Functional dentition and well-being among Chilean 80-year-olds.

BACKGROUND: The Decade of Healthy Aging 2021-2030 calls for a strengthening of the policies for older people in Latin America. An example of successful oral aging is the Japanese "8020" campaign, which achieved 50% of people aged 80 years having ≥20 teeth by 2016. OBJECTIVE: To evaluate the association between having a functional dentition (≥20 teeth) and cognitive health, social participation, and quality of life in people aged ≥80 years. METHODS: Cross-sectional data from 299 complete observations (weighted N = 436 981) of individuals aged ≥80 years from Chile's National Health Survey 2016-2017 were included (3% of the population; total = 5520 clinical observations/weighted N = 14 518 969). Generalised structural equation models (GSEM) evaluated the association between having a functional dentition and cognitive health, measured with the Mini-mental score, between having a functional dentition and social participation, and between having a functional dentition and quality of life, measured with the EQ-5D-3L. Models included the effect of mediators (daily fruit and vegetable consumption; oral health-related quality of life score) and controlled for the exposure-induced mediator-outcome variables: sex, educational level, and location. Data were analysed using the STATA-17 survey module. Statistical significance was set at P < .05 (95% confidence interval [CI]). RESULTS: The sample was mostly female, had <8 years of education, and lived in urban areas. The prevalence of a functional dentition was 9.2% (95% CI 3.6,21.3/n = 21). GSEM demonstrated that the association between functional dentition and cognitive health was mediated by daily fruits and vegetables consumption (ß = 0.12/95% CI 0.02,0.21/P = .015), with moderate strength of evidence. Additionally, there was strong evidence of an association between functional dentition and social participation frequency (ß = 2.76/95% CI 0.60,4.73/P = .009). Finally, the association between functional dentition and quality of life was mediated by cognitive health (ß =0.05/95% CI 0.02,0.09/P = .002) and oral health-related quality of life (ß = -0.04/95% CI -0.08 to -0.01/P = .025), with strong and moderate evidence, respectively. CONCLUSION: Given the beneficial implications of functional dentition in social participation, nutritional benefits and quality of life and well-being of individuals aged ≥80 years.

Active MMP-8 Quantitative Test as an Adjunctive Tool for Early Diagnosis of Periodontitis.

Periodontitis is a host-mediated bacterial disease that affects the tooth attachment apparatus. Metalloproteinase-8 (MMP-8), a validated biomarker, could aid in clinical diagnosis. This study aimed to evaluate the diagnostic performance of active (a) MMP-8 immunotest versus total (t) MMP-8 ELISA for quantitative real-time diagnosis and assessment of periodontitis severity at the site level. Gingival crevicular fluid (GCF) was sampled from 30 healthy, 42 mild, and 59 severe periodontitis sites from thirty-one volunteers. MMP-8 concentrations were determined by time-resolved immunofluorometric assay (IFMA) and enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed using the STATA package. Both active and total MMP-8-based methods discriminated among sites according to periodontal diagnosis and severity, with a positive correlation between the two tests (p < 0.001). (a) MMP-8 models showed the best performance in receiver operating characteristic (ROC) curves to discriminate between healthy and periodontitis sites (area under the curve [AUC] = 0.89), while (t) MMP-8 demonstrated a high diagnostic precision in the detection of mild from severe periodontitis sites (AUC ≥ 0.80). The use of (a) MMP-8 and (t) MMP-8 could represent a useful adjunctive tool for periodontitis diagnosis and severity. These results support the applicability of new point-of-care methods in the monitoring of high-risk periodontal patients.

Assessment of Cardiovascular Risk in Women with Periodontal Diseases According to C-reactive Protein Levels.

Cardiovascular diseases (CVD) are highly prevalent non-communicable diseases worldwide. Periodontitis may act as a non-traditional cardiovascular risk (CVR) factor, linked by a low-grade systemic inflammation mediated by C-reactive protein (CRP). Patients with periodontitis reported higher serum CRP levels; however, a CRP systemic and periodontal correlation in gingival crevicular fluid (GCF) and its CVR impact have been barely studied. We aimed to assess the association between periodontal diseases and CVR in a group of adult women, based on serum high-sensitivity CRP (hs-CRP) levels; and secondly, to determine the association between serum and GCF CRP levels. Gingival crevicular fluid and blood samples were obtained from women with periodontitis, gingivitis, and healthy controls. Serum and GCF CRP were determined by turbidimetric method and Luminex technology, respectively. Data were analyzed and adjusted by CVR factors. All women presented moderate CVR, without an evident association between serum hs-CRP levels and periodontal diseases. While serum hs-CRP concentrations did not significantly differ between groups, patients with gingivitis and periodontitis showed higher CRP levels in GCF, which positively correlated to CRP detection in serum.

Periodontal Treatment Protocol for Decompensated Diabetes Patients.

Background: Decompensated diabetes is associated with a higher prevalence and severity of periodontitis and poorer response to periodontal therapy. It is conceivable that periodontal therapy may cause systemic and local complications in this type of patients. The aim of the present study was to identify and describe the best available evidence for the treatment of periodontitis in decompensated diabetics. Material and methods: An expert committee including participants from different areas gathered to discuss and develop a treatment guideline under the guidance of the Cochrane Associate Center, Faculty of Dentistry, University of Chile. In total, four research questions were prepared. The questions prepared related to decompensated diabetic patients (glycated hemoglobin >8) were, (1) Does the exposure to periodontal treatment increase the risk of infectious or systemic complications? (2) Does the antibiotic treatment or prophylaxis, compared to not giving it, reduce infectious complications? (3) Does the exposure to periodontal treatment, compared to no treatment, reduce the glycated hemoglobin levels (HbA1c)? Last question was related to diabetic patients, (4) Does the exposure to a higher level of HbA1c, compared to stable levels, increase the risk of infectious complications? Based on these questions, a search strategy was developed using MEDLINE and EPISTEMONIKOS. Only systematic reviews were considered. Results: For question 1, the search yielded 12 records in EPISTEMONIKOS and 23 in MEDLINE. None of these studies addressed the question. For question 2, the search yielded 58 records in EPISTEMONIKOS and 11 in MEDLINE. None of these studies addressed the question. For question 3, the search yielded 16 records in EPISTEMONIKOS and 11 in MEDLINE. Thirteen addressed the question. For question 4, the search yielded 7 records in EPISTEMONIKOS and 9 in MEDLINE. One addressed the question. Conclusions: In decompensated diabetic patients, there is lack of scientific information about risk of infectious or systemic complications as a result of periodontal treatment and about the impact of antibiotic treatment or prophylaxis on reduction if infectious complications. A defined HbA1c threshold for dental and periodontal treatment in diabetic patients has yet to be determined. Finally, periodontal treatment does have an impact on HbA1c levels.

MMP-8, TRAP-5, and OPG Levels in GCF Diagnostic Potential to Discriminate between Healthy Patients', Mild and Severe Periodontitis Sites.

Biomarkers represent promising aids in periodontitis, host-mediate diseases of the tooth-supporting tissues. We assessed the diagnostic potential of matrix metalloproteinase-8 (MMP-8), tartrate-resistant acid phosphatase-5 (TRAP-5), and osteoprotegerin (OPG) to discriminate between healthy patients', mild and severe periodontitis sites. Thirty-one otherwise healthy volunteers with and without periodontal disease were enrolled at the Faculty of Dentistry, University of Chile. Periodontal parameters were examined and gingival crevicular fluid was sampled from mild periodontitis sites (M; n = 42), severe periodontitis sites (S; n = 59), and healthy volunteer sites (H; n = 30). TRAP-5 and OPG were determined by commercial multiplex assay and MMP-8 by the immunofluorometric (IFMA) method. STATA software was used. All biomarkers showed a good discrimination performance. MMP-8 had the overall best performance in regression models and Receiver Operating Characteristic (ROC) curves, with high discrimination of healthy from periodontitis sites (area under the curve (AUC) = 0.901). OPG showed a very high diagnostic precision (AUC ≥ 0.95) to identify severe periodontitis sites (S versus H + M), while TRAP-5 identified both healthy and severe sites. As conclusions, MMP-8, TRAP-5, and OPG present a high precision potential in the identification of periodontal disease destruction, with MMP-8 as the most accurate diagnostic biomarker.

Development of a self-report questionnaire designed for population-based surveillance of gingivitis in adolescents: assessment of content validity and reliability.

OBJECTIVE: This study aimed to develop and assess the content validity and reliability of a cognitively adapted self-report questionnaire designed for surveillance of gingivitis in adolescents. MATERIAL AND METHODS: Ten predetermined self-report questions evaluating early signs and symptoms of gingivitis were preliminary assessed by a panel of clinical experts. Eight questions were selected and cognitively tested in 20 adolescents aged 12 to 18 years from Santiago de Chile. The questionnaire was then conducted and answered by 178 Chilean adolescents. Internal consistency was measured using the Cronbach's alpha and temporal stability was calculated using the Kappa-index. RESULTS: A reliable final self-report questionnaire consisting of 5 questions was obtained, with a total Cronbach's alpha of 0.73 and a Kappa-index ranging from 0.41 to 0.77 between the different questions. CONCLUSIONS: The proposed questionnaire is reliable, with an acceptable internal consistency and a temporal stability from moderate to substantial, and it is promising for estimating the prevalence of gingivitis in adolescents.

Development of a self-report questionnaire designed for population-based surveillance of gingivitis in adolescents: assessment of content validity and reliability

Abstract The major infectious diseases in Chile encompass the periodontal diseases, with a combined prevalence that rises up to 90% of the population. Thus, the population-based surveillance of periodontal diseases plays a central role for assessing their prevalence and for planning, implementing, and evaluating preventive and control programs. Self-report questionnaires have been proposed for the surveillance of periodontal diseases in adult populations world-wide. Objective This study aimed to develop and assess the content validity and reliability of a cognitively adapted self-report questionnaire designed for surveillance of gingivitis in adolescents. Material and Methods Ten predetermined self-report questions evaluating early signs and symptoms of gingivitis were preliminary assessed by a panel of clinical experts. Eight questions were selected and cognitively tested in 20 adolescents aged 12 to 18 years from Santiago de Chile. The questionnaire was then conducted and answered by 178 Chilean adolescents. Internal consistency was measured using the Cronbach's alpha and temporal stability was calculated using the Kappa-index. Results A reliable final self-report questionnaire consisting of 5 questions was obtained, with a total Cronbach's alpha of 0.73 and a Kappa-index ranging from 0.41 to 0.77 between the different questions. Conclusions The proposed questionnaire is reliable, with an acceptable internal consistency and a temporal stability from moderate to substantial, and it is promising for estimating the prevalence of gingivitis in adolescents.

Eficacia de la arginina al 8% y nitrato potásico al 5% en el tratamiento de la hipersensibilidad dentinaria: ensayo clínico aleatorio / Efficacy of 8% arginine and 5% potassium nitrate in dentin hypersensitivity therapy: a randomized clinical trial

RESUMEN: Objetivo: Comparar la eficacia clínica de dentífricos en base a arginina al 8%/ monofluorfosfato de sodio 1450 ppm versus nitrato de potasio al 5%/fluoruro de sodio 2500 ppm en la terapia de la hipersensibilidad dentinaria (HSD). Materiales y método: Ensayo clínico, aleatorio, controlado, doble ciego, de grupos paralelos. Treinta y cuatro voluntarios de 18 a 70 años, con HSD en escala Visual Análoga (EVA) ≥4 en 2 ó más dientes no molares, fueron distribuidos aleatoriamente en 2 grupos: grupo T1 (n=16): dentífrico de Arginina al 8%/ monofluorfosfato de sodio 1450 ppm; y grupo T2 (n=18): dentífrico de nitrato de Potasio al 5%/fluoruro de sodio 2500 ppm. Se evaluó HSD en EVA con estímulos evaporativos y térmicos, y se compararon sus valores, así como el grado promedio de HSD y su reducción (∆HSD), intra e intergrupal, al inicio y a las 4 semanas de tratamiento. Resultados: Ambos dentífricos disminuyeron el grado promedio de HSD entre el inicio y las 4 semanas de tratamiento (T1: 5.03 ± 1.23 versus 2.60 ± 1.27, p<0.05; T2: 4.73 ± 1.51 versus 2.71 ± 1.17, p<0.05). No hubo diferencias estadísticamente significativas entre ambos dentífricos al comparar el grado promedio de reducción de HSD durante la terapia (∆HSD T1: -2.43 ± 1.22 versus ∆HSD T2: -2.27 ± 1.42). Los datos fueron analizados en Stata versión 11. Conclusiones: Ambos dentífricos fueron clínicamente eficaces en reducir la HSD a las 4 semanas, sin existir diferencias estadísticamente significativas entre ambos.

ABSTRACT: Aim: To compare the clinical efficacy of 8% arginine/1450ppm sodium monofluorophosphate and 5% potassium nitrate/2500 ppm sodium fluoride dentifrices in the treatment of dentin hypersensitivity (DH). Methods: Parallel-design, double-masked, randomized controlled clinical trial. Thirty four volunteers aged 18 to 70 years, with DH and a visual analog scale (VAS) score ≥4 at least in two or more non-molar teeth, were randomized in two groups: T1 (n=16): 8% arginine/1450 ppm sodium monofluorophosphate dentifrice; and T2 (n=18): 5% potassium nitrate/2500 ppm sodium fluoride dentifrice. DH was assessed with evaporative and thermal stimuli; and their VAS measurements, mean DH value and DH reduction (∆DH) were compared, inside and between the groups at baseline and 4-week follow-up. Data were analysed through Stata® V11 program. Results: Both toothpastes decreased mean DH value between baseline and 4 weeks (T1: 5.03 ± 1.23 versus 2.60 ± 1.27, p<0.05; T2: 4.73 ± 1.51 versus 2.71 ± 1.17, p<0.05). There were no statistical differences between both dentifrices in mean DH reduction values during therapy (∆HSD T1: -2.43 ± 1.22 versus ∆HSD T2:-2.27 ± 1.42). Conclusions: Both dentifrices had clinical efficacy in decreasing DH in a 4- week therapy, without statistical differences between both of them.

Systemic effects of controlled exposure to diesel exhaust: a meta-analysis from randomized controlled trials.

INTRODUCTION: Ambient air pollution is associated with adverse cardiovascular events. This meta-analysis aimed to investigate the short-term association between air pollution and cardiovascular effects on healthy volunteers. METHODS: We searched databases to identify randomized trials with controlled human exposures to either of two models for studying ambient particulate matter: diesel-exhaust or concentrated ambient particles. Estimates of size effect were performed using standardized mean difference (SMD). Heterogeneity was assessed with I2 statistics. Outcomes were vascular function estimated by forearm blood flow (FBF), blood pressure, heart rate, and blood analysis. RESULTS: Database searches yielded 17 articles (n = 342) with sufficient information for meta-analyses. High levels of heterogeneity for the some outcomes were analyzed using random-effects model. The pooled effect estimate showed that short-term exposure to air pollution impaired FBF response from 2.7 to 2.5 mL/100 mL tissue/min (SMD 0.404; p = .006). There was an increase in 5000 platelet/mm3 following pollution exposure (SMD 0.390; p = .050) but no significant differences for other outcomes. CONCLUSION: Controlled human exposures to air pollution are associated with the surrogates of vascular dysfunction and increase in platelet count, which might be related to adverse cardiovascular events. Given the worldwide prevalence of exposure to air pollution, these findings are relevant for public health. KEY MESSAGES Controlled exposure to air pollution impairs vasomotor response, which is a surrogate for adverse cardiovascular events. This is the first meta-analysis from randomized clinical trials showing short-term association between air pollution and cardiovascular effects on healthy volunteers. Given the worldwide prevalence of exposure to air pollution, this finding is important for public health.

Bioremediation of aquaculture wastes.

Environmental impacts of wastes from large-scale, intensive aquaculture are substantial and can lead to complex ecosystem changes. The application of known and new technologies can capture inorganic nitrogen from water and reduce organic enrichment of sediments. Biological methods, including Integrated Multi-trophic Aquaculture are now gaining interest for increasing in situ removal of nitrogen and other nutrients at sea cage sites. Several studies on biological nitrogen removal through nitrification, denitrification and anaerobic ammonium oxidation (anammox) have been reported and a number of bacterial groups active in this regard have been described. Nevertheless, additional efforts need to be focused on remediation of aquaculture wastewater and marine sediments. Conventional treatment systems have several disadvantages. Development of more efficient reactor systems and a holistic, integrated approach to waste treatment would allow more environmentally balanced aquaculture practices.