Surgical management of dentigerous cyst and keratocystic odontogenic tumor in children: a conservative approach and 7-year follow-up

Dentigerous cyst (DC) is one of the most common odontogenic cysts of the jaws and rarely recurs. On the other hand, keratocystic odontogenic tumor (KCOT), formerly known as odontogenic keratocyst (OKC), is considered a benign unicystic or multicystic intraosseous neoplasm and one of the most aggressive odontogenic lesions presenting relatively high recurrence rate and a tendency to invade adjacent tissue. Two cases of these odontogenic lesions occurring in children are presented. They were very similar in clinical and radiographic characteristics, and both were treated by marsupialization. The treatment was chosen in order to preserve the associated permanent teeth with complementary orthodontic treatment to direct eruption of the associated permanent teeth. At 7-years of follow-up, none of the cases showed recurrence

Effect of photobiomodulation on the viability of osteoblasts and fibroblasts submitted to alendronate sodium or zoledronic acid: an in vitro study

O objetivo deste estudo é avaliar o efeito da terapia de fotobiomodulação (TFBM) na viabilidade de osteoblastos e cultura de fibroblastos em diferentes concentrações de alendronato ou ácido zoledrônico. Duas linhagens celulares – células de camundongos semelhantes a osteoblastos (OSTEO 1) e fibroblastos de mucosa bucal humana (FMM1) – foram utilizadas. As células foram submetidas a diferentes concentrações de bisfosfonatos (1 μM, 10 μM e 100 μM de alendronato de sódio e 3 μM, 5 μM e 10 μM de ácido zoledrônico) por 24 horas. Em seguida, as culturas receberam TFBM. As irradiações foram aplicadas com laser de diodo (InGaAIP, 660 nm, 30 mW, spot 0,028 cm2) em modo contínuo, pontual e de contato, em duas densidades de energia: 5 J/cm2 (4,5 s) ou 10 J/cm2 (9s) com intervalos de 6 horas. A viabilidade celular foi determinada pelo ensaio de atividade mitocondrial (MTT) 24 h após a última irradiação. Os dados foram comparados pelo ANOVA One-Way, complementado pelo teste de Tukey (p < 0,05). O alendronato de sódio nas concentrações de 100 μM e 10 μM e o ácido zoledrônico na concentração de 10 μM apresentaram maior toxicidade a longo prazo. A viabilidade celular do grupo tratado com TFBM foi significativamente maior que a do grupo de controle negativo. O mesmo ocorreu com os osteoblastos tratados com as maiores concentrações do fármaco (5 e 10 μM), apesar de não atingir a viabilidade celular do grupo de controle positivo, apresentou maior viabilidade do que o controle negativo no qual as células não foram irradiadas. Nos grupos submetidos ao ácido zoledrônico, controles positivos apresentaram maior viabilidade celular. Concluímos que sob os parâmetros aplicados neste estudo, a TFBM, com uma densidade de energia de 5 J/cm2, foi capaz de reverter a toxicidade do alendronato sódico aplicado nas concentrações mais altas em ambos os tipos celulares, enquanto a toxicidade do ácido zoledrônico, independentemente de suas concentrações, foi não influenciada pela TFBM.The goal of this study is to evaluate the effect of photobiomodulation therapy (PBMT) on the viability of osteoblasts and cultured fibroblasts in different concentrations of alendronate or zoledronic acid. Two cell lines: osteoblast-like mouse cells (OSTEO 1) and human buccal mucosa fibroblast (FMM1) were used. Cells were submitted to different concentrations of bisphosphonates (1 μM, 10 μM, and 100 μM sodium alendronate and 3 μM, 5 μM and 10 μM zoledronic acid) for 24 hours. Next, the cultures received PBMT. The irradiations were applied with a diode laser (InGaAIP, 660 nm, 30 mW, spot 0.028 cm2) in continuous, punctual and contact mode at two energy densities: 5 J/cm2 (4.5 s) or 10 Jcm2 (9s) with 6 hours-intervals. Cell viability was determined by mitochondrial activity assay (MTT) 24 h after the last irradiation. The data were compared by the one way- ANOVA, complemented by the Tukey’s test (p < 0.05). Sodium alendronate at concentrations of 100 μM and 10 μM and zoledronic acid at 10 μM concentration showed higher long-term toxicity. The cellular viability of the PBMT treated group was significantly higher than that of the negative control group. The same occurred with the osteoblasts treated with the highest concentrations of the drug (5 and 10 μM), despite not reaching the cell viability of the positive control group, it presented greater viability than the negative control where the cells were not irradiated. In the groups submitted to zoledronic acid, positive controls presented greater cell viability. We concluded that under the parameters applied in this study, PBMT at an energy density of 5 J/cm2 was able to revert the toxicity of sodium alendronate applied at the higher concentrations in both cell types, whereas zoledronic acid toxicity, regardless of its concentrations, was not influenced by PBMT

Effect of different concentrations of alendronate on the viability and proliferation of different cell types

Os bisfosfonatos têm sido indicados para o tratamento de doenças ósseas líticas. Atualmente, seu emprego terapêutico aumentou e com ele os efeitos adversos, sendo um dos mais importante a indução da osteonecrose dos maxilares, uma complicação de difícil tratamento e solução. Até o presente, não se sabe ao certo qual o mecanismo de desenvolvimento da osteonecrose e nem qual deve ser o melhor tratamento estabelecido perante essa manifestação. Este trabalho teve como objetivo avaliar o efeito do alendronato sódico sobre a viabilidade e proliferação de osteoblastos e fibroblastos em cultura. Foram utilizados osteoblastos-símile linhagem OSTEO 1 e fibroblastos de mucosa bucal humana linhagem FMM1. Após serem submetidos aos testes de citotoxicidade com concentrações do alendronato sódico variando de 10-2M a 10-8M os fibroblastos apresentaram diminuição significante de viabilidade celular apenas na concentração de 10-2M (p<0,01). Os osteoblastos demonstraram viabilidade celular no grupo controle significantemente maior que todos os demais grupos; o grupo tratado com o alendronato na concentração de 10-4M apresentou viabilidade celular semelhante a de todos os grupos, exceto o grupo de concentração 10-2M e a viabilidade celular dos demais grupos foi semelhante entre si (p<0,01). As concentrações de alendronato sódico superiores a 10-5M impediram a proliferação dos osteoblastos. Foi possível concluir que o alendronato sódico é citotóxico para células osteoblastos-símile e fibroblastos em cultura em função de sua concentração. Os fibroblastos são menos sensíveis a concentrações maiores de alendronato sódico que os osteoblastos.Bisphosphonates have been therapeutically used for the management of lytic bone diseases. Their use has been increased nowadays and besides that associated adverse effects have been amplified. Jaw osteonecrosis induced by this drug is perhaps the most important complication because of the great morbidity and difficulty to deal with. Until now the physiopathology of osteonecrosis remains unclear and the treatment that should be established is uncertain. This study aimed to evaluate the effect of sodium alendronate a bisphosphonate used for the treatment of osteoporosis on the viability and proliferation of osteoblasts and fibroblasts in culture. Osteoblast-simile from the lineage OSTEO1 and a human oral mucosa fibroblasts from the lineage FMM1 were used. After being subjected to tests with concentrations of sodic alendronate ranging from 10-8M to 10-2M fibroblasts showed a significant decrease in cell viability at the concentration of 10-2M (p < 0.01). Osteoblasts showed that the cell viability in the control group was significantly higher than all other groups, the group treated with alendronate at a concentration of 10-4M had similar cell viability with all groups except the group of 10-2M concentration and the cell viability of other groups was similar between groups (p < 0.01). The concentrations of alendronate greater than 10-5M prevented the proliferation of osteoblasts. It was possible to conclude that alendronate is cytotoxic to osteoblast-símile cells and fibroblasts in culture due to its concentration. The fibroblasts are less sensitive to higher concentrations of alendronate than osteoblasts

Effect of low level laser therapy on viability of different cell types submitted to different concentrations of sodium alendronate and zoledronic acid

Os bisfosfonatos (BFs) têm sido amplamente utilizados para o tratamento de doenças do metabolismo ósseo, principalmente na prevenção de metástases ósseas e na prevenção e tratamento da osteoporose. No entanto, existem efeitos colaterais indesejáveis sendo um deles, a indução da Osteonecrose dos Maxilares (Medication-Related Osteonecrosis of the Jaws - MRONJ), uma complicação de difícil tratamento e solução. Até o presente momento, não foi definida a fisiopatologia da MRONJ e nem estabelecido protocolo de tratamento eficaz para esta doença. Diversas terapias vem sendo descritas na literatura para o tratamento da MRONJ dentre elas a laserfototerapia. Assim sendo, os objetivos deste estudo foram: inicialmente avaliar in vitro o efeito de diferentes concentrações dos BFs mais empregados na atualidade (alendronato e ácido zoledrônico) na viabilidade de células envolvidas na reparação de lesões MRONJ (osteoblastos e fibroblastos); secundariamente estudar o efeito da fototerapia com laser de baixa potência sobre estas células previamente induzidas pelos BFs. Foram utilizados osteoblastos-símile da linhagem OSTEO 1 e fibroblastos de mucosa bucal humana da linhagem FMM1. Após terem sido submetidos aos testes de citotoxicidade expondo as células as concentrações de 1?M, 10?M e 100?M de alendronato sódico e 3?M, 5?M e 10?M de ácido zoledrônico por 24 horas, os grupos testes foram irradiados com laser de diodo no modo contínuo, puntual e de contato (InGaAIP, 660nm, 30mW, spot 0,028cm2 ) com duas densidades de energia diferentes 5J/cm2 (4,5s) e 10J/cm2 (9s). Duas irradiações com intervalo de 6 horas entre cada uma delas foram executadas. A viabilidade celular foi determinada utilizando o ensaio de redução do MTT, e a atividade de fosfatase alcalina dos osteoblastos foi avaliada utilizando ensaio de ponto final. Os resultados obtidos foram submetidos à análise estatística ANOVA 1 critério complementado por Tukey (p<0,05). Foi possível concluir que: as concentrações de 100?M e 10?M do alendronato sódico foram tóxicas para os osteoblastos e fibroblastos em cultura. As concentrações de 3?M, 5?M e 10?M do ácido zoledrônico foram tóxicas para os osteoblastos e fibroblastos a longo prazo (48h e 72h). A atividade da fosfatase alcalina nos osteoblastos foi afetada por todas as concentrações de ácido zoledrônico testadas (3?M, 5?M e 10?M). Nos parâmetros aqui aplicados a LPT não teve efeito sobre a atividade da fosfatase alcalina das células tratadas com o alendronato de sódio ou ácido zoledrônico. E a laserfototerapia de baixa potência nos parâmetros utilizados nesse estudo não foi capaz de reverter a toxicidade dos bisfosfonatos testados, independentemente das concentrações destas substânciasBisphosphonates (BPs) have been widely used for treating bone metabolism diseases, especially for prevention of bone metastasis and osteoporosis. However, there are undesirable side effects and one of them, the induction of Osteonecrosis of the Jaw (Medication-Related Osteonecrosis of the Jaws - MRONJ), a complication of difficult treatment and solution. Until now the pathophysiology and an effective treatment protocol for MRONJ have not been established. Various therapies have been described in the literature for the treatment of MRONJ including laserphototherapy. The objectives of this study were to evaluate the effect of different concentrations of two BPs used today (alendronate and zoledronic acid) on the viability of cells involved in the repair of MRONJ lesions (osteoblasts and fibroblasts); and to study the effect of phototherapy with low power laser on these cells previously treated with referred BPs. After being submitted to cytotoxicity testing by exposing the cells to concentrations of 1?M, 10?M and 100?M of sodium alendronate and 3?M, 5?M and 10?M of zoledronic acid for 24 hours, the test groups were irradiated with diode laser in continuous mode, punctual and contact (InGaAIP, 660nm, 30mW, spot 0,028cm2) with two different energy densities 5 J/cm2 (4,5s) and 10J/cm2 (9s). Two irradiations with an interval of 6 hours between each of them were performed. Cell viability was determined using the MTT reduction assay, and the alkaline phosphatase activity of osteoblasts was evaluated using the end point assay. The results were submitted to statistical analysis using ANOVA 1 criteria complemented by Tukey (p <0.05). It was possible to conclude that: concentrations of 100?M and 10?M of alendronate were toxic to osteoblasts and fibroblasts in culture. The concentrations of 3?M, 5?M and 10?M of zoledronic acid was toxic to osteoblasts and fibroblasts in long-term (48h and 72h). The activity of alkaline phosphatase in osteoblasts was affected by all the zoledronic acid concentrations tested (3?M, 5?M and 10?M). In the LPT parameters applied here had no effect on alkaline phosphatase activity of the cells treated with the sodium alendronate or zoledronic acid. And low power laserphototherapy, in the parameters used in this study, was unable to reverse the toxicity of bisphosphonates tested, irrespective of the concentrations of these substances

Osteonecrose maxilar associada ao uso de bisfosfonatos Bisphosphonate-related osteonecrosis of the jaw

Os bisfosfonatos (BFs) têm sido indicados para o tratamento de doenças do metabolismo ósseo. Atualmente, seu emprego terapêutico aumentou e, com ele, os efeitos adversos, dos quais um dos mais importantes é a indução da osteonecrose dos maxilares, uma complicação de difíceis tratamento e solução. Até o presente, não se sabe ao certo qual é o mecanismo de desenvolvimento da osteonecrose dos maxilares induzida por bisfosfonatos (ONMB), nem qual deve ser o tratamento estabelecido perante essa manifestação. Apesar de a literatura apresentar formas variadas de tratamento, não existe um protocolo definido. Apresentamos uma revisão sobre a ONMB, enfocando sua etiopatogenia e as formas reportadas de tratamento.<br>Bisphosphonates (BPs) have been used for the management of bone metabolic diseases. Currently their therapeutic use has increased, as also have their adverse effects, one of the most important being the bisphosphonate-related osteonecrosis of the jaw (BRONJ), a complication of difficult treatment and solution. Until now, the physiopathology of BRONJ remains unclear, and its treatment is uncertain. Although the literature provides several treatment options, there is no defined protocol. We present a review about BRONJ, focusing on its pathogenesis and its reported forms of treatment

A global science mapping analysis on odontogenic infections

Objectives: Odontogenic infections are common and a topic of core interest for dentists, and maxillofacial surgeons. The aim of this study was to conduct a bibliometric analysis of the global literature on odontogenic infection and explore the top 100 most cited papers to identify the common causes, sequelae and management trends. Methods: Following a comprehensive literature search, a list of top 100 most cited papers was created. The VOSviewer software (Leiden University, The Netherlands) was used to create a graphical representation of the data, and statistical analyses were performed to analyze the characteristics of the top 100 most cited papers. Results: A total of 1,661 articles were retrieved with the first article published in 1947. There is an exponential upward trend on the number of publications (R2 = 0.919) and a majority of papers are in English language (n = 1,577, 94.94%). A total of 22,041 citations were found with a mean of 13.27 per article. The highest number of publications were recorded from developed countries. There was a male predilection in the reported cases and the most common sites included the submandibular and parapharyngeal spaces. Diabetes mellitus was identified as the commonest co-morbidity. Surgical drainage was ascertained to be the preferred method of management. Conclusions: Odontogenic infections remain prevalent and have a global distribution. Although prevention of odontogenic infection through meticulous dental care is ideal, early diagnosis and prompt management of established odontogenic infections is important to avoid morbidities and mortality. Surgical drainage is the most effective management strategy. There is lack of consensus regarding the role of antibiotics in the management of odontogenic infections

Nodular lymphocyte predominance Hodgkin lymphoma of the parotid gland: a case report

The parotid is the most frequent site of primary salivary gland tumors.Lymphomas represent 0.2 to 0.8% of all malignant parotid tumors. PrimaryHodgkin lymphoma of the parotid gland is rare with few cases reported inliterature. The nodular lymphocyte predominance Hodgkin lymphoma (HL)is considered a particular clinical and histopathological subtype of HL. Ithas never been reported in the parotid gland since its incorporation in the2001 World Health Organization Classification. The authors describe a caseof a 32-year-old male who sought medical attention because of a one-yearhistory of right cheek enlargement. A parotid nodule was submitted to a fineneedle aspiration biopsy which disclosed a suspected lymphoproliferativedisorder. A surgical dissection of the parotid gland was performed and anenlarged intraparotid lymph node measuring 4cm in its longest axis wasexcised, preserving the parotid gland integrity as well as the facial nerve.The pathological examination disclosed the diagnosis of nodular lymphocytepredominance Hodgkin lymphoma in this lymph node within the parotid gland.The treatment was completed with local radiotherapy and the 5-year follow upwas uneventful