RESUMEN
The osteolytic activity of odontogenic cysts and tumors is directly associated with their growth and aggressiveness. The influence of proteins expressed by epithelial and mesenchymal cells on this biological event differs between indolent cystic lesions, aggressive cystic lesions, and odontogenic tumors. The objective of this study was to compare the immunohistochemical expression of factors that stimulate (receptor activator of nuclear factor kappa-Β ligand - RANKL, cathepsin K - CatK and matrix metallopeptidase 8 - MMP-8) and inhibit (osteoprotegerin - OPG) osteoclastogenesis between dentigerous cyst (DC), glandular odontogenic cyst (GOC), odontogenic keratocyst (OKC), and ameloblastoma (AB). Paraffin-embedded sections of nine DCs, nine GOCs, 20 OKCs, 21 ABs, and four dental follicles (DFs) were subjected to immunohistochemistry. Immunoreactivity was analyzed semiquantitatively and quantitatively in epithelium and connective tissue, respectively. The proteins were immunoexpressed in epithelial and mesenchymal cells of all lesions studied. The expression of RANKL and CatK was higher in OKC, AB, and GOC (p<0.005). Higher expression of OPG was found in DF and DC compared to the other markers (p<0.005). MMP-8 expression was high in GOC and OKC. This study demonstrated the differential expression of factors that inhibit and stimulate bone resorption during the development of DC, GOC, OKC, and AB. Higher expression of RANKL and CatK was observed in more aggressive lesions. OPG appears to be one of the molecules responsible for the slower growth of DC.
Asunto(s)
Ameloblastoma , Quiste Dentígero , Quistes Odontogénicos , Tumores Odontogénicos , Humanos , Quiste Dentígero/metabolismo , Quiste Dentígero/patología , Metaloproteinasa 8 de la Matriz , Quistes Odontogénicos/patología , Ameloblastoma/metabolismo , Ameloblastoma/patología , Tumores Odontogénicos/patologíaRESUMEN
Abstract: The osteolytic activity of odontogenic cysts and tumors is directly associated with their growth and aggressiveness. The influence of proteins expressed by epithelial and mesenchymal cells on this biological event differs between indolent cystic lesions, aggressive cystic lesions, and odontogenic tumors. The objective of this study was to compare the immunohistochemical expression of factors that stimulate (receptor activator of nuclear factor kappa-Β ligand - RANKL, cathepsin K - CatK and matrix metallopeptidase 8 - MMP-8) and inhibit (osteoprotegerin - OPG) osteoclastogenesis between dentigerous cyst (DC), glandular odontogenic cyst (GOC), odontogenic keratocyst (OKC), and ameloblastoma (AB). Paraffin-embedded sections of nine DCs, nine GOCs, 20 OKCs, 21 ABs, and four dental follicles (DFs) were subjected to immunohistochemistry. Immunoreactivity was analyzed semiquantitatively and quantitatively in epithelium and connective tissue, respectively. The proteins were immunoexpressed in epithelial and mesenchymal cells of all lesions studied. The expression of RANKL and CatK was higher in OKC, AB, and GOC (p<0.005). Higher expression of OPG was found in DF and DC compared to the other markers (p<0.005). MMP-8 expression was high in GOC and OKC. This study demonstrated the differential expression of factors that inhibit and stimulate bone resorption during the development of DC, GOC, OKC, and AB. Higher expression of RANKL and CatK was observed in more aggressive lesions. OPG appears to be one of the molecules responsible for the slower growth of DC.
RESUMEN
OBJECTIVE: To identify the association between perception of body image and oral health in school bullying among adolescents of an urban locality in Brazil. METHODS: A self-questionnaire was applied on 381 students from public school between 12 and 15 years old. The variables studied were sex, age, schooling, school bullying events, and perception about their oral health and body image. The prevalence of bullying was 29.6%. The multivariate analysis showed that those who indicated that they were criticized due to the condition of their teeth had 4.37 more chance of victimization (oral 4371 CI 2325-8218). Those who felt that oral health had little effect on their relationship with other people had 2.2 times more chance to suffer from bullying (oral 2204 CI 1031-4708) than those who did not. Among adolescents who were not satisfied with their body image, 46.7% had more chance to be a victim of bullying (oral 2467 CI 1373-4431). CONCLUSION: A high prevalence of students affected by bullying was observed. It was possible to observe an association between bullying and dissatisfaction with oral health and body image. It is important to implement and evaluate public policies on oral health, expanding access to and improving these public services offered to the population.
Asunto(s)
Imagen Corporal , Acoso Escolar , Adolescente , Brasil , Niño , Humanos , Salud Bucal , Instituciones AcadémicasRESUMEN
BACKGROUND: Glypican-3 is a cell surface proteoglycan that is found in embrionary tissues, and there are no studies investigating this protein in odontogenic tumor. Thus, the aim of this study was to investigate glypican-3 in a series of aggressive and non-aggressive odontogenic tumors. METHODS: Fifty-nine cases of tumors were divided into aggressive odontogenic tumors (20 solid ameloblastomas, four unicystic ameloblastoma, 28 KOTs including five associated with Gorlin-Goltz syndrome) and non-aggressive odontogenic tumors (five adenomatoid odontogenic tumors and two calcifying cystic odontogenic tumors) and analyzed for glypican-3 using immunohistochemistry. RESULTS: Glypican-3 was observed in seven solid ameloblastoma and eighteen keratocystic odontogenic tumors including three of the five syndromic cases, but there was no significant difference between syndromic and sporadic cases (P > 0.05; Fisher's exact Test). All cases of unicystic ameloblastoma (n = 4), adenomatoid odontogenic tumor (n = 5), and calcifying cystic odontogenic tumor (n = 2) were negative. CONCLUSIONS: This provided insights into the presence of glypican-3 in odontogenic tumors. This protein distinguished aggressive from non-aggressive odontogenic tumors.
Asunto(s)
Glipicanos/metabolismo , Tumores Odontogénicos/patología , Ameloblastoma/metabolismo , Humanos , InmunohistoquímicaRESUMEN
BACKGROUND: The epithelial-mesenchymal transition (EMT) is the process where cells lose their epithelial features and acquire properties of typical mesenchymal cells. The dissociation of tumor cells due to changes in cell-cell adhesion is one of the key principles of tumor invasion and EMT. Thus, the knowledge of the molecular features of EMT in keratocyst odontogenic tumor (KOT) can provide useful markers to aid in the diagnosis and prognosis and perhaps contribute to an alternative therapeutic approach as it shows an aggressive clinical behavior and high recurrence rates. This study aimed to evaluate the EMT in KOT by the immunoexpression of E-cadherin, N-cadherin, Snail, and Slug and comparing to radicular cysts and dental follicles. METHODS: Thirty-two KOTs, 15 radicular cysts, and 08 dental follicles were used for immunohistochemistry, evaluating the extent, intensity, labeling pattern, cellular compartment in the epithelium and stroma, and the presence of inflammation. RESULTS: E-cadherin was preserved in most cases of keratocystic odontogenic tumor. N-cadherin was increased in the tumor epithelium, a result that was positively correlated with the heterogeneous and nuclear immunoexpression of Slug in the epithelium; Slug also correlated with high Snail immunoexpression. N-cadherin was positively correlated with Slug in the stroma of keratocystic odontogenic tumors. CONCLUSIONS: The high immunoexpression of Snail and nuclear Slug in keratocystic odontogenic tumors suggests these proteins as transcription factors without necessarily participating in 'cadherin switching'. However, the knowledge of their induction of the epithelial-mesenchymal transition in odontogenic tumors is still limited.
Asunto(s)
Cadherinas/biosíntesis , Epitelio/metabolismo , Quistes Odontogénicos/metabolismo , Tumores Odontogénicos/metabolismo , Adolescente , Adulto , Anciano , Animales , Antígenos CD/biosíntesis , Biomarcadores de Tumor/biosíntesis , Biomarcadores de Tumor/metabolismo , Cadherinas/metabolismo , Adhesión Celular/fisiología , Niño , Saco Dental/metabolismo , Saco Dental/patología , Transición Epitelial-Mesenquimal , Epitelio/patología , Femenino , Humanos , Persona de Mediana Edad , Quistes Odontogénicos/patología , Tumores Odontogénicos/patología , Pronóstico , Quiste Radicular/metabolismo , Quiste Radicular/patología , Factores de Transcripción de la Familia Snail/biosíntesis , Factores de Transcripción de la Familia Snail/metabolismo , Adulto JovenRESUMEN
BACKGROUND: The aim of this cross-sectional study was to evaluate the risk indicators of tooth loss in adult Kiriri Indians from Brazil. METHODS: A representative sample of 225 Indians (≥ 19 years of age) was assessed. Interviews using a structured written questionnaire were performed to collect data on demographics and socio-economic status, and health-related data. Probing depth, the distance between the cement-enamel junction and the free gingival margin, and decayed, missing or filled teeth were evaluated. Bivariate and logistic models were used to assess associations between tooth loss and age, sex, income, education, diabetic status, smoking habits, dental caries, severe periodontitis, plaque index and previous dental visit. RESULTS: Eighty per cent of subjects had lost one tooth or more, and 20% had lost eight teeth or more. Mean (± standard deviation) tooth loss was 5.09 (± 5.83) teeth. After adjustment for covariates, loss of one tooth or more was associated with older age [≥ 35 years; odds ratio (OR) = 4.06, 95% confidence interval (95% CI): 1.38-11.94, P = 0.01], severe periodontitis (OR = 3.35, 95% CI: 0.99-11.24, P = 0.05), higher dental caries (OR = 3.24, 95% CI: 1.35-7.78, P = 0.01) and previous dental visit (OR = 23.32, 95% CI: 5.75-94.63, P < 0.001). CONCLUSION: Tooth loss is highly prevalent in Kiriri Indians. Older age, severe periodontitis, higher caries index and previous dental visit were associated with tooth loss. Prevention and treatment programmes, targeting high-risk groups, are required to promote the oral health of the population.
Asunto(s)
Indígenas Sudamericanos/estadística & datos numéricos , Pérdida de Diente/epidemiología , Adulto , Factores de Edad , Anciano , Brasil/epidemiología , Brasil/etnología , Estudios Transversales , Índice CPO , Atención Odontológica/estadística & datos numéricos , Caries Dental/epidemiología , Índice de Placa Dental , Diabetes Mellitus/epidemiología , Escolaridad , Femenino , Encía/patología , Humanos , Renta/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Bolsa Periodontal/epidemiología , Periodontitis/epidemiología , Factores de Riesgo , Factores Sexuales , Fumar/epidemiología , Clase Social , Cuello del Diente/patología , Adulto JovenRESUMEN
The aim of this cross-sectional study was to evaluate the prevalence of oral mucosal lesions, and their risk indicators in adult Kiriri Indians from Northeast Brazil. Clinical oral examination was performed on a representative sample of 223 Indians (age ≥ 19 years). A systematic evaluation of lips, labial mucosa and sulcus, commissures, buccal mucosa and sulcus, gingiva and alveolar ridge, tongue, floor of the mouth, and soft and hard palate was performed. Bivariate analysis was conducted to assess associations between mucosal conditions and age, gender, income, educational level, diabetic status, and smoking status. Mucosal lesions were found in 50 participants (22.4%). The most prevalent lesions were fistulae (6.2%) and traumatic ulcers (4.48%). Oral mucosal was associated with higher age (≥ 35 years; odds ratio [OR]â= 1.99, 95% confidence interval [CI]: 1.05-3.76, P = 0.03) and lower education level (<9 years; OR = 2.13, 95% CI: 0.96-4.71, P = 0.06). Mucosal conditions are prevalent in Kiriri Indians and the presence of mucosal lesions is associated with advanced age and lower education. A public health program aimed at preventing and treating mucosal lesions and targeted toward the high-risk group is vital to improve the oral health status of this population.
Asunto(s)
Enfermedades de la Boca/epidemiología , Adulto , Anciano , Brasil/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mucosa Bucal/lesiones , Grupos de Población/estadística & datos numéricos , Prevalencia , Factores de Riesgo , Adulto JovenRESUMEN
BACKGROUND: Ameloblastomas and keratocystic odontogenic tumors (KOTs) are lesions that are characterized by locally invasive growth and cause extensive bone destruction. In addition, it is known that E-cadherin influences the adhesion of Langerhans cells (LCs) to keratinocytes. OBJECTIVE AND METHODS: The aim of this study was to investigate, using immunohistochemistry, the distribution of CD1a-positive cells in ameloblastomas and KOTs and their relationship with E-cadherin, in comparison to calcifying cystic odontogenic tumor (CCOT). RESULTS: The CD1a-positive LCs were observed in 11 ameloblastomas and KOTs. All of the cases of CCOT showed CD1a-positive LCs and a significant difference was found when this tumor was compared with ameloblastomas (P < 0.05, Mann-Whitney test). A statistically significant difference was also noted when comparing CD1a-positive LCs between CCOTs and KOTs (P < 0.05, Mann-Whitney test). Lower expression of E-cadherin in ameloblastomas (AMs) in relation to KOTs and CCOTs (P < 0.05, Fisher test) was observed. There was no correlation between E-cadherin and CD1a-positive LCs between all odontogenic tumors that were studied (P > 0.05, Spearman test). CONCLUSION: A quantitative difference of CD1a-positive cells between AMs and KOTs in comparison to CCOTs was observed. This permits to speculate that a depletion of CD1a-positive LCs might influence the local invasiveness of ameloblastomas and KOTs. Furthermore, it is suggested that E-cadherin mediates cell adhesion in these tumors.
Asunto(s)
Ameloblastoma/patología , Antígenos CD1/análisis , Cadherinas/análisis , Células de Langerhans/patología , Tumores Odontogénicos/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Adhesión Celular/fisiología , Recuento de Células , Forma de la Célula , Niño , Células Dendríticas/patología , Células Epiteliales/patología , Femenino , Humanos , Inmunohistoquímica , Queratinocitos/patología , Masculino , Neoplasias Mandibulares/patología , Neoplasias Maxilares/patología , Persona de Mediana Edad , Quiste Odontogénico Calcificado/patología , Adulto JovenRESUMEN
OBJECTIVE: The aim of this study was to investigate the presence of CD1a-positive Langerhans cells and their relationship with E-cadherin in minor salivary gland tumors. METHODS: Twenty-seven minor salivary gland tumors were investigated using immunohistochemistry for CD1a and E-cadherin. RESULTS: A significant difference regarding the mean density of CD1a-positive Langerhans cells was observed between pleomorphic adenomas and malignant tumors studied (P = 0.001). No CD1a-positive cells were detected in most cases (n = 5) of cystic adenoid carcinomas. CD1a-positive cells were detected in one mucoepidermoid carcinoma case, and six low-grade polymorphous adenocarcinomas cases. Comparison of the mean density of CD1a-positive cells between the three malignant tumors showed no significant difference (P = 0.127). No significant difference was observed in the presence of E-cadherin between tumors (P = 0.73), but it was detected in 24 cases. CONCLUSIONS: The lack of CD1a-positive in malignant salivary gland tumors facilitates the neoplastic development and suggests that these cells might be useful as auxiliary diagnostic and prognostic tool in minor salivary gland tumors. Furthermore, it is suggested that E-cadherin mediates cell adhesion in these tumors although we did not demonstrate significance.
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Antígenos CD1/análisis , Cadherinas/análisis , Células de Langerhans/patología , Neoplasias de las Glándulas Salivales/patología , Glándulas Salivales Menores/patología , Adenocarcinoma/patología , Adenoma Pleomórfico/patología , Carcinoma Adenoide Quístico/patología , Carcinoma Mucoepidermoide/patología , Recuento de Células , Colorantes , Células Dendríticas/patología , Epitelio/patología , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Inmunohistoquímica , Células de Langerhans/inmunología , Masculino , Persona de Mediana EdadRESUMEN
This study aimed to evaluate the utilization of dental services in four specialized dental clinics in Bahia State, Brazil, and to identify associated factors. This was an evaluative study in which the quantitative stage focused on a cross-sectional analysis of secondary data from the Outpatient Information System of the Unified National Health System and the qualitative component was based on 20 semi-structured interviews with coordinators and managers, in addition to on-site observation of health services. The study showed good results in the supply of these services from the health professionals' perspective, but with a low utilization rate. The low utilization rate reveals access barriers in the health services themselves, like the lack of performance standards and goals by specialty, lack of patients (who are not replaced), and different technologies used by each specialist. The results suggest the need for studies that analyze different forms of services organization that would have allowed greater utilization of the available supply, with pay differentials, linkage to primary care, and adjustment of the supply to the population's health needs.
Asunto(s)
Atención Odontológica/estadística & datos numéricos , Clínicas Odontológicas/estadística & datos numéricos , Brasil , Estudios Transversales , Clínicas Odontológicas/provisión & distribución , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Salud Bucal , Investigación CualitativaRESUMEN
O estudo visou avaliar a taxa de utilização dos serviços odontológicos especializados de quatro CEOs da Bahia, Brasil, identificando fatores relacionados. Trata-se de uma pesquisa avaliativa onde a etapa quantitativa foi conduzida através de um estudo transversal utilizando dados secundários do Sistema de Informações Ambulatoriais do Sistema Único de Saúde (SIA-SUS) e a qualitativa foi a partir de vinte entrevistas semi-estruturadas junto aos coordenadores e executores, além de observação in loco do serviço. O estudo revelou bons resultados na oferta desse serviço na percepção dos profissionais, mas há uma baixa taxa de utilização. A baixa taxa de utilização revela barreiras de acesso do próprio serviço de saúde, como a ausência de padrões e metas de desempenho por especialidade, a falta dos pacientes, que não são substituídos, além das diferentes tecnologias utilizadas por cada especialista. Sugerem-se estudos que analisem diferentes formas de organização do serviço que tenham possibilitado maior utilização da oferta disponível, como diferenças de remuneração, articulação com atenção primária e adequação da oferta às necessidades de saúde populacionais.
This study aimed to evaluate the utilization of dental services in four specialized dental clinics in Bahia State, Brazil, and to identify associated factors. This was an evaluative study in which the quantitative stage focused on a cross-sectional analysis of secondary data from the Outpatient Information System of the Unified National Health System and the qualitative component was based on 20 semi-structured interviews with coordinators and managers, in addition to on-site observation of health services. The study showed good results in the supply of these services from the health professionals' perspective, but with a low utilization rate. The low utilization rate reveals access barriers in the health services themselves, like the lack of performance standards and goals by specialty, lack of patients (who are not replaced), and different technologies used by each specialist. The results suggest the need for studies that analyze different forms of services organization that would have allowed greater utilization of the available supply, with pay differentials, linkage to primary care, and adjustment of the supply to the population's health needs.
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Investigación sobre Servicios de Salud , Accesibilidad a los Servicios de Salud , Atención Secundaria de Salud , Especialidades Odontológicas , Servicios de Salud Dental , Sistemas de Información en Atención Ambulatoria , Brasil , Estudios Transversales , Sistema Único de SaludRESUMEN
A partir da década de 80, as neoplasias ocuparam o segundo lugar entre as causas de óbitos por doenças. Esta mudança está relacionada a uma série de fatores, entre elas as mudanças sócio econômicas e uma maior exposição a fatores de risco, principalmente, o tabagismo e o consumo de bebidas alcoólicas. Este trabalho tem como objetivo identificar e analisar a distribuição de óbitos por cancer bucal no estado de Pernambuco, no período de 1979 a 1995, em relação ao sexo, faixa etária, grau de escolaridade, bem como alertar o cirurgião-dentista para os fatores de risco do câncer bucal. Foi realizado um estudo retrospectivo com a utilização de dados secundários do Sistema de Informações sobre Mortalidade do Ministério da Saúde. O número de óbitos por câncer bucal foi de 973 casos, sendo o sexo masculino (70,3 por cento) e a faixa etária entre os 45 e 75 anos os mais acometidos. Aproximadamente 40 por cento da população afetada apresentou o 1º grau incompleto ou nenhuma instrução. Observa-se que há a necessidade da incorporação do cirurgião-dentista em programas de prevenção com diagnóstico precoce e inclusão, nos prontuários, da abordagem sobre os malefícios, principalmente, do consumo de fumo e álcool como principais fatores de risco do câncer bucal