Desnutrição energético-protéica e cárie dentária na primeira infância

Antimicrobial Efficacy of Propolis-Containing Varnish in Children: A Randomized and Double-Blind Clinical Trial

Dental caries is a sugar-dependent condition common in childhood, which causes microbiological imbalance in dental biofilm. The present study evaluated the antimicrobial efficacy of a 2.5% Brazilian Red Propolis (BRP) dental varnish to prevent caries in children. Seventy-five children with high caries risk, aged between 36 and 71 months and with no caries, were assigned to three groups to receive varnish treatment containing 2.5% BRP, 1% chlorhexidine, or 5% fluoride. The varnish was applied to the occlusal surfaces of the deciduous second molars on the first day of treatment (D1), after 90 days (D90), and 180 days of the start of treatment (D180). Saliva was collected to assess S. mutans before each varnish application and 180 days at the end of treatment (D360). Values were expressed in log10 (CFU/mL). Statistics were performed by applying repeated measures of variance analysis, Tukey's multiple comparisons test, and paired t-test. In the first dilution (1 : 10), there was microbial load reduction at the following periods: BRP in D0-D90 (p < 0.05) and D0-D180 (p < 0.01); fluoride in D0-D90 (p < 0.001); and chlorhexidine in D0-D180 (p < 0.05). In the second dilution (1 : 100), there was microbial load reduction in the groups at the following periods: BRP in D0-D90 (p < 0.05) and D0-D180 (p < 0.01); fluoride in D0-D180 (p < 0.05), and chlorhexidine in D0-180 (p < 0.01) and D0-360 (p < 0.05). The 2.5% BRP dental varnish was effective in decreasing S. mutans colonies in saliva when used within 90 days.

Evaluation of vitamin D status bone mineral density and dental health in children with cholestasis

BACKGROUND

Hepatic osteodystrophy caused by vitamin D and calcium malabsorption is thought to develop in children with cholestatic liver disease leading to secondary hyperparathyroidism and rickets or osteomalacia. The aim of this study was to evaluate the dental and bone mineral densities and the serum level of vitamin D in cholestatic infants and children and to correlate this process with clinical and laboratory parameters.

METHODS

This is a cross-sectional study that include 50 patients presenting with cholestasis. Thirty age and sex matched controls recruited not complaining of liver disease. All cases were subjected to full history taking, clinical and dental examination, 25(OH)D level, ALT, AST, bilirubin, albumin, GGT, alkaline phosphatase, PT, INR, calcium, corrected calcium, phosphorus and DXA scan to those above 5 years old. Controls were subjected to measuring the serum levels of 25(OH)D, total bilirubin, direct bilirubin, ALT, GGT, AST, PT, INR, alkaline phosphatase, albumin, calcium and phosphorus.

RESULTS

Out of the 50 cases; 23 were females (46%), with a mean age of 6.17±3.9 years ranging from 1.1 to 17 years. Twenty-eight of the cases had signs of rickets (56%), 6 of them had bone fracture (12%) and 42.8% had milky teeth caries. The level of 25(OH) vitamin D was below normal range in around half of the patients. There was significant difference between cases and controls in calcium and phosphorus levels, ALT and alkaline phosphatase. Low bone mineral density (BMD) was present in 50% and 5 cases (17.9%) were diagnosed as having osteoporosis. There was a negative correlation between the Z-score, BMD of total body, BMD and bone mineral content (BMC) of spine and total and direct bilirubin. There was a positive correlation between (BMD of total body, spine and BMC of spine) and serum phosphorus, alkaline phosphatase and albumin. There was a positive correlation between the Z-score of total body and serum calcium.

CONCLUSION

Decreased level of 25-OH vitamin D is present in more than half of cholestatic patients, and is correlated positively to serum calcium. Decreased BMD was present in more than half of studied cholestatic patients correlated to the low serum calcium rather than the vitamin D level. The decreased BMD and the dental affection in cholestatic children is related to the level of hyperbilirubinemia.

Use of low-level laser therapy on children aged 1 to 5 years with energy-protein malnutrition: A clinical trial

BACKGROUND

Episodes of malnutrition in early childhood can produces alterations in the salivary glands. The investigation of mechanisms that can reduce the impact of malnutrition on the defenses of the organism is of the utmost important and interest to public health. The aim of this study is to evaluate the effect of low-level laser on the saliva of children aged 1 to 5 years with energy-protein malnutrition.

METHODS

Mandatory inclusion criteria are diagnosis of malnutrition. The sample will consist of 50 men and women malnourished children aged 12 to 71 months. Saliva will be collected and the volume of saliva will be measured and the salivary flow rate will be determined (mL/min). Concentrations of salivary IgA in all samples will be measured using a commercial Enzyme-Linked Immunosorbent Assay (ELISA) kit. Low-level laser (laser diode) will be administered in the region of the parotid glands bilaterally as well as in the regions of the submandibular and sublingual glands.

DISCUSSION

This study will be the first that investigate the effects of local laser therapy on the salivary glands of malnourished children.

TRIAL REGISTRATION

Clinical.trials.gov as NCT03355313, first received in 21 November 2017.

Differential diagnosis of dental fluorosis made by undergraduate dental students

OBJECTIVE

To check knowledge of undergraduate dental students to make diagnosis of dental fluorosis with varying degrees of severity and choose its appropriate treatment.

METHODS

Data were collected using a semi-structured questionnaire addressing knowledge of undergraduates based on ten images of mouths presenting enamel changes.

RESULTS

Only three images were correctly diagnosed by most undergraduates; the major difficulty was in establishing dental fluorosis severity degree.

CONCLUSION

Despite much information about fluorosis conveyed during the Dentistry training, as defined in the course syllabus, a significant part of the students was not able to differentiate it from other lesions; they did not demonstrate expertise as to defining severity of fluorosis and indications for treatment, and could not make the correct diagnosis of enamel surface changes.