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Glass ionomer cements (GICs) are the common materials employed in pediatric dentistry because of their specific applications in class I restorations and atraumatic restoration treatments (ART) of deciduous teeth in populations at high risk of caries. Studies show a limited clinical durability of these materials. Attempts have thus been made to incorporate nanoparticles (NPs) into the glass ionomer for improving resistance and make it like the tooth structure. An in vitro experimental study was conducted using the required samples dimensions and prepared based on the test being carried out on the three groups with or without the modification of light-cured glass ionomer. Samples were grouped as follows: control group (G1_C), 2% silver phosphate/hydroxyapatite NPs group (G2_SPH), and 2% titanium dioxide NPs group (G3_TiO2). The physical tests regarding flexural strength (n = 10 per group), solubility (n = 10 per group), and radiopacity (n = 3 per group) were performed. The data were analyzed by Shapiro Wilks test, and one-way analysis of variance (one-way ANOVA), and multiple comparisons by post hoc Tukey's test. The p-value of < 0.05 was considered significant. No statistically significant difference was observed between the control group (G1_C) and (G2_SPH) (p = 0.704) in the flexural strength test, however differences were found between G2_SPH and G3_TiO2 groups, ANOVA (p = 0.006); post hoc Tukey's test (p = 0.014). Pertaining to the solubility, G2_SPH obtained the lowest among the three groups, ANOVA (p = 0.010); post hoc Tukey's test (p = 0.009). The three study groups obtained an adequate radiopacity of >1 mm Al, respectively. The resin-modified glass ionomer cement (RMGIC) was further modified with 2% silver phosphate/hydroxyapatite NPs to improve the physical properties such as enhancing the solubility and sorption without compromising the flexural strength and radiopacity behavior of modified RMGIC. The incorporation of 2% titanium dioxide NPs did not improve the properties studied.
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Durapatita , Cimentos de Ionômeros de Vidro , Nanopartículas , Fosfatos , Titânio , Titânio/química , Cimentos de Ionômeros de Vidro/química , Durapatita/química , Nanopartículas/química , Fosfatos/química , Técnicas In Vitro , Teste de Materiais , Humanos , Compostos de Prata/química , Solubilidade , Resistência à FlexãoRESUMO
CD36 is a type 2 cell surface scavenger receptor expressed in various tissues. In macrophages, CD36 recognizes oxidized low-density lipoprotein (ox-LDL), which promotes the formation of foam cells, the first step toward an atherosclerotic arterial lesion. CD36 possesses a variety of posttranslational modifications, among them N-glycosylation and O-GlcNAc modification. Some of the roles of these modifications on CD36 are known, such as N-linked glycosylation, which provides proper folding and trafficking to the plasma membrane in the human embryonic kidney. This study aimed to determine whether variations in the availability of UDP-GlcNAc could impact Rab-5-mediated endocytic trafficking and, therefore, the cellular localization of CD36. These preliminary results suggest that the availability of the substrate UDP-GlcNAc, modulated in response to treatment with Thiamet G (TMG), OSMI-1 (O-GlcNAcylation enzymes modulators) or Azaserine (HBP modulator), influences the localization of CD36 in J774 macrophages, and the endocytic trafficking as evidenced by the regulatory protein Rab-5, between the plasma membrane and the cytoplasm.
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Antígenos CD36 , Macrófagos , Antígenos CD36/metabolismo , Macrófagos/metabolismo , Animais , Camundongos , Linhagem Celular , Glicosilação , Membrana Celular/metabolismo , Humanos , Lipoproteínas LDL/metabolismo , Hexosaminas/metabolismo , Hexosaminas/biossíntese , Proteínas rab5 de Ligação ao GTP/metabolismo , Transporte Proteico , Vias Biossintéticas , Processamento de Proteína Pós-TraducionalRESUMO
PURPOSE: Fixed restorations and dental enamel have different structures that produce different wear on opposing teeth, resulting in clinical problems. Therefore, it is necessary to determine the type of restoration that causes less wear on naturally opposing teeth to make recommendations. The objective of this study was to systematically analyze the evidence from observational studies and clinical trials on enamel wear in different ceramic restorations. STUDY SELECTION: The designs of the included studies were randomized clinical trials (RTCs), non-randomized clinical trials (non-RTCs), and observational studies (OS). The studies must answer the research question, be available in full text, be written in English or Spanish, and have had at least six months of follow-up. Protocol number: CRD42023397759. RESULTS: After screening 499 records, 20 RTCs were subjected to data extraction, 10 were excluded, 10 were included in the systematic review, and only 5 were included in the network meta-analysis. The risk of bias assessment reported moderate to high risk of bias, quality, and certainty of evidence was evaluated and rated as moderate. Network meta-analysis showed higher enamel wear was observed in natural dental enamel against metal-ceramic antagonists. CONCLUSIONS: Enamel wear occurs in all teeth, even when the antagonist is a natural tooth. The wear is larger on surfaces with the ceramic crown antagonists studied (metal-ceramic, glazed zirconia, and polished zirconia). It is necessary to conduct additional clinical trials with larger follow-up periods and sample sizes.
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OBJECTIVE: To perform a literature review aimed to analyze if acupoint stimulation increases lactation quantity. METHOD: Studies were collected from five electronic databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews. Eligibility criteria were full-text articles in English or Spanish with clinical trial design and observational studies, with no restriction on time of publication, in which the effect of acupoint stimulation on improving the quantity of lactation by conventional acupuncture, electroacupuncture, laser, fire needling, manual stimulation, tuina or catgut had been evaluated. Two authors independently extracted data for the characteristics and main outcomes of the studies selected for inclusion. The risk of bias (RoB 2 and Robins-I) and the quality assessments (GRADE) were performed. For the quantitative synthesis, the standardized mean difference was calculated for each individual study selected and then the data were combined using a random-effects meta-analysis. RESULTS: A total of 14 studies were included in the present review. Most of the included studies exhibited some concerns in the risk of bias assessment. The quality of the studies was moderate. The meta-analysis showed that manual acupoint stimulation improves the lactation quantity (SMD 95% CI = 1.63 [1.13-2.13]; p < 0.0001). CONCLUSION: The literature suggests that manual stimulation of acupuncture points improves the amount of milk produced during lactation.
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Pontos de Acupuntura , Terapia por Acupuntura , Humanos , Terapia por Acupuntura/métodos , Feminino , LactaçãoRESUMO
One potential application of neural networks (NNs) is the early-stage detection of oral cancer. This systematic review aimed to determine the level of evidence on the sensitivity and specificity of NNs for the detection of oral cancer, following the Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA) and Cochrane guidelines. Literature sources included PubMed, ClinicalTrials, Scopus, Google Scholar, and Web of Science. In addition, the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool was used to assess the risk of bias and the quality of the studies. Only 9 studies fully met the eligibility criteria. In most studies, NNs showed accuracy greater than 85%, though 100% of the studies presented a high risk of bias, and 33% showed high applicability concerns. Nonetheless, the included studies demonstrated that NNs were useful in the detection of oral cancer. However, studies of higher quality, with an adequate methodology, a low risk of bias and no applicability concerns are required so that more robust conclusions could be reached.
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Neoplasias Bucais , Redes Neurais de Computação , Humanos , Sensibilidade e Especificidade , Neoplasias Bucais/diagnósticoRESUMO
BACKGROUND: Elastomeric chains promote controlled movements and are widely used in orthodontics. OBJECTIVES: The aim of the study was to evaluate the force decay and elongation of orthodontic chains exposed to low-pH saliva (pH = 4) and different beverages common in the diet. MATERIAL AND METHODS: Force decay and elongation were determined in vitro at 6 time intervals over 21 days for 2 commercial elastomeric chains - Ormco (group A) and Borgatta (group B). The samples were immersed in artificial saliva (AS) at pH 4, Coca-Cola®, coffee, or beer for 15 min every day, or in AS (the control group). For the remaining time, the chains were placed into AS at 37°C. In addition, microscopic qualitative changes were recorded by means of scanning electron microscopy (SEM). RESULTS: The group B chains showed higher force decay and elongation at the end of the follow-up as compared to the group A chains. Exposure to beer had a greater impact on the force decay and elongation of the chains as compared to other liquids, but it was not statistically significant. The group A chains showed a more irregular surface than the group B chains, in particular, those exposed to coffee. CONCLUSIONS: Elastomeric chains suffer force decay and elongation as a function of time, mainly in the first 24 h. At the end of the follow-up, the group A chains exhibited less force decay in comparison with the group B chains. The qualitative observations showed that the chains in group A had a more irregular surface than the chains in group B.
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Café , Elastômeros , Humanos , Aparelhos Ortodônticos , Elasticidade , Saliva Artificial , DietaRESUMO
Dental caries is a serious multifactorial oral disease that causes demineralization of the tooth's hard tissues and affects more than half of the world's population. The objective of this exploratory systematic review was to determine the prevalence of dental caries in Mexican children and adolescents, as well as related factors such as sex, nutritional status, type of dentition, education, living conditions, socioeconomic level, and the type of demographic area. The eligibility criteria to be considered were observational studies whose sample included Mexicans 0-15 years of age in which the prevalence or an index of dental caries had been evaluated. Eligible studies were identified through the search carried out in 6 databases and manual search, without publication time restriction. Fifty-four studies were found that met the eligibility criteria. In these included studies it was observed that, in the last decades, the prevalence of caries in Mexican children and adolescents exhibits a tendency to decrease this disease. In the 1980s, caries prevalences of up to 92.8% were reported; between 1990-1999, the highest reported prevalence was 97%; from 2000-2009, the highest reported prevalence was 95%; from 2010 to 2019 the highest prevalence was 94.6%; and from 2020 and 2021, prevalences of up to 88.5% were reported. Although there has been a decrease in the prevalence of caries in Mexican children, this disease continues to be linked to biological, behavioral and socioeconomic determinants.
La caries dental es una enfermedad bucodental multifactorial grave que provoca la desmineralización de los tejidos duros del diente y afecta a más de la mitad de la población mundial. El objetivo de esta revisión sistemática exploratoria fue determinar la prevalencia de caries dental en niños y adolescentes mexicanos, así como los factores relacionados como el sexo, el estado nutricional, el tipo de dentición, la educación, las condiciones de vida, el nivel socioeconómico y el tipo de área demográfica. Los criterios de elegibilidad fueron estudios observacionales cuya muestra incluyera mexicanos de 0 a 15 años en los que se hubiera evaluado la prevalencia o un índice de caries dental. Los estudios elegibles fueron identificados mediante la búsqueda realizada en 6 bases de datos y de manera manual, sin restricción de tiempo de publicación. Se encontraron 54 estudios que cumplieron con los criterios de elegibilidad. En estos estudios incluidos se observó que en las últimas décadas la prevalencia de caries en niños y adolescentes mexicanos exhibe una tendencia a la baja. En la década de 1980, se reportaron prevalencias de caries de hasta 92.8%; entre 1990-1999, la mayor prevalencia reportada fue de 97%; de 2000-2009, la prevalencia más alta reportada fue de 95%; de 2010 a 2019 la mayor prevalencia fue de 94.6%; y de 2020 y 2021, se reportaron prevalencias de hasta 88.5%. Aunque ha habido un decremento en la prevalencia de caries en niños mexicanos, esta enfermedad continúa vinculada a determinantes biológicas, conductuales y socioeconómicas.
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Cárie Dentária , Adolescente , Criança , Humanos , Cárie Dentária/epidemiologia , Cárie Dentária/etiologia , Escolaridade , México/epidemiologia , Prevalência , Fatores SocioeconômicosRESUMO
Resumen El objetivo de este artículo fue evaluar la evidencia sobre el uso de una aparatología ortopédica prequirúrgica (AOP) en pacientes con labio y paladar hendido. Se realizó una búsqueda en las siguientes bases de datos: Medline/PubMed, Google Scholar, Clinical Trails.gov, ProQuest y Web of Science. En la búsqueda, se encontraron 7.926 registros, de los cuales se analizaron 105 artículos de texto completo; de éstos se incluyeron 23 estudios en pacientes con uso de AOP, asi como su grupo control sin el uso del AOP, previo al mismo tipo de cirugía. Los aparatos más utilizados para la AOP en el manejo de LPH fueron: el paladar pasivo (Paladar de Hotz), el modelador nasolaveolar (NAM), aparato McNeil y por último el T-traction; los principales desenlaces evaluados fueron: la estética facial y apariencia nasal; la evaluación de medidas cefalométricas, de vías aéreas superiores, nasales, del ancho de la fisura y así como puntos de referencia anatómicos como la distancia inter-canina e inter-tuberosidad. Además, se encontraron estudios que evaluaron oclusión y la fonación. La evidencia de esta literatura sugiere que el uso de aparatos activos tiene un mejor efecto que la placa pasiva, en términos de estética facial y aproximación de los segmentos maxilares para el cierre de la fisura. Sin embargo, la heterogeneidad, el riesgo de sesgo y la baja calidad de los estudios no permite tener conclusiones sólidas.
Abstract This review article aimed to evaluate the evidence on the use of a presurgical orthopedic appliance (POP) in patients with cleft lip and palate. The search was conducted using Medline/PubMed, Scholar Google, Clinical Trails, ProQuest, Scopus, and Web of Science databases. During the search, 7,926 records were found, of which 105 full-text articles were analyzed, and 23 studies included analysis in patients with the use of POP, and their control groups without the use of POP prior to the same type of surgery. The devices most used for POP in the management of LPH were: the passive palate (Hotz palate), the nasolaveolar moulding (NAM), the McNeil device, and finally, the T-traction. The primary outcomes evaluated were: facial aesthetics and nasal appearance; the evaluation of cephalometric measurements, upper airways, nasal fissure width, as well as anatomical references such as inter-canine and intertuberosity distances. In addition, studies that evaluated occlusion and phonation were found. The evidence from this literature suggests that the use of active appliances had a better effect than passive appliances in terms of facial aesthetics and approximation of the maxillary segments for the closure of the fissure. However, the heterogeneity, the risk of bias, and the low quality of the studies do not allow to state firm conclusions.
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BACKGROUND: A good level of knowledge in dentists is crucial for an early diagnosis of oral cancer (OC). In Latin America there are a few studies of OC knowledge among dentist, those has been performed in Brazil, Colombia, and Chile, and their results showed low level of OC knowledge. On the other hand, there is no publication in which the level of knowledge of dentists in Mexico has been addressed. Therefore, this study aimed to assess knowledge of OC and to determine the association of the level of knowledge with sociodemographic characteristics among dentists in Mexico. METHODS: A cross-sectional online survey was designed to obtain information via questionnaire. The questionnaire was developed in the Spanish language, and the content validity was determined. The study was conducted among Mexican dentists with a 23-item questionnaire that was designed to be anonymous. The sample size was calculated using the finite population formula. Based on the responses, the level of knowledge of OC was categorized as very low, low, regular, good, or excellent. Additionally, the association between sociodemographic characteristics and the level of knowledge about OC was evaluated. RESULTS: This research was conducted on a sample of 387 dentists. Most of the respondents were general dentists and worked in urban zones. The majority of dentists lacked a specialty (76.7%). Additionally, most of the respondents were students (44.2%). The level of knowledge of the participants was between regular and good (77.8%). On the other hand, concerning self-evaluation, most of the participants considered their knowledge of OC to be regular (50.6%). In addition, there was no association between sociodemographic characteristics and knowledge about OC. CONCLUSIONS: This research identified some weaknesses in most Mexican dentists' knowledge of OC.
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Neoplasias Bucais , Humanos , Atitude do Pessoal de Saúde , Estudos Transversais , Odontólogos , México , Neoplasias Bucais/diagnóstico , Inquéritos e QuestionáriosRESUMO
Recently, biomimetic bioactive biomaterials have been introduced to the market for dental pulp capping. This systematic review and meta-analysis aimed to determine any variation between the effect of using TheraCal LC and other bioactive biomaterials for pulp capping is different, as measured by dentin increment and clinical success. The risk of bias was assessed using the Risk of Bias 2 and Newcastle−Ottawa tools for randomized clinical trials and observational studies. A search for relevant articles was performed on five databases. Additionally, the quality of the included studies was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. A summary of individual studies and a meta-analysis were performed. The odds ratio of data from clinical success was combined using a random-effects meta-analysis. The meta-analysis results showed homogeneity between the studies (I2 = 0%). They revealed that the clinical success showed no differences between the patients who received TheraCal LC, light-cured calcium silicate-based biomimetic biomaterial, for dental pulp capping or the comparator biomaterials (p > 0.5). However, the certainty of the evidence was low to moderate due to the risk of bias in the included studies.
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Orthodontic treatment could lead to undesirable effects such as external apical root resorption (EARR). Moreover, trauma to both the face and teeth can predispose to EARR. On the other hand, the practice of combat sports results in increased maxillofacial injuries. Consequently, our objective was to determine if there is a statistically significant difference in the EARR of the patients undergoing fixed orthodontic treatment who practice combat sports and controls. Our null hypothesis was that there is no difference in the EARR between patients undergoing orthodontic treatment who practice combat sports and the patients under the same treatment that do not practice combat sports. An observational, descriptive, and prospective case-control pilot study was designed. The exposed group consisted of patients that practice combat sports. Whereas the control group was conformed of patients that do not practice combat sports without a previous history of facial trauma and without face trauma during the orthodontic treatment. EARR of the maxillary and mandibular anterior teeth was measured using cone-beam computed tomography (CBCT). The CBCT scans were obtained from all patients prior to the beginning of the orthodontic treatment and 1 year later. At the end of the follow-up for the maxillary right central and lateral incisors of the exposed group, the EARR was significantly higher than the homologous teeth of the control group (p < 0.05). As a consequence, the patients treated orthodontically who practice combat sports could be more susceptible to EARR.
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Reabsorção da Raiz , Humanos , Reabsorção da Raiz/etiologia , Projetos Piloto , Incisivo , Maxila , Estudos de Casos e ControlesRESUMO
External apical root resorption (EARR) is a serious complication that should be avoided during orthodontic treatment; this pathology depends on multiple factors. Data from clinical studies should be assessed to determine the influence these factors have on the development of EARR. This systematic review aims to compare EARR produced by different factors (orthodontic systems, dental trauma, and dental vitality). The protocol was registered on the PROSPERO database. The search was performed on 5 databases. Accepted study designs included randomized controlled trials, nonrandomized clinical trials, and observational studies. Full-text articles from clinical studies of EARR associated with orthodontic treatment in English, Spanish, or Portuguese with no publication date restrictions were selected. Data from the studies, such as age, population, study groups, and outcome measures, were recorded. Multiple meta-analyses were performed with data from the included studies. Evidence suggests that EARR induced by orthodontic treatment is similar, regardless of the technique used. Evidence of the effect of previous dental trauma on EARR during orthodontic treatment is limited. There is less EARR associated with orthodontic treatment in endodontically treated teeth than in vital teeth. These conclusions should be considered with caution due to the low certainty of the evidence.
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Reabsorção da Raiz , Dente não Vital , Humanos , Aparelhos Ortodônticos Fixos/efeitos adversos , Reabsorção da Raiz/etiologia , Dente não Vital/complicaçõesRESUMO
BACKGROUND: The assessment of motor function is vital in post-stroke rehabilitation protocols, and it is imperative to obtain an objective and quantitative measurement of motor function. There are some innovative machine learning algorithms that can be applied in order to automate the assessment of upper extremity motor function. OBJECTIVES: To perform a systematic review and meta-analysis of the efficacy of machine learning algorithms for assessing upper limb motor function in post-stroke patients and compare these algorithms to clinical assessment. MATERIAL AND METHODS: The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database. The review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. The search was performed using 6 electronic databases. The meta-analysis was performed with the data from the correlation coefficients using a random model. RESULTS: The initial search yielded 1626 records, but only 8 studies fully met the eligibility criteria. The studies reported strong and very strong correlations between the algorithms tested and clinical assessment. The meta-analysis revealed a lack of homogeneity (I2 = 85.29%, Q = 48.15), which is attributable to the heterogeneity of the included studies. CONCLUSION: Automated systems using machine learning algorithms could support therapists in assessing upper extremity motor function in post-stroke patients. However, to draw more robust conclusions, methodological designs that minimize the risk of bias and increase the quality of the methodology of future studies are required.
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Transtornos Motores , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Humanos , Extremidade Superior , Reabilitação do Acidente Vascular Cerebral/métodos , ParesiaRESUMO
The cardiovascular system is a complex and well-organized system in which glycosylation plays a vital role. The heart and vascular wall cells are constituted by an array of specific receptors; most of them are N- glycosylated and mucin-type O-glycosylated. There are also intracellular signaling pathways regulated by different post-translational modifications, including O-GlcNAcylation, which promote adequate responses to extracellular stimuli and signaling transduction. Herein, we provide an overview of N-glycosylation and O-glycosylation, including O-GlcNAcylation, and their role at different levels such as reception of signal, signal transduction, and exogenous molecules or agonists, which stimulate the heart and vascular wall cells with effects in different conditions, like the physiological status, ischemia/reperfusion, exercise, or during low-grade inflammation in diabetes and aging. Furthermore, mutations of glycosyltransferases and receptors are associated with development of cardiovascular diseases. The knowledge on glycosylation and its effects could be considered biochemical markers and might be useful as a therapeutic tool to control cardiovascular diseases.
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Cancer is one of the most prevalent diseases in the world and requires new therapies for its treatment. In this context, the biosynthesis of silver nanoparticles (AgNPs) has been developed to treat different types of tumors. The Annona muricata plant is known for having anticancer activity. Its main compounds present in the leaves, stems and skin, allowing for its use as reducing agents. In this manuscript, AgNPs with leaf extract (AgNPs-LE) and fruit peel extract (AgNPs-PE) of A. muricata were biosynthesized obtaining an average nanoparticle diameter sizes smaller than 50 nm, being 19.63 ± 3.7 nm and 16.56 ± 4.1 nm, and with a surface plasmonic resonance (SPR) at 447 and 448 nm, respectively. The lactone functional group present in the LE and PE extracts was identified by the FTIR technique. The behavior and antiproliferation activity of AgNPs-LE and AgNPs-PE were evaluated in breast, colon and melanoma cancer cell lines. Our results showed that Annona muricata fruit peel, which is a waste product, has an antitumor effect more potent than leaf extract. This difference is maintained with AgNPs where the destruction of cancer cells was, for the first time, achieved using concentrations that do not exceed 3 µg/mL with a better therapeutic index in the different tumor strains. In conclusion, we present a low-cost one-step experimental setup to generate AgNPs-PE whose in-vitro biocompatibility and powerful therapeutic effect make it a very attractive tool worth exploiting.
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Resumen La percepción del dolor es una respuesta adaptativa ante la presencia de eventos dañinos y potencialmente fatales. La Insensibilidad Congénita al Dolor, Neuropatía Autonómica y Sensorial Hereditaria Tipo II, o Síndrome de Morvan de causa desconocida, es una afección en la que se produce una pérdida de la discriminación de las señales dolorosas, así como de la respuesta emocional-afectiva. Debido a esto, la persona afectada no evade los estímulos dolorosos y, en consecuencia, puede infligirse daño a sí mismo. Incluso, durante el tratamiento de dichas lesiones pueden producir complicaciones graves como se describe en el desarrollo del presente caso clínico. Este síndrome es muy raro, de ahí la importancia de dar a conocer las complicaciones que pueden ocurrir con el fin de que la comunidad médica detecte a tiempo a este tipo de pacientes. Este reporte de caso muestra el seguimiento durante diez años de un paciente femenino con diagnóstico de Neuropatía Autonómica y Sensorial Hereditaria Tipo II. La paciente tuvo ingresos repetidos en los servicios de salud por procesos infecciosos en la cavidad bucal que involucró a múltiples órganos dentales, evolucionando a osteomielitis, por lo que tuvo que recurrirse a la mandibulectomía, incluso después de que se sometió a varios tratamientos farmacológicos. A pesar de los esfuerzos por mantener a la paciente con la mejor calidad de vida posible, este caso muestra que un diagnóstico tardío conduce a un pronóstico y condición de vida desfavorables.
Abstract The perception of pain is an adaptive response to the presence of harmful and potentially fatal events. Congenital insensitivity to pain, Hereditary Sensory and Autonomic Neuropathy Type II or Morvan syndrome of unknown cause, is a condition in which there is a loss of discrimination of the painful signals, as well as the emotional-affective response. Due to this, the person, that suffering this disorder, does not evade the painful stimuli and, consequently, can inflict damage to himself or herself. Even during the treatment of such lesions can produce serious complications as described in the development of the present clinical case. This syndrome is very rare, hence the importance of publicizing the complications that may occur in order for the medical community to detect this type of patients as soon as possible. This case report shows the follow-up of a female patient with Hereditary Sensory and Autonomic Neuropathy Type II for ten years. The patient has had several admissions to the hospital, due to infectious processes in the oral cavity that involved multiple dental organs, evolving to osteomyelitis, and for this reason, the mandibulectomy must performed in the patient; even after she underwent several pharmacological treatments. Despite the efforts to maintain the patient with the best possible quality of life, this case shows that a late diagnosis lead to an unfavorable prognosis and life condition for patients suffering from this genetic anomaly.
Resumo A percepção da dor é uma resposta adaptativa à presença de eventos potencialmente fatais e prejudiciais. A insensibilidade congênita à dor, neuropatia autonômica e sensorial hereditária tipo II, ou síndrome de Morvan de causa desconhecida, é uma condição na qual há perda de discriminação de sinais dolorosos e resposta emocional-emocional. Por esse motivo, a pessoa afetada não evita estímulos dolorosos e, consequentemente, danos podem ser infligidos a si mesma. Mesmo durante o tratamento das referidas lesões, elas podem produzir complicações graves, como descrito no desenvolvimento do presente caso clínico. Essa síndrome é muito rara, daí a importância de divulgar as complicações que podem ocorrer para que a comunidade médica detecte esse tipo de paciente a tempo. Este relato de caso mostra o seguimento de dez anos de uma paciente com diagnóstico de Neuropatia hereditária autonômica e sensorial tipo II. A paciente repetiu internações nos serviços de saúde por processos infecciosos na cavidade bucal que envolviam múltiplos órgãos dentários, evoluindo para osteomielite e, portanto, precisou recorrer à mandibulectomia, mesmo após vários tratamentos farmacológicos. Apesar dos esforços para manter o paciente com a melhor qualidade de vida possível, este caso mostra que um diagnóstico tardio leva a um prognóstico e condição de vida desfavoráveis.
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BACKGROUND: The incorporation of an antibacterial agent into an adhesive could improve its clinical performance. Some nanoparticles (NPs), including copper nanoparticles (Cu NPs), display an antibacterial effect. Therefore, Cu NPs could act as a nanofiller when added to an adhesive. OBJECTIVES: The aim of this study was to evaluate the antibacterial activity, cytotoxicity and shear bond strength (SBS) of an experimental dental adhesive with Cu NPs. MATERIAL AND METHODS: Different concentrations (0.0050 wt%, 0.0075 wt% and 0.0100 wt%) of Cu NPs were added to the adhesive. The distribution of Cu NPs in the polymer matrix was observed based on transmission electron microscope (TEM) images. The antimicrobial activity of the adhesive + Cu NPs was evaluated with the agar disk diffusion test against Staphylococcus aureus (S. aureus), Escherichia coli (E. coli) and Streptococcus mutans (S. mutans). The cytotoxicity assay was performed by means of the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) method with human pulp cells (HPC). Additionally, the SBS tests were carried out (n = 31) and the modes of fracture were registered. The vestibular and lingual surfaces of each tooth were randomly assigned to the study groups (group I - control adhesive; group II - adhesive + 0.0100 wt% Cu NPs). The samples were statistically analyzed (p ≤ 0.05). RESULTS: The adhesive + 0.0100 wt% Cu NPs showed inhibition zones against the strains under study that were similar to, or slightly smaller than, the halos produced by chlorhexidine (CHX) and specific drugs for each strain (30 µg of cefotaxime against S. mutans and S. aureus, and 1.25/3.75 µg of sulfamethoxazole/ trimethoprim against E. coli). The control adhesive was moderately cytotoxic (relative cell viability of 36.7 ±0.8%), being more cytotoxic than Cu NPs themselves (58.3 ±0.1%). A significantly higher SBS was obtained for the adhesive + 0.0100 wt% Cu NPs (6.038 ±2.95 MPa) than for the control group (3.278 ±1.75 MPa). The modes of fracture in group I were almost equally distributed between adhesive and cohesive failures whereas in group II, the failure was mainly cohesive. CONCLUSIONS: The results of this study suggest that incorporating Cu NPs into an adhesive improves its SBS and provides it with antibacterial properties, without increasing its inherent cytotoxicity - 2 desirable characteristics for the dental adhesives of composites.
Assuntos
Colagem Dentária , Nanopartículas , Cobre , Cimentos Dentários , Escherichia coli , Humanos , Staphylococcus aureusRESUMO
RESUMEN Introducción: Los selladores endodónticos desempeñan un papel crucial en la obturación, dado que dichos materiales, no solo actúan en el momento de su aplicación, sino que continúan haciéndolo con posterioridad, protegiendo al periodonto apical contra los organismos microbianos presentes. Precisamente, una de las propiedades deseadas en los selladores endodónticos es que posean acción antimicrobiana, para eliminar las bacterias remanentes después de la irrigación e instrumentación. Objetivo: Realizar una revisión sistemática del efecto antibacteriano de diferentes selladores endodónticos más utilizados en odontología contra Enterococcus faecalis (E. faecalis). Métodos: Esta revisión sistemática se llevó a cabo siguiendo los lineamientos PRISMA. La búsqueda se realizó en las bases de datos PubMed y Science Direct. Se revisaron los artículos de estudios antimicrobianos in vitro de selladores endodónticos y se excluyeron aquellos de fuente secundaria, como los de revisión de la literatura, así como artículos sobre cementos para otros usos. Desarrollo: Los cementos a base de hidróxido de calcio, resina o biocerámicos son biocompatibles y presentan algún porcentaje de actividad antimicrobiana; sin embargo, se puede apreciar que existe variabilidad en los resultados obtenidos en los estudios incluidos en la revisión, debido al uso de condiciones diferentes para la evaluación antibacteriana, excepto en los selladores endodónticos a base de silicona, los cuales tuvieron, de forma consistente, un efecto antibacterial nulo contra E. faecalis. Conclusión: De acuerdo a la bibliografía revisada, los selladores AH Plus, AH 26, TotalFill, BC Sealer y MTA Fillapex exhibieron efecto antimicrobiano, sin embargo, algunos de ellos mostraron escasa actividad contra E. faecalis(AU)
ABSTRACT Introduction: Endodontic sealers play a crucial role in sealing, for they not only act at the moment of their application, but continue to do so later, protecting the apical periodontium against microbial organisms. One of the properties desired in endodontic sealers is precisely their antimicrobial action against bacteria remaining after irrigation and instrumentation. Objective: Carry out a systematic review about the antibacterial effect of the endodontic sealers most commonly used in dental practice against Enterococcus faecalis (E. faecalis). Methods: The systematic review was based on PRISMA guidelines. The search was conducted in the databases PubMed and Science Direct. Papers were reviewed which dealt with in vitro antimicrobial studies about endodontic sealers, excluding secondary sources such as literature reviews and papers about cements used for other purposes. Discussion: Cements based on calcium hydroxide, resin or bioceramic are biocompatible and display some percentage of antimicrobial activity. However, variability was observed in the results obtained by the studies in the review, due to the use of different conditions for antibacterial evaluation, except for silicone-based endodontic sealers, which consistently displayed no antibacterial activity against E. faecalis. Conclusion: According to the bibliography reviewed, the sealers AH Plus, AH 26, TotalFill, BC Sealer and MTA Fillapex had an antimicrobial effect. However, some of them displayed scant activity against E. faecalis(AU)
Assuntos
Humanos , Selantes de Fossas e Fissuras/uso terapêutico , Tratamento do Canal Radicular/métodos , Cimentos Dentários/uso terapêutico , Antibacterianos/efeitos adversos , Literatura de Revisão como Assunto , Bases de Dados BibliográficasRESUMO
En 2008, la Organización Mundial de la Salud reportó que el 13% de las muertes en todo el mundo estuvieron relacionadas con el cáncer. Debido a su magnitud, es un problema prioritario de salud pública del cual se requiere información epidemiológica suficiente para optimizar programas nacionales de salud. El objetivo de esta revisión de la literatura es describir los tipos de cáncer más comunes de labio, cavidad oral y orofaringe reportados en la población mexicana. Se realizó una revisión sistemática siguiendo los lineamientos PRISMA. La información disponible se compiló de las bases de datos electrónicas PubMed, Google Académico y Science Direct, así como de las bases abiertas de datos de salud nacionales. La búsqueda electrónica se realizó con las siguientes palabras clave en inglés "(oral cancer OR oral neoplasm) AND (Mexico) AND (epidemiology OR prevalence)", y sus equivalentes en español.In 2008 the World Health Organization reported that 13% of worldwide deaths were related to cancer. Due to its magnitude, this pathology has become a central public health problem. Therefore epidemiological information at national level is required to optimize health care programs. The aim of this review is to describe the most common types of cancer in lips, oral cavity, and oropharynx reported in Mexican population. A systematic review was carried out following PRISMA guidelines; information was compiled from electronic databases PubMed, Google Scholar and Science Direct, as well as from open Mexican health databases. Electronic search was performed using following Medical Subject Headings, MeSH terms "(oral cancer OR oral neoplasm) AND (Mexico) AND (epidemiology OR prevalence)" and the equivalent keywords in Spanish.
RESUMO
OBJECTIVES: To evaluate the associations between dental caries classified according to the index for decayed, missing and filled teeth (DMFT) and stimulated salivary flow, salivary capacity for oxidation reduction and academic stress in undergraduate dental surgery students aged 18-22 years. METHODS: This research was performed at three time-points: March 2010, September 2010 and March 2011. The sample was composed of 73 students, including 15 male and 58 female subjects. Data were obtained using the DMFT index to detect incident dental caries, the RD test Showa for salivary capacity for oxidation reduction, the Sisco academic stress inventory, and sterile polyethylene to stimulate salivary flow. RESULTS: Logistic regression analysis showed that: subjects with stimulated salivary flow of <1 ml/min are at increased risk for developing caries compared with those with stimulated salivary flow of ≥1 ml/min; those with moderate or high levels of academic stress are at greater risk for developing carious lesions than those with low academic stress; women are at greater risk for developing carious lesions than men, and, of the subjects studied, younger students were more likely to develop caries. CONCLUSIONS: Moderate to high levels of academic stress, younger age and lower salivary flow rate represent risk factors for the development of dental caries in students.