Modulatory influence of melatonin on apical periodontitis in Wistar rats fed a high-fat diet.

OBJECTIVE: This study aimed to evaluate the influence of high-fat diet (HFD) and melatonin (MEL) treatment on the progression of inflammation and alveolar bone resorption (ABR) in rats with AP. DESIGN: Forty male Wistar rats were divided into four groups: apical periodontitis (AP), HFDAP, APMEL and HFDAPMEL. The animals were fed an HFD or standard diet for 107 days. On the 7th day, the rats were subjected to AP, and after 70 days, the rats in the MEL groups were treated with MEL for 30 days. Post treatment, the animals were euthanized, and their jaws were retrieved for evaluation of bone resorption, intensity of the inflammatory response, and immunohistochemical analysis including tartrate-resistant acid phosphatase (TRAP) and interleukin-1ß (IL-1ß) levels and tumor necrosis factor (TNF)-α expression. RESULTS: The APMEL group showed reduction in the inflammatory infiltrate and IL-1ß expression relation to HFDAP, while the TNF-α levels did not differ among the groups. The HFDAP group showed an increase in the ABR. MEL reduced the TRAP levels in the APMEL and HFDAPMEL groups. CONCLUSIONS: while MEL could reduce TRAP levels in the APMEL and HFDAPMEL groups, the reduction in the HFDAPMEL group was smaller than that in the APMEL group, demonstrating that the interaction between AP and HFD decreased the anti-resorptive effects of MEL.

Melatonin decreases plasma TNF-α and improves nonenzymatic antioxidant defence and insulin sensitivity in rats with apical periodontitis fed a high-fat diet.

AIM: To analyse the effects of melatonin (ME) treatment on oxidative stress and insulin resistance (IR) in rats with apical periodontitis (AP) fed a high-fat diet (HFD). METHODOLOGY: Eighty 60-day-old rats were divided into eight groups: control (CN), AP, HFD with AP (HFDAP), control with ME (CNME), AP with ME (APME), HFD with ME (HFDME) and HFD with AP+ME (HFDAPME). The animals from the HFD groups were fed a HFD throughout the experimental period. On day 7, the animals from the AP groups were subjected to experimental AP, and after 70 days, the ME groups were treated for 30 days. Glycaemia, insulinaemia, homeostatic model assessment for IR index, tumour necrosis factor-α (TNF-α), and interleukin-6 were analysed in plasma using biochemical tests and enzyme-linked immunosorbent assay. Thiobarbituric acid-reactive substances (TBARS), carbonyl protein (CP), superoxide dismutase (SOD), catalase, glutathione peroxidase, glutathione (GSH) and total antioxidant capacity (ferric reducing antioxidant power [FRAP]) were analysed in the gastrocnemius muscle. RESULTS: (1) Association of AP and HDF exacerbated IR, and ME treatment improved this alteration; (2) AP and HFD and their association showed increased TNF-α, and ME reversed it; (3) TBARS increased in the AP and HFDAP groups, and ME reversed only in the group with the association of disease and diet; (4) CP increased in all HFD groups and improved in the ME groups; (5) GSH activity decreased in all experimental groups, and ME increased this parameter only in the CN and AP groups; (6) FRAP did not change between the groups, but ME treatment increased its activity in the AP and HFD groups; (7) ME increased SOD in the CN and AP groups. CONCLUSION: Apical periodontitis and HFD promoted IR, and the association of AP with diet promoted IR exacerbation; this resistance might have been caused by an increase in TNF-α. AP promoted more intense changes in lipid oxidative damage than in protein oxidative damage. In non-enzymatic antioxidant defence, it was observed that both AP and HFD and their association promoted a decrease in GSH levels. Overall, ME treatment reversed changes such as oxidative stress and IR.

Effect of maternal true combined endodontic-periodontal lesion on insulin and inflammatory pathway in adult offspring.

BACKGROUND: Maternal periodontal disease (PED) and apical periodontitis (AP) are associated insulin resistance (IR), increased tumor necrosis factor-α (TNF-α) levels, and alterations in insulin signaling (IS) in the gastrocnemius muscle (GM) of adult offspring. TNF-α stimulates I kappa B kinase (IKK) and c-Jun N-terminal protein kinase (JNK), resulting in IS attenuation. However, studies that investigated the maternal true endodontic-periodontal lesion (EPL) in offspring are scarce, and in this case, the impact could be even higher. This study aimed to evaluate the effects of EPL on the IR, IS, and inflammatory pathways on the offspring GM. METHODS: Female Wistar rats were distributed into control, AP, PED, and EPL groups. After 30 days of oral inflammation induction, rats from all groups were allowed to mate with healthy rats. The body weight of the offspring was assessed from birth to 75 days of age. After 75 days, the following measurements were performed: glycemia, insulinemia, IR, TNF-α content, and IKKα/ß, JNK, pp185 (Tyr), and IRS-1 (Ser) phosphorylation status in the GM. RESULTS: Maternal PED and EPL were associated with low birth weights. All maternal oral inflammations promoted IR and IS impairment in the GM and only maternal PED and EPL caused an increase in TNF-α content and IKKα/ß phosphorylation status in the GM of offspring. The offspring of the rats with EPL group showed worsening of metabolic changes when compared with offspring of rats with AP or PED. CONCLUSION: Association of maternal AP and PED promoted a more pronounced worsening in the health of the adult offspring.

Malocclusion and its relationship with oral health-related quality of life in patients with eating disorders

ABSTRACT Objective: To evaluate the prevalence and severity of malocclusion and its impact on oral health-related quality of life (OHRQoL) and self-reported satisfaction of patients with anorexia and bulimia nervosa. Methods: The sample consisted of sixty women who attended a specialized mental health clinic of a Brazilian medical school. Participants were distributed into two groups: patients with anorexia and bulimia nervosa (ABN; n=30) and control patients without eating disorders (CN; n=30). The dental occlusion was evaluated by the Dental Aesthetic Index; the OHRQoL was assessed using the OHIP-14 questionnaire; and the self-reported satisfaction with the appearance of teeth, speech ability and chewing was obtained by interviews. Results: Severe and very severe malocclusion were observed in 26.67% and 46.67% of patients in the ABN group, respectively, while the CN group showed 80.00% of patients without abnormality/mild malocclusion. ABN group showed a higher proportion of patients (p < 0.05) with tooth loss, spacing in the region of incisors, maxillary misalignment, and mandibular misalignment in relation to CN group. ABN group presented lower (p< 0.05) OHRQoL and self-reported satisfaction with the appearance of teeth, speech ability and chewing, compared to the CN group. There was a significant positive correlation (p< 0.05) between the Dental Aesthetic Index and OHIP-14 scores in the ABN group. Conclusions: The prevalence of severe malocclusion in ABN group was high, with a negative impact on OHRQoL and self-reported satisfaction with the chewing ability, speech ability and appearance of teeth.

RESUMO Objetivo: Avaliar a prevalência e gravidade da má oclusão e seu impacto na qualidade de vida relacionada à saúde bucal (QVRSB) e a satisfação autorreferida de pacientes com anorexia e bulimia nervosa. Métodos: A amostra foi composta por 60 mulheres que compareceram a uma clínica especializada em saúde mental de uma faculdade brasileira de Medicina. Os participantes foram distribuídos em dois grupos: pacientes com anorexia e bulimia nervosa (ABN; n=30) e pacientes sem distúrbios alimentares (CN; n=30). A oclusão dentária foi avaliada pelo Índice de Estética Dental; a QVRSB foi avaliada usando o questionário OHIP-14; e a satisfação autorreferida com a aparência dos dentes, capacidade de fala e mastigação foi avaliada por meio de entrevistas. Resultados: Má oclusão grave e muito grave foi observada em 26,67% e 46,67% dos pacientes no grupo ABN, respectivamente, enquanto o grupo CN apresentou 80,00% dos pacientes sem anormalidade/má oclusão leve. O grupo ABN apresentou maior proporção de pacientes (p<0,05) com perda dentária, espaçamento na região dos incisivos, desalinhamento maxilar e desalinhamento mandibular, em relação ao grupo CN. O grupo ABN apresentou menor (p<0,05) QVRSB e satisfação autorreferida com a aparência dos dentes, capacidade de fala e mastigação, em comparação ao grupo CN. Houve uma correlação positiva (p<0,05) entre o Índice de Estética Dental e o escore do OHIP-14 no grupo ABN. Conclusões: A prevalência de má oclusão grave no grupo ABN foi alta, com impacto negativo na QVRSB e satisfação autorreferida com a aparência dos dentes, capacidade de fala e mastigação.

A triple-blind randomized clinical trial of different associations between dexamethasone and non-steroids anti-inflammatories for preemptive action in third molar extractions.

The aim of this study is to evaluate the preemptive analgesic effects of dexamethasone (DEX) alone or combined with non-steroidal anti-inflammatory drugs (NSAIDs) in third molar surgeries. The subjects were divided into five groups (n = 20 teeth/group); subjects received only 8 mg of dexamethasone 1 h before the surgical procedure (DEX group), or in combination with etodolac (DEX + ETO), ketorolac (DEX + KET), ibuprofen (DEX + IBU), loxoprofen (DEX + LOX). Paracetamol 750 mg was provided as the number of rescue analgesics (NRA). Salivary PGE2 expression was measured preoperatively and at 48 h. Edema and Maximum mouth opening (MMO) were measured postoperatively at 48 h and 7 days. A visual analog scale (VAS) was performed postoperatively at 6, 12, 24, 48, 72 h, and 7 days. Salivary expression of PGE2 showed a decrease only for the DEX group. Edema and MMO and NRA consumption showed no significant differences among the groups (P > 0.05). The VAS showed a significantly lower pain perception at 6 h after the surgery for the DEX + ETO and DEX + KET groups (P < 0.05). The combination of DEX and NSAIDS should be considered for preemptive acute postsurgical pain management in third molar surgery. In some drug associations such as dexamethasone 8 mg + NSAIDS (ETO and KET) in the pre-operative time, only a few rescue analgesics are necessary.

Dispensação de medicamentos na atenção primária do Sistema Único de Saúde / The dispensation of drugs in the primary health care of the Single Health System

Objetivo:analisar a dispensação de medicamentos na atenção primária do Sistema Único de Saúde em um município do Estado de São Paulo. Metodologia:realizou-se análise documental dos boletins de movimentação de medicamentos das farmácias das 19 Unidades Básicas de Saúde do município de Araçatuba-SP, sede do Departamento Regional de Saúde II-SP, durante 12 meses. Os medicamentos foram agregados segundo o sistema de classificação Anatomical Therapeutic Chemicale ação farmacológica. Analisou-se o total de medicamentos dispensados e o saldo final dos principais tipos de fármacos. Resultados:foram dispensados 60.479.959 medicamentos, sendo 53,10% antibióticos, 15,42% anti-hipertensivos, 5,09% antidepressivos, 4,81% hipoglicemiantes, 3,16% ansiolíticos, 2,82% complexos vitamínicos e minerais, 2,17% antipsicóticos, 1,99% analgésicos, dentre outros tipos (11,45%). Permaneceram disponíveis 8.778.863medicamentos, sendo os anti-hipertensivos, antidepressivos e ansiolíticos os que representam a maior proporção entre estes. Os antibióticos apresentaram a menor proporção de unidades disponíveis, com aproximadamente 2%. Os hipoglicemiantes apresentaram maior diversidade de fármacos sem unidades disponíveis para dispensação. Conclusão:os principais tipos de medicamentos dispensados foram antibióticos, anti-hipertensivos, antidepressivos e hipoglicemiantes. A dispensação de medicamentos foi satisfatória, considerando que mesmo os medicamentos que não apresentaram saldo residual positivo foram substituídos por outros de propriedades farmacológicas similares

Objective: to analyze the dispensation of drugs in the primary health care of the Single Health System in a city in the State of São Paulo.Methodology: a document analysis was carried out in the reports of how the movement of drugs took place in the 19 Primary Health Care Units in the city of Araçatuba-SP, head office of the Regional Health Department II-SP, for 12 months. The medications were classified according with the Anatomical Therapeutic Chemical system and with their pharmacological action. The total number of drugs dispensed and the remaining amount of the main types of drugs were analyzed.Results: 60,479,959 medications were dispensed, among which 53.10% were antibiotics, 15.42% antihypertensive, 5.09% antidepressant, 4.81% hypoglycemic, 3.16% anxiolytic, 2.82% vitamin and mineral complexes, 2.17% antipsychotics, 1.99% analgesics, among others (11.45%). 8,778,863 drugs were still available, among which the most numerous were hypertensive, antidepressants, and anxiolytics. Antibiotics represented the lowest percentage of available units, with approximately 2%. Hypoglycemic drugs were the ones that showed that highest diversity of unavailable medications.Conclusion: the main types of medications dispensed were antibiotics, antihypertensives, antidepressants, and hypoglycemic drugs. Drug dispensation was satisfactory,considering that even medications that did not have a positive residual supply were replaced by drugs with similar pharmacological properties

Miniplates coated by plasma electrolytic oxidation improve bone healing of simulated femoral fractures on low bone mineral density rats.

The treatment of polytrauma patients represents a great challenge in the maxillofacial and orthopedic surgery fields. Therefore, this study tested the hypothesis that the use of a bioactive coating (by plasma electrolytic oxidation, PEO) on titanium microplates could improve the fracture healing of low bone mineral density (BMD) rats. Thirty female rats underwent bilateral ovariectomy surgery (OVX), and 35 rats underwent fake surgery (SHAM). Three months later, animals were subjected to femoral fracture simulation and were fixed with either non-coated (CONV) or coated (PEO) titanium miniplates. Eight weeks postoperatively, microplate/bone complexes were analyzed through computed microtomography, histometric, confocal microscopy, molecular, and biomechanical analysis. Bioactive elements (Ca and P) were incorporated on the PEO microplate and the surface was modified in a volcano-like structure. In the microCT analysis the OVX/PEO group had greater values for Tb.Th (bone trabecular thickness), Tb.Sp (separation of bone trabeculae) and Tb.N (number of trabeculae) parameters compared to the OVX/CONV group. According to histometric analysis, the OVX/PEO group showed significantly higher new bone formation than the OVX/CONV group (P < 0.05). For the fluorochrome area, the OVX groups (PEO and CONV) showed greater values for calcein precipitation (old bone) than alizarin red (new bone). Molecular results showed greater values for proteins related to the final phase of bone formation (P < 0.05) in the OVX/PEO group. The OVX/PEO group showed higher bone/miniplate system resilience compared to the others (P < 0.05). It was concluded that PEO coating optimizes bone healing on simulated femoral fractures in low bone mineral density rats. This sheds new light in the treatment of osteoporotic patients with bone fractures.

Condição de saúde bucal e acesso aos serviços odontológicos em idosos atendidos em um hospital municipal da área rural de Benguela, Angola / Oral health condition and access to dental services in older people attended at a municipal hospital in the rural area of Benguela, Angola

Resumo Objetivo Analisar a condição de saúde bucal em idosos do município de Bocoio, província de Benguela, Angola, Africa. Métodos Estudo epidemiológico, transversal e analítico, realizado com 213 idosos, em 2019. Por meio de entrevistas e exames clínicos, analisou-se o perfil sociodemográfico; percepção de saúde bucal; higiene oral; uso de serviços odontológicos; consumo de tabaco, álcool, e açúcar; prejuízos funcionais e sociais devido a problemas bucais; índice de cárie dentária (CPOD); cárie radicular; condição periodontal; uso e necessidade de prótese; e lesões bucais. Resultados A maioria dos idosos era do sexo feminino (69,01%), com 60 a 70 anos (77,46%), não trabalhava (92,96%), não frequentou a escola (82,63%), e classificou sua saúde bucal como moderada (75,59%). Verificou-se que 52,58% realizava higienização bucal duas vezes por dia, utilizando escova dentária e dentifrício fluoretado (92,49%); nenhum participante utilizava fio dental; 47,89% realizou a última consulta odontológica há mais de dois anos; 20,66% fumavam diariamente; o consumo de álcool e alimentos açucarados foi baixo; 89,67% relataram dificuldade para mastigar; e 7,04% eram edêntulos totais. Houve associação (p<0,01) entre maior número de dentes perdidos, faixa etária mais avançada e baixo nível de escolaridade. O CPOD médio foi de 20,8±5,3 e nenhum dente obturado foi encontrado; a média de raízes cariadas foi de 2,43±2,10; a maioria dos dentes apresentava bolsa periodontal (50,32%) e perda de inserção (51,00%); 99,53% dos idosos necessitava de prótese; e 0,94% apresentava lesões bucais. Conclusão A condição de saúde bucal dos idosos de Bocoio é precária e marcada pela falta de acesso aos serviços odontológicos.

Abstract Objective To analyze the oral health status of elderly people in the municipality of Bocoio, Benguela province, Angola, Africa. Methods Epidemiological, cross-sectional and analytical study carried out with 213 elderly people in 2019. Through interviews and clinical examinations, the sociodemographic profile; oral health perception; oral hygiene; use of dental services; consumption of tobacco, alcohol, and sugar; functional and social impairments due to oral problems; dental caries index (DMFT); root caries; periodontal condition; use and need for prosthesis; and presence of oral lesions were analyzed. Results Most of the elderly were female (69.01%), aged 60 to 70 years (77.46%), did not work (92.96%), did not attend school (82.63%), and classified their oral health status as moderate (75.59%). It was found that 52.58% performed oral hygiene twice a day, using toothbrush and fluoridated dentifrice (92.49%); no participant used dental floss; 47.89% had their last dental appointment more than two years ago; 20.66% smoked daily; consumption of alcohol and sugary foods was low; 89.67% reported difficulty chewing; and 7.04% were fully edentulous. There was an association (p<0.01) between the greater number of missing teeth, and older age group and low level of education. The mean DMFT was 20.8±5.3 and no filled teeth were found; the mean of decayed roots was 2.43±2.10; most teeth had periodontal pocket (50.32%) and attachment loss (51.00%); 99.53% of the elderly needed a prosthesis; and 0.94% had oral lesions. Conclusion The oral health condition of the elderly in Bocoio is precarious and marked by the lack of access to dental services.

Dental auxiliary hepatitis B immunization: a cross-sectional study in the São Paulo state public health system, Brazil, 2018. / Imunização contra hepatite B em auxiliares em saúde bucal: estudo transversal no sistema público de saúde do estado de São Paulo, em 2018.

OBJECTIVE: to investigate dental auxiliaries (DA) hepatitis B immunization in Brazilian National Health System (SUS) services in nine cities in São Paulo State, Brazil, in 2018. METHODS: this was a cross-sectional study based on interviews using a questionnaire as well as evaluation of immunity using the anti-HBs test, evaluation of prior testing, test result and interpretation and guidance provided about hepatitis B. RESULTS: of the 70 registered DA, 35 completed the course of vaccinations, 29 had negative anti-HBs test results, 16 had tested previously, and 43 did not correctly understand their result; there was association (p=0.025) between completed course of vaccinations and receipt of guidance. CONCLUSION: most DA received guidance about hepatitis B; however, a considerable portion did not complete the course of vaccinations and had negative anti-HBs test results; few DA had tested previously nor correctly interpreted the result; evidence was found of an alarming scenario in which there are severe shortcomings in DA hepatitis B immunization.

Violência dimensionada: análise da notificação / Dimensioning of violence: analysis of notification

Objetivo: realizar um levantamento epidemiológico das notificações de violência registradas no Departamento Regional de Saúde de São Paulo, Brasil, instituição responsável por 40 municípios do noroeste paulista. Metodologia: trata-se de um estudo transversal, com pesquisa no banco de dados do Departamento Regional de Saúde de São Paulo, analisando fichas de notificação de acidentes e violências, no período de 2013 a 2015. O estudo foi aprovado pelo Comitê de Ética em Pesquisa (Processo n 2007-01343). Resultados: dos 133.537 atendimentos identificados, somente 153 foram registrados como violência; sendo 53,3% das vítimas mulheres; 45,1% de 20 a 34 anos; 48,7% brancos; 39,87% solteiros; 52,94% dos casos ocorreram em ambiente residencial; 47,71% deles entre 18:01 e 24:00 horas; 91,5% das ocorrências foram encaminhadas para as delegacias por meio de profissionais da área da enfermagem. Uma gama significativa das formas de violência, por despreparo ou desconhecimento do profissional, não é devidamente registrada, impedindo a formulação de novas políticas para o seu combate. Conclusão: a maioria das notificações de violência eram de vítimas mulheres, jovens, brancas e solteiras; com ocorrência em ambiente residencial no período noturno; e os encaminhamentos para delegacias foram realizados principalmente por técnicos de enfermagem.

Objective: to perform an epidemiological survey of notifications of violence registered at the Regional Health Department of São Paulo, Brazil, an institution responsible for 40 municipalities in the northwest of São Paulo. Methodology: this is a cross-sectional study, with research in the Regional Health Department of São Paulo database, analyzing accident and violence notification forms, from 2013 to 2015. The study was approved by the Research Ethics Committee (Process nº 2007-01343). Results: of the 133,537 services identified, only 153 were recorded as violence; 53.3% of the victims were women; 45.1% from 20 to 34 years old; 48.7% white; 39.87% single; 52.94% of cases occurred in a residential environment; 47.71% of them between 18:01 and 24:00 hours; 91.5% of the occurrences were referred to police stations by professionals in the nursing field. A significant range of forms of violence, due to the professional's lack of preparation or lack of knowledge, is not properly registered, preventing the formulation of new policies to combat it. Conclusion: most reports of violence were from women, young, white and single victims; occurring in a residential environment at night; and referrals to police stations were made mainly by nursing technicians.

Effect of Chlorhexidine and Fluoride Varnishes on Streptococcus mutans Count and Dental Plaque Index / Efeito dos Vernizes de Clorexidina e Flúor na Contagem de Streptococcus mutans e no Índice de Placa Dentária

The control of dental plaque by chemical means can be a valuable auxiliary resource for individuals who have difficulties in performing dental plaque control through regular oral hygiene procedures. The aim of this study was to evaluate the effect of chlorhexidine and fluorine varnishes on the levels of Streptococcus mutans (S. mutans) present in the dental biofilm and on the dental plaque index. The study was carried out in a sample comprised thirty-nine schoolchildren between 13 and 15 years of age, distributed into 2 groups. Group I received a single layer of varnish with chlorhexidine and thymol on the maxillary right first molar. Group II received the application of varnish with fluoride following the same methodology. S. mutans count and dental plaque index recording were performed 7 days before the application and 7, 15 and 30 days after the treatment. It was observed that chlorhexidine and fluoride varnishes significantly reduced the number of S. mutans in dental plaque for 30 days (p<0.05). There was no difference between the varnishes. With regard to the dental plaque index, there was no alteration in any of the experimental time periods for both groups. It was concluded that varnishes, mainly those that contain fluoride, can be an interesting alternative for the prevention of dental caries in collective oral health programs. (AU)

O controle da placa dental por meios químicos pode ser um valioso recurso auxiliar para indivíduos que apresentam dificuldades em realizar o controle da placa dental por meio de procedimentos regulares de higiene bucal. O objetivo neste estudo foi avaliar o efeito dos vernizes de clorexidina e de flúor sobre os níveis de Streptococcus mutans (S. mutans) presentes no biofilme dental e sobre o índice de placa dental. O estudo foi realizado em uma amostra composta por 39 escolares, entre 13 e 15 anos de idade, distribuídos em 2 grupos. O grupo I recebeu uma única aplicação de verniz com clorexidina e timol no primeiro molar superior direito. O grupo II recebeu a aplicação de verniz com flúor seguindo a mesma metodologia. A contagem de S. mutans e o índice de placa dental foram registrados 7 dias antes da aplicação e 7, 15 e 30 dias após o tratamento. Observou-se que os vernizes de clorexidina e flúor reduziram significativamente o número de S. mutans na placa dental por 30 dias (p <0,05). Não houve diferença entre os vernizes. Com relação ao índice de placa dental, não houve alteração em nenhum dos períodos experimentais para ambos os grupos. Concluiu-se que os vernizes, principalmente aqueles que contêm flúor, podem ser uma alternativa interessante para a prevenção da cárie dentária em programas coletivos de saúde bucal. (AU)

Effect of maternal periodontitis on GLUT4 and inflammatory pathway in adult offspring.

BACKGROUND: Maternal periodontal disease leads to low birth weight (LBW), insulin resistance (IR), increased TNF-α levels, and alterations in insulin signaling in adult offspring. TNF-α has been associated with the stimulation of IKKß/NF-κB, resulting in the decreased expression of GLUT4. Another mechanism that may be involved in decreasing GLUT4 expression is DNA methylation. This study aimed to evaluate in the adult offspring of rats with periodontal disease: IR, inflammatory pathways, DNA methylation, and expression of GLUT4. METHODS: Female Wistar rats were distributed into control and experimental periodontal disease groups. Seven days after induction of periodontal disease, both groups were mated with healthy male rats. After weaning, male offspring were distributed into control offspring (CN-o) and periodontal disease offspring (PED-o) groups. Body weights were measured from 0-75 days of age. At day 75, the following were measured in the offspring: IR (HOMA-IR index); TNF-α and NF-κBp65 content in the gastrocnemius muscle (GM) by western blotting; IKKα/ß, JNK, ERK 1/2, NF-κBp65, and NF-κBp50 phosphorylation status in the GM by western blotting; DNA methylation by restriction digest and real-time PCR(qAMP); and expression of GLUT4 mRNA in the GM by real-time PCR. RESULTS: LBW, IR, increases in TNF-α, IKKα/ß, ERK 1/2, NF-κBp65, and NF-κBp50 decreased expression of GLUT4 mRNA were observed in the PED-o rats. No differences were identified in JNK phosphorylation status and DNA methylation in the evaluated regions of the GLUT4-encoding gene Slc2a4. CONCLUSION: Maternal periodontal disease causes LBW, IR, activation of inflammatory pathways, and decreased GLUT4 expression in the GM of adult offspring.

Vaccination coverage and immunity against hepatitis B in public health dentists

Abstract INTRODUCTION: Occupational exposure is a major risk factor for hepatitis B (HB) transmission. METHODS: Vaccination coverage and immunity verification from 64 dentists of the Brazilian Unified Health System were investigated. An immunochromatographic method was used to verify immunity against the disease. RESULTS: Overall, 77.77% of participating dentists completed the vaccination schedule; 37.50% had negative anti-HBs test results. Furthermore, 60.93% of participants never underwent anti-HBs tests and 40% did not know how to correctly interpret results. CONCLUSIONS: Numerous dentists were not immune to the disease. Few participants previously performed the test, with many not knowing how to interpret the results.

Melatonin promotes reduction in TNF levels and improves the lipid profile and insulin sensitivity in pinealectomized rats with periodontal disease.

AIM: This study aimed to investigate the effects of melatonin (ME) on insulin resistance (IR) and signaling (IS), proinflammatory cytokine levels, and lipid profiles in pinealectomyzed (PNX) rats with periodontal disease (PD). MAIN METHODS: One hundred and forty-four rats (age = 40 days) were distributed into 8 groups: 1) control (CN); 2) PD only; 3) PNX only; 4) PNX and PD (PNXPD); 5) CN treated with ME (CNM); 6) PD treated with ME (PDM); 7) PNX treated with ME(PNXM); 8) PNX and PD treated with ME(PNXPDM). The PNX groups were subjected to pinealectomy at 40 and at 60 days of age. The animals were then subjected to PD induction in the mandibular first molars. After PD induction, the ME replacement therapy (MERT-5 mg/kg body weight) was performed using water for 28 days. After this period, the plasma concentration of glucose, insulin, TNF, IL-6, triglycerides, total cholesterol, HDL-cholesterol, LDL-cholesterol, and VLDL-cholesterol and the HOMA-IR index were determined. Akt serine phosphorylation status in the white adipose tissue, gastrocnemius muscle, and rat liver were also evaluated. KEY FINDINGS: PD, PNX, and PNXPD groups showed an increase in IR with elevated plasma levels of insulin and TNF compared to CN group. PNX and PNXPD groups presented alteration in lipid profile compared to CN group. MERT improved all of the analyzed parameters. No difference was observed in the IS among different groups. SIGNIFICANCE: The results suggest that MERT efficiently prevents IR, improves lipid profile, and increases plasma levels of insulin and TNF in PD and PNX rats.

Endodontic infections increase leukocyte and lymphocyte levels in the blood.

OBJECTIVES: The aim of this study was to determine whether the presence of single or multiple apical periodontitis (AP) alters blood cell counts and cytokine production. MATERIAL AND METHODS: Thirty rats were divided into three groups: a control group comprising rats without AP, a group called 1AP comprising rats with AP in one tooth, and a group called 4AP comprising rats with AP in four teeth. Endodontic infection was induced by pulp exposure of the first right maxillary molar in the 1AP group or by exposing the first and second right maxillary and mandibular molars in the 4AP group. A blood count and cytokine levels were obtained 30 days after infection by collecting blood by cardiac puncture. The maxillae were dissected and stained with hematoxylin and eosin to evaluate the inflammatory infiltrate. The data were tabulated and subjected to statistical analysis (P < 0.05). RESULTS: Histological analysis showed a predominance of mononuclear inflammatory cells. In blood, significant increase of leukocytes, lymphocytes, and tumor necrosis factor alpha (TNF-α) in 4AP compared with the control and 1AP groups (P < 0.05) was observed. In addition, significant decrease of interleukin-4 (IL-4) in 1AP and 4AP groups compared with the control was observed (P < 0.05). CONCLUSIONS: In the rat model, the presence of multiple AP can affect health by increasing lymphocyte and TNF-α levels in the blood. CLINICAL RELEVANCE: The presence of endodontic infections can interfere with the blood profile, altering systemic health.

Microscopic evaluation of rotatory and handle caries removal on glass ionomer cement/dentin interface

Aim: This study evaluated the interface between glass ionomer cement (GIC) and dentin using the conventional and atraumatic restorative treatment (ART) techniques for removal of decayed tissue. Materials and Methods: After preparation of the cavities by the conventional (Group I ­ GI) and ART (Group II ­ GII) techniques, the specimens were divided into 3 subgroups according to the GIC used (n=10). The conventional GIC KETAC FILL (3M/ESPE) was used in the groups GI-1 and GII-1, the conventional GIC VIDRION R (SS WHITE) in the groups GI-2 and GII-2, and the modified GIC FUJI II LC (GC Corporation) in the groups GI-3 and GII-3. For the microscopic analysis, the teeth were decalcified in a solution containing equal portions of 50% formic acid and 20% sodium citrate, dehydrated and submitted to paraffin baths. The samples were sectioned (6m in thickness), stained by the Brown and Brenn method, and evaluated in a light microscope. Results: The microscopic analysis revealed interaction between the material and dentin structure only with the FUJI II LC. In addition, the behavior was superior for the conventional technique in comparison to the ART technique. Conclusion: It was concluded that the technique used for carious dentin removal does not seem to be determinant for the bonding of ionomeric materials to the dental structure, except for the resin-modified GIC in which the formed hybrid layer was higher using the conventional technique

Periapical Lesions Increase Macrophage Infiltration and Inflammatory Signaling in Muscle Tissue of Rats.

INTRODUCTION: Our previous studies have shown that periapical lesions (PLs) in rats cause systemic disorders such as increased tumor necrosis factor-α plasma levels, insulin resistance, and impairment in insulin signal transduction in muscle tissue. However, the mechanisms involved in these alterations are not fully understood. Under chronic inflammatory conditions such as obesity, it has been shown that the skeletal muscle is affected by inflammation, and the number of resident macrophages that are associated with impairments of insulin action and sensitivity is increased. This study aimed to investigate the presence of macrophages, activation of inflammatory pathways in muscle tissue, glycemia, and insulinemia of rats with PLs. METHODS: Sixty Wistar rats were distributed into a control group; a group with 1 PL (1PL), which was induced in the right maxillary first molar; and a group with 4 PLs (4PL), which were induced in the right upper and lower first and second molars. We quantified macrophage content by immunohistochemistry for the F4/80 protein. We evaluated Jun N-terminal kinase and IKKα/ß phosphorylation status in the muscle tissue by Western blotting. Serum levels of lipopolysaccharide (LPS) and HSP70 and plasma levels of glucose and insulin were assessed by using commercial kits. RESULTS: The 1PL and 4PL groups showed increase in macrophage content, IKKα/ß, and Jun N-terminal kinase phosphorylation status, serum LPS and HSP70 levels, and insulin resistance and no changes in glycemia and insulinemia compared with the control group. There was no difference in these parameters between the 1PL and 4PL groups. CONCLUSIONS: PLs promoted an increase in macrophage infiltration, activation of inflammatory pathways in muscle tissue, and serum concentrations of HSP70 and LPS in rats. The present study improves the knowledge on the impact of oral inflammations on the development of systemic alteration, which can induce insulin resistance.

Effects of fluoride on insulin signaling and bone metabolism in ovariectomized rats.

Fluoride is an essential trace element for the maintenance of bone health owing to its capacity to stimulate proliferation and osteoblastic activity that can lead to increased bone formation. However, excessive sodium fluoride (NaF) intake can impair carbohydrate metabolism thereby promoting hyperglycemia, insulin resistance, and changes in insulin signaling. Thus, this study aimed to evaluate the effect of chronic treatment with NaF in bone metabolism, insulin signaling, and plasma concentrations of glucose, insulin, tumor necrosis factor-α (TNF-α), osteocalcin (OCN), and fluoride in ovariectomized rats. Thirty-two ovariectomized Wistar rats were randomly distributed into two groups: Control (OVX-C) and those undergoing treatment with NaF (50mg F/L) in drinking water for 42days (OVX-F). Glucose and insulin levels were assessed, followed by homeostasis model assessment of insulin resistance (HOMA-IR). Akt serine phosphorylation was evaluated by western blotting. Plasma concentrations of TNF-α and OCN were evaluated by ELISA. The left and right tibia was collected for immunohistochemical and histomorphometric analysis, respectively. Chronic treatment with NaF promoted insulin resistance, decreased insulin signal, increased plasma concentration of insulin, fluoride, OCN and TNF-α, decreased trabecular bone area of the tibia, and caused changes in bone metabolism markers in ovariectomized rats. These results suggest the need for caution in the use of NaF for the treatment of osteoporosis, especially in postmenopausal woman.

Relationship among Periodontal Disease, Insulin Resistance, Salivary Cortisol, and Stress Levels during Pregnancy

Abstract Pregnancy is a period involving important metabolic changes that enable the maintenance of the mother's health and development of the fetus. This study aimed to assess the relationship among periodontal disease, insulin resistance, salivary cortisol concentration and level of perceived stress in pregnant women. This was a cross-sectional study. The sample comprised 96 pregnant women between the fifth and seventh month of pregnancy registered at the Basic Health Units of the Unified Health System (SUS). The periodontal condition was assessed after obtainment free and informed consent from the participants. Participants were divided into three groups: control subjects with a healthy periodontal condition (CN; n=46), patients with gingivitis (GI; n=26), and patients with periodontitis (PI; n=24). Saliva and blood samples were collected for evaluation of salivary cortisol concentration, glycemia, insulinemia and Homeostasis Model Assessment-Insulin Resistance index. A validated survey for the assessment of perceived stress levels was also performed. PI group showed significantly higher (p<0.05) blood glucose levels (CN: 4.43±0.05; GI: 4.46±0.04; PI: 4.68±0.08), insulinemy (CN: 6.93±0.45; GI: 8.87±0.79; PI: 12.77±1.30), insulin resistance (CN: 1.40±0.10; GI: 1.81±0.18; PI: 2.66±0.29) compared with the CN and GI groups. The levels of perceived stress were higher (p<0.05) in PI and GI groups when compared to CN group (CN: 20.5±1.26; GI: 25.8±1.95; PI: 26.6±1.36). There was no significant difference in the concentration of salivary cortisol between the groups (CN: 11.13±0.58; GI: 11.96±0.74; PI: 11.47±0.74). It was concluded that there is a relationship between higher levels of perceived stress, insulin resistance and the occurrence of periodontal disease during pregnancy. This study emphasizes the importance of preventing periodontitis in order to avoid insulin resistance and stress during pregnancy since these can cause systemic complications for the mother and the fetus.

Resumo A gravidez é um período que envolve alterações metabólicas importantes que permitem a manutenção da saúde e desenvolvimento fetal e materno. Este estudo teve como objetivo avaliar a relação entre doença periodontal, resistência à insulina, concentração de cortisol salivar e nível de estresse percebido em gestantes. Trata-se de um estudo transversal. A amostra foi composta por 96 gestantes entre o quinto e sétimo mês, registradas em Unidades Básicas de Saúde do Sistema Único de Saúde. A condição periodontal foi avaliada após a obtenção do consentimento livre e esclarecido das participantes. As participantes foram divididas em três grupos: pacientes controle com condição periodontal saudável (CN; n=46), com gengivite (GI; n=26) e com periodontite (PI; n=24). As amostras salivares e sanguíneas foram coletadas para avaliação da concentração salivar de cortisol, glicemia, insulinemia e índice HOMA-IR. Foi aplicado um questionário validado para verificação dos níveis de estresse percebido. Grupo PI apresentou níveis significativamente mais elevados (p<0,05) de glicose no sangue (CN: 4,43±0,05; GI: 4,46±0,04; PI: 4,68±0,08), insulinemia (CN: 6,93±0,45; GI: 8,87±0,79; PI: 12,77±1,30), resistência à insulina (CN: 1,40±0,10; GI: 1,81±0,18; PI: 2,66±0,29) em comparação com os grupos CN e GI. Os níveis de estresse percebido foram maiores (p<0,05) nos grupos PI e GI quando comparados ao grupo CN (CN: 20,5±1,26; GI: 25,8±1,95; PI: 26,6±1,36). Não houve diferença significativa na concentração de cortisol salivar entre os grupos (CN: 11,13±0,58; GI: 11,96±0,74; PI: 11,47±0,74). Concluiu-se que há uma relação entre os níveis mais elevados de estresse percebido, resistência à insulina e ocorrência da doença periodontal durante a gravidez. Este estudo enfatiza a importância de prevenir a periodontite, a fim de evitar a resistência à insulina e estresse durante a gravidez, uma vez que estes podem causar complicações sistêmicas para a mãe e para o feto.

Maternal periodontitis decreases plasma membrane GLUT4 content in skeletal muscle of adult offspring.

AIMS: The fetal programming hypothesis suggests that intrauterine stimuli can induce metabolic changes in offspring, increasing the disease risk in adulthood. Periodontal disease may enhance serum cytokine levels. Cytokines such as tumor necrosis factor-alpha (TNF-α) have been associated with reduced glucose transporter type 4 (GLUT4) expression, decreased protein kinase B (Akt) phosphorylation, and insulin resistance. This study aimed to evaluate GLUT4 content, and Akt serine phosphorylation status in the gastrocnemius skeletal muscle (GSM), glycemia, insulinemia and change in body weight in offspring of rats with periodontal disease. MAIN METHODS: Female Wistar rats were distributed into a control group (CN) and an experimental periodontal disease group (PD), in which a ligature was placed around the mandibular first molars. Seven days after ligature placement, both groups were mated with normal male rats. The ligatures remained throughout pregnancy until weaning, after which the male offspring were distributed into groups: CN-o, control rat offspring; and PD-o, periodontal disease rat offspring. The body weight from 0 to 75days of age was measured. At 75days, the glycemia, insulinemia, TNF-α levels, Akt serine phosphorylation, and GLUT4 content in the GSM were measured in the offspring. KEY FINDINGS: The PD-o group showed a low birth weight (LBW), unchanged glycemia, increased insulinemia, insulin resistance, increased TNF-α levels, decreased Akt serine phosphorylation status, and reduced GLUT4 content in the plasma membrane and translocation index after insulin stimulation. SIGNIFICANCE: Maternal periodontal disease causes LBW, insulin resistance, and alterations in the final stage of insulin signaling in the GSM of adult offspring.