Search

Adverse reactions, caused during the inflammation and healing process, or even later, can be induced by the injection of dermal filler and can present a variety of clinical and histological characteristics. In this study we aimed to review the adverse reactions associated with the injection of aesthetic filling materials in the face and neck. The review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Studies published that mentioned adverse reactions in patients with aesthetic filling materials in the face or neck were included. Risk of bias was assessed using the Joanna Briggs Institute appraisal tool. After a 2-step selection process, 74 studies were included: 51 case reports, 18 serial cases, and five cohorts. A total of 303 patients from 20 countries were assessed. Lesions were more prevalent in the lip (18%), nasolabial folds (13%), cheeks (13%), chin (10%), submental (8%), glabella (7%), and forehead (6%). Histopathological analysis revealed a foreign body granuloma in 87.1% of the patients, 3% inflammatory granuloma, 3% lipogranuloma, 2.3% xanthelasma-like reaction, 1% fibrotic reaction, 0.7% amorphous tissues, 0.7% xanthelasma, 0.3% sclerosing lipogranuloma, 0.3% siliconoma, and 0.3% foreign body granuloma with scleromyxedema. In addition, two patients displayed keratoacanthoma and two others displayed sarcoidosis after cutaneous filling. The most commonly used materials were silicone fillers (19.7%), hyaluronic acid (15.5%), and hydroxyethyl methacrylate/ethyl methacrylate suspended in hyaluronic acid acrylic hydrogel (5.6%). All patients were treated, and only 12 had prolonged complications. There is evidence that adverse reaction can be caused by different fillers in specific sites on the face. Although foreign body granuloma was the most common, other adverse lesions were diagnosed, exacerbating systemic diseases. In this way, we reinforce the importance of previous systemic evaluations and histopathological analyses for the correct diagnosis of lesions.

Ameloblastomas are benign odontogenic tumors that can eventually mimic the clinical and radiological features of apical periodontitis. The aim of the present study was to evaluate the clinical, radiological and histological characteristics from a series of ameloblastomas mimicking apical periodontitis diagnosed in a 14-year period. all cases histologically diagnosed as ameloblastomas from 2005 to 2018 presenting a clinical diagnosis of periapical lesion of endodontic origin were selected for the study. Clinical, radiological and histological characteristics from all cases were tabulated and descriptively and comparatively analyzed. Twenty cases composed the final sample, including 18 solid and 2 unicystic ameloblastomas. Mean age of the affected patients was in the fifth decade with predilection for males (72%). The most common anatomical location was the posterior mandible (55%) and most cases presented a radiolucent unilocular (80%) well-defined (95%) image. Most cases were asymptomatic, but the presence of local swelling and bone cortical rupture were common. Ameloblastomas mimicking periapical lesions of endodontic origin are mostly diagnosed in adult males as well-defined radiolucent unilocular lesions producing local swelling and bone cortical rupture.

Smoking can be considered a risk factor for Chronic Apical Periodontitis (CAP). This study compared the immunoexpression of biomarkers RANKL, OPG, OPN and TNF- α in CAP in smokers and non-smokers.Twelve smokers (S) and twelve non-smokers (NS) diagnosed with CAP and indicated for extraction were selected. Exclusion factors were teeth with a diagnosis of root fracture, previous endodontic treatment and endoperiodontal injury, in addition to individuals with systemic diseases, under 18 years of age, users of anti-inflammatory and/or antibiotics in the last three months and drug users. Specimens were processed for histopathologic and immunohistochemical analysis.The qualitative analysis of RANKL expression showed 66.66% weak/moderate and 33.33% strong in S and 100% weak/moderate in the NS. OPG and OPN expressions were 100% negative to focal in the S group and 50% negative to focal, 50% weak/moderate in the NS. TNF- α was 25% negative to focal and 75% weak/moderate in the S and 33.33% negative to focal and 66.66% weak/moderate in the NS. The quantitative analysis of the data by the Mann-Whitney test, showed that was a significant difference in the immunoexpression of RANKL (p0.05), OPG (p0.05) and OPN (p0.05) but there was no statistical difference in the immunoexpression of TNF- α (p0.05) between the two groups.These findings suggest that smoking is capable of altering the inflammatory response, influencing the evolution of CAP.

Background The presence of human papilloma virus in benign oral lesions has been studied by different techniques obtaining extremely variable results. The objective of this study was to determine the presence of human papillomavirus in 83 cases of benign hyperplastic epithelial oral lesions. Material and Methods Eighty-three oral lesions with clinical or histopathological features suggestive of HPV infection were retrieved from the files of four oral pathology services. Demographic data were obtained from patient´s medical charts. All cases had available clinical image, H&E preparations and paraffin blocks with enough tissue for HPV detection by in situ hybridization, and immunohistochemical reactions for Ki67. Results Episomal positivity for wide spectrum HPV was observed in 24% of the cases; most of them (70%) HPV 6/11 positive. HPV 16/18 was not detected. Condyloma acuminatum was the most common lesion associated with HPV (75%), followed by verruca vulgaris (15%), squamous papilloma and multifocal epithelial hyperplasia, 5% each. Koilocytes were identified in all the HPV positive cases. Ki67 showed an abnormal proliferation pattern in 90% of the HPV positive cases; most of them (70%) showing groups of proliferating cells in focal superficial regions, and in 20% positivity was seen almost in the whole thickness of the epithelium. HPV negative cases showed Ki67 positive cells restricted to the basal layer. Conclusions Regarding oral lesions associated with HPV, condyloma is the most common lesion expressing low-risk subtypes. The etiology of squamous papilloma remains controversial as HPV was found in 1.9% of the cases. The identification of koilocytes and the pattern of expression of Ki67 reflect HPV infection and are helpful for classification. Papillary oral lesions not associated to HPV deserve further studies to better clarify its etiology. Key words:Human papillomavirus, condyloma, papilloma.

OBJECTIVE To describe the clinical and genetic features of patients with cherubism. MATERIAL AND METHODS A descriptive analysis of 14 cases from nine different families was carried out. Clinicopathological, imaging, and follow-up data were retrieved from patients' medical files and correlated with the genetic profile of each patient. Genomic DNA isolated from buccal mucosa cells was subjected to direct sequencing analysis of the SH3BP2 gene. RESULTS Females were more affected than males (8:6), and the mean age at diagnosis was 8.6 years (range 3-30 years). Eleven patients exhibited simultaneous bilateral involvement of the maxilla and mandible. Two patients did not have a familial history of cherubism. Progressive growth pattern was found in six patients and stable lesions were observed in other seven patients, whereas in one patient, complete spontaneous remission was documented during the follow-up (31 years). Mutations were found in 13 cases and included the typical heterozygous missense mutations R415Q, P418T, and P418H at exon 9 of SH3BP2. No correlation between the mutations and the clinical manifestations was observed. CONCLUSION Three different point mutations in the SH3BP2 gene were detected with variable clinical involvement. Genotype-phenotype association studies in larger population with cherubism are necessary to provide important knowledge about molecular mechanisms related to the disease.

The vascular anatomy of the pelvis has in the retro pubic space one the most dangerous artery variations for the surgical approach. The aim of this study was to evaluate arise from obturator artery and its implications. Eleven specimens were bisected pelvic an adult cadaver. The iliac artery and femoral artery were identified and divided in their branches. The anomalous origin was noted in 22.72% with an anastomotic branch between the external iliac or inferior epigastric vessels found in 13.69%. The right side showed a greater variation than left side with 27.27% versus 18.18%. Our data suggest that retro pubic space has critical vascular variations of the obturator artery with many probabilities of the lesions.

Primordial odontogenic tumor (POT) is composed of variably cellular myxoid connective tissue, surrounded by cuboidal to columnar odontogenic epithelium resembling the inner epithelium of the enamel organ, which often invaginates into the underlying connective tissue. The tumor is delimited at least partially by a thin fibrous capsule. It derives from the early stages of tooth development. Syndecan-1 is a heparan sulfate proteoglycan that has a physiological role in several cellular functions, including maintenance of the epithelial architecture, cell-to-cell adhesion and interaction of cells with extracellular matrix, and with diverse growth factors, stimulating cell proliferation. Ki-67 is considered the gold standard as a cell proliferation marker. The aim of this study was to examine the expression of Syndecan-1 and Ki-67 proliferation index in POT and normal tooth germs to better understand the biological behavior of this tumor. Results showed that Syndecan-1 was more intensely expressed in subepithelial mesenchymal areas of POT, in a pattern that resembles the early stages of tooth development. The cell proliferation index (4.1%) suggests that POT is a slow growing tumor. Syndecan-1 expression in tooth germs in late cap and early bell stages was similar to POT, showing immunopositivity in subepithelial mesenchymal condensed areas. The immunohistochemical findings showed a pattern in which the population of subepithelial mesenchymal cells exhibited greater proliferative activity than the central portion of the dental papilla.

Background This study aimed to compare the histological and immunohistochemical characteristics of ameloblastomas (AM) and ameloblastic carcinomas (AC). Material and Methods Fifteen cases of AM and 9 AC were submitted to hematoxilin and eosin (H&E) and immunohistochemical analysis with the following antibodies: cytokeratins 5,7,8,14 and 19, Ki-67, p53, p63 and the cellular adhesion molecules CD138 (Syndecan-1), E-cadherin and β-catenin. The mean score of the expression of Ki-67 and p53 labelling index (LIs) were compared between the groups using the t test. A value of p

Aims: The aims of this study were to describe the immunohistopathological and morphometric features of oral mucositis grade I (WHO). Material and Methods: Ten samples of oral mucositis were biopsied and submitted to histopathological, morphometric and immunohistochemical analyses (CD68, Ki-67 and p53). The samples were compared with the buccal mucosa of head and neck cancer patients before radiotherapy (NMCP), normal buccal mucosa (NM) and oral dysplasia (OD). Results: Epithelial thickness, area and perimeter were decreased in oral mucositis and inflammatory components, increased when compared with NMCP. CD68 immunoreactivity, near to the epithelium, was more evident in oral mucositis than in NMCP (P = 0.01). The Ki-67 counts were higher in oral mucositis than in NM and NMCP (P = 0.001 and P = 0.043, respectively), but without any difference with OD (P = 0.284). The p53 staining was present in all cases of mucositis and oral dysplasia, but negative in NMCP and NM. Conclusions: Oral mucositis grade I (WHO) presented epithelial atypia and atrophy, increased inflammatory response, with relevant Ki-67 count and positiveness for p53.

A aplicação de calcário na superfície do solo em sistema plantio direto, sem incorporação, em determinadas condições edafoclimáticas, não tem sido eficaz na correção da acidez e no fornecimento de cálcio e magnésio às plantas. Na busca de alternativas para a realização da calagem sem as operações convencionais de aração e gradagem, o trabalho teve como objetivo avaliar a eficiência de diferentes modalidades de calagem nos atributos químicos do solo, no estado nutricional e nas características agronômicas da cultura do milho. O delineamento experimental utilizado foi o de blocos ao acaso, em parcelas subdivididas, com três repetições. Os tratamentos aplicados nas parcelas foram: milho híbrido duplo Z 8447, variedade de milho AL 25 e híbrido duplo AG 122 e, nas subparcelas, testemunha sem calagem, calcário aplicado ao longo do perfil do solo no sulco de semeadura, calcário aplicado a lanço na superfície do solo e calcário aplicado ao longo do perfil do solo no sulco de semeadura, mais calcário aplicado a lanço na superfície. Nos tratamentos que receberam calcário no sulco, a semeadura foi realizada no mesmo sulco que recebeu o calcário. A amostragem do solo foi feita 30 e 150 dias após a calagem, a partir da linha de semeadura até 25 cm de distância desta, em cinco profundidades. Determinaram-se pH em água e Ca, Mg e Al trocáveis nas amostras. Avaliou-se o estado nutricional do tecido foliar dos três cultivares, bem como algumas características agronômicas da cultura. Os resultados indicaram que o calcário aplicado no sulco de semadura foi distribuído eficientemente ao longo do perfil do solo até 20 cm de profundidade, em uma faixa de 10 cm de largura. O calcário aplicado na superfície teve efeito sobre as características químicas do solo somente até 5 cm de profundidade. A aplicação conjunta de calcário ao longo do perfil do solo no sulco de semeadura mais calcário em superfície foi mais eficiente para elevar os valores de pH e os teores Ca e Mg trocáveis e diminuir os teores de Al trocável. O estado nutricional dos cultivares e as características agronômicas do milho não foram afetados pelos tratamentos. Lime application on the soil surface in no-tillage systems, without incorporation, has not been effective in certain edaphic and climatic conditions for the correction of acidity or for calcium and magnesium supply to plants. Searching alternatives for limestone application without the conventional tilling and harrowing operations, this study tried to evaluate the efficiency of different lime application forms for the chemical soil attributes, nutritional state, and agronomic characteristics of corn crop. A randomized block design with split-plots and three replications was used. The treatments applied on the plots were: double hybrid corn Z 8447; corn variety AL 25; and double hybrid AG 122; and on the split-plots: control without liming; lime applied along the soil profile in the planting furrow; lime applied by spreading on soil surface; lime applied along the soil profile into the planting furrow plus more lime spread on the soil surface. Where lime was applied in the furrows, maize was sown in the furrows that had received lime. Soils were sampled 30 and 150 days after liming, from the sowing line to a distance of 25 cm from the sowing line, and at five depths. The pH was determined in the water and exchangeable Ca, Mg and Al in the samples. The nutritional state of foliar tissue was evaluated for the three cultivars, as well as some agronomic crop characteristics. Results showed that the lime applied into the planting furrow was distributed efficiently along the soil profile down to a depth of 20 cm, in a 10 cm wide strip. Surface lime application only had an effect on the chemical soil characteristics down to a depth of 5 cm. The concurrent application along the soil profile into the planting furrow plus more lime on the surface was the most efficient, with higher values of pH, exchangeable Ca and Mg, and lower levels of exchangeable Al. No effect of the lime application mode was observed on the nutritional state of the tested cultivars or the agronomic characteristics of the corn crop.

Noma is a devastating oro-facial necrotic condition affecting debilitated subjects. Oral myiasis is an infectious disease caused by deposition of larval flies in oral wounds and lesions. Oro-facial noma-myiasis association has not been previously reported in the literature. The aim of this paper is to report a case of noma associated with myiasis in a 65-year-old Brazilian male.

Pemphigus vulgaris is an uncommon mucocutaneous disease caused by autoantibodies against desmosomal antigens. It affects mainly middle-aged adults, and juvenile cases are rare. The authors present a case of pemphigus vulgaris in adolescence and review the literature. A 16-year-old girl showed oral and cutaneous lesions suggestive of pemphigus vulgaris. Histopathology and direct immunofluorescence of the oral mucosa confirmed the diagnosis and systemic steroid therapy was efficient in controlling the disease. The recognition of the oral lesions of pemphigus by the clinician, its early diagnosis, and prompt therapy are essential for a favorable prognosis.

We present the case of 55-year old female patient with a rare malignant disease of the stomach associated with IgA deficiency. For its management the surgical, transfusional and renal support strategy required good coordination of pre, intra and post-operative care, and good articulation among the various sub-specialties. The patient experienced two severe anaphylactoid transfunctional reactions. Congenital IgA deficiency was detected with probable anti-IgA immunization associated with a metacrone adenocarcinoma of the stomach and nephrotic syndrome with renal failure. The transfusion methods utilized are discussed, and the results of the study aimed at detecting a compatible donor, with identical deficit, among family members are presented. In the absence of a national registry of donors with IgA deficiency, the prevention of these potentially dangerous reactions imposes a burden on the Service of Immuno-Hematherapy to take special measures on its own. This case points out the need to implement a blood bank with rare groups and IgA deficient blood, for homo/autologous transfusions.

Background Primordial Odontogenic Tumor (POT) is a recently described odontogenic tumor characterized by a variably cellular loose fibrous tissue with areas similar to the dental papilla, covered by cuboidal to columnar epithelium that resembles the internal epithelium of the enamel organ, surrounded at least partly by a delicate fibrous capsule. The purpose of this study was to investigate the possible histogenesis and biological behavior of this rare tumor by means of a wide immunohistochemical analysis of its epithelial and mesenchymal components. Material and Methods The immunoexpression of twenty-three different antibodies were evaluated in four cases of POT. Results The epithelial cells that cover the periphery of the tumor showed immunopositivity for Cytokeratins 14 and 19, while Amelogenin, Glut-1, MOC-31, Caveolin-1. Galectin-3, PITX2, p53, Bax, Bcl-2, Survivin and PTEN were variably expressed in focal areas. The mesenchymal component of the tumor was positive for Vimentin, Syndecan-1, PITX2, Endoglin (CD105), CD 34, Cyclin D1, Bax, Bcl-2, Survivin and p53. PTEN and CD 90 showed a moderate positivity. BRAF V600E and Calretinin were negative in all samples. Cell proliferation markers (Ki-67, MCM-7) were expressed in