Abstract Objective: To report the experience of creating and providing a self-instructional course about oral cancer, in a Telehealth platform, to Community Health Workers, and to analyze the participants’ clinic and demographic profile. Methods: Descriptive cross-sectional study of development and implementing experience of a course carried on a virtual learning environment, based on ADDIE, an Instructional Design model. The Kolmogorov-Smirnov test was applied, with 95% confidence level for quantitative variables. Results: The initial stage consisted of constructing the online course. In the second stage, the course was provided in a virtual learning environment. The course "Abre a boca, meu povo! - O que você precisa saber sobre o câncer de boca” was provided to the target audience with a student’s guide, initial survey, four modules with video lessons, initial and final knowledge test, satisfaction evaluation and certificate. Simplicity, clarity and objectivity have been prioritised in the transmission of knowledge. The final sample comprised 205 Community Health Workers. The predominant profile consisted of professionals aged between 40 and 49 years, female, with more than 10 years of career. Conclusions: The course achieved its objectives, revealing a satisfactory number of professionals in its first edition.

Resumo Objetivo: Relatar a experiência da criação e disponibilização de curso autoinstrucional sobre câncer de boca, em plataforma de Telessaúde, para Agentes Comunitários de Saúde, e analisar o perfil clínico-demográfico dos participantes. Metodologia: Estudo transversal descritivo da experiência de implantação e desenvolvimento de curso realizado em ambiente virtual de aprendizagem, baseado em ADDIE, um modelo de Design Instrucional. Foi aplicado teste de normalidade de Kolmogorov-Smirnov, com 95% de confiança para variáveis quantitativas. Resultados: A primeira fase consistiu na construção do curso on-line. Na segunda fase, o curso foi disponibilizado em ambiente virtual de aprendizagem. O curso "Abre a boca, meu povo! - O que você precisa saber sobre o câncer de boca” foi disponibilizado ao público-alvo com um manual do aluno, enquete inicial, quatro módulos com videoaulas, testes de conhecimentos inicial e final, avaliação de satisfação e certificado. Simplicidade, clareza e objetividade foram priorizadas na transmissão dos conhecimentos. A amostra final foi composta por 205 Agentes Comunitários de Saúde. O perfil predominante foi de profissionais com idade entre 40 e 49 anos, do sexo feminino, com mais de 10 anos de carreira. Conclusões: O curso atingiu os objetivos propostos, revelando um quantitativo satisfatório de profissionais, em sua primeira edição.

Resumo Estudos acerca do consentimento informado de paciente no âmbito da odontologia são escassos e apresentam divergências, evidenciando a necessidade de aprofundar o conhecimento sobre definições, dinâmica, atos normativos, jurisprudência e limites de responsabilidade diante de fatores diversos e riscos inerentes à profissão. Por meio de revisão bibliográfica que incluiu estudos indexados nas bases de dados SciELO e LILACS, bem como livros-texto, buscou-se definir o que se entende por consentimento livre e esclarecido do paciente, distinguir diferentes tipos e destacar a denominada “escolha esclarecida”, considerando que a atividade do cirurgião-dentista é classificada como serviço e é regulamentada pela Constituição Federal de 1988, Código de Defesa do Consumidor, Código Civil e leis especiais. Diante disso, busca-se verificar se é possível melhorar a obtenção do consentimento informado do paciente, transformando-a em processo de escolha esclarecida que considere tratamentos adequadamente indicados cuja finalidade principal é a saúde. divergências definições dinâmica normativos profissão LILACS livrostexto, livrostexto livros texto, texto livros-texto buscouse buscou esclarecida, , esclarecida” cirurgiãodentista cirurgião dentista 1988 Consumidor especiais disso buscase busca transformandoa transformando saúde 198 19 1

Abstract Studies on informed patient consent in the field of dentistry are scarce and present divergences, highlighting the need to deepen knowledge about definitions, dynamics, normative acts, case law and limits of responsibility in the face of diverse factors and risks inherent to the profession. From a bibliographic review that included studies indexed in the SciELO and LILACS databases, as well as textbooks, this study aimed to define what is meant by a patient’s free and informed consent, distinguish different types and highlight the so-called “informed choice,” considering that the activity of the dental surgeon is classified as a service and is regulated by the 1988 Federal Constitution of Brazil, the Consumer Defense Code, the Civil Code and special laws. The aim is to see if it is possible to improve the process of obtaining informed consent from patients, transforming it into a process of informed choice that takes into account appropriately indicated treatments whose main purpose is health. divergences definitions dynamics acts profession databases textbooks patients s socalled so called choice, 198 Brazil laws health 19 1

Resumen Los estudios del consentimiento informado del paciente en odontología son escasos y presentan divergencias, lo que revela la necesidad de profundizar en el conocimiento en definiciones, dinámicas, actos normativos, jurisprudencia y límites de responsabilidad frente a diversos factores y riesgos relacionados a la profesión. A partir de una revisión bibliográfica en las bases de datos SciELO y LILACS, y en libros, se buscó definir qué se entiende por consentimiento informado del paciente, distinguir diferentes tipos e identificar la llamada “decisión aclarada”, considerando que la actividad del cirujano dental está clasificada como un servicio y reglamentada por la Constitución Federal de 1988, el Código de Defensa del Consumidor, el Código Civil y leyes especiales. Se busca identificar si es posible mejorar el consentimiento informado al convertirlo en un proceso de obtención de decisión aclarada que considere adecuadamente los tratamientos cuya principal finalidad sea la salud. divergencias definiciones dinámicas normativos profesión LILACS libros aclarada, , aclarada” 1988 Consumidor especiales salud 198 19 1

Resumo Objetivo: Relatar a experiência da criação e disponibilização de curso autoinstrucional sobre câncer de boca, em plataforma de Telessaúde, para Agentes Comunitários de Saúde, e analisar o perfil clínico-demográfico dos participantes. Metodologia: Estudo transversal descritivo da experiência de implantação e desenvolvimento de curso realizado em ambiente virtual de aprendizagem, baseado em ADDIE, um modelo de Design Instrucional. Foi aplicado teste de normalidade de Kolmogorov-Smirnov, com 95% de confiança para variáveis quantitativas. Resultados: A primeira fase consistiu na construção do curso on-line. Na segunda fase, o curso foi disponibilizado em ambiente virtual de aprendizagem. O curso "Abre a boca, meu povo! - O que você precisa saber sobre o câncer de boca” foi disponibilizado ao público-alvo com um manual do aluno, enquete inicial, quatro módulos com videoaulas, testes de conhecimentos inicial e final, avaliação de satisfação e certificado. Simplicidade, clareza e objetividade foram priorizadas na transmissão dos conhecimentos. A amostra final foi composta por 205 Agentes Comunitários de Saúde. O perfil predominante foi de profissionais com idade entre 40 e 49 anos, do sexo feminino, com mais de 10 anos de carreira. Conclusões: O curso atingiu os objetivos propostos, revelando um quantitativo satisfatório de profissionais, em sua primeira edição. Objetivo boca Telessaúde Saúde clínicodemográfico clínico demográfico participantes Metodologia aprendizagem ADDIE Instrucional KolmogorovSmirnov, KolmogorovSmirnov Kolmogorov Smirnov, Smirnov Kolmogorov-Smirnov 95 quantitativas Resultados online. online on line. line on-line Abre povo públicoalvo público alvo aluno videoaulas certificado Simplicidade 20 4 feminino 1 carreira Conclusões propostos edição 9 2

Abstract Objective: To report the experience of creating and providing a self-instructional course about oral cancer, in a Telehealth platform, to Community Health Workers, and to analyze the participants’ clinic and demographic profile. Methods: Descriptive cross-sectional study of development and implementing experience of a course carried on a virtual learning environment, based on ADDIE, an Instructional Design model. The Kolmogorov-Smirnov test was applied, with 95% confidence level for quantitative variables. Results: The initial stage consisted of constructing the online course. In the second stage, the course was provided in a virtual learning environment. The course "Abre a boca, meu povo! - O que você precisa saber sobre o câncer de boca” was provided to the target audience with a student’s guide, initial survey, four modules with video lessons, initial and final knowledge test, satisfaction evaluation and certificate. Simplicity, clarity and objectivity have been prioritised in the transmission of knowledge. The final sample comprised 205 Community Health Workers. The predominant profile consisted of professionals aged between 40 and 49 years, female, with more than 10 years of career. Conclusions: The course achieved its objectives, revealing a satisfactory number of professionals in its first edition. Objective selfinstructional self instructional cancer platform Workers participants Methods crosssectional cross sectional environment ADDIE model KolmogorovSmirnov Kolmogorov Smirnov applied 95 variables Results Abre boca povo students student s guide survey lessons certificate Simplicity 20 4 female 1 career Conclusions objectives edition 9 2

Resumo As interleucinas 6 e 17 atuam na reabsorção óssea na presença de infecções de oriegem endodôntica para defesa do hospedeiro. Polimorfismos genéticos podem estar associados ao aumento da perda óssea, representada por áreas de lesões periapicais grandes. O objetivo deste estudo foi verificar a frequência do polimorfismo dos genes interleucina 6 e 17 em pacientes com periodontite apical assintomática ou abscesso apical crônico e verificar a existência de correlações entre área de lesão periapical com idade, sexo e presença do polimorfismo, na população estudada, no estado de Pernambuco. Foi incluída uma população constituída por trinta indivíduos diagnosticados. A áreas da lesões foram medidas em mm². O DNA genômico foi extraído e a genotipagem realizada por Polimorfismo de Comprimento de Fragmento de Restrição de Reação em Cadeia da Polimerase para interleucina 6 (rs 1800795) e interleucina 17 (rs 2275913). Os testes exato de Fisher, qui-quadrado e odds ratio foram utilizados. Uma análise de regressão logística também foi realizada usando sexo, idade e presença de polimorfismo como covariável, além de regressão linear para testar a relação da idade e área da lesão. Todos os testes utilizaram um nível de significância de 0,05% (p ≤0.05%). Não houve significância estatística na ocorrência das áreas grandes de lesões periapicais correlacionadas com idade, sexo e diagnóstico nem nas distribuições de alelos no polimorfismo das interleucinas 6 e 17 nos grupos estudados. A frequência de polimorfismo homozigoto e heterozigoto foi alta. O polimorfismo dessas interleucinas não está correlacionado ao aumento das áreas das lesões inflamatórias periapicais assintomáticas. 1 hospedeiro estudada Pernambuco diagnosticados mm² mm rs 1800795 2275913. 2275913 . 2275913) Fisher quiquadrado qui quadrado utilizados covariável 005 0 05 0,05 p ≤0.05%. ≤0.05% ≤0.05%) estudados alta assintomáticas 180079 227591 00 0,0 ≤0.05 18007 22759 0, ≤0.0 1800 2275 ≤0. 180 227 ≤0 18 22 ≤ 2

Abstract Interleukins 6 and 17 act in bone resorption in the presence of infections of endodontic origin for host defense. Genetic polymorphisms may be associated with increased bone loss, represented by areas of large periapical lesions. This study aimed to verify the frequency of interleukin 6 and 17 gene polymorphism in patients with asymptomatic apical periodontitis or chronic apical abscess and to verify the existence of correlations between periapical lesion area with age, gender, and presence of the polymorphism, in the studied population, in the state of Pernambuco. A population consisting of thirty diagnosed individuals was included. The area of the lesions was measured in mm². Genomic DNA was extracted and genotyping was performed by Polymerase Chain Reaction Restriction Fragment Length Polymorphism for interleukin 6 (rs 1800795) and interleukin 17 (rs 2275913). Fisher's exact, chi-square, and odds ratio tests were used. A logistic regression analysis was also performed using sex, age, and the presence of polymorphism as covariates, in addition to linear regression to test the relationship between age and lesion area. All tests used a significance level of 0.05% (p ≤0.05%). There was no statistical significance in the occurrence of large areas of periapical lesions correlated with age, sex, and diagnosis, nor in the distribution of alleles in the polymorphism of interleukins 6 and 17 in the studied groups. The frequency of homozygous and heterozygous polymorphism was high. The polymorphism of these interleukins is not correlated with the increase in the areas of asymptomatic periapical inflammatory lesions. 1 defense loss gender Pernambuco included mm² mm rs 1800795 2275913. 2275913 . 2275913) Fishers Fisher s exact chisquare, chisquare chi square, square chi-square sex covariates 005 0 05 0.05 p ≤0.05%. ≤0.05% ≤0.05%) diagnosis groups high 180079 227591 00 0.0 ≤0.05 18007 22759 0. ≤0.0 1800 2275 ≤0. 180 227 ≤0 18 22 ≤ 2

Abstract: Aldehyde dehydrogenase 1 (ALDH-1) is a marker of stem cells in a variety of diseases, but its role in individuals with chronic inflammatory periapical lesions remains unknown. The aim of this study was to investigate the presence of cells with a stem cell profile based on the immunoexpression of ALDH-1 in periapical granulomas (PGs) and radicular cysts (RCs). A total of 51 cases of periapical lesions (25 PGs and 26 RCs) were subjected to immunohistochemical study. The anti-ALDH-1 antibody was applied using the immunoperoxidase technique. An immunoexpression score (intensity vs. percentage of cells) was used, with the cases being classified as low expression (score: 0 to 4) and high expression (score: 6 to 9). The Chi-square test was used with a 5% level of significance. Immunoexpression of ALDH-1 was detected in all cases of PGs and RCs. In PG cases, the expression was diffuse in connective tissue cells, with most cases exhibiting high expression (n = 18; 69.2%), while in RC cases the expression revealed focal distribution in cells of the capsule and epithelial cells of the cystic lining, with most cases classified as low expression (n = 18; 72%). Significant differences in the expression scores of ALDH-1 were observed in PGs (p = 0.003). The variable expression of ALDH-1 suggests the presence of cells with stem cell profiles in PGs and RCs. These findings suggest that periapical tissues infiltrated by chronic inflammation can recruit important cells for the repair or evolution of periapical lesions.

Abstract The aim of this study was to investigate the prevalence of oral and maxillofacial lesions among children from representative regions of Brazil. A retrospective descriptive study was conducted. Biopsy records comprising the period from 2000 to 2015 were obtained from the archives of three Brazilian oral pathology referral centers. A total of 32,506 biopsy specimens were analyzed, and specimens from 1,706 children aged 0–12 years were selected. Gender, age, anatomical location and histopathological diagnosis were evaluated. Descriptive statistics was carried out. Likelihood ratio tests were used to evaluate the association between the categorical variables. The level of significance was set at 0.05. The post-hoc test was used to identify the subgroups that significantly differed from one another, and the Bonferroni correction was applied. A total of 1,706 oral and maxillofacial lesions were diagnosed in pediatric patients, including 51.9% girls. Oral mucocele was the most prevalent reactive/inflammatory lesion (64%). The most commonly affected sites were the lips (34.5%) and mandible (19.9%). A significant association was observed between age and the group of lesions of the oral cavity (p < 0.001), and between age and anatomical location (p < 0.001). Pediatric oral and maxillofacial lesions were frequent and showed wide diversity, with the prevalence of mucocele. Knowledge of oral lesions is important for pediatric dentists worldwide, since it provides accurate data for the diagnosis and oral health of children.

Abstract The objective of this study was to evaluate the expression of matrix metalloproteinase 9 (MMP-9) and transforming growth factor beta (TGF-β1) in periapical lesion samples correlated with the intensity of the inflammatory infiltrate and thickness of the epithelial lining. Forty-five cases of periapical lesions (23 periapical granulomas and 22 radicular cysts) were subjected to morphological and immunohistochemical analyses using anti-MMP-9 and anti-TGF-β1 antibodies. The data were analyzed using the following tests: non-parametric Mann-Whitney, chi-square, Fisher’s exact test and Spearman’s correlation test (P<0.05). Analysis of inflammatory infiltrate revealed that 78% of periapical granulomas presented infiltrate grade III, in contrast with 32% of radicular cysts (P<0.001). Morphological evaluation of the epithelial thickness in radicular cysts revealed the presence of atrophic epithelium in 86% of the cysts. The immunostaining of MMP-9 was score 2 in 67% of the granulomas and 77% of the cysts. Both lesions were predominantly score 1 for TGF-β1. Significant differences were confirmed between the expression scores of TGF-β1 and MMP-9 in periapical granulomas (p = 0.004) and in radicular cysts (p < 0.001). Expression of TGF-β1 was different for periapical granulomas and radicular cysts. This immunoregulatory cytokine seems more representative in asymptomatic lesions. The extracellular matrix remodeling process dependent on MMP-9 seems to be similar for both periapical granulomas and radicular cysts. TGF-β1 and MMP-9 may play an important role in the maintenance of periapical lesions.

OBJETIVO Avaliar a atividade antimicrobiana do MTA e do cimento Portland sobre bactérias cariogênicas MÉTODO Poços foram confeccionados e imediatamente preenchidos com os materiais. Doze amostras de cada material foram obtidas para realização do método de difusão em Ágar. As amostras foram testadas com o Streptococcus mutans (ATCC 700610), Enterococcus faecalis (ATCC 29212), Lactobacillus acidophilus (UFV) and Lactobacillus casei (UNICAMP). Placas de petri contendo Ágar Tripticase de Soja (MERCK) foi utilizado para o Streptococcus mutans e o Enterococcus faecalis e o meio Ágar Man Rogosa Sharpe (MRS) para os o Lactobacillus acidophilus e Lactobacillus casei. Depois de 48 horas de incubação foram realizadas as medidas dos halos de inibição com o auxílio de um paquímetro manual RESULTADOS Os diâmetros obtidos do MTA (2.50 ± 0.00; 2,92 ± 0.63; 2.58 ± 0.38), CP (1.17 ± 0.29; 2.00 ± 0.43; 1.33 ± 0.14) e cimento de hidróxido de cálcio (3.83 ± 0.29; 3.00 ± 0.00 ± 2.58 ± 0.72) foram expressos em milímetros e submetidos ao teste de Tukey (p 0.05) CONCLUSÃO De acordo com os resultados obtidos concluiu-se que o MTA e o cimento Portland demonstraram possuem propriedades antimicrobianas semelhantes, porém não foram efetivos contra o Enterococcus faecalis

OBJECTIVE: The objective of this study was to evaluate the antimicrobial activity of Mineral trioxide aggregate e Portland cement against some selected cariogenic bacteria. METHODS: Wells were made of approximately 0.5 mm in diameter, in solid culture media and immediately filled with cement. Twelve samples of each material were obtained for the realization of the agar diffusion method. These samples were tested with Streptococcus mutans (ATCC 700610), Enterococcus faecalis (ATCC 29212), Lactobacillus acidophilus (UFV) and Lactobacillus casei (UNICAMP). Petri plates containing Tripticase soy Agar (TSA) were used for the growth of Streptococcus mutans and Enterococcus faecalis, and plates of Man Rogosa & Sharpe Agar (MRS) for the Lactobacillus acidophilus and Lactobacillus casei. After 48 hours of incubation, it was made the measurement of inhibition halos with the aid of manual caliper. RESULTS: The diameters obtained to MTA (2.50 ± 0.00; 2,92 ± 0.63; 2.58 ± 0.38), PC (1.17 ± 0.29; 2.00 ± 0.43; 1.33 ± 0.14) and calcium hydroxide cement (3.83 ± 0.29; 3.00 ± 0.00 ± 2.58 ± 0.72) were expressed in millimeters and subsequently submitted to Tukey test (p<0.05). CONCLUSION: According to the results obtained, it was concluded that the MTA and Portland cement showed to have similar antimicrobial properties, however these were not effective against the Enterococcus faecalis.

Tooth calcification begins during the intrauterine life and is related to the nutritional status of fetus. The purpose of this study was to evaluate the dental calcification status of 15 low-weight human fetuses aged from the 14th to 28th weeks of intrauterine life through radiographic analyses and von Kossa histochemical technique, which is specific to the detection of calcium and other mineral salts in tissues. After dissection of jaws, the mandibles were submitted to lateral and occlusal radiographies. Three mm thick slide sections of jaws samples were stained by conventional and von Kossa methods. As results, radiographic analysis did not exhibit any suggestive image of tooth mineralization, although rudiments of mandibular ossification could be noted. Hematoxilin and eosin sections revealed tooth germs in advanced phases of odontogenesis, but relative delay in tooth development was observed. The von Kossa staining did not show any positivity to the deposition of mineral salts in tooth germs from maxilla and mandible, supporting our findings related to the delay of dental development that was found in studied sample. Hence, we suggest that there is relation between the fetal low-weight and the calcification and maturation status of teeth.

La calcificación del diente comienza durante la vida intrauterina y se relaciona con el estado nutricional del feto. El propósito de este estudio fue evaluar el estado de calcificación dental de 15 fetos humanos de bajo peso entre las 14 y 28 semanas de vida intrauterina mediante análisis radiográficos y técnica histoquímica von Kossa, específica para la detección de calcio y otras sales minerales en los tejidos. Después de su disección, las mandíbulas fueron sometidas a radiografías laterales y oclusales. Secciones de 3 mm de espesor de las mandibulas fueron teñidas con la técnica Von Kossa. El análisis radiográfico no mostró ninguna imagen sugerente de mineralización dentaria, aunque rudimentos de la osificación mandibular podrían tenerse en cuenta. Las secciones de H-E revelaron la presencia de los gérmenes dentarios en las fases avanzadas de odontogénesis, pero con un retraso relativo en el desarrollo normal. La tinción de von Kossa no mostró positividad a la deposición de sales minerales en gérmenes dentarios, lo que apoya nuestros hallazgos relacionados con el retraso de desarrollo dental que se encontró en la muestra estudiada. Se sugiere que existe relación entre el bajo peso del feto y el estado de calcificación y maduración de los dientes.

Many of Glycobyological aspects of human development remain still unclear, mainly in oral science, and this could be observed in a lack of literature with few and old papers about this subject. During tooth histo-morphogenesis changes occur in basement membrane composition, expression of signaling molecules and in localization of cell surface components, where glyco components could be involved. In this sense, this work aimed to analyze the ConA ligands commonly founded in glycoproteins cores and UEA-I ligands since fucolization is a Key event in many physiological and pathological processes. Therefore 15 jaws of human fetuses were ethically obtained, histologicaly processed and then submitted to lectin histochemistry with appropriated controls. The results showed that lectins staining increase their intensity during dental development; ConA only starts to recognize glucose/mannose residues on ectomesechymal cells in the crow phase revealing its ligands when the enamel matrix starts to be secreted. Interestingly, Con A ligands were not founded in the basement membrane of the stratum intermedium of the enamel differing from rodents models. The staining pattern of UEA-I was different, starting to be positive in the ectomesenchyma since the bud stage and shown variable expression in cell type and staining intensity, which appeared be directly proportional to the progress of odontogenesis. Thus, this work shows that Con A and UEA-I exhibit a growing staining directly proporcional to ameloblasts and odontoblasts cytodiferenciation and revels some glycan differences between human odontogenesis and rodents models.

Los aspectos glicobiológicos del desarrollo humano siguen siendo poco investigados, sobre todo en odontología, y esto puede ser observado en la literatura por los escasos y antiguos artículos sobre el tema. Durante la histomorfogénesis del diente se producen cambios en la composición de la membrana basal, en la expresión de moléculas de señalización y en la localización de la superficie celular de los componentes, donde los glico componentes podrían estar involucrados. Este trabajo tuvo como objetivo analizar los ligandos de la ConA ya que glucosa/manosa son comúnmente encontrados en núcleos de glicoproteínas y ligandos de la UEA-I debido a fucolización es un evento clave en muchos procesos fisiológicos y patológicos. Fueron obtenidas 15 mandíbulas de fetos humanos, procesadas y tratadas mediante histoquímica de lectinas con controles apropiados. Los resultados mostraron que la intensidad de tinción de las lectinas aumenta durante el desarrollo del diente. ConA sólo comienza a reconocer residuos de glucosa/manosa en células ectomesénquimales en la fase de corona revelando cuando la matriz de esmalte empieza a ser secretada. Curiosamente, ligandos de la ConA no se encontraron en la membrana basal de la capa intermedia del esmalte, difiriendo de los modelos de roedores. El patrón de tinción de la UEA-I fue diferente, empieza a ser positivo en el ectomesenquima desde la etapa de brotación y muestra variable expresión en el tipo de célula y la intensidad de la tinción, que parecía ser directamente proporcional al progreso de la odontogénesis. Por lo tanto, este trabajo demuestra que la Con A y la UEA-I presentan una coloración que crece directamente proporcional a citodiferenciación de los ameloblastos y odontoblastos, y revela algunas diferencias entre el estándar glicano de odontogénesis humanos y los modelos roedores.

This study investigated the immunodetection of PTCH in epithelial components of dental follicles associated with impacted third molars without radiographic signs of pathosis. One hundred and five specimens of dental follicles associated with impacted third molars with incomplete rhizogenesis (between Nolla's stage 6 and 9) were surgically removed from 56 patients. Epithelial cell proliferation was determined by using immunohistochemical labeling. Statistical analysis was performed using Fisher exact test and a level of significance of 5%. Of the 105 dental follicles collected, 3 were PTCH-positive. The specimens with squamous metaplasia and epithelial hyperplasia had higher rates of positivity for PTCH, as well as those with active remnants of odontogenic epithelium. This study suggests that the odontogenic cells of the dental follicle might be proliferating during the rhizogenesis, while the squamous metaplasia and hyperplasia of the epithelial lining and proliferative odontogenic epithelial rests show the differentiation potential of dental follicles.

Se investigó la inmunodetección de PTCH en los componentes epiteliales de los folículos dentales asociados a terceros molares retenidos sin signos radiográficos y morfológicos de patología. Fueron quirúrgicamente extraídos de 56 pacientes 105 muestras de folículos dentales asociadas a terceros molares retenidos con rizogénesis incompleta (entre el estadio de Nolla 6 y 9). La proliferación de células epiteliales se deteminó mediante inmunohistoquímica. El análisis estadístico se realizó mediante la prueba exacta de Fisher. De los 105 folículos dentales recogidos, 3 fueron PTCH-positivos. Las muestras con metaplasia escamosa e hiperplasia epitelial tuvieron mayores tasas de positividad para PTCH, así como aquellos con los restos de proliferación del epitélio odontogénico. En conclusión, este estudio sugiere que las células odontogénicas del folículo dental podrían estar proliferando durante la rizogénesis, mientras que la metaplasia escamosa e hiperplasia del epitelio y de restos epiteliales odontogénicos en proliferación muestran el potencial de diferenciación de los folículos dentales.

This study investigated the immunodetection of PCNA in epithelial components of dental follicles associated with impacted third molars without radiographical and morphological signs of pathosis. A total of 105 specimens of dental follicles associated with impacted third molars with incomplete rhizogenesis (between Nolla's stage 6 and 9) were surgically removed from 56 patients. Epithelial cell proliferating was determined by using immunohistochemical labeling. Statistical analysis was performed using the Fisher exact test. Of the 105 dental follicles collected, 6 were PCNA-positive ( 6%). The specimens with squamous metaplasia and epithelial hyperplasia had higher rates of positivity for PCNA, as well as those with proliferative remnants of odontogenic epithelium. In conclusion, this study shows that dental follicles at this stage of development have low proliferative potential, but suggests that squamous metaplasia, hyperplasia of the epithelial lining and presence of proliferative odontogenic epithelial rests in the connective tissue may be early signs of developing lesions of odontogenic origin.

Se investigó la inmunodetección de PCNA en los componentes epiteliales de los folículos dentales asociados a terceros molares retenidos sin signos radiográficos y morfológicos de la patología. Fueron extraídos quirúrgicamente, de 56 pacientes, 105 muestras de folículos dentales asociados a terceros molares retenidos con rizogénesis incompleta (entre los estadíos de Nolla 6 y 9) La proliferación de células epiteliales se deteminó mediante inmunohistoquímica. El análisis estadístico se realizó mediante la prueba exacta de Fisher. De los 105 folículos dentales recogidos, 6 fueron PCNA-positivos ( 6%). Las muestras con metaplasia escamosa e hiperplasia epitelial tuvieron mayores tasas de positividad para PCNA, así como aquellos con restos de proliferación del epitelio odontogénico. En conclusión, este estudio mostró que los folículos dentales en esta etapa del desarrollo tienen un potencial proliferativo bajo, pero sugiere que la metaplasia escamosa, la hiperplasia del epitelio y la presencia de restos epiteliales odontogénicos, en proliferación en el tejido conectivo, pueden ser signos tempranos de lesiones en el desarrollo de origen odontogénico.

INTRODUÇÃO E OBJETIVOS: O objetivo deste estudo foi pesquisar diferentes métodos alternativos de tissue microarray (TMA) à técnica original e conduzir adaptações desses, combinando diferentes métodos de punção das amostras teciduais e de montagem dos blocos de TMA, de modo a introduzir no Laboratório de Patologia Bucal da Faculdade de Odontologia de Pernambuco da Universidade de Pernambuco (LPBFOP/UPE) técnicas de TMA facilmente operáveis, reproduzíveis e de baixo custo. RESULTADOS: Foram reproduzidas quatro técnicas de punção dos blocos doadores e duas de montagem dos blocos de TMA, resultando em oito combinações possíveis. Para cada combinação, foram confeccionados três blocos de TMA, contendo nove, 16 e 32 amostras, respectivamente, e avaliadas quanto a perda de amostras, custo, tempo de confecção e dificuldade. Para blocos com nove amostras, a combinação 2 mostrou-se a mais adequada; para blocos com 16, a combinação 6 foi constatada como a mais eficiente; e para blocos com 32, a combinação 1 apresentou o melhor custo-benefício. CONCLUSÃO: Foi concluído que a escolha da combinação a ser utilizada depende do número de amostras a serem colocadas nos blocos de TMA.

INTRODUCTION AND OBJECTIVES: The aim of this study was to investigate different alternative tissue microarray (TMA) techniques and to make adaptations, combining different tissue punch and TMA block construction techniques in order to introduce easily reproducible, operational and cost effective TMA techniques in the Oral Pathology Laboratory of Pernambuco College of Dentistry, State University of Pernambuco. METHODS: Four donor punch techniques and two TMA block construction techniques were performed, resulting in a total of eight possible combinations. For each combination three TMA blocks were made, containing 9, 16 and 32 samples, respectively. They were evaluated as to sample loss, cost effectiveness, construction time and difficulty. RESULTS: For blocks with 9 samples, combination 2 was the most appropriate; for blocks with 16, combination 6 was the most efficient; and for blocks with 32, combination 1 was the most cost effective. CONCLUSION: It was concluded that the combination choice depends on the number of samples to be put in TMA blocks.

INTRODUÇÃO E OBJETIVO: O adenoma pleomórfico (AP) é o tumor das glândulas salivares mais comum. A parótida é o sítio anatômico mais frequente. Características clínicas e microscópicas são bem conhecidas, entretanto sua patogênese ainda é incerta, como a expressão de oncogenes e fatores que influenciam a transformação maligna. O objetivo deste estudo foi analisar e correlacionar os aspectos histopatológicos indicativos de transformação maligna de AP de glândula salivar maior, com a expressão da proteína p53 nesses tumores. MATERIAL E MÉTODO: Foram avaliados 106 casos de AP por pesquisa retrospectiva nos prontuários clínicos, revisão das preparações histológicas em hematoxilina e eosina (HE) e realização de técnica imuno-histoquímica, pelo método da estreptoavidina-biotina, utilizando o anticorpo primário anti-p53. RESULTADOS: Alterações histopatológicas relacionadas com a transformação maligna foram incomuns: hialinização extensa (5; 4,7%) e necrose (1; 0,9%). Houve positividade para a proteína p53 em 25 dos 106 casos estudados (23,58%). O arranjo histológico das células dos tumores considerados positivos para p53 foi principalmente dos tipos ductal (92%; 23) e cordonal (88%; 22). Não houve associação estatisticamente significante entre a positividade para o p53 e as variáveis histopatológicas, em comparação com os casos negativos: quantidade e tipo de matriz extracelular; alterações teciduais sugestivas de transformação maligna e metaplasia. CONCLUSÃO: Poucos casos que exibiram expressão para p53 apresentaram algum tipo de alteração morfológica sugestiva de malignidade, e a correlação entre a imunoexpressão da proteína p53 e a presença de alteração sugestiva de transformação maligna não foi estatisticamente significante, sugerindo que a expressão dessa proteína nesses tumores independe dessas características.

INTRODUCTION AND OBJECTIVE: The pleomorphic adenoma is the most common salivary gland tumor. The parotid gland is the most frequent anatomic site. Its clinical and microscopic features are widely known. However, its pathogenesis is still uncertain as well as the expression of oncogenes and other factors that influence malignant transformation. The objective of this study was to analyze the histopathological features of malignant transformation in pleomorphic adenoma (PA) of major salivary gland and correlate them with p53 protein expression in these tumors. MATERIAL AND METHOD: We evaluated 106 cases of PA by researching clinical records retrospectively, reviewing histological preparations in HE and applying immunohistochemical technique through streptavidin biotin method using primary anti-p53 antibody. RESULTS: Histopathological changes related to malignant transformation were unusual: extensive hyalinization (5; 4.7%) and necrosis (1; 0.9%). There was positivity for p53 protein in 25 out of 106 cases (23.58%). The histological cell arrangement of p53 - positive tumors was mainly the ductal type (92%; 23) and cordonal (88%, 22). There was no statistically significant association between positivity for p53 and histopathological variables in comparison with negative cases: quantity and type of extracellular matrix, tissue changes suggestive of malignant transformation and metaplasia. CONCLUSIONS: A few cases that showed p53 expression had some kind of morphological change suggestive of malignancy and the correlation between p53 immunoexpression and the presence of changes suggestive of malignant transformation was not statistically significant, which suggests that the protein expression in these tumors do not depend on these characteristics.