Parental beliefs in and attitudes toward teething signs and symptoms: A systematic review.

BACKGROUND: Parents believe that teething is associated with signs and symptoms, which may induce them to give medications that could harm their children. Some children may require alleviation of symptoms and overall attention. AIM: To assess parents' beliefs in and attitudes toward teething. DESIGN: Through electronic databases and gray literature, this systematic review identified cross-sectional studies reporting parents' beliefs in, knowledge about, and attitudes toward the signs and symptoms of primary tooth eruption in children aged between 0 and 36 months. Three reviewers independently selected the studies, collected the information, assessed methodological quality, and checked for accuracy with disagreements solved by a fourth reviewer. The Agency of Research and Quality in Health questionnaire for cross-sectional studies was used for quality assessment. Descriptive analysis with median and interquartile ranges was adopted. RESULTS: Twenty-nine studies comprising 10 524 participants from all geographic regions were included. The methodological quality of the studies was moderate. Most parents have beliefs in signs and symptoms during dentition, the most reported symptom being the desire to bite. Oral rehydration was the most exposed attitude in the studies included. Only a small proportion of parents reported no attitude. CONCLUSIONS: The majority of parents believed in at least one sign or symptom associated with teething, and only few of them would do nothing or just wait for the signs or symptoms to pass, with no difference among countries (Protocol doi: 10.17605/OSF.IO/S2KZ3).

Does use of animal therapy during dental care help to reduce anxiety in children and adolescents? A systematic review.

BACKGROUND: Animal-assisted therapy (AAT) is considered a useful technique to reduce anxiety in children and adolescents in medical settings. AIM: To investigate whether the use of AAT helps to reduce anxiety during dental care in children and adolescents. DESIGN: Systematic review that included randomized and nonrandomized clinical trials with children up to 18-years of age undergoing dental appointments. The databases Embase, Cochrane, Pubmed/Medline, LILACS, PsycInfo, Scopus, and Web of Science were searched including gray literature. Random-effects meta-analyses using mean difference (MD) and narrative synthesis (vote counting) were implemented. Risk of bias was assessed using RoB2 for randomized clinical trials. The certainty of the evidence was performed using GRADE. RESULTS: A total of 1103 references were identified, and after a two-phase selection, three studies were included. Anxiety, behavior, and pain were the outcomes. A meta-analysis with 146 participants was performed for anxiety at three time points: before treatment (MD -0.40, CI: -1.06 to 0.26; I2  = 0%; p = .24), during treatment (MD -3.64, CI: -11.18 to 3.91; I2  = 94%; p = .34), and after treatment (MD -5.97, CI: -17.08 to 5.14; I2  = 98% p = .29). There was no difference during dental treatment with or without ATT (dogs), as well as for narrative analysis for any outcome. The risk of bias was high mainly because of the randomization and outcome measurement. CONCLUSION: There is no evidence to support or refute that the presence of AAT during dental care can help reduce anxiety in children (5-11 years). Studies with larger samples are suggested. Protocol registration (CRD42021293593).

Manejo de cárie radicular: um guia para o dentista brasileiro baseado na tradução e adaptação cultural do consenso internacional/ORCA E EFCD / Management of root caries: a guide for the Brazilian dentist based on the translation and cultural adaptation of the international consensus/ORCA and EFCD

Objetivo: A cárie radicular é um problema da Odontologia moderna, porém é notável a falta de diretrizes sobre o seu manejo. Objetivamos elaborar e adaptar um guia a partir da tradução das recomendações do consenso in-ternacional European Organization for Caries Research (ORCA) e European Federation of Conservative Dentistry (EFCD) para as tomadas de decisão clínica na intervenção do processo de cárie na pessoa idosa, com foco na cárie radicular. Materiais e métodos: O protocolo de tradução das recomendações do consenso internacional consistiu nas etapas: (1) tradução inicial, (2) síntese da tradução, (3) retradução, (4) revisão por comitê de especialistas, com adaptação cultural. A partir da tradução, foi desenvolvido um guia com diretrizes para tratamento de cárie radicular no Brasil. Resultados: Para prevenção de novas lesões é recomendada a escovação diária com dentifrício >1.500ppm/F. Dentifrícios com 5.000ppm/F ou vernizes (>20.000ppm/F) podem ser indicados para paralisar lesões radiculares ativas e para prevenção em pessoas idosas com alta suscetibilidade à cárie radicular, e o Diamino Fluoreto de Prata (>30%) para paralisar lesões ativas. Intervenções invasi-vas diretas são indicadas dependendo da situação clínica. Discussão: Nota-se uma falta de interesse em estudos primários sobre tratamentos para cárie radicular, criando assim uma lacuna em relação ao seu manejo, que reflete no nível de evidência detectado pelo consenso. Conclusão: Guias clíni-cos são importantes para reduzir a lacuna entre a pesquisa e a prática clínica. Essa tradução para o português facilitará o acesso dos dentistas bra-sileiros em relação a evidência consolidada até o momento para o manejo de cárie radicular.

Aim: Root caries are a problem in modern dentistry, but the lack of guidelines regarding their management is notable. We aim to develop and adapt a guide based on the translation of the recommendations of the international consensus as outlined by the European Organization for Caries Research (ORCA) and the European Federation of Conservative Dentistry (EFCD) for clinical decision-making in the intervention of the caries process in the elderly, with a focus on root caries. Materials and methods: The protocol for translating the recommendations of the international consensus consisted of the following steps: (1) initial translation, (2) synthesis of the translation, (3) back-translation, (4) review by an expert committee with cultural adaptation. Based on the translation, a guide was developed with guidelines for the treatment of root caries in Brazil. Results: To prevent new lesions, daily brushing with toothpaste >1,500ppm/F is recommended. Toothpaste with 5,000ppm/F or varnishes (>20,000ppm/F) may be recommended to paralyze active root lesions and for prevention in elderly people with high susceptibility to root caries, and Silver Diamine Fluoride (>30%) to paralyze active lesions. Direct invasive interventions are indicated depending on the clinical situation. Discussion: There is a lack of interest in primary studies on treatments for root caries, thus creating a gap in relation to its management, which is reflected by the level of evidence detected in the consensus. Conclusion: Clinical guidelines are important to reduce the gap between research and clinical practice. This translation into Portuguese will facilitate access by Brazilian dentists to the consolidated evidence gathered to date for the management of root caries.

Traumatic dental injuries in the primary dentition and sequelae in the permanent dentition: a 7-year retrospective study / Lesões dentárias traumáticas na dentição decídua e sequelas na dentição permanente: um estudo retrospectivo de 7 anos

Objective: Traumatic dental injuries (TDIs) affect the aesthetics and function of primary teeth and can cause sequelae in their permanent successors. This study assessed the distribution of TDIs and sequelae in the primary dentition and the respective permanent dentition in children treated at the Dental Trauma Centre in Brazil. Material and Methods: This cross-sectional study was conducted by collecting data from 256 dental records over 7 years. Descriptive statistical analyses and the Fisher exact test were used (p=0.05). Results: Sixty-two patients presented with trauma in the deciduous teeth. TDIs were observed mostly in boys (64.50%) and in the 2 to 4-year age group (44.10%); most injuries occurred from fall from the child's own height (40.30%) and at home (71.20%). The most common type of trauma was subluxation (22.90%). The most prevalent clinical and radiographic sequelae were mobility (45.60%) and periapical lesion (31.80%), respectively. Regarding the permanent dentition, the most frequent sequela was hypomineralization (33.30%). Conclusion:According to this study, TDIs in deciduous teeth made up 29.24% of all the cases in the Dental Trauma Program. The major type of trauma in children was subluxation, with sequelae in both dentitions. Follow-up after trauma is important to the maintenance of primary dentition and to prevent and treat possible sequelae in the permanent dentition.(AU)

Objetivo: Lesões dentárias traumáticas (TDIs) afetam a estética e a função dos dentes decíduos e podem causar sequelas em sucessores permanentes. Este estudo avaliou a distribuição das TDIs e sequelas na dentição decídua e sua respectiva dentição permanente em crianças atendidas no Centro de Trauma Odontológico no Brasil. Material e Métodos: Trata-se de um estudo transversal realizado por meio da coleta de dados de 256 prontuários odontológicos ao longo de 7 anos. Foram utilizadas análises estatísticas descritivas e teste exato de Fisher (p <0,05). Resultados:Sessenta e dois pacientes apresentaram trauma na dentição decídua. As TDIs foram observadas principalmente em meninos (64,50%) e na faixa etária de 2 a 4 anos (44,10%); a maioria das lesões ocorreu por queda da própria altura (40,30%) e em casa (71,20%). O tipo de trauma mais comum foi a subluxação (22,90%). As sequelas clínicas e radiográficas mais prevalentes foram mobilidade (45,60%) e lesão periapical (31,80%), respectivamente. Em relação à dentição permanente, a sequela mais frequente foi a hipomineralização (33,30%). Conclusão: De acordo com este estudo, as TDIs em dentes decíduos foram de 29,24% de todos os casos do Programa de Trauma Dental. O principal tipo de trauma em crianças foi a subluxação, com sequelas em ambas as dentições. O acompanhamento após o trauma é importante para a manutenção da dentição decídua e para prevenir e tratar possíveis sequelas na dentição permanente. (AU)

Is there an association between dental caries, fluorosis, and molar-incisor hypomineralization?

OBJECTIVE: This cross-sectional study aimed to determine the prevalence of dental caries, dental fluorosis, and molar-incisor hypomineralization, and their associations in a group of Brazilian schoolchildren. METHODOLOGY: Adolescents (n=411) were evaluated by two calibrated examiners for dental caries (DC), dental fluorosis (DF), and molar-incisor hypomineralization (MIH) using the CAST (Caries Assessment Spectrum and Treatment) instrument, Thylstrup and Fejerskov (TF) index, and MIH Severity Scoring System (MIH-SSS), respectively. Descriptive statistics, chi-square tests, and logistic regression were used for statistical analysis. RESULTS: The sample comprised 42.75% boys and 57.25% girls. The prevalence of DC in permanent dentition was 94.75%, of which 29% were represented by dentin lesions. For DF, a prevalence of 40.75% was observed, with 69.32% mild, 12.88% moderate, and 17.79% severe. A positive association between the source of water and fluorosis was detected (p=0.01). The prevalence of MIH was 18%. Thirty adolescents (41.7%) presented with severe MIH. No association was found between DF or MIH and dentin DC or between MIH and DF at the individual level. However, a significant negative relationship was detected between DF and dentin carious lesions ( p <0.005) and DF and MIH ( p <0.00001) at the tooth level, whereas a positive association was observed between MIH and dentin carious lesions ( p <0.00001). A positive association was also observed between the severity of both conditions ( p <0.00001). Mild DF was the most prevalent problem observed. Cases of teeth with mild MIH were the most predominant in MIH-affected teeth. CONCLUSIONS: No association was observed among the dentin carious lesions, MIH, and DF at the participant level. However, a positive association between MIH and dentin carious lesions was found at the tooth level, whereas MIH, DF, and DF and dentin carious lesions showed a negative relationship.

Is there an association between dental caries, fluorosis, and molar-incisor hypomineralization?

Abstract Objective: This cross-sectional study aimed to determine the prevalence of dental caries, dental fluorosis, and molar-incisor hypomineralization, and their associations in a group of Brazilian schoolchildren. Methodology: Adolescents (n=411) were evaluated by two calibrated examiners for dental caries (DC), dental fluorosis (DF), and molar-incisor hypomineralization (MIH) using the CAST (Caries Assessment Spectrum and Treatment) instrument, Thylstrup and Fejerskov (TF) index, and MIH Severity Scoring System (MIH-SSS), respectively. Descriptive statistics, chi-square tests, and logistic regression were used for statistical analysis. Results: The sample comprised 42.75% boys and 57.25% girls. The prevalence of DC in permanent dentition was 94.75%, of which 29% were represented by dentin lesions. For DF, a prevalence of 40.75% was observed, with 69.32% mild, 12.88% moderate, and 17.79% severe. A positive association between the source of water and fluorosis was detected (p=0.01). The prevalence of MIH was 18%. Thirty adolescents (41.7%) presented with severe MIH. No association was found between DF or MIH and dentin DC or between MIH and DF at the individual level. However, a significant negative relationship was detected between DF and dentin carious lesions ( p <0.005) and DF and MIH ( p <0.00001) at the tooth level, whereas a positive association was observed between MIH and dentin carious lesions ( p <0.00001). A positive association was also observed between the severity of both conditions ( p <0.00001). Mild DF was the most prevalent problem observed. Cases of teeth with mild MIH were the most predominant in MIH-affected teeth. Conclusions: No association was observed among the dentin carious lesions, MIH, and DF at the participant level. However, a positive association between MIH and dentin carious lesions was found at the tooth level, whereas MIH, DF, and DF and dentin carious lesions showed a negative relationship.

Avaliação da eficácia anestésica do Morpheus® através da técnica intrasseptal CaZOE na pulpotomia de dentes decíduos: estudo-piloto / Anesthetic effectiveness evaluation of Morpheus® through intrasseptal technical CaZOE in pulpotomy of deciduous teeth: pilot study

Introdução: O medo de sentir dor é um dos principais motivos pelos quais muitos pacientes evitam submeter-se a tratamento dentário, principalmente as crianças. Em vários procedimentos odontopediátricos, o uso de anestésicos locais se faz necessário. O aparelho Morpheus® se propõe a uma introdução da agulha sem dor e anestesia satisfatória com uso de menor volume de anestésico local. Associando-o à técnica CaZOE, o paciente perceberia a pressão antes da dor, podendo assim evitá-la. Objetivo: Avaliar a eficácia anestésica do Morpheus® através da técnica intrasseptal CaZOE na pulpotomia de molares inferiores decíduos. Material e método: Dezenove voluntários foram selecionados de acordo com os critérios de inclusão e exclusão. O procedimento foi realizado em sessão única, utilizando 0,9 mL de Articaína 4% com epinefrina 1:100.000, através da técnica anestésica CaZOE, empregando o injetor de anestésicos Morpheus®. Esta foi realizada por um único operador, não envolvido na avaliação dos parâmetros da anestesia, e seguiu as recomendações do fabricante. Para a análise dos dados, foi realizada estatística descritiva. Resultado: Dos 19 voluntários, 63% foram do sexo feminino e 37%, do masculino. Em pouco mais da metade da amostra (63%), houve sucesso na realização do procedimento. Os casos de insucesso (37%) ocorreram durante a abertura coronária e a amputação da polpa. Conclusão: A eficácia anestésica do Morpheus® através da técnica intrasseptal CaZOE na pulpotomia de molares inferiores decíduos foi constatada em 63% da amostra. Para que possa ser comprovada a eficácia desse sistema, são necessários mais estudos.

Introduction: The fear of pain is one of the main reasons why many patients avoid dental treatment, especially children. In several pediatric dentistry procedures, the use of local anesthetic is necessary. Morpheus® system proposes an insertion of the needle painlessly and satisfactory anesthesia with lower volume of local anesthetic. With the CaZOE technique, the patient realizes the pressure before the pain, thus being able to avoid it. Objective: To evaluate the anesthetic efficacy of Morpheus® through intrasseptal technical CaZOE in pulpotomy of mandibular's primary molars. Material and method: Nineteen volunteers were selected according to the inclusion and exclusion criteria. The study was conducted in a single session using 0.9 mL of Articaine 4% with epinephrine 1: 100,000 through anesthetic CaZOE technique, using the Morpheus®. This was carried out by a single operator not involved in the evaluation of anesthesia parameters and followed the manufacturer's recommendations. For data analysis, descriptive statistics was performed. Result: Of the 19 volunteers, 63% were female and 37% male. In just over half of the sample (63%), was successful in performing the procedure. Cases of failure (37%) occurred during coronary opening and removal of pulp. Conclusion: The efficacy of Morpheus® through intrasseptal technical CaZOE in pulpotomy of mandibular's primary molars was noted in 63% of the sample. Further studies should be carried out to prove this efficacy.

Effect of Trimetaphosphate and Fluoride Association on Hydroxyapatite Dissolution and Precipitation In Vitro

The present study analyzed the action of sodium trimetaphosphate (TMP) and/or fluoride on hydroxyapatite. Hydroxyapatite powder was suspended in different solutions: deionized water, 500 µg F/mL, 1,100 µg F/mL, 1%TMP, 3%TMP, 500 µg F/mL plus 1%TMP and 500 µg F/mL plus 3%TMP. The pH value of the solutions was reduced to 4.0 and after 30 min, raised to 7.0 (three times). After pH-cycling, the samples were analyzed by X-ray diffraction and infrared spectroscopy. The concentrations of calcium fluoride, fluoride, calcium and phosphorus were also determined. Adding 1% or 3% TMP to the solution containing 500 µg F/mL produced a higher quantity of calcium fluoride compared to samples prepared in a 1,100 µg F/mL solution. Regarding the calcium concentration, samples prepared in solutions of 1,100 µg F/mL and 500 µg F/mL plus TMP were statistically similar and showed higher values. Using solutions of 1,100 µg F/mL and 500 µg F/mL plus TMP resulted in a calcium/phosphorus ratio close to that of hydroxyapatite. It is concluded that the association of TMP and fluoride favored the precipitation of a more stable hydroxyapatite.

O presente estudo avaliou a ação do trimetafosfato de sódio (TMP) e/ou fluoreto sobre a hidroxiapatita. Pó de hidroxiapatita foi suspenso em diferentes soluções: água deionizada, 500 µg F/mL, 1100 µg F/mL, 1%TMP, 3%TMP, 500 µg F/mL adicionado a 1%TMP e 500 µg F/mL associado a 3%TMP. O pH das soluções foi reduzido para 4,0 e depois de 30 min, elevado para 7,0 (três vezes). Depois do processo de ciclagem de pH, as amostras foram analisadas por difração de raios-X e espectroscopia por infravermelho. As concentrações de fluoreto de cálcio, fluoreto, cálcio e fósforo também foram determinadas. A adição de 1% ou 3% TMP na solução contendo 500 µg F/mL produziu uma maior quantidade de fluoreto de cálcio comparado às amostras tratadas com uma solução de 1100 µg F/mL. A respeito da concentração de cálcio, amostras tratadas com soluções de 1100 µg F/mL e 500 µg F/mL adicionado ao TMP foram estatisticamente similares e mostraram maiores valores. Soluções de 1100 µg F/mL e 500 µg F/mL adicionado ao TMP resultaram em uma proporção molar Ca/P mais próxima à da hidroxiapatita. Conclui-se que a associação de TMP e F favoreceu a precipitação de uma hidroxiapatita mais estável.

Effect of fluoride gels supplemented with sodium trimetaphosphate in reducing demineralization.

OBJECTIVES: The objective of this study was to evaluate the in vitro effect of low-fluoride (F) gels supplemented with sodium trimetaphosphate (TMP) on enamel demineralization. MATERIALS AND METHODS: Bovine enamel blocks (n = 160) were selected based on surface hardness (SH) and divided into eight treatment groups (n = 20 per group): no F or TMP (placebo), 3 % TMP (3 %TMP), 5 % TMP (5 %TMP), 4,500 µg F/g (4,500), 4,500 µg F/g + 3 % TMP (4,500 3 %TMP), 4,500 µg F/g + 5 % TMP (4,500 5 %TMP), 9,000 µg F/g (9,000), and 12,300 µg F/g (acid gel). Blocks were subjected to demineralization/remineralization cycling for 5 days. Subsequently, surface hardness (SH1) and integrated loss of subsurface hardness (ΔKHN) were assessed, and the concentrations of loosely bound (CaF2-like) and firmly bound (FA-like) formed and retained F were determined. RESULTS: The 4,500 5 %TMP and acid gel groups showed similar results and had the lowest mineral loss (SH1 and ∆KHN). The acid gel group had the highest concentration of CaF2-like F, but the formation and retention of FA-like F was greater in the 4,500 5 %TMP group than in the acid gel group (p < 0.05). CONCLUSION: It is possible to inhibit enamel demineralization with low-F gels supplementing these gels with 5 % TMP. CLINICAL RELEVANCE: The low-F gel containing TMP can be regarded as a safer alternative for clinical use from a toxicological point of view since it contains half of the amount of a conventional formulation while promoting similar anticaries effect.

Effect of trimetaphosphate and fluoride association on hydroxyapatite dissolution and precipitation in vitro.

The present study analyzed the action of sodium trimetaphosphate (TMP) and/or fluoride on hydroxyapatite. Hydroxyapatite powder was suspended in different solutions: deionized water, 500 µg F/mL, 1,100 µg F/mL, 1%TMP, 3%TMP, 500 µg F/mL plus 1%TMP and 500 µg F/mL plus 3%TMP. The pH value of the solutions was reduced to 4.0 and after 30 min, raised to 7.0 (three times). After pH-cycling, the samples were analyzed by X-ray diffraction and infrared spectroscopy. The concentrations of calcium fluoride, fluoride, calcium and phosphorus were also determined. Adding 1% or 3% TMP to the solution containing 500 µg F/mL produced a higher quantity of calcium fluoride compared to samples prepared in a 1,100 µg F/mL solution. Regarding the calcium concentration, samples prepared in solutions of 1,100 µg F/mL and 500 µg F/mL plus TMP were statistically similar and showed higher values. Using solutions of 1,100 µg F/mL and 500 µg F/mL plus TMP resulted in a calcium/phosphorus ratio close to that of hydroxyapatite. It is concluded that the association of TMP and fluoride favored the precipitation of a more stable hydroxyapatite.

Effect of low fluoride acidic dentifrices on dental remineralization.

This study evaluated the capacity of fluoride acidic dentifrices (pH 4.5) to promote enamel remineralization using a pH cycling model, comparing them with a standard dentifrice (1,100 µgF/g). Enamel blocks had their surface polished and surface hardness determined (SH). Next, they were submitted to subsurface enamel demineralization and to post-demineralization surface hardness analysis. The blocks were divided into 6 experimental groups (n=10): placebo (without F, pH 4.5, negative control), 275, 412, 550, 1,100 µgF/g and a standard dentifrice (positive control). The blocks were submitted to pH cycling for 6 days and treatment with dentifrice slurries twice a day. After pH cycling, surface and cross-sectional hardness were assessed to obtain the percentage of surface hardness recovery (%SHR) and the integrated loss of subsurface hardness (ΔKHN). The results showed that %SHR was similar among acidic dentifrices with 412, 550, 1,100 µgF/g and to the positive control (Tukey's test; p>0.05). For ΔKHN, the acidic dentifrice with 550 µg F/g showed a better performance when compared with the positive control. It can be concluded that acidic dentifrice 550 µgF/g had similar remineralization capacity to that of positive control.

Effect of low fluoride acidic dentifrices on dental remineralization

This study evaluated the capacity of fluoride acidic dentifrices (pH 4.5) to promote enamel remineralization using a pH cycling model, comparing them with a standard dentifrice (1,100 µgF/g). Enamel blocks had their surface polished and surface hardness determined (SH). Next, they were submitted to subsurface enamel demineralization and to post-demineralization surface hardness analysis. The blocks were divided into 6 experimental groups (n=10): placebo (without F, pH 4.5, negative control), 275, 412, 550, 1,100 µgF/g and a standard dentifrice (positive control). The blocks were submitted to pH cycling for 6 days and treatment with dentifrice slurries twice a day. After pH cycling, surface and cross-sectional hardness were assessed to obtain the percentage of surface hardness recovery (%SHR) and the integrated loss of subsurface hardness (ΔKHN). The results showed that %SHR was similar among acidic dentifrices with 412, 550, 1,100 µgF/g and to the positive control (Tukey's test; p>0.05). For ΔKHN, the acidic dentifrice with 550 µg F/g showed a better performance when compared with the positive control. It can be concluded that acidic dentifrice 550 µgF/g had similar remineralization capacity to that of positive control.

O presente estudo objetivou avaliar a capacidade de dentifrícios fluoretados acidulados (pH 4,5) em promover a remineralização do esmalte utilizando um modelo de ciclagem de pH e compará-lo a um dentifrício padrão (1.100 µgF/g). Blocos de esmalte tiveram suas superfícies polidas e a dureza de superfície determinada (SH). Em seguida, foram submetidos à desmineralização subsuperficial e a dureza de superfície pós-desmineralização foi determinada. Os blocos foram divididos em seis grupos experimentais (n=10): placebo (controle negativo), 275, 412, 550, 1.100 µgF/g e um dentifrício padrão (controle positivo). Os blocos foram submetidos à ciclagem de pH durante seis dias e tratamentos com dentifrício diluído duas vezes por dia. Após a ciclagem de pH, a dureza de superfície e em secção transversal foram avaliadas para obtenção da porcentagem de recuperação de dureza de superfície (%SHR) e área integrada da perda de dureza de subsuperfície (ΔKHN). Os resultados mostraram que %SHR foi semelhante entre os dentifrícios ácidos 412, 550, 1.100 µgF/g e controle positivo (teste de Tukey; p>0,05). Para ΔKHN, o dentifrício acidulado com 550 µgF/g mostrou uma performance melhor quando comparado ao controle positivo. Conclui-se que os dentifrícios acidulados 550 µgF/g apresentaram capacidade de remineralização semelhante ao controle positivo.

Avaliação da ação do trimetafosfato sobre o biofilme dentário, desmineralização e remineralização do esmalte: estudos in vitro e in situ / Evaluation of sodium trimataphosphate (TMP) effect on biolfim and enamel des- and remineralization: in vitro and in situ study

O uso de dentifrícios fluoretados por crianças menores de seis anos de idade é um fator de risco para a fluorose dentária. Uma maneira de diminuir a ingestão de fluoreto (F) seria reduzir a concentração desse íon; entretanto, é necessário manter a mesma efetividade de um dentifrício padrão (1100 μgF/g). Alguns estudos têm mostrado que dentifrícios suplementados com fosfato e cálcio são mais efetivos em prevenir a desmineralização e melhor a remineralização. O objetivo do presente estudo foi avaliar o efeito do trimetafosfato de sódio (TMP) associado à baixa concentração de F sobre o biofilme, a desmineralização e remineralização do esmalte através de modelos de estudo in vitro e in situ. Para avaliação in vitro sobre des-remineralização do esmalte foi utilizado o modelo de ciclagem de pH. Blocos de esmalte (n=35) com lesão de cárie artificial foram submetidos a 15 dias de ciclagem de pH com 6 ciclos diários de 0,5 h em solução desmineralizadora e 2,5 h em solução remineralizadora. O tratamento foi realizado durante 5 min com soluções diluídas de 0, 500, 1500 ou 3000 μg F/g com ou sem a adição de 3% TMP. Após a ciclagem de pH os blocos de esmalte foram analisados através da microrradiografia (TMR) que mostrou a formação de lesão secundária nos grupos com baixa concentração de F. Essa lesão, entretanto, não foi observada nos grupos associados ao TMP. Para avaliação in vitro sobre o biofilme foi utilizado um novo modelo que possibilita a formação de biofilme de multi e simples espécies. Com essa finalidade foram testados diferentes substratos, vidro e esmalte de dente bovino e os tratamentos realizados com soluções de TMP associado ou não a antimicrobianos. Os resultados mostraram que em ambos os biofilmes de multi- e simples espécie, o TMP não altera a produção de ácido lático nem a contagem de unidades formadoras de colônia. Para avaliação in situ sobre a des-remineralização do esmalte foram utilizados dois modelos de estudo. Para a avaliação sobre a...

The use of fluoridated dentifrices by children under 6 years old is a risk factor to dental fluorosis development. One way to reduce fluoride (F) ingestion would be the reduction of this ion concentration in dentifrices; however, it is necessary to maintain similar effectiveness to that of a standard dentifrice (1100 μgF/g). Some studies have demonstrated that dentifrices supplemented with phosphate and/or calcium are more effective in reduce the demineralization and increase the remineralization. The aim of this study was to evaluate the effect of TMP combined to low F concentration on enamel de- and remineralization and biofilm using in vitro and in situ models. To evaluate in vitro de- and remineralization, a pH cycling model was used. Bovine enamel specimens were submitted to 15 days of pH-cycling with a daily schedule of 6 cycles, each 0.5 h demineralization and 2.5 h remineralization. The treatment was performed for 5 min in aliquots of 30wt% dilutions of 0, 500, 1500 or 3000 μg F/g with or without the addition of 3% TMP. After the pH-cycling period the enamel specimens were analyzed by microradiography (TMR). The results showed that the TMR data showed that the formation of a second lesion in the low F groups. This phenomenon was not found in the TMP groups. To evaluate in vitro TMP effect on microcosm and single species biofilm, a new in vitro model was used. The experiments were carried out using different substratum, glass and enamel, and treatment was performed with antimicrobials with or without TMP. The results showed that in both microcosm and single species biofilm TMP did not alter lactic acid production and CFU counts. To evaluate in situ enamel de- and remineralization two different models were used. In the first model, 10 volunteers wearing acrylic palatal appliance containing four enamel bovine blocks selected through surface hardness, were submitted to 4 phases of 14 days each. The specimens (n=160) were allocated to four treatment groups…

Avaliação da ação do trimetafosfato sobre o biofilme dentário, desmineralização e remineralização do esmalte: estudos in vitro e in situ / Evaluation of sodium trimataphosphate (TMP) effect on biolfim and enamel des- and remineralization: in vitro and in situ study

O uso de dentifrícios fluoretados por crianças menores de seis anos de idade é um fator de risco para a fluorose dentária. Uma maneira de diminuir a ingestão de fluoreto (F) seria reduzir a concentração desse íon; entretanto, é necessário manter a mesma efetividade de um dentifrício padrão (1100 μgF/g). Alguns estudos têm mostrado que dentifrícios suplementados com fosfato e cálcio são mais efetivos em prevenir a desmineralização e melhor a remineralização. O objetivo do presente estudo foi avaliar o efeito do trimetafosfato de sódio (TMP) associado à baixa concentração de F sobre o biofilme, a desmineralização e remineralização do esmalte através de modelos de estudo in vitro e in situ. Para avaliação in vitro sobre des-remineralização do esmalte foi utilizado o modelo de ciclagem de pH. Blocos de esmalte (n=35) com lesão de cárie artificial foram submetidos a 15 dias de ciclagem de pH com 6 ciclos diários de 0,5 h em solução desmineralizadora e 2,5 h em solução remineralizadora. O tratamento foi realizado durante 5 min com soluções diluídas de 0, 500, 1500 ou 3000 μg F/g com ou sem a adição de 3% TMP. Após a ciclagem de pH os blocos de esmalte foram analisados através da microrradiografia (TMR) que mostrou a formação de lesão secundária nos grupos com baixa concentração de F. Essa lesão, entretanto, não foi observada nos grupos associados ao TMP. Para avaliação in vitro sobre o biofilme foi utilizado um novo modelo que possibilita a formação de biofilme de multi e simples espécies. Com essa finalidade foram testados diferentes substratos, vidro e esmalte de dente bovino e os tratamentos realizados com soluções de TMP associado ou não a antimicrobianos. Os resultados mostraram que em ambos os biofilmes de multi- e simples espécie, o TMP não altera a produção de ácido lático nem a contagem de unidades formadoras de colônia. Para avaliação in situ sobre a des-remineralização do esmalte foram utilizados dois modelos de estudo. Para a avaliação sobre a...

The use of fluoridated dentifrices by children under 6 years old is a risk factor to dental fluorosis development. One way to reduce fluoride (F) ingestion would be the reduction of this ion concentration in dentifrices; however, it is necessary to maintain similar effectiveness to that of a standard dentifrice (1100 μgF/g). Some studies have demonstrated that dentifrices supplemented with phosphate and/or calcium are more effective in reduce the demineralization and increase the remineralization. The aim of this study was to evaluate the effect of TMP combined to low F concentration on enamel de- and remineralization and biofilm using in vitro and in situ models. To evaluate in vitro de- and remineralization, a pH cycling model was used. Bovine enamel specimens were submitted to 15 days of pH-cycling with a daily schedule of 6 cycles, each 0.5 h demineralization and 2.5 h remineralization. The treatment was performed for 5 min in aliquots of 30wt% dilutions of 0, 500, 1500 or 3000 μg F/g with or without the addition of 3% TMP. After the pH-cycling period the enamel specimens were analyzed by microradiography (TMR). The results showed that the TMR data showed that the formation of a second lesion in the low F groups. This phenomenon was not found in the TMP groups. To evaluate in vitro TMP effect on microcosm and single species biofilm, a new in vitro model was used. The experiments were carried out using different substratum, glass and enamel, and treatment was performed with antimicrobials with or without TMP. The results showed that in both microcosm and single species biofilm TMP did not alter lactic acid production and CFU counts. To evaluate in situ enamel de- and remineralization two different models were used. In the first model, 10 volunteers wearing acrylic palatal appliance containing four enamel bovine blocks selected through surface hardness, were submitted to 4 phases of 14 days each. The specimens (n=160) were allocated to four treatment groups…

Efeito dos tratamentos superficiais para reparo em cerâmica: avaliação por meio da microscopia eletrônica de varredura / Effect of the superficial treatments to porcelain repair: scanning electron microscopy evaluation

As falhas em Prótese Parcial Fixa podem ocorrer de muitas maneiras, sendo a fratura da porcelana associada ao grupo de problemas mecânicos. Esta ocorrência pode ser reparada sem a necessidade de remoção da peça protética, embora a substituição da restauração seja considerada a solução ideal. Assim, diferentes tratamentos superficiais são utilizados para melhorar a força de união entre cerâmica – resina e viabilizar o reparo. Este estudo analisou a superfície cerâmica tratada com ácido fosfórico à 37% e ácido fluorídrico à 9,5% por meio da microscopia eletrônica de varredura. Quaren-ta amostras cerâmicas (VITA Zahnfabrik, Alemanha), foram confeccionadas a partir de uma matriz metálica circular, com dimensões de 10mmx3mm. As amostras foram divididas nos seguintes grupos, I) controle – sem tratamento; II) tratamento com ácido fluorídrico à 9,5% por 1 minuto; III) tratamento com ácido fluorídrico à 9,5% por 2 minutos; IV) tratamento com ácido fosfórico à 37% por 1 minuto; V) tratamento com ácido fosfórico à 37% por 2 minutos. Após os respectivos tratamentos, as amostras foram metalizadas (20Kv, 15mA, 2 minutos), no aparelho Denton Vaccum Desk II, sendo em seguida, analisadas no MEV (JEOL – JSM 5410). As superfícies tratadas com ácido fosfórico à 37% por 1 ou 2 minutos não apresentaram alterações morfológicas significativa, enquanto a superfície cerâmica tratada com ácido fluorídrico à 9,5% por 1 minuto já apresentou alteração morfológica significativa, sendo este achado mais evidente após 2 minutos de aplicação. Clinicamente este trabalho sugere um reparo mais eficiente quando a superfície cerâmica é tratada com ácido fluorídrico.

Effect of fluoride and gonadal steroid deficiency on enamel and dentin mineralization of female rats

O objetivo do trabalho foi verificar se a deficiência de estrógenos causava alteração na microdureza do esmalte e da dentina de incisivos de ratas e se a administração crônica de fluoreto alterava essa resposta. Ratas ovariectomizadas ou sham-ovariectomizadas receberam para beber água destilada contendo ou não NaF 10 ppm, durante 90 dias. Decorrido este tempo, os incisivos maxilares foram removidos e a microdureza determinada no esmalte e dentina. Os resultados foram submetidos à análise de variância e teste de Tukey (p<0,05). Constatou-se uma redução significante na mineralização da coroa (7,9% e 8,1%) e raiz (20,4% e 25,0%) nos grupos tratados com fluoreto ou água destilada, respectivamente e um aumento (14,2%) na dentina da coroa, após a ovariectomia. O tratamento com fluoreto não impediu a redução da mineralização no esmalte, porém interferiu na dentina diminuindo a mineralização, após a ovariectomia. Concluiu-se que o processo da mineralização do esmalte e da dentina dos incisivos de ratas sofre a ação de estrógenos, de maneira direta ou indireta e que os dois tecidos respondem de maneiras diferentes à administração de fluoreto.

Effect of fluoride and gonadal steroid deficiency on enamel and dentin mineralization of female rats.

The aim of this study was to verify the influence of estrogen deficiency on enamel and dentin microhardness of female rats' incisors, as well as the influence of chronic administration of fluoride on that response. Sham or OVX rats drank distilled water or distilled water with 10 ppm fluoride as NaF, for 90 days. The upper incisors were removed and the specimens submitted to microhardness analysis of enamel and dentin. The data were compared by variance analysis and Tukey's test (p<0.05). There was a significant reduction in the mineralization of crown (7.9% and 8.1%) and root (20.4% and 25.0%) in both groups treated with fluoride or distilled water, respectively and an increase (14.2%) in the mineralization of coronal dentin after ovariectomy. Fluoride treatment did not cause reduction in enamel mineralization; however, it reduced dentin mineralization following ovariectomy. It was possible to conclude that estrogens directly or indirectly influence the process of enamel and dentin mineralization of female rats' incisors. The results also indicate that enamel and dentin exhibit different responses to fluoride administration.