Expansion of the sagittal suture induces proliferation of skeletal stem cells and sustains endogenous calvarial bone regeneration.

In newborn humans, and up to approximately 2 y of age, calvarial bone defects can naturally regenerate. This remarkable regeneration potential is also found in newborn mice and is absent in adult mice. Since previous studies showed that the mouse calvarial sutures are reservoirs of calvarial skeletal stem cells (cSSCs), which are the cells responsible for calvarial bone regeneration, here we hypothesized that the regenerative potential of the newborn mouse calvaria is due to a significant amount of cSSCs present in the newborn expanding sutures. Thus, we tested whether such regenerative potential can be reverse engineered in adult mice by artificially inducing an increase of the cSSCs resident within the adult calvarial sutures. First, we analyzed the cellular composition of the calvarial sutures in newborn and in older mice, up to 14-mo-old mice, showing that the sutures of the younger mice are enriched in cSSCs. Then, we demonstrated that a controlled mechanical expansion of the functionally closed sagittal sutures of adult mice induces a significant increase of the cSSCs. Finally, we showed that if a calvarial critical size bone defect is created simultaneously to the mechanical expansion of the sagittal suture, it fully regenerates without the need for additional therapeutic aids. Using a genetic blockade system, we further demonstrate that this endogenous regeneration is mediated by the canonical Wnt signaling. This study shows that controlled mechanical forces can harness the cSSCs and induce calvarial bone regeneration. Similar harnessing strategies may be used to develop novel and more effective bone regeneration autotherapies.

Avenues of research in dietary interventions to target tumor metabolism in osteosarcoma.

Osteosarcoma (OS) is the most frequent primary bone cancer, affecting mostly children and adolescents. Although much progress has been made throughout the years towards treating primary OS, the 5-year survival rate for metastatic OS has remained at only 20% for the last 30 years. Therefore, more efficient treatments are needed. Recent studies have shown that tumor metabolism displays a unique behavior, and plays important roles in tumor growth and metastasis, making it an attractive potential target for novel therapies. While normal cells typically fuel the oxidative phosphorylation (OXPHOS) pathway with the products of glycolysis, cancer cells acquire a plastic metabolism, uncoupling these two pathways. This allows them to obtain building blocks for proliferation from glycolytic intermediates and ATP from OXPHOS. One way to target the metabolism of cancer cells is through dietary interventions. However, while some diets have shown anticancer effects against certain tumor types in preclinical studies, as of yet none have been tested to treat OS. Here we review the features of tumor metabolism, in general and about OS, and propose avenues of research in dietary intervention, discussing strategies that could potentially be effective to target OS metabolism.

White sponge nevus: A condition not always clinically suspected.

White sponge nevus (WSN) is an uncommon benign inherited disorder characterized by white and diffuse painless lesions in oral, esophageal, or genital mucosa. The lesions may develop at birth or later in childhood or adolescence, with careful clinical examination being sufficient for diagnosis in most cases. However, microscopic analysis may be necessary particularly in adults in which other whitish oral lesions may be clinically suspected. Dermatologists, dentists, and pathologists should consider WSN when evaluating multiple white oral lesions, thus preventing unnecessary treatments. Herein, we report four additional cases of WSN with emphasis on its clinical and histopathological features.

Bisphosphonate-related osteonecrosis of the jaws: Report of a case using conservative protocol.

Bisphosphonates have been the first-line treatment option for osteometabolic diseases, such as osteoporosis, hypercalcaemia in malignant bone diseases, and in bone metastasis. It is possible to observe a growing number of cases of osteonecrosis of the jaws in patients using this medication, called bisphosphonate-related osteonecrosis of the jaws. The purpose of this study was to report a conservative treatment for bisphosphonate-related osteonecrosis of the jaws--Stage 2, using antibacterial solution and low-level laser therapy. At the end of the treatment, the patient presented improvement of the lesion with the healing of the mucosa. The literature still lacks successful definite protocols, thus the present case may contribute with another option for conservative management for bisphosphonate-related osteonecrosis of the jaws. More research is necessary in order to develop a good protocol management for bisphosphonate-related osteonecrosis of the jaws.

Value of videoroscopy in the detection of alterations of Actinic Cheilitis and the selection of biopsy areas

BACKGROUND: To demonstrate the value of videoroscopy in identifying lesions and alterations not seen by oroscopy and to select the area for biopsy. MATERIAL AND METHODS: Eighty patients were subjected to anamnesis, physical exam, videoroscopy exam, toluidine blue test and biopsy. A diagram of the lips was created to record the exact location where the lesion was found. RESULTS: Physical exam identified 287 lesions, and videoroscopy identified 587 lesions; erythema and white lesions were the most common lesions associated with actinic cheilitis. Of the 59 performed biopsies, 32 (52.4%) cases were identified by videoroscopy that showed lesions that were not detected during physical examination. CONCLUSIONS: The establishment of a diagram of the lip permitted registration of the precise location of the lesion. Videoroscopy was effective in locating lesions not seen by oroscopy. Both videoroscopy and the diagram of the lips allowed for better and earlier diagnosis and better patient follow-up for those with actinic cheilitis

Value of videoroscopy in the detection of alterations of actinic cheilitis and the selection of biopsy areas.

BACKGROUND: To demonstrate the value of videoroscopy in identifying lesions and alterations not seen by oroscopy and to select the area for biopsy. MATERIAL AND METHODS: Eighty patients were subjected to anamnesis, physical exam, videoroscopy exam, toluidine blue test and biopsy. A diagram of the lips was created to record the exact location where the lesion was found. RESULTS: Physical exam identified 287 lesions, and videoroscopy identified 587 lesions; erythema and white lesions were the most common lesions associated with actinic cheilitis. Of the 59 performed biopsies, 32 (52.4%) cases were identified by videoroscopy that showed lesions that were not detected during physical examination. CONCLUSIONS: The establishment of a diagram of the lip permitted registration of the precise location of the lesion. Videoroscopy was effective in locating lesions not seen by oroscopy. Both videoroscopy and the diagram of the lips allowed for better and earlier diagnosis and better patient follow-up for those with actinic cheilitis.

Reanatomização estética de incisivos laterais superiores possibilitando o tratamento ortodôntico: caso clínico / Esthetic reanatomization of upper lateral incisors allowing orthodontic treatment: case report

O presente trabalho teve como objetivo relatar um caso clínico de reanatomização estética de ambos os incisivos laterais superiores a fim de possibilitar o tratamento ortodôntico. A paciente,de 14 anos de idade, procurou tratamento ortodôntico na clínica da Universidade do Estado do Rio de Janeiro. Durante o exame clínico, observou-se a presença de um incisivo lateral superior permanente com tamanho atípico (12) e outro conoide mesializado (22), além de vários diastemas entre os dentes anteriores. Assim, foi realizado o encaminhamento à Clínica de Dentística para a reanatomização estética de ambos os dentes, a fim de possibilitar a colagem de braquetes ortodônticos. Restaurações diretas de resina composta foram confeccionadas através da técnica da guia de silicone. Após o procedimento, a paciente pôde realizar o tratamento ortodôntico. Contudo, será novamente encaminhada à clínica de Dentística para realização de fechamento dos diastemas depois da remoção do aparelho ortodôntico, já que a aproximação dentária necessária causaria encurtamento da arcada superior.Muitas vezes, a integração entre Dentística e Ortodontia é fundamental para a obtenção de um resultado satisfatório.

This paper aims to report a case of esthetic reanatomization of both upper lateral incisors in order to allow orthodontic treatment. A 14 year-old patient presented at the State University of Rio de Janeiro clinic for orthodontic treatment. During the clinical exam, it was possible to observe an atypically shaped upper lateral incisor (#12) and a peg-shaped mesially positioned upper lateral incisor (#22),aside from multiple diastemas between upper teeth. She was then referred to the Operative Dentistry clinic for the esthetic reanatomization of both upper lateral incisors, in order to allow the bonding of orthodontic brackets. Direct restorations using composite resin were performed using a silicone guide. After the accomplishment of the restorations, the patient was able to undergo the orthodontic treatment. However, she will return to Operative Dentistry clinic for closing diastemas after the removal of orthodontic brackets, because the dental approximation needed would cause shortening of the upper arch. In many situations,the association between Operative Dentistry and Orthodontics is mandatory for a satisfactory result.

Odontogenic keratocystic tumor: a clinical and histopathologic retrospective study based on the New WHO classification / Tumor odontogénico queratoquístico: estudio clínico e histopatológico retrospectivo basado en la nueva clasificación de la OMS

The aim was to review previous cases of Odontogenic Keratocyst or Keratocystic Odontogenic Tumor according to the new WHO classification. We used all cases diagnosed as Odontogenic Keratocyst or Keratocystic Odontogenic Tumor registered in the archives of the Pathologic Anatomy Laboratory of the Department of Pathology and Oral Diagnosis of the School of Dentistry of the Federal University of Rio de Janeiro, Rio de Janeiro, Brazil, which were collected from September, 1983 until September, 2008. The terms “Keratocyst” or “Keratocystic Odontogenic Tumor” were searched for and the following data were collected from the case files: age, sex, location of the lesion(s), and patients’ chief complaints. Hematoxilin and Eosin slides were reviewed according to the 2005 WHO criteria. The results found are in accordance with the literature. Due to its benign features, the Orthokeratinized Odontogenic Keratocyst found in our sample had its diagnosis changed to Orthokeratinized Odontogenic Cyst, as recommended by the WHO. Histopathologic exams are required for every bone lesion, in order to establish correct diagnosis. Because of its features, the Keratocystic Odontogenic Tumor must have more aggressive treatment, compared with odontogenic cysts, and long-term follow-up is mandatory.

El objetivo fue revisar los casos anteriores de queratoquiste odontogénico (QO) o tumor odontogénico queratoquístico (TOQ) de acuerdo con la nueva clasificación de la OMS. Fueron utilizados todos los casos diagnosticados como QO o TOQ registrados en los archivos del Laboratorio de Anatomía Patológica del Departamento de Patología y Diagnóstico Oral de la Facultad de Odontología de la Universidad Federal de Río de Janeiro, Rio de Janeiro, Brasil, registrados a partir de septiembre de 1983 hasta septiembre del 2008. Los términos "Queratoquiste" o "tumor queratoquistes odontogénicos" se buscaron y los siguientes datos se obtuvieron de los archivos del caso: edad, sexo, localización de la lesión (es), y quejas de los pacientes. Las muestras histológicas de hematoxilina y eosina fueron revisadas de acuerdo a los criterios de la OMS 2005. Los resultados encontrados estaban de acuerdo con la literatura. Debido a sus características benignas, el queratoquiste odontogénico ortoqueratinizado encontrado en nuestra muestra había cambiado su diagnóstico de quiste odontogénico ortoqueratinizado, según lo recomendado por la OMS. Los exámenes histopatológicos son necesarios para toda lesión ósea, con el fin de establecer el diagnóstico correcto. Debido a sus características, el TOQ debe tener un tratamiento más agresivo, en comparación con los quistes odontogénicos, donde un seguimiento a mediano y largo plazo es obligatorio.

Efeitos dos agentes clareadores sobre a polpa dental: revisão de literatura / Effects of dental bleaching agents on dental pulp: a review of the literature

O objetivo do presente trabalho foi realizar uma revisão da literatura a respeito dos efeitos do clareamento dental sobre a polpa dental, incluindo a penetração dos agentes clareadores na câmara pulpar, as ações destas substâncias no interior da polpa e, por fim, os efeitos das fontes de luz sobre a polpa. Concluiu-se que os estudos a respeito deste assunto ainda são limitados, portanto deve-se ter cautela na aplicação destes agentes, bem como das fontes luminosas, sempre respeitando as indicações para cada situação.

The aim of this paper was to review the literature about the negative effects of bleaching agents on dental pulp tissue, including the penetration of these substances on the pulp chamber, the actions of these agents inside the pulp, and the effects of light sources on pulp. It was concluded that the studies about this subject are still limited, therefore caution is necessary when these agents are used, as well as light sources, and the indications must always be respected for each situation.