Association between dental age and malocclusions: a systematic review.

BACKGROUND: The evidence in the literature suggests that some skeletal or dental malocclusions are involved with dental development, resulting in advanced or delayed dental age (DA). The purpose of this systematic review was to investigate the association between DA and different types of malocclusions. METHODS: The search was carried out on PubMed, Scopus, Web of Science, Virtual Health Library, and in the gray literature. Observational studies that evaluated the association between DA and sagittal, vertical, or transversal malocclusions were included. The quality assessment was performed using the Newcastle-Ottawa Scale (NOS). The data from primary studies were narratively synthesized. The certainty of evidence was evaluated using the GRADE approach. The study was conducted from August 2023 to October 2023. RESULTS: One Thousand Nine Hundred Ninety-One records were identified in the initial search. Twenty (n = 20) studies were included. Most of the studies (n=15) presented a moderate quality according to NOS. Twelve studies evaluated the association between DA and sagittal discrepancies; eight studies evaluated vertical discrepancies, and only one study analyzed a transversal discrepancy. Demirjian's method for DA assessment was the most used among the studies. The primary studies observed that patients of both sexes presenting a vertical growth pattern and males with skeletal Class III malocclusion tend to have advanced DA. The study that investigated transversal malocclusion found that unilateral posterior cross-bite is associated with delayed DA. The certainty of evidence was very low for all outcomes evaluated. CONCLUSION: DA may be associated with the type of malocclusion. It is suggested that DA can be used as an initial diagnostic tool in orthodontics. Future well-designed studies should be performed in order to investigate the association between DA and different types of malocclusions in more detail. TRIAL REGISTRATION: This study was registered in the PROSPERO database (CRD42023454207).

Assessing the association between vitamin D receptor and dental age variability.

OBJECTIVES: To explore the association between genetic polymorphisms in vitamin D receptor (VDR), vitamin D serum levels, and variability in dental age. MATERIAL AND METHODS: This cross-sectional study was based on an oral examination, panoramic radiograph analysis, and genotype analysis from biological samples. Dental age was evaluated using two different methods: Demirjian et al. (Hum Biol 45:211-227, 1973) and Hofmann et al. (J Orofac Orthop.78:97-111, 2017). The genetic polymorphisms BglI (rs739837) and FokI (rs2228570) in VDR were genotyped through real-time PCR. The vitamin D level was also measured in the serum. Delta (dental age-chronological age) was compared among genotypes in VDR in the co-dominant model. Multiple linear regression analysis was also performed. An established alpha of 5% was used. RESULTS: Genotype distributions of BglI and FokI were not associated with dental maturity (p > 0.05). In the logistic regression analyses, genotypes in BglI and FokI and vitamin D levels were not associated with variability in dental age (p > 0.05). CONCLUSIONS: The genetic polymorphisms BglI and FokI in VDR and the vitamin D levels were not associated with variability in dental age. CLINICAL RELEVANCE: To unravel the factors involved in dental maturity can improve dental treatment planning in pediatric and orthodontic practice.

Influence of Single-Nucleotide Polymorphisms on Vitamin D Receptor Expression in Periodontal Ligament Fibroblasts as a Response to Orthodontic Compression.

This study aimed to evaluate if single-nucleotide polymorphisms (SNPs) in the vitamin D receptor (VDR) gene are associated with gene expression in human periodontal ligament (hPDL) fibroblasts under simulated orthodontic compressive force. hPDL samples from 57 patients were used. A physiological compressive strain was performed to simulate orthodontic tooth movement in pressure areas under cell culture conditions. The RNA from hPDL fibroblasts was isolated to determine the relative gene expression (mRNA) of the VDR. The DNA was also isolated for the genotyping analysis of five SNPs in the VDR gene: BglI (rs739837, G/T), BsmI (rs1544410, T/C), ApaI (rs7975232, A/C), FokI (rs2228570, A/G), and TaqI (rs731236, A/G). Real-time polymerase chain reaction was used for both analyses. Kruskal−Wallis tests were used to compare VDR expression among genotypes of each SNP. A linear regression analysis was performed to evaluate SNP−SNP interaction. An established alpha of 5% was used. The relative mRNA VDR expression according to the genotypes in the SNPs BglI, BsmI, ApaI, FokI, and TaqI was not statistically significantly different (p > 0.05). The SNP−SNP interaction evaluated by regression analysis did not demonstrate any statistically significant association. No association was observed (p > 0.05). In conclusion, the SNPs BglI (rs739837), BsmI (rs1544410), ApaI (rs7975232), FokI (rs2228570), and TaqI (rs731236) did not show an impact on VDR gene expression in hPDL fibroblasts under simulated orthodontic compressive force.

Er,Cr:YSGG and 980nm diode lasers influence dentin surface volume after cariogenic challenge: in vitro study.

This study aimed to evaluate the influence of the Er,Cr:YSGG irradiation and 980-nm diode lasers on the surface roughness (SR) and volume loss (VL) of dentin subjected to cariogenic challenge. Subsequently, 130 specimens of bovine dentin were divided into the following 13 groups: NT: no treatment; FG: fluoride gel; FV: fluoride varnish; Di: 980-nm diode; Di + FG; Di + FV; FG + D; FV + Di; Er: Er,Cr:YSGG; Er + FG; Er + FV; FG + Er and FV + Er. Er,Cr:YSGG laser parameters were as follows: 0.25 W; 5.0 Hz; 4.46 J/cm2 without water and 55% air. Furthermore, the 980-nm diode laser parameters were 2.0 W; 2.0 Hz; 21.41 J/cm2. The samples from each group were subjected to pH cycling. A confocal laser scanning microscope was used to evaluate SR and VL. Difference between the volume of the reference and treated areas + DES/RE was used to determine SR and VL. The mean values of the different groups were subjected to analysis of variance and Tukey's post-hoc test. The VL values were analyzed using the Kruskal-Wallis and Dunn post-hoc test (p < 0.05). The SR of the reference area did not show a statistically significant 1807-3107-bor-38-e025treatment and cariogenic challenge (p > 0.05). Moreover, VL in the FV + Di and FV + Er groups showed a statistically significant difference compared with areas submitted to different types of treatment and cariogenic challenge (p > 0.05). Er,Cr:YSGG and 980-nm diode lasers associated with fluoride varnishes decreased dentin VL in bovine teeth submitted to cariogenic challenge.

Influence of preventive remineralizing techniques on surface roughness and volume loss of dentin submitted to erosive and/or abrasive challenges.

Background: The objective this study was to evaluate the influence of preventive remineralizing techniques on surface roughness and volume loss of dentin submitted to erosive and/or abrasive challenges. Material and Methods: One hundred and eighty specimens of bovine root dentin were made; half of each was isolated (without treatment - WT) and half was subjected to the following remineralizing techniques: fluoride varnish (FV); Regenerate Boosting Serum® (RBS); Er,Cr:YSGG laser (L); fluoride varnish+laser (FV+L); Regenerate Boosting Serum®+laser (RBS+L). The specimens were submitted to erosive, abrasive and erosive followed by abrasive challenge. Erosion was carried out for 5 minutes, twice a day for 10 days. Abrasion was performed with an electric toothbrush and slurry solution for 60 seconds. The evaluation was performed by confocal laser scanning microscopy. Analysis of variance and Tukey tests were used for surface roughness; volume loss comparison was performed using the Kruskal-Wallis test and Dunn's post-hoc (p<0.05). Results: There was no statistically significant difference in the surface roughness of the reference area in relation to the areas submitted to different types of treatment and challenges (p>0.05). Regarding volume loss, the untreated group submitted to erosive/abrasive challenges showed greater percentage of volume loss compared to the other groups (p<0.05). Conclusions: It is concluded that preventive remineralizing techniques are effective in maintaining dentin volume after erosive/abrasive challenges. Key words:YSGG lasers, Dentin, Erosion, Tooth Abrasion.

Exploring the association between PITX2, third molars agenesis and sella turcica morphology : PITX2, third molars agenesis and sella turcica morphology.

OBJECTIVES: PITX2 is required for mammalian development and single nucleotide polymorphisms (SNPs) in this gene could be involved in dental agenesis and sella turcica patterns. Thus, the present study evaluated the association between SNPs in PITX2, third molars agenesis and sella turcica phenotypes. MATERIALS AND METHODS: The sample consisted of healthy orthodontic German patients with lateral cephalometric radiographs with clearly visualization of the sella turcica, and dental orthopantomograms. The morphological variations of the sella turcica were evaluated using the lateral cephalograms, while third molar agenesis was evaluated using orthopantomograms. DNA isolated from buccal cells was used for genotyping three SNPs in PITX2 (rs3796902, rs1947187, and rs2595110). The analyzes were performed using a significance of 5%. There was no association between third molar agenesis and sella turcica phenotypes (p > 0.05). SNPs in PITX2 were also not associated with third molars agenesis (p > 0.05). RESULTS: SNPs in PITX2 were associated with sella turcica phenotypes. The rs3796902 was associated with hypertrophic posterior clinoid process (p = 0.013). The rs1947187 and rs2595110 were associated with sella turcica bridge type A (p = 0.013 and p = 0.011, respectively for genotype distribution). Patients that carry the genotypes GG-CC-AG (rs3796902- rs1947187- rs2595110) had 7.2 higher chance to present sella turcica bridge type A (p = 0.002; Odds ratio = 7.2, Confidence interval 95% 2.04-27.04). CONCLUSIONS: Third molar agenesis was not associated with SNPs in PITX2 and sella turcica phenotypes. SNPs in PITX2 may have an important role in sella turcica pattern.

Is There Variation in the Morphology of the Frontal Sinus in Individuals with Different Craniofacial Patterns? A Systematic Review with Meta-Analysis.

To evaluate differences in the morphology of the frontal sinus in adolescents and adults with different craniofacial patterns, searches up to April 2024 were conducted in six databases and other information sources to identify observational studies. Study selection, data extraction, and quality assessment using the NOS scale were performed independently by two reviewers. Random effects meta-analyses were conducted to estimate the difference in frontal sinus measurements between different craniofacial skeletal patterns (α = 0.05). The certainty of the evidence was evaluated according to GRADE. Fourteen studies were included in the review. All studies had methodological limitations that affected their quality. The syntheses showed that skeletal Class II subjects presented a significantly smaller width of the frontal sinus than skeletal Class I subjects (MD = 0.56; 95% CI: 0.38, 0.74; p < 0.0001; I2 = 3%). Skeletal Class III subjects showed a frontal sinus width (MD = -0.91; 95% CI: -1.35, -0.47; p < 0.0001; I2 = 36%) and area (MD = -28.13; 95% CI: -49.03, -7.23; p = 0.0084; I2 = 66%) significantly larger than those of the skeletal Class I subjects. The available evidence suggests a positive relationship between mandibular and frontal sinus size. There is limited evidence to make reliable estimates of the association of other craniofacial patterns and frontal sinus characteristics. These reported results are not conclusive and should be evaluated carefully due to the very low certainty of the evidence. The current evidence is scarce and consists of studies with methodological limitations; the results of the studies are often inconsistent, and the pooled estimates are imprecise. New high-quality research is still necessary.

Single Nucleotide Polymorphisms in COX2 Is Associated with Persistent Primary Tooth and Delayed Permanent Tooth Eruption.

Persistent primary tooth (PPT) is a prevalent clinical condition that occurs when a primary tooth is over-retained beyond the established period of its normal exfoliation time, remaining in the oral cavity. Many factors could be involved in the risk of PPT; therefore, the aim of this study was to evaluate if single nucleotide polymorphisms (SNPs) in the COX2 gene are associated with PPT. Children undergoing orthodontic treatment were screened. Orthopantomographs were assessed to evaluate PPT according to the Nolla stage of its permanent successor. The primary tooth was considered retained when its successor permanent tooth was in Nolla stage 8 and below the alveolar crypt, Nolla stage 9, or Nolla stage 10. A saliva sample from each child was collected and used for DNA extraction. A real-time PCR of two SNPs, rs689466 (-1195 G/A) and rs5275 (+665 T/C), was performed. A chi-square test was used to compare the allele and genotype distribution. Haplotype analysis was also performed. A total of 100 children were included in the study. Fifty-one had at least one PPT, while 49 children were classified as a control. The number of teeth persistent in the oral cavity ranged from 1 to 8. The genotype distribution was associated with PPT in the co-dominant model (p = 0.006) for SNP rs5275. The individuals that carry two T alleles (TT) compared with the individuals that carry at least one C allele (C + TC) had an almost three times higher chance of presenting with PPT (p = 0.012; OR = 2.99, CI95% 1.28 to 6.95-recessive model). The haplotype C-A for the SNPs rs5275 and rs689466, respectively, was significantly associated (p = 0.042). In conclusion, single nucleotide polymorphisms in the gene encoding for COX2 are associated with persistent primary tooth and may delay permanent tooth eruption.

Assessing the prevalence of S-shaped root canal and associated genes in humans.

BACKGROUND: Multiple signaling molecules have been shown to play crucial roles in dental root development. Therefore, we aimed to investigate the prevalence of S-shaped roots and also to investigate, if single nucleotide polymorphisms (SNPs) in BMP2, BMP4 and SMAD6 are associated with this phenotype in humans. METHODS: This is a cross-sectional phenotype-genotype association study that used radiographs to determine the phenotypes and DNA to investigate SNPs in candidate genes. During the radiographic exam, teeth presenting root canal(s) doubly curved were considered S-shaped roots. SNPs in BMP2 (rs1005464 and rs235768), BMP4 (rs17563) and SMAD6 (rs2119261 and rs3934908) were blindly genotyped by real-time PCR using TaqMan assay. The relative and absolute frequency of S-shaped roots were calculated. Chi-square test was used to compare the genotype distributions between control and S-shaped groups. RESULTS: Among the 578 subjects, 61 (10.6 %) presented at least one tooth with an S-shaped root. The most commonly affected type of tooth was the premolar. rs1005464 in BMP2 was statistically associated with an S-shaped root (p = 0.036). rs235768 in BMP2 was associated with an S-shaped root also in mandibular teeth (p = 0.017). A statistical significance was observed for the rs3934908 in SMAD6 (p = 0.049) for S-shaped root in the mandible. In the analysis stratified according to the type of tooth, rs235768 in BMP2 was associated with S-shaped roots in premolars (p = 0.029). CONCLUSION: The prevalence of S-shaped roots is 10.6 % in permanent teeth. SNPs in BMP2 and SMAD6 could be involved in a higher chance to present S-shaped roots.

Transforming Growth Factor Beta Receptor 2 (TGFBR2) Promoter Region Polymorphisms May Be Involved in Mandibular Retrognathism.

Skeletal malocclusions are common phenotypes in humans and have a strong influence on genetic factors. Transforming growth factor beta (TGFß) controls numerous functions of the human body, including cell proliferation, differentiation, and migration. Thus, this study is aimed at evaluating whether genetic polymorphisms in TGFB1 and its receptor TGFBR2 are associated with mandibular retrognathism in German children and adolescents. Children and teenagers older than 8 years in the mixed or permanent dentition were included in this study. Patients with syndromes and facial trauma and patients with congenital alterations were excluded. Digital cephalometric tracings were performed using the anatomical landmarks point A, point B, sella (S), and nasion (N). Patients that have a retrognathic mandible (SNB < 78°) were selected as case group, and the patients with an orthognathic mandible (SNB = 78°- 82°) were selected as the control group. Genomic deoxyribonucleic acid (DNA) from saliva was used to evaluate four genetic polymorphisms in TGFB1 (rs1800469 and rs4803455) and TGBR2 (rs3087465 and rs764522) using real-time PCR. Chi-square or Fisher exact tests were used to compare gender, genotype, and allele distribution among groups. Genotype distribution was calculated in an additive and recessive model. Haplotype analysis was also performed. The established alpha of this study was 5%. A total of 146 patients (age ranging from 8 to 18 years) were included in this epidemiological genetic study. The genetic polymorphism rs3087465 in TGFBR2 was associated with mandibular retrognathism. Carrying the AA genotype in the rs3087465 polymorphism decreased the chance of having mandibular retrognathism (odds ratio = 0.25, confidence interval 95% = 0.06 to 0.94, p = 0.045). None of the haplotypes was associated with mandibular retrognathism (p > 0.05). In conclusion, we found that the genetic polymorphism rs3087465 in the promoter region of the TGFBR2 was associated with mandibular retrognathism in Germans.

Er,Cr:YSGG and 980nm diode lasers influence dentin surface volume after cariogenic challenge: in vitro study

Abstract This study aimed to evaluate the influence of the Er,Cr:YSGG irradiation and 980-nm diode lasers on the surface roughness (SR) and volume loss (VL) of dentin subjected to cariogenic challenge. Subsequently, 130 specimens of bovine dentin were divided into the following 13 groups: NT: no treatment; FG: fluoride gel; FV: fluoride varnish; Di: 980-nm diode; Di + FG; Di + FV; FG + D; FV + Di; Er: Er,Cr:YSGG; Er + FG; Er + FV; FG + Er and FV + Er. Er,Cr:YSGG laser parameters were as follows: 0.25 W; 5.0 Hz; 4.46 J/cm2 without water and 55% air. Furthermore, the 980-nm diode laser parameters were 2.0 W; 2.0 Hz; 21.41 J/cm2. The samples from each group were subjected to pH cycling. A confocal laser scanning microscope was used to evaluate SR and VL. Difference between the volume of the reference and treated areas + DES/RE was used to determine SR and VL. The mean values of the different groups were subjected to analysis of variance and Tukey's post-hoc test. The VL values were analyzed using the Kruskal-Wallis and Dunn post-hoc test (p < 0.05). The SR of the reference area did not show a statistically significant 1807-3107-bor-38-e025treatment and cariogenic challenge (p > 0.05). Moreover, VL in the FV + Di and FV + Er groups showed a statistically significant difference compared with areas submitted to different types of treatment and cariogenic challenge (p > 0.05). Er,Cr:YSGG and 980-nm diode lasers associated with fluoride varnishes decreased dentin VL in bovine teeth submitted to cariogenic challenge.

FT-Raman spectroscopy, µ-EDXRF spectrometry, and microhardness analysis of the dentin of primary and permanent teeth.

The chemical compositions (organic and inorganic contents) and mechanical behaviors of the dentin of permanent and deciduous teeth were analyzed and compared using X-ray fluorescence spectrometry (µ-EDXRF) Fourier transform Raman spectroscopy (FT-Raman) and a microhardness test (HD). Healthy fresh human primary and permanent molars (n = 10) were selected, The buccal surfaces facing upwards were stabilized in an acrylic plate, flattened, polished, and submitted to the µ-EDXRF, FT-Raman, and HD analysis. The results of the analysis were subjected to ANOVAs and Mann-Whitney U/Student's t multiple comparisons tests. The data showed similar values for the dentin of the primary and permanent teeth in P content, organic content (amide I peak), inorganic content ( PO43- - 430 and 590), and microhardness, Nevertheless, Ca content and Ca/P weight ratio were higher, and the CO32- peak was lower in the dentin of the permanent teeth compared to primary teeth. It be concluded that despite permanent teeth showed more Ca element, both substrates showed similar behavior of chemical and physical properties.

Estrogen deficiency influences TNF-α and IL-1ß gene expression in the odontogenic region of dental hypofunctional condition / A deficiência de estrógeno influencia a expressão gênica de TNF-α e IL-1ß na região odontogênica de dentes em hipofunção

Objetivo: Evidências científicas sugerem que a deficiência de estrógeno e fatores genéticos influenciam o desenvolvimento do sistema estomatognático. Este estudo teve como objetivo avaliar a influência da deficiência de estrógeno na expressão gênica de TNF-α, IL-1ß, IL-6 e IL-10 durante o desenvolvimento dentário em modelo murino. Material e Métodos: Ratas Wistar Hannover foram divididas em dois grupos de acordo com a intervenção recebida: Grupo Hipoestrogenismo - cirurgia de ovariectomia e Grupo Controle - cirurgia fictícia. Para avaliar o desenvolvimento dentário, o incisivo inferior foi escolhido. O modelo de hipofunção dos incisivos inferiores foi realizado por ajuste incisal. O incisivo homólogo exercia hiperfunção dentária. Os animais foram avaliados durante todo o período puberal. Após a eutanásia, as hemimandíbulas foram removidas para avaliar a expressão gênica do TNF-α, IL-1ß, IL-6 e IL-10 na região odontogênica dos incisivos por meio de PCR em tempo real. Foi realizado o teste de Kruskal-Wallis e o pós-teste de Dunn. O nível de significância foi de 5%. Resultados: Houve diferenças estatisticamente significativas na expressão gênica de TNF-α e IL-1ß entre os grupos hipoestrogenismo e controle sob condição de hipofunção dentária (p=0,0084, p=0,0072, respectivamente). Conclusão: A deficiência de estrógeno influencia a expressão gênica de TNF-α e IL-1ß na região odontogênica de dentes hipofuncionais (AU)

Objective: Scientific evidence suggests that estrogen deficiency and genetic factors have an influence on the development of the stomatognathic system. This study aimed to evaluate the influence of estrogen deficiency on the gene expression of TNF-α, IL-1ß, IL-6 and IL-10 during dental development in a murine model. Material and Methods: Wistar Hannover rats were divided into two groups according to the intervention received: Hypoestrogenism Group - ovariectomy surgery and Control Group - fictitious surgery. To evaluate the dental development, the lower incisor was chosen. The mandibular incisor hypofunction model was performed by incisal adjustment. The homologous incisor exerted a hyperfunction. The animals were evaluated throughout the pubertal period. After euthanasia, the hemimandibles were removed to evaluate the gene expression of the TNF-α, IL-1ß, IL-6 and IL-10 in the odontogenic region of the incisors through real time PCR. Kruskal-Wallis test and Dunn's posttest were performed. The level of significance was 5%. Results: There were statistically significant differences of TNF-α and IL-1ß gene expression between the hypoestrogenism and control groups under hypofunction condition (p=0.0084, p=0.0072, respectively). Conclusion: Estrogen deficiency influences TNF-α and IL-1ß gene expression in the odontogenic region of the hypofunctional teeth. (AU)

Salivary antibody response to streptococci in preterm and fullterm children: a prospective study.

OBJECTIVES: Secretory immunoglobulins present in mucosa surfaces represent the first line of defense of the adaptive immune system against infectious challenges. Preterm (PT) neonates' humoral immunity is diminished compared to full-term (FT) newborns. The identification of important antigens (Ags) of virulence of oral species may help in the investigation of the mechanisms of antigenic stimulation and the development of the mucosal immune response. In the present study, we measured saliva levels of immunoglobulins A (IgA) and M (IgM) and characterized the specificity of IgA against Ags of several streptococcal species found early in life. METHODS: This was a prospective observational study. Salivary IgA (sIgA) antibody responses to bacterial species that are prototypes of pioneer (Streptococcus mitis, S. sanguinis, S. gordonii) and pathogenic (Streptococcus mutans) microorganisms of the oral cavity were studied in FT and PT children in two visits: at birth (T0) and at 3 months of age (T3). Salivas from 123 infants (72 FT and 51 PT) were collected during the first 10h after birth (T0) and again at 3 months of age (T3). Salivary levels of IgA and IgM antibodies were analysed by enzyme-linked immunosorbent assay (ELISA). A subgroup of 26 FT and 24 PT children were compared with respect to patterns of antibody specificities against different streptococci Ags using Western blot assays. RESULTS: No significant differences (P>0.05) in salivary levels of IgA and IgM between FT and PT babies were found at birth. At T3, mean sIgA values were similar between groups and sIgM levels were significantly higher in PT than FT (P<0.05). Western blot assays identified positive IgA response to streptococci in the majority of children, especially in the FT group. There were some differences between groups in relation to the frequency of children with positive response to Ags and intensity of IgA response. In general, oral streptococci Ags were more frequently detected and bands were more intense in FT than in PT, especially in T3. Prospective analysis of patterns of sIgA against Ags of different streptococcal species revealed an increase in complexity of the sIgA antibody response from the first day of birth (T0) to T3 in PT and FT. CONCLUSION: The patterns of sIgA response to streptococci Ags appear to be influenced by the gestational age, which might reflect the level of immunological maturity of the mucosal immune system.

Use of Resin Infiltrate for the Treatment of White spot Lesions on Dental Enamel: Case Report / Utilização de Infiltrante Resinoso Para o Tratamento de Lesões de Mancha Branca do Esmalte Dental: Relato de Caso

Early diagnosis of white spot lesions allows non-invasive treatment to be indicated for the remineralization of active lesions. The goal was to report the clinical Protocol for the treatment of white spot lesion of a patient by the technique of resin infiltration, observing whether there is change of color on the white spot of the dental enamel after its treatment. The selected patient was 16 years old with good overall health, who featured white spot lesion of the dental enamel on tooth 13, classified as ICDAS score 2. The tooth was photographed, and its color was evaluated with the spectrophotometer in accordance with the CIELhC system. For comparison purposes, the color of tooth enamel in an area adjacent to the lesion was evaluated. The treatment of the lesion was performed with the resin infiltrate Icon (DMG, Hamburg, Germany), following the manufacturer's instructions. The color of the tooth was re-evaluated after the application of the resin infiltrate. At the end of the procedure, it was observed that the treatment of white spot lesion by resin infiltration technique reached its goal because, in addition to being minimally invasive, it was highly approved by patient and it provided the masking of the white spot lesion on the dental enamel. (AU).

O diagnóstico precoce de lesões de mancha branca permite que um tratamento não invasivo seja indicado para a remineralização das lesões ativas. O objetivo foi relatar o protocolo clínico para tratamento de lesão de mancha branca ativa de um paciente pela técnica do infiltrante resinoso, observando se existe alteração de cor da mancha branca do esmalte dental após o seu tratamento. Foi selecionada uma paciente, de 16 anos de idade, com boa saúde geral e que apresentava lesão de mancha branca no esmalte dental do dente 13, classificada pelo escore 2 do ICDAS. O dente foi fotografado e sua cor foi avaliada com o espectrofotômetro de acordo com o sistema CIELhC. Para fins de comparação, foi avaliada a cor do esmalte dental em uma área adjacente à lesão. O tratamento da lesão foi realizado com a resina infiltrante Icon (DMG, Hamburgo, Alemanha), seguindo as recomendações do fabricante. A cor do dente foi reavaliada após a aplicação do infiltrante. Ao final do procedimento, observou-se que o tratamento da lesão de mancha branca pela técnica da resina infiltrante atingiu seu objetivo pois, além de ter sido minimamente invasiva, foi bem avaliada pela paciente e proporcionou o mascaramento da lesão de mancha branca do esmalte dental. (AU).

Avaliação da condição bucal de pacientes portadores de paralisia cerebral na cidade de Uberaba / Evaluation of the oral health of patients with cerebral palsy in the city of Uberaba, Brazil

Objetivo: O objetivo deste estudo foi avaliar as condições de saúde bucal através de parâmetros salivares e microbiológicos associados á cárie dental em pacientes com PC submetidas ou não à gastrostomia na cidade de Uberaba. Métodos: Trata-se de um estudo observacional transversal, realizado com uma amostra selecionada por conveniência com 48 pacientes com idades entre 2 anos e 16 anos, pertencentes aos Ambulatórios de Cirurgia Pediátrica e da Neurologia do Hospital de Clínicas da UFTM e do Hospital da Criança da cidade de Uberaba, divididos em 3 grupos sendo, 16 pacientes sem deficiência (Grupo SD), 15 pacientes com Paralisia Cerebral (Grupo PC) e 17 pacientes com PC submetidas à gastrostomia e fundoplicatura de Nissen (Grupo PCG). Avaliou-se o índice de cárie (IC), o índice de placa (IP), contagem salivar do número de colônias de Streptococcus mutans (CB) e a capacidade de tamponamento salivar (CTS). Os dados obtidos de IP, CB e CTS foram submetidos à análise estatística One Way Anova (p<0,05), e os dados de IP ao Teste de Tukey (p<0,05). A avaliação do IC se deu através de análise estatística descritiva da porcentagem simples das faces cariadas em relação ao número total de faces. Resultados: Observou-se diferença estatística apenas entre os grupos para o IP, sendo que o grupo PCG apresentou os maiores valores de índices de placa quando comparados aos demais. Conclusão: Concluiu-se que a PC, associada ou não à gastrostomia, não é facilitador ou atenuante da doença cárie, nem atua como fator determinante da saúde bucal.(AU)

Aim: This study sought to evaluate oral health conditions through oral clinical examinations and salivary and microbiological analyses associated with dental caries in patients with Cerebral Palsy (CP) submitted or not to gastrostomy in the city of Uberaba, MG, Brazil. Methods: This is an observational cross sectional study, conducted in a conventional sample of 48 patients, 2 to 16 years of age, at the UFTM Clinical Hospital and the Children's Hospital of Uberaba, divided into 3 groups, as follows: 16 patients without disabilities (Group WD), 15 patients with CP (Group CP), and 17 patients with CP submitted to gastrostomy and Nissen fundoplication (Group WCP). This study evaluated the caries index (CI), plaque index (PI), salivary counts of the Streptococcus mutans bacterium (CB), and salivary buffering capacity (SBC). Data from PI, CB, and SBC were statistically analyzed by the One-Way ANOVA analysis (p<0.05), and PI data were submitted to the Tukey test (p<0.05). Results: A statistically significant difference was only observed among the groups as regards the PI analysis, given that the WCP group presented the highest values. Conclusion: It was concluded that the CP, with or without gastrostomy is not a facilitator or attenuating circumstance of caries, nor is it a determining factor of good or poor oral health.(AU)

Microstructure and mineral composition of dental enamel of permanent and deciduous teeth.

PURPOSE: This study evaluated and compared in vitro the microstructure and mineral composition of permanent and deciduous teeth's dental enamel. METHODS: Sound third molars (n = 12) and second primary molars (n = 12) were selected and randomly assigned to the following groups, according to the analysis method performed (n = 4): Scanning electron microscopy (SEM), X-Ray diffraction (XRD) and Energy dispersive X-ray spectrometer (EDS). Qualitative and quantitative comparisons of the dental enamel were done. The microscopic findings were analyzed statistically by a nonparametric test (Kruskal-Wallis). The measurements of the prisms number and thickness were done in SEM photomicrographs. The relative amounts of calcium (Ca) and phosphorus (P) were determined by EDS investigation. Chemical phases present in both types of teeth were observed by the XRD analysis. RESULTS: The mean thickness measurements observed in the deciduous teeth enamel was 1.14 mm and in the permanent teeth enamel was 2.58 mm. The mean rod head diameter in deciduous teeth was statistically similar to that of permanent teeth enamel, and a slightly decrease from the outer enamel surface to the region next to the enamel-dentine junction was assessed. The numerical density of enamel rods was higher in the deciduous teeth, mainly near EDJ, that showed statistically significant difference. The percentage of Ca and P was higher in the permanent teeth enamel. CONCLUSIONS: The primary enamel structure showed a lower level of Ca and P, thinner thickness and higher numerical density of rods.

Effect of erbium-doped yttrium aluminium garnet laser parameters on ablation capacity and morphology of primary dentin.

OBJECTIVE: To evaluate the ablation capacity of different energies and pulse repetition rates of an erbium-doped yttrium aluminium garnet (Er:YAG) laser on primary dentin by assessing mass loss and to analyze the surface morphology using scanning electron microscopy (SEM). BACKGROUND DATA: Previous studies have demonstrated the ability of the Er:YAG laser to ablate dentin substrate. METHODS: Forty-eight sound primary molars were bisected in the mesiodistal direction. The dentin surfaces were flattened, and initial mass (mg) was obtained. A 4-mm2 area was delimited. Specimens were randomly assigned to 12 groups according to the combination of energy (160, 200, 250, and 300 mJ) and pulse repetition rate (2, 3, and 4 Hz). Er:YAG laser irradiation was performed for 20 s. After irradiation, the final mass was obtained, and specimens were prepared for SEM. The data obtained by subtracting the final mass from the initial mass were statistically analyzed using analysis of variance and Tukey test (alpha=0.05). RESULTS: The pulse repetition rate of 4 Hz provided greater mass loss, and it was different from 2 Hz and 3 HZ. The energy of 300 mJ resulted in greater mass loss, similar to 200 and 160 mJ. SEM micrographs showed dentinal tubule obliteration, structural alterations, and the presence of cracked areas in all specimens. CONCLUSION: The settings of 160, 200, and 250 mJ at 2 and 3 Hz promoted a good ablation rate with fewer surface alterations in primary dentin.

Effect of mouthrinses on the surface roughness of nanofilled composite / Efeito de enxaguantes bucais sobre a rugosidade de superfície de um compósito nanoparticulado

Objective: The aim of this study was to evaluate the effect of mouthrinses on the surface roughness of nanofilled restorative composite. Material and Methods: Twenty Filtek Z350 resin composit discs (4 mm in diameter and 1 mm in height) were made and roughness (μm) was measured by using profilometer with diamond measuring needle tip of 0.5 μm and accuracy of 0.01 μm. The discs were stored in distilled water at 37 °C for 24 h and randomly divided into four groups (n=5): Control – distilled water; Group 1- Plax alcohol free mouthrinse ; Group 2 –Plax Whiteningmouthrinse; Group 3 –Listerine mouthrinseand individually stored in Eppendorf tubes with distilled water at 37 °C. The specimens were maintained in distilled water during 30 days and immersed in mouthrinses every 12 h for 1 min. Elapsed the 30 days, the specimens were cleaned and storedin distilled water, inside anincubatorat 37 °C during 24 h and the surface roughness test was repeated with the same parameters previously described. The data were submitted to Two-way ANOVA. Results: No significant differences among groups were detected for the variables mouthrinse (p = 0.9038) and time (p = 0.2056), R1: Control (0.12 ± 0.04); G1 (0.13 ± 0.05); G2 (0.11 ± 0.03); G3 (0.11 ± 0.02); and R2: Control (0.16 ± 0.04); G1 (0.15 ± 0.02); G2 (0.13 ± 0.01) and G3 (0.15 ± 0.02). Conclusions: In this study the mouthrinses solutions did not promote significant changes in the surface roughness of Filtek Z350 after 30 days.

Objetivo: O objetivo nesse estudo foi avaliar o efeito de enxaguantes bucais sobre a rugosidade superfície de um compósito restaurador nanoparticulado. Material e Métodos: Vinte discos (4 mm de diâmetro e 1 mm de altura) do compósito restaurador Filtek Z350 foram confeccionados e sua rugosidade (μm) foi mensurada utilizando um rugosímetro de contato com ponta de diamante de 0,5 μm e precisão de 0,01 μm. Os discos foram armazenados em água destilada a 37 °C por 24 h, aleatoriamente divididos em quarto grupos (n=5): Controle– água destilada; Grupo 1 –EnxaguantePlaxálcool free; Grupo 2 – Enxaguante PlaxWhitening; Grupo3 – Enxaguante Listerinee armazenados individualmente em Frascos Eppendorfs com água destilada a 37°C. Durante os 30 dias de armazenamento os corpos-de-prova foram imersos nos enxaguantes bucais a cada 12 h por 1 min. Após os 30 dias os corpos-de-prova foram limpos e armazenados em água destilada a 37 °C por 24 h e as medidas de rugosidade refeitas com os mesmos parâmetros descritos anteriormente. Os dados de rugosidade foram submetidos à Análise de Variância de dois fatores. Resultados: Não foram identificadas diferenças significativas entre os grupos para as variáveis enxaguante (p=0,9038) e tempo (p=0,2056), R1: Controle (0,12 ± 0,04); Grupo1 (0,13 ± 0,05); Grupo2 (0,11 ± 0,03); Grupo3 (0,11 ± 0,02); e R2: Controle (0,16 ± 0,04); Grupo1 (0,15 ± 0,02); Grupo2 (0,13 ± 0,01) e Grupo3 (0,15 ± 0,02). Conclusões: No presente estudo, os enxaguantes bucais não promoveram alterações significativas na rugosidade de superfície do compósito Filtek Z350 após 30 dias.