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Aim To evaluate the influence of radiation on root canal sealer push-out bond strength to dentine and sealer/dentine interface in teeth filled with AH Plus (Dentsply Ind. Com. Ltda, Petrópolis, RJ, Brazil) and MTA Fillapex (Angelus Ind. Prod. Odontológicos S/A, Londrina, PR, Brazil). Methodology Thirty-two maxillary canines were selected and randomly assigned to 2 groups ( n = 16): one group was not irradiated, and the other was subjected to a cumulative radiation dose of 60 Gy. Root canals were prepared with the Reciproc system ( VDW GmbH, Munich, Germany), and each group was divided into 2 subgroups ( n = 8) according to the sealer - AH Plus or MTA Fillapex - using the single-cone filling technique. Then, 1-mm-thick dentine slices were obtained from each root third for the push-out test to evaluate sealer bond strength to dentine and for scanning electron microscopy ( SEM) to examine the sealer/dentine interface. Failure mode after debonding was determined with a stereomicroscope at ×25 magnification. Bond strength data were analysed by two-way anova with a split-plot design and post hoc Tukey's test (α = 0.05). Results Significantly lower bond strength ( P < 0.0001) was obtained after irradiation (0.71 ± 0.20 versus 0.97 ± 0.29 MPa) and in specimens filled with MTA Fillapex (0.70 ± 0.18 MPa) compared with AH Plus (1.00 ± 0.27 MPa). Percentage of adhesive failures increased after radiation in all root thirds in the teeth filled with AH Plus. SEM revealed more gap-containing regions and fewer tags at the sealer/dentine interface in irradiated specimens, with more tag formation and fewer gaps with AH Plus sealer. Conclusions Radiation was associated with a decrease in the push-out bond strength of sealers to intraradicular dentine and formation of more gaps and fewer tags at the sealer/dentine interface regardless of the sealer. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the effects of radiotherapy (RT) and chemoradiotherapy (CRT) on the wear and surface roughness of in vitro irradiated human enamel and dentin subjected to abrasive challenge. Enamel and dentin specimens (n = 42) were prepared from teeth donated by healthy patients and those with head and neck cancer who had received radiotherapy (RT) or chemoradiotherapy (CRT). The specimens were categorized into three groups: control, RT, and CRT (n = 14 per group for both enamel and dentin). These samples were subjected to an in vitro abrasive experiment using a brushing machine, followed by wear and surface roughness assessments with a confocal laser scanning microscope conducted before and after the abrasive challenge, considering both exposed and non-exposed areas. Statistical analysis used Shapiro-Wilk tests for normality, Wilcoxon tests for comparing two means, and Kruskal-Wallis tests. A significance level of 5% was adopted. In enamel specimens, wear profile values ​​of CRT and RT groups were not different from the control (p > 0.05). The RT group presents lower step values than the CRT and control groups (p < 0.001). No significant difference in final surface roughness was observed in all groups (p > 0.05). In dentin specimens, no significant difference in wear profile and step was observed in all groups (p > 0.05). However, CRT and RT groups present higher values in final surface roughness (p < 0.001). The exposure to ionizing radiation (associated or not to chemotherapy) influenced the surface roughness of dentin and the wear (step) of enamel after the in vitro abrasive challenge.Trial registration: Ethical procedures were approved by the FORP/USP Research Ethics Committee (CAAE: 61308416.4.0000.5419), and Hospital do Câncer de Barretos/Fundação Pio XII (CAAE: 61308416.4.3001.5437)., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction: Red blood cell (RBC) transfusion is often required during cardiac surgery in children. However, RBC is a rare product, and its transfusion is associated with adverse events and a worse surgical outcome. Characterization of factors related to RBC transfusion during cardiac surgery in children would provide prevention strategies., Methods: We conducted a retrospective single-center study, including all children who underwent their first cardiac surgery using bloodless priming cardiopulmonary bypass (CPB)., Results: The study included 173 children between 2011 and 2019,; 57 had intraoperative transfusion and 17 postoperative transfusion. Age (OR: 0.76, p<0.001), weight (OR: 0.93, p<0.001), body mass index ([BMI] OR: 0.83, p<0.001), hemoglobin level (OR: 0.68, p<0.05), hematocrit level (OR: 0.88, p<0.05), mean corpuscular volume ([MCV] (OR: 0.86, p<0.001), hemodilution (OR: 100, p<0.01), and CPB duration (OR: 1.01, p<0.05) were associated with an increased risk of intraoperative transfusion in univariate analysis. In multivariate analysis, only CPB duration (OR: 1.02, p<0.001) and MCV (OR: 0.89, p<0.05) were associated with transfusion. Concerning postoperative transfusions, the RACHS surgical difficulty score (OR: 6.83, p<0.01), duration of CPB (OR: 1.01, p<0,001), length of stay in the PICU (OR: 2.37, p<0.001), length of hospitalization (OR: 1.2, p<0.001), and reoperation (OR: 20.59, p<0.001) were significant using univariate analysis, and only the need for a reoperation (OR: 19.16, p<0.01) remained significant in multivariate analysis., Conclusion: Low MCV appears to be one of the main risk factors for intraoperative transfusion in RBC. It may reflect iron deficiency that should be checked and supplemented preoperatively in order to reduce the risk of transfusion., Competing Interests: Declaration of Competing Interest none, (Copyright © 2022 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved.)

Introduction: This study aimed to determine whether single nucleotide polymorphisms in the growth hormone receptor (GHR) and insulin-like growth factor 2 receptor (IGF2R) genes are associated with different craniofacial phenotypes., Methods: A total of 596 orthodontic and 98 orthognathic patients from 4 cities in Brazil were included for analyses. Angular and linear cephalometric measurements were obtained, and phenotype characterizations were performed. Genomic DNA was collected from buccal cells and single nucleotide polymorphisms in GHR (rs2910875, rs2973015, rs1509460) and IGF2R (rs2277071, rs6909681, rs6920141) were genotyped by polymerase chain reactions using TaqMan assay. Genotype-phenotype associations were assessed in the total sample (statistical significance was set at P <8.333 × 10 -3 ) and by a meta-analytic approach implemented to calculate the single effect size measurement for the different cohorts., Results: Rare homozygotes for the GHR rs2973015 showed increased measurements for the lower anterior facial height (ANS-Me) and mandibular sagittal lengths (Co-Gn and Go-Pg). In contrast, common homozygotes for the IGF2R rs6920141 presented reduced measurements for these dimensions (ANS-Me and Go-Pg). Furthermore, the less common homozygotes for IGF2R rs2277071 had reduced maxillary sagittal length (Ptm'-A'). The meta-analytical approach replicated the associations of rs2973015 with ANS-Me, rs2277071 with Ptm'-A', and rs6920141 with Go-Pg., Conclusions: Our results provide further evidence that GHR contributes to the determination of mandibular morphology. In addition, we report that IGF2R is a possible gene associated with variations in craniofacial dimensions. Applying meta-analytical approaches to genetic variation data originating from likely underpowered samples may provide additional insight regarding genotype and/or phenotype associations., (Copyright © 2020 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Jeune syndrome (JS) is a rare disease, with systemic manifestations, such as renal and hepatic insufficiency, retinal pigmentation, and respiratory insufficiency. Etiological factors have not been completely elucidated, but the molecular biology has contributed to the diagnosis and understanding of JS with DNA sequencing, showing the association among polymorphisms in different genes DYNC2H1 (MIM 603297) and TCTEX1D2 (MIM617353), which are the main genes associated with JS. There are a few reports on buccal findings in these patients; here, we present dental anomalies and clinical oral findings in a patient with JS, focusing on a multidisciplinary approach for rehabilitation. A 15-year-old boy with JS was referred to our dental clinic. Clinical and radiographic examination revealed the presence of dental agenesis, taurodontism, and geographic tongue with lobulations. The treatment plan consisted of preventive, restorative, surgical, and oral rehabilitation. We observed that the treatment improved the patient's quality of life owing to improved functions, maintenance of oral health, and above all, self-esteem. Clinical findings in this case may contribute to a better characterization of JS and other ciliopathies., (© 2020 Special Care Dentistry Association and Wiley Periodicals, Inc.)

This study was performed to evaluate the interplay between dental caries, nutritional status, and genetic polymorphisms in TAS1R1 and TAS1R2 (taste receptor, type 1, member 1 and 2) in preschool children and pre-adolescents. We included 525 subjects (306 preschool children and 219 pre-adolescents). Parents/caregivers answered a self-administered questionnaire about their children's systemic health, characteristics, oral hygiene habits, and diet. Clinical examination was performed to evaluate dental caries and nutritional status. Saliva samples were collected for DNA extraction. The genotyping of rs17492553 ( TAS1R1 ), rs3935570, and rs4920566 ( TAS1R2 ) polymorphisms was performed using real-time PCR with Taqman Genotyping Master Mix and SNP assay. Both univariate and multivariate Poisson regression analyses with robust variance were used for the data analysis. In preschool children, consumption of sweets between meals increased the prevalence of dental caries by 85% (PR c = 1.85; 95%CI 1.39-2.46; p < 0.001), whereas in pre-adolescents, this prevalence increased by 34% (PR a = 1.34; 95%CI 1.11-1.62; p = 0.002), regardless of genetic polymorphisms . Moreover, individuals carrying at least one allele C in rs17492553 presented 23% more prevalence of dental caries (PR a = 1.23; 95%CI 1.02-1.49 p = 0.030). Nutritional status was not associated with dental caries, neither with genetic polymorphisms . Consumption of sweets between meals increased the prevalence of dental caries. In pre-adolescents, rs17492553 genetic polymorphism in TAS1R1 was associated with dental caries.

Bruxism is a masticatory muscle activity characterized by grinding of the teeth and clenching of the jaw that causes tooth wear and breakage, temporomandibular joint disorders, muscle pain, and headache. Bruxism occurs in both adults and children. Clinical characteristics and habits were evaluated in an adult sample. Moreover, we used DNA samples from 349 adults and 151 children to determine the presence of association with specific genes. Genomic DNA was obtained from saliva. The markers rs2241145 and rs243832 (metalloproteinase 2 ( MMP2 )), rs13925 and rs2236416 (metalloproteinase 9 ( MMP9 )), and rs6269 (cathecol-o-methyltransferase ( COMT )) were genotyped. Data were submitted to statistical analysis with a significance level of 0.05. In adults, in univariate logistic regression, presence of caries, attrition, and use of alcohol were increased in bruxism individuals ( p < 0.05). In addition, in adults, there was an association between bruxism and MMP9 ( rs13925 , p = 0.0001) and bruxism and COMT ( rs6269 , p = 0.003). In children, a borderline association was observed for MMP9 ( rs2236416 , p = 0.08). When we performed multivariate logistic regression analyses in adults, the same clinical characteristics remained associated with bruxism, and orthodontic treatment was also associated, besides rs13925 , in the AG genotype ( p = 0.015, OR a : 3.40 (1.27-9.07)). For the first time, we provide statistical evidence that these genes are associate with bruxism.

Purpose: To evaluate the morphological alterations in enamel and dentin of primary teeth following radiotherapy (RT) and to determine the best adhesive technique and time to carry out restorative procedures.
Methods: Enamel and dentin fragments of primary teeth were randomly assigned into four groups (n=30): G1 (control)-non-irradiated, only restorative procedure; G2- restorative procedure immediately before RT; G3-restorative procedure 24 hours after RT; and G4-restorative procedure six months after RT. Each group was divided into one of two subgroups according to the adhesive system used for restoration: (1) AdperSingle Bond 2 (SB); and (2) ClearfillSE Bond (CL). The specimens were submitted to fractionated RT until they reached the final dose of 60 Gy. They were then subjected to confocal microscopy and the shear bond strength test. Data were analyzed using two-way analysis of variance followed by Tukey's tests ( α = five percent).
Results: Morphological changes were first observed in enamel and dentin after 40 Gy of irradiation. G4 bond strength values were similar to G1 in the CL and SB groups for enamel and in the CL group for dentin ( P >0.05). G2 showed the lowest values for enamel and dentin ( P <0.05). In G3, CL presented the highest strength values in enamel; for G4, the highest values were found in dentin ( P <0.05).
Conclusions: Radiotherapy affected the morphological surface of enamel and dentin. The restorations placed immediately after RT had the weakest shear bond strength, and the restorations placed six months after RT had similar means of bond strength compared to the nonirradiated teeth in enamel, regardless of the adhesive system used. In dentin, CL showed better performance than SB.

The present study evaluated polymorphisms in RANK, RANKL and OPG-encoding genes to assess whether they are associated with mucositis and peri-implantitis in a population from the Brazilian Amazon region. One hundred and fourteen patients with dental implants were included in the study. After clinical and radiographic examination, the sample was categorized into 4 groups, according to the peri-implant status: Healthy (n=71), Mucositis (n=30), Peri-implantitis (n=13) and Diseased (Mucositis + Peri-implantitis, n=43). Genomic DNA was extracted from buccal cells from saliva, and the genetic polymorphism in osteoprotegerin (OPG), Kappa nuclear factor activator receptor (RANKL) and nuclear kappa factor activator receptor (RANK) were genotyped by the real time PCR. Univariate and multivariate statistical analyses were performed to compare clinical variables among groups and to evaluate genotypes and alleles distributions and the established alpha was 5%. Age, peri-implant biotype, diabetes and presence of peri-implant biofilm were associated with mucositis (p<0.05) and peri-implantitis (p<0.05). Smoking, alcoholism, and periodontal biofilms were also associated with the presence of peri-implantitis (p<0.05). Univariate and multivariate analysis did not demonstrate an association of peri-implantitis or mucositis with any genetic polymorphism in RANK (rs3826620), RANKL (rs9594738) and OPG (rs2073618) (p>0.05). The studied genetic polymorphism in RANK, RANKL and OPG were not associated with mucositis and peri-implantitis in a Brazilian population from the Amazon region.

Objectives: To evaluate the in vitro effects of radiotherapy (RT) on the morphological surface of the enamel and dentin and to determine the best adhesive system and most appropriate time to restore teeth in head and neck cancer patients., Methods: Sixty third molars were cut into 120 enamel fragments and 120 dentin fragments and divided into four groups (n = 30): G1 (control): nonirradiated, only restorative procedure; G2: restorative procedure immediately before RT; G3: restorative procedure immediately after RT; and G4: restorative procedure 6 months after RT. Each group was divided into two subgroups: Adper™ Single Bond 2 (SB) and Clearfill SE Bond (CL) based on the material used. After RT and restorative procedures, the specimens were subjected to confocal microscopy and shear bond strength test. Data were analyzed using a two-way ANOVA followed by Tukey's test at a significance level of 5%., Results: Morphological changes were observed in both substrates after a cumulative dose of 40 Gy, and after 60 Gy, the changes were more evident in both substrates. CL had the highest strength values in both substrates (p < 0.05), and G2 had the lowest strength values for the enamel and dentin (p < 0.05)., Conclusions: Based on the in vitro study results, we can conclude that RT substantially changes the morphological surface of enamel and dentin and impairs the bond strength. The Clearfill system yielded better results than Adper Single Bond 2, and restoring teeth before RT resulted in the worst results in both substrates.

Objective: The present cross-sectional, multi-centre, genetic study aimed to determine, whether single nucleotide polymorphisms (SNPs) in tooth agenesis (TA)-associated GLI2 and GLI3 genes contribute to the development of craniofacial skeletal morphology in humans., Design: Orthodontic patients from an ethnically heterogeneous population were selected for the present study (n = 594). The presence or absence of TA was determined by analysis of panoramic radiography and dental records. The subjects were classified according to their skeletal malocclusion and facial growth pattern by means of digital cephalometric analysis. Genomic DNA was extracted from squamous epithelial cells of the buccal mucosa and SNPs in GLI2 (rs3738880, rs2278741) and GLI3 (rs929387, rs846266) were analysed by polymerase chain reaction using TaqMan chemistry and end-point analysis., Results: Class II skeletal malocclusion presented a significantly lower frequency of TA (P < 0.05). Subjects without TA showed significantly higher ANB angles (P < 0.05). Genotype and/or allele distributions of the SNPs in GLI2 (rs3738880, rs2278741) and GLI3 (rs846266) were associated with the presence of TA (P < 0.05). The SNPs rs3738880, rs2278741 and rs929387 were also associated with some type of skeletal malocclusion (P < 0.05), but not with the facial growth pattern (P > 0.05). The G allele for TA-related GLI2 rs3738880 was strongly linked to the presence of Class III skeletal malocclusion (OR = 2.03; 95% CI = 1.37-3.03; P<3125 × 10 -6 ). GLI2 rs2278741 C allele was overrepresented in individuals without TA, suggesting it as a protective factor for this dental phenotype (OR = 0.43; 95% CI = 0.24-0.78; P<625 × 10 -5 )., Conclusion: The present study suggests that SNPs in TA-associated GLI2 and GLI3 genes may also play a role in the development of skeletal malocclusions. rs3738880 and rs2278741 in GLI2 seems to contribute to the genetic background for skeletal Class III and TA, respectively. TA could be an additional predictor of craniofacial morphology in some cases. Further research replicating the reported associations should be performed., (Copyright © 2019. Published by Elsevier Ltd.)

Background: Tooth eruption is a process that is not fully understood., Aim: To evaluate whether genetic polymorphisms for RANK/RANKL/OPG are associated with delayed tooth emergence. To evaluate whether the relative expression of this genes is associated with persistent primary teeth., Design: To evaluate whether genetic polymorphisms for RANK/RANKL/OPG could be involved in delayed tooth emergence, saliva samples from 160 children, aged 6-13 years old, were analysed. To test if there is correlation between gene expression of RANK/RANKL/OPG in children with delayed tooth emergence and persistent primary teeth, periapical tissue from 15 children with persistent primary teeth and from 15 control subjects were collected for qPCR analysis., Results: Fifty-six children with delayed tooth emergence (35%) had at least one permanent tooth with delayed emergence. The T allele in RANKL (rs9594738) increased the risk of delayed tooth emergence (P = 0.02; OR = 1.71, 95%CI 1.09-2.75). The relative gene expression for RANKL and the ratio RANKL/OPG in children with delayed tooth emergence and persistent primary teeth were lower compared to controls (P = 0.02 and P = 0.005, respectively)., Conclusions: Data suggest that the polymorphism rs9594738 in RANKL is associated with delayed permanent tooth emergence. Moreover, reduced relative gene expression of RANKL in periapical tissue is associated with persistent primary teeth., (© 2019 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Early diagnosis of neurofibromatosis is significant to start the multidisciplinary approach of this type of patient. This syndrome may be first identified in pediatric dental care. This study is about a 9-year-old patient who was diagnosed with neurofibromatosis type 1 from a plexiform neurofibroma displayed in the left hemi-maxilla. From the microscopic diagnosis of the lesion the investigation of other related injuries began, according to the diagnostic criteria of the National Institute of Health (NIH), leading to the diagnosis of systemic alterations. The parental awareness about the condition and the establishment of multidisciplinary care are important for the treatment to be more conservative and the patient has fewer complications with better quality of life. The use of the diagnostic criteria in this case shows how methodization is important for reaching more accurate and reliable diagnoses.

Background: Oestrogen (ES) and growth hormone (GH) are hormones that may have a role in caries aetiology and developmental defects of enamel (DDE) since their receptors (ERs and GHR) are expressed during amelogenesis., Aim: To evaluate whether genetic polymorphisms in the genes that codify the ERα (ESR1) and GHR are associated with caries experience and DDE in children., Design: Two hundred and sixteen children of both genders, aged 9-12 years, were examined and classified according to caries and DDE phenotype. Genomic DNA was extracted from buccal cells in saliva. Genetic polymorphisms in ERS1 (rs1884051 and rs12154178) and GHR (rs297305, rs2940913, rs2910875, and rs1509460) were genotyped using TaqMan chemistry. Data were analysed by PLINK, while the chi-square test was used to compare allele and genotype distributions (alpha of 5%)., Results: A total of 131 children (60.7%) had caries experience, and 43 (19.9%) presented DDE. Genotype and allele distributions were not associated with caries experience (P > 0.05). Genotype and allele distributions between DDE, affected and unaffected, were associated with the polymorphism rs12154178 in ESR1 (P = 0.01 and P = 0.001, respectively) and with the polymorphism rs1509460 in GHR (P = 0.05 and P = 0.02, respectively)., Conclusions: Genetic polymorphisms in ERS1 (rs12154178) and GHR (rs1509460) are associated with DDE., (© 2018 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The aim of this study was to investigate the association between genetic polymorphisms in MMP8, MMP13, and MMP20 with caries experience and developmental defects of enamel (DDE) in children from the Amazon region of Brazil. Den tal caries and DDE data were collected through clinical examination from 216 children. Genomic DNA was extracted from saliva, and genotyping of selected polymorphisms in MMP8 (rs17099443 and rs3765620), MMP13 (rs478927 and rs2252070), and MMP20 (rs1784418) was performed using TaqMan chemistry and endpoint analysis. χ2 or Fisher's exact tests were used to compare allele and genotype distributions between children with caries experience and caries-free children and between DDE-affected and -unaffected children with an established alpha of 5%. The polymorphism rs478927 in MMP13 was associated with caries experience and DDE (p < 0.05). The analysis performed comparing children with both conditions (caries experience plus DDE) and children with neither of the conditions (caries-free chil dren without DDE) demonstrated that children carrying the MMP13 rs478927 TT genotype were more likely to have concomitant occurrence of these two conditions (OR = 5.8, 95% CI 2.1-15.8; p = 0.0003). In conclusion, the genetic polymorphism rs478927 in MMP13 was associated with caries experience and DDE., (© 2019 S. Karger AG, Basel.)

A strong association between celiac disease (CD) and dental enamel defects (DEDs) have been extensively reported, however, the nature of this relationship is still unclear. The aim of this study was to evaluate DEDs phenotype in CD individuals according to the time they were introduced to a gluten-free diet (GFD). Forty-five CD individuals were examined by a pediatric dentist. DEDs were classified according to the type of affected teeth. CD individuals were classified into two groups (with or without DEDs) and the differences between these groups were tested using chi-square or Fisher´s exact tests and t-test to compare differences between means. The Pearson coefficient test was used to evaluate the degree of the correlation between the age of GFD introduction and number of affected teeth. Individuals with MIH were introduced earlier to the GFD (p = 0.038). An association was also observed for molar DED (p = 0.013). In conclusion, our study suggested an association between a specific type of DED and the time that CD individuals were introduced to a GFD., (© 2017 Special Care Dentistry Association and Wiley Periodicals, Inc.)

Permanent teeth that remain impacted could lead to the early loss of primary teeth and cause space problems in dental arches. We present two cases of ectopic eruption of the permanent maxillary first molars treated with soft distal movements using a modified Nance palatal arch (NPAm). The wire was soldered to the band and positioned distally to serve as support for the elastic chain, which was attached to a bonded button on the occlusal surface. After a few months, the ectopic eruption was corrected, preserving the adjacent primary teeth and restoring the occlusion. An NPAm is a viable option for distalization and space recovery in the maxillary arch.

A solitary median maxillary central incisor (SMMCI) is rare and affected individuals may carry a potentially serious condition known as SMMCI syndrome. However, many of these cases do not receive proper attention because they are misdiagnosed as agenesis of the maxillary central incisor. The purpose of this manuscript is to report two cases of children with only one maxillary central incisor and draw diagnostic differences between the entities. A correct diagnosis is very important because if an SMMCI is confirmed, the patient should be referred for genetic counseling.

Purpose: The purposes of this study were (1) to assess the endotoxin levels in root canals of primary teeth with necrotic pulps and periapical lesions; and (2) to evaluate the correlation of endotoxin levels with the periapical lesion size., Methods: Twenty primary molars with necrotic pulps and periapical lesions were selected. Standardized radiographs were obtained and the lesions were measured. Material from each root canal was collected to quantify the bacterial endotoxin. The results were analyzed using Pearson's correlation, student's t test, and Fisher's exact test (α equals five percent)., Results: The initial amount of bacterial endotoxin in the root canals ranged from 0.089 to greater than 50.00 endotoxin units (EU)/mL and was detected in 100 percent of the samples. A positive but not significant correlation was observed between the amount of endotoxin and periapical lesion size in primary molars., Conclusion: Endotoxin was observed in 100 percent of root canals of primary teeth with a periapical lesion. However, there was no statistical significance between bacterial endotoxin levels and the periapical lesion area.

Pyogenic granuloma (PG) is a reactive local benign vascular lesion, where connective tissue fibrovascular proliferation occurs. The most common etiology of PG is chronic, low-level irritation. PG affects females mainly. The purpose of this paper is to report a giant pyogenic granuloma caused by an acute trauma in the upper lip of an 11-year-old boy. The initial clinical diagnosis suggested PG, which was confirmed after an excisional biopsy and a microscopic exam. Oral lesions of large proportions in children can cause functional, esthetic, and behavioral issues, and should be promptly investigated.

This work presents the results of surgery in thoraco-abdominal aortic aneurysms (TAA) and thoracic descending aortic aneurysms (TDA) in one single center between January 1rst, 1996 and December 31, 2005. It concerns open surgery in 42 and endovascular procedures in ten patients. Forty two patients (11 TDA and 31 TAA (4 type I, 12 type II , 6 type III and 9 type IV)) define the open surgery series. Twenty six patients were operated on elective basis and 16 patients in emergency condition. Surgical correction was made under partial cardio-pulmonary bypass (PCPB) in 70% of cases via femoral vessels; most significant intercostal arteries were reimplanted and cerebro-spinal fluid (CSF) drainage used in half of the cases. Operative mortality was zero in the elective group (0/26) and attained 19% in the emergent group (3/16). Mortality was linked to cerebrovascular accidents (CVA) in two cases and post-pump left lung hemorrhagic infarction in one case. The paraplegia accounts 2/26 in the elective group and one in the emergent group (1/16). That is 7.1% in both groups. At the end of five years, survival is 66% in elective group and 74% in the emergency group. Ten patients (5 TDA and 5 TAA (2 type I, 3 type III)) were treated endovascularly. Operative mortality and postoperative paraplegia were nil.

Embolization of cholesterol crystals from atheromatous plaques is a rare entity most often seen after invasive procedures involving manipulation of the aorta. Spontaneous CE has been reported in very rare cases. Peripheral signs include livedo reticularis, muscle pain and palpable pulses. Depending on the site of the responsible plaque, emboli may involve visceral organs and produce a systemic illness. Diagnosis is confirmed using skin, muscle and/or renal biopsies. Surgery is recommended when the atheromatous disease is localized to a unique segment which can be replaced.