The influence of asthma onset and severity on malocclusion prevalence in children and adolescents

OBJECTIVE: The influence of asthma, its severity levels and onset time on malocclusion occurrence were investigated. METHODS: The sample was composed by 176 children/adolescents, of both genders, aged 3 to 15 years, that were divided in two groups. The asthma group (AG) enrolled 88 children/adolescents that were seen at the Breathe Londrina Program. The asthma-free group (AFG) enrolled 88 preschool and school children recruited in 2 public schools. Malocclusion diagnosis was made according to WHO criteria (OMS, 1999). RESULTS: A higher prevalence in malocclusions in asthmatic patients in mixed dentition was observed when compared to controls (p<0.05). On the other hand, these results were not observed for deciduous (p>0.05) and permanent dentition (p>0.05). A significant association was seen between asthma onset time and marked maxillary overjet (p<0.05), and open bite (p<0.05) in the mixed dentition, being both conditions more common among those that have presented the symptoms of asthma prior to 12 months of age. CONCLUSION: The results of this study indicate that the early manifestation of asthma at first year of life can cause dentofacial changes. Therefore, the prompt diagnostic of the illness, as well as the establishment of a proper therapy could improve the symptoms and chronic complications of asthma and also reduce its impact on craniofacial development.

Prevalence of developmental defects of enamel in children and adolescents with asthma.

OBJECTIVE: This study aimed to evaluate the prevalence of developmental defects of enamel (DDEs) in relation to asthma severity, symptom onset and pharmacological treatment in pediatric asthma patients. METHODS: Children and adolescents (68 asthma patients and 68 controls), 5-15 years of age and residents of the city of Londrina, Brazil, were enrolled in the study. Medical and dental histories were collected through the use of a structured questionnaire. Each participant underwent a dental examination in which the examiner employed the DDE index. RESULTS: Of the 68 asthma group subjects, 61 (89.7%) presented dental enamel defects, compared with only 26 (38.2%) of those in the control group. Using multivariate logistic regression analysis, we estimated the risk of DDEs in permanent dentition to be 11 times higher in pediatric subjects with asthma than in those without (OR = 11.88, p = 0.0001). The occurrence of dental enamel defects correlated with greater asthma severity (p = 0.0001) and earlier symptom onset (p = 0.0001). However, dental enamel defects did not correlate with the initiation of treatment (p = 0.08) or the frequency of medication use (p = 0.93). CONCLUSIONS: Pediatric patients with severe, early-onset asthma are at increased risk of dental enamel defects and therefore require priority dental care.

Prevalence of developmental defects of enamel in children and adolescents with asthma / Prevalência de defeitos do desenvolvimento do esmalte dentário em crianças e adolescentes com asma

OBJECTIVE: This study aimed to evaluate the prevalence of developmental defects of enamel (DDEs) in relation to asthma severity, symptom onset and pharmacological treatment in pediatric asthma patients. METHODS: Children and adolescents (68 asthma patients and 68 controls), 5-15 years of age and residents of the city of Londrina, Brazil, were enrolled in the study. Medical and dental histories were collected through the use of a structured questionnaire. Each participant underwent a dental examination in which the examiner employed the DDE index. RESULTS: Of the 68 asthma group subjects, 61 (89.7 percent) presented dental enamel defects, compared with only 26 (38.2 percent) of those in the control group. Using multivariate logistic regression analysis, we estimated the risk of DDEs in permanent dentition to be 11 times higher in pediatric subjects with asthma than in those without (OR = 11.88, p = 0.0001). The occurrence of dental enamel defects correlated with greater asthma severity (p = 0.0001) and earlier symptom onset (p = 0.0001). However, dental enamel defects did not correlate with the initiation of treatment (p = 0.08) or the frequency of medication use (p = 0.93). CONCLUSIONS: Pediatric patients with severe, early-onset asthma are at increased risk of dental enamel defects and therefore require priority dental care.

OBJETIVO: Avaliou-se a prevalência de developmental defects of enamel (DDEs, defeitos de desenvolvimento do esmalte dentário) em pacientes pediátricos com asma e sua relação com a severidade da asma, o início dos sintomas e o tratamento medicamentoso. MÉTODOS: Os participantes do estudo eram residentes do município de Londrina (PR), com 5 a 15 anos, sendo 68 asmáticos e 68 controles. Foram levantados dados retrospectivos da história médica e de saúde bucal da população do estudo através de um questionário estruturado. Todos os participantes foram submetidos a um exame dental. Para a avaliação dos defeitos de desenvolvimento do esmalte dentário, utilizou-se o Índice DDE. RESULTADOS: Neste estudo, foi observado que 61 (89,7 por cento) dos 68 pacientes asmáticos apresentavam defeitos de desenvolvimento do esmalte dentário quando comparado à ocorrência em 26 (38,2 por cento) dos no grupo controle. Através da análise multivariada por regressão logística, foi observado que um paciente pediátrico com asma apresenta risco aumentado em 11 vezes para o aparecimento de defeitos de desenvolvimento do esmalte em dentes permanentes (OR = 11,88, p = 0,0001). Além disso, foi observado uma associação entre defeitos do esmalte dentário e maior severidade da asma (p = 0,0001) e início dos sintomas mais precoce (p = 0,0001). Não se observou associação entre o início do tratamento (p = 0,08) ou frequência de uso da medicação (p = 0,93) com o aparecimento de defeitos de desenvolvimento do esmalte dentário. CONCLUSÕES: Pacientes pediátricos com asma apresentam risco aumentado para a ocorrência de defeitos de desenvolvimento do esmalte dentário relacionado à severidade da asma e início dos sintomas e, portanto, necessitam de atenção odontológica prioritária.

In vitro assessment of solvent evaporation from commercial adhesive systems compared to experimental systems.

Solvents should be properly evaporated after application to dental substrates. The aim of this study was to assess the evaporation of commercial, experimental and neat solvents. The tested null hypotheses were that there are no differences in solvent evaporation regardless of its formulation and over time. Evaporation from commercial adhesive systems (Scotchbond Multipurpose Primer, Scotchbond Multipurpose Adhesive, Prime & Bond NT, Multi Bond, Excite, Single Bond 2, Adhese Primer, Adhese Bond, Xeno III A and Xeno III B) and experimental primers (35% HEMA plus 65% acetone or ethanol or water v/v) were compared to neat solvents (acetone, ethanol and water). Samples (10 microL) of these products were dripped into glass containers placed on a digital precision balance. Evaporation was assessed at 0, 5, 10, 15, 30, 60, 120, 300 and 600 s times to calculate mass loss. Data were analyzed statistically by ANOVA and Bonferroni's correction (a=0.05). Acetone-based products exhibited a remarkable capacity to evaporate spontaneously over time. Neat acetone evaporated significantly more than the HEMA-mixtures and the commercial formulations (p<0.05). The incorporation of monomers and other ingredients in the commercial formulations seem to reduce the evaporation capacity. Solvent evaporation was time and material-dependent.

In vitro assessment of solvent evaporation from commercial adhesive systems compared to experimental systems

Solvents should be properly evaporated after application to dental substrates. The aim of this study was to assess the evaporation of commercial, experimental and neat solvents. The tested null hypotheses were that there are no differences in solvent evaporation regardless of its formulation and over time. Evaporation from commercial adhesive systems (Scotchbond Multipurpose Primer, Scotchbond Multipurpose Adhesive, Prime & Bond NT, Multi Bond, Excite, Single Bond 2, Adhese Primer, Adhese Bond, Xeno III A and Xeno III B) and experimental primers (35 percent HEMA plus 65 percent acetone or ethanol or water v/v) were compared to neat solvents (acetone, ethanol and water). Samples (10 µL) of these products were dripped into glass containers placed on a digital precision balance. Evaporation was assessed at 0, 5, 10, 15, 30, 60, 120, 300 and 600 s times to calculate mass loss. Data were analyzed statistically by ANOVA and Bonferroni's correction (a=0.05). Acetone-based products exhibited a remarkable capacity to evaporate spontaneously over time. Neat acetone evaporated significantly more than the HEMA-mixtures and the commercial formulations (p<0.05). The incorporation of monomers and other ingredients in the commercial formulations seem to reduce the evaporation capacity. Solvent evaporation was time and material-dependent.

O solvente deve ser adequadamente evaporado após aplicação ao substratos dentários. O objetivo deste estudo foi avaliar a evaporação de formulações comerciais, primers experimentais e solventes puros. As hipóteses nulas testadas foram de que não há diferenças da quantidade evaporada independentemente do material e tempo. Evaporação dos sistemas adesivos comerciais (Scotchbond multipurpose primer, Scotchbond multipurpose adhesive, Prime & Bond NT, Multi Bond, Excite, Single Bond 2, Adhese Primer, Adhese Bond, Xeno III A e Xeno III B) e primers experimentais (35 por cento HEMA associado com 65 por cento acetona, etanol ou água v/v) foram comparadas a solventes puros (acetona, etanol e água). Amostras (10 µL) de cada produto foram dispensadas em balança de precisão digital. As massas nos tempos 0, 5, 10, 15, 30, 60, 120, 300 e 600 s foram registradas. Os dados foram analisados estatisticamente por ANOVA e Bonferroni (a=0,05). Produtos a base de acetona exibiram maior capacidade de evaporação espontânea ao longo do tempo. Acetona pura evaporou significantemente mais que as misturas de HEMA e formulações comerciais (p<0,05). A incorporação de monômeros e outros ingredientes nas formulações comerciais reduzem a capacidade de evaporação. A evaporação é dependente do produto e do tempo.

Antimicrobial effect of propolis and other substances against selected endodontic pathogens.

OBJECTIVE: The aim of this study was to determine the antimicrobial effect of ethanol extract of propolis (EEP) and intracanal medicaments calcium hydroxide, camphorated paramonochlorophenol, and formocresol by means of the macrodilution method using the reinforced clostridial medium (RCM) and brucella and brain heart infusion media. STUDY DESIGN: The antimicrobial agents were sequentially diluted and tested against anaerobic bacteria Prevotella nigrescens, Fusobacterium nucleatum, Actinomyces israelii, and Clostridium perfringens and against Enterococcus faecalis, with the 5 x 10(5) CFU/mL standardized inocula. The tubes were anaerobically incubated and the minimum inhibitory concentration was detected. Blood agar RCM subcultures were performed to provide minimum bactericidal concentration. The results were analyzed by analysis of variance test. RESULTS: All drugs were effective against all tested strains, without statistical differences. E. faecalis was the less susceptible strain, and RCM broth promoted faster bacterial growth, but there were no significant differences in these results. Ethanol did not influence the antimicrobial effect of EEP.

Root canal microbiota of dogs' teeth with periapical lesions induced by two different methods.

OBJECTIVE: The microbial composition was investigated in root canals of dogs' teeth with periapical lesions induced by 2 different methods: open versus sealed canals. STUDY DESIGN: Teeth from Group I (n = 16) were left open for a week, then sealed with composite resin for 120 days. The teeth from Group II (n = 16) were left open for the same period. Microbiological samples from the root canals were collected and processed by the anaerobic technique for identification and counting of microorganisms after establishment of periapical reactions. RESULTS: Seventy-four cultivable isolates were recovered in sealed canals (Group I). Strict anaerobes accounted for 64.9% of all species isolated, and gram-negative microorganisms accounted for 55.4%. Microbial genera most frequently isolated were Prevotella, Fusobacterium, Peptostreptococcus, Streptococcus, Enterococcus, Clostridium, and Porphyromonas. Statistical analysis by Pearson chi-square or Fisher's test revealed positive association between sealed teeth and strict anaerobes (P < .05). In open canals (Group II), from a total of 58 cultivable isolates, 19% were strict anaerobes and 81% facultative anaerobes, with predominance of gram-positive species (75.8%). Genera most frequently isolated were Streptococcus, Propionibacterium, Staphylococcus, Neisseria, and Prevotella. CONCLUSION: Strict anaerobes were most frequently found in sealed teeth rather than in the teeth with canals left exposed to the oral cavity for 4 months. Therefore, the method that induced periapical inflammatory lesions by intentional oral exposure, followed by tooth sealing, produced root canal microbiota similar to the same found in humans.

Estudo comparativo do grau de limpeza de canais radiculares com duas formulaçöes de EDTA / Comparative study of root canal cleanness degree between two EDTA formulations

Comparou-se o grau de limpeza de canais radiculares de trinta caninos humanos extraídos empregando-se EDTA gel a 24 por cento (Grupo 1), EDTA líquido a 17 por cento (Grupo 2) e soro fisiológico (Grupo 3) como agentes de limpeza final, após preparo químico-mecânico. As raízes foram hemi-seccionadas e secas para avaliaçäo em microscopia eletrônica de varredura, sendo os terços radiculares médio e apical fotografados com 10 kV e aumento de 1.000 vezes, observando-se o grau de limpeza das paredes dos canais, de acordo com escores previamente estabelecidos. Após análise estatística pelo teste de Kruskal-Wallis, concluiu-se que: o terço médio apresentou-se significativamente mais limpo que o apical; o EDTA gel propiciou limpeza semelhante ao EDTA líquido e ambos propiciaram maior grau de limpeza, com diferença estatística significante, em relaçäo ao soro fisiológico

Avaliação antimicrobiana do tratamento endodôntico em dentes de cães submetidos à contaminação oral e à aplicação de endotoxina bacteriana / Antimicrobial evaluation of endodontic treatment and intracanal medications on dog's teeth with oral contamination and bacterial endotoxin aplication

Foi investigada a microbiota dos canais radiculares de dentes de cães com reação periapical induzida, antes e após o preparo biomecânico e após diferentes curativos. Foram utilizados 40 dentes pré-molares de 5 cães adultos. Quatro dentes do lado direito dos cães foram abertos e instrumentados com ampliação foraminal padronizada e mantidos abertos por 7 dias. Do lado esquerdo, quatro dentes foram abertos assepticamente sob isolamento absoluto e tiveram suas polpas removidas e os forames ampliados. Após isto, receberam endotoxina de Escherichia coli sorotipo 011-B4 (Sigma-Aldrich) na concentração de 50 g/mL. Todos os dentes foram vedados com resina composta e então feitos controles clínicos e radiográficos após 2, 3 e 4 meses, para verificação da presença de reação periapical. Quando esta foi radiograficamente evidente (3 meses em média) os dentes foram submetidos ao tratamento endodôntico. Coletas microbiológicas foram feitas antes (1a) e depois (2a) da instrumentação com soro fisiológico e precedidas de desinfecção do campo sob isolamento absoluto. Foram inseridos os curativos clorexidina gel a 2 por cento, hidróxido de cálcio a 10 por cento em água destilada e extrato etanólico de própolis a 10 por cento em propilenoglicol, além do grupo controle sem curativo, nos diferentes dentes e em sistema de rodízio. Após 15 dias do curativo, estes foram removidos assepticamente e feita nova coleta (3a). Os dentes foram selados com os canais vazios e dentro de uma semana foi feita a quarta e última coleta. As coletas foram processadas anaerobicamente para identificação dos microrganismos e feita a contagem das unidades formadoras de colônias (UFC). Foi observado que o preparo biomecânico proporcionou boa redução no número de UFCs e a redução significativa de anaeróbios. Os 3 curativos utilizados permitiram redução microbiana de forma semelhante, havendo a reincidência de microrganismos após 1 semana de canal vazio. Os dentes contaminados apenas com endotoxina bacteriana mostraram uma quantidade menor de UFCs e número de espécies nas diversas coletas. Foi concluido que a instrumentação promoveu uma redução significante de microrganismos, assim como o uso de medicamentos intracanais. Entretanto, a manutenção do canal vazio, após a medicação intracanal permite a recolonização do mesmo.

Activity of endodontic antibacterial agents against selected anaerobic bacteria.

The antimicrobial activity of substances used as antibacterial agents (solutions of 10% calcium hydroxide, camphorated paramonochlorophenol - PMCC, 2% chlorhexidine digluconate and 10% castor oil plant detergent) on anaerobic bacteria (Fusobacterium nucleatum ATCC 25586, Prevotella nigrescens ATCC 33563, Clostridium perfringens ATCC 13124 and Bacteroidesfragilis ATCC 25285), using a broth dilution technique, was evaluated in vitro. For determination of minimum inhibitory and minimum bactericide concentrations (MIC and MBC), two culture broths, Reinforced Clostridial Medium (RCM) and supplemented Brucella, standardized inoculum and serially diluted solutions were used. All antibacterial agents presented antimicrobial activity that varied for different bacteria. There were no differences in the performance of the two broths. Chlorhexidine digluconate was the most effective, with the lowest MICs, followed by castor oil detergent, PMCC and calcium hydroxide. C. perfringens and B. fragilis were the most resistant bacteria to all agents.

In vitro effect of intracanal medicaments on strict anaerobes by means of the broth dilution method.

The determination of bacterial susceptibility to intracanal medicaments is a necessity. Nevertheless, few studies utilize the proper methodology to carry out that evaluation with anaerobes. In this study, the steps of a broth dilution method, carried out in microplates (microdilution) and tubes (macrodilution), to test the effect of traditional intracanal medicaments on anaerobic bacteria are described. The results are presented as values of minimal inhibitory and bactericidal concentrations (MIC and MBC). Standardized inocula of the anaerobic bacteria Prevotella nigrescens (ATCC 33563), Fusobacterium nucleatum (ATCC 25586) and Clostridium perfringens (ATCC 13124), in reinforced Clostridium medium (RCM) and supplemented Brucella broth, were submitted to different concentrations of calcium hydroxide, chlorhexidine digluconate, camphorated paramonochlorophenol and formocresol solutions. The drugs were diluted in the same culture broths, in microplates and tubes, and were then incubated in anaerobiosis jars at 37 degrees C for 48 or 96 hours. The determination of MICs was carried out through visual and spectrophotometric readings, and the determination of MBCs, through the plating of aliquots on RCM-blood agar. For that kind of study, the macromethod with spectrophotometric reading should be the natural choice. MICs and MBCs obtained with the macromethod were compatible with the known clinical performance of the studied medications, and the values varied according to the bacteria and culture media employed. RCM was the most effective medium and C. perfringens, the most resistant microorganism.

In vitro effect of intracanal medicaments on strict anaerobes by means of the broth dilution method

A determinaçäo da suscetibilidade bacteriana aos medicamentos intracanal é uma necessidade, mas säo poucos os estudos que utilizam metodologia própria para anaeróbios estritos nessa avaliaçäo. Neste estudo, säo descritos os passos de um método de diluiçäo em caldo, feito em microplacas (microdiluiçäo) e em tubo (macrodiluiçäo), para testar a açäo de medicamentos intracanal tradicionais sobre bactérias anaeróbias estritas, com apresentaçäo dos resultados em Concentraçöes Inibitória e Bactericida Mínimas (CIM e CBM). Inóculos padronizados dos anaeróbios Prevotella nigrescens (ATCC 33563), Fusobacterium nucleatum (ATCC 25586) e Clostridium perfringens (ATCC 13124), em caldo Reinforced Clostridium Medium (RCM) e caldo Brucella suplementado, foram submetidos a diferentes concentraçöes de soluçöes de hidróxido de cálcio, digluconato de clorexidina, paramonoclorofenol canforado e formocresol, diluídas nos mesmos caldos de cultura, em microplacas e tubos, e depois incubados em jarras de anaerobiose a 37ºC por 48h ou 96h. A determinaçäo das CIMs foi feita através de leituras visual e em espectrofotômetro, e das CBMs, pela semeadura de alíquotas em ágar RCM-sangue. Para esse tipo de estudo, o macrométodo com leitura em espectrofotômetro deve ser a escolha natural. As CIMs e CBMs do macrométodo foram compatíveis com seu conhecido desempenho clínico, variando com as bactérias e meios de cultura empregados. O caldo RCM foi o mais efetivo e o C. perfringens, o microrganismo mais resistente

Activity of endodontic antibacterial agents against selected anaerobic bacteria

The antimicrobial activity of substances used as antibacterial agents (solutions of 10 calcium hydroxide, camphorated paramonochlorophenol - PMCC, 2 chlorhexidine digluconate and 10 castor oil plant detergent) on anaerobic bacteria (Fusobacterium nucleatum ATCC 25586, Prevotella nigrescens ATCC 33563, Clostridium perfringens ATCC 13124 and Bacteroidesfragilis ATCC 25285), using a broth dilution technique, was evaluated in vitro. For determination of minimum inhibitory and minimum bactericide concentrations (MIC and MBC), two culture broths, Reinforced Clostridial Medium (RCM) and supplemented Brucella, standardized inoculum and serially diluted solutions were used. All antibacterial agents presented antimicrobial activity that varied for different bacteria. There were no differences in the performance of the two broths. Chlorhexidine digluconate was the most effective, with the lowest MICs, followed by castor oil detergent, PMCC and calcium hydroxide. C. perfringens and B. fragilis were the most resistant bacteria to all agents.

Activity of endodontic antibacterial agents against selected anaerobic bacteria%Atividade antimicrobiana de agentes antibacterianos utilizados em Endodontia sobre bactérias anaeróbias estritas

Foi avaliada in vitro a capacidade antimicrobiana de substâncias utilizadas como agentes antimicrobianos (solução de hidróxido de cálcio 10 por cento, paramonoclorofenol canforado - PMCC, digluconato de clorexidina 2 por cento e detergente de mamona 10 por cento) sobre bactérias anaeróbias (Fusobacterium nucleatum ATCC 25586, Prevotella nigrescens ATCC 33563, Clostridium perfrigens ATCC 13124 e Bacteroides fragilis ATCC 25285), utilizando-se a técnica da diluição em caldo. Para a determinação das concentrações inibitória e bactericida mínimas (CIM e CBM), dois caldos, Reinforced Clostridial Medium (RCM) e Brucella suplementado, inóculo padronizado e diluições seriadas foram utilizados. Todos os agentes antimicrobianos apresentaram atividade antimicrobiana, variando para as diferentes espécies bacterianas, não havendo diferença entre os caldos utilizados. O digluconato de clorexidina demonstrou a melhor eficiência, com as menores CIMs, seguido pelo detergente de mamona, PMCC e hidróxido de cálcio. C. perfringens e B. fragilis foram as espécies mais resistentes aos agentes

Radiopacidade de cimentos endodônticos avaliada pelo sistema de radiografia digital / Digital radiographic assesment of endodontic cements radiopacity

Radiopacidade é uma das propriedades físicas requeridas para os cimentos endodônticos pela qual se avalia o preenchimento do sistema de canais radiculares. Rotineiramente utiliza-se o fotodensitômetro para a leitura de densidades em filmes radiográficos. A finalidade deste trabalho foi utilizar o sistema de imagem digital DIGORA, para determinar a radiopacidade de cinco cimentos endodônticos. Confeccionou-se 12 corpos de prova de 1,5 mm de espessura e 5 de diâmetro dos cimentos com e sem cones de guta-percha, e três fragmentos de dentina, que foram radiografados no sensor do Digora em 3 aparelhos de raios x: Dabi 50kV/4mAs, Siemens 60kV/3mAs e Dabi 70kV/2mAs, a uma distância de 40 cm. Após a leitura da placa de imagem no escaner a laser, o software do Digora 5.1 determinou a radiopacidade das áreas padronizadas fornecendo a média e o desvio-padräo da densidade radiográfica (níveis de cinza). Com os valores obtidos, a ordem dos cimentos do mais radiopaco para o memos foi: Vidrion, N-Rickert, Sealer 26, Endomethasone e Sealapex. Nos cimentos Sealer 26, Endomethasone e Sealapex a adiçäo de guta-percha aumentou a radiopacidade (em torno de 12 por cento), enquanto que nos outros dois houve a diminuiçäo (em torno de 4 por cento). A densidade radiográfica com 50 kV foi mais alta que com 60 e 70 kV devido a menor discriminaçäo dos níveis de cinza nesta quilovoltagem