Expressão imuno-histoquímica dos marcadores angiogênicos CD105 (endoglina) e CD34 em hemangiomas e granulomas piogênicos orais

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

Cisto dentígero: estudo epidemiológico, correlação clinicopatológica e caracterização de uma possível variante inflamatória

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

Expressão imuno-histoquímica da calponina em glândula parótida de rato após obstrução do ducto excretor principal

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.

Expressão imuno-histoquímica das proteínas IFN-γ e TGF-β1 em cistos radiculares e cistos dentígeros

Odontogenic cysts are pathologic cavities covered by odontogenic epithelium and filled by liquid, desquamated cells or other materials. The intraosseous lesions, such as radicular cyst and dentigerous cyst, present a potential of expansion capable of promoting the destruction of the surrounding osseous tissue. The mechanisms related to this process of expansion are the proliferation of cystic epithelium, the increase of the osmolarity of the cystic fluid and the synthesis of reabsorption factors such as IFN-γ and TGF-β1. The aim of this study was to evaluate and compare the immunohistochemical expression of IFN-γ and TGF-β1 between radicular cysts and dentigerous cysts in order to understand the role and behavior of these proteins in the expansion of these cysts. We selected 20 cases of radicular cyst and 20 cases of dentigerous cyst chosen from the files of UFRN s Laboratory of Oral Pathology. After analyzing the clinical data, the cases underwent the routine staining technique (HE) and immunohistochemistry for the appearance of IFN-γ and TGF-β1 in the epithelium and capsule of these cysts. The statistical analysis using the Mann-Whitney test revealed no statistically significant difference in immunoexpression of IFN-γ between the epithelium (p = 0.565) and capsules (p = 0.414) of radicular cysts and dentigerous cysts. Moreover, there was no statistically significant difference of immunoexpression of TGF-β1 between the epithelium (p = 0.620) and capsules (p = 0.056) of radicular cysts and dentigerous cysts. The Wilcoxon test revealed no statistically significant difference between IFN-γ and TGF-β1 imunoexpressions in the epithelium (p = 0.225) and capsules (p = 0.370) of radicular cysts. There was no statistically significant difference between IFN-γ and TGF-β1 imunoexpressions in the epithelium (p = 0.361) of dentigerous cysts. However, there was a statistically significant difference between IFN-γ and TGF-β1 immunoexpressions in the capsule (p = 0.001) of dentigerous cysts, being TGF-β1 the factor which presented the most significant immunoexpression. Given these results, we conclude that there was no difference in immunohistochemical expression of IFN-γ and TGF-β1 between radicular and dentigerous cysts and that TGF-β1 was more significant than the IFN-γ in the capsule of dentigerous cysts

Expressão imunoistoquímica de Glut-1 e marcadores de proliferação e apoptose em anomalias vasculares orais

Vascular anomalies constitute a distinct group of lesions, but they may present similar clinical and histopatological characteristics, which can lead to diagnostic mistakes. This study aimed by histopathology and immunohistochemical expression of human glucose transporter protein (GLUT-1), correctly identify and classify oral vascular anomalies, besides analyzing the immunoexpression of markers proliferation and apoptosis (Ki-67 and Bcl-2). All cases diagnosed as "oral hemangiomas" belonging to the archives of the Service of Pathological Anatomy from the subject of Oral Pathology of the Department of Dentistry (DOD), of the Federal University of Rio Grande do Norte (UFRN) were reviewed, totalizing 77 cases. Immunohistochemical analysis for GLUT-1 showed that only 26 (33.8%) of the specimens were true infantile hemangiomas (IHs). The 51 (66.2%%) GLUT-1 negative specimens were then reclassified as pyogenic granulomas (PGs) and vascular malformations (VMs) from their histopathologic characteristics,totalizing 26 (33.8%) cases of IHs, 20 (26.0%) of PGs and 31 (40.2) cases of oral VMs. The cases analyzed by the marker Ki-67 showed different median IH (13,85), PG (33,70) and VM (4.55) with statistically significant differences between them (p <0.001). In relation to the protein Bcl-2, the groups also showed different median of the established scores IH (1.00), PG (1.50), VMs (0.0) demonstrating statistically significant differences between them (p<0,001). No statistically significant correlation between the indexes of positivity for Ki-67 and the scores of immunoexpression of Bcl-2 were observed in any group. Thus, we can conclude that it is necessary a careful and parameterized review of cases of vascular anomalies making use of auxiliary tools such as GLUT-1, since the histopathological findings alone, sometimes, are not sufficient to differentiate some anomalies. Furthermore, analysis of the expressions of markers involved in the levels of proliferation of lesions is important for a better understanding of its biological behavior aspect

Setting time and thermal expansion of two endodontic cements

The purpose of this study was to evaluate the setting time and the thermal expansion coefficient of 2 endodontic cements, MTA-Angelus and a novel cement called CER. The setting time was determined in accordance to ANSI/ADA specifications no. 57. Three samples of 10 mm diameter and 2 mm thickness were prepared for each cement. The thermal expansion measurements were performed by strain gauge technique. Four samples of each cement were prepared using silicone rings of 5 mm diameter and 2 mm thickness. The data were analyzed statistically using the Student t test. The setting time obtained for the MTA-Angelus and CER cements was 15 (SD 1) min and 7 (SD 1) min, respectively. The linear coefficient of thermal expansion was 8.86 (SD 0.28) mu strain/degrees C for MTA-Angelus and 11.76 (SD 1.20) mu strain/degrees C for CER. The statistical analysis showed significant difference (P < .05) in the setting time and linear coefficient of thermal expansion between the 2 cements. The CER cement has a coefficient of expansion similar to dentin, which could contribute to a decrease of microleakage degree.

Genotoxicity of antimicrobial endodontic compounds by single cell gel (comet) assay in Chinese hamster ovary (CHO) cells

Objective. In the current study, the potential DNA damage associated with exposure to a number of antimicrobial endodontic compounds was assessed by the single cell gel (comet) assay in vitro.Study design. Chinese hamster ovary (CHO) cells were exposed to formocresol, paramonochlorophenol, calcium hydroxide, or chlorhexidine at final concentration ranging from 0.01% to 1%.Results. Formocresol, paramonochlorophenol, and calcium hydroxide, as well as chlorhexidine in all concentrations tested did not contribute to the DNA damage.Conclusion. These findings are clinically relevant since they represent an important contribution to the correct evaluation of the potential health risk associated with exposure to dental agents.

Mineral trioxide aggregate stimulates macrophages and mast cells to release neutrophil chemotactic factors: role of IL-1 beta, MIP-2 and LTB4

Objective. In the present study, the role of macrophages and mast cells in mineral trioxide aggregate (MTA)-induced release of neutrophil chemotactic factor was investigated.Study design. MTA suspension (50 mg/mL) was plated over inserts on macrophages or mast cells for 90 minutes. Untreated cells served as controls. Cells were washed and cultured for 90 minutes in RPMI without the stimuli. Macrophages and mast cell supernatants were injected intraperitoneally (0.5 mL/cavity), and neutrophil migration was assessed 6 hours later. In some experiments, cells were incubated for 30 minutes with dexamethasone (DEX, 10 mu M/well), BWA4C (BW, 100 mu M/well) or U75302 (U75, 10 mu M/well). The concentration of Leukotriene B-4 (LTB4) in the cell-free supernatant from mast cells and macrophage culture was measured by ELISA.Results. Supernatants from MTA-stimulated macrophages and mast cells caused neutrophil migration. The release of neutrophil chemotactic factor by macrophages and mast cells was significantly inhibited by DEX, BW, or U75. Macrophages and mast cells expressed mRNA for interleukin-1 (IL-1)beta and macrophage inflammatory protein-2 (MIP-2) and the pretreatment of macrophages and mast cells with DEX, BW, or U75 significantly altered IL-1 beta and MIP-2 mRNA expression. LTB4 was detected in the MTA-stimulated macrophage supernatant but not mast cells.Conclusions. MTA-induces the release of neutrophil chemotactic factor substances from macrophages and mast cells with participation of IL-1 beta, MIP-2, and LTB4. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 109: e135-e142)

Mechanism of calcium hydroxide-induced neutrophil migration into air-pouch cavity

The aim of this study was to investigate cellular migration induced by calcium hydroxide to air-pouch cavities in mice. The migration was more specific to neutrophil and was dose and time dependent (peaking 96 h after stimulation). This migration was inhibited by pretreatment with thalidomide, indomethacin, MK886, meloxicam, dexamethasone, MK886 associated with indomethacin, and MK886 associated with indomethacin and dexamethasone. The air-pouch exudate from animals stimulated with calcium hydroxide showed an increase of leukotriene-B4 (LTB4), interleukin-1 beta, tumor necrosis factor alpha (TNF-alpha), cytokine-induced neutrophil chemoattractant (KC), and macrophage inflammatory protein 2 (MIP-2) release. Pretreatment with 3% thioglycollate increased the macrophage population in the air pouch but did not change neutrophil migration. Depleting the resident mast cells through chronic pretreatment with compound 48/80 did not alter neutrophil migration in response to calcium hydroxide. It was possible to conclude that calcium hydroxide-induced neutrophil migration to the air-pouch cavity in mice is mediated by LTB4, TNF-alpha, KC, MIP-2, and prostaglandins, but it was not dependent on macrophages or mast cells.

Evaluation of alveolar socket response to Angelus MTA and experimental light-cure MTA

Objective. The aim of this study was to evaluate the rat alveolar socket response to implanted polyethylene tubes filled with a light-cured MTA or Angelus MTA.Study design. Fifty-seven Wistar rats received an implant filled with one of the materials in the dental socket of the right central incisor. After 30, 60, and 90 days, animals were killed, and the right hemimaxillas were removed and processed to be analyzed on light microscopy. After embedding in paraffin, 6-mu m-thick sections were obtained and stained with hematoxylin and eosin. Qualitative and quantitative analyses of the reaction were performed.Results. It was observed that the light-cured MTA presented a similar response compared with Angelus MTA, characterized by the reduction of the chronic inflammatory response and organization of the alveolar bone close to the materials, especially at the 90th day of observation.Conclusions. It was concluded that both materials were well accepted by the alveolar tissue of rats, with the formation of mineralized tissue close to the materials. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;110:e93-e97)

Bone healing in critical-size defects treated with platelet-rich plasma: a histologic and histometric study in the calvaria of diabetic rat

Objective. The objective of this study was to histologically analyze the influence of the platelet-rich plasma (PRP) on bone healing in surgically created critical-size defects (CSD) in the calvaria of diabetic rats.Study design. A total of 20 diabetic rats were divided into 2 groups: C (control) and PRP. A 5-mm diameter CSD was created in the calvarium of each animal. In Group C, the defect was filled by blood clot only. In Group PRP, 0.35 mL of PRP was placed in the defects. All animals were humanely killed 30 days postoperatively. Histometric and histologic analyses were performed. Data were statistically analyzed (t test, P < .05).Results. No defect completely regenerated with bone. Group PRP had a statistically greater amount of bone formation than Group C (37.22% +/- 6.00% and 21.68% +/- 11.35%, respectively).Conclusion. PRP placed in the defects significantly enhanced bone healing in CSD in the calvaria of diabetic rats both qualitatively and quantitatively. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 109: 72-78)

A modified approach for vestibuloplasty in severely resorbed mandible using an implant-retained postoperative stent: a case report

Background. Severely resorbed mandibles often present a short band of keratinized tissue associated with a shallow vestibule. As a result, prominent muscle insertions are present, especially in the mental region of the mandible. This case report describes the deepening of the vestibular sulcus in an atrophic mandible by combining free gingival grafts harvested from the palate and a postoperative acrylic resin stent screwed on osseointegrated implants placed at the anterior region of the mandible.Study design. During the second-stage surgery, a split-thickness labial flap was reflected and apically sutured onto the periosteum. Two free gingival grafts were obtained and then sutured at this recipient site. A previously custom-made acrylic stent was then screwed onto the most distally positioned implants. To document the procedure's stability over time, a metal ball was placed in the most apical part of the vestibule and standardized cephalometric radiographs were taken before and 6 months after the procedure. Linear measurements of vestibular depths over the observation time were realized using specific software for radiographic analysis.Results. The proposed technique augmented the band of attached masticatory mucosa, deepened the vestibule and prevented the muscle reinsertion. The difference between the 2 measurements of vestibular depths was 9.39 mm (initial 20.88 mm, final 11.49 mm) after a 6-month postoperative period.Conclusion. The technique, in combination with palatal mucosal graft and use of a postoperative stent, decreased the pull of mentalis muscle and provided a peri-implantally stable soft tissue around implants. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008; 106: e7-e14)

Ameloblastic carcinoma of the maxilla: A case report

This study aims to present the clinical features and treatment of a case of maxillary ameloblastic carcinoma. A meloblastic carcinoma is a rare malignant odontogenic carcinoma that has metastatic potential. Due to its rare incidence, there are few studies focusing on its radiological characteristics. When ameloblastic carcinoma demonstrates an aggressive appearance, it may be diagnosed as a malignant tumor; however, in cases showing a non-aggressive appearance, it is difficult to distinguish ameloblastic carcinoma from ameloblastoma. We report a case of ameloblastic carcinoma of the maxilla in a 59-year-old male patient, including the clinical signs, radiological images and pathological features. A partial area was surgically excised under local anesthesia and the material was sent to the Laboratory of Oral Pathology. The histological sections revealed a fragmented odontogenic tumor of epithelial origin, consisting of solid parenchyma and also revealed basal cells resembling ameloblasts, occasionally arranged in palisades. Certain parts of the architecture resembled that of an ameloblastoma; however, the cytology of other areas confirmed the diagnosis of ameloblastic carcinoma of the maxilla. The patient was scheduled for definitive surgery, including a right maxillectomy and radiotherapy. The patient was followed up every 3 months. After 2 years follow-up, there were no clinical or radiological signs of recurrence.

Epidemiologia do câncer de boca em laboratório público do Estado de Mato Grosso, Brasil

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Influence of apical foramen widening and sealer on the healing of chronic periapical lesions induced in dogs' teeth

Objective. The aim of this study was to evaluate the influence of apical foramen widening on the healing of chronic periapical lesions in dogs' teeth after root canal filling with Sealer 26 or Endomethasone.Study design. Forty root canals of dogs' teeth were used. After pulp extirpation, the canals were exposed to the oral cavity for 180 days for induction of periapical lesions, and then instrumented up to a size 55 K-file at the apical cemental barrier. In 20 roots, the cemental canal was penetrated and widened up to a size 25 K-file; in the other 20 roots, the cemental canal was preserved (no apical foramen widening). All canals received a calcium hydroxide intracanal dressing for 21 days and were filled with gutta-percha and 1 of the 2 sealers: group 1: Sealer 26/apical foramen widening; group 2: Sealer 26/no apical foramen widening; group 3: Endomethasone/apical foramen widening; group 4: Endomethasone/no apical foramen widening. The animals were killed after 180 days, and serial histologic sections from the roots were prepared for histomorphologic analysis. Scores were assigned according to preestablished histomorphologic parameters and analyzed statistically by Kruskal-Wallis and Mann-Whitney U tests.Results. Regarding new cementum formation, repair of cementum and bone resorption areas, presence of microorganisms, inflammatory cell infiltrate and periodontal ligament conditions, significantly better periapical healing was obtained when foramen widening was done and Sealer 26 was used.Conclusion. Apical foramen widening and calcium hydroxide-containing sealer were more favorable to the healing of chronic periapical lesions. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;109:932-940)