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1.
Biomolecules ; 11(8)2021 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-34439823

RESUMO

Alveolar osteitis (AO) is a common complication following the extraction of the teeth, particularly the lower third molars. It starts within a few days after the extraction and manifests mainly as pain in the extraction site. Several strategies of treatment are available in order to relieve pain and heal the extraction wound. Recently, a novel medical device combining hyaluronic acid (HA) and octenidine (OCT) was introduced for the treatment of AO. This series of case reports aims to summarize the initial clinical experiences with this new device and to highlight factors possibly interfering with this treatment. The medical documentation of five patients with similar initial situations treated for AO with HA + OCT device was analyzed in detail. Smoking and previous treatment with Alveogyl (Septodont, Saint-Maur-des-Fossés, France) were identified as factors interfering with the AO treatment with the HA + OCT device. In three patients without these risk factors, the treatment led to recovery within two or three days. The patient pretreated with Alveogyl and the smoker required six and seven applications of the HA + OCT device, respectively. According to these initial observations, it seems smoking and previous treatment with Alveogyl prolong the treatment of AO using the HA + OCT device that, in turn, shows a rapid effect if these risk factors are not present.


Assuntos
Alvéolo Seco/tratamento farmacológico , Ácido Hialurônico/uso terapêutico , Iminas/uso terapêutico , Dor/tratamento farmacológico , Piridinas/uso terapêutico , Cicatrização/efeitos dos fármacos , Adolescente , Adulto , Creosoto/efeitos adversos , Combinação de Medicamentos , Alvéolo Seco/etiologia , Alvéolo Seco/fisiopatologia , Alvéolo Seco/cirurgia , Equipamentos e Provisões , Feminino , Humanos , Hidrocarbonetos Iodados/efeitos adversos , Pessoa de Meia-Idade , Dente Molar/cirurgia , Dor/etiologia , Dor/fisiopatologia , Dor/cirurgia , Fatores de Risco , Fumar/efeitos adversos , Extração Dentária/efeitos adversos , Resultado do Tratamento , Cicatrização/fisiologia
2.
Acta Medica (Hradec Kralove) ; 64(2): 101-107, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34331430

RESUMO

Iatrogenic mandible fracture is a rare complication of a tooth extraction with an incidence between 0.0033-0.0034%. This study retrospectively analyzes a total of 8 patients who underwent lower molar extraction associated with mandible fracture during tooth removal in the period from April 2006 to March 2019. The assessed parameters were age and sex of patients, method of tooth extraction, side distribution of fracture, type of extracted tooth, the position of a lower third molar, presence of bone pathological lesion formed in connection with a tooth, displacement of bone fragments, and sensory impairment in the innervation area of the mental nerve. The position and impaction of the lower third molars were evaluated according to Pell and Gregory's classification and Winter's classification. One fracture was left-sided, and 7 fractures were right-sided. In 6 cases, Winter's extraction elevator was used. In 7 patients, the mandible fracture was treated surgically by performing stable osteosynthesis with the plates and screws. One patient was treated conservatively. This work analyzes the causes of iatrogenic mandible fractures and provides recommendations to reduce the risk of their occurrence.


Assuntos
Fraturas Mandibulares/etiologia , Dente Serotino/cirurgia , Extração Dentária/efeitos adversos , Feminino , Humanos , Doença Iatrogênica , Masculino , Fraturas Mandibulares/terapia , Estudos Retrospectivos
3.
Artigo em Inglês | MEDLINE | ID: mdl-31581430

RESUMO

Alveolar Osteitis (AO) is a complication following the extraction of a tooth. AO manifests through localized pain in, and around, the extraction site, where the post-operative blood clot has been disintegrated. The aim of this single cohort study was to evaluate the outcome of a treatment of AO, using a pharmacological device composed of hyaluronic acid and octenidine dihydrochloride. The tested device is a sponge-like material, composed solely of a fully dissoluble medicaments (hyaluronic acid, calcium chloride, and octenidine dihydrochloride). It was designed to serve as a non-toxic, slow-dissolving antiseptic, that adheres to mucosa and obturates the wound. This study includes 58 subjects who were diagnosed with AO. The tested device was administered once daily until local pain subsided to < 20 mm of the Visual Analog Scale (VAS). The treatment was considered effective when the pain subsided to < 20 mm VAS in < 8 days of treatment; as per comparative studies. Our findings provide a statistically significant success rate of 96.0% (95.0% confidence interval of 75.75% to 97.8%) after pharmacological device administrations. No adverse medical effects were detected. Acquired data confirmed that lyophilized hyaluronic acid, combined with octenidine, is effective for the treatment of AO. The results are clinically important as AO is a common complication after third molar extractions.


Assuntos
Anti-Infecciosos Locais/uso terapêutico , Alvéolo Seco/tratamento farmacológico , Ácido Hialurônico/uso terapêutico , Piridinas/uso terapêutico , Implantes Absorvíveis , Adulto , Anti-Infecciosos Locais/administração & dosagem , Estudos de Coortes , Feminino , Humanos , Ácido Hialurônico/administração & dosagem , Masculino , Pessoa de Meia-Idade , Piridinas/administração & dosagem , Extração Dentária/efeitos adversos
4.
Pathol Res Pract ; 213(2): 133-142, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28069272

RESUMO

The aim of the study was detailed clinicopathological investigation of SMARCB1/INI1-deficient sinonasal carcinomas, including molecular genetic analysis of mutational status and DNA methylation of selected protooncogenes and tumor suppressor genes by means of next generation sequencing (NGS) and methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA). A total of 4/56 (7%) cases of SMARCB1/INI1-deficient carcinomas were detected among 56 sinonasal carcinomas diagnosed over a 19year period using immunohistochemical screening. The series comprised 3 males and 1 female, aged 27-76 years (median 64 years). All tumors arose in the nasal cavity. Three neoplasms were diagnosed in advanced stage pT4. During the follow-up period (range 14-111 months (median 72 months)), three tumors recurred locally, but none of the patients developed regional or distant metastases. Ultimately, two patients died due to the tumor. Microscopically, all tumors consisted of infiltrating nests of polygonal basaloid cells with a variable component of rhabdoid cells with eosinophilic cytoplasm. Immunohistochemically, there was almost diffuse expression of cytokeratins (CK), p16, p40 and p63 in all cases, while expression of CK5/6, CK7 and vimentin was only focal or absent. The detection of NUT gave negative results. In three cases, the absence of SMARCB1/INI1 expression was due to deletion of SMARCB1/INI1 gene. Methylation of SMARCB1/INI1 gene was not found. One tumor harbored HPV18 E6/E7 mRNA. All 12 genes (BRAF, BRCA1, BRCA2, KIT, EGFR, KRAS, NRAS, PDGFRA, PIK3CA, PTEN, RET, and ROS1) tested for mutations using NGS were wild-type. Regarding DNA methylation, all four SMARCB1/INI1-deficient tumors showed methylation of RASSF1 gene by means of MS-MLPA. There was a statistically significant difference in RASSF1 gene methylation between SMARCB1/INI1-deficient and SMARCB1/INI1-positive tumors (p=0.0095). All other examined genes (ATM, BRCA1, BRCA2, CADM1, CASP8, CD44, CDKN1B, CDKN2A, CDKN2B, CHFR, DAPK1, ESR1, FHIT, GSTP1, HIC1, KLLN, MLH1a, MLH1b, RARB, and VLH) were unmethylated. In summary, we described four cases of SMARCB1/INI1-deficient sinonasal carcinoma with detailed clinicopathological data indicating that these tumors can be regarded as a distinct entity with aggressive behaviour. For the first time, we performed analysis of DNA methylation in SMARCB1/INI1-deficient sinonasal carcinomas, reporting on significantly higher methylation of RASSF1 gene in this neoplasm.


Assuntos
Carcinoma/genética , Metilação de DNA , Neoplasias do Seio Maxilar/genética , Proteína SMARCB1/genética , Proteínas Supressoras de Tumor/genética , Adulto , Idoso , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo , Carcinoma/metabolismo , Carcinoma/patologia , Feminino , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Imuno-Histoquímica , Masculino , Neoplasias do Seio Maxilar/metabolismo , Neoplasias do Seio Maxilar/patologia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Proteína SMARCB1/metabolismo , Proteínas Supressoras de Tumor/metabolismo
5.
Int J Surg Pathol ; 24(7): 586-94, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27240862

RESUMO

Ectomesenchymal chondromyxoid tumor (ECT) is a rare benign tumor of uncertain lineage, which almost exclusively affects the anterior tongue. Herein, we report 2 cases of ECT occurring in 58- and 56-year-old males on the right and on the left side of the dorsum of the anterior tongue, measuring 18 mm and 10 mm, respectively. Despite positive resection margin in one case, none of the tumors recurred during follow-up of 6 and 5 years. Microscopically, both tumors had lobular architecture with a mixture of solid, microcystic, and chondromyxoid areas. The tumor cells were polygonal or elongated and showed mild atypia in one case. Immunohistochemically, both tumors showed diffuse expression of vimentin and focal positivity of CD10 and of smooth muscle actin. Regarding neural tissue-related markers, there was nearly diffuse expression of CD56 and neuron-specific enolase and focal positivity of PGP 9.5 in both cases and variable expression of CD57, synaptophysin, glial fibrillary acidic protein, and S-100 protein. Interestingly, we observed diffuse expression of SOX10 in one case. In both tumors, diffuse strong nuclear expression of cyclin D1 was present, without CCND1/IGH translocation or CCND1 amplification. The EWSR1 gene rearrangement was not detected. To the best of our knowledge, expression of SOX10, which may support neural crest origin of this peculiar lesion, has not been reported in ECT. The significance of strong cyclin D1 expression remains to be further investigated.


Assuntos
Ciclina D1/biossíntese , Mesenquimoma/patologia , Mixoma/patologia , Neoplasias da Língua/patologia , Biomarcadores Tumorais/análise , Ciclina D1/análise , Humanos , Imuno-Histoquímica , Hibridização in Situ Fluorescente , Masculino , Mesenquimoma/diagnóstico , Microscopia Eletrônica de Transmissão , Pessoa de Meia-Idade , Mixoma/diagnóstico , Neoplasias da Língua/diagnóstico
6.
Virchows Arch ; 467(4): 405-15, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26229021

RESUMO

The aim of the study was to investigate prevalence of high-risk human papillomavirus (HR-HPV) infection in sinonasal carcinomas by immunohistochemistry, in situ hybridization, and polymerase chain reaction, detecting p16(INK4a) protein (p16) expression and presence of both HPV DNA and HPV E6/E7 messenger RNA (mRNA). The study comprised 47 males and 26 females, aged 23-83 years (median 62 years), mostly (67 %) with a squamous cell carcinoma (SCC). Of the tumors, 53 % arose in the nasal cavity, 42 % in the maxillary sinus, and 5 % in the ethmoid complex. The follow-up period ranged 1-241 months (median 19 months). HPV16, HPV18, or HPV35 were detected in 18/73 (25 %) tumors, 17 SCCs, and 1 small cell neuroendocrine carcinoma. There was a strong correlation between results of HPV detection methods and p16 expression (p < 0.005). HPV-positive SCCs occurred more frequently in smokers (p = 0.04) and were more frequently p16-positive (p < 0.0001) and nonkeratinizing (p = 0.02), the latter occurring more commonly in nasal cavity (p = 0.025). Median survival for HPV-positive SCC patients was 30 months, while for HPV-negative SCC patients was 14 months (p = 0.23). In summary, we confirm that HR-HPV is actively involved in the etiopathogenesis of a significant subset of sinonasal SCCs. p16 may be used as a reliable surrogate marker for determination of HPV status also in sinonasal SCCs. Although we observed a trend toward better overall survival in HPV-positive SCCs, the prognostic impact of HPV status in sinonasal carcinomas needs to be elucidated by further studies.


Assuntos
Carcinoma de Células Escamosas/virologia , Neoplasias de Cabeça e Pescoço/virologia , Papillomaviridae/isolamento & purificação , Neoplasias dos Seios Paranasais/virologia , RNA Mensageiro/análise , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/patologia , Inibidor p16 de Quinase Dependente de Ciclina , DNA Viral/análise , Feminino , Neoplasias de Cabeça e Pescoço/mortalidade , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Proteínas de Neoplasias/análise , Proteínas Oncogênicas Virais/genética , Proteínas E7 de Papillomavirus/genética , Neoplasias dos Seios Paranasais/mortalidade , Neoplasias dos Seios Paranasais/patologia , Proteínas Repressoras/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Carcinoma de Células Escamosas de Cabeça e Pescoço , Transcrição Genética
7.
Artigo em Inglês | MEDLINE | ID: mdl-24108250

RESUMO

AIM: This article covers the authors' experience with the treatment of bisphosphonate-related osteonecrosis of the jaw in 11 individuals. METHODS: A retrospective study of patients diagnosed and treated for bisphosphonate-related osteonecrosis of the jaw at the Department of Dentistry, University Hospital Hradec Králové during the period January 2006 to October 2012. The treatment protocol consisted of antimicrobial mouth rinses and systemic antibiotic administration according to the stage of the disease. Additional surgical debridement and sequestrectomy in combination with antimicrobial therapy was performed in two cases. RESULTS: Complete healing was achieved in six patients. In two cases, satisfactory healing was noted. Stage of the disease was lowered and only a small area of asymptomatic necrotic bone of up to five mm in diameter persisted. Two patients developed a stable disease without progression. In one patient, the disease progressed to the third stage with osteonecrosis involving all quadrants of both jaws. CONCLUSION: From these data it was concluded that conservative approach in the treatment of bisphosphonate-related osteonecrosis of the jaw led to symptom regression but was not curative. Surgical intervention, however, bears the risk of further progression of the osteonecrosis and must be carefully planned with respect to the patient's general health status and life expectancy. The treatment of bisphosphonate-related osteonecrosis of the jaw is generally difficult. For this reason, prevention plays a predominant role in the management of the disease.


Assuntos
Antibacterianos/administração & dosagem , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/tratamento farmacológico , Antissépticos Bucais/administração & dosagem , Idoso , Idoso de 80 Anos ou mais , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/cirurgia , Conservadores da Densidade Óssea/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Difosfonatos/efeitos adversos , Feminino , Humanos , Neoplasias Renais/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/tratamento farmacológico , Osteoporose/tratamento farmacológico , Estudos Retrospectivos , Resultado do Tratamento , Cicatrização
8.
Virchows Arch ; 466(3): 255-63, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25522952

RESUMO

The aim of the study was to test the hypothesis that oral plasma cell granuloma may represent a mucosal manifestation of immunoglobulin (Ig)G4-related disease (IgG4-RD) in the oral cavity. The study sample comprised two males and four females, aged 54-79 years (median 62 years). The lesions were localized on gingival/alveolar mucosa (four cases), hard palate, and floor of the mouth, measuring 17-40 mm (median 31 mm). The duration of the lesions ranged from 3 months to several years. Information on IgG4 serum levels was available for two patients, and these were increased to 1.85 and 1.65 g/L, respectively. The follow-up period ranged 11-30 months (median 13 months). None of the lesions recurred, and none of the patients developed any manifestation of IgG4-RD. Microscopically, all cases presented as nodular lesions composed of numerous polyclonal plasma cells admixed with lymphocytes, histiocytes, mast cells, and eosinophils, set within collagenized stroma in variable proportions. Obliterative phlebitis was observed in two cases. The number of IgG4-positive plasma cells ranged between 51 and 142 per HPF (median 114), while the IgG4/IgG ratio values ranged between 0.16 and 0.72 (median 0.44) and were above 0.40 in three cases. Based on international criteria, two cases were diagnosed as definite and one as probable IgG4-RD. Oral plasma cell granuloma is a heterogeneous group of lesions, and a subset may represent a mucosal manifestation of IgG4-RD in the oral cavity.


Assuntos
Granuloma de Células Plasmáticas/diagnóstico , Granuloma de Células Plasmáticas/imunologia , Doenças do Sistema Imunitário/diagnóstico , Imunoglobulina G/metabolismo , Doenças da Boca/diagnóstico , Doenças da Boca/imunologia , Mucosa Bucal/imunologia , Idoso , Diagnóstico Diferencial , Eosinófilos/patologia , Feminino , Gengivite/diagnóstico , Gengivite/imunologia , Gengivite/patologia , Granuloma de Células Plasmáticas/patologia , Histiócitos/patologia , Humanos , Doenças do Sistema Imunitário/imunologia , Doenças do Sistema Imunitário/patologia , Masculino , Mastócitos/patologia , Pessoa de Meia-Idade , Doenças da Boca/patologia , Mucosa Bucal/patologia , Plasmócitos/patologia , Fatores de Tempo
9.
Histopathology ; 58(7): 1157-63, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21438912

RESUMO

AIMS: Chronic sclerosing sialadenitis (CSS) has been proposed recently to be a member of the group of IgG4-related diseases in Japanese and American series. The aim of our study was to validate these results in a cohort of European patients. METHODS AND RESULTS: Our CSS series included four females and two males, aged 32-76 years, all presenting with unilateral swelling of submandibular gland. Microscopically, all CSS-cases showed similar morphology with preservation of lobular architecture accentuated by cellular fibrous bands, dense lymphoplasmacytic inflammation and varied acinar atrophy. Ductal lymphocytes were detected in three cases. In five cases, the presence of intraductal secretory material accompanied by parenchymal neutrophils was observed. Obliterative phlebitis was seen in three cases. The inflammatory infiltrate was composed of T and B lymphocytes and polyclonal plasma cells. The median number of IgG-positive plasma cells per high-power field (HPF) was 157; median number of IgG4-positive plasma cells per HPF was 133. Median value of the IgG4:IgG ratio was 0.84. CONCLUSIONS: This is the first European series to demonstrate that CSS belongs to the family of IgG4-related disease. Unlike previous studies, in CSS we found rarely described ductal lymphocytes and parenchymal neutrophils. CSS displays consistent morphology with increased numbers of IgG4-positive plasma cells, and should be regarded as a member of the IgG4-related disease group.


Assuntos
Doenças Autoimunes/patologia , Imunoglobulina G/imunologia , Sialadenite/patologia , Glândula Submandibular/patologia , Adulto , Idoso , Doenças Autoimunes/imunologia , Contagem de Células , Estudos de Coortes , Feminino , Humanos , Linfócitos/patologia , Masculino , Pessoa de Meia-Idade , Neutrófilos/patologia , Plasmócitos/imunologia , Plasmócitos/patologia , Ductos Salivares/patologia , Esclerose , Sialadenite/imunologia , Glândula Submandibular/imunologia
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