Juliana Portes

This issue is very relevant, and I think it could be explored in better detail. I think that the abstract is quite too large, and the aim of the review is not clear. Furthermore, I think the subject should be more in-depth; I felt it was too superfic...

Diabetes and periodontitis are two of the most prevalent diseases worldwide that negatively impact the quality of life of the individual suffering from them. They are part of the chronic inflammatory disease group or, as recently mentioned, non-communicable diseases, with inflammation being the meeting point among them. Inflammation hitherto includes vascular and tissue changes, but new technologies provide data at the intracellular level that could explain how the cells respond to the aggression more clearly. This review aims to emphasize the molecular pathophysiological mechanisms in patients with type 2 diabetes mellitus and periodontitis, which are marked by different impaired central regulators including mitochondrial dysfunction, impaired immune system and autophagy pathways, oxidative stress, and the crosstalk between adenosine monophosphate-activated protein kinase (AMPK) and the renin-angiotensin system (RAS). All of them are the shared background behind both diseases that could explain its relationship. These should be taken in consideration if we would like to improve the treatment outcomes. Currently, the main treatment strategies in diabetes try to reduce glycemia index as the most important aspect, and in periodontitis try to reduce the presence of oral bacteria. We propose to add to the therapeutic guidelines the handling of all the intracellular disorders to try to obtain better treatment success.

Objetivo: analisar artigos científicos sobre o índice de proliferação celular usando o anticorpo anti-Ki-67 em ceratocistos odontogênicos e comparar esses trabalhos para estimar um índice médio para essa lesão. Material e Métodos: dois pesquisadores realizaram a busca literária de forma independente na base de dados MEDLINE/PubMed e 28 artigos contendo dados relevantes foram selecionados. Resultados: a análise imuno-histoquímica utilizada nos artigos avaliados mostrou-se muito variável, não apresentando metodologias claras e unificadas, tornando a comparação entre os diferentes resultados difícil. Conclusão: Considerando o ceratocisto odontogênico uma lesão de comportamento clínico incomum, uma classificação adequada é necessária, assim como um tratamento apropriado com um bom prognostico deve ser estabelecido para o paciente de acordo com sua natureza. Dessa forma, um protocolo de análise imuno-histoquímica deve ser estabelecido para que possamos obter dados confiáveis sobre essa lesão

Evaluation and comparison of odontogenic keratocysts and detigerous cysts immunoexpression and immunostaining intensities of Ki-67 antigen by assessing the whole extent of the epithelium (all epithelium layers in combination) and each layer individually. Ki-67 immunoexpression was evaluated in 15 odontogenic keratocysts and 6 dentigerous cysts using automated methods and the Aperio Technologies Inc. computer system. No statistically significant differences were observed in immunoexpression nor in immunostaining intensities between both lesions. Also, no statistically significant differences were found between odontogenic keratocysts from maxilla versus mandible nor primary versus recurrent. However, odontogenic keratocyst showed a significantly higher cellular proliferation index in the suprabasal layers compared to the basal layer. Assessment of the cellular proliferation index through a computerized system enabled the evaluation of all epithelial tissue without field selection. The increased Ki-67 immunoexpression in suprabasal layers of odontogenic keratocyst suggests a different biological behavior and more aggressive proliferation potential when compared to dentigerous cyst. The same result was found in recurrent odontogenic keratocysts when compared with primary ones. The odontogenic keratocysts of the maxilla and mandible have similar Ki-67 immunoexpression. The evaluation of cellular proliferation only by immunohistochemical analysis with Ki-67 antigen does not provide enough data to elucidate the biological behavior of odontogenic keratocyst.

Calcifying odontogenic cyst is an uncommon oral lesion, accounting for less than 1% of all odontogenic cysts. We report a case of a 28-year-old female with a complaint of a painless swelling on the anterior mandible area. Panoramic radiography and computed tomography showed a well-defined unilocular radiolucency with a radiopaque focal area, extending from the apical region of teeth 34 to 43. An incisional biopsy showed a cystic lesion lined by ameloblastoma-like epithelium with the presence of ghost cells and calci- fying material consistent with the diagnosis of calcifying odontogenic cyst. The treatment of choice was decompression with posterior enucleation of the lesion, and the region was filled-up with L-PRF membrane (Leukocyte – Platelet Rich Fibrin) and lyophilized bovine bone graft (Bio-Oss®). A two-stage treatment starting with decompression allows the prevention of some complications, such as fracture of the jaw or injury of noble structures and consequently, decreases the chances of recurrence. To the best of our knowledge, there are few published cases of COC treated by decompression followed by enucleation. The patient remains on follow-up and after 14 months, there is no sign of recurrence.

Objetivo: relatar um caso de cisto dermóide abordando os critérios de diagnóstico clínico e histopatológico. Relato de caso: paciente de dezessete anos com aumento de volume no assoalho da boca. Uma biópsia foi realizada e o diagnóstico foi cisto dermóide. A enucleação intraoral da lesão foi realizada e não houve recidiva após 18 meses de seguimento. Conclusão: apesar de algumas características clínicas e exames de imagem sugerirem esse diagnóstico, apenas o exame histopatológico pode confirmá-lo. Assim, é importante que o cirurgião dentista conheça a lesão e as possíveis morbidades que pode causar, possibilitando um diagnóstico preciso e um comportamento adequado, beneficiando o paciente.