Sérgio Aparecido Ignácio

Effects of antidepressants and benzodiazepines on stimulated salivary flow rate and biochemistry composition of the saliva

OBJECTIVES To evaluate the effect of psychotropics on stimulated salivary flow rate (SSFR), total proteins, urea and calcium concentration, alpha-amylase activity, pH, saliva buffer capacity (SBC), and the prevalence of xerostomia in psychotropic users and its relationship with low SSFR and/or hyposalivation. STUDY DESIGN Thirty-three subjects were allocated to 4 groups: I (control): II (psychotropic users); III (subjects of group II using only selective serotonin reuptake inhibitors [SSRIs]); and IV (subjects of group II using SSRIs at recommended initial dose). The SBC was obtained by titrimetry and salivary composition by colorimetric method. RESULTS Group II presented a significant decrease (P = .0203), of 33.85% in SSFR compared with group I. Mean SSFR values in groups III and IV showed no significant difference compared with control group (P > .05). Xerostomia was observed in 37.50%, 38.46%, and 50% of subjects in groups II, III, and IV, respectively. Biochemical composition, pH, and SBC were not significantly affected (P > .05) by the use of psychotropics. CONCLUSIONS Xerostomia was associated with a decrease in SSFR and not with alterations in biochemical composition. Even when using the latest-generation drugs, there were complaints of xerostomia associated with decrease in SSFR.

Association between Vitamin D Receptor Gene Polymorphisms and Susceptibility to Chronic Kidney Disease and Periodontitis

Background/Aims: Chronic kidney disease (CKD) and periodontitis (PD) are serious public-health concerns. Vitamin D is a fat-soluble steroid hormone that interacts with its nuclear receptor (VDR) to regulate a variety of biological processes, such as bone metabolism, immune response modulation and transcription of several genes involved in CKD and PD disease mechanisms. The aim of this work was to investigate the association between polymorphisms in the VDR gene and end-stage renal disease (ESRD) and PD. Methods: 222 subjects with and without ESRD (in hemodialysis) were divided into groups with and without PD. Polymorphisms TaqI and BsmI in the VDR gene were analyzed by PCR restriction fragment length polymorphism. The significance of differences in allele, genotype and haplotype frequencies between groups was assessed by the χ2 test (p value <0.05) and odds ratio (OR). Results: Allele G was associated with protection against ESRD: groups without versus with ESRD (GG) × (GA+AA): OR = 2.5, 95% CI = 1.4–4.6, p = 0.00; (G × A): OR = 1.5, 95% CI = 1.0–2.3, p = 0.02; (TG + CG) × (TA + CA): OR = 1.5, 95% CI = 1.0–2.3, p = 0.02. No association was observed between the study polymorphisms and susceptibility to or protection against PD. Conclusion: Allele G of the VDR BsmI polymorphism was associated with protection against ESRD.

ORAL HEALTH IN BRAZILIAN PATIENTS WITH CHRONIC RENAL DISEASE

BACKGROUND Poor oral health status may have an impact on the health status of patients with chronic renal failure. AIM To describe the oral health status of a group of Brazilian patients with chronic renal failure. MATERIAL AND METHODS Retrospective review of the medical records of patients with chronic renal failure, of whom 13 (4.5%) were in a predialysis stage, 158 (55%) were on hemodialysis, 23 (8.4%) were on peritoneal dialysis and 92 (32.1%) were transplanted. General oral health, presence of dental calculus, and halitosis were recorded. The number of decayed, missed and filled teeth was analyzed by means of DMF-T (Decayed, Missed and Filled Teeth) index. RESULTS The sample was composed of 152 men (53%) and 134 women (47%), aged 42+/-13 years. Oral health status was considered defective in most patients (83%). Eighty-seven percent had dental calculus and 55% had halitosis. Transplant patients reported significantly less halitosis (40.2%) than the rest of the groups. The DMF-T for the whole population was 20.6 and had a positive correlation with age. CONCLUSIONS This group of patients with chronic renal failure presented a poor oral health status. Dental treatment programs for these patients should be implemented to avoid the exposure to dental pathogens.

Phenotypic evaluation of the effect of anaerobiosis on some virulence attributes of Candida albicans

The current assumption that Candida albicans is a facultatively anaerobic organism has been widely accepted since its recovery from anoxic sites became common. However, the link between anaerobiosis and virulence remains uncertain. This study investigated the differential cell-surface hydrophobicity (CSH) using a hydrocarbon/water partition technique and analysed the differential secretion rates of secretory aspartyl proteases (Saps), esterase, chondroitinase and haemolysins of C. albicans strains recovered from periodontal pockets and non-periodontium-related intra-oral sites. For the enzymic tests, all strains from both sets were grown under aerobic and anaerobic conditions and the harvested cells were inoculated onto suitable normal or pre-reduced culture media in the presence or absence of molecular oxygen, respectively. The results showed that no variations were perceptible for CSH and chondroitinase (P>0.05). The secretion rates of esterase and haemolysins strongly decreased in an anoxic environment (P<0.0001). However, a consistent increment (P<0.0001) in Sap secretion was detected when cultures were grown under anaerobic conditions. Based on these results, it is suggested that the oxygen concentration in the atmosphere surrounding cells exerts a variable influence on the virulence attributes of C. albicans.

Experimental Force Definition System for a New Orthodontic Retraction Spring

A new geometry of orthodontic retraction spring was experimentally studied through an electronic device (platform for measuring forces), using strain gauges that were adapted to cantilever beams. The sample consisted of 36 titanium-molybdenum springs, divided into three groups of 12 springs each. The springs were produced with different cross sections of 0.016 x 0.022 inch and 0.017 x 0.025 inch and with different angles between the extremities (120 degrees and 130 degrees). The springs were adapted to the platform in three different positions so that the force system developed by them could be known (horizontal forces, vertical forces, alpha-beta moments, and moment-to-force ratio M:F). The analysis of factorial variance and the Tukey honestly significant difference test were applied to verify the differences between the averages caused by three possible variation sources and the interactions between them. Regression analysis was also performed to obtain the spring rate. The results show the interactions between the three geometric variables, force magnitudes, and also the spring rates, which are compatible with the ones mentioned in the literature related to the subject. The spring rate was within the levels that are appropriate for clinical use (varying from beta = 33.1 gf/mm to beta = 43.9 gf/mm).

Analysis of the association of polymorphism in the osteoprotegerin gene with susceptibility to chronic kidney disease and periodontitis

BACKGROUND AND OBJECTIVE Chronic kidney disease (CKD) is a complex disorder, which results in several complications involving disturbance of mineral metabolism. Periodontal disease is an infectious disease that appears to be an important cause of systemic inflammation in CKD patients. Periodontal disease is characterized by clinical attachment loss (CAL) caused by alveolar bone resorption around teeth, which may lead to tooth loss. Osteoprotegerin (OPG) is a key regulator of osteoclastogenesis. Polymorphisms are the main source of genetic variation, and single nucleotide polymorphisms (SNPs) have been reported as major modulators of disease susceptibility. The aim of this study was to investigate the association of a polymorphism located at position -223 in the untranslated region of the OPG gene, previously known as -950, with susceptibility to CKD and periodontal disease. MATERIAL AND METHODS A sample of 224 subjects without and with CKD (in hemodialysis) was divided into groups with and without periodontal disease. The OPG polymorphism was analyzed by polymerase chain reaction and restriction fragment length polymorphism. RESULTS No association was found between the studied OPG polymorphism and susceptibility to CKD or periodontal disease. CONCLUSION It was concluded that polymorphism OPG-223 (C/T) was not associated with CKD and periodontal disease in a Brazilian population. Studies on other polymorphisms in this and other genes of the host response could help to clarify the involvement of bone metabolism mediators in the susceptibility to CKD and periodontal disease.

Correlation between morphology and function of the upper lip: a longitudinal evaluation

In order to evaluate the relationship between the morphology of the upper lip and muscle activity in a sample of 38 subjects (17 males and 21 females) with Angle Class II division 1 malocclusions, cephalometric and electromyographic analyses were conducted. The sample was subdivided into either predominantly nose or mouth breathers. The individuals were evaluated at two different periods, with a 2 year interval. At the first observation, the subjects were 11 years to 14 years 11 months of age and at the second observation, 13 years 4 months to 16 years 6 months of age. Height and thickness of the upper lip were measured on lateral cephalograms with the aid of a digital pachymeter. For each individual, electromyographic records were obtained of the orbicularis oris superior muscle at rest and in a series of 12 movements. The electromyographic data were normalized as a function of amplitude, for achievement of the percentage value of each movement. Pearson and Spearman correlation tests were applied. The results showed some correlation between morphology and muscle function (at a confidence level of 95 per cent). However, as the values of the correlation coefficient (r) were too low to establish associations between variables, it was concluded that the dimensions of the upper lip are not correlated with muscle activity.

Clinical diagnosis of hyposalivation in hospitalized patients

Objective The aim of this study was to evaluate the effectiveness of clinical criteria for the diagnosis of hyposalivation in hospitalized patients. Material and Methods A clinical study was carried out on 145 subjects (48 males; 97 females; aged 20 to 90 years). Each subject was clinically examined, in the morning and in the afternoon, along 1 day. A focused anamnesis allowed identifying symptoms of hyposalivation, like xerostomia complaints (considered as a reference symptom), chewing difficulty, dysphagia and increased frequency of liquid intake. Afterwards, dryness of the mucosa of the cheecks and floor of the mouth, as well as salivary secretion during parotid gland stimulation were assessed during oral examination. Results Results obtained with Chi-square tests showed that 71 patients (48.9%) presented xerostomia complaints, with a significant correlation with all hyposalivation symptoms (p<0.05). Furthermore, xerostomia was also significantly correlated with all data obtained during oral examination in both periods of evaluation (p<0.05). Conclusion Clinical diagnosis of hyposalivation in hospitalized patients is feasible and can provide an immediate and appropriate therapy avoiding further problems and improving their quality of life.

Identification and quantification of monomers released from dental composites using HPLC

The aim of this study was to detect and quantify the main residual monomers released from composites, using high performance liquid chromatography (HPLC). Discs were made with dental composites (Herculite XRV, Tetric Ceram and Filtek Z250) and immersed in deionized water at 37oC for 28 days, with water changes in 1, 7, 14 and 21 days. The mean concentration of residual monomers were subject to the Kruskal-Wallis test (p<0.05). Tetric Ceram exhibited significantly higher concentrations of leached monomers. Bis-GMA was the monomer released in lower concentrations for all the materials. There was no statistical difference between the amounts of TEGDMA and UDMA. Most of the monomers demonstrated maximal concentration at the 7-day period. The HPLC analysis identified Bis-GMA, TEGDMA and UDMA in detectable quantities for all the tested composites.

Bixin Action in the Healing Process of Rats Mouth Wounds

Oral lesions that manifest as ulcer lesions are quite common and can cause discomfort to the patient. Searching for drugs to accelerate the healing of these lesions is nonstop process. Bixin is a molecule found in annatto (urucum) seeds and is considered a viable therapeutic option to treat such lesions due to its anti-inflammatory, anti-oxidant, and healing properties. Therefore, the present study aimed to evaluate the effect of the bixin solution in the ulcer healing process in the oral mucosa of rats. Ulcers were induced with punches of 0.5 cm in the middle of the dorsum of the tongue of 64 Wistar rats. The animals were randomly divided into 8 groups, in which 4 groups were treated with saline solution, while the other 4 were treated with the bixin solution. The animals were sacrificed in the periods 2, 7, 14, and 21 days after the beginning of the treatment. The species were histologically processed and stained with hematoxylin/eosin and picrosirius. Fibroblasts, reepithelialization, and wound contraction could be observed, as could the quantification of neutrophils, macrophages, plasma cells, lymphocytes, and mature and immature collagen. On the seventh day, the experimental group, when compared to the control group, presented a higher proliferation of fibroblasts, more advanced reepithelialization, and a higher contraction in the wounds. A reduction in the average number of neutrophils in the experimental group, when compared to the control group, could be observed in all periods (p=0.000). Up to two days, the total collagen area was higher (p=0.044) in the experimental group (4139.60±3047.51t han in the control group (1564.81±918.47). The deposition of mature collagen, on the 14(th) day, was higher (p=0.048) in the experimental group (5802.40±3578.18) than in the control group (1737.26±1439.97). The results found in the present study indicate that the bixin solution inhibits the acute inflammatory response with a minor average number of neutrophils and accelerates reepithelialization, wound contraction and collagen maturation, thus illustrating that this solution does in fact represent an important adjuvant in the treatment of ulcers.