Different DNA methylation profile is demonstrated in paracoccidioidomycosis patients without oral lesions.

BACKGROUND: Paracoccidioidomycosis (PCM) is a neglected fungal infection with a high impact on the quality of life of the affected patients. The disease presents primary pulmonary involvement and systemic dissemination may occur. About 50% of the cases show oral involvement, and the factors that lead to this manifestation are not clear. OBJECTIVES: The aim of this study was to evaluate the DNA methylation profile in PCM patients with oral lesions. MATERIAL AND METHODS: Genomic DNA was extracted from whole blood of eighteen PCM patients, being ten with oral lesions and eight with no oral lesion. Analysis of methylation profile was performed using the technique of methylation-sensitive arbitrarily primed PCR (MS-AP-PCR). The sequences of recombinant plasmids obtained were evaluated according to parameters that define a CpG island, as well as their relative position in the known human genome genes and/or CpG islands. RESULTS: After DNA amplification, three different expressed bands were observed between the two groups, being found in the samples of patients with no oral manifestations. The cloned fragment in the plasmid showed similarity with a DNA sequence present in chromosome 20, next to the YTHDF1 gene. Other bands showed homology with intronic region in the genes RBPMS2 and DPH6 and no CpG island was identified. CONCLUSIONS: DNA methylation was found in PCM patients with no oral lesion affecting the YTHDF1 gene. Further studies are necessary to elucidate to role of YTHDF1 gene in the oral PCM manifestations.

Giant Peripheral Ossifying Fibroma Treated With Piezosurgery and Platelet-Rich Fibrin: A Rare Case Report.

INTRODUCTION: The peripheral ossifying fibroma (POF) is a benign reactive lesion that exclusively arises from gingiva. The lesion may gain considerably large sizes and present peculiar clinical and radiographic features that would then allow it to be called a giant POF; in that case, its otherwise simple surgical extraction could create a challenge. Thus, we elect here, for the very first time, a plausible alternative for treating giant POF: piezosurgery followed by placement of platelet-rich fibrin (PRF). CASE PRESENTATION: A 31-year-old black male presented a large asymptomatic nodule on the lower gingiva; the lesion had caused vestibular displacement of teeth and had been present for 18 years. Following the diagnostic hypothesis of a giant POF, an excisional biopsy was performed under local anesthesia using piezosurgery (microvibration of 36,000 times/sec was used in a bone cortical working mode), which confirmed the diagnosis. The surgical procedure was facilitated with the use of piezosurgery followed by placement of PRF, being the trans- and postoperative periods occurred with no complications. One year after the treatment, the patient shows no signs of disease recurrence and remains under follow-up. CONCLUSIONS: Giant POF is a rare gingival reactive lesion that can reach large dimensions, causing teeth displacement, functional, and esthetic impairments. The lesion can be successfully managed with piezosurgery and PRF, as illustrated herein, avoiding extensive bone loss and damage to the surrounding soft tissues.

Rare isolated oral manifestations of secondary syphilis in an adolescent.

Syphilis is a sexually transmitted infection caused by Treponema pallidum. The disease can manifest clinically through 3 different stages: primary, secondary, and tertiary. This report describes an uncommon case of secondary syphilis in a 16-year-old boy who showed only oral clinical manifestations. The infection was diagnosed through serologic tests. Treatment with intramuscular benzathine penicillin G led to complete remission of the oral lesions 3 weeks after initiation of treatment. The current case demonstrates the importance of laboratory tests in establishing an accurate diagnosis of syphilis and thereby avoiding unnecessary biopsies.

Photodynamic inactivation of Paracoccidioides brasiliensis helps the outcome of oral paracoccidiodomycosis.

The antifungal drug therapy often employed to treat paracoccidiodomycosis (PCM), an important neglected fungal systemic infection, leads to offensive adverse effects, besides being very long-lasting. In addition, PCM compromises the oral health of patients by leading to oral lesions that are very painful and disabling. In that way, photodynamic therapy (PDT) arises as a new promising adjuvant treatment for inactivating Paracoccidioides brasiliensis (Pb), the responsible fungus for PCM, and also for helping the patients to deal with such debilitating oral lesions. PDT has been linked to an improved microbial killing, also presenting the advantage of not inducing immediate microbial resistance such as drugs. For the present study, we investigated the generation of reactive oxygen species (ROS) by using the fluorescent probes hydroxyphenyl fluorescein (HPF) and aminophenyl fluorescein (APF) after toluidine blue (TBO-37.5 mg/L)-mediated PDT (660 nm, 40 mW, and 0.04 cm2 spot area) and the action of TBO-PDT upon Pb cultures grown for 7 or 15 days in semisolid Fava Netto's culture medium; we also targeted oral PCM manifestations by reporting the first clinical cases (three patients) to receive topic PDT for such purpose. We were able to show a significant generation of hydroxyl radicals and hypochlorite after TBO-PDT with doses around 90 J/cm2; such ROS generation was particularly useful to attack and inactivate Pb colonies at 7 and 15 days. All three patients reported herein related an immediate relief when it came to pain, mouth opening, and also the ability to chew and swallow. As extracted from our clinical results, which are in fact based on in vitro outcomes, TBO-PDT is a very safe, inexpensive, and promising therapy for the oral manifestations of PCM.

Association between dental anomalies and malocclusion in Brazilian orthodontic patients.

Developmental dental anomalies have been associated with different malocclusions in various populations. This study verified this association in Brazilian non-syndromic orthodontic patients. The prevalence of dental anomalies was evaluated by examining 2,052 pretreatment records of orthodontic patients. Panoramic radiographs, study designs, intraoral photographs and medical history were collected in order to identify hypodontia, hyperdontia, microdontia, macrodontia, taurodontism, transposition, impaction, and ectopia. Epidemiological data and classification of malocclusion were also obtained. Data were analyzed using chi-square and Fisher's exact test (P < 0.05), and the prevalence ratio was obtained from cases that had a significant association between anomaly and malocclusion. The results showed that 27.4% of the patients evaluated had some dental anomaly, and most of them were white women aged 11-20 years. Ectopia, microdontia, impaction, and hypodontia were more prevalent in patients with Class I malocclusion. Macrodontia was the only anomaly associated with Class II division 1. Impaction was associated with Class III malocclusion, at a 1.84-times higher prevalence. In conclusion, impaction was correlated with Class I malocclusion; macrodontia showed association with Class II division 1; and impaction and ectopia were associated with Class III malocclusion in Brazilian orthodontic patients. (J Oral Sci 58, 75-81, 2016).