Oral Lichenoid Lesion Manifesting as Desquamative Gingivitis: Unlikely Association? Case Report.

INTRODUCTION: The aim of this report is to present a clinical case of oral lichenoid lesions associated with amalgam restorations with the presence of desquamative gingivitis for a nine months follow up period. CASE REPORT: The histopathologic characteristics and direct immunofluorescence were compatible with Oral Lichenoid Lesion (LLO). Diagnosis was based on a synthesis of all available information, including medical history, clinical examination, histopathology and the results of specific tests, such as the patch test, which confirmed allergy to thimerosal, an organic compound of mercury. DISCUSSION: The replacement of amalgam restorations has brought improvements to the instrument, as evidenced by the disappearance of desquamative gingivitis, aspect erythematosus and erosive lesions. The fading does not complete the same, however, indicates the need to continue has been under continuous observation, the patient, having in view the possibility of the existence of an underlying lichen planus.

Pulp Revascularization: A Literature Review.

Reestablishing blood flow and allowing the continuation of root development are some of the objectives of pulp revascularization. This procedure is currently indicated for teeth with incomplete root formation as an alternative to the traditional treatment of apecification, which consists of inserting calcium hydroxide paste into the root canal for a determined time period in order to induce the formation of a calcified barrier. Although it is considered as the most classically employed therapy, the permanence of the paste for long time periods may lead to the weakening of the root due to hygroscopic properties, as well as proteolytic activities of calcium hydroxide. Therefore, there has been a permanent search for alternatives which allow the full development of immature teeth. Revascularization has emerged as such an alternative, and a range of treatment protocols can be found in the scientific literature. The aim of this paper is to accomplish a literature review concerning this issue.

Analysis of the presence and location of mast cells in periapical cysts and periapical granulomas / Análise da presença e localização de mastócitos nos cistos periapicais e granulomas periapicais

ABSTRACT Objective: The aim of the present study was to locate mast cells in chronic periapical lesions (granulomas and cysts) by using histochemical techniques and toluidine blue staining. Methods: A quantitative, descriptive, cross-sectional and retrospective research was performed. The sample was obtained from histopathological reports in the archives of the laboratory of surgical pathology of the University of Pernambuco between November 2014 and May 2015. Results: Sixteen cases of granuloma and 21 cases of periapical cysts were selected. The stained slides were analyzed by two examiners at different times, in a double-blind study. Mast cells were found in 13 (61.9%) of the periapical cyst cases, located in the capsule of the lesion. In the periapical granuloma cases, mast cells were found in eight cases (50%), located in the granulation tissue. Conclusion: Mast cells were detected in both cysts and periapical granuloma, located in the capsule and granulation tissue, respectively. Mast cells were more prevalent in periapical cysts than in periapical granuloma.

RESUMO Objetivo: Localizar mastócitos em lesões periapicais (granulomas e cistos) através de técnicas histoquímicas e corante azul de toluidina. Métodos: Uma pesquisa quantitativa, descritiva, transversal e retrospectiva foi realizada. As amostras foram obtidas de documentos histopatológicos nos arquivos do laboratório de patologia cirúrgica da Universidade de Pernambuco entre Novembro de 2014 e Março de 2015. Resultados: Dezesseis casos de granuloma e 21 casos de cistos periapicales foram selecionados. As lâminas coradas foram analisadas por dois examinadores em tempos diferentes, em um estudo duplo-cego. Mastócitos foram encontrados em 13 (61,9%) dos casos de cistos periapicales, localizados na cápsula da lesão. Nos granulomas periapicais, mastócitos foram encontrados em oito casos (50%), localizados no tecido de granulação. Conclusão: Mastócitos foram detectados tanto em cistos quanto em granulomas periapicais, localizados na cápsula e no tecido de granulação respectivamente. Os mastócitos estavam mais presentes nos cistos do que nos granulomas periapicais.

The Promising Applications of Stem Cells in the Oral Region: Literature Review.

INTRODUCTION: For a long time researchers have tried to find out a way to grow tissues back to the human body in order to solve transplantation problems by offering the unique opportunity to have their organs back, working properly, in search of life dignity. LITERATURE REVIEW: Stem cells seem to be present in many other tissues than researchers had once thought; and in some specific sites they can be easily collected, without the need of expensive interventions. The oral cavity is one of these regions where their collection can be accomplished, with plenty of accessible sites enriched with these precious cells. AIM: The aim of this literature review is to research where in the mouth can scientists find stem cells to be used in the near future. KEY-MESSAGE: The aim of this literature review is to research where stem cells can be found and collected in the oral cavity.

Facial herpes zoster – case report / Herpes Zóster Facial–Relato de caso

Este artigo descreve um caso de zoster facial o qual afetou um paciente do sexo masculino de dezesseis anos de idade. Suas ulcerações comprometiam a hemiface direita não ultrapassando alinha média facial. Foram realizados a observação e o acompanhamento do paciente durante e após o tratamento. O caso foi acompanhado do aparecimento das lesões até o processo final decicatrização, onde o paciente retornou à sua condição de vida normal.A infecção por herpes zoster parece ser o resultado de um sistema imunológico enfraquecido e os pacientes portadores devem ser monitorados a fim de detectar possíveis sequelas ou doenças oportunistas não diagnosticadas.

This article describes a case of facial zoster which affected a sixteen-year-old male patient. His ulcerations involved the majority of the right hemiface not surpassing the facial midline. The observation of fallow-up of the patient during and after treatment was accomplished and the case was followed up from appearance of the lesion up the final healing process, where the patient had retumed to his normal life condition. Herpes zoster infection seems to be an outcome of a weakened immunologic system and patients must be monitored in order to detect possible sequels or undetected non-diagnosed diseases.

Influence of apical foramen cleaning in the repair of periapical lesions / Influência da Limpeza do Forame Apical no Reparo de Lesões Periapicais

Objetivo: O presente estudo procurou acessar o efeito da limpeza do forame apical no reparo de lesões periapicais detectadas radiograficamente. Materiais e métodos: A amostra constituiu-se de 980 dentes selecionados de 25 de fevereiro de 1997 a 15 de março de 2005 que foram submetidos a tratamento endodôntico e exibiram lesões periapicais radiograficamente visíveis. A amostra foi então divididaem dois grupos: Grupo I, 402 tratamentos de canal em que a limpezado forame apical não foi realizada, e Grupo II, composto pelos 578 dentes restantes onde o procedimento foi realizado. Após um ano, os dentes foram clinica e radiograficamente avaliados.Resultados: No Grupo I, 360 canais (89,55%) não tiveram evidência de lesões periapicais, versus 521 (90,13%) no Grupo II. Presençaparcial dessas lesões foi observada em 23 canais (5,72%) no Grupo I versus 27 (4,67%) no Grupo II. O teste qui-quadrado de Pearson não demonstrou significância estatística entre os Grupos I e II (p=0,732).Conclusões: Estes achados sugerem que a limpeza do forame apical não é um determinante para o reparo de lesão periapical.

Aim: The present study sought to assessthe effect of apical foramen cleaningin the repair of periapical lesionsdetected by radiography. Methods:The sample comprised 980 teeth collected from 25 February 1997 to15 March 2005, which had been subjected to endodontic treatment and exhibited radiographically visibleperiapical lesions. The sample wasthen divided into two groups: Group I,402 root canal treatments in which cleaning of the apical foramen had notbeen performed, and Group II, composed of the remaining 578 rootcanal treatments where the procedure had been performed. After one year, the teeth were clinically and radiographically evaluated. Results: In Group I, 360 canals (89.55%) had no evidence of periapical lesions, versus 521 (90.13%) in Group II. Partial presence of thes e lesions was observedin 23 canals (5.72%) in Group I versus27 (4.67%) in Group II. No changes in images were observed in 19 (4.72%)canals in Group I and 30 in Group II. Pearson’s chi-square test showed nostatistically significant difference between the Groups I and II (p =0.732).Conclusions: These findings suggest thatforamen cleaning is not a determinantof periapical lesion repair.

Lymphangioma mimicking apical periodontitis.

INTRODUCTION: Lymphangiomas mimicking apical periodontitis, usually found in soft tissue of children and infants younger than 2 years, are extremely rare in aged patients, particularly in bone tissues. METHODS: An 81-year-old woman was seen in a radiological service to undergo imaging studies for the placement of dental implants. A panoramic radiograph showed a radiolucent multilocular structure in the left mandibular molar region, where teeth #17 and #18 had previously been treated endodontically. A fracture in tooth #17 was detected. Because of the patient's clinical history and the characteristics of the image, which showed changes in trabecular bone structure, the patient was referred for cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI) for further evaluation. CBCT scans demonstrated a well-circumscribed lesion immediately below the roots of teeth #17 and #18. MRI showed no involvement of the surrounding soft tissues, and the lesion affected only the mandibular bone. Incision biopsy was performed, and the tissue sample (histopathology specimen) was sent to microscopic evaluation. RESULTS: Microscopically, there was a proliferation of vascular endothelium covered by long and mature endothelial cells. In the vessel lumens, there was eosinophilic material similar to lymph. The microscopic examination suggested the diagnosis of lymphangioma. CONCLUSIONS: Pathologies of non-endodontic origin such as lymphangioma, which might be in the area of the tooth apex, should be included in the differential diagnosis of apical periodontitis. Histopathologic examination is mandatory for their diagnosis and treatment.

Comparative analysis of the radiopacity of MTA and Portland cement in conventional and digital radiographic systems / Análise Comparativa da Radiopacidade do MTA e Cimento Portland nos Sistemas Radiográficos Digitais e Convencionais

Objetivo: O presente estudo teve como objetivo avaliar a radiopacidade do Agregado de trióxido mineral (MTA) e Cimento Portland (PC) em imagens radiográficas convencionais e digitais a fim de verificar se estão em conformidade com a especificação ANSI / ADA. Materiais e Métodos: Cinco corpos de prova para cada material com 10mm de diâmetro, 1mm de espessura e um penetrômetro foram expostos a 70kVp, 8mA a uma distância foco-filme de 30cm. Os tempos de exposição foram 0,4 e 0,2 s para o filme Insight Kodak e sistema digital CR Kodak 7400, respectivamente. A densidade óptica foi medida na radiografia através de um fotodensitômetro e o valor de pixel foi obtido para as imagens digitais. Um gráfico dos valores obtidos versus mmAl foi elaborado a fim de gerar uma curva de radiopacidade dos degraus do penetrômetro, obtendo a correspondência em equivalência de mmAl dos materiais estudadosUm gráfico foi feito para os valores medidos em comparação mmAl, a fim de gerar uma curva de radiopacidade dos passos penetrômetro, obtendo-se a correspondência de equivalência de mmAl dos materiais estudados. Resultados: O teste estatístico de Mann-Whitney mostrou diferença estatística significativa na radiopacidade entre MTA e PC, tanto no sistema convencional (valor p = 0,009) e digital(valor p = 0,009). O mesmo teste também mostrou diferença estatística significativa entre os sistemas convencionais e digitais em ambos os materiais (p = 0,016 valueMTA-e p-valuecp = 0,009).Conclusões: MTA e CP não apresentaram radiopacidade dentro dos padrões exigidos pela especificação N ○ 57 do American National Standards / American Dental Association.

Objective: The present study aimed to evaluate the radiopacity of Mineral Trioxide Aggregate (MTA) and Portland Cement (PC) in conventional and digital radiographic images in order to verify if they are in accordance with ANSI/ADA specification. Materials and Methods: For each material five test specimens with 10mm of diameter, 1mm of thickness and a stepwedge were exposed at 70kVp, 8mA and focal distance of 30cm. Exposure times were 0,4 and 0,2s for Kodak Insight film and Kodak CR 7400 digital system, respectively. The optic density was measured in the radiograph using a photo-densitometer and the value of pixel was obtained for digital images. A graph was made for measured values versus mmAl in order to generate a radiopacity curve of the stepwedge steps, obtaining the correspondence in equivalence of mmAl of the studied materials. Results: The statistical Mann-Whitney test showed statistical significant difference in the radiopacity between MTA and PC in both conventional (p value = 0,009) and digital (p value = 0,009) systems. The same test also showed statistical significant difference between conventional and digital systems in both materials (p-valueMTA=0,016 and p-valuecp = 0,009). Conclusions: MTA and CP did not show radiopacity inside of the standards demanded by specification N○ 57 of the American National Standards/ American Dental Association.

The mechanisms of osteoclastic activity: literature review / Os Mecanismos da Atividade Osteoclástica: Revisão da Literatura

O tecido ósseo é continuamente remodelado dependendo da situação orgânica, com reabsorção dos tecidos duros e neoformação óssea. A homeostasia e condições inflamatórias envolvendo o osso podem ativar células hematopoiéticas com a capacidade de gerar ou dissolver a matriz óssea para uma grande variedade de necessidades orgânicas. Os mecanismos usados pelos osteoclastos para reabsorver tecidos duros e as interações básicas intercelulares, com a participação de células imunológicas tais como linfócitos, junto com outras substâncias, bem como a composição óssea são descritas nesta revisão.

Bone tissues are continually being remodeled depending on the organic situation, with hard tissue resorption and neoformation. Homeostasis and inflammatory conditions concerning bone may bring about the activation of hematopoietic cells with the ability to generate or dissolve bone matrix for a number of organic needs. The mechanisms used by osteoclasts to resorb hard tissues and the basic cell to cell interactions, with the participation of immune cells such as lymphocytes, along with other substances, as well as bone composition are described in this review.