Effects of quercetin on mineralized dental tissues: A scoping review.

OBJECTIVE: This scoping review (SR) aimed to investigate the impact of quercetin on mineralized dental tissues intended to be used in preventive and restorative dentistry. METHODS: This SR was conducted following the PRISMA-ScR statement. A comprehensive search was performed across databases for articles published up to March 2024. Eligible studies included in vitro and in situ studies and evaluating the potential therapeutic effects of quercetin on dental enamel and dentin. Data were extracted, and synthesis of study findings was conducted. RESULTS: Out of the 2322 records screened, 22 studies were included in the review. Quercetin, in solution or into dental materials increased the bond strength to enamel and dentin. Additionally, quercetin also enhanced the bond strength of enamel after bleaching. Co-administration of quercetin with fluoride prevented erosive wear and inhibited the proteolytic activity in dentin more effectively than either agent alone. Hardness and modulus of elasticity was higher in dentin treated with quercetin compared to placebo. Reduction of nanoleakage at the composite-dentin interface was reduced in the presence of quercetin as a solution or incorporated into dental adhesives. CONCLUSIONS: Quercetin exhibits promising therapeutic effects on mineralized dental tissues, including remineralization and enhancement of bond strength. It shows potential as a multifunctional agent for improving the longevity and effectiveness of dental biomaterials, as well as in preventing erosion and dental caries. However, as these conclusions are largely drawn from lab-based (in vitro) studies, further research, including clinical trials, is needed to fully explore its therapeutic potential and applications in dentistry.

Effect of a novel low-concentration hydrogen peroxide bleaching gel containing nano-sized sodium trimetaphosphate and fluoride.

OBJECTIVES: To evaluate in vitro the effects of nano-sized sodium trimetaphosphate (TMPnano) and sodium fluoride (F) added to a 17.5 % hydrogen peroxide (H2O2) bleaching gel on the color change, enamel mechanical and morphological properties, and H2O2 transamelodentinal diffusion. MATERIALS AND METHODS: Bovine enamel/dentin discs (n = 180) were divided according to the bleaching gel: 17.5 % H2O2 (17.5 % HP); 17.5 % H2O2 + 0.1 % F (HP/F); 17.5 % H2O2 + 1 % TMPnano (HP/TMPnano); 17.5 % H2O2 + 0.1 % F + 1 % TMPnano (HP/F/TMPnano) and 35 % H2O2 (35 % HP). The gels were applied for 40 min on three sessions, each session spaced 7 days apart. The total color change (ΔE*ab) according to the Commission Internationale de l'Eclairage (CIE) L*a*b* color change measured by CIEDE2000 (ΔE00), whitening index (ΔWID), surface hardness (SH), surface roughness (Ra), cross-sectional hardness (ΔKHN), and transamelodentinal diffusion were assessed. Enamel surfaces were examined using Scanning Electron Microscopy (SEM) and Energy Dispersive X-ray (EDS) analysis. The data were analyzed using ANOVA, followed by the Student-Newman-Keuls test (p < 0.05). RESULTS: ΔE*ab, ΔE00, and ΔWID values were comparable among the gels that produced a bleaching effect post-treatment (p < 0.001). The HP/F/TMPnano group exhibited lower mineral loss (SH and ΔKHN), Ra, and H2O2 diffusion compared to the 17.5 % HP and 35 % HP groups, which had the highest values (p < 0.001). SEM/EDS analysis revealed surface changes in all bleached groups, though these changes were less pronounced with F/TMPnano. CONCLUSIONS: The 17.5 % HP gel containing F/TMPnano maintains the bleaching effect while reducing enamel demineralization, roughness, H2O2 diffusion, and enamel morphological changes. CLINICAL RELEVANCE: Low-Concentration H2O2 bleaching gel containing F/TMPnano can be used as a novel approach to enhance safety and maintain the performance of aesthetic effects.

Exploring the potential of rapid maxillary expansion and masticatory muscle activity in unilateral posterior crossbite.

Background: This systematic review and meta-analysis aimed to evaluate if rapid maxillary expansion improves the activity of the masticatory muscles (masseter and temporal) in patients with unilateral posterior crossbite. Material and Methods: Searches were performed in PubMed/MEDLINE, Scopus, Web of Science, Embase, Cochrane Library, and grey literature. A manual search of orthodontic journals was also performed. Randomized clinical trials or longitudinal prospective studies were eligibles. Meta-analyses were conducted using R software with the "Meta" package, applying mean differences with a 95% confidence interval. Risk of bias was assessed using the Newcastle-Ottawa scale, and evidence certainty was evaluated using GRADE. Results: Nine articles were included. Qualitative analysis showed that RME treatment in patients with unilateral posterior crossbite showed a positive correlation with improvement in masseter and temporalis muscle activity. Meta-analyses indicated a significant difference for all models of muscle activity after treatment with rapid maxillary expansion, except for the temporal muscle in the force exerted on the maximum voluntary clenching on cotton rolls. The studies showed low bias risk, and the evidence certainty for each analysis was generally low to very low. Conclusions: This investigation demonstrated the benefits of R rapid maxillary expansion in treating unilateral posterior crossbite and its potential therapeutic effects on the masticatory muscles. Key words:Rapid maxillary expansion, masticatory muscles, unilateral posterior crossbite, systematic review, meta-analysis.

Antimicrobial photodynamic therapy in the nonsurgical treatment of periodontitis in patients with HIV infection: a systematic review and meta-analysis.

The aim of this systematic review and meta-analysis (SRM) was to evaluate the effectiveness of the adjunctive use of antimicrobial photodynamic therapy (aPDT) in non-surgical periodontal treatment (NSPT) in subjects with Human Immunodeficiency Virus (HIV) and periodontitis. This SRM was registered in PROSPERO (CRD42023410180) and followed the guidelines of PRISMA 2020. Searches were performed in different electronic databases. Risk of bias was performed using the Cochrane Risk of Bias tool (RoB 2.0) for randomized clinical trials (RCT). Meta-analysis was performed using Rev Man software. The mean difference (MD) measure of effect was calculated, the random effect model was applied with a 95% confidence interval, and heterogeneity was tested by the I2 index. The certainty of the evidence was rated using GRADE. A total of 1118 records were screened, and four studies were included. There was a greater reduction in the microbial load of periodontopathogens after NSPT with aPDT. Meta-analysis showed that probing depth (post 3 and 6 months) and clinical attachment loss (post 6 months) were lower for the aPDT-treated group than the NSPT alone: MD -0.39 [-0.74; -0.05], p = 0.02; MD -0.70 [-0.99; -0.41], p < 0.0001; MD -0.84 [-1,34; -0.34], p = 0.0001, respectively. Overall, the studies had a low risk of bias and, the certainty of evidence was rated as moderate. It is suggested that aPDT is a promising adjuvant therapy, showing efficacy in the reduction of the microbial load and in some clinical parameters of individuals with periodontitis and HIV.

Antimicrobial Effect of Low-Fluoride Toothpastes Containing Polyphosphate and Polyols: An In Vitro Assessment of Inhibition Zones.

This study evaluated the antimicrobial effect of toothpastes containing 200 ppm fluoride (200F), xylitol (X, 16%), erythritol (E, 4%), and sodium trimetaphosphate (TMP, 0.25%), alone or in different associations, against Streptococcus mutans (SM), Lactobacillus casei (LC), Actinomyces israelii (AI), and Candida albicans (CA). Suspensions of the micro-organisms were added to a BHI Agar medium. Five wells were made on each plate to receive toothpaste suspensions at different dilutions. Toothpastes containing no actives (placebo) or 1100 ppm F (1100F) were used as negative and positive controls. Two-way ANOVA and Tukey's HDS test were used (p < 0.05). For SM, the largest halo was for 200F+TMP at all dilutions, followed by the 200F+X+E toothpaste (p < 0.001). For LC, the overall trend showed that the polyols effectively inhibited microbial growth, and the association with the other compounds enhanced such effects (p < 0.001). For AI, a less-defined trend was observed. For CA, the experimental toothpaste (200F+X+E+TMP) was consistently more effective than the other treatments, followed by 200F+X+E (p < 0.001). The association of polyols and TMP in a low-fluoride toothpaste effectively reduced the growth of cariogenic micro-organisms (SM, CA, and LC), suggesting that this formulation could be an interesting alternative for children due to its low fluoride content.

Evaluation of Solutions Containing Fluoride, Sodium Trimetaphosphate, Xylitol, and Erythritol, Alone or in Different Associations, on Dual-Species Biofilms.

Although the association of polyols/polyphosphates/fluoride has been demonstrated to promote remarkable effects on dental enamel, little is known on their combined effects on biofilms. This study assessed the effects of solutions containing fluoride/sodium trimetaphosphate (TMP)/xylitol/erythritol on dual-species biofilms of Streptococcus mutans and Candida albicans. Biofilms were grown in the continuous presence of these actives alone or in different associations. Quantification of viable plate counts, metabolic activity, biofilm biomass, and extracellular matrix components were evaluated. Overall, fluoride and TMP were the main actives that significantly influenced most of the variables analyzed, with a synergistic effect between them for S. mutans CFUs, biofilm biomass, and protein content of the extracellular matrix (p < 0.05). A similar trend was observed for biofilm metabolic activity and carbohydrate concentrations of the extracellular matrix, although without statistical significance. Regarding the polyols, despite their modest effects on most of the parameters analyzed when administered alone, their co-administration with fluoride and TMP led to a greater reduction in S. mutans CFUs and biofilm biomass compared with fluoride alone at the same concentration. It can be concluded that fluoride and TMP act synergistically on important biofilm parameters, and their co-administration with xylitol/erythritol significantly impacts S. mutans CFUs and biomass reduction.

Efeito de géis fluoretados suplementados com trimetafosfato de sódio nanoparticulado sobre a remineralização do esmalte dental in situ / Effect of fluoride gels supplemented with nanosized sodium trimetaphosphate on enamel remineralization in situ

O objetivo do presente estudo foi avaliar o efeito de géis fluoretados suplementados com nanopartículas de Trimetafosfato de Sódio (TMP) sobre a remineralização de lesões de cárie artificiais in situ. Blocos de esmalte dental bovino (n=160) foram aleatoriamente divididos entre os grupos de estudo após análise de dureza de superfície (DS) e indução de lesões de subsuperfície. Os géis testados foram: Placebo (sem flúor ou TMP ­ controle negativo), 9000 µg F/g (9000F ­ controle positivo), 4500 µg F/g + 5% TMP microparticulado (4500 5%TMPmicro) e 4500 µg F/g + 5% TMP nanoparticulado (4500 5%TMPnano). Dez voluntários utilizaram dispositivos palatinos contendo 4 blocos de esmalte durante 3 dias, após uma única aplicação dos géis, seguindo um protocolo duplo-cego e cruzado. Dois blocos de esmalte foram removidos imediatamente após a aplicação dos géis, para determinar a concentração de fluoreto de cálcio (CaF2) formado. Após cada fase, determinou-se a porcentagem de recuperação de dureza de superfície (%RDS) e CaF2 retido no esmalte. Os dados foram submetidos ANOVA de medidas repetidas e teste de Student-Newman-Keuls (p< 0.05). A maior %RDS foi observada para o gel 4500 5%TMPnano, seguido por 4500 5%TMPmicro, 9000F e Placebo, com diferenças significativas entre os grupos. Em relação ao CaF2 formado, a maior concentração foi observada para o grupo 9000F. Não foram observadas diferenças significativas entre os grupos 9000F, 4500 5%TMPmicro e 4500 5%TMPnano para concentrações de CaF2 retido. Conclui-se que a adição de TMP a géis fluoretados melhorou significativamente a remineralização de lesões de cárie in situ. O uso de TMP em escala nanométrica potencializou ainda mais este efeito(AU)

The present study aimed to evaluate the effect of fluoride gels supplemented with nano-sized sodium trimetaphosphate (TMP) on the remineralization of artificial caries lesions in situ. Bovine enamel blocks (n=160) were randomly distributed among study groups after surface microhardness (SH) analysis and induction of subsurface lesions. Test groups included: Placebo (without F and TMP ­ negative control), 9000 µg F/g (9000F ­ positive control), 4500 µg F/g + 5% micrometric TMP (4500 5%+ TMPmicro) and 4500 µg F/g + 5% nano-sized TMP (4500 + 5%TMPnano). Ten volunteers used palatal devices containing 4 enamel blocks during 3 days, after a single application of gels, following a double-blind and crossover protocol. Two enamel blocks were removed immediately after topical application of F to determine calcium fluoride (CaF2) formed on enamel. After each phase, the samples were analyzed by percentage of surface hardness recovery (%SHR) and CaF2 retained on enamel. Data were analyzed by repeated-measures ANOVA and Student-NewmanKeuls test (p< 0.05). The highest %SHR was observed for 4500 5%TMPnano gel, following by 4500 5%TPMmicro, 9000F, and Placebo, with significant differences among all groups. Regarding CaF2 formed, the highest concentration was observed in the 9000F group. No significant differences were observed among 9000F, 4500 5%TMPmicro and 4500 5%TMPnano groups for concentrations of CaF2 retained. It was concluded that the addition of TMP to gels improved the remineralization of caries lesions in situ. The use of nano-sized TMP further enhanced this effect(AU)