Asociación de sialometría, fosfato y calcio en saliva total bajo estímulo y en líquido crevicular gingival con caries dental en escolares / Sialometry and concentration of phosphate and calcium in stimulated whole saliva and gingival crevicular fluid and its association with dental caries in schoolchildren

Resumen Introducción. La capacidad de la saliva para la remineralización contribuye a mantener la integridad fisicoquímica de la estructura mineral de los dientes, lo cual los protege de la aparición y evolución de la caries dentaria. Objetivo. Establecer la relación de la sialometría, la capacidad amortiguadora, la concentración de calcio y fosfato en la saliva total estimulada y en el líquido crevicular gingival, con la gravedad y la actividad de las caries en escolares. Materiales y métodos. Se seleccionaron 36 escolares de 6 años, 18 con caries (International Caries Detection and Assessment System, ICDAS, código 2 o mayor) y 18 sin caries (ICDAS, código 0). En la dentición primaria, se evaluaron la gravedad y la actividad de la caries dentaria en la superficie de oclusión de los molares y en la vestibular de los dientes anteriores, y se codificaron mediante el ICDAS-II. Resultados. Se evidenció una mayor gravedad de las caries en la superficie de oclusión que en la vestibular. Las concentraciones de calcio en la saliva y de fosfato en el líquido crevicular gingival de los dientes sanos, fueron mayores en el grupo con un código ICDAS de 2 o mayor. La concentración de calcio en el líquido crevicular gingival fue mayor en el grupo con código ICDAS 0 que en los dientes cariados del grupo con código ICDAS de 2 o mayor. Se encontró una asociación estadísticamente significativa entre la frecuencia de caries activas y la concentración de fosfato en el líquido crevicular gingival de los dientes afectados, como también entre la gravedad de las caries y la capacidad amortiguadora, por una parte, y la concentración de fosfato en el líquido crevicular gingival de los dientes afectados, por la otra. Conclusión. Se evidenció una asociación entre la caries dental, la capacidad amortiguadora y la química bucal del calcio y el fosfato.

Abstract Introduction: The remineralizing properties of saliva contribute to maintain the physical and chemical integrity of the mineral structure of teeth, which protects it from the installation and evolution of dental caries. Objective: To relate sialometry, buffering capacity, calcium and phosphate concentration in whole stimulated saliva, and in gingival crevicular fluid with school children caries severity and activity. Materials and methods: We selected 36 schoolchildren aged 6 years: 18 with caries (International Caries Detection and Assessment System, ICDAS>1 group) and 18 without caries (ICDAS=0 group). The severity and activity of dental caries were diagnosed in the primary dentition: in the occlusal surface of molars and in the vestibular of the anterior teeth by ICDAS-II. Results: Caries in occlusal surface were more severe than in vestibular surface. The concentration of calcium in saliva and phosphate in healthy teeth gingival crevicular fluid were higher in the ICDAS>1 group. The concentration of calcium in gingival crevicular fluid was higher in the ICDAS=0 group than in the decayed teeth of the ICDAS>1 group. We found a statistically significant association between the frequency of active caries andthe concentration of phosphate in gingival crevicular fluid of teeth with caries, as well as between the severity of caries with buffering capacity and the concentration of phosphate in the gingival crevicular fluid of teeth with caries. Conclusion: We found an association between dental caries with buffering capacity and buccal calcium and phosphate.

Cárie dentária e presença de placa visível em dentes ântero-superiores em crianças de 0 a 5 anos / Dental caries and presence of visible plaque on anterior teeth on 0 to 5 years old children

Objetivo: Identificar a associação entre cárie dentária e placa dental em função do estágio da primeira infância. Materiais e Métodos: Foram examinadas clinicamente 183 crianças de 8 a 69 meses de idade em dois Centros Municipais de Educação Infantil de Curitiba. As crianças foram divididas em dois grupos, de acordo com o estágio da primeira infância, G1 (até 36 meses)e G2 (37 a 69 meses). Experiência de cárie (ceo-d > 0) e presença de placa visível (em pelo menos um incisivo superior) foram avaliadas por um único pesquisador previamente calibrado (Kappainter e intraexaminador> 0,80). As mães responderam a um questionário sobre condições socioeconômicas, hábitos de higiene e alimentação. Os dados foram submetidos à análise bivariada,por meio dos testes de Qui-quadrado de Pearson e Exato de Fisher. Resultados: No grupo G1houve tendência de associação entre experiência de cárie e placa visível (p = 0,053), enquanto no grupo G2 esta associação apresentou-se significativa (p = 0,006). Houve associações entre o padrão de higienização após a alimentação durante a noite e placa visível (p= 0,026) no grupoG1; e entre estado civil das mães e placa visível no grupo G2 (p= 0,043). Conclusão: Dentro da primeira infância, a relação entre cárie dentária e placa visível em dentes anteriores torna-semais evidente com o aumento da idade.

Objective: To identify the association between dental caries and plaque in the different stages of the early childhood. Materials and Methods: 183 children 8-69 months of age from two Municipal Centers of Children Education, in Curitiba, were clinically examined for cariesand visible plaque. Children were divided in two groups according to the different stages ofthe early childhood, G1 (up to 36 months), G2 (37 to 69 months). Caries experience (ceo-d>0)and visible plaque on at least one upper incisor were evaluated by one previously calibrated examiner (kappa>0,80). Mothers were invited to answer a questionnaire about socioeconomic aspects, dental hygiene and feeding habits. Data were submitted to bivariate analysis using Pearson´s chi-square and Fisher´s exact tests. Results:G1 showed a tendency of association between caries experience and visible plaque (p=0,053), while in G2 a significant association wasfound (p=0,006).Association was found in G1 between dental hygiene after feeding during thenight and visible plaque (p=0,026), and between mother´s marital status and visible plaque onG2 (p=0,043). Conclusion: The association between dental caries and visible plaque on anteriorteeth becomes more evident on the late stages of early childhood.

Analysis of the stimulated whole saliva in overweight and obese school children / Análise da saliva total estimulada em escolares com sobrepeso e obesos

OBJECTIVE: To determine if some stimulated whole saliva parameters are influenced by an increase of Body Mass Index. METHODS: Controlled cross-sectional study involving 90 school children of both genders between 7 and 10 years of age, from Bragança Paulista - SP. Three groups were formed: overweight, obese and control. Body Mass Index and diet intake by the Food Register method were evaluated. The salivary pH, flow rate, buffer capacity, protein, phosphate, calcium, fluoride, total and free sialic acid, and peroxidase activity were determined. RESULTS: The overweight and obese groups showed greater energy and lipid intake (P< 0.001) than the control group. There was no difference in the saliva flow rate between groups, however only the control group showed a mean value considered normal. In the overweight and obese groups a decrease in both the concentration of phosphate (P< 0.001) and peroxidase activity (P<0.001) was observed. In the obese group an increase in the concentrations of free sialic acid (P= 0.004) and protein (P= 0.003) occurred. CONCLUSION: Overweight and obese children show alterations in the concentrations of phosphate, free sialic acid and proteins, and in the peroxidase activity that are favorable conditions for dental caries.

OBJETIVO: Verificar se alguns parâmetros da saliva total estimulada são influenciados pelo aumento do Índice de Massa Corporal. MÉTODOS: Estudo transversal controlado com 90 escolares, de ambos os sexos, de 7 a 10 anos incompletos de Bragança Paulista, SP, formando três grupos: sobrepeso, obeso e controle. Avaliou-se o Índice de Massa Corporal (P/E2) e a ingestão dietética pelo registro alimentar. Na saliva foram avaliados o fluxo, pH, capacidade tampão e concentrações de proteína, fósforo, cálcio, flúor, ácido siálico livre e total e atividade da peroxidase. RESULTADOS: Nos grupos sobrepeso e obeso houve maior consumo de energia e lipídios (P<0,001). Não houve diferença no fluxo salivar entre todos os grupos, mas somente o controle mostrou valor médio considerado normal. O pH salivar do grupo sobrepeso foi maior do que o do controle (P<0,001). Nos grupos sobrepeso e obeso houve decréscimo na concentração de fosfato (P<0,001) e na atividade da peroxidase (P<0,001). No grupo obeso houve aumento nas concentrações de ácido siálico livre (P= 0,004) e proteína (P= 0,003). CONCLUSÃO: Crianças com sobrepeso e obesas apresentam alterações nas concentrações salivares de fosfato, ácido siálico livre e proteínas e na atividade da peroxidade, as quais favorecem a formação de cárie dentária.

Association between dental-oral health in young adults and salivary glutathione, lipid peroxidation and sialic acid levels and carbonic anhydrase activity

The aim of the present study was to evaluate the relationship between salivary oxidative stress and dental-oral health. Healthy young adults, matched for gender and age, with (N = 21, 10 men, mean age: 20.3 ± 1 years) and without (N = 16, 8 men, mean age: 21.2 ± 1.8 years) caries were included in this study. The World Health Organization (WHO) caries diagnostic criteria were used for determining the decayed, missing, filled teeth (DMFT) index. The oral hygiene and gingival status were assessed using the simplified oral hygiene index and gingival index, respectively. Unstimulated salivary total protein, glutathione (GSH), lipid peroxidation and total sialic acid levels, carbonic anhydrase activity, and salivary buffering capacity were determined by standard methods. Furthermore, salivary pH was measured with pH paper and salivary flow rate was calculated. Simplified oral hygiene index and gingival index were not significantly different between groups but DMFT scores were significant (P < 0.01). Only, GSH values were significantly different (P < 0.05) between groups (2.2 and 1.6 mg/g protein in young adults without caries and with caries, respectively). There was a significant negative correlation between DMFT and GSH (r = -0.391; P < 0.05; Pearson's correlation coefficient). Our results suggest that there is an association between caries history and salivary GSH levels.

Association of salivary proteins with dental caries in a Colombian population

La saliva tiene un importante papel en el mantenimiento de las condiciones normales de los tejidos orales. La variabilidad en la composición salival determina su característica protectoracontra la caries dental. Conocer el contenido molecular de la saliva en humanos es importante para el entendimiento de sus propiedades biológicas. El objetivo de este trabajo fue reconocer la composición proteica de la saliva completa de sujetoscon caries activa (AC), historia de caries (HC) y libres de caries (H); en una población colombiana por medio del patrón electroforético y su correlación con el diagnóstico clínico. Cientocuarenta y cinco pacientes mayores de 18 años de edad fueron clasificados en los grupos de estudio por examinación clínica, las muestras de saliva fueron recolectadas, las determinacionesde proteína total fueron hechas por el método Bradford; la saliva individual fue separada por SDS-PAGE y relacionadas con el índice COP. Los geles fueron analizados por el software Quantity One® 1-D (BIO-RAD). No se encontraron diferencias estadísticamente significativas entre las concentraciones de proteína total y la experiencia o no de caries dental. La cantidad de proteína total fue mayor en mujeres que en hombres (p= 0.0028); y con respecto a la enfermedad fue mayor en mujeres con HC y AC. Las proteínas salivares comunes entre los individuos fueron de 101, 77, 62, 55, 44, 22 y 13 kDa. Se encontró asociación entre la proteína salival de 17 kDa y la AC enhombres. Conclusiones: Las proteínas presentes en la muestra de saliva completa son muy similares en los tres grupos de estudio, excepto por la proteína de 17 kDa la cual puede ser unmarcador de riesgo de caries dental.

Algunas consideraciones sobre caries dental, fluoruros, su metabolismo y mecanismos de acción / Some considerations on dental caries, fluorides, metabolism and mechanisms of action

El presente artículo esta dirigido a estudiantes y profesionales de la odontología interesados en profundizar sus conocimientos sobre caries dental y fluoruros. El objetivo primordial de la presente revisión es actualizar algunos conceptos sobre caries dental, su inicio y desarrollo, así como el papel principal que tienen los fluoruros como agente anticariogénico de primera elección para controlar o revertir la historia natural de la lesión cariosa. Se describe brevemente que son los fluoruros, origen, abundancia en la naturaleza y comportamiento químico, así como, los mecanismos de acción: inhibición de la desmineralización, remineralización y acción antibacteriana. De igual manera se mencionan aspectos relevantes sobre su metabolismo, absorción, distribución y excreción, así como su farmacocinética

This article presents a review of the current vision about dental caries, and microorganisms associated to the development of dental caries. Mechanisms of dental caries lesion, the role of fluoride through its mechanisms of action: demineralization, remineralization and antibacterial action. A scheme of the metabolism of fluorides, absorption, distribution and excretion is presented. Some considerations about the initiation of the natural water fluoridation program in the world, and about the threshold dose of fluoride, and dental fluorosis

Estimation of trace elements in sound and carious enamel of primary and permanent teeth by atomic absorption spectrophotometry: an in vitro study.

The influence of trace elements on the prevalence of caries is a complex subject. However, the demonstration of an inverse relationship between caries prevalence and fluoride (F) intake indicates the potential effect of trace elements on caries. AIMS AND OBJECTIVES: This in vitro study sought to estimate and compare the trace element concentrations in sound and carious enamel of primary and permanent teeth. MATERIALS AND METHODS: Forty sound and carious primary and permanent teeth, extracted from children and adolescents of Davangere city, were collected. The teeth were divided into four groups (of ten each) and enamel samples were prepared by mechanical grinding. The trace elements were estimated using atomic absorption spectrophotometer. RESULTS AND CONCLUSIONS: The results of our study showed the presence of 18 trace elements (F, Sr, K, Al, Si, Ni, B, Fe, Cu, Mn, Co, Cr, Zn, Mg, Se, Pb, Mo, and V) in the enamel of sound and carious primary and permanent teeth. The mean, standard deviation, and range (at 95% confidence level) were calculated for each element. The concentrations of F, Sr, and K were significantly ( P <0.05) higher in sound enamel of permanent teeth than in sound enamel of primary teeth. The concentrations of F, Sr, K, Al, and Fe were significantly ( P <0.05) higher in sound enamel of permanent teeth than in carious enamel of permanent teeth. The concentrations of F, K, and Si were significantly ( P <0.05) higher in sound enamel of primary teeth than in carious enamel of primary teeth.

Study of trace elements in mixed saliva of caries free and caries active children.

The present study was carried out to find out the amount of cariogenic and cariostatic trace elements in mixed saliva. It was observed that Cu, Pb, Na showed significant variation in case of one surface as compared to caries free group. Between the non-caries and multiple caries group Cu, Pb, K showed no significant variation Zn showed highly significant variation.

Chemical analysis of sound and carious enamel of permanent tooth.

Enamel consists mainly of inorganic material (96%) and only a small amount of organic substance and water (4%). The inorganic material is similar to apatite. The originally found apatite mineral remains basically unchanged except at the surface in contact with the oral tissues, where diffusion processes operate. Enamel reflects the trace element environment present in the tissue fluids at the time of tissue development. These are variations of types and concentration of inorganic elements found in permanent and deciduous enamel. Variations are also seen in sound and carious enamel.