Remineralization of white spot lesions in orthodontic. is that possible? Literature review / Remineralização de lesões de mancha branca em Ortodontia. Isso é possível? Revisão de literatura

Aim: The aim of this literature review is to describe the latest treatment available in the solution of this problem through remineralization. Literature review: A literature review was carried out in various electronic databases such as PubMed, MEDLINE, EBSCO, LILACS, EMBASE, Cochrane Library; from 1989 to 2022. The Medical Subject Headings (MeSH) terms used in the literature search were in English: "tooth reminaralization", "dental white spot", "orthodontic. Discussion: White spot lesions after orthodontic appliances is an undesired effect seen in dentistry. There is a wide option of agents that offer remineralization by the process of depositing calcium and phosphate ions into crystal voids in demineralized enamel, producing net mineral gain and preventing early enamel lesions progression, including fluoride toothpastes, fluoride varnishes, fluoride mouth rinses, and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP). Conclusion: Fluoride-based prevention strategies are the agent with the strongest evidence for the treatment of WSL. The dental professional should offer this therapy in the earliest phase of the lesions so that it can be remineralized.

Objetivo: O objetivo desta revisão de literatura é descrever osmais recentestratamentos disponíveisna remineralizaçãode lesões de mancha branca.Revisão da literatura: Foi realizada uma revisão da literatura em várias bases de dados eletrônicas como PubMed, MEDLINE, EBSCO, LILACS, EMBASE, Cochrane Library; de 1989 a 2022. Os termos do Medical Subject Headings (MeSH) utilizados na busca da literatura foram em inglês: "tooth reminaralization", "dental white spot", "orthodontics".Discussão: A lesão de mancha branca após utilização de aparelhos ortodônticos é um efeito indesejado observado na odontologia. Existe uma ampla opção de agentes que oferecem remineralização pelo processo de deposição de íons cálcio e fosfato nos cristaisdo esmalte desmineralizado, produzindoganho mineral líquido e prevenindo a progressão precoce das lesões do esmalte, incluindo cremes dentais com flúor, vernizes com flúor, enxaguatórios bucaiscom flúor e caseína fosfopeptídeo-fosfato de cálcio amorfo (CPP-ACP).Conclusão: As estratégias de prevenção utilizandoflúor constituem osagentescom mais evidências para o tratamento da mancha branca. O dentista deve oferecer essa terapia na fase inicial das lesões para que haja remineralização.

Dimensions of Occlusoproximal Cavitated Carious Lesions as a Cut-Off Point for Restorative Decision in Primary Teeth

ABSTRACT Objective: To investigate whether the dimensions of cavitated dentin carious lesions on the occlusoproximal surfaces of primary teeth could predict the location of cement-enamel junction (CEJ). Material and Methods: Two hundred extracted primary molars were selected and digital images were obtained. The teeth were set in arch models for clinical measurement. The cervical-occlusal (CO) and buccal-lingual/palatal (BL/P) cavities' dimensions were obtained by digital (Image J) and clinical (periodontal millimeter probe) assessments. The cervical margin location was also determined. The thresholds (cut-off points) were determined by sensitivity, specificity and the areas under the receiver operating characteristics curves (Az) for the two methods. Pearson's correlation coefficient was used to investigate the correlation between clinical and digital measurements. Logistic regression analysis was performed to evaluate the association between the dimensions and cervical margin location. Results: There was a strong correlation between methods for all measurements (CO: r=0.90, VL/P: r=0.95). Cavities with BL/P distance higher than 4.5 mm and CO dimension higher than 3.5 mm had a lower chance of presenting the cervical limit above the CEJ, irrespective of the measurement method. Conclusion: CO and VL/P dimensions could be used to predict the CEJ location and, ultimately, as a clinical parameter for restorative decision-making.

Erosión del esmalte dental en dientes expuestos a bebidas de origen industrial. Estudio piloto in vitro / Erosion of dental enamel in teeth exposed to industrial drinks. In vitro pilot study

RESUMEN: Objetivo: determinar el efecto erosivo sobre el esmalte dental de dientes humanos extraídos, después de la exposición a bebidas industriales distribuidas comercialmente en Cartagena, Colombia. Materiales y métodos: estudio experimental in vitro en 26 dientes humanos extraídos con esmalte dental sano, distribuidos aleatoriamente en doce grupos experimentales que fueron expuestos a bebidas industriales comercializadas en la ciudad de Cartagena. Las bebidas fueron expuestas durante 7 días, dos veces al día. Para determinar el efecto erosivo, se valoró pH de la bebida, pérdida de peso de los dientes expuestos y aspecto clínico del esmalte dental posterior a la exposición. Resultados: todas las bebidas evaluadas presentaron pH<4.5, siendo la Coca Cola® y jugo Hit® naranja las que exhibieron el pH más bajo. Todas las bebidas causaron desmineralización del esmalte, sin embargo, las que causaron mayor pérdida de peso fueron Speed Max®, Vive 100® y Coca-Cola®. Conclusiones: Speed Max® y Coca-Cola® fueron las bebidas que generaron mayor efecto erosivo sobre la estructura dental, por lo cual es necesario informar a la población los riesgos para la salud oral que se derivan del consumo desmedido de estas bebidas.

ABSTRACT: Objective: to determine the erosive effect on dental enamel of extracted human teeth, after exposure to industrial drinks distributed commercially in Cartagena, Colombia. Materials and methods: experimental in vitro study in 26 human teeth extracted with healthy dental enamel, randomly distributed in twelve experimental groups that were exposed to industrial beverages commercialized in the city of Cartagena. The teeth were exposed to the drinks for 7 days, twice a day. To determine the erosive effect, pH of the drink, weight loss of the exposed teeth and clinical appearance of the dental enamel after exposure were evaluated. Results: all the evaluated drinks presented pH <4.5, being Coca Cola® and Hit® Orange Juice the ones that exhibited the lowest pH. All the drinks caused enamel demineralization, however, the ones that caused the most weight loss were Speed ​​Max®, Vive 100® and Coca Cola®. Conclusions: Speed Max® and Coca Cola® were the drinks that generated the greatest erosive effect on the dental structure. Therefore, it is necessary to inform the population about the risks to oral health derived from the excessive consumption of these drinks.

Síntese e caracterização de ciclotrifosfato de sódio contendo cálcio e seu efeito na prevenção da erosão do esmalte in vitro / Synthesis and characterization of calcium-containing sodium cyclotriphosphate and its effect on preventing enamel erosion in vitro

O objetivo do presente estudo foi sintetizar e caracterizar ciclotrifosfato de sódio (NaTMP) contendo cálcio, e verificar seu efeito utilizando modelo de lesões iniciais de erosão do esmalte. Os ciclotrifosfatos contendo cálcio (CaNaTMP) foram sintetizados utilizando coluna para cromatografia e adição de sobrenadante de solução contendo hidróxido de cálcio e analisados por meio de microscopia eletrônica de varredura e espectroscopia de raios-X por dispersão de energia. Para determinar o efeito sobre lesões erosivas iniciais, blocos de esmalte bovino sadios (n=96) foram selecionados por dureza de superfície inicial e divididos em 8 grupos experimentais (12 blocos/grupo): controle (água deionizada), 0,24% NaF (1100 ppm F), 0,25%, 0,5% e 1% de NaTMP e CaNaTMP nas mesmas concentrações. Os blocos de esmalte foram imersos em 4 mL das soluções experimentais durante 2 minutos, seguidos por 4 desafios erosivos (ácido cítrico, 0,75%, pH 3,5, por 1 minuto, sob agitação). A porcentagem de perda da dureza de superfície (%SH) foi calculada após cada desafio ácido. Os dados foram submetidos à análise de variância de medidas repetidas a dois critérios, seguida pelo teste de Tukey (p< 0,05). O processo de síntese levou a substituição de átomos de Na por átomos de Ca e as partículas apresentaram tamanhos homogêneos. As soluções contendo 0,25%, 0,5% e 1% CaNaTMP apresentaram menor %SH quando comparadas as suas contrapartes sem cálcio (p< 0,001), após os quatro desafios erosivos. Quando comparado a solução contendo 1100 ppm F, as soluções 0,5% e 1% CaNaTMP promoveram redução na perda de dureza (p< 0,001). Concluiu-se que soluções contendo CaNaTMP promoveram efeitos protetores superiores em comparação ao grupo 1100 ppm F sobre lesões iniciais do esmalte(AU)

The objective of the present study was to synthesize and characterize sodium cyclotriphosphate (NaTMP) containing calcium and verify its effect using an initial enamel erosion model. Cyclotriphosphate containing calcium (CaNaTMP) was synthesized using column chromatography, and addition of a solution with calcio hydroxide supernatant and analyzed by scanning electron microscopy and energydispersive X-ray spectroscopy. To determine the effect on enamel initial erosion, sound bovine enamel blocks (n=96) were selected by initial surface hardness and divided into to 8 experimental groups (12 blocks/group): control (deionized water), 0.24% NaF (1100 ppm F), 0.25%, 0.5% and 1% NaTMP and CaNaTMP at the same concentrations. The enamel blocks were immersed in 4 mL of the experimental solutions for 2 minutes followed by 4 erosive challenges (citric acid, 0.75%, pH 3.5, for 1 minute, under stirring). The percentage of surface hardness variation (%SH) was calculated after each acid challenge. Data were subjected to two-way repeated measures analysis of variance, followed by Tukey's test (p< 0.05). The synthesis process led to the replacement atoms of Na by atoms of Ca with particles having, homogeneous sizes. The solutions containing 0.25%, 0.5% and 1% CaNaTMP promoted lower %SH when compared to their counterparts without calcium (p< 0.001), after the four erosive challenges. When compared to the solution containing 1100 ppm F, the 0.5% and 1% CaNaTMP solutions were superior in reducing hardness loss (p< 0.001). It was concluded that solutions containing CaNaTMP led to superior protective effects compared to the 1100 ppm F group on initial enamel erosion(AU)

Lesiones dentales no cariosas: etiología y diagnóstico clínico. Revisión de literatura / Non-carious dental lesions: etiology and clinical diagnosis. Literatura reviews

Las lesiones dentales no cariosas comprenden un conjunto de procesos que se caracterizan por la pérdida o el desgaste patológico de los tejidos duros del diente, como ser el esmalte y la dentina. En la etapa inicial es difícil el diagnóstico, cuando la lesión va en aumento y si no es tratada a tiempo ni se modifican los factores de riesgo pueden llegar afectar de manera progresiva la pulpa dental. Estas lesiones han aumentado en los últimos años, debido al mayor tiempo de dientes en boca, acompañado de hábitos parafuncionales y dietas altamente acidas, a esto se le agrega el estrés que también provoca perdida de estructura dental. Por lo que no toda perdida de tejido mineralizado de los diente es provocada por una carga bacteriana. Estas lesionesno cariosas difieren en su etiología, se debe ser muy minucioso en su evaluación clínica y descripción, ya que muchas características clínicas pueden generar un diagnóstico erróneo y por ende un tratamiento no predecible, se debe tomar en consideración la existencia de combinaciones entre lesiones. Objetivo: Conocer la etiología y características clínicas propias de cada lesión, para poder realizar un diagnóstico oportuno y seguro. La revisión se realizó por medio de una búsqueda en internet en los buscadores de Hinari, Science Direct, Google académico, revisando artículos originales y revisiones bibliográficas entre los años de 2014-2019. Conclusiones: Las lesiones dentales no cariosas tienen etiologías multi factoriales, características clínicas diferenciales y puede haber una combinación de varias patologías...(AU)

Odontología deportiva y prevención de trauma dentoalveolar / Sports dentistry and prevention of dentoalveolar traumas

La odontología deportiva es la rama de la medicina deportiva que se ocupa de la prevención y el tratamiento de las lesiones bucodentales y las enfermedades orales asociadas al deporte y el ejercicio. Por lo que se hace necesario la intervención de profesionales de la salud bucodental para hacer evaluaciones del deportista y el deporte que practica para ver los riesgos que puede tener de desarrollar y sufrir lesiones bucodentales como traumas dentoalveolares y lesiones no cariosas. Y de este modo realizar las recomendaciones a cada paciente que practica deporte, de los elementos que deben usar como equipamiento bucodental para evitar o reducir el daño dentoalveolar (AU)

Sports dentistry is the branch of sports medicine that deals with the prevention and treatment of oral injuries and oral diseases associated with sports and exercise. Therefore it is necessary the intervention of oral health professionals to make evaluations of the athlete and the sport he practices to see the risks that may have to develop and suffer oral injuries such as dentoalveolar trauma and non-carious lesions. And in this way make the recommendations to each patient who practices sports, of the elements that should be used as oral equipment to avoid or reduce dentoalveolar damage (AU)

Characterization of Enamel After the Use of Oral Hygiene Auxiliaries with Whiteners / Caracterización del esmalte después del uso de auxiliares de higiene bucal con blanqueadores

ABSTRACT The purpose of this study was to evaluate the effect of the use of the combined auxiliaries of oral hygiene with whitening agents on the micro-hardness and micro-morphology of dental enamel. Materials and Methods. 40 human incisors were used and sectioned to obtain 4x4mm samples and divided into four study groups. Group 1: Electric brushing with Toothpaste (BTP); Group 2: Electric brushing with Toothpaste+mouthwash (BTP+MW); Group 3: Electric brushing with Toothpaste+whitening pen (BTP+WP); Group 4: Electric brushing with Toothpaste+mouth wash+whitening pen (BTP+MW+WP). Samples were submitted toVickers micro-hardness test and visualized using scanning electron microscopy (SEM). Results. All groups, with the exception of group 1, showed a decrease in micro- hardness values after applying the treatments (p<0.05). Likewise, when comparing the values after the treatments between the groups, significant statistical differences were found in all of comparisons except for those of groups 2 and 4. SEM images showed changes in the morphology in all the study groups with the exception of group 1. Conclusion. Significant changes such as decrease in micro-hardness as well as in the topography of the enamel surface such as elevations, craters, porosities and etching patterns were founded after the use of the combination of auxiliaries of oral hygiene with whitening agents.

RESUMEN El propósito de este estudio fue evaluar el efecto del uso de los auxiliares de higiene oral combinados con agentes blanqueadores sobre la microdureza y la micro-morfología del esmalte dental. Materiales y métodos. Se utilizaron 40 incisivos humanos y se seccionaron para obtener muestras de 4x4 mm los cuales se dividieron en cuatro grupos de estudio. Grupo 1: cepillado eléctrico con pasta de dientes (BTP); Grupo 2: cepillado eléctrico con pasta dental+enjuague bucal (BTP+MW); Grupo 3: cepillado eléctrico con pasta dental+pluma blanqueadora (BTP+WP); Grupo 4: cepillado eléctrico con pasta dental+enjuague bucal+pluma blanqueadora (BTP+MW+WP). Las muestras fueron analizadas por medio de microdurezaVickers y microscopía electronica de barrido (SEM). Resultados. Todos los grupos, con la excepción del grupo 1, mostraron una disminución en los valores de microdureza después de aplicar los tratamientos (p<0.05). Del mismo modo, al comparar los valores después de los tratamientos entre los grupos, se encontraron diferencias estadísticamente significativas en todas las comparaciones, excepto en las de los grupos 2 y 4. Las imágenes de SEM nos muestran cambios en la morfología en todos los grupos de estudio con la excepción del grupo 1 Conclusión. Cambios significativos como la disminución de la microdureza y los cambios en la topografía de la superficie del esmalte, como elevaciones, cráteres, porosidades y patrones de grabado, se encontraron después del uso de la combinación de auxiliares de la higiene oral con agentes blanqueadores.

Método químico simplificado de desmineralización del esmalte dental humano / Simplified chemical method of demineralization in human dental enamel

Introducción: Se requieren métodos experimentales abreviados para simular las lesiones de desmineralización temprana de forma controlada y reproducible. Objetivo: Realizar una evaluación in vitro de un método simple de desmineralización incipiente del esmalte. Métodos: Estudio experimental aleatorizado con doble diseño factorial de réplicas. Se seleccionaron 12 terceros molares de sujetos humanos saludables para su desmineralización en solución de ácido láctico racémico. Las muestras se distribuyeron aleatoriamente: Grupo 1 (G1) (n= 6) ácido láctico a pH 2,4 y Grupo 2 (G2) (n= 6) ácido láctico a pH 5,4. A continuación, cada grupo se subdividió (n = 2) para evaluar el efecto de las soluciones a tres tiempos de exposición (7, 15 y 30 días) a 37 °C. La evaluación se llevó a cabo con estereomicroscopios, equipo de radiografía digital con un software de análisis digital de imágenes y microscopía de polarización. Se formuló una integración de los índices de respuesta y se realizó un ANOVA. Resultados: Los hallazgos visuales, radiográficos e histológicos mostraron que en el G1 en los tiempos 1 a 3, la desmineralización se caracterizó por una gran pérdida de la integridad del esmalte (80 por ciento a 100 por ciento). Visualmente, el G2 a los 7 días mostró opacidad y pérdida de brillo (16 por ciento) con preservación de la estructura superficial del esmalte. Conclusiones: Se demuestra que el empleo de ácido láctico durante 7 días a pH 5,4 produce una lesión clínica, radiográfica e histológica similar a una lesión temprana del esmalte(AU)

Introduction: Abridged experimental methods are required to simulate early demineralizing lesions in a controlled and reproducible way. Objective: Perform an in vitro evaluation of a simple method of incipient enamel demineralization. Methods: Randomized experimental study with a double factorial replication design. Twelve third molars from healthy human subjects were selected for demineralization in a racemic lactic acid solution. Samples were then distributed randomly: Group 1 (G1) (n= 6) lactic acid at pH 2.4 and Group 2 (G2) (n= 6) lactic acid at pH 5.4. Each group was then subdivided (n = 2) to evaluate the effect of the solutions at three exposure times (7, 15 and 30 days) at 37°C. The evaluation used stereomicroscopes, a digital x-rays apparatus with software for the digital analysis of images, and polarization microscopy. An integration of the response indices was formulated and ANOVA was performed. Results: Visual, radiographic and histological findings showed that G1 at time 1 through 3 displayed demineralization characterized by extensive loss (80 percent to 100 percent) of enamel integrity. Visually, G2 at 7 days exhibited opacity and loss of brightness (16 percent), with preservation of the surface structure of the enamel. Conclusions: It was shown that employing lactic acid for 7 days at pH 5.4 develops a clinical, radiographic and histological injury similar to an early enamel lesion(AU)

Efeito anti-erosivo de soluções contendo diferentes polímeros / Anti-erosive effect of solutions containing different polymers

O desgaste erosivo tem sido reconhecido como uma condição frequente nos últimos anos, principalmente devido a mudanças nos hábitos alimentares e comportamentais das populações em geral. Considerando a natureza irreversível desta condição, o diagnóstico precoce e a adoção de medidas preventivas são muito importantes. Dentre elas, a adição de polímeros a produtos de higiene bucal associados ou não a fluoretos apresenta-se como uma alternativa promissora, já que alguns polímeros apresentam compatibilidade com as estruturas dentais e capacidade de formação de um filme protetor. Este estudo foi subdivido em três artigos que visaram, através de diferentes abordagens, investigar o efeito anti- erosivo de polímeros formadores de filme, bem como o efeito da associação destes com fluoretos. O primeiro artigo consistiu em uma revisão da literatura sobre aspectos relacionados ao potencial de utilização dos polímeros para a prevenção da erosão dental. O segundo artigo consistiu em um estudo de varredura para verificar a capacidade de redução da dissolução da hidroxiapatita promovida por soluções contendo quatro polímeros (polioxirano, hidroxipropilmetilcelulose, pectina e um copolímero do polimetacrilato) associadas ou não com fluoreto de sódio -F (225 ppm F- ) e fluoreto de sódio + cloreto de estanho (800 ppm Sn2+) - FS. A mensuração do potencial zeta da hidroxiapatita dispersa tratada com as soluções experimentais foi realizada a fim de complementar a análise. O terceiro artigo consistiu em um estudo de ciclagem erosiva/reendurecedora na presença de película adquirida que se propôs a investigar o potencial de remineralização, potencial de proteção, a perda superficial e a tensão superficial do esmalte após o tratamento com as soluções contendo o copolímero do polimetacrilato. Concluiu- se que a utilização de polímeros formadores de filme, associados ou não a fluoretos, constitui uma abordagem promissora para prevenção da erosão dental. Dentre os polímeros investigados, o copolímero do polimetacrilato é um promissor agente para ser adicionado à produtos de higiene bucal visando a prevenção dos desgastes erosivos(AU)

Erosive wear has been recognized as a frequent condition in recent years, mainly due to changes in the dietary and behavioral habits of the general population. Considering the irreversible nature of this condition, early diagnosis and the adoption of preventive measures are very important. Among them, the addition of polymers to oral care products associated or not with fluorides is a promising alternative, as some polymers have compatibility with dental structures and ability to form a protective film. This study was subdivided into three articles that aimed, through different approaches, to investigate the anti-erosive effect of film- forming polymers, as well as the effect of their association with fluorides. The first article consisted of a literature review about aspects related to the potential use of polymers to prevent dental erosion. The second article consisted of a scanning study to verify the ability to decrease the hydroxyapatite dissolution promoted by solutions containing four polymers (polyoxyrane, hydroxypropyl methylcellulose, pectin and a polymethacrylate copolymer) associated or not with sodium fluoride -F (225 ppm F- ) and sodium fluoride + tin chloride (800 ppm Sn2+ ) -FS. Measurement of the zeta potential of dispersed hydroxyapatite treated with experimental solutions was performed to complement the analysis. The third article consisted of an erosive/rehardening cycling study in the presence of acquired pellicle that aimed to investigate remineralization potential, protection potential, surface loss and surface tension of the enamel after treatment with solutions containing the polymethacrylate. It was concluded that the use of film- forming polymers, associated or not with fluorides, is a promising approach for the prevention of dental erosion. Among the polymers investigated, the polymethacrylate copolymer is a promising agent to be added to oral hygiene products to prevent erosive wear(AU)

Prevalence of and factors associated with enamel fracture and other traumas in Brazilian children 8-10 years old

Abstract The aim of this study was to assess the prevalence and discriminate the associated factors between enamel fractures and other trauma/trauma sequelae in 8 to 10-year-old Brazilian schoolchildren. A representative sample of 1,201 children from public and private schools were enrolled in this cross-sectional study. Questionnaires about sociodemographic characteristics were answered by parents. The outcome variable (traumatic dental injury, TDI) was multi-categorized. Independent individual variables were sex, age, number of residents in household, parents/caregivers' level of education, family income, dental caries, and overjet. Type of school was considered an independent contextual variable. Multilevel analysis, bivariate, and multivariate multinomial logistic regression models were performed. The prevalence of TDI was 14.0% (2.8% with other trauma/trauma sequelae). The multilevel analysis revealed no significant difference between the type of school and TDI. The multinomial logistic regression showed that boys (OR = 2.3; 95%CI: 1.1-4.8), older children (OR = 1.8; 95%CI: 1.1-3.0) and individuals with an overjet > 3 mm (OR = 2.5; 95%CI: 1.0-6.2) were more likely to present other trauma/trauma sequelae. Enamel fracture was not significantly associated with any variables. The prevalence of TDI in 8 to 10-year-old schoolchildren was 14% but only 2.8% of other trauma/trauma sequelae. Differences regarding the associated factors of TDI involving enamel fracture or other trauma/trauma sequelae were detected, suggesting that the different TDI classification cannot be evaluated as a single category.

Influência do tratamento do substrato com plasma não térmico na resistência de união em cimentação adesiva / Influence of the substrate treatment with non-thermal plasma on bond strength of adhesive cementation

Objetivo: avaliar a influência do tratamento de superfície com plasma não térmico de argônio (PLA) na resistência de união de cimentos resinosos ao esmalte, à dentina e à cerâmica de dissilicato de lítio. Observar, no esmalte e na dentina, através de espectroscopia de infravermelho por transformada de Fourier (FTIR) os compostos inorgânicos e da cromatografia gasosa a alteração dos compostos orgânicos voláteis nas condições experimentais propostas. Material e Método: Foram avaliados 3 cimentos resinosos: Variolink Esthetic LC e N (Ivoclar Vivadent), e Panavia V5 (Kuraray). Foram utilizados 240 dentes bovinos, dos quais 150 tiveram a superfície do esmalte exposta e 90 a de dentina. Foram obtidas 150 lâminas de cerâmica de dissilicato de lítio (12 x 14 x 0,5 mm). Os grupos foram divididos de acordo com o tratamento de superfície e o substrato. Os tratamentos para as superfícies de esmalte e dentina foram: EA (esmalte/ácido fosfórico); DA (dentina/ácido fosfórico); EPS (esmalte/PLA 30 s); EPM (esmalte/PLA 1 min); DPS (dentina/PLA 30 s); EAPS (esmalte/ácido fosfórico/PLA 30 s) e EAPM (esmalte/ácido fosfórico/PLA 1 min); e, DAPS (dentina/ácido fosfórico/PLA 30 s). Os tratamentos para as superfícies da cerâmica foram: CA (cerâmica/ácido fluorídrico), CPS (cerâmica/PLA 30 s); CPM (cerâmica/PLA 1 min); CAPS (cerâmica/ácido fluorídrico/PLA 30 s) e CAPM (cerâmica/ácido fluorídrico/PLA 1 min). Posterior aos tratamentos, cilindros dos cimentos resinosos (0,8 mm/1,5 mm) foram confeccionados sobre as superfícies dos substratos. Após 48 h, os espécimes foram submetidos ao ensaio mecânico de microcisalhamento (10 Kgf/1 mm/min) até a fratura. A área fraturada foi analisada em estereomicroscópio. As superfícies tratadas e a interface adesiva foram analisadas por Microscopia Eletrônica de Varredura (MEV). Através do FTIR foram observados os espectros de amostras tratadas de esmalte e dentina. Os dados da resistência de união foram submetidos à análise estatística ANOVA e teste de Tukey (5%). Resultados: Para o esmalte os tratamentos de superfície não apresentaram diferença estatisticamente significante entre si; para a dentina o grupo DPS apresentou os maiores valores de resistência de união; e, para a cerâmica o tratamento CA apresentou os maiores valores de resistência de união. Para esmalte e dentina, o FTIR, mostrou alterações do conteúdo da água, carbonato e fosfato e a cromatografia gasosa das substâncias orgânicas voláteis. Conclusão: O tratamento de superfície com PLA não influencia a resistência de união de cimentos resinosos ao esmalte, aumenta à dentina e diminui ao dissilicato de lítio. As análises observacionais no FTIR sugerem que o plasma não altera compostos do esmalte e da dentina(AU)

Objective: to evaluate the influence of surface treatment with non - thermal argon plasma (PLA) on bond strength of resin cements to enamel, dentin and lithium disilicate glass ceramic; and, to observe, through Fourier Transform Modified Infrared Spectroscopy (FTIR), the inorganic compounds and through gas chromatography, the alteration of the volatile organic compounds, on the enamel and dentin, under the experimental conditions. Material and Method: Three resin cements: Variolink Esthetic LC and N (Ivoclar Vivadent) and Panavia V5 (Kuraray) were evaluated. Twenty hundred and forty bovine teeth were used, among which 150 specimens with enamel surface exposure and 90 with dentine exposure. One hundred and fifty lithium disilicate glass ceramic slices (12 x 14 x 0.5 mm) were obtained. The groups were divided according to the substrate and surface treatment. The treatments for enamel and dentin surfaces were: EA (enamel / phosphoric acid); DA (dentin / phosphoric acid); EPS (enamel / PLA 30 s); EPM (enamel / PLA 1 min); DPS (dentin / PLA 30 s); EAPS (enamel / phosphoric acid / PLA 30 s) and EAPM (enamel / phosphoric acid / PLA 1 min); and, DAPS (dentin / phosphoric acid / PLA 30 s). The treatments for the ceramic surfaces were: CA (ceramic / hydrofluoric acid), CPS (ceramic / PLA 30 s); CPM (ceramic / PLA 1 min); CAPS (ceramic / hydrofluoric acid / PLA 30s) and CAPM (ceramic / hydrofluoric acid / PLA 1 min). After the treatments, resin cement cylinders (0.8 mm / 1.5 mm) were built on the substrate's surfaces. After 48 h storage bond strength tests (µSBS) were performed in a universal testing machine (10 Kgf / 1 mm / min) until failure to fracture, and failure mode was analyzed under a stereomicroscope. The treated surfaces and the adhesive interface were analyzed by Scanning Electron Microscopy (SEM). The FTIR was used to observe the spectra of enamel and dentin treated samples. Bond strength data were submitted to ANOVA and Tukey test (5%). Results: for the enamel there was not a statistically significant difference among surface treatments; for the dentin, the DPS group presented the highest bond strength; and for the ceramic the AC treatment presented the highest values of bond strength. For the enamel and the dentin samples, the FTIR observations showed changes in water, carbonate and phosphate contents and the gas chromatography in the volatile organic substances. Conclusion: Surface treatment with PLA does not influence the bond strength of resin cements to the enamel, increases the bonding to dentin and decreases to the lithium disilicate. Observational analysis on FTIR suggest that non-thermal plasma does not alter enamel and dentin compounds(AU)

¿Es el descementado, un paso clínico crítico? / The clinical procedure of debonding

El procedimiento clínico de descementado de brackets es crítico para el esmalte. La superficie dentaria queda dañada después de este paso clínico, que, en un principio, parecería sencillo e inocuo. El propósito de este trabajo fue examinar la superficie del esmalte luego del descementado y pulido final. Para tal fin se utilizó la magnificación de imágenes, mediante el empleo de un microscopio óptico de luz coaxial. La muestra incluyó el análisis de 10 arcadas superiores de pacientes en la etapa final de tratamiento.

The clinical procedure of debonding of brackets is critical for the enamel. The dental surface remains damaged after this clinical step, which in principle would seem simple and harmless. The purpose of this work was to examine the surface of the enamel after debonding and final polishing. For such purpose the image magnification was used, by means of an optical microscope of coaxial light. The sample included the analysis of 10 upper arches of patients in the final of treatmente.

Infiltrante resinoso vs Microabrasão no manejo de lesões de mancha branca: relato de caso / Resin infiltration vs microabrasion in white-spot lesions treatment: case report

Objetivo: Apresentar caso clínico de tratamento estético das lesões de mancha branca após tratamento ortodôntico nos dentes superiores anteriores através de duas técnicas minimamente invasivas usando o sistema de infiltração de resina e microabrasão. Relato de caso: Paciente com 18 anos de idade apresentava lesões de manchas brancas inativas nos dentes 11, 12, 13, 21, 22, 23. O sistema de infiltrante de resina Icon (DMG, Hamburgo, Alemanha) foi utilizado nos dentes 11, 12, 13, enquanto os dentes 21, 22, 23 foram submetidos à microabrasão com Whiteness RM (FGM, Joinville, Santa Catarina, Brasil).Ambos os protocolos foram utilizados de acordo com as recomendações do fabricante.Nos dentes 21 e 22, o produto para microabrasão foi aplicado com espátula que acompanha o kit, enquanto que no dente 23 utilizou-se o mesmo produto aplicado com taça de borracha em baixa rotação, todos os procedimentos executados por um único operador. A microabrasão com taça de borracha proporcionou uma superfície mais lisa e homogênea.Ambos os produtos tiveram resultados satisfatórios na resolução estética das lesões de mancha branca após um ano de acompanhamento. Conclusão: Os dois produtos apresentam bom desempenho e resolutividade para os problemas estéticos de lesões de manchas brancas inativas, entretanto deve-se levar em conta o tempo clínico, toxicidade, a atividade da lesão e a possibilidade de desgaste da estrutura dentária.

Objective: To present a case report of aesthetic treatment of post orthodontic white--spot lesions in the anterior superior teeth through two minimally invasive technique susing resin infiltration system or microabrasion. Case report: Patient 17 years of age had inactive white-spots lesions on teeth 11, 12, 13, 21, 22, 23. The teeth 11, 12, 13 received the resin infiltrating system Icon (DMG, Hamburg, Germany) while the teeth 21, 22, 23were submitted to microabrasion with Whiteness RM (FGM, Joinville, Santa Catarina, Brazil). Both protocols were used according to manufacturer’s recommendations. In the teeth 21 and 22, the product of the microabrasion was applied with a spatula that accompanied the kit, while the tooth 23 received the same product applied with a rubbercup at low speed turbine, all by a single operator. The microabrasion with rubber cupoccasioned a more smooth and homogeneous surface. Both products had satisfactory results in aesthetic resolution of the white-spots lesions, for a 1-year follow-up. Conclusion:Although both products are able to resolve aesthetic problems of inactive white-spots lesions, it should be taken into account the clinical time, toxicity, the activity ofthe lesion and the possibility of wear of the tooth structure.

Efecto del uso de los broncodilatadores sobre el esmalte dentario de niños con afecciones respiratorias - asma / Erosive loss in children treated and not-treated with bronchodilators

El asma es una enfermedad inflamatoria crónica que provoca que las vías respiratorias se estrechen y dificulta la respiración. La medicación para el asma incluye broncodilatadores y fármacos anticolinérgicos. Objetivo: determinar la prevalencia de erosión dental en los niños que reciben salbutamol cmo medicación broncodilatadora y establecer diferencias con aquellos sin afecciones respiratorias. Métodos: la muestra incluyó 100 niños, 50 de ellos medicados usaqndo un inhalador de salbutamol a lo largo de los 9 meses anteriores al estudio (Md 5 años 6m) y 50 sin patología respiratoria. Los padres de los niños completaron un cuestionario del consumo de bebidas. Se llevaron a cabo exámenes dentales y se determinó la pérdida de tejido dental según índice de SyK y CDHS. Procesamiento estadístico: se utilizaron media, mediana, DS, distribución de frecuencias y chi cuadrado. Resultados: se observó erosión dental en el 52 por ciento de los niños medicados y en el 42 por ciento de los no medicados. Los niños con medicación y consumo de bebidas diarias presentaron erosión en un 64,7 por ciento y consumo fines de semana 50 por ciento. Los niños sin medicación y consumo de bebidas diarias presentaron erosión enb un 34,8 por ciento y consumo fines de semana 31,2 por ciento. No se observó asociación entre medicación y erosión dental. No ser observaron diferencias estadísticas entre grupos ni en la frecuencia de consumo de bebidas ácidas. Conclusión: en ambos grupos existe una alta prevalencia de erosión dental, no mostrando asociación entre la medicación y la erosión dental...

Odontopediatría y enfermedad celíaca: diagnóstico y tratmaiento de las lesiones bucales / Pediatric dentistry and celiac disease: diagnosis and treatment of the oral lesions

La enfermedad celíaca es una alteración de base inmunológica que puede presentarse en cualquier etapa de la vida. La causa es la intolerancia al gluten en aquellas personas predispuestas genéticamente. El diagnóstico precoz en niños permite adherir auna dieta libre de gluten y evitar consecuencias vinculadas con la enfermedad. El objetivo de este trabajo es orientar sobre las lesiones en tejidos blandos y duros de la cavidad bucal o retardo en la cronología de la erupción, que podrían asociarse a enfermedad celíaca (EC) y realizar la derivación oportuna al médico pediatra...

Efficiency of different protocols for enamel clean-up after bracket debonding: an in vitro study

Objective: This study aimed to assess the efficiency of six protocols for cleaning-up tooth enamel after bracket debonding.Methods:A total of 60 premolars were divided into six groups, according to the tools used for clean-up: 12-blade bur at low speed (G12L), 12-blade bur at high speed (G12H), 30-blade bur at low speed (G30L), DU10CO ORTHO polisher (GDU), Renew System (GR) and Diagloss polisher (GD). Mean roughness (Ra) and mean roughness depth (Rz) of enamel surface were analyzed with a profilometer. Paired t-test was used to assess Ra and Rz before and after enamel clean-up. ANOVA/Tukey tests were used for intergroup comparison. The duration of removal procedures was recorded. The association between time and variation in enamel roughness (∆Ra, ∆Rz) were evaluated by Pearson's correlation test. Enamel topography was assessed by scanning electron microscopy (SEM).Results:In Groups G12L and G12H, original enamel roughness did not change significantly. In Groups G30L, GDU, GR and GD, a smoother surface (p < 0.05) was found after clean-up. In Groups G30L and GD, the protocols used were more time-consuming than those used in the other groups. Negative and moderate correlation was observed between time and (∆Ra, ∆Rz); Ra and (∆Ra, ∆Rz); Rz (r = - 0.445, r = - 0.475, p < 0.01).Conclusion:All enamel clean-up protocols were efficient because they did not result in increased surface roughness. The longer the time spent performing the protocol, the lower the surface roughness.

Objetivo: esse estudo objetivou avaliar a eficiência de seis protocolos de remoção de resina do esmalte após a descolagem de braquetes.Métodos:sessenta (60) pré-molares foram divididos em seis grupos conforme as ferramentas utilizadas: broca de 12 lâminas em baixa rotação (G12L), broca de 12 lâminas em alta rotação (G12H), broca de 30 lâminas em baixa rotação (G30L), polidor DU10CO-ORTHO (GDU), Renew System (GR) e polidor Diagloss (GD). As médias de rugosidade (Ra) e profundidade média de rugosidade (Rz) da superfície do esmalte foram analisadas com perfilômetro. Teste t pareado foi utilizado para avaliar Ra e Rz antes e depois da limpeza do esmalte; testes de ANOVA/Tukey foram utilizados para avaliar a diferença intergrupos. A duração dos procedimentos de remoção da resina foi registrada. Ainda, a associação entre o tempo e a variação da rugosidade do esmalte (ΔRa, ΔRz) foi avaliada pelo teste de correlação de Pearson. A topografia do esmalte também foi avaliada, por microscopia eletrônica de varredura (MEV).Resultados:nos grupos G12L e G12H, a rugosidade do esmalte original não se alterou significativamente. Nos Grupos G30L, GDU, GR e GD, foi verificada superfície mais lisa após a limpeza (p< 0,05). Nos Grupos G30L e GD, os protocolos utilizados foram mais demorados que nos demais grupos. Foi observada correlação negativa e moderada entre tempo, ΔRa e ΔRz (r = -0.445, r = -0.475, p< 0,01).Conclusão:todos os protocolos de limpeza do esmalte foram eficientes, pois não resultaram no aumento da rugosidade superficial. Quanto maior o tempo gasto, menor a rugosidade da superfície.

Novo método para o estudo de desgaste por atrição (deslizamento alternado) em esmalte bovino, em função da carga normal e da lubrificação: redução do desgaste com gel lubrificante oral / New method to study the wear by attrition (reciprocating sliding) in enamel, depending on the normal load and lubrication: reduction in wear with gel oral lubricant

O esmalte dental é o tecido mineralizado mais duro do corpo humano; apesar disto, seu desgaste é um problema muito comum. Este pode estar associado aos processos de envelhecimento, ou ainda, ser encontrado em indivíduos jovens, como consequência de atividades parafuncionais, por exemplo, atrição dental. Este tipo de dano pode resultar em prejuízo da função mastigatória e em diminuição da qualidade de vida. Por isto, o desgaste do esmalte dental tem sido objeto de muitos estudos, embora poucos tenham utilizado conceitos tribológicos. Não foi encontrado nenhum estudo que explorasse o desgaste de esmalte e seus micromecanismos oriundos do deslizamento alternado de incisivo contra incisivo, configuração que mais se aproxima do tribossistema real de atrição. O presente estudo tem por objeto investigar o desgaste e seus mecanismos em pares deslizantes de esmalte incisal (configuração pino-plano), selecionados por seus similares valores de dureza e de tenacidade à fratura, submetidos a diferentes cargas normais e lubrificações do meio. Incisivos bovinos foram ensaiados em deslizamento alternado sob duas cargas normais (8 N e 16 N) e quatro modos de lubrificação: saliva natural; saliva artificial; gel lubrificante oral (Oralbalance!, Biotène); e grupo controle sem lubrificação (seco)...

Enamel is the hardest mineralized tissue in the human body; despite that, the enamel wear is a very common problem. The wear damage can be related to aging processes or also be found in young people as a result of parafunctional activities, for example, dental attrition. This type of damage can result in loss of masticatory function and decreased quality of life. Therefore, the wear of the enamel has been the subject of many studies, although few have used tribological concepts. The wear mechanisms of reciprocating sliding pairs from incisor against incisor have not been reported in the literature, this configuration is the one that is closest to the real tribosystem of attrition. The present study aims to investigate the wear behavior and the related mechanisms in reciprocating sliding pairs of incisal enamel (pin-on-flat configuration), selected for their similar hardness and fracture toughness values, with different applied normal loads and lubrication conditions. Bovine incisors were tested in reciprocating sliding with different applied normal loads (8 N and 16 N) and four lubrication conditions: natural saliva; artificial saliva; oral gel lubricant (Oralbalance!, Biotène); and control group (dry). During tests, the friction curves were recorded...

Epidemiological study of traumatic dental injuries in 5- to 6-year-old Brazilian children

Monitoring traumatic dental injury (TDI) in primary teeth through epidemiological cross-sectional surveys provides descriptive information relevant to the development of public policies focused on the prevention of such injuries for the target population. The aim of this study was to assess the prevalence of TDI in 5- to 6-year-old Brazilian children and its association with biological and socioeconomic factors. A total of 684 children aged 5 to 6 years old, from 11 public schools in the city of Barueri (Brazil) were evaluated. Clinical examinations were carried out in the schools, by two trained and calibrated examiners. Gauze and a mouth mirror were used for the examinations. The reported TDIs were classified according to the Andreasen (2007) criteria for primary teeth. The results showed that 52.3% of the children had TDI. Enamel fracture (63.4%) was the most frequently observed sign of TDI, and the most affected teeth were the primary maxillary central incisors (26.9% maxillary right central incisor and 24% maxillary left central incisor). There was no association between the presence of TDI and biological or socioeconomic factors. In conclusion, the prevalence of TDI was high and had no statistically significant association with biological and socioeconomic factors.

Diagnóstico etiológico de la pérdida dentaria erosiva en niños / Etiological diagnosis of erosive dental loss in children

La pérdida de tejido dentario por erosión es una lesión que se ha incrementado en los últimos años. Los datos mundiales de prevalencia muestran valores de hasta el 35 por ciento, según los indicadores utilizados y población estudiada. Objetivo: estimar la prevalencia de erosión dental en escolares de la CABA y establecer asociación con factores relacionados con estilo de vida. Materiales y métodos: se realizó un estudio observacional, descriptivo, en 189 niños que concurren a escuelas de la CABA, edad (x=8,48 +- 2,3 años) previo consentimiento informado. Los criterios de exclusión fueron: alumnos portadores de ortodoncia, con riesgo médico incrementado o con defectos estructurales del esmalte. Los padres de la población seleccionada respondieron un cuestionario con encuestador que incluía información acerca del estilo de vida. Se diagnosticó erosión mediante el registro de los índices de Smith y Knight (SyK) y de la Encuesta Nacional de Salud Oral del Reino Unido (CDHS). Se realizó el análisis estadístico mediante medidas de tendencia central y dispersión chi-cuadrado, coeficiente de correlación de Spearman y Odds Ratio. Resultados: según el índice de CDHS, 65,6 por ciento de los niños presentó pérdida erosiva y 91,5 por ciento acorde a SyK. Se encontraron diferencias estadísticamente significativas entre el consumo de gaseosas regulares e índice de SyK (x2 de 4,3 p=0,036). El OR para el consumo de gaseosa e índice de SyK fue de 2,9 (IC=1,03 - 8,49). No se encontró asociación entre erosión y el resto de las bebidas analizadas. Conclusiones: la estimación de la prevalencia fue elevada con los indicadores empleados y se encontró asociación positiva entre erosión (SyK) y el consumo de gaseosas...

Evaluation of the effect of different methods of microabrasion and polishing on surface roughness of dental enamel.

Description of the Technique: The microabrasion technique of enamel consists of selectively abrading the discolored areas or causing superficial structural changes in a selective way. Objective: In microabrasion technique, abrasive products associated with acids are used, and the evaluation of enamel roughness after this treatment, as well as surface polishing, is necessary. This in-vitro study evaluated the enamel roughness after microabrasion, followed by different polishing techniques. Settings and Design: Roughness analyses were performed before microabrasion (L1), after microabrasion (L2), and after polishing (L3).Thus, 60 bovine incisive teeth divided into two groups were selected (n=30): G1- 37% phosphoric acid (37%) (Dentsply) and pumice; G2- hydrochloric acid (6.6%) associated with silicon carbide (Opalustre – Ultradent). Thereafter, the groups were divided into three sub-groups (n=10), according to the system of polishing: A – Fine and superfine granulation aluminum oxide discs (SofLex 3M); B – Diamond Paste (FGM) associated with felt discs (FGM); C – Silicone tips (Enhance - Dentsply). A PROC MIXED procedure was applied after data exploratory analysis, as well as the Tukey-Kramer test (5%). Results: No statistical differences were found between G1 and G2 groups. L2 differed statistically from L1 and showed superior amounts of roughness. Differences in the amounts of post-polishing roughness for specific groups (1A, 2B, and 1C) arose, which demonstrated less roughness in L3 and differed statistically from L2 in the polishing system. Conclusion: All products increased enamel roughness, and the effectiveness of the polishing systems was dependent upon the abrasive used.