Erosive potential of powdered juice drinks on dental enamel.

This study aimed to evaluate the erosive potential of powdered juice drinks on dental enamel in 2 stages: physiochemical characterization and erosive challenge testing. In stage 1, the pH and titratable acidity of 5 commercially available powdered juices in 10 different flavors were analyzed. Five treatment groups were then established based on the pH values, titratable acidity, and presence of citric acid in the juices, and their energy-dispersive X-ray (EDX) spectroscopy profiles were studied. In stage 2, the erosive effect of the juices was tested using a pH cycling model; polished bovine dental enamel blocks (n = 8) were treated 4 times daily on 5 consecutive days with 1% citric acid (positive control) or lemon, orange, pineapple, or cashew juice. The specimens were immersed in the erosive solutions, under agitation (100 rpm), for 1 minute at 25°C. Overnight and between treatments, the blocks were stored in artificial saliva without agitation. At the end of cycling, the enamel surfaces were evaluated by profilometry and scanning electron microscopy. The stage 2 results were submitted to 1-way analysis of variance followed by Tukey test (α = 0.05). The pH values of the juices ranged between 2.86 (lemon) and 3.84 (cashew), while the titratable acidity ranged from 14.5 (cashew) to 90.00 (lemon) mmol/L. Lemon juice showed the least calcium content (2.76%) and no (0.00%) phosphorus concentration. Orange, pineapple, and cashew juices showed the greatest concentrations of calcium and phosphorus and were therefore less erosive than lemon juice. The mean [SD] surface loss was higher in the lemon juice group (0.52 [0.16] µm), with no significant differences (P > 0.05) from the control (0.39 [0.09] µm) and orange juice (0.41 [0.12] µm). In groups exposed to pineapple juice (0.36 [0.04] µm) and cashew juice (0.16 [0.08] µm), the surface loss was significantly lower (P < 0.05) than that found in lemon juice. The results demonstrate that powdered juice drinks (especially lemon juice) present erosive potential and lead to surface loss of dental enamel.

Blastic Plasmacytoid Dendritic Cell Neoplasm with Pulmonary Involvement and Atypical Skin Lesion.

BACKGROUND Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematodermic malignancy neoplasm with highly aggressive course and poor prognosis. This disease typically presents with cutaneous involvement as the first manifestation, with subsequent or simultaneous spread to bone marrow and peripheral blood.  CASE REPORT Here, we report the case of a 51-year-old woman who presented a violaceus skin lesion on the lateral region of the right thigh, weight loss, fever, and lymphadenopathies. Computed tomography (CT) displayed thoracic and abdominal lymph node and alveolar bleeding. Flow cytometry from circulating blastic cells was compatible with BPDCN (CD4+, CD56+ and CD123+). She underwent 5 cycles of hyper-CVAD alternating with high-dose methotrexate and cytarabine, but the patient died due to alveolar bleeding and sepsis. CONCLUSIONS We report a rare case of BPDCN characterized by an aggressive course, presence of atypical skin lesion, a finding suggestive of pulmonary infiltration, and nonresponse to induction chemotherapy, leading to late diagnosis and therapeutic management. Because of the late recognition of the skin lesion, neoplastic cells infiltrated the dermis and spread as the disease progressed rapidly to a fatal course.

Effect of in-office bleaching with 35% hydrogen peroxide with and without addition of calcium on the enamel surface.

This study aimed to evaluate effectiveness and effects of bleaching with 35% hydrogen peroxide with and without calcium on color, micromorphology, and the replacement of calcium and phosphate on the enamel surface. Thirty bovine enamel blocks (5.0 × 5.0 mm) were placed into the following groups: G1: artificial saliva (control); G2: 35% hydrogen peroxide gel without calcium (Whiteness HP Maxx-FGM); and G3: 35% hydrogen peroxide gel with calcium (Whiteness HP Blue-FGM). Three color measurements were performed with a spectrophotometer: untreated (baseline), after performing staining, and after application of bleaching agents. Calcium deposition on the enamel was evaluated before and after the application of bleaching agents using energy-dispersive X-ray spectrometry. The enamel surface micromorphology was observed under scanning electron microscopy. The pH of each product was measured. The data were subjected to one-factor analysis of variance (ANOVA), and any differences were analyzed using Tukey's test (P < 0.05). G3 showed greater variation in total color after the experiment than G2 and G1; there was no significant difference in calcium or phosphorus concentration before and after the experimental procedures; morphological changes were observed only in G2 and G3; and the pH values of the Whiteness HP Maxx and Whiteness HP Blue bleaching agents were 5.77 and 7.79, respectively. The 35% hydrogen peroxide with calcium showed greater bleaching potential, but the addition of calcium had no effect in terms of reducing morphological changes or increasing the calcium concentration on the enamel surface.

A clinical investigation of the efficacy of a commercial mouthrinse containing 0.05% cetylpyridinium chloride to control established dental plaque and gingivitis.

OBJECTIVE: The objective of this independent, double-blind, parallel, six-week clinical study was to assess the efficacy of a commercially available mouthrinse containing 0.05% cetylpyridinium chloride (CPC) for controlling established dental plaque and gingivitis relative to that of a control mouthrinse without CPC. METHODS: Adult male and female subjects from the Maceió, Brazil area reported to the clinical facility, after having refrained from any oral hygiene procedures for 12 hours, and from eating, drinking, and smoking for four hours, for an assessment of the oral soft and hard tissues, and for a baseline gingivitis and dental plaque evaluation. Qualifying subjects were randomly assigned to one of the two treatment groups, and were provided with their assigned mouthrinse, and an adult soft-bristled toothbrush and toothpaste for home use. Over the six-week period of home use, during which there were no restrictions regarding diet or smoking habits, subjects were instructed to brush their teeth for one minute twice daily with the supplied toothbrush and a commercially available fluoride toothpaste, to rinse their mouths with water after brushing, and then to rinse with their assigned mouthrinse for one minute before expectorating. The use of any other oral hygiene products or procedures, such as floss or interdental stimulators, was not permitted during the study. After six weeks of product use, subjects returned to the clinical facility, having followed the same restrictions with respect to oral-hygiene procedures, eating and drinking, as with the baseline visit, and the oral soft and hard tissue assessments and gingivitis and dental plaque evaluations were repeated. RESULTS: One-hundred and ten subjects complied with the protocol and completed the study. With regard to supragingival plaque, after six weeks of product use, the subjects using the 0.05% CPC mouthrinse exhibited statistically significant reductions from baseline in whole-mouth Plaque Index scores (32.1%), in Plaque Index scores measured at interproximal sites (31.3%), and in Plaque Severity Index scores (84.8%). Subjects using the control mouthrinse exhibited statistically significant reductions from baseline in whole-mouth Plaque Index scores (7.0%), in Plaque Index scores measured at interproximal sites (6.4%), and in Plaque Severity Index scores (24.5%). When compared to the control mouthrinse group, the 0.05% CPC mouthrinse group presented statistically significant greater reductions in whole-mouth Plaque Index scores (27.9%), in Plaque Index scores measured at interproximal sites (27.9%), and in Plaque Severity Index scores (81.1%) after six weeks of product use. With regard to gingivitis, after six weeks of product use, subjects using the 0.05% CPC mouthrinse exhibited statistically significant reductions from baseline in whole-mouth Gingival Index scores (25.0%), in Gingival Index scores measured at interproximal sites (25.3%), and in Gingivitis Severity Index scores (42.4%). Subjects using the control mouthrinse exhibited statistically significant reductions from baseline in whole-mouth Gingival Index scores (6.5%), in Gingival Index scores measured at interproximal sites (5.5%), and in Gingivitis Severity Index scores (11.6%). When compared to the control mouthrinse group, the 0.05% CPC mouthrinse group presented statistically significant greater reductions in whole-mouth Gingival Index scores (19.8%), in Gingival Index scores measured at interproximal sites (20.7%), and in Gingivitis Severity Index scores (35.5%) after six weeks of product use. CONCLUSION: The results of this double-blind, parallel, six-week clinical study support the conclusion that a mouthrinse containing 0.05% CPC is efficacious for controlling established dental plaque and gingivitis. As measurements were conducted 12 hours after product use, the results also demonstrate that the 0.5% CPC mouthrinse provides 12-hour protection against plaque and gingivitis.