In Vitro Regulation of CCL3 and CXCL12 by Bacterial By-products Is Dependent on Site of Origin of Human Oral Fibroblasts

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

Aspectos relacionados a procedimentos restauradores em odontopediatria

O objetivo deste texto foi realizar uma revisão crítica de trabalhos realizados após o doutoramento do autor, de parte de uma linha de pesquisa focalizada na dentística em odontopediatria. Desta forma, foram revisados artigos referentes a alguns procedimentos realizados na prática da odontologia restauradora, envolvendo estudos de microinfiltração, onde foi avaliada a influência de técnicas e materiais restauradores sobre este fenômeno. Outros trabalhos revisados relacionaram-se ao uso do microscópio eletrônico de varredura. Neste caso, foram descritos estudos que avaliaram aspectos micromorfológicos das estruturas dentárias (esmalte e dentina) de dentes permanentes, mas principalmente decíduos. Foram observados os efeitos de diferentes tratamentos realizados sobre as estruturas dentárias, como a ação de agentes condicionadores e métodos de desgaste das estruturas dentárias (laser, abrasão a ar, instrumentos cortantes rotatórios e ponta CVD). Também foram apresentados os trabalhos que avaliaram a interface adesiva, após diferentes tratamentos da dentina. Finalmente foram realizados comentários sobre os trabalhos revisados e apresentadas as tendências futuras desta linha de pesquisa.

Estrutura do esmalte humano e sua interface com sistemas adesivos

Esta tese sistematiza uma série de estudos dedicados à compreensão da interface do esmalte e sistemas adesivos. Para tanto, a estrutura da camada aprismática do esmalte em alta resolução pela microscopia eletrônica de varredura foi avaliada quanto a sua continuidade, espessura, distribuição nas faces coronárias e em fossas e fissuras, predominantemente em dentes decíduos não erupcionados. Foi também analisado pela microscopia eletrônica de varredura os efeitos do condicionamento de diferentes tipos de ácido e, em especial, do ácido fosfórico em diferentes concentrações, metodologias e tempos de aplicação. Estes trabalhos permitiram visualizar as principais ações ácidas desmineralizantes e os tipos de retenções no centro ou periferias dos prismas ou em ambas as regiões, bem como a profundidade e forma dos “tags” resinosos com carga e sem carga na intimidade do esmalte. No caso particular da aplicação dos selantes em fossas e fissuras foi também avaliada comparativamente a eficácia das técnicas invasivas ou não invasivas. Os últimos experimentos foram dedicados ao estudo da microinfiltração de diferentes sistemas adesivos e da resistência destes sistemas adesivos na estrutura do esmalte. Novos estudos merecem dar continuidade à linha de pesquisa de sempre priorizando o propósito de vincular os procedimentos aplicados com uma consistente e indispensável fundamentação de pesquisa básica no interesse da clínica odontopediátrica.

Dental caries in children participating in a dentistry for infants program

To assess the impact of the "Dentistry for Infants" early dental care program run by Jacareí County (SP) by comparing the caries of individuals participating and not participating in this program. Methods: In total, 300 children between 0 and 48 months old were assessed in the following two groups: infants not participating in the program (G1, n = 100) and infants participating in the program (G2, n = 200). Each group was further divided according to age in subgroups of 0 to 24 months and 25 to 48 months. All children were clinically assessed for carious lesions using the visual-tactile method. The data were statistically analyzed using a paired Student's t-test, Mann-Whitney test, and c 2 test at a 5% significance level. Results: There was a significant difference in the prevalence (P) and mean index of deciduous teeth (deft) (C) that were decayed, indicated for extraction and filled, and the highest values were observed in G1 (p < 0.0001). The values were as follows: PG1, 73%; PG2, 22%; CG1, 3.45 ± 3.84; and CG2, 0.66 ± 1.57. Conclusion: Participating in the program positively impacted the infants' oral health.

Conhecimento de mães sobre promoção de saúde bucal em bebês

The aim of this study was to assess the knowledge level on oral health promotion for babies of all mothers (n=60), aged 18-42 years, assisted in the Preventive Dentistry Clinic of the Faculty of Araraquara, at Universidade Estadual Paulista (UNESP), during the period 2005-2008. Methods - An interview was performed using a questionnaire with 18 open and five closed questions about knowledge and practices related to caries prevention as well as demographic information. Methods - The majority believed that breast milk does not cause caries (73,3%), that caries is not a transmissible disease (51,6%) and that anatibiotics cause caries (63,3%). Almost all mothers (93,3%) responded that brushing teeth could prevent the disease, action that should be initiated since first tooth erupts (75%). For 73,3% of the respondents, the use of dental floss should be initiated onle after all deciduous teeth erupt. Results - The majority (83,3%) knew what was fluoride, but a third of them (33,3%) did not know the best time to start using it. The dentist counseling related to oral health of babies was considered imoprtant by 96,7% of mothers. Conslusion - The mothers presented good knowledge about baby's oral hygiene, however, they did not know about other important variables for oral health promotin of babies.

Avaliação da produção de citocinas, expressão gênica e análise funcional de células SHED expostas ao LTA bacteriano

Pós-graduação em Odontologia Restauradora - ICT

Mensuração da profundidade da porção lateral da fossa mandibular, em imagens radiográficas da ATM, obtidas pela técnica transcraniana, em pacientes com dentição decídua, mista e permanente

The author has verified the average depth of the mandibular fossa, in the X-ray image, using the oblique lateral transcranial technique from the right and left sides samples of each patient, which included a total of 176 patients, 87 male and 89 female. The patients were in following phases: deciduous dentítion (the patients had only deciduous teeth in the oral cavity or, if they had any permanent teeth, they could not be in occlusion), mixed dentition (the patients presented deciduous and permanent in the oral cavity) and permanent dentition (the patients had only permanent teeth in the oral cavity), until the eruption of the permanent third molars, in the region from São José dos Campos. São Paulo. Brazil. The patients were under treatment at the Dental School. UNESP (São Paulo State University). ln order to measure the depth of the mandibular fossa in millimeters an imaginary line was traced on the X-ray image, perpendicular to the other line that served as a reference, which was traced from the botton part of the articular eminence up to the tympanosquamous fissure. After the data were obtained and put in a data sheet, they underwent statistical analysis. The results showed that, in the average, the depth of the mandibular fossa in masculine sex is non-statistically signíficant larger than what was observed in feminíne sex, and the right side is larger than the left side, with significant statistical differences. However, only in permanent dentition, in masculine sex, the depth of the mandibular fossa on the right side is larger than on the left side with significant statistical differences

Condições de saúde bucal de crianças e adolescentes portadores de síndrome de Down

Patients with Down syndrome have shown different conditions of oral health, and there is a low occurrence of dental caries and a higher susceptibility to periodontal diseases. Thus, this study aimed to evaluate the prevalence of dental caries and periodontal diseases in subjects with Down syndrome. The population was composed of 40 patients with the syndrome, aged 6 to 18 years, of both genders, and an equal number of non-syndromic patients. The periodontal conditions were evaluated by mean of the criteria of PSR and dental conditions were registered following indexes dmft and DMFT. It was found that in children with Down syndrome, the dmft index was 1.17 and DMFT 3.53 while the control group was verified dmft 1.97 and DMFT 2.77. The results of PSR evidenced that 32.5% of children with Down syndrome were periodontally healthy, 65% were gingivitis patients and 2.5% were periodontitis patients, while in the control group, 50% healthy and 50% were gingivitis patients. The results evidenced similar populations of cariogenic cocci between patients with Down syndrome and non-syndromic subjects. It was concluded that the incidence of caries in children with Down syndrome was higher in permanent teeth compared with the control group, while in the occurrence of deciduous teeth caries was slightly higher in the control group, so when children with Down syndrome are subjected to periodic examinations, they present themselves periodontally healthy.

Avaliação clínica de três sistemas de remoção minimamente invasivos do tecido cariado

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Thermal alteration and morphological changes of sound and demineralized primary dentin after Er:YAG laser ablation

The purpose of this study was to assess the influence of Er:YAG laser pulse repetition rate on the thermal alterations occurring during laser ablation of sound and demineralized primary dentin. The morphological changes at the lased areas were examined by scanning electronic microscopy (SEM). To this end, 60 fragments of 30 sound primary molars were selected and randomly assigned to two groups (n = 30); namely A sound dentin (control) and B demineralized dentin. Each group was divided into three subgroups (n = 10) according to the employed laser frequencies: I4 Hz; II6 Hz, and III10 Hz. Specimens in group B were submitted to a pH-cycling regimen for 21 consecutive days. The irradiation was performed with a 250 mJ pulse energy in the noncontact and focused mode, in the presence of a fine water mist at 1.5 mL/min, for 15 s. The measured temperature was recorded by type K thermocouples adapted to the dentin wall relative to the pulp chamber. Three samples of each group were analyzed by SEM. The data were submitted to the nonparametric Kruskal-Wallis test and to qualitative SEM analysis. The results revealed that the temperature increase did not promote any damage to the dental structure. Data analysis demonstrated that in group A, there was a statistically significant difference among all the subgroups and the temperature rise was directly proportional to the increase in frequency. In group B, there was no difference between subgroup I and II in terms of temperature. The superficial dentin observed by SEM displayed irregularities that augmented with rising frequency, both in sound and demineralized tissues. In conclusion, temperature rise and morphological alterations are directly related to frequency increment in both demineralized and sound dentin. Microsc. Res. Tech., 2011. (c) 2011 Wiley Periodicals, Inc.

Terapia pulpar em dentes decíduos: possibilidades terapêuticas baseadas em evidências

Introduction: Pulpotomy of primary teeth has been the treatment of choice in cases of inflammation of the coronal pulp caused by caries or trauma with no involvement of the radicular pulp, thus avoiding the premature loss of the teeth. Not only is the diagnosis of the inflamed dental pulp required for this therapy to succeed, but also the selection of an effective and biocompatible medicament. However, none of the drugs available and recommended for pulpotomy therapy present all the requirements of an ideal pulp capping agent. Objective: Through a systematic literature review, between the years of 2000 and 2011, focusing in randomized clinical trials, systematic reviews and meta-analysis, aiming to analyze and discuss based on alternatives for the treatment of pulpotomy in human deciduous teeth. Conclusion: Scientific evidences showed that the medicaments and techniques influence were few. Thus, further and well-designed studies are suggested for clarification. The information generated in such experiments may contribute to a better understanding of the mechanisms of pulp therapy to new therapeutic approaches aimed at improving pulp therapy in deciduous teeth.

Dental erosion in children

Erosive tooth wear in children is a common condition. The overlapping of erosion with mechanical forces like attrition or abrasion is probably in deciduous teeth more pronounced than in permanent teeth. Early erosive damage to the permanent teeth may compromise the dentition for the entire lifetime and require extensive restorative procedures. Therefore, early diagnosis of the condition and adequate preventive measures are of importance. Knowledge of the etiological factors for erosive tooth wear is a prerequisite for such measures. In children and adolescents (like in adults) extrinsic and intrinsic factors or a combination of them are possible reasons for the condition. Such factors are frequent and extensive consumption of erosive foodstuffs and drinks, the intake of medicaments (asthma), gastro-esophageal reflux (a case history is discussed) or vomiting. But also behavioral factors like unusual eating and drinking habits, the consumption of designer drugs and socio-economic aspects are of importance.

Prevalence, incidence and distribution of erosion

There is some evidence that the presence of erosion is growing steadily. Because of different scoring systems, samples and examiners, it is difficult to compare and judge the outcome of the studies. Preschool children aged between 2 and 5 years showed erosion on deciduous teeth in 6-50% of the subjects. Young schoolchildren (aged 5-9) already had erosive lesions on permanent teeth in 14% of the cases. In the adolescent group (aged between 9 and 17) 11-100% of the young people examined showed signs of erosion. Incidence data (= increase of subjects with erosion) evaluated in three of these studies were 12% over 2 years, 18% over 5 years and 27% over 1.5 years. In adults (aged between 18 and 88), prevalence data ranged between 4 and 82%. Incidence data are scarce; only one study was found and this showed an incidence of 5% for the younger and 18% for the older examined group (= increase of tooth surfaces with erosion). Prevalence data indicated that males had somewhat more erosive tooth wear than females. The distribution of erosion showed a predominance of occlusal surfaces (especially mandibular first molars), followed by facial surfaces (anterior maxillary teeth). Oral erosion was frequently found on maxillary incisors and canines. Overall, prevalence data are not homogeneous. Nevertheless, there is already a trend for more pronounced rate of erosion in younger age groups. Therefore, it is important to detect at-risk patients early to initiate adequate preventive measures.

Natale und neonatale Zähne

Natal teeth have been defined as teeth which are present at birth, while neonatal teeth erupt during the first 30 days. Their occurrence is rare, the prevalence ranges from 1:2000 to 1:3000 with a higher frequency in the lip and palate clefts and syndroms. In about 85% natal or neonatal teeth are lower central incisors (60% in pairs), rare are upper teeth, molars and multiple teeth. In almost 90% they are part of the deciduous dentition. A lot of possible causes of early eruption are discussed, but only the relation to hereditary factors seems to be evident. An autosomal dominant trait is often described. The appearance of these teeth is dependent on the degree of maturity, but most of the time it is loose, small, discoloured and hypoplastic. Histologically, enamel hypoplasia with normal prism structure is apparent. No significant disturbances of the dentin structures are observed, only cervically dentin becomes atubular with spaces and enclosed cells. A large vascular pulp and failure of root formation are further investigations. Our microhardness measurements showed values from 24.3-32.4 KHN for enamel and 48.3-62.2 KHN for dentin, while normal deciduous teeth have an enamel hardness of 322.0 +/- 17.5 KHN. The thickness of enamel was never more than 280 microm compared to up to 1200 microm in normal teeth. This shows the retarded development of natal and neonatal teeth, because mineralization has not finished at the time of birth. In accordance with developmental age tooth structure and appearence are normal. In consideration of complications as Riga-Fede-disease, feeding problems, possibility of infection and hypermobility most of the time extraction is the treatment of choice, but in the interest of protecting the child this decision should be made carefully.

Erosive tooth wear in children.

Erosive tooth wear in children is a common condition. Besides the anatomical differences between deciduous and permanent teeth, additional histological differences may influence their susceptibility to dissolution. Considering laboratory studies alone, it is not clear whether deciduous teeth are more liable to erosive wear than permanent teeth. However, results from epidemiological studies imply that the primary dentition is less wear resistant than permanent teeth, possibly due to the overlapping of erosion with mechanical forces (like attrition or abrasion). Although low severity of tooth wear in children does not cause a significant impact on their quality of life, early erosive damage to their permanent teeth may compromise their dentition for their entire lifetime and require extensive restorative procedures. Therefore, early diagnosis of erosive wear and adequate preventive measures are important. Knowledge on the aetiological factors of erosive wear is a prerequisite for preventive strategies. Like in adults, extrinsic and intrinsic factors, or a combination of them, are possible reasons for erosive tooth wear in children and adolescents. Several factors directly related to erosive tooth wear in children are presently discussed, such as socio-economic aspects, gastroesophageal reflux or vomiting, and intake of some medicaments, as well as behavioural factors such as unusual eating and drinking habits. Additionally, frequent and excessive consumption of erosive foodstuffs and drinks are of importance.