Regional odontodysplasia in early childhood: A clinical and histological study

Regional odontodysplasia (RO) is a rare disorder of dental development. The affected teeth are clinically hypoplastic and hypocalcified, presenting a ghost-like appearance radiographically. The aim of this work was to report a clinical case of a child with both primary and permanent dentition affected by RO. The conducted therapy was based on a conservative approach, which consisted of follow-up clinical evaluations of the anomalous teeth. However, the endodontic treatment of the primary incisors failed. Then, the chosen option for patient rehabilitation became extraction followed by removable of prosthesis confection. The extracted teeth were processed for histological analysis. In spite of the uncertain prognosis, but taking into account the psychological aspects of the patient, a conservative approach in an attempt to maintain those viable teeth in the oral cavity should be established.

DMFT index assessment and microbiological analysis of Streptococcus mutans in institutionalized patients with special needs

Aim: To assess the DMFT (D = decayed; M = missing; F = filled) index of institutionalized patients with mild and moderate physical and mental disabilities and to correlate it with the Streptococcus mutans (S. mutans) counts in the supragingival bacterial biofilm. Methods: Dental examination of 28 patients aged 15 to 25 years was conducted to determine the DMFT index (number of decayed, missing and filled teeth). Supragingival plaque samples were collected from the buccal surfaces of all teeth. The samples were inoculated in SB20 medium and incubated at 37 °C for 48 hours. Spearman's correlation test was applied (p = 0.05) to evaluate the correlation between the DMFT index and the amount of S. mutans. Results: The mean DMFT recorded was 7.68 and a large mean number of S. mutans colony-forming units (cfu > 10 6) was found. No statistically significant correlation was found between the DMFT index and the number of S. mutans. Conclusions: Under the conditions of this study, no correlation was found between the DMFT index and the number of S. mutans cfu in institutionalized patients with mental retardation and physical disabilities.

Congenital epulis: A rare benign tumor in the newborn

Congenital epulis (CE) of the newborn is a rare benign soft tissue tumor that presents at birth. It occurs usually as a single mass with various sizes, although some multiple lesions have also been reported. The lesion is more common in female neonates and normally affects the maxillary alveolar ridge. Rare recurrence and no malignant alteration have also been reported. This condition may interfere with respiration, feeding or adequate closure of the mouth. A decisive diagnosis is made by histopathologic analysis as other newborn lesions can be incorrectly diagnosed as CE. This article presents a case report of a female infant who presented a fibrotic mass in the primary lateral incisor and canine region of the maxillary alveolar ridge. The lesion was not causing feeding or respiratory problems. After a watchful waiting procedure and no spontaneous regression, the lesion was excised under local anesthesia and confirmed by histopathologic analysis as CE.

Response of human dental pulp to calcium hydroxide paste preceded by a corticosteroid/antibiotic dressing agent

Aim: To evaluate the treatment with corticosteroid/antibiotic dressing in pulpotomy with calcium hydroxide. Methods: Forty-six premolars were pulpotomized and randomly assigned into 3 groups. In Group I pulpal wound was directly capped with calcium hydroxide, and Group II and Group III received corticosteroid/antibiotic dressing for 10 min or 48 h, respectively, before pulp capping. Teeth were processed for histological analysis after 7, 30 or 60 days to determine inflammatory cell response, tissue disorganization, dentin bridge formation and presence of bacteria. Attributed scores were analyzed by Kruskal-Wallis and Mann-Whitney tests (α=0.05). Results: On the 7th day, all groups exhibited dilated and congested blood vessels in the tissue adjacent to pulpal wound. The inflammatory cell response was significantly greater in Group III (p<0.05). On the 30th day, in all groups, a thin dentin matrix layer was deposited adjacent to the pulpal wound and a continuous odontoblast-like cell layer underlying the dentin matrix was observed. On the 60th day, all groups presented a thick hard barrier characterized by an outer zone of dystrophic calcification and an inner zone of tubular dentin matrix underlined by a defined odontoblast-like cell layer. Conclusions: Within the limitations of present study, considering that the treatment was performed in healthy teeth, it may be concluded that the use of a corticosteroid/antibiotic dressing before remaining tissue protection with calcium hydroxide had no influence on pulp tissue healing.

A human retrieval study of plasma-sprayed hydroxyapatite-coated plateau root form implants after 2 months to 13 years in function

Calcium phosphate-based bioactive ceramics in various physical and chemical formulations have been extensively utilized as biomaterials for bone regeneration/conduction. However, the determination of their in vivo temporal behavior from the short to long term in humans has been a challenge due to the lack of physical reference for morphologic and morphometric evaluation. The present study evaluated bone morphology and morphometry (bone-to-implant contact [BIC]) around plasma-sprayed hydroxyapatite (PSHA)-coated endosseous implants that were retrieved due to prosthetic reasons while successfully in function at the posterior region of the jaws from as early as 2 months to ~13 years after a 6-month healing period after placement. Bone morphology was evaluated by light microscopy, and BIC was determined using computer software. Irrespective of the time in vivo, lamellar bone was observed in close contact with the implant PSHA-coated surface and between plateaus. BIC ranged from ~35-95%, was highly directional, and Haversian-like osteonic morphology between plateaus was observed for most implants. The PSHA coating was present with little variation in thickness between the samples retrieved regardless of time in vivo. © 2010 by Begell House, Inc.

Role of periodontal pathogenic bacteria in RANKL-mediated bone destruction in periodontal disease

Accumulated lines of evidence suggest that hyperimmune responses to periodontal bacteria result in the destruction of periodontal connective tissue and alveolar bone. The etiological roles of periodontal bacteria in the onset and progression of periodontal disease (PD) are well documented. However, the mechanism underlying the engagement of periodontal bacteria in RANKL-mediated alveolar bone resorption remains unclear. Therefore, this review article addresses three critical subjects. First, we discuss earlier studies of immune intervention, ultimately leading to the identification of bacteria-reactive lymphocytes as the cellular source of osteoclast-induction factor lymphokine (now called RANKL) in the context of periodontal bone resorption. Next, we consider (1) the effects of periodontal bacteria on RANKL production from a variety of adaptive immune effector cells, as well as fibroblasts, in inflamed periodontal tissue and (2) the bifunctional roles (upregulation vs. downregulation) of LPS produced from periodontal bacteria in a RANKL-induced osteoclast-signal pathway. Future studies in these two areas could lead to new therapeutic approaches for the management of PD by down-modulating RANKL production and/or RANKL-mediated osteoclastogenesis in the context of host immune responses against periodontal pathogenic bacteria. © 2010 Mikihito Kajiya et al.

Mast cells modulate the inflammatory process in endotoxin-induced uveitis

Purpose: To investigate the role of mast cells and annexin-A1 (Anxa1) in endotoxin-induced uveitis (EIU). Methods: EIU was induced by injection of lipopolysaccharide (LPS) into the paws of rats, which were then sacrificed after 24 and 48 h. To assess EIU in the absence of mast cells, groups of animals were pretreated with compound 48/80 (c48/80) and sacrificed after 24 h after no treatment or EIU induction. The eyes were used for histological studies and the aqueous humor (AqH) pool was used for the analysis of transmigrated cells and Anxa1 levels. In inflammatory cells, Anxa1 expression was monitored by immunohistochemistry. Results: After 24 h, rats with EIU exhibited degranulated mast cells, associated with elevated numbers of infiltrating leukocytes and the high expression of Anxa1 in the AqH and the neutrophils. After 48 h of EIU, the mast cells were intact, indicating granule re-synthesis, and there was a reduction of neutrophil transmigration and an increase in the number of mononuclear phagocytic cells in ocular tissues. Anxa1 expression was decreased in neutrophils but increased in mononuclear phagocytic cells. In the animals pretreated with c48/80 and subjected to EIU, mast cells responded to this secretagogue by degranulating and few transmigrated neutrophils were observed. Conclustions: We report that mast cells are a potential source of pharmacological mediators that are strongly linked to the pathophysiology of EIU, and the endogenous protein Anxa1 is a mediator in the homeostasis of the inflammatory process with anti-migratory effects on leukocytes, which supports further studies of this protein as an innovative therapy for uveitis. © 2011 Molecular Vision.

Morphological changes in the fast vs slow fiber profiles of the urethras of diabetic pregnant rats

Background: This study was undertaken to test the hypothesis that diabetes and pregnancy detrimentally affect the normal function of urethral striated muscles in rats, providing a model for additional studies related to urinary incontinence. The aim of this study was to evaluate morphological alterations in the urethral striated muscles of diabetic pregnant rats. Materials and Methods: Twenty female Wistar rats were distributed into four experimental groups of five rats as follows: virgin, pregnant, diabetic virgin, and diabetic pregnant. Diabetes was induced using streptozotocin administration (40 mg/kg i.v.). The rats were lethally anesthetized, and the urethra and vagina were extracted as a unit. Cryostat sections (6 μm thick) were cut and stained with hematoxylin-eosin, and immunohistochemical procedures were performed and subjected to morphological and semi quantitative analysis. Results: The urethral striated muscle from the diabetic pregnant rats presented with the following variations: thinning and atrophy, disorganization and disruption associated with the colocalization of fast and slow fibers and a steady decrease in the proportion of fast vs slow fibers. Conclusion: Diabetes and pregnancy impair the urethral striated muscle and alter its fiber type distribution. © Copyright G. Marini et al., 2011.

Carcinoma basocelular múltiplo e metastático concomitante a sarcoma pleomórfico e metástatico em área de linfedema crônico - Relato de caso

Chronic lymphedema presents as interstitial fluid retention due to a failure in the lymphatic system drainage. The affected region becomes more vulnerable immunologically and predisposed to the onset of neoplasms. Basal Cell Carcinoma is the most common sort of neoplasm, nevertheless it rarely metastisizes. Sarcomas are malignant mesenchymal neoplasms, locally aggressive, which can spread. Here is reported an infrequent case of multiple basal cell carcinoma, synchronous to a poorly differentiated pleomorphic sarcoma, both spreading to lymph nodes and arising from tissue compromised by chronic lymphedema. © 2012 by Anais Brasileiros de Dermatologia.

Osseointegration assessment of chairside argon-based nonthermal plasma-treated Ca-P coated dental implants

This study investigated the effect of an Argon-based nonthermal plasma (NTP) surface treatment-operated chairside at atmospheric pressure conditions applied immediately prior to dental implant placement in a canine model. Surfaces investigated comprised: Calcium-Phosphate (CaP) and CaP + NTP (CaP-Plasma). Surface energy was characterized by the Owens-Wendt-Rabel-Kaelble method and chemistry by X-ray photoelectron spectroscopy (XPS). Six adult beagles dogs received 2 plateau-root form implants (n = 1 each surface) in each radii, providing implants that remained 1 and 3 weeks in vivo. Histometric parameters assessed were bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO). Statistical analysis was performed by Kruskall-Wallis (95% level of significance) and Dunn's post-hoc test. The XPS analysis showed peaks of Ca, C, O, and P for the CaP and CaP-Plasma surfaces. Both surfaces presented carbon primarily as hydro-carbon (CAC, CAH) with lower levels of oxidized carbon forms. The CaP surface presented atomic percent values of 38, 42, 11, and 7 for C, O, Ca, and P, respectively, and the CaPPlasma presented increases in O, Ca, and P atomic percent levels at 53, 12, and 13, respectively, in addition to a decrease in C content at 18 atomic percent. At 1 week no difference was found in histometric parameters between groups. At 3 weeks significantly higher BIC and BAFO were observed for CaPPlasma treated surfaces. Surface elemental chemistry was modified by the Ar-based NTP. Ar-based NTP improved bone formation around plateau-root form implants at 3 weeks compared with CaP treatment alone. © 2012 Wiley Periodicals, Inc.

Chemical characterization and flexural strength of a denture base acrylic resin with monomer 2-tert-butylaminoethyl methacrylate

Purpose: The objectives of this study were to investigate the flexural strength (FS) and chemical interaction between 2-tert-butylaminoethyl methacrylate (TBAEMA) and a denture base acrylic resin. Materials and Methods: Specimens were divided into five groups according to the concentration of TBAEMA incorporated in acrylic resin Onda-Cryl (0%, 1%, 2%, 3%, 4%) and were submitted to Fourier transform infrared spectroscopy (FTIR), electron spectroscopy for chemical analysis (XPS-ESCA), and differential scanning calorimetry (DSC) analyses. FS of the specimens was tested, and results were analyzed by ANOVA/Tukey's test (α < 0.05). Results: Different nitrogen ratios were observed on specimens' surfaces: 0.36%, 0.54%, 0.35%, and 0.20% for groups 1%, 2%, 3%, and 4%, respectively. FTIR indicated copolymerization of acrylic resin and TBAEMA, and DSC results demonstrated a decrease in glass transition temperature (Tg). Significant differences were found for FS (p < 0.05). The mean values were 91.1 ± 5.5,A 77.0 ± 13.1,B 67.2 ± 12.5,B 64.4 ± 13.0,B and 67.2 ± 5.9B MPa for groups 0%, 1%, 2%, 3% and 4%, respectively (same superscript letters indicate no significant difference). Conclusions: The incorporation of TBAEMA in acrylic resin resulted in copolymerization and the presence of amine groups on specimens' surfaces, and in decreases of Tg and FS. © 2012 by the American College of Prosthodontists.

CDKN2A promoter hypermethylation in astrocytomas is associated with age and sex

CDKN2A promoter hypermethylation has been widely related to many cancers. In astrocytomas, although CDKN2A (p16INK4A protein) is often inactivated, there are still some controversial issues regarding the mechanism by which this alteration occurs. Thus, we analyzed a series of astrocytomas to assess the association between CDKN2A expression and methylation of grade I-IV tumors (WHO) and clinicopathological parameters. DNA extracted from formalin-fixed paraffin-embedded material of 93 astrocytic tumors was available for CDKN2A promoter methylation analysis and p16INK4A expression by methylation-specific PCR and immunohistochemistry, respectively. A strong negative correlation between nuclear and cytoplasmic immunostaining and CDKN2A promoter methylation was found. Additionally, a significant negative correlation between CDKN2A promoter methylation and age was observed; also, female patients had statistically more CDKN2A methylated promoters (p=0.036) than men. In conclusion, CDKN2A inactivation by promoter methylation is a frequent event in astrocytomas and it is related to the age and sex of patients. © 2013 Surgical Associates Ltd.

Histologic and biomechanical evaluation of 2 resorbable-blasting media implant surfaces at early implantation times

This study evaluated 3 implant surfaces in a dog model: (1) resorbable-blasting media + acid-etched (RBMa), alumina-blasting + acid-etching (AB/AE), and AB/AE + RBMa (hybrid). All of the surfaces were minimally rough, and Ca and P were present for the RBMa and hybrid surfaces. Following 2 weeks in vivo, no significant differences were observed for torque, bone-to-implant contact, and bone-area fraction occupied measurements. Newly formed woven bone was observed in proximity with all surfaces.

Leprosy treatment dropout: A sistematic review

Background: Leprosy is a chronic infectious disease endemic in some undeveloped areas, and still represents a public health problem in Brazil. Therefore, the control of this endemic disease depends necessarily on the institution of correct treatment and containment of treatment dropout. This study aims to conduct a systematic review of published studies on treatment dropout of leprosy. Methods. We conducted a systematic review of articles on treatment dropout of leprosy, published between january 2005 and april 2013, on MEDLINE and SciELO databases. The search was performed using the MeSH terms: leprosy; patients dropouts and the keywords: leprosy, treatment and noncompliance, leprosy in association, beside the equivalents in Portuguese. Results: There were originally 196 references. After analyzing the titles and abstracts of articles, 20 articles were obtained and included in the final sample. Discussion. Leprosy is a notifiable disease known as its disfiguring capability and the high rate of non-compliance to treatment. The low adhesion is responsible for the remaining potential sources of infection, irreversible complications, incomplete cure and, additionally, may lead to resistance to multiple drugs. Many factors are responsible for the interruption or dropout treatment: socioeconomic factors, education level, knowledge about the disease, lack of efficiency of health services, demographics, side effects of drugs, alcoholism, among others. Conclusion: The recent scientific literature about the subject diverge regarding the factors that most affect the dropout problem in treating leprosy patients. However, better integration between professionals and users, and greater commitment of the patient, are common points among the authors of the studies. © 2013 Girão et al.; licensee BioMed Central Ltd.