Anna Cecília Moraes Chaves

Odontogenic Epithelium: Immunolabeling of Ki-67, EGFR and Survivin in Pericoronal Follicles, Dentigerous Cysts and Keratocystic Odontogenic Tumors

The aim of this study was to evaluate the biological profile of odontogenic epithelium by immunolabeling of epidermal growth factor receptor (EGFR), Ki-67 and survivin in keratocystic odontogenic tumors (KOT), dentigerous cysts (DC), and pericoronal follicles (PF). Immunohistochemical analysis was performed in 13 KOTs, 14 DCs and 9 PFs. Immunolabeling was analyzed in the basal and suprabasal layers of KOTs and DCs, and in the islands of odontogenic epithelium and/or reduced enamel epithelium of PFs. KOTs showed the highest proliferation rate among the three groups, mainly in suprabasal layers. EGFR immunolabeling was observed mainly in the cytoplasm in basal and suprabasal layers of KOTs and in the suprabasal layer of DCs. Immunolabeling in both membrane and cytoplasm was greater in PFs. In PFs, membrane-only staining was observed. Survivin immunolabeling showed a greater percentage of positive cells (scoring +++) in the suprabasal layer of KOTs. In DCs, both layers showed similar percentages of cells scoring +++; PFs showed the highest percentage of these cells. In KOTs, epithelial cells showed stimulus-independent neoplastic proliferative characteristics, suggesting the presence of a suprabasal proliferative compartment, maintained by inhibition of apoptosis. In DCs, the basal layer seemed to proliferate in response to stimulus. Although PFs showed low proliferative activity, the expression of EGFR indicates that some cells have a high capacity to respond to stimuli, which could probably explain the origin of odontogenic lesions.

Peripheral clear cell variant of calcifying epithelial odontogenic tumor affecting 2 sites: report of a case

A case of clear cell variant of calcifying epithelial odontogenic tumor (CEOT) affecting 2 different extraosseous sites is described. A 43-year-old female patient presented with 2 gingival lesions (1 in the upper premolar and 1 in the lower incisor area), which were clinically diagnosed as inflammatory hyperplasia and surgically removed. Microscopically, both lesions were composed of polyhedral cells (some with clear cytoplasm); hyaline material and areas of calcification were also observed. The diagnostic hypotheses raised were clear cell variant of CEOT, hyalinizing clear cell carcinoma, and renal metastasis. The hyaline material was positive for Congo red, crystal violet, and Lugols iodine stains, but negative for Coomassie blue; the clear cells showed positively stained granules with PAS stain. Based on these results, the conclusive diagnosis for both lesions was clear cell variant of CEOT. No evidence of recurrence was observed after 1 year of follow-up.

Factors associated to salivary flow alterations in dry mouth female patients

BACKGROUND AND OBJECTIVES:Saliva plays an important role in oral health; it is involved in lubrication of the oral mucosa, protection against infections, transport of nutrients and digestive enzymes, remineralization of teeth, as well as aiding in chewing, swallowing and speech. Reductions in the amount of saliva are known to increase the risk of oral diseases. This study investigated the factors associated to salivary flow alterations and its relationship with age, burning mouth syndrome, psychiatric and sleep disorders, systemic diseases and chronic drug use.METHODS:A total of 30 patients complaining of dry mouth without unbalanced systemic diseases were included. Questionnaires regarding socio-demographic data, xerostomia, burning mouth, depression and anxiety symptoms, and sleep disturbances were applied. Measures of salivary flow rates were obtained using spit method. Correlation of hyposalivation and quantitative data was determined using a multivariate regression model.RESULTS:The age range was 31-83 years, hyposalivation was correlated positively with sleep disorder (β=0.079, 95% CI, to 0,124) and negatively with burning mouth (β=-0.043, 95% CI, -0.083 to -0.002).CONCLUSION:These results provide evidences regarding the association between reduced salivary flow and burning mouth, sleep disorders and chronic use of psychotropic medicines, and we highlighted the important role of antidepressants on modulation of burning mouth sensation.

Ulceração bucal com sequestro ósseo - relato de caso

Este estudo relata o caso de um paciente do genero masculino, 38 anos de idade, que apresentava ulceras bilaterais com necrose ossea na regiao lingual da mandibula no nivel da linha miloioidea ha trinta dias. O paciente relatava dor discreta e sangramento eventual. A radiografia oclusal mostrava exostoses osseas bilaterais na cortical ossea lingual da mandibula. O diagnostico de ulcera com sequestro osseo baseou-se no exame clinico e na radiografia oclusal. O paciente foi tratado com antiobioticos, bochechos com clorexidina a 0,12% e remocao dos sequestros osseos. Apos sessenta dias, na consulta de proservacao, observou-se que a regiao estava completamente cicatrizada. O paciente apresentava bruxismo, o qual foi diagnosticado pela observacao de facetas de desgaste nos incisivos inferiores e por meio de entrevista com os familiares. Em razao disso, o paciente foi encaminhado para um clinico geral para que fosse realizado um tratamento com placa miorrelaxante. Essa lesao e rara e o reconhecimento de suas caracteristicas e importante a fim de que se realize o diagnostico preciso e o tratamento apropriado.