Oral squamous cell carcinoma misdiagnosed as a denture-related traumatic ulcer: A clinical report.

A 65-year-old woman presented with an ulcerated lesion in the alveolar ridge mucosa, which appeared after new dentures had been inserted. Despite many treatment attempts, the lesion did not recede, even with the interruption of denture wearing. A biopsy was performed, and histopathologic examination revealed an ulcerated, invasive, poorly differentiated oral squamous cell carcinoma. The time from the patient's first contact with the prosthodontist because of the lesion until the appropriate diagnosis was established was approximately 6 months. This clinical report documents a significant delay in the oral squamous cell carcinoma diagnosis and treatment because of a clinical misdiagnosis of a traumatic ulcer resulting from complete dentures. Prosthodontists should be aware of the importance of early diagnosis of oral cancer among elderly prosthesis wearers.

Expression of odontogenic ameloblast-associated protein, amelotin, ameloblastin, and amelogenin in odontogenic tumors: immunohistochemical analysis and pathogenetic considerations.

Screening for expression of amelogenesis-related proteins represents a powerful molecular approach to characterize odontogenic tumors and investigate their pathogenesis. In this study, we have examined the presence and distribution of odontogenic ameloblast-associated protein (ODAM), amelotin (AMTN), ameloblastin (AMBN), and amelogenin (AMEL) by immunohistochemistry in samples of adenomatoid odontogenic tumor (AOT), calcifying epithelial odontogenic tumor (CEOT), developing odontoma, ameloblastoma, calcifying cystic odontogenic tumor (CCOT), ameloblastic fibroma (AF), myxoma, odontogenic fibroma (OF), and reduced enamel epithelia (REE). Positive results were obtained in those tumors with epithelial component, except for AF, OF, and ameloblastoma. ODAM was found around mineralized structures (dystrophic calcifications) and CEOT's amyloid, whereas AMTN stained the eosinophilic material of AOTs. The CCOT transitory cells to ghost cells were strongly positive with all proteins except AMEL, and the REE as well as odontomas showed immunoexpression for ODAM, AMTN, AMBN, and AMEL similar to those found in normal rat tooth germs. Based on these results, some histopathogenetic theories were formulated.

Efeito do estresse crônico e benzodiazepínicos no reparo ósseo: estudo histológico em ratos / Effect of chronic stress and benzodiazepines on bone repair: histologic study in rats

Aceita-se o estresse como um fator ambiental capaz de predispor o indivíduo à depressão. Os benzodiazepínicos têm sido prescritos como drogas eficazes nessas situações. O propósito deste trabalho foi estudar histologicamente o efeito do estresse crônico e drogas benzodiazepínicas sobre o reparo ósseo. Cavidades ósseas foram criadas em ambas as tíbias de 40 ratos machos, divididos em 2 grupos: Controle e Tratado. Neste, o estímulo estressor foi aplicado nos 40 dias pré-operatórios e em todos os dias pós-operatórios até o sacrifício, pela manhã por 2 horas, por meio da imobilização por contenção. Esses animais também receberam benzodiazepínico do grupo Diazepam, diariamente, na concentração de 5mg/Kg/peso corporal nos 15 dias pré-operatórios. Em grupos de cinco, os animais foram sacrificados aos 7, 14, 30 e 60 dias pós-operatórios. Aos 7 dias pós-operatórios, enquanto o grupo controle exibia tecido conjuntivo rico em fibroblastos, o grupo tratado mostrava tecido conjuntivo neoformado, com escassos fibroblastos e vasos capilares ao lado de linfócitos e macrófagos. Aos 14 dias pós-operatórios, o Grupo Controle exibiu trabeculado ósseo neoformado enquanto o Grupo Tratado evoluiu para trabéculas ósseas delgadas, com numerosos osteoblastos em suas bordas. Aos 30 dias pós-operatórios a reparação óssea está completa em ambos os grupos. Aos 60 dias pós-operatórios as características observadas nos grupos controle e tratado são semelhantes ao período anterior, porém com osteogênese mais avançada

Stress is an environmental factor that may predispose individuals to depression. Benzodiazepines have been prescribed as effective drugs in these situations. The purpose of this study was histological evaluate of the effect of chronic stress and benzodiazepine drugs on bone healing. Bone cavities were created in both tibias of 40 male rats were divided into two groups: Control and Treaty. In this, the stressor stimulus was applied 40 days pre-operative and all post-operative days until sacrifice in the morning for 2 hours, by immobilizing restraint. These animals also received diazepam benzodiazepine group, daily, at a concentration of 5mg/Kg/peso body within 15 days of preoperative. In groups of five animals were sacrificed at 7, 14, 30 and 60 days post-surgery. At 7 days postoperatively, while the control group exhibited tissue rich in fibroblasts, the treated group showed newly formed tissue with few fibroblasts and capillaries along with lymphocytes and macrophages. At 14 days postsurgery, the control group showed newly formed trabecular bone while the treated group progressed to thin trabecular bone with numerous osteoblasts on their borders. At 30 days post-operative bone healing is complete in both groups. At 60 days post-operative characteristics observed in the treated and control groups are similar to the previous period, but with more advanced osteogenesis

Osteolipoma of the buccal mucosa

Lipomas are benign mesenchymal neoplasms of soft tissue that can be found in any part of the human body. Conversely,their presence in the oral mucosa is rather uncommon, with approximately 4% of the cases occurring inthe oral cavity. In such cases, they are likely to have originated from mature adipose tissue and to be among severaldescribed histological variants of lipomas, which are identified according to the predominant type of tissue.There is a rare lipoma, known as an osteolipoma or an ossifying lipoma; however, little has been written this typeof lipoma characterized by a classical lipoma with areas of osseous metaplasia. Considering the few cases of oralosteolipomas previously described in the English-related literature and the consequent risk of misdiagnosis andovertreatment, this paper describes an extreme case of an osteolipoma affecting the buccal mucosa of an adult patient.This paper focuses particularly on the pathogenesis of this lesion and the discussion of a correct diagnosis (AU)

Conservative approach to the treatment of keratocystic odontogenic tumor.

The odontogenic keratocyst, also known as the keratocystic odontogenic tumor, is an aggressive, intraosseous lesion of odontogenic origin that presents a high rate of recurrence. Treatment modalities include aggressive surgical procedures and more conservative approaches that significantly influence the lesion's recurrence potential. The purpose of this case report was to demonstrate a conservative approach in the treatment of an extensive keratocystic odontogenic tumor, located in the mandible's posterior region, using decompression and enucleation.

Osteolipoma of the buccal mucosa.

Lipomas are benign mesenchymal neoplasms of soft tissue that can be found in any part of the human body. Conversely, their presence in the oral mucosa is rather uncommon, with approximately 4% of the cases occurring in the oral cavity. In such cases, they are likely to have originated from mature adipose tissue and to be among several described histological variants of lipomas, which are identified according to the predominant type of tissue. There is a rare lipoma, known as an osteolipoma or an ossifying lipoma; however, little has been written this type of lipoma characterized by a classical lipoma with areas of osseous metaplasia. Considering the few cases of oral osteolipomas previously described in the English-related literature and the consequent risk of misdiagnosis and overtreatment, this paper describes an extreme case of an osteolipoma affecting the buccal mucosa of an adult patient. This paper focuses particularly on the pathogenesis of this lesion and the discussion of a correct diagnosis.

Efeito do estresse crônico de contenção sobre o reparo de cavidades ósseas: estudo histológico em tíbias de ratos / Effect of chronic stress of restraint on repair of bone cavities: histological study in tibiae of rats

O estresse do cotidiano, considerado pela OMS problema de ordem pública, acomete expressiva faixa populacional. O propósito deste trabalho foi estudar histologicamente o efeito do estresse crônico sobre o reparo ósseo. Cavidades ósseas foram criadas em ambas as tíbias de 40 ratos machos, divididos em 2 grupos: controle e estressado. Neste, o estímulo estressor foi aplicado nos 40 dias pré-operatórios e em todos os dias pós-operatórios até o sacrifício, pela manhã por 2 horas, por meio da imobilização por contenção. Em grupos de cinco, os animais foram sacrificados aos 7, 14, 30 e 60 dias pós-operatórios. Aos 7 dias pós-operatórios enquanto o Grupo controle exibia tecido conjuntivo rico em fibroblastos, o Grupo estressado mostrava áreas de coágulo sanguíneo desorganizado. Aos 14 dias pós-operatórios, o Grupo controle evoluiu para trabeculado ósseo neoformado e o Grupo estressado para espículas delgadas. Aos 30 dias pós-operatórios a cavidade óssea mostrou-se totalmente reparada por tecido ósseo maduro no Grupo controle e, parcialmente reparada no Grupo estressado. Aos 60 dias pós-operatórios, osso maduro e bem diferenciado ocupava todos os espécimes. Com base nos resultados obtidos foi possível concluir que o estresse crônico atrasou a reparação óssea

The stress of everyday life, considered by the WHO public health issue, affecting a significant portion of the population. The purpose of this study was to evaluate histologically the effect of chronic stress of restraint on bone repair. Bone cavities were created in both tibias of 32 male rats were divided into two groups: control and stressed. In this, the stressor stimulus was applied within 40 days preoperative and all postoperative days until sacrifice in the morning for 2 hours, through immobilization in PVC tubes, according to the methodology of Alves-Rezende, Okamoto1,2. In groups of four animals were sacrificed at 7, 14, 30 and 60 days postoperatively. At 7 days post-surgery while the control group exhibited tissue rich in fibroblasts, the stressed group showed large areas of disorganized blood clot. At 14 days post-surgery, the control group progressed to bone trabeculae and newly formed group stressed to thin spines. At 30 days post-surgery the sinus was found to be completely repaired by bone tissue in the control group and partially repaired in the group stressed. At 60 days post-surgery, and well-differentiated mature bone occupying all the specimens. Based on the results we conclude that chronic stress delayed bone repair

Oral lichen planus versus oral lichenoid reaction: difficulties in the diagnosis.

Lichen planus (LP) is a mucocutaneous disease with well-established clinical and microscopic features. The oral mucosa and skin may present clinical and microscopic alterations similar to those observed in LP, called lichenoid reactions (LRs), which are triggered by systemic or topical etiological agents. The difficulties faced to establish the differential diagnosis between the two pathologies were investigated in the literature. It was observed that the etiology of LP is still under discussion, with a tendency to self-immunity, while the etiology of LRs is related to the contact with specific agents, such as metallic restorative materials, resins, and drugs, allowing the establishment of a cause-effect relationship. In this case, the disease is caused by the antigen fixation in the epithelial cells, which are destructed by the immune system. Based on these data, protocols are suggested for this differentiation. The important role played by the integration between the clinician and the oral pathologist in the diagnostic process is highlighted. The treatment of LP comprises mainly the utilization of corticosteroids and the LR is treated by removal of the causal factor. Differentiation between the two diseases allows an effective and correct therapeutic approach.

Granuloma gravídico: relato de caso / Gravidarum granuloma: case report

Conhecido como "granuloma gravídico" quando presente em grávidas, o granuloma piogênico manifesta-se clinicamente como uma lesão lobulada ou plana, pediculada e, em alguns casos, de superfície ulcerada. Como características histológicas evidentes há presença de tecido de granulação em áreas de proliferação endotelial e de espaços vasculares e massas lobuladas de tecido hiperplásico. O presente relato objetiva apresentar um caso clínico em paciente de 23 anos, grávida de sete meses, portadora de granuloma gravídico em região de gengiva vestibular inferior. O caso foi tratado cirurgicamente com prognóstico favorável.

The pyogenic granuloma may be classified as “pregnancy tumor” when it occurs in pregnant women manifests itself clinically as an injury lobulada or flat, pedicled and, in some cases, surface ulcerated. As histological features are obvious to the presence of granulation tissue, in areas of proliferation of endothelial and vascular spaces and lobulated masses of hyperplastic tissue.The objective of this study is to present a 23 years old patient’s case, 7 months pregnancy, bearer of pyogenic granuloma in vestibular lower gingival region. The case was surgically treated with favorable prognosis.

Immunoexpression of keratins in the calcifying cystic odontogenic tumor epithelium.

Ameloblastomatous epithelium containing clusters of ghost cells is the typical histopathology of calcifying cystic odontogenic tumor (CCOT). This paper aimed to assess keratins AE1-AE3, K7, K10/13, K14, K18, K19, vimentin, laminin, and collagen IV in 08 CCOTs to discuss their histopathogenesis. Similarity to the immunoprofile of the stratified squamous epithelium was seen in the with the basal layer expressing K14 and the upper cells expressing K10/13. When compared to the immunoprofile of the normal odontogenic epithelium, of odontogenic tumor epithelia and of the ghost cells described in the literature, it was possible to suggest that the CCOT epithelium differentiates towards squamous type.

Study on the origin and nature of the adenomatoid odontogenic tumor by immunohistochemistry

O tumor odontogênico adenomatóide (TOA) é uma lesão clinicamente benigna, cujas discussões acerca de sua natureza hamartomatosa ou neoplásica, e provável célula epitelial odontogênica de origem ainda existem. Este projeto de pesquisa teve por objetivo estudar o assunto através da detecção imuno-histoquímica das citoqueratinas, laminina, colágeno IV, PCNA e p53, utilizando-se para isso 08 amostras do tumor e 08 amostras de folículo pericoronário contendo epitélio reduzido do órgão do esmalte (EROE). Os resultados mostraram que a marcação da CK14 sinalizou graus de diferenciação para ameloblastos secretores ou pós-secretores nas estruturas adenomatóides do TOA, e a laminina presente em sua superfície luminal foi compatível com o EROE durante o "estágio protetor" da amelogênese. O PCNA marcou especificamente áreas enoveladas e cordões periféricos do TOA, indicando serem estes os responsáveis pelo seu crescimento. Após considerações sobre patogênese, os autores propuseram natureza hamartomatosa e histogênese a partir do EROE para o TOA.

Study on the origin and nature of the adenomatoid odontogenic tumor by immunohistochemistry%Estudo da origem e natureza do tumor odontogênico adenomatóide pela imunoistoquímica

O tumor odontogênico adenomatóide (TOA) é uma lesão clinicamente benigna, cujas discussões acerca de sua natureza hamartomatosa ou neoplásica, e provável célula epitelial odontogênica de origem ainda existem. Este projeto de pesquisa teve por objetivo estudar o assunto através da detecção imuno-histoquímica das citoqueratinas, laminina, colágeno IV, PCNA e p53, utilizando-se para isso 08 amostras do tumor e 08 amostras de folículo pericoronário contendo epitélio reduzido do órgão do esmalte (EROE). Os resultados mostraram que a marcação da CK14 sinalizou graus de diferenciação para ameloblastos secretores ou pós-secretores nas estruturas adenomatóides do TOA, e a laminina presente em sua superfície luminal foi compatível com o EROE durante o "estágio protetor" da amelogênese. O PCNA marcou especificamente áreas enoveladas e cordões periféricos do TOA, indicando serem estes os responsáveis pelo seu crescimento. Após considerações sobre patogênese, os autores propuseram natureza hamartomatosa e histogênese a partir do EROE para o TOA

Study on the origin and nature of the adenomatoid odontogenic tumor by immunohistochemistry.

The adenomatoid odontogenic tumor (AOT) is a clinically benign lesion. Discussions about the AOT hamartomatous or neoplastic nature, and the probable odontogenic epithelial cell it originates from still exist. This research aimed to study and discuss the subject by the immunohistochemical detection of cytokeratins, laminin, collagen IV, PCNA and p53 in 8 tumor samples and 8 dental follicle samples containing reduced enamel epithelium. The results have shown that CK14 labelling indicated differentiation grades for secreting ameloblasts or ameloblasts in the post-secreting stage in the adenomatoid structure of AOT. Laminin, found on the luminal surface of adenomatoid structures, was compatible with the reduced enamel epithelium during the "protective stage of amelogenesis". PCNA specifically labelled the spindled areas and peripheral cords of the AOT, indicating that these areas are responsible for tumor growth. After considerations about pathogenesis, the authors suggested that the nature of AOT is hamartomatous with histogenesis from the reduced enamel epithelium.