Natália Silva Andrade

Exploring the association between genetic and environmental factors and molar incisor hypomineralization: evidence from a twin study

BACKGROUND The etiology of molar-incisor hypomineralization (MIH) remains unknown. Studies indicate that it is multifactorial, and that genetic and environmental factors are involved. Research with twins provides important subsidy to investigate the Influence of genetics and environmental factors that act during pregnancy on the etiology of alterations. AIM This cross-sectional study evaluated the agreement of molar incisor hypomineralization (MIH) between monozygotic and dizygotic twin pairs and the association with environmental factors. DESIGN The sample consisted of 167 pairs of twins (8-15 years old), 94 monozygotic and 73 dizygotic. The parents answered a questionnaire on sociodemographic data and pre-, peri-, and postnatal health. A dental examination was performed by two calibrated examiners (Kappa ≥0.88) for MIH diagnosis, following the criteria proposed by the European Academy of Pediatric Dentistry in 2003. RESULTS The prevalence of MIH was 29.3%. There was greater concordance of MIH between monozygotic twins for affected first molars and permanent incisors (P = 0.0012) and pairs of twins assessed (P = 0.0211). The presence of MIH was associated with family income between one and two wages (P = 0.009, prevalence ratio [PR] = 3.82, confidence interval [CI 95%] 1.40-10.44), above two wages (P = 0.007, PR = 4.60, 95% CI: 1.51-14.05), and gestational hemorrhage (P = 0.032, PR = 5.70, 95% CI: 1.16-28.14). CONCLUSIONS The greater concordance in the diagnosis of MIH among monozygotic twins indicates a genetic influence, although environmental factors, such as family income and hemorrhage during pregnancy, are also associated with the occurrence of MIH.

Molar incisor hypomineralization in HIV‐infected children and adolescents

The objective was to determine the prevalence of molar incisor hypomineralization (MIH) among individuals between 7 and 15 years old infected or noninfected with human immunodeficiency virus (HIV). The study was conducted with 33 HIV-infected individuals (study group; SG) and 66 non-HIV-infected schoolchildren (control group; CG), paired by gender and age. Data collection was based on medical records (SG), a questionnaire for caregivers and oral examination for diagnosis of MIH (European Academy of Pediatric Dentistry criteria) and caries (DMFT index and ICDAS). Data were analyzed with Mann-Whitney, chi-square, and Fishers exact tests and logistic regression. In SG, MIH (45.5%) and caries (87.9%) had higher prevalence. MIH was associated with use of protease inhibitors in SG (OR: 2.14; 95% CI: 1.21 to 3.77) and incubator need in CG (OR: 2.80; 95% CI: 1.71 to 9.10). HIV-infected patients had a higher prevalence of MIH and dental caries in the permanent dentition.

Dental enamel development defects in children and adolescents with HIV infection: case-control study.

To determine the frequency of Enamel Development Defects (DDE) and associated factors in children and adolescents infected with HIV. A case-control study was conducted in HIV-infected patients (n = 52), aged 3 to 15, and a control group formed by preschool and schoolchildren (n = 104) matched according to gender, age and household income. Data on medical history, neonatal and maternal conditions were obtained. For diagnosis of enamel defects was used modified DDE Index. DDE frequency was 61.5% in the case group and 58.7% in the control group (p = 0.569). Infection of the genitourinary tract and maternal hemorrhage were factors associated with DDE in the case and control groups, respectively. An association was observed between the use of antiretroviral regimens with protease inhibitors or efavirenz and DDE in the permanent dentition. Children and adolescents HIV-infected showed a DDE frequency similar to healthy patients, but factors associated with this condition were different between the groups.

DIAGNÓSTICO DE LESÃO ORAL EM PACIENTE PORTADOR DE HEPATITE C CRÔNICA: RELATO DE CASO.

O virus da hepatite C (VHC) infecta 3% da populacao mundial e e a maior causa de doenca hepatica cronica, sendo responsavel por 70% das hepatites cronicas, 40%dos casos de cirrose e 60% dos casos de hepatocarcinoma. O tratamento odontologico desses pacientes deve levar em consideracao tanto as complicacoes da cirrose como as possiveis manifestacoes extra-hepaticas do VHC. Paciente do sexo feminino, leucoderma, 72 anos de idade, cirrotica em decorrencia de hepatite C cronica e apresentando paralisia facial em decorrencia da resseccao cirurgica de Schwanoma vestibular, procurou atendimento no Centro de Atendimento a Pacientes Especiais da Faculdade de Odontologia da Universidade de Sao Paulo (CAPE-FOUSP)., para tratamento odontologico. Sua queixa principal era a “falta de adaptacao da protese”. No exame fisico, foram identificadas lesoes ulceradas em rebordo alveolar superior, em fundo de sulco inferior e em mucosa jugal (proximo a comissura labial) do lado esquerdo, alem de placas esbranquicadas em fundo de sulco superior e hiperplasia fibrosa na regiao do 11 ao 13. Apesar do conteudo hemorragico de algumas ulceracoes, a hipotese inicial era de que essas alteracoes estariam vinculadas a ma adaptacao da protese e da paralisia hemifacial. Foi realizado reembasamento com resina macia. Apos 20 dias a paciente retornou com expressiva melhora do quadro clinico. Para um correto diagnostico das lesoes bucais a realizacao de uma anamnese detalhada e exame fisico minucioso sao fundamentais para determinar o diagnostico e assim a melhor conduta clinica do profissional.

Diagnosis of Oral Hairy Leukoplakia: The Importance of EBV In Situ Hybridization

Oral hairy leukoplakia (OHL) is caused by the Epstein-Barr virus (EBV), which has been related to HIV infection. In situ hybridization (ISH) is the gold-standard diagnosis of OHL, but some authors believe in the possibility of performing the diagnosis based on clinical basis. The aim of this study is diagnose incipient lesions of OHL by EBV ISH of HIV-infected patients and the possible correlations with clinical characteristics of the patients. Ninety-four patients were examined and those presenting with clinical lesions compatible to OHL were submitted to biopsy prior to EBV ISH. Twenty-eight patients had lesions clinically compatible to the diagnosis of OHL, but only 20 lesions were confirmed by EBV ISH. The patients with OHL had a mean age of 41.9 years and were HIV-infected for 11.2 years, on average, including CD4 count of 504.7 cells/mm3 and log10 viral load = 1.1. Among the quantitative variables, there was a statistically significant correlation with age only (P = 0.030). In conclusion, the presence of OHL in patients with HIV/AIDS results in changes in the epidemiological characteristics of the disease, and this fact allied with subtle clinical-morphological features makes clinical diagnosis very difficult. Therefore, EBV ISH is important for a definitive diagnosis of OHL.

Retrospective study of dental trauma in children with autism spectrum disorders: a paired study.

The objective was to evaluate the history of traumatic dental injury (TDI) among children with and without autism spectrum disorders (ASD) at the Centro Integrado de Educação Especial (CIES), in Teresina, Brazil. The dental records of 228 children, 114 with ASD (SG = study group) and 114 without ASD (CG = control group), paired by age, gender and socioeconomic characteristics between January 2007 and September 2014 were reviewed. Data were analyzed using chi-square test and multivariate logistic regression (alpha = 5.0%). Dental trauma in SG was lower than in the CG (24.6% and 41.2%, respectively, p = 0.007). The risk of trauma was lower among males in SG (OR: 0.35; 95%CI: 0.18 to 0.67). The likelihood of TDI in SG was 3.17 higher in females than that of males (p = 0.040). The prevalence of TDI was lower in ASD individuals compared to controls. Dental trauma was higher among ASD girls than ASD boys.