Kaposi sarcoma and paracoccidioidomycosis in the same fragment of oral mucosa biopsy: a rare association in human immunodeficiency virus-positive patient. A case report

The immunossuppression caused by HIV infection makes the affected individuals more susceptible to some diseases including infections, neoplasms, or even the association between them. Kaposi sarcoma (KS) is the most common AIDS-related neoplasm, featured as an angioproliferative disorder. Its cause seems to be related to the human herpesvirus type 8 and it is usually associated with lower CD4+ T cell count. Oral involvement is frequent, presenting red to blue-purplish plaques, maculaes, and nodules. On the other hand, paracoccidioidomycosis (PCM) is a systemic mycosis, endemic in Latin America, caused by Paracoccidioides brasiliensis. This mycosis is not commonly related to human immunodeficiency virus (HIV) infection, although PCM can be present in immunosuppression cases. Oral lesions, as granulomatous ulcers, are often identified in seropositive patients with PCM. A rare case, in which a male HIV-positive patient presented simultaneously Kaposi sarcoma and PCM in the same fragment of oral mucosa biopsy, is described. To the best of our knowledge, this concomitant association had not been previously described. (C) 2011 Elsevier Inc. All rights reserved.

Effect of supplementation of soft drinks with green tea extract on their erosive potential against dentine

Background: Matrix metalloproteinase (MMP) inhibitors reduce dentine erosion. This in vitro study evaluated the effect of the supplementation of soft drinks with green tea extract, a natural inhibitor of MMPs, on their erosive potential against dentine. Methods: For each drink tested (Coca-Cola (TM), Kuat (TM) guarana, Sprite (TM) and light Coca-Cola (TM)), 40 dentine specimens were divided into two subgroups differing with respect to supplementation with green tea extract at 1.2% (OM24 (R), 100% Camellia sinensis leaf extract, containing 30 +/- 3% of catechin; Omnimedica, Switzerland) or not (control). Specimens were subjected to four pH cycles, alternating de-and remineralization in one day. For each cycle, samples were immersed in pure or supplemented drink (10 minutes, 30 mL per block) and in artificial saliva (60 minutes, 30 mL per block) at 37 degrees C, under agitation. Dentine alterations were determined by profilometry (mu m). Data were analysed by two-way ANOVA and Bonferroni`s test (p < 0.05). Results: A significant difference was observed among the drinks tested with Sprite (TM) leading to the highest surface loss and light Coca-Cola (TM) to the lowest. Supplementation with green tea extract reduced the surface loss by 15% to 40% but the difference was significant for Coca-Cola (TM) only. Conclusions: Supplementation of soft drinks with green tea extract might be a viable alternative to reduce their erosive potential against dentine.

Effect of different concentrations of fluoride in dentifrices on dentin erosion subjected or not to abrasion in situ/ex vivo

This in situ/ex vivo study assessed the effect of different concentrations of fluoride in dentifrices on dentin subjected to erosion or to erosion plus abrasion. Ten volunteers took part in this crossover and double-blind study performed in 3 phases (7 days). They wore acrylic palatal appliances containing 4 bovine dentin blocks divided in two rows: erosion and erosion plus abrasion. The blocks were subjected to erosion by immersion ex vivo in a cola drink (60 s, pH 2.6) 4 times daily. During this step, the volunteers brushed their teeth with one of three dentifrices D (5,000 ppm F, NaF, silica); C (1,100 ppm F, NaF, silica) and placebo (22 ppm F, silica). Then, the respective dentifrice slurry (1: 3) was dripped on dentin surfaces. While no further treatment was performed in one row, the other row was brushed using an electric toothbrush for 30 s ex vivo. The appliances were replaced in the mouth and the volunteers rinsed with water. Dentin loss was determined by profilometry and analyzed by 2-way ANOVA/Bonferroni test (alpha = 0.05). Dentin loss after erosive-abrasive wear was significantly greater than after erosion alone. Wear was significantly higher for the placebo than for the D and C dentifrices, which were not significantly different from each other. It can be concluded that the presence of fluoride concentrations around 1,100 ppm in dentifrices is important to reduce dentin wear by erosion and erosion + abrasion, but the protective effect does not increase with fluoride concentration. Copyright (C) 2008 S. Karger AG, Basel.

Bacterial leakage in obturated root canals-part 2: a comparative histologic and microbiologic analyses

Objective. In this study, presence of dentin infection in root canals, obturated with 4 techniques submitted to the bacterial leakage test, was evaluated using histologic methods. Study design. The canals of palatal roots of 160 molars were instrumented and divided into different groups, according to the obturation technique used (lateral condensation, MicroSeal system, Touch `n Heat + Ultrafil, and Tagger`s hybrid technique) and extent of the remaining obturation material (5 mm and 10 mm). Ten additional roots were used as control samples. The roots were sterilized in ethylene oxide and mounted on a device for evaluation of bacterial leakage using the bacteria Enterococcus faecalis for 120 days. After the leakage test, roots were microscopically analyzed for the presence of dentin infection in the root canals and dentinal tubules. Results. A total of 154 specimens were analyzed using both methodologies in the experimental groups; 50 root canals (32.4%) showed bacterial leakage at the end of the experimental period, and 118 (76.6%) showed the presence of bacteria in the root canals using the histologic criteria. The lateral condensation technique allowed lower penetration of bacteria in the root canals and dentinal tubules, followed by Touch `n Heat + Ultrafil, MicroSeal, and Tagger`s hybrid technique, which allowed significantly greater penetration of bacteria. Root canals with 10 mm of remaining obturation material presented similar bacterial penetration as root canals with 5 mm. Conclusions. Even when an adequate seal of the apical foramen was shown by the absence of turbidity in the bacterial leakage test, E. faecalis dentin infection was present in a high percentage of the root canals after 120 days of root filling exposure to the bacteria. Tagger`s hybrid technique presented greater quantity of bacteria in histologic sections than root canals obturated with the other techniques. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 109: 788-794)

Bacterial leakage in root canals obturated by different techniques. Part 1: microbiologic evaluation

Objective. This study compared the coronal bacterial leakage of root canals obturated by different techniques and with different lengths of obturation. Study design. The canals of palatal roots of 160 maxillary molars were instrumented and divided into different groups according to the obturation technique used (lateral condensation, Microseal system, Touch `n Heat + Ultrafil system, or Tagger`s hybrid technique) and the length of obturation (5 mm or 10 mm). The roots were impermeabilized, sterilized in ethylene oxide, and mounted on a device for evaluation of the bacterial leakage. Results. Tagger`s hybrid technique produced a statistically greater number of specimens with coronal leakage than the other techniques. There was no statistically significant difference between the lateral condensation, Touch `n Heat + Ultrafil, and Microseal groups. Root canals with 10 mm of obturation produced a statistically significantly smaller number of specimens with leakage than root canals with 5 mm of obturation. Conclusion. Tagger`s hybrid technique produced a greater number of specimens with coronal leakage than the other techniques, and a greater number of root canals with 5 mm of obturation leaked than root canals with 10 mm of obturation.

Chronic maxillary sinusitis associated with dental impression material

A 62-year-old man was referred for routine treatment of hyperplasia of the mucosa in the anterior lower jaw. An oroantral fistula was detected in the right superior alveolar ridge. The patient had no complaints. Plain radiographs showed a radiopaque foreign body in the posterior region associated with opacification of the maxillary sinus. Computed tomography showed the same hyperdense foreign body located in the posterior lower part of the sinus and an abnormal soft tissue mass in the entire right maxillary sinus. When asked about sinusitis, the patient mentioned occasional episodes of pus taste and intermittent crises of headache lasting for one week. The patient has been edentulous for 20 years. Sinus debridement was performed and the oroantral fistula was closed. The clinical suspicion of the presence of zinc oxide-eugenol paste was confirmed by microscopical and chemical analysis. After 6 months of follow-up, the fistula continued to be closed and sinusitis did not recur. This clinical case of maxillary chronic sinusitis illustrates a different odontogenic origin.