José Luiz Cintra Junqueira

Peroxiredoxin I is overexpressed in oncocytic lesions of salivary glands

BACKGROUND Oncocytic lesions, particularly frequent in the salivary glands, are characterized by cells with an atypical accumulation of mitochondria. This accumulation has been recognized as a compensatory mechanism to intrinsic functional defects of these organelles, resulting in energy production impairment and increased generation of reactive oxygen species (ROS), including hydrogen peroxide (H(2)O(2)). Peroxiredoxin I (Prx I) is a H(2)O(2) scavenging protein and the expression of its yeast homolog was reported to be influenced by mitochondrial function. METHODS In this study, we evaluated Prx I expression in oncocytic lesions of salivary glands by immunohistochemistry. RESULTS Our results showed that Prx I is overexpressed in oncocytes regardless of the salivary gland lesion where they appear. CONCLUSIONS These results suggest that Prx I expression in oncocytes is related to its ability to decompose mitochondrial-derived H(2)O(2) and that it could provide to the cells a protective role in an environment that, by continuously producing potential DNA-damaging ROS, predisposes to genome instability and cellular transformation.

Cryosurgery as an Effective Alternative for Treatment of Oral Lesions in Children

Children can exhibit a wide variety of oral pathologies, such as oral lesions, bone lesions, tumors, cysts and cutaneous lesions. Different techniques have been described for the treatment of these lesions, but all of them are invasive. This paper presents a series of cases that demonstrate the clinical efficacy of cryosurgery as an alternative to invasive surgical treatments of the most common oral lesions in children. This technique has been well tolerated by patients due to the absence of anesthesia, rapid healing and minimal bleeding. Cryotherapy has many applications in oral medicine and is an extremely useful alternative in patients to whom surgery is contraindicated due to age or medical history. It is a simple procedure to perform, minimally invasive, low-cost and very effective in pediatric dentistry clinic.

Gardner syndrome with no clinical family history.

Gardner syndrome, a variant of familial adenomatous polyposis, is a hereditary disorder inherited as an autosomal dominant with high penetrance and variable expression that is caused by a mutation of the adenomatous polyposis coli gene. It is characterized by gastrointestinal polyps associated with multiple osteomas, dental anomalies, skin and soft tissue tumors, and congenital hypertrophy of the retinal pigment epithelium. Early diagnosis of Gardner syndrome is crucial and may be life saving because the polyps usually undergo malignant change by the fourth decade of life. The extraintestinal manifestations frequently precede gastrointestinal symptoms; consequently, the dentist may play an important role in the diagnosis of this syndrome. The authors report a case of Gardner syndrome with no clinical family history that was diagnosed by the dentist based on oral and maxillofacial findings.

Presence of Cells in Fresh-Frozen Allogeneic Bone Grafts from Different Tissue Banks

Bone replacement materials have been widely used to reconstruct atrophic jawbones. Based on previous reports demonstrating the presence of viable cells in bone blocks even after processing by musculoskeletal tissue banks for orthopedic use, the aim of this study was to evaluate the presence of cells in bone blocks from three Brazilian tissue banks for maxillary reconstructions. All samples were processed by the respective tissue banks, according to the guidelines of the Brazilian National Sanitary Surveillance Agency. Three samples were removed from each block for subsequent histological processing and stained using hematoxylin & eosin. Further evaluation included section staining by the Feulgen method and ultrastructural analysis using scanning electron microscopy (SEM). Light microscopy images from all bone samples showed presence of osteocyte-like cells in all groups and intense Feulgen staining, demonstrating presence of DNA in bone even after tissue processing. The ultrastructural analysis showed red blood cells in lacunae within the bone tissue. In conclusion, despite bone tissue processing by the musculoskeletal tissue banks, cells may be found within the bone used for allogeneic grafts.

Prevalence of Oral Lesions in Hospitalized Patients with Infectious Diseases in Northern Brazil

The aim of this study was to assess the prevalence of oral lesions in infectious-contagious diseases patients being treated in the University Hospital of the Federal University of Pará, northern Brazil. One hundred seven patients with infectious diseases were clinically investigated for oral lesions at the University Hospital of Pará, northern Brazil. From total sample, most patients were men (65.7%) with a mean age of 45.4 years. About prevalence of systemic diseases, tuberculosis was the most frequent illness, followed by AIDS, hepatitis types B and C, leishmaniasis, and meningitis. Analyzing oral manifestations, periodontal diseases and candidiasis were the most prevalent diseases in both genders, followed by recurrent aphthous ulcers, saburral tongue, simplex herpes, and squamous cell carcinoma. Of all 107 patients, only 10 males and 6 females did not present any oral manifestation. There was no statistical difference between genders with any systemic condition (P > 0.05). The great prevalence of oral manifestations in hospitalized patients with systemic disorder emphasizes the need of integral dental care in this context, aiming at a multidisciplinary approach of patients. Therefore, presence of some oral conditions, such as candidiasis, should be an alert to different systemic conditions, once in assistance with physicians; dentists can influence the early diagnosis and treatment.

Low dose propranolol decreases orthodontic movement

OBJECTIVE Low dose propranolol has previously been demonstrated to suppress bone remodelling. Therefore, its effect on orthodontic movement was tested. DESIGN Rats were assigned as follows (n=5): animals with no orthodontic appliance (G1); the remaining groups were fitted with a Ni-Ti closed-coil spring ligated to the upper left first molar and connected to the incisors using metal and resin and received vehicle only (G2), 0.1mg/kg (G3) or 20mg/kg (G4) of propranolol orally. Cone Beam Computed Tomography was performed using high resolution for image capture. The distance between the first and second upper molars, both with and without the orthodontic appliance, was measured in millimetres. Gingival tissue was harvested and assessed for IL-1β and IL-6 using ELISA and for ICAM-1 and RANKL by Western blotting. RESULTS The orthodontic appliance induced a significant tooth movement in G2 when compared to the animals without an orthodontic appliance (G1) (p<0.05). The animals from G3 showed a significantly reduction in tooth movement (p<0.05) when compared with rats from G2. Animals treated with 20mg/kg of propranolol (G4) showed tooth movement similar to that of G2. The reduced tooth movement observed in the animals treated with 0.1mg/kg of propranolol (G3) occurred due to decreased amounts of IL-1β and IL-6, in addition to lower ICAM-1 and RANKL expression. CONCLUSIONS Low dose propranolol inhibits bone remodelling and orthodontic movement.

Location and classification of Canalis sinuosus for cone beam computed tomography: avoiding misdiagnosis

The aim of this study was to assess the presence, location and, multiplanar distance of the canalis sinuosus (CS) between the incisive foramen and the anterior maxillary alveolar ridge using cone beam computed tomography (CBCT). Therefore, 500 CBCT maxillary images obtained from male and female patients aged 20 to 80 years were selected to assist in the dental treatment. Low-quality tomographic images were discarded. All images were captured with the i-CATTM Classic tomograph and assessed using the XoranCatTM software. The axial sections were analyzed at the incisive foramen in order to verify the CS presence in laterality and location. Furthermore, linear measurements of the nasal cavity floor, buccal cortical bone, and alveolar ridge crest were made. All the collected data were statistically analyzed. Results show a variation of the CS in relation to the classification and distance of anatomical structures, but no significant difference between the right and left sides. It should be highlighted that CBCT is necessary before invasive procedures in order to preserve important anatomical structures. In conclusion, the location of the CS varies in relation to the alveolar ridge crest and buccal cortical bone, assuming that it is going to be located by the upper lateral incisor palatine.

Prevalence evaluation and classification of bifid mandibular canals in CBCT exams in different facial types

Objetive: The aim of this study is to establish the prevalence and classification of mandibular canal alterations using cone beam computed tomography (CBCT) in different facial types. This research was submitted and approved by the research ethics committee, registration number 2.065.839. Material and method: The sample consisted of 90 CBCTs from the São Leopoldo Mandic Dental School database (Campinas-SP), divided into three groups according to brachycephalic, dolichocephalic and mesocephalic facial types. Result: Of the 90 patients, 23 presented bifid mandible canals (25.6%), of which 60.9% were in males and 39.1% in females. In 39.1%, the canal bifurcation occurred towards the retromolar region (class D), 21.7% had a trajectory to an alveolar or upper direction (class C) and 13.1% were classified as C-E. For the remaining classifications (A, E, F and A-E), the frequencies were in the range of 8.7% to 4.3%. None of the 23 cases of mandibular canal bifurcation was classified as B (mesial direction). Conclusion: According to the results obtained from this study, the prevalence of bifid mandibular canals was found to be 25.6%, with class D being the most prevalent for the retromolar region and the highest occurrence was unilaterally on the left side. When evaluating the occurrence of bifid mandibular canals in relation to facial types, brachycephalic patients were the most affected. Descriptors: Surgery; anatomy; mandible. Freitas, Freitas e Silva, Manhães Júnior et al. Rev Odontol UNESP. 2018 Mar-Apr; 47(2): 85-91 86 86/91

Mandible condyle osteochondroma: clinical case report

Osteochondroma is one of the most common benign bone tumours. Although frequently found in the general skeleton, it is rarely seen to involve the facial bones1-4. It usually occurs early in life affecting young adults between 10-30years of age but the craniofacial Osteochondroma are frequently seen in older women5. The clinical presentation of Osteochondroma includes facial asymmetry, malocclusion, cross-bite on contra-lateral side and lateral open-bite on the affected side, deviation on opening, hypomobility, pain and clicking6. Pre-auricular swelling, TMJ pain, cliking sound and recurrent joint dislocation are also common manifestation of the tumour7. Differential diagnosis of slow-growing tumours in the mandibular condyle Osteochondroma include giant cell tumor, condylar hyperplasia, fibro-osseous lesion, vascular malformation, osteoma, chondroma, and osteochondroma8-9. Pre operative computed tomography scans are (CT) scans is essential in the treatment planning of these tumours and depending on the symptoms and duration of the osteochondroma, the management ranges from excision of the tumor alone to condylectomy along with tumor excision1. A recent paper10 reported that the treatment of osteochondroma remains controversial because some authors have proposed conservative resection with

Use of botulinum toxin type a in temporomandibular disorder

ABSTRACT Temporomandibular disorder (TMD) may be defined as a set of clinical scenarios involving the masticatory muscles, the temporomandibular joint (TMJ) and associated structures. Currently, 40 to 75% of the population has some sign of temporomandibular disorder, mainly pain located in the muscles of mastication in the pre-auricular region. The present clinical case was diagnosed as muscle temporomandibular disorder secondary to parafunction, as well as muscle hyperactivity due to surgical displacement of the left temporal muscle on two occasions, one for placement of aneurysm clips and the other for tumor excision from the supraorbital region on the left side. The patient sought medical and dental attention for 10 years due to constant headaches, tiredness and pain in the cheeks. The patient tried numerous bite-guards and pharmacological therapies to no avail. The American Academy of Orofacial Pain Questionnaire was applied combined with the Criteria for Research and Diagnostics (DRC) and a decision was made to use botulinum toxin type A in the masseter and temporalis muscles. An analog pain scale was applied over 90 days. Three days following the application of botulinum toxin type A, the patient reported a significant improvement with complete resolution of pain (level 0) after 90 days. At 12 weeks from starting treatment, facial muscle physiotherapy was introduced to strengthen the muscles of mastication and the patient remained pain-free, which allowed the preparation and adaptation of a snap-on prosthetic appliance. In conclusion, the use of botulinum toxin in patients with temporomandibular disorder should be considered as a viable therapeutic option.Indexing term: Botulinum toxins, type A. Dentistry. Temporomandibular joint disorders.