RESUMO
PURPOSE: Data about molar-incisor hypomineralization (MIH) prevalence and its severity remains limited for some Latin American countries. Furthermore, its association with socioeconomic status (SES) is still unclear. Thus, this study aims to determine the prevalence and severity of MIH in Santiago, Chile and explore its association with SES. METHODS: A cross-sectional study with schoolchildren between 6 and 12 years was conducted. Children were evaluated using the European Academy of Paediatric Dentistry to diagnose MIH, and the Mathu-Muju and Wright criteria to determine its severity. RESULTS: A total of 1,270 children were included. The MIH prevalence was 12.8% without association with gender (p = 0.609). Prevalence was higher among schoolchildren ages 8 and 9 (p = 0.002), and in lower SES (p = 0.007). MIH mild cases were the most prevalent (63%), and severity was not related to gender (p = 0.656), age (p = 0.060), or SES (p = 0.174). CONCLUSIONS: The prevalence of MIH in the province of Santiago, Chile is 12.8% and was found to have a higher incidence in 8-9-year-old students and among those categorized by low SES. Furthermore, MIH prevalence was associated with low SES. IMPLICATIONS: Public health policies to address MIH in Chile should start with schoolchildren aged 8 to 9, and with low SES.
Assuntos
Hipoplasia do Esmalte Dentário , Hipomineralização Molar , Criança , Humanos , Estudos Transversais , Chile/epidemiologia , Dente Molar , Incisivo , Hipoplasia do Esmalte Dentário/epidemiologia , Prevalência , Classe SocialRESUMO
RESUMEN: Objetivo: el objetivo de este estudio epidemiológico, fue determinar la prevalencia y severidad de caries dental, expresados en el índice de dientes definitivos con caries, obturados y perdidos (COPD), índice de dientes primarios con caries, extraídos y obturados (ceod) e Índice Significante de Caries (ISC) además establecer la necesidad de tratamiento restaurador y recursos humanos necesarios para ello, en una población escolar de 6 a 12 años de la Provincia de Santiago, Región Metropolitana. Metodología: Este estudio de corte transversal se realizó en 7 colegios entre públicos y privados que se encontraban debidamente registrados en la base de datos de la Secretaría Regional Ministerial de Educación pertenecientes a Provincia de Santiago, Región Metropolitana. Se seleccionó mediante un muestreo aleatorio estratificado por nivel socioeconómico, sexo y edad, una muestra de 1333 escolares de entre 6 a 12 años los cuales fueron evaluados previo asentimiento y con el consentimiento de sus tutores legales, por dos dentistas calibrados (Kappa 0.94). Para el diagnóstico de caries se utilizaron los criterios OMS. Los datos fueron recolectados en una ficha diseñada especialmente para ello y analizados utilizando el programa estadístico SPSS realizando pruebas no paramétricas de Kruskal-Wallis y U Mann-Whitney con un valor de significancia estadística del 95% (p<0,05). Resultados La prevalencia de caries encontrada en esta población, en dentición permanente fue de 24,5%, mientras que para dentición primaria 47,8%, los valores obtenidos del Índice COPD 0,48; ceod 1,67; ISC para COPD 1,45 y ISC para ceod 4,52. Las horas profesionales de odontólogos/as con sus respectivos/as asistentes, necesarias destinadas sólo a tratamiento restaurador para dar solución al daño encontrado en la muestra de estudio al momento del examen, corresponden a 167 horas para dentición permanente y 689 horas para dentición primaria. Conclusiones: La prevalencia y distribución de caries dental en escolares de 6 a 12 años de la Provincia de Santiago correspondió a cifras menores a las consignadas en el Diagnóstico de Salud Oral del Ministerio de Salud del año 2007, y menores a los índices propuestos por las organizaciones internacionales. Para resolver la necesidad de tratamiento restaurador en esta muestra se necesitarán 856 horas odontológicas.
ABSTRACT: Objective: The aim of the study was to determine prevalence and severity of dental caries, treatment needs and human resources required, in a school population aged 6 to 12 years in province of Santiago. Methodology: This cross-sectional study was conducted in seven schools. A stratified random sample was selected by socioeconomic level, sex and age. 1333 school children were evaluated by two calibrated dentists (Kappa 0.94). WHO criteria were used for caries diagnosis. Data were statistically analyzed by nonparametric tests of Kruskal-Wallis and U Mann-Whitney, statistical significance value of 95% (p <0.05). Results: 1333 patients fit the inclusion criteria. Caries prevalence was 24.5% for permanent teeth and 47.8% for primary teeth. DMFT index was 0.48, dmft index was 1.67. SiC was 1.45 for DMFT and 4.52 for dmft. A total of 167 and 689 hours of restorative treatment were required for permanent dentition and primary dentition, respectively. Conclusions: The prevalence and severity distribution of dental caries in school children aged 6 to 12 years in the Province of Santiago were lower than those recorded in the past, and lower than the rates proposed by the international organizations. To restore damaged founded in this sample 856 hours will be needed.
Assuntos
Humanos , Masculino , Feminino , Criança , Estudantes , Terapêutica , Prevalência , Cárie DentáriaRESUMO
ABSTRACT: The use of resin sealants has shown partial infiltration of White-Spot Enamel Lesions in vitro (WSEL). The aim of the present study was to perform a morphological evaluation of natural WSEL when infiltrated using a commercially available sealant (Concise, 3M- ESPE). 20 bicuspids extracted for orthodontic reasons from patients ranging 18 to 30 years old, which had WSEL, were used in this study. The patients agreed to donate their teeth by signing a written consent. Every WSEL was assessed microscopically (Stereo Zeiss Axiscop) and then photographed (ProScope HR microscope). Prior to applying the sealant the lesion was etched using phosphoric acid at 37 % (3M-ESPE, St Paul, MN, USA.) for 30 seconds, washed for 40 seconds and then air-dried. The sealant was marked with rhodamine B (1mg/ml) and was applied according to the manufacturer directions. A specimen of approximately 100 mm was obtained for every WSEL by cutting perpendicularly through the lesion (Isomet 1000, Buehler Co.) and grinding (600 grit). The specimens were evaluated using: clear camp, polarized light, and epifluorescence microscopy. Images were taken of each specimen for every microscopic evaluation using a slide film (Kodak Ektachrome film 400 ASA). The images were digitalized by scanning at 1200 dpi resolution (Epson Filmscan 200) and then saved as JPEG and TIFF files. The sealant infiltration into The WSEL was assessed by means of analysis, processing and digital superimposing using Adobe Photoshop 7.0 and Matrox Inspector 1.07. It was concluded that the sealant infiltrated the whole body zone of the lesion. The depth of penetration of sealants into White Spot Enamel Lesion plays an important role in the control of caries lesion progression.
RESUMEN: El uso de sellantes de resina ha demostrado lograr la infiltración parcial de lesiones de mancha blanca en esmalte in vitro (LMBE). El objetivo del presente estudio fue realizar una evaluación morfológica de la infiltración a LMBE naturales utilizando un sellante disponible comercialmente (Concise, 3M-ESPE). Se utilizaron en este estudio, 30 bicúspides extraídos por razones de ortodoncia en pacientes que tenían entre 18 a 30 años de edad, y presentaban LMBE. Los pacientes aceptaron donar sus dientes firmando un consentimiento informado. Cada LMBE se evaluó microscópicamente (Stereo Zeiss Axiscop) y luego se fotografió (microscopio ProScope HR). Antes de aplicar el sellante, la lesión se grabó usando ácido fosfórico al 37 % (3M-ESPE, St Paul, MN, EE. UU.) durante 20 segundos, luego se lavó durante 40 segundos y finalmente se secó con aire de jeringa triple. El sellante se marcó con rodamina B (1 mg / ml) y se aplicó siguiendo las instrucciones del fabricante. Se obtuvo una muestra de aproximadamente 100 mm para cada LMBE cortando perpendicularmente a través de la lesión (Isomet 1000, Buehler Co.) y trituración (grano 600). Las muestras se evaluaron usando: campo claro, luz polarizada y microscopía de epifluorescencia. Se tomaron imágenes de cada espécimen para la evaluación microscópica usando una película deslizante (Kodak Ektachrome film 400 ASA). Las imágenes se digitalizaron escaneando a una resolución de 1200 ppp (Epson Filmscan 200) y luego se guardaron como archivos JPEG y TIFF. La infiltración del sellante en las LMBE se evaluaron mediante análisis, procesamiento y superposición digital utilizando Adobe Photoshop 7.0 y Matrox Inspector 1.07. Se concluyó que el sellante infiltró toda la zona del cuerpo de la lesión. La capacidad de penetración en profundidad de los sellantes en Lesiones de Mancha Blanca del Esmalte desempeñan un rol importante en el control de la progresión de las lesiones de caries.
Assuntos
Humanos , Adolescente , Adulto , Selantes de Fossas e Fissuras/uso terapêutico , Resinas Sintéticas , Cárie Dentária/terapia , Chile , Cárie Dentária/patologia , Cárie Dentária/prevenção & controle , Consentimento Livre e Esclarecido , MicroscopiaRESUMO
Las férulas o planos oclusales han sido utilizadas desde hace más de un siglo, generando controversia acerca de su verdadero valor terapéutico. Esto motivó una revisión histórica y actualizada que permitiera evaluar sus efectos de acuerdo a la evidencia científica. Se discuten múltiples aspectos como el concepto de relación céntrica y su determinación como punto de inicio de tratamiento en la rehabilitación oral; el uso de las férulas para deprogramar; su efecto sobre la conducta motora oral que conocemos como bruxismo; su efecto en la actividad electromiográfica tónica, durante la deglución y el máximo apriete en los músculos masticatorios y cervicales; su influencia en la eficiencia muscular; su efecto en la carga articular y las evidencias experimentales del uso de distintas férulas sobre signos y síntomas especíicos como dolor y ruido articular. Se plantean desafíos para la investigación sobre cambios degenerativos en las articulaciones, en la relación craneovertebral y en la curvatura e inclinación de la columna cervical. Se concluye que es necesario utilizar una férula diseñada para el trastorno específico del paciente y que su verdadero valor terapéutico queda demostrado al mejorar algunos signos y síntomas, en músculos masticatorios y cervicales. El conocimiento parcial del mecanismo de acción de las férulas contribuye a que persista la controversia de su utilización en el tratamiento de ruidos articulares y para revertir cambios degenerativos en las articulaciones. Persiste el desafío de nuevas investigaciones, que sustenten el uso de estos dispositivos como un método eficaz para tratar a nuestros pacientes, utilizando protocolos de manejo y controles periódicos.
Occlusal appliances or splints have been used for over a century, generating controversy about their real therapeutic value. This led to an updated review to assess their effects according to scientific evidence. The concept of centric relation and its determination as a starting point of treatment; the use of splints to deprogram; their effect on the oral motor behaviour known as bruxism are discussed. Their effect on EMG activity during resting, swallowing and maximal clenching in the masticatory and neck muscles; their effect on muscular eficiency; their effect decreasing the joint overload; and experimental evidence of the use of several appliances on speciic symptoms such as pain and joint noise, are also treated. The true challenge is to generate new knowledge about joint degenerative changes, the craniocervical relationships, tilt and curvature of the cervical spine. In conclusion, it's necessary to use an occlusal appliance designed for the specific condition of the patient, and its real therapeutic value is demonstrated by the improvement of some signs and symptoms in masticatory and cervical muscles. However, the action mechanisms of occlusal appliances are not fully understood. The lack of scientiic support contributes to the persistent controversy of the use of these appliances in the treatment of temporomandibular joint sounds and reversing degenerative changes. It is still a challenge to carry out new researches supporting the use of these appliances as an effective method to treat our patients using management protocols and periodic evaluations.
Assuntos
Humanos , Bruxismo/terapia , Placas Oclusais , Transtornos da Articulação Temporomandibular/terapia , Bruxismo/fisiopatologia , Relação Central , Eletromiografia , Músculos da Mastigação/fisiopatologia , Transtornos da Articulação Temporomandibular/fisiopatologiaRESUMO
Objetivo: El objetivo de este estudio transversal fue evaluar el estado de salud oral y cuantificar la prevalencia de caries dental, pérdida de dientes y necesidad de tratamiento en la población adulta de etnia Mapuche-Huilliche que habita la Isla Huapi. Método: Se examinó una muestra representativa de 64 habitantes adultos de la Isla Huapi, constituida por 31 hombres y 33 mujeres de entre 25 a 82 años de edad, que tenían a lo menos un apellido de origen Mapuche-Huilliche. Todos los individuos, previa firma de un consentimiento informado, fueron examinados por un solo dentista calibrado durante el mes de agosto 2009. Los datos fueron registrados en una ficha diseñada especialmente y analizados estadísticamente usando los test T de Student y ANOVA. Resultados: El promedio del índice COPD de la muestra fue 14.59. Todos los individuos tenían historia de caries. De los que conservaban dientes, el 71.43 por ciento tenían caries sin tratar, con un promedio de 1.25. El 98.43 por ciento de los individuos de la muestra presentaban algún grado de desdentamiento, el 12.5 por ciento eran edéntulos. El 100 por ciento de la población necesitaba atención odontológica, ya fuera para operatoria o prótesis. Conclusiones: Esta población presenta un gran daño en cuanto a su salud oral, especialmente debido a pérdida de dientes. La magnitud del daño e importancia del entorno social como determinante en la generación de éste, obliga a enfrentar el problema y buscar soluciones desarrollando y aplicando programas gubernamentales de promoción y atención en salud oral a toda la población.
Objectives: The aim of this cross- sectional study was to assess oral health status and quantify prevalence of dental caries, teeth loss and treatment needs in an ethnic group of Mapuche-Huilliche adult population in Isla Huapi. Method: A representative sample of 64 adult inhabitants of Isla Huapi was selected. 31 men and 33 women aged 25 to 82 years of age who had at least one Mapuche-Huilliche surname, after signing an informed consent, individuals were examined by a calibrated examiner during August 2009. Data were recorded and analyzed statistically using T Student and ANOVA tests. Results: The DMFT index average of the sample was 14.59. All individuals had caries experience. Untreated caries were found in a 71.43 percent of individuals retaining teeth, with an average of 1.25 each. 98.43 percent of the individuals had some degree of edentulism, 12.5 percent were edentulous. 100 percent of the population needed either restorative or prosthetic dental care. Conclusions: This population has a high degree of damage in their oral health, especially due to teeth loss, which could be explained by their limited access to preventive and restorative dental care. The extent of the damage and the importance of the social environment as a determiner in the generation of it, will mean addressing the problem and seeking solutions by developing and implementing government programs for the promotion and oral health care to the entire population.
Assuntos
Idoso , Cárie Dentária/epidemiologia , Indígenas Sul-Americanos , Avaliação das Necessidades , Perda de Dente/epidemiologia , Distribuição por Idade e Sexo , Assistência Odontológica , Estudos Transversais , Chile/etnologia , Índice CPO , Odontólogos/provisão & distribuição , Prevalência , Prótese Dentária/estatística & dados numéricosRESUMO
Image segmentation of 3D medical images is a challenging problem with several still not totally solved practical issues, such as noise interference, variable object structures and image artifacts. This paper describes a hybrid 3D image segmentation method which combines region growing and deformable models to obtain accurate and topologically preserving surface structures of anatomical objects of interest. The proposed strategy starts by determining a rough but robust approximation of the objects using a region-growing algorithm. Then, the closed surface mesh that encloses the region is constructed and used as the initial geometry of a deformable model for the final refinement. This integrated strategy provides an alternative solution to one of the flaws of traditional deformable models, achieving good refinements of internal surfaces in few steps. Experimental segmentation results of complex anatomical structures on both simulated and real data from MRI scans are presented, and the method is assessed by comparing with standard reference segmentations of head MRI. The evaluation was mainly based on the average overlap measure, which was tested on the segmentation of white matter, corresponding to a simulated brain data set, showing excellent performance exceeding 90% accuracy. In addition, the algorithm was applied to the detection of anatomical head structures on two real MRI and one CT data set. The final reconstructions resulting from the deformable models produce high quality meshes suitable for 3D visualization and further numerical analysis. The obtained results show that the approach achieves high quality segmentations with low computational complexity.
Assuntos
Imageamento Tridimensional/métodos , Imageamento por Ressonância Magnética , Modelos Anatômicos , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Tomografia Computadorizada por Raios X , Algoritmos , Encéfalo/diagnóstico por imagem , Simulação por Computador/normas , HumanosRESUMO
Human and murine infection with Trypanosoma cruzi parasite is usually accompanied by strong humoral and cellular immune response to cruzipain, a parasite immunodominant antigen. In the present study we report that the immunization of mice with cruzipain devoid of enzymatic activity, was able to induce antibodies which bind to a 223-kDa antigen from a mouse heart extract. We identified this protein as the mouse cardiac myosin heavy chain by sequencing analysis. The study of IgG isotype profile revealed the occurrence of all IgG isotypes against cruzipain and myosin. IgG1 showed the strongest reactivity against cruzipain, whereas IgG2a was the main isotype against myosin. Anti-cruzipain antibodies purified by immunoabsorption recognized the cardiac myosin heavy chain, suggesting cross-reactive epitopes between cruzipain and myosin. Autoimmune response in mice immunized with cruzipain was associated to heart conduction disturbances. In addition, ultrastructural findings revealed severe alterations of cardiomyocytes and IgG deposit on heart tissue of immunized mice. We investigated whether antibodies induced by cruzipain transferred from immunized mothers to their offsprings could alter the heart function in the pups. All IgG isotypes against cruzipain derived from transplacental crossing were detected in pups' sera. Electrocardiographic studies performed in the offsprings born to immunized mothers revealed conduction abnormalities. These results provide strong evidence for a pathogenic role of autoimmune response induced by a purified T. cruzi antigen in the development of experimental Chagas' disease.
Assuntos
Antígenos de Protozoários/imunologia , Cisteína Endopeptidases/imunologia , Cardiopatias/imunologia , Miosinas/imunologia , Sequência de Aminoácidos , Animais , Formação de Anticorpos , Antígenos de Protozoários/administração & dosagem , Cisteína Endopeptidases/administração & dosagem , Feminino , Cardiopatias/etiologia , Cardiopatias/parasitologia , Humanos , Imunização , Camundongos , Camundongos Endogâmicos BALB C , Dados de Sequência Molecular , Proteínas de Protozoários , Trypanosoma cruzi/imunologiaRESUMO
In previous studies we have identified and characterized an 80-kDa Trypanosoma cruzi urinary antigen (UAg) eliminated during acute infection. Polyclonal antibodies raised against this antigen revealed by western blotting and immunoprecipitation analyses showed the existence of another antigenic component of 50-55 kDa in the UAg preparation. The antiserum was also used for screening of a T. cruzi expression library. Sequencing of inserts from selected cDNA clones showed high homology with the 3' end of the T.cruzi beta-tubulin gene sequence encoding for the C-terminus of the protein. The presence of T. cruzi tubulin in the UAg was confirmed by immunoprecipitation of a 50-55-kDa protein from 125I-labeled UAg with monoclonal antibodies (MAbs) to human alpha/beta-tubulin. Interestingly, MAbs recognized radiolabeled T. cruzi tubulin eliminated in the urine of infected mice 24 hr postinoculation of [35S]methionine-labeled viable trypomastigotes. Tubulin found in the urine proved to be of T. cruzi origin because this protein could not be identified in urinary specimens from uninfected animals or mice acutely infected with Leishmania infantum or Toxoplasma gondii. We conclude that tubulin is one of the parasite antigens eliminated in the urine of T. cruzi-infected hosts. This finding may be used to develop a noninvasive procedure for early diagnosis of Chagas' disease.
Assuntos
Antígenos de Protozoários/urina , Doença de Chagas/urina , Proteínas de Protozoários/urina , Trypanosoma cruzi/química , Tubulina (Proteína)/urina , Sequência de Aminoácidos , Animais , Anticorpos Antiprotozoários/análise , Antígenos de Protozoários/química , Antígenos de Protozoários/genética , Sequência de Bases , Western Blotting , Doença de Chagas/diagnóstico , Feminino , Biblioteca Gênica , Soros Imunes/imunologia , Camundongos , Dados de Sequência Molecular , Reação em Cadeia da Polimerase , Testes de Precipitina , Proteínas de Protozoários/química , Proteínas de Protozoários/genética , Coelhos , Trypanosoma cruzi/genética , Trypanosoma cruzi/imunologia , Tubulina (Proteína)/química , Tubulina (Proteína)/genéticaRESUMO
The biochemical and functional properties of T. cruzi GP50/55, a novel glycosylphosphatidylinositol (GPI)-anchored membrane antigen have been investigated. A 50-52-kDa thiol proteinase activity could be immunoprecipitated with monoclonal antibodies (mAb) directed against GP50/55 (mAb C10), different from the one reactive with mAbs against lysosomal cysteine proteinase GP57/51. Furthermore, the mAb C10-reactive proteinase corresponded to the GPI-anchored surface antigen since the proteolytic and antigenic activity partitioned to the aqueous phase after Triton X114 phase separation of phosphatidylinositol specific phospholipase C (PI-PLC)-treated parasites. Of several proteins immunoprecipitated by a polyclonal anti-lysosomal cysteine proteinase, an mAb to GP57/51 recognized a 60-kDa protein, whereas mAb C10 recognized antigens ranging between 52 and 50 kDa. The GP50/55 antigen detected by mAb C10 is expressed on the parasite surface whereas the GP57/51 antigen is mainly intracellular. The internal peptide sequence obtained from purified GP50/55 showed that it is more homologous to the prototype of the cysteine proteinases superfamily, papain, than to the two T. cruzi lysosomal cysteine proteinases so far described. Our data indicate that the T. cruzi GP50/55 is a novel GPI-anchored cysteine proteinase and may represent another isoform of this heterogeneous group of proteinases.
Assuntos
Antígenos de Protozoários/química , Cisteína Endopeptidases/química , Glicoproteínas/química , Glicosilfosfatidilinositóis/química , Trypanosoma cruzi/química , Animais , Antígenos de Protozoários/metabolismo , Cisteína Endopeptidases/metabolismo , Citometria de Fluxo , Glicoproteínas/metabolismo , Glicosilfosfatidilinositóis/metabolismo , Testes de Precipitina , Trypanosoma cruzi/metabolismoRESUMO
Chagas' disease results from the infection of the protozoan parasite Trypanosoma cruzi and affects several million people in South America. Several alterations of the immune response have been described in this disease, such as severe immunosuppression of both cellular and humoral responses and the induction of autoantibodies crossreacting with host cells and tissues. We described here a GPI-linked 50/55 kDa antigen (GP50/55) present on the T. cruzi membrane, but not in the membrane of other parasites of the family Trypanosomatidae. We have obtained several monoclonal antibodies which specifically recognize this molecule. One of these GP50/55-specific mAbs (C10) crossreacts with a 28 kDa antigen expressed on the membrane of activated mouse and human T and B lymphocytes, after "in vitro" activation with mitogens, phorbol esters, or antigen, and on several murine T and B lymphocyte cell lines. Furthermore, this mAb was able to suppress mouse and human T and B cell proliferation to any of those stimuli. In addition, sera from T. cruzi-infected mice or Chagasic patients but not from uninfected mice or control patients contain antibodies which recognize a similar p28 antigen and also suppress the proliferation of human T lymphocytes. These results suggest a possible role of autoantibodies as an alternative mechanism for T. cruzi-associated immunosuppression.