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Abstract Treatment of oral vascular anomalies (OVA) has focused on minimally invasive techniques rather than radical surgery. We investigated the efficacy and safety of diode laser using the photocoagulation technique in the management of OVA. Forty-seven subjects with OVA were treated with forced dehydration with induced photocoagulation (FDIP) using diode laser (808 nm/4.5 W). This series consisted mostly of male (63.8%) and non-white (63.8%) patients with a mean age of 57.4 years. Varices (91.5%), venous malformations (6.4%), and hemangiomas (2.1%) with a mean size of 7.1 (±4.9) mm were the conditions treated. OVA presented as a nodular lesion (63.8%) involving mainly the lower lip (46.8%). Pulsed laser mode was used as standard and the number of applications varied from one to four sessions, with the majority requiring only one (83%) FDIP session. Kaplan-Meier analysis revealed that complete clinical healing can occur on the 15th day (n=9/29.5%), followed by the 20th (n=6/45.5%), and 30th (n=7/70.5%) days. Postoperative edema was observed in 31 (66%) patients, and recurrence of the lesion occurred in two (4.2%). Based on the data on complete clinical healing, minimal patient discomfort, and satisfactory esthetic results, we can confirm that FDIP by diode laser is a promising candidate for the safe and efficacious treatment of OVA.
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Abstract Introduction In chronic arthropathies, there are several mechanisms of joint destruction. In recent years, studies have reported the implication of receptor activator of nuclear factor kappa-B ligand (RANKL) and osteoprotegerin (OPG) in the process of activation and differentiation of osteoclasts, a key cell in the development of bone erosion. The RANKL/OPG ratio is increased in the serum of patients with malignant diseases and lytic bone disease, as well as rheumatoid arthritis (RA). The objective of this study was to measure and compare the concentrations of OPG and RANKL in the synovial fluid (SF) of patients with rheumatoid arthritis, spondyloarthritis (SpA) and osteoarthritis (OA). Methods This was an observational and cross-sectional study with 83 patients, 33 with RA, 32 with SpA and 18 with OA, followed up regularly in the outpatient clinics of the Rheumatology Department of the Clinics Hospital of the Ribeirão Preto Medical School-USP. All patients were assessed for indications for arthrocentesis by the attending physicians at the time of SF collection and were evaluated for demographic variables and medication use. Disease activity was assessed in individuals with RA and SpA. The quantification of SF OPG and RANKL levels was performed by ELISA, and the correlations of the results with clinical, laboratory and radiological parameters were assessed. Results We found no statistically significant difference in the RANKL and OPG levels among the groups. Patients with RA showed a positive correlation between the SF cell count and RANKL level (r = 0.59; p < 0.05) and the RANKL/ OPG ratio (r = 0.55; p < 0.05). Patients with OA showed a strong correlation between C-reactive protein (CRP) and the RANKL/OPG ratio (r = 0.82; p < 0.05). There was no correlation between the OPG and RANKL levels and markers of inflammatory activity or the disease activity index in patients with RA or SpA. Conclusion Within this patient cohort, the RANKL/OPG ratio was correlated with the SF cell count in patients with RA and with serum CRP in patients with OA, which may suggest a relationship with active inflammation and more destructive joint disease.
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Abstract: Bone quality is an important issue in dentistry. Low bone density may be associated with more severe periodontitis, and may influence implant therapy success. Recent evidence suggests that physical activity can improve alveolar bone quality. Irisin is an exercise-mediated peptide that might be involved in this process. We assessed the effect of exercise and that of intra-peritoneal irisin administration on bone quality in healthy and osteoporosis-induced rodents. This study was registered at PROSPERO (CRD42020184140), and followed PRISMA guidelines. A search by two independent examiners was conducted in five databases and gray literature up to July 2021, without restrictions regarding language or date of publication. Initially, they analyzed retrieved titles and abstracts (n=3,844) based on eligibility criteria. Of this total, 19 studies remained for full-text reading, and 16 proceeded to the data extraction and quality assessment phases. Meta-analyses were conducted (n= 6 studies) to establish the effects of irisin administration on cancellous bone mineral density (BMD). Exercise or irisin administration enhanced bone quality, but the meta-analysis showed that BMD increased only slightly in osteoporotic rodents (BMD: mean difference 0.03 mg/cm3 - 95% CI 0.01-0.05). This indicates that they had no significant benefits on the bones of healthy animals. Implications of key findings evidence the potential of irisin as an agent able to mitigate bone loss caused by osteoporosis, an outcome that could favor dental rehabilitation. More studies investigating the effect of irisin on alveolar bone are needed to elucidate its therapeutic viability and implications.
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Abstract We evaluated the accuracy of radiomorphometric indices (RI) and fractal dimension (FD) for screening bone mineral density (BMD) in postmenopausal patients who had breast cancer and were using aromatase inhibitors (AI). The sample consisted of 40 participants. Digital panoramic radiography (DPR) and cone beam computed tomography (CBCT) were evaluated along with dual-energy X-ray absorptiometry (DXA), which is the gold standard for detecting low BMD. According to the T-scores of DXA, the subjects were assigned into two groups: with normal BMD and with low BMD (osteopenia and osteoporosis). The area under the curve (AUC), sensitivity, and specificity with their respective confidence intervals were determined for DPR and CBCT. For DPR indices, AUC ranged from 52.6 to 75.8%. The mandibular cortical width (MCW) had the highest AUC. For FD, the total trabecular index had the highest sensitivity, while the index anterior to the mental foramen (MF) had the highest specificity. In CBCT, the AUC ranged from 51.8 to 62.0%. The indices with the highest AUC were the molar (M) and anterior (A). The symphysis (S) index had the highest sensitivity and the posterior (P) index had the highest specificity. Sensitivity and specificity were adequate for the computed tomography index (Inferior; CTI [I]). Therefore, MCW, FD of the mandible angle, and total trabecular ROI in DPR and the CTI (I), M, P, and A indices in CBCT proved to be promising tools in distinguishing individuals with low BMD. Cutoff point for these indices could be a useful tool to investigate low BMD in postmenopausal women taking AI.
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Abstract Periodontal diseases (PD) are inflammatory conditions that affect the teeth supporting tissues. Increased body fat tissues may contribute to activation of the systemic inflammatory response, leading to comorbidities. Some studies have shown that individuals with obesity present higher incidence of PD than eutrophics. Objective: To investigate the impact of obesity on periodontal tissues and oral microbiota in mice. Methodology: Two obesity mice models were performed, one using 12 weeks of the dietary protocol with a high-fat (HF) diet in C57BL/6 mice and the other using leptin receptor-deficient mice (db/db-/-), which became spontaneously obese. After euthanasia, a DNA-DNA hybridization technique was employed to evaluate the microbiota composition and topical application of chlorhexidine (CHX), an antiseptic, was used to investigate the impact of the oral microbiota on the alveolar bone regarding obesity. Results: Increased adipose tissue may induce alveolar bone loss, neutrophil recruitment, and changes in the oral biofilm, similar to that observed in an experimental model of PD. Topical application of CHX impaired bone changes. Conclusion: Obesity may induce changes in the oral microbiota and neutrophil recruitment, which are associated with alveolar bone loss.
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Abstract The coronavirus disease (COVID-19) has been prioritized in relation to other illnesses considered critical, such as cancer, cardiovascular diseases/stroke, diabetes, and autoimmune diseases. The management of patients with these diseases involves dental care to reduce systemic complications caused by odontogenic infections, and/or to treat oral manifestations of systemic comorbidities. In this regard, the dental care of these individuals must be guaranteed during the pandemic. Although a high risk of exposure to and catching of COVID-19 is expected to befall dental professionals, biosafety guidelines reduce the likelihood of infection. Thus, the current scenario poses challenges, and offers decision-making approaches and tools that facilitate the management of individuals with oral manifestations of chronic and/or critical diseases, using hospital-based services. This article presents an overview for hospital service providers who are at the forefront of COVID-19 care, including a secure protocol, and clinical guidelines based on the experience of the Hospital das Clínicas in Belo Horizonte, a public referral service, supported by the Brazilian National Health System.
Subject(s)
Humans , Pandemics , COVID-19 , Brazil/epidemiology , Dental Care , SARS-CoV-2 , HospitalsABSTRACT
Abstract Head and neck radiotherapy causes quantitative and qualitative changes in saliva. The objective of this case-control study was to evaluate the salivary biomarkers associated with bone remodeling and tissue repair in patients submitted to radiotherapy for head and neck cancer treatment, compared with non-irradiated individuals. Total unstimulated saliva was collected for ELISA assay analysis of receptor activator for nuclear factor κ B (RANK) and its ligand (RANK-L), osteoprotegerin, matrix metalloproteinase-9/ tissue inhibitor of metalloproteinase-2, vascular endothelial growth factor, and epidermal growth factor. Statistics were performed, and revealed that salivary RANK (p = 0.0304), RANK-L (p = 0.0005), matrix metalloproteinase-9/ tissue inhibitor of metalloproteinase-2 (p = 0.0067), vascular endothelial growth factor (p = 0.0060), and epidermal growth factor (p < 0.0001) were reduced in patients, compared with the control group. Osteoprotegerin did not differ between the groups (p = 0.3765). Salivary biomarkers did not differ according to radiotherapy completion time (p > 0.05). In conclusion, the lower output of the salivary molecules - essential for bone remodeling and tissue repair - may disrupt tissue homeostasis and play a role in the pathogenesis of the radiotherapy-induced deleterious effects in the oral cavity.
Subject(s)
Humans , Bone Remodeling , Head and Neck Neoplasms/radiotherapy , Saliva , Case-Control Studies , Tissue Inhibitor of Metalloproteinase-2 , Vascular Endothelial Growth Factor A , Epidermal Growth Factor , RANK LigandABSTRACT
Abstract Objective The aim of this study was to evaluate the levels of salivary biomarkers IL-1β, IL-10, RANK, OPG, MMP-2, TG-β and TNF-α in individuals with diagnosis of peri-implant mucositis in the absence or presence of periodontal and peri-implant maintenance therapy (TMPP) over 5 years. Material and Methods Eighty individuals diagnosed with peri-implant mucositis were divided into two groups: one group that underwent periodontal and peri-implant regularly maintenance therapy, called GTP (n=39), and a second group that received no regular maintenance GNTP (n=41). Each participant underwent a complete periodontal and peri-implant clinical examination. Collection of saliva samples and radiographic examination to evaluate peri-implant bone levels were conducted at two times: initial examination (T1) and after 5 years (T2). The salivary samples were evaluated through ELISA for the following markers: IL-1β, IL-10, RANK, OPG, MMP-2, TGF and TNF-α. Results A higher incidence of peri-implantitis was observed in the GNTP group (43.9%) than in the GTP group (18%) (p=0.000). All individuals (n=12) who presented peri-implant mucositis and had resolution at T2 were in the GTP group. After 5 years, there was an increase in the incidence of periodontitis in the GNTP group compared to the GTP group (p=0.001). The results of the study revealed an increase in the salivary concentration of TNF-α in the GNTP group compared to the GTP group. The other salivary biomarkers that were evaluated did not show statistically significant differences between the two groups. Conclusions The salivary concentration of TNF-α was increased in individuals with worse periodontal and peri-implant clinical condition and in those with a higher incidence of peri-implantitis, especially in the GNTP group. Longitudinal studies in larger populations are needed to confirm these findings and elucidate the role of this biomarker in peri-implant disease.
Subject(s)
Humans , Periodontitis/pathology , Saliva/chemistry , Stomatitis/pathology , Dental Implants/adverse effects , Cytokines/analysis , Receptor Activator of Nuclear Factor-kappa B/analysis , Osteoprotegerin/analysis , Periodontitis/diagnosis , Reference Values , Stomatitis/diagnosis , Enzyme-Linked Immunosorbent Assay , Biomarkers/analysis , Case-Control Studies , Risk Factors , Follow-Up Studies , Statistics, Nonparametric , Disease ProgressionABSTRACT
Abstract Objectives: Dental composites release unreacted resin monomers into the oral environment, even after polymerization. Periodontal cells are, therefore, exposed to substances that potentially elicit the immune inflammatory response. The underlying molecular mechanisms associated with the interaction between resin monomers and human immune cells found in the gingival crevicular fluid are not fully understood yet. This study investigated the ability of bisphenol A-glycidyl methacrylate (BISGMA), urethane dimethacrylate (UDMA) and triethylene glycol dimethacrylate (TEGDMA) to induce apoptosis and cytokine release by human leukocytes stimulated with a periodontal pathogen. Methodology: Peripheral blood mononuclear cells (PBMC) from 16 healthy individuals were included in this study. To determine the toxicity, the PBMC were incubated for 20 hours, with monomers, for the analysis of cell viability using MTT assay. To evaluate cell death in the populations of monocytes and lymphocytes, they were exposed to sub-lethal doses of each monomer and of heat-inactivated Porphyromonas gingivalis (P. gingivalis) for 5 hours. Secretions of IL-1β, IL-6, IL-10 and TNF-α were determined by ELISA after 20 hours. Results: UDMA and TEGDMA induced apoptosis after a short-time exposure. Bacterial challenge induced significant production of IL-1β and TNF-α (p<0.05). TEGDMA reduced the bacterial-induced release of IL-1β and TNF-α, whereas UDMA reduced IL-1β release (p<0.05). These monomers did not affect IL-10 and IL-6 secretion. BISGMA did not significantly interfere in cytokine release. Conclusions: These results show that resin monomers are toxic to PBMC in a dose-dependent manner, and may influence the local immune inflammatory response and tissue damage mechanisms via regulation of bacterial-induced IL-1β and TNF-α secretion by PBMC.
Subject(s)
Humans , Polyethylene Glycols/pharmacology , Polymethacrylic Acids/pharmacology , Polyurethanes/pharmacology , Leukocytes, Mononuclear/drug effects , Cytokines/metabolism , Bisphenol A-Glycidyl Methacrylate/pharmacology , Porphyromonas gingivalis/physiology , Methacrylates/pharmacology , Reference Values , Time Factors , Enzyme-Linked Immunosorbent Assay , Leukocytes, Mononuclear/metabolism , Cell Survival/drug effects , Reproducibility of Results , Analysis of Variance , Cytokines/analysis , Cytokines/drug effects , Apoptosis/drug effects , Statistics, Nonparametric , NecrosisABSTRACT
Abstract There are few studies on the clinical and immunological periodontal status of intensive care unit (ICU) in-patients. The aim of the present study was to evaluate the periodontal condition among ICU in-patients through clinical and immunological periodontal parameters. From the sample of 373 hospitalized ICU patients, 182 were submitted' to a thorough clinical periodontal and immunological evaluation. Data on bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL) were collected and gingival sulcular fluid samples were quantified through ELISA on IL-1, IL-6, and MMP-2 for immunological evaluation. Data was statistically analyzed by Chi-square, Fisher's exact, Mann-Whitney tests, and Sperman's correlation and multivariate logistic regression analysis. A high dental plaque index and a high prevalence of periodontitis (48.3%), mostly in moderate and localized chronic form, were observed. Individuals with periodontitis presented higher levels of IL-1 and MMP-2, while individuals with cardiovascular disease (CVD) and individuals with two or more systemic diseases (MSD) presented higher levels of IL-1; diabetes mellitus (DM) and MSD individuals presented higher levels of IL-6. A positive association was found between the severity of periodontitis and CVD (OR 2.2; CI = 1.11-4.42). This study reported a 48.3% of the prevalence of periodontitis in ICU patients and a positive association between the severity of periodontitis and CVD. Additionally, higher levels of IL-1 and MMP-2 were found in individuals with periodontitis, higher levels of IL-6 were found in individuals with DM, and higher levels of IL-1 were found in individuals with CVD.
Resumo Existem poucos estudos sobre o estado clínico periodontal e imunológico de pacientes em unidade de terapia intensiva (UTI). O objetivo do presente estudo foi avaliar a condição periodontal entre os pacientes internados na UTI através de parâmetros clínicos periodontais e imunológicos. De uma amostra inicial de 373 pacientes internados em UTI, 183 foram submetidos a exame periodontal completo e análise imunológica. Os dados sobre o sangramento na sondagem (BOP), profundidade de sondagem (PD) e nível clínico de inserção (CAL) foram coletados e as amostras de fluido sulcular gengival foram quantificadas para avaliação imunológica através de ELISA para IL-1, IL-6 e MMP-2. Os dados foram analisados estatisticamente pelos testes de Qui-quadrado, exato de Fischer, Mann-Whitney, correlação de Sperman e análise de regressão logística multivariada. Foi observado um alto índice de placa dental e uma alta prevalência de periodontite (48,3%), principalmente na forma crônica moderada e localizada. Os indivíduos com periodontite apresentaram níveis mais altos de IL-1 e MMP-2, enquanto indivíduos com doença cardiovascular (CVD) e com mais de duas doenças sistêmicas (MSD) apresentaram níveis mais altos de IL-1 e os com diabetes mellitus (DM) e MSD apresentaram níveis mais elevados de IL-6. Foi encontrada associação positiva entre a gravidade da periodontite e CVD (OR 2.2; IC = 1,11-4,42). Este estudo reportou uma prevalência de periodontite em 48.3% dos pacientes em UTI e uma associação positiva entre ocorrência de periodontite e CVD. Além disso, níveis mais elevados de IL-1 e MMP-2 foram encontrados em indivíduos com periodontite, de IL-6 em indivíduos com DM e de IL-1 em indivíduos com CVD.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Periodontal Diseases/complications , Periodontal Diseases/immunology , Inpatients , Intensive Care Units , Periodontal Diseases/pathology , Periodontal Pocket/immunology , Respiratory Tract Diseases/complications , Cardiovascular Diseases/complications , Periodontal Index , Dental Plaque Index , Cross-Sectional Studies , Gingival Crevicular Fluid/metabolism , Interleukin-6/metabolism , Interleukin-1/metabolism , Periodontal Attachment Loss/immunology , Matrix Metalloproteinase 2/metabolism , Diabetes ComplicationsABSTRACT
Abstract Osteoporosis is an insidious and increasingly prevalent disease that can cause fractures and affect patients' quality of life. The current study comparatively evaluates patients with and without loss of bone mass in terms of salivary calcium, viscosity, and pH. A controlled cross-sectional study was conducted in two groups of 32 postmenopausal women subjected to a bone densitometry scan and later referred for dental management at the Federal University of Minas Gerais, Brazil. The patients were assigned to two groups: Group 1 - patients with low bone mineral density (BMD) and Group 2 - patients without bone mineral changes. The following salivary parameters were evaluated: calcium concentration, flow rate, viscosity, pH, and average total protein. An oral examination was performed for assessment of DMFT variables and tongue coating. Data were analyzed using descriptive and inferential statistics, adopting a p-value < 0.05. The patients' mean age was 60 years (± 7.35). Salivary flow, pH, and viscosity were similar among the groups. Average total protein was 14.8 mg/mL and 19.0 mg/mL in Groups 1 and 2, respectively. Tongue coating and salivary calcium levels were significantly higher in Group 1 (p < 0.001). Salivary calcium is an important screening tool and may eventually be used for the diagnosis of bone mineral changes.
Subject(s)
Humans , Female , Aged , Saliva/chemistry , Osteoporosis, Postmenopausal/physiopathology , Osteoporosis, Postmenopausal/metabolism , Calcium/analysis , Oral Health , Reference Values , Tongue/physiopathology , Viscosity , Proteins/analysis , Absorptiometry, Photon , Bone Density/physiology , Case-Control Studies , DMF Index , Cross-Sectional Studies , Statistics, Nonparametric , Hydrogen-Ion Concentration , Middle AgedABSTRACT
ABSTRACT Objective: To evaluate the influence of periodontal treatment on rheumatoid arthritis activity. Methods: MEDLINE/PUBMED, The Cochrane Library, Clinical Trials, SciELO and LILACS were searched for studies published until December 2014. Included articles were: prospective studies; including patients older than 18 years, diagnosed with periodontitis and rheumatoid arthritis submitted to non-surgical periodontal treatment; with a control group receiving no periodontal treatment; with outcomes including at least one marker of rheumatoid arthritis activity. Methodological quality of the studies was assessed using PEDro scale. Quantitative data were pooled in statistical meta-analysis using Review Manager 5. Results: Four articles were included. Non-surgical periodontal treatment was associated with a significant reduction of DAS28 (OR: -1.18; 95% CI: -1.43, -0.93; p < 0.00001). Erythrocyte sedimentation rate, C-reactive protein, patient's assessment of rheumatoid activity using visual analogical scale, tender and swollen joint counts showed a trend toward reduction (not statistically significant). Conclusions: The reduction of DAS 28 in patients with rheumatoid arthritis after periodontal treatment suggests that the improvement of periodontal condition is beneficial to these patients. Further randomized controlled clinical trials are necessary to confirm this finding.
RESUMO Objetivo: Avaliar a influência do tratamento periodontal sobre a atividade da doença na artrite reumatoide. Métodos: Pesquisaram-se as bases de dados Medline/PubMed, The Cochrane Library, Clinical Trials, SciELO e Lilacs em busca de estudos publicados até dezembro de 2014. Incluíram-se estudos prospectivos que avaliaram pacientes com mais de 18 anos diagnosticados com periodontite e artrite reumatoide submetidos a tratamento periodontal não cirúrgico; os estudos deveriam ter também um grupo controle não submetido a tratamento periodontal. Os resultados dos estudos deveriam contar com pelo menos um marcador da atividade da doença na artrite reumatoide. A qualidade metodológica dos estudos foi avaliada com a escala PEDro. Reuniram-se os dados quantitativos em uma metanálise estatística com o uso do Review Manager 5. Resultados: Incluíram-se quatro artigos. O tratamento periodontal não cirúrgico esteve associado a uma redução significativa no DAS-28 (OR: -1,18; IC 95%: -1,43 a -0,93; p < 0,00001). A velocidade de hemossedimentação, a proteína C-reativa, a avaliação da atividade reumatoide pela escala visual analógica e as contagens de articulações sensíveis e inchadas apresentaram uma tendência de redução (não estatisticamente significativa). Conclusões: A redução no DAS-28 em pacientes com artrite reumatoide após tratamento periodontal sugere que a melhoria na condição periodontal é benéfica a esses pacientes. São necessários mais ensaios clínicos randomizados controlados para confirmar esse achado.
Subject(s)
Humans , Periodontal Diseases/therapy , Arthritis, Rheumatoid/complications , Periodontal Diseases/etiology , Arthritis, Rheumatoid/diagnosis , Arthritis, Rheumatoid/blood , Severity of Illness Index , Biomarkers/blood , Treatment OutcomeABSTRACT
Abstract Periodontitis can contribute to the development of insulin resistance. Gestational diabetes is a risk factor for type 2 diabetes. Therefore, periodontitis, when associated with gestational diabetes, could increase the risk for the development of type 2 diabetes after pregnancy. Objective The aim of this study was to verify the incidence on the development of type 2 diabetes in women with previous gestational diabetes with and without periodontitis after a three-year time interval. Material and Methods Initial sample of this follow-up study consisted of 90 women diagnosed with gestational diabetes who underwent periodontal examination. After three years, 49 women were subjected to new periodontal examination and biological, behavioral, and social data of interest were collected. Additionally, the quantification of the C-reactive protein in blood samples was performed. Fasting glucose and glycated hemoglobin levels were requested. Saliva samples were collected for quantification of interleukin 6 and 10, tumor necrosis factor α, matrix metalloproteinase 2 and 9. Results The incidence of type 2 diabetes mellitus was 18.4% and of periodontitis was 10.2%. There was no significant difference in the incidence of type 2 diabetes mellitus among women with and without periodontitis. It was observed impact of C-reactive protein in the development of type 2 diabetes mellitus. However, it was not observed impact of periodontitis on the development of type 2 diabetes mellitus among women with previous gestational diabetes. Conclusions It was not observed impact of periodontitis on the development of type 2 diabetes among women with previous gestational diabetes. The impact of C-reactive protein in the development of type 2 diabetes mellitus highlights the importance of an inflammatory process in the diabetes pathogenesis.
Subject(s)
Humans , Female , Pregnancy , Adult , Periodontitis/epidemiology , Diabetes, Gestational/epidemiology , Diabetes Mellitus, Type 2/epidemiology , Periodontitis/complications , Periodontitis/metabolism , Reference Values , Saliva/chemistry , Time Factors , Blood Glucose/analysis , Brazil/epidemiology , C-Reactive Protein/analysis , Glycated Hemoglobin/analysis , Epidemiologic Methods , Risk Factors , Interleukin-6/analysis , Tumor Necrosis Factor-alpha/analysis , Interleukin-10/analysis , Diabetes, Gestational/metabolism , Matrix Metalloproteinase 2/analysis , Matrix Metalloproteinase 9/analysis , Diabetes Mellitus, Type 2/etiology , Diabetes Mellitus, Type 2/metabolismABSTRACT
Little is known about whether midazolam sedation can reduce salivary cortisol levels and consequently influence children’s behaviour during dental treatment. The aim of this study was to evaluate the effect of midazolam sedation on salivary cortisol and its correlation with children’s behaviour during restorative dental treatment. Eighteen healthy children, aged two to five years, were randomly assigned to two dental treatment appointments, both with physical restraint: oral midazolam 1 mg/kg (MS) and placebo (PS). An observer assessed the children’s behaviour (videos) using the Ohio State University Behavioral Rating Scale (OSUBRS). The children’s saliva was collected just after waking up, on arrival at the dental school, 25 minutes after local anaesthesia, and 25 minutes after the end of the procedure. Salivary cortisol levels were determined using the enzyme-linked immunoabsorbent assay. The data were analysed by bivariate tests and multivariate analysis of variance (5% level). Salivary cortisol levels were lower in the MS group than in the PS group at the time of anaesthesia (p = 0.004), but did not vary during the appointment within sedation (p = 0.319) or placebo (p = 0.080) groups. Children’s behaviour was negative most of the time and did not differ between MS and PS; however, the behaviour (OSUBRS) did not correlate with salivary cortisol levels. Oral midazolam is able to control salivary cortisol levels during dental treatment of pre-schoolers, which might not lead to better clinical behaviour.
Subject(s)
Child, Preschool , Female , Humans , Male , Anesthesia, Local/methods , Child Behavior/drug effects , Hydrocortisone/analysis , Hypnotics and Sedatives/administration & dosage , Midazolam/administration & dosage , Saliva/chemistry , Administration, Oral , Analysis of Variance , Dental Anxiety/prevention & control , Dental Care for Children/methods , Movement/drug effects , Reproducibility of Results , Statistics, Nonparametric , Saliva/drug effects , Time Factors , Treatment OutcomeABSTRACT
Some studies have linked the presence of chemokines to the early stages of Alzheimer's disease (AD). Then, the identification of these mediators may contribute to diagnosis. Our objective was to evaluate the levels of beta-amyloid (BA), tau, phospho-tau (p-tau) and chemokines (CCL2, CXCL8 and CXCL10) in the cerebrospinal fluid (CSF) of patients with AD and healthy controls. The correlation of these markers with clinical parameters was also evaluated. The levels of p-tau were higher in AD compared to controls, while the tau/p-tau ratio was decreased. The expression of CCL2 was increased in AD. A positive correlation was observed between BA levels and all chemokines studied, and between CCL2 and p-tau levels. Our results suggest that levels of CCL2 in CSF are involved in the pathogenesis of AD and it may be an additional useful biomarker for monitoring disease progression.
Alguns estudos têm relacionado a presença de quimiocinas com estágios iniciais da doença de Alzheimer (ALZ). A identificação desses mediadores pode contribuir para um diagnóstico precoce. O objetivo deste estudo foi avaliar os níveis de beta-amiloide (BA), tau, fosfo-tau (p-tau) e quimiocinas (CCL2, CXCL8 e CXCL10) no líquido cefalorraquidiano dos pacientes com ALZ e controles saudáveis e a correlação destes marcadores com parâmetros clínicos. Os níveis de p-tau foram maiores nos pacientes com ALZ em relação aos controles, enquanto a razão tau/p-tau foi menor. Houve um aumento significativo de CCL2. Uma correlação positiva foi encontrada entre os níveis de BA e todas as quimiocinas estudadas e também entre os níveis de CCL2 e p-tau. Nossos resultados sugerem que a presença de CCL2 está envolvida na patogênese da ALZ e que esta quimiocina pode ser um marcador adicional para monitorar a progressão da doença.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Alzheimer Disease/cerebrospinal fluid , Amyloid beta-Peptides/cerebrospinal fluid , Chemokines/cerebrospinal fluid , tau Proteins/cerebrospinal fluid , Alzheimer Disease/diagnosis , Biomarkers/cerebrospinal fluid , /cerebrospinal fluid , /cerebrospinal fluid , Disease Progression , /cerebrospinal fluid , Prospective StudiesABSTRACT
O perfil dos pacientes que procuram tratamento ortodôntico mudou nas últimas décadas. O número de pacientes adultos e idosos do sexo feminino cresceu consideravelmente. Esta mudança na demanda trouxe desafios biológicos para o atendimento ortodôntico, por muitas vezes tratarem-se de pacientes com alterações sistêmicas ou sob uso de medicamentos controlados. Dentre estes, podese citar a deficiência de estrógeno e a osteoporose, comuns nessa faixa etária, e que podem interferir na movimentação dentária ortodôntica (MDO). Esta revisão de literatura se propõe a descrever os aspectos biológicos da movimentação ortodôntica e a identificar como a deficiência de estrógeno e a osteoporose podem interferir na remodelação óssea e, consequentemente, na MDO. Este artigo objetiva ainda alertar o ortodontista da importância de se avaliar cuidadosamente a condição sistêmica dos pacientes com possível deficiência de estrógeno/osteoporose, para um correto diagnóstico e elaboração do plano de tratamento.
An increasing number of adult patients are seeking for orthodontic treatment in the last decades, especially postmenopausal women. This represents a biological challenge for the orthodontic treatment, since these patients more often present systemic disorders or are routinely using controlling medication. Among them, estrogen deficiency and osteoporosis are commonly reported in elderly women. This review article elucidates the biological aspects of orthodontic tooth movement, emphasizing how the estrogen deficiency may interfere with this process. This literature review suggests that estrogen deficiency and the use of drugs for osteoporosis treatment may alter the bone remodeling and, consequently, the orthodontic tooth movement. The orthodontist must be aware of the patients systemic condition to better elaborate the correct treatment plan.
Subject(s)
Estradiol , Tooth Movement Techniques , OsteoporosisABSTRACT
Chromoblastomycosis (CR) is a subcutaneous chronic mycosis characterized by a granulomatous inflammatory response. However, little is known regarding the pattern of leukocyte subsets in CR and the pathways involved in their recruitment. The objective of this study was to assess the cellular subsets, chemokine, chemokine receptors and enzymes in CR. The inflammatory infiltrate was characterized by immunohistochemistry using antibodies against macrophages (CD68), Langerhans'cells (S100), lymphocytes (CD3, CD4, CD8, CD45RO, CD20 and CD56) and neutrophils (CD15). The expression of MIP-1alpha (Macrophage inflammatory protein-1alpha), chemokine receptors (CXCR3 and CCR1) and enzymes (superoxide dismutase-SOD and nitric oxide synthase-iNOS) was also evaluated by the same method. We observed an increase in all populations evaluated when compared with the controls. Numbers of CD15+ and CD56+ were significantly lower than CD3+, CD4+, CD20+ and CD68+ cells. Statistical analysis revealed an association of fungi numbers with CD3, CD45RO and iNOS-positive cells. Furthermore, MIP-1alpha expression was associated with CD45RO, CD68, iNOS and CXCR3. Our results suggest a possible role of MIP-1alpha and fungi persistence in the cell infiltration in CR sites.
A cromomicose é micose subcutânea crônica sistêmica caracterizada por resposta inflamatória crônica granulomatosa. No entanto, existem poucos dados a respeito do padrão de subtipos de leucócitos na cromomicose e sobre as vias envolvidas no recrutamento destas células. O objetivo deste trabalho foi avaliar os tipos celulares, bem como a expressão de quimiocinas, receptores de quimiocinas e enzimas em lesões de cromomicose. O infiltrado inflamatório foi caracterizado por meio de técnica imuno-histoquímica utilizando os seguintes marcadores CD68 (macrófagos), S100 (células de Langerhans), CD3, CD4, CD8, CD45RO, CD20 e CD56 (linfócitos) e CD15 (neutrófilos). A expressão de MIP-1alfa (Proteína Inflamatória do Macrófago-1alfa), receptores de quimiocinas (CXCR3 e CCR1) e enzimas (superóxido dismutase-SOD e óxido nítrico sintase induzida-iNOS) foi avaliada pelo mesmo método. Observou-se um aumento de todas as populações celulares avaliadas em relação às amostras controle. As populações de células CD15+ e CD56+ foram significativamente menores que células CD3+, CD4+, CD20+ e CD68+. A análise estatística revelou uma correlação positiva entre o número de fungos com as células CD3, CD45RO e iNOS-positivas. A expressão de MIP-1alfa foi também associada às populações de células CD45RO, CD68, iNOS e CXCR3 positivas. Nossos resultados apontam para um possível papel de MIP-1alfa e da persistência fúngica na infiltração de células inflamatórias nos sítios de cromomicose.
Subject(s)
Humans , Middle Aged , Chromoblastomycosis/immunology , Macrophage Inflammatory Proteins , Receptors, Chemokine/immunology , Biomarkers , Blood Cell Count , Case-Control Studies , Chromoblastomycosis/enzymology , Immunity, Cellular , Immunohistochemistry , Langerhans Cells/immunology , Lymphocytes/immunology , Macrophages/immunology , Neutrophils/immunology , Nitric Oxide Synthase/immunology , Superoxide Dismutase/immunologyABSTRACT
Pilomatricomas são tumores relativamente raros de origem ectodérmica a partir das células da bainha externa do folículo piloso. Estes se apresentam geralmente como nódulos dérmicos ou subcutâneos, usualmente assintomáticos, solitários, firmes ou duros e extremamente móveis. O objetivo deste artigo é apresentar um caso que ilustra a dificuldade de diagnóstico encontrada pelos cirurgiões e patologistas bucais e apresentar uma revisão da literatura relativa aos pilomatricomas da região auricular.
Subject(s)
Adult , Female , Humans , Hair Diseases/diagnosis , Pilomatrixoma/diagnosis , Skin Neoplasms/diagnosis , Ear, External , Hair Diseases/pathology , Pilomatrixoma/pathology , Skin Neoplasms/pathologyABSTRACT
Após a mineralizaçäo, as moléculas de dentina permanecem imobilizadas pela fase mineral da matriz, sendo expostas ou liberadas como conseqüência de danos ao ligamento periodontal e à polpa. Uma vez liberadas, estas moléculas poderiam participar na migraçäo e ativaçäo de células ósseas e inflamatórias influenciando o curso dos processos associados à dissoluçäo da matriz dentinária. Com o objetivo de avaliar a capacidade da dentina em induzir eventos inflamatórios, verificamos o efeito de extratos brutos na liberaçäo in vitro de mediadores inflamatórios por macrófagos e osteoblastos. Avaliamos ainda, a capacidade de extratos brutos e das Sialoproteína (DSP) e Fosfoproteína (DPP) dentinárias em induzir quimiotaxia de neutrófilos in vivo e caracterizamos os mediadores envolvidos neste processo. Os extratos dentinários induziram osteoblastos a produzir IL-1 , TNF- , IL-6, CINC-1 e IL-10, sem interferir com a morfologia e a diferenciaçäo destas células. Os extratos dentinários, a DSP e a DPP induziram macrófagos a produzir IL-1 , TNF- e as quimiocinas MIP-1 , KC e MIP-2, bem como estimularam a migraçäo de leucócitos de maneira dose-dependente. A investigaçäo dos mecanismos envolvidos revelou a participaçäo de IL-1 , TNF- , KC e MIP-2 e excluiu a participaçäo de prostaglandinas, leucotrienos e MIP-1 na migraçäo leucocitária. Observamos ainda que macrófagos e mastócitos respectivamente estimulam e inibem o recrutamento de neutrófilos induzido por DSP e DPP e que macrófagos estimulados in vitro produzem fator(es) quimiotático(s) para neutrófilos. A partir destes resultados, podemos concluir que a dentina é capaz de estimular a produçäo de mediadores inflamatórios, com reconhecida atividade sobre osteoclastos, por células osteoblásticas e macrófagos in vitro. Os mecanismos pelos quais as proteínas dentinárias induzem migraçäo de neutrófilos in vivo säo indiretos e dependentes de IL-1 , TNF- e das quimiocinas KC e MIP-2, sendo modulados por macrófagos e mastócitos
Subject(s)
Humans , Dentin , In Vitro Techniques , Macrophages , Osteoblasts , Phosphoproteins/adverse effects , Molar, Third , Pathology, Oral , Sialoglycoproteins/adverse effectsABSTRACT
O presente estudo visou analisar informaçöes sobre fatores de comportamento de adolescentes acerca de sua higiene bucal. Os dados obtidos foram coletados através de entrevistas realizadas em duas escolas, uma publica e uma particular, pertencentes a um mesmo bairro da cidade de Belo Horizonte MG- Brasil. A amostra constou de 117 adolescentes de ambos os sexos, com idades variando entre 14 e 17 anos. Os resultados indicaram que, indiferente à classe social e ao sexo, a escovaçäo se apresenta como um comportamento complexo com uma série de fatores influenciando sua prática, e que apesar dos adelescentes se preocuparem com a ocorrência da cárie dentária e com a limpeza de seus dentes, a escovaçäo para este grupo está fortemente associada a motivos relacionados à saúde bucal