Candida species from oral cavity of HIV-infected children exhibit reduced virulence factors in the HAART era.

This study aimed to assess, in vitro, the biofilm viability and the phospholipase and protease production of Candida spp. from the saliva of HIV infected children and healthy controls, and to correlate the results with the use of medical data. A total of 79 isolates were analyzed: 48 Candida albicans isolates (33/15) and 20 Candida parapsilosis sensu lato complex isolates (12/8) (from HIV/control patients, respectively), and 8 Candida krusei, 1 Candida tropicalis, 1 Candida dubliniensis and 1 Candida guilliermondii from HIV patients. The XTT (2, 3-bis (2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-Carboxanilide) reduction assay analyzed the biofilm viability. Phospholipase and protease assays were performed using the egg yolk and Bovine Serum Albumin agar plate methods, respectively. All isolates were able to form biofilm with cell viability. Quantitatively, Candida isolates from both groups presented a similar ability to form biofilm (p > 0.05). The biofilm viability activity was higher in C. albicans isolates than in non-albicans Candida isolates (p < 0.05) for both groups. Phospholipase activity was detected in 32 isolates (40.5%) and it was significantly higher in the HIV group (p = 0.006). Protease activity was detected in 66 isolates (84.8%) and most of them were relatively/very strong producers. No statistical association with medical data was found in the HIV group. Although Candida spp. isolates from HIV-positive children presented higher phospholipase production, in vitro they exhibited reduced virulence factors compared to isolates from healthy individuals. This finding may enlighten the role played by immunosuppression in the modulation of Candida virulence attributes.

Perception of laypersons and dental professionals and students as regards the aesthetic impact of gingival plastic surgery.

OBJECTIVE: To evaluate the degree of perception of laypersons, professionals, and dental students, regarding the aesthetic appearance of the smile in cases of gingival plastic surgery of the maxilla for correction of a gingival smile, by examining alterations in photographs. MATERIALS/METHODS: Alterations were made to an extraoral front-view-photograph of a gingival smile in normal occlusion, by gingival recontouring of the maxilla, simulating a gingival plastic surgery procedure to diminish gingival exposure. For this purpose, specific image-manipulation program (Adobe-Photoshop-Software-CS3) was used. Images were printed on photographic-paper, attached to questionnaire, distributed among laypersons, professionals, and dental students to evaluate degree of aesthetics (n = 150). To evaluate degree of aesthetics, an attractiveness scale was used, with 0 representing hardly attractive, 5 for attractive, and 10 for very attractive. Differences between examiners were examined by Mann-Whitney test. All the statistics were performed with a confidence level of 95 per cent. RESULTS: Both dental professionals and students and laypersons were capable of identifying alterations resulting from gingival plastic surgery. In all evaluated groups, they demonstrated that large gingival extension does not always affect aesthetic appearance of the smile, and maxillary incisors not being much visualized is characterized as hardly attractive, with statistically lower scores being attributed (P < 0.05). CONCLUSIONS: According to aesthetic parameters, the presence of the gingiva is important in the composition of the smile, however, only when exposed to small extent.

Effectiveness of Chewing Gum Containing CPP-ACP for Remineralisation of Demineralised Enamel around Orthodontic Brackets: An in Situ Study

Abstract Objective: To evaluate the effectiveness of chewing gums containing CPP-ACP in remineralisation of demineralised enamel around orthodontic brackets. Material and Methods: Enamel blocks from 120 bovine incisors were used. The blocks were flattened and polished, followed by the development of incipient subsurface caries. The blocks have been subjected to a baseline microhardness analysis. Orthodontic brackets were bonded to the exposed area of the blocks, reserving an area for hardness analysis. An in situ crossover (three-way crossover phases of 21 days with an interval of one week between them), controlled, randomised and blind experimental model was used, with the participation of 12 volunteers divided into groups: G1 - negative control group, without chewing gum; G2 - conventional sugar-free chewing gum, without CPP-ACP (placebo); and G3 - sugar-free chewing gum with CPP-ACP. The following parameters were analysed: superficial linear (Ra), volumetric roughness (Sa), and superficial structural loss, which was indicated by Gap measurement (difference between the healthy and treated area). Statistical tests used were the Friedman, Wilcoxon and Shapiro-Wilk, Kruskal Wallis' nonparametric tests and ANOVA. Results: There was a significant reduction in enamel microhardness after demineralisation in all the groups (p<0.05). This deleterious effect was attenuated in the three groups after the final evaluation, although there were no statistical differences (p<0.05); however, the final values did not return to the baseline values (p<0.05). Conclusion: Chewing gum containing CPP-ACP did not promote in situ remineralisation of demineralised enamel around orthodontic brackets.

Perception of the esthetic impact of gingival smile on laypersons, dental professionals, and dental students.

OBJECTIVE: The aim of this study was to evaluate perceptions regarding esthetic appearance of the smile in cases of orthognathic surgery for correction of maxillary gingival display. STUDY DESIGN: Alterations were made to an extraoral front-view photograph of a gingival smile in normal occlusion by repositioning the maxilla to simulate bone tissue removal and gingival exposure. Images were printed on photographic paper attached to questionnaires distributed among laypersons, professionals, and dental students to evaluate degree of esthetics (n = 150). To evaluate degree of esthetics, an attractiveness-scale was used, with 0 representing hardly attractive, 5 attractive, and 10 very attractive. RESULTS: All of the evaluated groups demonstrated that large gingival extension does not always affect esthetic appearance of the smile. Insufficiently visualized maxillary incisors were considered hardly attractive and received statistically lower scores (P < .05). CONCLUSIONS: According to esthetic parameters, gingiva play important roles in composition of the smile, but only when they are exposed to a small extent.

Candida spp. In Linear gingival erythema lesions in HIV-Infected children: report of six cases

Introduction: Linear gingival erythema (LGE), formally referred to as HIV-gingivitis, is the most common form of HIV-associated periodontal disease in HIV-infected individuals These lesions have been recently evaluated as a possible form of erythematous oral candidosis, mainly caused by Candida albicans. Other species such as C. tropicalis, C. stellatoidea, C. krusei, C. parapsilosis, C. glabrata and C. Dubliniensis, have also been identified in some HIV-infected subjects. Objective: This case report reveals the presence of typical LGE lesions in six HIV-infected children, and also investigates the etiologic agent through microbiological exams and correlates this oral manifestation with the patients' systemic conditions. Case report: Microbiological analyses showed growth for Candida spp in all patients; all of whom had severe immunosuppression. However, the regression of lesions was noted after antifungal medication. Conclusion: The presence of LGE in pediatric patients with AIDS may be a predictive marker in the progression of AIDS or it may be the first clinical manifestation of HIV infection in children. Hence it is important for dentists to be aware of such lesions.

Introdução: O eritema gengival linear (LGE), normalmente referido como gengivite do HIV, é a forma mais comum de doença periodontal presente em indivíduos infectados pelo HIV. Recentemente, estas lesões foram consideradas como uma possível forma de candidíase oral eritematosa causada por Candida. Albicans . Outras espécies, como C. tropicalis, C. stellatoidea,C. krusei, C. parapsilosis, C. glabrata e C. Dubliniensis também foram identificadas em indivíduos infectados pelo HIV associadas ao LGE. Objetivo: O presente artigo mostra a presença de lesões típicas de LGE em seis crianças infectadas pelo HIV e também investigou o agente etiológico das lesões orais através de exames microbiológicos, correlacionando o LGE com as condições sistêmicas dos pacientes. Case report: Análises microbiológicas mostraram crescimento positivo para Candida spp em todos os pacientes, os quais possuiam imunossupressão grave. Adicionalmente, a regressão total das lesões foi observada após medicação tópica antifúngica. Conclusão: A presença de LGE em pacientes pediátricos com AIDS pode ser um marcador preditivo da progressão.

Cross sectional: perception of children from public and private schools regarding the esthetic impact of different types of face masks.

PURPOSE: The purpose was to evaluate the esthetic perception among children from public and private schools regarding the use of different types of face masks. METHODS: Six different types of orthopedic face masks made from images of the same patient were evaluated. Initially, the images were standardized with the help of Adobe Photoshop software. The variable considered was type of mask: (A) Delaire with facebow; (B) Petit; (C) Delaire; (D)Turley; (E) Hickham; and (F) Sky Hook. The images were printed on photographic paper and incorporated into a specific personalized questionnaire that was distributed to 7- to 10-year-olds attending public and private schools (n=120). The data obtained were compared via chi-square, Fisher's exact tests, Mann-Whitney and Spearman's tests. RESULTS: The proportion of participants who chose image A as the best was significantly higher (P<.05) compared to the other masks. Images B and F were chosen as the worst, without a significant difference between them (P>.05). The mean scores between groups were not significantly correlated between private vs public schoolchildren (r=0.32) and between boys and girls (r=0.41). CONCLUSIONS: Delaire face mask with facebow was chosen as the most attractive, and the Petit and Sky Hook face masks were voted the least attractive.

Comparative evaluation of esthetic perception of black spaces in patients with mandibular incisor extraction.

OBJECTIVE: To evaluate the degree of perception of laypersons, dental professionals, and students with regard to the esthetics of the smile in cases of mandibular incisor extractions with the presence of black spaces between them. MATERIALS AND METHODS: Changes were made to a front-view intraoral photograph of occlusion treated by means of a mandibular incisor extraction, simulating various configurations of black spaces between mandibular incisors. For this purpose, a specific image manipulation program was used (Photoshop CS3). After digital manipulation the photographs were printed on photographic paper and attached to a questionnaire and distributed to laypersons, dental professionals, and students (n  =  90). To evaluate the degree of esthetics, an attractiveness scale was used, in which a score of 0 would represent "hardly attractive," 5 "attractive," and 10 "very attractive." The differences between examiners were checked using the Mann-Whitney test. All of the statistics were performed with a confidence level of 95%. RESULTS: The results demonstrated that dentistry professionals, students, and laypersons were capable of identifying cases with and without black spaces. In all groups evaluated, with the increase in black spaces the scores assigned were statistically lower (P < .05). CONCLUSIONS: It could be concluded that black spaces occurring after mandibular incisor extraction had a negative repercussion on dental esthetics for the dentist, the dental student, and the layperson.

Perception of the esthetic impact of mandibular incisor extraction treatment on laypersons, dental professionals, and dental students.

OBJECTIVE: To evaluate the degree of perception of laypersons, dental professionals, and dental students regarding dental esthetics in cases with mandibular central incisor extraction. MATERIALS AND METHODS: Using a smile photograph of a person with normal occlusion and all teeth, modifications were made to reflect the extraction of a mandibular incisor of various compositions and sizes. For this purpose a program specifically for image manipulation (Adobe Photoshop CS3, Adobe Systems Inc) was used. After manipulation the images were printed on photographic paper, attached to a questionnaire and distributed to laypersons, dental professionals, and dental students (n  =  90) to evaluate the degree of perception and esthetic using a scale of attractiveness, where 0  =  hardly attractive, 5  =  attractive, and 10  =  very attractive. The differences between examiners were checked by the Mann-Whitney test. All the statistics were performed with a confidence level of 95%. RESULTS: The results demonstrated the skill of the dental professionals and dental students in perceiving the difference between cases of normal occlusion and cases where an incisor was lacking (P < .05). The photograph in which the lateral incisors were shown to be larger than the central incisor was the one that obtained the highest value among the cases of extraction in all groups of evaluators. CONCLUSIONS: It can be concluded that dental professionals and dental students are more skillful at identifying deviation from normality. In addition, central incisor extraction should always be discarded when there are other treatment options available.

Diabetes mellitus: avaliação do conhecimento de cirurgiões-dentistas em municípios de três estados brasileiros / Diabetes mellitus: evaluation of dentists´ knowledge in cities of three Brazilian´s states

Introdução: Alterações patológicas na cavidade bucal associadas ao Diabetes mellitus (DM) podem incluir gengivite, doença periodontal, disfunção da glândula salivar (xerostomia), suscetibilidade para infecções bucais, síndrome de ardência bucal e alteração do paladar. Objetivo: Verificar o conhecimento técnico-científico de cirurgiões-dentistasque atuam na atenção básica do Sistema Único de Saúde (SUS) sobre o DM. Material e método: O estudo foi realizado nos municípios de Birigui-SP, Maringá-PR e Três Lagoas-MS, e os profissionais que consentiram (n = 76) responderam a um questionário sobre o tema. Os dados foram analisados quantitativamente. Resultado: Os dados obtidos junto a estes profissionais mostram que a maioria (94,7%) prestou consultas odontológicas a pacientes portadores de Diabetes; muitos (97,4%) sabem o que é o DM; sobre outros tipos de DM, 77,6% afirmaram que conhecem, sendo o mais citado - por 55,9% dos profissionais - o DM Gestacional; o DM2 foi apontado como o mais prevalente por 59,2%. A faixa normal de glicose em jejum foi citada corretamente por 2,6% dos participantes. Aobesidade foi apontada por 98,7% dos participantes como fator de risco para o DM. Grande parte (96,0%) assinalou corretamente quais os principais sinais e sintomas que levam à suspeita de DM. A doença periodontal foi apontada por 92,1% como manifestação bucal do paciente portador de DM. Conclusão: Os cirurgiões-dentistas devem desenvolver um conhecimento específico sobre o DM, estando atentos aos níveis normais de glicemia e prontos para identificar e atender o portador de DM.

Introduction: Pathological changes in the bucal cavity associated with Diabetes mellitus (DM) may include gingivitis, periodontal disease, salivary gland dysfunction and xerostomia (dry mouth), susceptibility to bucalinfections, burning mouth syndrome, and altered taste. Objective: This study assessed the technical and scientific knowledge of dentists working in primary care in the National Health System (SUS) on the DM. Material and method: The study was conducted in the municipalities of Birigui-SP, Maringá-PR and TrêsLagoas-MS, with the participation of 76 dentists working in the SUS primary care system.These professionals agreed to answer to a questionnaire developed for this study and the results of the questions were submitted to a quantitative analysis.Result: Showed that 94.7% were in contact with diabetic patients; 97.4% know what is DM; about other types of DM, 77.6% said they know, the most mentioned (by 55.9%) was the gestational DM. The DM2 was indicated as the most prevalent by 59.2%; the normal range of fasting blood glucose level was quoted correctly by 2.6% of the participants;obesity was reported by 98.7% of participants as a risk factor for DM; 96.0% stated correctly what are the main signs and symptoms related to Diabetes; periodontal disease was reported by 92.1% as an bucal manifestation in diabetic patients. Conclusion: The dentist needs to develop specific knowledge about DM, being able to identify normallevels of blood glucose and ready to identify and meet the bearer of DM.

Avaliação in vitro da Citotoxicidade de Enxaguatórios Bucais com e sem Álcool / In vitro assessment of the cytotoxicity of mouthwashes with and without alcohol

O objetivo do presente trabalho foi verificar a hipótese de que enxaguatórios bucais sem álcool apresentam menor citotoxicidade quando comparado aos com álcool. Avaliou-se os enxaguatórios Plax: Convencional (com álcool) e Sem álcool em diferentes tempos: 1, 15, 30, 45, 60 e 120 segundos quanto seu efeito citotóxico em fibroblastos gengivais L929. Utilizou-se 3 grupos controle: positivo (C+) detergente celular Tween 80, negativo (C-) PBS, e controle de célula (CC) onde as células não foram expostas a nenhum material. O ensaio de citotoxicidade foi realizado utilizando cultura celular de fibroblasto de camundongo (L929). Após contato do enxaguatório com as células, as mesmas foram colocadas em contato com o corante vital vermelho neutro utilizado-se a técnica ("dye uptake"). Os valores da quantidade de células viáveis, foram submetidos à análise da variância (ANOVA) para determinar se havia diferenças estatísticas entre os grupos, e posteriormente ao teste de Tukey (p<0.05). Os resultados demonstraram maior citotoxicidade dos enxaguatórios com álcool. Os enxaguatórios sem álcool apresentaram maior quantidade de células viáveis no entanto ainda assim apresentaram diferenças estatísticas com os grupos controle de células e controle negativo (p<0.05). A citotoxicidade foi diretamente proporcional ao tempo de exposição às culturas de células. Dessa forma pode-se concluir que a hipótese foi confirmada em partes, haja vista que os enxaguatórios sem álcool apresentaram menor citotoxicidade que os com álcool, mas ainda apresentaram citotoxicidade quando comparado aos grupos controle de célula e negativo.

Influência da cor na atratividade estética de arcos ortodônticos extrabucais / Influence of color in the aesthetic attractiveness of headgear orthodontic arches

Objetivo / Avaliar a influência da cor na percepção estética de aparelhos extrabucais em crianças na faixa etária entre 10 a 14 anos de escolas públicas e privadas, de ambos os sexos. / Métodos / Um questionário específico foi confeccionado contendo anexas imagens de uma paciente utilizando aparelho ortodôntico extrabucal em diferentes cores, sendo posteriormente aplicado a 200 crianças. As frequências das respostas obtidas e as comparações entre tipo de escola e sexo foram feitas por meio do teste qui-quadrado. Os escores das notas para cada imagem foram comparados utilizando-se o teste U de Mann-Whitney. As médias das notas para cada imagem foram calculadas em cada grupo, a fim de determinar os coeficientes de correlação de Spearman para avaliar a similaridade entre as percepções dos estudantes por tipo de escola e sexo. O nível de significância adotado foi de 5%. / Resultados / A imagem do aparelho extrabucal na cor preta foi ranqueada como a mais atraente pelas crianças. As comparações entre pares mostraram que os estudantes de escola pública pontuaram melhor todas as imagens, comparados com os de escola particular. Com relação ao sexo, não foram encontradas diferenças significativas entre grupos nas imagens com aparelho extrabucal. / Conclusão / A cor apresentada pelo aparelho ortodôntico extrabucal influencia diretamente em sua aceitação e percepção estética, assim como o tipo de escola

Influência da cor da máscara facial de Delaire na atratividade estética / The influence of Delaire´s facial mask color on esthetical attractiveness

Objetivo: avaliar a atratividade estética de máscaras faciais do tipo Delaire de diferentes cores. Métodos: oito cores de máscaras faciais ortopédicas do tipo Delaire foram avaliadas. As imagens foram obtidas de um mesmo paciente e padronizadas por meio do editor de imagens Adobe Photoshop CS. As cores avaliadas foram: branca, cinza, verde, amarela, azul, rosa, marrom e preta. Após a aquisição das imagens, essas foram impressas em papel fotográfico e incorporadas a um questionário específico e personalizado. O questionário foi distribuído para crianças de ambos os sexos, nas faixas etárias de 7 a 8 e de 9 a 10 anos, em escolas públicas e privadas (n = 200). O teste de Mann-Whitney foi usado para análise das notas atribuídas a cada imagem, e, para a análise entre os grupos, usou-se a correlação de Spearman. O nível de significância adotado foi de 5%. Resultados: apenas as notas dadas à cor azul apresentaram diferenças estatisticamente significativas entre os estudantes de escolas públicas e privadas. Na comparação entre sexos, os meninos pontuaram melhor as cores cinza e preta, enquanto as meninas pontuaram melhor a cor rosa. Comparando as faixas etárias examinadas, não houve diferença estatística. Conclusão: a cor da máscara facial do tipo Delaire influencia na atratividade estética para crianças de 7 a 10 anos, e a preferência por determinadas cores sofre influencia também do sexo e do tipo de escola (pública ou privada).