Mesenchymal Stem Cell Marker Expression in Periapical Abscess.

INTRODUCTION: There is evidence that acute periapical lesions present a greater potential for cyst formation. Recently, it was found that these lesions have cells with characteristics of pluripotent stem cells, which may influence cyst development. However, a more complete phenotype investigation of stem cells in a specific sample of periapical abscesses is required. The aim of this study was to analyze the immunohistochemical expression of mesenchymal stem cell (MSC) markers in periapical abscesses and to evaluate differences in their expression in relation to acute and chronic periapical lesions. METHODS: Immunohistochemistry was used to access MSC marker expression (CD44, CD73, and CD105) in samples of periapical abscesses (n = 10), granulomas (n = 10), cysts (n = 10), and apical papillae (n = 10). Immunohistochemical expression was evaluated by a quantitative scoring system. The chi-square test was used to assess the association between MSC marker expression and the histopathological diagnosis at a 5% significance level. RESULTS: CD44 and CD73 immunostaining was observed in mesenchymal cells located in the outer portion of the abscess and periapical cyst specimens. CD105 immunoexpression was found predominantly in mesenchymal and vascular endothelial cells of the lesions studied. MSC marker expression was higher in the periapical abscesses, with a significant association between MSCs and the histopathological diagnosis of an abscess (P < .05). CONCLUSIONS: The periapical region is a rich source of MSCs. The greater presence of MSCs in periapical abscesses found in this study could hold an important clue into understanding the pathological pathway of periapical cyst formation.

Osteomyelitis of the maxilla in a patient with Malignant Infantile Osteopetrosis / La osteomielitis crónica en pacientes con osteopetrosis maligna infantil. Presentación de un caso

Osteopetrosis is characterized by a considerable increase in bone density resulting in defective remodeling, caused by failure in the normal function of osteoclasts, and varies in severity. It is usually subdivided into three types: benign autosomal dominant osteopetrosis; intermediate autosomal recessive osteopetrosis; and malignant autosomal recessive infantile osteopetrosis, considered the most serious type. The authors describe a case of chronic osteomyelitis in the maxilla of a 6-year-old patient with Malignant Infantile Osteopetrosis. The treatment plan included pre-maxilla sequestrectomy and extraction of erupted upper teeth. No surgical procedure was shown to be the best to prevent the progression of oral infection. Taking into account the patient's general condition, if the patient develops severe symptomatic and refractory osteomyelitis surgery should be considered. The patient and his family are aware of the risks and benefits of surgery and its possible complications (AU)

La osteopetrosis se caracteriza por un aumento considerable de la densidad ósea que resulta en un remodelado defectuoso, causado por mal funcionamiento de los osteoclastos, de severidad variable. Usualmente se divide en 3 tipos: osteopetrosis dominante autosómica benigna, osteopetrosis recesiva autosómica intermedia y osteopetrosis infantil recesiva autosómica maligna, considerado el tipo de mayor gravedad. Los autores describen un caso de osteomielitis crónica en el maxilar superior de paciente de 6 años de edad con osteopetrosis infantil maligna. El plan de tratamiento incluyó secuestrectomía y exondoncia de los dientes superiores erupcionados. Ningún procedimento quirúrgico se ha comprobado que sea superior a otros en la prevención del avance de infecciones bucales. Tomando en cuenta las condiciones generales del paciente al desarrollar osteomielitis refractaria y sintomática severa, la cirugía debe ser considerada. El paciente y sus familiares deben ser conscientes de los riesgos y beneficios de la cirugía, así como de sus posibles complicaciones (AU)

Central mucoepidermoid carcinoma: Report of a case with 11 years’ evolution and peculiar macroscopical and clinical characteristics

Central mucoepidermoid carcinomas (CMC) are uncommon tumours, comprising 2-3% of all mucoepidermoid carcinomas reported. They have been reported in patients of all ages, ranging from 1 to 78-years, with the overwhelming majority occurring in the 4th and 5th decades of life. They are histologically low-grade cancers, usually affecting the mandible as uniocular or multiocular radiographic lesions. The authors report a case of CMC of the mandible with a long evolution, and peculiar clinical and macroscopical features related with the long term evolution of the disease. A 53-year-old male patient had expansion of buccal and lingual cortices of the anterior region of the mandible, covered by ulcerated mucosa, with 11 years evolution. An incisional biopsy was performed, and the histopathological findings confirm low-grade mucoepidermoid carcinoma. The patient was treated with a mandibulectomy, followed by supraomohyoid neck dissection. There was no evidence of local recurrence, regional or distant metastasis revealed; and the patient was alive and without disease after a follow- up interval of 36 months (AU)

Larva migrans in the oral mucosa: report of a case.

Larva migrans is a condition caused by subcutaneous or visceral migration of parasite larvae, usually Ancylostoma braziliense, and is characterized by pruriginous or serpiginous lesions. This article describes a case of larva migrans involving the oral mucosa in a 24-year-old woman.