Acceptability and effect of TiF4 on dental caries: a randomized controlled clinical trial.

This randomized three-armed controlled clinical trial compared the effect of titanium tetrafluoride (TiF4) and sodium fluoride (NaF) varnishes on caries control in smooth surfaces of permanent dentition and children's acceptability. Sixty children (6-8 y/o) were randomly divided into TiF4 (2.45% F-), NaF (2.26% F-) or placebo (control) groups. Varnishes were applied on permanent teeth once a week for the first 4 weeks and after the 6th and 12th months of the study. The variables were as follows: International Caries Detection and Assessment System (ICDAS) scores, quantitative fluorescence changes, visual plaque index (VPI) and degree of acceptability. Two-way RM-ANOVA, ANOVA/Tukey and χ2 tests were performed (p < 0.05). No differences were found between the treatments with respect to ICDAS scores (p = 0.32). Only TiF4 reduced the mean fluorescence loss significantly at 18 months compared to the baseline (p = 0.003). TiF4 showed a lower percentage of new caries lesions by tooth surface than the placebo, while NaF did not induce such a change (p < 0.014). Regardless of the treatment, more than 95% of the participants reported being satisfied. For all groups, the VPI decreased significantly at 3 months compared to the baseline value (p < 0.001), with no differences between the treatments (p = 0.17). TiF4 had a similar ability to control caries lesions as NaF; however, only TiF4 differed from the placebo (p = 0.004). The acceptability of TiF4 varnish was similar to that of NaF varnish.

Acceptability and effect of TiF4 on dental caries: a randomized controlled clinical trial

Abstract: This randomized three-armed controlled clinical trial compared the effect of titanium tetrafluoride (TiF4) and sodium fluoride (NaF) varnishes on caries control in smooth surfaces of permanent dentition and children's acceptability. Sixty children (6-8 y/o) were randomly divided into TiF4 (2.45% F-), NaF (2.26% F-) or placebo (control) groups. Varnishes were applied on permanent teeth once a week for the first 4 weeks and after the 6th and 12th months of the study. The variables were as follows: International Caries Detection and Assessment System (ICDAS) scores, quantitative fluorescence changes, visual plaque index (VPI) and degree of acceptability. Two-way RM-ANOVA, ANOVA/Tukey and χ2 tests were performed (p < 0.05). No differences were found between the treatments with respect to ICDAS scores (p = 0.32). Only TiF4 reduced the mean fluorescence loss significantly at 18 months compared to the baseline (p = 0.003). TiF4 showed a lower percentage of new caries lesions by tooth surface than the placebo, while NaF did not induce such a change (p < 0.014). Regardless of the treatment, more than 95% of the participants reported being satisfied. For all groups, the VPI decreased significantly at 3 months compared to the baseline value (p < 0.001), with no differences between the treatments (p = 0.17). TiF4 had a similar ability to control caries lesions as NaF; however, only TiF4 differed from the placebo (p = 0.004). The acceptability of TiF4 varnish was similar to that of NaF varnish.

Protective Effect of 4% Titanium Tetrafluoride Varnish on Dentin Demineralization Using a Microcosm Biofilm Model.

This study evaluated the effect of titanium tetrafluoride (TiF4) varnish on the development of dentin carious lesions. Bovine root dentin samples were treated for 6 h with: (A) 4% TiF4 varnish (2.45% F); (B) 5.42% sodium fluoride (NaF) varnish (2.45% F); (C) 2% chlorhexidine (CHX) gel - positive control; (D) placebo varnish; or (E) untreated - negative control (n = 4 × biological triplicate, n = 12). Treated dentin samples were exposed to human saliva mixed with McBain saliva (1:50) for the first 8 h in 24-well plates. Thereafter, the medium was removed, and McBain saliva containing 0.2% sucrose was applied for 16 h. From days 2 to 5, McBain saliva with sucrose was replaced daily (37°C, 5% CO2). The demineralization was measured using transverse microradiography, while the effect on biofilm was analyzed using viability, extracellular polysaccharide (EPS), and lactic acid production assays. The data were statistically analyzed (p < 0.05). All treatments (fluorides and CHX) significantly reduced the biofilm viability compared to placebo varnish and negative control. However, none of them was able to reduce the colony-forming unit counting for total microorganism, total streptococci, and Streptococcus mutans. NaF significantly reduced the number of Lactobacillus sp. compared to negative control. No effect was seen on lactic acid production neither on EPS synthesis, except that CHX significantly reduced the amount of insoluble EPS. Both fluorides were able to reduce dentin demineralization compared to placebo varnish and negative control; TiF4 had a better effect in reducing mineral loss and lesion depth than NaF. Therefore, TiF4 varnish has the best protective effect on dentin carious lesion formation using this model.

Comparison between static and semi-dynamic models for microcosm biofilm formation on dentin.

OBJECTIVE: Microcosm biofilm has been applied to induce carious lesions in dentin. However, no study has been done to compare the impact of the type of model for providing nutrients to microcosm biofilm formation on dentin. This study compared the performance of two kinds of models (static and semi-dynamic) on the biofilm formation and the development of dentin carious lesions. MATERIAL AND METHODS: In both models, biofilm was produced using inoculum from pooled human saliva mixed with McBain saliva for the first 8 h (5% CO2 and 37°C). Afterwards, for the static model, the samples were placed in 24-wells microplate containing McBain saliva with 0.2% sucrose, which was replaced at 24 h. In the semi-dynamic model, the samples were submitted to artificial mouth system with continuous flow of McBain saliva with 0.2% sucrose (0.15 ml/min, 37°C) for 10 h a day (for the other 14 h, no flow was applied, similarly to the static model). After 5 days, biofilm viability was measured by fluorescence and dentin demineralization by transverse microradiography. RESULTS: Biofilm viability was significantly lower for the static compared with semi-dynamic model, while dentin demineralization was significantly higher for the first one (p<0.05). The static model was able to produce a higher number of typical subsurface lesions compared with the semi-dynamic model (p<0.05). CONCLUSIONS: The type of model (static and semi-dynamic) applied in the microcosm biofilm may have influence on it's viability and the severity/profile of dentin carious lesions.

TiF4 and NaF varnishes induce low levels of apoptosis in murine and human fibroblasts through mitochondrial Bcl-2 family and death receptor signalling.

OBJECTIVES: This study evaluated the level and mechanism of apoptosis in human gingival fibroblasts (HGF) and murine fibroblasts (NIH/3T3) treated with a titanium tetrafluoride (TiF4) varnish compared those treated with a sodium fluoride (NaF) varnish. METHODS: Cells were treated with a TiF4, NaF (both 2.45%F) or placebo varnish for 6 h and were then examined using the TUNEL method. The activities of caspase-3, -8 and -9 were assessed. cDNA for Bax, Bad, Bcl-2 and Fas-L was amplified by quantitative PCR. Bax, Bcl-2 and Fas-L were further detected by western blot analysis. RESULTS: Both fluorides similarly increased the percentage of apoptosis, while they failed to activate caspases. The Bax/Bcl-2 gene expression ratio was not altered by either fluoride treatment regardless of the type of cell. NaF varnish increased the amplification of the Fas-L gene in NIH/3T3 and HGF cells, while treatment with the TiF4 varnish resulted in a lower Bad/Bcl-2 expression ratio compared to that of the control for NIH/3T3 cells, but not for HGF cells. No effect of the fluorides was detected in the protein analysis. CONCLUSIONS: NaF and TiF4, at the studied conditions, similarly induce a low level of apoptosis, with consequent modest activation of the Bcl-2 and Fas-l-dependent signalling pathways. Generally, HGF cells are more susceptible to the fluoride effect than NIH/3T3 cells.

Antimicrobial and Anti-Caries Effect of New Glass Ionomer Cement on Enamel Under Microcosm Biofilm Model.

The occurrence of caries lesions adjacent to restorations is a serious problem in Dentistry. Therefore, new antimicrobial restorative materials could help to prevent recurrent carious lesions. This study evaluated the effect of a new glass ionomer cement (Ion Z) on the viability of a microcosm biofilm and on the development of enamel demineralization. Enamel samples were filled with the following materials (n=9): A) Ion-Z (FGM Ltda); B) Maxxion R (FGM Ltda); C) Ketac Fil Plus (3M ESPE) and D) no restoration (control). The samples were then exposed to human saliva mixed with McBain saliva (1:50) containing 0.2% sucrose for 14 days. The live and dead bacteria were quantified by fluorescence using a confocal laser-scanning microscope. The enamel demineralization was analyzed using transverse microradiography (TMR). The data were submitted to ANOVA/Tukey or Kruskal-Wallis/Dunn test (p<0.05). Ion Z induced a higher percentage of dead bacteria (60.96±12.0%) compared to the other groups (Maxxion R: 39.8±6.7%, Ketac Fil Plus: 43.7±9.71% and control 46.3±9.5%). All materials significantly reduced the average mineral loss compared to control (Ion-Z 25.0±4.2%vol, Maxxion R 23.4±8.0%vol, Ketac Fil Plus 30.7±7.7 and control 41.2±6.6%vol). Ion-Z was the only material able to significantly improve the mineral content at the surface layer (Zmax: 63.5±18.2%vol) compared to control (38.9±11.3%vol). Ion-Z shows antimicrobial potential, but its anti-caries effect was similar to the other materials, under this model.

Antimicrobial and anti-caries effect of new glass ionomer cement on enamel under microcosm biofilm model

Abstract The occurrence of caries lesions adjacent to restorations is a serious problem in Dentistry. Therefore, new antimicrobial restorative materials could help to prevent recurrent carious lesions. This study evaluated the effect of a new glass ionomer cement (Ion Z) on the viability of a microcosm biofilm and on the development of enamel demineralization. Enamel samples were filled with the following materials (n=9): A) Ion-Z (FGM Ltda); B) Maxxion R (FGM Ltda); C) Ketac Fil Plus (3M ESPE) and D) no restoration (control). The samples were then exposed to human saliva mixed with McBain saliva (1:50) containing 0.2% sucrose for 14 days. The live and dead bacteria were quantified by fluorescence using a confocal laser-scanning microscope. The enamel demineralization was analyzed using transverse microradiography (TMR). The data were submitted to ANOVA/Tukey or Kruskal-Wallis/Dunn test (p<0.05). Ion Z induced a higher percentage of dead bacteria (60.96±12.0%) compared to the other groups (Maxxion R: 39.8±6.7%, Ketac Fil Plus: 43.7±9.71% and control 46.3±9.5%). All materials significantly reduced the average mineral loss compared to control (Ion-Z 25.0±4.2%vol, Maxxion R 23.4±8.0%vol, Ketac Fil Plus 30.7±7.7 and control 41.2±6.6%vol). Ion-Z was the only material able to significantly improve the mineral content at the surface layer (Zmax: 63.5±18.2%vol) compared to control (38.9±11.3%vol). Ion-Z shows antimicrobial potential, but its anti-caries effect was similar to the other materials, under this model.

Resumo A ocorrência de lesões de cárie adjacentes a restaurações é um sério problema na Odontologia. Portanto, novos materiais restauradores antimicrobianos poderiam ajudar a prevenir as lesões cariosas recorrentes. Este estudo avaliou o efeito de um novo cimento de ionômero de vidro (Ion Z) sobre a viabilidade de um biofilme microcosmo e o desenvolvimento da desmineralização do esmalte. Amostras de esmalte foram restauradas com os seguintes materiais (n=9): A) Ion-Z (FGM Ltda); B) Maxxion R (FGM Ltda); C) Ketac Fil Plus (3M ESPE) e D) sem restauração (controle). As amostras foram submetidas a uma mistura de saliva humana com saliva de McBain (1:50) contendo sacarose a 0,2% por 14 dias. As bactérias vivas e mortas foram quantificadas por fluorescência usando um microscópio confocal de varredura à laser. A desmineralização do esmalte foi analisada usando microradiografia transversal (TMR). Os dados foram submetidos aos testes ANOVA/Tukey ou Kruskal-Wallis/Dunn (p<0,05). O Ion Z induziu uma porcentagem mais elevada de bactérias mortas (60,96 ± 12,0%) comparado aos outros grupos (Maxxion R: 39,8 ± 6,7%, Ketac Fil Plus: 43,7 ± 9,71% e controle 46,3 ± 9,5%). Todos os materiais reduziram significativamente a perda mineral média em relação ao controle (Ion-Z 25,0 ± 4,2% vol, Maxxion R 23,4 ± 8,0% vol, Ketac Fil Plus 30,7 ± 7,7% vol e controle 41,2 ± 6,6% vol). O Ion-Z foi o único material capaz de melhorar significativamente o conteúdo mineral na camada superficial (Zmax: 63,5 ± 18,2% vol) em comparação com o controle (38,9 ± 11,3% vol). Ion-Z mostrou potencial antimicrobiano, mas seu efeito anti-cárie foi semelhante aos outros materiais, sob este modelo.

Effect of oral antimicrobial mouthrinses containing alcohol on viability of Streptococcus mutans and microcosm biofilm and on the prevention of enamel caries lesions.

PURPOSE: To evaluate the effect of PerioGard, Listerine, Noplak, Malvatricin and Cepacol commercial mouthrinses containing alcohol on the viability of Streptococcus mutans strain and of a microcosm biofilm and on the prevention of enamel demineralization. METHODS: The minimum inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) were determined against S. mutans (ATCC 25175). Microcosm biofilm formed from human saliva mixed with McBain saliva was created on bovine enamel for 5 days. From the 2nd to the 5th day, the enamel samples were exposed to McBain with 0.2% sucrose and to the mouthrinses (1 x 60 seconds). The biofilm viability was determined by fluorescence and the enamel demineralization by TMR. RESULTS: The lowest MIC and MBC values were observed for Cepacol, while the highest values were found for Listerine. The mouthrinses significantly increased the number of dead bacteria in biofilm, varying from 38.0± 11.2% (Noplak) to 58.5± 13.9% (Listerine), compared to control (12.7± 10.6%), except Periogard (30.1± 12.4%). All mouthrinses reduced mineral loss (P< 0.0001), but only Noplak and Cepacol were able to significantly reduce lesion depth. Cepacol and Noplak presented the best anti-caries effect under this experimental model. CLINICAL SIGNIFICANCE: This study shows that the anti-caries potential may vary between the commercial mouthrinses, which should be taken into account for their prescription.

Effect of a Titanium Tetrafluoride Varnish in the Prevention and Treatment of Carious Lesions in the Permanent Teeth of Children Living in a Fluoridated Region: Protocol for a Randomized Controlled Trial.

BACKGROUND: Titanium tetrafluoride (TiF4) has regained interest due to new formulations that have been shown to be more effective against tooth demineralization than sodium fluoride (NaF) formulations in vitro and in situ. OBJECTIVE: The aim of this study is to evaluate the effect of two types of varnishes (4% TiF4 and a commercial 5% NaF) on the prevention of carious lesions and the treatment of noncavitated enamel carious lesions in the permanent teeth of children living in a fluoridated area. METHODS: This randomized, controlled, parallel and single-blind clinical trial involves 63 children, 6-7 years old, living in Bauru, São Paulo, Brazil. Children were selected according to their caries activity (ie, presence of at least 1 tooth with a Nyvad score of 1) and randomly divided into the following treatment categories: 4% TiF4 varnish (2.45 % F-, pH 1, FGM); 5% NaF varnish (2.26% F-, pH 5, Duraphat, Colgate) and control (placebo varnish, pH 5, FGM). The varnishes will be applied on all permanent teeth, once a week for 4 weeks and they will be reapplied only once 6 and 12 months after the study begins. Two calibrated examiners will carry out the clinical examination (International Caries Detection and Assessment System [ICDAS] and Nyvad indexes, kappa>.8) at baseline, before the first application, after the 1st, 6th, 12th, and 18th month of the study begins. Furthermore, quantitative fluorescence changes will be measured using Quantitative Light-Induced Fluorescence (QLF). The degree of patient satisfaction with the treatment will also be computed. The data will undergo statistical analysis (P<.05). RESULTS: This ongoing study is funded by funding agencies from Brazil (São Paulo Research Foundation, FAPESP-015/14149-1, and National Council for Scientific and Technological Development, CNPq-401313/2016-6). We expect to confirm the efficacy of TiF4 on the prevention and treatment of carious lesions by comparing it to NaF varnish. The subjects are under 1 month evaluation and the dropout was about 8%. No differences between the treatments have been detected at the first month so far (P>.05). CONCLUSIONS: If our hypothesis is confirmed, TiF4 varnish can be marketed and applied at the individual level and used in community programs to control dental caries. TRIAL REGISTRATION: Brazilian Clinical Trials Registry: RBR-5VWJ4Y; http://www.ensaiosclinicos.gov.br/rg/?q=RBR-5VWJ4Y (Archived by WebCite at http://www.webcitation.org/6wUurEnm7).

Erosive softening and erosive loss of enamel: hardness and profilometry analysis / Erosão e desgaste erosivo do esmalte: análises por microdureza e perfilometria

Objetivo: Esse trabalho tem como objetivo determinar e diferenciar a erosão e o desgaste erosivo do esmalte induzidos pelos ácidos cítrico e clorídrico. Materiais e Métodos: Quarenta amostras de esmalte foram divididas em 2 grupos: 1) 0,05 M de ácido cítrico (pH 2,5) simulando a erosão extrínseca e 2) 0,01 M de ácido clorídrico (pH 2,2) simulando a erosão intrínseca. Amostras de esmalte foram submetidas aos desafios erosivos. A microdureza de superfície (erosão) ou a perfilometria (desgaste erosivo) foi realizada após 30 s, depois a cada 60 s até 10 min, depois a cada 5 min até 30 min e depois de 60, 90 e 120 min. Resultados: A erosão (perda de dureza do esmalte) foi mensurável até 1 e 2 min de exposição aos ácidos clorídrico e cítrico, respectivamente. O desgaste erosivo aumentou significativamente ao longo do tempo para ambos os ácidos. Após 8 min, o ácido cítrico foi mais agressivo comparado ao clorídrico (p < 0,001). Conclusão: A progressão da erosão do esmalte do amolecimento ao desgaste erosivo é altamente dependente do tipo de ácido, sendo o ácido cítrico mais agressivo em estágios avançados. Portanto, este resultado deve ser considerado na escolha do método de análise para estudos laboratoriais.

Objective: This study aimed to determine and differentiate erosive softening and enamel erosive loss induced by citric and hydrochloric acids. Material and Methods: Forty enamel specimens were divided into 2 groups: 1) 0.05 M citric acid (pH 2.5) simulating extrinsic erosion and 2) 0.01 M hydrochloric acid (pH 2.2) simulating intrinsic erosion. The enamel specimens were submitted to erosive challenges. Surface microhardness (softening) or contact profilometry (loss) was done after 30 s, after each 60 s up to 10 min, after each 5 min up to 30 min and after 60, 90 and 120 min. Results: Erosive softening (enamel hardness loss) was measurable up to 1 and 2 min for hydrochloric and citric acids, respectively. Erosive loss was significantly increased over time for both types of acids. After 8 min, citric acid was more aggressive than hydrochloric acid (p < 0.001). Conclusion: The progression of enamel erosion from erosive softening to erosive loss is highly dependent on the type of acid, being citric acid more aggressive in later stages. Therefore, this finding should be considered when choosing the method of analysis for laboratory studies

Efeito do tratamento com melatonina sobre a produção de metástases neoplasias / Result of the treatment with melatonin inthe production of neoplasic metastasis

Introdução: Neoplasias são células com proliferação e diferenciação anormais. Quando essas células tornam-se capazes de originar outras células em tecidos e vasos diferentes do inicial são denominadas metástases. A melatonina (N-acetil-5-metoxitripamina) é um hormônio secretado pela glândula pineal e que tem associação com o controle celular tumoral. Objetivo: pretendeu-se avaliar o efeito do tratamento com melatonina sobre a produção e crescimento de metástase linfática do tumor sólido de Ehrlich (TE) em camundongos. Método: foram empregados 14 camundongos distribuídos em 2 grupos: controle (GC, N = 07 / 0,1ml de solução fisiológica, via oral, 1x/dia) e teste (GT, N = 07 / 10mg/kg de melatonina, via oral, 1x/ dia). Todos os animais foram inoculados com 10 6 células tumorais no coxim plantar da pata traseira direita. Resultados e Discussão: D=decorridos 17 dias de tratamento os animais foram eutanasiados, removemos as 02 patas traseiras para avaliar o peso da massa tumoral sendo que o grupo controle apresentou peso maior (GC = 0,62 ± 0,14). Também foi removido o linfonodo poplíteo para mensuração da área, constatando redução significativa no grupo teste (GT = 4,37 ± 1,58). A redução da área do linfonodo pode ser associada a uma redução no número de células tumorais presentes nos linfonodos (GT = 62,8 ± 13,07). Conclusão: Concluímos que o tratamento com melatonina reduziu significativamente o crescimento tumoral e metastático do TE.

Introduction: Neoplasms are cells with unusual proliferation and differentiation. When these cells become able to generate other cells in material and veins different from the beginning one arenamed metastasis. The melatonin (N-acetil-5-methoxytryptamine) is a hormone secreted by the pineal gland and it has association with the tumor cell control. Objective: the general aim was to evaluate the treatment result with melatonin on the metastasis lymphatic production and growth of the Ehrlich Tumor in mice. For this experience, 14 mice were used and shared in 2 groups: control (GC, N = 07 / 0,1ml of sterilizing solution, oral, once a day) and test (GT, N = 07 / 10mg/kg of melatonin, oral, once a day). All the animals were inoculated with 106 tumor cells in the footpad of the right back paw. Results and discussion: after 17 days of treatment the animals were euthanized and 2 back paws were removed to evaluate the tumor bulk weight considering that the control group was heavier (GC = 0,62 ± 0,14). The popliteallymph node was also removed for the area measurement where asmaller area for the test group was observed (GT = 62,8 ± 13,07). Conclusion: we concluded that the treatment with melatonin meaningfully reduced the metastatic growth.