Spread of Gamma (P.1) Sub-Lineages Carrying Spike Mutations Close to the Furin Cleavage Site and Deletions in the N-Terminal Domain Drives Ongoing Transmission of SARS-CoV-2 in Amazonas, Brazil.

The Amazonas was one of the most heavily affected Brazilian states by the COVID-19 epidemic. Despite a large number of infected people, particularly during the second wave associated with the spread of the Variant of Concern (VOC) Gamma (lineage P.1), SARS-CoV-2 continues to circulate in the Amazonas. To understand how SARS-CoV-2 persisted in a human population with a high immunity barrier, we generated 1,188 SARS-CoV-2 whole-genome sequences from individuals diagnosed in the Amazonas state from 1st January to 6th July 2021, of which 38 were vaccine breakthrough infections. Our study reveals a sharp increase in the relative prevalence of Gamma plus (P.1+) variants, designated Pango Lineages P.1.3 to P.1.6, harboring two types of additional Spike changes: deletions in the N-terminal (NTD) domain (particularly Δ144 or Δ141-144) associated with resistance to anti-NTD neutralizing antibodies or mutations at the S1/S2 junction (N679K or P681H) that probably enhance the binding affinity to the furin cleavage site, as suggested by our molecular dynamics simulations. As lineages P.1.4 (S:N679K) and P.1.6 (S:P681H) expanded (Re > 1) from March to July 2021, the lineage P.1 declined (Re < 1) and the median Ct value of SARS-CoV-2 positive cases in Amazonas significantly decreases. Still, we did not find an increased incidence of P.1+ variants among breakthrough cases of fully vaccinated patients (71%) in comparison to unvaccinated individuals (93%). This evidence supports that the ongoing endemic transmission of SARS-CoV-2 in the Amazonas is driven by the spread of new local Gamma/P.1 sublineages that are more transmissible, although not more efficient to evade vaccine-elicited immunity than the parental VOC. Finally, as SARS-CoV-2 continues to spread in human populations with a declining density of susceptible hosts, the risk of selecting more infectious variants or antibody evasion mutations is expected to increase. IMPORTANCE The continuous evolution of SARS-CoV-2 is an expected phenomenon that will continue to happen due to the high number of cases worldwide. The present study analyzed how a Variant of Concern (VOC) could still circulate in a population hardly affected by two COVID-19 waves and with vaccination in progress. Our results showed that the answer behind that was a new generation of Gamma-like viruses, which emerged locally carrying mutations that made it more transmissible and more capable of spreading, partially evading prior immunity triggered by natural infections or vaccines. With thousands of new cases daily, the current pandemics scenario suggests that SARS-CoV-2 will continue to evolve and efforts to reduce the number of infected subjects, including global equitable access to COVID-19 vaccines, are mandatory. Thus, until the end of pandemics, the SARS-CoV-2 genomic surveillance will be an essential tool to better understand the drivers of the viral evolutionary process.

Microbiological effect of glass ionomer cement added by chlorhexidine diacetate / Efeito microbiológico do cimento de ionômero de vidro acrescido de diacetato de clorexidina

Objective: The objective of the present study was to evaluate the microbiological effectiveness of the glass ionomer cement added by 1% chlorhexidine diacetate. Methods: The antimicrobial activity was performed through the test of halo formation to inhibit Streptococcus mutans (S. mutans), Staphylococcus aureus (S. aureus) and Candida albicans (C. albicans) in the following groups: Group 1: glass ionomer cement (GIC), Group 2: GIC added by 1% chlorhexidine diacetate, Group 3: chlorhexidine digluconate solution at 0.12% and Group 4: chlorhexidine digluconate solution at 2%. The halo inhibition area was measured in square millimeter (mm²), at 24 and 48 hours after incubation (37o.C). Results: The chlorhexidine digluconate solution at 2% (group 4), used as a positive control had a significantly higher antimicrobial effect than the other groups (groups 1, 2 and 3) and against all the microorganisms tested (p<0.01, Kruskal-Wallis test). The glass ionomer cement added by 1.0% chorhexidine diacetate (group 2) showed a statistically higher antimicrobial effect against S. aureus and S. mutans species than groups 1 and 3 (p<0.01). Conclusion: It was concluded that the addition of 1% chlorhexidine diacetate enriched GIC functions demonstrated by the effectiveness in growth inhibition of Streptococcus mutans and Staphylococcus aureus.

Objetivo: O objetivo do presente estudo foi avaliar o efeito antimicrobiano do cimento de ionômero de vidro acrescido de diacetato de clorexidina a 1%. Métodos: A atividade antimicrobiana foi realizada por meio do teste de formação de halo de inibição de Streptococcus mutans (S. mutans), Staphylococcus aureus (S. aureus) e Candida albicans (C. albicans) nos seguintes grupos: Grupo 1: cimento de ionômero de vidro (CIV), Grupo 2: CIV acrescido de 1% de diacetato de clorexidina, Grupo 3: solução de digluconato de clorexidina a 0,12% e Grupo 4: solução de digluconato de clorexidina a 2%. A área do halo de inibição foi medida em milímetros quadrados (mm²),nos períodos de 24 e 48 horas após incubação (37ºC). Resultados: A solução de digluconato de clorexidina a 2% (grupo 4), utilizada como um controle positivo apresentou efeito antimicrobiano significativamente maior do que os outros grupos (grupos 1, 2 e 3), contra todos os microrganismos testados (p <0,01, teste de Kruskal-Wallis). O cimento de ionômero de vidro acrescido de 1% de diacetato de clorexidina (grupo 2) demonstrou efeito antimicrobiano estatisticamente maior do que os grupos 1 e 3, contra as espécies S. aureus e S. mutans (p <0,01). Conclusão: Conclui-se que a adição de 1% de diacetato de clorexidina enriqueceu as funções do cimento de ionômero de vidro demonstradas pela efetividade em inibir o crescimento de Streptococcus mutans e Staphylococcus aureus.

Influence of obesity on experimental periodontitis in rats: histopathological, histometric and immunohistochemical study.

OBJECTIVES: This study assessed the influence of obesity on the progression of ligature-induced periodontitis in rats. MATERIALS AND METHODS: Forty-eight adult Wistar rats were randomly divided into two groups: the HL group (n = 24) was fed high-fat animal food to induce obesity, and the NL group (n = 24) was fed normolipidic animal food. Obesity was induced within a period of 120 days, and the induction of experimental periodontitis (EP) was subsequently performed for 30 days. The animals were euthanized after 7, 15, and 30 days, and the jaws were removed for histopathological, histometric, and immunohistochemical analyses. Tartrate-resistant acid phosphatase (TRAP), receptor activator of nuclear factor kappa beta ligand (RANKL), and osteoprotegerin (OPG) were analyzed via immunolabeling. RESULTS: Histological findings indicated that the inflammation was more extensive and lasted longer in the HL/EP; however, advanced destruction also occurred in the NL/EP. Greater bone loss was verified in the HL/EP group (2.28 ± 0.35) in the period of 7 days than in the NL/EP group (1.2 ± 0.29). High immunolabeling was identified in the HL/EP group in the initial periods for RANKL and TRAP, whereas the NL/EP group presented with moderate immunolabeling for both factors. The HL/EP and NL/EP groups showed low immunolabeling for OPG. CONCLUSIONS: Obesity induced by a high-fat diet influenced alveolar bone metabolism when associated with experimental periodontitis and caused a more severe local inflammatory response and alveolar bone loss. CLINICAL RELEVANCE: Obesity is related to greater alveolar bone loss and an accentuated local inflammatory response, which may be reflected in the clinical severity of periodontitis and dental loss.

Tratamento periodontal em adolescente e avaliação do grau de severidade inflamatória gengival / Periodontal treatment and the severity of inflammatory disease in the adolescent ­ a case report

O objetivo deste estudo foi apresentar um caso avaliando os aspectos inflamatórios gengivais antes e após o tratamento periodontal não cirúrgico em uma paciente adolescente. Uma menina de 14 anos de idade apresentou-se com queixa principal de ausência das restaurações protéticas nos dentes 36 e 46. O índice de placa inicial era de 96%, e o exame radiográfico detectou perda óssea alveolar incipiente nos dentes 16 e 26 (coroas de aço inoxidável) com média de perda óssea próxima aos 3 mm. Após 60 dias de tratamento, o índice gengival (IG) final foi reduzido em 50% (de 1,6 para 0,5, teste de Qui-quadrado, p < 0,0001) com melhora signifi cativa nos graus 0 e 2. Ainda, os valores de profundidade de sondagem (2 mm para 1,7 mm) e sangramento (SS) ­ 90% contra 30% do sítios ­ também mostraram melhora signifi cativa (testes de Wilcoxon e McNemar, p < 0,001). Pode-se concluir que, apesar de haver influência dos hormônios sobre os tecidos periodontais durante a puberdade, com o aumento da condição inflamatória, o controle da placa bacteriana mostrou-se mais importante para a determinação da presença de saúde ou doença periodontal. A motivação e o acompanhamento constante desses pacientes em fase puberal são importantes para o controle de placa.

The aim of this study was to present a case assessing the inflammatory gingival aspects before and after non-surgical periodontal treatment in the adolescent patient. A 14-years-old girl presented with a chief complaint of absence of prosthetic restorations on teeth36 and 46. The initial plaque index was 96%, and the radiographic examination detected incipient alveolar bone loss for teeth 16 and 26 (stainless steel crowns) with a mean bone loss up to 3 mm. After 60 days of therapy, the gingival index (GI) was reduced by 50% (from 1.6 to 0.5, Chi-square test, p < 0.0001) with significant improvement in 0 and 2 scores. Also, probing depth (2 mm to 1.7 mm) and bleeding on probing (SS) ­ 90% versus 30% of the sites ­ values also showed signifi cant improvements (Wilcoxon and McNemar's tests, p < 0.001). It can be concluded that, although the hormonal imbalance can affect the periodontal tissues during puberty increasing the inflammatory condition, plaque control was more important to determine the presence of health or periodontal disease. Motivation and constant monitoring of these patients at the pubertal stage are fundamental.

Periodontal treatment in a patient with generalized idiopathic dystonia.

Dystonia is a neurological disorder that can cause constant muscle contractions and motor limitations. This work reports a clinical case of periodontal treatment in a patient with generalized idiopathic dystonia. The intraoral clinical examination was focused on the presence of caries and periodontal diseases. The plaque index (PI), probing depth (PD), and bleeding on probing (BOP) were measured. Initially, oral hygiene instruction was provided using a soft conventional toothbrush and dental floss, but the clinical results achieved using these methods were inadequate. Alternative methods of plaque removal were offered, such as the use of a power toothbrush and a dental floss fork, which resulted in improvement in the PI, PD, and BOP and allowed the patient to undergo periodontal surgery for the restoration of subgingival caries. Our results suggested that generalized idiopathic dystonia leads to motor limitations that may cause difficulty with regard to plaque control, but adaptations of the methods used for oral hygiene may improve the oral health conditions in these patients.

Oral Myiasis Caused by Cochliomyia hominivorax in a Disabled Person.

Myiasis is a parasitic disease caused by developing maggots of fly species, which can infect humans. Patients with special needs, especially those with severe neuropsychomotor limitations, may have oral manifestations of this disease. Here, we present a clinical case in which a disabled person was affected by oral myiasis caused by Cochliomyia hominivorax. Maggots were found in two ulcerated lesions, a 2 cm diameter lesion in the maxilla and a 6 cm diameter lesion in the mandible. Forty-five maggots were removed during inspection, whereas 75 maggots were surgically removed under general anesthesia with nasotracheal intubation. Dipyrone, ivermectin, and clindamycin were prescribed, and the patient remained hospitalized for 3 days. Seven days after surgical intervention, no maggots were observed. Our study emphasizes that dentists must recognize the symptoms and behaviors of parasitic diseases that affect the oral cavity.

Relação entre obesidade e doenças periodontais em crianças e adolescentes / Relationship between obesity and periodontal disease in children and adolescents

Alguns estudos têm sugerido que a obesidade é uma condição inflamatória que pode estar relacionada com o aumento da prevalência, severidade e progressão das doenças periodontais em adultos. No entanto, poucos estudos relevantes foram realizados em crianças e adolescentes obesos, de grupos de idades específicas, evidenciando-se que mais estudos são necessários para suportar a hipótese de que a obesidade infantil pode estar associada à doença periodontal. O objetivo desta revisão de literatura foi melhor investigar o nível de evidência científica da relação entre a doença periodontal e a obesidade em crianças e adolescentes. A partir dos trabalhos revisados, sugere-se que a obesidade pode ser associada com a doença periodontal em crianças e adolescentes. Porém, essa relação não está completamente elucidada, sendo necessários mais estudos com avaliação dos fatores que podem influenciar nessa relação. Além disso, uma abordagem multiprofissional se faz necessária, uma vez que o número de crianças e adolescentes obesos é crescente, e essa condição pode trazer efeitos prejudiciais, tanto para a saúde oral quanto geral.

Some studies have suggested that obesity is an inflammatory condition may be related to the increased prevalence, severity and progression of periodontal disease in adults. However, few relevant studies were performed in obese children and adolescents in specific age groups, indicating that further studies are needed to support the hypothesis that obesity may be associated with periodontal disease. The aim of this review was show the relationship between periodontal disease and obesity in children and adolescents. From the studies reviewed, it is suggested that obesity in children and adolescents can be associated with periodontal disease. However, this relationship is not completely elucidated, more research is needed to assess the factors that may influence this relationship. In addition, a team approach is required, since the number of obese children and adolescents is increasing and this condition may bring harmful effects both for the oral and systemic health.

Effect of statins and aerobic physical exercise on liver function in dyslipidemic rats: morphometric study / Efecto de las estatinas y ejercicio físico aeróbico sobre la función hepática en ratas dislipémicas: estudio morfométrico

The present study was carried out to evaluate the effect of statins associated with physical exercise (PE) in liver cells in dyslipidemic rats through cariometry. The animals were divided into six groups: animals subjected to a hypercholesterolemic diet (HD), simvastatin, with (G1) and without (G2) physical exercise (PE); HD submitted (G3) or not (G4) to PE, and commercial food diet (F) with (G5) and without (G6) PE. Histological analysis of the liver was performed by staining the slides with hematoxylin and eosin. The cariometric study included measuring the major and minor diameters of the hepatocytes nuclei. The Shapiro-Wilk test was also performed. To determine the differences among the groups, the Kruskal-Wallis Test with Dunn's post-test were conducted. The significance level was set at 5 percent. No difference was found in the hepatocytes nuclei between G5 and G6. When these groups were related with G3 and G4, reduced nuclei were observed. There was no difference between G1 and G6. The comparison between G6 and G2 showed that the nuclei in G2 were smaller. No difference was detected between G5 and G1. Changes were observed in the nuclei shape in G2 in comparison to G1. Considering G2 and G3, a decrease in the size of nuclei was observed in G3. On the other hand, G2 showed changes in shape in the comparative analysis with G4. The size and shape of G1 nuclei were larger than G3 as well as changes in shape were observed when compared to G4. G4 showed smaller nuclei than G3. Therefore, F, associated or not with the practice of PE, does not alter the size and shape of the hepatocytes nuclei; HD combined with sedentarism influences changes in the morphometric parameters of hepatocytes; and the association of simvastatin and PE seems to protect the hepatocytes nuclei with regard to HD.

El presente estudio se realizó con la finalidad de evaluar el efecto de las estatinas asociadas con el ejercicio físico (PE) en las células del hígado, en ratas con dislipidemia a través de cariometría. Los animales fueron divididos en seis grupos: animales sometidos a una dieta hipocolesterolemiante (HD), simvastatina, con (G1) y sin (G2) ejercicio físico (PE); HD enviado (G3) o no (G4) para educación física y dieta comercial (F) con (G5) y sin (G6) PE. El análisis histológico del hígado se realizó por tinción de los portaobjetos con hematoxilina y eosina. El estudio cariométrico incluyó la medición de los diámetros mayor y menor de los núcleos de hepatocitos. Se realizó la prueba de Shapiro-Wilk. Para determinar las diferencias entre los grupos, se realizó la prueba de Kruskal-Wallis con Dunn. El nivel de significación se fijó en 5 por ciento. No se encontraron diferencias en los núcleos de hepatocitos entre G5 y G6. Los núcleos fueron observados cuando estos grupos estaban relacionados con G3 y G4. No hubo diferencia entre G1 y G6. La comparación entre G6 y G2 mostró que los núcleos en G2 eran más pequeñas. No se detectaron diferencias entre el G5 y G1. Se observaron cambios en la forma núcleos en G2 en comparación con G1. Considerando G2 y G3, se observó en G3 una disminución en el tamaño de los núcleos. En el análisis comparativo con G4, G2 mostró cambios en la forma . El tamaño y forma de los núcleos G1 eran más grandes que G3, así como cambios en la forma se observaron cuando se compararó con G4. G4 mostraron núcleos menores que G3. Por tanto, F, asociados o no a la práctica de PE, no altera el tamaño y la forma de los núcleos de hepatocitos; HD combinada con influencias sedentarismo cambios en los parámetros morfométricos de los hepatocitos, y la asociación de simvastatina y PE parece proteger a los hepatocitos con respecto a la HD.

Estresse pós-privação de sono: análises morfométricas do fígado / Stress caused by sleep deprival: liver morphometric analysis

OBJETIVO: Avaliar o efeito da exposição ao estresse pós-privação de sono em características celulares e nucleares do fígado de ratos. MÉTODOS: 16 ratos (Wistar) machos adultos (200-260 g) foram mantidos em ciclo de luz controlado recebendo dieta com quantidades usuais de sal e livre acesso à água e alimento. Os animais foram divididos em dois grupos de oito animais (grupo experimental e grupo controle). Os animais permaneceram na mesma gaiola (dois de cada vez) durante sete dias e, após esse período, foram pesados e separados. O animal do grupo controle continuou na mesma gaiola e o animal do grupo experimental foi colocado em aparato de privação de sono. Após as 96 horas, os dois ratos foram pesados,anestesiados, sacrificados com dose excessiva de anestésico e os fígados foram retirados. RESULTADOS: Não há diferença significante entre o grupo experimental e grupo controle em relação ao peso, embora haja diminuição de peso no grupo experimental. Nas análises cariométricas, houve diferença significante em relação ao diâmetro menor (p=0,03) e volume (p=0,04) do núcleo dos hepatócitos do grupo experimental. Nas análises esteriológicas, houve diferença significante do grupo experimental no núcleo (maior, p=0,036), do citoplasma (menor p=0,009) e outras estruturas (maior p=0,008). CONCLUSÃO: O estresse parece contribuir para alteração na estrutura celular hepática.

OBJECTIVE: To evaluate the effect of stress induced by sleep deprivation on nuclear and cellular features of rat liver. METHODS: 16 adult male Wistar rats (200-260 g) in controlled light cycle received diet with customary salt quantity and free access to water and food. The animals were divided into two groups with 8 animals each (experimental group and control group). Animals stayed in the same box (two at a time) during seven days andafter that period they were weighted e separated. The control group animal continued in the same box and the experimental group animal were transferred to a sleep deprivation apparatus. After the 96 hours the animals were sacrificed by an excessive anesthetic dose; animals were weighted and their liver extracted. RESULTS: There was no significant difference between experimental and control group regarding weight, although therewas a decrease of weight on the experiment group. Karyotipical analysis showed significant smaller diameter (p=0.03) and volume (p=0.044) of hepatocyte nuclei in experimental group. Stereological analyses showed significant differences in experimental group for nucleus (larger, p=0.036), cytoplasm (smaller, p=0.009) and other structures (larger, p=0.008). CONCLUSION: Stress seems to contribute to alteration of hepatic cell structure.

Cardiovascular risk in obese patients with chronic periodontitis: a clinical controlled study / Risco cardiovascular em pacientes obesos com periodontite crônica: estudo clínico controlado

Introduction: Studies have shown that obesity is considered a risk factor for the development of periodontal disease and cardiovascular events. Objective: The objective was to evaluate the risk for cardiovascular diseases (CVDs) in obese patients with and without periodontal. Material and Method: One hundred patients were divided into four groups: Group O - obese without chronic periodontitis (n=25); Group OP - obese with chronic periodontitis (n=25); Group NO - non-obese without chronic periodontitis (n=25); and Group NOP - non-obese with chronic periodontitis (n=25). Demographic and laboratorial data (total cholesterol, high-density lipoprotein - HDL and low-density lipoprotein - LDL, triglycerides, and glucose); anthropometric measurements (body mass index - BMI; waist circumference - WC; body fat - BF); blood pressure; and periodontal parameters (bleeding on probing - BOP, periodontal probing depth - PPD, and the clinical attachment level - CAL) were evaluated. Cardiovascular risk was obtained according to the PROCAM's score. The correlation between obesity, periodontal disease and risk for CVD was verified by Spearman's test (α = 0.05). Result: The group OP showed a statistically higher rate of PPD ≥ 7 mm (11.2 ± 2.03) when compared with other groups, as well as higher levels of triglycerides, total cholesterol, and LDL (p<0.05). The risk for CVD was statistically higher in the group OP (28.1 ± 3.3) when compared with group O (16.5 ± 3.5), group NOP (12.8 ± 3.9), and group NO (7.7 ± 0.9). Obesity and periodontal disease are directly related to a moderate increase in CVD risk (r = 0.53, p <0.0001 and r = 0.62, p <0.0001, respectively). Conclusion: It was concluded that obesity and periodontal disease increases the risk to cardiovascular events.

Introdução: Estudos têm demonstrado que a obesidade tem sido considerada um fator de risco para o desenvolvimento de doença periodontal e dos eventos cardiovasculares. Objetivo: Avaliar o risco às doenças cardiovasculares (DCVs) em pacientes obesos com e sem doença periodontal. Material e Método: Participaram do estudo 100 pacientes, os quais foram divididos em quatro grupos: Grupo O - obeso sem periodontite crônica (n=25), Grupo OP - obeso com periodontite crônica (n=25), Grupo NO - não obeso sem periodontite crônica (n=25), Grupo NOP - não obeso com periodontite crônica (n=25). Foram avaliados dados demográficos e laboratoriais (colesterol total, lipoproteína de alta densidade - HDL e de baixa densidade - LDL, triglicérides e glicemia), dados antropométricos (índice de massa corporal - IMC; circunferência abdominal - CA; gordura corporal - GC), pressão arterial e parâmetros periodontais (sangramento à sondagem - SS, profundidade de sondagem - PS e nível de inserção clínico - NIC). O risco cardiovascular foi obtido baseado no escore de PROCAM. A correlação entre obesidade, doença periodontal e risco às DCVs foi verificado pelo teste de Spearman ((α=0,05). Resultado: O grupo OP apresentou estatisticamente maior quantidade de sítios com PS ≥ 7 mm (11,2±2,03) quando comparado aos outros grupos (p<0,05). Os níveis de triglicérides, colesterol total e LDL foram estatisticamente maiores no grupo OP. O risco às DCVs foi estatisticamente maior no grupo OP (28,1±3,3) quando comparado ao grupo O (16,5±3,5), grupo NOP (12,8±3,9) e grupo NO (7,7±0,9). A obesidade e a doença periodontal estão diretamente relacionadas com um aumento moderado do risco DCVs (r=0,53; p<0,0001 e r=0,62; p<0,0001, respectivamente). Conclusão: Conclui-se que a obesidade e a doença periodontal aumentam o risco à eventos cardiovasculares.

Apicectomia seguida de obturação retrógrada com cimento de Portland - Casos clínicos / Apicoectomy followed by retrograde filling with Portland cement - Clinical cases

O objetivo deste estudo foi avaliar o desempenho do cimento de Portland em dois casos clínicos, em que os pacientes foram submetidos à apicectomia seguida de obturação retrógrada. O material utilizado se mostrou biocompatível, sugeriu ação sobre os microorganismose as lesões periapicais foram reparadas. Pelo exposto, o cimento de Portlandfoi eficiente, pois definiu um prognóstico favorável aos dentes e apresentou custo baixo para o paciente. Novas pesquisas utilizando esse material devem ser realizadas no sentidode melhorar sua propriedade de radiopacidade.

The objective of this study was to evaluate the acting of the Portland cement in two clinical cases, in that the patients were submitted to the apicoectomy followed by retrograde filling. The used material if it showed biocompatible, suggested action on the microorganisms and the periapical lesions they were repaired. For the exposed, the Portland cement wasefficient, because it defined a favorable prognostic to the teeth and it presented low cost for the patient. New researches using that material should be accomplished in the sense of improving your contrast property.

Prevalence of Periodontal Bone Loss in Brazilian Adolescents through Interproximal Radiography.

Purpose. The aim of this study was to verify the prevalence of alveolar bone loss in Brazilian adolescents through the interproximal X-rays analysis. Methods. Bilateral and standardized interproximal (bitewing) X-rays were performed in 15-year-old adolescents (n = 326), and the processing of films and measurements of alveolar bone levels were accomplished by a single examiner. A distance between the cementoenamel junction (CEJ) and the alveolar bone crest more than 2 mm was considered as periodontal bone loss. Results. The results showed percentage of bone loss of 10.4% with predominance of horizontal defects (8.9%) over the vertical types (1.5%). It was verified higher individual distribution of one lesion (67.6%) than two (26.5%) or three lesions (5.6%), and higher occurrence was detected in men (14.95) than in women (8.21). Conclusion. It can be concluded that the interproximal radiography was an efficient method for the detection of alveolar bone loss, revealing low prevalence in adolescents and predominance of horizontal bone defects.

Clinical application of Cone-beam tomography in disorders of the head of mandible

This article aims to introduce or upgrade health professionals about the applicability of the use of Cone-beam Tomography in clinical and surgical studies of the head of mandible. Due to its location and functionality, the head of mandible has great importance in various specialties and, imaging tests are recommended for therapeutic methods. Regular radiographs show superimposed images of the mandibular region, hampering the morphological assessments. Through more precise images that identify minimal changes, the Cone-beam Tomography is an imaging method that optimizes the routine clinical performance by improving the diagnostic accuracy, since it makes visible three-dimensional bone structures and corrects overlapping areas.

Estudo sobre o aspecto financeiro da clínica integrada de um curso de odontologia / Study on the financial aspect of an integrated clinical course of dentistry

Objetivo: a analisar as razões que motivaram os pacientes a solicitar o ressarcimento financeiro por tratamentos realizados nas Clínicas do Curso de Odontologia do Centro Universitário da Fundação Educacional de Barretos (UNIFEB), São Paulo, Brasil. Material e métodos: foi realizado um levantamento nos prontuários que envolviam custos financeiros nos procedimentos odontológicos executados nas disciplinas de Clínicas Integradas. Duzentos prontuários que envolviam procedimentos odontológicos com custos enquadraram-se no estudo. Desses prontuários foram obtidas informações de procedimentos odontológicos realizados e solicitação de ressarcimento financeiro. Resultados: do total de prontuários levantados na clínica odontológica, 16 (8%) dos pacientes solicitaram ressarcimento financeiro. Todos os prontuários apresentavam a prótese dentária como à especialidade predominante na solicitação dos pacientes para ressarcimento financeiro. As justificativas dos usuários para solicitação dos ressarcimentos financeiros concentrou-se predominantemente no descumprimento do prazo de finalização do trabalho protético 6 (37%), na alteração do planejamento do tratamento 5 (32%), no estado não funcional das próteses 4 (25%) e as condições sistêmicas alteradas do usuário 1 (6%). Conclusão: essa pesquisa proporcionou um melhor entendimento sobre os aspectos financeiros que envolvem as devoluções em espécie por trabalhos protéticos realizados pelos alunos sob supervisão docente. Os dados apontam a conscientização do paciente em relação aos seus direitos, enquanto consumidores.

Objective: to examine the reasons for patients to ask for financial compensation for treatments performed in the Clinical Course of Dentistry of the University Center of the Educational Foundation of Barrie (UNIFEB), São Paulo, Brazil. Material and methods: We performed a survey in the medical records involving financial costs on dental procedures performed in the disciplines of Integrated Clinics. Two hundred medical records involving dental procedures cost framed in the study. These planning 5 (32%), non-functional state of the prosthesis 4 (25%) and systemic conditions changed the user 1 (6%). Conclusion: This research provided a better understanding of the issues involving the financial returns in kind prosthetic work performed records were collected from dental procedures carried out and request for financial compensation. Results: the total number of records collected in the dental clinic, 16 (8%) patients asked for financial compensation. All had the dental records as the predominant specialty of patients in the request for financial compensation. The reasons for requesting the users of financial remedies was predominantly concentrated in breach of the term of completion of the prosthetic work 6 (37%), changes in treatment by students under supervision. The data point to the patient's awareness regarding their rights as consumers.

Influence of anxiety on blood pressure and heart rate during dental treatment / Influência da ansiedade na pressão arterial e frequência cardíaca durante o tratamento odontológico

PURPOSE: To evaluate the influence of anxiety on blood pressure and heart rate during dental care in patients of the Dentistry Clinic in Rio Preto University Center - UNIRP, São José do Rio Preto, São Paulo, Brazil. METHODS: A sample of 60 volunteers who sought for the dental screening service was selected. We used a scale to evaluate the volunteers' anxiety level. Blood pressure and heart rate of patients were also checked in different periods of the dental treatment. RESULTS: Most of the volunteers were women. The relation between anxiety and pain before treatment, revealed that 54 (90.0%) had no pain. The patients had low anxiety towards the use of different anesthetic solutions used during dental procedures. There was no statistically significant difference concerning to systolic blood pressure at first and, after application of anesthetic, given the degree of anxiety. Heart rate does not change as a function of anxiety. There is a slight change in heart rate after anesthesia, and it soon gets back to normal. CONCLUSION: There was no difference in behavior of systolic and diastolic blood pressure in relation to the anxiety level and pain, measured before, during and after the procedure. Heart rate did not change during dental treatment in the patient anxiety level.

OBJETIVO: Avaliar a influência da ansiedade detectadas por meio de uma escala de ansiedade sobre os níveis de pressão arterial e a frequência cardíaca, durante o atendimento odontológico de pacientes das Clínicas de Odontologia do Centro Universitário de São José do Rio Preto, São Paulo, Brasil. METODOLOGIA: Foram selecionados ao acaso 60 voluntários que receberam atendimento odontológico de urgência. Foi utilizada uma escala para avaliar o grau de ansiedade dos voluntários. Foi verificada também a pressão arterial e a frequência cardíaca dos pacientes em três períodos distintos: pré, trans e pós-anestesia odontológica. RESULTADOS: A ansiedade não foi afetada pelas faixas etárias, apenas pelo gênero. A ansiedade não deve ser uma barreira, entre profissional/paciente e, ainda, a ansiedade apresentada não é um sinal clínico levado em consideração para a aplicação de medidas de controle. CONCLUSÃO: Não houve alteração da pressão arterial sistólica, diastólica e da frequência cardíaca em relação ao grau de ansiedade e dor e ao tipo de solução anestésica empregada.

Percepção dos cuidadores sobre os aspectos éticos do atendimento odontológico a pacientes com necessidades especiais / The caregivers' perception on the ethical aspects of the dentistry attendance to patient with special care

O objetivo do presente estudo foi avaliar a percepção dos cuidadores sobre os aspectos éticos do atendimento aos pacientes com necessidades especiais (PNE) pelo Grupo de Atendimento Multiprofissional a Pacientes com Necessidades Especiais (GAMPE) do Curso de Odontologia do Centro Universitário da Fundação Educacional de Barretos (UNIFEB). O projeto de pesquisa constou de um questionário estruturado com 14 questões fechadas, que abordavam os aspectos éticos do atendimento prestado aos PNE por meio do GAMPE. Dos 40 questionários distribuídos, todos foram respondidos, constatando-se que os pacientes são provenientes de diferentes cidades do estado de São Paulo. As mulheres acima de 50 anos de idade representaram 80% das entrevistadas. Verificou-se, também, alto índice de satisfação dos cuidadores em relação aos atendimentos prestados pelos profissionais aos pacientes. Conclui-se, portanto, que o atendimento disponibilizado aos PNE bem como aos cuidadores contém os fatores relacionados à humanização no atendimento odontológico, concomitantemente, à qualidade nos serviços odontológicos realizados pelo GAMPE.

The main concern of patients in dentistry is the aesthetics of the smile. In this sense, the manufacturers of dental materials have improved, like the resins that are used for restorations in anterior and posterior teeth and that have excellent aesthetics and good mechanical properties. The aim of this study is to evaluate the influence of different drinks (wine, Coke and coffee) on color stability of composite resin with and without brushing with toothpaste. Specimens were fabricated with composite resin, which underwent an initial assessment of color and divided into groups that were immersed for 30 and 60 days in their net regarding the experimental groups. After this period of immersion, the color was measured again, and the specimens were submitted to brushing, to assess whether toothbrushing is an effective method to prevent or reduce the staining in composite resin, caused by drinking in study. Drinks in the study affected the color stability of composite resins, with color changes visible. Brushing was not effective in removing the pigment in red wine, however, resulted in improved staining caused by Coke.

Effect of sodium cyclamate on the rat fetal exocrine pancreas: a karyometric and stereological study / Efectos del ciclamato de sodio en el pancreas exocrino fetal de ratas: estudio cariométrico y estereológico

The cyclamate, a sweetner substance derived from N-cyclo-hexyl-sulfamic acid, is largely utilized as a non-caloric artificial edulcorant in foods and beverages as well as in the pharmaceutical industry. The objective of this study was to evaluate karyometric and stereological alterations in the rat fetal pancreas resulting from the intraperitoneal administration of sodium cyclamate. The exocrine pancreas of ten fetuses of rats were evaluated, five treated and five controls chosen at random, in which five rats that received from the 10th to 14th days of pregnancy an intraperitoneal daily injection of sodium cyclamate at 60 mg/Kg of body weight during 5 days. At the 20th day of gestation, the animals were removed and weighed, as were their placentas; the length of the umbilical cords also were measured. After the laboratory processing, semi-seriated 6mm cuts stained with haematoxyline and eosine were performed. In seven karyometric parameters (major, minor, and medium diameters, volume, area, perimeter, and volume-area ratio), the increase was statistically significant in the treated group when compared with control group. Stereological parameters showed in the treated group a significant increase in the cellular volume and a significant reduction in the numerical cellular density. These results showed that the sodium cyclamate in pregnant rats led to retardation of fetal development and hypertrophy in the exocrine pancreas of the rat fetuses.

El ciclamato, es una substancia derivada del ácido N-ciclo-hexil-sulfámico, bastante usada como edulcorante no calórico en los alimentos y bebidas, así como en la industria farmacéutica. El objetivo de este estudio fue evaluar las alteraciones cariométricas y estereológicos en páncreas fetal de rata tras la administración intraperitoneal de ciclamato de sodio. El páncreas exocrino de diez de los fetos de rata fueron evaluados, cinco tratados y cinco controles seleccionados al azar, en el que cinco ratas recibieron del día 10 al día 14 de preñez una inyección intraperitoneal diaria de ciclamato de sodio a 60 mg/Kg de peso corporal durante 5 días. En el día 20 de gestación, los animales fueron retirados y pesados, al igual que sus placentas. Asimismo, se midió la longitud de los cordones umbilicales. Después del procesamiento de laboratorio, cortes semi-seriados de 6µm, se tiñeron con hematoxilina-eosina. En siete parámetros cariométricos (diámetros mayor, menor y medio, volumen, área, perímetro y relación área/volumen). El aumento fue estadísticamente significativo en el grupo tratado comparado con el grupo control. Los parámetros estereológicos mostraron en el grupo tratado un aumento significativo del volumen celular y una reducción significativa en la densidad numérica celular. Estos resultados mostraron que el uso del ciclamato de sodio en las ratas preñadas causa retardo en el desarrollo fetal e hipertrofia en el páncreas exocrino de los fetos de rata.

Avaliação da condição gengival em resposta aos picos hormonais do ciclo reprodutivo da mulher: estudo clínico controlado / Evaluation of the gingival condition in response to the hormonal peaks of the women’s reproductive cycle: controlled clinical trial

Vários autores consideram que os hormônios podem influenciar significativamente as doenças periodontais, particularmente em períodos de desequilíbrio do nível de hormônios sexuais relacionados ao ciclo da vida reprodutiva da mulher, desde a puberdade até a menopausa. O objetivo deste estudo foi avaliar as características gengivais relacionadas às alterações hormonais do ciclo mensal da mulher. Foram incluídas no estudo 32 mulheres, com idades entre 18 e 30 anos, independente de raça, com bom controle de placa bacteriana que foram avaliadas em três períodos distintos: 4 a 5 dias após o início da menstruação (Período controle – PC), 12 dias após o início da menstruação (Pico de estrogênio - PE) e 24 dias após o início da menstruação (Pico de progesterona - PP). Um questionário foi aplicado e em cada período de avaliação foram realizados os índices gengivais (IG) e os índices de placa (IPL). Os resultados demonstraram que não houve alterações estatisticamente significativas nos níveis de IG entre os períodos PC e PE do ciclo menstrual (p > 0,05), porém no PP verificou-se um aumento nos graus de sangramento gengival (p < 0,05). O IPL não demonstrou diferenças significativas em nenhum período experimental, com excelentes níveis de controle de placa (p > 0,05). Diante dos achados obtidos, pode-se concluir que os hormônios do ciclo menstrual, especialmente a progesterona, exercem alguma influência sobre os tecidos gengivais clinicamente saudáveis, com aumento dos sinais inflamatórios locais

Several authors consider that hormones may significantly influence the periodontal diseases, particularly in times of imbalance in the level of sex hormones related to the women’s reproductive cycle, from puberty to menopause. The aim of this study was to evaluate the characteristics of the gingiva related to hormonal changes during the mensal woman’s cycle. This study included 32 women, aged between 18 and 30 years, regardless of race, with good control of plaque, which were evaluated in three different periods: 4 to 5 days after onset of menstruation (Control period - PC), 12 days after the menstruation period (peak of estrogen - PE) and 24 day safter the menstruation period (peak of progesterone - PP). A questionnaire was applied, and the gingival index (GI) and plaque index (IPL) were performed in each period of evaluation. The results showed no statistically significant differences in the levels of GI between the periods PC and PE of the menstrual cycle (p> 0.05), but there was an increase in the degree of gingival bleeding in the condition of PP (p< 0.05). The IPL showed no significant differences in any experimental period, with excellent levels of plaque control in all of them (p> 0.05). Considering Our findings, it can be concluded that the hormones of the menstrual cycle, especially the progesterone, can exert some influence on the clinically healthy gingival tissues, with increased of the local inflammatory signs

Conhecimento de acadêmicos em Odontologia sobre a desinfecção de moldes de hidrocolóide irreversível / Knowledge of dental students about disinfection of irreversible hydrocolloid impressions

Objetivo: Avaliar o conhecimento de acadêmicos do curso de Odontologia sobre a desinfecção de moldes de hidrocolóide irreversível. Metodologia: A amostra foi constituída por 80 acadêmicos do sexto e oitavo termos do Curso de Odontologia do Centro Universitário da Fundação Educacional de Barretos, Barretos, SP. Os dados foram coletados através de um questionário com oito questões de múltipla escolha que abordavam a desinfecção de molde de hidrocolóide irreversível e biossegurança. Os dados foram analisados de forma descritiva e qualitativa. Resultados: A maioria (90%) dos sujeitos afirmou saber que o molde de hidrocolóide irreversível pode disseminar doenças infecto-contagiosas, mas apenas 66% responderam que aprenderam uma técnica de desinfecção do molde. Muitos acadêmicos (41%) não souberam responder qual substância seria indicada para a desinfecção de moldes de hidrocolóide irreversível e apenas 70% lavavam o molde em água corrente antes da desinfecção química. Conclusão: Os estudantes de Odontologia têm consciência dos riscos de contaminação do molde de hidrocolóide irreversível, mas os conhecimentos adquiridos e aplicados sobre os procedimentos técnicos para a realização da desinfecção de moldes e controle de infecção cruzada são insuficientes.

Purpose: To evaluate the knowledge of dental students about disinfection of irreversible hydrocolloid impression. Methods: The sample consisted of 80 dental students of the sixth and eight terms of the Dental Course at Centro Universitário da Fundação Educacional de Barretos, Barretos, SP. Data were collected using a questionnaire with eight multiple choice questions about disinfection of irreversible hydrocolloid impressions and biosafety. Data were analyzed in a descriptive and qualitative format. Results: Most subjects (90%) stated that they were aware of the risks of irreversible hydrocolloid impressions to spread infectious diseases. However, only 66% answered that they had learned a disinfection method for impressions. Many students (41%) did not know which solution should be indicated for impression disinfection and only 70% used to wash the impression in running water before chemical disinfection. Conclusion: The dental students are aware of the potential contamination risks by irreversible hydrocolloid impressions, but their acquired knowledge and practices on technical procedures to properly disinfect impressions and control cross-infection are insufficient.

Histometric study of alveolar bone in rats submitted to ethanol during lactation

The present work studied the adverse effects of maternal exposure of rats to alcohol during lactation, on the development of their off spring. Histometric evaluation by karyometry and of the alveolar bone at the level of the first upper molar of the sucking was perfomed. Two groups of animals, one coming from mothers exposed to drinking water containing 20 percent ethanol during the total lactation period and the other of controls coming from mothers receiving only alcohol-free drinking water during this period. On the 21 first day of lactation the young of each group were aleatorily selected and following anesthesia, their heads severed; after histological treatment, serial 6 ìm sections on the frontal plane at the molar level, stained with hematoxilin and eosin, were obtained. The experimental results produced, suggest that sucking from ethanol-treated mothers, show retarded post-natal growth, their alveolar bones presenting scarce, little calcified trabeculae, and a more abundant bone marrow compared to controls.

Considerando que la lactancia es un período importante y vulnerable, y que la exposición materna al alcohol durante esta fase puede provocar efectos adversos en las crías en desarrollo, el propósito del presente trabajo es evaluar histométricamente (mediante cariometría y estereología), el hueso alveolar a nivel del primer molar superior, de ratas lactantes sometidas a los efectos del etanol. Con esa finalidad utilizamos dos grupos, uno que recibió etanol al 20 por ciento en el bebedero, durante todo el período de lactancia (21días), y otro que recibió solo agua. En el 21° día de lactancia, 5 ratas de cada grupo fueron aleatoriamente seleccionadas. Después de sacrificados, los animales fueron fijados en formol al 10 por ciento. Las cabezas, separadas de los cuerpos, fueron incluidas en parafina, y cortadas seriadamente con 6 Lim de grosor, a partir de un plano frontal al nivel de los molares, y teñidas con hematoxilina y eosina. Basados en los resultados presentes, es posible concluir que el etanol al 20 por ciento en el agua de beber, administrado a ratas lactantes, provoca los siguientes efectos: reducción significativa del peso corporal, alteraciones de las trabéculas del hueso alveolar, observadas estereológicamente, evidenciadas por trabéculas delicadas y poco calcificadas, con médula abundante, núcleos menores en osteoblastos y osteocitos y más achatados en los primeros, y con osteocitos de volúmenes citoplasmático y celular menor y densidad numérica mayor.