Biological effects of sodium fluoride varnishes used in remineralisation of enamel: An in vitro study.

AIM: During the last three decades, fluoride varnishes have been recognised as effective strategies for caries prevention in the young-child population and have contributed to a decrease in its prevalence worldwide. The present study aimed to assess in vitro the level of cytotoxicity and genotoxicity in human primary pulp fibroblasts (DPFs) of two NaF varnishes. MATERIALS AND METHODS: Four experimental assays were carried out (MTS, Mitotracker® system [mitochondrial function and morphology], Live/Dead®, and Comet) to assess the morphology, viability, and genotoxicity of two NaF varnishes (Duraphat® and Clinpro White®, both at two different concentrations). The essays were conducted on cultured pulp fibroblasts, grouped in four experimental and two control groups. Collected data were analysed by one-way ANOVA followed by the post hoc Bonferroni test. RESULTS: Some morphological changes of DPFs could be detected after the NaFVs stimulation. Most DPFs incubated in Duraphat (22.6 mg/L) maintained their morphological characteristics, except for a small decrease in cell size and shorter cytoplasmic projections (filopodia); DPFs treated with Clinpro White Varnish (22.6 mg/L) presented a morphology and size similar to the control group. DPFs exposed to Duraphat (113 mg/L) exhibited significant morphological alterations with considerable cell size increases and DPFs treated with Clinpro White Varnish (113 mg/L) showed a slight cell size increase without noticeable morphological anomalies. The Duraphat (22.6 mg/L) and Clinpro White Varnish (22.6 mg/L) groups promoted 31% and 35% cell proliferation, respectively, whereas DPFs proliferation with Duraphat (113 mg/L) decreased up to 59%, and cell proliferation with Clinpro White Varnish (113 mg/L) was similar to that of control. CONCLUSION: All tested varnishes induced changes in the fibroblastic mitochondria. In general, Duraphat was less biocompatible and caused a change in the number of mitochondria compared to Clinpro White Varnish.

Dental approach for Apert syndrome in children: a systematic review.

BACKGROUND: Apert Syndrome (AS), or type I acrocephalosyndactyly, is a rare, congenital craniosynostosis condition resulting from missense mutations in the gene encoding fibroblast growth factor receptor 2. It is characterized by three specific clinical features: brachycephalic skull; midface hypoplasia, and limb abnormalities (syndactyly of hands and feet). The disorder exhibits variable presentations in bones, brain, skin, internal organs, and in the oral/maxillofacial region. The aim of the present paper was to show the main results from a systematic review of AS. MATERIAL AND METHODS: A search of the literature was performed from April to June 2016 in five electronic databases. Clinical interventional or observational studies, reviews, and case reports were included. The present systematic review was carried out strictly following PRISMA and Cochrane Collaboration criteria. RESULTS: A total of 129 potential references were identified. After reviewing titles and abstracts, 77 of these did not meet the desired criteria and were discarded. The full text of the remaining 52 manuscripts was critically screened. Finally, 35 relevant papers were identified for inclusion in the present systematic review and classified according to topic type. CONCLUSIONS: According to the information gathered, dentistry practitioners must be able to supply an early diagnosis through the recognition of AS clinical features and provide correct oral management. Additionally, they should be integrated in a multidisciplinary medical care team in order to improve the quality of life of the affected patients.

In vitro assessment of retention and microleakage in pit and fissure sealants following enamel pre-etching with sodium hypochlorite deproteinisation.

AIM: The purpose of this study was to assess and compare the rate of sealant retention and microleakage after placement on etched enamel with and without prior deproteinisation. STUDY DESIGN: 75 freshly extracted third molars were randomly assigned to either of two pit and fissure treatment methods. Samples from both groups were etched with 37% phosphoric acid gel for 15 seconds, followed by placement of a sealant, and then subjected to thermocycling for evaluation of sealant retention. After that, specimens were immersed in rhodamine B, sectioned longitudinally, and examined under a confocal laser scanning microscope for assessment of microleakage. Collected data were statistically analysed using chi-square and Fisher exact tests with an α level of 0.05. RESULTS: The rate of sealant retention was similar between the two study groups (P = 0.073), but the rate of sealant microleakage was significantly lower in the enamel deproteinisation group (P < 0.001) than in the control group. CONCLUSION: Based on these findings, we recommend the deproteinisation method prior to enamel acid etching to obtain better clinical results with sealants.

Subcutaneous Midazolam with and without Ketamine for Sedation In Children Undergoing Dental Treatment: A Pilot Study.

AIM: The objective of this study was to evaluate the efficacy of subcutaneous (SC) sedation using midazolam with and without ketamine in non-cooperative pediatric patients undergoing dental treatment. STUDY DESIGN: A prospective, randomized, controlled, double-blind, crossover pilot clinical trial was carried out in 13 children, aged between 17-46 months, ASA l, Frankl 1. Two sedation schemes were administered SC: Midazolam alone (M), and a combination of Midazolam-Ketamine (MK). Both regimens were administered to the same patient in two consecutive treatment sessions, in accordance with a random assignment. Overall behavior, movement, and crying were assessed according to the modified Houpt scale. Heart rate, blood pressure, blood oxygen saturation, and possible side effects were also monitored. RESULTS: The percentage of non-crying children was always higher in the treatment with MK compared with the treatment with M, but without a significant statistical difference. Regarding variable body movement, the percentage of children without movement was higher in the MK group, although only up to minute 10; no significant differences were found at 20, 30, and 40 minutes, and from minute 40, body movement was lower in the M group. CONCLUSIONS: Midazolam alone and the midazolam-ketamine combination administered subcutaneously resulted in a safe and efficient pharmacological method for providing moderate sedation to non-cooperative pediatric patients undergoing dental treatment.

Colonization levels of Streptococcus mutans between mother and infant: a postnatal prospective cohort study.

OBJECTIVE: To investigate the possible association between maternal S. mutans levels and those of the infant during the period between birth and 5 months and evaluate possible risk factors in the S mutans colonization. STUDY DESIGN: A prospective cohort study was carried out comprising 62 infants and their mothers, selected at the time of childbirth. For each infant, a sample swab was taken at 0, 15, 30, 90, and 150 days postpartum; on the same days, a sample was obtained from the mothers. TYCSB medium was employed for identifying the microorganism, which was later confirmed by Gram staining, the catalase activity test, and the API strep test. RESULTS: The final total sample consisted of 60 infants, from which S. mutans was detected in only 2 (3%) at the 150th day of oral sample collection. Of the sample of 60 mothers, 54 exhibited colonization levels. CONCLUSIONS: In the studied sample pairs up to 150 days, it was not possible to demonstrate the presence of a direct relationship between maternal S. mutans oral levels.