Recurrent peripheral ameloblastoma in an elderly patient: A case report.

OBJECTIVE: To report a case of recurrent peripheral ameloblastoma (PA) in an elderly patient. BACKGROUND: PA is a benign tumour that affects soft tissues of gingiva or edentulous alveolar areas, exhibiting histopathological characteristics of ameloblastoma. METHODS: A 79-year-old man showed a nodule in the edentulous right mandibular alveolar ridge diagnosed as recurrent PA. CONCLUSION: Clinicians should consider PA as a differential diagnosis of routine nodular lesions affecting the oral mucosa of geriatric patients.

Interceptação da impacção de um incisivo permanente superior / Interceptive approach of impacted maxillary permanent incisor

Um dente impactado é aquele que não conseguiu irromper na cavidade oral, geralmente devido a fatores genéticos ou obstáculos mecânicos. Acredita-se que a sua etiologia esteja mais ligada a fatores locais, sendo conhecidas as maiores incidências: terceiros molares inferiores, caninos superiores, terceiros molares superiores, segundos pré-molares inferiores e superiores e os incisivos centrais superiores, nesta ordem. A impacção de incisivos superiores é encontrada no cotidiano dos profissionais que tratam de pacientes jovens, tornando essenciais os embasamentos técnico e teórico-científico para condutas a serem tomadas durante a fase de dentadura mista para a obtenção de um sorriso harmônico e do restabelecimento psicossocial dos pacientes. A abordagem ortodôntica interceptora é indicada para minimizar os danos e reabilitar a estética do sorriso. Assim, o objetivo deste artigo é trazer uma revisão de literatura sobre a impacção dentária e relatar a fase interceptora ortodôntica de um paciente que apresentava um incisivo central superior permanente impactado (AU).

Impacted tooth is characterized by the failure of its eruption in the oral cavity due to genetic factors or mechanical obstacles. It is believed that its etiology is mainly associated to local factors, with the highest incidence of impaction found in lower third molars, upper canines, upper third molars, second lower and upper premolars, and upper central incisors, in this sequence. Impaction of permanent upper incisors tends to be found in the daily life of professionals who treat young patients, demanding previous technical and theoreticalscientific knowledge for conducts to be taken to obtain a harmonic smile and psychosocial balance. The orthodontic interceptive approach is indicated to minimize damage and rehabilitate the smile aesthetics. Thus the aim of this article is to perform a literature review on dental impaction and to report a clinical case of the interceptive phase of a patient with an impacted permanent upper central incisor (AU).

Peripheral Calcifying Odontogenic Cyst: A rare case report.

The Calcifying Odontogenic Cyst (COC) is a simple cyst lined by ameloblastoma-like epithelium with ghost cells. The peripheral COC is a rare lesion and few reports have been published considering its clinical and histopathological features. This article aimed to report on a case of a peripheral COC, discussing its clinical, imaginological and histopathological features. A 9-year-old male patient presented a 10x5 mm painless nodule in the palatal mucosa of the left central incisor. Panoramic, occlusal and periapical radiographs did not show alterations. A computed tomography exam showed a slight soft tissue swelling located in the palatal mucosa of the left maxillary central incisor. An excisional biopsy was performed. The histopathological analysis showed a cystic lesion adhered to an oral mucosa fragment and lined by an ameloblastoma-like epithelium with ghost cells. The diagnosis of peripheral COC was established and the patient has been disease-free for 5 years. Although rare, peripheral COC is an important lesion that should be considered as a differential diagnosis of gingival hyperplastic lesions. Key words:Calcifying odontogenic cyst, odontogenic tumors, peripheral calcifying odontogenic cyst.

Hyaluronic acid on collagen membranes: An experimental study in rats.

OBJECTIVE: The aim of this study was to evaluate the effect of hyaluronic acid (HA) in the structure and degradation patterns of BioGide® and OsseoGuard™ collagen membranes. HA mediates inflammation and acts in cell migration, adhesion, and differentiation, benefitting tissue remodeling and vascularization. These are desirable effects in guided regeneration procedures, but it is still unknown whether HA alters the barrier properties of absorbable membranes. DESIGN: Bone defects were created in the calvaria of rats, which were treated with HA gel 1% (HA group) or simply filled with blood clot (control group), and covered with BioGide® or OsseoGuard™. The animals were euthanized after 1, 30, and 60days, and their calvarias were processed for histological analysis. RESULTS: BioGide®, in both HA and control groups, showed vascularization, intense cell colonization, bone formation, and tissue integration at 30 and 60days. In contrast, Osseoguard™ presented minimal cellular colonization, and inflammatory reaction associated to foreign body reaction in both time points and groups. The HA group of BioGide® showed higher cell colonization (574.9±137.6) than the control group (269.1±70.83) at 60days (p<0.05). Despite this finding, the structure and degradation pattern were similar for BioGide® and Osseoguard™ in the HA and control groups. CONCLUSION: The results suggest that HA did not interfere with tissue integration and structural degradation of BioGide® and Osseoguard™ membranes.

Enamel Pearls Implications on Periodontal Disease.

Dental anatomy is quite complex and diverse factors must be taken into account in its analysis. Teeth with anatomical variations present an increase in the rate of severity periodontal tissue destruction and therefore a higher risk of developing periodontal disease. In this context, this paper reviews the literature regarding enamel pearls and their implications in the development of severe localized periodontal disease as well as in the prognosis of periodontal therapy. Radiographic examination of a patient complaining of pain in the right side of the mandible revealed the presence of a radiopaque structure around the cervical region of lower right first premolar. Periodontal examination revealed extensive bone loss since probing depths ranged from 7.0 mm to 9.0 mm and additionally intense bleeding and suppuration. Surgical exploration detected the presence of an enamel pearl, which was removed. Assessment of the remaining supporting tissues led to the extraction of tooth 44. Local factors such as enamel pearls can lead to inadequate removal of the subgingival biofilm, thus favoring the establishment and progression of periodontal diseases.

Análise crítica de estudos sobre biomateriais à base de fosfato de cálcio e HA, utilizados como enxertos ósseos em animais / Critical analysis of biomaterials, used as bone grafts, in animals studies

O objetivo desta revisão foi abordar o comportamento de diferentes biomateriais à base de fosfato de cálcio e/ou HA, utilizados como enxerto para reparo ósseo, bem como as respostas teciduais obtidas em modelos experimentais animais. A comparação direta entre estudos realizados em condições experimentais diversas é de difícil análise pelas variáveis envolvidas (métodos cirúrgicos, modelos experimentais, sítios de implantação e espécies). Dependendo do sítio de implantação, a arquitetura óssea difere em relação aos ossos cortical e medular, o que pode gerar diferentes tipos de estresse biomecânico e diferentes taxas de formação e remodelação ósseas. As características físico-químicas dos diferentes biomateriais influenciam consideravelmente na capacidade de estimulação da neoformação óssea. Os estudos analisados comprovam a atividade osteocondutiva das cerâmicas de fosfato de cálcio em vários sítios e modelos animais. Em relação às cerâmicas de fosfato de cálcio bifásico (BCP), suas características físico-químicas influenciam diretamente o grau de formação óssea e de sua estabilidade, estando relacionados à dissolução das fases de tricálcio fosfato e hidroxiapatita. Diversos estudos apontam para a utilização promissora do BCP como substituto ósseo e como uma alternativa viável aos enxertos de osso autógeno.

The aim of this review is to highlight the behavior of different calcium phosphate/HA-related biomaterials used as graftings for bone repair, as well as their tissue responses in experimental animal models. The direct comparison among varied experimental conditions is complicated due to the existing variables (surgical methods, experimental models, implantation sites, and selected species). Depending on the local site composition (cortical/marrow bone), different biomechanical patterns arise along with bone formation/remodeling outcomes. The physicochemical characteristics of available biomaterials significantly influence on the ability to form the new bone tissue. The presented studies corroborate the osteoconductive performance of calcium phosphate ceramics in several sites and animal models. Regarding the biphasic calcium phosphate ceramics (BCP), its physical and chemical properties influence on the bone formation degree and stability, being these related to the HA and tricalcium phosphate crystal dissolution rates. Also, several studies point out to the successful use of BCP as bone substitute and a viable alternative to the autogenous bone grafts.