885 resultados para Patologia oral


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Ameloblastoma and adenomatoid odontogenic tumor are odontogenic tumors arising from the odontogenic epithelium with distinct clinical behavior. In attempt to comprehend the interaction between the odontogenic tumor cells and the extracellular matrix, the present work evaluated and compared the immunohistochemical expression of the matrix metalloproteinases-1 (MMP-1), -2 (MMP-2) and -9 (MMP-9) in 20 cases of ameloblastoma and 10 adenomatoid odontogenic tumor. MMP-1 exhibited exuberant expression in the parenchyma and in the stroma of both studied tumors, while the MMP-2 showed varied expression with about of 80% and 60% of the neoplastic cells exhibiting positivity in the ameloblastoma and adenomatoid odontogenic tumor, respectively. With relation to the MMP-2 expression by the mesenchymal cells, it was observed that 65% of the ameloblastoma and 80% of the adenomatoid odontogenic tumor were positive. The immunoreactivity of MMP-9 was detected in all studied cases, although its expression had occurred predominantely in less than 50% of the parenchyma cells of the ameloblastoma, while in about of 60% of the adenomatoid odontogenic tumor more than 50% of cells were positive. The mesenchymal cells were positive to MMP-9 in 65% of the ameloblastoma and in 80% of the adenomatoid odontogenic tumor, respectively. Statistically significant difference was observed to the MMP-1 expression with relation to MMP-2 and MMP-9 in the ameloblastoma (p < 0.001). It was not possible to perform statistical analysis to the cases of adenomatoid odontogenic tumor, however there was a tendency toward a differential expression of the MMP-1 with relation to other studied MMPs. These results suggest that MMP-1, - 2 and -9 are implicated in the growth and progression of both tumors analyzed as well as the more pronounced participation of the stroma in the ameloblastoma could together to be related to the higher clinical aggressiveness

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The oral manifestations due to HIV infection are, a lot of times, the first clinical signs of the disease. These injuries may also function as beepers and sentries of the curse and progression of the HIV infection and AIDS. The objective of this work was to evaluate the prevalence of the oral injuries in HIV positive patients, relating them with the CD4+ cells counting and the viral load in patients from the Hospital of Infected contagious Gizelda Trigueiro in Natal-RN. One hundred and one patients were evaluated, where after the clinical exam of the oral cavity, these ones were conducted to the peripheral blood collection for the counting of CD4+ lymphocytes. We observed a prevalence of 25,6%, that is, 31 cases. The Oral Candidiasis was the most commum injure, followed by Oral Hairy Leukoplakia, linear gingival erytema, lips herpes, gingivitis and periodontitis - HIV. The average counting of cells CD4+ of the injury carrying patients was of 250 cells/mm3. We did not observe relation between the presence of injuries and the viral load of the individuals

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Angiogenesis, a fundamental mechanism in tumor development, is used for differential diagnosis and prognosis purposes in various neoplasias of the head and neck. This study proposes to assess angiogenic activity using immunohistochemical expression by anti-CD105 and anti-CD34 antibodies in 20 cases of hemangiomas and 20 cases of oral pyogenic granulomas, in addition to determining the usefulness of these markers as one of the differential diagnosis resources for these two oral lesions. The results showed no statistically significant difference between microvascular count (MVC) means determined by anti-CD105 (p = 0.803) and anti-CD34 (p = 0.279) antibodies. The mean number of vessels obtained by MVC in the oral hemangiomas immunostained by anti-CD105 and anti-CD34 was 18.75 and 59.72, respectively, whereas in the oral pyogenic granulomas, the mean number was 20.22 and 48.09 respectively. It was also shown that CD34 was more effective than CD105 in identifying blood vessels. However, it must be pointed out that the anti-CD105 antibody seems to be more related to vascular neoformation. Overall, this assay reinforces the role of angiogenic factors in the etiopathogenesis of hemangiomas and oral pyogenic granulomas, but the results showed that angiogenesis quantification cannot be used as a differential diagnosis parameter between the two lesions analyzed

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We investigated the immunohistochemistry expression of claudins -1 and -7 in ameloblastoma and in human dental germs on the pattern of distribution (focal, regional or diffuse), the cells that expressed (if central or peripheral) and the location of that expression in the cell components recital membrane, cytoplasm and nucleus. Among the 29 cases of ameloblastoma, 24 were type solid and 6 unicystic. In 7 mandibular specimens of human fetuses found dental germs from the stage of bud to the crown. We note that the pattern of expression in the dental germs was variable for claudinas studied according to the cell type and stage of differentiation and was invariate only in the cells of stellate reticulum. In epithelium internal of enamel organ, claudin-1 has been decreasing with the progression of differentiation as to claudina-7 that was found in the cells of the peripheral papilla. For ameloblastoma the expression was more significant than that observed in dental germs. Fisher s exact test no found association between the expression of claudinas cells in central and peripheral and the type of ameloblastoma (solid or unicystic). Thus, in general the claudin-1 was positive in the central cell of 93,1% of the cases and in peripheral cells of 51,7%. The claudin-7 was expressed in the cells of all cases central and peripheral cells from 89,7%. For both claudins the distribution was predominantly diffuse cells both in central and peripheral cells. Given our findings it is suggested that the expression of claudins may be indicative of the involvement of these molecules in morphogenetics events culminating with the dental development and that possibly influence the development of neoplastic ameloblastoma

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The aim of this study was to evaluate the clinical and pathological features of cases diagnosed as dentigerous cyst by the Department of Oral Pathology, School of Dentristy at the Federal University of Rio grande do Norte, attempting the possible correlation between histomorphological findings and epidemiological data contained at the files of the patients, in order to define a suggested variation of lesion named inflammatory dentigerous cyst. It was verified that dentigerous cyst are more frequently present in the earfy three decades of life, with the majority of cases occuring in the second decade (40,740/0 ), and also male (57,41%) and white patients (68,52%) were most affected. In relation to anatomic site, the dentigerous cyst was more prevalent at anterior maxila and posterior mandible, showing, usually, a slow growth pattem. The majority of lesions were asymptomatic and the radiographic observed was frequently na unilocular radiolucency. In regard to the histomorphological analysis, it was noticed that the lesions showed commonly a thin epithelium, with a capsule of fibrous connective tissue, richly vascularized and collagenized with an intense mononuclear inflammatory infiltrate. Finally, clinicopathological was performed and it was find out that cysts that showed a thick epithelium, with a high degree of vascularization and collagenization, intense inflammatory infiltrate in the cystic capsule, were located in the pre-molares region, in patients under 12 years old and the majority showing painfull sintomatology, properly, compatible with inflammatory dentigerous cyst. The findings of the present study indicate that, probably, there is a variant of the dentigerous cyst, and therefore, we suggest the denomination inflammatory follicular cyst for this entity

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Oral squamous cell carcinoma is the most common malignant neoplasm in oral cavity. Several studies have been carried out to establish biologic behaviour criteria of this neoplasm. Thus, the purpose of this experiment was to performe a clinic, morphologic and immunohistochemical analysis, by the expression of cytokeratins 7, 10, 13, 14, 16 and 19 in 30 cases of tongue squamous cell carcinoma from the files of Dr. Luiz Antônio Hospital (Natal-RN). It was verifeid of the immunoexpression the correlation clinic estadiament and histologic gradation system proposed by Bryne (1998), in order to investigate the use of these intermediate filaments as an indicator of tumour progression. Data was collected from the patients file and it was observed that information regarding sex, age and race was resemble to the literature. Data obtained from disease evolution, clinic estadiament, metastasis and expression of cytokeratins 7, 10, 13, 14, 16 and 19 was submited to statistical analysis (Test K2), which showed that only the histologic gradation didn t demonstrated significant correlation to the clinic variables. The expression the cytokeratins presented variation in the analysed tumours. CK 10 expression showed significant correlation to metastasis, and the presence of CK 16 was related to disease evolution (obit/remission) and also with the T3 and T4 of TNM. These results evidenced that metastasis and TNM showed a good efficacy as a prognostic indicator. The histologic gradation proposed by Bryne (1998) didn t reflect the biologic behaviour of the studied tongue squamous cell carcinoma, and the analysis of some intermediate filaments of cytokeratins seems to reflect the biologic behaviour and agressivity of some oral squamous cell carcinoma

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Glandular atrophy is one of several alterations which can aflict the salivary glands, caused generally by obstructive lesions such as sialo1ithiasis, infections or compression by neoplastic processes arnong others. In this work, a morphological and immunohistochemical study was carried out in rat parotid glands, which were submitted to obstruction of the main excretory duct suffering atrophy at varied time intervals, with the aim of appraising the behavior of myoepithelial cells during the process of glandular atrophy. It was analized the immunohistochemical expression of calponin which detects myoepithelial cells in the parotids of 28 animaIs, which were divided into 7 groups, each one made up of 4 rats, afier the ductal ligature procedure, in the following time intervals: zero hour (control), 24 hours, 7, 15, 21, 30 and 60 days. Analysis of the immunohistochemicaI profile was carried through in which the calponin expression was veritied through its distribution pattem and numericaI index. All specimens exhibited positivity for calponin in myoepithelial cells which were distributed around the acini and the ductaI structures, a small number of positiveIy marked cells being detected in the controI group and in the 24-hour group when compared to subsequent ones, where it was perceived a Iarge increase in the number of positiveIy marked cens, mainly surrounding the ductiform structures which originated during the obstruction time. Upon application of statistical tests it was verified that the rise in the number the myoepithelial positive cells for calponin, when the control groups (zero hour) was compared to the 7, 15,21, 30 and 60-day groups afier obstruction, was statistica1ly significant. It was concluded then that the detected rise probably carne about due to an elevation in the rate of proliferation of the myoepitheliaI cells subsequent to the ductal obstruction, associated with a growing resistance of these cells to glandular atrophy.

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Bone marrow transplantation (BMT) is currently the best therapeutic option for patients with hematologic diseases, solid tumors or autoimmune disorders. It is characterized by intravenous infusion of hematopoietic stem cells in order to restore marrow function. However, this procedure requires concomitant immunosuppression treatment, which favors the development of certain complications, often manifested in the oral cavity. This study aimed to evaluate the incidence of oral changes in patients undergoing BMT and to correlate these results with clinical aspects related to the patients and the transplants performed. This is a prevalence study, with cross-sectional design, carried out in a BMT service at the Institute of Onco-Hematology of Natal (ION) and Natal Hospital Center. Data collection was based on questionnaires, clinical examination of the oral cavity and consultation in the medical records. The sample consisted of 51 patients undergoing BMT. After the analysis, was found a general status with good health conditions and presence of oral changes in about half of patients who composed the sample. The manifestations observed were, in decreasing order of frequency: mucositis; gingival alteration and thrombocytopenic purpura; mucosal pigmentation; lichenoid reaction and candidiasis. The oral changes were observed more frequently in cases of allogeneic TMO, in different periods post-transplant, without significant differences related to the source of cells. It was found statistically significant association between the presence of graft-versus-host disease (GVHD) and oral changes (p < 0,001). Therefore, it is concluded that there is a relatively high incidence of changes in oral cavity of patients receiving bone marrow transplantation, a fact which confirms the need to consider this site for examination, diagnosis, treatment and prognosis of possible complications of BMT

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Central giant cell lesion (CGCL) and peripheral giant cell lesion (PGCL) of the jaws have a distinct clinical behavior, although they share histopathologic features. It is still unclear whether these clinical differences are supported by a distinct pattern of immunoexpression of markers for multinucleated giant cells (GC) and mononuclear cells (MC). The purpose of this study was to compare the immunohistochemical expression of VEGF, MMP-9 in CG and MC and measure the vascularization by vWF to check whether there are differences in expression of these biomarkers between CGCL and PGCL. Paraffin wax blocks of 20 cases of LCCG and 20 LPCG were retrieved. MMP-9 immunoreactivity was greater in the CM of PGCL compared to VEGF (p<0.05). VEGF expression was greater in the CM of CGCL compared to PGCL (p<0.05) and it was greater in the overall expression of CGCL compared to PGCL (p<0.05). Vascularity was quantified by microvascular counting (MVC). MVC was greater in the PGCL compared CGCL (p<0.05). MMP-9 showed a greater tendency of expression in CGCL, though was not significant (p>0.05). We tested correlation between the proteins studied in each group and found a significant negative correlation between VEGF and vWF in CGCL (p<0.05). These results suggest that there are differences in the expression of VEGF in CM and overall expression between the lesions, although no statistically significant difference in the overall expression of the MMP-9. Then, there was a trend in increased expression of MMP-9 and VEGF in CGCL, possibly by the involvement of both proteins in osteoclastogenesis. Additionally, the results of this study indicate a higher degree of vascularization in PGCL compared to CGCL, fact that can be directly linked to the reactive nature of the PGCL, where the inflammatory process with its rich angiogenesis contributes significantly to these findings.

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The squamous cell carcinoma (SCC) is the most common malignant neoplasm of epithelial origin in oral cavity and present high capacity to invade adjacent structures. Traditionally, SCC has a predominance of 50 years male patients with long-time use of tobacco and alcohol, and the tongue is the most affected anatomic site. At present, there is an increasing incidence of SCC in patients below 40 years of age, who has been exposed or not to risk factors, mainly for tongue lesions. This study aims to analyze cell proliferation index using Ki-67 antigen in SCC of the tongue for two groups of different age range: until 40 years and older than 50 years. The first group was composed by 16 patients and the second one was composed by 20 patients. Clinicopathological features of the cases were also assessed. There was a male predominance in both groups. Tobacco and alcohol habits were common for patients until 40 years (72,2%), as well as for patients older than 50 years (52,9%). The first group had statistical association with the presence of regional metastases (p = 0,036) and with the most advanced stages of the disease (p = 0,012). Considering the histological malignancy grading, there was higher incidence (56,2%) of high malignancy grade tumors in the group of patients until 40 years old, but no statistical difference has found between groups and histologic malignancy grading. Regarding the immunohistochemical expression of Ki-67, there was no statistically significant difference between the antibody expression of the groups, as well as between other clinical and histopathological parameters. This study identified no significant difference regarding cell proliferation between the analyzed groups

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Currently, bone morphogenetic proteins (BMPs) have effective participation in the growth of malignancies. Knowing that there are few studies involving BMPs and oral squamous cell carcinoma, this work constitutes an immunohistochemical study of BMP-2, BMPR IA and BMPR II in squamous cell carcinomas (SCC) of the lower lip relating to the clinical and pathological aspects of this lesion. The sample consisted of 40 cases of SCC of the lower lip, being 20 cases of SCC of the lower lip with regional metastasis and 20 cases without metastasis. We evaluated the intensity of expression (score 1 to mark absent / weak, score 2 for high ) and was found the percentage of labeled cells, where the score was 1 cases with 0 to 50% of positive cells, score 2 with 51 to 75% of positive cells, and score 3 more than 75% of positive cells. The sample comprised 72.5% of men with a mean age of 65.8 years, there was a predominance of stage II and 52.5% of the carcinomas were classified as low grade, being carcinoma with metastasis presenting most cases (70%) as carcinomas of high malignancy grade (p = 0.004). The largest number of cases of SCC of the lower lip that were in stages I / II (61, 9%) were classified as carcinomas of low grade malignancy and carcinomas in stages III / IV were classified as high-grade tumors (p = 0, 024). The BMP-2 showed strong intensity of immunostaining in 82.5%, BMPR-IA showed 55% of cases with an intensity of immunostaining absent / weak and BMPR-II showed 85% of cases with an intensity of immunostaining absent / weak. Only the protein BMPR-IA were significantly associated with all clinic-pathological parameters studied, metastasis (p <0.001), TNM (p <0.001) and histological grade of malignancy with (p = 0.028). The percentage of positive cells, all markers showed the highest number of cases with more than 75% of positive cells (score 3) and only BMPR-II showed statistical difference when related to the presence and absence of metastasis (p = 0.049 ). We conclude that there is disturbance in the BMP signaling pathway in EC-mediated lower lip and that high expression of BMP-2 associated with the expression of BMPR-IA and BMPR-II are associated with metastasis in carcinoma

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Receptor ativador nuclear κappa B (RANK), ligante do receptor ativador nuclear κappa B (RANKL) e osteoprotegerina (OPG) são membros da família do fator de necrose tumoral relacionados com o metabolismo ósseo. A formação, diferenciação e atividade dos osteoclastos são reguladas por estas três proteínas. RANK é um receptor transmembrana presente em diversos tipos celulares, principalmente em células de linhagem macrofágica, linfócitos, células dendríticas e fibroblastos e quando ativado pelo seu ligante, RANKL, promove a diferenciação e ativação de células osteoclásticas responsáveis pelo processo de reabsorção óssea. A OPG impede a ligação RANK/RANKL atuando como um receptor inibitório para a atividade osteolítica. O objetivo deste estudo foi comparar a expressão imuno-histoquímica destes biomarcadores em cistos radiculares (n=20) e cistos dentígeros (n=20). A expressão imuno-histoquímica destes marcadores foi avaliada no epitélio e na cápsula dos cistos por escores e percentuais médios de imunomarcação. Para o epitélio, a análise semi-quantitativa revelou um padrão similar dos escores de imunomarcação de RANK, RANKL e OPG nas lesões, não havendo diferença estatística significante (p=0.589, p=0.688, p=0.709, respectivamente). Para a cápsula cística a análise quantitativa, mostrou diferença estatística significante entre os percentuais médios de imunomarcação do RANK e RANKL (p=0,001 e p=0,005, respectivamente) nos cistos. A correlação dos escores de imunomarcação de RANKL e OPG no epitélio do CR e do CD revelou diferença estatística significante (p=0,029, p=0,003, respectivamente). No epitélio dos CRs e dos CDs observou-se uma maior imunoexpressão da OPG comparada a do RANKL. Os resultados apontam a presença de RANK, RANKL e OPG nos cistos radiculares e cistos dentígeros, sugerindo a atuação destas proteínas no desenvolvimento e expansão das lesões no osso adjacente

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Introdução: A displasia epitelial oral (DEO) é uma lesão potencialmente maligna, cujo diagnóstico e gradação se baseia na histologia das alterações arquiteturais e citológicas, preconizados pela OMS, que divide a lesão em leve, moderada e severa, o qual é subjetivo. Maior concordância é observada no uso do sistema binário (baixo/alto risco), o qual está relacionado ao risco de transformação maligna. As galectinas constituem uma família de lectinas e estão envolvidas na tumorigênese, sendo a -1, -3 e -7 as mais investigadas, devido a expressão alterada em cânceres orais. Materiais e métodos: Foi analisada a expressão imuno-histoquímica dessas proteínas em 50 espécimes de DEO (21 baixo/ 29 alto risco) e 5 de mucosa oral normal e relacionamos com a presença/ausência de marcação, padrão de distribuição, intensidade, localização epitelial (estratificação) (1/3 inferior, médio e superior), e localização celular (compartimento) (núcleo, citoplasma e membrana) . Resultados: Dos 29 casos de alto e dos 21 de baixo risco, 21 (72,4%) e 12 (57,1%) foram positivos para a galectina -1, respectivamente. Dessa forma, de 50 casos, 33 foram positivos. O núcleo e citoplasma foram positivos em 91,7% nas de baixo risco e em 90,5% nas de alto. Todos os casos de mucosa normal foram negativos. Com relação a galectina -3, dos 21 casos das DEOs de baixo risco, 12 (57,1%) apresentaram expressão e dos 29 casos das DEOs de alto risco, 15 (51,7%) foram positivos, havendo imunoexpressão em um total de 27 casos. O padrão difuso, assim como a fraca intensidade foram os mais freqüentes para os 2 graus. O núcleo e o citoplasma foram a localização mais comum tanto nas lesões de baixo (58,3%), quanto nas de alto risco (66,7%). Quatro casos de mucosa normal foram positivos, com marcação membranar e intensidade fraca. Dos 21 casos das DEOs de baixo risco, 17 (81%) apresentaram expressão imuno-histoquímica para a galectina -7 e das 29 DEOs de alto risco, 27 (93,1%) foram positivos. Então, a expressão imuno-histoquímica da galectina -7 foi observada em 44 casos, a maioria com intensidade de moderada a forte. O núcleo e o citoplasma foram a localização mais freqüente, nas de baixo (70,6%) e alto risco (66,7%). Quatro espécimes de mucosa normal marcaram membrana em terço médio e superior, com intensidade moderada a forte. Conclusões: Alterações na expressão das galectinas -3 e -7 e principalmente da -1 sugerem seu envolvimento na fisiopatologia das displasias, participando do processo de transformação de fenótipo normal para o displásico.

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The childhood cancer is characterized by a predominance of hematogenic and lymphatic system neoplasm, although a fTequency of the central nervous system tumors and sarcomas are widely common. Particularities of many childhood cancers and the adverses effect of the antineoplastic agents can change radically the oral environrnent and predisposes to the risk of oral complications. This study assessment clinically the oral health of 40 children on treatment for different types of malignant neoplasm with age range of O to 1S years old (Group I) and compared to 38 nonnal children in the same age range (Group lI). The results shown that nonnal patients had a gingival bleeding index (GBI) and caries experience minar than patients of Group lI, the visivel plaque index (VPI) was lightly higher in patients of Group 1. There was not difference statistically significant in the variables. Sixteen patients of Group I developed together 61 oral complications with predominance of mucositis, followed by spontaneous oral bleeding, candidiasis and xerostomy, that complication were most commons in patients with systemic neoplasm. Its was concluded that patients submitted to antineoplastic therapy with poor oral health had a higher risk to develop oral complications

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Lip squamous cell carcinoma (SCC) may develop from a premalignant condition, actinic cheilitis (AC) in 95% of the cases. Both premalignant and neoplastic lip diseases are caused mainly by chronic exposure to the ultraviolet component of solar radiation, especially UVB. This exposure causes disruption of the cell cycle and damage to DNA repair systems, like mismatch repair, altering proteins repair as hMLH1 and hMSH2. This research aimed to investigate the immunohistochemical expression of hMLH1 and hMSH2 proteins in lower lip SCCs and ACs, providing additional information about carcinogenesis of the lower lip. The sample consisted 40 cases of ACs and 40 cases of lower lip SCCs. Histological sections of 3 μm were submitted to immunoperoxidase method, for immunohistochemical analysis of lesions were counted in 1000 cells (positive and negative), data were evaluated both in absolute numbers and percentage of immunostained cells, the latter by assigning scores. Associations of the variables and comparative analysis of biomarker expression were performed by Fisher s exact and Pearson s chi-square, "t" student, one-way ANOVA, Mann- Whitney e Kruskal-Wallis tests. The level of significance was 5%. It was found that, in lower lip SCC, the mean of the proteins was higher in female patients (hMLH1= 369,80 + 223,98; hMHS2 = 534,80 + 343,62), less than 50 years old (hMLH1 = 285,50 + 190,65; hMHS2 = 540,00 + 274,79) and classified as low-grade malignancy (hMLH1 = 264,59 + 179,21; hMHS2 = 519,32 + 302,58), in these data only to sex, for hMLH1 protein, was statistically significant (p=0.034). Comparing the different lesions, we observed that for both hMLH1 and hMSH2 protein, the average of positive epithelial cells decreased as the lesion was graded at later stages. The ACs classified without dysplasia or mild dysplasia had the highest average of immunostained cells (hMLH1 = 721.23 + 88.116; hMHS2 = 781.50 + 156.93). The ACs classified as moderate or severe dysplasia had intermediate values (hMLH1 = 532,86 + 197,72; hMHS2 = 611,14 + 172,48) and SSCs of the lower lip had the lowest averages (hMLH1 = 255,03 + 199,47; hMHS2 = 518,38 + 265,68). There was a statistically significant difference between groups (p<0.001). In conclusion, our data support the hypothesis that changes in immunoexpression of these proteins is related to the process of carcinogenesis of the lower lip