Antimicrobial and cytotoxic capacity of pyroligneous extracts films of Eucalyptus grandis and chitosan for oral applications.

Chitosan films containing distilled pyroligneous extracts of Eucalyptus grandis (DPEC), characterized and developed by Brazilian Agricultural Research Corporation-Embrapa Temperate Agriculture (EMBRAPA-CPACT), were evaluated for antimicrobial activity against Candida albicans, Streptococcus mutans, and Lactobacillus acidophilus by direct contact test. Further, their capacity for the prevention of teeth enamel demineralization and cytotoxicity in vitro were also determined. The natural polymers were tested at different concentrations (1500-7500 µg mL-1) and the formulation of an experimental fluoride varnish with antimicrobial activity was evaluated by direct contact test, whereas cytotoxicity was analyzed through the colorimetric MTT assay. Preliminary data showed no statistically significant differences in cytotoxicity to NIH/3T3 cell line when DPEC is compared to the control group. On the other hand, the antimicrobial capacity and demineralization effects were found between the test groups at the different concentrations tested. Chitosan films containing distilled pyroligneous extracts of E. grandis may be an effective control strategy to prevent biofilm formation related to dental caries when applied as a protective varnish. They may inhibit the colonization of oral microorganisms and possibly control dental caries through a decrease in pH and impairment of enamel demineralization.

Effect of the casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF) and photobiomodulation (PBM) on dental hypersensitivity: A randomized controlled clinical trial.

OBJECTIVE: This randomized controlled clinical trial aimed to evaluate the effect of the casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF) and photobiomodulation (PBM) in the treatment of dentin hypersensitivity (DH), and the impact of this on the health-related quality of life (HRQL). METHODS: Eighty teeth with DH were randomized into four groups and received three treatment sessions: PLACEBO = placebo + LASER application mimicking; CPP-ACPF = CPP-ACPF + LASER application mimicking; PBM = placebo + LASER active application; CPP-ACPF+PBM = CPP-ACPF + LASER active application. Tactile (exploratory probe) and evaporative (triple syringe) stimuli were used to measure DH and were recorded with the aid of a visual analogue scale (VAS) after the 1st, 2nd and 3rd treatment sessions and one-month follow-up. The HRQL was recorded in the DH experience questionnaire (DHEQ). RESULTS: The intragroup comparison showed a significant reduction in DH (p < 0.05) with both stimuli after one-month follow-up. The intergroup comparison with the evaporative stimulus showed that CPP-ACPF+PBM significantly reduced DH when compared to the rest of treatments, after one-month follow-up. CPP-ACPF+PBM group statistically differed from the other treatment groups in the DHEQ evaluation after one-month follow-up. CONCLUSION: After one-month follow-up, the association of CPP-ACPF with PBM was effective in the reduction of DH and promoted a positive impact on the HRQL of the participants of this study.

The Role of Fluoride in the Prevention of Tooth Decay.

Although there are recommendations to prevent tooth decay by other means, this nonsystematic review finds that fluoride is the key to prevention and control of tooth decay. There are multiple fluoride modalities with effectiveness and safety of fluoride depending on dose and concentration. Prevention of tooth decay occurs at the individual level by fluoride use at home and with professional application and at the community level through fluoridation of water or salt.

Effect of Green Tea Varnish on Depth of Root Caries.

AIM: Root caries is a common, debilitating condition particularly in the elderly population, which can lead to tooth loss. Evidence shows that green tea has cariostatic effects. Considering the gap of information on green tea varnish, this study aimed to assess the efficacy of green tea varnish in the prevention of root caries. MATERIALS AND METHODS: This in vitro experimental study was performed on 42 sound premolars. Two layers of acid-resistant nail varnish were applied on root surfaces except for a window of 1 × 4 mm. The teeth were randomly divided into three groups (n = 14). Group I (control) received no intervention. Group II received green tea varnish applied on the roots every 48 hours for 21 days. Group III received green tea varnish every 24 hours for 21 days. Sections of 40 µ thickness were prepared from the center of the window, and the depth of carious lesion was measured in three points with 500 µ distance from each other using polarized light microscope. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 16 and non-parametric Kruskal-Wallis and Mann-Whitney U tests (α = 0.05). RESULTS: The mean (and standard deviation) depth of carious lesion was 54.30 ± 28.64 (µm), 0, and 0 in groups I, II, and III respectively. Control group showed the highest depth of caries. Groups II and III were not significantly different in this respect, but significant differences were noted in depth of caries between groups I and II and also groups I and III (p < 0.001). CONCLUSION: Based on the results, the green tea varnish may possess anticariogenic effects on root caries when applied every 24 or 48 hours over a 21-day period. Application of green tea varnish every 24 or 48 hours for 21 days may prevent root caries. CLINICAL SIGNIFICANCE: Application of green tea varnish can prevent root caries.

Can babies oral wipes with fluoride and/or calcium glycerophosphate prevent cariogenic demineralization? An in-vitro study.

BACKGROUND: The difficulties in reaching a good level of oral hygiene in young babies can be partly overcome with the use of baby oral wipes, which have been shown to effectively remove plaque from deciduous teeth. The presence of fluoride and calcium in these wipes could also prevent further demineralization of the teeth, as well as promote remineralization. The aim of this study is, therefore, was to analyze the preventive effect of OW containing F and CaGP on cariogenic demineralization in vitro. METHODS: For this, seventy enamel samples were treated with OW soaked in solutions containing different F concentrations (250 ppm; 500 ppm and 1500 ppm) with or not with 0.13% CaGP and distilled water for the control group. The samples were submitted to an 8-day cariogenic pH cycling. The experimental solutions were applied twice per cycle, by immersing a dry inert oral tissue into 4 mL of the solution and rubbing it over the enamel surface. Enamel microhardness was measured initially and after the experimental cycles. Environmental scanning electron microscope was taken to visualize and quantify elements on the enamel surface. RESULTS: No significant difference was observed (P=0.694), but when the groups containing CaGP were compared to the negative control solution, a significant difference was found. CONCLUSIONS: The presence of 0.13% CaGP and fluoride in concentrations greater than 500 ppm were able to provide protection of dental enamel against demineralization.

Interventions for orthodontically induced white spot lesions: a systematic review and meta-analysis.

Background: Although orthodontic white spot lesions (WSLs) are one of the most often and most evident adverse effects of comprehensive fixed appliance treatment, the efficacy of interventions for WSLs has not yet been adequately assessed in an evidence-based manner. Objective: Aim of this systematic review was to assess the therapeutic and adverse effects of interventions to treat post-orthodontic WSLs from randomized trials in human patients. Search methods: An unrestricted electronic search of eight databases from inception to May 2016. Selection criteria: Randomized controlled trials assessing any interventions for post-orthodontic WSLs on human patients. Data collection and analysis: After duplicate study selection, data extraction, and risk of bias assessment according to the Cochrane guidelines, random-effects meta-analyses of mean differences (MDs), standardized mean differences (SMDs), and odds ratios (ORs), including their 95% confidence intervals (CIs) were performed, followed by subgroup and sensitivity analyses. Results: A total of 20 unique studies and a total of 942 (42 per cent male and 58% per cent female) patients were included, with an average age of 16.2 years and a mean number of 8.2 WSLs (range 2.2 to 45.4) per patient. These were allocated to adjunct treatment with casein phosphopeptide-stabilized amorphous calcium phosphate creams, external tooth bleaching, low- or high-concentration fluoride films, gels, mouthrinses or varnishes, resin infiltration, miswak chewing sticks, bioactive glass toothpastse, or to no adjunct treatment (i.e. conventional oral hygiene). The monthly use of fluoride varnish was the best supplement to improve WSLs in terms of lesion area (1 trial; MD = -0.80 mm2; 95% CI = -1.10, -0.50 mm2; P < 0.05; high quality) and enamel fluorescence (3 trials; SMD = -0.92; 95% CI = -1.32, -0.52; P < 0.05; high quality), followed by the use of fluoride film. WSL treatment did not provide a considerable improvement in their clinical evaluation (3 trials; OR = 0.97; 95% CI = 0.60, 1.56; P > 0.05; moderate quality), with imprecision due to small sample size being the main limitation of existing evidence. Conclusions: Based on the existing trials, interventions for post-orthodontic WSLs, mainly fluoride varnish, seem to be effective, but further research is needed to elucidate their clinical relevance. Registration: PROSPERO (CRD42016037538).

A 12-Week Assessment of the Treatment of White Spot Lesions with CPP-ACP Paste and/or Fluoride Varnish.

This 12-week clinical study evaluated the impact of 10% CPP-ACP and 5% sodium fluoride varnish regimes on the regression of nonorthodontic white spot lesions (WSLs). The study included 21 children with 101 WSLs who were randomised into four treatment regimes: weekly clinical applications of fluoride varnish for the first month (FV); twice daily self-applications of CPP-ACP paste (CPP-ACP); weekly applications of fluoride varnish for the first month and twice daily self-applications of CPP-ACP paste (CPP-ACP-FV); and no intervention (control). All groups undertook a standard oral hygiene protocol and weekly consultation. Visual appraisals and laser fluorescence (LF) measurements were made in weeks one and twelve. The majority of WSLs in the control and FV groups exhibited no shift in appearance, whereas, in the CPP-ACP and CPP-ACP-FV groups, the lesions predominantly regressed. The visual and LF assessments indicated that the extent of remineralisation afforded by the treatments was of the following order: control ~ FV < CPP-ACP ~ CPP-ACP-FV. Self-applications of CPP-ACP paste as an adjunct to standard oral hygiene significantly improved the appearance and remineralisation of WSLs. No advantage was observed for the use of fluoride varnish as a supplement to either the standard or CPP-ACP-enhanced oral hygiene regimes.

Prevention and treatment of white spot lesions during and after fixed orthodontic treatment: A systematic literature review.

OBJECTIVE: The aim of the study is to evaluate the effectiveness of fluoride and casein topical preparations in the prevention of white spot lesions during and after fixed orthodontic treatment. MATERIAL AND METHODS: Information search for controlled studies on humans published in the English language between 2008 and 2013 was conducted in Medline via PubMed, ScienceDirect, and Oxford University Press: Oxford journals and The Cochrane Library, as well as the Web search Google Scholar. 177 articles were reviewed; eleven clinical studies fulfilled all inclusion criteria. RESULTS: In the clinical studies it was concluded that high-concentration fluoride supplements are effective in reducing white spot lesions. Results of the studies showed the same usefulness of fluoride varnish, MI Paste, and usual oral hygiene using 1100 ppm of fluoride toothpaste. Effect on the prevention and treatment of white spot lesions of oral hygiene with toothpaste containing 1450 ppm of fluoride in orthodontic patients was evaluated. The positive effect of casein phosphopeptide-amorphous calcium phosphate in white spot lesions treatment was found. Otherwise in some clinical studies use of casein derivates during fixed orthodontics for white spot lesions treatment was not effective. CONCLUSIONS: More clinical studies conducted during last five years yielded significantly positive results about the effectiveness of fluoride and caseine supplements in ameliorating white spot lesions during and after fixed orthodontic treatment. For a higher-risk patient group, additional supplements such as high-concentrated fluoride varnish, chewing sticks, or casein derivates, are required. A good oral hygiene regimen using high-fluoride toothpaste is as effective as fluoride or casein derivates in the prevention of new white spot lesions formation.

Fluoride varnish or fluoride mouth rinse? A comparative study of two school-based programs.

OBJECTIVE: In many Danish communities, school-based fluoride programs are offered to children with high caries risk in adjunct to tooth brushing. The purpose of this field trial was to compare the caries-preventive effectiveness of two different fluoride programs in 6-12 year olds. BASIC RESEARCH DESIGN: Clinical controlled trial. CLINICAL SETTING: The 2-year study was conducted in Public Dental Clinics in a multicultural low-socioeconomic suburban area of Odense, Denmark with an elevated prevalence of caries compared to the city average. PARTICIPANTS: 1,018 children (aged 6-12 years) from 9 different schools were enrolled after informed consent and their class unit was randomly allocated to one of two fluoride programs. INTERVENTIONS: One group received a semi-annual fluoride varnish applications (FV) and the other group continued with an existing program with fluoride mouth rinses once per week (FMR). All children received oral hygiene instructions and comprehensive dental care at the local Public Dental Clinics throughout the study period. MAIN OUTCOME MEASURES: Increment of caries lesions in permanent teeth at both cavitated and initial caries levels. RESULTS: The groups were balanced at baseline. After two years, 961 children (94.4%) were reexamined. The FV group showed a mean DMFS increment of 0.36 compared to 0.41 in the FMR group. The corresponding values for initial caries lesions were 0.83 and 0.91 respectively. CONCLUSION: There were no statistically significant differences in caries development over two years among children participating in a school-based fluoride varnish or mouth rinse program.

Effect of high-dose fluoride on antioxidant enzyme activities of amniotic Fluid in rats.

OBJECTIVE: To investigate the effect of high-dose fluoride on antioxidant enzyme activities of amniotic fluid and fluoride of serum in rats. METHODS: The experimental study was conducted from January 8, 2008, to December 14, 2010, at the Suleyman Demirel University Experimental Animals Laboratory and the Medical Biochemistry Department Research Laboratory, Isparta, Turkey. Impregnated Wistar albino rats were divided into two equal groups. Group I had controls, while Group II rats were exposed to high-dose fluoride. Group I was given drinking water mixed with 0.1 mg/kg/b.w./day of natrium fluoride, while group II was given drinking water mixed with 10 mg/kg/b.w./day of natrium fluoride for 18 days. At the end of 18 days, amniotic fluid and blood samples were collected from control and experimental groups of pregnancy. Superoxide dismutase, glutathione peroxidase, catalase activities and thiobarbituric acid reactive substances as antioxidant enzymes in amniotic fluid and levels of fluoride in serum samples were investigated. RESULTS: There were 14 rats, with 7(50%) in each group. Foetal weight in group II significantly decreased compared to the control group (p< 0.05). Antioxidant enzyme activities in amniotic fluid were significantly higher in group II than group I (p< 0.05) although thiobarbituric acid reactive substances in amniotic fluid and serum fluoride levels were significantly lower in group II than group I (p< 0.05). CONCLUSIONS: Fluoride that created oxidative stress inhibited lipid peroxidation and apparently increased the antioxidant defence system.

Fluoride gel supplemented with sodium hexametaphosphate reduces enamel erosive wear in situ.

OBJECTIVE: This study evaluated the effect of fluoride gels, supplemented or not with sodium hexametaphosphate (HMP), on enamel erosive wear in situ. METHODS: Twelve healthy volunteers wore palatal appliances containing four bovine enamel discs. Subjects were randomly allocated into four experimental phases (double-blind, crossover protocol) according to the gels: Placebo (no fluoride or HMP), 1% NaF, 2% NaF, and 1% NaF+9% HMP. Enamel discs were selected after polishing and surface hardness analysis, and treated only once with the respective gels prior to each experimental phase. Erosion (ERO) was performed by extra-oral immersion of the appliance in 0.05M citric acid, pH 3.2 (four times/day, five minutes each, 5 days). Additional abrasion (ERO+ABR) was produced on only two discs by toothbrushing with fluoridated dentifrice after ERO (four times/day, 30s, 5 days). The specimens were submitted to profilometry and hardness analysis. The results were analyzed by two-way ANOVA and the Student-Newman-Keuls test (p<0.05). RESULTS: The 1% NaF+9% HMP gel promoted significantly lower enamel wear for ERO compared to the other groups, being statistically lower than 1% NaF and Placebo for ERO+ABR. Similarly, the lowest values of integrated lesion area were found for 1% NaF+9% HMP and 2% NaF, respectively, for ERO and ERO+ABR. CONCLUSION: The addition of HMP to the 1% NaF gel promoted greater protective effect against ERO and ERO+ABR compared to the 1% NaF gel, achieving similar protective levels to those seen for the 2% NaF gel. CLINICAL SIGNIFICANCE: Gel containing 1% NaF+9% HMP showed a high anti-erosive potential, being a safer alternative when compared to a conventional 2% NaF gel.

A spectroscopic and surface microhardness study on enamel exposed to beverages supplemented with lower iron concentrations.

OBJECTIVES: This study aimed to compare the in vitro mineral loss and surface microhardness (SMH) changes in human enamel specimens following supplementation of acidic carbonated beverages with low iron concentrations than when treated without. STUDY DESIGN: 180 enamel blocks each from primary and permanent teeth were prepared and equally subdivided (n=10) for their respective treatments in Group 1 (Coca Cola and Sprite without iron supplementation) and Group 2 (beverages supplemented with 2/5 mmol/L FeSO4.7H2O). Following initial SMH estimation, the blocks were subjected to 3 treatment cycles of 5/20 minute incubation periods, equally interspaced by a 5-min treatment in artificial saliva. The calcium and phosphate released after each cycle were analyzed spectrophotometrically and the final SMH was recorded. The results were tested using student's T test, One-way ANOVA and Kruskal Walli's test (p<0.05). RESULTS: Two and five mmol/L FeSO4.7H2O supplementation produced a highly significant SMH change and calcium and phosphate reduction than when treated without (p<.0005). Both the enamel specimens showed similar patterns of mineral loss and SMH reduction, with pronounced effects in the twenty minute incubation cycles. CONCLUSION: Our results suggest that 2 mmol/L FeSO4.7H2O supplementation to acidic beverages is beneficial in reducing mineral loss and preserving surface microhardness of human enamel.

Influence of fruit consumption and fluoride application on the prevalence of caries and erosion in vegetarians--a controlled clinical trial.

BACKGROUND/OBJECTIVES: Caries and erosion are common diseases of the dental hard tissues. The influence of vegetarianism on the development of caries and erosion has scarcely been investigated in the past. The aim of the present study was to evaluate the influence of fruit consumption and topical fluoride application on the prevalence of caries and erosion in vegetarians. SUBJECTS/METHODS: In 100 vegetarians and 100 nonvegetarians, a dental examination was performed. The indices for decayed, missing, filled teeth (DMFT) and surfaces (DMFS) were determined. DMFT and DMFS were subdivided into decayed teeth (DT), filled teeth (FT), decayed surfaces (DS) and filled surfaces (FS). In addition, the hygiene index and the number of teeth with dental erosion (DE), root caries (RC) and overhanging restoration margins (ORM) were recorded. A questionnaire assessed patients' eating habits, frequency of oral hygiene, dentist visits and topical fluoride application. For statistical analysis, unpaired t-test, Mann-Whitney test and Pearson's chi-square test were applied. RESULTS: Vegetarians had significantly more DT (P<0.001), DS (P<0.001), more teeth with DE (P=0.026), RC (P=0.002) and ORM (P<0.001) than nonvegetarians. Daily consumption of fruits was significantly more prevalent (P<0.001), and topical fluoride application was less prevalent (P<0.001) in vegetarians compared with nonvegetarians. In particular, fluoride-containing toothpaste (P<0.001) and table salt (P=0.039) were less frequently used in vegetarians. CONCLUSION: The presented data suggest that vegetarians have an increased risk for caries and erosion. Topical fluoride application was shown to be effective in preventing caries, but not in preventing erosion.

In situ evaluation of low-fluoride toothpastes associated to calcium glycerophosphate on enamel remineralization.

OBJECTIVES: This study aimed to evaluate the effect of low-fluoride toothpastes with calcium glycerophosphate (CaGP) on enamel remineralization in situ. METHODS: Volunteers (n=10) wore palatal devices holding four bovine enamel blocks. The treatments involved 5 experimental phases of 3 days each according to the following toothpastes: placebo, 500 ppm F (500 NaF), 500 ppm F with 0.25% CaGP (500 NaF CaGP), 500 ppm F with 0.25% CaGP (500 MFP CaGP) and 1100 ppm F (1100; positive control). After this experimental period, the fluoride, calcium, and phosphorus ion concentrations from enamel were determined. Surface and cross-sectional hardness were also performed. Data were analysed by 1-way ANOVA, Student-Newman-Keuls' test and by Pearson's correlation. RESULTS: The addition of 0.25% CaGP improved the remineralization potential of low-fluoride toothpastes and the NaF as source of fluoride yielded the best results (p<0.001) as evidenced by the hardness analysis. The 1100 ppm F toothpaste provided higher presence of fluoride in the enamel after remineralization (p<0.001). The addition of CaGP to the NaF and MFP toothpastes led to similar calcium concentration in the enamel as the observed with the positive control (p=0.054). CONCLUSIONS: Toothpastes with 500 ppm F (NaF or MFP) and CaGP showed similar remineralization potential than 1100 ppm F toothpaste. CLINICAL SIGNIFICANCE: Toothpastes containing 500 ppm F associated to CaGP, with both fluoride source (NaF or MFP), showed a potential of remineralization similar to commercial toothpaste. Although there is a need for confirmation in the clinical setting, these results point to an alternative for improving the risk-benefit relationship between fluorosis and dental caries in small children.

The preventive effect of grape seed extract on artificial enamel caries progression in a microbial biofilm-induced caries model.

OBJECTIVES: The aim of this study was to evaluate the effect of grape seed extract (GSE) on enamel caries lesion formation in an in vitro Streptococcus mutans biofilm model. METHODS: Enamel fragments were prepared from bovine incisors and divided into six treatment groups (n=12): inoculated Brain Heart Infusion with 1% sucrose (BHIS), 1mg/mL GSE, 2mg/mL GSE, 3mg/mL GSE, 10ppm fluoride as NaF, and uninoculated BHIS. For biofilm formation, tooth fragments were incubated anaerobically in polystyrene 6-well tissue culture plates containing BHIS, the respective agents, and S. mutans (1×10(5)CFU/mL) for 24h at 37°C. Culture medium was replaced with fresh BHIS and respective agents daily over a 7-day period. Following caries lesion formation, lesion depth (LD) and relative optical density (ROD) were determined by polarized light microscopy (PLM) and confocal laser scanning microscopy (CLSM), respectively, to evaluate lesion progression. RESULTS: LDs of the 2mg/mL GSE group (122.86±13.41µm) and the 3mg/mL GSE group (111.92±11.39µm) were significantly smaller than those of the 1mg/mL GSE (198.33±17.70µm) and control groups (210.86±15.50µm) (p<0.05). Compared with the 2mg/mL and 3mg/mL groups, the control and 1mg/mL GSE groups showed significantly lower ROD values when depth was less than 200µm, indicating greater mineral loss. CONCLUSIONS: Dose-dependent GSE inhibits in vitro enamel caries formation due to its ability to suppress growth of S. mutans and the formation of biofilm. CLINICAL SIGNIfiCANCE: Grape seed extract may be a novel virulence-targeted natural antimicrobial agent for caries prevention.

Differential influence of fluoride concentration on the synthesis of bone matrix glycoproteins within mineralizing bone cells in vitro.

OBJECTIVE: This study investigated the influence of fluoride levels on the temporal synthesis of bone-associated glycoproteins, which have been assigned prominent roles in regulating crystal growth, size and shape during the mineralization process. MATERIALS AND METHODS: Bone marrow stromal cells were isolated from male Wistar rats and cultured under mineralizing conditions, supplemented with 0 M, 10(-7) M or 10(-5) M sodium fluoride. The presence of bone-associated glycoproteins was examined 2-13 days post-reseeding by immunocytochemical localization. Results: All bone-associated glycoproteins increased in 10(-7) M fluoride, compared to untreated controls, particularly at days 6 and 13 in culture. Conversely, higher 10(-5) M fluoride concentrations decreased glycoprotein levels, compared to controls. CONCLUSIONS: Results highlight a differential effect of fluoride concentration on glycoprotein synthesis by osteoblasts.

Anticariogenic properties and effects on periodontal structures of Stevia rebaudiana Bertoni: narrative review / Propiedades anticariogénicas y efectos a nivel periodontal de Stevia rebaudiana Bertoni: revisión narrativa

Introduction: Stevia rebaudiana Bertoni is a natural non-caloric sweetener, withmore sweetness than sucrose, without adverse effects, which has demonstrated to have multiples benefits to the systemic health and recently to the oral health. This review’s objective is to describe anti-cariogenic and anti-periodontophatics properties of its extracts. Results: Stevioside and rebaudioside A are the most important glycosides of the Stevia and none is cariogenic. In vitro researches have shown that Stevia extracts have anti-bacterial activity on Streptococcus mutans, Streptococcus sobrinus and Lactobacillus acidophilus, organisms that are closely related to the production and development of tooth decay. In vivo and in vitro it has been observed that the production of bacterial acids decrease attributing it a low acidogenic potential and a lesser effect of the demineralization of the enamel in comparison with others sweeteners. Furthermore, in vivo it has been proved an anti-plaque effect mainly due to a decrease in the production of bacterial insoluble polymers. These characteristics in combination with antiinflammatory properties could result potentially effective in the treatment of periodontal diseases in significant numbers, as it has been observed in studies conducted in animals. Conclusion: Stevia presents properties that potentially are anti-caries and anti periodontal diseases. However, in vivo studies are necessary to confirm these assumptions and provide a greater understanding of the mechanisms of action of this plant and the components involved. Notwithstanding, with the existing background, this sweetener can be postulated as a potential therapeutic complement in the odontological care, especially in patients that present base conditions such as obesity, diabetes and high blood pressure.

Introducción: Stevia rebaudiana bertoni es un edulcorante natural no calórico, con mayor dulzor que la sacarosa, sin efectos adversos, que ha demostrado tener múltiples beneficiosos para la salud sistémica y recientemente para la salud oral. El objetivo de esta revisión es describir propiedades anticariogénicas y antiperiodontopáticas de sus extractos. Resultados: Esteviósido y rebaudiósido A son los glicósidos más importantes de Stevia y ninguno es cariogénico. Estudios in vitro han demostrado que extractos de Stevia presentan actividad antibacteriana sobre Streptococcus mutans, Streptococcus sobrinus y Lactobacillus acidophillus, organismos estrechamente relacionados en la producción y desarrollo de caries. In vivo e in vitro se ha observado que disminuye la producción de ácidos bacterianos atribuyéndosele un bajo potencial acidogénico y un menor efecto de desmineralización del esmalte en comparación con otros edulcorantes. Además, in vivo se ha comprobado un efecto antiplaca principalmente debido a una disminución en la producción de polímeros insolubles bacterianos. Estas características, más sus propiedades antiinflamatorias y cicatrizantes, podrían resultar potencialmente efectivas en el tratamiento de enfermedades periodontales en cifras significativas, como se ha observado en estudios desarrollados en animales. Conclusión: Stevia presenta propiedades potencialmente anti-caries y anti-enfermedades periodontales. Sin embargo, son necesarios estudios in vivo que confirmen estos postulados y proporcionen una mayor comprensión de sus mecanismos de acción y de los componentes que intervienen. No obstante, con los antecedentes existentes, se puede postular a este edulcorante como un potencial complemento terapéutico en la atención odontológica, sobre todo en pacientes que presentan condiciones de base como obesidad, diabetes e hipertensión.

Effect of sodium trimetaphosphate on hydroxyapatite solubility: an in vitro study.

This study evaluated the effect of different concentrations of sodium trimetaphosphate (TMP) with and without fluoride (F) on the concentration of calcium (Ca), phosphorus (P) and F in hydroxyapatite (HA). Synthetic HA powder (0.15 g) was suspended (n=6) in solutions (75 mL) of TMP at 0%, 0.1%, 0.2%, 0.4%, 0.6%, 0.8%, 1.0%, 2.0%, 4.0%, 6.0%, 8.0% and 10% concentrations in the presence and absence of 100 ppm F and subjected to a pH-cycling process. The precipitates were filtrated, dried at 70° C for 24 h and ground onto a fine powder. The concentrations of F (KOH (CaF2) and HCl (FA) soluble), Ca (Arsenazo III), and P (molybdate method) in HA were determined. The Ca P, and Ca/P ratio data were subjected to Tukey's test and the F data were subjected to Student-Newman-Keuls test (p<0.05). The addition of TMP to the samples reduced F deposition to 98% (p<0.001). The groups containing 100 ppm F and 0.4% or 0.6% TMP exhibited a higher Ca concentration than the group containing only 100 ppm F (p<0.05). Furthermore, the HA treated with 0.2% and 0.4% TMP and 100 ppm F showed a higher Ca/P ratio than the other groups (p<0.001). In conclusion, TMP at 0.2%, 0.4% and 0.6% concentrations combined with F seemed to be able to precipitate HA with low solubility. However, especially at high concentrations, TMP interferes with F deposition on HA.