Evaluation of Receptor Activator of Nuclear Factor Kappa B Ligand, Osteoprotegerin, Osteopontin, and Tumor Necrosis Factor Alpha on Chronic Apical Periodontitis in Smokers.

INTRODUCTION: Smoking can be considered a risk factor for chronic apical periodontitis (CAP). This study compared the immunoexpression of biomarkers receptor activator of nuclear factor kappa B ligand (RANKL), osteoprotegerin (OPG), osteopontin (OPN), and tumor necrosis factor alpha (TNF-α) in CAP in smokers and nonsmokers. METHODS: Twelve smokers and 12 nonsmokers diagnosed with CAP and indicated for tooth extraction were selected. Exclusion factors were teeth with a diagnosis of root fracture, previous endodontic treatment, or endoperiodontal injury, in addition to individuals with systemic diseases, under 18 years of age, users of anti-inflammatory and/or antibiotics in the last 3 months, and drug users. Specimens were processed for histopathologic and immunohistochemical analysis. RESULTS: Qualitative analysis of RANKL expression showed 66.66% weak/moderate and 33.33% strong in smokers and 100% weak/moderate in nonsmokers. OPG and OPN expressions were 100% negative to focal in the smoker group and 50% negative to focal and 50% weak/moderate in the nonsmoker group. TNF-α was 25% negative to focal and 75% weak/moderate in the smoker group and 33.33% negative to focal and 66.66% weak/moderate in the nonsmoker group. Quantitative analysis of the data using the Mann-Whitney U test showed that there was a significant difference in the immunoexpression of RANKL (P < .05), OPG (P < .05), and OPN (P < .05), but there was no statistical difference in the immunoexpression of TNF-α (P > .05) between the 2 groups. CONCLUSIONS: These findings suggest that smoking is capable of altering the inflammatory response, influencing the evolution of CAP.

Association of clinical, social and environmental variables with dental caries prevalence in adolescents from a Brazilian municipality supplied with fluoridated water / Associação de variáveis clínicas, sociais e ambientais sobre a cárie dentária em adolescentes de um município brasileiro com água fluoretada

Abstract Background Although a trend towards dental caries reduction has been observed, further investigations on its pattern and development are still needed. Objective To investigate the influence of clinical, social and environmental variables on dental caries prevalence in adolescents from a Brazilian municipality supplied with fluoridated water in 2018. Method This study was conducted with a non-probabilistic sample of 277 adolescents aged 12 years of public schools in Nova Friburgo, state of Rio de Janeiro, Brazil. Clinical examinations were carried out by calibrated examiners to assess caries, periodontal disease, and fluorosis according to criteria of the World Health Organization (WHO). Semi-structured questionnaires were applied to record socio-environmental information. Results Individuals living in regions supplied with fluoridated water below the minimum required levels (OR=3.60, p=0.0006), with low income (OR=1.90, p=0.0444), presence of gingivitis (OR=3.36; p=0.0016), and whose reason for visiting the dentist was dental treatment (OR=2.41; p=0.0203) were more likely to have dental caries. A significant reduction (p<0.0001) in dental caries indexes was observed between 2012 and 2018. Conclusion Fluoridation of public water supply at unsuitable levels, as well as other social and clinical variables can influence the caries pattern in adolescents.

Resumo Introdução A tendência de redução da cárie dentária tem sido constatada, apesar de maiores investigações sobre seu padrão e desenvolvimento serem ainda necessárias. Objetivo investigar a influência de variáveis clínicas, sociais e ambientais sobre a cárie em adolescentes de um município brasileiro com água fluoretada, no ano de 2018. Método Empregou-se uma amostra não probabilística de 277 adolescentes de 12 anos, de escolas públicas de Nova Friburgo, Rio de Janeiro, Brasil. Exames clínicos foram realizados por examinadores calibrados, para avaliação de cárie, doença periodontal e fluorose, sob critérios da Organização Mundial da Saúde (OMS). Questionários semiestruturados foram aplicados para coletar informações socioambientais. Resultados Indivíduos residentes em regiões com flúor na água em subdoses (OR=3,60, p=0,0006), e aqueles com baixa renda (OR =1,90, p=0,0444), com presença de gengivite (OR = 3,36; p = 0,0016) e cuja razão para a visita ao dentista foi para tratamento dentário (OR=2,41; 0,0203), apresentaram mais chances de terem cárie. Uma redução significativa (p<0,0001) nos índices de cárie foi observada entre 2012 (primeiro levantamento epidemiológico) e 2018. Conclusão A fluoretação das águas de abastecimento público, quando em níveis não adequados, assim como outras variáveis sociais e clínicas, podem influenciar o padrão de cárie nos adolescentes.

The influence of the Brazilian school health program on the oral-health-related quality of life of adolescents.

The aim of this study was to evaluate the influence of the Brazilian School Health Program (SHP) on dental clinical disorders such as caries, gingivitis, and dental trauma as well as on the oral-health-related quality of life (OHRQoL) of adolescents in Nova Friburgo, RJ, Brazil. The study consisted of a non-probabilistic (convenience) sample comprising 319 12-year-old adolescents, both participants and non-participants of the SHP, for at least two years. Socio-demographic and OHRQoL questionnaires (CPQ11-14, the Child Perceptions Questionnaire) were applied as well as clinical examinations for caries, periodontal disease, and dental trauma following the World Health Organization (WHO) criteria by calibrated researchers. Mann-Whitney, chi-square tests, and multiple logistic regression models were used for the data analysis. Statistically significant differences were observed between the groups covered and not covered by the SHP for gingivitis (p = 0.0373) and OHRQoL on the social welfare subscale (p = 0.0265) and total scale (p = 0.0449) of CPQ11-14. Multivariate analysis showed that female adolescents were 1.74 times more likely to present a lower OHRQoL (OR = 1.74, 95%IC = 1.10-2.77, p = 0.0183) than males. In addition, non-SHP subjects were 1.56 times more likely to have poor OHRQoL (OR = 1.56, 95%IC = 0.94-2.59, p = 0.0873) than program participants. In conclusion, SHP positively influenced the OHRQoL of adolescents. However, follow-up studies are needed to verify the continued effectiveness of this Brazilian SHP in improving the oral health levels and quality of life of adolescents.

The influence of the Brazilian school health program on the oral-health-related quality of life of adolescents

Abstract The aim of this study was to evaluate the influence of the Brazilian School Health Program (SHP) on dental clinical disorders such as caries, gingivitis, and dental trauma as well as on the oral-health-related quality of life (OHRQoL) of adolescents in Nova Friburgo, RJ, Brazil. The study consisted of a non-probabilistic (convenience) sample comprising 319 12-year-old adolescents, both participants and non-participants of the SHP, for at least two years. Socio-demographic and OHRQoL questionnaires (CPQ11-14, the Child Perceptions Questionnaire) were applied as well as clinical examinations for caries, periodontal disease, and dental trauma following the World Health Organization (WHO) criteria by calibrated researchers. Mann-Whitney, chi-square tests, and multiple logistic regression models were used for the data analysis. Statistically significant differences were observed between the groups covered and not covered by the SHP for gingivitis (p = 0.0373) and OHRQoL on the social welfare subscale (p = 0.0265) and total scale (p = 0.0449) of CPQ11-14. Multivariate analysis showed that female adolescents were 1.74 times more likely to present a lower OHRQoL (OR = 1.74, 95%IC = 1.10-2.77, p = 0.0183) than males. In addition, non-SHP subjects were 1.56 times more likely to have poor OHRQoL (OR = 1.56, 95%IC = 0.94-2.59, p = 0.0873) than program participants. In conclusion, SHP positively influenced the OHRQoL of adolescents. However, follow-up studies are needed to verify the continued effectiveness of this Brazilian SHP in improving the oral health levels and quality of life of adolescents.

Investigations of the prevalence and virulence of Candida albicans in periodontal and endodontic lesions in diabetic and normoglycemic patients.

OBJECTIVE: The aim of this study was to investigate the prevalence of isolated Candida albicans from periodontal endodontic lesions in diabetic and normoglycemic patients, and the fungi's virulence in different atmospheric conditions. MATERIAL AND METHODS: A case-control study was conducted on 15 patients with type 2 diabetes mellitus (G1) and 15 non-diabetics (G2) with periodontal endodontic lesions. Samples of root canals and periodontal pockets were plated on CHROMagar for later identification by polymerase chain reaction (PCR) and virulence test. RESULTS: C. albicans was identified in 79.2% and 20.8% of the 60 samples collected from diabetic and normoglycemic patients, respectively. Of the 30 samples collected from periodontal pockets, 13 showed a positive culture for C. albicans, with 77% belonging to G1 and 23% to G2. Of the 11 positive samples from root canals, 82% were from G1 and 18% from G2. Production of proteinase presented a precipitation zone Pz<0.63 of 100% in G1 and 72% in G2, in redox and negative (Pz=1), under anaerobic conditions in both groups. Hydrophobicity of the strains from G1 indicated 16.4% with low, 19.3% with moderate, and 64.3% with high hydrophobicity in redox. In G2, 42.2% had low, 39.8% had moderate, 18% had high hydrophobicity in redox. In anaerobic conditions, G1 showed 15.2% with low, 12.8% with moderate, and 72% with high hydrophobicity; in G2, 33.6% had low, 28.8% had moderate, and 37.6% had high hydrophobicity. There was statistical difference in the number of positive cultures between G1 and G2 (p<0.05) with predominance in G1. There was statistical difference for all virulence factors, except hemolysis (p=0.001). CONCLUSIONS: Candida albicans was isolated more frequently and had higher virulence in diabetic patients.

Investigations of the prevalence and virulence of Candida albicans in periodontal and endodontic lesions in diabetic and normoglycemic patients

Abstract Pulpal and periodontal tissues have similar microbiota that allows cross-contamination between the pulp and periodontal tissues. Objective The aim of this study was to investigate the prevalence of isolated Candida albicans from periodontal endodontic lesions in diabetic and normoglycemic patients, and the fungi's virulence in different atmospheric conditions. Material and Methods A case-control study was conducted on 15 patients with type 2 diabetes mellitus (G1) and 15 non-diabetics (G2) with periodontal endodontic lesions. Samples of root canals and periodontal pockets were plated on CHROMagar for later identification by polymerase chain reaction (PCR) and virulence test. Results C. albicans was identified in 79.2% and 20.8% of the 60 samples collected from diabetic and normoglycemic patients, respectively. Of the 30 samples collected from periodontal pockets, 13 showed a positive culture for C. albicans, with 77% belonging to G1 and 23% to G2. Of the 11 positive samples from root canals, 82% were from G1 and 18% from G2. Production of proteinase presented a precipitation zone Pz<0.63 of 100% in G1 and 72% in G2, in redox and negative (Pz=1), under anaerobic conditions in both groups. Hydrophobicity of the strains from G1 indicated 16.4% with low, 19.3% with moderate, and 64.3% with high hydrophobicity in redox. In G2, 42.2% had low, 39.8% had moderate, 18% had high hydrophobicity in redox. In anaerobic conditions, G1 showed 15.2% with low, 12.8% with moderate, and 72% with high hydrophobicity; in G2, 33.6% had low, 28.8% had moderate, and 37.6% had high hydrophobicity. There was statistical difference in the number of positive cultures between G1 and G2 (p<0.05) with predominance in G1. There was statistical difference for all virulence factors, except hemolysis (p=0.001). Conclusions Candida albicans was isolated more frequently and had higher virulence in diabetic patients.

Intrusive luxation of an immature permanent incisor: a 10-year follow-up.

Intrusive luxation in the permanent dentition is rare and considered the most severe form of dental trauma. Intrusion is characterized by the axial displacement of the tooth into the alveolar bone. It normally affects pulpal vitality and the periodontal ligament. The most common forms of treatment are waiting for spontaneous reeruption, repositioning with orthodontic procedures, or immediate surgical repositioning. A well-planned approach to the treatment of an intrusive luxation is necessary to obtain a successful result. This case report describes treatment of an 8-year-old boy who suffered intrusive luxation of his permanent maxillary right central incisor while root formation was incomplete. The patient was followed clinically and radiographically for 10 years.

Fluoretação da Água e seu Heterocontrole no Município de Nova Friburgo, Rio de Janeiro - Brasil / Water Fluoridation and its external control in the municipality of Nova Friburgo, Rio de Janeiro - Brazil

A fluoretação da água, apoiada pela Política Nacional de Saúde Bucal, tem sido um desafio no Brasil, devido a algumas insuficiências atuais na gestão pública para a implantação e controle desta medida. Este estudo objetivou vigiar, de forma periódica e sistemática, os níveis de fluoretos na água para consumo humano, em Nova Friburgo - RJ- Brasil (NF), por um período de 12 meses, como medida de heterocontrole, realizada por uma universidade pública. As amostras de água foram coletadas mensalmente, em duplicata, em 26 localidades em todo o município e em datas estabelecidas por sorteio. O método para medir a concentração de fluoretos nas amostras de água foi o eletrométrico, utilizando-se um potenciômetro digital com eletrodo específico para o íon flúor. A concentração de fluoretos nas amostras foi analisada de acordo com padrões fornecidos pelo Cecol/USP (2011). Os dados mostraram grande variação na concentração de fluoretos nas amostras, variando entre um mínimo de 0,00 ppmF e um máximo de 0,98 ppmF, com algumas dentro do intervalo de 0,65 e 0,94 ppmF, considerado o de melhor benefício para prevenir a cárie dentária. A concentração de fluoretos na água de abastecimento público do município foi considerada abaixo dos níveis mínimos exigidos, na maioria das amostras avaliadas, mesmo naquelas pertencentes às Estações de Tratamento de Água (ETA), cuja medida de fluoretação fora previamente implantada. Desta forma, a fluoretação da água e seu respectivo heterocontrole deveriam ser estabelecidos de forma contínua em NF, já que são medidas públicas relevantes para a promoção de saúde bucal.

Water fluoridation, supported by the Brazilian Oral Health Policy, has been a challenge as a public measure to protect Oral Health, due to some current insufficiencies in public management for the implantation of this measure in most Brazilian cities. The present study aimed to monitor, the levels of fluoride in drinking water in Nova Friburgo - RJ-Brazil (NF), on a regular and a systematic manner for a 12 months period, as an external control measurement performed by a public university. Water samples were collected, in duplicate, from 26 localities throughout the city, on a monthly basis, on randomly established dates. The fluoride concentration in the water samples was measured by using an ion-specific electrode coupled to a potentiometer, according to standards supplied by Cecol/USP (2011). Data showed a large variation of fluoride concentration in water samples, ranging from minimum 0.00 ppmF and maximum 0.98 ppmF, with few samples into the interval between 0.65 and 0.94 ppmF, which had the best benefit to prevent dental caries. Fluoride concentration in public water in this city can be considered under the minimum required levels in most of the evaluated samples, even in those from the Water Treatment System (WTS), which has water fluoridation. Thus, water fluoridation and its external control should be established on a regular basis in Nova Friburgo-RJ, Brazil because they are relevant public measures to promote oral health.

Dental caries in inland Brazilian adolescents and its relationship with social determinants

AIM: To identify the prevalence of dental caries in inland Brazilian adolescents, and to analyze the influence of socio-demographic and clinical variables, and access to dental service on caries experience. METHODS: This study had a non-probabilistic sample comprising 504 adolescents aged 12 years, attending public schools in the city of Nova Friburgo, mountain region of Rio de Janeiro, Brazil. The World Health Organization (WHO, 1997) criterion was used by previously calibrated examiners to report dental caries. Variables were obtained by means of a semi-structured questionnaire applied to the adolescents' parents. RESULTS: The D3MFT mean was 1.90 and the Significant Caries (SIC) Index was 4.54, mainly represented by the carious component. Multiple logistic regression analysis revealed that parents with over 8 years of schooling (OR=0.579), absence of pain (OR=0.396) and not visiting the dentist (OR=0.270) might suggest protective factors against the disease; the possible risk factors were male gender (OR=1.982) and pain, extraction and others were reasons for consultation (OR=2.435). CONCLUSIONS: Although the prevalence of caries was slightly below the national mean, polarization of the disease was clearly observed. Education and no access to the dentist led to protection against the disease. These results may contribute to planning of oral health actions directed towards this target population for the control of caries...

Prevalência e severidade da doença periodontal em uma amostra da população do município de Itaocara / Prevalence and severity of periodontal disease in population sample from Itaocara municipality

O objetivo deste estudo foi analisar uma amostragem da população de Itaocara com severidade da doença periodontal e, também investigar a prevalência de diferentes fatores de risco que interferem na progressão da periodontite, como idade e o fumo. Foram examinados 270 indivíduos, registrando-se a presença de dentes cariados, obturados e perdidos. Foram feitas medições de profundidade de bolsa, nível de perda de inserção, mobilidade dentária e envolvimento de furca

As conseqüências da doença periodontal na qualidade de vida relacionada à saúde bucal e implicações para a definição de necessidade de tratamento / The consequences of periodontal disease on quality of life related to oral health and implications for the definition of treatment need

O método mais comumente utilizado para definir necessidade de tratamento periodontal tem se limitado à avaliação exclusivamente clínica pelo profissional, na qual a saúde é definida simplesmente como ausência de sinais de doença, não se levando em consideração a associação entre esses sinais e o risco de perda de dentes, bem como a associação com as funções bucais (mastigação, estética e etc.), o desempenho social, e o bem estar psicológico. Objetivo: este estudo avaliou o impacto da doença periodontal na qualidade de vida relacionada à saúde bucal. Metodologia: estudo transversal onde foram selecionados 3 grupos de indivíduos: com doença periodontal ausente/leve, moderada e severa. Os participantes foram selecionados entre aqueles que estavam inscritos para a triagem na clínica da faculdade de odontologia da Universidade Estácio de Sá, no Rio de Janeiro. Para o exame periodontal, foram utilizados os seguintes indicadores clínicos: sangramento marginal, bolsa periodontal, nível de inserção, recessão gengival, sangramento à sondagem, mobilidade dentária, envolvimento de furca, presença de supuração. Cada superfície dental foi classificada como cariada, perdida ou obturada. A qualidade de vida relacionada à saúde bucal foi avaliada pelo instrumento Dental Impact on Daily Living - DIDL, que analisa o impacto da cavidade bucal na qualidade de vida, através de 5 dimensões: aparência, conforto, restrição mastigatória dor e performance. Foram examinados 230 indivíduos, 141 mulheres (61.3%) e 89 homens (38.7%) com idade média de 36 anos (dp;11.3), variando de 18-69 anos. Resultados: baseado no escore total do DIDL, 66 indivíduos (28.7%) estavam insatisfeitos, 157 (68.3%) relativamente satisfeitos e 7 (3.0%) satisfeitos com a cavidade bucal. Não houve diferença na correlação entre os escores do DIDL e os critérios de definição de doença (Nova Classificação rs -0.226 p<0.001; AAP r 0.251 p<0.001)...

Incidência e severidade da periodontite, e sua importância para a perda do elemento dentário, em uma amostra de militares de duas unidades do Exército brasileiro / Incidence and severety of periodontitis and its importance for loss teeth in population's profile from two military organizations of the Brazilian Army

O objetivo deste estudo foi analisar uma amostra de militares de duas unidades do Exército Brasileiro, a fim de se obter informaçäo sobre a incidência e severidade da periodontite e também, de se avaliar o perfil da amostra, com suas necessidades de tratamento odontológico. Foram examinados 236 pacientes, registrando-se a presença de dentes cariados, extraídos e obturados. Foram feitas mediçöes de profundidade de bolsa, recessäo gengival e consequentemente, nível de perda de inserçäo