Effect of Silver Nanoparticle-Added Pit and Fissure Sealant in the Prevention of Dental Caries in Children.

OBJECTIVE: The objective of this study was to evaluate the effects of pit and fissure sealant mixed with silver nanoparticles on dental caries, by means of monthly measurement of fluorescence with DIAGNOdent over six months. STUDY DESIGN: This study was divided in two phases: experimental and clinical. In the experimental phase, the adhesion and microleakage of the pit and fissure sealant experiment were evaluated. Two groups of 10 teeth, without serious carious lesions, were included. Conventional (group A) and silver nanoparticles (group B) were added to the pit and fissure sealant. For the clinical phase, a split-mouth study was performed on 40 children aged 6-10 years old with healthy, erupted permanent first molars. A conventional pit and fissure sealant or a silver nanoparticle-mixed sealant was randomly placed. Repeated measures analysis was performed. RESULTS: Conventional sealant presented an average microleakage of 30.6%, and the silver nanoparticle-mixed sealant showed 33.6% (P=NS). A three times greater reduction in fluorescence was found in the silver nanoparticles group compared to the conventional group (P<0.05). No sex- or age-based associations were found. CONCLUSIONS: The silver nanoparticle-mixed sealant reduced tooth demineralization significantly and likely increased remineralization, compared to the conventional sealant.

Pain Measurement through Temperature Changes in Children Undergoing Dental Extractions.

Background and Objective. Pain evaluation in children can be a difficult task, since it possesses sensory and affective components that are often hard to discriminate. Infrared thermography has previously been used as a diagnostic tool for pain detection in animals; therefore, the aim of this study was to assess the presence of temperature changes during dental extractions and to evaluate its correlation with heart rate changes as markers of pain and discomfort. Methods. Thermographic changes in the lacrimal caruncle and heart rate measurements were recorded in healthy children scheduled for dental extraction before and during the procedure and compared. Afterwards, correlation between temperature and heart rate was assessed. Results. We found significant differences in temperature and heart rate before the procedure and during the dental extraction (mean difference 4.07°C, p < 0.001, and 18.11 beats per minute, p < 0.001) and no evidence of correlation between both measurements. Conclusion. Thermographic changes in the lacrimal caruncle can be detected in patients who undergo dental extractions. These changes appear to be stable throughout time and to possess very little intersubject variation, thus making them a candidate for a surrogate marker of pain and discomfort. Future studies should be performed to confirm this claim.

Zinc Oxide-Eugenol Pulpotomy in Primary Teeth: A 24-Month Follow-up.

OBJECTIVE: The purpose of the present study was to evaluate the clinical and radiographic effectiveness of zinc oxide-eugenol (ZOE) as the only pulp capping agent in pulpotomies carried out on decayed primary molars after a follow-up period of 24 months. STUDY DESIGN: In total, 60 pulpotomies were performed on 38 patients aged 3 to 11 years. Pulpotomy treatment consisted of the removal of the coronal pup tissue, subsequent hemostasis, irrigation with saline solution, drying and pressure with sterile cotton pellets, and placement of a thick regular ZOE base with a minimal amount of eugenol directly over the vital radicular pulp. Additionally, a histopathologic study was carried out on some of the molars treated. RESULTS: After a 24-month follow-up, we considered 51 procedures to be successful and 9 failures using clinical and radiographic criteria; most of the failures occurred between the 12th and 18th month. CONCLUSIONS: Results suggest that the proposed pulpotomy treatment with ZOE as the only capping agent may be considered as an alternative technique in the pulp treatment of primary molars.

Sustained release of calcium hydroxide from poly(DL-lactide-co-glycolide) acid microspheres for apexification.

Calcium hydroxide (CH) loaded poly(DL-lactide-co-glycolide) acid (PLGA) microspheres (MS) might be used for apexification requiring a sustained release of Ca(2+). The aim of this study was to formulate and characterize CH-PLGA-MS. The CH-loaded MS were prepared by either oil-in-water (O/W) or water-in-oil/in-water (W/O/W) emulsion solvent evaporation technique. MS produced by the O/W technique exhibited a larger diameter (18.63 ± 7.23 µm) than the MS produced by the W/O/W technique (15.25 ± 7.37 µm) (Mann-Whitney U test P < 0.001). The CH encapsulation efficiency (E e) and Ca(2+) release were calculated from data obtained by absorption techniques. Ca(2+) release profile was evaluated for 30 days. To know the E e, the CH-loaded MS were dissolved in 1 M NaOH to release all its content and a Ca(2+) colorimetric marker was added to this solution. The reagent marked the Ca(2+) in blue color, which was then measured by a UV-Vis system (650 nm). The percentage of E e was calculated on the basis of the theoretical loading. The E e of the O/W-produced MS was higher (24 %) than the corresponding percentage of the W/O/W-produced MS (11 %). O/W- and W/O/W-produced MS released slower and lower Ca(2+) than a control CH paste with polyethylene glycol 400 (Kruskal-Wallis test). O/W-produced MS released higher Ca(2+) than W/O/W-produced MS (statistically significant differences; P < 0.05). In conclusion, the CH-PLGA-MS were successfully formulated; the technique of formulation influenced the size, encapsulation efficiency and release profile. The MS were better sustained release system than the CH paste.

Biofilm formation by oral clinical isolates of Candida species.

We have conducted a longitudinal study to quantify biofilms in oral clinical isolates of Candida species (spp.) from adults with local and systemic predisposing factors for candidiasis. A total of 69 yeast isolates from 63 Mexican patients were evaluated. These isolates (39 C. albicans, 15 C. tropicalis, 7 C. glabrata, 4 C. krusei, 1 C. lusitaniae, 1 C. kefyr, 1 C. guilliermondii and 1 C. pulcherrima) were obtained from two clinical sites: 62.3% (n=43) from the oral mucosa of totally and partially edentulous patients, and 37.7% (n=26) from the oral mucosa of diabetics. In addition, Candida ATCC strains were used as controls for each experiment. The kinetics of biofilm formation were measured by 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-5-[(phenylamino)carbonyl]-2H-tetrazolium hydroxide [XTT] reduction; each isolate was tested at 6, 12 and 24h. Biofilm formation is dependent on the Candida spp. and its clinical origin. On average, the oral isolates of C. glabrata are strong biofilm producers, whereas C. albicans and C. tropicalis are moderate producers. The most common species in our population was C. albicans. While the kinetics of C. albicans biofilm formation varies between oral isolates, it generally maintains steady growth from 2 to 48h, when it reaches its maximum growth.

Root canal hydrophobization by dentinal silanization: improvement of silicon-based endodontic treatment tightness.

A new strategy to improve silicon-based endodontic treatment tightness by dentine hydrophobization is presented in this work: root dentine was silanized to obtain a hydrophobic dentine-sealer interface that limits fluid penetration. This strategy was based on the grafting of aliphatic carbon chains on the dentine through a silanization with the silane end groups [octadecyltrichlorosilane (OTS) and octadecyltriethoxysilane]. Dentine surface was previously pretreated, applying ethylenediaminetetraacetic acid and sodium hypochlorite, to expose hydroxyl groups of collagen for the silane grafting. Collagen fibers exposure after pretreatment was visible with scanning electron microscopy, and Fourier transform infrared (FTIR) spectroscopy showed their correct exposition for the silanization (amide I and II, with 1630, 1580, and 1538 cm⁻¹ peaks corresponding to the vibration of C=O and C--N bonds). The grafting of aliphatic carbon chains was confirmed by FTIR (peaks at 2952 and 2923 cm⁻¹ corresponding to the stretching of C--H bonds) and by the increasing of the water contact angle. The most efficient hydrophobization was obtained with OTS in ethyl acetate, with a water contact angle turning from 51° to 109°. Gas and liquid permeability tests showed an increased seal tightness after silanization: the mean gas and water flows dropped from 2.02 × 10⁻8 to 1.62 × 10⁻8 mol s⁻¹ and from 10.8 × 10⁻³ to 5.4 × 10⁻³ µL min⁻¹, respectively. These results show clear evidences to turn hydrophilic dentine surface into a hydrophobic surface that may improve endodontic sealing.

Orofacial findings and dental management of Williams-Beuren syndrome.

Williams-Beuren syndrome is a rare congenital disorder involving the cardiovascular system, mental retardation, distinctive facial features, and tooth anomalies. The aim of the present report is to show a 10-year-old girl with Williams-Beuren syndrome, her general and orofacial clinical characteristics and the dental management.

Rehabilitación protésica en displasia ectodérmica hipohidrótica: reporte de un caso / Prosthetic rehabilitation in hypohidrotic ectodermal dysplasia: Report of a case

La displasia ectodérmica hipohidrótica es un síndrome genético, caracterizado principalmente por hipohidrosis, hipotricosis e hipodoncia. Esta enfermedad es asociada con hipodoncia y atrofia de los procesos alveolares. El aspecto facial y la ausencia dental múltiple puede ser causa de problemas de socialización por parte de los niños afectados. El propósito de este reporte es describir las características y el manejo odontológico y protésico de un paciente masculino de 5 años de edad diagnosticado con el síndrome.

Hypodriotic ectotermal dysplasia is a genetic syndrome characterized mainly by hypodriosis, hypotrichosis and hypodontia. This disesase is associated with hypodontia and atrophy of the alveolar process. The facial aspect and the multiple missing teeth can cause problems of socialization of the affected children. The aim of this report is to describe features and dental and prosthetic management of a 5-year-old boy, diagnosed with the syndrome.

Orocraniofacial findings and dental management of a pediatric patient with Dubowitz syndrome.

Dubowitz syndrome is a rare genetic condition characterized by microcephaly, dysmorphic facial features and delayed general growth. It is transmitted through autosomal recessive inheritance. The purpose of this report is to describe the oral, craniofacial and systemic characteristics of a 7-year 11-month-old boy with Dubowitz syndrome and the dental management provided. The pediatric dentist should possess the ability to recognize this rare alteration, to provide dental treatment and to refer for the necessary medical and multidisciplinary treatment.

Caries de la infancia temprana: ¿negligencia o ignorancia?: reporte de un caso / Early childhood caries: ¿neglect or ignorance?: report of a case

El presente es el reporte de un caso de un niño de 5 años 4 meses de edad que exhibía un patrón de caries dental de la infancia temprana severa no tratada oportunamente, debido a ignorancia y posible negligencia por parte de los padres. Se describe el proceso diagnóstico y el tratamiento brindado al paciente y el manejo preventivo que se instituyó a corto, mediano y largo plazo.

This case report is of a 5 years 4 months old male patient who exhibited a pattern of severe dental early caries childhood not treated in a timely manner, due to parent ignorance and possible negligence. The diagnostic process, treatment provided to the patient, and instituted preventive management in the short, medium and long term, are described.

Comparison between rotary and manual techniques on duration of instrumentation and obturation times in primary teeth.

OBJECTIVE: The aim of this study was to compare the duration of instrumentation and obturation times and quality of root canal filling between rotary and manual instrumentation techniques in primary teeth. STUDY DESIGN: A randomized, controlled clinical trial was performed that included deciduous teeth with pulp necrotic. Forty necrotic teeth were included; 20 were instrumented with a rotary technique (experimental group) and 20 with a manual technique (control group). The time taken for instrumentation and for obturation were recorded in minutes, and the quality of the root canal filling was recorded as optimal, under-filled, or overfilled. RESULTS: The use of the rotary technique diminished the time of instrumentation to 63% and time of obturation to 68%, and it improved the quality of the root canalfilling. CONCLUSION: The use of rotary instruments in the pulpectomy of primary molars represents a promising technique; the time is significantly reduced.

Preemptive analgesic effectiveness of oral ketorolac plus local tramadol afterimpacted mandibular third molar surgery

Objective: The aim of this study was to compare preemptive analgesia of oral ketorolac plus submucous localplacebo with oral ketorolac plus submucous local tramadol after impacted mandibular third molar surgery.Study design: A double-blind, randomized, placebo-controlled clinical trial was conducted. Patients were randomizedinto two treatment groups (n = 15 per group): group A, oral ketorolac 10 mg, 30 minutes before surgeryplus submucous local placebo (1 mL saline solution); group B, oral ketorolac 10 mg, 30 minutes before surgeryplus submucous local tramadol (50 mg diluted in 1 mL saline solution). We evaluated the intensity of pain, timefor the first analgesic rescue medication, and total analgesic consumption.Results: Pain intensity, number of patients requiring analgesic rescue medication, number of patients in each groupnot requiring analgesic rescue medication, and total analgesic consumption showed statistical significance.Conclusions: Preemptive use of oral ketorolac plus submucous local tramadol is an alternative treatment for acutepain after surgical removal of an impacted mandibular third molar (AU)

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Instrumentación rotatoria en dientes temporales: reporte de un caso / Rotary instrumentation in primary teeth: report of a case

Los métodos mecánicos de la preparación del conducto radicular utilizando instrumentos de Ni-Ti se puede utilizar en dientes temporales. El objetivo del informe del caso es presentar los hallazgos radiológicos de un molar primario tratado con pulpectomía y el uso de instrumentación rotatoria para la preparación biomecánica en molar temporal de una niña de 4 años de edad.

Mechanical methods of root canal preparation using Ni-Ti files can be used in primary teeth. The aim of this case report is to present radiographic findings of a primary molar treated by pulpectomy therapy, using rotary instrumentation for biomechanical preparation in a 4-yearold girl.

Preemptive analgesic effectiveness of oral ketorolac plus local tramadol after impacted mandibular third molar surgery.

OBJECTIVE: The aim of this study was to compare preemptive analgesia of oral ketorolac plus submucous local placebo with oral ketorolac plus submucous local tramadol after impacted mandibular third molar surgery. STUDY DESIGN: A double-blind, randomized, placebo-controlled clinical trial was conducted. Patients were randomized into two treatment groups (n = 15 per group): group A, oral ketorolac 10 mg, 30 minutes before surgery plus submucous local placebo (1 mL saline solution); group B, oral ketorolac 10 mg, 30 minutes before surgery plus submucous local tramadol (50 mg diluted in 1 mL saline solution). We evaluated the intensity of pain, time for the first analgesic rescue medication, and total analgesic consumption. RESULTS: Pain intensity, number of patients requiring analgesic rescue medication, number of patients in each group not requiring analgesic rescue medication, and total analgesic consumption showed statistical significance. CONCLUSIONS: Preemptive use of oral ketorolac plus submucous local tramadol is an alternative treatment for acute pain after surgical removal of an impacted mandibular third molar.

Reattachment of anterior teeth fragments using a modified Simonsen's technique after dental trauma: report of a case.

This is a case report of a 9-year-old boy with complicated crown fractures of two traumatized teeth: left maxillary central and lateral incisors. The central incisor presented a small pulpal exposure of approximately 1 mm and the lateral incisor had an ulcerated and exposed pulp. Endodontic management included direct pulp capping, partial pulpotomy, and restorative management including reattachment of the teeth fragments using a modified Simonsen's technique. The reattached fragments were assessed clinically and radiographically at 12 months. The teeth remained vital, there were no color changes, and the restorations had an acceptable appearance.

In vitro cytotoxicity of silver nanoparticles on human periodontal fibroblasts.

UNLABELLED: Silver nanoparticles (NNPs) are extensively used for all kinds of antimicrobial applications in medical research. Their efficacy has been demonstrated against Streptococcus mutans, which is associated with dental caries. However their cytotoxic effects on human periodontal tissue are not completely understood. OBJECTIVE: The aim of this study was to evaluate the possible toxic cellular effects of different concentrations and sizes of silver nanoparticles, less than 10 nm, 15-20 nm, and 80-100 nm, respectively, on human periodontal fibroblasts. STUDY DESIGN: Primary culture cells isolated from human periodontal tissue were exposed to 0-1,000 microM silver nanoparticles of each size for 24-, 72-, and 168-hour periods. Cytotoxicity was evaluated with a nonradioactive, soluble MTS/PMS assay. RESULTS: The results demonstrated that silver nanoparticles of less than 20 nm increased cytotoxicity in human periodontal fibroblasts in a dose- and time-dependent manner. CONCLUSION: The 80-100-nm-sized nanoparticles did not modify the viability of human primary culture cells.

Identification of cultivable microorganisms from primary teeth with necrotic pulps.

The objective of this study was to identify cultivable microorganisms from primary teeth with necrotic pulps. This experimental study included 21 patients of both sexes between 4 and 7 years of age with necrotic pulps in primary teeth. Twenty-one maxillary and mandibular molars containing at least 1 necrotic canal, an abscess or sinus tract, one or more radiolucent areas in the furcation or periapical region, teeth having at least two thirds of root length, and carious lesions directly exposed to the oral environment were included. After antisepsis of the oral cavity, anesthesia of the affected tooth, and isolation and disinfection of the operative field, 3 sterile absorbent paper points were sequentially placed for 30 seconds for the collection of samples. The samples were immediately processed in an anaerobic chamber, and all isolated microorganisms were identified. Anaerobic species (anaerobic facultative and moderate anaerobes) were isolated in all root canals; 68.4% of root canal samples studied showed a polymicrobial nature. Most of the isolate consisted of Bifidobacterium Spp2 and Streptococcus intermedius. Other less frequently encountered species were Actinomyces israelii, Bifidobacterium spp 1, Clostridium spp, and Candida albicans. Results indicate the existence of combinations of bacterial species in root canal infections of the primary dentition with necrotic pulps, anaerobic bacteria predominating.

Use of therapeutic laser after surgical removal of impacted lower third molars.

PURPOSE: To evaluate the effectiveness of a therapeutic laser in the control of postoperative pain, swelling, and trismus associated with the surgical removal of impacted third molars. PATIENTS AND METHODS: A double-blind, randomized, controlled clinical trial was conducted in 2 groups of 15 patients each undergoing surgical removal of impacted lower third molars under local anesthesia. The experimental group received 4 J/cm(2) of energy density intraorally and extraorally, with a laser with a diode wavelength of 810 nm and output power of 100 mW in a continuous wave. The control group received only standard management. The degree of postoperative pain, swelling, and trismus was registered for both groups. RESULTS: The experimental group exhibited a lower intensity of postoperative pain, swelling, and trismus than the control group, without significant statistical differences. Patients of both groups required rescue medication; however, the time lapse between the end of the surgery and the administration of the medication was shorter for the control group. CONCLUSION: The use of therapeutic laser in the postoperative management of patients having surgical removal of impacted third molars, using the protocol of this study, decreases postoperative pain, swelling, and trismus, without statistically significant differences.

Bactericidal capacity of silver nanoparticles associated with Gantrez S-97 on Streptococcus mutans.

UNLABELLED: Dental caries is a worldwide public health problem. S mutans plays an important role in the etiology of caries. There have been studies that showed the antimicrobial properties of silver nanoparticles are an effective agent to diminish S. mutans. The objective of this study was to evaluate the bactericidal and bacteriostatic effects of silver nanoparticles in addition to the Gantrez S-27 copolymer, on S mutans. METHOD: We performed an in vitro experimental study using the liquid microdilution method in order to find the minimum inhibitory concentrations (MICs) and the minimum bactericidal concentrations (MBCs) with the subcultures obtained. The mixture was obtained by preparing 98 microg/mL of silver nanoparticles (10(3)mol) with Gantrez S-27 2%, in distilled water The readings were performed 24 hours after incubation and on 3 consecutive days. The results showed an average MTC of 6.12 microg /mL and MBC of 6.12 microg /mL. CONCLUSION: The addition of Gantrez 2% to silver nanoparticles does not alter its antimicrobial effect.

Direct pulp capping in primary molars with enamel matrix derivative: report of a case.

UNLABELLED: Enamel Matrix Derivative (EMD) is a rich amelogenin and amelin biomaterial that has been demonstrated to induce a reparative process similar to normal odontogenesis when placed in contact with pulp tissue. However its effects in pulp capping on primary teeth has not been previously reported. THE AIM of the present case report is to present the favorable clinical and radiographic findings of a primary molar treated with direct pulp capping (DPC) and using EMD as capping material in a 6-year-old girl. RESULTS: After 12 months, there was no sign or symptom indicative of treatment failure, such as pain, gingival swelling, sinus tract, sensitivity to percussion or palpation, abnormal mobility, widening of periodontal space, internal or external root resorption, or supporting bone or furcal area radiolucencies.