Effect of Chlorhexidine Gel in Mentally Handicapped Children highly Infected with Streptococcus Mutans

Objective:To evaluate the effect of 1% chlorhexidine (CHX) gel on mentally handicapped children (n=11) highly infected with Streptococcus mutans (SM) and evaluate the re-colonization time of this bacterium after the treatment period.. Material and Methods:Before CHX treatment, saliva samples were collected to establish baseline saliva SM levels. CHX gel was daily applied for 5 min, for 7 consecutive days. Saliva samples were then collected after 7, 30, 60, 90 and 120 days to evaluate SM oral re-colonization. Data were analyzed by the Wilcoxon test (α=0.05).Results:When compared to baseline (5.7 / 3.0 x 105), the collection performed 7 days after CHX treatment (0.06 / 0.2 x 105) showed a significant reduction (P <0.05) in SM saliva levels (mean / s.d., CFU ml-1). In subsequent collections, a gradual SM re-colonization was observed, and after 60 days of treatment, the levels of this bacterium (0.8 / 0.9 x 105) no longer statistically differed from SM levels considered high risk to caries (105) (P> 0.05).Conclusion:Treatment with CHX gel for 7 days was effective in reducing the SM levels of mentally handicapped children and should be repeated after 60 days to control the risk of caries in these children...

Fluoride concentration in the top-selling Brazilian toothpastes purchased at different regions.

To be relevant in terms of public health, widely-used toothpastes should have at least 1,000 ppm of soluble fluoride (F) concentration. Thus, the concentrations of total fluoride (TF) and total soluble fluoride (TSF) in the top-selling Brazilian toothpastes were evaluated. Samples (n=3) from toothpastes Colgate Anti-cáries(®), Colgate Total 12 Clean Mint(®), Colgate Tripla Ação Menta Original(®), Colgate Tripla Ação Menta Suave(®) and Sorriso Dentes Brancos(®) were obtained from each of the five regions of the country. The concentrations of TF and TSF were analyzed with ion-specific electrode calibrated with F standards and the results were expressed in ppm (µg F/g). All toothpastes showed TF concentration lower than 1,500 ppm F (1,388.2 ± 25.8 to 1,483.2 ± 98.2). The TSF values were higher than 1,000 ppm F and ranged from 1,035.5 ± 61.5 to 1,221.8 ± 35.2 for calcium carbonate/monofluorophosphate-based toothpastes and from 1,455.6 ± 12.5 to 1,543.0 ± 147.3 for silica/sodium fluoride-based toothpaste. Top-selling Brazilian toothpastes presented available fluoride concentration to control caries regardless of the region where they are purchased.

Fluoride concentration in the top-selling Brazilian toothpastes purchased at different regions

To be relevant in terms of public health, widely-used toothpastes should have at least 1,000 ppm of soluble fluoride (F) concentration. Thus, the concentrations of total fluoride (TF) and total soluble fluoride (TSF) in the top-selling Brazilian toothpastes were evaluated. Samples (n=3) from toothpastes Colgate Anti-cáries®, Colgate Total 12 Clean Mint®, Colgate Tripla Ação Menta Original®, Colgate Tripla Ação Menta Suave® and Sorriso Dentes Brancos® were obtained from each of the five regions of the country. The concentrations of TF and TSF were analyzed with ion-specific electrode calibrated with F standards and the results were expressed in ppm (µg F/g). All toothpastes showed TF concentration lower than 1,500 ppm F (1,388.2 ± 25.8 to 1,483.2 ± 98.2). The TSF values were higher than 1,000 ppm F and ranged from 1,035.5 ± 61.5 to 1,221.8 ± 35.2 for calcium carbonate/monofluorophosphate-based toothpastes and from 1,455.6 ± 12.5 to 1,543.0 ± 147.3 for silica/sodium fluoride-based toothpaste. Top-selling Brazilian toothpastes presented available fluoride concentration to control caries regardless of the region where they are purchased.

Para ter relevância em termos de saúde pública, os cremes dentais amplamente utilizados pela população devem ter fluoreto (F) solúvel numa concentração mínima de 1.000 ppm F. Assim, as concentrações de fluoreto total (FT) e flureto solúvel total (FST) nos cremes dentais mais vendidos no Brasil foram avaliados. Os cremes dentais (n=3) Colgate Anti-cáries®, Colgate Total 12 Clean Mint®, Colgate Tripla Ação Menta Original®, Colgate Tripla Ação Menta Suave® e Sorriso Dentes Brancos® foram obtidos nas cinco regiões do país. As concentrações de FT e FST foram analisadas com eletrodo íon-específico calibrado com padrões de F e os resultados foram expressos em ppm (µg F/g). Todos os cremes dentais apresentaram concentração de FT inferior a 1.500 ppm F (1.388,2 ± 25,8 a 1.483,2 ± 98,2). Os valores de FST foram superiores a 1.000 ppm F e variaram de 1.035,5 ± 61,5 a 1.221,8 ± 35,2 para cremes dentais a base de carbonato de cálcio/monofluorfosfato e de 1.455,6 ± 12,5 a 1.543,0 ± 147,3 para o creme dental à base de sílica/fluoreto de sódio. Os cremes dentais mais vendidos no Brasil apresentaram concentração de fluoreto solúvel para controlar cárie, independentemente da região onde foram comprados.

Speech evaluation in children with temporomandibular disorders.

OBJECTIVE: The aims of this study were to evaluate the influence of temporomandibular disorders (TMD) on speech in children, and to verify the influence of occlusal characteristics. MATERIAL AND METHODS: Speech and dental occlusal characteristics were assessed in 152 Brazilian children (78 boys and 74 girls), aged 8 to 12 (mean age 10.05 ± 1.39 years) with or without TMD signs and symptoms. The clinical signs were evaluated using the Research Diagnostic Criteria for TMD (RDC/TMD) (axis I) and the symptoms were evaluated using a questionnaire. The following groups were formed: Group TMD (n=40), TMD signs and symptoms (Group S and S, n=68), TMD signs or symptoms (Group S or S, n=33), and without signs and symptoms (Group N, n=11). Articulatory speech disorders were diagnosed during spontaneous speech and repetition of the words using the "Phonological Assessment of Child Speech" for the Portuguese language. It was also applied a list of 40 phonological balanced words, read by the speech pathologist and repeated by the children. Data were analyzed by descriptive statistics, Fisher's exact or Chi-square tests (α=0.05). RESULTS: A slight prevalence of articulatory disturbances, such as substitutions, omissions and distortions of the sibilants /s/ and /z/, and no deviations in jaw lateral movements were observed. Reduction of vertical amplitude was found in 10 children, the prevalence being greater in TMD signs and symptoms children than in the normal children. The tongue protrusion in phonemes /t/, /d/, /n/, /l/ and frontal lips in phonemes /s/ and /z/ were the most prevalent visual alterations. There was a high percentage of dental occlusal alterations. CONCLUSIONS: There was no association between TMD and speech disorders. Occlusal alterations may be factors of influence, allowing distortions and frontal lisp in phonemes /s/ and /z/ and inadequate tongue position in phonemes /t/; /d/; /n/; /l/.

Speech evaluation in children with temporomandibular disorders

OBJECTIVE: The aims of this study were to evaluate the influence of temporomandibular disorders (TMD) on speech in children, and to verify the influence of occlusal characteristics. MATERIAL AND METHODS: Speech and dental occlusal characteristics were assessed in 152 Brazilian children (78 boys and 74 girls), aged 8 to 12 (mean age 10.05 ± 1.39 years) with or without TMD signs and symptoms. The clinical signs were evaluated using the Research Diagnostic Criteria for TMD (RDC/TMD) (axis I) and the symptoms were evaluated using a questionnaire. The following groups were formed: Group TMD (n=40), TMD signs and symptoms (Group S and S, n=68), TMD signs or symptoms (Group S or S, n=33), and without signs and symptoms (Group N, n=11). Articulatory speech disorders were diagnosed during spontaneous speech and repetition of the words using the "Phonological Assessment of Child Speech" for the Portuguese language. It was also applied a list of 40 phonological balanced words, read by the speech pathologist and repeated by the children. Data were analyzed by descriptive statistics, Fisher's exact or Chi-square tests (α=0.05). RESULTS: A slight prevalence of articulatory disturbances, such as substitutions, omissions and distortions of the sibilants /s/ and /z/, and no deviations in jaw lateral movements were observed. Reduction of vertical amplitude was found in 10 children, the prevalence being greater in TMD signs and symptoms children than in the normal children. The tongue protrusion in phonemes /t/, /d/, /n/, /l/ and frontal lips in phonemes /s/ and /z/ were the most prevalent visual alterations. There was a high percentage of dental occlusal alterations. CONCLUSIONS: There was no association between TMD and speech disorders. Occlusal alterations may be factors of influence, allowing distortions and frontal lisp in phonemes /s/ and /z/ and inadequate tongue position in phonemes /t/; /d/; /n/; /l/.

Effect of chlorhexidine gel containing saccharin or aspartame in deaf children highly infected with mutans streptococci

Aim: Since deaf children are unable to comprehend or cooperate with dental treatment due to lack of communication, preventive measures may be an important way to control the high prevalence of dental caries in these patients. The aim of the this study was to evaluate the effect of an intensive treatment with chlorhexidine (CHX) gel, containing either saccharin or aspartame, in deaf children highly infected with mutans streptococci (MS). Methods: Eighteen children were randomly divided into two groups, according to the sweetener used to improve the CHX gel bitter taste: saccharin or aspartame. Before CHX treatment, saliva samples were collected to establish baseline microbial data for MS. CHX gel was applied on two consecutive days, four times the first day and three times the second day. Saliva samples were then taken after 7, 30, 60, 90 and 120 days to evaluate MS oral recolonization. Results: CHX gel containing saccharin was not effective on the reduction of MS levels, while the gel containing aspartame decreased significantly MS levels after treatment (P<.05). Conclusions: Although a new CHX application may be necessary after 60 days to control caries risk and MS levels, CHX treatment should be individually controlled because of variations in the response of subjects.

Preload loss and bacterial penetration on different implant-abutment connection systems.

Preload loss can favor the occurrence of implant-abutment interface misfit, and bacterial colonization at this interface may lead to implant failure. The aim of this study was to evaluate the preload loss and bacterial penetration through the implant-abutment interface of conical and external hexagon connection systems subjected to thermal cycling and mechanical fatigue (TM). Four different implant-abutment connection systems were evaluated (n=6): external hexagon with universal post, Morse taper with universal post, Morse taper with universal post through bolt, and locking taper with standard abutment. The assemblies (implant-abutment) were subjected to a thermal cycling regimen (1,000 cycles of 5 degrees C and 55 degrees C) and to mechanical fatigue (1.0 million cycles, 1.0 Hz, 120 N). The assemblies were immersed in Tryptic Soy + Yeast Extract broth containing Streptococcus sanguinis and incubated at 37 degrees C and 10% CO(2) for 72 h. Detorque values were recorded. The bacterial penetration was assessed and the abutments were observed by scanning electron microscopy. The preload data were analyzed statistically by two-way ANOVA and Tukey's test at 5% significance level. All screw abutment systems showed significantly higher (p<0.05) detorque values when subjected to TM and all conical systems presented bacterial penetration. The results show no relationship between the preload loss and the bacterial penetration.

Preload loss and bacterial penetration on different implant-abutment connection systems

Preload loss can favor the occurrence of implant-abutment interface misfit, and bacterial colonization at this interface may lead to implant failure. The aim of this study was to evaluate the preload loss and bacterial penetration through the implant-abutment interface of conical and external hexagon connection systems subjected to thermal cycling and mechanical fatigue (TM). Four different implant-abutment connection systems were evaluated (n=6): external hexagon with universal post, Morse taper with universal post, Morse taper with universal post through bolt, and locking taper with standard abutment. The assemblies (implant-abutment) were subjected to a thermal cycling regimen (1,000 cycles of 5°C and 55°C) and to mechanical fatigue (1.0 million cycles, 1.0 Hz, 120 N). The assemblies were immersed in Tryptic Soy + Yeast Extract broth containing Streptococcus sanguinis and incubated at 37°C and 10 percent CO2 for 72 h. Detorque values were recorded. The bacterial penetration was assessed and the abutments were observed by scanning electron microscopy. The preload data were analyzed statistically by two-way ANOVA and Tukey’s test at 5 percent significance level. All screw abutment systems showed significantly higher (p<0.05) detorque values when subjected to TM and all conical systems presented bacterial penetration. The results show no relationship between the preload loss and the bacterial penetration.

A perda da pré-carga pode favorecer o desajuste da interface implante-pilar e a colonização bacteriana nesta interface pode levar a perda de implantes. O objetivo deste estudo foi avaliar a perda de pré-carga e a infiltração bacteriana através da interface implante-pilar de sistemas de conexão cônica e hexágono externo, submetidos à ciclagem térmica e fadiga mecânica (CF). Quatro diferentes sistemas de conexão implante-pilar foram avaliados (n=6): hexágono externo com munhão universal, cone Morse com munhão universal, cone Morse com munhão universal parafuso passante e cônica justaposição com pilar padrão. Os espécimes (implante-pilar) foram submetidos à ciclagem térmica (1000 ciclos a 5°C e 55°C) e à fadiga mecânica (1,0 milhão de ciclos, 1,0 Hz, 120 N). Os espécimes foram imersos em caldo Tryptic Soy + Yeast Extract contendo Streptococcus sanguinis e incubados a 37°C e 10 por cento de CO2 por 72 h. Os valores de destorque foram registrados. A infiltração bacteriana foi avaliada e os pilares foram observados por microscopia eletrônica de varredura. Os dados de pré-carga foram analisados estatisticamente por ANOVA a dois critérios e teste de Tukey, com nível de significância de 5 por cento. Todos os sistemas de pilares parafusados apresentaram maiores valores de destorque quando submetidos à CF (p<0,05) e todos os sistemas cônicos apresentaram infiltração bacteriana. Os resultados mostram que não houve relação entre a perda da pré-carga e a infiltração bacteriana.