Nonsyndromic oral clefts and associated risk factors in the state of Bahia, Brazil.

AIM: Nonsyndromic cleft lip and/or palate (NSCL ± P) is the most common craniofacial birth defect. This study aims to determine demographic characteristics and the epidemiologic profile of NSCL ± P in Bahia, Brazil. SUBJECT AND METHODS: 692 patients of three Cleft Lip and Palate Treatment Centers were interviewed. RESULTS: Cleft lip and palate (CLP) was the most frequent type of oral cleft (52.8%), particularly unilateral (34.8%) and affecting the left side (p < 0.001). Family history of cleft was found in 27.6%, especially between cousins (49.7%; p < 0.001). The Salvador metropolitan area represented 45.2% of the samples, followed by Mid-South (17.7%) and Mid-North Bahia (13.9%). In the South of the state, the risk of developing CL and CLP was statistically significant (p = 0.03; p = 0.006, respectively), and in the region of Vale do São Francisco there was a significant risk of developing CLP (p = 0.01), both in relation to CP. Young age and alcohol use in pregnancy were associated to giving birth to children with CLP (p = 0.02, p = 0.03, respectively). The use of folate and other vitamins diminished the risk of developing CL and CLP if compared to CP (p = 0.009). CONCLUSION: It is hoped that the results of this research may be useful in planning actions of public service that should take care of affected individuals.

Characterization of vascular density and collagenous matrix in oral pleomorphic adenomas.

BACKGROUND: Tumor vascular density and collagen matrix organization are critical factors to neoplasia development and progression. This study aimed to analyze the variables associated with the extracellular matrix in oral pleomorphic adenomas. METHODS: This cross-sectional study comparatively evaluated 21 cases of pleomorphic adenomas and 21 sections of regular oral mucosa from the files of an oral pathology department. The tissue sections were subjected to immunohistochemical study with a monoclonal antibody specific to CD31 protein to assess vascular density and were also stained with Sirius red to evaluate the levels of collagen. The numbers of positively-stained cells were enumerated in specific fields through morphometric study, with subsequent statistical analysis. RESULTS: Higher numbers of CD31-positive cells were observed in tumor cells than in cells in the regular oral mucosa (P=0.004), which were always located around blood vessels. In tumor lesions, the correlation between the collagen area and vascular density was discrete between these two variables (r=0.046), although the association was not statistically significant. CONCLUSIONS: The results suggested that the increased expression of CD31+ in cells associated with capillaries may be related to tumor neoangiogenesis. Furthermore, an increase in the concentration of collagen fibers proportional to the number of blood vessels in the neoplastic sections suggested the active role of these lesions in the remodeling process.

Participation of the Immune System and Hedgehog Signaling in Neoangiogenesis Under Laser Photobiomodulation.

Introduction: This study aimed to characterize immune and endothelial cells, myofibroblasts and pericytes, and positive cells for hedgehog proteins in late tissue repair of rats skin wounds treated with 670 nm photobiomodulation therapy (PBMT). Methods: A blind experimental study was conducted, in order to assess the effect of PBMT in later stages of healing, with emphasis on neoangiogenesis, immune cells and Hedgehog signaling. Forty Wistar rats were allocated randomly in two groups; control and treated with a diode GaAlAs laser (9 mW, 670 nm, 0.031 W/cm2, spot size of 0.28 cm2, fluence of 4 J/ cm2 applied every other day, until a total dose of 16 J/cm2 was achieved). Standardized skin wounds were performed and the animals were euthanized at 14, 21, 28 and 35 days. Tissue sections were subjected to hematoxylin-eosin and immunohistochemistry for CD31, NG2, smooth muscle alpha actin, CD8, CD68, Ptch, Gli-2 and Ihh. All histomorphometric data were statistically analyzed and significance level was at P<0.05. Results: At late stages of wound healing, neoangiogenesis persisted as revealed for the number of CD31+ cells (P = 0.016) and NG2+ and smooth muscle alpha actin positive pericytes (P = 0.025), for both experimental groups. By day 21, laser-treated group had decreased CD68+ cells (P = 0.032) and increased CD8+ (P = 0.038). At remodeling stage, there were positive cells for the hedgehog signaling pathway family which seemed to be activated. Conclusion: These data suggest that photobiomodulation therapy was able to modulate extracellular matrix remodelling even at the later stages of wound healing.

Effect of 670 nm laser photobiomodulation on vascular density and fibroplasia in late stages of tissue repair.

This study aimed to investigate the effects of gallium-aluminum-arsenium (GaAlAs) (670 nm) laser therapy on neoangiogenesis and fibroplasia during tissue remodelling. Forty male Wistar rats underwent cutaneous surgery and were divided into 2 experimental groups: the Control and Laser group (9 mW, 670 nm, 0.031 W/cm2 , 4 J/cm2 ). After 14, 21, 28, and 35 days, the animals were euthanised. Descriptive and quantitative analyses were performed in sections stained with haematoxylin-eosin and Sirius Red, respectively. The amounts of VEGF+ and CD31+ cells were evaluated by immunohistochemistry and histomorphometric analysis, respectively. Statistical analysis was performed using the Mann-Whitney, Friedman, and Spearman correlation test, P < 0.05. The collagen expression was significantly higher in the laser group compared with the control group on days 14 and 21 after the creation of the skin wound (P = 0.008; P = 0.016) and in the control group between 14 and 28 and 14 and 35 days (P = 0.001; P = 0.007). There were more blood vessels in three periods of the study only in the (Laser) treated group, with statistical significance at day 14 (P = 0.016). There was no statistically significant difference in VEGF+ cell count in the different experimental groups throughout the study, although a positive correlation was shown with the area of collagen on days 14 and 28 (P = 0.037). Laser treatment had a positive effect in the late course of healing, particularly with regards to collagen expression and the number of newly formed vessels. VEGF+ cells were present in both experimental groups, and VEGF appeared to influence fibroplasia in the treated group.

Mast cells and its relation to collagen and VEGF in oral inflammatory lesions.

BACKGROUND: The aim of this study was to evaluate the population of intact and degranulated MCs in oral inflammatory lesions. METHODS: A cross sectional study of 48 samples, including inflammatory fibrous hyperplasia, pyogenic granulomas, periapical granulomas and radicular cysts, was performed. Samples of normal gingival mucosa were used as controls. The degree of edema and lymphoplasmacytic infiltrate was determined by the analysis of hematoxylin-eosin (HE)-stained sections. To determine the collagen fibers contents and correlate it with the MC count, sections stained with Sirius red and Toluidine blue were used. Immunohistochemistry with an antivascular endothelial growth factor (VEGF) was also used to count endothelial cells. RESULTS: Although the total number of intact MCs was higher in the oral inflammatory lesions, these differences were not statistically significant (P=0.33). There were statistically significant differences between the numbers of degranulated MCs from the lesions and those from the normal oral mucosae (P=0.001) and a positive correlation between the number of MCs and the degree of inflammation (P<0.001). The MC count did not correlate with the collagen fibers or VEGF positive cells (P>0.05). CONCLUSIONS: The involvement of MCs in the pathogenesis of the oral inflammatory lesions is suggested. However, there was no positive correlation with these cells and collagen fibers or angiogenesis in the lesions studied.

Influence of low level laser therapy on wound healing and its biological action upon myofibroblasts.

BACKGROUND AND OBJECTIVE: In re-evaluating the effects of laser therapy in wound healing, the role of extracellular matrix elements and myofibroblasts, was analyzed. STUDY DESIGN/MATERIALS AND METHODS: Cutaneous wounds were inflicted on the back of 72 Wistar rats. Low level laser was locally applied with different energy densities. Lesions were analyzed after 24, 48, 72 hours and 5, 7, and 14 days. Tissues were studied by histology, immunohistochemistry, and electron microscopy. RESULTS: In treated animals, the extent of edema and the number of inflammatory cells were reduced (P < 0.05), but the amount of collagen and elastic fibers appeared slightly increased. Desmin/smooth muscle alpha-actin-phenotype myofibroblasts were statistically more prominent on the 3rd day after surgery (P < 0.05) in treated wounds than in controls. Treatment with a dosage of 4 J/cm(2) was superior to that with 8 J/cm(2). CONCLUSIONS: Laser therapy reduced the inflammatory reaction, induced increased collagen deposition and a greater proliferation of myofibroblasts in experimental cutaneous wounds.