Psychological profile and α-amylase levels in oral lichen planus patients: A case-control preliminary study.

OBJECTIVE: To investigate psychological (anxiety, depression, and stress) and salivary (flow and concentration of α-amylase) profile associated with oral lichen planus. MATERIALS AND METHODS: A case-control preliminary study with oral lichen planus patients and age-gender matched controls was conducted. The participants underwent psychological tests (Beck depression and anxiety inventories and perceived stress scale) and saliva collection to determine the unstimulated salivary flow and α-amylase levels at three moments along the day. The data were analyzed statistically using Mann-Whitney, McNemar chi-square and Friedman tests, and the Spearman correlation coefficient. The significance level adopted was 5%. RESULTS: A total of 46 case-control pairs were recruited. There was a significant correlation between anxiety, depression, stress, and oral lichen planus, as well as the stress and decline of salivary α-amylase levels. Higher concentrations of this biomarker were found in the case group thirty minutes post-awakening. CONCLUSION: The applied psychological tests indicated that factors such as anxiety, depression, and stress were associated with oral lichen planus. Salivary analyses demonstrated a higher concentration of α-amylase thirty minutes post-awakening on individuals with the disease and its decline correlated with stress, suggesting the role of α-amylase as a promising biomarker for future studies.

Salivary biomarkers to evaluate psychological disorders in oral lichen planus: A systematic review with meta-analysis.

OBJECTIVE: To analyze the use of salivary biomarkers to identify psychological disorders (anxiety, depression, and stress) in individuals with oral lichen planus (OLP). MATERIALS AND METHODS: The search was made in Medline/Pubmed, Scopus, Web of Science, Virtual Health Library, ProQuest, and by cross-reference. Original case-control, cross-sectional, and cohort studies, in human subjects (age ≥18 years) with clinical and histopathological diagnosis, with or without the use of psychometric scales, published until June 2021, were included. Random-effects meta-analyses, subgroup analyses, and sensitivity were performed. Publication bias was measured using the Egger test and visual inspection of the funnel plot. RESULTS: A total of 67 articles were found, of which 12 were included in the meta-analysis. Among the different biomarkers identified, it was only possible to perform a meta-analysis for cortisol. The mean difference between salivary cortisol levels in patients with OLP compared to controls was 3.43 ng/ml (95% CI: 1.20-5.65) with I2  = 98.9%. Studies considered outliers were removed and based on sensitivity analyses, results did not change, therefore, being stable. CONCLUSION: The studies analyzed demonstrated that cortisol was the most quantified biomarker to identify psychological disorders; however, DHEA, IgA, adiponectin, and α-amylase were also evaluated.

In vivo evaluation of fluoride dentifrice and diet control on the demineralization/remineralization process using laser readouts at the margin of the orthodontic bracket/enamel interface.

PURPOSE: To evaluate, in vivo, the effect of fluoride dentifrice and diet control on the demineralization/remineralization processes at the margin of bracket/enamel interface bonded with four different bonding materials, using optical microscopy and fluorescent laser (DIAGNOdent). METHODS: Premolars in 35 subjects (11 to 20 years old) were divided into Group 1 (n = 15) and Group 2 (n = 20). Four bracket/enamel interfaces (near points) and four points at a distance of 2 mm (distant points) were observed. Evaluations were made at the following times: 15 days before bracket bonding (T0), on day of bonding (T1), 1 week after bonding (T2), and 4 weeks after bonding (T3). Subjects received fluoride dentifrice, and toothbrush and were instructed to brush 3x/day, after main meals. Group 1 received the instructions at T1 and Group 2 at T0 and these were reinforced weekly. The Microarch brackets were bonded with four materials: Transbond XT; Concise Ortodôntico; Fuji Ortho LC and Monolok2. DIAGNOdent laser readouts were used for comparison. RESULTS: Data were statistically analyzed by Mann-Whitney, Wilcoxon and Friedman tests (P < 0.05). Higher readouts were found at nearer points than at distant points; Group 2 presented lower readouts than Group 1; No differences were observed among bonding materials.

The effect of baking soda when applied to bleached enamel prior to restorative treatment.

This in vitro study evaluated the effect of 10% baking soda solution and sodium bicarbonate powder (applied with jets) when applied to bleached enamel prior to restorative treatment. The surfaces of 40 bovine incisors were flattened and divided into 5 groups (n = 8): Group B (bleached and restored, negative control), Group W (bleached, stored in distilled water for 7 days, and restored), Group BSJ (bleached, abraded with baking soda jet for 1 min, and restored), Group BSS (bleached, application of 10% baking soda solution for 5 min, and restored), and Group R (restored, without bleaching, positive control). The samples were bleached in 1 session with 3 applications of 35% HP-based gel and activated with a LED appliance for 9 min each. Resin composite cylinders (2 mm height and 0.8 mm diameter) were made on the enamel surface after the acid etching and a conventional 1-step single vial adhesive application was performed. After storage in distilled water (37 ± 1°C, 24 hr), the microshear bond test was performed (1 mm/min). ANOVA and Tukey tests were applied to compare the results. The mean results of these tests showed that Groups W, BBS, and R were not statistically different. These groups also indicated a higher bond strength when compared with Groups B and BSJ. The application of 10% baking soda solution for 5 min may be an alternative pre-restorative treatment for bleached enamel, but further studies are needed to consider whether or not this treatment may be effectively used in clinical practice.

Surface roughness evaluation and shade changes of a nanofilled resin composite after bleaching and immersion in staining solutions.

PURPOSE: To investigate the effect of bleaching and staining solutions on roughness and shade changes in a nanofilled resin composite [Filtek Supreme (FS)]. METHODS: FS specimens (n = 135) were light cured and separated into groups (n = 45) that were bleached with 10% carbamide peroxide (CP) agent or 16% or 35% hydrogen peroxide (HP). In the first two groups the bleaching gel was used for 4 hours a day, during 14 days, and for the third group in three sessions of 45 minutes. Each group was subdivided (n = 15) and immersed in coffee, red wine or distilled water for 3 hours a day during 40 days. The roughness values (Ra) and shade (parameter CLELab) were evaluated at baseline, after bleaching and after staining. The data was analyzed by ANOVA and Tukey test or Kruskal Wallis. RESULTS: The effects on specimens varied depending on the bleaching product and staining solution. FS after bleaching and after staining presented higher roughness. In the evaluation of shade changes after bleaching, it was observed that resin color changed and that 35% hydrogen peroxide bleached the resin more than the others. After staining in three solutions, all specimens changed color and wine showed the higher staining capacity.

Effect of a kickboxing match on salivary cortisol and immunoglobulin A.

The hypothesis that salivary cortisol would increase and salivary immunoglobulin A (IgA) decrease after a kickboxing match was tested among 20 male athletes. Saliva samples collected before and after the match were analyzed. Salivary cortisol and salivary IgA concentrations (absolute concentration, salivary IgAabs) and the secretion rate of IgA (salivary IgArate) were measured by enzyme-linked immunosorbent assay. A Wilcoxon test for paired samples showed significant increases in salivary cortisol from pre- to postmatch. No significant changes were observed in salivary IgAabs or secretory IgArate and saliva flow rate. This study indicates that a kickboxing match might increase salivary concentration and thereafter it could be considered a significant source of exercise-related stress. On the other hand, the effect of a kickboxing match on mucosal immunity seems not to be relevant.

Relationship of psychological factors with salivary flow rate and cortisol levels in individuals with oral lichen planus: A case-control study.

OBJECTIVE: The objective of this study was to analyze the relationship between psychological factors and salivary flow rate and cortisol levels in individuals with oral lichen planus. STUDY DESIGN: A case-control study of 21 individuals with clinical and histopathological diagnosis of oral lichen planus and 21 individuals without the disease (controls), matched by sex and age, was performed. The Beck Anxiety and Depression Inventories and Perceived Stress Scale were administered, and the salivary flow rate and salivary cortisol secretion pattern were determined. Data were statistically analyzed using Mann-Whitney U, McNemar's χ2, and Student's t tests and the Spearman correlation coefficient. The significance level adopted was 5%. RESULTS: Individuals with oral lichen planus had higher anxiety (P = .001), depression (P = .005), and perceived stress (P = .026) scores, but no association was found between the disease and salivary flow rate (P = .29) or with the pattern of salivary cortisol secretion (at awakening: P = .98; 30 min post-awakening: P = .95; at bedtime: P = .97). CONCLUSION: An association was observed between oral lichen planus and anxiety, depression, and stress scores through psychological tests but not in relation to salivary flow rate and the pattern of salivary cortisol secretion.

Exposure to fluoride of children during the critical age for dental fluorosis, in the semiarid region of Brazil. / Exposição a fluoreto por crianças na faixa etária crítica para fluorose dentária, residentes no semiárido brasileiro.

There is a concern about the increasing prevalence of dental fluorosis, which depends on the dose of fluoride (F) to which children are subjected during tooth formation. Environmental temperature affects water intake and therefore it would be important to assess whether children living in the semiarid region are exposed to an excessive dose of F. Therefore, the objective of this study was to determine the total dose of F to which children are exposed during the critical age for dental fluorosis, with diet (water and food) and toothpaste as F sources, in the semiarid region of Brazil. METHODOLOGY: 26 children aged 25.2 ± 9.1 months, residents in Feira de Santana, State of Bahia (with F in the public water supply) were selected. Duplicate-diet, water, products from toothbrushing and toothpaste samples were collected. F concentration was determined using an ion-specific electrode, after proper sample preparation. RESULTS: the mean and standard deviation of dose (mg F/kg/day) from diet, toothpaste and total were respectively: 0.016 ± 0.010; 0.030 ± 0.039 and 0.047 ± 0.043. CONCLUSIONS: the children evaluated living in the semiarid region are not exposed to a risk dose for dental fluorosis.

In vitro determination of potentially bioavailable fluoride in diet and toothpaste after ingestion

Aim: To propose a new method to determine in vitro potentially bioavailable fluoride (F) in diet and toothpaste after ingestion. Methods: Diet samples (D) were obtained from 15 portions of a meal served to children in a day care centre. To simulate the ingestion of toothpaste during brushing after meals, a specific amount of toothpaste was added to the diet samples (D + T). F was determined in D and D + T after incubation in a solution that simulated "gastric juice" (0.01 M hydrochloric acid) at 37oC for 30, 60 and 120 min. Microdiffusion facilitated by HMDS was used to determine the total F concentrations in samples D and D + T. The analyses were performed using an ion specific electrode. Results: For D samples, incubation in "gastric juice" for 30, 60 and 120 min resulted in F concentrations (µg F/mL) of 0.75 ± 0.06c, 0.77 ± 0.07c and 0.91 ± 0.09b, corresponding to 75.3, 77.3 and 90.7% of the total F (1.02 ± 0.12a), respectively (p = 0.0001; ANOVA + Tukey). For D + T samples, these values of F concentrations (µg F/mL) were 2.55 ± 0.46b, 2.83 ± 0.44ab and 3.15 ± 0.37a, corresponding to 86.9, 94.8 and 106.7% of the total F (2.99 ± 0.34a), respectively (p = 0.0023; ANOVA + Tukey). Conclusion: Then, it can be concluded that the proposed method of "gastric juice" is a promising protocol for determining potentially bioavailable fluoride in the diet and toothpaste after ingestion. However, additional studies are desirable

Exposição a fluoreto por crianças na faixa etária crítica para fluorose dentária, residentes no semiárido brasileiro / Exposure to fluoride of children during the critical age for dental fluorosis, in the semiarid region of Brazil

Resumo Há uma preocupação com o aumento da prevalência de fluorose dentária, que depende da dose de fluoreto (F) a que as crianças são submetidas durante a formação dos dentes. A temperatura ambiental afeta a ingestão de água e, portanto, seria importante avaliar se as crianças que vivem em uma região de clima semiárido estão expostas a uma dose excessiva de F. Assim, o objetivo do presente estudo foi determinar a dose total de F a que as crianças são expostas durante a idade crítica para a fluorose dentária, tendo dieta (água e alimentos) e dentifrício como fontes de F, em uma região de clima semiárido no Brasil. Metodologia: foram selecionadas 26 crianças com idade de 25,2 ± 9,1 meses, residentes em Feira de Santana-BA. Foram coletadas amostras de dieta-duplicada, água, produtos de escovação e dentifrícios. A concentração de F foi determinada após o devido preparo das amostras, utilizando um eletrodo específico. Resultados: a média e o desvio padrão de dose (mg F / kg / dia) em função da dieta, dentifrício e total foram, respectivamente: 0,016 ± 0,010; 0,030 ± 0,039 e 0,047 ± 0,043. Conclusões: as crianças avaliadas, residentes em uma região de clima semiárido, não estão expostas a uma dose de risco de fluorose dentária.

Abstract There is a concern about the increasing prevalence of dental fluorosis, which depends on the dose of fluoride (F) to which children are subjected during tooth formation. Environmental temperature affects water intake and therefore it would be important to assess whether children living in the semiarid region are exposed to an excessive dose of F. Therefore, the objective of this study was to determine the total dose of F to which children are exposed during the critical age for dental fluorosis, with diet (water and food) and toothpaste as F sources, in the semiarid region of Brazil. Methodology: 26 children aged 25.2 ± 9.1 months, residents in Feira de Santana, State of Bahia (with F in the public water supply) were selected. Duplicate-diet, water, products from toothbrushing and toothpaste samples were collected. F concentration was determined using an ion-specific electrode, after proper sample preparation. Results: the mean and standard deviation of dose (mg F/kg/day) from diet, toothpaste and total were respectively: 0.016 ± 0.010; 0.030 ± 0.039 and 0.047 ± 0.043. Conclusions: the children evaluated living in the semiarid region are not exposed to a risk dose for dental fluorosis.

Relação entre estresse percebido e fatores salivares, em mulheres, sob condições basais de estresse / Relationship between perceived stress and salivary parameters in women under regular stress conditions

Objetivo: Verificar a relação entre alguns fatores salivares (fluxo estimulado e não-estimulado, capacidade-tampão e atividade de a-amilase) e o estresse percebido por mulheres em condições basais de estresse. Materiais e Métodos: Selecionou-se 13 voluntárias do gênero feminino, com idade média de 31,4 ± 10,0 anos, alunas do curso de mestrado da Faculdade São Leopoldo Mandic, Campinas, SP. Foi determinado fluxo salivar estimulado (FSE) e não-estimulado (FSNE); capacidade tampão (CT), atividade de a-amilase salivar (AAS) pelo método colorimétrico (Caraway modificado) e índice de estresse percebido (EP) pelo questionário de Cohen. Foi calculado o coeficiente de correlação linear de Pearson (R) entre as variáveis avaliadas (a = 0,05). Resultados: a média ± desvio-padrão dos resultados foi FSE = 1,28 ± 0,39 ml/min; FSNE = 0,39 ± 0,18 ml/min; CT = 4,45 ± 1,53; AAS = 16.324,82 ± 12.001,26 U/dl e EP = 25,62 ± 7,09. Houve correlação positiva e estatisticamente significativa entre o FSE e FSNE (R = 0,5932; p = 0,0325). Não houve correlação entre as demais variáveis. Conclusão: em condições basais de estresse, não houve relação entre o fluxo, capacidade tampão e a atividade de a-amilase salivar com o estresse percebido.(AU)

Aim: To verify the relationship among salivary factors (flow rate, buffer capacity, and alphaamylase activity) and the perceived stress in women, when under basal conditions of stress. Materials and Methods: Fourteen volunteers, students from São Leopoldo de Mandic Faculty, Campinas, SP, females, at an average of 31.4 ± 10.0 years of age, were selected. The salivary flow rate (stimulated and non-stimulated), buffer capacity, activity of salivary alpha-amylase, and the perceived stress (Cohen's questionnaire) were determined. Pearson's coefficient of correlation (R) was applied among the studied factors (a=0.05). Results: Mean ± standard deviation of the results were FSE = 1.28 ± 0.39 ml/ min; FSNE = 0.39 ± 0.18 ml/min; CT = 4.45 ± 1.53; AAS = 16,324.82 ± 12,001.26 U/dl, and EP = 25.62 ± 7.09. A positive, statistically significant correlation between FSE and FSNE (R = 0.5932; p = 0.0325) could be observed. No significant correlations between any other variables could be identified. Conclusion: Under basal conditions of stress, no relationship among salivary flow rate, buffer capacity or alpha-amylase activity, and perceived stress could be observed.(AU)

Alkali soluble fluoride deposits on bovine dental enamel after treatment with a mouthwash containing fluoride and chlorhexidine / Deposição de fluoreto solúvel em álcali no esmalte dental bovino após tratamento com um enxaguatóriocontendo fluoreto e clorexidina

Aim: The aim of this in vitro study was to determine whether the addition of chlorhexidine (CHX)to a mouthwash containing fluoride (F) diminishes the concentration of soluble F and its reactivity withbovine dental enamel. Materials and Methods: First, the concentration of F found in mouthwashs wasdetermined by an ion-specific electrode. To test their reactivity, 30 slabs of bovine dental enamel (5 x 5mm)were distributed into three groups (n = 10), according to the treatment applied, for 30 seconds: controlgroup (distilled deionized water); NaF group (0.05% sodium fluoride); NaF + CHX group (Noplak Max®:0.05% sodium fluoride + 0.12% chlorhexidine digluconate). After, the slabs were washed with distilleddeionized water and individually immersed in artificial saliva for 30 minutes. They were dried and thenindividually immersed in 0.5 mL of 1M KOH for 24 hours, under agitation. After buffering the samples withHCI containing TISAB II, the concentration of F present in the KOH solutions was determined be means ofan ion-specific electrode. Results: No significant difference in the concentration of soluble F in the studiedmouthwashs (NaF and NaF+CHX; Student’s t-test, p > 0.05) could be observed. Furthermore, no differencecould be identified among the alkali soluble fluoride deposits from the NaF and NaF+CHX groups, andboth groups presented higher deposit levels than did the control group (Kruskal-Wallis and Dunn´s method,p < 0.05). Conclusion: The addition of CHX to a mouthwash containing F did not decrease its soluble Fconcentration, nor its reactivity to bovine dental enamel.

Evitando a exposição pulpar em lesões de cárie profunda com tratamento expectante / Avoiding pulp exposure in deep caries lesions: stepwise excavation technique

In cases of deep caries lesions, total removal of carious tissue can cause accidental pulp exposure, which can be avoided by using the stepwiseexcavation technique. This consists of the partial excavation of contaminated dentin and the application of a biomaterial, such as calciumhydroxide, with the aim of diminishing progression of the lesion or even arresting it. The aim of the article is to describe a clinical case in which the stepwise excavation technique was performed, relating its advantages, limitations and recommendations. A fourteen-year-old boy reported non-spontaneous pain in tooth 37. The clinical and radiographic examinations indicated an extensive cavity, with a risk of pulp exposure during removal of carious tissue; reversible pulpitis was diagnosed. The stepwise excavation technique was performed. Radiographic examinations performed at 12, 18 and 36 months showed a normal appearance in the apical region and an increase in tertiary dentin was observed. The stepwise excavation technique can be considered a safe therapy, scientifically corroborated, with a high rate of success, however with limited indications, since it requires the teeth to be young and the pulp to present as normal or with reversible inflammation.

Nos casos de lesões cariosas profundas, a remoção total do tecido cariado pode causar uma exposição pulpar acidental, o que pode ser evitado utilizando-se o tratamento expectante. Este consiste na escavação parcial da dentina contaminada e aplicação de um biomaterial, como o hidróxido de cálcio, visando à diminuição da progressão da lesão ou até mesmo sua paralisação. Este artigo tem por objetivo descrever um caso clínico no qual o tratamento expectante foi realizado, relatando suas vantagens, limitações e indicações. Um paciente do sexo masculino, de 14 anos de idade, apresentava dor espontânea no dente 37. Os exames clínico e radiográfico indicaram uma lesão extensa, com risco de exposição pulpar; foi diagnosticada pulpite reversível. O tratamento expectante foi realizado e exames radiográficos feitos após 12, 18 e 36 meses indicaram normalidade na região apical, com formação de dentina terciária. O tratamento expectante pode ser considerado seguro, cientificamente comprovado e com grande índice de sucesso, entretanto com indicação limitada, visto que requer um dente jovem, com polpa normal ou reversivelmente inflamada.

Fechamento de diastema posterior como complemento de um tratamento ortodôntico: caso clínico / Posterior diastema closure as a complement for the orthodontic treatment: clinical case

O objetivo deste trabalho foi demonstrar um caso clínico de fechamento de diastema entre o 2º pré-molar e 1º molar superiores esquerdo desde o planejamento, a escolha do material, as etapas clínicas da reconstituição do ponto de contato com resina composta fotopolimerizável, a fase de acabamento e polimento e o resultado final, complementando o tratamento ortodôntico.

This study reports a clinical case of closing posterior spaces between the 2nd upper premolar and 1st upper molar, in order to complete the orthodontic treatment. The planning, the choice of the restorative material and the clinical steps for repairing contact point with light-curing composite resins were described.

Comparação entre análises de referência incisal em indivíduos jovens melanodermas brasileiros com oclusão normal / Comparison among incisal landmark analysis of black brazilian youngsters with normal occlusion

A definição da posição do incisivo inferior oferece ao clínico dados para um correto planejamento e tratamento, assim como melhor estabilidade na pós-contenção. Observa-se, porém, que as análises cefalométricas mais utilizadas em Ortodontia para o diagnóstico geralmente são baseadas em indivíduos leucodermas, que diferem em características craniofaciais das outras raças. Desta forma, o presente trabalho teve como objetivo estudar o comportamento do incisivo inferior em relação às referências incisais preconizadas por Andrade (1-Jr), Interlandi (1-linhaI), Vigorito (1-linhaV) e Ricketts (1-linha AP) em jovens brasileiros melanodermas com oclusão normal, verificando também a ocorrência de dimorfismo sexual. Foram selecionadas 36 telerradiografias de cabeça tomadas em norma lateral de indivíduos brasileiros, melanodermas, na faixa etária de 10 a 14 anos, de ambos os gêneros, com oclusão clinicamente normal e que nunca se submeteram a tratamento ortodôntico, do Setor de Documentação Científica do Curso de Pós-Graduação em Ortodontia da FOP/UNICAMP, nas quais foram traçados os pontos, linhas e planos cefalométricos necessários para obtenção das referências incisais e medidas nas análises sugeridas pelos autores selecionados. Os valores médios obtidos para a posição do incisivo inferior diferiram entre si por duas análises estatísticas, havendo diferença significativa (p<0,05) entre os métodos estudados. Também não houve dimorfismo sexual. Concluiu-se que a posição dos incisivos inferiores em indivíduos jovens melanodermas brasileiros apresenta inclinação e vestibularização maior que a preconizada pelos autores consultados, e que a análise de referência incisal de Andrade (1-Jr) parece se comportar mais adequadamente para este grupo étnico.

Alterações bucais em pacientes com Síndrome de Sjõgren / Oral alterations in patients with Sjõgren's Syndrome

A Síndrome de Sjõgren (SS) é uma afecção auto-imune na qual o sistema imune compromete as glândulas exócrinas, envolvendo principalmente as glândulas salivares e lacrimais, determinando os quadros clínicos de xerostomia e ceratoconjuntivite seca. Entre os sintomas orais mais evidentes está a xerostomia, acarretando secura nos lábios, língua, faringe e conseqüente desconforto ao falar, mastigar e deglutir alimentos secos. A proposta deste trabalho foi apresentar um caso clínico de SS, enfatizando a sua importância clínica e a necessidade de um diagnóstico precoce, visando melhorar a qualidade de vida dos pacientes acometidos.