Effect of application time and concentration of silver diamine fluoride on the enamel remineralization.

BACKGROUND: Silver diamine fluoride has attracted attention because of its clinical success in arresting dental caries. Thus, the aim of this study was to evaluate the effect of different application times and concentrations of silver diamine fluoride (SDF) on deciduous tooth enamel remineralization. MATERIAL AND METHODS: Blocks of deciduous tooth enamel were categorized into six groups of 11 each: 2 control groups: intact enamel, and demineralized enamel; 38% SDF and 30% SDF which were subdivided according to application times (1 and 3 min). The microhardness of samples was determined, and all groups except the intact enamel group were subjected to pH cycling to produce initial carious lesions. The 38% and 30% SDF solutions were applied to the enamel for 1 or 3 min. After pH cycling and SDF treatments, the microhardness was again determined. Samples were sectioned to evaluate the cross-sectional microhardness. Furthermore, internal porosity of the samples was examined using micro-CT. Data were statistically analyzed by analysis of variance followed by Tukey's test, and linear regression analyses were performed. RESULTS: There was no difference in enamel remineralization based on surface and cross-sectional microhardness. The 30% SDF solution applied for 3 min promoted significantly less pores than the other groups. CONCLUSIONS: The 1-min application time promoted enamel remineralization regardless of the SDF concentration (30% or 38%). Key words:Cariostatic agents, dental caries, primary tooth, tooth remineralization.

Treatment of Dental Caries with Diamine Silver Fluoride: Literature Review / Tratamento da Cárie Dentária com Diamino Fluoreto de Prata: Revisão da Literatura

Brazilian health care programs recommend the use of cariostatic solutions of silver diamine fluoride (SDF) or sodium fluoride varnishes for children 0 to 3 years old with high or moderate caries activity for the control of caries lesions. SDF is a safe, economical, efficient and non-invasive coadjuvant agent, exerting an antibacterial action capable of reducing superficial mineral loss of the enamel and can be used in the treatment of deciduous and permanent teeth. The objective of this literature review was to gather current information on describing the mechanism of SDF action' and its clinical application in young children in caries prevention and paralysis. The PubMed / Medline and Cochrane Library databases were accessed by identifying the relevant studies published in English from 1960 to May 2017. The search strategy employed the keywords: "Silver diamine fluoride" and "Children "or "Infant" and "Caries prevention". Data extraction was performed in: 19 in vitro studies; 10 review articles and 8 in vivo studies. It was possible to conclude that SDF is almost twice as effective compared to fluoride varnish in caries paralysis. However, the contact time of the solution and the optimal frequency of application of the SDF are still undefined, inducing new projects and clinical studies in the search for an adequate clinical protocol of this cariostatic.(AU)

Os programas de assistência à saúde brasileiros recomendam para o controle das lesões de cárie a utilização de soluções cariostáticas de diamino fluoreto de prata - DFP ou vernizes de fluoreto de sódio para crianças de 0 a 3 anos com atividade de cárie alta ou moderada. O DFP é agente coadjuvante seguro, econômico, eficiente e não invasivo, exercendo ação antibacteriana capaz de reduzir a perda mineral superficial do esmalte e, pode ser utilizado no tratamento de dentes decíduos e permanentes. O objetivo desta revisão de literatura foi reunir informações atuais sobre descrever o mecanismo de ação do DFP e sua aplicação clínica em crianças de pouca idade na prevenção e paralisação da cárie. As bases de dados PubMed/Medline e Cochane Library foram acessadas identificando os estudos relevantes publicados em inglês, no período de 1960 a maio de 2017. A estratégia de busca empregou as palavras-chave: "Silver diamine fluoride" and "Children" or "Infant" and "Caries prevention". A extração dos dados foi realizada em: 19 estudos in vitro; 10 artigos de revisão e 8 estudos in vivo. Foi possível concluir que o DFP apresenta-se quase duas vezes tão eficaz comparado ao verniz fluoretado na paralização de cárie. Porém, o tempo de contato da solução e a frequência ótima de aplicação do DFP ainda estão indefinidos, suscitando novos projetos e estudos clínicos na busca de adequado protocolo clínico deste cariostático.(AU).

Influence of chloramine-T disinfection on elastomeric impression stability.

OBJECTIVE: The aim of this study was to evaluate the stability of elastomer through detail reproduction and its dimensional stability (DS) after disinfection with 0.2% chloramine-T. MATERIALS AND METHODS: The elastomeric impression dental materials used in this study were polydimethylsiloxane (Oranwash L), polyvinyl siloxane (Express), polysulfide (Permlastic), and polyether (Impregum Soft). The entire press procedure was performed on a matrix in accordance with the ISO 4823. Detail reproduction was analyzed using an optical microscope (Stereozoom Microscope) over the 20-µm line with 25 mm of length at a magnification of ×4. DS was measured using an optical microscope (Scanning Tunneling Microscope) by subtracting the distance between the lines X and X' over the 20-µm line on the matrix (DM) from the distance between the lines on the impression material (DI) divided by DM and multiplied by 100 establishing the equation: DS = ([DI - DM]/DM) ×100; then, 100% was added to the results of the equation. The detail reproduction values were subsequently subjected to descriptive analysis by percentage (%), and the DS values (%) were submitted to Kolmogorov-Smirnov test, two-way ANOVA (material × disinfectant), and Tukey's test (α = 0.05). RESULTS: All elastomeric impression materials showed 100% of detail reproduction, regardless of the disinfection procedure. Polysulfide (not disinfected) and polysulfide and polydimethylsiloxane (after disinfection with 0.2% chloramine-T) showed the smaller mean values of DS. CONCLUSION: According to the stability properties analyzed, chloramine-T can be used for disinfection of elastomer molds.

In Vitro Evaluation of the Remineralizing Potential and Antimicrobial Activity of a Cariostatic Agent with Silver Nanoparticles.

Cariostatic treatment has been shown to successfully arrest caries. However, it blackens the carious tooth structure. This study evaluated the effects of an experimental cariostatic agent with silver nanoparticles (Ag-Nano) using microhardness (MH) and microbiological tests. The cariostatic agents tested were: Saforide®, Cariestop®, Ancarie® and Ag-Nano. Sixty-six samples from deciduous enamel were submitted to initial (after pH cycling to obtain initial caries-like lesion) and final (after cariostatic application) MH testing and %MH values were calculated. After longitudinal sectioning, internal (I) MH was evaluated. Strains of Streptococcus mutans, Escherichia coli, and Enterococcus faecalis in brain-heart infusion culture were treated with the cariostatic agents. Agar diffusion tests (ADTs) were performed and minimum inhibitory concentrations were determined. The statistical tests used were: Kruskal-Wallis and Dunn (%MD; ADT; MIC) and ANOVA followed by Tukey's test (I-MH) (p<0.05). The %MH of Saforide® was significantly greater than that of Ag-Nano (p<0.05). Internal MH showed progressive improvement in the enamel remineralization for all cariostatic tested. In ADTs showed greater inhibition of S. mutans, E. faecalis, and E. coli by Saforide® than by Ancarie® and Ag-Nano. Ag-Nano was able to inhibit 100% microorganism growth at a lower concentration than required for the other agents. It was concluded that Ag-Nano treatment promoted remineralization of deciduous tooth enamel with initial caries-like lesion and bactericidal activity.

In Vitro Evaluation of the Remineralizing Potential and Antimicrobial Activity of a Cariostatic Agent with Silver Nanoparticles

Abstract Cariostatic treatment has been shown to successfully arrest caries. However, it blackens the carious tooth structure. This study evaluated the effects of an experimental cariostatic agent with silver nanoparticles (Ag-Nano) using microhardness (MH) and microbiological tests. The cariostatic agents tested were: Saforide®, Cariestop®, Ancarie® and Ag-Nano. Sixty-six samples from deciduous enamel were submitted to initial (after pH cycling to obtain initial caries-like lesion) and final (after cariostatic application) MH testing and %MH values were calculated. After longitudinal sectioning, internal (I) MH was evaluated. Strains of Streptococcus mutans, Escherichia coli, and Enterococcus faecalis in brain-heart infusion culture were treated with the cariostatic agents. Agar diffusion tests (ADTs) were performed and minimum inhibitory concentrations were determined. The statistical tests used were: Kruskal-Wallis and Dunn (%MD; ADT; MIC) and ANOVA followed by Tukey's test (I-MH) (p<0.05). The %MH of Saforide® was significantly greater than that of Ag-Nano (p<0.05). Internal MH showed progressive improvement in the enamel remineralization for all cariostatic tested. In ADTs showed greater inhibition of S. mutans, E. faecalis, and E. coli by Saforide® than by Ancarie® and Ag-Nano. Ag-Nano was able to inhibit 100% microorganism growth at a lower concentration than required for the other agents. It was concluded that Ag-Nano treatment promoted remineralization of deciduous tooth enamel with initial caries-like lesion and bactericidal activity.

Resumo O tratamento com cariostático tem demostrado sucesso na paralização da cárie. No entanto, causa escurecimento da estrutura dental cariada. Este estudo avaliou os efeitos de um agente cariostático experimental com nanopartículas de prata (Ag-Nano) através de microdureza (MD) e testes microbiológicos. Os cariostáticos testados foram: Saforide®, Cariestop®, Ancarie® e Ag-Nano. Sessenta e seis amostras de esmalte decíduo foram submetidos a MD inicial (após ciclagem de pH para obtenção da lesão de cárie inicial) e final (após aplicação dos cariostáticos), e os valores da porcentagem (%) de MD foram calculados. Após secção longitudinal, a MD interna (I) foi avaliada. Cepas de Streptococcus mutans, Escherichia coli e E. faecalis foram cultivados em ágar infusão de cérebro e coração (BHI) e submetidos aos cariostáticos testados. Além disso, foram realizados teste de difusão em ágar (TDA) e avaliação da concentração mínima inibitória (CIM) dos cariostáticos. Os testes estatísticos usados foram: Kruskall-Wallis e Dunn (%MD; TDA; CIM) e ANOVA seguido de teste de Tukey (MD-I) (p<0.05). A %MD do Saforide® foi significativamente maior do que a de Ag-Nano (p<0,05). A MD interna apresentou melhora progressiva na remineralização do esmalte para todos os cariostático testados. Os resultados do TDA mostraram que S. mutans, E. faecalis e E. coli sofreram maior inibição pelo Saforide® (p<0,05), em relação ao Ancarie® e Ag-Nano. No entanto, para o teste de CIM o Ag-Nano foi capaz de inibir 100% dos microorganismos, em menor concentração do que os demais cariostaticos. Conclui-se que, o tratamento Ag-Nano foi capaz de promover remineralização do esmalte dental decíduo com lesão de cárie inicial e apresentou atividade bactericida.

Evaluation of a preventive educational program for malocclusions: 7-year study.

RESULTS: 506 of the 802 guardians/children referred to the PPM joined. As for the children, the most frequently assessed habits were: bottle (56.1%), bottle and pacifier (18.4%), finger (11.9%), bottle and finger (7.1%), pacifier (5.7%), pacifier and finger (0.6%), and bottle/pacifier/finger (0.2%). After parent participation in the meetings, 335 (66.2%) children abandoned their habits. There was a statistical difference between type of oral habit and time to abandonment (p = 0.0001). However, those with only one habit abandoned it more easily (72.6%) than those with two or more associated habits (48.1%) (p = 0.042). Presence or absence of breastfeeding and parents' level of education had no significant effect on habit abandonment. CONCLUSION: PPM was an important tool for spreading knowledge to guardians, greatly contributing to the abandonment of deleterious oral habits. Bottle sucking warrants special attention - mentioned by 81.8% of parents - either alone or associated with other habits. Thus, educational actions to implement the children's approach to oral health are fundamental to making behavioral changes and promoting education of healthy habits, thereby keeping malocclusions from developing.

Evaluation of a preventive educational program for malocclusions: 7-year study

Abstract This study aimed at evaluating the Protocol for the Prevention of Malocclusions (PPM), established in the preventive educational program developed by the Public Infant Oral Health Program of the State University of Londrina (PIOHP-UEL). Guardians of three-year-olds or older, maintaining nutritive (bottle) and/or non-nutritive (pacifier and finger) sucking habits, attended meetings designed to alert and guide them to eliminating these habits from their children. PPM patient records (2006-2013) were assessed and the data were described and evaluated by the Chi-square test, with a 5% significance level. Results 506 of the 802 guardians/children referred to the PPM joined. As for the children, the most frequently assessed habits were: bottle (56.1%), bottle and pacifier (18.4%), finger (11.9%), bottle and finger (7.1%), pacifier (5.7%), pacifier and finger (0.6%), and bottle/pacifier/finger (0.2%). After parent participation in the meetings, 335 (66.2%) children abandoned their habits. There was a statistical difference between type of oral habit and time to abandonment (p = 0.0001). However, those with only one habit abandoned it more easily (72.6%) than those with two or more associated habits (48.1%) (p = 0.042). Presence or absence of breastfeeding and parents' level of education had no significant effect on habit abandonment. Conclusion PPM was an important tool for spreading knowledge to guardians, greatly contributing to the abandonment of deleterious oral habits. Bottle sucking warrants special attention - mentioned by 81.8% of parents - either alone or associated with other habits. Thus, educational actions to implement the children's approach to oral health are fundamental to making behavioral changes and promoting education of healthy habits, thereby keeping malocclusions from developing.