Caries and its association with infant feeding and oral health-related behaviours in 3-4-year-old Brazilian children

Objectives: To investigate the relationships between socio-demographic factors, infant feeding habits, oral hygiene and the prevalence and patterns of caries in Brazilian 3-4-year-olds. Methods: Systematic random sampling was used to select children enrolled in municipal nurseries in Araraquara, Brazil, in 1998. Clinical examinations were carried out by one examiner using dmft and dmfs indices and WHO criteria. Questionnaires for information related to the socio-demographic background, oral hygiene and dietary history of the children were completed by their mothers. Results: Caries was seen in 46% of the children; 17% of them had the more extensive pattern involving molars and incisors. Social class, mother's education, and age at which breast-feeding terminated showed statistically significant associations with caries. Feeding bottles with added sugars were still being given to 80% of the children. When the significant variables were taken into account only age at which breast-feeding terminated showed a significant relationship to the pattern of disease. Children who were never breast-fed or were breast-fed beyond the age of 24 months had a higher prevalence of the more extensive pattern of caries. Conclusions: The association between the length of time a mother breast-feeds and extensive caries should be a consideration in any local infant feeding policies or health promotion strategies. The duration for appropriate breast- or bottle-feeding should be emphasised.

The relationship between place BANA reactivity and clinical parameters in subjects with mental disabilities

The purpose of the present investigation was to determine whether subjects institutionalized with mental retardation have a relationship between periodontal clinical parameters and the presence of the BANA-positive periodontal pathogens Porphyromonas gingivalis, Treponema denticola, and Bacteroides forsythus in their subgingival plaques. Fifty institutionalized subjects (25 patients with Down syndrome and 25 subjects with mental retardation) were matched with respect to age and sex. Periodontal clinical parameters (Bleeding on Probing, BOP; Papillary Bleeding Score, PBS; and Probing Depth, PD) were obtained from 6 reference teeth (3, 8, 14, 19, 24, 30). In addition, subgingival plaque samples taken from the same 6 teeth were analyzed for the presence of the BANA-positive species, by means of the chairside BANA test. In both the patients with Down syndrome and the group with mental retardation, the presence of BANA-positive plaques was significantly associated with bleeding on probing (p < 0.05) and increased probing depth (p < 0.01, Chisquare). Analysis of these data indicated that the BANA test could be used in combination with clinical criteria to diagnose a periodontopathy anaerobic Infection in institutionalized subjects.

Subgingival utilization of a 1% chlorhexidine collagen gel for the treatment of periodontal pockets. A clinical and microbiological study.

This study evaluates the effect of subgingival irrigation with a 1% chlorhexidine collagen gel in periodontal pockets as an adjunct procedure to scaling and root planing (SRP). Thirty-seven sites with probing depth (PD) of 5-7 mm and BANA positive in 6 patients with chronic periodontal disease were selected. Sites were assigned to different treatment groups consisting of SRP only (group 1), SRP + irrigation with collagen gel (group 2), or SRP + irrigation with collagen gel containing 1% chlorhexidine (group 3). Subgingival irrigation was performed after initial SRP and at 7, 14 and 21 days. Clinical measurements including PD, plaque index (PI), gingival index (GI), gingival recession (GI), bleeding on probing (BOP) and clinical attachment level (CAL) were performed at the selected sites at baseline, 60 and 90 days and the BANA test was performed on plaque samples from the same sites at baseline and 90 days. There was an improvement in clinical parameters in all groups with a significantly greater decrease in GI and bleeding in the chlorhexidine group. There was a greater reduction of BANA positive sites in groups 2 and 3. The authors concluded that 1% chlorhexidine collagen gel is a promising adjunct to SRP in the treatment of adult periodontitis.

Calcium hydroxide root canal dressing. Histopathological evaluation of periapical repair at different time periods.

The objective of this study was to evaluate periapical and apical repair using calcium hydroxide root canal dressings for different lengths of times in teeth with induced chronic periapical lesions. A total of 61 root canals of maxillary and mandibular premolars from 4 dogs were used. After mechanical preparation of the root canals using the crown-down technique, and 5.25% NaOCl as irrigating solution, the apical foramen was enlarged in all cases. A calcium hydroxide root canal dressing was applied. The control group did not receive a root canal dressing. The animals were killed at 7, 15 or 30 days. After histological preparation, serial sections were stained with hematoxylin-eosin and Mallory's trichrome. The best histopathological results occurred at 15 and 30 days, and the worst results occurred at 7 days and in the control group.

Use of aspartate aminotransferase in diagnosing periodontal disease: a comparative study of clinical and microbiological parameters

The objective of this study was to assess the association between the levels of enzyme aspartate aminotransferase (AST) in gingival crevicular fluid (GCF) with the BANA hydrolysis microbiological test (Perioscan) and clinical periodontal diagnostic measurements, such as bleeding on probing, plaque index, gingival index, probing depth, and attachment level in patients with chronic periodontitis using an enzymatic test (PocketWatch). One hundred and forty-seven sites were evaluated in 22 patients with a probing depth of > or = 5 mm at selected sites. AST and BANA enzymatic tests were carried out, and clinical parameters recorded. Pearson's chi-square and Fisher's exact tests were used for statistical analysis. There was no statistical correlation between AST levels and any of the analyzed parameters. The lack of any association between the factors studied does not indicate, however, that the latter cannot be used in diagnosing the actual periodontal condition of patients and/or sites. However, more research should be carried out to evaluate the true relationship between AST and periodontal disease.

Behavioral evaluation during dental care in children ages 0 to 3 years

Purpose: Many studies concluded that the behavior of babies complicated dental care because of child immaturity or the difficulty of establishing acceptable communication and comprehension. Methods: The records of 696 babies were randomly selected from the baby clinic of Araçatuba in Brazil. Patient age ranged from 0 to 36 months. They were divided into 6 groups according to age: Group I-0 to 6 months; Group II-7 to 12 months; Group III-13 to 18 months; Group IV-19 to 24 months; Group V-25 to 30 months; Group VI-31 to 36 months. The behavior of the child was evaluated upon entrance in the dental office and during the first 4 clinical appointments with a clinical exam and oral physiotherapy. The baby was classified as collaborator (C) or noncollaborator (NC). Statistical analysis was performed using Pearson's chi-square method (P< .05). Results: The percentage of NC for Groups II, III, IV, and V (66%), was significantly higher than for groups I (30%) and VI (50%). Conclusions: Babies from 0 to 6 months showed a collaborative behavior; babies from 7 to 30 months showed noncollaborative behavior; and babies from 31 to 36 months showed no statistically significant difference between the percentage of C and NC.

Influence of dental care for infants on caries prevalence: A comparative study

Purpose: The influence of early dental care on the prevalence of dental caries was determined in children ages 35 to 40 months divided into 2 groups of 160 children each, with 1 group participating in a dental care program from the first year of life to the time of the study, while the other group did not receive any dental care. Methods: The clinical conditions considered for the evaluation were: sound teeth, enamel caries without cavitation, enamel caries with cavitation, and dentinal caries. The proportion and chi-square tests were used for statistical analysis with the level of significance set at 5%. Results: A significant difference regarding the presence of dental caries, especially in the number of children presenting enamel caries with cavitation (P<.0001), was observed between the 2 groups. The number of children with enamel caries without cavitation and dentinal caries was similar for the 2 groups. Conclusions: Considering the aspect of dental caries prevention, the authors concluded that children in the age range of 3 to 4 years who received early dental care showed better oral conditions.

Independent impact of glycemia ad blood pressure in albuminuria on high-risk subjects for metabolic syndrome

Background: Microalbuminuria may reflect diffuse endothelial damage. Considering that diabetes and hypertension cause vasculopathy, we investigated associations of albumin-to-creatinine ratio (ACR) with plasma glucose and blood pressure levels in high-risk subjects for metabolic syndrome. Methods: A sample of 519 (246 men) Japanese-Brazilians (aged 60 ± 11 years), who participated in a population-based study, had their ACR determined in a morning urine specimen. Backward models of multiple linear regression were created for each gender including log-transformed values of ACR as dependent variable; an interaction term between diabetes and hypertension was included. Results: Macroalbuminuria was found in 18 subjects. ACR mean values for subjects with normal glucose tolerance, impaired fasting glycemia, impaired glucose tolerance and diabetes were 9.9 ± 6.0, 19.0 ± 35.4, 20.7 ± 35.4, and 33.9 ± 55.0 mg/g, respectively. Diabetic subjects showed higher ACR than the others (p < 0.05). An increase in the proportion of albuminuric subjects was observed as glucose metabolism deteriorated (4.9, 17.0, 23.0 and 36.0%). Stratifying into 4 groups according to postchallenge glycemia (< 7.8 mmol/l, n = 9 1; ≥ 7.8 mmol/l, n = 4 10) and hypertension, hypertensive and glucose-intolerant subgroups showed higher ACR values. ACR was associated with gender, waist circumference, blood pressure, plasma glucose and triglyceride (p < 0.05); albuminuric subjects had significantly higher levels of such variables than the normoalbuminuric ones. In the final models of linear regression, systolic blood pressure and 2-hour glycemia were shown to be independent predictors of ACR for both genders (p < 0.05). In men, also waist was independently associated with ACR. No interaction was detected between diabetes and hypertension. Conclusions: These findings suggest that both glucose intolerance and hypertension could have independent but not synergistic effects on endothelial function - reflected by albumin loss in urine. Such hypothesis needs to be confirmed in prospective studies. © 2004 Dustri-Verlag Dr. K. Feistle.

Relationship between gingival clinical parameters and the reactivity of the BANA test in subgingival samples from children.

Gingivitis is the first manifestation of periodontal disease, and is characterized by painless and slow evolution. Early diagnosis and intervention must be done to avoid the possibility of precocious periodontitis during the childhood or teenage years. The enzymatic BANA test (N-benzoyl-DL-arginine-naphthylamide) was used to evaluate subgingival samples from 54 children between 6 and 9 years of age. Plaque index (PI) and gingival index (GI) were assessed according to the criteria recommended by Löe (1967). Subgingival plaque was collected from the region that featured the greatest periodontal alteration, represented by a higher gingival index. Resulting data were grouped individually according to visible and non-visible plaque and bleeding and non-bleeding gingiva. Results showed that there was no statistically significant correlation between the presence of visible plaque and the positivity of the BANA test, nor was there a statistically significant correlation between the presence of bleeding and the positivity of the BANA test in subgingival samples obtained from children. This study concluded that the BANA test is not an ideal diagnostic test to be applied to children.

Bond strength of adhesive systems to human tooth enamel

The purpose of this study was to evaluate in vitro three adhesive systems: a total etching single-component system (G1 Prime & Bond 2.1), a self-etching primer (G2 Clearfil SE Bond), and a self-etching adhesive (G3 One Up Bond F), through shear bond strength to enamel of human teeth, evaluating the type of fracture through stereomicroscopy, following the ISO guidance on adhesive testing. Thirty sound premolars were bisected mesiodistally and the buccal and lingual surfaces were embedded in acrylic resin, polished up to 600-grit sandpapers, and randomly assigned to three experimental groups (n = 20). Composite resin cylinders were added to the tested surfaces. The specimens were kept in distilled water (37°C/24 h), thermocycled for 500 cycles (5°C-55°C) and submitted to shear testing at a crosshead speed of 0.5 mm/min. The type of fracture was analyzed under stereomicroscopy and the data were submitted to Anova, Tukey and Chi-squared (5%) statistical analyses. The mean adhesive strengths were G1: 18.13 ± 6.49 MPa, (55% of resin cohesive fractures); G2: 17.12 ± 5.80 MPa (90% of adhesive fractures); and G3: 10.47 ± 3.14 MPa (85% of adhesive fractures). In terms of bond strength, there were no significant differences between G1 and G2, and G3 was significantly different from the other groups. G1 presented a different type of fracture from that of G2 and G3. In conclusion, although the total etching and self-etching systems presented similar shear bond strength values, the types of fracture presented by them were different, which can have clinical implications.

Divine proportions and facial esthetics after manipulation of frontal photographs.

AIM: To investigate the relationship between divine proportion and facial esthetics in frontal photographs as well as whether any of the 4 ratios for manipulation provide more favorable facial esthetics. MATERIAL AND METHODS: The sample comprised 20 frontal photographs of Caucasian individuals (11 males and 9 females). The photographs were digitized and stored on a compact disk. A photometric analysis was created with 7 facial segments that were measured on Image Tool software and 4 ratios between 2 facial segments calculated using Microsoft Excel. This manipulation led to 5 different photographs of the same individual: one photograph with no manipulation and the others with 1 of the ratios manipulated in the Deformer 2.0 to very close or equal to 1.618. Thereafter, the 5 photographs of all individuals were evaluated by 12 examiners. The examiners selected those photographs that were esthetically more pleasant. CONCLUSION: After evaluation, a chi-square test revealed a relationship between divine proportion and facial esthetics. Among the ratios selected, R1 and R2 provided more favorable facial esthetics.

Root trunk height as a risk factor for periodontal furcation involvement in maxillary first molars: an in vitro study.

The aim of this study was to correlate the root trunk height from the furcation openings on the buccal, mesial and distal surfaces to the cemento-enamel junction in upper first permanent molars in human beings with risk for periodontal disease progression. One hundred extracted maxillary first molars were used. Reference points and demarcations were determined from the entrance of the buccal (F1), mesial (F2) and distal (F3) furcations to the cemento-enamel junction in millimeters. The mean distances found were 3.50 mm, 4.44 mm and 4.26 mm for the buccal, mesial and distal furcations, respectively, in relation to the cemento-enamel junction. The statistical analyses were Student's t-test and Chi-square (X2). With periodontal disease progression, the buccal furcation presents a greater compromising risk due to its proximity to the cemento-enamel junction, while the mesial furcation is the most distant, comprising a lesser risk.

Efeito sinérgico entre a dexmedetomidina e a ropivacaína 0,75% na anestesia peridural

BACKGROUND. This study aimed to evaluate clinical characteristics of epidural anesthesia performed with 0.75% ropivacaine associated with dexmedetomidine. METHODS. Forty patients scheduled for hernia repair or varicose vein surgeries under epidural anesthesia participated in this study. They were assigned to: Control Group (n = 20), 0.75% ropivacaine, 20 ml (150 mg); and Dexmedetomidine Group (n = 20), 0.75% ropivacaine, 20 ml (150 mg), plus dexmedetomidine, 1 μg.kg -1. The following variables were studied: total analgesic block onset time, upper level of analgesia, analgesic and motor block duration time, intensity of motor block, state of consciousness, hemodynamics, postoperative analgesia and incidence of side-effects. RESULTS. Epidural dexmedetomidine did not affect onset time or upper level of anesthesia (p > 0.05) however it prolonged sensory and motor block duration time (p < 0.05) and postoperative analgesia (p < 0.05), and also resulted in a more intense motor block, 1 (p < 0.05). Values of bispectral index were lower in Dexmedetomidine Group (p < 0.05). There was no difference in incidence of hypotension and bradycardia (p > 0.05). Occurrence of side-effects (shivering, vomiting and SpO 2 < 90%) was low and similar between groups (p > 0.05). CONCLUSION. There is clear synergism between epidural dexmedetomidine and ropivacaine, further this drug association does not bring about additional morbidity.

Edentulous patients' knowledge of dental hygiene and care of prostheses

Objective: The aim of this study was to analyse denture users' oral care habits with regard to the use of their prostheses. Background: Rehabilitative treatment is only successful when patients are motivated and aware of correct prosthesis use and hygiene. Materials and methods: Questionnaires were distributed to 150 complete denture users at the Federal University of Bahia School of Dentistry, the Esmeralda Natividade Health Center, the Bahian Science Development Foundation and a Salvador nursing home. The questionnaire included information on gender, age, length of prosthesis use, cleaning methods and materials, etc. The data were analysed using EpiInfo version 6 software. The chi-squared test was used for statistical analysis, with a significance level of 5%. Results: Questionnaire results showed that 78% of the subjects, with an average age of 67.3 years, had used the same complete denture for over 5 years. 64% slept with their prostheses and 44% removed them from the mouth only for cleaning. None of the patients interviewed knew anything about brushes designed specifically for complete dentures. 37.3% had a restricted diet and 44% believed that a complete denture would last for more than 10 years. Conclusion: Within the limitations of this study, it was concluded that the edentulous patients surveyed had limited awareness of prosthetic hygiene and long-term oral care despite extended periods of denture use. © 2008 The Authors.

Serological survey of Toxoplasma gondii in captive Neotropical felids from Southern Brazil

Toxoplasma gondii is the causative intracellular protozoan of toxoplasmosis in human being and animals. Members of the Felidae family are considered the single definitive host for the infection; both wild and domestic cats are able to excrete oocysts in the environment. Wild cats maintained in captivity may serve as source of infection for other clinically susceptible animals in the same environment. The aim of this study was to determine the frequency of T. gondii IgG antibodies in 57 neotropical felids (1 Leopardus geoffroyi; 3 Puma yagouaroundi; 17 Leopardus wiedii; 22 Leopardus tigrinus; and 14 Leopardus pardalis) kept at the Bela Vista Biological Sanctuary, Itaipu Binacional, Southern Brazil, by the modified agglutination test (MAT) using titer 16 as cut-off point. Seropositivity was observed in 38/57 (66.67%; 95% CI 53.66-77.51%) samples, with higher frequency in ocelots (71.43%). Wild-caught felids were three times more likely to be infected when compared to zoo-born animals (P≤ 0.05) and age of wild-caught animals (P= 0.6892; 95% CI. = 0.7528-1.66) was not significant as a risk factor for the infection, the same occurring with zoo-born animals (P= 0.05; 95% CI. = 0.6267-24.052). These results suggest that, despite efforts to control T. gondii infection in zoo facilities, such as individual pens, hygiene monitoring, veterinary care and pre-frozen meat offered as food, non-domestic felids kept in captivity, particularly the wild-caught specimens, may be invariably exposed to infection due to other environmental sources. © 2010 Elsevier B.V.