Elaboração de um Jogo Digital Educacional sobre Saúde Bucal Direcionado para a População Infantil

Objective: The aim of this study was to develop an educational oral health digital game for 5-to-7-year-old children. Method: The game, called “Dr. Trata Dente”, was based on the approach to three different oral health-related topics: a) bacterial plaque and the main diseases caused by it; b) oral hygiene methods for bacterial plaque control; c) dental caries and preventive measures for this disease. These topics were discussed in sequential order in three different stages of the game. Dr. Trata Dente is represented by the figure of a little super-hero dentist, who talks to the children about oral health during the game. The game is sub-divided according to its propositions to the children, into an association game, a memory game and a coloring game. After its development, the game was evaluated by three professionals of each of the following areas: Dentistry, Pedagogy and Psychology (n=9), who verified the suitability of the concepts presented in the game as regards oral health, linguistic abilities worked with the children, fulfillment of the intended didactic criteria, and the playful aspect of the game. Results: According to the dentists, the dental concepts presented in the game are adequate. According to the pedagogues, the choice of a super-hero was correct and the given explanations are well elaborated, organized and have accessible language, although long. For the psychologists, the game has a potential positive effect on the children’s learning, but there should be more interaction of the character with the children. After this evaluation, changes were made in the game according to the professionals’ suggestions. Conclusion: It was concluded that in spite of the suggested alterations, the game is suitable for teaching oral health by means of children’s play.

Avaliação do perfil de risco de cárie dentária em gestantes de Araraquara, Brasil

The knowledge of risk of carried during pregnant is essential for an appropriate treatment using educational and preventives actions to mother for a good care of their oral health and that of children. The main objective of present retrospective study was to identify the risk of caries of pregnants (aged 15-44, mean= 25 years) came to clinic of Preventive Odontology of Araraquara-UNSEP from 1999 to 2007, using 166 medical records obtained by the third pregraduate year students, following the pre-established guidelines. The information collected includes: classification of caries risk diagnosis, pregnancy trimester, carbohydrates ingestion (between or during foods), dental plaques (O'Leary's plaque control registry) and the number of teeth with caries. The statistical analysis used the Chi2 and ANOVA tests. Most of patients showed a 25 % or more of teeth surfaces with dental plaques (92.1 %) and carbohydrates consumption among foods (89.2 %). The mean (SD) of carried and restores teeth was of 7.9 (5.1) and 4.0 (3.4), respectively and the posterior teeth were the more involved by caries/restorations. As regards the diagnosis of caries risk, classification of high risk was observed in the 38.5 % of pregnants, moderate in the 47.6 %) and low in the 13.9 %. There was a statistically significant association (p= 0.001) between the carbohydrates consumption and the diagnosis of caries risk. The plaque's rate was similar in the different trimesters of pregnancy (f= 0.223; p= 0.803). The caries risk of most pregnant women was high or moderate and it was associated with the consumption of carbohydrates.

Microbiological changes after periodontal therapy in diabetic patients with inadequate metabolic control

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Avaliação das alterações no nível da crista óssea e na estabilidade de implantes em função instalados na região anterior da maxila enxertada com osso autógeno ou rhBMP-2

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Intraoral fluoride levels after use of conventional and high-fluoride dentifrices

This study aimed to evaluate saliva and plaque as indicators of intraoral fluoride (F) levels after the use of conventional and high-fluoride dentifrices.Subjects were randomly assigned to brush their teeth with conventional (1000 ppm F), high-fluoride (5000 ppm F), and placebo dentifrices (fluoride free) for 10 days, following a double-blind, crossover protocol. Saliva and plaque samples were collected on the morning of the 5(th) and 10th days, respectively at 1 and 12 h after brushing, and analyzed with an ion-selective electrode after HMDS-facilitated diffusion. Data were analyzed by two-way repeated measures ANOVA, Tukey's test and Spearman's correlation coefficient (p < 0.05).Plaque and salivary F levels were significantly increased after the use of conventional and high-fluoride dentifrices when compared to values obtained for placebo, except plaque 12 h after the use of conventional dentifrice. A positive and significant correlation was found between fluoride concentrations in plaque and saliva for both times of sample collection.Both indicators assessed were able to detect significant differences among treatments and between times after brushing. The use of a high-fluoride dentifrice is able to significantly increase intraoral fluoride levels throughout the day, being therefore a useful therapy for patients at high caries risk.A dentifrice with high fluoride concentration could be regarded as a useful therapy of F delivery for high caries-risk patients, since intraoral F levels were sustained throughout most of the day after using this formulation.

Effects of Yersinia enterocolitica O:3 derivatives on B lymphocyte activation in vivo

The potential sequelae of intestinal infection with Yersinia enterocolitica include reactive arthritis, erythema nodosum, Reiter's syndrome and other autoimmune diseases. The role of the immune response in the pathogenesis of these diseases has not been fully defined, but autoimmune manifestations may be a consequence of the increase in autoantibodies as a result of polyclonal B-cell activation induced by Yersinia. We investigated the effects of Y enterocolitica 0:3 derivatives on B lymphocyte activation in vivo. Groups of five specific pathogen free (SPF) Swiss mice were inoculated with bacterial cell extract, Yersinia outermembrane proteins (Yops) or lipopolysaccharide (LPS) obtained from Y enterocolitica 0:3 and their immunoglobulin-secreting spleen cells were detected by isotype-specific protein A plaque assay. The presence of specific anti-Yersinia antibodies and autoantibodies was determined in mouse sera by ELISA. In all experiments a marked increase in the number of secretory cells of different isotypes was observed as early as the third day after inoculation. IgG and IgM anti-Yersinia antibodies were detected in the sera of all inoculated mice, and autoantibodies against myosin in the sera of those inoculated with bacterial cell extract. The sera from animals stimulated with LPS reacted with myelin, actin and laminin, while the sera from mice inoculated with Yops reacted with myelin, thyroglobulin and cardiolipin. These results suggest that SPF Swiss mice inoculated with any one of the Y enterocolitica derivatives tested exhibited polyclonal activation of B lymphocytes as a result of stimulation by various bacterial components and not only LPS stimulation.

Activation of monocytes and cytokine production in patients with peripheral atherosclerosis obliterans

Background: Arterial peripheral disease is a condition caused by the blocked blood flow resulting from arterial cholesterol deposits within the arms, legs and aorta. Studies have shown that macrophages in atherosclerotic plaque are highly activated, which makes these cells important antigen-presenting cells that develop a specific immune response, in which LDLox is the inducing antigen. As functional changes of cells which participate in the atherogenesis process may occur in the peripheral blood, the objectives of the present study were to evaluate plasma levels of anti-inflammatory and inflammatory cytokines including TNF-alpha, IFN-gamma, interleukin-6 (IL-6), IL-10 and TGF-beta in patients with peripheral arteriosclerosis obliterans, to assess the monocyte activation level in peripheral blood through the ability of these cells to release hydrogen peroxide (H(2)O(2)) and to develop fungicidal activity against Candida albicans (C. albicans) in vitro.Methods: TNF-alpha, IFN-gamma, IL-6, IL-10 and TGF-beta from plasma of patients were detected by ELISA. Monocyte cultures activated in vitro with TNF-alpha and IFN-gamma were evaluated by fungicidal activity against C. albicans by culture plating and Colony Forming Unit (CFU) recovery, and by H(2)O(2) production.Results: Plasma levels of all cytokines were significantly higher in patients compared to those detected in control subjects. Control group monocytes did not release substantial levels of H(2)O(2) in vitro, but these levels were significantly increased after activation with IFN-gamma and TNF-alpha. Monocytes of patients, before and after activation, responded less than those of control subjects. Similar results were found when fungicidal activity was evaluated. The results seen in patients were always significantly smaller than among control subjects. Conclusions: The results revealed an unresponsiveness of patient monocytes in vitro probably due to the high activation process occurring in vivo as corroborated by high plasma cytokine levels.

Morphological characteristics of neuromuscular junctions of the opossum (Didelphis albiventris) extraocular muscles: a scanning-electron-microscopic study

Three types of neuromuscular junctions were described in the extraocular muscles of the opossum. The present study demonstrates the three-dimensional characteristics of these neuromuscular junctions after HCl connective tissue digestion. Adult opossum of both sexes were used and the neuromuscular junctions of the extraocular muscles were examined after removal of the intramuscular connective tissue and basal layer. This material was examined with a scanning electron microscope. Two types of 'en plaque' neuromuscular junction were described: the continuous type revealed elongated and branched primary synaptic grooves separated from each other by sarcolemma protuberances with different sizes, and the discontinuous or punctiform type which presents very shallow and discontinuous grooves when compared with the former. The multiple neuromuscular junctions were observed as two or three junctions associated with the same muscular fiber. The multiple junctions were present in thin fibers (around 11 microm caliber); the en plaque junctions were associated with large diameter fibers (around 21 microm). This study confirms and reveals the detailed morphological characteristics of the three neuromuscular junction types previously described by transmission electron microscope in the extraocular muscles of opossum.

The effect of blue light on periodontal biofilm growth in vitro

We have previously shown that blue light eliminates the black-pigmented oral bacteria Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens, and Prevotella melaninogenica. In the present study, the in vitro photosensitivity of the above black-pigmented microorganisms and four Fusobacteria species (Fusobacterium nucleatum ss. nucleatum, F. nucleatum ss. vincentii, F. nucleatum ss. polymorphum, Fusobacterium periodonticum) was investigated in pure cultures and human dental plaque suspensions. We also tested the hypothesis that phototargeting the above eight key periodontopathogens in plaque-derived biofilms in vitro would control growth within the dental biofilm environment. Cultures of the eight bacteria were exposed to blue light at 455 nm with power density of 80 mW/cm(2) and energy fluence of 4.8 J/cm(2). High-performance liquid chromatography (HPLC) analysis of bacteria was performed to demonstrate the presence and amounts of porphyrin molecules within microorganisms. Suspensions of human dental plaque bacteria were also exposed once to blue light at 455 nm with power density of 50 mW/cm(2) and energy fluence of 12 J/cm(2). Microbial biofilms developed from the same plaque were exposed to 455 nm blue light at 50 mW/cm(2) once daily for 4 min (12 J/cm(2)) over a period of 3 days (4 exposures) in order to investigate the cumulative action of phototherapy on the eight photosensitive pathogens as well as on biofilm growth. Bacterial growth was evaluated using the colony-forming unit (CFU) assay. The selective phototargeting of pathogens was studied using whole genomic probes in the checkerboard DNA-DNA format. In cultures, all eight species showed significant growth reduction (p < 0.05). HPLC demonstrated various porphyrin patterns and amounts of porphyrins in bacteria. Following phototherapy, the mean survival fractions were reduced by 28.5 and 48.2 % in plaque suspensions and biofilms, respectively, (p < 0.05). DNA probe analysis showed significant reduction in relative abundances of the eight bacteria as a group in plaque suspensions and biofilms. The cumulative blue light treatment suppressed biofilm growth in vitro. This may introduce a new avenue of prophylactic treatment for periodontal diseases.

Effects of pH and fluoride concentration of dentifrices on fluoride levels in saliva, biofilm, and biofilm fluid in vivo

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Contribuição ao estudo das relações dos conectores maiores de próteses parciais removíveis com tecidos gengivais

The effect in the gingival tissue of four distinctive types of relationships between the major conector and the gingival margin was investigated in eight subjects in association with the experimental gingivitis model. The subjects wore appliances constructed in acrylic resin (retained by means of embrasure hooks) throughout the day an night, except during meals. After the appliances had been placed, the subjects were abstained from any oral hygiene for twenty-one days. Records of the Plaque Index, Gingival Index and probing deplh were taken at baseline and at each week. Data showed that there was a small increase in the Plaque Index and Gingival Index for the four areas and that the degree of inflammation of the covered areas was higher in the area without relief

Efeito de diferentes terapias locais para o tratamento de periodontite crônica em indivíduos diabéticos tipo 2: estudo clínico controlado randomizado triplo cego de boca dividida com acompanhamento de seis meses

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Halitose na geriatria: diagnóstico, causas e prevalência

Halitosis is the unpleasant odor of exhaust air through the mouth and lungs. There are over 50 causes, and approximately 90% of cases, is of oral origin. May have physiological origin (stress, breath of morning, fasting, and inappropriate diets), local reasons (bad oral hygiene, bacterial plaque retained on the tongue and/or tonsils, lower production of saliva, gum disease) or systemic reasons (diabetes, kidney or liver problems, constipation, etc.). In the Third Age, this problem tends to increase significantly. Thus, the aim of this study was to detect the presence of halitosis in the geriatric group attended in the dental clinic of UNIRP, identifying their incidence and principal causes. The sample consisted of 48 volunteer patients aged 60 years or older and included more than 90% of patients treated in this age group. It was performed a anamnesis and physical examination. The intra-oral halitosis was detected using a breath meter (halimeter). In the group studied, approximately 54.16% had halitosis, 84.61% of these were users of the prosthesis. The tongue coating was present in 80.76% of individuals with halitosis. After brushing the tongue, 88.46% of patients with halitosis have had the initial index oral malodor decreased. Based on the results of this study it was concluded that factors as dental prostheses and tongue coating are critical factors in causing halitosis.

Manutenção em próteses implantossuportadas: peri-implantite

The identification and treatment of peri-implant infections are an essential stage in the maintenance of dental implants, reflecting the longevity of rehabilitation. Therefore, the aim of the study was to conduct a literature review addressing peri-implantitis in dental implants in order to guide planning for the longevity of oral rehabilitation. It was conducted a detailed search strategy by the PubMed / Medline Dentistry and Oral Science, it was used as descriptors: “peri-implantitis” and “Dental Implant”, until July 2013. From 566 articles, after a review, according to the inclusion criteria, 34 articles were selected. The results were grouped together in topics (concept, etiology, diagnosis, surgical and nonsurgical, and aspects of oral rehabilitation) for further discussion and conclusions. Conclusions: The accumulation of plaque has been associated with a higher propensity to peri-implantitis. There is a higher incidence of the peri-implantitis disease among patients with previous history of periodontal disease. The local administration of antibiotics and association with mouthwashes / topical use are indicated as suitable for the treatment of moderate peri-implantitis.

Biofilmes orais como um possível fator de risco ao câncer bucal: revisão da literatura

Introduction: much studies regarding risk factors associated with oral cancer. Factors such as smoking and alcohol and solar radiation are well established, but others, such as bacterial influence in the development or progression of a tumor still remain unexplained. Interest in the possible relationship between bacteria and different stages of cancer development has increased since the classification of H. pylori by the WHO as a definite carcinogen. Subsequently, links between infection and the onset of cancer in various sites in the body were discovered. Review of literature: this literature review attempts to show the influence of poor oral hygiene, with consequent bacterial accumulation as a possible important risk factor for the initiation and development of mouth cancer, and correlate the possible mechanisms by which bacteria can initiate or promote carcinogenesis. Conclusion: there is much evidence that bacteria in the oral cavity and periodontopathic are present in tumor tissue, however, still can not affirm that these bacteria initiate or promote carcinogenesis.