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To investigate whether low-level laser therapy (LLLT), at different times of application (immediate and late) in the region of the parotid glands, has a distance effect on the microarchitecture of the trabecular bone in mandible of rats irradiated by volumetric modular arc therapy (VMAT). Thirty adult Wistar rats were randomly divided into placebo control groups (CG, n = 2), only radiotherapy (RG, n = 2), only LPLT (LG, n = 2), and two other groups using LLLT in the immediate time (24 h) (ILG, n = 12) and late (120 h) (LLG, n = 12) to radiotherapy by VMAT in a single dose of 12 Gy. LLLT with AsGaAl laser (660 nm, 100 mW), a spot size of 0.0028 cm2, was applied in three points in the region of the right parotid gland, with energy of 2 J/cm2, 20 s per point, for 10 consecutive days. After euthanasia, the right hemimandibles of each animal were dissected, prepared, and analyzed by computerized microtomography (micro-CT) and histomorphometry. The different groups were analyzed by the Tukey and Bonferroni multiple comparison tests. The micro-CT analysis found statistically significant differences between the groups, especially in the LLG, which had the highest average bone volume compared to the CG (p = 0.001) and ILG (p = 0.002) and a greater number of trabeculae than the CG (p = 0.000) and ILG (p = 0.031). The ILG also had a higher number of trabeculae than the CG (p = 0.005). Trabecula separation (Tb.Sp) was lower in the LLG (p = 0.000) and ILG (p = 0.002) when compared to the CG. In the histomorphometry, there was no statistical difference between the groups in relation to all the analyzed variables. Micro-CT analysis showed that the LLLT, even applied at a distance, both in the immediate and late VMAT times, has an effect on the mandibular bone microarchitecture by increasing the volume and number of trabeculae and decreasing the spaces between them.
Assuntos
Terapia com Luz de Baixa Intensidade , Animais , Osso Esponjoso , Terapia com Luz de Baixa Intensidade/métodos , Mandíbula/diagnóstico por imagem , Ratos , Ratos Wistar , Microtomografia por Raio-XRESUMO
Objetivo: relatar um caso raro de impacção de um incisivo decíduo inferior pela presença de odontoma composto, bem como descrever a sua abordagem clínica. Relato de caso: paciente do sexo masculino, com 4 anos de idade, apresentava ausência do incisivo lateral decíduo inferior esquerdo. O exame radiográfico mostrou impacção do incisivo não erupcionado próximo a estruturas radiopacas sugestivas de odontoma composto. O paciente foi acompanhado por dois anos, momento em que se realizou abordagem cirúrgica do caso. Após a cirurgia, a hipótese de diagnóstico de odontoma composto foi confirmada e com o acompanhamento ocorreu a erupção dos incisivos centrais permanentes inferiores. O paciente foi encaminhado para tratamento ortodôntico. Considerações finais: esse relato de caso aborda um caso raro de odontoma composto associado à não erupção de dente decíduo, uma vez que odontomas costumam ser detectados preferencialmente na segunda década de vida do paciente, sendo associados à impacção de dentes permanentes. Além disso, apresenta um protocolo de abordagem clínica para esses casos quando diagnosticados em idade precoce no paciente infantil.(AU)
Objective: to report a rare case of impaction of a primary mandibular incisor due to the presence of a compound odontoma and describe its clinical management. Case report: a 4-year-old boy presented with a "missing" primary left mandibular lateral incisor. Radiographs showed impaction of the unerupted incisor by adjacent radiopaque structures consistent with a compound odontoma. The patient was recalled periodically for 2 years, at which time surgical excision was performed. The diagnosis of compound odontoma was confirmed histologically, and the permanent mandibular central incisors erupted uneventfully; the patient was referred for orthodontic treatment. Final considerations: this case report describes an unusual case of compound odontoma associated with an unerupted deciduous tooth; odontomas are rare in this age range, occurring predominantly in the second decade of life and in association with impaction of permanent teeth. We also propose a protocol for clinical management of such early-onset cases.(AU)
Assuntos
Humanos , Masculino , Pré-Escolar , Dente Impactado/cirurgia , Dente Impactado/etiologia , Neoplasias Mandibulares/cirurgia , Neoplasias Mandibulares/complicações , Odontoma/cirurgia , Odontoma/complicações , Dente Impactado/diagnóstico por imagem , Radiografia Dentária , Neoplasias Mandibulares/diagnóstico por imagem , Odontoma/diagnóstico por imagem , Tomografia Computadorizada de Feixe CônicoRESUMO
Este estudo buscou verificar possíveis alterações sistêmicas causadas pelo flúor administrado em diferentes concentrações. Foi utilizado um modelo de estudo animal, no qual foram selecionados 60 rattus norvegicus, aleatoriamente divididos em 4 grupos, sendo três grupos testes (receberam água fluoretada nas concentrações de 0,7 ppm F; 1,2 ppm F e 2,0 ppm F), e um grupo controle que recebeu água destilada. Para análise histomorfológica por microscopia óptica, os ratos foram submetidos a dissecação dos seguintes órgãos: intestino alto (duodeno), rim e fígado. Os resultados obtidos após a avaliação descritiva comparativa dos grupos de estudo evidenciaram alterações morfológicas em todos os grupos testes, concluindo, desta forma, que o flúor administrado, nestas concentrações, pode ser tóxico.
This study sought to verify possible systemic changes caused by fluoride administered at different concentrations. An animal model was used in which 60 rattus norvegicus were randomly divided into 4 groups, with three test groups receiving fluoridated water at the different concentrations (0.7 ppm F, 1.2 ppm F and 2, 0 ppm F), and a control group receiving distilled water. A histomorphological analysis was performed by light microscopy after the dissection of the following rat organs: the large intestine (duodenum), the kidney and the liver. The results obtained after the comparative descriptive evaluation of the study groups showed morphological changes in all the test groups, concluding that the fluoride administered at these concentrations could be toxic.
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INTRODUCTION: Adverse effects on the oral mucosa after the use of dermal fillers have been reported due to their increased use for facial aesthetics. OBJECTIVE: This study aimed to evaluate, clinically and histologically, the local and systemic effects of two concentrations of polymethylmethacrylate (PMMA) dermal filler in rats. MATERIAL AND METHODS: Fifty-four female rats were allocated into three treatment groups (2% PMMA, 30% PMMA and 0.9% NaCl), according to the substance injected in the tongue, and three experimental periods: 7, 60 and 90 days. The rats were clinically evaluated and then euthanised, and their tongue and right kidney removed. The histological sections were stained with haematoxylin/eosin and picrosirius. RESULTS: Clinically, significant differences were found between test groups as to the occurrence of nodules (Kruskal-Wallis; p < 0.001). Histologically, there was greater inflammatory response in the PMMA compared with control (Kruskal-Wallis; p < 0.001). 30% PMMA had greater collagen formation (anova mixed models; p < 0.01). No migration of the material towards kidney was found. CONCLUSION: Polymethylmethacrylate induced intense reaction in the initial period of observation (7 days), followed by gradual decrease during the study, favouring the presence of fibroplasia adjacent to the material.
Assuntos
Polimetil Metacrilato/administração & dosagem , Polimetil Metacrilato/farmacologia , Língua/efeitos dos fármacos , Língua/patologia , Animais , Vasos Sanguíneos/efeitos dos fármacos , Vasos Sanguíneos/patologia , Colágeno/biossíntese , Preenchedores Dérmicos/administração & dosagem , Preenchedores Dérmicos/farmacologia , Eutanásia Animal , Feminino , Migração de Corpo Estranho/induzido quimicamente , Migração de Corpo Estranho/patologia , Reação a Corpo Estranho/induzido quimicamente , Reação a Corpo Estranho/patologia , Células Gigantes/efeitos dos fármacos , Células Gigantes/patologia , Inflamação/induzido quimicamente , Injeções Intradérmicas , Rim/efeitos dos fármacos , Rim/patologia , Mucosa Bucal/efeitos dos fármacos , Ratos , Ratos Wistar , Cloreto de Sódio/administração & dosagem , Cloreto de Sódio/farmacologia , Fatores de TempoRESUMO
OBJECTIVE: This study aimed to investigate local and systemic effects of 2 concentrations of hyaluronic acid (HA) in rats. STUDY DESIGN: Fifty-four female Wistar rats were allocated to 3 treatment groups (25 mg/mL HA, 5.5 mg/mL HA, and 0.9% NaCl) and 3 subgroups of experimental time (7, 60, and 90 days). The rats were evaluated clinically and then killed. The tongue and right kidney were removed and stained by hematoxylin and eosin and picrosirius (tongue only). RESULTS: The clinical changes did not differ significantly between groups (Kruskal-Wallis: P > .05). Histologically there was significantly greater inflammatory response in the groups with HA compared with control (Kruskal-Wallis: P < .001). All kidney samples were normal. The 25 mg/mL HA group had higher collagen formation (analysis of variance mixed models: P = .016). CONCLUSIONS: HA causes moderate inflammatory reaction to 7 days and mild to 60 and 90 days, which is compatible with tissue repair, and a slightly increased collagen formation around the material was detected.
Assuntos
Materiais Biocompatíveis/farmacologia , Ácido Hialurônico/farmacologia , Língua/efeitos dos fármacos , Substâncias Viscoelásticas/farmacologia , Abscesso/induzido quimicamente , Animais , Materiais Biocompatíveis/administração & dosagem , Colágeno/biossíntese , Tecido Conjuntivo/efeitos dos fármacos , Técnicas Cosméticas , Relação Dose-Resposta a Droga , Feminino , Ácido Hialurônico/administração & dosagem , Rim/efeitos dos fármacos , Distribuição Aleatória , Ratos , Ratos Wistar , Língua/metabolismo , Substâncias Viscoelásticas/administração & dosagemRESUMO
OBJECTIVES: This article is a review of PMMA focusing on its properties, indications, contra-indications and adverse effects. BACKGROUND: search to remain young is a constant attitude among Brazilians. The low cost of filling agents have stimulated its indiscriminate use, especially the bioplasty (non-incisional method). Polymethylmethacrylate (PMMA) is the cosmetic filling agent of choice, because of its low cost, easy access and simple application technique. The impact on dentistry and orofacial medicine needs further awareness. CONCLUSION: The article aims to draw the attention of odontology and medical professionals to the product's applicability and its possible complications.
Assuntos
Técnicas Cosméticas , Face , Arcada Osseodentária , Boca , Polimetil Metacrilato , Rejuvenescimento , Materiais Biocompatíveis/efeitos adversos , Materiais Biocompatíveis/química , Contraindicações , Humanos , Polimetil Metacrilato/efeitos adversos , Polimetil Metacrilato/químicaRESUMO
Dentigerous cyst (DC) and keratocystic odontogenic tumor (KOT) are odontogenic lesions arising from epithelial elements, such as those observed in dental follicles (DF), that have been part of the tooth forming apparatus. These lesions show different clinical and histological characteristics, as well as distinct biological behavior. This study aimed to qualify and quantify collagen and elastic fibers by means of histochemical techniques with light and confocal laser microscopic methods in three odontogenic entities. Eleven DF, 13 DC (n=10 with inflammation, n=3 without inflammation) and 13 KOT were processed to the following techniques: Hematoxylin and Eosin, Masson's Trichrome, Picrosirius, Direct Blue, and Orcein. DF and DC without inflammation exhibited collagen with similar characteristics: no parallel pattern of fiber orientation, thick fibers with dense arrangement, and absence of distinct layers. A comparison between DC with inflammation and KOT revealed similar collagen organization, showing distinct layers: thin collagen fibers with loose arrangement near the epithelium and thick fibers with dense arrangement in distant areas. The only difference found was that KOT exhibited a parallel collagen orientation in relation to the odontogenic epithelia. It may be suggested that the connective tissue of DC is a reactive tissue, inducing an expansive growth associated with fluid accumulation and inflammatory process, which in turn may be present as part of the lesion itself. In KOT, loosely arranged collagen may be associated with the behavior of the neoplastic epithelium.
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Introdução: O cisto periodontal lateral é um tipo de cisto odontogênico, de etiologia desconhecida, cuja prevalência na população não é frequente. Essa lesão ocorre geralmente na região de pré-molares inferiores, é assintomática e, em alguns casos, ocasiona expansão da cortical óssea. Radiograficamente, apresenta radio-lucidez unilocular bem definida. Objetivo e relato de caso: Este estudo tem por objetivo relatar o caso de um paciente do gênero masculino, 44 anos de idade, que procurou atendimento com queixa de aumento de volume associado a desconforto na região do segundo pré-molar inferior direito. Após criterioso processo de diagnóstico, procedeu-se à excisão cirúrgica e o exame microscópico revelou se tratar de cisto periodontal lateral, conforme a hipótese de diagnóstico clínico prévia. Considerações finais: Esse relato de caso clínico discute a importância da utilização de um protocolo de diagnóstico diferencial para estabelecer a conduta terapêutica adequada ao paciente.
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Self-inflicted lesions that cause mutilation are observed in schizophrenic patients. This case report describes the diagnosis and treatment of simple schizophrenia in a 31-year-old male patient who bit his own tongue and lower lip. The dental treatment proposed included the construction of a splint to prevent new lesions and to allow healing of existing ones. The treatment afforded to avoid tooth extraction before the patient responded to psychiatric drug treatment. The importance of a transdisciplinary approach to self-mutilation due to psychiatric disorders is stressed. The interaction between the two teams, stomatology and psychiatry, was crucial for the improvement of the patient's condition.
Assuntos
Lábio/lesões , Esquizofrenia/terapia , Automutilação/prevenção & controle , Língua/lesões , Adulto , Humanos , Masculino , Esquizofrenia/fisiopatologia , Automutilação/patologiaRESUMO
La mucositis es una de las complicaciones orales frecuentes en la terapia del cáncer, no obstante su tratamiento es controversial. Se ha señalado que la efectividad de algunos agentes depende de la fase de la mucositis en la que se inicia el tratamiento. El propósito de este estudio fue hacer una revisión de la literatura sobre las lesiones tenpranas eritenatosas de mucositis oral inducida por quimioterapia y/o radioterapia en pacientes pediátricos con cancer. Para tanto se realizó una revisión bibliográfica para conocer: frecuencia, diagnóstico y tratamiento de las lesiones tenpranas eritenatosas de mucositis oral en niños con cáncer. Los resultados denostraron que debido a la alta frecuencia de esta patología por ser inducida por quimioterapia en pacientes pediátricos con cáncer se cita la existencia de varios tratamientos, destacándose la utilización de la vitamina E y de laser, pudiendo ser terapias efectivas en el tratamiento de estas lesiones tenpranas de mucositis oral en pacientes pediátricos con cáncer
Mucositis is one of the frequent oral complications in the cancer therapy, however its treatment is controversial. Have been highlighted that the effectiveness of some agents depends on the mucositis development phase when the treatment is started. The purpose of this study was to do a revision on the literature regarding mucositis eritenatosas initial injuries induced by chenotherapy and/or radioteraphy in pediatric patients with cancer. A bibliographic revision was made to know: frequency, diagnosis and treatment for the oral mucositis eritenatosas initial injuries in children with cancer. The results shown that because of the high frequency of this pathology induced by chenotherapy and/or radioteraphy in pediatric patients with cancer, the existence of several treatments is highlighted, the use of vitamin E and laser stands out as an effective therapy for this oral mucositis initial injuries treatment in pediatric patients with cancer
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Humanos , Masculino , Feminino , Criança , Estomatite/diagnóstico , Estomatite/tratamento farmacológico , Estomatite/radioterapia , Neoplasias Bucais/tratamento farmacológico , Neoplasias Bucais/radioterapia , Odontologia , Tratamento Farmacológico/métodos , Radioterapia/métodosRESUMO
A síndrome da apneia-hipopneia obstrutiva do sono (SAHOS) é considerada uma doença evolutiva e com alta taxa de morbimortalidade. O uso dos aparelhos intraorais (AIO) tem importante papel no tratamento da SAHOS, especialmente nos casos leves e moderados. O presente artigo faz uma revisão das causas da SAHOS, seu diagnóstico e opções terapêuticas, segundo diretrizes baseadas em evidências atualizadas. Embora os AIOs ainda apresentem resultados inferiores em relação aos aparelhos com continuous positive airway pressure (CPAP), costumam ser melhor tolerados pelos pacientes, uma vez que são menores e esteticamente mais aceitáveis. Os AIOs, especialmente os de avanço mandibular, são alternativas de tratamento para a SAHOS leve e moderada.
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Apneia Obstrutiva do Sono/etiologia , Apneia Obstrutiva do Sono/terapia , Obesidade/complicações , Polissonografia , Ronco/epidemiologia , Ronco/etiologia , Ronco/terapiaRESUMO
A case of clear cell variant of calcifying epithelial odontogenic tumor (CEOT) affecting 2 different extraosseous sites is described. A 43-year-old female patient presented with 2 gingival lesions (1 in the upper premolar and 1 in the lower incisor area), which were clinically diagnosed as inflammatory hyperplasia and surgically removed. Microscopically, both lesions were composed of polyhedral cells (some with clear cytoplasm); hyaline material and areas of calcification were also observed. The diagnostic hypotheses raised were clear cell variant of CEOT, hyalinizing clear cell carcinoma, and renal metastasis. The hyaline material was positive for Congo red, crystal violet, and Lugol's iodine stains, but negative for Coomassie blue; the clear cells showed positively stained granules with PAS stain. Based on these results, the conclusive diagnosis for both lesions was clear cell variant of CEOT. No evidence of recurrence was observed after 1 year of follow-up.
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Neoplasias Gengivais/patologia , Tumores Odontogênicos/patologia , Adulto , Calcinose/patologia , Feminino , HumanosRESUMO
AIM: This paper reports the case of a sarcomatous tumor (probably a pleomorphic sarcoma) in a patient with Neurofibromatosis type 1 (NF1) and discusses the association between these two diseases. BACKGROUND: NF1 is an autosomal dominant tumor predisposition syndrome. Malignant transformation is observed in patients with this disease, usually in the form of malignant peripheral nerve sheath tumors (MPNSTs). REPORT: A 72-year-old female patient with diagnosis of NF1 presented with left mandibular region enlarged for about 6 months, intra-oral examination revealed a mass growth on the floor of the lower left posterior area of the oral cavity measuring 5 cm in its greatest diameter and covered by ulcerated mucosa. SUMMARY: Few cases of association of neurofibromatosis with other types of soft tissue sarcomas have been reported. Undifferentiated pleomorphic sarcomas are the most common of these tumors. We intend to call attention to the importance of patient follow-up and counseling.
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Neoplasias Mandibulares/patologia , Soalho Bucal/patologia , Neoplasias Primárias Múltiplas/patologia , Neurofibromatose 1/patologia , Sarcoma/patologia , Idoso , Feminino , Neoplasias Femorais/secundário , Humanos , Imuno-Histoquímica , Sarcoma/secundárioRESUMO
O objetivo desse estudo foi avaliar as características do tecido conjuntivo de 11 folículos pericoronários, 12 cistos dentígeros e de 14 tumores odontogênicos ceratocísticos (TOCs). A amostra foi submetida às técnicas de Hematoxilina e Eosina, Tricrômico de Masson, Picrosírius, Direct Blue e Orceína. Tricrômico de Masson foi utilizado para avaliação de diferenças de densidade e de paralelismo das fibras colágenas, bem como presença de infiltrado linfoplasmocitário. Picrosírius serviu para mensuração da quantidade de fibras colágenas; Direct Blue e Orceína, para identificação do sistema de fibras elásticas. Lâminas coradas por essas três últimas técnicas foram visualizadas em microscopia confocal a laser. Os resultados mostraram semelhança entre o folículo pericoronário e o TOC: paralelismo de fibras colágenas arranjadas em um padrão eminentemente denso, podendo conter uma camada de densidade frouxa junto ao tecido epitelial. As cápsulas de cistos dentígeros eram compostas por fibras colágenas desorganizadas, ou não paralelas, em um arranjo frouxo com presença de infiltrado infoplasmocitário. Não foi observada marcação para fibras do sistema elástico. Com base nos resultados, conclui-se que a cápsula do TOC representa o estroma da lesão, desempenhando função de suporte e que, diferentemente, o tecido conjuntivo do cisto dentígero é parte da resposta inflamatória.