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Background Salivary gland tumors are a rare and morphologically diverse group of lesions and their frequency is still unknown in several parts of the world. The knowledge of its population characteristics contributes to a better understanding of its etiopathogenesis. Objectives: This study investigated the frequency of salivary gland tumors in a region of southern Brazil and compared these data in a literature review. Material and Methods A retrospective study was conducted of salivary gland tumors diagnosed at two pathology centers from 1995 to 2016. Patient age and gender, tumor site and frequency, histopathological diagnosis, and symptomatology were evaluated. Chi-squared tests were used to assess the associations between variables. To compare our data, we also conducted a literature review of publications in the PubMed and LILACS databases of retrospective studies of salivary gland tumors. Results A total of 124 salivary gland tumor cases was identified, 81 (65.3%) of which were classified as benign and 43 (34.6%) as malignant. Most tumors occurred in the parotid gland (57.2%). Pleomorphic adenoma was the most common tumor (59.6%), followed by adenocarcinoma not otherwise specified (8.8%). The tumors occurred more often in women (54.8%) than in men (45.2%). Malignant tumors were associated with pain in 31.4% of cases (p

The aim of this study was to report two cases of newborns with natal and neonatal teeth. Case 1 - a female child presented a natal tooth in the region of lower central incisors since birth. Mother’s child reported a family history of this feature. Since the tooth did not present either mobility, prevent breastfeeding, cause discomfort to the child or hurt mother's breast, it was chosen for its maintenance and monitoring. Case 2 - a male child presented, during the first two weeks of life, the eruption of two neonatal teeth in the region of lower central incisors. During the interview, his mother reported no familiar history of this condition. Because the teeth has tapered edges, causing the Riga-Fede's disease, impairing breastfeeding, causing discomfort to the child and injuring the mother's breast, it was decided for its extraction. It may be concluded that the presence of natal and neonatal teeth represent a rare condition that requires further studies to confirm its etiology. Therapeutic approaches must be preceded by a careful clinical evaluation since, as it was seen in this report, both cases were submitted to different treatments showing good evolution.

Objective: To investigate the perceptions of dental students on the learning process regarding the dentist-pediatric patient relationship. Material and Methods: A qualitative study with an exploratory approach was conducted involving semi-structured interviews with sixteen dental undergraduate students randomly selected from the thirty-two students in the last semester of the dentistry course. The transcribed interviews were submitted to content analysis. Results: The sample was composed of nine female (56.3%) and seven male (43.7%) students (median age: 23 years). The factors perceived as most influential with regard to learning the dentist-pediatric patient relationship were observations of professors, other dentists or colleagues and the regular practice of dental procedures. While half of the participants considered lectures on the subject satisfactory, the other half reported a need for more instruction on how to deal with specific clinical situations. Most of the participants would like to have learned more about the dentist-pediatric patient relationship. Conclusion: The majority of students recognized that the teaching and learning process regarding the dentist-pediatric patient relationship is not easy. They reported having little counseling on the how to develop this relationship. The students suggested that the dentist-patient relationship should be addressed more during the course through the inclusion of lectures or classes on this issue as well as the demonstration of specific clinical situations.

Objective: Failures in endodontic treatment may occur by several reasons. Endodontic retreatment is an interesting alternative to manage this clinical problem. However, it is not possible to completely remove the root canal filling by any current retreatment technique. The aim of this study was to evaluate the presence of residual root canal filling materials after endodontic re-instrumentation. Material and Methods: Sixty extracted anterior human teeth were prepared by step-back technique with Flexofiles, K-files and Gates-Glidden (GG) burs. Between the use of each file or bur, root canals were irrigated with sodium hypochlorite (NaOCl). Smear layer was removed by irrigation with ethylenediaminetetraacetic acid and NaOCl. After drying with paper points the root canals were randomly divided into 5 groups (n = 12), according to filling material: Resilon cones/Real Seal sealer or gutta-percha cones and Endofill, Sealapex, AH Plus or MTA Fillapex sealers. After one week, root canal fillings were removed using Eucaliptol and K-files. Root canals were re-instrumented with K-files and GG burs sized larger than the first ones. The removal of root canal filling material was analyzed by radiography and scanning electron microscopy (SEM). Statistical analysis was performed using Binary Logistic Regression test (P < 0.05). Results: Radiographic and SEM analysis showed that material from the MTA Fillapex group was better removed than that from Endofill, Sealapex, AH Plus and Real Seal groups. Conclusion: After re-instrumentation, MTA Fillapex group showed less remnants into the root canals than Endofill, Sealapex, AH Plus and Real Seal groups. Residual material was most often found in the apical third.Keywords Dental radiography; Endodontic retreatment; Root canal filling materials; Scanning electron microscopy.

Medication-related osteonecrosis of the jaws (MRONJ) can be considered an inability of the alveolar bone to respond to an injury, which frequently leads to severe local and systemic complications. Once the problem is installed, dentist must use all therapeutic approaches recommended. This manuscript reports a successful management of MRONJ handled with antibiotics, conservative debridement, low-level laser therapy (LLLT), and photodynamic therapy (PDT) up to 12 months. As healing of MRONJ may be very slow, combined therapeutic approaches are required. Besides the recommended conventional treatment protocol, LLLT and PDT are important tools to contribute to healing and improvement of patient’s quality of life.

Regenerative endodontic procedure (REP) has been proposed as a new approach to treat immature permanent teeth. However, materials used in REP for root canal disinfection or cervical sealing may induce tooth discoloration. Objectives To assess tooth crown’s color after intracanal treatment with triple antibiotic paste (TAP) or calcium hydroxide (CH); cervical sealing with glass ionomer cement (GIC) or mineral trioxide aggregate (MTA); and bleaching with carbamide peroxide. Material and Methods After pulp removal and color spectrophotometer measurement, 50 bovine incisors were divided into 4 experimental groups and one control (untreated). Experiments were performed in phases (Ph). Ph1: TAP (ciprofloxacin, metronidazole, minocycline), TAPM (ciprofloxacin, metronidazole, amoxicillin), DAP (ciprofloxacin, metronidazole), or CH treatment groups. After 1 and 3 days (d); 1, 2, 3 weeks (w); and 1, 2, 3 and 4 months (m), color was measured and medications were removed. Ph2: GIC or MTA cervical sealing, each using half of the specimens from each group. Color was assessed after 1d, 3d; 1w, 2w, 3w; 1m and 2m. Ph3: Two bleaching sessions, each followed by color measurement. Data were analyzed with ANOVA and post-hoc Holm-Sidak method. Results Ph1: Specimens of TAP group presented higher color alteration (ΔE) mean than those of TAPM group. No significant difference was found among TAP or TAPM and CH, DAP or Control groups. Ph2: cervical sealing materials showed no influence on color alteration. Ph3: Different ΔE means (from different groups), prior to bleaching, became equivalent after one bleaching session. Conclusions TAP induces higher color alteration than TAPM; color alteration increases over time; cervical sealing material has no influence on color alteration; and, dental bleaching was able to recover, at least partially, the tooth crown’s color.

Objective: To estimate the prevalence of unintentional injuries among children attending public preschools of Florianopolis (Santa Catarina, Brazil) and describe their epidemiological characteristics. Materials and Methods: This is a descriptive cross-sectional study conducted with 398 children in 2009 and data were collected through a questionnaire, filled by parents. Statistical analysis was performed, considering a confidence interval of 95%. Results: Among the 398 children included, 275 (69.1% - 95%: 66.8 to 71.4%) suffered unintentional injuries, making a total of 573 cases. The sample comprised 55.5% male children between 13 and 36 months (61.6% - 95% CI: 59.3 to 63.9%) that were affected. Child home was the place where 352 (61.4% - 95% CI: 59.0 to 63.8%) injuries occurred, 372 (64.9% - IC95%: from 59.1 to 73.7%), which were caused by falls, and 342 (59.7% - 95%:57.3 to 62.1%) were considered mild. In 223 (38.9% - 95%: 36.5% -41.3%) cases, the mother accompanied the child at the time of injury. Conclusion: The prevalence of unintentional injuries was high. In the context of prevention, combined actions among health professionals, government and civil society should be proposed based on local research on the topic. In the era of family health care performed by multidisciplinary teams, it is critical that these injuries receive adequate importance by health professionals and attention in public health policies.

Ramos-Jorge ML, Vieira-Andrade RG, Martins-Junior PA, Cordeiro MMR, Ramos-Jorge J, Paiva SM, Marques LS. Level of agreement between self-administered and interviewer-administered CPQ8–10 and CPQ11–14. Community Dent Oral Epidemiol 2011. © 2011 John Wiley & Sons A/S Abstract – Objectives: The aim of the present study was to assess the psychometric properties and level of agreement between the self-administered and interviewer-administered Child Perceptions Questionnaire (CPQ) for children between 8 and 10 years of age (CPQ8–10) and between 11 and 14 (CPQ11–14) years of age. Methods: A randomized cross-over study was carried out, involving 180 children (Group 1 – 90 children between 8 and 10; Group 2 – 90 children between 11 and 14 years of age) in the state of Minas Gerais, Brazil. All children completed both administration modes of the CPQ; half of each group received interviewer-administered mode first [Subgroup A (CPQ8–10n = 45) and Subgroup C (CPQ11–14n = 45)], and the other half performed the self-administered mode first [Subgroup B (CPQ8–10n = 45) and Subgroup D (CPQ11–14n = 45)]. Test–retest reliability of each mode of administration was tested on 60 children (30 for CPQ8–10; 30 for CPQ11–14), who were not included in the other analyses. The level of agreement between scores on the self-administered and interviewer-administered versions of the CPQ8–10 and CPQ11–14 was established using the intraclass correlation coefficient (ICC). The order of presentation of both instruments was tested considering the four subgroups (A, B, C and D). The calculation of effect size proposed by Cohen (1992) was used to test the clinical significance of the findings. Results: Both the self-administered and interviewer-administered versions of CPQ8–10 and CPQ11–14 demonstrated acceptable psychometric properties. Agreement between the administration modes for the CPQ8–10 and CPQ11–14 was 0.90 and 0.88 (ICC), respectively. With the exception of the functional limitation subscale, the scores of the subscales and overall score on the CPQ8–10 were significantly higher in the group of children who responded to the interviewer-administered measure first. With the CPQ11–14, statistically significant differences were found only for the emotional well-being subscale. Conclusions: Both administration modes of the CPQ8–10 and CPQ11–14 demonstrated satisfactory psychometric properties and a high level of agreement. Although statistically significant differences were observed for oral symptoms, emotional well-being and social well-being, with the first administration of the interviewer-administered version, the effect of the order of administration had small to medium effects on the CPQ scores.

Background Physiological root resorption differentiates primary from permanent teeth. The understanding of what protects and regulates root resorption might help to develop therapies to its control. Aim To verify the presence and distribution of ECRM and the expression of CK14, OPG, TRAP and COX-2 in the periodontal ligament (PDL) of human primary and permanent teeth. Design. Eight primary teeth undergoing physiological or pathological root resorption and 4 permanent teeth were immunohistochemically processed for CK14, TRAP, COX-2 and OPG expression. Results PDL from primary and permanent teeth showed similar morphological features; however, fewer ECRM clusters and higher immunoreactivity to CK14 were found in primary PDL. In permanent teeth, ECRM were distributed along the entire PDL tissue. Howship's lacunae were found only in primary teeth, associated with the presence of TRAP-positive cells and increase in COX-2 expression. OPG expression in primary PDL was detected in nonresorptive cervical areas and in lacunae showing reparative tissue. It was observed higher expression of OPG in all permanent teeth when compared to primary specimens. Conclusions It may be concluded that PDL from primary teeth shows less ECRM clusters and lower expression of OPG. These features may be associated with lower protection against root resorption in primary teeth.

Stem cells constitute the source of differentiated cells for the generation of tissues during development, and for regeneration of tissues that are diseased or injured postnatally. In recent years, stem cell research has grown exponentially owing to the recognition that stem cell-based therapies have the potential to improve the life of patients with conditions that span from Alzheimer's disease to cardiac ischemia to bone or tooth loss. Growing evidence demonstrates that stem cells are primarily found in niches and that certain tissues contain more stem cells than others. Among these tissues, the dental pulp is considered a rich source of mesenchymal stem cells that are suitable for tissue engineering applications. It is known that dental pulp stem cells have the potential to differentiate into several cell types, including odontoblasts, neural progenitors, osteoblasts, chondrocytes, and adipocytes. The dental pulp stem cells are highly proliferative. This characteristic facilitates ex vivo expansion and enhances the translational potential of these cells. Notably, the dental pulp is arguably the most accessible source of postnatal stem cells. Collectively, the multipotency, high proliferation rates, and accessibility make the dental pulp an attractive source of mesenchymal stem cells for tissue regeneration. This review discusses fundamental concepts of stem cell biology and tissue engineering within the context of regenerative dentistry.

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Objective: To evaluate the parent's esthetic acceptance of the use of the cariostatic agent diamine silver fluoride in children aged 0 to 3 years treated at ...

Aim The aim of this paper is to present a review and discussion of the current status of stem cell research with regard to tooth generation. Background Stem cells have been isolated from the pulp tissue of both deciduous and permanent teeth as well as from the periodontal ligament. Dental pulp stem cells demonstrate the capacity to form a dentin pulp-like complex in immunocompromised mice. A tooth-like structure was successfully formed, using a heterogeneous mixture of dental enamel epithelium, pulp mesenchymal cells, and scaffolds. Conclusion The scientific community understands the need for more investigations to completely understand the conditions that would best favor the creation of a tooth substitute. Recent gains in the understanding of the molecular regulation of tooth morphogenesis, stem cell biology, and biotechnology offers the opportunity to realize this goal. Clinical Significance These findings, combined with the recent progress in stem cell research and tissue engineering, might allow the development of alternatives for current materials and therapies used to treat tooth tissue loss (e.g., enamel, dentin, pulp), reconstruct dentoalveolar and craniofacial bone defects, and eventually replace an entire tooth. Citation Nedel F, André DA, Oliveira IO, Cordeiro MM, Casagrande L, Tarquinio SBC, Nor JE, Demarco FF. Stem Cells: Therapeutic Potential in Dentistry. J Contemp Dent Pract 2009 July; (10)4:090-096.

Stem cells from human exfoliated deciduous teeth (SHED) have been isolated and characterized as multipotent cells. However, it is not known whether SHED can generate a dental pulp-like tissue in vivo. The purpose of this study was to evaluate morphologic characteristics of the tissue formed when SHED seeded in biodegradable scaffolds prepared within human tooth slices are transplanted into immunodeficient mice. We observed that the resulting tissue presented architecture and cellularity that closely resemble those of a physiologic dental pulp. Ultrastructural analysis with transmission electron microscopy and immunohistochemistry for dentin sialoprotein suggested that SHED differentiated into odontoblast-like cells in vivo. Notably, SHED also differentiated into endothelial-like cells, as demonstrated by B-galactosidase staining of cells lining the walls of blood-containing vessels in tissues engineered with SHED stably transduced with LacZ. This work suggests that exfoliated deciduous teeth constitute a viable source of stem cells for dental pulp tissue engineering.

Introduction Mineral trioxide aggregate (MTA) and calcium hydroxide [Ca(OH) 2 ] are promising biomaterials for stimulating dentinogenesis and cementogenesis. This research was undertaken to understand how MTA and CA(OH) 2 participate in the inflammatory, healing, and biomineralization processes. In this part of the study, we evaluated inflammatory signaling molecules promoted by in vivo host interaction with MTA and Ca(OH) 2 . Methods Human dentin tubes were filled with ProRoot MTA (Dentsply Tulsa Dental, Tulsa, OK), Ca(OH) 2 , or kept empty. After 12 hours and 1, 3, 7, 15, 30, and 60 days of implantation in subcutaneous tissues in the backs of mice, the tubes and surrounding tissues were retrieved for cytokine level quantification and histological and immunohistochemical analysis. Results MTA and Ca(OH) 2 induced proinflammatory cytokine up-regulation for up to 3 days. Moreover, interleukin-10 overexpression was noted on the tissue in contact with the biomaterials during the acute phase of the inflammatory reaction. Immunohistochemical analyses showed an increased expression of myeloperoxidase, nuclear factor kappa B (NF-κB), cyclooxygenase-2, inducible nitric oxide synthase enzymes, and vascular endothelial growth factor on day 1 for all groups. Conclusions MTA and Ca(OH) 2 increased the activation of the NF-κB signaling system on day 1 for all groups. This finding can be associated with a proinflammatory and pro–wound healing environment, which was promoted earlier by MTA.

Introduction: The biological processes underlying the ability of mineral trioxide aggregate (MTA) to promote hard-tissue deposition and wound healing remain unclear. To further study these processes, specific signaling molecules related to the inflammatory response and the biomineralization process were analyzed to assess host-MTA interactions in vivo. Methods: For cytokine level quantification and immunohistochemical analysis, human dentin tubes were filled with ProRoot MTA (Dentsply, Tulsa Dental, OK) or kept empty and were implanted in subcutaneous tissues in the backs of mice. Dentin tubes were retrieved and subsequently observed using a scanning electron microscope. Results: MTA induced a time-dependent proinflammatory cytokine up-regulation up to 3 days. Immunohistochemical analyses showed an upregulated expression of myeloperoxidase, nuclear factor-kappa B, activating protein-1, cyclooxygenase-2, inducible nitric oxide synthase, and vascular endothelial growth factor on day 1. Scanning electron microscopic examination revealed the presence of apatite-like clusters on collagen fibrils over the surface of tubes containing MTA. With the increase in time after implantation, a more extensive mineralization showing a compact layer of apatite was observed. Conclusion: MTA induced a proinflammatory and pro–wound healing environment. The biomineralization process occurred simultaneously at the biomaterial-dentin-tissue interface, with the acute inflammatory response. This promoted the integration of the biomaterial into the environment. (J Endod 2010;36:1347–1353)

Transformation of small avascular masses of tumor cells into rapidly progressive cancers is triggered by the angiogenic switch, a process that involves vascular endothelial growth factor (VEGF) signaling. We have shown that VEGF enhances the survival and angiogenic potential of endothelial cells by activating the Bcl-2-CXCL8 signaling axis. The purpose of this study was to evaluate the effect of a small-molecule inhibitor of VEGF receptors (PTK/ZK) on the initial stages of head and neck tumor angiogenesis. In vitro, PTK/ZK blocked head and neck tumor cell (OSCC3 or UM-SCC-17B)-induced Bcl-2 and CXCL8 expression in endothelial cells. Oral administration of PTK/ZK decreased xenograft head and neck tumor microvessel density, and inhibited Bcl-2 and CXCL8 expression in tumor-associated endothelial cells. Analysis of these data demonstrates that PTK/ZK blocks downstream targets of VEGF signaling in endothelial cells, and suggests that PTK/ZK may inhibit the angiogenic switch in head and neck tumors. Abbreviations: HDMEC, human dermal microvascular endothelial cells; VEGF, vascular endothelial growth factor; CXCL8, CXC ligand-8; PTK/ZK, PTK787/ZK222584.

This study aimed to evaluate, ex vivo, time and dentin removal by manual and rotary instrumentation in human primary teeth.Eighty primary teeth were divided into 2 groups, embedded in resin, and sectioned for evaluation before and after instrumentation. For manual technique, teeth were prepared using K-type files and rotary preparation was performed with Hero 642. All root canals were prepared up to size 40, and the instrumentation time was recorded. Dentin removal was calculated using digital image software. Data was statistically analyzed using chi-squared, Mann-Whitney, and t tests.Manual instrumentation removed more dentin in all groups compared with rotary instrumentation (P.05). In some specimens, root perforations were observed in areas coinciding with largest root resorption. Rotary technique showed the shortest instrumentation time (P.05).Deciduous teeth, without significant root resorption, have enough root structure for instrumentation up to size 40. Rotary technique required less time and generated less dentin removal.