LED photobiomodulation effect on the bleaching-induced sensitivity with hydrogen peroxide 35%-a controlled randomized clinical trial.

OBJECTIVES: The aim of this study was to evaluate the effect of a protocol of photobiomodulation (PBM) with light-emitting diodes (LED) on the clinical risk of bleaching-induced sensitivity. MATERIALS AND METHODS: Sixty-four volunteers were selected and randomly divided in two groups, placebo (PG) and LED (LG). The LG received PBM irradiation and tooth bleaching, while the PG received tooth bleaching and simulation of the irradiation. The occurrence of painful sensitivity was recorded during the dental bleaching; immediately after bleaching; and 24, 48, and 72 h after tooth bleaching. At the same measurement times, data were collected on the intensity of sensitivity (VAS and NRS scale) and teeth affected by bleaching-induced sensitivity. A questionnaire sought to measure how the painful sensitivity influenced basic daily activities. Tooth color measures were performed using subjective and objective methods. RESULTS: LED irradiation decreased the occurrence of sensitivity at all studied evaluation times as well as its intensity, with the exception of the 72-h data when both groups presented no difference. Teeth affected by bleaching-induced sensitivity were significantly greater in the PG. Color measurements presented no differences between the groups in the recently after and later measures. CONCLUSIONS: PBM with LED decreases sensitivity risk and sensibility intensity during and after office bleaching and causes no influence on the shade degree of whitening achieved. The decrease in tooth sensitivity provided more comfort and less suffering while drinking. CLINICAL RELEVANCE: LED irradiation is a promising intervention in the control of bleaching-induced sensitivity. TRIAL REGISTRATION: RBR-7hpfwj. Sensitivity intensity measured by the VAS scale (0-10) in the first whitening session (Graphic A) and second whitening session (Graphic B). Significance level set at ≤ 5%. *Mann-Whiteney U test. Columns followed by the same letter are significant different (ap < 0.001; bp < 0.001; cp < 0.001; dp =0.013; ep < 0.001; fp < 0.001; gp < 0.001; hp = 0.002).

In situ evaluation of 200 ppm fluoride toothpaste content trimetaphosphate, xylitol and erythritol on enamel demineralization and dental biofilm.

OBJECTIVE: To evaluate the effect of low-fluoride (F-) toothpaste and sodium trimetaphosphate (TMP) associated with xylitol and erythritol (XE) on enamel demineralization and biofilm composition. METHODS: This crossover double-blind in situ study consisted of five phases (seven days each), in which 14 volunteers wore oral appliances containing four enamel bovine blocks. The cariogenic challenge was performed by exposure to a 30% sucrose solution (6x/day). The toothpaste treatments (3x/day) were as follows: placebo (no F-/TMP/XE); 200 ppm F- (NaF) (200F); 1,100 ppm F- (1100F); 16% Xylitol and 4% Erythritol (XE); and 200 ppm F-, 0.2% TMP, 16% xylitol, and 4% erythritol (200F-TMP-XE). Percentage of surface hardness loss (%SH) and integrated loss of subsurface hardness (ΔKHN), and calcium (Ca2+), phosphate (PO43-), and F- on enamel and biofilm were determined; as well as insoluble extracellular polysaccharide (EPS). RESULTS: XE and 1100F groups showed no significant difference for %SH and ΔKHN values (p = 0.220 and p = 0.886), and the 200F-TMP-XE group had the lowest mineral loss (p < 0.001). Ca2+ and PO43- in the enamel showed the highest values (p < 0.001) for the 200F-TMP-XE group. Higher values of F- in the enamel and biofilm were observed for the 1100F group (p < 0.001). There was no difference for Ca2+ (p = 1.00) and EPS (p =0.918) values between XE and 200-TMP-XE groups in the biofilm, but their values were higher and lower than the 1100F (p = 0.002 and p = 0.029), respectively. CONCLUSIONS: 200F-TMP-XE promoted a greater protective effect against enamel demineralization and significantly affected the composition of biofilm formed in situ compared to 1100F toothpaste. CLINICAL SIGNIFICANCE: Low-F- toothpaste containing TMP and polyols can be considered an effective and safe measure to improve the oral health of individuals, especially patients with high caries activity.

Relationship of levels of trace elements in saliva and dental caries in preschool children using total reflection X-ray fluorescence technique (TXRF)⋆.

BACKGROUND: Considering that studies on the relationship between dental caries and trace elements present contradictory and inconclusive results, the purpose of this study was to determine the levels of salivary trace elements in saliva samples of preschool children and investigate their relationship with dental caries. METHODS: In total, 120 samples of unstimulated saliva were collected from children aged 36-72 months, of both sexes, who participate in the preventative educational program in oral health at the State University of Londrina, Brazil. The children were divided into two groups, caries (n = 60) and non-caries (n = 60). Levels of Al, Cu, Fe, Mn, and Zn were analyzed by total reflection X-ray fluorescence (TXRF). Descriptive statistics, the Student's t-test, Mann-Whitney U test, and Pearson's Chi-squared test were performed (P < 0.05). RESULTS: The concentrations of Mn and Fe were significantly higher in the caries group (Mn =0.015 mg/L [0.007-0.020]; Fe =0.080 mg/L [0.031-0.239] than the non-caries group (Mn =0.010 mg/L [0.001 - 0.017]; Fe =0.044 mg/L [0.023 - 0.107]). CONCLUSION: The results suggest a relationship between trace elements and dental caries, indicating possible involvement of these elements in the metabolism of microorganisms involved in the carious process. In addition, the use of TXRF presented satisfactory results, with a simple and fast methodology for the detection of the studied elements.

Ellis-Van Creveld Syndrome, neonatal teeth and breastfeeding impairment: a case report / Síndrome de Ellis-Van Creveld, dentes neonatais e dificuldade de aleitamento materno: um relato de caso

ABSTRACT Because of multisystemic impairment in patients with Ellis-van Creveld syndrome, multidisciplinary care may be demanded since birth to assure breastfeeding. This report presents a case of an Ellis-van Creveld infant that was facing breastfeeding difficulties because of maxillary neonatal teeth. A 3 months old male infant with Ellis-van Creveld syndrome was referred to Pediatric Dentistry Department because of two upper neonatal teeth causing breastfeeding difficulties. Clinical examination revealed that teeth position was compatible to 51 and 61, and both presented uncommon ectopic soft tissue placement, conical crown and hypoplastic enamel covered by a large amount of dental biofilm. Radiography indicated they were of normal series and had 2/3 of crown completion. Due to teeth mobility that impaired breastfeeding, treatment option was exodontia. Early tooth eruption, such as in natal and neonatal teeth, by itself can't be considered a reason for exodontia. But exodontia must be considered when an early erupted tooth(s) impairs breastfeeding, especially in systemically compromised infants. In this present case report, after teeth extraction, the infant was able to breastfeed and gain weight properly.

RESUMO Devido ao comprometimento multissistêmico em pacientes com Síndrome de Ellis-Van Creveld, cuidados multidisciplinares podem ser necessários desde o nascimento a fim de assegurar o aleitamento materno. O presente relato apresenta um caso de um bebê portador de Síndrome de Ellis-Van Creveld, o qual apresentava dificuldades durante a amamentação devido a dentes neonatais superiores. Um bebê de 3 meses de vida, portador da Síndrome de Ellis-Van Creveld foi encaminhado ao Departamento de Odontopediatria, por apresentar dois dentes neonatais superiores, os quais estavam causando dificuldades durante o aleitamento materno. O exame clínico demonstrou que a posição dos dentes era compatível com os dentes decíduos #51 e #61, ambos apresentavam implantação ectópica incomum em tecido mole, apresentavam coroa cônica e esmalte hipoplásico coberto por grande quantidade de biofilme dentário. O exame radiográfico indicou que os dentes eram compatíveis com a série normal e apresentavam desenvolvimento completo de 2/3 da coroa. Devido a mobilidade dentária, a qual prejudicava o aleitamento materno, a opção de tratamento foi a exodontia. A erupção dentária precoce, como ocorre com dentes natais ou neonatais, por si só não pode ser considerada motivo para a realização de exodontia, porém esta deve ser considerada, quando prejudica o aleitamento materno, especialmente em bebês sistemicamente comprometidos. No presente relato de caso, após a exodontia, o bebê conseguiu realizar o aleitamento materno e apresentou ganho de peso correto.

Microporosity and polymerization contraction as function of depth in dental resin cements by X-ray computed microtomography.

This research aimed to obtain the depth dependence of polymerization contraction and microporosity from irradiated dental resin cements by X-ray computed microtomography (µCT). Samples (n = 5) of commercial Relyx U200 (RU) and AllCem Core (AC) dual-cure resin cements were injected in a cylindrical Teflon sampler (25 mm3 ) and separated according to polymerization mechanism: self-cured (not irradiated) and dual-cured (irradiated from the top surface with a LED device). The cement's volume was scanned with the µCT scanning conditions kept constant. To assess the depth dependence of polymerization contraction, it was measured the displacement of the cement mass from the sample holder at 30 vertical cuts (0.1 mm distant). To probe the microporosity, the percentage of area with presence of porosity by slice was obtained. All data were statistically treated. It was observed a positive linear correlation between depth and polymerization contraction in the irradiated groups. In the other hand, the concentration of micropores decreased with increasing depth. Furthermore, the composition of the resin cement was determinant for the correlation's coefficients of these physical properties with depth. The µCT technique showed to be useful to probe physical properties of dental restorative materials that influence in the clinical outcomes, revealing that, for thin specimens, when light cured the RU cement presented mechanical behavior more favorable for clinical applications.

Salivary levels of Interleukin-6 and Tumor Necrosis Factor-alpha in girls aged 7-17 years practicing volleyball / Niveles salivales de interleucina 6 y factor de necrosis tumoral alfa en niñas de 7 a 17 años que practican voleibol

INTRODUCTION: The purpose of the study was to evaluate the salivary concentrations of Interleukin-6 (IL-6) and Tumor Necrosis Factor-alpha (TNFalfa) and correlate the findings with the caries index, body mass index (BMI), potency of lower limbs (vertical jump), cardiorespiratory fitness, and risk of developing cardiovascular diseases in girls practicing volleyball. MATERIAL AND METHODS: Two studies were performed: 1) a cross-sectional study (n = 120) on the association of IL-6 and TNFalfa with the caries index, anthropometric measures, physical tests, and experience in volleyball practice; 2) longitudinal study (n = 63) on the effects of 8 weeks of training on salivary IL-6 and TNFalfa in girls with intermediate experience in volleyball and competitive girls. RESULTS: The median levels of IL-6 were 1.98 [1.55-3.11] pg/ml and TNFalfa, 0.46 [0.28-0.59] pg/ml and these did not correlate with the caries index, BMI, training volume, training practice, or cardiovascular risk. A correlation was observed between IL-6 and TNFalfa (r = 0.34; p < 0.001), IL-6 and vertical jump height (r = -0.28, p < 0.005), and TNFα and age (r = 0.33; p < 0.001). After 8 weeks of training, TNFα levels increased in the intermediate and competitive groups (p < 0.05), while IL-6 levels decreased only in the intermediate level group (p < 0.05). CONCLUSION: the median levels of IL-6 and TNFalfa did not correlate with the caries index, BMI, training volume, experience practice, or cardiovascular risk. Salivary levels of IL-6 were downmodulated in the group with intermediate experience and TNFalfa was upmodulated by training

INTRODUCCIÓN: el objetivo del estudio fue evaluar las concentraciones salivales de interleukina-6 (IL-6) y factor de necrosis tumoral alfa (TNFalfa) y correlacionarlas con el índice de caries, el índice de masa corporal (IMC), potencia muscular de miembros inferiores (salto vertical), la aptitud cardiorrespiratoria y riesgo de desarrollar enfermedades cardiovasculares en niñas que practican voleibol. MATERIAL Y MÉTODOS: se realizaron dos estudios: 1) un estudio transversal (n = 120) sobre la asociación de IL-6 y TNFalfa con índice de caries, medidas antropométricas, pruebas físicas y experiencia en la práctica de voleibol; 2) estudio longitudinal (n = 63) sobre el efecto de 8 semanas de entrenamiento em IL-6 y TNFalfa salivales en niñas con experiencia intermedia en voleibol y chicas competitivas. RESULTADOS: los niveles medianos de IL-6 fueron 1.98 [1.55 - 3.11] pg/ml y TNFalfa fue 0.46 [0.28 - 0.59] pg/ml y no se correlacionaron con el índice de caries, el IMC, el volumen de entrenamiento, la práctica de entrenamiento y el riesgo cardiovascular. Se observó una correlación entre IL-6 y TNFalfa (r = 0.34; p < 0.001), IL-6 y altura de salto vertical (r = -0.28, p < 0.005), y TNFalfa y edad (r = 0.33; p < 0.001). Después de 8 semanas de entrenamiento, los niveles de TNFalfa aumentaron en los grupos intermedios y competitivos (p < 0.05), mientras que los niveles de IL-6 disminuyeron solo en el grupo intermedio (p < 0.05). CONCLUSIÓN: los niveles medianos de IL-6 y TNFalfa no se correlacionaron con el índice de caries, el IMC, el volumen de entrenamiento, la experiencia práctica y el riesgo cardiovascular. Los niveles salivales de IL-6 se modificaron a la baja en el grupo con experiencia intermedia y el TNFα se moduló al alza mediante el entrenamiento

Initial inflammatory response after the pulpotomy of rat molars with MTA or ferric sulfate.

PURPOSE: To compare, both qualitatively and quantitatively, the inflammatory cells, vascular density and IL-6 immunolabeled cells present in the pulp after pulpotomy with white MTA versus 15.5% ferric sulfate (FS). METHODOLOGY: Forty-eight mandibular first molars from 24 Wistar rats were divided into MTA or FS groups and subdivided according to the period after pulpotomy procedure (24, 48 and 72 hours). Four teeth (sound and untreated) were used as controls. Histological sections were obtained and assessed through the descriptive analysis of morphological aspects of pulp tissue and the quantification of inflammatory cells, vascular density and interleukin-6 (IL-6) expression. Data were statistically analyzed (p<0.05). RESULTS: The number of inflammatory cells was similar in both groups, being predominantly localized at the cervical radicular third. In the MTA group, increased inflammation was observed at 48 hours. Vascular density was similar in both groups and over time, being predominant in the medium radicular third. No correlation was found between the number of inflammatory cells and the vascular density. Pulp tissue was more organized in MTA-treated teeth. In both groups, a weak to moderate IL-6 expression was detected in odontoblasts and inflammatory cells. Comparing both groups, there was a greater IL-6 expression in the cervical radicular third of teeth treated with MTA at 24 hours and in the medium and apical thirds at 72 hours, while in the FS group a greater IL-6 expression was found in the apical third at 24 hours. CONCLUSION: The MTA group presented better histological features and greater IL-6 expression than the FS group. However, no difference was observed between the groups regarding the inflammatory status and vascularization, suggesting the usefulness of FS as a low-cost alternative to MTA.

Initial inflammatory response after the pulpotomy of rat molars with MTA or ferric sulfate

Abstract Purpose To compare, both qualitatively and quantitatively, the inflammatory cells, vascular density and IL-6 immunolabeled cells present in the pulp after pulpotomy with white MTA versus 15.5% ferric sulfate (FS). Methodology Forty-eight mandibular first molars from 24 Wistar rats were divided into MTA or FS groups and subdivided according to the period after pulpotomy procedure (24, 48 and 72 hours). Four teeth (sound and untreated) were used as controls. Histological sections were obtained and assessed through the descriptive analysis of morphological aspects of pulp tissue and the quantification of inflammatory cells, vascular density and interleukin-6 (IL-6) expression. Data were statistically analyzed (p<0.05). Results The number of inflammatory cells was similar in both groups, being predominantly localized at the cervical radicular third. In the MTA group, increased inflammation was observed at 48 hours. Vascular density was similar in both groups and over time, being predominant in the medium radicular third. No correlation was found between the number of inflammatory cells and the vascular density. Pulp tissue was more organized in MTA-treated teeth. In both groups, a weak to moderate IL-6 expression was detected in odontoblasts and inflammatory cells. Comparing both groups, there was a greater IL-6 expression in the cervical radicular third of teeth treated with MTA at 24 hours and in the medium and apical thirds at 72 hours, while in the FS group a greater IL-6 expression was found in the apical third at 24 hours. Conclusion The MTA group presented better histological features and greater IL-6 expression than the FS group. However, no difference was observed between the groups regarding the inflammatory status and vascularization, suggesting the usefulness of FS as a low-cost alternative to MTA.

Smear layer removal by different chemical solutions used with or without ultrasonic activation after post preparation.

OBJECTIVES: This study evaluated smear layer removal by different chemical solutions used with or without ultrasonic activation after post preparation. MATERIALS AND METHODS: Forty-five extracted uniradicular human mandibular premolars with single canals were treated endodontically. The cervical and middle thirds of the fillings were then removed, and the specimens were divided into 9 groups: G1, saline solution (NaCl); G2, 2.5% sodium hypochlorite (NaOCl); G3, 2% chlorhexidine (CHX); G4, 11.5% polyacrylic acid (PAA); G5, 17% ethylenediaminetetraacetic acid (EDTA). For the groups 6, 7, 8, and 9, the same solutions used in the groups 2, 3, 4, and 5 were used, respectively, but activated with ultrasonic activation. Afterwards, the roots were analyzed by a score considering the images obtained from a scanning electron microscope. RESULTS: EDTA achieved the best performance compared with the other solutions evaluated regardless of the irrigation method (p < 0.05). CONCLUSIONS: Ultrasonic activation did not significantly influence smear layer removal.

Anti-dentine Salivary SIgA in young adults with a history of dental trauma in deciduous teeth.

Anti-dentin autoantibodies are associated with inflammatory root resorption in permanent teeth and are modulated by dental trauma and orthodontic force. However, it is not known whether deciduous tooth trauma can stimulate the development of a humoral immune response against dentin. The aim of this study was to evaluate the levels of salivary SIgA reactivity against human dentin extract in young adults with a history of trauma in the primary dentition. A sample of 78 patients, aged 18 to 25, who had completed an early childhood (0 to 5 years old) caries prevention program years earlier at the Universidade Estadual de Londrina Pediatric Clinic, underwent radiographic examination and salivary sampling. Anti-dentin SIgA levels were analyzed by immunoenzymatic assay and Western blotting. Although dental trauma to deciduous teeth had occurred in 34 (43.6%) of the patients, no differences in SIgA levels were detected between individuals who had experienced trauma and those who had not (p > 0.05). Multivariate regression analysis showed no association between dental trauma and SIgA levels (p > 0.05). Patients with a history of deciduous trauma presented low levels of anti-dentin antibodies, associated with orthodontic root resorption (p < 0.05). Western blot analysis showed that salivary antibodies recognized a single band of approximately 45 kDa in dentin extract. We concluded that salivary SIgA recognizes a specific component of the dentin matrix and that anti-dentin antibodies were not triggered by trauma to primary teeth. However, trauma to deciduous teeth may down-modulate SIgA in response to orthodontic root response.

Anti-dentine Salivary SIgA in young adults with a history of dental trauma in deciduous teeth

Anti-dentin autoantibodies are associated with inflammatory root resorption in permanent teeth and are modulated by dental trauma and orthodontic force. However, it is not known whether deciduous tooth trauma can stimulate the development of a humoral immune response against dentin. The aim of this study was to evaluate the levels of salivary SIgA reactivity against human dentin extract in young adults with a history of trauma in the primary dentition. A sample of 78 patients, aged 18 to 25, who had completed an early childhood (0 to 5 years old) caries prevention program years earlier at the Universidade Estadual de LondrinaPediatric Clinic, underwent radiographic examination and salivary sampling. Anti-dentin SIgA levels were analyzed by immunoenzymatic assay and Western blotting. Although dental trauma to deciduous teeth had occurred in 34 (43.6%) of the patients, no differences in SIgA levels were detected between individuals who had experienced trauma and those who had not (p > 0.05). Multivariate regression analysis showed no association between dental trauma and SIgA levels (p > 0.05). Patients with a history of deciduous trauma presented low levels of anti-dentin antibodies, associated with orthodontic root resorption (p < 0.05). Western blot analysis showed that salivary antibodies recognized a single band of approximately 45 kDa in dentin extract. We concluded that salivary SIgA recognizes a specific component of the dentin matrix and that anti-dentin antibodies were not triggered by trauma to primary teeth. However, trauma to deciduous teeth may down-modulate SIgA in response to orthodontic root response.

Estratégias para a implantação das diretrizes curriculares nacionais nos cursos de odontologia / Strategies for implanting national curriculum directives for odontological education

A Rede Unida é um movimento social que reúne pessoas, projetos e instituições comprometidas com os movimentos de mudança na formação e desenvolvimento dos profissionais de saúde e construção de um sistema de saúde equitativo e eficaz, com forte partcipação social. A rede formou-se em 1991, da parceria entre a rede IDA e os projetos UNI. A rede IDA foi constituida em 1985 e, como rede, articulava os projetos de integração docente-assistencial que existiam no Brasil. Tinha como objetivo promover o intercâmbio de experiências entre seus membros. Os projetos UNI foram estruturados no início da década de 90 e se inegravam noprograma "Uma Nova Iniciativa na Educação dos Profissionais de Saúde: união com a Comunidade", financiados pela Fundação W.L. Kellogg.