Efeito remineralizador da caseína fosfato de cálcio fosfopeptídeo amorfo em dentes decíduos e permanentes in vivo / Remineralizing effect of casein fosfopeptideo amorphous calcium phosphate in primary and permanent teeth in vivo

O presente estudo in vivo avaliou o efeito remineralizador da caseína fosfato de cálcio fosfopeptídeo amorfo (CPP-ACP) tooth mousse em lesões de mancha branca em dentes decíduos e permanentes. Dezoito crianças de 4 a 8 anos apresentaram 81 lesões de mancha branca, as quais foram divididas de maneira randômica. Estas foram tratadas com verniz de flúor 2,26% (controle) e CPP-ACP mousse (teste), duas vezes por semana, durante seis e quatro semanas, respectivamente. Um examinador cego avaliou as lesões de mancha branca no período inicial (T0) e após 3 (T1) e 12 (T2) semanas de tratamento. Os dados de índice de placa visível, índice de sangramento gengival, índice ICDAS foram coletados. Em adição, foram realizadas tomadas fotográficas das lesões em todos os períodos analisados. Os dados foram analisados por testes qui-quadrado e t de Student. Resultados não demonstraram diferença entre os grupos controle e teste durante os períodos, a partir do índice ICDAS (p>0,05). No entanto, a partir do mesmo índice, o grupo teste demonstrou diferença significante entre os períodos analisados (p<0,05). A área das manchas brancas, em pixels, dos grupos controle e teste não demonstrou diferença estatística de cada grupo, em qualquer dos períodos analisados (p>0,05). Dessa forma, concluiu- se que a terapia de remineralização de lesões de manchas brancas foi efetiva em ambos os grupos. No entanto, devido ao número amostral reduzido e o curto período de análise do presente estudo, são necessários maiores esclarecimentos em relação a este efeito.

This in vivo study was conducted to evaluate the remineralization effects of CPP-ACP Tooth Mousse on white-spot lesion in primary and permanent teeth. Eighteen children (age from 4-8) exhibiting 81 white-spot lesions sites were randomly divided into two different treatments protocols: test group received applications of the remineralizing mousse twice a week for six weeks; control group received applications of a 2.26% fluoridated coating once a week for four weeks. A blind examiner evaluated the children at baseline, 3 and 12 weeks after the first visit, recorded visible plaque, gingival bleeding, ICDAS index and photographed the lesions. Data was analyzed with chi-square and Student t-test. According to ICDAS index, the control group was not statistically different from the treated group (p>0.05), in each time. However, results from treated group demonstrated that ICDAS index was statistically different from times (p<0.05). The area of the white spots (in pixels) of samples from control and treated groups were not statistically different from each group in any time (p>0.05). It was concluded that the remineralizing therapy of white spot lesions was efficient in the two groups. Nevertheless, due to the small sample size and the brief time for conducting the study, new research is necessary to increase the findings.

Analysis of factors associated with orthodontic microscrew failure.

The objective of this study was to examine whether factors such as insertion site, patient's facial pattern, microscrew features, type of tooth movement desired, level of experience handling orthodontic microscrews and operator expertise were associated with failure of microscrews. After the approval of an ethics committee, 166 patients of one practice signed an informed consent and received 293 microscrews randomly distributed by 3 operators with different levels of practical experience and expertise in handling microscrews. The microscrews were observed in a period of 365 days or as long as orthodontic forces had to be applied and independent variables were recorded. Analysis by the chi-square test did not produce enough evidence as to allow the assertion that there was an association between the variable "failure" and the variables "maxilla" (p=0.4775), "face" (p=0.1081), "facial pattern" (p=0.7522), "microscrew length" (p=0.9113), "desired movement" (p=0.0584), and "operator" (p=0.5785). The variable "insertion side" was significantly associated with "failure" (p=0.0022). In a 365-day survival analysis, the Log Rank test yielded a p-value of 0.00178 for the curve of variable "insertion side," and showed no significant differences for other variables. With a total success rate of 87.38%, the only variable found to be significant was "insertion side" (p=0.0022), with 3.088 more likelihood of a microscrew failing if placed on the left side than on the right side. The procedure of inserting microscrews involved a rapid learning curve for an inexperienced operator, which justifies their placement by orthodontists.

Analysis of Factors Associated with Orthodontic Microscrew Failure

The objective of this study was to examine whether factors such as insertion site, patient's facial pattern, microscrew features, type of tooth movement desired, level of experience handling orthodontic microscrews and operator expertise were associated with failure of microscrews. After the approval of an ethics committee, 166 patients of one practice signed an informed consent and received 293 microscrews randomly distributed by 3 operators with different levels of practical experience and expertise in handling microscrews. The microscrews were observed in a period of 365 days or as long as orthodontic forces had to be applied and independent variables were recorded. Analysis by the chi-square test did not produce enough evidence as to allow the assertion that there was an association between the variable "failure" and the variables "maxilla" (p=0.4775), "face" (p=0.1081), "facial pattern" (p=0.7522), "microscrew length" (p=0.9113), "desired movement" (p=0.0584), and "operator" (p=0.5785). The variable "insertion side" was significantly associated with "failure" (p=0.0022). In a 365-day survival analysis, the Log Rank test yielded a p-value of 0.00178 for the curve of variable "insertion side," and showed no significant differences for other variables. With a total success rate of 87.38%, the only variable found to be significant was "insertion side" (p=0.0022), with 3.088 more likelihood of a microscrew failing if placed on the left side than on the right side. The procedure of inserting microscrews involved a rapid learning curve for an inexperienced operator, which justifies their placement by orthodontists.

O objetivo deste estudo foi examinar se fatores como sítio de inserção, padrão facial do paciente, características do microparafuso, tipo de movimento dental desejado, nível de experiência com microparafusos e expertise do operador têm associação com o insucesso de microparafusos. Após a aprovação em um comitê de ética, 166 pacientes de uma clínica assinaram um consentimento informado e receberam 293 microparafusos aleatoriamente distribuídos entre 3 operadores com diferentes níveis de experiência prática e expertise no manuseio de microparafusos. Os microparafusos foram observados por um período de 365 dias ou pelo tempo necessário de aplicação de forças ortodônticas e as variáveis independentes foram registradas. Análise do teste de qui-quadrado não produziu evidência suficiente para afirmar que existe associação entre a variável "insucesso" e as variáveis "maxila" (p=0,4775), "face" (p=0,1081), "padrão facial" (p=0,7522), "comprimento do microparafuso" (p=0,9113), "movimento desejado" (p=0,0584), e "operator" (p=0,5785). A variável "lado de inserção" foi significantemente associada a "insucesso" (p=0,0022). Em uma análise de sobrevivência de 365 dias, o teste Log Rank resultou em um p-valor de 0,00178 para a curva da variável "lado de inserção" e não mostrou evidência suficiente para as outras variáveis. Com um sucesso total de 87,38%, a única variável significante encontrada foi "lado de inserção" (p=0,0022), com uma chance 3,088 vezes maior de se perder o microparafuso instalado do lado esquerdo do que do lado direito. O procedimento de inserção dos microparafusos envolveu uma rápida curva de aprendizado para um operador inexperiente, o que justifica sua instalação pelos ortodontistas.

Quality of life of children with sleep-disordered breathing after rapid maxillary expansion: assessment by Osa-18 / Qualidade de vida de crianças com distúrbios respiratórios do sono após expansão rápida da maxila: avaliação pelo Osa -18

Objective: This study assessed the quality of life of children with sleep-disordered breathing before and after rapid maxillary expansion. Methods: A prospective clinical study was done at the University of Brasilia with a sample of 22 children aged 4 to 10 years who complained ofdifficulty breathing during sleep, snoring, restless sleep and obstructive sleep apnea. Questionnaire administration, clinical tests, nasal endoscopy, and CT scans of the head and neck were done before and after rapid maxillary expansion. The Wilcoxon and chi-square tests, analysis of variance (ANOVA) and odds ratio were used for the statistical analyses.Results: The quality of life scores improved significantly. The total OSA-18 score decreased from 90.95 at baseline to 46.68 after rapid maxillaryexpansion. The mean quality of life score increased from 4.5 ± 1.7 to 7.9 ± 1.4, showing a significant improvement in the quality of life of thestudy children, regardless of the degree of airway obstruction or amount of expansion achieved. All study children complained of snoring, and68.2% snored every night. After expansion, 36.4% stopped snoring. Additionally, complaints of apnea fell by 77.3%. Conclusion: Children with sleep-disordered breathing have a poor quality of life mainly because of physical symptoms and sleep disturbances. The quality of life of these children improved significantly after rapid maxillary expansion, regardless of the degree of airway obstruction.

Objetivo: Avaliar a qualidade vida de crianças com distúrbios respiratórios do sono antes e após Expansão Rápida da Maxila. Métodos: Estudo clínico prospectivo realizado na Universidade de Brasília. A amostra contou com 22 crianças de 4 a 10 anos de idade, com queixas de dificuldade respiratória durante o sono, ronco, sono agitado e apneia obstrutiva do sono. A aplicação dos questionários, os exames clínicos, as tomografias computadorizadas da cabeça e pescoço e as nasofibroscopias foram realizadas antes e depois da Expansão Rápida da Maxila. Os testes Wilcoxon e o qui-quadrado, a análise de variância (ANOVA) e o cálculo da odds ratio foram utilizados para a análise estatística. Resultados: Houve mudança significativa nos escores de qualidade de vida em todas as comparações dos valores médios, que variaram de 90,95 inicialmentea 46,68 após a Expansão Rápida da Maxila. A média da nota global, na escala visual, aumentou de 4,5 ± 1,7 para 7,9 ± 1,4, demonstrandosignificativa melhora na qualidade de vida das crianças, independente do grau de obstrução adenotonsilar e da quantidade de expansão obtida. Cem por cento da amostra apresentavam queixas de ronco, 68,2% roncavam todas as noites e, após a Expansão Rápida da Maxila, 36,4% não roncavam mais. Já as queixas de apneia diminuíram em 77,3% dos casos. Conclusão: As crianças com distúrbios respiratórios do sono apresentam baixa qualidade de vida principalmente pelo sofrimento físico e perturbações do sono. A qualidade de vida destas crianças melhora consideravelmente após a expansão rápida da maxila, independente do grau de obstrução respiratória.

Prevalence of enamel defects and associated risk factors in both dentitions in preterm and full term born children.

OBJECTIVES: The aim of this study was to evaluate the prevalence of enamel defects and their risk factors on primary and permanent dentitions of prematurely born children and full-term born children born at Regional Hospital of Asa Sul, Brasília, DF, Brazil. MATERIAL AND METHODS: Eighty 5-10-year-old children of both genders were examined, being 40 born prematurely (G1) and 40 born full term (G2). The demographic variables, medical history and oral health behaviors were retrieved using a questionnaire and data obtained from clinical examination were recorded. The teeth were examined and the presence of enamel defects was diagnosed according to the DDE Index and registered in odontograms. Subsequently, the defects were categorized in four groups according to one of the criteria proposed in 1992 by the FDI Commission on Oral Health, Research and Epidemiology. Kruskal-Wallis, Chi-square, Kappa, Mann-Whitney tests and logistic regression were used for statistical analysis. RESULTS: 75% of total sample had enamel defects. There was a major prevalence of hypoplasia of the enamel in G1 (p<0.001). There was a significant relationship between low weight and presence of the imperfections on the enamel in G1 on the primary dentition. The logistic regression model showed that the other risk factors such as monthly per capita family income, educational level, dietary and hygiene habits, fluoride exposure, trauma, and diseases were not associated with enamel defects and caries. CONCLUSIONS: Pre-term labor can be a predisposing factor for the presence of the enamel hypoplasia in the primary dentition.

Prevalence of enamel defects and associated risk factors in both dentitions in preterm and full term born children

OBJECTIVES: The aim of this study was to evaluate the prevalence of enamel defects and their risk factors on primary and permanent dentitions of prematurely born children and full-term born children born at Regional Hospital of Asa Sul, Brasília, DF, Brazil. MATERIAL AND METHODS: Eighty 5-10-year-old children of both genders were examined, being 40 born prematurely (G1) and 40 born full term (G2). The demographic variables, medical history and oral health behaviors were retrieved using a questionnaire and data obtained from clinical examination were recorded. The teeth were examined and the presence of enamel defects was diagnosed according to the DDE Index and registered in odontograms. Subsequently, the defects were categorized in four groups according to one of the criteria proposed in 1992 by the FDI Commission on Oral Health, Research and Epidemiology. Kruskal-Wallis, Chi-square, Kappa, Mann-Whitney tests and logistic regression were used for statistical analysis. RESULTS: 75% of total sample had enamel defects. There was a major prevalence of hypoplasia of the enamel in G1 (p<0.001). There was a significant relationship between low weight and presence of the imperfections on the enamel in G1 on the primary dentition. The logistic regression model showed that the other risk factors such as monthly per capita family income, educational level, dietary and hygiene habits, fluoride exposure, trauma, and diseases were not associated with enamel defects and caries. CONCLUSIONS: Pre-term labor can be a predisposing factor for the presence of the enamel hypoplasia in the primary dentition.

Transverse measurements of the jaws of patients with a predominance of nose and mouth breathing in children between 6 and 14 years of age / Medidas transversais dos maxilares de pacientes com predominância de respiração nasal e bucal em crianças de 6 a 14 anos

Objectives: To determine and study the occurrence of possible growth and development anomalies of the craniofacial complex in patients aged between 6 and 14, diagnosed with predominantly mouth and nose breathing patterns, and without having received prior dental treatment. Methods: We performed transverse jaw measurements on 103 patients between 6 and 14 years of age, registered for orthodontic treatment in theMilitary Hospital in the Brasilia area. Divided into two groups: Group 1, patients with predominance of nose breathing and Group 2, patientswith predominance of mouth breathing. Results: There were no statistically significant differences between the upper and lower intercanine or upper intermolar distances, between groups 1 and 2. A smaller statistically significant difference was observed in group 2 when evaluating the lower intermolar distance. Conclusion: The group of mouth breathers showed statistically lower values in the lower jaw, thus suggesting a contraction in the posterior arch of patients diagnosed with this breathing pattern.

Objetivos: Verificar e estudar a ocorrência de possíveis anomalias de crescimento e desenvolvimento do complexo craniofacial, de pacientes diagnosticados com o padrão de respiração predominante bucal e nasal, na faixa etária de 6 a 14 anos de idade, sem tratamento ortodôntico prévio.Métodos: Foram realizadas as medidas transversais maxilares em 103 pacientes na faixa etária dos 6 a 14 anos de idade, inscritos para tratamento ortodôntico no Hospital Militar de Área de Brasília. Divididos em dois grupos: 1 pacientes com predominância de respiração nasal e 2 pacientes com predominância de respiração bucal. Resultados: Não foram observadas diferenças estatisticamente significativas entre as distâncias inter-caninos superior e inferior, inter-molares superior, entre os grupos 1 e 2. Foi observada diferença estatisticamente significativa menor no grupo 2 quando avaliada a distância inter-molar inferior. Conclusão: O grupo de pacientes respiradores bucais apresentou valores estatisticamente menores na arcada inferior, sugerindo desta forma uma contração posterior na arcada dos pacientes diagnosticados com este padrão de respiração.

Etiology and treatment of anterior open bite / Etiologia e tratamento da mordida aberta anterior

The term anterior open bite, which means no contact between anterior teeth, stands out in current orthodontic by the complexity of the treatment, associated with high levels of instability and recurrence. The purpose of this study is to emphasize that early etiological diagnosis is essential to the successful outcome of the technical intervention. The bibliographical study shows that, once the malocclusion in deciduous and mixed dentition is diagnosed, it simplifies the aparatology that is used, decreases the treatment time and conditions are created for a possible self-correction. In the permanent dentition, the authors recommend the removal of the etiological factor and the control of the vertical growth. The diversity of causes requires a multidisciplinary therapeutic approach.

A expressão mordida aberta anterior, que designa ausência de contato entre os dentes anteriores, destaca-se na ortodontia atual pela complexidade do tratamento, associada a altos níveis de instabilidade e recidiva. O objetivo deste trabalho é enfatizar que o diagnóstico etiológico precoce é fundamental para o bom resultado da intervenção técnica. O estudo bibliográfico mostra que, diagnosticada a maloclusão na dentadura decídua e mista, simplifica-se a aparatologia utilizada, diminui-se o tempo de tratamento e criam-se condições para uma possível autocorreção. Na dentadura permanente, os autores recomendam a remoção do fator etiológico e o controle do crescimento vertical. A diversidade de causas requer abordagem terapêutica multidisciplinar.

Candida albicans de cavidade oral de crianças com Síndrome de Down: prevalência e suscetibilidade in vitro a drogas antifúngicas pelo método de fitas de E-test® / Buccal Candida albicans in children with Down's syndrome: prevalence and in vitro susceptibility to antifungal drugsby E-test® ribbons method

The anatomo-physiological alterations of the mouth of children with Down's syndrome favor the proliferation of adiversified microbiota. This study aimed to verify the occurrence of Candida in buccal mucosa of children with Down's syndrome, from April/2006 to July/2007, and to detect the in vitro susceptibility to antifungal drugs by E-test® ribbons method. C. albicans wasthe only species of Candida identified in thirty five children with Down's syndrome (87.5%) and in 10 children of the control group (12.5%). All C. albicans have shown in vitro sensitive to the antifungals employed, especially the polyene drugs with the smallestminimum inhibitory concentrations.

As alterações anatomofisiológicas da cavidade oral de crianças com Síndrome de Down favorecem a proliferação de uma diversificada microbiota. Este estudo objetivou verificar a ocorrência de Candida na mucosa bucal de crianças com Síndrome de Down, no período de abril/2006 a julho/2007, e detectar a suscetibilidade in vitro a drogas antifúngicas pelo método de fitas de E-test. C. albicans foi a única espécie de Candida identificada em trinta e cinco (87,5%) crianças com Síndrome de Down e em 10 (12,5%) crianças do grupo controle. Todas as C. albicans mostraram-se sensíveis in vitro aos antifúngicos empregados, especialmente as drogas poliênicas com as menores concentrações inibitórias mínimas .

Comparative isolation protocols and characterization of stem cells from human primary and permanent teeth pulp

Aim: This study was developed to compare the morphological, proliferative and immunophenotypic profiles of pulp cells from permanent and primary teeth, obtained by two isolation methods. Methods: Normal human impacted third molars and exfoliated primary teeth were collected and cut around the cementoenamel junction. Pulp cells cultures were established by two approaches: enzyme digestion (3 mg/mL type I colagenase and 4 mg/mL dispase), or culture of the tissue explants in cell culture dishes. Morphological and proliferative analyses, as well as immunophenotype characterization with monoclonal antibodies against CD117, CD34 and CD45 surface receptors were performed. Results: For the permanent teeth, on the 4th day of culture, the cell number was significantly higher for the outgrowth method. By the end of the studied period (14th day), the enzymatic method was more efficient in promoting culture growth. On the other hand, for primary teeth, enzymatic digestion always promoted a higher cell proliferation. The immunophenotypic profiles were CD117+/ CD34-/ CD45- and CD117+/ CD34+/ CD45- for cells from permanent and primary teeth, respectively. Conclusions: The findings of this study indicate that both isolation methods can be efficiently used. The cell population displayed an immunophenotype compatible to the one of stem cells, with remarkable positive expression of CD117.

Immunohistochemical expression of vascular endothelial growth factor and matrix metalloproteinase-9 in radicular and residual radicular cysts

OBJECTIVE: This study assessed and compared the immunoexpression of vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9) in radicular cysts (RCs) and residual radicular cysts (RRCs), relating them to the angiogenic index and the intensity of the inflammatory infiltrate. MATERIAL AND METHODS: Twenty RCs and 10 RRCs were evaluated by immunohistochemistry using anti-VEGF and anti-MMP-9 antibodies. The angiogenic index was determined by microvessel count (MVC) using anti-von Willebrand factor antibody. RESULTS: The expression of both VEGF and MMP-9 was higher in RCs than in RRCs. RCs and RRCs presented strong epithelial expression of VEGF, irrespective of the intensity of the inflammatory infiltrate. Lesions with strong expression of MMP-9 showed significantly higher number of immunopositive cells for VEGF (p<0.05) and higher MVC (p<0.05). Lesions with dense inflammatory infiltrate exhibited significantly higher MVC (p<0.05) and higher number of immunopositive cells for VEGF (p<0.05). There was a positive correlation between both MVC (p<0.05) and the quantity of immunopositive cells for VEGF (p<0.05), with intensity of the inflammatory infiltrate. In addition, it was observed a positive correlation between the number of immunopositive cells for VEGF and MVC (p<0.05). CONCLUSIONS: VEGF and MMP-9 might play important roles in the angiogenesis in RCs and RRCs. In these lesions, the expression of these molecules and the MVC is closely related to the intensity of the inflammatory infiltrate. The expression of VEGF in the epithelial lining of RCs and RRCs might be important for the enlargement of these lesions.

Prevalence of dental caries and caries-related risk factors in premature and term children.

This study evaluated the prevalence of enamel defects and dental caries and their risk factors on primary and permanent dentitions of prematurely-born children and term children. Eighty children were examined, 40 born prematurely (G1) and 40 born term (G2), in the age group between 5 and 10 years. The demographic variables, medical history and oral health behaviors were recorded on a questionnaire. The teeth were examined for presence of deficiencies of the enamel and caries that were registered. The caries were registered, focusing on the indices dmft (decayed, missing, and filled primary teeth) and DMFT (decayed, missing, and filled permanent teeth). The results showed that 75% of the total sample had enamel defects. The logistic regression model showed that other risk factors such as per capita family income, educational level, dietary and hygiene habits, fluoride exposure, trauma, and diseases had no correlation with enamel defects and caries. A smaller value of total DMFT (0.95) was found in the group of premature children in comparison to the term children (2.07) p = 0.0164. There was no difference concerning the permanent dentition between the two groups (p = 0.9926). One concludes that prematurity can't be a predisposing factor for the presence of dental caries.

Genetic similarity of Candida albicans isolated from the buccal cavity of children with Down's syndrome and their parents and/or caregivers / Similaridade genética de Candida albicans isolada da cavidade bucal de crianças com síndrome de Down e seus pais e/ou responsáveis

Objective - Candida albicans is the fungus most closely related to the human oral mucosa colonization. Biological characteristics of the fungus allow high adaptation to the environmental conditions presented by the human mucosas, resulting in Candida species often being described as colonizers and pathogens in childrens with Down's syndrome. Methods - The DNA extraction of buccal C albicans simultaneously isolated of CWDS and P and/or R it was done. RAPD was accomplished using intra-specific primers for polymorphism analysis of C. albicans:RSD10 5'-CCGCAGCC A-3? and RSD12 5'-GGTCCGTGTTTCAAGACG-3'. Results - We detected a genetic similarity between Candida albicans isolated from the mouth of children with Down's syndrome and those of their parents and/or caregivers, using RAPD with the primers RSD10 and 12. Nine of the 40 (22.5%) pairs of oral C. albicans analyzed, had genetic homology (identical) in two conjugate pairs (2 / 9) (22.2%) (Similarity coefficient SAB 1). The other two conjugate pairs of buccal C. albicans (2 / 9) (22.2%) showed high relatedness (similarity coefficient SAB between 0.90 and 0.99). In other isolates (5 / 9) (55.6%), no correlation between the strains analyzed (similarity coefficient SAB <0.5) was found. Conclusion - The analysis of genetic similarity of the pairs of buccal C. albicans, isolated concomitantly from children with Down's syndrome and parents and/or caregivers, proved the intrafamilial transmission of this fungus between parents and their Down´s syndrome children, and confirmed the occurrence of isolates from other sources and possible genetic variation among these isolates.

Objetivo - Candida albicans é o fungo mais relatado como colonizador da mucosa bucal humana. Características biológicas do fungo permitem elevada capacidade de adequação às condições ambientais apresentadas pelas mucosas orgânicas humanas, tornando albicans, a espécie de Candida mais descritas nos processos de colonização e patogenidade da boca de crianças com síndrome de Down. Métodos - O DNA de C. albicans bucal simultaneamente isolado de crianças com síndrome de Down e pais e/ou responsáveis foi extraído. RAPD foi realizado usando primers intraespecíficos para a análise do polimorfismo de C. albicans: RSD10 5?-CCGCAGCC A-3' e RSD12 5'-GGTCCGTGTTTCAAGACG-3'. Resultados - Foi detectada uma semelhança genética entre Candida albicans isoladas da boca de crianças com síndrome de Down e de seus pais e/ou responsáveis, utilizando RAPD com os primers RSD 10 e 12. Nove dos 40 (22,5%) pares de C. albicans orais analisadas, possuiam homologia genética (idênticos) em dois pares conjugados (09/02) (22,2%) (coeficiente de similaridade SAB 1). Os outros dois pares conjugados de C. albicans bucais (09/02) (22,2%) apresentaram alta afinidade (SAB coeficiente de similaridade entre 0,90 e 0,99). Em outros isolados (09/05) (55,6%), nenhuma correlação entre as cepas analisadas (coeficiente de similaridade SAB<0,5) foi encontrado. Conclusão - A análise de similaridade genética dos pares de C. albicans bucais, isolado, concomitantemente, de crianças com síndrome de Down e pais e/ou responsáveis, comprovou a transmissão intrafamiliar desse fungo entre pais e filhos com síndrome de Down, e confirmou a ocorrência de isolados provenientes de outras fontes e possível variação genética entre os isolados.

Prevalence of dental caries and caries-related risk factors in premature and term children

This study evaluated the prevalence of enamel defects and dental caries and their risk factors on primary and permanent dentitions of prematurely-born children and term children. Eighty children were examined, 40 born prematurely (G1) and 40 born term (G2), in the age group between 5 and 10 years. The demographic variables, medical history and oral health behaviors were recorded on a questionnaire. The teeth were examined for presence of deficiencies of the enamel and caries that were registered. The caries were registered, focusing on the indices dmft (decayed, missing, and filled primary teeth) and DMFT (decayed, missing, and filled permanent teeth). The results showed that 75 percent of the total sample had enamel defects. The logistic regression model showed that other risk factors such as per capita family income, educational level, dietary and hygiene habits, fluoride exposure, trauma, and diseases had no correlation with enamel defects and caries. A smaller value of total DMFT (0.95) was found in the group of premature children in comparison to the term children (2.07) p = 0.0164. There was no difference concerning the permanent dentition between the two groups (p = 0.9926). One concludes that prematurity can't be a predisposing factor for the presence of dental caries.

Relação entre bruxismo, fatores oclusais e hábitos bucais / The relationship between bruxism, occlusal factors and oral habits

OBJETIVO: avaliar a relação entre bruxismo, fatores oclusais e hábitos bucais em crianças e adolescentes, alunos da rede pública da cidade de Brasília/DF. MÉTODOS: um grupo de 680 escolares, de ambos os gêneros, na faixa etária de 4 a 16 anos, foi aleatoriamente selecionado. Os dados foram coletados através da avaliação clínica e da aplicação de questionários aos responsáveis pelos alunos. Os aspectos morfológicos da oclusão foram avaliados segundo a classificação de Angle e critérios para a dentadura decídua, de Foster e Hamilton (1969). As mordidas cruzadas anterior e posterior, uni ou bilateral, foram avaliadas. O teste qui-quadrado, a Odds Ratio e o software SPSS foram utilizados para análise estatística. RESULTADOS E CONCLUSÕES: 592 questionários retornaram de maneira completa. A prevalência de bruxismo foi de 43 por cento, enquanto 57 por cento apresentaram má oclusão. Os hábitos bucais foram observados em 53 por cento. A prevalência de má oclusão aumentou de 42,6 por cento na dentadura decídua para 74,4 por cento na dentadura permanente. A avaliação dos resultados indicou que não houve relação estatisticamente significativa entre o bruxismo e os fatores oclusais estudados (p > 0,05). Não foram encontradas diferenças entre os gêneros em ambas as variáveis. A onicofagia foi o hábito mais prevalente (35 por cento) com preferência para o gênero feminino. Houve relação estatisticamente significativa entre bruxismo e hábitos bucais. Avaliando os tipos específicos de hábitos, apenas a sucção de chupeta se mostrou relacionada ao bruxismo. Estudos adicionais serão necessários para melhor compreensão dos fatores locais na gênese do bruxismo.

OBJECTIVE: Evaluating the relationship between bruxism, occlusal factors and oral habits in children and adolescent subjects, students from public schools in Brasília-Federal District city. METHODS: A group of 680 students, of both genders, average age 4 - 16 years, were randomly selected. Data was collected by clinical evaluation and questionnaires replied by the responsible for the students. The occlusion morphological aspects were evaluated according to Angle classification and following a criteria created for the deciduous dentition, according to Foster and Hamilton (1969). Uni or bilateral posterior and anterior crossbites were evaluated. The chi-square test, the Odds Ratio and the SPSS software were used for the statistic analysis. RESULTS AND CONCLUSION: 592 questionnaires were fulfilled completely. Bruxism had a prevalence of 43 percent, whilst 57 percent presented malocclusion. Oral habits were observed in 53 percent. The prevalence of a malocclusion increased from 42.6 percent in the deciduous dentition to 74.4 percent in the permanent dentition. The evaluation of the results showed that there was no statistically significant relationship between bruxism and the studied occlusal factors (p > 0.05). Differences were not found between genders in both variables. Onicofagy was the most frequent habit (35 percent), mainly in the female subjects. There was a statistically significant relationship between bruxism and oral habits. Evaluating the specific types of habits, just pacifier sucking showed to be related to the bruxism. Additional studies will be necessary for a better understanding of the local origin of bruxism.

Immunohistochemical expression of vascular endothelial growth factor and matrix metalloproteinase-9 in radicular and residual radicular cysts.

OBJECTIVE: This study assessed and compared the immunoexpression of vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9) in radicular cysts (RCs) and residual radicular cysts (RRCs), relating them to the angiogenic index and the intensity of the inflammatory infiltrate. MATERIAL AND METHODS: Twenty RCs and 10 RRCs were evaluated by immunohistochemistry using anti-VEGF and anti-MMP-9 antibodies. The angiogenic index was determined by microvessel count (MVC) using anti-von Willebrand factor antibody. RESULTS: The expression of both VEGF and MMP-9 was higher in RCs than in RRCs. RCs and RRCs presented strong epithelial expression of VEGF, irrespective of the intensity of the inflammatory infiltrate. Lesions with strong expression of MMP-9 showed significantly higher number of immunopositive cells for VEGF (p<0.05) and higher MVC (p<0.05). Lesions with dense inflammatory infiltrate exhibited significantly higher MVC (p<0.05) and higher number of immunopositive cells for VEGF (p<0.05). There was a positive correlation between both MVC (p<0.05) and the quantity of immunopositive cells for VEGF (p<0.05), with intensity of the inflammatory infiltrate. In addition, it was observed a positive correlation between the number of immunopositive cells for VEGF and MVC (p<0.05). CONCLUSIONS: VEGF and MMP-9 might play important roles in the angiogenesis in RCs and RRCs. In these lesions, the expression of these molecules and the MVC is closely related to the intensity of the inflammatory infiltrate. The expression of VEGF in the epithelial lining of RCs and RRCs might be important for the enlargement of these lesions.

Candida albicans bucais de crianças com síndrome de Down: comportamento de tubos germinativos, exoenzimas e sensibilidade a toxinas / Buccal Candida albicans of children with Dow's syndrome: behavior of germ tubes, exoenzimes and sensibility to killer toxins

Baseado na necessidade de melhor compreensão dos mecanismos de colonização e patogenicidade por leveduras de Candida provenientes da cavidade bucal de crianças com Síndrome de Down, o objetivo deste estudo de caso controle foi avaliar a capacidade de produção de tubos germinativos e exoenzimas (aspartil proteinases e fosfolipases) por C. albicans bucais e o comportamento frente a toxinas ôkillerõ. Foram empregadas 35 (87,5%) cepas de C. albicans bucais de crianças com Síndrome de Down e 10 (12,5%) de crianças sem síndrome. A produção de tubos germinativos e a detecção de exoenzimas e sensibilidade a toxinas por isolados de Candida foram realizadas segundo as técnicas de Reynolds-Braude, Ruchel, Prince e Polonelli et al. respectivamente. O teste de Reynolds-Braude mostrou melhor capacidade indutora de formação de tubos germinativos no grupo de crianças com Síndrome de Down. Em ambos grupos teste e controle houve a detecção de exoenzimas, entretanto cepas de C. albicans de crianças com alteração cromossômica apresentaram-se mais aspartil proteolíticas e fosfolipidolítipas. Diferenças estatísticas foram significativas em relação ambas capacidades biológicas anteriormente descritas (teste de Reynolds-Braude e atividade exoenzimßtica das cepas de Candida) (p < 0,05). Biotipagem por toxinas ôkillerõ mostrou maior diversidade de biotipos em crianças com síndrome de Down. Conclui-se que as cepas de C. albicans oriundas da mucosa bucal de crianças com Síndrome de Down apresentaram in vitro uma maior predisposição a colonização e a patogenicidade, além de uma melhor expressividade fenotípica em relação às toxinas.

Conhecimentos e práticas em saúde bucal de mães que freqüentaram um programa odontológico de atenção materno-infantil / Knowledge of oral health and practices among mothers attending a mother-child dental care program

O objetivo do presente estudo foi avaliar a assimilação e as práticas preventivas em saúde bucal adotadas por mães de crianças que freqüentaram um programa odontológico de atenção materno infantil. O Programa Preventivo para Gestantes e Bebês (PPGB) é um programa de extensão vinculado à Universidade Federal do Piauí (UFPI), que tem como meta a conscientização de gestantes e mães de crianças de zero a 36 meses para a adoção de hábitos favoráveis à obtenção de saúde bucal. Realizou-se uma seleção aleatória de fichas clínicas de crianças que haviam participado do PPGB e, através destas fichas, foram enviadas cartas às mães. Houve um retorno de 281 mães, as quais foram submetidas a entrevistas envolvendo os temas abordados pelo programa. Pelos resultados obtidos, pôde-se concluir que as mães freqüentadoras do PPGB detêm um bom nível de informação e adotam, no âmbito familiar, práticas de saúde favoráveis ao controle e prevenção de doenças bucais.

This study assesses the assimilation of knowledge and preventive practices in oral health among the mothers of children assisted by a mother-child dental care program. The Preventive Program for Pregnant Mothers and Babies (PPPMB) is an extension project run by the Piauí Federal University (UFPI), whose goal is to make pregnant women and mothers of children from zero to 36 months old more concerned about habits fostering oral health. After a random selection of clinical record cards for children who had participated in this Program, letters were sent to their mothers. Feedback was received from 281 mothers, who responded through interviews that included questions on matters addressed by the Program. The findings indicate that mothers attending this Program were properly informed, adopting hygienic practices in their families that underpin the control and prevention of oral diseases.

Avaliação do tratamento intensivo com clorexidina na redução das contagens salivares de estreptococos grupo mutans na fase de dentadura mista / Assessment of chlorhexidine intensive treatment on salivary mutans streptococci during mixed dentition

Introdução - Clorexidina tem demonstrado efetividade na redução das contagens de Estreptococos Grupo Mutans (SM) na saliva e placa dentária. Entretanto, poucos estudos clínicos avaliaram seus efeitos na dentadura mista. O objetivo deste trabalho foi avaliar o tratamento intensivo com clorexidina (gel a 1%) em comparação com o tratamento com flúor fosfato acidulado a 1, 23%, na redução das contagens salivares de SM em crianças ente 5 a 11 anos. Materiais e Métodos - Os participantes receberam tratamento odontológico na clínica de Odontologia Pediátrica do Hospital Universitário de Brasília - (HUB), Brasília - Brasil. Trinta e cinco crianças saudáveis foram alocadas em dois grupos formados por randomização simples (G1 /G2). O Grupo 1 (G1) recebeu seis aplicações de Clorexidina em dois dias consecutivos. O Grupo 2 (G2) recebeu duas aplicações de flúor durante 4 minutos, também em dois dias consecutivos. As contagens salivares foram realizadas através do Kit CARITEST SM - Herpo Produtos Odontológicos - Rio de Janeiro - Brasil, antes do tratamento (baseline) e após 4, 12 e 24 semanas. A análise estatística foi realizada pelo teste de Tukey (p<0,05). Resultados - Os resultados mostraram que somente no G1 as médias das contagens salivares foram significantemente reduzidas (82,14%). Após 24 semanas, houve aumento nas contagens salivares no G2 (não significativo) e tendência à redução nas contagens do G1, em comparação com a baseline. Conclusão - Os resultados permitem concluir que o tratamento intensivo com Clorexidina foi efetivo na redução das contagens salivares de SM durante 4 e 12 semanas após dupla aplicação, havendo, no entanto, retorno aos níveis iniciais ao final de 24 semanas.

Introduction - Chlorhexidine has been shown effective in reducing mutans streptococci (SM) counts in saliva and dental plaque. To date, few studies have compared its effects in mixed dentition children. The aim of the study was to assess the effects of an intensive treatment of 1% Chlorhexidine gel in comparison to a conventional fluoride preventive treatment on MS counts in saliva of children from 5 to 11 years old. Materials and Methods - All the participants received general dental care in the Pediatric Clinic at the Hospital of the University of Brasília - DF, Brazil . Thirty-five healthy children were randomly assigned in 2 groups. Group 1 (G1) received 6 applications of Chlorhexidine in 2 consecutive days. Group 2 (G2) received 2 applications of 1,23% sodium fluoride gel during 4 minutes. The MS salivary counts were determined by CARITEST SM Kit (Herpo Dental Products - Rio de Janeiro - Brazil) at the baseline, prior to treatments, and after 4, 12 and 24 weeks. The data were statistically analyzed by Tukey test (P<0,05). Results - Results showed that in G1 the MS mean counts were significantly reduced by chlorhexidine treatment at 4 and 12 weeks (82, 14%), while the G2 mean counts were not significantly affected. After 24 weeks there was a slight increase in MS counts in G2 (non significant) and a reduction tendency in G1, compared to the baseline counts. Conclusion - It was concluded that chlorhexidine intensive treatment was effective at reducing SM salivary counts during 4 and 12 weeks after double application, however there was a return to the baseline counts after 24 weeks.

Prevalence of dental caries in children born prematurely or at full term

The objective of this study was to evaluate the prevalence of dental caries in 192 children, 96 born prematurely and 96 at full term, in a regional hospital in Brazil. Mean age at clinical examination was 40.72 months in the full-term group (G1) and 30.44 months in the premature group (G2). The children were divided in two age subgroups: 0 to 3 and 4 to 6 years. Statistical results (Student's t and Kruskal-Wallis tests) showed that dmft was 0.43 for G1 and 0.01 for G2 in the 0-3 age subgroup, and 1.7 for G1 and 1.1 for G2 in the 4-6 age subgroup. Differences were significant between G1 and G2 only in the 0-3 age subgroup (p = 0.047). Caries evaluation showed that, of the 96 children in G1, 75 were caries free, while in G2, 84 did not have the disease. These differences were not significant (p = 0.088). The lower mean dmft found in the 0-3 age subgroup in G2 may be attributed to routines established by the hospital's neonatology staff, such as frequent dental visits and preventive instructions about oral habits, oral hygiene and diet. After this age, with the completion of the primary dentition, values increased and became similar between the G1 and G2 groups. Results also suggested a highly skewed distribution since most caries were found in only a small number of children.

O objetivo deste estudo foi avaliar a prevalência da cárie dentária em 192 crianças, 96 nascidas prematuramente e 96 a termo, em um hospital regional no Brasil. A média de idade ao exame clínico foi de 40,72 meses e 30,44 meses para os grupos a termo (G1) e prematuro (G2), respectivamente. As crianças foram divididas em faixas etárias de 0 a 3 e 4 a 6 anos. Os resultados estatísticos (testes t de Student e Kruskal-Wallis) mostraram que, entre 0 a 3 anos, o ceo-d foi 0,43 para o G1 e 0,01 para o G2. Entre 4 e 6 anos, o ceo-d foi 1,7 e 1,1 para G1 e G2, respectivamente. Os resultados foram significativos entre G1 e G2 apenas na faixa etária entre 0 e 3 anos (p = 0,047). A experiência de cárie mostrou que, das 96 crianças do G1, 75 estavam livres de cárie, enquanto que no G2, 84 não haviam tido a doença. Essas diferenças não foram significativas (p = 0,088). Conclui-se que o ceo-d médio menor encontrado no G2 entre 0 e 3 anos pode ser atribuído às freqüentes visitas de rotina e orientações sobre hábitos de higiene oral e dieta, oferecidos pela equipe de neonatologia. Após esta idade, com a dentição decídua completa, os valores aumentaram e se equipararam entre os grupos. Parece que o fenômeno de polarização esteve presente, visto que a experiência de cárie concentrou-se em um reduzido número de crianças.