Oral health and emotional well-being in premenopausal and postmenopausal women: a cross-sectional cohort study

Background Menopause, the absence of ovarian sex steroids, is frequently accompanied by emotional and physiological changes in a woman´s body, as well as oral health changes. The present study aimed to evaluate the association between the periodontal health status and emotional and physical well-being among postmenopausal women (PMW) in comparison with regularly menstruating premenopausal women (RMPW). Methods A total of 115 women (PMW, n = 56, mean age ± SD: 54 ± 5; RMPW, n = 59, mean age ± SD: 41 ± 4) received a comprehensive medical assessment and a full-mouth oral examination. All completed the Women’s Health Questionnaire (WHQ) to measure emotional and physical well-being. The corresponding bone mineral density (BMD) scores were obtained from participants´ medical records. Results Tooth loss was significantly higher in PMW than RMPW after adjusting for age (3.88 ± 2.41 vs 2.14 ± 2.43, p < 0.05). No significant difference was found in the prevalence of periodontitis between the two groups (PMW: 39.2%, RMPW: 32.2%, p > 0.05). The prevalence of periodontitis was associated with fewer daily brushing sessions in PMW (p = 0.021). Based on the WHQ, both PMW and RMPW with periodontitis had higher ‘’depressed mood’’ scores compared to periodontally healthy women (p = 0.06 and p = 0.038, respectively). The women who reported fewer daily toothbrushing sessions found to have higher depressive mood scores (p = 0.043). Conclusions Presence of periodontitis is associated with the emotional and physical well-being of women and reinforcement of oral healtcare is recommended at different stages of a woman’s life including menopause to reduce the risk for early tooth loss in women.

Space maintainer ‘Y model’ as a preventive orthodontic treatment for paediatric patients: a case report

Background: Caries is one of the most common oral diseases that occur among children. Caries and dental trauma in children may cause early tooth loss, also known as premature loss, and result in occlusion abnormalities caused by the dental arch narrowing. A space maintainer is a preventive orthodontic appliance designed to maintain a narrow arch to prevent premature loss. Purpose: This study aims to describe the treatment of a case of space management in a patient with premature loss by using the space maintainer ‘Y model’. Case: An eight-year-old boy was accompanied by his mother, complaining that the lower posterior right tooth had been extracted. The mother was worried that the new tooth would have an overlapping growth. Case Management: The diagnosis was mandibular primary molar loss. The study cast was analysed based on Moyers 2.62 cm, Huckaba 2.24 mm, and curve determination 2.40 mm. The mandibular removable space maintainer treatment was performed on the patient and was followed by nine control visits every week. The outcome was a successful treatment from the use of the space maintainer ‘Y model’. Conclusion: The space maintainer treatment with the Y model in the paediatric patient showed a good result, evidenced by the tube opening of 1.2 mm, showing that the appliance followed lateral jaw growth.

Use of Byproduct Feeds in Southeastern Beef Production Systems

Byproducts are an important component of many beef production systems in the southeast. A variety of byproducts are used as supplemental nutrition for pastured cattle, and a byproduct-based total mixed ration is commonly used in backgrounding enterprises. Byproducts of corn (wet and dry milling), soybean, cotton, peanuts, rice, citrus, brewing and vegetable processing are widely available. Regional availability will determine what optimal byproducts will be for a given area. The value of an alternative feed for beef cattle is commonly determined based on the TDN and CP levels relative to corn and soybean meal (the Peterson Method). This simple approach allows the user to calculate a $ per ton value at a given corn and soybean meal price, but may result in misleading information. Research comparing alternative feeds to the standard often find that a “realized value” is different than the calculated value. Intake may be stimulated or depressed by a given ingredient. Hidden costs including handling and shrinkage are often a problem for wet materials. Sometimes dramatic side effects occur despite a high calculated value for the feed. For example, fermented sweet potato cannery waste has a very high nutritive value that is realized when fed at low levels in a total mixed ration. However, when fed free-choice, it may cause severe dental erosion resulting in reduced gains in yearlings and early tooth loss in cows. Culled cured sweet potatoes coming from cold storage have a high calculated value yet can cause death in cows because of a lung toxin. There is actually a limited amount of research published with byproducts in southern beef production systems. Due to diversity of forage-base and wide variety of ingredients with potential associative effects, more research is needed to fully understand how byproducts are best utilized.

Pseudogenized Amelogenin Reveals Early Tooth Loss in True Toads (Anura: Bufonidae)

Extant anurans (frogs and toads) exhibit reduced dentition, ranging from a lack of mandibular teeth to complete edentulation, as observed in the true toads of the family Bufonidae. The evolutionary timeline of these reductions remains vague due to a poor fossil record. Previous studies have demonstrated an association between the lack of teeth in edentulous vertebrates and the pseudogenization of the major tooth enamel gene amelogenin (AMEL) through accumulation of deleterious mutations and the disruption of its coding sequence. In the present study we have harnessed the pseudogenization of AMEL as a molecular dating tool to correlate loss of dentition with genomic mutation patterns during the rise of the family Bufonidae. Specifically, we have utilized AMEL pseudogenes in three members of the family as a tool to estimate the putative date of edentulation in true toads. Comparison of AMEL sequences from Rhinella marina, Bufo gargarizans and Bufo bufo, with nine extant, dentulous frogs, revealed mutations confirming AMEL inactivation in Bufonidae. AMEL pseudogenes in modern bufonids also exhibited remarkably high 86–93% sequence identity among each other, with only a slight increase in substitution rate and relaxation of selective pressure, in comparison to functional copies in other anurans. Moreover, using selection intensity estimates and synonymous substitution rates, analysis of functional and pseudogenized AMEL resulted in an estimated inactivation window of 46-60 MYA in the lineage leading to modern true toads, a timeline that coincides with the rise of the family Bufonidae.

Manutenção de espaço: da etiologia à interceptação

INTRODUCTION: the maintenance of space, when early loss of primary teeth occurs, prevents a potential problem - tooth migration - from determining the formation of a malocclusion, constituting a preventive orthodontic maneuver. The loss of a deciduous tooth is considered premature when it is lost before its permanent successor has started the process of eruption. OBJECTIVE: this article aims to review the literature related to the early loss of deciduous teeth, emphasizing its etiology, its consequences on the development of the stomatognathic system, and, also, the devices indicated to prevent the establishment of malocclusions. METHODS AND MATERIALS: the search for the referenced articles was carried out in the PubMed and Google Scholar databases. Laboratory appliances were made in plaster models in order to demonstrate the possibilities and indications of fixed or removable appliances, for different situations involving early tooth loss. CONCLUSION: preventing and intercepting incipient problems is much easier than correcting them in the future.

Early Tooth Loss after Periodontal Diagnosis: Development and Validation of a Clinical Decision Model

The aim of this study was to develop and validate a predictive early tooth loss multivariable model for periodontitis patients before periodontal treatment. A total of 544 patients seeking periodontal care at the university dental hospital were enrolled in the study. Teeth extracted after periodontal diagnosis and due to periodontal reasons were recorded. Clinical and sociodemographic variables were analyzed, considering the risk of short-term tooth loss. This study followed the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD) guidelines for development and validation, with two cohorts considered as follows: 455 patients in the development phase and 99 in the validation phase. As a result, it was possible to compute a predictive model based on tooth type and clinical attachment loss. The model explained 25.3% of the total variability and correctly ranked 98.9% of the cases. The final reduced model area under the curve (AUC) was 0.809 (95% confidence interval (95% CI): 0.629–0.989) for the validation sample and 0.920 (95% CI: 0.891–0.950) for the development cohort. The established model presented adequate prediction potential of early tooth loss due to periodontitis. This model may have clinical and epidemiologic relevance towards the prediction of tooth loss burden.

Early Tooth Loss after Periodontal Diagnosis: Development and Validation of a Clinical Decision Model

The aim of this study was to develop and validate a predictive early tooth loss multivariable model for periodontitis patients before periodontal treatment. A total of 544 patients seeking periodontal care at a university dental hospital were enrolled in the study. Teeth extracted after periodontal diagnosis and due to periodontal reasons were recorded. Clinical and sociodemographic variables were analyzed, considering the risk of short-term tooth loss. This study followed the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) guidelines for development and validation, with two cohorts considered as follows: 455 patients in the development phase and 99 in the validation phase. As a result, it was possible to compute a predictive model based on tooth type and clinical attachment loss. The model explained 25.3% of the total variability and correctly ranked 98.9% of the cases. The final reduced model area under the curve (AUC) was 0.809 (95% Confidence Interval (95% CI): 0.629 - 0.989) for the validation sample and 0.920 (95% CI: 0.891 - 0.950) for the development cohort. The established model presented adequate prediction potential of early tooth loss due to periodontitis. This model may have clinical and epidemiologic relevance towards the prediction of tooth loss burden.

Effects of Fixed and Removable Space Maintainers on Dental Plaque and DMFT/dft Values

Purpose: Space maintainers are important for the health and placement of children’s primary and permanent teeth. However, plaque and caries levels can be negatively affected when a dental appliance is in the mouth. This study aims to evaluate the oral health of pediatric patients that have space maintainers applied as a result of early tooth loss. Methods: This study included 100 systemically healthy patients between the ages of 4-15 years that were treated with space maintainers due to early loss of teeth. Decayed, missing, filled tooth index values and dental plaque status of the participants were recorded. Controls were performed in the 6th and 12th month. The index results were compared and evaluated statistically using ANOVA and paired-t-tests. Results: A total of 116 space maintainers, including 36 band and loops, 16 lingual arches, 21 palatal arches, 43 removable appliances, were evaluated in the study. Statistically significant differences were found between the pre-treatment and post-treatment index values (p<0.001). In the group of band and loops and removable space maintainers; the increases in DMFT/dft values of 6th month and 12th month according to initial DMFT/dft values were statistically significant (p<0.05). For plaque index, the increase in 12th month of all types of appliances were found statistically significant (p<0.001). The greatest increase in plaque index level was seen in the teeth of patients that had been treated with a lingual arch. Conclusions: Incompatible space maintainers can lead to caries, increased plaque accumulation, demineralized areas, and periodontal problems. The accumulation of plaque and difficulty of cleaning the teeth, especially in the fixed space maintainers, negatively affects the health of teeth. For this reason, good oral hygiene should be provided to patients and controls should be regularly performed.

Radix entomolaris in permanent molars: Report of two cases

Molars are frequently affected by caries among children and adolescents. An efficient endodontic intervention is crucial for their successful preservation in oral environment. Proper knowledge of the internal anatomy of a tooth is the stepping stones for successful treatment outcome in regular endodontic practice. Improper diagnosis with inaccurate treatment planning often result a failure in case of molars with extra roots leading to early tooth loss and development of inevitable functional, esthetic, and psychological problems. Though anatomical variation of tooth morphology is common, incidence of an extra lingual root distally in case of mandibular molars i.e. Radix entomolaris is relatively rare. In this article, two case reports of endodontic management of Radix entomolaris (RE) are presented.

FRATURA DE MANDÍBULA EDÊNTULA ATRÓFICA: RELATO DE CASO

RESUMOA atrofia da mandíbula é mais comumente encontrada em pacientes idosos ou pacientes com perda dentária precoce, tornando tal osso mais suscetível a fraturas devido a diminuição da altura, da espessura óssea e de seu fluxo sanguíneo. O manejo de injúrias em mandíbulas nestas condições deve levar em consideração a idade e a condição sistêmica do paciente, o tempo decorrido desde o trauma e a complexidade do dano. O tratamento visa a redução e imobilização das fraturas a fim de restabelecer forma e função, incluindo técnicas abertas (cirúrgicas) e fechadas (não-cirúrgicas). Em fraturas de mandíbula atróficas, o tratamento não-cirúrgico não costuma ser uma opção viável em virtude da ausência de elementos dentários e pequena área de contato ósseo existente na região da fratura. Sendo assim, a redução aberta com fixação interna rígida tem sido o tratamento padrão associadas a sistemas de perfil pesado como as placas de reconstrução. O presente trabalho tem como objetivo relatar o caso clínico de uma paciente de 87 anos de idade, sexo feminino, leucoderma, atendida no Hospital Federal dos Servidores do Estado, apresentando fratura bilateral em corpo de mandíbula atrófica. Para o tratamento, foi realizada redução e fixação interna rígida com placas e parafusos. A paciente seguiu em controle pós-operatório durante seis meses sem a presença de complicações.Palavras-chave: Fratura mandibular; Mandíbula atrófica; Fixação interna rígida.ABSTRACTJaw atrophy is most commonly found in elderly patients or with early tooth loss, making such bone more susceptible to fractures due to decreased height, bone thickness and blood flow. The management of injuries in jaws in these conditions should take into account the age and the systemic condition of the patient, the time elapsed since the trauma and the complexity of the damage. The treatment aims to reduce and immobilize fractures to restore shape and function, including open and closed techniques. In atrophic mandible fractures, non-surgical treatment is usually not a viable option, due to the absence of dental elements and small area of bone contact in the fractured region. Thus, open reduction with rigid internal fixation has been the standard treatment associated with heavy profile systems. The present study aims to report the clinical case of an 87 years old female patient, leucoderma, attended at Hospital Federal dos Servidores do Estado, presenting bilateral fracture in atrophic jaw body. For treatment, reduction and rigid internal fixation with plates and screws were performed. The patient was followed up for six months without postoperative complications.Key words: Mandibular fracture; Atrophic jaw; Rigid internal fixation