MMP-13 Polymorphism as a Risk Factor in Implant Loss.

PURPOSE: To investigate whether MMP-13 g.-77 A > G (rs2252070) gene polymorphism is associated with early implants loss. MATERIALS AND METHODS: Two hundred nonsmoking volunteers in good oral health, > 18 years of age, and found to be periodontally healthy by clinical examination were matched by age, sex, and implant position and separated into two groups: control group (100 patients with one or more healthy implants for a minimum of 1 year) and test group (100 patients who had suffered early implant loss, considered when implants presented mobility and/or pain before or during abutment connection, requiring their removal). Genomic DNA from saliva was genotyped by PCR-RFLP. Statistical analysis of the results was done using Mann-Whitney U and chi-square tests, with a significance level of 5%. RESULTS: A significant difference in the presence of the different alleles and genotype was found between groups for the MMP-13 g.-77 A > G (rs2252070) gene polymorphism (P = .0161, OR 95% = 0.57 [0.37 to 0.89]; P = .007, OR 95% = 0.44 [0.25 to 0.78]). The A allele increased susceptibility to early implant loss and appeared to be a genetic risk factor. CONCLUSION: The findings suggest that MMP-13 g.-77 A > G (rs2252070) polymorphism may contribute to early implants loss.

Matrix metalloproteinases gene polymorphism haplotype is a risk factor to implant loss: A case-control study.

BACKGROUND: Dental implants consist in the treatment of choice to replace tooth loss. The knowledge that implant loss tends to cluster in subsets of individuals may indicate that host response is influenced by genetic factors. Matrix metalloproteinases (MMPs) are enzymes that contribute to degradation and removal of collagen from extracellular matrix. PURPOSE: This case-control study aimed to investigate the haplotypic combination of MMP polymorphism (rs1144393, rs1799750, rs3025058, and rs11225395) and implant loss. MATERIALS AND METHODS: Two hundred nonsmokers subjects were matched by gender, age, implant number and position and divided in control group, 100 patients with one or more healthy implants, and test group, and 100 patients with one or more implant failures. Genomic DNA was extracted from saliva and genotypes were obtained by PCR-RFLP. RESULTS: A significant association of rs1799750 (MMP-1) and rs11225395 (MMP-8) polymorphism on early implant loss was demonstrated (P ≤ 0.001). Global haplotype analysis indicated a significant difference between both groups (P < 0.0001). Haplotype T-A-GG-5A-C had a statistically significant risk effect, while haplotype C-A-G-6A-C andT-G-2G-5A-C had a protective effect in implant loss. CONCLUSIONS: The results of this study showed that MMPs haplotype are a risk factor to early implant loss.

Analysis of MMP-3 polymorphism in osseointegrated implant failure

Polymorphisms in matrix metalloproteinases (MMPs) genes have been associated with several pathologies, including dental implant loss. MMP-3 is crucial to the connective tissue remodeling process. The objective of this study was to investigate the possible relationship between -1612 MMP-3 polymorphism and the early implant failure. A sample of 240 non-smokers was divided: test group 120 patients with one or more early failed implants and control group 120 patients with one or more healthy implants. Genomic DNA from oral mucosa was analyzed by PCR-RFLP. No association of early implant loss with genotypes and alleles of the -1612 polymorphism in MMP-3 were found by the Chi-squared test. Only the presence of the -1612 polymorphism of MMP-3 is not a genetic risk factor for early loss of implants (AU)

Posterior tibial tendinopathy associated with matrix metalloproteinase 13 promoter genotype and haplotype.

BACKGROUND: Posterior tibial tendon (PTT) is particularly vulnerable and its insufficiency is recognized as the main cause of adult acquired flat foot. Some patients have a predisposition without a clinically recognized cause, suggesting that individual characteristics play an important role in tendinopathy. The present study investigated whether genetic variants in matrix metalloproteinases (MMPs) are associated with PTT dysfunction. METHODS: One hundred women who presented PTT dysfunction, with histopathological examination of the tendon and magnetic resonance imaging (MRI) confirming tendinopathy, as well as 100 asymptomatic women who presented intact PPT as assessed by MRI and constituting the control group, were evaluated for MMP-13 g.-77 A > G (rs2252070) polymorphism, individually and in haplotypes, as well as in combination with MMP-1 g.-519 A > G (rs1144393), MMP-1 g.-1607 G > GG (rs1799750) and MMP-8 g.-799 C > T (rs11225395) polymorphisms with PTT dysfunction. Genomic DNA was extracted from the saliva and genotypes were obtained by polymerase chain reaction-restriction fragment length polymorphism. Statistical analysis of the results included a Mann-Whitney U-test, Fisher's exact test, multiple logistic regression, chi-squared and SNPstats software (http://bioinfo. iconcologia.net/snpstats/start.htm). p < 0.05 was considered statistically significant. RESULTS: The A allele frequency (MMP-13 g.-77 A > G (rs2252070) polymorphism) was significantly higher in the case group (76% and 61%, respectively; p = 0.010, odds ratio = 2.02; 95% confidence interval = 1.32-3.12). The genotype distribution was also significantly different between groups (p = 0.001, odds ratio = 2.82; 95% confidence interval = 1.58-5.02). Global haplotype analysis indicated a significant difference between both groups. CONCLUSIONS: In conclusion, these findings indicate that MMP-13 g.-77 A > G (rs2252070) polymorphism individually, as well as its haplotypes MMP-1 g.-519 A > G (rs1144393), MMP-1 g.-1607 G > GG (rs1799750) and MMP-8 g.-799 C > T (rs11225395), may contribute to PTT dysfunction.

Profilaxia da endocardite bacteriana na clínica odontológica - o que mudou nos últimos anos? / Bacterial endocarditis prophylaxis in Dentistry. What is new?

Procedimentos odontológicos que causam bacteremia transitória, ou seja, a invasão de bactérias da microbiota bucal para a circulação sangüínea, ainda são comumente associados à etiopatogenia da endocardite bacteriana. No entanto, estudos recentes mostram que esta associação talvez seja equivocada. Da mesma forma, ainda pairam dúvidas quanto à eficácia dos antibióticos na prevenção desta doença e aos mecanismos pelos quais exerceriam a ação profilática; também é questionado se o risco de efeitos adversos por parte destes fármacos não seria maior que o benefício previsto. Com base numa revisão da literatura, são apresentados argumentos para tentar responder estas e outras perguntas a respeito da profilaxia da endocardite bacteriana na clínica odontológica.

A double-blind comparison of 0.5% bupivacaine with 1:200,000 epinephrine and 0.5% levobupivacaine with 1:200,000 epinephrine for the inferior alveolar nerve block.

This double-blind cross-over study compared the anesthetic success and onset and duration of lip and pulpal anesthesia of 0.5% bupivacaine and levobupivacaine solutions, both with 1:200,000 epinephrine, when administered for inferior alveolar nerve anesthesia. Thirty healthy volunteers were randomly anesthetized using one of the solutions. The inferior canine, second premolar, and molar were tested with electric stimulation. The pulpal anesthetic success rates for bupivacaine and levobupivacaine were 80% and 76.66%, respectively, for molars, 76.66% (both solutions) for premolars, and 70% (both solutions) for canines. At least 250 minutes of pulpal anesthesia was achieved. There were no significant differences between the solutions considering the measured parameters (P > .05). Because of the similar anesthetic behavior of the 2 solutions in this study and the low toxicity related in the literature for levobupivacaine, there is justification for replacing bupivacaine with levobupivacaine for inferior alveolar nerve local anesthesia.

Analgesic choice in dentistry. Part II: the toxicity

Nonopioid analgesics are widely prescribed in dentistry. The first article of this series reviewed the mechanism of action of acetylsalicylic acid (aspirin), acetaminophen (paracetamol) and dipyrone; this part discusses the risks related to the use of these drugs. Paracetamol and dipyrone in therapeutic doses, unlike aspirin, do not cause nausea, do not interfere with protrombin time, do not inhibit the platelet aggregation, and do not produce as many side effects as does aspirin. The adverse reactions in relation to paracetamol seem to be restricted to situations where acute overdosage occurs. In relation to dipyrone, blood dyscrasias such as the agranulocytosis are the main adverse reactions.

Analgesic choice in dentistry. Part I: the mechanism of action / Escolha analgésica na odontologia. Parte I: o mecanismo de ação

Analgesics are frequently used in dentistry for the management of dental pain. Dental clinicians should choose the medicine based on its mechanism of action and toxicity, to promote a successful analgesic effect as well as comfort to the patient. The purpose of this firstarticle is to describe the pharmacological mechanisms of action of the three analgesics considered for the management of mild to moderate acute dental pain

Verificação da variação da pressão arterial pelo uso de anestésicos locais com vasoconstritor / Verification of arterial blood pressure wich local anesthetics associated or not to vasoconstrictors

Os autores realizaram estudos com 100 pacientes divididos em 4 grupos, os quais foram anestesiados com lidocaína, variando apenas no uso ou não de vasoconstritor e no tipo de vasoconstritor associado (adrenalina ou noradrenalina 1:50.000). Os pacientes foram submetidos a exodontia, com aferição da pressão arterial antes do início do procedimento anestésico e após exodontia. Nos pacientes que receberam anestésico com vasoconstritor, normotensos ou hipertensos, não houve aumento significativo da pressão arterial; no grupo onde o sal anestésico não continha vasoconstritor, houve aumento estatisticamente significativo da pressão arterial