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Introdução: A síndrome pós-pólio (SPP) desenvolve-se geralmente décadas após o episódio agudo de poliomielite anterior. Os sintomas mais reconhecíveis são o desenvolvimento gradual de amiotrofia e danos musculares, acompanhados de lesões articulares. Covid longa é caracterizada como uma síndrome, com sintomas persistentes de COVID-19. Acredita-se que emerge após 3 semanas da primoinfecção. Ressaltamos que deve haver uma correlação confirmada entre COVID-19 e SPP - fato que justifica a importância da apresentação do caso. Relato de caso: CRC, 58 anos, sexo feminino, antecedentes de Poliomielite Anterior Aguda aos 4 anos. A doença afetou as quatro extremidades, com várias intervenções cirúrgicas na coluna vertebral, além de 3 transposições tendinosas. Em 2021, padeceu por infecção aguda por Sars-Cov-2, iniciando quadro clínico por alopecia, dispneia e paresia nos membros e tronco. Inicialmente, o diagnóstico clínico fora somente de Covid longa, mas, após minucioso exame neurológico e exames complementares, sinais e sintomas compatíveis com o Síndrome Pós-Pólio faziam-se presentes. Conclusão: O artigo de caso destaca a necessidade de compreender e realizar mais estudos sobre a possível relação entre PPS e Covid longa. Além disso, os pacientes necessitam de reabilitação física direcionada, visando otimizar a independência funcional depois do diagnóstico de SPP após infecção de Sars-Cov-2.

A poluição do ar se tornou uma grave ameaça à qualidade de vida da população, principalmente devido a alta densidade populacional que desempenha um papel importante na relação de causa e efeito em um círculo vicioso de emissões de poluentes na atmosfera. As concentrações elevadas de poluentes atmosféricos são extremamente prejudiciais ao meio ambiente, danificam a flora e a fauna e representam um risco para a saúde humana. A poluição do ar causa doenças respiratórias e aumento da mortalidade principalmente em idosos e crianças. Modelos estatísticos e a avaliação das concentrações de poluentes podem estimar a qualidade do ar nos níveis local, regional e nacional. A rede de monitoramento é um mecanismo essencial para o controle da qualidade do ar, auxiliando no desenvolvimento de projetos ambientais e avaliando os efeitos dos poluentes na saúde humana. São fundamentais a educação ambiental e uma ação coletiva para preservar o meio ambiente e proteger as áreas verdes das grandes cidades.

This study aimed to evaluate the effects of aging on the evolution of Apical Periodontitis (AP) lesions in rats. Elderly males (study group, n = 12) and young males (control group, n = 12) Wistar rats were used. When the study group were 24 months old and the control group were 3 months old, AP lesions were induced by creating pulp exposure of the mandibular left first molars. After 21 and 40 days, the animals were euthanized and the mandibles were removed. The left hemi- mandibles were radiographed and the AP lesions of the mesial roots of the first molars were measured using ImageJ software (National Institute of Mental Health, Bethesda, USA). The AP lesions were significantly larger in the Elderly (E) group (p = 0.0006) compared to the Control (C) group (E 21: 218.8 ± 72.96, C 21: 94.77 ± 9.44, E 40: 237.8 ± 57.20, C 40: 85.23 ± 6.63). The lesions of the animals in the elderly groups were significantly larger than the lesions in the younger animals. These findings suggest that the bone and immunological changes caused by aging can influence the progression of AP lesions. Este estudio tuvo como objetivo evaluar los efectos del envejecimiento en la evolución de las lesiones de Periodontitis Apical (PA) en ratas. Se utilizaron ratas Wistar macho ancianos (grupo de estudio, n = 12) y machos jóvenes (grupo de control, n = 12). Cuando el grupo de estudio tenía 24 meses de edad y el grupo control tenía 3 meses de edad, las lesiones AP fueron inducidas por exposición pulpar de los primeros molares inferiores izquierdos. Después de 21 y 40 días, los animales fueron sacrificados y se extrajeron las mandíbulas. Se radiografiaron las hemimandíbulas izquierdas y se midieron las lesiones AP de las raíces mesiales de los primeros molares con el software ImageJ (National Institute of Mental Health, Bethesda, EE. UU.). Las lesiones AP fueron significativamente mayores en el grupo Ancianos (E) (p = 0,0006) en comparación con el grupo Control (C) (E 21: 218,8 ± 72,96, C 21: 94,77 ± 9,44, E 40: 237,8 ± 57,20, C 40: 85,23 ± 6,63). Las lesiones de los animales en los grupos de edad avanzada fueron significativamente mayores que las lesiones de los animales más jóvenes. Estos hallazgos sugieren que los cambios óseos e inmunológicos causados por el envejecimiento pueden influir en la progresión de las lesiones de AP. Este estudo teve como objetivo avaliar os efeitos do envelhecimento na evolução das lesões de Periodontite Apical (PA) em ratos. Foram utilizados ratos Wistar machos idosos (grupo estudo, n = 12) e jovens (grupo controle, n = 12). Quando o grupo de estudo tinha 24 meses e o grupo controle tinha 3 meses, as lesões PA foram induzidas através da exposição pulpar dos primeiros molares inferiores esquerdos. Após 21 e 40 dias, os animais foram eutanasiados e as mandíbulas removidas. As hemimandíbulas esquerdas foram radiografadas e as lesões PA das raízes mesiais dos primeiros molares foram medidas com o software ImageJ (National Institute of Mental Health, Bethesda, EUA). As lesões PA foram significativamente maiores no grupo Idoso (E) (p = 0,0006) em comparação ao grupo Controle (C) (I 21: 218,8 ± 72,96, C 21: 94,77 ± 9,44, I 40: 237,8 ± 57,20, C 40: 85,23 ± 6,63). As lesões dos animais dos grupos idosos foram significativamente maiores do que as lesões dos animais mais jovens. Esses achados sugerem que as alterações ósseas e imunológicas causadas pelo envelhecimento podem influenciar na progressão das lesões de PA.

The purpose of this study was to compare the immunoexpression of biomarkers interleukin (IL)-17, IL-6, and IL-1β in primary chronic apical periodontitis in smokers and nonsmokers.Teeth with primary chronic apical periodontitis indicated for extraction in 16 cigarette smokers and 16 nonsmokers were selected. Silanized sections of tissue were used for immunohistochemical analysis after being stained with hematoxylin-eosin for histopathologic categorization. Subsequently, the images were analyzed with an optical microscope, and each slide was subdivided into 5 high-magnification fields, with scores (0-2) being assigned according to the amount of staining for each antibody.The qualitative analysis of IL-17 cytokine expression showed no focal expression in 5.8%, weak to moderate expression in 17.6%, and strong expression in 76.4% of the smokers and no focal expression in 78.5% and weak to moderate expression in 21.4% of the nonsmokers. IL-6 expression was negative to focal in 13.3%, weak to moderate in 53.3%, and strong in 33.3% of the smokers and negative to focal in 33.3%, weak to moderate in 25%, and strong in 41.6% of the nonsmokers. IL-1β expression was weak to moderate in 87.5% and negative to focal expression in 12.5% of the smokers and negative to focal expression in 100% of the nonsmokers. Quantitative evaluation of the data using the Mann-Whitney U test showed a significant difference in the immunoexpression of IL-17 (P.0001) and IL-1β (P.0001) and no significant difference in the immunoexpression of IL-6 (P = .46) between the 2 groups (P.05).The cytokines IL-17 and IL-1β were more highly expressed in smokers than nonsmokers, whereas IL-6 expression was similar in the 2 groups.

Objetivo: associar fatores ambientais com as hospitalizações e óbitos por doença cerebrovascular nos residentes do município de Nova Iguaçu. Métodos: estudo observacional, retrospectivo e analítico. Foram utilizados bases de dados de qualidade do ar (PM10) do INEA, dados de hospitalizações e óbitos do DATASUS, por Doenças Cerebrovasculares (DCBV) contidos no CID X (subcapítulos I63-I66 e I69). A inferência estatística utilizou as causas de hospitalizações e óbitos por DCBV dividida por sexo considerando o valor de p ≤ 0,05. Os fatores ambientais foram correlacionados as hospitalizações e óbitos por DCBV. As análises estatísticas utilizaram software SPSS IBM 25 e a confecção gráfica o Excel e R studio. Resultados: A média das médias anuais de PM10 ultrapassou em 4,4 vezes os padrões do CONAMA. O sexo masculino apresentou maior número de hospitalizações e óbitos por doenças cerebrovasculares, e em faixas etárias inferiores as mulheres. A correlação entre a poluição do ar e hospitalizações foi positiva muito forte (r = 0,990; p < 0,000) e com os óbitos foi positiva e fraca (r = 0,300; p < 0,000). Conclusão: Apesar da redução das concentrações de PM10 ao longo dos anos, os valores excederam os padrões do CONAMA, correlacionando-se com o aumento das hospitalizações e óbitos por DCBV no município.

Introdução: O recém-nascido prematuro apresenta uma imaturidade do sistema pulmonar o que o leva a uma necessidade de atenção integral e cuidados para evitar possíveis complicações, o fisioterapeuta atua junto a uma equipe multidisciplinar na Unidade de Terapia Intensiva Neonatal, utilizando técnicas respiratórias com o objetivo de contribuir na recuperação e prevenção dos neonatos visando a independência e melhora da capacidade respiratória, para assim diminuir o tempo de internação e aumentar a qualidade de vida. Objetivo: Analisar com base na literatura cientifica disponível o benefício do Fisioterapeuta na Unidade de Terapia Intensiva Neonatal ao utilizar as técnicas de terapia respiratória. Metodologia: Trata-se de uma revisão de literatura do tipo integrativa com busca realizada nas seguintes bases de dados: BVS, PEDro, PubMed, Scielo no período de 2012 a 2022. Resultados: Foram capturados 6 artigos que retratam técnicas de fisioterapia respiratória para assim analisar o benefício da terapia respiratória nos neonatos. Conclusão: A partir dos resultados obtidos no presente estudo, é possível concluir que a fisioterapia respiratória pode atuar em diversos casos diferentes, com múltiplas técnicas visando melhora do desconforto respiratório e do estado hemodinâmico.

The objective of this retrospective, observational study was to describe the oral lesions diagnosed in older patients through histopathological reports from the oral pathology service of a private university in Rio de Janeiro over a 19 year period (1999-2017) and to call attention to the oral health of the elderly. Information was collected and analyzed from 713 medical records of patients aged ≥ 60 years old. The data collected included the patient's age, gender and the type and location of the injury. The mean age of the patients was 68.1 years old, with a higher prevalence of lesions in the 60 to 74 age group. The results showed that three of the four most common oral lesions were more frequent in women and only one (oral squamous cell carcinoma) was more common in men. The 4 most common injuries were: fibrous inflammatory hyperplasia (187; 26.2%), oral squamous cell carcinoma (78; 10.9%), leukoplakia (40; 5.6%) and oral lichen planus (36; 5.0%). These lesions were distributed mainly in the alveolar edge (71; 20.8%) followed by tongue (57; 16.7%), bottom of the vestibule (55; 16.1%), and buccal mucosa (44; 12.9%). The results obtained should be used to alert health professionals, especially dentists, so that early diagnoses of such lesions can be made and thus contribute to improving the quality of care for the elderly. El objetivo de este estudio retrospectivo y observacional fue describir las lesiones bucales diagnosticadas en pacientes ancianos a través de informes histopatológicos del servicio de patología bucal de una universidad privada en Río de Janeiro durante un período de 19 años (1999-2017) y llamar la atención sobre la salud bucal de los ancianos. Se recopiló y analizó información de 713 historias clínicas de pacientes ≥ 60 años. Los datos recopilados incluyeron la edad, el sexo y el tipo y ubicación de la lesión del paciente. La edad media de los pacientes fue de 68,1 años, con mayor prevalencia de lesiones en el grupo de edad de 60 a 74 años. Los resultados mostraron que tres de las cuatro lesiones orales más comunes fueron más frecuentes en mujeres y solo una (Carcinoma de células escamosas de cavidad oral) fue más común en hombres. Las 4 lesiones más frecuentes fueron: hiperplasia fibrosa inflamatoria (187; 26,2%), carcinoma de células escamosas de cavidad oral (78; 10,9%), leucoplasia (40; 5,6%) y liquen plano oral (36; 5,0%). Estas lesiones se distribuyeron principalmente en el reborde alveolar (71; 20,8%), seguido de la lengua (57; 16,7%), fondo del vestíbulo (55; 16,1%) y mucosa de la mejilla (44; 12,9%). Los resultados obtenidos deben servir para alertar a los profesionales de la salud, especialmente a los odontólogos, para que se pueda realizar un diagnóstico precoz de estas lesiones y, así, contribuir a mejorar la calidad de la atención al anciano. O objetivo deste estudo retrospectivo e observacional foi descrever as lesões bucais diagnosticadas em pacientes idosos por meio de laudos histopatológicos do serviço de patologia bucal de uma universidade privada do Rio de Janeiro em um período de 19 anos (1999-2017) e chamar a atenção à saúde bucal do idoso. As informações foram coletadas e analisadas em 713 prontuários de pacientes com idade ≥ 60 anos. Os dados coletados incluíram a idade do paciente, o sexo e o tipo e localização da lesão. A idade média dos pacientes foi de 68,1 anos, com maior prevalência de lesões na faixa etária de 60 a 74 anos. Os resultados mostraram que três das quatro lesões orais mais comuns foram mais frequentes em mulheres e apenas uma (carcinoma de células escamosas oral) foi mais comum em homens. As 4 lesões mais comuns foram: hiperplasia fibrosa inflamatória (187; 26,2%), carcinoma de células escamosas oral (78; 10,9%), leucoplasia (40; 5,6%) e líquen plano oral (36; 5,0%). Essas lesões distribuíram-se principalmente na rebordo alveolar (71; 20,8%), seguida da língua (57; 16,7%), fundo de vestíbulo (55; 16,1%) e mucosa jugal (44; 12,9%). Os resultados obtidos devem servir para alertar os profissionais de saúde, principalmente os dentistas, para que o diagnóstico precoce dessas lesões possa ser feito e, assim, contribuir para a melhoria da qualidade da assistência ao idoso.

The aim of the study was to perform a morphological analysis of the effects of osteoporosis on the periodontal ligament of rats with periradicular injury. Adult rats (n = 24), of the Wistar lineage, 3 months old, were included in the study. Twelve animals were ovariectomized (group OVX) and 12 were operated by simulation (group C). One hundred and twenty days after surgery, all animals were anesthetized, and in each animal, periradicular lesion was developed in the mandibular left first molar, by making a coronal opening in the mesial fossa on the occlusal surface until the pulp was exposed. At the end of each experimental time interval (21 and 40 days after the lesion developed), the animals were sacrificed, and blood was collected to confirm the effects of castration by serum estrogen measurement. The jaws were removed and prepared for quantitative analysis of the periodontal ligament thickness, by using an optical microscope. Comparative analysis of the data was performed using the non-parametric Kruskal-Wallis and Dunn Multiple Comparison tests. A reduction in serum estrogen levels was observed in the OVX groups (p

RESUMEN: Los quistes periradiculares, tanto los de bolsillo como los verdaderos, son de origen inflamatorio; sin embargo, en la literatura ha existido una gran controversia asociada, en primer lugar, a la dependencia de la infección contenida dentro del sistema de conductos radiculares y, en segundo lugar, al tipo de tratamiento endodóntico llevado a cabo en este tipo de lesiones. Con el fin de dilucidar esta controversia se realizará una revisión a la literatura sobre quistes perira diculares donde se explicará cuál es la técnica más adecuada en el diagnóstico de quistes verdaderos y de bolsillo. Igualmente, se explicará la teoría de autosustentabilidad, así como el tratamiento endodóntico de grandes lesiones periradiculares asociadas a dichos quistes. Ahora bien, en la actualidad se ha demostrado que ambos quistes están asociados a infecciones contenidas en el sistema de conductos radiculares y son diferentes solamente en su morfología. Así mismo, se ha recomendado el tratamiento de conducto convencional en dientes con grandes lesiones asociadas a quistes.

To compare the expression of the receptor activator of nuclear factor-kappa B (RANK), matrix metalloproteinase 9 (MMP-9) and parathyroid hormone-related protein (PTHrP) in primary chronic apical periodontitis lesions (CAPLs) between people living with HIV (PLWHIV) undergoing antiretroviral therapy (ART) and HIV- individuals, 32 CAPLs (16 lesions from each group) were submitted to histopathological and immunohistochemical analyses and compared between groups. The majority of the PLWHIV group had undetectable plasma viral loads (n = 13, 81.3%). The means of TCD4+ lymphocytes, exposure to HIV-1 and the time of the use of ART were 542.1 cells/mm3 (SD = 256.4), 6.3 years (SD = 2.9) and 5.0 years (SD = 2.5), respectively. Of all variables studied, only histopathological diagnosis showed a significant difference between groups (LWHIV: granuloma n = 11 (68.0%), cyst n = 5 (31.2%), HIV-: granuloma n = 15 (93.8%), cyst n = 1 (6.2%), p = 0.015). When comparing the expressions of the three inflammatory markers between the groups, no significant differences were seen. There was no difference in the expression of RANK, PTHrP and MMP-9 in primary chronic apical periodontitis lesions between PLWHIV under ART and HIV- individuals.

This study evaluated the effects of a high-fat diet (HFD) on the progression of apical periodontitis (AP) in rats.Eight-week old Wistar rats (N = 24) were included in this study. Half of the animals received an HFD and the other half a control diet (CD). AP lesions were induced 8 weeks later by creating pulp exposure of the mandibular left first molars. The animal's body mass was verified on a weekly basis. After 21 and 40 days, the animals were sacrificed. Blood was collected for biochemical tests, and the liver was removed for hepatic triglycerides analysis. The left hemimandibles were removed, radiographed, and then prepared for histologic evaluation. The right hemimandibles (region near molars) were removed for bone mineral density analysis by dual-energy X-ray absorptiometry.Radiographs showed that AP lesions were significantly larger in the HFD group compared with the CD group (P.05). Histologic analysis confirmed that the AP lesions were larger and revealed a more severe inflammatory infiltrate in the HFD group. Bone mineral density was reduced in the HFD group compared with the CD groups (P.05). The HFD resulted in a significant increase in body mass (P.05), liver mass (P.05), relative liver mass (P.05), and hepatic triglycerides (P.05). The levels of triglycerides and very-low-density lipoprotein were significantly higher in the 40-day HFD group compared with the 21-day HFD and 21- and 40-day CD groups (P.05).Findings suggest that an HFD can influence the progression and severity of AP.

Background The aim of the present study was to analyze the clinicopathological and the ultrastructural features of periapical actinomycosis (PA) cases. Material and Methods Data from the files of an oral pathology laboratory were retrieved and the findings of histopathological analysis were evaluated. Hematoxylin–eosin (HE), a modified Brown & Brenn, and Grocott stains as well as ultrastructural analysis using scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDX) were utilized. Results Six cases were obtained, 4 females and 2 males, with a mean age of 34 year-old. Two cases were symptomatic, lower teeth and the anterior region were more commonly affected, and all cases were characterized by periapical radiolucencies. All cases presented sulfur granules with a ray-fungus or club-shaped pattern of the Splendore-Hoeppli phenomenon in HE-stained sections, with filamentous gram-positive bacteria aggregates highlighted by the modified Brown & Brenn stain. SEM analysis revealed abundant packed rod-like and filamentous bacteria associated with an extracellular amorphous material. EDX analysis showed predominant picks of calcium and sulfur in actinomycotic colonies. Conclusions Our findings suggest that PA manifests either clinically and radiologically as a non-specific and heterogeneous condition and that the actinomycotic colonies consist in a calcium- and sulfur-rich matrix. Furthermore, the results highlight the importance of submitting periapical specimens after surgical removal to histopathological analysis. Key words:Actinomyces, actinomycosis, periapical diseases.

Objective The biologic effects of surgical decompression on the epithelium and connective tissues of periapical cysts are not fully understood. The aim of this study was to evaluate the expression of tissue repair and inflammatory biomarkers in periapical cysts before and after surgical decompression. Study design Nine specimens of periapical cysts treated with decompression before undergoing complete enucleation were immunohistochemically analyzed to investigate the expression of interleukin-1β, tumor necrosis factor-α, transforming growth factor-β1, matrix metalloproteinase-9, Ki-67, and epidermal growth factor receptor. Expression of the biomarkers was classified as positive, focal, or negative. Ki-67 immunoexpression was calculated as a cell proliferation index. The expression of the biomarkers was compared in the specimens from decompression and from the final surgical procedure. Results Computed tomography demonstrated that volume was reduced in all cysts after decompression. There were no differences in the immunoexpression of the proinflammatory and tissue repair biomarkers when comparing the specimens obtained before and after the decompression. Conclusions Surgical decompression was efficient in reducing the volume of periapical cysts before complete enucleation. When comparing the specimens obtained from surgical decompression and from complete surgical removal, the immunohistochemical analysis did not show a decrease in proinflammatory biomarkers; neither did it show an increase in tissue repair biomarkers.

Os distúrbios de coagulação, como hemofilia e doença de Von Willebrand, são caracterizados por mudanças nas respostas inflamatórias e na reparação de tecidos. As respostas inflamatórias podem estar envolvidas na destruição do osso perirradicular e / ou interferir nos mecanismos de reparo após tratamento endodôntico. O objetivo deste estudo foi avaliar a prevalência de periodontite apical (PA) e tratamento endodôntico em diferentes distúrbios da coagulação. Radiografias panorâmicas (106 do grupo de estudo e 106 do controle) foram examinadas para a presença de lesões perirradiculares em dentes não tratados e tratados endodonticamente. O número de dentes e a prevalência de tratamentos endodônticos também foram registrados. Dois endodontistas avaliaram todos os itens separadamente. As análises estatísticas foram realizadas por meio do programa Statistical Package for Social Science (SPSS), versão 21.0 (IBM, Armonk, NY, EUA) e o nível de significância estatística foi estabelecido em 5% (p

Objetivos. Descrever o conhecimento de acadêmicos de Odontologia frente a pandemia da COVID-19 no atendimento odontológico quanto as normas de biossegurança e protocolos vigentes. Métodos. Estudo seccional e descritivo. A amostra foi composta por alunos de Odontologia de 8 universidades, públicas e privadas, localizadas no estado do Rio de Janeiro. Um roteiro de perguntas estruturado foi aplicado on line com questões sobre dados demográficos, aspectos associados a biossegurança na prática odontológica e, por fim, percepções em relação a COVID-19. Os alunos de graduação que estavam nos períodos pré-clínica foram excluídos. Resultados. Participaram 123 alunos, predominantemente do sexo feminino (85,37%). A média de idade dos participantes foi de 27,24 anos, 69,92% com idade variando entre 19 e 26 anos, a maior parte cursando os últimos períodos da graduação de Odontologia (63,42%) em Universidades privadas (88,62%). Todos os participantes reconheceram os sinais e sintomas da doença, sendo febre e falta de ar os sintomas mais citados. Cerca de 67,48% dos respondentes não se sentem seguros para atender os pacientes com mínimo risco de contaminação pela COVID-19, mesmo com conhecimentos de biossegurança. Conclusão. Os alunos de graduação reconhecem os principais sinais e sintomas da COVID-19 e os aspectos de biossegurança praticados por eles estão dentro das prerrogativas para o controle da infecção nas clínicas universitárias.

BACKGROUND Macrophages and plasma cells play a key role in the regulation of innate and adaptive immunity. The aim of this study was to assess the presence of these cells in apical periodontitis and their distribution comparing with clinical and image data. MATERIAL AND METHODS Thirty-three lesions were selected and divided in two groups (17 periapical cysts and 16 periapical granulomas). Immunoreactions using anti-CD68 and anti-CD138 antibodies were carried out; image analysis was performed with an optical microscope and 5 high-power fields from each slide were evaluated leading to an average score of immunoexpression. This mean score was compared between the two groups and correlated with the clinical and image data. RESULTS There was no statistically significant difference (p >0.05) for the mean average score of CD68+ macrophages and CD138+ plasma cells when comparing the two groups (cysts x granulomas) and the specimens included in each specific group. No statistically significant differences (p >0.05) were also observed when comparing the average scores with clinical and image data. CONCLUSIONS The presence of CD68+ macrophages and CD138+ plasma cells was similar in periapical cysts and granulomas and the presence of these cells did not correlate with clinical and image data from both groups. Key words:Macrophages, plasma cells, apical periodontitis, periapical granuloma, periapical cyst.

OBJECTIVES To evaluate the CD68 immunoexpression in post-treatment apical periodontitis lesions of older patients and compare them with lesions of younger/middle age adults. METHODS Biopsy specimens from 21 apical periodontitis lesions (12 granulomas and 9 cysts) were selected from older patients and 25 apical periodontitis lesions from younger/middle age adults (12 cysts and 13 granulomas) were selected and analyzed by immunohistochemistry using silanized slides with anti-CD68 antibody. The slides were subdivided in five high-power fields and the images were observed under an optical microscope to evaluate the epithelial and connective tissues. RESULTS The results showed that there was no statistical difference for the CD68 expression in epithelial tissue of cysts between younger/middle age adults and older patients. However, for the connective tissue of both cysts and granulomas, there was a statistical difference between the two age groups. There was a statistical difference between the epithelial and the connective tissues in cysts of younger/middle age adults, and also when the epithelial tissue of the cysts was compared with connective tissue of the granuloma. In the group of older patients, there was no statistical difference between the connective tissue of the cysts and granulomas. CONCLUSION The intensity of the macrophage staining was greater in the connective tissue of cysts and granulomas alike in the younger/middle age adult patients, suggesting that these cells participate actively in this tissue. Immune responses in older patients may be compromised, suggesting that there is a greater tendency for the endodontic treatment of these patients to fail.

BACKGROUND Periapical cysts (PC) and periapical granulomas (PG) are the two most common chronic inflammatory periapical diseases, but their clinicoradiological characteristics can vary depending on the methods employed in each study. The aim of the present work was to analyze the clinical and radiological profile of a series of PC and PG diagnosed in a Brazilian population. MATERIAL AND METHODS The files of two Oral Pathology laboratories were reviewed and all cases diagnosed as PG and PC were selected for the study. Clinical and radiological information were retrieved and data were tabulated and descriptively and comparatively analyzed. RESULTS Final sample was composed by 647 inflammatory periapical lesions, including 244 PG (38%) and 403 PC (62%). The number of women affected by PG was significantly higher than the number of women affected by PC (p=0.037). Anterior region of the maxilla was the most common affected area for both entities (39% of the cases), but the most common anatomical location of PG (anterior maxilla and posterior maxilla) was different from PC (anterior maxilla and posterior mandible) (p

Aim To compare the immunoexpression of RANK, MMP-9 and PTHrP in apical periodontitis lesions of diabetic and normoglycaemic individuals. Methodology Primary chronic apical periodontitis lesions associated with teeth indicated for extraction in 13 type 2 diabetic individuals and 13 normoglycaemic individuals who were screened for the glycaemic index and glycated haemoglobin (HbA1c) were analysed. Individuals with other systemic diseases and users of anti-inflammatories and/or antibiotics in the previous 3 months were excluded. Silanized slides with paraffin sections were used for immunohistochemical reactions and stained with haematoxylin and eosin for histopathological classification. The images were analysed with an optical microscope, and the slides were subdivided into five large fields assigning scores (0-2), according to the number of positive markings for each antibody. Fisher's exact test evaluated the parameters: gender, type of lesion, location and position in the arch. Nonparametric Mann-Whitney test was used for age, HbA1c values and comparison of marker expression. The chi-squared test was used to associate the expression of the markers. And the Spearman's coefficient correlated the markers with the size of the periapical lesion. Results The samples consisted of 69% periapical granulomas and 31% periapical cysts in each group. RANK expression was considered weak/moderate and strong in, respectively, 62% and 38% of the cases in both groups. MMP-9 expression was weak/moderate and strong in, respectively, 38% and 62% of the cases from the diabetic group, in comparison with 38% and 38% in the normoglycaemics (24% cases from this group were negative). In contrast, PTHrP expression was negative, weak/moderate and strong in, respectively, 46%, 46% and 8% of the cases from the diabetic group, in comparison with 38% negative and 62% weak/moderate in normoglycaemics. Quantitative analysis revealed that there were no significant differences in the immunoexpression of RANK (P = 0.26), MMP-9 (P = 0.17) and PTHrP (P = 0.43) between the groups. There was no significant correlation between the expression of bone resorption markers and the macroscopic size of the periapical lesions (P > 0.05). Conclusions The bone resorption mediators analysed had similar immunoexpression in the periapical lesions of diabetic and normoglycaemic individuals.

Background Severe alveolar atrophy often presents a challenge for the implant surgery. The significant lack of bone in the alveolar ridges may compromise the final restorations both from the aesthetic and functional standpoints. Objectives To evaluate the behavior of bone block allografts for the maxillary augmentation and to investigate its incorporation, remodeling, and implant survival rates in two different healing time points. Material and Methods Sixty-six consecutive patients (52 female/14 male, mean age: 57.95 ± 9.06 years old), presenting 113 atrophic alveolar ridges underwent maxillary augmentation with fresh-frozen allogeneic bone blocks from tibia. Patients were randomly assigned in two groups: Group 1—patients who would wait 4 months for implant placement after grafting, and Group 2—patients who would wait 6 months. Events of infection, suture dehiscence or mucosal perforation were recorded. Cone-beam computed tomography scans were compared volumetrically between the time of the grafting surgery and reentry procedure after incorporation. Biopsies were collected and subjected to histological, histomorphometric and immunehistochemical analysis. Results A total of 305 implants were placed in the reconstructed sites. The mean resorption rate in Group 1 (13.98% ± 5.59) was significantly lower than Group 2 (31.52% ± 6.31). The amount of calcified tissue, newly formed bone and remaining graft particles demonstrated no difference between groups. The samples showed evident immunolabeling for the podoplanin protein in both groups. The implants cumulative survival rate was 94.76%. Conclusions The findings of the present study indicate that there is a significant difference regarding the resorption of the grafts when waiting 4 or 6 months before placing the implants, even though no difference was found in the histological, histomorphometric, and immunohistochemical features. Both 4-month and 6-months healing times are suitable for the implant placement.

To evaluate the effects of a long period of oestrogen deficiency on the development of apical periodontitis in rats.Wistar rats (n = 24), 3 months old, evaluated by vaginal cytology, were included in the study. Twelve animals were ovariectomized (OVX group) and the other 12 were sham operated (control group). One hundred and twenty days after castration, the pulps of the left mandibular first molars were exposed to induce the development of apical periodontitis. Body mass was verified on a weekly basis. Following 21 and 40 days of lesion induction, the animals were sacrificed. Blood was collected for biochemical analysis, and mandibles were removed for radiographic analysis. Comparative analysis of the data was performed by the nonparametric Kruskal-Wallis and Dunn's multiple-comparisons tests. The t-test was applied to compare the oestrogen levels between control and OVX groups.Radiographs revealed that apical periodontitis lesions were significantly larger in the 40-day OVX group when compared with both 40-day (P 0.05) and 21-day (P 0.001) control groups. Serum oestrogen levels were significantly lower in the OVX group (P 0.01), confirming the efficacy of castration. Oestrogen deficiency resulted in significantly greater body mass gain (P 0.01) in 40-day OVX group when compared with 40-day control group. Serum concentrations of calcium were similar between groups (P 0.05). Alkaline phosphatase levels, although higher in the OVX groups (21 and 40 days), were not significantly different.Ovariectomized rats had significantly larger apical periodontitis lesions after 40 days of pulp exposure when compared with controls. These findings suggest that bone alterations as a result of long periods of oestrogen deficiency can influence the progression of apical periodontitis.

AIM In the present study, we compared the transportation of three different instrumentation systems in different levels of standardized artificial curved canals. METHODS Sixty epoxy resin blocks containing simulated canals were divided into three groups (n = 20) according to the instrument used for canal preparation: Reciproc (REC), Reciproc Blue (REC Blue), and XP-endo Shaper (XPS). Pre- and post-instrumentation digital images of each specimen were superimposed by Photoshop software to evaluate the different amount of transportation. The Kruskal-Wallis and Wilcoxon were the non-parametric tests applied for the intergroup and intragroup analyses, respectively. The significance level was set at 5%. RESULTS The XPS showed significantly less canal transportation than REC Blue at five levels (P

Objective: This study evaluated the expression of pro-inflammatory (IL-1β, IL-6, IFN-γ and TNF-α) and anti-inflammatory (IL-4 and TGF-β) cytokines in apical periodontitis lesions. Correlations between these cytokines and clinical and cone-beam computed tomographic (CBCT) data were also assessed. Material and Methods: Apical periodontitis lesions’ data were obtained from 27 patients subjected to periradicular surgery. Specimens were processed for histopathologic and immunohistochemical analysis. Sections were evaluated according to the amount of positive staining for each antibody. Expression levels of the target mediators were compared with clinical and CBCT data. Results: Twenty lesions were diagnosed as granuloma and 7 as cyst. In granulomas, IL-4 expression was significantly higher than IL-6 (p=0.001) and TNF-α (p=0.001). There was a significant relationship between high levels of TNF-α and lesions

AIM The aim of the present study was to evaluate how aging, sex, and hypogonadism influence mandibular bone density with and without the benefits of hormone treatment. METHODS Three-month old Wistar rats were randomly assigned to three experimental groups, with eights animals per group: controls, castrated (orchiectomized [ORX], ovariectomized [OVX]) and castrated with hormonal treatment (ORX + testosterone, OVX + estradiol benzoate). Females were previously evaluated by vaginal cytology. The corporal mass was verified weekly, and after three experimental periods (90, 120, and 150 days), the animals were killed. Blood was collected, and bones underwent densitometric and biomechanical analyses. RESULTS After castration, the male rats demonstrated low gain in body weight compared to females (P

Objectives the aim of this study was to analyze the radiological parameters and histological features and to evaluate the immunoexpression of bone-related proteins in condylar hyperplasia, comparing to age and gender of the affected patients. Forty specimens derived from the surgical treatment of condylar hyperplasia were selected and clinical data were retrieved from the patient files. Radiological information was obtained from panoramic radiographs comparing the affected to non-affected sides. All cases were histologically reviewed and immunoreactions against TRAP, PTHrp, podoplanin and RANK were performed in all cases by the immunoperoxydase technique. Data were descriptively and statistically analyzed comparing both gender and age of the patients with radiological, histological and immunohistochemical features. Findings radiological parameters did not correlate with age and gender of the patients; proportion of bone tissue:bone marrow and fibrous:cartilage layers showed no differences when comparing age of the affected patients, but gender of the patients correlated with the latter. There were no differences on TRAP, PTHrp, podoplanin and RANK expression according with gender and age of the affected patients. Conclusions there were no differences on radiological parameters, proportion of bone tissue:bone marrow and fibrous:cartilage layers and expression of bone-related proteins according with age and gender of patients affected by condylar hyperplasia. Females presented a higher proportion of fibrous:cartilage layers than males.

The aim of the present study was to compare the immunoexpression of CD34, intercellular adhesion molecule-1 (ICAM-1), and podoplanin and the presence of mast cells with clinical, demographic, radiologic, and histologic features from periapical granulomas, periapical cysts, and residual cysts.Thirty-one lesions (5 granulomas, 15 periapical cysts, and 11 residual cysts) were selected. Histologic sections in silanized slides were used for the immunohistochemical reactions. The analysis of the images was performed by using an optical microscope, and data were analyzed with 5% significance (P .05).Cysts presented atrophic and hyperplastic epithelium in 11 cases (35.5%) and 15 cases (48.8%), respectively (P .05). The intensity of the inflammatory infiltrate was similar when comparing the 3 groups (P .05). CD34 and podoplanin expression and the presence of mast cells were similar when comparing the 3 groups; ICAM-1 expression was more intense in granulomas than cysts (P .05). There were no statistically significant differences associated with the expression of the evaluated markers according to the intensity of the inflammatory infiltrate.There were no differences in the expression of CD34 and podoplanin and in the presence of mast cells when the 3 groups were compared. ICAM-1 expression was more common in periapical granulomas.

To evaluate the CD68 immunoexpression in post-treatment apical periodontitis lesions of older patients and compare them with lesions of younger/middle age adults.Biopsy specimens from 21 apical periodontitis lesions (12 granulomas and 9 cysts) were selected from older patients and 25 apical periodontitis lesions from younger/middle age adults (12 cysts and 13 granulomas) were selected and analyzed by immunohistochemistry using silanized slides with anti-CD68 antibody. The slides were subdivided in five high-power fields and the images were observed under an optical microscope to evaluate the epithelial and connective tissues.The results showed that there was no statistical difference for the CD68 expression in epithelial tissue of cysts between younger/middle age adults and older patients. However, for the connective tissue of both cysts and granulomas, there was a statistical difference between the two age groups. There was a statistical difference between the epithelial and the connective tissues in cysts of younger/middle age adults, and also when the epithelial tissue of the cysts was compared with connective tissue of the granuloma. In the group of older patients, there was no statistical difference between the connective tissue of the cysts and granulomas.The intensity of the macrophage staining was greater in the connective tissue of cysts and granulomas alike in the younger/middle age adult patients, suggesting that these cells participate actively in this tissue. Immune responses in older patients may be compromised, suggesting that there is a greater tendency for the endodontic treatment of these patients to fail.

BACKGROUND This study compared the incidence of deviation along curved canals after preparation with two nickel-titanium (NiTi) rotary systems, Twisted File Adaptive and BT-RaCe. MATERIAL AND METHODS Forty resin training blocks with curved canals were filled with ink and divided into two groups according to the instrumentation technique. Preinstrumentation images were acquired by using a stereomicroscope. The canals were up to an instrument #35/0.04. Postinstrumentation images were captured using the same conditions, and the images were superimposed. The amount of resin removed was measured at 8 different points, beginning at the apical terminus of the canal. Differences in the mesial and distal aspects were measured to evaluate the occurrence of deviation. The Student's-t test was used for comparison of the intragroup deviation. Intergroup analysis was performed by using one-way ANOVA for each level. For multiple comparisons, the Bonferroni test was used and a cutoff for significance was set at 5%. RESULTS Intragroup analysis showed that both instrumentation techniques promoted some deviation at all levels. BT-RaCe showed significantly lower deviation at 0 and 4-mm levels than Group Twisted File Adaptive (p

Objective The aim of this study was to compare the expression of proliferative markers and apoptosis-associated proteins in the oral mucosa adjacent to bone sequestrum associated with osteonecrosis (ON) of the jaws and florid osseous dysplasia (OD). Study Design Oral mucosal samples derived from surgical procedures performed for treatment of ON and OD (10 cases each) were retrieved. Histologic analysis was done on hematoxylin and eosin–stained slides; immunohistochemical reactions against epidermal growth factor (EGF), keratinocyte growth factor (KGF), vascular endothelial growth factor (VEGF), Bcl-2 protein, interleukin-6 (IL-6), and Ki-67 antigen were performed with the immunoperoxidase technique. Results The epithelium was hyperplastic in 60% and 22% of ON and OD samples, respectively. Cytoplasmic EGF and KGF expression; Bcl-2, VEGF, and IL-6 expressions; and the mean epithelial proliferative index were not statistically different between the 2 groups. Membranous EGF expression was more evident in samples showing hyperplastic epithelium. Conclusions Exposure to bisphosphonates did not alter the expression of KGF, EGF, VEGF, Bcl-2, IL-6, and the epithelial proliferating index in comparison with inflamed oral mucosa not exposed to bisphosphonates.

BACKGROUND: To compare the quality of calcium hydroxide paste fillings performed by three different techniques. MATERIAL AND METHODS: Sixty extracted maxillary central incisors, with previous root canal treatment, were decoronated and the gutta-percha was completely removed from the root canals. Subsequently, the canals were filled with a calcium hydroxide-based paste composed of calcium hydroxide, bismuth carbonate, and glycerin. The study samples were divided into the following three groups on the basis of three insertion techniques (n = 20, each): conventional technique using a hand instrument (MAN), rotary Lentulo spiral (LEN) technique, and a combined technique combining conventional hand files with sonic activation through the EndoActivator device (EA). The quality of fillings was evaluated radiographically by two examiners on the basis of the amount of voids and the apical limit. RESULTS: The canals filled with LEN or MAN had less void volume compared to the EA technique (P >0.01), with no significant differences between them. Considering the apical limits, the three tested techniques showed comparable results (P >0.05). CONCLUSIONS: A combined approach utilizing hand files with sonic activation showed no enhancements over the LEN or MAN techniques on the quality of intracanal placement of calcium hydroxide paste. Key words:Calcium hydroxide placement, EndoActivator, Lentulo spirals, intracanal medication, root canal treatment. ispartof: J Clin Exp Dent vol:9 issue:6 pages:e762-e766 ispartof: location:Spain status: Published online

Background This study compared the immunohistochemical expression of ki-67, transforming growth factor beta 1 (TGF-β1) and intercellular adhesion molecule-1 (ICAM-1) in inflammatory periapical cysts and residual cysts. Material and Methods The study sample was composed by 25 periapical cysts and 25 residual cysts and immunohistochemical reactions were carried out using antibodies directed against ICAM-1, TGF-β1 and ki-67. Clinical, radiological, gross, histological and immunohistochemical data were tabulated for descriptive and comparative analysis using the SPSS software and differences were considered statistically significant when p