960 resultados para Oral pathology
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Objective, the objective of this study was to evaluate the reliability of in vivo staining with toluidine blue in the detection of oral epithelial dysplasia, in situ carcinoma, and invasive squamous cell carcinomas in potentially malignant epithelial lesions (PMELs) and superficial oral ulcerations suggesting malignancy.Study design. Fifty patients with PMELs and superficial oral ulcerations suggestive of malignancy were selected from those treated at the Oral Medicine Service, Faculty of Dentistry, Araraquara, Brazil. All lesions were submitted to staining with an aqueous solution of 1% toluidine blue, followed by biopsy and histologic analysis. The sensitivity, specificity, and positive and negative predictive values were calculated.Results. Histologic diagnosis revealed that 14% of the lesions analyzed were in situ carcinoma and invasive squamous cell carcinomas, 12% were epithelial dysplasias, 13% were keratosis, 40% were lichen planus, and 8% were other benign lesions. The sensitivity uf the staining was 77%, the specificity 67%, and the positive and negative predictive values 43.5% and 88.9%, respectivelyConclusions, Staining with toluidine blue was demonstrated to be highly reliable in the detection of in situ carcinoma acid invasive squamous cell carcinoma, because false-negative results for the lesions did not occur. Toluidine blue staining is an adjunct to clinical judgment and not a substitute for either judgment or biopsy.
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Aims: To investigate the prevalence of oral mucosa alterations in patients with type 2 diabetes and to identify possible risk factors related to oral mucosa alterations.Methods: 146 patients with type 2 diabetes and 111 age-and gender-matched healthy controls subjects were consecutively recruited from Araraquara School of Dentistry to answer a structured questionnaire designed to collect demographic data as well as current and former history of diabetes. Clinical examination of the oral mucosa was carried out by a stomatologist.Results: A higher prevalence of oral mucosa alterations was found in patients with diabetes than in patients without diabetes (p < 0.001), with significant difference to development conditions (p < 0.0001), potentially malignant disorders (p < 0.0001) and fungal infections (p < 0.05). In the multiple logistic regression, diabetes (odds ratio 9.9 IC 5.11-19.16) and smoking habit (odds ratio 3.17 IC 1.42-7.12) increased the odds of oral mucosa alterations significantly.Conclusions: Patients with diabetes mellitus not only showed an increased prevalence of oral mucosa alterations but also a significant percentage of potentially malignant disorders. These findings elucidate the necessity of regular clinical examination to ensure early diagnosis and prompt management of oral mucosa lesions in patients with diabetes. (C) 2011 Elsevier B.V. All rights reserved.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Objectives: The aim of the present study was to analyze the main clinical and histopathological features of autoimmune diseases with oral manifestations such as oral lichen planus (OLP); mucous membrane pemphigoid (MMP); pemphigus vulgaris (PV) and erythema multiforme (EM). Study design: Retrospective review of 5770 files from the Oral Pathology Laboratory of Sao Jose dos Campos Dental School, São Paulo State University (UNESP) comprising a 27- year period from 1974 to 2000.Results: The cases accounted for 64 (1.10%) of 5770 anatomopathological examinations performed over the study period. Among the autoimmune diseases diagnosed, 49 (76.56%) were OLP, 6 (9.37%) were MMP, 5 (7.82%) were em and 4 (6.25%) were PV. Descriptive statistical analysis was used.Conclusion: The initial manifestations of most autoimmune diseases occur in the oral mucosa. An earlier diagnosis and proper therapeutic protocol will delay the dissemination of the lesions, thus greatly contributing to a better prognosis and quality of life of the patient.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Paracoccidioidomycosis (South American blastomycosis) is a systemic mycosis which can be associated with oral lesions. This study on a group of 14 patients showed oral lesions mainly on the gingival or alveolar mucosa, with pulmonary involvement detectable on chest radiography in most. Microscopic detection of the fungus on a direct smear showed positive results in all 14 patients. Serological investigations including immunodiffusion, counterimmunoelectrophoresis and immunoblot were also positive in 100% of cases. The results suggest that direct smear together with serology may obviate the need for lesional biopsy for the diagnosis of oral paracoccidioidomycosis.
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Frequent in developing countries, cysticercosis is a parasitic infection that rarely involves the mouth. This study reports a case of oral cysticercosis in a 13-year-old female patient who had an asymptomatic nodule in the right labial mucosa. An excisional biopsy was carried out and the histopathologic examination revealed a cystic space containing a Taenia solium larva.
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Paracoccidioidomycosis (South American blastomycosis) is an uncommon, progressive systemic mycosis, virtually only seen in persons who have visited Latin America. Reports of oral lesions are extremely rare in the English-language literature. Thirty-six adults with oral lesions as the first sign of paracoccidioidomycosis are described; this appears to be the largest series in the dental literature. All had chronic proliferative mulberry-like ulcerated oral lesions; the diagnosis was confirmed histologically. The gingiva or alveolar process was the typical site, but lesions were also seen particularly on the palate and lip. Most of the patients proved to have detectable pulmonary involvement. Patients with lesions in the oropharynx, tongue, or floor of mouth all had confirmed pulmonary lesions.
Exfoliative cytology of the oral mucosa in type II diabetic patients: morphology and cytomorphometry
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Background: In recent years, important advances have occurred in the determination of diagnostic criteria for the disease diabetes mellitus and in new strategies for its treatment. The purpose of this research was to develop a new method for diabetes diagnosis by microscopic and cytomorphometric analyses of the oral epithelium. Methods: the smears were obtained from three distinct oral sites: buccal mucosa (cheek), tongue dorsum, and floor of the mouth in 10 control individuals and 10 type II diabetic patients. The oral smears were stained with Papanicolaou EA-36 solution. The nuclear (NA) and cytoplasmic (CA) areas were evaluated from 50 integral cells predominant in each oral site by the use of the KS 300(TM) image analysis system (Carl Zeiss, Germany), by which the cytoplasmic/nuclear ratio (C/N) was calculated. Results: the results showed that: (i) the epithelial cells of the diabetic group exhibited figures of binucleation and occasional karyorrhexis in all layers; (ii) the NA was markedly higher (P<0.05) in the diabetic group; (iii) the CA did not exhibit a statistically significant difference (P>0.05) between these two groups; and (iv) the C/N mean was 37.4% lower in the type II diabetic group. Conclusions: These results associated with clinical observations suggest that diabetes mellitus can produce alterations in oral epithelial cells, detectable by microscopy and cytomorphometry, which can be used in the diagnosis of this disease.
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Objective: The objective of this study was to describe the oral health of elderly people diagnosed with Alzheimer's disease (AD). Study Design: Thirty elderly subjects with AD (mild, moderate, and severe) and 30 without AD (controls) were included in the study. Volunteer-reported oral health data were collected using the General Oral Health Assessment Index (GOHAI). Demographic and oral characteristics were assessed, including the number of natural teeth; number of decayed, missing, and filled teeth (DMTF); oral health index (OHI); removable prosthesis conditions; and oral pathologies. Results: GOHAI values were similar for both groups. Compared with the controls, the subjects with AD had a higher age, DMTF, OHI, and number of oral pathologies and a lower educational level and number of natural teeth. Conclusions: Elderly subjects with AD had poorer oral health than those without the disease. Despite the positive self-perception of their oral health, the oral health of subjects with AD tended to decline as their disease progressed. © 2012 Elsevier Inc.
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Background: The capacity for DNA repair is essential in maintaining cellular functions and homeostasis; however, this capacity can be altered based on DNA sequence variations in DNA repair genes, which may contribute to the onset of cancer. Many single-nucleotide polymorphisms (SNPs) in repair genes have been found to be associated with oral cancer. The aim of this study was to investigate the relationship between the presence of allelic variants Arg194Trp (rs:1799782) and Arg399Gln (rs: 25487) of XRCC1 gene and Thr241Met (rs: 861539) of XRCC3 gene and susceptibility to oral cancer. We also attempted to correlate the frequencies obtained for each of the SNPs to histopathological parameters. Methods: A case-control study was conducted with genomic DNA from 150 patients with oral squamous cell carcinomas and 150 controls. SNPs were genotyped by RFLP-PCR. Results: The presence of the polymorphic variants of the XRCC1 gene within codon 194 (OR 0.82, 95% CI: 0.44-1.51) and codon 399 (OR 0.94, 95% CI: 0.59-1.50) and within the XRCC3 gene (OR 0.72; 95% CI: 0.45-1.16) were not associated with an increased risk of oral cancer. A combinational analysis of SNPs in both genes indicated no association. The presence of the allelic variants of these two genes had no statistically significant effect on tumor differentiation, lymph node invasion or tumor size. Conclusions: These results suggest that allelic variants of XRCC1 and XRCC3 are not suitable markers for susceptibility to carcinomas of the oral cavity and are also not related to the later stages of such tumors. © 2012 John Wiley & Sons A/S.
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Background: Macrophage migration inhibitory factor (MIF) is a pleiotropic cytokine with pro-inflammatory functions and involved in tumorigenesis. The aim of this study was to evaluate the expression and localization of the macrophage MIF in oral squamous carcinoma (OSC). In addition, the relationship between MIF expression and clinicopathological parameters such as survival data, tobacco use, alcohol habits, TNM stage, tumor graduation, and peritumoral inflammatory infiltrate were evaluated. Methods: Using immunohistochemistry, expression and localization of MIF was detected in 44 specimens of OSC. The absolute number and relative proportions of MIF-positive cells detected were also determined separately for tumor parenchyma vs. stroma. All counts were determined from 10 consecutive high-power fields using an integration graticule. Moreover, some parameters were analyzed separately for lip and intra-oral cancers. Results: Migration inhibitory factor-positive cells were observed in both the tumor parenchyma and in inflammatory cells of all specimens. In contrast, MIF expression was not detected in tumoral nests associated with poorly differentiated tumors. In specimens of lip cancer, a greater number of MIF-positive stromal immune cells were detected than in intra-oral cancer specimens (Mann-Whitney test, P = 0.049). Conclusions: Oral squamous carcinoma cells consistently express MIF independent of their location. Lip tumors presented more MIF-positive peritumoral inflammatory cells, similar to control, suggesting that immunological differences in leukocyte activation exist between in lip and intra-oral cancers. © 2012 John Wiley & Sons A/S.