RESUMO
Evaluate the cytocompatibility of Calen®/ZO, Calcicur®, Vitapex®, Endoflas®, and zinc oxide/eugenol-based (ZOE) root canal pastes (RCP) to human primary osteoblasts (HPO) through a simplified model for primary teeth. The model employed pipette tips filled with 0.037 g of paste, exposed to 185 µL of culture medium for 24 h (n = 6). Release of components was analysed by Proton Nuclear Magnetic Resonance Spectroscopy (1H-NMR). HPO were exposed to conditioned media for 24 h. Cell viability was assessed by cell density and metabolic activity, and release of interleukin 6 (IL-6), vascular endothelial growth factor (VEGF) and fibroblast growth factor (bFGF) by immunological assay. Physicochemical properties and antimicrobial efficacy were also evaluated. 1H-NMR spectra analysis showed similarity between ZOE, Endoflas®, Calcicur®, and Vitapex® compared to Calen®/ZO and positive control, which showed distinct released components. Calen®/ZO and Calcicur® exhibited high alkaline pH in all periods and showed similar solubility. Calen®/ZO, ZOE, and Vitapex® showed similar flow rate. Calen®/ZO, Calcicur®, and Vitapex® did not exhibit antimicrobial efficacy. Calen®/ZO presented cytotoxicity (p < 0.05). Pastes did not increase IL-6 release compared to control. Apart from Vitapex®, all pastes significantly induced VEGF/bFGF release. Interactive effects among released products may affect biological response to filling pastes. Calcicur®, ZOE, Endoflas® and Calen®/ZO presented good to moderate cytocompatibility, with low impact on pro-inflammatory cytokine release and induction of growth factors of interest to tissue repair. This simplified model, specific for the evaluation of the cytocompatibility of RCPs on primary teeth, suggests how these pastes might contribute to bone repair in clinical situations of apical periodontitis in children.
Assuntos
Periodontite Periapical , Materiais Restauradores do Canal Radicular , Hidróxido de Cálcio , Criança , Humanos , Materiais Restauradores do Canal Radicular/farmacologia , Tratamento do Canal Radicular , Dente Decíduo , Fator A de Crescimento do Endotélio Vascular , Cimento de Óxido de Zinco e Eugenol/farmacologiaRESUMO
BACKGROUND: Malocclusion is a highly prevalent public health problem, and several studies have shown its negative correlation with quality of life, self-esteem, and social perceptions. However, its association with bullying is still controversial. OBJECTIVES: To evaluate the relationship between malocclusion and bullying in children and adolescents. SEARCH METHODS: The databases used for the electronic researches were PubMed, Scopus, Lilacs/BBO, Web of Science, and Cochrane Library. Grey literature was reviewed through Open Grey literature with no language or date restrictions. Selection criteria, based on the PECO strategy, were considered eligible observational studies that included schoolchildren or adolescents (P) with malocclusion (E), compared to those with normal occlusion (C), in which the relationship between malocclusion and bullying was determined (O). DATA COLLECTION AND ANALYSIS: Risk of bias evaluation was made for the qualitative synthesis by the Fowkes and Fulton criteria. Data regarding the age of participants and types of malocclusion and of bullying were extracted among other reported data. The quality of the evidence analyzed was evaluated through the GRADE approach. RESULTS: From 2744 articles identified in databases, nine met the eligibility criteria and were included in present systematic review, of which two studies were judged with methodological soundness. The quality of the evidence was classified as very low due to very serious problems for "risk of bias" and "other considerations" and serious problems of "indirectness". The age of participants ranged from 9 to 34 years considering a cohort study, with a bullying recalling perspective. Malocclusion was both evaluated by researchers and self-reported by participants addressing dentofacial characteristics mostly related to the incisors relationship. All studies evaluated the verbal type of bullying, while 3 also considered physical type. Both types were reported as related to malocclusion, although the results showed that extreme maxillary overjet (> 4 mm, > 6 mm, > 9 mm), extreme deep overbite, and having space between anterior teeth or missing teeth were the types of malocclusion with the strongest relations to bullying. CONCLUSIONS: With very low certainty of evidence, the results of this systematic review suggest that conspicuous extreme malocclusion may be related to the occurrence of bullying among children and adolescents.
Assuntos
Bullying , Má Oclusão , Sobremordida , Adolescente , Criança , Estudos de Coortes , Humanos , Qualidade de VidaRESUMO
The objective of this study was to report the clinical evaluation results and 3-dimensional (3-D) dental and craniofacial characteristics observed in 2 male patients with mucopolysaccharidosis type II. The patients were evaluated clinically (soft tissue evaluation, evaluation of occlusion, periodontal and dental examinations) and by using craniofacial computed tomography, with evaluation of 3-D images in ITK-Snap v. 2.2 (Penn Image Computing and Science Laboratory, Philadelphia, PA; http://www.itksnap.org/) and 3-D Slicer (http://www.slicer.org/) software. Mandibular 3-D volumetric label maps were built from computed tomography scans of both patients and compared through superimposition on a healthy patient's mandibular images. Clinically, the patients presented the following oral manifestations: macroglossia, total open bite and generalized diastemas, and absence of caries. Patient 1 showed dental calculus and bleeding at the gingival margin. Patient 2 showed bleeding at the gingival margin, a permanent maxillary left central incisor missing as a result of trauma, and impacted permanent mandibular left and right second molars. 3-D images showed wide arches, prominent antegonial notches, a narrow mandibular body in the region of the antegonial notches, bilateral severe condylar hypoplasia, and enlarged coronoid processes. 3-D imaging and superimpositions revealed oral and skeletal displacements, contributing to the identification of changes in the course of mucopolysaccharidosis type II in patients with a late diagnosis.
RESUMO
We described herein the oral and craniofacial features of a 7-year-old boy, diagnosed in utero with mucopolysaccharidosis II (MPS II), who was treated with hematopoietic stem cell transplantation (HSCT) at 70 days of age. The main oral clinical findings were the following: macroglossia, posterior cross-bite, crowding, pointed cuspid teeth, delayed tooth eruption, retained primary teeth, and enamel hypoplasia. The image examination showed: retention eruption, posterior primary teeth with short roots, absence of some permanent teeth, and stretching of the stylohyoid processes bilaterally. This patient showed the importance of early diagnosis and HSCT therapy in attenuating the clinical and radiographic oral and craniofacial manifestations of the MPS II patient.
Assuntos
Transplante de Células-Tronco Hematopoéticas , Anormalidades da Boca/etiologia , Mucopolissacaridose II/complicações , Mucopolissacaridose II/terapia , Criança , Humanos , MasculinoRESUMO
PURPOSE: The purpose of this study was to evaluate the relationship between socio-demographic characteristics of caregivers and the oral health of their children infected with human immunodeficiency virus (HIV+) compared to a group of HIV-children and their caregivers. METHODS: One hundred forty HIV+ and 140 healthy two- to five-year-old children and their caregivers who sought care at hospitals in Rio de Janeiro, Brazil, participated. Caregivers were interviewed for sociodemographic characteristics, and knowledge and attitudes regarding oral health. The decayed, missing and filled primary teeth (dmft) index was obtained for the children. Chi-square and Mann-Whitney tests were used (five percent significance level). Content analysis method was used for qualitative evaluation. RESULTS: Most interviewees were mothers (83.6 percent), did no work outside the home (69.3 percent), had low educational status (47.1 percent), and were born in the South/Southeast regions of Brazil (83.6 percent). The mean dmft was 3.48±3.14 for the HIV+ group and 1.02±1.00 for the healthy children. Oral care was reported as important by 54.1 percent of the caregivers. Those who didn't consider oral care important had never received information about oral health (P<0.01). Caregivers born in the North/Northeast regions took their children to the dentist less frequently than mothers born in other areas (P=0.02). Low educational status influenced the attitudes about oral health (P<0.01), irregular dental visits for the children (P<0.01), and the dmft index (P<0.01). CONCLUSION: Caregivers' low educational status and birthplace influenced the importance given to HIV+ children's oral health as well as the oral health knowledge and practices for both HIV+ and healthy children.
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Cuidadores/psicologia , Infecções por HIV/complicações , Conhecimentos, Atitudes e Prática em Saúde , Nível de Saúde , Saúde Bucal , Adulto , Brasil , Cuidadores/educação , Cuidadores/estatística & dados numéricos , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Pré-Escolar , Demografia/estatística & dados numéricos , Escolaridade , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Mães , Saúde Bucal/estatística & dados numéricos , Fatores Socioeconômicos , Estatísticas não Paramétricas , Inquéritos e Questionários , Dente DecíduoRESUMO
Metabolomics is an important tool for the evaluation of the human condition, in both health or disease. This study analyzed the salivary components of type I diabetic children (DM1) under six years of age, to assess oral health related to diabetes control, as well as metabolite profiling using NMR. Partial least squared discriminant analysis (PLS-DA) was used to compare healthy (HG) and uncontrolled DM1 subjects that demonstrated a separation between the groups with classificatory performance of ACC = 0.80, R(2) = 0.92, Q(2) = 0.02 and for DM1 children with glycemia >200 mg/dL of ACC = 0.74, R(2) = 0.91, Q(2) = 0.06. The metabolites that mostly contributed to the distinction between the groups in the loading factor were acetate, n-acetyl-sugar, lactate, and sugar. The univariate analysis showed a decreased salivary concentration of succinic acid and increased levels of lactate, acetate, and sucrose in uncontrolled and DM1 children with glycemia >200 mg/dL. The present study demonstrates that the salivary profile of DM1 differs from that of HG children. It appears that diabetes status control has an important effect on the salivary composition.
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Diabetes Mellitus Tipo 1/metabolismo , Metabolômica , Saliva/metabolismo , Acetatos/metabolismo , Estudos de Casos e Controles , Pré-Escolar , Análise Discriminante , Humanos , Ácido Láctico/metabolismo , Espectroscopia de Ressonância Magnética , Saliva/química , Sacarose/metabolismoRESUMO
OBJECTIVE: To undertake a systematic review to assess if HIV-infected children and adolescents have an increased dental caries experience. METHODS: A search of MEDLINE, BIREME, EMBASE, GOOGLE SCHOLAR, SIGLE (Grey Literature) and reference lists of included studies was carried out. To be eligible the studies had to present HIV-infected and non-infected children/adolescents between 0-18 years old. To assess the methodological quality, the studies were categorized in scores from 'A' to 'C'. To perform a meta-analysis a random effect model was used with 95% confidence intervals and two distinct sub-group analyses were carried out in terms of caries progression: data for cavitated and non-cavitated lesions (sub-group 1) and data only for cavitated lesions (sub-group 2). RESULTS: Five studies fulfilled the selection criteria. Four studies (two ranked A and two B in the quality assessment) revealed higher caries scores in primary teeth in the HIV-infected patients with mean dmft/dmfs scores of 3.8-4.1/7.8-11.0 compared to the control group 1.5-2.4/3.4-5.1. No differences in caries index were found for permanent dentition. The meta-analysis excluded caries data of permanent teeth and showed a significant association between caries experience in primary dentition and HIV infection considering cavitated and non-cavitated lesions (OR = 2.33, 95% CI = 1.48-3.68) or only cavitated lesions (OR = 2.98, 95% CI = 1.59-5.59). CONCLUSION: Evidence exists that suggests HIV-infected children/adolescents have an increased caries experience in primary dentition.
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Cárie Dentária/epidemiologia , Infecções por HIV/epidemiologia , Adolescente , Criança , Pré-Escolar , Índice CPO , Progressão da Doença , Humanos , Lactente , Recém-Nascido , Dente Decíduo/patologiaRESUMO
OBJECTIVES: A systematic review was performed with the aim of determining whether there is scientific evidence of the transmission of Streptococcus mutans from mother to child. DATA: The eligibility criteria, based on the PECO strategy, were the following: observational human studies whose subjects were mother and child pairs (P) contaminated by S. mutans (E); comparison according to the presence or absence of S. mutans (C); and whether there is transmission (O). The qualitative analysis was performed by assessing the risk of bias of the included studies, while quantitative synthesis was performed through comprehensive Meta-Analysis software (p<0.05). SOURCES: Two reviewers performed the database search of studies published between January 1950 and May 2014. The strategy included observational studies that assessed the vertical transmission of S. mutans from mothers to children through analyzing genetic strains. STUDY SELECTION: It was found 166 non-duplicated studies. However, after reviewing the articles in full and applying the eligibility criteria, 36 papers were selected for qualitative analysis and 19 for quantitative analysis. The cumulative meta-analysis demonstrated vertical transmission of S. mutans from mother to child (p<0.001). CONCLUSIONS: The present systematic review and meta-analysis demonstrated evidence of vertical transmission of S. mutans from mother to child because there was an association between S. mutans n mothers and their respective children. CLINICAL SIGNIFICANCE: The knowledge of the S. mutans strains is important because the virulence of the microorganisms is varied; also, the virulence affects the dental caries evolution rate, being more or less aggressive.
Assuntos
Transmissão Vertical de Doenças Infecciosas , Infecções Estreptocócicas/transmissão , Streptococcus mutans/fisiologia , Criança , Humanos , Viés de Publicação , Garantia da Qualidade dos Cuidados de Saúde , RiscoRESUMO
OBJECTIVES: This systematic review and meta-analysis is focused on evaluating the possible association of s-IgA levels and dental caries. DATA: The inclusion criteria comprised the clinical investigations with case and control groups, a caries diagnostic method, and evaluation of unspecific s-IgA concentration by using tests for both groups in humans, healthy subjects, and with statistical analyses. Quality assessment and data extraction of the included articles were performed. Meta-analysis of pooled data was performed through RevMan software after a sensitivity analysis. SOURCES: An electronic and manual search was performed in PubMed, ISI Web of Science, Scopus, Cochrane Library, and Lilacs, with a supplemental hand search of the references of retrieved articles. STUDY SELECTION: From 314 abstracts, 14 fulfilled the inclusion criteria. After reading the full articles, one of them was excluded due to the lack of a control group. Seven studies were included in the meta-analysis, and the heterogeneity among the studies (I(2)) was 41%. The pooled meta-analysis demonstrated higher levels of s-IgA in the caries active group (p<0.00001) than in the control group with a mean difference and confidence interval of 0.27 [0.17-0.38]. CONCLUSIONS: Based on these findings, there is evidence that supports the presence of increased s-IgA levels in caries-active subjects. CLINICAL SIGNIFICANCE: Dental caries is a multifactorial disease that comprehends intrinsic and extrinsic factors. The risk factors and events related to dental caries are overlooked in the literature. Additionally, it is also important to understand the host response against this disorder. Since the studies are contradictory in this field, we conducted a systematic review followed by meta-analysis to present the immunological host response evidence-based.
Assuntos
Cárie Dentária/imunologia , Imunoglobulina A Secretora/análise , Saliva/imunologia , Índice CPO , Suscetibilidade à Cárie Dentária/imunologia , HumanosRESUMO
OBJECTIVES: The aim of this study was to perform a systematic review and meta-analysis on the effectiveness of sealing non-cavitated proximal caries lesions in primary and permanent teeth. DATA: Only controlled clinical trials and randomized controlled clinical trials that evaluated the effectiveness of sealing on non-cavitated proximal caries with a minimum follow-up of 12 months were included in the study. The primary outcome should be arrestment/progression of proximal caries evaluated by bitewing radiographs. A risk of bias evaluation based on the Cochrane Collaboration common scheme for bias was carried out for each study. The meta-analysis was performed on the studies considered low risk of bias and with pair-wise visual reading results through RevMan software. SOURCES: A comprehensive search was performed in the Systematic Electronic Databases: Pubmed, Cochrane Library, Scopus, IBI Web of Science, Lilacs, SIGLE, and on website Clinical trials.gov, through until June 2013. STUDY SELECTION: From 967 studies identified, 10 articles and 3 studies with partial results were assessed for eligibility. However three articles were excluded and our final sample included 10 studies. According to the risk of bias evaluation, six studies were considered "high" risk of bias, and four "low" risk of bias. The forest plot of the meta-analysis showed low heterogeneity (I(2)=29%) and a favourable outcome for the Infiltrant. The chance of caries progression when this technique was used was significantly lower (p=0.002) compared with Placebo. CONCLUSION: Our results suggest that the technique of sealing non-cavitated proximal caries seems to be effective in controlling proximal caries in the short and medium term. Further long-term randomized clinical trials are still necessary to increase this evidence. CLINICAL SIGNIFICANCE: Contemporary dentistry is focused in minimally invasive approaches that prevent the destruction of sound dental tissues next to carious lesions. This paper searches for evidence of the efficacy of sealing/infiltrating non-cavitated proximal caries in arresting caries progression both in permanent and primary teeth.