Presence of myofibroblasts and matrix metalloproteinase 2 in radicular cysts, dentigerous cysts, and keratocystic odontogenic tumors: a comparative immunohistochemical study.

INTRODUCTION: The aim of this study was to analyze the presence of myofibroblasts and matrix metalloproteinase 2 (MMP-2) in radicular cysts (RCs), dentigerous cysts (DCs), and keratocystic odontogenic tumors (KOTs). METHODS: For the study, 29 RCs, 19 DCs, and 15 KOTs were selected. Immunohistochemical reactions were performed by using anti-MMP-2 and anti-α-smooth muscle actin (SMA) antibodies. For the analysis, 10 high-power fields were observed in each case to determine the percentage of positive cells, which was classified as negative, weak, or strong. RESULTS: The presence of myofibroblasts (α-SMA-positive cells) was most common in KOTs (46.67%), followed by DCs (36.84%) and RCs (31.04%); however, it was not statistically significant (P = .8). The stromal MMP-2 expression was positive in all lesions but 1 case of KOT. Most cases of RC and DC presented strong MMP-2 expression in the stroma, whereas half of the KOTs showed similar classification. The MMP-2 expression was commonly found in the epithelial lining of the lesions; it was strong in almost all KOTs. No correlation between epithelial and stromal MMP-2 and α-SMA expressions was observed. CONCLUSIONS: Myofibroblasts and MMP-2 are frequent in RCs, DCs, and KOTs and eventually can contribute to bone resorption, favoring the progression and growth of these lesions.

Conventional Treatment of Maxillary Incisor Type III Dens Invaginatus with Periapical Lesion: A Case Report.

Dens invaginatus is a developmental dental anomaly clinically characterized by a palatine furrow that can be limited to the coronal pulp or may extend to the radicular apex. The purpose of this paper was to present a clinical case of type III dens invaginatus, identified on the maxillary right central incisor in anterior periapical radiographs, in which the tooth was submitted to conventional endodontic treatment. The results obtained after five years of clinical and radiographic followup demonstrated that conventional endodontic treatment is a clinically viable alternative in cases of type III dens invaginatus.

Syndecan-1 (CD138) and Ki-67 expression in odontogenic cystic lesions.

The aim of this study was to assess the immunohistochemical expression of syndecan-1 (CD138) and Ki-67 in radicular cysts (RC), dentigerous cysts (DC) and keratocystic odontogenic tumors (KOT). Thirty-five RC, 22 DC and 17 KOT were used in the study and immunohistochemical reactions using anti-syndecan-1 and anti-Ki-67 antibodies were performed by the streptavidin-biotin-peroxidase method. Fisher's exact test and Spearman's correlation coefficient were used for statistical analysis of data. Among the studied lesions, no differences in the syndecan-1 expression were observed, but the suprabasal expression of Ki-67 was significantly higher in KOT (p<0.0001), when compared with RC and DC. In RC, there was positive correlation between the expression (p=0.02) and intensity (p=0.0001) of syndecan-1 and between the intensity of syndecan-1 and Ki-67 expression (p=0.01). In the KOT, Ki-67 expression in the suprabasal layer correlated positively with the expression (p=0.01) and intensity (p=0.01) of syndecan-1. The expression of syndecan-1 does not seem to be a determinant factor of the distinct histopathological features and biological behavior of the studied lesions. Nevertheless, positive correlation between syndecan-1 and a cell proliferation marker was observed in RC and KOT.

Syndecan-1 (CD138) and Ki-67 expression in odontogenic cystic lesions

The aim of this study was to assess the immunohistochemical expression of syndecan-1 (CD138) and Ki-67 in radicular cysts (RC), dentigerous cysts (DC) and keratocystic odontogenic tumors (KOT). Thirty-five RC, 22 DC and 17 KOT were used in the study and immunohistochemical reactions using anti-syndecan-1 and anti-Ki-67 antibodies were performed by the streptavidin-biotin-peroxidase method. Fisher's exact test and Spearman's correlation coefficient were used for statistical analysis of data. Among the studied lesions, no differences in the syndecan-1 expression were observed, but the suprabasal expression of Ki-67 was significantly higher in KOT (p<0.0001), when compared with RC and DC. In RC, there was positive correlation between the expression (p=0.02) and intensity (p=0.0001) of syndecan-1 and between the intensity of syndecan-1 and Ki-67 expression (p=0.01). In the KOT, Ki-67 expression in the suprabasal layer correlated positively with the expression (p=0.01) and intensity (p=0.01) of syndecan-1. The expression of syndecan-1 does not seem to be a determinant factor of the distinct histopathological features and biological behavior of the studied lesions. Nevertheless, positive correlation between syndecan-1 and a cell proliferation marker was observed in RC and KOT.

O objetivo deste estudo foi avaliar a expressão imunoistoquímica de syndecan-1 (CD138) e Ki-67 em cistos radiculares (CR), cistos dentígeros (CD) e tumores odontogênicos queratocísticos (TOQ). Trinta e cinco CR, 22 CD e 17 TOQ foram utilizados no estudo e as reações imunoistoquímicas usando os anticorpos anti-syndecan-1 e anti-Ki-67 foram realizadas pelo método estreptavidina-biotina-peroxidase. Para análise estatística, o teste exato de Fisher e o coeficiente de correlação de Spearman foram utilizados. Entre as lesões estudadas, não foram observadas diferenças na expressão de syndecan-1, mas a expressão suprabasal de Ki-67 foi significativamente maior nos TOQ (p<0,0001), quando comparado aos CR e CD. No CR, havia correlação positiva entre a expressão (p=0,02) e intensidade (p=0,0001) de syndecan-1 e entre a intensidade de syndecan-1 e expressão de Ki-67 (p=0,01). No TOQ, a expressão de Ki-67 na camada suprabasal correlacionou positivamente com a expressão (p=0,01) e intensidade de expressão (p=0,01) de syndecan-1. A expressão de syndecan-1 não parece ser um fator determinante das características histopatológicas distintas e do comportamento biológico das lesões estudadas. Entretanto, correlação positiva entre syndecan-1 e um marcador de proliferação celular foi evidenciado em CR e TOQ.

Effectiveness of different final irrigation protocols in removing debris in flattened root canals.

This study evaluated in vitro the capacity of debris removal from the apical third of flattened root canals, using different final irrigation protocols. Thirty human mandibular central incisors with a mesiodistal flattened root were prepared using rotary instrumentation by Endo-Flare 25.12 and Hero 642 30.06, 35.02, 40.02 files, irrigated with 2 mL of 1% NaOCl after each file. The specimens were randomly distributed into 5 groups according to the final irrigation of root canals: Group I: 10 mL of distilled water (control), Group II: 10 mL of 1% NaOCl for 8 min, Group III: 2 mL of 1% NaOCl for 2 min (repeated 4 times), Group IV: 10 mL of 2.5% NaOCl for 8 min, and Group V: 10 mL of 2.5% NaOCl for 2 min (repeated 4 times). The apical thirds of the specimens were subjected to histological processing and 6-microm cross-sections were obtained and stained with hematoxylin-eosin. The specimens were examined under optical microscopy at x40 magnification and the images were subjected to morphometric analysis using the Scion image-analysis software. The total area of root canal and the area with debris were measured in square millimeters. Analysis of variance showed no statistically significant difference (p>0.05) among the groups GI (2.39 +/- 3.59), GII (2.91 +/- 2.21), GIII (0.73 +/- 1.36), GIV (0.95 +/- 0.84) and GV (0.51 +/- 0.22). In conclusion, the final irrigation protocols evaluated in this study using the Luer syringe presented similar performance in the removal of debris from the apical third of flattened root canals.

Effectiveness of different final irrigation protocols in removing debris in flattened root canals

This study evaluated in vitro the capacity of debris removal from the apical third of flattened root canals, using different final irrigation protocols. Thirty human mandibular central incisors with a mesiodistal flattened root were prepared using rotary instrumentation by Endo-Flare 25.12 and Hero 642 30.06, 35.02, 40.02 files, irrigated with 2 mL of 1 percent NaOCl after each file. The specimens were randomly distributed into 5 groups according to the final irrigation of root canals: Group I: 10 mL of distilled water (control), Group II: 10 mL of 1 percent NaOCl for 8 min, Group III: 2 mL of 1 percent NaOCl for 2 min (repeated 4 times), Group IV: 10 mL of 2.5 percent NaOCl for 8 min, and Group V: 10 mL of 2.5 percent NaOCl for 2 min (repeated 4 times). The apical thirds of the specimens were subjected to histological processing and 6-μm cross-sections were obtained and stained with hematoxylin-eosin. The specimens were examined under optical microscopy at ×40 magnification and the images were subjected to morphometric analysis using the Scion image-analysis software. The total area of root canal and the area with debris were measured in square millimeters. Analysis of variance showed no statistically significant difference (p>0.05) among the groups GI (2.39 ± 3.59), GII (2.91 ± 2.21), GIII (0.73 ± 1.36), GIV (0.95 ± 0.84) and GV (0.51 ± 0.22). In conclusion, the final irrigation protocols evaluated in this study using the Luer syringe presented similar performance in the removal of debris from the apical third of flattened root canals.

Este estudo avaliou, in vitro, a capacidade de remoção de debris do terço apical de canais radiculares achatados, usando diferentes protocolos de irrigação final. Trinta incisivos centrais mandibulares humanos com a raiz mésio-distal achatada foram preparados usando instrumento rotatório Endo-Flare 25.12 e limas Hero 642 30.06, 35.02, 40.02, irrigadas com 2ml de NaOCl 1 por cento após cada lima. Os espécimes foram aleatoriamente distribuídos em cinco grupos de acordo com a irrigação final dos canais radiculares: Grupo I: 10 mL de água destilada (controle), Grupo II: 10 mL de NaOCl a 1 por cento por 8 min, Grupo III: 2 mL de NaOCl a 1 por cento por 2 min (repetidos 4 vezes), Grupo IV: 10 mL de NaOCl 2,5 por cento por 8 min e Grupo V: 10 mL de NaOCl 2,5 por cento por 2 min (repetido 4 vezes). Os terços apicais dos espécimes foram submetidos a processamento histológico de rotina e cortes transversais com 6 μm de espessura foram obtidos e corados com hematoxilina e eosina. Os espécimes foram analisados em microscopia óptica com aumento final de 40 X e as imagens submetidas à análise morfométrica com a utilização do software Scion Image. A análise de variância evidenciou não haver diferença estatística (p>0,05) entre os grupos GI (2,39 ± 3,59), GII (2,91 ± 2,21), GIII (0,73 ± 1,36), GIV (0,95 ± 0,84) e GV (0,51 ± 0,22). Conclui-se que os protocolos de irrigação final utilizando a seringa Luer apresentaram comportamentos semelhantes na remoção de debris do terço apical de canais radiculares achatados.

Oral soft tissue lipomas: a case series.

OBJECTIVE: Lipomas are relatively uncommon tumours in the oral cavity; only 1% to 4% of cases occur at this site. In this study, we describe the clinical and histopathologic features of 6 cases of oral lipoma. MATERIALS AND METHODS: Between 1997 and 2005, the files for all cases of oral lipoma at the oral pathology division, University of Ribeirão Preto, São Paulo, Brazil, were retrieved for study. Clinical data were retrieved from patient records, and all cases were reviewed microscopically and classified. RESULTS: Of the 6 cases, 3 occurred in males and 3 in females; their mean age was 50.2 years (range: 28-78 years). Most cases affected the buccal mucosa and the mean size of the tumours was 3.0 cm (range: 1.5-5.0 cm). Microscopically, 4 cases were classified as lipoma, 1 as fibrolipoma and 1 as intramuscular or infiltrative lipoma. All cases had been treated by simple surgical excision and there had been no recurrence after a mean treatment time of 50.3 months (range: 8-72 months). CONCLUSION: Oral lipomas are uncommon tumours that predominantly affect the buccal mucosa and are associated with an excellent prognosis.

Ocorrência de traumatismo dental e uso do protetor bucal em praticantes de pólo aquático / Dental trauma and the use of mouthguards by water polo players

O presente estudo verificou a ocorrência do traumatismo dental e o uso de protetores bucais de jogadores de pólo aquático. Cinqüenta e dois atletas responderam a questionário auto-aplicável. A análise dos resultados mostrou que 57,8% dos cirurgiões-dentistas dos atletas sabiam da prática do esporte, mas apenas 26,3% destes indicaram seu uso, apesar de 50% já terem sofrido traumatismo dental durante o esporte. O teste de Dunn demonstrou que com o aumento do tempo da prática do esporte aumentava a prevalência de traumas dentais e de estruturas de suporte (p<0,001); 96,6% dos atletas conhecem o protetor bucal e sabem de sua importância, porém nenhum faz uso do dispositivo (p<0,001). Conclui-se que o uso do protetor bucal não é disseminado entre estes atletas e que a orientação do cirurgião-dentista é essencial para mostrar que o dispositivo protege e dá segurança.

The present study verifyed the prevalence of dental trauma, and use of mouthguards in water polo players. Fifty-two athletes answered an auto-applicable survey. Results showed: 57.8% of the athletes dentist knew that they practiced the sport but only 26.3% indicated the use of mouthguards, although 50% had already suffered dental trauma during practice. Statistical analysis with the Dunn test showed that an increase in years of practice increased the prevalence of dental and surrounding structure trauma (p<0,001); 96.6% of the athletes knew of the existence of mouth guards and their importance, however, no one used them (p<0,001). We can conclude that mouthguards are not used among water polo players, and the dentists' orientation is essential to stimulate use and show that they protect during the practice of sport.

Simple bone cyst: possible misdiagnosis in periapical pathology.

Simple bone cysts are non-neoplastic bone lesions, classified as intraosseous pseudocysts without epithelial lining, that can be empty or filled by fluid and display uncommon clinical and radiographic features. This article presents an unusual case of a simple bone cyst with clinical and radiographic features similar to chronic apical periodontitis. A general dentist referred an 18-year-old man for endodontic treatment after the patient complained of pain in the mandibular right second molar, which displayed a significant bony radiolucency. Chronic periapical lesion was excluded after detailed clinical and radiographic examinations. During surgical exploration, an empty bone cavity was observed and curetted before wound closure. One year later, complete healing was observed.

Carcinoma adrenocortical associado a odontoma de maxila: relato de caso clínico / Carcinoma in cortex adrenal gland associated of maxilar odontoma: case report

O trabalho relata o caso clínico de uma paciente que apresentava um carcinoma no córtex da glândula suprarenal. Seus pais procuraram atendimento médico devido ao inchaço no abdômen e ao início da pubarca com 1 ano e 8 meses e sua menarca aos 4 anos e 4 meses de idade. A paciente encontra-se na fase de dentição mista. Existe alterações na mucosa bucal como o velamento e áreas de hipocromação e hipercromação. Com o auxílio dos exames complementares, como radiografia de mão e punho, teleradiografia em norma lateral e radiografia panorâmica, pudemos conhecer a idade óssea da paciente compatível com 11 anos, e algumas características de sua dentição. Além disso constatou-se a presença de um odontoma na região abaixo do bordo insisal do dente incisivo central superior direito