Effectiveness of a tissue conditioner containing antifungals in a rat model of denture stomatitis.

AIM: This study investigated the effectiveness of a drug-modified tissue conditioner in an animal model of denture stomatitis. METHODS AND RESULTS: Wistar rats wore a Candida albicans-contaminated palatal device for 4 days. Next, nystatin (Nys) or chlorhexidine (Chx) were added to a tissue conditioner in their raw or ß-cyclodextrin-complexed (ßCD) forms at their minimum inhibitory concentrations. As controls, one group was not subjected to any procedure (NC), one group used sterile devices, one group had denture stomatitis but was not treated (DS), and another had the devices relined with the tissue conditioner without the addition of any drug (Soft). After 4 days of treatment, treatment effectiveness was assessed visually, histologically, and through CFU count, and myeloperoxidase (MPO) and N-acetylglucosaminidase (NAG) assays. Rats from the Soft, Nys, Nys:ßCD, and Chx groups presented a significant decrease in the microbial load compared with the untreated group. Treatment groups showed lower MPO and NAG activity compared to the non-treated group. CONCLUSIONS: The addition of antifungals to a soft tissue conditioner can be a promising approach for denture stomatitis treatment.

A novel rat model of denture stomatitis and the role of antibiotics in the development of the disease.

This study compared different conditions to establish a rat model of denture stomatitis. Immunocompetent Wistar rats were divided into two groups (n = 35): Tetracycline = administration of 0.83 mg/ml of tetracycline hydrochloride 7 days before induction of denture stomatitis and amoxicillin = administration of 0.156 mg/ml of amoxicillin with clavulanic acid 4 days before induction of denture stomatitis. A suspension of Candida albicans was inoculated on the palate followed by the use of a palatal device contaminated with C. albicans inoculum for 4 days to induce denture stomatitis. As controls, some rats were not submitted to any procedure or used a sterile palatal device for 4 days. The development of denture stomatitis was confirmed by visual analysis, colony-forming units per milliliter (CFU/ml) count, histopathological and immunohistochemical analyses, and through myeloperoxidase (MPO) and N-acetylglucosaminidase (NAG) assays. Rats were euthanized right after device removal (T0), 4 (T4), or 6 (T6) days after device removal. Tetracycline improved the development of the disease, with more severe clinical signs at T0. Similar results were observed in the CFU/ml count and in the histometric and immunohistochemical analyses. Higher MPO expression was detected in the palates of the tetracycline group (P = .006). Despite the subtle differences between antibiotics, tetracycline showed better results in inducing and maintaining denture stomatitis for at least 4 days after device removal.

Denture stomatitis is an oral inflammatory disease with high recurrence rates. Different animal models have been reported in the literature, but some gaps still need to be addressed. A reproducible in vivo model should be established to test new treatment approaches.

Characterization of the Activity of Croton tiglium Oil in Hetter's Very Heavy Phenol-Croton Oil Chemical Peels.

BACKGROUND: Croton oil (CO) is used by dermatologists and plastic surgeons in deep chemical peels. It is mixed with phenol, water, and a soap in Baker-Gordon's or Hetter's formulas. There is controversy as to whether CO or phenol is the active agent in the dermal effect of deep chemical peels. OBJECTIVE: To better clarify the role of CO in deep peels, by identification of active compounds in commercially available CO in the United States and biological effects in vivo. MATERIALS AND METHODS: Liquid chromatography-tandem mass spectrometry on CO and a domestic pig model experiment using 3 different formulas: G1: 5% Septisol (SEP), G2: 1.6% croton oil in 35% phenol with 5% SEP, and G3: 35% phenol with 5% SEP. RESULTS: Liquid chromatography-tandem mass spectrometry indicated the presence of phorbol esters. G1 was null overall. Extent of the coagulative necrosis: G2 > G3. Vascular ectasia: G2 > G3. Inflammation pattern: intense neutrophilic inflammatory band in G2 versus mild, sparse, perivascular mononuclear cell infiltrate in G3. Neocollagenesis: pronounced in G2, negligible in G3. CONCLUSION: Coagulative necrosis of the epidermis, superficial fibroblasts, and vasculature can be attributed to the action of phenol. Phorbol esters on CO could be responsible for the dense deep acute inflammation and the distinctive neocollagenesis.

Effect of sealing infected dentin with glass ionomer cement on the abundance and localization of MMP-2, MMP-8, and MMP-9 in young permanent molars in vivo.

BACKGROUND: The study of MMPs' behavior in carious lesions contributes to the understanding of the mechanisms involved in dentin reorganization after restoration. AIM: To compare the abundance and localization of MMPs 2, 8, and 9 in infected dentin before and after restoration. DESIGN: The sample consisted of 23 young permanent molars with active deep carious lesions. Infected carious dentin samples were collected from the same tooth at baseline and 60 days after cavity lining with GIC and composite resin restoration and processed for immunohistochemistry assays. After digital images were obtained, two calibrated operators analyzed the samples according to the immunostaining intensity and the MMPs' localization. Chi-square test was used for statistical analysis. RESULTS: The intensity of immunostaining for MMP-8 was reduced after 60 days (P = 0.02), and no difference was observed for MMP-2 (P = 0.32) and MMP-9 (P = 0.14). The MMPs' distribution was generalized in the intertubular dentin and absent or located in the intratubular dentin, regardless of the period. CONCLUSION: The sealing of infected carious dentin in young permanent molars reduced the expression of MMP-8, which is consistent with the initial remodeling process of the dentin matrix.

Description of a Rat Palatal Acrylic Plate That Can Be Relined.

PURPOSE: The objective of this article is to describe a method to construct an intraoral acrylic device that permits a reline material to be added to the inner surface of the palatal plate. MATERIALS AND METHODS: Fifteen 60-day-old adult female rats (Rattus Norvegicus Albinus Wistar), weighing 150 to 250 g were used for this study and allocated to three groups (n = 5): G1, animals wearing a heat-polymerized acrylic resin palatal plate (Lucitone 550) for 14 days; G2, animals wearing a heat-polymerized acrylic resin palatal plate (Lucitone 550) relined with Tokuyama Rebase II for 14 days; and G3, animals maintained under the same conditions as the experimental groups, without wearing palatal plates for 14 days. The manipulation of the animals followed the guidelines of the Brazilian College of Animal Experimentation, under the approval of the animal ethics committee of the State University of Ponta Grossa. The palatal plates covered the whole palate, were fixed in the molar region with light-cured resin, and were kept there for 14 days. The animals received a paste diet and water ad libitum. Before and after the trial period, the rats were weighed individually on a precision scale. Statistical analysis was performed using a two-way analysis of variance (α = 0.05) test for comparison of the animals' weight (g) at time 0 and after 14 days of using the palatal plate. RESULTS: No statistical differences were observed regarding the weight of the animals among the experimental groups in the study. CONCLUSIONS: The individual master impressions, the molar teeth coverage, and the method of cementation with nonadhesive composite resin provided good stability for the palatal plate showed in this study, not disturbing the eating habits and nutrition of the animals. This model seems reproducible, offering adequate histopathological evaluation. Differences in tissue morphology exist between the animals that used the palatal plate and the animals that did not use this device. Use of these palatal plates could clarify how prostheses bring changes in the palatal mucosa of users.

Frequency of micronucleus in oral epithelial cells after exposure to mate-tea in healthy humans.

OBJECTIVES: The aim of this study was to evaluate the possibility of technique simplification for cytology slides in order to evaluate the frequency of micronuclei (FMic) and conduct a experiment looking to know the FMic of oral epithelial cells of healthy volunteers exposed to mate tea (Ilex paraguarariensis). MATERIAL AND METHODS: This is a laboratorial and nonrandomized trial (quasi-experiment), where the nonusers subjects were exposed to mate-tea, consumed in the traditional way, two drinks, two times a day for a single week. Two cytology of exfoliated epithelial cells were obtained before and after the mate tea exposition. RESULTS: The sample was composed by 10 volunteers. The age ranged from 18 to 33 years (Mean 23; SD5.5). The use of mate tea did not showed significant variation in the FMic (Wilcoxon Signed Ranks Test p= .24). CONCLUSIONS: The proposed technique simplification showed to be reliable, without losses when compared to the conventional technique and with the advantage of eliminate toxic substances, becoming simple and practical tool for research in dentistry. The acute exposure to mate tea did not induce an increase of FMic in exfoliated buccal cells of healthy nondrinkers and nonsmokers subjects and may not have genotoxic effect. More human studies are needed before a conclusion can be made on the oral carcinogenic risk of mate tea to humans.

Epithelial cyst following subepithelial connective tissue graft: A case report.

BACKGROUND: Various surgical approaches have been employed to manage gingival recession, including subepithelial connective tissue grafting, which has yielded favorable outcomes. METHODS AND RESULTS: We present the case of a 17-year-old patient who developed gingival recession on tooth #6 following an esthetic crown lengthening procedure. The recession was treated with a subepithelial connective tissue graft; however, this case details the occurrence of two epithelial cysts adjacent to the region subjected to the surgical procedure, 6 months after surgery. The treatment involved periodontal surgical intervention, during which the lesions were completely excised and the associated osseous defect was filled using an inorganic bovine bone matrix along with a collagen membrane. The healing progressed without any complications. Histopathological analysis revealed the presence of cystic lesions, which were characterized by a cystic cavity lined with stratified orthokeratinized epithelium with cuboidal cells in some areas surrounded by fibrous connective tissue. The patient's progress was monitored through tomography performed 6 months, 1 year, and 5 years post-procedure, all of which demonstrated the absence of any signs of lesion recurrence. CONCLUSION: This case study emphasizes the effectiveness and predictability of subepithelial connective tissue grafting in the treatment of gingival recession. However, dental professionals should be cautious about the potential risk of gingival recession following esthetic crown lengthening procedures and recognize the potential complications associated with subepithelial connective tissue grafting, such as the observed development of epithelial cysts in this specific case. KEY POINTS: Why is this case new information? We present a case of an epithelial cyst following a subepithelial connective tissue graft, which resulted in buccal cortical bone resorption. The treatment involved excisional biopsy and the use of an inorganic bovine bone matrix with a collagen membrane. What are the keys to the successful management of this case? Successful treatment included periodontal surgery, bone defect filling using an inorganic bovine bone matrix and a collagen membrane, and regular monitoring with CT scans at 6 months, 1 year, and 5 years post-surgery; all showed no recurrence. Success factors included careful surgery, appropriate biomaterial usage, and ongoing follow-up. What are the primary limitations to success in this case? The limitations involve potential complications from subepithelial connective tissue grafting such as cyst development. This report stresses the importance of meticulous patient selection and periodontal phenotype evaluation to minimize risks. Continuous follow-up is critical to detect recurrence and other issues.

Effect of bioactive glasses used as dentin desensitizers on the dentin-pulp complex in rats.

Bioactive glasses have been recommended for the occlusion of dentinal tubules in treating cervical dentin hypersensitivity. This study evaluates an in vivo model of dentin exposure, and tests the efficacy of bioglass treatments. Thirty male Wistar rats received gingival recession surgery on the upper left first molar. The treatments were applied over the surface of the exposed dentin every 4 days for 28 days. The groups were as follows: Naive; Gingival recession; Cavity varnish; Biosilicate®; Strontium bioglass; and Potassium bioglass. Changes in the dentin-pulp complex, and the presence of substance P, were evaluated through hematoxylin-eosin and immunohistochemical staining. The groups had similar results. Teeth with exposed dentinal tubules in rats showed a typical pattern in the dentin-pulp complex and immunotracing for substance P. The materials did not cause pulp damage. The effects of gingival recession and open dentinal tubules on pulp tissue require further clarification.

IMMUNOHISTOCHEMICAL DETECTION OF L CELLS IN GASTROINTESTINAL TRACT MUCOSA OF PATIENTS AFTER SURGICAL TREATMENT FOR CONTROL OF TYPE 2 DIABETES MELLITUS.

OBJECTIVE: Type 2 diabetes mellitus (T2DM) is a disease of global impact that has led to an increase in comorbidities and mortality in several countries. Immunoexpression of the incretin hormones such as glucagon-like peptide-1 (GLP-1) and peptide YY (3-36) (PYY3-36) can be used as a scorer in the gastrointestinal tract to analyze L-cell activity in response to T2DM treatment. This study aimed to investigate the presence, location, and secretion of L cells in the small intestine of patients undergoing the form of bariatric surgery denominated adaptive gastroenteromentectomy with partial bipartition. METHODS: Immunohistochemical assays, quantitative real-time polymerase chain reaction (qPCR), and Western blot analysis were performed on samples of intestinal mucosa from patients with T2DM in both the preoperative and postoperative periods. RESULTS: All results were consistent and indicated basal expression and secretion of GLP-1 and PYY3-36 incretins by L cells. A greater density of cells was demonstrated in the most distal portions of the small intestine. No significant difference was found between GLP-1 and PYY3-36 expression levels in the preoperative and postoperative periods because of prolonged fasting during which the samples were collected. CONCLUSION: The greater number of L cells in activity implies better peptide signaling, response, and functioning of the neuroendocrine system.

In vivo temperature rise and acute inflammatory response in anesthetized human pulp tissue of premolars having Class V preparations after exposure to Polywave® LED light curing units.

OBJECTIVE: To evaluate the influence of light emitted from two Polywave®, LED light-curing units (LCU) on in vivo pulp temperature (PT) rise and signs of acute inflammatory response in pulps of human premolar having deep Class V preparations. METHODS: Sixty intact, first premolars from 15 volunteers requiring extraction received infiltrative anesthesia. A sterile thermocouple probe was inserted within the pulp tissue through a minute occlusal pulp exposure in only 45 teeth (n = 9) to continuously monitor PT (°C). A deep buccal Class V preparation was created, and the surface was exposed to light from a commercial Polywave LCU (Bluephase 20i (20i), Ivoclar Vivadent) or from an experimental LCU (Exp) using the exposure modes (EM): 1s/Exp and 2s/Exp, 10s/20i, 20s/20i, and 60s/20i. Peak PT and PT rise values above baseline (ΔT) data were evaluated using a one-way ANOVA followed by Tukey's post-hoc test (α = 5%). Teeth used for histological and immunohistochemical analyses (n = 3) were extracted approximately 2 h after exposure to the LCU. RESULTS: No significant difference in peak PT and ΔT values was noted between 2s/Exp and 20s/20i groups, which both exhibited higher values than 1s/Exp and 10s/20i groups (p < 0.001). Dilated and congested blood vessels were seen after exposure to 1s/Exp, 2s/Exp, or 60s/20i EMs. The expression of IL-1ß and TNF-α tended to be more intense when higher irradiance was delivered. SIGNIFICANCE: Although higher irradiance delivered over a short exposure caused lower PT rise than 5.5 °C, such EMs should be used with caution, as they have more potential to harm the pulp tissue.

Oral lichen planus in a young patient: a case report with nine-year follow-up / Líquen plano oral em paciente jovem: um relato de caso com acompanhamento de nove anos

INTRODUCTION: Oral lichen planus is an inflammatory condition that affects the stratified squamous epithelium of the oral mucosa. It occurs more frequently in female patients and it is rarely observed in children, adolescents, or young adults. This study aims to report a case of oral lichen planus in a young patient with a nine-year followup. CASE REPORT: A 19-year-old man reported to the Dentistry Department with a complaint of an asymptomatic white lesion on the dorsum and left lateral border of his tongue, which had appeared a few weeks before. Two weeks later, a second lesion, very similar to the previous one, appeared on the central region of his tongue. An incisional biopsy was performed. The histological slides were stained with hematoxylin-eosin and the expression of interleukin-1beta (IL-1ß) and tumor necrosis factor-alpha (TNF-α) was assessed by immunohistochemistry. No pharmacological treatment was prescribed. The clinical and histopathological findings were suggestive of oral lichen planus. The IL-1ß/TNF-α expression was low. There was a spontaneous regression of the lesions after approximately one year. The nine-year follow-up showed no signs of recurrence. CONCLUSION: This case presents atypical features such as the age of the patient and the spontaneous remission of the lesions.

INTRODUÇÃO: O líquen plano oral é uma condição inflamatória que acomete o epitélio escamoso estratificado da mucosa oral. Ocorre mais frequentemente em pacientes do gênero feminino e é raramente encontrado em pacientes pediátricos ou juvenis. O objetivo do presente estudo é relatar um caso de líquen plano oral em um paciente jovem com acompanhamento de nove anos. RELATO DE CASO: Um rapaz de 19 anos procurou atendimento no Departamento de Odontologia com a queixa de uma lesão branca assintomática em região de dorso e borda lateral esquerda de sua língua, com tempo de evolução de algumas semanas. Duas semanas depois, uma segunda lesão, muito similar à primeira, apareceu na região central de sua língua. Uma biópsia incisional foi realizada. As lâminas histológicas foram coradas com hematoxilina-eosina e a expressão de interleucina-1beta (IL-1ß) e de fator de necrose tumoral alfa (TNF-α) foram avaliadas por imunohistoquímica. Nenhum tratamento farmacológico foi prescrito. Os achados clínicos e histopatológicos foram sugestivos de líquen plano oral. A expressão de IL-1ß/TNF-α foi baixa. Houve uma regressão espontânea das lesões após aproximadamente um ano. O acompanhamento de nove anos não detectou sinais de recorrência. CONCLUSÃO: Esse caso apresenta características atípicas, como a idade do paciente e a remissão espontânea das lesões.

Maxillary lesion presenting as a first sign of multiple myeloma: case report.

Plasma cell neoplasia is a lymphoid neoplastic proliferation of B cells. This denomination encloses multiple myeloma (MM), solitary bone plasmacytoma and extramedullary plasmacytoma. MM consists of a clonal proliferation of plasma cells based in the bone marrow, with various degrees of differentiation. Neoplastic cells usually produce great amounts of monoclonal light or heavy chains of immunoglobulin that can be detected in serum or urine. The disease is more frequently in men and the average age at diagnosis is about 60 years. The diagnosis is established by blood and urine exams and medullary biopsy. Patients may present renal failure, bone pain, fatigue, recurrent infections and nervous system dysfunction. Oral manifestations may be the first sign of MM, highlighting the importance of the dentist in the early diagnosis of the disease. Treatment involves mainly irradiation and chemotherapy and the prognosis is generally poor. This paper reports a case of a 65 years old black female who had a complaint of a painful mass in the maxilla that prompted a MM diagnosis.

Dental management in the Intensive Care Unit in the treatment of toxic epidermal necrolysis associated with phenytoin: case report / Manejo odontológico na Unidade de Terapia Intensiva no tratamento da necrólise epidérmica tóxica associada a fenitoína: relato de caso

ABSTRACT Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are adverse reactions, usually medicine-related, in which extensive and painful mucocutaneous lesions are formed. Oral lesions are characterized by the presence of erosions and ulcers. The treatment usually requires intensive care in a hospital setting, where the Dentist is essential in the multidisciplinary team, as he will act in the treatment of oral lesions. In this article, a 26-year-old female patient was reported, who presented TEN-compatible mucocutaneous lesions associated with the drug Phenytoin and required admission to a Teaching Hospital. The treatment consisted of the immediate suspension of the Phenytoin use and systemic therapy with corticosteroids and immunosuppressants. Oral lesions were monitored by the hospital dentistry team. The procedures adopted were: oral hygiene with 0.12% non-alcoholic Chlorhexidine Digluconate solution, hydration of the oral tissue with an essential fatty acid, application of frozen chamomile tea, and prescription of topical Triamcinolone Acetonide. Also, low-level laser therapy sessions (red and infrared) were performed. Oral lesions evolved with significant improvement. In this case, the importance of the Dentist in the multi-professional team is demonstrated. Although there is no protocol, the procedures used in the present case can be an alternative to therapies used in SSJ and TEN oral lesions.

RESUMO A Síndrome de Stevens Johnson (SSJ) e a Necrólise Epidérmica Tóxica (NET) são reações adversas, geralmente medicamentosas. Na pele, formam-se máculas que se tornam pápulas, vesículas e bolhas, além de eritema extenso e desprendimento da epiderme. As lesões bucais caracterizam-se pela presença de erosões e úlceras dolorosas. O tratamento geralmente é realizado em âmbito hospitalar, com necessidade de cuidados intensivos, onde o Cirurgião-dentista é fundamental na equipe multiprofissional, pois atuará na terapêutica das lesões bucais. Neste artigo foi relatado o caso de uma paciente do sexo feminino, de 26 anos, a qual apresentou lesões mucocutâneas compatíveis com NET associadas ao medicamento Fenitoína e necessitou de internamento em um Hospital Universitário. O tratamento realizado foi a suspensão imediata do fármaco desencadeador, além de terapia sistêmica com corticóide e imunossupressor. As lesões bucais foram acompanhadas pela equipe de odontologia hospitalar. As condutas adotadas foram: higiene bucal com solução de Digluconato de Clorexidina 0,12% não alcoólica, hidratação da mucosa bucal com Ácido Graxo Essencial, aplicação de raspas de chá de gelo de camomila e prescrição de Triancinolona Acetonida tópica. Além disso, foram realizadas sessões de laserterapia de baixa intensidade (vermelho e infravermelho). As lesões bucais evoluíram com melhora significativa. A paciente permaneceu internada durante 22 dias, sendo 12 em Unidade de Terapia Intensiva. Este caso demonstra a importância do Cirurgião-dentista na equipe multiprofissional. Apesar de não haver um protocolo para as lesões bucais, as condutas utilizadas no presente caso podem ser uma alternativa de terapêuticas utilizadas em lesões de SSJ e NET.

Analysis of temperature increase in swine gingiva after exposure to a Polywave® LED light curing unit.

OBJECTIVE: This study evaluated the temperature increase in swine gingival temperature after exposure to light emitted by a Polywave® LED light curing unit (LCU, Bluephase 20i, Ivoclar Vivadent). METHODS: After local Ethics Committee approval (protocol 711/2015), 40 pigs were subjected to general anesthesia and the LCU tip was placed 5mm from the buccal gingival tissue (GT) close to lower lateral incisors. A thermocouple probe (Thermes WFI, Physitemp) was inserted into the gingival sulcus before and immediately after exposure to light. Real-time temperature (°C) was measured after the following exposure modes were applied: High Power (20s-H, 40s-H, and 60s-H) or Turbo mode (5s-T), either with or without the presence of rubber dam (RD) interposed between the LCU tip and GT (n=10). The presence of gingival lesions after the exposures was also evaluated. Peak temperature (°C) and the temperature increase during exposure over that of the pre-exposure baseline value (ΔT) data were analyzed using 2-way ANOVA followed by Bonferroni's post-hoc test (α=5%). A binary logistic regression analysis determined the risk of gingival lesion development. RESULTS: Without RD, no significant difference in ΔT was observed among 20s-H, 40s-H, and 60s-H groups, which showed the highest temperature values, while the 5s-T exposure showed the lowest ΔT, regardless of RD. RD reduced ΔT only for the 20s-H group (p=0.004). Gingival lesions were predominantly observed using 40s-H, with RD, and 60s-H, with and without RD. SIGNIFICANCE: Exposure to a LCU light might be harmful to swine gingiva only when high radiant exposure values are delivered, regardless of the use of RD.

Immunohistochemical detection of l cells in gastrointestinal tract mucosa of patients after surgical treatment for control of type 2 diabetes mellitus / Detecção imunohistoquímica de células l na mucosa do trato gastrointestinal de pacientes após tratamento cirúrgico para controle de diabetes mellitus tipo 2

ABSTRACT - BACKGROUND: Type 2 diabetes mellitus (T2DM) is a disease of global impact that has led to an increase in comorbidities and mortality in several countries. Immunoexpression of the incretin hormones such as glucagon-like peptide-1 (GLP-1) and peptide YY (3-36) (PYY3-36) can be used as a scorer in the gastrointestinal tract to analyze L-cell activity in response to T2DM treatment. OBJECTIVE: This study aimed to investigate the presence, location, and secretion of L cells in the small intestine of patients undergoing the form of bariatric surgery denominated adaptive gastroenteromentectomy with partial bipartition. METHODS: Immunohistochemical assays, quantitative real-time polymerase chain reaction (qPCR), and Western blot analysis were performed on samples of intestinal mucosa from patients with T2DM in both the preoperative and postoperative periods. RESULTS: All results were consistent and indicated basal expression and secretion of GLP-1 and PYY3-36 incretins by L cells. A greater density of cells was demonstrated in the most distal portions of the small intestine. No significant difference was found between GLP-1 and PYY3-36 expression levels in the preoperative and postoperative periods because of prolonged fasting during which the samples were collected. CONCLUSION: The greater number of L cells in activity implies better peptide signaling, response, and functioning of the neuroendocrine system.

RESUMO - RACIONAL: O diabetes tipo 2 (DM2) é uma doença de impacto mundial que tem levado ao aumento de comorbidades e mortalidade em vários países. A imunoexpressão dos hormônios incretínicos glp-1 e pyy3-36, pode ser usada como marcador no trato gastrointestinal para analisar a atividade da célula L em resposta ao tratamento do DM2. OBJETIVO: O presente estudo teve como objetivo investigar a presença, localização e secreção de células L no intestino delgado de pacientes submetidos à forma de cirurgia bariátrica denominada gastroenteromentectomia adaptativa com bipartição parcial. MÉTODOS: Ensaios imunohistoquímicos, reação quantitativa em cadeia de polimerase em tempo real (qPCR) e análise de manchas ocidentais foram realizados em amostras de mucosa intestinal de pacientes com diabetes tipo 2 nos períodos pré- e pós-operatório. RESULTADOS: Todos os resultados foram consistentes e indicaram expressão basal e secreção de peptídeos glucagon-1 (GLP-1) e peptídeos YY (PYY3-36) incretinas por células L. Uma maior densidade de células foi demonstrada nas porções mais distais do intestino delgado. Não foi encontrada diferença significativa entre os níveis de expressão GLP-1 e PYY3-36 nos períodos pré-operatório e pós-operatório, provavelmente devido ao estado de jejum prolongado durante o qual as amostras foram coletadas CONCLUSÃO: O maior número de células L em atividade implica melhor sinalização de peptídeo, resposta e funcionamento do sistema neuroendócrino.

Nasolabial Cyst Associated with Odontogenic Infection.

The nasolabial cyst or Klestadt cyst is a relatively uncommon nonodontogenic cyst that develops in the nasal alar region; it has uncertain pathogenesis. This lesion has slow growth and variable dimensions and is characterized clinically by a floating tumefaction in the nasolabial fold area around the bridge of the nose, causing an elevation of the upper lip and relative facial asymmetry. Diagnosis is primarily made clinically; if necessary, this is complemented by imaging. This paper reports the case of a 39-year-old male patient who complained of pain in the right upper premolar region and poor aesthetics due to a firm tumor in the right wing of the nose. Initially, this was thought to be due to an odontogenic abscess; however, the differential diagnosis was that a nasolabial cyst was communicating with the apex of teeth 14 and 15. Surgical treatment was carried out, followed by histopathological examination and concomitant endodontic treatment of the teeth involved.

Efeito da clorexidina em microrganismos na saliva de doentes internados em unidade de terapia intensiva / Effects of chlorhexidine on the salivary microorganisms of patients in intensive care units / Efecto de la clorhexidina en los microorganismos de la saliva de pacientes ingresados en una unidad de cuidados intensivos

Resumo Enquadramento: O controlo do biofilme oral com anti-sépticos deve ser adequado aos protocolos elaborados para os doentes na unidade de terapia intensiva (UTI). Objetivo: Avaliar o efeito da solução de clorexidina 0,12% na redução de microrganismos na saliva de doentes de UTI. Metodologia: Estudo coorte com 45 voluntários divididos em: Clínica Médica (controlo, auto higiene oral), UTI não-entubado e UTI entubado. A higiene oral na UTI foi realizada com clorexidina. A análise microbiológica foi realizada com a contagem de microrganismos na saliva. A análise dos dados foi feita com ANOVA. Resultados: Houve uma redução dos microrganismos após higiene oral. O controlo apresentou diferença significativa com UTI entubado nos períodos imediato e após 30 min. Doentes entubados apresentaram redução dos microrganismos até 12 horas após higiene com clorexidina. Conclusão: A higiene com clorexidina reduz em até 12 horas os microrganismos bucais de doentes entubados. Estes resultados podem contribuir para elaboração de protocolos de higiene oral em UTI, além de sustentar estratégias como redução nos custos e efeitos colaterais associados à clorexidina.

Abstract Background: The control of oral biofilm with antiseptics should follow the protocols designed for patients in intensive care units (ICUs). Objective: To assess the effects of using 0.12% chlorhexidine solution in reducing the number of microorganisms in the saliva of ICU patients. Methodology: Cohort study with 45 volunteers divided into Medical Clinic (control group, oral self-care), non-intubated ICU, and intubated ICU. Oral hygiene in the ICU was performed with chlorhexidine. Microbiological analysis was performed through salivary bacterial count. Data were analyzed using ANOVA. Results: The number of microorganisms decreased after oral hygiene. A significant difference was found between the control and the ICU intubated groups in the immediate period and after 30 minutes. The number of microorganisms in intubated patients decreased 12 hours after oral hygiene with chlorhexidine. Conclusion: The number of oral microorganisms decreases in intubated patients 12 hours after oral hygiene with chlorhexidine. These results may contribute to elaborating oral hygiene protocols for ICUs and planning strategies, for example, to reduce the costs and the side effects associated with chlorhexidine use.

Resumen Marco contextual: El control de la biopelícula oral con antisépticos debe ser adecuado a los protocolos elaborados para los pacientes de una unidad de cuidados intensivos (UCI). Objetivo: Evaluar el efecto de la solución de clorhexidina al 0,12% en la reducción de los microorganismos en la saliva de los pacientes en una UCI. Metodología: Estudio de cohorte con 45 voluntarios divididos en Clínica Médica (control, autohigiene bucal), UCI no intubados y UCI intubados. La higiene bucal en la UCI se realizó con clorhexidina. El análisis microbiológico se realizó con el recuento de microorganismos en la saliva. El análisis de los datos se realizó con ANOVA. Resultados: Hubo una reducción de los microorganismos después de la higiene bucal. El control mostró una diferencia significativa con los pacientes intubados en la UCI en el momento y después de 30 minutos. Los pacientes intubados mostraron una reducción de los microorganismos hasta 12 horas después de la higiene con clorhexidina. Conclusión: La higiene con clorhexidina reduce en un máximo de 12 horas los microorganismos bucales en pacientes intubados. Estos resultados pueden contribuir a la elaboración de protocolos de higiene bucal en las UCI, además de apoyar estrategias como la reducción de costes y los efectos secundarios asociados a la clorhexidina.

Anti-ulcer mechanisms of polyphenols extract of Euphorbia umbellata (Pax) Bruyns (Euphorbiaceae).

ETHNOPHARMACOLOGICAL RELEVANCE: Euphorbia umbellata (leitosinha) is used in southern Brazilian folk medicine to treat gastric problems, as well as for its analgesic and anti-inflammatory properties. AIM OF STUDY: To evaluate the anti-ulcer effects of methanolic bark fraction (MF) against in vivo and in vitro assays, as well as an antioxidant, antibacterial and chromatographic study of this fraction. MATERIALS AND METHODS: In vivo anti-ulcer activity was performed using ethanol and indomethacin models with different MF concentrations (50, 100 or 200mg/Kg). The stomachs of the animals were applied to histological evaluation, and the serum to evaluate the ABTS(•+) radical capture. The 200mg/Kg dose was used to analyze the mechanisms involved in antiulcerogenic properties of methanolic fraction. The in vitro activity was performed using several different antioxidant assays, in addition to anti-Helicobacter pylori and anti-urease experiments. The chromatographic study was carried out by LC-MS analysis. RESULTS: Pharmacological investigation of the MF showed an anti-ulcer potential in ethanol and indomethacin in vivo assays. The material presented a high antioxidant activity for several oxidant in vitro systems (DPPH(•), ABTS(•+), O2(•-), HOCl, TauCl and HRP), as well as an ABTS(•+) capture increasing (7.5%) by the treated animals serum (when compared to the negative control). Prostaglandins, nitric oxide/ cyclic guanosine monophosphate pathway and involvement of the protein components of the glutathione complex are some of the mechanisms related with this potential anti-ulcer action. The histological examination of the stomachs of the animals showed that the MF also prevents local action of offensive agents. Chemical analysis using LC-QTOF-MS revealed the presence of ellagic and gallic acid derivatives and flavonols. CONCLUSION: The findings provide scientific basis to the ethnopharmacological purpose of the studied plant and the biological activities of MF of E. umbellata stem bark may be due to the presence of phenolic compounds.

Impact of Dentofacial Deformity on Quality of Life: Age and Gender Differences Evaluated Through OQLQ, OHIP and SF36.

OBJECTIVES: The aim of this study was to verify the impact of dentofacial deformity on quality of life and explore gender and age differences. MATERIAL AND METHODS: The impact of dentofacial deformity (DD) on quality of life was evaluated through questionnaires; Short Form Health Survey (SF36), Oral Health Impact Profile Questionnaire (OHIP), Orthognathic Quality of Life Questionnaire (OQLQ) and a single question answered by a Visual Analogue Scale. RESULTS: Significant differences between male and female patients were observed in domains of OQLQ (oral function, P = 0.006; awareness of facial deformity, P = 0.018; and facial aesthetics, P < 0.001) and OHIP (physical pain, P = 0.006; psychological discomfort, P = 0.007; psychological disability, P = 0.006; and handicap, P = 0.01). CONCLUSIONS: The impact of dentofacial deformity was more pronounced in female Brazilian population. Age of patients with dentofacial deformity produced impacts over quality of life in different ways and according to the applied questionnaire and the interaction between age and gender may also produce different impacts in patients with dentofacial deformity. The domains of Orthognathic Quality of Life Questionnaire, Oral Health Impact Profile Questionnaire and Short Form Health Survey showed unaccepted distances in the pattern of answer rising doubts of their ability to assess quality of life as a generic and broad concept. There is a necessity to create a single quality of life instrument capable to measure impacts with sensitivity and specificity and from a generic concept to condition-specific health problem.