Necrotizing sialometaplasia: systematic review and meta analyses over the past 46 years

Objectives: The aim of this study was to characterize the main characteristics of this disease in relation to diagnosis, clinical aspects, progression and treatment as well as correlating them with remission time. Material and Methods: A systematic search was performed following the guidelines given by PRISMA and the Joanna Briggs Institute. PubMed, Web of Science and Scopus were the databases used. Results: The final analysis resulted in 108 articles with 173 clinical cases. The longest remission time for signs and symptoms (>7 weeks) was registered among male patients (p = 0.02) and outside the oral cavity; however no significant correlation was observed (p>0.05). A high risk of bias was the most common rating among the articles analyzed (55%); followed by moderate (27%) and low (18%). The lack of standardization in clinical case report descriptions made it difficult to gain a thorough knowledge of the essential characteristics of the NS patho-logical processes. Conclusion: It is recommended that publications follow the standards recommended by the literature; in addition, studies using advanced technologies to better understand NS's pathological path are recommended so as to propose effective treatments for this disease. (AU)

Contribution of public oral pathology services to the diagnosis of oral and oropharyngeal cancer in Brazil.

This study aimed to evaluate the contribution of oral and maxillofacial pathology laboratories (OMPLs) in Brazilian public universities to the diagnosis of lip, oral cavity, and oropharyngeal squamous cell carcinoma (SCC). A cross-sectional study was performed using biopsy records from a consortium of sixteen public OMPLs from all regions of Brazil (North, Northeast, Central-West, Southeast, and South). Clinical and demographic data of patients diagnosed with lip, oral cavity, and oropharyngeal SCC between 2010 and 2019 were collected from the patients' histopathological records. Of the 120,010 oral and maxillofacial biopsies (2010-2019), 6.9% (8,321 cases) were diagnosed as lip (0.8%, 951 cases), oral cavity (4.9%, 5,971 cases), and oropharyngeal (1.2%, 1,399 cases) SCCs. Most cases were from Brazil's Southeast (64.5%), where six of the OMPLs analyzed are located. The predominant profile of patients with lip and oral cavity SCC was Caucasian men, with a mean age over 60 years, low schooling level, and a previous history of heavy tobacco consumption. In the oropharyngeal group, the majority were non-Caucasian men, with a mean age under 60 years, had a low education level, and were former/current tobacco and alcohol users. According to data from the Brazilian National Cancer Institute, approximately 9.9% of the total lip, oral cavity, and oropharyngeal SCCs reported over the last decade in Brazil may have been diagnosed at the OMPLs included in the current study. Therefore, this data confirms the contribution of public OMPLs with respect to the important diagnostic support they provide to the oral healthcare services extended by the Brazilian Public Health System.

Twenty-year analysis of photobiomodulation clinical studies for oral mucositis: a scoping review.

OBJECTIVE: Our objective was to review the first 20 years of photobiomodulation (PBM) clinical studies for oral mucositis (OM) mitigation. STUDY DESIGN: A scoping review screened controlled clinical studies. The PBM devices, protocols, and clinical outcomes were analyzed. RESULTS: Seventy-five studies met the inclusion criteria. The first study dated from 1992, and the term "PBM" was first published in 2017. Public services, placebo-controlled randomized trials, and patients with head and neck chemoradiation were predominant among included studies. Prophylactic red intraoral laser protocols were mostly used. Comparing the outcomes of all protocols was unfeasible due to missing treatment parameters and nonhomogeneous measurements. CONCLUSIONS: The main barrier to optimizing clinical protocols of PBM for OM was the lack of standardization in clinical studies. Although PBM use is now globally present in oncology settings and generally marked by good outcomes reported, additional randomized clinical trials with well-described methods are necessary.

Expression and degranulation of mast cells in laser photobiomodulated mucositis chemo-induced: pilot study in hamsters.

This study aimed to evaluate the influence of laser photobiomodulation on the expression and degranulation of mast cells in chemo-induced oral mucositis (OM) lesions in hamsters. Twelve adult male Syrian hamsters (Mesocricetus auratus), golden lineage, were submitted to OM induction. They were divided into three groups: control-OM without treatment (C), OM treated with red laser (RL), OM treated with infrared laser (IL) and analyzed in the experimental time of 7 days. Three and 4 days after the intraperitoneal injection of the chemotherapy drug fluorouracil, the OM lesions were induced by making grooves in the right cheek pouch. Immediately after chemoinduction, the hamsters were submitted to photobiomodulation every 48 h for 7 days. The specimens were processed and stained using the hematoxylin-eosin and toluidine blue techniques. There was a predominance of mild chronic inflammation in the experimental groups and a greater persistence of neutrophils in the control group (C), although not statistically significant. The group irradiated with red laser (RL) had the highest mean mast cell expression (38.28 ± 19.05) (p < 0.001). As for the degranulation activity in mast cells, the control group (C) showed a greater number of fields with more than 50% of degranulated cells, presenting statistical significance when comparing it with the RL (p < 0.009) and IL (p = 0.036) group. It can be concluded that photobiomodulation, at both wavelengths, decreased mast cell degranulation, accelerating the inflammatory process. The use of infrared laser provided, in addition to less degranulation, the quantitative reduction of mast cells.

Contribution of public oral pathology services to the diagnosis of oral and oropharyngeal cancer in Brazil

Abstract This study aimed to evaluate the contribution of oral and maxillofacial pathology laboratories (OMPLs) in Brazilian public universities to the diagnosis of lip, oral cavity, and oropharyngeal squamous cell carcinoma (SCC). A cross-sectional study was performed using biopsy records from a consortium of sixteen public OMPLs from all regions of Brazil (North, Northeast, Central-West, Southeast, and South). Clinical and demographic data of patients diagnosed with lip, oral cavity, and oropharyngeal SCC between 2010 and 2019 were collected from the patients' histopathological records. Of the 120,010 oral and maxillofacial biopsies (2010-2019), 6.9% (8,321 cases) were diagnosed as lip (0.8%, 951 cases), oral cavity (4.9%, 5,971 cases), and oropharyngeal (1.2%, 1,399 cases) SCCs. Most cases were from Brazil's Southeast (64.5%), where six of the OMPLs analyzed are located. The predominant profile of patients with lip and oral cavity SCC was Caucasian men, with a mean age over 60 years, low schooling level, and a previous history of heavy tobacco consumption. In the oropharyngeal group, the majority were non-Caucasian men, with a mean age under 60 years, had a low education level, and were former/current tobacco and alcohol users. According to data from the Brazilian National Cancer Institute, approximately 9.9% of the total lip, oral cavity, and oropharyngeal SCCs reported over the last decade in Brazil may have been diagnosed at the OMPLs included in the current study. Therefore, this data confirms the contribution of public OMPLs with respect to the important diagnostic support they provide to the oral healthcare services extended by the Brazilian Public Health System.

Florid cemento-osseous dysplasia-related osteonecrosis: A series of cases.

OBJECTIVE: The aim of this study was to assess the clinicopathological features of florid cemento-osseous dysplasia (FCOD)-related osteonecrosis highlighting their histopathological aspects and bone structure. METHODS: Twenty-two FCOD-related osteonecrosis cases were evaluated retrospectively. Osteonecrosis, osteomyelitis, bacterial colonization, bone resorption, reactive bone, osteon-like structure, lamellar bone, and basophilic lines were analyzed. Specific staining and fluorescence and polarized light microscopy analyses were also performed. RESULTS: The mandible was more affected by FCOD-related osteonecrosis. There was a predominance of African-Brazilian women in the fifth and seventh decades of life. Osteomyelitis was present in 82 % of cases whereas bone resorption and bacterial colonization were present in 100 % of FCOD-related osteonecrosis cases. Thick basophilic lines were seen in all cases (100 %). Actinomycosis and osteoclasts were not often. CONCLUSIONS: This study showed female adult preference, mandibular location, and some findings such as osteomyelitis, bone resorption, and bacterial colonization were histopathological features more frequent in FCOD-related osteonecrosis. In the absence of a close clinical and radiographic correlation, the morphology of the necrotized bone similar to cementum could help to recognize FCOD.

Escleroterapia como tratamento conservador para hemangioma oral: relato de caso / Sclerotherapy as a conservative approach for oral hemangioma: case report

Introdução: o hemangioma é um tumor benigno vascular de origem endotelial, definido por crescimento anormal dos vasos sanguíneos. Essa lesão pode atingir qualquer parte do corpo, porém a região de cabeça e pescoço tem uma incidência de 60% dos casos; na cavidade oral, ela pode se apresentar na língua, na mucosa bucal, no palato, nos lábios. O tratamento é multimodal, incluindo laser, crioterapia, excisão cirúrgica, agentes quimioterápicos e escleroterapia. Objetivo: apresentar um relato de caso de escleroterapia em hemangioma de dorso de língua, tratado com dose única de oleato de monoetanolamina. Metodologia: paciente do sexo feminino, 35 anos, branca, apresentou-se a um consultório particular queixando-se de lesão pigmentada na língua, assintomática, notada após contato com aparelho ortodôntico lingual. Ao exame clínico intrabucal foi observada lesão nódulo papular, de coloração vermelha, localização em dorso de língua, com 0.5 cm de diâmetro e inserção séssil com diagnóstico de hemangioma oral. Tratado em dose única com oleato de monoetanolamina a 0.4ml na proporção de 50%, diluído na solução anestésica local de lidocaína com adrenalina 1\100.000 no centro da lesão. Resultados: a lesão apresentou regressão total da lesão e sem recidiva após uma sessão do tratamento. Conclusão: escleroterapia é um tratamento conservador, eficiente e com resultado estético positivo, nos casos de hemangioma, porém vale ressaltar que esta deve ser devidamente indicada, analisando sempre as suas limitações e os seus benefícios.

Introduction: hemangioma is a benign vascular tumor of endothelial origin defined by abnormal growth of blood vessels. This injury can affect any part of the body, but the head and neck region has an incidence of 60% of cases. In the oral cavity it may be present in the tongue, buccal mucosa, palate, lips. Treatment is multimodal including laser, cryotherapy, surgical excision, chemotherapeutic agents and sclerotherapy. Objective: to present a case report of sclerotherapy in tongue dorsal hemangioma treated with a single dose of monoethanolamine oleate. Methodology: a 35-year-old white female patient presented to a private practice complaining of asymptomatic pigmented tongue injury noted after contact with the lingual orthodontic appliance. Clinical examination revealed a red papular nodule lesion, located on the back of the tongue, 0.5 cm in diameter and sessile insertion diagnosed with Oral Hemangioma. The nodule was treated in the lesion center with a single dose of 0.4 ml monoethanolamine oleate, at a proportion of 50% dilution in 1\100,000 local anesthetic solution of lidocaine with adrenaline. Results: total regression of the lesion and no recurrence was presented after 01 treatment session. Conclusion: sclerotherapy is a conservative treatment, efficient and with positive aesthetic result in cases of Hemangioma, but it is worth mentioning that it should be properly indicated always considering its limitations and its benefits.

Análise comparativa entre a coloração do azul de toluidina e a imunoexpressão da ciclina D1 em leucoplasias da mucosa bucal com diferentes graus de atipia / Comparative analysis between the coloring of toluidine blue and the immunoexpression of cyclin D1 in leucoplakias of the bucal mucosa with different degrees of atipia

O câncer de boca ocupa uma posição de destaque em relação ao número total de casos registrados no Brasil. A displasia epitelial (DE) oral é um achado histopatológico associado a um risco aumentado de transformação maligna do epitélio oral. A falha nos mecanismos de sinalização celular, no controle do ciclo celular ou nos mecanismos para reparar danos celulares pode favorecer a processos que culminam com a progressão para o câncer. Objetivo: avaliar comparativamente a resposta clínica da marcação do azul de toluidina (AT) e a imunoexpressão da proteína ciclina D1, uma proteína nuclear de grande importância como regulador da transição da fase G1 para fase S do ciclo celular, em leucoplasias oral (LO). Metodologia: avaliamos 12 pacientes que apresentavam, na cavidade bucal, lesões com diagnóstico clínico de LO. O estudo se desenvolveu em duas etapas: clínica e laboratorial. Foi feita marcação com AT e avaliação Imuno-histoquímica, respectivamente. Após análise quantitativa das lâminas, os dados obtidos foram analisados pelo programa BIOESTAT 2.0, por meio dos testes de Spearman e pelo teste de correlações múltiplas de Pearson. Resultados: não foi observada relação entre a marcação clínica do AT, o grau de displasia da lesão e a imunoexpressão da Ciclina D1 em LO. Conclusão: 82% das lesões apresentaram DE em graus variados, confirmando a necessidade de se realizar o diagnóstico histopatológico das LO e o acompanhamento clínico posterior dos pacientes.

Mouth cancer occupies a prominent position in relation to the total number of cases registered in Brazil. Oral epithelial dysplasia (ED) is a histopathological finding associated with an increased risk of malignant transformation of oral epithelium. The failure in the mechanisms of cell signaling, cell cycle control mechanisms or to repair cell damage can favor processes that culminate with the progression to cancer. Objective: evaluate comparatively the clinical response of the toluidine blue marking (TB) and immuno-expression of cyclin D1 protein, a nuclear protein of great importance as a factor regulating the transition from G1 phase to S phase of the cell cycle, in oral leukoplakia (OL). Methodology: we evaluated 12 patients who presented lesions in the oral cavity with clinical diagnosis of OL. The study was developed in two stages: Clinical and Laboratorial. Marking was made with TB and immunohistochemical evaluation, respectively. After quantitative analysis of blades, the data obtained were analyzed by BIOESTAT program 2.0 through Spearman tests and by Pearson multiple correlation test. Results: no relation was observed between clinical marking of TB, the degree of dysplasia of the lesion and the immuno-expression of Cyclin D1 in OL. Conclusion: 82% of the lesions presented DE in varying degrees, confirming the need to perform histopathological diagnosis of the OL and the subsequent clinical monitoring of the patients.

Effect of low-level laser therapy (λ780 nm) on the mechanically damaged dentin-pulp complex in a model of extrusive luxation in rat incisors.

In order to regenerate the dental pulp, many strategies have been developed as phototherapy. In the pulp repair, we do not know if gallium-aluminum-arsenide (GaAlAs) laser preserves the primary odontoblasts or stimulates the formation of more dentin matrix when dental pulp is damaged. The aim of the present study was to examine the effect of laser phototherapy (λ780 nm) on vascularization, inflammation, density of the primary odontoblast layer, and formation of reactionary and reparative dentin in the dental pulp by provoking extrusion of the rat incisor. The upper incisors were extruded 3 mm and then repositioned into their original sockets followed by a laser irradiation of the palatal mucosa (λ = 780 nm; p = 70 mW; CW; 4.2 J/cm2; 60 s) every 48 h. Non-traumatized and/or non-irradiated incisors were used as the controls. At 8 and 30 days after surgery, incisors were processed for histological and histomorphometric analysis. Morphological analysis revealed no differences in vascularization between groups, but showed discrete inflammation in some non-irradiated and injured specimens, which correlated with a more irregular reparative dentin. The density of primary odontoblasts in the groups treated with lasers was higher when compared to non-irradiated groups, but no statistically significant difference between groups (p > 0.05). The thickness of the tertiary dentin was increased in both traumatized groups with no statistically significant difference between non-irradiated and irradiated groups (p > 0.05).The present findings revealed that the GaAlAs laser induced small changes on dentin-pulp complex, with more regular dentin matrix in the irradiated dental pulps.

Laser phototherapy improves early stage of cutaneous wound healing of rats under hyperlipidic diet.

The aim of this study was to evaluate the influence of laser photobiomodulation in cutaneous healing of rats under a hyperlipidic diet. Forty-eight Wistar Albinus rats, weaned, received standard diet (SD) or hyperlipidic diet (HD) for 20 weeks. The groups were divided into SD rats and HD rats, SD-irradiated rats (LSD), and HD-irradiated rats (LHD). Standard cutaneous wound (1 cm(2)) was created on the dorsum of each rat. The irradiation started immediately after surgery and every 48 h for 7 or 14 days (λ660 nm, 40 mW, 6 J/cm(2), ϕ 0,04 cm(2), CW), when they were killed under deep anesthesia. The specimens were removed, routinely processed, stained with hematoxylin/eosin (H/E), and evaluated by light microscopy. Rats fed with hyperlipidic diet had greater intensity in the inflammatory process and prolonged hyperemia. At day 7, the intensity of inflammation was reduced in LSD and LHD groups when compared to their control groups, SD (p = 0.002) and HD (p = 0.02). There was an increase in fibroblast proliferation and collagen deposition, especially in the LHD group. At day 14, the HD group presented more intensive hyperemia than the SD group. It can be concluded that the hyperlipidic diet modified the inflammation pattern in wound healing and that laser light has a positive biomodulative effect on the healing process only in early stages.

Evaluation of laser phototherapy (λ 780 nm) after dental replantation in rats.

BACKGROUND/AIM: Tooth replantation is the treatment of choice in cases of avulsion although the outcomes are variable. The teeth can be lost due to external root resorption. The aim of this study was to histologically assess of the effect of laser phototherapy (λ780 nm) on replanted teeth in rats. MATERIAL AND METHODS: Sixty Wistar Albinus rats had their maxillary right incisors extracted and were then divided into four groups: G1-absence of storage medium; G2-milk as storage medium; G3-milk as storage medium followed by a laser irradiation of the root surfaces and entrance of the alveolus (λ = 780 nm; P = 70 mW; CW; DE = 21 J/cm2 ); G4-milk as storage medium, laser irradiation as in G3 before replantation. After this procedure, laser irradiation was performed on the buccal and palatal mucosa (8.4 J/cm2 per session) every 48 h for 15 days. The animals were euthanized 15, 30, and 60 days after replantation. RESULTS: The histological results showed that after 15 days, G4 exhibited intense chronic inflammation with the presence of clastic cells and moderate external inflammatory root resorption (P < 0.05) when compared with G3, in which these outcomes were not observed. At the 30th day, G1, G2, and G4 showed chronic inflammation varying from discrete to moderate, as well as intense external inflammatory root resorption. G3 remained without any inflammation and external inflammatory root resorption up to the 60th day. CONCLUSIONS: The use of laser phototherapy on the root surface and at the entrance of the alveolus prior to replantation had a positive biomodulative effect on alveolar repair after tooth replantation in rats.

E-cadherin regulators are differentially expressed in the epithelium and stroma of keratocystic odontogenic tumors.

BACKGROUND: The epithelial-mesenchymal transition (EMT) is the process where cells lose their epithelial features and acquire properties of typical mesenchymal cells. The dissociation of tumor cells due to changes in cell-cell adhesion is one of the key principles of tumor invasion and EMT. Thus, the knowledge of the molecular features of EMT in keratocyst odontogenic tumor (KOT) can provide useful markers to aid in the diagnosis and prognosis and perhaps contribute to an alternative therapeutic approach as it shows an aggressive clinical behavior and high recurrence rates. This study aimed to evaluate the EMT in KOT by the immunoexpression of E-cadherin, N-cadherin, Snail, and Slug and comparing to radicular cysts and dental follicles. METHODS: Thirty-two KOTs, 15 radicular cysts, and 08 dental follicles were used for immunohistochemistry, evaluating the extent, intensity, labeling pattern, cellular compartment in the epithelium and stroma, and the presence of inflammation. RESULTS: E-cadherin was preserved in most cases of keratocystic odontogenic tumor. N-cadherin was increased in the tumor epithelium, a result that was positively correlated with the heterogeneous and nuclear immunoexpression of Slug in the epithelium; Slug also correlated with high Snail immunoexpression. N-cadherin was positively correlated with Slug in the stroma of keratocystic odontogenic tumors. CONCLUSIONS: The high immunoexpression of Snail and nuclear Slug in keratocystic odontogenic tumors suggests these proteins as transcription factors without necessarily participating in 'cadherin switching'. However, the knowledge of their induction of the epithelial-mesenchymal transition in odontogenic tumors is still limited.

Oral mucosal lesions in Indians from Northeast Brazil: cross-sectional study of prevalence and risk indicators.

The aim of this cross-sectional study was to evaluate the prevalence of oral mucosal lesions, and their risk indicators in adult Kiriri Indians from Northeast Brazil. Clinical oral examination was performed on a representative sample of 223 Indians (age ≥ 19 years). A systematic evaluation of lips, labial mucosa and sulcus, commissures, buccal mucosa and sulcus, gingiva and alveolar ridge, tongue, floor of the mouth, and soft and hard palate was performed. Bivariate analysis was conducted to assess associations between mucosal conditions and age, gender, income, educational level, diabetic status, and smoking status. Mucosal lesions were found in 50 participants (22.4%). The most prevalent lesions were fistulae (6.2%) and traumatic ulcers (4.48%). Oral mucosal was associated with higher age (≥ 35 years; odds ratio [OR] = 1.99, 95% confidence interval [CI]: 1.05-3.76, P = 0.03) and lower education level (<9 years; OR = 2.13, 95% CI: 0.96-4.71, P = 0.06). Mucosal conditions are prevalent in Kiriri Indians and the presence of mucosal lesions is associated with advanced age and lower education. A public health program aimed at preventing and treating mucosal lesions and targeted toward the high-risk group is vital to improve the oral health status of this population.

Estudo da Expressão imuno-histoquímica da Wnt-5a em displasias epiteliais bucais / Immunohistochemical Study of Wnt-5a Expression in Oral Epithelial Dysplasias

Alterações na expressão das proteínas Wnt no carcinoma espinocelular bucal, permitiram a construção de hipóteses sobre o papel da Wnt-5a em desordens potencialmente malignas. Objetivo: Avaliar a expressão imuno-histoquímica da proteína Wnt-5a em displasias epiteliais bucais. Metodologia: Foram analisados 18 casos de displasia epitelial bucal e 05 casos de tecido bucal sadio oriundos do Serviço de Patologia Bucal da Faculdade de Odontologia da UFBA. A expressão da Wnt-5a foi avaliada de acordo com a localização celular (membranoso, citoplasmático e/ou nuclear) e o índice de marcação estabelecendo-se a intensidade de expressão (ausente, fraca, moderada e forte). Resultados: Não houve maior prevalência entre os gêneros, sendo que a maioria dos pacientes encontrava-se na faixa etária entre 20 e 49 anos (50%). Não houve casos de displasia severa, sendo a maior parte de displasia leve (72,2%). A expressão da proteína Wnt-5a aconteceu principalmente como citoplasmática/nuclear, com a intensidade forte sendo a mais prevalente. Conclusão: O aumento da imuno-expressão da proteína Wnt-5a, observadas nas displasias epiteliais bucais, difere significativamente do padrão da mucosa bucal normal e denota a mudança fenotípica das células epiteliais como parte dos eventos precursores da carcinogênese bucal. Não foi possível verificar a relação entre graduação histológica da displasia epitelial bucal e expressão da Wnt-5a... (AU)

Introduction: Changes in the expression of Wnt proteins in oral squamous cell carcinoma allowed the construction of hypothesis about the role of Wnt-5a in potential malignant disorders. Objective: To evaluate the immunohistochemistry expression of the protein wnt-5a in oral epithelial dysplasia. Method: It was analyzed 18 cases of oral epithelial dysplasia from the Department of Oral Pathology, School of Dentistry (UFBA). The expression of Wnt-5a protein was evaluated as membranous, cytoplasmatic and/or nuclear. The labeling index established the intensity of expression (absent, low, moderate and strong). Results: There was no gender prevalence, being the majority of patients aged between 20 and 49 years (50%). There were no cases of severe dysplasia and mostly was mild dysplasia (72.2%). The cytoplasmic / nuclear expression of Wnt-5a was the most frequent, with the strong intensity being the most prevalent. Conclusion: The increased immuno-expression of the protein Wnt-5a observed in oral epithelial dysplasias, differ significantly from the normal pattern of healthy oral mucosa and shows a phenotypic change of epithelial cells as part of the events precursors of oral carcinogenesis. It was not possible to verify the relation between histological grading of oral epithelial dysplasia and expression of Wnt-5a... (AU)

Effect of laser phototherapy (λ660 nm) on type I and III collagen expression during wound healing in hypothyroid rats: an immunohistochemical study in a rodent model.

OBJECTIVE: The aim of this study was to assess, immunohistochemically, the impact of hypothyroidism and the effect of laser phototherapy on the expression of type I and III collagen during wound healing. BACKGROUND DATA: Hypothyroidism has been associated with the disruption of the body's metabolism, including the healing process. Laser phototherapy has been shown to be effective in improving wound healing, but its usefulness on enhancing wound healing under hypothyroid condition remains unknown. MATERIALS AND METHODS: Using general anesthesia, a standard surgical wound (1 cm(2)) was created on the dorsa of 48 Wistar rats divided into four groups of 12 animals each: control euthyroid (EC), euthyroid plus laser (EL), control hypothyroid (HC), and hypothyroid plus laser (HL). The irradiation with laser GaAlAs [λ660 nm, 40 mW, 1 W/cm(2), continuous wave (CW), ø=0.04 cm(2)] started immediately after surgery and was repeated every other day until end-point of study was reached, and animals were euthanized (i.e., 7 and 14 days). Laser light was applied on four different points (6 J, 150 sec and 150 J/cm(2) per point). Hypothyroidism was induced in rats with propylthiouracil (0.05 g/100 mL) administered orally for 4 weeks and maintained until the end of the experiment. Immunohistochemistry for collagen I and III was performed with EnVision(™) in the specimens removed. RESULTS: Seven days after the surgery EC, EL, and HL groups showed higher immunoexpression of collagen I and lower immunoexpression of collagen III in the newly formed tissue. There was increased immunoexpression of collagen I in EC when compared with HC (p=0.019). The immunoexpression of collagen III was significantly lower in EL than in EC (p=0.047) and HL (p=0.019). No significant difference was found in the experimental period of 14 days among the groups. CONCLUSIONS: Laser light therapy performed with the parameters of this investigation increased immunoexpression of collagen type I during tissue repair, and improved the quality of newly formed tissue in the presence of hypothyroidism.

Oral mucoceles: a clinical, histopathological and immunohistochemical study.

The aim of study was to evaluate the clinicopathological features of oral mucoceles and the immunohistochemical expression of cellular and extracellular matrix components in these lesions. One hundred cases of oral mucoceles were examined for clinicopathological features. The expression of mast cell tryptase, CD68, MMP-1 (matrix metalloproteinase-1), MMP-9 (matrix metalloproteinase-9) and CD34 was investigated immunohistochemically in 32 cases. The lesions arose as nodules or blisters of variable color. The mean age was 23.2 years and a higher male frequency was observed. The most common locations were the lower lip (92%), followed by the floor of the mouth (7%), and palate (1%). The lesion size ranged from 0.4 to 3.0cm. Unusual histopathological findings as superficial mucoceles (n=16, 16%), pseudopapillary projections (n=3, 3%), epithelioid histiocytes (n=4, 4%), multinucleated giant cells (n=1, 1%) and myxoglobulosis (n=9, 9%) were also seen. Mast cells and CD68-positive macrophages, MMP-1, MMP-9 and CD34-positive blood vessels were seen in all cases. A significant association was seen between mast cells and MMP-1 (p=0.03) and between macrophages and MMP-1 (p=0.01). This study provided important insight into the demographic and histopathological occurrence of oral mucoceles. The tissue remodeling seen in these lesions mainly involved the migration and interaction of mast cells, macrophages and MMP-1.

Effects of LED phototherapy on relative wound contraction and reepithelialization during tissue repair in hypothyroid rats: morphometric and histological study.

The aim of this study was to assess morphometrically and histologically, the effects of light-emitting diode (LED) (λ630 ± 20 nm) phototherapy on reepithelialization and wound contraction during tissue repair in hypothyroid rats. Thyroid hormone deficiency has been associated with disorders of tissue repair. LED phototherapy has been studied using several healing models, but their usefulness in the improvement of hypothyroidism wound healing remains unknown. Under general anesthesia, a standard surgical wound (1 cm(2)) was produced on the dorsum of 48 male Wistar rats divided into four groups of 12 animals each: EC-control euthyroid, ED-euthyroid + LED, HC-control hypothyroid, and HD-Hypothyroid + LED. The irradiation started immediately after surgery and was repeated every other day for 7 and 14 days. Photographs of the wound were taken at the day of the surgical procedure and on days 8 and 15 after surgery, when animals' deaths occurred. The specimens were removed, routinely processed, and stained with hematoxylin/eosin. Seven days after the surgery, it was possible to observe statistically significant reductions in the wound area of the irradiated euthyroid group, in comparison to hypothyroid group, irradiated and non-irradiated (ANOVA, p < 0.05). The reepithelialization was significantly higher in the euthyroid and hypothyroid groups irradiated with LED than in the non-irradiated groups (Fisher's test, p < 0.05). No significant difference was found in the experimental period of 14 days among the groups. The hypothyroidism delayed wound healing and the LED phototherapy, at these specific parameters, improved the process of reepithelialization in the presence of hypothyroidism.

Evidências da interação entre obesidade e doença periodontal: uma revisão de literatura / Evidence of interaction between obesity and periodontal disease: a review of literature

A obesidade e o sobrepeso, acúmulo em excesso de gordura no organismo, apresentam um perfil epidemiológico cada vez maior mundialmente e representam um risco geral à saúde, já que estão associados ao desenvolvimento de doenças cardiovasculares e cerebrovasculares, hipertensão, diabetes tipo 2, cânceres, hiperlipidemia e colelitíase. Além disso, citocinas derivadas do tecido adiposo e hormônios podem desempenhar um papel modulador de processos inflamatórios, dentre eles a periodontite. Esta doença periodontal é caracterizada por causar danos à gengiva, ao tecido conjuntivo de suporte e ósseo, os quais ancoram os dentes aos maxilares. É infecciosa, crônica e causada predominantemente por bactérias que estimulam um infiltrado inflamatório de células de defesa, estabelecendo sua progressão. A relação entre a doença periodontal e sobrepeso/obesidade tem sido discutida por diversos estudos. Alguns sugerem que a obesidade pode exacerbar a susceptibilidade à doença periodontal por apresentarem distúrbios hormonais e inflamatórios. O objetivo desta revisão de literatura é reunir as principais evidências que discutem esse tema a fim de direcionar estudos que estabeleçam a causalidade desta interação e, caso haja conclusões identificadas, buscar melhorias na condição de saúde geral da população. A literatura vem tentando comprovar essa relação mas encontra dificuldades em diversos aspectos como critérios de avaliação utilizados, parâmetros de definição das doenças, população a ser estudada, metodologias empregadas, e ausência de estudos com observações longitudinais

The obesity and the overweight, accumulation of excessive fat in the body, have an epidemiological increase worldwide and represent a general risk to health, because they are associated with the development of cardiovascular and cerebrovascular diseases, hypertension, type 2 diabetes, cancers, hyperlipidemia, and cholelithiasis. Beside, cytokines from adipose tissue and hormones may play a modulatory role in inflammatory processes, including periodontitis. This periodontal disease is characterized by damage the gums, connective tissue and bone support, which anchor the teeth to the jaws. It is infectious, chronic and predominantly caused by bacteria that stimulate an inflammatory infiltrate of immune cells, setting its progression. The relationship between periodontal disease and overweight / obesity has been discussed by several studies. Some studies suggest that obesity can exacerbate periodontal disease susceptibility for having hormonal disorders and inflammatory conditions. The aim of this review is to show the main evidences that discuss this issue in order to direct studies to establish the causality of this interaction and to search improvements in the general health condition of the population. The literature has been trying to prove this relationship but finds difficulties in various aspects such as evaluation standard, parameters defining diseases, population studied, methodologies, and lack of studies with longitudinal observations.

Destructive periodontal disease in adult Indians from Northeast Brazil: cross-sectional study of prevalence and risk indicators.

AIM: The aim of this cross-sectional study was to evaluate the prevalence of destructive periodontal disease and its risk indicators in adult Kiriri Indians from Northeast Brazil. MATERIALS AND METHODS: Full-mouth periodontal examinations were performed on a sample of 215 Indians (≥19 years). Bivariate analyses and logistic models were applied to assess associations between periodontitis and its putative risk factors. RESULTS: Prevalence of clinical attachment loss of ≥3, ≥5 and ≥7 mm was 97.8%, 63.8% and 30.8% respectively. Percentage of teeth per individual showing clinical attachment loss of ≥3, ≥5 and ≥7 mm was 49.8%, 18.4% and 8.0% respectively. After adjustment for covariates, individuals aged ≥35 years (OR = 5.83, 95% CI: 3.09-11.00; p < 0.001), men (OR = 2.18, 95% CI: 1.15-4.11; p = 0.02) and diabetics (OR = 3.92, 95% CI 1.03-14.99; p = 0.05) had a higher risk for destructive periodontitis, classified according to the CDC/AAP case definition. CONCLUSION: Though periodontitis was highly prevalent in Kiriri Indians, only few teeth showed advanced disease, and periodontitis was associated with higher age, male sex and diabetes. A public health action that includes programs of prevention and treatment targeting high-risk groups is vital to improve the periodontal status of this population.