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Ethnopharmacological Relevance: The antimicrobial potential of propolis - a honey bee product - was correlated with its traditional use as a natural medicine, mainly known for antimicrobial and antioxidant properties. Moreover, research on natural products in dentistry has increased in recent years in the search for products with greater therapeutic activity, lower toxicity, better biocompatibility, and more affordable cost to the population., Objective: Considering that the beneficial effect of propolis is acknowledged for several oral conditions, this study aimed to synthesize the research and technological forecasts of existing evidence on the use of propolis extract as a potential antimicrobial agent in dentistry., Methods: Studies were identified through an investigation in the PubMed, Web of Science, Scopus, and Scielo electronic databases. Additionally, the following patent databases were screened: Google Patents, WIPO, INPI, Espacenet, and Questel Orbit. The data were tabulated and analyzed using Microsoft Office Excel 2013 and Questel Orbit., Results: A total of 174 scientific articles and 276 patents fulfilled all the criteria and were included in the investigation. The highest number of patents (n = 144) was produced by China. Additionally, the most prevalent studies were performed on an experimental basis (72%), followed by clinical studies (n = 27) and review articles (n = 21). The effect of using propolis has been extensively observed in oral care products, periodontics, pathology, and cariology, among other dental specialties., Conclusion: It was possible to identify the current scientific and technological scenario of the application of propolis in dentistry, with the number of patents increasing in recent years. However, all studies related to the use of propolis in dentistry have shown a potentially safe antimicrobial agent in an extensive field of application., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Purpose: To evaluate the preferences of children and adolescents regarding the professional attire used by dentists (pediatric or white attire)., Materials and Methods: Seven electronic databases were searched without restriction regarding language and publication date. The primary outcome was the preference of patients regarding pediatric or white attire; secondary outcomes were preference for a female or male dentist and the use of personal protective equipment or not. We ran a meta-analysis of prevalence data of preferences, calculating effect estimate (ES), 95% CI, subgrouped by anxiety status and sex of the patient. Z -test of interactions was used to compare prevalence between groups ( p < 0.05)., Results: Fourteen cross-sectional studies were included, consisting of 5,756 patients with ages ranging from 2 to 15 years. Anxious children preferred more pediatric attire (ES: 0.03; 95% CI: 0.02, 0.03) than non-anxious children (ES: 0.02; 95% CI: 0.01, 0.02) ( p = 0.0085). Female dentists were preferred (ES: 0.62; 95% CI: 0.52, 0.72) over male dentists (ES: 0.40; 95% CI: 0.30, 0.49) ( p = 0.003) in general and by the girls (ES: 0.41; 95% CI: 0.25, 0.56) but not by boys (ES: 0.20; 95% CI: 0.09, 0.30) ( p = 0.036)., Conclusion: There is no difference in the preferences of children and adolescents regarding a specific attire. Anxious children and adolescents preferred dentists using pediatric attire. In general, female dentists were preferred over male dentists and also were preference among girls., How to Cite This Article: Kastelic DRA, Volpato LER, de Campos Neves ATS, et al. Do Children and Adolescents Prefer Pediatric Attire over White Attire during Dental Appointments? A Meta-analysis of Prevalence Data. Int J Clin Pediatr Dent 2021;14(1):14-29., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.)

Introduction: This study aimed to assess the eruption of impacted teeth in cleft lip and/or palate (CLP) after alveolar bone graft., Materials and Methods: Research was carried out through a cross-sectional study at the Craniofacial Rehabilitation Center of the University General Hospital of the University of Cuiabá, Mato Grosso, Brazil. Variables related to cleft, cleft side, gender, age, laterality of cleft, impacted teeth, and orthodontic traction were analyzed., Results: Forty-two patients treated at the institution from 2004 to 2011 had their charts retrospectively reviewed. They were 54.7% male and 45.2% female. The group aged 9 to 11 years was most affected, representing 59.5% of cases. A unilateral cleft was the most prevalent craniofacial anomaly (85.7%). A total of 57 impacted teeth were observed. Maxillary canines were the most commonly impacted teeth (97.6%) and the most frequently identified in patients with a transforamen incisor cleft (TIC) (76.3%). Orthodontic traction was required for both impacted maxillary canines and impacted lateral incisors (64.3 and 35.7% respectively). The orthodontic traction was required only in patients with a TIC (p = 0.0101)., Conclusion: The canine teeth were the most commonly impacted teeth, found mainly in patients with a TIC. After placement of the alveolar bone graft in patients with a preforamen incisor cleft (PIC), all impacted teeth erupted spontaneously., Clinical Significance: An impacted tooth can have negative consequences on a patient's quality of life. Thus, a survey evaluating the incidence and prognosis of impacted teeth after an alveolar bone graft for CLP was important.

Aim: This study aimed to assess the eruption of impacted teeth in cleft lip and/or palate (CLP) after alveolar bone graft., Materials and Methods: Research was carried out through a cross-sectional study at the Craniofacial Rehabilitation Center of the University General Hospital of the University of Cuiaba, Mato Grosso, Brazil. Variables related to cleft, cleft side, gender, age, laterality of cleft, impacted teeth, and orthodontic traction were analyzed., Results: Forty-two patients treated at the institution from 2004 to 2011 were recruited. There were 54.76% males and 45.24% females. The age group between 9 and 11 years was most affected in 59.53% of cases. The unilateral cleft was the most prevalent (85.71%). A total of 57 impacted teeth were observed. Maxillary canine was the most prevalent impacted teeth (97.61%) and more frequent in transforamen incisor cleft (TIC) (76.3%). The orthodontic traction was needed in both maxillary canines and lateral incisor impacted teeth, 64.3 and 35.7% respectively. The orthodontic traction was needed only in TIC (p = 0.0101)., Conclusion: The canine teeth were the most prevalent, mainly related to the TIC and all impacted teeth erupted spontaneously in the preforamen incisor cleft (PIC) after placement of the bone graft., Clinical Significance: There was spontaneous eruption of impacted teeth after secondary alveolar bone graft in CLP.

Background: The aim of study was to evaluate the oral health status, salivary flow and halitosis among individuals diagnosed with leprosy as compared with healthy subjects., Material and Methods: A sample of 160 individuals was allocated into four groups, as follows: (G1) individuals with complete leprosy treatment; (G2) individuals diagnosed with leprosy and under multi-drug therapy; (G3) individuals diagnosed with leprosy not yet under treatment; and (G4) healthy individuals. Then individuals were submitted to periodontal clinical examination (visible plaque index, bleeding index, depth of probing and clinical attachment level); DMFT index (decayed-missing-filled teeth index); evaluation of salivary flow and halitosis using a halimeter equipment (Interscan Corp, Chatsworth, CA, USA)., Results: The data were analyzed using Kruskal-Wallis and chi-square tests. The mean DMFT was found to be higher than 6.6, which is considered very high, with no significant difference between groups (P>0.05). As for salivary flow, 76.2% of the subjects presented normal flow rates, while 10% and 13.7% showed low and very low salivary flow rates, respectively, with hyposalivation being mostly observed in Groups 1 and 2. The highest prevalence of noticeable odor was found in healthy individuals (G4), and the most prevalent periodontal diagnosis was gingivitis (63.1%) in Group 3 (individuals with leprosy not yet under multi-drug therapy) followed by periodontitis (25%) in Group 1 (individuals who had completed leprosy treatment)., Conclusions: It was observed that individuals with a history of leprosy present poor oral health similar to that of systemically healthy individuals.

Purpose: The purpose of this study was to examine the rate of dental caries and the periodontal status of children and adolescents with cleft lip and palate (CLP) and to compare them with gender- and age-matched control subjects., Methods: A total of 156 five- to 18-year-olds, with or without CLP, were examined for dental caries (decayed, missing and filled permanent teeth and primary surfaces [DMFT and dmfs, respectively] indices), plaque index (PI), the gingival bleeding index (BI), clinical attachment level (CAL), and probing pocket depth (PPD). Diagnoses of gingivitis (localized and generalized) and periodontitis (mild, moderate, and advanced) were performed. Characteristics such as gender, age group, cleft type, socioeconomic status, dental occlusion, and the use of orthodontic appliance were analyzed., Results: DMFT and dmfs scores were significantly higher in the control group. The PI, BI, and PPD indices were higher in the CLP group. Respectively, in individuals with and without CLP, 49 percent and 75 percent, had good gingival health, 22 percent and 24 percent had localized gingivitis, and 29 percent and one percent had generalized gingivitis., Conclusions: The results demonstrate that caries experience in both dentitions was higher for CLP patients, and the presence of CLP is a determining factor for higher risk of gingival inflammation.

Introduction: The bidirectional relationship between the periodontal diseases and systemic diseases was attributed to the focal infection concept. The aims of this study were to assess the periodontal and microbiological profile of intensive care unit (ICU) inpatients submitted to orotracheal intubation, and classify them regarding gender, age group, ethnic, hospitalization reason and period, nosocomial infection occurrence, and death., Materials and Methods: Inpatients were assessed, distributed into toothed and toothless groups. The periodontal clinical condition was assessed 24 hours after the ICU admission through plaque index, gum index, probing depth, and clinical level of insertion. All microbiological samples were collected on the 6th day of admission. These samples were collected from different intraoral sites, depending on the group: In the toothed group, samples were collected from gingival sulcus and in the toothless group, from buccal mucosa and tongue. Identification for Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), and Tannerella forsythia (Tf) was accomplished and analyzed, using absolute quantification and specific primer pairs through an amplification system with probes., Results: Forty subjects composed the sample: Gender characterized by 60% of male, 27.5% of all patients were older than 60, and 22.5% were hospitalized due to cerebrovascular accident. Regarding hospitalization period, 55% of patients were hospitalized for 6 days and 70% of them died during the period of hospitalization. Of inpatients, 40% presented periodontal disease and 100% presented dental biofilm on assessed sites. When assessing the microbiota, statistical significance was observed between Aa, Pg, and Tf, for both toothed and toothless group (p < 0.0001)., Conclusion: Large quantities of Aa were found in samples of toothless inpatients, a fact that suggests that the oral environment, even without teeth, presents favorable conditions for bacterial biofilm formation with a related pathogenic potential., Clinical Significance: The dental biofilm may comprise pulmonary pathogen colonies, promoting a perfect environment for their growth and development, facilitating the colonization of the lower airways, as well as colonization by bacteria originally from the oral cavity.

Background: A cross-sectional study was conducted at the Craniofacial Rehabilitation Center in the General Hospital of the University of Cuiabá, Cuiabá city, Mato Grosso, Brazil., Materials and Methods: Poisson regression model was used to analyze the relationship between antenatal factors and the occurrence of oral clefts in 116 patients., Results: Oral clefts were more common in males (64.66%) and White race (46.02%). The mean age of the children was 21.91 months. The most common type of cleft was cleft lip and palate (CLP, 55.17%). Maternal and paternal smoking in the first trimester of pregnancy and parity were significantly associated with the occurrence of CLP. Parent's age, educational level, and occupation did not interfere in the occurrence of oral clefts. There was also no significant association between maternal illness, medication use, alcohol consumption, and maternal exposure to chemicals in the first trimester of pregnancy and the occurrence of clefts in this population., Conclusion: The analysis of the environmental factors present during the pregnancy of children with oral clefts revealed a significant association between parity (second onward), maternal smoking, and paternal smoking and the occurrence of CL and/or palate in this population.

Introduction: The objective of this study was to evaluate the influence of cervical preflaring on the amount of apically extruded debris after root canal preparation using different instrumentation systems., Methods: One hundred eighty human maxillary central incisors were selected and randomly divided into 12 groups (n = 15). Root canals were instrumented according to manufacturers' instructions using 2 reciprocating single-file systems (Reciproc [VDW, Munich, Germany] and WaveOne [Dentsply Maillefer, Ballaigues, Switzerland]), 3 full-sequence rotary systems (ProTaper Universal [Dentsply Maillefer], ProTaper Next [Dentsply Tulsa Dental, Tulsa, OK], and ProFile [Dentsply Maillefer]), and K-files (Dentsply Maillefer) driven by an oscillatory system with and without cervical preflaring. Bidistilled water was used as irrigant. Apically extruded debris was collected in preweighed glass vials using the Myers and Montgomery method. After drying, the mean weight of debris was determined using a microbalance. Kolmogorov-Smirnov and Levene tests followed by the Tukey post hoc test were used for statistical analysis., Results: K-files produced significantly more debris than all of the other systems (P < .05). For all systems, cervical preflaring reduced the amount of apically extruded debris when compared with no cervical preflaring (P < .05)., Conclusions: All of the systems extruded debris, irrespective of the preparation technique used (with or without cervical preflaring). Cervical preflaring was associated with the extrusion of smaller quantities of apical debris., (Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

The aim of this study was to investigate the antibacterial activity of pulp capping materials used in primary teeth (formocresol [FC], zinc oxide and eugenol cement [ZOE], ZOE mixed with FC [ZOEFC], mineral trioxide aggregate [MTA] and calcium hydroxide [CH]) against cariogenic bacteria. The agar plate diffusion test was used for the cultures, including saline solution as a negative control. A base layer of 15 mL of brain heart infusion agar was inoculated with 300 mL of each inoculum. Twelve wells were made and completely filled with one of the testing materials for each bacteria strain. The plates were incubated at 37°C for 48 h. Zones of microbial inhibition and material diffusion were measured and photographed. The results obtained were analyzed by Kruskal-Wallis and Mann-Whitney non-parametric tests. Respectively, the medium zones of bacteria inhibition of FC, ZOE, ZOEFC, MTA and CH against Streptococcus mutans growth were 28.5, 15.2, 20.8, 9.3 and 11.6; against Lactobacillus acidophilus growth were 28.7, 14.8, 15.3, 15.2 and 20.0, and against Actinomyces viscosus growth were 13.6, 13.5, 14.7, 10.0 and 13.6. We might confirmed the high antibacterial activity of FC solution, especially against S. mutans and L. acidophilus, as wells as, the low inhibitory effect of MTA cement on the cariogenic bacteria studied.

The aim of this study was to evaluate the in vitro antimicrobial activity of Brazilian brown propolis as an intracanal medication against Enterococcus faecalis. Thirty dentin discs prepared from intact freshly extracted bovine maxillary central incisors were infected with E. faecalis for 21 days. The specimens were distributed into six groups according to the medicament used as follows: G1- calcium hydroxide paste; G2- Carbowax 400 (control group); G3- 20% brown propolis paste; G4- 40% brown propolis paste; G5- 20% brown propolis paste + calcium hydroxide paste; and G6- 40% brown propolis paste + calcium hydroxide paste. The experimental pastes were placed into the canal lumen and left for 14 days. After each period, irrigation was performed with sterile saline to remove the medicament, and the canals were dried with sterile paper points. The dentin chips were removed from the canals with sequential sterile round burs at low speed and were immediately collected in separate test tubes containing BHI broth. The tubes were incubated at 37°C, and microbial growth was analyzed by spectrophotometry after 15 days. All the experimental medications significantly reduced the number of viable bacteria. The G4 and G5 pastes were more effective than the G1 paste, with 35.8%, 41%, and 21.3% antibacterial activity, respectively. Brazilian brown propolis shows antibacterial capacity against E. faecalis.

Purpose. To compare the results of secondary alveolar bone grafts in patients with complete cleft lip and cleft lip and palate using 2 radiographic scales and according to the rate of canine eruption through the newly formed bone. Materials and Methods. We analyzed pre- and postoperative radiographs of 36 patients for the amount of bone in the cleft site according to the Bergland and Chelsea scales. The associations between the variables and the correlation between the scales were measured. Results. A total of 54.2% and 20.8% of cases were classified as type I and type II, respectively, using the Bergland scale, whereas 50% and 22.5% were classified as types A and C, respectively, using the Chelsea scale. A positive correlation between the 2 scales was observed. In 33.3% of males, 58.3% of females, 54.5% of unilateral cleft cases, and 12.5% of bilateral cleft cases, the permanent canines had erupted. Bone grafts performed prior to canine eruption achieved more satisfactory results. Conclusions. Our results suggest that both radiographic scales are important tools for the evaluation of bone grafts. Additionally, longer time periods of evaluation were associated with improved results for patients with secondary alveolar bone grafts.

Physicochemical properties of pozzolan Portland cement were compared to ProRoot MTA and MTA BIO. To test the pH, the samples were immersed in distilled water for different periods of time. After the pH analysis, the sample was retained in the plastic recipient, and the electrical conductivity of the solution was measured. The solubility and radiopacity properties were evaluated according to specification 57 of the American National Standard Institute/American Dental Association (ANSI/ADA). The statistical analyses were performed using ANOVA and Tukey's test at a 5% level of significance. Pozzolan Portland cement exhibited pH and electrical conductivity mean values similar to those of the MTA-based cements. The solubilities of all tested materials were in accordance with the ANSI/ADA standards. Only the MTA-based cements met the ANSI/ADA recommendations for radiopacity. It might be concluded that the pH and electrical conductivity of pozzolan Portland cement are similar to and comparable to those of MTA-based cements.

Unlabelled: Previous studies demonstrate that the balance between pro- and anti-inflammatory mediators determines the stable or progressive nature of periapical granulomas by modulating the balance of the osteoclastogenic factor RANKL and its antagonist OPG. However, the cytokine networks operating in the development of periapical lesions are quite more complex than what the simple pro- versus anti-inflammatory mediators' paradigm suggests. Here we simultaneously investigated the patterns of Th1, Th2, Th9, Th17, Th22, Thf, Tr1 and Tregs cytokines/markers expression in human periapical granulomas., Methods: The expression of TNF-α, IFN-γ, IL-17A, IL23, IL21, IL-33, IL-10, IL-4, IL-9, IL-22, FOXp3 markers (via RealTimePCR array) was accessed in active/progressive (N=40) versus inactive/stable (N=70) periapical granulomas (as determined by RANKL/OPG expression ratio), and also to compare these samples with a panel of control specimens (N=26). A cluster analysis of 13 cytokine levels was performed to examine possible clustering between the cytokines in a total of 110 granulomas., Results: The expression of all target cytokines was higher in the granulomas than in control samples. TNF-α, IFN-γ, IL-17A and IL-21 mRNA levels were significantly higher in active granulomas, while in inactive lesions the expression levels of IL-4, IL-9, IL-10, IL-22 and FOXp3 were higher than in active granulomas. Five clusters were identified in inactive lesion groups, being the variance in the expression levels of IL-17, IL-10, FOXp3, IFN-γ, IL-9, IL-33 and IL-4 statistically significant (KW p<0.05). Three clusters were identified in active lesions, being the variance in the expression levels of IL-22, IL-10, IFN-γ, IL-17, IL-33, FOXp3, IL-21 and RANKL statistically significant (KW p<0.05)., Conclusion: There is a clear dichotomy in the profile of cytokine expression in inactive and active periapical lesions. While the widespread cytokine expression seems to be a feature of chronic lesions, hierarchical cluster analysis demonstrates the association of TNF-α, IL-21, IL-17 and IFN-γ with lesions activity, and the association of FOXP3, IL-10, IL-9, IL-4 and IL-22 with lesions inactivity.

Background: This work aimed to access the profile of cleft lip and palate patients of a sub-population in Mid-West Brazil., Materials & Methods: Research was carried out through a cross-sectional study at the Craniofacial Rehabilitation Center of the University General Hospital of the University of Cuiabá, Mato Grosso, Brazil. Variables related to oral cleft type, gender, race, age and presence or absence of associated congenital anomalies or syndromes were analyzed., Results: 313 patients treated at the institution from 2004 to 2007 were recruited. There were 54% male and 46% female patients with the mean age of 11.4 years. Cleft lip and palate was the most prevalent alteration in 49.6% of cases. Caucasians were the most affected in 54.6% of cases. 6.4% of patients had other anomalies or syndromes associated with cleft., Conclusion: More comprehensive surveys should be conducted in order to supply the lack of data on the occurrence and determinants of oral clefts in this region. How to cite this article:Cuozzo FD, Espinosa MM, Serafim da Silva KT, Martins de Barros YB, Bandeca MC, Aranha AM, Borges AH, Volpato LE. Cleft lip and palate in a Brazilian subpopulation. J Int Oral Health 2013; 5(4):15-20.

Background: The aim was to analyze an infant preventive program determining at what age parents take their children for their first dental visit and the reasons why they do it., Materials & Methods: A total of 844 children aged from 0 to 36 months, enrolled in the program of oral health maintenance of the Baby Clinic, participated in this study. During the first dental visit, the parents were inquired about the reasons that led them to enroll their children in the program. One trained investigator identified this reasons on the records and classified them according to the following scores: orientation/prevention, caries treatment, malpositioned teeth, dental trauma, tooth color alterations and others., Results: Orientation/prevention was the most prevalent reason from 0-6 months to 25-30 months of age, and at the age 30-36 months, the reason caries/treatment overcame orientation/prevention, becoming the most prevalent reason in that age group. The third place was occupied by dental trauma. The mean age parents seek for dental care to their children was 14, 92 months., Conclusion: This study showed a preferentially preventive/educational profile for the children. However, lots of parents still take children to the dentist preferentially for curative instead of preventive treatment. How to cite this article: Volpato LE, Palti DG, Lima JE, Machado MA, Aranha AM, Bandeca MC, Pedro FL, Borges AH. When and Why Parents Seek Dental Care for Children under 36 Months. J Int Oral Health 2013; 5(4):21-25.

Introduction: The development of periapical granulomas is dependent on the host response and involves Th1, Th2, Th17, and Treg-related cytokines. The discovery of new Th9 and Th22 subsets, with important immunomodulatory roles mediated by interleukin (IL)-9 and IL-22, respectively, emphasizes the need for reevaluation of current cytokine paradigms in context of periapical lesions. We investigated the expression of IL-9 and IL-22 in active and stable human granulomas and throughout experimental lesion development in mice., Methods: Periapical granulomas (N = 83) and control specimens (N = 24) were evaluated regarding the expression of IL-9 and IL-22 via real-time polymerase chain reaction. Experimental periapical lesions were induced in mice (pulp exposure and bacterial inoculation) and the lesions evolution correlation with IL-9 and IL-22 expression kinetics was evaluated., Results: IL-9 and IL-22 mRNA expression was higher in periapical lesions than in control samples; higher levels of IL-9 and IL-22 were observed in inactive than in active lesions. In the experimental lesions model, increasing levels of IL-9 and IL-22 mRNA were detected in the lesions, and inverse correlations were found between IL-9 and IL-22 and the increase of lesion area in the different time point intervals., Conclusions: Our results suggest that Th9 and Th22 pathways may contribute to human and experimental periapical lesion stability., (Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Instances of unoperated cleft lip and/or palate (CLP) in adult or elderly patients are still seen in developing countries. This paper presents the multidisciplinary management and the personal identity revival of a 72-year-old patient with unoperated unilateral complete cleft lip. The facial deformity was characterized by a protrusion of the excess of orbicularis oris muscle, irregularities of the upper lip, nose distortion, and septum deviation to the cleft side. The patient was edentulous with the maxillary alveolar ridge collapsed and an associated fistula. The cleft lip was repaired using the Tennison-Randall technique and complete dentures were delivered after the oroantral fistula had been closed. The patient was very pleased with the improvement in speech and eating and she approved of her facial esthetics. The existence of unoperated oral clefts in the elderly population highlights the need to improve policies in treating patients with CLP, mainly in developing countries., (© 2012 Special Care Dentistry Association and Wiley Periodicals, Inc.)

Introduction: Trauma can result in the severing of the dental pulp vessels, leading to hypoxia and ultimately to pulp necrosis. Improved understanding of mechanisms underlying the response of dental pulp cells to hypoxic conditions might lead to better therapeutic alternatives for patients with dental trauma. The purpose of this study was to evaluate the effect of hypoxia on the angiogenic response mediated by human dental pulp stem cells (DPSCs) and human dental pulp fibroblasts (HDPFs)., Methods: DPSCs and HDPFs were exposed to experimental hypoxic conditions. Hypoxia-inducible transcription factor-1alpha (HIF-1alpha) was evaluated by Western blot and immunocytochemistry, whereas vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) expression was evaluated by enzyme-linked immunosorbent assay. YC-1, an inhibitor of HIF-1alpha, was used to evaluate the functional effect of this transcriptional factor on hypoxia-induced VEGF expression. Conditioned medium from hypoxic and normoxic pulp cells was used to stimulate human dermal microvascular endothelial cells (HDMECs). HDMEC proliferation was measured by WST-1 assay, and angiogenic potential was evaluated by a capillary sprouting assay in 3-dimensional collagen matrices., Results: Hypoxia enhanced HIF-1alpha and VEGF expression in DPSCs and HDPFs. In contrast, hypoxia did not induce bFGF expression in pulp cells. YC-1 partially inhibited hypoxia-induced HIF-1alpha and VEGF in these cells. The growth factor milieu of hypoxic HDPFs (but not hypoxic DPSCs) induced endothelial cell proliferation and sprouting as compared with medium from normoxic cells., Conclusions: Collectively, these data demonstrate that hypoxia induces complex and cell type-specific pro-angiogenic responses and suggest that VEGF (but not bFGF) participates in the revascularization of hypoxic dental pulps., (Copyright © 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Unlabelled: This in vitro study evaluated the cytotoxicity of an experimental restorative composite resin subjected to different light-curing regimens., Methods: Forty round-shaped specimens were prepared and randomly assigned to four experimental groups (n=10), as follows: in Group 1, no light-curing; in Groups 2, 3 and 4, the composite resin specimens were light-cured for 20, 40 or 60 s, respectively. In Group 5, filter paper discs soaked in 5 µL PBS were used as negative controls. The resin specimens and paper discs were placed in wells of 24-well plates in which the odontoblast-like cells MDPC-23 (30,000 cells/cm²) were plated and incubated in a humidified incubator with 5% CO2 and 95% air at 37ºC for 72 h. The cytotoxicity was evaluated by the cell metabolism (MTT assay) and cell morphology (SEM). The data were analyzed statistically by Kruskal-Wallis and Mann-Whitney tests (p<0.05)., Results: In G1, cell metabolism decreased by 86.2%, indicating a severe cytotoxicity of the non-light-cured composite resin. On the other hand, cell metabolism decreased by only 13.3% and 13.5% in G2 and G3, respectively. No cytotoxic effects were observed in G4 and G5. In G1, only a few round-shaped cells with short processes on their cytoplasmic membrane were observed. In the other experimental groups as well as in control group, a number of spindle-shaped cells with long cytoplasmic processes were found., Conclusion: Regardless of the photoactivation time used in the present investigation, the experimental composite resin presented mild to no toxic effects to the odontoblast-like MDPC-23 cells. However, intense cytotoxic effects occurred when no light-curing was performed.

This study evaluated the cytotoxic effects of 2 mineral trioxide aggregate (MTA) cements - White-MTA-Angelus and a new formulation, MTA-Bio - on odontoblast-like cell (MDPC-23) cultures. Twenty-four disc-shaped (2 mm diameter x 2 mm thick) specimens were fabricated from each material and immersed individually in wells containing 1 mL of DMEM culture medium for either 24 h or 7 days to obtain extracts, giving rise to 4 groups of 12 specimens each: G1 - White-MTA/24 h; G2 - White-MTA/7 days; G3 - MTA-Bio/24 h; and G4 - MTA-Bio/7 days. Plain culture medium (DMEM) was used as a negative control (G5). Cells at 30,000 cells/cm(2) concentration were seeded in the wells of 24-well plates and incubated in a humidified incubator with 5% CO2 and 95% air at 37 degrees C for 72 h. After this period, the culture medium of each well was replaced by 1 mL of extract (or plain DMEM in the control group) and the cells were incubated for additional 2 h. Cell metabolism was evaluated by the MTT assay and the data were analyzed statistically by ANOVA and Tukey's test (alpha=0.05). Cell morphology and the surface of representative MTA specimens of each group were examined by scanning electron microscopy. There was no statistically significant difference (p>0.05) between G1 and G2 or between G3 and G4. No significant difference (p>0.05) was found between the experimental and control groups either. Similar cell organization and morphology were observed in all groups, regardless of the storage periods. However, the number of cells observed in the experimental groups decreased compared to the control group. MTA-Bio presented irregular surface with more porosities than White-MTA. In conclusion, White-MTA and MTA-Bio presented low cytotoxic effects on odontoblast-like cell (MDPC-23) cultures.

Background: Skin tags are dermatological lesions commonly found in the general population and have been associated with diabetes mellitus, obesity, insulin resistance and atherosclerosis. Early detection of patients with insulin resistance may play an important preventive role., Objective: To evaluate the association between skin tags in the neck or axillary regions and insulin resistance., Methods: A cross-sectional study involving adult patients receiving care at a university teaching hospital. Cases were defined as patients with > 5 skin tags in the neck region and/or axillae. Insulin resistance was estimated using the HOMA-IR index. Results were adjusted for the other known covariates of risk for insulin resistance using a multiple logistic regression model., Results: Ninety-eight cases and 103 controls were evaluated. There was no difference between the groups with respect to age or gender. Skin tags were directly associated with HOMA-IR values (odds ratio = 1.4), hypertriglyceridemia and body mass index, irrespective of adjustment for diabetes mellitus, age, skin phototype, gender, family history of diabetes mellitus or hip/waist ratio. Qualitatively elevated HOMA-IR levels (>3.8) were also significantly associated (odds ratio = 7.5)., Conclusions: The presence of multiple skin tags was strongly associated with insulin resistance irrespective of other risk factors.

Unlabelled: Chlorhexidine gluconate (CHX) is recommended for a number of clinical procedures and it has been pointed out as a potential cavity cleanser to be applied before adhesive restoration of dental cavities., Objective: As CHX may diffuse through the dentinal tubules to reach a monolayer of odontoblasts that underlies the dentin substrate, this study evaluated the cytotoxic effects of different concentrations of CHX on cultured odontoblast-like cells (MDPC-23)., Material and Methods: Cells were cultured and exposed to CHX solutions at concentrations of 0.06%, 0.12%, 0.2%, 1% and 2%. Pure culture medium (alpha-MEM) and 3% hydrogen peroxide were used as negative and positive control, respectively. After exposing the cultured cells to the controls and CHX solutions for 60 s, 2 h or 60 s with a 24-h recovery period, cell metabolism (MTT assay) and total protein concentration were evaluated. Cell morphology was assessed under scanning electron microscopy. CHX had a dose-dependent toxic effect on the MDPC-23 cells., Results: Statistically significant difference was observed when the cells were exposed to CHX in all periods (p<0.05). Significant difference was also determined for all CHX concentrations (p<0.05). The 60-s exposure time was the least cytotoxic (p<0.05), while exposure to CHX for 60 s with a 24-h recovery period was the most toxic to the cells (p<0.05)., Conclusion: Regardless of the exposure time, all CHX concentrations had a high direct cytotoxic effect to cultured MDPC-23 cells.

Purpose: To investigate the effects of intrapulpal temperature changes induced by a quartz tungsten halogen (QTH) and a light emitting diode (LED) curing units on the metabolism of odontoblast-like cells., Methods: Thirty-six 0.5 mm-thick dentin discs obtained from sound human teeth were randomly assigned into three groups: QTH, LED and no light (control). After placement of the dentin discs in pulp chamber devices, a thermistor was attached to the pulpal surface of each disc and the light sources were applied on the occlusal surface. After registering the temperature change, odontoblast-like cells MDPC-23 were seeded on the pulpal side of the discs and the curing lights were again applied. Cell metabolism was evaluated by the MTT assay and cell morphology was assessed by SEM., Results: In groups QTH and LED the intrapulpal temperature increased by 6.4 degrees C and 3.4 degrees C, respectively. The difference between both groups was statistically significant (Mann-Whitney; P < 0.05). QTH and LED reduced the cell metabolism by 36.4% and 33.4%, respectively. Regarding the cell metabolism, no statistically significant difference was observed between both groups (Mann-Whitney; P > 0.05). However, when compared to the control, only QTH significantly reduced the cell metabolism (Mann-Whitney; P < 0.05). It was concluded that the irradiance of 0.5 mm-thick human dentin discs with a QTH in comparison to a LED curing unit promoted a higher temperature rise, which propagates through the dentin negatively affecting the metabolism of the underlying cultured pulp cells.

Objective: The aim of this in vitro study was to evaluate the cytotoxicity of resin-modified glass-ionomer lining cements submitted to different curing regimes and applied to an immortalized odontoblast-cell line (MDPC-23)., Methods: Forty round-shaped specimens of each experimental material (Fuji Lining LC and Vitrebond) were prepared. They were light-cured for the manufacturers' recommended time (MRT = 30 s), under-cured (0.5 MRT = 15 s), over-cured (1.5 MRT = 45 s) or allowed to dark cure (0 MRT). Sterilized filter papers soaked with either 5 microL of PBS or HEMA were used as negative and positive control, respectively. After placing the specimens individually in wells of 24-well dishes, odontoblast-like cells MDPC-23 (30,000 cells/cm2) were plated in each well and incubated for 72 h in a humidified incubator at 37 degrees C with 5% CO2 and 95% air. The cytotoxicity was evaluated by the cell metabolism (MTT assay) and cell morphology (SEM)., Results: Fuji Lining LC was less cytotoxic than Vitrebond (p < 0.05) in all the experimental conditions. However, the cytotoxicity of Fuji Lining LC was noticeably increased in the absence of light-curing while the same was not observed for Vitrebond. The length of light-curing (15, 30 or 45 s) did not influence the toxicity of both lining materials when they were applied on the odontoblast-cell line MDPC-23., Significance: The light-activation plays an important role in reducing the cytotoxicity of Fuji Lining LC. Following the manufacturer' recommendation regarding the light-curing regime may prevent toxic effect to the pulp cells.

Objectives: To evaluate the effects of current resin-modified glass-ionomer cements (RMGICs) applied on culture of cells or implanted into subcutaneous tissue of rats., Methods: Experiment 1 - Thirty round-shaped samples of every RMGICs: Rely X Luting Cement (RL), Vitremer (VM), and Vitrebond (VB) were placed into wells with 1.1 mL of culture medium (DMEM), and incubated for 24, 48 or 72 h. The extracts from every sample were applied on the MDPC-23 cells. Fresh DMEM was used as control group. The MTT assay was carried out for mitochondrial respiration. Experiment 2 - Fifty-four polyethylene tubes filled with the experimental materials were implanted into the dorsal subcutaneous tissue of rats. At 7, 30, and 90 days the animals were killed and the biopsies were processed for histological evaluation., Results: Experiment--Both time of elution and material significantly influenced cell respiratory activity. In general, the extracts obtained at 24 h were less cytotoxic than 48 and 72 h incubation. The cytotoxic effect of VM and RL were not statistically different (p < 0.05) for the 24-hour period. VB showed the highest cytotoxic effect. Experiment 2--All RMGICs elicited at 7 days a moderate to intense inflammatory reaction which decreased over time. However, connective healing occurred for most of samples at 90-day evaluation., Significance: Glass-ionomer cements may cause noticeable inflammatory response when in direct contact to connective tissue. The toxic effects of this kind of soluble material depend on the amount of components released in the aqueous environment.

Even though fluoride provides a significant contribution in dental caries prevention, it is known that its random employment may lead to enamel alterations such as dental fluorosis, besides the possibility of severe systemic alterations. The aim of this study was to evaluate the ingestion of mouthwashes administered to preschool children. It was concluded that parents and teachers of young children must be very careful during the accomplishment of educational programs comprising fluoridated mouthwashes, because of the high possibility of ingestion.

The main object of this study is to analyze the prevalence of oral trauma in subjects with complete bilateral clefts, with anterior projection of the premaxilla. A total of 106 children aging 6 months to 9 years were analyzed. The caretakers answered a specific questionnaire, in order to report the presence or absence of trauma to the soft and/or hard tissues of the child's mouth. Whenever there was a history of trauma, the patients were submitted to clinical examination. The prevalence of oral trauma was 53%, being 91% of soft tissue lesions, 8.9% of avulsion, 7% of luxation and 1.8% of intrusion. For the males, the prevalence was 56% and for the females it was 47%, with no statistical significance. Regarding the following aspects:period of time spent with the parents and at school, and presence or absence of siblings, no statistical difference could be found. Among the traumatized individuals, 80% aged less than 3 years by the moment of the trauma, 89% suffered the trauma at home, 75% presented lesions in the soft tissue at the premaxilla, 16% in the maxillary incisors, and 8.9% presented lesions in both structures. It was noticed that 45% of the permanent incisors that succeeded the traumatized deciduous teeth presented alterations, being 48% of structure and 52% of structure and position. The prevalence of trauma in this sample was superior to that observed in the literature, without any positive associations between the evaluated aspects. These results suggest that the projection of the premaxilla brings about a higher risk of oral trauma around this area.

The present study aimed at evaluating the prevalence of tooth ankylosis in deciduous molars of Caucasian children with cleft lip and/or palate aged 5 to 12 years, of both genders. A total of 330 patients seen at the Hospital for Rehabilitation of Craniofacial Anomalies of the University of São Paulo for routine treatment were clinically evaluated. The prevalence of ankylosis was analyzed in relation to gender, age range (5-7, 8-10, 11-12 years), type of cleft, affected tooth and arch. The total group showed a prevalence of 18%, with no statistical difference between genders and among types of cleft; ankylosis was more often in the mandibular arch, lower first molars and among children in the age ranges 8-10 and 11-12 years. The results agreed with those observed in the related literature for patients without clefts, pointing out the absence of influence of the cleft on the prevalence of ankylosis. This reinforces the importance of early diagnosis of this anomaly and of the treatment of choice, which are similar in patients with or without clefts.

Objective: To determine the chronology and sequence of eruption of the deciduous teeth in children with complete unilateral cleft lip and palate., Design: Cross-sectional study., Setting: Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Bauru, Sao Paulo, Brazil., Sample: A total of 435 children aged 0 to 48 months who presented with complete unilateral cleft lip and palate., Results: All teeth on the cleft side in both jaws for both sexes presented a higher mean age of eruption than their homologues at the noncleft side. This difference was statistically significant for the maxillary lateral incisor, maxillary cuspid, and mandibular lateral incisor. There was a statistically significant sex difference regarding the mean age of eruption only for the maxillary second molar for the girls and mandibular cuspid for the boys. The maxillary lateral incisor on the cleft side was the last tooth to erupt, thus modifying the sequence of eruption of the deciduous teeth., Conclusions: The results suggest the interference of the cleft on the chronology of eruption of the deciduous teeth that are directly related to it.