Retrospective analysis of jaw biopsies in young adults. A study of 1599 cases in Southern Brazil

To evaluate the prevalence and the characteristics of jaw lesions diagnosed in young adults aged 20 to 30 years in a southern Brazil reference center, over a period of 25 years. And to analyze the concordance between clinical and histological diagnosis. In this cross-sectional retrospective study, the biopsies files from this center were retrieved and data regarding sex, age, bone localization, clinical and histological diagnosis were collected. The histological diagnosis were grouped into the categories Cystic lesions of odontogenic origin, Periapical inflammation, Odontogenic tumors, Bone diseases, Health tissue and Nonspecific diagnostic. Absolute and relative frequencies were estimated with descriptive analysis. The agreement between clinical and histological diagnosis was measured through Kappa statistic. A total of 18,181 histopathological analysis were performed during the period of the study, registering 1,599 jaw lesions in young adults. The average age of individuals was 24,59 years (SD 3,1). Nine hundred ninety-one (62%) lesions were found in females and 608 (38%) in males. More than half of pathologies were cystic lesions of odontogenic origin (822/51.4%), followed by periapical inflammation (282/17.6%). Regarding the site of lesions, more than half occurred in posterior mandible (877/54.8%), followed by posterior maxilla (339/21.2%). The most frequent entities were periapical cyst, chronic periapical granuloma, dental follicle and paradental cyst, corresponding to a total of 1,202 (75.2%) evaluated cases. In relation to the analysis of concordance between clinical and histological diagnosis the general Kappa index was 0.5, which is considered moderate. Finally, the findings confirm data from literature about the most frequent jaw pathologies in young adults and serve as aid for preventive measures of some entities. Additionally, they can improve the formulation of differential diagnosis and the patient management

Oral bilateral collagenous fibroma : a previously unreported case and literature review

Collagenous fibroma, also known as desmoplastic fibroblastoma, is a rare benign slow growing tumor particularly uncommon in the oral cavity. The aim of this study was to analyze the clinical and histopathological features of an oral collagenous fibroma as well as to compare this data with those reported in an English-literature review. The thirteenth case of collagenous fibroma in the oral cavity and the first to present clinically as a bilateral mass was described. A 48-years-old female patient was referred to a School of Dentistry, complaining about an asymptomatic swelling on the hard palate, lasting around ten years. The intraoral examination revealed two well-defined mass, bilaterally in the hard palate. An excisional biopsy was performed. Microscopically, the connective tissue consisted of dense collagen bundles in which were seen scarcely distributed spindle-shaped to stellate fibroblastic cells. Blood vessels were few, as well as inflammatory cells. Immunohistochemical staining was positive for vimentin, ?-smooth muscle actin and factor XIIIa and negative for S-100, CD68, CD34, HHF35, desmin and AE1/AE3. The patient remains disease-free 24 months after excision. In conclusion, oral collagenous fibroma should be included in the differential diagnosis of bilateral sessile nodules in the oral cavity

Demographic profile of oral nonodontogenic cysts in a Brazilian population

Objectives: The purpose of this study was to determine the clinical and demographic characteristics of oral non- odontogenic cysts (ONOC) in a Brazilian population over a 53-year period and to compare this data with the literature. Study D esign: A total of 20.391 biopsies records were evaluated, from April/1959 to August/2012. Cases of oral developmental cysts were selected. Data regarding age, gender, time of evolution, and anatomic site of all cases were collected. The data were analyzed by descriptive statistics. Results: Among 20.391 oral biopsies, 71 (0.35%) met the criteria of ONOC. Females accounted for 50.70% of all cases. The mean age observed was 38.14 years (range: 5-88 years). Nasopalatine duct cysts, oral lymphoepithelial cysts and epidermoid cysts were the most common ONOC, accounting for 63 cases (88.73%). Nasopalatine duct cysts occurred in 31 cases (43.66%), followed by 22 patients with oral lymphoepithelial cysts (30.99%) and 10 cases of epidermoid cysts (14.08%). Nasopalatine duct cysts revealed predominance among males (58.06). Oral lymphoepithelial cysts were more commonly observed in tongue (50%). Epidermoid cysts were most frequently found in the buccal mucosa (40.00%). Conclusions: The differential diagnosis of ONOC is based on the clinical, radiological, and histological findings. It is difficult to establish an epidemiological profile of ONOCs, considering the low frequency of these lesions and the divergences in the demographic and clinical presentation data among different populations

Clinicopathologic and immunohistochemical characterization of 14 cases of angioleiomyomas in oral cavity

Angioleiomyoma (ALM) is a benign neoplasm that originates from vascular smooth muscle. It is extremely rare in oral cavity. The objective of this study was to evaluate the clinicopathological and immunohistochemical characteristics of all oral angioleiomyomas registered in a Center of Diagnosis of Oral Diseases from 1959 to 2017. Slides from 14 cases of ALM stained with hematoxylin and eosin (H&E) were analyzed to confirm the diagnosis. Moreover, an immunohistochemical panel with alpha-smooth muscle actin (alpha-SMA), desmin, AE1/AE3, CD68, S-100, and CD34 antibodies was performed to evaluate semi-quantitatively the positive cells. ALM correspond to 0.08% of all benign oral tumors analyzed during the 57-year period. The mean age of the patients was 45 years with a predilection to males (58%). The most frequently reported site was lips (50%). Microscopic analysis on H&E sections revealed similar pattern in all cases, showing well-circumscribed and encapsulated tumors, characterized by a proliferation of smooth muscle cells and wide vascular spaces of varying sizes. The predominant immuno profiles were: alpha-smooth muscle actin (alpha-SMA) positive (strong immunoreactivity); positive variable pattern for desmin, negative immunoprofile for AE1/AE3, CD68, and S-100. The endothelial cells of vascular spaces were CD34+. Based on the results, the alpha-SM actin can be elected as a good marker for angioleiomyomas and can help the confirmation of the morphologic diagnosis of this lesion

Simple and aneurysmal bone cyst : aspects of jaw pseudocysts based on an experience of Brazilian pathology service during 53 years

Jaw pseudocysts are benign osseous lesions of unclear etiology. Among these, the simple bone cyst (SBC) and aneurysmal bone cyst (ABC) are intriguing bone pathologies still rarely studied together. This retrospective study aimed to present the long-term case series of patients with jaw pseudocysts focusing on the clinical, radiographic, and transoperative aspects. A retrospective case series of patients with SBC and ABC was performed. Clinical, radiographic, and transoperative aspects of both pseudocysts were reviewed from the histopathological archives of 20,469 cases between 1959-2012. All descriptive data were summarized. Of 354 (15.25%) bone pathologies, 54 cases of jaw pseudocysts were found, with 42 (11.86%) SBC and 12 (3.39%) ABC cases. For both lesions, most of the sample were young Caucasian women with an asymptomatic posterior mandible lesion with undetermined time of evolution and none trauma history. A unique radiolucent scalloped lesion presenting an empty cavity were also observed for both conditions. However, some atypical findings were found for SBC including: the expansion of bone cortical, tooth resorption, displacement of the mandibular canal, and recurrence. The absence of painful symptoms and the lack of classical blood-filled cavity were observed in some cases of ABC. The SBC and ABC are bone pathologies with few retrospective studies, no previous studies on the two conditions, varied nomenclature, and atypical aspects in some cases. Therefore, the knowledge of clinical, imaging, and transoperative features of such pseudocysts are clinically valuable as diagnosis hypothesis of radiolucent lesions of the jaws

Salivary characteristics may be associated with burning mouth syndrome?

Burning mouth syndrome (BMS) it is characterized by burning and uncomfortable sensations with no clinical alterations or laboratory findings. The evaluation of the salivary characteristics of people with BMS can help the understanding of the pathogenesi

Influência da qualidade da restauração sobre o sucesso da pulpotomia: estudo preliminar

The aim of this study was to evaluate the clinical status of pulpotomy treatment with calcium hydroxide and to correlate it with the quality of restoration of the treated teeth. Patients were retrieved from the files of the Operative Dentistry clinics (FOUFPel) between 1996 and 2000. Twenty-two patients were recalled, which had 23 teeth treated with pulpotomy due to exposure by caries. Seven anterior and 16 posterior teeth composed the evaluated group, being all restored with composite resin. The age varied from 15-50 years (mean 23.9) and the follow-up mean was 34.52 months. Clinical and radiographic examinations were performed to evaluate the clinical status of treatment. The criteria used, clinically favorable and failure, were based on the following clinical exams: pulp vitality; sensitivity; and periapical alterations. The quality of the restorations was based on the USPHS criteria. Pulpotomy treatment was ranked as clinically favorable in 10 teeth (43.5%), 4 in anterior and 6 in posterior teeth. Failure was verified in 13 teeth (56.5%), 4 anterior and 9 posterior. From the group clinically favorable, 90% of the restorations were ranked as clinically satisfactory, while only 10% were unsatisfactory. In the failure group, 77.8% of the restorations were classified was unsatisfactory and 22.2% were ranked as satisfactory. The statistical analysis (Fisher´s exact test) demonstrated that there is a statistically significant association between the clinical status of pulpotomy and restoration quality (p<0.05). Within the limitation of the study, it was verified that the quality of restoration could influence the favorable clinical status of pulpotomized teeth. Randomized clinical trials are required to confirm these preliminary data.O objetivo deste estudo foi avaliar a condição clínica de dentes submetidos à pulpotomia com hidróxido de cálcio, correlacionando com a qualidade das restaurações dos respectivos dentes. A partir dos prontuários da clínica de Odontologia Restauradora da FOUFPel, foram selecionados 22 pacientes (23 dentes) submetidos a pulpotomia entre 1996 e 2000. Ao todo, 23 dentes (7 anteriores e 16 posteriores) receberam o tratamento de pulpotomia, indicado devido à exposição por cáries, sendo que todas as restaurações foram confeccionadas com resina composta. A idade dos pacientes variou de 15-50 anos (média de 23,9 anos) e o tempo médio de acompanhamento das pulpotomias foi de 34,52 meses. Avaliações clínicas e radiográficas foram realizadas para a avaliação das pulpotomias. Ausência de hipersensibilidade, de alterações periapicais e teste de vitalidade pulpar positivo, eram as condições necessárias para que o tratamento fosse incluído no grupo "clinicamente favorável" utilizados para avaliar a condição clínica dos dentes tratados. Os critérios de avaliação clínica da USPHS foram utilizados para avaliar a qualidade das restaurações. Dez dentes (43,5%) receberam o escore clinicamente favorável, 4 anteriores e 6 dentes posteriores. O critério falha foi atribuído a 13 dentes (56,5%), 4 dentes anteriores e 9 posteriores. Entre os dentes do grupo clinicamente favorável, 90% das restaurações foram classificadas como clinicamente satisfatória, enquanto 10% estavam insatisfatórias. No grupo onde houve falha, 77,8% das restaurações foram classificadas como insatisfatória enquanto 22,2% foram classificadas como satisfatórias. A análise estatística (Teste exato de Fisher) demonstrou que existe uma associação estatisticamente significante entre a condição clínica da pulpotomia e a qualidade da restauração (p<0,05). Respeitando as limitações do estudo, é possível verificar que a qualidade da restauração pode ser um fator influente para uma condição clínica favorável de dentes tratados com pulpotomia. Estudos clínicos controlados são necessários para confirmar esses achados preliminares

Unilateral condylar hyperplasia: evaluation of 6 cases

This study aimed to report six cases of unilateral condylar hyperplasia (CH), regarding their demographic and clinical characteristics and imaging and histopathological findings. Sex, age, affected side, history of the case, complementary examinations and treatment were recorded. Five cases (83.3%) were females and the mean age of the study population was 19.3 years (range: 14-28 years). The right condyle was affected in 4 cases (66.6%). Five (83.3%) patients were subjected to condylotomy, and high condylectomy was done in 1 (16.6%) case. The patients were followed up postoperatively for a mean period of 27.5 months. All patients received surgical and orthodontic treatment. In the present study, CH occurred more frequently in the first decades of life and it was more prevalent in females. The right condyle was more affected than the left one and condylotomy combined with orthodontics was the main treatment performed

Unilateral condylar hyperplasia: evaluation of 6 cases

This study aimed to report six cases of unilateral condylar hyperplasia (CH), regarding their demographic and clinical characteristics and imaging and histopathological findings. Sex, age, affected side, history of the case, complementary examinations and treatment were recorded. Five cases (83.3%) were females and the mean age of the study population was 19.3 years (range: 14-28 years). The right condyle was affected in 4 cases (66.6%). Five (83.3%) patients were subjected to condylotomy, and high condylectomy was done in 1 (16.6%) case. The patients were followed up postoperatively for a mean period of 27.5 months. All patients received surgical and orthodontic treatment. In the present study, CH occurred more frequently in the first decades of life and it was more prevalent in females. The right condyle was more affected than the left one and condylotomy combined with orthodontics was the main treatment performed