Low-fluoride gels supplemented with nano-sized sodium trimetaphosphate reduce dentin erosive wear in vitro.

OBJECTIVE: The study assessed the effect of low-fluoride gels supplemented with micrometric or nano-sized sodium trimetaphosphate (TMP) on dentin erosive wear in vitro. DESIGN: Bovine dentin blocks (n = 154) were selected by surface microhardness and randomly allocated into seven groups (n = 22/group), according to the gels: Placebo; 4500 ppm F (4500F); 9000 ppm F (9000F); 5% TMP microparticulate plus 4500F (5TMPm+4500F); 2.5% TMP nanoparticulate plus 4500 F (2.5TMPn+4500F); 5% TMP nanoparticulate plus 4500F (5TMPn+4500F); and 12,300 ppm F acid gel (APF). All blocks were treated only once for 60 s and cyclically eroded (ERO, citric acid, 4 × 90 s/day) or eroded and brushed (4 × 15 s/day, five strokes/s, ERO+ABR) over five days (each subgroup n = 11). Dentin wear and integrated hardness loss in depth (ΔKHN) were determined, and the data were submitted to two-way ANOVA, followed by Tukey's test, and Spearman's correlation (p < 0.05). RESULTS: For ERO, all gels containing 4500F supplemented with TMP significantly reduced dentin wear compared with their counterpart without TMP, reaching values similar to 9000F. For ERO+ABR, 5TMPn+ 4500F gel led to significantly lower wear than all its counterparts, reaching values similar to 9000F and APF. As for ΔKHN, all gels containing TMP promoted superior protective effects compared with 4500F, reaching values similar to 9000F and APF under both challenges. A positive correlation between dentin wear and mineral content in depth was verified. CONCLUSIONS: Gels containing 4500F supplemented with TMP significantly reduced dentin erosive wear compared with pure 4500F, with additional benefit from the use of nanoparticles.

Are salivary NO2- / NO2- and NO3- levels biomarkers for dental caries in children? Systematic review and meta-analysis.

The literature is conflicting regarding salivary nitrite (NO2-)/nitrite and nitrate (NO2- and NO3-) levels in children affected by dental caries. For this reason, a systematic review to provide a consensus on the subject was propose, whose objective is to verify whether these molecules could be used as biomarkers in children with caries. A comprehensive search was performed on online database and eleven articles were included in the meta-analysis. The methodological quality of studies was assessed by Newcastle-Ottawa Scale recommended for case-control studies and by AXIS tool for cross-sectional studies. Grading of Recommendations Assessment, Development and Evaluation was used for the assessment of the certainty of the evidence for each outcome. The results showed lower NO2- levels in the group of children affected by dental caries (SMD = -2.18 [-3.24, -1.13], p < 0.01). Age, saliva collection and methods of evaluation can impact the results. When evaluating the severity of the condition, an important variation was detected in relation to the different evaluation methods NO2-/NO2- and NO3-. In conclusion, based on the evidence presented, the results suggest that NO2- levels in saliva are a possible biomarker of dental caries. Results should be evaluated with caution due to the very low evidence from primary studies. Longitudinal studies are necessary to strengthen this hypothesis.

Effectiveness of fluconazole as antifungal prophylaxis in cancer patients undergoing chemotherapy, radiotherapy, or immunotherapy: systematic review and meta-analysis.

This review assessed the effectiveness of fluconazole as antifungal prophylaxis on the incidence of oral fungal diseases in patients undergoing cancer treatment. The secondary outcomes evaluated were the adverse effects, discontinuation of cancer therapy due to oral fungal infection, mortality by a fungal infection, and the mean duration of antifungal prophylaxis. Twelve databases and records were searched. The RoB 2 and ROBINS I tools were used to assess the risk of bias. The relative risk (RR), risk difference, and standard mean difference (SMD) were applied with 95% confidence intervals (CI). The certainty of the evidence was determined by GRADE. Twenty-four studies were included in this systematic review. In randomized controlled trials pooling, fluconazole was a protective factor for the primary outcome (RR = 0.30; CI: 0.16, 0.55; p < 0.01, vs placebo). Compared to other antifungals, fluconazole was only more effective than the subgroup of amphotericin B and nystatin (alone or in combination) (RR = 0.19; CI: 0.09, 0.43; p < 0.01). Fluconazole was also a protective factor in non-randomized trials pooling (RR = 0.19; CI: 0.05, 0.78; p = 0.02, vs untreated). The results showed no significant differences for the secondary outcomes. The certainty of the evidence was low and very low. In conclusion, prophylactic antifungals are necessary during cancer treatment, and fluconazole was shown to be more effective in reducing oral fungal diseases only compared with the subgroup assessing amphotericin B and nystatin, administered alone or in combination.

Salivary biomarkers of oxidative stress in children with dental caries: Systematic review and meta-analysis.

OBJECTIVE: To assess the relationship between salivary biomarkers of oxidative stress and dental caries in children. METHODS: Studies conducted in children up to 12 years old comparing salivary biomarkers of oxidative stress such as malondialdehyde (MDA), superoxide dismutase (SOD), uric acid, and total antioxidant capacity (TAC), considering children with dental caries lesions and caries-free ones were selected. In addition, salivary parameters such as salivary flow, pH, buffering capacity, calcium and total protein levels were evaluated. A systematic literature review was carried out in 8 databases. The standardized mean difference (SMD) was measured using inverse variance as a statistical method and random effects as an analysis model, corresponding to a 95% confidence interval (CI). RESULTS: The TAC levels were higher in children affected by dental caries compared to caries-free ones (control group), regardless of age (SMD 2.66, CI 1.33, 3.98), or gender (SMD 0.98, CI 0.56, 1.39). When adjusted for normalized protein, MDA levels were lower in the dental caries group than in the control group (SMD -16.51, CI -29.02, -4.00), and SOD levels were higher in the dental caries group (SMD 5.09, CI 0.01.10.18). The total protein concentration in saliva of children with dental caries was higher than in the control group, regardless of age (SMD 0.98, CI 0.27, 1.69), or gender (SMD 0.77, CI 0.45, 1.10). The salivary parameters assessed had lower levels in children affected by dental caries (p < 0.05). CONCLUSIONS: The levels of oxidative stress biomarkers and salivary parameters are altered in saliva of children with dental caries.

Are Serum Ferritin Levels a Reliable Cancer Biomarker? A Systematic Review and Meta-Analysis.

Although serum ferritin (SF) has been shown in several studies to be a potential cancer biomarker, the results are inconsistent. Herein, a systematic review was performed to investigate the clinical SF levels in different types of tumors in order to verify the role of SF levels as a biomarker for cancer diagnosis. The search was performed using the PubMed/Medline, Cochrane Library, and Scopus databases. Observational studies comparing SF levels between healthy adults and patients with cancer were included. The meta-analysis was carried out according to the inverse variance and random effects model. The standardized mean differences (SMDs) were assessed at 95% confidence intervals (CIs). We found that SF was higher in patients with cancer (SMD 3.07; CI 1.96,4.17), especially for head and neck cancer (SMD 3.88; CI 0.42,7.34), lung cancer (SMD 1.72; CI 0.67,2.78), pancreatic cancer (SMD 6.79; CI 5.66,7.91), and renal cell carcinoma (SMD 1.77; CI 0.48,3.05). Moreover, in the advanced stages (Stages III and IV), ferritin levels were higher than in healthy adults (SMD 4.89; CI 2.72,7.06, and SMD 8.40; CI 6.99,9.82, respectively). SF acts as a biomarker for pancreatic cancer, renal cell carcinoma, lung cancer, and head and neck cancer and is a sensitive biomarker for the detection of advanced stages of tumors.

Relación entre la calidad de los cuidados primarios y la caries dental en preescolares / Relationship between primary health care quality and dental caries in preschoolers

Introducción: La atención primaria de salud aporta la resolución de la mayoría de los problemas de salud de la población, proporciona el acceso primario al servicio, la continuidad e integralidad de la atención y la coordinación de los cuidados. Objetivo: Evaluar la relación entre la calidad de los cuidados primarios y la caries dental en preescolares. Métodos: Se realizó un estudio descriptivo de corte transversal en una muestra de 515 preescolares. La selección de las escuelas tuvo lugar a partir de un muestreo aleatorio estratificado, seguido por muestreo aleatorio simple para la selección de los participantes. Se realizó un examen bucal para evaluar caries dental y se aplicó a los padres/responsables un cuestionario de calidad de los servicios primarios utilizados por los niños. Se emplearon chi cuadrado, Wilcoxon y el coeficiente de Spearman (95 por ciento de confianza) para el cálculo de los datos. Resultados: La calidad de la atención primaria tuvo relación con el índice ceod de preescolares (p = -0,19; p < 0,05). Se observó diferencias significativas entre la prevalencia de caries dental cuando comparados servicios de calidad (ceod = 0,50) con el grupo baja calidad (ceod = 1,13). También, la calidad fue asociada con la modalidad del servicio (p < 0,001), obteniéndose en los servicios privado y la estrategia de salud de la familia puntajes mayores (55,31 por ciento y 69,48 por ciento de calidad, respectivamente). Conclusiones: La calidad de la atención primaria está estrechamente relacionada con salud bucal, de esta forma, cuando la calidad de los servicios de atención primaria no es buena, repercute en un mayor índice de caries dental en los preescolares.

ABSTRACT Introduction: Primary health care solves most of the health problems of the population, provides primary access to the service, ensures the continuity and comprehensiveness of health care, and coordinates its different forms. Objective: Evaluate the relationship between primary health care quality and dental caries in preschoolers. Methods: A cross-sectional descriptive study was conducted of a sample of 515 preschoolers. Participant schools were selected by stratified random sampling, followed by simple random sampling for the selection of participant children. Oral examination was performed to evaluate dental caries, and parents / guardians were given a questionnaire about the quality of the primary services attended by their children. Data were estimated with the chi-squared test, the Wilcoxon test and Spearman's coefficient (95 percent confidence). Results: A relationship was found between primary health care quality and the ceod index of preschoolers (p = -0.19; p < 0.05). Significant differences were observed in the prevalence of dental caries when quality services (ceod = 0.50) were compared with the low quality group (ceod = 1.13). Quality was also associated to the service mode (p < 0.001). Private services and the family health strategy obtained higher quality scores (55.31 percent and 69.48 percent, respectively). Conclusions: Primary health care quality is closely related to oral health, in such a way that when the quality of primary health care services is not good, a higher dental caries rate is observed among preschoolers(AU)

Recesión periodontal en pacientes del municipio Rodas. Cienfuegos, 2016-2017 / Periodontal recession in patient from the Rodas Municipality. Cienfuegos, 2016-2017

Fundamento: Los análisis de la situación de salud evidencian en la actualidad un incremento de la recesión periodontal, enfermedad que constituye un problema de salud bucal relevante.Objetivo: caracterizar la recesión periodontal en pacientes del municipio de Rodas, provincia Cienfuegos.Métodos: se realizó un estudio descriptivo, en Rodas, provincia de Cienfuegos, durante el período de octubre 2016 a abril 2017. Fueron analizados 22 pacientes con diagnóstico de recesión periodontal, según las variables edad, sexo, nivel educacional, factores de riesgo de recesión periodontal, grupo dentario afectado y grado de recesión (según clasificación de Miller). La información fue tomada de la historia clínica individual de estomatología y la de periodoncia.Resultados: el grupo etario de 35 a 59 años y el sexo femenino fueron los más afectados. Los factores de riesgo más frecuentes resultaron la presencia de cálculo y placa dentobacteriana, secuela de enfermedad periodontal destructiva crónica y falta de función de los dientes implicados por ausencia de antagonista. El grupo dentario caninos-bicúspides presentó recesión con mayor frecuencia, y prevaleció la clase II.Conclusión: elementos como el nivel educacional y los factores de riesgo más importantes que afectan a dicha población, son fundamentales para llevar a cabo acciones contra esta enfermedad, la cual puede derivar hacia otras dolencias bucales igualmente patológicas.

Foundation: The analysis of the health situation at present shows an increase in periodontal recession, disease which is a significant oral health problem.Objective: to characterize periodontal recession in patients from the Rodas municipality, Cienfuegos province.Methods: a descriptive study was developed in Rodas, Cienfuegos province, from October 2016 to 2017. Twenty two patients with the diagnosis of periodontal recession, according to the variables age, sex, educational level, risk factors for periodontal recession, dental group affected and degree of recession (according to the Miller classification). The information was obtained from the individual clinical records of dentistry and of periodontics.Results:  the age group 35 to 59 and female sex was the most affected. The most frequent risk factors were the presence of calculus or dento-bacterial plaque which is a sequel of chronic destructive periodontal disease and the lack of function of the implied teeth due missing teeth. The canine bicuspid dental group presented recession more frequently and class II prevailed.Conclusion: elements as educational level and the most important risk factors that affect this population are determinant to carry out actions against this disease from which other oral conditions may appear similarly pathological.