Salivary protein candidates for biomarkers of oral disorders in people with a crack cocaine use disorder.

The use of cocaine and its main derivative, crack, can cause some systemic effects that may lead to the development of some oral disorders. To assess the oral health of people with a crack cocaine use disorder and identify salivary protein candidates for biomarkers of oral disorders. A total of 40 volunteers hospitalized for rehabilitation for crack cocaine addiction were enrolled; nine were randomly selected for proteomic analysis. Intraoral examination, report of DMFT, gingival and plaque index, xerostomia, and non-stimulated saliva collection were performed. A list of proteins identified was generated from the UniProt database and manually revised. The mean age (n=40) was 32 (±8.88; 18-51) years; the mean DMFT index was 16±7.70; the mean plaque and gingival index were 2.07±0.65 and 2.12±0.64, respectively; and 20 (50%) volunteers reported xerostomia. We identified 305 salivary proteins (n=9), of which 23 were classified as candidate for biomarkers associated with 14 oral disorders. The highest number of candidates for biomarkers was associated with carcinoma of head and neck (n=7) and nasopharyngeal carcinoma (n=7), followed by periodontitis (n=6). People with a crack cocaine use disorder had an increased risk of dental caries and gingival inflammation; less than half had oral mucosal alterations, and half experienced xerostomia. As possible biomarkers for 14 oral disorders, 23 salivary proteins were identified. Oral cancer and periodontal disease were the most often associated disorders with biomarkers.

Salivary protein candidates for biomarkers of oral disorders in people with a crack cocaine use disorder

Abstract The use of cocaine and its main derivative, crack, can cause some systemic effects that may lead to the development of some oral disorders. Objective To assess the oral health of people with a crack cocaine use disorder and identify salivary protein candidates for biomarkers of oral disorders. Methodology A total of 40 volunteers hospitalized for rehabilitation for crack cocaine addiction were enrolled; nine were randomly selected for proteomic analysis. Intraoral examination, report of DMFT, gingival and plaque index, xerostomia, and non-stimulated saliva collection were performed. A list of proteins identified was generated from the UniProt database and manually revised. Results The mean age (n=40) was 32 (±8.88; 18-51) years; the mean DMFT index was 16±7.70; the mean plaque and gingival index were 2.07±0.65 and 2.12±0.64, respectively; and 20 (50%) volunteers reported xerostomia. We identified 305 salivary proteins (n=9), of which 23 were classified as candidate for biomarkers associated with 14 oral disorders. The highest number of candidates for biomarkers was associated with carcinoma of head and neck (n=7) and nasopharyngeal carcinoma (n=7), followed by periodontitis (n=6). Conclusions People with a crack cocaine use disorder had an increased risk of dental caries and gingival inflammation; less than half had oral mucosal alterations, and half experienced xerostomia. As possible biomarkers for 14 oral disorders, 23 salivary proteins were identified. Oral cancer and periodontal disease were the most often associated disorders with biomarkers.

Oral conditions and salivary analysis in HIV-uninfected subjects using preexposure prophylaxis

Background: New prevention strategies have been advocated to control the progression of HIV/AIDS, such as preexposure prophylaxis (PrEP). The aim of this study is to evaluate the potential changes in the oral and salivary conditions of HIV-uninfected subjects using PrEP. Material and Methods: Subjects were evaluated before beginning the medication (T0), at the first follow-up (T1), and at the second follow-up (T2). Xerostomia, presence of untreated cavitated caries, oral hygiene habits, taste, gingival and plaque index, stimulated salivary flow rate (SSFR), and salivary concentrations of calcium, glucose, urea, and total proteins were evaluated. Data obtained were analyzed using statistical tests (p<0.05). Results: Forty-seven participants (41 men; 6 women) were evaluated at T0. Thirty (28 men; 2 women) and 17 men were reassessed at T1 and T2, respectively. There was no difference between the SSFR and oral and salivary conditions between T0, T1, and T2 (p>0.05), except for the salivary calcium concentration, that increased at T2 compared to T1 (p=0.02). There was significant difference between taste and xerostomia at T1 (p=0.017), and the need to drink to swallow at T2 (p=0.015). There was significant correlation between the reported amount of saliva and taste (p=0.039, r=-0.378) at T1. Conclusions: The prolonged use of PrEP seems to be associated with reports of dry mouth and worsening of taste, possibly associated with increased salivary calcium concentration.(AU)

Periodontal Surgery for Correction of Gingival Smile: a Case Report Analysis of Periodontal Parameters After 2 Years / Cirurgia Periodontal para Correção de Sorriso Gengival: Relato de Caso e Análise dos Parâmetros Periodontais Após 2 Anos

Gingival smile is a term used to describe an aesthetic condition in which excessive gingival exposure at the jaw level occurs during smile. There are several factors related to its etiology, the most common is the altered passive eruption of anterior superior teeth. To correct this disharmony, a multidisciplinary approach is necessary, and the treatment plan depends on a correct diagnosis and assessment for a better prognosis. The present study aims to describe a clinical case where periodontal surgical techniques were used to correct this condition. Female patient, 25 years old, with aesthetic complaint of the amount of gum exposed when smiling and diagnosed with altered passive eruption. Clinical crown augmentation surgery was performed on the anterior superior teeth. After 1 and 2 years, periodontal clinical parameters (probing bleeding, probing depth, clinical attachment level, crown length, keratinized mucosa width and plaque index) were reassessed, through clinical examination, digital photographic monitoring and measurement tools. In two years, it was possible to note the stability of the results achieved, maintaining values similar to those of the immediate postoperative period. The case report confirmed the success of the clinical crown augmentation surgery and the periodontal parameters stability evaluated after 2 years. (AU)

Sorriso gengival é o termo utilizado para descrever uma condição estética em que ocorre uma exposição gengival excessiva ao nível da maxila, durante o sorriso. Há diversos fatores relacionados a sua etiologia, sendo a mais comum a erupção passiva alterada dos dentes ântero-superiores. Para correção dessa desarmonia é necessária uma abordagem multidisciplinar, sendo o plano de tratamento dependente de um correto diagnóstico e avaliação para um melhor prognóstico. O presente estudo tem objetivo de descrever um caso clínico onde técnicas cirúrgicas periodontais foram utilizadas para correção dessa condição. Paciente gênero feminino, 25 anos de idade, com queixa estética da quantidade de gengiva exposta ao sorrir e com diagnóstico de erupção passiva alterada. Foi submetida a cirurgia de aumento de coroa clínica nos dentes antero-superiores. Após 1 e 2 anos foram reavaliados os parâmetros clínicos periodontais (sangramento a sondagem, profundidade de sondagem, perda de inserção, comprimento da coroa, largura da mucosa queratinizada e índice de placa), através de exame clinico, acompanhamento digital fotográfico e ferramentas de medição de imagem. Em dois anos, foi possível constatar a estabilidade dos resultados alcançados, mantendo valores semelhantes aos do pós-operatório imediato. O relato de caso confirmou o sucesso da cirurgia de aumento de coroa clínica e a estabilidade dos parâmetros periodontais avaliados após 2 anos. (AU)

Inflammatory cytologic alterations in the oral epithelium associated with HIV pre-exposure prophylaxis: a preliminary study.

OBJECTIVE: The objective of this study was to assess inflammatory cytologic alterations in the oral epithelium of patients on human immunodeficiency virus pre-exposure prophylaxis (PrEP). MATERIAL AND METHODS: Epithelial cells from the buccal mucosa of 30 patients were collected by exfoliative cytology and were evaluated according to inflammatory cellular alterations: karyomegaly, bi- or multinucleation, karyopyknosis, karyorrhexis, perinuclear halo formation, metachromasia, cytoplasmic vacuolization, indistinct cytoplasmic border, keratinization, and atrophy. Epithelial cells were collected initially before PrEP onset (T1) and then after 30 days of PrEP use (T2). Two experienced cytopathologists independently analyzed the slides. RESULTS: The nonparametric Wilcoxon test showed that there was a statistically significant increase in the number of cells with karyomegaly at T2 compared to T1 (P = .033). The other cellular alterations did not present with statistically significant differences between the 2 moments of evaluation (P > .05). CONCLUSION: The increased number of oral epithelial cells with karyomegaly after 30 days of using PrEP suggests the presence of inflammatory alterations at this site.

Associação entre ganho de peso gestacional e prognóstico da gestação / Association between gestational weight gain and pregnancy outcome

Objetivos: Avaliar associação entre ganho de peso gestacional e prognóstico da gestação.Métodos: Um estudo transversal avaliou puérperas de uma maternidade do município de Aracaju, Sergipe, no período de março a junho de 2012. Os dados foram obtidos por meio de entrevistas, registros dos prontuários hospitalares e Cartão da Gestante. Foram pesquisadas variáveis relacionadas à gestação, condições do recém-nascido, retenção de peso no pós-parto e amamentação. Com base na classificação do ganho ponderal gestacional segundo as recomendações do Institute of Medicine, formaram-se três grupos: 1) grupo com ganho ponderal insuficiente; 2) grupo com ganho ponderal adequado; e 3) grupo com ganho excessivo. Na análise estatística foram utilizados os testes Qui-Quadrado e Análise de Variância, adotando nível de significância estatística inferior a 5%.Resultados: Foram incluídas no estudo 158 puérperas. Verificou-se alto percentual de mulheres que iniciaram a gestação com sobrepeso/ obesidade (30,4%). Durante a gestação, não ocorreu ganho ponderal excessivo entre puérperas com baixo peso pré-gestacional, o que aconteceu em 25,2% das eutróficas, em 57,6% das com sobrepeso e em 53,3% das obesas. O ganho ponderal excessivo durante a gestação foi associado com maior peso e comprimento do recém-nascido, maior prevalência de macrossomia fetal, maior índice de massa corporal materno e maior retenção de peso pela puérpera no terceiro mês pós-parto. Dificuldade em amamentar no terceiro mês pós-parto ocorreu em 4,5% das mães com ganho ponderal adequado durante a gestação e em 33,3% daquelas com ganho de peso excessivo (p=0,025). A ocorrência de parto cesáreo foi de 20% nas gestantes com ganho ponderal insuficiente, 40% nas que ganharam peso adequadamente e 47% naquelas com ganho ponderal excessivo (p=0,012).Conclusões: Observaram-se valores maiores de ganho de peso excessivo entre mulheres que iniciaram a gestação com excesso de peso. O ganho de peso excessivo durante a gestação foi associado com maior peso médio e prevalência de macrossomia no recém-nascido, ocorrência de parto cesáreo, retenção de peso materno no pós-parto e dificuldade em amamentar.

Aims: To evaluate the association between gestational weight gain and pregnancy outcome.Methods: A cross-sectional study evaluated postpartum women from a maternity ward in a hospital located in Aracaju, Sergipe, Brazil, from March to June 2012. Data were obtained through interviews, medical records and records of prenatal care. Pregnancy-related variables, conditions of the newborn, weight retention in the postpartum period and breastfeeding were investigated. Based on the classification of gestational weight gain as recommended by the Institute of Medicine, three groups were formed: 1) group with insufficient weight gain; 2) group with adequate weight gain; and 3) group with excessive gain. Statistical analysis used chi-square and analysis of variance, with a level of statistical significance less than 5%.Results: At all 158 women were included in the study. There was a high percentage of women entering pregnancy with overweight/obesity (30.4%), however, those with low pre-pregnancy weight did not gain excessive weight during their gestational period. Excessive gain was associated with greater weight and length of the newborn, higher prevalence of fetal macrosomy, increased maternal body mass index and higher postpartum weight retention in the third month after birth. Difficulty with breastfeeding in the third month postpartum occurred in 4.5% of mothers with adequate weight gain during pregnancy but it occurred in 33.3% of women with excessive weight gain (p=0.025). A cesarean section was done in 20% of the women with insufficient gestational weight gain, in 40% of those who gained weight adequately and in 47% of those with excessive weight gain (p=0.012).Conclusions: Excessive gestational weight gain was associated with higher average weight and prevalence of macrosomy in neonates, cesarean section, maternal weight retention in the postpartum and breastfeeding difficulty.