A Systematic Review of Root Canal Filling Materials for Deciduous Teeth: Is There an Alternative for Zinc Oxide-Eugenol?

The aim of this systematic review was to determine whether there is a root canal filling for deciduous teeth equally or more effective than zinc oxide-eugenol cement (ZOE). Six clinical trials selected for inclusion were independently reviewed by two researchers. Only two showed statistically significant different success rates between the test and the control groups. One found that an iodoform paste with calcium hydroxide (IP + Ca) performed better than ZOE, and the other found that ZOE performed similarly to IP + Ca. The other four studies compared ZOE with an iodoform paste (IP), a calcium hydroxide cement (Ca(OH)2), or IP + Ca. In these trials, the success rates in the ZOE groups were slightly lower than in the other groups. There seems to be no convincing evidence to support the superiority of any material over ZOE, and both ZOE and IP + Ca appear to be suitable as root canal fillings for deciduous teeth

Survey of Knowledge, Attitudes and Practices of Brazilian Dentists Regarding Silver Diamine Fluoride

Objective: Current acceptability, barriers to use, and clinical/teaching practices of Silver Diamine Fluoride (SDF) among Brazilian dentists were investigated. Material and Methods: A Google forms questionnaire was sent to dentists (n=10,500) to collect information about the use of SDF and the dentists' workplace, experience, specialty, and city of practice. A logistic regression model was performed. Results: From 409 respondents, 13.2% used SDF. Working at universities increased the use of SDF by 2.29 times (p=0.018) compared to private offices. Each training year, the chance of SDF usage increased by 3%  (p=0.008). Pediatric dentists are more likely to use SDF (OR=6.76, p<0.001). There is no association between SDF usage and the city of practice. The majority (75.9%) indicated SDF for noncompliant patients. Dentists (75.9%) reported the exclusive use in deciduous teeth, while 24.1% also use in permanent teeth. The main barrier for non-users was a lack of knowledge (58.3%), while for users, tooth staining (90.7%) and parental acceptance (64.8%) were the complaints. Conclusion: The Silver Diamine Fluoride is not a common product used by the dentists from RJ. Its clinical applicability should be further disseminated; thus, lack of scientific knowledge would cease to be a problem in the use of SDF to arrest caries lesions

Efficacy of 30% and 38% Silver Diamine Fluoride in Arresting Caries Lesions After Different Application Times: An in Vitro Study

Objective: To evaluate the efficacy of silver diamine fluoride (SDF) in arresting dentin caries lesions when applied under different concentrations and times. Material and Methods: Forty-two bovine blocks were selected and fixed in 24-well plates. Each well received a mixed bacterial inoculum added to the culture medium with 5% sucrose. The plates were incubated in microaerophilia (7 days) for caries formation, confirmed by micro-CT (M1). SDF was applied over the carious lesions for different times and concentrations (n=6): SDF 30% - immediate removal, 1 minute and 3 minutes; SDF 38%, - immediate removal, 1 minute and 3 minutes. The group without treatment was the control. Then, the samples were again scanned by micro-CT (M2) and submitted to a second cariogenic challenge for 21 days. Then, a final scan was performed (M3). Results: Mean pH at the culture medium and lesion depth were compared using Kruskal-Wallis and Wilcoxon tests. 38% SDF showed the lowest metabolic activity of the biofilm. All 38% groups and 30% 1 and 3 minutes did not show an increase in mean lesion depth comparing M3 with M1. However, only 30% 3 minutes and 38% 1 and 3 minutes showed a significant reduction of lesion depth. Conclusion: The minimum application time of 30% SDF to arrest dentin caries lesion was 1 minute, while 38% SDF arrested with application and immediate removal

Plant Ureases and Related Peptides: Understanding Their Entomotoxic Properties

Recently, ureases were included in the arsenal of plant defense proteins, alongside many other proteins with biotechnological potential such as insecticides. Isoforms of Canavalia ensiformis urease (canatoxin—CNTX and jack bean urease—JBURE-I) are toxic to insects of different orders. This toxicity is due in part to the release of a 10 kDa peptide from the native protein, by cathepsin-like enzymes present in the insect digestive tract. The entomotoxic peptide, Jaburetox-2Ec, exhibits potent insecticidal activity against several insects, including many resistant to the native ureases. JBURE-I and Jaburetox-2Ec cause major alterations of post-feeding physiological processes in insects, which contribute to, or can be the cause of, their entomotoxic effect. An overview of the current knowledge on plant urease processing and mechanisms of action in insects is presented in this review

Salivary protein profile study of obese prepuberal children with a focus on metainflammation mediators changes

Fundação de Amparo à Pesquisa do Estado do Rio de JaneiroO objetivo deste estudo foi investigar na saliva de crianças pré-púberes obesas, em comparação com crianças eutróficas, a presença de possíveis diferenças na expressão de mediadores proteicos relacionados à metainflamação através de um estudo observacional transversal. Foram selecionadas 105 crianças pré-púberes com idade entre 5 e 9 anos, sem quaisquer outros comprometimentos sistêmicos ou bucais sendo realizada a mensuração do comprimento da circunferência da cintura (CC), além do peso e estatura para cálculo do IMC e seu escore Z (zscore IMC), de forma a compor 3 grupos: EU - eutrofia (-2SD&#8804; zscore IMC&#8804;1SD), SP - sobrepeso (1SD < zscore IMC < 2SD) e OB obesidade (zscore IMC &#8805; 2SD). Após o exame médico e odontológico foi feita a coleta de sangue e de saliva total não estimulada, de forma protocolada. Amostras séricas e salivares foram analisadas, individualmente, para a dosagem de IL1&#946;, IL6, IL8. IL10, IL12p70, TNF&#945;, MCP1, leptina, grelina e insulina, por Multiplex e adiponectina total e de alto peso molecular (adipoHMW), por ELISA. Além disso, as amostras séricas foram utilizadas para o delineamento hemodinâmico dos pacientes. As amostras salivares de EU e OB foram também analisadas em pools por espectrometria de massa (MS) e a presença de algumas proteínas foi validada por imunoblotting, para a comparação do perfil salivar proteico. As concentrações dos analitos foram comparadas tanto entre os grupos (teste de Kruswall-Wallis), como em relação ao zscore IMC e ao CC (Correlação de Spearman ou Pearson). Dos 12 analitos, somente a adipoHMW não foi detectada em nenhuma das amostras salivares. Na comparação OBxEU houve aumento na concentração total de proteínas salivares, da insulina e leptina sérica e salivar e do MCP1, além de diminuição da adiponectina sérica total e de adipoHMW e uma menor relação adiponectina/leptina (A/L) no grupo OB. As principais correlações obtidas com o zscore IMC foram com as concentrações séricas e salivares de insulina e leptina (positivas) e com a relação A/L (negativa), observando-se também a correlação negativa com a adiponectina total e adipoHMW séricas. Na comparação entre as concentrações séricas e salivares, foi possível detectar correlação positiva entre as dosagens de insulina e leptina, assim como com os valores da relação A/L. Na análise proteômica por MS foram identificadas 670 proteínas, sendo 163 delas com expressão diferenciada na saliva de OB em relação a EU. Dentre estas, encontram-se alteradas proteínas relacionadas à resposta inflamatória humoral, em especial com a via alternativa do sistema complemento e do metabolismo redox. Foram selecionadas três destas proteínas para validação por imunoblotting, que confirmou o aumento do Fator H e a diminuição do Fator B e da tioredoxina na saliva de OB em relação a EU. Considerando os resultados, podemos verificar que embora com menores concentrações absolutas dos mediadores, a saliva mostrou praticamente as mesmas associações observadas no sangue, em especial para a insulina, leptina e relação A/L, sendo possível admitir que a análise salivar venha a ser um bom método diagnóstico não invasivo para a obesidade infantil.The aim of this study was to investigate possible different expressions of protein mediators related to metaflammation, in normal and obese prepubertal children`s saliva. For this cross-sectional observational study, 105 prepubertal children, between 5 and 9 years old, without oral or systemic disorders were selected. Weight, height and waist circumference (CC) were measured and body mass index (BMI) and BMI zscore were calculated in order to classify the children into the following groups: EU - lean (-2SD &#8804; BMI zscore &#8804; 1SD), SP - overweight (1SD < BMI zscore <2SD) and OB - obese (BMI zscore &#8805; 2SD). Following medical and dental examination, blood and unstimulated whole saliva were sampled. The samples were individually analyzed by immunoassay for IL1&#946;, IL6, IL8, IL10, IL12p70, TNF, MCP1, leptin, insulin and ghrelin, using Multiplex. Total and high molecular weight (adipoHMW) adiponectin were analyzed using ELISA. Additionally, serum samples were used to assess the patients lipid profile. Pools of EU and OB saliva samples were also analyzed by mass spectrometry (MS). The presence of some proteins was validated for by immunoblotting. The concentrations of analytes were compared between the groups EU, SP and OB (Kruswall-Wallis test), and in relation to BMI zscore and CC (Pearson or Spearman correlation). Only adipoHMW was not detected in any saliva sample. In comparison with EU, OB showed an increase in total concentration of salivary proteins, salivary and serum insulin, serum and salivary leptin and serum MCP1. Also, a decreased serum total adiponectin and adipoHMW and a lower A/L ratio were observed in the OB group. BMI zscore was positively correlated with insulin and leptin salivary and serum concentrations. A negative correlation with A/L ratio, serum total adiponectin and adipoHMW was also observed. These correlations were also found with CC. Comparing blood and saliva concentrations, significant associations between the dosages of insulin and leptin, as well as the values of A/L ratio were found. In proteomic analysis, by MS, 670 proteins were identified, and 163 of them with differential expression in saliva of OB in comparison to EU. Proteins related to the inflammatory response, in particular with the alternative pathway of the complement system and of redox metabolism were differently expressed between EU and OB. Three of these proteins were selected for validation by immunoblotting, which confirmed the increase of complement H Factor and reduced thioredoxin and complement B Factor expression in the saliva of OB compared to EU. Considering the results, it can be concluded that, although at lower absolute concentrations, the inflammatory mediators in saliva showed the same associations observed in blood, especially insulin, leptin, and A/L ratio. It is possible to assume that salivary analysis may become a useful noninvasive diagnosis method for childhood obesity

In vivo and in vitro study of an antibiotic root canal filling material used in endodontic treatment of primary teeth

Fundação de Amparo à Pesquisa do Estado do Rio de JaneiroO objetivo destes estudos "in vitro" e "in vivo" foi avaliar uma técnica de tratamento endodôntico de dentes decíduos, minimamente invasiva, utilizando a pasta CTZ (cloranfenicol, tetraciclina e óxido de zinco/eugenol). No estudo "in vitro" foi analisada a ação antimicrobiana da pasta CTZ, sobre microrganismos-padrão (E.coli, S.aureus, S.mutans, E.faecalis e P.aeruginosa), pelos métodos de difusão em ágar e diluição em caldo, comparativamente com o OZE (óxido de zinco e eugenol) e as pastas L&C (hidróxido de cálcio), 3 Mix (metronidazol, ciprofloxacin e minociclina e propileno glicol) e Guedes-Pinto (iodofórmio, paramonoclorofenol e Rifocort). A difusibilidade da atividade antimicrobiana da CTZ através dos túbulos dentinários de raízes dentes decíduos recém extraídos, sobre S.mutans, E.faecalis e P.aeruginosa também foi analisada. No estudo "in vivo" foi avaliado o desempenho clínico da pasta CTZ no tratamento endodôntico de dentes decíduos em comparação com o OZE. Seis crianças, com idades entre 7 e 8 anos, apresentando um dente decíduo posterior inferior com comprometimento pulpar extenso, foram alocadas aleatoriamente em dois grupos, sendo que em um foi utilizada a técnica da pasta CTZ (grupo teste) e no outro o tratamento endodôntico radical com OZE (grupo controle). O acompanhamento clínico e radiográfico foi realizado em intervalos de 2 semanas, 3 e 6 meses. Os resultados dos experimentos "in vitro" demonstraram que a pasta CTZ possui atividade antimicrobiana da comparável a da pasta 3 Mix e superior aos demais materiais sobre todos os tipos de microrganismos, exceto para a P.aeruginosa onde a CTZ apresentou uma atividade menor do que a da pasta 3 Mix apesar de ainda superior as demais. Além disso, a CTZ demonstrou atividade antimicrobiana por difusibilidade sobre o S.mutans e E.faecalis. Os resultados do experimento clínico demonstraram um desempenho similar entre a pasta CTZ e o OZE, especialmente logo após o tratamento. Esses resultados sugerem que a técnica minimamente invasiva empregando a pasta CTZ pode ser um alternativa ao tratamento endodôntico radical evitando a perda precoce de dentes decíduos, com comprometimento pulpar. Porém, um ensaio clinico com tamanho amostral adequado e acompanhamento de longa duração deve ser realizado para que se possa obter evidência conclusiva sobre a efetividade do tratamento clínico com a pasta CTZ.The aim of these "in vitro" and "in vivo" studies was to evaluate an endodontic treatment for deciduous teeth, minimally invasive, using the CTZ paste (chloramphenicol, tetracycline and zinc oxide/eugenol). In the "in vitro" study the antimicrobial activity of the CTZ paste on standard microorganisms (E.coli , S.aureus, S.mutans, E.faecalis and P.aeruginosa) was evaluated. The agar diffusion and broth dilution methods were used and the CTZ paste was compared to the ZOE (zinc oxide/eugenol), L&C (calcium hydroxide), 3-Mix (minociclyne, ciprofloxacin, metronidazole e propylene glycol) and Guedes-Pinto (iodoform, paramonoclorophenol e Rifocort) pastes. The antimicrobial activity of the CTZ paste, through the dentinal tubules, were tested on S.mutans, E.faecalis and P.aeruginosa. In the study "in vivo" the clinical performance of CTZ paste was acessed. Six children, aged 7 and 8 years, presenting a decayed lower primary molar decayed with pulp pathology were randomly allocated into the test group (CTZ) and in the control group (ZOE). Clinical and radiographic exams were performed after 2 weeks, 3 and 6 months of follow-up. The results of the "in vitro" experiments demonstrated that CTZ paste had an antimicrobial activity similar to the antimicrobial activity of the 3 Mix paste, with the exception of P.aeruginosa, where CTZ paste presented a worse antimicrobial activity than the 3 Mix paste. The antimicrobial activity of CTZ paste was better than the antimicrobial activity of the other tested materials. Moreover, the CTZ showed an antimicrobial activity through the dentine on S.mutans and E.faecalis. CTZ and ZOE presented a similar clinical performance especially immediately after the treatment. These results suggest that the minimally invasive technique employing the CTZ paste can be an alternative to traditional endodontic treatment and may prevent the early loss of deciduous teeth with pulp pathology. Nevertheless, a clinical trial with an adequate sample size and a longer follow-up period should be performed in order to produce conclusive evidence about the clinical effectiveness of the CTZ paste

Diamino fluoreto de prata no controle da cárie precoce na infância em uma criança com epilepsia: um relato de caso

Objective: silver diamine fluoride (SDF) is a safe, effective and painless product to control dental caries. As it requests short-time appointments, its use in epileptic patients can reduce the risk of seizures. Case Report: a two-year old female patient with severe early childhood caries involving six primary incisors was referred to the University Clinic. Her medical history revealed the presence of cerebral palsy and epilepsy with daily medicines usage to control the disease. Due to the lower age of the patient, the risk of seizures during an invasive and time-consuming dental treatment, and avoiding general anesthesia, SDF 30% was chosen to arrest the caries lesions. A quality of life questionnaire (B-ECOHIS) was applied before and after treatment. Conclusion: the treatment with SDF was effective in arresting dental caries in a young epileptic child, without change in her quality of lifeObjetivo: o diamino fluoreto de prata (DFP) é um produto seguro, eficaz e indolor para controlar a cárie dentária. Como requer consultas de curta duração, seu uso em pacientes epiléticos pode reduzir o risco de convulsões. Relato de caso: uma paciente de dois anos de idade com cárie severa na primeira infância envolvendo seis incisivos decíduos foi encaminhada à Clínica da Universidade. Seu histórico médico revelou a presença de paralisia cerebral e epilepsia com o uso diário de medicamentos para controlar a doença. Devido à menor idade da paciente, ao risco de convulsões durante um tratamento odontológico invasivo e demorado, e para evitar uma possível anestesia geral, o DFP 30% foi escolhido para paralisar as lesões de cárie. Um questionário de qualidade de vida (B-ECOHIS) foi aplicado antes e após o tratamento. Conclusão: o tratamento com SDF foi eficaz na paralisação da cárie dentária em uma criança epiléptica jovem, sem alteração em sua qualidade de vida

Recommendations from paediatric dentistry associations of the Americas on breastfeeding and sugar consumption and oral hygiene in infants for the prevention of dental caries: A bibliometric review

[EN] Background The Internet provides a plethora of information on health issues related to children's oral health. Aim Identify online recommendations of paediatric dentistry associations of the Americas (PDAAs) regarding breastfeeding practices, weaning, sugar introduction and initiating oral hygiene. Design Websites of PDAAs were accessed to record recommendations/questions (Q) relevant to early childhood that specifically covered issues about exclusive breastfeeding-Q1, indications of bottle feeding-Q2, when and how to start weaning-Q3 and Q4, respectively, association of breast milk and dental caries-Q5, when to start oral hygiene and how to introduce it-Q6 and Q7, respectively, and guidance on the introduction of sugar-Q8. Similarity/dissimilarity frequencies between the associations (Euclidean distances) were calculated. Results From 35 countries on the two American continents, 21 associations were affiliated with the International Association of Paediatric Dentistry and/or the Latin American Pediatric Dentistry Association, whereas eight did not have websites. Higher (P .05). No association mentioned Q2, Q3 or Q4 responses, whereas Q7 was the most frequently discussed issue. Conclusion Not all of the investigated issues are mentioned on websites of PDAAs, potentially stymieing efforts by both the layperson and health professional to gather information.Fundacao Carlos Chagas Filho de Amparo a Pesquisa do Estado do Rio de Janeiro, Grant/Award Number: E-26/202.766/2019Gomes Silva Cerqueira, A.; Baraúna Magno, M.; Barja-Fidalgo, F.; Vicente Gomila, JM.; Cople Maia, L.; Fonseca-Gonçalves, A. (2021). Recommendations from paediatric dentistry associations of the Americas on breastfeeding and sugar consumption and oral hygiene in infants for the prevention of dental caries: A bibliometric review. International Journal of Paediatric Dentistry. 31(5):664-675. https://doi.org/10.1111/ipd.1275466467531