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OBJECTIVES: To evaluate the effects of photobiomodulation (PBM) in gingival lesions resulting from autoimmune diseases; to compare PBM and topical corticosteroid (CS) treatment; and to assess PBM outcome over time of follow-up. MATERIALS AND METHODS: A comprehensive electronic search was performed in four electronic databases. Treatment effects were measured through visual analog scale of pain (VAS) and clinical evolution of lesion (Thongprasom scale for oral lichen planus (OLP)). Meta-analysis was performed to compare PBM with topical corticosteroid treatment and to evaluate PBM effect over time of follow-up. RESULTS: Seventeen studies were included in this review, of which six were used for the meta-analysis. Meta-analysis results showed no significant differences between PBM and topical CS in pain reduction at baseline (MD = 0.20, 95% CI = - 0.92, 1.32, p = 0.72) and 60-day follow-up (MD = 0.63, 95% CI = - 3.93, 5.19, p = 0.79); however, VAS showed significant pain reduction when compared before and after PBM at 30-day (MD = - 3.52, 95% CI = - 5.40, - 1.64, p = 0.0002) and 60-day (MD = - 5.04, 95% CI = - 5.86, - 4.22, p < 0.00001) follow-up. Thongprasom clinical scale for OLP also showed significant improvement at 30-day follow-up (MD = - 2.50, 95% CI = - 2.92, - 2.08, p < 0.00001) after PBM. CONCLUSION: PBM led to significant reduction of pain and clinical scores of the lesions, not having shown significant differences when compared to topical CS. CLINICAL RELEVANCE: PBM has been used in the treatment of autoimmune gingival lesions, but so far there is little strong evidence to support its use.
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Doenças Autoimunes , Líquen Plano Bucal , Corticosteroides/uso terapêutico , Doenças Autoimunes/tratamento farmacológico , Doenças Autoimunes/radioterapia , Glucocorticoides/uso terapêutico , Humanos , Líquen Plano Bucal/tratamento farmacológico , Líquen Plano Bucal/radioterapia , DorRESUMO
This study aims to evaluate the effects of photobiomodulation (PBM) on human monocytes, assessing the oxidative burst and ultimate fungicidal potential of these cells, as well as the gene expression at the mRNA level of CD68, CD80, CD163, CD204, IL-6, TNF-α and IL-10 in derived macrophages. Primary cultures of human monocytes were irradiated with an InGaAlP (660 nm)/GaAlAs (780 nm) diode laser (parameters: 40 mW, 0.04 cm2, 1 W/cm2; doses: 200, 400 and 600 J/cm2). Cells were submitted to the chemiluminescence assay, and a microbicidal activity assay against Candida albicans was performed. Reactive oxygen species (ROS) and nitric oxide (NO) production were measured, and cell viability was assessed by the exclusion method using 0.2% Trypan blue reagent. Irradiated monocytes were cultured for 72 h towards differentiation into macrophages. Total RNA was extracted, submitted to reverse transcription and real-time PCR. The results were analysed by ANOVA and the Tukey test (α = 0.05). Irradiated monocytes revealed a significant increase in their intracellular and extracellular ROS (P < 0.001). The 660 nm wavelength and 400 J/cm2 dose were the most relevant parameters (P < 0.001). The fungicidal capacity of the monocytes was shown to be greatly increased after PBM (P < 0.001). PBM increased the expression of TNF-α (P = 0.0302) and the production of NO (P < 0.05) and did not impair monocyte viability. PBM induces a pro-inflammatory Th1-driven response in monocytes and macrophages.
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Lasers Semicondutores , Monócitos , Sobrevivência Celular , Humanos , Imunidade , MacrófagosRESUMO
Introduction: Oral squamous cell carcinoma (OSCC) is one of the most frequent cancers whose main causes are preventable because oral cavity is easily accessible for examination. OSCC involves many steps from the diagnosis until treatment which can result in late diagnosis and worst prognosis. Objective: Development and evolution of a Stomatology and Oral Pathology Service at the Federal University of Alfenas addressing early diagnosis and management of oral lesions. Method: Retrospective study developed with the files from 1998 to 2019. Data from all the cases diagnosed as oral malignancies were collected and the demographical, clinical, and microscope diagnosis were included. Results: 270 (84.64%) OSCC were found among 8,952 histopathological diagnoses. The patients age ranged from 24 to 94 years (mean 59.7±13.1 years), and more frequent in the sixth (32.3%) and seventh (26%) decades of life. Men were 2.5 times more affected than women. Most of patients were Caucasian (74.8%), and users of tobacco and alcohol. Over the years, there was an increase in the number of cases diagnosed and expansion of the area covered by the Service. Conclusion: The Dental Clinic (Stomatology) and Oral Pathology Laboratory has been playing an important role for the establishment and improvement of the healthcare system to the local population, mainly in rural áreas
Introdução: O carcinoma de células escamosas (CEC) de boca está entre os cânceres mais frequentes. Suas principais causas são evitáveis, pois a cavidade oral é uma área de fácil acesso para exame. No entanto, desde o estabelecimento do diagnóstico até o tratamento final dos pacientes, o CEC envolve muitas etapas e pode resultar em diagnóstico tardio e, portanto, em pior prognóstico para os pacientes. Objetivo: Apresentar o desenvolvimento e a evolução de um Serviço de Estomatologia e Patologia Oral da Universidade Federal de Alfenas, que tem como foco o diagnóstico precoce e o tratamento de lesões bucais. Método: Estudo retrospectivo com os prontuários de 1998 a 2019. Foram coletados dados de todos os casos diagnosticados como malignidades orais e incluídos os diagnósticos demográficos, clínicos e microscópicos. Resultados: Entre 8.952 diagnósticos histopatológicos realizados, 270 (84,64%) eram CCE. A idade dos pacientes variou de 24 a 94 anos (média 59,7±13,1 anos), sendo mais frequente na sexta (32,3%) e sétima (26%) décadas de vida. Os homens foram 2,5 vezes mais afetados do que as mulheres. A maioria dos pacientes era branca (74,8%) e o uso de tabaco e álcool, frequente. Ao longo dos anos, houve um aumento do número de casos diagnosticados, bem como uma ampliação da área de cobertura do Serviço. Conclusão: O Serviço de Estomatologia e Patologia Oral tem desempenhado um papel importante na implantação e melhoria do sistema de saúde da população local, principalmente nas Regiões interioranas e em áreas rurais
Introducción: El carcinoma de células escamosas (CCE) de boca se encuentra entre los cánceres más frecuentes. Sus principales causas se pueden prevenir ya que la cavidad bucal es un área de fácil acceso para su examen. Sin embargo, desde el establecimiento del diagnóstico hasta el tratamiento final de los pacientes, la CEC implica muchos pasos y puede resultar en un diagnóstico tardío y, por lo tanto, un peor pronóstico para los pacientes. Objetivo: Presentar el desarrollo y evolución de un Servicio de Estomatología y Patología Bucal de la Universidad Federal de Alfenas que se enfoca en el diagnóstico y tratamiento precoz de las lesiones bucales. Método: Estudio retrospectivo con historias clínicas de 1998 a 2019. Se recolectaron datos de todos los casos diagnosticados como neoplasias bucales, incluyendo diagnósticos demográficos, clínicos y microscópicos. Resultados: De los 8.952 diagnósticos histopatológicos realizados, 270 (84,64%) fueron CCE. La edad de los pacientes osciló entre 24 y 94 años (media 59,7±13,1 años), siendo más frecuente en la sexta (32,3%) y séptima (26%) décadas de la vida. Los hombres se vieron 2,5 veces más afectados que las mujeres. La mayoría de los pacientes eran de raza blanca (74,8%) y el consumo de tabaco y alcohol era frecuente. A lo largo de los años, ha habido un aumento en el número de casos diagnosticados, así como una expansión del área de cobertura del Servicio. Conclusión: El Servicio de Estomatología y Patología Bucal ha jugado un papel importante en la implementación y mejora del sistema de salud para la población local, especialmente en las Regiones del interior y áreas rurales
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Humanos , Masculino , Feminino , Neoplasias Bucais/diagnóstico , Carcinoma de Células Escamosas , Diagnóstico Precoce , Serviços de SaúdeRESUMO
Paracoccidioidomycosis (PCM) is an infection caused by fungi of the genus Paracoccidioides and is marked by a strong predilection for men; nevertheless, some women have had developed PCM and have presented oral involvement by the disease. OBJECTIVES: To review all published cases until August 2020 of oral PCM in women, with emphasis on the presence of systemic changes, deleterious habits (tobacco and alcohol) and oral manifestation features through a systematic review. METHODS: Observational studies (both prospective and retrospective) and case reports indexed in the Embase, PubMed, Scopus, Web of Science and LIVIVO databases were selected by two reviewers in a two-phase process following the pre-established PICOS criteria. RESULTS: Twenty-five studies met the eligibility criteria and were selected for qualitative synthesis, of which 72 participants were enrolled. Brazilian White women between 40 and 50 years were the most affected and social history revealed them to be housewives or rural workers. Fifteen women (33.3% of the informed cases) presented any systemic change at the time of PCM diagnosis, namely pregnancy, HIV infection and/or depression. Moriform stomatitis was predominant and affected preferentially the gingivae and alveolar processes in the form of a single painful lesion. Most patients were treated with sulfamethoxazole + trimethoprim or itraconazole. CONCLUSIONS: Oral PCM in women is rare; some cases showed systemic changes at the time of PCM diagnosis, namely HIV infection, pregnancy and depression. New studies should be conducted to elucidate the influence of systemic alterations on the development of oral PCM in women.
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Paracoccidioides , Paracoccidioidomicose/epidemiologia , Paracoccidioidomicose/microbiologia , Adulto , Brasil/epidemiologia , Coinfecção , Bases de Dados Factuais , Feminino , Infecções por HIV , Humanos , Itraconazol , Pessoa de Meia-Idade , Paracoccidioidomicose/diagnóstico , Gravidez , Combinação Trimetoprima e SulfametoxazolRESUMO
OBJECTIVES: This study approaches the history of reclassifications and redefinitions around the odontogenic keratocyst (OK), as proposed by the World Health Organization (WHO), and aims to understand the impact of those changes on the prevalence and epidemiology of odontogenic tumors (OTs). METHODOLOGY: Cases of OTs diagnosed in an Oral Pathology service between January 1996 and December 2016 were reviewed. Demographic data of patients such as age, gender and site of lesions were retrieved from their respective records. RESULTS: Within the studied period, 7,805 microscopic reports were elaborated and 200 (2.56%) of these were diagnosed as OTs. Out of these 200, between 1996 and 2005, prior to the 2005 WHO classification, there were 41 (20.5%) OTs cases, being odontoma the most frequent (23; 56.09%), followed by ameloblastoma (8; 19.51%) and myxoma (03; 7.31%). Between 2006 and 2016, after the previous 2005 WHO classification there were 159 (79.5%) OTs, being odontogenic keratocystic tumor (KCOT) the most frequent (68; 42.76%), followed by odontoma (39; 24.52%) and ameloblastoma (21; 13.20%). CONCLUSIONS: As of today, the most recent WHO classification to be followed brings KCOT back to the cyst category, which will impact on the prevalence and epidemiology of OTs; thus, this study was able to identify a considerable increase (287.80%) in the prevalence of OTs when the 2005 WHO classification was utilized. Despite being an important academic exercise, classifying odontogenic lesions and determining whether to place the odontogenic keratocyst in a cyst or tumor category is crucial to establish the correct diagnosis and treatment to follow, whether by oral medicine or oral surgery specialist, or by the general practitioner.
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Tumores Odontogênicos/classificação , Organização Mundial da Saúde , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Tumores Odontogênicos/diagnóstico , Tumores Odontogênicos/epidemiologia , Prevalência , Adulto JovemRESUMO
Abstract Objectives: This study approaches the history of reclassifications and redefinitions around the odontogenic keratocyst (OK), as proposed by the World Health Organization (WHO), and aims to understand the impact of those changes on the prevalence and epidemiology of odontogenic tumors (OTs). Methodology: Cases of OTs diagnosed in an Oral Pathology service between January 1996 and December 2016 were reviewed. Demographic data of patients such as age, gender and site of lesions were retrieved from their respective records. Results: Within the studied period, 7,805 microscopic reports were elaborated and 200 (2.56%) of these were diagnosed as OTs. Out of these 200, between 1996 and 2005, prior to the 2005 WHO classification, there were 41 (20.5%) OTs cases, being odontoma the most frequent (23; 56.09%), followed by ameloblastoma (8; 19.51%) and myxoma (03; 7.31%). Between 2006 and 2016, after the previous 2005 WHO classification there were 159 (79.5%) OTs, being odontogenic keratocystic tumor (KCOT) the most frequent (68; 42.76%), followed by odontoma (39; 24.52%) and ameloblastoma (21; 13.20%). Conclusions: As of today, the most recent WHO classification to be followed brings KCOT back to the cyst category, which will impact on the prevalence and epidemiology of OTs; thus, this study was able to identify a considerable increase (287.80%) in the prevalence of OTs when the 2005 WHO classification was utilized. Despite being an important academic exercise, classifying odontogenic lesions and determining whether to place the odontogenic keratocyst in a cyst or tumor category is crucial to establish the correct diagnosis and treatment to follow, whether by oral medicine or oral surgery specialist, or by the general practitioner.
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Organização Mundial da Saúde , Tumores Odontogênicos/classificação , Brasil/epidemiologia , Tumores Odontogênicos/diagnóstico , Tumores Odontogênicos/epidemiologia , PrevalênciaRESUMO
BACKGROUND: Odontomas are the most frequent odontogenic tumors in the oral cavity and can result in failure of eruption of permanent teeth or be associated with impacted teeth. MATERIAL AND METHODS: The present study evaluated the prevalence of complex and compound odontomas in non-syndromic patients prior to the onset of orthodontic treatment. Panoramic radiographs of 4,267 non-syndromic patients were evaluated; 22 cases were included being 54.5% complex and 45.4% compound odontomas. RESULTS: The sample was composed predominantly by White males with mean age of 14.5 years. Complex odontomas were commonly found in the maxilla (83.3%) while compound type was mostly located on mandible (60%), presenting a significant association (P=0.027). Moreover, odontomas were significantly associated with impacted teeth (P<0.0001). The most frequently odontoma-associated impacted teeth were lower canines, followed by upper central incisors and upper canines, while impacted teeth with no odontoma were predominantly upper canines, lower second premolars and upper second premolars. Compound and complex odontomas showed mean size of 10.5 and 7.25 mm, respectively, presenting significant association between lesion size and odontoma type (P=0.021). CONCLUSIONS: Odontomas affected mainly White male patients with mean age of 14.5 years, being the complex type commonly found in the maxilla and the compound type mostly located on mandible. Furthermore, odontomas were significantly associated with impacted teeth, affecting mainly lower canines. Early diagnosis and correct treatment are essential to avoid any complications, such as prolonged retention of primary teeth and delayed eruption of permanent teeth. Key words:Odontoma, odontogenic tumors, dental anomalies.
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BACKGROUND: Bell's palsy represents a peripheral unilateral facial nerve paralysis, being an acute, idiopathic disorder, which can affect children and adolescents. Some therapeutic approaches have been proposed including facial exercises, biofeedback, photobiomodulation, electrotherapy, massage, and thermotherapy. The present report documents a rare case of Bell's palsy in an adolescent successfully treated with a new protocol of photobiomodulation, consisting of a short-term treatment. CASE REPORT: A 13-year-old girl presented absence of facial movement on the right side when smiling, inability to close the right eye and to raise the right eyebrow, intense painful symptoms on the right side of the face, difficult in chewing and talking, and sialorrhea. She was diagnosed with an idiopathic facial paralysis or Bell's palsy associated with right masseter myalgia, and treated with three sessions of photobiomodulation using infrared laser, 100 mW output power, 100 J/cm2 of energy density, 28 seconds per point, applied at the origin and insertion of the right superficial masseter muscle. The patient presented complete regression of paralysis, improvement of speech and chewing, and absence of muscular pain. CONCLUSION: Photobiomodulation was effective to treat Bell's palsy in a pediatric patient, being a true noninvasive approach and with no side effects, although there is still no established definitive protocol.
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Paralisia de Bell/terapia , Terapia com Luz de Baixa Intensidade/métodos , Adolescente , Paralisia de Bell/diagnóstico , Paralisia de Bell/diagnóstico por imagem , Paralisia de Bell/fisiopatologia , Feminino , Humanos , Raios Infravermelhos , Terapia a Laser , Terapia com Luz de Baixa Intensidade/instrumentação , Músculo Masseter , Movimento , Dor , Sialorreia , Resultado do TratamentoRESUMO
BACKGROUND: Paracoccidioidomycosis is a neglected tropical fungal infection with great predilection for adult men, indicating the participation of female hormone estrogen in preventing paracoccidioidomycosis development in women. Estrogen has an immunologic effect leading to polarization toward the Th2 immune response, which favors the disease evolution. OBJECTIVES: To evaluate estrogen and progesterone receptors in oral paracoccidioidomycosis lesions and to verify any association with tissue fungi counting in women and men. METHODS: Thirty-two cases of chronic oral paracoccidioidomycosis were included. Immunohistochemical analyses for anti-estrogen receptor-α, anti-progesterone receptor and anti-Paracoccidioides brasiliensis antibodies were performed. The differences between women and men and the relations among the immunomarkers for each gender were also evaluated. RESULTS: A significant positive correlation was observed between estrogen receptor-α and the amount of fungi in women. In addition, estrogen receptor-α was mildly expressed in the inflammatory cells of female patients, while progesterone receptor was expressed in both genders, with similar expression between women and men. Moreover, fungi counting revealed no differences between genders. CONCLUSIONS: Estrogen receptor-α was expressed only in women and showed a positive correlation with the amount of fungi in oral paracoccidioidomycosis, while progesterone receptor was observed in both genders and exhibited no correlation with estrogen receptor-α or fungi counting.
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Contagem de Colônia Microbiana , Receptor alfa de Estrogênio/análise , Paracoccidioides/isolamento & purificação , Paracoccidioidomicose/patologia , Adulto , Idoso , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Doenças da Boca/microbiologia , Doenças da Boca/patologia , Paracoccidioidomicose/microbiologia , Receptores de Progesterona/análise , Estudos Retrospectivos , Adulto JovemRESUMO
OBJECTIVE: To report a case of primary diffuse large B-cell lymphoma (DLBCL) of the maxillary sinus in an 82-year-old Caucasian woman. BACKGROUND: Diffuse large B-cell lymphoma of the maxillary sinus has non-specific signs and symptoms that may be confused with benign inflammatory conditions and upper respiratory infections. METHODS: An incisional biopsy was performed. CD20+ /CD3- /Ki-67: 95% cells were observed. CONCLUSION: A good medical history, clinical and imaging evaluations and immunohistochemical reactions are crucial to establish a correct and early diagnosis of DLBCL.
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Linfoma Difuso de Grandes Células B/diagnóstico , Neoplasias do Seio Maxilar/diagnóstico , Idoso de 80 Anos ou mais , Biópsia , Erros de Diagnóstico , Evolução Fatal , Feminino , Humanos , Linfoma Difuso de Grandes Células B/patologia , Seio Maxilar/patologia , Neoplasias do Seio Maxilar/patologia , Sinusite Maxilar/diagnósticoRESUMO
OBJECTIVES: This manuscript presents a systematic review of the clinicopathologic features and outcomes of conservative surgical treatments for nonsyndromic odontogenic keratocysts (OKCs) and assesses the recurrence rates through a meta-analysis, in order to indicate the best conservative approach. MATERIALS AND METHODS: PRISMA guidelines for systematic reviews were followed, and the protocol was registered (PROSPERO/Nr.: CRD42017060964). An electronic search was conducted using the PubMed/MEDLINE, Science Direct, Web of Science, Scopus, and The Cochrane Library databases, and relevant articles were selected based on specific inclusion criteria. The PICOS criteria (Population: nonsyndromic patients of any age with OKC, with histopathological diagnosis and minimum follow-up of 12 months; Intervention and Comparison: marsupialization or decompression with or without enucleation, and enucleation alone; Outcome: recurrence rates; Study design: clinical trials, controlled trials, retrospective studies, and case series containing at least 10 cases of OKC) were employed. A pooled odds ratio (OR) was computed through the Mantel-Haenszel test (M-H) with 95% confidence intervals (CI). RESULTS: One thousand nine hundred OKCs were analyzed; the age of the patients varied from 6 to 90 years (mean of 38.6 years); a male to female ratio of 1.57:1 was observed; 74.5% of the lesions occurred in the mandible; 75.7% of OKCs were unilocular; the association with impacted tooth was reported for 344 OKCs; and the mean follow-up was 60.1 months. One thousand three hundred thirty-one OKCs were treated by conservative surgical treatments, and 261 cases (19.8%) presented recurrence. Nonetheless, minor total recurrence rates were observed after decompression followed by enucleation (11.9%) and marsupialization followed by enucleation (17.8%). In contrast, enucleation alone showed a total recurrence rate of 20.8%. CONCLUSION: The results suggest a significant superiority of success for OKC treatments that use decompression followed by enucleation, instead of an initial enucleation (M-H, OR = 0.48; 95% CI = 0.22 to 1.08; P = 0.0163). CLINICAL RELEVANCE: No consensus exists concerning the best management for OKCs. More aggressive treatments (ostectomy, resection, or use of adjunctive therapies like Carnoy's solution and liquid nitrogen) can have many disadvantages and risks. Therefore, it is necessary to identify the conservative approach for OKCs that results in a lower recurrence rate.
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Tratamento Conservador , Cistos Odontogênicos/cirurgia , Humanos , Cistos Odontogênicos/patologia , RecidivaRESUMO
The purpose of this study was to assess, for the very first time, the effects of photodynamic therapy (PDT) on Schistosoma mansoni in vitro by measuring reactive oxygen species (ROS) generation throughout the treatment, as well as the behavior of the parasites (mating, motility and contraction/shortening), and damage to their tegument and excretory systems. The parasites were divided into 4 groups: control, photosensitizer, laser and PDT. Light irradiation was delivered with an InGaAlP low-level laser device operating at 660nm, with 40mW and 100J/cm2. For PDT, different toluidine blue dye (TBO) concentrations and times of exposure were utilized. Interestingly, TBO-mediated PDT was able to kill S. mansoni (P<0.001) due to the significant amount of ROS released that inflicted damages in the tegument and excretory system, as well as contraction and cessation of motility. In addition, males of S. mansoni were shown to be more sensitive to PDT if compared to their corresponding females when the optimal TBO concentration of 31.2µL was considered (P=0.0126). PDT presents two major advantages: not inducing microbial resistance and also lacking adverse effects. Therefore, PDT may become a promising therapeutic alternative for schistosomiasis in the near future, especially for cases of allergy and resistance to praziquantel.
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Schistosoma mansoni/efeitos dos fármacos , Cloreto de Tolônio/farmacologia , Animais , Feminino , Lasers , Masculino , Microscopia , Fármacos Fotossensibilizantes/química , Fármacos Fotossensibilizantes/farmacologia , Espécies Reativas de Oxigênio/metabolismo , Schistosoma mansoni/metabolismo , Cloreto de Tolônio/químicaRESUMO
Follicular lymphoid hyperplasia is a very rare though benign reactive process of an unknown pathogenesis that may resemble a follicular lymphoma, clinically and histologically. Oral reactive follicular hyperplasia (RFH) has been described on the hard or soft palate and at the base of the tongue. We describe here the first case of RFH presenting as an aggressive tumor on the right posterior side of the maxilla in a 24-year-old male patient. The lesion had a clinical evolution of 18 months and was noticed after the surgical extraction of the right third molar, although we cannot assume a cause-effect relation with that surgical event whatsoever. His medical history was unremarkable. Following an incisional biopsy, histological examination revealed lymphoid follicles comprised by germinal centers surrounded by well-defined mantle zones. The germinal centers were positive for Bcl-6, CD10, CD20, CD21, CD23, CD79a, and Ki-67, while negative for Bcl-2, CD2, CD3, CD5, and CD138. The mantle and interfollicular zones were positive for Bcl-2, CD2, CD3, CD5, CD20, and CD138. Both areas were diffusively positive for kappa and lambda, showing polyclonality. The patient underwent a vigorous curettage of the lesion with no reoccurrences at 36 months of follow-up. This case report demonstrates that morphologic and immunohistochemical analyses are crucial to differentiate RFH from follicular lymphoma, leading to proper management.
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Hiperplasia do Linfonodo Gigante/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Doenças Maxilares/diagnóstico por imagem , Radiografia Panorâmica , Adulto , Biópsia , Hiperplasia do Linfonodo Gigante/patologia , Hiperplasia do Linfonodo Gigante/cirurgia , Curetagem , Diagnóstico Diferencial , Seguimentos , Humanos , Imuno-Histoquímica , Masculino , Doenças Maxilares/patologia , Doenças Maxilares/cirurgia , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/patologia , Seio Maxilar/cirurgia , Dente Serotino/cirurgia , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/patologia , Complicações Pós-Operatórias/cirurgia , Extração DentáriaRESUMO
Ameloblastic fibro-odontoma (AFO) is a mixed odontogenic tumor that presents epithelial and mesenchymal components. Ameloblastic fibro-odontoma is generally diagnosed between the first and second decades of life and normally shows a slow clinical growth in the posterior portion of the maxilla or mandible, being mostly associated with 1 or more impacted teeth. Radiographic features of AFO show a radiolucent well-defined, uni, or multilocular defect due to containing variable amounts of calcified material. The enucleation of the tumor is the usual conduct and should be followed up for a long period of time. Here, the authors report the case of 17-year-old male patient who presented an extensive AFO on the right posterior side of the mandible. The panoramic radiograph and the tomographic examination revealed a multilocular radiolucent lesion with impacted teeth. Histological examination revealed connective tissue resembling the dental papilla along with epithelial strands or islands, as well as dental hard tissue such enamel and dentin. Enucleation and curettage was performed and led to good outcome. There was no recurrence after an 8-year follow-up, and oral rehabilitation was performed with dental implants.
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Mandíbula/diagnóstico por imagem , Neoplasias Mandibulares/diagnóstico , Odontoma/diagnóstico , Adolescente , Biópsia , Humanos , Masculino , Mandíbula/cirurgia , Neoplasias Mandibulares/cirurgia , Osteotomia Mandibular/métodos , Odontoma/cirurgia , Radiografia Panorâmica , Tomografia Computadorizada por Raios XRESUMO
Low-level laser therapy (LLLT) is known to enhance mitochondrial electron transfer and ATP production; thus, this study asked whether LLLT could stimulate the oxidative burst in human neutrophils (PMN) and improve their ability to kill microorganisms. Blood from healthy human subjects was collected and PMN were isolated from the samples. PMN were treated in vitro with 660 nm or 780 nm CW laser light at 40 mW power and increasing energies up to 19.2 J and were subsequently incubated with Candida albicans cells. Generation of hydroxyl radicals, hypochlorite anions and superoxide anions by PMN were checked using fluorescent probes and chemiluminescence assays; a microbicidal activity assay against C. albicans was also performed. LLLT excited PMN to a higher functional profile, which was translated as superior production of reactive oxygen species (ROS) and increased fungicidal capacity. The most efficacious energy was 19.2 J and, interestingly, the 660 nm light was even more efficacious than 780 nm at increasing the respiratory burst of PMN and the fungicidal capacity. Human neutrophils (PMN) were stimulated in vitro with 660 nm or 780 nm CW laser light at 40 mW of power and a total energy of 19.2 J. Low-level laser therapy (LLLT) excited PMN to a higher functional profile, which was translated as a superior production of reactive oxygen species (ROS) such as hydroxyl radicals (HO⢠) and hypochlorite anions (ClO- ) (Figure) and increased fungicidal capacity against Candida albicans cells.
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Candida albicans , Terapia com Luz de Baixa Intensidade , Neutrófilos/efeitos da radiação , Explosão Respiratória/efeitos da radiação , Humanos , Neutrófilos/imunologia , Espécies Reativas de Oxigênio/metabolismoRESUMO
Multinucleated giant cells (MGC) are considered to be a hallmark of granulomatous inflammation; thus, they may play an essential role in the host response against pathogens, particularly Paracoccidioides brasiliensis. This study characterizes the MGC found in oral paracoccidioidomycosis and assesses the correlation of MGC with the amount of fungi within oral tissues. Twenty-six cases were included. They were classified as loose or dense granulomas, and the total MGC, including foreign-body and Langhans giant cells, besides the total and intracellular fungi, were taken into consideration. CD163 immunoexpression was performed, and CD163+ multinucleated giant cells were also quantified. Dense granulomas revealed more foreign-body type and total giant cells than loose granulomas (P < 0.05). Total giant cells showed a positive linear correlation with the CD163+ cells (P = 0.003; r = 0.56) and intracellular fungi quantification (P = 0.045; r = 0.40). Oral paracoccidioidomycosis lesions contain MGC that mainly belong to a CD163+ phenotype, also showing both Langhans and foreign-body arrangements. Additionally, the higher the presence of MGC, the higher the amount of phagocytized fungi.
Assuntos
Antígenos CD/análise , Antígenos de Diferenciação Mielomonocítica/análise , Células Gigantes/química , Granuloma/patologia , Doenças da Boca/patologia , Paracoccidioidomicose/patologia , Receptores de Superfície Celular/análise , Contagem de Colônia Microbiana , Citosol/microbiologia , Histocitoquímica , Humanos , Imuno-Histoquímica , Microscopia , Paracoccidioides/isolamento & purificação , FagocitoseRESUMO
Tuberous sclerosis is an extremely variable disease that can affect virtually any organ in the body. The most common findings are cutaneous manifestations, that are critical features in helping to establish diagnosis. We present a case of young man with diagnosis of tuberous sclerosis presenting multiple shagreen patches around the trunk, in the neck and genital region; large plaques with uneven surfaces on the right side of the lower back; and multiple papular lesions in his face, particularly around the nasolabial region, eyebrows and forehead. Considering that tuberous sclerosis is a disease with a highly variable clinical presentation, thus dentists and doctors should be aware of the different manifestations that may be found.
Assuntos
Angiofibroma/patologia , Neoplasias Cutâneas/patologia , Esclerose Tuberosa/complicações , Esclerose Tuberosa/patologia , Angiofibroma/etiologia , Face/patologia , Humanos , Masculino , Neoplasias Cutâneas/etiologia , Adulto JovemRESUMO
Paracoccidioidomycosis (PCM) is a neglected fungal disease that elicits an important granulomatous inflammatory reaction which aims to isolate the fungi and resolve the infection; besides the innate cellular response, the patients' sera may contain different levels of antibodies directed against PCM's pathogenic agent: Paracoccidioides brasiliensis (Pb). The aim of the study was to assess the distinct serum antibody levels of 19 chronic PCM patients and to associate these levels to the granulomatous inflammatory response and presence of fungi in oral lesions caused by Pb. The presence of Pb was detected and counted within oral tissues using immunohistochemistry; antibody levels were classified as negative, low-grade, moderate or high-grade groups. The Kruskal-Wallis and Dunn's test were used to verify possible associations among the groups. Interestingly, lower antibody titres were associated with lesser numbers of Pb, which favours the cellular response over the humoral response to fight PCM. On the other hand, negative serological results were linked to a higher presence of Pb in the tissues, indicating that a deficient humoral response supports the fungal proliferation. The number of Pb was conveniently associated with the level of serum antibodies, showing that the humoral immune response is required, however, not solely responsible to restrain the dissemination of Pb.
Assuntos
Anticorpos Antifúngicos/sangue , Contagem de Colônia Microbiana , Boca/microbiologia , Paracoccidioides/isolamento & purificação , Paracoccidioidomicose/imunologia , Paracoccidioidomicose/microbiologia , Adulto , Idoso , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Boca/patologia , Paracoccidioidomicose/tratamento farmacológico , Soro/químicaRESUMO
Paracoccidioidomycosis (PCM) is a systemic fungal infection, endemic in Brazil, that leads to severe morbidity and even mortality if not correctly treated. Patients may respond differently to PCM depending on the pattern of the acquired immune response developed. The onset of protective immune response is notably mediated by neutrophils (PMN) that play an important role through directly killing the fungi and also by interacting with other cell types to modulate the acquired protective immune response that may follow. In that way, this study aimed to present and compare different experimental models of PCM (intraperitoneal and subcutaneous) regarding PMN production and maturation inside femoral bone marrow and also PMN infiltration in peritoneal and subcutaneous exudates of resistant and susceptible mice. We also assessed the fungal colony forming units and the levels of soluble inflammatory mediators (LTB4, KC, IFN-γ, GM-CSF, and IL-10) inside subcutaneous air-pouches to compare the efficiency of the PMN present at this site in relation to the two main neutrophil functions: initial lysis of the invading pathogen and modulation of the acquired immune response. P. brasiliensis inoculated intraperitoneally was able to disseminate to the bone marrow of susceptible mice, causing a more marked alteration of PMN production and maturation than that observed after resistant mice infection by the same route. Subcutaneous air-pouch inoculation of P. brasiliensis elicited a controlled and limited infection that produced a PMN-rich exudate, thus favoring the study of the interaction between the fungus and the neutrophils. Susceptible mice produced higher numbers of PMN; however, these cells were less effective in killing the fungi. Inflammatory cytokines were more pronounced in resistant mice, which supports their PCM raised resistance.