Atypical Developmental Defects of Enamel in Primary Incisors Versus Preeruptive Intracoronal Resorption (PEIR): Case Reports.

Developmental defects of enamel (DDE) in children range from moderate to severe and may predispose to dental fractures and early childhood caries. The prevalence of DDE in the primary dentition range from 24 to 75 percent, and the right time to diagnose DDE should be as soon as the teeth erupt. However, early detection of DDE in primary incisors is difficult because parents seldom visit the dentist at this age and, later on, caries lesions mask the original alteration. The purpose of this paper was to present three cases of unique and similar dental defects appearing in very young children from different countries-defects that probably share the same etiology. Given the severity of the defects and the children's' age, these could be the first reported cases of preeruptive intracoronal resorption (PEIR) in primary incisors. This paper also discusses the differentiation between DDE and PEIR.

A simplified protocol to determine total fluoride concentration in NaF/silica-based toothpastes

Aim: To determine total fluoride (TF) concentration in Na2FPO3/Ca-based toothpastes, using fluoride ion selective electrode (F-ISE) by the direct technique, it is necessary to use acid (Ac+) to hydrolyze the FPO32- ion and to dissolve insoluble fluoride salts bound to the abrasive. For NaF/silica-based toothpastes, the use of acid is not necessary (Ac-) and a simplified protocol could be followed. Methods: Thus, we evaluated TF concentration in seven brands of NaF/silica-based toothpastes, following the validated conventional Cury's protocol (Ac+) or a simplification of this protocol (Ac-).Fluoride was analyzed with ISE calibrated with fluoride standard solutions prepared in the same conditions as the samples (Ac+ or Ac-). Results: The mean (±SD; n=21) of TF concentrations (µg F/g) found by Ac+ (971.3±191.2) and Ac- (982.4±201.3) protocols were not statistically different (t test, p=0.22). The TF concentrations found agree with those declared by the manufacturers, except for one toothpaste imported from China. Conclusion: The findings suggest that the determination of fluoride in NaF/silica-based toothpastes can be accurately made using a simplified protocol of analysis

Early Childhood Caries in Peru.

Early Childhood Caries (ECC) is a global oral health problem, and Peru may be one of the countries with high prevalence of untreated ECC in South America. In this study, we constructed an epidemiologic profile of ECC in Peru through a comprehensive review of published data. The prevalence of ECC, risk factors for it, its impact on child development, and public oral health interventions on ECC have been included. The study revealed extremely high rates of ECC in Peru and significant oral-health disparities. Risk factors for ECC were poverty, high sugar consumption, and low oral health literacy. However, the number of studies is limited and their quality questionable. Oral health has not received high public-health priority in Peru. However, in recent years, new regulations and evidence-based documents (the first Clinical Practice Guideline for the Prevention, Diagnosis, and Management of Caries in Children; the Guideline for Children's healthy Growth and Development; the Law on Healthy Diet; and the Manual on Food Advertising) give hope for the future of infants' oral health in the nation.

Milk Sweetened with Xylitol: A Proof-of-Principle Caries Prevention Randomized Clinical Trial.

PURPOSE: To evaluate the efficacy of xylitol-sweetened milk as a caries-preventive strategy. METHODS: In this nine-month prospective proof-of-principle trial, Peruvian schoolchildren were randomized to one of five different milk groups: (1) eight g of xylitol per 200 mL milk once per day; (2) four g of xylitol per 100 mL milk twice per day; (3) eight g of sorbitol per 200 mL milk once per day; (4) four g of sorbitol per 100 mL milk twice per day; or (5) eight g of sucrose per 200 mL milk once per day. The primary outcome was plaque mutans streptococci (MS) at nine months. A secondary outcome was caries incidence. We hypothesized that children in the xylitol groups would have a greater MS decline and lower caries incidence. RESULTS: One hundred fifty-three children were randomized in the intent-to-treat analyses. Children receiving xylitol had a greater decline in MS than children receiving sucrose (P=0.02) but were not different from children receiving sorbitol (P=0.07). Dental caries incidence for xylitol once per day or twice per day was 5.3±3.4 and 4.3±4.0 surfaces, respectively, compared to sorbitol once per day, sorbitol twice per day, or sucrose (4.1±2.8, 3.7±4.2, and 3.2±3.4 surfaces, respectively). There were no differences in caries incidence between xylitol and sucrose (rate ratio [RR] = 1.51; 95 percent confidence interval [CI] = 0.88, 2.59; P=0.13) or between xylitol and sorbitol (RR = 1.28; 95 percent CI = 0.90, 1.83; P=0.16). CONCLUSION: Xylitol-sweetened milk significantly reduced mutans streptococci levels compared to sucrose-sweetened milk, but differences in caries incidence were not detected.

Efecto del pH del agua de piscina en esmalte de dientes deciduos humanos. Estudio de microscopía electrónica de barrido / Effect of pH levels of swimming pool water on enamel of human deciduos teeth. Study with scanning electron microscopy

El objetivo de este trabajo fue evaluar in vitro el efecto de los niveles de pH ácidos del agua de piscina en la morfología de la superficie del esmalte de piezas deciduas. Se utilizaron 10 piezas deciduas extraídas divididas en dos grupos. Un grupo fue expuesto al agua de piscina de pH 5.5 y el otro a pH 7, ambos por 20 horas. Se realizó una evaluación macroscópica y luego se metalizaron las muestras para la evaluación con microscopía electrónica de barrido. Al aplicar la prueba exacta de Fisher, se encontró diferencia significativa (chi-cuadrado=6,0 p = 0,024) entre los grupos en la evaluación macroscópica y altamente significativa (chi-cuadrado= 9,0 p = 0,0039) en la evaluación microscópica. Las observaciones microscópicas mostraron patrones de grabado tipo 1 y 4 en las muestras expuestas al agua de piscina de pH 5.5. En conclusión, el agua de piscina con un nivel de pH de 5.5 ocasiona patrones de pérdida mineral, con evidencia microscópica, en la superficie del esmalte de piezas deciduas tras una exposición de 20 horas.