Maternal and child oral health barriers and solutions: Case studies from South Africa, Brazil, and Indonesia.

The World Federation of Public Health Associations (WFPHA) has introduced a maternal oral health framework and launched its Global Maternal and Child Oral Health Initiative, advocating for maternal and child health as a strategic entry point for oral health to be integrated into primary healthcare systems. This article delves into maternal oral health initiatives in South Africa, Brazil, and Indonesia, exploring challenges and proposing context-specific solutions aligned with the WFPHA maternal oral health framework and its Global Maternal and Child Oral Health Initiative. The apartheid legacy in South Africa has led to the gross health inequalities, including oral health disparities characterized by maldistribution of dental facilities and dental professionals in the public sector. The proposed objectives focus on effective leadership, human resource capacity building, and integration of maternal and child oral health policy into existing health policies. Brazil faces challenges in reaching pregnant women, especially pregnant teens, due to workforce shortages. Brazil's Oral Health National Program mandates all pregnant women undergo at least one dental appointment, but a shortage of oral health teams persists and impedes timely access to dental care during pregnancy. Dental students' outreach to vulnerable pregnant teens can enhance the future oral health workforce's sensitivity to maternal oral health matters. In Indonesia, the Antenatal Care Innovative (iANC) Project has introduced a co-training model for midwives and oral health professionals addressing oral health needs of mothers and their spouses and fostering a comprehensive understanding of the interplay between oral health and maternal well-being. These country cases demonstrate the importance of tailored policies, health promotion, and care delivery interventions in maternal oral health. All cases highlight the importance of workforce training and distribution, fostering cross-disciplinary collaboration and future oral health workforce who can promote health beyond treatment delivery.

Remineralization and inactivation of carious lesions treated with silver fluoride in Brazilian children with special healthcare needs.

Introduction: Providing conventional, restorative dental care to children with special healthcare needs (CSHCN) often requires sedation using general anesthesia. Saliva consistency, diet, and oral hygiene practice are different for CSHCN, and limited evidence is available on the efficacy of silver fluoride (SF) for the management of carious lesions for this vulnerable population. Methods: Parents of CSHCN were educated about silver fluoride as a treatment option for caries. In total, 550 carious lesions from 100 participants were identified and scored according to the Nyvad Caries criteria. A total of 100 lesions with Nyvad scores 1, 2, and 3 were treated with a single application of silver fluoride and observed postoperatively at 1, 3, and 6 weeks. Result: The results indicate statistically significant (p < 0.05) differences in lesion remineralization over the 6-week follow-up period. At the 6-week follow-up, more than 85% of all lesions were remineralized across all children, regardless of condition or original Nyvad score of 1, 2, or 3. Conclusion: A single application of silver fluoride has demonstrated effectiveness in remineralization and inactivation of carious lesions over 6 weeks among Brazilian CSHCN. Silver fluoride should be considered an option for the management of carious lesions among CSHCN. Further studies are recommended, including larger sample sizes, longer follow-up times, a second application of SF, and different special needs conditions.

A pilot study on the global practice of informed consent in paediatric dentistry.

Background: Conducting oral treatment early in the disease course, is encouraged for better health outcomes. Obtaining informed consent is an essential part of medical practice, protecting the legal rights of patients and guiding the ethical practice of medicine. In practice, consent means different things in different contexts. Silver Diamine Fluoride (SDF) and Silver Fluoride (SF) is becoming popular and cost effective methods to manage carious lesions, however, cause black discolouration of lesions treated. Obtaining informed consent and assent is crucial for any dental treatment-and has specific relevance with SDF/ SF treatments. Methods: The aim of this paper is to describe informed consent regulations for dental care in a selection of countries, focusing on children and patients with special health care needs. An online survey was shared with a convenience sample of dental professionals from 13 countries. The information was explored and the processes of consent were compared. Results: Findings suggest that there are variations in terms of informed consent for medical practice. In Tanzania, South Africa, India, Kenya, Malaysia and Brazil age is the determining factor for competence and the ability to give self-consent. In other countries, other factors are considered alongside age. For example, in Singapore, the United Kingdom, and the United States the principle of Gillick Competence is applied. Many countries' laws and regulations do not specify when a dentist may overrule general consent to act in the "best interest" of the patient. Conclusion: It is recommended that it is clarified globally when a dentist may act in the "best interest" of the patient, and that guidance is produced to indicate what constitutes a dental emergency. The insights gathered provide insights on international practice of obtaining informed consent and to identify areas for change, to more efficient and ethical treatment for children and patients with special needs. A larger follow up study is recommended to include more or all countries.

Legislation in Hospital Dentistry: Gaps, Perspectives and Desires

Abstract Objective: To analyze the existing state legislation, including not only the ordinary laws, but also their infralegal regulation and the state legislation on Hospital Dentistry. Material and Methods: A survey was carried out in the databases of the Legislative Assemblies of the Brazilian States and the Federal District, as well as the Regional and Federal Councils of Dentistry in Brazil. Subsequently, a survey was carried out in the databases of the Ministry of Health, State Dental Councils and Federal Dental Council in Brazil. Results: Only 8 Brazilian states have legislation in force regarding hospital dentistry, which represents 29.63% of the federative units. Among the Brazilian regions, the Midwest presented the highest prevalence of the laws found (37.50%), followed by the North (25%) and the other regions with the same coverage (12.50%). Also, an orientation and an ordinance from the Ministry of Health, six resolutions from the Federal Council of Dentistry, and a technical note from the National Health Surveillance Agency were found. Conclusion: Several States do not have rules on the subject, making it imperative to create a federal rule that not only imposes the presence of the dentist, but also regulates the proportion of the team, workload, and availability.

Use of Reflectometer Optipen to assess the preventive effect of a sugarcane cystatin on initial dental erosion in vivo.

The sugarcane cystatin 5 (CaneCPI-5) showed protection against erosion and erosive tooth wear (ETW) under several protocols. However, evaluating these conditions in vivo is hard due to the lack of a suitable device. The aim of this study was to use clinically the relative surface reflection intensity (%SRI) by the Reflectometer Optipen to assess the acquired pellicle engineering with CaneCPI-5 rinse for the prevention of initial erosion in vivo. Nine volunteers were distributed in three cross-over phases, according to the rinse used, as follows: 1) Deionized water (negative control); 2) Elmex® (800 ppm Sn2+, 500 ppm F-; positive control); 3) 0.1 mg/mL CaneCPI-5. The following experimental steps were performed: Initially, the volunteers received prophylaxis and the initial %SRI was performed. Subsequently, they rinsed with the solutions (10 mL; 1min), followed by the formation of the acquired enamel pellicle (AEP; 120min). After, the erosive challenge with citric acid 1%, pH 2.5 (10 µL; 10s) was performed (in isolation) on the buccal surface of the maxillary central incisors (right and left). The calcium present in the acid was analyzed by Arsenazo III method. Finally, the final %SRI was performed. Data were analyzed by Kruskal-Wallis/Dunn's tests and Spearman's correlation were used (p < 0.05). For both variables, the negative control led to significantly less protection (lower reflectivity and higher calcium release) in comparison with the other groups. The best protection (higher reflectivity and lower calcium release) was observed for the Elmex® and the CaneCPI-5 groups, with no significant differences between them (p < 0.05). There was a significant correlation between both analyzes. The Reflectometer Optipen demonstrated to be a good device to assess clinically. Moreover, CaneCPI-5 rinse proved effective through acquired pellicle engineering against initial erosion in vivo.

Preventive effect of chitosan gel containing CaneCPI-5 against enamel erosive wear in situ.

OBJECTIVE: This study evaluated the preventive effect of a chitosan gel containing CaneCPI-5 against enamel erosion and erosion + abrasion in situ. METHODS: Sixteen volunteers participated in a crossover, double-blind protocol, comprising 4 phases: (1) no treatment (Nt); (2) chitosan gel (Cg); (3) chitosan gel + 12,300 ppm NaF (Cg + NaF); and (4) chitosan gel + 0.1 mg/mL CaneCPI-5 (Cg + Cane). Volunteers wore an appliance containing 4 specimens. Once/day, they applied the gel (except for Nt) (4 min/specimen). Erosive challenges were performed extra-orally (0.1% citric acid, 90 s, 4 × /day; ERO). Specimens were also abraded (toothbrush, 15 s/specimen, 2 × /day; ERO + ABR). Enamel wear was assessed by profilometry and relative surface reflection intensity (%SRI). Two-way RM-ANOVA/Sidak's tests and Spearman's correlation were used (p < 0.05). RESULTS: For profilometry, ERO + ABR promoted significantly greater wear when compared with ERO. There was a significant difference among all treatments. The lowest enamel loss occurred for Cg + Cane, followed by Cg + NaF, Cg, and Nt (p < 0.05). The %SRI was significantly lower for ERO + ABR when compared to ERO, only for the Nt group. The greatest %SRI was found for the Cg + NaF and Cg + Cane groups, which did not differ significantly, regardless of the conditions. The lowest %SRI was found for the Nt and Cg groups, which did not differ from each other, regardless of the conditions. The Nt group did not differ significantly from the Cg + NaF (ERO). There was a significant correlation between both analyses. CONCLUSION: The incorporation of CaneCPI-5 in the chitosan gel prevented erosive wear in situ. CLINICAL RELEVANCE: These results open a new perspective for the use of CaneCPI-5 in other application vehicles, such as chitosan gel.

Sugar-sweetened beverage taxes in Brazil: past, present, and future.

Increasing rates of non-communicable diseases (NCDs) (obesity, type 2 diabetes, and dental caries) are positively associated with the consumption of added sugars, particularly in sugar-sweetened beverages (SSB). Governments worldwide have implemented SSB taxes to reduce the consumption of sugars added to beverages to reduce the prevalence of NCDs. There is a tax on manufactured products, including SSBs in Brazil. However, in 2016 and 2018, the Brazilian federal government decreased the tax rate, bucking global trends. The SSB industry has criticised such policies, and current tax levels are too low to reduce consumption sufficiently to prevent harm. Research supports positive public health impact potential for a higher SSB tax in Brazil. Sharing experience among countries and complementary policies (nutrition education and front of pack labelling) could increase the positive impacts of an SSB tax. We describe the history of SSB taxes in Brazil and the rationale it provides for specific SSB taxes across the country.

Surface roughness evaluation and whitening efficiency on tooth enamel after using whitening toothpaste: a randomized double-blinded study

The aim of this randomized double-blinded study was to evaluate the enamel surface roughness and color change after one month of whitening toothpaste use and the color stability obtained 1 month after its interruption. 30 volunteers were divided into 3 groups (n = 10) corresponding to the dentifrices: 1) Colgate Total 12 Clean Mint (TD) (Control), 2) Colgate Luminous White (LW) and 3) Sensodyne Whitening Extra Fresh (SB). The volunteers were impression with addition silicone to obtain an epoxy resin replica of the upper central incisor for the initial surface roughness evaluation using a profilometer and the initial color of the incisors and canines was evaluated with a spectrophotometer after one week of wash-out. After 1 month, the color of the central incisors and canines was measured again, and the volunteers were molded to obtain a second replica to the final roughness analysis. Data were submitted to ANOVA-one way (p≤0.05). The results showed that there was no statistical difference between the dentifrices for color difference and surface roughness for all the studied conditions. It was possible to conclude that the whitening dentifrices used in this study were not able to alter the initial color of the teeth and did not cause changes in the surface roughness of enamel.

Ellagic acid on the quality of the adhesive interface of class I composite resin restorations after aging

To evaluate the effect of ellagic acid on the inhibition of matrix metalloproteinase by analyzing the quality of the adhesive interface with bond strength measures in periods of 24 hours and six months of storage. Method: 40 healthy human third molars were prepared with class I cavities (5x4x3mm). The teeth were divided into four experimental groups: Group 1- without application of ellagic acid and storage time of 24 hours; Group 2- with ellagic acid/24 hours; G3- without ellagic acid/six months; Group 4- with ellagic acid/six months. Then, the cavities were restored with Single Bond Universal adhesive and Z350 composite resin, with and without the previous application of ellagic acid. Subsequently, hourglass-shaped specimens were obtained and subjected to the bond strength (BS) test (n = 10) in a universal testing machine. The bond test was performed after 24 hours and six months of storage. For the standard evaluation (n = 3) the samples were infiltrated with silver nitrate and placed in a developing solution for analysis in a Scanning Electron Microscope (SEM). The data obtained were analyzed with the Kruskal-Wallis non-parametric test, showing a statistically significant difference. Results: The highest bond strength values were found for the 24-hour groups followed by the groups with six months of storage. For nano-infiltration, groups G1 and G2 showed lower infiltration than groups G3 and G4. Conclusion: The previous application of ellagic acid did not affect the BS of the adhesive interface of the adhesive system analyzed, regardless of storage time.

Effect of a sugarcane cystatin on the profile and viability of microcosm biofilm and on dentin demineralization.

To analyze the effect of a sugarcane cystatin (CaneCPI-5) on the microbial profile and viability, as well as on the prevention of dentin demineralization using a microcosm biofilm model. Ninety bovine dentine specimens were divided into five experimental groups according with the solution they were treated for 60 s: (1) PBS (negative control), (2) 0.12% chlorhexidine (positive control), (3) Fluoride (500 ppm F, as NaF), (4) 0.025 mg/ml CaneCPI-5, and (5) 0.05 mg/ml CaneCPI-5. Specimens were incubated with inoculum (McBain's saliva plus human saliva) in the first 8 h, and from then on, they were exposed to McBain saliva containing sucrose and daily treated (60 s) with the solutions for 5 days. Resazurin and colony-forming unit counting assays were performed. Dentin demineralization was measured by transverse micro-radiography (TMR). 0.12% chlorhexidine significantly reduced the metabolic activity of the microcosm biofilm in relation to the negative control and treated groups (p < 0.01). CHX and F significantly reduced the counts of total microorganisms, mutans group streptococci, and lactobacilli when compared with the negative control. None of the treatments was able to significantly reduce dentin demineralization in comparison with the negative control. In the model evaluated, CaneCPI-5 neither altered the microcosm biofilm profile and viability nor protected dentin against demineralization.

Influence of different photoinitiators on the resistance of union in bovine dentin: Experimental and microscopic study.

BACKGROUND: To evaluate in vitro the influence of photoinitiators on the microtensile strength of adhesive systems and composite resins in bovine dentin. MATERIAL AND METHODS: Forty dentin obtained from bovine teeth were randomly distributed in four groups (n = 10) according to the different adhesive systems and composite resins used: G1 - AAPS + VAPS (Ambar APS + Vittra APS); G2- AAPS + O (Ambar APS + Opallis); G3 - A + VAPS (Ambar + Vittra APS) and G4 - A + O (Ambar + Opallis). After restoration with the composite, the samples were sectioned to obtain toothpicks that were subjected to the microtensile and nanofiltration test (1.0 mm/min). RESULTS: The Kruskal-Wallis test did not show significant differences between the groups (p<0.05). The values in MPa were: AAPS + VAPS - 19.56 MPa; AAPS + O - 19.77 MPa; A + VAPS - 17.78 MPa; A + O - 22.44 MPa. The result of the Mann-Whitney test showed no significant differences depending on the adhesive (Ambar Universal- 19.11 MPa, Ambar APS Universal- 21.70 MPa) and the composite resin used (Vittra APS- 18.75 MPa, Opallis - 23.75 MPa). The AAPS + VAPS and AAPS + O groups showed intense silver nitrate infiltration. The A + APS group showed a moderate infiltration and the A + O group had a mild infiltration in the adhesive system/dentin interface. CONCLUSIONS: The use of different photoinitiators in the composition of adhesive systems and restorative composites did not affect their bond strength values and the presence of water in the solvent of the APS photoinitiator system had a negative influence, increasing the degree of infiltration in the hybrid layer when compared to the camphorquinone photoinitiator. Key words:Dentin, adhesive systems, composite resin, photoinitiators, tensile strength, nano-infiltration.

Do commercial whitening dentifrices increase enamel erosive tooth wear?

OBJECTIVE: This in vitro study evaluated the effect of commercial whitening dentifrices on erosive tooth wear (ETW) of bovine enamel samples, in comparison with commercial regular dentifrices. METHODOLOGY: Sixty bovine crowns were embedded in acrylic resin, polished and then had their baseline profile determined. They were randomly assigned to 5 groups (n=12/group), according to the type of commercial dentifrice to be tested: GI - Crest Anti-cavity Regular; GII - Crest 3D White; GIII - Colgate Total 12 Clean Mint; GIV - Colgate Optic White; GV - Placebo (negative control, fluoride-free dentifrice). The samples were submitted to daily erosive and abrasive challenges for 3 days. The erosive challenges were performed 3 times a day by immersing the specimens in 0.1% citric acid solution (pH 2.5) for 90 s. Each day after the first and last erosive challenges, the specimens were subjected to the abrasive challenge for 15 s, using a toothbrushing machine (Biopdi, São Carlos, SP, Brazil), soft toothbrushes and slurry (1:3 g/ml) of the tested toothpastes (1.5 N). The specimens were kept in artificial saliva between the challenges. The final profile was obtained and the ETW (µm) was calculated. Data were analyzed by Kruskal-Wallis and Dunn's tests (p<0.05). RESULTS: All dentifrices tested significantly reduced the enamel wear in comparison with the Placebo, except GIII. The median (95% CI) ETW was 1.35 (1.25-1.46)bc for GI, 1.17 (1.01-1.34)cd for GII, 1.36 (1.28-1.45)ab for GIII, 1.08 (1.04-1.14)d for GIV and 2.28 (2.18-2.39)a for GV. CONCLUSION: When dentifrices from the same manufacturer were compared, the whitening dentifrices led to similar or less wear than the regular ones.

Do commercial whitening dentifrices increase enamel erosive tooth wear?

Abstract Objective This in vitro study evaluated the effect of commercial whitening dentifrices on erosive tooth wear (ETW) of bovine enamel samples, in comparison with commercial regular dentifrices. Methodology Sixty bovine crowns were embedded in acrylic resin, polished and then had their baseline profile determined. They were randomly assigned to 5 groups (n=12/group), according to the type of commercial dentifrice to be tested: GI - Crest Anti-cavity Regular; GII - Crest 3D White; GIII - Colgate Total 12 Clean Mint; GIV - Colgate Optic White; GV - Placebo (negative control, fluoride-free dentifrice). The samples were submitted to daily erosive and abrasive challenges for 3 days. The erosive challenges were performed 3 times a day by immersing the specimens in 0.1% citric acid solution (pH 2.5) for 90 s. Each day after the first and last erosive challenges, the specimens were subjected to the abrasive challenge for 15 s, using a toothbrushing machine (Biopdi, São Carlos, SP, Brazil), soft toothbrushes and slurry (1:3 g/ml) of the tested toothpastes (1.5 N). The specimens were kept in artificial saliva between the challenges. The final profile was obtained and the ETW (µm) was calculated. Data were analyzed by Kruskal-Wallis and Dunn's tests (p<0.05). Results All dentifrices tested significantly reduced the enamel wear in comparison with the Placebo, except GIII. The median (95% CI) ETW was 1.35 (1.25-1.46)bc for GI, 1.17 (1.01-1.34)cd for GII, 1.36 (1.28-1.45)ab for GIII, 1.08 (1.04-1.14)d for GIV and 2.28 (2.18-2.39)a for GV. Conclusion When dentifrices from the same manufacturer were compared, the whitening dentifrices led to similar or less wear than the regular ones.

Cariology education for undergraduate Brazilian dental students / Ensino da cariologia para estudantes de graduação em odontologia no Brasil

ABSTRACT This study sought to provide an overview of current cariology education for undergraduate Brazilian dental students. Data collection was via a Portuguese version of a 12-item questionnaire (Schulte et al., 2011) that was sent to all Brazilian dental schools (n = 219). The response rate was 57.0% (n = 125). Of the schools that returned the questionnaire, 84.8% supported the development of a Brazilian cariology curriculum. The units responsible for teaching cariology were predominantly operative dentistry (49.6%), pediatric dentistry (49.6%), dental public health (44.8%), and cariology (32%). Theoretical teaching of cariology (74.4%) and pre-clinical exercises (63.2%) were cited to occur mainly during the second year of the course, while clinical activities were placed in the third (71.2%) and fourth (64.8%) years. Among respondents, 76.8% of the schools included dental erosion and 86.4% included defects of dental hard tissues, such as abrasion, in teaching cariology. This survey was able to determine the panorama of cariology education in Brazil and to detect some differences among Brazilian geographic areas. The promotion of a workshop to discuss the topics that should be taught to undergraduate dental students and the development of a Brazilian core curriculum in cariology would be likely to reduce the differences in teaching cariology in Brazil.

RESUMO Este estudo teve como objetivo apresentar um panorama do ensino de cariologia nos cursos de graduação em Odontologia no Brasil. A coleta de dados foi realizada por meio de uma versão em Português Brasileiro de um questionário de 12 itens (Schulte et al., 2011) que foi enviado a todas as faculdades de Odontologia brasileiras (n = 219). A taxa de resposta foi de 57,0% (n = 125). Dentre as faculdades que responderam o questionário, 84,8% apoiam o desenvolvimento de um currículo brasileiro de cariologia. As disciplinas responsáveis por lecionar os conteúdos de cariologia são principalmente dentística (49,6%), odontopediatria (49,6%), saúde bucal coletiva (44,8%), e cariologia (32%). O ensino teórico de cariologia (74,4%) e os exercícios de pré-clínica (63,2%) são abordados principalmente durante o segundo ano do curso, enquanto as atividades clínicas ocorrem, em geral, no terceiro (71,2%) e quarto (64,8%) anos. Dentre os respondentes, 76,8% das faculdades incluem erosão dentária e 86,4% incluem defeitos dos tecidos dentários duros, como abrasão, no ensino da cariologia. Essa pesquisa foi capaz de determinar o panorama do ensino da cariologia no Brasil e detectar algumas diferenças de currículo entre as regiões do país. A promoção de um workshop para discutir os assuntos que devem ser ministrados aos estudantes de graduação em Odontologia e para desenvolver um currículo brasileiro de cariologia seria válida para reduzir as diferenças no ensino de cariologia no Brasil.

Analysis of Chemical Composition of Different Irreversible Hydrocolloids.

Irreversible hydrocolloids (IR) is a dental impression material commonly used in Brazilian and European dental practice because it is inexpensive, easy to handle, has good reproductive detail and is comfortable for the patient. This research aimed to analyze the chemical composition of eight different IRs for dental use. A sample of 0.2 g was weighed and transferred to a Teflon beaker moistened with drops of distilled or deionized water; 5 mL of nitric acid was added until total solubility of the sample; the solution was transferred to a 100 mL volumetric flask, the volume was filled with distilled or deionized water and homogenized. Thirty-five chemical elements were found: Lithium, Beryllium, Boron, Sodium, Magnesium, Aluminum, Silicon, Phosphorus, Potassium, Titanium, Manganese, Cobalt, Nickel, Vanadium, Zinc, Rubidium, Arsenic, Iron, Copper, Strontium, Yttrium, Zirconium, Niobium, Molybdenum, Ruthenium, Cadmium, Tin, Antimony, Barium, Lanthanum, Cerium, Mercury, Lead, Thorium and Uranium. Only one of the samples contained no Nickel, Antimony and Lead; and Arsenic and Uranium were found in 2 samples. This study provided evidence of high toxicity of the IR brands, pointing out the need for better quality control of this product, in order to prevent health damage in dentists, prosthesis technicians and patients.

Análise qualitativa do interior de imperfeições presentes em 5 marcas de implantes brasileiros por microscopia eletrônica de varredura e espectroscopia por energia dispersiva / Qualitative analysis of inner imperfections present in 5 brands of brazilian dental implants by scanning electron microscopy and dispersive energy spectroscopy

O titânio é um dos 10 mais comuns elementos da terra, existem diferentes pesos atômicos, isótopos estáveis e radioisótopos conhecidos, está presente em ligas comerciais e semicomerciais, sendo que o titânio puro apresenta diferentes graus de pureza. Além disso, as ligas possuem classificações que agregam outros elementos neutros e/ou estabilizadores, são submetidas a diferentes tipos de tratamento de superfícies. Na fabricação dos implantes, o processo industrial da extração da rocha até a colocação na boca pode corromper o grau de pureza. A proposta do presente estudo foi avaliar qualitativamente buracos presentes em 5 implantes dentários brasileiros. As amostras foram preparadas em resina acrílica e realizados cortes sagitais com lâmina de diamante e analisadas no Microscópio Eletrônico de Varredura TM 3030 PLUS TABLESTOP MICROSCOPE HITACHI e reanalisadas no Microscópio Fei Quanta 400. Os resultados evidenciaram que os implantes apresentaram impurezas e estas impurezas podem ser os estabilizadores ou elementos neutros presentes no titânio ou nas ligas utilizadas. Implantodontistas devem ficar alertas sobre a qualidade do implante

Titanium is one of the 10 most common elements of the earth, there are different atomic weights, stable isotopes and known radioisotopes, it is present in commercial and semi-commercial alloys and pure titanium has different degrees of purity. In addition, alloys have classifications that add other neutral elements and/or stabi¬lizers, they are submitted to different types of surface treatments. In manufacturing the implants, the industrial process of extracting the rock into the mouth can corrupt the degree of purity. The purpose of the present study was to qualitatively evaluate holes present in 5 Brazilian dental implants. The samples were prepared in acrylic resin and sagittal cuts with diamond blade and analyzed in the Scanning Electron Microscope TM 3030 PLUS TABLESTOP MICROSCOPE HITACHI and Fei quanta 400. The results showed that the implants presented impurities and these impurities may be the stabilizers or neutral elements present in the titanium or the alloys used. Implant dentists should be alert to the quality of the implant

Pró-saúde e a reforma curricular em uma escola de odontologia à luz da teoria da estruturação / Pró-saúde and curriculum reform in a school of dentistry in light of the structuration theory

O presente estudo de caso analisou em que medida a adesão ao Pró-Saúde contribuiu para o andamento da reforma curricular em uma faculdade pública de Odontologia no Rio de Janeiro. Para essa análise foram coletados documentos e realizadas treze entrevistas semiestruturadas com atores-chave. Utilizou-se como referencial teórico a Teoria da Estruturação de Giddens. Os resultados da pesquisa apontaram avanços e entraves no novo Projeto Político Pedagógico. Entretanto, desafiando as características de uma instituição tradicional de formação, o Pró-Saúde, associado ao interesse dos dirigentes locais em realizar a reforma, cumpriu o papel de indutor das transformações curriculares

The present case study analyzed how the adherence to Pró-Saúde contributed to the process of the curriculum reform done by a public school of dentistry in Rio de Janeiro state. In order to find evidences, documents were collected and thirteen semi-structured interviews with key actors were conducted. The data analysis was performed in light of Giddens' Structuration Theory. The results of the research show both advances and obstacles in the new pedagogical project. In conclusion, challenging the characteristics inherent to an institution of traditional education, Pró-Saúde, associated with school managers interests, fulfilled the role of a catalyst to curricular transformation.

Análise qualitativa da estrutura química de quatro marcas comerciais de implantes dentários brasileiros: Estudo-piloto / Qualitative analysis of the chemical composition of four Brazilian dental implant manufacturers: a pilot study

Objetivo: avaliar qualitativamente a estrutura química de quatro marcas comerciais de implantes dentários brasileiros. Material e métodos: 12 amostras de diferentes lotes foram fixadas em resina acrílica usando um processo padronizado, e cortes sagitais foram realizados. As amostras foram analisadas em dois microscópios eletrônicos de varredura (FEI Quanta 400, TM 3030 Plus Tablestop Microscope Hitachi). Resultados: a maioria apresentou na sua porção interna (8 das 12) diferentes níveis de níquel, variando de uma marca para outra. Entretanto, este metal não foi detectado na superfície externa. A presença de níquel talvez seja atribuída às matérias-primas e metodologia de produção, desde a sua extração até a comercialização. Conclusão: dentro dos limites desta investigação, há necessidade de mais estudos qualitativos, em todo o processo de fabricação de todos os implantes comercializados, assim como estudos quantitativos com relação ao elemento níquel nos implantes dentários.

Objective: to perform a qualitative evaluation of the chemical structure of four commercial dental implant Brazilian brands. Material and methods: 12 samples of different batches were embedded in acrylic resin according to a standardized process, and sagittal sections were made accordingly. All the samples were analyzed under two SEM devices (FEI Quanta 400, TM 3030 Plus Tablestop Microscope Hitachi). Results: most samples (8 of 12) revealed at their internal portions different levels of Nickel, from one manufacturer to the other. However, this metal was not detected at the external implant portion. The presence of Nickel maybe can be attributed to the raw materials and production process, from extraction to commercialization. Conclusion: within the limits of this investigation, more qualitative studies are necessary throughout the fabrication process of all investigated implants in the market, as well as quantitative evaluations regarding the presence of Nickel on dental implants.

Proteomics of Secretory-Stage and Maturation-Stage Enamel of Genetically Distinct Mice.

The mechanisms by which excessive ingestion of fluoride (F) during amelogenesis leads to dental fluorosis (DF) are still not precisely known. Inbred strains of mice vary in their susceptibility to develop DF, and therefore permit the investigation of underlying molecular events influencing DF severity. We employed a proteomic approach to characterize and evaluate changes in protein expression from secretory-stage and maturation-stage enamel in 2 strains of mice with different susceptibilities to DF (A/J, i.e. 'susceptible' and 129P3/J, i.e. 'resistant'). Weanling male and female susceptible and resistant mice fed a low-F diet were divided into 2 F-water treatment groups. They received water containing 0 (control) or 50 mg F/l for 6 weeks. Plasma and incisor enamel was analyzed for F content. For proteomic analysis, the enamel proteins extracted for each group were separated by 2-dimensional electrophoresis and subsequently characterized by liquid-chromatography electrospray-ionization quadrupole time-of-flight mass spectrometry. F data were analyzed by 2-way ANOVA and Bonferroni's test (p < 0.05). Resistant mice had significantly higher plasma and enamel F concentrations when compared with susceptible mice in the F-treated groups. The proteomic results for mice treated with 0 mg F/l revealed that during the secretory stage, resistant mice had a higher abundance of proteins than their susceptible counterparts, but this was reversed during the maturation stage. Treatment with F greatly increased the number of protein spots detected in both stages. Many proteins not previously described in enamel (e.g. type 1 collagen) as well as some uncharacterized proteins were identified. Our findings reveal new insights regarding amelogenesis and how genetic background and F affect this process.