Can jua be a weapon in combating oral diseases?

Jua (or Joazeiro) is a plant that has been used in Brazil as a folk remedy for many diseases, but mostly as a dentifrice. Several scientific investigations have been conducted in Brazil to examine the therapeutic use of Jua for oral health. This article presents information about the Ziziphus joazeiro plant, its medicinal use, and its chemical components while also reviewing the literature concerning Jua and especially its anti-plaque activity. Although Joazeiro has been investigated, more studies must be performed to better understand these Jua compounds, their antimicrobial activity, and their mechanism of action. Such studies would confirm whether Joazeiro has the potential to fight or prevent diseases like dental caries and periodontitis.     

Multi-staged flap reconstruction for complex radiation thoracic ulcer

INTRODUCTION

Chest wall reconstruction due to previous radiation therapy can be challenging and complex, requiring a multidisciplinary approach.

PRESENTATION OF CASE

The authors present the case of a 84-year-old woman with a right chest wall radionecrosis ulcer, that was submitted to an ablative surgery resulting in a full-thickness defect of 224 cm², firstly reconstructed with a pedicled omental flap. Due to partial flap necrosis, other debridements and chest wall multi-staged flap reconstruction were performed.

DISCUSSION

This case highlights that the reconstructive choice should be individualized and dependent on patient and local factors. The authors advise that surgical team should work closely and be well versed in chest wall reconstruction with a variety of pedicled flaps, when a complication occurs.

CONCLUSION

A multi-staged flap reconstruction could be a salvage procedure for the coverage of complex, great and complicated chest wall defects due to previous radiation therapy.     

Association of Gingivitis With Child Oral Health–Related Quality of Life

Background: Child oral health–related quality of life (COHRQoL) has been increasingly assessed. However, the full relationship between gingivitis and COHRQoL has been assessed by only a small number of studies. This study aims to assess the association between gingival bleeding and how a child perceives its OHRQoL. Methods: This cross‐sectional study used multistage random sampling to enroll 1,134 12‐year‐old schoolchildren from Santa Maria, a southern city in Brazil. Participants were examined for gingival bleeding according to the community periodontal index criteria, a full‐mouth clinical examination of six sites per tooth. COHRQoL was assessed by the Brazilian version of the Child Perceptions Questionnaire for 11‐ to 14‐Year‐Old Children (CPQ11–14), and data on socioeconomic status were collected. Multilevel Poisson regression models fitted the association of gingivitis with overall and domain‐specific CPQ11–14 scores. Results: In general, children with bleeding in ≥15% of sites had higher total CPQ11–14 scores and domain‐specific scores than their counterparts. This association persisted after adjustment for other potential confounders. The presence and extent of gingival bleeding was associated mainly with emotional limitation domains of the CPQ11–14; those with extended levels of gingivitis had a 1.20 times higher mean score than those with low‐level/no gingival bleeding (rate ratio = 1.20; 95% confidence interval = 1.10 to 1.31). Conclusion: The present results indicate that the presence of extensive levels of gingivitis might be negatively associated with how children perceive their oral health and their daily life.     

Response of Human Osteoblastic and Osteoclastic Cells to AH Plus and Pulp Canal Sealer Containing Quaternary Ammonium Polyethylenimine Nanoparticles

Introduction

The incorporation of quaternary ammonium polyethylenimine (QPEI) nanoparticles into endodontic sealers induces alterations in their structure and surface properties, which may affect the compatibility with the periapical tissues. This work addressed the behavior of human bone cells exposed to extracts from commercial and QPEI containing AH Plus (DeTrey, Konstanz, Germany) and Pulp Canal Sealer EWT (PCS; Kerr Italia Srl, Salerno, Italy).

Methods

Freshly mixed AH Plus and PCS or containing 2% QPEI (0.3 mL spread over the well bottom of a 24-well plate) were extracted with culture medium (1.5 mL for 24 hours at 37°C) and diluted (1:20–1:5000). Osteoblastic or osteoclastic cells were cultured in the presence of QPEI particles (1%–10%) and were exposed to the extracts from unmodified and QPEI containing sealers.

Results

QPEI nanoparticles, at 1% and 2%, did not affect cell behavior. On osteoblastic cells, AH Plus and PCS increased DNA at 1:2500 dilution (levels ≤1:100 were cytotoxic). Alkaline phosphatase activity decreased at dilutions ≤1:500. Comparatively, QPEI containing AH Plus increased DNA at 1:2500 and 1:500 dilutions, and QPEI containing PCS induced ALP activity at 1:2500 and 1:500 dilutions. Regarding osteoclastic cells, DNA increased (AH Plus) or was not affected (PCS) at dilutions up to 1:500 and decreased with more concentrated extracts. Tartrate-resistant acid phosphatase activity decreased with dilutions ≤1:500 for both sealers. QPEI containing sealers presented a similar behavior. The sealers affected some intracellular signaling pathways, and QPEI containing sealers further modulate these mechanisms.

Conclusions

QPEI nanoparticles, at 2%, did not affect cell behavior. However, the incorporation of 2% QPEI particles into AH Plus and PCS modulates the proliferation and differentiation of bone cells, depending on the sealer and the cell type, without increasing the sealers' cytotoxicity.