In vivo modification of the enamel pellicle and saliva resveratrol levels after use of resveratrol-containing orodispersible capsules.

OBJECTIVES: To evaluate in vivo 1) the bioavailability of trans-resveratrol when administered through sublingual capsules; 2) the effect of resveratrol on the protein composition of the acquired enamel pellicle (AEP). DESIGN: Ten volunteers received a sublingual capsule containing 50 mg of trans-resveratrol. Unstimulated saliva was then collected after 0, 30, 60, and 120 min and AEP was collected after 120 min following administration of the capsule. In the next week, the volunteers received a placebo sublingual capsule, and saliva and AEP were collected again. Saliva samples were analyzed for free trans-resveratrol using high-performance liquid chromatopgraphy (HPLC), and AEP samples were subjected to proteomic analysis (nLC-ESI-MS/MS). RESULTS: Trans-resveratrol was detected in saliva at all the time points evaluated, with the peak at 30 min. A total of 242 proteins were identified in both groups. Ninety-six proteins were increased and 23 proteins were decreased in the Resveratrol group. Among the up-regulated proteins, isoforms of cystatins, PRPs, Mucin-7, Histatin-1, Lactotrasnferrin and Lysozyme-C were increased and the isoforms of Protein S100, Neutrophil defensins, Albumin, PRPs, and, Statherin were decreased in Resveratrol group. CONCLUSION: The sublingual capsule is effective at increasing the bioavailability of trans-resveratrol in saliva. Several proteins involved in important processes to maintain systemic and oral health homeostasis were identified. These proteins differently expressed due to the presence of trans-resveratrol deserve attention for future studies, since they have important functions, mainly related to antimicrobial action.

Increase in plasma resveratrol levels and in acid-resistant proteins in the acquired enamel pellicle after use of resveratrol-containing orodispersible tablets.

OBJECTIVE: This study evaluated the effect of administration of trans-resveratrol-containing orodispersible tablets on the protein composition of the AEP and on blood plasma trans-resveratrol concentrations. METHODS: Ten volunteers participated in two crossover double-blind phases. In each phase, after dental prophylaxis, they received a trans-resveratrol (15 mg) orodispersible tablet, or a placebo tablet (without actives). The AEP formed after 120 min was collected with electrode filter papers soaked in 3 % citric acid. Blood samples were collected 30, 45, 60 and 120 min after the use of the tablet. After protein extraction, AEP samples were analyzed by shotgun labelfree quantitative proteomics and plasma samples were analyzed by high-performance liquid chromatography (HPLC). RESULTS: Eight hundred and two proteins were identified in the AEP. Among them, 336 and 213 were unique to the trans-resveratrol and control groups, respectively, while 253 were common to both groups. Proteins with important functions in the AEP had increased expression in the trans-resveratroltreated group, such as neutrophil defensins, S100 protein isoforms, lysozyme C, cystatin-D, mucin-7, alphaamylase, albumin, haptoglobin and statherin. Trans-resveratrol was detected in the plasma at all the times evaluated, with the peak at 30 min. CONCLUSIONS: The administration of trans-resveratrol in sublingual orodispersible tablets was effective both to increase the bioavailability of the polyphenol and the expression of antibacterial and acid-resistant proteins in the AEP, which might benefit oral and general health.

"RichBlend" protocol for full-face filling and collagen biostimulation / Protocolo "RichBlend" para preenchimento facial e bioestimulação de colágeno

ABSTRACT The "RichBlend" protocol was designed for facial filling and collagen biostimulation, by means of a mixture of calcium hydroxyapatite (CaHA), hyaluronic acid (AH) and autologous platelet concentrates. This work reports the case of a 53-year-old patient with cutaneous photoaging, loss of facial volume, multiple rhythms in the frontal and periorbital regions, also marked skin flaccidity, especially the eyelid. The treatment was done with botulinum toxin (65 U) and the "RichBlend" protocol. Venipuncture was performed and the blood was centrifuged to obtain i-PRF (injectable platelet-rich fibrin) and plasma gel. After venipuncture and blood centrifugation, i-PRF and plasma gel were obtained. CaHA (Radiesse®) was diluted: a) in saline solution + i-PRF (hyperdilution) for biostimulationof the lower third of the face; and b) in AH (Juvederm Ultraplus XC®) + plasma gel, for hydrolifting on the forehead and dark circles, malar and temples. Plasma gel was applied to the nasogenian grooves and then the entire face was properly massaged. The "RichBlend" protocol rejuvenated the patient, as it promoted filling, volumizing, collagen formation (biostimulation), reduction of flaccidity, in addition to skin whitening. Since HA and CaHA are high-cost products, their mixture with autologous platelet concentrates, in liquid or gel form, allows the use of a greater amount of filled and biostimulator material on the face, at a more affordable cost.

RESUMO O protocolo "RichBlend" foi idealizado para preenchimento facial e bioestimulação de colágeno, por meio da mistura de hidroxiapatita de cálcio (CaHA), ácido hialurônico (AH) e concentrados plaquetários autólogos. Este trabalho relata o caso de um paciente de 53 anos, com fotoenvelhecimento cutâneo, perda de volume facial, múltiplas rítides nas regiões frontal e periorbital, apresentando também acentuada flacidez cutânea, especialmente palpebral. Foi feito o tratamento com toxina botulínica (65 U) e protocolo "RichBlend". Foi realizada a venopunção e o sangue foi centrifugado para obtenção da i-PRF (fibrina rica em plaquetas injetável) e do plasma gel. Após venopunção e centrifugação sanguínea, obtiveram-se a i-PRF e o plasma gel. A CaHA (Radiesse®) foi diluída: a) em soro + i-PRF (hiperdiluição) para bioestimulação do terço inferior da face; e b) em AH (Juvederm Ultraplus XC®) + plasma gel, para hidrolifting na fronte e preenchimentos de olheira, malar e têmporas. Plasma gel foi aplicado nos sulcos nasogenianos e, em seguida, toda a face foi devidamente massageada. O protocolo "RichBlend" rejuvenesceu o paciente, pois promoveu preenchimento, volumização, formação de colágeno (bioestimulação), redução da flacidez, além do clareamento cutâneo. Uma vez que o AH e a CaHA são produtos de alto custo, sua mistura com os concentrados plaquetários autólogos, na forma líquida ou gel, permite a utilização de uma maior quantidade de material preenchedor e bioestimulador na face, com custo mais acessível.

Acquired Pellicle Engineering Using a Combination of Organic (Sugarcane Cystatin) and Inorganic (Sodium Fluoride) Components against Dental Erosion.

This study evaluated the combination of a sugarcane cystatin (CaneCPI-5) and sodium fluoride (NaF) in acquired pellicle engineering for the prevention of dental erosion in vitro. Seventy-five human enamel specimens were prepared and divided into 5 treatment groups (n = 15/group): Deionized water (Control); Elmex™ (SnCl2/NaF/AmF); 0.1 mg/mL CaneCPI-5; 500 ppm NaF; and CaneCPI-5+NaF (Combination). The specimens were individually treated (200 µL; 2 min; 37°C), then incubated in human saliva (200 µL; 1 h, at 37°C) for acquired pellicle formation. Afterward, the specimens were submitted to an erosive challenge (1% citric acid [CR], pH 3.6, 10 mL, 2 min, 25 °C). This sequence was conducted 5 times. Percentage of surface microhardness change (%SMC), relative surface reflection intensity (rSRI), and calcium released to the CR were measured and analyzed by one-way ANOVA followed by Tukey's test (p < 0.05). In general, all the treatments (SnCl2/NaF/AmF, CaneCPI-5, NaF, and Combination) significantly protected the enamel when compared the control group. Regarding %SMC and rSRI, the Combination was the most effective treatment, reducing the %SMC significantly (p < 0.01) when compared to all the other treatments, although this difference was not significant in the CR analysis. All treatments demonstrated a protective effect on enamel against dental erosion; however, the combination of CaneCPI-5 with NaF showed a greater protection.

Characterization of white spot lesions formed on human enamel under microcosm biofilm for different experimental periods

Abstract The initial characteristics of white spot lesion (WSLs), such as the degree of integrated mineral loss (ΔZ), depth and pattern of mineral distribution, have an impact on further demineralization and remineralization. However, these lesion parameters have not been evaluated in WSLs produced from microcosm biofilms. Objective: This study characterized artificial white spot lesions produced on human enamel under microcosm biofilm for different experimental periods. Methodology: In total, 100 human enamel specimens (4x4mm) were assigned to 5 distinct groups (n=20/group) differing according to the period of biofilm formation (2, 4, 6, 8 or 10 days). Microcosm biofilm was produced on the specimens from a mixture of human and McBain saliva at the first 8h. Enamel samples were then exposed to McBain saliva containing 0.2% sucrose. WSLs formed were characterized by quantitative light-induced fluorescence (QLF) and transverse microradiography (TMR). Data were analyzed by ANOVA/Tukey or Kruskal-Wallis/Dunn tests (p<0.05). Results: A clear time-response pattern was observed for both analyses, but TMR was able to better discriminate among the lesions. Regarding QLF analysis, median (95%CI; %) changes in fluorescence ∆Z were -7.74(-7.74:-6.45)a, -8.52(-8.75:-8.00)ab, -9.17(-10.00:-8.71)bc, -9.58(-10.53:-8.99)bc and -10.01(-11.44:-9.72)c for 2, 4, 6, 8, and 10 days, respectively. For TMR, median (95%CI; vol%.µm) ∆Z were 1410(1299-1479)a, 2420(2327-2604)ab, 2775(2573-2899)bc, 3305(3192-3406)cd and 4330(3972-4465)d, whereas mean (SD; µm) lesion depth were 53.7(12.3)a, 71.4(12.0)a, 103.8(24.8)b, 130.5(27.2)bc, 167.2(39.3)c for 2, 4, 6, 8 and 10 days, respectively. Conclusion: The progression of WSLs formed on human enamel under microcosm biofilm can be characterized over 2-10 days, both by QLF and TMR analyses, although the latter provides better discrimination among the lesions.

Autologous platelet concentrates for facial rejuvenation

Abstract Autologous platelet concentrates (APCs) are promising therapeutic agents in facial rejuvenation since they are a great source of cytokines, growth factors and other biologically active substances. Obtained from the patient's blood, they have the advantages of reducing immunological reactions, making the procedure safer, well tolerated, with minimal adverse effects and lower cost. Currently, they are used for facial rejuvenation both in combination with microneedling and in mesotherapy techniques, as well as to treat facial acne scars, melasma and wounds after laser ablative treatments. This review summarizes current knowledge on the use of APCs, ranging from basic concepts related to their composition and mechanisms of action to up-to-date information on their clinical efficacy. Methodology MEDLINE (PubMed) was searched from inception through 2021 for English language publications on APCs for facial rejuvenation. Results A total of 100 files were found. Based on the available literature, APCs for skin rejuvenation are safe and well tolerated. The most studied product is the first-generation material, platelet-rich plasma (PRP). Conclusions The results are in general favorable, but the quality of the studies is low. The second and third generation products, platelet-rich fibrin (PRF) and injectable platelet-rich fibrin (i-PRF), respectively, are easier to be obtained and, at least in vitro , seem to induce greater collagen production than PRP, especially under lower relative centrifugation forces, but to date only a few clinical trials evaluating these products exist. More high-quality trials with appropriate follow-up are necessary to provide adequate evidence that may help to improve the treatment regimens with APCs. Many aspects should be considered when designing clinical trials to evaluate APCs, such as the patients' characteristics that best predict a favorable response, the optimal number of sessions and the interval between them, the characteristics of the studies and the development of better instruments to evaluate skin aging.

Solutions and Gels Containing a Sugarcane-Derived Cystatin (CaneCPI-5) Reduce Enamel and Dentin Erosion in vitro.

The effect of solutions and gels containing a sugarcane-derived cystatin (CaneCPI-5) on the protection against enamel and dentin erosion in vitro was evaluated. Bovine enamel and dentin specimens were divided into 2 groups (n = 135 and 153/group for enamel and dentin, respectively) that were treated with solutions or chitosan gels containing 0.1 or 0.25 mg/mL CaneCPI-5. The positive controls for solutions and gels were Elmex Erosion Protection™ solution and NaF gel (12,300 ppm F), respectively. Deionized water and chitosan gel served as controls, respectively. The solutions were first applied on the specimens for 1 min and the gels for 4 min. Stimulated saliva was collected from 3 donors and used to form a 2-h acquired pellicle on the specimens. Then, the specimens were submitted to an erosive pH cycling protocol 4 times/day for 7 days (0.1% citric acid pH 2.5/90 s, artificial saliva/2 h, and artificial saliva overnight). The solutions and gels were applied again during pH cycling, 2 times/day for 1 min and 4 min, respectively, after the first and last erosive challenges. Enamel and dentin losses (µm) were assessed by contact profilometry. Data were analyzed by 2-way ANOVA and Tukey's test (p < 0.05). All the treatments significantly reduced enamel and dentin loss in comparison with controls. Both CaneCPI-5 concentrations had a similar protective effect against enamel erosion, but only the higher concentration was as effective against dentin erosion as the positive control. Regarding the vehicles, only the 0.1 mg/mL gel performed worse than the positive control for dentin. CaneCPI-5 reduced enamel and dentin erosion to a similar extent as the fluoride-containing vehicles. However, dentin requires higher CaneCPI-5 concentrations, in the case of gels. Solutions or gels containing CaneCPI-5 might be a new approach to protect against dental erosion.

Do commercial whitening dentifrices increase enamel erosive tooth wear?

Abstract Objective This in vitro study evaluated the effect of commercial whitening dentifrices on erosive tooth wear (ETW) of bovine enamel samples, in comparison with commercial regular dentifrices. Methodology Sixty bovine crowns were embedded in acrylic resin, polished and then had their baseline profile determined. They were randomly assigned to 5 groups (n=12/group), according to the type of commercial dentifrice to be tested: GI - Crest Anti-cavity Regular; GII - Crest 3D White; GIII - Colgate Total 12 Clean Mint; GIV - Colgate Optic White; GV - Placebo (negative control, fluoride-free dentifrice). The samples were submitted to daily erosive and abrasive challenges for 3 days. The erosive challenges were performed 3 times a day by immersing the specimens in 0.1% citric acid solution (pH 2.5) for 90 s. Each day after the first and last erosive challenges, the specimens were subjected to the abrasive challenge for 15 s, using a toothbrushing machine (Biopdi, São Carlos, SP, Brazil), soft toothbrushes and slurry (1:3 g/ml) of the tested toothpastes (1.5 N). The specimens were kept in artificial saliva between the challenges. The final profile was obtained and the ETW (µm) was calculated. Data were analyzed by Kruskal-Wallis and Dunn's tests (p<0.05). Results All dentifrices tested significantly reduced the enamel wear in comparison with the Placebo, except GIII. The median (95% CI) ETW was 1.35 (1.25-1.46)bc for GI, 1.17 (1.01-1.34)cd for GII, 1.36 (1.28-1.45)ab for GIII, 1.08 (1.04-1.14)d for GIV and 2.28 (2.18-2.39)a for GV. Conclusion When dentifrices from the same manufacturer were compared, the whitening dentifrices led to similar or less wear than the regular ones.

Avaliação da ingestão de flúor de crianças brasileiras de 2 a 6 anos de idade / Fluoride intake evaluation of 2-6-year-old brazilian children

Este estudo comparou a ingestão de flúor (F) de crianças de 2 a 6 anos residentes em área fluoretada (Bauru-SP, 0,6-0,8 ppm F) e não fluoretada (Pirajuí-SP), avaliada através do método da dieta duplicada associado à escovação simulada e do Questionário de Freqüência Alimentar semi-quantitativo (QFAsq) associado a questionário para estimativa de ingestão de F a partir do dentifrício. Inicialmente, o QFAsq foi aplicado em 398 crianças residentes no município de Pirajuí-SP. Posteriormente, foram avaliadas subamostras de 25 crianças residentes em Bauru e 24 residentes em Pirajuí. Nestas subamostras, a quantidade de F ingerida através da dieta foi determinada pelo QFAsq e também pela "dieta duplicada", considerando seus diferentes constituintes (água, outros líquidos e sólidos). A ingestão de F através do dentifrício foi determinada pelo questionário para estimativa da ingestão de dentifrício e pela escovação simulada. O F foi analisado por eletrodo, depois de difusão facilitada por hexametildiloxano ou após tamponameno com TISAB. A análise estatística foi feita utilizando o software GraphPad InStat, aplicando os testes t pareado, t não pareado, Wilcoxon pareado, Mann-Whitney e estatística de correlação (p < 0.05). O QFAsq aplicado à amostra de 398 crianças de Pirajuí encontrou valores de ingestão total de F significativamente menores que os relatados previamente para crianças residentes em Bauru (Miziara, 2006). Na subamostra de crianças avaliadas, a média (±DP, mg) da ingestão de F estimada a partir do QFAsq e da dieta duplicada, considerando-se a dieta total foi de 0,420±0,087 e 0,805±0,190 (Bauru) e 0,227±0,072 e 0,144±0,050 (Pirajuí), sendo a diferença entre os métodos significativa em ambos os municípios. Somente foi obtida uma correlação significativa entre os dois métodos no caso dos sólidos, para ambos os municípios...

This study compared the fluoride (F) intake of 2-6-year-old children, living in fluoridated (Bauru-SP, 0,6-0,8 ppm F) and non-fluoridated (Pirajuí-SP) areas. The methods used were the duplicate diet associated to simulated toothbrushing and the semi-quantitative food frequency questionnaire (sqFFQ) associated to a questionnaire for estimation of F intake from dentifrice. Initially, the sqFFQ was applied to 398 children living in Pirajuí. In another phase, subsamples of 25 children living in Bauru and 24 living in Pirajuí were evaluated. In these subsamples the F intake from diet was determined using the sqFFQ as well as the duplicate diet method, considering the different constituents of the diet (water, other liquids and solids). The F intake from the dentifrice was determined using the questionnaire for estimation of F intake, as well as simulated toothbrushing. F was analyzed with the electrode, following hexamethyldisiloxanefacilitated diffusion or after buffering with TISAB. For statistical analysis, the GraphPad InStat software was used. The applies tests were paired and unpaired t tests, paired Wilcoxon test, Mann-Whitney test and correlation analysis (p < 0.05). The sqFFQ, when applied to the sample constituted by 398 children living in Pirajuí, found values of total F intake significantly lower when compared to previous data reported by Miziara (2006) for children living in Bauru. In the subsample of evaluated children, the mean (±SD, mg) F intakes estimated by the sqFFQ and duplicate diet (total diet) were 0.420±0.087 and 0.805±0.190 (Bauru) and 0.227±0.072 and 0.144±0.050 (Pirajuí), respectively. The difference between the methods was significant for both municipalities. For both municipalities, a significant correlation between the methods was obtained in the case of solids only...

Absence of DNA damage in multiple organs (blood, liver, kidney, thyroid gland and urinary bladder) after acute fluoride exposure in rats.

Fluoride has been widely used in dentistry as a caries prophylactic agent. However, there has been some speculation that excess fluoride could cause an impact on genome integrity. In the current study, the potential DNA damage associated with exposure to fluoride was assessed in cells of blood, liver, kidney, thyroid gland and urinary bladder by the single cell gel (comet) assay. Male Wistar rats aging 75 days were distributed into seven groups: Groups 1 (control), 2, 3, 4, 5, 6 and 7 received 0 (deionized water), 10, 20, 40, 60, 80 and 100 mgF/Kg body weight from sodium fluoride (NaF), respectively, by gastrogavage. These groups were killed at 2 h after the administration of the fluoride doses. The level of DNA strand breaks did not increase in all organs evaluated and at all doses of NaF tested, as depicted by the mean tail moment. Taken together, our results suggest that oral exposure to NaF did not result in systemic genotoxic effect in multiple organs related to fluoride toxicity. Since DNA damage is an important step in events leading to carcinogenesis, this study represents a relevant contribution to the correct evaluation of the potential health risk associated with chemical exposure.

Prevalence of dental fluorosis in Bauru, São Paulo, Brazil

OBJECTIVE: To evaluate the prevalence of dental fluorosis in scholars aging 12 to 15 years old, residents in the city of Bauru, State of São Paulo, Brazil. METHODS: 1318 volunteers were enrolled in this study and examined in 18 public schools of the State of São Paulo. The examinations were performed in the schools' court by three dentists (with a Master's degree in Public Health), after toothbrushing supervised by another dentist. The teeth were dried with cotton pellets and examined under natural light by visual inspection, using an explorer as recommended by the WHO, a plane mirror and a tongue depressor. The Thylstrup-Fejerskov (TF) index was used for rating fluorosis. Intra and inter-examiner reproducibility was calculated and data were submitted to descriptive analysis. RESULTS: Approximately 36 percent of the children presented dental fluorosis, of which 28 percent was diagnosed as TF1 while the remaining received scores between TF2 and TF4. CONCLUSION: The prevalence of dental fluorosis in Bauru is within the expected range, based on previous studies. Although fluoride is an important resource for caries control, its use must be adequate to the needs of each specific population.

Consumo de fluoreto a partir de alimentos por crianças de 2 a 6 anos de idade, no município de Bauru, São Paulo / Consumption of fluoride from food by children aged 2 to 6 years in the city of Bauru, São Paulo

Taking into consideration that the dental fluorosis has increased in all regions, it is important to evaluate the daily contribution of children's food consumption and the concentration of fluoride in these food items, besides the water and tooth paste, to the intake of fluoride. The objective of this work was to describe the food fluoride intake by children aged 2 to 6 years. A sample of 379 children from Bauru, state of São Paulo, were evaluated. The sampling was stratified by sector based on the Directive Planning of the City. The food intake was evaluated by the Food Frequency Semi quantitative Questionnaire applied to parents or people responsible for the children, and the concentration of fluoride in the food items was determined by laboratory analyses. The most consumed food items presented an average (±DP) fluoride concentration of(0.015±0.028mg F/portion), significantly lower (p=0.03) than the concentration in the less consumed food items (0.107±0.162mgF/portion).The food items with the greatest concentrations of fluoride contributed significantly (p<0.001) to the intake of the mineral (0.018±0.037mgF/day).The average amount of fluoride intakes from solid and liquid foods, water and tooth brushing were 0.017±0.016; 0.011±0.004 and 0.036±0.028mgF/kgweight/day, respectively, summing up 0.064±0.035mgF/kg weight/day. Of the379 children, 31.2% presented risk of fluorosis. The toothpaste and the food items contributed with 57% and 43%, respectively, to the intake of fluoride. The toothpaste was the main source of fluoride intake by children. However, the concentration of this mineral in food items contributed significantly to its intake by the children, representing a risk for dental fluorosis

Considerando que la fluorosis dental há aumentado en todas las regiones, es importante evaluar, además del agua y del dentífrico, la contribución diaria del consumo alimentario delos niños y la concentración de flúor en es os artículos alimentarios para la ingestión de este halógeno. Describir el consumo alimentario de niños, de 2 a 6 años, en relación al flúor. Fueron evaluados 379 niños residentes en Bauru ­ São Paulo. La muestra fue escalonada por sector del Plano Director del Municipio. El consumo alimentario fue evaluado utilizando el Cuestionario de Frecuencia Alimentaria Semicuantitativa, aplicado a los padres o apoderados, y la concentración de flúor en los artículos alimentarios por medio de análisis de laboratorio. Los artículos alimentarios más consumidos presentaron, como promedio (-DP), concentración de flúor (0,015 ­ 0,028mgF/porción)significantemente menor (p = 0,03) que los menos consumidos (0,107 ­ 0,162mgF/porçión).Los artículos alimentarios con mayor concentración de flúor contribuyeron significativamente (p<0,001) para la ingestión del halógeno (0,018 ­ 0.037mgF/día). El promedio de la ingestión de flúor contenido em alimentos sólidos y líquidos, del agua y delcepillado fue de 0,017 ­ 0,016; 0,011 ­ 0,004 y0,036 ­ 0,028mgF/kg peso/día, respectivamente, totalizando 0,064 ­ 0,035mgF/kg peso/día. De los379 niños, 31,2% presentan riesgo de fluorosis. El dentífrico y los artículos alimentarios contribuyeron con 57% y 43%, respectivamente, para la ingestión de flúor. El dentífrico fue la principal fuente para la ingestión de flúor por los niños, pero la concentración de ese halógeno em los artículos alimentarios contribuyó significativamente para la ingestión, representando riesgo para la fluorosis dentaria

Considerando-se que a fluorose dentária tem aumentado em todas as regiões é importante avaliar, além da água e do dentifrício, a contribuição diária do consumo alimentar das crianças e a concentração de flúor nesses itens alimentares para a ingestão deste halogênio. O trabalho teve por objetivo descrever o consumo alimentar de crianças, de 2 a 6 anos, com relação ao flúor. Foram avaliadas 379 crianças residentes em Bauru ­ São Paulo. A amostragem foi estratificada por setor, baseando-se no Plano Diretor do Município. O consumo alimentar foi avaliado pelo Questionário de Freqüência Alimentar Semiquantitativo, aplicado aos pais ou responsáveis, e a concentração de flúor nos itens alimentares a partir de análises laboratoriais. Os itens alimentares mais consumidos apresentaram, em média (±DP),concentração de flúor (0,015 ± 0,028 mgF/porção)significantemente menor (p = 0,03) que os menos consumidos (0,107 ± 0,162 mgF/porcão). Os itens alimentares com maior concentração de flúor contribuíram significantemente (p<0,001) para a ingestão do flúor (0,018 ± 0,037 mgF/dia). A média da ingestão de flúor por meio dos alimentos sólidos e líquidos, da água e da escovação foi de 0,017 ± 0,016; 0,011 ± 0,004 e 0,036 ± 0,028 mgF/kg peso/dia, respectivamente, totalizando 0,064 ± 0,035 mgF/kg peso/dia. Das 379 crianças, 31,2% apresentaram risco de fluorose. O dentifrício e os itens alimentares contribuíram com 57% e 43%, respectivamente, para a ingestão de flúor. O dentifrício foi a principal fonte para a ingestão de flúor pelas crianças, porém, a concentração do flúor nos itens alimentares contribuiu significantemente para a ingestão, representando risco para a fluorose dentária

Fluorose dentária e a concentração de flúor nos alimentos: uma revisão / Dental fluorosis and the fluoride concentration in the foods: a review

A fluorose dentária é um defeito de desenvolvimento do esmalte, caracterizado pela presença de estrias esbranquiçadas, em geral horizontais e opacas, nos casos mais suaves, e manchas amarronzadas e depressões nos casos mais severos. Sua causa é a ingestão excessiva de flúor durante o período de formação dos dentes. Considerando-se que a prevalência de fluorose dentária tem aumentado tanto em regiões fluoretadas quanto em regiões não fluoretadas, nesta revisão será abordado o fato de que, além da água e da pasta de dente fluoretadas, é importante avaliar a contribuição dos alimentos e bebidas consumidos por crianças na faixa etária de risco para fluorose dentária. Estudos demonstram que alguns alimentos e bebidas apresentam uma concentração de flúor acima do recomendado pela Dietary References Intakes (2001), sendo, portanto, fatores de risco importantes para a fluorose. Assim sendo, é fundamental que as indústrias alimentícias sigam as recomendações, pois, dessa forma, estarão contribuindo para redução da prevalência da fluorose dentária e respeitando a saúde das crianças

[Community health agent program: perception by patients and health service workers]. / Programa de agentes comunitários de saúde: a percepção de usuários e trabalhadores da saúde.

Two basic premises of Brazil's Community Health Agents Program (PACS) are to value the family and community to which the program belongs and to encourage their participation in health promotion and disease prevention. This study focused on the work developed by PACS in Bauru, São Paulo State, as perceived by the community health agents and the families served by them. As the study's point of departure, 22 community health agents and 22 representatives of families were interviewed, randomly selected according to residential micro-areas. Two focus groups were formed according to the PACS to which the community agents and families belonged. Qualitative analysis of the answers demonstrated agreement between the perceptions by community health agents and the community in the two focus groups. However, the two focus groups differed from each other. Distinct realities were observed in the two communities, thereby orienting new program actions and handling of local difficulties.

Programa de agentes comunitários de saúde: a percepção de usuários e trabalhadores da saúde / Community health agent program: perception by patients and health service workers

Valorizar a família e a comunidade em que se insere, além de estimular a sua participação na promoção da saúde e na prevenção das doenças são linhas-eixo da filosofia do PACS (Programa de Agentes Comunitários de Saúde). Este trabalho teve como elemento de estudo as ações desenvolvidas no PACS do Município de Bauru, São Paulo, segundo a percepção dos agentes comunitários de saúde (ACS) e das famílias por eles atendidas. Como ponto de partida para realização deste trabalho, foram entrevistados 22 agentes e 22 representantes de famílias, selecionadas aleatoriamente segundo a microárea de sua residência. Formaram-se dois grupos focais, a partir do PACS ao qual estavam vinculados agentes e usuários. A análise qualitativa das respostas demonstrou correspondência entre a percepção de ACS e comunidade nos dois grupos focais, que, no entanto, diferiram entre si. Foram observadas realidades distintas, norteando a realização de algumas ações programáticas e o enfrentamento das dificuldades locais.

Fluoride conten of several brands of teas and juices found in Brazil and risk of dental fluorosis

Given that increasing numbers of people are consuming beverages instead of water, fluoride (F) intake should not be determined solely upon the concentration of the drinking water, but should also consider the amount of different beverages consumed and their fluoride content. The aim of this study was to evaluate the fluoride content of (A) 12 infusion black tea (Camellia sinensis); (B) 15 ready-to-drink teas; (C) 10 powdered juices; (D) 3 powdered tea-containing juices; and (E) 4 ready-to-drink juices found in Brazil. Samples of A were prepared by infusion of a bag in 80mL of boiling deionized water, for 3 minutes. Powdered juices were prepared with deionized water, following the manufacturer's instructions. F analysis was made in triplicate using the ion-specific electrode (Orion 96-09). The mean F concentration ± SD (amplitude; unit mg/mL) were 2.57±0.99 (1.07-3.99); 0.37±0.20 (0.08-0.81); 0.02±0.05 (0-0.03); 1.10±0.15 (0.99-1.22); 0.30±0.18 (0.12-0.52), for A, B, C, D and E, respectively. All the A, 2 of the B and all of the D samples showed a F concentration higher than 0.7 mg/mL. Regarding the juices, only the D could significantly contribute to the daily maximum recommended F intake (0.07 mg/Kg body weight). However, if the other juices were reconstituted with fluoridated water they could also contribute. It was concluded that some products analyzed may be important contributors to the total daily F intake. Their consumption by children at the age of risk to dental fluorosis should be avoided. The [F] in these products should be informed on their labels

Avaliaçäo pela análise de conhecimento de professores e alunos de pós-graduaçäo da Faculdade de odontologia de Bauru - USP, em relaçäo a aspectos legais do cotidiano clínico / Evaluation of the knowledge level about legal aspects of daily clinical practice by professors and graduate students at the Bauru Dental School, University of Säo Paulo

Introduçäo: O presente estudo teve como objetivo avaliar o nível de conhecimento de docentes e discentes de pós-graduaçäo da Faculdade de Odontologia de Bauru da Universidade de Säo Paulo (USP), quando aos aspectos legais dos seus cotidianos clínicos. Métodos: Foi elaborado um questionário com questöes objetivas sobre a especialidade de atuaçäo do profissional, o tempo de formado, auto-avaliaçäo quanto ao seu nível de conhecimento sobre seus direitos e do paciente e qual seria a conduta legal frente a situaçöes do cotidiano laborativo. As entrevistas foram realizadas no primeiro semestre de 2002, a amostra constou de 100 profissionais cirurgiöes-dentistas escolhidos aleatoriamente na Faculdade de Odontologia de Bauru-USP, entre professores e alunos de pós-graduaçäo. Resultados: Os dados obtidos foram analisados através da análise estatística descritiva e foi atribuído para cada questionário notas de 0 (zero) a 10 (dez) e fez-se a média aritmética das notas dos docentes e pós-graduandos. Os resultados demonstraram que os conhecimentos quanto aos aspectos legais do cotidiano clínico säo mínimos, sendo que as notas estiveram entre 6,25 (docentes) e 6,46 (pós-graduandos). Conclusäo: A amostra estudada refletiu um conhecimento desses profissionais aquém do esperado para este grupo, haja vista o perfil dos entrevistados estar relacionado a profissionais no ambiente acadêmico, cujo conhecimento frente às diversas áreas procura ser sempre o mais atualizado possível para ser transmitido às novas geraçöes de cirurgiöes-dentistas

Concentraçäo de flúor em água mineral engarrafada e de fontes naturais das cidades de Lindóia, Aguas de Lindóia e Serra Negra, Brasil / Fluorine concentration in bottled mineral water and natural sources in the citie of Lindóia and Serra Negra, Brazil

A manutençäo da concentraçäo ótima de flúor minerais e a presença deste íon em águas de fontes naturais säo fundamentais para garantir eficiência desse método em relaçäo a saúde pública. A utilizaçäo de flúor sistêmico deve ser controlada em termos de riscos/benefícios, pois, se a subdosagem näo traz benefícios anticárie, a sobredosagem está associada com fluorose dental. O objetivo deste estudo foi avaliar as condiçöes atuais de concentraçäo de flúor existente nas fontes naturais e nas águas minerais das cidades de Aguas de Lindóia, Lindóia e Serra Negra, regiäo chamada de "Circuito das Aguas". Foram analisadas vinte amostras de água de fontes naturais coletadas em pontos diferentes e nove amostras de água mineral obtidas no comércio. Utilizou-se eletrodo específico (Orion 9609), acoplado ao aparelho analisador de pH/F (procyon SA 720), previamente calibrado com soluçöes padröes de flúor. Foram observadas concentraçöes de flúor variando de 0 a 0,46 ppm. Todas as amostras apresentaram concentraçöes de flúor abaixo dos limites considerados preventivos de cárie. Conclui-se que há necessidade de divulgaçäo desses dados para que a populaçäo e os profissionais de saúde sejam alertados para tal fatos, uma vez que tem ocorrido o aumento do consumo dessas águas minerais, que säo vendidas em todo o território nacional. Além disso, a populaçäo da regiäo por razöes culturais, consome apenas a água proveniente das fontes naturais, näo sendo beneficiada pelo flúor presente na água de abastecimento público

Conteúdo de flúor observado nos refrescos em pó encontrados no comércio de Bauru - SP / Fluoride content observed in powder refreshments found in the market of Bauru - SP

A cidade de Bauru está localizada no centro geográfico do Estado de São Paulo, e apresenta elevadas temperaturas, durante todo o ano. Portanto, o consumo de líquidos é, obviamente, muito alto também. Este consumo é representado, basicamente, por água, refrescos, sucos e refrigerantes. A proposta desta pesquisa é analisar o conteúdo de fluor nos refrescos em pó, normalmente encontrados no mercado. Os autores prepararam sucos com água deionizada, para analisar o conteúdo de flúor destas misturas