Association between pulp stones and systemic diseases: a case-control study / Associação entre nódulos pulpares e doenças sistêmicas: um estudo caso-controle

INTRODUCTION: Pulp stones (PS) are calcifications commonly found in the pulp tissue that may be associated with systemic diseases. OBJECTIVE: To evaluate the association between PS and systemic diseases. METHODS: A case-control study with the inclusion of individuals from 18 to 65 years of age, of both sexes. Analysis was made of 1047 digital panoramic radiographs. The controls could not have any teeth with PS; the cases were the contrary. A questionnaire comprising demographic, habit, and general health (diabetes, problems with blood vessels, altered cholesterol level, heart attack, kidney or gallbladder stone, arthritis, or autoimmune disease, and for women, endometriosis, and ovarian cyst). Data were submitted to the Student's t-test to identify differences between groups about sex and age. The Chi-square test was applied to the cross-tabulation. The analyses were performed using SPSS®, version 25.0, with a 5% significance level. RESULTS: 490 patients participated (242 cases and 248 controls). There was no difference between groups for the sex (p=0.966) and age (p=0.186). Only "kidney stone" was associated with the case group (p=0.001), being almost three times higher when compared to the control group. No significant differences were found in females about the presence or absence of PS (p>0.05). CONCLUSÃO: In this research, it is suggested the existence of an association between kidney stones and the presence of pulp stones.

INTRODUÇÃO: Nódulos pulpares (NP) são calcificações comumente encontradas no tecido pulpar que podem estar associadas a doenças sistêmicas. OBJETIVO: Avaliar a associação entre NP e doenças sistêmicas. MÉTODOS: Estudo caso-controle com inclusão de indivíduos de 18 a 65 anos de idade, de ambos os sexos. Foram analisadas 1047 radiografias panorâmicas digitais. Os controles não poderiam ter dentes com NP; os casos foram o contrário. Foi aplicado um questionário aos participantes, contendo variáveis demográficas, de hábitos e de saúde geral (diabetes, problemas com vasos sanguíneos, nível de colesterol alterado, ataque cardíaco, cálculo renal ou biliar, artrite ou doença autoimune, e para as mulheres, endometrioses e cisto no ovário). Os dados foram submetidos ao teste t de Student para identificar diferenças entre os grupos em relação ao sexo e à idade. O teste Qui-quadrado foi aplicado para a tabulação cruzada. As análises foram realizadas no SPSS®, versão 25.0, com nível de significância de 5%. RESULTADOS: Participaram 490 pacientes (242 casos e 248 controles). Não houve diferença entre os grupos para sexo (p=0,966) e idade (p=0,186). Apenas "cálculo renal" associou-se ao grupo caso (p=0,001), sendo quase três vezes maior quando comparado ao grupo controle. Não foram encontradas diferenças significativas no sexo feminino em relação à presença ou ausência de PS (p>0,05). CONCLUSÃO: Nesta pesquisa, sugere-se a existência de uma associação entre cálculos renais e presença de Nódulos pulpares.

Investigation of polymorphisms in BMP2, BMP4, SMAD6 and RUNX2 genes and pulp stones.

This study aimed to assess the association between genetic polymorphisms in BMP2 (rs1005464 and rs235768), BMP4 (rs17563), SMAD6 (rs2119261 and rs3934908) and RUNX2 (rs59983488 and rs1200425) and pulp stones (PS). A total of 117 participants, consisting of 63 individuals with PS and 54 without PS, were included. Digital radiographs and a demographic/clinical questionnaire were used. Genomic DNA from salivary cells was genotyped via real-time polymerase chain reaction. Statistical analyses, including Chi-Square, Fisher's exact tests, Poisson regression and dimensionality reduction, were conducted. The rs2119261 polymorphism in the SMAD6 gene showed an association with genotype distribution in the recessive model (p = 0.049). The T-T haplotype in the SMAD6 gene (rs2119261 and rs3934908) was more prevalent in the control group and significantly linked with PS (p = 0.029). No associations were found between PS risk and genetic polymorphisms in BMP2, BMP4 and RUNX2. Polymorphisms in the SMAD6 gene were associated with PS.

Periapical Lesions Associated with Demographic Variables, Dental Conditions, Systemic Diseases, and Habits.

AIM AND BACKGROUND: The aim of this study was to analyze the prevalence of periapical lesions and possible associations with demographic, dental conditions, systemic diseases, and habit variables in patients from a private Brazilian university. MATERIALS AND METHODS: Data from 452 patients of both sexes, aged 18-78 years, from a Brazilian university were evaluated. Panoramic radiographs were analyzed, and the presence of periapical lesions was recorded. In these cases, the dental condition was assessed for the presence or absence of endodontic treatment. Medical records provide information related to general health (diabetes, cardiovascular diseases, altered cholesterol, autoimmune diseases, gallstones, or kidney stones) and habits (smoking or alcoholism). The data were descriptively analyzed, and then logistic regression and the Wald test were performed in Stata/SE v.14.1. RESULTS: A rate of 58.4% of participants were women, and the mean age was 36.4 (±14.6) years. Periapical lesions prevailed in 193 (42.7%) patients, and 281 (72.4%) teeth were not previously endodontically treated. Mandibular first molars (19%) and men (48.9%) were the most affected. The adjusted model showed that the age group of 26-45 years was 5 times more likely [odds ratio (OR) = 5.01; 95% confidence interval (CI): 2.85-8.82] to have lesions than those aged ≤25 years. Participants aged above 46 years were 19.1 times more prone (OR = 19.1; 95% CI: 10.2-36.0) to morbidity than younger ones (≤25 years). CONCLUSION: The studied sample showed that periapical lesions were more prevalent in males, in mandibular molars, and without prior endodontic treatment. There was no observed association between periapical lesions and comorbidities or habits; however, a significant correlation occurred with advancing age. CLINICAL SIGNIFICANCE: Comorbidities and habits were not associated with the presence of periapical lesions. However, aging has been identified as a significant risk factor for the development of periapical lesions. This finding is clinically relevant as it highlights the importance of monitoring and maintaining oral health in patients with advanced age. How to cite this article: dos Santos VC, de Oliveira Kublitski PM, Marques da Silva B, et al. Periapical Lesions Associated with Demographic Variables, Dental Conditions, Systemic Diseases, and Habits. J Contemp Dent Pract 2023;24(11):864-870.

Cleaning of long oval canals with WaveOne Gold system associated with different irrigant agitation protocols

Aim: The aim of the study was to evaluate the cleaning of mandibular incisors with WaveOne Gold® (WO) under different preparation techniques. Methods: A total of 210 human mandibular incisors were selected and divided into seven groups (n = 30), prepared by WO single-files (Small 20/.07 ­ WOS; Primary 25/.07 ­ WOP; Medium 35/.06 ­ WOM; or Large 45/.05 - WOL) and sequential-file techniques (WOS to WOP; WOS to WOM; and WOS to WOL). Further subdivision was made according to irrigation protocol: control group (manual irrigation - CON), E1 Irrisonic® - EIR, and EDDY® - EDD. Debris removal and the smear layer were evaluated by scanning electron microscopy. Data were analyzed by using Spearman's correlation test. The significance level was set at 5%. Results: For debris and smear layer removal, WOS and WOP, EIR differed from CON and EDD (p <0.05). Conclusion: Regardless of the instrumentation used, the agitation of the irrigant solution provided better cleanability. These findings reinforce the need for agitation techniques as adjuvants in cleaning root canal systems in mandibular incisors

Sialometric and Sialochemical Analysis in Individuals With Pulp Stones.

The aim of this study was to analyze the saliva of patients with pulp stones, with sialometric and sialochemical tests. Eighty individuals, aged between18 and 65 years, of both sexes, were investigated. Patients were included in the pulp stone group when radiographic examination was suggestive of pulp stones in at least one permanent tooth, whereas those without this alteration were considered controls. Saliva was collected by stimulation, followed by salivary flowrate (SFR) and pH analysis tests. The organic components, such as urea (URE), glucose (GLU), total proteins (TPTs), alkaline phosphatase, creatinine (CRE), salivary amylase (SAM), and uric acid (URA), and the inorganic components, such as calcium, iron, and phosphorus, were evaluated by colorimetric techniques in an ultraviolet-visible (UV-vis) spectrophotometer. Differences among pulp stones and control groups were compared using Student's t-test, with a significance level of p < 0.05. In both groups prevailed the female. Statistically significant differences between groups were observed for pH (p = 0.027), SFR (p = 0.002), alkaline phosphatase (p = 0.008), and URA (p = 0.005). None of the inorganic components showed significant difference (p > 0.05). In the analyses stratified by sex, difference between groups was observed for pH (p = 0.007) and URA (p = 0.003) in women. In conclusion, sialometric and sialochemical alterations occurred in patients with pulp stones, with significantly higher levels of pH, SFR, alkaline phosphatase, and URA.

Atividades educativas em saúde bucal desenvolvidas por cirurgiões-dentistas com escolares: uma revisão sistematizada da literatura / Oral health educational activities developed by dentists with students: a systematized literature review

Promover saúde bucal por meio da educação é uma estratégia possível de ser realizada por profissionais da área odontológica. No entanto, é tarefa desafiadora no que se refere à garantia de uma aprendizagem efetiva e transformadora de atitudes e de hábitos de vida. Esta revisão sistematizada teve como objetivo abordar o papel do cirurgião-dentista enquanto educador, capaz de atuar em ações voltadas para escolares, e em seguida fazer uma reflexão acerca do processo de formação profissional nesse contexto. Foram consultadas as bases LILACS e BBO via Biblioteca Virtual em Saúde e SciELO, com busca restrita para publicações entre os anos de 2009 a 2019, em língua portuguesa e realizadas no Brasil. Os descritores empregados foram educação, criança, saúde bucal e Odontologia. Foram selecionados e analisados nove artigos, os quais contemplavam atividades educativas em saúde bucal para crianças em escolas. Adicionalmente, foi feita uma reflexão sobre a capacitação do cirurgião-dentista, com base na nas Diretrizes Curriculares Nacionais em Odontologia. Observou-se que a ações educativas são de suma importância para as crianças, com impactos positivos em suas vidas, em condições clínicas e comportamentais. De modo reflexivo, coube um olhar crítico à fragilidade do que ainda é proposto durante a formação do cirurgião-dentista, mesmo mediante propostas curriculares atuais que almejam a expansão de competências e habilidades para fora do ambiente clínico. Concluiu-se que as pesquisas consultadas revelaram o aspecto positivo das ações em saúde bucal executadas. Contudo, sabe-se que, apesar do atual cenário estimulado por novas propostas curriculares, aos cirurgiões-dentistas ainda é custosa a transposição de barreiras que permitam maior engajamento em atividades educativas, que aqui foram reveladas como essenciais para o público escolar (AU).

Dentists can effectively promote oral health through education. However, this is challenging in terms of ensuring effective and transformative learning attitudes and lifestyle habits. This systematized review addressed the role of the dentist as an educator capable of promoting student action while further reflecting on the professional training process in the same context. The LILACS and BBO databases were thus consulted through the Biblioteca Virtual em Saúde and SciELO. Searches were restricted to publications from 2009 to 2019 that were written in Portuguese and conducted in Brazil. The following search terms were used: education, childhood, oral health, and dentistry. A total of nine returned articles dealing with educational activities designed to teach oral health to schoolchildren were selected for analysis. A subsequent reflection was conducted to assess dentist qualifications according the National Curricular Guidelines on Dentistry. It was observed that educational actions were extremely important for children, with positive impacts on their lifestyles in regard to both clinical and behavioral conditions. A careful assessment was conducted regarding the elements proposed to dentists during training, including current curricular proposals aimed at expanding competencies and skills outside the clinical setting. There were positive aspects related to oral health actions in this regard. However, dentists are still expected to transpose barriers that allow greater participation in educational activities despite the current environment created by new curricular proposals, which this study found were essential for schoolchildren (AU).