Prevalência das lesões orais em idosos atendidos no serviço de estomatologia do Instituto de Saúde de Nova Friburgo ­ UFF/RJ / Prevalence of oral lesions in the elderly treated at the stomatology service of the Instituto de Saúde de Nova Friburgo ­ UFF/RJ

Objetivo: realizar um levantamento epidemiológico acerca das alterações na mucosa oral dos pacientes acima de 60 anos, atendidos no serviço de Estomatologia do Instituto de Saúde de Nova Friburgo - UFF/RJ, no período de 2013 a 2018, e estabelecer as principais causas e formas de tratamento. Materiais e Métodos: estudo retrospectivo e observacional, com análise descritiva, através da coleta de dados nos prontuários: idade, sexo, cor da pele, ocupação, lesão e sua localização. Resultados: foram analisados 640 prontuários, destes, 395 (61,7%) apresentaram lesão, sendo 132 (20,6%) deles com mais de uma lesão. Dos 395 com lesão, 57,0% (225) eram do sexo feminino. A cor de pele branca representou 56,7% (224), porém 107 prontuários não apresentaram essa informação. A amostra contou com pacientes de 60 a 91 anos, com média de 65 anos. No total foram encontradas 613 lesões. Queilite actínica foi a mais prevalente 15,5% (95), seguida da estomatite protética 14,0% (86) e hiperplasia fibrosa 13,4% (82). Conclusão: os indivíduos idosos do presente estudo apresentaram alta frequência de lesões orais, sendo a queilite actínica, estomatite protética e hiperplasia fibrosa as mais comuns.

Objective: to carry out an epidemiological survey of oral mucosa lesions of patients aged over 60 years, attended at the Stomatology Service of the Nova Friburgo Health Institute - UFF/RJ, from 2013 to 2018, and to establish the main etiologies and forms of treatment. Materials and Methods: retrospective and observational study through data collection from medical records as: age, gender, skin color, occupation, lesion and its location. Results: 640 medical records were analyzed, of which 395 (61.7%) had lesions, 132 (20.6%) had more than one lesion. Of the 395 with injuries, 57.0% (225) were female. White skin color represented 56.7% (224), but 107 medical records did not present this information. The sample included patients aged 60 to 91 years, with a mean of 65 years. In total, 613 injuries were found. Actinic cheilitis was the most prevalent 15.5% (95), followed by prosthetic stomatitis 14.0% (86) and fibrous hyperplasia 13.4% (82). Conclusion: the elderly individuals in the present study had a high frequency of oral lesions, with actinic cheilitis, denture stomatitis and fibrous hyperplasia being the most common.

Sociodemographic and clinicopathological profile of 80 cases of oral squamous cell carcinoma / Perfil sociodemográfico e clinicopatológico de 80 casos de carcinoma de células escamosas de boca

ABSTRACT Objective: To describe demographic and clinicopathologic profile of oral squamous cell carcinoma (OSCC) cases from incisional biopsies collected at the Nova Friburgo Health Institute of the Fluminense Federal University [Instituto de Saúde de Nova Friburgo da Universidade Federal Fluminense (ISNF/UFF)] and at the Raul Sertã Municipal Hospital [Hospital Municipal Raul Sertã (HMRS)]. Methods: Oral Pathology Laboratory records from the ISNF/UFF were reviewed and all cases of OSCC were primarily selected. Cases from ISNF/UFF and HMRS were selected and had their demographic data collected from the medical records. Clinical characteristics were evaluated using the images of the lesions taken on the biopsy day and the laboratory files. The histological slides were later reviewed. Results: Eighty cases of OSCC were identified. Most patients were male (56.7%), with a mean age of 60 years, smoker (62.71%) and/or alcoholic (44.55%). The most affected anatomic site was the tongue (39.49%), presenting mainly as an ulcer (39.49%). Microscopically, the well-differentiated lesions were more common (35.44%), and the mean counting of mitoses was 5.5/10 high-power field. Conclusion: The profile of OSCC patients in Nova Friburgo partly reflects the world literature, with emphasis on the following differences: low average number of mitoses found in the histopathological analysis and prevalence of well-differentiated lesions. Such differences may be a result of the characteristic variations of the local population, reinforcing the importance of conducting epidemiological studies that demonstrate OSCC peculiarities in different regions.

RESUMEN Objetivo: Trazar el perfil sociodemográfico y clínico de los casos de biopsia incisional de carcinoma oral de células escamosas (COCE) recogidos en el Instituto de Saúde de Nova Friburgo de la Universidade Federal Fluminense (ISNF/UFF) y en el Hospital Municipal Raul Sertã (HMRS). Métodos: Se revisaron los archivos del Laboratorio de Patología Oral, y todos los casos de COCE han sido primariamente seleccionados. Los casos procedentes del ISNF/UFF y del HMRS han sido seleccionados y sus datos demográficos han sido recogidos a partir de los historiales médicos. Las características clínicas fueron evaluadas basándose en las fotografías de las lesiones sacadas en el día de la biopsia y en las informaciones descriptas en las boletas de solicitud del laboratorio. Los portaobjetos histopatológicos fueron posteriormente revisadas. Resultados: Ochenta casos de COCE fueron identificados. La mayoría de los pacientes era del sexo masculino (56,7%), con edad media de 60 años, fumadores (62,71%) y/o alcohólicos (44,55%). La localización anatómica más afectada fue la lengua (39,49%), presentándose, principalmente, como una úlcera (39,49%). Microscópicamente, las lesiones bien diferenciadas fueron las más comunes (35,44%), y la media de mitosis cuantificada fue de 5,5/10 campos de aumento mayor. Conclusión: El perfil de los pacientes con COCE em Nova Friburgo refleja, parcialmente, la literatura mundial, destacando las siguientes diferencias: bajo número medio de mitosis encontradas en el análisis histopatológico y prevalencia de lesiones bien diferenciadas. Dichas diferencias pueden ser resultado de variaciones características de la población local, reforzando la importancia de la realización de estudios epidemiológicos que evidencien las particularidades de COCE en diferentes regiones.

RESUMO Objetivo: Traçar o perfil sociodemográfico e clinicopatológico dos casos de biópsia incisional de carcinoma de células escamosas bucal (CCEB) coletados no Instituto de Saúde de Nova Friburgo da Universidade Federal Fluminense (ISNF/UFF) e no Hospital Municipal Raul Sertã (HMRS). Métodos: Os arquivos do Laboratório de Patologia Oral foram revisados, e todos os casos de CCEB foram primariamente selecionados. Os casos oriundos do ISNF/UFF e do HMRS foram selecionados e tiveram seus dados demográficos coletados a partir dos prontuários. As características clínicas foram avaliadas com base nas fotografias das lesões tiradas no dia da biópsia e nas informações descritas nas fichas de requisição laboratorial. As lâminas histopatológicas foram revisadas posteriormente. Resultados: Oitenta casos de CCEB foram identificados. A maioria dos pacientes era do sexo masculino (56,7%), com idade média de 60 anos, tabagista (62,71%) e/ou etilista (44,55%). A localização anatômica mais acometida foi a língua (39,49%), apresentando-se, principalmente, como uma úlcera (39,49%). Microscopicamente, as lesões bem diferenciadas foram as mais comuns (35,44%), e a média de mitoses quantificada foi de 5,5/10 campos de grande aumento. Conclusão: O perfil dos pacientes com CCEB em Nova Friburgo reflete, em parte, a literatura mundial, com destaque para as seguintes diferenças: baixo número médio de mitoses encontradas na análise histopatológica e prevalência de lesões bem diferenciadas. Tais diferenças podem ser resultado das variações características da população local, reforçando a importância da realização de estudos epidemiológicos que evidenciem as particularidades de CCEB em diferentes regiões.

Peripheral giant cell granuloma associated with a dental implant.

BACKGROUND: Peripheral giant cell granuloma (PGCG) is an uncommon pathology that affects gingival or alveolar mucosa. Although PGCG can be associated with dental implants, little is known about this lesion and implant osseointegration as well as its etiopathogenesis and the treatments available. This study sought to report a rare case of PGCG associated with dental implant, emphasizing its clinical and histopathological aspects. CASE PRESENTATION: A 53-year-old man had an exophytic, reddish lesion, around a crown attached to a dental implant located in the left mandible. Radiographically, there was bone loss around the implant. After excisional biopsy, histological examination revealed a submucosal proliferation of multinucleated giant cells rendering the diagnosis of peripheral giant cell granuloma. Patient has been under follow-up for 6 months with no recurrence. CONCLUSIONS: Peri-implant lesions must be completely removed to prevent recurrence of PGCG and implant failure, even in cases suspected to be reactive. Besides, histological examination must be performed on all peri-implant reactions to achieve the appropriate diagnosis and, consequently, the best treatment and follow up.

Analysis of risk factors for maxillary denture-related oral mucosal lesions: A cross-sectional study

Background: To evaluate the frequency of maxillary dentures-related lesions and the possible associated risk factors. Material and Methods: Ninety-seven participants were selected, and a complete anamnesis, physical examination and tests of occlusion vertical dimension (OVD), retention and stability of the denture, biofilm quantification, cytopathology, sialometry, pH analysis and buffer capacity of the saliva were performed. Statistical analyses were performed with the Pearson's chi-square, Mann-Whitney tests, and Pearson’s coefficient (p < 0.05). Results: In 78% of the participants at least one denture-related lesion was found. Denture-associated stomatitis (63%), inflammatory fibrous hyperplasia (19%) and traumatic ulceration (11%) were the 3 most frequent lesions. The habit of night use of the denture was considered an independent risk factor for the development of oral lesions [OR = 3.0 (95% CI 1.09-8.56); p < 0.05]. Furthermore, the longest period of use of the same denture and biofilm also had statistically significant relation to oral lesions. The biofilm seems to be more related to the prevalence of oral lesions according to the multiple logistic regression [OR = 1.3 (95% CI: 1.01-1.83) p < 0.05]. The lack of a dentures' cleaning solution and detrition of the prothesis were independent risk factors for denture-associated stomatitis. Male gender, loss of OVD and bad buffer capacity were risk factors for angular cheilitis. Fractures of the base and repair of broken dentures were risk factors for traumatic ulcers. Conclusions: These results show a high frequency of denture-related lesions. Besides, participants hygiene habits and poor quality of the dentures were the main factors for the development of these lesions

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Atletas paralímpicos brasileiros: uma avaliação da saúde bucal / Brazilian paralympic athletes: an evaluation of oral health status

Objetivo: o objetivo deste trabalho foi avaliar as condições de saúde bucal e investigar hábitos de vida que poderiam revelar fatores de risco para cárie dentária de atletas paraolímpicos paratletas brasileiros e, assim, identificar quais problemas de saúde bucal podem impactar seu desempenho, possibilitando a implementação de políticas públicas voltadas para essa população. Material e Métodos: os dados foram coletados de atletas participantes de um programa financiado pelo governo denominado "Odontologia Esportiva para Atletas de Alto Desempenho", realizado no Instituto de Pesquisa em Saúde - INPES em São Paulo, Brasil. Um total de 96 atletas paralímpicos de alto desempenho foram examinados por 4 dentistas treinados e calibrados. Higiene bucal, relatos de dor bucal, exame da ATM, índice de má oclusão e informações sociodemográficas foram os dados coletados. Resultados: A idade dos atletas variou de 18 a 56 anos, com média de idade de 34 anos. A maioria dos atletas era nadadora (55,2%). 27,1% apresentaram sangramento gengival e 31,0% relataram sensibilidade dentária. 47,9% tinham classe I (Angle) e a maioria dos atletas (71,9%) não apresentou sinais clínicos de disfunção temporomandibular. A média do índice de cariados, perdidos e obturados (CPOD) foi de 10,5, variando de 0 a 28. Conclusões: os exames clínicos indicam uma população que necessita significativamente de procedimentos preventivos e restauradores de saúde bucal. Esperamos que nossos dados sejam úteis e ajudem as autoridades responsáveis na criação de políticas públicas curativas e preventivas para a população analisada.

Objective: To estimate the oral health status and investigate lifestyle habits that may reveal risk factors for dental caries of Brazilian competitive athletes and thus identify which oral health problems may impact their performance, enabling the implementation of public policies focused on this population. Material and Methods: This study collected data to describe the oral health status of Brazilian Paralympics Athletes participating in a government funded program named "Sports Dentistry for High Performed Athletes" performed at the Institute of Health Research ­ INPES in Sao Paulo, Brazil. A total of 96 high performed paralympic athletes were screened by 4 trained and calibrated dentists. Oral hygiene, reports of oral pain, TMJ examination, malocclusion index and sociodemographic information were recorded. Results: The age of the athletes ranged from 18 to 56 years, with a mean age of 34 years. The majority of the athletes were swimmers (55.2%). 27.1% had gum bleeding, and 31.0% reported tooth sensitivity. 47.9 % had class I (Angle) and most athletes (71.9%) didn´t show clinical signs of temporomandibular disorders. The mean of decayed, missing and filled index (DMFT) was 10.5, varying 0 to 28. Conclusions: clinical examinations indicate a population that significantly needs preventive and restorative oral health procedures. We hope that our data will be useful and assist the responsible authorities in creating curative and preventive public policies for the analyzed population.

Análise do diagnóstico citopatológico realizado em pacientes atendidos na clínica de estomatologia do curso de odontologia da Universidade Federal Fluminense, Nova Friburgo / RJ / Diagnostic cytopathologicalanalysis performed in patients attended by the stomatology clinic of the Universidade Federal Fluminense, Nova Friburgo / RJ

A citopatologia é uma técnica que propicia diagnósticos rápidos para lesões em mucosas, além de ser bastante acessível do ponto de vista econômico. Na odontologia, pode ser um bom exame auxiliar no diagnóstico de lesões bucais, principalmente lesões infecciosas, bem como na detecção precoce do câncer de boca. Objetivos: estabelecer a técnica de citopatologia no laboratório de Patologia Oral do Instituto de Saúde de Nova Friburgo da UFF, bem como avaliar dados demográficos e discutir os diagnósticos citopatológicos desses pacientes. Métodos: foram selecionados 90 pacientes atendidos na clínica de Estomatologia da UFF-NF com lesões orais que tinham indicação para realização da citopatologia oral. Após obtenção de dados demográficos, a coleta de material foi feita, seguida da realização do esfregaço em duas lâminas de vidro. Resultados: Dos 90 pacientes, 54 (60%) eram mulheres e 36 (40%) homens. A idade dos pacientes variou de 30 a 82 anos, com média de 56,60 anos. Desses pacientes, 23 (26%) declararam-se tabagistas, 27 (30%) declararam-se etilistas e 77 (86%) eram usuários de próteses dentárias. Os esfregaços dos 90 pacientes foram diagnosticados de acordo com as classes de Papanicolaou, sendo a maioria, 84 pacientes (93%), diagnosticada como Classe II. Desses 84 pacientes, 34 (40,4%) apresentaram candidíase. Conclusão: após a realização deste trabalho, além da técnica de citopatologia ser estabelecida, pode-se perceber que os esfregaços inflamatórios e apresentando fungo foram predominantes, o que demonstra a boa capacidade diagnóstica da técnica de citopatologia para lesões infecciosas(AU)

Objectives: to establish the technique of cytopathology in the laboratory of Oral Pathology of the Institute of Health of Nova Friburgo of the UFF, as well as to evaluate demographic data and to discuss the cytopathological diagnoses of these patients. Methods: 90 patients attended at the Stomatology clinic of the UFF-NF with oral lesions that had been indicated for oral cytopathology were selected. After obtaining demographic data, the material was collected, followed by the smearing on two glass slides. Results: Of the 90 patients, 54 (60%) were women and 36 (40%) were men. The patients' ages ranged from 30 to 82 years, with a mean of 56.60 years. Of these patients, 23 (26%) declared themselves smokers, 27 (30%) declared themselves alcoholics and 77 (86%) were users of dental prostheses. The smears of the 90 patients were diagnosed according to the classes of Papanicolau, being the majority, 84 patients (93%), diagnosed as Class II. Of these 84 patients, 34 (40.4%) presented candidiasis. Conclusion: after this work, besides the cytopathology technique was established, it can be noticed that the inflammatory smears and presenting fungus were predominant, which demonstrates the good diagnostic capacity of the cytopathology technique for infectious lesions(AU)

Carcinoma de células escamosas oral em pacientes jovens: uma realidade que deve ser reconhecida pelos dentistas / Oral squamous cell carcinoma in young patients: a reality that must be recognized by dentists

O carcinoma de células escamosas (CCE) é a neoplasia maligna mais comum da boca. O diagnóstico definitivo requer que o cirurgião dentista tenha conhecimento clínico e suspeite da possível natureza maligna da lesão, de forma que indique corretamente os exames complementares. Embora a prevalência seja mais expressiva em homens com idade entre 50 e 70 anos e os fatores associados mais comuns sejam o tabagismo e etilismo, os casos em pacientes com idade abaixo dos 40 anos têm aumentado no mundo todo. Neste grupo de pacientes jovens há uma proporção semelhante entre homens e mulheres acometidos, o que deve ser, portanto, também considerado pelo cirurgião dentista. Assim, este trabalho relatará o caso de um paciente jovem com CCE de boca, ressaltando a necessidade da correlação clínico-patológica e o papel do estomatologista e do patologista oral no estabelecimento do diagnóstico definitivo, bem como a importância do diagnóstico precoce no tratamento e prognóstico destes casos. Paciente do sexo masculino, 22 anos, não tabagista e não etilista, foi encaminhado pelo ortodontista ao estomatologista para avaliação de uma úlcera localizada na borda lateral posterior de língua, assintomática, com histórico de aproximadamente 2 meses. Foi realizada a biópsia incisional e a análise histopatológica concluiu o diagnóstico em carcinoma de células escamosas. O paciente foi submetido à excisão cirúrgica com glossectomia parcial e esvaziamento cervical. Foi realizada a técnica de hibridização in situpara identificar a presença do papiloma vírus humano, cujo resultado foi negativo. O paciente encontra-se bem e em acompanhamento há 8 meses, sem sinais de recorrências (AU).

Squamous cell carcinoma (SCC) is the most common oral malignant neoplasm. The definitive diagnosis requires that the dentist has clinical knowledge and suspects the possible malignant nature of the lesion, so that he can correctly indicate the complementary examinations. Although the prevalence is more significant in men aged between 50 and 70 years old and the most common associated factors are smoking and alcoholism, cases in patients under 40 years old have increased worldwide. In this group of young patients there is a similar proportion between men and women affected, which should therefore also be considered by the dentist. This article will report the case of a young patient with oral SCC, highlighting the need for clinicopathological correlation and the stomatologist and oral pathologist role in establishing the definitive diagnosis, as well as the importance of early diagnosis in the treatment and prognosis of these cases. A 22-year-old male patient non-smoker, non-alcoholic was referred by the orthodontist to the stomatologist for evaluation of an ulcer located at the lateral border of the tongue, asymptomatic, with a history of approximately 2 months. An incisional biopsy was performed and the histopathological analysis concluded the diagnosis of squamous cell carcinoma. The patient underwent surgical excision with partial glossectomy and neck dissection. In situ hybridization technique was performed to identify the presence of human papilloma virus, whose result was negative. The patient is well and in 8 months followup has showed no recurrences signs (AU).

Bisphosphonate-related osteonecrosis of the jaws: analysis of a case series at a dental school.

Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is an adverse effect of drugs used to treat bone metabolism diseases, such as osteoporosis and bone metastases. The present study retrospectively evaluated the clinical characteristics and evolution of BRONJ cases that were diagnosed and treated at a dental school from 2004 to 2011. During that period, 13 patients met the criteria of the study among a population of 2,342 patients with oral lesions. Of the 13 patients, 12 were females. Ten were intravenous bisphosphonate users, and nine had breast cancer as the primary disease. Eight mandibular cases were observed. Eight patients interrupted the use of the bisphosphonates temporarily during the treatment. Surgical treatment was conducted in 10 patients, which was associated with platelet-rich plasma in six cases, which led to a regression to Stage I in 50% of these and cure in 33.3%. Of the total sample, four (30.8%) cases were cured, six (46.1%) regressed to Stage I, and three (23.1%) remained in Stage II after treatment. Dental rehabilitation occurred in seven patients. Dissemination of knowledge among professionals is essential for prevention and early diagnosis of BRONJ. Dental schools must act as reference centers and participate in the multidisciplinary care of bisphosphonate users.

Biocompatibility evaluation of 3 facial silicone elastomers.

The failure of facial prostheses is caused by limitations in the properties of existing materials, especially the biocompatibility. This study aimed to evaluate the biocompatibility of maxillofacial silicones in subcutaneous tissue of rats. Thirty Wistar rats received subcutaneous implants of 3 maxillofacial silicone elastomers (LIM 6050, MDX 4-4210, and industrial Silastic 732 RTV). A histomorphometric evaluation was conducted to analyze the biocompatibility of the implants. Eight areas of 60.11 mm(2) from the surgical pieces were analyzed. Mesenchymal cells, eosinophils, and foreign-body giant cells were counted. Data were submitted to analysis of variance and Tukey test. Initially, all implanted materials exhibited an acceptable tissue inflammatory response, with tissue reactions varying from light to moderate. Afterward, a fibrous capsule around the silicone was observed. The silicones used in the current study presented biocompatibility and can be used for implantation in both medical and dental areas. Their prosthetic indication is conditioned to their physical properties. Solid silicone is easier to adapt and does not suffer apparent modifications inside the tissues.

HOXB5 expression in oral squamous cell carcinoma.

UNLABELLED: Human HOX genes encode transcription factors that act as master regulators of embryonic development. They are important in several processes such as cellular morphogenesis and differentiation. The HOXB5 gene in particular has been reported in some types of neoplasm, but not in oral cancer. OBJECTIVE: The present study investigated the expression of HOXB5 in oral squamous cell carcinoma (SCC) and in non-tumoral adjacent tissues, focusing on verifying its possible role as a broad tumor-associated gene and its association with histopathological and clinical (TNM) characteristics. MATERIAL AND METHODS: RT-PCR was performed to amplify HOXB5 mRNA in 15 OSCCs and adjacent non-tumoral epithelium. A possible association with TNM and histopathologic data was verified by the chi-square and post-hoc t-test. RESULTS: HOXB5 was amplified in 60% non-tumoral epithelium and in 93.3% carcinomas. No statistically significant differences were found regarding the HOXB5 mRNA expression and TNM or histological grade. CONCLUSION: HOXB5 is expressed in OSCCs and its role in cancer progression should be further investigated.

HOXB5 expression in oral squamous cell carcinoma

Human HOX genes encode transcription factors that act as master regulators of embryonic development. They are important in several processes such as cellular morphogenesis and differentiation. The HOXB5 gene in particular has been reported in some types of neoplasm, but not in oral cancer. OBJECTIVE: The present study investigated the expression of HOXB5 in oral squamous cell carcinoma (SCC) and in non-tumoral adjacent tissues, focusing on verifying its possible role as a broad tumor-associated gene and its association with histopathological and clinical (TNM) characteristics. MATERIAL AND METHODS: RT-PCR was performed to amplify HOXB5 mRNA in 15 OSCCs and adjacent non-tumoral epithelium. A possible association with TNM and histopathologic data was verifed by the chi-square and post-hoc t-test. RESULTS: HOXB5 was amplifed in 60 percent non-tumoral epithelium and in 93.3 percent carcinomas. No statistically signifcant differences were found regarding the HOXB5 mRNA expression and TNM or histological grade. CONCLUSION: HOXB5 is expressed in OSCCs and its role in cancer progression should be further investigated.

Influência do formato das roscas dos implantes na distribuição de tensões no tecido ósseo: análise fotoelástica / Influence of dental implant thread shape on bone stress distribution: photoelastic analysis

A forma do implante, mais especificamente o perfil de suas roscas, pode influenciar significativamente na distribuição de tensões sobre o tecido ósseo. Dessa forma, fica evidente a importância da realização de estudos laboratoriais que permitam a verificação do comportamento dos implantes quando a carga incide sobre diferentes formatos de roscas. Este trabalho teve como objetivo analisar, por meio da análise fotoelástica, a influência dos formatos das roscas dos implantes na distribuição de tensões à estrutura de suporte de um modelo experimental. Foram construídos dois corpos de prova em resina fotoelástica, sendo que no modelo I foram colocados dois implantes de roscas trapezoidais e no modelo II foram colocados dois implantes com roscas triangulares com os seus respectivos componentes. Primeiramente, foi feita a aplicação de carga vertical de 6,4 kgf, a seguir, de 11,2 kgf e por último uma carga aplicada de 16 kgf, simulando uma sobrecarga no modelo I e no modelo II. Nos dois modelos (II e II) houve distribuição homogênea das franjas isocromáticas no terço cervical, médio e apical, porém, no modelo I a intensidade das franjas foi maior. Conclui-se que não houve diferença nos locais de distribuição das tensões entre os modelos I e II, mas a intensidade das franjas isocromáticas no modelo I mostra que existe maior compressão ao redor do implante de roscas trapezoidais.

The design of a dental implant thread shape can be decisive on bone stress distribution. Thus, basic research is fundamental to identify its mechanical behavior when the load is applied on different types of thread formats. This study analyzed, by photoelastic techniques, the influence of the screw-thread formats in the stress distribution on the experimental model. Two photoelastic resin models were fabricated: model 1 consisted of trapezoidal-shaped and model 2 of triangle-shaped screw-thread implants with its respective components. Sequential loads of 6.4kgf, 11.2kgf, and 16kgf (overload) were applied in both groups. Uniform distribution of isochromatic fringes was verified at the cervical, middle and apical thirds of both models, with fringe intensity being higher in the model 1. One can conclude that greater compression was found around the trapezoidalshaped, screw-thread implants.

Avaliação de 14 casos de carcinomaepidermoide de boca com diagnóstico tardio / Evaluation of 14 cases of oral squamous cellcarcinoma with delayed diagnosis

Introdução: Processos patológicos de diversas causas, como doençasinfecciosas, inflamatórias, imunológicas, alérgicas, sistêmicase traumáticas, acometem frequentemente a cavidade bucal. Aresponsabilidade do diagnóstico de todas essas lesões é do cirurgiãodentista.Da mesma forma, é dele a responsabilidade pelo diagnóstico docâncer de boca. A cavidade bucal permite a visão direta das estruturas,fato que facilita a identificação de lesões iniciais; consequentementedeveria haver maior probabilidade de diagnósticos precoces de lesõesbucais. Mas observam-se ainda nos dias de hoje muitos casos de câncer bucal diagnosticados tardiamente no Brasil. O atraso no diagnósticoimplica um pior prognóstico e diminuição na taxa de sobrevida dospacientes. Objetivo, relato de caso e conclusão: O objetivo destetrabalho é relatar casos clínicos de carcinomas epidermoides de bocadiagnosticados em estágio avançado no Departamento de Estomatologiado Hospital do Câncer de Cuiabá (MT, Brasil), assim como discutir asprincipais razões que levam ao atraso do diagnóstico, sugerindo açõespara modificação desse quadro.

Introduction: Pathological processes of several causes such as infectious,inflammatory, immunological, allergic, systemic and traumatic diseasesoften affect the oral cavity. The dentist is responsible for the diagnosis ofthese oral lesions. Likewise, the dentist is responsible for the oral cancerdiagnosis. The oral cavity allows direct visualization of the structures,which facilitates the identification of initial lesions and, consequently,there should be a higher probability of early diagnosis of oral lesions.However, there are still many cases of oral cancer in Brazil with delayeddiagnosis, which implies a worse prognosis and a decrease in the survivalrate of patients. Objective, case report and conclusion: The aim ofthis work is to report oral squamous cell carcinoma cases with delayeddiagnosis in the Stomatology Department of the Cuiabá Cancer Hospital(MT, Brazil), as well as to discuss the main reasons that lead to the delayin diagnosis, besides giving suggestions to modify this situation.

Avaliação histológica de hidroxiapatita com colágeno quatro e dez meses após levantamento de seio maxilar / Hydroxyapatite-collagen graft composite material for sinus lifting procedures: analysis of 4 and 10 month histological results

Os biomateriais são produtos utilizados em regeneração tecidual que apresentam soluções clínicas satisfatórias, elevado índice de sucesso e mínimo desconforto para o paciente. Dentre os biomateriais mais utilizados destaca-se a hidroxiapatita, uma matriz mineral biocompatível que apresenta similaridade com a composição do osso mineral e a capacidade de osteocondução. A associação da hidroxiapatita com o colágeno adiciona propriedades osteoindutoras ao material. O objetivo deste trabalho foi avaliar histologicamente a utilização de um biomaterial nacional composto por hidroxiapatita e colágeno Tipo I (Extra Graft XG-13) em levantamento de seio maxilar. Amostras do enxerto ósseo foram removidas após quatro e dez meses e comparadas histologicamente. Observamos que, após dez meses da realização do enxerto, o biomaterial não foi reabsorvido e a quantidade de tecido ósseo neoformado foi significativamente maior do que a presente na amostra de quatro meses, sugerindo a substituição do tecido conjuntivo por tecido ósseo.

Bone regeneration procedures utilizing biomaterials have achieve satisfactory clinical results, high successful rates and less surgical discomfort to the patient. One of the most used biomaterials, hydroxyapatite, is a biocompatible inorganic matrix similar to the mineral bone composition and has bone conductive capacity. Association of collagen to hydroxyapatite adds osteoinductive properties to the graft material. The aim of this study is to evaluate the bone formation capacity of a national biomaterial composed by hydroxyapatite and collagen type I (Extra Graft XG-13) in sinus lifting procedures. Samples were removed 4 and 10 months after graft and compared by histometric evaluation. We detected that after 10 months the biomaterial was not reabsorbed but the amount of new bone tissue was significantly higher than in the 4-month period samples, suggesting that the connective tissue was substituted by new bone tissue.

Central mucoepidermoid carcinoma: Report of a case with 11 years’ evolution and peculiar macroscopical and clinical characteristics

Central mucoepidermoid carcinomas (CMC) are uncommon tumours, comprising 2-3% of all mucoepidermoid carcinomas reported. They have been reported in patients of all ages, ranging from 1 to 78-years, with the overwhelming majority occurring in the 4th and 5th decades of life. They are histologically low-grade cancers, usually affecting the mandible as uniocular or multiocular radiographic lesions. The authors report a case of CMC of the mandible with a long evolution, and peculiar clinical and macroscopical features related with the long term evolution of the disease. A 53-year-old male patient had expansion of buccal and lingual cortices of the anterior region of the mandible, covered by ulcerated mucosa, with 11 years evolution. An incisional biopsy was performed, and the histopathological findings confirm low-grade mucoepidermoid carcinoma. The patient was treated with a mandibulectomy, followed by supraomohyoid neck dissection. There was no evidence of local recurrence, regional or distant metastasis revealed; and the patient was alive and without disease after a follow- up interval of 36 months (AU)

Central mucoepidermoid carcinoma: report of a case with 11 years' evolution and peculiar macroscopical and clinical characteristics.

Central mucoepidermoid carcinomas (CMC) are uncommon tumours, comprising 2-3% of all mucoepidermoid carcinomas reported. They have been reported in patients of all ages, ranging from 1 to 78-years, with the overwhelming majority occurring in the 4th and 5th decades of life. They are histologically low-grade cancers, usually affecting the mandible as uniocular or multiocular radiographic lesions. The authors report a case of CMC of the mandible with a long evolution, and peculiar clinical and macroscopical features related with the long term evolution of the disease. A 53-year-old male patient had expansion of buccal and lingual cortices of the anterior region of the mandible, covered by ulcerated mucosa, with 11 years evolution. An incisional biopsy was performed, and the histopathological findings confirm low-grade mucoepidermoid carcinoma. The patient was treated with a mandibulectomy, followed by supraomohyoid neck dissection. There was no evidence of local recurrence, regional or distant metastasis revealed; and the patient was alive and without disease after a follow-up interval of 36 months.

Expressão do RNA mensageiro de genes HOX em linhagens celulares de carcinomas epidermoides de cabeça e pescoço / HOX genes mRNA expression in head and neck squamous cell carcinoma cell lineages

Os genes HOX são importantes para o controle do desenvolvimento embrionário e regulam aspectos da morfogênese e diferenciação celular. A associação entre os genes HOX e o processo da oncogênese tem sido verificada em casos de carcinomas de cólon, pele, rim, pulmão, mama, leucemias e outros tipos de câncer. O objetivo deste trabalho foi verificar a expressão de genes HOX em linhagens celulares de carcinomas epidermoides de cabeça e pescoço. Para tanto, utilizamos a técnica RT-PCR para analisar a expressão de três grupos de genes HOX em linhagens celulares de carcinomas epidermoides de cabeça e pescoço: HN-6, HN-19, HN-30 e HN-31, utilizando-se os primeiros degenerados HOX1, HOX2 e HOX3 e coamplificação com o gene constitutivo da β-actina. Material de gengiva humana e embrião de camundongo foram utilizados como controle de expressão do gene HOX. Os resultados obtidos mostraram que a expressão dos genes HOX apresentou padrão semelhante aos controles utilizados. Houve, porém, subexpressão do grupo HOX1 nas linhagens HN-6 e HN-19 e superexpressão do grupo HOX-2 na linhagem HN-31. Esses achados nos permitem levantar a hipótese de que os genes HOX podem participar das alterações moleculares observadas em carcinomas epidermoides de cabeça e pescoço.

Utilização de biomaterial e osso autógeno em levantamento de seio maxilar: relato de caso clínico com avaliação histológica / Split-mouth design for biomaterial and autogenous bone combinations in sinus lifting procedures: a case report with histological evaluation

Os biomateriais são produtos auxiliares nos tratamentos de regeneração tecidual que apresentam soluções clínicas satisfatórias, elevado índice de sucesso e mínimo desconforto para o paciente. Dentre os biomateriais mais utilizados destaca-se a hidroxiapatita, uma matriz mineral biocompatível que apresenta similaridade com a composição do osso mineral e capacidade de osseocondução. Alguns produtos utilizam a associação da hidroxiapatita com o colágeno, que é um material biocompatível, biodegradável e osseoindutor. O objetivo deste trabalho foi avaliar a utilização de dois tipos de enxertos em procedimento de levantamento de seio maxilar. Em uma técnica utilizou-se biomaterial composto por hidroxiapatita e colágeno tipo I (Extra Graft XG-13) e na área contralateral adotamos o protocolo de osso autógeno associado a PRP (plasma rico em plaquetas). Amostras dos dois enxertos ósseos foram removidas após quatro meses, quando a área foi reaberta para colocação dos implantes e então foram comparadas histologicamente. Observou-se que no lado controle, utilizando osso autógeno, existiu formação de osso primário. Na contagem realizada pela grade de Merz comprova-se maior quantidade de tecido ósseo. Já no lado do biomaterial verificamos a formação óssea preenchendo os espaços entre os biomateriais. Na contagem pela grade de Merz verificou-se maior quantidade de biomaterial do que de tecido ósseo. Concluímos que no caso relatado, encontrou-se uma maior quantidade de tecido ósseo na área de enxerto autógeno, porém, o enxerto realizado com o biomaterial também viabilizou a formação óssea e promoveu um leito consistente e resistente para a colocação de implantes dentários.

Biomaterials are treatment adjuncts for tissue regeneration providing satisfactory clinical solutions, high success rates and minimum discomfort to the patients. Amongst the most widely used biomaterials there is hydroxyapatite, a biocompatible mineral matrix which shows similarity to the composition of bone mineral and osteoconductive properties. Some products use a combination of hydroxyapatite and collagen, a biocompatible, biodegradable and osteoinductive material. The objective of this study was to evaluate the use of two techniques to repair bone defects in the process of sinus lifting. In a split-mouth design, a biomaterial composed of hydroxyapatite and collagen type I (Extra Graft XG-13) was inserted on one side, and an autogenous bone combined with PRP (platelet-rich plasma) used as control on the other side. Samples of the two bone grafts were removed after four months with implant placement thereafter. Histological comparisons were performed with a Merz's grid. It was observed that control side demonstrated formation of primary bone and the area was composed mainly by osseous tissue. On the other hand, the experimental side showed bone formation filling the spaces between biomaterials, mainly composed by the grafted biomaterial. We concluded that there was a greater amount of bone tissue in the area of autogenous graft; however, the graft held with the biomaterial also allowed bone formation and promoted a consistent and resistant bed to the placement of dental implants.

Cisto de Gorlin: revisão de literatura / Gorlin's cyst: review of literature

O Cisto Odontogênico Epitelial Calcificante(COEC) é uma lesão incomum que apresenta comportamentoclínico variável e características histopatológicas peculiares,além de uma grande diversidade de terminologias, devido àssuas variáveis clínica, radiográfica e microscópica. Podeaparecer associado com outros tumores odontogênicos,mudando suas características. Somente em 1971 o COEC,também conhecido com Cisto de Gorlin, foi reconhecido pelaOMS como entidade patológica distinta, e classificado comolesão cística não neoplásica pelo Centro de ReferênciaInternacional para a Definição e Classificação Histológica dosTumores Odontogênicos, Cistos dos Maxilares e Lesões Afinsda OMS. Atualmente a Organização Mundial de Saúde define oCisto de Gorlin como tumor odontogênico, incluindo todas assuas variantes. Objetivo: Faremos neste trabalho uma revisãode literatura sobre o COEC e relataremos um caso clínico destaentidade, enfatizando aspectos clínicos, radiográficos ehistopatológicos relevantes para o diagnóstico e tratamentodesta patologia. Conclusão:O Cisto de Gorlin é uma entidadepatológica distinta, incomum e com características clínicas,radiográficas e histopatológicas variáveis; acomete tantomandíbula como maxila, preferencialmente na região anterior enão existe predileção por sexo ou raça, surgindo na maioria doscasos na 4a década de vida; apesar da ocorrência maisevidente em adultos, o COEC pode acometer crianças e oCirurgião-Dentista deve estar atento para realizar o diagnóstico desta patologia

Comparative immunoprofile of polymorphous low-grade adenocarcinoma and canalicular adenoma.

Immunohistochemistry is an important tool when dealing with salivary gland neoplasms. Canalicular adenoma and polymorphous low-grade adenocarcinoma may share some histologic characteristics that can cause difficulties in their separation. In the present study, cases of polymorphous low-grade adenocarcinoma and canalicular adenoma were submitted to a panel of antibodies to evaluate the differences in their immunoprofiles. The results obtained showed that, while vimentin is only expressed by polymorphous low-grade adenocarcinoma, CK7 and CK8 are present in both neoplasms. Therefore, vimentin is the best marker to differentiate between these tumors.