RESUMEN
OBJECTIVE: This study aimed to evaluate the relationship between oral candidiasis with salivary features, neutrophil function, and glycemic control in type 2 diabetes (T2D). DESIGN: Twenty-nine individuals were included, 16 with T2D and 13 without the disease. The participants underwent clinical examination, neutrophilic function tests, fasting glycemia and glycated hemoglobin (A1c), stimulated and unstimulated saliva collection, and swab and exfoliative cytology. Salivary flow, pH, and total fungi count were evaluated on saliva, and identification of the Candida species was performed in saliva and swab samples. RESULTS: There was no difference in unstimulated salivary flow and pH of the stimulated and unstimulated saliva for participants with T2D and controls (P > .05). Individuals from both groups presented no candidal lesions. The salivary fungal growth in the T2D group was higher than that in controls (P < .05). Only individuals with T2D presented alterations in the neutrophilic functions (14/16; 87.5%; P < .05). There was no relationship between high A1c values and neutrophil dysfunction with the presence of Candida spp. in both saliva and mucosa (P > .05). CONCLUSIONS: High A1c level, reduction in neutrophil activity, salivary flow and pH, and increase in total salivary Candida spp. counts were not related to oral candidiasis in patients with T2D.
Asunto(s)
Candidiasis Bucal , Diabetes Mellitus Tipo 2 , Candida , Candidiasis Bucal/microbiología , Diabetes Mellitus Tipo 2/complicaciones , Hemoglobina Glucada , Humanos , SalivaRESUMEN
BACKGROUND: The authors undertook a prospective study to determine whether kidney transplant recipients had an increased risk of developing complications, such as local acute infection, alveolitis, increased bleeding, pain, and delayed healing, after tooth extraction. METHODS: The authors selected patients who underwent kidney transplants more than 6 months ago (study group) and patients who had not (control group) older than 18 years who needed to undergo extraction of erupted teeth. The same oral surgeon performed all tooth extractions while the patients were under local anesthesia. Another blind researcher examined the patients 3, 7, and 21 days after tooth extraction. The first end point was occurrence of complications (local acute infection, alveolitis, increased bleeding), and the second end point was socket reepithelialization on day 21. RESULTS: Forty-five tooth extractions were performed on 38 study group participants and 61 on 57 control group participants. There was no statistical difference between the groups regarding the incidence of any complication or delayed socket epithelialization. CONCLUSIONS: The results of this pilot study suggest that there is no difference in postoperative healing after tooth extractions between stable kidney transplant patients and control patients. PRACTICAL IMPLICATIONS: This is the first prospective study assessing the frequency of postoperative complications after tooth extraction in kidney transplant recipients. This clinical trial was registered at ClinicalTrials.gov. The registration number is NCT02547753.
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Trasplante de Riñón , Humanos , Trasplante de Riñón/efectos adversos , Proyectos Piloto , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Estudios Prospectivos , Extracción Dental/efectos adversos , Extracción Dental/métodosRESUMEN
PURPOSES: The main purpose of this study was to assess the measurements and shape of the sella turcica by using cone beam computed tomography (CBCT) and to associate the data to skeletal class II and class III patients, including correlations with gender, age and measurements of the anterior cranial base. MATERIAL AND METHODS: A trained examiner specialist in dental radiology selected and evaluated randomly 95 CBCT images of pre-orthognathic surgery patients, 60 (63.2%) being female and 35 (36.8%) male with age between 16 and 57 years. All images were evaluated to determine the size, shape and volume of the sella turcica. The anterior cranial base, represented by the S-N line (sella-nasion), was also measured. RESULTS: Of these 95 patients, 48 (50.5%) had class III facial skeletal pattern, whereas 47 (49.5%) had class II. No statistically significant differences were found between class II and class III patients in the measurements and shape of the sella turcica (P > 0.05). The diameter and volume of the sella turcica had higher values in female patients, whereas the measurements of the anterior cranial base were higher in males (P < 0.05). CONCLUSION: Therefore, one can conclude that measurements of the sella turcica are not reliable parameters to evaluate whether a class II or class III patient will or will not need orthognathic surgery.
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Toma de Decisiones Clínicas/métodos , Maloclusión de Angle Clase III/cirugía , Maloclusión Clase II de Angle/cirugía , Cirugía Ortognática/métodos , Silla Turca/anatomía & histología , Adolescente , Adulto , Factores de Edad , Cefalometría/métodos , Tomografía Computarizada de Haz Cónico , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cuidados Preoperatorios/métodos , Estudios Prospectivos , Reproducibilidad de los Resultados , Silla Turca/diagnóstico por imagen , Factores Sexuales , Base del Cráneo/anatomía & histología , Base del Cráneo/diagnóstico por imagen , Adulto JovenRESUMEN
PURPOSE: The main goal of the present study was to verify the presence, spatial location, the end of the canalis sinuosus (CS) trajectory and size of CS using cone beam computed tomography (CBCT) to characterise it as either a structure or an anatomical variation. METHODS: A trained examiner specialist in dental radiology and imagenology selected 200 CBCT images of the maxilla from 107 (53.5%) female and 93 (46.5%) male individuals aged between 18 and 85 years. RESULTS: A total of 133 (66.5%) patients had CS, being 61 (45.86%) unilateral and 72 (54.14%) bilateral. A higher frequency of CS was observed in males (P < 0.05) and no relationship was found between its presence and age. The end of the CS trajectory was more frequent in the regions of central incisor (n = 91; 44.39%), followed by lateral incisor (n = 45; 21.95%) and canine (n = 29; 14.15%). In our sample, the majority of these canals had a diameter of up to 1 mm (n = 198/205; 96.6%). No statistically significant relationship between diameter and the end of the CS trajectory, with location (i.e. bilateral or unilateral) was found. Gender and age had no influence on diameter, spatial location and the end of the CS trajectory (P > 0.05%). CONCLUSION: As CS was frequently found in our sample, it can be considered an anatomical structure, and as such, it is fundamental that the dentist requests a CBCT examination before performing any invasive procedure in the maxillary region to preserve this important structure.
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Tomografía Computarizada de Haz Cónico , Maxilar/anatomía & histología , Maxilar/diagnóstico por imagen , Seno Maxilar/anatomía & histología , Seno Maxilar/diagnóstico por imagen , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Variación Anatómica , Femenino , Humanos , Imagenología Tridimensional , Masculino , Maxilar/irrigación sanguínea , Maxilar/inervación , Seno Maxilar/irrigación sanguínea , Seno Maxilar/inervación , Persona de Mediana Edad , Adulto JovenRESUMEN
O tratamento do câncer de cabeça e pescoço depende da idade do paciente, presença de comorbidades, tamanho do tumor, localização, grau, estágio, presença de linfonodos afetados e de metástases, e inclui cirurgia, radioterapia e quimioterapia, combinadas ou separadamente. As complicações bucais da radioterapia em região de cabeça e pescoço são amplamente conhecidas, tais como, mucosite, xerostomia, disgeusia, trismo, cárie de radiação e osteorradionecrose. A prevenção ou redução da incidência e severidade dessas complicações são fundamentais para a manutenção da saúde bucal, tendo o dentista um papel primordial antes, durante e após a radioterapia. Dessa forma, este relato de caso visa discutir o atendi¬mento odontológico de uma paciente irradiada em região de cabeça e pescoço, salientando as principais complicações bucais, manejo odontológico e a importância da Odontologia na equipe multidisciplinar no tratamento do câncer bucal
The head and neck cancer treatment depend on age, comorbidities, tumor size, site, stage, grade, lymph nodes status and metastases, and include surgery, radiotherapy and chemotherapy, combined or separately. Oral complications of radiotherapy in the head and neck region are widely known, such as mucositis, xerostomia, dysgeusia, trismus, radiation caries and osteoradionecrosis. The prevention or reduction of incidence and severity of oral complications are essential in the maintenance of oral health, and the dentist having a primary role before, during and after radiotherapy. Thus, this case report aims to discuss the dental care of a patient irradiated in the head and neck region, highlighting the main oral complications, dental management and the importance of Dentistry in the multidisciplinary team in the treatment of oral cancer
RESUMEN
Leukemic infiltration of the gingival tissue associated or not with gingival enlargement may be the first manifestation of acute leukemia, despite being rarely reported in the literature. A 10-year-old female patient presented with a 1-month history of an asymptomatic, firm, and pinkish-red generalized gingival overgrowth. There was no bone resorption. Incisional biopsy of the gingival tissue was performed, with histopathological examination revealing a diffuse and hypercellular infiltration of monocytoid cells. The patient was referred to a hematologist and underwent a bone marrow biopsy, which led to a conclusive diagnosis of acute myeloid leukemia. The patient was treated with chemotherapy and we observed regression of gingival enlargement after 4 weeks from the initial therapy.
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Sobrecrecimiento Gingival/patología , Leucemia Mieloide Aguda/diagnóstico , Infiltración Leucémica/patología , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Biopsia , Niño , Femenino , Sobrecrecimiento Gingival/diagnóstico por imagen , Sobrecrecimiento Gingival/tratamiento farmacológico , Humanos , Leucemia Mieloide Aguda/diagnóstico por imagen , Leucemia Mieloide Aguda/tratamiento farmacológico , Infiltración Leucémica/diagnóstico por imagen , Infiltración Leucémica/tratamiento farmacológico , Radiografía PanorámicaRESUMEN
Objetivo: Determinar o pH crítico para ocorrer a corrosão de arcos NiTi em soluções de flúor a 1,1%, variando o pH de 3,5 a 7,0. Materiais e Métodos: Doze amostras com 10mm de comprimento de fio superelástico NiTi 0017 x 0025 (Abzil), obtidas do segmento distal dos arcos. As amostras foram aleatoriamente separadas e imersas dentro de recipientes contendo 40ml de seis soluções (água, soluções fluoretadas com pH: 3,5; 4,0; 4,5; 5,0; 5,5; 6,0; 6,5 e 7,0), sob uma mesa agitadora durante 90 minutos. Todas as amostras foram, então, levadas ao MEV. As imagens das amostras imersas em água e soluções fluoretadas com pH 7,0, 6,5 e 6,0 não se apresentaram diferentes, no entanto a partir da solução fluoretada com pH 5,5, as imagens superficiais apresentaram características diferentes dos grupos anteriores. Conclusão: Com base nos resultados obtidos neste estudo, o pH crítico para corrosão de arcos NiTi em soluções de flúor a 1,1% parece estar entre 6,0 e 5,5
Objective: To determine the critical pH to occur corrosion of NiTi arches in 1.1% fluoride solutions by varying the pH between 3.5 and 7.0. Materials and Methods: Twelve samples of 10 mm length superelastic NiTi wire 0017 x 0025 (Abzil) obtained in the distal segment of the arcs. The samples were randomly separated and immersed in 40 ml of six solutions (water, fluoride solutions with pH: 3.5; 4.0; 4.5; 5.0; 5.5; 6.0; 6.5 and 7.0) under a shaker table for 90 minutes. All samples were observed under SEM. The images of the samples immersed in water and fluoride solutions at pH 7.0, 6.5 and 6.0 did not show differences, however from the fluoride solution at pH 5.5, the surface characteristics of images presented differences from above groups. Conclusion: Based on the results obtained in this study the critical pH for corrosion of NiTi arches in fluoride solutions to 1.1% appears to be between 6.0 and 5.5
Asunto(s)
Corrosión , Flúor , SolucionesRESUMEN
Oral manifestations of common variable immunodeficiency (CVID) are rare, have rarely been studied and have given controversial results. There are few data about IgA, IgG, and IgM antibody salivary levels in the literature, and there are few papers about the clinical impact of antibody deficiencies and CVID on the oral health of such patients. The aim of this study was to measure serum and salivary IgA, IgG, and IgM levels in CVID participants and controls, and to associate immunoglobulin levels with caries and periodontal disease. This was a case-control study involving 51 CVID individuals and 50 healthy controls. All participants underwent examination for dental caries and periodontal disease. Blood and whole saliva samples were collected on the same day of the oral examination. Serum IgA, IgM, and IgG levels were measured by turbidimetry and salivary IgA, IgM, and IgG titers were assessed by enzyme-linked immunosorbent assay. Incidences of caries and gingivitis were significantly higher in the CVID group than in the control group (p<0.05). Salivary and blood IgA and IgM titers were significantly reduced in the CVID group, but there was no association of salivary immunoglobulin levels with periodontal disease or with caries incidence (p>0.05 for both). Although CVID was associated with increased susceptibility to caries and gingivitis, it was not associated with low salivary levels of IgA and IgM.
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Inmunodeficiencia Variable Común/metabolismo , Inmunoglobulinas/metabolismo , Saliva/metabolismo , Adolescente , Adulto , Anciano , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
Abstract Oral manifestations of common variable immunodeficiency (CVID) are rare, have rarely been studied and have given controversial results. There are few data about IgA, IgG, and IgM antibody salivary levels in the literature, and there are few papers about the clinical impact of antibody deficiencies and CVID on the oral health of such patients. The aim of this study was to measure serum and salivary IgA, IgG, and IgM levels in CVID participants and controls, and to associate immunoglobulin levels with caries and periodontal disease. This was a case-control study involving 51 CVID individuals and 50 healthy controls. All participants underwent examination for dental caries and periodontal disease. Blood and whole saliva samples were collected on the same day of the oral examination. Serum IgA, IgM, and IgG levels were measured by turbidimetry and salivary IgA, IgM, and IgG titers were assessed by enzyme-linked immunosorbent assay. Incidences of caries and gingivitis were significantly higher in the CVID group than in the control group (p<0.05). Salivary and blood IgA and IgM titers were significantly reduced in the CVID group, but there was no association of salivary immunoglobulin levels with periodontal disease or with caries incidence (p>0.05 for both). Although CVID was associated with increased susceptibility to caries and gingivitis, it was not associated with low salivary levels of IgA and IgM.
Resumo As manifestações orais em pacientes com imunodeficiência comum variável (ICV) têm sido pouco estudadas e com resultados variados. Há escassos dados na literatura sobre os níveis de IgA, IgG e IgM na saliva, e pouco se sabe sobre o impacto clínico da deficiência destes anticorpos sobre a saúde bucal de pacientes com ICV. O objetivo deste estudo foi medir os níveis séricos e salivares de IgA, IgG e IgM em indivíduos com ICV e controles, e associar os níveis de imunoglobulinas com cárie e doença periodontal. Este foi um estudo de caso-controle, envolvendo 51 indivíduos ICV e 50 controles saudáveis. Todos os participantes foram examinados para cárie e doença periodontal. As amostras de sangue e saliva foram coletadas no mesmo dia do exame intraoral. Os níveis de IgA, IgM e IgG foram medidos por turbidimetria, e os títulos salivares de IgA, IgM e IgG foram avaliados através método imunoenzimático (ELISA). As incidências de cáries e gengivite foram significativamente maiores no grupo ICV do que no grupo controle (p<0,05). Os níveis de IgA e IgM salivares e no sangue foram significativamente reduzidos no grupo ICV, porém não houve associação dos níveis de imunoglobulina salivar com doença periodontal ou com a incidência de cárie (p>0,05 para ambos). Embora ICV foi associado com um aumento da susceptibilidade à cárie e gengivite, não estava associado com baixos níveis salivares de IgA e IgM.
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Adulto Joven , Inmunodeficiencia Variable Común/metabolismo , Inmunoglobulinas/metabolismo , Saliva/metabolismo , Estudios de Casos y ControlesRESUMEN
Kostmann syndrome (KS) is an autosomal recessive disorder characterized by a low neutrophil count and recurrent bacterial infections, including periodontal disease. This report describes the case of a 5-year-old female KS patient treated with regular infusions of granulocyte stimulating factor (granulokine), with primary complaint of gingival bleeding and tooth mobility, and followed up for 10 years. Conventional periodontal treatment and some extractions were performed, after neutrophil function tests using flow cytometry. The invasive procedures were carried out at an outpatient clinic under antibiotic prophylaxis due to a low neutrophil count and an impaired neutrophil function presented. During the 10-year follow-up period, despite episodes of recurrent gingivitis and periodontitis the present report describes the positive outcome of dental treatment of a patient with KS.
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Atención Dental para Niños , Atención Dental para Enfermos Crónicos , Enfermedades de la Boca/etiología , Enfermedades de la Boca/terapia , Neutropenia/congénito , Preescolar , Síndromes Congénitos de Insuficiencia de la Médula Ósea , Femenino , Humanos , Neutropenia/complicacionesRESUMEN
BACKGROUND: The purpose of this study was to assess the association between metabolic control and immune dysfunction, and postoperative complications and wound healing after dental extractions in people with type 2 diabetes and control participants. METHODS: The authors performed a prospective, case-control study enrolling 53 participants with type 2 diabetes and 29 participants who did not have type 2 diabetes. Exclusion criteria included being a smoker and having teeth with periodontal pockets deeper than 4 millimeters, among others. All participants underwent an extraction of 1 erupted tooth. The investigators assessed patients' signs and symptoms at 3, 7, 21, and 60 days after surgery. The investigators measured glycemic control and immunologic profile at the time of the extraction. They compared the pattern of healing and the incidence of postextraction complications between the 2 groups. RESULTS: Even in the presence of impaired neutrophil function and poor glycemic control, we found no increase in the number of postoperative complications. There was no association between delayed wound epithelialization on postoperative day 21 and level of glycemic control, and reduced neutrophil function. On postoperative day 60, all alveolar sockets were epithelialized completely and showed no signs of infection. CONCLUSIONS: The study results suggest that type 2 diabetes per se or glycemic control is not a risk factor for experiencing postoperative complications in people undergoing dental extractions. Although people with type 2 diabetes may have impaired neutrophil function, the study results revealed that having this condition was not associated with an increased risk of experiencing postoperative complications. Additional research studies with larger sample sizes of patients who have diabetes are needed to confirm this study's findings. PRACTICAL IMPLICATIONS: The results allow clinicians to infer that people with type 2 diabetes undergoing dental extractions of erupted teeth that do not have an acute odontogenic infection should not receive antibiotic prophylaxis simply because of their diabetic status or level of glycemic control.
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Diabetes Mellitus Tipo 2/complicaciones , Extracción Dental/efectos adversos , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Diabetes Mellitus Tipo 2/inmunología , Diabetes Mellitus Tipo 2/terapia , Femenino , Hemoglobina Glucada/análisis , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Estudios ProspectivosRESUMEN
Wilson's disease (WD) is an autosomal recessive genetic disease, characterized by the accumulation of copper in the body--primarily in the brain and liver--due to defective biliary copper excretion by hepatocytes. WD may manifest clinically as liver disease, neurologic symptoms, and Kayser-Fleischer corneal rings. This article presents a case involving a 43-year-old man who had WD prior to liver transplantation. Oral examination revealed petechiae in the oral mucosa, poor oral hygiene, periodontal disease, missing teeth, and several carious teeth. Patients with WD may present systemic changes that affect dental care. Dental treatment prior to liver transplantation is recommended to eliminate the oral foci of infection and control oral disease.
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Atención Odontológica/métodos , Degeneración Hepatolenticular/complicaciones , Adulto , Caries Dental/complicaciones , Caries Dental/diagnóstico por imagen , Caries Dental/terapia , Restauración Dental Permanente/métodos , Raspado Dental/métodos , Humanos , Trasplante de Hígado , Masculino , Enfermedades Periodontales/complicaciones , Enfermedades Periodontales/diagnóstico por imagen , Enfermedades Periodontales/terapia , Radiografía PanorámicaRESUMEN
A condição de imunossupressão de pacientes transplantadoscardíacos possibilita o surgimento de manifestações bucaisimportantes que representam risco para o sucesso dotransplante cardíaco. A avaliação e o acompanhamentoodontológico desses pacientes são fundamentais na prevençãodessas manifestações bucais e infecções sistêmicas. Por meiodo relato dos casos clínicos de três pacientes transplantadoscardíacos, apresentamos e discutimos as condições clínicas eas opções terapêuticas das manifestações bucais mais comunsneste grupo de pacientes...
The condition of immunosuppression in heart transplant patientsenables emergence of oral manifestations that represent significantrisk to the success of heart transplantation. The oral and dentalevaluation and the follow up of these patients are critical in preventingthese oral manifestations and systemic infections. Through thereports files of three patients who underwent cardiac transplantation,we present and discuss the clinical and therapeutic options of themost common oral manifestations in this group of patients...
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Humanos , Masculino , Femenino , Adulto , Anciano , Enfermedades Periodontales/complicaciones , Enfermedades Periodontales/rehabilitación , Hiperplasia Gingival/terapia , Trasplante de Corazón/efectos adversos , Azitromicina/administración & dosificación , Encía/patología , Infecciones Oportunistas/terapia , Odontología/clasificaciónRESUMEN
Canalicular adenoma (CA) is an uncommon benign salivary gland tumor that mostly occurs in the upper lip. Despite its benign nature, some patients may present multiple nodules and also microscopic growth that can be multifocal with foci of tumor within the adjacent gland. Microscopically, CA can be mistaken for a polymorphous low-grade adenocarcinoma (PLGA) or basal cell adenoma (BCA), and immunohistochemistry can be helpful in differentiating them. Two cases of canalicular adenoma showing tumor foci within the adjacent gland are described. Both cases occurred in the upper lip of white females aged 72 and 79 years. In addition to the histological multifocal aspect, one of the patients presented bi-lateral nodules. Histological examination of both lesions revealed interconnecting and branching canal-like structures composed by uniform columnar and sometimes cuboidal cells, partially encapsulated. Immunohistochemical analysis showed intense expression of cytokeratins (CK) 7, a weak reaction to CK14 and a negative reaction to vimentin. Upon the diagnosis of CA the lesions were excised. In conclusion, it is important to properly diagnose CA and differentiate its multifocal aspect from a malignant behavior.
O adenoma canalicular (AC) é uma rara neoplasia benigna de glândula salivar que ocorre com maior frequência em lábio superior. Apesar de sua natureza benigna, alguns pacientes podem apresentar múltiplos nódulos, além de apresentar microscopicamente um crescimento multifocal com focos de neoplasia na glândula adjacente. Microscopicamente, AC pode ser confundido com adenocarcinoma polimorfo de baixo grau ou adenoma de células basais, sendo a imunohistoquímica útil na diferenciação entre eles. Dois casos de AC com focos de neoplasia dentro da glândula são descritos. Ambos os casos ocorreram em lábio superior de dois indivíduos do sexo feminino com 72 e 79 anos de idade. Além do aspecto histológico multifocal, um dos pacientes apresentou nódulos bilaterais. A análise histológica dos dois casos revelou estruturas canaliculares interligadas, compostas por células colunares uniformes e cuboidais, parcialmente encapsuladas. A análise imunohistoquímica mostrou intensa marcação de citoqueratina (CK) 7, uma fraca expressão para CK14, e reação negativa para vmentina. Após o diagnóstico as lesões foram excisionadas. Conclusão: É importante o correto diagnóstico do AC e a diferenciação do aspecto multifocal de um comportamento maligno.
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Humanos , Femenino , Anciano , Adenoma/patología , Neoplasias de los Labios/patología , Adenoma/cirugía , Neoplasias de los Labios/cirugíaAsunto(s)
Condiloma Acuminado/virología , Seropositividad para VIH , Mucosa Bucal/virología , Adulto , Terapia Antirretroviral Altamente Activa , Biopsia , Condiloma Acuminado/diagnóstico , Diagnóstico Diferencial , Seropositividad para VIH/tratamiento farmacológico , Humanos , Inmunohistoquímica , Hibridación in Situ , MasculinoRESUMEN
Canalicular adenoma (CA) is an uncommon benign salivary gland tumor that mostly occurs in the upper lip. Despite its benign nature, some patients may present multiple nodules and also microscopic growth that can be multifocal with foci of tumor within the adjacent gland. Microscopically, CA can be mistaken for a polymorphous low-grade adenocarcinoma (PLGA) or basal cell adenoma (BCA), and immunohistochemistry can be helpful in differentiating them. Two cases of canalicular adenoma showing tumor foci within the adjacent gland are described. Both cases occurred in the upper lip of white females aged 72 and 79 years. In addition to the histological multifocal aspect, one of the patients presented bi-lateral nodules. Histological examination of both lesions revealed interconnecting and branching canal-like structures composed by uniform columnar and sometimes cuboidal cells, partially encapsulated. Immunohistochemical analysis showed intense expression of cytokeratins (CK) 7, a weak reaction to CK14 and a negative reaction to vimentin. Upon the diagnosis of CA the lesions were excised. In conclusion, it is important to properly diagnose CA and differentiate its multifocal aspect from a malignant behavior.
Asunto(s)
Adenoma/patología , Neoplasias de los Labios/patología , Adenoma/cirugía , Anciano , Femenino , Humanos , Neoplasias de los Labios/cirugíaRESUMEN
Nodular fasciitis is a lesion found in the subcutaneous fascia that micoscopically presents as a benign proliferation of fibroblasts and myofibroblasts, which may be mistaken for a sarcoma due to clinically rapid growth. Diagnosis is by histopathology and of the immunohistochemical profile. We describe a case of nodular fasciitis in the oral cavity that demonstrated partial spontaneous regression. The patient was a 32-year-old man with a buccal mucosal mass, which had grown rapidly for 45 days. On microscopic examination, the lesion displayed a well-delineated but not encapsulated proliferation of spindle cells, with a nodular growth pattern. Immunohistochemical analysis showed positivity of the spindle cells for the antibodies against smooth muscle actin and muscle-specific actin (HHF-35). Treatment of such lesions typically involves complete conservative excision, but the lesion may regress eventually in the absence of definitive treatment.
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Fascitis/patología , Enfermedades de la Boca/patología , Boca/patología , Remisión Espontánea , Adulto , Fascitis/metabolismo , Humanos , Masculino , Enfermedades de la Boca/metabolismoRESUMEN
A hiperglicemia, bem como o diabetes, é reconhecida como fator de risco para infecções pós-cirúrgicas, assim manter o controle glicêmico perioperatório tem sido padrão de cuidado em saúde. Entretanto há poucos estudos sobre o impacto do controle glicêmico no processo de reparação de cirurgias de extração dentária. Apesar da escassez de estudos e de evidências clínicas e científicas que investiguem o risco de infecções pós-exodônticas em pessoas com diabetes, existem livros, artigos e guias que recomendam aos dentistas o uso de antibióticos profiláticos nesses indivíduos, especialmente para aqueles descompensados. O objetivo deste estudo foi avaliar clinicamente a cicatrização pós-exodôntica, em relação à cronologia dos eventos reparacionais e em relação à ocorrência de complicações pós-operatórias, em indivíduos com diabetes tipo 2 comparados a um grupo controle. Além disso, procuramos relacionar os eventos pós-cirúrgicos com o controle metabólico e com o perfil imunológico dos pacientes. Este estudo prospectivo longitudinal caso controle incluiu 53 indivíduos com diabetes tipo 2 (grupo de estudo=GE) e 29 indivíduos sem diabetes (grupo controle=GC). Foi aplicado questionário sobre a história médica, realizados exames clínicos intraoral e extraoral e exames laboratoriais para conhecimento do controle glicêmico e do perfil imunológico do indivíduo, tais como, hemograma completo, hemoglobina glicada (A1C), glicemia de jejum, IgA, IgG, IgM, C3, C4, linfócitos T CD3+, CD4+, CD8+, quimiotaxia de neutrófilos, oxidação de neutrófilos, fagocitose de neutrófilos e monócitos. Todos os participantes foram submetidos a extrações padronizadas de dentes erupcionados...
Hyperglycemia and diabetes are recognized as a risk factor for postoperative infections. Thus, maintaining perioperative glucose control has become the standard of care. However, there are scarce data on the appropriate glucose control during minor dental surgery. Despite the paucity of studies investigating the risk of postsurgical oral infections in persons with diabetes, there are text books, papers and guidelines recommending to dentists the use of prophylactic antibiotics for patients with poorly controlled diabetes undergoing invasive oral procedures. The aim of this study was to clinically evaluate the post extraction healing regarding to the chronology and to the occurrence of postoperative complications in patients with type 2 diabetes compared to a control group. Additionally, we associated the postoperative events with metabolic control and the immunological profile of the participants. This prospective case-control study included 53 subjects with type 2 diabetes (SG) and 29 controls without diabetes (CG). A questionnaire on medical history was applied, intraoral and extraoral clinical examinations were conducted and laboratory tests for glycemic control and immunological profile of the individual, such as complete blood count, glycated hemoglobin (A1C), fasting glucose, IgA, IgG, IgM, C3, C4, lymphocytes T CD3+, CD4+, CD8+, neutrophil chemotaxis, oxidation of neutrophil phagocytosis by neutrophils and monocytes, were obtained at the time of the extraction. All participants underwent standardized extractions of erupted teeth and clinical assessments were performed 3, 7, 21 and 60 days after surgery...
Asunto(s)
Humanos , Masculino , Femenino , Extracción Dental/efectos adversos , Neutrófilos , Cicatrización de HeridasRESUMEN
OBJECTIVE: The overall objective of this study was to assess the oral manifestations and their association with immunologic status and health history, of individuals with hypogammaglobulinemia. STUDY DESIGN: A case-controlled study of 100 subjects with hypogammaglobulinemia and 93 control individuals was performed. All participants were examined for dental caries, periodontal disease, mucosal lesions/infections, and general oral health problems. Decayed, missing, filled teeth and community periodontal index were recorded. Complete blood count, serum immunoglobulins, and lymphocyte immunophenotyping were measured on the same day of the oral health assessment. RESULTS: Individuals with hypogammaglobulinemia showed higher prevalence of enamel hypoplasia and complaints of dry mouth, and lower prevalence of dental caries and periodontal disease. CONCLUSIONS: The systemic conditions associated with hypogammaglobulinemia were not associated with enhanced susceptibility to caries, gingivitis, or periodontitis; however, individuals with hypogammaglobulinemia were more likely to report more episodes of recurrent aphthous ulcers compared with control individuals.