Alexandrino Pereira dos Santos Neto

Analysis of Dental Enamel Surface Submitted to Fruit Juice Plus Soymilk by Micro X-Ray Fluorescence: In Vitro Study

Objective. This paper aimed to analyze the in vitro industrialized fruit juices effect plus soy to establish the erosive potential of these solutions. Materials and Methods. Seventy bovine incisors were selected after being evaluated under stereomicroscope. Their crowns were prepared and randomly divided into 7 groups, using microhardness with allocation criteria. The crowns were submitted to the fruit juice plus soy during 15 days, twice a day. The pH values, acid titration, and Knoop microhardness were recorded and the specimens were evaluated using X-ray microfluorescence (µXRF). Results. The pH average for all juices and after 3 days was significantly below the critical value for dental erosion. In average, the pH value decreases 14% comparing initial time and pH after 3 days. Comparing before and after, there was a 49% microhardness decrease measured in groups (p < 0.05). Groups G1, G2, G5, and G6 are above this average. The analysis by μXRF showed a decrease of approximately 7% Ca and 4% P on bovine crowns surface. Florida (FL) statistical analysis showed a statistically significant 1 difference between groups. Thus, a tooth chance to suffer demineralization due to industrialized fruit juices plus soy is real.

The Promising Applications of Stem Cells in the Oral Region: Literature Review

Introduction: For a long time researchers have tried to find out a way to grow tissues back to the human body in order to solve transplantation problems by offering the unique opportunity to have their organs back, working properly, in search of life dignity. Literature Review: Stem cells seem to be present in many other tissues than researchers had once thought; and in some specific sites they can be easily collected, without the need of expensive interventions. The oral cavity is one of these regions where their collection can be accomplished, with plenty of accessible sites enriched with these precious cells. Aim: The aim of this literature review is to research where in the mouth can scientists find stem cells to be used in the near future. Key-message: The aim of this literature review is to research where stem cells can be found and collected in the oral cavity.

Oral Lichenoid Lesion Manifesting as Desquamative Gingivitis. Unlikely association? Case Report

Introduction: The aim of this report is to present a clinical case of oral lichenoid lesions associated with amalgam restorations with the presence of desquamative gingivitis for a nine months follow up period. Case Report: The histopathologic characteristics and direct immunofluorescence were compatible with Oral Lichenoid Lesion (LLO). Diagnosis was based on a synthesis of all available information, including medical history, clinical examination, histopathology and the results of specific tests, such as the patch test, which confirmed allergy to thimerosal, an organic compound of mercury. Discussion: The replacement of amalgam restorations has brought improvements to the instrument, as evidenced by the disappearance of desquamative gingivitis, aspect erythematosus and erosive lesions. The fading does not complete the same, however, indicates the need to continue has been under continuous observation, the patient, having in view the possibility of the existence of an underlying lichen planus.

Pulp Revascularization: A Literature Review

Reestablishing blood flow and allowing the continuation of root development are some of the objectives of pulp revascularization. This procedure is currently indicated for teeth with incomplete root formation as an alternative to the traditional treatment of apecification, which consists of inserting calcium hydroxide paste into the root canal for a determined time period in order to induce the formation of a calcified barrier. Although it is considered as the most classically employed therapy, the permanence of the paste for long time periods may lead to the weakening of the root due to hygroscopic properties, as well as proteolytic activities of calcium hydroxide. Therefore, there has been a permanent search for alternatives which allow the full development of immature teeth. Revascularization has emerged as such an alternative, and a range of treatment protocols can be found in the scientific literature. The aim of this paper is to accomplish a literature review concerning this issue.

Analysis of the presence and location of mast cells in periapical cysts and periapical granulomas

Objective: The aim of the present study was to locate mast cells in chronic periapical lesions (granulomas and cysts) by using histochemical techniques and toluidine blue staining. Methods: A quantitative, descriptive, cross-sectional and retrospective research was performed. The sample was obtained from histopathological reports in the archives of the laboratory of surgical pathology of the University of Pernambuco between November 2014 and May 2015. Results: Sixteen cases of granuloma and 21 cases of periapical cysts were selected. The stained slides were analyzed by two examiners at different times, in a double-blind study. Mast cells were found in 13 (61.9%) of the periapical cyst cases, located in the capsule of the lesion. In the periapical granuloma cases, mast cells were found in eight cases (50%), located in the granulation tissue. Conclusion: Mast cells were detected in both cysts and periapical granuloma, located in the capsule and granulation tissue, respectively. Mast cells were more prevalent in periapical cysts than in periapical granuloma.

The Immunologic Relationship between Root Resorptions and Osteoclastic Activity - Literature Review

Current literature indicates the close relationship between root resorptions and the role of clasts responsible for hard tissue destruction. The process is complex and involves mechanical factors and intense biological activity. Immunological interactions stimulate the recruitment and migration of clasts into a specific area, in order to destroy bone, cementum and dentin. Nevertheless, understanding the whole process will bring light to other questions concerning the role of the immunologic system in other parts of the human body. The aim of this review was to describe the development of the process, from mineralization to the destruction of hard tissues and the possible relationship between root resorption and cellular immune system.

A Rare Malignant Peripheral Nerve Sheath Tumor of the Maxilla Mimicking a Periapical Lesion

Malignant peripheral nerve sheath tumor is a malignant neoplasm that is rarely found in the oral cavity. About 50% of this tumor occurs in patients with neurofibromatosis type I and comprises approximately 10% of all soft tissue sarcomas of head and neck region. Intraosseous malignant peripheral nerve sheath tumor of the maxilla is rare. This article is the first to address malignant peripheral nerve sheath tumor of the maxilla presenting as a periapical radiolucency on nonvital endodontically treated teeth in the English medical literature. Surgical approaches to malignant soft tissue tumor vary based on the extent of the disease, age of the patient, and pathological findings. A rare case of intraosseous malignant peripheral nerve sheath tumor is reported in a 16-year-old woman. The patient presented clinically with a pain involving the upper left incisors region and with defined unilocular periapical radiolucency lesion involved between the upper left incisors. An incisional biopsy was made. Histological and immunohistochemical examination were positive for S-100 protein and glial fibrillary acidic protein showed that the lesion was an intraosseous malignant peripheral nerve sheath tumor of the maxilla. Nine years after the surgery, no regional recurrence was observed.

Oroantral fistulas closure using Bichat's fat pad

The oroantral fistula is one of the complications most common after dental extractions in posterior maxillary, mainly in the region of second and third molar. The diagnosis is based on clinical signs and symptoms, which may be present in pain, fever, hyposmia and drainage of purulent discharge; additional examinations such as computed tomography and sinus nasal endoscopy improve diagnostic precision. It is therefore of paramount importance to correct early diagnosis and treatment avoiding in this way, the symptons of sinusitis, infections and dysphonia. Several surgical techniques have been proposed for the closure of the bucosinusal fistula; the use of Bichat´s fat pad has become a successful alternative among them. Many surgical treatments have been to propose for closure of bucosinusal fistula; Bichat fat pad has been a good alternative. The propose for this article is report two cases with closure of bucosinusal fistulas through Bichats fat pad, as well as to discuss the surgical techniques, characteristics, indications and peculiarities.

P-202 - Delirious mania or delirious affective disorder: when depression meets delirium. a case report where cognitive deficits thicken the plot

Introduction The co-occurrence of mania and delirium, named “delirious mania”, is an under-recognized entity not listed in major diagnostic classifications. Literature about this syndrome is still scarce and lacking evidence. Usually, reports of affective syndromes with delirium tend to be subdued in the manic descriptor Objectives We report the case of a 44 year old female patient with a simultaneous affective episode and delirium. Aims To demonstrate the co-occurrence of depressive/mixed symptoms and delirium Methods Review of clinical records and complementary exams. Results The patient was admitted after a three week long depressive syndrome with psychomotor agitation, followed by a week-long fluctuating pattern of delirious and mixed affective features. Shortly after admission the patient exhibited a stuporous state, with nocturnal agitation. A fluctuating pattern of symptoms ensued, with disorientation, disorganized behavior, cognitive impairment, anxiety and depressive features. The patient was put on mood stabilizers, antipsychotics and benzodiazepines. She was discharged symptom-free two months later and re-admitted 4 weeks later due to recurrence of symptoms. Electroconvulsive treatment was applied,with quick remission of affective symptoms. Yet, it took another two months until discharge, due to persistent cognitive symptoms. Medical conditions were excluded. Conclusions This case shows the simultaneous occurrence of an affective syndrome alongside delirium. The strongest treatment response occurred with ECT. The presence of depressed mood highlights the fact that this syndrome can begin without clear-cut manic symptoms. We suggest that its name should be changed to Delirious Affective Disorder, which might help to avoid misdiagnosis. Persistent cognitive deficits raise some questions in this case.

P-760 - Neurosyphilis: four case reports of immunocompetent patients presenting initially to psychiatry

Introduction Symptomatic neurosyphilis in immunocompetent patients is nowadays a rare diagnosis. Yet, if not properly diagnosed and treated, consequences for the patients health are severe. Known as “the great imitator”, its detection involves both a high degree of suspicion and adequate diagnostic tests. Psychiatric symptoms are often the presenting symptoms of this illness. Objectives The authors report four cases of neurosyphilis with psychiatric symptoms (general paresis) in immunocompetent patients. All four patients were initially referred for observation by a psychiatrist in the emergency room. Special diagnostic features of each case and potential diagnostic pitfalls are highlighted. Aims To raise awareness to the importance of this rare but highly disabling disease. Methods Review of clinical records and complementary exams. Results All patients were male, two Caucasian and two African Black, with ages ranging from 41–56 years old. Clinical presentations were quite distinct, showing the symptomatic heterogeneity of paretic neurosyphilis. Blood VDRL test was negative in one case, CSF VDRL was negative in another case. TPHA was always positive in blood and CSF. White cell count and protein quantification in the CSF remains important to confirm diagnosis. Conclusions Current prevalence of symptomatic neurosyphilis in Western Europe is unknown. Atypical cases presenting with heterogeneous psychiatric and neurologic symptoms, with no previous history of mental illness, should undergo blood VDRL testing, and specific blood treponemal testing should be considered in specific situations. A high index of clinical suspicion is needed. Confirmation of diagnosis is only possible through further CSF analysis.