Atorvastatin attenuates spinal cord injury by chronic fluorosis in rats.

The aim of the study was to explore the effect of atorvastatin on improvement of the function of the spinal cord in rats with chronic fluorosis. Sixty 3-month-old Wistar rats were separated randomly into three groups: normal group (N group), control group (C group) and atorvastatin group (A group). The Basso Beattie and Bresnahan scale and oblique board test showed that the rats in A group got higher score and better hind-limb motor function than C group. Immunohistochemistry and western blotting revealed that compared with N group, matrix metalloproteinase 9 (MMP-9) and p53 were highly expressed and myelin basic protein (MBP) was low expressed in spinal cord of C group. Meanwhile, MMP-9 and p53 expression were decreased and MBP was upregulated by atorvastatin compared with C group. In conclusion, the improvement of the function of the spinal cord in rats can be found when they were treated with atorvastatin.

Fluorosis increases the risk of postmenopausal osteoporosis by stimulating interferon γ.

Estrogen deficiency in postmenopausal women frequently activates osteoclasts (OC), accelerates bone resorption, and leads to osteoporosis (OP). Previous studies have demonstrated that interferon γ (IFNγ) could increase bone resorption and may be involved in postmenopausal OP. Fluorosis also increased the risk of fractures and dental fluorosis, and fluoride may enhance osteoclast formation and induce osteoclastic bone destruction in postmenopausal women, but the underlying mechanisms are as yet unknown. Here, we show that serum fluoride and IFNγ levels are negatively correlated with bone mineral density (BMD) in postmenopausal women residing in a fluorotic area. Estrogen suppresses IFNγ, which is elevated by fluoride, playing a pivotal role in triggering bone loss in estrogen-deficient conditions. In vitro, IFNγ is inhibited by estrogen treatment and increased by fluoride in Raw264.7 cell, an osteoclast progenitor cell line. In ovariectomized (Ovx) mice, estrogen loss and IFNγ promote OC activation and subsequent bone loss in vivo. However, IFNγ deficiency prevents bone loss in Ovx mice even in fluoride conditions. Interestingly, fluoride fails to increase IFNγ expression in estrogen receptor α (ERα)-deficient conditions, but not in ERß-deficient conditions. These findings demonstrate that fluorosis increases the bone loss in postmenopausal OP through an IFNγ-dependent mechanism. IFNγ signaling activates OC and aggravates estrogen deficiency inducing OP. Thus, stimulation of IFNγ production is a pivotal ''upstream'' mechanism by which fluoride promotes bone loss. Suppression of IFNγ levels may constitute a therapeutic approach for preventing bone loss.

Revisión Sistemática sobre los Efectos Adversos de la Fluoración del Agua / Systematic Review of the Adverse Effects of Water Fluoridation

Durante las últimas décadas, una considerable atención científica ha sido puesta en la seguridad de los fluoruros, dada la amplia variedad de fuentes de ingestión a la que la población se encuentra expuesta y los riesgos a la salud de las personas que esto puede acarrear. El objetivo de esta investigación fue determinar si la fluoración del agua a concentraciones de 0,6 a 1 ppm se asocian a una mayor proporción de efectos adversos en la población general al compararlo con concentraciones subóptimas. Se realizó una revisión sistemática de la literatura en MEDLINE, EMBASE, COCHRANE, SCIELO, LILACS, CRD, BBO, PAHO y WHOLIS, limitada desde el 2002 al 2012. Se incluyeron estudios primarios y secundarios en español, inglés y portugués con al menos dos poblaciones comparadas, una con niveles óptimos de flúor en agua (0,6­1 ppm) y otra sin fluoración del agua (<0,3 ppm) o con niveles subóptimos (>0,3 < 0,6 ppm). Dos investigadores de forma independiente realizaron evaluación de la calidad de los artículos seleccionados y que cumplieron los criterios de inclusión. La búsqueda arrojó 1024 artículos de los cuales 24 cumplieron los criterios de inclusión y 10 fueron incluidos como evidencia. Con excepción de fluorosis dental, no hay asociación entre fluoración del agua con fracturas óseas, cáncer u otro efecto adverso. A pesar de la mayor prevalencia de fluorosis en zonas fluoradas, esta fue principalmente del tipo cuestionable a leve y la proporción de fluorosis con daño estético no difiere significativamente de la presente en zonas sin fluoración del agua.

During the last decades, considerable scientific attention has been paid to the safety of fluoride, given the wide variety of sources of intake at which the population is exposed and the risks to the health of people this may produce. The aim was to determine whether water fluoridation at concentrations from 0.6 to 1 ppm is associated with a higher proportion of adverse effects in the general population when comparing them to suboptimal concentrations. A systematic review was conducted of the literature in MEDLINE, EMBASE, COCHRANE, SCIELO, LILACS, CRD, BBO, PAHO and WHOLIS, limited to 2002 to 2012. Included were primary and secondary studies in Spanish, English and Portuguese with at least two compared populations, one with optimal fluoride levels in the water (0.6­1 ppm) and another without water fluoridation (<0.3 ppm) or with suboptimal levels (>0.3 < 0.6ppm). Two researchers independently evaluated the quality of the articles selected and which met the inclusion criteria. The search revealed 1024 articles, of which 24 met the inclusion criteria and 10 were included as evidence. With the exception of dental fluorosis, there is no association between any other adverse effect and water fluoridation. Despite the greater prevalence of fluorosis in fluoride than in non-fluoride zones, this was mainly questionable to slight and the proportion of fluorosis with esthetic damage does not differ significantly from this in zones without water fluoridation.

The analog of Ginkgo biloba extract 761 is a protective factor of cognitive impairment induced by chronic fluorosis.

Ginkgo biloba extract EGb761 is widely used to treat patients with learning and memory impairment in Alzheimer's disease and Parkinson's disease in China. However, it is not yet clear whether the analog of EGb761 (EGb) has a protective effect on the learning and memory damage induced by chronic fluorosis. In this study, 30 Wistar rats were randomly divided into three groups: a control group, a sodium fluoride (NaF) + EGb group, and a NaF group. The rats were administered 0.5 ml water containing NaF (100 mg/l) and EGb (120 mg/kg) per day via gavage. After 3 months, the rats' capacity for learning and memory was tested using a Y-maze. Damage to hippocampal neurons was evaluated by histological examination of the CA3 area. Superoxide dismutase (SOD) activity and the levels of glutathione peroxidase (GSH-Px) and malondialdehyde (MDA) were measured. Furthermore, the expression levels of Bcl-2 and Bax and the levels of cleaved Caspase3 in the hippocampus were evaluated by RT-PCR and Western blotting. The results showed that EGb could improve learning and memory abilities, enhance the activities of SOD and GSH-Px, attenuate the level of MDA, upregulate the ratio of Bcl-2/Bax, and downregulate the level of cleaved Caspase3.

Clinical status of permanent first molars in children aged seven to ten years in a Brazilian rural community

Aim: To evaluate the clinical status of permanent first molars and associations with dental caries, gingival bleeding, dental fluorosis and malocclusion. Methods: An observational study wascarried out in a rural community denominated Morro do Saboó in the city of São Roque, state of São Paulo, Brazil. A total of 194 children aged seven to ten years were examined for dental caries using the index proposed by the World Health Organization. Other conditions were determined using the Gingival Alterations Index, Dean’s Index and Dental Aesthetic Index. The chi-squared test was used for the statistical analysis of the data. Results: A total of 85.5% of the sample exhibited gingival bleeding and 69.9% exhibited malocclusion. A total of 53.6% had a clinical aspect of normality with regard to dental fluorosis. There was a predominance of sound teeth in the upper arch and teeth with carious lesions in the lower arch. No significant differences were found between sexes regarding gingival bleeding, dental fluorosis or malocclusion. Significant associations were found between tooth status and oral alterations (gingival bleeding, malocclusion and fluorosis) in teeth 16, 26 and 46 and between tooth status and gingival bleeding in tooth 36 (p<0.001). Conclusions: Caries activity in the permanent first molars was mainly associated with dental fluorosis and malocclusion. Strategies aimed at health promotion should be adopted on a large scale to minimize the prevalence of oral diseases.

O sal fluoretado como alternativa em saúde bucal coletiva: vantagens e desvantagens / Salt fluoridation as an alternative in dental public health: advantages and disadvantages

O trabalho relata a possibilidade de fluoretação do sal como veículo de escolha na prevenção da cárie dentária e também comenta sobre as vantagens e as devantagens do acréscimo do flúor no sal de cozinha. As dosagens do flúor no sal recomendadas variam conforme os hábitos alimentares e os custos são baixos comparados com os demais meios sistêmicos. A fluoretação da água não poderia ocorrer em associação com o uso do sal fluoretado, pois a população estaria exposta a uma alta dosagem de flúor sistêmico. Portanto, o flúor no sal é um método substitutivo por forçar sempre uma escolha entre um método e outro.

Endemic fluorosis in Turkish patients: relationship with knee osteoarthritis.

Fluoride excess primarily effects dental and skeletal tissues. leading to a condition known as endemic fluorosis. The radiological and clinical features of endemic fluorosis vary in different parts of the world. The aim of this study was to investigate the clinical and radiological features of endemic fluorosis in Turkish patients. Physical examination and radiological investigations were performed in 56 patients with endemic fluorosis and 40 age- and sex-matched controls. Knee osteoarthritis (OA) was the main abnormality in both groups, both clinically and radiologically. The radiological severity of knee OA was greater in the endemic fluorosis group than in controls (P=0.01). Osteophytes at the tibial condyles and superior margin of the patellar articular surface of the femur, polyp-like osteophytes on the non-weight-bearing medial side of the femoral condyle, and popliteal loose bodies were detected more frequently in the endemic fluorosis group than in controls (P=0.0001). We suggest that the presence of atypically located osteophytes in the knees may be a feature of endemic fluorosis in Turkish patients and that endemic fluorosis may increase the severity of OA in the knees.

Exposiçäo ao flúor e fluorose dental: uma revisäo de literatura / Fluoride exposures and dental fluorosis: a literature review

O declínio na prevalência e incidência de cárie dentária nas duas últimas décadas é considerado ser devido, em grande parte ao amplo uso do flúor. Entretanto, a prevalência de fluorose dentária aumentou simultaneamente. O aumento foi nas formas de fluorose suave e muito suave, tanto em áreas fluoretadas como näo fluoretadas. Uma grande quantidade de dados epidemiológicos mostra que a ocorrência de lesöes fluoróticas está associada à ingestäo excessiva de flúor durante o período de desenvolvimento dental. Muitas fontes de flúor têm sido identificadas. Esta revisäo descreve a condiçäo e sumariza a literatura recente acerca dos fatores de risco para fluorose dentária. Quatro fatores de risco maiores foram consistentemente identificados: uso de água fluoretada, suplemementos de flúor, dentifrícios fluoretados ou fórmulas infantis. Em adiçäo alguns alimentos e bebidas manufaturados podem ser importantes contribuintes para a ingestäo diária total de flúor

Tooth discolouration and staining: a review of the literature.

OBJECTIVE: To carry out an extensive review of the literature on tooth staining with particular regard to some of the more recent literature on the mechanisms of tooth staining involving mouthrinses. DESIGN: Comprehensive review of the literature over four decades. CONCLUSIONS: A knowledge of the aetiology of tooth staining is of importance to dental surgeons in order to enable a correct diagnosis to be made when examining a discoloured dentition and allows the dental practitioner to explain to the patient the exact nature of the condition. In some instances, the mechanism of staining may have an effect on the outcome of treatment and influence the treatment options the dentist will be able to offer to patients.

Estudo multicentro da fluorose dental e da cárie dental em escolares de 7 e 10 anos de Belo Horizonte: parte I / Multicentric study of dental fluorose and dental caries in 7-and in 10-year-old schoolchildren from Belo Horizonte, Brazil-Part I

Este estudo transversal examinou 797 escolares de 7 a 10 anos, de seis diferentes setores urbanos de Belo Horizonte, pretendendo verificar a prevalência da fluorose dentária e sua relaçäo com a cárie dental, estado nutricional, exposiçäo à água fluoretada e gênero. Os resultados aqui apresentados referem-se às crianças de 7 anos. Os indicadores utilizados foram CPOS/ceos, Indice de Dean e relaçäo peso/altura. Para verificaçäo da concentraçäo de flúor na água, análises de cromatografia líquida foram realizadas. Os resultados deste estudo mostram que a fluorose branda é o tipo mais comum aos 7 anos. A variaçäo na ocorrência da fluorose entre os fatores é significativa (p = 0,04), sendo que o setor 2 (Santo André) apresentou a maior prevalência (69,3 por cento), e o 3 (Ouro Preto), a menor prevalência (45,59 por cento). Os setores com maior prevalência de fluorose foram aqueles que apresentaram a menor prevalência de cárie dental, mas esta reaçäo näo foi comprovada matematicamente (p = 0,07). Segundo ainda esse modelo, as variáveis sexo e concentraçäo de flúor na água näo interferem no comportamento da fluorose; entretanto, as crianças subnutridas apresentam

Microabrasäo do esmalte como tratamento estético da fluorose dentária / Enamel microabrasion as an aesthetic treatment for dental fluorosis

Os autores relatam um caso de fluorose dentária causada pela utilizaçäo inadequada de fluoreto sistêmico em gotas, acometendo todos os dentes permanentes e com grande comprometimento da estética. Descrevem o tratamento empregado, a microabrasäo do esmalte com ácido clorídrico e pedra pomes, após breve revisäo de literatura sobre esta técnica

Endemic fluorosis presenting as cervical cord compression.

Neurological involvement in fluorosis occurs in the advanced stage of the disease and is due to compression of the spinal cord and/or nerve roots. There are only a few reports on the role of surgical management of these cases in the medical literature. Five cases of fluorosis from the endemic areas of Uttar Pradesh, India, had associated cervical cord compression. Their mean age was 43 yr (range 35-50), and all cases were manual laborers. Three patients with blocked cervical subarachnoid space on myelography underwent laminectomy using local anesthesia. All three cases improved significantly after surgery. The usefulness of laminectomy in selected cases of cervical cord compression due to fluorosis is suggested.

Neurosurgery in India.

This is a brief account of Neurosurgery in India. Prior to 1949, Neurosurgery was being practised by General Surgeons. With the return of Professor Jacob Chandy to the Christian Medical College, Vellore in 1949 modern neurosurgery was born and progressed, and today there are more than 180 neurosurgeons in India. Even so, the ratio works out to one neurosurgeon for every 3,600,000 individuals! Conditions commonly encountered such as hydrocephalus, craniovertebral anomalies, pyogenic, fungal and tuberculous infections of the central nervous system, and fluorosis are being discussed. Stereotaxic surgery for pain, epilepsy, behaviour disorders and involuntary movements is being practised at several centres especially at Madras. Following the workshops conducted by Professor Pia and his co-worker Professor Grote , enthusiasm for microneurosurgery has waxed.

Dental fluorosis associated with hereditary diabetes insipidus.

Among the characteristics of hereditary pituitary diabetes insipidus are polydipsia and polyuria from early infancy. Drinking of large amounts of water, even with lower than accepted fluoride content, can produce fluorosis of the teeth. A mother and her four children affected by this disorder presented different degrees of fluorosis directly related to the stage at which hormonal therapy was introduced.