Enzyme production by Candida albicans and Candida dubliniensis in periodontal HIV-positive patients receiving and not receiving antiretroviral therapy.

Candida dubliniensis (Cd) and Candida albicans (Ca) are the most frequently isolated yeasts in HIV+ patients. Some of the enzymes produced by these yeasts are considered virulence factors since they contribute to pathogenicity of Candida spp. The aim of the present study was to compare production of enzymes such as phospholipase (Ph), proteinase (P), and hemolysin (H) by Cd and Ca strains isolated from periodontal HIV-positive patients receiving and not receiving highly active antiretroviral therapy (HAART). Subgingival biofilm samples were obtained using paper points, and a sample of oral mucosa was taken using a swab. Phenotypic and molecular methods were used to isolate 39 strains of Candida, including 25 strains of Cd and 14 strains of Ca, obtained from 33 periodontal pocket samples and 6 oral mucosa samples collected from 15 HIV+ patients (8 receiving and 7 not receiving HAART). Malt egg-yolk agar, albumin agar and blood agar were used to evaluate pH, P and H production respectively. The strains were inoculated in duplicate and incubated at 37 ºC. Colony and halo diameters were measured. A greater proportion of Ca was observed in patients not receiving HAART, and a higher proportion of Cd was observed in those under HAART, Chi2 p< 0.001. Phospholipase production was observed in 92.9% percent of isolated Ca strains but in none of the isolated Cd strains. Proteinase production was high in Ca and Cd strains isolated from patients not receiving HAART. Hemolysin production was observed in all the studied strains, though it was significantly higher (p=0.04) in Ca and Cd strains isolated from patients not receiving HAART. To sum up, the proportion of Candida dubliniensis strains was highest in the subgingival biofilm of patients receiving HAART, and Cd strains were found to express fewer virulence factors than Ca strains.

Las levaduras más aisladas en pacientes VIH+ son Candida dubliniensis (Cd) y Candida albicans (Ca). Algunas de sus enzimas constituyen factores de virulencia ya que favorecen la diseminación tisular. El objetivo fue comparar la producción de enzimas como fosfolipasa (F), proteinasa (P) y hemolisina (H) en cepas de Cd y Ca aisladas de pacientes VIH+ tratados y no tratados con antirretrovirales (TARGA). Se realizó la toma del biofilm de placa subgingival con conos de papel y la muestra de la mucosa bucal con hisopo. Se aislaron y tipificaron por métodos fenotípicos y moleculares 39 cepas: 25 de Cd y 14 Ca, obtenidas 33 de bolsas periodontales y 6 de mucosa bucal de 15 pacientes VIH+ (8 con y 7 sin tratamiento). Se utilizó agar malta con yema de huevo, agar albúmina y agar sangre para demostrar la producción de F, P y H, respectivamente. Se inocularon por duplicado e incubaron a 37°C. Se midieron los diámetros de las colonias y los de hidrólisis alrededor de las mismas. Se observó mayor proporción de Ca en los pacientes sin tratamiento y mayor proporción de Cd en los con tratamiento; Chi2 p< 0.001. El 92,9% de las Ca estudiadas, fueron productoras de fosfolipasa. En tanto que ninguna Cd produjo la enzima. En cuanto a la producción de proteinasa se observa una alta producción tanto en las cepas de Ca, como en las Cd aisladas en los pacientes no tratados. Todas las cepas estudiadas produjeron hemolisina, observándose una diferencia estadísticamente significativa (p=0,04) en ambas especies a favor de la alta producción de la enzima en las cepas obtenidas de pacientes no tratados. Podemos concluir que en el biofilm subgingival, en los pacientes bajo TARGA, se aíslan mayor proporción de Candida dubliniensis las cuales expresan menos factores de virulencia.

Enzyme production by Candida albicans and Candida dubliniensis in periodontal HIV-positive patients receiving and not receiving antiretroviral therapy / Producción enzimática de Candida albicans y Candida dubliniensis de pacientes con periodontitis VIH+ con y sin tratamiento antirretroviral

ABSTRACT Candida dubliniensis (Cd) and Candida albicans (Ca) are the most frequently isolated yeasts in HIV+ patients. Some of the enzymes produced by these yeasts are considered virulence factors since they contribute to pathogenicity of Candida spp. The aim of the present study was to compare production of enzymes such as phospholipase (Ph), proteinase (P), and hemolysin (H) by Cd and Ca strains isolated from periodontal HIV-positive patients receiving and not receiving highly active antiretroviral therapy (HAART). Subgingival biofilm samples were obtained using paper points, and a sample of oral mucosa was taken using a swab. Phenotypic and molecular methods were used to isolate 39 strains of Candida, including 25 strains of Cd and 14 strains of Ca, obtained from 33 periodontal pocket samples and 6 oral mucosa samples collected from 15 HIV+ patients (8 receiving and 7 not receiving HAART). Malt egg-yolk agar, albumin agar and blood agar were used to evaluate pH, P and H production respectively. The strains were inoculated in duplicate and incubated at 37 ºC. Colony and halo diameters were measured. A greater proportion of Ca was observed in patients not receiving HAART, and a higher proportion of Cd was observed in those under HAART, Chi2 p< 0.001. Phospholipase production was observed in 92.9% percent of isolated Ca strains but in none of the isolated Cd strains. Proteinase production was high in Ca and Cd strains isolated from patients not receiving HAART. Hemolysin production was observed in all the studied strains, though it was significantly higher (p=0.04) in Ca and Cd strains isolated from patients not receiving HAART. To sum up, the proportion of Candida dubliniensis strains was highest in the subgingival biofilm of patients receiving HAART, and Cd strains were found to express fewer virulence factors than Ca strains.

RESUMEN Las levaduras más aisladas en pacientes VIH+ son Candida dubliniensis (Cd) y Candida albicans (Ca). Algunas de sus enzimas constituyen factores de virulencia ya que favorecen la diseminación tisular. El objetivo fue comparar la producción de enzimas como fosfolipasa (F), proteinasa (P) y hemolisina (H) en cepas de Cd y Ca aisladas de pacientes VIH+ tratados y no tratados con antirretrovirales (TARGA). Se realizó la toma del biofilm de placa subgingival con conos de papel y la muestra de la mucosa bucal con hisopo. Se aislaron y tipificaron por métodos fenotípicos y moleculares 39 cepas: 25 de Cd y 14 Ca, obtenidas 33 de bolsas periodontales y 6 de mucosa bucal de 15 pacientes VIH+ (8 con y 7 sin tratamiento). Se utilizó agar malta con yema de huevo, agar albúmina y agar sangre para demostrar la producción de F, P y H, respectivamente. Se inocularon por duplicado e incubaron a 37°C. Se midieron los diámetros de las colonias y los de hidrólisis alrededor de las mismas. Se observó mayor proporción de Ca en los pacientes sin tratamiento y mayor proporción de Cd en los con tratamiento; Chi2 p< 0.001. El 92,9% de las Ca estudiadas, fueron productoras de fosfolipasa. En tanto que ninguna Cd produjo la enzima. En cuanto a la producción de proteinasa se observa una alta producción tanto en las cepas de Ca, como en las Cd aisladas en los pacientes no tratados. Todas las cepas estudiadas produjeron hemolisina, observándose una diferencia estadísticamente significativa (p=0,04) en ambas especies a favor de la alta producción de la enzima en las cepas obtenidas de pacientes no tratados. Podemos concluir que en el biofilm subgingival, en los pacientes bajo TARGA, se aíslan mayor proporción de Candida dubliniensis las cuales expresan menos factores de virulencia.

Parameters of oxidative stress in saliva from patients with aggressive and chronic periodontitis.

OBJECTIVES: Free radicals play an important role in the onset and progression of many diseases. The aim of this study was to investigate the contribution of oxidative stress in the pathology of aggressive (AgP) and chronic (CP) periodontitis and its relation with the clinical periodontal status. METHODS: Eighty subjects were divided into two groups: 20 patients with AgP and 20 patients with CP with their 20 corresponding matched controls, based on clinical attachment loss (CAL), probing pocket depth (PPD), and bleeding on probing (BOP). Saliva reactive oxygen species (ROS), lipid peroxidation, and non-enzymatic antioxidant defences were measured by luminol-dependent chemiluminescence assay, as thiobarbituric acid-reactive substances (TBARs) and total radical-trapping antioxidant potential (TRAP), respectively. Pearson's correlation and multivariate analysis were used to determine the relationship between ROS and TBARs and the clinical parameters. RESULTS: ROS and TBARs were increased in AgP while TRAP was decreased, comparing with CP. In AgP, a strong and positive correlation was observed between ROS and TBARs and they were closely associated with CAL and PPD. DISCUSSION: In AgP, but not in CP, oxidative stress is a high contributor to periodontal pathology and it is closely associated with the clinical periodontal status.

Characterization of third molar morphometric variables.

The third molar is a tooth of anatomical, surgical, prosthetic and forensic dental interest. However, there is currently a lack of updated data regarding its morphology. The aim of this study was to determine the morphometric features of third molars and their predictive capability as regards dental arch and side. Two calibrated operators (ƙ = 0.83) determined the cervicalocclusalvestibular (COV), cervicalocclusalpalatal (COP) and occlusalapical (OA) distances, mesiodistal (MD), and vestibularpalatal (VP) diameters, number of roots (R) and number of cusps (C) of 961 cadaveric third molars, both upper (n = 462) and lower (n = 499), using a CONCOR 050 thin mandible caliper (resolution 0.01 mm). Median and range for each variable were calculated and compared using Mann Whitney nonparametric test (p < 0.05). Multivariate cluster analysis was used to determine the predictive capability of each variable for dental arch and side. For upper molars (UM), 50.6% were from the right side (RS) and 49.4% from the left side (LS), while for lower molars (LM), 60.9% were from the RS and 39.1% from the LS. No significant difference was found in the study variables in LM according to side. For UM, MD diameter (10.90 mm), COP(7.42 mm) distance and number of R (3) were significantly higher (p < 0.05) forRS, and number of C (3) was higher (p < 0.0001) for LS. They were also significant predictive grouping factors for side. For dental arch, OA (17.84 mm) and COV (7.60 mm) distances, MD (11.26 mm) diameter and the number of C (5) were significantly higher (p < 0.0001) for LM, while VP (10.84 mm) and COP (7.34 mm) distances, and the number of R (3) were significantly higher (p < 0.0001) for UM. These variables were significant predictive factors for dental arch. Despite the morphometric heterogeneity of third molars, there are intrinsic parameters with predictive capability for dental arch and side, but it would be advisable to supplement this study with data from topographic occlusal variables in order to validate their predictive capability.

El tercer molar es una pieza dentaria de interés odontológico anatómico, quirúrgico, endodóntico, protético y forense. Sin embargo, no hay disponibles hoy en día datos morfométricos actualizados del molar. El objetivo del trabajo fue determinar las características morfométricas de terceros molares y establecer el carácter predictivo de las mismas en cuanto a arco dental y lado. Dos operadores calibrados (ƙ = 0.83) determinaron la longitud oclusocervical vestibular (OCV) y palatina (OCP), oclusoapical (OA), diámetro mesiodistal (MD), diámetro vestíbulopalatino (VP), número de raíces (R) y número de cúspides (C), de 961 terceros molares cadavéricos, superiores (n = 462) e inferiores (n = 499), mediante el uso de un calibre de mandíbula fina CONCOR 050 (resolución 0.01 mm). Calculamos mediana y rango para cada variable y las comparamos haciendo uso de la prueba de Mann Whitney (p < 0.05). Utilizamos el análisis de cluster para determinar el valor predictivo de cada variable en cuanto a arco y lado. De los molares superiores (MS), 50.6% correspondió al lado derecho (LD) y 49.4% al lado izquierdo (LI). De los inferiores (MI), 60.9% correspondió al LD y 39.1% al LI. No hallamos diferencias significativas para las variables en estudio para los MI según su lado. Para los MS, el MD (10.90 mm), la OCP (7.42 mm) y el R (3) resultaron significativamente mayores (p < 0.05) para el LD, y el C (3), mayor (p < 0.0001) para el LI; y, además evidenciaron significancia como factores predictivos de agrupamiento para la predicción del lado. En relación al arco, la OA (17.84 mm), la OCV (7.60 mm), el MD (11.26 mm) y el C (5), resultaron significativamente mayores (p < 0.0001) en los MI, mientras que el VP (10.84 mm), la OCP (7.34 mm) y el R (3) fueron significativamente mayores (p < 0.0001) en MS. Dichas variables evidenciaron significan cia como factores predictivos para el arco. Pese a la heteroge neidad morfométrica del tercer molar, existen parámetros característicos con valor predictivo para el arco y lado, aunque sería recomendable complementar el estudio con variables topográficas oclusales a fin de validar la capacidad predictiva de los mismos.

Association between Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis in subgingival plaque and clinical parameters, in Argentine patients with aggressive periodontitis.

BACKGROUND: Aggregatibacter actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg) have been associated with aggressive (AgP) and chronic periodontitis. OBJECTIVE: The aim of this study was to evaluate the levels of Aa and Pg in gingival crevicular fluid (GCF) of patients with AgP and its relation with clinical parameters. DESIGN: Sixteen females and fourteen males with clinical diagnosis of AgP aged 17-23 years and their match's controls, were included in this study. Clinical recording concerning probing pocket depth, clinical attachment level, plaque index and gingival bleeding index were performed at baseline, 30 and 60 days after baseline. After clinical examination GCF samples were analyzed for Aa and Pg with a real-time polymerase chain reaction technique. Patients group was treated with a combined of mechanical and oral antibiotic therapy (doxycycline 100 mg/day, during 21 days). A multivariate analysis was used to determine the relationship between Aa and Pg counts with clinical parameters. RESULTS: GCF from all subjects was positive for Aa and PG. In controls Pg concentration was higher than Aa (Pg: 42,420 ± 3,034 copies/ml; Aa: 66.6 ± 5.4 copies/ml p < 0.001) while in patients both microbes showed the same concentration (Aa: 559,878 ± 39,698 Pg: 572,321 ± 58,752). A significant and positive correlation was observed between counts of Aa and Pg (R square: 0.7965, p < 0.0001). Female showed more counts/ml. Aa might be closely associated with clinical parameters while Pg did not. At 30 and 60 days Aa counts in patients were similar to controls while Pg counts were equal to baseline. However, in spite of Pg presence a clinical improvement was observed in all patients. CONCLUSIONS: In our population the presence of Aa may be associated with AgP while Pg may be in GCF as an opportunistic pathogen which might caused disease when the ecological balance was favorable.

Assessment of physicians' perception of HIV+ patients' oral health.

The aim of this study was to design and validate an instrument for establishing perceptions of oral health held by physicians treating people living with HIV/AIDS. In order to design the instrument, four domains were identified that could measure the object of study and a 22-item questionnaire was created. The domains established were: knowledge of oral health; personal experience with oral health care; knowledge of oral health regarding HIV/AIDS; professional medical practices. To validate the instrument 50 physicians specializing in infectious diseases from public hospitals of Buenos Aires city completed the questionnaire using a Likert-type scale with 5 categories. The reliability of the instrument was assessed with the test and retest method at 30 days; internal consistency with Cronbach's alpha coefficient; content validity was determined by expert opinion; construct validity with the extreme groups method (Mann Whitney test, p < 0.05). All participants completed the test and retest questionnaires. Their mean age was 37.7 +/- 0.9 years; 36% were female and 64% male. The average experience in medical practice was 8.7 +/- 0.6 years. The instrument proved to be reliable as shown by the value of r(s) = 0.94 in the test-retest method; a satisfactory intra-item consistency was shown by Cronbach's alpha coefficient value of 0.91. The differences between the results of the groups of physicians in the extreme groups were statistically significant (p < 0.001). It is concluded that the instrument designed to measure the perception of oral health of physicians treating people living with HIV/AIDS is valid. However it would be desirable to enlarge the sample and determine criterion validity by comparison with other instruments.

Expression of sarcoplasmic-endoplasmic reticulum Ca-ATPase isoforms in masticatory muscles.

The aim of this study was to characterize the sarcoplasmic-endoplasmic reticulum Ca-ATPase (SERCA) isoforms in rabbit masticatory muscles compared with those in fast-twitch muscle. It was hypothesized that combined expression of the SERCA isoforms in fast- and slow-twitch muscles accounts for lower Ca-ATPase activity. SERCA was isolated by differential centrifugation, the isoforms were determined by ELISA, and the activity of each isoform was measured using a colorimetric method. Activity was tested for significance by anova, and the distribution of isoforms was assessed using the chi-square test (P < 0.05) and correlated to SERCA activity using Spearman's rank correlation. SERCA1 was predominant (90.5%) in fast-twitch muscle, whereas a mixture of SERCA isoforms was found in masticatory muscles: 62-78% was SERCA2, 20-37% was SERCA1, and the SERCA3 content was negligible. Depressor muscles showed a significantly higher content (77.8%) of SERCA2, and elevator muscles showed a higher content (35.4%) of SERCA1. Elevator muscles showed higher expression of SERCA2a (58%), and depressor muscles showed higher expression of SERCA2b (20%). The SERCA1 content was mainly SERCA1a and significantly higher for elevator muscles (33%), whereas depressor muscles showed a higher content of SERCA1b (4%). The SERCA1 content of fast-twitch muscle was mainly SERCA1a (88.5%). It is concluded that the mixture of different SERCA isoforms, along with a substantial content of SERCA2b, in masticatory muscles would support lower Ca-ATPase activity and calcium transport.

Total salivary nitrates and nitrites in oral health and periodontal disease.

It is well known that nitrites are increased in saliva from patients with periodontal disease. In the oral cavity, nitrites may derive partly from the reduction of nitrates by oral bacteria. Nitrates have been reported as a defence-related mechanism. Thus, the aim of the present study was to determine the salivary levels of total nitrate and nitrite and their relationship, in unstimulated and stimulated saliva from periodontal healthy subjects, and from patients with chronic periodontal disease. Nitrates and nitrites were determined in saliva from thirty healthy subjects and forty-four patients with periodontal disease. A significant increase in salivary nitrates and nitrites was observed. Nitrates and nitrites concentration was related to clinical attachment level (CAL). A positive and significant Pearson's correlation was found between salivary total nitrates and nitrites. Periodontal treatment induced clinical improvement and decreased nitrates and nitrites. It is concluded that salivary nitrates and nitrites increase, in patients with periodontal disease, could be related to defence mechanisms. The possibility that the salivary glands respond to oral infectious diseases by increasing nitrate secretion should be explored further.

Assessment of physicians perception of HIV+ patients oral health. / Assessment of physicians perception of HIV+ patients oral health.

The aim of this study was to design and validate an instrument for establishing perceptions of oral health held by physicians treating people living with HIV/AIDS. In order to design the instrument, four domains were identified that could measure the object of study and a 22-item questionnaire was created. The domains established were: knowledge of oral health; personal experience with oral health care; knowledge of oral health regarding HIV/AIDS; professional medical practices. To validate the instrument 50 physicians specializing in infectious diseases from public hospitals of Buenos Aires city completed the questionnaire using a Likert-type scale with 5 categories. The reliability of the instrument was assessed with the test and retest method at 30 days; internal consistency with Cronbachs alpha coefficient; content validity was determined by expert opinion; construct validity with the extreme groups method (Mann Whitney test, p < 0.05). All participants completed the test and retest questionnaires. Their mean age was 37.7 +/- 0.9 years; 36

were female and 64

male. The average experience in medical practice was 8.7 +/- 0.6 years. The instrument proved to be reliable as shown by the value of r(s) = 0.94 in the test-retest method; a satisfactory intra-item consistency was shown by Cronbachs alpha coefficient value of 0.91. The differences between the results of the groups of physicians in the extreme groups were statistically significant (p < 0.001). It is concluded that the instrument designed to measure the perception of oral health of physicians treating people living with HIV/AIDS is valid. However it would be desirable to enlarge the sample and determine criterion validity by comparison with other instruments.

Salivary IL-1ß and PGE2 as biomarkers of periodontal status, before and after periodontal treatment.

AIM: Interleukin-1ß (IL-1ß) and prostaglandin E2 (PGE2 ) are key inflammatory mediators involved in periodontitis. The purpose was to compare their salivary concentrations in relation to periodontal status and their changes after periodontal treatment, to determine their use as non-invasive diagnostic tools. MATERIALS AND METHODS: In this study, 74 subjects grouped in periodontally healthy, mild, moderate and severe periodontitis, according to clinical attachment level (CAL) and probing pocket depth (PPD) served as participants. IL-1ß and PGE2 were determined in unstimulated whole saliva by enzyme-linked-immunosorbent assay (ELISA). RESULTS: Interleukin -1ß increased with the severity of periodontitis with a large effect size in prediction of CAL (η(2)  = 0.35, p = 0.0001). PGE2 showed an increment in mild periodontitis and another in moderate. A significant effect size was also found between PGE2 and PPD (η(2)  = 0.12, p = 0.003). Both mediators decreased after periodontal treatment. With a selected threshold of 212 pg/ml, salivary IL1-ß predicted periodontitis with 78% sensitivity and 100% specificity. With a selected threshold of 121 pg/ml, salivary PGE2 predicted periodontitis with 78% sensitivity and 91% specificity. CONCLUSION: The high sensitivity and specificity of salivary IL-1ß and PGE2 in identifying periodontitis suggest a potential use as biomarkers for diagnosis of periodontitis presence and severity.

Effect of articaine on calcium transport in sarcoplasmic reticulum membranes isolated from medial pterygoid muscle.

Local anesthetics used in dentistry have myotoxic effects. Articaine, also known as carticaine, is one of the local anesthetics most widely used in clinical dentistry. The aim of this work was to describe its effect on the sarcoplasmic reticulum Ca-ATPase isolated from medial pterygoid muscle. Ca-ATPase enzymatic activity was determined by a colorimetric method and ATP-dependent calcium uptake with a radioisotopic technique. Articaine inhibited both Ca-ATPase activity and calcium uptake in a concentration-dependent manner. Both inhibitory effects became evident at articaine concentrations lower than those employed in clinical dentistry. Half-maximal inhibitory concentrations (K) were 15.1 +/- 1.8 mM (n = 6) and 25.2 +/- 1.6 mM (n = 6) for enzymatic activity and calcium uptake, respectively. Preincubation of sarcoplasmic reticulum membranes with articaine enhanced Ca-ATPase activity in the absence of calcium ionophore, suggesting an ionophoric-like effect of the local anesthetic. We conclude that the inhibitory effect of articaine on the sarcoplasmic reticulum Ca-ATPase isolated from medial pterygoid muscle is due to a direct interaction of the anesthetic with the enzyme and to the increased membrane permeability to calcium induced by this drug.

Relationship between dental status and family, school and socioeconomic level.

The aim of this study was to analyze the association between the knowledge, attitudes, practices and formal schooling ofparents and the oral health status in schoolchildren enrolled in educational institutions of different socioeconomic levels, using dental caries as the tracer disease. A convenience sample of 300 school children aged 6-14 years old and living in Mar del Plata city, Argentina, was composed according to income characterization in three strata: low, middle and high income. The children were grouped according to age (6-8, 9-11 and 12-14 years old). A validated questionnaire on knowledge, attitudes and oral health practices was administered to parents. Children were examined for dental and gingival status. DMFS, dmfs, plaque and gingival bleeding indexes were determined. Mean and SEM and/or frequency distribution of each variable were determined and diferences assessed by ANOVA, chi-squared, Yates chi-squared and Scheffé tests (p < 0.05). Association among variables was tested by chi-squared test. The children from low income families showed significantly higher levels oforal disease in all the studied age groups. These families revealed significantly less healthy practices and attitudes along with lower formal schooling level. Dental indicators were inversely and significantly associated with parents' knowledge, attitudes and formal schooling and with plaque index. Bleeding on probing was inversely and significantly associated with plaque index, parents 'formal schooling and practices. Plaque index was found to be inversely associated with parents' knowledge, attitudes and formal schooling. Parents 'knowledge, formal schooling, attitudes and health practices are intervening variables on oral health status ofschool children and an intervention field with potential impactfor the oral component of health.

Influence of experimental periodontitis on cholinergic stimulation of K⁺ release in rat parotid glands.

In a rat model of experimental periodontitis it was investigated whether the presence of the inflammatory disease induced changes in carbachol-induced fluid secretion in parotid glands, by monitoring potassium release. The potency of carbachol, to induce K⁺ release, was higher in parotid glands from rats with experimental periodontitis. The antagonist with higher affinity for M3 muscarinic acetyl-choline receptor subtype, 4-DAMP (selectivity: M1=M3), was more potent in inhibiting K⁺ release in periodontitis rats while the antagonist with a muscarinic M1-receptor-selective profile (selectivity: M1>M3), pirenzepine, was more potent in control rats. Competition binding assays showed that both, M1 and M3 muscarinic acetyl-choline receptor subtypes are expressed in membranes of parotid glands. The K(i) of 4-DAMP was decreased in parotid glands from rats with experimental periodontitis while the Ki of pirenzepine was increased. The effect of periodontitis was reverted by the inhibition of the cyclooxygenase activity through indomethacin treatment (100 mg/k ip, 4 days). It was concluded that periodontitis could induce changes in muscarinic acetyl-choline receptor subtypes expression with a preferential increase of M3 subtype, resulting in increased K⁺ released in response to carbachol and in a greater potency of 4-DAMP. These findings agree with the fact that a decrease of fluid secretion is not a condition of patients with periodontal disease.

Effect of articaine on calcium transport in sarcoplasmic reticulum membranes isolated from medial pterygoid muscle

Local anesthetics used in dentistry have myotoxic effects. Articaine, also known as carticaine, is one of the local anesthetics most widely used in clinical dentistry. The aim of this work was to describe its effect on the sarcoplasmic reticulum Ca-ATPase isolated from medial pterygoid muscle. Ca-ATPase enzymatic activity was determined by a colorimetric method and ATP-dependent calcium uptake with a radioisotopic technique. Articaine inhibited both Ca-ATPase activity and calcium uptake in a concentrationdependent manner. Both inhibitory effects became evident at articaine concentrations lower than those employed in clinical dentistry. Half-maximal inhibitory concentrations (Ki) were 15.1± 1.8 mM (n = 6) and 25.2 ± 1.6 mM (n = 6) for enzymatic activity and calcium uptake, respectively. Preincubation of sarcoplasmic reticulum membranes with articaine enhanced Ca-ATPase activity in the absence of calcium ionophore, suggesting an ionophoriclike effect of the local anesthetic. We conclude that the inhibitory effect of articaine on the sarcoplasmic reticulum Ca-ATPase isolated from medial pterygoid muscle is due to a direct interaction of the anesthetic with the enzyme and to the increased membrane permeability to calcium induced by this drug.

Los anestésicos locales de uso odontológico tienen efectos miotóxicos. La carticaína, también conocida como articaína, es uno de los anestésicos locales más usados en la clínica odontológica actual. El objetivo del trabajo fue describir el efecto de la carticaína sobre la Ca-ATPasa del retículo sarcoplásmico aislada del músculo pterigoideo interno. La actividad enzimática de la bomba de calcio se determinó por un método colorimétrico y se utilizó un método radioisotópico a fin de determinar la captación de calcio dependiente de ATP. La carticaína inhibió la actividad enzimática y la captación de calcio en función de su concentración. Ambos efectos se observaron a concentraciones de carticaína menores a las utilizadas en la clínica. Las concentraciones de carticaína necesarias para inhibir la actividad Ca-ATPásica y la captación de calcio a la mitad de su valor máximo (Ki) fueron 15.1 ± 1.8 mM (n = 6) y 25.2 ± 1.6 mM (n = 6) respectivamente. La preincubación con carticaína de las membranas de retículo sarcoplásmico del músculo pterigoideo interno, en ausencia de ionóforo de calcio, incrementó la actividad de la enzima, evidenciando un efecto ionofórico del anestésico local. Concluimos que el efecto inhibitorio de la carticaína sobre la Ca-ATPasa de retículo sarcoplásmico del músculo pterigoideo interno se debe a la acción directa del anestésico local sobre la enzima y al incremento de la permeabilidad de la membrana del retículo sarcoplásmico al calcio inducido por esta droga.

Relationship between dental status and family, school and socioeconomic level / Relación entre el estado dentario de escolares y los conocimientos, actitudes y prácticas y nivel de escolaridad de los padres

El objetivo de este estudio fue analizar la asociación entre conocimientos, actitudes, práctica y escolaridad formal de los padres y el estado dentario de escolares asistentes en institucionesde diferente nivel socioeconómico, empleando la caries dental como enfermedad trazadora. Fue seleccionadauna muestra intencionada de 300 escolares de 6 a 14 años de edad, asistentes a escuelas representantes de tres niveles de ingresos familiares. Los niños fueron agrupados en 3 nivelesetarios (6-8, 9-11 y 12-14 años de edad). Un cuestionario validadoreferido a conocimientos, actitudes y prácticas fue administrado a los padres (Anrup et al, 2001). Los niños fueronexaminados clínicamente y determinados los índices CPOS,ceos, índice de biofilm de placa y sangrado gingival. Las medias y el error standard y la frecuencia de distribución de cada variable fue establecida y calculada según ANOVA, chi2, Yates chi2 y tests de Scheffé (p < 0.05). La asociación entre variables fue calculada por medio del test chi2. Los resultadosrevelaron que los niños pertenecientes a familias con menores ingresos presentaban mayores niveles de enfermedad bucal en todos los grupos de edad. Estas familias revelan menos prácticas y actitudes saludables coincidentes con un menor nivel deescolaridad. Los indicadores dentarios, el sangrado gingival y el índice de biofilm resultaron inversa y sigficativamente asociados con los conocimientos, las actitudes y la escolaridad formal de los padres. Los conocimientos, la escolaridad formal,las actitudes y prácticas de los padres resultaron variables intervinientes sobre el estado de salud bucal de escolares yconstituyen un campo de intervención con potencial impacto sobre el componente bucal de la salud de los escolares.

Relationship between dental status and family, school and socioeconomic level / Relación entre el estado dentario de escolares y los conocimientos, actitudes y prácticas y nivel de escolaridad de los padres

El objetivo de este estudio fue analizar la asociación entre conocimientos, actitudes, práctica y escolaridad formal de los padres y el estado dentario de escolares asistentes en institucionesde diferente nivel socioeconómico, empleando la caries dental como enfermedad trazadora. Fue seleccionadauna muestra intencionada de 300 escolares de 6 a 14 años de edad, asistentes a escuelas representantes de tres niveles de ingresos familiares. Los niños fueron agrupados en 3 nivelesetarios (6-8, 9-11 y 12-14 años de edad). Un cuestionario validadoreferido a conocimientos, actitudes y prácticas fue administrado a los padres (Anrup et al, 2001). Los niños fueronexaminados clínicamente y determinados los índices CPOS,ceos, índice de biofilm de placa y sangrado gingival. Las medias y el error standard y la frecuencia de distribución de cada variable fue establecida y calculada según ANOVA, chi2, Yates chi2 y tests de Scheffé (p < 0.05). La asociación entre variables fue calculada por medio del test chi2. Los resultadosrevelaron que los niños pertenecientes a familias con menores ingresos presentaban mayores niveles de enfermedad bucal en todos los grupos de edad. Estas familias revelan menos prácticas y actitudes saludables coincidentes con un menor nivel deescolaridad. Los indicadores dentarios, el sangrado gingival y el índice de biofilm resultaron inversa y sigficativamente asociados con los conocimientos, las actitudes y la escolaridad formal de los padres. Los conocimientos, la escolaridad formal,las actitudes y prácticas de los padres resultaron variables intervinientes sobre el estado de salud bucal de escolares yconstituyen un campo de intervención con potencial impacto sobre el componente bucal de la salud de los escolares. (AU)

Impact of oral health care needs on health-related quality of life in adult HIV+ patients.

The aim of this work was to determine the social impact of oral conditions on health-related quality of life in adult HIV+ patients and create a predictive model. The oral health impact profile questionnaire OHIP-49 was randomly administered to 200 HIV+ adults patients of any age and either sex at the High Risk Patients Dental Care Unit (CLAPAR I), School of Dentistry, University of Buenos Aires. Argentina. For each of the 49 items, participants indicated their responses on a five point Likert-type frequency scale ranging from "never" to "very often". Oral health needs were assessed through the CCITN (Community Caries Index of Treatment Need) and CPITN (Community Periodontal Index of Treatment Need). The Mann-Whitney test was used to compare the OHIP-49 score between male and female respondents. The Kruskal-Wallis test was used to assess score differences among the OHIP-49 domains. Altogether, 50% of the respondents were male and 50% were female, aged 36.45 +/- 0.70 years and 38.03 +/- 0.78 years respectively. The assessment of oral health care needs revealed a great need for treatment. Mean CCITN was 11.15 +/- 0.35 and CPITN was 2.41 +/- 0.12. The average total OHIP-49 score (83) revealed a high level of social impact, which was higher for female compared to male respondents (Z(T) = 2.08, p = 0.037). The domains concerning functional limitation (domain 1), physical pain (domain 2) and psychological discomfort (domain 3) showed higher levels of social impact (H = 395.06, p < 0.0001). The social impact observed in these domains was higher for female compared to male patients. In the correlation analysis, oral conditions, age, gender and social impact were significantly associated. These results demonstrate that unmet oral health care need impairs the quality of life of HIV+ patients and suggest the need of comprehensive oral health care interventions.

Iimpact of oral health care needs on health-related quality of life in adult HIV+ patients

El propósito de este trabajo fue determinar el impacto social del estado de salud bucal sobre la calidad de vida de los pacientes VIH+ y establecer un modelo predictivo. El cuestionario correspondiente al perfil del impacto social de la salud bucal, OHIP-49, se administró aleatoriamente a 200 pacientes adultos VIH+ de ambos géneros enla Clínica para la Atención de Pacientes de alto riesgo I (CLAPAR I) de la Facultad de Odontología de la Universidad de Buenos Aires, Argentina. Los pacientes indicaron su respuesta a cada una de las 49 preguntas del cuestionario en una escala de frecuencia tipo Likert (nunca, casi nunca, casi siempre, siempre). La necesidad de tratamiento odontológico se determinó haciendo uso del Indice de Necesidad de Tratamiento de Caries (INTC) y del Indice de Necesidad de Tratamiento Periodontal (INTP). La prueba de Mann-Whitney se utilizó para analizar la diferencia del puntaje global del OHIP-49 entre hombres y mujeres. La prueba de Kruskal-Wallis se empleó para evaluar las diferencias de los puntajes observados entre los diferentes dominios del OHIP-49. La influencia de la necesidad de tratamiento odontológico, la edad y el género se desempeñaron como variables independientes. El 50 por ciento de los pacientes eran de sexo masculino con una edad promedio de 36.45 +- 0.70 años y el otro 50 por ciento correspondió al sexo emenino, con una edad promedio de 38.03 +- 0.78 años. La evaluación del estado bucodental evidenció una alta necesidad de tratamiento odontológico. El valor medio del INTC fue 11.15 +- 0.35 y el del INTPC fue 2,41 +- 0.12. La media del puntaje registrado en el OHIP-49 (83) reveló un alto nivel de impacto social de las condiciones de salud bucal, siendo dicho impacto mayor en mujeres que en hombres (Z(t)=2.08, p=0.037). Los dominios relativos a la limitación funciona (dominio 1), al dolor físico (dominio 2) y al discomfort psicológico (dominio 3) mostraron mayores niveles de impacto social (H=395.06, p<0.0001).

Inhibitory effect of lidocaine on the sarcoplasmic reticulum Ca2+-dependent atpase from temporalis muscle.

Myotoxic effects of local anesthetics on skeletal musclefibers involve the inhibition ofsarcoplasmic reticulum Ca2+ -dependent ATPase activity and Ca2 transport. Lidocaine is a local anesthetic frequently used to relieve the symptoms of trigeminal neuralgia. The aim of this work was to test the inhibitory and/or stimulatory effect of lidocaine on sarcoplasmic reticulum Ca2+ -dependent ATPase isolated from rabbit temporalis muscle. Ca2+ -dependent ATPase activity was determined by a colorimetric method Calcium-binding to the Ca dependent ATPase, Ca2+ transport, and phosphorylation of the enzyme by ATP were determined with radioisotopic techniques. Lidocaine inhibited the Ca2+ -dependent ATPase activity in a concentration-dependent manner. The preincubation of the sarcoplasmic reticulum membranes with lidocaine enhanced the Ca2+ dependent ATPase activity in the absence of calcium ionophore. Lidocaine also inhibited both Ca2+ uptake and enzyme phosphorylation by ATP but had no effect on Ca2+ -binding to the enzyme. We conclude that the effect of lidocaine on the sarcoplasmic reticulum Ca2+ -dependent ATPase from temporalis muscle is due to the drug's direct interaction with the enzyme and the increased permeability of the sarcoplasmic reticulum membrane to Ca.

Inhibitory effect of lidocaine on the sarcoplasmic reticulum Ca2+- dependent ATPase from temporalis muscle

Myotoxic effects of local anesthetics on skeletal muscle fibers involve the inhibition of sarcoplasmic reticulum Ca2+-dependent ATPase activity and Ca2+ transport. Lidocaine is a local anesthetic frequently used to relieve the symptoms of trigeminal neuralgia. The aim of this work was to test the inhibitory and/or stimulatory effect of lidocaine on sarcoplasmic reticulum Ca2+-dependent ATPase isolated from rabbit temporalis muscle. Ca2+-dependent ATPase activity was determined by a colorimetric method. Calcium-binding to the Ca2+- dependent ATPase, Ca2+ transport, and phosphorylation of the enzyme by ATP were determined with radioisotopic techniques. Lidocaine inhibited the Ca2+-dependent ATPase activity in a concentration- dependent manner. The preincubation of the sarcoplasmic reticulum membranes with lidocaine enhanced the Ca2+- dependent ATPase activity in the absence of calcium ionophore. Lidocaine also inhibited both Ca2+ uptake and enzyme phosphorylation by ATP but had no effect on Ca2+-binding to the enzyme. We conclude that the effect of lidocaine on the sarcoplasmic reticulum Ca2+-dependent ATPase from temporalis muscle is due to the drug's direct interaction with the enzyme and the increased permeability of the sarcoplasmic reticulum membrane to Ca.

La toxicidad de los anestesicos locales sobre las fibras musculares esqueleticas involucra a la inhibicion de la actividad de la calcio ATPasa del reticulo sarcoplasmico y a la inhibicion del transporte del calcio. Tales efectos inhibitorios no han sido aun descriptos en el musculo temporal. La lidocaina es un anestesico local habitualmente usado para aliviar los sintomas de la neuralgia del trigemino por medio de la anestesia infiltrativa de la region temporal. El objetivo del trabajo fue demostrar el efecto inhibitorio y/o activador de la lidocaina sobre la calcio ATPasa del reticulo sarcoplasmico del musculo temporal del conejo. La actividad de la calcio ATPasa se determino empleando un metodo colorimetrico. La union del calcio a la enzima, el transporte del calcio y la fosforilacion de la ATPasa por ATP se determinaron mediante el empleo de tecnicas radioisotopicas. La lidocaina inhibio a la actividad de la calcio ATPasa. El efecto inhibitorio incremento en funcion de la concentracion del anestesico. La preincubacion de las membranas del reticulo sarcoplasmico en lidocaina incremento la actividad de la calcio ATPasa en ausencia de un ionoforo de calcio. Tal resultado avala el efecto permeabilizante del anestesico local sobre las membranas del reticulo sarcoplasmico del musculo temporal. La lidocaina inhibio la captacion del calcio y la fosforilacion de la calcio ATPasa por ATP, pero no evidencio efecto sobre la union del calcio a la enzima. Concluimos que el efecto de la lidocaina sobre la calcio ATPasa del reticulo sarcoplasmico del musculo temporal se debe a la accion directa de la droga sobre la enzima y al incremento inducido de la permeabilidad de la membrana del reticulo sarcoplasmico al Ca.