma longa apresentou atividade mais significativa em relação aos extratos de Ajuga bracteosa (caule, folhas e raiz). Os dados obtidos neste estudo revelaram que os antibióticos foram mais eficazes para os patógenos bacterianos orais do que os dentifrícios e os extratos vegetais que apresentaram atividade moderada e baixa, respectivamente. Portanto, sugere-se que os compostos ativos em plantas medicinais individuais como Curcuma longa e Ajuga bracteosa possam substituir os antibióticos quando usados na rotina diária como limpadores de dentes ou enxaguatórios bucais.

Granuloma Periférico de Células Gigantes e Hiperparatiroidismo. Presentación de un Caso / Peripheral Giant Cell Granuloma and Hyperparathyroidism. Case Report

RESUMEN: Se presenta el caso de un paciente sexo femenino 31 años, insuficienciente renal crónica en hemodiálisis, hipertensa secundaria, consulta por aumento de volumen oral en relación a encía marginal vestibular izquierda, 6 meses de evolución. Al examen se observa aumento de volumen de 15 mm en relación a piezas. 3.6 y 3.7. Radiografía muestra compromiso periodontal pieza 3.7. Se realiza biopsia excisional y exodoncia pieza 3.7. Histopatología informa granuloma periférico de células gigantes. Se solicitan exámenes de laboratorio para estudio de hiperparatiroidismo (PTH elevada, calcemia fosfatemia normales). Evoluciona favorablemente. Sin signos de recidiva a los 3 meses. El diagnóstico histopatológico de lesión de células gigantes debe ser complementado con la clínica, exámenes de laboratorio e imagenología, el objetivo final es definir si tal diagnóstico corresponde a un tumor pardo, a un granuloma central de células gigantes o a un granuloma periférico de células gigantes. En la literatura los reportes de asociación entre granuloma periférico de células gigantes e hiperparatiroidismo son escasos. Este caso corresponde a granuloma periférico células gigantes, asociado a hipersecreción de paratohormona.

ABSTRACT: A 31-year-old female patient with chronic renal insufficiency in hemodialysis and secondary hypertension consulted due to an enlarging intraoral lesion in relation to the left marginal vestibular gingival, with 6 months of evolution. A 15mm mass in relation to mandibular left molars was noted. Radiograph showed periodontal involvement of mandibular left second molar. Excisional biopsy and tooth 3.7 extraction were performed. Histopathology reported a peripheral giant cell granuloma. Laboratory tests were requested for suspected hyperparathyroidism (aiding in the diagnosis) (high PTH, normal phosphatemia and calcemia). Evolution was favorable, without signs of reappearance after 3 months. The histopathological diagnosis of giant cell lesions should be complemented with clinical, laboratory and imaging tests. The final objective is to make the differential diagnosis between brown tumor, central giant cell granuloma and peripheral giant cell granuloma because the treatment varies considerably. There are few reports in the literature about the association between peripheral giant cell granuloma and hyperparathyroidism. This case corresponds to peripheral giant cell granuloma, possibly associated with parathormone hypersecretion.

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.

Solução estética após falha de planejamento protético / Esthetic solution after prosthesis design failure

A manutenção de uma auto imagem positiva tem relação direta a dentição do indivíduo. A utilização de próteses sejam elas parciais ou totais, tem papel fundamental tanto na saúde oral, quanto na saúde sistêmica do paciente. O restabelecimento da função oclusal, a preservação de estruturas orais remanescentes dependem diretamente de um planejamento protético rigoroso. A satisfação do paciente é fator determinante do sucesso ou insucesso de uma reabilitação protética, bem como o restabelecimento do bem-estar físico, mental e social. Paciente sexo feminino, 32 anos, relata insatisfação estética 120 dias após reabilitação estética com prótese parcial removível. A oroscopia observou-se, inclinação para distal dos elementos 12 e 21 bem como excesso de material restaurador. Observou-se ainda lesão séssil de cor avermelhada em gengiva inserida na região do elemento 11 (ausente), bordas delimitadas, apresentando dor provocada ao toque, sem sangramento e de surgimento a aproximadamente 12 meses, sendo anterior a instalação da PPR. Realizado biópsia excisional, com histopatologia compatível ao granuloma. Tratamento endodôntico do elemento 21. Remoção de carie dos elementos acometidos, inclusive pilar protético. Faceta direta em Resina Fotopolimerizável nos elementos 12 e 21. Recuperação da estética dentaria e saúde dos tecidos de suporte. O objetivo do presente está em destacar aspectos relacionados à falhas de PPR se não corretamente diagnosticadas, avaliadas e prevenidas.(AU)

Oral granuloma gravidarum: a retrospective study of 41 cases in Southern Brazil

Granuloma gravidarum (GG) is an inflammatory lesion, which develops in the oral mucosa of pregnant women in response to chronic low-grade irritants, under the influence of hormonal factors. Objective To characterize GG clinically by means of a retrospective study of the cases of the Oral Medicine Division, São Lucas Hospital, Brazil. Material and Methods Cases of GG diagnosed between 1980 and 2012 were analyzed. Data were obtained referring to the age of the patients, lesion location, clinical features, as well as the presence of local irritants. The gestation period in which the lesion developed was also investigated. Results Forty-one cases of GG were found. The lesions developed predominantly in the third trimester of pregnancy (51.22%) and the mean age of the patients was 28 years. Most GG was found in the gingiva (73.17%), was reddish color and had a mean diameter of 1.5 cm. Local irritants were involved in 75.6% of the cases. Conclusions The hormonal conditions of pregnancy can have an impact on the oral cavity, predisposing the patient to inflammatory lesions such as GG. .

Complicaciones estomatológicas en pacientes VIH positivos: correlaciones clínico demográficas y de laboratorio / Dental complications in HIV positive patients: clinical correlations demographic and laboratory

Las complicaciones estomatológicas (CE) en pacientes VIH+ muchas veces constituyen los primeros signos clínicos de la enfermedad, pudiendo funcionar como señalizadores del curso y progresión de la infección por el VIH y el SIDA. Este estudio evaluó la prevalencia de lesiones orales en pacientes VIH+ del Hospital de Enfermedades Infectocontagiosas Gizelda Trigueiro, en Natal-RN, Brasil y correlacionarlas con factores socio-demográficos como el sexo, edad, forma de contagio y status inmunológico. De acuerdo con los criterios de la EC-CLEARINGHOUSE/WHO, a través de examen clínico oral y conteo de células T CD4+ fueron evaluados 121 pacientes VIH+. Las lesiones más frecuentes fueron candidiasis (45.2%), leucoplasia vellosa (16.1%), eritema gingival linear (16.1%), herpes labial (12.9%), periodontitis necrosante (6.5%) y gingivitis necrosante (3.2%), ocurriendo con mayor frecuencia en hombres entre las edades de 30 a 44 años, que adquirieron el VIH a través de contacto sexual. Basado en los resultados de este estudio concluyese que hubo una prevalencia del perfil de complicaciones estomatológicas comúnmente relatado en la literatura. Las lesiones estuvieron asociadas a la reducción del número de células TCD4+, representando, por lo tanto marcadores de la progresión de la infección por el virus y/o de falla de la HAART, siendo así, un exhaustivo examen oral es importante en la evaluación clínica y acompañamiento de pacientes con VIH.

The stomatologic complications due to VIH infection are, a lot of times, the first clinical signs of the disease. These injuries may also function as beepers and sentries of the curse and progression of the VIH infection and SIDA. The objective of this work was to evaluate the prevalence of the oral injuries in VIH positive patients from the Hospital of Infected contagious Gizelda Trigueiro in Natal-RN, Brazil, and correlate them with demographic factors such as gender, age, form of VIH infection and immune status (T CD4+ cells). According to the criteria of EC-CLEARINGHOUSE/WHO, through clinical oral examination and T CD4+ cell count 121 patients were evaluated. The oral candidiasis was the most common lesion (45.2%), followed by oral hairy leukoplakia (16.1%), linear gingival erythema (16.1%), lips herpes (12.9%), necrotizing periodontitis (6.5%) and necrotizing gingivitis (3.2%), occurring predominantly in men between the ages 30 to 44 years, who acquired VIH infection through sexual contact. Based on the results of this study, concluded that there was a prevalence of the stomatologic complications profile that is commonly reported in the literature. These changes were associated with a decrease in the number of CD4+ T cells, representing markers of the infection progression and / or failure of HAART, so a thorough oral examination is important in clinical evaluation and follow up of patients with VIH.

Gingival plasma cell granuloma.

Plasma cell granuloma is a rare reactive lesion composed of polyclonal plasma cells. It manifests primarily in the lungs, but may occur in various other anatomic locations like the oral cavity. Intraoral plasma cell granulomas involving the tongue, lip, oral mucosa and gingiva have been reported in the past. This case presents a 54-year-old female with chronic periodontitis and mandibular anterior gingival overgrowth treated by Phase I therapy (scaling and root planing) and excisional biopsy. Histological examination revealed inflammatory cell infiltrate containing sheets of plasma cells. Immunohistochemistry for kappa and lambda light chains showed a polyclonal staining pattern confirming a diagnosis of plasma cell granuloma. This case highlights the need to biopsy for unusual lesions to rule out potential neoplasms.

Histopathologic changes in soft tissue associated with radiographically normal impacted third molars.

Background: The incidence of impacted or embedded third molars accounts for approximately 98%. Since 1948, there are studies reporting pathological changes in an asymptomatic dental follicle. Controversy still exists for removal of asmptomatic impacted teeth. Hence, this study was performed to histologically evaluate soft tissue pathosis in the pericoronal tissues of impacted third molars with pericoronal radiolucency measuring up to 2.5 mm on orthopantomographs. Materials and Methods: Forty-one asymptomatic impacted third molars with follicular space of up to 2.5 mm on radiographs were included. The disimpacted teeth and the follicular tissues were obtained for histological examination. Results: Age of the patients ranged from 14 to 25 years. Of 41 tissues evaluated, histopathological reports of 18 follicles were suggestive of dentigerous cyst, two follicles showed odontogenic keratocyst, one follicle each of calcifying epithelial odontogenic cyst, ameloblastoma-like proliferation, odontogenic myxoma and odontogenic fibroma. Conclusion: This study showed 58.5% of asymptomatic cases with definite pathological changes. Hence, thorough clinical and radiographic examination should be carried out for all impacted third molars and the dental follicular tissue should be submitted for histopathological evaluation.

Granuloma piógeno del embarazo: presentación de un caso con valoración de receptores de estrógeno y progesterona / Pyogenic granuloma of pregnancy: case report with estrogen and progesterone receptor evaluation

El granuloma piógeno de la cavidad oral ocurre entre el 2 y el 5% de las gestantes. En su patogenia se sospecha la acción de irritantes locales sobre un metabolismo tisular alterado por la acción de las hormonas sexuales. Presentamos una paciente de 26 años sin antecedentes patológicos que cursa el octavo mes de gestación. Consulta por presentar una lesión exofítica en gíngiva inferior de 6 meses de evolución. El estudio histopatológico informa compatible con tejido de granulación. Luego de 2 meses posparto se observa una gradual involución del granuloma. Se investigaron receptores de estrógeno y progesterona, los cuales resultaron negativos.

Peripheral giant cell granuloma and peripheral ossifying fibroma in children: two case reports

The aim of this study was to present the clinical and histopathological evaluation of reactive gingival lesions, such as peripheral giant cell granuloma [PGCG] and peripheral ossifying fibroma [POF], as exemplified in two cases. A 12- and a 13-year-old girl were referred to the Department of Pedodontics, both complaining of a painless swelling mass. After histopathological evaluation, the lesions were diagnosed as PGCG and POE. These gingival enlargements were totally resected after adequate clinical and radiological examinations. No recurrence has occurred in the 1-year follow-up period. These cases show that without histopathological evaluation, these two lesions could have been misdiagnosed due to their similarity in appearance. Early detection and treatment of these lesions are important to reduce bone loss or displacement of dental germs or teeth

Abscesos del periodonto: conducta odontológica / The periodontal abscess: dentist behaviour

En la cavidad bucal se pueden producir una variedad de enfermedades de diferente etiología, por ello es muy importante que el odontólogo las identifique y conozca las consecuencias que ocasiona si no se previenen o tratan a tiempo. Se funda como premisa que el cuidado periodontal es, en esencia, labor del odontólogo general y que éste no puede pasar por alto la responsabilidad de proveer atención a todos los pacientes. La incidencia excesivamente alta de los problemas periodontales entre las población, dificulta que un número reducido de especialistas los pueda enfrentar. Asimismo, el estrecho vínculo entre los tratamientos dentales restaurativos y los regímenes periodontales hace muy importante que el odontólogo general disponga de conocimientos a fondo sobre periodoncia. En la cavidad bucal se producen variedades de enfermedades de etiología infecciosa bacteriana, lo más común son los abscesos del periodonto, estas entidades clínicas han sido reconocidas desde finales del siglo XIX. Es una infección localizada destructiva compuesta de colecciones sero-purulentas restos celulares, bacterianos con/sin fistulización. Es importante que el odontólogo, las identifique, así como las consecuencias que ocasionan si no se tratan a tiempo. El propósito de este reporte es describir de los abscesos del periodonto, su etiología, características clínicas, diagnósticos diferenciales y diferentes métodos de tratamiento, así como valorar sus complicaciones y cuidados postoperatorios. Para ello se realizó basado en los lineamientos de la investigación descriptiva documental, una revisión de la literatura nacional e internacional

A variety of different etiologies pathologies can affect the oral cavity, due to this reason, dentists must be able to identify them and their consequences if they are not treated on time. It is primordial for the general practitioner dentists the periodontal care of their patients. Among the population the periodontal diseases are very common and only a reduced number of specialists can treat them. The close relation between restorative dental treatments and periodontal treatment procedures lead to the tendency that de general practitioner has enough knowledge in the periodontal field. A variety of etiologies infectious bacterium different disease can affect the oral cavity, the most common is the periodontal abscess, this clinical lesions These clinical entities have been recognized from the ends of the XIXth century. Localized destructive infections which consists in serum purulents cellular debris, bacteriae with or without sinus tract formation. Dentist must be able to recognize and treat them. The purpose of this research is to describe the possible etiologic, clinical features and treatment of this disease and also to recommend the multidisciplinary attention to these patients. For this paper was made a study based on the lineaments of the descriptive documental research, mainly with scientific bibliographic references literature national and international

Uso de la técnica de hibridización checkerboard ADN-ADN para la identificación de la microbiota periimplantaria: revisión bibliográfica / Use of checkerboard DNA-DNA hybridization technique for periimplantitis microbiota identification: literature review

El término Periimplantitis hace referencia a la condición de enfermedad en los tejidos de soporte de los implantes bucales. Su etiología es multifactorial, aunque la biopelícula microbiana desempeña un papel esencial en la etiopatogenia de la enfermedad. A través de técnicas de cultivo, se han identificado algunas bacterias implicadas en la etiopatogenia de las periodontopatías, entre estas, especies pertenecientes a los Géneros Fusobacterium, Prevotella y Porphyromonas. El desarrollo de técnicas de biologia molecular permite la identificación de especies bacterianas que antes no eran referidas como parte de la microbiota responsable de la patogénesis periodontal. La detección de la microbiota presente en los sacos periodontales que se originan alrededor de los implantes es necesaria para el establecimiento de la conducta terapéutica a ser instruida, más aún si se toma den consideración que las alteraciones de las estructuras de soporte están directamente relacionadas con muchos de los microorganismos presentes y constituyen una de las causas más frecuentes de fracaso del tratamiento rehabilitador con implantes. El objetivo de este artículo es presentar una revisión bibliográfica de la técnica de hibridización checkerboard ADN-ADN para la identificación de los microorganismos más frecuentemente asociados a la peri-implantitis

The periimplantitis term is characterized as a disease that affects the support implant tissues. It has a multifactorial etiology, with an important role of the biofilm on the periodontal diseases. The culture techniques use possibilited to identify bacterias responsible for periodontal alterations, as Fusobacterium, Prevotella and Porphyromonas ssp. The development of the molecular biology techniques possibilited the identification of some bacterial species, that there were not related in the literature and there were responsible for periodontal pathogenesis. The microbiota present on the periodontal pockets in overdentures may contribute in the orientation of the therapeutic procedures, considering that the structural alterations on the periodontal tissues are straightly related to microorganism presence, and it constitutes one of the causes that affect the oral rehabilitation treatment with implants. This, the aim of this study was to present a literature review of DNA-DNA hybridization technique in the identification of the microorganisms more related to periimplantitis

Pathosis associated with radiographically normal follicular tissues in third molar impactions: a clinicopathological study.

BACKGROUND: The follicular tissue around impacted third molars has a potential to develop pathosis. However, it is generally assumed that the absence of abnormal radiolucency indicates the presence of a normal follicle. AIMS: The aim of this study was to investigate abnormalities associated with radiographically normal follicular tissue of third molar impactions. MATERIALS AND METHODS: One hundred eighty-five impacted third molars from 170 patients with no signs of abnormal radiolucency (follicular space < 3 mm) were used for this study. Follicular tissues of the relevant teeth were collected. Specimens were fixed in 10% formalin and stained routinely with hematoxilin and eosin to be independently examined by two pathologists. A diagnosis was registered only when the results from both pathologists were in concordance. Clinical details for each patient were registered in WHO standard forms to undergo chi-square statistical analysis. RESULTS: Fifty-three per cent of the specimens had developed pathosis. The incidence of pathosis was higher in the age group of 20-30 years, in men compared to women and in the mandible compared to the maxilla. CONCLUSION: The findings of this study suggest that radiographic appearance may not be reliable in the diagnosis of pathosis in follicular tissue as a surprisingly high rate of pathosis was found in the absence of any radiographically detectable sign.

Primary isolated gingival tuberculosis

Tuberculosis of the oral cavity is a rare event and when present is usually secondary to pulmonary tuberculosis. We present a case of a 33-year-old male patient who presented with symptoms of gingivitis. Local examination revealed multiple ulcers and a few nodules over the gingiva. A nodule biopsy was consistent with the diagnosis of gingival tuberculosis. The patient had no evidence of tuberculosis any where else in the body. Medical treatment was curative. As this condition is very rare, it is often over looked as it is never thought as a common clinical diagnosis. A biopsy is mandatory to establish diagnosis. The relevant literature is reviewed.

Correlación clínica, bioquímica e histopatológica en pacientes periodontales diabéticos / Clinical, biochemical and histopatological correlación in diabetic patients with periodontal disease

Introducción - El objetivo de este trabajo fue estudiar la correlación clínica, histológica y Bioquímica por efecto del raspaje y alisado radicular en pacientes diabéticos con enfermedad periodontal. Materiales y Métodos.- Se seleccionó una población total de 80 pacientes de ambos sexos (edad 25-60 años), 40 diabéticos 1 y 2, Y 40 no diabéticos. Se eligieron los s~etos compensados, según examen médico. Se examinó el terreno periodontal, seleccionándose pacientes con bolsas reales iguales o menores a 5 mm. Criterio de laboratorio: se consideraron diabéticos sujetos con glucemia igualo mayor a 140 mg.'dl, y HbAIC igual o mayor a 8 %. No diabéticos, los de glucemias inferiores a 115 mg.'dl, y HbAIC menor a 8 %. Previa administración de 2 g. de amoxicilina, se tomaron biopsias de encía libre e insertada a todos los pacientes,. Se realizó raspaje y alisado de todos los elementos dentarios, y se colocó protector periodontal. Se realizaron sesiones de higiene supervisada semanalmente. A los 40 Y 120 días se aplicaron nuevamente los criterios de selección clínicos y bioquímicos. Se tomaron biopsias, las que fueron analizadas microscópicamente. Se aplicaron las coloraciones HjE, PAS, y Tricrómico de Masson. Resultados.- Al tiempo 40, y principalmente 120 se encontró que en el 90 % de los pacientes seleccionados disminuyeron los valores de glucemia. En un 70 % de los casos estudiados se estabilizaron los valores de HbAIC, y se revirtieron los signos clínicos de enfermedad periodontal en un 80 % de los pacientes. El análisis histológico al tiempo demostró infiltrado mononuclear, congestión y proliferación de la capa media de los vasos, cuando se comparó con los controles no diabéticos. Al tiempo 40 y al 120, disminución del infiltrado y de los depósitos sensibles a Pas en las paredes de los pequeños vasos. Conclusión.- Se propone que el raspaje y alisado es un método eficaz para revertir los valores de glucemia, HbA 1 C, las microangiopatías gingivales y los signos clínicos en pacientes periodontales diabéticos.

Introduction - The aim of this paper was to study the clinical, biochemical and histopathological correlation caused by scaling and root planning in diabetic patients with periodonta1 disease. Material and Methods.- The study was conducted on 80 patients, both males and females, (age 25-60 years). Fourty patients had type 1 and type 2 diabetes, while 40 were non-diabetic patients. According to the medical examination, the subjects including in the study were well compensated. After studying the periodontal field, patients with real pockets measuring 5 mm or less were selected. Laboratory Criteria.- The subjects were considered to be diabetic when their basal…

Periodontite crônica e a infecção pelo HIV. I. Aspectos microbiológicos / Chronic periodontitis and HW infection. I. Microbiologic features

A microbiologia da periodontite crônica em pacientes HIV+ apresenta uma semelhança na prevalência de periodontopatógenos clássicos quando comparada com a de indivíduos HIV negativo. Contudo, em função da imunossupressão, microrganismos, atípicos, tais como Staphylococcus epidermidis, Candida albicans. Enterococcus faecalis. Clastridium clastridiforme. Clastridium difficile e Mycoplasma salivarium, podem ser encontrados na microbiota subgengival. Além disso, os tecidos periodontais podem ser invadidos po Candida spp em periodontites severas. Essa característica particular pode justificar a maior severidade das periodontites nos pacientes HIV. Alguns vírus, incluindo o herpesvírus e o próprio HIV, também podem desempenhar um papel importante na patogênese de doenças periodontais nessa população.

Plasma cell granuloma of gingiva.

An exceedingly rare case of gingival plasma cell granuloma is reported in a 40-year old female patient. The case presented as an exophytic mass of gingiva, clinically resembling traumatic fibroma. Histopathologic findings revealed dense sheets of plasma cells infiltrate. Immunohistochemistry for kappa and lambda light chains showed polyclonal (benign) staining pattern confirming a diagnosis of plasma cell granuloma. It is important to recognise this peculiar lesion because of its highly unusual incidence in involving the periodontium. Clinical features are usually suggestive of traumatic fibroma (benign) but histopathologicaly in early stages it closely resembles plasmacytoma (malignant). This case highlights the need to biopsy unusual lesions to rule out potential neoplasms and also emphasizes the need to submit all the excised tissue for histological examination regardless of clinical impression and/or perceived surgical success. Only by such practice can rare lesion of this type be diagnosed and their incidence studied.

Gingival cyst of adult--a case report with unusual findings.

Gingival cysts of adult are rare odontogenic cysts of developmental origin. They occur as swellings on the gingiva, most commonly between 5th and 6th decade of life and usually do not exceed 1cm in size. The epithelial lining of these cysts are thin non-keratinised and are thought to arise from the rests of dental lamina. We report a case of multicystic variant of a gingival cyst in adult patient with few unusual findings regarding the age of occurrence, size of the lesion and the histopathological appearance. Gingival cyst of adult occurring in an 18-year-old male patient, measuring about 3 x 4 sq. cms on the facial attached gingiva in relation to 42, 43, and 44 was observed. The histopathological findings were that of the rare multicystic variant with keratinised lining and epithelial plaques in the lining. The lumen of the cyst showed keratin with one of the lumen showing calcifications within it. This case documents many interesting and unusual findings in gingival cyst of adults. It appears to be the first documentation of gingival cyst of adult containing calcifications within the cystic lumen.