Morphological analysis of cell cannibalism: An auxiliary tool in the prediction of central giant cell granuloma clinical behavior.

Central giant cell granuloma (CGCG) is a benign jaw lesion with variable clinical behavior. Cell cannibalism is a cellular process associated with aggressiveness and invasion in malignant neoplasms. Here, we morphologically investigated cell cannibalism as an auxiliary method to predict CGCG clinical behavior. Cell cannibalism was quantitatively evaluated in 19 cases of peripheral giant cell granuloma (PGCG), 38 cases of CGCG (non-aggressive and aggressive), and 19 cases of giant cell tumor of bone (GCT) stained with hematoxylin and eosin. T-test was performed to assess the differences between the variables analyzed (p ≤ 0.05). Cell cannibalism was identified in 21% of non-aggressive CGCGs and 68.4% of aggressive CGCGs. A significantly higher amount of cannibal multinucleated giant cells (CMGC) was observed in aggressive CGCG compared to PGCG and non-aggressive CGCG (p = 0.042; p = 0.044, respectively). There were no significant differences in the CMGC index between non-aggressive CGCG and PGCG (p = 0.858) and between aggressive CGCG and GCT (p = 0.069). CGGC cases that exhibited rapid growth and tooth displacement and/or root resorption had a higher amount of CMGC (p = 0.035; p = 0.041, respectively). Cell cannibalism can be identified in CGCG through routine anatomopathological examination. The quantification of CMGC can help to predict the clinical behavior of central giant cell granuloma.

Comparative study of royal jelly, propolis, and photobiomodulation therapies in 5-fluorouracil-related oral mucositis in rats.

PURPOSE: This study aimed to evaluate the effects and mechanisms of action of royal jelly (RJ) and propolis compared to photobiomodulation therapy (PBMT) in an animal model of 5-fluorouracil-related oral mucositis (OM). METHODS: Seventy-two male Wistar rats were randomly allocated to four groups (n = 18 each): control (no treatment), PBMT (intraoral laser, 6 J/cm2), RJ, and propolis. On days 0 and 2, the animals received an injection of 5-fluorouracil (5-FU). The buccal mucosa was scratched (days 3 and 4) and the treatments were initiated on day 5. Six animals of each group were euthanized on days 8, 10, and 14. Phytochemical analysis (thin-layer chromatography, TLC) and clinical, histopathological, and immunohistochemical analysis of pS6, pAKT, and NF-κB were performed, and oxidative stress markers were also investigated. RESULTS: TLC revealed the presence of large amounts of sucrose (Rf 0.34) in RJ and of flavonoids in propolis. Lower clinical OM scores were observed on day 8, and improved morphological data were observed on day 10 in the PBMT, RJ, and propolis groups (p < 0.05). On day 8, immunoexpression of pS6, pAKT, and NF-κB was increased compared to control. On day 14, reduced glutathione (GSH) antioxidant levels were increased in the propolis group compared to control (p < 0.05). CONCLUSIONS: Our results showed that RJ and propolis, as well as PBMT, are effective in the treatment of OM. Considering that some patients who develop OM do not have access to PBMT, the present study demonstrated that topical application of RJ and propolis may be an important alternative for the treatment of OM.

Pigmented lesions of the oral mucosa: epidemiological survey of 172 cases with focus on differential diagnosis / Lesões pigmentadas da mucosa oral: estudo epidemiológico de 172 casos com foco no diagnóstico diferencial

The research purpose to perform a retrospective study of pigmented lesions in the oral mucosa and to discuss important aspects of their differential diagnosis and management in dental practice. Methods: This is a descriptive retrospective study of pigmented lesions in the oral cavity that were recorded and diagnosed at a referral service over a period of 28 years. Results: There were 172 cases of pigmented lesions among a total of 13,743 records, corresponding to a prevalence of 1.25% at this service. Females accounted for 61.6% of cases. The most affected age range was 31-40 years (23.8%). The most common anatomical location involved was the cheek mucosa (20.19%), followed by the lower lip (19.2%) and alveolar ridge (15.2%). Amalgam tattoo and melanotic macule (33.1%) were the most common pigmented lesions, followed by melanocytic nevus (21.6%). The lack of some information on the biopsy request forms was the main limitation of the study. Conclusion: Oral pigmented lesions were uncommon at the service analyzed, probably because not all of them were sent for histopathological analysis. However, a correct diagnosis is important so that patients receive adequate treatment(AU)

O objetivo da pesquisa é realizar um estudo retrospectivo de lesões pigmentadas na mucosa bucal e discutir aspectos importantes de seu diagnóstico e tratamento diferenciado na prática odontológica. Métodos: Trata-se de um estudo retrospectivo descritivo de lesões pigmentadas na cavidade oral que foram registradas e diagnosticadas na clínica de Estomatologia e laboratório de Patologia Oral por um período de 28 anos. Resultados: Ocorreram 172 casos de lesões pigmentadas em um total de 13.743 registros, correspondendo a uma prevalência de 1,25% neste serviço. O sexo feminino foi responsável por 61,6% dos casos. A faixa etária mais afetada foi de 31 a 40 anos (23,8%). A localização anatômica mais comum envolvida foi a mucosa da bochecha (20,19%), seguida pelo lábio inferior (19,2%) e crista alveolar (15,2%). Tatuagem de amálgama e mácula melanótica (33,1%) foram as lesões pigmentadas mais comuns, seguidas por nevo melanocítico (21,6%). A falta de algumas informações nos formulários de solicitação de biópsia foi a principal limitação do estudo. Conclusão: Lesões orais pigmentadas eram incomuns no serviço analisado, provavelmente porque nem todas foram encaminhadas para análise histopatológica. No entanto, um diagnóstico correto é importante para que os pacientes recebam tratamento adequado(AU)

Teratocarcinoma-derived growth factor-1 (Cripto-1) is overexpressed in epithelial odontogenic lesions displaying more aggressive behaviour.

PURPOSE: Cripto-1 also known as teratoma-derived growth factor 1 (TDGF-1) belongs to the EGF-CFC family of growth factor-like molecules. Cripto-1 is involved with embryonic development and not expressed in adult tissue, but some tumours are accompanied by reactivation. METHODS: The aim of this study was to evaluate the immunohistochemical expression of Cripto-1 in most common odontogenic cysts and tumours. Thirty ameloblastomas, 30 keratocysts, 30 dentigerous cysts and two ameloblastic carcinomas were evaluated using the polymeric immunoperoxidase technique. Immunohistochemical expressions were analysed by the IRS (immunoreactive score). Statistical analyses were performed by the Kruskal-Wallis and Mann-Whitney tests (p ≤ 0.05). RESULTS: Age ranged from 9 to 75 years old, with a prevalence of females (n = 49/53.3%). The mandible was the most affected anatomical site (n = 69/75.0%). Cripto-1 immunoexpression was observed in all ameloblastoma, keratocyst and ameloblastic carcinoma cases, although nine dentigerous cyst cases (30%) were negative. Expression scores were higher in ameloblastoma, keratocyst and ameloblastic carcinoma cases (median ranging from 8 to 11) when compared with dentigerous cyst cases (median of 2), with a statistically significant difference (p < 0.001). CONCLUSIONS: Cripto-1 is critically important in the progression of several tumours since it is related to significant cell survival and differentiation pathways. The high expression of Cripto-1 in more aggressive odontogenic lesions suggests that this molecule may be involved in the activation of important pathways related to the etiopathogenesis of these lesions.

Comparison of photobiomodulation using either an intraoral or an extraoral laser on oral mucositis induced by chemotherapy in rats.

PURPOSE: The aim of the present study was to compare the effect of intraoral (IO) and extraoral (EO) diode laser irradiation on oral mucositis (OM) induced by 5-fluorouracil (5-FU) in rats. METHODS: Animals (n = 78) were divided into the following groups: negative control (NC), positive control (PC), IO 6 J/cm2, EO with 6 J/cm2 (EO 6 J/cm2), and 12 J/cm2 (EO 12 J/cm2). OM was induced with an intraperitoneal injection of 5-FU and scarification of the buccal mucosa. Over the following 14 days, animals received photobiomodulation (PBM) daily. Clinical and histological evaluation was done by scores at days 8, 10, and 14. The redox state was evaluated by reactive species levels, antioxidant network, and immunohistochemistry analysis. RESULTS: Clinically, on day 8, PBM groups showed lower scores of OM with EO 6 J/cm2 presenting a significantly lower degree compared to PC (p < 0.05). On days 10 and 14, all PBM groups exhibited improvement of OM compared to PC (p < 0.01). On day 8, all PBM groups exhibited an accelerated healing process compared to PC (p < 0.01) and reduction of reactive species (p < 0.001). Also, all PBM groups demonstrated higher levels of antioxidant GPx compared to PC (p < 0.001). Analysis of nitrotyrosine revealed that on day 14, this protein damage marker was significantly reduced in the EO 6 J/cm2 group (p > 0.05). CONCLUSIONS: An EO diode laser protocol promoted positive effects in the clinical, histopathological, and redox state in OM induced by 5-FU in rats. Among the EO protocols, EO 6 J/cm2 showed the most encouraging results.

Estudo comparativo do uso do gel de própolis e da geleia real no tratamento da mucosite oral induzida quimicamente? Estudo experimental in vivo / Comparative study of the use of propolis gel and royal jelly in the treatment of chemically induced oral mucositis? In vivo experimental study

Objetivo: Avaliar os efeitos da própolis(P) e da geleia real(GR) em comparação a terapia de fotobiomodulação (FBM) com laser de baixa intensidadeem um modelo animal de mucosite oral (MO) quimioinduzida por 5-fluorouracil (5-FU). Adicionalmente, verificar por meio de uma revisão sistemática da literatura o efeito da fitoterapia no tratamento da MO quimioinduzida 5-FU em modelo animal. Material e Métodos: Trata-se de um estudo in vivo, experimental, controlado e cego. Setenta e dois ratos Wistar foram distribuídos aleatoriamente em quatro grupos (n = 18): controle (C) (sem tratamento), terapia de fotobiomodulação (FBM) (laser intraoral 6 J/cm2 ), gel de própolis (P) e geleia real (GR). Nos dias 0 e 2, os animais receberam uma injeção intraperitoneal de 5-FU. Nos dias 3 e 4, a mucosa bucal foi escarificada. As terapias foram iniciadas no dia 5. Seis animais por grupo foram eutanasiados nos dias 8, 10 e 14. A análise fitoquímica da própolis e da geleia real foi realizada por Cromatografia em Camada Delgada (CCD). As análises clínica e histopatológica (baseada nos escores de reepitelização e inflamação) foram realizadas por fotografias e lâminas coradas em Hematoxilina e Eosina, respectivamente. Os estudos imuno-histoquímicos (pAKT, p-S6 e NFκB) e do estresse oxidativo (Superóxido Dismutase-SOD, Glutationa reduzida-GSH e Malonaldeído-MDA) foram realizados.Em seguida, uma busca sistemática da literatura foi realizada por meio da pesquisa nas bases de dados PubMed/Medline, CENTRAL (The Cochrane Library), EMBASE e Web of Science, a partir dos registros iniciais até janeiro de 2020. Resultados: A análise da CCD revelou à presença de compostos como terpenos, saponinas, óleos essenciais e flavonoides no P e de alta quantidade de sacarose (Rf 0,34) na RG. Nos dias 8 e 10, os animais dos grupos FBM, P e GR apresentaram melhora clínica da MO e cicatrização acelerada com menores escores morfológicos, aumento da imunoexpressão das proteínas pS6 (exceto no dia 10), pAKT (ANOVA e teste de Tukey; p <0,05) e fator de transcrição NF-kB (teste de Mann Whitney; p <0,05) quando comparados ao grupo controle. No dia 14, o grupo P aumentou os níveis do antioxidante GSH quando comparado ao grupo controle (ANOVA e teste de Tukey; p <0,05). Treze artigos foram incluídos na revisão sistemática da literatura (todos utilizando o 5-FU para indução de MO em animais), de um total de 503 artigos. A formulação dos tratamentos variou de aplicação tópica de pomada, gel e extrato, até a ingestão de fitoterápicos. Todas as pesquisas investigadas exibiram resultados promissores no uso de fitoterápicos no manejo da MO. Conclusões: Nossos resultados evidenciaram que a P e a GR, assim como a FBM, são terapias eficazes no tratamento da MO. A presença de açúcares na GR e de flavonoides, terpenos e óleos essenciais na P justifica a excelente ação cicatrizante de feridas e seus efeitos antiinflamatórios. Adicionalmente, o grupo P, exibiu redução do estresse oxidativo tecidual, em comparação aos grupos FBM, GR e controle.Nas 13 pesquisas avaliadas, pôde-se observar excelentes resultados na cicatrização tecidual, ação antiinflamatória, antimicrobiana e antioxidante, com o uso de fitoterápicos no tratamento da MO. Diante disso, pode-se sugerir que o uso de fitoterápicos é uma alternativa promissora no tratamento da MO quimioinduzida (AU).

Objective: To evaluate the effects of propolis (P) and royal jelly (RJ) compared to photobiomodulation therapy (PBMT) with low intensity laser in an animal model of oral mucositis (OM) chemically induced by 5-fluorouracil (5-FU). Additionally, to verify by means of a systematic review of the literature the effect of phytotherapy in the treatment of chemoinduced OM 5-FU in an animal model. Material and Methods: This is an in vivo, experimental, controlled and blind study. Seventy-two male and female Wistar rats were randomly assigned to four groups (n = 18): control (C) (without treatment), photobiomodulation therapy (PBMT) (6 J / cm2 intraoral laser), propolis gel (P) and royal jelly (RJ). On days 0 and 2, the animals received an intraperitoneal injection of 5-FU. On days 3 and 4, the oral mucosa was scarified. Therapies were started on day 5. Six animals per group were euthanized on days 8, 10 and 14. Phytochemical analysis of P and RJ were performed by Thin Layer Chromatography (TLC). The clinical analysis was performed using photographs and the histopathological evaluation (hematoxylin / eosin) was based on the reepithelization and inflammation scores. Immunohistochemical studies (pAKT, p-S6 and NFκB) and oxidative stress (Superoxide Dismutase-SOD, Glutathione reduced-GSH and Malonaldehyde-MDA) were performed. Then, a systematic search of the literature was performed, by searching the PubMed / Medline, CENTRAL (The Cochrane Library), EMBASE and Web of Science databases, from the initial records until January 2020). Results: The TLC analysis revealed the presence of compounds such as terpenes, saponins, essential oils and flavonoids in P and a high amount of sucrose (Rf 0.34) in RJ. On days 8 and 10, animals in the PBMT, P and RJ groups showed clinical improvement of OM and accelerated healing with lower morphological scores, increased immunoexpression of pS6 proteins (except on day 10), pAKT (p <0.05, ANOVA and Tukey test) and NF-kB transcription factor (Mann Whitney test; p <0.05) when compared to the control group. On day 14, the P group increased the levels of the antioxidant GSH when compared to the control group (p <0.05, ANOVA and Tukey's test). Thirteen articles were included in the systematic literature review (all using the 5-FU to induce OM in animals), out of a total of 503 articles. The formulation of treatments ranged from topical application of ointment, gel and extract, to the intake of herbal medicines. All investigations showed promising results in the use of herbal medicines in the management of OM. Conclusions: Our results showed that P and RJ, as well as PBMT, are effective therapies in the treatment of OM. The presence of sugars in RJ and flavonoids, terpenes and essential oils in P justifies the excellent wound healing action and its anti-inflammatory effects. In addition, the P group exhibited a reduction in tissue oxidative stress compared to the PBMT, RJ and control groups. In the 13 studies evaluated, it was possible to observe excellent results in tissue healing, antiinflammatory, antimicrobial and antioxidant action with the use of herbal medicines in the treatment of OM. Therefore, it can be suggested that the use of herbal medicines is a promising alternative in the treatment of chemically induced OM (AU).

Epidemiologic study of odontogenic and non-odontogenic cysts in children and adolescents of a Brazilian population

Background: the objective of this study was to describe the frequency of cystic lesions in a Brazilian population of patients histopathologically diagnosed in the first and second decade of life. Material and Methods: Retrospective descriptive cross-sectional study was performed. Biopsy records were obtained from the archives of a Brazilian referral center between 1980 and 2016. Results: A total of 2.114 biopsy records of pediatric patients were analyzed with oral and maxillofacial lesions. Data such as gender, age, anatomical location, and histopathological diagnosis were collected and categorized. Among all oral and maxillofacial lesions (n=2.114), were diagnosed 294 cases of odontogenic cysts (13.9%) and 16 cases of non-odontogenic cysts (0.8%). The most frequent lesions in each group were, respectively: radicular cyst (n=145) and epidermoid cyst (n=4). These lesions were most common in female (n=158), with a mean age of 14 years. For intraosseous lesions, the mandible (n=148) was the most affected anatomic site; moreover, the floor of the mouth (n=6) was most affected by cysts in soft tissues. Conclusions: Odontogenic cysts were relatively common in population studied, but non-odontogenic cysts were rare in these patients (AU)

No disponible

Vesiculobullous autoimmune diseases with oral mucosa manifestations: retrospective and follow-up study / Doenças autoimunes bolhosas com manifestação em mucosa oral: estudo retrospectivo e de acompanhamento

ABSTRACT Objective: To conduct a retrospective study on a series of cases of PV and BMMP with manifestations in the oral cavity in order to ascertain prevalence, sociodemographic characteristics, diagnostic maneuvers, treatment and follow-up. Methods: This is a retrospective, descriptive study in which clinical data were collected from the medical records of all cases of PV and BMMP registered and diagnosed, between 1995 and 2015, in the Oral Diagnostic Service of the UFRN Department of Dentistry. Results: The mean age of the total sample (n = 36) was 41.64, with females the most frequent (n = 26; 72.22%) and the cheek mucosa being the site most affected (n = 20; 27.40%). Eight patients (22.22%), including 5 cases of PV and 3 BMMP, were clinically reevaluated. All patients exhibited lesions at the time of follow-up. Prednisone (n=7; 87.5%) and clobetasol propionate (n=8, 100%) were the most widely used drugs in the systemic and topical treatment, respectively. The follow-up period ranged from 5 months to 5 years. Conclusion: The clinical profile of patients in this study was similar to that evidenced in the literature. However, it was found that the oral lesions were more resistant to the treatment used on the patients evaluated.

RESUMO Objetivo: Realizar um estudo retrospectivo em uma série de casos de PV e BMMP com manifestações em cavidade oral com o intuito de verificar suas prevalências, características sociodemográficas, diagnóstico, tratamento e acompanhamento. Métodos: Trata-se de um estudo retrospectivo descritivo no qual os dados clínicos foram coletados a partir dos prontuários de todos os casos de PV e BMMP registrados e diagnosticados, entre 1995 e 2015, no serviço de Diagnóstico Oral do Departamento de Odontologia da UFRN. Resultados: Da amostra total (n=36), a age média foi de 41,64 anos, sendo o sexo female o mais frequente (n=26; 72,22%) e a mucosa jugal o sítio mais afetado (n=20; 27,40%). Oito pacientes (22,22%), dos quais 5 são casos de PV e 3 de BMMP, foram reavaliados clinicamente. Todos os pacientes exibiram lesões no momento do acompanhamento, sendo a prednisona (n=7) e o propionato de clobetasol (n=8) os fármacos mais utilizados no tratamento sistêmico e tópico, respectivamente. O tempo de acompanhamento variou de 5 meses a 5 anos. Conclusão: O perfil clínico dos pacientes da presente pesquisa foi semelhante ao da literatura. No entanto, verificou-se que as lesões orais foram mais resistentes ao tratamento empregado nos pacientes avaliados.

Lesões Orais Malignas e Potencialmente Malignas: Percepção de Cirurgiões-Dentistas e Graduandos de Odontologia / Lesiones Orales Malignas y Potencialmente Malignas: Percepción de los Odontólogos y Estudiantes de Odontología / Malignant and Potentially Malignant Oral Lesions: Level of Knowledge of Dentists and Dental Students

Introducción: El cáncer oral es un problema de salud pública em muchos países, a pesar de que es una enfermedad que se puede prevenir debido a sua sociación bien estabelecida com ciertos factores de riesgo que pueden ser fácilmente identificados por el professional durante la evaluación clínica del paciente. Objetivo: Analizar la percepción de los odontólogos y estudiantes de odontología em los factores de riesgo y diagnóstico de lesiones bucales malignas y potencialmente malignas. Método: Los datos fueron recolectados através de um cuestionario validado y adaptado para este estudio, incluyendo, preguntas sobre datos sociodemográficos y la percepción del conocimiento de las lesiones bucales potencialmente malignas y el cáncer oral. De acuerdo com la puntuación obtenida, se establecier on cuatro conceptos, A (nivel óptimo de lainformación), B (bueno), C (regular) y D (insatisfactorio). Resultados: De las 292 personas, lamayoríatenía entre 20 y 29 años (48,97%) y erandel sexo femenino (62%). Los participantes más jóvenes, estudiantes yrecién graduados, tenían mejores conceptos em relación com el cáncer oral (p=0,000). La leucoplasia fue una de las lesiones buçales potencialmente malignas más relacionada com el cáncer oral (76,4%). Sólo el 12,7% de los participantes obtuvo el concepto, sin embargo, el 85,4%requeríanactualizarsesobre el tema de cáncer oral. Conclusión: Se observo un bajo nivel de consciência em el conocimiento de las lesiones bucales potencialmente malignas y cáncer oral, sin embargo, los jóvenes participantes, estudiantes y recién graduados de odontólogos, tenían mejores conceptos. Palabras clave: Diagnóstico; Factores de Riesgo; Neoplasias de la Boca

Introduction: Oral cancer is a public health problem in many countries. However, it is a disease that is preventable because of its well-established association with certain risk factors that can be easily identified by health care professionals during the clinical evaluation of patients. Objective: To analyze the knowledge (real and perceived) that dentists and dental students have regarding the diagnosis of and risk factors for malignant and potentially malignant oral lesions. Method: Data were collected with a previously validated questionnaire, adapted for use in this study, including questions designed to collect sociodemographic data and information about the level of knowledge of potentially malignant oral lesions and oral cancer. According to the score, the level of knowledge was categorized as follows: A (excellent); B (good); C (satisfactory); and D (poor). Results: A total of 292 individuals completed the questionnaire. Most (48.97%) of the respondents were between 20 and 29 years of age, and the majority (62.0%) were female. Younger participants, students, and recent graduates displayed the best knowledge of oral cancer (p=0.000). The clinical aspect that was most commonly associated with oral cancer (by 76.4% of the respondents) was leukoplakia. Although 85.4% of the respondents reported being up to date on the topic of oral cancer, only 12.7% had an A level of knowledge. Conclusion: Overall, the level of knowledge of potentially malignant oral lesions and oral cancer was low. However, younger respondents, students, and recent graduates displayed better knowledge of the topic. Key words: Diagnosis; Risk Factors; Mouth Neoplasms.

Introdução: O câncer oral é um problema de saúde pública em vários países do mundo, entretanto é uma doença que pode ser prevenida em razão da sua bem estabelecida associação com certos fatores de riscos que podem ser facilmente identificados pelo profissional no momento da avaliação clínica do paciente. Objetivo: Analisar a percepção dos cirurgiões-dentistas e universitários de Odontologia em relação ao diagnóstico e a fatores de risco das lesões orais malignas e potencialmente malignas. Método: Os dados foram coletados por meio de um questionário validado e adaptado para a presente pesquisa, incluindo perguntas sobre dados sociodemográficos e percepção do conhecimento das lesões orais potencialmente malignas e câncer oral. De acordo com a pontuação obtida, atribuíram-se quatro conceitos, A (ótimo nível de informação); B (bom); C (regular); e D (insatisfatório). Resultados: Duzentos e noventa e dois indivíduos participaram do estudo, a maioria tinha entre 20 e 29 anos (48,97%) e era do sexo feminino (62%). Os participantes mais jovens, estudantes e graduados apresentaram melhores conceitos com relação ao câncer oral (p=0,000). A leucoplasia foi a lesão oral potencialmente maligna mais relacionada ao câncer (76,4%). Apenas 12,7% dos participantes obtiveram conceito A, embora 85,4% referissem atualizar-se sobre esse tema. Conclusão: Notou-se baixo nível de percepção no conhecimento das lesões orais potencialmente malignas e câncer oral, entretanto os participantes mais jovens, estudantes e graduados com menos tempo de formado apresentaram melhores conceitos.