Ricardo Alves Mesquita

A survey of 460 supernumerary teeth in Brazilian children and adolescents

OBJECTIVE This study aimed to survey the demographic profile of supernumerary teeth (ST) in Brazilian children and adolescents. METHODS A retrospective analysis was carried out of all nonsyndromic patients with ST attended at the Pediatric Oral Surgery Service of the Universidade Federal de Minas Gerais between 1995 and 2004. Diagnosis of ST was based on clinical and radiographic examination. Chi-squared test was used for statistical analysis. RESULTS This study included 460 ST found in 305 patients. Radiographic assessment (32.1%) was the main care-seeking reason and also the means through which most (97.6%) permanent ST were identified. Most cases were single (63.0%), conical (44.6%), and unerupted (76.8%) ST. Most teeth were fully developed (41.3%), normally orientated (78.9%), placed in a palatal/lingual-sagittal position (84.1%), adjacent to the crown of permanent teeth (50.2%) (P < 0.001). The most frequent clinical complication was permanent teeth displacement (36.0%). Treatment was surgical removal followed by orthodontics (61.6%). CONCLUSIONS The demographic profile of ST herein presented will be useful to provide additional epidemiological information. A wide range of factors should be considered when evaluating ST. In addition, it is essential to detect ST as early as possible to avoid complications and to assure successful management. Even after treatment, patients must be followed up.

Efficacy of Brazilian propolis gel for the management of denture stomatitis: a pilot study

Denture stomatitis presents as a chronic disease in denture‐bearing patients, especially under maxillary prosthesis. Despite the existence of a great number of antifungal agents, treatment failure is observed frequently. Propolis, a natural bee product, possesses well‐documented antifungal and anti‐inflammatory activities. The purpose of this study was to evaluate the clinical efficacy of a new Brazilian propolis gel formulation in patients diagnosed with denture stomatitis. Thirty complete‐denture wearers with denture stomatitis were enrolled in this pilot study. At baseline, clinical evaluation was performed by a single clinician and instructions for denture hygiene were provided. Fifteen patients received Daktarin® (Miconazole gel) and 15 received Brazilian propolis gel. All patients were recommended to apply the product four times a day during one week. Clinical evaluation was repeated by the same clinician after treatment. All patients treated with Brazilian propolis gel and Daktarin® had complete clinical remission of palatal edema and erythema. This new Brazilian propolis gel formulation had efficacy comparable to Daktarin® and could be an alternative topical choice for the treatment of denture stomatitis. Copyright

A Review of the Nonsurgical Treatment of Oral Leukoplakia

The aim of this paper was to assess the nonsurgical treatment of oral leukoplakia (OL). A medline search from 1983 to 2009 was conducted. The topical or systemic nonsurgical treatments or combination of both was reviewed. The primary outcomes of interest were clinical resolution, malignant transformation, follow-up, and recurrence of OL. Studies showed a rate higher than 50% of clinical resolution with photodynamic therapy, beta-carotene, lycopene, or vitamin A. Few studies reported rates of recurrence from 5 to 67% and of malignant transformation from 8 to 23%. There is a lack of randomized clinical trials that assess the effectiveness of nonsurgical treatment of OL. At this time, randomized controlled trials for nonsurgical treatment of OL demonstrate no evidence of effective treatment in preventing malignant transformation and recurrence. It reinforces that even after clinical resolution, OL should be regularly followed.

Alveolar and extra-alveolar granular cell lesions of the newborn: report of case and review of literature

Multiple congenital granular cell lesions occurring on the maxillary alveolar ridge and ventral aspect of the tongue were identified in a 22-day-old girl. The prevalence, histogenesis, and treatment of this lesion are discussed and the literature is reviewed.

Prevalence of oral hemangioma, vascular malformation and varix in a Brazilian population.

Hemangioma, vascular malformation and varix are benign vascular lesions, common in the head and neck regions. Studies about the prevalence of these lesions in the oral cavity are scarce. The aim of this study was to estimate the prevalence of and to obtain clinical data on oral hemangioma, vascular malformation and varix in a Brazilian population. Clinical data on those lesions were retrieved from the clinical forms from the files of the Oral Diagnosis Service, School of Dentistry, Federal University of Minas Gerais, Brazil, from 1992 to 2002. Descriptive analysis was performed. A total of 2,419 clinical forms in the 10-year period were evaluated, of which 154 (6.4%) cases were categorized as oral hemangioma, oral vascular malformation or oral varix. Oral varix was the most frequent lesion (65.6%). Females had more oral hemangioma and oral varix than males. Oral vascular malformation and oral varix were more prevalent in the 7th and 6th decades, respectively. Oral hemangioma and oral varix were more prevalent in the ventral surface of the tongue and oral vascular malformation, in the lips. Oral hemangioma was treated with sclerotherapy (54.5%), and vascular malformation was managed with sclerotherapy and surgery (19.4% each). The data of this study suggests that benign vascular lesions are unusual alterations on the oral mucosa and jaws.

Retrospective analysis of oral peripheral nerve sheath tumors in Brazilians

Traumatic neuroma, neurofibroma, neurilemmoma, palisaded encapsulated neuroma and malignant peripheral nerve sheath tumor (MPNST) are peripheral nerve sheath tumors and present neural origin. The goal of this study was to describe the epidemiological data of oral peripheral nerve sheath tumors in a sample of the Brazilian population. Biopsies requested from the Oral Pathology Service, School of Dentistry, Federal University of Minas Gerais (MG, Brazil), between 1966 and 2006 were evaluated. Lesions diagnosed as peripheral nerve sheath tumors were submitted to morphologic and to immunohistochemical analyses. All cases were immunopositive to the S-100 protein. Thirty-five oral peripheral nerve sheath tumors were found, representing 0.16% of all lesions archived in the Oral Pathology Service. Traumatic neuroma (15 cases) most frequently affected the mental foramen. Solitary neurofibroma (10 cases) was more frequently observed in the palate. Neurofibroma associated with neurofibromatosis type I (2 cases) was observed in the gingival and alveolar mucosa. Neurilemmoma (4 cases) was more commonly observed in the buccal mucosa. Malignant peripheral nerve sheath tumors (3 cases) occurred in the mandible, palate, and tongue. Palisaded encapsulated neuroma (1 case) occurred in the buccal mucosa. The data confirmed that oral peripheral nerve sheath tumors are uncommon in the oral region, with some lesions presenting a predilection for a specific gender or site. This study may be useful in clinical dentistry and oral pathology practice and may be used as baseline data regarding oral peripheral nerve sheath tumors in other populations.

Avaliação de três métodos de extração de DNA de material parafinado para amplificação de DNA genômico pela técnica da PCR

Existem na literatura varios protocolos para extracao de DNA genomico a partir de material fixado em formol e embebido em parafina. A obtencao de DNA genomico e importante para realizacao de experimentos em biologia molecular, dentre eles a PCR. Este trabalho teve por objetivo otimizar a extracao de DNA genomico a partir de material fixado (hiperplasia fibrosa inflamatoria) e nao-fixado (mucosa bucal normal) em formol, comparando-se tres metodologias diferentes: fenol com digestao enzimatica, particulas de silica com e sem digestao enzimatica. Para amplificacao do DNA pela tecnica da PCR, utilizou-se iniciadores para o exon 7 da citoqueratina humana tipo 14. O sucesso da amplificacao foi verificado pela eletroforese do produto em gel de poliacrilamida 8% contendo glicerol 5% corado com prata. Obteve-se amplificacao do DNA genomico extraido com fenol/digestao enzimatica e com particulas de silica/digestao enzimatica, para ambos tecidos utilizados. O metodo padronizado tem potencial para auxiliar no diagnostico histopatologico, assim como no estudo retrospectivo de material de arquivo.There are several protocols reported in the literature for the extraction of genomic DNA from formalin-fixed paraffin-embedded samples. Genomic DNA is utilized in molecular analyses, including PCR. This study compares three different methods for the extraction of genomic DNA from formalin-fixed paraffin-embedded (inflammatory fibrous hyperplasia) and non-formalin-fixed (normal oral mucosa) samples: phenol with enzymatic digestion, and silica with and without enzymatic digestion. The amplification of DNA by means of the PCR technique was carried out with primers for the exon 7 of human keratin type 14. Amplicons were analyzed by means of electrophoresis in an 8% polyacrylamide gel with 5% glycerol, followed by silver-staining visualization. The phenol/enzymatic digestion and the silica/enzymatic digestion methods provided amplicons from both tissue samples. The method described is a potential aid in the establishment of the histopathologic diagnosis and in retrospective studies with archival paraffin-embedded samples.

AgNOR count in exfoliative cytology of normal buccal mucosa : Effect of smoking

OBJECTIVE To compare the argyrophilic nucleolar organizer region (AgNOR) count of cells collected from normal buccal mucosa of cigarette smokers with that obtained from nonsmokers. STUDY DESIGN Cytologic smears of normal buccal mucosa from 20 smokers and 20 nonsmokers were stained for AgNORs. The AgNOR count was established on 100 cells. The count values of groups were compared and analyzed using Students unpaired t test. RESULTS The AgNORs were round and had a clustered distribution in both groups. The mean AgNOR count was statistically higher in cells of smokers than nonsmokers (P < .01). CONCLUSION Analysis of AgNORs suggests that cigarette smoking influences proliferative activity in cells of normal buccal mucosa.

P21/ WAF1 and cyclin D1 variants and oral squamous cell carcinoma

BACKGROUND Genetic factors are known to be involved in oral squamous cell carcinoma (OSCC) development. METHOD We evaluated a possible association between CCND1 A870G and P21/WAF1 C98A polymorphisms and OSCC, as well as the impact of the genotypes on protein immunoexpression. The study group consisted of 80 individuals with histopathological diagnosis of OSCC and the control group consisted of 80 healthy individuals without oral lesions and matched by age, sex and tobacco usage. The genotypes were studied by the polymerase chain reaction and restriction fragment length polymorphic analysis. Paraffin-embedded sections were used for immunohistochemical analysis. RESULTS No statistical association between CCND1 and/or P21/WAF1 genotypes and OSCC was demonstrated, although we found that people harbouring the combined presence of at least one variant allele of both genes showed a 1.8 times more chance of developing OSCC compared to the referent genotype. OSCC tumours from individuals with P21 heterozygous genotype showed a significantly higher immunopositivity than tumours from wild-type individuals. CONCLUSION The present study did not demonstrate a significant association between CCND1 and / or P21 / WAF1 genotypes and OSCC. However, P21 protein expression in OSCC tumours is affected by P21 / WAF1 genotype.

Effect of Smoking on Langerhans and Dendritic Cells in Patients With Chronic Gingivitis

BACKGROUND Previous literature showed contrasting results regarding dendritic cell (DC) counts in patients with periodontal diseases. Although smoking decreases the number of DCs in the lungs, the effect of smoking on the quantitative distribution of Langerhans cells (LCs) and DCs in patients with chronic gingivitis has not been investigated to our knowledge. METHODS Gingival samples were obtained from 30 patients (15 smokers and 15 non-smokers). Immunohistochemical staining was performed to identify CD1a+ immature LCs and CD83+ mature DCs. The inflammatory infiltrate was evaluated and counted. Densities of cells were calculated within the oral epithelium (OE), sulcular epithelium (SE), and lamina propria (LP) for CD1a+ cells and within the LP for CD83+ cells. Results were compared between groups. This study evaluates whether the high number of cigarettes and smoking years affects densities of cells. Correlations among densities of LCs and DCs with densities of inflammatory infiltrate, number of cigarettes, and smoking years were performed. RESULTS Densities of inflammatory infiltrate and CD1a+ cells from the SE and LP were significantly lower for smokers than for non-smokers (P <0.05). This result could not be identified for CD1a+ cells from the OE and for CD83+ cells from the LP. The number of cigarettes and smoking years did not affect densities of cells. No statistically significant correlations could be drawn among densities of LCs and DCs and inflammatory infiltrate, number of cigarettes, and smoking years. CONCLUSION Smoking proved to affect the quantitative distribution of LCs and DCs in patients with chronic gingivitis.