Adriana Etges

A survey of oral and maxillofacial biopsies in children: a single-center retrospective study of 20 years in Pelotas-Brazil

Despite the large number of published cases about oral and maxillofacial pediatric lesions, the literature is scarce on epidemiological studies regarding the prevalence of these entities. This study retrieved oral and maxillofacial pediatric lesions from the Center of Diagnosis of Oral Diseases (CDDB) at the Dental School of the Federal University of Pelotas (UFPEL), comprising a 20-year period (1983-2002). From the total of 9,465 biopsies received in this period, 625 (6.6%) were from children aged 0 to 14 years. Regardless of the histopathological diagnosis, patient data referring to lesion location, sex and age were collected. Diagnoses were grouped in 13 categories. As much as 89% of the cases occurred in patients aged 7 to 14 years (53% in females and 47% in males). Mucocele (17.2%) was the most common type of lesion, followed by dentigerous cyst (8.6%). In the category of odontogenic tumors, odontoma was the most frequent lesion (64.2%). Malignant lesions were observed in a small section of the sample (1.2%). Generally, the results of the present study are in line with those reported in the literature concerning the most prevalent lesions in the pediatric population. Most lesions were benign, and malignant lesions were diagnosed in a very small part of the sample.

2-Hydroxyethyl methacrylate as an inhibitor of matrix metalloproteinase-2

This study evaluated the effect of different concentrations of 2-hydroxyethyl methacrylate (HEMA) on the inhibition of matrix metalloproteinase-2 (MMP-2) in vitro. Mouse gingival explants were cultured overnight in Dulbeccos modified Eagles minimal essential medium, following which the expression of secreted enzymes was analyzed by gelatin zymography and the effects of different amounts of HEMA on enzyme activity were investigated. The gelatinolytic proteinases present in the conditioned media were characterized as being matrix metalloproteinases (MMPs) by means of specific chemical inhibition. The MMPs present in the conditioned media were identified, using immunoprecipitation, as MMP-2. Three major bands were detected in the zymographic assays and were characterized, according to their respective molecular weights, into the following forms of MMP-2: zymogene (72 kDa), intermediate (66 kDa), and active (62 kDa). All forms of MMP-2 were inhibited by HEMA in a dose-dependent manner, implying that MMP-2 may be inhibited by HEMA in vivo.

Etiologic factors associated with oral squamous cell carcinoma in non-smokers and non-alcoholic drinkers: a brief approach

Oral squamous cell carcinoma (OSCC) is the fifth most common type of cancer in the world. The effect of some etiological factors is well established in the literature, such as consumption of tobacco and alcohol. However, approximately 15 to 20% of all oral cancer cases occur in patients without the traditional risk factors, reflecting in numerous cases of OSCC in non-smokers and non-alcoholic drinkers. Also, several studies have suggested a possible association between human papillomavirus and OSCC. Under these aspects, the purpose of this study is to address cases of oral cancer in non-smokers and non-drinkers focusing on the role of HPV, thus contributing to improve the diagnosis and monitoring of OSCC. A computer database search was performed using the Pubmed database. The search key words were: epidemiology, oral squamous cell carcinoma, risk factors and human papillomavirus. It is important to assess patients without the potential risk factors, since this knowledge may help identifying other features associated with the occurrence of oral cancer, enabling an appropriate clinical management and monitoring.

Occurrence, isolation and differentiation of Candida spp. and prevalence of variables associated to chronic atrophic candidiasis.

The purpose of this study was to survey the frequency of Candida spp. in patients with chronic atrophic candidiasis (CAC), to differentiate Candida species and to assess the prevalence of certain infection‐associated variables to this disease. Patients with CAC and wearing partial or complete dentures were recruited. Data were obtained by means of a questionnaire with details involving identification of the subject, demographic characteristics, behaviour and medical history, clinical and mycological evaluation and identification of yeast. The sample collection was carried out in the palate or palate and tongue of the subjects using sterilised swabs. Data were submitted to statistical analyses using Fischer’s test. Forty‐three (53%) cases of CAC showed the presence of Candida albicans. Females (75.2%) wearing complete dentures (60.1%) for more than 10 years (58%) were risk factors to CAC development. It could be concluded that: (a) the results did not confirm a significant difference among patients with CAC concerning the presence or absence of Candida spp.; (b) the occurrence of Candida was negatively related to important factors associated to this opportunistic infection; and (c) mycological findings did not indicate that the variables investigated have a significant effect on oral infections by C. albicans or other Candida species.

Genotoxic potential of 10% and 16% Carbamide Peroxide in dental bleaching

Dental bleaching has become one of the most frequently requested esthetic treatments in dental offices. Despite the high clinical success observed with this procedure, some adverse effects have been reported, including a potential for developing premalignant lesions, root resorption and tooth sensitivity, especially when misused. The aim of this study was to evaluate the genotoxic response using a micronucleus (MN) assay, after the application of two concentrations of carbamide peroxide. Thirty-seven patients were divided into two groups and randomly received either a 10% carbamide peroxide (CP) (19) or a 16% carbamide peroxide (18) concentration for 21 days in individual dental trays. Gingival margin cells were collected immediately before the first use (baseline), and then 15 and 45 days after baseline. The cells were placed on a histological slide, stained by the Feulgen technique, and evaluated by an experienced blinded examiner. One thousand cells per slide were counted, and the MN rate was determined. The two groups were analyzed by the Wilcoxon rank-sum test and the Kruskal-Wallis equality-of-populations rank test. A slight increase in MN was observed for both groups, in comparison with the baseline, at 15 days. However, no difference was observed between the two groups (10% and 16%), at either 15 or 45 days (p = 0.90). When bleaching is not prolonged or not performed very frequently, bleaching agents containing carbamide peroxide alone will not cause mutagenic stress on gingival epithelial cells.

Evaluation of the genomic DNA extracted from formalin-fixed, paraffin-embedded oral samples archived for the past 40-years

INTRODUCAO: O material fixado em formol e embebido em parafina constitui hoje a maior fonte de tecido humano arquivado. O DNA extraido de tecido parafinado por vezes nao e adequado para as tecnicas de biologia molecular, visto que se apresenta parcialmente degradado. OBJETIVOS: O objetivo desse estudo foi verificar se tecido humano de boca parafinado e arquivado pelos ultimos 40 anos pode ser usado para a reacao em cadeia da polimerase (PCR). METODOS: Amostras foram submetidas a tecnica de extracao de DNA pelo metodo do fenol-cloroformio. Para quantificacao e qualificacao do DNA foram realizadas analise em espectrofotometro, eletroforese em gel de agarose e amplificacao pela tecnica da PCR. RESULTADOS: Foi observada fraca correlacao positiva entre a quantidade de DNA obtida e a idade das amostras. A eletroforese em gel de agarose demonstrou que a maioria do DNA obtido foi constituida de fragmentos pequenos. O fragmento de 268-pb do gene da b-globina foi amplificado em 55% dos casos, preferencialmente nos casos mais recentes. O fragmento de 149-pb do gene WAF1 apresentou amplificacao fraca, mas presente em 75% dos casos. O fragmento de 536-bp do gene da b-globina foi detectado em somente 25% dos casos e tambem preferencialmente nos casos mais recentes. CONCLUSOES: Esse estudo mostrou que, apesar de o DNA estar degradado, e possivel usar DNA genomico extraido de tecido parafinado arquivado pelos ultimos 40 anos em reacoes de PCR de produtos pequenos. A amplificacao de produtos maiores, entretanto, e mais dificil.

Outcome of Periapical Lesions in a Rat Model of Type 2 Diabetes: Refractoriness to Systemic Antioxidant Therapy

INTRODUCTION This study evaluated the development of periapical lesions in a rat model of type 2 diabetes and assessed the potential actions of the antioxidant agent tempol in this model. METHODS Male Wistar rats were used; they received tap water (N = 5) or a 20% glucose solution (N = 15) during a period of 9 weeks. At the sixth week, periapical lesions were induced on the first mandibular molars, and the animals were subdivided into 4 groups. The subgroup 1 was composed of nondiabetic rats orally receiving saline solution (10 mL/kg). Chronically glucose-fed rats were divided into the following subgroups: (2) saline-treated animals (10 mL/kg by oral route), and animals treated with tempol by gavage at doses of (3) 50 mg/kg or (4) 100 mg/kg. The body weight was monitored thoroughly. After 21 days of apical periodontitis induction, the animals were killed, and the mandibles were collected and submitted to radiographic and histologic analysis. The livers were collected to determine free radicals, and the blood plasma was used to measure insulin levels. RESULTS Type 2 diabetic rats displayed a significant decrease of body weight gain and a slight increase of insulin levels, which were allied to reduced levels of the antioxidant components catalase and reduced glutathione; these alterations were reversed by tempol. Concerning the periapical lesions, neither radiographic nor histologic analysis revealed any significant difference between control and type 2 diabetic rats. In diabetic rats, the apical periodontitis was refractory to tempol treatment. CONCLUSIONS The extent and cellularity of periapical lesions in glucose-fed type 2 diabetic rats were similar to those seen in control rats. Despite affecting other parameters related to diabetes, tempol failed to improve the outcome of endodontic lesions in type 2 diabetic animals.

Collagenous fibroma (desmoplastic fibroblastoma) of alveolar bone: a case report

O fibroma colagenoso (fibroma desmoplasico) e um tumor de tecido mole raro de origem fibroblastica. Na mucosa oral apenas dois casos foram descritos pela literatura. Nos descrevemos o caso de uma mulher de 42 anos de idade, cuja queixa era uma lesao indolor, de crescimento lento sob sua protese total superior. Os achados histologicos da lesao incluiram fibroblastos escassos, estrelados ou fusiformes, dispersos em um estroma rico em colageno. As celulas lesionais foram positivas para vimentina, mas rara marcacao foi observada para actina musculo liso e fator XIIIa. A excisao cirurgica total foi realizada e a recidiva da lesao nao e esperada.

Kinin B1 Receptor Deletion Affects Bone Healing in Type 1 Diabetic Mice

The effects of kinin B1 receptor (B1R) deletion were examined on femur bone regeneration in streptozotocin (STZ)‐type 1 diabetes. Diabetes induction in wild‐type C57/BL6 (WTC57BL6) mice led to decrease in body weight and hyperglycemia, compared to the non‐diabetic group of the same strain. The lack of B1R did not affect STZ‐elicited body weight loss, but partially prevented hyperglycemia. Diabetic mice had a clear delay in bone regeneration, and displayed large areas of loose connective tissue within the defects, with a reduced expression of the mineralization‐related protein osteonectin, when compared to the non‐diabetic WTC57/BL6. The non‐diabetic and diabetic B1R knockout (B1RKO) mice had bone regeneration levels and osteonectin expression comparable to that seen in control WTC57/BL6 mice. WTC57/BL6 STZ‐diabetic mice also showed a marked reduction of collagen contents, with increased immunolabeling for the apoptosis marker caspase‐3, whereas diabetic B1RKO had collagen levels and caspase‐3 activity comparable to those observed in non‐diabetic WTC57/BL6 or B1RKO mice. No significant difference was detected in the number of tartrate‐resistant acid phosphatase (TRAP)‐stained cells, or in RANK/RANKL/OPG system immunolabeling throughout the experimental groups. Data bring novel evidence on the relevance of kinin B1R under type 1 diabetes with regards to its role in bone regeneration. J. Cell. Physiol. 230: 3019–3028, 2015.

Demographic profile of oral nonodontogenic cysts in a Brazilian population

Objectives: The purpose of this study was to determine the clinical and demographic characteristics of oral non-odontogenic cysts (ONOC) in a Brazilian population over a 53-year period and to compare this data with the literature. Study Design: A total of 20.391 biopsies records were evaluated, from April/1959 to August/2012. Cases of oral developmental cysts were selected. Data regarding age, gender, time of evolution, and anatomic site of all cases were collected. The data were analyzed by descriptive statistics. Results: Among 20.391 oral biopsies, 71 (0.35%) met the criteria of ONOC. Females accounted for 50.70% of all cases. The mean age observed was 38.14 years (range: 5-88 years). Nasopalatine duct cysts, oral lymphoepithelial cysts and epidermoid cysts were the most common ONOC, accounting for 63 cases (88.73%). Nasopalatine duct cysts occurred in 31 cases (43.66%), followed by 22 patients with oral lymphoepithelial cysts (30.99%) and 10 cases of epidermoid cysts (14.08%). Nasopalatine duct cysts revealed predominance among males (58.06). Oral lymphoepithelial cysts were more commonly observed in tongue (50%). Epidermoid cysts were most frequently found in the buccal mucosa (40.00%). Conclusions: The differential diagnosis of ONOC is based on the clinical, radiological, and histological findings. It is difficult to establish an epidemiological profile of ONOCs, considering the low frequency of these lesions and the divergences in the demographic and clinical presentation data among different populations. Key words:Diagnosis, epidemiology, jaw cysts, mouth.