Assessment of dental and periodontal indices and Streptococcus mutans virulence in fragile X syndrome patients.

INTRODUCTION: Fragile X syndrome (FXS) is the most common cause of hereditary genetic disorder in a single gene characterised by intellectual disability. Behavioural features such as autism, hyperactivity and anxiety disorder may be present. Biofilm development and pathogenicity of Streptococcus mutans may be altered because FXS renders the dental approach and oral hygiene more complex. OBJECTIVES: The purpose of this study was to compare the levels of transcripts for VicRK and CovR of S. mutans isolated from FXS patients with the levels of transcripts for VicRK and CovR of standard strain ATCC, using a quantitative polymerase chain reaction (qPCR). METHODS: The caries experience index was assessed by the International Caries Detection and Assessment System (ICDAS), Periodontal Condition Index (PCI) and Invasive Dental Treatment Need Index (INI). RESULTS: The clinical index findings revealed a high rate of caries cavities and bleeding on probing of FXS patients. When VicRK and CovR transcript levels were compared with the reference strain, Fragile X patients were found to have significantly higher values. CONCLUSION: The present study demonstrated that FXS patients have more adverse clinical conditions, with increased biofilm accumulation and virulence. When combined with behavioural abnormalities, these patients become even more vulnerable to dental caries.

Soluble epoxide hydrolase inhibitor promotes immunomodulation to inhibit bone resorption.

BACKGROUND AND OBJECTIVE: Soluble epoxide hydrolase (sEH) is an enzyme in the arachidonate cascade which converts epoxy fatty acids (EpFAs), such as epoxyeicosatrienoic acids (EETs) produced by cytochrome P450 enzymes, to dihydroxy-eicosatrienoic acids. In the last 20 years with the development of inhibitors to sEH it has been possible to increase the levels of EETs and other EpFAs in in vivo models. Recently, studies have shown that EETs play a key role in blocking inflammation in a bone resorption process, but the mechanism is not clear. In the current study we used the sEH inhibitor (1-trifluoromethoxyphenyl-3-(1-propionylpiperidin-4-yl) urea [TPPU]) to investigate the immunomodulatory effects in a mouse periodontitis model. MATERIAL AND METHODS: Mice were infected on days 0, 2, and 4 with Aggregatibacter actinomycetemcomitans and divided into groups (n = 6) that were treated orally, daily for 15 days, with 1 mg/kg of TPPU. Then, the mice were killed and their jaws were analyzed for bone resorption using morphometry. Immunoinflammatory markers in the gingival tissue were analyzed by microarray PCR or western blotting. RESULTS: Infected mice treated with TPPU showed lower bone resorption than infected mice without treatment. Interestingly, infected mice showed increased expression of sEH; however, mice treated with TPPU had a reduction in expression of sEH. Besides, several proinflammatory cytokines and molecular markers were downregulated in the gingival tissue in the group treated with 1 mg/kg of TPPU. CONCLUSION: The sEH inhibitor, TPPU, showed immunomodulatory effects, decreasing bone resorption and inflammatory responses in a bone resorption mouse model.

Enamel Mineral Content Changes After Bleaching With High and Low Hydrogen Peroxide Concentrations: Colorimetric Spectrophotometry and Total Reflection X-ray Fluorescence Analyses.

The purpose of this study was to evaluate the calcium (Ca) and phosphorous (P) content in enamel bleached with high and low concentrations of hydrogen peroxide (HP) using Total Reflection X-Ray Fluorescence (TXRF) and colorimetric spectrophotometry (SPEC). Forty-eight sound human third molars were used. Their roots were embedded in polystyrene resin and immersed for seven days in an artificial saliva solution. Then they were distributed into six groups to receive the bleaching treatments. The agents of high HP concentration (for in-office use) evaluated were Whiteness HP Maxx/FGM (35% HP), Whiteness HP Blue/FGM (35% HP, 2% calcium gluconate), Pola Office+/SDI (37.5% HP, 5% potassium nitrate), and Opalescence Boost/Ultradent (38% HP, 1.1% ion fluoride, 3% potassium nitrate); these agents were applied to enamel in three sessions. The agents of low HP concentration (for home use) evaluated were Pola Day/SDI (9.5% HP) and White Class 10%/FGM (10% HP, potassium nitrate, calcium, fluoride), and these agents were applied for 14 days. Enamel microbiopsies were evaluated by TXRF and SPEC analysis before the bleaching treatment (baseline), during the treatment, and 14 days after the end of the treatment. For TXRF, the Kruskal-Wallis test showed that Ca and P were not influenced by agent (p>0.05). For SPEC, Pola Office+, Opalescence Boost, Pola Day, and White Class 10% caused a decrease of Ca over time; there was a significant decrease of P over time to Pola Office+ and White Class 10%. The Spearman test showed no correlation between the Ca (p=0.987; r2=-0.020) and P (p=0.728, r2=0.038) obtained by SPEC and TXRF. For TXRF and SPEC, changes in Ca and P during bleaching occurred independently of the HP concentration used.

[Achilles tendon plasty in inveterate lesions. Pérez Teuffer modified technique]. / Plastía del tendón de Aquiles en lesiones inveteradas. Têcnica modificada de Pérez Teuffer.

The purpose of this paper is to convey our experience with the technique used to treat chronic Achilles tendon lesions at ISSSTE "1 de Octubre" Regional Hospital. A prospective study with descriptive longitudinal follow-up was conducted in 30 patients with Achilles tendon rupture that occurred more than 10 days earlier. They were treated with the modified Perez-Teuffer technique at the Orthopedics and Trauma Service from March 2004 to March 2008. Plasty with transposition of the lateral peroneus brevis to the tendon stump was performed. The right side was affected in 70% of patients, mean age was 31.1 years, and males were predominant and accounted for 90%. Time elapsed since the lesion was 10-62 days with a mean of 26 days. We obtained excellent results in 90%, and good results in 10% of patients. One case had skin necrosis and limited mobility and two had pain. They were not considered as poor results as this did not interfere with the final functional results.

Periodontal infections and community-acquired pneumonia: a case-control study.

The aim of this study was to evaluate if the presence of periodontal infections (PI) is associated with community-acquired pneumonia (CAP) in a group of patients admitted to a hospital. A total of 140 patients were enrolled in this case-control study, with 70 patients having CAP (case group) and the other 70 patients diagnosed with other systemic diseases (control group). A periodontal examination was carried out to assess pocket probing depth (PPD), clinical attachment loss (CAL), bleeding on probing (BOP), and presence of bacterial plaque (BP). CAL and BOP showed higher scores in the case group over the control group. They were, respectively, 3.16 ± 2.43 mm and 0.33 ± 0.24 % for the case group, and 1.99 ± 2.23 mm and 0.25 ± 0.24 % for the control group (p < 0.05). High scores for BP were observed in both groups (case: 97.1 %; control: 98.6 %, p = 1.0000). Chronic periodontitis (CP) was more frequent in patients with CAP (case: 61.4 %; control: 41.4 %). The presence of moderate or severe CP increased the risk for CAP [odds ratio (OR) = 4.4, 95 % confidence interval (CI) = 1.4-13.8], even when adjusted for age, ethnicity, gender, and smoking. Moderate and severe chronic periodontitis were associated with CAP in this study.

In vitro immunoexpression of extracellular matrix proteins in dental pulpal and gingival human fibroblasts.

AIM: To compare the expression of extracellular matrix (ECM) components in human pulpal and gingival fibroblasts in vitro. METHODOLOGY: Cultured dental pulp fibroblasts and gingival mucosa fibroblasts were used. Tenascin (TN), fibronectin (FN), type I (col I) and III collagen (col III) and osteonectin (ONEC) were detected by immunofluorescence. Main morphological characteristics were also analysed by light microscopy (LM) and transmission electron microscopy. RESULTS: The results revealed different expression patterns of the proteins. TN and ONEC were only immunoexpressed by pulpal fibroblast cells, suggesting a role of these glycoproteins in formation of mineralized tissues. FN and col I were present in the cytoplasms of both cell types. No expression of col III was detected. Different morphological characteristics were visualized under LM, in which pulpal fibroblasts were spindle-shaped with a wide cytoplasm, while gingival fibroblast cells exhibited stellate/pyramidal configuration, with rounded nuclei. However, ultrastructurally, both cell lineages showed very well developed rough endoplasmatic reticulum and Golgi complex. CONCLUSIONS: Due to the immunodetection of TN and ONEC on pulpal fibroblasts, the present findings demonstrated that a pulpal fibroblast cell is similar to an osteoblastic cell rather than an undifferentiated mesenchymal cell, such as a gingival fibroblast cell. Functional differences between the two cell lines may then be suggested.

Immunohistochemical localization of tenascin, fibronectin, and type III collagen in human dental pulp.

The distribution of tenascin (TN), fibronectin (FN), and type III collagen (col III) in the extracellular matrix of the connective tissue of normal, inflamed, and hyalinized human dental pulp was studied by immunohistochemical staining with monoclonal antibodies against these molecules. TN, FN, and col III were present in all normal tissues studied. In areas of hyalinization only col III was observed. None of the molecules studied were seen in areas of inflammatory exudate. Strong staining for TN and FN was found in the periphery of all specimens analyzed next to the odontoblastic layer. We therefore conclude that TN, FN, and col III are present in the extracellular matrix of normal human dental pulp. TN, FN, and col III distribution in inflammatory and degenerative processes is different from that observed in normal human dental pulp.