Higher immunoexpression of CK14 from the Wnt-1/ß-catenin pathway in the development of odontomas.

Tooth development depends on a series of reciprocal signaling interactions between the oral epithelium and ectomesenchyme. This study aimed to investigate the role of CK14, a protein involved in Wnt-1/ß-catenin signaling, in odontogenesis and the development of odontomas. This cross-sectional, retrospective, immunohistochemical study analyzed 30 compound odontomas, 30 complex odontomas, and 17 tooth germs. Higher immunoexpression of CK14 was observed in odontogenic epithelial cells of tooth germs (p < 0.001) and odontogenic epithelial cells of odontomas (p < 0.001). There was higher immunoexpression of Wnt-1 and ß-catenin proteins in epithelial cells of tooth germs (p = 0.002 and p < 0.001, respectively), as well as in the ectomesenchyme of odontomas (p = 0.003 and p < 0.001, respectively). ß-Catenin was moderately and significantly correlated with CK14 in the membrane of reduced enamel epithelial cells in odontomas (p = 0.007). Higher immunoexpression of CK14 was observed in the odontogenic epithelium during the bud and cap stages and lower immunoexpression in the internal enamel epithelium during the bell stage. In odontomas, lower expression of Wnt-1/ß-catenin and higher immunoexpression of CK14 were found in odontogenic epithelial cells, especially adjacent to the mineralized material resembling the tooth formed in these lesions.

Higher immunoexpression of CK14 from the Wnt-1/β-catenin pathway in the development of odontomas

Abstract Tooth development depends on a series of reciprocal signaling interactions between the oral epithelium and ectomesenchyme. This study aimed to investigate the role of CK14, a protein involved in Wnt-1/β-catenin signaling, in odontogenesis and the development of odontomas. This cross-sectional, retrospective, immunohistochemical study analyzed 30 compound odontomas, 30 complex odontomas, and 17 tooth germs. Higher immunoexpression of CK14 was observed in odontogenic epithelial cells of tooth germs (p < 0.001) and odontogenic epithelial cells of odontomas (p < 0.001). There was higher immunoexpression of Wnt-1 and β-catenin proteins in epithelial cells of tooth germs (p = 0.002 and p < 0.001, respectively), as well as in the ectomesenchyme of odontomas (p = 0.003 and p < 0.001, respectively). β-Catenin was moderately and significantly correlated with CK14 in the membrane of reduced enamel epithelial cells in odontomas (p = 0.007). Higher immunoexpression of CK14 was observed in the odontogenic epithelium during the bud and cap stages and lower immunoexpression in the internal enamel epithelium during the bell stage. In odontomas, lower expression of Wnt-1/β-catenin and higher immunoexpression of CK14 were found in odontogenic epithelial cells, especially adjacent to the mineralized material resembling the tooth formed in these lesions.

Resumo O desenvolvimento dentário depende de uma série de interações de sinalização recíproca entre o epitélio oral e o ectomesênquima. O objetivo deste estudo foi investigar o papel da CK14 das vias WNT-1/β-catenina na odontogênese e no desenvolvimento de odontomas. Este estudo transversal, retrospectivo, imuno-histoquímico analisou 30 odontomas compostos, 30 odontomas complexos e 17 germes dentários. A CK14 apresentou maior imunoexpressão em células epiteliais odontogênicas de germes dentários (p<0,001) e em células epiteliais odontogênicas de odontomas (p<0,001). A Wnt-1 e a β-catenina apresentaram maior imunoexpressão de proteínas nas células epiteliais dos germes dentários (p = 0,002 e p<0,001, respectivamente), bem como no ectomesênquima dos odontomas (p = 0,003 e p < 0,001, respectivamente). A β-catenina correlacionou-se moderada e significativamente com a CK14 na membrana de células epiteliais reduzidas do esmalte em odontomas (p = 0,007). Maior imunoexpressão da CK14 foi observada no epitélio odontogênico nos estágios de botão e capuz com menor imunoexpressão no epitélio interno do órgão do esmalte no estágio de sino. Nos odontomas, foi observado menor expressão de Wnt-1/β-catenina e maior imunoexpressão da CK14 presente nas células epiteliais odontogênicas, especialmente, vizinhas ao material mineralizado semelhante ao dente formado nessas lesões.

Clinical, Radiographic and Histopathological Analysis of Craniopharyngiomas and Ameloblastomas: A Systematic Review.

BACKGROUND: Craniopharyngiomas and ameloblastomas are tumors of epithelial origin, mostly characterized by a benign course, slow growth and for being locally invasive. Some studies highlight the similarity of these neoplasms, especially regarding histopathological aspects. In this context, the aim of the present study was to carry out a systematic literature review correlating the clinical, radiographic, and histopathological aspects of these two tumors. METHODS: Searches were conducted at the Pubmed, Periódicos Capes, Scopus, Science Direct, Web of Science and Scielo databases, according to the following inclusion criteria: publications in English or Spanish, from the 2000s and 2021, comprising case report studies, case series and literature reviews. RESULTS: Considering clinical and radiographic aspects, it is evident that craniopharyngiomas and ameloblastomas exhibit few similarities. Histopathologically, however, adamantinomatous craniopharyngiomas are the type of tumor that most resembles ameloblastomas, both concerning the formation of palisade epithelial cords and epithelial formations. Regarding to recurrences in cases of craniopharyngioma, it appears that a more radical surgical resection is more related to a lower recurrence rate for both craniopharyngiomas and ameloblastomas. As for the outcome, it was observed that craniopharyngiomas have a greater relationship with possible systemic disorders. CONCLUSIONS: This histopathological similarity is related to their origin, since both craniopharyngiomas and ameloblastomas share a relationship with the oral cavity, either partially, as in the case of craniopharyngiomas, or totally, as in ameloblastomas, not comprising the same lesion in different locations. It is important to note that the differential morphogenetic evidence observed herein between these lesions opens up a new field of study aiming at better treatment alternatives in the future.

Use of topical anti-inflammatory and antineoplastic agents in the treatment of young-aged actinic cheilitis: A systematic review.

INTRODUCTION: Several treatments have been used to reduce inflammation and to reverse epithelial alterations in actinic cheilitis (AC). AIM: A systematic review was conducted to analyze the potential of topical treatments for remission and clinical improvement of AC as well as patient acceptability. METHODS: A systematic review of clinical trials was conducted following the PICO strategy to answer the following question: Are topical anti-inflammatory and antineoplastic agents effective in the treatment of actinic cheilitis? The quality of the studies was assessed by ROB-2, and the certainty of evidence was rated by GRADE guidelines. RESULTS: Eight clinical trials were selected, including four that investigated the use of anti-inflammatory drugs and four use of antineoplastic agents. The use of 3% diclofenac sodium was associated with partial remission of AC, while 5% imiquimod and ingenol mebutate promoted complete remission. Furthermore, 5% fluorouracil was the drug most associated with complications during treatment. Diclofenac sodium (3%) and fludroxycortide showed the best acceptance by the patients, especially in terms of symptom relief and comfort provided. CONCLUSION: The anti-inflammatory and antineoplastic agents analyzed largely provided good clinical outcomes, with evidence of remission of AC lesions, development of few local adverse reactions during treatment, and good patient adherence.

Perfil clínico-epidemiológico das fissuras orofaciais em um centro de referência do nordeste do Brasil / Clinical-epidemiological profile of orofacial fissures in a reference center from northeast Brazil / Perfil clinico-epidemiológico de las fisuras orofaciales en un centro de referencia en el noreste de Brasil

RESUMO Objetivo Descrever o perfil clínico-epidemiológico dos portadores de fissuras orofaciais, atendidos em um Centro de Referência do Nordeste do Brasil. Métodos Estudo descritivo, baseado em dados secundários de prontuários médicos. Informações sociodemográficas do portador e da mãe, uso de medicamentos durante a gestação, aspectos clínicos e cirúrgicos relacionados às fissuras, histórico familiar da malformação e consanguinidade dos pais foram investigadas. Os dados foram analisados descritivamente, com o uso do programa estatístico SPSS (Statistical Package for te Social Sciences), no qual foram obtidas medidas de frequência, média e desvio padrão. Resultados 51,1% dos portadores de fissuras orofaciais eram do sexo feminino, 46,2% menores de um ano e 54,4% eram procedentes na zona urbana. A maioria das mães encontrava-se na faixa etária entre 16 a 25 anos durante o período gestacional e relatou uso de medicação em 59,2% dos casos. A fissura transforame incisivo foi a mais diagnosticada (34,4%). No momento de cadastro ao Centro de Reabilitação de Anomalias Craniofaciais, 90,5% dos indivíduos ainda não haviam realizado tratamento cirúrgico. História familiar de fissura foi observada em 29,8% dos casos estudados e em apenas 7,1% desses foi reportado consanguinidade entre os pais. Conclusão Os fatores socioeconômicos e genéticos podem exercer influência sobre o desenvolvimento de fissuras orofaciais, o que exige uma maior atenção governamental assim como novos estudos para melhor investigação.(AU)

ABSTRACT Objective To describe the clinical-epidemiological profile of patients with orofacial fissures treated at a reference center from northeast Brazil. Materials and Methods Descriptive study, based on secondary data obtained from medical records. Sociodemographic information of patients and their mothers, use of medication during pregnancy, clinical and surgical aspects related to fissures, family history of malformation, and consanguinity among the parents were investigated. Data were analyzed descriptively using the SPSS (Statistical Package for Social Sciences) statistical program to obtain frequency, mean and standard deviation measures. Results 51.1% of the patients with orofacial fissures were female, 46.2% were under one year of age and 54.4% lived in urban areas. The majority of mothers were between the ages of 16 and 25 during the gestational period, and 59.2% reported the use of medication. Cleft lip and palate were the most prevalent types of fissures (34.4%). On admission to the Craniofacial Anomaly Rehabilitation Center, 90.5% of the individuals had not yet undergone surgical treatment. Family history of fissure was found in 29.8% of the cases studied, but inbreeding among parents was reported in only 7.1% of them. Conclusion Socioeconomic and genetic factors can influence the development of orofacial fissures; this requires greater governmental attention as well as new studies for better investigation.(AU)

RESUMEN Objetivo Describir el perfil clínico-epidemiológico de los portadores de fisuras orofaciales, atendidos en un Centro de Referencia del Nordeste de Brasil. Métodos Estudio descriptivo, basado en datos secundarios de pronóstico médicos. La información sociodemográfica del portador y de la madre, uso de medicamentos durante la gestación, aspectos clínicos y quirúrgicos relacionados con las fisuras, historia familiar de la malformación y consanguinidad de los padres fueron investigadas. Los datos fueron analizados descriptivamente, con el uso del programa estadístico SPSS (Statistical Package for te Social Sciences), en el cual se obtuvieron medidas de frecuencia, media y desviación estándar. Resultados 51,1% de los portadores de fisuras orofaciales eran del sexo femenino, 46,2% menores de un año y 54,4% eran procedentes en la zona urbana. La mayoría de las madres se encontraban en el grupo de edad entre 16 a 25 años durante el período gestacional y relató uso de medicación en el 59,2% de los casos. La fisura transforam incisiva fue la más diagnosticada (34,4%). En el momento de la inscripción en el Centro de Rehabilitación de Anomalías Craneofaciales, el 90.5% de los individuos aún no se habían sometido a tratamiento quirúrgico. La historia familiar de fisura fue observada en el 29,8% de los casos estudiados y en apenas el 7,1% de esos fue reportado consanguinidad entre los padres. Conclusión Los factores socioeconómicos y genéticos pueden influir en el desarrollo de fisuras orofaciales, lo que exige una mayor atención gubernamental así como nuevos estudios para una mejor investigación.

Immunohistochemical expression of myofibroblasts, TGF-ß1 and IFN-γ in oral fibrous lesions.

OBJECTIVE: Analyze the presence of myofibroblasts (MFBs) in oral fibrous lesions and investigate TGF-ß1 and IFN-γ expression by immunohistochemistry during their differentiation. DESIGN: Twenty giant cell fibromas (GCFs), 20 fibromas (FIBs), and 20 fibrous hyperplasias (FHs) were selected. To evaluate the presence of MFBs, anti-α-SMA-immunoreactive cells were quantified in connective tissue. TGF-ß1 and IFN-γ expressions were evaluated in epithelial and connective tissue by determining the percentage of immunoreactive cells. RESULTS: Higher MFBs concentrations were observed in GCFs (median of 20.00), followed by FHs (15.00) and FIBs (14.00) (P = 0.072). No significant correlation between TGF-ß1 or IFN-γ immunoexpression and the number of MFBs in oral fibrous lesions was observed (P > 0.05). CONCLUSIONS: The higher density of MFBs found in GCFs, followed by FHs and FIBs, reaffirms the fibrogenic role of these cells, while the higher concentrations detected in GCFs, including evidence of giant MFBs, also suggest a role in the neoplastic behavior of these lesions. No correlation was observed between TGF-ß1 and IFN-γ in the myofibroblastic transdifferentiation process of the analyzed lesions.

Immunohistochemical analysis of myofibroblasts, TGF-ß1, and IFN-γ in epithelial odontogenic lesions.

AIM: To investigate the presence of myofibroblasts (MFBs) in epithelial odontogenic lesions by immunohistochemistry and to correlate the findings with tumor aggressiveness, as well as to analyze the expression of TGF-ß1 and IFN-γ during the differentiation of these cells. METHODS AND RESULTS: Twenty solid ameloblastomas (SAs), 10 unicystic ameloblastomas (UAs), 20 keratocystic odontogenic tumors (KCOTs), and 20 adenomatoid odontogenic tumors (AOTs) were selected. For evaluation of the presence of MFBs, anti-α-SMA-immunoreactive cells were quantified in connective tissue near the epithelium. The expression of TGF-ß1 and IFN-γ was evaluated in epithelial and connective tissue by determining the percentage of immunoreactive cells. A higher concentration of MFBs was observed in SAs (mean of 30.55), followed by KCOTs (22.50), UAs (20.80), and AOTs (19.15) (P = 0.001). There was no significant correlation between the immunoexpression of TGF-ß1 or IFN-γ and the number of MFBs (P > 0.05). CONCLUSIONS: The larger number of MFBs suggests that these cells are one of the factors responsible for the more aggressive biological behavior of these lesions. The lack of correlation between the number of MFBs and immunoexpression of TGF-ß1 and IFN-γ indicates that these proteins are not involved in the differentiation of this type of contractile cell in the lesions studied and that only the use of immunohistochemistry to establish such a correlation is a limiting factor.

Epithelial odontogenic tumors: analysis of 156 cases in a Brazilian population / Tumores odontogénicos epiteliales: análisis de 156 casos en una población brasileña

The objective of this study was to determine the distribution of epithelial odontogenic tumors diagnosed histologically in a period of 41 years in a Brazilian population according to age, gender, site affected and compare these data with previously reported studies from other countries. Data of epithelial odontogenic tumors diagnosed were collected from the files of the Oral Pathology Laboratory of Federal University of Rio Grande do Norte, Natal, RN, Brazil, and entered in a standardized form for later comparisons. Clini-cal features obtained from the patient records and microscope slides were reviewed according to the 1992 World Health Organization classification. A total 156 epithelial odontogenic tumor were reported. Of these, all of them were benign. Ameloblastoma was the most frequent type (85.9 %), followed by adenomatoid odontogenic tumor (10.9 %) and calcifying epithelial odontogenic tumor (3.2 %). The mean age of the patients was 38 years, with a wide range (11­80 years). The posterior region of mandible was the anatomic site most frequently affected by this disease, and no significant differences were found between sexes in the diagnosis of odontogenic tumors. A marked geographic variation in the relative incidences of various epithelial odontogenic tumors was found. It was particularly notable in ameloblastomas and adenomatoid odontogenic tumors, with the incidences observed in the present study being similar, sometimes different to earlier studies in others parts of the world.

El objetivo fue determinar la distribución de los tumores odontogénicos epiteliales diagnosticados histológicamente en un período de 41 años en una población brasileña según edad, sexo y la zona afectada y comparar estos datos con estudios anteriores de otros países. Los datos de los tumores odontogénicos epiteliales diagnosticados fueron obtenidos de los archivos del Laboratorio de Patología Oral de la Universidad Federal de Rio Grande do Norte, Natal, RN, Brasil, e introducidos en un formulario estandarizado para comparaciones futuras. Las características clínicas obtenidas a partir de los registros de los pacientes y los portaobjetos de microscopio fueron revisados de acuerdo a la clasificación de la Organización Mundial de la Salud 1992. Se informó de un total de 156 tumores epiteliales odontogénicas. De estos, todos eran benignos. Ameloblastoma fue el tipo más frecuente (85,9 %), seguido por el tumor odontogénico adenomatoide (10,9 %) y el tumor odontogénico epitelial calcificante (3,2 %). La edad media de los pacientes fue de 38 años, con un rango amplio (11­80 años). La región posterior de la mandíbula era el sitio anatómico más afectado por esta enfermedad, y no se encontraron diferencias significativas entre sexos en el diagnóstico de los tumores odontogénicos. Se encontró una marcada variación geográfica en las incidencias relativas de diversos tumores odontogénicos epiteliales. Fue particularmente notable en ameloblastomas y tumores odontogénicos adenomatoide, con las incidencias observadas en este estudio siendo a veces similares, y a veces diferentes de los estudios anteriores en otras partes del mundo.

RELAÇÃO ENTRE DESORDENS TEMPOROMANDIBULARES (DTM) E PACIENTES PORTADORES DE PRÓTESES PARCIAIS REMOVÍVEIS / RELATIONSHIP BETWEEN TEMPOROMANDIBULAR DISORDERS (DTM) AND PATIENTS WITH PARTIAL REMOVABLE PROSTHESIS

Apesar de todos os avanços a dor ainda é um dos problemas que afetam a qualidade de vida das pessoas, podendo estar relacionada às Desordens Temporomandibulares (DTMs), que muitas vezes são diagnosticadas de forma errônea. Esses desdentados parciais podem optar pelo não uso das próteses parciais removíveis (PPRs) contribuindo para um colapso no sistema estomatognático assim como nas articulações temporomandibulares. Caso a opção seja a reposição dos dentes perdidos pela PPR, devemos estar atentos para a confecção deste tipo de prótese, seguindo critérios que devem ser obedecidos tanto na sua confecção como em função e o não respeito a esses parâmetros podem levar a danos ao sistema estomatognático. Por este motivo essa revisão de literatura busca evidenciar, se a PPR pode ser um dos fatores relacionados ao aparecimento da DTM e de que forma poderíamos fazer com que a PPR proteja também a articulação temporomandibular. A metodologia adotada consistiu em uma revisão bibliográfica, através de livros texto, monografias e artigos científicos coletados nas bases de dados: Medline/Pubmed; Scielo; Periódicos CAPES e Lilacs. Concluiu-se nesse estudo que o uso da PPR bem confeccionada, adaptada, respeitando os princípios básicos de execução e função, não leva ao aparecimento de DTMs por si só e que essa relação entre DTMs e PPR é possível quando se negligenciam esses princípios tanto por parte dos laboratórios de prótese, quanto por parte do Cirurgião-Dentista.

Despite all the advances, pain is still one of the problems that affect the quality of life, and may be related to temporomandibular disorders (TMD), which are often wrongly diagnosed. These partial edentulous may choose for not using of removable partial dentures (RPD), contributing to a collapse in the stomatognathic system and temporomandibular joint, if the option is the replacement of missing teeth by RPD, we should pay attention to the making of this type of prosthesis, following criteria that must be met, both in its production as a function, and failure to comply with these parameters can lead to damage to the stomatognathic system. For this reason, this literature review seeks to show if the RPD can be one of the factors related to the onset of TMD and which other way we could also make the RPD to protect the temporomandibular joint. The methodology consisted of a literature review, through textbooks, monographs and scientific articles collected in databases: Medline/Pubmed; SciELO, CAPES Periodicals and Lilacs. It was concluded in this study that the use of well prepared RPD, adapted, which respects the basic principles of implementation and function, does not lead to the onset of TMD itself and that this relationship between TMD and RPD is possible when neglect these principles both part of prosthetic laboratories, as by the Dental Surgeon.

Neurilemmoma of the oral cavity in pediatric patient / Neurilemoma em cavidade oral acometendo paciente pediátrico

Neurilemmomas arising from Schwann cells, rarely found in oral cavity, are characterized by solitary occurrence, slow growth and smooth surface with variable clinical aspects, depending on the nerve origin. Most instances are typically asymptomatic. Microscopically, the histopathological characteristic consists of alternating regions of hypercellularity and hypocellularity such as Antoni A and Antoni B, respectively. The prognosis is favorable; complete surgical removal is the treatment of choice, no recurrence should be expected. The present report shows the case of neurilemmoma in bucal mucosa, in a 9-year-old child. Patient was referred to the Stomatology Clinic of School of Dentistry, Universidade Federal do Rio Grande do Norte, with complaint of nodular mass, with approximately one year development. Patient was submitted to excisional biopsy, with histopathological exam showing diagnosis of neurilemmoma. After 1 year follow-up there has been no recurrence of lesion.

Os neurilemomas se originam das células de Schwann e raramente são encontrados na cavidade oral, sendo caracterizados por uma ocorrência solitária de crescimento lento e superfície lisa com aspectos clínicos variáveis dependendo do nervo de origem, sendo tipicamente assintomático. Microscopicamente, as características histopatológicas consistem de regiões alternadas de hipercelularidade e hipocelularidade, conhecidas como Antoni A e Antoni B respectivamente. Apresentando um prognóstico favorável, onde o tratamento de escolha é a excisão cirúrgica completa, não sendo esperada recorrência. O presente relato descreve a presença de um neurilemoma em mucosa jugal, acometendo uma criança de 9 anos de idade, que compareceu ao Serviço de Estomatologia da Faculdade de Odontologia da Universidade Federal do Rio Grande do Norte, queixando-se de uma massa nodular, há aproximadamente 1 ano. O paciente foi submetido a biópsia excisional, sendo diagnosticado através do exame histopatológico como neurilemoma e há 1 ano vem sendo acompanhado por nossa equipe sem recorrência da lesão.

Intraoral granular cell tumors: clinicopathologic and immunohistochemical study.

OBJECTIVE: To describe a case series of intraoral granular cell tumors in terms of clinical, histologic, and immunohistochemical features. METHOD AND MATERIALS: Nine cases of intraoral granular cell tumors were described in terms of clinical features (patient sex and age, anatomical location, size, type, time to clinical progression, and lesion treatment), histologic features (necrosis, spindling, vesicular nuclei with large nucleoli, increased mitotic activity, high nuclear to cytoplasmic ratio, and pleomorphism) and immunohistochemical features using S-100, CD68, neurofilament protein, desmin, and galectin-1. RESULTS: Studied patients were mostly women with a mean age of 32 years. Lesions arose as solitary nodules on the tongue, with size ranging from 0.1 to 3.0 cm. Mean time to evolution was 21.83 months. All cases were treated by surgical excision. Two cases were classified as atypical and seven as benign. All cases presented immunoreactivity for S-100, CD68, and galectin-1, and there was no reactivity for desmin and neurofilament protein. CONCLUSION: General practitioners should consider granular cell tumors during the differential diagnosis of nodular lesions on the tongue. Results suggest that histologic criteria may be used to distinguish between benign and atypical intraoral granular cell tumors. Finally, analysis of the clinical profile and the use of immunohistochemical markers may facilitate diagnosis and clarify the histogenesis of these lesions.

An epidemiological study of immune-mediated skin diseases affecting the oral cavity.

BACKGROUND: Immune-mediated skin diseases encompass a variety of pathologies that present in different forms in the body. OBJECTIVE: The objective of this study was to establish the prevalence of the principal immune-mediated skin diseases affecting the oral cavity. METHODS: A total of 10,292 histopathology reports stored in the archives of the Anatomical Pathology Laboratory, Department of Oral Pathology, Federal University of Rio Grande do Norte, covering the period from 1988 to 2009, were evaluated. For the cases diagnosed with some type of disease relevant to the study, clinical data such as the gender, age and ethnicity of the patient, the anatomical site of the disease and its symptomatology were collected. RESULTS: Of all the cases registered at the above-mentioned service, 82 (0.8%) corresponded to immune-mediated skin diseases with symptoms affecting the oral cavity. The diseases found in this study were: oral lichen planus, pemphigus vulgaris and benign mucous membrane pemphigoid. Oral lichen planus was the most common lesion, comprising 68.05% of the cases analyzed. Of these cases, 64.3% were women and the cheek mucosa was the anatomical site most commonly affected (46.8%). CONCLUSION: Immune-mediated skin diseases affecting the oral cavity continue to be rare, the prevalence found in this study being similar to that reported for the majority of regions worldwide. Nevertheless, early diagnosis is indispensable in the treatment of these diseases, bearing in mind that systemic involvement is possible in these patients.

Estudo epidemiológico das doenças dermatológicas imunologicamente mediadas na cavidade oral / An epidemiological study of immune-mediated skin diseases affecting the oral cavity

FUNDAMENTO: As doenças dermatológicas imunologicamente mediadas compõem diversas patologias que apresentam formas variadas de manifestação no organismo. OBJETIVO: Foi proposição desta pesquisa, estabelecer a prevalência das principais doenças dermatológicas imunologicamente mediadas que apresentam manifestação oral. MÉTODOS: Foram avaliados laudos histopatológicos de 10.292 casos arquivados no Serviço de Anatomia Patológica da Disciplina de Patologia Oral da Universidade Federal do Rio Grande do Norte, no período de 1988 a 2009. Dos casos diagnosticados como algum tipo de doença em estudo, coletaram-se dados clínicos como sexo, idade, raça, sítio anatômico e sintomatologia das doenças. RESULTADOS: Do total de casos registrados, no serviço supracitado, 82 (0,8 por cento) corresponderam a doenças dermato lógicas imunologicamente mediadas com manifestação na cavidade oral. As doenças encontradas neste estudo foram: líquen plano oral, pênfigo vulgar e penfigoide benigno das membranas mucosas, sendo o líquen plano oral a lesão mais prevalente, representando 68,05 por cento dos casos analisados, dos quais 64,3 por cento apresentavam-se em mu lheres, sendo a mucosa jugal o sítio anatômico mais acometido (46,8 por cento). CONCLUSÃO: A ocorrência de doenças dermatológicas imunologicamente mediadas que apresentam manifestação oral ainda é um fato incomum, semelhante ao observado na maioria das regiões mundiais. No entanto, a busca pelo diagnóstico precoce é um requisito essencial para a condução do tratamento dessas doenças, tendo em vista o possível comprometimento sistêmico do organismo nos pacientes.

BACKGROUND: Immune-mediated skin diseases encompass a variety of pathologies that present in different forms in the body. OBJECTIVE: The objective of this study was to establish the prevalence of the principal immune-mediated skin diseases affecting the oral cavity. METHODS: A total of 10,292 histopathology reports stored in the archives of the Anatomical Pathology Laboratory, Department of Oral Pathology, Federal University of Rio Grande do Norte, covering the period from 1988 to 2009, were evaluated. For the cases diagnosed with some type of disease relevant to the study, clinical data such as the gender, age and ethnicity of the patient, the anatomical site of the disease and its symptomatology were collected. RESULTS: Of all the cases registered at the above-mentioned service, 82 (0.8 percent) corresponded to immune-media ted skin diseases with symptoms affecting the oral cavity. The diseases found in this study were: oral lichen planus, pemphigus vulgaris and benign mucous membrane pemphigoid. Oral lichen planus was the most common lesion, comprising 68.05 percent of the cases analyzed. Of these cases, 64.3 percent were women and the cheek mucosa was the anatomical site most commonly affected (46.8 percent). CONCLUSION: Immune-mediated skin diseases affecting the oral cavity continue to be rare, the prevalence found in this study being similar to that reported for the majority of regions worldwide. Nevertheless, early diagnosis is indispensable in the treatment of these diseases, bearing in mind that systemic involvement is possible in these patients.

Immunohistochemical expression of mast cell tryptase in giant cell fibroma and inflammatory fibrous hyperplasia of the oral mucosa.

This study analysed the immunohistochemical expression of mast cell tryptase in giant cell fibromas (GCFs). In addition, the possible interaction of mast cells with stellate giant cells, as well as their role in fibrosis and tumour progression, was investigated. For this purpose, the results were compared with cases of inflammatory fibrous hyperplasia (IFH) and normal oral mucosa. Thirty cases of GCF, 30 cases of IFH and 10 normal mucosa specimens used as control were selected. Immunoreactivity of mast cells to the anti-tryptase antibody was analysed quantitatively in the lining epithelium and in connective tissue. In the epithelial component (p=0.250) and connective tissue (p=0.001), the largest mean number of mast cells was observed in IFHs and the smallest mean number in GCFs. In connective tissue, the mean percentage of degranulated mast cells was higher in GCFs than in IFHs and normal mucosa specimens (p<0.001). Analysis of the percentage of degranulated mast cells in areas of fibrosis and at the periphery of blood vessels also showed a larger mean number in GCFs compared to IFHs and normal mucosa specimens (p<0.001). The percent interaction between mast cells and stellate giant cells in GCFs was 59.62%. In conclusion, although mast cells were less numerous in GCFs, the cells exhibited a significant interaction with stellate giant cells present in these tumours. In addition, the results suggest the involvement of mast cells in the induction of fibrosis and modulation of endothelial cell function in GCFs.

Botryoid odontogenic cyst: a clinicopathologic study of 10 cases.

Botryoid odontogenic cyst is a rare multilocular variant of lateral periodontal cysts. In this study, a series of 10 cases of botryoid odontogenic cysts retrieved from the archives of the Postgraduation Program in Oral Pathology, Federal University of Rio Grande do Norte (Brazil), were reviewed for epidemiologic data, clinical presentation, radiographic and histopathologic characteristics, treatment, and recurrence.

Relação entre mastócitos e células T na inflamação / Relationship between mast cels and T cells in inflamation

Os mastócitos são tipos celulares que executam uma série de funções por meio da liberação de mediadores químicos, quando devidamente estimulados, interagindo com várias células das mais diferentes origens. Sabe-se, ainda, que as interações entre mastócitos e células T existem, porém ainda não são muito claras. O objetivo deste trabalho foi o de realizar uma revisão de literatura dos aspectos atuais a respeito da possível relação entre mastócitos e células T em processos inflamatórios.

The mast cells are cellular types that execute a series of functions through the release of chemical mediators when duly stimulated, interacting with some cells of the most different origins. It is known despite the interactions between mast cells and cells T exist, however aren't very clear yet. The objective of this work was to carry through a literary revision of the related current aspects of a possible relationship between mast cells and T cells in inflammatory process.

Clinicopathologic analysis of 7 cases of oral schwannoma and review of the literature.

Schwannomas, also known as neurilemmomas, are uncommon neoplasms apparently derived from Schwann cells. The growth of these tumors causes displacement and compression of the nerve of origin. Schwannomas are usually solitary lesions but can be multiple when associated with neurofibromatosis. Anti-S100 protein is the most widely used antibody for the identification of this neoplasm. Surgical excision is the treatment of choice for schwannomas, with few and controversial reports of recurrence or malignant transformation. The present article reports 7 additional cases of oral schwannoma, and the literature is reviewed regarding clinicopathologic features, immunohistochemical findings, differential diagnosis, and therapeutic management of this benign neural tumor.

Queilite glandular: uma entidade patológica rara: [revisão] / Cheilitis glandularis: a rare pathologic entity: [review]

A queilite glandular trata-se de um processo inflamatório crônico que acomete as glândulas salivares e ductos excretores dos lábios, preferencialmente acometendo o lábio inferior. Entretanto sua etiologia ainda é incerta, acredita-se tratar-se de uma doença hereditária com um padrão autossômico dominante. Três tipos de quelite glandular tem sido descrito na literatura e esta classificação é baseada em características clínicas e histopatológicas. Esta revisão tem o objetivo de deixar claro as características desta rara lesão bem como seu tratamento.

The cheilitis glandulares is a chronic inflamatory process affecting salivary glands and ducts of lips, preferential in lowe lip. Although its etiology still unknown, it is believed to be a hereditary disease with an autosomal dominant pattern. Three types of cheilitis glandularis have been described in the literature and this classication is based on the clinics and histopathologic caractheristics. This revision has the objective to clarify the characterístics of this rare injury as well as its treatment.