Modulation of Matrix Metalloproteinase 14, Tissue Inhibitor of Metalloproteinase 3, Tissue Inhibitor of Metalloproteinase 4, and Inducible Nitric Oxide Synthase in the Development of Periapical Lesions.

INTRODUCTION: Periapical cysts and granulomas are chronic lesions caused by an inflammatory immune response against microbial challenge in the root canal. Different cell types, cytokines, and molecules have been associated with periapical lesion formation and expansion. Therefore, because of the chronic inflammatory state of these lesions, the aim of this study was to evaluate the in situ expression of matrix metalloproteinase (MMP)-14 and -19, tissue inhibitor of metalloproteinase (TIMP)-3 and -4, CD68, and inducible nitric oxide synthase (iNOS) in periapical cysts and granulomas. METHODS: Sixteen cases of periapical cysts and 15 cases of periapical granulomas were analyzed. Ten normal dental pulps were used as the negative control. Immunohistochemistry was performed with anti-MMP-19, anti-MMP-14, anti-TIMP-3, anti-TIMP-4, anti-iNOS, and anti-CD68 antibodies. RESULTS: The expression of TIMP-3, TIMP-4, iNOS, and CD68 was significantly higher in both the cyst and granuloma groups than in the control group. TIMP-4 was also significantly higher in cases of chronic apical abscess. There was also a significant difference in the expression of MMP-14 between the cyst and control groups. However, there were no differences in the expression of MMP-19 between the 3 groups. CONCLUSIONS: Our data suggest that the expression of MMP-14, TIMP-3, and TIMP-4 is associated with the development of periapical lesions.

Galectin-9 as an important marker in the differential diagnosis between oral squamous cell carcinoma, oral leukoplakia and oral lichen planus.

OBJECTIVES: To evaluate the expression of Galectins (Gal) 1, 3 and 9, Metalloproteinase 3 (MMP-3) and mast cell density in oral lesions of patients with potentially malignant disorders (PMD) and oral squamous cell carcinomas (OSCC) by comparison with the controls. STUDY DESIGN: We selected 40 cases of PMD, 40 OSCC and 13 with normal histopathological profile. Immunohistochemistry was performed for Gal-1, Gal-3, Gal-9 and MMP-3. RESULTS: Gal-9 was significantly higher in patients with OSCC than in others groups (p < 0.001). Gal-1 expression was significantly lower in patients with leukoplakia than those with OSCC and controls (p = 0.0001). Gal-3 was significantly lower in patients with OSCC than those with leukoplakia (p = 0.03). MMP-3 was lower in patients with leukoplakia in comparison with the lichen planus group (p = 0.013). CONCLUSION: The increased expression of Gal-9 may be helpful to differentiate of OSCC from other oral cavity lesions.

Evaluation of in situ expression of effector and regulatory cytokines, TLR, galectins and matrix metalloproteinases in oral manifestations of paracoccidioidomycosis.

BACKGROUND: Although the pathophysiology of paracoccidioidomycosis (PCM) is not completely understood, the study of immune response against fungus has provided insight into understanding the natural course of the disease and its clinical manifestations, hence contributing to the development of preventive measures and treatment proposals. The aim of this study was to evaluate the histopathological and immunological aspects involved in the role of different effector and regulatory responses, as well as the correlation between the TLRs, Galectins, Matrix Metalloproteinases and cytoplasmic proteases of mast cells in this infection. METHODS: Sixteen biopsy specimens with oral lesions of chronic PCM, as well as 13 sections of normal oral mucosa were analyzed. Histopathological and immunological aspects involved in the role of different effector and regulatory responses were evaluated. Indirect immunohistochemistry was performed for IL-17, IL-10, IL-4, TGF-ß, FoxP3, Gal-1, Gal-3, Gal-9, TLR-2, TLR-4, MMP-3 and MMP-9, as well as for chymase and tryptase for mast cells identification. Fibrosis was quantified using Picrosirius. RESULTS: There was a significant increase in the area of fibrosis and in the number of cells expressing IL-10, IL-4, IL-17, FoxP3, Gal-3, TLR-2, MMP3 and MMP9 in patients with PCM in comparison with patients in the group control. There was no difference in the expression of TGF-ß, TLR-4, Gal-1 or Gal-9. Mast cells number was found to be significantly lower in oral chronic PCM when compared to control samples after quantification of mast cells and expression of chymase and tryptase. PCM granulomas were classified to the morphological aspects in organized ou non-organized. Expression of IL-4 in non-organized granulomas was significantly higher. CONCLUSION: The proteins studied herein appear to play an important role in the development and maintenance of oral lesions of PCM, as well as in the processes of development and progression of lesions caused by the fungus and by the immune response associated with the infection.

Higher expression of galectin-3 and galectin-9 in periapical granulomas than in radicular cysts and an increased toll-like receptor-2 and toll-like receptor-4 expression are associated with reactivation of periapical inflammation.

INTRODUCTION: Cysts and periapical granulomas are inflammatory reactions that develop in response to periapical infection by microbial species in dental root canal. It is known that toll-like receptors (TLRs) are pathogen recognition molecules and that galectins are lectins that can be associated with the inflammatory process, stimulating or inhibiting the immune system. The objective of this study was to evaluate the in situ expression of TLRs and galectins in radicular cysts and periapical granulomas. METHODS: We analyzed 62 cases (30 radicular cysts, 27 periapical granulomas, and 5 control cases). Indirect immunohistochemistry was used to evaluate the expression of TLRs (TRL-2 and TLR-4) and galectins (Gal-3 and Gal-9). RESULTS: The expression of Gal-3 and Gal-9 was significantly higher in periapical granulomas and radicular cysts than in the control group. Similarly, both Gal-3 and Gal-9 were expressed significantly more in periapical granulomas than in radicular cysts. The expression of TLR-2 was significantly higher in periapical granulomas and radicular cysts than in the control group, and it was also significantly higher in radicular cysts with sinus tract than in the cases without sinus tract. Furthermore, the expression of TLR-4 was significantly higher in the cases of periapical granulomas with sinus tract than in the cases without sinus tract. CONCLUSIONS: Gal-3/Gal-9 and TLR-2/TLR-4 expression in the periapical granulomas and radicular cysts is associated with reactive periapical inflammation. Pathobiology of periapical disease is a very complex interplay of many bioactive molecules involved in immunoinflammatory responses. Up-regulation of these bioactive molecules might be an important modulator of inflammatory periapical lesions.

Quantification of fibrosis and mast cells in the tissue response of endodontic sealer irradiated by low-level laser therapy.

Low-level laser therapy (LLLT) accelerates tissue repair. Mast cells induce the proliferation of fibroblasts and the development of local fibrosis. The objective of this study was to quantify fibrosis rate and mast cells in connective tissue after endodontic sealer zinc oxide and eugenol (ZOE) was implanted and submitted to LLLT, immediately after implant and again 24 h later. Sixty mice were distributed into three groups: GI, GII, and GIII (n = 20). In GI, the tubes filled with Endofill were implanted in the animals and were not irradiated with LLLT. In GII, the tubes containing Endofill were implanted in the animals and then irradiated with red LLLT (InGaAIP) 685-nm wavelength, D = 72 J/Cm(2), E = 2 J, T = 58 s, P = 35 mW, and in GIII, the tubes with Endofill were implanted and irradiated with infrared LLLT (AsGaAl) 830-nm wavelength, D = 70 J/Cm(2), E = 2 J, T = 40 s, P = 50 mW. After 7 days and 30 days, the animals were killed. A series of 6-µm-thick sections were obtained and stained with Toluidine Blue and Picrosirius and analyzed under a standard light microscope using a polarized light filter for the quantification of fibrosis. The statistics were qualitative and quantitative with a significance of 5%. The irradiation with LLLT did not offer improvement in the fibrosis rate, however, it provided a significant decrease in the concentration of independent mast cells for the period studied.

[Evaluation of cytopathologic exam for diagnosis of oral chronic paracoccidioidomycosis]. / Avaliação do exame citopatológico como método para diagnosticar a paracoccidioidomicose crônica oral.

With the aim of evaluating exfoliative cytology for the diagnosis of paracoccidioidomycosis oral lesions, eight patients that presented the disease were studied. The presence of fungi was demonstrated in all these cases. It was concluded that the oral exfoliative cytology exam can be effectively used in the diagnosis of paracoccidioidomycosis and contribute to the therapeutic control of oral forms of this mycosis.

Avaliaçäo do exame citopatológico como método para diagnosticar a paracoccidioidomicose crônica oral / Evaluation of cytopathologic exam for diagnosis of oral chronic paracoccidioidomycosis

Com o objetivo de avaliar o exame citológico esfoliativo no diagnóstico das lesöes orais da paracoccidioidomicose, foram estudados oito portadores desta doença. Em todos os casos, demonstrou-se o fungo através de esfregaços citológicos corados com impregnaçäo pela prata Gomori-Grocott. Conclui-se que a citologia esfoliativa oral é um método diagnóstico útil e válido na paracoccidioidomicose, podendo auxiliar no controle terapêutico das formas orais desta micose

Mucocele (fenômeno de extravasamento de muco) de assoalho bucal: caso clínico / Mucocele (mucous extravasation phenomenon) of mouth floor

Os autores fazem uma revisäo da literatura sobre as mucoceles e apresentam um caso clínico de mucocele de extravasamento no assoalho bucal, que foi tratado cirurgicamente. Dada sua freqüência na cavidade bucal, seja por fenômeno de extravasamento, seja por retençäo de muco, e pelo fato de se apresentarem com diferentes características clínicas, os autores enfatizam a necessidade da realizaçäo do diagnóstico diferencial, e que todos os cirurgiöes-dentistas deveriam familiarizar-se com a etiopatogenia, as características clínicas e microscópicas, o diagnóstico, o prognóstico e o tratamento dessas lesöes

Análise epidemiológica de pacientes acometidos com paracoccidioidomicose em regiäo endêmica do estado de Minas Gerais / Epidemiologic study of patients with paracoccidioidomycosis in an endemic region of Minas Gerais

A paracoccidioidomicose é uma micose autóctone da América Latina, sendo as maiores causuísticas registradas no Brasil, Argentina, Colômbia e Venezuela. Com a finalidade de identificar dados relevantes sobre a história clínica e patológica, sistêmica e oral dos pacientes com a micose, foram analisados 92 prontuários de casos de paracoccidioidomicose do Arquivo Nosológico do Hospital-Escola da Faculdade de Medicina do Triângulo Mineiro da cidade de Uberaba - MG, que ocorreram entre os anos de 1982 a 1997. A análise dos dados revelou que 100 pacientes foram internados com a micose nos últimos 15 anos, com média anual de 6,6 casos, com maior prevalência para indivíduos do sexo masculino entre 31 e 50 anos de idade, afetando principalmente aqueles envolvidos com atividades agrícolas. Foi observada a ausência de um protocolo específico para a coleta de informaçöes anamnésicas, principalmente as de interesse odontológico, dos pacientes internados em decorrência da micose. Também, näo se observou nenhum tipo de intervençäo odontológica durante o tratamento, bem como no prognóstico e proservaçäo das lesöes orais ocorridas

Cisto dermóide mediano de assoalho bucal - relato de caso clínico / Median dermoid cyst of the mouth floor - a case report

Os autores apresentam um caso de cisto demóide mediano de assoalho bucal, volumoso, que foi tratado cirurgicamente sob anestesia local. Mesmo sendo estes cistos de desenvolvimento infreqüêntes na cavidade bucal, seja mediano ou lateral, e pelo fato de suas características clínicas assemelharem-se com cisto epidermóide e outras patologias, os autores enfatizam a necessidade da realização do diagnóstico diferencial, e que todos os cirurgiões-dentistas deveriam familiarizar-se com estas lesões: etiopatogenia, características clínicas e miocroscópicas, diagnóstico, prognóstico e tratamento, fazendo revisão da literatura