Salivary glands’ neoplasms are hard to diagnose and present a complex etiology. However, several viruses have been detected in these neoplasms, such as HCMV, which can play a role in certain cancers through oncomodulation. The co-infections between HCMV with betaherpesviruses (HHV-6 and HHV-7) and polyomaviruses (JCV and BKV) has been investigated. The aim of the current study is to describe the frequency of HCMV and co-infections in patients presenting neoplastic and non-neoplastic lesions, including in the salivary gland. Multiplex quantitative polymerase chain reaction was used for betaherpesvirus and polyomavirus quantification purposes after DNA extraction. In total, 50.7% of the 67 analyzed samples were mucocele, 40.3% were adenoma pleomorphic, and 8.9% were mucoepidermoid carcinoma. Overall, 20.9% of samples presented triple-infections with HCMV/HHV-6/HHV-7, whereas 9.0% were co-infections with HCMV/HHV-6 and HCMV/HHV-7. The largest number of co-infections was detected in pleomorphic adenoma cases. All samples tested negative for polyomaviruses, such as BKV and JCV. It was possible to conclude that HCMV can be abundant in salivary gland lesions. A high viral load can be useful to help better understand the etiological role played by viruses in these lesions. A lack of JCV and BKV in the samples analyzed herein does not rule out the involvement of these viruses in one or more salivary gland lesion subtypes.

Localized juvenile spongiotic gingival hyperplasia (LJSGH) is a gingival lesion with distinct clinicopathologic features that may represent an isolated exteriorized junctional patch. This study showed a 7-year-old male patient presenting a well-circumscribed, erythematous overgrowth on the anterior maxillary gingiva. He had a history of several traumas in deciduous dentition in the same region. Intra-oral evaluation demonstrated easy bleeding upon manipulation of the lesion. Periapical and panoramic radiography showed no alterations. An incisional biopsy was performed and the histopathological and immunohistochemical analysis revealed prominent spongiosis in a hyperplastic epithelium, exocytosis by neutrophils, and immunopositivity to CK19. These findings correspond to an epithelium, similar to junctional areas, that does not occur in facile gingiva, establishing the diagnosis of LJSGH. The patient remains in follow-up with no recurrence of the lesion.

Amiloidose é uma doença de causa desconhecida caracterizada por deposição extracelular de material fibrilar amiloide, ou seja, de proteínas insolúveis que podem se acumular localmente em diferentes locais do corpo e poderá ocorrer acúmulo intenso e progressivo que causaria disfunção da área envolvida, como por exemplo, insuficiência cardíaca, insuficiência renal e macroglossia. O diagnóstico definitivo se faz por biopsia do tecido afetado. O objetivo deste relato de caso e revisão da literatura é descrever um caso de amiloidose primaria em glândula salivar. Paciente do gênero masculino, 74 anos, procurou atendimento médico queixando-se de inchaço na região do pescoço e abaixo da língua. Assintomático desde o ano de 2015. Negou ser etilista e tabagista e ter qualquer doença prévia. Exames laboratoriais sanguíneos e ressonância do abdomen e tórax normais. Foi realizada tomografia computadorizada e massa densa foi observada em glândula salivar. Exames complementares laboratoriais confirmaram o diagnóstico. A amiloidose pode ser adquirida ou hereditária se manifestando de forma localizada ou sistêmica, na qual normalmente acomete o coração, rim, trato gastrointestinal e língua. Essa condição nas regiões da cabeça e pescoço são mais raras, sendo que os locais mais acometidos nesses sítios são cavidade bucal, laringe e faringe. O paciente optou por não realizar qualquer procedimento cirúrgico e realiza acompanhamento anual.

Dentigerous cyst is the most common developmental maxillary cyst, often being associated with impacted third molars. The occurrence of bilateral or multiple lesions is usually associated with syndromes. The present report describes a case of multiple dentigerous cyst affecting both maxilla and mandible in association with impacted third molars in a non-syndromic patient. The complementary use of cone beam computed tomography (CBCT) could provide accurate knowledge for pre-operative radiologic assessment to delineate the extension of the lesion as well as its relationship with adjacent structures. The typical imaging characteristics can be useful for an adequate diagnosis. This type of lesion requires comprehensive pre-operative evaluation and logical operational approach.

Objective: This study analyzed the prevalence and clinic-pathological features of soft-tissue sarcomas diagnosed in a single-center of oral pathology from a School of Dentistry in Brazil. Materials and methods: All consecutive cases of intra-oral soft-tissue sarcomas diagnosed between January of 2002 and December of 2018 were retrieved from the files; patient data (sex, age and race) and characteristics of the lesions (site, size, clinical aspect and duration of injury) were collected. Results: Among a total of 62,255 biopsies diagnosed in the studied period, soft-tissue oral sarcomas comprised 76 cases (0.12%). Kaposi sarcoma, rhabdomyosarcoma, leiomyosarcoma encompassed 64.5% of the cases, and 53% of these were diagnosed as Kaposi Sarcoma. Male patients were more affected (59.2%) and white patients comprised 50%. In general, 39.4% of the patients were between 21-40yo. Conclusion: Soft-tissue sarcomas are rare in oral soft-tissue and in our pathology service, they comprised only 0.12% of all diseases diagnosed in the studied period. Kaposi sarcoma was the most frequent, followed by leiomyosarcoma and rhabdomyosarcoma. Thus, it is important for stomatologists and pathologists to be aware of their characteristics when examining oral mucosa, mainly their peculiarities regarding patient’s age, clinical appearance, and site of occurrence.

To assess the serum and salivary levels of biomarkers related to bone metabolism in cirrhotic patients as well as the evidence of osteoporotic changes on panoramic radiographs. Thirty-eight cirrhotic patients underwent anamnesis and physical examination. Specimens of blood and saliva were collected for evaluation by using Luminex™ xMAP technology to quantify RANKL, OPG, IL-1β, IL-6 and TNF-α. Panoramic radiographs were evaluated based on the mandibular cortical index (MCI) and the resulting data were compared to the expression of biomarkers in serum and saliva. Descriptive data analysis was performed and the Mann–Whitney’s test and Spearman’s correlation were used. Most of the sample consisted of males (68.4%) who had cirrhosis mostly resulting from alcoholism (28.9%). Median concentration values of RANKL (74.44 pg/mL), IL-1 β (45.91 pg/mL), IL-6 (67.69 pg/mL) and TNF-α (5.97 pg/mL) in saliva were higher than those observed in serum. In 72.7% of the panoramic radiographs, MCI was found to be suggestive of osteoporotic changes. No statistically significant correlation was observed between salivary and serum expressions of biomarkers or between biomarkers and MCI. RANKL, OPG, IL-1β, IL-6 and TNF-α are expressed differently in serum and saliva and the concentration of these biomarkers is not related to MCI. This study contributes to the study of the mechanisms of osteoporosis in cirrhotic individuals.

Objective: This study aimed to investigate the use of texture analysis for characterization of radicular cysts and periapical granulomas and to assess its efficacy to differentiate between both lesions with histological diagnosis. Methods: Cone beam computed tomography (CBCT) images were obtained from 19 patients with 25 periapical lesions (14 radicular cysts and 11 periapical granulomas) confirmed by biopsy. Regions of interest were created in the lesions from which 11 texture parameters were calculated. Spearman's correlation analysis was performed and adjusted with Benjamini-Hochberg false discovery rate procedure (FDR <0.005). Results: The texture parameters used to differentiate the lesions were assessed by using a receiver operating characteristic analysis. Five texture parameters were predictive of lesion differentiation for eight positions: angular second moment; sum of squares; sum of average; contrast; correlation. Conclusion: Texture analysis of CBCT scans distinguishes radicular cysts from periapical granulomas and can be a promising diagnostic tool for periapical lesions. Clinical significance: Texture analysis can be used in diagnostic and treatment monitoring to provide supplementary information.

La difficulté à mener à bien une grossesse (G) en cas de projet parental (PP) est une complication majeure du syndrome de Turner, liée à une dysgénésie gonadique et/ou à des contre -indications (CI) cardio-vasculaires à la G. L’objectif de ce travail était d’analyser rétrospectivement le taux et les causes d’échec du PP dans la cohorte monocentrique strasbourgeoise de patientes suivies selon les recommandations du PNDS 2008. Sur 93 patientes, 44 (47,3 %) avaient un PP, 19 (43,1 %) l’ont concrétisé par 2 (4 %) G spontanées, 13 (30 %) dons d’ovocytes (DO), 1 (2 %) FIV, 3 (7 %) adoptions. Il a été observé 36 G (47,7 %), 20 naissances (55,5 %), 4 patientes avec complications obstétricales mineures (1 cas de préeclampsie non sévère), 4 complications néonatales dont 2 sévères (1 hypotonie, et 1 hypotrophie sévères idiopathiques), 0 malformation congénitale. Vingt-cinq (57 %) patientes ont échoué du fait de 6 CI à la G, 12 échecs du DO, 1 FCS à répétition sur GS. Neuf (20 %) patientes ont abandonné leur PP ; 4 pour CI à la G et refus d’adoption, 1 pour refus du DO, 3 pour raisons personnelles. Trois patientes sont en attente de DO, 2 en démarche d’adoption. L’absence de contraception a entraîné 3 IVG. À notre connaissance, il s’agit des premières données sur le PP chez les patientes turnériennes ; données utiles pour l’accompagnement des patientes : 43 % de réussite du PP ; efficacité du DO identique aux autres indications, bon pronostic des G avec ovocyte maternel, penser à l’adoption.

Asymptomatic Apical Periodontitis is essentially an inflammatory disease of microbial aetiology. Association and function of the cell components involved, or specific inductive factors and growth mediators associated with development, maintenance and resolution of the periapical lesions are still unknown. The objective of this study was to evaluate the concentration of Regulatory T cells (FoxP3+; Treg), Langerhans cells (CD1a+; LC) and mast cells in asymptomatic apical periodontitis. 73 cases were selected: 30 periapical granulomas, 29 radicular cysts and 14 residual cysts. All groups were submitted to morphological analysis for classification of inflammatory infiltrate and thickness of the epithelial lining as well as to immunohistochemical analysis for detection of LC and Treg cells. Toluidine blue staining was used for detecting mast cells. Analysis showed higher mean numbers of LC (8.2 cells/0.2mm2), and Treg cells in radicular cysts (5.910 cells/0.2mm2). As for mast cells, it was found that radicular cysts had a higher mean number of these cells compared to other periapical lesions (12.68 cells/0.2mm2). The association between thickness of the epithelial lining and inflammatory cells showed that the presence of hypertrophic epithelium in radicular cysts presented higher density of LC. The number of LC and Treg cells play an important role in the control of the inflammatory micro-environment in periapical granulomas and radicular cysts, respectively. The presence of mast cells in radicular cysts may be associated with progression of the lesion. Knowledge regarding the inflammatory cell profile is therefore essential for a better understanding of the pathogenesis of asymptomatic periapical periodontitis.

Odontomas are benign, non-aggressive, and the most common odontogenic tumor of the jaws. Composed of dental tissues, it can be classified as compound or complex odontomas depending on their radiological and histological features. Among them, complex odontomas are less common and usually is presented as a small and asymptomatic radiopaque mass surrounded by a radiolucent halo, found on routine radiographic examination. Although benign tumors, odontomas can reach large sizes leading to facial asymmetry and decreasing bone strength, which predisposes fractures and infection. Our aim was to present a case report of an unusual giant mandibular odontoma on the left mandibular angle and ramus successfully treated by surgical excision and highlight the importance of the earlier diagnostic to minimize damages.

The differential diagnosis of fibro-osseous lesions (FOL) presents oral clinician stomatologists with a challenging task because of their similar clinical, radiographic and histopathological behavior that will also hinder the therapeutic planning. Presentation of case to describe the clinical, radiographic and histopathological features of an unusual case of FOL presented by the patient, a Black woman, and the results obtained with the conservative surgical treatment and 3-month follow-up. The presence of cementum in the histopathological analysis of cemento-osseous dysplasias, according to the current literature, is an important factor for the diagnosis of this lesion. Considering the characteristics presented by this particular case, we could suggest another entity that could be named a benign cemento-osseous lesion with adult onset. Some occurrences, as in the present case, do not fit properly into the current World Health Organization classification, thereby generating some doubts concerning the correct management of these patients. Conservative surgical treatment is the first choice in the management of these lesions due to their self-limiting nature, which show a behavior of clinical involution.

Benign nerve sheath tumours include perineuriomas, schwannomas and neurofibromas. Hybrid schwannoma-perineurioma represents a cutaneous, subcutaneous or occasionally intra-osseous tumour with schwannian cytomorphology and perineurioma-like architecture consisting of a mixture of both types of cells. These tumours can develop at any age and there is no gender-predilection. Tongue is the most frequently affected site, followed by palate, mouth floor, jugal mucosa, lips and, more rarely, mandible. We present a case of hybrid tumour with schwannoma-perineurioma morphology located on the right mandibular body (intra-osseous) of a 54-year-old female patient. The tumour was symptomatic and evolving for six months. Microscopically, it was encapsulated and highly cellularised, presenting fascicular aspect and exhibiting scant mitotic activity. The tumour consisted of distinct cellular populations involving fusiform cells, cells with wavy and hyperchromatic nucleus or even epithelioid cells. Positive immunostaining for S-100 and epithelial membrane antigen (EMA) was observed. The lesion was completely removed under general anaesthesia, with the patient showing no clinical or radiographic sign of relapse after two-year follow-up. Despite the limited knowledge on the pathogenesis of Hybrid Schwannoma-Perineurioma, these tumours seem to present a non-aggressive biological behaviour. Conservative surgery provides adequate solution without recurrence, even after a long-term follow-up. Key words:Nerve sheath tumours, Schwannoma, Perineurioma, Immunohistochemistry.

Apical periodontitis caused by root canal infection is the most frequent pathological lesion in the jaws, mainly manifested as periapical granulomas and cysts. Understanding of the formation and progression of apical periodontitis as well as the identification of inflammatory biomarkers can help increase the knowledge of pathogenic mechanisms, improve the diagnosis and provide support for different therapeutic strategies. The objective of the present article is to review inflammatory biomarkers such as cytokines, chemokines, inflammatory cells, neuropeptides, RANK/RANKL/OPG system and other inflammatory markers and to relate these systems to the development and progression of pathological conditions related to apical periodontitis.

PURPOSE:The aim of this study was evaluate the effect of HBO on diabetic rats. MATERIALS AND METHODS:Twenty rats were distributed into four groups (n = 5): Control (C); Control + HBO (CH); Diabetes (D) and Diabetes + HBO (DH). Diabetes was induced by streptozotocin, and bone defects were created in both femurs in all animals. HBO therapy began immediately after surgery and was performed daily in the CH and DH groups. After 7 days, the animals were euthanized. The femurs were removed, demineralized, embedded in paraffin, and histologic images were analyzed. RESULTS:Qualitative histologic analyses showed more advanced stage bone regeneration in control groups (C and CH) compared with diabetic groups (D and DH). Histomorphometric analysis showed significantly increased bone neoformation in CH compared with the other groups (p < 0.001). Diabetic Group (D) showed decreased bone neoformation compared with non-diabetic groups (C and CH) (p < 0.001); however DH did not differ from C Group (p > 0.05). The mast cell population increased in CH compared with the other groups (C, D, and DH) (p < 0.05). The mast cell population did not differ between D and DH Groups. CONCLUSIONS:This study showed that HBO therapy improved early bone regeneration in diabetic rats and increased the mast cell population only in non-diabetic animals. HBO was shown to be important treatment for minimizing deleterious effects of diabetes on bone regeneration.

Syphilis is an infectious disease caused by Treponema pallidum, a spirochete microorganism that is pathogenic only to humans. Its transmission occurs predominantly by sexual contact. Clinically, it has four stages: primary, secondary, latent, and tertiary. In most instances, the diagnosis is made during the secondary stage, on which lesions are more numerous, symptomatic, and may affect skin and mucosa areas simultaneously. On the other hand, the primary stage manifests by single, usually painless, ulceration that goes into spontaneously healing between 2 to 4 weeks after its appearance. This will, eventually, progress to the secondary-stage disease. More often than not, the primary stage is usually missed since patients did not seek any medical evaluation. This article is protected by copyright. All rights reserved.

The objective of this review was to identify recurrences (ipsilateral, contralateral, metastases and deaths) occurring after controlled ovarian hyperstimulation (COH) or cryopreservation of ovarian tissue (CPTO) for patients treated for a breast cancer.Methods. - We performed a bibliographical research through the Pubmed/Medline database, including all the references from January 2006 until September 2016, in French or in English, after exclusion of animal studies. The keywords association "breast neoplasms", "fertility preservation", "reproductive techniques", "ovarian cryopreservation" and "in vitro fertilization" allowed the selection of 852 publications among which only 6 were selected because they included data on recurrence andlong term follow up. Four publications involved HSC (3 before breast cancer treatment and 1 after) and 2 concerned CPTO with re-implantation.Results. - This analysis has not shown increasing of breast recurrences after HSC and CPTO. However, results were not statistically significant, due to several biases in particular heterogeneousness of the groups of patients.Conclusion. - A survey of patients who used fertility preservation or assisted reproductive technologies after breast cancer would be helpful to better estimate their oncological risk. 2017 Published by Elsevier Masson SAS.

Light and electron microscopy were used to analyze the epithelial lining of odontogenic cysts excised from edentulous regions of the jaws. Clinically, three cases were identified as keratocysts, and 21 cases as cysts other than keratocysts ("non-keratocysts"). The epithelium of the former was found to achieve keratinization over most of the surface and to never contain mucus secreting cells. The epithelium of the latter appeared to be in part stratified squamous, with cells loosely connected to each other, and in part stratified columnar, with superficial cells connected to each other by tight junctions and secreting mucus. The results suggest that cysts arising from edentulous regions of the jaws may be either keratocysts or cysts with heterogeneous, non-keratinizing epithelium; the content of keratocysts can be formed mainly by shedding of cornified epithelial layers, and that of non-keratocysts by mucus secretion from columnar epithelium associated to fluid filtration through non-keratinizing squamous epithelium.