Vascular Malformation of the Face: a Rare Case with Follow-up of 18 Years

Svrha rada: Vaskularne malformacije strukturne su anomalije krvnih žila. Prisutne su od rođenja i ostaju cijeli život. Mogu se klasificirati prema vrsti žila koje zahvaćaju. Tako su vinski madeži vaskularne malformacije koje obilježava povećan broj ektatičnih žila u dermalnom vaskularnom pleksusu, a mogu se nalaziti na bilo kojem dijelu tijela, uključujući i područje glave i vrata. Tijekom godina većina tih mrlja potiče hipertrofiju mekog tkiva, pa taj rast može uzrokovati tešku deformaciju lica. Materijali i metode: U ovom radu opisan je rijedak slučaj divovske proliferativne vaskularne anomalije koja je nastala od vinskog madeža na licu. Rezultati: U prikazu se naglasak stavlja na kontinuirani i proliferativni rast lezije koja je praćena 18 godina te na poteškoće pri utvrđivanju dijagnoze zbog njezine složenosti i dimenzije te okolnosti povezanih s lošim socijalno-ekonomskim statusom pacijenata. Zaključak: Opisujemo rijedak i neuobičajen slučaj divovske proliferativne vaskularne malformacije koja potječe od vinskog madeža na licu.Objective: Vascular malformations are structural anomalies in the blood vessels. They are present at birth and persist throughout life. These malformations can be classified according to the type of vessel involved. A port-wine stain is a vascular malformation characterized by an increased number of ectatic vessels in the dermal vascular plexus, which can be found in any part of the body, including the head and neck region. Over time, most of these stains result in soft tissue hypertrophy and this growth can cause severe facial deformity. Materials and Methods: This study describes a rare case of a giant proliferative vascular anomaly arising from a port-wine stain on the face. Results: The report highlights the continuous and proliferative growth of the malformation observed after follow-up of 18 years, as well as the difficulty in establishing the diagnosis due to the complexity and dimension of the lesion and the conditions related to the patient’s low socioeconomic status. Conclusions: We have described a rare and unusual case report of a giant proliferative vascular malformation arising from a Port-wine stain on the face

Evaluation of peripheral nerve fibers and mast cells in burning mouth syndrome

Abstract Emerging evidence has revealed a cross-talk in the etiopathogenesis of burning mouth syndrome (BMS) related to peripheral nerve fibers (NF) and neuropeptides secreted by mast cells. Here, we investigated the S-100+ density and PGP 9.5+ integrity of peripheral NF and the tryptase+ mast cell density in the oral mucosa of BMS patients and healthy individuals. A total of 23 oral mucosa specimens (12 BMS and 11 controls) were evaluated. The clinical diagnosis of BMS was based on a careful examination, excluding other local and systemic causes. Samples were taken from an incisional biopsy of the tongue mucosa of individuals with symptomatic BMS, while the margins of the non-neoplastic tongue biopsy served as controls of healthy individuals. Immunohistochemistry was performed to determine the density/mm2 of S-100+, PGP 9.5+ peripheral NF, and tryptase+ mast cells. Similar densities of S-100+, PGP 9.5+ peripheral NF, and tryptase+ mast cells were found in cases of BMS, with a median value of 3.70, 0.70, and 29.24/mm2, respectively, and in the control group, with a median value of 2.60, 0.80, and 26.01/mm2, respectively (p > 0.05). Moreover, the relationship between S100+ and PGP 9.5+ peripheral NF was the same in both groups (p = 0.70). This study demonstrated that there were no alterations in the density and integrity of peripheral NF in the tongue of symptomatic BMS patients. However, the sensitization of peripheral NF in this disease may not depend on mast cell density

Photobiomodulation Therapy in the Proliferation and Differentiation of Human Umbilical Cord Mesenchymal Stem Cells: An In Vitro Study

Introduction: Since photobiomodulation therapy (PBMT) favors in vitro mesenchymal stem cell (MSC) preconditioning before MSC transplantation, increasing the proliferation of these cells without molecular injuries by conserving their characteristics, in the present in vitro study we analyzed the effect of PBMT on the proliferation and osteogenic differentiation of human umbilical cord mesenchymal stem cells (hUCMSCs).Methods: Irradiation with an InGaAIP Laser (660 nm, 10 mW, 2.5 J/cm2, 0.08 cm2 spot size, and 10 s) was carried out. The cells were divided into four groups: CONTROL [cells grown in Dulbecco’s Modified Eagle Medium (DMEM)], OSTEO (cells grown in an osteogenic medium); PBMT (cells grown in DMEM+PBMT), and OSTEO+PBMT (cells grown in an osteogenic medium-plus PBMT). The cell proliferation curve was obtained over periods of 24, 48 and 72 hours using the 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay. Osteogenic differentiation was analyzed by the formation of calcium nodules over periods of 7, 14 and 21 days. Morphometric analysis was performed to quantify the total area of nodular calcification.Results: The highest cell proliferation and cell differentiation occurred in the OSTEO+PBMT group, followed by the PBMT, OSTEO, and CONTROL groups respectively, at the observed times (P < 0.05).Conclusion: PBMT enhanced the osteogenic proliferation and the differentiation of hUCMSCs during the periods tested, without causing damage to the cells and preserving their specific characteristics, a fact that may represent an innovative pretreatment in the application of stem cells

Calcifying odontogenic cyst: a multicenter study

Submitted by Rafael Paula ([email protected]) on 2019-10-11T18:07:40Z No. of bitstreams: 1 Dissertação José Alcides .pdf: 6345209 bytes, checksum: 26e7d3daed18a95af5871c88f89f5546 (MD5)Approved for entry into archive by Eliane Andrade ([email protected]) on 2019-10-14T14:54:33Z (GMT) No. of bitstreams: 1 Dissertação José Alcides .pdf: 6345209 bytes, checksum: 26e7d3daed18a95af5871c88f89f5546 (MD5)Made available in DSpace on 2019-12-11T19:24:37Z (GMT). No. of bitstreams: 1 Dissertação José Alcides .pdf: 6345209 bytes, checksum: 26e7d3daed18a95af5871c88f89f5546 (MD5) Previous issue date: 2019-07-03CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível SuperiorEste estudo investigou a frequência do cisto odontogênico calcificante (COC) submetido à análise histopatológica em diferentes regiões geográficas do Brasil. Em uma análise retrospectiva (1953-2016), arquivos de biópsias de 10 centros de Patologia Oral e Maxilofacial localizados em diferentes estados do Brasil: Goiás, Minas Gerais, Pará, Rio de Janeiro, Rio Grande do Norte, Rio Grande do Sul, Santa Catarina e São Paulo foram analisados. Dados demográficos, características clinicopatológicas, aspectos radiográficos e tipos de biópsia foram avaliados descritivamente. O teste Mann-Whitney foi utilizado para determinar a associação entre sintomas, tempo de evolução e tamanho da lesão. A significância estatística foi estabelecida como p<0,05. O diagnóstico do COC foi de acordo com a classificação da Organização Mundial de Saúde (2017). Adicionalmente, uma revisão da literatura de série de casos de COC foi realizada em quatro bases de dados eletrônicas (PubMed, Medline Ovid, Web of Science e Scopus). Dos 198.350 espécimes de biopsias exploradas, 268 casos de COC foram avaliados, representando 0,1% das lesões orais dos centros estudados. Em geral, indivíduos do sexo feminino (n=142, 54.0%), na segunda década de vida (n=76, 31.0%) com acometimento da maxila (n=141, 54.4%) foram os mais afetados. O tamanho médio das lesões dos indivíduos sintomáticos foi maior que o dos casos assintomáticos (p=0,026). A revisão da literatura apresentou maior frequência dos casos de COC na Ásia (186 casos) e na Europa (68 casos), acometendo principalmente os homens (n=247, 56.2%) na terceira década de vida. O COC é uma lesão rara. Novos dados sobre as características clinicopatológicas de 268 casos foram adicionados à literatura. Os dados referentes ao gênero e idade dos pacientes brasileiros aqui relatados são diferentes dos achados de séries de casos relatados já na literatura. Este estudo fornece informações que podem ajudar os clínicos, patologistas e cirurgiões no diagnóstico e manejo do COC.This study investigated the frequency of calcifying odontogenic cyst (COC) submitted to histopathological analysis in different geographic regions of Brazil. In a retrospective analysis (1953-2016), biopsy files of 10 Oral and Maxillofacial Pathology centers located in different states of Brazil: Goiás, Minas Gerais, Pará, Rio de Janeiro, Rio Grande do Norte, Rio Grande do Sul, Santa Catarina and São Paulo were analyzed. Demographic data, clinicopathological characteristics, radiographic aspects and treatment were evaluated descriptively. The Mann-Whitney test was used to determine the association between symptoms, evolution time and lesion size. Statistical significance was set as p<0.05. The diagnosis of COC was according to the classification of the World Health Organization (2017). In addition, a literature review of case series was carried out in four electronic databases (PubMed, Medline Ovid, Web of Science and Scopus). Of 198,350 specimens of biopsies analyzed, 268 cases of COC were surveyed, representing 0.1% of the oral lesions at the centers studied. Overall, female patients (n=142, 54.0%) in their second decade of life (n=76, 31.0%) and the maxilla (n=141, 54.4%) were more affected. The mean lesion size of symptomatic individuals was larger than that of cases without symptoms (p=0.026). The literature review showed a higher frequency in Asia (186 cases) and Europe (68 cases), mainly affecting men (n=247, 56.2%) in the third decade of life. COC is a rare lesion. Additional data on the clinicopathological features of 268 cases have been added to the literature. Data regarding gender and age of the Brazilian patients reported herein are different with findings of case series and retrospective studies reported in the literature. This study provides information that could help clinicians, pathologists, and surgeons in the diagnosis and management of COC

Persistent Necrotizing Mediastinitis after Dental Extraction

Mediastinitis is a rare, progressive, and destructive infectious process due to cervical or odontogenic infections, which, if not diagnosed early, may lead to several complications, including airway involvement and even an imminent risk of death. Herein, we report an unusual case of a 37-year-old male with a bilateral submandibular hard swelling after the left third molar extraction. After surgical intervention with submandibular drainage and antibiotic therapy, the infection persisted without explanation, since the patient was not hypertensive, did not have diabetes mellitus or sexually transmitted infections such as HIV or syphilis, and did not smoke or drink alcoholic beverages. A thoracic surgeon then intervened, treating the mediastinitis surgically by drainage, thus obtaining a significant improvement of the patient’s health. Mediastinitis is a serious condition. Clinicians and maxillofacial surgeons should be alert to make an immediate diagnosis and select the appropriate treatment in order to prevent worsening of the patient’s clinical condition

Oral conditions of children with microcephaly associated with congenital Zika syndrome: a cross-sectional study

Abstract The aim of the present study was to compare the oral conditions of children with congenital Zika syndrome (CZS)-associated microcephaly, non-CZS-associated microcephaly, and normotypical children, as well as to characterize their sociodemographic aspects and medical history. A paired cross-sectional study was carried out on 14 children with CZS-associated microcephaly and 24 age-matched controls, in Belo Horizonte, in southeastern Brazil. Children’s oral conditions were assessed: dental caries experience (dmft/DMFT indices); developmental defects of enamel (DDE) index; dental anomalies; mucosal changes; lip sealing, and malocclusion (overjet, overbite, and/or posterior crossbite alterations). The quality of oral hygiene was analyzed by the simplified oral hygiene index. The children’s mothers also answered a questionnaire about sociodemographic and medical history data. The variables were analyzed descriptively. Female participants were more prevalent (60.5%), and the mean age of the participants was 4.9 years (±1.4) (range: 2–8 years) and 92.1% of their exhibited some oral condition. All participants with CZS-associated microcephaly showed absence of lip sealing and had malocclusion (100.0%). When compared to the other groups, children with CZS had a higher percentage of dental anomalies (35.7%), mucosal changes (71.4%), and unsatisfactory oral hygiene (64.3%). In a sample composed mainly of female participants aged less than 5 years, the prevalence of oral conditions and unsatisfactory oral hygiene was higher in the group with CZS-associated microcephaly, followed by the group with non-CZS-associated microcephaly. Normotypical children had the highest percentage of dental caries experience

Effects of tobacco on the DNA of smokers and non-smokers affected by OSCC: systematic review and meta-analysis

Abstract Scientific evidence about genetic and molecular changes in oral squamous cell carcinoma (OSCC) among smokers and non-smokers is inconclusive. This systematic review and meta-analysis assessed the effects of tobacco on the DNA of individuals with OSCC based on protein mutations. Electronic searches were conducted on PubMed, Ovid, Web of Science, and Scopus to identify observational studies published up to January/2022. The Joanna Briggs Institute tool was used for the critical appraisal of studies. The certainty of the evidence was evaluated. Twenty-three studies assessing 4,060 individuals (2,967 smokers vs. 1,093 non-smokers) were included in this review. Fifteen groups of proteins/genes were investigated. Analysis of the quality of articles revealed low risk of bias in most studies. The certainty of the evidence was very low. The meta-analysis confirmed no significant difference between smokers and non-smokers with respect to damage to GSTM1 (OR: 0.60; 95%CI: 0.30–1.18), GSTT1 (OR: 1.18; 95%CI:0.49–2.83), hydrolase proteins (Ku70 and Ku80) (OR: 0.74; 95%CI: 0.18–3.05), and transferase proteins (GSTM1, GSTT1, GSTM3) (OR: 0.74; 95%CI: 0.47–1.18). Most of the studies included showed that smokers are more likely to exhibit genetic instability. However, the meta-analysis revealed that smokers do not necessarily have more genetic alterations in the DNA than non-smokers

Immunohistochemical expression of TGF-β1 and MMP-9 in periapical lesions

Abstract The objective of this study was to evaluate the expression of matrix metalloproteinase 9 (MMP-9) and transforming growth factor beta (TGF-β1) in periapical lesion samples correlated with the intensity of the inflammatory infiltrate and thickness of the epithelial lining. Forty-five cases of periapical lesions (23 periapical granulomas and 22 radicular cysts) were subjected to morphological and immunohistochemical analyses using anti-MMP-9 and anti-TGF-β1 antibodies. The data were analyzed using the following tests: non-parametric Mann-Whitney, chi-square, Fisher’s exact test and Spearman’s correlation test (P<0.05). Analysis of inflammatory infiltrate revealed that 78% of periapical granulomas presented infiltrate grade III, in contrast with 32% of radicular cysts (P<0.001). Morphological evaluation of the epithelial thickness in radicular cysts revealed the presence of atrophic epithelium in 86% of the cysts. The immunostaining of MMP-9 was score 2 in 67% of the granulomas and 77% of the cysts. Both lesions were predominantly score 1 for TGF-β1. Significant differences were confirmed between the expression scores of TGF-β1 and MMP-9 in periapical granulomas (p = 0.004) and in radicular cysts (p < 0.001). Expression of TGF-β1 was different for periapical granulomas and radicular cysts. This immunoregulatory cytokine seems more representative in asymptomatic lesions. The extracellular matrix remodeling process dependent on MMP-9 seems to be similar for both periapical granulomas and radicular cysts. TGF-β1 and MMP-9 may play an important role in the maintenance of periapical lesions

Fungal footprints in oral cancer: unveiling the oral mycobiome

Oral squamous cell carcinoma (OSCC) is the most common type of head and neck cancer, with a high mortality rate. There is growing evidence supporting a link between oral cancer and the microbiome. The microbiome can impact various aspects of cancer, such as pathogenesis, diagnosis, treatment, and prognosis. While there is existing information on bacteria and its connection to oral cancer, the fungi residing in the oral cavity represent a significant component of the microbiome that remains in its early stages of exploration and understanding. Fungi comprise a minuscule part of the human microbiome called the mycobiome. Mycobiome is ubiquitous in the human body but a weakened immune system offers a leeway space for fungi to showcase its virulence. The role of mycobiome as a colonizer, facilitator, or driver of carcinogenesis is still ambiguous. Reactivating the mycobiome that undergoes collateral damage associated with cancer treatment can be watershed event in cancer research. The coordinated, virulent, non-virulent behavior of the fungi once they reach a critical density must be hacked, considering its diagnostic, prognostic and therapeutic implications in cancer. This review highlights the diversity of the mycobiome and its potential role in oral cancer