Biocompatibility of the 8.25% sodium hypochlorite irrigant solution in endodontics: An in vivo study.

The biocompatibility of irrigant solutions, including 8.25% sodium hypochlorite (NaOCl), was analyzed in samples (n = 25) of chorioallantoic membranes (CAM) from embryos of the Gallus gallus, using the hen's egg test on chorioallantoic membrane (HET-CAM). The following irrigants were tested: saline (control), 2% chlorhexidine (2% CHX), and NaOCl (2.5%, 5.25%, and 8.25%), and morphological and microcirculatory changes were investigated. Images were selected and quantified with Image J®. The macroscopic data were submitted to ANOVA, followed by the Tukey's test (p < .05); non-parametric Kruskal-Wallis and Mann-Whitney tests were applied to histological data (p < .05). The frequency of hyperemia differed significantly in the 8.25% NaOCl compared to the other groups, with the exception of 5.25% NaOCl (p = .096). Coagulation was more frequent in the 2% CHX group, differing significantly from the 2.5% NaOCl group (p = .038). In mean values, NaOCl 8.25% caused the decrease (NaOCl = 2.60, and control = 5.00) of vessels in the microcirculation, as well as triggered the increase (NaOCl = 425.50, and control 44.50) of inflammatory cells in the observed areas. There was necrosis in all samples in the 5.25% NaOCl group and in 80% in the 2% CHX, 2.5% NaOCl, and 8.25% NaOCl groups. Fibroblasts were detected only in the control group. It was concluded that the 8.25% NaOCl solution showed significantly high toxicity on CAM. However, these results were comparable to the other concentrations of NaOCl and to 2% CHX. Thus, in this experimental protocol, 8.25% NaOCl proved to be viable as an irrigant solution.

Gene-environment interaction in molar-incisor hypomineralization.

Molar incisor hypomineralization (MIH) is an enamel condition characterized by lesions ranging in color from white to brown which present rapid caries progression, and mainly affects permanent first molars and incisors. These enamel defects usually occur when there are disturbances during the mineralization or maturation stage of amelogenesis. Both genetic and environmental factors have been suggested to play roles in MIH's development, but no conclusive risk factors have shown the source of the disease. During head and neck development, the interferon regulatory factor 6 (IRF6) gene is involved in the structure formation of the oral and maxillofacial regions, and the transforming growth factor alpha (TGFA) is an essential cell regulator, acting during proliferation, differentiation, migration and apoptosis. In this present study, it was hypothesized that these genes interact and contribute to predisposition of MIH. Environmental factors affecting children that were 3 years of age or older were also hypothesized to play a role in the disease etiology. Those factors included respiratory issues, malnutrition, food intolerance, infection of any sort and medication intake. A total of 1,065 salivary samples from four different cohorts were obtained, and DNA was extracted from each sample and genotyped for nine different single nucleotide polymorphisms. Association tests and logistic regression implemented in PLINK were used for analyses. A potential interaction between TGFA rs930655 with all markers tested in the cohort from Turkey was identified. These interactions were not identified in the remaining cohorts. Associations (p<0.05) between the use of medication after three years of age and MIH were also found, suggesting that conditions acquired at the age children start to socialize might contribute to the development of MIH.

Single nucleotide polymorphism rs4284505 in microRNA17 and risk of dental fluorosis.

OBJECTIVES: The aim of this study is to evaluate the association between the single nucleotide polymorphism (SNP) rs4284505 within the gene that codifies microRNA17 (miRNA17) and dental fluorosis (DF) in a group of children. METHODS: Children living in a city with fluoridation of public water supplies were included. DF was assessed in erupted permanent teeth by Dean's modified index. The miR-SNP rs4284505 was selected in miRNA17 and genotyping was carried out by real-time PCR. Genotype and allelic distributions between DF and control, and between DF phenotypes (mild, moderate and severe) and control were analysed. RESULTS: Among a total of 527 children enrolled for the study, 383 were DF free and 144 presented DF. In the dominant model analysis (AA + AG vs. GG) the miR-SNP rs4284505 was associated with moderate DF, with carriers of the GG genotype having an increased risk of more than two times for DF (p = 0.031; Odds Ratio = 2.26, Confidence Interval 95%= 1.04-4.73). Allelic distribution showed borderline statistical significance for moderate DF with the carriers of G allele having an increased risk for DF (p = .050; Odds Ratio = 1.75, Confidence Interval 95%= 1.00-3.12). CONCLUSION: The miR-SNP rs4284505 in miRNA17 was associated with an increased risk of DF.

Immunohistochemical panel of degenerated articular discs from patients with temporomandibular joint osteoarthritis.

BACKGROUND: Temporomandibular joint osteoarthritis (TMJOA) is a progressive degenerative disease caused by imbalance between anabolic and catabolic stimuli. OBJECTIVE: The aim of this study was to evaluate histopathological changes, collagen degeneration and the expression of eleven TMJOA biomarkers in articular discs. METHODS: Specimens were obtained from eight female patients submitted to discectomy. Discs were divided into anterior band (AB), intermediate zone (IZ) and posterior band (PB) for computerised histomorphometric analyses. Each was assigned a histopathological degeneration score (HDS). Collagen degeneration was assessed with Picrosirius-polarisation method. Biomarkers were evaluated through immunohistochemistry, including IGF-1, OPG, VEGF, TNF-α, FGF-23, IHH, MMP-3, MMP-9, TGF-ß1 , BMP-2 and WNT-3. Image processing software was used to calculate average immature collagen ratios and immunostained areas. Spearman rank tests were applied to verify correlations, with significance level of 0.05. RESULTS: The HDS showed negative correlation with expression of VEGF in IZ and PB (P < .05) and positive with TNF-α in AB (P < .01). Collagen degeneration correlated with TGF-ß1 (P < .05), BMP-2 (P < .01) and IHH (P < .05) immunostained areas in the IZ; TGF-ß1, BMP-2 and IHH expression correlated among each other in AB and IZ (P < .05). CONCLUSION: Angiogenesis and tissue fragmentation may result from aberrant physiologic responses mediated by VEGF and TNF-α, compromising TMJ discs during OA progression. The expression of TGF-ß1, BMP-2 and IHH could be related to collagen degeneration in displaced discs and may participate in TMJOA pathogenesis.

Changes in salivary composition of chemically dependent subjects / Cambios en la composición salival de personas químicamente dependientes

Abstract Chemically dependent subjects may present relevant changes in the volume and composition of salivary fluid because the secretion of the salivary glands is controlled by the parasympathetic and sympathetic system. The aim of this study was to compare the salivary concentration of total proteins, amylase, urea, calcium, phosphate and flow rate between chemically dependent and non-chemically dependent subjects. Saliva flow rate, calcium, phosphate, total protein, amylase and urea concentrations were measure in both groups: chemical dependent group (n=27) and control group (n=27). Saliva samples, from the chemically dependents, were taken one day before the beginning of the detoxification treatment. Statistical analysis was undertaken using t-test. The salivary flow and the urea concentration did not present statistically significant difference between the groups. However, total proteins, amylase, calcium and phosphate concentrations were statistically higher on the chemical dependents group. Saliva composition seems to be modified by the chronic use of alcohol and illicit drugs.

Resumen Los dependientes químicos pueden presentar cambios relevantes en el volumen y la composición de la saliva, debido a que la secreción de las glándulas salivales es controlada por el sistema parasimpático y simpático. El objetivo de este estudio fue comparar la concentración salival de proteínas totales, amilasa, urea, calcio, fosfato y la velocidad de flujo salival entre personas con dependencia química y no dependientes. Cada grupo fue formado por 27 participantes. La velocidad del flujo salival y las concentraciones de calcio, fosfato, proteína total, amilasa y urea se midieron en ambos grupos. Las muestras de saliva de los dependientes químicos se tomaron un día antes de comenzar el tratamiento de desintoxicación. El análisis estadístico se realizó por medio del test t de student. El flujo salival y la concentración de urea no presentaron diferencias estadísticamente significativas entre los grupos. Sin embargo, las concentraciones de proteínas totales, amilasa, calcio y fosfato fueron estadísticamente mayores en el grupo de dependientes químicos. El uso crónico de alcohol y de drogas ilícitas provocan modificaciones en la composición salival.

Estrogen receptor gene is associated with dental fluorosis in Brazilian children.

OBJECTIVES: The aim of this study was investigate the association between genetic polymorphisms in ESR1, ESR2, and ESRRB and dental fluorosis (DF) in a well-characterized sample of children from Curitiba, Brazil. MATERIAL AND METHODS: From a representative sample of 538 children, 12-year-old were evaluated. DF was assessed in erupted permanent teeth by the Dean's index modified. Fourteen polymorphisms were selected in intronic and intergenic regions of ESR1, ESR2, and ESRRB and genotyped in genomic DNA source from saliva using TaqMan chemistry and end-point analysis. Allele and genotype distributions between DF and DF free groups were analyzed using the Epi Info 7.2. Chi-square or Fisher's exact tests at a level of significance of 5% and odds ratios calculations with 95% confidence intervals were used to determine the statistical associations. RESULTS: Among 538 children, 147 were DF and 391 were DF free. Genotype distribution for the polymorphism rs12154178 in ESR1 was different between the two groups (p = 0.037; OR = 0.91; CI = 0.67-1.22). The dominant model analysis (AA+AC vs. CC) demonstrated that CC is a protective factor for DF (p = 0.038; OR = 0.51, 0.27-0.97 95% CI). We did not find differences in frequency distributions in the other evaluated polymorphisms. CONCLUSION: This study provides evidence that ESR1 is associated with DF. CLINICAL RELEVANCE: Dental fluorosis is an important condition that affects the mineralized tissues of the teeth. In severe cases, the treatment takes time and is extremely costly. This research provides evidences that there are genetic factors involved in dental fluorosis and will help professionals to plan more precise strategies to reduce dental fluorosis occurrence.

Oral Health of Children and Adolescents with Attention Deficit Hyperactivity Disorder.

AIM: The aim of the study was to evaluate the oral health conditions of children and adolescents with attention deficit hyperactivity disorder (ADHD). MATERIALS AND METHODS: Two groups were selected: a test group comprising 51 individuals with ADHD and a control group with 50 individuals without ADHD, with ages ranging from 7 to 14 years. Through an intraoral clinical examination, the numbers of decayed, missing, and filled teeth (DMFT index), the visible plaque index (VPI), the gingival bleeding index (GBI), bruxism, and dental traumatism were verified. A questionnaire confirmed oral hygiene supervision. RESULTS: In the test group, the average DMFT index was 3.41 while it was 2.52 in the control group (p = 0.405). The VPI in the test and control groups was 36.84% and 24.54%, respectively (p = 0.004). The GBI was 8.37% for the test group and 4.94% for the control group (p = 0.012). The DMFT index when supervised the oral hygiene by those responsible in comparison with the nonsupervision was 1.89 and 4.31, respectively, in the test group, and 1.71 and 2.94, respectively, in the control group. CONCLUSION: These data suggest that children and adolescents with ADHD present with worse oral health conditions and need greater attention from dental professionals and those responsible for their diet and oral hygiene. CLINICAL SIGNIFICANCE: Attention deficit hyperactivity disorder needs a special attention. This research brings this important issue focus on oral health. HOW TO CITE THIS ARTICLE: Begnini GJ, Brancher JA, Guimarães ATB, et al. Oral Health of Children and Adolescents with Attention Deficit Hyperactivity Disorder. Int J Clin Pediatr Dent 2019;12(6):543-547.

Sialometric and Sialochemical Changes in Morbidly Obese Patients before and after Bariatric Surgery.

AIM: To evaluate the sialometric and sialochemical changes in morbidly obese patients before and after bariatric surgery. MATERIALS AND METHODS: A total of 74 participants were divided into three groups paired by sex and age: (a) Experimental 1 (E1)-morbid obesity (n = 40)-according to the Fobi-Capella technique, corresponding to the individuals with a body mass index (BMI) of greater than 40 kg/m2 prior to bariatric surgery; (b) Experimental 2 (E2)-the same individuals after surgery; and (c) control (C) (n = 34)-individuals with a BMI of nearly 23 kg/m2. The measure of salivary flow was carried out by collecting stimulated saliva. The pH was evaluated using the pocket pH meter, while the salivary buffer capacity (SBC) was determined by the titration method. Analyses of the salivary concentration of total proteins (TPs), amylase activity, urea, calcium (Ca++), and glucose were evaluated using the calorimetric method. RESULTS: Group E1, as compared with group C, presented the highest pH levels (p = 0.03), amylase activity (p = 0.00), and calcium (p = 0.00). The opposite was observed for glucose (p = 0.00), TP (p = 0.04), and urea (p = 0.04). Group E2, as compared with group C, revealed higher levels of amylase (p = 0.00) and calcium (p = 0.00). The opposite was observed for SBC (p = 0.01), PT (p = 0.00), and glucose (p = 0.00). Group E1, as compared with group E2, presented higher values of SBC (p = 0.00) and urea (p = 0.00). The lowest values were found for calcium and urea (p = 0.03). CONCLUSION: Both weight gain and bariatric surgery are risk factors for the oral condition, causing change in some important salivary components, such as TP, amylase, calcium, and glucose. CLINICAL SIGNIFICANCE: This article is a valuable addition to the scientific literature, due to its novelty. There are no papers that show salivary alterations related to bariatric surgeries.

Lactotransferrin Gene Polymorphism Associated with Caries Experience.

Dental caries is a common multifactorial disease, resulting from the interaction of biofilm, cariogenic diet and host response over time. Lactotransferrin (LTF) is a main salivary glycoprotein, which modulates the host immune-inflammatory and antibacterial response. Although a genetic component for caries outcome has been identified, little is known over the genetic aspects underlying its susceptibility. Thus, the aim of this study was to investigate the association between LTF polymorphisms and caries susceptibility. Six hundred seventy seven 12-year-old students were selected: 346 with (DMFT ≥ 1) and 331 without caries experience (DMFT = 0). Also, individuals concentrating higher levels of disease (polarization group, DMFT ≥ 2, n = 253) were tested against those with DMFT ≤ 1 (n = 424). Along with clinical parameters, three representative LTF tag SNPs (rs6441989, rs2073495, rs11716497) were genotyped and the results were evaluated using univariate and multivariate analyses. Allele A for tag SNP rs6441989 was found to be significantly less frequent in the polarization group, conferring a protective effect against caries experience [AA + AG × GG (OR: 0.710, 95% CI: 0.514-0.980, p = 0.045)], and remained significantly associated with caries protection in the presence of gingivitis (p = 0.020) and plaque (p = 0.035). These results might contribute to the understanding of the genetic control of caries susceptibility in humans.

Role of TRAV locus in low caries experience.

Caries is the most common chronic, multifactorial disease in the world today; and little is still known about the genetic factors influencing susceptibility. Our previous genome-wide linkage scan has identified five loci related to caries susceptibility: 5q13.3, 13q31.1, 14q11.2, 14q 24.3, and Xq27. In the present study, we fine mapped the 14q11.2 locus to identify genetic contributors to caries susceptibility. Four hundred seventy-seven subjects from 72 pedigrees with similar cultural and behavioral habits and limited access to dental care living in the Philippines were studied. An additional 387 DNA samples from unrelated individuals were used to determine allele frequencies. For replication purposes, a total of 1,446 independent subjects from four different populations were analyzed based on their caries experience (low versus high). Forty-eight markers in 14q11.2 were genotyped using TaqMan chemistry. Transmission disequilibrium test was used to detect over transmission of alleles in the Filipino families, and Chi-square, Fisher's exact and logistic regression were used to test for association between low caries experience and variant alleles in the replication data sets. We finally assessed the mRNA expression of TRAV4 in the saliva of 143 study subjects. In the Filipino families, statistically significant associations were found between low caries experience and markers in TRAV4. We were able to replicate these results in the populations studied that were characteristically from underserved areas. Direct sequencing of 22 subjects carrying the associated alleles detects one missense mutation (Y30R) that is predicted to be probably damaging. Finally, we observed higher expression in children and teenagers with low caries experience, correlating with specific alleles in TRAV4. Our results suggest that TRAV4 may have a role in protecting against caries.

Enamel formation genes influence enamel microhardness before and after cariogenic challenge.

There is evidence for a genetic component in caries susceptibility, and studies in humans have suggested that variation in enamel formation genes may contribute to caries. For the present study, we used DNA samples collected from 1,831 individuals from various population data sets. Single nucleotide polymorphism markers were genotyped in selected genes (ameloblastin, amelogenin, enamelin, tuftelin, and tuftelin interacting protein 11) that influence enamel formation. Allele and genotype frequencies were compared between groups with distinct caries experience. Associations with caries experience can be detected but they are not necessarily replicated in all population groups and the most expressive results was for a marker in AMELX (p=0.0007). To help interpret these results, we evaluated if enamel microhardness changes under simulated cariogenic challenges are associated with genetic variations in these same genes. After creating an artificial caries lesion, associations could be seen between genetic variation in TUFT1 (p=0.006) and TUIP11 (p=0.0006) with enamel microhardness. Our results suggest that the influence of genetic variation of enamel formation genes may influence the dynamic interactions between the enamel surface and the oral cavity.