[Etiology, diagnosis, prevention and treatment of dental fluorosis].

Dental fluorosis is the most common and prominent symptom in the early stage of chronic fluorosis, which is caused by excessive fluorine intake during tooth development. In severe cases, it may be accompanied by skeletal fluorosis. There are also systemic damages to the nervous system, cardiovascular system, endocrine system and so on. The pathogenesis of dental fluorosis is not totally clear, which may be a complex pathological process involving both genetic and environmental factors. The prevalence of dental fluorosis has an upward trend arround the world, thus certain public prevention and treatment strategies need to be taken. This article focuses on the prevalence, etiology, diagnosis and scoring system, as well as the public prevention and treatment strategies, of dental fluorosis, so that to provide reference for the research and prevention of the disease.

Chitosan-Based Extrafibrillar Demineralization for Dentin Bonding.

Instability of resin-dentin bonds is the Achilles' heel of adhesive dentistry. To address this problem, a chelate-and-rinse extrafibrillar dentin demineralization strategy has been developed that keeps intrafibrillar minerals within collagen fibrils intact to prevent activation of endogenous proteases that are responsible for collagen degradation within hybrid layers. The objective of the present study was to evaluate the potential of using chitosan >40 kDa as an antimicrobial extrafibrillar dentin-chelating agent to enhance bond durability. Transmission electron microscopy provided evidence for retention of intrafibrillar minerals and smear plugs in dentin conditioned with 1 wt% chitosan. Analyzed by Kruskal-Wallis analysis of variance, Dunn's statistic, and separate Mann-Whitney tests, tensile bond strengths to wet- and dry-bonded dentin indicated that chelating dentin with chitosan for 60 s prior to bonding did not result in a significant decline in resin-dentin bond strength when compared with that of phosphoric acid etching ( P > 0.05). Gelatinolytic activity within the hybrid layers was examined via in situ zymography after 24-h storage or after thermomechanical cycling and analyzed with 3-factor analysis of variance. After 24 h, enzymatic activity was detected only within completely demineralized phosphoric acid-etched dentin, with values derived from dry bonding significantly higher than those derived from wet bonding ( P < 0.05). Negligible fluorescence was detected within hybrid layers when dentin was conditioned with chitosan, even after thermomechanical cycling, as compared with the controls. Reduction in water permeability in chitosan-conditioned dentin, attributed to smear plug retention, also fostered long-term bond stability. Antibacterial testing performed with live/dead staining indicated that the acetic acid-solubilized chitosan possessed antibacterial activities against 3 single-species biofilms: Streptococcus mutans, Actinomyces naeslundii, and Enterococcus faecalis. Taken together, the new chitosan-based extrafibrillar demineralization strategy retains intrafibrillar minerals, reduces endogenous protease-initiated collagen degradation, prevents water permeation within hybrid layers, and kills bacteria on dentin surfaces, which are crucial factors for enhancing resin-dentin bond durability.

Efficacy of ProTaper Universal rotary retreatment system for gutta-percha removal from root canals.

AIM: To evaluate the efficacy of the ProTaper Universal rotary retreatment system for gutta-percha (GP) removal from root canals. METHODOLOGY: Root canals of 60 extracted human maxillary anterior teeth were prepared and filled with laterally condensed GP and AH Plus sealer. Teeth were divided into three groups: group A--GP removal completed with the ProTaper Universal rotary retreatment system and with further canal repreparation accomplished with ProTaper Universal rotary instruments; group B--GP removal was completed using Gates Glidden drills and Hedström files with chloroform as a solvent, followed with further canal repreparation with ProTaper Universal rotary instruments; group C--the same as group B for GP removal with further canal preparation with stainless steel K-flex files (Kerr). The operating time was recorded. Teeth were rendered transparent for the evaluation of the area of remaining GP/sealer in bucco-lingual and mesial-distal directions. Statistical analysis was performed by using repeated measures analysis of variance and anova. Results The ProTaper Universal technique (group A) resulted in a smaller percentage of canal area covered by residual GP/sealer than in groups B and C, with a significant difference between groups A and C (P < 0.05). Mean operating time for group A was 6.73 min, which was significantly shorter (P < 0.05) than group B (10.86 min) and group C (13.52 min). CONCLUSIONS: In this laboratory study all test techniques left GP/sealer remnants within the root canal. The ProTaper Universal rotary retreatment system proved to be an efficient method of removing GP and sealer from maxillary anterior teeth.