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OBJECTIVE: To perform a comparative study of the cellular proliferation in the peripheral and central fibromas. MATERIAL AND METHODS: Immunohistochemistry for PCNA and the AgNOR technique were performed in 9 cases of peripheral odontogenic fibroma (POF), in 4 cases of odontogenic fibroma (OdF), in 8 cases of peripheral ossifying fibroma (PEOF) and 7 cases of ossifying fibroma (OsF). The Kruskal-Wallis and Mann-Whitney tests were used for the statistical analyses. RESULTS: Mesenchymal component of the central lesions presented a higher mean number of AgNOR per nucleus and PCNA index than did the peripheral lesions (P≤0.05). The mean number of AgNOR per nucleus in the epithelial component proved to be higher in the OdF than in the POF (P≤0.05). The mesenchymal and epithelial components presented similar mean numbers of AgNOR per nucleus and PCNA index in the OdF, as well as a similar mean number of AgNOR per nucleus in the POF. CONCLUSIONS: The mesenchymal component may well play a role in the differences between the biological behaviour of the central lesions as compared to the peripheral lesions. Moreover, considering that the epithelial and mesenchymal components in odontogenic fibromas presented a similar proliferation index, more research is warranted to understand the true role of the epithelial components, which are believed to be inactive in nature, as well as in the development and biological behaviour of these lesions.

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ABSTRACT Objective: To perform a comparative study of the cellular proliferation in the peripheral and central fibromas. Material and Methods: Immunohistochemistry for PCNA and the AgNOR technique were performed in 9 cases of peripheral odontogenic fibroma (POF), in 4 cases of odontogenic fibroma (OdF), in 8 cases of peripheral ossifying fibroma (PEOF) and 7 cases of ossifying fibroma (OsF). The Kruskal-Wallis and Mann-Whitney tests were used for the statistical analyses. Results: Mesenchymal component of the central lesions presented a higher mean number of AgNOR per nucleus and PCNA index than did the peripheral lesions (P≤0.05). The mean number of AgNOR per nucleus in the epithelial component proved to be higher in the OdF than in the POF (P≤0.05). The mesenchymal and epithelial components presented similar mean numbers of AgNOR per nucleus and PCNA index in the OdF, as well as a similar mean number of AgNOR per nucleus in the POF. Conclusions: The mesenchymal component may well play a role in the differences between the biological behaviour of the central lesions as compared to the peripheral lesions. Moreover, considering that the epithelial and mesenchymal components in odontogenic fibromas presented a similar proliferation index, more research is warranted to understand the true role of the epithelial components, which are believed to be inactive in nature, as well as in the development and biological behaviour of these lesions. .

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Traumatic neuroma, neurofibroma, neurilemmoma, palisaded encapsulated neuroma and malignant peripheral nerve sheath tumor (MPNST) are peripheral nerve sheath tumors and present neural origin. The goal of this study was to describe the epidemiological data of oral peripheral nerve sheath tumors in a sample of the Brazilian population. Biopsies requested from the Oral Pathology Service, School of Dentistry, Federal University of Minas Gerais (MG, Brazil), between 1966 and 2006 were evaluated. Lesions diagnosed as peripheral nerve sheath tumors were submitted to morphologic and to immunohistochemical analyses. All cases were immunopositive to the S-100 protein. Thirty-five oral peripheral nerve sheath tumors were found, representing 0.16% of all lesions archived in the Oral Pathology Service. Traumatic neuroma (15 cases) most frequently affected the mental foramen. Solitary neurofibroma (10 cases) was more frequently observed in the palate. Neurofibroma associated with neurofibromatosis type I (2 cases) was observed in the gingival and alveolar mucosa. Neurilemmoma (4 cases) was more commonly observed in the buccal mucosa. Malignant peripheral nerve sheath tumors (3 cases) occurred in the mandible, palate, and tongue. Palisaded encapsulated neuroma (1 case) occurred in the buccal mucosa. The data confirmed that oral peripheral nerve sheath tumors are uncommon in the oral region, with some lesions presenting a predilection for a specific gender or site. This study may be useful in clinical dentistry and oral pathology practice and may be used as baseline data regarding oral peripheral nerve sheath tumors in other populations.

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AIM: The aim of this report is to present the management of a patient with pernicious anemia afflicted with recurrent aphthous stomatitis (RAS). BACKGROUND: RAS is one of the most common lesions of the oral mucosa. Although the exact etiology of RAS is still unknown different hematinic deficiencies have been proposed. CASE REPORT: Painful recurrent ulcers covered with a grayish pseudomembrane surrounded by an erythematous margin were identified on the tongue and in the buccal mucosa of a 71-year-old woman. The patient also presented with depapilation of the tongue. The clinical diagnosis was RAS. Laboratory tests including a hemogram were ordered to determine existing levels of folic acid, iron, ferritin, and vitamins B2, B6, and B12. Levels of serum vitamin B12 and serum hemoglobin were low. The laboratory investigation also showed a medium corpuscular volume of 104.1 fl. A gastroduodenoscopy revealed no macroscopic abnormality. A gastric biopsy showed mucosal atrophy in the gastric corpus with evidence of intestinal metaplasia. Antibodies against an intrinsic factor were negative. The diagnosis pernicious anemia was made, with RAS caused by vitamin B12 malabsorption. Treatment consisted of the administration of 1.0 ml of hydroxocolabamin intramuscularly twice weekly over four weeks followed by 1.0 ml once weekly for four weeks. Clinical resolution was observed after two months. SUMMARY: The association of RAS with vitamin B12 malabsorption is a rare event. However, along with conventional RAS clinical management, iron, folic acid, vitamin B deficiencies, and nutritional intolerance must be considered. Evaluation of the predisposing factors is imperative in treating patients with RAS including vitamin B12 malabsorption. CLINICAL SIGNIFICANCE: Determination of the levels of vitamin B12 should be the basis for replacement therapy. Such therapy can be considered a benefit to the patients with RAS as its etiology remains unclear. Clinicians must be alert to the possibility this lesion could be a signal of systemic disease.

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Traumatic neuroma, neurofibroma, neurilemmoma, palisaded encapsulated neuroma and malignant peripheral nerve sheath tumor (MPNST) are peripheral nerve sheath tumors and present neural origin. The goal of this study was to describe the epidemiological data of oral peripheral nerve sheath tumors in a sample of the Brazilian population. Biopsies requested from the Oral Pathology Service, School of Dentistry, Federal University of Minas Gerais (MG, Brazil), between 1966 and 2006 were evaluated. Lesions diagnosed as peripheral nerve sheath tumors were submitted to morphologic and to immunohistochemical analyses. All cases were immunopositive to the S-100 protein. Thirty-five oral peripheral nerve sheath tumors were found, representing 0.16% of all lesions archived in the Oral Pathology Service. Traumatic neuroma (15 cases) most frequently affected the mental foramen. Solitary neurofibroma (10 cases) was more frequently observed in the palate. Neurofibroma associated with neurofibromatosis type I (2 cases) was observed in the gingival and alveolar mucosa. Neurilemmoma (4 cases) was more commonly observed in the buccal mucosa. Malignant peripheral nerve sheath tumors (3 cases) occurred in the mandible, palate, and tongue. Palisaded encapsulated neuroma (1 case) occurred in the buccal mucosa. The data confirmed that oral peripheral nerve sheath tumors are uncommon in the oral region, with some lesions presenting a predilection for a specific gender or site. This study may be useful in clinical dentistry and oral pathology practice and may be used as baseline data regarding oral peripheral nerve sheath tumors in other populations.

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Amalgam-associated oral lichenoid reaction (AAOLR) is a rare lesion in dental practice. This article presents a case involving a striated, white, symptomatic plaque with an atrophic central area located in the left buccal mucosa and making direct contact with an amalgam restoration. Management included removing the amalgam restoration and using composite resin as a substitute. After 30 days, complete health was observed and AAOLR was diagnosed.

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A lesão liquenóide oral relacionada ao amálgama, condição rara na prática odontológica, constitui importante diagnóstico diferencial no grupo das leucoplasias orais. Relatam-se dois casos que apresentaram rápida resolução clínica após a substituição das restaurações de amálgama.

Amalgam-related oral lichenoid lesion, a rare disorder in dental practice, is an important differential diagnosis among oral leukoplastic lesions. We report two cases with rapid clinical resolution following the replacement of amalgam fillings.

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The peripheral ameloblastoma (PA) is a rare, benign, extraosseous odontogenic soft tissue tumour that is confined to the gingiva or alveolar mucosa. The PA presents the same histological characteristics of intraosseous ameloblastoma, although it is less aggressive than this classical subtype. We report a clinical case of PA of the alveolar mucosa in the right posterior maxilla, highlighting the importance of histological examination to the diagnosis.

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PURPOSE: Osseous choristoma is a rare, benign lesion of the oral cavity and is usually found in the tongue. It presents as a tumour-like mass of normal bony structure with mature cells in an abnormal position. The object of this paper is to report one case of osseous choristoma. PATIENT: A 32-year-old male presented with a lesion in the submandibular region, which was treated by excision. After 28 months of follow-up there was no recurrence. CONCLUSION: Upon reviewing the English literature, no previous case of an osseous choristoma located in the submandibular region has been found. Extended clinical and radiographic follow-up is necessary after surgical excision of an osseous choristoma, despite its benign nature.

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