A Cross-Sectional Study of the Association Between Chronic Oral Disease Burden and Serum Biomarkers in Kidney Transplant Recipients.

INTRODUCTION: Poor oral health can negatively affect general health and quality of life of kidney transplant recipients. The study aimed to investigate the association between chronic oral disease burden, serum biomarkers, and comorbidities in kidney transplant recipients. DESIGN: A cross-sectional comparative study was conducted with 44 patients after kidney transplant. The burden of chronic oral disease was composed of the following observable variables: moderate periodontitis and presence of dental caries. Serum biomarkers and comorbidities data were collected. The chi-square or Fisher's exact tests for categorical variables and Student's t-test or Mann-Whitney test for continuous variables were used. Robust Poisson regression was used to model the association. RESULTS: Higher levels of mean uric acid (P = .01) and creatinine (P = .03) were observed in the group of patients with oral disease burden, while the highest level of high-density lipoprotein was observed in the group without oral disease. Higher values of uric acid were associated with the occurrence of chronic oral disease burden (Adjusted PR = 1.24, 95% CI: 1.03-1.48, P = .019). There was no statistical difference between the groups with and without oral disease burden in comorbidities present. CONCLUSION: The findings suggest that chronic oral diseases burden can be associated with uric acid and creatinine levels in kidney transplant recipients.

The effect of nonsurgical periodontal therapy on hepcidin and on inflammatory and iron marker levels.

Serum hepcidin levels may increase in response to infection and inflammation. The present study investigated the effect of nonsurgical periodontal therapy (NSPT) on levels of serum hepcidin, inflammatory markers, and iron markers. An interventional study was conducted on 67 patients (age 30-65 years) without other diseases, except for chronic periodontitis (CP). Patients were allocated to either CP or control groups. The CP group received supragingival and subgingival scaling and root planing procedures, whereas the control group received supragingival scaling. Probing depth (PD), bleeding on probing, clinical attachment level (CAL), visible plaque index (VPI), serum hepcidin and interleukin-6 (IL-6) levels, high-sensitivity C-reactive protein (hs-CRP), hematological markers, and iron markers were measured at baseline and at 90 days after NSPT. The CP group had statistically significant lower mean values for mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) (p ≤ 0.05). The control group had statistically significant reductions in hemoglobin, hematocrit, MCV, and MCH (p ≤ 0.05). Serum hepcidin, IL-6, and erythrocyte sedimentation rate (ESR) levels were significantly decreased in both groups after NSPT. Periodontal markers were more markedly reduced in the CP group compared with the control group (p ≤ 0.05). These findings suggest that NSPT may reduce the serum levels of IL-6, hepcidin, and periodontal parameters.

The effect of nonsurgical periodontal therapy on hepcidin and on inflammatory and iron marker levels

Abstract Serum hepcidin levels may increase in response to infection and inflammation. The present study investigated the effect of nonsurgical periodontal therapy (NSPT) on levels of serum hepcidin, inflammatory markers, and iron markers. An interventional study was conducted on 67 patients (age 30-65 years) without other diseases, except for chronic periodontitis (CP). Patients were allocated to either CP or control groups. The CP group received supragingival and subgingival scaling and root planing procedures, whereas the control group received supragingival scaling. Probing depth (PD), bleeding on probing, clinical attachment level (CAL), visible plaque index (VPI), serum hepcidin and interleukin-6 (IL-6) levels, high-sensitivity C-reactive protein (hs-CRP), hematological markers, and iron markers were measured at baseline and at 90 days after NSPT. The CP group had statistically significant lower mean values for mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) (p ≤ 0.05). The control group had statistically significant reductions in hemoglobin, hematocrit, MCV, and MCH (p ≤ 0.05). Serum hepcidin, IL-6, and erythrocyte sedimentation rate (ESR) levels were significantly decreased in both groups after NSPT. Periodontal markers were more markedly reduced in the CP group compared with the control group (p ≤ 0.05). These findings suggest that NSPT may reduce the serum levels of IL-6, hepcidin, and periodontal parameters.

Conhecimentos e práticas de saúde bucal de gestantes usuárias dos serviços de saúde em São Luís, Maranhão, 2007-2008 / Oral health knowledge and practices among pregnant women using health services in São Luís, Maranhão, Brazil, 2007-2008 / Conocimientos y prácticas de salud oral en gestantes usuarias de servicios de salud en São Luís, Maranhão, Brasil, 2007-2008

OBJETIVO: descrever as características dos cuidados de saúde bucal durante o acompanhamento pré-natal e o conhecimento sobre saúde bucal entre gestantes usuárias de serviços de saúde público e privado em São Luís, Maranhão, Brasil. MÉTODOS: estudo descritivo com 300 gestantes entrevistadas em serviço público e 300 em serviço privado, no período de agosto de 2007 a julho de 2008. RESULTADOS: a frequência de escovação dentária foi similar entre as usuárias dos serviços público e privado (p=0,156), enquanto o uso de fio dental (64,0% e 47,0%; p<0,001) e de colutórios (39,7% e 27,0%; p=0,001) foi mais frequente no serviço privado, em relação ao público; a maioria das usuárias, tanto do serviço público (60,3%) como do privado (65,7%), desconheciam a associação entre saúde bucal e gravidez. CONCLUSÃO: a frequência de escovação dentária foi similar entre gestantes dos serviços público e privado; os efeitos da gestação sobre a saúde bucal eram pouco conhecidos.

OBJECTIVE: to describe characteristics of oral health care during prenatal check-ups and knowledge about oral health among pregnant women using public and private health services in São Luís, Maranhão, Brazil. METHODS: this is a descriptive study of 300 women interviewed in public health services and a further 300 interviewed in private health services between August 2007 and July 2008. RESULTS: tooth brushing frequency was similar among users of public and private services (p=0.156), while flossing (64.0% and 47.0%; p<0.001) and mouthwashing (39.7% and 27.0%; p=0.001) was more frequent among private service users in relation to public service users; most users of public services (60.3%) and private services (65.7%) were unaware of the association between oral health and pregnancy. CONCLUSION: frequency of tooth brushing was similar among pregnant women in public and private services; the effects of pregnancy on oral health were not well known.

OBJETIVO: identificar las características de los cuidados en salud oral durante el prenatal y el conocimiento acerca de salud oral entre gestantes de servicios de salud públicos y privados en São Luís, Maranhão, Brasil. MÉTODOS: estudio descriptivo de 300 mujeres entrevistadas en servicio público y 300 en servicio privado, entre agosto de 2007 y julio de 2008. RESULTADOS: la frecuencia del cepillado dental fue similar entre usuarias de servicios públicos y privados (p=0,156), mientras que el uso de hilo dental (64,0% y 47,0%, p<0,001) y enjuagues bucales (39,7% y 27,0%, p=0,001) fue más frecuente en el servicio particular; la mayoría de las usuarias de los servicios públicos (60,3%) y privados (65,7%) no eran conscientes de la asociación de salud oral y embarazo. CONCLUSIÓN: la frecuencia cepillado dental fue similar entre las mujeres embarazadas en los servicios públicos y privados; los efectos del embarazo en la salud bucal eran poco conocidos.

[Oral health knowledge and practices among pregnant women using health services in São Luís, Maranhão, Brazil, 2007-2008]. / Conhecimentos e práticas de saúde bucal de gestantes usuárias dos serviços de saúde em São Luís, Maranhão, 2007-2008.

OBJECTIVE: to describe characteristics of oral health care during prenatal check-ups and knowledge about oral health among pregnant women using public and private health services in São Luís, Maranhão, Brazil. METHODS: this is a descriptive study of 300 women interviewed in public health services and a further 300 interviewed in private health services between August 2007 and July 2008. RESULTS: tooth brushing frequency was similar among users of public and private services (p=0.156), while flossing (64.0% and 47.0%; p<0.001) and mouthwashing (39.7% and 27.0%; p=0.001) was more frequent among private service users in relation to public service users; most users of public services (60.3%) and private services (65.7%) were unaware of the association between oral health and pregnancy. CONCLUSION: frequency of tooth brushing was similar among pregnant women in public and private services; the effects of pregnancy on oral health were not well known.

Avaliação do nível de cooperação de pacientes em terapia periodontal de suporte / Assessment of patients´ cooperation level in basic periodontal therapy

O objetivo deste estudo foi avaliar o grau de cooperação dos pacientes da Clínica de Periodontia do Curso de Odontologia da Universidade Federal do Maranhão durante a terapia periodontal de suporte (TPS). Avaliou-se a profundidade de sondagem (PS), recessão gengival (RG), nível de inserção clínica (NIC), mobilidade dentária, envolvimento de furca, índice de placa (IP) e índice de sangramento gengival (ISG) de 16 pacientes adultos em três fases: baseline, T1 e T2. Os indivíduos foram diagnosticados quanto à condição periodontal e responderam ao questionário sobre o impacto na rotina e qualidade de vida nos últimos seis meses pelo índice OHIP-14 (Oral Health Impact Profile). Os dados foram submetidos à análise estatística. Os pacientes foram classificados conforme o grau de cooperação em: colaboradores (75%), colaboradores irregulares (12,5%) e não colaboradores (12,5%). A PS e o NIC dos pacientes colaboradores durante as três fases não sofreram diferenças significativas. O ISG sofreu uma redução comparada ao baseline. A média do IP dos pacientes colaboradores sofreu uma pequena redução, ao contrário dos colaboradores irregulares. Não houve escores de impacto forte na avaliação do OHIP-14, demonstrando uma boa percepção da qualidade da saúde bucal pelos indivíduos. Os pacientes colaboradores tiveram um impacto fraco em relação à doença periodontal nas duas fases do estudo (T1 e T2). Os principais diagnósticos foram a gengivite associada ao biofilme (38,46%) e periodontite crônica avançada localizada (30,76%). Pode-se concluir que os pacientes, em sua maioria, mostraram-se colaboradores na TPS, mantendo sua condição periodontal estável ou progredindo para saúde periodontal.

Motivation and education in mouth health are basic tools to prevent periodontal diseases. Current study assesses patients´ cooperation level at the Periodontal Clinic of the Dentistry Course of the Universidade Federal do Maranhão during Basic Periodontal Therapy (BPT). Sounding depth (PS), gum recession (RG), level of clinical insertion, dental mobility, furca involvement, plaque index (IP) and gum blooding index (ISG) of six adult were assessed clinically at three phases: baseline, T1 and T2. The patients were diagnosed with regard to their periodontal condition and answered a questionnaire on the impact on routine and life quality during the last six months, using Oral Health Impact Profile (OHIP-14). Data underwent statistical analysis and patients were classified according to their cooperation level, namely, collaborators (75%), irregular collaborators (12.5%) and non-collaborators (12.5%). No significant differences existed in collaborators´ PS and NIC during the three phases. ISG decreased when compared to baseline. IP mean of collaborating patients showed a slight decrease when compared to that of irregular collaborators. Since no significant score impact existed in OHIP-14 assessment, there was a good perception by patients with regard to mouth health quality. Collaborating patients had a weak impact with regard to periodontal disease in the two phases (T1 and T2). Main diagnoses were gingivitis plus biofilm gum (38.46%) and local advanced chronic periodontitis (30.76%). Results show that most patients collaborated with BPT, with a stable or advanced periodontal condition in periodontal health.

Uso de células-tronco na odontologia: realidade ou utopia? / Use of stem cells in dentistry: reality or utopia?

A perda dental ainda é um grande problema na Odontologia. Entretanto, com novas pesquisas, uma proposta de tratamento por meio do uso das células-tronco vem sendo utilizada para melhorar as funções do órgão dental. Essas células trazem alternativas para regeneração dentino-pulpar, do tecido periodontal, óssea, da cartilagem da articulação temporo-mandibular e o desenvolvimento da terceira dentição. As principais fontes são: células mesenquimais presentes na região periodontal e na polpa dental, em especial de dentes decíduos, ainda folículo dental e papila apical. Todas estas células apresentam capacidade proliferativa e regenerativa dos tecidos humanos, sejam eles dentais ou não. Dessa forma, este trabalho teve o propósito de fazer uma revisão da literatura sobre a ENGENHARIA TECIDUAL com enfoque para células-tronco quanto ao uso, fontes, vantagens e desvantagens, bem como elucidar as reais aplicabilidades na Odontologia.

Tooth loss is still a major problem in Dentistry. However, new treatments may be achieved by using stem cells to restore all functions of the tooth. These cells provide new alternatives such as: regeneration of pulp-dentin, periodontal tissue and temporomandibular joint cartilage and the development of third dentition. The main sources are: mesenchymal cells in the periodontium and dental pulp, especially in primary teeth, even the dental follicle and the apical papilla. All these cells have shown proliferative and regenerative capacity of human tissues, whether or not dental tissues. Thus, the aim of this study was to perform a literature review on tissue engineering focusing on stem cells, their use, sources, advantages and disadvantages, as well as to clarify the real applicability in Dentistry.

Relação entre doença periodontal e anemia / Relationship between periodontal diseases and anemia

Doença Periodontal é um grupo de doenças inflamatórias de origem infecciosa que afetam os tecidos de proteção e sustentação do dente. A perpetuação da resposta do hospedeiro devido à infecção bacteriana persistente interrompe os mecanismos homeostáticos e resulta na liberação de citocinas pró-inflamatórias, proteases e prostanóides, que podem promover destruição da matriz extracelular na gengiva e estimular a reabsorção óssea, além de estimular a produção de proteínas de fase aguda, sendo a IL-6 seu principal indutor. Dentre as proteínas de fase aguda cuja produção é intensamente aumentada durante a infecção e inflamação está a hepcidina que é predominantemente produzida pelo fígado, tendo como principal função a regulação homeostática do metabolismo de ferro, a modulação da defesa orgânica e contribuindo para a patogênese de anemias de causas diversas. O objetivo do estudo foi realizar uma revisão da literatura utilizando uma consulta às bases de dados Cochrane, Bireme e MedLine, tendo como eixo as seguintes palavras-chaves em associação: periodontite crônica, Inflamação e hemoglobina. Foram encontradas 101 publicações científicas por meio de busca eletrônica, sendo 9 da Bireme, 21 do Pubmed e 71 da Cochrane, além de títulos oriundos de referências de outros artigos. Concluiu-se que há indícios que hepcidina esteja associada ao processo inflamatório sendo responsável pela homeostase do ferro e, desta forma, contribuindo para processo patológico da anemia da inflamação crônica. Constatou-se ainda a escassez de artigos que investiguem a possível associação entre a doença periodontal e a anemia

Periodontal diseases can be defined as inflammatory disease from infectious origin that affect the protection and support tooth tissues. The host response perpetuation due to persistent bacterial infection disrupts the homeostatic mechanisms and results in releasing of the proinflammatory cytokines, proteases and prostanoids that can promote the destruction of extracellular matrix in the gingiva and cause bone resorption, also stimulate the production of acute phase proteins, being the IL-6 the main inductor. Among the acute phase proteins whose production is widely increased during infection and inflammation, there is hepcidin which is predominantly produced by the liver, having as main function the homeostatic regulation of iron metabolism, organic defense modulation and contributing to the pathogenesis of various causes of anemias. The aim of the study was to perform a literature review by using databases Cochrane, Bireme and MedLine, and the following keywords in combination: chronic periodontitis, inflammation and hemoglobin. A total of 101 scientific publications was found by electronic search, 9 from Bireme, 21 from PubMed and 71 from Cochrane, also titles from references by other articles. It was concluded that the hepcidin is associated to inflammatory process and it is responsible for the iron homeostasis therefore leading is associated to the pathologic process of the chronic disease anemia. Also, it was noted the lack of manuscripts that investigate the possible association between periodontal diseases and anemia.

Incidência de perfurações em luvas de látex estéreis utilizadas por estudantes nas clínicas de periodontia e cirurgia bucal / Incidence of perforation in sterile latex gloves used by students in periodontic and oral surgery clinical

O objetivo deste estudo comparativo foi determinar a incidência e locais de ocorrência de perfurações em luvas anatômicas estéreis, utilizadas por estudantes de Odontologia durante os procedimentos clínicos das Disciplinas de Periodontia e Cirurgia Bucal. Um total de 220 luvas utilizadas por estudantes com mão dominante direita foram incluídas neste estudo. O teste da inflação com solução corante foi utilizado para avaliar visualmente a presença ou ausência de perfurações. Foram coletados dados sobre quantidade, mão (direita/esquerda) e região anatômica de ocorrência das perfurações. Para a análise estatística, foi usado o Teste Exato de Fisher. Observou-se que a probabilidade de ocorrência de perfurações em luvas utilizadas por estudantes em procedimentos cirúrgicos foi 1,4 maior, quando comparados a procedimentos periodontais. A incidência de luvas perfuradas foi de 11,8% e 37,3% nas clínicas de Periodontia e Cirurgia, respectivamente (p<0,001). As regiões mais afetadas foram os dedos polegares e indicadores. Os resultados revelam que as luvas podem perder uma integridade física durante a utilização clínica, portanto deve ser dada uma maior ênfase aos cuidados quando do manuseio de instrumentais e materiais pérfuro-cortantes.

The objective of this comparative study was to determine the incidence and sites of occurrence of perforations on anatomical sterile gloves used by students of dentistry during the Periodontics and Oral Surgery clinical procedures. A total of 220 gloves used by students with the right dominant hand were included in this study. The test of inflation with a dye solution was used to visually evaluate the presence or absence of perforations. We collected data on quantity, hand (right / left) and anatomical region of occurrence of perforations. For statistical analysis we used the Fisher exact test. It was observed that the risk of punctures in gloves used by students in surgical procedures was 1.4 higher when compared to periodontal procedures. The incidence of perforated gloves was 11.8% and 37.3% in periodontics and surgery clinical, respectively (p <0.001). The regions most affected were the thumb and index finger. The results show that the gloves may lose a limb during clinical use and should therefore be given greater emphasis to care when the instruments and materials handling sharps.

Influência do tempo de cessação do hábito de fumar na condição periodontal / Influence of smoking cessation on periodontal status

Objetivo - O objetivo desse estudo transversal foi relacionar a cessação do hábito de fumar e condição periodontal. Métodos - Foram examinados 80 pacientes, de ambos os sexos, de 15 a 65 anos, sendo 23 não-fumantes, 17 fumantes e 40 ex-fumantes. Profundidade de sondagem (PS), nível de inserção clínica (NIC), recessão gengival (RG), mobilidade dentária, lesão de furca, índice de sangramento à sondagem (ISS) e índice de placa visível (IPV) foram os parâmetros clínicos avaliados. Resultados - Os dados referentes à PS, NIC, RG, mobilidade e furca foram submetidos à Análise de Variância um critério (p < 0,05), e a estatística descritiva foi usada para o ISS e IPV. O maior valor de NIC foi observado nos ex-fumantes. Os não fumantes obtiveram melhor resultado para o ISS, enquanto os fumantes apresentaram maior IPV. Para os ex-fumantes (< 10 anos de cessação), foram observados maiores valores para o NIC. Quanto ao consumo de cigarros, PS e NIC foram mais expressivos em pacientes com 20 anos de uso. Conclusão - Concluiu-se que ex-fumantes após 20 anos de cessação demonstraram melhora significativa em sua condição periodontal.

Objective - The aim of this cross-sectional study was to associate the time of smoking cessation and periodontal status. Methods - The sample consisted of 80 patients of both sexes, aged 15 to 65 years, 23 non-smokers, 17 smokers and 40 former smokers. Probing depth (PD), clinical attachment level (CAL), gingival recession (GR), tooth mobility, furcation lesions, bleeding on probing (BOP) and visible plaque index (PI) were the clinical parameters evaluated. Results - PD, CAL, GR, mobility and furcation data were submitted to one-way ANOVA (p < 0.05) and the descriptive statistics was used for BOP and PI. The highest values of CAL were observed for former smokers. Nonsmokers had better outcome for BOP, while smokers had higher rates for PI. For former smokers (< 10 years of cessation), there were better results for CAL. Concerning the past use of cigarettes, PD and CAL have showed more significant values for patients up to 20 years of use. Conclusion - It can conclude that former smokers up to 20 years of smoking cessation showed significant improvement in their periodontal condition.

Salivary IgA and periodontal treatment needs in diabetic patients.

Salivary IgA can serve as a first line of defense against pathogens that colonize and invade mucosal surfaces and may be protective against periodontal disease. The aim of this study was to assess salivary immunoglobulin A levels in diabetic and non-diabetic patients with different periodontal treatment needs. The Periodontal Screening & Recording (PSR) system was used to evaluate the periodontal treatment needs of 41 diabetic and 42 non-diabetic patients. Unstimulated whole saliva was collected from each patient immediately before clinical examination and stored at -20 °C until analysis. Salivary immunoglobulin A (s-IgA) levels were determined using an enzyme-linked immunosorbent assay, and values were expressed as optical density. Diabetic and non-diabetic patients were compared using clinical and laboratory data. PSR data indicated that periodontal disease was more frequent and more severe in diabetic patients. A higher prevalence of codes 3 and 4 was observed in diabetics as compared with non-diabetics (odds ratio = 2, P < 0.05). Furthermore, non-diabetic patients had more healthy sextants (code 0) than did diabetic patients. Over half of diabetic patients (∼54%) presented with s-IgA levels that were lower than the normal range (optical density from 0.4 nm to 0.6 nm; P < 0.05). In addition, diabetic patients showed a higher variability in s-IgA levels as compared with non-diabetic patients. In conclusion, diabetic individuals had lower s-IgA levels, more-frequent and more-severe periodontal disease, and a greater need for periodontal treatment as compared with non-diabetic patients.

Salivary IgA and periodontal treatment needs in diabetic patients

Salivary IgA can serve as a first line of defense against pathogens that colonize and invade mucosal surfaces and may be protective against periodontal disease. The aim of this study was to assess salivary immunoglobulin A levels in diabetic and non-diabetic patients with different periodontal treatment needs. The Periodontal Screening & Recording (PSR) system was used to evaluate the periodontal treatment needs of 41 diabetic and 42 non-diabetic patients. Unstimulated whole saliva was collected from each patient immediately before clinical examination and stored at -20 °C until analysis. Salivary immunoglobulin A (s-IgA) levels were determined using an enzyme-linked immunosorbent assay, and values were expressed as optical density. Diabetic and non-diabetic patients were compared using clinical and laboratory data. PSR data indicated that periodontal disease was more frequent and more severe in diabetic patients. A higher prevalence of codes 3 and 4 was observed in diabetics as compared with non-diabetics (odds ratio = 2, P < 0.05). Furthermore, non-diabetic patients had more healthy sextants (code 0) than did diabetic patients. Over half of diabetic patients (∼54 percent) presented with s-IgA levels that were lower than the normal range (optical density from 0.4 nm to 0.6 nm; P < 0.05). In addition, diabetic patients showed a higher variability in s-IgA levels as compared with non-diabetic patients. In conclusion, diabetic individuals had lower s-IgA levels, more-frequent and more-severe periodontal disease, and a greater need for periodontal treatment as compared with non-diabetic patients.

Reparo dos tecidos periodontais após cirurgia ressectiva: relato de caso clínico / Repair of periodontal tissues following ressective surgery: a case report

The aim of this study was to demonstrate the reestablishment of the biological width with periodontal surgery and follow up the positional changes of the gingival and bone tissues after a six-month healing period. The measures of gingival margin, level of relative attachment, mucogingival junction, cervical preparation cavity were obtained before full-thickness flap with osteotomy and osteoplasty, and repeated in the postoperative. Radiographs were made to verify the formation of lamina dura at that period of evaluation. The results have showed: 1) mucogingival junction without major changes after 6 months, 2) mean of level of relative attachment 0,5 mm; 3) coronary migration of gingival margin at the 2-month and stabilization at the 4-month periods; 4) stabilization of the papilla according to the shape and to the fold after 6 months and to the appearance in 4 months, 5) visible lamina dura was observed at proximal alveolar crests at the 6-month period. It can conclude that there was repair of gingival and bone tissues, thus enabling the placement of accurate prosthetic procedure in order to provide aesthetics, function, and the maintenance of periodontal health.

Immunohistochemical expression of E-cadherin and CD44v6 in squamous cell carcinomas of the lower lip and tongue.

This study analyzed the immunohistochemical expression of E-cadherin and CD44v6 in 15 squamous cell carcinomas (SCCs) of lower lip and 15 SCCs of tongue in order to verify a possible association between these proteins and the anatomic location of the lesion, nodal metastasis and histological grading of malignancy. The pattern of expression and number of immunopositive cells were evaluated. The results were analyzed with the Fisher's exact test, Mann-Whitney test and Spearman's Correlation Coefficient (r). using the SPSS software 10.0 for Windows. Statistical significance was set at 5% determined for a p-value<0.05 for all tests. There was no significant difference (p>0.05) in the pattern of expression and number of immunopositive cells for E-cadherin and CD44v6, regarding the anatomical location and nodal metastasis. For the histological grading, low score SCCs showed higher immunopositivity for E-cadherin and CD44v6, both for the pattern of expression and number of immunopositive cells (p<0.05). There was a negative correlation between the total score of malignancy and the pattern of expression and number of immunopositive cells for E-cadherin and CD44v6 (p<0.05). In conclusion, SCCs of the lower lip and tongue did not reveal significant differences in the expression of E-cadherin and CD44v6. The expression of these adhesion molecules revealed association only with tumor histological grading of malignancy. Therefore, these results suggest that E-cadherin and CD44v6 may not help elucidating the differences between the biological behavior of SCCs of the lower lip and tongue.

Lesões brancas da cavidade oral: uma abordagem estomatológica / White lesions of the oral cavity: a stomatology approach

Introdução: As lesões brancas da cavidade oral constituem um complexo conjunto de entidades, cuja principal característica clínica se evidencia pela presença de áreas esbranquiçadas na boca. Sua etiologia é extremamente variada, sendo que certas lesões não apresentam uma causa única, mas o resultado da interação de diversos fatores. Objetivo e Método: Pretende-se, com este trabalho, realizar uma revisão de literatura sobre essas lesões, onde serão discutidas as algumas das lesões brancas da cavidade oral, seus fatores etiológicos e características clínicas além de enfocar aspectos necessários para o estabelecimento do diagnóstico diferencial das referidas lesões. Conclusão: Pode-se inferir que é necessário o conhecimento das lesões brancas da cavidade oral pelo cirurgião-dentista, a fim de que seja estabelecido o diagnóstico correto das lesões para que seja instituído o tratamento adequado a cada tipo, e então, recuperada a condição de saúde do paciente.

Introduction: White lesions of oral cavity constitute a complex group of entities, whose the main clinical characteristic is evidenced by the presence of white areas in the mouth. Your aetiology is extremely varied and some lesions don't present an only cause, but they are the result of the interaction of several factors. Aim and methods:It is intended, with this work, to accomplish a literature revision on those lesions, where it is discussedthe main white lesions of the oral cavity, your aetiology factors and clinical characteristics besides focusing necessary aspects for the establishment of the diferencial diagnosis of the referred lesions. Conclusion: It can be inferred that is necessary the knowledge of the white lesions of the oral cavity for the dentist, to established the correct diagnosis of the lesions to institute the appropriate treatment to each type, and then, the condition of the patient's health.

Changes in immunoexpression of E-cadherin and beta-catenin in oral squamous cell carcinoma with and without nodal metastasis.

The aim of this study is to analyze the immunohistochemical expression of E-cadherin and beta-catenin in oral squamous cell carcinoma to better understand the biological behavior of this lesion. The sample consisted of 15 cases of the tongue and 15 of the lower lip. The pattern and intensity of the labeling and the analysis of the percentage of tumor cells immunopositive in membrane for E-cadherin and beta-catenin were related to the anatomic location of the lesion, the presence or absence of nodal metastasis, and the histological gradation of malignancy in the tumor invasion front. The presence or absence of cytoplasmic and nuclear labeling was also recorded. The membrane expression for E-cadherin and beta-catenin predominately displayed a heterogeneous pattern in the carcinomas studied. No significant difference was observed between the expression pattern and the quantity of cells immunopositive for E-cadherin and beta-catenin and the anatomic location of the lesion or the presence or absence of nodal metastasis. However, a statistically significant difference was found between the reduced expressio\n of these proteins and the high malignancy score. The reduced immunoexpression of these proteins in the membrane may be related to the high degree of cell indifferentiation in cases of oral squamous cell carcinoma with high scores.

Immunohistochemical expression of E-cadherin and CD44v6 in squamous cell carcinomas of the lower lip and tongue

This study analyzed the immunohistochemical expression of E-cadherin and CD44v6 in 15 squamous cell carcinomas (SCCs) of lower lip and 15 SCCs of tongue in order to verify a possible association between these proteins and the anatomic location of the lesion, nodal metastasis and histological grading of malignancy. The pattern of expression and number of immunopositive cells were evaluated. The results were analyzed with the Fisher's exact test, Mann-Whitney test and Spearman's Correlation Coefficient (r). using the SPSS software 10.0 for Windows. Statistical significance was set at 5 percent determined for a p-value<0.05 for all tests. There was no significant difference (p>0.05) in the pattern of expression and number of immunopositive cells for E-cadherin and CD44v6, regarding the anatomical location and nodal metastasis. For the histological grading, low score SCCs showed higher immunopositivity for E-cadherin and CD44v6, both for the pattern of expression and number of immunopositive cells (p<0.05). There was a negative correlation between the total score of malignancy and the pattern of expression and number of immunopositive cells for E-cadherin and CD44v6 (p<0.05). In conclusion, SCCs of the lower lip and tongue did not reveal significant differences in the expression of E-cadherin and CD44v6. The expression of these adhesion molecules revealed association only with tumor histological grading of malignancy. Therefore, these results suggest that E-cadherin and CD44v6 may not help elucidating the differences between the biological behavior of SCCs of the lower lip and tongue.

Este estudo analisou a expressão imuno-histoquímica de E-caderina e CD44v6 em 15 carcinomas de células escamosas (CCEs) de lábio inferior e em 15 CCEs de língua, com o intuito de identificar possíveis associações entre a expressão destas proteínas e a localização anatômica da lesão, ocorrência de metástase nodal e gradação histológica de malignidade. Foram avaliados o padrão de expressão e o número de células imunopositivas. Os resultados foram analisados pelo teste exato de Fisher, teste de Mann-Withney e coeficiente de correlação de Spearman (r), utilizando o software SPSS 10.0 para Windows. Para todos os testes, a significância estatística foi determinada em 5 por cento, para um valor de p<0,05. Os resultados revelaram não haver diferença significativa no padrão de expressão e na quantidade de células imunopositivas para E-caderina e CD44v6 em relação à localização anatômica e metástase nodal (p>0,05). Para a gradação histológica de malignidade, os CCEs de baixo escore revelaram maior imunopositividade para E-caderina e CD44v6, tanto para o padrão de expressão quanto para o número de células imunopositivas (p<0,05). Observou-se correlação negativa entre o escore total de malignidade e o padrão de expressão e a quantidade de células imunopositivas para E-caderina e CD44v6 (p<0,05). Em conclusão, CCEs de lábio inferior e língua não revelaram diferenças significativas na expressão de E-caderina e CD44v6. A expressão destas moléculas de adesão revelou associação apenas com gradação histológica de malignidade dos CCEs. Dessa forma, os resultados sugerem que E-caderina e CD44v6 podem não ser capazes de elucidar as diferenças existentes no comportamento biológico de CCEs de lábio inferior e língua.

Estudo das recessões gengivais em pacientes adultos atendidos na faculdade de odontologia da UFMA: etiologia, prevalência e severidade / A stufy of gingival recessions in adult patients attended at school of dentistry of UFMA: etiology, prevalence and severity

Avaliou-se a etiologia, prevalência e severidade das recessões gengivais em 49 pacientes de ambos os sexos, atendidos na Clínica de Periodontia do Curso de Odontologia da Universidade Federal do Maranhão, com idades variando de 20 a 60 anos. As recessões foram mensuradas a partir da junção amelocementária até a margem gengival livre nas faces vestibular e palatina/lingual. De acordo com os resultados, os incisivos inferiores constituíram o grupo de dentes mais acometido (26,7% das lesões). Do total das recessões, a maioria encontrava-se na face vestibular (58,25%). A análise entre a presença de placa visível e a recessão, através do coeficiente de correlação(r), mostrou que 76,71% dos sítios de recessão podem ter sido influenciados por esse fator, porém outros fatores participantes da etiologia das recessões foram também pesquisados. Quanto ao grau da patologia, observou-se que as recessões classe I foram as mais freqüentes em todos os grupos etários, contudo, houve maior percentual das recessões mais severas nos indivíduos com idade superior a 50 anos. Conclui-se, portanto que, os incisivos inferiores e faces vestibulares foram mais afetados. A presença de placa bacteriana foi consideravelmente relacionada à patologia e a severidade das recessões aumentou com o avanço da idade.

[Evaluation of oral condition of patients with chronic renal failure submitted to hemodialysis]. / Avaliação da condição bucal em pacientes renais crônicos submetidos à hemodiálise.

BACKGROUND: Evaluate the oral conditions of patients with chronic renal failure submitted to hemodialysis in the city of São Luís, by comparing three reference centers and the times of hemodialysis. METHODS: The sample consisted of 107 patients, distributed among the centers. Plaque Index (IP) and Dental Caries Prevalence (DMF-T) were evaluated. Patients were subdivided into three groups according to time of hemodialysis (3 months to <1 year, 1 the 3 years and >3 years). Data were analyzed using the ANOVA and the Kruskal-Wallis test with a level of significance of 5%. RESULTS: Plaque index averages in the groups were respectively, 0.91+/-0.67; 1.04+/-0.60; 1.25+/-0.61. The averages of DMF-T in the respective groups were 13.63+/-8.91; 13.89+/-8.12; 16.79+/-7.31. There were no significant differences between the centers of reference and the times of hemodialysis. CONCLUSION: Time of treatment of the disease did not change or interfere on plaque accumulation and prevalence of the dental caries. There was uniformity in the patients' oral condition in the three reference centers under study.

A doença periodontal como fator de risco para os acidentescerebrovasculares / Periodontal disease as risk factor for cerebrovascular accidents

Introdução: As doenças cardiovasculares, entre elas osacidentes vasculares cerebrais, são responsáveis por 20% detodas as mortes anualmente. Estudos têm evidenciado a associaçãodas doenças periodontais com fatores inerentes ao hospedeirocomo fumo, doenças sistêmicas, estresse, obesidade e outros.Recentemente, a doença periodontal tem sido estudada como fatorde risco para a ocorrência de acidentes vasculares cerebrais.Objetivo: Analisar a relação existente entre acidente vascularcerebral e doenças periodontais, através de evidências da literaturauma vez que ambas as doenças são de grande prevalência nasociedade atual.Conclusão: Apesar de estudos mostrarem evidências da doençaperiodontal como fator de risco para os acidentes vascularescerebrais, os mecanismos biológicos que ligam as duas doençasainda não estão totalmente esclarecidos. Estudos adicionais devemser realizados para esclarecer esta associação, bem como medidaspreventivas devem ser realizadas, visando prevenir a ocorrênciade ambas as doenças.