Clinical and histopathological analysis of intramucosal zirconia inserts used for improving maxillary denture retention

Intramucosal inserts made of zirconia ceramic have been used for the rehabilitation of edentulous patients. This study aimed to follow up on patients with complete dentures having intramucosal zirconia inserts and to perform a histological analysis of biopsies of the epithelium surrounding the inserts. Twelve 31-66-year-old subjects of both genders received complete denture treatment having the intramucosal inserts in place. Detailed clinical, prosthetic and surgical procedures were described. Clinical exams were done on postoperative days 3, 7, 15, 120 and 360. One year after denture placement, the subjects received local anesthesia and the tissues surrounding the insertion sites in the alveolar ridge were removed using a scalpel blade. Biopsies were fixed for up to 48 h in 10% phosphate-buffered formaldehyde and 5-µm-thick sections were cut and stained with hematoxylin and eosin and Gomori Trichrome. Immunohistochemistry was used to identify endothelium (anti-CD3) and T lymphocytes (anti-CD31). Removing and reinserting the denture was painful until day 15, but all patients reported a marked increase in the retention and stability of the complete denture with little or no discomfort after 30 days. The histopathological analysis showed that zirconia inserts were well tolerated by the oral mucosa, with the presence of collagen fibers in the tissue around the insert, with mild inflammatory response and allowing reepithelialization, expressed by parakeratosis, epithelial hyperplasia and presenting granular layer. In conclusion, intramucosal zirconia inserts did not affect the health of oral mucosa and provide adequate retention and stability of the complete denture and comfort to the patients

Oral hairy leukoplakia: histopathologic features of the subclinical stage

A leucoplasia pilosa oral (LPO) é uma das manifestações orais mais comuns na AIDS, com valor diagnóstico e prognóstico. A LPO está relacionada ao Epstein-Barr vírus (EBV), com características clínicas e histopatológicas definidas. Já existem relatos de uma fase subclínica da LPO, porém sem caracterização histopatológica. O presente trabalho teve por objetivo descrever os aspectos histopatológicos desta fase, bem como realizar uma análise comparativa entre a LPO subclínica e clínica, com a finalidade de verificar a suficiência diagnóstica dos critérios histopatológicos. Trata-se de um estudo retrospectivo de 11 casos, obtidos a partir de cinco biópsias realizadas em pacientes com lesão e da borda de seis línguas sem lesão macroscopicamente detectável, provenientes de necropsias. Foram utilizados os seguintes métodos: histopatologia, imuno-histoquímica e hibridização in situ. Os aspectos histopatológicos que caracterizaram a fase subclínica da LPO foram: ausência de paraceratose e papilomatose, acantose leve, presença de células claras e alterações nucleares (inclusão tipo Cowdry A, núcleo em "vidro fosco" e núcleo "em colar"). Houve identificação do EBV através da hibridização in situ e da imuno-histoquímica nas alterações nucleares observadas na histopatologia. Concluiu-se, com fundamentos na identificação do EBV nas alterações nucleares, que a LPO em sua fase subclínica, da mesma forma que na lesão clínica, apresenta características histopatológicas específicas e suficientes para um diagnóstico definitivo, independentemente da identificação do EBV.Oral hairy leukoplakia (OHL) is one of the most common oral manifestations of AIDS, with diagnostic and prognostic value. OHL is associated to the Epstein-Barr virus and presents clinical and histological defined characteristics. There have already been reports about a subclinical stage of OHL, although they lacked histopathologic characterization. The present study had the aim to describe the histopathological characteristics of subclinical hairy leukoplakia, as well as to carry out a comparative analysis between clinical and subclinical OHL. For that, 11 cases were analyzed - 5 biopsies from patients who presented with the lesion and 6 samples from the borders of tongues obtained in necropsies. The histopathological findings in subclinical OHL were: absence of parakeratosis and papillomatosis, mild acanthosis, ballooning cells and nuclear alterations. In situ hybridization and immunostaining were positive for EBV in the nuclear alterations identified in the histophatological analysis. Based on the identification of EBV in the nuclear alterations, it was possible to conclude that subclinical OHL, similarly to the clinical lesion, presents histopathological features that are specific and sufficient to establish the definitive diagnosis, regardless of the identification of the virus

Detection of Sulphate-Reducing Bacteria and Others Cultivable Facultative Bacteria in Dental Tissues

Svrha: Željelo se detektirati bakterije koje reduciraju sulfate (BRS) i procijeniti moguću povezanost između BRS-a i fakultativnih bakterija na različitim mjestima u usnoj šupljini s različitim stanjem parodonta. Metode: Za istraživanje je od osmero pacijenata uzeto devet uzoraka (od jednog pacijenta uzeta su dva) s različitih mjesta u usnoj šupljini. Skupljeni su s pomoću modificiranog medija Postgate E namijenjenog uzgoju, rastu i izolaciji BRS-a. Osim toga upotrijebljena je i reducirana otopina za anaerobne bakterije kao otopina za transport fakultativnih bakterija identificiranih s pomoću lančane reakcije polimeraze te sekvencije gena 16S rRNK. Rezultati: BRS je pronađen u trima uzorcima – u fragmentu korijena, u fragmentu korijena i u zdravom zubu s vertikalnim gubitkom kosti i pomičnošću treće razine, te u zdravom zubu izvađenom zbog ortodontskih razloga. Kod posljednjeg pacijenta fakultativna bakterija identificirana je kao Lactobacillus casei. Ostale bakterije bile su Kurthia gibsonii (pacijent 5) i Pseudomonas aeruginosa (pacijent 7). Zaključak: Otkrivanje BRS-a na različitim zubnim tkivima s izrazitim parodontnim problemima upozorilo je na to da su potrebna nova istraživanja kako bi se otkrila prava uloga BRS-a u oralnoj mikroflori. Također smo, osim BRS-a, u istom uzorku mogli potvrditi i prisutnost Lactobacillus casei.Aim: To detect for the presence of sulphate-reducing bacteria (SRB) and evaluate the possible association between SRB and cultivable facultative bacterial of oral sites with different periodontal conditions. Methods: The study was carried out on 9 samples from different oral sites in 8 patients (two samples were collected from the same patient). Material was collected using modified Postgate E culture medium, indicated for the growth and isolation of SRB. In addition, a reducing solution for anaerobic bacteria was used as a transport solution for facultative bacteria and identified by polymerase chain reaction amplification (PCR) and sequencing of the 16S rRNA gene. Results: SRB was found in 3 patient samples: the first in a root fragment, the second in a root fragment and a healthy tooth with vertical bone loss and a mobility degree of 3; and the third in a healthy tooth extracted for orthodontic treatment. In the final patient, the cultivable facultative species Lactobacillus casei was identified. Other facultative bacterial species were identified in patient 5 (Kurthia Gibsonii) and patient 7 (Pseudomonas aeruginosa). Conclusions: The detection of SRB in different dental tissues with distinct periodontal features demonstrated that new studies need to be developed in order to determine the true role of SRB in the oral microbiota. In addition, it was possible to verify the presence of Lactobacillus casei together with SRB in one sample

INVESTIGAÇÃO DA ASSOCIAÇÃO ENTRE LÍNGUA GEOGRÁFICA E PSORÍASE ATRAVÉS DA ANÁLISE DAS FREQUENCIAS DOS GENES HLA E KIR.

INTRODUÇÃO: A psoríase é uma doença cutânea-articular, imunologicamente mediada de base genética. A presença de lesão oral é controversa, sendo a língua geográfica (LG) considerada a manifestação oral mais associada à psoríase. Alguns estudos demonstram uma relação direta entre a psoríase, a LG e as moléculas de Antígenos Leucocitários Humanos (HLA). Além disso, estudos genéticos recentes correlacionaram determinados genes para receptores semelhantes à imunoglobulina para células Natural Killer (KIR) com o aumento da susceptibilidade à psoríase vulgar não sendo realizado nenhum trabalho sobre a relação da LG e estes genes. Apesar daassociação genética entre estas condições, as informações são limitadas e imprecisas não permitindo o esclarecimento da etiopatogenia da LG e confirmação desta relação. OBJETIVO: Diante disto, o objetivo deste estudo foi demonstrar a existência de similaridade na expressão dos genes HLA e KIR entre indivíduos com LG e psoríase. MÉTODOS: A amostra foi constituída por 174 participantes, divididos em 58 com psoríase (GT-P), 30 com LG sem psoríase (GT-LG) e 86 indivíduos saudáveis (grupo controle - GC), submetidos à coleta de sangue periférico para extração de DNA e análises moleculares. RESULTADOS: O alelo HLA-B*57 apresentou-se significativo na Psoríase e o HLA-B*58 na LG, sendo ambos representados pelo mesmo antígeno -B17 identificado por métodos sorológicos. Os genes KIR2DS1, KIR2DL5, KIR3DS1 apresentaram maior frequência na LG e psoríase, assim como o haplótipo B de genes KIR. Verificou-se frequências semelhantes entre KIR2DS2 e ligantes HLA-C1 e KIR3DS1 e ligantes HLA-Bw4 nos grupos testes. CONCLUSÃO: Há similaridade na expressão dos genes HLA e KIR entre indivíduos com LG e com Psoríase, reforçando a associação entre essas condições

Comparative analysis of Gram’s method and PAS for the identification ofCandidaspp. samples from the oral mucosa

Introduction: Candida species are part of the normal microbiota of healthy subjects, living as commensals. However, they can become pathogenic when changes in the mechanisms of host defense or disruption of anatomic barriers occur. Candidiasis is the most common fungal infection in the oral cavity, mainly caused by Candida albicans. The diagnosis is based on symptoms and clinical aspects, in association with laboratory methods. Objective: To evaluate the sensitivity and specificity of Gram’s method for Candida spp. identification in scrapes from the buccal mucosa and evaluate the degree of concordance between clinical and cytological methods in the diagnosis of oral candidiasis. Material and methods: A blind study was performed in 170 smears from patients of Hospital Universitário Antônio Pedro of Universidade Federal Fluminense (HUAP/UFF), stained by Gram (n = 57), periodic acid-Schiff (PAS) (n = 57) and Papanicolaou (Pap) (n = 57) methods. Results: The comparative analysis of the methods demonstrated a higher prevalence of Candida spp. (12%) in PAS than in Gram staining, without statistic significance. The cytology method was positive in 93% of the clinical diagnosis of candidiasis. Conclusion: Gram was an adequate method; however more intensive professional training would be necessary to identify the fungus morphological structures. Although Pap test is the most common method of routine cytopathologic examination, for candidiasis diagnosis PAS staining is also recommended. Thus, it is suggested that candidiasis diagnosis should be accomplished by clinical evaluation in association with cytopathological analysis based on the identification of hyphae and/or pseudohyphae

Prevalence of Hyposalivation in Patients with Systemic Lupus Erythematosus in a Brazilian Subpopulation

Background. Systemic lupus erythematosus (SLE) is a chronic inflammatory, multisystem, and autoimmune disease. Objective. The aim of this study was to describe the prevalence of hyposalivation in SLE patients and evaluate factors associated. Methods. This is a cross-sectional study developed at the Cuiaba University General Hospital (UNIC-HGU), Mato Grosso, Brazil. The study population consisted of female SLE patients treated at this hospital from 06/2010 to 12/2012. Unstimulated salivary flow rates (SFRs) were measured. Descriptive and inferential analyses were performed in all cases using a significance level P<0.05. Results. The results showed that 79% of patients with systemic lupus erythematosus suffered from hyposalivation and that the disease activity and age in years were the factors that resulted in statistically significant differences. Conclusion. The activity of the disease, age >27 years, and the drugs used were factors associated with hyposalivation, resulting in a statistically significant decrease in saliva production

Estudo da cinética de crescimento de bactérias redutoras de sulfato (BRS) orais e ambientais em condições aeróbias e anaeróbias

Biocorrosion is a process induced by microorganisms such as sulfate-reducing bacteria (SRB), which are able to reduce sulfate to sulfide under different environmental conditions. Such biocorrosive ability renders these microorganisms highly important on a biotechnological scope. However, few studies have addressed the cultivation and behavior of Desulfovibrio sp. in laboratory conditions. We therefore aimed to describe the growth kinetics of Desulfovibrio desulfuricans (oral and environmental strains) and D. fairfieldensis, in aerobic and anaerobic conditions. Three strains were manipulated in a glovebox-type controlled atmosphere chamber, which allowed for cultivation under anaerobic conditions in modified Postgate E culture medium without agar-agar and Postgate C culture medium without agar-agar. Strains were grown in the same culture media under aerobic conditions, within a laminar flow hood. After adaptation, cultures were incubated at 30 °C for 147 h in an automatic microplate reader. Plates were shaken for 3 s on an hourly-basis and their absorbance was read at the 590-nm wavelength using software Gen5TM. In parallel, we evaluated SRB growth in modified Postgate culture medium without agar-agar by assessing iron sulfide formation. The strain D. fairfieldensis grew on both culture medium types, in both conditions. The other strains showed variation in the applied conditions, with divergences in readings of the growth curve being observed with iron sulfide formation in the modified Postgate E culture medium without agar-agar. The occurrence of growth in a culture medium specific to Desulfovibrio sp. in an aerobic environment suggests that these bacteria may be facultative anaerobic or aerotolerant, and not strict, as previously reported in most studies. Thus, such trait suggests that there is no restriction to these bacteria in anaerobic environments, and they therefore may be able to move across different niches of the oral cavity with different oxygen concentrations.Introdução: A biocorrosão é induzida por microorganismos, como, por exemplo, as Bactérias Redutoras de Sulfatos, com a capacidade de reduzir íon sulfato a sulfeto, sob diferentes condições ambientais. Assim, essa capacidade biocorrosiva faz com que esses microrganismos possuam grande potencial biotecnológico. Porém, existem poucos relatos na literatura sobre o cultivo e o comportamento das Desulfovibrio spp. em laboratório. Objetivo: Descrever a cinética de crescimento de duas espécies microbianas do gênero Desulfovibrio, Desulfovibrio desulfuricans (cepa oral e ambiental) e Desulfovibrio fairfieldensis, em condição de aerobiose e anaerobiose. Material e métodos: As três cepas foram manipuladas dentro de uma câmara de controle atmosférico, Glove box, permitindo utilizar as condições anaeróbicas para cultivo em meio de cultura Postgate E modificado sem Agar-agar e Postgate C sem Agar-agar. As cepas também foram cultivadas nos mesmos meios de culturas em condições aeróbicas, dentro de uma câmara de fluxo laminar. Após adaptação das cepas, as placas de cultivo foram incubadas a 30ºC, por 147 horas, em uma leitora automática de microplacas. A cada hora, a placa era agitada por três segundos e a leitura da absorbância no comprimento de onda de 590 nm realizada pelo software Gen5TM. Paralelamente, foi avaliado o crescimento de BRS em meio de cultura Postgate E modificado sem Agar-agar pela formação de sulfeto de ferro. Resultados: A cepa D. fairfieldensis apresentou crescimento nos dois tipos de meios de cultura e ambas as condições. As demais cepas apresentaram variações nas condições aplicadas, com divergência na leitura da curva de crescimento com a formação de sulfeto de ferro no meio de cultura Postgate E, modificado sem Agar-agar. Conclusão. O crescimento em meio de cultura especifico para Desulfovibrio sp. em ambiente aeróbico, sugere que estas bactérias podem ser anaeróbicas facultativas ou aerotolerantes e não estritas como vem sendo descrito na maior parte da literatura. Sendo assim, esta característica sinaliza não haver uma restrição desta bactéria a ambientes anaeróbicos, permitindo que ela possa transitar em diferentes nichos da cavidade oral com distintas concentrações de oxigênio