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4.
Med. oral patol. oral cir. bucal (Internet) ; 25(1): e84-e88, ene. 2020. tab
Artigo em Inglês | IBECS-Express | IBECS | ID: ibc-ET6-978

RESUMO

BACKGROUND: The frequency and distribution of oral potentially malignant disorders (OPMD) may vary among dif-ferent populations. The aim of the present study was to evaluate the clinical-pathological characteristics of OPMD diagnosed in a Brazilian oral pathology laboratory over a period of 11 years. MATERIAL AND METHODS: All cases diagnosed as leukoplakia, speckled leukoplakia, erythroplakia, and actinic chei-litis from 2005 to 2015 were analyzed. Clinical information was obtained from laboratory forms and histological information was obtained from histological slides stained with hematoxylin and eosin. RESULTS: the final sample was comprised of 684 cases, of which 292 were males and 392 were females. The mean age was 58 years. The anatomical site most often involved was the lateral border of the tongue (23%), followed by the lower lip (20%), and by the buccal mucosa/vestibule (18%). Leukoplakia accounted for 82% of the sample (564 cases). The mean size of the leukoplakia and speckled leukoplakia lesions was 13 mm (ranging from 1 to 100 mm) and 15 mm (ranging from 5 to 30 mm), respectively (p = 0.460). Males reported smoking and drinking alcohol more frequently than females (p = 0.001 and p < 0.0001, respectively). In half of the cases, dysplasia was not histo-logically detected, while slight dysplasia was detected in 28% of the cases. The lesions from patients aged from 41 to 80 years presented moderate and severe dysplasia more often than lesions from patients in other age groups. CONCLUSIONS: OPMD were more common in females in their sixties. Females were more frequently affected in all anatomical sites, except for the lips. Leukoplakia lesions were the most common OPMD, followed by actinic cheili-tis. The lateral border of the tongue was the most affected anatomical site. OPMD located in the floor of the mouth/sublingual mucosa and lesions from older patients presented severe epithelial dysplasia with greater frequency


No disponible

5.
Med. oral patol. oral cir. bucal (Internet) ; 25(1): e131-e136, ene. 2020. ilus, tab
Artigo em Inglês | IBECS-Express | IBECS | ID: ibc-ET6-984

RESUMO

BACKGROUND: The aim of the present study was to analyze the clinicopathological and the ultrastructural features of periapical actinomycosis (PA) cases. MATERIAL AND METHODS: Data from the files of an oral pathology laboratory were retrieved and the findings of histopathological analysis were evaluated. Hematoxylin-eosin (HE), a modified Brown & Brenn, and Grocott stains as well as ultrastructural analysis using scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDX) were utilized. RESULTS: Six cases were obtained, 4 females and 2 males, with a mean age of 34 year-old. Two cases were symptomatic, lower teeth and the anterior region were more commonly affected, and all cases were characterized by periapical radiolucencies. All cases presented sulfur granules with a ray-fungus or club-shaped pattern of the Splendore-Hoeppli phenomenon in HE-stained sections, with filamentous gram-positive bacteria aggregates highlighted by the modified Brown & Brenn stain. SEM analysis revealed abundant packed rod-like and filamentous bacteria associated with an extracellular amorphous material. EDX analysis showed predominant picks of calcium and sulfur in actinomycotic colonies. CONCLUSIONS: Our findings suggest that PA manifests either clinically and radiologically as a non-specific and heterogeneous condition and that the actinomycotic colonies consist in a calcium- and sulfur-rich matrix. Furthermore, the results highlight the importance of submitting periapical specimens after surgical removal to histopathological análisis


No disponible

6.
BMC Oral Health ; 19(1): 283, 2019 12 16.
Artigo em Inglês | MEDLINE | ID: mdl-31842866

RESUMO

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.


Assuntos
Implantes Dentários , Granuloma de Células Gigantes , Células Gigantes , Gengiva , Humanos , Masculino , Mandíbula , Pessoa de Meia-Idade
7.
Case Rep Surg ; 2019: 6840873, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31781466

RESUMO

The occurrence of metastatic tumors in the orofacial region is rare and may represent the first clinical manifestation of occult malignant disease. An orofacial lesion diagnosed as a metastatic tumor from a renal cell carcinoma in a 68-year-old man is reported. This metastatic tumor caused significant facial asymmetry involving the parotid gland and mandible regions, and the patient died four months after diagnosis. Here, we discuss the clinical aspects, the diagnostic approach, and the importance of early diagnosis to obtain a better response to treatment and provide longer survival time.

8.
Med. oral patol. oral cir. bucal (Internet) ; 24(6): e739-e745, nov. 2019. tab, ilus, graf
Artigo em Inglês | IBECS | ID: ibc-192233

RESUMO

BACKGROUND: Few cases or periimplant peripheral giant cell lesions (PGCL) have been reported in the literature. The aim of this study was to report 13 new cases of peri-implant PGCL and compare the expression of smooth muscle actin, Bcl-2 protein, GLUT-1, CD68, osteoprotegerin, receptor activator of nuclear factor kappa-B, Ki-67 and CD34 in these cases with PGCL and central giant cell lesions (CGCL). MATERIAL AND METHODS: Clinical data were retrieved from the laboratory records and histological analysis was performed using HE-stained slides. Immunohistochemical reactions for the above mentioned antibodies were performed and digitally scored. RESULTS: Peri-implant PGCL mostly affected the posterior mandible of adult females. CD68 and Bcl-2 expressions were higher in conventional PGCL and CGCL than in peri-implant PGCL (p = 0.033 for CD68 and p < 0.0001 for Bcl-2). Microvessel density was higher in conventional peripheral than in central and peri-implant PGCL (p = 0.002). Proliferative index of the mononuclear cells showed no statistically significant differences comparing the three groups but it was higher in peri-implant PGCL. CONCLUSIONS: The current study demonstrated that peri-implant PGCL is more common in the posterior mandible of adult females. There were some differences in microvessel density, proliferative activity and expression of CD68 and Bcl-2 among conventional PGCL, peri-implant and CGCL. Further studies are encouraged to better understand these early findings


No disponible


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Granuloma de Células Gigantes/cirurgia , Granuloma de Células Gigantes/patologia , Doenças da Gengiva/cirurgia , Doenças da Gengiva/patologia , Implantação Dentária , Imuno-Histoquímica
9.
J Clin Exp Dent ; 11(9): e845-e849, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31636878

RESUMO

Geographic stomatitis is an uncommon inflammatory condition of unknown etiology. It is characterized by reddish areas surrounded by white borders affecting any location in the oral cavity and presenting a migratory and cyclic pattern. The most common affected sites include buccal mucosa, labial mucosa and mucobuccal fold. Some patients can complain of pain or burning sensation. There are few reports in the literature about this entity and its relationship with other oral and cutaneous conditions such as fissured tongue, Reiter's syndrome, atopy and psoriasis has been suggested but it is still controversial. In the present study we describe three cases of geographic stomatitis associated with fissured tongue. Lesions involved the buccal mucosa, labial mucosa, soft palate and mucobuccal fold and all cases were diagnosed based on their clinical features. All patients were oriented about the innocuous behavior of the condition and were advised to avoid exposure of the lesions to irritation factors. The three presented cases highlighted the importance of a detailed oral mucosal examination by clinicians and provided further information about the natural history and clinical presentation of geographic stomatitis. Key words:Geographic stomatitis, geographic mucositis, geographic tongue.

10.
Int J Surg Pathol ; 27(6): 624-630, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30991859

RESUMO

Objective. To present 4 new cases of oral leiomyomatous hamartomas (OLH), describing its clinical, microscopical, and immunohistochemical features, and a literature review. Methods. The OLH cases were retrieved from the files of 2 Brazilian and 1 Peruvian oral pathology services. Clinical data were obtained from the pathology reports. Microscopical features were reviewed, and immunohistochemical reactions were performed. A review of the English-language literature about OLH was done. Results. The sample was composed of 3 females (4-, 10-, and 15-year-old) and 1 male (3-year-old). Three cases affected the dorsum of the tongue and one the incisive papilla, and all presented sessile or pedunculated smooth nodules. Microscopically, the lesions were composed of varying-size fascicles of smooth muscle fibers in a fibrous connective tissue background. Immunohistochemistry revealed positivity of the smooth muscle bundles for myogenic markers. The English-language literature review revealed 38 OLH cases reported, most were congenital or diagnosed up to 5 years old. The main locations were tongue and anterior maxilla. Conclusions. Although OLH is a rare lesion, it must be considered in the differential diagnosis of midline tongue or maxillary masses in newborns, infants, and youngsters.


Assuntos
Gengiva/patologia , Doenças da Gengiva/diagnóstico , Hamartoma/diagnóstico , Doenças da Língua/diagnóstico , Língua/patologia , Adolescente , Fatores Etários , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Gengiva/cirurgia , Doenças da Gengiva/congênito , Doenças da Gengiva/cirurgia , Hamartoma/congênito , Hamartoma/cirurgia , Humanos , Imuno-Histoquímica , Masculino , Maxila , Língua/cirurgia , Doenças da Língua/congênito , Doenças da Língua/cirurgia
11.
Artigo em Inglês | MEDLINE | ID: mdl-30316882

RESUMO

Cowden syndrome (CS) is a phosphatase and tensin homolog gene (PTEN)-associated condition characterized by multiple mucocutaneous hamartomas and an increased risk of malignancies. We reported an isolated case and another of several individuals in one family affected by CS. The isolated case showed typical features, including fibrocystic breast disease, benign thyroid nodules, and multiple papillomatous lesions in the face and oral cavity, and the cause was a novel nonsense mutation-guanine (G) to thymine (T) transition at position 940 (c.940 G>T)-in PTEN. In the family, the proband showed erythema nodosum, duodenal ulcer, intestinal polyps, cervical lipoma, renal cysts, and glaucoma, whereas multiple members of her family were found to have intestinal polyps, and a sister had been diagnosed with breast cancer at early age. An intronic mutation-T>G transition at the +32 position of intron 8 (c.1026+32 T>G)-was found in this family, with in silico analysis revealing the creation of a new donor splice site. This study confirmed the involvement of PTEN in CS and the variable clinical expressivity of disease.


Assuntos
Síndrome do Hamartoma Múltiplo , PTEN Fosfo-Hidrolase , Neoplasias da Mama , Feminino , Síndrome do Hamartoma Múltiplo/genética , Humanos , Mutação , PTEN Fosfo-Hidrolase/genética
12.
Gen Dent ; 66(5): e6-e11, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30188864

RESUMO

Lingual mandibular bone depressions mainly affect the posterior region of the mandible. Depressions in the anterior region are rare, frequently posing difficulties in diagnosis. The aim of this article is to present a case of an anterior lingual mandibular bone depression (ALMBD) that was radiographically superimposed on the roots of anterior teeth. A 43-year-old man was referred for evaluation of a slight depression on the lingual surface of the anterior mandible. The depression was associated with a well-defined radiolucent area superimposed on the roots of the right canine and incisors. All teeth in the area proved to be vital, and cone beam computed tomography (CBCT) revealed a lingual depression in the area. The final diagnosis was an ALMBD, and the patient underwent clinical and radiographic follow-up examinations for 22 months that revealed no alterations in the area. When anterior mandibular radiolucencies are superimposed on the roots of the adjacent teeth, ALMBDs should be considered in the differential diagnosis along with periapical cysts and granulomas. Radiographic and CBCT analyses are useful to avoid unnecessary endodontic and surgical approaches.


Assuntos
Doenças Mandibulares/diagnóstico , Adulto , Tomografia Computadorizada de Feixe Cônico , Diagnóstico Diferencial , Granuloma/diagnóstico , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Doenças Mandibulares/diagnóstico por imagem , Doenças Periapicais/diagnóstico , Doenças Periapicais/diagnóstico por imagem , Cisto Radicular/diagnóstico , Radiografia Dentária , Radiografia Panorâmica
13.
Rev. Rede cuid. saúde ; 12(1): 55-63, 15/07/2018.
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-998946

RESUMO

As imagens radiográficas periapicais, essenciais para a realização e para o acompanhamento do sucesso do tratamento endodôntico, em virtude de limitações técnicas, não são capazes de oferecer visualização anatômica de toda a estrutura dos elementos dentários. Técnicas contemporâneas de obtenção de imagens, como a tomografia computadorizada realizada pela técnica de feixe cônico (TCFC) parecem ter o potencial de avaliar de forma mais adequada a qualidade da obturação e do remanescente radicular, e o estado perirradicular. O objetivo deste trabalho foi realizar uma avaliação descritiva das imagens obtidas pela técnica de TCFC de 100 elementos dentários tratados endodonticamente, buscando os achados referentes ao estado perirradicular, as lesões de furca, à presença de núcleos intrarradiculares e as fraturas radiculares. Nos 100 dentes analisados, 83 (83%) apresentavam áreas compatíveis com a presença de alteração perirradicular. Dos dentes multirradiculares, 51% apresentavam presença de lesão de furca e 91% apresentavam rarefação perirradicular. Vinte dos 83 dentes com alterações perirradiculares (24%) apresentavam imagem sugestiva de fratura radicular. A TCFC revelou a existência de diversas alterações radiculares e perirradiculares nos dentes tratados endonticamente estudados nesta amostra, sugerindo sua utilidade no acompanhamento imaginológico após o tratamento endodôntico.


Periapical radiographs are essential for endodontic treatment and for following the tooth response after finishing the treatment. Unfortunately, due to their technical limitations, they are not capable of offering a complete anatomical view of the dental structure. More recent image techniques, such as cone-beam computed tomograph (CBCT), seem to offer a more complete picture of the pulp chamber obturation and the remaining dental structure, as well as the periradicular status. The aim of our study was to analyze CBCT images obtained from 100 endodontically treated teeth, focusing on the obturation of the pulp chamber, periapical status, interadicular alterations and root fractures. From the 100 teeth, 83 (83%) presented periradicular alterations. From multiradicular teeth, 51% presented with alterations in the interadicular area and 91% showed periradicular alterations. Twenty out 83 teeth presenting periradicular alterations (24%) showed also root fractures. CBCT images revealed the presence of several root and periradicular alterations in the endodontically treated teeth studied in this sample, suggesting its utility as an adjunctive auxiliary in the follow-up of teeth after endodontic treatment.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Tomografia Computadorizada por Raios X , Endodontia , Tomografia Computadorizada de Feixe Cônico , Raiz Dentária , Cavidade Pulpar
14.
Oral Dis ; 24(7): 1226-1234, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29908099

RESUMO

OBJECTIVE: Primordial odontogenic tumour (POT) is a rare benign mixed epithelial and mesenchymal odontogenic tumour. POT is composed of dental papilla-like tissue covered with cuboidal to columnar epithelium that resembles to inner and outer enamel epithelium of the enamel organ without dental hard tissue formation. The aim of this study was to examine pathogenesis of POT based on tumourigenesis and odontogenesis. SUBJECTS AND METHODS: Six cases of POT were submitted for study. DNA analysis and transcriptome analysis were performed by next-generation sequencing. Expression of amelogenin, ameloblastin and dentin sialophosphoprotein (DSPP) was examined by immunohistochemistry. RESULTS: There were no gene mutations detected in any of analysed 151 cancer- and 42 odontogenesis-associated genes. Enamel protein-coding genes of Amelx, Ambn and Enam, and dentin protein-coding genes of Col1a1, Dspp, Nes and Dmp1 were expressed, whereas expression of dentinogenesis-associated genes of Bglap, Ibsp and Nfic was negative or very weak suggesting inhibition of dentin formation in POT after odontoblast differentiation. Immunoreactivity of amelogenin, ameloblastin and DSPP was detected in POT. CONCLUSIONS: Pathogenesis of POT is considered to be genetically different from other odontogenic tumours. It is suggested that inhibition of enamel and dentin formation in POT is due to defects in dentin formation process.


Assuntos
Carcinogênese/genética , DNA de Neoplasias/análise , Odontogênese/genética , Tumores Odontogênicos/genética , Adolescente , Amelogenina/genética , Amelogenina/metabolismo , Carcinogênese/metabolismo , Criança , Pré-Escolar , Colágeno Tipo I/genética , Proteínas do Esmalte Dentário/genética , Proteínas do Esmalte Dentário/metabolismo , Proteínas da Matriz Extracelular/genética , Proteínas da Matriz Extracelular/metabolismo , Feminino , Perfilação da Expressão Gênica , Humanos , Sialoproteína de Ligação à Integrina/genética , Masculino , Fatores de Transcrição NFI/genética , Nestina/genética , Osteocalcina/genética , Fosfoproteínas/genética , Fosfoproteínas/metabolismo , Sialoglicoproteínas/genética , Sialoglicoproteínas/metabolismo
15.
J Appl Oral Sci ; 26: e20170455, 2018 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-29898177

RESUMO

OBJECTIVE: This study evaluated the expression of pro-inflammatory (IL-1ß, IL-6, IFN-γ and TNF-α) and anti-inflammatory (IL-4 and TGF-ß) cytokines in apical periodontitis lesions. Correlations between these cytokines and clinical and cone-beam computed tomographic (CBCT) data were also assessed. MATERIAL AND METHODS: Apical periodontitis lesions' data were obtained from 27 patients subjected to periradicular surgery. Specimens were processed for histopathologic and immunohistochemical analysis. Sections were evaluated according to the amount of positive staining for each antibody. Expression levels of the target mediators were compared with clinical and CBCT data. RESULTS: Twenty lesions were diagnosed as granuloma and 7 as cyst. In granulomas, IL-4 expression was significantly higher than IL-6 (p=0.001) and TNF-α (p=0.001). There was a significant relationship between high levels of TNF-α and lesions <5 mm (p=0.017). In cysts, IL-6 expression was significant lower than IL-4 (p=0.001) and IFN-γ (p=0.004). There was a significant relationship between high levels of TGF-ß and endodontic treatment performed ≤4 years before (p=0.045). In general, IL-4 was the most expressed mediator in both cysts and granulomas. CONCLUSIONS: There was a balance between the expression of pro-inflammatory and anti-inflammatory cytokines associated with the chronic periradicular inflammatory process. TNF-α and TGF-ß were related to some clinical and CBCT data.


Assuntos
Citocinas/análise , Granuloma Periapical/patologia , Granuloma Periapical/cirurgia , Cisto Radicular/patologia , Cisto Radicular/cirurgia , Adulto , Idoso , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Valores de Referência , Estatísticas não Paramétricas , Resultado do Tratamento
16.
J Endod ; 44(7): 1105-1109, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29941110

RESUMO

INTRODUCTION: The aim of the present study was to compare the immunoexpression of CD34, intercellular adhesion molecule-1 (ICAM-1), and podoplanin and the presence of mast cells with clinical, demographic, radiologic, and histologic features from periapical granulomas, periapical cysts, and residual cysts. METHODS: Thirty-one lesions (5 granulomas, 15 periapical cysts, and 11 residual cysts) were selected. Histologic sections in silanized slides were used for the immunohistochemical reactions. The analysis of the images was performed by using an optical microscope, and data were analyzed with 5% significance (P < .05). RESULTS: Cysts presented atrophic and hyperplastic epithelium in 11 cases (35.5%) and 15 cases (48.8%), respectively (P > .05). The intensity of the inflammatory infiltrate was similar when comparing the 3 groups (P > .05). CD34 and podoplanin expression and the presence of mast cells were similar when comparing the 3 groups; ICAM-1 expression was more intense in granulomas than cysts (P < .05). There were no statistically significant differences associated with the expression of the evaluated markers according to the intensity of the inflammatory infiltrate. CONCLUSIONS: There were no differences in the expression of CD34 and podoplanin and in the presence of mast cells when the 3 groups were compared. ICAM-1 expression was more common in periapical granulomas.


Assuntos
Antígenos CD34/metabolismo , Molécula 1 de Adesão Intercelular/metabolismo , Mastócitos/metabolismo , Glicoproteínas de Membrana/metabolismo , Doenças Periapicais/metabolismo , Granuloma Periapical/metabolismo , Cisto Radicular/metabolismo , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Mastócitos/patologia , Pessoa de Meia-Idade , Doenças Periapicais/patologia , Granuloma Periapical/patologia , Tecido Periapical/metabolismo , Tecido Periapical/patologia , Cisto Radicular/patologia , Estudos Retrospectivos , Adulto Jovem
17.
Angle Orthod ; 88(2): 179-186, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29131664

RESUMO

OBJECTIVES: To analyze histologic findings of bone remodeling at the time of surgery and 90 days later at corticotomized and noncorticotomized sites. MATERIALS AND METHODS: Eight adult patients with bilaterally inclined mandibular molars were included in this split-mouth study. Corticotomy was performed on the test side, and bone was harvested on both mandibular hemi-arches. Bone blocks were shipped to Forsyth Institute lab (Boston, Mass). After surgery, cantilevers were activated to upright inclined mandibular molars on both sides. Approximately 90 days after surgery, new mandibular bone blocks were harvested from test and control sites. Histologic analyses were performed on both groups (test and control sides) at two time points: baseline (T0) and 90 days after surgery (T90). Bone blocks were stained with hematoxylin and eosin, and Masson's trichrome. The protocols enabled screening of new bone formation and collagen in mineralized and nonmineralized connective tissue. Outcomes were compared using a clustered generalized estimating equations model Results: The test group at T90 exhibited an increase of 16% of primary bone ( P < .05), an increase of 6.6 in osteocytes quantity ( P = .039), and an increase of 4.06 in reversal lines quantity ( P = .924). Both groups exhibited a decrease in the inorganic proportion. CONCLUSIONS: The intentional bone injury performed in adult patients undergoing orthodontic treatment can be considered temporary and reversible. Evidence indicates that baseline bone characteristics are unaltered.


Assuntos
Processo Alveolar/cirurgia , Técnicas de Movimentação Dentária , Adulto , Biópsia , Feminino , Humanos , Masculino , Má Oclusão/cirurgia , Dente Molar/cirurgia , Osteoblastos/metabolismo , Osteócitos/metabolismo , Técnicas de Movimentação Dentária/métodos
18.
Artigo em Inglês | MEDLINE | ID: mdl-29104033

RESUMO

OBJECTIVE: To describe the oral and maxillofacial manifestations of patients diagnosed with chronic kidney disease-mineral and bone disorders. STUDY DESIGN: Over a 13-year period, clinicopathologic data of patients diagnosed with CKD-MBD who had oral and maxillofacial alterations were retrieved from the files of 4 Brazilian institutions. Data included clinical, radiographic, microscopic, and biochemical findings; treatment employed; and follow-up status. RESULTS: Twenty-one cases were identified, with 13 patients diagnosed as brown tumor of hyperparathyroidism (BTH) and 8 as osteitis fibrosa/renal osteodystrophy (OF/RO) (4 of them clinically consistent with Sagliker syndrome). The mean age was 32.7 years, and the mandible was the most affected site (42.8%). OF/RO had an ill-defined "ground glass" radiographic appearance, and BTH produced well-defined radiolucent images. Biochemically the following mean values were obtained: parathormone 1511.07 pg/mL, calcium 9.25 mg/dL, phosphorus 5.19 mg/dL, alkaline phosphatase 941.55 U/L, urea 125.42 mg/dL, and creatinine 7.14 mg/dL. Treatment comprised vitamin D and calcium intake, parathyroidectomy, hemodialysis, renal transplantation, and local surgery. During follow-up, 5 patients with BTH were free of lesions, whereas 2 affected by OF/RO/Sagliker syndrome died. CONCLUSIONS: Oral and maxillofacial manifestations of BTH and OF/RO are uncommon, but they can be associated with an important life-threatening scenario.


Assuntos
Distúrbio Mineral e Ósseo na Doença Renal Crônica/complicações , Doenças da Boca/etiologia , Adolescente , Adulto , Idoso , Brasil , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
20.
J. appl. oral sci ; 26: e20170455, 2018. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-954524

RESUMO

Abstract Objective: This study evaluated the expression of pro-inflammatory (IL-1β, IL-6, IFN-γ and TNF-α) and anti-inflammatory (IL-4 and TGF-β) cytokines in apical periodontitis lesions. Correlations between these cytokines and clinical and cone-beam computed tomographic (CBCT) data were also assessed. Material and Methods: Apical periodontitis lesions' data were obtained from 27 patients subjected to periradicular surgery. Specimens were processed for histopathologic and immunohistochemical analysis. Sections were evaluated according to the amount of positive staining for each antibody. Expression levels of the target mediators were compared with clinical and CBCT data. Results: Twenty lesions were diagnosed as granuloma and 7 as cyst. In granulomas, IL-4 expression was significantly higher than IL-6 (p=0.001) and TNF-α (p=0.001). There was a significant relationship between high levels of TNF-α and lesions <5 mm (p=0.017). In cysts, IL-6 expression was significant lower than IL-4 (p=0.001) and IFN-γ (p=0.004). There was a significant relationship between high levels of TGF-β and endodontic treatment performed ≤4 years before (p=0.045). In general, IL-4 was the most expressed mediator in both cysts and granulomas. Conclusions: There was a balance between the expression of pro-inflammatory and anti-inflammatory cytokines associated with the chronic periradicular inflammatory process. TNF-α and TGF-β were related to some clinical and CBCT data.

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