Pathways in the association between added sugar consumption, obesity in mother-child dyads, and chronic oral disease burden in early childhood.

In this study, we modeled the pathways in the association of socioeconomic status, frequency of added sugar consumption, and obesity in mother-child dyads with chronic oral disease burden in early childhood using structural equation modeling. A population-based study was conducted on preschoolers from public daycare centers in São Luís, Brazil (n = 674) and their mothers. Chronic oral disease burden in early childhood was a latent variable, representing the shared variance of the following indicators: visible plaque index, gingivitis, and dental caries. A higher consumption frequency of added sugars by children [standardized regression coefficient (SC) = 0.219] explained the chronic oral disease burden. A higher consumption frequency of added sugars by mothers was associated with greater consumption of sugar by children (SC = 0.236), and indirectly with a greater chronic oral disease burden (SC = 0.052). Maternal obesity was associated with obesity in the offspring (SC = 0.130). The chronic oral disease burden is already present in early childhood and can be explained by the higher consumption of added sugars by the mother-child dyad. Approaches to preventing chronic oral diseases should focus on common risk factors, start early in life, and promote family involvement in this process.

Caesarean delivery and early childhood caries: Estimation with marginal structural models in Brazilian pre-schoolers.

OBJECTIVE: This study analysed the association between caesarean section and early childhood caries (ECC), estimating the effects using regression and causal inference models. METHODS: This was a historical cohort study of 697 mother-child dyads, conducted in São Luís, Brazil. The caesarean section was the exposure, and the severity of ECC (dmft) was the outcome. Covariates household income, maternal schooling, maternal hypertension, maternal obesity and birth weight were adjusted for in the models. The effects were estimated by Poisson regression (Means Ratio-MR) and causal inference using a marginal structural model (MSM) (MR and Average Treatment Effect-ATE coefficients), weighted by the inverse probability (IPW) of exposure. RESULTS: Caesarean section was protective against caries in the bivariate (MR 0.81; CI 0.70-0.94; P = 0.005) and multivariate (MR 0.78; CI 0.67-0.91; P = 0.002) models. In MSM analyses, the caesarean section had no effect on ECC (ATE = -0.35; P = 0.107), controlling for IPW of exposure. CONCLUSION: The apparent association between caesarean section and ECC severity seems spurious, as it did not persist after employing a superior approach to estimating causality.

Proinflammatory cytokines in early childhood caries: Salivary analysis in the mother/children pair.

HYPOTHESIS: Proinflammatory cytokines are increased in saliva of mother/children pairs with caries. DESIGN: Case-control study involving caries-free children (n = 20) and children with early childhood caries (ECC) (n = 20), and their mothers (n = 40). The maternal variables analyzed were waist circumference (WC), decayed, missing and filled teeth (DMFT) and sugar intake; and in the children were body mass index (BMI), def-t and sugar intake. Salivary levels of VEGF, IL-6 and TNF-α were analyzed of mother/children pairs. RESULTS: In the mothers, salivary VEGF levels were correlated with DMFT (r = 0.35; p = .03), WC (r = 0.35; p = .02), and sugar intake (r = 0.32; p = .04). Higher salivary IL-6 levels were also correlated with maternal DMFT (r = 0.45; p = .004) and WC (r = 0.32; p = .04). In the children, higher salivary VEGF levels were correlated with higher def-t scores (r = 0.42; p = .008). Children with caries had a 63% higher median salivary VEGF and twofold higher mean IL-6 levels compared to caries-free children. Mothers of children with ECC showed higher mean of salivary IL-6 levels compared to those of children without ECC (p = .03). CONCLUSION: Salivary proinflammatory cytokines are correlated with the severity of caries in the mother-children pair. Obesity and excessive sugar consumption seem to underlie the associations between proinflammatory cytokines and caries in the family environment.

Association between early childhood caries and maternal caries status: A cross-section study in São Luís, Maranhão, Brazil.

OBJECTIVE: This study aims to evaluate the association between early childhood caries (ECC) and maternal caries status, and the maternal perception of ECC risk factors. MATERIALS AND METHODS: A cross-sectional study was carried out with 77 mother-child pairs, the children ranging from 12 to 36 months of age and their mothers, who were seeking dental care at a health center in São Luís, Maranhão, Brazil. Data collection was conducted using a specific questionnaire for mothers. Oral clinical examination of the mother-child binomial to assess caries incidence, gingival bleeding (GB) and visible plaque was done. Home visits were performed in 10% of the sample in order to observe the environmental conditions, dietary habits and dental hygiene practices. RESULTS: The findings showed that the caries prevalence in children was 22.5 times higher in the mother who had decayed tooth (prevalence ratio [PR] = 22.5, confidence interval [CI] 95% = 3.2-156.6, P < 0.001). GB also was observed in 14 mothers and children, the PR in pair was 12.2 (CI95% = 1.6-88.9, P < 0.001). The variables are related for the mother-child binomial in regression linear analysis. CONCLUSION: The maternal caries status was associated with ECC.

Socioeconomic, nutritional and behavioral factors associated with severe childhood caries in children aged 18-36 months

Objective:To relate the occurrence of severe childhood caries with nutritional, socioeconomic and behavioral factors among preschool children. Material and Methods:This cross-sectional study included 111 children aged 18-36 months who sought dental care in basic health units of São Luis, Brazil. The oral health status was measured by the DMFT index (number of decayed, missing and filled teeth), IPV/ISG. Socioeconomic, nutritional and behavioral data were collected through a questionnaire applied to parents. Caries Group was defined as DMFT ≥ 1. Data were analyzed using the Chi-square test and Fisher exact test. Poisson regression models and incidence rate ratio (IRR)were used for multivariate analysis, adopting significance level of 5% and confidence interval (CI) of 95%. Results:It was observed that 61 children (55%) were free from caries and 50 (45%) had the disease. In the Caries Group, 38 (76%) had white spot lesions, 70% had the habit of consuming sweets between meals (p=0.04) and the sucrose intake frequency was considered high (3x daily). After multivariate analysis, age (IRR=1.05, 95%CI=1.03 to 1.07, p <0.001) and consumption of sweets (IRR=1.46, 95%CI=1.11 to 1.92 p=0.006) were associated with increased incidence of caries. Conclusion:The findings of this study suggest that frequent exposure to sugars in the form of sweets between meals, lack of guidance of mothers on oral hygiene and increased age were determining factors for the occurrence of severe childhood caries

Efeito da clorexidina a 2% no mecanismo de adesão do cimento de ionômero de vidro: resistência ao cisalhamento / Chlorhexidine's effect at 2% in the mechanism of adhesion of glass ionomer: shear bond strength

Objetivo: O objetivo deste estudo foi verificar a influência da clorexidina gel a 2% na resistência de união ao cisalhamento do cimento de ionômero de vidro (CIV). Material e Métodos: Foram confeccionados 45 blocos de 10x10mm de dentes bovinos, incluídos em resina acrílica, lixados até obter uma superfície plana em dentina e divididos em 3 grupos (n=15): I - Controle: superfície limpa com spray, seca e restaurada com CIV-Vitro Molar; II - superfície limpa com spray, seca, seguida de aplicação de clorexidina gel a 2%, deixada em repouso por 2 minutos, limpa com "bola" de algodão e restaurada; III - lavagem, aplicação de clorexidina gel a 2%, deixada em repouso por 2 minutos, limpeza com spray, seca e restaurada. Os corpos de prova foram submetidos ao teste de cisalhamento em uma máquina TIRATest 2420. Resultados: Os resultados foram avaliados pelo teste Kruskal-Wallis (p<0,05). Verificou-se diferença significante em função do tratamento aplicado p=0,049. Conclusão: A aplicação da clorexidina por 2 minutos e lavagem posterior comportou-se semelhante ao grupo-controle.

Objective: The goal of this study was to investigate the interference of chlorhexidine gel at 2% by shear tests the adhesion of Glass Ionomer Cement. Material and Methods: The 45 bovine teeth were used and made of blocks of 10x10 mm, including acrylic resin and polished until a flat dentin surface. Then randomly divided into 3 groups (n = 15): I - Control: the surface was cleaned with spray (water/air), dried and restored with glass ionomer Vitro Molar (DFL) II - the surface washed with spray (water/air), dried, followed by the application of chlorhexidine gel at 2%, left to stand for 2 minutes, cleaned with a "ball" of cotton and restored; III - the washing was done with an application of chlorhexidine gel at 2%, left rest to for 2 minutes, then cleaned with spray (water/air), dried and restored. The specimens were subjected to shear stress by the machine TIRATest 2420. Results: The results were analyzed by Kruskal-Wallis (p < 0,05). From the graphical analysis, we found the shear stresses with p = 0,049. It showed a significant difference between the tensions according the treatment applied. Conclusion: The application of chlorhexidine for 2 minutes and posterior rinsing behaved similar to the control group.

Evaluation of shear bond strength of orthodontic resin and resin modified glass ionomer cement on bonding of metal and ceramic brackets

Objective:The aim of this study was to evaluate the shear bond strength of orthodontic resin and resin-modified glass ionomer cement on bonding of metal and ceramic brackets. Material and methods: Forty bovine teeth were sectioned and embedded into PVC with chemically-cured acrylic resin. The labial surfaces were flattened and received prophylaxis with pumice and water. Then they were divided into four groups, according to the bonding material and the type of bracket. Group 1: metallic bracket + Transbond XT; Group 2: metallic bracket + Vitremer; Group 3: ceramic bracket + Transbond XT; Group 4: ceramic bracket + Vitremer. The bonding was performed according to the manufacturers’ recommendations. The shear bond strength test was conducted in a universal testing machine (TIRAtest 2420) at a crosshead speed of 0.5 mm/min. Then, the fractured surfaces were evaluated using a stereomicroscope (x15 magnification) to check the adhesive remnant index. Data was subjected to two-way ANOVA and Tukey’s test for pairwise comparisons (a = 0.05).Results: The results suggested a non-significant effect of the interaction (p > 0.97), and only main factors were significant (p = 0.0001). The bond strength of Transbond XT was statistically higher than Vitremer. Ceramic brackets obtained the highest values of resistance when compared with metal brackets. Conclusion: The ceramic brackets bonded with Transbond XT orthodontic resin have excellent bond strength results.

Microinfiltração em restaurações classe V: análise da forma geométrica da cavidade e do tipo de adesivo / Microleakage of class V restorations: analyses of the cavity's geometric shape and type of adhesive

Introdução: o desenvolvimento de materiais e técnicas na Odontologia Restauradora tem como finalidade a obtenção de um confiável vedamento marginal, pois a microinfiltração ainda é um dos principais motivos de insucesso das restaurações. Objetivo: analisar "in vitro" o efeito da configuração cavitária e do tipo de sistema adesivo na microinfiltração em restaurações classe V, em esmalte, com resina composta. Material e método: foram selecionados 60 dentes bovinos, confeccionadas 30 cavidades na face vestibular de forma retangular e 30 de forma circular, sendo então divididos aleatoriamente em seis grupos, conforme a forma geométrica e o sistema adesivo utilizado: Magic Bond, Adper Single Bond 2 e Clearfil SE BOND. Os dentes foram restaurados com resina composta Z-350, utilizando um incremento, fotopolimerizado por 40 segundos, e feito o acabamento/polimento com disco Sof-Lex. Posteriormente, os dentes foram armazenados em água destilada à temperatura ambiente por sete dias e impermeabilizados com esmalte cosmético, deixando uma margem de 1 mm ao redor da restauração. Foram imersos, então, em solução aquosa de nitrato de prata a 50% por um período de duas horas no escuro, lavados com água corrente, colocados em solução reveladora por seis horas, lavados, seccionados no centro da restauração e as fatias foram analisadas na lupa estereoscópica de 25× de aumento. Os dados foram submetidos à análise estatística não paramétrica de Kruskal-Wallis (p < 0,05). Resultado: não houve diferença estatisticamente significante para ambos os fatores analisados (p = 0,233 e p = 0,158). Conclusão: a forma da cavidade não influenciou na microinfiltração; todos os adesivos comportaram-se de maneiras semelhantes quanto à microinfiltração.

Introduction: the development of materials and techniques in restorative dentistry aims to achieve a good marginal sealing because microleakage is still one of the main reasons for failure of restorations. Objective: To analyze "in vitro" the effect of cavity configuration and the type of adhesive system on microleakage of class V resin composite, in enamel. Material and method: 60 bovine teeth were selected, and 60 cavities were prepared on the buccal surface, 30 rectangular and 30 rounded shaped. They were randomly divided in 6 groups according to the geometric form and the bonding system used: Magic Bond, Adper Single Bond 2 and Clearfil SE BOND. The teeth were restored with Z-350 composite resin, using one increment, lightcured for 40 seconds and polished with a Sof-Lex disc. After that the teeth were stored in distilled water at room temperature for seven days and further sealed with nail varnish, leaving a 1 mm window around the restoration margin. They were then immersed in 50% aqueous silver nitrate solution for 2 hours in the dark, rinsed under tap water, placed in revealing solution for 6 hours under fluorescent light, washed, sectioned in the center of the restoration and the slices were viewed under stereoscopic glasses at 25× magnification. The data were submitted to Kruskal-Wallis non-parametric test (p < 0.05). Result: no statistically significant difference for either factor analyzed (p = 0.233 and p = 0.158) was observed. Conclusion: the cavity shape did not influence in microleakage; all the adhesives behaved in similar manners as to microleakage.

Efeito do substrato e do tipo de adesivo dental na microinfiltração em restaurações de resina composta / Effect of substrate and types of dental adhesive on microleakage in composite resin restoration

Foi avaliada in vitro a influência do substrato (bovino e humano) e do sistema adesivo (condicionamentototal e primer autocondidionante) na microinfiltração, em restauração classe II. Em 16 terceiros molares humanos e 16 incisivos bovinos, foram confeccionadas duas cavidades proximais ?Slot? vertical(OM-OD), com margem gengival em dentina. Em seguida, as cavidades foram divididas em 4 grupos(n=16), conforme o adesivo e o substrato: grupo I ? substrato humano/adesivo de condicionamentototal; grupo II ? substrato humano/adesivo de primer autocondicionante; grupo III ? substrato bovino/adesivo de condicionamento total; grupo IV ? substrato bovino/adesivo de primer autocondicionante.As cavidades foram restauradas com composito Tetric Ceram com 3 incrementos. Em seguida, osdentes foram estocados a 37º C por 30 dias. Após, impermeabilizados com esmalte cosmético, foramimersos em solução de nitrato de prata a 50%, por 2 horas, lavados e imersos em solução reveladorapor 6 horas. Depois foram seccionados, e as amostras, analisadas em lupa de 25X. Os dados foram submetidosà análise estatística não paramétrica de Kruscal-Wallis (p<0,05) que revelou existência de diferença significativa entre os adesivos (p=0.000). Quanto ao substrato, não houve diferença significativa(p>0.05). Concluiu-se que os substratos humano e bovino comportaram-se estatisticamente, de forma semelhante; o adesivo de condicionamento total comportou-se estatisticamente de forma significante.

It was evaluated in vitro the substrate influence (bovine and human) and the adhesive system (totaletching and self-etching primer) on microleakage, in class II restoration. In 16 human third molarsand 16 bovine incisors were prepared two proximal cavities vertical "Slot" (OM-DO), with the gingivalmargin in dentin. Then, the cavities were divided into four groups (n = 16) according to the adhesiveand the substrate: group I - human substrate / total etching adhesive, group II - human substrate /self-etching primer adhesive, group III - bovine substrate / total etching adhesive, group IV - bovinesubstrate / self-etching primer adhesive. The cavities were restored with Tetric Ceram composite withthree increments. Then the teeth were stored at 37 º C for 30 days. After that, sealed with cosmetic nailvarnish, immersed in a 50% solution of silver nitrate, for 2 hours, washed and immersed in revealingsolution for 6 hours. After the samples were sectioned and analyzed in a 25X loupe. Data were subjectedto nonparametric statistical analysis of Kruscal-Wallis (p<0.05) revealed the existence of significantdifferences between the adhesives (p=0.000). Regarding to the substrate, there was no significant difference(p>0.05). It was concluded that: the human and bovine substrates behaved statistically in a similar way, the total etching adhesive behaved statistically significant.

Efeito da forma geométrica da cavidade e do tipo de adesivo na microinfiltração em restaurações classe V / Effect of the geometric way of the cavity and the sticker type in the microleakage in restorations classe V

Foi avaliada "in vitro" a influência da forma da cavidade e do tipo de adesivo (frasco único e primer autocondicionante) na microinfiltração, em restaurações classe V. Em 40 incisivos bovinos, foram confeccionadas 40 cavidades com margens em esmalte, sendo 20 retangulares e 20 circulares. Em seguida, foram divididas em 4 grupos (n=10), de acordo com o adesivo e a forma geométrica: grupo 1 - circular/adesivo de frasco único; grupo 2 - retangular/adesivo de frasco único; grupo 3 - retangular/adesivo de primer autocondicionante; grupo 4 - circular/adesivo de primer autocondicionante. As cavidades foram restauradas com resina composta Tetric Ceram®, com incremento único. Em seguida, os dentes foram estocados a 37ºC, por 30 dias, e, em seguida, impermeabilizados com esmalte cosmético e imersos em solução de nitrato de prata a 50% por 2 horas, lavados e imersos em solução reveladora por 6 horas. Após isto, foram seccionados, e as amostras, analisadas em lupa estereoscópica de 25X. Os dados foram submetidos à análise estatística não paramétrica de Kruskal?Wallis (p<0,05) em que se constatou diferença estatisticamente significante entre os grupos estudados. Concluiu-se que o adesivo de frasco único associado à cavidade circular comportou-se estatisticamente significante frente às outras combinações; as cavidades circulares comportaram-se significantes em relação às retangulares.

It was evaluated ?in vitro? the shape of the cavity influence and the type of adhesive (single bottle and self-etching primer) on microleakage, in class V restorations. In 40 bovine incisors were prepared 40 cavities with margins in enamel, 20 rectangular and 20 circular. Then, were divided into four groups (n = 10) according to the adhesive and geometrical form: group 1 - circular / single bottle adhesive, Group 2 - rectangular / single bottle adhesive, Group 3 - rectangular / self-etching primer adhesive, group 4 - circular / self-etching primer adhesive. The cavities were restored with composite resin Tetric Ceram? with only one increment. Then the teeth were stored at 37?C, for 30 days, and then sealed with cosmetic nail varnish and immersed in a 50% solution of silver nitrate for 2 hours, washed and immersed in revealing solution for 6 hours. After that, the samples were sectioned and examined under stereoscopic loupe of 25X. Data were subjected to non-parametric Kruskal-Wallis statistical analysis (p <0.05) which showed statistically significant difference among the groups. It was concluded that: The single-bottle adhesive associated with circular cavity behaved statistically significant according to the other combinations, the circular cavities behaved significant in relation to the rectangular.

Efeito da clorexidina na adesão do cimento de ionômero de vidro utilizado em restaurações atraumáticas através de teste de microinfiltração / Effect of chlorhexidine on the adhesion of glass ionomer cement used in atraumatic restorative treatments through microleakage test

Objetivo: Avaliar por meio de teste de microinfiltração in vitro, a interferência do "tratamento" da cavidade com clorexidina gel a 2% na adesão do ionômero de vidro indicado para tratamento restaurador atraumático. Métodos: Foram utilizados 60 dentes bovinos, nos quais foram confeccionadas cavidades classe V na face vestibular. Os dentes foram divididos em três grupos (n=20), aleatoriamente e restaurados conforme a distribuição dos grupos: Grupo 1, controle; Grupo 2, aplicação da clorexidina seguida de lavagem e restauração com o ionômero; Grupo 3, aplicação da clorexidina seguida de secagem com algodão e restauração com o ionômero. Confeccionadas as restaurações, os dentes foram estocados em uma estufa umidificadora a 37ºC por 30 dias. Em seguida, impermeabilizados com esmalte cosmético, imersos em solução de nitrato de prata a 50% por 2 horas, lavados e, por fim, imersos em solução reveladora por 6 horas. Logo após, foram lavados e submetidos a 1 corte no sentido mésio-distal no meio da restauração, obtendo-se 120 amostras, que foram analisadas em Lupa Estereoscópica (25X) por três examinadores, segundo os escores de 0 a 4. Resultados: Os resultados obtidos foram tabulados e submetidos à análise estatística não-paramétrica de Kruskal-Wallis, constatando-se que houve diferença significativa entre os grupos estudados (p<0,05). Conclusão: O uso da clorexidina aplicada sob o ionômero de vidro, sem lavagem da cavidade, apresentou infiltração significativa; a aplicação da clorexidina por 2 minutos com lavagem posterior da cavidade comportou-se semelhante ao grupo controle; independente do grupo estudado, nenhum conseguiu evitar a microinfiltração.

Objective: The objective of this study was to assess in vitro how 2% chlorhexidine gel affects the adhesion of the glass ionomer indicated for atraumatic restorative treatments. The assessment was based on the microleakage test. Methods: A total of 60 bovine incisive teeth were used, where sixty Class V cavities were prepared in the middle of the buccal surface. These teeth were randomly divided into 3 groups (n=20 each), and restored as follows: Group 1: control; Group 2: chlorhexidine administration followed by rinsing and restoration with the ionomer; Group 3: chlorhexidine administration followed by drying with cotton and restoration with the ionomer. Once the restorative procedures were done, the teeth were stored in a humidified holding cabinet at 37ºC for 30 days. After that, the teeth were waterproofed with nail polish and immersed in a 50% silver nitrate solution for 2 hours, rinsed, and finally immersed in a developing solution for 6 hours. They were then rinsed, cut horizontally in the middle of the restoration and the resulting 120 samples were analyzed with a stereo microscope with a magnification of 25X by three examiners, who gave the specimens scores from 0 to 4. Results: The data were statistically analyzed by the non-parametric Kruskal-Wallis test. Significant differences were found among the studied groups (p<0.05). Conclusion: When chlorhexidine is administered under the ionomer glass and the cavity is not rinsed, significant infiltration occurs. When chlorhexidine is administered for 2 minutes with subsequent rinsing of the cavity, the result is similar to that to the control group. Nevertheless, microleakage occurred in all groups.