Serotype diversity of Streptococcus mutans and caries activity in children in Argentina.

AIM: The purpose of this study was to analyse the serotype distribution of S. mutans and their association with caries activity in school children from Córdoba, Argentina. MATERIALS AND METHODS: Clinical examination was performed in 133 children. The dmft+DMFT and Significant Caries (SiC) indices were calculated to identify individuals with high caries activity. After DNA extractions of S. mutans strains, serotypes were determined by PCR amplifications. The median caries activity of each serotype group was compared using a non-parametric Kruskall-Wallis test. RESULTS: We obtained S. mutans strains from stimulated saliva of 94 children. The mean dmft+DMFT was 4.14 and the mean SiC index was 8.65. Serotype c was the most frequent (53.2%), followed by e (31.9%), f (8.5%) and k (6.4%). The comparison between the SiC and Non-Sic groups showed significant differences in the frequency of serotypes c and k. The median caries activity was non-significant in the different serotypes. CONCLUSION: The difference between the serotype frequencies detected in Argentina compared to those of other countries could be related with contrasting dietary habits. The results obtained in the present study would increase the knowledge about the epidemiology of dental caries in children from Argentina.

Reconocimiento de salud y registro de enfermedad en la promoción de la salud bucal / Assessment of health and record of disease in the promotion of health oral

BACKGROUND: At present, epidemiologic dentistry has numerous indexes to measure illness such as DMFT, dmft and S-OHI which are broadly used for illness diagnosis in different population groups. On the other hand, the index INSAO proposed differs from the approach focused on the disease itself. INSAO offers a parameter to measure the degree of health of teeth and gums and thus provides the patient with the information about their health. OBJECTIVE: The aim of this study is to analyze the usefulness of the information provided by the traditional indexes and those recorded by INSAO, to the oral health evaluation in rural schools of the north of Córdoba, Argentina. MATERIAL AND METHODS: A cross-sectional study was carried out in school children, aged 5 to 14 attending 8 rural primary schools. Data was collected from a clinical examination. Caries experience was measured according WHO indications. The dmf-t and DMF-T indexes were determined. Oral hygiene was evaluated by means S-OHI. The total amount of teeth present in the mouth, sound teeth number, and the state of the gum were registered to built INSAO index. RESULTS: Inverse correspondence is observed between dental health level through INSAO and the disease through proportion of permanent and temporary teeth with cavities active recorded by dmf-t and DMF-T indexes. CONCLUSION: The application of INSAO is presented as a valuable instrument in the promotion of oral health in communities that belong to excluded social groups due to their special characteristics.

Antecedentes: La epidemiología odontológica dispone en la actualidad de numerosos índices capaces de medir enfermedad, CPOD, ceod e IHO-s, son índices ampliamente utilizados para el registro de enfermedad. Por su parte el índice INSAO, sale del enfoque asentado en la enfermedad ofreciendo un parámetro para medir el grado de salud de dientes y encías en forma conjunta. Objetivo: Comparar la información proporcionada por los índices tradicionales, CPOD, ceod e IHO-S, y por INSAO (índice de Salud Oral), y la utilidad de su aplicación en la evaluación de la salud oral de escolares rurales. Materiales Métodos: Se realizó examen clínico-odontológico a escolares rurales de 5 a 14 años de edad, ambos sexos, concurrentes a 8 escuelas rurales del norte de la Provincia de Córdoba, Argentina. Se evaluó la experiencia de caries según los criterios de la OMS y se elaboraron los correspondientes índices ceo-d y CPO-D. Se valoró la higiene oral mediante el Índice de Higiene Oral simplificado (IHO-S) de Green y Vermillon. Se registró además, total de dientes presentes en boca, cantidad de dientes sanos, y el estado de la encía, para la construcción del índice INSAO. Resultados: Se observó una correspondencia inversa entre el nivel de salud evaluado por INSAO y la proporción de elementos dentarios temporarios y permanentes con actividad de caries registrada por ceo-d y CPO-D respectivamente. Conclusiones: El reconocimiento de salud a través de la aplicación de INSAO, se presenta como una valiosa estrategia en la promoción de la salud bucal. La valoración positiva que los propios sujetos puedan hacer de sus elementos dentales y encías sanas a través de INSAO, contribuirá a la construcción de la cultura de la salud bucal en las comunidades a las que ellos pertenecen, lo que es de especial importancia cuando se trata de comunidades que por sus características especiales constituyen grupos sociales excluidos o marginados.

Reconocimiento de salud y registro de enfermedad en la promoción de la salud bucal / Assessment of health and record of disease in the promotion of health oral

BACKGROUND: At present, epidemiologic dentistry has numerous indexes to measure illness such as DMFT, dmft and S-OHI which are broadly used for illness diagnosis in different population groups. On the other hand, the index INSAO proposed differs from the approach focused on the disease itself. INSAO offers a parameter to measure the degree of health of teeth and gums and thus provides the patient with the information about their health. OBJECTIVE: The aim of this study is to analyze the usefulness of the information provided by the traditional indexes and those recorded by INSAO, to the oral health evaluation in rural schools of the north of Córdoba, Argentina. MATERIAL AND METHODS: A cross-sectional study was carried out in school children, aged 5 to 14 attending 8 rural primary schools. Data was collected from a clinical examination. Caries experience was measured according WHO indications. The dmf-t and DMF-T indexes were determined. Oral hygiene was evaluated by means S-OHI. The total amount of teeth present in the mouth, sound teeth number, and the state of the gum were registered to built INSAO index. RESULTS: Inverse correspondence is observed between dental health level through INSAO and the disease through proportion of permanent and temporary teeth with cavities active recorded by dmf-t and DMF-T indexes. CONCLUSION: The application of INSAO is presented as a valuable instrument in the promotion of oral health in communities that belong to excluded social groups due to their special characteristics.(AU)

Antecedentes: La epidemiología odontológica dispone en la actualidad de numerosos índices capaces de medir enfermedad, CPOD, ceod e IHO-s, son índices ampliamente utilizados para el registro de enfermedad. Por su parte el índice INSAO, sale del enfoque asentado en la enfermedad ofreciendo un parámetro para medir el grado de salud de dientes y encías en forma conjunta. Objetivo: Comparar la información proporcionada por los índices tradicionales, CPOD, ceod e IHO-S, y por INSAO (índice de Salud Oral), y la utilidad de su aplicación en la evaluación de la salud oral de escolares rurales. Materiales Métodos: Se realizó examen clínico-odontológico a escolares rurales de 5 a 14 años de edad, ambos sexos, concurrentes a 8 escuelas rurales del norte de la Provincia de Córdoba, Argentina. Se evaluó la experiencia de caries según los criterios de la OMS y se elaboraron los correspondientes índices ceo-d y CPO-D. Se valoró la higiene oral mediante el Indice de Higiene Oral simplificado (IHO-S) de Green y Vermillon. Se registró además, total de dientes presentes en boca, cantidad de dientes sanos, y el estado de la encía, para la construcción del índice INSAO. Resultados: Se observó una correspondencia inversa entre el nivel de salud evaluado por INSAO y la proporción de elementos dentarios temporarios y permanentes con actividad de caries registrada por ceo-d y CPO-D respectivamente. Conclusiones: El reconocimiento de salud a través de la aplicación de INSAO, se presenta como una valiosa estrategia en la promoción de la salud bucal. La valoración positiva que los propios sujetos puedan hacer de sus elementos dentales y encías sanas a través de INSAO, contribuirá a la construcción de la cultura de la salud bucal en las comunidades a las que ellos pertenecen, lo que es de especial importancia cuando se trata de comunidades que por sus características especiales constituyen grupos sociales excluidos o marginados.(AU)

Fetal dysmorphism in spontaneous abortions in a Mexican population.

OBJECTIVE: The purpose of this research was to find out the frequency and type of fetal dysmorphism in spontaneous abortions among the Mexican population. METHOD: A prospective study was carried out in all the cases of spontaneous miscarriages occurring at the 'Dr. Manuel Gea González' General Hospital in Mexico City, from July 1989 to June 1999. RESULT: Two hundred and one empty sacs and 1555 well-defined embryos or fetuses were analyzed. Dysmorphism was observed in 48% of the cases, malformations being the most frequently found. Among malformations the largest group corresponded to morphological alterations not recognized in the postnatal life, facial clefts and closure defects of the abdominal wall were the known malformations of the postnatal period most frequently found. The most common syndromic entities were suggestive of bone dysplasia and Turner phenotype. CONCLUSION: The frequency of fetal dysmorphism in spontaneous abortions is higher than in newborns. Its diagnosis is very important for genetic counseling.

Evolution of saliva and serum components in patients with oral candidosis topically treated with Ketoconazole and Nystatin.

The present study involves the analysis of some saliva components (SC) and serum components in patients with oral candidosis topically treated with Ketoconazole 2% (K) or Nystatin 100,000 IU (N). Twenty-four male and female patients, age range 39-82 years, were included in the study. A double-blind study was undertaken in which the patients were divided into 2 treatment groups. These groups were compared with a control group (CG) of 16 healthy patients, both male and female, age-matched with the treated groups. The parameters evaluated were oral mucous membrane lesion index (MLI), CFU of Candida, saliva flow rate, protein-bound Fe (Fe-prot), Fe-prot binding capacity (Fe-prot cap), IgAs, peroxidase activity (PA), hypothiocyanite and thiocyanite. The values of Candida CFU and MLI were significantly reduced in patients treated with K and N. The pre-treatment values of SC as compared to the CG revealed a reduction in Fe-prot and Fe-prot cap. These parameters reach values similar to control towards the end of the treatment. The PA was significantly higher in candidosis patients and fell to control values with treatment. The other SC and serum components did not exhibit significant differences with the CG. Patients with oral candidosis treated locally exhibit not only an improvement in clinical manifestations but also a return to control values of altered SC.

[Oral health status evaluation of pre-school children: longitudinal epidemiologic study (1993-1994), Córdoba, Argentina]. / Evaluación del estado de salud bucodental en preescolares: estudio epidemiológico longitudinal (1993-1994), Córdoba, Argentina.

A one-year longitudinal survey was carried out on a sample of the Cordoba City 4-year old kindergarten population (n = 820); so as to determine the role of several variables upon the incidence of caries. The dmf-t, dmf-s, oral hygiene and oral health indexes as well as incidence rates and caries relative risks of caries were inversely related to the socioeconomic level (SEL) of the children involved. Thus in the SEL III (typical proletariat, non-typical proletariat and sub-proletariat) children, the relative risk of caries was almost five times higher (RR = 4.9) than in the SEL I (entrepreneureal and managerial bourgeoisie) children. In SEL I, almost all new lesions occurred on smooth surfaces (61.2%), while in SEL III the molar occlusal faces were mainly affected (66.3%). Daily sugar intake was higher in SEL III children but experience of caries showed poor correlation to the amount (r = 0.40) and frequency (r = 0.52) of carbohydrate intake. No significant interlevel differences were observed in the biochemical salivary parameters analyzed. Assisted toothbrushing and fluoride topications strongly lowered the incidence of caries among SEL III children, also making the corresponding rates fall almost to SEL I values (0.31, 0.23 and 0.22 vs. 0.21). In conclusion, SEL III children should be treated prophylactically with effective preventive measures, because of their susceptibility to caries. Such preventive measures include assisted toothbrushing and fluoride topications.

Evaluation of serum and saliva components in candidosis patients.

The serum and saliva components of 36 chronic Candidosis patients, both male and female, ages 38-82 who attended the Department of Clinical Stomatology were studied. Total Mucous Lesion Index (TMLI) and salivary flow rate were assessed. The following parameters were evaluated: iron bound protein, unsaturated iron binding capacity, peroxidase activity, protein content, OSCN-, SCN-, IgAs, Candida and St. mutans levels and lactobacilli activity. Candidosis patients exhibited higher Candida CFU values and increased activity of the peroxidase system (p < 0.05) whereas unsaturated iron binding capacity was significantly lower as compared to healthy subjects (p < 0.05). Furthermore, TMLI and Candida CFU values were higher in diseased subjects wearing complete prosthesis as compared to those without complete prosthesis. Diseased subjects with < 1.2 ml/min salivary flow rate exhibited even greater differences with control. This subgroup exhibited a marked reduction in IgAs. The serum components assayed were iron bound protein, unsaturated iron binding capacity, IgG, IgA and IgM. Unsaturated iron binding capacity was significantly lower in the Candidosis group (p = 0.03). Subjects suffering from oral Candidosis display deficiencies in some of their saliva components, evidencing impaired oral defense capacity.

Bucodental health condition in patients with Down syndrome of Cordoba City, Argentina.

The oral health condition of children and youngsters with Down Syndrome (DS) was evaluated on a sample of 86 mongolic subjects ages 3 to 19, both sexes, residents in the city of Córdoba (Argentina), and compared with control groups. Those persons were attended special educational institutions for the care of that type of disabled individuals. In every age group, the dmf-t and dmf-s indexes were higher in the mongolic children than in the control population, while from the age of 10 onwards the DMF-T and DMF-S of the control population were higher than those of the DS individuals. In spite of this, the scarce participation of the DF component in the mentally disabled showed deficiencies in their dental care. This population exhibited a high frequency of retarded eruption, agenesis, conoidism, Angle's type III malocclusion, posterior cross bite and deficient gingival health. A positive correlation was found between tha activity of Lactobacillus and the amount of Streptococcus and the caries indicators. A high concentration of calcium and secretory IgA was found in the group of mongolic subjects. Our analysis evidences that DS patients are at a disadvantage in relation with healthy individuals in terms of oral health. An early program of preventive measures is proposed (dental hygiene, anti-plaque agents, Therapy of Orofacial Regulation) which would involve the education of parents and teachers.

[Dental caries distribution in preschool children in an urban area of Argentina, 1992]. / Distribución de la caries dental en niños preescolares en una región urbana, Argentina, 1992.

An investigation undertaken into a sample of 1,115 five-year old children attending kindergartens in the city of Córdoba (Argentina) is described. The investigation aimed at establishing the prevalence and distribution of dental caries by socioeconomic level. Research showed that the prevalence of caries had decreased 55.0% in relation to the 1973 figure, while the proportion of children with healthy teeth was 26.7% greater. The frequency and seriousness of the caries increased as the child's social position declined. At the highest socioeconomic level NES I = entrepreneurial and managerial bourgeoisie), the rates of caries were significantly lower than those at the lowest socioeconomic level (NES III = typical proletariat, nontypical proletariat and sub-proletariat) presenting dmf-t of 0.8 and 2.7, and dmf-s of 0.9 and 4.9, respectively. In NES III, the dmf-t main components were decayed and missing teeth, while in NES I filled teeth were the main components. The proportion of children with no experience of caries was 63.1% in NES I and 11.5% in NES III. Inversly, the rate dental health was higher in NES I (8.8) than in NES III (5.1). The cost per child required for the restorative treatment in approximately two and a half times greater in NES III than in NES I. Considering the sample as a whole the expenditure required for NES III would be more than ten times higher than that required for NES I.(ABSTRACT TRUNCATED AT 250 WORDS)

Vigencia de la cirugia como tratamiento de eleccion en el hipertiroidismo. / Validity of surgery as elective treatment in hyperthyroidism

Se analizan los resultados en 1.015 pacientes hipertiroideos, I131 y cirugia. Evidenciandose que con el tratamiento quirurgico se obtiene un inmediato control del sindrome, menor recidiva, y los casos de hipotiroidismo serian inferiores a los del I131 para igual seguimiento. Se analizan los resultados del empleo, pre, intra y postoperatorio del propanolol, y se concluye que la cirugia continua siendo el tratamiento de eleccion, fundamentalmente en un area de bocio endemico

Vigencia de la cirugia como tratamiento de eleccion en el hipertiroidismo. / Validity of surgery as elective treatment in hyperthyroidism

Se analizan los resultados en 1.015 pacientes hipertiroideos, I131 y cirugia. Evidenciandose que con el tratamiento quirurgico se obtiene un inmediato control del sindrome, menor recidiva, y los casos de hipotiroidismo serian inferiores a los del I131 para igual seguimiento. Se analizan los resultados del empleo, pre, intra y postoperatorio del propanolol, y se concluye que la cirugia continua siendo el tratamiento de eleccion, fundamentalmente en un area de bocio endemico