What is the preferred concentration of ethanolamine oleate for sclerotherapy of oral vascular anomalies?

BACKGROUND: This study compared three different concentrations of EO (1.25%, 2.5% and 5%) for the treatment of oral vascular anomalies (OVAs). MATERIAL AND METHODS: This was a retrospective comparative analysis of patients with OVAs treated with EO. Anomalies smaller than 20 mm were included. The patients were treated with 1.25% (G1), 2.5% (G2), and 5% (G3) and clinical data were obtained. The number of sessions, the final volume and dose of EO were statistically analyzed to verify effectiveness and safety of the treatment. The different concentrations of EO were compared considering the number of sessions, the final volume and total dose of EO. Analysis of covariance (ANCOVA) was used to evaluate the influence of covariates on the outcomes. A p-value < 0.05 was considered significant. RESULTS: Nineteen women and 11 men with a median age of 54 years were included. The OVAs were most frequent in the lip (n=14) and cheek (n=9). All lesions exhibited complete clinical healing within 28 days. Patients of G3 required fewer sessions than those of G2 (p=0.017), a lower final volume compared to the other groups (p<0.001), and a lower total dose than G1 (p<0.001). Patients of G1 used a lower total dose than G2 (p=0.003). CONCLUSIONS: The concentration of 5% EO performed better than 1.25% and 2.5% for sclerotherapy of OVAs measuring up to 20 mm. This preliminary result should be the preferred concentration of EO to provide an effective and safe treatment of OVAs.

Allelic loss in amalgam-associated oral lichenoid lesions compared to oral lichen planus and mucosa.

BACKGROUND: The amalgam-associated oral lichenoid lesion (AAOLL) shows clinical and histopathological features similar to oral lichen planus (OLP). Molecular researches to improve knowledge of pathogenesis and clinical behavior of AAOLL are still scarce. OBJECTIVE: We investigated for the first time the use of loss of heterozygosity (LOH) as a molecular approach for genetic characterization of AAOLL in comparison with OLP and evaluated the cell proliferation index. MATERIALS AND METHODS: The sample comprised nine AAOLLs, 10 OLPs, and eight NOMs matched by patients' gender and age. LOH was assessed using polymorphic microsatellite markers at chromosomes 9p (D9S157, D9S162, D9S171), 11q (D11S1369), and 17p (TP53, AFM238WF2). Cell proliferation was assessed by immunohistochemical expression of Ki-67 (MIB-1). The association between LOH and Ki-67 was investigated. RESULTS: Loss of heterozygosity occurred in 5/9 AAOLLs and in 2/10 OLPs in at least one marker each, while NOM showed no LOH. Cell proliferation index in AAOLL ranged from 2 to 23%. There was no association between cell proliferation and LOH, independent of the marker. CONCLUSION: Our study shows that the profile of molecular changes in AAOLL and OLP, evaluated by LOH and Ki-67 expression, is similar. Additional studies including larger samples should be performed to confirm or to refute our findings.

Periodontal outcomes of children and adolescents with attention deficit hyperactivity disorder: a systematic review and meta-analysis.

BACKGROUND: This systematic review and meta-analysis aimed to answer the following question: Are children and adolescents with attention deficit hyperactivity disorder (ADHD) more likely to have gingival or periodontal disease-related outcomes than their non-ADHD peers? METHODS: Searches were conducted in the following databases: Embase, Scopus, Web of Science, and PubMed. Google Scholar and OpenGrey were also verified. Observational studies were included in which children and adolescents with ADHD were compared with their healthy peers in terms of gingival and/or periodontal endpoints. Bias appraisal was performed using the Joann Briggs tool for case-control and cross-sectional studies. Meta-analysis was performed using R language. Results are reported as mean difference (MD) and odds ratio (OR). Statistical analyses were performed in RStudio. RESULTS: A total of 149 records were identified in the searches. Seven studies were included. The meta-analysis showed that children and adolescents with ADHD had a higher mean gingival bleeding index (percentage) than their non-ADHD peers (MD = 11.25; CI = 0.08-22.41; I2 = 73%). There was no difference between groups for plaque index (MD = 4.87; CI = - 2.56 to 12.30; I2 = 63%) and gingivitis (OR = 1.42; CI = 0.22-9.21; I2 = 76%). Regarding the assessment of risk of bias, the major issue found in the articles was the absence of analyses for the control of confounding factors. CONCLUSION: Children and adolescents with ADHD had more gingival bleeding than their non-ADHD peers, but no difference regarding plaque or gingivitis was detected between groups. CLINICAL REGISTRATION: CRD42021258404.

Forty cases of acquired oral syphilis and a review of the literature.

The aim of this study was to describe 40 cases of acquired oral syphilis (AOS) and to discuss the distribution of demographic characteristics, clinical features, and differential diagnosis of the disease. A retrospective study was conducted covering a 17-year period at a single institution in southern Brazil. Moreover, a literature review was performed through a search of the PubMed database for articles on AOS published between 1955 and March 2018. Data were analyzed descriptively. The predominant group within the case series was male patients in their twenties. The vast majority of cases (92.5%) were in the secondary stage of the disease. The lips were the most commonly affected site, with greyish-white mucous patches and reddish ulcers. In the literature review, the largest number of reported cases came from North America. Male patients in the third and fourth decades of life were most affected. AOS occurred more commonly as mucous patches and ulcers on the tongue and palate. Similarities regarding the distribution by sex, age, and anatomical location were found in the present study when compared to cases reported elsewhere. Clinicians, oral pathologists, and maxillofacial surgeons should familiarize themselves with the variable spectrum of signs and symptoms of AOS in their clinical practice to improve diagnosis and management.

Immunohistochemical study of GLUT-1 in oral peripheral nerve sheath tumors.

AIM: To investigate the immunoexpression and diagnostic applicability of human erythrocyte-type glucose transporter protein (GLUT-1) in oral peripheral nerve sheath tumors. MATERIAL AND METHODS: Specimens diagnosed as oral peripheral nerve sheath tumors archived in the Oral Pathology Service of Universidade Federal de Minas Gerais from 1966 to 2006 were evaluated. Thirty-four lesions were included: 15 traumatic neuromas, 11 neurofibromas, four neurilemmomas, and four malignant peripheral nerve sheath tumors (MPNST). One case of neurofibroma was associated with neurofibromatosis type I. Immunohistochemistry for S-100 and GLUT-1 was performed. S-100 was immunopositive in all lesions. RESULTS: Benign lesions were immunopositive for GLUT-1 except in two (18.2%) cases of neurofibromas. In the traumatic neuroma, the perineuriums were immunopositive for GLUT-1. In the neurofibroma, the immunoreactivity was heterogeneous. Immunopositivity was observed at levels of 54.5% in the periphery of the lesion, 9.1% in the center, and 18.2% in both. The neurilemmoma demonstrated immunopositivity in the capsule. One case (25%) of MPNST presented GLUT-1 positive stain in occasional cells distributed homogeneously in all the tumor area. CONCLUSION: GLUT-1 is a useful marker for perineurial cells and should be included in the oral peripheral nerve sheath tumors immunophenotyping thus aiding in the correct diagnosis of these lesions.

A rare case of sclerosing mucoepidermoid carcinoma arising in minor salivary glands with immunohistochemical evaluation.

Mucoepidermoid carcinomas (MECs) are the most common malignancy of the salivary glands demonstrating a wide range of histologic variants and behavior. However, the sclerosing mucoepidermoid carcinoma (SMEC), a morphologic variant of this tumor is extremely rare and has been described almost exclusively in the major glands. The prominent sclerosis observed may obscure its typical morphological feature resulting in a diagnostic challenge. We describe herein a case of SMEC in a 43-year-old-woman, occurring in the minor salivary glands of palate. To our knowledge only 13 cases have been reported until this moment, being only 2 in minor salivary glands. We also performed the immunohistochemical evaluation of c-erbB-2 and Ki-67, searching for an association with the histopathological findings and behavior.

Inflammatory myofibroblastic tumor of the alveolar mucosa of the mandible.

Inflammatory myofibroblastic tumor is a rare lesion composed of myofibroblastic spindle cells accompanied by inflammatory infiltrate. The objective of this paper is to report an uncommon case of inflammatory myofibroblastic tumor located in the alveolar mucosa of the mandible. A 33-year-old male presented an asymptomatic tumoral lesion, firm, pedunculated, pink-colored, covered by smooth mucosa, with focal ulceration, measuring 30x20x20 mm, located in the left posterior alveolar mucosa. Clinical diagnosis was soft tissue tumor. An excisional biopsy was made. Microscopic examination showed compact fascicular spindle cells proliferation with a diffuse inflammatory infiltrate of plasma cells, lymphocytes, and eosinophils. Large ganglion-like cells were observed. The lesional cells were immunopos-itive to vimentin, a-smooth muscle actin, muscle specific actin, and CD68. Negative immunostain was observed to S-100, Bcl-2, Ki-67, desmin, CD34, and cytokeratin. A diagnosis of inflammatory myofibroblastic tumor was performed. After 28 months of follow-up there was no recurrence. Although no evidence of oral inflammatory myofibroblastic tumor recurrence or malignant transformation has been reported, it has been observed that in inflammatory myofibroblastic tumor of other regions a prolonged follow-up is necessary after surgical excision.

Effectiveness and safety of foam sclerotherapy with 5% ethanolamine oleate in the treatment of low-flow venous malformations in the head and neck region: a case series.

The aim of this study was to evaluate the effectiveness and safety of 5% ethanolamine oleate (EO) foam in the treatment of low-flow venous malformations in the head and neck region. Seventeen consecutive patients (six male, 11 female) and 34 low-flow venous malformations were enrolled. The vascular anomalies ranged between 20mm and 80mm in size. The typical clinical indication was a swelling (88.2%) with a purple colour (85.3%); the most frequent location was the tongue (23.5%). Ethanolamine oleate foam was produced via the Tessari method and applied at 10mg per 1cm to the vascular anomalies. This process resulted in the highest clinical healing score in 64.7% of cases, and half of the patients reported a high level of satisfaction (score >9). In the majority of cases (88.2%), the patients reported that the pain immediately postoperative was mild or moderate. There were direct relationships between vascular anomaly size and the volume of EO applied, the number of sessions, and healing (P<0.05). No recurrence was observed during 6 months of follow-up. This case series showed the effectiveness and safety of 5% EO foam for the treatment of venous malformations in the head and neck region.

Retrospective analysis of peripheral odontogenic fibroma (WHO-type) in Brazilians.

AIM: The purpose of this study is to present data on a series of peripheral odontogenic fibroma, WHO (World Health Organization)-type (POF), in Brazilians and to compare the results with previously reported studies. METHODS: The study sample was made from the number of POF cases and its synonymies diagnosed from 1950 to 2004 at the Oral Pathology Service of the Federal University of Minas Gerais. The cases were reviewed in hematoxylin-eosin stain and the histological features were evaluated in accordance with the classification WHO. Patient's data about gender, age and race and the lesion's clinical data were obtained from the biopsy request forms, after the definite diagnosis of POF. RESULTS: Seventeen diagnoses of POF were found. Data showed that POF has a higher prevalence in females (88.2%), occurring in the second and fourth decades of life (29.4% each), and in Caucasians (64.7%). The most common location was the posterior region of the mandible (41.1%). It was an asymptomatic lesion (23.5%) with an average size of 1.1 to 2.0 cm (35.2%). The histological findings were: 1) fibroblastic tissue high cellularity (58.8%); 2) scarce odontogenic epithelium (64.7%); 3) inflammation (94.1%) and 4) absence of calcification (58.8%). CONCLUSIONS: Clinical and histological data of POF in Brazilians showed important characteristcs for its diagnosis. This epidemiological data will generate a substantial contribution to the clinical, histological diagnosis and behavior of this lesion.

Use of cone beam computed tomography in identifying postmenopausal women with osteoporosis.

The aim of this study is to correlate radiometric indices from cone beam computed tomography (CBCT) images and bone mineral density (BMD) in postmenopausal women. Quantitative CBCT indices can be used to screen for women with low BMD. PURPOSE: Osteoporosis is a disease characterized by the deterioration of bone tissue and the consequent decrease in BMD and increase in bone fragility. Several studies have been performed to assess radiometric indices in panoramic images as low-BMD predictors. The aim of this study is to correlate radiometric indices from CBCT images and BMD in postmenopausal women. METHODS: Sixty postmenopausal women with indications for dental implants and CBCT evaluation were selected. Dual-energy X-ray absorptiometry (DXA) was performed, and the patients were divided into normal, osteopenia, and osteoporosis groups, according to the World Health Organization (WHO) criteria. Cross-sectional images were used to evaluate the computed tomography mandibular index (CTMI), the computed tomography index (inferior) (CTI (I)) and computed tomography index (superior) (CTI (S)). Student's t test was used to compare the differences between the indices of the groups' intraclass correlation coefficient (ICC). RESULTS: Statistical analysis showed a high degree of interobserver and intraobserver agreement for all measurements (ICC > 0.80). The mean values of CTMI, CTI (S), and CTI (I) were lower in the osteoporosis group than in osteopenia and normal patients (p < 0.05). In comparing normal patients and women with osteopenia, there was no statistically significant difference in the mean value of CTI (I) (p = 0.075). CONCLUSIONS: Quantitative CBCT indices may help dentists to screen for women with low spinal and femoral bone mineral density so that they can refer postmenopausal women for bone densitometry.

Cardioprotection mediated by urocortin is dependent on PKCepsilon activation.

Urocortin (Ucn) is an endogenous cardioprotective agent that protects against the damaging effects of ischemia and reperfusion injury in vitro and in vivo. We have found that the mechanism of action of Ucn involves both acute activation of specific target molecules, and using Affymetrix (Santa Clara, CA) gene chip technology, altered gene expression of different end effector molecules. Here, from our gene chip data, we show that after a 24 h exposure to Ucn, there was a specific increase in mRNA and protein levels of the protein kinase C epsilon (PKCepsilon) isozyme in primary rat cardiomyocytes compared with untreated cells and in the Langendorff perfused ex vivo heart. Furthermore, a short 10 min exposure of these cells to Ucn caused a specific translocation/activation of PKCepsilon in vitro and in the Langendorff perfused ex vivo heart. The importance of the PKCepsilon isozyme in cardioprotection and its relationship to cardioprotection produced by Ucn was assessed using PKCepsilon-specific inhibitor peptides. The inhibitor peptide, when introduced into cardiomyocytes, caused an increase in apoptotic cell death compared with control peptide after ischemia and reperfusion. When the inhibitor peptide was present with Ucn, the cardioprotective effect of Ucn was lost. This loss of cardioprotection by Ucn was also seen in whole hearts from PKCepsilon knockout mice. These findings indicate that the cardioprotective effect of Ucn is dependent upon PKCepsilon.

Early remodeling of rat cardiac muscle induced by swimming training.

The aim of the present investigation was to study the effect of acute swimming training with an anaerobic component on matrix metallopeptidase (MMP) activity and myosin heavy chain gene expression in the rat myocardium. Animals (male Wistar rats, weighing approximately 180 g) were trained for 6 h/day in 3 sessions of 2 h each for 1 to 5 consecutive days (N = 5 rats per group). Rats swam in basins 47 cm in diameter and 60 cm deep filled with water at 33 to 35 degrees C. After the training period a significant increase (P < 0.05) was observed in the heart weight normalized to body weight by about 22 and 35% in the groups that trained for 96 and 120 h, respectively. Blood lactate levels were significantly increased (P < 0.05) in all groups after all training sessions, confirming an anaerobic component. However, lactate levels decreased (P < 0.05) with days of training, suggesting that the animals became adapted to this protocol. Myosin heavy chain-beta gene expression, analyzed by real time PCR and normalized with GAPDH gene expression, showed a significant two-fold increase (P < 0.01) after 5 days of training. Zymography analysis of myocardium extracts indicated a single approximately 60-kDa activity band that was significantly increased (P < 0.05) after 72, 96, and 120 h, indicating an increased expression of MMP-2 and suggesting precocious remodeling. Furthermore, the presence of MMP-2 was confirmed by Western blot analysis, but not the presence of MMP-1 and MMP-3. Taken together, our results indicate that in these training conditions, the rat heart undergoes early biochemical and functional changes required for the adaptation to the new physiological condition by tissue remodeling.

Diode laser surgery versus scalpel surgery in the treatment of fibrous hyperplasia: a randomized clinical trial.

Fibrous hyperplasia is treated by surgical incision using a scalpel, together with removal of the source of chronic trauma. However, scalpel techniques do not provide the haemostasis that is necessary when dealing with highly vascular tissues. Diode laser surgery can be used in the management of oral tissues due to its high absorption by water and haemoglobin, and has provided good results in both periodontal surgery and oral lesions. The aim of the present study was to compare the effects of diode laser surgery to those of the conventional technique in patients with fibrous hyperplasia. A randomized clinical trial was performed in which surgical and postoperative evaluations were analyzed. On comparison of the laser-treated (study group) patients to those treated with a scalpel (control group), significant differences were observed in the duration of surgery and the use of analgesic medications. Over a 3-week period, clinical healing of the postoperative wound was significantly faster in the control group as compared to the study group. In conclusion, diode laser surgery proved to be more effective and less invasive when compared to scalpel surgery in the management of fibrous hyperplasia. However, wound healing proved to be faster when using scalpel surgery.

Collagenous fibroma (desmoplastic fibroblastoma) of the palate: a case report.

Collagenous fibroma is an uncommon benign soft tissue lesion that has a wide anatomic distribution. We describe a case of a collagenous fibroma that appeared in the left soft and hard palate of a 37-year-old woman as a 5.0-cm solitary, firm nodule. Microscopically, it was composed of stellate or spindle-shaped cells embedded in hypovascular fibrous stroma. Entrapment of fat was focally identified at the edges. Mitotic figures and tumor necrosis were absent. Tumor cells were immunopositive for vimentin, and a few cells were positive for alpha-smooth muscle actin. Tumor extracellular matrix was immunopositive for type I and type III collagen, as well as for fibronectin. These findings satisfied the diagnostic criteria for collagenous fibroma (desmoplastic fibroblastoma). This case, to our knowledge, represents the first report of this tumor in the mouth. The differential diagnosis of fibrous lesions of the mouth is discussed.

Alveolar and extra-alveolar granular cell lesions of the newborn: report of case and review of literature.

Multiple congenital granular cell lesions occurring on the maxillary alveolar ridge and ventral aspect of the tongue were identified in a 22-day-old girl. The prevalence, histogenesis, and treatment of this lesion are discussed and the literature is reviewed.

AgNOR count in exfoliative cytology of normal buccal mucosa. Effect of smoking.

OBJECTIVE: To compare the argyrophilic nucleolar organizer region (AgNOR) count of cells collected from normal buccal mucosa of cigarette smokers with that obtained from nonsmokers. STUDY DESIGN: Cytologic smears of normal buccal mucosa from 20 smokers and 20 nonsmokers were stained for AgNORs. The AgNOR count was established on 100 cells. The count values of groups were compared and analyzed using Student's unpaired t test. RESULTS: The AgNORs were round and had a clustered distribution in both groups. The mean AgNOR count was statistically higher in cells of smokers than nonsmokers (P < .01). CONCLUSION: Analysis of AgNORs suggests that cigarette smoking influences proliferative activity in cells of normal buccal mucosa.

Oral exfoliative cytology in the diagnosis of paracoccidioidomycosis.

OBJECTIVE: To assess the efficacy of conventional oral exfoliative cytology as a diagnostic tool in paracoccidioidomycosis. STUDY DESIGN: Cytologic smears and incisional biopsies were obtained from 10 patients with a clinical suspicion and oral manifestations of paracoccidioidomycosis. Cytologic smears and sections of the incisional biopsy underwent methenamine silver staining for fungi according to the Gomori-Grocott method. The dry glass slides were examined at 400 or 1,000 x magnification, and the presence and shape of yeasts of Paracoccidioides brasiliensis were investigated. RESULTS: Yeasts of the fungus P brasiliensis were clearly identified in cytologic smears and sections from incisional biopsies in all cases analyzed (100.0%). CONCLUSION: Cytology of oral samples proved an effective diagnostic method for the detection of paracoccidioidomycosis in humans.

Population studies of the Y-chromosome of loci DYS390, DYS391 and DYS393 in Brazilian subjects and its use in human identification.

Human identification can be accomplished by several technical procedures, especially by the comparative analysis of dental documents. Recent advances in molecular biology have now widened the scope for human identification and defined the protocols for the collection of biological material. Allele patterns of a population are particularly useful and they should be verified since they vary in different populations. We have studied the frequency of the alleles in three STR loci of the Y chromosome (DYS390, DYS391 and DYS393) in a group of Brazilian caucasian subjects. Results presented alleles 21, 22, 23, 24, 25 and 26 in locus DYS390, alleles 8, 9, 10, 11 12 and 13 in STR DYS391 and alleles in STR DYS393 were 11, 12, 13 14 and 15. The highest frequencies were 24 (0.46), 11 (0.37) and 13 (0.45). Each of the three STR systems had a PE (power of exclusion) of 0.6764 (DYS390), 0.5988 (DYS391) and 0.6136 (DYS393), The combination of the three STR systems revealed a PE of 0.9498, suggesting that this data can help in human identification.

Retrospective analysis of 15 cases of nasolabial cyst.

The nasolabial cyst is classified as a nonodontogenic cyst and is the only nonodontogenic cyst to occur in soft tissue. The aim of this retrospective analysis was to gather demographic, clinical, radiographic, and histopathologic data on the nasolabial cysts described in the files of the Oral Pathology Laboratory of Minas Gerais University School of Dentistry. Fifteen cases were included in the analysis. The mean age of the patients at the time of diagnosis was 42 years, and there was a female predilection. All the cysts were asymptomatic. Pseudostratified columnar (respiratory) epithelium, alone or in combination with other types of epithelium, was present in all cysts. Recurrence was not observed after surgical excision.