Cementoblastoma affecting the maxilla of a pediatric patient: A case report

AbstractCementoblastoma is a benign odontogenic tumor, classified as a rare lesion, of slow growth, with expansion of the cortical bone; it is associated with the root of a tooth with pulp vitality, appearing more commonly in the posterior region of the mandible. In this paper, a rare case report of a surgically treated benign cementoblastoma affecting the maxilla of an 11-year- old patient is presented. Furthermore, the diagnostic methods, the clinical, imaging and histopathological features, and the treatment options are discussed. Finally, correlations are made with findings in the scientific literature

Spontaneous Regression of an Oral Manifestation of Plasmablastic Lymphoma: Literature Review and Commentary about the Phenomena

Plasmablastic Lymphoma (PBL) is a hematolymphoid malignant disease that has a predilection for the oral cavity and jaw. The aim of this paper is report a total resolution of oral manifestation of PBL without any oncological treatment; this process is extremely rare and we discuss the mechanism which can occur. We present a case of PBL in left maxilla and oral mucosa in a woman HIV-positive patient. After an incisional biopsy an unusual outcome of spontaneous regression of the disease occurred, we reported the diagnostic process, the management and the follow up of case. We revised the similar cases reported in the literature and we will discuss the hypotheses how the phenomenon can occur. Although the PBLs are aggressive lesions, with questionable prognosis, the spontaneous regression can occur and the patient should be monitored for the risk of metastases and possible recurrence of the disease

CHARACTERIZATION OF PHYSICAL AND CELLULAR PROPERTIES OF MEMBRANES OF L-PRF PRODUCED BY DIFFERENT CENTRIFUGES/ CENTRIFUGATION PROTOCOLS.

Leukocyte and platelet-rich fibrin (L-PRF), an essential source of cytokines and growth factors, has been widely used to regulate the healing process. The quality of the L-PRF obtained is dependent on technical factors and the centrifugation protocol used. Thus, the present study aimed to macro and microscopically evaluate the formation of the L-PRF membrane/clot in two centrifuge models and protocols recommended by manufacturers. Four blood samples from 8 healthy volunteers undergoing rehabilitation surgery with dental implants were used. In group 1 of the Montserrat centrifuge (model 80-2B 15mL) 400g of centrifugal force were used for 10 minutes, 27ºC, and 2700 rpm, while in group 2 of the Intra Spin-Intra-Lock centrifuge (IntraSpin™, Intra-Lock Iberia) 400g of centrifugal force were used for 12 minutes, 27ºC and 2700 rpm. After obtaining 32 L-PRF clots/membranes, the pieces were recorded, measured, and weighed, separating the L-PRF from the supernatant/clot of red blood cells, remaining in the tubes. The specimens were then histologically processed for Hematoxylin/Eosin (H/E) staining and each slide was divided into three called areas: proximal, center, and distal. The presence of leukocytes was analyzed semi-quantitatively in each area. The results revealed no significant macroscopic differences in L-PRF between the two groups. However, the central areas of the L-PRF membranes produced in group 2 showed higher intensity of leukocytes (p=0.012), as well as the presence of concomitant leukocytes in at least 2 of the evaluated areas (p=0.003). In the proximal area, no significant differences were observed between the two groups. The results allow us to postulate that technical protocol factors influence the presence and distribution of leukocytes between the L-PRF membranes, obtained in different centrifuges.Leukocyte and platelet-rich fibrin (L-PRF), an essential source of cytokines and growth factors, has been widely used to regulate the healing process. The quality of the L-PRF obtained is dependent on technical factors and the centrifugation protocol used. Thus, the present study aimed to macro and microscopically evaluate the formation of the L-PRF membrane/clot in two centrifuge models and protocols recommended by manufacturers. Four blood samples from 8 healthy volunteers undergoing rehabilitation surgery with dental implants were used. In group 1 of the Montserrat centrifuge (model 80-2B 15mL) 400g of centrifugal force were used for 10 minutes, 27ºC, and 2700 rpm, while in group 2 of the Intra Spin-Intra-Lock centrifuge (IntraSpin™, Intra-Lock Iberia) 400g of centrifugal force were used for 12 minutes, 27ºC and 2700 rpm. After obtaining 32 L-PRF clots/membranes, the pieces were recorded, measured, and weighed, separating the L-PRF from the supernatant/clot of red blood cells, remaining in the tubes. The specimens were then histologically processed for Hematoxylin/Eosin (H/E) staining and each slide was divided into three called areas: proximal, center, and distal. The presence of leukocytes was analyzed semi-quantitatively in each area. The results revealed no significant macroscopic differences in L-PRF between the two groups. However, the central areas of the L-PRF membranes produced in group 2 showed higher intensity of leukocytes (p=0.012), as well as the presence of concomitant leukocytes in at least 2 of the evaluated areas (p=0.003). In the proximal area, no significant differences were observed between the two groups. The results allow us to postulate that technical protocol factors influence the presence and distribution of leukocytes between the L-PRF membranes, obtained in different centrifuges

Análise do comportamento das células de linhagens de carcinoma espinocelular de boca em microambiente ácido

Ampliar nosso conhecimento sobre a biologia do carcinoma espinocelular bucal é fundamental para o desenvolvimento de novas estratégias terapêuticas e para melhorar a sobrevida dos pacientes acometidos por essa patologia. Para tanto, compreender as contribuições do microambiente tumoral à carcinogênese é muito importante. Um característica importante a ser avaliada do microambiente tumoral é a acidificação do meio extracelular. Considerando que o pH ácido tumoral está relacionado à maior agressividade da lesão, o objetivo deste projeto é estudar os efeitos de um microambiente ácido na biologia de células de carcinoma espinocelular bucal. Para tanto, foram realizadas duas revisões da literatura, nas quais foram avaliados os seguintes temas: influência da acidez extracelular na invasão e migração; e os mecanismos moleculares envolvidos na resistência ao tratamento quimioterápico, induzida pela acidez do microambiente tumoral. Tais revisões embasaram a construção do terceiro artigo desta tese, o qual se propôs a comparar o comportamento de células linhagens de carcinoma espinocelular bucal (SCC-4 e SCC-9) e queratinócitos (HaCat) cultivadas em meio de cultura de pH 6.8 com células mantidas em meio neutro pH 7.4. As células foram expostas de forma contínua ou intermitente ao pH 6.8 e a adaptação das células foi avaliada pelo ensaio clonogênico. Além disso, as células foram avaliadas quanto à sua capacidade migratória pelo ensaio de cicatrização de feridas e de time lapse. A expressão gênica relacionada à indiferenciação e pluripotência foi investigada por PCR em tempo real com os marcadores Bmi-1 e CD44, assim como pelo ensaio de orosferas. A resistência desses grupos de células ao tratamento anti-câncer foi avaliada pelo ensaio de viabilidade celular da sulforodamina B após o tratamento com Cisplatina. Para a análise estatística, inicialmente foi realizada a distribuição dos dados, seguido da comparação estatística dos grupos utilizando, para distribuição normal, os testes ANOVA e ANOVA de duas vias. Toda a análise foi realizada no programa GraphPad Prism 5.0 e o nível de significância considerado foi de p0,05). Concluímos que a acidez extracelular no carcinoma espinocelular bucal aumenta a capacidade de migração, induz o fenótipo de células tronco-tumorais e aumenta a resistência a quimioterápicos.To expand our knowledge about the biology of oral squamous cell carcinoma is crucial for the development of new therapeutic strategies and to improve the survival of the patients affected by this pathology. Therefore, understanding the contributions of the tumor microenvironment to carcinogenesis is very important. An important feature to be evaluated of the tumor microenvironment is the acidification of the extracellular medium. Considering that acidic pH is related to the greater aggressiveness of the tumor, the aim of this study is to analyze the effects of an acidic microenvironment on the biology of oral squamous cell carcinoma cells. We realized two reviews of the literature, in which the following themes were evaluated: the influence of extracellular acidity on the invasion and migration; and the molecular mechanisms involved in the resistance to chemotherapeutic treatment, induced by the acidity of the tumor microenvironment. These revisions helped to construct the third article of this thesis, which proposed to compare the behavior of squamous cell carcinoma lines (SCC-4 and SCC-9) and keratinocytes (HaCat), cultured under pH 6.8 was compared to cells maintained at pH 7.4. For the statistical analysis, the data distribution was initially performed, followed by the statistical comparison of the groups using, for normal distribution, ANOVA and ANOVA two-way tests. All analysis was performed in the GraphPad Prism 5.0 program and the level of significance considered was p 0,05). We conclude that extracellular acidity in oral squamous cell carcinoma increases the migration capacity, induces the cancer stem cell phenotype and increases resistance to chemotherapy

Analysis of agreement between the clinical and histopathological diagnosis of dental follicles

Os folículos pericoronários são tecidos que circundam as coroas de dentes não erupcionados. Sua estrutura tecidual é composta por tecido conjuntivo, remanescentes do epitélio odontogênico e restos do epitélio reduzido do órgão do esmalte, os quais podem sofrer estímulos e se transformar em cistos ou tumores odontogênicos. Alguns estudos têm se dedicado a entender o potencial de proliferação e as chances de transformação patológica desses remanescentes epiteliais. Porém, observa-se que, na literatura, não há consenso no que diz respeito a esses assuntos. Diante do exposto, o presente trabalho teve como objetivo avaliar o índice de concordância entre os diagnósticos clínicos e histopatológicos de folículos pericoronários. Para tal finalidade, foi realizado um levantamento de casos com diagnóstico clínico de folículo pericoronário do banco de arquivos do Laboratório de Patologia Bucal da Faculdade de Odontologia da Universidade do Rio Grande do Sul, referente aos anos de 2000 a 2008. Após a revisão das lâminas, os diagnósticos foram relacionados com idade, gênero, localização e presença de remanescentes epiteliais e inflamação difusa . A amostra de conveniência foi de 1302 casos. O índice de concordância entre o diagnóstico clínico e os diagnósticos revisados não teve significância estatística (pabak: 0.479). Os diagnósticos histopatológicos demonstraram 59.8% de folículos pericoronários, 30% de cistos dentígeros, 6,8% de cistos paradentais e 1,6% de pericoronarite. Observou-se que os folículos foram predominantes na segunda década de vida (58.8%), enquanto que as pessoas na terceira e na quarta década obtiveram esse diagnóstico diminuído e patologias aumentadas. Diante dos achados, concluímos que os folículos pericoronários apresentam chances significativas para desenvolvimento de patologias odontogênicas. Por isso, consideramos pertinente a adoção do exame anátomo-patológico de rotina dos folículos pericoronários na prática clínica odontológica.Pericoronal follicles are soft tissues located around the crowns of unerupted teeth. This physiological structure is composed mainly by connective tissue, reduced enamel epithelium and remnants of odontogenic epithelium. It can be assumed that structures have the potential to turn into cysts or odontogenic tumors. Even being controversial, some studies have been yielded to assess the relation between proliferative behavior of odontogenic epithelium and its capacity to develop pathologic lesions. The present study aimed to evaluate the level of agreement between clinical and histopathologic diagnosis of pericoronal follicles. For this purpose, 1302 cases with clinical diagnosis of dental follicle retrieved from the archives of the of the Laboratory of Oral Pathology, Faculty of Dentistry, University of Rio Grande do Sul (2000-2008). After revision, the association between the diagnoses and age, gender, location and presence of epithelial remnants and diffuse inflammation was assessed. It was observed a low level (Pabak test=0.479) of agreement between the clinical and the histopathologic diagnosis. The histopathological diagnoses were pericoronal follicles (59.8%), dentigerous cysts (30%), cysts paradentais (6.8%) and pericoronaritis (1.6%). Pericoronal follicles were more frequent at second decade (58.8 %), whereas those from patients at third and fourth decade had more diagnosis of pathologies. Given the findings, we conclude that the follicles pericoronal have considerable chances for develop odontogenic pathologies. Therefore, the histopathological examination of pericoronal follicles should be adopted as routine in clinical practice

Análise do comportamento das células de linhagens de carcinoma espinocelular de boca em microambiente ácido

Ampliar nosso conhecimento sobre a biologia do carcinoma espinocelular bucal é fundamental para o desenvolvimento de novas estratégias terapêuticas e para melhorar a sobrevida dos pacientes acometidos por essa patologia. Para tanto, compreender as contribuições do microambiente tumoral à carcinogênese é muito importante. Um característica importante a ser avaliada do microambiente tumoral é a acidificação do meio extracelular. Considerando que o pH ácido tumoral está relacionado à maior agressividade da lesão, o objetivo deste projeto é estudar os efeitos de um microambiente ácido na biologia de células de carcinoma espinocelular bucal. Para tanto, foram realizadas duas revisões da literatura, nas quais foram avaliados os seguintes temas: influência da acidez extracelular na invasão e migração; e os mecanismos moleculares envolvidos na resistência ao tratamento quimioterápico, induzida pela acidez do microambiente tumoral. Tais revisões embasaram a construção do terceiro artigo desta tese, o qual se propôs a comparar o comportamento de células linhagens de carcinoma espinocelular bucal (SCC-4 e SCC-9) e queratinócitos (HaCat) cultivadas em meio de cultura de pH 6.8 com células mantidas em meio neutro pH 7.4. As células foram expostas de forma contínua ou intermitente ao pH 6.8 e a adaptação das células foi avaliada pelo ensaio clonogênico. Além disso, as células foram avaliadas quanto à sua capacidade migratória pelo ensaio de cicatrização de feridas e de time lapse. A expressão gênica relacionada à indiferenciação e pluripotência foi investigada por PCR em tempo real com os marcadores Bmi-1 e CD44, assim como pelo ensaio de orosferas. A resistência desses grupos de células ao tratamento anti-câncer foi avaliada pelo ensaio de viabilidade celular da sulforodamina B após o tratamento com Cisplatina. Para a análise estatística, inicialmente foi realizada a distribuição dos dados, seguido da comparação estatística dos grupos utilizando, para distribuição normal, os testes ANOVA e ANOVA de duas vias. Toda a análise foi realizada no programa GraphPad Prism 5.0 e o nível de significância considerado foi de p0,05). Concluímos que a acidez extracelular no carcinoma espinocelular bucal aumenta a capacidade de migração, induz o fenótipo de células tronco-tumorais e aumenta a resistência a quimioterápicos.To expand our knowledge about the biology of oral squamous cell carcinoma is crucial for the development of new therapeutic strategies and to improve the survival of the patients affected by this pathology. Therefore, understanding the contributions of the tumor microenvironment to carcinogenesis is very important. An important feature to be evaluated of the tumor microenvironment is the acidification of the extracellular medium. Considering that acidic pH is related to the greater aggressiveness of the tumor, the aim of this study is to analyze the effects of an acidic microenvironment on the biology of oral squamous cell carcinoma cells. We realized two reviews of the literature, in which the following themes were evaluated: the influence of extracellular acidity on the invasion and migration; and the molecular mechanisms involved in the resistance to chemotherapeutic treatment, induced by the acidity of the tumor microenvironment. These revisions helped to construct the third article of this thesis, which proposed to compare the behavior of squamous cell carcinoma lines (SCC-4 and SCC-9) and keratinocytes (HaCat), cultured under pH 6.8 was compared to cells maintained at pH 7.4. For the statistical analysis, the data distribution was initially performed, followed by the statistical comparison of the groups using, for normal distribution, ANOVA and ANOVA two-way tests. All analysis was performed in the GraphPad Prism 5.0 program and the level of significance considered was p 0,05). We conclude that extracellular acidity in oral squamous cell carcinoma increases the migration capacity, induces the cancer stem cell phenotype and increases resistance to chemotherapy

Analysis of agreement between the clinical and histopathological diagnosis of dental follicles

Os folículos pericoronários são tecidos que circundam as coroas de dentes não erupcionados. Sua estrutura tecidual é composta por tecido conjuntivo, remanescentes do epitélio odontogênico e restos do epitélio reduzido do órgão do esmalte, os quais podem sofrer estímulos e se transformar em cistos ou tumores odontogênicos. Alguns estudos têm se dedicado a entender o potencial de proliferação e as chances de transformação patológica desses remanescentes epiteliais. Porém, observa-se que, na literatura, não há consenso no que diz respeito a esses assuntos. Diante do exposto, o presente trabalho teve como objetivo avaliar o índice de concordância entre os diagnósticos clínicos e histopatológicos de folículos pericoronários. Para tal finalidade, foi realizado um levantamento de casos com diagnóstico clínico de folículo pericoronário do banco de arquivos do Laboratório de Patologia Bucal da Faculdade de Odontologia da Universidade do Rio Grande do Sul, referente aos anos de 2000 a 2008. Após a revisão das lâminas, os diagnósticos foram relacionados com idade, gênero, localização e presença de remanescentes epiteliais e inflamação difusa . A amostra de conveniência foi de 1302 casos. O índice de concordância entre o diagnóstico clínico e os diagnósticos revisados não teve significância estatística (pabak: 0.479). Os diagnósticos histopatológicos demonstraram 59.8% de folículos pericoronários, 30% de cistos dentígeros, 6,8% de cistos paradentais e 1,6% de pericoronarite. Observou-se que os folículos foram predominantes na segunda década de vida (58.8%), enquanto que as pessoas na terceira e na quarta década obtiveram esse diagnóstico diminuído e patologias aumentadas. Diante dos achados, concluímos que os folículos pericoronários apresentam chances significativas para desenvolvimento de patologias odontogênicas. Por isso, consideramos pertinente a adoção do exame anátomo-patológico de rotina dos folículos pericoronários na prática clínica odontológica.Pericoronal follicles are soft tissues located around the crowns of unerupted teeth. This physiological structure is composed mainly by connective tissue, reduced enamel epithelium and remnants of odontogenic epithelium. It can be assumed that structures have the potential to turn into cysts or odontogenic tumors. Even being controversial, some studies have been yielded to assess the relation between proliferative behavior of odontogenic epithelium and its capacity to develop pathologic lesions. The present study aimed to evaluate the level of agreement between clinical and histopathologic diagnosis of pericoronal follicles. For this purpose, 1302 cases with clinical diagnosis of dental follicle retrieved from the archives of the of the Laboratory of Oral Pathology, Faculty of Dentistry, University of Rio Grande do Sul (2000-2008). After revision, the association between the diagnoses and age, gender, location and presence of epithelial remnants and diffuse inflammation was assessed. It was observed a low level (Pabak test=0.479) of agreement between the clinical and the histopathologic diagnosis. The histopathological diagnoses were pericoronal follicles (59.8%), dentigerous cysts (30%), cysts paradentais (6.8%) and pericoronaritis (1.6%). Pericoronal follicles were more frequent at second decade (58.8 %), whereas those from patients at third and fourth decade had more diagnosis of pathologies. Given the findings, we conclude that the follicles pericoronal have considerable chances for develop odontogenic pathologies. Therefore, the histopathological examination of pericoronal follicles should be adopted as routine in clinical practice

Optimizing fixation protocols to improve molecular analysis from FFPE tissues

Most Departments of Pathology around the world have a considerable archive of formalinfixed paraffin-embedded (FFPE) tissue suitable for molecular assessment. This article points out the potential DNA damage that may occur if basic steps are not followed during processing and storage of these samples. Furthermore, it hopes to establish parameters to optimize quality and quantity of DNA extracted from FFPE tissues

EFEITO DOS DISCOS DE LIXA D'ÁGUA NO ACABAMENTO E POLIMENTO DE RESINA COMPOSTA EFFECT OF WATER SANDPAPER DISCS ON COMPOSITE RESIN FINISHING AND POLISHING

Objetivo: Avaliar a influência da técnica de acabamento e polimento na rugosidade superficial de dois compósitos. Materiais e Métodos: Foram confeccionados 40 corpos de prova cilíndricos de 8mmX2mm, distribuídos em 4 grupos, conforme o tipo de resina composta: Filtek Z250 (3MESPE) para os grupos G1 e G2 e P60 (3M ESPE) para G3 e G4. Os cilindros receberam acabamento inicial com lixa de óxido de alumínio (granulação 400) em politriz por 30s sob irrigação e foi realizada a leitura inicial da topografia de superfície (Ra, μm) com rugosímetro. Em seguida, cada grupo recebeu seu respectivo método de acabamento e polimento final: G1 e G3 (técnica com materiais comercialmente disponíveis), Discos Sof-Lex em sequência decrescente de abrasividade (3M ESPE) e G2 e G4, (técnica alternativa), lixas de óxido de alumínio granulação 2000 e 2500 (Norton®). Após, uma segunda leitura da rugosidade superficial foi realizada, e os dados obtidos foram analisados estatisticamente (ANOVA/Tukey; α=0,05).Resultados: Houve interação significativa entre os fatores grupo x tempo (p=0,04). Todos os métodos de acabamento e polimento resultaram em redução da rugosidade superficial. Apesar de previamente ao acabamento e polimento a resina composta P60 apresentar maior rugosidade superficial comparada à Z250; após a realização deste procedimento, suas topografias de superfície apresentam lisura semelhante. Conclusão: Concluiu-se que lixas de óxido de alumínio podem se apresentar como alternativa de baixo custo à materiais comercialmente disponíveis, sendo eficazes para obtenção de superfícies lisas. Purpose: To evaluate the influence of the finishing and polishing technique on the surface roughness of two composites. Methods: Forty cylindrical specimens of 8mmX2mm were made, distributed in 4 groups, according to the type of composite resin: Filtek Z250 (3MESPE) for groups G1 and G2 and P60 (3M ESPE) for G3 and G4. The cylinders were initially finished with aluminum oxide sandpaper (400 grit) in a polishing machine for 30s under irrigation and the initial surface topography (Ra, μm) was read with a rugosimeter. Then, each group received its respective method of finishing and final polishing: G1 and G3 (technique with commercially available materials), Sof-Lex discs in decreasing abrasion sequence (3M ESPE) and G2 and G4, (alternative technique), 2000 and 2500 granulation aluminum oxide sandpaper (Norton®). Afterwards, a second reading of the surface roughness was performed, and the obtained data were statistically analyzed (ANOVA / Tukey; α = 0.05). Results: There was a significant interaction between the factors group x time (p = 0.04). All finishing and polishing methods resulted in a reduction of surface roughness. Although prior to finishing and polishing, the composite resin P60 has a higher surface roughness compared to the Z250; after performing this procedure, their surface topographies show similar smoothness. Conclusion: It was concluded that aluminum oxide sandpaper can be presented as a low cost alternative to commercially available materials, being effective for obtaining smooth surfaces