The stromal immunoexpression of CLIC4 may be related to the difference in the biological behavior between oral squamous cell carcinoma and oral verrucous carcinoma

Background: Oral squamous cell carcinoma (OSCC) has high morbidity and mortality rates while oral verrucous carcinoma (OVC), an uncommon variant of OSCC, exhibits a distinct biological behavior. CLIC4 protein plays a role in the cell cycle and apoptosis regulation and participates in the myofibroblasts transdifferentiation process, which are the main cells of the tumor stroma. This study analyzed the immunoexpression of CLIC4 and α-SMA in 20 OSCC cases and 15 OVC cases. Material and methods: A semiquantitative analysis of CLIC4 and α-SMA immunoexpression was performed in the parenchyma and stroma. Nuclear and cytoplasmic reactivity was analyzed separately for the CLIC4 immunostaining. The data were submitted to Pearson's chi-square and Spearman's correlation tests (p ≤ 0.05). Results: In the CLIC4 analysis, there was a significant difference in the immunoexpression of this protein between OSCC and OVC stroma (p < 0.001). It was observed a higher expression of α-SMA in the OSCC stroma. There was a positive and significant correlation between CLIC4 and α-SMA immunoexpression in the OVC stroma (r = 0,612; p = 0,015). Conclusions: The decrease or absence of nuclear CLIC4 immunoexpression in the neoplastic epithelial cells and the increase of its expression in the stroma may influence the difference in biological behavior between OSCC and OVC. (AU)

Prognostic and clinicopathological significance of tumor-stroma ratio in head and neck squamous cell carcinoma: A systematic review

Background: Analysis of the tumor microenvironment has been proposed as a strategy for the treatment and prognosis of different neoplastic processes. A grading system based on the tumor-stroma ratio (TSR), which evaluates theproportion of stroma in relation to neoplastic parenchyma at the invasion front, has shown a strong prognostic valuein different neoplastic processes. The aim of the present systematic review was to understand the role of the TSR inhead and neck squamous cell carcinoma (HNSCC), evaluating its correlation with clinical and prognostic parameters.Material and Methods: An electronic search was performed in PubMed/Medline, Web of Science, Science Direct,Scopus, Embase, and the Cochrane Collaboration Library. Publications assessing the relationship between TSRand prognosis in cases of HNSCC were eligible. The quality of the studies was assessed independently by fourevaluators using the Newcastle-Ottawa scale.Results: After application of the previously es+lished inclusion/exclusion criteria, nine articles were included inthe qualitative synthesis. With regards to quality on the Newcastle-Ottawa scale, an overall value of 4.55 was obtained. This systematic review demonstrated a strong association between TSR and prognosis in esophageal andoral squamous cell carcinomas.Conclusions: Histopathological analysis of the TSR can optimize the analysis of the prognosis of cases diagnosedwith HNSSC. In addition, the TSR is a reliable and simple parameter that can be evaluated in hematoxylin/eosinstained slides during routine laboratory examinations, showing high inter- and intraobserver agreement. (AU)

Pindborg tumor associated with a supernumerary tooth: a case report.

The calcifying epithelial odontogenic tumor is a rare benign neoplasm that accounts for approximately 1% of all odontogenic tumors. Most of the cases occur in the posterior mandible, and a few involve the maxilla. Despite their relatively indolent biological behavior, tumors in the maxilla tend to grow fast. We report the case of a 33-year-old female patient exhibiting swelling in the right maxilla. An isodense area associated with an impacted supernumerary tooth was found on imaging examination. The histopathologic diagnosis was a calcifying epithelial odontogenic tumor. The treatment of choice was surgical removal of the lesion and associated dental elements. The patient has been followed up for 11 months and shows no signs of recurrence. Besides describing this case, we reviewed the literature on the association of calcifying epithelial odontogenic tumors with supernumerary teeth and found two case reports addressing this subject.

Pindborg tumor associated with a supernumerary tooth: a case report

The calcifying epithelial odontogenic tumor is a rare benign neoplasm that accounts for approximately 1% of all odontogenic tumors. Most of the cases occur in the posterior mandible, and a few involve the maxilla. Despite their relatively indolent biological behavior, tumors in the maxilla tend to grow fast. We report the case of a 33-year-old female patient exhibiting swelling in the right maxilla. An isodense area associated with an impacted supernumerary tooth was found on imaging examination. The histopathologic diagnosis was a calcifying epithelial odontogenic tumor. The treatment of choice was surgical removal of the lesion and associated dental elements. The patient has been followed up for 11 months and shows no signs of recurrence. Besides describing this case, we reviewed the literature on the association of calcifying epithelial odontogenic tumors with supernumerary teeth and found two case reports addressing this subject.

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)

Clinicopathological evaluation and survival of patients with squamous cell carcinoma of the tongue

BACKGROUND: Early detection of oral cancer is the most effective means of reducing morbidity, complexity, and extent of treatment. This study evaluated the clinicopathological profile of epidermoid carcinoma of the tongue, including treatment and survival. MATERIAL AND METHODS: This observational, retrospective cross-sectional study evaluated patients with squamous cell carcinoma of the tongue treated at the Dr. Luiz Antônio Hospital, Natal, Brazil, from January 2001 to December 2011. Survival variables were calculated using the Kaplan-Meier method and compared by log rank tests. RESULTS: Of the 412 patients diagnosed in this period, 298 (72.3%) were men; their mean age was 60.5 years, and 69.2% were diagnosed with stage III/IV tumours. Improved survival was associated with early stage diagnosis, absence of affected lymph nodes at diagnosis, and treatment with surgery alone. CONCLUSIONS: Late stage diagnosis of oral cancer negatively affects patient survival. In addition, the general public should be made aware of the prognostic factors for oral SCC of the tongue and of the importance of periodic examinations of the oral cavity

A importância do conhecimento científico para as instituições de ensino superior / The importance of scientific knowledge to institutions higher education

O conhecimento científico para as instituições de ensino superior no Brasil é de suma importância para impulsionar a qualificação das nossas Universidades. Temos que reconhecer que esse fato só foi possível haja vista o grande crescimento da Pós-Graduação stricto sensu que se consolidou como grande incentivadora e produtora de boa parte da pesquisa produzida em todo o país. Não podemos deixar de ressaltar o aprimoramento continuado do processo de avaliação trienal da CAPES, o qual tem estimulado a publicação de trabalhos científicos qualificados e consequentemente o desenvolvimento de pesquisas básicas e aplicadas tanto na área da saúde como em outras grandes áreas do conhecimento (AU).

Minor intraoral salivary gland tumors: a clinical-pathological study / Neoplasias intraorais de glândula salivar menor: estudo clínico-patológico

ABSTRACT Objective To evaluate the clinical-pathological profile of patients with minor salivary gland neoplasms. Methods A retrospective study of specific cases diagnosed as benign and malignant tumors of the minor salivary glands was performed. The data were collected from medical records of patients seen at a hospital over a period of 15 years. The sample was made up of 37 cases. For the pathological study, slides containing 5μm thick sections stained with hematoxylin and eosin were used. The data were tabulated using descriptive statistics. Results Malignant neoplasms represented 70.3% of cases. The mucoepidermoid carcinoma was the most common neoplasm (45.9%), followed by pleomorphic adenoma (24.4%). Most patients were female (70.3%), aged between 71 and 80 years. The palate (67.6%) and the retromolar region (10.8%) were the most affected sites. Conclusion Mucoepidermoid carcinoma was the most common tumor in minor salivary glands. These tumors are more common in females aged over 40 years. The palate was the most common affected site.

RESUMO Objetivo Avaliar o perfil clínico-patológico de pacientes com neoplasias de glândula salivar menor. Métodos Foi realizado um estudo retrospectivo de casos específicos diagnosticados como neoplasias benignas ou malignas de glândula salivar menor. Os dados foram coletados dos prontuários dos pacientes atendidos em um hospital no período de 15 anos. A amostra final foi de 37 casos. Para o estudo histopatológico, foram usadas lâminas contendo secções com 5μm de espessura, coradas pela técnica de hematoxilina e eosina. Os dados foram tabulados de forma descritiva. Resultados As neoplasias malignas representaram 70,3% dos casos. O tipo histológico mais prevalente foi o carcinoma mucoepidermoide (45,9%), seguido do adenoma pleomórfico (24,4%). A maioria dos pacientes era do sexo feminino (70,3%), com idade entre 71 e 80 anos. O palato (67,6%) e a região retromolar (10,8%) foram os sítios mais acometidos. Conclusão O carcinoma mucoepidermoide foi o tumor mais comum das glândulas salivares menores. Estes tumores foram mais comuns em mulheres com mais de 40 anos. O palato foi o sítio mais acometido.

Immunoexpression of HIF-1α and VEGF in Periodontal Disease and Healthy Gingival Tissues.

Hypoxia-inducible factor 1 alpha (HIF-1α) and vascular endothelial growth factor (VEGF) are proteins that stimulate the proliferation and migration of endothelial cells. These proteins have been described in many pathologic and inflammatory conditions, but their involvement in the development of periodontitis has not been thoroughly investigated. This study compared the immunohistochemical expression of these proteins, involved in angiogenesis and hypoxia, by immunostained inflammatory and endothelial cells in periodontal disease and healthy gingival tissues. Gingival tissue samples were divided as follows: 30 samples with chronic periodontitis, 30 with chronic gingivitis, and 30 of healthy gingiva. Results were analyzed statistically by the Kruskal-Wallis, Mann-Whitney and Spearman correlation tests (p=0.01). Inflammatory and endothelial cells were found to express these proteins. Periodontitis showed median percentage of HIF-1α-positive cells of 39.6%, 22.0% in cases of gingivitis and 0.9% in the healthy gingiva group (p=0.001). For VEGF, median percentage of immunopositive cells was 68.7% for periodontitis, 66.1% in cases for gingivitis, and 19.2% for healthy gingival specimens (p<0.001). Significant correlation between VEGF and HIF-1α was also observed in healthy gingiva (p<0.001).The increased expression of HIF-1α and VEGF in periodontitis, compared to gingivitis and healthy gingiva, suggests possible activation of the HIF-1α pathway in advanced periodontal disease. The correlation between HIF-1α and VEGF expression in healthy gingiva suggests a physiological function for these proteins in conditions of homeostasis. In periodontal disease, HIF-1α and VEGF expression may be regulated by other factors, in addition to hypoxia, such as bacterial endotoxins and inflammatory cytokines.

Immunoexpression of HIF-1α and VEGF in Periodontal Disease and Healthy Gingival Tissues

Abstract Hypoxia-inducible factor 1 alpha (HIF-1α) and vascular endothelial growth factor (VEGF) are proteins that stimulate the proliferation and migration of endothelial cells. These proteins have been described in many pathologic and inflammatory conditions, but their involvement in the development of periodontitis has not been thoroughly investigated. This study compared the immunohistochemical expression of these proteins, involved in angiogenesis and hypoxia, by imunnostained inflammatory and endothelial cells in periodontal disease and healthy gingival tissues. Gingival tissue samples were divided as follows: 30 samples with chronic periodontitis, 30 with chronic gingivitis, and 30 of healthy gingiva. Results were analyzed statistically by the Kruskal-Wallis, Mann-Whitney and Spearman correlation tests (p=0.01). Inflammatory and endothelial cells were found to express these proteins. Periodontitis showed median percentage of HIF-1α-positive cells of 39.6%, 22.0% in cases of gingivitis and 0.9% in the healthy gingiva group (p=0.001). For VEGF, median percentage of immunopositive cells was 68.7% for periodontitis, 66.1% in cases for gingivitis, and 19.2% for healthy gingival specimens (p<0.001). Significant correlation between VEGF and HIF-1α was also observed in healthy gingiva (p<0.001).The increased expression of HIF-1αα and VEGF in periodontitis, compared to gingivitis and healthy gingiva, suggests possible activation of the HIF-1α pathway in advanced periodontal disease. The correlation between HIF-1α and VEGF expression in healthy gingiva suggests a physiological function for these proteins in conditions of homeostasis. In periodontal disease, HIF-1 and VEGF expression may be regulated by other factors, in addition to hypoxia, such as bacterial endotoxins and inflammatory cytokines.

Resumo O fator induzível por hipóxia 1 alfa (HIF-1α) e o fator de crescimento endotelial vascular (VEGF) são proteínas que estimulam a proliferação e a migração de células endoteliais. Estas proteínas têm sido descritas em muitas condições patológicas e inflamatórias, mas o envolvimento dessas no desenvolvimento de periodontite não foi completamente investigado. Este estudo comparou a expressão imunohistoquímica destas proteínas, envolvidas na angiogênese e hipóxia, na doença periodontal e em tecidos gengivais saudáveis por meio de contagem de células inflamatórias e endoteliais imunomarcadas. As amostras de tecido gengival foram divididas da seguinte forma: 30 amostras com periodontite crônica, 30 com gengivite crônica e 30 de gengiva saudável. Os resultados foram analisados estatisticamente pelos testes de Kruskal-Wallis e Mann-Whitney (p=0.01). As células inflamatórias e endoteliais foram positivas para estas proteínas. A porcentagem média de células positivas para HIF-1α foi de 39,6% nos casos de periodontite, 22,0% nos casos de gengivite e de 0,9% no grupo de gengiva saudável (p = 0,001). A porcentagem média de células imunopositivas para o VEGF foi de 68,7% nos casos de periodontite, 66,1% nos casos de gengivite, e 19,2% em espécimes gengivais saudáveis (p<0,001). Correlação significativa entre o VEGF e HIF-1α foi observada em gengival. A expressão elevada do HIF-1α e VEGF em periodontite, comparada a gengivite e gengiva saudável, sugere ativação da via do HIF-1α, na doença periodontal avançada. A correlação entre o HIF-1α e expressão de VEGF na gengiva saudável, sugere uma função fisiológica para estas proteínas em condições de homeostase. Na doença periodontal, a expressão de HIF-1α e VEGF pode ser regulada por outros fatores, além da hipóxia, tais como endotoxinas bacterianas e citocinas inflamatórias.

Minor intraoral salivary gland tumors: a clinical-pathological study.

OBJECTIVE: To evaluate the clinical-pathological profile of patients with minor salivary gland neoplasms. METHODS: A retrospective study of specific cases diagnosed as benign and malignant tumors of the minor salivary glands was performed. The data were collected from medical records of patients seen at a hospital over a period of 15 years. The sample was made up of 37 cases. For the pathological study, slides containing 5µm thick sections stained with hematoxylin and eosin were used. The data were tabulated using descriptive statistics. RESULTS: Malignant neoplasms represented 70.3% of cases. The mucoepidermoid carcinoma was the most common neoplasm (45.9%), followed by pleomorphic adenoma (24.4%). Most patients were female (70.3%), aged between 71 and 80 years. The palate (67.6%) and the retromolar region (10.8%) were the most affected sites. CONCLUSION: Mucoepidermoid carcinoma was the most common tumor in minor salivary glands. These tumors are more common in females aged over 40 years. The palate was the most common affected site. OBJETIVO: Avaliar o perfil clínico-patológico de pacientes com neoplasias de glândula salivar menor. MÉTODOS: Foi realizado um estudo retrospectivo de casos específicos diagnosticados como neoplasias benignas ou malignas de glândula salivar menor. Os dados foram coletados dos prontuários dos pacientes atendidos em um hospital no período de 15 anos. A amostra final foi de 37 casos. Para o estudo histopatológico, foram usadas lâminas contendo secções com 5µm de espessura, coradas pela técnica de hematoxilina e eosina. Os dados foram tabulados de forma descritiva. RESULTADOS: As neoplasias malignas representaram 70,3% dos casos. O tipo histológico mais prevalente foi o carcinoma mucoepidermoide (45,9%), seguido do adenoma pleomórfico (24,4%). A maioria dos pacientes era do sexo feminino (70,3%), com idade entre 71 e 80 anos. O palato (67,6%) e a região retromolar (10,8%) foram os sítios mais acometidos. CONCLUSÃO: O carcinoma mucoepidermoide foi o tumor mais comum das glândulas salivares menores. Estes tumores foram mais comuns em mulheres com mais de 40 anos. O palato foi o sítio mais acometido.

Calcifying cystic odontogenic tumour associated with odontoma involving mixed dentition / Tumor odontogênico cístico calcificante associado a odontoma envolvendo dentição mista

Calcifying cystic odontogenic tumor (CCOT) is a benign tumor relatively uncommon that may be associated with other odontogenic lesions. This manuscript describes the case of a 9-year-old girl affected by CCOT associated with odontoma, presenting as a slight swelling along with prolonged retention of a maxillary primary central incisor. Radiographic examination showed a unilocular radiolucent lesion containing radiopaque material associated with an unerupted tooth. Taking into consideration the clinical diagnostic of odontoma, an excisional biopsy was carried out. Microscopic examination established the diagnosis of a CCOT associated with odontoma. The association of these lesions is rare in individuals in the first decade of life, particularly involving mixed dentition, as outlined in this case. The patient remains under care with no clinical signs of recurrence.

O tumor odontogênico cístico calcificante (TOCC) é um tumor odontogênico cístico benigno relativamente raro e pode estar associado a outras lesões odontogênicas. Este manuscrito descreve um caso de CCOT associado a odontoma em uma menina de 9 anos de idade, que se apresentou com um ligeiro aumento de volume associado a retenção prolongada de um incisivo central superior. O exame radiográfico revelou uma lesão radiolúcida unilocular contendo material radiopaco, associado a um dente incluso. Tomando em consideração o diagnóstico clínico de odontoma, uma biópsia foi realizada. O exame microscópico estabeleceu o diagnóstico de um TOCC associado a odontoma. A associação destas lesões é rara em indivíduos na primeira década de vida, particularmente envolvendo dentição mista, conforme descrito no presente caso. O paciente permanece sob cuidados sem sinais clínicos de recorrência.

Effects of photodynamic therapy mediated by nanoemulsion containing chloro-aluminum phthalocyanine: a histologic and immunohistochemical study in human gingiva.

BACKGROUND: Photodynamic therapy (PDT) uses photosensitizing agents, which are delivered in target cells, followed by local application of visible light in specific wavelengths. This reaction produce reactive oxygen species able to induce cell death by apoptosis or necrosis, injured to the local vasculature, and exert important effects on the immune system. OBJECTIVE: The present work evaluated the clinical findings, histomorphological alterations and immunodetection of VEGF after PDT using chloro-aluminum phthalocyanine (AlClPc) entrapped in a lipid nanoemulsion in a split-mouth clinical trial. MATERIAL AND METHODS: Eight healthy volunteers with clinical indication for extraction were included in the study. Seven days before the extraction 40 ul of nanoemulsion AlClPc 5µM was injected into gingival tissue followed by irradiation with diode laser, the contralateral side was used as control. Tissue specimens were removed seven days after the PDT and divided into two groups (test and control groups) for histological and immunohistochemical analysis. Patients were monitored at days, 0, 7, 14 and 30 to assess adverse effects of the therapy. RESULTS: The therapy was well tolerated by all patients. Adverse effects were short-time and completely reversible. Areas of edema, vascular congestion, and intense vascularization were viewed in gingival samples that received PDT. Additionally, dystrophic calcification was observed in subepithelial region. VEGF showed moderate to strong immunostaining in specimens subjected to PDT. CONCLUSIONS: Taken together, the results showed that the protocol used in this study mediated by nanoemulsion containing AlClPc is safe for clinical application in gingival tissue and suggests that VEGF is increased after PDT.

Phenytoin-induced gingival overgrowth management with periodontal treatment.

Phenytoin-induced gingival overgrowth (PIGO) is a common complication of the continuous use of medications. This paper presents a case of PIGO hindering oral function and compromising oral hygiene and aesthetics, which was treated with a combination of nonsurgical and surgical periodontal therapies. A 39-year-old male patient was referred for dental treatment with several complaints, especially upper and lower gingival overgrowth that hindered speech and swallowing. Generalized deep probing pockets and bone loss were detected. Diagnosis of gingival overgrowth associated with phenytoin and chronic periodontitis was established. The treatment plan consisted of conservative therapy with education on oral health, motivation and meticulous oral hygiene instruction in combination with scaling and root planing. During the revaluation period, a marked reduction in the clinical parameters was noted, particularly probing pocket depth reduction. Surgical therapy for removal of gingival overgrowth was also performed to achieve pocket reduction. Supportive periodontal therapy was proposed and the patient is currently under follow-up for 4 years. Management of PIGO may be obtained by the use of periodontal procedures combined with good oral hygiene and periodontal supportive care.

Phenytoin-Induced Gingival Overgrowth Management with Periodontal Treatment

Phenytoin-induced gingival overgrowth (PIGO) is a common complication of the continuous use of medications. This paper presents a case of PIGO hindering oral function and compromising oral hygiene and aesthetics, which was treated with a combination of nonsurgical and surgical periodontal therapies. A 39-year-old male patient was referred for dental treatment with several complaints, especially upper and lower gingival overgrowth that hindered speech and swallowing. Generalized deep probing pockets and bone loss were detected. Diagnosis of gingival overgrowth associated with phenytoin and chronic periodontitis was established. The treatment plan consisted of conservative therapy with education on oral health, motivation and meticulous oral hygiene instruction in combination with scaling and root planing. During the revaluation period, a marked reduction in the clinical parameters was noted, particularly probing pocket depth reduction. Surgical therapy for removal of gingival overgrowth was also performed to achieve pocket reduction. Supportive periodontal therapy was proposed and the patient is currently under follow-up for 4 years. Management of PIGO may be obtained by the use of periodontal procedures combined with good oral hygiene and periodontal supportive care.

O crescimento gengival induzido pela fenitoína é uma complicação comum do uso contínuo da medicacão. Este artigo apresenta um caso de crescimento gengival excessivo que dificultava a função oral e comprometia a higiene oral e a estética, o qual foi tratado com uma combinação de terapias periodontais não-cirúrgicas e cirúrgicas. Paciente masculino de 39 anos de idade foi encaminhado para tratamento odontológico com várias queixas, especialmente do crescimento gengival superior e inferior que prejudicava a fala e deglutição. Profundidades de sondagens severas generalizadas e perda óssea foram detectadas. Diagnóstico de crescimento gengival induzido pela fenitoína e periodontite crônica foi estabelecido. O plano de tratamento consistiu de terapia conservadora com educação, motivação e meticulosa instrução de higiene oral em associação com raspagem e alisamento corono-radicular. Durante o período de reavaliação, uma acentuada redução nos parâmentros clínicos foi observada, principalmente uma redução das profundidades de sondagem. Terapia cirúrgica para remoção do excesso de tecido gengival também foi realizada para conseguir redução das bolsas. Terapia periodontal de suporte foi proposta e o paciente está atualmente sob acompanhamento por um período de 4 anos. O manejo do crescimento gengival induzido pela fenitoína pode ser obtido pelo uso de procedimentos periodontais combinados com uma boa higiene oral e cuidados periodontais de suporte.

Aggressive multilocular osteoblastoma in the mandible: a rare and difficult case to diagnose.

Osteoblastoma is a benign neoplasia and is uncommon in the jaws. In some cases, this lesion presents extremely aggressive local characteristics and is termed aggressive osteoblastoma. Because the clinical, radiographic and histopathologic characteristics are similar to those of a variety of benign and malignant tumors, it poses a diagnostic dilemma. This report presents a case of an aggressive osteoblastoma in the mandible and discusses the differential diagnosis of this lesion. A 13-year-old white male sought the Stomatology Clinic at the State University of Paraíba, Campina Grande, PB, Brazil, complaining of asymptomatic swelling on the left side of his face. Cone-beam computerized tomography showed a multilocular, hypodense bone lesion, located in the body of the left mandible and lower third of the ascending ramus. The initial diagnostic hypothesis was juvenile ossifying fibroma or osteosarcoma. After histopathologic examination, the final diagnosis was aggressive osteoblastoma. Surgical resection with a safety margin was performed. There was no evidence of recurrence after a follow-up period of 4 years.

Aggressive Multilocular Osteoblastoma in the Mandible: A Rare and Difficult Case to Diagnose

Osteoblastoma is a benign neoplasia and is uncommon in the jaws. In some cases, this lesion presents extremely aggressive local characteristics and is termed aggressive osteoblastoma. Because the clinical, radiographic and histopathologic characteristics are similar to those of a variety of benign and malignant tumors, it poses a diagnostic dilemma. This report presents a case of an aggressive osteoblastoma in the mandible and discusses the differential diagnosis of this lesion. A 13-year-old white male sought the Stomatology Clinic at the State University of Paraíba, Campina Grande, PB, Brazil, complaining of asymptomatic swelling on the left side of his face. Cone-beam computerized tomography showed a multilocular, hypodense bone lesion, located in the body of the left mandible and lower third of the ascending ramus. The initial diagnostic hypothesis was juvenile ossifying fibroma or osteosarcoma. After histopathologic examination, the final diagnosis was aggressive osteoblastoma. Surgical resection with a safety margin was performed. There was no evidence of recurrence after a follow-up period of 4 years.

O osteoblastoma é uma neoplasia benigna e incomum nos maxilares. Em alguns casos esta lesão apresenta características locais extremamente agressivas, sendo denominada osteoblastoma agressivo. Devido às características clínicas, radiográficas e histopatológicas serem similares a uma variedade de tumores benignos e malignos, o seu diagnóstico é um dilema. Este relato apresenta o caso de um osteoblastoma agressivo na mandíbula e discute o diagnóstico diferencial desta lesão. Paciente, branco, 13 anos de idade, foi atendido na Clínica de Estomatologia da Universidade Estadual da Paraíba, Campina Grande, PB, Brasil, queixando-se de aumento de volume assintomático do lado esquerdo de sua face. A tomografia computadorizada de feixe cônico revelou uma lesão óssea hipodensa multilocular, localizada no corpo do lado esquerdo da mandíbula e no terço inferior do ramo ascendente da mandíbula. A hipótese diagnóstica foi de fibroma ossificante juvenil e osteosarcoma. Após exame histopatológico, o diagnóstico final foi osteoblastoma agressivo. Foi realizada ressecção cirúrgica com margem de segurança. Não houve sinais de recorrência após 4 anos de acompanhamento.

Immunoexpression of transforming growth factor beta and interferon gamma in radicular and dentigerous cysts.

INTRODUCTION: The aim of this study was to evaluate and compare the immunohistochemical expression of transforming growing factor beta (TGF-ß) and interferon gamma (IFN-γ) between radicular cysts (RCs) and dentigerous cysts (DCs). METHODS: Twenty RCs and DCs were selected for analysis of the immunoexpression of TGF-ß and IFN-γ in the epithelium and capsule. RESULTS: The cell reactivity of TGF-ß and IFN-γ in the lining epithelium and capsule of RCs showed no significant differences when compared with DCs (P > .05). There was a tendency of a higher expression of TGF-ß in the capsule of DCs. CONCLUSIONS: Our results showed the presence of TGF-ß and IFN-γ in RCs and DCs, supporting the hypothesis that both participate in the development of these lesions, where IFN-γ usually plays a role in bone resorption, which is counterbalanced by the osteoprotective activity performed by TGF-ß.

Immunohistochemical staining of Langerhans cells in HPV-positive and HPV-negative cases of oral squamous cells carcinoma

The Human Papillomavirus (HPV) has been strongly implicated in development of some cases of oral squamous cell carcinoma (OSCC). However, the immunological system somehow reacts against the presence of this virus. Among the cells involved in such mechanism of defense Langerhans cells (LC) stand out, which are responsible for processing and presenting antigens. OBJECTIVES: The purposes of this study were to investigate the presence of HPV DNA and to evaluate the immunohistochemical reactivity for Langerhans cells between HPV-positive and HPV-negative OSCC. Twenty-seven cases of OSSC were evaluated. MATERIAL AND METHODS: DNA was extracted from paraffin-embedded tissue samples and amplified by Polymerase Chain Reaction (PCR) for the detection of HPV DNA. Viral typing was performed by dot blot hybridization. Immunohistochemistry was performed by the Streptavidin-biotin technique. RESULTS: From the 27 cases, 9 (33.3 percent) were HPV-positive and 18 (66.0 percent) HPV-negative. HPV 18 was the most prevalent viral type (100 percent cases) and infection with HPV-16 (co-infection) was detected in only 1 case. In the OSCC specimens examined, immunoreactivity to S-100 antibody was detected in all cases, with a mean number of 49.48±30.89 Langerhans cells positive for immunostaining. The mean number of immunostained Langerhans cells was smaller in the HPV-positive cases (38 cells/case) than in the HPV-negative cases (42.5 cells/case), but this difference was not significant (p=0.38). CONCLUSIONS: The low frequency of detection of HPV DNA in OSCC indicates a possible participation of the virus in the development and progression of only a subgroup of these tumors. There was no association between the immunohistochemical labeling for Langerhans cells (S-100+) and HPV infection of in OSSC. These findings suggest that the presence of HPV in such OSCC cases could not alter the immunological system, particularly the Langerhans cells.