RESUMEN
Ameloblastoma is a locally aggressive neoplasm with a poorly understood pathogenesis. Therefore, the aim of this study is to investigate whether COX-2 expression is associated with ameloblastoma microvascular density (MVD) and with tumor aggressiveness. Sixty-three cases of primary ameloblastomas arranged in tissue microarray were submitted to immunohistochemistry against cyclooxigenase-2 (COX-2) and CD34. Clinicopathological parameters regarding sex, age, tumour size, tumour duration, tumour location, treatment, recurrences, radiographic features, vestibular/lingual and basal cortical disruption and follow-up data were obtained from patients' medical records and correlated with the proteins expression. The results on BRAF-V600E expression were obtained from our previous study and correlated with COX-2 and CD34 expressions. Log-rank univariate analysis and multivariate Cox regression model were done to investigate the prognostic potential of the molecular markers. Twenty-eight cases (44.4%) exhibited cytoplasmic positivity for COX-2, predominantly in the columnar peripheral cells, with a mean MVD of 2.2 vessels/mm2. COX-2 was significantly associated with recurrences (pâ¯<â¯0.001) and BRAF-V600E expression (pâ¯<â¯0.001), whereas lower MVD was associated with the use of conservative therapy (pâ¯=â¯0.004). Using univariate and multivariate analyses, COX-2 was significantly associated with a lower 5-year disease-free survival (DFS) rate (pâ¯<â¯0.001 and pâ¯=â¯0.012, respectively), but not with a higher MVD (pâ¯=â¯0.68). In conclusion, COX-2 expression in ameloblastomas is not associated with MVD, but it is significantly associated with recurrences and with a lower DFS.
Asunto(s)
Ameloblastoma/patología , Biomarcadores de Tumor/análisis , Ciclooxigenasa 1/biosíntesis , Neoplasias Maxilomandibulares/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Ameloblastoma/mortalidad , Niño , Ciclooxigenasa 1/análisis , Supervivencia sin Enfermedad , Femenino , Humanos , Neoplasias Maxilomandibulares/mortalidad , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Pronóstico , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Adulto JovenRESUMEN
O tratamento de remanescentes radiculares, muitas vezes é inviável pelas suas características clínicas e radiográficas, havendo necessidade de extração. Apesar do advento dos implantes, este relato de caso clínico discute o tratamento por meio de uma prótese parcial fixa alternativa após a extração de um remanescente radicular anterior. O resultado do tratamento demonstrou sucesso funcional e estético. Foi preservado um dos elementos de suporte pela utilização de sistema de encaixe adesivo CWB como um dos retentores, e no outro dente suporte foi indicada uma coroa metaloplástica veneer de confecção retrógrada, uma vez que a mesma é retentor indireto de uma prótese parcial removível recém confeccionada. É descrito também o condicionamento tecidual pós-exodontia, com prótese provisória para receber o pôntico oval