Evaluation of peripheral nerve fibers and mast cells in burning mouth syndrome

Abstract Emerging evidence has revealed a cross-talk in the etiopathogenesis of burning mouth syndrome (BMS) related to peripheral nerve fibers (NF) and neuropeptides secreted by mast cells. Here, we investigated the S-100+ density and PGP 9.5+ integrity of peripheral NF and the tryptase+ mast cell density in the oral mucosa of BMS patients and healthy individuals. A total of 23 oral mucosa specimens (12 BMS and 11 controls) were evaluated. The clinical diagnosis of BMS was based on a careful examination, excluding other local and systemic causes. Samples were taken from an incisional biopsy of the tongue mucosa of individuals with symptomatic BMS, while the margins of the non-neoplastic tongue biopsy served as controls of healthy individuals. Immunohistochemistry was performed to determine the density/mm2 of S-100+, PGP 9.5+ peripheral NF, and tryptase+ mast cells. Similar densities of S-100+, PGP 9.5+ peripheral NF, and tryptase+ mast cells were found in cases of BMS, with a median value of 3.70, 0.70, and 29.24/mm2, respectively, and in the control group, with a median value of 2.60, 0.80, and 26.01/mm2, respectively (p > 0.05). Moreover, the relationship between S100+ and PGP 9.5+ peripheral NF was the same in both groups (p = 0.70). This study demonstrated that there were no alterations in the density and integrity of peripheral NF in the tongue of symptomatic BMS patients. However, the sensitization of peripheral NF in this disease may not depend on mast cell density.

Assessment of child's dental anxiety/fear and stress during dental treatment: a systematic review by CEDACORE

Abstract: There is a lack of evidence on the correlation between salivary biomarkers and subjective measures of dental fear and anxiety in children. This systematic review aimed to retrieve the scientific evidence comparing the results of dental anxiety measured by salivary biomarkers with patient-reported outcomes in pediatric dental setting. The PECOS was as follows: population: pediatric patients aged ≤ 18 years; exposure: patient-reported outcome measures, such as scales and/or questionnaires; comparator: salivary biomarkers; outcome: anxiety, fear, phobia or stress during dental treatment; study design: observational studies or controlled trials. Electronic searches were conducted in PubMed, Scopus, Web of Science, and Ovid databases. Studies that compared scales/questionnaires and salivary biomarkers for the evaluation of dental anxiety, fear, and stress in children/adolescents during dental treatment were included. Certainty of evidence was assessed with GRADE. Risk of bias of the included studies was assessed with the Cochrane tool or the University of Adelaide tool. From the 314 studies identified, eight were included. Participants' age ranged from three to 13 years. The most used salivary biomarkers and instruments were cortisol and the Dental Subscale of the Children's Fear Survey Schedule, respectively. Most studies showed a weak correlation between objective and subjective measures. The main issues regarding bias were on allocation concealment, blinding of assessors, follow up, and exposure assessment. Certainty of evidence was low/very low. Evidence of salivary biomarkers and patient-reported outcome measures to investigate anxiety, fear and stress in children during in the dental environment is limited. There was no correlation between subjective and objective measures in almost all included studies.

Biological effects of formulation containing curcuminoids and Bidens Pilosa L. in oral carcinoma cell line

Abstract: FITOPROT, which contains curcuminoids and Bidens pilosa L. extract, is an innovative mucoadhesive formulation indicated for the topical treatment of chemoradiotherapy-induced oral mucositis (OM) in patients with advanced and visible oral squamous cell carcinoma. The formulation is used as a mouthwash directly on tumor tissue of patients with advanced neoplasms, without triggering cancer cell proliferation or tumor invasiveness. Thus, the aim of this study was to evaluate the biological effects of FITOPROT on an oral squamous cell carcinoma cell line (SCC-4). The viability of SCC-4 cells was assessed after exposure to FITOPROT using MTT reduction assay. The effects of the mucoadhesive formulation on cell cycle progression and cell death parameters were evaluated using flow cytometry. In addition, the inflammatory profile of the tumor cells was evaluated using the cytometric bead array (CBA) assay. FITOPROT promoted a concentration-dependent decrease in cell viability and cell cycle arrest at the G2/M phase (p < 0.05). Mitochondrial membrane potential was also altered after exposure to the formulation (p < 0.05), in parallel with a reduction in VEGF and IL-8 production (p = 0.01 and p = 0.05, respectively). In summary, the results indicate that FITOPROT reduces SCC-4 cell viability, promotes cell cycle arrest, modulates mitochondrial membrane potential, and exhibits antiangiogenic and anti-inflammatory properties, thus indicating its potential for topical use in patients with OM and visible tumors in the mouth.

Chronic inflammatory periapical diseases: a Brazilian multicenter study of 10, 381 cases and literature review

Abstract The aim of this study was to investigate the epidemiological and clinical characteristics of chronic inflammatory periapical diseases in different regions of Brazil and to compare with data from the literature. A multicenter study was carried out in four Brazilian referral centers in oral diagnosis. Histopathological records were reviewed, and all cases diagnosed microscopically as periapical granuloma, radicular cyst, and periapical abscess were included. Demographic and clinical data were collected. Descriptive statistics and Pearson's chi-square test were performed. A total of 10,381 cases of chronic inflammatory periapical diseases were found (13.8% of 74,931 archived specimens) over a period of 65 years. Radicular cysts were the most common lesion (59.9%). Women (56.1%) with a mean age of 37.01 years old (range 13 to 100 ± 14.42) and people of white skin color (59.2%) were the most affected individuals by chronic inflammatory periapical diseases. The lesions were generally asymptomatic (28.1%), located in the maxilla (60.1%), and posterior region (49.8%). The radicular cysts were larger when compared to periapical granulomas (p < 0.001). The disagreement between the clinical and histopathological diagnoses was higher when the final diagnosis was a periapical granuloma (p < 0.001). Chronic inflammatory periapical diseases continue to be common lesions affecting mainly adults. This should be a consequence of the burden of untreated caries in permanent teeth. Women are more affected and radicular cyst was the most common lesion.

FoxP3+ regulatory T cells in oral tongue squamous cell carcinoma in young and older patients

Abstract Regulatory T (Treg) cells can suppress antitumor immune response, but little is known about possible age-related differences in the number of these cells in the microenvironment of oral tongue squamous cell carcinoma (OTSCC). The aim of this study was to determine the number of FoxP3+ Treg cells in the microenvironment of OTSCC in young (≤ 45 years) and older (≥ 60 years) patients, and to correlate the findings with clinicopathological parameters (sex, tumor size/extent, regional lymph node metastasis, clinical staging, and histopathological grade of malignancy). Forty-eight OTSCCs (24 diagnosed in young patients and 24 diagnosed in older patients) were selected. Lymphocytes exhibiting nuclear immunopositivity for FoxP3 were quantified at the tumor invasive front and the results were analyzed statistically using the non-parametric Mann-Whitney test. FoxP3+ lymphocytes were observed in all cases assessed. The number of FoxP3+ lymphocytes in OTSCC tended to be higher in older patients (p = 0.055). Analysis of OTSCC in males and in early clinical stages revealed a higher number of Treg cells in older patients than in young ones (p < 0.05). In older patients, the number of Treg cells tended to be higher in smaller tumors (p = 0.079). Tumors with intense inflammatory infiltrate exhibited a larger number of Treg cells, both in young (p = 0.099) and older patients (p = 0.005). The results suggest a greater participation of Treg cells in immunoinflammatory responses in the microenvironment of OTSCC in older patients, particularly in males and in early stages.

Crossover studies of pediatric dental sedation are inappropriate

Abstract Crossover studies continue to be published in spite of warnings about their inherent risks in relation to behavioral outcomes. This study took the opportunity of access to secondary data analysis in order to demonstrate the impact of a crossover design on the outcomes of randomized clinical trials aimed at the behavior of children during dental treatment. We evaluated the effect of the sequence of sedative administration, the sedative and the participant's age on the behavior of children undergoing two sequential dental visits. Eighteen uncooperative healthy young children were equally randomly assigned to: (G1) 1.0 mg/kg oral midazolam (first session) and oral placebo (second session); (G2) oral placebo (first) and 1.0 mg/kg oral midazolam (second). One trained observer assessed children's behavior. Data were analyzed by three-way mixed ANOVA. Both midazolam [mean(SD); 71.7%(16.5)] and placebo [48.6%(33.1)] produced more struggling behavior when they were administered in the first session compared to the second one (p=0.001). For the placebo, children aged 2-3 years exhibited more struggling behavior [G1 54.9%(36.2); G2 80.5%(8.3)] than those aged 4-5 years (p=0.04). Also, the reduction of percentage of struggling behavior was higher in G1 for older children (76.2%) and in G2 for younger children (32.9%). There were significant interactions between drug and sequence of administration, and between drug and age. The results of our study confirm the conventional wisdom that crossover study design is inappropriate to evaluate children's behavior/anxiety related-dental treatment under sedation and the results of crossover studies of dental sedation should be treated with extreme caution.

Resumo Pouco se sabe sobre o impacto de um delineamento cruzado nos desfechos de ensaios clínicos randomizados voltados ao comportamento de crianças durante tratamento odontológico. Este estudo objetivou avaliar o efeito da sequência de administração do sedativo, da droga em si e da idade dos participantes no comportamento de crianças que receberam duas consultas odontológicas consecutivas. Dezoito crianças saudáveis não colaboradoras, 2-5 anos de idade, foram randomizadas em dois grupos: G1 - 1,0 mg/kg midazolam oral (primeira sessão) e placebo oral (segunda sessão); G2 - placebo (primeira) e 1,0 mg/kg midazolam oral (segunda). Um observador treinado avaliou o comportamento infantil. Os dados foram analisados por ANOVA de três fatores (alfa=0,05). Midazolam [média(DP); 71,7%(16,5)] e placebo [48,6%(33,1)] resultaram em mais comportamento não cooperativo quando administrados na primeira sessão comparado com a segunda (p=0,001). Com o uso do placebo, crianças de 2-3 anos de idade exibiram mais comportamento não cooperativo [G1 54,9%(36,2); G2 80,5%(8,3)] que as de 4-5 anos de idade (p=0,04). Além disso, a porcentagem de redução do comportamento não cooperativo foi maior em crianças mais velhas em G1 (76,2%) e em crianças mais novas em G2 (32,9%). Considerando a avaliação do comportamento infantil sob sedação, a primeira sessão odontológica influenciou a segunda visita. Os resultados deste estudo confirmam a especulação de que o delineamento cruzado é inadequado para avaliar o comportamento odontológico relacionado à ansiedade/comportamento infantil; os resultados dos ensaios cruzados de sedação odontológica devem ser tratados com extrema cautela.

Toxicological evaluation of Lafoensia pacari A. St.-Hil. (Lythraceae) stem bark extract: Acute and subchronic studies in mice

This study evaluated the safety of Lafoensia pacari A. St.-Hil. (Lythraceae) stem bark hydroalcoholic extract (LPE) through acute and subchronic toxicological assessments in mice. In the acute toxicity evaluation, a single 2000 mg/kg oral dose of LPE was administered to mice and clinical observations were conducted for 14 days. For subchronic toxicity, LPE doses (6.25-1000 mg/kg) were administered orally for 28 days and biochemical, hematological, histopathological analyses and renal and liver expression of Ki-67 were carried out. The acute oral toxicity evaluation of LPE showed no toxicity in mice and it was was classified as category 5 (LD50>2000-5000 mg/kg). In a repeated dose 28-day toxicity study, LPE (100-1000 mg/kg) led to an increase in reticulocytes, which suggests a possible proliferative effect on blood cells. In addition, LPE (400-1000 mg/kg) of produced alterations in biochemical parameters, although no microscopic changes were found in the organs analyzed. A normal expression of the Ki-67 cell proliferation indicator was observed in the kidney and liver tissues, which suggests that LPE does not bring about changes in the proliferative activity of these organs. In conclusion, LPE should be used with caution, particularly in larger doses over longer periods and also in combination with other medication.

Chondroblastic osteosarcoma mimicking periapical abscess

Abstract Lesions of non-endodontic origin may mimic periapical abscess. Osteosarcoma is a rare malignant lesion. Case report The present report describes a case of chondroblastic osteosarcoma in the periapical region of teeth #29, #30, and #31 of an 18-year-old male. Clinical history showed self-reported discomfort in the right posterior gingiva for over a month. Physical examination showed a small expansion and redness of the right mandibular buccal and lingual cortical plates, but no signs of pain or inflammation were observed. All the teeth responded positively to pulp sensibility. Periapical and panoramic radiographs showed slight periapical radiolucency in the roots of teeth #29 and #30, clear periodontal ligament space widening, and evident loss of lamina dura. Incisional biopsy was performed, and based on microscopic findings the diagnosis of chondroblastic osteosarcoma was confirmed. Conclusions Non-endodontic diseases associated with tooth root apex, such as chondroblastic osteosarcoma, should be included in differential diagnosis of jaw lesions that resemble periapical abscess.

Inflammatory response of human dental pulp to at-home and in-office tooth bleaching

ABSTRACT Tooth bleaching is a technique of choice to obtain a harmonious smile, but bleaching agents may damage the dental pulp. Objective: This study evaluated the inflammatory responses of human dental pulp after the use of two bleaching techniques. Material and Methods: Pulp samples were collected from human third molars extracted for orthodontic reasons and divided into three groups: control - no tooth bleaching (CG) (n=7); at-home bleaching with 15% carbamide peroxide (AH) (n = 10), and in-office bleaching with 38% hydrogen peroxide (IO) (n=12). Pulps were removed and stained with hematoxylin-eosin for microscopic analysis of inflammation intensity, collagen degradation, and pulp tissue organization. Immunohistochemistry was used to detect mast cells (tryptase+), blood vessels (CD31+), and macrophages (CD68+). Chi-square, Kruskal-Wallis, and Mann Whitney tests were used for statistical analysis. The level of significance was set at p<.05. Results: The inflammation intensity and the number of macrophages were significantly greater in IO than in AH and CG (p<0.05). The results of CD31+ (blood vessels per mm2) were similar in CG (61.39±20.03), AH (52.29±27.62), and IO (57.43±8.69) groups (p>0.05). No mast cells were found in the pulp samples analyzed. Conclusion: In-office bleaching with 38% hydrogen peroxide resulted in more intense inflammation, higher macrophages migration, and greater pulp damage then at-home bleaching with 15% carbamide peroxide, however, these bleaching techniques did not induce migration of mast cells and increased the number of blood vessels.

Altered ß-catenin expression in oral mucosal dysplasia: a comparative study

Objective The current study aimed to investigate the β-catenin expression in oral leukoplakia (OL) with different degrees of epithelial dysplasia and normal oral mucosa.Material and Methods Formalin-fixed, paraffin-embedded tissue samples of 39 OL (mild dysplasia n=19, moderate dysplasia n=13, and severe dysplasia n=7), and 10 normal oral mucosa (control group) were submitted to immunohistochemical reactions to anti-β-catenin primary antibody. A qualitative β-catenin analysis was performed based on the percentage of positive cells. The cellular location and the epithelial layer were also considered. The Chi-square test and the Fisher’s exact test were used to verify possible differences in the β-catenin expression among the OL groups. A p-value of <0.05 was considered statistically significant.Results Membranous expression of β-catenin in parabasal and basal layers was gradually lost in the higher degrees of epithelial dysplasia. In normal oral mucosa, β-catenin was detected only in the cytoplasmic membrane. However, a significant increase in cytoplasmic β-catenin could be observed between mild and moderate dysplasia (Fisher Exact test - p<0.001) and between mild and severe dysplasia (p<0.001).Conclusions The β-catenin cytoplasmic expression observed in this study may represent the initial stage of modifications in the E-cadherin-catenin complex, along with morphological cellular changes.

Oral midazolam reduces cortisol levels during local anaesthesia in children: a randomised controlled trial

Little is known about whether midazolam sedation can reduce salivary cortisol levels and consequently influence children’s behaviour during dental treatment. The aim of this study was to evaluate the effect of midazolam sedation on salivary cortisol and its correlation with children’s behaviour during restorative dental treatment. Eighteen healthy children, aged two to five years, were randomly assigned to two dental treatment appointments, both with physical restraint: oral midazolam 1 mg/kg (MS) and placebo (PS). An observer assessed the children’s behaviour (videos) using the Ohio State University Behavioral Rating Scale (OSUBRS). The children’s saliva was collected just after waking up, on arrival at the dental school, 25 minutes after local anaesthesia, and 25 minutes after the end of the procedure. Salivary cortisol levels were determined using the enzyme-linked immunoabsorbent assay. The data were analysed by bivariate tests and multivariate analysis of variance (5% level). Salivary cortisol levels were lower in the MS group than in the PS group at the time of anaesthesia (p = 0.004), but did not vary during the appointment within sedation (p = 0.319) or placebo (p = 0.080) groups. Children’s behaviour was negative most of the time and did not differ between MS and PS; however, the behaviour (OSUBRS) did not correlate with salivary cortisol levels. Oral midazolam is able to control salivary cortisol levels during dental treatment of pre-schoolers, which might not lead to better clinical behaviour.

Monitoring Nonsurgical and Surgical Root Canal Treatment of Teeth with Primary and Secondary Infections

The aim of this study was to monitor nonsurgical and surgical root canal treatment (RCT) of teeth with primary and secondary infections and apical periodontitis (AP). This prospective clinical study comprised the treatment of 80 patients with primary and persistent secondary infections and AP. Of this initial sample, forty patients did not return. Periapical index using cone beam computed tomography scans (CBCTPAI) was used to aid diagnosis, planning and to determine the better therapeutic strategy. Twenty patients (26 teeth) diagnosed with primary infection and AP received conventional RCT and were followed up for 10 to 36 months. Twenty patients (31 teeth) diagnosed with persistent secondary infection were submitted to periapical surgical and followed up for 6 to 30 months. The results showed RCT successful in 19/26 cases with complete AP healing (5/26 with partial repair) in 10-36 months of follow up. For the surgically managed cases, effectiveness of surgical therapy was detected in 10/31 cases with complete healing (10/31 cases with partial repair) within 6-30 months follow up. The return of patients for clinical and radiographic follow-up, and obedience to the proposed time period was very short from ideal. The levels of success in both therapeutic protocols were high. RCT failures were detected even with rigorous standard clinical protocols.

O objetivo do estudo foi monitorar tratamentos de canais radiculares (TCR) convencionais e com auxílio de cirurgia periapical. Este estudo prospectivo constituiu de 80 pacientes portadores de infecções primárias e secundárias persistentes e periodontite apical (PA). O índice periapical utilizando tomografia computadorizada de feixe cônico (CBCTPAI) foi utilizado como auxiliar no diagnóstico, planejamento e para determinar a melhor estratégia terapêutica. Apenas 40 pacientes retornaram para o TCR. Em 20 pacientes (26 dentes) com diagnósticos de infecções primárias e PA foram feitos TCR convencionais e monitoramentos por 10 a 36 meses. Em 20 pacientes (31 dentes) com diagnósticos de infecções secundárias persistentes foram submetidos a procedimentos cirúrgicos e acompanhamentos durante 6 a 30 meses. Os resultados mostraram TCR bem sucedidos em 19 de 26 casos, com curas completas das PA (5 de 26 com reparação parcial) em controles de 10 a 36 meses. Para os casos de tratamentos cirúrgicos foram detectadas eficácias das terapêuticas cirúrgicas em 10 de 31 casos com curas completas (10 de 31 casos com reparação parcial) em controles de 6 a 30 meses. O retorno dos pacientes para controle clínico e radiográfico e a obediência ao período de tempo proposto está muito aquém do ideal. Os níveis de sucesso em ambos os protocolos terapêuticos se mostraram elevados. Fracassos no TCR foram detectados mesmo utilizando protocolo clínico com rigoroso padrão.

Avaliação histológica de hidroxiapatita sintética associada a fosfato de cálcio (ß-TCP) utilizados em levantamento de assoalho de seio maxilar / Histological evaluation of biphasic hydroxyapatite associated to beta tricalcium phosphate (ß-TCP) used in maxillary sinus lift

Introdução: Quando a altura do osso alveolar residual é insuficiente na região posterior da maxila, a elevação do assoalho do seio maxilar visando a viabilizar a instalação de implantes dentários é um procedimento indicado. O enxerto autógeno (EA) de regiões intra ou extraorais é considerado o padrão ouro para esse procedimento. Novas opções de substitutos ósseos vêm surgindo, como o Straumann(r) BoneCeramic (BC) - 60% constituído de hidroxiapatita e 40% de ß tricálcio fosfato, 100% sintético -, sendo o material utilizado no presente trabalho. Objetivo: Avaliar e comparar histologicamente o comportamento deste substituto ósseo com o enxerto ósseo autógeno. Material e método: Dez pacientes saudáveis e parcialmente desdentados na região posterior da maxila foram submetidos à elevação do assoalho do seio maxilar previamente à instalação de implantes dentários osseointegráveis, sendo, destes, cinco com EA e cinco com BC. Após seis meses do tempo de integração do enxerto ósseo, as amostras foram coletadas por uma trefina e coradas em hematoxilina e eosina para microscopia. Resultado: Todos os implantes osseointegráveis apresentaram boa estabilidade primária. A análise histológica demonstrou tecido ósseo neoformado viável em quatro das cinco amostras do BC, além de um íntimo contato do tecido ósseo mineralizado recém-formado com as partículas do BC. Em uma amostra do BC, não foi observada formação de osso viável. O tecido ósseo formado a partir do EA e do BC apresentou uma característica histológica similar. Conclusão: O BC se mostrou um material adequado para a elevação do assoalho do seio maxilar previamente à instalação ...

Introduction: Sinus lift to permit insertion of implants when alveolar residual bone height is insufficient may be considered an effective procedure. The use of autogenous bone from intraoral or extraoral sources is considered as the gold standard for this procedure. New options of bone substitutes have been emphasizing, such as Straumann(r) BoneCeramic (BC), consisting of 60% of hydroxyapatite and 40% of calcium phosphate, 100% synthetic material that was used in this work. Objective: This investigation was designed to evaluate and compare the behavior of a fully synthetic biphasic calcium phosphate (BCP) 60% hydroxyapatite and 40% of ß-tricalcium phosphate (Straumann(r) Bone-Ceramic) to the autogenous bone graft (ABG) in maxillary sinus floor elevation procedure prior to installation dental implants. Material and method: Ten healthy patients who were partially edentulous in the posterior maxilla were included in this study and submitted to a unilateral maxillary sinus floor elevation procedure, with grafting using either ABG (control group; 5 patients) or BCP (test group; 5 patients). After 6 months of healing implant sites were created and biopsies taken for histological analyses. Result: A primary stability was achieved with all dental implants after the biopsies. Histological investigation showed a viable new bone tissue formed in 4 of 5 BCP specimens. Also, showed close contact between new bone and BCP particles, in 4 of 5 specimens. In 1 of 5 BCP specimens no viable bone tissue was found. Both ABG and BCP produced similar amounts of newly formed bone, with similar histologic appearance. Conclusion: The results indicate that BCP is a suitable material for sinus augmentation for the placement of dental implants. .

Matrix metalloproteinases 2 and 9 expression in canine normal prostate and with proliferative disorders / Expressão de metaloproteinases de matriz 2 e 9 na próstata canina normal e com lesões proliferativas

In this study the expression of metalloproteinases 2 (MMP-2) and 9 (MMP-9) in canine normal prostates and with proliferative disorders was evaluated to verify the role of these enzymes in extracellular matrix remodeling (ECM) and in the tissue invasion process. A total of 355 prostatic samples were obtained, from which 36 (10.1%) were normal prostates, 46 (13.0%) with benign prostatic hyperplasia (BPH), 128 (36.1%) with proliferative inflammatory atrophy (PIA), 74 (20.8%) with prostatic intraepithelial neoplasia (PIN), and 71 (20.0%) with prostatic carcinoma (PC). Difference in cytoplasmic immunohistochemical staining of MMP-2 and MMP-9 between acinar epithelium and periacinar stroma was found regarding the different diagnosis. The correlation between MMP-2 and MMP-9 expression in relation to the number of labeled cells in acinar epithelium and periacinar stroma, as well as to the staining intensity in the periacinar stromal cells was evidenced in canine prostates with PIA. In conclusion, MMP-2 and MMP-9 expression has a variation in canine prostate according to the lesion, with lower expression in normal tissue and with BPH, and higher expression in those with PIA, PIN and PC. Moreover, the inflammatory microenvironment of the PIA has influence in the activity of both enzymes.

Este estudo teve como objetivo avaliar a expressão das metaloproteinases 2 (MMP-2) e 9 (MMP-9) em próstatas caninas normais e com desordens proliferativas, verificando o papel dessas enzimas na remodelação da matriz extracelular (MEC) e no processo de invasão tecidual. Um total de 355 amostras prostáticas foram obtidas, sendo 36 (10,1%) normais, 46 (13,0%) com hiperplasia prostática benigna (HPB), 128 (36,1%) com atrofia inflamatória proliferativa (PIA), 74 (20,8%) com neoplasia intraepitelial prostática (PIN) e 71 (20,0%) com carcinoma prostático (CP). Houve diferença de imunomarcação citoplasmática para MMP-2 e MMP-9 entre o epitélio acinar e o estroma periacinar, quanto aos diferentes diagnósticos. Observou-se correlação entre a expressão de MMP-2 e MMP-9 em relação ao número de células marcadas no epitélio acinar e estroma periacinar, bem como para a intensidade de marcação das células estromais periacinares em próstatas caninas com PIA. Conclui-se que há variação na expressão de MMP-2 e MMP-9 em próstatas caninas de acordo com a lesão, com menor expressão em próstatas caninas normais e com HPB, e maior naquelas com PIA, PIN e CP. Ainda, o microambiente inflamatório na PIA influencia a atividade de ambas as enzimas.

Hypomethylation of tumor suppressor genes in odontogenic myxoma

Odontogenic myxoma (OM) is an ectomesenchymal benign odontogenic tumor characterized by spindle or stellate-shaped cells embedded in an abundant myxoid or mucoid extracellular matrix. DNA methylation is characterized by the addition of methyl groups in cytosines within CpG islands in the promoter gene. DNA methylation can decrease the expression of tumor suppressor genes and contribute to the development of neoplastic lesions. The aim of study was to evaluate the methylation pattern of the tumor suppressor genes P16 (CDKN2A), P21 (CDKN1A), P27 (CDKN1B), P53 (TP53) and RB1 in OM and dental pulp. Methylation was evaluated using methylation-specific polymerase chain reaction (PCR). The transcription was studied in some cases by using reverse transcription quantitative PCR. A higher frequency of unmethylated P27, P53, and RB1 samples was observed in the OM when compared with the dental pulp. OM expressed mRNA of all the genes evaluated. Considering all the samples together, the expression of Rb was higher in the unmethylated samples compared with the partially methylated samples. This investigation revealed hypomethylation of the genes P27, P53, and RB1 in OM. In addition, methylation of tumor suppressor genes was found to be an usual event in normal dental pulp.

O mixoma odontogênico (MO) é um tumor odontogênico benigno de origem mesenquimal caracterizado pela presença de células fusiformes ou estreladas dispostas em abundante matriz extracelular mucóide. A metilação do DNA é caracterizada pela adição de grupos metil em citosinas constituintes de ilhas CpG na região promotora do gene. A metilação pode diminuir a expressão de genes supressores de tumor e contribuir para o desenvolvimento de lesões neoplásicas. O objetivo deste trabalho foi avaliar o padrão de metilação nos genes P16 (CDKN2A), P21 (CDKN1A), P27 (CDKN1B), P53 (TP53), RB1 nos MO e na polpa dental. A metilação foi avaliada pela reação em cadeia da polimerase específica para a metilação. A transcrição dos genes foi estudada em alguns casos pela reação da transcriptase reversa (PCR quantitativa). Uma maior frequência de amostras não metiladas para os genes P27, P53 e RB1 foi observada nos MO quando comparados à polpa dental. Os MO expressaram RNAm de todos os genes avaliados. Considerando todas as amostras juntas, a expressão de Rb foi maior em amostras não metiladas comparadas as amostras parcialmente metiladas. Esta investigação mostrou a hipometilação dos genes P27, P53 e RB1 nos MO. Adicionalmente, a metilação nos genes supressores de tumor é um evento frequente em polpa dental normal.

Epidermoid cyst: highlights on diagnosis and magnetic resonance imaging features / Cisto epidermóide: processo de diagnóstico e características das imagens por ressonância magnética

Purpose: Epidermoid and dermoid cysts are extremely rare developmental cysts of a benign nature, which may occur anywhere in the body, although about 7% are found in the head and neck. This article reports a clinical case of a patient who had an epidermoid cyst and its magnetic resonance imaging (MRI) features. Case report: This case discusses an epidermoid cyst in a 36-year-old woman complaining about speech difficulty. Clinical examination revealed an extensive swelling on the floor of the mouth. MRI findings showed a cystic homogenous lesion located underneath the mylohyoid muscle which was removed by surgery. Histological examination of the mass confirmed the diagnosis of an epidermoid cyst. Conclusion: We concluded that MRI was considered useful for a more accurate diagnosis prior to treatment.

Proposta: Cistos epidermóide e dermóide são cistos de desenvolvimento extremamente raros, de natureza benigna, que podem ocorrer em qualquer região do corpo e somente 7% são encontrados na região de cabeça e pescoço. Este artigo apresenta o caso clínico de uma paciente que possuía um cisto epidermóide juntamente com as características das imagens por ressonância magnética. Descrição do caso: Paciente do gênero feminino, 36 anos, apresentou-se com queixa de dificuldade de fonação e deglutição. O exame clínico intrabucal revelou uma extensa tumefação em soalho bucal. As imagens por ressonância magnética indicaram uma lesão de natureza cística, homogênea, de conteúdo sólido e localizada abaixo do músculo milohiódeo. A lesão foi enucleada e encaminhada para exame anatomopatológico, cujo diagnóstico foi compatível com cisto epidermóide. Conclusão: A imagem por ressonância magnética foi essencial para determinar as características da lesão de acordo com a sua localização anatômica.

Análise microscópica de polpas de dentes humanos permanentes traumatizados / Microscopic analysis of the human pulp of permanent traumatized teeth

O presente estudo tem como objetivos analisar microscopicamente a polpa de 20 dentes humanos permanentes traumatizados com coroa intacta e diagnóstico clínico de necrose pulpar, e avaliar a confiabilidade desse diagnóstico mediante os achados histopatológicos. As amostras depolpas removidas foram coradas pelas técnicas de Hematoxilina e Eosina, para avaliar possíveis alterações morfológicas, e pelo método de Brown e Brenn, para verificação de microrganismos. As análises - subjetiva geral e estatística (análise de diagnóstico) - revelaram que 3 dentes (15%) nãoapresentaram tecido pulpar, sendo caracterizados como autólise total, e 17 (85%) tiveram suas amostras de polpas analisadas à microscopia, sendo que 3 (15%) apresentaram necrose parcial sem condições de reparo e 14 (70%), necrose total; em 12 (65%) das 17 amostras de polpas, pôde ser verificada, pelo método de Brown e Brenn, a presença de microrganismos e nenhum dos critérios clínicos empregados no diagnóstico de necrose pulpar em dentes traumatizados foi patognomônico. Diante dos resultados, as seguintes conclusões podem ser destacadas: a) mediante os achados microscópicos, 100% dos dentes traumatizados estavam necróticos e em 65% destes,constatou-se presença de microrganismos; b) os testes de vitalidade pulpar ao calor, ao frio e o teste de percussão vertical foram os mais confiáveis para o diagnóstico de necrose pulpar nos dentes traumatizados.

This study microscopically analyzed the pulp of 20 human permanent traumatized teeth with intact crowns and clinical diagnosis of pulp necrosis, and evaluated this diagnosis concerning histopatologic findings. The removed pulp specimens were stained with hematoxylin and eosin, for evaluation of possible morphological alterations, and Brown e Brenn method, to verify microorganisms. General subjective analysis and statistical analyses (diagnostic analysis) revealed that 3 teeth (15%) did not present pulp tissue, being characterized as complete autolysis; analysis of pulp samples was performed on the other 17 (85%) cases, among which 3 (15%) exhibited partial necrosis without possibility of repair and 14 (70%) presented complete necrosis; in 12 (65%) outof 17 pulps the presence of microorganisms could be conformed by Brown and Brenn method and none of the clinical criteria employed for the diagnosis of pulp necrosis in traumatized teeth was pathognomonic. The present results allowed the following conclusions: concerning the microscopic findings, 100% of traumatized teeth presented pulp necrosis and 65% of them with microorganisms; the pulp vitality tests to heat, cold and vertical percussion test were the most reliable to diagnose pulp necrosis in traumatized teeth.

Failure of nitric oxide production by macrophages and decrease in CD4+ T cells in oral paracoccidioidomycosis: possible mechanisms that permit local fungal multiplication

A paracoccidioidomicose é uma doença granulomatosa crônica que induz resposta inflamatória e imune específica. A participação do óxido nítrico (NO), produto da enzima óxido nítrico sintase induzível (iNOS), como uma importante molécula fungicida contra o fungo Paracoccidioides brasiliensis tem sido demonstrada. Com o objetivo de melhor caracterizar as lesões orais da paracoccidioidomicose (OP), propusemos estudo imunohistoquímico das células iNOS+ e das células CD45RO+, CD3+, CD8+, CD20+, CD68+ e mastócitos. As amostras foram distribuídas em grupos de acordo com o número de fungos viáveis por mm2. Nossos resultados demonstraram leve imunomarcação para iNOS nas células gigantes multinucleadas (MNGC) e na maioria das células mononucleares (MN), e a proporção de células MN/MNGC iNOS+ na OP foi comparável a do grupo Controle (tecido bucal clinicamente saudável). Adicionalmente, nossa análise revelou similaridade no número de células CD4+ entre o Controle e o grupo de OP com elevado número de fungos. Estes achados sugerem que a baixa expressão de iNOS e a diminuição de células CD4+ na OP podem representar possíveis mecanismos que permitiram a multiplicação local do fungo e a manutenção das lesões bucais ativas.

Estudo dos tipos e subtipos celulares predominantes e de expressão da enzima óxido nítrico sintase induzível (iNOS) na paracoccidioidomicose bucal / Investigation of predominnt cell types and subtypes and expression of the inducible nitric oxide synthase enzyme (iNOS) in oral paracoccidioidomycosis

A Paracoccidioidomicose é uma doença granulomatosa crônica que induz uma resposta inflamatória e imune específica. A participação do óxido nítrico (NO), produto da enzima óxido nítrico sintase induzível (iNOS), como uma importante molécula fungicida contra o fungo Paracoccidioides brasiliensis tem sido demonstrada. Com o objetivo de melhor caracterizar as lesões bucais da Paracoccidioidomicose e esclarecer a dinâmica da resposta imune neste sítio inflamatório, propusemo-nos a identificar e quantificar as células iNOS+, CD45RO+, CD3+, CD8+, CD20+, CD68+ e mastócitos em 20 amostras de Paracoccidioidomicose bucal (forma crônica) e 8 amostras de mucosa bucal clinicamente saudável (Controle) utilizando a técnica de imuno-histoquímica, por meio da imunoperoxidase. O número de fungos viáveis foi verificado em todas as amostras de Paracoccidioidomicose, e estas foram distribuídas em cinco grupos: 1 (1-50 fungos por 'mm POT.2'), 2 (51-100 fungos por 'mm POT.2'), 3 (101-200 fungos por 'mm POT.2'), 4 (201-400 fungos por 'mm POT.2') e 5 (401-800 fungos por 'mm POT.2'). Nossos resultados demonstraram leve imunomarcação para iNOS em todos os aglomerados de células epitelióides e células gigantes multinucleadas (CGMN), bem como forte imunomarcação em escassas células mononucleares (MN) localizadas na periferia dos granulomas. Não foi observado significante aumento na proporção de células MN e CGMN iNOS+ nos grupos de Paracoccidioidomicose bucal quando comparados individualmente com o grupo Controle. Nossos resultados também demonstraram que, embora em baixo número, os polimorfonucleares neutrófilos (PMN) presentes nos granulomas e microabscessos são fortemente iNOS+. Adicionalmente, nosso estudo revelou similaridade no número de células CD4+ quando se considerava os grupos de amostras de Paracoccidioidomicose bucal com elevado número de fungos (grupos 4 e 5) e o grupo Controle. Nossos achados sugerem que a baixa expressão de iNOS por macrófagos e CGMN na Paracoccidioidomicose bucal e o pouco número de células CD4+ nas lesões com elevado número de fungos podem representar uma falha da ativação do sistema imune local, o que permitiu a multiplicação e disseminação do fungo e manutenção das lesões bucais ativas

Selamento marginal de obturações retrógradas / The marginal sealing of retrograde fillings

Neste estudo avaliou-se o selamento marginal em obturações retrógradas com os cimentos de ionômero de vidro resisnoso (Fuji Ortho LC) e de resina expóxica com hidróxido de cálcio (Sealer 26). Foram selecionados trinta e nove caninos superiores permanentes de humanos, com raízes íntegras, retas e ápices completamente formados. Estes dentes foram preparados biomecanicamente, obturados e apicectomizados. Depois de impermeabilizados, procedeu-se a obturação retrógrada. As raízes foram divididas de maneira aleatória em 3 grupos de 13 unidades cada. Nestes foram empregados os seguintes materiais: grupo A: - Sealer 26, espatulado clinicamente; - grupo B: Sealer 26, proporcionado em 2,4g de pó para 0,68g de resina; - grupo C: Fuji Ortho LC, clinicamente proporcionando. Os dentes foram, então, imersos em solução de azul metileno à 2 por cento por 7 dias à 37°C. Posteriormente, com o seccionamento das raízes determinou-se a magnitude da infiltração com auxílio do porfilômetro. Os resultados mostraram que, entre os materiais utilizados, o cimento de ionômero de vidro Fuji Ortho LC foi o que apresentou, estatisticamente, a maior média de infiltração marginal. Não houve diferença entre grupos nos quais empregou-se o Sealer 26.