Dog-assisted therapy for control of anxiety in pediatric dentistry.

Anxiety is common in pediatric dental care, and affects the behavioral management of children. Animal-assisted therapy (AAT) has been shown to improve children's behavior. However, few studies have applied this technique in dentistry. The aim of the present study was to evaluate the applicability of dog-assisted therapy to control anxiety during pediatric dental treatment. Twenty children were selected from the Pediatric Dentistry Clinic of the Pontifical Catholic University of Campinas (PUC-Campinas), Brazil. Participants were divided into two groups: Control (n = 11; visits = 16), in which children were conditioned by methods routinely used in the clinic; and AAT (n = 9; visits = 23), in which children had contact with a dog therapist first at the reception desk and then again inside the office. The dog therapist stayed beside the dental chair with the child throughout the procedures. Corah's Dental Anxiety Scale (CS) and heart rate (HR) were used for evaluation of child anxiety. The results were tested for normality of distribution with the Shapiro-Wilk method, and subsequently analyzed in BioEstat 5.0. HR results were compared by Analysis of Variance (ANOVA) with Tukey's test, and CS scores, with the Wilcoxon test. There was a significant reduction in HR in the AAT group (p = 0.0069). In the Control group, HR did not change before, during, or after treatment (p = 0.6052). Controls showed a significant increase in anxiety measured by CS before and after treatment (p = 0.0455). In the AAT group, there was no change in CS scores before and after treatment (p = 0.3739). AAT could be an alternative to reduce anxiety during pediatric dental care.

In vitro evaluation of EDTA combined with photodynamic therapy to reduce Streptococcus mutans in carious dentin.

BACKGROUND: This in vitro study aimed to evaluate the use of EDTA combined with photodynamic therapy to reduce Streptococcus mutans in carious dentin. METHODS: Sixty third molars were sectioned to obtain flat dentin surfaces. All specimens were waterproofed, except for the coronal dentin, and subjected to cariogenic challenge in brain-heart infusion (BHI) broth supplemented with 0.5% yeast extract, 1% glucose, 1% sucrose, and standard strain of S. mutans (ATCC 25175). The specimens were divided into 6 groups (n = 10 each): (1) control - caries collection; (2) EDTA - 17% EDTA was actively applied with a microbrush for 1 min; (3) aPDT - antimicrobial photodynamic therapy with 0.01% methylene blue photosensitizer (wavelength of 660 nm, energy of 4 J, power of 100 mW, spot size of 0.028 cm2, energy density of 142 J/cm2 for 40 s); (4) EDTA+aPDT - 17% EDTA actively applied for 1 min plus aPDT; (5) (EDTA+PT) + L - application of EDTA compounded with photosensitizer plus laser irradiation; and (6) PT - photosensitizer alone. Collection of caries was performed after the different cavity disinfection protocols. Aliquots from each dilution were seeded for colony-forming unit (CFU) counts. The results were log10-transformed and analyzed by the Kruskal-Wallis test (Student-Newman-Keuls). RESULTS: There was a significant reduction in S. mutans after aPDT (p<0.05), EDTA+aPDT (p<0.001), and (EDTA+PT) + L (p<0.001). The percentage of microbial reduction in ascending order was as follows: EDTA: 1.65%; PT: 15.51%; aPDT: 38.28%; EDTA+aPDT: 75.24%; and (EDTA+PT) + L: 97.35%. CONCLUSION: Application of 17% EDTA prior to photosensitization or compounded with a photosensitizer increased the antimicrobial effect of aPDT on S. mutans in carious dentin.

Avaliação do efeito de enxaguatórios contendo diferentes agentes dessensibilizantes na oclusão tubular e na prevenção da progressão do desgaste erosivo e abrasivo em dentina / Evaluation of the mouth rinses containing different desensitizing agents on dentin tubular occlusion and erosive and abrasive wear

Os objetivos do estudo foram: 1. Avaliar, na dentina humana hipersensível, o efeito de enxaguatórios dessensibilizantes quanto à oclusão tubular dentinária; 2. Verificar a resistência da oclusão tubular promovida pelos tratamentos frente a desafios erosivos e abrasivos, realizados separadamente e em uma ciclagem erosiva-abrasiva; 3. Avaliar o efeito dos enxaguatórios no desgaste erosivo e abrasivo da dentina; 4. Avaliar a quantidade de fluoreto adsorvido no substrato dentinário após o tratamento com os enxaguatórios. Espécimes de 3 mm × 3 mm × 2 mm foram obtidos a partir da dentina radicular de 345 molares hígidos, e depois, polidos. Esses foram imersos em solução de EDTA 17% e, então, estratificadamente alocados em 10 grupos experimentais (n=10): Controle (água destilada); Enxaguatórios com ação dessensibilizante: Listerine Sensitive; Colgate Sensitive; Sensodyne Sensitive; Elmex Sensitive; enxaguatórios convencionais: Listerine; Colgate; Sensodyne; Elmex e ClinproTMXT Varnish (C+), como controle positivo. Na fase 1, espécimes foram tratados com os enxaguatórios e, depois, submetidos a um desafio erosivo ou a um desafio abrasivo. Na fase 2, os espécimes foram submetidos à um modelo de ciclagem de erosão-abrasão-remineralização (n=10) de 5 dias, onde o tratamento com os enxaguatórios foram aplicados 2 vezes ao dia. Após o EDTA, após os tratamentos (na fase 1 somente) e após os desafios ou ciclagem, os espécimes foram analisados por meio de Microscopia Eletrônica de Varredura Ambiental (MEV), e o programa de imagem Image J (NIH) foi utilizado para a contagem do número de túbulos dentinários abertos (TDA). A perda superficial (Surface Loss - SL) da dentina foi determinada com o uso de um perfilômetro óptico ao final dos desafios. Adicionalmente, a quantidade de fluoreto solúvel em KOH foi avaliada após uma aplicação dos enxaguatórios. Os dados foram analisados utilizando os testes Kruskal-Wallis, Dunn e Wilcoxon (=0,05). Na avaliação da oclusão tubular, após o tratamento, erosão e abrasão, C+ foi o único grupo que mostrou redução no número de TDA quando comparado ao Controle (p<0,05). Após a ciclagem, nenhum dos grupos exibiu uma redução significativa no número de TDA em relação ao Controle (p>0,05). Na análise de SL, para ambos os desafios isolados, não houve diferença significativa entre os grupos (p=0,372 e p=0,405). Para a ciclagem, o Listerine Sensitive apresentou significativamente o menor valor de SL e foi o único enxaguatório que diferiu significativamente do Controle (p<0,001). Nenhum enxáguatório foi capaz de promover oclusão significativa dos túbulos dentinários após o tratamento ou os desafios. C+ foi o único produto que efetivamente promoveu a oclusão tubular, mas esse efeito não suportou vários desafios erosivos e abrasivos. O único enxaguatório capaz de reduzir significativamente a SL dentinária comparada ao controle após desafios erosivos e abrasivos foi o Listerine Sensitive, que contém oxalato de potássio e fluoreto de sódio. Listerine e Sensodyne apresentaram a maior quantidade de fluoreto adsorvido.

Effect of cetrimide 2% with and without photodynamic therapy to reduce Streptococcus mutans burden in dentinal carious lesions.

To evaluate the use of cetrimide alone and combined with photodynamic therapy to reduce S. mutans burden in carious lesions. Sixty permanent third molars were sectioned and the coronal dentin exposed. A cariogenic challenge was performed using brain-heart infusion (BHI) medium supplemented and S. mutans ATCC 25175. Specimens were incubated in anaerobic jars at 37 °C for 15 days, with BHI renewed every 24 h. After 15 days, specimens were randomly divided into six groups (n = 10): C, control (no treatment); CHX, application of chlorhexidine 2%; CT, application of cetrimide 2%; CT+aPDT, application of cetrimide 2% followed by methylene blue dye and aPDT (antimicrobial photodynamic therapy: wavelength 660 nm, energy 4J, power 100 mW, spot size 0.0028 cm2, energy density 142 J/cm2 for 40 s); ES+aPDT, application of experimental solution (methylene blue dye with cetrimide) and aPDT; and aPDT alone. Carious tissue from each specimen was collected before and after the applications. Five decimal dilutions were performed, and the resulting solution was seeded in mitis-salivarius-bacitracin agar. Plates were incubated in anaerobic jars at 37 °C for 48 h. Analysis of variance (ANOVA) with post hoc Tukey's test was used to compare total S. mutans counts. Significant reductions in S. mutans were observed after application of CT+aPDT (0.30 (0.97), p < 0.0001) and ES+aPDT (0.52 (1.13), p < 0.0001). Cetrimide 2% with methylene blue dye, applied consecutively or as a mixture, can be used as a photosensitizing agent for aPDT to reduce S. mutans burden in dentinal caries.