Influence of preventive dental treatment on mutans streptococci counts in patients undergoing head and neck radiotherapy

The aim of this study was to evaluate the influence of chlorhexidine gluconate, sodium fluoride and sodium iodine on mutans streptococci counts in saliva of irradiated patients. MATERIAL AND METHODS: Forty-five patients were separated into three experimental groups and received chlorhexidine (0.12%), sodium fluoride (0.5%) or sodium iodine (2%), which were used daily during radiotherapy and for 6 months after the conclusion of the treatment. In addition, a fourth group, composed by 15 additional oncologic patients, who did not receive the mouthwash or initial dental treatment, constituted the control group. Clinical evaluations were performed in the first visit to dental clinic, after initial dental treatment, immediately before radiotherapy, after radiotherapy and 30, 60, 90 days and 6 months after the conclusion of radiotherapy. After clinical examinations, samples of saliva were inoculated on SB20 selective agar and incubated under anaerobiosis, at 37ºC for 48 h. Total mutans streptococci counts were also evaluated by using real-time PCR, through TaqMan system, with specific primers and probes for S. mutans and S. sobrinus. RESULTS: All preventive protocols were able to reduce significantly mutans streptococci counts, but chlorhexidine gluconate was the most effective, and induced a significant amelioration of radiotherapy side effects, such as mucositis and candidosis. CONCLUSION: These results highlights the importance of the initial dental treatment for patients who will be subjected to radiotherapy for head and neck cancer treatment

Cell proliferation and p53 expression in pseudoepitheliomatous hyperplasia of oral paracoccidioidomycosis

Paracoccidioidomycosis (PCMycosis) is a systemic mycosis frequently found in many regions of Latin America. Microscopically, it is characterised by granulomatous inflammation and pseudoepitheliomatous hyperplasia (PEH). This work describes the proliferation index and p53 expression by immunohistochemistry in PEH of PCMycosis, normal oral mucosa (NOM) and mild oral epithelial dysplasia (ED). Ki67 positive cells were present in the basal and parabasal layers in NOM and PEH, while in ED it was also observed in the spinous layer. Percentage of ki67 positive cells was 7.7, 28.2 and 46.0 in NOM, PEH and ED respectively. p53 was negative in NOM and in PEH it was expressed by few cells in the basal layer of only three cases. However, it was expressed in all cases of ED, in basal and parabasal layers. Although histologically PEH mimics well-differentiated squamous cell carcinoma, its proliferative pattern and p53 expression are more similar to NOM than to dysplasia. These findings, confirm PEH as a reactive process probably associated with the underlying chronic inflammation.49539339

Analysis of familial incidence of non-syndromic cleft lip and palate in a Brazilian population

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Background: The purpose of this study is to follow the familial incidence of non-syndromic or isolated cleft lip, with or without cleft palate (NSCL/P), and to analyze the relationships between the type of NSCL/P in the affected individual and his/her parent, looking at children in the first grade. Material and Methods: To investigate the familial incidence of NSCL/P we analyzed the records of 185 patients from 2004-2008, retrospectively. Detailed histories were collected regarding the familial incidence of NSCL/P. For the 185 individuals, the relationship between the type of NSCL/P and the sociodemographic and personal characteristics of the affected person and her/his cleft relatives was obtained. Results: The individuals were 42 carriers of CL, 109 with CLP (joined in one group) and 34 with CP (p<0.001). Of the total of participants, 65 (35.13%) presented a positive history of cleft in their families and 120 (64.86%) presented a negative history (p<0.001). There were differences between the cleft groups according to types of cleft and positive familial history (p<0.001). In both groups, the relatives with higher incidence of NSCL/P were cousins, with the same pattern of distribution between the two groups (p=0.175). Conclusions: Most frequently, fissures result from CL/CLP with no familial history. However, CL/CLP was found in familial cases and cousins were the relative type more likely to be affected.156E898E901Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

Denture stomatitis and salivary Candida in Brazilian edentulous patients

Denture stomatitis (DS) is frequently associated with high levels of Candida in saliva and deficient denture hygiene. In order to analyse the incidence of DS and its pre-disposing factors, we evaluated 77 edentulous patients before and 6 months after the placement of new complete dentures. Denture stomatitis was observed in 50.6 and 18.2% of the patients at the first and second evaluation, respectively. Salivary flow, Candida counts in saliva and Candida species were similar in both evaluations. Denture stomatitis and Candida in saliva were more common in females. Our results showed that denture replacement and denture hygiene improvement were useful for DS resolution, particularly types I and II. However, oral and denture hygiene must be continuous, inasmuch as salivary Candida counts remained high and it is considered an important pre-disposing factor for DS.29111115111

Cytokeratin expression in pseudoepitheliomatous hyperplasia of oral paracoccidioidomycosis

Paracoccidioidomycosis (Pmycosis) is one the most prevalent deep systemic mycoses in Latin America. It is characterized by granulomatous inflammation and pseudoepitheliomatous hyperplasia. Cytokeratins (CKs) are a group of intermediate filaments of epithelial cells and their expression varies according to the epithelium type, differentiation and pathological processes. This study describes cytokeratin expression as examined by immunohistochemistry, in 28 cases of oral Pmycosis involving the buccal mucosa, lip, gingiva and hard palate. Expression of CKs in the basal layer of the epithelium in pseudoepitheliomatous hyperplasia of Pmycosis was similar to that in normal oral mucosa (NOM), but in Pmycosis CK1 and CK10 were not expressed in the spinous and superficial layers of the lip, gingiva or hard palate, and, in the spinous and superficial layers of the lip and buccal mucosa, CK14 was positive in contrast to NOM where it was negative. In Pmycosis, CK6 was more frequently expressed in the spinous layer of the lip, gingiva and hard palate, but nevertheless CK16 expression was decreased in the spinous and superficial layers of the gingiva and hard palate. We conclude that pseudoepitheliomatous hyperplasia in oral Pmycosis shows a different pattern of CK expression, particularly CKs 1, 10 and 14, compared with NOM.44539940

Cytokeratin expression in initial oral mucositis of head and neck irradiated patients

Objective. The aim of this work was to study cytokeratin (Ck) expression in initial radiation-induced oral mucositis. Study design. Eleven cases of initial radiomucositis of the buccal mucosa and 9 normal specimens were immunostained for Ck 1, 5, 6, 7, 8, 10, 14, 16, 18, and 19 by immunoperoxidase method. Results. Expression of Ck 1, 6, 10, and 16 was stronger in mucositis than in normal mucosa. Ck 7, 8, and 18 were negative for both control and study groups. Ck 5, 13, and 14 were positive for both groups, nevertheless suprabasal staining for Ck 14 was more evident in mucositis than in the control group. Sporadic staining for Ck 19 was observed in 1 case of mucositis and in 2 controls. Conclusions. Increased Ck expression can be associated with the reactive proliferation of the epithelium and increasing resistance of the oral mucosa during the initial phases of radiotherapy.101220721

Histomorphometry and immunohistochemical features of grade I (WHO) oral radiomucositis

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 p53.13217017