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Made available in DSpace on 2021-06-25T12:26:45Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-11-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) The aim of this study was to evaluate the in vivo repair using an experimental model of osteoarthritis of the temporomandibular joint in rabbits, treated with hyaluronic acid (HA), isolated or combined with platelet rich plasma (PRP). Forty New Zealand rabbits were divided into 4 groups: G1 - normal TMJ, G2 - lesion / untreated, G3 - lesion / HA, and G4 - lesion / PRP + HA. The disc and the condyle were evaluated using radiographies, macro and microscopic analysis through routine histotechnique, Picrosirius red staining and immunohistochemistry. The results were evaluated by descriptive and inferential statistics. Macroscopically, the disc in the treated groups presented, in most of the specimens, partial or total filling of the defect. Histological analysis confirmed the presence of mineralized material, near and distant perforation, as well as decreased cellularity and fibrosis. The collagen I was demonstrated in higher amounts when compared to type III collagen, independently of the group and period evaluated; in the condyle, G3 and G4 presented significant higher percentage of type I collagen, than G2. In conclusion, the groups that were treated with HA and PRP combined with HA presented no significant differences in microscopic pattern. The macroscopic finding that in some samples in HA treated group and one sample in PRP + HA group presented complete filling of the perforation let us to conclude that new experiments adding more sensitive methods may clear the influence of these treatments in reduce the damage in the osteochondral surface related the lesioned disc. Sao Paulo State Univ, UNESP, Inst Sci & Technol, Dept Biosci & Oral Diag, Ave Eng Francisco Jose Longo 777, BR-12245000 Sao Jose Dos Campos, SP, Brazil Sao Paulo State Univ, UNESP, Inst Sci & Technol, Dept Dent Mat & Prosthesis, Ave Eng Francisco Jose Longo 777, BR-12245000 Sao Jose Dos Campos, SP, Brazil Sao Paulo State Univ, UNESP, Inst Sci & Technol, Dept Biosci & Oral Diag, Ave Eng Francisco Jose Longo 777, BR-12245000 Sao Jose Dos Campos, SP, Brazil Sao Paulo State Univ, UNESP, Inst Sci & Technol, Dept Dent Mat & Prosthesis, Ave Eng Francisco Jose Longo 777, BR-12245000 Sao Jose Dos Campos, SP, Brazil FAPESP: 16/23446-2 FAPESP: 18/13473-8

The applications of titanium based alloys are widely used as orthopedic implants due to their excellent combination of mechanical properties, corrosion resistance and outstanding biocompatibility. Recently studies have been demonstrated titanium-niobium alloys do not present cytotoxicity, exhibit corrosion resistance similar or superior to titanium and have elastic modulus significantly lower than other titanium alloys. These characteristics make these materials an alternative for several biomedical applications, mainly implants. Previous studies demonstrated that Ti-35Nb alloy exhibits the closest elastic modulus of bone, and have good performance in key parameters of osteogenesis, which means that this alloy has an excellent biological profile and shows a great potential for biomedical application. In the present study it was demonstrated that Ti-35Nb alloy did not present DNA damage. Thus, these results consolidate this alloy has a promising material to substitution to the materials currently used in orthopedics and in dentistry, with absence of cytotoxity and genotoxity.

Oral potentially malignant disorders (OPMD) may develop malignant characteristics and transform into oral squamous cell carcinoma (OSCC) in a range of 1% to 2% of cases. Chronic alcohol consumption is associated with carcinogenesis, but its mechanism has not yet been fully elucidated. ALDH1A1 and 2, isoenzymes responsible for aldehyde oxidation involved in ethanol metabolism may be associated with the development of malignant head and neck neoplasms. The aim of this study was to analyze the expression of ALDH1A1 and ALDH2 in oral leukoplakia with epithelial dysplasia (OLP) and OSCC. A retrospective study was conducted on 27 cases of OLP and 30 cases of OSCC. Clinical data were obtained from medical records, and all cases were classified as mild, moderate, and severe for OLP, and well-differentiated, moderately differentiated, or poorly differentiated for OSCC cases. The ALDH1A1 and ALDH2 expression in OLP and OSCC was evaluated by the immunohistochemical technique. There was predominance of the male sex, in both OLP and OSCC cases. Oral tongue was the most affected site in both groups. OLP showed positive protein expression of ALDH1A1 in all cases, both basal and suprabasal epithelial layers, whereas ALDH2 showed less protein expression. In OSCC, the immunohistochemical reaction for ALDH1A1 expression was negative in 70%, whereas ALDH2 expression was positive in all cases. This study demonstrated the gradual loss of ALDH1A1 expression in OSCC in comparison with OLP, and the increased ALDH2 expression in OSCC.

This case report describes an intraosseous neurilemoma, observed radiographically as a multilocular lesion, in a 12-year-old patient. Physical examination revealed facial asymmetry, swelling on the right side of the mandibular body, and bone expansion in the region of the base of the buccal sulcus. Panoramic radiography revealed a multilocular radiolucency on the right side of the mandibular body in the periapical region extending from the distal region of the first premolar root to the second molar and adjacent to the third molar. Evaluation of a radiograph obtained 3 years earlier for an orthodontic assessment revealed that the lesion was present, appearing as a unilocular radiolucency near the root of the mandibular right first molar. An incisional biopsy of the multilocular lesion was performed, and Antoni A and Antoni B histologic patterns were identified by microscopic analysis. Immunohistochemical analysis was conducted, and neoplastic cells stained positive for the S-100 protein. The patient underwent conservative surgical excision of the lesion, and no recurrence was observed during 7 years of clinical follow-up. Based on analysis of the present case and previous cases reported in the literature, intraosseous neurilemoma, especially its multilocular variant, is an uncommon neoplasm. In the present case, evaluation of the lesion when it was first radiographically detectable, prior to orthodontic treatment, would have permitted a more limited surgical approach for the excision of a small intraosseous lesion.

Ameloblastoma is an odontogenic tumor that affects the bones of the jaw, often affecting posterior region of the mandible. It is a benign neoplasm and is fre­quently associated to an unerupted tooth. The purpose of this article is to report a case of failure in making an immediate full denture in a patient that had an ameloblastoma. A female patient aged 67 years complained of a hard swelling in the right mandible at the premolar region, that she noted after teeth extraction and confection of an immediate denture. Intraoral examination showed buccal and lingual cortical plate expansion and radiograph examination showed multilocular radiolucency with a well-defined margin. Fine needle aspiration was nonproductive and the provisional diagnosis was ameloblastoma. An incisional biopsy was performed and the histopathological report was conclusive of an acanthomatous ameloblastoma. The patient was sent for surgical excision of the lesion and after three years, the patient returned reporting that she was operated elsewhere in the past year and had an unsuccessful bone graft. She was sent to a prosthodontist to make a complete denture. In the present case the ameloblastoma was diagnosed only after the teeth extraction and immediate denture. KeywordsAmeloblastoma; Diagnosis; Mandibular neoplasms; Odontogenic tumors.

Odontogenic lesions comprise a diverse group of lesions which usually affect the oral cavity and are derived from embryonic dental tissues. Their mechanisms of development and progression are still not fully known, but there are some studies investigating the participation of specific proteins in these events. Objective: The objective of this study was to investigate the expression of KRAS protein in these pathologies and also to correlate the protein expression with the behaviour of the lesions studied. Material and Methods: Immunohistochemical analysis of 20 cases was performed for each one of the following lesions: dentigerous cyst (DC), odontogenic keratocyst (OKC) and ameloblastoma (AB), totalising 60 cases to be analysed. Results: By considering the KRAS immune-expression, there were 11 cases (55%) presenting over-expression (score 3) in the basal layer of DC and 13 cases (65%) in the supra-basal layer. A similar finding was observed in the analysis of OKC, with eight cases (40%) in the supra-basal layer (score 3) and only five cases (25%) in the basal layer. As for AB, the over-expression was found in six cases (30%). Conclusion: Therefore, one believes that the KRAS expression in odontogenic lesions is inversely proportional to their aggressive behaviour.KeywordsKRAS; Odontogenic lesions; Immunohistochemistry

A 10-year-old boy was referred after orthodontic documentation because of maxillary lesions. On cone beam computed tomography scan, the right side lesion presented a volumetric increase with a ground-glass appearance, affecting the maxilla, zygomatic, sphenoid, squamous, and petrous portions of the temporal bones. The lesion on the left side presented a mixed, expansive aspect, with multilocular hypodense areas, containing internal hyperdense foci, similar to mineralized dental components, on the alveolar ridge, involving unerupted and displaced teeth. The right side lesion had a clinical diagnosis of craniofacial fibrous dysplasia. Incisional biopsy of the left lesion revealed an ameloblastic fibro-odontoma, which was surgically treated. After 4 years, no recurrence of the excised lesion was observed. Therefore, the patient remains in periodic follow-up. Craniofacial fibrous dysplasia presents a slight volumetric increase in the alveolar region. The authors did not find any report in the literature of coexistence of these lesions in the same patient.

Adenosquamous carcinoma is an aggressive variant of squamous cell carcinoma. This report describes a case of adenosquamous carcinoma with clinical features of a benign lesion and discusses the differential diagnoses, especially regarding histopathological and immunohistochemical analyses. A 45-year-old male was referred to our outpatient clinic complaining about a rapid-growing enlargement in hard palate. Clinical examination revealed an erythematous and pedunculated nodule with lobulated non-ulcerated surface. Excisional biopsy was performed following clinical diagnosis of pyogenic granuloma. Histologically, the specimen consisted of areas characterizing both well-differentiated squamous cell carcinoma and true adenocarcinoma. After a broad list of immunohistochemical markers was evaluated (AE1/AE3, CEA, CK5, CK7, CK8/18, p53, p63 and Ki67), the diagnosis of adenosquamous carcinoma was rendered and the patient referred to complementary surgery. Adenosquamous carcinoma represents a challenge in diagnostic routine due to its rarity, diverse range of clinical presentations and histological features. Furthermore, classical clinical benign features may be present in malignant lesions; hence the submission of every surgical specimen to histological analysis is mandatory to provide the patient the adequate treatment. Resumo O carcinoma adenoescamoso é uma variante agressiva do carcinoma de células escamosas. Este relato descreve um caso de carcinoma adenoescamoso que apresenta características clínicas de uma lesão benigna e discute o diagnóstico diferencial, especialmente em relação à análise histopatológica e imuno-histoquímica. Um homem de 45 anos foi encaminhado ao nosso serviço queixando-se um aumento de volume de rápido crescimento no palato duro. O exame clínico revelou um nódulo eritematoso e pedunculado com superfície lobulada não ulcerada. Foi realizada biópsia excisional seguindo a hipótese clínica de granuloma piogênico. Histologicamente o fragmento consistia em áreas de carcinoma de células escamosas bem diferenciado e áreas de adenocarcinoma verdadeiro. Após a avaliação de uma ampla lista de marcadores imuno-histoquímicos (AE1/AE3, CEA, CK5, CK7, CK8/18, p53, p63 e Ki67), o diagnóstico de carcinoma adenoescamoso foi atribuído e o paciente foi encaminhado à cirurgia complementar. O carcinoma adenoescamoso representa um desafio na rotina de diagnóstico, devido à sua raridade, diversificada gama de apresentações clínicas e características histológicas. Além disso, características clínicas benignas podem estar presentes em lesões malignas, por isto a submissão de todas as peças cirúrgicas à análise histológica é obrigatória para fornecer ao paciente o tratamento adequado.

Made available in DSpace on 2018-12-11T17:30:01Z (GMT). No. of bitstreams: 0 Previous issue date: 2016-11-01 Objective Despite the advances in medicine, the oral squamous cell carcinomas still have high incidence and are very important to study topics such as their lymphatic and microvessel density. This research assessed the correlation between histological grading, formation of new lymphatic and blood vessels and cell proliferation in squamous cell carcinomas (SCC). Methods Twenty-nine oral floor SCC and 30 tongue cases were assessed for their clinical characteristics and histological grading of malignancy. Results The presence of VEGF (vascular endothelial growth factor VG1), VEGF-C (vascular endothelial growth factor-C), CD105, to determine blood microvascular (MVD), and D2-40 to determine lymphatic density (LMD) was investigated using immunohistochemistry. Histological grading revealed that 73.3% of tongue and 96.67% of floor cases were classified as highly aggressive. Cell proliferation was greater on the floor; however, no significant difference was observed. Most carcinomas were VEGF negative (tongue 63.3% and floor 70.0%) and VEGF-C positive (tongue 73.3% and floor 79.3%). LMD was considerably greater on the tongue. High MVD values occurred in cases with greater cell proliferation. No relationship was determined between the growth factors VEGF and VEGF-C and MVD and LMD, respectively. Conclusion Floor of mouth SCC cases was morphologically more aggressive than tongue cases; however, in tongue carcinomas a greater quantity of lymphatic vessels could represent potential ways for locoregional cell dissemination of the neoplastic cells, independent of histological grading. Blood vascularization presented correlation with cell proliferation in intraoral squamous cell carcinoma and could be useful in the prognostic assessment of this neoplasm. Department of Bioscience and Oral Diagnosis Institute of Science and Technology Univ Estadual Paulista (UNESP), Av. Engenheiro Francisco José Longo, 777 Faculdade de Medicina Universidade de Santo Amaro – UNISA, Rua Professor Enéas de Siqueira Neto, 340 Department of Bioscience and Oral Diagnosis Institute of Science and Technology Univ Estadual Paulista (UNESP), Av. Engenheiro Francisco José Longo, 777

Diamond-like carbon (DLC) film is a biocompatible hard coating material that can prevent the leaching of metal ions. This study evaluates the structural characteristics of DLC, with and without silver nanoparticles, deposited by plasma (PECVD) on titanium alloy (Ti-6Al-4V) and bone formation in contact with DLC films. Sixty Ti-6Al-4V samples were used divided in: uncoated, coated with DLC and coated with DLC-Ag. After structural characterization, samples were fixed bilaterally at the rabbit's mandible. After 15 and 90 days, samples were characterized again and bone formation in the area was analyzed by histomorphometry. Statistical analysis was performed by two-way ANOVA. Both the DLC and DLC-Ag films were firmly adhered and showed a high electrical resistance without significant changes in the Raman spectrum after in vivo integration. After 15 days, there were immature bone trabeculae in the interface and partially covering the surface. After 90 days, mature bone filled the interface and coved the surface. There was no statistically significant difference among the three groups in both periods. In conclusion, osseointegration with DLC, DLC-Ag and uncoated Ti-6Al-4V is similar. However, DLC and DLC-Ag coverings have the advantage of electrical insulation and can presumably control bacterial activity and ion leaching. Resumo O filme de carbono semelhante a diamante (DLC) é um material de revestimento duro e biocompatível que pode impedir a corrosão com liberação de íons metálicos. Este estudo avaliou as características estruturais do filme de DLC, com e sem nanopartículas de prata (Ag), depositadas por plasma (PECVD) em liga de titânio (Ti-6Al-4V) e formação óssea em contato com filmes de DLC. Foram utilizadas 60 amostras de Ti-6Al-4V divididas em: não recobertas, recobertas com DLC e recobertas com DLC-Ag. Após caracterização estrutural, amostras foram fixadas bilateralmente na mandíbula de coelhos. Após 15 e 90 dias, as amostras foram novamente caracterizadas e a formação óssea na área foi analisada por histomorfometria. A análise estatística foi realizada por ANOVA dois fatores. Ambos os filmes DLC e DLC-Ag foram firmemente aderidos e mostraram uma alta resistência elétrica sem alterações significativas no espectro Raman após a osseointegração in vivo. Após 15 dias, havia trabéculas ósseas imaturas na interface e cobrindo parcialmente a superfície. Após 90 dias, o osso maduro preencheu a interface e a superfície. Não houve diferença estatisticamente significante entre os três grupos nos dois períodos. Em conclusão, a osseointegração com DLC, DLC-Ag e Ti-6Al-4V não revestido é similar. No entanto, os revestimentos DLC e DLC-Ag têm a vantagem do isolamento elétrico e podem presumivelmente controlar a atividade bacteriana e a corrosão com liberação de íons.

Vascular leiomyomas (VL) are benign lesions of perivascular origin. We report two new cases and discuss their clinical, histological and immunohistochemical characteristics, in order to facilitate the diagnosis and treatment of such lesions. The patients, both male, presented asymptomatic nodules located in the bottom of the labial sulcus and buccal mucosa. In the second case, color doppler ultrasonography was performed, which showed no change in blood flow. After excisional biopsies, a limited lesion was observed histologically, with multiple tortuous vessels of varying sizes and calibers, and among them, spindle cells bundles, positive for smooth muscle actin. Oral VLs have clinical features similar to those of other more common lesions, making preoperative diagnosis difficult. Imaging examination, such as color doppler ultrasonography, may help in diagnosis. In general, excisional biopsy is performed, due to the ease of removal of the lesion during surgery. The treatment of choice is the complete excision of the lesion, which has an excellent prognosis and a low rate of recurrence. Key words:Vascular leiomyoma, spindle cells, thrombus, Doppler.

Made available in DSpace on 2022-04-29T08:27:45Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-01-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) The most important microscopic characteristic of Cyclosporine A-induced gingival overgrowth is fibroepithelial hyperplasia. Objective: The objective was to investigate the influence of previous exposure to Cyclosporine A over gingival epithelium in experimental periodontitis in rats. Methods: Twenty Wistar rats with 12 weeks-old were divided into four groups with 5 animals each: Control Group (CG); Cyclosporine Group (CsAG); Ligature group (LG) and Cyclosporine and Ligature Group (CsALG). Daily doses of CsA (10 mg/kg) were applied to CsAG and CsALG during 60 days since the beginning of the experiment and, a ligature was placed in LG and CsALG 30 days after the beginning of the experiment. After 60 days, animals were euthanized and gingival tissue was processed to histomorphometric analysis of epithelial thickness (mm2), immunohistochemical expression of PCNA (%) and inflammatory response. Data were analyzed by Kruskal-Wallis and Mann Whitney at 0.05 significance level. Results: Considering epithelial thickness, CG was thinner than all groups, CsALG was the largest and CsAG and LG were similar between each other. Regarding the PCNA expression CG (16.46 ± 9.26) was similar to CsAG (34.47 ± 19.75) and, LG (59.02 ± 10.33) was similar to CsALG (40.59 ± 18.25). Significant difference (p < 0.05) occurred only in inflammation presence comparing CG/LG and CsAG/CsALG. A weak positive correlation between the number of PCNA+ and inflammatory cells (p = 0.001; r = 0.611) was observed. Conclusion: Based on these results it was concluded that the enlargement of gingival epithelium observed in experimental periodontitis can be increased by previous exposition to CsA and inflammatory conditions enhanced proliferative activity of the keratinocytes. Periodontics Department Department of Dentistry of Universiy of Taubaté Departament of Oral Biopathology of Institute of Science and Tecnology São Paulo State University, São José Dos Campos UNISA - Santo Amaro University Departament of Oral Biopathology of Institute of Science and Tecnology São Paulo State University, São José Dos Campos FAPESP: 08/54784-4

Made available in DSpace on 2019-09-12T16:53:31Z (GMT). No. of bitstreams: 0 Previous issue date: 2017 Objectives: Retention cysts are common in the maxillary sinuses. Combined vascular malformations are abnormalities that involve at least two types of vessels and are frequent in different regions of the organism, especially the skin. The association of a combined vascular malformation and retention cyst in the maxillary sinus is rare. We report the case of a 35-year-old asymptomatic male patient in whom a maxillary sinus cyst was detected during orthognathic surgery. The histopathological findings were compatible with a combined capillary and lymphatic malformation associated to a retention cyst. Methods: Case report of a combined vascular malformation in a maxillary sinus retention cyst. Results: Histopathological analysis revealed findings compatible with a combined vascular and lymphatic malformation and a retention cyst lined with ciliated pseudostratified respiratory epithelium. Numerous dilated blood and lymphatic vessels, delimited by a single layer of endothelial cells, were observed near the cyst. Immunohistochemistry for D2-40 antigen was positive in the lining cells of lymphatic vessels and CD34 was detected in endothelial cells of capillary blood vessels. Conclusion: To our knowledge, this is the first case of the association of a combined capillary and lymphatic malformation and retention cyst in the maxillary sinus. Vascular malformations should be included in the diagnostic hypotheses for cystic lesions of the maxillary sinus usually considered retention cysts. It is possible that other cases of combined vascular malformations exist. In this way, it is important to emphasize the need of histopathological examination of all specimen removed during maxillofacial surgeries. (C) 2016 Asian AOMS, ASOMP, JSOP, JSOMS, JSOM, and JAMI. Published by Elsevier Ltd. All rights reserved. [de Almeida, Adriana Avila; Anbinder, Ana Lia; Carvalho, Yasmin Rodarte; Almeida, Janete Dias] UNESP Univ Estadual Paulista, Inst Sci & Technol, Dept Biosci & Oral Diag, Sao Jose Dos Campos, SP, Brazil [de Almeida, Sergio Abreu; Guimaraes Filho, Rubens] Universidade de Taubaté (Unitau), Sch Dent, UNITAU

Oral leukoplakia (OL) may precede squamous cell carcinoma and its histologic grading is subjective. Loss of heterozygosity (LOH) has been reported as risk predictor of OL malignant transformation. Objective: Correlate histologic and immunohistochemical characteristics of OL and evaluate molecular aspects, aiming at to demonstrate their malignant potential. Study Design: Ninety-six cases of OL were stratified by the World Health Organization (WHO) and Kujan systems by 3 blinded pathologists and correlated to the immunohistochemical biomarkers (IBs) p53, Ki-67, pRb, and p16. In 25 cases, LOH analysis was performed. Results: A moderate concordance among pathologists in both systems (Kendall correlation) was observed. Weak to moderate correlation among IBs was observed, as well as among IBs and histologic grading (Spearman correlation). Staining for p16 showed agreement with all the others IBs. Ki-67 was the most concordant marker in Kujan's system. The LOH was found in moderate and severe dysplasia for the markers TP53 (17 p13.1) and IFNA (9 p21), in 2 cases each. Conclusions: Greater concordance among pathologists as well as between histologic grading and IBs was demonstrated by Kujan's system. In OL, p16 can express alone the diagnoses obtained by all others IBs together. LOH could be related to the degree of histopathologic severity and to the greater expression of IBs.

Metastatic dissemination to the mouth is uncommon, representing nearly 1% of all oral cavity malignant neoplasms. We present a case of oral metastasis as the initial presentation of colon adenocarcinoma in an 80-year-old man with a 4-cm ulcerated nodule in the left palate. The clinical hypotheses were squamous cell carcinoma, pyogenic granuloma, and metastatic lesion. Incisional biopsy was performed, and a malignant neoplasm composed by glandular structures lined by simple or stratified epithelium with polarized basal cells and papillary or cribriform pattern was found. Endoscopy and colonoscopy showed several lesions in the gut with similar histologic aspects to the oral lesion, which was diagnosed as metastatic colon adenocarcinoma. The patient started chemotherapy but unfortunately died several months after the diagnosis. Although rare in mouth, metastatic lesions should be included in the differential diagnosis and can be the first sign of a distant malignant neoplasm.

A 21-year-old man was referred to the oral medicine clinic for investigation of a mandibular lesion after orthodontic documentation. Extraoral examination revealed asymmetry with a volumetric increase of the mandibular angle on the left side. Intraorally, the mucosa was preserved with no expansion. Cone beam computed tomography (CBCT) revealed a well-circumscribed hypodense lesion, with anteroposterior growth involving the mandibular body in the region of teeth 37 and 38. Incisional biopsy was performed based on the diagnosis of odontogenic myxoma that was confirmed in the histopathologic examination. Partial mandibular resection through a Risdon access surgery was conducted under general anesthesia with the installation of mandibular reconstruction plate system of 2.4 mm and immediate reconstruction with a particulate graft of iliac crest associated with platelet-rich fibrin (PRF). The patient is in a follow-up of 6 months, and the last CBCT showed local bone formation.

Polymorphous adenocarcinoma (PAC) is the second most common intraoral malignant salivary gland tumor. Although generally considered a low-grade tumor, when presenting a cribriform or papillary configuration there is a poorer prognosis. We report 2 PAC cases. Case 1: A 35-year-old man presented a pediculated nodule with reddish areas. Case 2: A 67-year-old woman presented with sessile nodule exhibiting telangiectatic areas. Both lesions occurred in the left hard palate, had smooth surface, measured approximately 3 cm, were painless, and at had least 4 years of evolution. Microscopically, both showed round isomorphic cells with indistinct cytoplasmic outlines and ovoid nuclei. Architectural pattern showed solid sheets, single files of cells, ducts with 1 cell layer, and papillary cystic formations. Perineural and minor salivary glands invasion were observed. The stroma is variably hyalinized and myxoid. In case 2, cribriform structures were also observed, indicating a higher probability of metastasis.

Subgemmal neurogenous plaque (SNP) is a neural structure present in the posterolateral border of the tongue, forming a morphophysiological complex with the taste buds. It was first described 20 years ago, and still now it is not well recognized by clinicians and pathologists. The aim of this study is to report 3 cases of SNP incidentally found after biopsies of posterior tongue lesions (lymphoepithelial cyst, lymphatic malformation, and mucoepidermoid carcinoma). The plexus usually exhibits a biphasic pattern, with bundle of fusiform wavy cells parallel to the epithelial surface, and a deepest portion composed of small nerve fascicles. The clinical findings of the SNP are unspecific, but several cases are symptomatic. The histologic pattern can be mistaken for soft tissue reactive or neoplastic neural lesions, which makes the recognition of the morphologic aspects of this anatomic structure very important.

Oral hairy leukoplakia (OHL) is a condition caused by Epstein-Barr virus (EBV) infection, usually associated with immunosuppressed patients. This study aims to report a case of atypical clinical presentation of OHL involving a 9-year-old girl, without previous history of immunosuppression. During anamnesis, the person in charge reported that the patient had recently started treatment for allergic dermatitis. Clinically, there were white corrugated lesions on both lateral tongue borders. Under the OHL diagnosis hypothesis, an incisional biopsy was performed. Microscopically, underlying the keratin layer, there were keratinocytes with pale cytoplasm, perinuclear haloes, and nuclei with margination of chromatin (nuclear beading). The final diagnosis was confirmed by chromogenic in situ hybridization (CISH) for EBV detection test. The occurrence of OHL in childhood is extremely uncommon, even in pediatric patients who are positive for human immunodeficiency virus (HIV). OHL should be included in the differential diagnosis when assessing white lesions in the oral mucosa.

Author(s): Vicensoto Moreira Milhan, Noala; Cavassini Torquato, Leticia; Costa, Victor; Carvalho De Marco, Andrea; Rodarte Carvalho, Yasmin; Lia Anbinde, Ana | Abstract: Intravascular papillary endothelial hyperplasia (IPEH) is an unusual benign, non-neoplastic vascular lesion that usually occurs in skin, but is uncommon in the oral cavity. Herein, we review the pertinent literature of oraiiPEH and report a new mixed form. A 61-year­ old man presented with an ulcerated nodule in the lingual portion of the gingiva related to the left mandibular canine. An excisional biopsy was performed presuming the clinical diagnosis of pyogenic granuloma. Histopathological analysis showed areas of granulation tissue consistent with pyogenic granuloma. But in addition, there were thin-wall dilated vessels with papillary projections of endothelial cells producing vascular channels, associated with an area of organizing thrombus. These microscopic findings led to the diagnosis of pyogenic granuloma associated with IPEH. The immunohistochemical reactions revealed a diffuse positivity of the vascular cells for CD-34 and smooth muscle actin antibodies.In addition,there was partial positivity for podoplanin and negativity for CD-1OS in the IPEH areas. No signs of recurrence were observed after 6 months of follow-up. The most prevalent site of IPEH in the oral region is the lower lip. IPEH is slightly more common in women and exhibits peaks of prevalence between the fourth and sixth decades of life.

Osteosarcoma of jaw bones represents less than 1% of all head and neck malignancies. Malignancy in pregnant women is also an uncommon event, and occurs in a ratio of one case per 1000 deliveries. The aim of this study is to report a rare case of maxillary osteosarcoma in a pregnant woman, and to review the previous cases published in English literature. A 29-year old woman, in the 33rd week of gestation, presented with a 2.5 cm reddish, multilobulated and ulcerated nodule in posterior maxilla with 1 month of evolution. Computerized tomography showed an expansive tumor destroying the alveolar bone around the molars and invading the maxillary sinus. The material of the first incisional biopsy was not enough to conclude the diagnosis. Before a second biopsy was done, the patient delivered normally a healthy boy. Histologically, the tumor was composed by round cells with prominent cytoplasm and pleomorphic nuclei, sometimes multinucleated. Areas with spindle and epithelioid cells were also found, among osteoid or chondroid matrix. The lesion was extremely vascularized, with mixomatous and telangiectatic regions. The final diagnosis was conventional osteosarcoma, and the lesion was surgically removed, with clear margins. A microsurgical flap was used for reconstruction and the patient received adjuvant radiation and chemotherapy. She has been followed up for one year, with no signs of metastasis or recurrence. The influence of pregnancy on the initiation, promotion and development of sarcomas is not well established. To the best of our knowledge, no more than 10 cases of jaw osteosarcoma in pregnant women have been reported up to now. The co-existence of malignancy and pregnancy is very uncommon, and sometimes a challenge for medical professionals, especially regarding the diagnosis, the use of ancillary examinations and the treatment.

Made available in DSpace on 2018-12-11T17:20:25Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-01-01. Added 1 bitstream(s) on 2019-10-09T18:31:45Z : No. of bitstreams: 1 S1516-14392018000267111.pdf: 5074346 bytes, checksum: 5cd926068e4bf6d9184434c8d970c0d5 (MD5) Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) This in vitro and in vivo study compared different topographies of Ti samples (dense, porosity of 30% and 40%) with or not CaP coating, prepared by powder metallurgy. Osteogenic cells from newborn rat calvaria were plated onto the samples and cell adhesion (24 hours), alkaline phosphatase activity (7 and 10 days) and mineralization nodules (14 days) were assessed. Sixteen rabbits were used for in vivo study. Each animal received three non-treated and three treated implants in the right or left tibia, respectively. Histometric evaluation of bone-implant contact (BIC) were assessed at 1, 2, 4 and 8 weeks. Metallographic analysis revealed porosities of 30% and 40%, with pore size ranging from 250 to 350 µm. Cell adhesion test and ALP revealed similar cell behavior, independently of topography and CaP coating (P > 0.05%). However, CaP coating combined with porosity of 40% influenced positively the mineralized matrix formation (P < 0.05%). CaP-coated implants showed higher BIC than non-CaP implants and BIC was different between the short (1 and 2 weeks) and long (4 and 8 weeks) healing periods (P < 0.05%). The results suggest that CaP coating combined with 40% porosity implants allowed greater osteogenesis in vitro and increased BIC in vivo. Instituto de Ciência e Tecnologia de São José dos Campos Departamento de Biociências e Diagnóstico Oral Universidade Estadual Paulista - UNESP Instituto de Ciência e Tecnologia de São José dos Campos Departamento de Diagnóstico e Cirurgia Universidade Estadual Paulista - UNESP Instituto de Divisão de Materiais Ar e Espaço CTA Instituto de Ciência e Tecnologia de São José dos Campos Departamento de Materiais Odontológicos e Prótese Universidade Estadual Paulista - UNESP Instituto de Ciência e Tecnologia de São José dos Campos Departamento de Biociências e Diagnóstico Oral Universidade Estadual Paulista - UNESP Instituto de Ciência e Tecnologia de São José dos Campos Departamento de Diagnóstico e Cirurgia Universidade Estadual Paulista - UNESP Instituto de Ciência e Tecnologia de São José dos Campos Departamento de Materiais Odontológicos e Prótese Universidade Estadual Paulista - UNESP FAPESP: 2005/03709-4 FAPESP: 2007/08593-0

Syphilis is a sexually transmitted infectious disease caused by Treponema pallidum. This study reports 3 cases of syphilis and highlights the importance of identifying oral lesions for its final diagnosis. Case 1: a 48-year-old male patient presented with a bleeding ulcer in the lower lip. Overall clinical examination revealed patchy alopecia and skin target lesions. Case 2: a 61-year-old male patient presented with white spots on the lateral tongue and nodules on the dorsum of the tongue. Overall clinical examination showed erythematous target lesions on the abdomen, forearm, palms of the hand, and soles of the feet. Case 3: a 17-year-old male patient presented with an ulcerated lesion on the tongue and lymph node involvement. The following serologic tests were requested: Venereal Disease Research Laboratory, fluorescent treponemal antibody–absorption, anti–HIV-1 and anti–HIV-2, and anti–hepatitis C virus. An incisional biopsy revealed epithelial hyperplasia associated with intense and diffuse mononuclear inflammatory cell infiltration consisting mainly of plasma cells, in a perivascular and perineural distribution. The final diagnosis in the 3 patients was syphilis. Treatment consisted of 1 weekly dose of penicillin (2.4 million units, intramuscular) for 2 or 3 weeks. Immunohistochemical reactions for XIIIa, CD3, CD20, CD68, CD163, S100, CD1a, CD11c, CD83, CD138, and CD208 were performed. Clinicians should be familiarized with oral syphilis lesions in order to be able to diagnose this emerging infectious disease of variable clinical presentation.

Made available in DSpace on 2019-09-11T20:51:35Z (GMT). No. of bitstreams: 0 Previous issue date: 2017 Resumo Tumor de células gigantes tenossinovial do tipo difuso (TCGT-d) ou sinovite vilonodular pigmentada (SVP) é uma lesão localmente agressiva que afeta principalmente as articulações dos ossos longos. Tumor de células gigantes tenossinovial condroide (TCGTC) ou SVP com metaplasia condroide é um tipo distinto e raro de tumor sinovial que tem a predileção pela articulação temporomandibular (ATM). Nós relatamos um caso raro de TCGTC da ATM, inicialmente diagnosticado, equivocadamente, como disfunção temporomandibular (DTM). Uma mulher de 51 anos foi encaminhada ao cirurgião com a queixa principal de dor na ATM por 5 anos, e uma história de tratamento de DTM sem sucesso. O exame extrabucal revelou discreto aumento de volume preauricular e movimentação mandibular restrita. A radiografia panorâmica e a tomografia computadorizada evidenciaram destruição da fossa mandibular e côndilo. Histologicamente, o tumor era composto por células mononucleares grandes, com amplo citoplasma eosinofílico e núcleo sulcado, pequenas células histiocitoides, células multinucleadas semelhantes a osteoclastos, pigmentação acastanhada e áreas de metaplasia condroide. As características morfológicas e imuno-histoquímicas levaram ao diagnóstico final de TCGTC. A raridade desta lesão pode estar associada ao seu não reconhecimento, sendo casos diagnosticados como condroblastoma, condromatose sinovial ou condrossarcoma. A paciente recebeu reconstrução imediata e recorrência foi observada 22 meses após a intervenção inicial. TCGT-d e TCGTC da ATM podem apresentar sintomas similares à DTM, mas os clínicos devem diferenciar ambas as lesões por meio do exame clínico completo, exames de imagem e, quando necessário, avaliação histopatológica. Abstract Tenosynovial giant cell tumor of diffuse type (TGCT-d) or pigmented villonodular synovitis (PVNS) is a locally aggressive lesion that mostly affects the joints of long bones. Chondroid tenosynovial giant cell tumor (CTGCT) or PVNS with chondroid metaplasia is a rare distinct subset of synovial tumors that has a predilection for the TMJ. We report a rare case of CTGCT in the TMJ, initially misdiagnosed as temporomandibular disorder (TMD). A 51-year-old woman was referred to the surgeon with the chief complaint of TMJ pain for 5 years and a past history of an unsuccessful TMD treatment. Extraoral examination revealed discrete preauricular swelling and restricted mandibular range of motion. Panoramic radiograph and computerized tomography showed destruction of the mandibular fossa and condyle. Histologically, the tumor was composed by large mononuclear cells with prominent eosinophilic cytoplasm and grooved nuclei, small histiocytoid cells, osteoclast-like multinucleated cells, brown pigmentation and areas of chondroid metaplasia. Morphological and immunohistochemical characteristics lead to the final diagnosis of CTGCT. The rarity of CTGCT could be attributed to the lack of recognition of this lesion, with cases diagnosed as chondroblastomas, synovial chodromatosis and chondrosarcoma. The patient received immediate reconstruction and recurrence was found 22 months after initial intervention. TGCT-d and CTGCT of the TMJ can present similar symptoms to TMD, but clinicians must distinguish both lesions by complete examination, imaging and, when necessary, histopathologic evaluation. [Pereira, Débora Lima; Almeida, Oslei Paes de] Universidade Estadual de Campinas, Brazil Guimarães Filho, Rubens] Universidade de Taubaté, Brazil Anbinder, Ana Lia; Geraldo, Barbara Maria Corrêa; Carvalho, Yasmin Rodarte] Universidade Estadual Paulista, Brazil

Made available in DSpace on 2018-12-11T17:36:01Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-01-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Background: The host's answer has an important role in periodontal disease, and the mast cells have a prime role. Such cells seem to be influenced by estrogen deficiency. The objective was to evaluate the mast cells and the expression of metalloproteinase(MMP)-9 in periodontal disease induced in ovariectomized rats. Methods: For that purpose, 36 rats were used; 18 ovariectomized (OVX) and another 18 Sham-operated (SHAM). After 60 days the periodontal disease was induced by a ligature around the first lower right molars (group P). The opposite side was the control group (group C). The euthanasia occurred 3, 7 and 14 days after the placement of the ligature. The gingiva was removed and analyzed histochemically and immunohistochemically to quantify the mast cells and to analyze MMP 9 expression. Results: By comparing the groups SHAM-P and C and groups OVX-C and P, it was noted that mast cells from group C were higher than P in all experimental periods. When comparing groups SHAM-C and OVX-C, significant factors were not found. When comparing groups SHAM-P and OVX-P, there was an inclination for mast cells reduction with time. The MMP-9 expression was related to the presence of periodontitis. Conclusions: It was concluded that periodontitis led to mast cells reduction and MMP-9 increase. The ovariectomy itself did not alter the MMP-9 expression and did not influence the presence of mast cells in rat papilla, however, when associated to inflammation led to a reduction of mast cells. PhD Laboratory of Anatomy Faculty of Pindamonhangaba (FAPI), Via Radialista Percy Lacerda, S/N Saída km 99 da via Dutra, Pindamonhangaba Department of Bioscience and Oral Diagnosis Institute of Science and Technology UNESP – Univ Estadual Paulista School of Dentistry, Av. Eng. Francisco José Longo, 777 Department of Bioscience and Oral Diagnosis Institute of Science and Technology UNESP – Univ Estadual Paulista School of Dentistry, Av. Eng. Francisco José Longo, 777 FAPESP: 08/54771-0

Actinic cheilitis exhibits a potential of malignant transformation in 10-20 % of cases. The objective of this study was to compare the expression of MDM2 and SUMO-1 proteins between actinic cheilitis (AC) and squamous cell carcinoma (SCC) of the lip. The sample consisted of lower lip mucosa specimens obtained from cases with a clinical and histopathological diagnosis of AC (n = 26) and SCC (n = 25) and specimens of labial semi-mucosa (n = 15) without clinical alterations or inflammation. The tissue samples were stained with hematoxylin-eosin and anti-MDM2 and anti-SUMO-1 antibodies. Data were analyzed by the Kruskal-Wallis and Dunn's tests (5 %). The median expression of MDM2 (kW = 36.8565; df = 3-1 = 2; p = 0.0001) and SUMO-1 (kW = 32.7080; df = 3-1 = 2; p = 0.0001) was similar in cases of AC and SCC of the lip, but differed significantly from that observed for normal labial semi-mucosa. Despite the limitations of the present study, immunohistochemistry demonstrated the overexpression of important proteins (MDM2 and SUMO-1) related to regulatory mechanisms of apoptosis in AC and SCC of the lip, but further studies are needed.

Estrogen deficiency results in increased bone turnover and can lead to osteoporosis. Hormone replacement therapy (HRT) seems to be the most effective means of reducing bone loss and fractures. However, the effects of the period of HRT onset on bone tissue require further elucidation. This study aimed to evaluate the effects of different periods of HRT onset on the trabecular bone of ovariectomized rats. Seventy-five ovariectomized Wistar rats were divided into five groups according to the onset of treatment. Each group was subdivided into experimental (E; n = 10) and control (C; n = 5), according to treatment with 17-β-estradiol or vehicle alone (soybean oil), respectively, administered subcutaneously. The first group received treatment immediately post-surgery, while treatment in the remaining groups was initiated 1, 2, 3 and 4 weeks post-surgery. Euthanasia occurred at 9 weeks post-surgery. The left tibias were removed and prepared for histomorphometric analyses. The histomorphometric results were statistically analyzed by the Student’s t test (p

Objectives Describe a new case of keratocyst of the buccal mucosa and compare its immunohistochemical features with 13 sporadic intraosseous keratocystic odontogenic tumors (KOT). Case Report and Study Design A male complaining about an enlargement on the left buccal mucosa was referred to the Stomatology Clinic. Clinical examination revealed a solitary nodule posterior to the parotid papilla. An excisional biopsy was performed following clinical diagnosis of epidermoid cyst. Microscopically, the lesion was characterized by a lining of five cell layers, with columnar basal cells and a corrugated parakeratinized surface. Immunohistochemical reactions for PTCH-1, Smo, Shh, mTOR, bcl-2, Ck17, and Ck19 were performed. PTCH-1 was not expressed in the keratocyst of the buccal mucosa, but was observed in suprabasal layers of eight (61.5%) cases of sporadic intraosseous KOT. Shh, mTOR, bcl-2, Ck17, and Ck19 expression was observed in all the cases investigated. Conclusions The morphology and immunoprofile of this lesion are similar to sporadic intraosseous KOT.

The study investigates the influence of low-level laser therapy (LLLT) on bone healing in the femur of osteopenic and normal rats with titanium implants. Ovariectomy and control group were randomly submitted to LLLT, which was applied by gallium-aluminum-arsenium (GaAlAs) laser at the surgical site before and after placing the implant, for seven times. Histomorphometric and statistical analysis were performed. Most irradiated groups showed higher values than the nonirradiated groups. The GaAlAs infrared diode laser may improve the osseointegration process in osteopenic and normal bone, particularly based on its effects in the initial phase of bone formation.

The aim of this study was to investigate different periods of estrogen replacement therapy onset on the progression of experimental periodontitis in ovariectomized rats. MATERIAL AND METHODS: Sixty five female Wistar rats were ovariectomized and divided into two groups, experimental and control that received 17ß estradiol or vehicle, respectively. Each group was subdivided into five subgroups that started the treatment immediately, one, two, three and four weeks after the ovariectomy. A month after ovariectomy, a cotton ligature was placed around the maxillary second molars. Thirty five days after ligature placement, the animals were killed. It was analyzed the macroscopic, radiographic, microscopic and histometric aspects of the periodontal area. RESULTS: The results indicated that estrogen-deficient state may not have a direct effect on the alveolar bone adjacent to the maxillary second molar roots. CONCLUSIONS: Under the conditions of this experiment, estrogen replacement therapy did not delay the progression of induced periodontitis. KEYWORDS: Estradiol; osteoporosis, ovariectomy; periodontal diseases.