Infiltration by Streptococcus mutans in provisional crowns fixed by two types of cementing agents ­ pilot double-blind randomized clinical trial / Infiltração por Streptococcus mutans em coroas dentárias provisórias fixadas por dois tipos de agentes cimentantes ­ estudo clínico randomizado duplo-cego piloto

Objective: When provisional acrylic crowns are used for a long time, they become more susceptible to marginal leakage by cariogenic bacteria. The objectives of this pilot clinical study were to compare cement based on zinc oxide-eugenol and calcium hydroxide by contamination with Streptococcus mutans, and calculate the sample size for the continuation of this study. Methods: Individuals receiving provisional crowns and following inclusion/exclusion criteria, were randomly distributed into 2 groups: zinc oxide-eugenol (n=8); calcium hydroxide (n=9). The temporary crowns were made by a blind researcher and cemented by another. Patients were also blinded by the cement used inside their crowns. After 2 months, a cement sample from the crowns' peripheral inner face was collected, placed in a tube containing 1 mL of sterile saline, serially diluted, plated on Mitis Salivarius Bacitracin agar, and incubated for 48 hours. Colony-forming units (CFU/mL) were counted. A statistical power analysis was performed to calculate sample size (1-ß=80%) and the Mann Whitney test to compare both cements (α=0.05). Results: Both cements were contaminated with S. mutans, with an average of 166.6 x 102 CFU/mL for calcium hydroxide and 435.3 x 102 CFU/mL for zinc oxide-eugenol, with no significant difference (p=0.311). The sample size calculated for this study was 36 per group. Conclusion: This pilot study suggests that there is important contamination inside provisional crowns used for two months, independent of the cement. The continuation of this study is needed, with a bigger sample size, to enable a comparison between the cements.

Objetivo: Quando coroas dentais provisórias são utilizadas por um longo período, elas se tornam susceptíveis à infiltração marginal por bactérias cariogênicas. O objetivo deste estudo clínico piloto foi comparar os cimentos a base de óxido de zinco e eugenol e hidróxido de cálcio pela contaminação com Streptococcus mutans e calcular o tamanho amostral para continuação deste estudo. Métodos: Indivíduos recebendo coroas provisórias e seguindo critérios de inclusão/exclusão, foram distribuídos aleatoriamente em dois grupos: óxido de zinco e eugenol (n=8); hidróxido de cálcio (n=9). As coroas provisórias foram feitas por um pesquisador cego e cimentadas por outro. Os pacientes também foram cegos quanto ao cimento utilizado dentro de suas coroas. Depois de 2 meses, amostras de cimentos foram coletadas da face interna periférica das coroas, colocadas em um tubo contendo 1 mL de solução salina estéril, diluídas de forma seriada, plaqueadas em ágar Mitis Salivarius Bacitracina e incubadas por 48 horas. Unidades formadoras de colônias (UFC/mL) foram contadas. Um teste de poder estatístico foi realizado para calcular o tamanho amostral (1-ß=80%) e o teste de Mann Whitney para comparar os dois cimentos (α=0.05). Resultados: Os dois cimentos foram contaminados com S. mutans, com uma média de 166.6 x 102 UFC/mL para o hidróxido de cálcio e 435.3 x 102 UFC/mL para o óxido de zinco e eugenol, com nenhuma diferença significativa (p=0.311). O cálculo amostral para este estudo foi 36 indivíduos por grupo. Conclusão: Este estudo piloto sugere que existe importante contaminação dentro de coroas provisórias utilizadas por 2 meses, independente do cimento. A continuação deste estudo é necessária, com maior tamanho amostral, para possibilitar a comparação entre os cimentos.

Combined Effectiveness of ß-Cyclodextrin Nanoparticles in Photodynamic Antimicrobial Chemotherapy on In Vitro Oral Biofilms.

Objective: This study aimed to investigate if ß-cyclodextrin nanoparticles potentiate the photodynamic antimicrobial chemotherapy (PACT) effects in single and microcosm oral biofilms using methylene blue (MB) and a red laser. Background data: Studies of PACT have demonstrated promising effects; however, the association of nanoparticles with photosensitizers could enhance the antimicrobial result. Materials and methods: Biofilms were grown on enamel blocks either with Streptococcus mutans or in a microcosm model (salivary microorganisms) supplemented with sucrose. PACT using 50 µM MB associated or not with 32 µM encapsulated ß-cyclodextrin with MB for 5 min, followed by irradiation with red laser (λ = 660 nm, 320 J/cm2), was conducted and the counts of viable microorganisms in proper selective media were determined. Data were analyzed by one-factor ANOVA, followed by Tukey's test, or Kruskal-Wallis test, followed by Dunn's post hoc test, all with a significance level of 5%. Results: In the single-species biofilm model, a significant reduction in S. mutans counts was found for all groups when light was present. In the microcosm biofilm model, no significant difference was found among the groups for total streptococci, but a significant reduction of S. mutans was observed for the PACT group of encapsulated ß-cyclodextrin+MB. However, no statistically significant difference was observed among the PACT groups. Conclusions: PACT with ß-cyclodextrin mediated with MB associated with a red laser reduced S. mutans in microcosm biofilms. However, the presence of ß-cyclodextrin nanoparticles did not potentiate the PACT effects in single or microcosm oral biofilms.