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Obtener una buena adhesión entre esmalte y bracket es un aspecto fundamental para el éxito del tratamiento en Ortodoncia. Algunos casos presentan desafíos en esta adhesión, especialmente cuando nos enfrentamos ante un esmalte con alteraciones como hipomineralizaciones, hipoplasias o fluorosis dental. Para sobreponer esta dificultad en la unión adhesiva se han propuesto diversas estrategias terapéuticas como es el uso de agentes desproteinizantes. El objetivo de esta revisión narrativa es describir el uso de hipoclorito de sodio como agente desproteinizante en dientes con alteraciones de esmalte para mejorar la adhesión en Ortodoncia. Se realizó una búsqueda bibliográfica en PubMed de los últimos 5 años. Se encontraron 116 artículos, de los cuales 23 cumplieron con los criterios requeridos y fueron seleccionados para la revisión. La desproteinización del esmalte con hipoclorito de sodio como paso previo al grabado ácido, es una estrategia útil en el proceso de cementación de aparatología de ortodoncia fija en dientes con alteraciones del esmalte. El uso de hipoclorito de sodio al 5,25 % es una alternativa de bajo co sto, no invasiva y eficiente para mejorar la fuerza de adhesión en pacientes con alteraciones del esmalte.
Obtaining good adhesion between enamel and bracket is a fundamental aspect for success in Orthodontics. Some cases present challenges in this adhesion, especially when we are faced with enamel with alterations such as hypomineralization, hypoplasia or dental fluorosis. To overcome this difficulty in adhesive bonding, various therapeutic strategies have been proposed, such as the use of deproteinizing agents. The objective of this study is to describe the use of sodium hypochlorite as a deproteinizing agent in teeth with enamel alterations to improve adhesion in Orthodontics. A bibliographic search was carried out in PubMed for articles within the last 5 years. In this study 116 articles were found, of which 23 met the required criteria and were selected for the review. Deproteinization of the enamel with sodium hypochlorite as a prior step to acid etching is an important stage in the cementation process of fixed appliances in orthodontics. The use of 5.25% sodium hypochlorite is a low-cost, non-invasive and efficient alternative to improve adhesion strength in patients with anomalies of tooth enamel.
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BACKGROUND:Previous studies have shown that N-methyl-D-aspartic acid receptor(NMDA)receptors are associated with fluorine,but the role in fluoride-induced endoplasmic reticulum stress remains unclear. OBJECTIVE:To observe the changes of excitatory neurotransmitter NMDA receptor and endoplasmic reticulum stress IRE1α-ASK1-JNK pathway protein expression in brain tissue of rats with experimental fluorosis,and to investigate the pathogenesis of neurological injury in fluorosis by giving NMDA receptor inhibitor to SH-SY5Y cells. METHODS:(1)Animal model:18 1-month-old SD rats were randomly divided into control group(drinking water fluoride content<0.5 mg/L),low fluoride group(drinking water fluoride content 10.0 mg/L)and high fluoride group(drinking water fluoride content 100.0 mg/L),with 6 rats in each group,half of each sex.After 6 months of fluoride intake,the rats were observed for the occurrence of dental fluorosis,and the 24-hour urinary fluoride content was measured.After anesthesia and euthanasia,the brain tissue of rats was taken to observe the pathological changes.Western blot assay was used to detect NMDA receptors and IRE1α,ASK1 and JNK protein expression in the brain tissue.(2)Cell model:SH-SY5Y cells were cultured in vitro and treated with sodium fluoride at final concentrations of 0.3 mmol/L and 3 mmol/L.The fluoride-stained cells were interfered with 10 μmol/L NMDA receptor antagonists Ifenprodil and MK-801 to observe the relevant protein changes. RESULTS AND CONCLUSION:(1)The incidence of dental fluorosis and urinary fluoride level in rats in the high fluoride group were significantly higher than that in the control and low fluoride groups(P<0.05).(2)Compared with the control group,the cytoplasm of neuronal cells in the CA3 area of the hippocampus in the low fluoride group was slightly more basophilic,while the neuronal cells in the CA3 area of the high fluoride group were disorganized,with increased basophilicity and some of the nuclei solidified.(3)In rat brain tissue,the expressions of NR2A in the high fluoride group and NR2B in the low fluoride group were significantly higher compared with the control group(P<0.05),and NR2B,IRE1,ASK1,and p-JNK protein expression levels were increased in the high fluoride group compared with the control and low fluoride groups(P<0.05).(4)In SH-SY5Y cells,NR1,NR2A and NR2B protein expressions were significantly increased in the high fluoride group compared to the control group(P<0.05).The protein levels of NR1 and NR2A were significantly reduced in the high fluorine + Ifenprodil group and high fluorine + MK-801 group compared with the high fluorine group(P<0.05).NR2B protein expression was significantly lower in the high fluorine + Ifenprodil group than that in the high fluorine group(P<0.05).(5)In SH-SY5Y cells,IRE1,ASK1,and p-JNK protein expression was significantly higher in the high fluoride group compared with the control group(P<0.05),while ASK1 and p-JNK protein expressions were significantly decreased in the high fluorine + Ifenprodil group and high fluorine + MK-801 group compared with the high fluorine group(P<0.05).IRE1 protein level was significantly lower in the high fluorine + Ifenprodil group than that in the high fluorine group(P<0.05).(6)It is concluded that excessive fluorine intake activates NMDA receptors in the central nervous system,causing increased expression of endoplasmic reticulum stress IRE1α,ASK1,and p-JNK proteins,and the use of NMDA receptor inhibitors has a mitigating effect on endoplasmic reticulum stress caused by fluorosis.
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BACKGROUND:Fluorosis is a disorder of enamel development caused by long-term intake of large amounts of fluoride during enamel development. OBJECTIVE:To further explore the molecular mechanism of dental fluorosis formation by screening the differentially expressed genes associated with calcium homeostasis in ameloblasts by transcriptome sequencing technology. METHODS:LS8 cells were treated with 0,0.4,0.8,1.6,3.2 and 6.4 mmol/L sodium fluoride(NaF)for 24,48 and 72 hours to observe the effects of different concentrations of NaF on the morphology,cell activity and intracellular Ca2+ concentration of LS8 cells.The differentially expressed genes were screened by transcriptome sequencing and validated. RESULTS AND CONCLUSION:After 24 hours of treatment,the cells treated with 0,0.4,and 0.8 mmol/L NaF were in good growth condition,with increased cell number and clear cell outline.When the NaF concentration was≥1.6 mmol/L,the cells were gradually shrunken and became smaller and the number of cells decreased with the increase of NaF concentration.After 48 and 72 hours of treatment,the number of cells increased in the 0,0.4 mmol/L NaF groups,while gradually decreased in the 0.8,1.6,3.2 mmol/L NaF groups,with rounded and smaller cell morphology.The cells in the 6.4 mmol/L NaF group were shrunken,rounded and suspended in the medium,with almost no adherent cells.When treated with the same concentration of NaF,LS8 cells were in optimal growth after 24 hours of treatment.Results from cell counting kit-8 assay showed that when treated with the same concentration of NaF,the cell activity decreased with the increase of treatment time;when the treatment time was the same,the cell activity decreased with the increase of NaF concentration.After 24 hours of treatment,the intracellular Ca2+ concentration increased with the increase of NaF concentration.Transcriptome sequencing analysis identified genes involved in the regulation of cellular calcium homeostasis:Hsp90b1,Canx,Calr,and Hspa5 that were significantly upregulated(P＜0.05)and Cacna1a that was significantly downregulated(P＜0.05).To conclude,the inhibitory effect of NaF on LS8 cell proliferation may be related to the abnormal increase in intracellular Ca2+ concentration,and the mechanism may be caused by the upregulation of the expression of protein processing and synthesis pathways Hsp90b1,Canx,Calr,and Hspa5 and the downregulation of the expression of calcium signaling pathway Cacna1a.
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@#Histone acetylation and methylation can affect chromatin conformation and regulate a variety of biological activities. Abnormal histone acetylation and methylation modifications are related to the occurrence and development of a variety of oral diseases. Histone acetylation and methylation increase or decrease in an orderly manner to regulate the development of teeth. Fluoride ions can destroy the balance between histone acetylation and methylation, which may be related to the occurrence of dental fluorosis. In addition, histone acetylation and methylation are involved in the regulation of oral inflammatory diseases. In the inflammatory microenvironment, the expression of histone acetyltransferase GCN5 decreases, and the expression of Dickkopf 1 (DKK1) decreases, activating the Wnt/β-catenin pathway and ultimately inhibiting the osteogenic differentiation of periodontal ligament stem cells. Enhancer of zeste homolog 2 (EZH2) and H3K27me3 levels were decreased in inflamed dental pulp tissues and cells. EZH2 inhibition inhibited the expression of interleukin (IL)-1b, IL-6 and IL-8 in human dental pulp cells under inflammatory stimulation. Histone acetylation/methylation modifications can interact with multiple signaling pathways to promote the occurrence and development of oral tumors and are related to the high invasiveness of salivary gland tumors. Small molecule drugs targeting histone acetylation and methylation-related enzymes can regulate the level of histone methylation/acetylation and have shown potential in the treatment of oral and maxillofacial diseases. For example, the histone deacetylase inhibitor vorinostat can inhibit the secretion of inflammation-related cytokines; it also promotes the maturation of odontoblasts and the formation of dentin-related matrix, demonstrating its potential in pulp preservation. Understanding the role of histone acetylation/methylation modifications in the occurrence and development of oral diseases will help promote research on epigenetic modifications in oral diseases and provide new perspectives for disease diagnosis and treatment.
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Objective:To investigate the control situation of drinking water-type endemic fluorosis (hereinafter referred to as drinking water fluorosis) in Xinjiang Production and Construction Corps (hereinafter referred to as the Corps), identify weak links in prevention and control, and provide reference for precise prevention and control of drinking water fluorosis in the Corps.Methods:Monitoring data of drinking water fluorosis areas in the Corps from January to December 2022 were collected from the Corps Center for Disease Control and Prevention, the level of fluoride in drinking water and the prevalence of dental fluorosis in children aged 8 - 12 were analyzed retrospectively.Results:In 2022, the qualified rate of water fluoride in the disease affected TuanChang of the Corps was 100.00% (62/62), and the qualified rate of water fluoride in the disease affected company was 99.44% (705/709). The prevalence of dental fluorosis in children aged 8 - 12 in the disease affected TuanChang was 3.38% (1 412/41 714), and there was no statistically significant difference in the prevalence of dental fluorosis among different age groups (χ 2 = 6.07, P = 0.194). The prevalence of dental fluorosis in children aged 8 - 12 in the TuanChang where the company with water fluoride exceeding standard was located (6.00%, 106/1 768) was higher than that in the TuanChang where the company with qualified water fluoride was located (3.27%, 1 306/39 946, χ 2 = 38.47, P < 0.001). Conclusion:In 2022, the drinking water fluorosis in the Corps has reached the control standard, but attention still should be paid to the water improvement situation and maintenance of water improvement projects in some water fluoride exceeding standard companies, in order to prevent sustained dental fluorosis damage to children in the affected areas, and consolidate the achievements of prevention and control.
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Objective:To investigate the prevalence of adult skeletal fluorosis caused by drinking tea-type endemic fluorosis in Yushu Tibetan Autonomous Prefecture (hereinafter referred to as Yushu Prefecture), Qinghai Province, and provide scientific basis for prevention and control of the disease.Methods:In August 2021, one village was selected as a survey site in six counties (cities) in Yushu Prefecture, including Nangqian, Chindu, Yushu, Zadoi, Qumarlêb, and Zhiduo. Drinking water samples and 10 brick tea samples were collected from each village to determine the fluoride content in water and brick tea; at least 100 permanent residents aged ≥ 25, who had a habit of drinking brick tea and had lived in the local area for more than 5 years, were selected for X-ray imaging to examine the prevalence of adult skeletal fluorosis.Results:A total of 75 samples of residential drinking water were collected, with a fluoride content of (0.21 ± 0.05) mg/L, ranging from 0.11 to 0.34 mg/L; 60 samples of brick tea, with a fluoride content of (626.70 ± 157.27) mg/kg, ranging from 324.00 to 2 102.00 mg/kg. A total of 1 136 adults were examined, and 318 cases of skeletal fluorosis were diagnosed, with a detection rate of 27.99%. Among them, the detection rates of mild, moderate, and severe skeletal fluorosis were 20.95% (238/1 136), 6.07% (69/1 136), and 0.97% (11/1 136), respectively, with mild symptoms being the main. The detection rates of skeletal fluorosis in males and females were 29.09% (121/416) and 27.36% (197/720), respectively, with no statistically significant difference between the gender (χ 2 = 0.39, P = 0.533). Comparison of the skeletal fluorosis in different gender, the differences were statistically significant (χ 2 = 22.31, P < 0.001). The detection rates of skeletal fluorosis in the age groups of 25 - 35, 36 - 45, 46 - 55, 56 - 65, 66 - 75, and ≥76 years old were 6.86% (7/102), 22.37% (51/228), 24.02% (92/383), 37.44% (73/195), 43.48% (70/161), and 37.31% (25/67), respectively. The differences between the groups were statistically significant (χ 2 = 59.84, P < 0.001). Moreover, there was a statistically significant difference in the composition of skeletal fluorosis among different age groups ( H = 37.66, P < 0.001). The Spearman correlation analysis results showed that the severity of adult skeletal fluorosis was positively correlated with age ( r = 0.34, P < 0.001). Conclusions:There is a certain degree of prevalence of adult skeletal fluorosis in Yushu Prefecture. And as age increases, the condition of skeletal fluorosis becomes more severe.
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Objective:To investigate the current situation and related factors of children's growth and development in drinking-water-borne endemic fluorosis areas after water improvement, and provide a basis for improving the control strategies.Methods:The stratified random sampling method was used to select children aged 7 to 13 in villages with different years of water improvement in Xi'an from November 2019 to June 2020. The height and weight of children were measured, and body mass index (BMI) was calculated. The height development level of children was graded according to the "Standard for Height Level Classification among Children and Adolescents Aged 7 - 18 Years" (WS/T 612-2018), and the physical development (BMI) level of children was determined according to the "Comprehensive Evaluation of Development Level for Children and Adolescents" (GB/T 31178-2014). At the same time, according to the standard of "Diagnosis of Dental Fluorosis" (WS/T 208-2011), the diagnosis of dental fluorosis in children was performed. The serum fluoride level was determined by ion selective electrode method, and the levels of other chemical elements (calcium, iron, magnesium, copper, zinc, iodine, selenium, lead, arsenic, cadmium, chromium, mercury, nickel) in blood were determined by inductively coupled plasma mass spectrometry.Results:A total of 469 children were included in the investigation. After water improvement, 67.38% (316/469) of the children in the disease area were at the moderate level of height development, 7.89% (37/469) were at the medium to upper and upper levels, and 24.73% (116/469) were at the medium to lower and lower levels. The BMI of the children in the emaciation group was 8.53% (40/469), while it was 10.87% (51/469) in the overweight group and 8.74% (41/469) in the obesity group. There was statistically significant difference in the distribution of height development level of children in areas with different water improvement years ( P = 0.005), but no statistically significant difference in BMI distribution ( P = 0.154). There was no significant difference in height development level and BMI distribution of children with or without dental fluorosis ( P > 0.05). There were significant differences in serum levels of iron and zinc among children with different height development levels ( P < 0.05). There were significant differences in serum levels of magnesium, copper, iodine and chromium among children with different BMI ( P < 0.05). Conclusion:The growth and development of children in drinking-water-borne endemic fluorosis area after water improvement are not correlated with the prevalence of dental fluorosis, but may be related to the levels of chemical elements such as iron, magnesium, copper, and iodine in the body.
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La prevalencia de fluorosis dental presenta una gran variabilidad a nivel mundial. Es necesario su análisis como parte de la vigilancia epidemiológica. Objetivo: Conocer la literatura disponible sobre prevalencia de fluorosis dental a la edad de 12 años en relación con el método de fluoruración comunitario utilizado. Metodología: Dos investigadoras realizaron una revisión sistemática de la literatura sin límites temporales siguiendo las pautas PRISMA, utilizando las bases de datos Pubmed, Cochrane, Scopus, BVS y Google Schoolar en idioma inglés, español, portugués e italiano. Resultados: Fueron incluidos 19 artículos de diseño transversal, 16 pertenecientes a comunidades que utilizan agua fluorurada, uno que utiliza sal fluorurada y 2 que comparan resultados entre comunidades que utilizan agua o sal fluorurada. Conclusiones: existe gran variabilidad en los reportes de prevalencia de fluorosis dental. Independientemente del método de fluoruración comunitario utilizado las lesiones de fluorosis de severidad leve son las más prevalentes.
Os relatos sobre a prevalência de fluorose dentária aos 12 anos apresentam grande variabilidade, não havendo unificação quanto ao uso dos índices. Independentemente do meio comunitário de fluoretação e do índice utilizado, a fluorose dentária leve é ââa mais prevalente. Objetivo: Conhecer a literatura disponível sobre prevalência de fluorose dentária aos 12 anos em relação ao método comunitário de fluoretação utilizado. Metodologia: Dois pesquisadores realizaram uma revisão sistemática da literatura sem limites de tempo seguindo as diretrizes PRISMA, utilizando as bases de dados Pubmed, Cochrane, Scopus, BVS e Google Schoolar em inglês, espanhol, português e italiano. Resultados: Foram incluídos 19 artigos transversais, sendo 16 pertencentes a comunidades que utilizam água fluoretada, un sal fluoretada e 2 que comparam resultados entre comunidades que utilizam água fluoretada ou salgada. Conclusões: Há grande variabilidade nos relatos de prevalência de fluorose dentária. Independentemente do método de fluoretação comunitária utilizado, as lesões de fluorose de gravidade leve são as mais prevalentes.
The prevalence of dental fluorosis presents great variability worldwide. Its analysis is necessary as part of epidemiological surveillance Objective: To know the available literature on the prevalence of dental fluorosis among 12 years-old in relation to the community fluoridation method used. Methodology: Two researchers carried out a systematic review of the literature without time limits following the PRISMA guidelines, using the Pubmed, Cochrane, Scopus, BVS and Google Schoolar databases in English, Spanish, Portuguese and Italian. Results: 19 cross-sectional articles were included, 16 belonging to communities that use fluoridated water, one that use fluoridated salt and 2 that compare results between communities that use fluoridated water or salt. Conclusions: there is great variability in the reports of prevalence of dental fluorosis. Regardless of the community fluoridation method used, fluorosis lesions of mild severity are the most prevalent.
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ABSTRACT Fluorosis is a worldwide public health problem. One of the factors related to it is the type of water consumed, such as groundwater. High fluoride concentration in groundwater may be explained by contamination from local industries. Since fluoride and arsenic are the main pollutants of groundwater, some studies correlate groundwater consumption with high prevalence of fluorosis Aim The aim of this study was to conduct a systematic review to determine whether children's risk of fluorosis is related to drinking groundwater Materials and Method The protocol for this systematic review was registered at the National Institute of Health Research Database (CRD42021227298). A comprehensive search was conducted to identify potentially relevant studies by exploring a range of electronic databases (Medline via PubMed, Scopus, Cochrane Library, Science Direct, Web of Science Core Collection, Medline via Ovid, Lilacs, Embase, and grey literature) Results A total 2189 articles were found. After reading titles and abstracts, 63 were selected for screening, and the final data was extracted from 15 articles Conclusion A relationship was identified between drinking fluoridated water from wells and the prevalence of fluorosis in individuals up to 18 years old. This is the first study to assess the issue systematically worldwide.
RESUMEN La fluorosis es un problema de salud pública a nivel mundial y el tipo de agua consumida es uno de los factores relacionados con ella, como el consumo de aguas subterráneas. La alta concentración de fluoruro en estas aguas puede justificarse por la contaminación por industrias locales y las características del suelo, donde algunos estudios correlacionan el consumo de aguas subterráneas con una alta prevalencia de fluorosis, ya que el fluoruro, junto con el arsénico, se consideran los principales contaminantes de estas aguas Objetivo El objetivo es realizar una revisión sistemática que relacione el riesgo de fluorosis en niños expuestos al consumo de agua procedente de pozos Materiales y Método El protocolo de esta revisión sistemática fue registrado en el National Institute of Health Research Database (CRD42021227298). Se realizó una búsqueda bibliográfica de estudios primarios explorando diversas bases de datos electrónicas (Medline vía PubMed, Scopus, Cochrane Library, Science Direct, Web of Science Core Collection, Medline vía Ovid, Lilacs, Embase y literatura gris) Resultados Se encontraron 2189 artículos, tras la lectura de títulos y resúmenes se seleccionaron 63 referencias para examinar y, finalmente, se extrajeron los datos de 15 artículos Conclusiones Se identificó una relación entre el consumo de agua fluorada de pozo y la prevalencia de fluorosis en individuos de hasta 18 años, siendo este estudio el primero en evaluarlo sistemáticamente a nivel mundial.
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Introducción: La fluorosis dental es una patología endémica causada por la ingestión excesiva de fluoruros que pueden producir una alteración durante el desarrollo del esmalte, y es considerado un importante problema de salud pública porque afecta la salud bucal y sistémica de la población. Objetivo: Este estudio tuvo como idea principal determinar la frecuencia y los niveles de fluorosis dental en escolares de 12 a 15 años pertenecientes a dos instituciones educativas de Lima - Perú. Método: Se realizó un estudio descriptivo de tipo transversal, la muestra estuvo conformada por 252 estudiantes, entre 12 y 15 años de dos centros educativos de Lima. El muestreo fue por selección sistemática de elementos muestrales. La fluorosis dental se evalúo mediante el Índice de Dean. Para determinar la frecuencia y los niveles de fluorosis dental, se realizó un examen clínico bucal y se desarrolló un cuestionario validado previamente. Resultados: La frecuencia de fluorosis dental fue de 44,8% (n=113) afectando más a los varones en un 27,39% (n=69) y a los adolescentes de 13 años (15,1%). En relación con los niveles de fluorosis, predominó el tipo "muy leve" (34,9%). También se encontró una asociación entre la presencia y el nivel de fluorosis con el número de aplicaciones de flúor (p<0,05). Además, se dijo que el índice comunitario de fluorosis de Dean fue de 0,43. Conclusiones: En la población escolar evaluada, la frecuencia de fluorosis fue de 44,8% y el nivel predominante de fluorosis fue muy leve. Además, el índice comunitario fue de 0,43, el cual mostró un nivel límite de importancia para la salud pública. Por lo que se puede considerar que el número de aplicaciones tópicas de flúor recibido por la población sin una planificación adecuada se podría convertir en un factor de riesgo para causar fluorosis dental.
Introduction: Dental fluorosis is an endemic pathology caused by the excessive ingestion of fluorides that can produce an alteration during the development of the enamel and is considered an important public health problema because it affects the oral and systemic health of the population. Objective: The objective of this study was to determine the frequency and levels of dental fluorosis in school children between 12 and 15 years of age belonging to two educational institutions in Lima, Peru. Method: A descriptive cross-sectional study was carried out, the sample consisted of 252 students between 12 and 15 years of age from two educational centers in Lima. Sampling was by systematic selection of sample elements. Dental fluorosis was evaluated using the Dean Index. To determine the frequency and levels of dental fluorosis a clinical oral examination was carried out and a previously validated questionnaire was developed. Results: The frequency of dental fluorosis was 44.8% (n=113) affecting more males by 27.39% (n=69) and adolescents aged 13 years (15.1%). In relation to the levels of fluorosis, the "very mild" type predominated (34.9%). An association was also found between the presence and level of fluorosis with the number of fluoride applications (p<0.05). In addition, Dean's community fluorosis index was reported to be 0.43. Conclusions: In the school population evaluated, the frequency of fluorosis was 44.8% and the predominant level of fluorosis was very mild. In addition, the community index was 0.43, which indicated a borderline level of public health importance. Therefore, it can be considered that the number of topical fluoride applications received by the population without adequate planning could become a risk factor for causing dental fluorosis.
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Humans , Male , Female , Child , Adolescent , Dental Caries/drug therapy , Fluorosis, Dental/epidemiology , PeruABSTRACT
La fluorosis dental se caracteriza por una hipomineralización de la estructura dental causada por ingesta excesiva de flúor sistémico. En la dentición decidua, su diagnóstico precoz es importante, dado que será un predictor para la aparición de lesiones en la dentición permanente. El objetivo de esta revisión fue describir la evidencia científica sobre la fluorosis dental en dentición decidua reportando su etiología y factores relacionados, prevalencia, diagnóstico y tratamiento. Se realizaron búsquedas electrónicas en las bases de datos Pub-Med/Medline, EbscoHost y ScienceDirect (noviembre/2020), utilizando las palabras clave "dental fluorosis", "deciduous teeth", "primary tooth", "primary teeth". El desarrollo de fluorosis dental en dentición decidua se relacionó con la ingesta de múltiples fuentes de flúor principalmente, agua potable, alimentos de la dieta, fórmulas infantiles, suplementos y uso de dentífricos fluorados en dosis inadecuadas. Algunos factores prenatales, como vivir en terrenos montañosos o de gran altitud y habitar en lugares cercanos a minas de combustión de carbón, también fueron asociados. La prevalencia de fluorosis dental reportada en los estudios varió entre 6,2 y 96,6 %, dependiendo principalmente de la concentración de flúor en agua potable. Para el diagnóstico de la fluorosis dental en la dentición decidua se deben considerar características como la localización, aspecto, extensión y color de la lesión, realizando diagnóstico diferencial con otro tipo de defectos en esmalte y dentina. Así mismo, el tratamiento de las lesiones dependerá de la severidad del defecto y condiciones individuales del paciente.
Dental fluorosis is characterized by a hypomineralization of the tooth structure caused by excessive intake of systemic fluoride. In the deciduous dentition, its early diagnosis is important since it will be a predictor for the appearance of lesions in the permanent dentition. The objective of this review was to describe the scientific evidence on dental fluorosis in deciduous dentition, reporting its etiology and related factors, prevalence, diagnosis and treatment. Electronic searches were conducted PubMed / Medline, EbscoHost and ScienceDirect (November / 2020) databases, using the keywords "dental fluorosis", "deciduous teeth", "primary tooth", "primary teeth". The development of Dental fluorosis in deciduous dentition was related to the intake of multiple sources of fluoride mainly; drinking water, diet foods, infant formulas, supplements and the use of luoridated toothpastes in inadequate doses. Some prenatal factors such as living in mountainous or high altitude terrain and living in places near coal-burning mines were also associated. The prevalence of dental fluorosis in early childhood reported in the studies varied between 6.2% and 96.6%, depending mainly on the concentration of fluoride in drinking water. For the diagnosis of dental fluorosis in the deciduous dentition, characteristics such as the location, appearance, extension and color of the lesion must be considered, making a differential diagnosis with other types of enamel and dentin defects. Evenly, the treatment of lesions will depend on the severity defects and individual patient conditions.
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Dental fluorosis can cause changes in the enamel surface, conditioning its functionality and esthetics. The application of dental adhesives is a treatment option; however, their use on fluorotic teeth can result in limitations. The aim of this study was to compare the shear bond strength of two different adhesives, one with 10-MDP and one without 10-MDP, in different degrees of dental fluorosis.This is an in vitro study on dental enamel samples, a total of 180 samples with the inclusion criteria were treated, randomly divided into two groups of 90, according to the type of dental adhesive, where each group was again divided into three groups of 30 samples, representing different degrees of dental fluorosis according to the Thylstrup-Fejerskov index (Group I: TF1 and TF2; Group II: TF3; Group III: TF4). Normality tests, two-factor ANOVA, and post-hoc tests were used to determine differences between the groups, with a significance level of 95%. As results, a statistically significant difference was shown between the use of dental adhesive with 10-MDP and the three groups of dental fluorosis (p=0.011), in addition, a Tukey post-hoc test on the groups treated with 10-MDP adhesive revealed a statistically significant difference between group I versus group II, and group I versus group III, (p=<0.05). It is concluded that the use of adhesive systems with 10-MDP presents a better shear bond strength on enamel with dental fluorosis grades I and II in the Thylstrup-Fejerskov index.
La fluorosis dental puede ocasionar cambios en la superficie del esmalte, condicionando su funcionalidad y estética, la aplicación de adhesivos dentales es una opción de tratamiento, sin embargo, su uso en dientes fluoroticos puede resultar en limitaciones. El objetivo de este estudio consistió en comparar la fuerza de adhesión a la cizalladura de dos diferentes adhesivos, uno con 10-MDP y otro sin 10-MDP, en diferentes grados de fluorosis dental. Se trata de un estudio in vitro en muestras de esmalte dental, un total de 180 muestras con los criterios de inclusión fueron tratadas, aleatoriamente divididas en dos grupos de 90, de acuerdo al tipo de adhesivo dental, donde cada grupo fue dividido nuevamente en tres grupos de 30 muestras, representando diferentes grados de fluorosis dental según el índice de Thylstrup- Fejerskov (Grupo I: TF1 y TF2; Grupo II: TF3; Grupo III: TF4). Para determinar diferencias entre los grupos se utilizaron pruebas de normalidad, ANOVA de dos factores, y pruebas post-hoc, con un nivel de significancia de 95%. Como resultados, se mostró una diferencia estadísticamente significativa entre el uso de adhesivo dental con 10- MDP y los tres grupos de fluorosis dental (p=0.011), además, una prueba post hoc de Tukey sobre los grupos tratados con adhesivo 10-MDP revelaron una diferencia estadísticamente significativa entre el grupo I frente al grupo II, y el grupo I frente al grupo III, (p=<0.05) Se concluye que el uso de sistemas adhesivos con 10-MDP presentan una mejor resistencia de adhesión al cizallamiento en esmalte con grados de fluorosis dental I y II en el índice de Thylstrup-Fejerskov
Subject(s)
Dentin-Bonding Agents/therapeutic use , Fluorosis, Dental/diagnosis , Resin CementsABSTRACT
Background At present, a large number of reports focus on the bones of limbs and trunk, while there are few studies on the effect of fluorosis on jawbone which is the inevitable structural basis for the development and treatment of oral diseases. Objective To preliminarily investigate the effect of fluoride exposure on the mechanical properties of jawbone by observing the changes in the intraosseous environment and the maximum load against shearing force (LSFmax) of the jawbone in rats with chronic fluoride treatment. Methods Screening experiment: 48 SD male rats were randomly divided into a control group and three fluoride exposure groups (50, 150, and 250 mg·L−1 fluoride concentration), 12 rats in each group. The fluoride exposure groups were molded by feeding different concentrations of sodium fluoride solution, and the control group drank tap water from Guizhou area. Each group was further divided into 4 subgroups with 3 animals each according to observation time points after 0, 2, 4, and 6 months. The LSFmax of the jawbone was measured with an electronic universal ergometer, the expression of type I collagen (Col1) was shown by Sirius red staining, and the expression of runt-related transcription factor 2 (Runx2) was determined semi-quantitatively by immunohistochemistry at selected time points. Formal experiment: 12 male SD rats were randomly divided into a fluoride exposure group and a control group. The fluoride exposure group were fed with 150 mg·L−1 sodium fluoride solution, and the control group drank tap water from Guizhou. After feeding with fluoride for 5 months, the ergometer was used to measure the LSFmax of the jawbone. Osteoclasts were counted after tartrate resistant acid phosphatase (TRAP) staining. Col1, Runx2, bone morphogenetic protein 2 (BMP-2), alkaline phosphatase (ALP), and cathepsin K (Cath K) were detected semi-quantitatively by immunohistochemistry expression and Sirius red staining. Micro computed tomography (Micro CT) was used to observe the trabecular bone microstructure. Results Screening experiment: The LSFmax of the control group and the 50 mg·L−1 fluoride exposure group reached the peak value at the 2nd month, and the LSFmax of the 50 mg·L−1 fluoride exposure group reached the valley value at the 4th month. The LSFmax of the 150 mg·L−1 fluoride exposure group at the 4th month was higher than that at the 6th month (P<0.05). There was no significant difference in the LSFmax at each time point in the 250 mg·L−1 fluoride exposure group. At the same time point, there was no statistically significant difference in LSFmax among the groups. The Col1 levels of the 50 mg·L−1, 150 mg·L−1, and 250 mg·L−1 fluoride exposure groups were higher than the time point 0 from the 2nd month (P＜0.05). The Runx2 showed no statistically significant difference by concentration or time. Formal experiment: After feeding with 150 mg·L−1 fluoride for 5 months, the LSFmax of the fluoride exposure group was greater than that of the control group (P<0.05). The expressions of Col1, Runx2, BMP2, ALP, and Cath K in the fluorosis exposure group were higher than those in the control group (P<0.05). There were no statistically significant differences in osteoclast count or indicators of bone trabecular microstructure. Conclusion Chronic fluoride exposure may increase the shear strength of jaw bone.
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Background Fluorine accumulates in the brain tissue after long-term excessive intake and subsequently cause nerve damage and decline of learning and memory ability. Receptor of advanced glycation end-products (RAGE)/p38 mitogen-activated protein kinase (p38MAPK)/nuclear factor kappa-B (NF-κB) signaling pathway is considered to be involved in the associated mechanism. Objective To study the changes of RAGE/ p38MAPK/ NF-κB signaling pathway in rats with subchronic fluorosis, and to explore the protective effects of extract of Ginkgo biloba 761 (EGb761) and RAGE antagonist (FPS-ZM1) on neuromemory ability. Methods Ninety male clean SD rats were divided into 9 groups with 10 rats in each group. The modeling period was 6 months. Control group (C group): free drinking tap water (fluoride content <0.5 mg·L−1), low- and high-dose fluoride groups (LF group, HF group): free drinking tap water with 10 or 50 mg·L−1 fluoride; intervention group of Ginkgo biloba extract (CE, LFE, and HFE groups): on the basis of the C group, LF group, and HF group, 100 mg·kg−1·d−1 EGb761 was given daily via intragastric administration; FPS-ZM1 intervention groups (CF, LFF, and HFF groups): 7 d before the end of modeling, 1 mg·kg−1·d−1 FPS-ZM1 was injected intraperitoneally daily on the basis of the C group, LF group, and HF group. The contents of fluoride in brain and blood of each group were detected. The learning and memory ability was tested by water maze experiment. The histopathologic changes of the hippocampus were detected by Nissl staining. The protein expression levels of RAGE and its ligand high mobility group protein B1 (HMGB1), NF-κB, p38MAPK, phospho-p38MAPK (p-p38MAPK), interleukin-6 (IL-6), and tumour necrosis factor-α (TNF-α) in brain tissue were detected by Western blotting. The mRNA expression levels of RAGE, HMGB1, and p38MAPK were detected by quantitative real-time PCR. Results Compared with the C group, the contents of blood fluoride and brain fluoride in the LF and the HF groups were increased (P<0.05). The results of the water maze experiment showed that, compared with the C group, the escape latency time of the LF group and the HF group was longer and the crossing times were reduced; compared with the HF group, the escape latency time of the HFE group and the HFF group was shortened, and the crossing times were increased (P<0.05). The Nissl staining results showed that the number of Nissl body in the HF group decreased compared with the C group; compared with the HF group, the number of Nissl body in the HFE group and the HFF group increased. The Western blotting results showed that compared with the relative protein expression levels of RAGE, HMGB1, NF-κB, p38MAPK, p-p38MAPK, IL-6, and TNF-α in the C group , the levels of above indicators in the HF group and the levels of RAGE, HMGB1, NF-κB, p-p38MAPK, and IL-6 in the LF group were up-regulated (P<0.05); compared with the HF group, the levels of above indicators in the HFE group and the HFF group were all down-regulated (P<0.05); compared with the relative protein expression levels of RAGE and HMGB1 in the LF group, the levels in the LFE group and the LFF group were all down-regulated (P<0.05). The quantitative real-time PCR results showed that compared with the C group, the mRNA expression levels of RAGE and HMGB1 in the LF group and the HF group were up-regulated; compared with the LF group, the mRNA expression levels of RAGE in the LFE group and the LFF group were down-regulated ; compared with the HF group, the mRNA expression levels of RAGE and HMGB1 in the HFE group and the HFF group were down-regulated (P<0.05). Conclusion The central nervous system injury caused by subchronic fluorosis may be related to the activation of RAGE/p38-MAPK/NF-κB signaling pathway, which can impair the learning and memory ability of rats, while EGb761 and FPS-ZM1 may have certain protective effects on the nerve injury.
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Objective:To investigate the value of common clinical symptoms and signs of knee joint, elbow joint and lumbar spine in clinical diagnosis of endemic skeletal fluorosis.Methods:From August to October 2020, a cross-sectional survey of skeletal fluorosis was conducted in 8 administrative villages in Gaotai County and 5 administrative villages in Gaolan County, which were serious areas of drinking-water-borne endemic fluorosis in Gansu Province. Individuals aged ≥25 years old, residing for more than 1 year, and exhibiting symptoms and signs of the motor system in the affected villages were selected as the survey subjects. According to the X-ray diagnostic criteria in the "Diagnostic Standard for Endemic Skeletal Fluorosis" (WS/T 192-2021), they were divided into skeletal fluorosis group and non skeletal fluorosis group. The basic information of the two groups was collected, and orthopedic examination and digital radiography (DR) were performed. Multivariate logistic regression model was used to fit the effects of knee joint, elbow joint and lumbar spine related symptoms and signs on the diagnosis of skeletal fluorosis. Receiver operating characteristic (ROC) curve was drawn to evaluate the predictive effectiveness of the model for skeletal fluorosis, and Kappa test was used to evaluate the consistency between the model and X-ray diagnosis (the gold standard for diagnosis of skeletal fluorosis). Results:A total of 970 subjects were included in the investigation, including 501 in the skeletal fluorosis group and 469 in the non skeletal fluorosis group. Multivariate logistic regression analysis showed that elbow joint flexion and extension range of motion (ROM) decreased by ≥45° [odds ratio ( OR) = 2.73, 95% confidence interval ( CI): 2.00 - 3.72], elbow joint rotation ROM decreased by ≥30° ( OR = 3.34, 95% CI: 1.96 - 5.68), ulnar nerve injury symptoms ( OR = 3.77, 95% CI: 3.21 - 4.42), intermittent claudication ( OR = 2.72, 95% CI: 1.48 - 4.99), and positive straight leg elevation test ( OR = 1.69, 95% CI: 1.09 - 2.61) had certain impact on the diagnosis of skeletal fluorosis. The area under the ROC curve was 0.88, and the model had a good predictive ability for the diagnosis of skeletal fluorosis. After Kappa test, the Kappa value was 0.61, which suggested that the prediction of skeletal fluorosis by this model was in good agreement with X-ray diagnosis. Conclusions:Elbow joint flexion and extension limitation, elbow joint rotation limitation, ulnar nerve injury, intermittent claudication, and positive straight leg elevation test have certain diagnostic value for skeletal fluorosis. The combined diagnosis of these signs has good predictive ability for skeletal fluorosis.
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Objective:To investigate the epidemic situation of drinking water-borne endemic fluorosis in Henan Province, evaluate the effectiveness of prevention and control measures, and provide a basis for formulating further prevention and control policies.Methods:From April to November 2021, a census of all diseased villages registered in 112 drinking water-borne endemic fluorosis counties (cities, districts, hereinafter referred to as counties) of 17 provincial-level cities and 9 provincial-level counties (cities) in Henan Province was conducted to collect the basic information of diseased counties and villages. The content of fluoride in drinking water and the prevalence of dental fluorosis in children aged 8 - 12 years old were measured on a village by village basis.Results:By the end of 2021, drinking water-borne endemic fluorosis was prevalent in 112 diseased counties in Henan Province, involving 17 450 diseased villages. Among them, 17 433 villages had implemented measures to reduce fluoride and improve water quality, with a water improvement rate of 99.90% (17 433/17 450). There were 14 920 villages with qualified water, and the qualified rate of water fluoride was 85.50% (14 920/17 450). There were a total of 4 232 water improvement projects in all diseased villages, with a normal operation rate of 97.09% (4 109/4 232) and a qualified rate of 93.03% (3 937/4 232) for water fluoride in the projects. The total detection rate of dental fluorosis in children in the province was 9.64% (39 391/408 584), with moderate to severe dental fluorosis accounted for 8.08% (3 182/39 391), the dental fluorosis index was 0.18. The prevalence of fluorosis was negative.Conclusions:In 2021, the prevalence of drinking water-borne endemic fluorosis is widespread in Henan Province, and measures to reduce fluoride and improve water quality in diseased villages have been basically implemented. However, the fluoride content of water in some villages still does not meet the standard, and some water improvement projects cannot operate normally throughout the year. In the future, it is necessary to address the above issues one by one and consolidate the achievements in prevention and control of drinking water-borne endemic fluorosis.
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Objective:To analyze the monitoring results of skeletal fluorosis in coal-burning type endemic fluorosis areas in Guizhou Province, and evaluate the effectiveness of comprehensive treatment of coal-burning type endemic fluorosis in the affected areas.Methods:In 2009, 2014, and 2019, monitoring of skeletal fluorosis was carried out in six counties (cities, districts) of Renhuai City, Qixingguan District, Dafang County, Qianxi City, Puding County, and Pu'an County in Guizhou Province. Age stratification was conducted in each county (city, district) for permanent residents aged 25 and above, and survey subjects were selected for X-ray examination of skeletal fluorosis.Results:The detection rates of skeletal fluorosis in 2009, 2014, and 2019 were 51.48% (798/1 550), 34.88% (308/883), and 6.51% (60/922), respectively, showing a decreasing trend year by year (χ 2trend = 505.83, P < 0.001), decreased by 44.97 percentage points from 2009 to 2019. The age distribution of patients with skeletal fluorosis was mainly in the age group of 55 years and older, with annual proportions of 53.88% (430/798), 56.49% (174/308), and 78.33% (47/60), all higher than 50%. In 2009, 2014, and 2019, 483, 222 and 21 cases of mild skeletal fluorosis were detected, and 315, 86, and 39 cases of moderate to severe skeletal fluorosis were detected. There was a statistically significant difference in disease grading among different years(χ 2 = 32.63, P < 0.001). Among them, there were statistically significant differences in the grading of skeletal fluorosis in Qixingguan District, Qianxi City, Puding County, and Pu'an County(χ 2 = 14.56, 12.24, 35.01, 23.35, P < 0.05). Conclusions:The detection rate of skeletal fluorosis in Guizhou Province decreases year by year, and the prevention and control effect is significant. Patients with skeletal fluorosis are mainly in the age group of 55 years and older, and the proportion of patients with moderate to severe skeletal fluorosis is increasing. We should continue to monitor and manage the treatment of current patients with skeletal fluorosis.
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Objective:To investigate the epidemiological situation of drinking water-type endemic fluorosis in Gansu Province, and scientifically evaluate the effectiveness of water improvement and fluoride reduction projects in preventing and controlling the disease.Methods:The drinking water-type endemic fluorosis areas in Gansu Province were divided into five regions according to different ecological types: the Longzhong Loess Plateau Hilly Area in central Gansu, the Longdong Loess Plateau Gully Area in eastern Gansu, the Longnan Qinling Zhongshan Canyon Area in southern Gansu, the Gobi area of the Hexi Desert, and the Alpine Grassland Meadow Area in southern Gansu. In 2021, a survey was conducted on the basic situation, running situation of the water improvement and fluoride reduction projects, fluoride content in drinking water(fluorine ion-selective electrode), and the prevalence of dental fluorosis (Dean) among children aged 8 to 12 in all drinking water-type endemic fluorosis villages in the five regions. The pertinent assessments were executed in accordance with national guidelines such as the "Standards for Drinking Water Quality" (GB 5749-2006) and "Diagnosis of Dental Fluorosis" (WS/T 208-2011).Results:A total of 2 000 villages in drinking water-type endemic fluorosis areas were monitored, among which 1 999 villages had implemented water improvement and fluoride reduction projects, with a coverage rate of 99.95% (1 999/2 000). All water improvement and fluoride reduction projects were operating normally, with no intermittent operation or scrapping. A total of 34 616 children aged 8 to 12 were investigated for dental fluorosis. The detection rate of dental fluorosis was 4.18% (1 448/34 616), and the dental fluorosis index was 0.09. There was a statistically significant difference in the detection rate of dental fluorosis among children of different ages (χ 2 = 69.77, P < 0.001). The difference in the detection rate of dental fluorosis among children of different ecological types of areas was statistically significant (χ 2 = 775.11, P < 0.001). The dental fluorosis index of children aged 8 - 12 was significantly correlated with the historical water fluoride level ( r = 0.29, P = 0.042). The water improvement time in the Gobi area of the Hexi Desert was significantly correlated with the detection rate of dental fluorosis in local children ( r = - 0.48, P = 0.023). Conclusions:In 2021, the prevention and control of drinking water-type endemic fluorosis in all villages in Gansu Province has reached the national control standards. However, due to the different ecological characteristics and changes in water source distribution in different ecological types of areas, it is still necessary to further strengthen the monitoring of the condition of drinking water-type endemic fluorosis in all the affected villages and consolidate the existing prevention and control achievements.
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Objective:To study the effects of water fluoride and tea fluoride on the occurrence of dental fluorosis in children, and to provide a basis for scientific prevention and control of the disease.Methods:From April to September 2020, Baolongshan Town with qualified water fluoride but no habit of drinking brick tea, Xingyao Town with qualified water fluoride and habit of drinking brick tea, Baokang Town with exceeded water fluoride but no habit of drinking brick tea, and Wuliyasitai Town with exceeded water fluoride and habit of drinking brick tea were selected as survey sites in Inner Mongolia Autonomous Region based on historical monitoring data. In all Gacha (villages) of 4 towns, a survey was carried out on residents' drinking water, brick tea drinking habits and children's dental fluorosis detection, and the water fluoride, tea fluoride exceeding standard rates, daily per capita intake of brick tea fluoride and the detection rate of children's dental fluorosis were calculated. At the same time, multivariate logistic regression was used to analyze the influencing factors affecting the occurrence of dental fluorosis in children.Results:In 2020, a total of 165 water samples were collected in 4 towns of Inner Mongolia Autonomous Region, and the total water fluoride exceeding standard rate was 38.18% (63/165). A total of 320 tea samples were collected, the tea fluoride exceeding standard rates in Xingyao Town and Wuliyasitai Town were 96.38% (213/221) and 89.90% (89/99), respectively; the daily per capita intake of brick tea fluoride was 5.67 and 7.35 mg, respectively. A total of 1 652 children were examined for dental fluorosis, and 639 cases were detected, the detection rate was 38.68%. The detection rates of dental fluorosis in boys and girls were 37.18% (322/866) and 40.33% (317/786), respectively, with no significant difference between sexes (χ 2 = 1.72, P = 0.104); the detection rates of dental fluorosis in children aged 8 - 12 years were 43.93% (105/239), 40.50% (147/363), 46.57% (163/350), 30.56% (88/288) and 33.01% (136/412), respectively, with statistical significant difference among ages (χ 2 = 26.07, P < 0.001); the detection rates of dental fluorosis in children in Baolongshan, Baokang, Xingyao and Wuliyasitai towns were 0.68% (2/293), 14.09% (31/220), 24.79% (89/359) and 66.28% (517/780), respectively, with statistical significant differences among regions (χ 2 = 213.05, P < 0.001). Multivariate logistic regression analysis showed that when the fluoride content in water was 1.2 - < 2.0, 2.0 - < 2.5, and ≥2.5 mg/L, the risk of dental fluorosis in children was 3.93, 6.60, and 9.02 times of water fluoride content < 1.2 mg/L; when the daily per capita intakes of brick tea fluoride was 3.6 - 7.0 and > 7.0 mg, the risk of dental fluorosis in children was 2.94 and 3.90 times of daily per capita intakes of brick tea fluoride ≤3.5 mg; the risk of dental fluorosis in children aged 10 years was 1.81 times of children aged 8 years; the risk of dental fluorosis in children in Xingyao, Baokang, and Wuliyasitai towns was 22.35, 40.93, and 151.58 times of Baolongshan Town, respectively. Conclusions:The prevalence of dental fluorosis in children still exists in Inner Mongolia Autonomous Region, and the detection rate of dental fluorosis is high. High water fluoride and high tea fluoride are the main risk factors for dental fluorosis in children.
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Dental caries is one of the common chronic diseases in children. Fluoride plays a key role in the prevention and treatment of dental caries, but it also carries certain health risks. There are many sources of fluoride in daily life, and appropriate intake is beneficial to the human body. Excessive intake can easily cause dental fluorosis, gastrointestinal adverse reactions, and even fluorosis. This article focuses on the mechanism and health risks of fluoride in preventing and treating dental caries in this progress, aiming to provide theoretical support for the rational use of dental fluoride preparation and the formulation of fluoride content standard in water.