PREVENTIVE EFFECT OF CRANBERRY GEL ON DENTIN SUBMITTED TO EROSION

Aims: Considering that Cranberry's components might inhibit dentin metalloproteinases exposed to erosive agents, the aim of this study was to evaluate in situeffect of a Cranberry gel application on dentin before an erosive challenge.Materials and methods: This crossover double-blinded study was performed in 2 phases of 5 days each, with 10 healthy volunteers who wore 2 palatal devices (1 for each phase) with 4 dentin specimens (2 specimens for each group). The groups under study were:First Phase: G1 -Erosivechallenge (Coca-cola®) over dentin without any previous treatment (1st negative control group); G2 -Erosive challenge over dentin previously treated with Cranberry gel (test group); and Second Phase: G3 -Erosive challenge over dentin previously treated with a gel without any active principle (2ndnegative control group); G4 -Erosive challenge over dentin previously treated with 0.12% Chlorhexidine gel (positive control group). Each device was immersed into the acid beverage, 3 times daily for 5 minutes during 5 days. Profilometry (µm) was used to quantify the dentin wear. Data were analyzed by Repeated Measures Analysis of Variance followed by Fisher's test (p<0.05).Results: Data (G1: 4.98 ± 1.36a; G2: 3.29 ± 1.16b; G3: 4.38 ± 1.19a; G4: 3.32 ± 1.55b) showed no statistical difference between G1 and G3. There was also no difference between G2 and G4. However, G2 and G4 presented lower wear when compared to G1 and G3, and this difference was statistically significant. Conclusion: The results of this studysuggest a significant efficacy of Cranberry gel in preventing wear of dentin subjected to dental erosion.

Acquired enamel pellicle protects gastroesophageal reflux disease patients against erosive tooth wear

Abstract The objective of this study was to compare the protein profile of the acquired enamel pellicle (AEP) formed in vivo in patients with or without gastroesophageal reflux disease (GERD), and with or without erosive tooth wear (ETW). Twenty-four volunteers were divided into 3 groups: 1) GERD and ETW; 2) GERD without ETW; and 3) control (without GERD). The AEP formed 120 min after prophylaxis was collected from the lingual/palatal surfaces. The samples were subjected to mass spectrometry (nLC-ESI-MS/MS) and label-free quantification by Protein Lynx Global Service software. A total of 213 proteins were identified, or 119, 92 and 106 from each group, respectively. Group 2 showed a high number of phosphorylated and calcium-binding proteins. Twenty-three proteins were found in all the groups, including 14-3-3 protein zeta/delta and 1-phosphatidylinositol. Several intracellular proteins that join saliva after the exfoliation of oral mucosa cells might have the potential to bind hydroxyapatite, or participate in forming supramolecular aggregates that bind to precursor proteins in the AEP. Proteins might play a central role in protecting the dental surface against acid dissolution.

S-PRG-based toothpastes compared to NaF toothpaste and NaF varnish on dentin permeability in vitro

Abstract Objectives To analyze the effect of 5 toothpastes containing different percentages of S-PRG fillers compared to NaF toothpaste and NaF varnish on the dentin hydraulic conductance (Lp). Methodology Dentin disks (1.0±0.2 mm thickness) were cut from third molars, and their Lp values were evaluated using Flodec. The specimens were allocated into 7 groups (n=8). The minimum (smear layer) and the maximum (after acid etching) Lp values were recorded. Lp was also assessed after treatment with either a 0wt.%, 1wt.%, 5wt.%, 20wt.%, or 30wt.% S-PRG toothpaste, a NaF toothpaste, or a NaF varnish. Toothpastes were applied by brushing for 15 s, allowing it to settle for 1 min, and rinsing with deionized water. The NaF varnish was applied for 4 min and was removed with a probe. Specimens were exposed to citric acid (6%, pH 2.1, 1 min) and their final Lp was recorded. The pH of all products was recorded (n=3) and specimens from each group were analyzed by Laser Scanning Confocal Microscopy (LSCM). Data were subjected to 2-way repeated measures ANOVA and post-hoc Bonferroni (a=0.05). Results The highest Lp reduction was noticed for the 5wt.% S-PRG toothpaste, NaF toothpaste, and NaF varnish. However, the toothpastes containing 5wt.%, 20wt.%, and 30wt.% of S-PRG were similar to all toothpastes but differed from the NaF varnish. After erosion, all groups retrieved their maximum Lp values, except for the NaF varnish. The LSCM evidenced deposits on the surface of specimens treated with 5%, 20%, and 30% S-PRG-based toothpastes and NaF toothpaste. Even more deposits were observed for the NaF varnish. After the erosive challenge, the deposits were diminished in all groups. Conclusion Toothpastes containing 5wt.%, 20wt.%, and 30wt.% of S-PRG fillers behaved similarly to a conventional NaF toothpaste, even after an erosive challenge. The NaF varnish promoted better reduction of the Lp, but its effect was also diminished after erosion.

Sodium trimetaphosphate combined to calcium as a strategy to improve dentin-bonding interface / Trimetafosfato de sódio associado ao cálcio como uma estratégia para melhorar a interface adesiva da dentina

Objective: The aim of this study was to evaluate the effect of STMP as biomimetic analog of dentin matrix on the dentin bond strength submitted to artificial cariogenic challenge over time. Material and Methods: The total number of teeth used in the experiment was 60 teeth, which were divided into 6 groups (n = 10). Of these total amount, 10 teeth were not submitted to the artificial cariogenic challenge (ACC), serving as control group (Sound Dentin - SD) while the other 50 were submitted to an ACC (7d/37ºC), being treated with treatment solutions according to each group: SD- deionized water/sound dentin, CD- deionized water/ artificial caries dentin, GIII- STMP, GIV- STMP + Ca(OH)2, GV- STMP + NaF, and GVI- NaF. After treatments (24h), the specimens were restored (Adper Single Bond Universal + Filtek Z250), to obtain resin­dentin sticks with a cross sectional area of 0.8mm2, approximately. Two-third of these sticks were stored in artificial saliva (37°C) for analyzes after 6 and 12 months. The 1/3 remains were subjected to µTBS test (baseline). Data were analyzed by two-way ANOVA and Tukey tests (p<0.05). Results: In general, the highest µTBS values were obtained in sound condition (SD), while the artificial caries condition (CD) determined minimum values. Groups treated with NaF (with or without STMP- GV and GVI) were not able to improve adhesion over time. Only the use of STMP + Ca(OH)2(GIV) improved the µTBS compared to the others caries-challenged dentin after 1 year. The adhesive failure pattern was predominant in all time. Conclusion: The use of the STMP associated with Ca(OH)2 seems to be a viable therapeutic strategy conciliating the biomimetizing capacity to the adhesive process satisfactorily even its performance is not superior to initial condition (AU)

Objetivo: O objetivo deste estudo foi avaliar o efeito do STMP como análogo biomimético da matriz dentinária na resistência de união à dentina submetida a desafio cariogênico artificial ao longo do tempo. Material e Métodos:foram utilizados um total de 60 dentes neste experimento, os quais foram divididos em 6 grupos (n = 10). Desse total, 10 dentes não foram submetidos ao desafio cariogênico artificial (DCA), servindo como grupo controle (Dentina Hígida - DH) enquanto os outros 50 foram submetidos ao DCA (7d / 37ºC), sendo tratados com soluções de tratamento específicas para cada grupo: DH- água deionizada / dentina hígida, DC- água deionizada / dentina submetida ao DCA, GIII- STMP, GIV- STMP + Ca(OH)2, GV- STMP + NaF e GVI- NaF. Após os tratamentos (24h), os corpos-de-prova foram restaurados (Adper Single Bond Universal + Filtek Z250), para obtenção de palitos de resina-dentina com área transversal de aproximadamente 0,8mm2. Dois terços desses palitos foram armazenados em saliva artificial (37°C) para análises após 6 e 12 meses. Os outros 1/3 foram submetidos ao teste µTBS (baseline). Os dados foram analisados por ANOVA a dois fatores e testes de Tukey (p <0,05). Resultados:Em geral, os maiores valores de µTBS foram obtidos em condição hígidas (DH), enquanto a condição subtmetidas ao DCA determinou os menores valores. Os grupos tratados com NaF (com ou sem STMP associado -GV e GVI) não foram capazes de melhorar a resistência de união, ao longo do tempo. Somente o uso de STMP + Ca (OH)2(GIV) melhorou o µTBS em comparação com as outras condições desafiadas por cárie após 1 ano. O padrão de falha adesiva foi predominante em todos os tempos. Conclusão: O uso do STMP associado ao Ca (OH)2 parece ser uma estratégia terapêutica viável conciliando a capacidade biomimetizante ao processo adesivo de forma satisfatória mesmo que seu desempenho não seja superior à condição inicial.(AU)

Giomer technology for preventive and restorative clinical management of erosive tooth wear: a case report / Tecnologia Giomer para manejo clínico preventivo e restaurador de desgaste dentário erosive: relato de caso

Increasing prevalence of erosive tooth wear (ETW) is notable mainly due to current knowledge and its early diagnosis. Once teeth are functionally and/or esthetically affected, dental restorations may become necessary. Materials capable of interacting with the eroded dental tissue allied to their resistance to subsequent continuous erosive challenges are desirable. Giomer technology based on S-PRG (surface pre-reactive glass) filler has been launching to provide benefits for the dental treatment due to its innovative multi-ionic release system, which involves fluoride. This case report describes the employment of preventive and restorative materials based on this technology for a patient under frequent erosive challenges and complaining about dental sensitivity. Patient reported immediate reduction on this sensitivity and the restorations has been followed up for 2 years, presenting satisfactory performance. S-PRG-based systems seem to be promissory for preventive and therapeutic management of ETW used simultaneously with the patient compliance. (AU)

O aumento da prevalência do desgaste dentário erosivo (DDE) é notável especialmente devido ao conhecimento atual e seu diagnóstico precoce. Uma vez que os dentes são afetados funcional e/ou esteticamente, restaurações dentárias se tornam necessárias. Materiais focados na habilidade de interagir com o tecido dentário erodido associados com sua resistência aos desafios erosivos contínuos subsequentes são desejáveis. A tecnologia Giomer baseada em partículas S-PRG (superfície de vidro pré-reativo) foi lançada no mercado para oferecer benefícios para o tratamento odontológico devido ao seu sistema inovador de liberação multi-iônica, que envolve o flúor. Esse caso clínico descreve o uso de materiais preventivo e restaurador baseados nessa tecnologia em um paciente em desafio erosivo e com queixa de sensibilidade. O paciente relatou redução imediata da sensibilidade e as restaurações foram acompanhadas por 2 anos apresentando desempenho satisfatório. Sistemas baseados em S-PRG se mostram promissores para manejo preventivo e terapêutico do DDE empregados simultaneamente à colaboração do paciente.(AU)

Acceptability and effect of TiF4 on dental caries: a randomized controlled clinical trial

Abstract: This randomized three-armed controlled clinical trial compared the effect of titanium tetrafluoride (TiF4) and sodium fluoride (NaF) varnishes on caries control in smooth surfaces of permanent dentition and children's acceptability. Sixty children (6-8 y/o) were randomly divided into TiF4 (2.45% F-), NaF (2.26% F-) or placebo (control) groups. Varnishes were applied on permanent teeth once a week for the first 4 weeks and after the 6th and 12th months of the study. The variables were as follows: International Caries Detection and Assessment System (ICDAS) scores, quantitative fluorescence changes, visual plaque index (VPI) and degree of acceptability. Two-way RM-ANOVA, ANOVA/Tukey and χ2 tests were performed (p < 0.05). No differences were found between the treatments with respect to ICDAS scores (p = 0.32). Only TiF4 reduced the mean fluorescence loss significantly at 18 months compared to the baseline (p = 0.003). TiF4 showed a lower percentage of new caries lesions by tooth surface than the placebo, while NaF did not induce such a change (p < 0.014). Regardless of the treatment, more than 95% of the participants reported being satisfied. For all groups, the VPI decreased significantly at 3 months compared to the baseline value (p < 0.001), with no differences between the treatments (p = 0.17). TiF4 had a similar ability to control caries lesions as NaF; however, only TiF4 differed from the placebo (p = 0.004). The acceptability of TiF4 varnish was similar to that of NaF varnish.

Diagnóstico diferencial e conduta clínica de um cisto folicular inflamatório mandibular / Differential diagnosis and management of inflammatory follicular cyst in mandibular anterior area

Este artigo descreve a dificuldade em diagnosticar um cisto folicular inflamatório na área anterior da mandíbula em um menino com dentinogênese imperfeita tipo I (DI-1). Um menino de 6 anos de idade, com DI-1, procurou tratamento devido ao comprometimento estético. O exame radiográfico revelou uma lesão periapical envolvendo os dentes decíduos incisivo central e lateral direitos. Esses dentes foram extraídos sem intercorrências. Após três meses, a criança se queixou de dor em um edema de cor azulada na mesma área. O diagnóstico diferencial foi de cisto folicular e a lesão foi acompanhada. Como os sinais e sintomas persistiram, o tratamento de escolha foi a descompressão da lesão, seguido por irrigação abundante e curetagem das paredes da lesão. O acompanhamento clínico e radiográfico, mostrou, após 6 meses, remissão da lesão, reparo ósseo, e erupção ativa dos incisivos permanentes. As características incomuns deste caso, fizeram com que o diagnóstico de cisto folicular inflamatório fosse dificultado.

This article reports the difficulties in diagnosing an inflammatory follicular cyst in the mandibular anterior area of a boy with type 1 dentinogenesis imperfecta (DI-1). A 6-year-old boy, with DI-1, sought treatment due to esthetic complaints. The radiographic examination revealed a periapical lesion involving the right primary central and lateral incisors. These teeth were extracted with no complications. After three months, the boy complained of pain in a blue-black edema in the same area. The differential diagnosis was of follicular cyst and the lesion was followed-up. As the signs and symptoms persisted, the treatment of choice was to decompress the lesion, followed by copious irrigation, and lesion's wall curettage. After six months, the clinical and radiographic follow-up showed lesion remission, bone repair, and active eruption of permanent incisors. The uncommon characteristics of the case make the diagnosis of inflammatory follicular cyst difficult.

Tratamento odontológico na atenção básica à saúde de crianças durante a pandemia da COVID-19: o que fazer? / Dental care in primary health care of children during COVID-19 pandemic: what to do?

Este artigo objetivou discutir estratégias de atendimento odontológico para crianças na atenção básica à saúde considerando a transmissibilidade do SARS-COV-2. O telemonitoramento seria o meio mais exequível de prestar a promoção da orientação/reforço da higiene oral/aconselhamento dietético. Os procedimentos de mínima intervenção em dentes decíduos/permanentes possibilitariam o manejo de lesões de cárie iniciais, moderadas e severas, sem geração de aerossol. Quando procedimentos com geração de aerossol são necessários, esses devem ser agendados para o final do período, esperando- -se pelo menos 30 minutos para iniciar a desinfecção do ambiente. A abordagem odontológica às crianças com necessidades especiais deve ser direcionada primeiramente para promoção e prevenção da saúde bucal, seguida da preferência pelas técnicas não farmacológicas para o gerenciamento do comportamento, como FALAR-MOSTRAR-FAZER, para aqueles pacientes com cognitivo que permita a interação e entendimento razoáveis. Recursos como estabilização protetora devem ser utilizados para os casos de comportamentos mais difíceis e, por fim, a intervenção sob anestesia geral com indicação bem restrita.

This study aimed to discuss dental care approaches for the primary health care of children considering the SARS-COV-2 transmissibility. Teledentistry would be the most reasonable way of promoting oral health guidance and dietary counseling. Minimum intervention procedures in primary/permanent teeth would enable the management of initial, moderate, and severe caries lesions without generating aerosol. When aerosol-generating procedures are necessary, these should be scheduled at the end of the working day, waiting for at least 30 minutes after the procedure for disinfection. The dental care of children with special needs should firstly address oral health promotion and prevention, followed by non-pharmacological behavioral techniques (TELL-SHOW-DO) in children with reasonable cognitive understanding. For difficult behaviors, we suggest the use of resources as protective stabilization and general anesthesia in a very restrictive manner.

Non-inferiority clinical trials: importance and applications in health sciences

Abstract Non-inferiority randomized clinical trials are indicated when it is intended to prove that an experimental group is not inferior to a control group by more than a margin of non-inferiority. However, this type of study differs from traditional randomized clinical trials (superiority studies) because they have particularities that impact on the formulation of hypothesis to be tested, experimental design (non-inferiority margin determination, adapted sample size calculation, sensitivity of the study and data final analysis) and also on the presentation of data when writing the manuscript. Therefore, this article aims to present and discuss the particularities of non-inferiority clinical studies, since these requirements are fundamental to guarantee the validity of the conclusions of this type of study.

In Situ Effect of Intra-Oral Application of Pastes Containing CPP-ACP or CPP-ACPF Against Initial Enamel Erosion

Objective: To evaluate in situ the effect of toothpastes containing casein phosphopeptide - amorphous calcium phosphate (CPP-ACP) and casein phosphopeptide-amorphous calcium phosphate associated to fluoride (CPP-ACPF) on initial erosion prevention. Material and Methods: Bovine enamel blocks (n = 192) were randomly assigned into 4 phases according to the baseline surface hardness: GI: CPP-ACP Paste (MI Paste™), GII: CPP-ACPF Paste (MI Paste Plus™), GIII: Fluoridated paste and GIV: Placebo Paste. In each of the 4 crossover phases, twelve volunteers wore intraoral palatal appliances containing 4 enamel blocks for 2 hours, then the tested treatments were applied intraorally (3 min) and the appliance was maintained in the mouth for another 3 hours. After, the appliances were removed and immersed in hydrochloric acid (0.01 M, pH 2.3) for 30 seconds to promote erosive demineralization. The final surface hardness was evaluated and percentage of surface hardness loss was calculated. The data were analyzed by ANOVA and Tukey's test (α = 5%). Results: The application of CPP-ACP paste, independent of fluoride content, resulted in significant lower enamel hardness loss (GI: 9.26% ±3.48 and GII: 9.14% ±1.73) compared to NaF (GIII: 15.5% ± 3.94) and placebo (GIV: 16.7% ± 4.07) pastes, which did not show difference between them. Conclusion: The CPP-ACP pastes were able to reduce initial erosive demineralization in relation to fluoride and placebo pastes. Nevertheless the formulation of CPP-ACP with fluoride did not provide an additional benefit.

Diálogos y Saberes sobre Sexualidad de Padres con Hijos e Hijas Adolescentes Escolarizados / Dialog and Knowledge about Sexuality of Parents of Adolescent School Children / Diálogos e Saberes sobre Sexualidade de Pais com Filhos Adolescentes Escolarizados

Resumen El objetivo de la investigación fue explorar los diálogos y saberes sobre sexualidad expresados por padres o madres de adolescentes. La metodología fue cualitativa con diseño narrativo, y los grupos focales sirvieron como técnica de recolección. Los resultados evidencian que los padres o madres aprenden sobre sexualidad desde sus propias experiencias, por lo cual este aspecto está presente en la comunicación con sus hijos. Respecto a los temas, siguen prevaleciendo discursos preventivos en torno al embarazo, excluyendo las infecciones de transmisión sexual (ITS), pornografía y diversidades sexuales. Se concluye que en los diálogos sobre sexualidad en estos participantes coexisten múltiples discursos, y se requieren estrategias de intervención orientadas a promover espacios formativos y habilidades para la comunicación referente a la sexualidad.

Abstract The study aimed to explore the dialog and knowledge of sexuality expressed by fathers or mothers of adolescents. A qualitative methodology with narrative design was used, with focus groups used for data collection. The results demonstrate that the parents or mothers learn about sexuality from their own experiences, so this aspect is present in communication with their children. The most discussed topic was pregnancy, excluding sexually transmitted infections (sti), pornography and sexual diversity. The study concludes that dialogs with these participants about sexuality contain multiples discourses; intervention strategies oriented to promoting training spaces and communication skills regarding sexuality are required.

Resumo O objetivo desta pesquisa foi explorar os diálogos e saberes sobre sexualidade expressos por pais ou mães de adolescentes. A metodologia foi qualitativa com desenho narrativo, e os grupos focais serviram como técnica de coleta. Os resultados demonstram que os pais ou mães aprendem sobre sexualidade a partir de suas próprias experiências, razão pela qual esse aspecto está presente na comunicação com seus filhos. A respeito dos temas, continuam prevalecendo discursos preventivos sobre a gravidez e excluem-se os referentes a infecções sexualmente transmissíveis (1st), pornografia e diversidade sexual. Conclui-se que, nos diálogos sobre sexualidade nesses participantes, coexistem múltiplos discursos e requerem-se estratégias de intervenção orientadas a promover espaços de formação e habilidades para a comunicação referente à sexualidade.

Oral health-related quality of life of children with oral clefts and their families

Abstract Oral health problems can influence people's Quality of Life (QoL) because of pain, discomfort, limitations, and other esthetics problems, affecting their social life, feeding, daily activities, and the individual's well-being. Objective: To compare oral health-related quality of life (OHRQoL) of children with and without oral clefts and their families. Materials and Methods: 121 children aged from 2 to 6 years, from both sexes, enrolled in the treatment routine of the Pediatric Dentistry Clinics of a Dental School and a Hospital for Cleft Treatment were divided into two groups: Group 1 - children with cleft lip and palate; Group 2 - children without cleft lip and palate. The OHRQoL was assessed using the validated Portuguese version of the Early Childhood Oral Health Impact Scale (B-ECOHIS). The questionnaire was answered individually, only once, at a private place. Mann-Whitney U test was used to verify differences between groups. Spearman's Rho test was used to associate sex and age with quality of life. The level of significance was set at 5% (p<0.05). Results: According to the parents' perception on the OHRQoL of children with and without cleft lip and palate, oral health of children with oral clefts (Group 1) had a statistically significant impact on OHRQoL. The correlation of sex with impact on OHRQoL did not show statistically significant differences. On the other hand, the higher the age the higher the impact on QoL. Conclusions: The group comparison revealed that the cleft lip and palate negatively impacted on OHRQoL of 2 to 6-year-old children and their parents.

Effect of vegetable oils applied over acquired enamel pellicle on initial erosion

Abstract Objective The prevalence of dental erosion has been recently increasing, requiring new preventive and therapeutic approaches. Vegetable oils have been studied in preventive dentistry because they come from a natural, edible, low-cost, and worldwide accessible source. This study aimed to evaluate the protective effect of different vegetable oils, applied in two concentrations, on initial enamel erosion. Material and Methods Initially, the acquired pellicle was formed in situ for 2 hours. Subsequently, the enamel blocks were treated in vitro according to the study group (n=12/per group): GP5 and GP100 - 5% and pure palm oil, respectively; GC5 and GC100 - 5% and pure coconut oil; GSa5 and GSa100 - 5% and pure safflower oil; GSu5 and GSu100 - 5% and pure sunflower oil; GO5 and GO100 - 5% and pure olive oil; CON− - Deionized Water (negative control) and CON+ - Commercial Mouthwash (Elmex® Erosion Protection Dental Rinse, GABA/positive control). Then, the enamel blocks were immersed in artificial saliva for 2 minutes and subjected to short-term acid exposure in 0.5% citric acid, pH 2.4, for 30 seconds, to promote enamel surface softening. The response variable was the percentage of surface hardness loss [((SHi - SHf) / SHf )×100]. Data were analyzed by one-way ANOVA and Tukey's test (p<0.05). Results Enamel blocks of GP100 presented similar hardness loss to GSu100 (p>0.05) and less than the other groups (p<0.05). There was no difference between GP5, GC5, GC100, GSa5, GSu100, GSa100, GSu5, GO5, GO100, CON− and CON+. Conclusion Palm oil seems to be a promising alternative for preventing enamel erosion. However, further studies are necessary to evaluate a long-term erosive cycling.

In situ effect of CPP-ACP chewing gum upon erosive enamel loss

Abstract Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) is able to increase salivary calcium and phosphate levels at an acidic pH. Previous studies demonstrated that a CPP-ACP chewing gum was able to enhance the re-hardening of erosion lesions, but could not diminish enamel hardness loss. Therefore, there is no consensus regarding the effectiveness of CPP-ACP on dental erosion. Objective This in situ study investigated the ability of a CPP-ACP chewing gum in preventing erosive enamel loss. Material and Methods: During three experimental crossover phases (one phase per group) of seven days each, eight volunteers wore palatal devices with human enamel blocks. The groups were: GI - Sugar free chewing gum with CPP-ACP; GII - Conventional sugar free chewing gum; and GIII - No chewing gum (control). Erosive challenge was extraorally performed by immersion of the enamel blocks in cola drink (5 min, 4x/day). After each challenge, in groups CPP and No CPP, volunteers chewed one unit of the corresponding chewing gum for 30 minutes. Quantitative analysis of enamel loss was performed by profilometry (µm). Data were analyzed by Repeated-Measures ANOVA and Tukey's test (p<0.05). Results The use of chewing gum (CPP and No CPP) resulted in lower erosive enamel loss compared with the control group (p<0.05). CPP-ACP chewing gum (CPP) did not improve the protection against erosive enamel loss compared with conventional chewing gum (No CPP) (p>0.05). Conclusion The CPP-ACP chewing gum was not able to enhance the anti-erosive effect of conventional chewing gum against enamel loss.

CO2 laser and/or fluoride enamel treatment against in situ/ex vivo erosive challenge

ABSTRACT Objective This in situ/ex vivo study investigated the effect of CO2 laser irradiation and acidulated phosphate fluoride gel (APF) application, separately and in combination, on enamel resistance to erosion. Material and Methods During 2 experimental 5-day crossover phases, 8 volunteers wore intraoral appliances containing bovine enamel blocks which were submitted to four groups: 1st phase - control, untreated and CO2 laser irradiation, 2nd phase - fluoride application and fluoride application before CO2 laser irradiation. Laser irradiation was performed at 10.6 µm wavelength, 5 µs pulse duration and 50 Hz frequency, with average power input and output of 2.3 W and 2.0 W, respectively (28.6 J/cm2). APF gel (1.23%F, pH 3.5) was applied on enamel surface with a microbrush and left on for 4 minutes. Then, the enamel blocks were fixed at the intraoral appliance level. The erosion was performed extraorally 4 times daily for 5 min in 150 mL of cola drink. Enamel loss was measured profilometrically after treatment and after the in situ phase. The data were tested using one-way Repeated Measures Anova and Tukey's test (p<0.05). Results CO2 laser alone (2.00±0.39 µm) did not show any significantly preventive effect against enamel erosion when compared with the control group (2.41±1.20 µm). Fluoride treated enamel, associated (1.50±0.30 µm) or not (1.47±0.63 µm) with laser irradiation, significantly differed from the control. Conclusion The APF application decreased enamel wear; however, CO2 laser irradiation did not enhance fluoride ability to reduce enamel wear.

Pit and Fissure Sealants with Different Materials: Resin Based x Glass Ionomer Cement ­ Results after Six Months

Objective: To compare the retention and superficial characteristics between a new resin-modified glass ionomer sealant and resin sealant. In addition, the teeth sealed were compared to partially erupted first molars (control group) without sealing in relation to the incidence of dental caries. Material and Methods: Initially, 31 children aged 6-8 years participated in this study. The study children showed caries history, but had at least two healthy first molars. A total of 114 teeth were randomly divided into three groups: Clinpro (n=36), Fluroshield (n=38), and control (n=40). The two sealants were applied under relative isolation after previous prophylaxis and enamel etching with phosphoric acid 35% (15s). Clinical evaluation was performed by two calibrated examiners. They evaluated the retention and surface characteristics of the occlusal surface. Results: Fluroshield® showed significantly greater retention than ClinproTM Varnish® XT (p=0.002). However, the performance analysis of the success and failure of retention presented no significant difference between the materials (p=0.141). Concerning to the surface characteristics, Fluroshield performed better than Clinpro after analyzing the marginal deterioration, marginal discoloration, and superficial discoloration (p<0.05). The surface texture of the materials under study was similar (p=0.071). Sealed groups (Clinpro=Fluroshield) showed similar performance in the prevention of dental caries, which was significantly lower than that of control group (p=0.001). Conclusion: Both sealants, Fluroshield® and Clinpro TM Varnish® XT were effective in preventing caries lesion within 6 months, although Fluroshield sealant showed better clinical retention.

Impact of Saliva and Intraoral Appliance on Erosion Lesions Rehardening Ability - A Pilot Study

Objective: To evaluate the ability of different periods of salivary exposure and two different removable appliances to rehardening initial erosive lesions. Material and Methods: This randomized, single blind in situ study was conducted with 2 crossover phases. The factors under study were: period of salivary exposure (15 minutes, 30 minutes, 1 hour and 2 hours) and type of oral appliance (maxillary or mandibular). Two hundred enamel blocks were selected by initial surface hardness (SHi). Enamel blocks were demineralized in vitro (0.05M citric acid; pH2.5 for 15 seconds), surface hardness (SHd) was remeasured and 160 blocks were selected and randomized among groups. Thus, there were 2 blocks per period of salivary exposure in each type of oral appliance for each one of the 10 volunteers. In each phase, one of the removable appliances was tested. The response variable was percentage of surface hardness recovery (%SHR=[(SHf-SHd)/SHi)]x100). Two-way ANOVA and Tukey's post hoc test were applied adopting 5% of significance. Results: No difference was found among oral appliances on enamel rehardening (p>0.01). Salivary exposure of 2 hours promoted similar enamel rehardening when compared to 1 hour (p>0.05), which showed similar rehardening to 30 min. All mentioned period of salivary exposure promoted superior rehardening than 15 min (p>0.01). Conclusion: The salivary time exposure between erosive attacks might be 2 hours to achieve a feasible maximum rehardening. In addition, both maxillary and the mandibular appliance have presented a similar rehardening ability.

Do technology-based devices improve carious lesion detectionin children with oral cleft? / Os aparelhos baseados em tecnologia melhoram a detecção de lesões de cárie em crianças com fissura labiopalatina?

Objetivo: Comparar o exame visual-tátil com os exames baseados em tecnologia na detecção de lesões de cárie em crianças com fissuras labiopalatina. Material e Métodos: 405 faces mesial, distal, vestibular e palatina dos dentes permanentes anteriores superiores próximos a área da fissura de 95 crianças com idade entre 6-12 anos (média 10 anos± 2 anos e 9 meses) foram avaliadas por dois examinadores previamente calibrados. Os seguintes métodos de detecção de lesão de cárie foram usados: exame visual-tátil (Método 1), exame visual-tátil com o auxílio do microscópio operatório (Método 2), exame visual por meio de um aparelho de fluorescência por LED (Método 3). ICDAS foi o sistema usado para classificar todas as lesões de cárie nos três métodos. A sonda OMS foi usada durante o exame visual-táctil. O microscópio operatório foi usado em magnificação de 10x. O aparelho de fluorescência por LED (Evince ®) tinha uma câmera ligada à peça de mão e conectada ao computador. Os métodos auxiliares de detecção de cárie foram comparados ao exame visual-táctil pelo teste de Friedman (P < 0,05). Resultados: Não houve diferença estatisticamente significante na eficácia dos métodos de detecção de lesão de cárie (P = 0,786). Conclusão: O microscópio operatório e o aparelho de fluorescência por LED não mostraram diferença na a detecção de lesão de cárie para avaliar dentes próximos à área da fissura labiopalatina.

Objective: To compare the visual-tactile examination with the technology-based caries detection examinations in children. Material and Methods: Two previously calibrated examiners assessed 405 mesial, distal, labial, and palatal surfaces of the upper anterior permanent teeth next to the cleft area of 95 children aged 6 to 12 years (mean age of 10 years ± 2 years and 9 months) with oral clefts but without the presence of any associated syndrome or craniofacial anomaly. The following detection methods were used: visual-tactile examination (Method 1), visual-tactile examination through operating microscope (Method 2), visual examination through LED-based fluorescence device (Method 3). ICDAS was the system used to score all caries lesions for all methods. WHO probe was used during the examination with visual-tactile examination. Operating microscope was used at x10 magnification. LED-based fluorescence (Evince™) had a video camera coupled to the handpiece and linked to a computer. The adjunct caries detection methods were compared to visual-tactile examination by Friedman test (P < 0.05). Results: The efficacy of carious lesion detection methods were statistically similar (P = 0.786). Conclusion: Both the operating microscope and the LED-based fluorescence device did not improve caries lesion detection in the permanent anterior teeth next to the cleft area.

Effect of different salivary exposure times on the rehardening of acid-softened enamel

Abstract This in situ study assessed the effect of different times of salivary exposure on the rehardening of acid-softened enamel. Bovine enamel blocks were subjected in vitro to a short-term acidic exposure by immersion in 0.05 M (pH 2.5) citric acid for 30 s, resulting in surface softening. Then, 40 selected eroded enamel blocks were randomly assigned to 10 volunteers. Intraoral palatal appliances containing 4 enamel blocks were constructed for each volunteer, who wore the appliance for 12 nonconsecutive hours: initial 30 min, followed by an additional 30, and then by an additional 1 hour. For the last additional 10 hours the appliances were used at night, during the volunteers' sleep. Surface hardness was analyzed in the same blocks at baseline, after erosion and after each period of salivary exposure, enabling percentage of surface hardness recovery calculation (%SHR). The data were tested using repeated measures ANOVA and Tukey's test (α = 0.05). Increasing periods of salivary action promoted a progressive increase in the surface hardness (p < 0.001). However a similar degree of enamel rehardening (p = 0.641) was observed between 2 hours (49.9%) and 12 hours (53.3%) of salivary exposure. Two hours of salivary exposure seems to be appropriate for partial rehardening of the softened enamel surface. The use of the intraoral appliance during sleep did not improve the enamel rehardening after erosion.

A Two-Year Clinical Evaluation of Fluoride and Non-Fluoride Resin-Based Pit-and-Fissure Sealants

The aim of this study was to evaluate and compare for 24 months, the retention and surface characteristics of two pit-and-fissure sealants: Helioseal Clear and Helioseal F (Ivoclar Vivadent). The correlation between the different stages of eruption and sealant retention was also verified. Fifty children aged 6 to 8 years participated in the study, totalizing 153 teeth divided into two groups: HC (Helioseal Clear) and HF (Helioseal F). After 6, 12, 18 and 24 months, a clinical examination was performed by previously calibrated examiners. The surface characteristics and the retention of the sealants (modified RYGE & SNYDER criteria) were assessed. Analyzing the occlusal surface, HC exhibited a statistically significant higher retention at 12 (p=0.0345) and 24 months (p=0.0076). Concerning the surface characteristics, only the superficial discoloration of HC was smaller than HF, during the entire studied period. For all the other characteristics, the results of the Mann-Whitney test were highly significant at different periods (p=0.0000 to 0.0421). The frequency of air bubbles within the sealant surfaces, determined by Chi-square test, was significantly higher in HF (p=0.000:12 and 18 months to p=0.002: 6 and 24 months). HC sealant material exhibited the best performance regarding the retention and surface characteristics on the occlusal surface.

Resumo Os objetivos deste trabalho foram avaliar e comparar por 24 meses, a retenção e as características superficiais de dois diferentes materiais seladores, Helioseal Clear e Helioseal F(Ivoclar Vivadent). A correlação entre os diferentes graus de erupção e a retenção dos selantes também foram verificadas. Cinquenta crianças de 6 a 8 anos de idade participaram deste estudo, totalizando de 153 dentes divididos em dois grupos: HC (Helioseal Clear) e HF (Helioseal F). Após 6, 12, 18 e 24 meses, avaliação clínica foi realizada por dois examinadores calibrados. As caracterísiticas superficiais e a retenção (critério modificado de Ryge &Snyder) foram avaliadas. A análise da superfície oclusal, o HC demostrou retenção estatisticamente significante maior para os 12 meses (p=0,0345) e 24 meses (p=0,0076). Em relação às características superficiais, somente para descoloração superficial, o HC foi menor que do HF, durante o período estudado. Para as demais características, os resultados do teste de Mann-Whitney foram altamente significantes para HC em diferentes períodos (p=0,0000 a 0,0421). A frequência de bolhas nas superfícies seladas, determinada pelo teste do Qui-quadrado, foi maior e mais significante no HF (p=0,000:12 e 18 meses a p=0,002: 6 e 24 meses). O selante HC apresentou melhor desempenho à retenção e características superficiais.