[Artigo Parcialmente Retratado] Prevalência da infecção por Helicobacter pylori em pacientes dispépticos e associação com fatores de riscos clínicos para o desenvolvimento de adenocarcinoma gástrico / [article partial retraction] prevalence of helicobacter pylori infection in dyspeptic patients and its association with clinical risk factors for developing gastric adenocarcinoma

ABSTRACT BACKGROUND: In Brazil, particularly in the underdeveloped localities, the prevalence of Helicobacter pylori (H. pylori) infections can range up to 90%. These rates are higher in older individuals and vary by country region. H. pylori infections are linked to the development of gastric pathologies, namely mild to moderate gastritis, gastroenteritis, peptic ulcer, intestinal metaplasia, and gastric cancer. In 1994, this organism was classified by the International Agency for Research on Cancer (IARC) as pertaining to the Group 1 carcinogen for gastric adenocarcinoma etiology. Gastric cancer represents a significant public health problem, being the fourth most common malignant tumor and the second largest cause of cancer-related deaths. OBJECTIVE: To investigate the prevalence of H. pylori infection in dyspeptic patients and determine the link between clinical risk factors and gastric adenocarcinoma diagnosis. METHODS: Polymerase chain reaction (PCR) analysis was employed for molecular diagnosis of gastric tissue biopsies collected from 113 dyspeptic patients at the University Hospital of Federal University of Goiás. Molecular analyses allowed the identification of H. pylori infections. Furthermore, histopathological examinations were performed to determine the clinical risks of developing gastric malignancies. RESULTS: The test results identified 69 individuals older than 44 years, from 75 (66.4%) positive H. pylori infection samples. The prevalence of gastric adenocarcinoma in this study was 1.3%. Among the infected patients, six (8.2%) had high risk, and 67 (91.8%) had a low risk of developing gastric cancer (P<0.05). CONCLUSION: This study shows a high prevalence of H. pylori infection and identifies its contribution to gastric inflammations, which in the long term are manifested in high-risk clinical factors for the development of gastric adenocarcinoma.

RESUMO CONTEXTO: No Brasil, particularmente nas áreas mais pobres, a prevalência da infecção por Helicobacter pylori pode variar até 90%. Esses índices aumentam com o envelhecimento da população e são distintos entre as diferentes regiões do país. Podendo manifestar diferentes sintomatologias, essa infecção está diretamente relacionada com o desenvolvimento de patologias gástricas como gastrite leve a moderada, gastroenterites, úlcera péptica, metaplasia intestinal e principalmente, o câncer gástrico. Em 1994 a bactéria foi categorizada pela International Agency for Research on Cancer (IARC) como carcinógeno do Grupo 1 para adenocarcinoma gástrico, tipo de câncer que representa um importante problema de saúde pública, sendo o quarto tumor maligno mais comum e a segunda maior causa de mortes por câncer no mundo. OBJETIVO: Analisar a prevalência da bactéria em pacientes dispépticos e avaliar a associação de fatores de risco clínicos para desenvolvimento de adenocarcinoma gástrico. MÉTODOS: Biópsias de tecido gástrico coletadas de 113 pacientes dispépticos, atendidos no Hospital das Clínicas da Universidade Federal de Goiás, foram submetidas a diagnóstico molecular por meio de Reação em Cadeia da Polimerase, para identificação da infecção por Helicobacter pylori, e exame histopatológico, para avaliar o risco clínico de desenvolvimento de adenocarcinoma gástrico. RESULTADOS: Foram diagnosticadas 75 (66,4%) amostras positivas para infecção por Helicobacter pylori, sendo 69 indivíduos maiores de 44 anos de idade. A prevalência do adenocarcinoma gástrico nesse estudo foi de 1,3% e dentre os pacientes positivos para a infecção bacteriana seis (8,2%) possuem alto risco e 67 (91,8%) baixo risco de desenvolver esse tipo de câncer (P<0,05). CONCLUSÃO: Esse estudo mostra uma alta prevalência da infecção por H. pylori na população estudada e identifica sua intrínseca contribuição para inflamações gástricas, que a longo prazo se manifestam em fatores clínicos de alto risco para o desenvolvimento de adenocarcinoma gástrico.

Macrophages subpopulations in chronic periapical lesions according to clinical and morphological aspects

Abstract: The aim of this study was to evaluate macrophage M1 and M2 subpopulations in radicular cysts (RCs) and periapical granulomas (PGs) and relate them to clinical and morphological aspects. M1 macrophages were evaluated by the percentage of CD68 immunostaining associated with the inflammatory cytokine TNF-α, and M2 macrophages, by its specific CD163 antibody. The CD68+/CD163+ ratio was adopted to distinguish between the two macrophage subpopulations. Clinical, radiographic, symptomatology, treatment, and morphological parameters of lesions were collected and a significance level of p = 0.05 was adopted for statistical analysis. The results showed that the CD68+/CD163+ ratio was higher in the RCs (median = 1.22, p = 0.002), and the highest TNF-α immunostaining scores were found in RCs (p = 0.018); in PGs, the CD68+/CD163+ ratio was lower and associated with a greater CD163+ immunostaining (median = 1.02, p <0.001). The TNF-α in cyst epithelium had a score of 3 in 10 cases and predominance of M1 macrophages by CD68+/CD163+ (median = 2.23). In addition, CD68+ cells had higher percentage of immunostaining in smaller RCs (p = 0.034). Our findings suggest that increased CD68 immunostaining associated with TNF-α cytokine in RCs results in a greater differentiation of the M1 phenotype. The higher CD163 immunostaining in PGs results in greater differentiation of the M2 phenotype. Therefore, the inflammatory state promoted by M1 macrophages is related to growth and progression of RCs; on the other hand, the immunomodulatory state of M2 macrophages is related to maintenance of PGs.

Periodontitis apical: caracterización histológica y morfométrica de quistes radiculares y granulomas periapicales / Apical periodontitis: histological and morphometric characterization of radicular cysts and periapical granulomas

La periodontitis apical es una patología inflamatoria que afecta los tejidos periapicales de un diente desvitalizado. El objetivo de este estudio fue caracterizar histológica y morfométricamente las lesiones de quistes y granulomas utilizando microscopía óptica. Se analizaron seis biopsias obtenidas de dientes con indicación de exodoncia. El análisis histológico se realizó mediante microscopía óptica y microfotografías, con análisis de contraste de imágenes y conteo celular mediante ImageJ. Descripción de las características histológicas: en los quistes se observaron cavidades rodeadas de epitelio escamoso estratificado no queratinizado y una cápsula fibrosa compuesta de fibrocitos, fibroblastos e infiltrado inflamatorio crónico; en los granulomas se observaron capilares, una capsula fibrosa de fibrocitos/fibroblastos y un infiltrado inflamatorio de predominio linfocitario. Cuantificación del número celular de infiltrado inflamatorio: para quistes fue de 9,2 cel/10000 µm2, mientras que para granulomas fue de 20,8 cel/10000 µm2, sin diferencias estadísticas significativas entre ambos (p=0,654). Cuantificación del número celular de fibrocitos/fibroblastos: para quistes fue de 15,4 cel/10000 µm2, mientras que para granulomas fue de 18,5 cel/10000 µm2, sin diferencia estadística significativa (p=0,499). Porcentaje de colágeno tipo I: para los quistes fue de 37,8±19,2 %, mientras que para granulomas fue de 33,8±23,3 %, sin diferencias estadísticas significativas (p=0,704). Se observó una correlación negativa moderada para el infiltrado inflamatorio (R=0,637) y una correlación positiva baja para fibrocitos/fibroblastos (R=0,121), en relación a la cantidad de colágeno tipo I. Medición del área de las lesiones periapicales: el promedio total de las lesiones fue de 10,7±5,0 mm2, siendo el mayor tamaño un quiste de 18,1 mm2 y el menor un granuloma de 5,2 mm2. El análisis histológico permite realizar un diagnóstico diferencial de lesiones con características similares y así definir el tratamiento más adecuado.

Apical periodontitis is an inflammatory pathology that affects the periapical tissues of a devitalized tooth. The aim of this study was to histologically and morphometrically characterize lesions of cysts and granulomas using light microscopy. Six biopsies obtained from teeth with indication of exodontia were analyzed. The histological analysis was carried out by means of optical microscopy and microphotographs, with contrast analysis of images and cell count by ImageJ. A description of the histological characteristics was made, observing the cavities surrounded by stratified squamous non-keratinized epithelium and a fibrous capsule composed of fibrocytes, fibroblasts and chronic inflammatory infiltrate; in the granulomas, capillaries, a fibrous capsule of fibrocytes/fibroblasts and a predominantly lymphocytic inflammatory infiltrate were observed. In relation to quantification of the cellular number of inflammatory infiltrate, for cysts itwas of 9.2 cel / 10000 mm2, while for granulomas it was 20.8 cel / 10000 mm2, without significant statistical differences between both (p = 0.654). The quantification of the fibrocyte / fibroblast cell number was, for cysts, 15.4 cells / 10000 mm2, while for granulomas it was 18.5 cells / 10000 mm2, without significant statistical difference (p = 0.499). With respect to the percentage of collagen type I, for the cysts was 37.8 ± 19.2%, while for granulomas it was 33.8 ± 23.3%, without significant statistical differences (p = 0.704). A moderate negative correlation was observed for the inflammatory infiltrate (R = 0.667) and a low positive correlation for fibrocytes / fibroblasts (R = 0.121), in relation to the amount of type I collagen. Measurement of the area of the periapical lesions: the total average of lesions were 10.7 ± 5.0 mm2, the largest being a cyst of 18.1 mm2 and the smallest a granuloma of 5.2 mm2. The histological analysis allows to make a differential diagnosis of lesions with similar characteristics and thus define the most appropriate treatment.

Pro-inflammatory and anti-inflammatory cytokine expression in post-treatment apical periodontitis

Abstract Objective: This study evaluated the expression of pro-inflammatory (IL-1β, IL-6, IFN-γ and TNF-α) and anti-inflammatory (IL-4 and TGF-β) cytokines in apical periodontitis lesions. Correlations between these cytokines and clinical and cone-beam computed tomographic (CBCT) data were also assessed. Material and Methods: Apical periodontitis lesions' data were obtained from 27 patients subjected to periradicular surgery. Specimens were processed for histopathologic and immunohistochemical analysis. Sections were evaluated according to the amount of positive staining for each antibody. Expression levels of the target mediators were compared with clinical and CBCT data. Results: Twenty lesions were diagnosed as granuloma and 7 as cyst. In granulomas, IL-4 expression was significantly higher than IL-6 (p=0.001) and TNF-α (p=0.001). There was a significant relationship between high levels of TNF-α and lesions <5 mm (p=0.017). In cysts, IL-6 expression was significant lower than IL-4 (p=0.001) and IFN-γ (p=0.004). There was a significant relationship between high levels of TGF-β and endodontic treatment performed ≤4 years before (p=0.045). In general, IL-4 was the most expressed mediator in both cysts and granulomas. Conclusions: There was a balance between the expression of pro-inflammatory and anti-inflammatory cytokines associated with the chronic periradicular inflammatory process. TNF-α and TGF-β were related to some clinical and CBCT data.

Immunohistochemical expression of TGF-ß1 and MMP-9 in periapical lesions

Abstract The objective of this study was to evaluate the expression of matrix metalloproteinase 9 (MMP-9) and transforming growth factor beta (TGF-β1) in periapical lesion samples correlated with the intensity of the inflammatory infiltrate and thickness of the epithelial lining. Forty-five cases of periapical lesions (23 periapical granulomas and 22 radicular cysts) were subjected to morphological and immunohistochemical analyses using anti-MMP-9 and anti-TGF-β1 antibodies. The data were analyzed using the following tests: non-parametric Mann-Whitney, chi-square, Fisher's exact test and Spearman's correlation test (P<0.05). Analysis of inflammatory infiltrate revealed that 78% of periapical granulomas presented infiltrate grade III, in contrast with 32% of radicular cysts (P<0.001). Morphological evaluation of the epithelial thickness in radicular cysts revealed the presence of atrophic epithelium in 86% of the cysts. The immunostaining of MMP-9 was score 2 in 67% of the granulomas and 77% of the cysts. Both lesions were predominantly score 1 for TGF-β1. Significant differences were confirmed between the expression scores of TGF-β1 and MMP-9 in periapical granulomas (p = 0.004) and in radicular cysts (p < 0.001). Expression of TGF-β1 was different for periapical granulomas and radicular cysts. This immunoregulatory cytokine seems more representative in asymptomatic lesions. The extracellular matrix remodeling process dependent on MMP-9 seems to be similar for both periapical granulomas and radicular cysts. TGF-β1 and MMP-9 may play an important role in the maintenance of periapical lesions.

Analysis of CD57+ natural killer cells and CD8+ T lymphocytes in periapical granulomas and radicular cysts

Abstract: The aim of this study was to compare the number of CD57+ natural killer (NK) cells and CD8+ T lymphocytes between periapical granulomas (PGs) and radicular cysts (RCs). Twenty-fives cases of PGs and 25 of RCs were submitted to histological analysis and immunohistochemistry using anti-CD57 and anti-CD8 biomarkers. Positive cells were counted in 10 fields (400× magnification) and the median value was calculated for each case. Statistical tests were used to evaluate differences in the number of CD57+ NK cells and CD8+ T lymphocytes according to type of lesion, intensity of the infiltrate and thickness of the lining epithelium. The number of CD57+ NK cells and CD8+ T lymphocytes was higher in PGs than in RCs (p = 0.129 and p = 0.541, respectively). Comparison of the number of CD57+ NK cells in atrophic and hyperplastic epithelium revealed a larger number of cells in the atrophic epithelium (p = 0.042). A larger number of CD57+ NK cells and CD8+ T lymphocytes were observed in grade III infiltrates compared to grade I/II (p = 0.145 and p = 0.725, respectively). CD8+ T lymphocytes were more prevalent than CD57+ NK cells in most cases when PGs and RCs were analyzed separately or in combination (p < 0.0001). CD57+ NK cells and CD8+ T lymphocytes play a key role in antiviral defense and the presence of these cells supports evidence suggesting the participation of these microorganisms in the pathogenesis of PGs and RCs. The response mediated by CD8+ T lymphocytes was more frequent, indicating greater participation of the adaptive immunity in these chronic lesions.

Analysis of Interleukin 17A in periapical abscess and granuloma lesions

Abstract Interleukin 17A (IL-17A) is a proinflammatory cytokine responsible for the initiation and propagation of inflammation. One of its actions is the recruitment of neutrophils to the site of infection. The aim of this study was to investigate whether there is association between IL-17A expression and neutrophil infiltration in periapical abscesses and periapical granulomas, as well as to find which type of T lymphocyte effector (CD4+ or CD8+) expresses IL-17A in these lesions. Elastase, CD4, CD8, and IL-17A were analyzed by immunohistochemistry and immunofluorescence, in the biopsies of periapical lesions. Abscess lesions exhibited the highest labeling area for IL-17A (p = 0.011). During double immunofluorescence staining, there were significantly more CD4+/IL-17A+ cells compared to CD8+/IL-17A+ cells, both in the abscesses (p = 0.025) and granulomas (p = 0.011). In conclusion, IL-17A was intensively expressed in periapical abscesses rich in neutrophils. The high percentage of IL-17A in these cases suggests the participation of this cytokine particularly in the acute stages of the inflammatory process of the periapical lesions.

Displasia cemento ¢sseo periapical e o diagn¢stico diferencial com lesães de origem endod“ntica – relato de caso / Periapical cemento osseous dysplasia and differential diagnosis with lesions of endodontic origin – case report

A Displasia Cement ria Periapical ‚ um tumor odontogˆnico de origem mesenquimal, derivado do ligamento periodontal. Por nÆo apresentar sinais e sintomas, normalmente ‚ descoberto em exames radiogr ficos de rotina. O aspecto radiogr fico ‚ semelhante a lesães periapicais de origem endod“ntica, o que pode confundir o cl¡nico no momento do diagn¢stico e lev -lo a um tratamento desnecess rio. O objetivo deste trabalho foi relatar um caso cl¡nico de Displasia Cement ria Periapical, apresentar as caracter¡sticas, bem como ressaltar a importƒncia do correto diagn¢stico diferencial.

Periapical Cemento Dysplasia is an odontogenic tumor of mesenchymal origin, derived from the periodontal ligament. Because it doesn’t show signs and symptoms, it is usually discovered on routine radiographic examination. The radiographic appearance is similar to periapical lesions of endodontic origin, which can confuse the clinician at the time of diagnosis and lead to an unnecessary treatment. The aim of this study was to report a case of Periapical Cemento Dysplasia, and present its characteristics as well as underscoring the importance of the proper diagnosis.

Simultaneous analysis of T helper subsets (Th1, Th2, Th9, Th17, Th22, Tfh, Tr1 and Tregs) markers expression in periapical lesions reveals multiple cytokine clusters accountable for lesions activity and inactivity status

Previous studies demonstrate that the balance between pro- and anti-inflammatory mediators determines the stable or progressive nature of periapical granulomas by modulating the balance of the osteoclastogenic factor RANKL and its antagonist OPG. However, the cytokine networks operating in the development of periapical lesions are quite more complex than what the simple pro- versus anti-inflammatory mediators' paradigm suggests. Here we simultaneously investigated the patterns of Th1, Th2, Th9, Th17, Th22, Thf, Tr1 and Tregs cytokines/markers expression in human periapical granulomas. Methods: The expression of TNF-α, IFN-γ, IL-17A, IL23, IL21, IL-33, IL-10, IL-4, IL-9, IL-22, FOXp3 markers (via RealTimePCR array) was accessed in active/progressive (N=40) versus inactive/stable (N=70) periapical granulomas (as determined by RANKL/OPG expression ratio), and also to compare these samples with a panel of control specimens (N=26). A cluster analysis of 13 cytokine levels was performed to examine possible clustering between the cytokines in a total of 110 granulomas. Results: The expression of all target cytokines was higher in the granulomas than in control samples. TNF-α, IFN-γ, IL-17A and IL-21 mRNA levels were significantly higher in active granulomas, while in inactive lesions the expression levels of IL-4, IL-9, IL-10, IL-22 and FOXp3 were higher than in active granulomas. Five clusters were identified in inactive lesion groups, being the variance in the expression levels of IL-17, IL-10, FOXp3, IFN-γ, IL-9, IL-33 and IL-4 statistically significant (KW p<0.05). Three clusters were identified in active lesions, being the variance in the expression levels of IL-22, IL-10, IFN-γ, IL-17, IL-33, FOXp3, IL-21 and RANKL statistically significant (KW p<0.05). Conclusion: There is a clear dichotomy in the profile of cytokine expression in inactive and active periapical lesions. While the widespread ...

Microscopía electrónica de barrido del granuloma periapical de origen endodóntico / Scanning electron microscopy of periapical granulomas of endodontic origin

Objetivos: el propósito de este estudio fue observar por medio del microscopio electrónico de barrido (MEB) las estructuras que forman parte del granuloma periapical humano de origen endodóntico. Materiales y métodos. Se analizaron doce muestras obtenidas mediante criofractura y tratadas por medio de la técnica de punto crítico. Resultados: se pudieron reconocer linfocitos, polimorfonucleares neutrófilos, macrófagos, células gigantes, corpúsculos hialinos de Russell, vasos sanguíneos y áreas hemorrágicas. La mayoría de los linfocitos demostraron superficies rugosas compatibles con linfocitos T. Los macrófagos fueron frecuentemente observados en contacto con linfocitos B, o fagocitando eritrocitos u otros cuerpos extraños. Conclusiones: las observaciones realizadas sugieren que el MEB constituye un interesante medio para el estudio morfológico de las diferentes estructuras celulares que componen el granuloma periapical humano.

Stem cells and androgen receptor in human periapical periodontitis / Células madre y receptor de andrógenos en periodontitis periapical humana

Activation of macrophages in periapical granulomas occurs through the presence of cytokines, endotoxin and other genetic and epigenetic factors, allowing the initiation of inflammation and bone resorption. The present study aims to analyze the presence of CD133 protein (marker of stem cells) and the AR (androgen receptor) protein in biopsies of human odontogenic periapical granuloma. Biopsies from 14 adult male patients with diagnosis of periapical granuloma included in paraffin blocks were processed histologically to obtain 5-um thick sections. Protein presence was detected and analyzed by immunohistochemistry of CD133 and AR. The quantification considered the number of positive cells in 0.17 mm2 random areas under the microscope using a 1000X objective. Both CD133 and AR proteins are expressed abundantly in cells in pathological periapical granulomas tissue. The number of cells expressing CD133 and AR shows a wide variation coefficient, so its variation is a particular feature for each individual. We concluded that in human odontogenic periapical granuloma there are abundant stem cells and cells expressing AR that may be important for the pathogenic inflammatory process.

La activación de los macrófagos en los granulomas periapicales humanos se producen a través de la presencia de citoquinas, endotoxinas y otros factores genéticos y epigenéticos que permiten la iniciación de la inflamación y la reabsorción ósea. El presente estudio pretende analizar la presencia de proteína CD133 (marcador de células madre) y de la proteína RA (receptor de andrógenos) en las biopsias de granulomas periapicales odontogénicos humanos. Las biopsias de 14 pacientes varones adultos con diagnóstico de granuloma periapical fueron incluidos en bloques de parafina y se procesaron histológicamente para obtener secciones de 5 micras de espesor. La presencia de CD133 y RA fueron detectadas y analizadas por inmunohistoquímica. La cuantificación se realizó considerando el número de células positivas en áreas al azar de 0,17mm2, utilizando microscopio con objetivo de 1000X. Ambas proteínas, CD133 y RA se expresan en abundancia en las células del tejido patológico con granuloma periapical. El número de células que expresan CD133 y RA presentan un amplio coeficiente de variación, por lo que su variación es una característica particular de cada individuo. Se concluye que en granuloma periapical odontogénico humano se expresan abundantes células madre y proteínas receptoras de andrógenos, antecedentes que pueden sermuy importantes en la expresión y diagnosis de los procesos patológicos inflamatorios.

A scanning electron microscopic study of the patterns of external root resorption under different conditions

OBJECTIVE: The aim of this study was to examine if there are qualitative differences in the appearance of external root resorption patterns of primary teeth undergoing physiologic resorption and permanent teeth undergoing pathological root resorption in different conditions. MATERIAL AND METHODS: A total of 40 teeth undergoing external root resorption in different conditions were divided into 4 groups and prepared for examination under scanning electron microscopy at magnifications ranging from 20x to 1000x. Group I: 10 primary molars exfoliated due to physiologic root resorption; Group II: 10 permanent teeth with periapical granulomas showing signs of resorption; Group III:10 permanent teeth therapeutically extracted during the course of orthodontic therapy with evidence of resorption, and Group IV: 10 permanent teeth associated with odontogenic tumors that showed evidence of resorption. RESULTS: In Group I, the primary teeth undergoing resorption showed smooth extensive and predominantly regular areas reflecting the slow ongoing physiologic process. In Group II, the teeth with periapical granulomas showed the resorption was localized to apex with a funnel shaped appearance in most cases. Teeth in Group III, which had been subjected to a short period of light orthodontic force, showed the presence of numerous resorption craters with adjoining areas of cemental repair in some cases. Teeth associated with odontogenic tumors in Group IV showed many variations in the patterns of resorption with extensive loss of root length and a sharp cut appearance of the root in most cases. CONCLUSION: Differences were observed in the patterns of external root resorption among the studied groups of primary and permanent teeth under physiologic and pathological conditions.

Formación de los granulomas y quistes radiculares: una revisión de los aspectos inmunopatológicos / Formation of granulomas and radicular cysts: a review of the immunopathological aspects

Los granulomas y quistes radiculares representan lesiones crónicas que comprometen la región perirradicular, consideradas secuelas directas de la necrosis pulpar. El estudio de tales lesiones adquiere una importancia particular en la práctica odontológica debido a su alta frecuencia clínica. Este artículo presenta una revisión de la literatura sobre los principales eventos que llevan a la formación del granuloma periapical y la posterior formación de cavidades quísticas, dándole énfasis especial a los mecanismos inmunopatológicos relacionados con la patogénesis de tales lesiones.

Respuesta inflamatoria en granulomas apicales de pacientes VIH positivos (CDC II) y sanos (I) / Inflammatory response in apical granulomas fron HIV-positive patients (CDC II) and healthy subjects (I)

Entre las infecciones bacterianas bucales asociadas al SIDA, se describe la exacerbación de periodontitis apicales, siendo la naturaleza de las alteraciones celulares ocurridas en el ápice de dichas piezas dentarias desconocida, por lo que buscamos identificar y cuantificar células inflamatorias presentes en granulomas apicales de pacientes sanos y portadores del VIH (CDC II). Seleccionamos seis pacientes (5 hombres y 1 mujer) CDC II que tuvieran piezas dentarias con indicación de extracción y que, ya sea a la radiografía o al momento de hacer la extracción, se observara lesión apical. Estas las comparamos con 10 casos diagnosticados como granulomas apicales en el Instituto de Referencia de Patología Oral de la Facultad de Odontología de la Universidad de Chile y utilizando técnicas histológicas convencionales, evaluamos la presencia de PMNN, linfocitos, plasmocitos, macrófagos, fibroblastos, células en espuma, células no determinadas, áreas con y sin infiltrado inflamatorio y áreas con islotes epiteliales. Encontramos que los linfocitos fueron la población celular más numerosa en ambos grupos de pacientes, VIH+ (CDC II) y sanos, así como una mayor dificultad en la identificación celular en el grupo VIH+. El análisis estadístico de los recuentos celulares de los granulomas apicales en ambos tipos de pacientes no reveló diferencias estadísticamente significativas en las poblaciones celulares y áreas observadas. En el granuloma apical estarían participando reacciones de hipersensibilidad retardada, las que podrían estar alteradas en presencia de la infección por VIH, virus que podría ocasionar o condicionar alguna alteración morfológica en el infiltrado inflamatorio de las lesiones apicales

Células cebadas en granulomas periapicales humanos / Mast cells in human periapical granuloma

La célula cebada está presente en los procesos inflamatorios periapicales crónicos (granulomas periapicales), mas su papel no está definido en este tipo de reacciones. El objetivo de este estudio fue cuantificarlas en granulomas periapicales humanos (GPH) y tratar de esclarecer que papel juegan en la patogénesis de estas lesiones. Nuestros resultados muestran que las células cebadas aumentaron conforme lo hizo la edad del paciente; fueron más números en lesiones de pacientes masculinos y en la región posterior. Se observaron con mayor frecuencia en áreas de infiltración inflamatoria y la degranulación fue más común en estas zonas. Estos resultados sugieren que las células cebadas tienen un papel activo en la patogénesis de los GPH y que puede estar relacionada con la iniciación y desarrollo de la lesión granulomatosa periapical

Estudio histopatológico de granuloma periapical / Histopathologic study of the periapical granuloma

Las células plasmáticas por lo general representan el estado final de diferenciación de los linfocitos B y por lo tanto no sufren una división. Sin embargo, formas binucleadas y ocasionalmente multinucleadas de células plasmáticas se han registrado dentro de los materiales histológicos que contienen infiltrado plasmático. Se decidió conducir un estudio para proporcionar más información sobre las características microscópicas de éstas células binucleadas. De las 50 muestras quirúrgicas recolectadas de diferentes lesiones orales y examinadas con microscopio de luz, se encontraron 33 muestras con células plasmáticas binucleadas. La medida máximo de diámetro, área de superficie y volumen fueron 26.87 m, 534.61 m3 y 9466.28 m3 respectivamente. Morfológicamente, se asemejas a las células plasmáticas mononucleadas, su citoplasma contiene abundante citoplasma basofílico y una imagen perinuclear del golgi prominente. Los dos núcleos presentan una apariencia como de la cara de un reloj o la llanta de una carrosa

Lesöes periapicais crônicas: inter-relacionamento histopatológico, radiográfico e clínico dos insucessos endodônticos / Chronic periapical lesions: inter-relationship histophatologic, radiographic and clinic in endodontic failures

As periapicopatias, decorrentes dos insucessos endodônticos, foram estudadas através dos exames clínico, radiográfico e histopatológico de 150 lesöes periapicais. O estudo inter-relaciona os dados obtidos entre si e com os diagnósticos histopatológicos. Parâmetros como dor, tumefaçäo, fístula, mobilidade dentária, lesäo periodontal, fratura radicular, cirurgia anterior, reabsorçäo radicular, qualidade da obturaçäo dos canais radiculares e fenômenos histopatológicos como reaçäo inflamatória aguda exsudato purulento e fibrosamento säo estudados. Os resultados obtidos foram processados por sistemas informatizados e säo apresentados em tabelas e gráficos. As conclusöes da pesquisa mostraram que nas lesöes periapicais crônicas: a maior incidência foi de granulomas (63,3 por cento), depois os cistos (16,7 por cento); a dor esteve presente em 50 por cento do grupo testado; o diagnóstico final independeu do tamanho das periapicopatias; a tumefaçäo predomina nos granulomas; em todos os tipos e tamanhos de lesöes observaram-se fístula e reabsorçäo radicular; o exame histopatológico é relevante para estabelecer o diagnóstico e análise do processo evolutivo das periapicopatias

Granuloma piogenico vs hemangioma capilar lobular: análisis histopatológico y epidemiológico (Venezuela) / Pyogenic granuloma vs lobular capillary hemangioma: histopathologic and epidemiologic analysis (Venezuela)

Se hace una revisión de la literatura concerniente a Granuloma Piogénico en donde se destacan los aspectos clínicos e histopatológicos del mismo. De un total de 6.500 muestras procesadas en la Facultad de Odontología de la Universidad Central de Venezuela; se obtienen 238 casos de Granuloma Piogénico de los cuales se separan 24 casos histológicamente diferentes. Todas estas lesiones fueron estudiadas de acuerdo a ciertas variables epidemiológicas que incluyen edad, sexo y localización. Se hace un análisis histopatológico, se establecen comparaciones con otros estudios realizados y se obtienen conclusiones. Dentro de estas últimas se determina la existencia de un pequeño grupo que se identifica con el nombre de Hemangioma Capilar Lobular el cual se considera como una entidad