Assessment of the knowledge of canalis sinuosus amongst dentists and dental students: An online-based cross-sectional study.

INTRODUCTION: Canalis sinuosus (CS) is a neurovascular canal that corresponds to a small branch of the infraorbital canal. This study aimed at assessing the knowledge and detection performance of CS amongst dentists and dental students. MATERIALS AND METHODS: Four-hundred and five dentists and dental students answered a questionnaire with three parts: 1. Socio-demographical; 2. Clinical cases with cone- beam computed tomography (CBCT) sections showing CS and 3. Previous knowledge about CS. The chi-squared test and Spearman's correlation test were used to compare results as appropriate. p-values below .05 were considered statistically significant. RESULTS: Most participants did not identify CS in any CBCT. There was an association between the number of correct answers and dental specialties. Most individuals had not learned about CS previously. There was an association between past knowledge of CS and gender, highest academic degree, working environment, dental specialty and number of correct answers but not with age or experience in Dentistry. CONCLUSION: This study suggests that most dentists are not aware about CS and do not know how to diagnose it. Previous knowledge about CS positively influenced its identification in CBCT.

Craniofacial Features in Richieri-Costa-Pereira Syndrome.

OBJECTIVE: Patients with Richieri-Costa-Pereira syndrome (RCPS) present severe craniofacial alterations and frequently require orthodontic and surgical procedures. Thus, this study aims to describe the craniofacial relationships in patients with RCPS. DESIGN: Panoramic radiographs and lateral cephalometric teleradiographs of 7 patients with RCPS and 7 age- and sex-matched nonsyndromic patients were analyzed. Cephalometric measurements were used to determine the size of apical bases, the relationship between them, the pattern of craniofacial growth, and the facial heights of the patients. Interobservers' concordance was verified by intraclass coefficient. For comparison between the groups, paired t test was employed. P values <.05 indicated statistical significance. RESULTS: Average age of patients with RCPS was 18.5 years. Six patients were female. All patients with RCPS had Pierre-Robin sequence while 2 also presented cleft mandible. Most patients with RCPS had missing lower central incisors (100%), lower lateral incisors (85.7%), lower second premolars (85.7%), and/or upper lateral incisors (57.1%). Concordance between observers was excellent for all cephalometric measurements (0.87-0.99). Patients with RCPS presented severe craniofacial alterations when compared to control group: sella-nasion-B point (SNB) angle (73.8o ± 4.86o vs 78.85o ± 4.53o, P = .029), maxillary length (7.89 cm ± 0.58 cm vs 16.36 cm ± 0.75 cm, P = .001), mandibular length (9.90 cm ± 0.46 cm vs 20.61 cm ± 0.45 cm, P = .001), upper anterior face height (5.41 cm ± 0.50 cm vs 9.40 cm ± 0.47 cm, P = .001), lower anterior face height (5.48 cm ± 0.75 cm vs 11.66 cm ± 0.55 cm, P = .001), and posterior face height (6.70 cm ± 0.33 cm vs 13.65 cm ± 1.06 cm, P = .001). There was no difference in SNB, A point-nasion-B point, pogonion-nasion-B point, and mandibular place angles between the groups (P > .05). CONCLUSION: Patients with RCPS present deficient development of maxilla and mandible when compared with nonsyndromic patients.

Canalis sinuosus: An Anatomic Repair that May Prevent Success of Dental Implants in Anterior Maxilla.

Canalis sinuosus (CS) is a neurovascular canal that corresponds to a small branch of the infraorbital canal. It contains the anterior superior alveolar nerve and vessels, supplying the anterior maxilla. Despite having been described 81 years ago, CS is not recognized by many dental practitioners and may be the cause of unintended injuries during dental procedures. The aims of this study are to report a case of a patient who suffered pain due to exposure of the CS, to provide a comprehensive review of other CS cases that were challenging to diagnose, and to propose guidelines for preoperative examination of patients undergoing surgical procedures in the anterior maxilla. The review of the literature revealed six cases, in addition to the one presented here, of unintended or potential damage to CS. Five out of seven cases were related to dental implant placement and resulted in postoperative pain and/or paresthesia. The dental implant was removed in 4 out of the 5 cases. This study reinforces the importance of awareness of CS by dental practitioners and provides a protocol for the preoperative examination of the patient to prevent avoidable injuries to CS.

Extra-Gingival Pyogenic Granuloma Displacing Teeth.

Pyogenic granuloma is a common cause of growth of soft tissue in the oral cavity, especially in the gingiva. It is mainly associated with local and chronic irritants besides hormonal changes during pregnancy. Here, the authors present an unusual patient of an extra-gingival pyogenic granuloma with large dimensions and displacing teeth arising in a male patient. This is an interesting patient to be reported due to its exacerbated and atypical clinical features.

Pemphigus Vulgaris: How to Perform an Oral Biopsy Properly?

Oral biopsy of vesiculobullous diseases such as pemphigus vulgaris often raises questions due to some particularities involving this procedure. The adequate selection of the area to be biopsied defines if the final diagnosis will be reached, being the Achiles heel of the proper management of the patient. Here, the authors report a case of a woman who sought for treatment of generalized oral blisters and ulcers that caused severe pain. She had undergone a previous biopsy by other professionals that was inconclusive. The authors' team diagnosed the patient with pemphigus vulgaris and treated her properly. The authors provide a brief discussion about the adequate oral site to be chosen when dealing with vesiculobullous diseases once it still remains a source of doubts for the dental surgeons.

The relationship between ezrin and podoplanin expressions in keratocystic odontogenic tumors.

BACKGROUND: The aims of this study were to investigate the immunolocalization of ezrin and its relationship with the podoplanin expression in keratocystic odontogenic tumors. MATERIAL AND METHODS: The immunohistochemical expressions of ezrin and podoplanin by odontogenic epithelium were evaluated in keratocystic odontogenic tumors using monoclonal antibodies. RESULTS: Our results showed strong cytoplasmic ezrin and membranous podoplanin expressions in basal epithelial layer of all keratocystic odontogenic tumors. The cytoplasmic and membranous ezrin expressions were also detected in suprabasal epithelial layers of tumors. Statistically significant difference between cellular immunolocalization of ezrin and podoplanin odontogenic epithelium were found by Wilcoxon's test (p < 0.05). No correlation between both proteins in keratocystic odontogenic tumors was detected by Spearman test. CONCLUSIONS: These results suggest that ezrin and podoplanin may contribute to the expansive growth and local invasiveness of keratocystic odontogenic tumors. Additionally, as both proteins were overexpressed by odontogenic epithelium, their possible roles need to be further explored in benign odontogenic tumors.

Clinical behavior of recurrent pleomorphic adenoma in the palate: a systematic review.

PURPOSE: This systematic review analyzed the clinical behavior and odds of malignancy of the palatal recurrent pleomorphic adenomas. METHODS: Systematic review of patients with recurrent pleomorphic adenoma arising in the palate. Database search: MEDLINE, Scopus, Web of Science, Cochrane, EMBASE, Virtual Health Library, Google Scholar, and OpenGrey. A binomial logistic regression was performed to assess the odds of detecting recurrence five, 10 and 20 years after the treatment of primary tumor. RESULTS: Thirteen studies (n = 18 patients) out of 336 were included. The recurrent pleomorphic adenoma in palate was more common in females (61.6%), average age was 49 years old (range 9-73 years old). Four patients progressed to malignant transformation. The odds ratio (OR) of detecting a recurrence at 10 (OR = 5.57; 95% confidence interval - 95%CI 1.13-27.52), and 20 years (OR = 18.78; 95%CI 3.18-110.84) after treatment of primary pleomorphic adenoma was significantly higher than at one-year follow-up. CONCLUSIONS: The recurrence of pleomorphic adenoma in palate remains a rare event of late occurrence. It mainly affects middle-aged female and carries a risk of malignant transformation. Although uncommon, patients with palatal pleomorphic adenoma should be warned about the possibility of recurrence or malignant transformation of tumor at advanced ages.

Relevance of Cone-beam computed tomography on diagnosis and surgical planning of the cementoblastoma.

The cementoblastoma is a rare odontogenic tumor occurring in the mandibular molar and premolar of the patients in the second and third decades of life. Despite its typical benign behavior, this tumor may promote local destruction by perforating the cortical bone and displacing the mandibular canal. This case report shows a 31-year-old man with an aggressive cementoblastoma attached to the apex of the mandibular first molar. Cone-beam computed tomography revealed a hyperdense mass connected to the root of mandibular molar surrounded by a hypodense area. Multiplanar reconstructions showed rupture of buccal bone plate and tumor invasion of the mandibular canal roof. The surgical planning included enucleation of tumor with the first and second molars extractions and the diagnosis of cementoblastoma was confirmed by histopathology. This case report emphasizes the contribution of cone-beam computed tomography on diagnosis and appropriate surgical planning of the cementoblastoma. Key words:Cone-Beam computed tomography, odontogenic tumors, diagnosis.

Atypical clinical manifestation of mucoepidermoid carcinoma in the palate.

A 62-year-old woman sought treatment for a red macule in her hard palate. Examination of the oral cavity revealed an ovoid-shaped erythematous macule on the right side of the hard palate. The patient was edentulous and used a poorly adapted maxillary denture. The initial diagnosis was chronic atrophic candidosis and trauma; however, when the lesion did not heal following removal of the prosthesis and application of topical antifungal medication, an incisional biopsy was performed, resulting in a final diagnosis of low-grade mucoepidermoid carcinoma. The patient was referred to a head and neck surgeon and the tumor was excised.

Clinical behavior of recurrent pleomorphic adenoma in the palate: a systematic review

Purpose: This systematic review analyzed the clinical behavior and odds of malignancy of the palatal recurrent pleomorphic adenomas. Methods: Systematic review of patients with recurrent pleomorphic adenoma arising in the palate. Database search: MEDLINE, Scopus, Web of Science, Cochrane, EMBASE, Virtual Health Library, Google Scholar, and OpenGrey. A binomial logistic regression was performed to assess the odds of detecting recurrence five, 10 and 20 years after the treatment of primary tumor. Results: Thirteen studies (n = 18 patients) out of 336 were included. The recurrent pleomorphic adenoma in palate was more common in females (61.6%), average age was 49 years old (range 9-73 years old). Four patients progressed to malignant transformation. The odds ratio (OR) of detecting a recurrence at 10 (OR = 5.57; 95% confidence interval - 95%CI 1.13-27.52), and 20 years (OR = 18.78; 95%CI 3.18-110.84) after treatment of primary pleomorphic adenoma was significantly higher than at one-year follow-up. Conclusions: The recurrence of pleomorphic adenoma in palate remains a rare event of late occurrence. It mainly affects middle-aged female and carries a risk of malignant transformation. Although uncommon, patients with palatal pleomorphic adenoma should be warned about the possibility of recurrence or malignant transformation of tumor at advanced ages.

Immunolocalization of podoplanin in benign odontogenic tumours with and without ectomesenchyme.

OBJECTIVES: To investigate podoplanin expression in epithelial odontogenic tumours with and without ectomesenchyme and verify the association between its immunoexpression and proliferative activity in keratocystic odontogenic tumours (KCOTS) and orthokeratinized odontogenic cysts (OOCs). DESIGN: Eight ameloblastomas, nine adenomatoid odontogenic tumours, twenty KCOTS, five OOC, one calcifying epithelial odontogenic tumour, two ameloblastic fibromas, four ameloblastic fibro-odontomas and five calcifying cystic odontogenic tumours were immunohistochemically analysed with anti-podoplanin antibody. For KCOTS and OOC, the cell proliferation index was determined with Ki-67 immunostaining and compared by Spearman correlation coefficient. RESULTS: Podoplanin was expressed in the peripheral odontogenic epithelium of most tumours. Ectomesenchyme was negative, except for odontoblasts. KCOTS exhibited positive podoplanin expression while in OOC it was absent/weak. There was statistically significant correlation (p=0.006) between podoplanin expression and cellular proliferation index of KCOTS and OOC. CONCLUSION: Podoplanin seems to be related to the proliferative activity of KCOTS and may have a role in the process of local invasion of odontogenic tumours with and without ectomesenchyme.

The onset of a peripheral ameloblastoma.

Incipient odontogenic tumors often display intermediate features between two or more lesions leading to diagnosis dilemma. We report the onset of a peripheral ameloblastoma fortuitously found subjacent to a nondysplastic leukoplakia in the region of missing 38 teeth of a 52-year-old man. The aim of this paper is the discussion of the microscopical features observed in the case reported which allowed the establishment of the final diagnosis of an early peripheral ameloblastoma.

Sialolitíase em glândula salivar menor: relato de caso e revisão de literatura / Sialolithiasis in minor salivary gland: case report and literature review

A sialolitíase é uma afecção que se caracteriza pela obstrução da glândula salivar ou de seu ducto devido à formação de estruturas calcificadas acometendo predominantemente as glândulas submandibulares e muito raramente as glândulas salivares menores. O objetivo deste trabalho é realizar um relato de caso sobre sialolitíase em glândula salivar menor. Paciente do sexo masculino, leucoderma, 54 anos, se apresentou com queixa principal de "tumor na boca". O exame físico intrabucal revelou um nódulo localizado na mucosa labial do lado superior direito, próximo a comissura, único, medindo aproximadamente 2 centímetros no seu maior diâmetro. A ultrassonografia da região do lábio superior evidenciou a hipótese diagnóstica de corpo estranho. O diagnóstico diferencial e o clínico incluíram reação a corpo estranho. Foi realizada a biópsia excisional e durante o ato cirúrgico, foi encontrado um material endurecido, de aproximadamente 3 mm, de cor amarelada, que foi enviado para análise histopatológica, a qual revelou fragmento mineralizado compatível com sialolito. Com base nos achados clínicos e imaginológicos o diagnóstico foi de sialolitíase. Após três meses de acompanhamento, o paciente se apresentou sem evidência da doença. Esta revisão de literatura e o presente relato permitiram concluir que um exame clínico criterioso associado a exames imaginológicos adequados são essenciais para a obtenção de um diagnóstico clínico correto(AU)

Sialolithiasis is a condition characterized by obstruction of salivary gland or its duct due to formation of calcified structure, predominantly affecting the submandibular glands or, rarely, the minor salivary glands. The main objective is to report a case of sialolithiasis in the minor salivary gland on a male patient, leucoderma,54, and his main complaint was a "tumor in the mouth". Intraoral physical examination revealed a nodule located on labial mucosa of the upper right side of the mouth, near the commissure, single, and its diameter measuring approximately 2 cm. The ultrasound examination on the upper lip region resulted in a strange body. The differencial and clinical diagnosis was included strange body. During the excision biopsy surgery, a hardened material, measuring about 3 mm and yellowish was removed and sent for histopathologic exams and the diagnosis was sialolithiasis. After three mouths' follow-up, the patient was free of the disease. This literature review and the present case concluded that a careful clinical examination associated with imaging and histopathology examinations are essential for obtaining a correct clinical diagnosis(AU)

Psammomatoid juvenile ossifying fibroma: an analysis of 2 cases affecting the mandible with review of the literature.

Juvenile ossifying fibroma (JOF) is a rare fibro-osseous neoplasm, defined as a variant of the ossifying fibroma that arises within the craniofacial bones. Two subgroups, juvenile psammomatoid ossifying fibroma (PsJOF) and juvenile trabecular ossifying fibroma, have been delineated by their histology. PsJOF occurs predominantly in the sinonasal and orbital bones. This work reports on 2 cases of extensive PsJOF in the body of the right mandible as well as reviews the literature regarding the radiographic and histologic features, treatment, and prognosis of PsJOF of the jaws.

Surgical management of palatine Torus - case series / Tratamento cirúrgico de Tórus palatino - série de casos

Introduction: Torus palatinus is a specific name to identify exostoses developed in the hard palate along the median palatine suture. Despite of not being a pathological condition, its presence requires attention and knowledge regarding its management. Surgical removal of exostoses is indicated when the patient frequently traumatizes the area of palatine torus during mastication and speech or when it is necessary for the rehabilitation of the upper arcade with complete dentures. Objective: The aim of this article is to present three cases of Torus palatinus and to discuss the management of them. Case Report: In the first case, a 57-year-old Caucasian man sought oral rehabilitation of his edentulous maxilla but presented a hard nodules in the hard palate; in the second case, a 40-year-old Caucasian woman was referred for frequent trauma of palatal mucosa during mastication, aesthetic complaint, and discomfort caused by the trauma of her tongue in this area; and in the third case, a 45-year-old Caucasian woman presented with a lesion on the palate that caused difficulty swallowing. When the Torus palatinus was impairing the basic physiological functions of the patients, all cases were surgically treated, improving the patients' quality of life. Final Consideration: The dentist should be properly prepared to choose the best from among the existing surgical approaches for each individual lesion in order to improve the results and avoid possible complications. .

Introdução: Torus palatinus é um nome específico usado para identificar exostoses no palato duro ao longo da sutura palatina mediana. Apesar de não ser considerado uma condição patológica, sua presença requer atenção e conhecimento no que diz respeito ao seu tratamento. A remoção cirúrgica de exostoses é indicada quando o paciente traumatiza frequentemente a área do Torus palatinus durante a mastigação e a fala, ou quando for necessária a reabilitação da arcada dentária superior com próteses totais. Objetivo: O objetivo deste trabalho é apresentar três casos de Torus palatinus e discutir os seus respectivos tratamentos. Caso Clínico: O primeiro caso era de um homem leucoderma e com maxila edêntula que procurou reabilitação dentária, porém apresentou um nódulo no palato duro. O segundo caso era de uma mulher, leucoderma e de 40 anos que foi encaminhada devido ao trauma frequente na mucosa do palato durante a mastigação, insatisfação com a estética e desconforto causado pelo trauma na língua. O terceiro caso era de uma mulher de 45 anos de idade, leucoderma com uma lesão no palato e dificuldade pra engolir. Uma vez que o Torus palatinus estava prejudicando as funções fisiológicas básicas dos pacientes, todos os casos foram cirurgicamente tratados, melhorando a qualidade de vida dos mesmos. Consideração final: O dentista deve estar preparado para selecionar a técnica cirúrgica mais indicada para cada caso buscando o melhor resultado e evitando possíveis complicações. .

Reposicionamento de fármacos no câncer de boca: Identificação de possíveis agentes / Drug repositioning for oral cancer: Identifying candidate therapeutic agents

Objetivos: O objetivo deste estudo foi o de identificar compostos seletivamente tóxicos ao carcinoma espinocelular de boca in vitro por meio do reposicionamento de fármacos. Material e Métodos: Por meio de um escaneamento baseado na viabilidade celular de 1.280 fármacos, nós selecionamos três princípios ativos (luteolin, metixene hydrochloride e nitazoxanide) letais às células de câncer de boca SCC-25 e pouco tóxicos às células de queratinócitos cutâneos imortalizados HaCaT. Os fármacos candidatos foram investigados quanto à sua dose- e tempo-resposta bem como comparados e combinados à agentes quimioterápicos padrão por meio do ensaio por colorimetria com brometo de tiazolil azul de tetrazolio (MTT). O impacto dos fármacos na motilidade do SCC-25 e do HaCaT foi verificado pelo ensaio de migração celular e seus mecanismos de ação também foram explorados por meio da verificação dos níveis das proteínas fosforiladas pelo western blotting. Todos os experimentos foram realizados em triplicata e, pelo menos, três vezes independentes. O teste t de student foi utilizado para confrontar as variáveis e nível de significância de 5% foi estabelecido para todos os testes. Resultados: O flavonoide natural luteolin exerceu citotoxicidade potente contra as células de câncer de boca in vitro, apresentando baixa toxicidade ao HaCaT e alta eficiência quando comparado a quimioterápicos como a cisplatina e o AG1478. Do ponto de vista molecular, a luteolin ativou a via de sinalização do dano do DNA e, combinada com um inibidor do Chk, apresentou efeitos potencializados. Além disso, nós demonstramos que a nitazoxanide e o metixene hydrochloride são capazes de destruir células SCC-25 porém não as HaCaT de maneira proporcional à dose e ao tempo de tratamento. As combinações entre os três fármacos hit e com a cisplatina ou o AG1478 potencializaram seus efeitos contra as células malignas. Conclusões: O presente estudo traz a luteolin, o metixene hydrochloride e a nitazoxanide como...

Objectives: Here we aimed at identifying and reposition approved drugs that could be selectively toxic towards oral squamous cell carcinoma cells. Materials and Methods: Through a cell-based drug screening of 1,280 chemical molecules, we selected 3 compounds (luteolin, metixene hydrochloride, and nitazoxanide) lethal to oral cancer SCC-25 cells, while sparing immortalized keratinocyte HaCaT cells. The drugs were then further challenged for their time- and dose-responses, as well as their comparison and combination to standard chemotherapeutic agents by colorimetric assay 1-(4,5-Dimethylthiazol-2-yl)-3,5-diphenylformazan, Thiazolyl blue formazan (MTT). The impact on SCC-25 and HaCaT motility as well as the mode of action of the drugs was then further explored by scratching assay and western blotting, respectively. All the experiments were performed in triplicated and, at least, three independent times. Students t test was performed to verify the differences among the variables and the level of significance was set at 5%. Results: The natural flavonoid luteolin was a potent cytotoxic agent against oral cancer cells in vitro, presenting low toxicity against HaCaT cells and high efficiency as compared to standard-of-care, such as cisplatin and AG1478. From a molecular standpoint, luteolin coopted the DNA-damage pathway and could be efficiently combined with Chk pharmacological inhibitor. Moreover, we demonstrated that nitazoxanide and metixene hydrochloride kill the SCC-25 but not the HaCaT cells in a dose- and time-dependent. The combinations among the three drugs hit and with cisplatin and AG1478 improved their effect against the malignant cells. Conclusions: Luteolin, metixene hydrochloride, and nitazoxanide emerge as strong cytotoxic and/or adjuvant therapy in oral cancer, as these compounds present higher efficiency and lower toxicity against oral cancer cells in vitro than conventional chemotherapeutic agents.

Reposicionamento de fármacos no câncer de boca: Identificação de possíveis agentes / Drug repositioning for oral cancer: Identifying candidate therapeutic agents

O objetivo deste estudo foi o de identificar compostos seletivamente tóxicos ao carcinoma espinocelular de boca in vitro por meio do reposicionamento de fármacos. Material e Métodos: Por meio de um escaneamento baseado na viabilidade celular de 1.280 fármacos, nós selecionamos três princípios ativos (luteolin, metixene hydrochloride e nitazoxanide) letais às células de câncer de boca SCC-25 e pouco tóxicos às células de queratinócitos cutâneos imortalizados HaCaT. Os fármacos candidatos foram investigados quanto à sua dose- e tempo-resposta bem como comparados e combinados à agentes quimioterápicos padrão por meio do ensaio por colorimetria com brometo de tiazolil azul de tetrazolio (MTT). O impacto dos fármacos na motilidade do SCC-25 e do HaCaT foi verificado pelo ensaio de migração celular e seus mecanismos de ação também foram explorados por meio da verificação dos níveis das proteínas fosforiladas pelo western blotting. Todos os experimentos foram realizados em triplicata e, pelo menos, três vezes independentes. O teste t de student foi utilizado para confrontar as variáveis e nível de significância de 5% foi estabelecido para todos os testes. Resultados: O flavonoide natural luteolin exerceu citotoxicidade potente contra as células de câncer de boca in vitro, apresentando baixa toxicidade ao HaCaT e alta eficiência quando comparado a quimioterápicos como a cisplatina e o AG1478. Do ponto de vista molecular, a luteolin ativou a via de sinalização do dano do DNA e, combinada com um inibidor do Chk, apresentou efeitos potencializados. Além disso, nós demonstramos que a nitazoxanide e o metixene hydrochloride são capazes de destruir células SCC-25 porém não as HaCaT de maneira proporcional à dose e ao tempo de tratamento. As combinações entre os três fármacos hit e com a cisplatina ou o AG1478 potencializaram seus efeitos contra as células malignas. Conclusões: O presente estudo traz a luteolin, o metixene hydrochloride e a nitazoxanide como...

Here we aimed at identifying and reposition approved drugs that could be selectively toxic towards oral squamous cell carcinoma cells. Materials and Methods: Through a cell-based drug screening of 1,280 chemical molecules, we selected 3 compounds (luteolin, metixene hydrochloride, and nitazoxanide) lethal to oral cancer SCC-25 cells, while sparing immortalized keratinocyte HaCaT cells. The drugs were then further challenged for their time- and dose-responses, as well as their comparison and combination to standard chemotherapeutic agents by colorimetric assay 1-(4,5-Dimethylthiazol-2-yl)-3,5-diphenylformazan, Thiazolyl blue formazan (MTT). The impact on SCC-25 and HaCaT motility as well as the mode of action of the drugs was then further explored by scratching assay and western blotting, respectively. All the experiments were performed in triplicated and, at least, three independent times. Students t test was performed to verify the differences among the variables and the level of significance was set at 5%. Results: The natural flavonoid luteolin was a potent cytotoxic agent against oral cancer cells in vitro, presenting low toxicity against HaCaT cells and high efficiency as compared to standard-of-care, such as cisplatin and AG1478. From a molecular standpoint, luteolin coopted the DNA-damage pathway and could be efficiently combined with Chk pharmacological inhibitor. Moreover, we demonstrated that nitazoxanide and metixene hydrochloride kill the SCC-25 but not the HaCaT cells in a dose- and time-dependent. The combinations among the three drugs hit and with cisplatin and AG1478 improved their effect against the malignant cells. Conclusions: Luteolin, metixene hydrochloride, and nitazoxanide emerge as strong cytotoxic and/or adjuvant therapy in oral cancer, as these compounds present higher efficiency and lower toxicity against oral cancer cells in vitro than conventional chemotherapeutic agents...

Cisto radicular inflamatório extenso envolvendo seio maxilar / Large radicular cyst involving the maxillary sinus

O cisto radicular é o cisto odontogênico de maior significado clínico para o cirurgião-dentista. Por ser a lesão cística inflamatória mais frequentemente encontrada dos maxilares, é a mais tratada. Ocorre nos ápices de dentes infectados em decorrência à necrose pulpar. Embora o cisto radicular faça parte do cotidiano do clínico, há poucos trabalhos descrevendo as suas características clínicas e tomográficas. Assim, o objetivo deste trabalho é o de apresentar um cisto radicular extenso com envolvimento do seio maxilar e cavidade nasal cujo exame de tomografia computadorizada por feixe cônico foi essencial para o delineamento do plano de tratamento...

The radicular cyst is the odontogenic lesion with major clinical significance for the dental surgeon. Once this is the most common inflammatory cystic lesion, the radicular cyst is the most treated one. It affects the apical portion of infected teeth after the pulp necrosis. Although the radicular cyst is part of the routine of the dental practice, there are only few studies describing its clinical and thomographic features. Thus, the aim of this work is to report an extensive radicular cyst involving the maxillary sinus and nasal cavity which cone bean computerized tomography was essential for the surgical planning...

Expressão da podoplanina em ameloblastomas e folículos pericoronários de dentes não-irrompidos: estudo comparativo com a expressão do Ki-67 / Podoplanin expression in ameloblastomas and dental follicles of unerupted teeth: comparative estudy with Ki-67 expression

A relação da podoplanina com a proliferação celular tem sido demonstrada, porém ainda é tema de controvérsia. O objetivo deste estudo foi investigar a expressão da podoplanina em ameloblastomas e remanescentes de epitélio odontogênico (REO) de folículos pericoronários de dentes não-irrompidos e verificar a relação da imunomarcação da podoplanina com a proliferação celular. A amostra incluiu 33 pacientes submetidos à biópsia incisional ou à exérese de ameloblastomas e 32 folículos de pacientes submetidos à extração de dentes não-irrompidos. Todos os espécimes selecionados foram corados pela técnica imuno-histoquímica com os anticorpos anti-podoplanina e anti-Ki-67. A expressão da podoplanina foi avaliada por um método semi-quantitativo de escores. Já o índice de proliferação celular foi obtido pela porcentagem de células positivas (no mínimo 500 células/ameloblastoma e todas as células do REO foram avaliadas). Todos os ameloblastomas apresentaram imunomarcação pela podoplanina nas células periféricas. Nas células centrais, a expressão foi ausente ou fraca. Nos REO, a podoplanina apresentou expressão predominantemente nas células em contato com o tecido conjuntivo. A expressão membranosa da podoplanina foi superior nos ameloblastomas em relação aos REO (!=0,001). Também houve diferença significante entre a imunomarcação citoplasmática e membranosa da podoplanina nos REO (!=0,001). A expressão do Ki-67 foi mais acentuada nos ameloblastomas do que nos REO (!<0,001). A correlação entre a expressão citoplasmática (r= -0,15, != 0, 396) e membranosa (r= 0,00, != 0, 989) da podoplanina e do Ki-67 nos ameloblastomas não foi estatisticamente significante, tampouco entre a imunomarcação citoplasmática (r= 0,15, != 0, 421) e membranosa (r= -0, 09, ! = 0, 629) da podoplanina e do Ki-67 nos REO. Os resultados sugerem que não há associação da podoplanina com a proliferação celular e reforçam a necessidade da elucidação do papel desta proteína em tumores odontogênicos benignos.

The association between podoplanin and cellular proliferative activity has been demonstrated but is still source of debate. The aim of this study was to investigate the expression of podoplanin in ameloblastomas and remnants of odontogenic epithelium (ROE) from dental follicles of unerupted teeth and verify the relation between the podoplanin expression and proliferative activity of the odontogenic cells. Thirty-three patients submitted to the incisional biopsy or resection of ameloblastoma and 32 patients submitted to the extraction of unerupted tooth were selected for analysis. Archived paraffin-embedded ameloblastomas and dental follicles specimens were sectioned and stained with anti-human podoplanin and anti-Ki-67 antibodies. The podoplanin expression by odontogenic epithelial cells was evaluated using a score method and the Ki-67 labelling index was obtained by the percentage of positive odontogenic cells (at least 500 cells/ameloblastoma and all ROE cells). All ameloblastomas showed podoplanin expression in ameloblast-like cells of the epithelial islands. Weak or absent immunostaining was observed in the central cells resembling stellate reticulum. Podoplanin expression in ROE was mainly found in the cells in contact with the connective tissue. Membranous expression of podoplanin in ameloblastomas was stronger than its expression in ROE (!=0.001). Statistically significant difference between cytoplasmic and membranous expression of podoplanin in ROE was observed (!=0.001). The index of cellular odontogenic proliferative activity, verified by Ki-67 expression, was highest in ameloblastomas when compared with ROES (!<0.001). No statistically significant correlation between podoplanin and cellular odontogenic proliferative activity in ameloblastomas and dental follicles was found (!>0.05). These results support the evidence that there is no connection between podoplanin expression and odontogenic cellular proliferative activity in ameloblastomas and...