Níveis de cortisol salivar e sérico, alfa-amilase e fluxo de saliva total não estimulada em gestantes e não gestantes

OBJETIVO: Comparar os níveis de cortisol sérico e salivar, alfa-amilase salivar (sAA) e fluxo de saliva não estimulada (UWS) em gestantes e não gestantes. MÉTODOS: Trata-se de um estudo longitudinal realizado no centro de promoção da saúde de um hospital universitário. Nove gestantes e 12 não gestantes participaram do estudo. Foram coletados e analisados soro e UWS nos três trimestres gestacionais e duas vezes por mês durante o ciclo menstrual. A análise do cortisol salivar e sérico foi realizada com o uso de quimiluminescência e a atividade da sAA foi determinada por meio de analisador automático para bioquímica. RESULTADOS: Foi verificado que a mediana (intervalo interquartil) dos níveis de cortisol sérico no grupo de gestantes foi maior que 23,8 µL/dL (19,4-29,4) quando comparado ao grupo de não gestantes, que teve média de 12,3 (9,6-16,8; p<0,001). Os níveis de sAA seguiram o mesmo padrão, com médias de 56,7 U/L (30,9-82,2) e 31,8 (18,1-53,2; p<0,001), respectivamente. Foram observadas diferenças dos níveis de cortisol sérico e salivar (µL/dL) e de sAA entre a fase folicular versus a fase lútea (p<0,001). As medianas dos fluxos salivares (UWS) foram semelhantes em gestantes (0,26 [0,15-0,30] mL/min) e não gestantes (0,23 [0,20-0,32] mL/min). Foram encontradas correlações significativas entre o cortisol salivar e o sérico (p=0,02) e entre o cortisol salivar e a sAA (p=0,01). CONCLUSÕES: Os níveis de cortisol sérico de sAA durante a gestação elevam-se. Na fase lútea do ciclo ovariano, os níveis de cortisol salivar aumentam ao passo que os níveis de cortisol sérico e sAA diminuem. _______________________________________________________________________________________ ABSTRACTPURPOSE: To compare salivary and serum cortisol levels, salivary alpha-amylase (sAA), and unstimulated whole saliva (UWS) flow rate in pregnant and non-pregnant women. METHOD: A longitudinal study was conducted at a health promotion center of a university hospital. Nine pregnant and 12 non-pregnant women participated in the study. Serum and UWS were collected and analyzed every trimester and twice a month during the menstrual cycle. The salivary and serum cortisol levels were determined by chemiluminescence assay and the sAA was processed in an automated biochemistry analyzer. RESULTS: Significant differences between the pregnant and non-pregnant groups were found in median [interquartile range] levels of serum cortisol (23.8 µL/dL [19.4-29.4] versus 12.3 [9.6-16.8], p<0.001) and sAA (56.7 U/L [30.9-82.2]versus 31.8 [18.1-53.2], p<0.001). Differences in salivary and serum cortisol (µL/dL) and sAA levels in the follicularversus luteal phase were observed (p<0.001). Median UWS flow rates were similar in pregnant (0.26 [0.15-0.30] mL/min) and non-pregnant subjects (0.23 [0.20-0.32] mL/min). Significant correlations were found between salivary and serum cortisol (p=0.02) and between salivary cortisol and sAA (p=0.01). CONCLUSIONS: Serum cortisol and sAA levels are increased during pregnancy. During the luteal phase of the ovarian cycle, salivary cortisol levels increase, whereas serum cortisol and sAA levels decline

Morphological alterations of the parotid gland of rats maintained on a liquid diet

The purpose of this study was to analyze the morphological alterations that occurred in the parotid glands of rats maintained on a liquid diet compared to a solid diet. Thirty-six animals were randomly divided into two groups. The control group received a solid diet, and the experimental group received a liquid diet. The animals were killed after 8, 15 and 30 days. The glands were prepared for inclusion in paraffin and analyzed with a light microscope. The results showed a statistically significant reduction of the parotid gland weight of the animals from the experimental group compared to the control group at 15 and 30 days. The strongest morphological alteration displayed was the presence of cytoplasm vacuoles on the parotid glands of the animals maintained on the liquid diet. Specific stain techniques for glycoproteins and mucopolysaccarides could not identify the substances inside the vacuoles observed in the experimental animals. We conclude that a liquid diet caused atrophy of the parotid gland after 15 and 30 days. ___________________________________________________________________________________________________________ RESUMOEsse trabalho teve por objetivo analisar as alterações morfológicas das glândulas parótidas de ratos submetidos a uma dieta líquida. Trinta e seis animais foram divididos aleatoriamente em dois grupos. O grupo controle recebeu dieta sólida, e o grupo experimental recebeu dieta líquida. Os animais foram sacrificados 8, 15 e 30 dias após o início da experimentação. As glândulas foram incluídas em parafina e analisadas no microscópio de luz. Os resultados mostraram uma redução estatisticamente significante no peso das glândulas parótidas dos animais do grupo experimental quando comparado aos dos animais do grupo controle nos períodos de 15 e 30 dias. A alteração morfológica mais importante foi a evidenciação de vacúolos no citoplasma das glândulas parótidas dos animais alimentados com dieta líquida. Os vacúolos citoplasmáticos reagiram negativamente às técnicas de coloração específicas para glicoproteínas e mucopolissacarídeos (PAS e Alcian blue). Concluiu-se que a dieta líquida causou atrofia das glândulas parótidas nos períodos experimentais de 15 e 30 dias

Caries risk assessment in schoolchildren - a form based on Cariogram® software

Identifying caries risk factors is an important measure which contributes to best understanding of the cariogenic profile of the patient. The Cariogram® software provides this analysis, and protocols simplifying the method were suggested. Objectives: The aim of this study was to determine whether a newly developed Caries Risk Assessment (CRA) form based on the Cariogram® software could classify schoolchildren according to their caries risk and to evaluate relationships between caries risk and the variables in the form. Material and Methods: 150 schoolchildren aged 5 to 7 years old were included in this survey. Caries prevalence was obtained according to International Caries Detection and Assessment System (ICDAS) II. Information for filling in the form based on Cariogram® was collected clinically and from questionnaires sent to parents. Linear regression and a forward stepwise multiple regression model were applied to correlate the variables included in the form with the caries risk. Results: Caries prevalence, in primary dentition, including enamel and dentine carious lesions was 98.6%, and 77.3% when only dentine lesions were considered. Eighty-six percent of the children were classified as at moderate caries risk. The forward stepwise multiple regression model result was significant (R2=0.904;

Sugar-free chewing gum and dental caries : a systematic review

OBJECTIVE: To appraise existing evidence for a therapeutic / anti-cariogenic effect of sugar-free chewing gum for patients. METHOD: 9 English and 2 Portuguese databases were searched using English and Portuguese keywords. Relevant articles in English, German, Portuguese and Spanish were included for review. Trials were excluded on lack of randomisation, control group, blinding and baseline data, drop out rate >33%, no statistical adjustment of baseline differences and no assessment of clinically important outcomes. Reviews were excluded on lack of information, article selection criteria, search strategy followed, search keywords, searched databases or lack of study-by-study critique tables. In cases of multiple reports from the same study, the report covering the longest period was included. Two reviewers independently reviewed and assessed the quality of accepted articles. RESULTS: Thirty-nine articles were included for review. Thirty were excluded and 9 accepted. Of the 9 accepted, 2 trials of reasonable and good evidence value did not demonstrate any anti-cariogenic effect of sugar-free chewing gum. However, 7 articles, with 1 of strong, and 6 of good evidence value, demonstrated anti-cariogenic effects of chewing Sorbitol, Xylitol or Sorbitol/Xylitol gum. This effect can be ascribed to saliva stimulation through the chewing process, particularly when gum is used immediately after meals; the lack of sucrose and the inability of bacteria to metabolize polyols into acids. Conclusion: The evidence suggests that sugar-free chewing gum has a caries-reducing effect. Further well-designed randomised trials are needed to confirm these findings

Prevalência de cárie na população indígena Brasileira de áreas urbanas com base no levantamento de Saúde Bucal Nacional - 2010

É importante ter uma compreensão epidemiológica das doenças orais entre as populações indígenas, a fim de contribuir com a organização dos serviços de saúde para essas populações. O banco de dados SB Brasil 2010 foi utilizado para comparar a prevalência de cárie entre os 308 autoidentificados indígenas e 37.211 indivíduos não indígenas de áreas urbanas, nas idades/grupos etários: 5, 12, 15-19, 35-44, 65-74. O estudo também analisou o efeito do desenho amostral complexo e o peso da amostra nos resultados. Kruskal-Wallis, Wilcoxon Scores (Rank Sums), regressão logística e linear múltipla foram utilizados para análise estatística. O índice ceo-d médio para crianças indígenas e não indígenas com idade de cinco foram 4,02 ± 4,01 e 2,41 ± 3,35, respectivamente, e 46% dos não nativos e 30,8% das crianças nativas estavam livres de cárie. A média CPOD para indígenas e não indígenas foram 10,90 ± 11,69 e 10,93 ± 11,58, respectivamente, para público em geral, quando não levando em conta o efeito do peso da amostra. Ao considerar o desenho amostral complexo e o efeito do peso da amostra, o estudo encontrou uma diferença estatisticamente significativa. Os resultados dão crédito às suspeitas de que no Brasil existem disparidades nos padrões de cárie entre indivíduos indígenas e não indígenas autoidentificados.It is important to have an epidemiological understanding of oral diseases among indigenous persons, in order to contribute with the organization of health services for these populations. The SB Brasil 2010 database was used to compare the prevalence of dental caries among 308 self-identified indigenous and 37,211 non-indigenous individuals from urban areas, in the following age/age-groups: 5, 12, 15-19, 35-44, 65-74. The study also analyzed the effect of the complex sample design and the sample weight in the outcomes. Kruskal-Wallis, Wilcoxon Scores (Rank Sums), logistic and multiple linear regressions were used for statistical analysis. The mean dmft index for indigenous and non-indigenous children aged five were 4.02 ± 4.01 and 2.41 ± 3.35, respectively, and 46% of non-native and 30.8% of native children were caries-free. The mean DMFT for indigenous and non-indigenous were 10.90 ± 11.69 and 10.93 ± 11.58, respectively, for all age groups when not taking into account the sample weight effect. When considering the complex sample design and the sample weight effect, the study found a statistical significant difference. The results lend credence to suspicions that in Brazil there are disparities in the patterns of caries between self-identified indigenous and non-indigenous individuals

Alzheimer’s disease : characteristics and guidelines in dentistry

A demência é classificada como uma desordem mental de caráter neurodegenerativo que atinge o Sistema Nervoso Central. A doença de Alzheimer é a forma de demência mais prevalente que acomete pessoas idosas e é definida como a perda progressiva e persistente de múltiplas áreas das funções intelectuais. Promove gradual deteriorização da memória, aprendizado, orientação, estabilidade emocional e capacidade de comunicação. Além disso, pensamentos abstratos (paranóias e alucinações) e o declínio dos cuidados pessoais, como tomar banho e a realização da higiene bucal são comuns, interferindo na vida social e diária do indivíduo. De acordo com a evolução, a doença de Alzheimer é dividida em três fases distintas: inicial, intermediária e final. Este estudo objetiva abordar as características e sugerir orientações ao atendimento odontológico nas fases representativas da evolução desse quadro demencial. O cirurgião-dentista deve ter conhecimento dos diferentes estágios desta doença e suas características para direcionar a atenção em saúde bucal de forma individualizada a seus pacientes. A participação dos cuidadores, familiares, além da equipe de saúde é fundamental e também necessária para a manutenção da saúde bucal desses idosos. ____________________________________________________________________________________________________________ ABSTRACTDementia is classified as a mental disorder of a neurodegenerative nature that affects the Central Nervous System. Alzheimer’s disease is the most prevalent form of dementia that affects elderly people and it is defined as a progressive and persistent loss of multiple areas of intellectual functions. It gradually promotes deterioration in memory, learning, orientation, emotional stability and ability to communicate. Moreover, abstract thinking (paranoia and hallucinations) and the decline of personal care such as bathing and performing oral hygiene are common, interfering in the individual’s social and daily life. According to its development, Alzheimer’s disease is divided into three distinct stages: initial, intermediate and terminal stage. The aim of this study was to approach the characteristics and suggest guidelines for dental attendance in the representative stages in the development of this dementia condition. The dentist should be aware of the different stages of this disease and its characteristics to provide patients with individual oral health attention. The participation of caregivers, family, and the health team is fundamental and it is also necessary to maintain oral health of these elderly patients