Rubenice Amaral da Silva

Oral and maxillofacial biopsied lesions in Brazilian pediatric patients: A 16-year retrospective study

PURPOSE: To survey oral and maxillofacial lesions biopsied in a Brazilian pediatric hospital. METHODS: Biopsy records over a 16-year period (1992-2008) were retrieved from the files of the Anatomy and Pathology Service, Hospital Presidente Dutra, Federal University of Maranhao, Brazil. Pediatric cases patients aged 16 years old or younger were selected. Oral and maxillofacial diagnoses were grouped into 10 categories, and lesions were evaluated for age, gender, anatomic location and pathological diagnosis. Data were analyzed using descriptive statistics. RESULTS: Of a total of 3,550 pediatric biopsies, 88 cases (2.48%) were located in oral or maxillofacial sites. Similar incidence rates were observed between the genders and the prevalence of lesions was highest in the permanent dentition period (>12-16 years old). Maxilla was the most commonly affected anatomic location. As regards the diagnostic categories, the highest number of lesions was in the hyperplastic/reactive category. The most frequently encountered lesions were inflammatory fibrous hyperplasia and mucocele. Malignant lesions were rarely described. CONCLUSION: This study shows a similar trend to that reported in previous studies on the most frequent oral and maxillofacial lesions found in the pediatric population. The majority of lesions detected were benign, and malignant lesions were diagnosed in a very low number of patients.

streptococcus mutans : Examining Factors Underlying Bacterial Colonizationin Mother-child Dyads and Early Childhood Caries: Examining Factors Underlying Bacterial Colonization

This study investigated the association between colonization of mother-child dyads with Streptococcus mutans (SM) and early childhood caries (ECC), with consideration of the mediator and confounders, using a theoretical model. Four hundred mothers and their children from São Luís, Brazil, were included in the study. A diagram based on directed acyclic graphs was elaborated to analyze the association between SM colonization of the mother, mediated by child SM, and ECC. Other maternal (socioeconomic, waist circumference, sugar consumption, DMFT index, and visible plaque) and child factors (sugar consumption, visible plaque, and child age) composed the theoretical model. A total effect model (maternal SM on ECC) and a direct effect model, adjusted by the mediation effect of child SM (maternal SM via child SM) on ECC, were analyzed. The outcome of interest in this study was ECC (number of teeth with caries experience, dmft), which was analyzed as a discrete variable by Poisson regression. The Paramed test was used to analyze mediation. The following variables were associated with ECC in the total effect model: maternal SM, maternal waist circumference ≥80 cm, DMFT, maternal visible plaque, child age ≥4 years, and increased sugar consumption of the child (>3 times/day). In the direct effect model, high maternal SM levels remained associated with ECC, while moderate and high colonization of the child with SM was also associated with ECC. Child SM colonization just partially mediated the effect of maternal SM on ECC (33%). Thus, factors other than the mechanism of bacterial colonization should be considered in mother-child dyads, including eating habits, oral hygiene practices, and a family history of caries.

Proinflammatory cytokines in early childhood caries: Salivary analysis in the mother/children pair

HighlightsHigh consumption of added sugars has been associated with caries and obesity.VEGF were correlated with caries, waist circumference and sugar intake in mothers.IL‐6 are correlated with the severity of caries in the mother‐children pair. &NA; Hypothesis: Proinflammatory cytokines are increased in saliva of mother/children pairs with caries. Design: Case‐control study involving caries‐free children (n = 20) and children with early childhood caries (ECC) (n = 20), and their mothers (n = 40). The maternal variables analyzed were waist circumference (WC), decayed, missing and filled teeth (DMFT) and sugar intake; and in the children were body mass index (BMI), def‐t and sugar intake. Salivary levels of VEGF, IL‐6 and TNF‐&agr; were analyzed of mother/children pairs. Results: In the mothers, salivary VEGF levels were correlated with DMFT (r = 0.35; p = .03), WC (r = 0.35; p = .02), and sugar intake (r = 0.32; p = .04). Higher salivary IL‐6 levels were also correlated with maternal DMFT (r = 0.45; p = .004) and WC (r = 0.32; p = .04). In the children, higher salivary VEGF levels were correlated with higher def‐t scores (r = 0.42; p = .008). Children with caries had a 63% higher median salivary VEGF and twofold higher mean IL‐6 levels compared to caries‐free children. Mothers of children with ECC showed higher mean of salivary IL‐6 levels compared to those of children without ECC (p = .03). Conclusion: Salivary proinflammatory cytokines are correlated with the severity of caries in the mother‐children pair. Obesity and excessive sugar consumption seem to underlie the associations between proinflammatory cytokines and caries in the family environment.

Serum levels of proinflammatory cytokines are high in early childhood caries

HighlightsObesity has been consistently associated with caries in children.Daily consumption of added sugars has been associated to caries and obesity.High intake of sugar‐sweetened beverages may result in systemic inflammation.Proinflammatory cytokines (IL‐6, TNF‐&agr;, NGAL) are high in children with caries.Caries in children may be a clinical signal of underlying systemic inflammation. Abstract It is unknown whether serum levels of proinflammatory cytokines would be high in children with early childhood caries (ECC). This study investigated the association between serum levels of proinflammatory cytokines and severity of caries in preschoolers younger than 72 months. A case‐control study was performed with a random sample of 72 children with ECC and 80 caries‐free children. The explanatory variables were serum levels of proinflammatory cytokines (IL‐6, TNF‐&agr;, and NGAL) and the outcome was severity of ECC (number of decayed teeth). The crude analyses were used to estimate the association between each cytokine and ECC. Then, the analyses were adjusted for socioeconomic factors, excess weight and sugar sweetened beverages consumption using Poisson regression models. The estimated coefficients were expressed as Means Ratio (MR), with 95% confidence intervals (CI). In the crude analyses, the highest tertiles of IL‐6 (MR = 1.47, IC = 1.09–2.00, p = 0.012), TNF‐&agr; (MR = 1.33, CI = 1.00–1.78, p = 0.040) and NGAL (MR = 2.20, CI = 1.39–3.49, p = 0.001) were associated to ECC. After adjustment, the highest tertiles of IL‐6 levels (MR = 1.54, IC = 1.13–2.10, p = 0.005), and NGAL (MR = 1.71, CI = 1.04–2.80, p = 0.032) remained associated to ECC; while TNF‐&agr; was no longer associated to ECC (MR = 1.31, CI = 0.98–1.75, p = 0.066). Higher serum levels of proinflammatory cytokines were associated to severity of caries in preschoolers, suggesting that chronic inflammation underlies ECC.