Immunohistochemical Analysis of Cyclooxygenase-2 and Tumor Necrosis Factor Alpha in Periapical Lesions.

INTRODUCTION: The purpose of this study was to evaluate the expression of cyclooxygenase-2 (COX-2) and tumor necrosis factor alpha (TNF-α) in periapical granuloma (PG) and radicular cyst (RC) samples and to correlate it with the type of lesion, the intensity of the inflammatory infiltrate, and the thickness of the epithelial lining. METHODS: A total of 51 cases of periapical lesions (25 PGs and 26 RCs) were subjected to morphologic analysis and immunohistochemical study. The anti-COX-2 and anti-TNF-α antibodies were applied using the immunoperoxidase technique. Data were analyzed by the Mann-Whitney test, Pearson chi-square test, Fisher exact test, and Spearman correlation. RESULTS: Analysis of the inflammatory infiltrate revealed that 80% of PGs exhibited a grade III infiltrate as opposed to a 19% rate in RCs (P < .001). Morphologic evaluation of the epithelial thickness of RCs revealed the presence of atrophic epithelium in 73% of cases. The majority of PGs had a score of 1 for COX-2 immunoexpression (n = 14, 54%) and a score of 2 for TNF-α expression (n = 16, 64%), whereas in cases of RCs a score of 1 was more prevalent for COX-2 and TNF-α expression (n = 17, 65%). Significant differences in the expression scores of COX-2 and TNF-α were detected in periapical lesions (P < .001). CONCLUSIONS: Based on these findings, we emphasize that RCs and PGs have a similar expression of inflammatory mediators (COX-2 and TNF-α) although the secretion of TNF-α by macrophages and of COX-2 by several cells was higher in PGs, indicating a greater inflammatory response in these lesions.

Differential expression of cyclooxygenase-2 and cyclin D1 in salivary gland tumors.

PURPOSE: Salivary gland tumors are complex and have a great histomorphological diversity; more than 30 histological subtypes are currently described and the study of proteins that help understand and differentiate these tumors is essential. We aimed to analyze the immunoexpression of cyclooxygenase-2 (COX-2) and cyclin D1 proteins in pleomorphic adenomas (PA), mucoepidermoid carcinomas (MEC) and adenoid cystic carcinomas (AdCC) of salivary glands. METHODS: A total of 38 PA, 12 AdCC and 12 MEC underwent immunohistochemical study by the polymeric biotin-free technique. Immunopositive cells were analyzed semi-quantitatively. For statistical analysis, a significance level was set at p ≤ 0.05. RESULTS: Overall, these tumors were more prevalent in women (n = 37). The mean age of these patients was 58-year-old and the parotid gland was the most affected anatomic site (n = 33). All cases of AdCC and MEC showed immunopositivity to cyclin D1; however, 39.5% of the PAs were negative (p < 0.001). Regarding COX-2 immunoexpression, we observed that all cases of CME were positive, whereas 60.5% of the PA and 75% of the CAC analyzed were completely negative (p = 0.042). CONCLUSIONS: The overexpression of COX-2, observed only in MEC, emphasizes that salivary gland tumors have different profiles. Cyclin D1 is more immunoexpressed in malignant tumors. Together, these immunohistochemical findings may be useful in differentiating the studied tumors.

Clinicopathological and cell proliferation evaluation of ameloblastomas and keratocystic odontogenic tumors: a 10 year retrospective study.

Odontogenic tumors (OTs) are important lesions of the gnathic bones due to their clinicopathological heterogeneity and variable biological behavior; therefore, epidemiological studies are needed to outline the incidence and behavior of these tumors. To evaluate the incidence and epidemiological profile of ameloblastoma (AMB) and keratocystic odontogenic tumor (KCOT) from an oral pathology service, and correlate morphological findings of these tumors with the immunoexpression of a cellular proliferation marker (Ki-67), a retrospective study (2002-2012) was conducted to characterize demographic, clinical, radiological, and morphological data of AMBs and KCOTs. Then, a representative sample composed of 49 cases of each tumor was selected to perform immunohistochemical (IHC) analysis of Ki-67 through the streptavidin biotin peroxidase technique. For statistical analysis, we used Fisher's exact test (p < 0.05). A total of 279 OTs were found in the service, in which 91 (32.6%) were AMB and 98 (35 %) were KCOT. Most cases occurred in white women, and the average age of patients with AMB and KCOT was 32 and 33 years, respectively. The maxilla-mandible ratio was 1:6 and 1:3.6 for AMB and KCOT, respectively. Regarding IHC analysis, AMB and KCOT had similar levels of cellular proliferation. However, KCOTs with intense inflammation showed higher Ki-67 expression (p < 0.001). Recurrent cases had similar Ki-67 immunoexpression. The demographic profile of the studied tumors corroborates with data reported in the literature, and the levels of cellular proliferation were similar in both tumors, although the inflammation seems to induce a differential proliferative behavior in KCOT.

Tooth Calcification in Low-Weight Human Fetuses / Calcificación de Dientes en Fetos Humanos de Bajo Peso

Tooth calcification begins during the intrauterine life and is related to the nutritional status of fetus. The purpose of this study was to evaluate the dental calcification status of 15 low-weight human fetuses aged from the 14th to 28th weeks of intrauterine life through radiographic analyses and von Kossa histochemical technique, which is specific to the detection of calcium and other mineral salts in tissues. After dissection of jaws, the mandibles were submitted to lateral and occlusal radiographies. Three mm thick slide sections of jaws samples were stained by conventional and von Kossa methods. As results, radiographic analysis did not exhibit any suggestive image of tooth mineralization, although rudiments of mandibular ossification could be noted. Hematoxilin and eosin sections revealed tooth germs in advanced phases of odontogenesis, but relative delay in tooth development was observed. The von Kossa staining did not show any positivity to the deposition of mineral salts in tooth germs from maxilla and mandible, supporting our findings related to the delay of dental development that was found in studied sample. Hence, we suggest that there is relation between the fetal low-weight and the calcification and maturation status of teeth.

La calcificación del diente comienza durante la vida intrauterina y se relaciona con el estado nutricional del feto. El propósito de este estudio fue evaluar el estado de calcificación dental de 15 fetos humanos de bajo peso entre las 14 y 28 semanas de vida intrauterina mediante análisis radiográficos y técnica histoquímica von Kossa, específica para la detección de calcio y otras sales minerales en los tejidos. Después de su disección, las mandíbulas fueron sometidas a radiografías laterales y oclusales. Secciones de 3 mm de espesor de las mandibulas fueron teñidas con la técnica Von Kossa. El análisis radiográfico no mostró ninguna imagen sugerente de mineralización dentaria, aunque rudimentos de la osificación mandibular podrían tenerse en cuenta. Las secciones de H-E revelaron la presencia de los gérmenes dentarios en las fases avanzadas de odontogénesis, pero con un retraso relativo en el desarrollo normal. La tinción de von Kossa no mostró positividad a la deposición de sales minerales en gérmenes dentarios, lo que apoya nuestros hallazgos relacionados con el retraso de desarrollo dental que se encontró en la muestra estudiada. Se sugiere que existe relación entre el bajo peso del feto y el estado de calcificación y maduración de los dientes.

A 38-year review of oral schwannomas and neurofibromas in a Brazilian population: clinical, histopathological and immunohistochemical study.

The benign peripheral nerve sheath tumours are rare lesions mainly represented by schwannoma and neurofibroma. The present work evaluated the clinical and histopathological features of schwannomas and neurofibromas of the oral cavity diagnosed in a Brazilian population. Among 9.000 cases of oral lesions archived from 1970 to 2008, four schwannomas and 12 neurofibromas were identified, microscopically revised and immunohistochemically certified through a panel including monoclonal antibodies (anti-S100, vimentin, HHF-35 and desmin). From biopsy and histological sections records, clinical and histopathological data were retrieved, reviewed and statistically analysed. Predominantly, schwannomas affected non-white males (3:1), with an age and size averages of 34.7 years and 2.8 cm, respectively. Neurofibromas preferentially occurred on the gingival/alveolar ridge of white females (5:1), with 35.7-year mean age, peak of incidence between 3rd and 5th decade, and size average of 1.7 cm. (12 cases, 75%). The studied tumours exhibited more frequently as a painless, sessile and slow growth very similar to other oral lesions, but their microscopic features differed significantly. Schwannomas and neurofibromas are extremely uncommon in the oral cavity, exhibiting clinical features very similar but specific and peculiar microscopic findings that are useful in the establishment of the diagnosis, which in some particular cases must be confirmed by immunohistochemistry.

Epidemiological study of 534 biopsies of oral mucosal lesions in elderly Brazilian patients.

BACKGROUND: The number of elderly people in Brazil has increased during the last few decades. Oral lesions are very common in this age group, but few studies have examined the prevalence of these conditions worldwide and, particularly, in Brazil. PURPOSE: This study aimed to evaluate the frequency of oral lesions in an elderly Brazilian population. MATERIALS AND METHODS: A total of 534 cases of oral lesions retrieved from the files of the Oral Pathology Laboratory of the School of Dentistry, University of Pernambuco, between 1991 and 2008, were descriptively and qualitatively evaluated. RESULTS: In this study, the oral mucosal lesions cases preferentially affected women (n=357; 66.8%), white persons (n=253; 47.3%), in the seventh decade of life (n=361; 67.6%), and with lesions predominantly located on the gingival/alveolar ridge (n=102; 19.1%). The non-neoplastic lesions (n=353; 66.1%) were more prevalent than benign neoplasms (n=85; 15.9%), oral cancers (n=56; 10.4%) and potentially malignant lesions (n=40; 7.4%). The five most predominant diseases were fibrous hyperplasia, non-specific chronic inflammatory processes, oral squamous cell carcinoma, non-specified odontogenic cysts and epithelial dysplasia. CONCLUSIONS: Our results may be helpful in understanding the distribution of oral diseases in this very specific age group that requires special attention.

Association of aesthetic and orthodontic treatment in Parry-Romberg syndrome.

Parry-Romberg syndrome (PRS) is an uncommon degenerative condition characterized by a slow, progressive, and, generally, unilateral atrophy of facial tissues, including muscles, bones and skin. Ophthalmological and neurological manifestations have frequently been observed and few oral changes have been reported. This article reports a case of PRS in a 22-year-old woman, exhibiting facial asymmetry, hypoplasia of the right side of the face, areas of skin hyperpigmentation, and oral alterations, involving the mandible and teeth. These clinical and radiological findings led to the diagnosis of PRS. In an attempt to improve the patient's facial aesthetic and the dental functions, oral pentoxifylline, orthodontic rehabilitation, and subcutaneous injections of polymethylmethacrylate microspheres were used as part of the treatment for the facial atrophy. Together, these approaches accounted for a minimal invasive treatment with long term satisfactory results.