Cristina Areias

Reduced salivary flow and colonization by mutans streptococci in children with Down syndrome

OBJECTIVES: Although individuals with Down syndrome have considerable oral disease, the prevalence of dental caries in this group is low. The present study aimed to compare known risk factors for dental caries development in children with Down syndrome and a matched population (siblings). In both populations, the number of acidogenic microorganisms, such as mutans streptococci, lactobacilli and Candida species, and the paraffin-stimulated pH, flow rate and IgA concentration in whole saliva were evaluated and compared. METHOD: Saliva was collected, and the caries index was evaluated in 45 sibling pairs aged between 6 and 18 years old. The salivary IgA concentration was determined by immunoturbidimetry. Salivary mutans streptococci, lactobacilli and Candida species were quantified on mitis salivarius agar containing bacitracin and 20% sucrose, rogosa agar supplemented with glacial acetic acid and sabouraud agar supplemented with chloramphenicol, respectively. RESULTS: Down syndrome children had a higher caries-free rate (p<0.05) and lower salivary mutans streptococci counts (p<0.03) compared to their siblings. Similar numbers of lactobacilli and Candida species were found in both groups. Salivary flow rates were 36% lower in Down syndrome children compared to their siblings (p<0.05). The salivary pH did not differ between Down syndrome children and controls. The Down syndrome children had an IgA secretion rate 29% lower than that of their siblings, but this difference was not statistically significant. CONCLUSIONS: In conclusion, the lower number of mutans streptococci in the saliva may be one of the factors contributing to the lower caries rate observed in Down syndrome children, despite evidence of hyposalivation.

Higiene de Próteses Removíveis

Resumo A protese removivel e, com alguma frequencia (por condicionantes economicas, esteticas ou funcionais), a unica solucao para a reabilitacao de arcadas desdentadas. A colocacao de uma protese provoca uma alteracao qualitativa e quantitativa da placa microbiana aumentando a predisposicao dos seus portadores ao desenvolvimento de determinadas patologias (carie dentaria, periodontopatias e processos inflamatorios da mucosa). Consequentemente, a higiene oral e a higiene protetica sao essenciais para a manutencao da saude dos tecidos. Dos diversos metodos de higiene protetica descritos a escovagem e o mais utilizado. No entanto, alguns autores consideram essencial a introducao de uma solucao quimica de imersao como adjuvante do processo mecânico. Atendendo ao descrito, foram objectivos deste estudo: - quantificar a placa microbiana presente na superficie de proteses removiveis higienizadas por um processo mecânico (escovagem com agua) e por um processo mecânico/quimico (escovagem com agua associada a uma solucao quimica de imersao); - comparar a eficacia, na remocao da placa microbiana dos dois metodos referidos. Constituiram a nossa amostra 44 individuos (adultos de ambos os sexos) que se encontravam a confeccionar nova(s) protese(s) na consulta de Protese Removivel da Faculdade de Medicina Dentaria da Universidade do Porto. Para a populacao estudada, a analise dos resultados permite concluir que: 1- Aproximadamente metade das proteses removiveis avaliadas apresenta um deficiente grau de higiene apos escovagem (50,9%) assim como apos associacao de uma solucao quimica de imersao a escovagem (42,1%); 2- A diferenca de eficacia dos metodos analisados na remocao da placa microbiana da superficie protetica nao e estatisticamente significativa.

Comparative Study of the Prevalence of Occlusal Anomalies in Down Syndrome Children and Their Siblings

Aims: The aim of this study was to characterize occlusal anomalies in a Portuguese population with Down Syndrome (DS) and to compare its distribution with that of their siblings. Study Design: A sibling-matched, population-based and cross-sectional survey was performed. Methodology: This study involved 132 children with DS and 84 of their siblings, aged 2 to 26 years. Data were gathered through the use of a complete questionnaire and clinical observation. Data analysis was performed by using SPSS® v.20.0 and any p-value <.05 was considered significant. Results: Seventy six percent of the DS children and 72% of their siblings showed class I of Angle. There were no statistically significant differences between both groups regarding class I ( P=.60). Only 4% of the DS children presented class II versus 22% of the siblings ( P=.001). Twenty percent of the DS children and 6% of the siblings presented class III ( P=.008). The DS group presented occlusal anomalies more frequently, especially posterior crossbite ( P<.001), anterior open bite ( P=.005) and Original Research Article

Dental hypomineralization treatment: A systematic review

INTRODUCTION Defects in the maturation stage of amelogenesis result in a normal volume of enamel but insufficient mineralization, called hypomineralization. Molar-incisor hypomineralization (MIH), amelogenesis imperfecta and dental fluorosis (DF) are examples of such defects. OBJECTIVE To evaluate the effectiveness of the treatments applied to the different forms of dental hypomineralization. MATERIALS AND METHODS PubMed, Scopus, Cochrane Library, Web of Science, and Embase were screened. The research was limited to studies published in English, Spanish, and Portuguese, until May 30, 2018. The research question was formulated following the Population, Intervention, Comparison, Outcome strategy. The quality of the methodology of each article was evaluated employing the Cochrane Handbook for Systematic Reviews. RESULTS From the initial research, 7895 references were obtained, of which 33 were included in the systematic review. The following treatments were reported: desensitizing and remineralizing products, resin infiltration, restorations, fissure sealants, tooth bleaching, enamel microabrasion and calcium, and vitamins supplements. CONCLUSIONS Although the results are suggestive, there is a clear need for a greater uniformity of the methodologies, thus allowing for the development of clinical guidelines. Nevertheless, it was possible to identify several effective treatments for teeth with MIH (arginine pastes or fluoride varnishes) and DF (tooth bleaching and/or enamel microabrasion). CLINICAL SIGNIFICANCE Because MIH, amelogenesis imperfecta, and DF are commonly seen in dental daily practice, it is extremely important to analyze the literature regarding its treatment.

Oral Health in Down Syndrome

Oral health in Down Syndrome (DS) individuals has some peculiar aspects that must be considered in the follow up of these patients. In this chapter, we will focus on the oral and maxillofacial morphological alteration, the most prevalent oral pathologies as well as preventive measures and strategies for pathologies management in this population. Also, future research on oral health of DS will be discussed.

Medicine and Social Media - Ethical Challenges of the 21st Century

Introduction: With the huge growth of social networks, their use is increasing in hospitals and clinics and by physicians. However, health professionals are not always aware of the risks inherent to the use of these tools. The aim of this study is to analyse the problems associated with the use of social media in doctor-patient communication, as well as some rules that may help overcoming the potential risks of this situation. Methodology: Searches were conducted on Google Scholar, Google and Medline and limited to articles published in English, between 2004 and 2014. Twenty-three articles were selected out of 52. Boudreaux’s social media governance website was also used to identify institutional policies on social media. The articles were analysed through thematic coding using template analysis. Discussion and Conclusion: The control of the published information, the regular review of the privacy settings and the limiting access to personal information is of great interest not only for the physician but also for the profession he/she represents. To ensure that health professionals are Mini-review Article