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OBJECTIVE: This study aimed to evaluate the presence of human papillomavirus (HPV) and Epstein-Barr virus (EBV) and the expression of p53, p16, E-cadherin, COX-2, MLH1, and MYC in oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS: One hundred OSCC specimens were submitted to in situ hybridization for HPV and EBV, and immunohistochemistry for detection of the human proteins. RESULTS: Thirty-one cases showed HPV in tumor tissue. EBV was not detected in any case investigated. The HPV(+) group demonstrated an increase of staining scores for nuclear p16 (p = .047), cytoplasmic MYC (p = .002), while a decrease for nuclear MLH1 (p = .048), suggesting that HPV may upregulate the expression of the first two proteins and down-regulate the latter. CONCLUSION: Our findings reinforce the hypothesis of the HPV-related oral carcinogenesis involving the expression of p16 and MYC, and MLH1 suppression. Exclusively cytoplasmic stainings for p16, MLH1, and MYC were also associated with more advanced tumors. Finally, in view of the lack of studies correlating the HPV or EBV infection to the expression of oncoproteins, more researches assessing a broader panel of markers and employing different approaches are still necessary in order to understand the role of these viruses as well as the molecular mechanisms involved in the development and progression of oral carcinomas.
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Alphapapillomavirus , Carcinoma de Células Escamosas , Infecções por Vírus Epstein-Barr , Neoplasias de Cabeça e Pescoço , Neoplasias Bucais , Infecções por Papillomavirus , Alphapapillomavirus/metabolismo , Caderinas/metabolismo , Carcinoma de Células Escamosas/patologia , Inibidor p16 de Quinase Dependente de Ciclina/metabolismo , Ciclo-Oxigenase 2/metabolismo , Infecções por Vírus Epstein-Barr/complicações , Herpesvirus Humano 4/genética , Humanos , Neoplasias Bucais/metabolismo , Proteína 1 Homóloga a MutL/genética , Proteína 1 Homóloga a MutL/metabolismo , Papillomaviridae , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/diagnóstico , Carcinoma de Células Escamosas de Cabeça e Pescoço , Proteína Supressora de Tumor p53RESUMO
BACKGROUND: This study analyzed the immunoexpression of calcitonin receptor (CTR) and glucocorticoid receptor (GR) in central giant cell lesions (CGCLs) and verified potential associations with patient's response to clinical treatment with intralesional injection of triamcinolone. MATERIALS AND METHODS: Fifty-four cases of CGCLs, including 22 non-aggressive, and 32 aggressive, were investigated by immunohistochemistry. RESULTS: Surgery was the therapeutic choice for 53.1% of the aggressive CGCLs, and 46.9% were submitted to the conservative treatment with intralesional triamcinolone injections. Among patients submitted to conservative treatment, 60% (n = 9) showed favorable response. CTR expression was observed in 68.51%, and GR in 94.44% of the total sample. There were no differences in the expression of CTR, neither GR in mononucleated stromal cells (MSCs) or multinucleated giant cells (MGCs), in relation to aggressiveness, treatment performed for and the response to conservative treatment. Both markers showed a positive correlation between their expression in MSCs and MGCs in the total sample (P < 0.0001). CTR expression on MSCs showed a positive correlation with MGCs in the aggressive and non-aggressive groups (P < 0.0001). CONCLUSIONS: Calcitonin receptor and GR expression were diffuse and similar in non-aggressive and aggressive cases, and it did not influence the response to clinical treatment with triamcinolone in the sample studied.
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Células Gigantes/metabolismo , Granuloma de Células Gigantes/tratamento farmacológico , Granuloma de Células Gigantes/metabolismo , Imuno-Histoquímica , Doenças Maxilomandibulares/tratamento farmacológico , Doenças Maxilomandibulares/metabolismo , Receptores da Calcitonina/metabolismo , Receptores de Glucocorticoides/metabolismo , Triancinolona , Adolescente , Adulto , Criança , Feminino , Expressão Gênica , Humanos , Injeções Intralesionais , Masculino , Pessoa de Meia-Idade , Receptores da Calcitonina/genética , Receptores de Glucocorticoides/genética , Estudos Retrospectivos , Resultado do Tratamento , Adulto JovemRESUMO
An alternative technique to reconstruct atrophic alveolar vertical bone after implant placement is presented. The technique consists of distraction osteogenesis or direct surgical repositioning of an implant-and-bone block segment after segmental osteotomies that can be used in esthetic or unesthetic cases. Initially, casts indicating the implant position are obtained and the future ideal prosthetic position is determined to guide the model surgery. After the model surgery, a new provisional prosthesis is fabricated, and an occlusal splint, which is used as a surgical guide and a device for distraction osteogenesis, is custom fabricated. Then, the surgery is performed. For mobilization of the implant-and-bone block segment, 2 vertical osteotomies are performed and then joined by a horizontal osteotomy. The implant-and-bone block segment is moved to the planned position. If a small movement is planned, then the implant-and-bone segment is stabilized; for larger movements, the implant-and-bone segment can be gradually moved to the final position by distraction osteogenesis. This technique has good predictability of the final position of the implant-and-bone segment and relatively fast esthetic rehabilitation. It can be considered for dental implants in regions of vertical bone atrophy.
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Aumento do Rebordo Alveolar/métodos , Implantação Dentária/métodos , Maxila/cirurgia , Osteogênese por Distração/métodos , HumanosRESUMO
The thyroglossal duct cyst is the neck congenital abnormality most common in the childhood. Clinically, it shows itself as a solitary neck mass in the region of hyoid bone, it is painless and can be dislocated during de physical examination and tongue protrusion. The most common treatment is its removal through the Sistrunk technique. Patient with diagnosis of thyroglossal duct cyst in neck region with extension to the mouth floor was treated by total surgical removal through intraoral access. The intraoral approach to the treatment of the thyroglossal duct cyst showed itself practicable and permitted the total removal of the lesion with no recurrence signs.
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Cisto Tireoglosso/cirurgia , Criança , Humanos , Masculino , Soalho Bucal , PescoçoRESUMO
Condylar resorption is understood as changes in shape and volume of the condylar bone, due to local, systemic, and iatrogenic factors. The occurrence of condylar resorption after orthognathic surgery can occur when the condylar repositioning in mandibular fossa is performed improperly. In addition, systemic diseases such as osteoarthritis and rheumatoid arthritis seem to influence this process. The aim of this study was to report 3 cases of patients with severe condylar alterations, submitted to orthognathic surgery for treatment of dentofacial deformities. Considerations regarding the diagnosis, surgical planning (counterclockwise rotation), surgical techniques (bilateral sagittal split osteotomy, bimaxillary osteotomies, rigid fixation, maxillomandibular fixation period), and results (short terms) are discussed.
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Reabsorção Óssea/cirurgia , Côndilo Mandibular/cirurgia , Cirurgia Ortognática/métodos , Adulto , Reabsorção Óssea/etiologia , Cefalometria , Feminino , Humanos , Técnicas de Fixação da Arcada Osseodentária , Masculino , Má Oclusão Classe II de Angle/etiologia , Má Oclusão Classe II de Angle/cirurgia , Osteotomia de Le Fort , Adulto JovemRESUMO
Ameloblastoma treatment can lead to significant bone defects; consequently, oral rehabilitation can be challenging. We present the case of a 14-year-old girl diagnosed with a conventional ameloblastoma in the mandible who was treated using en bloc resection and rehabilitated with autotransplantation of the immature third molars and orthodontic treatment. The lesion was in the region of the lower left canine and premolars, and en bloc resection resulted in a significant alveolar bone defect. Autotransplantation of the lower third molars to the site of the lower left premolars was performed. After 2 years, the upper left third molar was transplanted to the site of the lower left canine. During the orthodontic treatment period, considerable alveolar bone formation was observed in the region of the transplanted teeth, and roots developed. To the best of our knowledge, this is the first reported case of alveolar bone formation induction caused by tooth transplantation after ameloblastoma treatment.
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Ameloblastoma/cirurgia , Neoplasias Mandibulares/cirurgia , Dente Serotino/cirurgia , Ortodontia , Reimplante Dentário , Adolescente , Ameloblastoma/diagnóstico por imagem , Feminino , Humanos , Neoplasias Mandibulares/diagnóstico por imagem , Radiografia PanorâmicaRESUMO
Bisphosphonates are widely used for treatment or prevention of bone diseases characterized by high osteoclastic activity. Among the oral medicines used to treat osteoporosis, alendronate has been often used. Despite of the low rate of complications on its use, cases of osteonecrosis of the jaw have been reported on literature after tooth extractions. The main symptoms include pain, tooth mobility, swelling, erythema, and ulceration. The risk factors related to osteonecrosis of the jaw associated with bisphosphonate are exposition time to the medicine, routes of administration, and oral surgical procedures performed. The aim of this work is to report a case of a patient showing osteonecrosis of the jaw associated with the use of oral bisphosphonates after tooth extractions. The patient was treated through the suspension of the alendronate with the removal of the necrotic tissue and the foci of infection. After a year's follow-up, the patient showed no recurrence signs. From the foregoing, the interruption of the alendronate use and the surgical treatment associated to antibiotic therapy showed effective on the patient's treatment.
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Alendronato/efeitos adversos , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/etiologia , Conservadores da Densidade Óssea/efeitos adversos , Doenças Mandibulares/induzido quimicamente , Extração Dentária/efeitos adversos , Administração Oral , Idoso , Alendronato/administração & dosagem , Antibacterianos/uso terapêutico , Anti-Infecciosos Locais/uso terapêutico , Conservadores da Densidade Óssea/administração & dosagem , Clorexidina/uso terapêutico , Clindamicina/uso terapêutico , Desbridamento/métodos , Feminino , Seguimentos , Humanos , Antissépticos Bucais/uso terapêutico , Osteoporose Pós-Menopausa/tratamento farmacológico , Resultado do TratamentoRESUMO
Background: Differences in the pathogenesis and biological behavior of sporadic and Gorlin-Goltz syndrome-related odontogenic keratocysts (OKCs) have been reported, but the underlying mechanisms are not fully elucidated. Chemokine CXCL12 and its main receptor CXCR4 regulate important events in the pathogenesis of several lesions. Material and Methods: This study evaluated the immunoexpression of CXCL12 and CXCR4 in sporadic and syndromic OKCs. Twenty-two sporadic OKCs and 22 syndromic OKCs were subjected to immunohistochemistry. The percentages of cytoplasmic (CXCL12 and CXCR4) and nuclear (CXCR4) staining in epithelial and fibrous capsule cells were determined. The results were analyzed statistically using the nonparametric Mann-Whitney test and Spearman correlation test (p<0.05). Results: Higher cytoplasmic expression of CXCL12 was observed in the epithelial lining and fibrous capsule of sporadic OKCs compared to syndromic OKCs (p<0.001). No statistically significant differences in the cytoplasmic expression of CXCR4 were observed between syndromic OKCs and sporadic OKCs (p>0.05). Compared to syndromic OKCs, sporadic OKCs exhibited higher nuclear expression of CXCR4 in the epithelial lining and lower immunoexpression in the fibrous capsule (p<0.05). In the epithelial lining of syndromic OKCs, positive correlation was observed between cytoplasmic and nuclear expressions of CXCR4 (p=0.003). In the fibrous capsule of syndromic OKCs and sporadic OKCs, cytoplasmic and nuclear expressions of CXCR4 were positively correlated (p<0.001). Conclusions: The results suggest a potential participation of CXCL12 and CXCR4 in the development of OKCs. The heterogeneous expression of these proteins in syndromic and sporadic OKCs may reflect differences in their pathogenesis and biological behavior. Key words:Odontogenic keratocyst, CXCL12, CXCR4, Immunohistochemistry.
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INTRODUCTION: The probability of improvement in the upper airway space (UAS) with orthognathic surgery should be considered during the surgical-orthodontic treatment decision, providing not only an esthetic, but also a functional benefit for the patient. OBJECTIVE: The purpose of this study was to evaluate the 3D changes in the upper airway space after maxillomandibular advancement surgery (MMA). METHODS: A retrospective analysis of 56 patients, 21 male and 35 female, with a mean age of 35.8 ± 10.7 years, who underwent MMA was performed. Pre- and postoperative cone-beam computed tomography scans (CBCT) were obtained for each patient, and the changes in the UAS were compared using Dolphin Imaging 11.7 software. Two parameters of the pharyngeal airway space (PAS) were measured: airway volume (AV) and minimum axial area (MAA). Paired t-test was used to compare the data between T0 and T1, at 5% significance level. RESULTS: There was a statistically significant increase in the UAS. Bimaxillary advancement surgery increased the AV and the MAA, on average, by 73.6 ± 74.75% and 113.5 ± 123.87%, respectively. CONCLUSION: MMA surgery tends to cause significant increase in the UAS; however, this increase is largely variable.
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Cirurgia Ortognática , Procedimentos Cirúrgicos Ortognáticos , Cefalometria , Tomografia Computadorizada de Feixe Cônico , Estética Dentária , Feminino , Humanos , Imageamento Tridimensional , Masculino , Faringe/diagnóstico por imagem , Estudos RetrospectivosRESUMO
OBJECTIVE: To evaluate the immunoexpression of DNA base excision repair (BER) [apurinic/apyrimidinic endonuclease 1 (APE-1), X-ray repair cross complementing 1 (XRCC-1)] and nucleotide excision repair (NER) [xeroderma pigmentosum complementation group (XPF)] proteins in benign epithelial odontogenic lesions with different biological behaviors. DESIGN: Thirty solid ameloblastomas, 30 non-syndromic odontogenic keratocysts (NSOKCs), 29 syndromic odontogenic keratocysts (SKOCs), 30 dentigerous cysts (DCs) and 20 dental follicles (DFs) were evaluated quantitatively for APE-1, XRCC-1 and XPF through immunohistochemistry. RESULTS: Nuclear expression of APE-1 was significantly higher in NSOKCs, SOKCs, and ameloblastomas in comparison to DCs (p < 0.001). Nuclear expression of XRCC-1 was higher in NSOKCs and SOKCs than in DCs (p < 0.05). At the nuclear level, XPF expression was higher in NSOKCs and SOKCs than in DCs and ameloblastomas (p < 0.05). A statistically significant higher expression of APE-1 (nuclear), XRCC-1 (nuclear), and XPF (nuclear and cytoplasmic) was found in all odontogenic lesion samples as compared to DFs (p < 0.05). For all lesions, there was a positive correlation between nuclear expression of APE-1 and XRCC-1 or XPF (p < 0.05). CONCLUSIONS: Our results suggest a potential involvement of APE-1, XRCC-1 and XPF proteins in the pathogenesis of benign epithelial odontogenic lesions, especially in those with more aggressive biological behavior, such as ameloblastomas, NSOKCs, and SOKCs. We also showed that the expression of APE-1 was positively correlated with the nuclear expression of XRCC-1 and XPF, which may suggest an interaction between the BER and NER pathways in all odontogenic lesions studied herein.
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Ameloblastoma , Reparo do DNA , DNA Liase (Sítios Apurínicos ou Apirimidínicos) , Proteínas de Ligação a DNA , Cisto Dentígero , Cistos Odontogênicos , Proteína 1 Complementadora Cruzada de Reparo de Raio-X , Ameloblastoma/genética , DNA , DNA Liase (Sítios Apurínicos ou Apirimidínicos)/metabolismo , Proteínas de Ligação a DNA/metabolismo , Cisto Dentígero/genética , Expressão Gênica , Humanos , Cistos Odontogênicos/genética , Proteína 1 Complementadora Cruzada de Reparo de Raio-X/metabolismoRESUMO
PURPOSE: The maxillary advancement using Le Fort I osteotomy directly affects in the positioning of the upper lip (UL) and the nasolabial angle (NLA), which plays an important role in facial expression and aesthetics, because of this, the aim of this study was to evaluate the ability of Dolphin Imaging 11.8 software in predicting changes to the UL position and NLA in patients undergoing maxillary advancement. MATERIALS AND METHODS: It was a retrospective cohort study. Predictive and final tracings using pre- and postoperative Cone beam computed tomography (CBCT) of 24 patients undergoing maxillary advancement, regardless of mandibular movement, were compared. Whether the amount of advancement changes this predictability was also analyzed. The predictive and the 12-month postoperative data were evaluated using Dolphin Imaging 11.8 software and compared. Student t test was used to get the results. RESULTS: The vertical analysis of the incisal tip and cementoenamel junction of the upper central incisor (UCI) and of the UL were statistically significant (P = .001 for all). The horizontal measurements of the same variables (P = .238, P = .516, P = .930, respectively) and the NLA (P = .060) showed no statistical significance. The amount of advancement did not interfere with the variables analyzed, except for the exposure (P = .009) and inclination of the UCI (P = .010). CONCLUSION: It was concluded that the amount of maxillary advancement does not interfere with the UL prediction; the prediction capacity of the software was good for the horizontal measurements, but had a significant error index for vertical measurements.
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Three-dimensional (3D) software has revolutionized planning in orthognathic surgery. This technology allows the simulation of surgical movements and evaluation of the volume and area of the pharyngeal airway space (PAS), which are not possible with two-dimensional (2D) software. Many patients undergo orthognathic surgery to improve occlusion and facial profile. The PAS may increase or decrease depending on the surgical movements. This study aimed to evaluate the changes in the area and volume of the PAS in patients having bimaxillary movement in orthognathic surgery. The minimum axial area and volume of the PAS (preoperative (T0) and postoperative (T1) air volumes) of 68 patients (26 male and 42 female, mean age 36.6 ± 12.1 years) were analyzed. Evaluations were conducted using cone-beam computed tomography in the Nemoceph 3D-OS program. A paired t-test was used to compare pre- and postoperative volume data, and the Wilcoxon test was used to compare pre- and postoperative data of the minimal axial area. All the tests were performed with Statistica software (StatSoft Inc., Tulsa, OK, USA), and a significance level of 5% was adopted. In the study of the method error, no casual or systematic error was found between the first and second measurements of the variables (p > 0.05 in all measurements). Bimaxillary surgery presented a mean of 70.46% in volume and a median increase of 61.27% in the minimum axial area, which varied from -22.50% to 659.06%. The results demonstrated that bimaxillary advancement significantly increased the volume and minimum axial area of the upper airway; however, the increase was not homogeneous in all the patients.
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Cirurgia Ortognática , Procedimentos Cirúrgicos Ortognáticos , Adulto , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Imageamento Tridimensional , Masculino , Pessoa de Meia-Idade , Faringe , Adulto JovemRESUMO
Hyperparathyroidism (HPT) is an endocrine metabolic disorder characterized by increased secretion of parathyroid hormone. Untreated secondary HPT leads to renal osteodystrophy (ROD). Facial skeletal abnormalities in patients with ROD are rare. The purpose of this paper is to report a conservative surgical approach of exuberant osteitis fibrosa lesions in patient with chronic kidney disease. A 24-year-old female was referred to maxillofacial surgery department with giants ROD affecting palate, maxilla, and mandible, resulting in esthetic and functional impairment. The pathogeneses and multidisciplinary management of ROD are discussed with a brief literature review. Eight years after the conservative treatment of exuberant jaw lesions, no noticeable bone changes were observed in the patient. A multidisciplinary therapy is essential for correct diagnosis of ROD and optimal multimodality treatment. The conservative management was an efficient alternative for the success of the case reported.
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Distúrbio Mineral e Ósseo na Doença Renal Crônica/etiologia , Hiperparatireoidismo Secundário/complicações , Falência Renal Crônica/complicações , Doenças Mandibulares/etiologia , Doenças Mandibulares/cirurgia , Doenças Maxilares/etiologia , Doenças Maxilares/cirurgia , Procedimentos Cirúrgicos Bucais/métodos , Osteíte Fibrosa Cística/etiologia , Osteíte Fibrosa Cística/cirurgia , Palato/patologia , Palato/cirurgia , Diagnóstico Diferencial , Estética Dentária , Feminino , Humanos , Imageamento Tridimensional , Falência Renal Crônica/cirurgia , Transplante de Rim , Doenças Mandibulares/diagnóstico por imagem , Doenças Maxilares/diagnóstico por imagem , Palato/diagnóstico por imagem , Retalhos Cirúrgicos , Tomografia Computadorizada por Raios X , Adulto JovemRESUMO
BACKGROUND: Implant-bone block segment repositioning may be an option of treatment for patients with vertical alveolar bone atrophy. PURPOSE: To assess implant-bone block movement, gingival outcome and the subjective appreciation of patients after an alternative treatment of an implant-bone block segment repositioning in the maxillary esthetic region. MATERIALS AND METHODS: Patients who underwent implant-bone block segment relocation in areas of vertical alveolar bone atrophy in the anterior esthetic region were assessed. The outcome measures were implant failure, complications after initial loading, vertical bone augmentation, papilla index, width of the keratinized mucosa, and patient satisfaction. RESULTS: Twenty-five implants in nine consecutive patients were included in this study. During the follow-up period, only one implant failed. Vertical bone augmentation ranged from 3.0 to 8.4 mm (mean 4.9 mm). A significant improvement (P < .001) in the papilla index was observed, improving the esthetic outcome. Six patients (66.6%) had more than 2 mm of keratinized mucosa and all of the patients were satisfied with the treatment. CONCLUSIONS: The esthetics and functional gingival outcome of oral rehabilitation in areas with vertical alveolar bone atrophy can be successfully improved with the presented technique, which had a high overall implant survival rate within a short period.
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Perda do Osso Alveolar/cirurgia , Implantação Dentária Endóssea/métodos , Implantes Dentários , Osteotomia/métodos , Adulto , Estética Dentária , Feminino , Humanos , Masculino , Maxila/cirurgia , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
The aim of this study was to evaluate the immunoexpression of glucose transporters 1 (GLUT-1) and 3 (GLUT-3) in keratocystic odontogenic tumors associated with Gorlin syndrome (SKOTs) and non-syndromic keratocystic odontogenic tumors (NSKOTs), and to establish correlations with the angiogenic index. Seventeen primary NSKOTs, seven recurrent NSKOTs, and 17 SKOTs were selected for the study. The percentage of immunopositive cells for GLUT-1 and GLUT-3 in the epithelial component of the tumors was assessed. The angiogenic index was determined by microvessel count. The results were analyzed statistically using the nonparametric Kruskal-Wallis test and Spearman's correlation test. High epithelial immunoexpression of GLUT-1 was observed in most tumors (p = 0.360). There was a higher frequency of negative cases for GLUT-3 in all groups. The few GLUT-3-positive tumors exhibited low expression of this protein in epithelial cells. No significant difference in the angiogenic index was observed between groups (p = 0.778). GLUT-1 expression did not correlate significantly with the angiogenic index (p > 0.05). The results suggest that the more aggressive biological behavior of SKOTs when compared to NSKOTs may not be related to GLUT-1 or GLUT-3 expression. GLUT-1 may play an important role in glucose uptake by epithelial cells of KOTs and this process is unlikely related to the angiogenic index. GLUT-1 could be a potential target for future development of therapeutic strategies for KOTs.
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Síndrome do Nevo Basocelular/patologia , Transportador de Glucose Tipo 1/análise , Transportador de Glucose Tipo 3/análise , Neovascularização Patológica/patologia , Cistos Odontogênicos/patologia , Tumores Odontogênicos/patologia , Síndrome do Nevo Basocelular/metabolismo , Células Epiteliais/patologia , Humanos , Imuno-Histoquímica , Cistos Odontogênicos/química , Tumores Odontogênicos/química , Inclusão em Parafina , Valores de Referência , Estatísticas não ParamétricasRESUMO
ABSTRACT Introduction: The probability of improvement in the upper airway space (UAS) with orthognathic surgery should be considered during the surgical-orthodontic treatment decision, providing not only an esthetic, but also a functional benefit for the patient. Objective: The purpose of this study was to evaluate the 3D changes in the upper airway space after maxillomandibular advancement surgery (MMA). Methods: A retrospective analysis of 56 patients, 21 male and 35 female, with a mean age of 35.8 ± 10.7 years, who underwent MMA was performed. Pre- and postoperative cone-beam computed tomography scans (CBCT) were obtained for each patient, and the changes in the UAS were compared using Dolphin Imaging 11.7 software. Two parameters of the pharyngeal airway space (PAS) were measured: airway volume (AV) and minimum axial area (MAA). Paired t-test was used to compare the data between T0 and T1, at 5% significance level. Results: There was a statistically significant increase in the UAS. Bimaxillary advancement surgery increased the AV and the MAA, on average, by 73.6 ± 74.75% and 113.5 ± 123.87%, respectively. Conclusion: MMA surgery tends to cause significant increase in the UAS; however, this increase is largely variable.
RESUMO Introdução: A probabilidade de melhoria do espaço aéreo superior (EAS) com cirurgia ortognática deve ser considerada durante a decisão do tratamento ortodôntico-cirúrgico, proporcionando não somente um benefício estético, mas também funcional, para o paciente. Objetivo: O objetivo do presente estudo foi avaliar as alterações 3D no espaço das vias aéreas superiores após a cirurgia de avanço maxilomandibular (AMM). Métodos: Foi realizada uma análise retrospectiva de 56 pacientes, 21 homens e 35 mulheres, com média de idade de 35,8 ± 10,7 anos, submetidos a AMM. Foram obtidas tomografias computadorizadas de feixe cônico (TCFC) pré- e pós-operatórias para cada paciente, e as alterações no EAS foram comparadas usando o software Dolphin Imaging v. 11.7. Foram medidos dois parâmetros do espaço aéreo faríngeo (EAF): volume das vias aéreas (VVA) e área axial mínima (AAM). Foi utilizado o teste t pareado para comparar os dados entre T0 e T1, com nível de significância de 5%. Resultados: Houve um aumento estatisticamente significativo no EAS. A cirurgia de avanço bimaxilar aumentou o volume das vias aéreas (VVA) e a área axial mínima (AAM) em média 73,6 ± 74,75% e 113,5 ± 123,87%, respectivamente. Conclusão: A cirurgia de AMM tende a causar o aumento significativo do EAS; no entanto, esse aumento é altamente variável.
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Humanos , Masculino , Feminino , Procedimentos Cirúrgicos Ortognáticos , Cirurgia Ortognática , Faringe/diagnóstico por imagem , Cefalometria , Estudos Retrospectivos , Imageamento Tridimensional , Estética Dentária , Tomografia Computadorizada de Feixe CônicoRESUMO
Central giant cell lesions (CGCLs) are uncommon benign jaw lesions with uncertain etiology and a variable clinical behavior. In neoplasms, alterations in molecules involved in the G1/S checkpoint are frequently found. Loss of p16(INK4a) expression or overexpression of cyclin D1 may stimulate cell proliferation. The purpose of this study was to analyze CCND1 gene amplification and the expression of p16(INK4a) in CGCLs. Structural analysis of the CCND1 was performed using chromogenic in situ hybridization. Immmunohistochemistry was used to identify p16(INK4a) protein levels. Statistical analysis correlated the two biomarkers with clinical behavior and between each other. Twenty-four lesions were included, being 11 aggressive and 13 non-aggressive. Moderate/high-level CCND1 amplification was found in 12 lesions. Also, immunoreactivity for p16(INK4a) was present in 12 cases, mainly in mononuclear cells. There was a significantly higher level of p16(INK4a) expression in mononuclear cells of non-aggressive lesions and lesions with moderate/high-level CCND1 amplification in mononuclear cells. It could be speculated that some CGCLs may develop as a true benign neoplasm. The higher expression of p16(INK4a) in non-aggressive lesions and in cases with moderate/high-level CCND1 amplification may show that these molecules have a role in CGCLs.
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Ciclina D1/genética , Inibidor p16 de Quinase Dependente de Ciclina/genética , Amplificação de Genes , Células Gigantes/metabolismo , Arcada Osseodentária/metabolismo , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Dosagem de Genes , Expressão Gênica , Células Gigantes/patologia , Humanos , Arcada Osseodentária/patologia , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de DoençaRESUMO
OBJECTIVE: The aim of this study was to immunohistochemically analyse bone resorption regulators (receptor activator of nuclear factor kappa B ligand [RANKL] and osteoprotegerin [OPG]), angiogenic index, and myofibroblasts in Gorlin syndrome-related odontogenic keratocysts (SOKCs) and non-syndrome odontogenic keratocysts (NSOKCs). STUDY DESIGN: Twenty-two SOKCs, 22 primary NSOKCs, and eight recurrent NSOKCs were evaluated by immunohistochemistry using anti-RANKL and anti-OPG antibodies. The angiogenic index was determined by microvessel count (MVC) using anti-CD34 antibody. Anti-α-smooth muscle actin (α-SMA) antibody was used for the identification of myofibroblasts. RESULTS: Analysis of the expression of RANKL and OPG in the epithelial lining and fibrous capsule did not reveal significant differences between groups (P>0.05). In the epithelial lining, the RANKL/OPG ratio was RANKL
Assuntos
Síndrome do Nevo Basocelular/metabolismo , Reabsorção Óssea/metabolismo , Miofibroblastos/metabolismo , Cistos Odontogênicos/metabolismo , Osteoprotegerina/metabolismo , Ligante RANK/metabolismo , Antígenos CD34/análise , Células Epiteliais/metabolismo , Humanos , Imuno-Histoquímica , Neovascularização Patológica , Cistos Odontogênicos/irrigação sanguíneaRESUMO
Central Giant Cell Lesion (CGCL) is an uncommon benign jaw lesion, with uncertain etiology, and a variable clinical behavior. Studies of molecular markers of CGCL, may help understanding better the nature and behavior of this lesion, and eventually may represent a definitive target to pharmacological approach in the treatment of CGCL. Chronic inflammation has been found to mediate a wide variety of diseases including neoplasms. Among the gene products involved in the induction of the inflammatory process, Cyclooxygenase 2 (COX-2) has been shown to have a close relationship with tumorigenesis, however COX-2 expression has never been evaluated in CGCL. The aim of the study was to investigate the expression of COX-2 in CGCL. Immunohistochemical assessment for COX-2 expression was performed in 18 patients previously diagnosed with CGCL. Multinucleated giant cells (MGC) and mononucleated stromal cells (MSC) were used in the slide analysis. Among the patients studied, 10 were male and 8 were female, with a median age of 15.4 years. Lesions in the mandible were observed in 11 cases and 7 were found in the maxilla. There were 9 aggressive and 9 non-aggressive CGCLs. COX-2 immunopositivity was present in only 3 cases stained in both MGC and MSC. All 3 cases presented with ulcerations in the mucosa lesion, suggesting that the COX-2 expression is due to the presence of inflammation. This study does not support the involvement of COX-2 in the etiophatogenesis of CGCL.
Assuntos
Ciclo-Oxigenase 2/metabolismo , Células Gigantes/enzimologia , Doenças Maxilomandibulares/enzimologia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Células Gigantes/patologia , Humanos , Imuno-Histoquímica , Doenças Maxilomandibulares/patologia , Masculino , Adulto JovemRESUMO
Abstract The aim of this study was to evaluate the immunoexpression of glucose transporters 1 (GLUT-1) and 3 (GLUT-3) in keratocystic odontogenic tumors associated with Gorlin syndrome (SKOTs) and non-syndromic keratocystic odontogenic tumors (NSKOTs), and to establish correlations with the angiogenic index. Seventeen primary NSKOTs, seven recurrent NSKOTs, and 17 SKOTs were selected for the study. The percentage of immunopositive cells for GLUT-1 and GLUT-3 in the epithelial component of the tumors was assessed. The angiogenic index was determined by microvessel count. The results were analyzed statistically using the nonparametric Kruskal-Wallis test and Spearman’s correlation test. High epithelial immunoexpression of GLUT-1 was observed in most tumors (p = 0.360). There was a higher frequency of negative cases for GLUT-3 in all groups. The few GLUT-3-positive tumors exhibited low expression of this protein in epithelial cells. No significant difference in the angiogenic index was observed between groups (p = 0.778). GLUT-1 expression did not correlate significantly with the angiogenic index (p > 0.05). The results suggest that the more aggressive biological behavior of SKOTs when compared to NSKOTs may not be related to GLUT-1 or GLUT-3 expression. GLUT-1 may play an important role in glucose uptake by epithelial cells of KOTs and this process is unlikely related to the angiogenic index. GLUT-1 could be a potential target for future development of therapeutic strategies for KOTs.