Isolated intra-oral granular cell tumor: report of two cases and review of the literature.

Granular cell tumor (GCT) is a relatively uncommon lesion occurring in almost any part of the body, including the orofacial region. The tongue and the buccal mucosa are common intra oral sites. Although aggressive and malignant variants of this neoplasm have been described, most GCTs are benign. The histogenesis of the lesion still remains unknown. However, histochemical and ultra-structural studies propose the origin of the lesion from Schwann cells, striated muscle, mesenchymal cells, histiocytes and epithelial cells. The tumor generally occurs in middle-aged or older adults. The lesion is typically seen as an uninflamed asymptomatic mass measuring about two cm in diameter with reddish surface coloring. As most granular cell tumors are benign, surgical excision of the lesion is the treatment of choice. In this study, 2 oral GCT cases are presented, corresponding to 2 male patients, with a mean age of 27 years and a mean time of evolution of the lesions of 8 months. Both lesions were located on the tongue. Differential diagnoses include fibrous hyperplasia, minor salivary gland tumor condyloma acuminatum and neurilemmoma. In all the cases a resection with safety margins of the lesions was carried out under local anesthesia. The samples were fixed and processed for histopathological study. The main clinical pathology and diagnostic features of this neoplasm are reviewed and discussed.

Isolated intra-oral granular cell tumor: report of two cases and review of the literature

Granular cell tumor (GCT) is a relatively uncommon lesion occurring in almost any part of the body, including the orofacial region. The tongue and the buccal mucosa are common intra oral sites. Although aggressive and malignant variants of this neoplasm have been described, most GCTs are benign. The histogenesis of the lesion still remains unknown. However, histochemical and ultra-structural studies propose the origin of the lesion from Schwann cells, striated muscle, mesenchymal cells, histiocytes and epithelial cells. The tumor generally occurs in middle-aged or older adults. The lesion is typically seen as an uninflamed asymptomatic mass measuring about two cm in diameter with reddish surface coloring. As most granular cell tumors are benign, surgical excision of the lesion is the treatment of choice. In this study, 2 oral GCT cases are presented, corresponding to 2 male patients, with a mean age of 27 years and a mean time of evolution of the lesions of 8 months. Both lesions were located on the tongue. Differential diagnoses include fibrous hyperplasia, minor salivary gland tumor, condyloma acuminatum and neurilemmoma. In all the cases a resection with safety margins of the lesions was carried out under local anesthesia. The samples were fixed and processed for histopathological study. The main clinical pathology and diagnostic features of this neoplasm are reviewed and discussed.

O tumor de celulas granulares (TCG) e uma lesao relativamente incomum que pode acometer qualquer parte do corpo, incluindo a regiao buco-maxilo-facial. A lingua e a mucosa bucal sao localizacoes intraorais comuns. Embora casos de transformacoes malignas e agressividade terem sido descritos, a maioria dos TCG sao benignos. A histogenese desta lesao continua desconhecida. No entanto estudos de imunohistoquimica e ultraestruturais sugerem que a lesao se origina das celulas de schwann, musculatura estriada, celulas mesenquimais, histiocitos e celulas epiteliais. O tumor geralmente ocorre na meia idade ou em pacientes idosos. A lesao e tipicamente vista como uma massa assintomatica nao inflamatoria que mede cerca de dois centimetros de diametro com uma superficie de coloracao avermelhada. A maioria dos tumores de celulas granulares sao benignos cuja excisao cirurgica e o tratamento de escolha. Neste estudo, 2 casos orais de TCG sao apresentados sendo ambos em pacientes do sexo masculino, com media de idade de 27 anos e tempo medio de evolucao da lesao de 8 meses. A localizacao de ambas as lesoes foi o dorso da lingual. O dignostico diferencial incluiu a hiperplasia fibrosa, tumor de glandulas salivares menores, condiloma aculminado e neiurilenoma. Em todos os casos a resseccao com margens de seguranca foi realizado sob anesthesia local. As amostras foram fixadas e processadas para o estudo histopatologicos. As principais caracteristicas clinicopatologicas e de disgnostico foram revisadas e discutidas.

Methodological quality of systematic reviews analyzing the use of laser therapy in restorative dentistry.

The purpose of this study was to identify systematic reviews (SRs) that compared laser with other dental restorative procedures and to evaluate their methodological quality. A search strategy was developed and implemented for MEDLINE, the Cochrane Library, LILACS, and the Brazilian Dentistry Bibliography (1966- 2007). Inclusion criteria were: the article had to be an SR (+/- meta-analysis); primary focus was the use of laser in restorative dentistry; published in English, Spanish, Portuguese, Italian, German. Two investigators independently selected and evaluated the SRs. The overview quality assessment questionnaire (OQAQ) was used to evaluate methodological quality, and the results were averaged. There were 145 references identified, of which seven were SRs that met the inclusion criteria (kappa=0.81). Of the SRs, 71.4% appraised lasers in dental caries diagnosis. The mean overall OQAQ score was 4.4 [95% confidence interval (CI) 2.4- 6.5]. Of the SRs, 57.1% had major flaws, scoring < or = 4. SR methodological quality is low; therefore, clinicians should critically appraise them prior to considering their recommendations to guide patient care.

Odontogenic cysts: a clinicopathological study of 507 cases.

The purpose of this study was to determine the prevalence of odontogenic cysts at the Pernambuco School of Dentistry - Universidade de Pernambuco (Brazil) and compare this prevalence with other international studies. Data for the study were obtained from reports of patients diagnosed with odontogenic cysts between 1992 and 2007. Case records of patients who fit the Histological Classification of the World Health Organization (2005) were included. The following variables were analyzed: gender, age group, anatomical location, histological type and ethnic background. Odontogenic cysts accounted for 9.94% of all lesions biopsied throughout the study period. Mean patient age was 28.9 years and 57.6% of the patients were males (P > 0.05). Radicular cyst was the most prevalent histological type (52.2%), followed by dentigerous cyst (30.7%). Regarding ethnic background, 41.8 % of the patients were of African descent, followed by Caucasians and other ethnic groups (P > 0.05). The mandible was the most prevalent site of the lesions (56%). Odontogenic cysts appear to have a distinct predilection for the male gender, the second and third decades of life (P < 0.05) and are more frequent in the mandible. The removal of odontogenic keratocysts from the new WHO classification has not altered the order of the most prevalent cysts in the maxillofacial complex.

Effects of demineralized bone matrix and a 'Ricinus communis' polymer on bone regeneration: a histological study in rabbit calvaria.

The aim of the present study was to histologically analyze the effects of bovine and human demineralized bone matrix and a Ricinus communis polymer on the bone regeneration process. Two surgical bone defects were created in rabbit calvaria, one on the right and the other on the left side of the parietal suture. Eighteen rabbits were divided into three groups. In Group I, the experimental defect was treated with bovine demineralized bone matrix, Group II with human demineralized bone matrix, and in Group III, the experimental cavity was treated with polyurethane resin derived from Ricinus communis oil. The control defects were filled with the animals' own blood. The animals were sacrificed after 7 and 15 weeks. Histological analysis revealed that in all groups (control and experimental), bone regeneration increased with time. The least time required for bone regeneration was noted in the control group, with a substantial decrease in the thickness of the defect. All materials proved to be biologically compatible, but polyurethane resorbed more slowly and demonstrated considerably better results than the demineralized bone matrices.

Treatment of large ameloblastic fibroma: a case report.

Ameloblastic fibroma (AF) is an extremely rare true mixed benign tumor that can occur in either the mandible or the maxilla, but is most frequently found in the posterior region of the mandible. It usually occurs in the first two decades of life and is associated with tooth enclosure, causing a delay in eruption or altering the dental eruption sequence. AF is diagnosed on routine radiographic evaluation and is clinically and radiographically similar to ameloblastic fibrodontoma and odontoma, which makes an accurate diagnosis mandatory. There is controversy in the literature as to whether treatment should be conservative or agressive. A conservative treatment strategy, such as enucleation and curettage, is usually sufficient. However, extensive lesions require radical treatment. We describe a case of ameloblastic fibroma with a very unusual clinical manifestation: it demonstrated considerable extension but no associated impacted tooth, was located in the anterior region of the mandible, and became symptomatic in the fifth decade of life. A radical surgical approach was taken, with immediate reconstruction.

Origin of stellate giant cells in oral fibrous lesions determined by immunohistochemical expression of vimentin, HHF-35, CD68 and factor XIIIa.

AIMS: To determine the origin of mono-, bi- and multinucleate stellate giant cells in giant cell fibroma, fibrous hyperplasia and fibroepithelial polyp of the oral mucosa. METHODS: Ten cases of each lesion were studied immunohistochemically using anti-vimentin, -HHF-35, -CD68 and -factor XIIIa antibodies. Immunoreactivity of the cells was determined in the papillary and reticular lamina propria of these lesions. RESULTS: Vimentin positivity in both the papillary and reticular lamina propria was observed for most samples, especially giant cell fibroma cases. CONCLUSIONS: The immunohistochemical findings of the present study suggest that the mono-, bi- or multinucleate stellate giant cells observed in the lesions studied derived from the fibroblastic lineage.