Effects of cyclosporin, phenytoin, and nifedipine on the synthesis and degradation of gingival collagen in tufted capuchin monkeys (Cebus apella): Histochemical and MMP-1 and -2 and collagen I gene expression analyses

Background: The purpose of this experimental study was to evaluate the collagen fiber distribution histologically after phenytoin, cyclosporin, or nifedipine therapy and to correlate it with collagen I and matrix metalloproteinase (MMP)-1 and -2 gene expression levels.Methods: Gingival samples from the canine area were obtained from 12 male monkeys (Cebus apella). The mesial part of each sample was assessed by reverse transcription-polymerase chain reaction, whereas the distal part was processed histologically for picrosirius red and hematoxylin and eosin stainings, as well as for collagen IV immunostaining. One week after the first biopsy, the animals were assigned to three groups that received daily oral dosages of cyclosporin, phenytoin, or nifedipine for 120 days. Additional gingival samples were obtained on days 52 and 120 of treatment from two animals from each group on the opposite sides from the first biopsies.Results: Picrosirius red staining showed a predominance of mature collagen fibers in the control group. Conversely, there was an enlargement of areas occupied by immature collagen fibers in all groups at days 52 and 120, which was not uniform over each section. There was a general trend to lower levels of MMP-1 gene expression on day 52 and increased levels on day 120. Phenytoin led to increased levels of MMP-2 and collagen I gene expression on day 120, whereas the opposite was observed in the nifedipine group.Conclusion: Cyclosporin, phenytoin, and nifedipine led to phased and drug-related gene expression patterns, resulting in impaired collagen metabolism, despite the lack of prominent clinical signs.

Clinical and histological evaluation of subepithelial connective tissue after collagen sponge implantation in the human palate

Rocha AL, Shirasu BK, Hayacibara RM, Magro-Filho O, Zanoni JN, Araujo MG. Clinical and histological evaluation of subepithelial connective tissue after collagen sponge implantation in the human palate. J Periodont Res 2012; 47: 758765. (c) 2012 John Wiley & Sons A/S Background and Objective: Successful root-coverage treatment depends on the thickness of the donor tissue. This study aimed to evaluate the thickness of donor tissue after augmentation of the connective tissue in the palatal area by implantation of lyophilized collagen sponge (Hemospon (R)). Material and Methods: Ten patients with an indication for root coverage, whose palate was deficient in adequate connective tissue, were recruited. The procedure was carried out in two stages. In the first stage, the palatal thickness in the donor site was measured at three standardized points (points 1, 2 and 3), from the distal of the canine to the distal of the first molar, and the lyophilized collagen sponge was inserted. In the second stage, the palatal thickness over the implant was measured (at points 1, 2 and 3), two biopsies of the palatal mucosa were collected one over the implant (experimental sample) and the other on the contralateral side (control sample) and then root-coverage treatment was performed. Analyses consisted of clinical assessment of the palatal measurements before and after sponge implantation, and histological assessment of the experimental and control biopsy samples. Data were analyzed using the Wilcoxon test. Results: Both analyses showed a significant increase in mean thickness, of 1.08 mm of neoformed tissue in the clinical analysis (the tissue at point 2 was the thickest of the three points) and of 0.53 mm in the histological analysis. Conclusion: The insertion of lyophilized collagen sponge induced a significant increase in the thickness of palatal connective tissue.

Bioactive Glass for Alveolar Ridge Augmentation

The restoration and recovery of the alveolar healing process are a challenge to dental surgeons to achieve satisfactory results at the osseointegration of implants and implant rehabilitation. Different operative technique and biomaterials are being used to reconstruct the framework of the alveolar process. One of the biomaterials used for this purpose is the bioactive glass. The aim of this study was to report clinical and histologic final results of 7 clinical reports of alveolar ridge augmentation using bioactive glass. Clinically, bioglass was able to maintain bone architecture of the alveolar bone and repaired satisfactory. Biopsy was performed on the histologic samples and showed bone formation in intimate contact to the particles of the biomaterial.

Peripheral Ossifying Fibroma

The peripheral ossifying fibroma (POF) is a common gingival growth usually arising from the interdental papilla. The anterior maxilla is the most common location of involvement. The etiology and pathogenesis of POF remains unknown. Some investigators consider it a neoplastic process, whereas others argue that it is a reactive process; in either case, the lesion is thought to arise from cells in the periodontal ligament. Trauma or local irritants, such as dental plaque, calculus, microorganisms, masticatory force, ill-fitting dentures, and poor quality restorations, have been implicated in the etiology of POF. The recommended treatment is the excisional biopsy; however, it can leave a defect if the procedure is not followed by a subepithelial connective tissue graft. The main objective of this article was to present a clinical case of excisional biopsy of a POF followed by a subepithelial connective tissue graft to correct the defect caused by the biopsy. The biopsy defect was satisfactorily repaired, and the lesion has not recurred after 6 years of follow-up.

Large Unicystic Ameloblastoma of the Mandible: Management Guided by Biological Behavior

Ameloblastoma is a true neoplasm of odontogenic epithelial origin. It is a slow-growing benign tumor of the jaw, and patients usually present late after the tumor achieves considerable size to cause facial disfigurement. Diagnosis mainly from tissue biopsy and radiograph findings does assist in differentiating between types of ameloblastoma. Unicystic ameloblastoma is a tumor with a strong propensity for recurrence. There is a difference in biological behavior between mural unicystic ameloblastoma and those which are simply cystic or show intraluminal proliferation. The challenges in the management of this tumor are to provide complete excision in addition to reconstructing the bony defect, to provide the patient with reasonable cosmetic and functional outcome. The authors report a case of a mural unicystic ameloblastoma in a 23-year-old man who was treated by partial resection of the mandible. Biomedical prototypes were used because they provide acceptable precision and are useful for treatment planning.

Hyperbaric oxygen therapy treatment for the fixation of implant prosthesis in oncology patients irradiated

doi: 10.1111/j.1741-2358.2012.00636.x Hyperbaric oxygen therapy treatment for the fixation of implant prosthesis in oncology patients irradiated Objectives: This study aimed to present a clinical report of an irradiated oncologic patient who underwent hyperbaric oxygen therapy to be rehabilitated with implant-supported prosthesis. Materials and Methods: A 67-year-old man was admitted at Oral Oncology Center (FOA-UNESP) presenting a lesion on the mouth floor. After clinical evaluation, incisional biopsy and histopathological exam, a grade II squamous cell carcinoma was diagnosed. The patient was subjected to surgery to remove the lesion and partial glossectomy. Afterwards, the radiotherapy, in the left/right cervicofacial area of the supraclavicular fossa, was conducted. After 3 years of the surgery, the patient was submitted to hyperbaric oxygen therapy. Then, four implants were installed in patients mandible. Five months later, an upper conventional complete denture and lower full-arch implant-supported prosthesis were fabricated. Conclusion: The treatment resulted in several benefits such as improving his chewing efficiency, swallowing and speech, less denture trauma on the mucosa and improving his self-esteem.

A importância da interação entre odontopediatrias e pediatrias no manejo de dentes natais e neonatais

OBJETIVO: Apresentar revisão de literatura sobre dentes natais e neonatais, abordando características clínicas, fatores etiológicos, medidas terapêuticas e a importância do conhecimento desta anomalia, por odontopediatras e pediatras. FONTES DE DADOS: Foram selecionados os artigos mais relevantes sobre o tema, desde 1950 até 2006, pesquisados no Medline e na Bibliografia Brasileira em Odontologia (BBO), além de livros de pertinentes. SÍNTESE DOS DADOS: Os dentes natais e neonatais consistem em uma anomalia de erupção, sendo caracterizados por seu irrompimento na cavidade oral durante o período intra-uterino ou no primeiro mês de vida respectivamente, podendo fazer parte da dentição decídua normal ou supranumerária. Esses dentes, em geral, apresentam bordos cortantes e podem estar relacionados ao aparecimento de ulcerações na base da língua do bebê e/ou no seio materno, comprometendo a amamentação. A fraca implantação óssea desses dentes favorece sua grande mobilidade, tornando-se, assim, um fator de risco à sua aspiração ou deglutição pela criança. A abordagem terapêutica depende da dentição à qual pertence o dente e dos possíveis problemas que este pode causar à saúde da criança ou da mãe. CONCLUSÕES: O conhecimento sobre as características clínicas e os possíveis distúrbios aos quais os dentes natais e neonatais estão relacionados por odontopediatras e pediatras possibilita a interação necessária para o diagnóstico precoce e a abordagem integral da criança.

Gingival lesions diagnosed as pemphigus vulgaris in an adolescent. Case report

Desquamative gingivitis (DG) is a fairly common disorder in which the gingivae show chronic desquamation. Originally considered to be related to hormonal changes at menopause, since many of the patients are middle-aged women, DG is now recognized to be mainly a manifestation of a number of disorders ranging from vesiculobullous diseases to adverse reactions to a variety of chemicals or allergens. Desquamative gingivitis can be an important early clinical manifestation of serious systemic diseases such as pemphigus vulgaris. The authors present a case that illustrates the importance of a specific diagnosis in patients with desquamative gingival lesions previously treated for 6 months as classical gingivitis. Gingival biopsy showed histologic patterns typical of pemphigus vulgaris. The patient was treated with systemic and topical corticosteroids in association with miconazole the patient is now under control with low-close systemic corticosteroids. Proper recognition of lesions in the oral mucosa leads, in several situations, to an early diagnosis of a systemic disease.

Reliability of toluidine blue application in the detection of oral epithelial dysplasia and in situ and invasive squamous cell carcinomas

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.

Incisive Canal Deflation for Correct Implant Placement: Case Report

Aim: This article is a case report of a patient in whom the prosthetic planning indicated the necessity of an incisive canal deflation for the correct installation of all implant that is to be osseointegrated.Case Report. In the reopening phase after the bone graft installation, the incisive canal deflation (biopsy of its content) was done and titanium implants were installed with one of them invading the anatomical space occupied previously by the incisive canal. The biopsy analysis showed fragments of the incisive artery and nerve., which are responsible for the anterior upper-tooth pulp, the periodontium vascularization. and the innervation. Front the anastomosis present along with other structures allied with the absence of teeth in the region, there was no detriment to the patient caused by the deflation.Conclusion: Incisive canal deflation is a viable technique in implantology. It can permit ideal prosthetic planning with no detriment to the patient. (Implant Dent 2009;18:473-479)

Freqüência de Candida sp. em biópsias de lesões da mucosa bucal

O objetivo desse trabalho foi determinar a freqüência da infecção por Candida sp. em biópsias de lesões da mucosa bucal, assim como associar a presença de Candida sp. com lesões malignas e lesões com vários graus de displasia. Foram utilizadas 832 biópsias da mucosa bucal, previamente incluídas em parafinas, cujos blocos foram obtidos dos arquivos da Disciplina de Patologia da Faculdade de Odontologia de Araraquara da UNESP, no período entre 1990-2001. Três cortes seqüenciais foram corados pelo ácido periódico de Schiff (PAS). do total de biópsias 27,2% foram PAS positivas, dessas 83,25% eram provenientes de pacientes do sexo masculino. Houve associação positiva entre infecção com displasia epitelial leve, moderada, severa, carcinoma espinocelular e hiperqueratose (p < 0,05). Não houve associação entre hiperplasia fibrosa inflamatória, líquen plano, granuloma piogênico (p < 0,05) com infecções fúngicas. A língua foi o sítio mais acometido por infecções em relação a outros sítios (p < 0,05). A partir dos dados quantitativos, concluiu-se que houve correlação positiva de infecção por fungos, lesões displásicas e carcinoma, sendo mais freqüente no sexo masculino. Estes dados não permitem inferir se o fungo causa displasia epitelial e carcinoma, mas confirmam a maior presença de Candida nessas lesões.

Effectiveness of two disinfectant solutions and microwave irradiation in disinfecting complete dentures contaminated with methicillin-resistant Staphylococcus aureus

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

The use of bone scintigraphy to detect active Hansen's disease in mutilated patients

Mutilation of extremities was very frequent in patients affected by leprosy in the past; although it is now much less common, it is still seen, mainly in patients with long-term disease. In general, mutilation of the nose and ears is caused by the bacillus and mutilation of the hands and feet a consequence of chronic trauma. Leprosy must be chronically treated and any decision to interrupt therapy is based on laboratory tests and biopsy. Scintigraphy is a non-invasive procedure which could be of great value in to determining disease activity. We studied eight patients (five males and three females, aged 64-73 years) who presented with mutilation of the nose (2), ear (1), feet (3) or foot and hand (2), Conventional three-phase bone scintigraphy (750 MBq) and X-ray examinations of the affected areas were performed in all patients. Bone scintigraphy was abnormal in four patients (the presence of bacilli was confirmed by biopsy in two of them), and normal in the other four. In all patients except for the one with ear mutilation, radiography only showed the absence of bone. We conclude that bone scintigraphy is very useful to determine disease activity in cases of mutilation caused by leprosy. It seems to be superior to conventional radiography and may enable bone biopsies to be avoided.

A simple procedure for rehybridization of nuclei analyzed previously by fish

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Expressão dos genes que codificam as proteínas anexina-1 e galectina-1 nos pólipos rinossinusais e sua modulação pelo glicocorticoide

A fisiopatologia da polipose rinossinusal não é totalmente compreendida, apesar de várias hipóteses em relação ao seu processo inflamatório. OBJETIVOS: Estudo prospectivo da expressão dos genes das proteínas, anexina-1 e a galectina-1, que têm ação anti-inflamatória, e sua modulação pelo glicocorticoide. MATERIAL E MÉTODOS: Onze pacientes portadores de polipose rinossinusal tiveram biopsiados seus pólipos em dois momentos: na ausência de glicocorticoide sistêmico, e na sua presença. Nas duas amostras, foi avaliada a expressão desses genes e comparada com a expressão na mucosa nasal normal do meato médio. RESULTADOS: Verificou-se que a média de expressão dos genes que codifica a anexina-1 e galectina-1 estava predominantemente aumentada, independente do uso do glicocorticoide em relação à mucosa nasal controle. Entretanto, nos pólipos sem uso de corticoide, a média de expressão do gene da anexina-1 foi significativamente maior do que nos pólipos que estavam sob uso de glicocorticoide. Com relação à galectina-1 não houve diferença significativa entre as médias de expressão antes e após o uso de glicocorticoide sistêmico. CONCLUSÃO: Os genes apresentaram um aumento da expressão na mucosa nasal polipoide, independente do uso do glicocorticoide, porém a relação destes dois genes das proteínas anti-inflamatórias com o glicocorticoide não ocorreu da mesma maneira.