Multi-ancestry Genome-Wide Association Study of Early Childhood Caries.

Early childhood caries (ECC) is the most common non-communicable childhood disease. It is an important health problem with known environmental and social/behavioral influences that lacks evidence for specific associated genetic risk loci. To address this knowledge gap, we conducted a genome-wide association study of ECC in a multi-ancestry population of U.S. preschool-age children (n=6,103) participating in a community-based epidemiologic study of early childhood oral health. Calibrated examiners used ICDAS criteria to measure ECC with the primary trait using the dmfs index with decay classified as macroscopic enamel loss (ICDAS ≥3). We estimated heritability, concordance rates, and conducted genome-wide association analyses to estimate overall genetic effects; the effects stratified by sex, household water fluoride, and dietary sugar; and leveraged the combined gene/gene-environment effects using the 2-degree-of-freedom (2df) joint test. The common genetic variants explained 24% of the phenotypic variance (heritability) of the primary ECC trait and the concordance rate was higher with a higher degree of relatedness. We identified 21 novel non-overlapping genome-wide significant loci for ECC. Two loci, namely RP11-856F16 . 2 (rs74606067) and SLC41A3 (rs71327750) showed evidence of association with dental caries in external cohorts, namely the GLIDE consortium adult cohort (n=∼487,000) and the GLIDE pediatric cohort (n=19,000), respectively. The gene-based tests identified TAAR6 as a genome-wide significant gene. Implicated genes have relevant biological functions including roles in tooth development and taste. These novel associations expand the genomics knowledge base for this common childhood disease and underscore the importance of accounting for sex and pertinent environmental exposures in genetic investigations of oral health.

Adaptación transcultural y validez de un pictograma para evaluar necesidades de comunicación en adultos con vía aérea artificial en cuidados intensivos / Transcultural adaptation and validity of a pictogram to assess communication needs in adults with artificial airway in intensive care

Objetivo Realizar la adaptación transcultural y validez de un pictograma para evaluar necesidades de comunicación en adultos con vía aérea artificial en UCI en Cartagena, Colombia. Método Estudio de validación de escalas, población constituida por todos los pacientes que estuvieron hospitalizados en seis UCI de Cartagena, Colombia. La muestra fue conformada por 181 pacientes adultos con vía aérea artificial, y se determinó la adaptación al español (traducción, retro-traducción, revisión por expertos, versión pre-final, prueba piloto, versión final), la validez facial por acuerdo de expertos, la validez de contenido con el índice de Lawshe modificado por Tristán (punto de corte 0,58), el análisis de factor exploratorio (AFE) con la prueba de esfericidad de Barlett y gráfico de Catell, y la consistencia interna medida a través del estadístico alfa Cronbach. Resultados Participaron pacientes con edades entre 19 y 88años (media, 54±17); el 91,71% expresaron necesidades frecuentes de acompañamiento, conocer fecha y hora; el 61% de los expertos estuvieron de acuerdo con los ítems adaptados transculturalmente. El índice de validez de contenido (IVC) general fue de 0,86, con acuerdo en comprensión de once ítems. El AFE sugirió retener 13 reactivos y 3 factores (percepción/cognición, eliminación e intercambio, confort), que explican el constructo. La consistencia interna alfa de Cronbach fue de 0,64. Conclusiones El material pictográfico versión español mostró ser un instrumento multidimensional compuesto por 18 ítems agrupados en 3 factores, por lo que se recomienda aplicarlo al paciente con vía aérea artificial y establecer una comunicación como punto preliminar de los cuidados enfermeros. (AU)

Objective To perform the cross-cultural adaptation and validity of a pictogram to assess communication needs in adults with artificial airway in ICU in Cartagena, Colombia. Method Scale validation study, population comprising all the patients who were hospitalized in six ICU of Cartagena-Colombia. The sample was made up of 181 adult patients with artificial airway, the adaptation to Spanish was determined (translation, backtranslation, expert review, pre-final version, pilot test, final version), facial validity by expert agreement, content validity with the Lawshe index modified by Tristan (cut-off point 0.58), exploratory factor analysis (AFE) with the Bartlett's test of sphericity and Cattell's graph; internal consistency measured through the Cronbach alpha statistic. Results Patients between the ages of 19 and 88years participated (mean: 54±17); 91.71% expressed frequent needs for accompaniment, knowing date and time; 61% of the experts agreed with the cross-culturally adapted items, the overall Content Validity Index (CVI) was 0.86 with agreement in understanding eleven items. The AFE suggested retaining 13 items and 3 factors (perception/cognition, elimination and exchange, comfort), which explain the construct. The internal alpha Cronbach consistency was 0.64. Conclusions The pictographic material, Spanish version, was shown to be a multidimensional instrument composed of 18 items grouped in 3 factors. Therefore, it is recommended it be applied to the patient with artificial airway and to establish communication as a preliminary point of care in nursing. (AU)

Transcultural adaptation and validity of a pictogram to assess communication needs in adults with artificial airway in intensive care.

OBJECTIVE: To perform the cross-cultural adaptation and validity of a pictogram to assess communication needs in adults with artificial airway in ICU in Cartagena, Colombia. METHOD: Scale validation study, population comprising all the patients who were hospitalized in six ICU of Cartagena-Colombia. The sample was made up of 181 adult patients with artificial airway, the adaptation to Spanish was determined (translation, backtranslation, expert review, pre-final version, pilot test, final version), facial validity by expert agreement, content validity with the Lawshe index modified by Tristan (cut-off point 0.58), exploratory factor analysis (AFE) with the Bartlett's test of sphericity and Cattell's graph; internal consistency measured through the Cronbach alpha statistic. RESULTS: Patients between the ages of 19 and 88 years participated (mean = 54 ±â€¯17), 91.71% expressed frequent needs for accompaniment, knowing date and time; 61% of the experts agreed with the cross-culturally adapted items, the overall Content Validity Index (CVI) was 0.86 with agreement in understanding eleven items. The AFE suggested retaining 13 items and 3 factors (perception/cognition, elimination and exchange, comfort), which explain the construct. The internal alpha Cronbach consistency was 0.64. CONCLUSIONS: The pictographic material, Spanish version, was shown to be a multidimensional instrument composed of 18 items grouped in 3 factors. Therefore, it is recommended it be applied to the patient with artificial airway and to establish communication as a preliminary point of care in nursing.

Transcultural adaptation and validity of a pictogram to assess communication needs in adults with artificial airway in intensive care. / Adaptación transcultural y validez de un pictograma para evaluar necesidades de comunicación en adultos con vía aérea artificial en cuidados intensivos.

OBJECTIVE: To perform the cross-cultural adaptation and validity of a pictogram to assess communication needs in adults with artificial airway in ICU in Cartagena, Colombia. METHOD: Scale validation study, population comprising all the patients who were hospitalized in six ICU of Cartagena-Colombia. The sample was made up of 181 adult patients with artificial airway, the adaptation to Spanish was determined (translation, backtranslation, expert review, pre-final version, pilot test, final version), facial validity by expert agreement, content validity with the Lawshe index modified by Tristan (cut-off point 0.58), exploratory factor analysis (AFE) with the Bartlett's test of sphericity and Cattell's graph; internal consistency measured through the Cronbach alpha statistic. RESULTS: Patients between the ages of 19 and 88years participated (mean: 54±17); 91.71% expressed frequent needs for accompaniment, knowing date and time; 61% of the experts agreed with the cross-culturally adapted items, the overall Content Validity Index (CVI) was 0.86 with agreement in understanding eleven items. The AFE suggested retaining 13 items and 3 factors (perception/cognition, elimination and exchange, comfort), which explain the construct. The internal alpha Cronbach consistency was 0.64. CONCLUSIONS: The pictographic material, Spanish version, was shown to be a multidimensional instrument composed of 18 items grouped in 3 factors. Therefore, it is recommended it be applied to the patient with artificial airway and to establish communication as a preliminary point of care in nursing.

Metabolomics Insights in Early Childhood Caries.

Dental caries is characterized by a dysbiotic shift at the biofilm-tooth surface interface, yet comprehensive biochemical characterizations of the biofilm are scant. We used metabolomics to identify biochemical features of the supragingival biofilm associated with early childhood caries (ECC) prevalence and severity. The study's analytical sample comprised 289 children ages 3 to 5 (51% with ECC) who attended public preschools in North Carolina and were enrolled in a community-based cross-sectional study of early childhood oral health. Clinical examinations were conducted by calibrated examiners in community locations using International Caries Detection and Classification System (ICDAS) criteria. Supragingival plaque collected from the facial/buccal surfaces of all primary teeth in the upper-left quadrant was analyzed using ultra-performance liquid chromatography-tandem mass spectrometry. Associations between individual metabolites and 18 clinical traits (based on different ECC definitions and sets of tooth surfaces) were quantified using Brownian distance correlations (dCor) and linear regression modeling of log2-transformed values, applying a false discovery rate multiple testing correction. A tree-based pipeline optimization tool (TPOT)-machine learning process was used to identify the best-fitting ECC classification metabolite model. There were 503 named metabolites identified, including microbial, host, and exogenous biochemicals. Most significant ECC-metabolite associations were positive (i.e., upregulations/enrichments). The localized ECC case definition (ICDAS ≥1 caries experience within the surfaces from which plaque was collected) had the strongest correlation with the metabolome (dCor P = 8 × 10-3). Sixteen metabolites were significantly associated with ECC after multiple testing correction, including fucose (P = 3.0 × 10-6) and N-acetylneuraminate (p = 6.8 × 10-6) with higher ECC prevalence, as well as catechin (P = 4.7 × 10-6) and epicatechin (P = 2.9 × 10-6) with lower. Catechin, epicatechin, imidazole propionate, fucose, 9,10-DiHOME, and N-acetylneuraminate were among the top 15 metabolites in terms of ECC classification importance in the automated TPOT model. These supragingival biofilm metabolite findings provide novel insights in ECC biology and can serve as the basis for the development of measures of disease activity or risk assessment.

Expresión del gen esp (enterococcus surface protein) de enterococcus faecalis en un modelo in vitro de dientes extraídos / Gene expression esp (enterococcus surface protein) of enterococcus faecalis in an in vitro model of extracted teeth

Objetivo: Determinar la presencia y expresión del gen esp en cepas clínicas de Enterococcus faecalis a partir de un modelo in vitro de dientes extraídos. Métodos: Se diseñó un sistema in vitro para evaluar la formación del biofilm mediante microscopía de fluorescencia y la expresión del gen esp. El sistema estuvo constituido por un diente humano previamente extraído, cortado y preparado que proporcionó, mediante su conducto radicular, una superficie adecuada para la formación del biofilm por parte de E. faecalis. El sistema dispuso de una cámara anaerobia que permitió el crecimiento de la bacteria en el caldo de cultivo y evitó su contaminación con otros microorganismos. Esta cámara estuvo constituida por un tubo de micro centrifuga estéril, cortado y unido por el extremo inferior al extremo apical del diente seccionado. Resultados: Los resultados que se obtuvieron tanto por microscopia de fluorescencia como por RT-PCR permitieron cuantificar el nivel de expresión del gen esp en las bacterias durante su crecimiento y formando el biofilm en la superficie de los conductos radiculares. Todas las cepas evaluadas presentan el gen esp. Sin embargo, el biofilm de la cepa CC02 expresó el gen esp cuatro veces más en comparación al gen esp de la cepa de referencia. Conclusión: La expresión del gen esp podría estar asociada con la formación de biofilm en E. faecalis y la adherencia a superficies abióticas. Podría convertirse en una diana terapéutica prometedora en los programas de control de infecciones persistentes por Enterococcus spp. asociados a la presencia de biofilm (AU)

Objective: To determine the presence and expression of Enterococcus faecalis Esp gene in several strains from an in vitro model on extracted teeth. Methods: An in vitro system was designed to evaluate the biofilm formation through fluorescence microscopy and gene expression that could be associated to biofilm formation. The system consisted of a previously extracted human tooth that was cut and prepared to provide by means of its root canal, an adequate surface for biofilm formation on behalf of Enterococcus faecalis. The system disposed an anaerobe chamber that allowed the growth of bacteria in broth culture and avoided contamination with other microorganisms. This chamber consisted of a sterile micro centrifuge tube, which was cut and united by its inferior end to the apical end of the sectioned tooth. Results: The results obtained with fluorescence microscopy and RT-PCR allowed the quantification of the Esp gene levels of expression in bacteria growing and forming biofilm in root canal surfaces. Conclusion: The expression of Esp gene is associated with biofilm formation in E. faecalis and in the adherence to abiotic surfaces. It could be a promising therapeutic target in control programs for the eradication of persistent infections associated with the presence of E faecalis in biofilm (AU)

Comparación histomorfométrica in vitro del ligamento periodontal de premolares extraídos mantenidos en cuatro medios de conservación / In vitro histomorphometric comparison of periodontal ligament of extracted premolar teeth preserved in different media storage

OBJETIVO: El propósito de este estudio fue evaluar histológica y morfométricamente los resultados de diferentes tipos de medios de almacenamiento para los dientes avulsionados en el mantenimiento de la preservación de la integridad del ligamento periodontal. MATERIAL Y MÉTODOS: Estudio de tipo experimental de laboratorio, se utilizaron veintitrés premolares extraídos por motivos ortodóncicos. Los medios de conservación evaluados fueron: leche tipo "B" y tipo "C", solución salina y medio seco. Un total de cinco dientes fueron almacenados en cada uno de los medios de conservación durante 120 minutos. Otros tres dientes sirvieron como controles fijados inmediatamente después de la extracción representando el ligamento periodontal íntegro. Los dientes se fijaron, procesaron y tiñeron con hematoxilina y eosina para evaluación histológica a través de microscopia óptica. RESULTADOS: La edad de los pacientes que aportaron los dientes osciló entre 13 a 17 años. Los resultados de la evaluación cualitativa mostraron que la solución fisiológica fue el medio de almacenamiento más adecuado seguido de la leche tipo C y tipo B. En el análisis estadístico no hubo diferencia estadísticamente significativa entre los grupos de solución fisiológica y leche tipo C. Después de 120 minutos se encontraron diferencias estadísticamente significativas entre las alteraciones histomorfométricas del grupo control y los grupos de dientes que se mantuvieron en condiciones de humedad y los secos. CONCLUSIÓN: Dados los resultados de este estudio, la solución salina (grupo II) y la leche tipo C(Grupo III) pueden considerarse como las formas de conservación más adecuadas de los dientes avulsionados

OBJECTIVE: The aim of this study was to histologically and morphometrically evaluate the results of different types of storage media for avulsed teeth in the maintenance and preserving the integrity of the periodontal ligament. MATERIAL AND METHODS: Experimental study. It was used twenty-three extracted premolars for orthodontic reasons. Preserving methods evaluated were: type "B" and "C" milk, saline and dry environment. A total of five teeth were stored in each storage media for 120 minutes. Three teeth served as controls fixed immediately after extraction representing the entire periodontal ligament. The teeth were fixed, processed and stained with hematoxylin/eosin for histological evaluation by light microscopy. RESULTS: The age of the patients who provided the teeth ranged from 13-17 years. The results of the qualitative assessment showed that saline was the most appropriate storage medium, followed by milk type C and type B. In the statistical analysis there was no statistically significant difference between saline and type C milk. After 120 minutes it was found statistically significant differences between histomorphometric changes in the control group and groups of teeth that were kept in wet conditions and dry. CONCLUSION: Given the results of this study, saline (group II) and milk type C (Group III) can be considered as the most suitable form of storage of avulsed teeth

Proteínas expresadas durante la periodontitis crónica. Revisión de la literatura / Expression of proteins in chronic periodontitis. Literature review

La periodontitis resulta en un daño tisular complejo en las estructuras de soporte dentario debido al efecto de la respuesta inmune. Sin embargo, la naturaleza de los componentes de este proceso son interés de muchos investigadores y se determinaron a través de estudios experimentales algunas moléculas de carácter proteínico que activan y/o regulan otras sustancias y/o células para el desarrollo de la lesión. El objetivo de esta revisión de literatura es conducir un análisis crítico de la evidencia disponible sobre las proteínas expresadas durante la periodontitis crónica y su correlación con los cambios clínicos producidos en las lesiones. Se identificaron las publicaciones más relevantes a través de una búsqueda en bases de datos electrónicas como MEDLINE, EBSCO-HOST y "The Cochrane Database of Systematic Reviews". Para ser incluidos en la revisión, los estudios debieron definir la proteína investigada, en pacientes con periodontitiscrónica. Los experimentos que investigaban proteínas expresadas en gingivitis y tumores fueron excluidos. De los 1210 artículos obtenidos en la fase inicial de la revisión, sólo 175 estaban disponibles en full text y de éstos sólo cumplieron los requisitos de inclusión 25 artículos, los cuales fueron confrontados, analizados y discutidos posteriormente. La evidencia disponible demuestra que las proteínas juegan un papel importante en la transducción de señales y que utilizan diversas vías para activar compuestos químicos y así contribuir al desarrollo de lesiones periodontales crónicas (AU)

Periodontitis is a complex tissue damage to the supporting structures of teeth due to the effect of the immune response. However, the nature of the components of this process are of interest to many researchers and were determined through experimental studies of some molecules that activate a protein or regulating other substances and cells for the development of the lesion. The aim of this literature review is to conduct a critical analysis of available evidence on the expressed proteins inchronic periodontitis and its clinical correlation with the changes produced in the lesions. We identified relevant publications through a search of electronic databases such as MEDLINE, EBSCOHOST, and The Cochrane Database of Systematic Reviews. The search was conducted by two of the authors. To be included in the review, studies had to define the protein investigated in patients with chronic periodontitis. Experiments investigating protein expressed in gingivitis and tumors were excluded. Of the 1210 articles retrieved from the initial phase of the review, only 175 were available (..) (AU)

Mineral trióxido agregado en pulpotomías de dientes primarios. Revisión de la literatura / Mineral trioxide aggregate in primary teeth pulpotomy. Literature review

Introducción: la odontología basada en la evidencia supone una evaluación, crítica, de la evidencia disponible para mejorar la toma de decisiones en relación con el cuidado individual de los pacientes y/o comunidades. Objetivo: analizar la literatura científica disponible sobre los resultados clínicos y radiográficos de cuatro materiales empleados en pulpotomías en la dentición temporal: formocresol, sulfato férrico, hidróxido de calcio, mineraltrióxido agregado. Materiales y métodos: se identificaron las publicaciones más relevantes a través de una búsqueda en bases de datos electrónicas como MEDLINE (Ovid) y “The Cochrane Library”. Para ser incluidos en la revisión, los estudios debieron definir el material utilizado, en pacientes niños con exposición pulpar por caries o trauma dentoalveolar. Resultados: de los 21 artículos obtenidos en la fase inicial de la revisión, sólo 19 estaban disponibles en texto completo y de éstos sólo cumplieron los requisitos de inclusión 6 artículos, los cuales fueron confrontados, analizados y discutidos posteriormente. Conclusiones: la evidencia disponible demuestra que no existen diferencias clínicas en cuanto a la utilización de un material u otro, sin embargo se deben tener en cuenta otras variables como factores económicos y edad del paciente para la correcta terapéutica (AU)

Introduction: evidence-based dentistry is a critical evaluation, raise awareness of the available evidence to improve decision making about the care of individual patients and / or communities. Objective: to analyze the available scientific literature on clinical and radiographic outcomes of two materials used in pulpotomy inprimary teeth: formocresol and mineral trioxide aggregate. Materials and methods: it was identified relevant publications through a search of electronic databases such as MEDLINE (Ovid) and The Cochrane Library. To be included in the review, studies had to define the material used in child patients with pulp exposure by caries or tooth-alveolar trauma. Results: of the 21 items obtained in the initial phase of the review, only 19 were available in full text and of these only met the requirements for inclusion 6 items, which were confronted, analyzed and discussed later. Conclusions: the available evidence shows that there are no clinical differences regarding the use of a material or another, but must take into account other variables such as economic factors and patient age for proper treatment (AU)