Influence of the degree of conversion and Bis-GMA residues of bulk fill resins on tissue toxicity in an subcutaneous model in rats.

AIM: To analyse the influence of the degree of conversion (DC) and light curing residues of different bulk fills (BFs) composites on the inflammatory profile in the subcutaneous tissue of rats. MATERIALS AND METHODS: Resin disks of BF-resins and their active conventional resins (CR; 3M®, Ivoclar®, and Kerr®) were light-cured at 2 mm (BF-superficial) and 4 mm (BF-deep) thicknesses and analyzed by infrared spectroscopy (FTIR; n = 3/group; DC and light curing residues). Then, the disks were implanted in four quadrants in the subcutaneous tissue of Wistar rats (sham, CR, BF-superficial and RF-deep), and after 7, 14, and 28 days, the animals (n = 6/day) were euthanized for histological analysis of the intensity of the inflammatory process (scores 0-3). Kruskal-Wallis/Dunn and ANOVA/Bonferroni tests were used (p < 0.05, Graph Pad Prism 5.0). RESULTS: The DC of CR 3M® did not differ significantly compared to BF-superficial and BF-deep resins (p = 0.235). The Ivoclar® and Kerr® resins showed a higher DC with CR and BF-superficial compared to the BF-deep (p = 0.005 and p = 0.011, rctively). Kerr® resins showed a higher Bis-GMA/UDMA ratio, especially in BF-deep resin (p < 0.05). 3M® and Ivoclar resins did not show high inflammation scores, but for Kerr® BF resins (superficial and deep), the inflammatory process was significantly higher than that in the CR and sham quadrants (p = 0.031). CONCLUSION: The tissue inflammatory response after resin inoculation depends on the DC and light curing residues of Bis-GMA.

Clinical-pathological and sociodemographic factors associated with the distant metastasis and overall survival of oral cavity and oropharynx squamous cell carcinoma

BACKGROUND: The objective of this study was to evaluate the influence of clinical-pathological and sociodemographic factors on the prevalence of distant metastasis (DM) and overall survival in patients with oral cavity and oropharynx squamous cell carcinoma (OOSCC). MATERIAL AND METHODS: Cross-sectional study based on the records of 404 OOSCC patients evaluated for DM, covering the period 2000-2014. We analysed the influence of age, sex, level of schooling, primary tumor subsite, treatment, marital status, family history of cancer, history of smoking and alcohol consumption, type of health care coverage (private vs. public) and overall survival. Findings were submitted to Fisher's exact test, Pearson's chi-squared test, Mantel-Cox log-rank testing and multinomial and Cox regression analysis (SPSS V. 20.0; p < 0.05). RESULTS: The prevalence of DM was 5.4% (22/404). The respiratory tract was the most affected DM site (n=9; 40.9%). Male sex (p = 0.049), oropharyngeal primary tumor (p = 0.008), stage T3-4 (p = 0.022), lymph node metastasis (N+) (p < 0.001) and palliative treatment (p = 0.005) were directly associated with DM. Patients with oral primary tumours (p = 0.343) and primary oropharyngeal tumours (p = 0.242) did not differ significantly with regard to the prevalence of DM. N+ was an independent risk factor for DM (p = 0.017). Five variables independently reduced overall survival: male sex (p = 0.035), age >65 years (p = 0.046), indigenous/brown racial type (p = 0.045), palliative treatment (p = 0.035) and DM (p = 0.048). CONCLUSIONS: Lymph node metastasis independently increased the prevalence of DM and, along with male sex, older age, brown racial type and palliative treatment, was independently associated with poor prognosis in patients with OOSCC

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Spontaneous Bisphosphonate-related Osteonecrosis Associated with a Tooth that Had a Necrotic Pulp: A Case Report.

This study reports the endodontic treatment performed in a patient who presented with spontaneous bone exposure in the mandible while using intravenous bisphosphonate medication (Zometa , Novartis Pharmaceuticals Co., Basel, Switzerland). A 63-year-old female patient was referred to a private dental clinic at Fortaleza, Brazil. The patient reported that one year before, she had undergone chemotherapy for the treatment of lung cancer and associated bone metastasis. Among the medications administered was the zolendronic acid, with dosage of 4 mg every 21 days. In the oral exam, the presence of extensive bone exposure was observed in the lingual region near tooth 37. The patient reported severe pain on palpation in the region; in the pulpal sensitivity test with cold stimulus, there was an absence of pain, characteristic of pulp necrosis. Radiographically, no periapical lesion was observed. Thus, endodontic treatment was performed, and instrumentation with Reciproc R25 files in the mesial root canals and R40 in the distal canal was done, alongside with abundant 2.5% sodium hypochlorite irrigation. Interappointment medication with calcium hydroxide was maintained for 15 days. In the second session, there was the spontaneous detachment of the exposed cortical bone fragment. The root canals were filled with gutta-percha and Endosequence BC Sealer cement. After two years, complete tissue repair was observed, and the patient presented with normal periapical tissues and the tooth in masticatory function. It may be concluded that a possible relationship between pulp and periapical infections and osteonecrosis exists in patients who use bisphosphonates.

Ránulas intraorales en una población brasileña: estudio retrospectivo del empleo de la marsupialización modificada / Intraoral ranulas in a brazilian population: a retrospective study of the use of modified marsupialization

Las ránulas son seudoquistes resultantes de la extravasación salival de las glándulas sublinguales. Diversos tratamientos han sido empleados, no obstante, la marsupializaión se ha demostrado es el método más utilizado. La modificación de la técnica convencional, haciendo un taponamiento con gasas medicadas, presenta bajos índices de recurrencia, mientras su aplicación cuidadosa. El objetivo de este trabajo fue evaluar los resultados obtenidos por el empleo de la técnica de marsupialización modificada en los casos de ránulas intraorales diagnosticadas en el Servicio de Estomatología de la Facultad de Odontología de la Universidade Federal do Ceará, entre marzo de 1999 a diciembre de 2010, y comparar estos datos con estudios previamente reportados en la literatura. Los datos, tras su colecta, fueron tabulados y analizados estadísticamente (SPSS, versión 17.0). Del total de 2.103 biopsias, 17 (0.8%) correspondieron a ránulas intraorales, con edad comprendida entre 10 y 34 años de edad (media de 22,9 años), siendo 82,4 mujeres y 17,6 hombres. El tamaño de las lesiones varió entre 0,3 y 4 cm, con un promedio de aproximadamente 1,8 cm. La técnica de marsupialización modificada empleada en 13 pacientes, presentó un solo caso de recidiva. Otras dos recurrencias fueron observadas cuando se utilizó la técnica de la extirpación de la lesión, usada en cuatro casos. Nuestros resultados mostraron que la marsupialización, con cambio de la técnica convencional, es un método conservador eficaz, aunque no estadísticamente significativo (p>0,05), debiendo ser elegido como primera opción en el tratamiento de ránulas intraorales, con tasas reducidas de recurrencia.

Ranulas are pseudocysts as a result of salivary extravasation of the sublingual glands. Various treatments have been used, however, has been shown marsupialization the most used. The modification of the conventional technique, carefully filling of the lesion with gauze soaked in nitrofurazone (Furacin ®), have low rates of recurrence. The aim of this study was to evaluate the results obtained using the technique of marsupialization modified in the treatment of intraoral ranulas diagnosed in the Service of Stomatology, Faculty of Dentistry at the Universidade Federal do Ceará, from March 1999 to December 2010, and compare these data with previously reported studies in the literature. The data, after collection, were tabulated and statistically analyzed (SPSS, version 17.0). Of the total of 2,103 biopsies, 17 (0.8%) were intraoral ranulas, aged between 10 and 34 years of age (mean 22.9 years), with 82.4 men and 17.6 women. The lesion size ranged from 0.3 to 4 cm, with an average of about 1.8 cm. Modified marsupialization technique used in 13 patients, presented a single case of recurrence. Two other recurrences were observed when using the technique of surgical excision, used in four cases. Our results showed that marsupialization, with change of the conventional technique is an effective conservative approach, although not statistically significant (p> 0.05), must be chosen as first choice in the treatment of intraoral ranulas, with reduced rates of recurrence.

Oral lipomas in a Brazilian population: A 10-year study and analysis of 450 cases reported in the literature

Objectives: Lipomas are common benign mesenchymal neoplasms that rarely occur in the oral cavity and correspond to less than 4.4% of all benign oral soft tissue tumors. This study describes the clinical, radiological and histological features of cases of oral lipomas seen over a period of 10 years and compared the findings with those reported in the literature.Study Design: All cases of oral lipomas seen between 1999 and 2009 were retrieved from the archives of the Stomatology Division of the Federal University of Ceará, Brazil. Age, gender, tumor location, clinical findings,duration, histological subtypes, and treatment outcome were recorded. In addition, the English-language literature was searched for studies published between 1966 and 2009.Results: Ten patients (6 women and 4 men) were enrolled in this study. The mean age was 53.4 years (range: 21-73 years).The specific sites involved were the oral mucosa (n=5), vestibule (n=3), gingiva (n=1), and retromolar region (n=1). The mean size of the tumors was 1.94 cm (range 1.0 to 3.0 cm). Radiographically, only one case appeared as a radiolucentarea on occlusal film. Microscopically, 4 cases were classified as simple lipoma, 4 as fibrolipoma, 1 as myxoid lipoma,and 1 as angiolipoma. The duration of the tumors ranged from 2 to 84 months, with a mean duration of 30.4 months. Allcases were treated by simple surgical excision and there was no recurrence after a mean post-treatment period of 34.5 months. The findings were compared with 450 cases of oral lipomas reported in the literature.Conclusions: Lipomas continue to be an uncommon neoplasm of the oral cavity. Radiography is a valuable tool due to the possible occurrence of bone involvement. Surgical excision is the treatment of choice and recurrenceis not expected (AU)

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Oral Granulocytic Sarcoma: A case report

Granulocytic sarcoma (GS) is a localized infiltrate of immature granulocytes in an extramedullary site. This lesion is most frequently associated with leukemia, but can occur associated with others myeloproliferative disorders. GS can affect virtually any part of the body, but lesions in the oral cavity are rare, with only 37 cases described. Case Description: We present a rare case of GS in a 23-year-old female, with a prior history of acute myeloid leukemia, presenting with a solitary mandibular swelling in the region of the erupting 3rd lower left molar. After biopsy, conventional immunohistochemical stains were positive for CD45 (hematological marker) and myeloid markers, such as myeloperoxidase, and CD68, demonstrating myeloid lineage with monocytic cells differentiation, suggesting the diagnosis of GS associated to Acute Myeloid Leukemia (AML-M5). Clinical implication: Although GS is a rare tumor in oral cavity, and its diagnosis is usually difficult, the clinician must know about its existence to make differential diagnosis (AU)