ABSTRACT
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.
Subject(s)
Tooth Demineralization , Toothpastes , Animals , Biofilms , Cariostatic Agents/pharmacology , Cattle , Cross-Over Studies , Dental Enamel , Double-Blind Method , Erythritol , Fluorides/pharmacology , Hardness , Humans , Tooth Demineralization/prevention & control , Toothpastes/pharmacology , Xylitol/pharmacologyABSTRACT
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.
