Toxoplasma gondii Infection Decreases Intestinal 5-Lipoxygenase Expression, while Exogenous LTB4 Controls Parasite Growth.

5-Lipoxygenase (5-LO) is an enzyme required for the production of leukotrienes and lipoxins and interferes with parasitic infections. In vitro, Toxoplasma gondii inhibits leukotriene B4 (LTB4) production, and mice deficient in 5-LO are highly susceptible to infection. The aim of this study was to investigate the effects of the pharmacological inhibition of the 5-LO pathway and exogenous LTB4 supplementation during experimental toxoplasmosis. For this purpose, susceptible C57BL/6 mice were orally infected with T. gondii and treated with LTB4 or MK886 (a selective leukotriene inhibitor through inhibition of 5-LO-activating protein [FLAP]). The parasitism, histology, and immunological parameters were analyzed. The infection decreased 5-LO expression in the small intestine, and treatment with MK886 reinforced this reduction during infection; in addition, MK886-treated infected mice presented higher intestinal parasitism, which was associated with lower local interleukin-6 (IL-6), interferon gamma (IFN-γ), and tumor necrosis factor (TNF) production. In contrast, treatment with LTB4 controlled parasite replication in the small intestine, liver, and lung and decreased pulmonary pathology. Interestingly, treatment with LTB4 also preserved the number of Paneth cells and increased α-defensins expression and IgA levels in the small intestine of infected mice. Altogether, these data demonstrated that T. gondii infection is associated with a decrease in 5-LO expression, and on the other hand, treatment with the 5-LO pathway product LTB4 resulted in better control of parasite growth in the organs, adding to the knowledge about the pathogenesis of T. gondii infection.

The imbalance of TNF and IL-6 levels and FOXP3 expression at the maternal-fetal interface is involved in adverse pregnancy outcomes in a susceptible murine model of congenital toxoplasmosis.

Vertical transmission of Toxoplasma gondii leads to adverse pregnancy outcomes depending on the time at which the infection occurs and the immunological state of the mother. C57BL/6 and BALB/c mice have been described as susceptible and resistant mouse lineages to congenital T. gondii infection, respectively. This study aimed to elucidate the systemic and local cytokine profile of pregnant mice infected with T. gondii and whether the expression of the transcription factor FOXP3, related to T regulatory cells, is associated with the resistance/susceptibility of these lineages of mice in the context of experimental congenital toxoplasmosis. For this purpose, C57BL/6 and BALB/c females were orally infected with the T. gondii ME-49 strain on the day of vaginal plug detection or day 14 of gestation, examined 7 or 5 days later, respectively, as models of early and late pregnancy. Cytokine levels were measured systemically and in the uterus/placenta. Additionally, the uterus/placenta were evaluated macroscopically for resorption rates and histologically for parasite and FOXP3 immunostaining. The FOXP3 protein expression was also evaluated by western blotting assay. It was found that, during early pregnancy, the infection leads to high IFN-γ, TNF and IL-6 levels systemically, with the TNF levels being higher in C57BL/6 mice. At the maternal-fetal interface, the infection induced high levels of IFN-γ in both mouse lineages; however, higher levels were observed in BALB/c, while high TNF and IL-6 levels were found in C57BL/6, but not in BALB/c mice. In contrast, in late gestation, T. gondii interfered less strongly with the cytokine profile. In early pregnancy, a reduction of FOXP3 expression at the maternal-fetal interface of infected mice was also observed, and the reduction was larger in C57BL/6 compared with BALB/c mice. Additionally, the parasite was seldom found in the uterus/placenta. Thus, the worse pregnancy outcomes observed in C57BL/6 mice were associated with higher TNF systemically, and TNF and IL-6 at the maternal-fetal interface, with lower FOXP3 expression.

Susceptibility of human villous (BeWo) and extravillous (HTR-8/SVneo) trophoblast cells to Toxoplasma gondii infection is modulated by intracellular iron availability.

Congenital toxoplasmosis is a serious health problem that can lead to miscarriage. HTR-8/SVneo is a first trimester extravillous trophoblast, while BeWo is a choriocarcinoma with properties of villous trophoblast cells. In the placenta, iron is taken up from Fe-transferrin through the transferrin receptor being the ion an important nutrient during pregnancy and also for Toxoplasma gondii proliferation. The aim of this study was to evaluate the role of iron in T. gondii proliferation in BeWo and HTR-8/SVneo cells and in human chorionic villous explants. The cells were infected with T. gondii, iron supplemented or deprived by holo-transferrin or deferoxamine, respectively, and parasite proliferation and genes related to iron balance were analyzed. It was verified that the addition of holo-transferrin increased, and DFO decreased the parasite multiplication in both trophoblastic cells, however, in a more expressive manner in HTR-8/SVneo, indicating that the parasite depends on iron storage in trophoblastic cells for its growth. Also, tachyzoites pretread with DFO proliferate normally in trophoblastic cells demonstrating that DFO itself does not interfere with parasite proliferation. Additionally, T. gondii infection induced enhancement in transferrin receptor mRNA expression levels in trophoblastic cells, and the expression was higher in HTR-8/SVneo compared with BeWo. Finally, DFO-treatment was able to reduce the parasite replication in villous explants. Thus, the iron supplementation can be a double-edged sword; in one hand, it could improve the supplement of an essential ion to embryo/fetus development, and on the other hand, could improve the parasite proliferation enhancing the risk of congenital infection.

Assessment of erythrocyte alloimmunization among patients treated at a Brazilian university hospital.

INTRODUCTION: Alloimmunization and transfusion reactions underscore the crucial role of precise immunohematological techniques to enhance safety in transfusion. This study aims to determine the frequency of alloimmunization in patients treated at a Brazilian university hospital, investigate demographic, clinical, and epidemiological characteristics of patients with positive irregular antibody screening, as well as to assess the frequency of erythrocyte antigens and anti-erythrocyte antibodies in the population. MATERIALS AND METHODS: This retrospective observational study included all irregular antibody-positive patients treated at the transfusion service of Hospital de Clínicas of the Federal University of Uberlandia between January 2019 and December 2020. RESULTS: Of the 201 irregular antibody-positive patients, alloimmunization was more common in women (64.2%) than in men (35.8%). Blood groups A (39.8%) and O (38.8%), and Rh positive samples (69.1%) predominated, and about half (48.2%) of the patients were transfused for preoperative procedures. The most frequently found clinically significant alloantibodies were anti-D (27.2%), anti-E (15.0%), and anti-Kell (11.5%). Of the patients, 30.6% had multiple antibody associations, with anti-D and anti-C being the most common combination. Erythrocyte immunophenotyping was performed for 76 patients with the most frequent antigens detected being e (100%), c (86.8%), and C (40.8%). Among the 14 pregnant women evaluated, most were multiparous, 85.7% had anti-D as the most prevalent antibody, and had the A-negative blood type (33.3%). CONCLUSION: Alloantibody screening and identification associated with erythrocyte immunophenotyping are necessary for a better understanding of the alloimmunized population, ensuring greater safety and efficacy of transfusion therapy in the hospital setting.

Both C57BL/KsJ (H2d haplotype) and CB10-H2 (H2b haplotype) mice are highly susceptible to congenital toxoplasmosis.

Congenital toxoplasmosis may cause abortion, neonatal death, or foetal abnormalities. Despite little information from human studies, a genetic influence over congenital disease was demonstrated and, host genome have been implicated to resistance/susceptibility to Toxoplasma gondii infection in both human and mice. It was previously shown that BALB/c mice (H2d) were more resistant to congenital toxoplasmosis than C57BL/6 mice (H2b). However, it is unclear whether these differences are attributable to the MHC haplotype or to other components of the mouse's genetic background. Therefore, in this work, we intend to address this question by investigating the pregnancy outcome in H2d -congenic C57BL/6 mice (C57BL/KsJ-H2d) and H2b-congenic BALB/c mice (CB10-H2-H2b). For this, animals were infected by intragastric route on the first day of pregnancy and examined on days 8 (8dP/8dI) or 18 (18dP/18dI) of gestation and infection. The pregnancy outcome, parasite burden, systemic cytokine profile and antibody response to infection were evaluated. Infected mice showed adverse pregnancy outcomes, in parallel low parasite detection in the uterus/placenta, being that the C57BL/KsJ showed the worst results in relation to CB10-H2 mice. Both mouse lineages showed an increase in IFN-γ and TNF levels systemically on 8dP/8dI and on 18dP/18dI, and C57BL/KsJ showed an increase in IL-6 levels in both gestation/infection periods. Additionally, C57BL/KsJ showed 7- and 7-fold increase in IL-6, 4- and 2.5-fold increase in IFN-γ and, 6- and 4-fold increase in TNF production on 8dP/8dI and 18dP/18dI, respectively in association with 1.5-fold decrease in TGF-ß levels on 8dP/8dI compared to CB10-H2 mice. In conclusion, the high IFN-γ and TNF serum levels observed in C57BL/KsJ (H2d) and CB10-H2 (H2b) mice were involved in the poor pregnancy outcomes in congenital toxoplasmosis. In addition, the higher IFN-γ, IL-6 and TNF levels detected in C57BL/KsJ in relation to CB10-H2 mice on 8dP/8dI seem to be related to the genetic background of C57BL/6J mice that may have contributed to the worse pregnancy outcome in this mouse lineage.

Impact of sickle cell disease on work activity.

Introduction: Sickle cell disease is a group of conditions caused by anomalous hemoglobin that predisposes people to some clinical syndromes. Because of these recurrent syndromes, patients have difficulty finding and, often, keeping a job. Objectives: To evaluate the impact of sickle cell disease on the job situation of people with the condition. Methods: Thirty-two working-age people with sickle cell disease were recruited using the snowball sampling method and underwent semistructured interviews for demographic, socioeconomic, and clinical data collection. Results: Only 28.1% of the interviewees engaged in paid work, 46.9% had already worked but were not working at the time of the interview, and 25% had never worked. About 6% of participants lived in extreme poverty, and 28.4% lived on the poverty line. Monthly per capita income was less than one minimum salary in 56.2% of cases and less than 1.5 minimum salaries in 9.4%. Conclusions: Sickle cell disease has an important negative impact on employment situation, as about 70% of working-age people were inactive. This results in a high social cost represented by a very low monthly per capita income (≤ 1 minimum salary) in 93.7% of the participants.

Cyclooxygenase (COX)-2 modulates Toxoplasma gondii infection, immune response and lipid droplets formation in human trophoblast cells and villous explants.

Congenital toxoplasmosis is represented by the transplacental passage of Toxoplasma gondii from the mother to the fetus. Our studies demonstrated that T. gondii developed mechanisms to evade of the host immune response, such as cyclooxygenase (COX)-2 and prostaglandin E2 (PGE2) induction, and these mediators can be produced/stored in lipid droplets (LDs). The aim of this study was to evaluate the role of COX-2 and LDs during T. gondii infection in human trophoblast cells and villous explants. Our data demonstrated that COX-2 inhibitors decreased T. gondii replication in trophoblast cells and villous. In BeWo cells, the COX-2 inhibitors induced an increase of pro-inflammatory cytokines (IL-6 and MIF), and a decrease in anti-inflammatory cytokines (IL-4 and IL-10). In HTR-8/SVneo cells, the COX-2 inhibitors induced an increase of IL-6 and nitrite and decreased IL-4 and TGF-ß1. In villous explants, the COX-2 inhibitors increased MIF and decreased TNF-α and IL-10. Furthermore, T. gondii induced an increase in LDs in BeWo and HTR-8/SVneo, but COX-2 inhibitors reduced LDs in both cells type. We highlighted that COX-2 is a key factor to T. gondii proliferation in human trophoblast cells, since its inhibition induced a pro-inflammatory response capable of controlling parasitism and leading to a decrease in the availability of LDs, which are essentials for parasite growth.

The Availability of Iron Is Involved in the Murine Experimental Toxoplasma gondii Infection Outcome.

Iron is an important constituent of our environment, being necessary for both mammalian and pathogenic protozoa survival. Iron-containing proteins exert a wide range of biological processes such as biodegradation and biosynthesis, as well as immune function, fetal development, and physical and mental well-being. This work aimed to investigate the effect of iron deprivation in Toxoplasma gondii infection outcome. C57BL/6 mice were orally infected with T. gondii and treated with an iron chelator, deferoxamine, or supplemented with iron (ferrous sulfate), and the parasitism as well as immunological and histological parameters were analyzed. It was observed that the infection increased iron accumulation in the organs, as well as systemically, and deferoxamine treatment diminished the iron content in serum samples and intestine. The deferoxamine treatment decreased the parasitism and inflammatory alterations in the small intestine and lung. Additionally, they partially preserved the Paneth cells and decreased the intestinal dysbiosis. The ferrous sulfate supplementation, despite not significantly increasing the parasite load in the organs, increased the inflammatory alterations in the liver. Together, our results suggest that iron chelation, which is commonly used to treat iron overload, could be a promising medicine to control T. gondii proliferation, mainly in the small intestine, and consequently inflammation caused by infection.

Relationship between stress and sleep bruxism in children and their mothers: A case control study.

INTRODUCTION: Sleep bruxism (SB) is a frequent condition in children. Its pathophysiology involves certain neurotransmitters (serotonin, dopamine, noradrenalin, histamine), but the environment seems to influence its occurrence. OBJECTIVE: The objective of this study was to investigate the prevalence of SB in children and their biological mothers, relating it to stress through a case control study. METHODS AND MATERIAL: The group of cases (SG) was composed of 48 subjects, including 24 children with SB and their mothers, and the control group (CG), formed by 36 children without SB and their mothers. The chi-Square test was used and the probability was computed with 95% confidence intervals (p<0.05). Results: The prevalence of probable awareness of SB in children was 22.6%, while it was 30.8% among caregivers. There were no significant associations between the socio-demographic variables and SB. There was an increase in the occurrence of SB in children (p=0.02) when their caregiver also had this condition. CONCLUSIONS: Psychological stress did not establish a significant relationship with SB in either the child or their mothers.

Infectious diseases during pregnancy in Brazil: seroprevalence and risk factors.

INTRODUCTION: Vertically transmitted infections are caused by a diversity of pathogenic microorganisms. Pregnant women are routinely screened to evaluate the risks and reduce the burden of disorders in their unborn children. We assessed the prevalence and possible risk factors for Cytomegalovirus (CMV), Rubella, Human T lymphotropic virus (HTLV), and Toxoplasma gondii in pregnant women from the South region of Bahia State, Brazil. METHODOLOGY: Serum samples were obtained from 726 pregnant women aged between 13 and 44 years, with a median age of 24 years. ELISA assays were used to detect CMV, Rubella, HTLV and T. gondii IgG and IgM antibodies. RESULTS: The prevalence rates of IgG antibodies found were 95.2% for CMV, 97.0% for Rubella, and 72.3% for T. gondii. Furthermore, the prevalence of HTLV-1/2 was 1.2%. IgM antibodies were reactive only for CMV (0.8%) and T. gondii (3.7%). Variables independently associated with the detection of anti-T. gondii IgG antibodies were white self-reported race/ethnicity (Odds Ratio [OR] 2.26, 95% CI 1.26-4.06, P = 0.006), wage income (OR 0.55, 95% CI 0.35-0.88, P = 0.013), and history of previous pregnancy (OR 1.60, 95% CI 1.02-2.50, P = 0.038). CONCLUSIONS: This study highlights the importance of monitoring for infectious diseases during pregnancy and initiation of early interventions to reduce the burden of fetal losses and other important infant sequelae attributable to congenital infections.

Temporomandibular disorders in elderly individuals: the influence of institutionalization and sociodemographic factors.

PURPOSE: The aim of this study was to determine the factors associated with temporomandibular disorders (TMD) in the non-institutionalized and institutionalized elderly population of Feira de Santana, Bahia, Brazil. METHODS: A cross-sectional study was carried out in 307 subjects over 60 years old of both genders, where 80 are institutionalized and 227 are non-institutionalized. The evaluation of TMD signs and symptoms was performed using the Fonseca Anamnestic Index (IAF) as to sociodemographic, systemic and otological factors. The results were analyzed by correlating the study factors and the prevalence of TMD. A 95% confidence interval (CI) and a 5% significance level were established for all the tests used. RESULTS: The results showed that 50.5% of the subjects presented some degree of TMD. The prevalence of TMD was 49.8% among non-institutionalized elderly individuals and of 52.5% among institutionalized individuals. Variation in the prevalence of TMD, with statistical significance according to gender, age, income, tinnitus, dizziness, and depression was observed. CONCLUSION: The prevalence of TMD was significant among the elderly population. There was no statistically significant difference between the prevalence of TMD in institutionalized and non-institutionalized individuals. Identifying TMD in the elderly population may be difficult because the symptoms of these disorders are similar to symptoms commonly presented in some systemic disorders associated with aging.

Uso dos laminados cerâmicos como alternativa restauradora para solucionar a presença de espaços negros no sorriso / Use of ceramic veneers as an alternative to solve the presence of black spaces in smile

Os avanços alcançados no desenvolvimento dos materiais restauradores e procedimentos adesivos têm possibilitado a realização de procedimentos minimamente invasivos nas reabilitações orais. Neste contexto, os laminados cerâmicos tornaram-se uma alternativa viável para a resolução de diversos problemas que acometem a função e estética. Assim, este trabalho apresentou como objetivo relatar um caso clínico de reabilitação estética do sorriso com o fechamento de espaços negros, originados a partir de um trauma, seguido de movimentação ortodôntica, através da utilização de laminados cerâmicos. Neste foram descritas as etapas clínicas de diagnóstico, planejamento e execução do procedimento restaurador, observando que o tratamento proposto foi uma alternativa conservadora e eficaz na resolução dos espaços negros existentes, reestabelecendo a estética do sorriso e devolvendo a auto-estima do paciente(AU)

The advances achieved in the development of restorative materials and adhesive procedures have made possible to perform minimally invasive procedures in oral rehabilitation. In this context, ceramic veneers have become a viable alternative for solving several problems that affect function and aesthetics. Thus, this study aimed to report a clinical case of aesthetic smile rehabilitation with the closure of black spaces, originated from trauma, followed by orthodontic movement, through the use of ceramic veneers. In this, the clinical stages of diagnosis, planning and execution of the restorative procedure were described, noting that the proposed treatment was a conservative and effective alternative in the resolution of existing black spaces, reestablishing the aesthetic of the smile and restoring the patient's selfesteem(AU)

Efeitos do uso de produtos clareadores de autoaplicação sobre a superfície de uma resina composta nanoparticulada / The effects of over-the-counter bleaching products on the surface of nanofilled composite

Objetivo: Avaliar a alteração da rugosidade superficial de uma resina composta nanoparticulada (Filtek Z350 XT ® ) após o uso de produtos clareadores de autoaplicação contento baixa concentração de peróxido de hidrogênio. Métodos: Para isto, foram confeccionados 30 corpos de prova deste material, divididos aleatoriamente em 3 grupos com 10 amostras cada, da seguinte forma: G1 (grupo controle) no qual as amostras não foram submetidas à ação de nenhum produto clareador; G2, realização de procedimento clareador com peróxido de hidrogênio a 10% (Crest 3D White Professional Effects Whitestrips ® ) em 2 aplicações de 30 minutos, por 10 dias consecutivos; e G3, tratamento com peróxido de hidrogênio a 7,7% (pincel Pretty Smile ® ) com o mesmo número de aplicações, tempo e dias do G2. Após este período cada corpo de prova foi analisado no rugosímetro Surftest SJ-301, para determinar a sua rugosidade superficial média. Estes dados foram então submetidos à análise estatística por meio da análise de variância (ANOVA) e teste de Tukey, nível de significância de 5% para comparações múltiplas. Resultados: Ao final do experimento, houve diferenças estatísticas significantes entre o grupo controle (G1) e os demais grupos (G2 e G3), com p < 0,05. Porém, quando analisados apenas os grupos submetidos ao clareamento com o peróxido de hidrogênio em diferentes concentrações (G2 e G3), não foi encontrada diferença significativa (p > 0,05). Conclusão: Após 10 dias, os produtos clareadores testados determinaram aumento significativo nos valores de rugosidade superficial média da resina composta nanoparticulada.

Aim: Tod evaluate the change in surface roughness of a nanoparticulate composite resin (Filtek Z350 XT ® ) after using over-the-counter bleaching products, containing a low concentration of hydrogen peroxide. Methods: For this, 30 specimens of this material were made, randomly divided into 3 groups with 10 samples each, as follows: G1 (control group) in which the samples were not subjected to the action of any bleaching product; G2, performing a bleaching procedure with 10% hydrogen peroxide (Crest 3D White Professional Effects Whitestrips ® ), in 2 applications of 30 minutes, for 10 consecutive days; and G3, treatment with 7.7% hydrogen peroxide (Pretty Smile ® ), with the same number of applications, time, and days as G2. After this period, each specimen was analyzed, using the Surftest SJ-301, to determine its average surface roughness. These data were then subjected to statistical analysis through analysis of variance (ANOVA) and Tukey's Test, with a significance level of 5% for multiple comparisons. Results: Statistically significant differences were found between the control group (G1) and the other groups (G2 and G3), with p < 0.05. However, when analyzing only the groups submitted to bleaching agents with hydrogen peroxide in different concentrations (G2 and G3), no significant difference was found (p > 0.05). Conclusions: After 10 days, the bleaching products tested in this study determined a significant increase in the average surface roughness values of the nanoparticulate composite resin.

Toxoplasma gondii 70 kDa heat shock protein: systemic detection is associated with the death of the parasites by the immune response and its increased expression in the brain is associated with parasite replication.

The heat shock protein of Toxoplasma gondii (TgHSP70) is a parasite virulence factor that is expressed during T. gondii stage conversion. To verify the effect of dexamethasone (DXM)-induced infection reactivation in the TgHSP70-specific humoral immune response and the presence of the protein in the mouse brain, we produced recombinant TgHSP70 and anti-TgHSP70 IgY antibodies to detect the protein, the specific antibody and levels of immune complexes (ICs) systemically, as well as the protein in the brain of resistant (BALB/c) and susceptible (C57BL/6) mice. It was observed higher TgHSP70-specific antibody titers in serum samples of BALB/c compared with C57BL/6 mice. However, the susceptible mice presented the highest levels of TgHSP70 systemically and no detection of specific ICs. The DXM treatment induced increased parasitism and lower inflammatory changes in the brain of C57BL/6, but did not interfere with the cerebral parasitism in BALB/c mice. Additionally, DXM treatment decreased the serological TgHSP70 concentration in both mouse lineages. C57BL/6 mice presented high expression of TgHSP70 in the brain with the progression of infection and under DXM treatment. Taken together, these data indicate that the TgHSP70 release into the bloodstream depends on the death of the parasites mediated by the host immune response, whereas the increased TgHSP70 expression in the brain depends on the multiplication rate of the parasite.

Reabilitação estética e funcional do sorriso com restaurações cerâmicas de diferentes espessuras / Aesthetic and functional rehabilitation of smile with ceramic restorations of different thickness

A busca pela saúde bucal passou a não se limitar apenas à remoção da dor ou restabelecimento da função, mas, também, à devolução da forma, proporção, cor e características perdidas do elemento dentário, almejando um sorriso harmônico e estético. Assim, este trabalho teve como objetivo relatar um caso clínico de um tratamento de reabilitação estética do sorriso com o uso de restaurações cerâmicas de diferentes espessuras: laminados cerâmicos e coroas totais unitárias. Abordando, desta forma, todas as etapas clínicas, desde o planejamento, escolha do material à cimentação das restaurações. A realização deste tratamento reabilitador com o uso de uma cerâmica à base de dissilicato de lítio possibilitou a recuperação funcional e estética do sorriso, além da satisfação e melhora da autoestima da paciente, sendo este sucesso atribuído, a um bom planejamento, escolha do material, conhecimento da técnica dos preparos dentais convencionais e minimamente invasivos, e dos procedimentos restauradores, levando-se em consideração as necessidades e expectativas do paciente(AU)

The search for oral health wasn't limited to the removal of pain or restoration of function, but also to the return of form, proportion, color and lost characteristics of the dental element, aiming for a harmonious and aesthetic smile. The aim of this study was to report a clinical case of a smile aesthetic rehabilitation treatment with the use of ceramic restorations of different thickness: dental veneers and crowns, covering all the clinical stages, from the planning, choice of the material until the cementation of the restorations. The accomplishment of this rehabilitation treatment with the use of a ceramic based on lithium disilicate enabled the functional and aesthetic recovery of the smile, besides the satisfaction and improvement of the self-esteem of the patient, being this success attributed, first, to a good planning, choice of the material, knowledge of the technique of conventional and minimally invasive dental preparations, and restorative procedures, taking into account the needs and expectations of the patient(AU)

Abordagem interdisciplinar na reabilitação estética do sorriso / Interdisciplinary approach to aesthetic rehabilitation of smile

A estética do sorriso correlaciona a harmonia dos dentes, gengiva e lábios com as estruturas faciais. Diante da importância da obtenção desta harmonia para o restabelecimento da estética, o presente trabalho tem como objetivo relatar um caso clínico de abordagem terapêutica interdisciplinar, empregando protocolos da odontologia restauradora e da cirurgia plástica periodontal. O paciente procurou atendimento para solucionar sua insatisfação com a forma, cor e assimetria dos dentes, presença de diastemas e a aparência gengival excessiva durante o sorriso. Assim, o tratamento constituiu-se de procedimentos profiláticos para controle do biofilme dental, gengivoplastia nos dentes incisivos, caninos e pré-molares superiores, clareamento dental e confecção de laminados cerâmicos com preparos minimamente invasivos. Utilizou-se o planejamento digital do sorriso como ferramenta para o ensaio restaurador, em cuja fase a participação do paciente teve fundamental importância nas decisões do tratamento definitivo, tendo como resultado uma melhor harmonização da estética dental e gengival, e recuperação da sua autoestima(AU)

The aesthetics of the smile correlates the harmony of the teeth, gingiva and lips with the facial structures. Considering the importance of obtaining this harmony for aesthetics reestablishment, this article reports a case of an interdisciplinary therapeutic approach, using restorative and periodontal plastic surgery dentistry protocols. The patient sought care to resolve his dissatisfaction with teeth shape, colour and asymmetry, presence of diastema, and excessive gingival appearance during smile. Therefore, the treatment consisted of prophylactic procedures to control the dental biofilm, gingivoplasty of superior incisors, canines and premolars, dental bleaching and confection of ceramic laminates with minimally invasive preparations. Digital smile planning was used as a tool for a restorative test, in which the patient's participation was of fundamental importance in the definitive treatment decisions, resulting in a better dental and gingival aesthetics harmonization, and recovery of his self-esteem(AU)

Temporomandibular disorders in elderly individuals: the influence of institutionalization and sociodemographic factors

ABSTRACT Purpose The aim of this study was to determine the factors associated with temporomandibular disorders (TMD) in the non-institutionalized and institutionalized elderly population of Feira de Santana, Bahia, Brazil. Methods A cross-sectional study was carried out in 307 subjects over 60 years old of both genders, where 80 are institutionalized and 227 are non-institutionalized. The evaluation of TMD signs and symptoms was performed using the Fonseca Anamnestic Index (IAF) as to sociodemographic, systemic and otological factors. The results were analyzed by correlating the study factors and the prevalence of TMD. A 95% confidence interval (CI) and a 5% significance level were established for all the tests used. Results The results showed that 50.5% of the subjects presented some degree of TMD. The prevalence of TMD was 49.8% among non-institutionalized elderly individuals and of 52.5% among institutionalized individuals. Variation in the prevalence of TMD, with statistical significance according to gender, age, income, tinnitus, dizziness, and depression was observed. Conclusion The prevalence of TMD was significant among the elderly population. There was no statistically significant difference between the prevalence of TMD in institutionalized and non-institutionalized individuals. Identifying TMD in the elderly population may be difficult because the symptoms of these disorders are similar to symptoms commonly presented in some systemic disorders associated with aging.

Influência dos agentes clareadores de baixa concentração sobre a rugosidade superficial do esmalte bovino

Avaliar a rugosidade superficial do esmalte bovino após aplicação de clareadores dentais a base de peróxido de hidrogênio, em 3 diferentes formas de apresentação e concentração. Materiais e método: utilizou-se corpos de prova obtidos a partir de 40 unidades de incisivos centrais inferiores bovinos, que foram divididos, aleatoriamente, em 4 grupos experimentais (n=10) e submetidos a diferentes tratamentos clareadores da seguinte maneira: Grupo 1 (controle) ­ nenhum tratamento clareador; Grupo 2 ­ clareamento com peróxido de hidrogênio 7,5% (Total Blanc HOME- DFL), durante 1 hora, por 14 dias; Grupo 3 ­ clareamento com peróxido de hidrogênio 6,5% (3D White Whitestrips- Crest) durante 30 minutos, por 14 dias; e Grupo 4 ­ clareamento com peróxido de hidrogênio 7,7% (Pretty Smile- DMC) durante 30 minutos, por 14 dias. Cada corpo de prova foi submetido à leitura da rugosidade superficial e os dados obtidos foram submetidos à análise estatística por meio do ANOVA e teste de Tukey, com nível de significância de 5%. Resultados: todos os produtos testados aumentaram a rugosidade superficial do esmalte bovino. Conclusão: o uso do peróxido de hidrogênio em baixas concentrações, nas diferentes formas de apresentação testadas, promoveu um aumento da rugosidade superficial do esmalte de dentes bovinos, proporcional ao seu tempo de atuação

REAÇÕES ADVERSAS DO CLAREAMENTO DE DENTES VITAIS / ADVERSE EFFECTS OF VITAL TEETH BLEACHING

O objetivo deste trabalho foi revisar as reações adversas do clareamento de dentes vitais, já que o mesmo tem sido bastante popularizado e realizado atualmente. As técnicas para o clareamento de dentes vitais utilizam como o principal agente clareador o peróxido de hidrogênio. Vantagens como preservação da estrutura dentária, menor custo e resultados estéticos satisfatórios, têm sido relatadas, no entanto, podem ocorrer reações adversas, como irritação dos tecidos moles, hipersensibilidade dentária, alterações na textura de superfície do esmalte e dos materiais restauradores, além de alterações no tecido pulpar. Estudos demonstram que estes efeitos adversos existentes são mínimos e reversíveis, sendo o clareamento de dentes vitais uma técnica eficaz e segura.

The aim of this study was to review the side effects of vital teeth bleaching, since it has been widely popularized and performed today. The techniques of vital teeth bleaching use the hydrogen peroxide as the main bleaching agent. Advantages such as preservation of tooth structure, lower cost and satisfactory cosmetic results have been reported, however, side effects may occur, such as irritation of the soft tissues, dental hypersensitivity, changes in the texture of the enamel and restorative materials surfaces, and changes the pulp tissue. Studies show that these side effects are minimal and reversible, being the vital teeth bleaching effective and safe. This review was performed using Scielo, Bireme and Lilacs data base as a source of research, the mostly of scientific articles was published between the years 2000 to 2012.

Análise da adaptação marginal e interna em próteses sobre implantes cimentadas com diferentes tipos de cimentos / Analysis of marginal and internal fi t of cement retained implant-supported single crowns luted with different cements

Objetivo: avaliar a desadaptação marginal vertical e interna entre o cilindro cimentável e o coping metálico de próteses sobre implantes com o uso de três diferentes tipos de cimentos: um provisório, o cimento de hidróxido de cálcio (Dycal, Dentsply); e dois definitivos, o cimento de fosfato de zinco (SSWhite) e o cimento resinoso (Relyx Unicem, 3M Espe). Material e métodos: foram confeccionados 30 corpos-de-prova constituídos pelo cilindro cimentável e coping metálico, divididos em três grupos (n=10) que receberam os diferentes agentes de cimentação. As amostras foram submetidas à termociclagem, em seguida hemisseccionadas e então avaliadas em microscópio eletrônico de varredura (MEV) com aumento de 420 vezes. Resultados: não foram observadas diferenças signifi cativas entre os valores de desajuste marginal vertical para os três cimentos, porém, para a desadaptação interna, a maior discrepância foi obtida pelo cimento de hidróxido de cálcio. Conclusão: o cimento provisório apresentou comportamento similar aos cimentos definitivos em relação à adaptação marginal, porém, foi menos eficiente no desajuste interno dos copings.

Objective: to evaluate the vertical and internal marginal leakage between the cement cylinder and the metallic coping using three different types of cements, one temporary cement, calcium hydroxide cement (Dycal, Dentsply) and two definitive cements, zinc phosphate cement (SSWhite) and resin cement (Relyx Unicem, 3M Espe). Material and methods: 30 specimens were prepared, constituted by the cement cylinder and the metallic coping, divided into 3 groups (n=10) which received different luting agents. The samples were submitted to thermocycling and then hemisected. These were then evaluated in a scanning electron microscope (SEM) with 420 x magnification. Results: there were no statistically signifi cant differences between the vertical misfit values for the three cements, however, for the internal fit, the largest discrepancy was obtained by the calcium hydroxide cement. Conclusion: the temporary cement showed similar behavior to definitive cements on the marginal adaptation, but its internal misfit was higher.