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Clinicopathological and ultrastructural characterization of periapical actinomycosis

    1. [1] Universidade Estadual de Campinas

      Universidade Estadual de Campinas

      Brasil

    2. [2] Hospital Sírio-Libanês

      Hospital Sírio-Libanês

      Brasil

    3. [3] Universidade do Estado do Rio de Janeiro

      Universidade do Estado do Rio de Janeiro

      Brasil

    4. [4] Departamento de Diagnóstico Oral, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba, São Paulo, Brasil; Departamento de Saúde III, Faculdade de Ciências Médicas, Universidade Nove de Julho, São Paulo, São Paulo, Brasil
    5. [5] Programa de pós-graduação em Odontologia, Universidade Estácio de Sá, Rio de Janeiro, Rio de Janeiro, Brasil
  • Localización: Medicina oral, patología oral y cirugía bucal. Ed. inglesa, ISSN-e 1698-6946, Vol. 25, Nº. 1 (January), 2020
  • Idioma: inglés
  • Enlaces
  • Resumen
    • The aim of the present study was to analyze the clinicopathological and the ultrastructural features of periapical actinomycosis (PA) cases.

      Data from the files of an oral pathology laboratory were retrieved and the findings of histopathological analysis were evaluated. Hematoxylin–eosin (HE), a modified Brown & Brenn, and Grocott stains as well as ultrastructural analysis using scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDX) were utilized.

      Six cases were obtained, 4 females and 2 males, with a mean age of 34 year-old. Two cases were symptomatic, lower teeth and the anterior region were more commonly affected, and all cases were characterized by periapical radiolucencies. All cases presented sulfur granules with a ray-fungus or club-shaped pattern of the Splendore-Hoeppli phenomenon in HE-stained sections, with filamentous gram-positive bacteria aggregates highlighted by the modified Brown & Brenn stain. SEM analysis revealed abundant packed rod-like and filamentous bacteria associated with an extracellular amorphous material. EDX analysis showed predominant picks of calcium and sulfur in actinomycotic colonies.

      Our findings suggest that PA manifests either clinically and radiologically as a non-specific and heterogeneous condition and that the actinomycotic colonies consist in a calcium- and sulfur-rich matrix. Furthermore, the results highlight the importance of submitting periapical specimens after surgical removal to histopathological analysis.


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