RESUMO
OBJECTIVE: This study aimed to identify radiographic alterations in patients administered bisphosphonate treatment that would permit early diagnosis of osteonecrosis of the jaw. STUDY DESIGN: A prospective study was conducted with clinical and radiographic analysis of 60 patients divided into 2 groups. Thirty patients treated with zoledronate were included in group 1, and 30 patients that had never been treated with bisphosphonate were included in group 2. Digital panoramic radiographs were performed on all patients and subsequently evaluated by 2 radiologists. RESULTS: Data analysis revealed that patients treated with zoledronate presented a statistically significant increase in the number of radiographic abnormalities compared with the control group. Female patients presented significantly more alterations than male patients, and the posterior region of the mandible was the most affected region. CONCLUSIONS: Analysis of the data obtained revealed that the use of panoramic radiographs facilitates early identification of bone alterations, which can improve early diagnosis of bisphosphonate-associated osteonecrosis of the jaw.
Assuntos
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/diagnóstico por imagem , Conservadores da Densidade Óssea/efeitos adversos , Difosfonatos/efeitos adversos , Imidazóis/efeitos adversos , Arcada Osseodentária/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Precoce , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Radiografia Panorâmica/métodos , Fatores Sexuais , Ácido ZoledrônicoRESUMO
BACKGROUND: Ameloblastoma is a benign odontogenic tumor, exhibiting local invasiveness and high rate of recurrence. Metallothionein is a protein associated with tumorigenesis, serving as prognostic factor in different neoplasms. We are interested in mechanisms underlying ameloblastoma local invasiveness. Thus, we decided to analyze expression of metallothionein in this tumor. MATERIALS AND METHODS: An immunohistochemical evaluation of metallothionein in ameloblastoma was carried out. As control, we assessed expression of the same molecule in calcifying cystic odontogenic tumor (CCOT), a non-invasive odontogenic neoplasm with ameloblastomatous epithelium. RESULTS: We studied 12 cases of solid/multicystic ameloblastomas. Metallothionein was observed in all samples. This molecule was observed in columnar cells in the periphery and in central polyhedral cells. CCOT (four cases) also showed the presence of metallothionein. Morphometry of stained areas showed that expression of metallothionein in ameloblastoma was significantly higher compared to CCOT (P < 0.0001). CONCLUSIONS: This protein may have an impact on ameloblastoma behavior. Metallothionein would act as a zinc reservoir for important proteases related to ameloblastoma biology, such as MMPs. This protein could also display pro-mitotic and anti-apoptotic features in the tumor.