Vitamin E: A potential preventive approach against dental erosion-an in vitro short-term erosive study.

OBJECTIVES: This study evaluated the in vitro effect of different components of palm oil on enamel in a short-term erosive challenge. METHODS: The acquired enamel pellicle (AEP) was previously formed in situ for 2 h. Subsequently, the bovine enamel blocks were treated in vitro according to following solutions: G1-palm oil; G2-85% tocotrienol solution; G3-oily vitamin E; G4-oily vitamin A; G5-deionized water (negative control); G6-stannous-containing solution (Elmex® Erosion Protection Dental Rinse) (positive control). After application of the treatment solutions (500 µl, 30 s), the blocks were immersed in 0.5% citric acid (pH 2.4) during 30 s (initial erosion). The response variable was the percentage of surface hardness loss. Data were analyzed by one-way ANOVA and Fisher's Test (p < 0.05). RESULTS: The positive control (G6), palm oil (G1) and oily vitamin E (G3) groups presented the lowest percentage of surface hardness loss, and were statistically different from the negative group (G5) (p < 0.05), and no differences were found between these three groups. The 85% tocotrienol solution (G2) and oily vitamin A groups (G4) were not different to the negative control group. CONCLUSIONS: Stannous-containing positive control (Elmex® Erosion Protection), palm oil and oily Vitamin E were able to protect enamel against the erosive challenge performed in this in vitro study. In addition, vitamin E is probably the key ingredient of palm oil responsible for preventing enamel erosion. CLINICAL SIGNIFICANCE: Vitamin E presented similar preventive effect to a commercial mouthwash stannous-containing solution (Elmex® Erosion Protection) against initial erosion and, it can be considered as a promising natural alternative for the formulations of solutions aiming to prevent erosive tooth wear.

Effect of in situ aspartame mouthwash to prevent intrinsic and extrinsic erosive tooth wear.

BACKGROUND: The aim was to evaluate whether aspartame regular mouthwash prior to erosive challenges with citric or hydrochloric acids would be able to prevent erosive enamel wear. MATERIAL AND METHODS: This randomized, single blind in situ study was conducted with 3 crossover phases of 5 days. Polished bovine enamel blocks (n=252) were randomly divided among 6 groups/ 3 phases/ 21 volunteers. The groups under study were: aspartame solution (0.024% of aspartame in deionized water - experimental group), deionized water (negative-control) and stannous-containing solution (Elmex® Erosion Protection Dental Rinse; positive-control); subjected to erosion on citric acid or hydrochloric acid. Four times per day the volunteers rinsed the intraoral appliance with the respective solutions (in situ) prior to immersion of half of the appliance in 0.05M citric acid and the other half in 0.01M hydrochloric acid for 120 seconds (extraoral). The response variable was enamel loss by profilometry. Data were analyzed by ANOVA and Tukey's test (p<0.05). RESULTS: No difference on enamel loss was found between aspartame solution and deionized water. Stannous-solution resulted in less enamel loss compared to deionized water. Hydrochloric acid resulted in higher enamel loss than citric acid. CONCLUSIONS: In this model, aspartame was not able to prevent erosive tooth wear against citric or hydrochloric acids. Key words:Dental erosion, aspartame, stannous fluoride, citric acid, hydrochloric acid.

Consequences of tooth luxation associated with complicated crown fracture: a case report.

The objective of this clinical case report is to describe the late treatment performed in a 10-year-old patient who suffered a complicated crown fracture associated with luxation of the maxillary left central incisor. The patient-s parents reported that the patient fell and was immediately taken to a hospital, where radiographs, splinting, and suturing were performed and an anti-inflammatory prescription was provided, but no treatment was given for the exposed pulp. The parents and patient sought treatment at a pediatric dentistry clinic 16 days post-trauma. The clinical examination revealed the presence of a left central incisor with a fracture of enamel and dentin involving the pulp, which was necrotic, and a splint extending from the right lateral incisor to the left lateral incisor. However, it was not possible to diagnose the type of luxation that had occurred. The fractured incisor was treated with periodic changes of calcium hydroxide dressing for apexification for 10 months, and the root was subsequently obturated with gutta percha and root canal sealer. The tooth fragment was stored in physiologic solution during this time. After obturation, tooth darkening was observed, and LED-assisted tooth bleaching was accomplished prior to reattachment of the fractured fragment. The tooth was reexamined every 6 months. Two years after the traumatic event, the left central incisor was infraoccluded in relation to the right central incisor. A radiograph confirmed ankylosis of the traumatized tooth. When trauma affects the enamel, dentin, pulp, and supporting tissues, the prognosis can be unfavorable even when late treatment is adequate, especially when a tooth in a growing patient has points of ankylosis.

Is the dentifrice containing calcium silicate, sodium phosphate, and fluoride able to protect enamel against chemical mechanical wear? An in situ/ex vivo study.

OBJECTIVES: The aim of this study was to investigate the effect of a dentifrice that contains calcium silicate, sodium phosphate, and fluoride on erosive-abrasive enamel wear. MATERIAL AND METHODS: This randomized, single-blind in situ/ex vivo study was conducted with four crossover phases of 5 days (one group tested per phase). Bovine enamel blocks (n = 256) were allocated to 16 volunteers and 8 groups. The groups under study were test dentifrice, with calcium silicate, sodium phosphate, and 1450 ppm sodium monofluorophosphate; tin dentifrice, with 3500 ppm stannous chloride, 700 ppm amine fluoride, and 700 ppm sodium fluoride; conventional dentifrice, with 1450 ppm sodium monofluorophosphate; and control (deionized water). Half of the enamel blocks were subjected to erosion and the other half to erosion plus abrasion. The daily extraoral protocol consisted in four citric acid exposures (2 min) and two applications of dentifrice slurry on all blocks for 30 s; after, half of the blocks were brushed for 15 s. The response variable was enamel loss. Data were analyzed by two-way ANOVA and Fisher's test (p < 0.05). RESULTS: For erosion, the test dentifrice promoted less enamel loss than water (4.7 ± 3.1 and 5.8 ± 2.5 µm, respectively, p < 0.05), and did not differ from tin (4.8 ± 2.5 µm) and conventional (4.8 ± 1.4 µm) dentifrices (p > 0.05). However, the test dentifrice (7.7 ± 3.8 µm) promoted higher wear after erosive plus abrasive procedures than tin (5.4 ± 1.5 µm) and conventional (6.2 ± 1.7 µm, p < 0.05) dentifrices, and did not differ from water (6.9 ± 2.0 µm). CONCLUSIONS: The investigated dentifrice reduced enamel loss against acid challenge but had no effect against acid and brushing challenge. CLINICAL RELEVANCE: Little is known regarding the preventive effect of dentifrices indicated for dental erosion. The tested anti-erosive dentifrice was unable to protect enamel when erosion was associated to toothbrushing abrasion.

Influence of mandibular and palatal intraoral appliances on erosion in situ study outcome.

OBJECTIVE: The standardization of in situ protocols for dental erosion is important to enable comparison between studies.Thus, the objectives of this study were to evaluate the influence of the location of in situ intraoral appliance (mandibular X palatal) on the extent of enamel loss induced by erosive challenges and to evaluate the comfort of the appliances. MATERIAL AND METHODS: One hundred and sixty bovine enamel blocks were selected according to their initial surface hardness and randomly divided into two groups: GI - palatal appliance and GII - mandibular appliance. Twenty volunteers wore simultaneously one palatal appliance (containing 4 enamel blocks) and two mandibular appliances (each one containing 2 enamel blocks). Four times per day during 5 days, the volunteers immersed their appliances in 0.01 M hydrochloric acid for 2 minutes, washed and reinserted them into the oral cavity for 2 hours until the next erosive challenge. After the end of the in situ phase, the volunteers answered a questionnaire regarding the comfort of the appliances. The loss of tissue in the enamel blocks was determined profilometrically. Data were statistically analyzed by paired t-test, Chi-square and Fisher's Exact Test (p<0.05). RESULTS: The enamel blocks allocated in palatal appliances (GI) presented significantly higher erosive wear when compared to the blocks fixed in mandibular appliances (GII). The volunteers reported more comfort when using the palatal appliance. CONCLUSIONS: Therefore, the palatal appliance is more comfortable and resulted in higher enamel loss compared to the mandibular one.

The effect of aspartame and pH changes on the erosive potential of cola drinks in bovine enamel: An in vitro study.

BACKGROUND: The aim of this study was to clarify the mechanism behind the different erosive potential of regular and light cola drinks: pH difference and/or aspartame presence. MATERIAL AND METHODS: Sixty bovine enamel blocks were randomly divided into 5 groups: RC - regular cola, RCpH - addition of base to increase regular cola pH, RCAS - addition of aspartame to regular cola, LC - light cola, and LCpH - addition of acid to decrease light cola pH. Two-thirds of the blocks surface was coated with nail varnish for reference. The samples were daily subjected to four erosive challenges for 2 minutes. Between the erosive challenges (2h) and overnight the samples were maintained in artificial saliva. The response variable was the percentage surface hardness change (%SHC) after 1st experimental day and enamel surface loss (µm) measured at the 5th day by profilometry. Data were analyzed by ANOVA and Tukey's test (p<0.05). RESULTS: Independently of the cola modifications, all groups promoted similar hardness change of enamel surface. RC promoted higher enamel loss (6.69±0.71µm) than LC (4.80±0.77µm). The acid addition to light cola (LCpH: 6.60±1.78µm) significantly enhanced its erosive potential, which did not differ from RC. The base addition to regular cola (RCpH-4.00±0.64µm) resulted in similar wear to LC. The addition of aspartame to the regular cola (RCAS 5.44±0.65µm) resulted in similar wear to LC and RC. CONCLUSIONS: The data suggest that the pH alteration has a major impact on the erosive potential of cola drinks, however, the sweetener also has some influence. Key words:Tooth erosion, dental enamel, soft drinks, ph, sweetener.

Effect of palm oil alone or associated to stannous solution on enamel erosive-abrasive wear: A randomized in situ/ex vivo study.

OBJECTIVE: Palm oil has demonstrated preventive potential against initial erosive demineralization in vitro. This in situ study evaluated the effect of palm oil alone or associated with stannous-containing (Sn) solution on preventing enamel loss from an erosive/abrasive challenge. DESIGN: This single-blind, randomized, crossover in situ/ex vivo study was developed in four phases (one per group of five days) with sixteen volunteers. Enamel blocks (n = 256) were allocated to groups according to the treatment: Palm oil; Palm oil plus Sn solution; Sn solution - positive control; and Deionized water - negative control. Half of the enamel blocks of each group was subjected to erosion and the other half to erosion + abrasion. The daily ex vivo protocol consisted of four citric acid immersions (2 min). Before the first and third acid exposure, the blocks were treated with the test solutions (1 drop/block) for 1 min followed by acid immersion and abrasive challenge (toothpaste was applied on all blocks and half were brushed for 15 s/block). Enamel loss was quantified profilometrically and data were analyzed by two-way ANOVA and Tukey's test (p < 0.05). RESULTS: A significant difference was found for type of treatment (p < 0.001); wear condition (p = 0.38) and the treatment x condition interaction (p = 0.33) was non-significant. Palm oil associated or not to Sn solution significantly reduced enamel wear in comparison with the negative control but did not differ from the positive control (p > 0.05). CONCLUSIONS: Palm oil was able to prevent enamel loss under erosive and erosive + abrasive challenges in a similar extend to stannous-containing commercial solution.

Reimplantation of an avulsed mature permanent tooth after 6 days: a 1-year follow-up.

Tooth avulsion in children and adolescents demands emergency treatment to increase the chances of successful reimplantation. The treatment prognosis depends on intrinsic and extrinsic factors, such as the extra-alveolar time until reimplantation, storage medium, handling, and periodontal ligament condition of the avulsed tooth as well as the patient's general health. This case report describes the treatment of an 11-year-old boy who suffered an avulsion of the maxillary right central incisor followed by delayed reimplantation after the tooth was stored in a dry medium for 6 days. Although the tooth was kept in extremely unfavorable conditions, tooth reimplantation was attempted because the patient was young and it was desirable to avoid psychological trauma as well as esthetic and functional problems. The treatment performed followed the guidelines of the International Association of Dental Traumatology for an avulsed tooth with a closed apex and extraoral dry time exceeding 60 minutes. At a 1-year follow-up appointment, the tooth exhibited clinical function, no mobility or pain symptoms, and mild signs of ankylosis. A radiographic image showed resorption by substitution. Although the long-term prognosis is uncertain, this treatment approach was advantageous for the patient because it maintained esthetics, function, and alveolar bone height.

Impact of a simplified in situ protocol on enamel loss after erosive challenge.

This study investigated the effect of the period of use and location of intraoral appliances on enamel surface loss. This randomized, single blind in situ study was conducted in 2 crossover phases based on the period of use, in which maxillary and mandibular appliances were simultaneously worn. Bovine enamel blocks (n = 120) were randomly divided among the studied groups by surface hardness. In each phase, fifteen volunteers used one maxillary appliance and two mandibular appliances for 5 days. Erosive challenge was performed 4X/day by immersion in 0.01 M HCL for 2 minutes. In the continuous phase, the intraoral appliances were worn for 20 hours. In the intermittent phase the appliances were worn for 8 hours and 30 minutes. Enamel loss was determined profilometrically. The discomfort of use of the appliances were evaluated in a questionnaire. Data were analyzed by two-way ANOVA/Tukey's test and chi-square test (p<0.05). The maxillary appliance promoted higher enamel loss compared to the mandibular one (p<0.001). Intermittent use of appliances resulted in similar enamel loss to the continuous one (p = 0.686). All volunteers preferred to use the maxillary appliance in an intermittent regimen. The intermittent use of maxillary appliance is a simplified reliable protocol appropriated for in situ erosion studies in enamel.

Delayed tooth reimplantation with 4-year follow-up: the management of ankylosis during facial growth.

This case report describes the consequences of delayed (24 hours) reimplantation of an avulsed maxillary central incisor, findings over a 4-year follow-up period, and the management of ankylosis during facial growth. After a traumatic event, a 10-year-old boy was taken to a hospital emergency department due to injuries to his face, including avulsion of the maxillary left central incisor. Despite the short amount of time before arriving at the hospital (10 minutes) and use of the correct storage medium (milk), the tooth was not reimplanted, and the parents did not receive instructions to seek dental treatment. The next day, the child was brought to a dental school because he objected to the loss of his tooth. The treatment chosen was delayed tooth reimplantation. At the 1-year follow-up, the reimplanted tooth was infraoccluded, and periapical radiography revealed signs of ankylosis and initial replacement root resorption. At the 2- and 3-year follow-up examinations, resorption and infraocclusion of the central incisor had progressed. In this case, the delayed reimplantation resulted in ankylosis that had a significant clinical impact due to the patient's facial growth. Direct resin restoration of the reimplanted tooth was therefore performed 3 years after trauma. Despite continued resorption and infraocclusion of the tooth observed 4 years posttrauma, the esthetic, low-cost treatment was well accepted, and the patient's quality of life was improved until definitive treatment can be performed.

Effect of vegetable oils applied over acquired enamel pellicle on initial erosion.

OBJECTIVE: The prevalence of dental erosion has been recently increasing, requiring new preventive and therapeutic approaches. Vegetable oils have been studied in preventive dentistry because they come from a natural, edible, low-cost, and worldwide accessible source. This study aimed to evaluate the protective effect of different vegetable oils, applied in two concentrations, on initial enamel erosion. MATERIAL AND METHODS: Initially, the acquired pellicle was formed in situ for 2 hours. Subsequently, the enamel blocks were treated in vitro according to the study group (n=12/per group): GP5 and GP100 - 5% and pure palm oil, respectively; GC5 and GC100 - 5% and pure coconut oil; GSa5 and GSa100 - 5% and pure safflower oil; GSu5 and GSu100 - 5% and pure sunflower oil; GO5 and GO100 - 5% and pure olive oil; CON- - Deionized Water (negative control) and CON+ - Commercial Mouthwash (Elmex® Erosion Protection Dental Rinse, GABA/positive control). Then, the enamel blocks were immersed in artificial saliva for 2 minutes and subjected to short-term acid exposure in 0.5% citric acid, pH 2.4, for 30 seconds, to promote enamel surface softening. The response variable was the percentage of surface hardness loss [((SHi - SHf) / SHf )×100]. Data were analyzed by one-way ANOVA and Tukey's test (p<0.05). RESULTS: Enamel blocks of GP100 presented similar hardness loss to GSu100 (p>0.05) and less than the other groups (p<0.05). There was no difference between GP5, GC5, GC100, GSa5, GSu100, GSa100, GSu5, GO5, GO100, CON- and CON+. CONCLUSION: Palm oil seems to be a promising alternative for preventing enamel erosion. However, further studies are necessary to evaluate a long-term erosive cycling.

Effect of vegetable oils applied over acquired enamel pellicle on initial erosion

Abstract Objective The prevalence of dental erosion has been recently increasing, requiring new preventive and therapeutic approaches. Vegetable oils have been studied in preventive dentistry because they come from a natural, edible, low-cost, and worldwide accessible source. This study aimed to evaluate the protective effect of different vegetable oils, applied in two concentrations, on initial enamel erosion. Material and Methods Initially, the acquired pellicle was formed in situ for 2 hours. Subsequently, the enamel blocks were treated in vitro according to the study group (n=12/per group): GP5 and GP100 - 5% and pure palm oil, respectively; GC5 and GC100 - 5% and pure coconut oil; GSa5 and GSa100 - 5% and pure safflower oil; GSu5 and GSu100 - 5% and pure sunflower oil; GO5 and GO100 - 5% and pure olive oil; CON− - Deionized Water (negative control) and CON+ - Commercial Mouthwash (Elmex® Erosion Protection Dental Rinse, GABA/positive control). Then, the enamel blocks were immersed in artificial saliva for 2 minutes and subjected to short-term acid exposure in 0.5% citric acid, pH 2.4, for 30 seconds, to promote enamel surface softening. The response variable was the percentage of surface hardness loss [((SHi - SHf) / SHf )×100]. Data were analyzed by one-way ANOVA and Tukey's test (p<0.05). Results Enamel blocks of GP100 presented similar hardness loss to GSu100 (p>0.05) and less than the other groups (p<0.05). There was no difference between GP5, GC5, GC100, GSa5, GSu100, GSa100, GSu5, GO5, GO100, CON− and CON+. Conclusion Palm oil seems to be a promising alternative for preventing enamel erosion. However, further studies are necessary to evaluate a long-term erosive cycling.

Delayed Treatment of Traumatized Primary Teeth with Distinct Pulp Response: Follow-Up until Permanent Successors Eruption.

Complicated crown fracture and crown-root fracture with pulp involvement expose dental pulp to the oral environment. The pulp outcome is often unpredictable because the patient and injury which are related to variables can influence the treatment of choice and the prognosis of the case. This report presents the case of a 4-year-old boy with complicated crown fracture with pulp polyp in the primary right maxillary central incisor (51) and crown-root fracture with pulp involvement in the primary left maxillary central incisor (61), which was treated only 3 months after the tooth injuries. The treatment of choice was extraction of tooth (61) due to a periapical lesion with disruption of the dental follicle of the permanent successor and pulpotomy (MTA) of the tooth (51), because the pulp presented signs of vitality. At the follow-up visits, no clinical, symptomalogical, and radiographic changes were observed until the primary tooth's exfoliation. However, at 3-year follow-up, the permanent successors showed hypocalcification and the position of the permanent right maxillary central incisors (11) was altered. Besides the conservative and adequate delayed treatment, the sequelae on the permanent successors could not be avoided.

In situ effect of enamel salivary exposure time and type of intraoral appliance before an erosive challenge.

OBJECTIVES: This study tested the effect of enamel salivary exposure time prior to an acid challenge (30 min, 1, 2, or 12 h) and type of intraoral appliance (palatal or mandibular) on initial erosion. METHODS: After initial surface hardness evaluation, enamel blocks (n = 340) were randomly divided into groups and volunteers (n = 20). The control group was not exposed to saliva previously to the erosive challenge. The volunteers wore palatal and mandibular appliances simultaneously. After salivary exposure, the blocks were subjected to acid exposure by immersion in hydrochloric acid (0.01 M, pH 2.3) for 30 s. Then, the enamel surface hardness was evaluated. Data were analyzed using ANOVA, Kruskal-Wallis and Tukey's test (p < 0.05). RESULTS: No difference was observed on percent surface hardness change (% SHC) in the enamel blocks between the types of intraoral appliances. Exposure to saliva for 30 min and 1 h promoted similar enamel resistance to the erosive attack, which was similar to the control group for both appliances. Blocks exposed to saliva for 2 h showed less hardness loss when compared to 30 min. Keeping the blocks in saliva during 12-h overnight resulted in similar percentage of enamel hardness loss compared to 2 h. CONCLUSIONS: A 2-hour in situ exposure to saliva is adequate to promote partial protection against initial erosive lesions, independently of the type of intraoral appliance used. CLINICAL SIGNIFICANCE: This finding will help researchers in the development of erosion studies, which will provide information for dentists to offer a better treatment for erosion.

Conservative management of external root resorption after tooth reimplantation: a 3-year follow-up.

The aim of this case report is to describe the treatment of a 9-year-old patient who suffered external root resorption of the permanent maxillary left lateral incisor following reimplantation of the avulsed left central and lateral incisors. Sixteen days after reimplantation and splinting of the incisors in a hospital emergency department, the patient was brought to the pediatric department of a dental school for further treatment. Root canal access was created in the maxillary left lateral and central incisors, and calcium hydroxide paste was used as intracanal dressing. At the 5-month follow-up, a radiograph revealed extensive external root resorption, a communicating root canal, and a periodontal lesion affecting the left lateral incisor. Management of the root resorption included obturation of the apical third of the canal with gutta percha and the middle third with mineral trioxide aggregate (MTA). At the 3-year recall examination, the patient was asymptomatic, and no mobility or soft tissue alterations were observed clinically. There was no radiographic sign that resorption had progressed. Despite the success of treatment, observation is still required. The use of MTA may be considered an alternative treatment for external root resorption after tooth reimplantation. The technique may allow tooth preservation in children until skeletal growth and development are completed and implant treatment may be considered.

Impact of Saliva and Intraoral Appliance on Erosion Lesions Rehardening Ability - A Pilot Study

Objective: To evaluate the ability of different periods of salivary exposure and two different removable appliances to rehardening initial erosive lesions. Material and Methods: This randomized, single blind in situ study was conducted with 2 crossover phases. The factors under study were: period of salivary exposure (15 minutes, 30 minutes, 1 hour and 2 hours) and type of oral appliance (maxillary or mandibular). Two hundred enamel blocks were selected by initial surface hardness (SHi). Enamel blocks were demineralized in vitro (0.05M citric acid; pH2.5 for 15 seconds), surface hardness (SHd) was remeasured and 160 blocks were selected and randomized among groups. Thus, there were 2 blocks per period of salivary exposure in each type of oral appliance for each one of the 10 volunteers. In each phase, one of the removable appliances was tested. The response variable was percentage of surface hardness recovery (%SHR=[(SHf-SHd)/SHi)]x100). Two-way ANOVA and Tukey's post hoc test were applied adopting 5% of significance. Results: No difference was found among oral appliances on enamel rehardening (p>0.01). Salivary exposure of 2 hours promoted similar enamel rehardening when compared to 1 hour (p>0.05), which showed similar rehardening to 30 min. All mentioned period of salivary exposure promoted superior rehardening than 15 min (p>0.01). Conclusion: The salivary time exposure between erosive attacks might be 2 hours to achieve a feasible maximum rehardening. In addition, both maxillary and the mandibular appliance have presented a similar rehardening ability.

Penetration of resin-based materials into initial erosion lesion: A confocal microscopic study.

The application of resin-based materials is an alternative of treatment for eroded lesions. Nevertheless, there are no studies about the penetration of these materials into eroded lesion, which might affect its adhesion. Therefore, this study evaluated the penetration of four resin-based materials, with and without enamel etching. By using an in vitro protocol, types of treatment were studied at five levels (AdheSE(®) , Tetric N-Bond(®) , Single Bond 2(®) , Helioseal Clear(®) , Icon(®) ) and types of enamel etching in two levels (with and without). Materials were stained with 0.02 mg/mL ethanolic solution of tetramethylrhodamine isothiocyanate. Bovine enamel samples (4 × 4 mm) were immersed in 0.01 M HCl, pH 2.3, for 30 seconds to produce initial eroded lesions. Afterward, the materials were applied on half of sample enamel surface following the manufacturer's instructions. On the other half of sample, the materials were applied without etching the enamel. Materials penetration into the enamel was assessed by Confocal Laser Scanning Microscopy on reflection and fluorescence modes. The penetration depth (PD) was measured using ImageJ software. Data were analyzed by two-way ANOVA and Tukey test (P < 0.05). Regardless of the material, etched enamel resulted in higher PD than non-etched (P < 0.05). Icon(®) showed the highest PD in enamel followed by Helioseal Clear(®) (P < 0.05), with significant difference between them (P < 0.05) and no difference was found among AdheSE(®) , Tetric N-Bond(®) , and Single Bond 2(®) (P > 0.05). It can be concluded that prior enamel etching increased the materials penetration into eroded enamel and the Icon(®) -infiltrant presented highest penetration.

Resin infiltration of early carious lesion in early childhood: a case report.

The treatment of white-spot lesions in infants and young children with early childhood caries is a challenge. The ideal management of the disease and subsequent remineralization of the lesions depend on the family's commitment to dietary behavior modifications to address the causes of the disease. If this proves ineffective or unlikely, resin infiltration has been developed to slow or arrest progression of white-spot lesions. In resin infiltration, the porous lesion body is penetrated by a special low-viscosity resin, blocking the diffusion of cariogenic acids into the lesion. This case report describes the use of a resin infiltrant to treat white-spot lesions in a 24-month-old boy with early childhood caries.

Changes in Oral Health-related Behavior of Infants following a Preventive Program of Continuing Education Directed to their Parents

To evaluate changes in oral health-related behavior of infants following preventive program of continuing education directed to their parents.Material and Methods:We analyzed 53 dental files of infants aged up to 36 months, who participated in the Prevention and Education Program of the Infants Clinic, School of Dentistry of Bauru (USP), and attended at least 2 visits with a maximum of 4 missing appointments. Initially an educational lecture was conducted, pointing issues related to diet and oral hygiene. At the following visit, the professional filled in a form with questions about diet and hygiene performed at home. The following information was extracted from dental files: reason of the first visit, age, number of teeth, number of visits, missing appointments, and dietary and oral hygiene risk factors. The data were tabulated and analyzed using descriptive statistics comparing the information obtained from the first visit to that of the last one.Results:The reason for the first visit was dental caries prevention (88.68%) followed by dental trauma (7.55%), and needed of curative treatment (3.77%). The mean age of the sample was 14.85 months, the tooth number mean was 12.64 at first visit, the mean number of visits was 7 and the mean missing appointments was 0.83. The percentage of infants with inadequate diet and hygiene habits was 88.68% and 62.26%, and only 12.762% and 57.57% of these have changed their habits, respectively.Conclusion:After the preventive program of continuing education, the dietary habits showed were more difficult to change in relation to hygiene ones...

In vitro assessment of artificial saliva formulations on initial enamel erosion remineralization.

OBJECTIVES: Various formulations of artificial saliva are present in the literature and little guidance is available on the standardization of type of saliva for use in in vitro protocols for erosive studies. The aim of this study was to evaluate the remineralizing capacity of different formulations of artificial saliva on initial enamel erosive lesion. METHODS: Bovine enamel blocks were subjected to short-term acidic exposure by immersion in citric acid 0.05 M (pH 2.5) for 15s, resulting in surface softening without tissue loss. Then 90 selected eroded enamel blocks were randomly and equally divided into 6 groups according to saliva formulation (n=15): Saliva 1 (contain mucin); Saliva 2 (Saliva 1 without mucin); Saliva 3; Saliva 4; Saliva 5 (contain sodium carboxymethyl cellulose) and control (C) (deionized water). After demineralization enamel blocks were subjected to remineralization by immersion in the saliva's formulations for 2h. Enamel remineralization was measured by superficial hardness test (% superficial hardness change). The data were tested using ANOVA and Tukey's test (p<0.05). RESULTS: All the tested formulations of artificial saliva resulted in significantly higher enamel remineralization compared to control (p<0.001). Saliva 3 showed higher percentage of enamel remineralization than Saliva 5 (p<0.05). CONCLUSIONS: Besides the variety of artificial saliva for erosion in vitro protocols, all the formulations tested were able to partially remineralize initial erosive lesions.