Serum levels of proinflammatory cytokines are high in early childhood caries.

It is unknown whether serum levels of proinflammatory cytokines would be high in children with early childhood caries (ECC). This study investigated the association between serum levels of proinflammatory cytokines and severity of caries in preschoolers younger than 72 months. A case-control study was performed with a random sample of 72 children with ECC and 80 caries-free children. The explanatory variables were serum levels of proinflammatory cytokines (IL-6, TNF-α, and NGAL) and the outcome was severity of ECC (number of decayed teeth). Thecrudeanalyses were used toestimate the association between each cytokine and ECC. Then, the analyses were adjusted for socioeconomic factors, excess weight and sugar sweetened beverages consumption using Poisson regression models. The estimated coefficients were expressed as Means Ratio (MR), with 95% confidence intervals (CI). In the crude analyses, the highest tertiles of IL-6 (MR = 1.47, IC = 1.09-2.00, p = 0.012), TNF-α (MR = 1.33, CI = 1.00-1.78, p = 0.040) and NGAL (MR = 2.20, CI = 1.39-3.49, p = 0.001) were associated to ECC. After adjustment, the highest tertiles of IL-6 levels (MR = 1.54, IC = 1.13-2.10, p = 0.005), and NGAL (MR = 1.71, CI = 1.04-2.80, p = 0.032) remained associated to ECC; while TNF-α was no longer associated to ECC (MR = 1.31, CI = 0.98-1.75, p = 0.066). Higher serum levels of proinflammatory cytokines were associated to severity of caries in preschoolers, suggesting that chronic inflammation underlies ECC.

Salivary Iron (Fe) Ion Levels, Serum Markers of Anemia and Caries Activity in Pregnant Women.

Introduction Anemia is a very frequent event among pregnant women. There are evidences of differences in the incidence of dental caries between pregnant and non-pregnant women, but the relationship between salivary iron (Fe) and serum markers of anemia and caries development has not been investigated. Objective To evaluate the correlation between salivary (Fe) and serum iron (Fe, ferritin and hemoglobin) parameters in pregnant women with the development of dental caries. Methods A prospective cohort was conducted with 59 women. The outcome of interest was represented by new dental caries lesions during pregnancy, using the Nyvad criteria. Pregnant women were evaluated at three clinical times: up to the 16th week of gestational age (GA) (T1), in the last trimester of pregnancy (T2), and postpartum (T3), at the Mother and Child Unit of University Hospital of the Universidade Federal do Maranhão. A stimulated saliva sample was collected for biochemical analysis of salivary Fe, and a blood sample was collected early in the morning. The correlation between salivary and serum Fe was evaluated through the Pearson correlation test. Analysis of variance (ANOVA) and Kruskal-Wallis were used to compare the means of anemia parameters at different times. The Student's t and Mann-Whitney tests were used to compare the anemia parameters between the groups of pregnant women (with and without new caries lesions). Results Serum Fe concentrations were higher in the first trimester of pregnancy and lower after delivery (p = 0.036). It was also observed that the ferritin concentrations were higher in the first trimester and lower at the end of gestation (p = 0.011). There was no association between the expositions of salivary iron and anemia, and the development of dental caries. There was a positive correlation between serum Fe in T1 and salivary Fe in T2 (p < 0.05). Conclusion The serum markers of anemia were more prevalent in the last trimester of pregnancy.

Salivary Iron (Fe) Ion Levels, Serum Markers of Anemia and Caries Activity in Pregnant Women / Níveis de íon ferro (Fe) salivar, marcadores séricos de anemia, e atividade de cárie em mulheres grávidas

Abstract Introduction Anemia is a very frequent event among pregnant women. There are evidences of differences in the incidence of dental caries between pregnant and nonpregnant women, but the relationship between salivary iron (Fe) and serummarkers of anemia and caries development has not been investigated. Objective To evaluate the correlation between salivary (Fe) and serum iron (Fe, ferritin and hemoglobin) parameters in pregnant women with the development of dental caries. Methods A prospective cohort was conducted with 59 women. The outcome of interest was represented by new dental caries lesions during pregnancy, using the Nyvad criteria. Pregnant women were evaluated at three clinical times: up to the 16th week of gestational age (GA) (T1), in the last trimester of pregnancy (T2), and postpartum (T3), at the Mother and Child Unit ofUniversityHospital of the Universidade Federal doMaranhão.A stimulated saliva sample was collected for biochemical analysis of salivary Fe, and a blood sample was collected early in the morning. The correlation between salivary and serum Fe was evaluated through the Pearson correlation test. Analysis of variance (ANOVA) and Kruskal-Wallis were used to compare the means of anemia parameters at different times. The Student's t and Mann-Whitney tests were used to compare the anemia parameters between the groups of pregnant women (with and without new caries lesions). Results SerumFe concentrationswere higher in the first trimester of pregnancy and lower after delivery (p = 0.036). It was also observed that the ferritin concentrations were higher in the first trimester and lower at the end of gestation (p = 0.011). Therewas no association between the expositions of salivary iron and anemia, and the development of dental caries. There was a positive correlation between serum Fe in T1 and salivary Fe in T2 (p < 0.05). Conclusion The serummarkers of anemiaweremore prevalent in the last trimester of pregnancy.

Resumo Introdução A anemia é um evento muito frequente entre mulhres grávidas. Existem evidências de diferenças na incidência de cárie dentária entre mulheres grávidas e não grávidas,mas a relação entre o íon ferro (Fe) salivar, osmarcadores séricos de anemia e o desenvolvimento de cárie não foi investigada. Objetivo Avaliar a correlação entre os parâmetros salivares (Fe) e séricos (Fe, ferritina e hemoglobina) em gestantes e o desenvolvimento de cárie dentária. Métodos Uma coorte prospectiva foi conduzida com 59 mulheres. O desfecho de interesse foi representado por novas lesões de cárie durante a gravidez, medido pelo critério Nyvad. Mulheres grávidas foram avaliadas em três tempos clínicos: até a 16ª semana de idade gestacional (IG) (T1), no último trimestre de gravidez (T2), e no puerpério (T3), na Unidade Materno-infantil do Hospital Universitário da Universidade Federal do Maranhão. A amostra de saliva estimulada foi coletada para análise bioquímica de Fe salivar, e a amostra de sangue foi coletada no início da manhã. A correlação entre o Fe salivar e o Fe sérico foi avaliada através do teste de correlação de Pearson. Os testes ANOVA e Kruskal-Wallis foram utilizados para comparar parâmetros de anemia em diferentes momentos. Os testes t de Student e Mann-Whitney foram utilizados para comparar os parâmetros da anemia entre os grupos de gestantes (come sem lesões de cárie). Resultados As concentrações séricas de Fe foram maiores no primeiro trimestre de gestação e menores após o parto (p = 0,036). Observou-se também que as concentrações de ferritina forammaiores no primeiro trimestre emenores no final da gestação (p = 0,011). Não houve associação entre as exposições e o desenvolvimento de cárie dentária. Houve correlação positiva entre o Fe sérico em T1 e o Fe salivar em T2 (p < 0,05). Conclusão Os marcadores séricos de anemia foram mais prevalentes no último trimestre de gestação.

Anemia and Dental Caries in Pregnant Women: a Prospective Cohort Study.

The objective was to evaluate the effect of anemia during pregnancy on the risk of dental caries development in pregnant women. A prospective cohort including a sample of pregnant women in a prenatal care unit of São Luís, Brazil, was done. The incidence of dental caries during pregnancy, according to Nyvad's criteria, was the outcome. The main independent variables were serum iron, ferritin, hemoglobin, erythrocyte, hematocrit, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and red cell distribution width (RDW). Pregnant women (n = 121) were evaluated at two moments: up to 16th week of gestational age (T1) and in the last trimester of pregnancy (T2). Crude and adjusted associations were estimated by the incidence ratio risk (IRR) and respective 95% confidence intervals (95%CI). After adjustment, higher serum concentrations of ferritin (IRR = 0.97, 95%CI 0.95-0.99) in T1, and Fe (IRR = 0.99, 95%CI 0.98-0.99), ferritin (IRR = 0.99, 95%CI 0.98-0.99), erythrocyte (IRR = 0.71, 95%CI 0.50-0.99), hemoglobin (IRR = 0.84, 95%CI 0.73-0.96), hematocrit (IRR = 0.93, 95%CI 0.88-0.98), MCV (IRR = 0.91, 95%CI 0.86-0.96), and MCH (IRR = 0.83, 95%CI 0.74-0.93) in T2, were associated with fewer incidence of dental caries in pregnant women. Iron deficiency anemia during pregnancy is a risk factor for the incidence of dental caries in these women.

Bleeding evaluation during single tooth extraction in patients with coronary artery disease and acetylsalicylic acid therapy suspension: a prospective,double-blinded, and randomized study

Purpose: Acetylsalicylic acid (ASA) has been used for the primary and secondary prevention of cardiovascularevents. To reduce bleeding, the administration of ASA has traditionally been suspended before dentalprocedures; however, this suspension potentially increases the risk of thromboembolic events. The effect ofASA on the amount of bleeding that occurs during tooth extraction procedures is controversial, andperioperative guidelines recommend that ASA administration should not be altered for such procedures. Theaim of this study was to evaluate the amount of bleeding that occurs during the intraoperative period of toothextraction procedures in patients with coronary artery disease who are either undergoing acetylsalicylic acid(ASA) therapy or who have been instructed to suspend their ASA use.Patients and Methods: Sixty-three patients with coronary artery disease who required tooth extractionwere enrolled in this study. All patients were receiving 100 mg/d of ASA at the time of enrollment and wererandomly placed into 2 groups: group S, which was comprised of patients whose ASA therapy was suspended7 days before tooth extraction, and group NS, comprised of patients whose ASA therapy was unaltered. Aplatelet aggregation test was carried out on the day of the operation, and the amount of bleeding wasmeasured during the intraoperative period by means of aspirated blood collection. All the extractions wereperformed by the same surgeon, who was unaware of whether the patient’s ASA therapy had been suspended.Results: The mean ( SD) volume of bleeding was 12.10 9.37 mL for patients who underwent ASAtherapy suspension and 16.38 13.54 mL for those patients whose treatments were unaltered (P .151). Local hemostatic methods were sufficient to control bleeding, and there were no reportedepisodes of hemorrhaging during the intra- and postoperative periods...

SOLUCION ESTETICA Y FUNCIONAL PARA LA CARIES RAMPANTE O DEL BIBERON MEDIANTE LA CONFECCION DE CORONAS TIPO JACKET DE BIOLON

Las coronas de biolón que se elaboraron, se ajustan perfectamente al cuello dentario y se modelan a la forma anatómica original del diente. La técnica del biolón aplicada en el estudio, proporciona resultados estéticos óptimo, pues posibilita la restitución de la forma y el color natural del diente. Económicamente so accesibles para cualquier paciente. Estas coronas además de cumplir una función restauradora, estética y funcional, mantienen el espacio dentario correspondiente para el diente permanente. Se consigue en el paciente una actitud emocional y social positiva al restablecer en la apariencia de sus dientes una imagen natural y saludable