ABSTRACT Objective: To assess the relationship between celiac disease and the prevalence of dental caries in children and adolescents and also evaluate if dental enamel defects in celiac children predispose to dental caries. Material and Methods: Searches were performed in the following databases: PubMed, Scopus, Cochrane Library, Latin American and Caribbean Literature on Health Sciences, and OpenGrey. The risk of bias was assessed using the Newcastle-Ottawa Scale. DMFT/dmft and DMFS/dmfs data of observational studies that compared the prevalence of caries between children and adolescents with celiac disease and healthy individuals. Meta-analysis was performed using a random effects model. Heterogeneity between studies was estimated using Cochran’s Q test, and inconsistency was measured using I2 statistics. Results: Of the 121 studies retrieved, 17 were selected, and 12 were included in the meta-analysis. The prevalence of caries in the primary dentition (dmft) did not differ between celiac patients and controls [SMD = -0.35; 95% CI (-0.83; 0.13); p = 0,15; I2 = 89%]. There was also no difference in the prevalence of caries in permanent teeth (DMFT) between groups [SMD = -0.44; 95% CI (-1.02; 0.14); p = 0.14; I2 = 95%]. Conclusion: Celiac disease is not a determinant factor in the development of dental caries in children and adolescents compared to the control group. Objective Methods databases PubMed Scopus Library Sciences OpenGrey NewcastleOttawa Newcastle Ottawa Scale DMFTdmft DMFT dmft DMFSdmfs DMFS dmfs individuals Metaanalysis Meta analysis model Cochrans Cochran s test I statistics Results retrieved 1 selected metaanalysis. metaanalysis meta analysis. meta-analysis (dmft SMD 0.35 035 0 35 -0.35 95 0.83 083 83 (-0.83 0.13 013 13 0.13) 0,15 015 15 89%. 89 89% . 89%] (DMFT 0.44 044 44 -0.44 1.02 102 02 (-1.02 0.14 014 14 0.14) 95%. 95%] Conclusion group 0.3 03 3 -0.3 9 0.8 08 8 (-0.8 0.1 01 0,1 0.4 04 4 -0.4 1.0 10 (-1.0 0. -0. (-0. 0, 1. (-1. -0 (-0 (-1 - (- (

Abstract This study aimed to detect, quantify and compare the immunohistochemical expression of EGFR and VEGF and microvessel count (MVC) in oral lipomas, and to correlate the findings with clinical and morphological characteristics of the cases studied. The sample consisted of 54 oral lipomas (33 classic and 21 non-classic) and 23 normal adipose tissue specimens. Cytoplasmic and/or nuclear immunohistochemical staining of EGFR and VEGF was analyzed. The angiogenic index was determined by MVC. Cells were counted using the Image J® software. The Statistical Package for the Social Sciences was used for data analysis, adopting a level of significance of 5% for all statistical tests. A statistically significant difference in EGFR immunoexpression (p=0.047), especially, between classic lipomas and normal adipose tissue. There was a significant difference in MVC between non-classic lipomas and normal adipose tissue (p=0.022). In non-classic lipomas, only VEGF immunoexpression showed a significant moderate positive correlation (r=0.607, p=0.01) with MVC. In classic lipomas, the number of EGFR-immunostained adipocytes was directly proportional to the number of VEGF-positive cells, demonstrating a significant moderate positive correlation (r=0.566, p=0.005). The results suggest that EGFR, VEGF, and angiogenesis participate in the development of oral lipomas but are not primarily involved in the growth of these tumors. detect (MVC studied 5 33 (3 2 nonclassic non specimens andor or analyzed J software analysis tests p=0.047, p0047 p p=0.047 , 0 047 (p=0.047) especially p=0.022. p0022 p=0.022 . 022 (p=0.022) r=0.607, r0607 r 607 (r=0.607 p=0.01 p001 01 EGFRimmunostained immunostained VEGFpositive cells r=0.566, r0566 566 (r=0.566 p=0.005. p0005 p=0.005 005 p=0.005) tumors 3 ( p004 p=0.04 04 (p=0.047 p002 p=0.02 02 (p=0.022 r=0.607 r060 60 (r=0.60 p=0.0 p00 r=0.566 r056 56 (r=0.56 p000 p=0.00 00 (p=0.04 (p=0.02 r=0.60 r06 6 (r=0.6 p=0. p0 r=0.56 r05 (r=0.5 (p=0.0 r=0.6 r0 (r=0. p=0 r=0.5 (p=0. r=0. (r=0 p= (p=0 r=0 (r= (p= r= (r (p

Resumo Lipomas são as neoplasias mesenquimais benignas mais comuns, no entanto sua etiopatogenia ainda permanece desconhecida. Dessa forma, essa pesquisa teve como objetivo detectar, quantificar e comparar a expressão imunoistoquímica do EGFR, VEGF e contagem microvascular (MVC) dos lipomas orais, relacionando-os com as características clínicas e morfológicas dos casos estudados. A amostra foi composta por 54 lipomas orais (33 clássicos e 21 não clássicos) e 23 casos de tecido adiposo normal. A análise da expressão imunoistoquímica de EGFR e VEGF foi fundamentada na marcação citoplasmática e/ou nuclear. O índice angiogênico foi avaliado por meio da MVC. A contagem de células foi realizada utilizando software IMAGE J®. Os dados obtidos foram analisados no software Statistical Package for Social Science. O nível se significância de 5% foi adotado para os testes estatístico. A análise da imunoexpressão das proteínas revelou para o EGFR diferença estatisticamente significativa (p=0,041) entre o lipoma clássico e o tecido adiposo normal. Houve diferença significativa na MVC entre lipomas não clássicos e tecido adiposo normal (p=0,022). Nos lipomas não clássicos, apenas a imunoexpressão de VEGF apresentou correlação do tipo moderada, positiva e significativa (r=0,607; p=0,010) em relação a MVC. Ademais, nos lipomas clássicos foi percebido que os adipócitos imunomarcados para EGFR estiveram diretamente proporcionais a imunoexpressão de VEGF, apresentando correlação do tipo moderada, positiva e estatisticamente significativa (r=0,566; p = 0,005). Com base nos resultados, pode-se sugerir que o EGFR, VEGFR e MCV participam do desenvolvimento nos lipomas orais, contudo, não estão primariamente envolvidos no crescimento tumoral dessas neoplasias. comuns desconhecida forma detectar (MVC relacionandoos relacionando estudados 5 33 (3 2 eou ou nuclear J J® Science estatístico p=0,041 p0041 0 041 (p=0,041 p=0,022. p0022 p=0,022 . 022 (p=0,022) moderada r=0,607 r0607 r 607 (r=0,607 p=0,010 p0010 010 Ademais r=0,566 r0566 566 (r=0,566 0,005. 0005 0,005 005 0,005) resultados podese pode contudo 3 ( p=0,04 p004 04 (p=0,04 p002 p=0,02 02 (p=0,022 r=0,60 r060 60 (r=0,60 p=0,01 p001 01 r=0,56 r056 56 (r=0,56 000 0,00 00 p=0,0 p00 (p=0,0 (p=0,02 r=0,6 r06 6 (r=0,6 r=0,5 r05 (r=0,5 0,0 p=0, p0 (p=0, r=0, r0 (r=0, 0, p=0 (p=0 r=0 (r=0 p= (p= r= (r= (p (r

Resumo Objetivos: O trabalho tem por objetivo avaliar o conhecimento, práticas e atitudes do pediatra em relação à promoção de saúde oral, cuidados orais, cáries e lesões orais em crianças. Métodos: Tratou-se de um estudo transversal, realizado com pediatras do Estado de Alagoas, Brasil. Os dados foram recolhidos no período entre março e junho de 2019, por meio de um questionário respondido por 134 pediatras. Resultados: Embora 91% da amostra tenha relatado orientar o início da escovagem dentária após a erupção do primeiro dente, apenas 10,4% dos pediatras orientam o uso do dentifrício com base em evidência (contendo pelo menos 1000 ppm de flúor). Em relação à orientação dietética, 71% da amostra admitiu alertar sobre o consumo excessivo de alimentos açucarados, porém apenas 28,4% da amostra reconheceu a sacarose (açúcar da cana) como o carboidrato mais cariogénico da dieta. A maior parte da amostra (59,7%) afirmou reconhecer os primeiros sinais de surgimento de cárie, embora apenas 10% tenham classificado a presença de manchas brancas como um sinal precoce da doença. Conclusões: Os conhecimentos, atitudes e práticas dos pediatras em relação à saúde oral torna-se imprescindível para que estes profissionais possam pautar a sua conduta clínica com base em evidências científicas

Abstract Objectives: The study aimed to evaluate the pediatrician’s knowledge, practices, and attitudes regarding oral health promotion, oral care, caries, and oral lesions in children. Methods: This cross-sectional study was carried out with pediatricians from the State of Alagoas, Brazil. Data were collected between March and June 2019 through a questionnaire answered by 134 pediatricians. Results: Although 91% of the sample reported that they recommended starting toothbrushing after the first tooth eruption, only 10.4% recommended using toothpaste based on evidence (containing at least 1000 ppm of fluoride). Regarding dietary advice, 71% of the sample admitted warning about excessive consumption of sugary foods, but only 28.4% recognized sucrose (cane sugar) as the most cariogenic carbohydrate in the diet. Most of the sample (59.7%) claimed to recognize the first signs of caries, although only 10% classified the presence of white spots as an early sign of the disease. Conclusions: Pediatricians’ knowledge, attitudes, and practices regarding oral health are essential to guide their clinical conduct based on scientific evidence.

Abstract Tooth development depends on a series of reciprocal signaling interactions between the oral epithelium and ectomesenchyme. This study aimed to investigate the role of CK14, a protein involved in Wnt-1/β-catenin signaling, in odontogenesis and the development of odontomas. This cross-sectional, retrospective, immunohistochemical study analyzed 30 compound odontomas, 30 complex odontomas, and 17 tooth germs. Higher immunoexpression of CK14 was observed in odontogenic epithelial cells of tooth germs (p < 0.001) and odontogenic epithelial cells of odontomas (p < 0.001). There was higher immunoexpression of Wnt-1 and β-catenin proteins in epithelial cells of tooth germs (p = 0.002 and p < 0.001, respectively), as well as in the ectomesenchyme of odontomas (p = 0.003 and p < 0.001, respectively). β-Catenin was moderately and significantly correlated with CK14 in the membrane of reduced enamel epithelial cells in odontomas (p = 0.007). Higher immunoexpression of CK14 was observed in the odontogenic epithelium during the bud and cap stages and lower immunoexpression in the internal enamel epithelium during the bell stage. In odontomas, lower expression of Wnt-1/β-catenin and higher immunoexpression of CK14 were found in odontogenic epithelial cells, especially adjacent to the mineralized material resembling the tooth formed in these lesions. CK Wnt1/βcatenin Wnt1βcatenin Wntβcatenin Wnt 1/β catenin 1 β crosssectional, crosssectional cross sectional, sectional cross-sectional retrospective 3 CK1 0.001 0001 0 001 0.001. . Wnt1 Wnt- βcatenin 0002 002 0.00 respectively, respectively , respectively) 0003 003 respectively. βCatenin Catenin 0.007. 0007 0.007 007 0.007) stage lesions 1β 000 00 0.0 0.

Resumo O desenvolvimento dentário depende de uma série de interações de sinalização recíproca entre o epitélio oral e o ectomesênquima. O objetivo deste estudo foi investigar o papel da CK14 das vias WNT-1/β-catenina na odontogênese e no desenvolvimento de odontomas. Este estudo transversal, retrospectivo, imuno-histoquímico analisou 30 odontomas compostos, 30 odontomas complexos e 17 germes dentários. A CK14 apresentou maior imunoexpressão em células epiteliais odontogênicas de germes dentários (p<0,001) e em células epiteliais odontogênicas de odontomas (p<0,001). A Wnt-1 e a β-catenina apresentaram maior imunoexpressão de proteínas nas células epiteliais dos germes dentários (p = 0,002 e p<0,001, respectivamente), bem como no ectomesênquima dos odontomas (p = 0,003 e p < 0,001, respectivamente). A β-catenina correlacionou-se moderada e significativamente com a CK14 na membrana de células epiteliais reduzidas do esmalte em odontomas (p = 0,007). Maior imunoexpressão da CK14 foi observada no epitélio odontogênico nos estágios de botão e capuz com menor imunoexpressão no epitélio interno do órgão do esmalte no estágio de sino. Nos odontomas, foi observado menor expressão de Wnt-1/β-catenina e maior imunoexpressão da CK14 presente nas células epiteliais odontogênicas, especialmente, vizinhas ao material mineralizado semelhante ao dente formado nessas lesões. CK CK1 WNT1/βcatenina WNT1βcatenina WNTβcatenina WNT 1/β catenina 1 β transversal retrospectivo imunohistoquímico imuno histoquímico 3 compostos p<0,001 p0001 0 001 (p<0,001 p<0,001. . Wnt1 Wnt Wnt- βcatenina 0002 002 0,00 respectivamente, respectivamente , respectivamente) 0003 003 0001 0,001 respectivamente. correlacionouse correlacionou se 0,007. 0007 0,007 007 0,007) sino Wnt1/βcatenina Wnt1βcatenina Wntβcatenina especialmente lesões WNT1 1β p<0,00 p000 00 (p<0,00 000 0,0 p<0,0 p00 (p<0,0 0, p<0, p0 (p<0, p<0 (p<0 p< (p<

Abstract Verruciform xanthoma (VX) is a rare benign lesion of unknown etiology, with a rough or papillary aspect, painless, sessile, well-defined, most lesions do not exceed 2 cm in their largest diameter, the degree of keratinization of the surface influences color, varying white to red, affecting mainly the gingiva and alveolar mucosa, and can also be seen in skin and genital. Herein, we present a report a clinical case of oral verruciform xanthoma in the buccal mucosa associated with the lichen planus lesion, as well as the morphological and immunohistochemical characteristics of the lesion. The clinical diagnostic hypothesis of oral lichen planus of the white reticular lesions on the buccal mucosa and on the tongue was confirmed by histopathology before a subepithelial connective tissue exhibiting intense inflammatory infiltrate in a predominantly lymphocytic band. In contrast, the hypothesis of the verrucous lesion in the left buccal mucosa was leukoplakia, with histopathological evidence showing exophytic and digitiform proliferations with parakeratin plugs between the papillary projections. Subepithelial connective tissue was characterized by macrophages with foamy cytoplasm (xanthoma cells). An immunohistochemical examination was performed, showing positivity for CD68, a macrophage marker, in addition to testing by Schiff's periodic acid (PAS) with diastasis, which was detected the presence of lipids inside these macrophages. The patient is free of recurrences of verruciform xanthoma and is being monitored due to the presence of lesions of oral lichen planus.

Resumo Introdução: Picnodisostose é uma síndrome autossômica recessiva rara que resulta em um metabolismo ósseo anormal e aumenta a suscetibilidade dos pacientes a desenvolver osteomielite. Objetivo: Analisar os fatores de risco associados ao desenvolvimento de complicações nos maxilares (fraturas e osteomielite), assim como suas características anatomoclínicas e abordagens terapêuticas nos pacientes com picnodisostose. Método: As buscas foram feitas nas bases de dados PubMed, Web of Science, Scopus, Lilacs e Cochrane. Foram incluídos relatos de casos ou séries de casos que atenderam aos critérios de elegibilidade de acordo com o PRISMA. Os textos completos de 31 artigos foram analisados. Foram selecionados 20 desses artigos, publicados entre 1969 e 2018, e que descreveram 26 casos de osteomielite em pacientes com picnodisostose. Resultados: A média de idade dos pacientes foi de 37,84 anos; a proporção do sexo masculino para o feminino foi de 1,36:1. A mandíbula foi o local mais afetado (76,9%). A extração dentária foi o principal fator de risco para osteomielite (61,5%), seguida de infecção (26,8%) e fratura mandibular (23,0%). A antibioticoterapia isolada ou associada a algum procedimento cirúrgico foi o tratamento usado na maioria dos casos (80,7%). Conclusão: Os achados desta revisão mostraram que os pacientes com picnodisostose têm maior probabilidade de desenvolver osteomielite dos maxilares após procedimentos cirúrgicos, principalmente na extração dentária, e configura o principal fator de risco para o seu estabelecimento. Além disso, a antibioticoterapia profilática pré e pós-operatória pode prevenir o desenvolvimento de osteomielite em pacientes com picnodisostose.

Abstract Introduction: Pycnodysostosis is a rare autosomal recessive syndrome that provides the abnormal bone metabolism that increases the susceptibility of patients to develop osteomyelitis. Objective: This systematic review was conducted to analyze the risk factors associated with the development of complications in the jaws (fractures and osteomyelitis), as well as their clinicalpathological characteristics and therapeutic approaches in patients with pycnodysostosis. Methods: Searches were performed in the PubMed, Web of Science, Scopus, Lilacs, and Cochrane databases. Case reports or case series that met the eligibility criteria according to the PRISMA statement were included. The full texts of 31 articles were retrieved. Twenty of these articles published between 1969 and 2018 were selected, which described 26 cases of osteomyelitis in patients with pycnodysostosis. Results: The mean age of the patients was 37.84 years; the male-to-female was 1.36:1. The mandible was the most affected site (76.9%). Tooth extraction was the main risk factor for osteomyelitis (61.5%), followed by infection (26.8%) and mandibular fracture (23.0%). Antibiotic therapy alone or combined with some surgical procedure was the treatment used in most cases (80.7%). Conclusion: The findings of this review showed that patients with pycnodysostosis are more likely to develop osteomyelitis of the jaws after surgical procedures, especially tooth extraction which remains the main risk factor for its establishment. In addition, prophylactic antibiotictherapy in the pre- and postoperative periods may prevent the development of osteomyelitis in pycnodysostosis.

Resumo Um cisto odontogénico calcificante pode estar associado a tumores odontogénicos, particularmente odontomas. No entanto, a associação entre cisto odontogénico calcificante e cistos odontogénicos é rara. O objetivo deste estudo é relatar o primeiro caso de um cisto odontogénico calcificante associado a um pseudocisto antral. Um paciente do sexo masculino apresentou lesão tumoral em rebordo alveolar superior direito após 6 meses de evolução e quadro doloroso. A radiografia panorâmica indicou lesão radiolúcida entre os dentes 13 a 15 e velamento do seio maxilar. Foi realizada biópsia excisional e realizado diagnóstico histopatológico de cisto odontogénico calcificante associado a pseudocisto antral. O tratamento de escolha foi a enucleação das lesões e curetagem. A paciente está em acompanhamento há cerca de 3 anos sem recidiva da lesão, caracterizando comportamento indolente do cisto odontogénico calcificante.

Abstract A calcifying odontogenic cyst may be associated with odontogenic tumors, particularly odontomas. However, the association between calcifying odontogenic cysts and odontogenic cysts is rare. This study aims to report the first case of a calcifying odontogenic cyst associated with an antral pseudocyst. A male patient presented a tumor lesion in his right maxillary alveolar ridge with 6 months of evolution and painful symptoms . An excisional biopsy was performed, and a histopathological diagnosis of calcifying odontogenic cyst associated with an antral pseudocyst was issued. The treatment of choice was lesion enucleation and curettage. The patient has been under follow-up for about 3 years without lesion recurrence, which is typical indolent calcifying odontogenic cyst behavior.

Resumo Os cistos teratóides são hamartomas, que contém tecidos derivados do endoderma, mesoderme e ectoderma, relativamente raros na cavidade oral, onde são frequentemente encontrados na região da linha média do assoalho bucal. Este estudo relata um caso de cisto teratoide assintomático, localizado em região sublingual, em paciente do sexo feminino lactente, com 1 ano de idade, com histórico de dificuldade de amamentação. A lesão foi removida cirurgicamente e após 2 anos de acompanhamento não foram observados sinais de recidivas. Após a avaliação morfológica, foi classificado como coristoma por conter epitélio gastrointestinal, epitélio respiratório e anexos dérmicos. Concluímos enfatizando a relevância do correto diagnóstico do cisto teratoide para o estabelecimento da conduta adequada, considerando as implicações clínicas capazes de comprometer as funções de deglutição, mastigação e respiração do indivíduo afetado.

Abstract Teratoid cysts are hamartomas, which contain tissues derived from the endoderm, mesoderm, and ectoderm, and are relatively rare in the oral cavity, where they are often found in the midline region of the oral floor. This study reports a case of an asymptomatic teratoid cyst located in a sublingual region, in a 1-year-old female infant with a history of breastfeeding difficulty. The lesion was surgically removed, and, after 2 years of follow-up, no signs of recurrence were observed. After morphological evaluation, it was classified as a choristoma due to containing gastrointestinal epithelium, respiratory epithelium, and dermal appendages. We emphasize the importance of a correct diagnosis of the teratoid cyst for the establishment of appropriate management, considering the clinical implications that can compromise the swallowing, chewing, and breathing functions of the affected individual.

Abstract: The aim of this study was to evaluate macrophage M1 and M2 subpopulations in radicular cysts (RCs) and periapical granulomas (PGs) and relate them to clinical and morphological aspects. M1 macrophages were evaluated by the percentage of CD68 immunostaining associated with the inflammatory cytokine TNF-α, and M2 macrophages, by its specific CD163 antibody. The CD68+/CD163+ ratio was adopted to distinguish between the two macrophage subpopulations. Clinical, radiographic, symptomatology, treatment, and morphological parameters of lesions were collected and a significance level of p = 0.05 was adopted for statistical analysis. The results showed that the CD68+/CD163+ ratio was higher in the RCs (median = 1.22, p = 0.002), and the highest TNF-α immunostaining scores were found in RCs (p = 0.018); in PGs, the CD68+/CD163+ ratio was lower and associated with a greater CD163+ immunostaining (median = 1.02, p <0.001). The TNF-α in cyst epithelium had a score of 3 in 10 cases and predominance of M1 macrophages by CD68+/CD163+ (median = 2.23). In addition, CD68+ cells had higher percentage of immunostaining in smaller RCs (p = 0.034). Our findings suggest that increased CD68 immunostaining associated with TNF-α cytokine in RCs results in a greater differentiation of the M1 phenotype. The higher CD163 immunostaining in PGs results in greater differentiation of the M2 phenotype. Therefore, the inflammatory state promoted by M1 macrophages is related to growth and progression of RCs; on the other hand, the immunomodulatory state of M2 macrophages is related to maintenance of PGs.

RESUMO A actinomicose é uma infecção rara causada pela bactéria do gênero Actinomyces, que pode acometer tanto tecidos moles como ósseo; pode estar associada a traumas ou infecções prévias. O presente trabalho tem o objetivo de relatar um caso clínico de actinomicose na borda lateral de língua originária de um trauma prévio com o uso de substância esclerosante para tratamento de malformação vascular. A paciente foi submetida ao debridamento de tecido necrótico na região, e o material, encaminhado para análise histopatológica, confirmando o diagnóstico de actinomicose. Após dois anos de acompanhamento, não se detectou recidiva.

ABSTRACT Actinomycosis is a rare infection caused by bacteria of Actinomyces genus that can affect both soft and bone tissues; it may be associated with trauma or previous infections. This paper aims to report a clinical case of actinomycosis on the lateral border of the tongue originating from a previous trauma with the use of sclerosing substance for treatment of vascular malformation. The patient underwent debridement of necrotic tissue in the region, and the material was sent for histopathological analysis, which confirmed the diagnosis of actinomycosis. After two years of follow-up, no recurrence was detected.