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Objective: To describe the prevalence of physical activity among subjects from birth cohorts of three cities located in different regions of Brazil according to sociodemographic characteristics and sex, comparing the relationships within and between cohorts. Methods: Cross-sectional study involving 12,724 adolescents and young adults who participated in five birth cohorts: Ribeirão Preto [1978/79 (37/39 years old in 2016) and 1994 (22 years in 2016)]; Pelotas [1982 (30 years in 2012) and 1993 (22 years in 2015)], and São Luís [1997/98 (18/19 years in 2016)]. Leisure-time physical activity was evaluated with questionnaires (insufficiently active

To evaluate the effect of vomer position and prevalence of periodontal dehiscence in patients who underwent surgically assisted rapid palatal expansion (SARPE). The null hypotheses were the following: (1) vomer position in the coronal plane does not influence the degree of skeletal and dental expansion; and (2) there is no association between expansion, periodontal dehiscence and vomer position. Twenty-one patients were evaluated before treatment (T0) and immediately after SARPE expansion (T1). After SARPE, the vomer was in the right side in 11 patients and in the left in 10 patients. Skeletal and dental effects were evaluated using CBCT, landmarks and measurements. The maxilla and the nasal cavity expanded asymmetrically. The side containing the vomer had less skeletal expansion but more dental tipping. Dehiscence increased significantly from T0 to T1 and was associated with the amount of skeletal displacement, especially when greater than 3.20 mm. In the first premolars region, there was more than 2 mm of asymmetric expansion observed in 38.5% of the patients. The null hypotheses were rejected. The side containing the vomer had less skeletal expansion of the maxilla and nasal cavity but more dental tipping. Dehiscence increased after expansion, but there were no differences between sides.

To evaluate the efficiency of photobiomodulation therapy (PBMT) in the midpalatal suture (MPS) and pain sensation in patients undergoing rapid palatal expansion (RPE). Thirty-four individuals with the diagnosis of skeletal maxillary hypoplasia were divided in two groups: laser (n = 18) and control (n = 16). Treatment plan consisted of the use of the Hyrax expander in all patients. Subjects in the laser group were irradiated with diode laser (980 nm, 0.3 W) in six spots bilaterally distributed along the MPS for 10 s during the active phase of treatment and after overcorrection (passive phase of RPE). Control group received sham irradiations with the laser in standby mode to characterize the placebo effect. Digital occlusal radiographs were performed at different time-points for bone formation evaluation in both groups. The effects of laser irradiation on pain were assessed by the visual analog scale (Wong-Baker Faces Pain Scale). Bone formation between groups was not significantly different (p = 0.2273). At 3 months, bone formation was not yet complete in both groups. Pain sensation was similar between groups (p = 0.3940). However, pain was significantly higher for the first 7 days of treatment compared with the 14th day. PBMT did not accelerate bone regeneration in the MPS and pain sensation was similar.

AIM To investigate the presence, localization and the possible correlation of the fibroblast growth factor receptor-2 (FGFR2) with inflammatory resorption of cementum, periodontal ligament and alveolar bone during development of apical periodontitis in mice. METHODOLOGY Apical periodontitis was experimentally induced in mandibular first molars of mice by pulp exposure to the oral environment. Healthy teeth without pulp exposure were used as controls. At 7, 21 and 42 days following pulp exposure, the animals were euthanized and the jaws were prepared for analysis under conventional and fluorescence microscopy, immunohistochemistry (FGFR2), RT-PCR (RNAm levels of RANK, RANKL, OPG, Runx2 and cathepsin K) and enzyme histochemistry (cementoclasts and osteoclasts). Statistical analysis was performed by Kruskal-Wallis tests and Dunn's post hoc tests for multiple comparisons (α = 0.05) using SAS 9.4 software. RESULTS FGFR2-positive cells were not observed in the tissues surrounding healthy teeth but were observed in teeth with periapical lesions from seven days after root canal contamination. At days 21 and 42 after endodontic infection, the increase in periapical lesion size was accompanied by significantly enhanced expression of FGFR2 (P

Analyze the association between higher added sugar exposure and periodontal disease in adolescents (18–19 years old). This was a cross-sectional study nested to RPS Cohorts Consortium, Sao Luis, Brazil (n = 2515). The exposure was percentage of daily calories from added sugar (≥ 10%), estimated from a quantitative food frequency. The outcome was periodontal disease estimated by the number of teeth affected by bleeding on probing, periodontal probing depth ≥ 4 mm, and clinical attachment level ≥ 4 mm at the same site. A theoretical model was depicted in a directed acyclic graph to identify the minimal sufficient adjustment set: household income, adolescent’s educational level, sex, alcohol use, and smoking. Periodontal disease was categorized into < 2 teeth affected, 2 to 3 teeth affected, and ≥ 4 teeth affected to estimate prevalence ratios (PR) by multinomial logistic regression. To test for consistency, means ratio (MR) were estimated using zero-inflated Poisson. High sugar intake was associated with ≥ 4 teeth affected by periodontal disease (PR = 1.42; 95% confidence interval (CI) = 1.03–1.94; p = 0.030); consistency Poisson analysis reinforced these results (MR = 1.15; 95% CI = 1.03–1.29; p = 0.011). High level of added sugar intake was associated with greater extent of periodontal disease in adolescents. High sugar intake was associated with periodontal disease in adolescents, supporting the integrated hypothesis of dental caries and periodontal disease and giving impetus to future clinical investigation on the effect of restriction of added sugar consumption in periodontal parameters, which potentially may change traditional treatment protocols of periodontal disease.

Objective The aim of the present study was to compare different techniques for resin remnant removal (RRR) after orthodontic bracket debonding and to evaluate alterations on the dental enamel caused by these methods. The null hypothesis tested was that there is no difference between RRR techniques in relationship the changes caused on the dental enamel. Methods A total of 75 bovine mandibular permanent incisors were used in the study. Brackets were bonded and debonded in each tooth in two experimental regions. Five RRR techniques were used in the experimental groups (n=15): Group 1-diamond bur (6-bladed), Group 2-diamond bur (12-bladed), Group 3-diamond bur (30-bladed), Group 4-aluminum oxide sandblasting (AOS), and Group 5-Er:YAG laser. Enamel surface was evaluated using profilometry, and surface roughness analysis was performed at three time intervals: before bracket bonding, after RRR techniques, and after final polishing. Qualitative analyses of the enamel surfaces were performed using scanning electron microscopy. Results Multiblade burs showed the best results, and the 30-bladed bur created a less irregular enamel surface. AOS caused greater enamel wear, and Er:YAG laser caused more surface irregularity. Conclusion The null hypothesis was rejected. The multiblade burs were the least harmful than the other techniques. Enamel surface roughness after using the 30-blade bur was similar to the original enamel. These results indicate that the type of bur tested (30-bladed) can be indicated to remove resin remnants after bracket debonding.

Preeclampsia is a multifactorial disease. Among these factors, untreated hypertension during pregnancy can result in high morbidity and mortality rates and may also be related to the future development of cardiovascular diseases.Therefore, this systematic review aimed to determine the association of previous preeclampsia with the future development of cardiovascular diseases. Studies on the association between preeclampsia and future cardiovascular diseases published in the last 10 years (2009–2019) were identified from the PubMed/Medline (207 articles), Embase (nine articles), and Cochrane (three articles) databases using the keywords ‘‘preeclampsia’’ and ‘‘future cardiovascular diseases’’, ‘‘preeclampsia’’ and ‘‘future heart attack’’, and ‘‘preeclampsia’’ and ‘‘future cardiac disease’’. After applying the inclusion and exclusion criteria, 15 articles were analyzed by systematic review and meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The meta-analysis and the determination of the quality of the articles were conducted using RevMan software, version 5.3. Statistically significant differences were observed between the control and previous preeclampsia groups with respect to systolic blood pressure (mean difference [MD] 4.32; 95% confidence interval [95%CI] 3.65, 4.99; po0.001), diastolic blood pressure (MD: 2.11; 95%CI: 1.68, 2.55; po0.0001), and insulin level (MD: 2.80; 95% CI: 0.50, 5.11; po0.001). Body mass index (MD: 2.57, 95%CI: 2.06, 3.07; p=0.0001), total cholesterol (MD: 10.39; 95% CI: 8.91, 11.87; p=0.0001), HDL (MD: 2.83; 95%CI: 2.20, 3.46; p=0.0001), and LDL (MD: 1.77; 95%CI: 0.42, 3.13; p=0.0001) also differed significantly between groups. Thus, the results of the present study showed that women with a history of preeclampsia were more likely to develop cardiovascular disease.

The aim of this study was to evaluate the effect of photobiomodulation (PBM) on the stability and displacement of orthodontic mini-implants (MIs) submitted to loading. Forty-eight and 35 mini-implants (1.5 × 8 × 1 mm) were assessed for stability and displacement, respectively (19 patients). MIs were allocated according to the intervention in 1—PBM + immediate loading (IL), 2—PBM + delayed loading (DL) (four weeks after implantation), 3—IL only, and 4—DL only. PBM (Therapy XT, DCM) was implemented using a red emission (660 nm, 4 J/cm2, 0.1 W, 20 s) immediately after implantation (day 0) and infrared emissions (808 nm; 8 J/cm2, 0.1 W, 40 s) in the following appointments every 48–72 h during two weeks (days 2, 4, 7, 9, 11, and 14). Loading of 150 gF was applied during three months for all MIs. The stability was assessed by resonance frequency analysis (Osstell ISQ), and images from Cone beam computed tomography were evaluated to determine the amount of the displacement of the MI’s head. MIs from the PBM groups presented lower loss of stability (P = 0.0372). When the analysis considered the loading protocol as an additional variable, group two showed the lowest loss of stability, being significantly different from groups that did not receive PBM (P = 0.0161). There was no difference between groups two and four during the period without loading (P > 0.05). DL groups presented lower loss when the effective period of loading was assessed, independently of the application of PBM (P 0.05). DL potentiated the effect of PBM, decreasing the loss of stability.

This study aimed to verify the effects of bleaching toothpaste on colour stability, elastic properties, surface topography between aesthetic polyurethane and silicone elastomeric ligatures from different brands.Elastomeric ligatures tested were: 1-Mini Single Case Ligature Stick (RMO-polyurethane); 2-Ligature "S" Shaped Dispenser (RMO-Silicone); 3-Sany-tie (GAC-translucent polyurethane); and 4-Sili-tie (GAC-translucent silicone). The ligatures were randomly assigned from the brackets of canines and lower incisors of 40 patients. The study had two phases of 30 days in which a different toothpaste was used, followed by a washout period of 30 days. After each phase, ligatures were submitted to colour checking, tensile strength, and SEM.The average of the ultimate tensile strength (m = 2.59; DP = 0.014) was higher in the control ligatures if compared to the tested ones (m = 2.24; DP = 0.014). There were no statistically significant differences between toothpastes regarding the type of ligature. Also, no interaction was observed between toothpastes in ligature's ultimate tensile strength and strain. The type of toothpaste did not minimize colour changes.In conclusion, there was no difference in colour stability and elastic properties between polyurethane or silicone aesthetic elastomeric modules. Whitening toothpastes had no impact on ligatures performance after 30 days in the oral cavity.

The introduction of early complementary feeding (ECF) is determined by different factors depending on when it occurs. The objective of this study was to analyze factors associated with the introduction of ECF in two different moments of the infant's life: from zero to three and from four to five months of age. A cohort with 3,306 dyads studied in the BRISA survey in Sao Luis/MA in 2010 was used. Questionnaires were applied at birth and at follow-up when the infants were 15 to 36 months of age of women with more than 20 weeks of gestational age, residing in this municipality. A multivariate model of multinomial logistic regression was used to verify associations between independent variables and ECF at 0 to 3 months and at 4 to 5 months of age. A hierarchical analysis model was used to select variables for confounding adjustment. Variables with a P-value

Background: The aim of this study was to evaluate whether the recommendations of General Dentists (GD) and Pediatric Dentists (PD) on the use of fluoride dentifrice by children are in agreement with the recommendations given in dental association guidelines. Methods: A questionnaire with 11 questions was applied to GD and PD. Questions were about professional performance, as well as type and amount of dentifrices recommended according to the child's age. The way information was conveyed to patients and caregivers was also evaluated. The analysis of the associations between responses and professional training were performed using the Chi-square or Fisher's Exact tests. Results: 354 professionals filled out the questionnaire. The final response rates were 68% for GD and 85% for PD. GD had more recommendations that differ from those found in the guidelines than PD. Conclusion: There is still divergence between the guidelines recommended by dental associations with those of GD and PD. Therefore, it is necessary to conduct educational campaigns for all professionals in the oral health area.

Objective This study sought to analyze the impact of oral and mental health on the quality of life of older people enrolled in a Family Health Unit, as well as its associated factors. Methods This was a cross-sectional, descriptive, exploratory study, conducted through interviews. The probabilistic sample consisted of 86 older people, users of the unit, aged 60 and over, dependent or independent, from both sexes. The methodological frameworks adopted for data collection were the evaluation of oral health conditions (edentulism) and the structured interview, employing oral health perception questionnaires (SB-Brazil), the OHIP – 14 (Oral Health Impact Profile), and the PHQ-2 (Patient Health Questionnaire – Two Items) screening tool for depressive disorders. Secondary data was collected from e-SUS individual records (e-SUS Primary Care). Results The majority of the sample (64%) was female, between 60 and 90 years old (mean of 72.4 years). Most frequently occurring OHIP-14 dimensions were pain (16.3%) and psychological disability (11.6%). The variables age, income, schooling, need for and use of prostheses, activities of daily living (ADL), self-reported diseases (diabetes, hypertension and cancer) had no significant association with quality of life measures related to oral health. A good correlation and association (p < 0.001) between PHQ-2 (depressive disorders) and OHIP-14 scores was observed. Conclusion In conclusion, an association between oral and mental health can be observed in older people; thus, for this population-especially in the case of older women oral and mental health care requires an extensive and multiprofessional approach, aimed at improving quality of life. RESUMO Objetivo O presente estudo procurou analisar o impacto da saúde bucal e mental na qualidade de vida de idosos cadastrados em uma unidade de saúde da família, e fatores associados. Métodos Trata-se de um estudo descritivo de corte transversal de caráter exploratório, realizado por meio de entrevistas. A amostra probabilística foi composta de 86 usuários idosos com 60 anos ou mais, dependentes ou não, de ambos os sexos, cadastrados em uma Unidade de Saúde da Família. As estruturas metodológicas adotadas para coleta de dados foram a avaliação das condições de saúde bucal (edentulismo) e entrevista estruturada, em que foram utilizados questionários de percepção da saúde bucal (SB-Brasil), o OHIP – 14 (Oral Health Impact Profile), e o instrumento de rastreamento para transtornos depressivos PHQ-2 (Patient Health Questionnaire – Two Items); e coletas de dados secundários do Cadastro Individual (e-SUS Atenção Básica). Resultados Na amostra, 64% eram do gênero feminino, tinham idade entre 60 a 90 anos (média de 72,4 anos). As frequências das dimensões do OHIP-14 com maior impacto foram: dor (16,3%) e incapacidade psicológica (11.6%). As variáveis idade, renda, escolaridade, necessidade e uso de próteses, atividades de vida diária (AVD), doenças referidas (diabetes, hipertensão e câncer) não tiveram associação significativa com as medidas de qualidade de vida relacionada à saúde bucal. Foi observada uma boa correlação e associação entre PHQ-2 (transtornos depressivos) e os escores do OHIP-14 (p

Candida albicans is the main causative agent of oral lesions in HIV-infected patients and its oral colonization is a potential source of systemic dissemination. Although the high prevalence of lesions in HIV patients can be explained by the immunosuppressive condition, several studies have reported that natural selection can make C. albicans more virulent in this group of patients. Comparisons of the activity of exoenzymes (phospholipase, proteinase and hemolysin) in C. albicans isolated from HIV-infected and uninfected patients have yielded conflicting results. This study aimed, through a systematic review and meta-analysis, to answer the question: “Is the hydrolytic enzymatic activity of C. albicans, isolated from the oral cavity, different in individuals infected and not infected with HIV?” The question was addressed using the PECO framework: P (Population): children and adults, E (Exposure): HIV infection, C (Comparator): non-HIV-infected patients; O (Outcomes): exoenzymes activity i.e. phospholipase, proteinase and hemolysin. We conducted a systematic search on Pubmed, Embase, Scopus, Livivo, Lilacs, Web of Science, and Science Direct databases, and Google Scholar. The MAStARI tool was used to evaluate the risk of bias in the selected studies. From 2259 studies, 19 were included in this review and 11 comprised the meta-analysis. The activity of phospholipase (M-H = 0.15; Z = 2,76; p = 0.0006) and hemolysin exoenzymes (M-H = 0.07; z = 1,94; p = 0.05) was higher in C. albicans isolated from the oral cavity of HIV-infected patients, whereas the levels of protease activity were not different compared with non-HIV-infected individuals. This study showed a higher phospholipase and hemolysin activity in C. albicans isolates from the oral cavity of HIV-infected patients.

Fetuses exposed to alcohol and/or tobacco are at risk for perinatal adversities. However, little is currently known about the association of the separate or concomitant use of alcohol and tobacco with infant motor and cognitive development. Thus, the objective of the present study was to investigate the association between maternal consumption of alcohol and/or tobacco during pregnancy and the motor and cognitive development of children starting from the second year of life. The study included 1006 children of a cohort started during the prenatal period (22-25 weeks of pregnancy), evaluated at birth and reevaluated during the second year of life in 2011/2013. The children were divided into four groups according to the alcohol and/or tobacco consumption reported by their mothers at childbirth: no consumption (NC), separate alcohol consumption (AC), separate tobacco consumption (TC), and concomitant use of both (ACTC). The Bayley Scale of Infant and Toddler Development Third Edition screening tool was used for the assessment of motor and cognitive development. Adjusted Poisson regression models were used to determine the association between groups and delayed development. The results indicated that only the ACTC group showed a higher risk of motor delay, specifically regarding fine motor skills, compared to the NC group (RR=2.81; 95%CI: 1.65; 4.77). Separate alcohol or tobacco consumption was not associated with delayed gross motor or cognitive development. However, the concomitant use of the two substances increased the risk of delayed acquisition of fine motor skills.

This paper describes the history, objectives and methods used by the nine Brazilian cohorts of the RPS Brazilian Birth Cohorts Consortium (Ribeirão Preto, Pelotas and São Luís) Common thematic axes are identified and the objectives, baseline periods, follow-up stages and representativity of the population studied are presented. The Consortium includes three birth cohorts from Ribeirão Preto, São Paulo State (1978/1979, 1994 and 2010), four from Pelotas, Rio Grande do Sul State (1982, 1993, 2004 and 2015), and two from São Luís, Maranhão State (1997 and 2010). The cohorts cover three regions of Brazil, from three distinct states, with marked socioeconomic, cultural and infrastructure differences. The cohorts were started at birth, except for the most recent one in each municipality, where mothers were recruited during pregnancy. The instruments for data collection have been refined in order to approach different exposures during the early phases of life and their long-term influence on the health-disease process. The investigators of the nine cohorts carried out perinatal studies and later studied human capital, mental health, nutrition and precursor signs of noncommunicable diseases. A total of 17,636 liveborns were recruited in Ribeirão Preto, 19,669 in Pelotas, and 7,659 in São Luís. In the studies starting during pregnancy, 1,400 pregnant women were interviewed in Ribeirão Preto, 3,199 in Pelotas, and 1,447 in São Luís. Different strategies were employed to reduce losses to follow-up. This research network allows the analysis of the incidence of diseases and the establishment of possible causal relations that might explain the health outcomes of these populations in order to contribute to the development of governmental actions and health policies more consistent with reality.

Clinical success with mandibular implant overdentures is highly dependent on a reliable attachment system connecting prosthesis and implants.To compare the levels of retention and patient-based outcomes on implant overdentures retained/supported by cylindrical (LA) and ball (RA) attachment systems overtime and investigate their relationship.Attachment retention (Newtons), and patient satisfaction with the treatment, prosthesis stability, and ability to chew (VAS, 100 mm) were assessed in a crossover trial for both attachment systems at baseline, 1 week, 3, 6, and 12 months and compared to preintervention values. Patients' preference was also recorded.Mean retention of worn attachments and patient satisfaction with denture retention assessed in the preintervention phase were 3.2 N (SD 4.9) and 23.5 mm (IQR 6.5-65.5), respectively. Overall mean retention along the study was higher for RA than LA (difference of 5.0 N, 95%CI: 2.5-7.6; P = 0.0005), declining significantly overtime (P 0.0001), more steeply for the cylindrical attachment. Differences in VAS ratings between attachments were nonsignificant in the crossover phase (P 0.05), but general satisfaction, satisfaction with retention, and comfort were significantly higher when compared with preintervention scores (P 0.05). Ratings of retention decreased significantly overtime for both systems and earlier for LA than RA. Satisfaction was lower when retention was either too low or too high, although there was large variation in this association. At the end of the study, all participants chose to remain with the attachment system that they had received last.Attachment selection should be based on patients' individual characteristics and expectations as satisfaction with the attachment retention and denture stability vary largely among patients.

Research pertaining to exposure of humans to per- and polyfluorinated alkyl substances (PFASs) has received considerable public and regulatory attention in recent years. Although several studies have reported exposure to PFASs by populations in North America and western Europe, such information is still scarce in Latin America, including Brazil. In this study, concentrations of thirteen PFASs were determined in whole blood collected during the second trimester from 252 pregnant Brazilian women. This is a nested case-control study within the Brazilian Ribeirao Preto and Sao Luiz Birth Cohort Study (BRISA) with selected birth outcomes cases (n = 63) and matched controls (n = 189). PFASs concentrations were associated with conditions including preeclampsia, birth weight (BW), preterm birth, and intrauterine growth restriction (IUGR). Among PFASs measured, perfluorooctane sulfonate (PFOS) was found at the highest concentration (range: 1.06–106 ng mL−1 with a median value of 3.41 ng mL−1) which was followed by perfluorooctanoic acid (PFOA, range: 0.11–2.77 ng mL−1 with a median value of 0.20 ng mL−1). A significant positive association of PFOS and PFOA concentrations with fetal growth restriction (p

To estimate and assess pregnancy smoking trends since 1978, according to sociodemographic characteristics, in three Brazilian sites. We used cross-sectional data from the perinatal studies of nine birth cohorts, located in the southeast (Ribeirao Preto—1978/1979, 1994, and 2010), south (Pelotas—1982, 1993, 2004, and 2015), and northeast (Sao Luis—1997/1998 and 2010) regions of Brazil. We estimated the prevalence of pregnancy smoking at each time point according to age, education, and family income, in each cohort, and evaluated smoking trends. We analyzed data of 17,275 women in Ribeirao Preto, 19,819 in Pelotas, and 7753 in Sao Luis. Smoking decreased by 59% in Ribeirao Preto (p

Objectives The aim of this study was to assess the diagnostic sensitivity of body mass index (BMI) in detecting obesity according to different cutoff points in order to classify a high body fat percentage (%BF) in adolescents and young adults. Methods This was a cross-sectional study conducted with 2447 adolescents 18 and 19 y of age residing in Sao Luis, Brazil and 951 young adults 21 to 23 y of age residing in Ribeirao Preto, Brazil. Three references were used to define a high %BF (i.e., those of Williams et al., Ramirez-Velez et al., and Macias et al.). The area under the receiver operating characteristic area under the curve (AUC) was used to assess the performance of BMI. Results Sensitivity ranged from 38.3% to 54.1% among boys and from 12.7% to 72.7% among girls. Among young adults, it ranged from 52.3% to 67.1% in men and from 33.7% to 86.6% in women. The AUC ranged from 0.69 to 0.76 among boys, from 0.56 from 0.85 among girls, from 0.75 to 0.80 among men, and from 0.67 to 0.88 among women. The best cutoff points for the BMI were 24.79 to 25.10 kg/m2 for boys, 21.89 to 27.04 kg/m2 for girls, 26.43 to 28.22 kg/m2 for men, and 23.34 to 29.28 kg/m2 for women. Conclusion The use of different references for the classification of a high %BF implied a difference in the diagnostic sensitivity of the BMI. Higher cutoff points resulted in greater sensitivity and ability to differentiate individuals with and without obesity.

OBJECTIVE: To estimate the effect of being a beneficiary of the Bolsa Família Program (BFP) in the vaccination of children aged 13 to 35 months. METHODS: Our study was based on all birth records of residents of Ribeirão Preto (SP) and probabilistic sampling with 1/3 of the births of residents of São Luís (MA), selecting low-income children, born in 2010, belonging to the cohorts Brazilian Ribeirão Preto and São Luís Birth Cohort Studies and eligible for the Bolsa Família program. The information of Cadastro Único (CadÚnico – Single Registry) was used to categorize the receipt of benefit from the BFP (yes or no). The final sample consisted of 532 children in Ribeirão Preto and 1,229 in São Luís. The outcome variable was a childhood vaccine regimen, constructed with BCG, tetravalent, triple viral, hepatitis B, poliomyelitis, rotavirus and yellow fever vaccines. The adjustment variables were: economic class, mother’s schooling and mother’s skin color. Children with monthly per capita family income of up to R$ 280.00 and/or economic class D/E were considered eligible for the benefit of the BFP. A theoretical model was constructed using a directed acyclic graph to estimate the effect of being a beneficiary of the BFP in the vaccination of low-income children. In the statistical analyses, weighing was used by the inverse of the probability of exposure and pairing by propensity score. RESULTS: Considering a monthly per capita family income of up to R$ 280.00, being a beneficiary of the BFP had no effect on the childhood vaccination schedule, according to weighing by the inverse of the probability of exposure (SL-coefficient: −0.01; 95%CI −0.07 to 0.04; p = 0.725 and RP-coefficient: 0.04; 95%CI −0.02 to 0.10; p = 0.244) and pairing by propensity score (SL-coefficient: −0.01; 95%CI −0.07 to 0.05; p = 0.744 and RP-coefficient: 0.04; 95%CI −0.02 to 0.10; p = 0.231). CONCLUSIONS: The receipt of the benefit of the BFP did not influence childhood vaccination, which is one of the conditionalities of the program. This may indicate that this conditionality is not being adequately monitored.

Background Human immunodeficiency virus-1 (HIV-1) infected people are more likely to develop tuberculosis (TB), being the leading cause of death in HIV-1. Candida spp has emerged as potential pathogenic fungi in patients with HIV and bronchopulmonary diseases. This systematic review summarizes the available data on the occurrence of oral candidiasis (OC) in the HIV-1/pulmonary tuberculosis (pTB) coinfection. Methods Articles that reported the occurrence of OC in the HIV-1-pTB coinfection were searched in eight databases. Observational studies that evaluated the association between OC and HIV-1-pTB coinfection were selected. The risk of bias was assessed using the meta-analysis of statistics assessment and review instrument (MAStARI) checklist. Results From a total of 1858 records, after application of inclusion and exclusion criteria, six were included in the meta-analysis. Three studies were at low risk, one at moderate risk, and two at high risk of bias. Considerable heterogeneity across the studies was identified. Meta-analyses performed showed no difference in the prevalence of OC between HIV-1 patients with and without pTB coinfection (odds ratio M-H = 1.77; 95% CI = 0.69 to 4.52). Conclusion There is no association between OC and HIV-1/pTB coinfection. PROSPERO registration number CRD42019128735.

Objectives: Miniscrew has been frequently used, considering that anchorage control is a critical point in orthodontic treatment, and its failure, the main adverse problem. Using two groups of stable (successful) and unstable (failed) mini-implants, this in vivo study aimed to quantify proinflammatory cytokines IL-1 α, IL-6, IL-17, and TNF-α and osteoclastogenesis marker RANK, RANKL, and OPG in gingival tissue, using the real-time polymerase chain reaction technique. Methodology: Thirteen patients of both sexes (11-49 years old) under orthodontic treatment were selected, obtaining 11 successful and 7 failed mini-implants. The mini-implants were placed and removed by the same surgeon, in both jaws. The mean time of permanence in the mouth was 29.4 months for successful and 7.6 months for failed mini-implants. At removal time, peri-mini-implant gingival tissue samples were collected and processed for quantification of the proinflammatory cytokines and osteoclastogenesis markers. Nonparametric Wilcoxon rank-sum test considering the clusters and Kruskal-Wallis test were used for statistical analysis (α=0.05). Results: No significant difference (p>0.05) was observed between the groups for either quantification of cytokines or osteoclastogenesis markers, except for IL-6 (p

Estudo transversal aninhado a uma coorte, que teve como objetivo descrever foco e cobertura do programa Bolsa Família em crianças de 13-35 meses de idade. Fez-se uso de dados das coortes de nascimento BRISA, em Ribeirão Preto, São Paulo, e São Luís, Maranhão, Brasil. O início das coortes ocorreu em 2010, com a inclusão de todos os nascimentos em Ribeirão Preto (7.794) e 5.236 em São Luís, abrangendo amostra aleatória de um terço. No seguimento, realizado de 2011 a 2013, retornaram 3.805 crianças em Ribeirão Preto e 3.308 em São Luís. Foram utilizados dados do momento do seguimento, e estes foram integrados às informações do Cadastro Único (CadÚnico). Consideraram-se dois critérios de elegibilidade para o benefício do Bolsa Família: renda familiar per capita mensal de até R$ 140,00 e classe econômica D/E. Estimaram-se percentuais de foco e cobertura do Bolsa Família. Realizou-se ponderação para perdas de seguimento. O foco do Bolsa Família, segundo renda familiar per capita mensal, foi de 33,8% em São Luís e 15,9% em Ribeirão Preto, e de acordo com a classe econômica foi de 33,7% em São Luís e 15,3% em Ribeirão Preto. A cobertura do Bolsa Família, de acordo com o critério de renda familiar per capita mensal, foi de 82,1% em São Luís e 71,6% em Ribeirão Preto; e segundo classe econômica foi de 68,9% em São Luís e 46,8% em Ribeirão Preto. Foram baixos os percentuais de foco e melhores os de cobertura do Bolsa Família, com estimativas destes indicadores maiores para São Luís em relação a Ribeirão Preto. The aim of this cross-sectional study nested in a cohort was to describe the targeting and coverage of the Family Income program in children 13 to 35 months of age. Data were obtained from the BRISA Birth Cohorts in Ribeirão Preto, São Paulo State, and São Luís, Maranhão State, Brazil. The cohorts started in 2010 with the inclusion of all the births in Ribeirão Preto (7,794) and 5,236 in São Luís, covering a random sample of one third. In the follow-up waves in 2011 and 2013, 3,805 children returned in Ribeirão Preto and 3,308 in São Luís. The data were used from the time of follow-up and were integrated with the information from the Single Registry (CadÚnico). Two eligibility criteria were considered for receiving the Family Income benefit: monthly per capita family income of BRL 140.00 or less (approximately USD 38.00) and economic classes D/E. The percentages of targeting and covering were estimated for Family Income. Weighting was performed for losses to follow-up. According to family income, the program’s targeting was 33.8% in São Luís and 15.9% in Ribeirão Preto; according to economic class, it was 33.7% in São Luís and 15.3% in Ribeirão Preto. According to per capita family income, coverage was 82.1% in São Luís and 71.6% in Ribeirão Preto; and according to economic class it was 68.9% in São Luís and 46.8% in Ribeirão Preto. The program’s targeting rates were low, while the coverage rates were better. Both indicators were higher in São Luís than in Ribeirão Preto. Se trata de un estudio transversal anidado en una cohorte, cuyo objetivo fue describir la atención y cobertura del programa Bolsa Familia (PBF), en niños de 13 a 35 meses de edad. Se usaron datos de las cohortes de nacimiento BRISA, en Ribeirão Preto, São Paulo, y São Luís, Maranhão, Brasil. El inicio de las cohortes fue 2010, con la inclusión de todos los nacimientos en Ribeirão Preto (7.794) y 5.236 en São Luís, abarcando un tercio de la muestra aleatoria. En el seguimiento, realizado de 2011 a 2013, regresaron 3.805 niños en Ribeirão Preto y 3.308 en São Luís. Se utilizaron los datos recogidos cuando se realizó el seguimiento y, posteriormente, se integraron en la información que proporciona el Registro Único (CadÚnico). Se consideraron dos criterios de elegibilidad para ser beneficiario del Bolsa Familia renta familiar per cápita mensual de hasta BRL 140,00 y clase económica D/E. Se estimaron porcentajes de atención y cobertura del Bolsa Familia. Se realizó una ponderación respecto a las pérdidas en el seguimiento. La atención del Bolsa Familia, según renta familiar per cápita mensual, alcanzó a un 33,8% en São Luís y un 15,9% en Ribeirão Preto; y según la clase económica, fue de un 33,7% en São Luís y un 15,3% en Ribeirão Preto. La cobertura del Bolsa Familia, de acuerdo con el criterio de renta familiar per cápita mensual, fue de un 82,1% en São Luís y un 71,6% en Ribeirão Preto; y según la clase económica fue de un 68,9% en São Luís y un 46,8% en Ribeirão Preto. Fueron bajos los porcentajes de atención y mejores los porcentajes de cobertura del Bolsa Familia, con estimaciones mayores de esos indicadores en São Luís, en comparación con los de Ribeirão Preto.

This study aimed to evaluate the genotoxic effects in the oral epithelial cells of patients undergoing fixed orthodontic treatment and to compare these to a control group without treatment. The null hypothesis to be tested is that corrective orthodontic treatment at different periods does not cause genotoxic effects in patients. An observational cross-sectional study including 74 patients enrolled in corrective orthodontic treatment and 21 control patients, between 11 and 35 years of age, of both genders, participated in the research. Patients undergoing treatment were divided into four treatment groups differentiated by treatment periods: G1, n = 21 (1 month to 12 months); G2, n = 21 (13 to 24 months); G3, n = 23 (25 to 48 months); and G4, n = 9 (over 48 months). Cells were collected by scraping the internal side of the cheek and subsequently placed in tubes containing 0.9% sodium chloride solution. The sample underwent evaluation for genotoxic effects by means of the micronucleus test (MNT). Bivariate analyses were performed using parametric tests (t test or ANOVA) and nonparametric tests (Chi-square test, Kruskal-Wallis test, Dunn post-test). The adopted level of significance was 5%. Statistically significant differences for any of the genotoxic abnormalities (binucleated, trinucleated, karyolysis, piknosis, nuclear buds) were not found except for karyolysis, which was higher in the control group than in G4 (p

The present study investigated the association between preterm birth PT conditions, intrauterine growth restriction IUGR and the combination of both PT-IUGR with infant motor development. A cohort with 1006 children was monitored during prenatal, at birth, and two years of age. Bayley-III screening was used to evaluate of fine and gross motor skills. The data did not indicate an increased risk for motor delays in the PT or IUGR, composed mainly by mild cases. However, the combination of the conditions PT-IUGR increased the risk of delays in motor, which emphasizes the importance of monitoring the motor development of the group.

Objectives This study investigated the effect of nonsurgical periodontal therapy (NSPT) on the clinical and immunologic profile and oral colonization of Candida spp in patients infected with human immunodeficiency virus (HIV) and chronic periodontitis (CP). Study Design HIV-infected (test group) and non–HIV-infected (control group) adults patients with CP were selected. Gingival index (GI), probing depth (PD), clinical attachment level (CAL), number of teeth, CD4+ T lymphocytes and viral load, salivary interleukin (IL)-6, IL-8, and tumor necrosis factor-alpha (TNF-α), and Candida spp count were analyzed at baseline, 30, and 90 days after NSPT. Results Twenty-two patients infected with HIV and 20 patients not infected with HIV were evaluated. Candida spp count and salivary IL-6, IL-8, and TNF-α levels were higher in the test group than in the control group. Both groups presented decrease in Candida spp oral count, GI, PD, IL-6, and IL-8 as well as gain of CAL after NSPT at 30 and 90 days. In addition, patients from test group showed an increase of CD4+ T lymphocytes and a decrease of viral load. Conclusions NSPT had a beneficial effect on the clinical parameters of CP and on the Candida spp oral count and salivary levels of IL-6 and IL-8 in both groups, and also on the HIV-infection status.

The aim of this cross-sectional study nested in a cohort was to describe the targeting and coverage of the Family Income program in children 13 to 35 months of age. Data were obtained from the BRISA Birth Cohorts in Ribeirão Preto, São Paulo State, and São Luís, Maranhão State, Brazil. The cohorts started in 2010 with the inclusion of all the births in Ribeirão Preto (7,794) and 5,236 in São Luís, covering a random sample of one third. In the follow-up waves in 2011 and 2013, 3,805 children returned in Ribeirão Preto and 3,308 in São Luís. The data were used from the time of follow-up and were integrated with the information from the Single Registry (CadÚnico). Two eligibility criteria were considered for receiving the Family Income benefit: monthly per capita family income of BRL 140.00 or less (approximately USD 38.00) and economic classes D/E. The percentages of targeting and covering were estimated for Family Income. Weighting was performed for losses to follow-up. According to family income, the program's targeting was 33.8% in São Luís and 15.9% in Ribeirão Preto; according to economic class, it was 33.7% in São Luís and 15.3% in Ribeirão Preto. According to per capita family income, coverage was 82.1% in São Luís and 71.6% in Ribeirão Preto; and according to economic class it was 68.9% in São Luís and 46.8% in Ribeirão Preto. The program's targeting rates were low, while the coverage rates were better. Both indicators were higher in São Luís than in Ribeirão Preto.Estudo transversal aninhado a uma coorte, que teve como objetivo descrever foco e cobertura do programa Bolsa Família em crianças de 13-35 meses de idade. Fez-se uso de dados das coortes de nascimento BRISA, em Ribeirão Preto, São Paulo, e São Luís, Maranhão, Brasil. O início das coortes ocorreu em 2010, com a inclusão de todos os nascimentos em Ribeirão Preto (7.794) e 5.236 em São Luís, abrangendo amostra aleatória de um terço. No seguimento, realizado de 2011 a 2013, retornaram 3.805 crianças em Ribeirão Preto e 3.308 em São Luís. Foram utilizados dados do momento do seguimento, e estes foram integrados às informações do Cadastro Único (CadÚnico). Consideraram-se dois critérios de elegibilidade para o benefício do Bolsa Família: renda familiar per capita mensal de até R$ 140,00 e classe econômica D/E. Estimaram-se percentuais de foco e cobertura do Bolsa Família. Realizou-se ponderação para perdas de seguimento. O foco do Bolsa Família, segundo renda familiar per capita mensal, foi de 33,8% em São Luís e 15,9% em Ribeirão Preto, e de acordo com a classe econômica foi de 33,7% em São Luís e 15,3% em Ribeirão Preto. A cobertura do Bolsa Família, de acordo com o critério de renda familiar per capita mensal, foi de 82,1% em São Luís e 71,6% em Ribeirão Preto; e segundo classe econômica foi de 68,9% em São Luís e 46,8% em Ribeirão Preto. Foram baixos os percentuais de foco e melhores os de cobertura do Bolsa Família, com estimativas destes indicadores maiores para São Luís em relação a Ribeirão Preto.Se trata de un estudio transversal anidado en una cohorte, cuyo objetivo fue describir la atención y cobertura del programa Bolsa Familia (PBF), en niños de 13 a 35 meses de edad. Se usaron datos de las cohortes de nacimiento BRISA, en Ribeirão Preto, São Paulo, y São Luís, Maranhão, Brasil. El inicio de las cohortes fue 2010, con la inclusión de todos los nacimientos en Ribeirão Preto (7.794) y 5.236 en São Luís, abarcando un tercio de la muestra aleatoria. En el seguimiento, realizado de 2011 a 2013, regresaron 3.805 niños en Ribeirão Preto y 3.308 en São Luís. Se utilizaron los datos recogidos cuando se realizó el seguimiento y, posteriormente, se integraron en la información que proporciona el Registro Único (CadÚnico). Se consideraron dos criterios de elegibilidad para ser beneficiario del Bolsa Familia renta familiar per cápita mensual de hasta BRL 140,00 y clase económica D/E. Se estimaron porcentajes de atención y cobertura del Bolsa Familia. Se realizó una ponderación respecto a las pérdidas en el seguimiento. La atención del Bolsa Familia, según renta familiar per cápita mensual, alcanzó a un 33,8% en São Luís y un 15,9% en Ribeirão Preto; y según la clase económica, fue de un 33,7% en São Luís y un 15,3% en Ribeirão Preto. La cobertura del Bolsa Familia, de acuerdo con el criterio de renta familiar per cápita mensual, fue de un 82,1% en São Luís y un 71,6% en Ribeirão Preto; y según la clase económica fue de un 68,9% en São Luís y un 46,8% en Ribeirão Preto. Fueron bajos los porcentajes de atención y mejores los porcentajes de cobertura del Bolsa Familia, con estimaciones mayores de esos indicadores en São Luís, en comparación con los de Ribeirão Preto.

Background After the introduction of antiretroviral therapy (ART), human immunodeficiency virus (HIV) infection has become a chronic controllable disease. For this reason, chronic conditions related to both HIV infection and senescence, such as chronic periodontitis (CP) need to be studied. This study investigated the impact of non-surgical periodontal therapy (NSPT) on clinical and immunological features of CP, and on oral colonization by Candida spp. in HIV-infected and non-HIV-infected individuals. Methods HIV-infected (test group) and non-HIV-infected (control group) adults patients with CP were selected. Gingival bleeding index (GI), probing depth (PD), clinical attachment level (CAL), number of teeth, CD4+ T lymphocytes and viral load (only for HIV-infected individuals), salivary cytokines (interleukin, [IL]-6, IL-8, and tumoral necrosis factor-alpha [TNF-α]), and oral Candida infection (colony forming units and species) were assessed at baseline, and 30 and 90 days after NSPT. Results Twenty-two HIV-infected patients and 20 non-HIV-infected patients were evaluated. Candida counts and salivary IL-6, IL-8, and TNF-a levels were higher in the test group than in the control group. Both groups showed a decrease in oral Candida counts, GI, PD, IL-6, and IL-8 as well as gain in CAL at 30 and 90 days after NSPT. In addition, patients in the test group showed an increase of CD4+ T lymphocytes and a decrease of viral load. Conclusion NSPT had a beneficial impact on clinical and immunological parameters of CP, reduction of oral Candida counts, and improvement of HIV-infection status.

This study evaluated the effect of CO2laser irradiation and topical fluoride therapy in the control of caries progression on primary teeth enamel. 30 fragments (3×3×2 mm) from primary canines were submitted to an initial cariogenic challenge that consisted of immersion on demineralizing solution for 3 hours and remineralizing solution for 21 hours for 5 days. Fragments were randomly assigned into three groups (n=10): L: CO2laser (λ=10.6 μm), APF: 1.23% acidulated phosphate fluoride, and C: no treatment (control). CO2laser was applied with 0.5 W power and 0.44 J/cm2energy density. Fluoride application was performed with 0.1 g for 1 minute. Cariogenic challenge was conducted for 5 days following protocol previously described. Subsurface Knoop microhardness was measured at 30 μm from the edge. Obtained data were subjected to analysis the variance (ANOVA) and Duncan test with significance of 5%. It was found that the L group showed greater control of deciduous enamel demineralization and were similar to those of APF group, while being statistically different from C group (P≤0.05) that showed the lowest microhardness values. It was concluded that CO2laser can be an additional resource in caries control progression on primary teeth enamel.

Article Title and Bibliographic Information Are fluoride levels in drinking water associated with hypothyroidism prevalence in England? A large observational study of GP practice data and fluoride levels in drinking water. Peckham S, Lowery D, Spencer S. J Epidemiol Community Health 2015;0:1-6. Reviewers John J. Warren, DDS, MS, Maria C.P. Saraiva, DDS, MSc, PhD Purpose/Question Is there an association between water fluoridation levels and the prevalence of Hypothyroidism? Source of Funding Information not available Type of Study/Design Ecological study Level of Evidence Level 3: Other evidence Strength of Recommendation Grade Not applicable

The present in vivo study was designed to evaluate the efficacy of apical negative pressure irrigation (ANP), passive ultrasonic irrigation (PUI) and positive pressure irrigation (PP) in the reduction of intracanal bacteria of dogs' teeth with pulp necrosis and apical periodontitis. Eighty root canals were randomly distributed into 3 experimental and 2 control groups according to the irrigation delivery system: group ANP (n=20), group PUI (n=20), group PP (n=20), group PC (positive control – sterile saline irrigation; n=10) and group NC (negative control - vital pulps not subjected to bacterial inoculation; n=10). The first sample (S1) was collected at baseline, and the second sample (S2) was collected after the disinfection protocols. All samples were seeded in culture media for anaerobic bacteria. CFU counts were analyzed statistically by the Kruskal-Wallis, Dwass-Steel-Critchlow-Fligner post-hoc and Chi-square followed by Tukey like multiple comparisons for proportions (α=0.05). All experimental groups were effective in reducing Gram-positive bacteria compared with PC (p0.05). In dog's teeth with apical periodontitis, the use of ANP and PUI can be considered promising disinfection protocols as both delivery systems promoted a significant bacterial reduction. O presente estudo foi conduzido para avaliar a eficácia da irrigação por pressão apical negativa (ANP), irrigação ultrassônica passiva (PUI) e irrigação por pressão positiva (PP) na redução do número de bactérias presentes nos canais radiculares de dentes de cães com necrose pulpar e lesão periapical. Um total de 80 canais radiculares foram aleatoriamente distribuídos em 3 grupos experimentais e 2 grupos controles, de acordo com o sistema de irrigação empregado: grupo ANP (n=20), grupo PUI (n=20), grupo PP (n=20), grupo PC (controle positivo – irrigação com solução salina; n=10) e grupo NC (controle negativo – tecido pulpar com vitalidade, não submetido à contaminação bacteriana; n=10). A primeira amostra (S1) foi coletada no início do estudo, e a segunda amostra (S2) foi coletada após a utilização dos protocolos de irrigação. Todas as amostras foram semeadas em meio de cultura para micro-organismos anaeróbios. As contagens de unidades formadoras de colônia (cfu) foram analisadas estatisticamente por meio dos testes de Kruskal-Wallis, pós-teste de Dwass-Steel-Critchlow-Fligner e teste do qui-quadrado seguido do teste Tukey like para comparações múltiplas (α=0,05). Todos os grupos experimentais foram efetivos na redução de micro-organismos Gram-positivos, comparados ao grupo PC (p0,05). Conclui-se que, em dentes de cães com periodontite apical, os sistemas de irrigação ANP e PUI podem ser considerados métodos promissores, uma vez que ambos os protocolos promoveram uma redução bacteriana significante.

Objectives: Previous studies have found an association between bruxism and emotional and behavioral problems in children, but reported data are inconsistent. The objective of this study was to estimate the prevalence of bruxism, and of its components clenching and grinding, and its associations with mental problems and depression. Methods: Data from two Brazilian birth cohorts were analyzed: one from 869 children in Ribeirao Preto - RP (Sao Paulo), a more developed city, and the other from 805 children in Sao Luis-S L (Maranhao). Current bruxism - evaluated by means of a questionnaire applied to the parents ⁄persons responsible for the children - was defined when the habit of tooth clenching during daytime and ⁄or tooth grinding at night still persisted until the time of the assessment. Additionally, the lifetime prevalence of clenching during daytime only and grinding at night only was also evaluated. Mental health problems were investigated using the Strength and Difficulties Questionnaire (SDQ) and depression using the Children's Depression Inventory (CDI). Analyses were carried out for each city: with the SDQ subscales (emotional symptoms, conduct problems, peer problems, attention ⁄hyperactivity disorder), with the total score (sum of the subscales), and with the CDI. These analyses were performed considering different response variables: bruxism, clenching only, and grinding only. The risks were estimated using a Poisson regression model. Statistical inferences were based on 95% confidence intervals (95% CI). Results: There was a high prevalence of current bruxism: 28.7% in RP and 30.0% in SL. The prevalence of clenching was 20.3% in RP and 18.8% in SL, and grinding was found in 35.7% of the children in RP and 39.1% in SL. Multivariable analysis showed a significant association of bruxism with emotional symptoms and total SDQ score in both cities. When analyzed separately, teeth clenching was associated with emotional symptoms, peer problems, and total SDQ score; grinding was significantly associated with emotional symptoms and total SDQ score in RP and SL. Female sex appeared as a protective factor for bruxism, and for clenching and grinding in RP. Furthermore, maternal employment outside the home and white skin color of children were associated with increased prevalence of teeth clenching in SL. Conclusions: Mental health problems were associated with bruxism, with teeth clenching only and grinding at night only. No association was detected between depression and bruxism, neither clenching nor grinding. But it is necessary to be cautious regarding the inferences from some of our results.

Higher blood lead (BPb) levels have been reported in children living in communities that receive fluoride-treated water. Here, we examined whether fluoride co-administered with lead increases BPb and lead concentrations in calcified tissues in Wistar rats exposed to this metal from the beginning of gestation. We exposed female rats and their offspring to control water (Control Group), 100mg/L of fluoride (F Group), 30mg/L of lead (Pb Group), or 100mg/L of fluoride and 30mg/L of lead (F+Pb Group) from 1 week prior to mating until offspring was 81 days old. Blood and calcified tissues (enamel, dentine, and bone) were harvested at day 81 for lead and fluoride analyses. Higher BPb concentrations were found in the F+Pb Group compared with the Pb Group (76.7+/-11.0microg/dL vs. 22.6+/-8.5microg/dL, respectively; p

Objective: To evaluate the effectiveness of a 0.5% chlorhexidine gel on the reduction of interdental gingival bleeding. Material and Methods: Forty-three mentally handicapped subjects, living in an institution (Casas Andre Luiz, Brazil), were enrolled in a double-blind randomised clinical trial. The subjects were randomly divided into two groups: test (chlorhexidine gel) and control (placebo gel). The gel was applied with trays, twice a day, over a period of 8 weeks. The interdental bleeding index (IBI) was recorded before and after the period in which the gel was used. Results: Statistical analysis showed that baseline IBI scores were similar (p=0.82) for test and control groups (55.6% and 54.5%, respectively). After 8 weeks, a statistically significant (p

Using checkerboard DNA-DNA hybridisation (CDDH) assay, this randomised clinical study evaluated the contamination of metallic brackets by four cariogenic bacterial strains (Streptococcus mutans, Streptococcus sobrinus, Lactobacillus casei and Lactobacillus acidophilus) and the efficacy of 0.12% chlorhexidine gluconate (CHX) mouthwashes in reducing bacterial contamination.Thirty-nine 11-33-year-old patients under treatment with fixed orthodontic appliances were enrolled in the study and had 2 new metallic brackets bonded to premolars. Nineteen patients used a 0.12% CHX mouthwash (Periogard) and 20 patients used a placebo mouthwash (control) twice a week. After 30 days, the brackets were removed and samples were obtained for analysis by CDDH. Data were analysed statistically by the Kruskal-Wallis test (α=0.05) using the SAS software.S. mutans, S. sobrinus, L. casei and L. acidophilus were detected in 100% of the samples from both groups. However, brackets of the control group were more heavily contaminated by S. mutans and S. sobrinus (P0.01). In the experimental group, although all counts decreased after rinsing with the chlorhexidine solution, there was significant difference only for S. mutans (P=0.03).The use of 0.12% chlorhexidine gluconate mouthwashes can be useful in clinical practice to reduce the levels of cariogenic microorganisms in patients under treatment with fixed orthodontic appliances.

Knowing the microbiota that colonizes orthodontic appliances is important for planning strategies and implementing specific preventive measures during treatment. The purpose of this clinical trial was to evaluate in vivo the contamination of metallic orthodontic brackets with 40 DNA probes for different bacterial species by using the checkerboard DNA-DNA hybridization (CDDH) technique.Eighteen patients, 11 to 29 years of age having fixed orthodontic treatment, were enrolled in the study. Each subject had 2 new metallic brackets bonded to different premolars in a randomized manner. After 30 days, the brackets were removed and processed for analysis by CDDH. Data on bacterial contamination were analyzed descriptively and with the Kruskal-Wallis and Dunn post tests (α = 0.05). Forty microbial species (cariogenic microorganisms, bacteria of the purple, yellow, green, orange complexes, "red complex +Treponema socranskii," and the cluster of Actinomyces) were assessed.Most bacterial species were present in all subjects, except for Streptococcus constellatus, Campylobacter rectus, Tannerella forsythia, T socranskii, and Lactobacillus acidophillus (94.4%), Propionibacterium acnes I and Eubacterium nodatum (88.9%), and Treponema denticola (77.8%). Among the cariogenic microorganisms, Streptococcus mutans and Streptococcus sobrinus were found in larger numbers than L acidophillus and Lactobacillus casei (P 0.001). The periodontal pathogens of the orange complex were detected in larger numbers than those of the "red complex +T socranskii" (P 0.0001). Among the bacteria not associated with specific pathologies, Veillonella parvula (purple complex) was the most frequently detected strain (P 0.0001). The numbers of yellow and green complex bacteria and the cluster of Actinomyces were similar (P 0.05).Metallic brackets in use for 1 month were multi-colonized by several bacterial species, including cariogenic microorganisms and periodontal pathogens, reinforcing the need for meticulous oral hygiene and additional preventive measures to maintain oral health in orthodontic patients.

Introduction High levels of periodontal pathogens can cause periodontal alterations. The presence of endotoxin might be responsible for the occurrence and progression of tissue inflammation and bone resorption. The aims of this study were to use checkerboard DNA-DNA hybridization and limulus amebocyte lysate assay to evaluate in metallic orthodontic brackets (1) the presence of 16 gram-negative periodontal pathogenic microorganisms of the orange complex and red complex + Treponema socranskii, (2) the amount of bacterial endotoxin, and (3) the efficacy of 0.12% chlorhexidine gluconate mouthwash in reducing bacterial contamination and endotoxin amount. Methods Thirty-three patients (ages, 11-33 years) under orthodontic treatment with fixed appliances had 3 new metallic brackets bonded to 3 different premolars. Sixteen patients used a 0.12% chlorhexidine gluconate mouthwash (Periogard, Colgate-Palmolive, Sao Bernardo do Campo, Sao Paulo, Brazil) (experimental group), and 17 patients used a placebo mouthwash (control group) twice a week. After 30 days, the brackets were removed, and the samples were obtained. The data were analyzed statistically by Mann-Whitney, Kruskal-Wallis, and Dunn tests (α = 0.05). Results The 0.12% chlorhexidine gluconate group accumulated significantly lower levels of microorganisms than did the placebo group (P = 0.01). When each microbial complex was analyzed separately, a statistically significant difference between the experimental and control groups was found for the orange complex (P = 0.04). A greater amount of bacterial endotoxin was detected in the 0.12% chlorhexidine gluconate group than in the control group (P = 0.02). Conclusions The 0.12% chlorhexidine gluconate oral rinses can be useful to reduce the levels of gram-negative periodontal pathogenic microorganisms in patients with fixed orthodontic appliances. Considering the increased amount of bacterial endotoxin after chlorhexidine gluconate use, further research is necessary to develop clinical procedures or antimicrobial agents with action against bacterial endotoxin adhering to metallic brackets.

Background: Periodontal disease has been associated with many chronic inflammatory systemic diseases, and a common chronic inflammation pathway has been suggested for these conditions. However, few studies have evaluated whether periodontal disease, in the absence of other known inflammatory conditions and smoking, affects circulating markers of chronic inflammation. This study compared chronic inflammation markers in control individuals and patients with periodontal disease and observed whether non-surgical periodontal therapy affected inflammatory disease markers after 3 months. Methods: Plasma and serum of 20 controls and 25 patients with periodontal disease were obtained prior to and 3 months after non-surgical periodontal therapy. All patients were non-smokers, they did not use any medication, and they had no history or detectable signs and symptoms of systemic diseases. Periodontal and systemic parameters included probing depth, bleeding on probing, clinical attachment level, hematologic parameters, as well as the following inflammatory markers: interleukin (IL)-6, high-sensitivity C-reactive protein (hs-CRP), CD40 ligand, monocyte chemoattractant protein (MCP)-1, soluble P-selectin (sP-selectin), soluble vascular adhesion molecule (sVCAM)-1, and soluble intercellular adhesion molecule (sICAM)-1. Results: There were no differences in the hematologic parameters of the patients in the control and periodontal disease groups. Among the tested inflammatory markers, IL-6 concentrations were higher in the periodontal disease group at baseline compared to the controls (P = 0.006). Therapy was highly effective (P

Multiple factors have been considered in the etiology of bruxism in pediatric patients, among which are infestations by intestinal parasites suggested by some authors. No empirical evidence exists, however, of such association. Therefore, this study's purpose was to investigate the existence of an association between bruxism and intestinal parasitic infestation in children.Fifty-seven 6- to 11-year-olds (30 cases and 27 controls) who had not used anthelminthics 2 months before the baseline examination were enrolled in the study. A diagnosis of bruxism was based on an intraoral clinical examination performed by a single trained examiner and on the parent/guardian's report of any perceived parafunctional habits (questionnaire-based interview). Bruxism cases were defined as those children with a report of currently perceived habits of eccentric or centric bruxism (tooth-grinding and tooth-clenching, respectively) combined with clinical evidence of nonphysiologic wear facets. The volunteers were required to collect 3 fecal samples (1 every 2 to 3 days). Parasitologic analysis was performed using the spontaneous sedimentation method. Data gathered from the intraoral clinical examination, questionnaire, and parasitologic analysis were tabulated and submitted to statistical analysis using the chi-square test and student's t test.Intestinal parasitic infestation was observed in 30% (N=9) of cases and 41% (N=11) of controls, but no statistically significant association was observed (P=.40).This study's findings do not support the existence of an association between intestinal parasitic infestation and bruxism among the evaluated pediatric population.