Cardiovascular adverse effects associated with the use of anti-HER2 in breast cancer treatment.

Background: Cancer represents an important public health problem with increasing incidence, prevalence, and mortality, affecting the entire Western population, especially in developed and developing countries. The use of monoclonal antibodies has revolutionized the treatment of cancer, but this treatment can cause adverse cardiovascular effects (AE). Objective: The objective of this paper is to identify and classify AE in breast cancer patients in the use of Trastuzumab in two health institutions. Methods: Retrospective study of medical records of patients with breast cancer Her 2+ submitted the therapy with trastuzumab in early and advanced stage of the disease. Review conducted in a university hospital and a private clinic, both located in Rio de Janeiro State, Brazil. Results: Cardiovascular events were late for trastuzumab, with predominance of moderate reactions. There was a predominance of dyspnea, increased blood pressure, fatigue and reduced left ventricular ejection. Conclusion: The results resemble similarities in the pattern of the institutions' reactions. Identify possible AE and know the toxicity profile of trastuzumab can contribute to a safer therapy.

A novel evaluation method for Ki-67 immunostaining in paraffin-embedded tissues.

The Ki-67 labeling index is traditionally used to investigate tumor aggressiveness. However, no diagnostic or prognostic value has been associated to the heterogeneous pattern of nuclear positivity. The aims of this study were to develop a classification for the patterns of Ki-67-positive nuclei; to search scientific evidence for the Ki-67 expression and location throughout the cell cycle; and to develop a protocol to apply the classification of patterns of Ki-67-positive nuclei in squamous epithelium with different proliferative activities. Based on empirical observation of paraffin sections submitted to immunohistochemistry for the determination of Ki-67 labeling index and literature review about Ki-67 expression, we created a classification of the patterns of nuclear positivity (NP1, NP2, NP3, NP4, and mitosis). A semi-automatic protocol was developed to identify and quantify the Ki-67 immunostaining patterns in target tissues. Two observers evaluated 7000 nuclei twice to test the intraobserver reliability, and six evaluated 1000 nuclei to the interobserver evaluation. The results showed that the immunohistochemical patterns of Ki-67 are similar in the tumoral and non-tumoral epithelium and were classified without difficulty. There was a high intraobserver reliability (Spearman correlation coefficient > 0.9) and moderate interobserver agreement (k = 0.523). Statistical analysis showed that non-malignant epithelial specimens presented a higher number of NP1 (geographic tongue = 83.8 ± 21.8; no lesion = 107.6 ± 52.7; and mild dysplasia = 86.6 ± 25.8) when compared to carcinoma in Situ (46.8 ± 34.8) and invasive carcinoma (72.6 ± 37.9). The statistical evaluation showed significant difference (p < 0.05). Thus, we propose a new way to evaluate Ki-67, where the pattern of its expression may be associated with the dynamics of the cell cycle. Future proof of this association will validate the use of the classification for its possible impact on cancer prognosis and guidance on personalized therapy.

Computerized Evaluation of the Immunoexpression of Ki-67 Protein in Odontogenic Keratocyst and Dentigerous Cyst.

Evaluation and comparison of odontogenic keratocysts and detigerous cysts immunoexpression and immunostaining intensities of Ki-67 antigen by assessing the whole extent of the epithelium (all epithelium layers in combination) and each layer individually. Ki-67 immunoexpression was evaluated in 15 odontogenic keratocysts and 6 dentigerous cysts using automated methods and the Aperio Technologies Inc. computer system. No statistically significant differences were observed in immunoexpression nor in immunostaining intensities between both lesions. Also, no statistically significant differences were found between odontogenic keratocysts from maxilla versus mandible nor primary versus recurrent. However, odontogenic keratocyst showed a significantly higher cellular proliferation index in the suprabasal layers compared to the basal layer. Assessment of the cellular proliferation index through a computerized system enabled the evaluation of all epithelial tissue without field selection. The increased Ki-67 immunoexpression in suprabasal layers of odontogenic keratocyst suggests a different biological behavior and more aggressive proliferation potential when compared to dentigerous cyst. The same result was found in recurrent odontogenic keratocysts when compared with primary ones. The odontogenic keratocysts of the maxilla and mandible have similar Ki-67 immunoexpression. The evaluation of cellular proliferation only by immunohistochemical analysis with Ki-67 antigen does not provide enough data to elucidate the biological behavior of odontogenic keratocyst.

Maxillary dental midline deviation in the patient perspective

Objective: This study aimed to determine aesthetic perceptions of midline deviations by orthodontic patients; influence of adjacent structures to smile in the perception of deviations; and difference between patients treated in University and in private practice. Methods: In this observational comparative cross-sectional study a smiling woman photograph was digitally modified, producing left maxillary dental midline deviations relative to facial midline. Twelve photographs were cropped in Group LCN including lips, chin and 2/3 of the nose; and group L including the lips. Non-parametric Friedman test ( = 0.05), followed by Wilcoxon test corrected by Bonferroni test ( = 0.0033) were used for multiple comparisons. Pearson correlation coefficient was used to study of the correlation and regression of the degree of smile esthetics on the midline deviations, adopting a significance level of 5%. Results: Patients were able to identify deviations from 2 mm. Among the groups of photos there was statistically significant difference in deviations of 2 and 3 mm. Comparing patients from University and private there was significant difference when comparing the photos in group LCN, without deviation and deviation of 2, 4 and 5 mm. Conclusions: Orthodontic patients are able to detect maxillary dental midline deviation from 2 mm. There was influence of viewing structures adjacent to smile in the perception of deviation for the private patients. University patients were more critical than private patients.

Objetivo: O objetivo foi avaliar a percepção estética do desvio da linha média dentária por pacientes ortodônticos; influência de estruturas adjacentes ao sorriso na percepção de desvios; e diferença de percepção entre pacientes tratados em Universidade e consultório particular. Métodos: Neste estudo comparativo observacional transversal uma fotografia de mulher sorrindo foi modificada digitalmente com desvios da linha média para a esquerda em relação à face. Doze fotografias foram recortadas para obter o grupo LCN incluindo lábios, queixo e 2/3 nariz; e grupo L incluindo lábios. O teste não paramétrico de Friedman ( = 0.05), seguido pelo de Wilcoxon, corrigido pelo teste de Bonferroni ( = 0.0033) foram utilizados para comparações múltiplas. O teste de Mann-Whitney foi aplicado para comparar grupos LCN e L, verificando a influência das estruturas adjacentes ao sorriso. O coeficiente de Pearson foi usado para correlação e regressão dos desvios sobre a estética do sorriso, adotando nível de significância de 5%.Resultados: Desvios de 2 mm foram identificados. Comparando grupos LCN e L houve diferença estatisticamente significante nos desvios de 2 e 3 mm. Entre pacientes da universidade e do consultório houve diferença significativa ao comparar fotografias no grupo LCN, sem desvio e desvios de 2, 4 e 5 mm. Conclusões: pacientes ortodônticos são capazes de detectar desvio da linha média dentária maxilar de 2 mm. Estruturas adjacentes ao sorriso influenciaram na percepção do desvio para os pacientes privados. Os pacientes da Universidade foram mais críticos do que os de consultório particular.

Protocol for the evaluation of chewing among older adults / Protocolo de avaliação da mastigação do idoso

Abstract Objectives : To evaluate the functional and physiological structures of the stomatognathic system of the oral cavity of older adults based on self-perception, comparing the same with a professional clinical evaluation, and investigating the difficulties encountered when chewing. Method : An analytical cross-sectional study with a quantitative approach was conducted with a sample of 53 older adults aged 60 to 90 years. A protocol consisting of three questionnaires was used: a sociodemographic evaluation, a self-perception based interview with 19 questions on the chewing of the older adults and a clinical evaluation containing 30 questions covering aspects of the oral cavity tissue. The self-perception and clinical evaluation scores were compared using the Mann-Whitney test and the proportions observed for each item were compared by the binomial test. Results : It was found that the self-perception of older adults did not correspond to the result of the clinical evaluation. While 31 (58.5%) reported satisfaction with chewing, 16 (30.2%) had high/very high impairment and 14(26.4%) moderate impairment, based on the results of the clinical evaluation found. Conclusion : It was found that the chewing analysis process cannot be exclusively based on the answers provided by the older adults, and assessment proved to be more accurate when combined with a clinical evaluation performed by a professional.

Resumo Objetivos : Avaliar as estruturas funcionais e fisiológicas do sistema estomatognático da cavidade bucal dos idosos diante da autopercepção, comparando-as com a avaliação clínica profissional e investigar as dificuldades encontradas para realizar sua mastigação. Método : Estudo transversal analítico de abordagem quantitativa, realizado com uma amostra de 53 idosos, idade entre 60 e 90 anos. Foi utilizado um protocolo constituído de três questionários: uma avaliação sociodemográfica, uma entrevista de autopercepção com 19 quesitos da mastigação do idoso e uma avaliação clínica contendo 30 quesitos abrangendo os aspectos teciduais da cavidade bucal. Os escores da autopercepção e da avaliação clínica foram comparados pelo teste de Mann-Whitney e as proporções observadas para cada item pelo teste binomial. Resultados : Constatou-se que a autopercepção relatada pelos idosos não correspondeu ao resultado da avaliação clínica. Enquanto 31 (58,5%) relataram satisfação com a mastigação, 16 (30,2%) possuíam comprometimento alto/muito alto e 14 (26,4%) comprometimento moderado. Conclusão : Evidenciou-se que o processo de análise da mastigação não pode ser realizado exclusivamente pelas respostas prestadas pelo idoso, sendo mais adequado quando se adiciona a etapa da avaliação clínica feita por um profissional.

Craniomaxillofacial morphology alterations in children, adolescents and adults with neurofibromatosis 1: A cone beam computed tomography analysis of a Brazilian sample

Background: Oral manifestations are common in neurofibromatosis 1 (NF1), and include jaws and teeth alterations. Our aim was to investigate the craniomaxillofacial morphology of Brazilian children, adolescents and adults with NF1 using cone beam computed tomography. Material and Methods: This study was conducted with 36 Brazilian individuals with NF1 with ages ranging from 4 to 75. The participants were submitted to anamnesis, extra and intraoral exam and cephalometric analysis using cone beam computed tomography. Height of the NF1 individuals was compared to the length of jaws and skull base. The results of the cephalometric measurements of the NF1 group were compared with a control group paired by age, gender and skin color. Results: Individuals with NF1 had lower maxillary length (p<0.0001), lower mandibular length (p<0.0001), lower skull base length (p<0.0001. In children and adolescents, the mandible was more posteriorly positioned (p=0.01), when compared with the control group. There was no association between jaws and skull base length with the height of the individuals with NF1. Conclusions: Brazilian children, adolescents and adults with NF1 have short mandible, maxilla and skull base. Moreover, children and adolescents present mandibular retrusion (AU)

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BiodentineTM is cytocompatible with human primary osteoblasts.

Calcium silicate-based materials have been widely studied due to their resemblance to, and similar applicability of, mineral trioxide aggregate (MTA). Among these, Biodentine™ (BD) was specifically designed as a "dentin replacement" material for applications such as root perforations, apexification, treatment of resorptive lesions, and as a retrograde filling material. The present study aimed to assess the in vitro response of human primary osteoblasts to BD using MTA AngelusTM as a reference material, by simultaneously analyzing three different cell viability parameters, namely mitochondrial activity, membrane integrity, and cell density. BD and MTA extracts were prepared by incubation on culture media for 24 h or 42 days after mixing. Primary human osteoblasts were exposed to extracts for 24 h, at 37oC with 5% CO2, and cell viability was evaluated by the XTT, NRU, and CVDE assays. Both materials induced cell viability levels higher than 70% when extracted for 24 h. However, when cells were exposed to extracts with increased conditioning times, MTA presented significant cytotoxic effects (p < 0.05) in comparison to the control and MTA at 24 h. After 42 days, the XTT assay identified a significant reduction in cell viability by BD when compared to the control (p<0.05), despite the fact that levels above the 70% viability cutoff were attained for biocompatible materials. It can be concluded that BD is cytocompatible with human primary osteoblasts, indicating its adequacy in direct contact with bone tissues.

Efeitos da irradiação gama sobre a estabilidade físico-química de anéis de lula congelados / Effects of gamma irradiation on the physico-chemical stability of frozen squid rings

O principal objetivo deste trabalho foi avaliar os efeitos do processo de exposição à radiação gama (césio- 137) na estabilidade físico-química de anéis de lula, Dorytheutis plei, congelados. Foram investigadas 30 amostras, separadas em três grupos, de acordo com a dose de radiação absorvida: 0 kGy (controle), 1,5 kGy e 3,0 kGy. Análises físico-químicas, de Base Voláteis Totais e pH, relevantes na determinação da qualidade do pescado, foram realizadas durante o período de seis semanas. Durante a estocagem, observou-se uma relativa estabilidade físico-química nas amostras estudadas, caracterizando um produto viável para a comercialização. Dentre as doses investigadas, 1,5 kGy mostrou-se a mais apropriada para tratamento do produto. Não houve alteração significativa da composição centesimal das amostras.

Bond Strength Evaluation of Two Adhesive Systems in Fiberglass Posts Cementation

Objective: To compare the bond strength of three-step and self-etch adhesive systems with and without prior acid etching on bonding of fiberglass posts in root canals. Material and Methods: Experiments were conducted on roots of five upper molars without curvature and sectioned in a cervical-apical direction. With the aid of a highspeed turbine and diamond tips, cylindrical cavities 7 mm in depth and 1.4 mm in diameter were made in the dentine. The roots of the same tooth were used, where the retainers were cemented, thus generating three groups: Group A: Adper Scotchbond Multipurpose Plus (SBMP) + Rely X ARC; Group B: Single Bond Universal (SBU-1) + Rely X ARC, with acid etching prior to adhesive insertion; Group C: Single Bond Universal (SBU-2) + Rely X ARC. The samples were stored in a bacteriological incubator at 37ºC with 100% humidity for 48h and were subsequently cross-sectioned to obtain 3 dentine discs 1mm in thickness. Forty-five specimens were subjected to the push-out test. Results: Through the analysis of variance and Tukey's test, it was found that SBMP showed, with statistical significance (p<0.05), highest bond strength when compared with the SBU-1 and SBU-2 systems. The observed difference in the discs was located in the cervical portion. Conclusion: The three-step adhesive system had higher bond strength with the substrate than the self-etching adhesive only in the disc in the cervical portion; further, statistically, the prior application of phosphoric acid in SBU-1 did not affect its bond strength significantly.

BiodentineTM is cytocompatible with human primary osteoblasts

Abstract Calcium silicate-based materials have been widely studied due to their resemblance to, and similar applicability of, mineral trioxide aggregate (MTA). Among these, Biodentine™ (BD) was specifically designed as a "dentin replacement" material for applications such as root perforations, apexification, treatment of resorptive lesions, and as a retrograde filling material. The present study aimed to assess the in vitro response of human primary osteoblasts to BD using MTA AngelusTM as a reference material, by simultaneously analyzing three different cell viability parameters, namely mitochondrial activity, membrane integrity, and cell density. BD and MTA extracts were prepared by incubation on culture media for 24 h or 42 days after mixing. Primary human osteoblasts were exposed to extracts for 24 h, at 37oC with 5% CO2, and cell viability was evaluated by the XTT, NRU, and CVDE assays. Both materials induced cell viability levels higher than 70% when extracted for 24 h. However, when cells were exposed to extracts with increased conditioning times, MTA presented significant cytotoxic effects (p < 0.05) in comparison to the control and MTA at 24 h. After 42 days, the XTT assay identified a significant reduction in cell viability by BD when compared to the control (p<0.05), despite the fact that levels above the 70% viability cutoff were attained for biocompatible materials. It can be concluded that BD is cytocompatible with human primary osteoblasts, indicating its adequacy in direct contact with bone tissues.

Impact of gender in early structural changes of contrast induced nephropathy in rats.

INTRODUCTION: Contrast-induced nephropathy (CIN) is a major iatrogenic cause of acute kidney injury. Experimental studies have shown that intravascular injection causes intense vacuolization of the contrast agent in the proximal renal tubules cells, preceding the increase in serum creatinine, and that the female may be at a higher risk for CIN. OBJECTIVE: To study the early kidney histomorphometric changes in contrast-induced nephropathy according to the gender. METHODS: Twenty previously uninephrectomized Wistar rats were divided into 4 groups (n = 5): control males; control females; contrast exposed males; and contrast exposed females. The animals were sacrificed immediately after contrast administration and kidney tissue samples were collected for histomorphometric analysis. The research project was approved by the Research Ethics Committee of the School of Medicine of Universidade Federal Fluminense. RESULTS: There was a more intense presence of microvacuoles in proximal tubules in the rats exposed to contrast than in the control groups. Such proximal tubular vacuolation was more intensive in the female rats (p = 0.001). CONCLUSION: Proximal tubular vacuolation is a very early change in CIN and is more intensive in female than in male rats.

Impact of gender in early structural changes of contrast induced nephropathy in rats / Impacto do gênero em alterações estruturais precoces da nefropatia induzida por contraste em ratos

Abstract Introduction: Contrast-induced nephropathy (CIN) is a major iatrogenic cause of acute kidney injury. Experimental studies have shown that intravascular injection causes intense vacuolization of the contrast agent in the proximal renal tubules cells, preceding the increase in serum creatinine, and that the female may be at a higher risk for CIN. Objective: To study the early kidney histomorphometric changes in contrast-induced nephropathy according to the gender. Methods: Twenty previously uninephrectomized Wistar rats were divided into 4 groups (n = 5): control males; control females; contrast exposed males; and contrast exposed females. The animals were sacrificed immediately after contrast administration and kidney tissue samples were collected for histomorphometric analysis. The research project was approved by the Research Ethics Committee of the School of Medicine of Universidade Federal Fluminense. Results: There was a more intense presence of microvacuoles in proximal tubules in the rats exposed to contrast than in the control groups. Such proximal tubular vacuolation was more intensive in the female rats (p = 0.001). Conclusion: Proximal tubular vacuolation is a very early change in CIN and is more intensive in female than in male rats.

Resumo Introdução: A nefropatia induzida por contraste (NIC) é uma das principais causas iatrogênicas de lesão renal aguda. Estudos experimentais têm demonstrado que a injeção intravascular do agente de contraste provoca vacuolização intensa nas células dos túbulos renais proximais, que precede o aumento da creatinina sérica, e que a fêmea podem estar em maior risco de CIN. Objetivo: Estudar as primeiras mudanças histomorfométricas renais na nefropatia induzida por contraste de acordo com o gênero. Métodos: Vinte ratos Wistar anteriormente uninefrectomizados foram divididos em 4 grupos (n = 5): machos de controle; fêmeas de controle; machos expostos ao contraste e fêmeas expostas ao contraste. Os animais foram sacrificados imediatamente após a administração de contraste e amostras de tecido de rim foram coletadas para análise histomorfométrica. O projeto de pesquisa foi aprovado pelo Comitê de Ética em Pesquisa da Faculdade de Medicina da Universidade Federal Fluminense. Resultados: Houve presença mais intensa de microvacuolização em túbulos proximais nos ratos expostos ao contraste do que nos grupos de controle. Tal vacuolização tubular proximal foi mais intensa nos ratos do sexo feminino p = 0,001). Conclusão: Vacuolização do tpubulo proximal é uma mudança precoce na CIN e é mais intensa em ratos fêmeas do que em ratos machos.

Perception of midline deviations in smile esthetics by laypersons

ABSTRACT Objective: To evaluate the esthetic perception of upper dental midline deviation by laypersons and if adjacent structures influence their judgment. Methods: An album with 12 randomly distributed frontal view photographs of the smile of a woman with the midline digitally deviated was evaluated by 95 laypersons. The frontal view smiling photograph was modified to create from 1 mm to 5 mm deviations in the upper midline to the left side. The photographs were cropped in two different manners and divided into two groups of six photographs each: group LCN included the lips, chin, and two-thirds of the nose, and group L included the lips only. The laypersons performed the rate of each smile using a visual analog scale (VAS). Wilcoxon test, Student’s t-test and Mann-Whitney test were applied, adopting a 5% level of significance. Results: Laypersons were able to perceive midline deviations starting at 1 mm. Statistically significant results (p< 0.05) were found for all multiple comparisons of the values in photographs of group LCN and for almost all comparisons in photographs of group L. Comparisons between the photographs of groups LCN and L showed statistically significant values (p< 0.05) when the deviation was 1 mm. Conclusions: Laypersons were able to perceive the upper dental midline deviations of 1 mm, and above when the adjacent structures of the smiles were included. Deviations of 2 mm and above when the lips only were included. The visualization of structures adjacent to the smile demonstrated influence on the perception of midline deviation.

RESUMO Objetivo: este estudo teve por objetivo avaliar a percepção estética dos desvios da linha média dentária superior por indivíduos leigos, assim como se as estruturas adjacentes influenciam nesse julgamento. Métodos: um álbum contendo 12 fotografias frontais do sorriso de uma mulher, aleatoriamente distribuídas e com a linha média desviada digitalmente, foi avaliado por 95 indivíduos leigos. As fotografias frontais de sorriso foram modificadas para criar desvios de 1 mm a 5 mm para a esquerda na linha média superior. As fotografias foram obtidas de duas maneiras e divididas em dois grupos de seis fotografias cada: Grupo LCN, incluindo lábios, mento e dois terços do nariz; e Grupo L, incluindo apenas os lábios. Os indivíduos leigos classificaram o sorriso de acordo com uma Escala Visual Analógica (EVA). Os testes de Wilcoxon, tde Student e Mann-Whitney foram aplicados, adotando-se um nível de significância de 5%. Resultados: os leigos foram capazes de perceber desvios da linha média a partir de 1 mm. Resultados estatisticamente significativos (p < 0,05) foram encontrados para todas as múltiplas comparações dos valores nas fotografias do Grupo LCN e para quase todas as comparações nas fotografias do Grupo L. As comparações entre as fotografias dos grupos LCN e L mostraram valores estatisticamente significativos (p < 0,05) quando o desvio foi de 1 mm. Conclusões: os indivíduos leigos foram capazes de perceber os desvios da linha média de 1 mm; e acima desses, quando estruturas adjacentes ao sorriso apareciam nas fotografias. Desvios de 2 mm ou mais foram percebidos apenas quando os lábios apareciam nas fotografias; a visualização das estruturas adjacentes ao sorriso pareceu ter influência sobre a percepção dos desvios da linha média.

Immunoexpression of cleaved caspase-3 shows lower apoptotic area indices in lip carcinomas than in intraoral cancer.

OBJECTIVE: This study aimed to evaluate apoptosis by assessing cleaved caspase-3 immunoexpression in hyperplastic, potentially malignant disorder (PMD), and malignant tumors in intraoral and lower lip sites. MATERIAL AND METHODS: A retrospective study using paraffin blocks with tissues from patients with inflammatory fibrous hyperplasia (IFH), actinic cheilitis, oral leukoplakia, lower lip and intraoral squamous cell carcinoma (SCC) was performed. The tissues were evaluated by immunohistochemical analysis with anti-cleaved caspase-3 antibody. Apoptotic area index was then correlated with lesion type. RESULTS: From 120 lesions assessed, 55 (46%) were cleaved caspase-3-positive. The SCC samples (n=40) had the highest apoptotic area indices (n=35; 87.5%). Significant differences were detected between SCCs and PMDs (p=0.0003), as well as SCCs and IFHs (p=0.001), regarding caspase-3 immunopositivity. Carcinomas of the lower lip had lower apoptotic area indices than intraoral cancer (p=0.0015). CONCLUSIONS: Cleaved caspase-3 immunoexpression showed differences in oral SCCs and PMDs and demonstrated a distinct role of apoptosis in carcinogenesis of intraoral and lower lip cancer. In future, the expression of cleaved caspase-3 with other target molecules in oral cancer may be helpful in delineating the prognosis and treatment of these tumors.

Immunoexpression of cleaved caspase-3 shows lower apoptotic area indices in lip carcinomas than in intraoral cancer

ABSTRACT Objective This study aimed to evaluate apoptosis by assessing cleaved caspase-3 immunoexpression in hyperplastic, potentially malignant disorder (PMD), and malignant tumors in intraoral and lower lip sites. Material and Methods A retrospective study using paraffin blocks with tissues from patients with inflammatory fibrous hyperplasia (IFH), actinic cheilitis, oral leukoplakia, lower lip and intraoral squamous cell carcinoma (SCC) was performed. The tissues were evaluated by immunohistochemical analysis with anti-cleaved caspase-3 antibody. Apoptotic area index was then correlated with lesion type. Results From 120 lesions assessed, 55 (46%) were cleaved caspase-3-positive. The SCC samples (n=40) had the highest apoptotic area indices (n=35; 87.5%). Significant differences were detected between SCCs and PMDs (p=0.0003), as well as SCCs and IFHs (p=0.001), regarding caspase-3 immunopositivity. Carcinomas of the lower lip had lower apoptotic area indices than intraoral cancer (p=0.0015). Conclusions Cleaved caspase-3 immunoexpression showed differences in oral SCCs and PMDs and demonstrated a distinct role of apoptosis in carcinogenesis of intraoral and lower lip cancer. In future, the expression of cleaved caspase-3 with other target molecules in oral cancer may be helpful in delineating the prognosis and treatment of these tumors.

Effect of Citric Acid and Ethylenediaminetetraacetic Acid on the Surface Morphology of Young and Old Root Dentin.

INTRODUCTION: The aim of this in vitro study was to evaluate the effect of 10% citric acid and 17% ethylenediaminetetraacetic acid (EDTA) irrigating solutions on the surface morphology of young and old root dentin by determining the number and diameter of dentinal tubules using scanning electron microscopy (SEM). METHODS AND MATERIALS: Fifty healthy human teeth collected from young (≤30 years) and old (≥60 years) individuals (n=25) were first prepared with a Largo bur #2 to produce smear layer on the root canal surface. Subsequently, the crowns and the root middle and apical thirds were sectioned and removed, and the cervical thirds were sectioned vertically in the buccal-lingual direction into two equal halves. The obtained samples were then immersed in 2.5% sodium hypochlorite for 30 min and randomly separated into two treatment groups for each age group. In each age group, ten samples were selected as controls and did not receive any type of treatment. The rest of the specimens were then rinsed, dried and treated for 4 min with 10% citric acid or 17% EDTA. The samples were then assessed with SEM regarding the number and diameter of dentinal tubules. All data were assessed using Student's t-test. The level of significance was set at 0.05. RESULTS: Regardless of the type of treatment, no significant differences were observed in the number of open tubules between the young and old root dentin (P>0.05). Nonetheless, the diameter of the tubules in the old root dentin was larger when 17% EDTA was used (P<0.05). Both, young and old root dentin did not differ with the 10% citric acid treatment (P>0.05). CONCLUSION: The results showed that 17% EDTA treatment induced a significant demineralization in old root dentin.

DENGUE DURING PREGNANCY: ASSOCIATION WITH LOW BIRTH WEIGHT AND PREMATURITY.

The aim of this study was to evaluate the effects of dengue virus infection during pregnancy and its correlation with low birth weight, prematurity, and asphyxia. A non-concurrent cohort study reveals the association of dengue during pregnancy with prematurity and low birth weight, when birth occurred during the maternal-fetal viremia period (p = 0.016 and p < 0.0001, respectively).

Perception of midline deviations in smile esthetics by laypersons.

OBJECTIVE:: To evaluate the esthetic perception of upper dental midline deviation by laypersons and if adjacent structures influence their judgment. METHODS:: An album with 12 randomly distributed frontal view photographs of the smile of a woman with the midline digitally deviated was evaluated by 95 laypersons. The frontal view smiling photograph was modified to create from 1 mm to 5 mm deviations in the upper midline to the left side. The photographs were cropped in two different manners and divided into two groups of six photographs each: group LCN included the lips, chin, and two-thirds of the nose, and group L included the lips only. The laypersons performed the rate of each smile using a visual analog scale (VAS). Wilcoxon test, Student's t-test and Mann-Whitney test were applied, adopting a 5% level of significance. RESULTS:: Laypersons were able to perceive midline deviations starting at 1 mm. Statistically significant results (p< 0.05) were found for all multiple comparisons of the values in photographs of group LCN and for almost all comparisons in photographs of group L. Comparisons between the photographs of groups LCN and L showed statistically significant values (p< 0.05) when the deviation was 1 mm. CONCLUSIONS:: Laypersons were able to perceive the upper dental midline deviations of 1 mm, and above when the adjacent structures of the smiles were included. Deviations of 2 mm and above when the lips only were included. The visualization of structures adjacent to the smile demonstrated influence on the perception of midline deviation.

DENGUE DURING PREGNANCY: ASSOCIATION WITH LOW BIRTH WEIGHT AND PREMATURITY

The aim of this study was to evaluate the effects of dengue virus infection during pregnancy and its correlation with low birth weight, prematurity, and asphyxia. A non-concurrent cohort study reveals the association of dengue during pregnancy with prematurity and low birth weight, when birth occurred during the maternal-fetal viremia period (p = 0.016 and p < 0.0001, respectively).