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Oliveira LM, Zanatta FB, Costa SA, Pelissari TR, Baumeister SE, Demarco FF, Nascimento GG. The Alcohol Harm Paradox in Periodontitis. J Dent Res 2024:220345241235614. [PMID: 38605651 DOI: 10.1177/00220345241235614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024] Open
Abstract
Individuals of lower socioeconomic position (SEP) experience a greater rate of alcohol-related harms, yet they consume equal or lower amounts of alcohol than higher-SEP individuals. This phenomenon, called the "alcohol harm paradox" (AHP), gained attention recently, and different mechanisms have been proposed to explain it. Since both SEP and alcohol have been suggested to be associated with periodontitis risk, we conducted a secondary analysis using data from the National Health and Nutrition Examination Survey 2011 to 2012 and 2013 to 2014 cycles, aiming to examine 1) whether the association between alcohol consumption and periodontitis is modified by SEP and 2) the extent to which the effect of SEP inequalities on periodontitis is mediated by and/or interacts with alcohol consumption. We set educational attainment as the main SEP proxy and tested the poverty income ratio in subsequent sensitivity analyses. Effect measure modification analysis was employed, considering heavy drinking as exposure, and causal mediation analysis based on the potential outcome's framework decomposed the effect of SEP on periodontitis in proportions attributable to mediation and interaction. Models were fitted using binary logistic regression and adjusted for sex, ethnicity, age, body mass index, smoking status, diabetes, binge drinking, and regular preventive dental visits. The analytical sample comprised 4,057 participants. After adjusting for covariates, less educated heavy drinkers presented 175% (odds ratio, 2.75; 95% confidence interval [CI], 2.04-3.72) higher odds of periodontitis than their counterparts, and super-additive associations were found (relative excess risk due to interaction: 1.35; 95% CI, 0.49-2.20). Additionally, -69.5% (95% CI, -122.1% to -16.8%) of the effects of education on periodontitis were attributable to interaction with heavy drinking, consistent with the AHP. No contribution was found for the mechanism of mediation. Heavy drinking disproportionately impacts the occurrence of periodontitis in lower-SEP individuals. Lower-SEP individuals seem to experience differential effects of heavy drinking on periodontitis.
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Affiliation(s)
- L M Oliveira
- Department of Stomatology, Postgraduate Program in Dentistry, Santa Maria, Rio Grande do Sul, Brazil
- Emphasis on Periodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - F B Zanatta
- Department of Stomatology, Postgraduate Program in Dentistry, Santa Maria, Rio Grande do Sul, Brazil
- Emphasis on Periodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - S A Costa
- Graduate Dentistry Program, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - T R Pelissari
- Department of Stomatology, Postgraduate Program in Dentistry, Santa Maria, Rio Grande do Sul, Brazil
- Emphasis on Endodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - S E Baumeister
- Institute of Health Services Research in Dentistry, University of Münster, Münster, Germany
| | - F F Demarco
- Graduate Program in Dentistry, Universidade Federal de Pelotas (UFPel), Pelotas, Rio Grande do Sul, Brazil
- Graduate Program in Epidemiology, Universidade Federal de Pelotas (UFPel), Pelotas, Rio Grande do Sul, Brazil
| | - G G Nascimento
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore
- Oral Health Academic Programme, Duke-NUS Medical School, Singapore
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Schertel Cassiano L, Leite FRM, Alves-Costa S, Costa SA, Nascimento GG. Oral conditions are associated with salt taste disability among American adults. Oral Dis 2024. [PMID: 38566452 DOI: 10.1111/odi.14926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 10/30/2023] [Accepted: 03/05/2024] [Indexed: 04/04/2024]
Abstract
AIM To explore the association between oral conditions and their interaction with salt taste disability among American adults. METHODS Data from the 2013-2014 NHANES cycle were used (n = 2373). The exposures were periodontitis, defined by the 2017 EFP-AAP classification, dental caries, missing teeth, and edentulism, as per the DMF-T index, and xerostomia. The outcome was salt taste disability, objectively assessed. Covariates included sex, age, educational level, poverty index, obesity, diabetes, smoking, alcohol consumption, and medications related to mouth dryness. Weighted multivariable logistic regression modeling was used to evaluate the relationship between oral conditions and their interaction and salt taste disability. RESULTS Participants who reported xerostomia were more likely to have salt taste disability (OR 2.42; 95%CI 1.44-4.07), especially those older than 60 years (OR 3.63; 95%CI 1.72-7.63). Among participants aged 40-59, xerostomia increased the chance of salt taste disability; however, the confidence interval included the null value. The interactions between xerostomia and edentulism increased the chance of salt taste disability. CONCLUSION Oral conditions seem to influence the ability to taste salt. Dental professionals may help identify individuals with taste alterations and raise their awareness of the risk of systemic diseases that require the reduction of salt intake.
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Affiliation(s)
| | - Fábio R M Leite
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Silas Alves-Costa
- Graduate Program in Dentistry, Federal University of Maranhão, São Luís, Brazil
| | | | - Gustavo G Nascimento
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
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Alves-Costa S, Nascimento GG, Peres MA, Li H, Costa SA, Ribeiro CCC, Leite FRM. Sugar-sweetened beverage consumption and periodontitis among adults: A population-based cross-sectional study. J Clin Periodontol 2024. [PMID: 38454156 DOI: 10.1111/jcpe.13961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 01/22/2024] [Accepted: 01/26/2024] [Indexed: 03/09/2024]
Abstract
AIM Investigating the association between sugar-sweetened beverages (SSBs) and periodontitis and whether the awareness of diabetes modifies this relationship. MATERIALS AND METHODS Cross-sectional analysis was conducted using the National Health and Nutrition Examination Survey (NHANES III) data involving US adults aged 30-50. Periodontitis was classified according to the Centers for Disease Control and Prevention and American Academy of Periodontology (CDC-AAP), and SSB consumption as dichotomous (<5 or ≥5, <7 or ≥7 and <14 or ≥14 times/week), ordinal and continuous variables. Confounders included family income poverty ratio, education, race/ethnicity, sex, age, food energy intake, smoking and alcohol. Odds ratios (ORs) were obtained by logistic regressions using inverse probability weighting. Effect modification analysis was performed considering self-reported diabetes. RESULTS Among 4473 cases analysed, 198 self-reported diabetes. SSBs were associated with periodontitis when individuals consumed ≥5 (OR 1.64; 95% confidence interval [CI] = 1.30-2.06), ≥7 (OR 1.92; 95% CI = 1.50-2.46) and ≥14 (OR 2.19; 95% CI = 1.50-3.18) times/week. The combined effect of consuming SSBs (≥5 and ≥14 times/week) and self-reported diabetes had less impact than the cumulative effect. CONCLUSIONS SSB consumption was associated with higher odds of periodontitis, and the estimates were reduced among those with awareness of diabetes.
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Affiliation(s)
- Silas Alves-Costa
- Graduate Program in Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
| | - Gustavo G Nascimento
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Marco A Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Huihua Li
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Susilena Arouche Costa
- Graduate Program in Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | | | - Fábio Renato Manzolli Leite
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
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Bitencourt FV, Nascimento GG, Costa SA, Andersen A, Sandbæk A, Leite FRM. Co-occurrence of Periodontitis and Diabetes-Related Complications. J Dent Res 2023; 102:1088-1097. [PMID: 37448314 DOI: 10.1177/00220345231179897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023] Open
Abstract
Periodontitis is a common finding among people with diabetes mellitus (DM) and has been cited as a DM complication. Whether and how periodontitis relates to other diabetes-related complications has yet to be explored. This study aims to examine the clustering of periodontitis with other diabetes-related complications and explore pathways linking diabetes-related complications with common risk factors. Using data from participants with DM across 3 cycles of the National Health and Nutrition Examination Survey (NHANES) (n = 2,429), we modeled direct and indirect pathways from risk factors to diabetes-related complications, a latent construct comprising periodontitis, cardiovascular diseases, proteinuria, and hypertension. Covariates included age, sex, socioeconomic status (SES), smoking, physical activity, healthy diet, alcohol consumption, hemoglobin A1c (HbA1c), dyslipidemia, and body mass index (BMI). Sensitivity analyses were performed considering participants with overweight/obesity and restricting the sample to individuals without DM. Periodontitis clustered with other diabetes complications, forming a latent construct dubbed diabetes-related complications. In NHANES III, higher HbA1c levels and BMI, older age, healthy diet, and regular physical activity were directly associated with the latent variable diabetes-related complications. In addition, a healthy diet and BMI had a total effect on diabetes-related complications. Although sex, smoking, dyslipidemia, and SES demonstrated no direct effect on diabetes-related complications in NHANES III, a direct effect was observed using NHANES 2011-2014 cycles. Sensitivity analysis considering participants with overweight/obesity and without DM showed consistent results. Periodontal tissue breakdown seems to co-occur with multiple diabetes-related complications and may therefore serve as a valuable screening tool for other well-known diabetes-related complications.
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Affiliation(s)
- F V Bitencourt
- Department of Dentistry and Oral Health, Section for Periodontology, Aarhus University, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - G G Nascimento
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore
| | - S A Costa
- Graduate Dentistry Program, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - A Andersen
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - A Sandbæk
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - F R M Leite
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore
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Costa SA, Nascimento GG, Leite FRM, Ribeiro CCC, de Fatima Carvalho Souza S. Intake and serum levels of micronutrients and chronic oral diseases burden. Oral Dis 2023. [PMID: 37288704 DOI: 10.1111/odi.14640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/07/2023] [Accepted: 05/23/2023] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To investigate pathways from micronutrient intake and serum levels to Chronic Oral Diseases Burden. METHODS We analyzed cross-sectional data from NHANES III (n = 7936) and NHANES 2011-2014 (n = 4929). The exposure was the intake and serum levels of vitamin D, calcium, and phosphorus. Considering the high correlation of those micronutrients in the diet, they were analyzed as a latent variable dubbed Micronutrient intake. The outcome was the Chronic Oral Diseases Burden, a latent variable formed by probing pocket depth, clinical attachment loss, furcation involvement, caries, and missing teeth. Pathways triggered by gender, age, socioeconomic status, obesity, smoking, and alcohol were also estimated using structural equation modeling. RESULTS In both NHANES cycles, micronutrient intake (p-value < 0.05) and vitamin D serum (p-value < 0.05) were associated with a lower Chronic Oral Diseases Burden. Micronutrient intake reduced the Chronic Oral Diseases Burden via vitamin D serum (p-value < 0.05). Obesity increased the Chronic Oral Diseases Burden by reducing vitamin D serum (p-value < 0.05). CONCLUSION Higher micronutrient intake and higher vitamin D serum levels seem to reduce Chronic Oral Diseases Burden. Healthy diet policies may jointly tackle caries, periodontitis, obesity, and other non-communicable diseases.
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Affiliation(s)
| | - Gustavo G Nascimento
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore City, Singapore
- Oral Health ACP, Duke-NUS Medical School, Singapore City, Singapore
| | - Fábio R M Leite
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore City, Singapore
- Oral Health ACP, Duke-NUS Medical School, Singapore City, Singapore
| | - Cecilia Claudia Costa Ribeiro
- Graduate Program in Dentistry, Federal University of Maranhão, São Luís, Brazil
- Department of Public Health, Federal University of Maranhão, São Luís, Brazil
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Costa SA, Ribeiro CCC, Leite FRM, Peres MA, Souza SDFC, Nascimento GG. Chronic oral diseases burden: The confluence of caries and periodontitis throughout life. J Clin Periodontol 2023; 50:452-462. [PMID: 36549902 DOI: 10.1111/jcpe.13761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
AIM To investigate the confluence of caries and periodontitis indicators from adolescence to elderhood among Americans. MATERIALS AND METHODS This cross-sectional study explored the grouping among a set of caries and periodontitis indicators (the proportion of sites with bleeding on probing, moderate probing pocket depth [PPD, 4-5 mm], severe PPD [≥6 mm], moderate clinical attachment level [CAL, 3-4 mm], severe CAL [≥5 mm], number of teeth with furcation involvement, number of decayed teeth, number of teeth with pulp involvement, and the number of missing teeth) in 14,421 Americans from the NHANES III study. Exploratory factorial analysis was used to determine the constructs between those indicators (factorial loading ≥0.3). These analyses were stratified by age and confirmed with a confirmatory factorial analysis. We also performed a sensitivity analysis using the NHANES 2011-2014. RESULTS Two constructs were extracted. The first, Chronic Oral Diseases Burden, grouped caries indicators with moderate PPD and moderate CAL for the youngest subjects (13-39 years old), while for the subjects over 50 years, the Chronic Oral Disease Burden grouped caries indicators with severe CAL and PPD and furcation involvement. The second construct, Periodontal Destruction, grouped only periodontitis indicators. CONCLUSIONS Caries and periodontitis indicators grouped consistently across the different age ranges in lapse times of 25 years.
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Affiliation(s)
- Susilena Arouche Costa
- Graduate Program in Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Cecilia Claudia Costa Ribeiro
- Graduate Program in Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil
- Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Fábio Renato Manzolli Leite
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
- Oral Health ACP, Duke-NUS Medical School, Singapore, Singapore
| | - Marco A Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
- Oral Health ACP, Duke-NUS Medical School, Singapore, Singapore
| | | | - Gustavo G Nascimento
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
- Oral Health ACP, Duke-NUS Medical School, Singapore, Singapore
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Costa SA, Ribeiro CCC, Thomaz EBAF, Costa CPS, Souza SDFC. Mechanisms underlying the adaptive pulp and jaw bone trabecular changes in sickle cell anemia. Oral Dis 2023; 29:786-795. [PMID: 34369045 DOI: 10.1111/odi.13998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/28/2021] [Accepted: 08/01/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Mechanisms underlying the oral outcomes in sickle cell anemia (HbSS) have been less explored. This study aimed to investigate the association of morbimortality indicators and hydroxyurea use with adaptive pulp and jaw bone trabecular changes in HbSS. METHODS This cross-sectional study included 123 individuals with HbSS. The exposures were the morbimortality indicators of HbSS (number of vaso-occlusive crises, organ damage, hemoglobin level, and leukocyte count) and the use of hydroxyurea for HbSS treatment. The outcomes were adaptive pulp and jaw bone trabecular changes confirmed by radiographic examination. Associations were estimated by Poisson regression in crude and adjusted analyses for sex, skin color, socioeconomic class, and age. RESULTS The vaso-occlusive crises (mean ratio (MR) = 3.5, p = 0.045), lower hemoglobin (MR = 2.4, p = 0.037), and higher leukocyte count (MR = 2.17, p = 0.036) were risk factors, while the use of hydroxyurea was inversely associated with adaptive pulp changes (MR = 0.23, p = 0.024). The vaso-occlusive crises were associated with jaw bone trabecular changes (MR = 1.33, p = 0.02). CONCLUSION Adaptive pulp changes may be a potential clinical marker of chronic vasculopathy in HbSS. The use of hydroxyurea may reduce the frequency of adaptive pulp changes.
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Bitencourt FV, Nascimento GG, Costa SA, Orrico SRP, Ribeiro CCC, Leite FRM. The Role of Dyslipidemia in Periodontitis. Nutrients 2023; 15:nu15020300. [PMID: 36678171 PMCID: PMC9864120 DOI: 10.3390/nu15020300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/27/2022] [Accepted: 12/31/2022] [Indexed: 01/10/2023] Open
Abstract
Studies have suggested an important role of dyslipidemia, a condition with alterations in blood lipid levels, in promoting an additional effect on periodontal breakdown. Thus, this study aimed to explore the theoretical pathways associated with dyslipidemia and periodontitis. We used data from 11,917 US adults with complete periodontal examinations participating in the Third National Health and Nutrition Examination Survey (NHANES III). Our hypothesis was tested using structural equation modelling (SEM). Dyslipidemia was defined according to the National Cholesterol Education Program (NCEP-ATP III) and periodontitis as a latent variable reflecting the shared variance of the number of surfaces with periodontal pocket depth [PPD] = 4 mm, PPD = 5 mm, PPD ≥ 6 mm, clinical attachment level [CAL] = 4 mm, CAL = 5mm, CAL ≥ 6 mm, and furcation involvement. The model also considered distal determinants (age, sex, and socioeconomic status) and proximal determinants (HbA1c, smoking and alcohol consumption, and obesity). The model showed sufficient global fit (Root Mean Squared Error of Approximation = 0.04, 90%CI = 0.04−0.05, Tucker−Lewis Index = 0.93, Comparative Fit Index = 0.95). Age, sex, socioeconomic status, obesity, and smoking were directly associated with periodontitis (p < 0.01). Dyslipidemia revealed a significant direct effect on periodontitis (standardized coefficient [SC] = 0.086, SE 0.027; p < 0.01), also mediated via an indirect pathway through HbA1c (SC = 0.021; SE 0.010; p = 0.02) and obesity (SC = 0.036; SE 0.012; p < 0.01) and resulted in a total effect on periodontitis. Dyslipidemia was associated with periodontitis through a direct pathway and indirectly through HbA1c and obesity in the US population. These results support the need for a multi-professional approach to tackling oral and noncommunicable diseases (NCDs), directed at their common risk factors.
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Affiliation(s)
- Fernando Valentim Bitencourt
- Department of Dentistry and Oral Health, Section for Periodontology, Aarhus University, 8000 Aarhus, Denmark
- Steno Diabetes Center Aarhus, 8200 Aarhus, Denmark
- Correspondence:
| | - Gustavo G. Nascimento
- Department of Dentistry and Oral Health, Section for Periodontology, Aarhus University, 8000 Aarhus, Denmark
- National Dental Centre Singapore, National Dental Research Institute Singapore, Singapore 168938, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Susilena Arouche Costa
- Department of Dentistry and Oral Health, Section for Periodontology, Aarhus University, 8000 Aarhus, Denmark
- Graduate Dentistry Program, Federal University of Maranhão, São Luís 65080805, Brazil
| | - Silvana Regina Perez Orrico
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University (UNESP), Araraquara 14801385, Brazil
- Advanced Research Center in Medicine, Union of the Colleges of the Great Lakes (UNILAGO), São José do Rio Preto 15030070, Brazil
| | | | - Fábio Renato Manzolli Leite
- Department of Dentistry and Oral Health, Section for Periodontology, Aarhus University, 8000 Aarhus, Denmark
- National Dental Centre Singapore, National Dental Research Institute Singapore, Singapore 168938, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore 169857, Singapore
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Costa SA, Nascimento GG, Colins PMG, Alves CMC, Thomaz EBAF, Carvalho Souza SDF, da Silva AAM, Ribeiro CCC. Investigating oral and systemic pathways between unhealthy and healthy dietary patterns to periodontitis in adolescents: A population-based study. J Clin Periodontol 2022; 49:580-590. [PMID: 35415936 DOI: 10.1111/jcpe.13625] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/10/2022] [Accepted: 04/02/2022] [Indexed: 01/11/2023]
Abstract
AIM To investigate pathways between unhealthy and healthy dietary patterns and periodontitis in adolescents (18-19 years of age). MATERIALS AND METHODS This population-based study (n = 2515) modelled direct and mediated pathways (via biofilm and obesity) from patterns of healthy diet (fruits, fibre, vegetables, and dairy) and unhealthy diet (sugars, snacks, and salty/fast foods) with initial periodontitis (bleeding on probing [BoP], probing depth [PD] ≥ 4 mm, clinical attachment loss [CAL] ≥ 4 mm), moderate periodontitis (BoP, PD ≥ 5 mm, and CAL ≥ 5 mm), and European Federation of Periodontology and the American Academy of Periodontology (EFP-AAP) periodontitis definitions, adjusting for sex, socio-economic status, smoking, and alcohol, through structural equation modelling (α = 5%). RESULTS Higher values of healthy diet were associated with lower values of initial periodontitis (standardized coefficient [SC] = -0.160; p < .001), moderate periodontitis (SC = -0.202; p < .001), and EFP-AAP periodontitis (p < .05). A higher value of unhealthy diet was associated with higher values of initial periodontitis (SC = 0.134; p = .005) and moderate periodontitis (SC = 0.180; p < .001). Biofilm mediated the association between higher values of unhealthy diet and all periodontal outcomes (p < .05). CONCLUSIONS Our findings suggest that both healthy and unhealthy dietary patterns may contribute to reduced or increased extent and severity of periodontitis by local and systemic mechanisms, preceding the effect of other established causes such as smoking and obesity, in younger population.
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Affiliation(s)
| | - Gustavo G Nascimento
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
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Costa SA, Ribeiro CCC, Moreira ARO, Carvalho Souza SDF. High serum iron markers are associated with periodontitis in post-menopausal women: A population-based study (NHANES III). J Clin Periodontol 2021; 49:221-229. [PMID: 34879443 DOI: 10.1111/jcpe.13580] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/11/2021] [Accepted: 11/25/2021] [Indexed: 11/26/2022]
Abstract
AIM To investigate the association between increased serum markers of iron (ferritin and transferrin saturation) and the severity and extent of periodontitis in post-menopausal (PM) women. MATERIALS AND METHODS Data from 982 PM women participating in NHANES III were analysed. Exposures were high ferritin (≥300 μg/ml) and transferrin saturation (≥45%). The primary outcome was moderate/severe periodontitis defined according to Centers for Disease Control and Prevention and the American Academy of Periodontology. The extent of periodontitis was also assessed as outcome: proportion of sites affected by clinical attachment loss ≥4 mm and probing depth ≥4 mm. Crude and adjusted prevalence ratio (PR) and mean ratio (MR) were estimated using Poisson regression. RESULTS The prevalence of moderate/severe periodontitis was 27.56%. High ferritin was associated with moderate/severe periodontitis in the crude (PR 1.55, p = .018) and in the final adjusted model (PR 1.53, p = .008). High ferritin and transferrin saturation levels were associated with a higher proportion of sites with clinical attachment loss ≥4 mm (p < .05). CONCLUSIONS The increasing serum iron markers seem to contribute to periodontitis severity and extent in PM women.
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Costa SA, Ribeiro CCC, de Oliveira KR, Alves CMC, Thomaz EBAF, Casarin RCV, Souza SDFC. Low bone mineral density is associated with severe periodontitis at the end of the second decade of life: A population-based study. J Clin Periodontol 2021; 48:1322-1332. [PMID: 34288024 DOI: 10.1111/jcpe.13525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 11/29/2022]
Abstract
AIM To evaluate the association between low bone mineral density (BMD) and severe periodontitis at the end of the second decade of life. MATERIALS AND METHODS This population-based study analysed 2032 youngers (18-19 years old) of the RPS cohort. BMD of lumbar spine (BMD-LS) and of the whole body (BMD-WB) were assessed by dual x-ray emission densitometry. Low BMD-LS (Z-score ≤ -2) and low BMD-WB (Z-score ≤ -1.5) were correlated with severe periodontitis. The extent of periodontal disease was also evaluated as the following outcomes: proportions of teeth affected by clinical attachment loss ≥5 mm and probing depth ≥5 mm. Multivariate models by sex, education, family income, risk of alcohol dependence, smoking, plaque, bleeding index, and body mass index were estimated through logistic regression (binary outcomes) and Poisson regression (continuous outcomes). RESULTS The prevalence of severe periodontitis was 10.97%. Low BMD-LS (odds ratio [OR] = 2.08, confidence interval [CI] = 1.12-3.85, p = .01) and low BMD-WB (OR = 1.34, CI = 1.001-1.81, p = .04) were associated with severe periodontitis in the final multivariate models. Low BMD-LS and BMD-WB were also associated with a greater extent of periodontitis (p < .05). CONCLUSIONS Low BMD was found to be associated with the severity and extent of periodontitis in adolescents. Adolescents at peak bone mass age presenting low BMD are more likely to be affected by severe periodontitis.
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Prado IA, Costa CM, Costa SA, Carmo CDSD, Thomaz EBAF, Souza SDFC, Ribeiro CCC. Association Between Anaemia and Dental Caries in Brazilian Adolescents. Oral Health Prev Dent 2020; 18:1055-1060. [PMID: 33499558 DOI: 10.3290/j.ohpd.b871067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose: The present study analysed the association between anaemia and dental caries in adolescents on the basis of predisposing factors and presence of severely decayed teeth. Materials and Methods: This observational study included a complex probabilistic sample of adolescents (17-18 years old) enrolled at public schools in São Luís, Brazil (n = 363). Two hypothesis models were tested: (1) anaemia and dental caries are associated given that they share predisposing factors, such as socioeconomic and high sugar consumption, and (2) the presence of severely decayed teeth may increase the susceptibility of patients to anaemia. In the first model, the association between anaemia and the history of dental caries (the outcome number of affected teeth) was analysed by Poisson regression. In the second model, the association between the presence of severely decayed teeth with pulp exposure/necrosis and the outcome anaemia was analysed by logistic regression. Bivariate and multivariate analyses after adjusting for socioeconomic factors and sugar consumption were performed, considering 5% of statistical significance level and using STATA 115.0. Results: Anaemia was associated with a higher number of affected teeth with a history of dental caries in bivariate (means ratio [MR]: 1.30; 95% confidence intervals [CI95%]: 1.10-1.52; p = 0.001) and multivariate (MR: 1.18; CI95%: 1.01-1.39; p = 0.046) analyses. Severely decayed teeth with pulp exposure/necrosis were associated with anaemia in bivariate (odds ratios [OR]: 5.75; CI95%: 1.97-16.8; p = 0.001)] and multivariate (OR 5.51; CI95%: 1.71-17.74; p = 0.004) analyses. Conclusion: This study suggests that anaemia and dental caries are associated in a population-based sample of adolescents and that predisposing factors and severely decayed teeth seem to be involved in this association..
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Costa SA, Moreira ARO, Costa CPS, Carvalho Souza SDF. Iron overload and periodontal status in patients with sickle cell anaemia: A case series. J Clin Periodontol 2020; 47:668-675. [PMID: 32189376 DOI: 10.1111/jcpe.13284] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 02/14/2020] [Accepted: 03/15/2020] [Indexed: 12/13/2022]
Abstract
AIM To investigate the association among iron overload, periodontal status, and periodontitis progression rate in sickle cell anaemia (SCA). MATERIALS AND METHODS This case series evaluated 123 patients. Clinical attachment level (CAL) and probing depth (PD) were evaluated at six sites per tooth. Alveolar bone loss was estimated using periapical radiography. Study outcomes were periodontal status (measured as number of sites with CAL of ≥3 mm, CAL of ≥5 mm, PD of ≥4 mm, and PD of ≥6 mm) and periodontitis progression rate (determined as ratio of alveolar bone loss to age). Serum transferrin saturation and ferritin levels were obtained from medical records. Poisson regression was performed to estimate associations. Covariables included in the adjusted models (comorbidities, skin colour, socioeconomic class, and vaso-occlusive crisis) were defined by DAGs. RESULTS Serum transferrin saturation level revealed a significant positive association with the number of sites with CAL of ≥3 mm, CAL of ≥5 mm, PD of ≥4 mm, and PD of ≥6 mm. Patients with serum transferrin saturation level of >45% were 1.93 times more likely to have rapid periodontitis progression. CONCLUSION High serum transferrin saturation level is associated with a greater extent of periodontitis and rapid periodontitis progression in SCA.
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Sirino GDJS, Costa SA, Pereira EM, Souza SDFC. Management of atypical mucosal lesions from primary endodontic infection. Braz J Oral Sci 2019. [DOI: 10.20396/bjos.v18i0.8655143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Aim/Case report: We have described here the diagnosis and treatment of two cases involving atypical mucosal lesions originating from primary endodontic infections in young patients. Differential diagnoses were established by clinical and radiographic examinations. In both the cases, a red-colored lesion was observed in the alveolar mucosa, with a soft consistency and a sessile-base without any drainage path in tooth 31 (case 1) and with a sinus tract in tooth 36 (case 2), as confirmed by X-ray. The cleaning and shaping of the root canals were performed, and camphorated paramonochlorofenol (CPMC)-enriched calcium hydroxide paste was used as an intracanal dressing for 6 months, with replacement every 60 days. Conclusion: Based on our experience, we thus conclude that long-term root canal maintenance with CPMC-enriched calcium hydroxide was an effective therapeutic protocol for promoting the healing of atypical mucosal lesions.
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Costa SA, Souza SDFC, Nunes AMM. Oral manifestations of renal tubular acidosis associated with secondary rickets: case report. ACTA ACUST UNITED AC 2018; 41:433-435. [PMID: 30199559 PMCID: PMC6788841 DOI: 10.1590/2175-8239-jbn-2018-0105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 07/13/2018] [Indexed: 11/22/2022]
Abstract
This report describes the oral manifestations of renal tubular acidosis (RTA)
associated with secondary rickets and discusses the biological plausibility of
these findings. The characteristic electrolyte changes during RTA or genetic
mutations that trigger RTA may be responsible for impaired amelogenesis, dental
malocclusion, impacted teeth, and absent lamina dura. This report reinforces the
possibility of an association between RTA and the oral manifestations
described.
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Affiliation(s)
- Susilena Arouche Costa
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Odontologia, São Luís, MA, Brasil
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Lamattina D, Venzal JM, Costa SA, Arrabal JP, Flores S, Berrozpe PE, González-Acuña D, Guglielmone AA, Nava S. Ecological characterization of a tick community across a landscape gradient exhibiting differential anthropogenic disturbance in the Atlantic Forest ecoregion in Argentina. Med Vet Entomol 2018; 32:271-281. [PMID: 29368343 DOI: 10.1111/mve.12295] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 10/10/2017] [Accepted: 12/03/2017] [Indexed: 06/07/2023]
Abstract
An ecological analysis of a tick (Ixodida: Ixodidae) community across a landscape gradient presenting differential anthropogenic disturbance in the Atlantic Forest ecoregion in Argentina was performed. Ticks were collected from vegetation and hosts between September 2014 and August 2016. A total of 12 697 free-living ticks and 3347 specimens from hosts were collected, including 317 ticks infesting humans. The values obtained show considerable species diversity in the forest environment accompanied by low equitability. The similarity index derived from a comparison of forest and agricultural environments was higher than that calculated by comparing forest and urban environments. The data suggest that although a cycle of one generation per year is apparent in some species, more than one cohort may co-exist within the populations of some of these species. Well-marked patterns of the seasonal distribution of free-living tick species emerged in environments with no anthropic modification. The results indicate that forest environments are more suitable habitats than agricultural and urban environments for many species of native tick, but are unsuitable for exotic species that have successfully established in environments that have been modified by man.
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Affiliation(s)
- D Lamattina
- Instituto Nacional de Medicina Tropical (INMeT), Ministerio de Salud de la Nación, Puerto Iguazú, Argentina
| | - J M Venzal
- Laboratorio de Vectores y Enfermedades Transmitidas, Facultad de Veterinaria, CENUR Litoral Norte-Salto, Universidad de la República, Salto, Uruguay
| | - S A Costa
- Instituto Nacional de Medicina Tropical (INMeT), Ministerio de Salud de la Nación, Puerto Iguazú, Argentina
| | - J P Arrabal
- Instituto Nacional de Medicina Tropical (INMeT), Ministerio de Salud de la Nación, Puerto Iguazú, Argentina
| | - S Flores
- Instituto Nacional de Medicina Tropical (INMeT), Ministerio de Salud de la Nación, Puerto Iguazú, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - P E Berrozpe
- Instituto Nacional de Medicina Tropical (INMeT), Ministerio de Salud de la Nación, Puerto Iguazú, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - D González-Acuña
- Departamento de Ciencia Animal, Facultad de Ciencias Veterinarias, Universidad de Concepción, Chillán, Chile
| | - A A Guglielmone
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Instituto Nacional de Tecnología Agropecuaria, Estación Experimental Agropecuaria Rafaela, Rafaela, Argentina
| | - S Nava
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Instituto Nacional de Tecnología Agropecuaria, Estación Experimental Agropecuaria Rafaela, Rafaela, Argentina
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Oliveira AL, Malafaya PB, Costa SA, Sousa RA, Reis RL. Micro-computed tomography (micro-CT) as a potential tool to assess the effect of dynamic coating routes on the formation of biomimetic apatite layers on 3D-plotted biodegradable polymeric scaffolds. J Mater Sci Mater Med 2007; 18:211-23. [PMID: 17323152 DOI: 10.1007/s10856-006-0683-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2006] [Accepted: 10/19/2006] [Indexed: 05/14/2023]
Abstract
This work studies the influence of dynamic biomimetic coating procedures on the growth of bone-like apatite layers at the surface of starch/polycaprolactone (SPCL) scaffolds produced by a 3D-plotting technology. These systems are newly proposed for bone Tissue Engineering applications. After generating stable apatite layers through a sodium silicate-based biomimetic methodology the scaffolds were immersed in Simulated Body Fluid solutions (SBF) under static, agitation and circulating flow perfusion conditions, for different time periods. Besides the typical characterization techniques, Micro-Computed Tomography analysis (micro-CT) was used to assess scaffold porosity and as a new tool for mapping apatite content. 2D histomorphometric analysis was performed and 3D virtual models were created using specific softwares for CT reconstruction. By the proposed biomimetic routes apatite layers were produced covering the interior of the scaffolds, without compromising their overall morphology and interconnectivity. Dynamic conditions allowed for the production of thicker apatite layers as consequence of higher mineralizing rates, when comparing with static conditions. micro-CT analysis clearly demonstrated that flow perfusion was the most effective condition in order to obtain well-defined apatite layers in the inner parts of the scaffolds. Together with SEM, this technique was a useful complementary tool for assessing the apatite content in a non-destructive way.
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Affiliation(s)
- A L Oliveira
- 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, Univ. of Minho, Campus Gualtar, 4710 Braga, Portugal.
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Costa SA, Reis RL. Immobilisation of catalase on the surface of biodegradable starch-based polymers as a way to change its surface characteristics. J Mater Sci Mater Med 2004; 15:335-342. [PMID: 15332596 DOI: 10.1023/b:jmsm.0000021098.75103.3a] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
In this study, a specific enzyme catalase was immobilised onto the surface of two different biodegradable materials, starch cellulose acetate (SCA) and starch polycrapolactone (SPCL) blends. This immobilisation was achieved by several different routes, mainly by covalent binding and an adsorption method using as activation agents epichlorohydrin, cyanogen bromide (CNBr), and aminopropyltriethoxysilane. The effect of the coupling pH of the enzyme-support reaction was determined in terms of activity recovery (%). The catalase immobilised on SCA showed higher activity recovery (%) for all the methods used as compared with results obtained with SPCL. The immobilisation process using epichlorohydrin as an activation agent and polyethylenimine as a spacer-arm enhanced the stability and the half-lives at pH 7.0, 30 degrees C, for immobilised catalase on both SCA and SPCL. The half-lives were respectively, 1162 and 870 h compared with other treatments and free enzyme (480 h). The free glycerol present in the immobilisation medium was also a factor that contributed toward the better performance regarding the long-term stability at 30 degrees C and neutral pH. The extension of the morphological modifications on the surface of the materials was observed by scanning electron microscopy. In general, the results indicated that the chemical modification with epichlorohydrin could provide a simple and rather efficient technique to modify the starch-based materials' surface that might be useful in several biomedical applications.
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Affiliation(s)
- S A Costa
- 3B's Research Group, Biomaterials, Biodegradables and Biomimetics, Campus de Gualtar, 4710-057 Braga, Portugal.
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Costa SA, Pessoa A, Roberto IC. Partitioning of xylanolitic complex from Penicillium janthinellum by an aqueous two-phase system. J Chromatogr B Biomed Sci Appl 2000; 743:339-48. [PMID: 10942304 DOI: 10.1016/s0378-4347(00)00212-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This work evaluates the influences of five parameters (pH, PEG molecular mass, PEG concentration, concentration of buffer K2HPO4-KH2PO4 and NaCl concentration) on xylanolitic complex partitioning produced by P. janthinellum in aqueous two-phase systems, using a 2(5) factorial experimental design. A mathematical model to quantify the influence of these parameters was attained and statistically tested. The optimum point for total protein extraction was obtained under the following conditions: pH 7.0, PEG 10 000, 3.67% PEG, 10% potassium phosphate and 12.4% NaCl. The partition coefficient (K) value experimentally obtained was 5.25 and that predicted by the model was 5.89.
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Affiliation(s)
- S A Costa
- Department of Biotechnology, Faculty of Chemical Engineering of Lorena, Lorena/SP, Brazil
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