Estudo epidemiológico de biópsias realizadas em uma clínica odontológica universitária no período entre 2011 e 2018 / Epidemiological survey of biopsies performed in a dental school clinic in the period from 2011 to 2018

A grande quantidade de patologias com características clínicas semelhantes possibilita a coexistência de vários diagnósticos diferenciais frente a uma única lesão na mucosa bucal. Muitas vezes a realização de exames complementares, como a biópsia, torna-se mandatória para confirmação do diagnóstico sugestivo. Realizar levantamento dos laudos histopatológicos provenientes de biópsias executadas em uma clínica-escola odontológica no período entre 2011 e 2018. A partir dos prontuários odontológicos, as informações foram coletadas e tabuladas. Foram determinadas a frequência de cada lesão em relação ao total e ao seu próprio grupo de doenças e as características dos indivíduos. Um total de 106 diagnósticos de 105 pacientes (idade média 47,5 anos), sendo a maioria do sexo feminino (68 indivíduos - 64,8%) e leucoderma (67 indivíduos - 63,8%), foram avaliados. Em relação aos grupos de doenças, o mais representativo foi o das neoplasias benignas epiteliais ou mesenquimais (35 casos - 33%), seguido pelo dos processos proliferativos não neoplásicos (30 casos - 28,3%). Quanto aos diagnósticos, foram observados 25 diferentes, nos quais se destacaram o fibroma (30 casos - 28,3%) e a hiperplasia fibrosa inflamatória (22 casos - 20,8%). Não foi constatada nenhuma patologia maligna. Traçar o perfil epidemiológico de certo grupo de indivíduos pode muitas vezes facilitar os diagnósticos, além de auxiliar na implementação de medidas de prevenção e na orientação dos assuntos a serem abordados nos cursos das instituições de ensino superior(AU)

A large number of pathologies with similar clinical features may allow coexistence of several differential diagnoses in a single lesion on the buccal mucosa. According to the clinical picture, complementary exams such as biopsy are often mandatory to confirm the suggestive diagnosis. To carry out a survey of histopathological diagnoses from biopsies performed in a dental school clinic in the period from 2011 to 2018. Information from dental records was gathered and tabulated. The frequency of each lesion was determined in relation to the total and its own group of diseases as well as the epidemiological characteristics of the individuals. A total of 106 diagnoses from 105 patients (mean age 47.5 years) were evaluated, being the majority of them female (68 individuals - 64.8%) and white (67 individuals - 63.8%). In relation to the groups of diseases, epithelial or mesenchymal benign neoplasms (35 cases - 33%) were the most representative, followed by nonneoplastic proliferative processes (30 cases - 28.3%). Regarding the diagnoses, 25 different ones were observed, in which fibroma (30 cases - 28.3%) and inflammatory fibrous hyperplasia (22 cases - 20.8%) were more prevalent. No malignant pathology was found. To describe the epidemiological profile of a population can often facilitate diagnoses, besides assisting in the implementation of preventive measures and in the definition of graduate and post-graduate courses' scope(AU)

PAI-1, CAIX, and VEGFA expressions as prognosis markers in oral squamous cell carcinoma.

BACKGROUND: In oral squamous cell carcinoma (OSCC), the HIF-1 complex promotes the expression of genes involved in specific mechanisms of cell survival under hypoxic conditions, such as plasminogen activator inhibitor-1 (PAI-1), carbonic anhydrase 9 (CAIX), and vascular endothelial growth factor A (VEGFA). The study aimed to investigate the presence and prognostic value of PAI-1, CAIX, and VEGFA in OSCC. MATERIALS AND METHODS: Immunohistochemistry was used to analyze the expressions of these proteins in 52 tumoral tissue samples of patients with OSCC, surgically treated and followed by a minimum of 24 months after surgery. The correlations between protein expressions and clinicopathological parameters and prognosis were analyzed. RESULTS: Positive PAI-1 membrane expression was significantly associated with local disease relapse (P = .027). Multivariate analysis revealed that the positive PAI-1 membrane expression is an independent marker for local disease relapse, with approximately 14-fold increased risk when compared to negative expression (OR = 14.49; CI = 1.40-150.01, P = .025). Strong PAI-1 cytoplasmic expression was significantly associated with the less differentiation grade (P = .027). Strong CAIX membrane expression was significantly associated with local disease-free survival (P = .038). Positive CAIX cytoplasmic expression was significantly associated with lymph node affected (P = .025) and with disease-specific survival (P = .022). Multivariate analysis revealed that the positive CAIX cytoplasmic expression is an independent risk factor for disease-related death, increasing their risk approximately 3-fold when compared to negative expression (HR = 2.84; CI = 1.02-7.87, P = .045). Positive VEGFA cytoplasmic expression was significantly associated with less differentiation grade (P = .035). CONCLUSION: Our results suggest a potential role for these expressions profiles as tumor prognostic markers in OSCC patients.

Comparative effects of low-level laser therapy pre- and post-injury on mRNA expression of MyoD, myogenin, and IL-6 during the skeletal muscle repair.

This study analyzed the effect of pre-injury and post-injury irradiation with low-level laser therapy (LLLT) on the mRNA expression of myogenic regulatory factors and interleukin 6 (IL-6) during the skeletal muscle repair. Male rats were divided into six groups: control group, sham group, LLLT group, injury group; pre-injury LLLT group, and post-injury LLLT group. LLLT was performed with a diode laser (wavelength 780 nm; output power 40 mW' and total energy 3.2 J). Cryoinjury was induced by two applications of a metal probe cooled in liquid nitrogen directly onto the belly of the tibialis anterior (TA) muscle. After euthanasia, the TA muscle was removed for the isolation of total RNA and analysis of MyoD, myogenin, and IL-6 using real-time quantitative PCR. Significant increases were found in the expression of MyoD mRNA at 3 and 7 days as well as the expression of myogenin mRNA at 14 days in the post-injury LLLT group in comparison to injury group. A significant reduction was found in the expression of IL-6 mRNA at 3 and 7 days in the pre-injury LLLT and post-injury LLLT groups. A significant increase in IL-6 mRNA was found at 14 days in the post-injury LLLT group in comparison to the injury group. LLLT administered following muscle injury modulates the mRNA expression of MyoD and myogenin. Moreover, the both forms of LLLT administration were able to modulate the mRNA expression of IL-6 during the muscle repair process.

Photobiomodulation with 660-nm and 780-nm laser on activated J774 macrophage-like cells: Effect on M1 inflammatory markers.

M1 profile macrophages exert a major influence on initial tissue repair process. Few days after the occurrence of injury, macrophages in the injured region exhibit a M2 profile, attenuate the effects of the M1 population, and stimulate the reconstruction of the damaged tissue. The different effects of macrophages in the healing process suggest that these cells could be the target of therapeutic interventions. Photobiomodulation has been used to accelerate tissue repair, but little is known regarding its effect on macrophages. In the present study, J774 macrophages were activated to simulate the M1 profile and irradiated with two different sets of laser parameters (780 nm, 70 mW, 2.6J/cm(2), 1.5s and 660 nm, 15 mW, 7.5 J/cm(2), 20s). IL-6, TNF-α, iNOS and COX-2 gene and protein expression were analyzed by RT-qPCR and ELISA. Both lasers were able to reduce TNF-α and iNOS expression, and TNF-α and COX-2 production, although the parameters used for 780 nm laser provided an additional decrease. 660 nm laser parameters resulted in an up-regulation of IL-6 expression and production. These findings imply a distinct, time-dependent modulation by the two different sets of laser parameters, suggesting that the best modulation may involve more than one combination of parameters.

Low-level laser irradiation modulates cell viability and creatine kinase activity in C2C12 muscle cells during the differentiation process.

Low-level laser irradiation (LLLI) is increasingly used to treat musculoskeletal disorders, with satisfactory results described in the literature. Skeletal muscle satellite cells play a key role in muscle regeneration. The aim of the present study was to evaluate the effect of LLLI on cell viability, creatine kinase (CK) activity, and the expression of myogenic regulatory factors in C2C12 myoblasts during the differentiation process. C2C12 cells were cultured in Dulbecco's modified Eagle's medium (DMEM) containing 2% horse serum and submitted to irradiation with GaAlAs diode laser (wavelength, 780 nm; output power, 10 mW; energy density, 5 J/cm2). Cell viability and the expression of myogenic regulatory factors were assessed 24, 48, and 72 h after irradiation by 3-(4,5-dimethylthiazol-2-yl)-2,5,-diphenyltetrazolium bromide (MTT) assay and quantitative real-time polymerase chain reaction (RT-qPCR), respectively. CK activity was analyzed at 24 and 72 h. An increase in cell viability was found in the laser group in comparison to the control group at all evaluation times. CK activity was significantly increased in the laser group at 72 h. Myogenin messenger RNA (mRNA) demonstrated a tendency toward an increase in the laser group, but the difference in comparison to the control group was non-significant. In conclusion, LLLI was able to modulate cell viability and CK activity in C2C12 myoblasts during the differentiation process.

Immunoglobulin heavy chain gene rearrangement in oral B cell lymphomas.

OBJECTIVE: Oral non-Hodgkin lymphomas (NHLs) are an extensive group of malignant lymphoid cell neoplasms that are the second most common group of oral cancers. Subtyping NHL is important to plan for appropriate treatment, and the analysis of clonality is in many instances used for helping in the diagnosis of NHL. Thus, the aim of this study was to analyze immunoglobulin heavy chain (IgH) gene rearrangement in a series of oral B cell lymphomas to investigate the sensitivity of seminested polymerase chain reaction (snPCR). STUDY DESIGN: Paraffin embedded tissue samples from 16 cases of oral B cell lymphomas were retrieved and subjected to snPCR to investigate the IgH gene rearrangement. RESULTS: The results showed monoclonal IgH rearrangement in 85.7% of the cases studied, as represented by finding one band within the expected range of amplification. CONCLUSIONS: This study found that snPCR is a consistent method for the detection of gene rearrangement in paraffin-embedded tissue.

Mucoepidermoid carcinoma diagnosed in orthodontic patients.

A detailed clinical examination is important for early diagnosis of oral lesions in every dental specialty, including orthodontics, particularly because these patients are constantly checked during orthodontic treatment. This report describes 2 men receiving orthodontic treatment and who had swelling on the hard palate diagnosed as mucoepidermoid carcinoma. Both patients received appropriate treatment and had a good prognosis because of the rapid recognition of these oral lesions by their orthodontists.

Fingernail may not be a reliable biomarker of fluoride body burden from dentifrice.

Fingernail has been suggested as a biomarker of fluoride (F) body burden, but there is no consensus if it would be a reliable indicator of F exposure from dentifrice. Therefore, the present study was conducted to investigate if fingernails would have sensitivity to detect F exposure from dentifrice in young children. Twenty-three 1-3-year-old children living in the city of Piracicaba (0.72 ppm F in water), Brazil, were enrolled in two phases of different F exposure: in phase A (1st to 11th week), they were exposed to the combination of F from diet (solids and liquids) and dentifrice (1,500 microg F/g as MFP), and in phase B (12th to 29th week), only to F from diet (the use of F dentifrice was interrupted). Fingernails were weekly clipped during 35 weeks for F determination. F intake from diet and dentifrice in each phase was also determined. Both analyses were made with ion-specific electrode. F intake (Mean +/- SD) was significantly higher (p<0.01) when the children were exposed to F from diet+dentifrice than only to F from diet (0.086 +/- 0.032 and 0.040 +/- 0.009 mg F/day/kg body weight, respectively). However, F concentrations in nails collected during the whole experimental period of 35 weeks presented great variation with no trend of decreasing after F dentifrice intake interruption. The findings suggest that fingernail may not be a reliable F biomarker of body burden from dentifrice.

Oral metastasis of alveolar soft-part sarcoma: a case report and review of literature.

Alveolar soft-part sarcoma (ASPS) is a rare malignant neoplasm with uncertain histogenesis and with a distinctive morphology. It has been described in the oral cavity, but this is the first report of ASPS metastasizing to the maxillary tuber region. A 27-year-old male patient, who was under chemotherapy treatment for ASPS of the thigh, presented in our dental clinic with a painless and pedunculated nodule on the right tuber maxillae. The nodule was erythematous with smooth and lobular surface, measuring 3 cm in maximum diameter. An incisional biopsy was performed and the diagnosis of metastatic ASPS was made. Histologically, the tumor was characterized by a proliferation of polyhedral cells in pseudoalveolar pattern. Tumor cells were large, showing granular cytoplasm, periodic acid-Schiff positive diastase-resistant intracytoplasmic material, and vesicular nuclei with prominent nucleoli. Unfortunately, the patient died 2 months after the diagnosis of the oral metastasis. Metastases of ASPS to the mouth are very rare and indicate a poor prognosis.

Fingernail may not be a reliable biomarker of fluoride body burden from dentifrice

Fingernail has been suggested as a biomarker of fluoride (F) body burden, but there is no consensus if it would be a reliable indicator of F exposure from dentifrice. Therefore, the present study was conducted to investigate if fingernails would have sensitivity to detect F exposure from dentifrice in young children. Twenty-three 1-3-year-old children living in the city of Piracicaba (0.72 ppm F in water), Brazil, were enrolled in two phases of different F exposure: in phase A (1st to 11th week), they were exposed to the combination of F from diet (solids and liquids) and dentifrice (1,500 µg F/g as MFP), and in phase B (12th to 29th week), only to F from diet (the use of F dentifrice was interrupted). Fingernails were weekly clipped during 35 weeks for F determination. F intake from diet and dentifrice in each phase was also determined. Both analyses were made with ion-specific electrode. F intake (Mean ± SD) was significantly higher (p<0.01) when the children were exposed to F from diet+dentifrice than only to F from diet (0.086 ± 0.032 and 0.040 ± 0.009 mg F/day/kg body weight, respectively). However, F concentrations in nails collected during the whole experimental period of 35 weeks presented great variation with no trend of decreasing after F dentifrice intake interruption. The findings suggest that fingernail may not be a reliable F biomarker of body burden from dentifrice.

As unhas têm sido consideradas um biomarcador para a exposição ao flúor (F), mas não há consenso se é um indicador confiável para exposição ao F a partir do dentifrício. Vinte e três crianças, com idade entre 1 a 3 anos, moradoras de Piracicaba (0,72 ppm F na água), Brasil, foram submetidas a duas fases de diferentes exposição ao F: fase A (1a a 11a semanas), as crianças foram expostas à combinação de F a partir da dieta (sólidos e líquidos) e dentifrício (1500 µg F/g como MFP); e na fase B (12ª a 29ª semanas), apenas ao F da dieta, uma vez que usaram dentifrício não fluoretado. As unhas das mãos foram coletadas semanalmente durante 35 semanas para determinação de F. A exposição ao F a partir da dieta e dentifrício foi também determinada. Ambas análises foram feitas com eletrodo específico para F. A exposição ao F foi significativamente maior (p<0,001) quando as crianças foram expostas ao F da dieta + dentifrício que ao F da dieta (0,086 ± 0,032 e 0,040 ± 0,009 mg F/kg corpóreo/dia, respectivamente). Entretanto, a concentração de F nas unhas coletadas durante todo o período experimental não diminuiu após a interrupção da ingestão do F a partir do dentifrício. Os resultados sugerem que as unhas das mãos não são um biomarcador confiável para refletir a exposição ao F pelo dentifrício.

A cintilografia óssea no tratamento odontológico de pacientes em seguimento clínico de câncer de mama / Bone scintigraphy in dental treatment of patients under breast carcinoma follow-up

A cintilografia óssea é um exame de imagem que tem por objetivo a análise do metabolismo ósseo. É indicada em diversas situações, no entanto, é usada com maior freqüência no estadiamento e seguimento clínico de pacientes com tumores malignos com potencial de desenvolver metástases ósseas. Eventualmente, áreas cintilográficas positivas podem ser observadas na mandíbula e maxila desses pacientes levantando a suspeita de tumor metastático. Por outro lado, estes locais comumente apresentam afecções dentárias, levando à dúvida quanto ao diagnóstico. Neste trabalho, relatamos o caso de uma paciente de 55 anos em follow-up de carcinoma de mama que procurou tratamento odontológico devido região de hipercaptação na mandíbula.

Bone scintilography is an image exam that analyzes bone metabolism. It is performed in patients with different diseases; however it is more frequently used for bone metastasis survey in staging and follow-up of oncologic patients. Eventually, focal increased uptake in the mandible and maxilla may be observed, leading to a suspicion of a metastatic tumor. On the other hand, jaw bones usually present dental diseases, which make the condition a diagnostic challenge. In this study, we report a case of a 55 year-old-female under breast cancer follow-up, who was referred for dental evaluation due to increased uptake in the mandible.

Necessidade de tratamento odontológico de pacientes adultos e infantis atendidos pela Faculdade de Odontologia de Piracicaba (FOP-Unicamp) / Dental treatment needs of adults and children attended at the School of Dentistry of Piracicaba (FOP-Unicamp)

Diversos programas preventivos em Odontologia têm resultado em maior educação em saúde bucal, diminuição da doença cárie e menor edentulismo. Conseqüentemente, podem ser notadas alterações nas necessidades de tratamento odontológico, como a diminuição dos procedimentos mais invasivos e o aumento dos procedimentos preventivos. Sendo assim, o objetivo deste estudo foi avaliar as necessidades dos pacientes que procuram atendimento odontológico na Faculdade de Odontologia de Piracicaba (FOP-Unicamp), visando melhorias no planejamento da grade curricular e no serviço oferecido à comunidade. Foram avaliados prontuários de mil pacientes infantis e mil pacientes adultos. Observou-se entre os pacientes adultos um grande número de necessidades, sendo mais freqüetes nas áreas de periodontia, dentística e prótese. Já entre os pacientes infantis, pudemos observar que a maioria (87,6%) apresentava necessidades preventivas e procedimentos mais simples, como restaurações diretas Classe I. Por outro lado, apenas 12,4% dos pacientes infantis tinham necessidades mais invasivas, como tratamento endodôntico ou restaurações indiretas. De acordo com os resultados obtidos, podemos concluir que, embora os pacientes adultos tenham um acúmulo de necessidades complexas a serem efetuadas, uma alteração no enfoque da Odontologia, de curativo para preventivo, já pode ser observada entre os pacientes infantis.

Achados radiográficos em pacientes infantis triados para atendimento odontológico / Radiographic findings in children screened for dental treatment

Apesar da radiografia panorâmica permitir avaliação abrangente de toda a região maxilo-mandibular, mostrando-se como importante ferramenta diagnóstica, seu uso rotineiro ainda é discutido. O Objetivo deste estudo foi avaliar a importância deste exame complementar em pacientes infantis. Foram analisadas mil radiografias panorâmicas de pacientes com idade de 3 a 12 anos, que procuraram atendimento odontológico na FO de Piracicaba - Universidade Estadual de Campinas. Os achados radiográficos mais comuns foram agenesias dentárias, anomalias dentárias de forma ou tamanho de dentes supranumerários. Em menor frequência foram observadas algumas imagens sugestivas de cisto dentígeno e odontoma. Pudemos concluir que embora as alterações radiográficas não sejam comuns nesta faixa etária, o uso da radiografia panorâmica contribui para o melhor planejamento odontológico.