Surgical management of dentigerous cyst and keratocystic odontogenic tumor in children: a conservative approach and 7-year follow-up.

Dentigerous cyst (DC) is one of the most common odontogenic cysts of the jaws and rarely recurs. On the other hand, keratocystic odontogenic tumor (KCOT), formerly known as odontogenic keratocyst (OKC), is considered a benign unicystic or multicystic intraosseous neoplasm and one of the most aggressive odontogenic lesions presenting relatively high recurrence rate and a tendency to invade adjacent tissue. Two cases of these odontogenic lesions occurring in children are presented. They were very similar in clinical and radiographic characteristics, and both were treated by marsupialization. The treatment was chosen in order to preserve the associated permanent teeth with complementary orthodontic treatment to direct eruption of the associated permanent teeth. At 7-years of follow-up, none of the cases showed recurrence.

Surgical management of dentigerous cyst and keratocystic odontogenic tumor in children: a conservative approach and 7-year follow-up

Dentigerous cyst (DC) is one of the most common odontogenic cysts of the jaws and rarely recurs. On the other hand, keratocystic odontogenic tumor (KCOT), formerly known as odontogenic keratocyst (OKC), is considered a benign unicystic or multicystic intraosseous neoplasm and one of the most aggressive odontogenic lesions presenting relatively high recurrence rate and a tendency to invade adjacent tissue. Two cases of these odontogenic lesions occurring in children are presented. They were very similar in clinical and radiographic characteristics, and both were treated by marsupialization. The treatment was chosen in order to preserve the associated permanent teeth with complementary orthodontic treatment to direct eruption of the associated permanent teeth. At 7-years of follow-up, none of the cases showed recurrence.

Detecção do papilomavírus humano em lesões verrucosas orais por meio da técnica de hibridização in situ / Detection of human papillomavirus in oral warts using in situ hybridization

Objetivo: Analisar a prevalência do papilomavírus humano e seus subtipos em 50 lesões verrucosas orais, sendo 20 papilomas, 17 condilomas acuminados e 13 verrugas vulgares. Método: O método de escolha foi a hibridização in situ utilizando sondas biotiniladas de amplo espectro para papilomavírus humano e sondas específicas para papilomavírus humano 6/11, papilomavírus humano 16/18 e papilomavírus humano 31/33. Resultados: Dez dos 50 casos (20%) de lesões verrucosas orais apresentaram positividade para a reação de hibridização in situ para a sonda de amplo espectro, sendo três (3/20) papilomas, cinco (5/17) condilomas e duas (2/13) verrugas vulgares. Destes, oito (16%) apresentaram positividade para a sonda papilomavírus humano 6/11, sendo cinco condilomas acuminados, um papiloma e duas verrugas vulgares. Três casos (6%) apresentaram positividade para a sonda papilomavírus humano 16/18, sendo dois casos de condilomas acuminados e o outro caso de papiloma. Dos seis casos positivos para a sonda papilomavírus humano 31/33 (12%), quatro eram condilomas e dois eram papilomas. Conclusão: A presença do papilomavírus humano (20%) encontrada neste estudo foi baixa, porém dentro da média encontrada na literatura, mostrando que a hibridização in situ pode não detectar a presença de DNA viral quando em quantidades pequenas; nestes casos, a realização de outros métodos de detecção de papilomavírus humano pode ser necessária.

Objective: The human papillomavirus is a group of DNA epitheliotrophic viruses associated with the etiology of benign and malignant oral warts. More than 100 types have been identified and among them, 24 have been found into the oral cavity. The aim of this study was to analyze human papillomavirus prevalence and its subtypes in 50 oral warts, of which 20 were squamous papillomas, 17 condyloma acuminatum and 13 verruca vulgaris. Method: In situ hybridization was used with biotinylated DNA probes for wide-spectrum HPV and with specific probes for human papillomavirus 6/11, human papillomavirus 16/18 and human papillomavirus 31/33. Results: Human papillomavirus was present in ten (20%) of the 50 oral wart cases, 03 (3/20) squamous papillomas, 05 (5/17) condyloma acuminatum and 02 (2/13) verruca vulgaris. Of these, 8 (16%) were positive to the HPV probe 6/11 being 5 condyloma acuminatum, 1 squamous papilloma and 2 verruca vulgaris. Three cases (6%) demonstrated positivity to the human papillomavirus probe 16/18, with 2 being cases of condyloma and the other a case of squamous papilloma. Of the six positive cases to the human papillomavirus probe 31/33, (12%) 4 were condyloma acuminatum and 2 squamous papillomas. Conclusion: The human papillomavirus expression (20%) found in this study was low, but within the average found in the literature. Nonetheless, in addition to in situ hybridization, other methods may be necessary for confirming the presence of human papillomavirus.

Correlation between c-Jun and human papillomavirus in oral premalignant and malignant lesions.

c-Jun, one of the components of the transcription factor activating protein-1 (AP-1), is suggested as a factor in malignant progression of oral lesions. c-Jun and other AP-1 components relationships with human papillomavirus (HPV) infection have been investigated, but not yet focusing on oral carcinogenesis. The aim of this study was to verify whether c-Jun immunohistochemical expression is related to HPV DNA detection in oral premalignant and malignant lesions. Fifty cases diagnosed as oral leukoplakias, with different degrees of epithelial dysplasia, and as oral squamous cell carcinomas (OSCC) were submitted to immunohistochemistry to detect c-Jun and to in situ hybridization with signal amplification to assess HPV DNA. It was verified that c-Jun nuclear expression increased according to the degree of dysplasia within the lesion, with the greatest expression in OSCC. The same did not happen concerning HPV infection--a discrete proportional relation was observed in indexes found in leukoplakia with no dysplasia, leukoplakia with dysplasia and OSCC, but statistically insignificant. When separating the group of leukoplakia by degrees of dysplasia, this relation of proportion was not observed. Nevertheless, the overall prevalence of HPV infection was 24% and the high-risk HPV types were the most frequently identified, which does not allow excluding HPV as a risk factor in oral carcinogenesis. When relating c-Jun expression and HPV infection, no statistically significant relationship is observed. Results suggest then that malignant progression mediated by c-Jun is independent of the presence of HPV in oral carcinogenesis.

Evaluation of proliferative potential in oral lichen planus and oral lichenoid lesions using immunohistochemical expression of p53 and Ki67.

A small proportion of cases diagnosed as oral lichen planus (OLP) and oral lichenoid lesions (OLL) can undergo malignant transformation. Some authors, however, stand that only dysplastic lichenoid lesions, not true OLP, have the potential to progress to oral squamous cell carcinoma (OSCC). The histologic diagnosis is a subjective resource and is not always accurate in differentiating OLP from OLL. Thus, this study attempted to evaluate the malignant potential of lesions diagnosed as OLP and as OLL without dysplasia. The Streptavidin-biotin method of immunohistochemistry was used for the staining with p53 and Ki67 in 22 cases of OLP and 27 cases diagnosed as OLL. Ki67 immunoexpression was not statistically different between OLP and OLL (p = 0.353), but, p53 staining showed a significant contrast (p = 0.036). A higher average of staining was detected in the group of OLP. The study showed that apparently a diagnosis of OLP or OLL makes no difference for the patient regarding malignant transformation, although in OLP p53 showed a higher index of expression, probably related to the intensity of inflammatory infiltrate.