Karla Mayra Rezende

Clinical and evolutionary characteristics of four patients with pulmonary histoplasmosis reported in the Paraíba Paulista Valley region.

The type of pulmonary histoplasmosis presents limited lesions to the lungs, with symptoms that are clinically and radiological similar to chronic pulmonary tuberculosis. This paper describes the clinical features of four cases of pulmonary histoplasmosis. Aspects of diagnostic and clinical, epidemiological, laboratory and imaging exams are discussed, in addition to the clinical status of the individuals five years after disease onset. The treatment of choice was oral medication, following which all the patients improved. It is important to understand the clinical status and the difficulties concerning the differential diagnosis of histoplasmosis, to assist the proper indication of cases, thus reducing potential confusion with other diseases.

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.

Chediak-Higashi Syndrome and Premature Exfoliation of Primary Teeth

The Chediak-Higashi syndrome (CHS) is a rare hereditary fatal disease, if not treated. These changes are associated with various diseases and syndromes that mainly cause periodontal disease and thus the premature loss of teeth. This paper describes the monitoring of premature loss of primary teeth that began when the child was 5 years old. On presentation his teeth were mobile and there was a history of gingival bleeding. Panoramic radiography revealed generalized and severe bone loss, and the teeth showed no bony support enough for their stability. Blood test was ordered to assess the overall health of the child and giant cells with cytoplasmic granules were found, confirming the diagnosis of CHS. The management of periodontal disease focused on the control of infection and bacterial plaque by mechanical and chemical methods.

Hyperbilirubinemia and Intrinsic Pigmentation in Primary Teeth: A Case Report and Histological Findings:

Dear Editor, We present a case in which primary teeth were affected by neonatal hyperbilirubinemia that yielded a clinically detected intrinsic green pigmentation. A 7-year-old boy was referred by his general dental practitioner to the pediatric dental clinic. According to the parents’ interview, the patient weighed 3.2 kg at birth. Twelve days later, he presented with 15.3 mg/dL of bilirubin in the blood and consequent jaundice, which lasted 4 months. Toxoplasmosis, human immunodeficiency virus, hepatitis B antigen, cytomegalovirus, rubeola, and urine sediment tests were performed to identify the presence of infection or other pathology, and all yielded negative results. Based on these results, the patient was referred for liver exploratory surgery, and a biopsy was performed. The final diagnosis was partial congenital intrahepatic biliary atresia. Intraoral examination revealed a normal texture and color in the oral soft tissues. The presence of primary upper and lower canines and molars was consistent with the chronological age of the patient and presented different levels of green pigmentation (Fig. 1A). The crowns of the primary molars were dark green in almost two thirds, while the primary canines were pigmented only at the incisal third. Tooth areas that were calcified after the hyperbilirubinemia period showed normal color, and a sharp dividing line was observed separating the green portion from the normal one in canines and molars. The distribution of pigmented areas corresponded to the period in which the patient suffered biliary atresia. Because diagnosis was made early and exploratory liver surgery was carried out, the incisal/occlusal regions of primary teeth were affected, whereas the tooth regions that developed after surgical treatment were not pigmented. The calcification of primary teeth starts between the 4th and 6th month of intrauterine life, and this process continues until 11 months after birth, with the end of the calcification of second molars [1]. If there are too much bilirubin and biliverdin pigments in the blood, a change in tooth color might occur, because these substances might be incorporated in the dentin and/or enamel formation. Although other oral manifestations, such as enamel hypoplasia and delayed tooth eruption, have been reported [2], they seldom occur. The histological analysis was made after the exfoliation of the primary upper central incisors (Fig. 1B) and revealed that the green pigment was only deposited on dentin (Fig. 2). At least 3 lines of pigmentation resembling incremental lines were evident when unstained sections were examined under light microscopy. On the other hand, enamel did not exhibit areas or lines of pigmentation. Many specific reciprocal interactions govern dentin and enamel formation, but they follow different mechanisms. Although odontoblasts synthesize and secrete the organic collagen-rich dentin matrix that subsequently mineralize [1], ameloblasts secrete a poorly mineralized matrix until the end of the secretory phase of amelogenesis. Then, ameloblasts degrade almost all the organic matrix to allow the increasing of the enamel mineral content during the maturation phase of amelogenesis [3]. Thus, it is conceivable that the green pigment was deposited into dentin when it was being secreted by odontoblasts. On the other hand, the green pigment deposited into enamel during the secretory phase of amelogenesis must have been removed during the maturation phase, in conjunction with the other organic matrix components [4]. Pediatric and Developmental Pathology 14, 155–156, 2011

Avaliação da Erupção Dentária Decídua em Bebês Considerados de Risco

Resumen pt: Objetivo: Estudar a erupcao dentaria decidua e as patologias possiveis encontradas na cavidade bucal de bebes de zero a tres anos, considerados de riscos...

Early diagnosis of regional odontodysplasia in an infant.

Regional odontodysplasia is a rare and significant dental malformation. It is a dental alteration of unknown etiology, involving both mesodermal and ectodermal dental components, which present clinical, radiographic, and histologic features. This article reports a clinical case of a 10-month-old child who was diagnosed with regional odontodysplasia in the maxilla, confirmed by radiographic examination, with a follow-up of 5 years. The clinical, radiographic, and histologic features were reviewed.

Motivation chart as a supporting tool in pediatric dentistry

Infant fear and anxiety are two feelings that cause stress in pediatric dental treatment. Many management techniques have been described in the literature, with the aim of controlling this anxiety and fear that are ultimately a big challenge for the dental surgeon. The aim of this study is to present a clinical case of a five-year-old child who would not cooperate with the dental treatment. To this end, an incentive chart was devised that is specific for treatment. The chart focuses on encouraging the child to comply with rules in the pediatric dentist office and, as the child completes his objectives, the chart is filled with happy faces and at the end of the appointment, depending on the outcome, the patient is rewarded with something. We concluded that the use of the incentive chart was particularly satisfactory in terms of the patient’s conduct and developing maturity over the course of his dental treatment and it may be an additional option to use as an adjunct in the approach to behavior in private or public dental clinics, and even in Universities. Indexing terms: Anxiety. Pediatric dentistry. Psychology.ABSTRACT Infant fear and anxiety are two feelings that cause stress in pediatric dental treatment. Many management techniques have been described in the literature, with the aim of controlling this anxiety and fear that are ultimately a big challenge for the dental surgeon. The aim of this study is to present a clinical case of a five-year-old child who would not cooperate with the dental treatment. To this end, an incentive chart was devised that is specific for treatment. The chart focuses on encouraging the child to comply with rules in the pediatric dentist office and, as the child completes his objectives, the chart is filled with happy faces and at the end of the appointment, depending on the outcome, the patient is rewarded with something. We concluded that the use of the incentive chart was particularly satisfactory in terms of the patient’s conduct and developing maturity over the course of his dental treatment and it may be an additional option to use as an adjunct in the approach to behavior in private or public dental clinics, and even in Universities.Indexing terms: Anxiety. Pediatric dentistry. Psychology.

Configuración del Sistema de Canales en la Raíz Mesiovestibular de los Primeros Molares Superiores

Univ Estadual Paulista, Dept Biosci & Oral Diag, Sch Dent, Campus Sao Jose dos Campos, Sao Paulo, SP, Brazil

Synchrotron radiation X-ray micro-fluorescence: Protocol to study mesenchymal stem cells.

The micro‐X‐ray fluorescence by synchrotron radiation (μ‐XRF) is a method to determine the composition of tissues without destroying the samples. However, this technique has never been used for the analysis of mesenchymal stem cells (MSC). This study compared different protocols for fixing, storing, preserving, and establishing the correct numbers of dental derived MSC submitted to μ‐XRF analysis. Stem cells were obtained from human dental tissue. After cell expansion, and MACS isolation, the samples were fixed and the following quantities of cells 1 × 104 to 1 × 107 were divided in two groups: G1: fixed in 4% paraformaldehyde diluted in phosphate‐buffered saline solution, and G2: fixed in 4% paraformaldehyde diluted in MilliQ water. The G1 cells showed precipitation of chemical components from the solution resulting in the formation of salt crystals while G2 cells were clear and almost transparent in the sample holder. With regards to cells concentration, the best results occurred when four droplets of 1 × 107 cells were analyzed. This work shows that to identify and study the distribution of trace elements in MSC by μ‐XRF, the best protocol is fixation in 4% paraformaldehyde diluted with MilliQ water at 4°C and a concentration of four incremental droplets of 1 × 107 cells. Microsc. Res. Tech. 79:149–154, 2016.

Histogenesis and clinical analysis of 2 cases of congenital gingival granular cell tumour.

Dentistry for babies aims to contribute to the formation of a generation with fewer dental problems, higher quality of oral health and more aware of the importance of prevention. The congenital gingival granular cell tumour (CGCT) is a rare benign soft tissue tumour in the newborn that can lead to respiratory difficulties and feeding. The aim of this work was to report two cases of CGCT in babies and discuss the clinical and histological differential diagnosis and their treatment, as well as the importance of knowledge of this pathology for dentists. Clinical features and treatment approaches are presented and discussed. The surgical approach improved the child quality of life and restored the parents confidence and emotional stability. Knowledge of this pathology helps in better diagnosis and treatment, which lead to a better quality of life of children and return confidence and emotional stability to parents.