Search

Leishmaniasis is a tropical disease caused by protozoan parasites of the genus Leishmania. Mucosal leishmaniasis has been described as secondary to the cutaneous form; however, isolated mucosal involvement can also occur. Specifically, mucosal leishmaniasis of the lip is poorly described and its diagnosis challenges clinicians.We herein report a case of mucosal leishmaniasis affecting the lower lip without cutaneous involvement in a 20-year-old Venezuelan man. The patient had no relevant past medical history. Clinically, a mass-like lesion with ulcerations and crusts was observed.Microscopically, the lesion was composed of granulomatous inflammation along with macrophages containing intracytoplasmic inclusions similar to round-shaped Leishmania. The species Leishmania (Viannia) braziliensis was confirmed. Treatment with meglumine antimonate was effective. The lesion healed satisfactorily, and no side effects or recurrences were observed.Clinicians should be aware of isolated forms of mucosal leishmaniasis of the lip, even in cases where the cutaneous lesion is undetected or clinically manifests as self-limiting. Knowing the endemic areas in the scenario of the dynamics of the ecoepidemiology of leishmaniasis is also essential for surveillance and counselling of the population.

BACKGROUND Increased lipogenesis and lipid droplet accumulation are observed in diverse tumors, and these processes are associated with poor prognosis in several tumors, representing potential therapeutic targets. The presence of lipid droplets in odontogenic tissues and/or tumors is unknown. METHODS Immunohistochemistry for perilipin 1 and adipophilin was performed in 12 human tooth germs (TG), 27 conventional ameloblastoma (AM), and 8 ameloblastic carcinoma (AC) samples. Cytoplasmic staining was analyzed using an immunoreactive score (IRS), and the results were compared for the TG, AM, and AC samples by Kruskal-Wallis test followed by Dunn's post-test and confirmed by Mann-Whitney U test. RESULTS Perilipin 1 was negative in 91.7% of the TG samples, positive in 48.2% of the AM samples, and positive in 87.5% of the AC samples. Adipophilin was positive in 100% of the TG samples, 92.6% of the AM samples, and 100% of the AC samples. The perilipin 1 and adipophilin IRS revealed statistically significant differences between the TG, AM, and AC samples (p = .007 and p = .018, respectively). The perilipin 1 levels among the TG and AC samples were statically significant (**p = .0085), as well as the adipophilin levels when TG and AM samples were compared (**p

Resumen Antecedentes y objetivo La enfermedad de Hansen o lepra es una enfermedad causada por Mycobacterium leprae y Mycobacterium lepromatosis. Estas bacterias ingresan al organismo por las vias aereas superiores, por lo que generan manifestaciones clinicas en la mucosa nasal y en la cavidad bucal. El objetivo del estudio es caracterizar las lesiones bucales de los pacientes con una enfermedad de Hansen. Materiales y metodos Se diseno un estudio observacional, transversal, de 100 pacientes con diagnostico de lepra. Se examino la cavidad bucal y se registraron los hallazgos clinicos en una ficha epidemiologica. Ademas, se incluyo el estudio histopatologico de las lesiones que requirieron de una biopsia. Los casos sugestivos de lepra fueron tenidos y analizados con hematoxilina y eosina, Ziehl-Neelsen y Fite-Faraco. Las variables fueron analizadas y comparadas mediante las pruebas Chi2, correlacion de Spearman y U de Mann-Whitney. Resultados El grupo de estudio estuvo conformado por 67 hombres y 33 mujeres, con una media (± desviacion estandar) de 48,1±16,4 anos de edad. Fueron observadas lesiones bucales en 34 pacientes. Las lesiones orales relacionadas con lepra, presentes en 9 pacientes, se ubicaron en el paladar duro y el labio superior. Estas fueron significativamente mas frecuentes en la lepra lepromatosa, la borderline lepromatosa (p=0,029) y en el eritema nudoso leproso (p=0,031). Conclusiones Las lesiones bucales asociadas a lepra ocurren con una frecuencia baja, manifestandose como lepromas y placas leprosas en el paladar duro y el labio superior.

Background The caveolin-1 protein (structural component of membrane caveolae) plays important roles in several biological functions, such as endocytosis, cell adhesion, and cell signaling. However, this protein has been associated with mechanisms of tumorigenesis in several neoplasms. The expression patterns and roles of caveolin-1 in the oral epithelium and in embryonic and odontogenic tumor tissues are still unclear. Material and Methods The expression of caveolin-1 was evaluated in samples of the normal gingival epithelium (n=7), human tooth germ (TG) (n=12), ameloblastoma (AM) (n=83), and ameloblastic carcinoma (AC) (n=9) by immunohistochemistry. Additionally, AM samples were analyzed by qRT-PCR and Western blot. Results Most TG (91.7%), AM (73.5%) and AC (100%) samples showed diverse patterns of immunohistochemical positivity for caveolin-1, while only one gingival sample was positive. The transcript levels of cav-1 were significantly upregulated by 14.9-fold in AM tissue (P = 0.0014) compared to those in normal gingival epithelial tissue, as shown by qRT-PCR. Presence of caveolin-1 protein was confirmed by Western blot analysis. The caveolin-1 immunoexpression patterns throughout the stages of TG show its importance during odontogenesis. Conclusions The overexpression of caveolin-1 in AM and AC compared to its expression in normal gingival epithelium (adult tissue) suggests a possible role of caveolin-1 in protumoral events, but due to the similar immunoexpression observed in AM and AC, caveolin-1 may not necessarily participate in the malignant transformation process. However, future studies are needed to clarify and confirm these hypotheses. Key words:Ameloblastoma, ameloblastic carcinoma, caveolin-1, immunohistochemistry, real-time polymerase chain reaction.

Background and objective Hansen disease, or leprosy, is caused by Mycobacterium leprae or Mycobacterium lepromatosis. Because these bacteria enter the body via the upper airways, they generate clinical manifestations in the nasal mucous membranes and the mouth. We aimed to describe the characteristics of oral lesions in patients with Hansen disease. Material and methods Cross-sectional observational study of 100 patients diagnosed with Hansen disease. We examined the oral cavity and recorded clinical findings on a disease reporting form for each patient. We also included the histopathologic findings for lesions that required a biopsy. Samples suggestive of Hansen disease were processed with hematoxylin-eosin, Ziehl–Neelsen, and Fite–Faraco staining. Variables were analyzed, as appropriate, with the χ2 test, the Mann-Whitney U test, or the Spearman correlation coefficient. Results Sixty-seven men and 33 women were included. The mean (SD) age was 48.1 (16.4) years. Thirty-four patients had oral lesions. Lesions related to Hansen disease were found in 9 patients. The locations were the hard palate and upper lip. Oral lesions were significantly more frequent in patients with lepromatous leprosy, borderline lepromatous leprosy (P = .029), and erythema nodosum leprosum (P = .031). Conclusions The frequency of oral lesions is low in Hansen disease. Such lesions present as lepromas and leprous plaques on the hard palate and upper lip.

Introduction Lupus erythematosus (LE) is an autoimmune disease often treated with antimalarial drugs. The prolonged use of chloroquine and hydroxychloroquine can cause hyperpigmentation in the skin, oral mucosa and retinal pigment epithelium, which in turn can trigger toxicity in this epithelium, which in some cases causes vision loss. The objective of the present work was to establish the association between the presence of oral pigmented macules by antimalarial and secondary retinal toxicity. Methods A total of 105 patients diagnosed with LE being treated with chloroquine/hydroxychloroquine were evaluated. All patients were ophthalmologically evaluated for retinopathy screening. When the patient showed oral hyperpigmented maculae, an incisional biopsy was performed with the corresponding histopathological study with informed consent. The variables were compared using the chi-square test for quantitative variables and the non-parametric Mann–Whitney U-test for categorical variables. The confidence level was established at 95%, and p-values of ≤0.005 were considered statistically significant. Results Only 9.5% of the patients showed oral brown spots. Histopathologically, 100% of the oral macules showed characteristics of oral pigmentation by drug and 100% ophthalmological parameters of normality. Two patients presented with a diagnosis of pre-retinopathy, but none showed oral lesions. Conclusion Hyperpigmented macules in the buccal mucosa in lupus patients receiving antimalarial treatment are not frequent and do not represent a predictive finding of toxicity of the drug.

Objective: To evaluate interleukin-1ß (IL-1ß) and interleukin-8 (IL-8) epithelial expressions in potentially malignant disorders of the oral mucosa as malignant predictive markers.Study design: About 55 tissues embedded in paraffin, comprising 15 oral lichen planus (OLP) lesions, 15 leukoplakias, 15 oral squamous cell carcinomas (OSCC), and 10 samples of normal oral mucosa were included in the study. IL-1ß and 8 expressions were assessed by immunohistochemistry using antibodies antihuman IL-1ß human (sc-7884, Santa Cruz® H-153) and antihuman IL-8 (ab7747, abcam®). The number of positive cells was compared using Student's t-test. Any p-value < 0.05 was considered statistically significant.Results: Nuclear and cytoplasmatic keratinocyte staining were positive for both cytokines in all study groups. However, a statistically significant decrease was observed within all cases compared to normal mucosa, both staining for IL-1β and 8. Moreover, IL-8 showed significant differences between OLP and leukoplakia, and when compared to OSCC.Conclusions: Oral epithelial expression of IL-1β and 8 seems to decrease when the malignant transformation of the oral mucosa increases.

La cavidad ósea de Stafne (CS) ha sido descrita como una radiolucencia oval, de bordes definidos y corticalizados, localizada por debajo del conducto mandibular entre el primer molar y el ángulo de la mandíbula. Casos atípicos de presentación de la cavidad en forma lobulada con márgenes irregulares, escleróticos o incompletos, así como una localización inusual requieren el empleo de métodos imagenológicos que posibiliten realizar un diagnóstico diferencial, evitando un procedimiento invasivo. El objetivo del presente trabajo fue describir un caso de CS en un paciente masculino de 74 años de edad, con antecedente de cáncer de próstata. Las imágenes de tomografía computarizada de haz cónico evidenciaron una cavidad abierta hacia la tabla lingual por debajo del conducto mandibular. Las imágenes de resonancia magnética y tomografía computarizada multicorte permitieron identificar el contenido del defecto, identificado en ambos métodos imagenólogicos como tejido adiposo. El examen radiográfico de una CS de aspecto atípico debe ser complementado con estudios tomográficos y de resonancia magnética, estos proporcionan información relevante para el diagnóstico definitivo, limitando la realización de una exploración quirúrgica. En el caso clínico presentado, la caracterización de la extensión del defecto, su relación con los dientes y estructuras vecinas, así como la identificación del contenido permitieron descartar la presencia de una metástasis de cáncer de próstata.

OBJECTIVE: To report the clinicopathologic features of acquired oral syphilis cases in South American countries. MATERIALS AND METHODS: Clinical data were retrospectively collected from the records of 18 oral diagnostic services in Argentina, Brazil, Chile, Colombia, Venezuela, Uruguay, and Peru. Serologies of nontreponemal and treponemal tests were used for diagnosis. RESULTS: The series comprised 339 cases of acquired oral syphilis. Secondary syphilis ranked as the most common stage (86.7%). Lesions were more frequent among males (58.0%) and young adults with a mean age of 33.3 years. Individuals aged 20-29 years were most affected (35.3%). The most commonly involved sites were the tongue (31.6%), lip/labial commissure (25.1%), and hard/soft palate (20.4%). Clinically, acquired oral syphilis usually presented as mucous patches (28.4%), papules (25.7%), and ulcers (18.1%). Skin manifestations occurred in 67.7% of individuals, while lymphadenopathy and fever were observed in 61.3% and 11.6% of all subjects, respectively. Most patients were treated with the benzathine penicillin G antibiotic. CONCLUSION: This report validates the spread of acquired oral syphilis infection among young adults in South America. Our directives include accessible diagnostic tools for proper disease screening, surveillance, and counselling of affected individuals, especially in low- and middle-income countries

Chronic mandibular hypomobility is characterized by a long-standing limitation of the mouth opening related to multiple etiologies, including elongation of the coronoid apophysis. Unlike the most frequent pathologies that cause coronoid elongation, such as hyperplasia, osteoma (OM), and osteochondroma (OC), the accessory mandibular condyle (AMC) is a rare entity.This case report presents a case of an AMC to describe the clinical, imaging, surgical, and histological characteristics, establishing its differential diagnosis with hyperplasia, OM, and OC of the coronoid apophysis.

Objective This study aimed to assess the frequency of KRAS mutation and its association with the presence of the MAPK/ERK signaling pathway proteins in adenomatoid odontogenic tumors. Study design Paraffin-embedded tissue samples from nine cases of adenomatoid odontogenic tumor were used. Genomic DNA was extracted from each sample; in one case, genetic mutations in 50 cancer-associated genes were examined by next-generation sequencing. Hotspot mutations in the RAS family were analyzed by Luminex assay using the remaining eight cases. Subsequently, immunohistochemistry for KRAS, CRAF, BRAF, EGFR, ERK, MEK, and BRAFV600E was performed. Results A KRAS G12D missense mutation was detected in the DNA sequence of the tumor cells, but it was not detected in the stromal tissue. KRAS G12V and KRAS G12R mutations were detected in two and four cases, respectively. For immunohistochemistry, all the cases were EGFR, KRAS, BRAF, CRAF positive, one case was ERK negative,and one case was MEK and ERK negative, all the other remaining cases were MEK and ERK positive. Conclusion KRAS mutation at codon 12 and the presence of MAPK/ERK pathway proteins were detected suggesting their association with tumorigenesis of adenomatoid odontogenic tumors.

Osseous dysplasias are idiopathic processes located in the periapical region of the maxillary-mandibular complex. They are characterized by the substitution of normal osseous tissue for fibrous tissue and metaplastic osseous tissue. Florid osseous dysplasia (FOD) describes a set of radio-lucid and radio opaque inter-radicular and periapical lesions, bilaterally found in the mandible and sometimes in the upper jaw. The present project presented a FOD case diagnosed by means of histological, radiological and clinical findings; there was presence of infection and painful symptoms. A 62 year old female patient treated at the Oral-Maxillofacial Surgery Unit of the General Hospital «Dr. Domingo Luciani», Caracas, Venezuela sought medical care. The patient reported onset of the condition two weeks before consultation, she experienced intense pain in the right mandibular posterior region with presence of intra-oral fistula and purulent discharge. X-ray examination revealed multiple radio-opaque lesions involving all four quadrants. Excision biopsy was undertaken, histopathological study indicated presence of florid osseous dysplasia. The patient was assessed during an 11 month asymptomatic post-operative period.

Many predisposing factors to caries are present in autism, however, it is unlikely that autistic patients exhibit higher caries indexes than the rest of the population. Objective: To evaluate salivary factors related to caries in autistic patients. Study design: 34 autistics and 34 controls aged between 4–13 years old were included. Decayed, missing, and filled teeth (DMFT) index and oral hygiene simplified index (IHO-S) were assessed, as well as, pH, total proteins, phosphate, calcium and IgA in saliva. All data were analyzed by chi2 and Student t tests for independent samples. P values

Background Presence of parathyroid hormone related protein (PTHrP) might suggest that ameloblastomas recapitulate features of the enamel epithelium and induce bone resorption, which would facilitate their growth and local invasion. The aim of this study was to determine the expression of PTHrP in ameloblastomas. Material and Methods An observational research study was designed including 39 cases of histologically diagnosed ameloblastomas (39 out of 42 patients gave consent for the use of their medical records and all data required for this study). Gender, age, tumor location, histological type and subtype of the tumor were recorded and PTHrP expression was determined by indirect immunohistochemistry using monoclonal anti-human PTHrP (1D1 / Santa Cruz Biotechnology). Protein expression and intensity were evaluated under light microscope and finally data recorded and statistically analyzed. This research was approved by the Caracas West General Hospital review board. Results 39 cases of ameloblastomas were evenly distributed between genders (49% male and 51% female) with a mean age of 33 ± 3.53 years, mainly affecting the posterior mandible. 20 cases (51.28%) showed positive cytoplasmic immunoreactivity to PTHrP. 8 out of 15 cases of solid/multicystic ameloblastomas and 12 out of 23 cases of unicystic ameloblastomas were PTHrP positive. Intense expression of PTHrP was observed in 4 unicystic ameloblastomas (all luminal subtype) and in 5 cases of conventional ameloblastomas. Conclusions In the present study PTHrP expression in solid multicystic and unicystic ameloblastoma suggests its possible function in the biological behavior of the tumor. More studies are needed in order to determine the possible role of this protein related to bone invasion processes. Key words:Parathyroid hormone related protein, PTHrP, ameloblastoma, bone.

BACKGROUND: The aim of this study was to characterize oral lesions in patients with systemic and cutaneous lupus erythematosus (LE) in a Venezuelan group. METHODS: Ninety patients with LE were studied. Oral biopsies were taken from patients who showed oral mucosal involvement. Tissue samples were investigated with histology and direct immunofluorescence techniques for the presence of immunoglobulins G, M, A and complement factor C3. RESULTS: In 90 patients with LE, 10 patients showed oral lesions related to the disease. Sixteen lesions were investigated. Oral ulcerations accompanied by white irradiating striae occurred in five patients, erythema was observed in five patients and a white homogeneous plaque in one patient. Fifteen lesions demonstrated vacuolar basal degeneration and 12 thickening of the basement membrane histologically. Direct immunofluorescence was negative in three samples. CONCLUSIONS: These findings corroborated that ulcers are not the only manifestation of LE in the oral mucosa. Clinical and histological examinations are significant as immunoproteins are not always found on the oral sample. J Oral Pathol Med (2007) 36: 524–7

Background: CD40 has a role in the regulation of immune responses, cell proliferation and migration, and apoptosis. Little is known of its distribution in oral mucosal pathology. Methods: Oral keratinocyte lines were tested for CD40 protein by Western blotting. Immunohistochemistry was used to stain paraffin sections of oral mucosa in health and in inflammatory, reactive, dysplastic and malignant disease. Results: Western blotting confirmed the presence of CD40 in oral keratinocytes. CD40 was generally expressed by keratinocytes in the basal layer, with variable parabasal expression. Langerhans cells also stained positively. Expression was lost in nine of 33 (27%) epithelial dysplasias, seven of which were severe. Eighty-one percent of well, 69% of moderately and 50% of poorly differentiated oral squamous cell carcinomas (OSCC) expressed CD40. Overall, 45 of 65 (69%) OSCC were positive. The pattern of expression was unrelated to tumour differentiation. Conclusion: CD40 expression by basal and parabasal oral keratinocytes is physiological. Expression is lost in approximately one-third of oral epithelial dysplasias and OSCC. The significance of such loss remains unknown, but may be related to immunological or other abnormalities of keratinocyte homeostasis.

Background: Current evidence suggests that immunological mechanisms are involved in oral lichen planus (OLP) pathogenesis. The events implicate activated epithelia that comprise antigen-presenting Langerhans cells, immunocompetent keratinocytes and subepithelial inflammatory infiltrate. Also, the presence of a high density of leucocyte cells may occur for the expression of a variety of adhesion molecules. The aim of this study was to analyse the immunoexpression of some adhesion molecules as well as lymphocytic markers in order to determine the disease pathogenesis in a Venezuelan population. Methods: The 18 OLP and 10 normal oral mucosa biopsies were immunostained for CD4, CD8, CD1a, LFA-1, VCAM-1 and ICAM-1. Results: The results showed an increased number of CD4+, CD8+, CD1a+ cells in OLP. Serial sections showed CD4+ and CD8+ cells also expressed LFA-1. The expression of ICAM-1 and VCAM-1 were significantly higher in OLP. Conclusions: The immunological reaction begins with Langerhans cells activation, which presents an antigen to CD4+ lymphocytes. Those cells through ICAM-1 and LFA-1 promote epithelial destruction. Afterwards, cytokine production, ICAM-1 and VCAM-1 expression can activate CD8+ lymphocytes leading to the chronic form of the disease.

La tomografía axial computarizada (TC) es un recurso imagenológico de gran utilidad que brinda la posibilidad de medir los coeficientes de atenuación de diferentes tejidos examinados mediante una escala de grises, determinado por las Unidades Hounsfield (UH). En medicina se ha venido utilizando con éxito la TC como método “Gold Standard” para el diagnóstico de diversas entidades, sin embargo, en el área maxilofacial, los valores de densidad de las lesiones han sido poco investigados. El objetivo de esta investigación fue determinar los perfiles de UH como herramienta diagnóstica de lesiones intra-óseas del complejo maxilo-mandibular. Metodología: Fue realizada una investigación clínico observacional para la evaluación de las UH como test diagnóstico de las lesiones maxilofaciales. Se incluyeron 42 lesiones intra-óseas de los maxilares evaluadas con TC (sistema CT Scan-multicorte). 11 individuos sin lesiones tumorales o infecciosas que se realizaron TC por razones de implantes fueron incluidos como controles. Se seleccionó un ROI amplio y un ROI reducido para cada lesión, este último para mediciones de UH correspondiente al centro y periferia, para cada plano espacial. El evaluador no tuvo conocimiento del diagnóstico de las lesiones al valorar cada tomografía (enmascaramiento simple). Los datos se analizaron bajo estadística descriptiva comparando el índice de UH con el diagnóstico histopatológico. Resultados: No se observaron diferencias significativas entre las mediciones con ROI amplio y reducido. Los perfiles de UH de mayor densidad se obtuvieron para la displasia ósea y el odontoma compuesto. El tumor odontogénico quístico queratinizante (TOQQ) fue el único grupo de lesiones con valores negativos en su perfil. Se evidenciaron similitudes para el perfil de quiste periapical y quiste óseo simple. Las medias de UH más altas fueron observadas en los casos de displasia ósea y odontoma (1732,4/1698/1707,5 y 1582,9/1523/1512,9 UH respectivamente), mientras que las más bajas fueron observadas en el TOQQ con valores medios alrededor de -15 UH. Conclusiones: Cada lesión muestra un perfil de UH distinto que debe ser utilizado como examen complementario mas no como herramienta diagnóstica única.

Squamous cell carcinoma is a rare consequence of lupus erythematosus and it is generally associated with skin lesions rather than with oral mucosa. This paper reports a patient diagnosed with systemic lupus erythematosus who developed a squamous cell carcinoma on the palate as an outcome of a persistent ulcer, a frequent lesion in patients with this disease and, in fact, clinical criterion for its diagnosis. A 38-year-old female patient diagnosed with systemic lupus erythematosus 12 years previously, who attended the dental school for routine dental control. The patient was being treated with prednisone 10 mg per day and cyclophosphamide 750 mg per month until 10 months prior to her diagnostic biopsy. She had, however, been previously treated with chloroquine. Oral lesions started 6 months before consultation as symptomatic multiple ulcers on the palate. After topical treatment with steroids for 1 month, the lesions regressed except for the central lesion, from which an incisional biopsy was taken and a well differentiated squamous cell carcinoma was diagnosed. The oncological phase consisted of partial palatectomy. To date, 3 years after surgery, the patient is free from malignant lesions. Lupus erythematosus is considered a potentially malignant disorder, although the cause for neoplasic transformation in these patients is still not clear, but cyclophosphamide consumption may be implicated; the case emphasizes the importance of periodical oral evaluation of such patients. Repeated biopsies should be performed if there is failure to respond to conventional therapy.

The aim of this study was to characterize oral lesions in patients with systemic and cutaneous lupus erythematosus (LE) in a Venezuelan group.Ninety patients with LE were studied. Oral biopsies were taken from patients who showed oral mucosal involvement. Tissue samples were investigated with histology and direct immunofluorescence techniques for the presence of immunoglobulins G, M, A and complement factor C3.In 90 patients with LE, 10 patients showed oral lesions related to the disease. Sixteen lesions were investigated. Oral ulcerations accompanied by white irradiating striae occurred in five patients, erythema was observed in five patients and a white homogeneous plaque in one patient. Fifteen lesions demonstrated vacuolar basal degeneration and 12 thickening of the basement membrane histologically. Direct immunofluorescence was negative in three samples.These findings corroborated that ulcers are not the only manifestation of LE in the oral mucosa. Clinical and histological examinations are significant as immunoproteins are not always found on the oral sample.

CD40 is a transmembrane glycoprotein belonging to the tumour necrosis factor receptor superfamily, which has a role in a number of biological functions, including the regulation of cell growth and division, and cell mediated immunity. Although originally described on leucocytes, principally B lymphocytes, there is now abundant evidence for the cellular diversity of CD40. The aim of this article is to review the available data on CD40 in oral epithelium, principally that lining the oral mucosa, but also that of the salivary glands.

La enfermedad de Adamantiades-Behçet es una vasculitis multisistémica crónica, potencialmente capaz de afectar a cualquier órgano o sistema del cuerpo humano y en la que la aparición repetida de úlceras orales es una de sus principales expresiones clínicas. La EAB es una patología de carácter universal, con una prevalencia variable en función de la población estudiada y que muestra una curiosa distribución geográfica. A pesar de ser un proceso conocido desde la antigüedad, su etiopatogenia en la que probablemente se hayan implicados factores genéticos, microbiológicos e inmunológicos, continua siendo enigmática. Su amplio espectro de manifestaciones clínicas orales, genitales, cutáneas, oculares, neurológicas, vasculares y gastrointestinales y su impredecible evolución con periodos de exacerbación y de remisión son dos de los aspectos más representativos de esta patología. El complejo tratamiento de la EAB requiere una estrecha cooperación multidisciplinar dado su carácter multisistémico. Gracias a ello y al desarrollo de nuevos agentes terapéuticos su pronóstico ha mejorado sensiblemente con respecto a décadas pasadas. En esta revisión analizamos los principales aspectos etiopatogénicos, clínicos y terapéuticos de esta enfermedad. Adamantiades-Behçet disease (ABD) is a chronic multisystemic vasculitis that is able to affect any human organ or system. Recurrent oral ulcers are a very important clinical sign. ABD is a worldwide pathology, which prevalence varies according to the population and geographic location. Although ABD has been known for ages, its aetiology remains an enigma. Genetic, immunological and microbiological factors have been associated. A wide spectrum of clinical manifestations (oral, genital, cutaneous, ocular, neurological, vascular and gastrointestinal) and an unpredictable evolution with repeated periods of exacerbation and remission are the most representative aspects of this pathology. The complex treatment of ABD requires a deep multidisciplinary cooperation; therefore, there is an extensive development of new therapeutic agents that have improved the prognosis of ABD. In this review were analysed the main etiological, clinical and therapeutic aspects of the disease.

The pathogenesis of periodontal disease involves the sequential activation of a great variety of components of the host immune response, primarily acting to defend periodontal tissues against bacterial aggression, but also functioning as mediators of tissue destruction. The expression of the disease results from the interaction of host, microbiological agents, and environmental factors. Leukocytes play a critical role in the pathogenesis of the disease, producing different cytokines, chemokines, and other mediators, thus generating a host defense response, as well as inducing tissue inflammation and bone destruction. The aim of this review is to address the role of some inflammatory mediators in response to bacterial aggression in periodontitis.

Current evidence suggests that immunological mechanisms are involved in oral lichen planus (OLP) pathogenesis. The events implicate activated epithelia that comprise antigen-presenting Langerhans cells, immunocompetent keratinocytes and subepithelial inflammatory infiltrate. Also, the presence of a high density of leucocyte cells may occur for the expression of a variety of adhesion molecules. The aim of this study was to analyse the immunoexpression of some adhesion molecules as well as lymphocytic markers in order to determine the disease pathogenesis in a Venezuelan population.The 18 OLP and 10 normal oral mucosa biopsies were immunostained for CD4, CD8, CD1a, LFA-1, VCAM-1 and ICAM-1.The results showed an increased number of CD4+, CD8+, CD1a+ cells in OLP. Serial sections showed CD4+ and CD8+ cells also expressed LFA-1. The expression of ICAM-1 and VCAM-1 were significantly higher in OLP.The immunological reaction begins with Langerhans cells activation, which presents an antigen to CD4+ lymphocytes. Those cells through ICAM-1 and LFA-1 promote epithelial destruction. Afterwards, cytokine production, ICAM-1 and VCAM-1 expression can activate CD8+ lymphocytes leading to the chronic form of the disease.

RESUMENLas displasias óseas son procesos idiopáticos ubicados en la región periapical del complejo maxilar mandibular caracterizados por un reemplazo de hueso normal por tejido fibroso y hueso metaplásico. La displasia ósea florida (DOF) se refiere a un conjunto de lesiones periapicales e interradiculares radiolúcidas y radiopacas ubicadas en la región mandibular bilateral y ocasionalmente en el maxilar. El presente trabajo tiene como objetivo presentar un caso de DOF diagnosticada mediante hallazgos clínicos, radiográficos e histológicos, con presencia de sintomatología dolorosa e infección. Se presenta femenina de 62 años tratada en la Unidad de Cirugía Buco-Maxilofacial del Hospital General del Este, «Dr. Domingo Luciani», Caracas, Venezuela, quien refiere inicio de enfermedad actual dos semanas previas a la consulta presentando dolor intenso en región posterior mandibular derecha con presencia de fístula intraoral y secreción purulenta. Al examen radiográfico se observaron múltiples lesiones radiopacas que involucraban los cuatro cuadrantes. Se realizó biopsia excisional y el estudio histopatológico concluyó displasia ósea florida. La paciente fue evaluada durante un periodo postoperatorio de 11 meses asintomático.ABSTRACTOsseous dysplasias are idiopathic processes located in the periapical region of the maxillary-mandibular complex. They are characterized by the substitution of normal osseous tissue for fibrous tissue and metaplastic osseous tissue. Florid osseous dysplasia (FOD) describes a set of radio-lucid and radio opaque inter-radicular and periapical lesions, bilaterally found in the mandible and sometimes in the upper jaw. The present project presented a FOD case diagnosed by means of histological, radiological and clinical findings; there was presence of infection and painful symptoms. A 62 year old female patient treated at the Oral-Maxillofacial Surgery Unit of the General Hospital «Dr. Domingo Luciani», Caracas, Venezuela sought medical care. The patient reported onset of the condition 2 weeks before consultation, she experienced intense pain in the right mandibular posterior region with presence of intra-oral fistula and purulent discharge. X-ray examination revealed multiple radioopaque lesions involving all four quadrants. Excision biopsy was undertaken, histopathological study indicated presence of florid osseous dysplasia. The patient was assessed during an 11 month asymptomatic post-operative period.

El descubrimiento de que el epitelio escamoso estratificado que cubre la mucosa oral podia expresar moleculas del Complejo Mayor de Histocompatibilidad clase II en varias condiciones patologicas de tipo inflamatorio abrio la posibilidad de que los queratinocitos orales sean celulas inmunologicamente activas, las cuales pueden funcionar con .celulas presentadoras de antigenos'ñ. Para una efectiva activacion de los linfocitos T, las celulas presentadoras de antigenos requieren, ademas de la expresion de moleculas del Complejo Mayor de Histocompatibilidad clase II, senales co-estimuladoras. El proposito del presente estudio fue determinar la expresion de moleculas del Complejo Mayor de Histocompatibilidad clase II y las moleculas co-estimuladoras CD40, CD80 y CD86 en queratinocitos bucales normales y derivados de carcinomas de celulas escamosas. Usando citometria de flujo en queratinocitos cultivados de mucosa oral sana y siete lineas celulares derivadas de carcinomas orales, fue confirmado que los queratinocitos expresan moleculas del Complejo Mayor de Histocompatibilidad clase II despues de estimulacion con IFN'Á in vitro. Todas las lineas celulares expresaron constitutivamente CD40, por el contrario, CD80 y CD86 universalmente fueron negativos. La ausencia de estas ultimas moleculas pudiera ser la causa por la cual los carcinomas orales escapan de la vigilancia inmunologica y pueden crecer, invadir y hacer metastasis pese al sistema inmunologico. Recognition in the 1980Es that keratinocytes can express class II molecules of the Major Histocompatibility Complex (MHC) first raised the possibility that these cells might have an immunological function, and may even act as antigen presenting cells (APC). For effective T lymphocyte activation, APC require, in addition to MHC II, appropriate costimulatory signals. The aim of this study was to determine the expression of MHC class II and the co-stimulatory molecules CD40, CD80 and CD86 in keratinocytes derived from healthy oral mucosa and oral carcinomas. Using flow cytometry, it was confirmed that oral keratinocytes .switch on'ñ expression of MHC class II molecules after stimulation with IFN'Á in vitro. All keratinocyte lines expressed CD40 constitutively; by contrast, CD80 and CD86 were universally absent. Loss of CD80 and CD86 may be one means whereby tumours escape immunological surveillance..