Demineralizing potential of dental biofilm added with Candida albicans and Candida parapsilosis isolated from preschool children with and without caries.

This study aimed to investigate the demineralizing potential of dental biofilm added of Candida albicans (CA) and Candida parapsilosis (CP), isolated from preschoolers with and without caries. Bovine enamel blocks (n = 48), with initial hardness = 341.50 ± 21,83 kg/mm2 were fixed in 24 well plates containing culture media. A pool of children saliva (PHS) was the inoculum for biofilm formation in the presence or absence of isolated CA or CP in accordance with each group (G n = 8): G1 - PHS; G2 - PHS + CA isolated from children with caries; G3 - PHS + CP isolated from children with caries; G4 - PHS + CA isolated from children without caries; G5 - PHS + CP isolated from children without caries; and G6 - blank control. The plates were incubated at 37 °C for 5 days, with daily changes of culture media. The microhardness loss percentage (MHL%) of the blocks was calculated, taking in account the hardness values before and after the experiment. Dental biofilm became more cariogenic, independently of the isolated Candida species. The highest MHL% was observed in G4 (85.90 ± 8.72%) and G5 (86.13 ± 6.74%) compared to the others (p < 0.001): G1 (34.30 ± 14,30%) < G2 (59.40 ± 10.56%) and G3 (65.80 ± 6.36%) < G6 (13.68 ± 4.86%) (p < 0.001). C. albicans and C. parapsilosis isolates induced the demineralization of the dental enamel.

Influence of Caregiver's Sociodemographic Background on the Oral Health Status and Care of HIV-infected Children.

PURPOSE: The purpose of this study was to evaluate the relationship between socio-demographic characteristics of caregivers and the oral health of their children infected with human immunodeficiency virus (HIV+) compared to a group of HIV-children and their caregivers. METHODS: One hundred forty HIV+ and 140 healthy two- to five-year-old children and their caregivers who sought care at hospitals in Rio de Janeiro, Brazil, participated. Caregivers were interviewed for sociodemographic characteristics, and knowledge and attitudes regarding oral health. The decayed, missing and filled primary teeth (dmft) index was obtained for the children. Chi-square and Mann-Whitney tests were used (five percent significance level). Content analysis method was used for qualitative evaluation. RESULTS: Most interviewees were mothers (83.6 percent), did no work outside the home (69.3 percent), had low educational status (47.1 percent), and were born in the South/Southeast regions of Brazil (83.6 percent). The mean dmft was 3.48±3.14 for the HIV+ group and 1.02±1.00 for the healthy children. Oral care was reported as important by 54.1 percent of the caregivers. Those who didn't consider oral care important had never received information about oral health (P<0.01). Caregivers born in the North/Northeast regions took their children to the dentist less frequently than mothers born in other areas (P=0.02). Low educational status influenced the attitudes about oral health (P<0.01), irregular dental visits for the children (P<0.01), and the dmft index (P<0.01). CONCLUSION: Caregivers' low educational status and birthplace influenced the importance given to HIV+ children's oral health as well as the oral health knowledge and practices for both HIV+ and healthy children.

Multidisciplinary conservative management of dental fracture in young patient: case report

The management of fractured permanent teeth due to dental trauma in young patients is a challenge that requires an efficient approach. Objective: Describe a conservative and multidisciplinary treatment of a case of dental trauma in a 13 years-old boy. Case report: At clinical examination was verified enamel and dentin fracture in the left upper central incisor and a fracture with pulp exposure in the right upper lateral incisor, with subgingival extension of its margin at lingual surface, and no swelling or tooth displacement was observed. At radiographic evaluation, no pulp or periradicular disturbances were verified. It was proposed the surgical lengthening of the clinical crown of the right upper lateral incisor for later performing endodontic treatment. It was decided to make direct composite resin restorations in both fractured teeth, instead of doing a prosthetic treatment in the affected lateral incisor, such as the placement of a full ceramic crown, in an attempt to perform a less invasive treatment, mainly due to the age of the patient. At a two years follow-up visit was observed the maintenance of the health of periapical tissues and the absence of clinical alterations. Conclusion: The restorations were kept in good conditions and aesthetics was considered satisfactory by professionals, patient and parents.

Introdução: O manejo de dentes permanentes fraturados por traumatismo dentário em pacientes jovens é desafiador e requer uma abordagem eficiente. Objetivo: Descrever o tratamento conservador e multidisciplinar em um caso de traumatismo dentário de um menino de 13 anos de idade. Relato do caso: Ao exame clínico foi verificada uma fratura de esmalte e dentina no incisivo central superior esquerdo e uma fratura complicada no incisivo lateral superior direito, com extensão subgengival da margem na face palatina, e não foram observados edema ou deslocamento dentário. Ao exame radiográfico, não foram verificadas alterações pulpares ou perirradiculares. Foi proposta realização de aumento da coroa clínica do incisivo lateral superior direito para posterior realização do tratamento endodôntico. Para os dois dentes traumatizados foi proposta a realização de restauração direta com resina composta, proporcionando um tratamento menos invasivo ao incisivo lateral superior direito, ao invés de submetê-lo a um tratamento protético, como a colocação de uma coroa total cerâmica, principalmente devido à pouca idade do paciente. Na visita de dois anos de acompanhamento, observou-se a manutenção da saúde dos tecidos periapicais e ausência de alterações clínicas. Conclusão: As restaurações se mantiveram em boas condições e a estética foi considerada satisfatória pelos profissionais, paciente e pais.

Transient functional crossbite and lip biting caued by eruption of the first permanent molar: a case report

Introduction: Tooth eruption is a physiological phenomenon that typically causes local changes. Objective: The aim of this paper is to report an unusual functional crossbite and lip biting caused by eruption of the first permanent molar. Case report: A 5-year-old female sought dental treatment with the chief complaint of pain in the posterior region. At the clinical examination, swelling, accumulation of biofilm, local ulceration and severe traumatic tissue inflammation due to eruption of the first permanent lower left molar were observed. Furthermore, functional unilateral crossbite and lip biting were observed. Local hygiene associated with chlorhexidine 0.12% and topical analgesic/anti-inflammatory ointment (Triamcinolone Acetonide) were prescribed for 10 and 7 days, respectively. At 1-month follow up, resolution of local inflammation was observed as well as spontaneous correction of the crossbite and lip biting. Conclusion: Since functional occlusal deviations can be caused by tooth eruption, it is important that dentists are able to diagnose and treat this condition.

Introdução: A erupção dentária é um fenômeno fisiológico que costuma causar alterações locais. Objetivo: Relatar um caso incomum de mordida cruzada transitória e mordedura de lábio causadas pela erupção do primeiro molar permanente. Relato do caso: Uma garota de 5 anos buscou tratamento odontológico com a queixa principal de dor em região posterior inferior. No exame clínico, foram observados edema, acúmulo de biofilme, ulceração local e inflamação por trauma do tecido devido à erupção do primeiro molar permanente inferior esquerdo. Além disso, foram observadas mordida cruzada unilateral funcional e mordedura de lábio. Foi prescrita clorexidina a 0,12% e pomada analgésica/antiinflamatória (Triancinolona Acetonida) tópica por 10 e 7 dias, respectivamente, associada à higiene local na área afetada. No acompanhamento de 1 mês, observou-se a resolução da inflamação local, bem como a correção espontânea da mordida cruzada e da mordedura do lábio. Conclusão: Uma vez que os desvios oclusais funcionais podem ser causados pela erupção dentária, é importante que os profissionais saibam diagnosticar e tratar corretamente esta condição.

Ação antifúngica da lactoferrina frente Candida non-albicans isoladas da cavidade oral de crianças infectadas pelo HIV / Antifungal action of lactoferrin against Candida non-albicans isolated from the oral cavity of HIV-infected children

A lactoferrina é uma glicoproteína de ligação ao ferro, que está presente na saliva, no leite, e em outras secreções exócrinas. Essa proteína tem inúmeras funções biológicas, incluindo efeitos antifúngicos e antibacterianos, além de imunomoduladores. O objetivo do presente estudo foi avaliar, in vitro, pela primeira vez, a atividade antifúngica da lactoferrina contra cepas de Candida nãoalbicans isoladas da cavidade oral de crianças infectadas pelo HIV e crianças saudáveis. Além disso, mensurar a degradação da lactoferrina por essas cepas através de SDS-PAGE (análise eletroforética em gel de poliacrilamida) e determinar, in vitro, a concentração mínima inibitória de lactoferrina capaz de matar 50% das células de Candida não-albicans. Cepas de Candida spp. foram obtidas através da coleta de saliva de 70 crianças infectadas pelo HIV e 50 crianças sem evidências de imunossupressão, com idade de 3 a 13 anos (ALVES, 2014). As diferentes espécies de Candida foram identificadas através de assimilação e fermentação de açúcar (API 20C, Biomérieux, França). Para o ensaio, in vitro, de morte de celular na presença de lactoferrina, 24 isolados de Candida, entre elas parapsilosis, tropicalis, krusei, guillermondi e dubliniensis, foram selecionados. Para a realização da análise por SDS-PAGE, cepas de todas as espécies consideradas resistentes nos ensaios de morte celular, foram incluídas. O porcentual de morte celular (%) de Candida não- albicans com a adição de 100 µg/ml de lactoferrina variou de 3,1% (C. dubliniensis) a 88,1% (C. tropicalis) no grupo HIV, e de 14,1% a 30,37% no grupo não-HIV (C . parapsilosis). Não houve correlação entre a densidade celular e o percentual de morte celular. C. dubliniensis foi a espécie mais resistente a lactoferrina e o porcentual de morte celular de C. parapsilosis foi significativamente maior em comparação com C. krusei na concentração de 1X104 células/ml (p = 0,033). Todos os isolados foram capazes de degradar a lactoferrina na concentração 1x108 células/ml, especialmente C. parapsilosis, pelo grupo HIV. Além disso, a lactoferrina na concentração de 500 µg/ml foi capaz de matar mais de 50% das células apenas dos isolados de C. tropicalis e C. guilliermondii. Concluiu-se que a lactoferrina tem atividade antifúngica contra Candida não-albicans de crianças infectadas pelo HIV, mas algumas espécies apresentam alguma resistência a esta proteína. Além disso, todas as Candida spp. foram capazes de degradar a lactoferrina quando estavam em concentração de 1X108 cels/ml, e a lactoferrina na concentração de 500µl/ml foi capaz de matar mais que 50% das células de C. tropicalis e C. guillermondii

Lactoferrin is an iron-binding glycoprotein, which is present in saliva, milk and other exocrine secretions. This protein has a number of biological functions, including antifungical, antimicrobial and immunomodulatory effects. The aim of this study was to evaluate, for the first time, the antifungal activity of lactoferrin against isolates of Candida spp. from the oral cavity of HIV-infected children and children with no clinical evidence of immunosuppression. Furthermore, measure, in vitro, the degradation of lactoferrin by Candida spp. through SDS-PAGE (electrophoretic analysis on polyacrylamide gel) and determine, in vitro, the minimum inhibitory concentration of lactoferrin able to kill 50% of cells of Candida non-albicans. Strains of Candida spp. were obtained through saliva collect of 70 HIV-infected children and 50 children without evidence of immunosuppression ageing between 3 to13 years old (ALVES, 2014). All Candida species were identified by sugar assimilation and fermentation (API 20C, Biomerieux, France). For the in vitro study, death of lactoferrin of 24 Candida isolates, including parapsilosis, tropicalis, krusei, guillermondii, and dubliniensis, were selected. To perform the analysis by SDS-PAGE, strains of all available species considered resistants, which were observed at lactoferrin death`s study, were included. The cell death percentage (%) of non-albicans Candida by addition of 100 µg of lactoferrin range from 3.1% (C. dublinienes) to 88.1% (C. tropicalis) in HIV group, and 14.1% to 30.37% in N-HIV (C. parapsilosis), but there was no correlation between cell density and death %. C. dubliniensis was the most resistant specie to lactoferrin and the cell death % of C. parapsilosis was significant higher comparing to C. krusei at 1X104 cells/ml (p=0.033). All the isolates were able to degrade lactoferrin at 108 cells/ml, mainly C. parapsilosis from HIV. Furthermore, lactoferrin at 500 µg/ml concentration was able to kill more than 50% of the cells only for C. tropicalis and C. guillermondii isolates. It was concluded that lactoferrin has antifungal activity against non-albicans Candida from HIV children, but some species present some resistance to this protein. Furthermore, all Candida spp. were able to degrade lactoferrin when was at concentration of 1x108 cells / ml, also, lactoferrin at concentration 500µl / ml was able to kill more than 50% of C. tropicalis and C. guillermondii cells.