Marina de Deus Moura de Lima

MDM2, P53, P21WAF1 and pAKT protein levels in genesis and behaviour of adenoid cystic carcinoma ☆

BACKGROUND MDM2, P53, P21(WAF1) and pAKT are proteins associated with the balance between cell death and survival. There are many hypotheses regarding the role of these proteins in salivary gland tumours. However, many molecular events that activate or inactivate regulatory genes remain unknown. The aim of this study was to evaluate and to correlate MDM2, P53, P21(WAF1) and pAKT protein expressions in adenoid cystic carcinomas (ACC). METHODS Twenty-two cases of ACC were evaluated by immunohistochemistry and one cell line derived from ACC was analyzed by Western Blotting and immunofluorescence techniques. RESULTS Strong MDM2 and pAKT, variable P53 and null P21 expressions were found in the cases analyzed, but no statistical correlation was established when comparing MDM2 and pAKT expressions in the 3 different ACC subtypes. The ACC cell line showed intense nuclear and cytoplasmatic MDM2 and pAKT expressions and null P53 and P21 expressions. CONCLUSIONS Results indicate that MDM2 and pAKT are related to the tumorigenesis of ACC, but they might not be directly connected to tumour progression. We also demonstrate that the pAKT pathway is active in ACC and it seems to be activating the MDM2 shuttle from the cytoplasm to the nucleus, where it phosphorylates P53 and carries it to the cytoplasm for degradation.

Mdm2, p53, p21 and pAKT protein pathways in benign neoplasms of the salivary gland

The p53 protein can be altered virtually in all human cancers. In the absence of p53 mutations, p53 inactivation is possible via complex formation with other proteins, such as Mdm2. Previous studies have shown an overexpression of Mdm2 and lack of p53 expression in pleomorphic adenomas. The pAkt protein is closely related to Mdm2, and has not been previously reported in salivary gland tumors. The aim of this study was to analyze the expression of Mdm2, p53, p21 and pAkt proteins in pleomorphic adenomas and myoepitheliomas by immunohistochemistry, Western blotting and immunofluorescence techniques. Overexpression of Mdm2 and pAkt was present in all the cell lines and tumors studied, whereas the expression of p53 and p21 proteins was considered absent. In conclusion, the signaling pathway in benign salivary gland neoplasm showed an important participation of Mdm2 overexpression protein in tumor formation, progression through inactivation of p53 action, or both, and of pAkt overexpression through increased translocation of Mdm2 protein to cellular nuclei.

Hybrid central giant cell granuloma and central odontogenic fibroma-like lesion of the mandible.

Central odontogenic fibroma (COF) is a benign and rare neoplasm characterized by varying amounts of inactive-looking odontogenic epithelium embedded in a fibrous stroma. Central giant cell granuloma (CGCG) is an uncommon, locally destructive, but benign lesion that occurs in the craniofacial bones. It consists of fibrous tissue with hemorrhage and hemosiderin deposits, osteoclast-like giant cells, and reactive bone. A hybrid lesion that contains histologic characteristics of both COF and CGCG was first described in 1992, and until now there are few reported cases. This study presents the case and outlines the immunologic profile of a mandibular lesion that has histologic features of both a COF and a CGCG. During a dental evaluation, a 24-year-old Caucasian female presented swelling of the mandible, which she had first noticed eight years earlier. Local physical examination revealed a mandibular cortical expansion and adjacent teeth had been displaced. A panoramic radiograph revealed an extensive heterogeneous image, which extended from the right to the left lower first molars, but did not perforate the cortical bone. Laboratory assays, including a parathormone level assessment, were within normal values and the patient was not taking medication. We do not have an institutional review board; however, informed consent was taken from the patient. A clinical diagnosis of benign odontogenic neoplasm was rendered. An incisional biopsy of a representative portion of the lesion was carried out. Microscopic examination revealed a cellular, fibroblastic connective tissue interwoven with less cellular and often vascular areas, which contained islands and strands of odontogenic epithelium. Some of these epithelial islands had vacuolated clear cells (Fig 1; panel A). Occasionally, the areas of COF were interspersed with spindle-shaped fibroblastic cells, loosely arranged in a fibrous, sometimes fibromyxoid, vascularized tissue with hemorrhagic areas and small clusters of osteoclast-like giant cells that resembled CGCG (Fig 1; panel B). Traversing collagen

Oral and cervical HPV infection in HIV‐positive and HIV‐negative women attending a sexual health clinic in São Paulo, Brazil

To investigate the prevalence of HPV infections in the oral and cervical mucosa of HIV‐positive and HIV‐negative women attending a sexual health clinic.

Exploring the association between genetic and environmental factors and molar incisor hypomineralization: evidence from a twin study

BACKGROUND The etiology of molar-incisor hypomineralization (MIH) remains unknown. Studies indicate that it is multifactorial, and that genetic and environmental factors are involved. Research with twins provides important subsidy to investigate the Influence of genetics and environmental factors that act during pregnancy on the etiology of alterations. AIM This cross-sectional study evaluated the agreement of molar incisor hypomineralization (MIH) between monozygotic and dizygotic twin pairs and the association with environmental factors. DESIGN The sample consisted of 167 pairs of twins (8-15 years old), 94 monozygotic and 73 dizygotic. The parents answered a questionnaire on sociodemographic data and pre-, peri-, and postnatal health. A dental examination was performed by two calibrated examiners (Kappa ≥0.88) for MIH diagnosis, following the criteria proposed by the European Academy of Pediatric Dentistry in 2003. RESULTS The prevalence of MIH was 29.3%. There was greater concordance of MIH between monozygotic twins for affected first molars and permanent incisors (P = 0.0012) and pairs of twins assessed (P = 0.0211). The presence of MIH was associated with family income between one and two wages (P = 0.009, prevalence ratio [PR] = 3.82, confidence interval [CI 95%] 1.40-10.44), above two wages (P = 0.007, PR = 4.60, 95% CI: 1.51-14.05), and gestational hemorrhage (P = 0.032, PR = 5.70, 95% CI: 1.16-28.14). CONCLUSIONS The greater concordance in the diagnosis of MIH among monozygotic twins indicates a genetic influence, although environmental factors, such as family income and hemorrhage during pregnancy, are also associated with the occurrence of MIH.

Saúde bucal na estratégia de saúde da família em um colegiado gestor regional do estado do Piauí

Este estudo transversal avaliou o perfil dos cirurgioes-dentistas (CD) que trabalham na Estrategia Saude da Familia (ESF) e a partir deste, refletiu sobre aspectos do desenvolvimento das acoes odontologicas na atencao primaria em saude, de municipios de um colegiado do processo de regionalizacao sanitaria do estado do Piaui, Brasil. O estudo abrangeu os dezenove municipios do referido colegiado. No periodo de agosto a dezembro de 2008, foram aplicados questionarios a 111 CD, que aceitaram participar do estudo e trabalhavam no respectivo territorio. Os dados foram transferidos para o programa Excel®, tabulados e analisados. Os CD avaliados foram predominantemente do genero feminino, com idade entre 20-39 anos, tempo de formado entre um a cinco anos. Eles possuem, em sua maioria, curso de especializacao em area clinica. A maioria faz visitas domiciliares, mas sem a presenca da equipe, com baixa periodicidade e raramente reune-se com esta. Os resultados apontam problemas que provavelmente sao encontrados em outras realidades do territorio nacional. A tendencia do CD a nao interdisciplinaridade e questao ainda em aberto, quando examinado o papel da odontologia e sua potencialmente inquestionavel participacao na estrategia saude da familia.

Vigilância epidemiológica da fluorose dentária em município de clima tropical com água de abastecimento público fluoretada

The scope of this study was to evaluate the prevalence and severity of dental fluorosis among 11 to 14-year-old schoolchildren in Teresina, Piauí, Brazil, which is a tropical city with a fluoridated public drinking water supply. It involved a cross-sectional observational study on a sample of 571 students in public and private schools. Informed Consent forms were approved for the data collection and the exams were conducted at the schools. Data were recorded on a questionnaire answered by the parents, regarding the socioeconomic and demographic characteristics and oral hygiene habits of the sample. The dental exam was performed qualified dental sugeons. The Thylstrup-Fejerskov (TF) index was used. The prevalence of fluorosis was 77.9%, and only 12.5% of the affected children had TF ≥ grade 3 (with aesthetic damage). The premolars were the teeth most affected by fluorosis. Among the students with the highest severity of fluorosis, 98.6% belonged to the lowest social bracket (> B2), 91.5% were born and had always lived in Teresina, 94.4% consumed water from the fluoridated public supply, 76% used toothpaste for children and 64% of mothers reported that they swallowed toothpaste. The prevalence of fluorosis was high, though the severity was low in individuals exposed to fluoridation since birth.The scope of this study was to evaluate the prevalence and severity of dental fluorosis among 11 to 14-year-old schoolchildren in Teresina, Piaui, Brazil, which is a tropical city with a fluoridated public drinking water supply. It involved a cross-sectional observational study on a sample of 571 students in public and private schools. Informed Consent forms were approved for the data collection and the exams were conducted at the schools. Data were recorded on a questionnaire answered by the parents, regarding the socioeconomic and demographic characteristics and oral hygiene habits of the sample. The dental exam was performed qualified dental sugeons. The Thylstrup-Fejerskov (TF) index was used. The prevalence of fluorosis was 77.9%, and only 12.5% of the affected children had TF ≥ grade 3 (with aesthetic damage). The premolars were the teeth most affected by fluorosis. Among the students with the highest severity of fluorosis, 98.6% belonged to the lowest social bracket (> B2), 91.5% were born and had always lived in Teresina, 94.4% consumed water from the fluoridated public supply, 76% used toothpaste for children and 64% of mothers reported that they swallowed toothpaste. The prevalence of fluorosis was high, though the severity was low in individuals exposed to fluoridation since birth.

Oral health in the family health strategy in a regional management territory of the state of Piaui

The objective of this cross-sectional study was to assess the professional profile of dental-surgeons (DS) who work in the Family Health Strategy (FHS), and on the basis of this reflect upon aspects of the development of dental actions in primary health care in municipalities of a health region of the state of Piauí (Brazil) The study covered the nineteen municipalities of the region. The sample consisted of 111 dentists and data was collected using a questionnaire from August to December 2008. An Excel Ò database was created for the statistical analysis. The dentists were predominantly female, aged 20-39 years, with one to five years of professional experience. Most of them are specialists in a clinical field of dentistry and make home care visits. However, these visits are infrequent and without a health team and they rarely meet with the health team to compare notes. The results indicate that the problems that were detected are likely to be the same in other regions of the country. The lack of an interdisciplinary professional approach among DS is an issue to be properly addressed when examining the role of dentistry and its potentially unquestionable participation in the family health strategy.

Total Fluoride Intake by Children from a Tropical Brazilian City.

The main sources of fluoride intake by children are fluoridated water and toothpaste. Little has been studied regarding fluoride intake from these sources in regions with tropical climates and high temperatures throughout the year. This study aimed to determine the amount of fluoride ingested from diet and tooth brushing by children who live in a city with a tropical climate. Sixty-seven children from Teresina, Piauí, Brazil, took part in this study. The citys water supply was optimally fluoridated. The duplicate-diet method was used to determine the fluoride intake from diet. The intake of fluoride from dentifrice was determined by subtracting the amount of fluoride placed on the toothbrush and that recovered after brushing. The concentration of fluoride was measured using an ion-specific electrode and is expressed as milligrams/kilogram of body weight/day. The mean (±SD) total amount was 0.071 ± 0.036 mg F/kg body weight/day, and the relative contributions of diet and toothpaste were 0.025 ± 0.010 and 0.046 ± 0.035, respectively. The factors associated with fluoride intake from toothpaste were: use of childrens toothpaste (p = 0.003), use of large amounts of toothpaste (p < 0.001), and a high frequency of tooth brushing (p = 0.003). Sixty-four percent of children had an intake of less than 0.07 mg F/kg body weight/day, which is considered the upper limit for an aesthetically tolerable fluorosis risk. The results suggest that the amount of fluoride ingested by most children who live in a Brazilian city with a tropical climate is considered safe in terms of the risk of dental fluorosis.

Homogenous bonding – case report and 18‐year follow up

Fracture of the anterior teeth by trauma is the most frequent type of injury affecting the permanent dentition, especially the maxillary central incisors. When the fragment is not available or its use is not recommended, donated extracted teeth (homogenous bonding) can be used. The aim of this paper is to report the successful 18-year follow up of a maxillary central incisor fracture in which homogenous bonding was performed.