Acquired Pellicle Engineering Using a Combination of Organic (Sugarcane Cystatin) and Inorganic (Sodium Fluoride) Components against Dental Erosion.

This study evaluated the combination of a sugarcane cystatin (CaneCPI-5) and sodium fluoride (NaF) in acquired pellicle engineering for the prevention of dental erosion in vitro. Seventy-five human enamel specimens were prepared and divided into 5 treatment groups (n = 15/group): Deionized water (Control); Elmex™ (SnCl2/NaF/AmF); 0.1 mg/mL CaneCPI-5; 500 ppm NaF; and CaneCPI-5+NaF (Combination). The specimens were individually treated (200 µL; 2 min; 37°C), then incubated in human saliva (200 µL; 1 h, at 37°C) for acquired pellicle formation. Afterward, the specimens were submitted to an erosive challenge (1% citric acid [CR], pH 3.6, 10 mL, 2 min, 25 °C). This sequence was conducted 5 times. Percentage of surface microhardness change (%SMC), relative surface reflection intensity (rSRI), and calcium released to the CR were measured and analyzed by one-way ANOVA followed by Tukey's test (p < 0.05). In general, all the treatments (SnCl2/NaF/AmF, CaneCPI-5, NaF, and Combination) significantly protected the enamel when compared the control group. Regarding %SMC and rSRI, the Combination was the most effective treatment, reducing the %SMC significantly (p < 0.01) when compared to all the other treatments, although this difference was not significant in the CR analysis. All treatments demonstrated a protective effect on enamel against dental erosion; however, the combination of CaneCPI-5 with NaF showed a greater protection.

Solutions and Gels Containing a Sugarcane-Derived Cystatin (CaneCPI-5) Reduce Enamel and Dentin Erosion in vitro.

The effect of solutions and gels containing a sugarcane-derived cystatin (CaneCPI-5) on the protection against enamel and dentin erosion in vitro was evaluated. Bovine enamel and dentin specimens were divided into 2 groups (n = 135 and 153/group for enamel and dentin, respectively) that were treated with solutions or chitosan gels containing 0.1 or 0.25 mg/mL CaneCPI-5. The positive controls for solutions and gels were Elmex Erosion Protection™ solution and NaF gel (12,300 ppm F), respectively. Deionized water and chitosan gel served as controls, respectively. The solutions were first applied on the specimens for 1 min and the gels for 4 min. Stimulated saliva was collected from 3 donors and used to form a 2-h acquired pellicle on the specimens. Then, the specimens were submitted to an erosive pH cycling protocol 4 times/day for 7 days (0.1% citric acid pH 2.5/90 s, artificial saliva/2 h, and artificial saliva overnight). The solutions and gels were applied again during pH cycling, 2 times/day for 1 min and 4 min, respectively, after the first and last erosive challenges. Enamel and dentin losses (µm) were assessed by contact profilometry. Data were analyzed by 2-way ANOVA and Tukey's test (p < 0.05). All the treatments significantly reduced enamel and dentin loss in comparison with controls. Both CaneCPI-5 concentrations had a similar protective effect against enamel erosion, but only the higher concentration was as effective against dentin erosion as the positive control. Regarding the vehicles, only the 0.1 mg/mL gel performed worse than the positive control for dentin. CaneCPI-5 reduced enamel and dentin erosion to a similar extent as the fluoride-containing vehicles. However, dentin requires higher CaneCPI-5 concentrations, in the case of gels. Solutions or gels containing CaneCPI-5 might be a new approach to protect against dental erosion.

Efficacy of TiF4 and NaF varnish and solution: a randomized in situ study on enamel erosive-abrasive wear.

OBJECTIVES: This in situ/ex vivo study analysed the anti-erosive/abrasive effect of TiF4 and NaF varnish and solution on enamel wear. MATERIALS AND METHODS: Twelve subjects took part in this study which was performed in three periods (phases) with the duration of 5 days each. Each two human enamel specimens per subject were pretreated with experimental NaF varnish or solution (phase A), experimental-TiF4 varnish or solution (phase B) and placebo varnish or untreated control (phase C). The specimens were worn in palatal appliances; one enamel specimen, from each treatment, was subjected to erosion (ERO; cola soft drink, 4 × 90 s/day), and the other specimen was subjected to erosion plus abrasion (ERO + ABR; tooth brushing, 2 × 10 s/day). The tooth wear was quantified by a contact profilometer (micrometre) and analysed using two-way repeated measures ANOVA and Bonferroni's test (n = 12 subjects, p < 0.05). RESULTS: All fluoride varnishes and solutions reduced the enamel wear (around 25 %) significantly compared to the control and placebo varnish. There were no significant differences among the fluoride formulations and between the conditions ERO and ERO + ABR. CONCLUSIONS: Therefore, it can be concluded that TiF4 has the same protective potential as NaF formulations to reduce human enamel wear under this experimental in situ model. CLINICAL SIGNIFICANCE: In vitro studies have indicated a better anti-erosive/abrasive effect of TiF4 compared to NaF varnish. The present in situ study does not support the previous findings. Therefore, any of the tested professional fluoride varnishes in principle could be able to partially reduce enamel wear.

In vivo modification of the enamel pellicle and saliva resveratrol levels after use of resveratrol-containing orodispersible capsules.

OBJECTIVES: To evaluate in vivo 1) the bioavailability of trans-resveratrol when administered through sublingual capsules; 2) the effect of resveratrol on the protein composition of the acquired enamel pellicle (AEP). DESIGN: Ten volunteers received a sublingual capsule containing 50 mg of trans-resveratrol. Unstimulated saliva was then collected after 0, 30, 60, and 120 min and AEP was collected after 120 min following administration of the capsule. In the next week, the volunteers received a placebo sublingual capsule, and saliva and AEP were collected again. Saliva samples were analyzed for free trans-resveratrol using high-performance liquid chromatopgraphy (HPLC), and AEP samples were subjected to proteomic analysis (nLC-ESI-MS/MS). RESULTS: Trans-resveratrol was detected in saliva at all the time points evaluated, with the peak at 30 min. A total of 242 proteins were identified in both groups. Ninety-six proteins were increased and 23 proteins were decreased in the Resveratrol group. Among the up-regulated proteins, isoforms of cystatins, PRPs, Mucin-7, Histatin-1, Lactotrasnferrin and Lysozyme-C were increased and the isoforms of Protein S100, Neutrophil defensins, Albumin, PRPs, and, Statherin were decreased in Resveratrol group. CONCLUSION: The sublingual capsule is effective at increasing the bioavailability of trans-resveratrol in saliva. Several proteins involved in important processes to maintain systemic and oral health homeostasis were identified. These proteins differently expressed due to the presence of trans-resveratrol deserve attention for future studies, since they have important functions, mainly related to antimicrobial action.

Increase in plasma resveratrol levels and in acid-resistant proteins in the acquired enamel pellicle after use of resveratrol-containing orodispersible tablets.

OBJECTIVE: This study evaluated the effect of administration of trans-resveratrol-containing orodispersible tablets on the protein composition of the AEP and on blood plasma trans-resveratrol concentrations. METHODS: Ten volunteers participated in two crossover double-blind phases. In each phase, after dental prophylaxis, they received a trans-resveratrol (15 mg) orodispersible tablet, or a placebo tablet (without actives). The AEP formed after 120 min was collected with electrode filter papers soaked in 3 % citric acid. Blood samples were collected 30, 45, 60 and 120 min after the use of the tablet. After protein extraction, AEP samples were analyzed by shotgun labelfree quantitative proteomics and plasma samples were analyzed by high-performance liquid chromatography (HPLC). RESULTS: Eight hundred and two proteins were identified in the AEP. Among them, 336 and 213 were unique to the trans-resveratrol and control groups, respectively, while 253 were common to both groups. Proteins with important functions in the AEP had increased expression in the trans-resveratroltreated group, such as neutrophil defensins, S100 protein isoforms, lysozyme C, cystatin-D, mucin-7, alphaamylase, albumin, haptoglobin and statherin. Trans-resveratrol was detected in the plasma at all the times evaluated, with the peak at 30 min. CONCLUSIONS: The administration of trans-resveratrol in sublingual orodispersible tablets was effective both to increase the bioavailability of the polyphenol and the expression of antibacterial and acid-resistant proteins in the AEP, which might benefit oral and general health.

Effect of NaF and TiF(4) varnish and solution on bovine dentin erosion plus abrasion in vitro.

OBJECTIVES: This in vitro study aimed to analyze the effect of TiF(4) compared to NaF varnishes and solutions, to protect against dentin erosion associated with abrasion. MATERIALS AND METHODS: Bovine dentin specimens were pre-treated with NaF-Duraphat (2.26% F), NaF/CaF(2)-Duofluorid (5.63% F), experimental-NaF (2.45% F), experimental-TiF(4) (2.45% F) and placebo varnishes; NaF (2.26% F) and TiF(4) (2.45% F) solutions. Controls remained untreated. The erosive pH cycling was performed using a soft drink (pH 2.6) 4 × 90 s/day and the toothbrushing-abrasion 2 × 10 s/day, in vitro for 5 days. Between the challenges, the specimens were exposed to artificial saliva. Dentin tissue loss was measured profilometrically (µm). RESULTS: ANOVA/Tukey's test showed that all fluoridated varnishes (Duraphat, 7.5 ± 1.1; Duofluorid, 6.8 ± 1.1; NaF, 7.2 ± 1.9; TiF(4), 6.5 ± 1.0) were able to significantly reduce dentin tissue loss (40.7% reduction compared to control) when compared to placebo varnish (11.2 ± 1.3), control (11.8 ± 1.7) and fluoridated (NaF, 9.9 ± 1.8; TiF(4), 10.3 ± 2.1) solutions (p < 0.0001), which in turn did not significantly differ from each other. CONCLUSION: All fluoridated varnishes, but not the solutions, had a similar performance and a good potential to reduce dentin tissue loss under mild erosive and abrasive conditions in vitro. Risk patients for erosion and abrasion, especially those with exposed dentin, should benefit from this clinical preventive measure. Further research has to confirm this promising result in the clinical situation.

The erosion and abrasion-inhibiting effect of TiF(4) and NaF varnishes and solutions on enamel in vitro.

OBJECTIVE. Previous in vitro study has shown that TiF(4) varnish might reduce enamel erosion. No data regarding the effect of this experimental varnish on enamel erosion plus abrasion, however, are available so far. Thus, this in vitro study aimed to analyse the effect of TiF(4) compared with NaF varnishes and solutions, to protect against enamel erosion with or without abrasion. METHODS. Enamel specimens were pre-treated with experimental-TiF(4) (2.45% F), experimental-NaF (2.45% F), NaF-Duraphat (2.26% F), and placebo varnishes; NaF (2.26% F) and TiF(4) (2.45% F) solutions. Controls remained untreated. The erosive challenge was performed using a soft drink (pH 2.6) 4 × 90 s/day (ERO) and the toothbrushing abrasion (ERO+ABR) 2 × 10 s/day, for 5 days. Between the challenges, the specimens were exposed to artificial saliva. Enamel loss was measured profilometrically (µm). RESULTS. Kruskal-Wallis/Dunn tests showed that all fluoridated varnishes (TiF(4) -ERO:0.53 ± 0.20, ERO+ABR:0.65 ± 0.19/NaF-ERO:0.94 ± 0.18, ERO+ABR:1.74 ± 0.37/Duraphat-ERO:1.00 ± 0.37, ERO+ABR:1.72 ± 0.58) were able to significantly reduce enamel loss when compared with placebo varnish (ERO:3.45 ± 0.41/ERO+ABR:3.20 ± 0.66) (P < 0.0001). Placebo varnish, control (ERO:2.68 ± 0.53/ERO+ABR:3.01 ± 0.34), and fluoridated (NaF-ERO:2.84 ± 0.09/ERO+ABR:2.40 ± 0.21/TiF(4) -ERO:3.55 ± 0.59/ERO+ABR:4.10 ± 0.38) solutions did not significantly differ from each other. CONCLUSION. Based on the results, it can be concluded that the TiF(4) varnish seems to be a promising treatment to reduce enamel loss under mild erosive and abrasive conditions in vitro.

Characterization of white spot lesions formed on human enamel under microcosm biofilm for different experimental periods.

The initial characteristics of white spot lesion (WSLs), such as the degree of integrated mineral loss (ΔZ), depth and pattern of mineral distribution, have an impact on further demineralization and remineralization. However, these lesion parameters have not been evaluated in WSLs produced from microcosm biofilms. OBJECTIVE: This study characterized artificial white spot lesions produced on human enamel under microcosm biofilm for different experimental periods. METHODOLOGY: In total, 100 human enamel specimens (4x4mm) were assigned to 5 distinct groups (n=20/group) differing according to the period of biofilm formation (2, 4, 6, 8 or 10 days). Microcosm biofilm was produced on the specimens from a mixture of human and McBain saliva at the first 8h. Enamel samples were then exposed to McBain saliva containing 0.2% sucrose. WSLs formed were characterized by quantitative light-induced fluorescence (QLF) and transverse microradiography (TMR). Data were analyzed by ANOVA/Tukey or Kruskal-Wallis/Dunn tests (p<0.05). RESULTS: A clear time-response pattern was observed for both analyses, but TMR was able to better discriminate among the lesions. Regarding QLF analysis, median (95%CI; %) changes in fluorescence ∆Z were -7.74(-7.74:-6.45)a, -8.52(-8.75:-8.00)ab, -9.17(-10.00:-8.71)bc, -9.58(-10.53:-8.99)bc and -10.01(-11.44:-9.72)c for 2, 4, 6, 8, and 10 days, respectively. For TMR, median (95%CI; vol%.µm) ∆Z were 1410(1299-1479)a, 2420(2327-2604)ab, 2775(2573-2899)bc, 3305(3192-3406)cd and 4330(3972-4465)d, whereas mean (SD; µm) lesion depth were 53.7(12.3)a, 71.4(12.0)a, 103.8(24.8)b, 130.5(27.2)bc, 167.2(39.3)c for 2, 4, 6, 8 and 10 days, respectively. CONCLUSION: The progression of WSLs formed on human enamel under microcosm biofilm can be characterized over 2-10 days, both by QLF and TMR analyses, although the latter provides better discrimination among the lesions.

Protective effect of calcium silicate toothpaste on enamel erosion and abrasion in vitro.

OBJECTIVES: To compare in vitro the effect of a toothpaste containing fluoride (F), calcium silicate (CaSi) and sodium phosphate salts to conventional toothpaste (NaF) on human enamel specimens submitted to erosive and abrasive challenges. METHODS: 48 sound and 48 enamel samples pre-treated with 1% citric acid were divided into 4 groups (n = 12): Group 1- Non-fluoride toothpaste; Group 2- NaF toothpaste (1450 ppmF); Group 3- CaSi toothpaste (1450 ppmF; MFP); Group 4- Erosion only. The samples were subjected to pH cycling (3 cycles/day; 90s; 1% citric acid, pH 3.6) and to abrasion for 7 days. After the 1st and the last cycle, they were submitted to abrasion (15s, 1.5N load), using a brushing machine, soft toothbrush and toothpaste slurry (1:3; 15ml/sample) and then immersed in the slurry for 45s. Samples were immersed in artificial saliva between the challenges. Enamel loss was evaluated using profilometry on days 3 and 7. Data were analysed by ANOVA and Tukey's test (p < 0.05). RESULTS: For sound enamel at baseline, mean (±SD) enamel loss (µm) for groups 1-4 on day 3 was 2.15 ± 0.35a, 1.20 ± 0.22b, 0.95 ± 0.19b and 1.98 ± 0.32a; on day 7 was 3.05 ± 0.40a, 2.07 ± 0.32b, 1.36 ± 0.33c and 3.69 ± 0.27d respectively. For acid-softened enamel at baseline, enamel loss on day 3 was 3.16 ± 0.19a, 2.17 ± 0.14b, 1.70 ± 0.11c and 3.04 ± 0.19a; on day 7 was 3.92 ± 0.25a, 3.07 ± 0.13b, 2.09 ± 0.15c and 3.87 ± 0.25a respectively. CONCLUSIONS: Both F toothpastes led to significantly higher enamel protection from short-term erosion and abrasion in comparison to the non-F toothpaste and erosion only. In the longer term, CaSi toothpaste conferred significantly higher protection than NaF toothpaste. CLINICAL SIGNIFICANCE: The results showed that for the longer term the CaSi toothpaste provided significantly higher protection than the NaF toothpaste, which indicates a good potential of the former to help prevent erosive tooth wear.

Do commercial whitening dentifrices increase enamel erosive tooth wear?

OBJECTIVE: This in vitro study evaluated the effect of commercial whitening dentifrices on erosive tooth wear (ETW) of bovine enamel samples, in comparison with commercial regular dentifrices. METHODOLOGY: Sixty bovine crowns were embedded in acrylic resin, polished and then had their baseline profile determined. They were randomly assigned to 5 groups (n=12/group), according to the type of commercial dentifrice to be tested: GI - Crest Anti-cavity Regular; GII - Crest 3D White; GIII - Colgate Total 12 Clean Mint; GIV - Colgate Optic White; GV - Placebo (negative control, fluoride-free dentifrice). The samples were submitted to daily erosive and abrasive challenges for 3 days. The erosive challenges were performed 3 times a day by immersing the specimens in 0.1% citric acid solution (pH 2.5) for 90 s. Each day after the first and last erosive challenges, the specimens were subjected to the abrasive challenge for 15 s, using a toothbrushing machine (Biopdi, São Carlos, SP, Brazil), soft toothbrushes and slurry (1:3 g/ml) of the tested toothpastes (1.5 N). The specimens were kept in artificial saliva between the challenges. The final profile was obtained and the ETW (µm) was calculated. Data were analyzed by Kruskal-Wallis and Dunn's tests (p<0.05). RESULTS: All dentifrices tested significantly reduced the enamel wear in comparison with the Placebo, except GIII. The median (95% CI) ETW was 1.35 (1.25-1.46)bc for GI, 1.17 (1.01-1.34)cd for GII, 1.36 (1.28-1.45)ab for GIII, 1.08 (1.04-1.14)d for GIV and 2.28 (2.18-2.39)a for GV. CONCLUSION: When dentifrices from the same manufacturer were compared, the whitening dentifrices led to similar or less wear than the regular ones.

"RichBlend" protocol for full-face filling and collagen biostimulation / Protocolo "RichBlend" para preenchimento facial e bioestimulação de colágeno

ABSTRACT The "RichBlend" protocol was designed for facial filling and collagen biostimulation, by means of a mixture of calcium hydroxyapatite (CaHA), hyaluronic acid (AH) and autologous platelet concentrates. This work reports the case of a 53-year-old patient with cutaneous photoaging, loss of facial volume, multiple rhythms in the frontal and periorbital regions, also marked skin flaccidity, especially the eyelid. The treatment was done with botulinum toxin (65 U) and the "RichBlend" protocol. Venipuncture was performed and the blood was centrifuged to obtain i-PRF (injectable platelet-rich fibrin) and plasma gel. After venipuncture and blood centrifugation, i-PRF and plasma gel were obtained. CaHA (Radiesse®) was diluted: a) in saline solution + i-PRF (hyperdilution) for biostimulationof the lower third of the face; and b) in AH (Juvederm Ultraplus XC®) + plasma gel, for hydrolifting on the forehead and dark circles, malar and temples. Plasma gel was applied to the nasogenian grooves and then the entire face was properly massaged. The "RichBlend" protocol rejuvenated the patient, as it promoted filling, volumizing, collagen formation (biostimulation), reduction of flaccidity, in addition to skin whitening. Since HA and CaHA are high-cost products, their mixture with autologous platelet concentrates, in liquid or gel form, allows the use of a greater amount of filled and biostimulator material on the face, at a more affordable cost.

RESUMO O protocolo "RichBlend" foi idealizado para preenchimento facial e bioestimulação de colágeno, por meio da mistura de hidroxiapatita de cálcio (CaHA), ácido hialurônico (AH) e concentrados plaquetários autólogos. Este trabalho relata o caso de um paciente de 53 anos, com fotoenvelhecimento cutâneo, perda de volume facial, múltiplas rítides nas regiões frontal e periorbital, apresentando também acentuada flacidez cutânea, especialmente palpebral. Foi feito o tratamento com toxina botulínica (65 U) e protocolo "RichBlend". Foi realizada a venopunção e o sangue foi centrifugado para obtenção da i-PRF (fibrina rica em plaquetas injetável) e do plasma gel. Após venopunção e centrifugação sanguínea, obtiveram-se a i-PRF e o plasma gel. A CaHA (Radiesse®) foi diluída: a) em soro + i-PRF (hiperdiluição) para bioestimulação do terço inferior da face; e b) em AH (Juvederm Ultraplus XC®) + plasma gel, para hidrolifting na fronte e preenchimentos de olheira, malar e têmporas. Plasma gel foi aplicado nos sulcos nasogenianos e, em seguida, toda a face foi devidamente massageada. O protocolo "RichBlend" rejuvenesceu o paciente, pois promoveu preenchimento, volumização, formação de colágeno (bioestimulação), redução da flacidez, além do clareamento cutâneo. Uma vez que o AH e a CaHA são produtos de alto custo, sua mistura com os concentrados plaquetários autólogos, na forma líquida ou gel, permite a utilização de uma maior quantidade de material preenchedor e bioestimulador na face, com custo mais acessível.

Absence of DNA damage in multiple organs (blood, liver, kidney, thyroid gland and urinary bladder) after acute fluoride exposure in rats.

Fluoride has been widely used in dentistry as a caries prophylactic agent. However, there has been some speculation that excess fluoride could cause an impact on genome integrity. In the current study, the potential DNA damage associated with exposure to fluoride was assessed in cells of blood, liver, kidney, thyroid gland and urinary bladder by the single cell gel (comet) assay. Male Wistar rats aging 75 days were distributed into seven groups: Groups 1 (control), 2, 3, 4, 5, 6 and 7 received 0 (deionized water), 10, 20, 40, 60, 80 and 100 mgF/Kg body weight from sodium fluoride (NaF), respectively, by gastrogavage. These groups were killed at 2 h after the administration of the fluoride doses. The level of DNA strand breaks did not increase in all organs evaluated and at all doses of NaF tested, as depicted by the mean tail moment. Taken together, our results suggest that oral exposure to NaF did not result in systemic genotoxic effect in multiple organs related to fluoride toxicity. Since DNA damage is an important step in events leading to carcinogenesis, this study represents a relevant contribution to the correct evaluation of the potential health risk associated with chemical exposure.

Availability of fluoride from meals given to kindergarten children in Brazil.

OBJECTIVES: The aim of this study was to evaluate the amount of fluoride supplied daily in the meals given in 44 public kindergarten schools in Bauru, Brazil. In addition, the fluoride concentration of water supplies and its impact on the amount of fluoride found in the meal samples were also investigated. METHODS: Meal samples and water were collected during 2 weeks (10 working days) in public kindergarten schools. Samples of meals were homogenized with known volumes of deionized water. Fluoride present in meal samples was analyzed with the ion-specific electrode (Orion 9609), after hexamethyldisilazane-facilitated diffusion. Fluoride in water samples was analyzed with the same electrode, after buffering with TISAB II. All the analyses were made in duplicate. RESULTS: Fluoride analyzed (mean+/-SD) was 0.50+/-0.20 microg/ml, ranging from nondetectable to 1.42 microg/ml for water samples (n=424) and 0.067+/-0.059 mg, ranging from 0.007 to 0.580 mg for meal samples (n=431). A weak but significant correlation was observed between the amount of fluoride in meals and fluoride concentration in water supplies (r=0.139, P=0.0042). CONCLUSIONS: Despite the seemingly small role played by school meals in the total daily fluoride intake, they can contribute to the total fluoride intake of children on a chronic basis, when in association with other fluoride products. Additionally, the impact of fluoridated public water supply on the final fluoride concentration of the school meals analyzed may be regarded as low.

Do commercial whitening dentifrices increase enamel erosive tooth wear?

Abstract Objective This in vitro study evaluated the effect of commercial whitening dentifrices on erosive tooth wear (ETW) of bovine enamel samples, in comparison with commercial regular dentifrices. Methodology Sixty bovine crowns were embedded in acrylic resin, polished and then had their baseline profile determined. They were randomly assigned to 5 groups (n=12/group), according to the type of commercial dentifrice to be tested: GI - Crest Anti-cavity Regular; GII - Crest 3D White; GIII - Colgate Total 12 Clean Mint; GIV - Colgate Optic White; GV - Placebo (negative control, fluoride-free dentifrice). The samples were submitted to daily erosive and abrasive challenges for 3 days. The erosive challenges were performed 3 times a day by immersing the specimens in 0.1% citric acid solution (pH 2.5) for 90 s. Each day after the first and last erosive challenges, the specimens were subjected to the abrasive challenge for 15 s, using a toothbrushing machine (Biopdi, São Carlos, SP, Brazil), soft toothbrushes and slurry (1:3 g/ml) of the tested toothpastes (1.5 N). The specimens were kept in artificial saliva between the challenges. The final profile was obtained and the ETW (µm) was calculated. Data were analyzed by Kruskal-Wallis and Dunn's tests (p<0.05). Results All dentifrices tested significantly reduced the enamel wear in comparison with the Placebo, except GIII. The median (95% CI) ETW was 1.35 (1.25-1.46)bc for GI, 1.17 (1.01-1.34)cd for GII, 1.36 (1.28-1.45)ab for GIII, 1.08 (1.04-1.14)d for GIV and 2.28 (2.18-2.39)a for GV. Conclusion When dentifrices from the same manufacturer were compared, the whitening dentifrices led to similar or less wear than the regular ones.

Effect of domestic water filters on water fluoride content and level of the public water supply in Bauru, Brazil.

PURPOSE: The purpose of this study was to evaluate the extent to which domestic, activated carbon water filters remove fluoride from water and to analyze the fluoride level of the public water supply in Bauru, province of São Paulo, Brazil. METHODS: Samples of filtered and nonfiltered tap water were collected from 180 houses in 9 different regions in the city; each served with its own water treatment facility. Fluoride was analyzed with the ion specific electrode (Orion 9609). RESULTS: Of the filters presented in the 180 houses, only 12 removed fluoride from water, either totally (3) or partially (9). Water fluoride concentrations in 6 regions were within the acceptable range (0.5 to 1.0 ppm). Overfluoridation was observed in 1 area, and underfluoridation was seen in 2 areas. CONCLUSIONS: Most domestic activated carbon filters did not remove fluoride from water. Children who drank filtered water did not need fluoride supplementation. As has been shown in other studies, the fluoride level in the public water supply in some regions of Bauru was not adequate on the day analyzed.

Nails as biomarkers of fluoride in children of fluoridated communities.

PURPOSE: The objective of this study was to verify the use of nails as biomarkers of chronic fluoride (F) exposure from the diets of children living in communities with negligibly or optimally fluoridated water. METHODS: Fifteen 2- to 6-year-old children living in Bauru-São Paulo (fluoridated) and 15 lifelong residents of Itápolis-São Paulo (nonfluoridated) participated in the study. Fluoride concentrations in nails and duplicate diet were analyzed with the electrode, following hexamethyldisiloxane (HMDS)-facilitated diffusion. Data were analyzed by student's t-test and linear regression (P < .05). RESULTS: Mean fluoride concentrations ([microg/g) in fingernails and toenails of Bauru children were 3.56 +/- 1.3 and 2.81 +/- 1.29, respectively, and for Itápolis children 2.29 +/- 1.25 and 1.58 +/- 0.59, respectively. The differences between Bauru and Itápolis children, as well as between fluoride concentrations in fingernails and toenails, were statistically significant. The estimated fluoride intake from the diet was significantly higher for Bauru children (0.55 +/- 0.61 mg) when compared to Itápolis children (0.09 +/- 0.06 mg). A significant positive correlation was found between the mean of fingernail and toenail fluoride concentrations and estimated fluoride intake from the diet (r = 0.57). CONCLUSIONS: This study's preliminary data suggests that fingernails and toenails may be used as biomarkers of chronic fluoride exposure from the diet. Additional studies are necessary to determine the predictive values, sensitivity, and specificity of this biomarker so that nails are used to differentiate children at the age of dental fluorosis risk and who live in communities with negligibly or optimally fluoridated water.

Effect of a single application of TiF(4) and NaF varnishes and solutions on dentin erosion in vitro.

OBJECTIVES: This in vitro study aimed to analyse the effect of a single application of TiF(4) and NaF varnishes and solutions to protect against dentin erosion. METHODS: Bovine root dentin samples were pre-treated with NaF-Duraphat varnish (2.26%F, pH 4.5), NaF/CaF(2)-Duofluorid varnish (5.63%F, pH 8.0), NaF-experimental varnish (2.45%F, pH 4.5), TiF(4)-experimental varnish (2.45%F, pH 1.2), NaF solution (2.26%F, pH 4.5), TiF(4) solution (2.45%F, pH 1.2) and placebo varnish (pH 5.0, no-F varnish control). Controls remained untreated. Ten samples in each group were then subjected to an erosive demineralisation (Sprite Zero, 4x 90s/day) and remineralisation (artificial saliva, between the erosive cycles) cycling for 5 days. Dentin loss was measured profilometrically after pre-treatment and after 1, 3 and 5 days of de-remineralisation cycling. The data were statistically analysed by two-way ANOVA and Bonferroni's post hoc test (p<0.05). RESULTS: After pre-treatment, TiF(4) solution significantly induced surface loss (1.08+/-0.53 microm). Only Duraphat reduced the dentin loss overtime, but it did not significantly differ from placebo varnish (at 3rd and 5th days) and TiF(4) varnish (at 3rd day). CONCLUSIONS: Duraphat varnish seems to be the best option to partially reduce dentin erosion. However, the maintenance of the effects of this treatment after successive erosive challenges is limited.

Fluoride ingestion from food items and dentifrice in 2-6-year-old Brazilian children living in a fluoridated area using a semiquantitative food frequency questionnaire.

OBJECTIVES: The aim of this study was to evaluate the fluoride intake of 2-6-year-old Brazilian children using a semiquantitative food frequency questionnaire (FFQ) which also estimated fluoride intake from dentifrice. METHODS: The FFQ was previously validated through application to 78 2-6-year-old Brazilian children and then administered to 379 children residing in an optimally fluoridated community in Brazil (Bauru, State of São Paulo). The FFQ was applied to the parents and used to estimate the food intake of the children. The constituents of the diet were divided into solids, water and other beverages. The fluoride content of the diet items was analyzed with the fluoride electrode. The questionnaire also estimated fluoride intake from dentifrice. RESULTS: The average (+/-SD) fluoride intake from solids, water, other beverages and dentifrice was 0.008 +/- 0.005; 0.011 +/- 0.004; 0.009 +/- 0.014 and 0.036 +/- 0.028 mg F/kg body weight/day, respectively, totalizing 0.064 +/- 0.035 mg F/kg body weight/day. The dentifrice and the diet contributed with 56.3% and 43.7% of the daily fluoride intake, respectively. Among the children evaluated, 31.2% are estimated to have risk to develop dental fluorosis (intake>0.07 mg F/kg body weight/day). CONCLUSIONS: The dentifrice was the main source of fluoride intake by the children evaluated. However, the fluoride concentration in food items also significantly contributed to the daily ingestion by 2-6-year-old children. The questionnaire used seems to be a promising alternative to duplicate diet to estimate the fluoride intake at this age range and may have potential to be used in broad epidemiological surveys.

Prevalence of dental fluorosis in Bauru, São Paulo, Brazil.

OBJECTIVE: To evaluate the prevalence of dental fluorosis in scholars aging 12 to 15 years old, residents in the city of Bauru, State of São Paulo, Brazil. METHODS: 1318 volunteers were enrolled in this study and examined in 18 public schools of the State of São Paulo. The examinations were performed in the schools' court by three dentists (with a Master's degree in Public Health), after toothbrushing supervised by another dentist. The teeth were dried with cotton pellets and examined under natural light by visual inspection, using an explorer as recommended by the WHO, a plane mirror and a tongue depressor. The Thylstrup-Fejerskov (TF) index was used for rating fluorosis. Intra and inter-examiner reproducibility was calculated and data were submitted to descriptive analysis. RESULTS: Approximately 36% of the children presented dental fluorosis, of which 28% was diagnosed as TF1 while the remaining received scores between TF2 and TF4. CONCLUSION: The prevalence of dental fluorosis in Bauru is within the expected range, based on previous studies. Although fluoride is an important resource for caries control, its use must be adequate to the needs of each specific population.

Consumo de fluoreto a partir de alimentos por crianças de 2 a 6 anos de idade, no município de Bauru, São Paulo / Consumption of fluoride from food by children aged 2 to 6 years in the city of Bauru, São Paulo

Taking into consideration that the dental fluorosis has increased in all regions, it is important to evaluate the daily contribution of children's food consumption and the concentration of fluoride in these food items, besides the water and tooth paste, to the intake of fluoride. The objective of this work was to describe the food fluoride intake by children aged 2 to 6 years. A sample of 379 children from Bauru, state of São Paulo, were evaluated. The sampling was stratified by sector based on the Directive Planning of the City. The food intake was evaluated by the Food Frequency Semi quantitative Questionnaire applied to parents or people responsible for the children, and the concentration of fluoride in the food items was determined by laboratory analyses. The most consumed food items presented an average (±DP) fluoride concentration of(0.015±0.028mg F/portion), significantly lower (p=0.03) than the concentration in the less consumed food items (0.107±0.162mgF/portion).The food items with the greatest concentrations of fluoride contributed significantly (p<0.001) to the intake of the mineral (0.018±0.037mgF/day).The average amount of fluoride intakes from solid and liquid foods, water and tooth brushing were 0.017±0.016; 0.011±0.004 and 0.036±0.028mgF/kgweight/day, respectively, summing up 0.064±0.035mgF/kg weight/day. Of the379 children, 31.2% presented risk of fluorosis. The toothpaste and the food items contributed with 57% and 43%, respectively, to the intake of fluoride. The toothpaste was the main source of fluoride intake by children. However, the concentration of this mineral in food items contributed significantly to its intake by the children, representing a risk for dental fluorosis

Considerando que la fluorosis dental há aumentado en todas las regiones, es importante evaluar, además del agua y del dentífrico, la contribución diaria del consumo alimentario delos niños y la concentración de flúor en es os artículos alimentarios para la ingestión de este halógeno. Describir el consumo alimentario de niños, de 2 a 6 años, en relación al flúor. Fueron evaluados 379 niños residentes en Bauru ­ São Paulo. La muestra fue escalonada por sector del Plano Director del Municipio. El consumo alimentario fue evaluado utilizando el Cuestionario de Frecuencia Alimentaria Semicuantitativa, aplicado a los padres o apoderados, y la concentración de flúor en los artículos alimentarios por medio de análisis de laboratorio. Los artículos alimentarios más consumidos presentaron, como promedio (-DP), concentración de flúor (0,015 ­ 0,028mgF/porción)significantemente menor (p = 0,03) que los menos consumidos (0,107 ­ 0,162mgF/porçión).Los artículos alimentarios con mayor concentración de flúor contribuyeron significativamente (p<0,001) para la ingestión del halógeno (0,018 ­ 0.037mgF/día). El promedio de la ingestión de flúor contenido em alimentos sólidos y líquidos, del agua y delcepillado fue de 0,017 ­ 0,016; 0,011 ­ 0,004 y0,036 ­ 0,028mgF/kg peso/día, respectivamente, totalizando 0,064 ­ 0,035mgF/kg peso/día. De los379 niños, 31,2% presentan riesgo de fluorosis. El dentífrico y los artículos alimentarios contribuyeron con 57% y 43%, respectivamente, para la ingestión de flúor. El dentífrico fue la principal fuente para la ingestión de flúor por los niños, pero la concentración de ese halógeno em los artículos alimentarios contribuyó significativamente para la ingestión, representando riesgo para la fluorosis dentaria

Considerando-se que a fluorose dentária tem aumentado em todas as regiões é importante avaliar, além da água e do dentifrício, a contribuição diária do consumo alimentar das crianças e a concentração de flúor nesses itens alimentares para a ingestão deste halogênio. O trabalho teve por objetivo descrever o consumo alimentar de crianças, de 2 a 6 anos, com relação ao flúor. Foram avaliadas 379 crianças residentes em Bauru ­ São Paulo. A amostragem foi estratificada por setor, baseando-se no Plano Diretor do Município. O consumo alimentar foi avaliado pelo Questionário de Freqüência Alimentar Semiquantitativo, aplicado aos pais ou responsáveis, e a concentração de flúor nos itens alimentares a partir de análises laboratoriais. Os itens alimentares mais consumidos apresentaram, em média (±DP),concentração de flúor (0,015 ± 0,028 mgF/porção)significantemente menor (p = 0,03) que os menos consumidos (0,107 ± 0,162 mgF/porcão). Os itens alimentares com maior concentração de flúor contribuíram significantemente (p<0,001) para a ingestão do flúor (0,018 ± 0,037 mgF/dia). A média da ingestão de flúor por meio dos alimentos sólidos e líquidos, da água e da escovação foi de 0,017 ± 0,016; 0,011 ± 0,004 e 0,036 ± 0,028 mgF/kg peso/dia, respectivamente, totalizando 0,064 ± 0,035 mgF/kg peso/dia. Das 379 crianças, 31,2% apresentaram risco de fluorose. O dentifrício e os itens alimentares contribuíram com 57% e 43%, respectivamente, para a ingestão de flúor. O dentifrício foi a principal fonte para a ingestão de flúor pelas crianças, porém, a concentração do flúor nos itens alimentares contribuiu significantemente para a ingestão, representando risco para a fluorose dentária