Keratin 5 (K5) is present in the basal layer of a stratified squamous keratinized and non-keratinized epithelium. K5 and K14 have been demonstrated in the mucosa and tumors of the oral cavity, oropharynx, hypopharynx and larynx, and in the mitotic active basal cells of a stratified squamous epithelium. The aim of the present study was to assess K5 expression in squamocellular carcinoma with various localizations in the head and neck. A total of 13 biopsy fragments were included from patients diagnosed with squamocellular carcinoma of the larynx area (n=2), pharynx (n=2), hard palate (n=1), tongue (n=2), submandibular (n=1), lip (n=1), gingival sulcus (n=1), nasal pyramid (n=1), maxilla (n=1) and zygomatic (n=1). The immunohistochemical staining for K5 was evaluated according to the following score criteria: 0 (0% positive cells); 1 (<10% positive cells); 2 (10–30% positive cells); and 3 (>30% positive cells). K5 expression was observed in all squamocellular carcinomas included in the present study with scores between 1 and 3. For well- and moderately-differentiated histopathological types, a maximum score of 3 was recorded for all of the cases, not including the laryngeal area, which presented a score of 2. The following scores were identified in the regions of the poorly differentiated carcinomas: Jaw, 3; gingival sulcus, 2; and tongue and submandibular area, 1. These observations may aid with an improved stratification of head and neck squamocellular carcinoma, thus improving the diagnosis and treatment strategies for this type of cancer.
E-cadherin is present in the epithelial cells and its aberrant expression is correlated with different kinds of head and neck squamocellular carcinomas. The purpose of the present study was to identify the expression particularities of analyzed E-cadherin in rapport with the localization and the differentiation of various head and neck squamocellular carcinomas. 18 biopsy fragments obtained by squamocellular carcinoma patients (larynx, pharynx, hard palate, tongue, submandibular, lip, gingival sulcus, nasal pyramid, maxillary, zygomatic) were processed by immunohistochemical staining. Immunoreactions for E-cadherin in the tumoral cells were examined according to the score: 0 (0% positive cells of specimen); 1 (<10% positive cells of specimen); 2 (10%-30% of specimen); 3 (>30% of specimen). The immunohistochemical staining indicated the presence of 12 cases of well-differentiated squamocellular carcinoma (7 cases with score 3, 3 cases with score 2 and 1 case with score 1). Moderately-differentiated carcinomas were observed in the 3 cases (2 with score 2 and 1 with score 1). The poorly-differentiated histopathological type was present in 3 cases (all with score 1). Three types of E-cadherin distribution patterns were found: cytoplasmatic; cytoplasmatic and membranar; membranar. The presence of maximum score (value 3) of E-cadherin was found in well-differentiated squamocellular carcinomas of laryngeal, tongue, lip, nasal pyramid, and zygomatic area origin. A lower value of the score was present in the less differentiated histopathological type.
Endodontic retreatment with direct crown access is the main choice in cases of endodontic treatment failure, even if the practitioner`s effort and duration is significantly greater compared with other procedures. The retreatment with crown access repeats root canal treatment through direct access at the level of tooth crown. The objective is to clean up the canal from irritant agents, such as microorganisms, surviving from the previous therapy or passed through afterwards. Thus, a treatment restart is in accordance with the logics of root canal therapy and is preferred at any time if possible. The aim of this study was to observe, over a 4-year span, the efficiency of endodontic retreatment with direct coronary approach. From 2012 to 2016, 148 patients, with ages ranging from 18 to 65 years, were retreated endodontically. All patients were included in a regular monitoring plan of 3 months and 1-year post treatment. X-rays were performed during these observations, assessed with Orstavik criteria (1991), each radiography having assigned a periapical index (PeriApical Index – PAI). In conclusion, this study confirms that first choice of retreatment in case of endodontic treatment failure is restarting of the retreatment with direct crown access (91% success rate), failure of which leads to a surgical approach using endodontic microsurgery techniques.
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