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Med Oral Patol Oral Cir Bucal. 2009 Jul 1;14(7):E319-E324. Expression
of pro-inflammatory protein, iNOS, VEGF and COX-2
in Oral Squamous Cell Carcinoma (OSCC),
relationship with angiogenesis and their clinico-pathological
correlation. Department
of Tropical Pathology, Faculty of Tropical Medicine, Mahidol
University, Bangkok, Thailand, skraisorn@yahoo.com. One
main etiology for oral squamous cell carcinoma
(OSCC) is inflammation. Inducible nitric oxide synthase
(iNOS), vascular endothelial growth factor (VEGF)
and cyclooxygenase-2 (COX-2) are the important molecules showing close
relation to not only inflammation but also carcinogenesis and angiogenesis.
Angiogenesis is defined as the formation of new blood vessels from existing
vasculature. It is necessary for tumor growth and progression and also
involved in metastasis. The objective of this research was to study the
expression and relationship among iNOS, VEGF,
COX-2, angiogenesis and their clinico-pathological
correlation in OSCC. In this study, standard indirect immunohistochemical
technique using polyclonal antibodies specific to human iNOS,
VEGF, COX-2 and CD31 was performed in formalin-fixed paraffin-embedded tissue
sections of 66 OSCC samples. The staining patterns and intensity are measured
and analyzed statistically. The results showed that epithelial components of squamous cell carcinomas demonstrated moderate to intense
staining for iNOS, VEGF and COX-2. iNOS shows correlation with
cervical lymph node metastasis and tumor staging (TNM) of the patients and
angiogenesis. VEGF shows correlation with tumor grading, tumor staging and
angiogenesis. COX-2 shows correlation with cervical lymph node metastasis. In
conclusion, the expression of iNOS, VEGF and COX-2
exists in OSCC. The data provided show the expression of these chemical
mediators associated with carcinogenesis and angiogenesis in OSCC. It can be
the primary database before using angiogenesis drug against these mediators
for OSCC treatment. |
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Med Oral Patol Oral Cir Bucal. 2009 Jul 1;14(7):E337-E339. The
post-mortem pink teeth phenomenon: A case report. Faculdade de Odontologia de Pernambuco - FOP/UPE, Av. General Newton Cavalcanti, nº 1650, Tabatinga - Camaragibe–PE – Brazil, evelynesoriano@yahoo.com.br. This
study presents the case of the post-mortem pink teeth phenomenon observed
during an autopsy procedure performed on the body of a man who was kidnapped
and murdered approximately 30 days before the examination. The corpse was in
an advanced stage of decomposition and putrefaction. Both maxillary and jaw
bones were intact, as well as the permanent teeth which presented the
"pink teeth phenomenon" , probably due to
a haemorrhage in the pulp chambers. The pink discolouration was most pronounced at the neck of the
teeth. The cause of death was asphyxia. Although the examiners stressed that
post-mortem pink teeth must not be considered as a reliable odontological parameter for determining the cause of
death, the results of other studies have shown that the pink teeth phenomenon
is a common finding related to cases of asphyxia such as strangulation,
drowning or suffocation. Thus, the pink teeth phenomenon must be studied in
order to determine its role as a post-mortem finding. As of now, an exact
relationship between the cause of death and this phenomenon remains unknown. |
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Med Oral Patol Oral Cir Bucal. 2009 Jul 1;14(7):E349-E354. Relationship
between mandibular fracture and impacted lower
third molar. Faculdade de Odontologia de Pernambuco, Departamento de Cirurgia e Traumatologia BMF, Av. General Newton Cavalcanti, 1650 Camaragibe – PE, 54753–220, Brazil, belmiro@pesquisador.cnpq.br. Many
studies have shown that the greatest risk of fracture of the mandibular angle is related to the presence of an unerupted lower third molar, based on the hypothesis that
there is a decrease in the area of bone and absorption of the impact in this
area, leading some surgeons to indicate its prophylactic removal in patients
most exposed to the risk factors of facial trauma. On the other hand, other
authors have observed a greater frequency of condylar
fractures in patients without an impacted lower third molar. Purpose: The aim
of this study was to relate the condylar and angle
fracture with an unerupted lower third molar,
taking into account the position of the tooth. Material and Methods:
Panoramic radiographs were used to determine if the presence or absence of
the third molar is related to the occurrence of mandibular
fractures, such as angle and condylar fractures.
Results: In a total of 43 patients with angle fractures, the greatest
percentage had erupted teeth, and 41.9% had impacted teeth; however there was
no significant difference between the fractured side and the tooth condition
(p=0.350). There were 91 condylar fractures and in
42.9% the third molar was absent and in 40.7% the tooth was erupted . There was no significant difference between the
fractured side and the tooth condition (p=0.852). Conclusions: The absence of
an impacted third molar may increase the risk of condylar
fractures and decrease the prevalence of mandibular
angle fractures. |
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Med Oral Patol Oral Cir Bucal. 2009 Jul 1;14(7):E315-E318. Oral
lichen planus: A retrospective study of 420 Iranian
patients. Mashhad
Dental School, Vakil Abad Blvd, Mashhad, Iran,
atessapakfetrat@yahoo.com. Objective:
In terms of the demographic and clinical characteristics, this is the one of
the largest studies on Iranian patients with Oral Lichen Planus
(OLP). Study design: Data was taken from the medical records of 420
consecutive patients referred to the Oral Medicine Department, and who were
subsequently found to have clinical and usual histopathology consistent with
features of OLP. Results: Seventy percent of the patients had been referred
to the Oral Medicine Department by general dental practitioners. 52.6% were
referred due to oral mucosal and/or gingival pain or burning sensation.
Reticular OLP was the most common presentation (76.9%); about 18% of patients
reported symptoms or signs, or had a known history of OLP, or possible Lichen
Planus affecting non-oral epithelia. A malignant
transformation rate of 0.07% was observed. |
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Med Oral Patol Oral Cir Bucal. 2009 Jul 1;14(7):E325-E330. Sjögren's syndrome of the oral cavity. Review and update. Hospital General Universitario, Servicio de
Estomatología, Avda. Tres
Cruces s/n, 46014 Valencia, Spain,margaix1980@hotmail.com. Sjögren's syndrome is one of the most frequent
autoimmune diseases. It is a chronic and systemic disorder predominantly
found in women, and is characterized by the appearance of a lymphocytic
inflammatory infiltrate, with dryness of the oral cavity and eyes, secondary
to involvement of the salivary and lacrimal glands.
The underlying causal mechanism involves a number of factors and has not been
clearly established, though an autoimmune response is known to be triggered,
with the accumulation of immune complexes in the gland acini
that interfere with gland function. In the oral cavity, xerostomia
or hyposialia is the most disabling manifestation
for patients, and is accompanied by rapidly progressing caries, candidiasis and an important worsening of buccodental health. The most important complication is a
44-fold increase in the risk of developing non-Hodgkin lymphoma, compared
with the general population. The treatment of Sjögren's
syndrome is limited to symptomatic management, and involves the use of
solutions to replace salivary secretion and afford a measure of hydration,
cholinergic agents such as pilocarpine to stimulate
the unaffected gland tissue and, recently, the administration of substances
that act against surface antigens of the B lymphocytes, such as anti-CD20 and
anti-CD22 antibodies. The present study provides an update on this disease,
placing special emphasis on its odontologic
implications. |
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Med Oral Patol Oral Cir Bucal. 2009 Jul 1;14(7):E344-E348. Orofacial
features of Treacher Collins syndrome. Stomatology Clinic, Dental School, State University of
Montes Claros, Montes Claros, Minas Gerais, Brazil,
pbonan@yahoo.com. Treacher Collins syndrome (TCS) is a rare autosomal dominant disorder of craniofacial development.
Major features include midface hypoplasia,
micrognathia, microtia,
conductive hearing loss, and cleft palate. The present study is on the orofacial features of 7 Brazilian patients with sporadic
TCS aged 4 to 38 years. All patients presented the typical down-slanting palpebral fissures, colobomas, zygomatic and mandibular hypoplasia, partial absence of the lower eyelid cilia,
and abnormalities of the ears. Malocclusion was present in all patients, and
an anterior open bite was found in 3 patients. None of the patients had a
cleft palate. |
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Med Oral Patol Oral Cir Bucal. 2009 Jul 1;14(7):E310-E314. Oral
lichen planus and oral lichenoid
lesions; a critical appraisal with emphasis on the diagnostic aspects. VU
University Medical Center (VUmc)/Academic Centre
for Dentistry Amsterdam (ACTA), Department of Oral and Maxillofacial Surgery,
P.O. Box 7057, 1007 MB Amsterdam,The Netherlands,
ivanderwaal@vumc.nl. Oral
lichen planus (OLP) has a prevalence of
approximately 1%. The etiopathogenesis is poorly
understood. The annual malignant transformation is less than 0.5%. There are
no effective means to either predict or to prevent such event. Oral lesions
may occur that to some extent look like lichen planus
but lacking the characteristic features of OLP, or that are indistinguishable
from OLP clinically but having a distinct cause, e.g. amalgam restoration
associated. Such lesions are referred to as oral lichenoid
lesions (OLLs). The management of OLP and the various OLLs may be different.
Therefore, accurate diagnosis should be aimed at. |
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Med Oral Patol Oral Cir Bucal. 2009 Jul 1;14(7):E340-E343. Ellis-Van
Creveld Syndrome. Case report and literature
review. Centro Médico Teknon, C/ Vilana 12, 08022 – Barcelona, Spain, cgay@ub.edu. Ellis-van
Creveld syndrome is a genetic disorder that was
first described by Richard Ellis and Simon van Creveld
in 1940. The four principal characteristics are chondrodysplasia,
polydactyly, ectodermal
dysplasia and congenital heart defects. The orofacial
manifestations include multiple gingivolabial musculofibrous fraenula, dental
anomalies, hypodontia and malocclusion. The disease
can be diagnosed at any age, even during pregnancy. The differentiation
should be made between Jeune syndrome and other orofaciodigital syndromes. |
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Med Oral Patol Oral Cir Bucal. 2009 Jul 1;14(7):E331-E336. Multiple
supernumerary teeth not associated with complex syndromes: A retrospective
study. Centro Médico Teknon, C/ Vilana 12, 08022 – Barcelona, Spain, cgay@ub.edu. Objectives:
To determine the epidemiology and describe the clinical and radiographic
characteristics, the type of treatment, and the possible delayed appearance
of new supernumerary teeth in patients with non-syndromic
multiple hyperdontia. Patients and methods: We
conducted a small retrospective observational study of 8 patients diagnosed
with non-syndromic multiple hyperodontia.
Multiple hyperdontia not associated to complex
syndromes was defined as apparently generally healthy patients with one or
more supernumerary teeth in two or more areas. Results: The average patient
age was 16.23 years; males predominated (3:1). Multiple hyperodontia
with a minimum of 2 and a maximum of 9 supernumerary teeth was found (total:
34 mean: 4.25). The most frequent location was the upper jaw (76.47%). Eumorphic teeth were seen at lower premolar level, while
the rest were all heteromorphic. There was altered
eruption of the contiguous teeth of 4 of the impacted supernumerary teeth all
the rest being asymptomatic. Extraction was the treatment in all patients,
and in one of them the delayed appearance of 4 supernumerary teeth was
detected. Conclusions: Multiple hyperodontia rarely
occurs without being associated with complex syndromes. Prophylactic surgical
removal of the supernumerary teeth is generally the treatment of choice. |
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Med Oral Patol Oral Cir Bucal. 2009 Jul 1;14(7):E361-E364. Surgical ciliated cyst of the maxilla. Clinical case. Dpto Medicina y Cirugía Bucofacial, Facultad de Odontología, UCM– Madrid 28040, Spain , jcampo@odon.ucm.es. Surgical
ciliated cyst is uncommon in Western countries but frequently reported in
Asian populations as a delayed complication of surgery, with inclusion in the
bone of nasal or sinus mucosa. Isolated cases have also been reported in the
mandible after orthognathic surgery. We report a
case in the maxillary region three years after radical sinus surgery for
chronic sinusitis. Intraoral examination revealed a small painless
tumefaction with no color change in the surrounding tissues. Computed
tomography demonstrated a well-defined intraosseous
lesion lateral to the maxillary sinus. The lesion was completely excised,
when histology demonstrated a pseudostratified
ciliated epithelial lining. Differential diagnosis from
other lesions such as an odontogenic keratocyst or inflammatory cyst were also made.
This case report,uncommon
in Western countries, of a surgical ciliated cyst illustrates the need for a
meticulous surgical technique, proper management of complications, and
routine, long-term follow-up of patients undergoing any type of sinus
surgery. |
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Med Oral Patol Oral Cir Bucal. 2009 Jul 1;14(7):E355-E360. Bisphosphonates and dental implants: Current problems. Oral
Surgery. Medical and Dental School, University of Valencia,Spain,
C/ Gascó Oliag N 1, 46021
Valencia, Miguel.Penarrocha@uv.es. Osteonecrosis of the jaw has been described in patients
taking bisphosphonates after oral surgery
procedures, including the placement of dental implants. This review is an
update of the relationship between bisphosphonates
and dental implants. Results obtained by different authors are compared,
contrasting earlier studies where an improvement in implant osseointegration using bisphosphonates
was observed, with ones where statistically significant differences were
found, and more recent studies disagreeing with the use of bisphosphonates for causing necrosis of the jaw. The
differing results obtained between animal studies and the situation observed
in humans may be due to a short medication and follow-up period, as well as
to the existence of few research studies where dental implants are placed in
the oral cavity. Currently, dental implants are contraindicated in patients
being treated with intravenous bisphosphonates. In
2007, the American Association of Oral and Maxillofacial Surgeons suggested
guidelines for patients treated with oral bisphosphonates,
based on the clinical situation of the patient and the length of treatment with
the drug, and that greater caution prior and subsequent to surgery should be
taken for three years after treatment. All patients treated with bisphosphonates must have the risk of possible loss of
implants and the risk of suffering a bony necrosis of the operated jaw
explained to them, and give their informed consent prior to dental implant
surgery. |