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Rocha de Oliveira LQ, de Souza Nicolau HC, Barbosa Martelli DR, Martelli-Júnior H, Scariot R, Ayroza Rangel ALC, de Almeida Reis SR, Coletta RD, Machado RA. Ethnic Differences in the Brazilian Population Influence the Impact of BMP4 Genetic Variants on Susceptibility of Nonsyndromic Orofacial Clefts. Cleft Palate Craniofac J 2024; 61:1701-1712. [PMID: 37272066 DOI: 10.1177/10556656231180086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
OBJECTIVE The study evaluated the association of BMP4 tag-SNPs and SNP-SNP interactions involving genes active by BMP4 pathway during craniofacial development in the susceptibility of nonsyndromic orofacial clefts (NSOC) in the Brazilian population. DESIGN Case-control study. SETTING Brazilian Oral Cleft Group. PARTICIPANTS The study included 881 healthy controls and 800 patients with different types of NSOC: 232 with cleft lip only (NSCLO), 568 with cleft lip and palate (NSCLP), and 274 with cleft palate only (NSCPO). INTERVENTIONS The genomic DNA was genotyped with allelic discrimination assays for five BMP4 tag-SNPs (rs11623717, rs17563, rs2071047, rs2761887 and rs4898820), and analyzed their allelic and genotypic associations using multiple logistic regression. The interactions of these variants with genes involved in the BMP4 signaling pathway, including FGFR1, GREM1, NOG, VAX1 and the 4p16.2 locus, were explored. MAIN OUTCOME MEASURES BMP4 variants in the NSOC risk. RESULTS Although only nominal p values were identified when the whole sample was considered, subgroup analysis including the patients with high African genomic ancestry showed significant associations of rs2761887 with risk for nonsyndromic cleft lip with or without cleft palate (NSCL ± P)[(ORhom: 2.16; 95% CI: 1.21-3.85; p = 0.01) and (ORrec: 2.05; 95% CI: 1.21-3.47; p = 0.006)]. Thirteen significant SNP-SNP interactions involving BMP4 and the SNPs at FGFR1, GREM1, NOG and VAX1 and at locus 4p16.2 for increased risk of NSCL ± P were identified. CONCLUSIONS Our results demonstrate an increased risk of NSCL ± P in Brazilian individuals with enrichment of African ancestry in the presence of the BMP4 rs2762887 polymorphism, and reveal relevant genetic contribution of SNP-SNP epistatic interactions involving BMP4 variants to NSCL ± P risk.
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Affiliation(s)
| | | | | | - Hercílio Martelli-Júnior
- Stomatology Clinic, Dental School, State University of Montes Claros, Montes Claros, Minas Gerais, Brazil
- Center for Rehabilitation of Craniofacial Anomalies, Dental School, University of Professor Edson Antônio Velano, Alfenas, Minas Gerais, Brazil
| | - Rafaela Scariot
- Department of Oral and Maxillofacial Surgery, School of Health Science, Federal University of Paraná, Curitiba, Brazil
| | - Ana Lúcia Carrinho Ayroza Rangel
- Center of Biological Sciences and of the Health, School of Dentistry, State University of Western Paraná, Cascavel, Paraná, Brazil
| | | | - Ricardo D Coletta
- Graduate Program in Oral Biology, School of Dentistry, University of Campinas, Piracicaba, São Paulo, Brazil
- Department of Oral Diagnosis, School of Dentistry, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Renato Assis Machado
- Graduate Program in Oral Biology, School of Dentistry, University of Campinas, Piracicaba, São Paulo, Brazil
- Department of Oral Diagnosis, School of Dentistry, University of Campinas, Piracicaba, São Paulo, Brazil
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Korczeniewska OA, Dakshinamoorthy J, Prabhakar V, Lingaiah U. Genetics Affecting the Prognosis of Dental Treatments. Dent Clin North Am 2024; 68:659-692. [PMID: 39244250 DOI: 10.1016/j.cden.2024.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2024]
Abstract
Genetics plays a significant role in determining an individual's susceptibility to dental diseases, the response to dental treatments, and the overall prognosis of dental interventions. Here, the authors explore the various genetic factors affecting the prognosis of dental treatments focusing on dental caries, orthodontic treatment, oral cancer, prosthodontic treatment, periodontal disease, developmental disorders, pharmacogenetics, and genetic predisposition to faster wound healing. Understanding the genetic underpinnings of dental health can help personalize treatment plans, predict outcomes, and improve the overall quality of dental care.
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Affiliation(s)
- Olga A Korczeniewska
- Department of Diagnostic Sciences, Center for Orofacial Pain and Temporomandibular Disorders, Rutgers School of Dental Medicine, Rutgers, The State University of New Jersey, 110 Bergen Street, Room D-880, Newark, NJ 07101, USA
| | - Janani Dakshinamoorthy
- GeneAura Pvt. Ltd, AP1166, 4th street, Anna Nagar, Thendral Colony, Chennai 600040, India.
| | - Vaishnavi Prabhakar
- Department of Dental Sciences Dr. M.G.R. Educational And Research Institute Periyar E.V.R. High Road, (NH 4 Highway) Maduravoyal, Chennai 600095, India
| | - Upasana Lingaiah
- Upasana Lingaiah, Department of Oral Medicine and Radiology, V S Dental College and Hospital, Room number 1, K R Road, V V Puram, Bengaluru, Karnataka 560004, India
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Lafuente-Ibáñez-de-Mendoza I, Marichalar-Mendia X, Setién-Olarra A, García-de-la-Fuente AM, Martínez-Conde-Llamosas R, Aguirre-Urizar JM. Genetic polymorphisms of inflammatory and bone metabolism related proteins in a population with dental implants of the Basque Country. A case-control study. BMC Oral Health 2024; 24:659. [PMID: 38840172 PMCID: PMC11155173 DOI: 10.1186/s12903-024-04319-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 05/02/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Peri-implantitis (PI) is a frequent inflammatory disorder characterised by progressive loss of the supporting bone. Not all patients with recognised risk factors develop PI. The aim of this study is to evaluate the presence of single nucleotide polymorphisms (SNP) of inflammatory and bone metabolism related proteins in a population treated with dental implants from the Basque Country (Spain). METHODS We included 80 patients with diagnosis of PI and 81 patients without PI, 91 women and 70 men, with a mean age of 60.90 years. SNPs of BMP-4, BRINP3, CD14, FGF-3, FGF-10, GBP-1, IL-1α, IL-1β, IL-10, LTF, OPG and RANKL proteins were selected. We performed a univariate and bivariate analysis using IBM SPSS® v.28 statistical software. RESULTS Presence of SNPs GBP1 rs7911 (p = 0.041) and BRINP3 rs1935881 (p = 0.012) was significantly more common in patients with PI. Patients with PI who smoked (> 10 cig/day) showed a higher presence of OPG rs2073617 SNP (p = 0.034). Also, BMP-4 rs17563 (p = 0.018) and FGF-3 rs1893047 (p = 0.014) SNPs were more frequent in patients with PI and Type II diabetes mellitus. CONCLUSIONS Our findings suggest that PI could be favoured by an alteration in the osseointegration of dental implants, based on an abnormal immunological response to peri-implant infection in patients from the Basque Country (Spain).
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Affiliation(s)
- Irene Lafuente-Ibáñez-de-Mendoza
- Research Group: GIU21/042, University of the Basque Country (UPV/EHU), Leioa, Spain
- Department of Stomatology, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, Leioa, 48940, Spain
| | - Xabier Marichalar-Mendia
- Research Group: GIU21/042, University of the Basque Country (UPV/EHU), Leioa, Spain.
- Department of Nursery I, Barrio Sarriena s/n, Leioa, 48940, Bizkaia, Spain.
- Biobizkaia Health Research Institute, Barakaldo, Spain.
| | - Amaia Setién-Olarra
- Research Group: GIU21/042, University of the Basque Country (UPV/EHU), Leioa, Spain
- Department of Nursery I, Barrio Sarriena s/n, Leioa, 48940, Bizkaia, Spain
| | - Ana María García-de-la-Fuente
- Research Group: GIU21/042, University of the Basque Country (UPV/EHU), Leioa, Spain
- Department of Stomatology, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, Leioa, 48940, Spain
| | | | - José Manuel Aguirre-Urizar
- Research Group: GIU21/042, University of the Basque Country (UPV/EHU), Leioa, Spain
- Department of Stomatology, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, Leioa, 48940, Spain
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Zhao Z, Wang H, Li X, Hou J, Yang Y, Li H. Comprehensive analysis of DNA methylation for periodontitis. Int J Implant Dent 2022; 8:22. [PMID: 35491409 PMCID: PMC9058047 DOI: 10.1186/s40729-022-00420-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 04/11/2022] [Indexed: 11/26/2022] Open
Abstract
Background Periodontitis is an infectious disease, and a risk factor for peri-implantitis that could result in the implant loss. DNA methylation has an essential role in the etiology and pathogenesis of inflammatory disease. However, there is lack of study on methylation status of genes in periodontitis. This study sought to explore the gene methylation profiling microarray in periodontitis. Methods Through searching in the Gene Expression Omnibus database, a gene methylation profiling data set GSE173081 was identified, which included 12 periodontitis samples and 12 normal samples, respectively. Thereafter, the data of GSE173081 was downloaded and analyzed to determined differentially methylated genes (DMGs), which then were used to perform Gene Ontology analysis and pathway enrichment analyses through online database. In addition, the DMGs were applied to construct the protein–protein interaction (PPI) network information, predict the hub genes in pathology of periodontitis. Results In total 668 DMGs were sorted and identified from the data set, which included 621 hypo-methylated genes and 47 hyper-methylated genes. Through the function and ontology analysis, these 668 genes are mainly classified into intracellular signaling pathway, cell components, cell–cell interaction, and cellular behaviors. The pathway analysis showed that the hypo-methylated genes were mostly enriched in the pathway of cGMP–PKG signaling pathway; RAF/MAP kinase; PI3K–Akt signaling pathway, while hyper-methylated genes were mostly enriched in the pathway of bacterial invasion of epithelial cells; sphingolipid signaling pathway and DCC mediated attractive signaling. The PPI network contained 630 nodes and 1790 interactions. Moreover, further analysis identified top 10 hub genes (APP; PAX6; LPAR1; WNT3A; BMP2; PI3KR2; GATA4; PLCB1; GATA6; CXCL12) as central nodes that are involved in the immune system and the inflammatory response. Conclusions This study provides comprehensive information of methylation status of genes to the revelation of periodontitis pathogenesis that may contribute to future research on periodontitis. Supplementary Information The online version contains supplementary material available at 10.1186/s40729-022-00420-8.
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Küchler EC, Hannegraf ND, Lara RM, Reis CLB, Oliveira DSBD, Mazzi-Chaves JF, Ribeiro Andrades KM, Lima LFD, Salles AG, Antunes LAA, Sousa-Neto MD, Antunes LS, Baratto-Filho F. Investigation of Genetic Polymorphisms in BMP2, BMP4, SMAD6, and RUNX2 and Persistent Apical Periodontitis. J Endod 2020; 47:278-285. [PMID: 33245975 DOI: 10.1016/j.joen.2020.11.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/17/2020] [Accepted: 11/11/2020] [Indexed: 11/18/2022]
Abstract
INTRODUCTION This study aimed to evaluate the interplay among single-nucleotide polymorphisms (SNPs) in the encoding genes BMP2, BMP4, SMAD6, and RUNX2 in persistent apical periodontitis (PAP). METHODS In this multicentric study, 272 patients diagnosed with pulp necrosis with apical periodontitis before root canal therapy who attended regular follow-up visits for at least 1 year were screened. Periapical radiographs and clinical aspects were evaluated, and the participants were classified as PAP (n = 110) or repaired (n = 162). Genomic DNA was used for the genotyping of the following SNPs: rs1005464 and rs235768 in bone morphogenetic protein 2 (BMP2), rs17563 in bone morphogenetic protein 4 (BMP4), rs2119261 and rs3934908 in SMAD family member 6 (SMAD6), and rs59983488 and rs1200425 in runt-related transcription factor 2 (RUNX2). The chi-square test was used to compare genotype distributions between groups. The multifactor dimensionality reduction method was applied to identify SNP-SNP interactions. The alpha for all the analysis was 5%. RESULTS The multifactor dimensionality reduction suggested the rs235768 in BMP2 and rs59983488 in RUNX2 as the best SNP-SNP interaction model (cross-validation = 10/10, testing balanced accuracy = 0.584, P = .026) followed by rs17563 in BMP4 and rs2119261 in SMAD6 (cross validation = 10/10, testing balanced accuracy = 0.580, P = .031). In the rs235768 in BMP2 and rs59983488 in RUNX2 model, the high-risk genotype was TT + TT (odds ratio = 4.36; 95% confidence interval, 0.44-42.1). In model rs17563 in BMP4 and rs2119261 in SMAD6, GG + TT (odds ratio = 2.63; 95% confidence interval, 0.71-11.9) was the high-risk genotype. CONCLUSIONS The interactions between rs235768 in BMP2 and rs59983488 in RUNX2 and between rs17563 in BMP4 and rs2119261 in SMAD6 are associated with PAP, suggesting that an interplay of these SNPs is involved in the higher risk of developing PAP.
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Affiliation(s)
- Erika Calvano Küchler
- Department of Pediatric Dentistry, School of Dentistry of Ribeirao Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
| | | | - Rafaela Mariana Lara
- Department of Pediatric Dentistry, School of Dentistry of Ribeirao Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Caio Luiz Bitencourt Reis
- Department of Clinic and Surgery, School of Dentistry, Federal University of Alfenas, Minas, Gerais, Brazil
| | | | - Jardel Francisco Mazzi-Chaves
- Department of Restorative Dentistry Department, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Kesly Mary Ribeiro Andrades
- Department of Restorative Dentistry Department, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Lorena Ferreira de Lima
- Department of Pediatric Dentistry, School of Dentistry of Ribeirao Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Alessandro Guimarães Salles
- Postgraduate Program in Dentistry of Health Institute of Nova Friburgo from the Fluminense Federal University; and Postgraduate Program in Dentistry, School of Dentistry, Fluminense Federal University from the Fluminense Federal University, Nova Friburgo, Rio de Janeiro, Brazil
| | - Livia Azeredo Alves Antunes
- Postgraduate Program in Dentistry of Health Institute of Nova Friburgo from the Fluminense Federal University; and Postgraduate Program in Dentistry, School of Dentistry, Fluminense Federal University from the Fluminense Federal University, Nova Friburgo, Rio de Janeiro, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry Department, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Leonardo Santos Antunes
- Postgraduate Program in Dentistry of Health Institute of Nova Friburgo from the Fluminense Federal University; and Postgraduate Program in Dentistry, School of Dentistry, Fluminense Federal University from the Fluminense Federal University, Nova Friburgo, Rio de Janeiro, Brazil
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Roelandt MA, Devriendt K, de Llano-Pérula MC, Raes M, Willems G, Verdonck A. Dental and Craniofacial Characteristics in Patients With 14Q22.1-Q22.2 Deletion: A Case Series. Cleft Palate Craniofac J 2020; 58:505-513. [PMID: 33063524 DOI: 10.1177/1055665620954090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This case series is a follow-up report focusing on dental and facial characteristics in patients with a rare microdeletion in chromosome 14q22.1-q22.2. Usually, these patients have severe ocular, brain, and digital abnormalities. However, this case series shows that clinical presentation can be mild. Four relatives spanning 3 generations were diagnosed with a familial autosomal dominant 2.79 Mb microdeletion in chromosome 14q22.1-q22.2. Genetic screening was done by the Bacterial Artificial Chromosome array-comparative genome hybridization and was confirmed by the fluorescence in situ hybridization technique. Dental and craniofacial data were collected from medical files, clinical examinations, clinical photos, panoramic and cephalometric radiographs, and dental casts. Written informed consent for scientific use was obtained for all family members. No larger syndrome could be identified. All cases had similar facial red flag characteristics, consisting of a long face with retrognathia and open mouth relation, associated oral clefts in varying degrees, depressed nasal bridge, delayed tooth development, hypertelorism, and low-set angular ears. The dental casts showed a distal molar occlusion and a lack of space in the dental arches. Developmental delay was noted together with limb defects such as poly- and syndactyly. Microphthalmia and hearing loss were present in the most severe cases. This rare congenital disorder, associated with facial dysmorphia, oral clefts, and tooth agenesis, can remain undiagnosed until adulthood. A family history of short stature, developmental delay, poly- or syndactyly, and micropthalmia are suggestive features. Similar reports help to raise awareness among dental practitioners, leading to an early genetic diagnosis.
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Affiliation(s)
- Marie Anne Roelandt
- Department of Oral Health Sciences-Orthodontics, 60182KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | | | - Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, 60182KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Margot Raes
- Department of Oral Health Sciences-Orthodontics, 60182KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Guy Willems
- Department of Oral Health Sciences-Orthodontics, 60182KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Anna Verdonck
- Department of Oral Health Sciences-Orthodontics, 60182KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium.,Multidisciplinary Cleft Lip and Palate Team, University Hospitals Leuven, Leuven, Belgium
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Carinci F, Romanos GE, Scapoli L. Molecular tools for preventing and improving diagnosis of peri-implant diseases. Periodontol 2000 2019; 81:41-47. [PMID: 31407432 DOI: 10.1111/prd.12281] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Peri-implantitis is an inflammatory disease of tissues surrounding osseointegrated dental implants. Inflammation affecting soft and hard peri-implant tissues can cause alveolar bone resorption and subsequent implant loss. Clinical surveillance and early diagnosis are of paramount importance to reduce clinical failures and improve implant survival. Current diagnosis of implants is based on clinical and radiological signs. Molecular tests are an emerging diagnostic methodology, which potentially can help to detect and prevent early peri-implantitis and monitor the efficacy of therapy as well. A plethora of potential biomarkers are potentially available to support the clinical diagnosis of peri-implantitis. However, conflicting diagnostic conclusions have been reached, probably related to weak statistical results due to limited sample size or disease heterogeneity. The present paper reviews candidate diagnostic biomarkers for peri-implantitis, including infective agents, genetic susceptibility factors, and key proteins related to inflammation and tissue remodeling.
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Affiliation(s)
- Francesco Carinci
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Georgios E Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Luca Scapoli
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
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Chen X, Zhao Y. Genetic Involvement in Dental Implant Failure: Association With Polymorphisms of Genes Modulating Inflammatory Responses and Bone Metabolism. J ORAL IMPLANTOL 2019; 45:318-326. [PMID: 31207194 DOI: 10.1563/aaid-joi-d-18-00212] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Implant loss is the most serious complication of dental implants. Although the problems and causes behind the implant failure are clearly defined today, determination of the underlying causes of failure varies by the case. The clusterization phenomenon of implant loss (multiple implant failures) implies the existence of genetic risk factors. Inflammation has a critical effect on osseointegration and implant success. Peri-implantitis is an inflammatory disease of tissue supporting the tooth or implant. Inflammation leads to loss of support tissue, particularly bone, resulting in failure of implants. A single nucleotide polymorphism (SNP) of pro-inflammatory mediator genes may affect their expression levels or amino acid sequence, and, consequently, the host inflammatory response. Since the end of the past century, many studies have been conducted to investigate the association of SNP with implant failure and related conditions. Involvement of several groups of genes-including interleukins, tumor necrosis factor-α, matrix metalloproteinases, and growth factors involved in immune regulation, inflammatory response, and bone metabolism-has been explored. Some have been found to be associated with implant loss and considered potential genetic risk factors for implant failure. In this review, we summarize results of recent studies of impact of genetic factors on dental implant failure.
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Affiliation(s)
- Xun Chen
- Department of Prosthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, People's Republic of China
| | - Yu Zhao
- Department of Prosthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, People's Republic of China
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Casado PL, Quinelato V, Cataldo P, Prazeres J, Campello M, Bonato LL, Aguiar T. Dental genetics in Brazil: Where we are. Mol Genet Genomic Med 2018; 6:689-701. [PMID: 30078197 PMCID: PMC6160708 DOI: 10.1002/mgg3.457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 07/12/2018] [Indexed: 12/11/2022] Open
Abstract
Dentistry constitutes the basic nucleus of professionals of higher level of health in Brazil with one of the largest concentrations of dentists per capita in the world. However, the genetic in dentistry in Brazil is explored, basically, in research field. Future actions need to be performed in order to deep the whole knowledge about diagnosis and treatment of diseases with genetic basis in dentistry, in Brazil.
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Affiliation(s)
| | | | | | | | | | | | - Telma Aguiar
- Universidade Federal Fluminense, Niterói, Brazil
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