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BACKGROUND: Patients with diabetes mellitus have been associated with a number of changes in the oral cavity, such as gingivitis, periodontitis, mucosal diseases, salivary dysfunction, altered taste, and burning mouth. OBJECTIVES: To determine the prevalence of oral mucosal lesions in patients with diabetes mellitus. METHODS: A cross-sectional observational study between August and October 2012 with a convenience sampling was performed for 51 patients with diabetes mellitus (type 1 and type 2). The study consisted of two phases: 1) a questionnaire application; 2) intraoral clinical examination. For the analysis of data, we used descriptive statistics, Fisher's exact test in bivariate analysis (significance level of 0.05), and Poisson Regression. RESULTS: The prevalence of oral lesions was 78.4%. Traumatic ulcers (16.4%) and actinic cheilitis (12.7%) were the most prevalent lesions. The lips (35.3%) and tongue (23.5%) were the most common location. The bivariate analysis showed an association with the type of diabetes, and two variables (age and comorbidity) were quite close to the significance level. In the Poisson Regression analysis, only diabetes type 2 remained significant after adjusting the model. CONCLUSIONS: The results of this study show a high prevalence of oral mucosal lesions in diabetic patients. The oral mucosal lesions are mostly associated with diabetes type 2.

As fissuras labio-palatinas sao patologias biopsicossociais graves que se situam entre o 3o ou 4o defeito congenito mais frequente. Um bebe em cada 650 nascidos vivos apresenta o problema em algum estadiamento, de modo que, no Brasil, existem, aproximadamente, 180.000 fissurados. As fissuras podem ser labiais, palatinas e labio-palatinas completas ou incompletas. O tratamento de fissuras deve ser multidisciplinar e propoe-se a correcao do defeito e dos problemas associados, devendo ser iniciado precocemente, a fim de melhorar o prognostico. O presente trabalho apresenta dois casos de fissura labio-palatina em pacientes infantis, ambas unilaterais, completas, congenitas e com fortes prejuizos esteticos e funcionais. Os dois pacientes receberam atendimento interiorizado e integral, com grande sucesso no tratamento, desafiando a vigente necessidade de deslocamento a grandes centros para obtencao de atendimento diferenciado e integral.

Mucopolysaccharidosis (MPS) is a group of rare metabolic diseases characterized by intralysosomal accumulation of glycosaminoglycans. MPS type VI or Maroteaux-Lamy syndrome is an autosomal-recessive syndrome caused by mutations in the lysosomal enzyme arylsulfatase B. A defect in the gene leads to accumulation of nondegraded mucopolysaccharides, resulting in severe cellular dysfunction with multisystem expression. The oral manifestations of MPS VI are not well described in the literature. This paper presents a series of seven patients with MPS VI, with the description of the general clinical manifestations and focus on the still rarely studied oral manifestations of the syndrome. Among them were high palate, open bite, impacted and/or included teeth, thickening of the pericoronal follicle, and changes in the temporomandibular joint.

It was assessed the immunohistochemical profile of CD25+ cells in cases of chronic gingivitis (CG) and chronic periodontitis (CP). Immunohistochemistry was carried out using streptoavidin-biotin complex and anti-CD25 antibody in 17 cases of CG and 25 cases of CP. Sixteen cases (94.1%) of CG were immunopositive. CD25 was focally expressed in 50% of the sample and diffusely expressed in 25%. The stained cells were localized not only beneath the epithelium, but also far from it. In relation to the cellular density quantification of CD25+ cells, score ++ was the most common. Concerning CP, all cases were immunopositive. CD25+ cells were expressed in focal or diffuse pattern either close or far from the epithelium. Diffuse distribution of positive cells throughout the connective tissue was seen in 60% of the cases and 32% showed focal or diffuse cellular pattern. Sixteen cases (64%) received score +++. It was identified that CD25+ cells are present in either a focal or a diffuse pattern in connective tissue. Significant differences in the density of cellular immunostaining between CG and CP were found. The greatest density was observed in CP cases, which suggests that the infiltrate of lymphocytes show a higher degree of cellular activation in periodontitis compared with gingivitis. Foi avaliado o perfil imunohistoquímico das células CD25+ em casos de gengivite (CG) e periodontite crônica (CP). A imunohistoquímica foi realizada utilizando o complexo de streptoavidina-biotina e o anticorpo anti-CD25 em 17 casos de CG e 25 casos de CP. 16 casos (94.1%) de CG foram imunopositivos. O CD25 foi expresso focalmente em 50% da amostra e difusamente em 25% dos casos. As células imunomarcadas estavam localizadas não apenas no epitélio, mas também por todo o tecido conjuntivo. Em relação à quantificação da densidade celular de células CD25+, o escore ++ foi o mais comum. Em relação a CP, todos os casos foram imunopositivos. As células CD25+ foram expressas em padrão ora focal ora difuso, tanto no epitélio como no conjuntivo. A distribuição difusa das células positivas apenas no tecido conjuntivo foi observada em 60% dos casos, e 32% dos casos exibiram padrão celular ora focal ora difuso. 16 casos (64%) foram considerados como escore +++. Identificamos que as células CD25+ estão presentes em padrão ora focal ora difuso no tecido conjuntivo. Diferenças significantes na densidade da imunomarcação celular entre CG and CP foram encontradas. A maior densidade celular foi observada na periodontite, sugerindo que o infiltrado de linfócitos mostrou um maior grau de ativação celular na periodontite comparada à gengivite

O presente trabalho objetivou estudar a influência do processo inflamatório na expressão dos filamentos intermediários de citoqueratinas utilizando espécimes de gengivite crônica, além de traçar um perfil destes polipeptídeos na gengiva inflamada. Para tanto, foi feita uma avaliação histomorfológica, no que diz respeito ao tipo e intensidade do infiltrado inflamatório presente na gengivite crônica e a análise imuno-histoquímica da expressão das citoqueratinas 10, 13, 14 e 16, quanto à localização topográfica no epitélio em 10 casos de gengivite crônica. Constatou-se que o tipo de infiltrado inflamatório presente na gengivite crônica foi intenso e predominantemente mononuclear. Quanto aos achados imuno-histoquímicos, observou-se uma redução e até mesmo a ausência de expressão da CK 10 em cerca de 70% da amostra, a expressão da CK 13 estendendo-se por toda a camada suprabasal na grande maioria dos casos (90%), bem como expressão da CK 14 em toda a extensão do epitélio (90%) e ainda expressão variável da CK 16. A partir destes achados, concluiu-se que a expressão das citoqueratinas é alterada durante a inflamação, e que o processo inflamatório interfere na maturação epitelial, cujas evidências foram encontradas nas mudanças no perfil destas proteínas na gengiva inflamada.

Ephitelial-myoepithelial carcinoma (EMC) is a neoplasm of salivary gland extremely rare and low-grade malig- nant, exhibiting predilection for major salivary gland, especially parotid gland. This paper described a case of EMC localized in soft palate. The initial clinical diagnosis were mucoepidermoid and adenoid cystic carcinoma. A incisional biopsy was performed, and the histological diagnosis was adenocarcinoma not otherwise specified. The patient underwent excisional biopsy, where was realized immunohistochemical analysis, staining the duct-like structures, where the inner layer of epithelial cells positively for CK 14, whereas outer layer of myoepithelial cells stained positively for smooth muscle actin (SMA) and vimentin antibodies. Based on these findings, the final histological diagnosis was EMC. The patient was submitted 30 sessions of radiotherapy, and she is being follow-up about 2 years without evidence recurrences.

1 Master’s degree student of oral pathology, UFRN.2 Master’s degree student of dentistry, UEPB.3 Doctoral student of materials science and engineering. Full professor, UEPB.4 Doctoral student of materials science and engineering. Full professor, UEPB.5 Doctorate in oral pathology, UFRN. Full professor of oral pathology, UEPB.Send correspondence to: Dmitry Jose de Santana Sarmento - Rua Jose Jesuino de Brito 415 Quarenta Campina Grande PB 58.416-270.Paper submitted to the BJORL-SGP (Publishing Management System – Brazilian Journal of Otorhinolaryngology) on December 13, 2009; and accepted on March 23, 2010. cod. 6838

El objetivo del estudio fue determinar la expresion inmmunohistoquimica de las proteinas PCNA, p53 y bcl-2 en adenomas pleomorficos. Fueron seleccionados 19 especimenes de adenomas pleomorficos para analisis a traves del metodo de la estreptavidina-biotina-peroxidasa con anticuerpos contra las proteinas p53, PCNA y bcl-2. Fue observada leve marcacion para p53 en 12 casos (63,1%) y para PCNA en 8 (42,1%). Con relacion al indice de marcacion para bcl-2,ono fue detectada en 12 casos (63,1%) expresion de esta proteina. En base a los resultados, se concluyo que las proteinas p53 y PCNA pueden favorecer la actividad proliferativa de adenomas pleomorficos, y por otro lado, la bcl-2 probablementeono participaria efectivamente de la patogenia de este tumor.

In order to contribute to the knowledge of the pathogenesis of periodontal disease, an immunohistochemical analysis of the density of inflammatory mononucleated cells and the number of dendritic cells was performed using anti-CD4, anti-CD20, anti-CD25, anti-CD68 and anti-protein S-100 antibodies in 17 cases of chronic gingivitis (CG) and 25 of chronic periodontitis (CP). The CD4+ and CD68+ cells exhibited a diffuse distribution in the connective tissue. CD20+ cell distribution was predominantly in groups and the CD25+ cells exhibited a diffuse or focal distribution. The S-100+ cells were identified in the epithelium and the lamina propria, exhibiting distinct morphology and number. The statistical analysis showed no significant differences (p>0.05) between CG and CP regarding the density of the CD4+ and CD20+ cells and the number of S-100+ cells. However, significant differences (p

OBJECTIVE: Investigate the immunohistochemical distribution of fibronectin, tenascin, laminin and collagen IV in syndrome (SOKC) and non-syndrome odontogenic keratocysts (NSOKC). MATERIALS AND METHODS: Ten cases of SOKC and five of NSOKC were selected and streptoavidin-biotin technique was applied. The specimens were analyzed taking into account the following evaluation parameters: presence, continuity and thickness in the basement membrane and intensity, distribution and association with inflammatory cells in the cyst wall. RESULTS: Differences could be detected regarding tenascin, fibronectin and collagen IV between the SOKC and NSOKC. Tenascin was present in all cases along the basement membrane in SOKC and in five cases of NSOKC predominated negative areas. Furthermore, tenascin distribution was focal in the cyst wall in SOKC whereas in NSOKC it was diffuse. Concerning fibronectin, it was detected as a discontinuous band when present in SOCK and as a continuous band in NSOKC. Collagen IV was not present in the majority of the cases in SOKC. Negative areas for laminin predominated in the basement membrane in both groups. CONCLUSIONS: These findings show differences between the immunohistochemical expression of tenascin, fibronectin and collagen IV which might indicate a more aggressive biological behavior of SOKC as compared with NSOKC.

INTRODUÇÃO: As lesões bucais e peribucais são comuns nos pacientes infectados pelo vírus HIV e podem representar os primeiros sinais da doença, antes mesmo das manifestações sistêmicas. OBJETIVO: Este estudo objetivou estimar a prevalência de manifestações bucais em indivíduos soropositivos para o HIV, considerando aspectos sociodemográficos, imunológicos e terapêuticos. MATERIAL E MÉTODO: Foi realizado um estudo de natureza clínico-epidemiológica transversal, entre outubro de 2007 e abril de 2008, com amostra composta por 40 pacientes. Utilizou-se a técnica de observação direta intensiva por meio de exame clínico apropriado. Os dados foram registrados em fichas pré-elaboradas e analisados por estatística descritiva e inferencial. RESULTADO: Verificou-se a prevalência do gênero feminino (52,5%), na faixa etária de 40 a 49 anos (45%). O tratamento com antirretrovirais foi constatado em 85,0% dos casos, sendo todos com terapia de alta potência (HAART). Observou-se que 52,5% dos pacientes apresentaram a contagem de linfócitos TCD4+ acima de 500cél/mm³ e 50,0% apresentaram carga viral indetectável. A prevalência das manifestações bucais foi 42,5%, sendo a mais expressiva a candidose pseudomembranosa (19,23%), seguida da periodontite úlcero-necrosante (15,38%), da leucoplasia pilosa (11,54%) e da queilite angular (11,54%). Não foi verificada associação entre manifestações bucais e carga viral (p=0,1268), nem com o número de células T CD4 (p=0,3458). CONCLUSÃO: A prevalência de algumas manifestações bucais associadas à infecção pelo HIV ainda é alta, sendo a candidose pseudomembranosa a infecção mais prevalente, principalmente entre pessoas com baixo nível de escolaridade e maior tempo de infecção pelo vírus HIV, independentemente da terapia utilizada e do estado imunológico do paciente. INTRODUCTION: The oral and perioral lesions are common in patients infected with HIV, and may represent the first signs of the disease, even before the systemic manifestations. OBJECTIVE : This study aimed to estimate the prevalence of oral manifestations in HIV seropositive individuals, considering the aspects socio-demographic, immunological and therapeutic. MATERIAL AND METHOD: Was performed nature study clinical-epidemiological transverse, between October 2007 to April 2008, with a sample of 40 patients. Was used the technique of intensive direct observation through appropriate clinical exam. Data were recorded on data sheets pre-prepared and analyzed by descriptive and inferential statistics. RESULT: There was a prevalence of females (52.5%), aged 40-49 years (45%). Treatment with antiretroviral drugs was found in 85.0% of cases, all being with high power therapy (HAART). It was observed that 52.5% of patients had a TCD4+ lymphocyte count above 500cél/mm ³ and 50.0% had an undetectable viral load. The prevalence of oral manifestations was 42.5%, the most significant for pseudomembranous candidiasis (19.23%), followed necrotizing ulcerative periodontitis (15.38%), hairy leukoplakia (11.54%) and angular cheilitis (11.54%). No association was observed between oral lesions and viral load (p=0.1268) nor the TCD4 cell count (p=0.3458). CONCLUSION: Prevalence of some oral manifestations associated with HIV infection is still high, with pseudomembranous candidiasis infection more prevalent, mainly among people with low education levels and longer HIV infection, independent of the therapy and immune status of the patient.

A 41-year-old female leukoderma patient was referred bythe orthodontist with a suspected maxillary injury. Thepatient had no complaints, and reported 11/21 extrac-tions due to caries as a child. On physical examination,no facial asymmetry was noted mucosae were intact(Fig. 1A). Computed tomography (CT) showed a sin-gle hypodense and well-delineated lesion, approximately1.0 cm×0.7 0.8 in size, following thecourse ofnasopalatineduct(Fig.1B).Excisionalbiopsywasperformed(Fig. 1C), and thespecimen was sent to Oral Pathol-ogy Laboratory, where a cystic cavity lined by thin columnarpseudostratified epithelium, consisting of one to three celllayers and a dense fibrous cystic capsule, was observedon microscopic examination (Fig. 1D). A predominantlymononuclear inflammatory infiltrate was evident in the cystlumen. From the clinical, tomographic, and histopatholog-ical findings, the diagnosis of nasopalatine duct cyst was

Introdução: linfomas e leucemias são neoplasias linfohematopoiéticas que podem acometer região oral e maxilofacial, incluindo os ossos gnáticos, com aspectos imaginológicos semelhantes a outras neoplasias e processos reativos. Objetivo: Investigar os aspectos radiográficos de linfomas e leucemias em maxila e mandíbula. Metodologia: Uma revisão sistemática foi realizada nas bases eletrônicas Pubmed, Web of Science e Scopus utilizando estratégias específicas de busca. Os critérios de inclusão compreenderam artigos que forneceram imagens do tipo periapical, panorâmica ou tomografia computadorizada (TC) dos casos individualizados e o diagnóstico de leucemia/linfoma pôde ser confirmado por imunoistoquímica. Três avaliadores analisaram e descreveram individualmente as imagens e a qualidade dos exames radiográficos. Resultados: Do total de 1079 artigos escaneados, foram selecionados 129 casos contendo 88 tomografias computadorizadas, 77 panorâmicas e 26 exames periapicais, a maioria (54%) classificados com uma qualidade excelente. O linfoma difuso de grandes células B, sem outras especificações (LDGCB SOE) (32,6%), linfoma de Burkitt (17,1%), infiltrado leucêmico (14,7%), linfoma plasmablástico (7,8%) e linfoma de células NK/T (5,4%) foram os subtipos mais comuns. Os dentes envolvidos apresentaram mobilidade em 37,2% dos casos e um diagnóstico primário de doenças infecciosa/inflamatória foi considerado em 49,2% dos pacientes. A maioria dos casos eram radiolúcidos em exames periapical e panorâmico e a TC estava disponível em 76% dos casos, com um aspecto hipodenso e de bordas mal definidas. Reação periosteal foi pouco comum (4,7%). Conclusões: linfomas/leucemia com destruição dos ossos gnáticos usualmente representam subtipos de alto grau e raramente apresentam reação periosteal na imagem radiográfica. Objective: To investigate the radiographic features of lymphomas and leukemias in the jaws. Study Design: A systematic review was carried out in the electronic databases Pubmed, Web of Science and Scopus using specific search strategies. Inclusion criteria comprised articles that provided periapical, panoramic or computed tomography (CT) images for individual cases and diagnoses of lymphoma/leukemia confirmed by immunohistochemistry. Three experts evaluated and described individually the images and the quality of the radiographic exams. Results: From 1079 reports screened, 129 cases containing 88 tomographic, 77 panoramic and 26 periapical exams were selected, most of them classified as excellent (54%). Diffuse large B-cell lymphomas NOS (DLBCL), Burkitt lymphoma, leukemic infiltration, T/NK-cell lymphoma and plasmablastic lymphoma were the most common subtypes. Involved teeth presented mobility in 37.2% of the cases and a provisional diagnosis of inflammatory/infectious dental disease was considered in 49.2% of the patients. Most cases were radiolucent in plain exams and conventional CT exams were available for 76% of the cases, with hypodense aspect and ill-defined borders. Periosteal reactions were uncommon. Conclusion: Lymphoma/leukemia with gnathic bone destruction are usually of high-grade subtypes and rarely present periosteal reactions.

O objetivo desse estudo transversal foi avaliar as Teleconsultorias Odontológicas offline do Programa Telessaúde Brasil Redes Núcleos Minas Gerais, com ênfase em Endodontia. Foram coletadas informações dos bancos de dados secundários dos núcleos: Hospital das Clínicas da Universidade Federal de Minas Gerais (HC-UFMG) e Faculdade de Medicina da UFMG (FM-UFMG), de jul/2015 a jul/2017. Foram analisadas as variáveis: núcleo de telessaúde, sexo e profissão do solicitante da teleconsultoria; data e horário da pergunta e resposta; tempo até a resposta em dias; se a dúvida foi devidamente respondida; se a teleconsultoria foi atendida; status de postagem; satisfação do profissional; conduta após a teleconsultoria; área e subárea da especialidade odontológica e tipo de dúvida da teleconsultoria. Dados sóciodemográficos das Regiões Geográficas Intermediárias de Minas Gerais, Índice de Desenvolvimento Humano Municipal (IDHM) e Índice de Gini também foram coletados. Os resultados foram analisados descritivamente usando o programa SPSS v.22.0. Foram realizadas 3920 teleconsultorias com uma procura crescente no período (n=187 de Julho a Dezembro de 2015; n=2.214 em 2016; n=1.519 de Janeiro a Julho de 2017), com maior demanda feita por dentistas (93,3%) e sexo feminino (66,7%), dentro do horário de trabalho (78,6%), sendo sobre conduta geral, englobando dúvidas sobre o tratamento, prevenção e proservação das condições bucais (72,1%). Quase a totalidade foi atendida (99,7%), com uma devolutiva de até dois dias em 75% dos casos. Houve baixo feedback dos profissionais em relação a satisfação e resolução das dúvidas (57,2% e 70,2% sem informação, respectivamente). Apenas 5,2% apresentavam informações sobre o encaminhamento dos pacientes. A maior prevalência de dúvidas relacionou-se às áreas de Patologia/Estomatologia (19,0%), seguidas por Farmacologia/Anestesiologia (18,8%), Odontopediatria (10,3%), Cirurgia (10,2%), Dentística/Prótese (8,6%) e Endodontia (7,4%). A devolutiva das dúvidas ocorreu dentro do tempo esperado, com maior prevalência em áreas básicas e condutas gerais. As dúvidas Endodônticas mais prevalentes foram sobre alterações pulpares e periapicais (32,3%), traumatismos dentários (15,6%), urgências endodônticas (11,4%) e medicação intracanal (7,3%). As áreas básicas devem receber uma maior ênfase nos cursos de graduação, para formar profissionais mais preparados para a prática clínica, que realizem um adequado diagnóstico e tratamento integral ao paciente. As dúvidas endodônticas mais prevalentes estiveram relacionadas com os desafios no dia-a-dia dos profissionais da Atenção Primária à Saúde (APS). É de fundamental importância a atualização contínua dos profissionais, tanto por meio de programas de educação continuada, como pela própria busca por novos conhecimentos, promovendo um reforço dessas competências. Além disso, é preciso estimular o feedback dos solicitantes para permitir melhor análise e melhorias para o programa. This cross-sectional study aimed to evaluate the off-line dental teleconsulting of Telehealth Brazil Networks Program in Minas Gerais state Telehealth centers, with emphasis in Endodontics. Data were collected from secondary databases of the Clinical Hospital of the Federal University of Minas Gerais (CH/UFMG) and Medical School of UFMG (MS/UFMG), from July 2015 to July 2017. The variables analyzed were telehealth center; applicants gender and profession; date and time of question and answer; response time in days; if the issue was duly answered; if teleconsulting was attended; posting status; professionals satisfaction; conduct adopted after teleconsulting; dental specialty area and subarea and type of issues. Sociodemographic data from the Intermediate Geographical Regions (IGR) of Minas Gerais, the Municipal Human Development Index (MHDI) and Gini Index were also collected. The results were descriptively analyzed using SPSS v.22.0. In total, 3,920 teleconsulting sessions were recorded, with increasing demand in the period (n=187 from July to December 2015; n=2,214 in 2016 and; n=1,519 from January to July 2017). Most were demanded by dentists (93.3%) and female (78.6%) professionals, during office hours (78.6%) and related to general conducts, with doubts related to treatment, prevention and preservation of oral conditions (72.1%). Almost all were attended (99.7%), with a maximum response time of two days (75.0%). There was low feedback regarding satisfaction and resolution of issues (57.2% and 70.2%, respectively, without information). Only 5.2% had information on whether patients were referred. The higher prevalence of issues related to Pathology/Stomatology specialties (19.0%), followed by Pharmacology/Anesthesiology (18.8%), Pediatric Dentistry (10.3%), Surgery (10.2%), Dentistry/Prosthesis (8.6%) and Endodontics (7.4%). The response occurred within the expected time, with the prevalence of issues in primary dental areas and general conducts. The most prevalent Endodontic doubts were related to pulp and periapical alterations (32.3%), dental trauma (15.6%), endodontic urgencies (11.4%) and intracanal medication (7.3%). The basic areas should receive a greater emphasis on undergraduate courses, to better prepare professionals for clinical practice and determine the adequate diagnosis and integral treatment to the patient. The most prevalent endodontic doubts were related to the daily challenges of Primary Health Care (PHC) professionals. It is of fundamental importance the continuous updating of the professionals, both through continuing education programs and through the search for new knowledge, promoting a reinforcement of these competences. In addition, applicants feedback needs to be encouraged to allow better analysis and improvements to the program.