Publications by authors named "Roberta Barroso Cavalcante"

30 Publications

  • Page 1 of 1

Sialolipomas of minor salivary glands: A multi-institutional study and literature review.

J Oral Pathol Med 2021 Feb 12;50(2):210-219. Epub 2021 Jan 12.

Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil.

Background: Sialolipoma is a rare histological variant of lipoma commonly misdiagnosed and composed of a proliferation of mature adipocytes with secondary entrapment of normal salivary gland tissue. The purpose of the present study is to report the clinicopathologic and immunohistochemical features of 10 new cases of sialolipomas in conjunction with a review of the literature.

Methods: A retrospective descriptive cross-sectional study was performed. A total of 54,190 biopsy records of oral and maxillofacial lesions from four oral and maxillofacial pathology services in Brazil were analysed. All cases of lipomas were reviewed, and clinical, demographic and histopathological data were collected of all cases compatible with sialolipomas. In addition, immunohistochemistry stains (AE1/AE3, CK7, 34βE12, S-100, HHF35, α-SMA and Ki-67) and a literature review based on a search of three electronic databases (PubMed, Web of Science and Scopus) were performed.

Results: Among all lipomas reviewed, there were 10 cases of sialolipomas. The series comprised of 7 females (70.0%) and 3 males (30.0%), with a mean age of 46.1 ± 21.5 years (range: 11-71 years) and a 2.3:1 female-to-male ratio. The lower lip (n = 3, 30.0%) and tongue (n = 2, 20.0%) were the most common locations, presenting clinically as a nodule of slow growth and normal colour. Conservative surgical excision was the treatment in all cases. No recurrence was observed.

Conclusion: Sialolipomas are a rare histological variant of lipoma, affecting the salivary glands, mainly in the parotid gland and palate of female adults. Pathologists must recognise sialolipomas to avoid misdiagnoses with other lipomatous tumours that can affect salivary glands.
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http://dx.doi.org/10.1111/jop.13124DOI Listing
February 2021

CD133 Role in Oral Carcinogenesis.

Asian Pac J Cancer Prev 2020 Sep 1;21(9):2501-2506. Epub 2020 Sep 1.

Departament of Morphology, School of Medicine, Federal University of Ceará, Fortaleza, Brazil.

Objective: to investigate CD133 immunoexpression, cancer stem cells marker, in oral epithelial dysplasias (OEDs) and oral squamous cells carcinomas (OSCCs) and understandits possible involvement in the malignant transformation process of these lesions and to better elucidate their biological behavior.

Material And Methods: Tissue samples of 15 cases of OSCCs and 15 OEDs were subjected to CD133 antibody immunohistochemistry reactions. The analysis used quantitative parameters (number of immunostained cells regardless of immunostaining sublocations).

Results: All samples of OSCCs and OEDs showed positive immunostaining, with no significant difference between these groups (p = 0.283). We did not observe statistical difference between the degree of dysplasia and the amount of CD133+ cells (p = 0.899). CD133 immunoexpression showed no association with the OEDs and OSCCs sites. It was observed that nuclear and cytoplasmic immunostaining was more evident with the progression of the malignant process.

Conclusion: It is suggested that the CD133 cellular localization together with the histopathological criteria of OEDs classification can contribute to provide more concrete indications about the oral carcinogenesis process.
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http://dx.doi.org/10.31557/APJCP.2020.21.9.2501DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7779460PMC
September 2020

Immunoexpression of DNA base excision repair and nucleotide excision repair proteins in ameloblastomas, syndromic and non-syndromic odontogenic keratocysts and dentigerous cysts.

Arch Oral Biol 2020 Feb 3;110:104627. Epub 2019 Dec 3.

Department of Dentistry, Federal University of Rio Grande do Norte, Natal, RN, Brazil. Electronic address:

Objective: To evaluate the immunoexpression of DNA base excision repair (BER) [apurinic/apyrimidinic endonuclease 1 (APE-1), X-ray repair cross complementing 1 (XRCC-1)] and nucleotide excision repair (NER) [xeroderma pigmentosum complementation group (XPF)] proteins in benign epithelial odontogenic lesions with different biological behaviors.

Design: Thirty solid ameloblastomas, 30 non-syndromic odontogenic keratocysts (NSOKCs), 29 syndromic odontogenic keratocysts (SKOCs), 30 dentigerous cysts (DCs) and 20 dental follicles (DFs) were evaluated quantitatively for APE-1, XRCC-1 and XPF through immunohistochemistry.

Results: Nuclear expression of APE-1 was significantly higher in NSOKCs, SOKCs, and ameloblastomas in comparison to DCs (p < 0.001). Nuclear expression of XRCC-1 was higher in NSOKCs and SOKCs than in DCs (p < 0.05). At the nuclear level, XPF expression was higher in NSOKCs and SOKCs than in DCs and ameloblastomas (p < 0.05). A statistically significant higher expression of APE-1 (nuclear), XRCC-1 (nuclear), and XPF (nuclear and cytoplasmic) was found in all odontogenic lesion samples as compared to DFs (p < 0.05). For all lesions, there was a positive correlation between nuclear expression of APE-1 and XRCC-1 or XPF (p < 0.05).

Conclusions: Our results suggest a potential involvement of APE-1, XRCC-1 and XPF proteins in the pathogenesis of benign epithelial odontogenic lesions, especially in those with more aggressive biological behavior, such as ameloblastomas, NSOKCs, and SOKCs. We also showed that the expression of APE-1 was positively correlated with the nuclear expression of XRCC-1 and XPF, which may suggest an interaction between the BER and NER pathways in all odontogenic lesions studied herein.
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http://dx.doi.org/10.1016/j.archoralbio.2019.104627DOI Listing
February 2020

A retrospective study of an alternative technique for implant repositioning in the maxillary esthetic region.

Clin Implant Dent Relat Res 2018 Dec 19;20(6):915-922. Epub 2018 Sep 19.

Department of Oral and Maxillofacil Surgery, School of Dentistry, Christus University Center (Centro Universitário Christus), Fortaleza, Ceará, Brazil.

Background: Implant-bone block segment repositioning may be an option of treatment for patients with vertical alveolar bone atrophy.

Purpose: To assess implant-bone block movement, gingival outcome and the subjective appreciation of patients after an alternative treatment of an implant-bone block segment repositioning in the maxillary esthetic region.

Materials And Methods: Patients who underwent implant-bone block segment relocation in areas of vertical alveolar bone atrophy in the anterior esthetic region were assessed. The outcome measures were implant failure, complications after initial loading, vertical bone augmentation, papilla index, width of the keratinized mucosa, and patient satisfaction.

Results: Twenty-five implants in nine consecutive patients were included in this study. During the follow-up period, only one implant failed. Vertical bone augmentation ranged from 3.0 to 8.4 mm (mean 4.9 mm). A significant improvement (P < .001) in the papilla index was observed, improving the esthetic outcome. Six patients (66.6%) had more than 2 mm of keratinized mucosa and all of the patients were satisfied with the treatment.

Conclusions: The esthetics and functional gingival outcome of oral rehabilitation in areas with vertical alveolar bone atrophy can be successfully improved with the presented technique, which had a high overall implant survival rate within a short period.
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http://dx.doi.org/10.1111/cid.12663DOI Listing
December 2018

Immunohistochemical Evaluation of GLUT-3 and GLUT-4 in Oral Epithelial Dysplasia and Oral Squamous Cell Carcinoma

Asian Pac J Cancer Prev 2018 Jul 27;19(7):1779-1783. Epub 2018 Jul 27.

Department of Dental Clinic, Division of Oral Pathology, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceara, Fortaleza, Brazil. Email:

Objectives: To evaluate immunohistochemically the expression of GLUT-3 and GLUT-4 in oral epithelial dysplasia (OED) and the oral squamous cell carcinoma (OSCC) and assess possible involvement in the malignant transformation of oral lesions. Methods: Tissue samples of 15 cases of OSCC and 15 of OED were subjected to immunohistochemistry with anti-GLUT-3 and anti-GLUT-4 antibodies. Five fields of each case were analyzed, to provide percentages of positive cells at 400X magnification. Result: GLUT-3 and GLUT-4 were positive in 100% of the analyzed samples, the percentage immunolabeling for GLUT-3 ranging from 19% to 73% in the OED group and 10% to 89% in the OSCC group. Positive immunolabeling for GLUT-4 ranged from 15.2% to 79.9% in the OSCC group and 27.1% to 92.6% in the OED group. Statistical analysis with the Mann-Whitney test revealed that there was a higher expression of GLUT-4 in the OED group than in the OSCC group (p=0.04) without any significant difference in the GLUT-3 expression (p=0.852). Conclusion: GLUT-4 expression may indicate some role in oncogenic mechanisms which can determine a malignant phenotype. Thus, it is suggested that further studies on the role of GLUT-3 in oral carcinogenesis be conducted.
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http://dx.doi.org/10.22034/APJCP.2018.19.7.1779DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165633PMC
July 2018

Immunoexpression of calcitonin and glucocorticoid receptors in central giant cell lesions of the jaws.

J Oral Pathol Med 2018 Oct 12;47(9):907-913. Epub 2018 Aug 12.

Postgraduate Program in Oral Pathology, Dentistry Department, Federal University of Rio Grande do Norte, Natal, RN, Brazil.

Background: This study analyzed the immunoexpression of calcitonin receptor (CTR) and glucocorticoid receptor (GR) in central giant cell lesions (CGCLs) and verified potential associations with patient's response to clinical treatment with intralesional injection of triamcinolone.

Materials And Methods: Fifty-four cases of CGCLs, including 22 non-aggressive, and 32 aggressive, were investigated by immunohistochemistry.

Results: Surgery was the therapeutic choice for 53.1% of the aggressive CGCLs, and 46.9% were submitted to the conservative treatment with intralesional triamcinolone injections. Among patients submitted to conservative treatment, 60% (n = 9) showed favorable response. CTR expression was observed in 68.51%, and GR in 94.44% of the total sample. There were no differences in the expression of CTR, neither GR in mononucleated stromal cells (MSCs) or multinucleated giant cells (MGCs), in relation to aggressiveness, treatment performed for and the response to conservative treatment. Both markers showed a positive correlation between their expression in MSCs and MGCs in the total sample (P < 0.0001). CTR expression on MSCs showed a positive correlation with MGCs in the aggressive and non-aggressive groups (P < 0.0001).

Conclusions: Calcitonin receptor and GR expression were diffuse and similar in non-aggressive and aggressive cases, and it did not influence the response to clinical treatment with triamcinolone in the sample studied.
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http://dx.doi.org/10.1111/jop.12766DOI Listing
October 2018

Expansive renal osteitis fibrosa: a case report.

Oral Maxillofac Surg 2018 Sep 4;22(3):323-327. Epub 2018 May 4.

Department of Oral Surgery, Discipline of Oral and Maxillofacial Surgery and Stomatology, Federal University of Ceará School of Dentistry, Fortaleza, Ceará, Brazil.

Hyperparathyroidism (HPT) is an endocrine metabolic disorder characterized by increased secretion of parathyroid hormone. Untreated secondary HPT leads to renal osteodystrophy (ROD). Facial skeletal abnormalities in patients with ROD are rare. The purpose of this paper is to report a conservative surgical approach of exuberant osteitis fibrosa lesions in patient with chronic kidney disease. A 24-year-old female was referred to maxillofacial surgery department with giants ROD affecting palate, maxilla, and mandible, resulting in esthetic and functional impairment. The pathogeneses and multidisciplinary management of ROD are discussed with a brief literature review. Eight years after the conservative treatment of exuberant jaw lesions, no noticeable bone changes were observed in the patient. A multidisciplinary therapy is essential for correct diagnosis of ROD and optimal multimodality treatment. The conservative management was an efficient alternative for the success of the case reported.
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http://dx.doi.org/10.1007/s10006-018-0697-7DOI Listing
September 2018

Assessment of CTNNB1 gene mutations and β-catenin immunoexpression in salivary gland pleomorphic adenomas and adenoid cystic carcinomas.

Virchows Arch 2018 Jun 26;472(6):999-1005. Epub 2018 Mar 26.

Department of Oral Pathology, Federal University of Rio Grande do Norte, Natal, RN, Brazil.

β-Catenin exerts multiple functions in several neoplasms, playing a major role in cell signaling and tumor progression. This study analyzed possible CTNNB1 mutations in salivary gland pleomorphic adenomas (PAs) and adenoid cystic carcinomas (ACCs), and determined possible differences in β-catenin immunoexpression in relation to these mutations, as well as histopathological aspects of these tumors. Twenty-four PAs (15 cell-rich and 9 cell-poor tumors) and 24 ACCs (10 tubular, 8 cribriform, and 6 solid tumors) were selected for the analysis of β-catenin distribution and cellular localization. Furthermore, β-catenin expression was evaluated using the H-score scoring system. Mutations in CTNNB1 exon 3 were investigated by the single-strand conformational polymorphism test. Diffuse β-catenin expression was more frequently observed in ACCs compared to PAs (P = 0.008). No significant difference in β-catenin cellular localization was observed between these tumors (P = 0.098). Comparisons between PA and ACC cases revealed a higher median H-score in the latter (P = 0.036). Cell-rich PAs exhibited a trend for higher H-score than cell-poor tumors (P = 0.060), whereas lower H-scores were observed in cribriform ACCs when compared to tubular and solid ACCs (P = 0.042). Mutations in CTNNB1 were observed in 6 PAs and 7 ACCs, with no significant difference in H-scores for β-catenin according to mutation status (P = 0.135). β-Catenin is important in the pathogenesis of salivary gland PAs and ACCs. In addition, CTNNB1 exon 3 mutations do not seem to significantly influence β-catenin cytoplasmic/membranous expression or nuclear translocation in these tumors.
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http://dx.doi.org/10.1007/s00428-018-2335-zDOI Listing
June 2018

Analysis of GLUT-1, GLUT-3, and angiogenic index in syndromic and non-syndromic keratocystic odontogenic tumors.

Braz Oral Res 2017 Apr 27;31:e34. Epub 2017 Apr 27.

Universidade Estadual da Paraíba - UEPB, Dental School, Department of Dentistry, Campina Grande, PB, Brazil.

The aim of this study was to evaluate the immunoexpression of glucose transporters 1 (GLUT-1) and 3 (GLUT-3) in keratocystic odontogenic tumors associated with Gorlin syndrome (SKOTs) and non-syndromic keratocystic odontogenic tumors (NSKOTs), and to establish correlations with the angiogenic index. Seventeen primary NSKOTs, seven recurrent NSKOTs, and 17 SKOTs were selected for the study. The percentage of immunopositive cells for GLUT-1 and GLUT-3 in the epithelial component of the tumors was assessed. The angiogenic index was determined by microvessel count. The results were analyzed statistically using the nonparametric Kruskal-Wallis test and Spearman's correlation test. High epithelial immunoexpression of GLUT-1 was observed in most tumors (p = 0.360). There was a higher frequency of negative cases for GLUT-3 in all groups. The few GLUT-3-positive tumors exhibited low expression of this protein in epithelial cells. No significant difference in the angiogenic index was observed between groups (p = 0.778). GLUT-1 expression did not correlate significantly with the angiogenic index (p > 0.05). The results suggest that the more aggressive biological behavior of SKOTs when compared to NSKOTs may not be related to GLUT-1 or GLUT-3 expression. GLUT-1 may play an important role in glucose uptake by epithelial cells of KOTs and this process is unlikely related to the angiogenic index. GLUT-1 could be a potential target for future development of therapeutic strategies for KOTs.
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http://dx.doi.org/10.1590/1807-3107BOR-2017.vol31.0034DOI Listing
April 2017

Surgical Treatment, Oral Rehabilitation, and Orthognathic Surgery After Failure of Pharmacologic Treatment of Central Giant Cell Lesion: A Case Report.

J Oral Maxillofac Surg 2016 Dec 31;74(12):2567.e1-2567.e10. Epub 2016 Aug 31.

Associate Professor, São Leopoldo Mandic, Fortaleza, Brazil.

Although pharmacologic treatments for central giant cell lesions have gained much emphasis, these treatment modalities do not always have successful outcomes, and surgical treatment may be necessary. The purpose of the present study was to report a case of aggressive central giant cell lesion initially treated by nonsurgical methods without satisfactory results, necessitating segmental mandibular resection for definitive treatment and oral rehabilitation. A 20-year-old woman was diagnosed with an aggressive central giant cell lesion in the mandible. The patient was first treated with intralesional corticosteroid injections. Subsequently, the lesion increased in size. Therefore, a second pharmacologic treatment was proposed with salmon calcitonin nasal spray, but no signs of a treatment response were noted. Because of the lack of response, surgical excision was performed, and a mandibular reconstruction plate was installed. At 12 months after surgical resection, the patient underwent mandibular reconstruction with bone grafts. After 6 months, 7 dental implants were installed, and fixed prostheses were made. After installation of the prostheses, the patient experienced persistent mandibular laterognathism, and a mandibular orthognathic surgery was performed to correct the laterognathia. The follow-up examination 4 years after orthognathic surgery showed no signs of recurrence and good facial symmetry.
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http://dx.doi.org/10.1016/j.joms.2016.08.038DOI Listing
December 2016

Pleomorphic adenoma and adenoid cystic carcinoma of salivary glands: E-cadherin immunoexpression and analysis of the CDH1 -160C/A polymorphism.

Arch Oral Biol 2017 Jan 15;73:48-54. Epub 2016 Sep 15.

Department of Oral Pathology, Federal University of Rio Grande do Norte, Natal, RN, Brazil. Electronic address:

Objective: Despite their similar cellular origin, pleomorphic adenomas (PA) and adenoid cystic carcinomas (ACC) present distinct behaviors. This study aimed to analyze the immunoexpression of E-cadherin in PA and ACC of salivary glands, and to investigate differences in its expression in relation to E-cadherin gene (CDH1) -160C/A polymorphism.

Design: Twenty-four PA (15 cell-rich and 9 cell-poor tumors) and 24 ACC (10 tubular, 8 cribriform and 6 solid tumors) were selected for the analysis of pattern of distribution, and cellular localization of E-cadherin. In addition, E-cadherin expression was evaluated using the H-score scoring system. The CDH1 -160C/A polymorphism was investigated by PCR-RFLP.

Results: No significant differences in pattern of distribution (p=0.181) and cellular localization (p=0.192) of E-cadherin were observed between PA and ACC. Comparison of PA and ACC cases revealed a higher median H-score in the latter (p=0.036). Cell-rich PA presented a higher H-score than cell-poor tumors (p=0.013), whereas no significant differences in E-cadherin expression were observed between ACC subtypes (p=0.254). The heterozygous genotype of the CDH1 -160C/A polymorphism was detected in only one PA and one ACC. H-scores for tumors carrying the polymorphism were below the lower quartile of their respective groups.

Conclusions: The results suggest that E-cadherin expression in PA and ACC is mainly related to cellular composition (epithelial cells versus myoepithelial cells) and degree of differentiation of myoepithelial cells in these tumors. The CDH1 -160C/A polymorphism does not seem to significantly influence the expression of E-cadherin in PA and ACC of salivary glands.
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http://dx.doi.org/10.1016/j.archoralbio.2016.09.005DOI Listing
January 2017

Immunohistochemical Evaluation of Glucose Transporter Type 1 in Epithelial Dysplasia and Oral Squamous Cell Carcinoma.

Asian Pac J Cancer Prev 2016 ;17(1):147-51

Department of Oral Pathology, School of Dentistry, Federal University of Ceara - Campus Sobral, Sobral, Brazil E-mail :

Oral squamous cell carcinoma (OSCC) is the most common malignancy of the oral cavity and some of these have been documented in association or preceded by oral epithelial dysplasia (OED). Aggressive cancers with fast growth have demonstrated overexpression of some glucose transporters (GLUTs). Thus, the aim of this study was to analyze the immunohistochemical expression of the glucose transporter, GLUT-1, in OEDs and OSCCs, seeking to better elucidate the biological behavior of neoplasias. Fifteen cases were selected this research of both lesions. Five areas were analyzed from each case by counting the percentage of positive cells at 400x magnification. Immunoreactivity of GLUT-1 was observed in 100% of the samples ranging from 54.2% to 86.2% for the OSCC and 73.9% to 97.4% for the OED. Statistical test revealed that there was greater overexpression of GLUT-1 in OED than the OSCC (p=0.01). It is believed the high expression of GLUT-1 may reflect the involvement of GLUT-1 in early stages of oral carcinogenesis.
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http://dx.doi.org/10.7314/apjcp.2016.17.1.147DOI Listing
December 2016

Participation of hMLH1, p63, and MDM2 proteins in the pathogenesis of syndromic and nonsyndromic keratocystic odontogenic tumors.

Oral Surg Oral Med Oral Pathol Oral Radiol 2015 Jul 9;120(1):52-7. Epub 2015 Apr 9.

Postgraduate Program of Oral Pathology, Department of Oral Pathology, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil. Electronic address:

Objectives: To evaluate the expression of hMLH1, p63, and MDM2 in Gorlin syndrome-associated keratocystic odontogenic tumors (SKOTs) and nonsyndromic keratocystic odontogenic tumors (NSKOTs).

Study Design: Seventeen primary NSKOTs, 17 SKOTs, and 8 recurrent NSKOTs were analyzed by using immunohistochemistry.

Results: No significant differences in the hMLH1, p63, or MDM2 labeling indices were observed between groups (P = .398; P = .232; P = .426, respectively). Higher hMLH1 immunoexpression was found in the basal layer of primary NSKOTs. Most KOTs exhibited p63 immunoexpression in the upper layers of the epithelium. MDM2 immunoexpression was observed in the upper epithelial layers of SKOTs and recurrent NSKOTs.

Conclusion: It was not possible to correlate the immunoexpression of hMLH1, p63, and MDM2 in SKOTs and primary and recurrent NSKOTs, suggesting that these proteins exert independent effects on the development of these groups of tumors.
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http://dx.doi.org/10.1016/j.oooo.2015.03.011DOI Listing
July 2015

Solitary neurofibroma of the palate.

Braz J Otorhinolaryngol 2014 Apr;80(2):184-5

Universidade Federal do Rio Grande do Norte, Natal, RN, Brasil.

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http://dx.doi.org/10.5935/1808-8694.20140038DOI Listing
April 2014

A clinicoradiographic and pathological study of pericoronal follicles associated to mandibular third molars.

J Craniofac Surg 2014 May;25(3):e283-7

From the *Oral Radiology Department and †Stomatology Department, School of Dentistry, Federal University of Ceará; and ‡Oral Pathology Department, School of Dentistry, Fortaleza University, Fortaleza; and §Stomatology and Oral Pathology Department, School of Dentistry, Federal University of Ceará, Campus Sobral, Ceará, Brazil.

Background: Third molar surgery is considered the most frequently performed procedure in oral surgery. Although there are some indications for the removal of this tooth, such as the possibility of cystic degeneration or a tumor of the adjacent pericoronal follicle, there is no consensus in the literature about their prophylactic removal.

Objectives: The aims of this study were to investigate the pathological alterations related to mandibular third molar dental follicles and to perform a narrative literature review.

Methods: A prospective clinical, radiographic, and histopathologic study was conducted with pericoronal follicles of third molars. After histopathologic evaluation and establishment of diagnosis, 2 groups were defined: G1 (pericoronal tissues with pathological alterations based on histopathologic analysis) and G2 (pericoronal tissues without pathological alterations based on histopathologic analysis). In addition, a systematic review of the literature was performed.

Results: One hundred thirteen specimens were analyzed. G1 was the most prevalent (P = 0.0004). Lesions were found in patients between 20 and 25 years of age (P < 0.004). The most prevalent histological diagnosis was the paradental cyst (47.7%; P < 0.0001). The narrative literature review showed that the majority of cases were mainly dentigerous cysts (P < 0.05).

Conclusions: The mandibular third molars in young adults showed a direct relationship with age and a statistical propensity for the development of these cystic alterations, notably paradental cysts.
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http://dx.doi.org/10.1097/SCS.0000000000000712DOI Listing
May 2014

Central giant cell lesion of the jaws: study of CCND1 gene amplification and p16INK4a protein levels.

J Mol Histol 2013 Oct 16;44(5):527-34. Epub 2013 Mar 16.

Department of Dental Clinic, Discipline of Oral and Maxillofacial Surgery and Stomatology, Federal University of Ceara School of Dentistry, Fortaleza, Brazil.

Central giant cell lesions (CGCLs) are uncommon benign jaw lesions with uncertain etiology and a variable clinical behavior. In neoplasms, alterations in molecules involved in the G1/S checkpoint are frequently found. Loss of p16(INK4a) expression or overexpression of cyclin D1 may stimulate cell proliferation. The purpose of this study was to analyze CCND1 gene amplification and the expression of p16(INK4a) in CGCLs. Structural analysis of the CCND1 was performed using chromogenic in situ hybridization. Immmunohistochemistry was used to identify p16(INK4a) protein levels. Statistical analysis correlated the two biomarkers with clinical behavior and between each other. Twenty-four lesions were included, being 11 aggressive and 13 non-aggressive. Moderate/high-level CCND1 amplification was found in 12 lesions. Also, immunoreactivity for p16(INK4a) was present in 12 cases, mainly in mononuclear cells. There was a significantly higher level of p16(INK4a) expression in mononuclear cells of non-aggressive lesions and lesions with moderate/high-level CCND1 amplification in mononuclear cells. It could be speculated that some CGCLs may develop as a true benign neoplasm. The higher expression of p16(INK4a) in non-aggressive lesions and in cases with moderate/high-level CCND1 amplification may show that these molecules have a role in CGCLs.
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http://dx.doi.org/10.1007/s10735-013-9494-7DOI Listing
October 2013

Intralesional corticosteroid injections in the treatment of central giant cell lesions of the jaws: a meta-analytic study.

Med Oral Patol Oral Cir Bucal 2013 Mar 1;18(2):e226-32. Epub 2013 Mar 1.

Department of Pathology, Fortaleza University School of Medicine, Fortaleza, Brazil.

Objective: The aim of this study was to evaluate the response of treatment of central giant cell lesion to intralesional corticosteroid injections.

Study Design: Review of articles indexed in PubMed on the topic between the years 1988 and 2011, and development of a descriptive meta-analysis of the results.

Results: Sample of 41 patients primarily treated with intralesional corticosteroid injections was obtained, with a male female ratio of 1:0.95, being 23 aggressive and 18 non-aggressive central giant cell lesions. Triamcinolone acetonide and triamcinolone hexacetonide were the drugs used, and 78.0% cases were considered as good result, 14.6% were considered as moderate response and 7.3% were considered as negative result to treatment. Considering the aggressiveness, 88.9% of non-aggressive lesions presented a good response to treatment, in aggressive central giant cell lesions, 69.6% presented a good response to intralesional corticosteroid injections.

Conclusion: In view of the results analyzed, intralesional corticosteroid injections could be considered as first treatment option for central giant cell lesion.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3613330PMC
http://dx.doi.org/10.4317/medoral.18345DOI Listing
March 2013

Response of mice connective tissue to three different endodontic materials.

Microsc Res Tech 2013 Mar 19;76(3):311-5. Epub 2013 Jan 19.

Department of Clinical Dentistry, Federal University of Ceará (UFC) Fortaleza, CE, Brazil.

The aim of this study was to evaluate the biocompatibility of mineral trioxide aggregate (MTA) Bio and Portland cement (PC) and compare with those of ProRoot MTA. Polyethylene tubes were filled with materials and placed into dorsal subcutaneous connective tissue of Wistar albino rats. After 7, 30, and 60 days after the surgical procedure, the implants with the surrounding tissue were removed. Tissue samples were subjected to histological processing, and sections were stained with hematoxylin and eosin. Sections were evaluated for the intensity of inflammation, predominant cell type, presence of fibrous capsule and granulation tissue. Data were submitted to Kruskal-Wallis test at a significant level of P ≤ 0.05. No statistical differences were observed at any evaluated condition among tested materials (P > 0.05). Statistically significant differences were observed between mean inflammatory scores, cell types and granulation tissue of the same material in different experimental periods (P < 0.05). Can be concluded that biocompatibility of MTA bio and PC were comparable with that of ProRoot MTA.
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http://dx.doi.org/10.1002/jemt.22168DOI Listing
March 2013

Exuberant pyogenic granuloma in extragingival site.

Braz J Otorhinolaryngol 2012 Jul-Aug;78(4):134

curso de Odontologia, UFC.

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December 2012

Extensive thyroglossal duct cyst in 83-year-old patient.

N Y State Dent J 2012 Apr;78(3):39-41

Department of Clinical Dentistry, School of Dentistry, Fortaleza University, Fortaleza, Brazil.

Thyroglossal duct cysts (TDCs) are developmental cysts that occur in the neck. These lesions are usually encountered in the first decade of life; cases appear to be rare in elderly patients. Thirteen cases have been reported so far in patients over 70 years of age. Although the Sistrunk procedure remains the standard treatment, the management of TDCs continues to be a matter of controversy in some instances. We report the third case of extensive TDC published in patients over 80 years of age.
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April 2012

Cyclooxygenase-2 expression in central giant cell lesion of the jaws: an immunohistochemical study.

J Mol Histol 2012 Feb 1;43(1):59-62. Epub 2011 Nov 1.

Department of Dental Clinic, Discipline of Oral and Maxillofacial Surgery and Stomatology, Federal University of Ceará School of Dentistry, Dom Luiz 1200, Torre I, Sala 410, Aldeota, Fortaleza, Ceará, Brazil.

Central Giant Cell Lesion (CGCL) is an uncommon benign jaw lesion, with uncertain etiology, and a variable clinical behavior. Studies of molecular markers of CGCL, may help understanding better the nature and behavior of this lesion, and eventually may represent a definitive target to pharmacological approach in the treatment of CGCL. Chronic inflammation has been found to mediate a wide variety of diseases including neoplasms. Among the gene products involved in the induction of the inflammatory process, Cyclooxygenase 2 (COX-2) has been shown to have a close relationship with tumorigenesis, however COX-2 expression has never been evaluated in CGCL. The aim of the study was to investigate the expression of COX-2 in CGCL. Immunohistochemical assessment for COX-2 expression was performed in 18 patients previously diagnosed with CGCL. Multinucleated giant cells (MGC) and mononucleated stromal cells (MSC) were used in the slide analysis. Among the patients studied, 10 were male and 8 were female, with a median age of 15.4 years. Lesions in the mandible were observed in 11 cases and 7 were found in the maxilla. There were 9 aggressive and 9 non-aggressive CGCLs. COX-2 immunopositivity was present in only 3 cases stained in both MGC and MSC. All 3 cases presented with ulcerations in the mucosa lesion, suggesting that the COX-2 expression is due to the presence of inflammation. This study does not support the involvement of COX-2 in the etiophatogenesis of CGCL.
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http://dx.doi.org/10.1007/s10735-011-9369-8DOI Listing
February 2012

Immunohistochemical analysis of bone resorption regulators (RANKL and OPG), angiogenic index, and myofibroblasts in syndrome and non-syndrome odontogenic keratocysts.

Arch Oral Biol 2012 Mar 25;57(3):230-7. Epub 2011 Aug 25.

Department of Oral Pathology, Federal University of Rio Grande do Norte, Natal, RN, Brazil.

Objective: The aim of this study was to immunohistochemically analyse bone resorption regulators (receptor activator of nuclear factor kappa B ligand [RANKL] and osteoprotegerin [OPG]), angiogenic index, and myofibroblasts in Gorlin syndrome-related odontogenic keratocysts (SOKCs) and non-syndrome odontogenic keratocysts (NSOKCs).

Study Design: Twenty-two SOKCs, 22 primary NSOKCs, and eight recurrent NSOKCs were evaluated by immunohistochemistry using anti-RANKL and anti-OPG antibodies. The angiogenic index was determined by microvessel count (MVC) using anti-CD34 antibody. Anti-α-smooth muscle actin (α-SMA) antibody was used for the identification of myofibroblasts.

Results: Analysis of the expression of RANKL and OPG in the epithelial lining and fibrous capsule did not reveal significant differences between groups (P>0.05). In the epithelial lining, the RANKL/OPG ratio was RANKL0.05). In the fibrous capsule, the ratio was RANKL=OPG in most primary (81.8%) and recurrent NSOKCs (75.0%) and in most SOKCs (45.5%) (P>0.05). No significant differences in the angiogenic index or number of myofibroblasts were observed between primary NSOKCs, recurrent NSOKCs, and SOKCs (P>0.05).

Conclusions: The present results suggest that differences in the biological behaviour of SOKCs and NSOKCs may not be related to the expression of RANKL and OPG, to the RANKL/OPG ratio, to the angiogenic index, or to the number of myofibroblasts in these lesions.
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http://dx.doi.org/10.1016/j.archoralbio.2011.08.002DOI Listing
March 2012

Odontogenic tumors: a 5-year retrospective study in a Brazilian population and analysis of 3406 cases reported in the literature.

Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011 Apr 15;111(4):474-81. Epub 2011 Jan 15.

Department of Pathology, Fortaleza University School of Medicine, Fortaleza, Ceara, Brazil.

Objective: The objective of this study was to analyze the frequency and distribution of odontogenic tumors in Fortaleza, Brazil, and compare the findings with those reported in the literature.

Study Design: A total of 6231 oral lesions retrieved from 5 anatomic pathology services in Fortaleza, Brazil, over a 5-year period, were reviewed. In addition, the literature was searched for studies on odontogenic tumors (OTs) according to the 2005 WHO classification.

Results: Within the total 6231 oral lesions, 185 (2.97%) were OTs, all benign. OTs presented a female predilection, with a male:female ratio of 0.62:1.00. These neoplasms occurred over a wide range of ages (1 to 78 years), with a mean of 30.5 years. Ameloblastomas, keratocystic odontogenic tumors, and odontomas were the most frequent OT types.

Conclusions: OTs are rare neoplasms and appear to show geographic variations. In Fortaleza, Brazil, they are more common in female patients, with ameloblastoma followed by keratocystic odontogenic tumors as the most frequent OTs.
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http://dx.doi.org/10.1016/j.tripleo.2010.10.018DOI Listing
April 2011

Chondrolipoma of the posterior tongue.

J Craniofac Surg 2010 Nov;21(6):1982-4

Division of Oral Surgery, School of Dentistry, Federal University of Ceará, Sobral Campus, Sobral-Ce, Brazil.

Chondrolipomas are rare benign mesenchymal tumors characterized by the proliferation of mature adipocytes associated with variable amounts of mature cartilaginous tissue. To our knowledge, only 11 cases of chondrolipoma affecting the oral cavity have been published in the English-language literature (PubMed database), and no cases of this condition up to 20 years of complaint duration have been reported. Thus, this article describes an interesting and atypical case of a 68-year-old woman who presented an asymptomatic slow-growing swelling on the posterior dorsal surface of the tongue. In addition, we reviewed the international literature from 1976 to 2009.
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http://dx.doi.org/10.1097/SCS.0b013e3181f503a7DOI Listing
November 2010

Regional odontodysplasia involving three quadrants of the jaws: a case report.

Quintessence Int 2010 Jan;41(1):13-6

Pediatric Dentistry Department, Federal University of Rio Grande do Norte, Rio Grande do Norte, Brazil.

Regional odontodysplasia is a rare developmental anomaly of the teeth that affects enamel and dentin. Its etiology is unknown, but the most accepted theory refers to circulatory disorders associated with vascular nevi. An uncommon case of regional odontodysplasia involving three quadrants of the jaws is reported. An 8-year-old boy was referred to the authors' institution with lack of teeth as a major symptom. There was no hereditary anomaly in the family. Extraoral examination revealed a brown discoloration on the skin on the right side of the face, neck, and chest. Detailed intraoral examination showed hypoplastic and carious teeth. Fistulae and gingival overgrowth were also observed. Radiographically, the affected teeth presented the pathognomonic image of "ghost teeth." Conservative treatment was instituted.
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January 2010

Immunohistochemical expression of MMPs 1, 7, and 26 in syndrome and nonsyndrome odontogenic keratocysts.

Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008 Jul;106(1):99-105

Department of Oral Pathology, School of Dentistry, University of Fortaleza, Ceará, Brazil.

Objective: The objective of this study was to analyze the expression of matrix metalloproteinases (MMPs) 1, 7, and 26 in odontogenic keratocysts (OKCs) associated with Gorlin syndrome (SOKCs) and nonsyndrome OKCs (NSOKCs).

Study Design: Twenty-one SOKCs and 20 NSOKCs were evaluated for epithelial expression of MMP-1, MMP-7, and MMP-26 and for mesenchymal expression of MMP-1 by immunohistochemistry.

Results: Strong epithelial positivity to MMP-1 was observed in 76% of SOKCs and in 15% of NSOKCs (P < .05). Strong mesenchymal immunoreactivity to MMP-1 was observed in 38% of SOKCs and in 20% of NSOKCs (P > .05). Epithelial immunoreactivity to MMP-7 was strongly positive in 67% of SOKCs and in 40% of NSOKCs (P > .05). For MMP-26, strong positivity was found in 62% of SOKCs, in contrast to 35% of NSOKCs (P > .05).

Conclusion: MMPs-1, -7 and -26 may play important roles in the biology of OKCs. Furthermore, the presence of these proteases at higher levels in SOKCs may help to explain increased OKC aggressiveness associated with nevoid basal cell carcinoma syndrome.
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http://dx.doi.org/10.1016/j.tripleo.2007.12.028DOI Listing
July 2008

Immunohistochemical expression of vimentin, calponin and HHF-35 in salivary gland tumors.

Braz Dent J 2007 ;18(3):192-7

Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Norte, Natal, RN, Brazil.

Myoepithelial cells present a complex immunophenotype, with the expression of proteins varying according to the stage of normal or neoplastic differentiation of the cell. In order to evaluate the immunohistochemical markers expressed by these cells, a panel of antibodies composed of vimentin, calponin and HHF-35 was applied to 28 salivary gland tumors. The results demonstrated a higher percent sensitivity of vimentin and calponin compared to HHF-35. However, calponin and HHF-35 presented a focal labeling pattern in contrast with the diffuse distribution of vimentin. The cells predominantly stained by all tested antibodies included nonluminal cells in duct-like and tubular structures, such as those seen in pleomorphic adenomas and adenoid cystic carcinomas, as well as cells in the cords and nests of polymorphous low-grade adenocarcinomas and peripheral cells of sheets and nests of myoepitheliomas. In conclusion, the combination of calponin and vimentin is suggested for the identification of myoepithelial cells in salivary gland tumors.
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http://dx.doi.org/10.1590/s0103-64402007000300003DOI Listing
March 2009

Papillary cystadenocarcinoma: report of a case of high-grade histopathologic malignancy.

Auris Nasus Larynx 2007 Jun 11;34(2):259-62. Epub 2006 Oct 11.

Laboratory of Oral Pathology, Dentistry School, Federal University of Rio Grande do Norte, Natal, Brazil. Av. Senador Salgado Filho, 1787 CEP-59056-000 Natal, RN, Brazil.

Papillary cystadenocarcinoma is an extremely rare malignant tumor of the salivary gland which is cytologically considered to be of low-grade malignancy, showing an indolent biological behavior. Histologically, the tumor is characterized by cysts and papillary endocystic projections. This tumor most commonly arises in the major salivary glands, mainly the parotid gland. We report here a case of papillary cystadenocarcinoma originating from the minor salivary gland, which showed marked growth over a short period of time. Histologically, the tumor was characterized by intense cellular and nuclear pleomorphism and numerous mitotic figures. These findings indicate a tumor of high-grade malignancy.
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http://dx.doi.org/10.1016/j.anl.2006.07.010DOI Listing
June 2007