Cytological and cytomorphometric evaluation of the oral mucosa in HIV-infected patients undergoing antiretroviral therapy.

BACKGROUND: To evaluate HIV infection-induced alterations in the oral mucosa by comparing inflammation, cell maturation, and cytomorphometric changes in oral mucosal cells between HIV-infected patients undergoing highly active antiretroviral therapy (HAART) and non-HIV-infected patients. METHODS: Thirty HIV-infected patients undergoing HAART and 30 non-HIV-infected patients were studied. Four smears were obtained from the lateral border of the tongue and floor of the mouth with a cytobrush. One sample was stained by the Papanicolaou technique, and three samples were processed for Feulgen staining. Papanicolaou-stained smears were analyzed by light microscopy, and the cytoplasmic (CA) and nuclear (NA) area were measured with the Software AxioVision 4.7. RESULTS: The Wilcoxon signed-rank test showed a significant difference in intermediate epithelial cell types between the HIV-infected and non-HIV-infected groups (P=.005). However, this difference was not observed for superficial epithelial cell types with (P=.672) and without a nucleus (P=.069). Comparative analysis revealed no significant difference in CA (P=.604), NA (P=.298) or NA/CA (P=.456) between the HIV-infected and non-HIV-infected groups. Keratohyalin granules were more frequent in the non-HIV-infected group (P=.0001). CONCLUSIONS: The results showed alterations in cell maturation in HIV-infected patients undergoing HAART with undetectable viral load, but no morphometric changes were observed.

Qualidade do reparo ósseo em ratas ovariectomizadas, lesionadas e tratadas com Arnica montana fitoterápica e homeopática / Quality of bone repair in ovariectomized rats with bone lesions treated with phytotherapic and homeopathic Arnica montana

Objetivo: Dados estatísticos nacionais e mundiais demonstram que o número de indivíduos idosos tende a crescer de maneira exponencial nos próximos anos, tornando-se uma população significativamente e proporcionalmente maior que as demais. Entre as doenças mais comuns nessa faixa estaria encontra-se a osteoporose, doença que reduz a massa esquelética e deteriora a microarquitetura do osso causando fragilidade e aumentando o risco de fraturas. Material e Métodos: Este estudo teve como proposta avaliar o efeito da Arnica montana fitoterápica e homeopática no reparo de lesões ósseas, visando uma possível forma de tratamento de fraturas na vigência da osteoporose. Os ensaios experimentais foram realizados em ratas Wistar adultas, divididas em quatro grupos: ovariectomizado tratado com Arnica montana 6CH homeopática (OVZ 6CH); ovariectomizado tratado com extrato fitoterápico de Arnica montana (OVZ TM); ovariectomizada tratado com placebo (OVZ PL) falsa cirurgia de ovariectomia e tratado com placebo (Sham PL). Após 45 dias da cirurgia sham ou de ovariectomia, foi realizada uma lesão óssea monocortical. Os animais foram eutanasiados após 6, 12, 18 e 28 dias e as tíbias retiradas para avaliação das suas dimensões e analise do reparo ósseo através de densidade óssea radiográfica, ensaios biomecânicos e microscopia eletrônica de varredura (MEV). Os dados do teste de flexão foram submetidos à analise estatística pelos testes de ANOVA e Tukey (p< 5%). Resultados: Conclui-se que o tratamento com arnica 6CH foi melhor que o com arnica TM quanto à resistência e à qualidade de regeneração óssea, enquanto a TM mostrou melhor valor de densidade óptica. Conclusão: Esse estudo concluiu que o tratamento com Arnica montana homeopática foi mais eficiente que com Arnica fitoterápica na regeneração óssea de ratas com osteoporose (AU)

Objective: National and international data show that in the next years the elder population tends to have an exponential increase becoming to be significantly higher than other ages. Among the frequent diseases in the elderly, osteoporosis is a disease that decreases bone mass and deteriorates bone structure causing fragility and a high risk of fracture. This study aimed to evaluate the effect of phytotherapic and homeopathic Arnica montana on bone repair quality and its possible use in the treatment of bone fracture in patients with osteoporosis. Material and Methods: This experimental study was performed in Wistar adult female rats divided in 4 groups according to the following treatments: ovariectomized treated with homeopathic A. montana 6CH (OVZ 6CH); ovariectomized treated with phytotherapic A. montana (OVZ TM); ovariectomized with placebo (OVZ PL) and rats with sham surgery and placebo (Sham PL). In a period of 45 days after ovariectomy or sham surgery, all animals got a monocortical lesion. They were euthanized after 6, 12, 18 and 28 days and had the tibiae removed to evaluate dimensions and bone repair by radiographic density, biomechanical test and scanning electronic microscopy (SEM). Data were analyzed by ANOVA and TUKEY tests (p < 0.05). Results: Results showed that treatment with Arnica 6CH was better than Arnica TM considering bone resistance and bone repair quality. Conclusion: This study concluded that treatment with homeopathic A. montana was more efficient than with phytotherapic Arnica in bone regeneration in rats with osteoporosis.(AU)

Elastic band causing exfoliation of the upper permanent central incisors.

Objective. This study reports a case in which elastic band use culminated in the loss of the incisors. Case Report. An 11-year-old white girl was seen complaining of pain, with purulent discharge and severe tooth mobility. The bone destruction detected radiographically in the region, despite its single location and absence in posterior quadrants of the maxilla and/or mandible, was similar to that observed in Langerhans cell disease. To our surprise, an elastic band involving the midportion of the roots of the two upper central incisors was found during biopsy. The debris was removed and a metal wire was placed in permanent maxillary right and left incisors. The patient was followed up, but no improvement in tooth mobility was observed. Bone loss increased, and internal resorption and root exposure occurred, which culminated in the extraction of permanent maxillary right and left incisors. Conclusion. The present case highlights the fact that professionals sometimes are confronted by anamnestic reports never seen before.

Correlation of clinical, cytological and histological findings in oral squamous cell carcinomas.

The present study aimed to investigate the efficiency of exfoliative cytology by correlating the clinical lesions of oral squamous cell carcinoma (OSCC) with exfoliative cytology and histopathological findings. Cases of OSCC diagnosed between 1984 and 2010 were analyzed. The inclusion criteria for the present study were the availability of detailed clinical findings and a diagnosis of the disease through exfoliative cytology and histopathology. The cases were assessed and assigned scores, which were then submitted to modal expression analysis, which considers the higher frequency scores, thus relating the variables. The cytological findings demonstrated that the majority of the cases had malignant potential. Exfoliative cytology should be used as a supplementary tool for the diagnosis of OSCC, as it enables the early detection of these lesions. However, cytology should not be used as a substitute for histopathological examination.

Ação do Symphytum officinale homeopático e fitoterápico na reparação óssea: análise microscópica

O Symphytum officinale ou confrei é uma planta medicinal usada no tratamento auxiliar da consolidação de fraturas. Entretanto, casos de intoxicação hepática pela planta levaram a proibição de seu uso interno. Este fato justifica a avaliação da formulação homeopática. Os relatos de sua aplicação são basicamente populares e clínicos e existe pouca literatura científica investigando sua ação na reparação óssea. Este estudo avaliou a ação do Symphytum officinale na reparação de lesões ósseas em tíbia de ratos, através de análise microscópica. Foi comparada a ação do extrato fitoterápico 500mg/Kg/dia, da formulação homeopática de 6CH dois glóbulos/dia e de um placebo controle. Os tratamentos com Symphytum officinale em ambas as formulações estimularam a reparação óssea. O medicamento fitoterápico Symphytum officinale estimulou formação de tecido osteocondral e de tecido ósseo periosteal. O medicamento homeopático Symphytum officinale 6CH apresentou formação de osso na cavidade medular alguns dias mais tardia que o fitoterápico, estimulou a formação de tecido ósseo periosteal e apresentou remodelação óssea mais rapidamente. São necessários mais estudos analisando os efeitos do Symphytum officinale homeopático no reparo ósseo. (AU)

Symphytum officinale (Comfrey) is a medicinal plant used in the treatment of fractures consolidation. However, reports of hepatic intoxication after consuming Comfrey led to prohibiting its internal use. Taking into account this aspect the homeopathic formulation of Symphytum officinale should be investigated. There are few scientific reports about its effects on bone repair. This study evaluated the effects of Symphytum officinale on bone regeneration in rat’s tibiae, by microscopic analysis. It was compared the effect of the Phytotherapic (Phy) Symphytum officinale 500mg/Kg/day, of the Homeopathic (H) Symphytum officinale 6CH two globules/day, and of a control placebo. Both the homeopathic and the phytotherapic medicine stimulated bone repair. Phy showed more periosteal bone and cartilage formation. Homeopathic Symphytum stimulated bone formation in the medullary cavity some days later than Phy. It also stimulated periosteal bone formation and had a more intense bone remodeling. Further studies are necessary to evaluate the homeopathic Symphytum officinale effects on bone regeneration. (AU)

Immunohistochemical features of multifocal melanoacanthoma in the hard palate: a case report.

BACKGROUND: Melanoacanthoma (MA) has been described in the oral mucosa as a solitary lesion or, occasionally, as multiple lesions. MA mainly affects dark skinned patients and grows rapidly, showing a plane or slightly raised appearance and a brown to black color. The differential diagnosis includes oral nevi, amalgam tattoos, and melanomas. We report here the case of a 58-year-old black woman who presented multiple pigmented lesions on the hard palate. CASE PRESENTATION: Based on the differential diagnosis of melanoma, a punch biopsy (4 mm in diameter) was performed. The material was fixed in 10% formalin, embedded in paraffin, and stained with hematoxylin-eosin or submitted to immunohistochemical analysis. Immunohistochemistry using antibodies against protein S-100, melan-A, HMB-45, MCM-2, MCM-5, Ki-67 and geminin was performed. Immunohistochemical analysis revealed strong cytoplasmic immunoreactivity of dendritic melanocytes for proteinS-100, HMB-45 and melan-A.Positive staining for proliferative markers (MCM-2, MCM-5, Ki-67) was only observed in basal and suprabasal epithelial cells, confirming the reactive etiology of the lesion. The diagnosis was oral Melanoacanthoma (MA). CONCLUSION: The patient has been followed up for 30 months and shows no clinical alterations. MA should be included in the differential diagnosis of pigmented lesions of the oral cavity.

Effects of the medicinal plants Curcuma zedoaria and Camellia sinensis on halitosis control

Volatile sulphur compounds (VSC) are the gases mainly responsible for halitosis (bad breath). The aim of this research was to evaluate the effects of medicinal plants on halitosis control. Two commonly used plants were tested: Curcuma zedoaria and Camellia sinensis (green tea). These plants were prepared as an aqueous solution and used as mouthwashes, compared with a standard mouthwash of 0.12% chlorhexidine gluconate and a placebo (water). The experiment was conducted with 30 volunteers from the School of Dentistry of São Jose dos Campos, Univ. Estadual Paulista - UNESP, SP, Brazil. Each volunteer tested the four mouthwashes. The Cysteine Challenge Method, modified for this study, was used for initial breath standardization. Four breath assessments were conducted after volunteers rinsed orally with acetylcysteine: one before the test mouthwash was used; the second, one minute after its use; a third 90 minutes later; and the last 180 minutes later. The results showed that chlorhexidine gluconate lowered VSC production immediately, and that this effect lasted up to 3 hours, while the tested plants had immediate inhibitory effects but no residual inhibitory effects on VSC. We concluded that Curcuma zedoaria and Camellia sinensis, prepared as infusions and used as mouthwashes, did not have a residual neutralizing effect on VSC.

Effects of the medicinal plants Curcuma zedoaria and Camellia sinensis on halitosis control.

Volatile sulphur compounds (VSC) are the gases mainly responsible for halitosis (bad breath). The aim of this research was to evaluate the effects of medicinal plants on halitosis control. Two commonly used plants were tested: Curcuma zedoaria and Camellia sinensis (green tea). These plants were prepared as an aqueous solution and used as mouthwashes, compared with a standard mouthwash of 0.12% chlorhexidine gluconate and a placebo (water). The experiment was conducted with 30 volunteers from the School of Dentistry of São Jose dos Campos, Univ. Estadual Paulista - UNESP, SP, Brazil. Each volunteer tested the four mouthwashes. The Cysteine Challenge Method, modified for this study, was used for initial breath standardization. Four breath assessments were conducted after volunteers rinsed orally with acetylcysteine: one before the test mouthwash was used; the second, one minute after its use; a third 90 minutes later; and the last 180 minutes later. The results showed that chlorhexidine gluconate lowered VSC production immediately, and that this effect lasted up to 3 hours, while the tested plants had immediate inhibitory effects but no residual inhibitory effects on VSC. We concluded that Curcuma zedoaria and Camellia sinensis, prepared as infusions and used as mouthwashes, did not have a residual neutralizing effect on VSC.

Peripheral calcifying cystic odontogenic tumour of the maxillary gingiva.

BACKGROUND: Odontogenic tumors are lesions that are derived from remnants of the components of the developing tooth germ. The calcifying cystic odontogenic tumor or calcifying odontogenic cyst is a benign cystic neoplasm of odontogenic origin that is characterized by an ameloblastoma-like epithelium and ghost cells. Calcifying cystic odontogenic tumor may be centrally or peripherally located, and its ghost cells may exhibit calcification, as first described by Gorlin in 1962. Most peripheral calcifying cystic odontogenic tumors are located in the anterior gingiva of the mandible or maxilla. CASE PRESENTATION: Authors report a rare case of a peripheral calcifying cystic odontogenic tumor of the maxillary gingiva. A 39-year-old male patient presented with a fibrous mass on the attached buccal gingiva of the upper left cuspid teeth. It was 0.7-cm-diameter, painless and it was clinically diagnosed as a peripheral ossifying fibroma. After an excisional biopsy, the diagnosis was peripheric calcifying cystic odontogenic tumor. The patient was monitored for five years following the excision, and no recurrence was detected. CONCLUSIONS: All biopsy material must be sent for histological examination. If the histological examination of gingival lesions with innocuous appearance is not performed, the frequency of peripheral calcifying cystic odontogenic tumor and other peripheral odontogenic tumors may be underestimated.

Oral granuloma formation after injection of cosmetic filler.

The increased use of orofacial fillers in cosmetic procedures has led to new diagnostic challenges for dentists and oral pathologists. Here, we describe a case with multiple oral foreign body granulomas, which were formed after a polymethylmetacrylate injection for cosmetic purposes.

Influence of different durations of estrogen deficiency on alveolar bone loss in rats.

The purpose of this study was to morphometrically evaluate the influence of different durations of ovariectomy-induced estrogen deficiency on alveolar bone loss associated with ligature-induced bone loss in rats. Sixty female Wistar rats were randomly assigned to ovariectomy (OVX test group) or sham operation (SHAM control group). The OVX and SHAM groups were each distributed into three subgroups of ten rats each according to the duration of estrogen deficiency (30, 60 and 90 postoperative days). In all groups, for the last 30 days of the experimental period, cotton ligatures were placed around the cervix of the right upper second molar; the contralateral tooth was left unligated to serve as a control. The maxillary bones were removed, and the alveolar bone loss was analyzed by measuring the distance between the cementoenamel junction and the alveolar bone crest at the buccal site of the right upper second molar. A comparison between the ligated and unligated groups verified the presence of ligature-induced alveolar bone loss (p < 0.05). No significant differences were observed among the unligated groups (p > 0.05). A significant increase in bone loss was observed when ligation occurred 90 days after ovariectomy compared with the sham group (p < 0.05). These results demonstrate that long-term estrogen deficiency affects ligature-induced alveolar bone loss.

Influence of different durations of estrogen deficiency on alveolar bone loss in rats

The purpose of this study was to morphometrically evaluate the influence of different durations of ovariectomy-induced estrogen deficiency on alveolar bone loss associated with ligature-induced bone loss in rats. Sixty female Wistar rats were randomly assigned to ovariectomy (OVX test group) or sham operation (SHAM control group). The OVX and SHAM groups were each distributed into three subgroups of ten rats each according to the duration of estrogen deficiency (30, 60 and 90 postoperative days). In all groups, for the last 30 days of the experimental period, cotton ligatures were placed around the cervix of the right upper second molar; the contralateral tooth was left unligated to serve as a control. The maxillary bones were removed, and the alveolar bone loss was analyzed by measuring the distance between the cementoenamel junction and the alveolar bone crest at the buccal site of the right upper second molar. A comparison between the ligated and unligated groups verified the presence of ligature-induced alveolar bone loss (p < 0.05). No significant differences were observed among the unligated groups (p > 0.05). A significant increase in bone loss was observed when ligation occurred 90 days after ovariectomy compared with the sham group (p < 0.05). These results demonstrate that long-term estrogen deficiency affects ligature-induced alveolar bone loss.

Lateral periodontal cyst: a case report and literature review.

BACKGROUND: The lateral periodontal cyst is considered a developmental odontogenic cyst with unusual occurrence. In most cases it is preliminary diagnosed as a radiographic finding, presenting as well circumscribed or as a round or teardrop-shaped radiolucent area. Due to its location it can easily be misdiagnosed as a lesion of endodontic origin. Final diagnosis should be based on histopatological examination. The purpose of this paper is to report a classic case of lateral periodontal cyst located in the anterior region of mandible and to review the relevant literature which describes the clinical, radiological and histopathological features of lateral periodontal cysts. METHODS: A 50 years female patient complained of an asymptomatic gingival swelling in the region between the left mandibular lateral incisor and canine. Radiographic examination revealed a well circumscribed radiolucency with approximately 0.5 cm diameter with a radiopaque margin between the roots of the left mandibular lateral incisor and canine. The adjacent teeth had vital pulp. RESULTS: A total enucleation of the lesion was performed, and intraoperative examination showed a single lesion with no communication between the cyst's cavity and the oral environment. Histological examination revealed that the lesion was "lateral periodontal cyst of developmental origin". There was no recurrence or complications for 24 months follow-up. CONCLUSIONS: The lateral periodontal cyst can be considered in the differential diagnosis when a radioloucent lesion appears adjacent to the roots of vital teeth. The treatment of choice is surgical removal and subsequent histological evaluation to confirm the diagnosis. Relapses are infrequent.

Verruciform xanthoma and neurofibromatosis: a case report.

We report an unusual case of verruciform xanthoma in a patient with neurofibromatosis and some clinical features of oral lichen planus.

Exfoliative cytology of the oral mucosa: comparison of two collection methods.

This study compared the sampling efficacy of a cytobrush and metal spatula for exfoliative cytology of the oral mucosa. Thirty students with no detectable oral alterations upon clinical examination were submitted to exfoliative cytology of the lateral border of the tongue, using a metal spatula on the left side and a cytobrush on the right side. The smears were stained using the Papanicolaou technique and evaluated for cellularity, cell type, cell distribution, homogeneity, and cellular distortion, as well as the presence of mucus, inflammatory infiltrate, and hemorrhage. A statistical test (Z-test) with a 95% confidence interval (CI) showed a significant difference between the metal spatula and cytobrush in terms of cellularity (p = 0.02) and homogeneity (p = 0.01). No difference between the two methods was observed regarding cell type (p = 0.4, Z-test) or cell distribution for the 95% confidence interval (p = 0.2, Fisher's test). Cell distortion and the presence of mucus were observed in five cases that used the metal spatula and in two cases that used the cytobrush. No hemorrhage or inflammatory infiltrate was detected in any of the slides. Based on the results of this study, the cytobrush produced qualitatively better smears in terms of cellularity and homogeneity compared to the metal spatula.

Spectral region optimization for Raman-based optical biopsy of inflammatory lesions.

OBJECTIVE: The biochemical alterations between inflammatory fibrous hyperplasia (IFH) and normal tissues of buccal mucosa were probed by using the FT-Raman spectroscopy technique. The aim was to find the minimal set of Raman bands that would furnish the best discrimination. BACKGROUND: Raman-based optical biopsy is a widely recognized potential technique for noninvasive real-time diagnosis. However, few studies had been devoted to the discrimination of very common subtle or early pathologic states as inflammatory processes that are always present on, for example, cancer lesion borders. METHODS: Seventy spectra of IFH from 14 patients were compared with 30 spectra of normal tissues from six patients. The statistical analysis was performed with principal components analysis and soft independent modeling class analogy cross-validated, leave-one-out methods. RESULTS: Bands close to 574, 1,100, 1,250 to 1,350, and 1,500 cm(-1) (mainly amino acids and collagen bands) showed the main intragroup variations that are due to the acanthosis process in the IFH epithelium. The 1,200 (C-C aromatic/DNA), 1,350 (CH(2) bending/collagen 1), and 1,730 cm(-1) (collagen III) regions presented the main intergroup variations. This finding was interpreted as originating in an extracellular matrix-degeneration process occurring in the inflammatory tissues. The statistical analysis results indicated that the best discrimination capability (sensitivity of 95% and specificity of 100%) was found by using the 530-580 cm(-1) spectral region. CONCLUSIONS: The existence of this narrow spectral window enabling normal and inflammatory diagnosis also had useful implications for an in vivo dispersive Raman setup for clinical applications.

Papiloma escamoso bucal e condiloma acuminado: relato de caso clínico / Oral squamous papilloma and condyloma accuminattum: a case report

Objetivos: O presente artigo relata um caso clínico de papiloma em ventre lingual associado à história pregressa de condiloma acuminado em região peniana. Materiais e métodos: Paciente do gênero masculino, leucoderma, 28 anos, foi encaminhado à clínica de Propedêutica Estomatológica. O paciente relatou queixa de "condiloma bucal" (sic). O mesmo informou que havia notado uma "bolinha na base da língua" e que havia cauterizado uma lesão peniana há sete meses, com diagnóstico de condiloma acuminado. Ao exame clínico intrabucal notou-se lesão nodular pediculada, papilomatosa, assintomática, de coloração semelhante à mucosa adjacente, localizada em região de freio lingual, medindo aproximadamente 0,5 cm no maior diâmetro. Foi realizada biópsia excisional e o material enviado para exame histopatológico. Resultados: O exame histológico mostrou lesão proliferativa epitelial benigna, constituída por numerosas projeções papíliferas revestidas por epitélio pavimentoso estratificado, que mostrava áreas de espessura aumentada, exibindo várias células com vacuolização citoplasmática, halos perinucleares e/ou aspecto coilocitótico, recebendo diagnóstico de papiloma escamoso. Conclusão: No caso clínico relatado, o papiloma escamoso bucal sugere inter-relação com a história pregressa de condiloma acuminado em região peniana do paciente. Cabe ao cirurgião dentista minuciosa observação clínica e atenta anamnese visando favorecer o diagnóstico, o tratamento, a orientação, e o esclarecimento ao paciente quanto aos riscos e as medidas profiláticas a serem tomadas.

Objectives: This article reports a case of oral papilloma in the ventral tongue associated to previous penile Condyloma acuminatum. Materiais and methods: A white male, 28 years old, was referred to the Propaedeutic Stomatology University Clinic claiming of a nodule at the base of the tongue. He had a penile lesion removed seven months before, with diagnosis of Condyloma acuminatum. Clinical exarnination showed a 0.5 cm intraoral pedunculated nodular papillomatous asymptomatic lesion, located in the tongue frenulum. Excisional biopsy was performed. Results: Histological examination showed a benign epithelial proliferative lesion, presenting numerous long papillary projections with thinned extremities, lined by stratified epithelium, with areas of increased thickness and severa I coilocytotic cells characterized by cytoplasmic vacuolization and perinuclear halos, receiving the diagnosis of squamous papilloma. Conclusion: The oral squamous papilloma, in this case, suggests inter-relationship with the penile Condyloma acuminatum. Dental professionals must be able to make a good clinical examination and anamnesis in order to promote the patients diagnosis, treatment and orientation about the risks and prophylactic measures regarding this lesion.

Cytogenetic damage of oral mucosa by consumption of alcohol, tobacco and illicit drugs.

BACKGROUND: The aim of the present study was to quantitatively evaluate micronuclei (MN) in the mucosa of users of alcohol, tobacco and illicit drugs in a Brazilian population. METHODS: Patients were divided: (i) experimental group - 24 patients users of alcohol, tobacco and illicit drugs from the Center of Psychosocial Care for Alcohol and other Drugs (CAPSad), São José dos Campos city, and (ii) control group: 24 patients attending the clinics of the São José dos Campos Dental School FOSJC-UNESP. Criterion for inclusion in the two groups was no visible clinical alteration in the oral mucosa. Exfoliative cytology specimens were obtained from the left side of the border of the tongue. Feulgen staining was used and 600 cells per subject were evaluated by light microscopy. RESULTS: The frequency of MN and micronucleated cells was analysed statistically using the Kruskal-Wallis and Mann-Whitney tests. The incidence of MN was 3.08 +/- 3.20 in the CAPSad group and 2.08 +/- 1.93 in the control group. The frequency of micronucleated cells was 2.38 +/- 2.57 in the CAPSad group and 1.42 +/- 1.25 in the control group. CONCLUSION: The results showed a higher frequency of MN and micronucleated cells in the CAPSad group, but the difference compared with the control group was not significant.

Gingival squamous cell carcinoma: a case report.

BACKGROUND: Squamous cell carcinoma is a malignant epithelial neoplasm characterized by variable clinical manifestations. When located in the gingiva, this neoplasm may mimic common inflammatory lesions. The aim of this study was to report a case of atypical squamous cell carcinoma, in which the patient had no risk factors for the development of this neoplasm. METHODS: A 61 year old Caucasian female was seen with a 3 month history of a rapidly growing, painful nodule in the gingiva adjacent to tooth #11. Clinical examination revealed a proliferative lesion in the vestibular marginal gingiva of teeth #11 and #12, presenting with purulent exudation. Thus, in view of the clinical symptoms and differential diagnosis of an infectious granulomatous process and malignant neoplasm, an incisional biopsy was obtained from the lesion. RESULTS: The diagnosis of squamous cell carcinoma was made and fourteen days after incisional biopsy, healing was found to be unsatisfactory. The patient was referred for treatment consisting of surgical excision of the tumour. A removable partial denture was fabricated for rehabilitation, one month after surgery of the maxilla; the patient was submitted to dissection of the regional lymph nodes and radiotherapy for an additional 3 months. Three years after the end of treatment, the patient continues to be followed-up and does not show any sign of recurrence. CONCLUSIONS: Gingival squamous cell carcinoma is a condition which chance of cure is higher when carcinomatous lesions are diagnosed and treated early. In this instance dentists play an important role in early detection of gingival squamous cell carcinoma.

Oral exfoliative cytology for the diagnosis of paracoccidoidomycosis in a patient with human immunodeficiency virus: a case report.

BACKGROUND: Paracoccidioidomycosis is not the most common fungal disease in patients infected with human immunodeficiency virus (HIV), except for endemic regions in Latin America countries. CASE: A 33-year-old man with HIV presented with mulberry-like lesions on the palate. The diagnosis was made by exfoliative cytology and Papanicolaou staining. Microscopic analysis revealed fungal structures with birefringent walls and exosporulation conferring an airplane radial motor appearance, or even bowel-like or goblet-like forms compatible with Paracoccidioides brasiliensis. CONCLUSION: This process spares the immunosuppressed patient from undergoing invasive biopsy procedures.