Detection and quantification of prostaglandin E2 in saliva by liquid chromatography-tandem mass spectrometry using microextraction by packed sorbent.

The detection of eicosanoids in saliva samples can assist pharmacokinetic/pharmacodynamic studies due to the facility of obtaining samples, minimal discomfort and high adherence of volunteers to the study. The present study enabled determine prostaglandin E2 concentrations in saliva samples, using a microextraction by packed sorbent methodology and subsequent detection in liquid chromatography-tandem mass spectrometry. Twelve volunteers underwent scaling and coronary-radicular polishing of the upper molars and sequential saliva collections: 0.25-96 h after ingestion of a 600 mg ibuprofen tablet, to quantify prostaglandin E2 concentrations. There was an increase in the level of prostaglandin E2 with a significant difference after the dental procedure (0.25 h) compared to 11, 24, 48 and 72 h (*p < 0.05). After taking the drug, these levels begin to decrease up to 5 h, returning to normal in the subsequent hours. The method was developed and validated with linearity between 2.4 and 1250 ng/mL and r2 above 0.9932. The limit of quantitation was about 2.4 ng/mL. The coefficients of variation and the relative standard errors of the accuracy and precision analyzes were < 15%. The proposed extraction and analysis methodology proved to be efficient, fast and promising for pharmacokinetic/pharmacodynamic assays after using anti-inflammatory drugs.

Analysis of Different Methods of Extracting NSAIDs in Biological Fluid Samples for LC-MS/MS Assays: Scoping Review.

The aim of this study was to carry out a systematic investigation and analysis of different drug extraction methods, specifically non-steroidal anti-inflammatory drugs in biological fluid samples, for Liquid Chromatography in Mass Spectrometry assays (LC-MS/MS). A search was carried out in the main databases between 1999 and 2021, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. Data were obtained through PubMed, Lilacs, Embase, Scopus, and Web of Science databases using the Boolean operators AND and OR. Studies were pre-selected by title and abstract by two independent reviewers. The selected texts were read in full, and only those that were complete and compatible with the inclusion and exclusion criteria were eligible for this research. A total of 248 references were obtained in the databases. After removing the duplicates and analyzing the titles and abstracts, 79 references were evaluated and passed to the next phase, which comprised the complete reading of the article. A total of 39 publications were eligible for this study. In 52% of the studies, the authors used the liquid-liquid extraction method (LLE), while in 41%, the solid-phase extraction method (SPE) was used. A total of 5% used microextraction methods and 2% used less-conventional techniques. The literature on the main methods used, the LLE and SPE methods, is extensive and consolidated; however, we found other studies that reported modifications of these traditional techniques, which were equally validated for use in LC-MS/MS. From this review, it is concluded that the diversity of techniques, reliability, and practical information about each analytical method used in this study can be adapted to advances in LC-MS/MS techniques; however, more ecological, economic, and sustainable approaches should be explored in the future.

Multifocal Analysis of Acute Pain After Third Molar Removal.

Background: To analyze the pain modulation capacity profile in a Brazilian population, the relationship between opioid receptor (OPRM1) and Catechol-O-methyltransferase (COMT) 1polymorphisms and pain modulation capacity was determined through preoperative pain modulation tests and acute postoperative pain control evaluation, swelling, and trismus in 200 volunteers undergoing lower third molar removal. Methods: Psychologic and clinical parameters were measured. Patient DNA was sequenced for single nucleotide polymorphisms in OPRM1 and COMT, and the salivary concentration of interleukin (IL)-2 (IL)-6, interferon (IFN)-γ and tumor necrosis factor (TNF)-α was evaluated. Primary outcomes were the influence of all predictors on the fluctuation of pain intensity using a visual analogue scale (VAS), and swelling and trismus on the 2nd and 7th postoperative days. Preoperative pain modulation capacity (CPM), pain catastrophizing scale (PCS), body mass index (BMI), and surgery duration and difficulty were evaluated. Results: Salivary concentration of IFN-γ and IL-2 as well as the duration of surgery influenced the fluctuation of postoperative pain in the VAS, and in the sum of the differences in pain intensity test at 8, 48, and 96 h. BMI influenced swelling, while both BMI and COMT haplotype influenced trismus on the 2nd postoperative day. Conclusion: Polymorphisms in COMT, salivary concentrations of IL-2 and IFN-γ, BMI, and duration of surgery were predictors for pain fluctuation, swelling, and trismus on the 2nd day after lower third molar extraction. This therapy was effective in controlling inflammatory symptomatology after lower third molar extraction and ibuprofen was well tolerated by patients. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT03169127.

Efficacy of Ketoprofen With or Without Omeprazole for Pain And Inflammation Control After Third Molar Removal.

In view of the gastrointestinal problems generated by the ketoprofen use, the ketoprofen association with omeprazole is available on the market. However, this association efficacy in acute pain control has not been established. Bilateral extraction of lower third molars in similar positions is currently the most used model for the evaluation and investigation of the efficacy and pharmacological effects of new compounds for the treatment of acute postoperative pain. The randomized and crossover study consisted in evaluating the clinical efficacy of therapy performed by ketoprofen 100 mg (twice daily-b.i.d.) versus ketoprofen 200 mg + omeprazole 20 mg (once daily-q.d.) to pain, swelling and trismus control in the bilateral extraction model of lower third molars in similar positions in two different appointments, in 50 volunteers. Volunteers reported significantly less postoperative pain at various post-operative periods and consumed less rescue analgesic medication (acetaminophen 750 mg) throughout the study when they took the combination of ketoprofen 200 mg + omeprazole 20 mg (q.d.). Following administration of both study drugs, no gastrointestinal adverse reactions were reported by volunteers. Furthermore, the evaluations of the drugs in pain control by the volunteers were significantly favorable to ketoprofen 200 mg + omeprazole 20 mg (q.d.). For swelling and trismus control, the treatments presented similar results. In conclusion, when volunteers took ketoprofen 200 mg + omeprazole 20 mg (q.d.), they reported significantly less postoperative pain at various post-surgical periods and consumed less rescue analgesic medication throughout the study compared with ketoprofen 100 mg (b.i.d).

Parents' perception of dental caries in intellectually disabled children.

The aim of this study was to evaluate the parents' perception of dental caries in children with intellectual disability. This cross-sectional study was conducted with 6 to 14 years old schoolchildren: Group 1 (50 children diagnosed with intellectual disabilities) and Group 2 (50 children without it). The dental caries was assessed by the World Health Organization (WHO) criteria for primary and permanent teeth. Parents' psychosocial perception was assessed by Early Childhood Oral Health Impact Scale (ECOHIS). Similar prevalence of caries free children was found between groups in both dentitions. In primary dentition the caries index was higher in Group 2, and the opposite occurred in permanent teeth. Group 1 presented higher impact (p < .05) in the dimension drinking, eating and pronunciation, whereas in Group 2 there was higher impact (p = .01) on pain, sleep, irritation, the smile and family finances. Findings showed significant impact of dental caries on parents' perception of the oral health related quality of life of children with intellectual disabilities.

Taurodontism, Root Dilaceration, and Tooth Transposition: A Radiographic Study of a Population With Nonsyndromic Cleft Lip and/or Palate.

OBJECTIVES: In an effort to contribute to proper dental planning and define possible dental phenotypes of nonsyndromic cleft lip and/or palate (CL/P), this study aimed to investigate the occurrence of taurodontism, root dilaceration, and tooth transposition in persons with nonsyndromic CL/P, specifically analyzing the differences among gender, cleft types, and the most affected teeth. DESIGN: This retrospective study analyzed 974 panoramic x-rays from nonsyndromic Brazilians older than 16 years and categorized into the following four groups: group 1, 250 persons with unilateral cleft lip and palate; group 2, 250 persons with unilateral cleft lip; group 3, 224 persons with cleft palate; and a control group of 250 persons without clefts. Radiographs were digitalized with a scanner and analyzed. RESULTS: In the Brazilian population studied, the prevalence of taurodontism was 60.4% in group 1, 62.4% in group 2, 67.0% in group 3, and 42.8% in the control group. Root dilacerations had a prevalence of 31.2% in group 1, 29.6% in group 2, 26.3% in group 3, and 27.2% in the control group. The teeth most affected by taurodontism were 17 and 27; whereas root dilacerations were most common in teeth 38 and 48. No tooth transpositions were found in any radiograph analyzed. CONCLUSIONS: Taurodontism is significantly more prevalent in Brazilians with nonsyndromic CL/P than in persons without clefts; whereas the prevalence of root dilaceration no different from that in the control group. However, root dilacerations in anterior teeth were increased in groups 1 and 2 when compared to the control group.

Comparação da eficácia clínica do naproxeno, associado ou não ao esomeprazol, no controle da dor, edema e trismo em exodontias deterceiros molares inferiores / Comparison of the clinical efficacy of naproxen, associated or not with esomeprazole, in the control of pain, swelling and trismus in lower third molar removal

Anti-inflamatórios não esteroidais (AINEs) são frequentemente utilizadospara controlar a dor pós-operatória e inflamação em pacientes após a cirurgia oral emaxilofacial, mas eles são muitas vezes associados a problemas gastrointestinais.Recentemente, o AINE naproxeno foi introduzido no mercado em combinação comesomeprazol, um inibidor da bomba de prótons que reduz a formação de ácido doestômago, com o intuito de amenizar esses efeitos colaterais. Usando um designduplo-cego randomizado e cruzado, este estudo teve como objetivo avaliar, pelaprimeira vez, o controle da dor aguda pós-operatória em 46 pacientes queconsumiram um comprimido de NE (naproxeno 500 mg + esomeprazol 20 mg) ou denaproxeno puro (500 mg) a cada 12 horas por 4 dias após a cirurgia dos doisterceiros molares inferiores em posições semelhantes, em dois momentos distintos.As pacientes do sexo feminino relataram significativamente mais dor em 1, 1,5, 2, 3e 4 horas após a cirurgia e também consumiram sua primeira medicação de socorro(paracetamol) em um tempo significativamente menor quando consumiram NE emcomparação com naproxeno puro (3,7 horas e 6,7 horas, respectivamente). Nãoforam encontradas diferenças significativas nos pacientes do sexo masculino entrecada grupo de pesquisa. Em conclusão, o naproxeno melhorou o manejo da doraguda pós-operatória quando comparado ao NE em mulheres, embora, ao longo detodo o estudo, a dor foi considerada leve após o uso de ambos os medicamentosem homens e mulheres com escores de dor em média bem abaixo de 40 mm naEAV.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently used tomanage postoperative pain and inflammation in patients after oral and maxillofacialsurgery, yet they are often associated with gastrointestinal problems. Recently theNSAID naproxen was introduced in combination with esomeprazole, a proton pumpinhibitor that reduces stomach acid formation, in an effort to assuage these sideeffects. Using a double-blinded randomized crossover design, this study aimed toevaluate, for the first time, acute postoperative pain management in 46 volunteerswho consumed a tablet of either naproxen (500 mg) with esomeprazole (20 mg) (NE)or only naproxen (500 mg) every 12 hours for 4 days after extractions of the twolower third molars, in two different appointments. Female volunteers reportedsignificantly more pain at 1, 1.5, 2, 3 and 4 hours after surgery and also consumedtheir first rescue medication (acetaminophen) at a time significantly earlier whenconsuming NE when compared to naproxen (3.7 hours and 6.7 hours, respectively).No significant differences were found in the males between each research group. Inconclusion, naproxen improved acute postoperative pain management whencompared to NE in women although, throughout the entire study, pain was mild afterthe use of both drugs in both men and women with pain scores on average wellbelow 40 mm on the VAS.