Effect of two irrigating solutions on antimicrobial activity and clinical and radiographic success after endodontic treatment in primary teeth: a randomized clinical trial.

OBJECTIVES: This study evaluated the antimicrobial activity, clinical and radiographic outcome of pulpectomy in primary teeth using either 1% sodium hypochlorite (NaOCl) or 2% chlorhexidine (CHX) as irrigants. MATERIALS AND METHODS: A randomized double-blind controlled clinical study in which primary teeth were allocated to 1% NaOCl (n = 20) and 2% CHX (n = 20) groups. Microbiological collections were performed before and after irrigation for agar culture and real-time polymerase chain reaction (qPCR). Clinical and radiographic success was assessed at different times. Data were submitted to descriptive analysis, chi-square, Mann-Whitney, and Wilcoxon tests (p  < .05). RESULTS: For 1% NaOCl, the following clinical and radiographic success rates were observed: 7 days (93%/80%); 30 days, 3 and 6 months (100%). For 2% CHX: 7 days (73%/53%); 30 days (93%); 3 months (100%/93%); 6 months (100%) (p > .05). One percent NaOCl and 2% CHX effectively reduced total microorganisms (p < .05) but not mutans streptococci (p > .05). In qPCR analysis, the solutions promoted a reduction of total bacteria and Streptococcus mutans, and no difference was observed between times and groups (p > .05). CONCLUSIONS: One percent NaOCl and 2% CHX were effective for clinical and radiographic success and antimicrobial activity in primary teeth submitted to pulpectomy. CLINICAL RELEVANCE: Studying the antimicrobial activity and clinical and radiographic outcomes of pulpectomy in primary teeth using NaOCl and CHX as irrigants is clinically relevant because it provides information for optimizing treatment protocols and improving the quality of care for pediatric patients. It contributes to evidence-based practice and can potentially lead to better outcomes, reduced complications, and enhanced patient experiences.

Relationship between cariogenic bacteria and molar incisor hypomineralization in Brazilian schoolchildren.

Background: Teeth with defects in their structure, such as the ones affected by molar-incisor hypomineralization (MIH), are more susceptible to carious lesions. Caries is a complex and multifactorial disease highly prevalent in childhood. The present research evaluated the relationship between the stages of MIH and cariogenic bacteria in children. Methods: After examining 566 schoolchildren, four groups of 10 children each were formed: healthy (G1), mild MIH (G2 and G3), and severe MIH + caries (G4). Dental biofilm was assessed to quantify Streptococcus mutans (SM) and Lactobacillus spp. (LB) using real-time polymerase chain reaction (RT-PCR). Results: LB counting in biofilm samples of healthy children (G1) and those with mild MIH characterized by white opacities (G2) were not significantly different. The same happened when the ones with yellow opacities (G3) were compared with severe MIH + caries (G4) (P>0.05). The post hoc Tukey test proved that G4 had greater levels of SM and LB when compared with G2 (P<0.05); however, the control group did not diverge from the others considering SM (P>0.05). Increased LB enhanced the severity of MIH [rate ratio (RR): 7.706; P=0.035]. Conclusions: LB was influenced by different degrees of MIH and the presence of caries and could guide clinical decisions and patients' recommendations to prevent carious lesions in MIH children.

Understanding the Predictive Potential of the Oral Microbiome in the Development and Progression of Early Childhood Caries.

BACKGROUND: Early childhood caries (ECC) is the most common chronic disease in young children and a public health problem worldwide. It is characterized by the presence of atypical and fast progressive caries lesions. The aggressive form of ECC, severe early childhood caries (S-ECC), can lead to the destruction of the whole crown of most of the deciduous teeth and cause pain and sepsis, affecting the child's quality of life. Although the multifactorial etiology of ECC is known, including social, environmental, behavioral, and genetic determinants, there is a consensus that this disease is driven by an imbalance between the oral microbiome and host, or dysbiosis, mediated by high sugar consumption and poor oral hygiene. Knowledge of the microbiome in healthy and caries status is crucial for risk monitoring, prevention, and development of therapies to revert dysbiosis and restore oral health. Molecular biology tools, including next-generation sequencing methods and proteomic approaches, have led to the discovery of new species and microbial biomarkers that could reveal potential risk profiles for the development of ECC and new targets for anti-caries therapies. This narrative review summarized some general aspects of ECC, such as definition, epidemiology, and etiology, the influence of oral microbiota in the development and progression of ECC based on the current evidence from genomics, transcriptomic, proteomic, and metabolomic studies and the effect of antimicrobial intervention on oral microbiota associated with ECC. CONCLUSION: The evaluation of genetic and proteomic markers represents a promising approach to predict the risk of ECC before its clinical manifestation and plan efficient therapeutic interventions for ECC in its initial stages, avoiding irreversible dental cavitation.

Host-microbiome interactions regarding peri-implantitis and dental implant loss.

In the last decades, the ortho-aesthetic-functional rehabilitation had significant advances with the advent of implantology. Despite the success in implantology surgeries, there is a percentage of failures mainly due to in loco infections, through bacterial proliferation, presence of fungi and biofilm formation, originating peri-implantitis. In this sense, several studies have been conducted since then, seeking answers to numerous questions that remain unknown. Thus, the present work aims to discuss the interaction between host-oral microbiome and the development of peri-implantitis. Peri-implantitis was associated with a diversity of bacterial species, being Porphiromonas gingivalis, Treponema denticola and Tannerella forsythia described in higher proportion of peri-implantitis samples. In a parallel role, the injury of peri-implant tissue causes an inflammatory response mediated by activation of innate immune cells such as macrophages, dendritic cells, mast cells, and neutrophils. In summary, the host immune system activation may lead to imbalance of oral microbiota, and, in turn, the oral microbiota dysbiosis is reported leading to cytokines, chemokines, prostaglandins, and proteolytic enzymes production. These biological processes may be responsible for implant loss.

Early childhood caries, obesity and anthropometric measurements: Is there a relationship?

This brief research report explored the relationship among obesity, anthropometric measurements, and early childhood caries (ECC), in 3-5 years-old children. Three hundred and ninety-one Brazilian preschoolers were given anthropometric examinations for the assessment of general, peripheral, and central adiposity, by the following measures: body mass index (BMI), hip circumference, and waist circumference. Obesity status was determined by BMI according to WHO standards. Parent's age and BMI were assessed by questionnaire, and sucrose exposure was tracked by means of a food diary. For the assessment of ECC, dental examinations were performed according to modified WHO criteria. Also, the presence of dental biofilm in maxillary incisors was detected. A direct association between BMI and ECC was found in the bivariate analysis and the best possibility of logistic regression model showed that hip circumference (HC) values ≥62 centimeters (OR = 1.63; p = 0.033) jointly with the presence of dental biofilm (OR = 2.38; p = 0.000), children's ages ≥37 months (OR = 5.09; p = 0.012), and mothers younger than 35 years (OR = 1.96; p = 0.004) were significantly connected with ECC. In conclusion, peripheral adiposity (represented by HC) in young children was in fact associated with ECC. Thus, hip circumference might be a valuable tool for exploring the relationship between caries and obesity in the early years of life.

Possible Relationship Between the Oral and Gut Microbiome, Caries Development, and Obesity in Children During the COVID-19 Pandemic.

The COVID-19 pandemic has brought health damage and socioeconomic disruptions, together with lifestyle disorders around the world. Children are one of the most commonly affected, mainly due to social isolation and changes in eating habits and physical activities. This way, the risk of weight gain and obesity is possibly enhanced, as well as poor oral hygiene conditions and early childhood caries (ECC) development during the lockdown. In children under 6 years of age, ECC is defined as carious lesions in one or more primary teeth, with or without cavitation. Importantly, alterations in the oral microbiome caused by changes in children lifestyles have much more than a local impact on oral tissues, interplaying with the gut microbiome and influencing systemic environments. Recent studies have been exploring the oral health conditions, eating habits, and weight gain in the childhood population during the COVID-19 pandemic; however, there is a lack of information concerning the association among oral and gut microbiome, dental caries, and obesity in the COVID-19 era. In this context, this review aimed at analyzing a possible relationship between the oral and gut microbiome, caries, and obesity in children during the COVID-19 pandemic.

Exploring the Relationship between Salivary Levels of TNF-α, Lactobacillus acidophilus, Lactobacillus gasseri, Obesity, and Caries in Early Childhood.

This research aimed to explore the relationship between tumor necrosis factor-α (TNF-α), Lactobacillus acidophilus (L. acidophilus), Lactobacillus gasseri (L. gasseri), obesity, and early childhood caries. After caries and obesity diagnosis based on the WHO criteria, 94 preschoolers were assessed. Unstimulated saliva was collected for analysis of TNF-α by the Milliplex system and for L. acidophilus and L. gasseri using real-time polymerase chain reaction (RT-PCR). In obese children, each unit increase in the body mass index (BMI), and the TNF-α levels was associated with a one-time increase in the number of decayed surfaces (p < 0.05). Meanwhile, in eutrophic preschoolers, the presence of L. gasseri and L. acidophilus was linked, respectively, to an increase of 3.04 and 1.59 times in the number of decayed surfaces (p < 0.05); in obese children, the presence of L. acidophilus was not significant (p > 0.05) and L. gasseri was shown as a possible protective indicator (RR:0.49−p < 0.05). In conclusion, TNF-α and BMI were connected to carious lesions only in obese preschoolers, suggesting that inflammation could be underscored when both pathologies are concomitant. The presence of both species of lactobacilli investigated was connected with early childhood caries in eutrophic children, whereas in obese children only L. gasseri was significant, and in an opposite way, reinforcing that obesity can modulate oral bacteria.

Firmicutes Dysbiosis After Chlorhexidine Prophylaxis in Healthy Patients Submitted to Impacted Lower Third Molar Extraction.

Prophylaxis with antiseptic and antibiotic therapy is common in impacted lower third molar surgeries, despite the lack of consensus among professionals and researchers in the indication for healthy patients. The aim of the present preliminary study was to verify the impact of prophylaxis therapy with antiseptic and antibiotic in healthy patients submitted to impacted lower third molar extraction, according to oral microorganism quantification. Eleven patients submitted to impacted lower third molar extraction, under prophylactic therapy with 0.12% chlorhexidine and amoxicillin in four experimental phases, were evaluated. Our results showed no significant reduction in total bacteria load, as well as in Bacteroidetes and C. albicans loads in the oral cavity, after prophylactic therapy with antiseptic and antibiotic. On the other hand, there was a significant difference between the Firmicutes levels across the follow-up, and this effect seems to be large (ηp²=0.94). Post-hoc test demonstrated that the levels of Firmicutes in T1 were higher than T0, T2, and T3, suggesting a microbiota dysbiosis, when 0.12% chlorhexidine use, which may be responsible for selection of antibiotic-resistant microorganisms. Our results alert for an overuse of antiseptic and antibiotics by dentists and for a better evaluation of the available protocols.

Firmicutes Levels in the Mouth Reflect the Gut Condition With Respect to Obesity and Early Childhood Caries.

The present cross-sectional study investigated whether Firmicutes (F) and Bacteroidetes (B) levels in the mouth reflected the gut condition in obesity and early childhood caries (ECC). Eighty preschoolers (3-5 years) were equally assigned into four groups: 1. obese + ECC, 2. obese + caries-free (CF), 3. eutrophic + ECC, and 4. eutrophic + CF. Nutritional status and ECC were assessed based on the WHO criteria. Dental biofilm and fecal samples were collected for F and B quantification using RT-PCR analysis. Data were evaluated using three-way-ANOVA and Pearson's correlation (α = 0.05). Regardless of the anatomical location effect (p = 0.22), there were higher values for F in the obese children + ECC compared with those in obese + caries-free (CF) in both mouth and gut (p < 0.05). The correlation for F at these sites was negative in obese children + ECC (r = -0.48; p = 0.03) and positive in obese children + CF (r=0.50; p = 0.03). Bacteroidetes were influenced by ECC (p = 0.03) and the anatomical location (p = 0.00), and the levels tended to be higher in the mouth of the obese children + ECC (p = 0.04). The F/B ratio was higher in the gut and was affected by the anatomical location (p = 0.00). This preliminary study suggested that modulated by ECC, counts of oral Firmicutes reflected corresponding condition in the gut of obese preschoolers. In addition, we first evidenced that the Firmicutes phylum behave differently according to the nutritional status and caries experience and that supragingival biofilm and gut could share levels of similarity.

A higiene bucal de bebês edêntulos e sua influência na microbiota bucal: os profissionais de saúde devem preconizá-la? ­ revisão crítica / Oral hygiene in edentulous infants and its influence on oral microbiota: should the health professionals recommend it? ­ a critical review

Introdução: A indicação de higiene bucal em bebês edêntulos entre os profissionais de saúde ainda é controversa, sendo necessária a busca científica sobre esta indicação e a padronização da informação. Objetivo: Investigar criticamente as evidências relacionadas a indicação da higiene bucal para bebês edêntulos. Métodos: A busca de artigos foi realizada nas bases de dados PubMed, LILACS e Google Scholar, de modo a avaliar a seguinte pergunta: "A higienização da cavidade bucal de bebês edêntulos pode influenciar a microbiota bucal?". Uma busca em 8 livros de Odontopediatria também foi realizada. Resultados: Foram encontrados 317 artigos (167-PubMed, 146-Google Scholar e 4-LILACS). Não foram encontrados estudos primários que avaliaram o efeito da higiene bucal em bebês edêntulos na microbiota, impossibilitando a condução de revisão sistemática. Assim, para a revisão foram incluídos 6 estudos que investigaram micro-organismos na cavidade bucal de bebês edêntulos e o papel das imunoglobulinas salivares. Dentre os livros avaliados, somente 4 indicaram a higiene bucal em bebês edêntulos. Conclusão: Diante dos dados analisados, não existem estudos primários que avaliaram o efeito da higienização na microbiota bucal de bebês edêntulos. Torna-se relevante a condução de estudos clínicos para obtenção de evidências científicas sobre a indicação ou não da higienização da cavidade bucal de bebês edêntulos.

Introduction: The indication of oral hygiene in edentulous babies is still controversial among health professionals, being necessary the search of this recommendation and the standardization of information. Objective: To inves-tigate critically the evidence related to the indication of oral hygiene for edentulous babies. Methods: The search for articles was performed in the PubMed, LILACS and Google Scholar databases, in order to assess the following question: "Can oral cavity hygiene of edentulous babies influence oral microbiota?" A search in 8 books of Pediatric Dentistry was also performed. Results: 317 articles were found (167-PubMed, 146-Google Scholar and 4-LILACS). There were no primary studies that evalu-ated the effect of oral hygiene of edentulous infants on microbiota, which impair the conduction of a systematic review. Thus, it was included for this review six studies that investigated microorganisms in the oral cavity of edentulous infants and the role of salivary immunoglo- bulins. Among the textbooks evaluated, only 4 indicated the oral hygiene in edentulous infants. Conclusion:According to the data, there are no primary studies that assessed the effect of oral hygiene in the oral microbiota of edentulous babies. It is relevant to conduct clinical studies in order to obtain scientific evidence about the indication or no of the oral hygiene in edentulous babies

Prevalência de obesidade infantil: há motivo de preocupação? / Prevalence of childhood obesity: is there a cause for concern?

O objetivo deste estudo foi determinar a prevalência de sobrepeso/obesidade em pré-escolares e investigar a relação entre o índice de massa corporal (IMC) das crianças e o de seus pais. Para tanto, conduziu-se uma pesquisa transversal com 968 crianças, de 3-5 anos, regularmente matriculadas em pré-escolas públicas. O estado nutricional infantil foi definido pelo IMC após aferição do peso e estatura no próprio ambiente escolar, considerando-se o sexo e a idade em meses. De acordo com os critérios da Organização Mundial da Saúde (OMS), as crianças foram classificadas em eutróficas, baixo peso, risco de sobrepeso, sobrepeso ou obesas. O IMC dos pais foi calculado com os dados de peso e estatura obtidos por meio de questionário. Observou-se que 1% de crianças tinham baixo peso, 62% eram eutróficas, 17% apresentavam risco de sobrepeso, 12% sobrepeso e 8% obesidade. O IMC infantil mostrou-se positivamente correlacionado com o IMC materno e paterno (p < 0,05). Concluiu-se que a prevalência de obesidade e sobrepeso infantil na população estudada é alarmante e que o IMC da criança foi correlacionado ao dos pais. Tais achados devem ser motivo de preocupação das autoridades, reforçando a necessidade de estratégias de atenção à saúde abrangendo todo o núcleo familiar.

This study aimed to determine the prevalence of overweight/obesity in preschoolers and to investigate the relationship between the body mass index (BMI) of the children and of their parents. Therefore, a cross-sectional study was conducted with 968 children aging 3-5 years old from public preschools. The children's nutritional status was defined by the BMI, after measuring their weight and height at the preschool, considering sex and age in months. According to the World Health Organization (WHO) criteria, the children were classified as eutrophic, thin, at risk of being overweight, overweight or obese. The parents' BMI was calculated using weight and height data obtained through a questionnaire. One percent of children were thin, 62% eutrophic, 17% at risk of overweight, 12% were overweight and 8% obese. Children's BMI was positively correlated with maternal and paternal BMI (p <0.05). It was concluded that the prevalence of obesity and overweight in the population studied is alarming, and the child's BMI was correlated to their parents' BMI. Such findings should be of concern for the authorities, reinforcing the need for health care strategies covering the entire family.

Relationship Between Mutans Streptococci and Lactobacilli in the Oral Cavity and Intestine of Obese and Eutrophic Children With Early Childhood Caries-Preliminary Findings of a Cross-Sectional Study.

This brief communication assessed whether there was any relationship between the counts of lactobacilli (LB) and mutans streptococci (MS) in the oral cavity and intestine of obese and eutrophic children with early childhood caries (ECC). Seventy-eight preschoolers were assigned into the following groups: 1. obese children with ECC (OECC), 2. eutrophic children with ECC (EECC), 3. obese caries-free children (OCF), and 4. eutrophic caries-free children (ECF). The diagnosis of obesity and ECC was based on the World Health Organization criteria. Dental plaque and fecal samples were collected to assess the counts of MS and LB using selective media. Data were evaluated by Poisson regression analysis, Wilcoxon test, and Sign test. Microbial indicators of ECC in obese children were MS counts in the intestine [rate ratio (RR): 4.38] and presence of LB in the oral cavity (RR: 2.12). The indicators in eutrophic children were MS levels and the presence of LB, both in the oral cavity (RR: 6.35/1.50) and intestine (RR: 2.35/2.38) (p < 0.05). The comparison between MS levels in the mouth and in the intestine revealed significant differences only in the ECF group (p = 0.04). Regarding LB presence in the mouth vs. in the intestine, except for the OCF group (p = 0.03), no other statistical differences were found. Our preliminary findings highlighted that the levels of MS and the presence of LB in the oral cavity, as well as in the lower gastrointestinal tract were associated with ECC. Moreover, obesity was found to influence this relationship.

A high salivary calcium concentration is a protective factor for caries development during orthodontic treatment.

BACKGROUND: This research aimed to evaluate the salivary concentrations of fluoride (F-), calcium (Ca2+), and phosphate (Pi) after brackets bonding, and to identify the role of [F-], [Ca2+], and [Pi] on the development of active caries lesion (ACL) in individuals under fixed orthodontic treatment. MATERIAL AND METHODS: A longitudinal investigation with twenty-two individuals from 11 to 22 years of age was performed in four phases (baseline and after 1, 3, and 6 months). Analyses were carried out considering the salivary concentration of [F-], [Ca2+], and [Pi], as well as the caries index. Data were analyzed using the Friedman test, followed by the Wilcoxon test and the multivariate Cox model (p≤0.05). RESULTS: 1 and 3 months after appliance bonding, the [Ca2+] was statistically lower than after 6 months (p<0.0083). On the other hand, salivary [F-] and [Pi] did not show any significant difference during the follow-up. The Cox model demonstrated that the increase of 1 µg/mL in Ca2+ decreased the risk of ACL development by 27%. In conclusion, the levels of Ca2+ changed during orthodontic treatment. CONCLUSIONS: A high Ca2+ level in the saliva is a protective factor for ACL development over time. Key words:Adolescents, bioinorganic chemistry, dental caries, orthodontic appliances.

Plaque Fluoride Levels as a Predictor of Caries Development in Early Childhood with High Sugar Exposure - A Preliminary Study.

OBJECTIVE: This longitudinal study aimed to investigate if the plaque fluoride (PF) concentration can predict the early childhood caries onset. Design: As part of a larger study, 188 preschoolers were clinically evaluated for early childhood caries diagnosis, at baseline and after 1-year follow-up. After that, the final sample comprised: 1. children who had already caries at baseline (decayed, missing or filled surfaces, as well as white chalky white spot lesions adjacent to gingival margins) and developed at least one more cavitation after one year (n=16), and 2. children who never had or developed any caries lesions, including active white spots lesions (n=15). Before the clinical examinations, dental plaque was collected. PF concentration was determined with an ion-specific electrode. A chart was used to estimate the mean daily sugar exposure. The results were statistically analyzed by Spearman correlation and logistic regression analyses (α=0.05). RESULTS: After one year, a positive significant correlation between caries development and liquid sucrose, total sugar and total sucrose consumption increments was found (p<0.05). Moreover, the solid sugar, solid sucrose and total sugar exposure at baseline were positively correlated with the presence of dental plaque at follow-up (p<0.05). To top it all, children with PF concentrations ≤0.1 µg/mg at baseline were 10 times more likely to develop caries. CONCLUSION: In conclusion, this study demonstrated for the first time in vivo that low PF concentration is a predictor of caries development in primary teeth.

Childhood Obesity and Firmicutes/Bacteroidetes Ratio in the Gut Microbiota: A Systematic Review.

BACKGROUND: The aim of the present study was to undertake a systematic review exploring the relationship between childhood obesity and fecal microorganisms, to answer the following question: "Are Firmicutes and Bacteroidetes a significant risk indicator/factor for obesity in children?" The main search terms were "child" and "obesity" together with "gut microbiota" (PubMed: 2005-2017). The minimal requirements for inclusion were the evaluation of gut microbiota composition and BMI in children between 0 and 13 years of age. METHODS: Assessed articles were carefully classified according to a predetermined criterion, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were considered. Seven articles were critically appraised and used as a basis for conclusions. RESULTS: Three studies showed a positive association between Bacteroides fragilis and obesity. In addition, a high value of evidence indicated that a decrease in the Bacteroidetes phylum and in Bacteroides/Prevotella groups was related to high BMI. For the Firmicutes phylum, one high-quality study highlighted that it was positively correlated with weight gain. With regard to Firmicutes species, Clostridium leptum, Eubacterium hallii, and Lactobacillus spp. indicated adipose tissue storage, while Clostridium difficile and the Staphylococcus genus were correlated with low BMI. Despite the fact that only one study did not perform real-time polymerase chain reaction to quantify the microorganisms, its results corroborated those of the studies that did. CONCLUSIONS: Changes in Firmicutes and Bacteroidetes phyla/species levels might in fact be significant indicators/factors for childhood obesity. However, given the small number of articles appraising these entire phyla and the heterogeneity among the species assessed, further well-designed studies are required to improve the knowledge.

Contribution of Streptococcus Mutans Virulence Factors and Saliva Agglutinating Capacity to Caries Susceptibility in Children: A Preliminary Study.

BACKGROUND: Many factors contribute to caries development in humans, such as diet, host factors - including different saliva components - and the presence of acidogenic bacteria in the dental biofilm, particularly Streptococcus mutans (S. mutans). Despite the influence of S. mutans in caries, this bacterium is also prevalent among healthy individuals, suggesting the contribution of genetic variation on the cariogenic potential. Based on this hypothesis, the present work investigated the influence of S. mutans virulence factors and saliva agglutinating capacity on caries susceptibility in children. STUDY DESIGN: Saliva samples of 24 children from low income families (13 caries-free and 11 caries-active individuals) were collected and tested for their ability to agglutinate S. mutans. The bacteria were isolated from these samples and analyzed for the presence of the gene coding for mutacin IV (mut IV). Biofilm formation and acid tolerance were also investigated in both groups (caries-free and caries-active). RESULTS: Saliva samples from caries-free children showed an increased capacity to agglutinate S. mutans (p=0.006). Also, bacteria isolated from the caries-free group formed less biofilm when compared to the caries-active group (p=0.04). The presence of mut IV gene did not differ between bacteria isolated from caries-free and caries-active individuals, nor did the ability to tolerate an acidic environment, which was the same for the two groups. CONCLUSIONS: Altogether, the results suggest that the adhesive properties of S. mutans and the agglutinating capacity of the saliva samples correlated with the presence of caries lesions in children.

Do aesthetics dental needs interfere in the oral health-related quality of life and in the self-steem of patients seeking for treatment at University São Francisco Dental School ?

Aim: The objective was to evaluate oral health-related quality of life (OHRQOL) in patients aging 18 - 60 years, considering oral health, dental aesthetic impact and self-esteem. Methods: The sample comprised 81 patients, regardless gender/ethnicity, seeking for dental aesthetic treatment at University São Francisco, Bragança Paulista-SP. The instruments used to assess the OHRQOL were the questionnaires: 1. Rosenberg Self-Esteem Scale (RSS); 2. Oral Health Impact Profile-14 Brazil (OHIP) and 3. Psychosocial Impact and Aesthetic Dental Questionnaire-Brazil (PIADQ). Data were analyzed by Spearman correlation (α=5%) and descriptive statistics. Results: The older the patient the worse the oral and general health conditions found (p<0.05). Moreover, the age showed significant correlation with OIHP and PIADQ questionnaires scores (p=0.000). The three questionnaires showed moderate positive correlations (p<0.05 r=0.461­0.685) among them. In addition, OHIP and QIPED questionnaires correlated with general health and oral health (p<0.05 r=0.230­0.558). Conclusion: It could be concluded that aesthetic dental needs interfere, in fact, in the oral health-related quality of life and in the self-steem of patients seeking for treatment University São Francisco Dental School (AU)

Selamento de lesões de cárie oclusais em metade externa de dentina em dentes decíduos: estudo clínico randomizado em crianças cearenses / Sealing dentinal caries lesion in deciduous teeth: clinical trial randomized

Objetivo: Avaliar o efeito do selamento de lesões de cárie com resina flow no controle de lesões cariosas oclusais comparado ao tratamento restaurador com resina composta. Material e Método: foram selecionadas 22 crianças na faixa etária de 4 a 9 anos que frequentam a Clínica Infantil da Universidade de Fortaleza (UNIFOR). Foi realizado um exame clínico inicial a fim de selecionar molares decíduos apresentando lesão de cárie na superfície oclusal, com envolvimento de dentina e abertura em esmalte menor ou igual a 3 mm. O exame radiográfico foi utilizado para verificar a profundidade da lesão de cárie, onde foram selecionadas as lesões que se apresentavam em metade externa de dentina. As crianças foram divididas aleatoriamente em 2 grupos, onde o primeiro foi realizado o selamento de cárie com resina flow (GRF) e o segundo grupo (GRC) restauração convencional com resina composta (remoção total do tecido cariado). Após 6 meses, 03 pacientes foram perdidos da pesquisa e, os grupos foram avaliados radiograficamente, afim de se verificar o comportamento das lesões: progressão (escore 2), paralisação (escore 1), ou regressão (escore 0) para o grupo GRF e para o Grupo GRC progressão (escore 2) e paralisação (escore 1). Uma avaliação clínica foi conduzida para verificação da integridade dos selamentos e das restaurações: retenção completa, parcial, perda total. Os dados foram comparados por meio do teste Mann-Whitney, com nível de significância de 5%. Resultados: não houve diferença estatística entre os grupos, onde 90% dos dentes do grupo GRF apresentaram retenção completa do material e em 100% dos casos houve ausência de progressão da lesão. Cem por cento dos molares pertencentes ao grupo GRC apresentaram, retenção completa do material, em 100% dos casos houve ausência da progressão da lesão. Conclusão: o selamento de lesão de cárie com resina flow constitui-se uma alternativa conservadora ao tratamento restaurador, propiciando a paralisação de lesões de cárie em metade externa de dentina.

The objective of this study was to evaluate the effect of sealing cavities with flow resin for controlling occlusal carious lesions compared with restorative treatment using composite resin. Twenty two children between 4 to 9 years attending the Children's Clinic of the University of Fortaleza (UNIFOR) were selected. After the initial clinical examination primary molars showing caries lesions on the occlusal surface (involving dentin and enamel in the opening less than or equal to 3 mm) were selected. Radiographic examination was used to check the depth of carious lesions and the selected lesions were those that affected the outer half of dentin. Children were randomly divided into 2 groups: group GRF ­ the sealing of cavities with flowable composite was conducted, and group GRC - conventional restoration with composite resin (total removal of decayed tissue) was performed. After six months of follow-up, 03 patients were excluded from the study, the groups were evaluated radiographically (to check the behavior of the lesions: progression, paralization or regression for the group GRF and for the group GRC progression or paralization) and clinically (to verify the integrity of sealing and restorations: complete retention, partial retention and loss total). Data were compared using the Mann-Whitney test at 5% significance level. The results showed that 90% of the teeth from group GRF showed complete retention of the material and 100% did not show progression of the lesion. One hundred percent of the molars belonging to group GRC showed complete retention of the material and 100% did not show progression of the lesion. In conclusion, the sealing of carious lesions with flowable composite constitutes a conservative alternative to restorative treatment, providing the paralization of carious lesions in the outer half of dentin.

Children with a Higher Activity of Carbonic Anhydrase VI in Saliva Are More Likely to Develop Dental Caries.

OBJECTIVE: This study aimed to analyze the concentration and activity of carbonic anhydrase (CA) VI in the saliva of school children. We investigated the relationship among caries, CA VI concentration/activity, flow rate, pH, and buffering capacity. MATERIALS AND METHODS: Seventy-four school children were divided into a caries-free group and a caries group. Clinical examinations were conducted by one examiner according to World Health Organization criteria + early caries lesions. Salivary flow rate, pH, and buffering capacity were analyzed. Salivary CA VI concentration and activity were evaluated by ELISA and zymography, respectively. The data were analyzed using Student's t test and the Mann-Whitney test, and Pearson and Spearman correlation analyses were also done. In multivariate modeling, associations between variables were expressed as odds ratios. RESULTS: The results showed that salivary flow rate, salivary pH, and BC were significantly higher in the saliva of caries-free children. Also, the salivary CA VI concentration was significantly higher in the saliva of caries-free children. The salivary CA VI activity was higher in children with caries. We found a negative correlation between BC and dental caries. Also, in the caries group we found a positive correlation between the concentration and the activity of CA VI and a negative correlation between BC and CA VI activity. A negative correlation between salivary pH and CA VI concentration was observed in the caries-free group. A high activity of CA and a low salivary flow rate were associated with dental caries. CONCLUSION: These results support the conclusion that dental caries is highly affected by the activity of CA VI in saliva as well as by the salivary flow rate.

Relationship between the IgA antibody response against Streptococcus mutans GbpB and severity of dental caries in childhood.

OBJECTIVE: Explore the associations between the severity of dental caries in childhood, mutans streptococci (MS) levels and IgA antibody response against Streptococcus mutans GbpB. Moreover, other caries-related etiological factors were also investigated. DESIGN: 36-60 month-old children were grouped into Caries-Free (CF, n=19), Early Childhood Caries (ECC, n=17) and Severe Early Childhood Caries (S-ECC, n=21). Data from socio-economic-cultural status, oral hygiene habits and dietary patterns were obtained from a questionnaire and a food-frequency diary filled out by parents. Saliva was collected from children for microbiological analysis and detection of salivary IgA antibody reactive with S. mutans GbpB in western blot. RESULTS: S-ECC children had reduced family income compared to those with ECC and CF. There was difference between CF and caries groups (ECC and S-ECC) in MS counts. Positive correlations between salivary IgA antibody response against GbpB and MS counts were found when the entire population was evaluated. When children with high MS counts were compared, S-ECC group showed significantly lower IgA antibody levels to GbpB compared to CF group. This finding was not observed for the ECC group. CONCLUSIONS: This study suggests that children with S-ECC have reduced salivary IgA immune responses to S. mutans GbpB, potentially compromising their ability to modify MS infection and its cariogenic potential. Furthermore, a reduced family income and high levels of MS were also associated with S-ECC.