Reduced salivary flow rate and high levels of oxidative stress in whole saliva of children with Down syndrome.

AIM: To investigate salivary parameters between children with Down Syndrome (DS) and without DS. MATERIALS AND METHODS: Stimulated whole saliva was collected from 18 children with DS and 23 without DS. Salivary flow rate, pH, and salivary buffering capacity were determined. Cariogenic microorganisms were quantified by culture, and periodontopathogens by quantitative real-time polymerase chain reaction. The antioxidant profile was quantified spectrophotometrically, while malondialdehyde (MDA) was quantified by high-performance liquid chromatography. Data were analyzed by Mann-Whitney test and Spearman correlation (α = 0.05). RESULTS: Salivary flow rate was significantly lower in DS than in controls (p < 0.0001). Significant higher difference was observed for total protein dosage (p < 0.0001), superoxide dismutase activity (SOD) (p = 0.0002), and MDA (p < 0.001) in DS group. CONCLUSIONS: Reduced salivary flow rate might be an important factor in oral diseases development. High salivary levels of SOD and MDA show the significant influence of the oxidative stress and the early-onset periodontal disease in DS people.

Caracterização dos pacientes e procedimentos executados no serviço de atendimento a pacientes com necessidades especiais da Faculdade de Odontologia de Araraquara - UNESP / Characterization of patients and procedures performed in the service to patients with special needs of Araraquara School of Dentistry - UNESP

Objetivo: Caracterizar os pacientes atendidos e os procedimentos realizados no Serviço de Atendimento a Pacientes com Necessidades Especiais da Faculdade de Odontologia de Araraquara (FOAr) - UNESP. Metodologia: A partir dos prontuários odontológicos dos pacientes atendidos em nível ambulatorial entre 2007 e 2013, foram obtidas informações em relação a idade no início do tratamento, tipo de deficiência, medicamentos usados, número de sessões de atendimento e número e tipo de procedimentos odontológicos realizados. Resultado: Dos 232 prontuários analisados, observou-se que mais da metade dos pacientes (56,0%) apresentava deficiência mental, paralisia cerebral ou anomalias congênitas determinadas por agentes infecciosos, com deficiência mental associada. Entre as anomalias congênitas, a mais prevalente foi a Síndrome de Down (9,9%). Apenas 20% dos pacientes iniciaram o tratamento antes dos dez anos de idade e 62,0% faziam uso de anticonvulsivantes, antipsicóticos, ansiolíticos, antiepilépticos e antidepressivos. Foram realizados 4.506 procedimentos odontológicos, sendo 37,6% preventivos e 62,4% curativos (Restauradores, 28,0%; Periodontais, 13,9%; Endodônticos, 9,7%; Cirúrgicos, 9,1%; Protéticos, 1,7%). Observou-se também que, para a maior parte dos pacientes (63%), foram necessárias até dez sessões para a realização do tratamento. Conclusão: Os pacientes que procuraram tratamento odontológico no Serviço de Atendimento a Pacientes com Necessidades Especiais da FOAr apresentavam, na sua maioria, deficiências com envolvimento neurológico. Apesar de esse serviço priorizar os procedimentos preventivos, a maior parte dos procedimentos executados foi curativa, o que está diretamente relacionado com a procura tardia pelo tratamento odontológico.

Objective: To characterize the patients and dental procedures performed in Service to Patients with Special Needs of Araraquara School of Dentistry (FOAr) - UNESP. Methodology: From the dental records of patients treated at outpatient basis between 2007 and 2013, information regarding age at the beginning of treatment, type of disability, controlled medications used, number of dental sessions, and number and type of dental procedures performed was obtained. Result: Of the 232 records analyzed, more than half of the patients (56.0%) had mental retardation, cerebral palsy or congenital abnormalities caused by infectious agents associated with mental retardation. Among the congenital abnormalities, the most prevalent was the Down syndrome (9.9%). Only 20% of patients started treatment before the age of ten and 62.0% used anticonvulsants, antipsychotics, anxiolytics, antidepressants and antiepileptics. A total of 4,506 dental procedures were performed, 37.6% were preventive procedures and 62.4% curative procedures (restorative, 28.0%; periodontal, 13.9%; endodontic, 9.7%; surgical, 9.1%, and prosthetic 1.7%). Also was observed that for most patients (63%) up to 10 sessions were required for the completion of treatment. Conclusion: Most patients with special needs who sought dental treatment at FOAr presented neurological involvement. Despite this service prioritize preventive procedures; most of the procedures carried out were curative, fact directly linked to late search for the dental treatment.

Exposed collagen in resin bonds to caries-affected dentin after dentin treatment with aqueous and alcoholic chlorhexidine solutions.

PURPOSE: To evaluate the effect of saturation of demineralized dentin with aqueous and alcoholic excipients of chlorhexidine (CHX) on the exposure of collagen fibrils in resin-dentin bonds in sound and caries-affected dentin. MATERIALS AND METHODS: Flat midcoronal dentin surfaces were prepared from 24 noncarious molars, and artificial caries was induced in half of the sample. For each substrate, the surfaces were assigned to 4 groups (n = 3) according to the saturation solution of the dentin: water, ethanol, 1% CHX aqueous or alcoholic solution. Infected dentin was removed by abrasive papers. After acid etching, the dentin surface was saturated with each solution for 60 s followed by application of Single Bond. The specimens were processed for Goldner's trichrome staining and the thickness of the exposed collagen zone (ECZ) at the resin/dentin interfaces was measured under optical microscopy. Data were analyzed statistically by Kruskal-Wallis and Mann-Whitney tests (α = 0.05). RESULTS: Regardless of the saturation solution, caries-affected dentin presented a thicker ECZ at the bottom of the hybrid layer than did sound dentin. For both substrates, 100% ethanol had a negative influence on collagen exposure in comparison with water, but the same was not observed for the CHX alcoholic solution. CHX solutions did not differ significantly from each other or from their respective solvents. CONCLUSION: The saturation of phosphoric acid-demineralized dentin with either CHX aqueous or alcoholic solutions did not affect the exposure of collagen fibrils in the resin-dentin bonds produced in sound and caries-affected dentin. A thicker zone of exposed collagen was found in hybridized caries-affected dentin compared to noncarious dentin.

Effect of time between adhesive application and photoactivation on adhesion and collagen exposure.

PURPOSE: To evaluate the influence of the time elapsed between the application and photoactivation of Single Bond 2 (SB) on microtensile bond strength (µTBS) and collagen exposure at the adhesive interface produced in the presence of intrapulp pressure. METHODS: Dentin occlusal surfaces were prepared in 72 molars, and divided into eight groups (n = 9). After acid etching, SB was applied, with or without simulated intrapulp pressure, and remained undisturbed for 0, 20, 40 or 60 seconds, before photoactivation. Three teeth/group were processed for staining with Goldner trichrome and evaluation of the thickness of exposed collagen zone (CZ) at the base of the hybrid layer. Composite resin build-ups were placed on the remaining six prepared teeth prior to sectioning for microtensile testing. Data were submitted to ANOVA and Tukey tests (α = 0.05). RESULTS: In the absence of pressure, immediate photoactivation resulted in the lowest µTBS, while the other groups did not differ among them. Under intrapulp pressure, the lowest values were observed after 60 seconds. There was no difference in the thickness of the exposed collagen zone among the groups without pressure. However, thicker layers were recorded in the presence of pressure after 40 and 60 seconds. Waiting 60 seconds between application and photoactivation of SB significantly reduced resin-dentin bond strength when pulpal pressure was simulated.