Association between molar hypomineralization, genes involved in enamel development, and medication in early childhood: A preliminary study.

BACKGROUND: Molar hypomineralization (MH) is defined as a multifactorial condition, and thus, its presence may be defined by interactions between environmental and genetic factors. AIM: To evaluate the association between MH, genes involved in enamel development, and the use of medication during pregnancy in early childhood. DESIGN: One hundred and eighteen children, 54 with and 64 without MH, were studied. The data collected included demographics, socioeconomic data, and the medical history of mothers and children. Genomic DNA was collected from saliva. Genetic polymorphisms in ameloblastin (AMBN; rs4694075), enamelin (ENAM; rs3796704, rs7664896), and kallikrein (KLK4; rs2235091) were evaluated. These genes were analyzed by real-time polymerase chain reaction using TaqMan chemistry. The software PLINK was used to compare allele and genotype distributions of the groups and to assess the interaction between environmental variables and genotypes (p < .05). RESULTS: The variant allele KLK4 rs2235091 was associated with MH in some children (odds ratio [OR]: 3.75; 95% confidence interval [CI] = 1.65-7.81; p = .001). Taking medications in the first 4 years of life was also associated with MH (OR: 2.94; 95% CI = 1.02-6.04; p = .041) and specifically in association with polymorphisms in ENAM, AMBN, and KLK4 (p < .05). The use of medications during pregnancy was not associated with MH (OR: 1.37; 95% CI = 0.593-3.18; p = .458). CONCLUSION: The results of this study suggest that taking medication in the postnatal period appears to contribute to the etiology of MH in some evaluated children. There may be a possible genetic influence of polymorphisms in the KLK4 gene with this condition.

Are low serum levels of Vitamin D associated with dental developmental defects in primary teeth? A systematic review.

OBJECTIVE: To identify, qualify and synthesize all studies that assessed if low serum level of 25(OH)D (<50 nmol/L) is associated with dental developmental defects (DDD) in primary teeth. MATERIALS AND METHODS: Observational studies or clinical trials were included if measured 25(OH)D serum levels in pregnant women and/or in their children (up to 3 years old) and evaluated the occurrence of DDD in the primary dentition of offspring associated with the low 25(OH)D levels. Literature reviews, case reports, laboratory and/or animals' studies, conference abstracts, letters to the editor, book chapters and clinical protocols were excluded. Searches were carried out in 6 electronic databases and in the gray literature until March 2023, without restrictions. The study quality was assessed by the Newcastle-Ottawa Scale and the certainty of the evidence by GRADE. Data were descriptively synthesized considering the association between DDD and 25(OH)D levels. RESULTS: Seven studies were included. Only developmental enamel defects (DED) were observed after examination of 6651 children. The incidence of DED ranged from 8.9% to 66%. Six studies found no association between low levels of 25(OH)D and DED. However, one reported correlation between hypomineralization of the primary second molar (HSMD) and low levels of 25(OH)D at birth. Methodological flaws were observed in all studies and the certainty of the evidence was very low. CONCLUSION: Although HSMD was the only DDD associated with low levels of 25(OH)D in children, the available evidence is still not conclusive. More robust studies are needed to endorse the biological plausibility of DDD in primary teeth due to low serum levels of 25(OH)D in pregnant women or in their children. FAPERJ financed this study, which was registered in PROSPERO (CRD42022357511).

Did the Use of Minimum Interventions for Caries Management Change during the COVID-19 Pandemic? A Cross-Sectional Study.

The aim of this study was to evaluate changes in the frequency of use of minimum intervention (MI) techniques for caries management during the COVID-19 pandemic. A questionnaire was applied through the SurveyMonkeyTM platform to evaluate changes in the dentist's frequency of use of noninvasive, microinvasive, minimally invasive, and mixed interventions, nonaerosol or aerosol productive, to manage dental caries before and during COVID-19 pandemic. Differences in the use of MI techniques were analyzed by Wilcoxon test, and the effect size (ES) was calculated. An α = 0.05 was adopted. A total of 781 dentists answered the questionnaire; most of them were female (76.4%), with 30s (76.4%), graduated over 10-24 years ago (38%) in public dental schools (62%), graduated in southwest of Brazil (38%), that work in clinical environment (66.8%) and in private jobs (53.4%). During COVID-19, among the sample, 91 respondents were not working. In relation to the noninvasive techniques, only the use of casein phosphopeptide amorphous calcium phosphate (CPP-ACP) decreased during the COVID-19 pandemic (p < 0.01; ES = 0.11). The frequency of sealants to repair defective restorations was the only microinvasive technique that increased during the pandemic (p < 0.01; ES = 0.03). Among the minimally invasive techniques, the use of atraumatic restorative treatment increased significantly (p < 0.01; ES = 0.06), while the use of air abrasion decreased (p = 0.02; ES = 0.04) during COVID-19 pandemic. Moreover, nonrestorative cavity control (mixed intervention) increased during pandemic period (p < 0.001; ES = 0.11). Although the results demonstrated differences in the use of some procedures, a very small magnitude of the effect was perceived, demonstrating that the influence of COVID-19 pandemic was very little, if any, in the use of MI techniques for caries management. Moreover, the use of MI strategies was already well established between Brazilian dentists before the pandemic period.

Determinants of Dual-task Gait Speed in Older Adults with and without Parkinson's Disease.

Mobility difficulties for people with Parkinson's disease (PwPD) are more pronounced when they perform a simultaneous cognitive task while walking. Although it is known that neurodegeneration results in widespread motor and brain impairments, few studies have comprehensively examined possible physical and mental determinants of dual task walking in PwPD. In this cross-sectional study, we aimed to investigate if and how muscle strength (sit-to-stand 30-sec test), cognition (mini-mental state examination) and functionality (timed up and go test) affect walking performance (10-meter walking test) with and without arithmetic dual task from older adults with and without Parkinson's disease. Walking speed was reduced by 16% and 11% with arithmetic dual task for PwPD (from 1.07±0.28 to 0.91±0.29 m.s-1, p<0.001) and older adults (from 1.32±0.28 to 1.16±0.26 m.s-1, p=0.002) compared to essential walking. The cognitive state was similar among the groups, but it was only associated with the dual-task walking speed in PwPD. In PwPD, lower limb strength was the better predictor of speed, whereas mobility was more related to it in older adults. Therefore, future exercise interventions aiming to improve walking in PwPD should consider these findings to maximize their effectiveness.

Critical appraisal of the information available on traumatic dental injuries found in applications.

BACKGROUND/AIMS: Traumatic dental injuries (TDI) are a public health problem and the search for information becomes essential to help in their management. The aim of this study was to search existing TDI applications (Apps) to critically describe the characteristics and main information found in them regarding TDI. METHODOLOGY: Searches were performed in the Play Store (Android) and App Store (iOS), using MeSH terms, synonyms and terms related to dental emergencies and TDI, in English, Spanish and Portuguese. Apps with information on the management of post-TDI emergencies or TDI prevention were included. The type of operating system (Android/iOS), cost (free/paid), target audience (dentist/patient), age of classification (free/>17 years old), language, star rating (1★ to 5★), number of downloads and post-download ratings, type of dentition (primary/permanent), reference used for classification according to TDI type and management (International Association for Dental Traumatology/Andreasen/others/not reported), and available content (prevention/emergency management/preservation/illustrations) were evaluated. RESULTS: Among 486 apps, 13 were eligible: 11 for Android and 2 for iOS. Most were free (92.3%), for patients (38.4%) and had a free age classification (90.9%). The main language was English (53.8%), and most of the Apps either had no information on star ratings (46.1%) or received 4★ (23.1%). The number of downloads was not reported (23.1%) or was fewer than 100 (23.1%). Most of the Apps were for permanent teeth (61.5%) and had explanations about dental management for TDI emergencies (92.3%) and multiple TDIs (61.5%). Most Apps addressed the importance of monitoring TDIs (76.9%) and contained illustrative images (76.9%). However, many did not report the TDI classification (46.1%), and 38.5% reported TDI prevention. CONCLUSIONS: Information on dental trauma management according to dental injury, inclusion of images, target audience, type of TDI and their prevention varied in the available Apps. However, most were focused on permanent teeth and addressed several TDI in English language only.

Evaluation of Alveolar Bone Quality: Correlation Between Histomorphometric Analysis and Lekholm and Zarb Classification.

OBJECTIVES: This study evaluated the bone quality of the maxilla and mandible by using the classification proposed by Lekholm and Zarb (L & Z) and histomorphometry. METHODS: Sixty edentulous areas were evaluated. The classification by L & Z was obtained through the evaluation of periapical and panoramic radiographs associated with the surgeon's tactile perception during milling and implant installation. Before implant installation, bone biopsies of standardized sizes were performed for histological evaluation. RESULTS: Type III bone quality was more frequent in the posterior (73.33%) and anterior (73.33%) maxilla, whereas type II bone quality was more frequent in the posterior (53.33%) and anterior (60.00%) mandible. Through histometry, statistical difference was observed for the amount of bone tissue of the posterior region of the maxilla in relation to the anterior and posterior regions of the mandible (P ≤ 0.043). However, there was no difference in osteocyte counts between alveolar regions (P = 0.2946). In the female gender, the age showed a low positive correlation with the L & Z classification (rho = 0.398; P = 0.006) and in the male gender, a moderate negative correlation was observed (rho = -0.650, P = 0.016). CONCLUSIONS: Both methods detected differences in the bone quality of the alveolar regions of the maxilla/mandible and that the classification by L & Z is a reliable method, since it was consistent with histomorphometry, considered the "gold standard" method for the evaluation of bone quality and greater bone density was observed in older men.

Does a Multicomponent Exercise Program Improve Physical Fitness in Older Adults? Findings From a 5-Year Longitudinal Study.

The objective was to assess the physical fitness of older adults participating in a 5-year multicomponent exercise program. The sample consisted of 138 older adults aged 60-93 years (70.4 ± 7.8 years) evaluated with the Senior Fitness Test (muscle strength, flexibility, balance, and cardiorespiratory fitness). The multicomponent program was carried out between the months of March and November of each year. Data were analyzed using generalized estimating equations (factor year: Year 1, Year 2, Year 3, Year 4, and Year 5; factor time: pretest and posttest) with Bonferroni's post hoc test. Participation in the multicomponent exercise program for 5 years (baseline pretest Year 1 and follow-up Year 5) improved lower and upper limb strength, lower limb flexibility, and balance and cardiorespiratory fitness, while upper limb flexibility was maintained. Year-by-year analysis revealed variable patterns for each fitness parameter. The results of this study show the potential benefits of implementing a long-term community-based exercise program.

Cytocompatibility of filling pastes by primary teeth root simulating model.

Evaluate the cytocompatibility of Calen®/ZO, Calcicur®, Vitapex®, Endoflas®, and zinc oxide/eugenol-based (ZOE) root canal pastes (RCP) to human primary osteoblasts (HPO) through a simplified model for primary teeth. The model employed pipette tips filled with 0.037 g of paste, exposed to 185 µL of culture medium for 24 h (n = 6). Release of components was analysed by Proton Nuclear Magnetic Resonance Spectroscopy (1H-NMR). HPO were exposed to conditioned media for 24 h. Cell viability was assessed by cell density and metabolic activity, and release of interleukin 6 (IL-6), vascular endothelial growth factor (VEGF) and fibroblast growth factor (bFGF) by immunological assay. Physicochemical properties and antimicrobial efficacy were also evaluated. 1H-NMR spectra analysis showed similarity between ZOE, Endoflas®, Calcicur®, and Vitapex® compared to Calen®/ZO and positive control, which showed distinct released components. Calen®/ZO and Calcicur® exhibited high alkaline pH in all periods and showed similar solubility. Calen®/ZO, ZOE, and Vitapex® showed similar flow rate. Calen®/ZO, Calcicur®, and Vitapex® did not exhibit antimicrobial efficacy. Calen®/ZO presented cytotoxicity (p < 0.05). Pastes did not increase IL-6 release compared to control. Apart from Vitapex®, all pastes significantly induced VEGF/bFGF release. Interactive effects among released products may affect biological response to filling pastes. Calcicur®, ZOE, Endoflas® and Calen®/ZO presented good to moderate cytocompatibility, with low impact on pro-inflammatory cytokine release and induction of growth factors of interest to tissue repair. This simplified model, specific for the evaluation of the cytocompatibility of RCPs on primary teeth, suggests how these pastes might contribute to bone repair in clinical situations of apical periodontitis in children.

A world panorama of bruxism in children and adolescents with emphasis on associated sleep features: A bibliometric analysis.

BACKGROUND AND OBJECTIVES: To present a world panorama of the published papers on bruxism in children and adolescents, emphasising the characteristics of studies related to the sleep features of these patients. METHODS: Literature searches were conducted in six databases without language or date restrictions. Data on the titles, types of study, main subjects, countries of origin, keywords, years of publication, authors and their network collaborations, journals and sleep studies were extracted and analysed using VantagePoint™ software. RESULTS: A total of 725 studies met the eligibility criteria. Most included only children (75.31%), with observational design (66.34%), and risk or aetiology (53.93%) as the main subject. Brazil (18.06%) and Brazilian authors (54.84%) had the largest number of studies, with a low amount of network collaboration. The Journal of Oral Rehabilitation published most of the studies (6.2%); publications in this field have grown considerably from 2000 to 2020. Of the studies, 123 (16.96%) included sleep studies; night sweating, restless sleep, sleep talking, mouth breathing, snoring, obstructive sleep apnoea syndrome, sleep-disordered breathing, nightmares, poor sleep quality and duration, and daytime naps were significantly associated with bruxism in most. CONCLUSION: Studies on bruxism in children and adolescents have increased in the past 20 years, with most being observational, and risk or aetiology as the main subject. Brazil and the Journal of Oral Rehabilitation have published most in the field. Sleep studies have shown some features associated with bruxism, such as night sweating, restless sleep, somniloquy, snoring, breathing problems, nightmares, daytime naps, and poor sleep quality and duration.

Recommendations from paediatric dentistry associations of the Americas on breastfeeding and sugar consumption and oral hygiene in infants for the prevention of dental caries: A bibliometric review.

BACKGROUND: The Internet provides a plethora of information on health issues related to children's oral health. AIM: Identify online recommendations of paediatric dentistry associations of the Americas (PDAAs) regarding breastfeeding practices, weaning, sugar introduction and initiating oral hygiene. DESIGN: Websites of PDAAs were accessed to record recommendations/questions (Q) relevant to early childhood that specifically covered issues about exclusive breastfeeding-Q1, indications of bottle feeding-Q2, when and how to start weaning-Q3 and Q4, respectively, association of breast milk and dental caries-Q5, when to start oral hygiene and how to introduce it-Q6 and Q7, respectively, and guidance on the introduction of sugar-Q8. Similarity/dissimilarity frequencies between the associations (Euclidean distances) were calculated. RESULTS: From 35 countries on the two American continents, 21 associations were affiliated with the International Association of Paediatric Dentistry and/or the Latin American Pediatric Dentistry Association, whereas eight did not have websites. Higher (P < .05) dissimilarities for Q6 (68.2%), Q7 (72.7%), and Q8 (62.1%) were observed. Results were similar for Q1 and Q5 (P > .05). No association mentioned Q2, Q3 or Q4 responses, whereas Q7 was the most frequently discussed issue. CONCLUSION: Not all of the investigated issues are mentioned on websites of PDAAs, potentially stymieing efforts by both the layperson and health professional to gather information.

A Simultaneous Differential Scanning Calorimetry-X-ray Diffraction Study of Olanzapine Crystallization from Amorphous Solid Dispersions.

Amorphous solid dispersions (ASDs) of class II and IV biopharmaceutics classification system drugs in water-miscible polymers are a well-recognized means of enhancing dissolution, while such dispersions in hydrophobic polymers form the basis of micro- and nanoparticulate technologies. However, drug recrystallization presents significant problems for product development, and the mechanisms and pathways involved are poorly understood. Here, we outline the use of combined differential scanning calorimetry (DSC)-synchrotron X-ray diffraction to monitor the sequential appearance of polymorphs of olanzapine (OLZ) when dispersed in a range of polymers. In a recent study (Cryst. Growth Des.2019,19, 2751-2757), we reported a new polymorph (form IV) of OLZ which crystallized from a spray-dried dispersion of OLZ in polyvinylpyrrolidone. Here, we extend our earlier study to explore OLZ dispersions in poly(lactide-co-glycolide) (PLGA), polylactide (PLA), and hydroxypropyl methyl cellulose acetate succinate (HPMCAS), with a view to identifying the sequence of form generation on heating each dispersion. While spray-dried OLZ results in the formation of crystalline form I, the spray-dried material with HPMCAS comprises an ASD, and forms I and IV are generated upon heating. PLGA and PLA result in a product which contains both amorphous OLZ and the dichloromethane solvate; upon heating, the amorphous material converts to forms I, II, and IV and the solvate to forms I and II. Our data show that it is possible to quantitatively assess not only the polymorph generation sequence but also the relative proportions as a function of temperature. Of particular note is that the sequence of form generation is significantly more complex than may be indicated by DSC data alone, with coincident generation of different polymorphs and complex interconversions as the material is heated. We argue that this may have implications not only for the mechanistic understanding of polymorph generation but also as an aid to identifying the range of polymorphic forms that may be produced by a single-drug molecule.

Effect of xylitol tablets with and without red propolis on salivary parameters, dental biofilm and sensory acceptability of adolescents: a randomized crossover clinical trial.

The effect of xylitol tablets with (XPT) and without (XT) red propolis on salivary parameters, dental biofilm and acceptability of adolescents was evaluated through a blinded randomized crossover clinical trial. Healthy volunteers were allocated in the XPT and XT groups with a 30-day washout period for consumption of two tablets/dayfor seven days. An increase in salivary parameters was only observed immediately after tablet consumption, without differences between XPT and XT. The results for total microorganisms were similar, but XT was better in controlling Streptococcus spp. Rothia dentocariosa and Streptococcus salivarius were the most frequent in the biofilm and saliva, respectively. XPT and XT showed similar acceptability, with the highest purchase intention for XT. Although propolis did not enhance the properties of XT, further studies testing different protocols and follow-up are necessary; XT controlled Streptococcus spp. in biofilms, which demonstrate its potential for clinical application.

Radiographic Evaluation in the Diagnosis of Alveolar Bone Quality in Implant Rehabilitation.

This study evaluated the optical bone density of the maxilla and mandible and correlate with the classification of bone quality of the Lekholm and Zarb (L & Z). Sixty edentulous areas were evaluated. Panoramic and periapical radiographs were performed with an aluminum scale to evaluate the optical bone density. L & Z classification was also applied. By using periapical radiographs, a statistically significant difference was observed in the optical bone density of the posterior maxilla (2.38 ±â€Š1.06) and the posterior mandible (3.84 ±â€Š0.68), when compared to the other regions (P ≤ 0.015). However, with panoramic radiographs, no differences were observed in the optical bone density (P = 0.6322). A negative correlation was observed between the L & Z classification and the optical bone density obtained by the periapical radiographs (rho = -0.463; P < 0.001), that is, the worse the bone quality, the lower the bone density. However, there was no significant correlation with the bone density obtained by panoramic radiographs (rho = -0.009; P = 0.948). As for gender, a correlation between aging and the presence of medullary bone was observed in females, assessed by the L & Z classification (rho = 0.398; P = 0.006). However, there was a correlation between aging and a denser and less medullary presence in males, both assessed by the L & Z classification (rho = -650; P = 0.016), as well as the optical density assessed by periapical (rho = 0.621; P = 0.023) and panoramic (rho = 0.588; P = 0.035) radiographs. These results suggest that gender and age interfere with the bone quality and periapical radiographs are an acceptable method for evaluating bone density. However, a panoramic radiograph was not found to be a reliable method.

Is there association between dental malocclusion and bruxism? A systematic review and meta-analysis.

OBJECTIVES: Given that current literature largely dissociates dental malocclusion and bruxism, the objective of this study was to gather, through a systematic review, scientific evidence to support their relationship. METHODOLOGY: This study was performed according to the PECO strategy (where P = general population; E = dental malocclusion; C = no dental malocclusion; and O = bruxism). Literature searches were conducted without language or date restrictions in the following databases: PubMed, Scopus, the Web of Science, the Cochrane Library, LILACS/BBO via VHL and the grey literature. The search strategy included Medical Subject Headings/DECs, synonyms and free terms relevant to each database, with no age restrictions applied. Once the relevant data were extracted from the articles, the Fowkes and Fulton guidelines were followed to assess the quality and risk of bias. For quantitative analysis, dental malocclusions were divided into groups according to their type in order to perform odds ratio (OR) meta-analyses with 95% confidence intervals (CI) using the Review Manager software program (Cochrane, London, UK). The level of certainty of evidence was demonstrated through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). RESULTS: After 1,502 studies found, 10 studies were included for qualitative analysis and nine for quantitative synthesis. Four studies presented high methodological quality. Five meta-analyses suggested a non-association between bruxism and Angle class I (OR: 1.05, 95% CI: 0.41-2.69; P = .92; I2  = 84%), Angle class II (OR: 1.49, 95% CI: 0.77-2.87; P = .23; I2  = 71%) or Angle class III (OR: 0.77, 95% CI: 0.31-1.93; P = .58; I2  = 0%). Bruxism was associated with children who did not present with a posterior crossbite (OR: 0.70, 95% CI: 0.51-0.96; P = .03; I2  = 27%) and present crowding (OR: 1.53, 95% CI: 1.03-2.26; P = .03; I2  = 0%). The GRADE analysis presented a very low quality of evidence. CONCLUSION: Individuals who present with bruxism have a greater chance of crowding. However, bruxism is not associated with the presence of any of the other malocclusions evaluated.

Mineral density changes in bovine carious dentin after treatment with bioactive dental cements: a comparative micro-CT study.

OBJECTIVES: To evaluate the potential of conventional glass ionomer cement (GIC), Biodentine™, MTA, and Portland cement to induce mineral density changes in carious dentin compared to zinc oxide eugenol control cement (ZOE). MATERIALS AND METHODS: Fifty blocks of bovine root dentin were prepared and a biofilm model using ATCC strains of S.mutans, S.sobrinus, and L.casei was used to promote artificial dentin lesions. After demineralization, the blocks were randomly divided into the five cement groups. Half of the surface of each specimen received the tested material and the other half was covered with wax (control). Samples were stored in phosphate buffered saline solution for 30 days and after that were scanned in a micro-CT with standardized parameters. Dentin mineral density changes were calculated using differences in plot profiles of the exposed and control carious dentin. Friedman's test, followed by Wilcoxon signed-rank test was used with 5% significance. RESULTS: Mean ΔZ values for the cements were 48.63 ± 19.09 for the control (ZOE), 63.31 ± 32.59 for Biodentine™, 114.63 ± 72.92 for GIC, 109.56 ± 66.28 for MTA, and 106.88 ± 66.02 for Portland cement. All cements showed a statistically significant increase in ΔZ values compared to the control, but Biodentine™ values were statistically significantly lower compared to GIC and the other calcium silicate cements. CONCLUSIONS: Tested materials present potential to induce mineral density changes in carious bovine dentin. MTA, Portland, and GIC showed higher bioactivity potential than Biodentine™. CLINICAL RELEVANCE: Based on minimally invasive concept, materials with remineralization potential can be used to preserve diseased but still repairable dental tissue.

Aesthetic perception, acceptability and satisfaction in the treatment of caries lesions with silver diamine fluoride: A scoping review.

BACKGROUND: Silver diamine fluoride (SDF) causes dental black staining after its application. AIM: Evaluate the aesthetic perception, acceptability, and/or satisfaction of patients, parents, and professionals to the treatment of caries lesions with SDF through a scoping review. DESIGN: A search was performed in seven databases and two key journals with no language or date restrictions. Studies that evaluated the aesthetic perception, satisfaction, and/or acceptability of patients, parents, and professionals to the treatment of carious lesions with SDF were considered eligible. RESULTS: From a total of 1177 articles, 10 studies were full text assessed for eligibility, with nine included in this scoping review. In general, the studies varied by population, study design, and methodologic evaluation. The type of tooth (anterior or posterior), family income, parental schooling, ethnicity, and need for advanced behaviour control methods were factors that influenced the results. The acceptability level increased as the child required more advanced methods of behaviour guidance. In general, the pigmentation caused by SDF did not interfere with the parents' acceptability of the treatment; however, professionals believe that this could have influence. Regarding satisfaction, pigmentation did not influence parental satisfaction. CONCLUSION: Parents were satisfied with and found SDF acceptable, whereas professionals did not.

Knowledge of parents/caregivers about the sleep bruxism of their children from all five Brazilian regions: A multicenter study.

BACKGROUND: Sleep bruxism (SB) is a masticatory muscle activity that affects children. Parents' knowledge is important for its identification and report to dentists. AIM: To investigate parents' knowledge about SB among their children. DESIGN: A cross-sectional study included 1325 parents of children from dental clinics of seven institutions from all regions of Brazil. Parents answered questions about child's sleep, knowledge about SB and its occurrence among children and parents. SB definition given by parents was dichotomized as "correct"/"incorrect", based on the American Academy of Sleep Medicine definition. Descriptive, bivariate and multivariate analyses were performed (P < 0.05). RESULTS: Most parents (57.3%) did not know what SB is and 88.9% would like to receive more information. SB prevalence among parents was 15.4% and 24.0% among children. Between parents who correctly defined SB, its prevalence increased to 27.5% among parents and 40.6% among children. Parents whose children had/have SB, who would like to receive more information about SB and were from the North, Central-West, Southeast, and South regions were more likely to define SB correctly (P > 0.05). CONCLUSION: There is a lack of knowledge of parents about SB. SB among children, parents' interest in receiving more information and their location were factors associated to their knowledge.

Zinc Supplementation Attenuates Cardiac Remodeling After Experimental Myocardial Infarction.

BACKGROUND/AIMS: The objective of our study was to evaluate the effects of zinc supplementation on cardiac remodeling following acute myocardial infarction in rats. METHODS: Animals were subdivided into 4 groups and observed for 3 months: 1) Sham Control; 2) Sham Zinc: Sham animals receiving zinc supplementation; 3) Infarction Control; 4) Infarction Zinc. After the followup period, we studied hypertrophy and ventricular geometry, functional alterations in vivo and in vitro, changes related to collagen, oxidative stress, and inflammation, assessed by echocardiogram, isolated heart study, western blot, flow cytometer, morphometry, and spectrophotometry. RESULTS: Infarction induced a significant worsening of the functional variables. On the other hand, zinc attenuated both systolic and diastolic cardiac dysfunction induced by infarction. Considering the infarct size, there was no difference between the groups. Catalase and superoxide dismutase decreased in infarcted animals, and zinc increased its activity. We found higher expression of collagens I and III in infarcted animals, but there was no effect of zinc supplementation. Likewise, infarcted animals had higher levels of IL-10, but without zinc interference. Nrf-2 values were not different among the groups. Infarction increased the amount of Treg cells in the spleen as well as the amount of total lymphocytes. Zinc increased the amount of CD4+ in infarcted animals, but we did not observe effects in relation to Treg cells. CONCLUSION: zinc attenuates cardiac remodeling after infarction in rats; this effect is associated with modulation of antioxidant enzymes, but without the involvement of collagens I and III, Nrf-2, IL-10, and Treg cells.

The Development of Quasi-isothermal Calorimetry for the Measurement of Drug-Polymer Miscibility and Crystallization Kinetics: Olanzapine-Loaded PLGA Microparticles.

The assessment of drug-polymer equilibrium solubility is of critical importance for predicting suitable loading and physical stability of solid dispersion formulations. However, quantitative measurement of this parameter is nontrivial due to the difficulties associated with ascertaining equilibrium values in systems that are prone to supersaturation and are simultaneously highly viscous, thereby slowing the equilibration process considerably; no standard methodology has yet been agreed for such measurements. In this study, we propose a new approach involving quasi-isothermal modulated temperature DSC (QiMTDSC), whereby unsaturated and supersaturated samples are held at defined temperatures and subject to a sinusoidal heating signal at a zero underpinning heating rate, thereby allowing the heat capacity of the sample to be measured as a function of time and temperature. We are not only able to ascertain whether equilibrium has been reached by monitoring the time-dependent heat capacity signal, but we can also measure solubility as a function of temperature via the absolute heat capacity values of the components. We are also able to measure the kinetics of recrystallization from the supersaturated systems. Dispersions of olanzapine in PLGA at concentrations up to 50% w/w, prepared by spray drying, were prepared and characterized using conventional and QiMTDSC as well as hot stage microscopy. The new QiMTDSC protocol was successfully able to determine olanzapine solubility in PLGA at 90 °C to be 23.1 ± 6.1% w/w, which was comparable to the values calculated using other established methods at this temperature, while a temperature/solubility profile was obtained using the method at a range of temperatures. Drug crystallization kinetics from the solid dispersions could also be modeled directly from the QiMTDSC data using the Avrami approach, thereby allowing the effect of drug loading on the rate of crystallization and the effective completion of crystallization to be investigated. Overall, an alternative protocol for measuring drug-polymer solubility has been developed and validated via comparison to established methods, the approach allowing solubility as a function of temperature, identification of equilibrium following demixing, and kinetic analysis of crystallization to be performed within one set of experiments.

Evaluation of Oral Health-Related Quality of Life to Assess Dental Treatment in Preschool Children with Early Childhood Caries: A Preliminary Study.

PURPOSE: The oral health-related quality of life (OHRQoL) of preschool children with Early Childhood Caries (ECC) was used to assess the outcome of dental treatment. STUDY DESIGN: Children (3.56±1.31years) affected by ECC were selected. Anamnesis, clinical and radiographic exams were performed. Data about sociodemographic aspects, OHRQoL and dmf-t index were collected. The Brazilian version of Early Childhood Oral health Impact Scale (B-ECOHIS) was applied in two time intervals: before and after 30 days of treatment. B-ECOHIS scores and effect size (ES) were used to evaluate the OHRQoL of preschool children. The Student's-t test was used for comparison between the B-ECOHIS averages, considering the following aspects: gender, age, socioeconomic status, severity of caries and type of treatment. RESULTS: The mean dmf-t was 6.25±4.20 and no differences between boys (6.00±4.32) and girls (6.83±4.35) (p=0,942) were found. Pain and psychological problems among children and parents feeling upset and guilty were the most frequently reported impacts at baseline. There was a greater impact on girls (17.67±8.68) than on boys (13.30±10.53) (p<0.001); and on children younger than 4 years (16.71±9.96) (p<0.05). The highest B-ECOHIS scores were observed in treatments involving dental extractions and space maintainers. There was no difference between the total B-ECOHIS scores of subjects from middle (16.24±10.30) and lower socioeconomic classes (15.97±10.26). The total scores of B-ECOHIS and its domains decreased after 30-day follow-up. Dental rehabilitation of preschool children showed a large effect size for these subjects (ES=1.19) and their families (ES=1.00). CONCLUSION: Dental treatment resulted in significant improvement of the preschool children's OHRQoL.