Immunohistochemistry of resorption and inflammation factors in the periodontal ligament of human deciduous teeth.

The understanding of the biological mechanisms involved in root resorption in deciduous teeth is important to the future development of preventive measures and treatments of this condition. The aim of the present study was to compare the expression and immunostaining of iNOS, MMP-9, OPG and RANKL in the periodontal ligament (PDL) of deciduous teeth with physiologic root resorption (GI), inflammatory pathological root resorption (GII) and permanent teeth (GIII), the negative control. Teeth in GI (n = 10), GII (n = 10) and (GIII) (n = 10) were submitted to immunohistochemical analysis to determine the expression of iNOS, MMP-9, OPG, and RANKL. The immunostaining was analysed by optical density. Statistical analysis included one-way ANOVA, followed by Student-Newman-Keuls post hoc test (p < 0.05). The results showed that iNOS, MMP-9 and RANKL expression in the PDL was higher in GII compared to GI and GIII (p < 0.05). Moreover, RANKL expression was higher in GI compared to GIII (p < 0.001), while OPG immunolabelling was lower in GII compared to GI and GIII (p < 0.001). The PDL of deciduous teeth bearing inflammatory processed exhibited upregulation of resorption-associated factors as well as enzymes related to tissue degradation which, in turn explains the exacerbation and greater susceptibility of those teeth to root resorption process.

Immunohistochemistry of resorption and inflammation factors in the periodontal ligament of human deciduous teeth

Abstract: The understanding of the biological mechanisms involved in root resorption in deciduous teeth is important to the future development of preventive measures and treatments of this condition. The aim of the present study was to compare the expression and immunostaining of iNOS, MMP-9, OPG and RANKL in the periodontal ligament (PDL) of deciduous teeth with physiologic root resorption (GI), inflammatory pathological root resorption (GII) and permanent teeth (GIII), the negative control. Teeth in GI (n = 10), GII (n = 10) and (GIII) (n = 10) were submitted to immunohistochemical analysis to determine the expression of iNOS, MMP-9, OPG, and RANKL. The immunostaining was analysed by optical density. Statistical analysis included one-way ANOVA, followed by Student-Newman-Keuls post hoc test (p < 0.05). The results showed that iNOS, MMP-9 and RANKL expression in the PDL was higher in GII compared to GI and GIII (p < 0.05). Moreover, RANKL expression was higher in GI compared to GIII (p < 0.001), while OPG immunolabelling was lower in GII compared to GI and GIII (p < 0.001). The PDL of deciduous teeth bearing inflammatory processed exhibited upregulation of resorption-associated factors as well as enzymes related to tissue degradation which, in turn explains the exacerbation and greater susceptibility of those teeth to root resorption process.

Apoia: protótipo para aplicativo móvel de apoio social à gestação / Supports: prototype for mobile application of social support to pregnancy / Apoia: prototipo para aplicación de apoyo social móvil al embarazo

Objetivo: elaborar um protótipo para um aplicativo móvel a fim de ampliar a disponibilidade de apoio social para as gestantes. Método: trata-se de um estudo misto, tipo transversal, realizado com gestantes usuárias da atenção básica à saúde de unidades vinculadas ao Sistema Único de Saúde (SUS). Elaborou-se, a partir dos resultados obtidos na pesquisa, um protótipo para aplicativo móvel no modelo SCRUM para sistema operacional Android. Resultados: nominou-se o protótipo de Apoia. Revelam-se as funcionalidades do Apoia de proporcionar a interação entre a gestante e as pessoas por ela escolhidas para comporem a rede social, possibilitar a troca de mensagens de apoio, resgatar a disponibilidade das pessoas em oferecer ajuda, assessorando, dessas formas, a mulher grávida no processo de viabilização do apoio social. Conclusão: acredita-se que o Apoia é um recurso inovador, com o intuito de construir e ampliar o apoio social para gestantes usuárias a partir da construção e flexibilização da rede social com o uso das tecnologias da informação e comunicação na saúde.(AU)

Objective: to develop a prototype for a mobile application in order to increase the availability of social support for pregnant women. Method: this is a cross-sectional, mixed study conducted with pregnant women who use basic health care in units linked to the Unified Health System (UHS). Based on the results obtained in the research, a prototype for a mobile application in the SCRUM model for the Android operating system was elaborated. Results: the prototype of Apoia was named. The functionalities of Apoia are revealed: to provide interaction between the pregnant woman and the people she has chosen to make up the social network, to enable the exchange of support messages, to rescue people's willingness to offer help, thus assisting the pregnant woman in the process of making social support possible. Conclusion: It is believed that Apoia is an innovative resource, with the aim of building and expanding social support for pregnant users from the construction and flexibility of the social network with the use of information and communication technologies in health.(AU)

Objetivo: desarrollar un prototipo de aplicación móvil con el fin de aumentar la disponibilidad de apoyo social para mujeres embarazadas. Método: se trata de un estudio mixto, transversal, realizado con mujeres embarazadas usuarias de atención primaria de salud en unidades vinculadas al Sistema Único de Salud (SUS). A partir de los resultados obtenidos en la investigación se elaboró un prototipo de aplicación móvil en el modelo SCRUM para sistema operativo Android. Resultados: se nombró el prototipo de Apoia. Las características de Apoia se revelan para brindar interacción entre la gestante y las personas elegidas por ella para componer la red social, posibilitar el intercambio de mensajes de apoyo, rescatar la disponibilidad de personas para ofrecer ayuda, asesorando así a la mujer. embarazada en el proceso de habilitar el apoyo social. Conclusión: se cree que Apoia es un recurso innovador, con el objetivo de construir y ampliar el apoyo social a usuarias embarazadas desde la construcción y flexibilización de la red social con el uso de tecnologías de la información y la comunicación en salud. (AU)

Nível socioeconômico, saúde bucal e fatores associados no suporte social de gestantes: estudo transversal / Socioeconomic level, oral health, and associated factors in the social support of pregnant women: a cross-sectional study

Avaliar a associação entre variáveis socioeconômicas e relacionadas a saúde bucal no suporte social percebido por gestantes. Esse estudo transversal incluiu uma amostra obtida em conglomerados de gestantes atendidas no serviço público de saúde no sul do Brasil. As gestantes responderam questionários acerca de características demográficas, socioeconômicas e relacionadas à saúde bucal. O suporte social foi avaliado através da escala Medical Outcomes Study. As variáveis clínicas incluíram cárie dentária não tratada e sangramento gengival. Análise de Regressão de Poisson em multinível foram utilizados para avaliar a influência dos preditores no suporte social. A amostra foi composta por254 gestantes. Gestantes com pior autopercepção de saúde bucal, níveis extensivos de sangramento gengival e com menor nível socioeconômico apresentaram um pior suporte social. Fatores socioeconômicos e relacionados à saúde bucal exerceram impacto no suporte social percebido por gestantes.

To evaluate the association between socioeconomic and oral health-related variables in the social support perceived by pregnant women. This cross-sectional study included a sample obtained from clusters of pregnant women who attended public health services in southern Brazil. The pregnant women answered questionnaires about demographic, socioeconomic, and oral health characteristics. Social support was assessed using the Medical Outcomes Study scale. Clinical variables included untreated dental caries and gingival bleeding. Multilevel Poisson regression analysis was used to assess the influence of predictors on social support. The sample consisted of 254 pregnant women. Those with poorer self-perceived oral health, extensive levels of gingival bleeding, and lower socioeconomic status, presented poor social support. Socioeconomic factors and factors related to oral health had an impact on the social support perceived by pregnant women.

Access and use of dental services by pregnant women: an integrative literature review. / Acesso e utilização de serviços odontológicos por gestantes: revisão integrativa de literatura.

The objective of this article is to identify the scientific productions on the access and use of dental services by pregnant women. A search was carried out on the BVS and MEDLINE/PubMed online databases to produce this integrative literature review. In the BVS database, the Portuguese descriptors were: "acesso aos serviços de saúde", "saúde bucal" and "gestantes", and in PubMed: "Health services accessibility", "oral health" and "pregnant women", all associated with each other by the Boolean operator "AND". We identified five studies that met the inclusion and exclusion criteria and were systematized into two empirical and co-related categories: the significant number of pregnant women who do not perform prenatal dental care and the importance of educational measures that signal the need to receive dental care during prenatal visits. Further studies on the subject are required to support public health policies that consider this theme. Existing research shows low adherence to prenatal dental care and that the main factors hindering the access to and use of dental services were related to socioeconomic, cultural and educational aspects.

O objetivo deste artigo é identificar as produções científicas sobre o acesso e utilização de serviços odontológicos por gestantes. Foi realizada uma revisão integrativa de literatura com busca nas bases de dados BVS e MEDLINE/PubMed. Na base BVS os descritores foram: "acesso aos serviços de saúde", "saúde bucal" e "gestantes", e na PubMed: "Health services accessibility", "oral health" e "pregnant women", associados entre si pelo operador booleano AND. Foram encontrados cinco estudos que preencheram os critérios de inclusão e exclusão, sendo sistematizados em duas categorias empiricas e co-relacionadas: número expressivo de gestantes que não realizam o pré-natal odontológico e importância de medidas educativas que sinalizem a necessidade de receberem acompanhamento odontológico durante as consultas de pré-natal. Existe a necessidade de mais estudos, para embasar políticas de saúde pública que contemplem esta temática. As pesquisas existentes demonstram baixa adesão ao pré-natal odontológico e que os principais fatores observados como complicadores do acesso e utilização dos serviços odontológicos foram os relacionados aos aspectos socioeconômicos, culturais e educacionais.

Acesso e utilização de serviços odontológicos por gestantes: revisão integrativa de literatura / Access and use of dental services by pregnant women: an integrative literature review

Resumo O objetivo deste artigo é identificar as produções científicas sobre o acesso e utilização de serviços odontológicos por gestantes. Foi realizada uma revisão integrativa de literatura com busca nas bases de dados BVS e MEDLINE/PubMed. Na base BVS os descritores foram: "acesso aos serviços de saúde", "saúde bucal" e "gestantes", e na PubMed: "Health services accessibility", "oral health" e "pregnant women", associados entre si pelo operador booleano AND. Foram encontrados cinco estudos que preencheram os critérios de inclusão e exclusão, sendo sistematizados em duas categorias empiricas e co-relacionadas: número expressivo de gestantes que não realizam o pré-natal odontológico e importância de medidas educativas que sinalizem a necessidade de receberem acompanhamento odontológico durante as consultas de pré-natal. Existe a necessidade de mais estudos, para embasar políticas de saúde pública que contemplem esta temática. As pesquisas existentes demonstram baixa adesão ao pré-natal odontológico e que os principais fatores observados como complicadores do acesso e utilização dos serviços odontológicos foram os relacionados aos aspectos socioeconômicos, culturais e educacionais.

Abstract The objective of this article is to identify the scientific productions on the access and use of dental services by pregnant women. A search was carried out on the BVS and MEDLINE/PubMed online databases to produce this integrative literature review. In the BVS database, the Portuguese descriptors were: "acesso aos serviços de saúde", "saúde bucal" and "gestantes", and in PubMed: "Health services accessibility", "oral health" and "pregnant women", all associated with each other by the Boolean operator "AND". We identified five studies that met the inclusion and exclusion criteria and were systematized into two empirical and co-related categories: the significant number of pregnant women who do not perform prenatal dental care and the importance of educational measures that signal the need to receive dental care during prenatal visits. Further studies on the subject are required to support public health policies that consider this theme. Existing research shows low adherence to prenatal dental care and that the main factors hindering the access to and use of dental services were related to socioeconomic, cultural and educational aspects.

Oral manifestations and challenges in dental treatment of epidermolysis bullosa dystrophica.

Epidermolysis bullosa (EB) is a rare congenital disease characterized by the formation of blisters following minimal trauma. Oral health can be compromised by oral bullae, perioral fibrosis, ankyloglossia, and a high risk for dental caries, all of which lead to a decreased quality of life. The purpose of this paper is to report the case of an 11-year-old female who presented with autosomal recessive dystrophic EB. Besides the skin manifestations, the extra- and intra-oral exams revealed lesions on the lips and mucosa, microstomia, ankyloglossia, depapillated tongue, and carious teeth. This case emphasizes that patients diagnosed with EB require multidisciplinary care, with the dentist playing an important role in oral health management.

Praticas alimentares cariogenicas e fatores associados em criancas do sul do Brasil / Cariogenic feeding habits and associated factors in children from the southern Brazil

Objetivo: Identificar praticas alimentares cariogenicas e estimar os fatores associados ao consumo de guloseimas entre as refeicoes em pre-escolares de Ijui-RS. Metodo: A amostra consisti u em 481 criancas de 0 a 6 anos pertencentes a 12 pre-escolas deste municipio, sorteadas aleatoriamente. O instrumento de pesquisa foi questionario estruturado respondido pelos pais, que avaliou variaveis demograficas, socioeconomicas e as seguintes praticas alimentares: idade de introducao do acucar e o comportamento de consumir guloseimas (doces ou salgadinhos) entre as refeicoes. Foi utilizada regressao de Poisson com variancia robusta para identificar e quantificar os fatores associados ao consumo de guloseimas entre as refeicoes. Resultados: Aproximadamente 90% das criancas da amostra tiveram o acucar introduzido na dieta antes de completar o primeiro ano de vida. Alem disso, 3/4 dos pre-escolares consomem guloseimas entre as refeicoes, nao havendo diferenca entre os sexos, categorias de renda e estruturacao familiar. O modelo multivariavel mostrou que a probabilidade de consumir guloseimas entre as refeicoes foi 16% maior em criancas de 5 a 6 anos em relacao as criancas de ate 2 anos (RP=1,16; IC 95%= 1,00?1,34) e 14% maior quando a mae tinha 4 anos ou menos de escolaridade (RP=1,14; IC 95%= 1,01-1,29) em relacao as maes com mais de 8 anos de estudo. Fazer chantagem para receber guloseimas aumentou em 72% a probabilidade deste comportamento (RP= 1,72; IC 95%= 1,46-2,03). Conclusao: A introducao de acucar e precoce nesta populacao e um percentual elevado dos pre-escolares consome guloseimas entre as refeicoes, estando este desfecho associado a maior idade da crianca, menor escolaridade materna e comportamento da crianca. Programas preventivos devem incluir orientacao para praticas alimentares desde o primeiro ano de vida, especialmente para maes com menor escolaridade.

Objective: To identify cariogenic feeding habits and estimate the factors associated with the consumption of snacks between meals in preschoolers from the city of Ijui, RS, Brazil. Method: The sample was composed of 481 children aged 0 to 6 years attending 12 preschools of this city, chosen at random. The research instrument was a structured questionnaire filled out by the parents, which assessed demographic and socioeconomic data and information on feeding habits (age of introduction of sugar in the diet and consumption of sweet and salty snacks between meals). Poisson's regression with robust variance was used to identify and quantify the factors associated with the consumption of snacks between meals. Results: Approximately 90% of the children had sugar introduced in their diet before 1 year of age. In addition, ó of the preschoolers consume sweets between meals, without statistically significant difference between genders, income levels and family structure. The multi variable model showed that the probability of consuming snacks between meals was 16% higher in 5-6-year-old children compared to those up to the age of 2 (PR=1.16; 95% CI= 1.00-1.34), and 14% higher when the mother's educational level was up to 4 years (PR=1.14; 95% CI= 1.01-1.29) compared to those with more than 8 years of school education. Blackmailing to receive snacks increased in 72% the probability of this behavior (PR= 1.72; 95% CI= 1.46-2.03). Conclusion: The introduction of sugar was premature in the studied population, and a high percentage of the preschoolers were found to eat snacks between meals. This outcome is associated with older children, low maternal educational level, and child's behavior. Preventive programs must include diet counseling since the first year of life, especially for mothers with low educational level.