Variability of exostoses on human jaws during the past six millennia in Northern China / Variabilidad de las exostosis en las mandíbulas humanas durante los últimos seis milenios en el norte de China

SUMMARY: The aim of this study was to survey oral exostoses in human populations that belonged to the same region encompassing five periods over 6000 years, to determine the prevalence and its changing trend over time. A total of 306 human jaws belonging to the modern Xi'an region and four archeological sites, Banpo (6700-5600 years BP), Shaolingyuan (3000 years BP), Shanren (2200 years BP) and Chang'an (1000-1300 years BP), were investigated. The degree of buccal exostosis (BE), torus mandibularis (TM) and torus palatinus (TP) and the TP shape were recorded. The prevalence of BE, TM, and TP in the five groups was 20.8 %-62.5 %, 17.5 %-71.5 %, and 31.7 %-74.2 %, respectively. The differences in the three types of exostoses among the five groups were all statistically significant, but only TM and TP showed a decreasing trend over time. A high and quite diverse prevalence of oral exostoses was found in the five groups of samples. Decreasing trends in relation to time for TM and TP were detected.

RESUMEN: El objetivo de este estudio fue sondear las exostosis orales en poblaciones humanas que pertenecían a la misma región abarcando cinco períodos durante 6000 años, para determinar la prevalencia y su tendencia cambiante a lo largo del tiempo. Un total de 306 mandíbulas humanas pertenecientes a la moderna región de Xi'an y cuatro sitios arqueológicos, Banpo (6700-5600 años AP), Shaolingyuan (3000 años AP), Shanren (2200 años AP) y Chang'an (1000-1300 años AP) BP), fueron investigados. Se registró el grado de exostosis bucal (EO), torus mandibular (TM) y torus palatino (TP) y la forma de TP. La prevalencia de EO, TM y TP en los cinco grupos fue 20,8 % -62,5 %, 17,5 % -71,5 % y 31,7 % -74,2 %, respectivamente. Las diferencias en los tres tipos de exostosis entre los cinco grupos fueron todas estadísticamente significativas, pero solo TM y TP mostraron una tendencia decreciente con el tiempo. Se encontró una prevalencia alta y bastante diversa de exostosis oral en los cinco grupos de muestras. Se detectaron tendencias decrecientes en relación al tiempo para TM y TP.

Preventive and therapeutic effects of relaxin on bisphosphonate related osteonecrosis of the jaw: an experimental study in rats / Efeitos preventivos e terapêuticos da relaxina na osteonecrose da mandíbula relacionada a bisfosfonatos: um estudo experimental em ratos

Objective: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a challenging complication of chronic bisphosphonate (BP) use. The hormone relaxin is able to induce the multistep differentiation process of human osteoclastogenesis, exhibits antifibrotic and anti-inflammatory actions, and promotes vasodilatation, wound healing, and angiogenesis. The present study aimed to evaluate the effects of relaxin in the prevention and management of BRONJ. Material and Methods: Thirty-six male Sprague Dawley rats were randomly divided into four groups. Rats in group 1 (n = 10) received relaxin and BP simultaneously for 12 weeks. Rats in group 2 (n = 10) received injections of BP for 12 weeks, followed by relaxin for another 12 weeks. Rats in group 3 (n = 10) received only BP injections, and those in group 4 (control, n = 6) received only saline. Necrosis and inflammation in the rats' mandibles were evaluated as indicators of BRONJ. Results: Necrosis and inflammation were not detected in group 1 (BP + relaxin). In group 3 (BP only), incidence rates of necrosis and inflammation were 90% and 60%, respectively. Conclusions: Our findings suggest that relaxin may be potently effective in preventing BRONJ and have some benefit in the treatment of existing BRONJ (AU)

Objetivo: A osteonecrose da mandíbula relacionada ao bisfosfonato (BRONJ) é uma desafiadora complicação do uso crônico de bisfosfonato (BP). O hormônio relaxina é capaz de induzir o processo múltiplo de diferenciação da osteoclastogênese humana, exibe ações anti-fibróticas e anti-inflamatórias e promove vasodilatação, cicatrização de feridas e angiogênese. O presente estudo teve como objetivo avaliar os efeitos da relaxina na prevenção e tratamento do BRONJ. Material e Métodos: Trinta e seis ratos Sprague Dawley machos foram divididos aleatoriamente em quatro grupos. Os ratos do grupo 1 (n = 10) receberam relaxina e BP simultaneamente por 12 semanas. Os ratos do grupo 2 (n = 10) receberam injeções de BP por 12 semanas, seguidos de relaxina por mais 12 semanas. Os ratos do grupo 3 (n = 10) receberam apenas injeções de BP e os do grupo 4 (controle, n = 6) receberam apenas solução salina. Necrose e inflamação nas mandíbulas dos ratos foram avaliadas como indicadores de BRONJ. Resultados: Necrose e inflamação não foram detectadas no grupo 1 (BP + relaxina). No grupo 3 (somente BP), as taxas de incidência de necrose e inflamação foram de 90% e 60%, respectivamente. Conclusões: Nossos resultados sugerem que a relaxina pode ser potentemente eficaz na prevenção do BRONJ e ter algum benefício no tratamento do BRONJ existente.(AU)

Estudo clínico-patológico de odontomas diagnosticados no Laboratório de Patologia Bucal da Faculdade de Odontologia de Pernambuco - FOP / Odontomas Pathological-Clinical Study DiagnosedattheOral Pathology Laboratory from Pernambuco College of Dentistry

O Odontoma é o tipo mais comum de tumor odontogênico. Os odontomas são subdivididos em composto e complexo. Diferem-se histológica e radiograficamente pelo fato de o tipo complexo não apresentar a organização ordenada dos tecidos como o são no tipo composto, no qual estruturas pequenas se assemelham a dentículos. Os odontomas compostos, geralmente, são mais diagnosticados do que a forma complexa. Podem ocupar ambos os maxilares, sendo o tipo composto mais frequente na região ântero-superior e o complexo nas regiões posteriores, superior e inferior. Acometem mais adultos jovens, entretanto sem grandes disparidades quanto aos gêneros. Essa lesão geralmente é assintomática. O objetivo deste trabalho foi analisar os casos de odontomas diagnosticados no Laboratório de Patologia Bucal da Faculdade de Odontologia da Universidade de Pernambuco (FOP/UPE), a fim de verificar a frequência dos tipos clínico-radiográficos, correlacionando com a localização anatômica da lesão e fatores demográficos dos portadores do tumor. A metodologia seguiu: seleção dos casos a partir dos laudos anátomo-patológicos, revisão das lâminas para confirmação diagnóstica e para definição do tipo clínico-radiográfico e obtenção dos dados demográficos constantes na ficha de encaminhamento de cada caso. Foram diagnosticados 59 casos de odontomas, sendo 25 do tipo complexo (42,37%) e 34 do tipo composto (57,63%). A faixa etária mais acometida compreendeu de 11-20 anos, o sexo feminino foi o mais afetado, e a raça branca, a mais predominante, tendo a região ânterosuperior representado a localização anatômica mais frequente... (AU)

The Odontoma is the most common type of odontogenic. Odontomas are subdivided into compound and complex. They differ histologically and radiographically because of the complex type does not present the orderly organization of tissues such as are in the compound type, in which small structures resemble the denticles.Odontomas compounds are generally diagnosed more than complex type. Can occupy both jaws, with the compound type most frequent in the upper anterior region and posterior complex in upper and lower regions. It affects mostly young adults, however no major differences as to gender. This lesion is usually asymptomatic. The objective of this study was to analyze cases of odontoma diagnosed at the Laboratory of Oral Pathology, Faculty of Dentistry, University of Pernambuco (FOP/UPE) in order to verify the frequency of clinical and radiographic types and to correlate with the anatomical location of the lesion and factors demographics of patients the tumor. The methodology followed: selection of cases from the pathological files, review of slides for diagnostic confirmation reports and to define the clinical and radiographic type, and obtain demographic data contained in the routing record of each case. Were diagnosed 59 cases of patients with odontoma, complex type were 25 (42.37 %) and 34 of the composite type (57.63 %) were diagnosed . It was concluded that the most affected age group was between 11-20 years, females were more affected, the white race was the most prevalent, and the anterosuperior region represented the most frequent anatomical location... (AU)

Odontoma complexo extenso em mandíbula: revisão e relato / Complex odontoma extensive in jaw: review and report

Os odontomas são os tumores odontogênicos mais comumente encontrados nos maxilares, formados por esmalte, dentina, cemento e polpa, que podem estar dispostos de forma organizada ou não. Não são considerados neoplasmas verdadeiros, mas sim, anomalias de desenvolvimento - hamartomas. Geralmente são assintomáticos, e o tratamento preconizado na literatura é a sua remoção cirúrgica por enucleação. Porém, casos de odontomas complexos extensos e localizados mais profundamente, como o descrito neste trabalho podem se tornar um tratamento desafiador. Apesar de serem lesões de fácil diagnóstico e bom prognóstico, um correto planejamento e diagnóstico precoce é fundamental para se evitaram complicações, sequelas futuras e condições estigmatizantes, promovendo reabilitação precoce e saúde do paciente... (AU)

Odontomas are odontogenic tumors most commonly found in the jaws formed by enamel, dentin, cementum and pulp, which can be arranged in an organized way or not. They are not considered true neoplasms but, developmental abnormalities - hamartomas. They are usually asymptomatic and the recommended treatment is the surgical removal by enucleation. But cases of extensive and complex odontoma located deeper, as described in this article can become a challenging treatment. Although they are easy to diagnose injuries and good prognosis, correct planning and early diagnosis is essential to prevent complications, future sequels and stigmatizing conditions, promoting early rehabilitation and patient health... (AU)

Tumor odontogênico adenomatoide mimetizando um cisto radicular / Adenomatoid odontogenic tumour mimetizing a radicular cyst

O tumor odontogênico adenomatoide (TOA) foi considerado como uma entidade clínica distinta, em 1969, por Philipsen e Birn. Trata-se de um tumor odontogênico, de caráter totalmente benigno, assintomático, de crescimento lento e raramente atingindo tamanho maior que 3 cm. Acomete, preferencialmente, a região anterior dos ossos gnáticos, principalmente a maxila, ocorrendo duas vezes mais no gênero feminino, sendo incomum em pacientes maiores que 20 anos. O objetivo deste trabalho é relatar um caso clínico atípico de tumor odontogênico adenomatoide em região anterior de mandíbula, mimetizando cisto radicular, acometendo um paciente de 45 anos, do gênero masculino, tratado com enucleação cirúrgica. O paciente encontra-se atualmente em proservação, não apresentando sinais clínicos e imaginológicos de recidiva. No presente artigo, os aspectos clínicos, radiográficos e histológicos do tumor odontogênico adenomatoide serão discutidos assim como o tratamento recomendado... (AU)

Adenomatoid Odontogenic Tumor (AOT) was so classified as a new tumor in 1969 by Philipsen and Birn. This odontogenic tumor is benign, asymptomatic, has a slow growing and rarely reach a size greater than 3 cm. AOT usually occurs in anterior jaw bones, affects females twice more than males and is unusual in patients older than 20 years-old. The aim of this study is to report an atipic case of AOT in the anterior mandible mimetizing a radicular cyst, affecting a 45 years-old male patient, who was treated by surgical enucleation. The patient has been followed-up and has no clinical and imaging signs of recurrence. In this paper, adenomatoid odontogenic tumor's clinical, radiographic and histological aspects will be discussed, as well the recommended treatment... (AU)

Management of Large Mandibular Ameloblastoma Crossing Midline: Reconstructed by Bilateral Iliac Crest Graft: A Rare Entity.

Ameloblastoma is a true neoplasm of odontogenic epithelial origin. It is the second most common odontogenic neoplasm. It’s incidence approximately 1% of all oral tumors and 18% of all odontogenic tumors. More than 80% of cases of ameloblastoma occur in mandible. The ameloblastoma occurs in three variants solid or multicystic, unicystic, and peripheral. A painless expansion of the jaws is the most common clinical presentation. The correct diagnosis can be easily made with the help of plain X-rays and tissue biopsy. The standard management of ameloblastoma is marginal resection but sometimes a large tumor requires complete resection of affected part. Untreated tumors may lead to tremendous facial disfigurement, a severe malocclusion and pathological fractures of the jaw. Here we present a case of a young man with the chief complaint of facial asymmetry. The orthopantomogram of the patient was showing a multilocular radiolucency with Buccal and lingual cortical expansion. A diagnosis was made on the basis of the biopsy as multicystic ameloblastoma, and resection of the mandible was carried out. The mandibular primary reconstruction was done with avascular bilateral iliac crest bone graft. Long term prognosis showed satisfactory healing and good facial esthetics.

Prevalência de cistos dentígeros na Universidade Federal do Paraná / Dentigerous cysts prevalence at Federal University of Paraná

O cisto dentígero destaca-se como o mais comum entre os cistos odontogênicos de desenvolvimento dos ossos maxilares. Frequentemente são encontrados em exames radiográficos de rotina devido a alterações na cronologia de erupção dentária. O tratamento dessas lesões varia de acordo com a presença de sintomatologia dolorosa, tamanho e proximidade com estruturas anatômicas nobres. O objetivo deste trabalho foi avaliar a prevalência de cisto dentígero no Serviço de Cirurgia e Traumatologia Buco-Maxilo-Facial da Universidade Federal do Paraná, entre 2008 e 2010. Durante esse período, foram avaliados 24 prontuários de pacientes com cisto dentígero. Dados, como gênero, idade, localização e forma de tratamento da lesão, foram coletados. Os resultados mostraram predileção pelo gênero masculino (63%), com maior incidência na segunda década de vida (42%), estando geralmente localizado na região posterior da mandíbula (62%). A principal forma de tratamento foi a enucleação associada ou não à extração do elemento dentário envolvido (75%). Todos os tratamentos mostraram-se eficazes com regressão da lesão após acompanhamento clínico e radiográfico... (AU)

The dentigerous cyst stands out as the most common among odontogenic cysts development of the jaws. They are often found in routine radiographic examination due to changes in timing of tooth eruption. The treatment of these lesions varies according to the presence of painful symptoms, size and proximity to significant anatomical structures. The objective of this study was to evaluate the prevalence of dentigerous cystin Surgery and Traumatology Oral and Maxillofacial at Federal University of Paraná between 2008 and 2010. During this period were evaluated 24 medical records of patients with dentigerous cyst. Data such as gender, age, location and method of treatment of the injury were collected. The results showed a predominance of male patients (63%), with the highest incidence in the second decade of life (42%) and is usually located in the posterior mandible (62%). The main form of treatment was enucleation with or without the extraction of the involved tooth (75%). All treatments were effective with regression of the lesion after clinical and radiographic follow-up... (AU)

Quantitative ultrasound at the hand phalanges in patients with bisphosphonate-related osteonecrosis of the jaws

Patients with bisphosphonate-related osteonecrosis of the jaws (BRONJ) who received intravenous or oral bisphosphonates (BP) were selected for determination of their bone microarchitecture as a risk predictor of BRONJ development. The diagnosis of BRONJ was made based on clinical and radiographic findings. The control group consisted of healthy patients. All patients underwent quantitative and qualitative ultrasound measurements of bone at the hand phalanges carried out using the DBM Sonic BP. Ultrasound bone profile index (UBPI), amplitude-dependent speed of sound (AD-SoS), bone biophysics profile (BBP), and bone transmission time (BTT) were measured. The BRONJ group consisted of 17 patients (62 ± 4.24; range: 45-82); 10 (58.8%) were male and seven (41.1%) were female, of whom 11 (64.7%) suffered from multiple myeloma, three (17.6%) from osteoporosis, one (5.8%) from prostate cancer, one (5.8%) from kidney cancer, and one (5.8%) from leukemia. Fourteen (82.3%) of them received intravenous BP whereas three (17.6%) received oral BP. Nine (9/17; 52.9%) patients developed bone exposure: two in the maxilla and seven in the mandible. Regarding quantitative parameters, Ad-SoS was low in the BRONJ group, but not significant. The UBPI score was significantly reduced in BRONJ patients with exposed bone when compared to controls (0.47 ± 0.12 vs. 0.70 ± 0.15; p = 0.004). The present study demonstrated that quantitative ultrasound was able to show bone microarchitecture alterations in BRONJ patients, and suggests that these analyses may be an important tool for early detection of bone degeneration associated with BRONJ.

Avaliação histológica e histomorfométrica do comportamento ósseo em relação à profundidade da linha marginal de cimentação de próteses sobre implantes Cone Morse: estudo experimental em cães / Histologic and histomorphometric evaluation of bone behavior in relation to the depth of the line of marginal cementation on Morse taper implants: experimental study in dogs

A utilização dos implantes cone morse muito favorece a estética peri-implantar e seu uso em conjunto com próteses cimentadas favorece ainda mais a estabilidade do sistema, simplificando também os procedimentos protéticos. O presente estudo histológico e histomorfométrico utilizou os implantes cone morse com o intuito de avaliar o comportamento tecidual com relação à posição da margem da cimentação protética em relação ao tecido ósseo quando se faz o uso próteses cimentadas. Foram utilizados quatro cães, os quais tiveram todos os pré-molares inferiores extraídos numa primeira fase cirúrgica. Após três meses, realizou-se a segunda fase cirúrgica, na qual foi realizada a técnica da carga imediata, com a instalação dos implantes juntamente com os pilares protéticos. Foram instalados vinte e quatro implantes numa profundidade de 3 mm infra óssea e eles foram igualmente divididos entre os grupos Controle e Experimental. Os pilares protéticos utilizados foram do tipo munhão universal e apresentavam diferentes alturas transmucosas iguais a 1.5 mm, 3.5 mm, e 5.5 mm. Isto fez com que a margem da cimentação se posicionasse a 1.5 mm infra óssea, a 0.5 mm supra óssea e a 2.5 mm supra óssea. No grupo Controle, foi realizada a instalação dos implantes e dos pilares protéticos somente. No grupo Experimental, foi realizada a instalação dos implantes, dos pilares protéticos e, sobre estes, foram cimentados cilindros de alumina. Os animais permaneceram sobre controle de placa durante 10 semanas subsequentes a instalação dos implantes, sendo este o tempo final do experimento através da realização da eutanásia. As amostras foram preparadas para análise histológica e avaliação dos tecidos peri-implantares. A região de interesse foi medida através da distância entre a margem do pilar protético e a porção mais coronal da crista óssea peri-implantar. Foram utilizados os testes estatísticos ANOVA a três critérios com medidas repetidas e teste de Tukey com o nível de significância de...

The use of Morse taper implants has increased because of some positive features. Cemented crowns can be extensively used, taking advantage of the system connection stability, also simplifying the prosthetic procedures. The present histological and histomorphometric study used Morse taper implants with the purpose of evaluating bone behavior with respect to the cementation margin position of the prosthetic crown. Four dogs had all premolars extracted at a first surgical procedure. After three months, there was a second surgical procedure with simultaneous installation of implants and abutments, submitted to immediate load. Twenty four implants were installed 3 mm below the bone level and they were equally divided between Control and Experimental groups. The universal post abutments used had three different transmucosal heights, 1.5 mm, 3.5 mm and 5.5 mm. Thus there were implants with the level of the cementation margin positioned 1.5 mm below the bone level, as well as 0.5 mm and 2.5 mm above the bone level. In the Control group, installation of implants and abutments only was performed. In the Experimental group immediately after the placement of implants and abutments alumina cylinders were cemented. The animals were kept on plaque control for 10 weeks after implant placement and then euthanized. Samples were prepared for histological analysis and evaluation of peri-implant tissues. The region of interest was measured by the distance between the prosthetic margin of the abutment to the most coronal peri-implant bone crest. ANOVA test at three criteria with repeated measures and Tukey test with a significance level of p < 0.05 were applied. The results showed no statistically significant differences between Control and Experimental groups (p = 0.2764). The 1.5 mm abutments presented less bone loss compared to all other abutments tested, because the distance average of bone remodelation was shorter in this group (0.6859 mm) compared to the...

Avaliação histológica e histomorfométrica do comportamento ósseo em relação à profundidade da linha marginal de cimentação de próteses sobre implantes Cone Morse: estudo experimental em cães / Histologic and histomorphometric evaluation of bone behavior in relation to the depth of the line of marginal cementation on Morse taper implants: experimental study in dogs

A utilização dos implantes cone morse muito favorece a estética peri-implantar e seu uso em conjunto com próteses cimentadas favorece ainda mais a estabilidade do sistema, simplificando também os procedimentos protéticos. O presente estudo histológico e histomorfométrico utilizou os implantes cone morse com o intuito de avaliar o comportamento tecidual com relação à posição da margem da cimentação protética em relação ao tecido ósseo quando se faz o uso próteses cimentadas. Foram utilizados quatro cães, os quais tiveram todos os pré-molares inferiores extraídos numa primeira fase cirúrgica. Após três meses, realizou-se a segunda fase cirúrgica, na qual foi realizada a técnica da carga imediata, com a instalação dos implantes juntamente com os pilares protéticos. Foram instalados vinte e quatro implantes numa profundidade de 3 mm infra óssea e eles foram igualmente divididos entre os grupos Controle e Experimental. Os pilares protéticos utilizados foram do tipo munhão universal e apresentavam diferentes alturas transmucosas iguais a 1.5 mm, 3.5 mm, e 5.5 mm. Isto fez com que a margem da cimentação se posicionasse a 1.5 mm infra óssea, a 0.5 mm supra óssea e a 2.5 mm supra óssea. No grupo Controle, foi realizada a instalação dos implantes e dos pilares protéticos somente. No grupo Experimental, foi realizada a instalação dos implantes, dos pilares protéticos e, sobre estes, foram cimentados cilindros de alumina. Os animais permaneceram sobre controle de placa durante 10 semanas subsequentes a instalação dos implantes, sendo este o tempo final do experimento através da realização da eutanásia. As amostras foram preparadas para análise histológica e avaliação dos tecidos peri-implantares. A região de interesse foi medida através da distância entre a margem do pilar protético e a porção mais coronal da crista óssea peri-implantar. Foram utilizados os testes estatísticos ANOVA a três critérios com medidas repetidas e teste de Tukey com o nível de significância de...

The use of Morse taper implants has increased because of some positive features. Cemented crowns can be extensively used, taking advantage of the system connection stability, also simplifying the prosthetic procedures. The present histological and histomorphometric study used Morse taper implants with the purpose of evaluating bone behavior with respect to the cementation margin position of the prosthetic crown. Four dogs had all premolars extracted at a first surgical procedure. After three months, there was a second surgical procedure with simultaneous installation of implants and abutments, submitted to immediate load. Twenty four implants were installed 3 mm below the bone level and they were equally divided between Control and Experimental groups. The universal post abutments used had three different transmucosal heights, 1.5 mm, 3.5 mm and 5.5 mm. Thus there were implants with the level of the cementation margin positioned 1.5 mm below the bone level, as well as 0.5 mm and 2.5 mm above the bone level. In the Control group, installation of implants and abutments only was performed. In the Experimental group immediately after the placement of implants and abutments alumina cylinders were cemented. The animals were kept on plaque control for 10 weeks after implant placement and then euthanized. Samples were prepared for histological analysis and evaluation of peri-implant tissues. The region of interest was measured by the distance between the prosthetic margin of the abutment to the most coronal peri-implant bone crest. ANOVA test at three criteria with repeated measures and Tukey test with a significance level of p < 0.05 were applied. The results showed no statistically significant differences between Control and Experimental groups (p = 0.2764). The 1.5 mm abutments presented less bone loss compared to all other abutments tested, because the distance average of bone remodelation was shorter in this group (0.6859 mm) compared to the...

Cemento-Ossifying Fibroma of the Mandible: Case Report / Fibroma cemento-ossificante de mandíbula: relato de caso

Cemento-ossifying fibroma is a relatively rare, benign, non-odontogenic tumour of the jaws, regarded as a subdivision of fibro-osseous lesions. The usual age of occurrence is between 20 and 40 years. The female:male ratio is 5:1, usual site being the posterior mandible. The aim of this report to present the clinical and radiological features and management of a 32-year-old female Libyan patient who presented with an asymptomatic giant swelling of three years' duration in the left mandible, the diagnosis of which was confirmed by histopathology. Cemento-ossifying fibroma (COF) is a benign, asymptomatic lesion of the jaws characterized by the production of well-demarcated bone of slow growth. It typically affects females aged between 20 and 40 years, in the premolar and molar area, causing a painless swelling, of slow, expansile growth. The periodontal ligament contains both bone and cementum. The pathogenesis of extraosseous COF, where there is no periodontal tissue, as suggested by Cakir and Karadayi, originates in embryonic nests and the ectopic periodontal membrane, as suggested by Brademann et al. in their cytogenetic studies. Depending on the stage of maturation, cemento-ossifying fibroma may range from radiolucent, through mixed, to completely radio-opaque. Histopathologically, it appears as well-circumscribed, occasionally encapsulated with various amounts of bony trabecular/cementum formation in a fibrous stroma... (AU)

Fibroma Cemento-ossificante é um tumor benigno relativamente raro, não odontogênico dos maxilares, considerado como subdivisão de lesões fibro-ósseas. A idade usual de ocorrência é entre 20 e 40 anos. Há predileção do sexo feminino na proporção 5:1, e da região posterior da mandíbula. Esse relato de caso apresenta uma paciente libanês de 32 anos, que se apresentou com aumento grande de volume, achados clínicos e radiológicos assintomáticos na mandíbula esquerda com duração de três anos, o diagnóstico histopatológico confirma o diagnóstico clínico. Fibroma cemento-ossificante (COF) é caracterizado pela produção óssea de crescimento lento, bem demarcada, assintomática, benigna dos maxilares. Geralmente afeta mulheres entre a idade de 20 a 40 anos na área molares e pré-molares, causando um edema, indolor, crescimento lento e expansível. A patogênese das lesões extras ósseas do COF podem não apresentar tecidos periodontais, como sugerido por Cakir e Karadayi e sim células embrionárias e membrana periodontal ectópica como sugerido por Brademann et al. em seus estudos citogenéticos. Dependendo do estágio de maturação, fibroma cemento-ossificante pode ter umavariedaderadiolúcida, mista ou completamente radiopaca. Histopatologicamente, aparecem circunscritos, ocasionalmente encapsulados com alta quantidade de formação trabecular... (AU)

Tumor odontogênico adenomatoide: relato de caso / Adenomatoide Odontogenic Tumor: Case Report

O Tumor Odontogênico Adenomatoide (TOA) é uma rara lesão benigna, que acomete, mais comumente, pacientes do sexo feminino (2:1) e jovens. A maxila é o local de maior ocorrência, com predileção pela região anterior com envolvimento do canino permanente. Clinicamente apresenta-se com um crescimento lento, progressivo e indolor, de consistência firme, que geralmente não atinge grandes proporções. Essa lesão é comumente descoberta em exames radiográficos de rotina. O TOA apresenta três variantes clínicopatológicas: folicular, extrafolicular e a forma periférica. As características radiográficas do TOA podem variar de acordo com o tipo da lesão. O presente artigo objetiva fazer o relato de um tumor odontogênico adenomatoide, presente na região anterior da maxila de uma paciente, apresentando suas características clínicas, radiográficas e histopatológicas assim como a terapêutica empregada... (AU)

The Adenomatoid Odontogenic Tumor (AOT) is a rare benign lesion, that is common in young females patients (2:1). This injury is more frequent in anterior jaw, generally involves the permanent canine. Clinically, this tumor presents slow, painless and progressive growth, firm consistency, that in general doesn't grows to large proportions. This lesion is detected in routine radiographic exams. AOT presents three clinic-pathologic nuances: follicular, extra follicular and peripheral. This paper presents an adenomatoid odontogenic tumor of a female patient aged 30 years old in the region of the right maxilla presenting their clinical, radiographic, histopathologic and therapy used. This article aims to report an adenomatoid odontogenic tumor present in the anterior maxilla of a female patient, presenting their clinical, radiological and histopathological features as well as the therapy employed... (AU)

Cherubism - A case report with long term follow up.

Cherubism is a rare non-neoplastic disease of the bone characterized by bilateral painless enlargement of the jaws giving a cherubic appearance to the patient. It is an autosomal dominant disorder but may occur sporadically. In this paper, we have tried to explain about the clinical, radiological and histopathologic features of cherubism by presenting a case study. A case study of a 7 year old male patient, who first presented with mandibular bilateral swellings to our department in 1998, has been presented. In-depth clinical, radiological and histopathologic examination was done. An extensive long-term follow-up till 11 years was maintained. When presented for the first time, radiological investigation showed characteristic multilocular lytic lesions of the mandible bilaterally. Histopathological examination of the biopsy specimen showed proliferating fibrous connective tissue interspersed by multinucleated giant cells. It was diagnosed as a case nonfamilial cherubism. Follow-up after 5 years showed involvement of the maxilla as well, which was then corrected by surgical methods. Upon follow up 11 years after the first presentation, it was seen that the lesion was regressing by itself and there was improvement in facial contour. The natural course of Cherubism through its progression, stabilization and involution of the disease after puberty, has been highlighted in this case. More, in-depth studies to understand the nature and the pathogenesis of this condition better are required.

Immunohistochemical expression of matrix metalloproteinase-9 in jaws and long bones osteosarcomas

Matrixmetalloproteinases [MMPs] are a class of matrix basement membrane degrading enzymes which were shown to be associated with metastases in several human tumors. This study is aimed to investigate the potential effect of MMP-9 in imparting the frequently reported different behavioral pattern between jaws and long bones osteosarcomas. Tissue blocks of ten cases of jaws osteosarcomas and another ten of long bones osteosarcomas were collected and stained immunohistochemically with monoclonal antibodies to MMP-9. The majority of cases [70%] were positive for MMP-9 expression which indicates a role in tumor spread, however; there was no significant difference between the sites. The study indicates that MMP-9 is probably not involved in the biologic differences between jaws and long bones osteosarcomas

Oral and maxillofacial biopsied lesions in Brazilian pediatric patients: a 16-year retrospective study / Biópsias de lesões orais e maxilo-faciais em pacientes pediatricos brasileiros: estudo retrospectivo de 16 anos

PURPOSE: To survey oral and maxillofacial lesions biopsied in a Brazilian pediatric hospital. METHODS: Biopsy records over a 16-year period (1992-2008) were retrieved from the files of the Anatomy and Pathology Service, Hospital Presidente Dutra, Federal University of Maranhão, Brazil. Pediatric cases patients aged 16 years old or younger were selected. Oral and maxillofacial diagnoses were grouped into 10 categories, and lesions were evaluated for age, gender, anatomic location and pathological diagnosis. Data were analyzed using descriptive statistics. RESULTS: Of a total of 3,550 pediatric biopsies, 88 cases (2.48 percent) were located in oral or maxillofacial sites. Similar incidence rates were observed between the genders and the prevalence of lesions was highest in the permanent dentition period (>12-16 years old). Maxilla was the most commonly affected anatomic location. As regards the diagnostic categories, the highest number of lesions was in the hyperplastic/reactive category. The most frequently encountered lesions were inflammatory fibrous hyperplasia and mucocele. Malignant lesions were rarely described. CONCLUSION: This study shows a similar trend to that reported in previous studies on the most frequent oral and maxillofacial lesions found in the pediatric population. The majority of lesions detected were benign, and malignant lesions were diagnosed in a very low number of patients.

OBJETIVO: Realizar levantamento das lesões orais e maxilo-faciais biopsiadas em um hospital pediátrico brasileiro. METODOLOGIA: Biópsias registradas ao longo de um período de 16 anos (1992-2008) foram recuperadas dos arquivos do Serviço de Anatomia e Patologia do Hospital Presidente Dutra, Universidade Federal do Maranhão, Brasil. Pacientes com até 16 anos de idade foram selecionados. Os diagnósticos de lesões orais e maxilo-faciais foram agrupados em 10 categorias e as lesões foram avaliadas quanto a idade, sexo, localização anatômica e diagnóstico. Os dados foram analisados usando estatística descritiva. RESULTADOS: De um total de 3.550 biópsias registradas, 88 casos (2,48 por cento) estavam localizadas na região oral ou maxilo-facial. Taxas de incidência similares foram observadas entre os sexos e a prevalência de lesões foi maior na dentição permanente (> 12-16 anos). A maxila foi a localização anatômica mais acometida. Quanto às categorias de diagnóstico, o maior número de lesões foi encontrado na hiperplásica/reativo. As lesões mais freqüentemente encontradas foram a hiperplasia fibrosa inflamatória e mucocele. Lesões malignas foram raramente descritas. CONCLUSÃO: Este estudo mostra uma tendência semelhante à relatada em estudos anteriores sobre as lesões mais freqüentes na região oral e maxilo-facial na população pediátrica. A maioria das lesões detectadas foram benignas, enquanto as malignas foram diagnosticadas em um número muito reduzido de pacientes.

Cherubism in siblings: A case report.

Cherubism is a benign disease of bones affecting the jaws and giving a characteristic cherubic appearance to the patient. On radiography, the lesions exhibit bilateral multilocular radiolucent areas. Histopathology shows numerous multinucleated giant cells in the background of proliferating fibrous connective tissue. Cherubism can be a solitary case. The present report describe cherubism in two siblings and briefly review the literature on this subject.

[ new index [micro angle] for evaluating sagittal jaw relationship in comparison with beta angle; a cephalometric study]

In Orthodontic diagnosis and treatment planning one of the most important issue is an accurate anteroposterior measurement of jaw relationship. The most commonly used angular and linear measurements that have been proposed, such as ANB angle and Wit's appraisal can be inaccurate and misleading due to their dependence on various factors. This study was aimed at establishing a new cephalometric measurement, named the micro angle, to assess the sagittal jaw relationship with accuracy and reproducibility. The micro angle uses 3 skeletal landmarks, point A, point B and a perpendicular line from point A to the mandibular plan. One hundred and fifteen pretreatment cephalometric radiographs of orthodontic patients [mean age 16 +/- 2 years] were selected on the basic of inclusion criteria according to their skeletal and profile patterns. The patients compromised of 30 class I, 45 class II and 40 class III skeletal relationships and profile pattern, the mean and standard deviation for the new angel [micro] and the previous reported angle [beta] were evaluated. One way analysis of variance [ANOVA] and the Newman-Keuls test were used for data analysis as well as, dermination of the new angle's specifity and sensitivity comparing with beta angle. The results obtained showed that a patient with a micro angle between 16.1 degree and 23.9 degree can be considered to have a class I skeletal pattern. A more acute micro angle is an indication of a class II skeletal pattern and a more obtuse micro angle indicates a class III skeletal pattern. The new angle [micro angle] has an acceptable specificity and sensitivity in determining the anteroposterior relation of jaws and thus can be used for assessing the type and severity of jaw discrepancies, besides the other diagnostic parameters

Odontoma of the jaws: a clinical study of 15 cases

Odontomas are benign tumor of odontogenic origin characterized by their slow growth. They may lead to interference with eruption of its associated tooth. A retrospective study was conducted on patients with odontoma of the jaws who were treated between 1999 and 2006. Patients were analyzed with regard to the following parameters: age, gender, anatomic location, size of the lesion, histopathological classification, and associated tooth. Fifteen patients with odontomas of the jaws were included, [8 females and 7 males]. Their age ranged from 9 to 38 years [mean 21.1 years]. Of the 15 cases, 11 were complex odontoma, and 4 were compound odontoma. Whereas no site preference for complex odontoma, compound odontoma had a predilection for the anterior maxilla. Although odontoma has a limited growth potential, it should be removed because it contains various tooth formulations that can predispose to cystic change, interference with eruption of permanent teeth and cause considerable destruction of bone

Aplicaciones de la tomografía computada al diagnóstico en el territorio maxilofacial y la cavidad bucal / Applications of the computed tomography to the diagnosis in the maxilofacial territory and the buccal cavity

La Tomografía Computada es muy útil para el diagnóstico de la patología maxilofacial y de la cavidad bucal. El advenimiento de los equipos multicorte ha permitido obtener imágenes de alta resolución, en diversidad de presentaciones y en menor tiempo. En este trabajo se revisan diversas aplicaciones de este examen para el diagnóstico en el territorio maxilofacial.