Effects of probiotic fermented milk on biofilms, oral microbiota, and enamel

The aim of this study was to evaluate in vitro and in vivo the effects of 2 brands of probiotic fermented milk on biofilms, oral microbiota, and enamel. For the in situ experiment, ten volunteers wore palatine devices containing four blocks of bovine dental enamel over 3 phases, during which 20% sucrose solution, Yakult® (Treatment A), and Batavito® (Treatment B) were dropped on the enamel blocks. Salivary microbial counts were obtained and biofilm samples were analyzed after each phase. For the in vivo experiment, the same ten volunteers drunk Yakult® (Treatment C) and Batavito® (Treatment D) in two phases. Saliva samples were collected for microbial analysis after each phase. The in situ study showed that in comparison with Treatment A, Treatment B resulted in fewer total cultivable anaerobes and facultative microorganisms in biofilms, higher final microhardness, lower percentage change in surface hardness, and smaller integrated subsurface enamel hardness. In the in vivo study, Treatment D resulted in a reduction in the counts of all microorganisms. The results suggested that the probiotic fermented milk Batavito®, but not Yakult®, reduced the amount of oral microorganisms and mineral loss in bovine enamel.

Effect of fluoride varnish supplemented with sodium trimetaphosphate on enamel erosion and abrasion.

PURPOSE: To assess in vitro the effect on enamel erosion (ERO) and erosion followed by abrasion (ERO+ABR) of varnishes with different fluoride concentrations, supplemented or not with sodium trimetaphosphate (TMP). METHODS: Bovine enamel blocks were randomly divided into six groups according to the type of varnish used: placebo (no F), NaF 5%, NaF 2.5%, NaF 2.5% plus TMP 3.5%, NaF 2.5% plus TMP 5%, NaF 2.5% plus TMP 10%. Varnishes were tested for ERO and ERO+ABR, separately for 3 and 5 days. ERO was done by immersion in Sprite Zero (5 minutes, 4x/day), while ERO+ABR was performed by brushing for 15 seconds after each erosive challenge. Enamel wear (microm) and cross-sectional hardness (AKHN) were assessed after the experimental periods. Data were analyzed by ANOVA, Tukey's test and Pearson's correlation coefficient (P< 0.05). RESULTS: Varnishes supplemented with TMP promoted significantly lower wear and hardness loss when compared to the other treatments in all conditions studied (P< 0.05). Similar wear rates were observed for the placebo, NaF 2.5% and NaF 5% varnishes (P> 0.05). Greater wear was observed after 5 days of ERO and ERO+ABR when compared with 3 days (P< 0.05). Positive and significant correlations were found between enamel wear and AKHN. No dose-response relationship was found between TMP concentration and wear and hardness. It was concluded that fluoride varnishes supplemented with TMP had a higher protective effect against ERO and ERO+ABR, which was associated with a reduction in enamel softening.

Evaluation of some properties of fermented milk beverages that affect the demineralization of dental enamel

The aim of this in vitro study was to evaluate the erosive capacity of fermented milk beverages, as well as some of their properties that affect the demineralization of dental enamel (pH, buffering capacity, fluoride, calcium and phosphorus contents). Three different batches of 6 commercial brands of fermented milk beverages were analyzed. pH evaluation was accomplished using a potentiometer. The buffering capacity was measured by adding 1 mol L-1 NaOH. Fluoride concentration was assessed by an ion specific electrode after hexamethyldisiloxane-facilitated diffusion, and calcium and phosphorus concentrations were assessed by a colorimetric test using a spectrophotometer. Sixty specimens of bovine enamel were randomly assigned to 6 groups (n = 10). They were exposed to 4 cycles of demineralization in the fermented milk and remineralization in artificial saliva. Enamel mineral loss was determined by surface microhardness ( percentSMHC) and profilometric tests. The samples' pH ranged from 3.51 to 3.87; the buffering capacity ranged from 470.8 to 804.2 µl of 1 mol L-1 NaOH; the fluoride concentration ranged from 0.027 to 0.958 µgF/g; the calcium concentration ranged from 0.4788 to 0.8175 mgCa/g; and the phosphorus concentration ranged from 0.2662 to 0.5043 mgP/g. The percentSMHC ranged from -41.0 to -29.4. The enamel wear ranged from 0.15 µm to 0.18 µm. In this in vitro study, the fermented milk beverages did not promote erosion of the dental enamel, but rather only a superficial mineral loss.

The influence of residual salivary fluoride from dentifrice on enamel erosion: an in situ study

The objective of this study was to assess the salivary residual effect of fluoride dentifrice on human enamel subjected to an erosive challenge. This crossover in situ study was performed in two phases (A and B), involving ten volunteers. In each phase, they wore acrylic palatal appliances, each containing 3 human enamel blocks, during 7 days. The blocks were subjected to erosion by immersion of the appliances in a cola drink for 5 minutes, 4 times a day. Dentifrice was used to brush the volunteers’ teeth, 4 times a day, during 1 minute, before the appliance was replaced into the mouth. In phases A and B the dentifrices used had the same formulation, except for the absence (PD) or presence (FD) of fluoride, respectively. Enamel alterations were determined using profilometry, microhardness ( percentSMHC), acid- and alkali-soluble F analysis. The data were tested using ANOVA (p < 0.05). The concentrations (mean ± SD) of alkali- and acid-soluble F (µgF/cm²) were, respectively, PD: 1.27ª ± 0.70/2.24A ± 0.36 and FD: 1.49ª ± 0.44/2.24A ± 0.67 (p > 0.05). The mean wear values (± SD, µm) were PD: 3.63ª ± 1.54 and FD: 3.54ª ± 0.90 (p > 0.05). The mean percentSMHC values (± SD) were PD: 89.63ª ± 4.73 and FD: 87.28ª ± 4.01 (p > 0.05). Thus, we concluded that the residual fluoride from the fluoride-containing dentifrice did not protect enamel against erosion.

Effect of iron on inhibition of acid demineralisation of bovine dental enamel in vitro.

OBJECTIVES: Iron ions (Fe(2+)) have been shown to be cariostatic in many studies particularly by their ability to reduce bacterial metabolism. Nevertheless, the role of iron ions on dissolution of enamel is unexplored. The aim of the present study was therefore to investigate the protective effect of increasing concentrations (0-120mmol/L) of Fe(2+) on the dissolution of enamel. DESIGN: Enamel powder was subjected to acetic acid made with increasing concentrations with respect to FeSO(4)x7H(2)O. In order to determine the amount of enamel dissolved, the phosphate released in the medium was analysed spectrophotometrically using the Fiske-Subarrow method. Data were tested using Kruskall-Wall and Dunn's tests (p<0.05). The degree of protection was found to approach maximum at about 15mmol/L Fe(2+). Higher concentrations of Fe(2+) did not have an extra effect on inhibition of dissolution of enamel powder. In the next step, the protective effect of 15mmol/L Fe(2+) against mineral dissolution of the bovine enamel was evaluated using a simple abiotic model system. Enamel blocks were exposed to a sequence of seven plastic vials, each containing 1mL of 10mmol/L acetic acid. The acid in vial 4 was made 15mmol/L with respect to FeSO(4)x7H(2)O. The mineral dissolved during each challenge was thus determined by phosphate released as described above. Data were tested using two-way ANOVA (p<0.05). RESULTS: Lower demineralisation (around 45%) was found in vial 4 (with Fe) that continued stable until vial 7. CONCLUSIONS: Thus, our data suggest that Fe(2+) can be effective on inhibition of dissolution of enamel and that this effect may be durable.

Effect of iron on bovine enamel and on the composition of the dental biofilm formed "in situ".

OBJECTIVES: This study investigated in situ the effect of iron (Fe) on the reduction of demineralization of bovine enamel, as well as on the composition of dental biofilm. DESIGN AND METHODS: Twelve volunteers were included in this blind crossover study, which was conducted in two stages of 14 days each. For each stage, the volunteers received palatal appliances containing four blocks of bovine enamel (4 mm x4 mm x 2.5 mm). Six volunteers dripped a solution of 15 mmol L(-1) ferrous sulphate onto the fragments and the remaining six dripped deionized water (eight times per day). After five minutes, a fresh 20% (w/v) sucrose solution was dripped onto all enamel blocks. During the experimental period the volunteers brushed their teeth with non-fluoridated dentifrice. After each stage, the percentage of surface microhardness change (%SMHC) and area of mineral loss (DeltaZ) were determined on enamel and the dental biofilm formed on the blocks was collected and analysed for F, P, Ca, Fe and alkali-soluble carbohydrates. The concentrations of F, Ca and Fe in enamel were also analysed after acid biopsies. RESULTS: There was a statistically significant increase in the P and Fe concentrations in the biofilms treated with ferrous sulphate (p<0.05), which was not observed for F, Ca and alkali-soluble carbohydrates. The group treated with ferrous sulphate had significantly lower %SMHC and DeltaZ when compared to control (p<0.05). CONCLUSIONS: These results showed that ferrous sulphate reduced the demineralization of enamel blocks and altered the ionic composition of the dental biofilm formed in situ.

Efeito do ferro na composição do esmalte bovino e na placa dentária formada in situ / Effect of iron on the hardness and composition of bovine enamel and dental plaque formed in situ

O objetivo deste estudo foi avaliar, in situ, o efeito do Fe sobre a desmineralização do esmalte dentário bovino, bem como na composição da placa dentária formada sob situação de alto desafio cariogênico. Doze voluntários participaram deste estudo cruzado e cego, desenvolvido em 2 etapas de 14 dias, separadas por um intervalo de 7 dias. Em cada etapa, os voluntários receberam dispositivos palatinos contendo 4 blocos de esmalte bovino (4X4X2,5 mm). Durante o período experimental, em ambas as etapas, os voluntários realizaram escovação com dentifrício não fluoretado e oito vezes por dia, 6 voluntários gotejaram uma solução de sulfato ferroso 15 mM sobre os fragmentos, enquanto que os outros 6 gotejaram água deionizada. Cinco minutos após, uma solução de sacarose 20% fresca foi gotejada sobre todos os blocos de esmalte. A análise da dureza superficial nos blocos foi determinada antes e após a etapa in situ, utilizando um penetrador Knoop acoplado a um software com carga de 50 g por 10 seg. Ao final de cada fase experimental, a placa bacteriana formada sobre os blocos foi coletada e submetida à análise da concentração de F, P, Ca, Fe e carboidratos álcali-solúveis. Também foram avaliados a dureza em seção longitudinal (carga de 25 g por 10 seg) e a concentração de F, Ca e Fe do esmalte. Os dados foram analisados por ANOVA e teste "t" emparelhado (p < 0,05). Na placa tratada com sulfato ferroso, houve um aumento estatisticamente significante nas concentrações de P e Fe, o que não ocorreu para os teores de F, Ca e carboidratos álcali-solúveis. O grupo que recebeu o sulfato ferroso obteve % SMHC e "delta"Z significativamente menores que o grupo controle. A percentagem de volume mineral foi maior para o grupo que recebeu Fe, em todas as profundidades, embora a diferença não tenha sido estatisticamente significante para as profundidades de 110 e 220 µm. Não foi encontrada diferença significante entre os grupos com relação ao F, Ca e Fe incorporados no esmalte. Os resultados indicam que o Fe causa um aumento na concentração de P da placa dentária, bem como reduz a perda mineral, tanto em superfície, quanto em profundidade no esmalte

A utilização da técnica da mão-sobre-a-boca (MSB) em odontopediatria: revisão de literatura / The utilization of the hand-over-mouth (HOM) technique in pediatric dentistry: a review of the literature

Esta revisão de literatura tem por objetivo principal trazer à tona aspectos clínicos, éticos e legais relacionados à utilização da técnica de mão-sobre-a-boca(MSB) em Odontopediatria. As principais indicações e contra-indicações, a percepção que os profissionais, pais e/ou responsáveis pelas crianças têm desta manobra e as implicações éticas e legais deste procedimento também são discutidos