Activation of gelatinases in permanent human teeth after different experimental radiotherapy protocols.

The objective of this study was to compare the activation of gelatinases in dentin-enamel junction (DEJ) and underlying dentin of permanent teeth after experimental radiotherapy in conventional and hypofractionated modalities. Newly extracted third molars (n = 15) were divided into three experimental radiotherapy groups: control, conventional (CR), and hypofractionated (HR) (n = 5 per group). After in vitro exposure to ionizing radiation, following standardized protocols for each modality, a gelatinous substrate was incubated on the tooth slices (n = 10 per group). Activation of gelatinases was measured by in situ zymography, expressed in arbitrary fluorescence units (mm2) from three tooth regions: cervical, cuspal, and pit. Fluorescence intensity was compared among radiotherapy protocols and tooth regions in each protocol, considering a significance level of 5%. Considering all tooth regions, the fluorescence intensity of the CR group was higher than the HR and control groups, both in DEJ and underlying dentin (p <0.001). In addition, the fluorescence intensity was higher in underlying dentin when compared to DEJ in all groups (p <0.001). Considering each tooth region, a statistically significant difference between CR and HR was only observed in the pit region of underlying dentin (p <0.001). Significant and positive correlations between fluorescence intensities in DEJ and underlying dentin were also observed (p <0.001). Experimental radiotherapy influenced the activation of gelatinases, as well as exposure to the conventional protocol can trigger a higher activation of gelatinases when compared to hypofractionated, both in DEJ and underlying dentin.

Conhecimento e repercussões emocionais da COVID-19 entre estudantes de Odontologia brasileiros / Conocimientos y repercusiones emocionales de la COVID-19 entre estudiantes brasileños de odontología / Knowledge about and emotional impact of COVID-19 among Brazilian dental students

Em decorrência da pandemia de COVID-19, implementou-se atividades remotas de ensino, como medida de distanciamento social. O objetivo deste estudo foi avaliar o conhecimento dos graduandos de Odontologia brasileiros sobre a COVID-19, bem como o possível impacto da pandemia nas condições emocionais e sociais destes estudantes. Trata-se de um estudo transversal com coleta de dados primários, por meio de questionário estruturado. O questionário ficou vigente no período de 11 de agosto a 11 de setembro de 2020, com envios semanais, com amostragem de conveniência. Os dados foram submetidos à análise descritiva. A pesquisa abrangeu discentes doprimeiro ao décimo período do curso de Odontologia, das diferentes regiões brasileiras. Foram coletadas 520 respostas, de 14 estados do país. Os alunos demonstraram ter um alto nível de conhecimento sobre a COVID-19, 77,31% não se sentiam seguros, 85,96% alegaram medo em relação ao futuro e 96,15% afirmaram ter havido prejuízos no seu curso de graduação. Dentre os alunos, 69,56% relataram piora no estado emocional, 83,08% perceberam-se mais estressados, 58,46% afirmaram ter desenvolvido insônia e 51,25% afirmaram que a pandemia afetou negativamente as finanças familiares. Conclui-se que os graduandos de Odontologia brasileiros têm conhecimento sobre a COVID-19 e a pandemia os afetou negativamente em relação aos aspectos emocionais e sociais (AU).

A raíz de la pandemia del COVID-19, se implementaron actividades de enseñanza a distancia como medida de distanciamiento social. El objetivo de este estudio fue evaluar el conocimiento de los estudiantes brasileños de odontología sobre el COVID-19, así como el posible impacto de la pandemia en las condiciones emocionales ysociales de estos estudiantes. Se trata de un estudio transversal con recogida de datos primarios a través de un cuestionario estructurado. El cuestionario estuvo vigente del 11 de agosto al 11 de septiembre de 2020, con envíos semanales, con muestreo porconveniencia. Los datos fueron sometidos a análisis descriptivo. La investigación abarcó estudiantes del primero al décimo período de la carrera de Odontología, de diferentes regiones brasileñas. Se recogieron 520 respuestas de 14 estados del país. Los estudiantes demostraron un alto nivel de conocimiento sobre el COVID-19, el 77,31 % no se sentía seguro, el 85,96 % manifestó tener miedo al futuro y el 96,15 % manifestó haber tenido pérdidas en su carrera de grado. Entre los estudiantes, el 69,56 % reportóun empeoramiento en su estado emocional, el 83,08 % se sintió más estresado, el 58,46 % dijo haber desarrollado insomnio y el 51,25 % dijo que la pandemia tuvo un efecto negativo en la economía familiar. Se concluye que los estudiantes de odontología brasileños son conscientes de la COVID-19 y la pandemia los ha afectado negativamente en los aspectos emocionales y sociales (AU).

As a result of the COVID-19 pandemic, remote teaching activities have been implemented as a social distancing measure. The objective of this study was to assess the knowledge that Brazilian dental students have about COVID-19, as well as the possible impact of the pandemic on these students' emotional and social conditions. This is a cross-sectional study using primary-data collection by means of a structured questionnaire. The latter was open from August 11 to September 11, 2020, with weekly submissions, and with convenience sampling. Data were subjected to descriptive analysis. The research included students attending the first to the tenth period of Dentistry courses, from different Brazilian regions. A total of 520 responses were collected from 14 statesin the country. The students proved to have a high level of knowledge about COVID-19; 77.31% did not feel safe, 85.96% claimed to be afraid of the future, and 96.15% stated that their undergraduate courses went through losses. Moreover, 69.56% reported a worsening in their emotional state, 83.08% perceived themselves as being more stressed, 58.46% said they developed insomnia, and 51.25% stated that the pandemic had a negative effect on family finances. It is concluded that Brazilian dental students have knowledge about COVID-19, and the pandemic has negatively affected them in terms of emotional and social aspects (AU).

Electromyographic analysis of the stomatognathic system of children with Molar-incisor hypomineralization.

INTRODUCTION: Molar-incisor hypomineralization (MIH) is a qualitative defect of dental enamel that affects one or more permanent first molars, with or without involvement of the incisor teeth. This condition leads to challenges to dental care and treatment planning. AIM: Based on the hypothesis that children who have MIH possibly present alterations in postural and masticatory activities and considering the absence of studies investigating these parameters, the present study evaluated the functionality of the stomatognathic system considering the mentioned aspects. MATERIALS: The comparison of individuals with (MIHG; n = 32) and without MIH (CG; n = 32) was evaluated by electromyographic activity of the masseter and temporal muscles (right and left), as well as evaluation of the masticatory cycles during habitual mastication. RESULTS: MIHG showed muscle hyperactivity in postural and dynamic conditions compared to the CG; higher electromyographic values for MIHG when compared to CG in the following postural conditions: at rest for the right temporal (p = 0.00) and left temporal muscles (p = 0.03); in the protrusion to the right temporal muscle (p = 0.02); in the right laterality for the right masseter (p = 0.00) and left temporal muscles (p = 0.01); in the left laterality for the right masseter (p = 0.03) and left temporal (p = 0.04) muscles. In dynamic conditions with consistent food, significance was observed for the left temporal (p = 0.01); and with soft food for the right (p = 0.01) and left temporal muscles (p = 0.04). CONCLUSIONS: Children with MIH seem to have impaired functionality of the stomatognathic system. Children with MIH have alterations in the stomatognathic system.

Silver nanoparticles in mouthwashes against infection caused by SARS-CoV-2: a scoping review / Nanopartículas de prata em enxaguatórios bucais para uso em infecções por SARS-CoV-2: uma revisão de escopo

The Silver nanoparticle (AgNPs) have received attention for their antiviral potential against SARS-CoV-2. The objective is to conduct a scope review and map the scientific evidence on the use of AgNPs in mouthwashes as an adjunct in decreasing the viral load in the oral cavity of patients with SARS-CoV-2. A search was performed in the PubMed, Medline, Scielo databases, and a manual search in the reference lists, following the standards of the Joanna Briggs Institute for Scoping Review without restriction of year, language or sample size. Thus, 14 articles were included, where they researched the use of AgNPs with antiviral effect against SARS-CoV-2, mouthwashes for SARS-CoV-2 and AgNPs as mouthwashes. We can suggest that AgNPs are likely antiviral therapies for SARS-CoV-2 and its use in mouthwashes associated with other therapies are promising strands for decreasing viral load and infection by the vírus (AU)

As nanopartículas de prata (AgNPs) têm recebido atenção por seu potencial antiviral no SARS-CoV-2. O objetivo deste trabalho é realizar uma revisão de escopo e mapear as evidências científicas sobre o uso de AgNPs em bochechos como adjuvante na diminuição da carga viral na cavidade oral de pacientes com SARS-CoV-2. Foi realizada busca nas bases de dados PubMed, Medline, Scielo e busca manual nas listas de referências, seguindo os padrões do Joanna Briggs Institute for Scoping Review sem restrição de ano, idioma ou tamanho da amostra. Assim, foram incluídos 14 artigos, onde pesquisaram o uso de AgNPs com efeito antiviral contra SARS-CoV-2, enxaguatórios bucais para SARS-CoV-2 e AgNPs como enxaguatórios bucais, vertentes promissoras para diminuição da carga viral e infecção pelo vírus.(AU)

Activation of gelatinases in permanent human teeth after different experimental radiotherapy protocols

Abstract The objective of this study was to compare the activation of gelatinases in dentin-enamel junction (DEJ) and underlying dentin of permanent teeth after experimental radiotherapy in conventional and hypofractionated modalities. Newly extracted third molars (n = 15) were divided into three experimental radiotherapy groups: control, conventional (CR), and hypofractionated (HR) (n = 5 per group). After in vitro exposure to ionizing radiation, following standardized protocols for each modality, a gelatinous substrate was incubated on the tooth slices (n = 10 per group). Activation of gelatinases was measured by in situ zymography, expressed in arbitrary fluorescence units (mm2) from three tooth regions: cervical, cuspal, and pit. Fluorescence intensity was compared among radiotherapy protocols and tooth regions in each protocol, considering a significance level of 5%. Considering all tooth regions, the fluorescence intensity of the CR group was higher than the HR and control groups, both in DEJ and underlying dentin (p <0.001). In addition, the fluorescence intensity was higher in underlying dentin when compared to DEJ in all groups (p <0.001). Considering each tooth region, a statistically significant difference between CR and HR was only observed in the pit region of underlying dentin (p <0.001). Significant and positive correlations between fluorescence intensities in DEJ and underlying dentin were also observed (p <0.001). Experimental radiotherapy influenced the activation of gelatinases, as well as exposure to the conventional protocol can trigger a higher activation of gelatinases when compared to hypofractionated, both in DEJ and underlying dentin.

Resumo O objetivo deste estudo foi comparar a ativação de gelatinases na junção dentina-esmalte (DEJ) e na dentina subjacente de dentes permanentes após a radioterapia experimental nas modalidades convencional e hipofracionada. Os terceiros molares recém-extraídos (n = 15) foram divididos em três grupos de radioterapia experimental: controle, convencional (CR) e hipofracionada (HR) (n = 5 por grupo). Após a exposição in vitro à radiação ionizante, seguindo protocolos padronizados para cada modalidade, um substrato gelatinoso foi incubado nas fatias de dente (n = 10 por grupo). A ativação das gelatinases foi medida por zimografia in situ, expressa em unidades arbitrárias de fluorescência (mm2) de três regiões do dente: cervical, cúspide e fossa. A intensidade da fluorescência foi comparada entre os protocolos de radioterapia e as regiões do dente em cada protocolo, considerando um nível de significância de 5%. Considerando todas as regiões do dente, a intensidade de fluorescência do grupo CR foi maior do que a dos grupos HR e controle, tanto no DEJ quanto na dentina subjacente (p <0,001). Além disso, a intensidade da fluorescência foi maior na dentina subjacente quando comparada à DEJ em todos os grupos (p <0,001). Considerando cada região do dente, uma diferença estatisticamente significativa entre CR e HR foi observada apenas na região da fossa da dentina subjacente (p <0,001). Também foram observadas correlações significativas e positivas entre as intensidades de fluorescência no DEJ e na dentina subjacente (p <0,001). A radioterapia experimental influenciou a ativação das gelatinases, assim como a exposição ao protocolo convencional pode desencadear uma maior ativação das gelatinases quando comparada ao hipofracionamento, tanto no DEJ quanto na dentina subjacente.

Use of Images and Clinical Experience to Calibrate Dental Surgeons for the Diagnosis of Molar Incisor Hypomineralization

ABSTRACT Objective: To evaluate an imaging protocol for use as a diagnostic and calibration tool for dentists before and after practical activity. Material and Methods: Thirty photos of children's teeth with or without changes in dental enamel were selected and evaluated by a group of experienced dentists previously calibrated to establish the diagnosis defined as the gold standard. After instructions, the images were shown to a group of postgraduate dentists for free identification of dental changes. Subsequently, a lecture on molar incisor hypomineralization (MIH) was carried out, and, at 14 days and all calibration was performed using the criteria previously. The retest was performed at 28 days. After experience in clinical activity in the following two weeks, the post-test was performed at 49 days. Data were analyzed using Cohen's kappa coefficient. Results: Theoretical learning on the subject showed low inter-examiner agreement when the diagnosis of defects was made from images obtained from intraoral photographs. After clinical practice, there was greater intra-examiner agreement. After theoretical training, dentists started to identify different types of enamel alteration, although with low agreement between them. Conclusion: Clinical experience in theoretical and imaging training favored the identification of defects. However, it is necessary to improve the protocol to establish a reliable and viable diagnostic method for calibration in MIH.

Use of Restorative Materials in Primary Teeth - A Retrospective University-Based Study

ABSTRACT Objective: To investigate the types of restorative materials used for restorative treatment in primary teeth through a retrospective university-based study. Material and Methods: The sample consisted of all clinical records of children attended at the Pediatric Dentistry Clinic at the School of Dentistry of Ribeirão Preto at the University of São Paulo in Brazil. Inclusion criteria were primary anterior and posterior teeth that received dental restorations for treatment of dental caries lesions, dental trauma or dental development defects from 2013 to 2018. Restoration repairs and interim restorations during this period were also recorded. Descriptive analyzes were performed to assess the distribution according to the type of restorative material used over the years. Results: A total of 5,236 restorative procedures were performed in primary teeth, including restoration repair and interim restorations. Of those, 69% were done in posterior teeth and 31% in anterior teeth. Sixty percent of the procedures performed during this period were made of composite resin and a lower percentage of glass ionomer cement (18%) followed by silver amalgam (1%). The number of interim restorations was smaller but proportional to those of composite resin over the years. Conclusion: A tendency to carry out restorative treatment of primary teeth with composite resin during the 6 years of follow-up was observed.

Adhesion of a sealant with pre-reacted glass ionomer particles under salivary contamination: an in vitro study

Objective: this in vitro study compared the adhesive strengths of the resin sealant with the Giomer technology sealant under salivary contamination. Materials and Methods: fifty-two bovine incisors were randomly divided into four groups (n=13): GI, a resin sealant (Fluroshield®) without salivary contamination (control of GII); GII, Fluroshield sealant + salivary contamination; GIII, a Giomer technology sealant (BeautiSealant®) without salivary contamination (control of GIV); and GIV, BeautiSealant® sealant + salivary contamination. In the salivary contamination groups, artificial saliva was used through a pipette, and after 20 s, it was air-dried and the sealant was applied. Shear strength tests were performed using a universal testing machine. One-way ANOVA variance and Tukey's test were used for multiple comparisons. The fracture types were analyzed using a stereomicroscope with 40X magnification. Results: the means and standard deviations (SD) of adhesion for Fluroshield® and BeautiSealant® in the group without salivary contamination were 15.27 (±0.96) and 11.90 (±0.94), and for the group with salivary contamination, 13.14 (±1.03) and 8.95 (±1.33), respectively, indicating a statistically significant difference between GI and GII p=0.020, GIII and GIV p=0.041. Mixed failures were detected in GI (38%), GII (44%), GIII (38%), and GIV (62%). Conclusion: there was a statistically significant decrease in the adhesive strength values in the groups with salivary contamination for both the sealants studied. However, no significant difference was observed between the two sealants when the materials used were compared.

Objetivo: este estudo in vitro comparou as forças adesivas do selante resinoso com o selante da tecnologia Giomer sob contaminação salivar. Materiais e Métodos: cinquenta e dois incisivos bovinos foram divididos aleatoriamente em quatro grupos (n=13): GI, um selante resinoso (Fluroshield®) sem contaminação salivar (controle do GII); GII, selante Fluroshield + contaminação salivar; GIII, um selante com tecnologia Giomer (BeautiSealant®) sem contaminação salivar (controle do GIV); e GIV, selante BeautiSealant® + contaminação salivar. Nos grupos de contaminação salivar, a saliva artificial foi utilizada por meio de uma pipeta e, após 20 s, foi seca ao ar e aplicado o selante. Os testes de resistência ao cisalhamento foram realizados usando uma máquina de teste universal. A variância ANOVA de uma via e o teste de Tukey foram usados para comparações múltiplas. Os tipos de fratura foram analisados em estereomicroscópio com aumento de 40X. Resultados: as médias e desvios padrão (DP) de adesão para Fluroshield® e BeautiSealant® no grupo sem contaminação salivar foram 15,27 (±0,96) e 11,90 (±0,94), e após contaminação salivar foram 13,14 (±1,03) e 8,95 (±1,33), respectivamente, indicando haver diferença estatisticamente significante entre GI e GII p=0.020, GIII e GIV p=0.041. Falhas mistas foram detectadas em GI (38%), GII (44%), GIII (38%) e GIV (62%). Conclusão: houve diminuição estatisticamente significativa dos valores de resistência adesiva nos grupos com contaminação salivar para ambos os selantes estudados. No entanto, não foi observada diferença significativa entre os dois selantes quando comparados os materiais utilizados.

Leukotriene B4 Loaded in Microspheres Inhibits Osteoclast Differentiation and Activation.

To investigate osteoclast formation in vivo and if leukotriene B4 (LTB4) loaded in microspheres (MS) could be used as a therapeutical strategy to promote a sustained delivery of the mediator and prevent osteoclast differentiation. Methods: In vivo, apical periodontitis was induced in mice to investigate osteoclast differentiation and signaling in absence of 5-lipoxygenase (5-LO). In vitro, LTB4-MS were prepared using an oil-in-water emulsion solvent extraction-evaporation process. Characterization and efficiency of LTB4 encapsulation were investigated. J774A.1 macrophages were cultured in the presence of monocyte colony-stimulating factor (M-CSF) and ligand for receptor activator of nuclear factor kappa B (RANKL) and then stimulated with LTB4-MS. Cytotoxicity, in vitro MS-LTB4 uptake, osteoclast formation and gene expression were measured. Results: We found that 5-LO negatively regulates osteoclastic formation in vivo during apical periodontitis development. In vitro, LTB4-MS were up-taken by macrophages and were not cytotoxic to the cells. LTB4-MS inhibited osteoclast formation and the synthesis of osteoclastogenic genes Acp5, Mmp9, Calcr and Ctsk. LTB4-MS inhibited differentiation of macrophages into an osteoclastic phenotype and cell activation under M-CSF and RANKL stimulus.

Leukotriene B4 Loaded in Microspheres Inhibits Osteoclast Differentiation and Activation

Abstract To investigate osteoclast formation in vivo and if leukotriene B4 (LTB4) loaded in microspheres (MS) could be used as a therapeutical strategy to promote a sustained delivery of the mediator and prevent osteoclast differentiation. Methods: In vivo, apical periodontitis was induced in mice to investigate osteoclast differentiation and signaling in absence of 5-lipoxygenase (5-LO). In vitro, LTB4-MS were prepared using an oil-in-water emulsion solvent extraction-evaporation process. Characterization and efficiency of LTB4 encapsulation were investigated. J774A.1 macrophages were cultured in the presence of monocyte colony-stimulating factor (M-CSF) and ligand for receptor activator of nuclear factor kappa B (RANKL) and then stimulated with LTB4-MS. Cytotoxicity, in vitro MS-LTB4 uptake, osteoclast formation and gene expression were measured. Results: We found that 5-LO negatively regulates osteoclastic formation in vivo during apical periodontitis development. In vitro, LTB4-MS were up-taken by macrophages and were not cytotoxic to the cells. LTB4-MS inhibited osteoclast formation and the synthesis of osteoclastogenic genes Acp5, Mmp9, Calcr and Ctsk. LTB4-MS inhibited differentiation of macrophages into an osteoclastic phenotype and cell activation under M-CSF and RANKL stimulus.

Resumo O objetivo deste trabalho foi Investigar a formação de osteoclastos in vivo e se o leucotrieno B4 (LTB4) incorporado em microesferas (MS) poderia ser usado como estratégia terapêutica para promover uma entrega sustentada do mediador e prevenir a diferenciação dos osteoclastos. Métodos: In vivo, a periodontite apical foi induzida em camundongos para investigar a diferenciação e sinalização de osteoclastos na ausência de 5-lipoxigenase (5-LO). In vitro, LTB4-MS foi preparado usando um processo de evaporação e extração de solvente de emulsão de óleo em água. A caracterização e a eficiência do encapsulamento do LTB4 foram investigadas. Macrófagos J774A.1 foram cultivados na presença de fator estimulador de colônia de monócitos (M-CSF) e ligante para o receptor ativador do fator nuclear kappa B (RANKL) e, então, estimulados com LTB4-MS. Citotoxicidade, captação in vitro de MS-LTB4, formação de osteoclastos e expressão gênica foram avaliadas. Resultados: A via 5-LO regula negativamente a formação de osteoclastos in vivo durante o desenvolvimento da periodontite apical. In vitro, LTB4-MS foram fagocitadas pelos macrófagos e não foram citotóxicos para as células. LTB4-MS inibiu a formação de osteoclastos e a síntese dos genes pró-osteoclastogênicos Acp5, Mmp9, Calcr e Ctsk. Conclusões: LTB4-MS inibiu a diferenciação de macrófagos em um fenótipo osteoclástico e a ativação celular sob estímulo de M-CSF e RANKL.

Preemptive analgesia with ibuprofen increases anesthetic efficacy in children with severe molar: a triple-blind randomized clinical trial.

Molar incisor hypomineralization (MIH) is often accompanied by dental hypersensitivity and difficulty in achieving effective analgesia. OBJECTIVE: This study evaluated the effectiveness of preemptive analgesia in children with severe MIH, post-eruptive enamel breakdown, and hypersensitivity. METHODOLOGY: Ibuprofen (10 mg/kg child weight) or placebo was administered, followed by infiltrative anesthesia and restoration with resin composite. Hypersensitivity was evaluated in five moments. The data were analyzed using the chi-square test, Fisher's exact test, and t-test. RESULTS: Preemptive analgesia provided benefits for the treatment of severe cases of MIH, with an increase in the effectiveness of infiltrative anesthesia and improved patient comfort during the restorative procedure. CONCLUSION: Preemptive analgesia has shown efficacy in reducing hypersensitivity during restorative dental procedures, evidencing the significance of this study for patients with MIH and hypersensitivity.

Preemptive analgesia with ibuprofen increases anesthetic efficacy in children with severe molar hypomineralization: a triple-blind randomized clinical trial

Abstract Molar incisor hypomineralization (MIH) is often accompanied by dental hypersensitivity and difficulty in achieving effective analgesia. Objective: This study evaluated the effectiveness of preemptive analgesia in children with severe MIH, post-eruptive enamel breakdown, and hypersensitivity. Methodology: Ibuprofen (10 mg/kg child weight) or placebo was administered, followed by infiltrative anesthesia and restoration with resin composite. Hypersensitivity was evaluated in five moments. The data were analyzed using the chi-square test, Fisher's exact test, and t-test. Results: Preemptive analgesia provided benefits for the treatment of severe cases of MIH, with an increase in the effectiveness of infiltrative anesthesia and improved patient comfort during the restorative procedure. Conclusion: Preemptive analgesia has shown efficacy in reducing hypersensitivity during restorative dental procedures, evidencing the significance of this study for patients with MIH and hypersensitivity.

Visual Inspection and Toothbrush Care: A Mother-Baby Paired Cross-Sectional Study

ABSTRACT Objective To evaluate the physical conditions and presence of residues of toothbrushes used by mothers and their babies and mothers' knowledge about toothbrush care. Material and Methods This was a cross-sectional study comprising a convenience sample represented by 60 mother-baby pairs. The mothers answered a questionnaire to evaluate their knowledge of toothbrush care. A calibrated dentist performed a visual inspection of the toothbrushes. Statistical analysis was performed using the chi-square and Fisher's exact tests, with a significance level of 5%. Results It was found that 82% of the mothers had never received instructions regarding the care of toothbrushes after use (p=0.024). Most of them believed that their toothbrushes (70%) and their children's toothbrushes (88%) were in good condition to use (p=0.043). However, most mother's toothbrushes presented an unacceptable deformity of the bristles (65%) and the presence of residues (60%). In addition, babies' toothbrushes also presented unacceptable deformities of the bristles (52%) and residues (55%). There was an association between the lack of instructions received by the mother and the presence of deformity and residues on the mother's toothbrush bristles (p=0.037 and p=0.003, respectively). Conclusion Most mothers had never received instructions regarding toothbrush care, which is reflected in the condition of their and their baby's toothbrushes, which presented unacceptable physical conditions concerning deformation and presence of residues.

Sports mouthguards: Contamination, roughness, and chlorhexidine for disinfection - A randomized clinical trial

Abstract The aim of the present in vivo study was to evaluate the bacterial contamination of sports mouthguards, surface roughness, and the efficacy of chlorhexidine gluconate spray in the disinfection of these devices. A randomized, blinded cross-over clinical trial was performed with twenty 9 to 13 years old children who practiced martial arts and participated in all phases of the study. They were instructed to wear mouthguards 3 alternated days a week for 1 hour and, after use, to spray sterile tap water or chlorhexidine 0.12%. The mouthguards were analyzed by MTT assay, Checkerboard DNA-DNA hybridization, and confocal laser microscopy prior and after use for 2 weeks. Data were analyzed by Wilcoxon and t-Student, and Pearson correlation tests, with 5% significance level. Were observed that mouthguards of the control group were more contaminated with cariogenic microorganisms than those of the chlorhexidine group (p<0.05). The mouthguards use of spray of chlorhexidine reduced significantly the bacteria contamination compared with control group (p = 0.007). The surface roughness of the mouthguards increased significantly after use, irrespective of application of chlorhexidine spray. A moderate correlation (r=0.59) was observed between surface roughness and the cariogenic microorganism's contamination only for control group. Sports mouthguards had intense microbial contamination and increased surface roughness after its use. The use of chlorhexidine spray was effective for reducing the mouthguards contamination used by children.

Resumo O objetivo do presente estudo in vivo foi avaliar a contaminação bacteriana de protetores bucais esportivos, a rugosidade da superfície e a eficácia do spray de gluconato de clorexidina na desinfecção desses dispositivos. Um ensaio clínico randomizado, cego, cruzado foi realizado com vinte crianças de 9 a 13 anos, que praticavam artes marciais, participaram de todas as fases do estudo. As crianças foram orientadas a usar o protetor bucal por 3 dias alternados durante 1 hora e, após o uso, borrifar água de torneira estéril ou clorexidina 0,12%. Os protetores foram analisados por ensaio MTT, Hibridização DNA-DNA e microscopia confocal a laser antes e após o uso por 2 semanas. Os dados foram analisados pelos teste de Wilcoxon, teste t de Student, e correlação de Pearson, com nível de significância de 5%. Observou-se que os protetores bucais do grupo controle estavam mais contaminados com microrganismos cariogênicos do que os do grupo experimental (clorexidina) (p <0,05). O uso de protetores bucais com spray de clorexidina reduziu significativamente a contaminação bacteriana em relação ao grupo controle (p = 0,007). A rugosidade da superfície dos protetores bucais aumentou significativamente após o uso, independentemente da aplicação de spray de clorexidina. Uma correlação moderada (r = 0,59) foi observada entre a rugosidade da superfície e a contaminação do micro-organismo apenas para o grupo controle. Os protetores bucais esportivos apresentam intensa contaminação microbiana e aumento da rugosidade superficial após o uso. O uso de spray de clorexidina foi eficaz para reduzir a contaminação dos protetores bucais usados por crianças.

Síndrome da deleção 2q37.3 ­ A primeira descrição de achados orais, relato de caso / 2q37.3 delection syndrome ­ The first description of oral phenotype, a case repor

Introdução: A síndrome de deleção 2q37.3 é uma desordem causada pela microdeleção de uma subbanda no cromossomo 2, cuja epidemiologia é de aproximadamente 150 casos no mundo, e a incidência de 1:10000. As características da síndrome são: atraso no desenvolvimento, dismorfia facial, anormalidades musculoesqueléticas e aumento ao risco de doenças congênitas. O objetivo deste relato de caso é apresentar, pela primeira vez na literatura, os achados clínicos orais e dentários associados à síndrome. Relato de caso: As principais características físicas da síndrome foram identificadas na paciente durante o exame físico: lábio superior fino, columela proeminente e dobras epicânticas. No exame intraoral, relatou-se as características odontológicas, que podem estar associadas à síndrome: acúmulo de cálculo dental, hipomineralização e hipoplasia, mordida cruzada, mordida aberta, agenesias, taurodontia e cisto dentígero. O tratamento dental consistiu na aplicação de técnicas de manejo de comportamento, instrução de higiene oral e de dieta, profilaxia, raspagem supragengival, aplicação tópica de flúor, além da extração do segundo molar decíduo inferior. Este é o primeiro relato de características orais da síndrome de deleção 2q37.3 dando importância às características observadas nesta paciente. Tais achados também serão úteis na caracterização da síndrome, que é extremamente rara, podendo contribuir para o diagnóstico clínico desses pacientes, além de subsidiar o tratamento odontológico de outros indivíduos. Conclusão: Apresentamos os achados clínicos orais como hipomineralização e hipoplasia, mordida cruzada e aberta, agenesia, taurodontia e cisto dentígero presentes na paciente com a síndrome e sugerimos que o gene envolvido ou sua deleção possam ser responsáveis por tais achados.

Introduction: The 2q37.3 deletion syndrome is a disorder caused by the microdeletion of a subband on chromo-some 2, whose epidemiology is approximately 150 cases worldwide, and the prevalence of 1:10000. Its charac-teristics are developmental delay, facial dysmorphia, musculoskeletal abnormalities, and increased risk of congenital diseases. The purpose is to present, for the first time in the literature, the oral and dental clinical findings associated with the syndrome. Case report: The main physical characteristics of the syndrome were identified during the physical examination: thin upper lip, prominent columella, and epicanthic folds. In the intraoral examination, dental characteristics were reported, which may be associated with the syndrome: accumulation of dental calculus, hypomineralization and hypoplasia, crossbite, open bite, agenesis, taurodontism, and dentigerous cyst. The dental treatment consisted of the application of behavior management techniques, oral hygiene and diet instruction, prophylaxis, supragingival scraping, topical fluoride application, and extraction of the lower second molar. This is the first report of oral characteristics of the 2q37.3 deletion syndrome, giving importance to the characteristics observed in this patient. Such findings will be useful in the characterization of the syndrome, which is extremely rare, and may contribute to the clinical diagnosis of these patients, in addition to subsidizing the dental treatment of other individu-als. Conclusion: We present oral clinical findings such as hypomineralization and hypoplasia, crossed and an open bite, agenesis, taurodontism, and dentigerous cyst present in the patient with the syndrome and we suggest that the involved gene or its deletion may be responsible for such findings.

Múltiplas lesões dentárias em paciente com Síndrome de Lennox-Gastaut / Multiple dental lesions in a patient with Lennox-Gastaut Syndrome

Introdução: A Síndrome de Lennox-Gastaut (SLG) é uma encefalopatia epiléptica grave na infância. Seu tratamento é complexo, principalmente devido à multiplicidade das crises epilépticas, o que favorece à ocorrência de lesões dentais Objetivo: O objetivo deste relato é apresentar o manejo clínico de um paciente com SLG, vítima de traumas recorrentes, discutir os achados dentais observados e o tratamento odontológico realizado. Relato do caso: Paciente L.H.D.L., do sexo masculino, com 15 anos de idade, apresentando grande acúmulo de biofilme dental, alto risco de cárie, fluorose leve e gengivite generalizada. Clinicamente foi possível observar fratura de esmalte dos dentes 12 e 14. Os dentes 21, 22, 32 e 42 estavam ausentes clinicamente, o que se confirmou radiograficamente. Além disso, notou-se giroversão de 180 graus do dente 11, com a face palatina voltada para a vestibular. O dente apresentou-se com leve alteração de cor, mas com resposta positiva aos testes de vitalidade. Resultados: Técnicas de manejo de comportamental, foram adotadas e orientações quanto à higiene bucal e dietéticas foram fornecidas tanto ao paciente quanto ao seu cuidador. Quatro sessões de profilaxia e aplicação tópica de flúor foram realizadas semanalmente. O tratamento endodôntico foi realizado no dente 12, seguido da restauração de resina composta do dente 12 e 14 e a restauração estética do dente 11 (girovertido). Por fim, foi realizada uma prótese adesiva para restaurar a estética da região de incisivo central superior. Apesar das dificuldades para tratar pacientes com SLG, no presente caso foi possível obter resultados funcionais e estéticos satisfatórios com um diagnóstico e tratamento cuidadoso, envolvendo uma equipe multiprofissional treinada no atendimento de pacientes com necessidades especiais. Conclusão: Pode-se concluir que o cirurgião dentista deve estar familiarizado com as possíveis manifestações bucais da SLG e realizar uma pesquisa criteriosa de sinais de traumatismo dental e, sempre que possível, solicitar um exame radiográfico para que traumatismos não identificados ao exame clínico não passem desapercebidos.

Introduction: Lennox-Gastaut Syndrome (LSG) is a severe childhood epileptic encephalopathy. Its treatment is complex, mainly due to the multiplicity of epileptic crises, which in turn favors the occurrence of dental injuries. Objective: The aim of this case report is to present the clinical management of a patient with LGS, victim of recurrent trauma, discuss the observed dental findings and the dental treatment. Case report: Patient L.H.D.L., male, 15 years old presenting high quantity of oral biofilm, mild fluorosis and generalized gingivitis. Clinically, it was possible to observe enamel fractures of teeth 12 and 14. Teeth 21, 22, 32 and 42 were clinically absent, which was confirmed radiographically. In addition, a 180-degree rotation of tooth 11 was noted, with the palate facing the buccal aspect. The tooth presented a slight change in color, but with a positive response to vitality tests. Results: Behavioral management techniques were adopted and guidelines on oral hygiene and diet were provided to both the patient and their caregiver. Four sessions of prophylaxis and topical application of fluoride were performed weekly. Endodontic treatment was performed on tooth 12, followed by aesthetic restoration of teeth 12 and 14 and esthetic restoration of tooth 11 (rotated). Finally, an adhesive prosthesis was performed to restore the esthetics of the upper central incisor region. Despite the difficulties of treating patients with LGS, in the present case it was possible to obtain satisfactory functional and aesthetic results with a careful diagnosis and treatment, involving a multidisciplinary team trained in the care of patients with special needs. Conclusion: It can be concluded that the dental surgeon must be aware with the possible oral manifestations of GLS and carry out a careful search for signs of dental trauma and, whenever possible, request a radiographic examination so that unidentified traumas on clinical examination do not pass unnoticed.

Tratamento odontológico de paciente com Síndrome de Singleton-Merten / Dental treatment of a patient with Singleton-Merten Syndrome

Introdução: A Síndrome de Singleton-Merten (SMS) é uma doença autossômica dominante hereditária rara caracterizada por alterações cardiovasculares, ósseas e dentais, pouco discutida na literatura em relação ao tratamento odontológico. Objetivo: O objetivo do presente estudo foi relatar o caso de uma paciente com SMS, descrevendo seus aspectos bucais e o plano de tratamento proposto, em conjunto com uma equipe multiprofissional. Relato do caso: Durante a anamnese constatou-se que o paciente apresentava alterações cutâneas decorrentes da síndrome. Os exames clínico, radiográfico e tomográfico revelaram maxila e mandíbula parcialmente edêntulas, ampla reabsorção do osso maxilar, além da maioria dos dentes permanentes incluídos e com raízes curtas. O plano de tratamento multidisciplinar incluiu a extração de dentes com formação radicular deficiente, tração ortodôntica dos caninos superiores incluídos e a confecção de próteses parciais superiores e inferiores removíveis, para reabilitação das funções mastigatória, fonética e estética. Conclusão: É importante ressaltar que durante o atendimento odontológico de pacientes com SMS, deve-se considerar o estado geral de saúde anterior, principalmente em relação às possíveis complicações cardiovasculares existentes, e a necessidade de reabilitação destes pacientes, por apresentarem perda dentária extensa.

Intoduction: Singleton-Merten Syndrome (SMS) is a rare in herited autosomaldominant disorder. Characterized by cardiovascular, bone and dental alterations, little discussed in the literature regarding dental treatment. Objective: The aim of this study was to report the case of a patient with SMS, describing her oral aspects and the proposed treatment plan, together with a multidisciplinary team. Case report: During the anamnesis it was found that the patient has alterations due to the syndrome. Clinical, radiographic and tomographic examinations revealed partially edentulous maxilla and mandible, wide resorption of maxillary bone, in addition to most of the permanent teeth included and with short roots. The multidisciplinary treatment plan included the extraction of teeth with deficient root formation, orthodontic traction of the included upper canines and the making of removable upper and lower partial dentures, for rehabilitation of masticatory, phonetic and aesthetic functions. Conclusion: It is important to emphasize that during dental care of patients with SMS, the previous general state of health should be considered, especially in relation to possible existing cardiovascular complications, and the need for rehabilitation of these patients, since they will present extensive tooth loss.

Sports mouthguards: Contamination, roughness, and chlorhexidine for disinfection - A randomized clinical trial.

The aim of the present in vivo study was to evaluate the bacterial contamination of sports mouthguards, surface roughness, and the efficacy of chlorhexidine gluconate spray in the disinfection of these devices. A randomized, blinded cross-over clinical trial was performed with twenty 9 to 13 years old children who practiced martial arts and participated in all phases of the study. They were instructed to wear mouthguards 3 alternated days a week for 1 hour and, after use, to spray sterile tap water or chlorhexidine 0.12%. The mouthguards were analyzed by MTT assay, Checkerboard DNA-DNA hybridization, and confocal laser microscopy prior and after use for 2 weeks. Data were analyzed by Wilcoxon and t-Student, and Pearson correlation tests, with 5% significance level. Were observed that mouthguards of the control group were more contaminated with cariogenic microorganisms than those of the chlorhexidine group (p<0.05). The mouthguards use of spray of chlorhexidine reduced significantly the bacteria contamination compared with control group (p = 0.007). The surface roughness of the mouthguards increased significantly after use, irrespective of application of chlorhexidine spray. A moderate correlation (r=0.59) was observed between surface roughness and the cariogenic microorganism's contamination only for control group. Sports mouthguards had intense microbial contamination and increased surface roughness after its use. The use of chlorhexidine spray was effective for reducing the mouthguards contamination used by children.

Evaluation of microbial contamination and efficacy of antimicrobial agents in disinfection of handicapped patients' toothbrushes

This study aimed to evaluate the contamination of toothbrushes usedby patients with disabilities, by microbial culture and cariogenic biofilm formation,and to explore two methods of disinfection. Methods: Experimental procedures were divided into three stages, with the same interval between each stage. In the first stage, the patients brushed their teeth, rinsed them with water, and their toothbrushes were sprayed with sterilized tap water. In the second and third stages, the steps were similar to those of Stage I, except the toothbrushes were sprayed with 0.12% chlorhexidine and 0.05% cetylpyridinium chloride solutions, respectively. At the end of each stage, the toothbrush bristles were cultured in bacitracin sucrose broth (CaSaB) medium. Data were analyzed through Friedman's nonparametric test (5% significance level). Results: In Stage I, mutans group streptococci (MS) were present in 30 toothbrushes (76.9%), and the number of colonies/biofilms ranged from 0 to +100. In Stage II, no MS colonization was observed. In Stage III, only 10.2% of the toothbrushes were contaminated with MS, and the number of colonies/biofilms ranged from 1 to 31. Conclusion: Bristles of toothbrushes used by patients with disabilities became contaminated with MS after a single brushing. The 0.12% chlorhexidine solution eliminated all microorganisms from the bristles of the toothbrushes used by the patients. Both 0.12% gluconate chlorhexidine and 0.05% cetylpyridinium chloride spray solutions can effectively be used for toothbrush disinfection to reduce contamination.

Objetivo: O presente estudo teve como objetivo avaliar a contaminação de escovas de dente utilizadas por pacientes especiais, por meio de cultura microbiana e formação de biofilme cariogênico, explorando dois métodos de desinfecção. Métodos: O estudo foi dividido em três estágios, com o mesmo intervalo de tempo entre cada estágio. No primeiro estágio, os pacientes escovaram os dentes e enxaguaram com água, em seguida, suas escovas foram borrifadas com água destilada. No segundo e terceiro estágios, as etapas foram semelhantes às do estágio I, exceto que as escovas de dente foram borrifadas com soluções de clorexidina 0,12% e cloreto de cetilpiridínio 0,05%, respectivamente. Ao final de cada etapa, as cerdas das escovas de dente foram cultivadas em meio de Caldo Sacarose Bacitracina (CaSaB). Os dados foram analisados por meio do teste não paramétrico de Friedman (nível de significância de 5%). Resultados: No estágio I, os estreptococos do grupo mutans (EM) estavam presentes em 30 escovas de dente (76,9%), e o número de colônias / biofilmes variou de 0 a +100. No estágio II, nenhuma colonização por MS foi observada. No estágio III, apenas 10,2% das escovas de dente estavam contaminadas com MS, e o número de colônias / biofilmes variou de 1 a 31. Conclusão: As cerdas das escovas de dente utilizadas por pacientes especiais contaminaram-se com EM após uma única escovação. A solução de clorexidina 0,12% eliminou todos os microrganismos das cerdas das escovas de dente utilizadas pelos pacientes. Ambas as soluções em spray (gluconatode clorexidina 0,12% e cloreto de cetilpiridínio 0,05%) podem ser utilizadas com eficácia para desinfecção das escovas de dente para reduzir a contaminação.

Association between Genetic Polymorphisms in RANK, RANKL and OPG and Peri-Implant Diseases in Patients from the Amazon Region.

The present study evaluated polymorphisms in RANK, RANKL and OPG-encoding genes to assess whether they are associated with mucositis and peri-implantitis in a population from the Brazilian Amazon region. One hundred and fourteen patients with dental implants were included in the study. After clinical and radiographic examination, the sample was categorized into 4 groups, according to the peri-implant status: Healthy (n=71), Mucositis (n=30), Peri-implantitis (n=13) and Diseased (Mucositis + Peri-implantitis, n=43). Genomic DNA was extracted from buccal cells from saliva, and the genetic polymorphism in osteoprotegerin (OPG), Kappa nuclear factor activator receptor (RANKL) and nuclear kappa factor activator receptor (RANK) were genotyped by the real time PCR. Univariate and multivariate statistical analyses were performed to compare clinical variables among groups and to evaluate genotypes and alleles distributions and the established alpha was 5%. Age, peri-implant biotype, diabetes and presence of peri-implant biofilm were associated with mucositis (p<0.05) and peri-implantitis (p<0.05). Smoking, alcoholism, and periodontal biofilms were also associated with the presence of peri-implantitis (p<0.05). Univariate and multivariate analysis did not demonstrate an association of peri-implantitis or mucositis with any genetic polymorphism in RANK (rs3826620), RANKL (rs9594738) and OPG (rs2073618) (p>0.05). The studied genetic polymorphism in RANK, RANKL and OPG were not associated with mucositis and peri-implantitis in a Brazilian population from the Amazon region.