Single Nucleotide Polymorphisms and Dental Fluorosis: A Systematic Review.

Genetic factors contribute to susceptibility and resistance to fluoride exposure. The aim of this systematic review was to identify alleles/genotypes of single nucleotide polymorphisms (SNPs) associated with dental fluorosis (DF) and to identify them as protective or risk factors. PubMed, ScienceDirect, Cochrane Library, Scopus and Web of Science were searched for articles; the last search was performed in August 2022. Human studies that analyzed the relationship between SNPs and DF published in English were included; systematic reviews and meta-analyses were excluded. Methodological quality was graded using the Joanna Briggs Institute checklist and risk of bias was assessed using the Cochrane Collaboration's tool. Eighteen articles were included, 44% of which showed high methodological quality and data from 5,625 participants aged 6 to 75 years were analyzed. The SNPs COL1A2, ESR2, DLX1, DLX2, AMBN, TUFT1, TFIP11, miRNA17, and SOD2 were considered risk factors, and ESR1, MMP20, and ENAM were considered protective factors. In conclusion, there are alleles and genotypes of different single nucleotide polymorphisms involved in increasing or decreasing the risk of developing dental fluorosis.

Nano-structured hydroxyapatite and titanium dioxide enriching PENTA /UDMA adhesive as aesthetic coating for tooth enamel.

OBJECTIVES: The aim of this study was to investigate the effect of the nanostructured hydroxyapatite (NHAp) and titanium dioxide nanoparticles (NTiO2) on dispersion in an adhesive containing monomers of Dipenta erythritol penta-acrylate monophosphate (PENTA) and Urethane dimethacrylate (UDMA), as well as evaluating the structural, optical and mechanical behavior of the composite material for dental aesthetic application. METHODS: The NHAp powders were synthesized through the wet chemical methods of hydrothermal and ultrasound-assisted precipitation. The microstructure, morphology and composition analysis of the powder of NHAp and NTiO2 were performed by scanning and transmission electron microscopy. The optical microscopic identification of the different colors was obtained due to varying the amounts of NHAp and NTiO2 in the adhesive. On the other hand, the diffuse reflectance spectra of the coatings were evaluated every 2nm with the wavelength from 400 to 800nm for combined specular and diffuse reflectance. The nanomechanical properties of the aesthetic coating such as (H), elastic modulus (E) and nanoscratching were evaluated by nanoindentation. The roughness of the composite coatings were evaluated by AFM. RESULTS: From different powders combinations, NHAP 75%Wt-NTiO2 %25Wt, at (10Wt %) into a dental adhesive, the resulting mixture manifested the optimum aesthetic white appearance. The scanning and transmission electron microscopy images confirmed that the HAp nanorods and TiO2 nanoparticles sized were 55nm and 20nm respectively prepared by the high-energy ball mixed process. The values of nanomechanical properties of the optimum aesthetic coating were hardness, H=3.2±0.3GPa, elastic modulus, E=78±3GPa, Yield point, Y=107MPa±2 and scratching, maximum wear track deformation 3.7±0.12 µm2. The percentage of reflectance to optimum aesthetic white appearance was of 46.83% at 423nm of wavelength. CONCLUSIONS: The nanocomposite PENTA/UDMA with mixtures of Nanohydroxyapatite and titanium dioxide may be considerate as a mechanical toughened, also an option to modify shade qualities for dental aesthetic applications.

Recent Biomarkers for Monitoring the Systemic Fluoride Levels in Exposed Populations: A Systematic Review.

Fluorides are compounds that can be found in the minerals of soil with volcanic rocks. Different populations are exposed to high levels of fluorides through drinking water that, due to their chronic intake, cause several types of damage to health. Nails and hair, denominated as recent biomarkers, have been employed for monitoring systemic fluoride from long-term exposure to fluorides. The aim of this study was to perform a systematic review of the use of recent biomarkers for monitoring systemic fluoride levels in exposed populations and verify their validity in the measurement of the fluorine (F-) concentration within the body. A digital search was performed in the databases PubMed/Medline, Springer Link, Cochrane, and Scopus of original articles that employed recent biomarkers for monitoring systemic F-. Seventeen articles were included in this analysis; the recorded variables were the F- amount in each assessed biomarker, source of exposure, and total daily fluoride intake (TDFI). TDFI was associated with F- in nails and hair, as well as the exposure through drinking water. In conclusion, recent biomarkers are adequate for monitoring the systemic fluoride levels by evaluating the chronic/subchronic exposure through different sources, mainly drinking water, considering nails better than hair for this purpose.

ENAM Gene Variation in Students Exposed to Different Fluoride Concentrations.

The ENAM gene is important in the formation of tooth enamel; an alteration can affect the lengthening of the crystals, and the thickness in enamel. The objective was to determine the presence of the single nucleotide variant (SNV) rs12640848 of the ENAM gene in students exposed to different concentrations of fluoride. METHODS: A cross-sectional study was conducted on students exposed to high concentrations of fluoride in the city of Durango which were divided according to the severity of fluorosis and dental caries. Genotype determination was performed by DNA sequencing. The relationship between the severity of dental fluorosis and the allele distribution was determined by the Fisher's exact and Kruskal-Wallis tests. RESULTS: Seventy-one students were included for the sequencing. In the different allelic variations, for the normal genotype AA/TT, the control group presented 75%, for the AG/TC variation, 70.8% in the TF ≤ 4 group, 65% in TF ≥ 5, and 16.7% in TF = 0; with respect to GG/CC variation, 12.5% in TF ≤ 4, 22% in TF ≥ 5, and 8.3% in TF = 0 group (p = 0.000). CONCLUSION: The ENAM gene showed an association in the population exposed to different concentrations of fluoride.

Effectiveness of a microabrasion technique using 16% HCL with manual application on fluorotic teeth: A series of studies.

BACKGROUND: Dental fluorosis is caused by excessive fluoride ingestion during tooth formation. As a consequence, there is a higher porosity on the enamel surface, which causes an opaque look. AIM: The aim of this study was to identify a dental intervention to improve the smile in patients with tooth fluorosis. Additional aims were to relate the stain size on fluorotic teeth with the effectiveness of stain removal, enamel loss and procedure time using a manual microabrasion technique with 16% hydrochloric acid (HCL). METHODS: An experimental study was carried out on 84 fluorotic teeth in 57 adolescent patients, 33 females and 24 males, with moderate to severe fluorosis. The means, standard deviations and percentages were analyzed using nonparametric statistics and ArchiCAD 15 software was used for the variables including stain size and effectiveness of stain removal. RESULTS: The average enamel loss was 234 µm and was significantly related to the procedure time categorized as 1-4 min and 4.01-6 min, resulting in a P > 0.000. The microabrasion technique using 16% HCL was effective in 90.6% of patients and was applied manually on superficial stains in moderate and severe fluorosis. Procedure time was less than 6 min and enamel loss was within the acceptable range. CONCLUSION: Microabrasion is a first-line treatment; however, the clinician should measure the average enamel loss to ensure that it is within the approximate range of 250 µm in order to avoid restorative treatment.

Environmental Exposure of Arsenic in Groundwater Associated to Carcinogenic Risk in Underweight Children Exposed to Fluorides.

BACKGROUND: The purpose of this study was to determine the concentration of inorganic arsenic (As) in the potable water available to the population to be able to estimate the non-carcinogenic risks for underweight children and the carcinogenic risk for adults exposed to As intake who live in the Mezquital municipality, Durango, Mexico. METHODS: The As content was quantifed in the water supply sources for human use and its intake was estimated in Mezquital population, southern Durango. With the data obtained, the hazard quotient (HQ) was calculated to determine the non-carcinogenic risk to develop chronic systemic effects in underweight children. The Environmental Protection Agency (EPA) reference health values estimating As exposure risk are from 0.0003 mg/kg/day (non-carcinogenic) to 1.5 mg/kg/day (carcinogenic risk). RESULTS: The analyzed waters presented as concentrations that varied from 0.3 to 10.2 µg/L, with a mean of 7.35 µg/L (CI 95% 6.27-8.38). The exposure dose was 0.4 to 1.36, and the HQ was 1.90 to 6.48 mg/kg/day, the estimated carcinogenic risk from adults varied from 1.28 to 4.37E-4, with values of 3.74-4.37E-4 mg/kg/day in central area. CONCLUSIONS: The children are at risk to develop chronic systemic effects due to ingestion of As from water.

Impact of Dental Fluorosis, Socioeconomic Status and Self-Perception in Adolescents Exposed to a High Level of Fluoride in Water.

Objective: To identify adolescents' self-perception of dental fluorosis from two areas with different socioeconomic levels. Methods: A cross-sectional, descriptive study was conducted with 15-year-old youths by applying a questionnaire designed and validated to assess self-perceptions of dental fluorosis in two areas with different socioeconomic statuses (SESs). Fluorosis was clinically evaluated by applying the Thylstrup and Fejerkov (TF) index on the upper front teeth. Results: A total of 308 adolescents were included in the study. The medium-SES population, which was exposed to 2.5 ppm of fluoride in water, and the low-SES population, which was exposed to 5.1 ppm, presented the following levels of dental fluorosis: TF 2-3 (50%), TF 4-5 (45.6%) and TF 6-7 (4.4%) for medium SES and TF 2-3 (12.3%), TF 4-5 (67.1%) and TF 67 (20.6%) for low SES. A significant association was found between self-perception and dental fluorosis in those with medium and low SESs (p < 0.05). The multiple regression model found differences between TF levels and self-perception, with a 6-7 TF level for concerns about color (OR = 1.6), smile (OR = 1.2) and appearance (OR = 3.36). Conclusions: Self-perceptions of dental fluorosis affect adolescents such that adolescents with a medium SES have more negative perceptions than those with a low SES. Such perceptions increase as the TF index increases.

Aspectos descriptivos del odontoma: revisión de la literatura / Descriptive aspects of odontoma: literature review

Resumen: Los odontomas corresponden a los tumores odontogénicos más comunes (35-76%). Es un tumor benigno originado a partir de una alteración de células odontogénicas epiteliales y mesenquimatosas diferenciadas con capacidad de formar esmalte, dentina y cemento. Se clasifican en compuestos y complejos en una relación de 2:1, siendo la diferencia entre ambos la organización del tejido dentario. La etiología es desconocida pero se ha explorado la ocasión a infecciones, anomalías hereditarias, hiperactividad odontoblástica y traumatismos. El 75% de los casos se diagnostican antes de la segunda década de vida debido a un retraso en la erupción dental permanente, ya que son asintomáticos. El tratamiento es la enucleación tratando de conservar el diente permanente, siendo las recidivas poco frecuentes.

Abstract: Odontoma is the most commonly found odontogenic tumor (3576%). Odontoma is a benign tumor originating from an alteration of differentiated mesenchymal and epithelial odontogenic cells; it has the capacity of forming enamel, dentin and cement. They are classifi ed into compound and complex, in a 2:1 relationship, the difference between both being dental tissue organization. Etiology is still unknown but relation to infections, hereditary anomalies, odontoblastic hyperactivity and trauma has been explored. Since these tumors are asymptomatic, 75% of all cases are diagnosed before the second decade of life, due to a delay in eruption of permanent teeth. Treatment of choice for these tumors is enucleation, attempting to preserve the tooth; relapse is very uncommon.

Synthesis, biocompatibility and mechanical properties of ZrO2-Al2O3 ceramics composites.

This study evaluated cell viability, microhardness and flexural strength of two ceramic composites systems (ZA and AZ), pure alumina and zirconia. There were prepared homogeneous mixtures of 78wt%Al2O3+20wt%3Y-TZP+2wt%Al2O3w (AZ) and 80wt%3YTZP+18wt%Al2O3+2wt%Al2O3w (ZA), as well as 3Y-TZP (Z), pure Al2O3 (A) and commercial monolithic 3Y-TZP (Zc). Also mouse fibroblast cells 3T3-L1 and a MTT test was carried out at 24, 48 and 72 h. The surfaces were observed with SEM and the microhardness and three-point flexural strength values were estimated. The absolute microhardness values were: A>AZ>Z>Zc>ZA. Flexural strength of Zc, Z, and ZA were around double than AZ and A. All groups showed high biocompatibility trough cell viability values at 24, 48 and 72 h. Factors like grain shape, grain size and homogeneous or heterogeneous grain distributions may play an important role in physical, mechanical and biological properties of the ceramic composites.

Fluoride Exposure Effects and Dental Fluorosis in Children in Mexico City.

BACKGROUND The objective of the present study was to determine the prevalence and severity of dental fluorosis and to evaluate exposure to fluoridated products in students in the southwest part of the Federal District (Mexico City). MATERIAL AND METHODS Students between 10 and 12 years of age who were born and raised in the study zone were evaluated. The level of dental fluorosis was determined using the modified Dean index (DI) using criteria recommended by the World Health Organization (WHO). A bivariate analysis was performed with the χ2 test, and odds ratios (OR) and 95% confidence intervals (CI) are presented. Logistic regression was performed to evaluate the association between dental fluorosis and the independent variables. RESULTS A total of 239 students were evaluated. Their mean age was 11±0.82 years, and there were 122 (51%) males. Overall, dental fluorosis was found in 59% of participants; 29.3% had very mild fluorosis, 20.9% had mild fluorosis, 6.7% had moderate fluorosis, and 2.1% had severe fluorosis. The mean fluorosis score was 0.887±0.956. In the final logistic regression model, dental fluorosis was significantly associated with frequency of brushing (OR: 0.444; 95% CI: 0.297-0.666) and with the absence of parental supervision (OR: 0.636; 95% CI: 0.525-0.771). CONCLUSIONS The association found with frequency of brushing and lack of parental supervision may be contributing to the prevalence and severity of dental fluorosis.

Microdureza profunda en una resina compuesta fotopolimerizada por diferentes fuentes de luz / Microhardness at depth of a dental composite resin fotocured troughthdiferents light sources

Introducción y Objetivo: Las lámparas fotopolimerizadoras son utilizadas actualmente en la práctica odontológica para estimular el endurecimiento de diferentes materiales de reconstruccióndental a base de resina compuesta, también llamada composite dental. El objetivo fue comparar la profundidad de polimerización provocada en una resina compuesta de uso dental, por dos sistemas convencionales de fotocurado y un láser Innova 300 adaptado experimentalmente a una longitud deonda de 488nm.

Introduction and Objective: The depth of polymerization caused in a dental composite resin through the fotoactivation with two conventional light sources and Innova 300 laser light adapted experimentally to 488nm length of wave were compared. Materials and Methods: 12 compositesamples were fotocured using 3 different sources of light in 2 different thickness dimensions,according to ISO 4049:2000 regulations. After 60 days of polymerization, micro hardness analyseswere carried out.

Tratamiento para manchas por fluorosis dental por medio de micro abrasión sin instrumentos rotatorios / Treatment for dental fluorosis spots by micro abrasion without rotary instruments

El diagnóstico juega un papel importante para elegir el tratamiento en los dientes con cambios de coloración provocados por caries o tinciones dentarias, dicho tratamiento debe ser apropiado para llenar las expectativas estéticas del paciente.

Diagnosis plays a major role when choosing a treatment for Fluor-stained teeth; such treatment must be appropriate to meet the patient’s expectations.