Association between pulp stones and systemic diseases: a case-control study / Associação entre nódulos pulpares e doenças sistêmicas: um estudo caso-controle

INTRODUCTION: Pulp stones (PS) are calcifications commonly found in the pulp tissue that may be associated with systemic diseases. OBJECTIVE: To evaluate the association between PS and systemic diseases. METHODS: A case-control study with the inclusion of individuals from 18 to 65 years of age, of both sexes. Analysis was made of 1047 digital panoramic radiographs. The controls could not have any teeth with PS; the cases were the contrary. A questionnaire comprising demographic, habit, and general health (diabetes, problems with blood vessels, altered cholesterol level, heart attack, kidney or gallbladder stone, arthritis, or autoimmune disease, and for women, endometriosis, and ovarian cyst). Data were submitted to the Student's t-test to identify differences between groups about sex and age. The Chi-square test was applied to the cross-tabulation. The analyses were performed using SPSS®, version 25.0, with a 5% significance level. RESULTS: 490 patients participated (242 cases and 248 controls). There was no difference between groups for the sex (p=0.966) and age (p=0.186). Only "kidney stone" was associated with the case group (p=0.001), being almost three times higher when compared to the control group. No significant differences were found in females about the presence or absence of PS (p>0.05). CONCLUSÃO: In this research, it is suggested the existence of an association between kidney stones and the presence of pulp stones.

INTRODUÇÃO: Nódulos pulpares (NP) são calcificações comumente encontradas no tecido pulpar que podem estar associadas a doenças sistêmicas. OBJETIVO: Avaliar a associação entre NP e doenças sistêmicas. MÉTODOS: Estudo caso-controle com inclusão de indivíduos de 18 a 65 anos de idade, de ambos os sexos. Foram analisadas 1047 radiografias panorâmicas digitais. Os controles não poderiam ter dentes com NP; os casos foram o contrário. Foi aplicado um questionário aos participantes, contendo variáveis demográficas, de hábitos e de saúde geral (diabetes, problemas com vasos sanguíneos, nível de colesterol alterado, ataque cardíaco, cálculo renal ou biliar, artrite ou doença autoimune, e para as mulheres, endometrioses e cisto no ovário). Os dados foram submetidos ao teste t de Student para identificar diferenças entre os grupos em relação ao sexo e à idade. O teste Qui-quadrado foi aplicado para a tabulação cruzada. As análises foram realizadas no SPSS®, versão 25.0, com nível de significância de 5%. RESULTADOS: Participaram 490 pacientes (242 casos e 248 controles). Não houve diferença entre os grupos para sexo (p=0,966) e idade (p=0,186). Apenas "cálculo renal" associou-se ao grupo caso (p=0,001), sendo quase três vezes maior quando comparado ao grupo controle. Não foram encontradas diferenças significativas no sexo feminino em relação à presença ou ausência de PS (p>0,05). CONCLUSÃO: Nesta pesquisa, sugere-se a existência de uma associação entre cálculos renais e presença de Nódulos pulpares.

Did Perceived Stress Influence Possible Sleep Bruxism and Awake Bruxism in Dentistry Students During COVID-19 Pandemic? A Web-Based Cross-Sectional Study

ABSTRACT Objective: To assess the influence of perceived stress during the COVID-19 pandemic over awake bruxism (AB) and sleep bruxism (SB). Material and Methods: Observational web-based research carried out in a state in the Brazilian Northeast. The sample was composed of dental students from seven faculties, divided into three groups: beginning (1-4 semesters), middle (5-7), and end (8-10). An online questionnaire was constructed: Socio-demographic, Perceived Stress Scale (PSS-10), Self-reported AB and SB, and COVID-19 Fear Scale. Data were collected from April to June 2021 by sending the questionnaire through WhatsApp®, e-mail, and Instagram®. After bivariate analyses, a multiple logistic regression model was performed to discriminate variables for perceived stress and AB and SB. Hosmer and Lemeshow and chi-square tests were used to check the model's goodness of fit. Results: A total of 391 dental students participated in this research - most women (69.8%), unmarried (69.8%), family income less than three minimum wages (60.9%), self-reported physical activity (63.3%). Perceived stress was low to moderate (72.1%), SB was 39.6%, AB was 49.6%, and low COVID-19 fear was 81.1%. COVID-19 fear (3.03), being female (2.47), and using psychotropic (2.53) increases the chance of being stressed. Perceived stress can predict AB in models 1 (p=0.008) and 4 (p=0.039). There was no significance for perceived stress and SB. Conclusion: Perceived stress during the COVID-19 pandemic influenced awake bruxism.

Activation of gelatinases in permanent human teeth after different experimental radiotherapy protocols

Abstract The objective of this study was to compare the activation of gelatinases in dentin-enamel junction (DEJ) and underlying dentin of permanent teeth after experimental radiotherapy in conventional and hypofractionated modalities. Newly extracted third molars (n = 15) were divided into three experimental radiotherapy groups: control, conventional (CR), and hypofractionated (HR) (n = 5 per group). After in vitro exposure to ionizing radiation, following standardized protocols for each modality, a gelatinous substrate was incubated on the tooth slices (n = 10 per group). Activation of gelatinases was measured by in situ zymography, expressed in arbitrary fluorescence units (mm2) from three tooth regions: cervical, cuspal, and pit. Fluorescence intensity was compared among radiotherapy protocols and tooth regions in each protocol, considering a significance level of 5%. Considering all tooth regions, the fluorescence intensity of the CR group was higher than the HR and control groups, both in DEJ and underlying dentin (p <0.001). In addition, the fluorescence intensity was higher in underlying dentin when compared to DEJ in all groups (p <0.001). Considering each tooth region, a statistically significant difference between CR and HR was only observed in the pit region of underlying dentin (p <0.001). Significant and positive correlations between fluorescence intensities in DEJ and underlying dentin were also observed (p <0.001). Experimental radiotherapy influenced the activation of gelatinases, as well as exposure to the conventional protocol can trigger a higher activation of gelatinases when compared to hypofractionated, both in DEJ and underlying dentin.

Resumo O objetivo deste estudo foi comparar a ativação de gelatinases na junção dentina-esmalte (DEJ) e na dentina subjacente de dentes permanentes após a radioterapia experimental nas modalidades convencional e hipofracionada. Os terceiros molares recém-extraídos (n = 15) foram divididos em três grupos de radioterapia experimental: controle, convencional (CR) e hipofracionada (HR) (n = 5 por grupo). Após a exposição in vitro à radiação ionizante, seguindo protocolos padronizados para cada modalidade, um substrato gelatinoso foi incubado nas fatias de dente (n = 10 por grupo). A ativação das gelatinases foi medida por zimografia in situ, expressa em unidades arbitrárias de fluorescência (mm2) de três regiões do dente: cervical, cúspide e fossa. A intensidade da fluorescência foi comparada entre os protocolos de radioterapia e as regiões do dente em cada protocolo, considerando um nível de significância de 5%. Considerando todas as regiões do dente, a intensidade de fluorescência do grupo CR foi maior do que a dos grupos HR e controle, tanto no DEJ quanto na dentina subjacente (p <0,001). Além disso, a intensidade da fluorescência foi maior na dentina subjacente quando comparada à DEJ em todos os grupos (p <0,001). Considerando cada região do dente, uma diferença estatisticamente significativa entre CR e HR foi observada apenas na região da fossa da dentina subjacente (p <0,001). Também foram observadas correlações significativas e positivas entre as intensidades de fluorescência no DEJ e na dentina subjacente (p <0,001). A radioterapia experimental influenciou a ativação das gelatinases, assim como a exposição ao protocolo convencional pode desencadear uma maior ativação das gelatinases quando comparada ao hipofracionamento, tanto no DEJ quanto na dentina subjacente.

Comportamiento de las enfermedades bucodentales en el Hospital Referal Maliana de Timor Leste / Behavior of oral and dental diseases at Referal Maliana Hospital, Timor Leste

RESUMEN Introducción: la salud bucodental es un indicador clave de salud, bienestar y calidad de vida. Las enfermedades bucodentales como caries, periodontopatías, cáncer bucal pueden prevenirse y tratarse en sus etapas iniciales. Objetivo: determinar el comportamiento de las enfermedades bucodentales en la población que asistió a la consulta de estomatología del Hospital Referal Maliana, distrito Bobonaro, Timor Leste durante 2017-2018. Métodos: estudio observacional descriptivo de corte transversal en 480 pacientes afectados con alguna patología bucodentaria, seleccionados por muestreo intencional no probabilístico. Resultados: predominó el sexo masculino (51,9 %), el grupo de edad más afectado fue 10-19 años (40,4 %), las patologías más diagnosticadas fueron las caries (79,1 %) en edades entre 0 y 39 años, gingivitis (58,6 %) en jóvenes, y desdentamiento parcial (49,4 %) en todas las edades. Prevaleció la higiene bucal deficiente (83,8 %) en ambos sexos y consumo de mama malus (64,8 %) más observado en mujeres. Conclusiones: la población timorense estudiada es mayormente masculina, predominó el grupo de edad de 10 a 19 años; las enfermedades bucodentales más frecuentes fueron las caries en menores de 40 años, gingivitis en jóvenes, y edentulismo parcial en todas las edades. Los principales factores de riesgo asociados fueron la higiene bucal deficiente para ambos sexos y masticación de la mama malus (nuez de Areca o de betel) en las féminas, lo que evidencia una alta probabilidad de que incremente y confirma la severidad de las enfermedades bucodentales como problema de salud en esta población.

ABSTRACT Introduction: oral-dental health is a key indicator of wellbeing and quality of life. Oral-dental diseases as caries, periodontopathies and oral cancer can be prevented and treated at early stages. Objective: to determine the behavior of oral-dental diseases in the population attending the dentistry office at Referal Maliana Hospital, Bobonaro district, Timor Leste during 2017-2018. Methods: observational, descriptive and cross-sectional study in 480 patients who suffered from some of the oral-dental pathologies chosen by non-probabilistic intentional sampling. Results: male sex prevailed (51,9 %), the age bracket most affected was 10-19 years old (40,4 %), dental caries was the pathology having the highest diagnosis (79,1 %) between 0 and 39 years old, gingivitis (58,6 %) in young patients and partially-toothless patients in all ages. Deficient oral hygiene prevailed in both sexes (83,8 %) and mama malus consumption (64,8 %) more observed in women. Conclusions: the East Timorese population studied was mainly male, the predominant age group was 10-19 years; the most frequent oral-dental diseases were caries in younger than 40 years old, gingivitis in young population and partial edentulous in all ages. The main risk factors associated were deficient oral-dental hygiene for both sexes and the mastication of mama malus (Areca Nut or Betel Quid) in female population, which evidences a high probability of a continuous increasing and confirms the severity of the oral-dental diseases as a health problem in this population.

Clinical Approach to External Cervical Resorption in the Anterior Teeth: A Case Report Study.

External cervical resorption (ECR) is a pathology that is difficult to diagnose early, and because it is often confused with root decay, it can be treated inadequately and even result in tooth loss. Currently, treatment does not have a defined protocol, being widely varied in the literature. This article proposes that cases of ECR should be treated individually, following different criteria, based on aspects related to the patient and the tooth involved. Furthermore, this work illustrates, through a case report, how a patient can present unique characteristics that require treatment to be case-dependent and should be discussed among a multidisciplinary team.

Infiltrantes para tratamiento estético de lesiones de manchas blancas por fluorosis: Reporte de caso / Infiltrants for Aesthetic Treatment of White Spots Lesions by Fluorosis: Case Report

Resumen La fluorosis dental es una anomalía en el desarrollo del esmalte debido a la excesiva ingesta de flúor durante la formación de los tejidos dentales, y se caracteriza principalmente por la hipomineralización y mayor porosidad de la estructura del esmalte. Muchas veces las manchas ocasionadas por la fluorosis dental pueden comprometer la estética del paciente y afectar su autoestima. En años recientes ha sido desarrollado una nueva generación de materiales odontológicos conocida como infiltrantes resinosos, que básicamente son resinas de baja viscosidad que infiltran y paralizan la progresión de las lesiones cariosas incipientes no cavitadas. Cuando infiltrantes resinosos han sido utilizados para detener las lesiones cariosas se ha verificado que también producen cambios en la apariencia de la mancha blanca, atenuándola o tornándola imperceptible. El presente artículo describe un reporte de caso del uso de infiltrantes resinosos para tratamiento estético de lesiones de manchas blancas ocasionadas por fluorosis.

Abstract Dental fluorosis is an abnormality in the development of enamel due to the excessive intake of fluoride during formation of dental tissues, mainly characterized by hypomineralization and increased porosity of the enamel structure. Oftenly the spots caused by dental fluorosis can compromise the aesthetics of the patient and affect their self-esteem. In recent years a new generation of dental materials has been developed, known as resin infiltrants, which are basically low viscosity resins that infiltrate and paralyze the progression of incipient non cavitated carious lesions. When resin infiltrants have been used to stop carious lesions it has been verified that they also produce changes in the appearance of white spots, masking or making them imperceptible. The present article describes a case report of the use of resin infiltrants for aesthetic treatment of white spot lesions caused by fluorosis.

El estado periodontal de los pacientes diabéticos en Caroní, Venezuela / Diabetic patients´ periodontal state at Caroni, Venezuela

Introducción: las afecciones periodontales están catalogadas entre las más comunes del género humano, y como la causa más frecuente de la morbilidad y mortalidad dentarias. Objetivo: caracterizar las enfermedades periodontales crónicas en pacientes diabéticos. Métodos: se realizó un estudio transversal sobre la epidemiología de las enfermedades periodontales crónicas en pacientes diabéticos, del Consultorio Médico Popular Colinas, del Área de Salud Integral Comunitaria (ASIC) La Unidad, municipio de Caroní, estado de Bolívar, Venezuela, entre septiembre del 2014 a diciembre del 2015. El universo lo integraron 61 pacientes diabéticos de 19 a 60 años, y la muestra quedó constituida por 52 pacientes que cumplieron con los criterios de inclusión. Se utilizó el Índice Periodontal de Russell, conforme a la Organización Mundial de la Salud (OMS); revisado para determinar la prevalencia y gravedad de la enfermedad periodontal. Resultados: en el grupo de 41 a 60 años predominó 40,4% de pacientes con periodontitis. El sexo masculino fue el más afectado por la enfermedad periodontal crónica, con 51,9%. Tanto la gingivitis como la periodontitis se presentaron en su forma leve con mayor frecuencia, con el 57,9%. Conclusiones: elevada prevalencia de enfermedades periodontales crónicas, según la edad y el sexo, con mayor intensidad y frecuencia en las periodontitis en su forma leve, donde el sexo masculino resultó ser el más afectado.

Introduction: periodontal affections are, among most common mankind jaws´ morbility and mortality causes. Objective: to characterize diabetic patients´chronic periodontal diseases. Methods: a traverse study on diabetic patients´ chronic periodontal diseases epidemiology, was carried out at Colinas doctor's office, from the Community Integral Health Area (CIHA) La Unidad, Caroni municipality, Bolivar state, Venezuela; from September 2014 to December 2015. The universe was composed by 61 from 19 to 60 years old diabetic patients, and the sample was formed by 52 patients which fulfill inclusion expectatations. Periodontal Russell index was used by the World Health Organization (WHO), in order to find periodontal diseases´graveness and prevalence. Results: the 40.4 % of the 41 to 60 year-old periodontitis patients, prevailed. The 51.9% of males were the most affected by periodontal chronic diseases. Gingivitis and periodontitis showed in their light form, up to 57.9%. Conclusions: the elevated chronic periodontal diseases prevalence. Light periodontitis intensity and frequency, according to age and sex, showed males as the most affected group.

Impacto de la hipomineralización incisivo molar en la experiencia de caries en escolares de 6-12 años en Santiago, Chile / Molar incisor hypomineralisation and its impact on caries experienced by 6-12 year-old schoolchildren from Santiago, Chile

Objetivo: El objetivo de este estudio fue determinar las consecuencias clínicas expresadas en índices COPD y ceod y su relación con la presencia de hipomineralización incisivo molar (HIM) en una población de escolares de 6 a 12 años de la provincia de Santiago. Método: Este estudio de corte transversal fue realizado en 851 escolares de 6 a 12 años de la provincia de Santiago, quienes fueron evaluados por 2 dentistas calibrados. Con consentimiento de los tutores legales, los escolares fueron examinados, y se utilizaron los criterios diagnósticos para HIM de la Academia Europea de Odontopediatría (EAPD). La historia de caries fue determinada con COPD/ceod de acuerdo a los criterios de la OMS. Los datos fueron recolectados en una ficha especialmente diseñada para esto. Los datos fueron analizados con test «t¼ para muestras individuales (considerando p < 0,05). Resultados: Los escolares afectados por HIM tuvieron una media de COPD de 0,91 (±1,21) y una media de ceod de 1,98 (±2,48), el cual fue mayor que el COPD y ceod de escolares sin HIM (0,41 [±0,95] y 1,34 [±2,15] respectivamente). La diferencia entre ambos grupos fue estadísticamente significativa para COPD (p < 0,000) y ceod (p = 0,002). Conclusiones: Escolares de la provincia de Santiago de 6 a 12 años afectados con HIM presentaron mayor COPD/ceod que escolares sin HIM.

Objective. The aim of this study was to determine the clinical consequences, expressed in DMFT and dmft, and their relationship with Molar Incisor Hypomineralisation (MIH) in a population of schoolchildren of 6 to 12 years old in the Santiago Province. Method: A cross-sectional study was conducted on 851 schoolchildren between 6-12 years old from the Santiago Province were examined by two calibrated examiners. With informed consent from their parents, the schoolchildren were examined, and the European Academy of Paediatric Dentistry (EAPD) diagnostic criteria was used for MIH detection. Caries history was assessed with the DMFT/dmft score according to WHO criteria. Data was collected with a form specially designed for this study. Data was analysed using Student's t-test for individual samples and a post-hoc Bonferroni (P < .05). Results: The mean DMFT score in the MIH-affected schoolchildren was 0.91 (±1.21), with a mean dmft score of 1.98 (±2.48), which were greater than the scores in the non-MIH affected schoolchildren (mean DMFT score 0.41 [±0.95] and mean dmft 1.34 [±2.15]). The differences between DMFT and dmft scores in the two groups were statistically significant (P < .000 and P = .002, respectively). Conclusions: Schoolchildren of Santiago Province of 6-12 year old diagnosed with MIH had higher DMFT/dmft scores compared to schoolchildren not affected with MIH.

Tooth loss and associated factors in patients with coagulopathies in the State of Paraíba, Brazil.

BACKGROUND: The most common and best known hereditary coagulopathies are hemophilia A and B followed by von Willebrand Disease. OBJECTIVE: This study aimed to estimate the prevalence of tooth loss and investigate its association with demographic and socioeconomic data, as well as to discuss self-reported oral morbidity and use of health services by patients with coagulopathies treated in blood centers in Paraíba, Brazil. METHODS: This was a quantitative cross-sectional epidemiological survey. Data was collected in the period from October 2011 to July 2012 by clinical examination and by assessing interviews using a semi-structured questionnaire. The findings were analyzed by descriptive and inferential statistics with the level of significance (α) being set at 10%. RESULTS: One hundred and six, predominantly male (88.8%), patients with coagulopathies were evaluated. The ages ranged from one to 59 years. Most patients were of mixed race (61.3%), most reported family incomes between R$ 501.00 and R$ 1500.00 (49.1%), and most had not completed elementary school (37.1%). Hemophilia A was found in 76.4% of the cases. The prevalence of dental caries among individuals was 50.0% predominantly in the 13- to 19-year-old age range (66.7%). As regards to tooth loss, teeth were missing in 35.1% of the study participants. CONCLUSION: Tooth loss is high in this population. Males with severe hemophilia A, those who use fluoride and have a good or very good perception about their last dental appointment have a reduced chance of losing their teeth.

Tooth loss and associated factors in patients with coagulopathies in the State of Paraiba, Brazil

BACKGROUND The most common and best known hereditary coagulopathies are hemophilia A and B followed by von Willebrand Disease. OBJECTIVE This study aimed to estimate the prevalence of tooth loss and investigate its association with demographic and socioeconomic data, as well as to discuss self-reported oral morbidity and use of health services by patients with coagulopathies treated in blood centers in Paraíba, Brazil. METHODS This was a quantitative cross-sectional epidemiological survey. Data was collected in the period from October 2011 to July 2012 by clinical examination and by assessing interviews using a semi-structured questionnaire. The findings were analyzed by descriptive and inferential statistics with the level of significance (α) being set at 10%. RESULTS One hundred and six, predominantly male (88.8%), patients with coagulopathies were evaluated. The ages ranged from one to 59 years. Most patients were of mixed race (61.3%), most reported family incomes between R$ 501.00 and R$ 1500.00 (49.1%), and most had not completed elementary school (37.1%). Hemophilia A was found in 76.4% of the cases. The prevalence of dental caries among individuals was 50.0% predominantly in the 13- to 19-year-old age range (66.7%). As regards to tooth loss, teeth were missing in 35.1% of the study participants. CONCLUSION Tooth loss is high in this population. Males with severe hemophilia A, those who use fluoride and have a good or very good perception about their last dental appointment have a reduced chance of losing their teeth.

Lesiones quísticas asociadas a terceros molares retenidos que requirieron hospitalización

Se realiza una investigación retrospectiva y descriptiva de 18 pacientes hospitalizados que recibieron tratamiento quirúrgico por presentar lesiones quísticas asociadas a un tercer molar retenido, con el objetivo de evaluar dichas lesiones durante el período 1985-1994. De los 18 pacientes 13 eran masculinos, la edad media fue de 33,7 años, 12 pacientes (66,7 %) fueron diagnosticados por exámenes radiológicos. La longitud media de la lesión fue de 39,8 mm, 3 pacientes presentaron signos clínicos de infección al ingreso. La longitud media de la lesión fue de 39,8 mm. Todos los quistes fueron tratados quirúrgicamente con una proporción de infección del 11,1 %.

A retrospective and descriptive research was made in 18 in-patients underwent to surgical approach because of cystic injuries associated with a impacted third molar, to evaluate such injuries during period from 1985 to 1994. From among 18 patients, 13 were males, with a mean age of 33,7 years; 12 patients (66,7 %) were diagnosed by radiological examinations. Mean extent of injury was of 39,8 mm, 3 patients presenting clinical signs of infection in admission. All cysts were surgically removed with a infection ratio of 11,1 %.