Evaluation of the effects of canning variables on the mineral composition of canned cowpeas (Vigna unguiculata l. Walp) using multi-response analysis

This study aims to investigate the effects of canning variables (cooking time, storage time, volume of vinegar, salt and sugar) on the mineral composition of canned cowpea (Vigna unguiculata (L.) Walp) and which conditions provide optimised preservation of the mineral content of the grains. Different formulations of canned cowpeas were produced following two levels factorial experimental design using five variables. A set of 11 different formulations were evaluated using the desirability function with essential minerals (Ca, Cu, Fe, Mn, Mg, P and Zn) as the response. The optimal multi-response conditions for higher mineral retention were: 360 days of storage at 30 ± 5 °C (ST2), 30 ml of vinegar, 9.0 g of NaCl, 18 min of cooking time, and 9.0 g, 19.5 g or 30 g of sugar (the effect of the sugar content at the evaluated range was not significant at 95% confidence level).

Brazilian dentist's knowledge of minimum intervention dentistry for caries management: application of a developed knowledge scale (MIDDeC-KS) and evaluation of its psychometric properties

AIM

To assess the knowledge of Brazilian dentists about Minimum Intervention (MI) using a Minimum Intervention Dentistry to Dental Caries-Knowledge Scale (MIDDeC-KS) and evaluate its psychometric properties.

MATERIALS AND METHODS

An online scale was developed to evaluate dentists' knowledge about MI. The higher the score, the greater the knowledge and vice versa. A preliminary study was carried out with 143 dentists to validate the MIDDeC-KS. For psychometric properties analysis, convergent and discriminant validity, test-retest reliability, and internal consistency of the instrument were assessed. After validation, MIDDeC-KS was applied to a representative sample of Brazilian dentists. T test for independent samples, Chi-square, and/or ANOVA one-way tests were applied.

RESULTS

The MIDDeC-KS convergent (Spearman's = 0.48) and discriminant (P = 0.001) validity and reliability (ICC = 0.85, α = 0.72 and ω = 0.74) were proved. The participants (n = 637) obtained an overall mean score of 7.4 ± 2.5. The sample was mainly composed of females (P < 0.01), who graduated over 10 years prior (P = 0.02), from public colleges (P < 0.01), and most were pediatric dentists (38.2%). The highest and lowest scores were reached by pediatric dentists (9.2 ± 1.6) and bucomaxillofacial professionals (3.1 ± 2.1), respectively. Brazilian dentists demonstrated more knowledge about diet, biofilm, and topical fluoride control (84.3%), while the Hall technique (31.9%), resin infiltrant (47.6%), and chemical mechanical caries removal (48.4%) were the least known MI techniques.

CONCLUSION

Brazilian dentists demonstrated more knowledge about preventive measures and less about more recent protocols, such as the Hall technique, resin infiltrant, and chemical mechanical caries tissue removal. Sufficient psychometric evidence of the MIDDeC-KS was found.

CLINICAL RELEVANCE

Identify dentist's knowledge about MI.

Assessment of the reliability of YouTube™ videos about zirconia crowns in pediatric dentistry

PURPOSE

To evaluate the reliability of YouTube™ videos on zirconia crowns in pediatric dentistry.

METHODS

On January 4, 2022, a search was performed using the term "pediatric zirconia crown". The first 100 videos on the subject were included. Non-English videos, duplicates, and off-topic videos were excluded. For each video, an examiner recorded the number of views, likes, comments, channel followers, upload date, duration, and category rating. Two examiners assessed the reliability of the information presented in the videos using DISCERN, a brief questionnaire and scale score used to assess in a valid and reliable way the quality of information on treatment choices for health problems. Descriptive and inferential analyses were performed (p < 0.05).

RESULTS

Of the initial 100 videos, 72 were excluded because of language, duplication, and subject matter. The 28 remaining videos had an average of 3.5 comments, 8,896.18 channel followers, 5,614.00 views, 19.14 likes, and a duration of 840.32 s. The average view rate was 7.54 per day ± 10,206.81. There was a statistically significant difference between the number of views and comments (p < 0.001), likes and comments (p < 0.001), and likes and views (p = 0.006). According to the DISCERN, none of the videos received the maximum grade to be considered very good. Two were considered good, nine fair, fourteen poor, and three very poor.

CONCLUSION

Given that the majority of YouTube™ videos currently available on zirconia crowns in pediatric dentistry were deemed unreliable according to the DISCERN questionnaire, caution should be exercised when using the information presented.

Does the addition of chlorhexidine to glass ionomer cements influence its antimicrobial effect and survival rate? A systematic review

PURPOSE

To evaluate the influence of the addition of chlorhexidine on the antimicrobial effect and on the survival of restorations performed with glass ionomer cement.

METHODS

Nine databases were used to search for randomized clinical trials that compared the survival rate and the antimicrobial effect of glass ionomer cement (GIC) restorations with and without the incorporation of chlorhexidine (CHX), without restrictions on year or language. Cochrane Collaboration's Risk of Bias 2 was used to assess the risk of bias. The GRADE approach was used to assess the certainty of evidence.

RESULTS

From 593 studies found, seven met the inclusion criteria. The concentration of CHX varied between 0.5 and 2%. In general, the addition of CHX to GIC promoted reductions in Streptococcus mutans and Lactobacillus acidophilus burdens when compared to those without CHX. No study showed a difference in the survival of restorations between GIC with CHX and conventional GIC. Individual risk of bias varied from low to high and the certainty of evidence was classified as very low.

CONCLUSIONS

Based on a very low level of certainty, the evidence suggests that the incorporation of CHX in GIC might improve the antimicrobial effects for a short time, in addition to having little influence on the survival of the restoration.

Worldwide trends on molar incisor and deciduous molar hypomineralisation research: a bibliometric analysis over a 19-year period

AIM

To identify the worldwide trends in scientific evidence and gaps in knowledge regarding molar incisor hypomineralisation (MIH) and deciduous molar hypomineralisation/hypomineralised second primary molars (DMH/HSPM), exploring the contribution of authors and countries, possible etiological factors and proposed treatments, in order to guide future research in the area.

METHODS

Searches were conducted in MEDLINE, Scopus, Web of Science, Cochrane Library, Lilacs/BBO, Embase and Google Scholar. Studies employing the terms MIH, DMH/HSPM and their linguistic variations were included. The following data were extracted: title, authors, year and journal of publication and first author's affiliation country. Studies were categorized according to topic, dentition, study design, etiological factors and types of treatments. Categories were analysed in relation to their distribution, co-occurrence, cross-correlation and/or autocorrelation.

RESULTS

Five hundred and three studies were included. The most published authors were Manton D (n = 47), de Souza JF (n = 22) and Ghanim A (n = 22) and four main collaboration clusters have been identified. Most of the studies were conducted on permanent dentition (MIH) (87.4%); with observational design (57.2%). The "European Archives of Paediatric Dentistry" was the most published journal (13.3%) and a significant increase in the number of publications was observed in the last decade. MIH was most studied in relation to prevalence/incidence, systemic factors involved in its aetiology and treatment with composite restorations, while a gap in knowledge was observed for extraction and sealants. Less studies were published on DMH/HSPM and most of them evaluated risk factors or prevalence/incidence. The gap of knowledge was observed in relation to treatments and patient's quality of life.

CONCLUSIONS

This bibliometric review provided a comprehensive overview of research in MIH and DMH/HSPM over the past 19 years. Within the limitations of the present study, the following conclusions can be drawn: global trends point to an increasing peak of scientific publication, especially in the last decade, while there is a shortage of clinical studies on treatments, mainly evaluating tooth extractions. Finally the multifactorial nature should be further explored, considering environmental and systemic factors together.

Treatment time, pain experience and acceptability of the technique for caries removal in primary teeth using the ART approach with or without Brix3000™ papain gel: a preliminary randomised controlled clinical trial

PURPOSE

To compare the Atraumatic Restorative Treatment (ART) associated with Brix3000™ to ART considering treatment time, pain experienced, and acceptability to children.

METHODS

This study was accepted in Research Ethics Committee in July 2019 (number 3469402). Healthy patients (n = 20) aged 3-9 years, with at least one primary molar with occlusal dentine caries without cusp involvement were randomly allocated to either the ART + Brix3000™ group or the ART-only group. The sample was characterised by sex, age, tooth location and caries experience. Time spent and pain experience scores were recorded at prophylaxis, caries removal and restoration. The pain experience (intense, moderate, or mild) was evaluated by the Face, Legs, Activity, Cry, Consolability-revised scale (FLACC-r). Acceptability was assessed by a five-point hedonic facial scale (dichotomised into 'like' and 'indifferent/dislike' bins) and by an open-question interview. Mann-Whitney, Chi-square, and Fisher's exact tests were applied to discern differences in time, pain/sample characterisation and acceptability, respectively.

RESULTS

The ART + Brix3000™ group required 8.6 ± 3.1 min to remove caries tissue, whereas the ART group required only 4.8 ± 2.0 min (p = 0.03). The total time spent with treatments was 13.1 ± 4.0 min for ART + Brix3000™, and 9.8 ± 2.7 min for ART (p = 0.03). There was no difference in pain experience and acceptability found among the groups (p > 0.05).

CONCLUSION

Although the ART + Brix3000™ technique demanded more treatment time than the ART alone, there were no differences in either pain experience or acceptability.

Does Addition of 10-MDP Monomer in Self-etch Adhesive Systems Improve the Clinical Performance of Noncarious Cervical Lesion Restorations? A Systematic Review and Meta-analysis

BACKGROUND

Functional acidic monomers are able to chemically interact with hydroxyapatite, and this bond appears to be very stable. Therefore, this aspect of the 10-MDP molecule made it attractive and added to self-etch adhesives.

OBJECTIVES

The objective of this Systematic Review (SR) and Meta-analysis (MA) was to determine whether systems with the 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) functional monomer in their formula showed better clinical performance in restorations placed in noncarious cervical lesions (NCCL) when compared to systems without it. The PROSPERO registration number of the MA is CRD42016050538.

DATA AND SOURCES

An e-search was conducted through MEDLINE via PubMed, Cochrane Library, Scopus, Web of Science, OpenGrey, Clinical Trials, Current Controlled Trials, and EU Clinical Trials Register, and a search through the references of included studies was also performed. Randomized Controlled Clinical Trials, in which the effectiveness of self-etch adhesive systems, with or without the 10-MDP functional monomer for NCCL, was discussed, were included. Risk of bias was performed according to the Cochrane Collaboration tool, and the certainty of evidence was evaluated through GRADE.

STUDY SELECTION

The data were grouped, heterogeneity (I2) was tested, and after duplicate removal, 4208 manuscripts were retrieved. From these, 11 studies were included in the qualitative analysis (risk of bias), with nine classified as low risk and two unclear. GRADE analysis detected moderate-to-high certainty of evidence, so the quantitative synthesis [Meta-analysis (MA)] was performed including the 11 studies.

RESULTS AND CONCLUSION

There were no statistical differences in the clinical performance of restorations conducted using "with or without 10-MDP" adhesive types, for all evaluated criteria (p=0.05), with heterogeneity ranging from 0% to 53%. Thus, the presence of 10-MDP functional monomer did not influence the clinical performance of restorations placed in NCCL.

Evaluation of the nutritional quality of cereal bars made with pulse flours using desirability functions

The development of nutritious, low-cost snacks has become increasingly important due to consumer demand for healthier diets. In this study, sensory and physical-chemical parameters and mineral compositions (P, Ca, Na, K, Mg, Fe, Zn, Al, Cu, Mn, Ni and Ba) of cereal bars were evaluated. The bars were made with flours of Lablab purpureus L. Sweet (mangalo), Vigna unguiculata L. Walp (cowpea) or Cajanus cajan L. Huth (pigeon pea) and the desirability function was used to attain the best formulation for maximising the content of protein, fibre, ashes and essential elements. Sensory analysis revealed satisfactory acceptability. Acidity did not change significantly (p > 0.05), and water activity values ​​did not exceed 0.557 over 90 days, indicating stability. Principal component analysis revealed no significant differences when comparing the mineral content between the bars. The desirability function indicated that the cowpea-based bar had a higher nutritional quality, with a protein content of 4.91 ± 0.25 g 100 g^-1, P content of 187.7 ± 3.6 mg 100 g^-1, Mg content of 87.37 ± 1.19 mg 100 g^-1 and Mn content of 2020 ± 130 µg 100 g^-1, than the other bars. The overall sensory evaluation also yielded a high score for the cowpea-based bar (overall quality equal to 6.23 ± 1.10). Therefore, pulse flours could be potential nutritional ingredients for making snacks, and in particular, cereal bars containing them could be a viable product alternative for small rural cooperatives.

Does the Type of Solvent in Dental Adhesives Influence the Clinical Performance of Composite Restorations Placed in Noncarious Cervical Lesions? A Systematic Review and Meta-analysis

CLINICAL RELEVANCE

According to the clinical and scientific evidence presented in this systematic review and meta-analysis, dental adhesives containing either organic solvent (acetone or alcohol) can be used to achieve similar clinical performance and longevity of composite restorations.

SUMMARY

Objectives: This systematic review and meta-analysis compared the clinical performance and survival rates of composite restorations placed in noncarious cervical lesions (NCCLs) using dental adhesives containing acetone or alcohol-based solvents.Methods and Materials: PubMed, Scopus, Web of Science, Virtual Health Library (VHL) LILACS, Cochrane Library, OpenGrey, Clinical Trials, and Rebec were searched. MeSH terms, supplementary concepts, synonyms, and free keywords were used in the search strategy. All references were crosschecked by two independent investigators following the PICOS strategy (population, NCCLs; intervention, acetone-based bonding agent; comparison, alcohol-based bonding agent; outcome, clinical evaluation parameters and survival rates; study design, randomized controlled clinical trials). Cochrane Collaboration's tool was used to assess risk of bias, and two distinct meta-analyses were performed using the RevMan software. The prevalence of success and the total number of restorations for each group (acetone- or alcohol-based) were used to calculate the risk difference at a confidence interval of 95%. Random-effects models were applied, and heterogeneity was assessed using the I2 index in the pooled and subgrouped meta-analyses. The certainty of evidence was evaluated through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.Results: A total of 7876 studies were retrieved, from which 27 studies were selected for the systematic review. Ten studies were classified as "low risk of bias" and included in the meta-analyses. Overall heterogeneity was not significant (I2 = 0.00%). The clinical performance of restorations placed with bonding agents based on both solvents for each of the available parameters presented no statistical significance for any of the meta-analyses (p>0.05).Conclusion: Scientific evidence suggests composite restorations placed with acetone or alcohol-based dental adhesives present similar clinical performance and survival rates in NCCLs.

MTT versus other cell viability assays to evaluate the biocompatibility of root canal filling materials: a systematic review

OBJECTIVES

This systematic review aimed to compare the cytotoxicity of root canal filling materials (RCFMs) assessed using tetrazolium salt-based tests (TSBT), including the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay, with those obtained using other cell viability assays.

METHODS

A search was performed on PubMed, Scopus, Web of Science and OpenGrey up to March 2019, followed by a manual search. According to the Participants, Exposure, Comparator and Outcomes (PECO) criteria, in vitro studies that evaluated the cytotoxic effect of RCFMss on animal and/or human cells through TSBT and at least one other viability assay were compared. The methodological quality of selected papers was assessed using ToxRTool^® and SciRAP^® . Data were analysed using Wilcoxon's signed-rank test for paired samples and linear weighting kappa.

RESULTS

A total of 230 non-duplicated records were identified. After applying the eligibility criteria, 55 studies were selected for methodological evaluation, seven were selected by manual searching, 22 were excluded for methodological reasons, and 40 were included. A total of 410 comparisons were performed between TSBT and distinct cell viability tests (DCVT). MTT had moderate concordance with DCVT using human cells (n = 138 samples) (P = 0.507; k = 0.4225) and animal cells (n = 122 samples) (P = 0.124; k = 0.5775). XTT had good concordance using human (n = 110 samples) (P = 0.507; k = 0.6336) and animal cells (n = 12 samples) (P = 0.564; k = 0.6604). MTT, XTT, WST and MTS assays showed moderate concordance with DCVT (n = 410 samples) (P = 0.375; k = 0.5138) and complete agreement in 226 samples.

DISCUSSION

The included studies had methodological heterogeneity that was minimized by the systematic review methodology.

CONCLUSIONS

MTT and XTT do not cause over- or underestimation of cell viability during cytotoxicity screening of root canal filling materials, implying that these assays can be considered reliable for this purpose. Nonetheless, the development of protocols for the cytotoxic screening of these materials on 3D tissue-like cultures aiming to improve their predictability in the clinical scenario is suggested.

Does tobacco smoking predispose to apical periodontitis and endodontic treatment need? A systematic review and meta-analysis

BACKGROUND

Controversial findings exist in the literature regarding the association between tobacco smoking and development of apical periodontitis or need for root canal treatment, with some studies reporting an increase in the prevalence of these outcomes in smokers, whilst others reporting no association.

AIM

To evaluate if there is scientific evidence to support an association between tobacco smoking and a greater prevalence of apical periodontitis and/or root canal treatments.

DATA SOURCES

A systematic search was performed using MeSH terms and free terms in the PubMed, Scopus, Virtual Health Library (VHL), Cochrane library and Open Gray databases.

STUDY ELIGIBILITY CRITERIA, PARTICIPANTS AND INTERVENTIONS

Observational studies that evaluated the association between smoking and the development or healing of periapical lesion and/or the prevalence of root canal treatment in humans were included.

STUDY APPRAISAL AND SYNTHESIS METHODS

A quality assessment of included studies was performed, and the relevant information and findings were evaluated. A meta-analysis using nine included studies was performed through RevMan software, and the certainty of evidence was evaluated through GRADE.

RESULTS

Fifteen studies were included, of which 10 were classified as low risk of bias, 4 were considered as moderate risk of bias and 1 as high risk of bias. Ten studies reported that smoking was associated with a greater prevalence of periapical periodontitis and/or root canal treatment. Five studies reported no association. Nine studies were included in the pooled meta-analysis, comprising two subgroups: apical periodontitis and root canal treatment. From these nine studies, eight studies were included in the apical periodontitis subgroup meta-analysis and demonstrated that this condition was significantly more prevalent in smokers when compared to the nonsmokers (odds ratio = 2.78[CI: 1.60, 4.85], P < 0.001; I²  = 79%; no adjusted odds ratio). Three studies were included in the root canal treatment subgroup meta-analysis and demonstrated an increased prevalence in smokers when compared to the nonsmokers (odds ratio = 2.73 [CI: 1.06, 2.83], P < 0.001; I²  = 72%; no adjusted odds ratio). The pooled meta-analysis demonstrated that smokers had twice the chance of having apical periodontitis and/or root canal treatment when compared to nonsmokers (odds ratio of 2.42 [CI: 1.59, 3.68], P < 0.01; I²  = 85%). The GRADE analysis demonstrated moderate certainty of evidence.

LIMITATIONS

Several confounding factors were identified such as misinformation regarding the period of time subjects had smoked, as well as the frequency of smoking and the number of cigarettes consumed. No adjustment in odds ratio data for confounding was performed.

CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS

This systematic review and meta-analysis indicate that tobacco smokers have an increased prevalence of periapical periodontitis and root canal treatments with moderate certainty of evidence.

Do Tooth- and Cavity-related Aspects of Noncarious Cervical Lesions Affect the Retention of Resin Composite Restorations in Adults? A Systematic Review and Meta-analysis

PURPOSE

The purpose was to perform a systematic review and meta-analysis based on the following research question: do tooth- and cavity-related aspects of noncarious cervical lesions (NCCLs) affect the retention of composite restorations?

METHODS

Randomized clinical trials (RCTs) that evaluated the retention rate of resin restorations in NCCLs were included for the identification and comparison of their characteristics. The search was conducted in PubMed and adapted for Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database (LILACS), Brazilian Library in Dentistry (BBO), Cochrane Library, and System for Information on Grey Literature in Europe (SIGLE) without restrictions until July 2018. Unpublished and ongoing trial registries were also searched. The Cochrane Collaboration tool was used for assessing risk of bias. The quality of the evidence was graded using the Grading of Recommendations: Assessment, Development and Evaluation. Using the random effects model, a meta-analysis was conducted for each aspect (arch distribution, tooth location, wear facets, dentin sclerosis, shape, size, depth, occluso-gingival distance, and margin location).

RESULTS

We retrieved 6738 articles. After removal of duplicates and nonrelevant articles, 24 RCTs remained. The anterior tooth location favored the retention rates of restoration of NCCLs (relative risk [RR], 1.08; 95% confidence interval [CI], 1.00-1.16). The presence of wear facets is a risk factor for the retention of restorations (RR, 0.91; 95% CI, 0.83-0.99). The evidence was moderate for arch distribution and low or very low for all other factors because of heterogeneity, imprecision, and inconsistency.

CONCLUSION

The tooth location and the presence of wear facets can affect the retention of composite resins in NCCLs.

Antibacterial properties and compressive strength of new one-step preparation silver nanoparticles in glass ionomer cements (NanoAg-GIC)

OBJECTIVES

This work aimed (1) to develop polyacid formulations by the one-step photoreduction of silver nanoparticles (AgNP) in a polyacrylate solution of conventional glass ionomer cement (GIC), imparting antibacterial activity; and (2) to evaluate handling and mechanical properties of experimental ionomers in comparison to a commercially available conventional GIC.

METHODS

Formulations with increasing sub-stoichiometric amounts of AgNO₃ were monitored during continuous UV light exposure by UV-vis spectroscopy and analyzed by transmission electron microscopy. The resulted synthesis of formulations containing small and disperse spherical nanoparticles (∼6 nm) were used to design the experimental nano-silver glass ionomer cements (NanoAg-GIC). The cements were characterized as to net setting time and compressive strength according to ISO 9917-1:2007 specifications. The antibacterial activity of these cements was assessed by Ag⁺ diffusion tests on nutritive agar plates (E. coli) and by MTT assay (S. mutans).

RESULTS

The higher concentration of silver (0.50% by mass) in the matrix of NanoAg-GIC allowed viable net setting time and increased in 32% compressive strength of the experimental cement. All groups containing AgNP induced statistically significant E. coli growth inhibition zones (p-value <.05), indicating diffusion of Ag⁺ ions on the material surroundings. Metabolic activity of S. mutans grown on NanoAg-GIG with higher concentration of silver was significantly affected compared to control (p-value <.01).

CONCLUSIONS

Silver nanoparticles one-step preparation in polyacrylate solution allowed the production of highly bioactive water-based cements within suitable parameters for clinical use and with large potential of dental and biomedical application.

The influence of inflammatory cytokines in physiopathology of suicidal behavior

BACKGROUND

Based on the urgent need for reliable biomarkers in relation to suicide risk both for more accurate prediction as well as for new therapeutic opportunities, several researchers have been studied evidences of the potential participation of inflammatory processes in the brain, in particular cytokines, in suicide. The purpose of this review was to analyze the associations between inflammation markers and suicide.

METHODS

To achieve this goal, a systematic review of literature was conducted via electronic database Scopus using the Medical Subject Headings (MeSH) terms: "cytokines", "suicide" and "inflammation". Through this search it was found 54 articles. After analyzing them 15 met the eligibility criteria and were included in the final sample.

RESULTS

One of the most mentioned inflammatory markers was Interferon-α (IFN-α), a pro-inflammatory cytokine which has been shown to increase serum concentrations of pro-inflammatory cytokines such as interleukin (IL)-1, IL-6, tumor necrosis factor-a (TNF- α) and IFN-ϒ, which are factors increased suicide victims and attempters. In this line, IL-6 is not only found to be elevated in the cerebrospinal fluid of suicide attempters, even its levels in the peripheral blood have been proposed as a biological suicide marker. Another study stated that increased levels of IL-4 and IL-13 transcription in the orbitofrontal cortex of suicides suggest that these cytokines may affect neurobehavioral processes relevant to suicide.

LIMITATIONS

A lack of studies and great amount of cross-sectional studies.

CONCLUSION

Inflammation may play an important role in the pathophysiology of suicide, especially, levels of some specific inflammatory cytokines.

Multidisciplinary approach for the treatment of extensive external cervical resorption after dental trauma

External cervical resorption (ECR) is a sequela of dentoalveolar trauma that may cause functional, esthetic, and psychologic alterations. The aim of this study was to report a successful multidisciplinary treatment approach performed in a 12-year-old patient who presented with posttraumatic ECR associated with extensive opened cavity, pulp necrosis, and periapical lesion of tooth number 9, with an initial unfavorable prognosis. Crown lengthening was done to enable restoration of vestibular surface with resin composite, forming a barrier that allowed endodontic treatment. Afterwards, a prefabricated fiberglass post was cemented and esthetic restoration was performed using the adhesive technique and direct composite veneer. Reconstructive periodontal surgery was performed to correct irregular gingival contour. After treatment and successive follow-up sessions, it was concluded that although the tooth had been indicated for extraction, low invasive direct techniques were effective to recover function and esthetics and to maintain the tooth in the oral cavity.

Short communication: polymicrobial community in teeth associated with severe early-childhood caries

AIM

This was to characterise the microbial diversity in the complex dental plaque of children with severe early-childhood caries (S-ECC), using the denaturing gel gradient electrophoresis (DGGE) technique.

METHODS

The DGGE technique was used as a diagnostic tool to analyse samples from the oral cavity of a patient with S-ECC. Dental plaque samples from a 3-year-old child with S-ECC were taken from the primary central maxillary incisor (biofilm on vestibular surface), primary maxillary molar (biofilm on vestibular surface), primary central maxillary incisor (dentine), primary maxillary molar (dentine) and saliva and then analysed by PCR-DGGE.

RESULTS

Three bands occurred in all samples, moreover, 86% of similarity was observed in the pattern of bands between incisor and molar teeth biofilm samples, including four similar bands.

CONCLUSION

DGGE is a valuable tool for differentiating the microbial composition of the oral plaque in S-ECC children.

Effects of orthognathic surgery on oropharyngeal airway: a meta-analysis

Oropharyngeal changes caused by orthognathic surgery have been a concern because the sleep quality of patients may be enhanced or worsened by these changes. The purpose of this meta-analysis was to identify, review and compare scientific literature about changes in airway in adult patients undergoing orthognathic surgery to correct anteroposterior osseous discrepancies. An electronic search of four databases was carried out up to July 2010, with supplemental hand searching of the references of the retrieved articles. Quality assessment of the included articles was carried out. Data were extracted and a meta-analysis was performed. Heterogeneity was assessed amongst the studies and results were presented in forest plots. 49 studies met the inclusion criteria. Only studies with moderate or high methodological soundness were included in the review. Moderate evidence was found to support a significant decrease in the oropharyngeal airway in mandibular setback surgery, a milder decrease in bimaxillary surgery to correct Class III and an increase in maxillomandibular advancement surgery. Evidence is lacking on airway volume changes after orthognathic surgery.

Are paediatric medicines risk factors for dental caries and dental erosion?

THE OBJECTIVE

To assess in vitro the cariogenic and erosive potentials of Brazilian liquid oral paediatric medicines.

SETTING

Twenty-three paediatric medicines available on the Brazilian market were evaluated. The sample consisted of antihistamines, antitussives, bronchodilators and mucolytics.

MAIN OUTCOME MEASURES

Duplicates of each bottle were analyzed for sugar concentration using normal-phase- high-performance liquid chromatography (HPLC). Quantification of sugars and sorbitol was calculated using the peak heights of commercial standards as references. pH measurements were determined using a digital pH meter. Titratable acidity was assessed by diluting three aliquots of each medicine, and increments of 0.1N NaOH were titrated until neutrality was reached. Viscosity was determined using a viscosemeter.

RESULTS

Sugars were detected in 56.5% of the medicines. Sucrose was identified in 10 medicines, with concentrations ranging from 11.36 g% to 85.99 g%. Glucose was detected in five medicines, with concentrations varying from 4.64 g% to 40.19 g%; fructose in six medicines, with concentrations ranging from 5.09 g% to 46.71 g%. Twelve medicines exhibited sorbitol, with values ranging from 5.39 g% to 46.09 g%. Most tested medicines were acidic, with pH values ranging between 2.6 and 5.7. Only two medicines (Fluimucil and Polaramine) presented pH 6.4 and 6.0, respectively. Titratable acidity mean values ranged between 0.28 and 16.33 mL. Viscosity values varied between 2.8 cP and 412.3 cP.

CONCLUSIONS

Many paediatric medicines showed high sugar concentration, pH values below the critical value and high titratable acidity values, all of which increase the medicines' cariogenic and erosive potentials.

Reliability assessment of a plaque scoring index using photographs

OBJECTIVES

The need to evaluate the reliability of a clinical index before using it as a research tool is clearly recognized. Therefore the aim of this study was to evaluate whether a new calibration method by means of photographs would be useful for assessing the examiners' reliability in the interpretation of a plaque index.

METHODS

Nine children were randomly recruited from a public school in Rio de Janeiro, Brazil. Two trained examiners evaluated these children for dental plaque, in a classroom environment, in order to record plaque scores. The children's teeth were dyed and colored photographs were taken of all tooth surfaces using a camera, mouth mirrors and lip retractors. The photographs were evaluated to select and identify the best visible tooth surfaces, and the final sample consisted of 343 tooth surfaces. One week after the clinical examination, both examiners scored the tooth surfaces from the photographs according to the index used. The intra and inter-examiner agreements were measured by intra-class correlation coefficient (ICC) for individual mean scores and for tooth surfaces scores.

RESULTS

The data showed an excellent agreement (ICC >0.80) between clinical and photographic examinations, for both examiners, both for tooth surface and patient analysis. The statistics also demonstrated excellent (ICC >0.80) inter-examiner agreement on clinical and photographic examinations.

CONCLUSION

The method seems to be an effective technique to evaluate the reliability of the plaque index, improving the reproducibility of epidemiological studies.

Case report: ultrasonic cavity preparation -- an alternative approach for caries removal in paediatric dentistry

BACKGROUND

Since the invention and application of rotating instruments, the operative treatment of carious lesions has often resulted in considerable removal of tooth structure. Moreover, conventional caries removal and cavity preparation by a combination of the use of a turbine and a handpiece with a bur presents disadvantages to very young patients, whose perception of drilling is unpleasant. This report concerns an alternative approach for caries removal in a child using ultrasound and discusses the advantages and disadvantages of this technique.

CASE REPORT

A 2-year-old male child was brought by his mother to a private paediatric dental clinic in Rio de Janeiro, Brazil. The mother's main complaint was the presence of dental caries in her son's anterior teeth. Intraoral clinical examination revealed that the patient had two carious lesions in the maxillary central incisors on mesial surfaces. Cavity preparation was performed using ultrasound and restoration with a light-curing resin.

FOLLOW-UP

One year and a half after the restorative procedure the patient presented with the restored teeth in perfect condition.

Case report: the importance of oral manifestations in diagnosing iron deficiency in childhood

AIM

The aim of this article is to report a case of iron deficiency diagnosed in a child after routine oral examination.

CASE REPORT

A 5-year-old male child of African descent was brought to the paediatric dental clinic of a public university in Rio de Janeiro, Brazil. His mother's main complaint was her child's decayed teeth and sensitivity in the tongue every time he ate spicy or hot food. Anamnesis revealed chronic respiratory problems due to allergy, two previous episodes of anaemia and hospitalization about 15 months before the dental visit because of severe primary herpetic gingivostomatitis. Soft tissue examination revealed his tongue had various patches of atrophic mucosa characterizing absence of papillae in these areas. The child's dietary assessment indicated that he never ate meat or vegetables. Haematological investigation showed that the child probably had an iron deficiency, although the full blood count was not totally compatible with anaemia. A rapid initial recovery was quite noticeable after the beginning of oral therapy with ferrous sulphate, as remission of tongue sensitivity as well as papillae neoformation were observed.

Effect of arbuscular mycorrhizal fungi and soil phosphorus level on expression of protein and activity of peroxidase on passion fruit roots

The effects of mycorrhizal inoculation and increasing soil P levels on the expression of total proteins and peroxidase activity on passion fruit roots were evaluated. The experimental design was entirely at random, with four treatments of inoculation (a--control; b--Gigaspora albida; c--Scutellospora heterogama; d--mixture of G. albida, G. margarita, S. heterogama, and Glomus clarum) x three levels of soil P (4, 11, and 30 mg/dm3 of soil), each with three replicates. Plants were harvested 70 days after inoculation, when root colonization, shoot P level, protein content, and enzymatic activity of peroxidase (PAGE--7%) on root extract were evaluated. Regarding protein, there was no significant difference among the treatments, except between those roots receiving mixed inoculum and 11 mg P/dm3 of soil. Effect of P on protein concentration, when compared with the inoculation effect was observed. For peroxidase, there was an eletrophoretic band common to all treatments (rf: 0.43) and another that was absent only in noncolonized plants, grown in soil with lower P (rf: 0.46). Mycorrhizal specific bands were not present but a small decrease of intensity of bands in noncolonized plants was observed. Conversely, the control roots presented a single band (rf: 0.33) not observed in the other extracts, that may demonstrate an inhibitory effect of AMF on some host activities. The data showed the influence of P level in soil on the protein expression of roots, suggesting the influence of this nutrient on root genetic expression as well as on the mechanisms of symbiotic control/recognition.

Craniometaphyseal dysplasia: case report

Craniometaphyseal dysplasia is a rare genetic bone remodeling disorder characterized by undertubulation of the long bones, especially in the lower extremities, causing deformities of the metaphyses of the long bones, and sclerosis of the skull base or cranial bone hyperostosis. The authors report a case of craniometaphyseal dysplasia in an 8-year-old Brazilian child, emphasizing the importance of precocious diagnosis of this rare genetic disorder.

Seven novel mutations in the APC gene of Portuguese families with familial adenomatous polyposis: correlation with phenotype

Germ-line mutations in the adenomatous polyposis coli (APC) gene are responsible for familial adenomatous polyposis (FAP). In the present study, we have used the protein truncation test to screen for mutations in exon 15 and exons 1-14 of the APC gene and denaturing gradient gel electrophoresis to analyze exons 1-14. We have studied nine unrelated FAP kindreds, eight with the classical phenotype and one with an atypical phenotype, with several family members exhibiting fewer than 50 colonic polyps. The combined use of these two methodologies allowed the identification of seven novel mutations, with two unrelated families sharing the same mutation. All mutations were chain terminating: six resulted from small deletions, one from a small insertion, and one was a point mutation, resulting in a premature stop codon. Seven mutations were located in exon 15 of the APC gene, one was in exon 10, and the remaining one, which corresponded to the kindred with an atypical phenotype, was located in exon 4.

Immunopathology of experimental Chagas' disease: binding of T cells to Trypanosoma cruzi-infected heart tissue

The immunopathology of Chagas' disease was studied in the experimental model of chronic infection in C57BL/10JT or mice. Sublethal infection with Trypanosoma cruzi, Y strain, induced specific antibodies and a delayed hypersensitivity response to parasite antigens. Mice developed chronic chagasic myocarditis but not skeletal muscle myositis. Binding of T cells to infected heart tissue was investigated during short-term cocultivation of lymphocytes with heart cryostat sections. T cells from infected mice and from normal controls bound equally to myocardium and liver sections from both infected and normal mice. A search in depth was attempted with cells heavily tagged with 99mTc. Labeled T cells from chagasic mice bound to both normal and infected myocardium slices. 99mTc-labeled T cells from controls gave the same binding values. Glass-adherent spleen cells behaved identically to T cells. Prior treatment of the tissue with serum from chronically infected mice did not increase the number of binding cells. Peritoneal macrophages tagged with 99mTc-sulfur colloid also bound to infected myocardium slices. The binding of macrophages was not changed by pretreatment of infected tissue with anti-T, cruzi antibodies. In short, this work did not detect any population of T cells or macrophages which could bind specifically to infected heart tissue to initiate an autoreactive process.

Absence of immunosuppression in DBA/2 mice vaccinated with Trypanosoma cruzi treated with actinomycin-D

The subcutaneous (s.c.) vaccination of DBA/2 mice with 4 weekly doses of 3 x 10(7) living metacyclic forms of T. cruzi, Y strain, obtained from culture in axenic medium and treated for 24 h with actinomycin-D (50 micrograms/10(7) parasites), a drug that promotes an irreversible blockade of the parasite replication, do not induce any detectable degree of humoral and cellular immunosuppression as assessed by a) the production of anti-SRBC antibodies, b) the permanence of delayed cutaneous reaction to T. cruzi antigen, to PPD and DNCB and c) the degree of blastogenic transformation of spleen lymphocytes in the presence of the specific antigen.

Immune response to BCG-Moreau (Rio de Janeiro) strain. Spectrum of delayed hypersensitivity in genetically defined mice

Generation of delayed hypersensitivity (DTH) in genetically defined mice immunized with Mycobacterium bovis BCG of the Moreau (Rio de Janeiro) strain was studied. This vaccine strain has been reported as the most virulent and able to induce strong tuberculin sensitivity. Mice were selected by the expression of Bcg gene trait, by responsiveness to mycobacterial antigens and H2 haplotype. DTH was evaluated by the ear-swelling test of mice immunized subcutaneously with live BCG at doses ranging from 1 microgram to 1000 micrograms. A survey of inbred strains of mice showed H2b and H2q mice as high responders, H2d as an intermediate responder, H2k as a low responder and H2a as a non-responder. Study of H2-congenic pairs of high and non-responder strains showed significant DTH in all mice independently of the genetic background and H2 haplotype. A mouse strain expressing Bcg (r) trait displayed DTH superior to a Bcg (s) strain. Comparison of DTH response of strains expressing Bcg (r) or (s) trait showed no relationship between the Bcg locus and DTH to mycobacteria. These data suggest DTH is under polygenic control including the major histocompatibility complex but excluding the Bcg locus.

Absorption of Mycobacterium bovis BCG administered by the oral route

The action of gastric and duodenal juices on BCG as well as on its absorption and its distribution in the organs after intragastric administration in mice were studied. A significant decrease in BCG oxygen uptake and a moderate loss of viability were found after 2 h treatment with gastric juice. Using duodenal juice, a marked decrease of respiration and a notable fall in viability were observed. Labelling of BCG with carbon-14 was accomplished using [14C]glycerol as a precursor of mycobacterial lipids. Similar levels of radioactivity were recovered in organs of mice 24 h after intragastric administration of 14C-BCG, sonicated 14C-BCG and [14C]glycerol. The level of 14C-BCG remained stable from 6 to 24 days, while sonicated 14C-BCG and [14C]glycerol defined a biological decay process. Studies of biological decay from the small intestine and liver indicated that the absorptive process started rapidly and reached its highest level at 24 h, declining thereafter according to the complexity of the material given to mice. However, living bacilli were not cultured from organs of mice given single doses of unlabelled BCG. Therefore, judging from the above data it may be concluded that the majority of BCG bacilli absorbed intact were not alive.

[Effect of digestive juices on the absorption and destination of oral BCG vaccine]

Estudou-se a ação do suco gástrico artificial e suco duodenal humano sobre a vacina BCG, bem como a absorção e destino desta após administração intragástrica em camundongos. O contato de 2 horas do bacilo com o suco gástrico provocou uma diminuição significante do consumo de oxigênio e uma moderada perda da viabilidade. O suco duodenal induziu marcante decréscimo da respiração bacilar egrande redução da viabilidade. O BCG foi marcado com carbono-14 usando-se 14C-glicerol como precursor dos lipidios micobacterianos. Níveis similares de radioatividade foram obtidos nos órgãos dos animais, 24 horas após administração intragástrica de 14C- BCG, 14C-BCG rompido por ultra-som e 14C-glicerol. Os níveis de 14C-BCG permaneceram estáveis do 6º ao 24º dia, enquanto o sonicado de 14C-BCG e 14C-glicerol definiram um processo de decaimento biológico. As curvas de biodecaimento no intestino delgado e no fígado indicaram que o processo de absorção foi desencadeado rapidamente e alcançou seu nível máximo às 24 horas, decaindo em seguida de acordo com a complexidade química do material dado aos camundongos. Não foram isolados bacilos viáveis dos órgãos dos animais que receberam BCG não marcado. Pode-se concluir, portanto, que a maioria dos bacilos foram absorvidos intactos mas não viáveis.

[Influence of BCG in the control of humoral deficiency induced by mastocytoma p-815]

Viable BCG bacilli, in a lipid emulsion, inoculated intravenously, were capable of reverting the profound humoral immunosuppression induced in adult DBA/2 mice by the mastocytoma P-815. BCG increased not only the number of hemolytic plaque forming cells, but also the serum titers of hemagglutinating IgM antibodies. However, no blocking effect was detected on normal tumor progression.

Cross-reaction of tick salivary antigens in the Boophilus microplus-cattle system

Calves were immunized with Boophilus microplus saliva, filtered through Millipore membranes, in Freund's complete adjuvant. Serum samples were tested by passive hemagglutination against Babesia bigemina, Anaplasma marginale, B. microplus larvae extract, Stomoxys calcitrans extract and B. microplus saliva. After immunization, titers to saliva, larval tick-extract and to S. calcitrans were increased. The challenge with live tick larvae enhanced the formation of antibodies against larva extract, fly extract and tick saliva, which supports the idea that under natural controlled conditions this cross-reactivity could occur.

Quantitation of tumor growth in the ears of mice

Transplantation of ascitic P-815 mastocytoma cells intradermally in the ears of syngeneic DBA/2J mice allows a simple and precise quantitation of tumor growth by ear swelling. Tumor growth was retarded and then arrested in allogeneic DBA/1J mice, whereas syngeneic hosts died as a result of tumor dissemination in draining lymph nodes, liver and spleen.

Cross-suppression of specific immune responses after oral tolerance

Adult normal inbred mice rendered tolerant to OVA by previous oral exposure do not respond to intraperitonela immunization with DNP-OVA in adjuvant. These tolerant mice also form less DNP-specific antibodies to DNP-KLH when immunized with mixtures of DNP-KLH and DNP-OVA, or less HGG-specific antibodies when immunized with cross-linked conjugates of OVA and HGG. These same procedures increased DNP-specific or HGG-specific responses in non-tolerant control mice. The cross-supperssion was ineffective, however, to inhibit already ongoing antibody responses.

Inhibition of homocytotropic antibody responses in adult inbred mice by previous feeding of the specific antigen

Profound and prolonged states of specific immunologic tolerance were induced in adult mice of high-responder genetic background by a single exposure to moderate doses of the specific antigen by digestive route.

Effects of Bordetella pertussis on the sensitivity of inbred mice to vasoactive amines

Pretreatment with Bordetella pertussis was determined to increase significantly the hypovolemia induced by intravenous injections of histamine either alone or in mixture with serotonin in a total of 26 different strains of mice. Two factors affecting the mortality rates observed by challenge after B. pertussis treatment were: the sensitivity of the strains to vasoactive amines before B. pertussis treatment, and their resistance to acute hypovolemic shock. Appropriate crosses and backcrosses between resistant and susceptible strains failed to demonstrate a clear pattern of inheritance of the susceptibility to B. pertussis effects.

Inhibition of specific immune responses by feeding protein antigens

A profound and long-lasting state of specific immune unresponsiveness may be induced in adult inbred mice given a single dose of protein immunogens--such as ovalbumin or hemocyanin--by the digestive route. The degree of unresponsiveness induced by intragastric exposure to ovalbumin could not be achieved by intravenous injection of deaggregated ovalbumin solutions across a wide range of doses. Unresponsiveness induced by intragastric exposure to hapten-protein conjugates is specific to the carrier protein.

Genetic control of immune responsiveness in mice. Responsiveness to ovalbumin in (C57BL X DBA-2)F1 mice

Antibody formation following injection of a low dose (0.1 <i>μ</i>g)of ovalbumin was significantly higher in (C57BL × DBA/2)F1 mice than in parental strains. The antibody response of genetically related strains and hybrids, such as B10.D2, (C57BL × B10.D2)F1, and (DBA/2 × B10.D2)F1 was lower than that of (C57BL × DBA/2)F1 mice.