Talita Ribeiro Tenório de França

Salivary shedding of HHV-8 in people infected or not by human immunodeficiency virus 1

BACKGROUND Human herpesvirus 8 (HHV-8), the main agent involved in the etiopathogenesis of Kaposis sarcoma (KS) is primarily transmitted through sexual contact. The potential of saliva as a source of HHV-8 transmission remains unclear. The purpose of this work was to determine the frequency of HHV-8 detection in saliva of HIV-infected individuals and their family contacts. METHODS The study group comprised 210 individuals. Group 1: 35 HIV-infected patients; group 2: 35 non-HIV individuals; group 3: two siblings for each patient from group 1; group 4: two siblings for each individual from group 2. Each participant had non-stimulated whole saliva collected and DNA was extracted. HHV-8-DNA amplification from ORF-26 was performed using a nested PCR protocol. RESULTS HHV-8 DNA was detected in saliva from 14/35 (40%) HIV-infected individuals and 4/35 (11.4%) non-HIV-infected individuals (OR = 5.16, CI [1.49-17.88], P = 0.006). It was also possible to amplify HHV-8 DNA in 11/70 (15.7%) relatives of HIV-infected participants and 4/70 (5.71%) relatives of non-HIV-infected individuals(P = 0.041). Among the 14 group 1 patients with HHV-8 DNA detected in saliva, eight (57.1%) had a household member in whom HHV-8 DNA was also amplified (OR = 8, CI [1.58-40.29] P = 0.007). CONCLUSIONS HHV-8 DNA is frequently found in saliva. HIV-infected individuals showed a higher frequency of detection of HHV-8 than healthy controls. HHV-8 DNA was significantly amplified in saliva of household members of HIV/HHV-8 co-infected individuals.

Solitary peripheral osteomas of the jaws

Osteoma is a benign osteogenic tumor composed of cancellous or compact bone, classified as peripheral, central, or extraskeletal. Peripheral osteomas are uncommon. Excluding the maxillary sinuses, the maxilla is a rare site for osteomas. The purpose of this report was to describe clinicopathological and radiological features of two peripheral osteomas occurring in the jaws, one located in the mandible and another in the edentulous maxillary alveolar ridge. The tumors were asymptomatic and were fully excised without any complications or recurrence. The lesions were submitted to histopathological analysis and diagnosed as peripheral osteoma, compact type.

Mixed Periapical Lesion: An Atypical Radicular Cyst with Extensive Calcifications

The radicular cyst is an inflammatory odontogenic cyst of endodontic origin. Radiographically, the lesion appears as a periapical radiolucent image. This report describes a very rare case of a mixed periapical radiographic image diagnosed as a radicular cyst. A 37-year-old female patient presented a mixed, well-circumscribed image located in the periapical region of the left maxillary central incisor, which presented unsatisfactory endodontic treatment. Microscopic examination revealed a cavity lined by non-keratinized squamous epithelium and extensive calcifications in the cystic lumen and lining epithelium. Diagnosis of radicular cyst with extensive calcifications was established. Endodontic retreatment was performed and no radiographic signs of recurrence were observed 18 months after treatment. Although very rare, a radicular cyst should be considered in the differential diagnosis of a mixed periapical image associated to teeth with pulp necrosis.

Nasal sinus tract associated with dental infection.

Dear Editor: Sinus tracts of odontogenic origin are usually intraoral. However, extraoral sinus tracts associated with odontogenic infections have been reported1 and they often represent a diagnostic challenge. The occurrence of nasal sinus tract of dental origin is very rare2. We observed a case of a 58-year-old female patient who complained of a nodule in the right nostril since approximately the last 2 months. The physical examination revealed an erythematous painless nodule in the right nostril with a purulent discharge (Fig. 1A). On intraoral examination, the right maxillary incisor crown was dark in color, and there was extensive restoration due to secondary caries. The pulp vitality test for assessing the response to cold was negative, indicating pulp necrosis. Radiographically, there was a diffuse radiolucent image in the periapical region of this tooth, with disruption of the lamina dura (Fig. 1B). A nasal sinus tract associated with an odontogenic infection was the main diagnosis. Hence, nonsurgical endodontic treatment was performed for the involved tooth. After 1 week, the purulent discharge stopped completely, confirming the initial clinical diagnosis (Fig. 2). Fig. 1 (A) An erythematous painless nodule in the right nostril. (B) A diffuse radiolucent image in the periapical region of the right maxillary central incisor, with disruption of the lamina dura (cortical alveolar bone) (arrows). Fig. 2 Complete healing of the nasal lesion after the nonsurgical endodontic treatment. A sinus tract of dental origin is caused by pulp necrosis associated with bacterial infection, which causes an inflammatory lesion in the periapical region of the involved tooth1-3. This inflammatory reaction may spread to the alveolar bone, following the path of least resistance, and externalize on the oral mucosa or skin1,3. Although a nasal sinus tract of dental origin is very uncommon, this condition may occur in periapical infections from maxillary central incisors2,3. The evaluation of cutaneous fistulas must begin with thorough history taking and awareness that any cutaneous lesion on the face and neck could be of dental origin4. In maxillary teeth, the cheek is the most common site of an extraoral sinus tract originating from molars and premolars; and the nasolabial fold, upper lip, and infraorbital region are common sites of an extraoral sinus tract originating from incisors and canines. In the mandible, the submandibular region and the neck are the extraoral sites of a sinus tract originating from molars and premolars, whereas the chin and submental region are the most common extraoral sites of a sinus tract originating from incisors and canines3. Eventually, the patients history may reveal dental pain2, but clinicians should keep in mind that most of the teeth progress to pulp necrosis without causing any discomfort to the patient5. A chronic, purulent drainage via the sinus tract also reduces the pressure and swelling and consequently, the pain3. The differential diagnosis of an extraoral sinus tract of odontogenic origin includes the other dermatoses, such as folliculitis, actinomycosis, tuberculosis, pyogenic granulomas, foreign bodies, osteomyelitis, congenital fistulas, and squamous and basal cell carcinomas1,4. Nevertheless, these cases have been misdiagnosed and treated inappropriately, mainly with recurrent unnecessary surgical procedures and antibiotic therapy1. In the present case, the initial diagnosis was an odontogenic nasal sinus tract after adequate clinical and radiographic exams. Appropriate treatment results in predictable and rapid healing of these lesions3. If there is an extra-oral sinus tract associated with dental infection, the elimination of infection through effective endodontic treatment will lead to resolution of the lesion1. Dental extraction is indicated in nonrestorable teeth3.

Effects of Zoledronic Acid in Experimental Periapical Lesions in Rats: An Imaging and Histological Analysis

The aim of this study was to assess the imaging and histological features of experimental periapical lesions, including the adjacent alveolar bone, in rats under zoledronic acid treatment. The study used 40 male Wistar rats distributed into 8 groups of 5 animals each: G1: induction of periapical lesion (PL) and weekly intraperitoneal administration (WIPA) of saline solution (0.9% NaCl) for 4 weeks; G2: PL induction and WIPA of zoledronic acid (0.15 mg/kg/week) for 4 weeks; G3: PL induction and WIPA of saline solution for 8 weeks; G4: PL induction and WIPA of zoledronic acid for 8 weeks; G5:WIPA of saline solution for 4 weeks and subsequent PL induction; G6: WIPA of zoledronic acid for 4 weeks and subsequent PL induction; G7: WIPA of saline solution for 8 weeks and subsequent PL induction; G8: WIPA of zoledronic acid for 8 weeks and subsequent PL induction. The administration of zoledronic acid or saline solution continued after PL induction until the euthanasia. Thus, cone beam computed tomography and histological analysis were performed. Statistical analyzes were performed by ANOVA and Kruskal-Wallis test. Groups treated with zoledronic acid showed significantly smaller size of PL than the groups treated with 0.9% NaCl (p<0.05). PLs were formed by chronic inflammation ranging from mild to moderate, with no difference between groups. In all specimens, no mandibular necrosis was observed. In conclusion, the presence of PLs apparently does not represent an important risk factor for the development of bisphosphonate-related osteonecrosis of the jaws.

Ameloblastic Fibroma: A Rare Case Appearing as a Mixed Radiographic Image

Ameloblastic fibroma (AF) is a benign tumor of mixed odontogenic origin, which affects predominantly young individuals. AF appearing as a mixed radiographic image is very rare. This report describes a case of AF in a 12-year-old male identified during a routine radiographic exam for orthodontic treatment planning. The panoramic radiography revealed a well-defined multilocular mixed image located in the mandible between the roots of the left mandibular second premolar and first molar. The lesion was excised under local anesthesia. Histopathological analysis revealed islands of epithelial cells and columnar peripheral cells showing a nucleus in inverted polarization, interspersed with spindle-shaped cells and abundant extracellular matrix deposition. No atypia was observed. The diagnosis of AF was established. No tumor recurred up to 30 months after treatment. Although rare, AF should be also considered in the differential diagnosis of mixed radiographic images of the jaws in young patients. Key words:Ameloblastic fibroma, differential diagnosis, incidental finding, mixed image, radiographic features.

Emprego do Cimento de Ionômero de Vidro: Uma Revisão Sistemática

1Doutoranda em Odontologia pela Universidade Federal de Pernambuco (UFPE), Recife/PE, Brasil. 2Mestre em Odontologia pela Universidade Federal de Pernambuco (UFPE), Recife/PE, Brasil. 3Professora Associada do Departamento de Protese e Cirurgia Buco-Facial da Universidade Federal de Pernambuco (UFPE), Recife/PE, Brasil. 4Professor Adjunto do Departamento de Protese e Cirurgia Buco-Facial da Universidade Federal de Pernambuco (UFPE), Recife/PE, Brasil.