Effect of sealing infected dentin with glass ionomer cement on the abundance and localization of MMP-2, MMP-8, and MMP-9 in young permanent molars in vivo.

BACKGROUND: The study of MMPs' behavior in carious lesions contributes to the understanding of the mechanisms involved in dentin reorganization after restoration. AIM: To compare the abundance and localization of MMPs 2, 8, and 9 in infected dentin before and after restoration. DESIGN: The sample consisted of 23 young permanent molars with active deep carious lesions. Infected carious dentin samples were collected from the same tooth at baseline and 60 days after cavity lining with GIC and composite resin restoration and processed for immunohistochemistry assays. After digital images were obtained, two calibrated operators analyzed the samples according to the immunostaining intensity and the MMPs' localization. Chi-square test was used for statistical analysis. RESULTS: The intensity of immunostaining for MMP-8 was reduced after 60 days (P = 0.02), and no difference was observed for MMP-2 (P = 0.32) and MMP-9 (P = 0.14). The MMPs' distribution was generalized in the intertubular dentin and absent or located in the intratubular dentin, regardless of the period. CONCLUSION: The sealing of infected carious dentin in young permanent molars reduced the expression of MMP-8, which is consistent with the initial remodeling process of the dentin matrix.

The influence of the lining material on the repair of the infected dentin in young permanent molars after restoration: A randomized clinical trial.

AIM: This study evaluated the impact of liner material on the fluorescence, morphological and mineral characteristics of permanent carious dentin after cavity sealing. METHODS: Thirty children (11.0 ± 2.7 years old) presenting at least one active deep carious lesion in permanent molars were selected. Fragments of carious dentin were removed from teeth before lining the cavity (baseline samples) with high-viscosity glass ionomer cement (G1) or an inert material (wax - G2). Cavities were restored with composite resin and reopened 60 days later, and other fragments were removed (60-day sample). The laser fluorescence (LF) readings and morphological and mineral changes of both groups were compared. RESULTS: After 60 days, forty teeth were available for evaluation. Lower LF means were obtained (Wilcoxon signed-rank test; P < 0.05), and enhanced calcium and phosphorus levels were detected for both groups (t-test, P < 0.05). An uptake of fluorine was observed only in G1 (t-test; P < 0.05). Regardless of the group, baseline samples exhibited clear signs of bacterial invasion, and the collagen fibers were exposed; the 60-day samples showed a better-organized tissue with a more compact intertubular dentin. CONCLUSION: Caries arrestment with dentin reorganization occurs regardless of the lining material placed in contact with the infected dentin.

Ethanol-wet bonding technique: Clinical versus laboratory findings.

OBJECTIVES: This study evaluated the microtensile bond strength (µTBS) and nanoleakage (NL) of dentin bonded interfaces produced with ethanol-wet and water-wet bonding protocols under clinical and laboratory conditions. METHODS: The sample was composed of forty primary second molars in advanced exfoliation process. Occlusal cavities were prepared leaving a flat dentin surface on the pulpal floor. In half of the teeth, the water-wet protocol was followed using a three-step etch-and-rinse adhesive. In the other half, dentin was dehydrated with ascending ethanol solutions (50%, 70%, 80%, 95% and 3×100%), 15s each for the ethanol-bonding protocol. An experimental hydrophobic primer was used, followed by the neat adhesive application. Resin build-ups were prepared, stored for 24h, sectioned into sticks and tested in tensile mode (0.5mm/min). NL was performed for all groups. The µTBS and NL data were submitted to two-way ANOVA and Kruskall-Wallis tests, respectively (α=0.05). RESULTS: Under clinical conditions, the highest µTBS was observed for the water-wet bonding while under the laboratory setting, the highest µTBS was obtained for the ethanol-wet bonding. Increased NL was observed in the water-wet bonding groups irrespective of the bonding condition. SIGNIFICANCE: The immediate benefits of the ethanol-bonding observed in the laboratory setting was not confirmed when the same protocol was performed in vivo. However, as reduced nanoleakage was seen in adhesive interfaces produced with the ethanol-wet bonding technique, suggests that the hybrid layer may be more resistant to degradation.

The role of glass ionomer cement on the remineralization of infected dentin: an in vivo study.

PURPOSE: This study's purpose was to investigate the effect of a glass ionomer cement as a liner over infected unexcavated dentin after 60 days and at 10 to 15 months. METHODS: Forty-five permanent molars with deep carious lesions were selected. Fragments of carious dentin were removed prior to lining the cavity (baseline sample) with glass ionomer cement (G1) or an inert wax material (G2). Cavities were restored with composite resin and reopened 60 days later, when other fragments were removed (60-day sample). The dentin morphology (scanning electron microscopy) and mineral content of calcium, phosphorus, and fluorine were assessed. During the follow-up periods (60 days and 10 to 15 months), restorations were evaluated and standardized radiographs were taken. A postprocessing routine was used to identify changes in the radiographic density between periods. RESULTS: After 60 days, the dentin exhibited a better organization, fewer bacteria, and signs of remineralization. The weight percents of calcium and phosphorus were higher 60 days after the cavity sealing, regardless of the group. Higher gray levels of carious and sound dentin were seen on the 10- to 15-month radiographs, irrespective of the group. The success rates of G1 and G2 were 89 percent and 88 percent, respectively. CONCLUSIONS: The lining material isn't fundamental for caries arrestment. Early (60-day) and late (10 to 15 months) dentin changes occurred, indicating the remineralization of dentin carious tissue.

Infant motivation in dental health: attitude without constant reinforcement.

INTRODUCTION: Social factors determine the child's behavior and motivation is an important task in the teaching-learning process. This longitudinal and cross-sectional study aimed to analyze the effectiveness of a motivational activity program for oral hygiene habits formation after motivation and without constant reinforcement. MATERIALS AND METHODS: The sample was constituted of 26 children (mean 6 years old) from a Public Kindergarten School in Ponta Grossa, PR, Brazil. Data were collected applying a test-chart, with figures reporting the process of dental health/illness. Some figures were considered positive to dental health (dentist/Cod 1, toothbrush/Cod 3, dentifrice/dental floss/Cod 6, fruits/vegetables/Cod 7 and tooth without caries lesion/Cod 8) and negative on dental health (sweets/Cod 2, bacteria/Cod 4, tooth with caries lesion/Cod 5). The figures presentation occurred in three different stages: First stage - figures were presented to children without previous knowledge; second stage - following the motivational presentation, and third stage - 30 days after the first contact. RESULTS: On the first stage, most children select good for the figures considered harmful to their teeth (Cod 2-88%; Cod 4-77% and Cod 5-65%). On the second stage, there was a lower percentage: 23% (P < 0.0001), 8% (P < 0.0001), and 23% (P = 0.0068) related to the Cod 2, 4, and 5. On the third stage, the results showed again an association with the good choice to these figures considered harmful (Cod 2-85%, Cod 4-65% and Cod 5-54%) similar the results obtained on the first stage. CONCLUSION: The motivational programs performed without constant reinforcement does not have a positive influence in changing the child's behavior related to a better dental care.

O impacto da extensão universitária sobre a formação acadêmica em Odontologia / The impact of university extension on academic training in Dentistry / El impacto de la extensión universitaria sobre la formación en Odontología

Com objetivo de avaliar a contribuição da extensão universitária na formação e história de vida de estudantes de Odontologia, realizou-se um estudo qualitativo, de caráter descritivo-exploratório, utilizando a técnica do grupo focal. O material foi analisado com a técnica de análise do discurso do sujeito coletivo. Os resultados referiram-se ao impacto exercido pela vivência acadêmica em atividades extensionistas nos campos pessoal, profissional e da cidadania. As percepções dos sujeitos revelaram a oportunidade de desenvolvimento e aprimoramento de suas habilidades profissionais, por meio do reconhecimento de distintas realidades de vida, da ruptura do modelo tradicional de ensino e do profícuo relacionamento entre acadêmico, universidade e sociedade. Foram relatados sentimentos de satisfação, realização pessoal, reconhecimento, e de ser um cidadão ativo e crítico. Conclui-se ser a experiência no campo da extensão um importante agente para o processo individual e coletivo de formação acadêmica.

This qualitative study of descriptive and exploratory nature was conducted with the aim of evaluating the contribution of university extension towards the training and life histories of dentistry students, using the focus group technique. The material was assessed using the collective subject discourse analysis technique. The results showed the impact exerted by academic experience, in extension activities within the personal, professional and active citizenship spheres. The subjects' perceptions revealed an opportunity to develop and improve their professional skills, through recognition of distinct realities of life, through breaking away from the traditional model of teaching and through fruitful relationships between students, university and society. Feelings of satisfaction, personal fulfillment, recognition and being an active and critical citizen were reported. It was concluded that experience within the field of extension is an important agent for the individual and collective process of academic training.

Se realizó un estudio cualitativo de carácter descriptivo-exploratorio para evaluar la contribución de la extensión universitaria en la formación e historia de vida de los estudiantes de Odontología. Para la recolección de datos fue utilizado el grupo focal y el material fue analizado por medio de la técnica de análisis del discurso del sujeto colectivo. Los resultados se refirieron al impacto ejercido por la vivencia académica en actividades de extensión en los campos personal, profesional y de ciudadanía. Las percepciones de los sujetos revelaron la oportunidad de desarrollo y perfeccionamiento de sus habilidades profesionales, por medio de reconocimiento de distintas realidades de vida, de la ruptura del modelo tradicional de enseñanza y de la provechosa relación entre el sector académico, la universidad y la sociedad. Fueron relatados los sentimientos de satisfacción, realización personal, reconocimiento y de ser un ciudadano activo y critico. Se concluyó que la experiencia en el campo de extensión es un importante agente para el proceso de formación académica individual y colectiva.

Percepção das mães e pediatras de Ponta Grossa/PR em relação as alterações ocorridas em bebês durante a erupção da dentição decídua / Perception of mothers and pediatricians from Ponta Grossa/PR about alterations occurred in infants during the eruption of the primary dentition

Objetivo: Verificar a percepcao de maes e pediatras sobre a presenca de sintomas sistemicos e/ou locais durante o periodo de erupcao da denticao decidua. Metodo: Realizou-se um estudo observacional e transversal, sendo a amostra composta por 25 medicos pediatras e 118 maes de bebes de 03 a 36 meses de idade, de diferentes classes sociais, selecionados aleatoriamente, que se dirigiram as Unidades de Saude de Ponta Grossa/PR. Os dados foram coletados por meio de uma entrevista e o instrumento de pesquisa consisti u de um formulario incluindo as principais manifestacoes locais e sistemicas relatadas pelas maes e pediatras durante a erupcao dos dentes deciduos, entre as quais irritabilidade, salivacao aumentada, febre, irritacao local, sono agitado e reducao de apetite. Os dados foram organizados com auxilio do Software EPI Info, 6.04 e apresentados por meio da estatistica descritiva e inferencial. A analise bivariada foi feita atraves dos Testes Qui- Quadrado e Exato de Fischer sendo empregado um nivel de significancia de 5%. Resultados: 21 pediatras (84%) notaram alteracoes em seus pacientes durante a erupcao da denticao decidua enquanto que 113 maes (96%) tambem afirmaram observar algumas alteracoes. Os sintomas mais citados pelos pediatras foram: irritabilidade (84%), inflamacao gengival e irritacao local (64%), salivacao aumentada (60%), e sono agitado (40%), enquanto que as maes relataram: salivacao aumentada (80%), irritabilidade (75%), irritacao local (66%), febre (55%) e diarreia (52%). Nao houve diferenca significativa p= 0,223 (teste qui-quadrado) em relacao a regiao da boca mais afetada sendo para os medicos a anterior (43%) e para as maes a posterior (39%). Conclusao: A maioria dos medicos pediatras e maes ou responsaveis afirmaram observar a associacao entre a sintomatologia sistemica e/ou local com a erupcao dos dentes deciduos.

Objective: To assess the perception of mothers and pediatricians about the presence of systemic and/or local symptoms during the period of eruption of the primary dentition. Method: This study was an observational and cross-sectional investigation with a sample composed by 25 pediatricians and 118 mothers of infants aged 3 to 36 months from different social classes selected at random from users of the Public Health Centers of Ponta Grossa, PR, Brazil. Data were collected by means of an interview and the research instrument was a form including the main local and systemic manifestations reported by the mothers and pediatricians during the eruption of primary teeth, among which irritability, increased salivary flow, fever, local irritation, agitated sleep and reduced appetite. Data were organized using the EPI Info, 6.04 soft ware and were presented by descriptive and inferential statistics. A bivariate analysis was done by the chi-square test and Fischer?s exact test with a significance level of 5%. Results: 21 pediatricians (84%) noticed alterations in their patients during the eruption of the primary dentition, while 113 mothers (96%) also observed some alterations. The most commonly cited symptoms by the pediatricians were: irritability (84%), gingival inflammation and local irritation (64%), increased salivary flow (60%), and agitated sleep (40%), while the mothers reported: increased salivary flow (80%), irritability (75%), local irritation (66%), fever (55%) and diarrhea (52%). There was no statistically significant difference (p= 0.223) regarding the most frequently affected region of the mouth, that is, anterior for the pediatricians (43%) and posterior for the mothers (39%). Conclusion: Most pediatricians and mothers/caregivers affirmed that they observed an associati on between systemic and/or local symptomatology and eruption of primary teeth.

Incidência de lesões de cárie em bebês após 15 meses de um programa educativo-preventivo / Incidence of carious lesions in infants after 15 months of an educative-preventive program

Objetivo: Avaliar um programa educativo/preventivo no controle da doença cárie em 160 bebês na faixa etária de 1 a 21 meses. Método: As crianças selecionadas, saudáveis e sem cárie, foram atendidas de 3 em 3 meses durante 15 meses. Em cada consulta, dependendo da idade da criança, o biofilme era removido com gaze ou escova infantil. Após exame visual, o número de dentes e eventuais alterações eram registradas. As mães foram orientadas em práticas preventivas adequadas utilizando-se de orientação verbal, cartazes e projeção de slides. Palestras educativas foram ministradas no início da pesquisa e de 6 em 6 meses. O exame bucal e treinamento materno em higiene foram realizados nas Unidades Básicas de Saúde, Centros Comunitários e Universidade. Com o intuito de verificar alterações nos hábitos alimentares e de higiene, foram aplicados questionários no início do estudo e após 12 meses. Resultados: A maioria das mães não possuía o ensino fundamental completo e a renda familiar variava de um a três salários mínimos. Após 15 meses, o percentual de desistência foi de 23,8%, sendo examinados 122 bebês. Nesses, a incidência de cárie foi de 7,3% com uma média de 0,25 dentes cariados. Incluindo as manchas brancas, a incidência de cárie foi de 9,8% com uma média de 0,4 dentes cariados. Conclusão: O programa educativo/preventivo contribuiu para uma menor incidência de cárie, estimulando a adoção de hábitos mais saudáveis, uma vez que ocorreu redução de 33% na amamentação noturna e aumento de 20,9% na higiene bucal.

Purpose: To evaluate an educative-preventive program in the control of caries disease in 160 infants aged 1 to 21 months.Method: Healthy and caries-free children were enrolled in the study and attended clinical visits at three-month intervals during 15 months. At each visit, depending on the child's age, the biofilm was removed with gauze or pediatric toothbrush. After visual examination, the number of teeth and eventual alterations were recorded. The mothers were instructed during adequate preventive practical activities using verbal instruction, posters and slide projection. Educative lectures were given at the beginning of the study and at 6-month intervals thereafter. The oral examination and maternal training were conducted at Basic Health Units, CommunityCenters and at the University. To verify the occurrence of changes in the dietary and hygiene habits, questionnaires were applied at the beginning of the study and after 12 months.Results: Most mothers have not completed the elementary education and their family income ranged from 1 to 3 minimum salaries. After 15 months, the withdrawal rate was 23.8%, totalizingan examined population of 122 babies. In these babies, caries incidence was 7.3% with 0.25 decayed teeth on average. Including the white spot lesions, caries incidence was 9.8% with 0.4 decayed teeth on average.Conclusions: The educative-preventive program contributed to lessen caries incidence by stimulating the adoption of healthier habits, as it was observed a reduction of 33% in nocturnal bottlefeedingand an increase of 20.9% in oral hygiene.

Promoção da saúde bucal em bebês participantes de um programa educativo-preventivo na cidade de Ponta-Grossa-PR / Oral health promotion in infant participants of one program educative preventive in the city of Ponta Grossa-PR

Avalia a influência de um programa educativo/preventivo na promoção da saúde bucal de 122 bebês, na faixa etária de 1 a 36 meses e suas respectivas mães, residentes na cidade de Ponta Grossa/PR. Através de questionários aplicados no início do estudo, e após 12 meses, identificou-se o conhecimento materno prévio e hábitos adotados com sua própria saúde bucal e a de seus filhos, bem como alterações ocorridas após transmissão de informações, para a instituição de hábitos saudáveis, desde os primeiros anos de vida. O grupo sob intervenção foi atendido de 3 em 3 meses, durante 15 meses. A cada consulta, as crianças tinham seus dentes higienizados, e suas mães acesso a orientações formativas, para práticas preventivas adequadas, além da possibilidade de incluí-las em suas pautas de vida. Ao final do estudo, foi examinado um segundo grupo com 106 crianças, na mesma faixa etária, não participantes do programa educativo/preventivo. A redução de hábitos inadequados e o menor percentual de lesões cariosas no grupo sob intervenção (9,83 por cento), em comparação com o grupo que não sofreu intervenção (38,68 por cento), sugere que: a) Apenas a informação ou conhecimento materno prévio sobre hábitos adequados, constatado através do questionário, não refletiu em atitudes saudáveis em relação à saúde bucal de seus filhos; b) O envolvimento materno com medidas educativas e preventivas, em programas de promoção da saúde bucal, podem determinar redução na prevalência da doença cárie em bebês; c) Ações educativas em programas de promoção da saúde bucal, aliadas ao reforço constante, desenvolveram habilidade e competência materna, estimulando o autocuidado em relação à saúde bucal de seus filhos; d) Integradas a um sistema de saúde de atenção básica, as ações educativas e preventivas resultam em medidas de impacto significativo, de baixa complexidade e baixo custo.