ABSTRACT
Abstract Literature has reported positive results regarding the use of lasers in the control of erosive lesions; however, evaluating whether they are effective in the control of the progression of erosive/abrasive lesions is important. Objectives This study aimed to evaluate the effect of the Er:YAG laser irradiation in controlling the progression of erosion associated with abrasive lesions in enamel. Material and methods Bovine incisors were sectioned, flattened and polished. Forty-eight enamel slabs were subjected to treatment in an intraoral phase. Twelve volunteers used an intraoral appliance containing one slab that was irradiated with an Er:YAG laser (5.2 J/cm2, 85 mJ, 2 Hz) and another non-irradiated slab on each side of the appliance, during one phase of 5 d, under a split-mouth design. Devices were subjected to erosive challenges (1% citric acid, 5 min, 3 times a day) and abrasive challenges one h after (brushing force of 1.5 N for 15 s) randomly and independently on each side of the device. Measurements of enamel loss were performed via 3D optical profilometry (μm). We analyzed data using the Kruskal-Wallis and Mann-Whitney tests and morphological characteristics via scanning electron microscopy. Results Following erosive and abrasive challenges, the group that was irradiated with the Er:YAG laser presented less loss of structure than the non-irradiated group. The group that underwent erosion and irradiation did not exhibit a significant difference from the non-irradiated group. Conclusion Irradiation with the Er:YAG laser did not control the loss of structure of enamel subjected to erosion but did control abrasion after erosion.
Subject(s)
Animals , Cattle , Tooth Abrasion/prevention & control , Tooth Erosion/prevention & control , Dental Enamel/radiation effects , Lasers, Solid-State/therapeutic use , Surface Properties/radiation effects , Materials Testing , Microscopy, Electron, Scanning , Reproducibility of Results , Statistics, Nonparametric , Disease Progression , Citric Acid/chemistry , Imaging, Three-Dimensional , Dental Enamel/drug effects , Hardness TestsABSTRACT
El objetivo de este trabajo consiste en describir las distintas lesiones cervicales no cariosas, la abrasión, la erosión y la abfracción. Se desarrollarán en detalle su etiología, localización y características clínicas. Se mencionarán los diferentes procedimientos a realizar para su prevención y los materiales a utilizar para su restauración.
This article describes the different types of non-cariouscervical lesions, for example abrasion, erosionand abfraction. We will discuss their etiology, location and clinical features in detail. We will describe the procedures to prevent them, aswell as the materials used for their restoration.
Subject(s)
Humans , Tooth Cervix/injuries , Tooth Erosion/etiology , Tooth Erosion/prevention & control , Tooth Erosion/therapy , Tooth Abrasion/etiology , Tooth Abrasion/prevention & control , Tooth Abrasion/therapy , Tooth Wear , Crown Lengthening/methods , Tooth Attrition/etiology , Tooth Attrition/prevention & control , Tooth Attrition/therapy , Fluorides, Topical/administration & dosage , Tooth Remineralization/methods , Preventive Dentistry , Dental Occlusion , Malocclusion/prevention & controlABSTRACT
O presente trabalho teve como objetivo avaliar em esmalte, a aplicação de materiais resinosos com e sem excesso, quando submetido à erosão de curta duração in vitro (subprojeto 1) e avaliar a resistência desses materiais quando submetidos à erosão e/ou abrasão em estudo prolongado in vitro (subprojeto 2) e in situ (subprojeto 3). O estudo foi desenvolvido com espécimes/blocos preparados a partir de esmalte bovino previamente erodidos (imersão em HCl 0,01 M, pH 2,3 por 30 s), os quais foram aleatorizados entre os grupos e tratados de acordo com as recomendações do fabricante. No subprojeto 1 foram avaliados dois fatores: o tipo de tratamento (controle, selante de fossas e fissuras, sistema adesivo convencional de 3 passos, sistema adesivo autocondicionante e infiltrante) e a condição do material (com/sem remoção de material na superfície de esmalte). Em metade dos espécimes, após a aplicação dos materiais houve a remoção de seu excesso na superfície de esmalte, anteriormente à fotoativação. Após os tratamentos os espécimes foram submetidos à ciclagem erosiva por 5 dias (HCl 0,01 M, pH 2,3, por 2 min e saliva artificial por 2 h, 4 vezes/dia) e os resultados delinearam os demais sobreprojetos. No subprojeto 2 foram avaliados dois fatores: o tipo de tratamento (controle, selante de fossas e fissuras, sistema adesivo convencional de 3 passos e infiltrante) e o tipo de desgaste (erosão, abrasão, erosão/abrasão). Após os tratamentos, os espécimes sem remoção do excesso foram submetidos à ciclagem erosiva (HCl 0,01 M, pH 2,3, por 2 min e saliva artificial por 2 h, 4 vezes/dia), abrasiva (30 movimentos recíprocos, com força de 1,5 N e solução de slurry 1:3, dentifrício fluoretado) e associação de ambas (erosão 4 vezes/dia + 2 vezes/dia de abrasão) durante 30 dias. No subprojeto 3 foram avaliados três fatores: tipo de tratamento (controle, selante de fossas e fissuras, sistema adesivo convencional de 3 passos e infiltrante), o tipo de desgaste (erosão, erosão/abrasão) e o tempo de desafio (5 e 28 dias). Em uma única fase, 21 voluntários usaram um dispositivo palatino contendo os blocos de esmalte tratados sem remoção do excesso (uma fileira correspondia à erosão e a outra a erosão/abrasão, e cada uma continha 2 espécimes por tratamento). Durante 28 dias úteis de desafio, os blocos foram submetidos ex vivo à erosão (HCl 0,01 M, pH 2,3, por 2 min, e saliva humana por 2 h, 4 vezes/dia), e erosão/abrasão (erosão, 4 vezes/dia + 2 vezes/dia de abrasão, com movimentos oscilatórios por 15 s e solução de slurry 1:3, com dentifrício fluoretado), sendo que após os desafios e durante os finais de semana, os aparelhos permaneceram imersos em saliva artificial, totalizando 28 dias de ciclagem. Os resultados foram avaliados por perfilometria e os dados foram submetidos à ANOVA, seguido do teste Tukey (p <0,05). No subprojeto 1, observou-se que todos os materiais sem remoção do excesso formaram uma camada protetora sobre o esmalte, e após o desafio erosivo, permaneceram sobre a superfície inibindo a sua perda. Nos grupos onde o excesso de material foi removido, houve perda de esmalte no selante, adesivo convencional e infiltrante já após o tratamento, e todos os materiais nos quais o excesso foi removido houve perda de esmalte estatisticamente semelhante ao grupo controle, com exceção do selante, que promoveu menor perda de esmalte. No subprojeto 2, houve diferença na espessura de material após o tratamento, sendo que o adesivo foi o que apresentou maior espessura, seguido do selante e infiltrante. Após a fase in vitro, observou-se que a erosão/abrasão resultou em perda de esmalte significativamente maior que a erosão e esta, por sua vez, maior que a abrasão. Todos os materiais, independente do tipo de desgaste, se mantiveram após os 30 dias de desafio, porém, o adesivo foi o que sofreu maior perda em espessura, diferindo estatisticamente do selante e infiltrante. No subprojeto 3, houve diferença na espessura de material após o tratamento, sendo que o infiltrante foi o grupo que apresentou maior espessura, seguido do selante e depois do adesivo. Após a fase in situ, não houve diferença entre erosão e erosão/abrasão, e ao comparar os materiais, com 5 e 28 dias de desafio, não foi observada mudança significativa na espessura de material. A perda de esmalte foi superior com 28 dias de desafio. Considerando os resultados, conclui-se que os materiais resinosos aplicados sobre o esmalte erodido foram efetivos na inibição da perda de esmalte, quando submetidos a desafios erosivos associados ou não a abrasão in vitro e in situ.(AU)
This study aimed to evaluate the application of resin-based materials on enamel with and without removal of the excess subjected to short erosion in vitro (subproject 1) and to evaluate the resistance of these materials when subjected to erosion and/or abrasion in a prolonged study in vitro (subproject 2) and in situ (subproject 3). Specimens/blocks of bovine enamel previously eroded (immersion in 0.01 M HCl, pH 2.3 for 30 s) were randomized among groups and treated following the manufacturer's instructions. On subproject 1 there were 2 factors under study, type of treatment (control, sealant, self-etching adhesive, 3-step adhesive and infiltrant) and materials condition (with/without material excess removal). After materials application, in half of the specimens, the excess was removed, prior to polymerization. The specimens were subjected to erosive cycling for 5 days (0.01 M HCl, pH 2.3 for 2 min and artificial saliva for 2 h, 4 times/day). On the subproject 2, there were 2 factors under study, type of treatment (control, sealant, adhesive and infiltrant) and type of wear (erosion, abrasion, erosion/abrasion). After the treatments, the specimens were subjected to erosive cycling (0.01 M HCl, pH 2.3 for 2 min and artificial saliva for 2 h, 4 times/day), abrasive (30 reciprocal movements, force 1.5 N and slurry with fluoride dentifrice) and combination of both (erosion, 4 times/day + abrasion 2 times/day) for 30 days. On subproject 3, there were 3 factors under study, types of treatment (control, sealant, adhesive and infiltrant), type of wear (erosion, erosion/abrasion) and challenge time (5 and 28 days). In a single phase, 21 volunteers used a palatal appliance (one row corresponded to erosion and the other to erosion/abrasion, 2 specimens per treatment in each row). During 20 days of challenge, the blocks were subjected to erosion (0.01 M HCl, pH 2.3 for 2 min, and human saliva for 2 h, 4 times/day), and erosion/abrasion (erosion 4 times/day + abrasion 2 times/day with oscillatory motions for 15 s and slurry with fluoridated dentifrice). After the challenges and during the weekends, the appliance was kept immersed in artificial saliva. The results were evaluated by profilometry and the data were analyzed by ANOVA, followed by the Tukeys test (p<0.05). On subproject 1, it was observed that all materials without excess removal formed a layer over enamel. After the erosive challenge this layer remained inhibiting enamel loss. Sealant, 3- steps adhesive and infiltrant with material excess removal showed enamel loss after treatment. All materials with excess removal, showed loss of enamel statistically similar to the control group, except for the sealant, that promoted minor enamel loss. On subproject 2, after the treatment, materials thickness showed significance differences. The adhesive had the highest thickness followed by the sealant and infiltrant. There was no significant difference between sealant and infiltrant. After the erosive challenge in vitro it was observed that erosion/abrasion resulted in significantly higher enamel loss than erosion, which was higher than abrasion. All materials, regardless wear conditions, were maintained after the 30 days of challenge, however, the adhesive showed greatest material thickness loss, statistically differing from the sealant and infiltrant. On subproject 3, the application of resin-based materials did not cause superficial enamel loss. After the erosive challenge, there was no difference between the conditions ERO and ERO + ABR (p=0.869). All materials promoted protection against erosion compared to control group (p=0.001). The infiltrant group showed a thicker layer of material above enamel compared to the other materials (p =0.001). Based on results, it is concluded that the resin-based materials applied onto enamel were effective in inhibiting enamel loss subjected to erosive challenges associated or not with abrasion in vitro and in situ.(AU)
Subject(s)
Humans , Animals , Cattle , Dental Enamel/chemistry , Dental Enamel/drug effects , Resins, Synthetic/chemistry , Tooth Abrasion/prevention & control , Tooth Erosion/prevention & control , Hardness Tests , Reference Values , Saliva/chemistry , Time FactorsABSTRACT
ABSTRACT The use of gels and mouthrinses with MMP inhibitors (chlorhexidine, and green tea extract) was shown to prevent erosive wear. The aim of this study was to analyze the protective effect of toothpastes containing MMP inhibitors on dentine loss induced by erosion in vitro. Material and Methods Five groups each containing 12 specimens of human root dentine were prepared. The specimens were subjected to 1 min erosion by immersion in a cola drink, 4 times a day, for 5 d. Each day, after the first and last erosive challenges, the specimens were brushed for 15 s with a slurry of dentifrice and water (1:3) containing placebo, 1,100 ppm fluoride, 0.61% green tea extract, 0.12% chlorhexidine or 0.004% chlorhexidine (commercial toothpaste). Between the acid challenges, the specimens were stored in artificial saliva with remineralizing potential until the next treatment. Dentine loss was determined using profilometry. Data were analyzed using one-way ANOVA after log transform (p<0.05). Results The mean wear values (μm) were as follows: placebo 1.83±0.53; 0.61% green tea extract 1.00±0.21; fluoride 1.27±0.43; 0.12% chlorhexidine 1.19±0.30; and 0.004% chlorhexidine 1.22±0.46. There was a significant difference in wear between placebo and all the treatment toothpastes, which did not differ from each other. Conclusion The results suggest that toothpastes containing MMP inhibitors are as effective as those based on NaF in preventing dentine erosion and abrasion.
Subject(s)
Humans , Tooth Abrasion/prevention & control , Tooth Erosion/prevention & control , Toothpastes/chemistry , Dentin/drug effects , Matrix Metalloproteinase Inhibitors/chemistry , Saliva, Artificial/chemistry , Surface Properties/drug effects , Time Factors , Toothbrushing , Materials Testing , Carbonated Beverages , Random Allocation , Chlorhexidine/chemistry , Analysis of VarianceABSTRACT
Abstract This study evaluated the effect of Euclea natalensis gel on the reduction of erosive wear with or without abrasion, in enamel and dentin. During two five-day experimental crossover phases, volunteers (n = 10) wore palatal devices containing human enamel and dentin blocks (E = 8 and D = 8). The gel was applied in a thin layer in the experimental group, and was not applied in the control group. In the intraoral phase, volunteers used the palatal appliance for 12 h before the gel treatment, and were instructed to start the erosive challenges 6 h after the gel application. Erosion was performed with Coca-Cola® (for 5 min) 4 times/day. The appliance was then put back into the mouth and was brushed after 30 minutes. After intraoral exposure, the appliances were removed and the specimens were analyzed using profilometry (mean ± SD, μm). The Euclea natalensis gel caused less wear in enamel in the experimental group (EROS = 12.86 ± 1.75 µm; EROS + ABRAS = 12.13 ± 2.12 µm) than in the control group (EROS = 14.12 ± 7.66 µm; EROS + ABRAS = 16.29 ± 10.72 µm); however, the groups did not differ from each other significantly. A statistically significant value was found for erosion and eros + abrasion in dentin (p = 0.001). Euclea natalensis may play a role in the prevention of dentin loss under mild erosive and abrasive conditions. A clinical trial is required to confirm these promising results in a clinical situation.
Subject(s)
Humans , Adolescent , Adult , Young Adult , Tooth Abrasion/prevention & control , Tooth Erosion/prevention & control , Ebenaceae/chemistry , Dental Enamel/drug effects , Dentin/drug effects , Salivation , Surface Properties/drug effects , Time Factors , Carbonated Beverages , Reproducibility of Results , Analysis of Variance , Treatment Outcome , Statistics, Nonparametric , Gels , Hardness TestsABSTRACT
Este trabalho, conduzido na forma de 2 subprojetos, avaliou: 1) o potencial preventivo de pastas à base de hidroxiapatita (nanopartículas de fosfato de cálcio) sobre a erosão e a abrasão do esmalte e dentina bovinos in vitro e in situ e 2) o efeito de um bochecho com solução de lactato de cálcio antes da escovação com dentifrício fluoretado sobre a erosão associada ou não à abrasão do esmalte e dentina bovinos in vitro e in situ. Na fase in vitro do 1o subprojeto, submeteram-se blocos de esmalte e dentina bovinos, por 5 dias, à erosão (coca-cola, pH 2,6, 4x/dia, 90s cada) + abrasão (escova elétrica + solução do dentifrício sem flúor, 10s cada, 2x/dia) e os tratamentos foram realizados após a abrasão, através da aplicação das seguintes pastas sobre os blocos (3 min, 2x/dia): 10% HAP, 10% HAP + 0,2% NaF, 20% HAP, 20% HAP + 0,2% NaF, 20% HAP + 2% NaF, placebo, 0,2% NaF, 2% NaF, MI paste, MI paste plus e controle. Na fase in situ, (4 fases, 5 dias/cada), 12 voluntários utilizaram dispositivo intrabucal palatino contendo 4 blocos de dentina e 4 de esmalte bovinos divididos nas condições: erosão e erosão+abrasão. Em cada fase foi feito tratamento com uma das seguintes pastas: 10% HAP, 10% HAP + 0,2% NaF, MI paste plus ou Placebo. O protocolo erosivo e abrasivo foi semelhante ao in vitro. No 2o subprojeto, a fase in vitro foi semelhante ao subprojeto 1, porém apresentou as condições erosão e erosão+abrasão. O estudo compreendeu os seguintes tratamentos: BCa + DF, BCa + DP, BP + DF e BP + DP. Após erosão, os blocos foram imersos em água deionizada (BP) ou solução de lactato de cálcio 150 mM (BCa; 1 min, sob agitação). Na condição erosão apenas, a solução de dentifrício fluoretado (DF) ou placebo (DP) foi pipetada sobre as amostras. A fase in situ foi semelhante ao experimento in vitro, porém com 15 voluntários e escovação por 15 s. A variável de resposta para os 2 subprojetos foi a análise de desgaste, avaliada por perfilometria (μm) e para a fase in situ...
This study, conducted in the form of two subprojects, evaluated: 1) the preventive potential of hydroxyapatite-based (calcium phosphate nanoparticles) pastes on erosion and abrasion of bovine enamel and dentin in vitro e in situ and 2) the effect of rinsing with a solution of calcium lactate before brushing with fluoride toothpaste on erosion associated or not with abrasion of bovine enamel and dentin in vitro e in situ. In the in vitro phase of the 1st subproject, bovine enamel and dentin blocks were submitted to erosion (coca-cola, pH 2.6, 4x/day, 90s each) + abrasion (electric toothbrush + fluoride-free toothpaste slurry, 10s each, 2x/day) for 5 days. Treatments were performed after abrasion, by applying the following pastes on the blocks (3 min, 2x/day): 10% HAP, 10% HAP + 0.2% NaF, 20% HAP, 20% HAP + 0.2% NaF, 20% HAP + 2% NaF, placebo, 0.2% NaF, 2% NaF, MI paste, MI paste plus and control. In the in situ phase (4 phases, 5 days each), 12 volunteers used intraoral palatal appliance containing four blocks of dentin and four blocks enamel divided into conditions erosion and erosion+abrasion. In each phase, treatment was done with one of the following pastes: 10% HAP, 10% HAP + 0.2% NaF, MI paste plus or Placebo. The erosive and abrasive protocol was similar to the in vitro phase. In the 2nd subproject, the in vitro phase was similar to subproject 1, but presented both conditions erosion and erosion + abrasion. The study included the following treatments: BCa + DF, BCa + DP, BP + DF e BP + DP. After erosion, the blocks were immersed in deionized water (BP) or calcium lactate solution 150 mM (BCa; 1 min, stirring). For the condition erosion only, the slurry of fluoride (DF) or placebo (DP) dentifrice was pipetted on the samples. The in situ phase was similar to the in vitro experiment, but 15 volunteers were included and brushing was conducted for 15 s. The response variable for the two subprojects was wear, evaluated by profilometry (μm)...
Subject(s)
Humans , Animals , Cattle , Tooth Abrasion/prevention & control , Dentin , Durapatite/therapeutic use , Tooth Erosion/prevention & control , Dental Enamel , Biocompatible Materials/therapeutic use , Materials Testing , Reproducibility of Results , Surface Properties , Time Factors , Treatment OutcomeABSTRACT
Este trabalho, conduzido na forma de 2 subprojetos, avaliou: 1) o potencial preventivo de pastas à base de hidroxiapatita (nanopartículas de fosfato de cálcio) sobre a erosão e a abrasão do esmalte e dentina bovinos in vitro e in situ e 2) o efeito de um bochecho com solução de lactato de cálcio antes da escovação com dentifrício fluoretado sobre a erosão associada ou não à abrasão do esmalte e dentina bovinos in vitro e in situ. Na fase in vitro do 1o subprojeto, submeteram-se blocos de esmalte e dentina bovinos, por 5 dias, à erosão (coca-cola, pH 2,6, 4x/dia, 90s cada) + abrasão (escova elétrica + solução do dentifrício sem flúor, 10s cada, 2x/dia) e os tratamentos foram realizados após a abrasão, através da aplicação das seguintes pastas sobre os blocos (3 min, 2x/dia): 10% HAP, 10% HAP + 0,2% NaF, 20% HAP, 20% HAP + 0,2% NaF, 20% HAP + 2% NaF, placebo, 0,2% NaF, 2% NaF, MI paste, MI paste plus e controle. Na fase in situ, (4 fases, 5 dias/cada), 12 voluntários utilizaram dispositivo intrabucal palatino contendo 4 blocos de dentina e 4 de esmalte bovinos divididos nas condições: erosão e erosão+abrasão. Em cada fase foi feito tratamento com uma das seguintes pastas: 10% HAP, 10% HAP + 0,2% NaF, MI paste plus ou Placebo. O protocolo erosivo e abrasivo foi semelhante ao in vitro. No 2o subprojeto, a fase in vitro foi semelhante ao subprojeto 1, porém apresentou as condições erosão e erosão+abrasão. O estudo compreendeu os seguintes tratamentos: BCa + DF, BCa + DP, BP + DF e BP + DP. Após erosão, os blocos foram imersos em água deionizada (BP) ou solução de lactato de cálcio 150 mM (BCa; 1 min, sob agitação). Na condição erosão apenas, a solução de dentifrício fluoretado (DF) ou placebo (DP) foi pipetada sobre as amostras. A fase in situ foi semelhante ao experimento in vitro, porém com 15 voluntários e escovação por 15 s. A variável de resposta para os 2 subprojetos foi a análise de desgaste, avaliada por perfilometria (μm) e para a fase in situ...
This study, conducted in the form of two subprojects, evaluated: 1) the preventive potential of hydroxyapatite-based (calcium phosphate nanoparticles) pastes on erosion and abrasion of bovine enamel and dentin in vitro e in situ and 2) the effect of rinsing with a solution of calcium lactate before brushing with fluoride toothpaste on erosion associated or not with abrasion of bovine enamel and dentin in vitro e in situ. In the in vitro phase of the 1st subproject, bovine enamel and dentin blocks were submitted to erosion (coca-cola, pH 2.6, 4x/day, 90s each) + abrasion (electric toothbrush + fluoride-free toothpaste slurry, 10s each, 2x/day) for 5 days. Treatments were performed after abrasion, by applying the following pastes on the blocks (3 min, 2x/day): 10% HAP, 10% HAP + 0.2% NaF, 20% HAP, 20% HAP + 0.2% NaF, 20% HAP + 2% NaF, placebo, 0.2% NaF, 2% NaF, MI paste, MI paste plus and control. In the in situ phase (4 phases, 5 days each), 12 volunteers used intraoral palatal appliance containing four blocks of dentin and four blocks enamel divided into conditions erosion and erosion+abrasion. In each phase, treatment was done with one of the following pastes: 10% HAP, 10% HAP + 0.2% NaF, MI paste plus or Placebo. The erosive and abrasive protocol was similar to the in vitro phase. In the 2nd subproject, the in vitro phase was similar to subproject 1, but presented both conditions erosion and erosion + abrasion. The study included the following treatments: BCa + DF, BCa + DP, BP + DF e BP + DP. After erosion, the blocks were immersed in deionized water (BP) or calcium lactate solution 150 mM (BCa; 1 min, stirring). For the condition erosion only, the slurry of fluoride (DF) or placebo (DP) dentifrice was pipetted on the samples. The in situ phase was similar to the in vitro experiment, but 15 volunteers were included and brushing was conducted for 15 s. The response variable for the two subprojects was wear, evaluated by profilometry (μm)...
Subject(s)
Humans , Animals , Cattle , Tooth Abrasion/prevention & control , Dentin , Durapatite/therapeutic use , Tooth Erosion/prevention & control , Dental Enamel , Biocompatible Materials/therapeutic use , Materials Testing , Reproducibility of Results , Surface Properties , Time Factors , Treatment OutcomeABSTRACT
O objetivo deste estudo foi investigar o potencial inibidor de desgaste dentário ocasionado por erosão e abrasão de um novo produto, o verniz ClinPro XT Varnish, em comparação com vernizes fluoretados convencionais à base de TiF4 e NaF. Sessenta amostras de esmalte bovino (n=15/grupo) com microdureza superficial entre 300-380KHN foram selecionadas e aleatoriamente tratadas com: verniz de NaF (Duraphat®, 2,26% F-), verniz de TiF4 (2,45% F-), ClinPro XT varnish (fluoraluminiosilicato e glicerofosfato de cálcio) e controle (sem tratamento). Após receberem os respectivos tratamentos, as amostras foram submetidas a 3 dias de desafios erosivos de 4x5 min/dia (Sprite® Zero) e a abrasão 2x15s/dia, utilizando uma máquina de escovação. Entre os ciclos de erosão e abrasão, as amostras permaneceram em saliva artificial. A perda de esmalte foi medida com perfilômetro óptico. Os dados foram submetidos ao teste Kruskal-Wallis seguido pelo Dunn (p<0,05) .Ambos vernizes de NaF (-5,84m [-12,06; 1,64]b) (mediana ± 95%IC) e TiF4 (-3,60m [-8,72; -0,45]b) foram eficazes em reduzir o desgaste do esmalte quando comparados ao grupo controle (-16,60m [-19,92; -10,04]a). O ClinPro XT varnish permaneceu na superfície do esmalte (106,21m [30,67; 126,22]c), impedindo completamente o desgaste. Assim foi possível concluir que o ClinPro XT teve um efeito superior aos outros vernizes, impedindo completamente a erosão e abrasão do esmalte por 3 dias in vitro.
The purpose of this study was to investigate the erosion and abrasion inhibiting effect of a newly released product, Vanish XT varnish, and compare it to conventional TiF4 and NaF varnishes. Sixty bovine enamel blocks (300-380 KHN) were selected and randomly allocated into 4 treatment groups (n=15/group): NaF varnish (Duraphat®, 2.26% F-), TiF4 varnish (2.45% F-), Vanish XT varnish (fluoroaluminosilicate and calcium glycerophosphate), and control (no treatment). The samples received their respective treatments one single time at the beginning of the experiment. During a total of 3 days, erosive challenges were done 4x5min/day (Sprite Zero®) and abrasion 2x15s/day using a brushing machine. In between the erosive and abrasive challenges and overnight the samples remained immersed in artificial saliva. Enamel loss was measured using a non-contact profilometer. The data were subjected to Kruskal-Wallis and Dunn tests (p<0.05). Both NaF (-5.84m [-12.06; 1.64]b) (median ± 95%CI) and TiF4 (-3.60m [-8.72; -0.45]b) varnishes were able to reduce enamel wear when compared to the control group (-16.60m [-19.92; -10.04]a). Vanish XT varnish remained on the enamel surface (106.21m [30.67; 126.22]c), completely preventing enamel wear. Therefore, we concluded that Vanish XT presented a superior effect when compared to conventional varnishes, completely preventing enamel erosion and abrasion for 3 days in vitro.
Subject(s)
Animals , Cattle , Tooth Abrasion/prevention & control , Fluorine Compounds/analysis , Tooth Erosion/prevention & control , Pediatric DentistryABSTRACT
A degradação da dentina pelas metaloproteinases da matriz (MMPs) pode facilitar a progressão de lesões erosivas. Objetivos: Avaliar, por meio de uma série de 5 subprojetos: 1) A atividade de MMPs em dentina bovina e humana; 2) O efeito do chá verde contra erosão/abrasão de dentina; 3 e 4) Géis contendo inibidores de MMPs (epigallocatechin-3-galatte-EGCG, clorexidina-CHX e sulfato ferroso-FeSO4) sobre a prevenção de erosão de dentina sozinha ou associada à abrasão, respectivamente, e 5) Sobre a degradação de colágeno e desgaste. Material e Métodos: 1) Extração proteica de dentina de coroa e raiz bovina e humana foi realizada (ácido cítrico a 0,87 M, pH 2,3) e testada por zimografia e atividades gelatinolíticas; 2) Voluntários (n=10) bochecharam chá verde ou água (1 min, 10 mL) entre os desafios erosivos (Coca-Cola, pH 2,6, 4x/dia/5 min, extraoralmente) e abrasivos. A abrasão (escova elétrica + dentifrício não fluoretado) foi realizada imediatamente ou 30 min depois da erosão por 30 s. O desgaste da dentina foi analisado por perfilometria (µm); 3 e 4) Voluntários (n=10-13) utilizaram dispositivos palatinos contendo 12 blocos de dentina e distribuídos aleatoriamente para 6 grupos, de acordo com o tipo de gel aplicado ou não (não tratado-NT). Os géis tinham composição idêntica, exceto pela presença de EGCG (400 µM), CHX (0,012%), FeSO4 (1 mM), flúor (NaF-1,23%) ou sem ativo (Placebo-P). Os géis foram ou não aplicados sobre os espécimes em fina camada e removidos depois de 1 min. A erosão (Coca-Cola, pH 2,6, 4x5min/dia, extraoralmente) foi realizada por 5 ou 10 dias, respectivamente. A cada dia, depois do primeiro e último desafios erosivos, os blocos eram (ERO) ou não escovados (ERO+ABR) por 15 s (escova elétrica + solução de dentifrício não fluoretado). O desgaste da dentina foi avaliado por perfilometria (µm) depois de 5 e 10 dias. 5) Dentina (n=45/grupo) foi desmineralizada com ácido cítrico (0,87 M, pH 2,3) por 36 h. Na sequência, foi ou não tratada (NT)...
The dentin degradation by matrix metalloproteinases (MMPs) can increase the progression of erosive lesions. Objectives: Five studies were conducted to evaluate: 1) The activity of MMPs in bovine and human dentin; 2) The effect of green tea rinse against dentin erosion/abrasion; 3 and 4) Gels containing MMP inhibitors (epigallocatechin-3-galatte-EGCG, chlorexidine-CHX and ferrous sulphate-FeSO4) to prevent dentin erosion alone or associated with abrasion, respectively, and 5) On collagen degradation and wear. Material and Methods: 1) Protein extraction from crown and root of bovine and human dentin was performed (0.87 M citric acid, pH 2.3) and tested by zymography and gelatinolytic activities; 2) Volunteers (n=10) rinsed with green tea or water (1 min, 10 mL) between the erosive (Coke, pH 2.6, 4x5min/day, extraorally) and abrasive challenges. The abrasion (electric toothbrush + fluoride-free toothpaste) was performed immediately or 30 min after erosion for 30 s. Dentin wear was analyzed by profilometry (µm); 3 and 4) Volunteers (n=10-13) wore palatal devices containing 12 bovine dentin blocks randomly allocated to 6 groups, according to the type of gels applied or not (not treated-NT). The gels had identical composition, except for the presence of EGCG (400 µM), CHX (0.012%), FeSO4 (1 mM), fluoride (NaF-1.23%) or not (Placebo-P). Gels were applied or not on specimens once in a thin layer and removed after 1 min. Erosion (Coke, pH 2.6, 4x5 min/day, extraorally) was performed for 5 or 10 days, respectively. Each day, after first and last erosive challenges, blocks were (ERO) or not brushed (ERO+ABR) for 15 s (electric toothbrush + fluoride-free toothpaste slurry). Dentin wear was evaluated by profilometry (µm) after days 5 and 10. 5) Demineralization of dentin (n=45/group) was performed with 0.87 M citric acid, pH 2.3, for 36 h. In sequence, dentin was or not (NT) treated with the same gels described above. Specimens were stored in artificial saliva (5 days,...
Subject(s)
Humans , Animals , Cattle , Dentin/chemistry , Tooth Erosion/prevention & control , Matrix Metalloproteinases/antagonists & inhibitors , Analysis of Variance , Tooth Abrasion/prevention & control , Camellia sinensis , Fluorine/therapeutic use , In Vitro Techniques , Time FactorsABSTRACT
Este projeto teve como objetivos investigar o efeito do íon ferro (Fe+2), associado ou não ao íon flúor (F-), na redução da erosão do esmalte e da dentina bovinos, bem como desenvolver e avaliar um dentifrício enriquecido com Fe+2 para a prevenção da erosão associada à abrasão. Foram realizados 4 subprojetos: (1) Determinação do efeito protetor de concentrações crescentes do Fe+2 (0 a 120 mmol/L) associadas ou não ao F- (0 a 4 g/mL), contra a dissolução do pó de esmalte bovino in vitro; (2) Avaliação, in vitro, do efeito protetor do Fe+2 a 10 mmol/L contra a dissolução mineral da superfície do esmalte bovino; (3) Desenvolvimento e avaliação, in vitro, de dentifrícios fluoretados enriquecidos com diferentes concentrações de Fe+2, visando à prevenção da perda mineral do esmalte bovino; (4) Avaliação, in situ, do efeito inibidor do dentifrício acrescido de Fe+2 e F- na desmineralização do esmalte e dentina bovinos sadios ou previamente erodidos. As variáveis de resposta utilizadas foram a quantificação da perda de fósforo (colorimetria) e o desgaste (perfilometria, m) para os subprojetos 1 e 2, e 3 e 4, respectivamente. Os dados foram submetidos à análise estatística (p<0,05). Para o Subprojeto (1), a ANOVA a 2 critérios e o teste de Bonferroni revelaram que soluções contendo Fe+2 a 1,25, 2,5, 5,0, 10, 15 e 30 mmol/L reduziram significativamente a dissolução do pó de esmalte bovino em 18, 18, 23, 35, 35 e 55%, respectivamente, em comparação ao controle (sem Fe+2). Na presença de F-, o efeito do Fe+2 na inibição da dissolução do esmalte foi reduzido, não havendo efeito sinérgico entre estes íons nas condições testadas. No Subprojeto (2), a ANOVA a 2 critérios e o teste de Bonferroni, mostraram uma redução significativa na desmineralização da superfície do esmalte bovino em torno de 30 a 40%, quando se utilizou solução de Fe+2 a 10 mmol/L. No Subprojeto (3), a ANOVA revelou diferença significativa...
The aims of this study were to investigate the effect of iron (Fe+2) associated or not to fluoride (F-) on the reduction of bovine enamel and dentin erosion, as well as to develop and evaluate a dentifrice containing Fe+2 to prevent erosion associated to abrasion. Four subprojects were done: (1) In vitro determination of the protective effect of increasing Fe+2 concentrations (0 to 120 mmol/L) associated or not to F- (0 to 4 g/mL) against the dissolution of powdered enamel; (2) In vitro evaluation of the protective effect of 10 mol/L Fe+2 against the mineral dissolution of superficial bovine enamel; (3) Development and in vitro evaluation of fluorided dentifrices containing different Fe+2 concentrations in order to prevent the mineral loss of bovine enamel; and (4) In situ evaluation of the effect of a dentifrice containing Fe+2 and F- on the demineralization of sound or previously eroded bovine enamel and dentin. The response variables were quantification of phosphate loss (colorimetry) and tooth wear (perfilometry, m) for the subprojects 1 and 2, and 3 and 4, respectively. Data were submitted to statistical analyses (p <0.05). In subproject (1), two-way ANOVA and Bonferronis test revealed that solutions containing 1.25, 2.5, 5.0, 10.0, 15.0 and 30.0 mmol/L Fe+2 significantly reduced the dissolution of powdered enamel at 18, 18, 23, 35, 35 and 55%, respectively, in comparison to control (without Fe+2). In the presence of F-, the effect of Fe+2 on the dissolution of enamel was reduced and no synergistic effect between these ions was observed in the tested conditions. In Subproject (2), two-way ANOVA and Bonferronis test showed a significant reduction on surface demineralization of bovine enamel (around 30-40%), when the solution containing Fe+2 at 10 mmol/L was used. In Subproject (3), ANOVA revealed a significant difference among the groups (Placebo, 1,100 g/mL F, Crest®, 1.0 mg/g Fe+2, 2.5 mg/g Fe+2, 5.0 mg/g Fe+2, F- (1, 100 g/mL) + 1,0 mg/g...
Subject(s)
Animals , Cattle , Tooth Erosion/prevention & control , Iron/therapeutic use , Fluorine/therapeutic use , Ions/therapeutic use , Analysis of Variance , Tooth Abrasion/prevention & control , Dentifrices/chemistry , Dentin/pathology , Dental Enamel/pathology , Phosphorus/analysis , Hardness Tests , In Vitro TechniquesABSTRACT
Este projeto teve como objetivos investigar o efeito do íon ferro (Fe+2), associado ou não ao íon flúor (F-), na redução da erosão do esmalte e da dentina bovinos, bem como desenvolver e avaliar um dentifrício enriquecido com Fe+2 para a prevenção da erosão associada à abrasão. Foram realizados 4 subprojetos: (1) Determinação do efeito protetor de concentrações crescentes do Fe+2 (0 a 120 mmol/L) associadas ou não ao F- (0 a 4 g/mL), contra a dissolução do pó de esmalte bovino in vitro; (2) Avaliação, in vitro, do efeito protetor do Fe+2 a 10 mmol/L contra a dissolução mineral da superfície do esmalte bovino; (3) Desenvolvimento e avaliação, in vitro, de dentifrícios fluoretados enriquecidos com diferentes concentrações de Fe+2, visando à prevenção da perda mineral do esmalte bovino; (4) Avaliação, in situ, do efeito inibidor do dentifrício acrescido de Fe+2 e F- na desmineralização do esmalte e dentina bovinos sadios ou previamente erodidos. As variáveis de resposta utilizadas foram a quantificação da perda de fósforo (colorimetria) e o desgaste (perfilometria, m) para os subprojetos 1 e 2, e 3 e 4, respectivamente. Os dados foram submetidos à análise estatística (p<0,05). Para o Subprojeto (1), a ANOVA a 2 critérios e o teste de Bonferroni revelaram que soluções contendo Fe+2 a 1,25, 2,5, 5,0, 10, 15 e 30 mmol/L reduziram significativamente a dissolução do pó de esmalte bovino em 18, 18, 23, 35, 35 e 55%, respectivamente, em comparação ao controle (sem Fe+2). Na presença de F-, o efeito do Fe+2 na inibição da dissolução do esmalte foi reduzido, não havendo efeito sinérgico entre estes íons nas condições testadas. No Subprojeto (2), a ANOVA a 2 critérios e o teste de Bonferroni, mostraram uma redução significativa na desmineralização da superfície do esmalte bovino em torno de 30 a 40%, quando se utilizou solução de Fe+2 a 10 mmol/L. No Subprojeto (3), a ANOVA revelou diferença significativa...
The aims of this study were to investigate the effect of iron (Fe+2) associated or not to fluoride (F-) on the reduction of bovine enamel and dentin erosion, as well as to develop and evaluate a dentifrice containing Fe+2 to prevent erosion associated to abrasion. Four subprojects were done: (1) In vitro determination of the protective effect of increasing Fe+2 concentrations (0 to 120 mmol/L) associated or not to F- (0 to 4 g/mL) against the dissolution of powdered enamel; (2) In vitro evaluation of the protective effect of 10 mol/L Fe+2 against the mineral dissolution of superficial bovine enamel; (3) Development and in vitro evaluation of fluorided dentifrices containing different Fe+2 concentrations in order to prevent the mineral loss of bovine enamel; and (4) In situ evaluation of the effect of a dentifrice containing Fe+2 and F- on the demineralization of sound or previously eroded bovine enamel and dentin. The response variables were quantification of phosphate loss (colorimetry) and tooth wear (perfilometry, m) for the subprojects 1 and 2, and 3 and 4, respectively. Data were submitted to statistical analyses (p <0.05). In subproject (1), two-way ANOVA and Bonferronis test revealed that solutions containing 1.25, 2.5, 5.0, 10.0, 15.0 and 30.0 mmol/L Fe+2 significantly reduced the dissolution of powdered enamel at 18, 18, 23, 35, 35 and 55%, respectively, in comparison to control (without Fe+2). In the presence of F-, the effect of Fe+2 on the dissolution of enamel was reduced and no synergistic effect between these ions was observed in the tested conditions. In Subproject (2), two-way ANOVA and Bonferronis test showed a significant reduction on surface demineralization of bovine enamel (around 30-40%), when the solution containing Fe+2 at 10 mmol/L was used. In Subproject (3), ANOVA revealed a significant difference among the groups (Placebo, 1,100 g/mL F, Crest®, 1.0 mg/g Fe+2, 2.5 mg/g Fe+2, 5.0 mg/g Fe+2, F- (1, 100 g/mL) + 1,0 mg/g...
Subject(s)
Animals , Cattle , Tooth Erosion/prevention & control , Iron/therapeutic use , Fluorine/therapeutic use , In Vitro Techniques , Ions/therapeutic use , Analysis of Variance , Tooth Abrasion/prevention & control , Dentifrices/chemistry , Dentin/pathology , Dental Enamel/pathology , Phosphorus/analysis , Hardness TestsABSTRACT
OBJECTIVE: This in situ study evaluated the protective effect of green tea on dentin erosion (ERO) and erosion-abrasion (ABR). MATERIAL AND METHODS: Ten volunteers wore intraoral palatal appliances with bovine dentin specimens subjected to ERO or ERO + toothbrushing abrasion performed immediately (ERO+I-ABR) or 30 min after erosion (ERO+30-min-ABR). During 2 experimental 5-day crossover phases, the volunteers rinsed with green tea or water (control, 1 min) between each erosive (5 min, cola drink) and abrasive challenge (30 s, toothbrushing), 4x/day. Dentin wear was measured by profilometry. RESULTS: The green tea reduced the dentin wear significantly for all conditions compared to control. ERO+I-ABR led to significantly higher wear than ERO, but it was not significantly different from ERO+30-min-ABR. ERO+30-min-ABR provoked significant higher wear than ERO, only for the placebo treatment. CONCLUSIONS: From the results of the present study, it may be concluded that green tea reduces the dentin wear under erosive/abrasive conditions.
Subject(s)
Adult , Animals , Cattle , Humans , Young Adult , Protective Agents/therapeutic use , Tea , Tooth Abrasion/prevention & control , Tooth Erosion/prevention & control , Cross-Over Studies , Carbonated Beverages/adverse effects , Dentin/pathology , Hardness , Materials Testing , Toothbrushing/instrumentation , Water , Young AdultABSTRACT
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.
Subject(s)
Adult , Humans , Young Adult , Cariostatic Agents/therapeutic use , Dental Enamel/drug effects , Dentifrices/chemistry , Fluorides, Topical/therapeutic use , Saliva/chemistry , Tooth Erosion/prevention & control , Analysis of Variance , Cross-Over Studies , Carbonated Beverages/adverse effects , Cariostatic Agents/chemistry , Double-Blind Method , Fluorides, Topical/chemistry , Saliva/physiology , Tooth Abrasion/prevention & control , Tooth Erosion/chemically induced , Young AdultABSTRACT
O trabalho comparou a perda de massa e a rugosidade superficial de materiais restauradores diretos polimerizados por luz halógena e por diodo emissor de luz (LED). A partir de uma matriz de politetrafluoretileno, foram confeccionados 20 corpos-de-prova (12 mm de diâmetro; 1,0 mm de espessura) para cada material restaurador [TPH (Dentsply); Definite (Degussa); Charisma (Heraus Kulzer)], sendo 10 espécimes polimerizados por LED e 10 polimerizados por luz halógena durante 40 s. Os corpos-de-prova foram polidos, levados ao rugosímetro para análise da rugosidade superficial (Ra inicial - mm) e armazenados em água a 37°C por 15 dias. Os corpos-de-prova foram pesados (M1) e submetidos a escovação simulada com suspensão preparada com dentifrício de alta abrasividade. Após 100 minutos no simulador de escovação, os espécimes foram limpos e tiveram o peso (M2) e rugosidade superficial (Ra final - mm) aferidos novamente. A perda de massa foi calculada pela diferença entre M1 e M2. Os dados foram registrados e analisados por meio de ANOVA a um critério e teste de Tukey para diferenciação das médias com nível de significância de 5%. Os resultados demonstraram que a resina Definite foi o material que apresentou menor resistência à abrasão quando polimerizada com luz LED, apresentando maiores valores de rugosidade superficial e perda de massa (p<0.05). Quando utilizada a lâmpada halógena, os valores não mostraram diferença estatisticamente significante entre si (p>0.05). O LED não mostrou a mesma eficiência que a lâmpada halógena para polimerização desta resina especificamente. Pode-se concluir que a unidade de luz fotopolimerizadora e a composição das resinas compostas interferiram na resistência à abrasão dos materiais restauradores testados.
Subject(s)
Acrylic Resins/radiation effects , Composite Resins/radiation effects , Polyurethanes/radiation effects , Tooth Abrasion/prevention & control , Analysis of Variance , Acrylic Resins/chemistry , Composite Resins/chemistry , Polymers/chemistry , Polymers/radiation effects , Polyurethanes/chemistry , Surface PropertiesABSTRACT
The increasing use of foreign toothbrushes along with their higher prices in comparison with Iranian toothbrushes has made us to perform this study in order to evaluate macroscopic characteristics of ten types of toothbrushes Laleh, Mina, Jarda, Jourdan, AlFalij, Dr.Best, Oral-B, Butler and Crest before and after 1, 2 and 3 months using. This experimental study was carried out on 240 students [12 years old girls], of Shahid Beheshti school with observation and questionnaire as its technique. The students were divided to 10 groups according to 10 kinds of toothbrushes. They used the toothbrushes for 1,2 and 3 months. Finally, the toothbrushes were gathered and their bristles were evaluated. Tests [Analysis of variance, Tukey and chi square] showed that all the toothbrushes except of Laleh, Mina and Oral-B were in the range of standard. Laleh and Mina toothbrushes just in the bristle-less edge and Oral-B in the size of toothbrush head were out of standard range. There was a significant difference between the end roundness of different toothbrushes and between the changes of bristles after 1, 2, 3 month application [P<0.001]. Satisfaction of using and end roundness among foreign toothbrushes was more than Iranian toothbrushes
Subject(s)
Humans , Male , Female , Toothbrushing/standards , Tooth Abrasion/prevention & control , Analysis of Variance , Dental Devices, Home Care , Equipment Design , Consumer BehaviorABSTRACT
La bulimia significa "hambre de buey" y es un trastorno alimenticio que se caracteriza por la ingestión episódica de grandes cantidades de alimentos de manera compulsiva, con un consecuente sentimiento de culpa y depresión por no poder controlar la conducta. Debido a ello el paciente trata de recuperar el control, al principio mediante la inducción al vómito y posteriormente con el uso de laxantes, diuréticos, ayunos y hasta ejercicios compulsivos. Si un paciente bulímico acude a nuestra consulta, el examen clínico generalmente puede arrojar erosiones, abrasiones, opacidades a nivel del esmalte dental en determinadas zonas que solían ser observadas en pacientes con trastornos alimenticios que presentan regurgitación gástrica, tales como: esofagitis, gastritis, úlcera péptica, úlcera duodenal, etc. La manifestación más resaltante es la amilolisis (desmineralización) que es la pérdida de esmalte y dentina en la superficie de los dientes, resultante de la acción química y mecánica. Esta manifestación se observa mayormente en casos muy severos y de mucha data, de allí la importancia de nuestro papel para su diagnóstico, debido a que lesiones de este tipo son irreversibles
Subject(s)
Humans , Male , Female , Bulimia , Feeding and Eating Disorders/diagnosis , Feeding and Eating Disorders/etiology , Feeding and Eating Disorders/pathology , Tooth Abrasion/etiology , Tooth Abrasion/prevention & control , Anxiety Disorders , Dental Care/standards , Bulimia , Dentist-Patient Relations , Tooth Demineralization/etiology , Tooth Demineralization/prevention & control , Diagnosis, Differential , Tooth Erosion/etiology , Tooth Erosion/prevention & control , Fluorides, Topical/therapeutic use , Patient Care Team , Patients , Psychotherapy , Dental Restoration, Permanent/instrumentation , Dental Restoration, Permanent/methodsABSTRACT
El presente trabajo describe algunos procesos de etiología no bacteriana: abrasión, atrición y erosión que afectan la integridad de los tejidos dentarios relacionados con los trastornos de la alimentación. La erosión dental, patología que aparece como secuela frecuente en pacientes con vómitos autoinducidos, es definida y clasificada. Son enumeradas las manifestaciones bucales y las medidas para prevenir la progresión de la lesión. La presencia de signos dentarios de la enfermedad permite al odontólogo identificar una patología que muchas veces es ocultada por la paciente, cumpliendo un importante rol en el equipo terapéutico