Exploring the role of flavonoids in caries-affected dentin adhesion: A comprehensive scoping review.

OBJECTIVES: The aim of this scoping review was to evaluate the available scientific evidence regarding the use of flavonoids in the treatment of caries-affected dentin focusing on bonding to dentin. METHODS: A comprehensive literature search was performed in five databases from March 2022 and updated in April 2023: PubMed, EMBASE, Scopus, Web of Science, and Scielo. Additionally, the references of included studies were manually searched. Gray literature was excluded from the review. STUDY SELECTION: Inclusion criteria included in vitro, in situ, and in vivo studies (animal or human) published in English. Abstracts, reviews, case reports, book chapters, doctoral dissertations, guidelines, and studies using pure plant extracts were excluded. Data collected from the selected studies were summarized and subjected to narrative and descriptive analysis. Out of the 91 studies identified, only 16 studies met the inclusion criteria. RESULTS: The review analyzed eight different flavonoids (hesperidin, galardin, proanthocyanidin, genipin, quercetin, naringin, epigallocatechin-3-gallate, and other catechins subtypes) used as pretreatment or loaded into adhesive systems, primers, and phosphoric acid. The use of flavonoids improved the mechanical properties of the materials and modified the biological properties of the dentin, reducing collagen loss by the inhibition of proteolytic activity of matrix metalloproteinases (MMPs). CONCLUSIONS: Based on the findings of this scoping review, it can be concluded that the use of flavonoids as pretreatment or incorporation into dental materials preserves collagen in the hybrid layer, inhibiting the MMPs activities, modifying the collagen fibrils of the dentin matrix and improving the mechanical properties of the dental adhesive systems. Therefore, it represents a promising approach for promoting dentin biomodification. This can result in more stable bonding of adhesive restorations to caries-affected dentin.

Translation and cultural adaptation of the Children's Experiences of Dental Anxiety Measure (CEDAM) to Brazilian Portuguese / Tradução, adaptação cultural e análise das propriedades psicométricas da "Children's Experiences of Dental Anxiety Measure" para uso em crianças brasileiras

Objetivo: A escala Children's Experiences of Dental Anxiety Measure (CEDAM) foi originalmente desenvolvida em Inglês para avaliar importantes aspectos da ansiedade odontológica em crianças. Os objetivos do estudo foram traduzir e realizar a adaptação cultural da CEDAM para o Português Brasileiro. Material e Métodos: A CEDAM consiste de 14 itens, medidos por escala Likert de 3 pontos, que indica a intensidade da ansiedade odontológica. O questionário foi traduzido para o Português Brasileiro, retraduzido para o Inglês, revisado por um Comitê de Especialistas e pré-testado em 10 escolares de oito a doze anos. Resultados: O Comitê Revisor de Especialistas comparou as versões original, traduzida (T1, T2) e retraduzida (BT1, BT2) e recomendou algumas mudanças a fim de obter uma boa compreensão dos itens. No pré-teste, somente a questão 8 não foi compreendida por uma criança, isto é, a versão traduzida foi bem compreendida por mais de 85% dos participantes. Conclusão: A versão brasileira da CEDAM foi culturalmente adaptada para a população avaliada de crianças.(AU)

Objective: The Children's Experiences of Dental Anxiety Measure (CEDAM) was originally developed in English to assess important aspects of dental anxiety for children. The aims of the study were to translate and perform the cultural adaptation of the CEDAM to Brazilian Portuguese. Material and Methods: The CEDAM consists of 14 items, measured by a Likert scale of 3 points, that indicates the intensity of dental anxiety. The questionnaire was translated to Brazilian Portuguese, back-translated to English, reviewed by an Expert Committee and pretested in 10 eight- to twelve-year-old schoolchildren. Results: The Expert Committee Review compared the original, translated (T1, T2) and back-translated (BT1, BT2) versions and recommended some changes in order to achieve good understanding of the items. In the pretest, only question 8 was misunderstood by one child, i.e., the translated version was well-understood by more than 85% of the participants. Conclusion: The Brazilian CEDAM was culturally adapted for the evaluated population of children(AU)

Correction: Trans,trans-farnesol, an antimicrobial natural compound, improves glass ionomer cement properties.

[This corrects the article DOI: 10.1371/journal.pone.0220718.].

Trans,trans-farnesol, an antimicrobial natural compound, improves glass ionomer cement properties.

A series of experiments were conducted to characterize a novel restorative material. We explored the effect on biological, physical and chemical properties of glass ionomer cement (GIC) adding-the naturally occurring tt-farnesol (900 mM). Two groups were accomplished for all assays: GIC+tt-farnesol and GIC (control). Biological assays: 1) agar diffusion against some cariogenic bacteria; 2) S. mutans biofilm formation and confocal laser scanning microscopy-CLSM. 3) gtfB, gtfC, gtfD, gbpB, vicR, and covR expression; 4) MTT and microscopic morphology. Physical properties assays: 1) roughness; 2) hardness; 3) compressive strength and 4) diametral tensile strength. Chemical assay: Raman spectroscopy. The adding of tt-farnesol to GIC led to larger zones of inhibition (p<0.05), biofilms with a short-term reduction in bacterial viability but similar biomass (p>0.05). Polysaccharides levels increased over time, similarly over groups (p>0.05). Viable and non-viable S. mutans were seen on the specimens' surface by CLSM but their virulence was not modulated by tt-farnesol. The tt-farnesol increased the HaCaT cell viability without impact on compressive and diametral tensile strength and roughness although the hardness was positively affected (p<0.05). Raman confirmed the presence of tt-farnesol. The incorporation of tt-farnesol into GIC inhibited the growth of cariogenic bacteria but had a little effect on the composition, structure and physiology of the biofilm matrices. Also, the tt-farnesol increased the hardness and the biocompatibility of the GIC, not influencing negatively other physical properties of the restorative material.

Inactivation of Streptococcus mutans genes lytST and dltAD impairs its pathogenicity in vivo.

Background: Streptococcus mutans orchestrates the development of a biofilm that causes dental caries in the presence of dietary sucrose, and, in the bloodstream, S. mutans can cause systemic infections. The development of a cariogenic biofilm is dependent on the formation of an extracellular matrix rich in exopolysaccharides, which contains extracellular DNA (eDNA) and lipoteichoic acids (LTAs). While the exopolysaccharides are virulence markers, the involvement of genes linked to eDNA and LTAs metabolism in the pathogenicity of S. mutans remains unclear. Objective and Design: In this study, a parental strain S. mutans UA159 and derivative strains carrying single gene deletions were used to investigate the role of eDNA (ΔlytS and ΔlytT), LTA (ΔdltA and ΔdltD), and insoluble exopolysaccharides (ΔgtfB) in virulence in a rodent model of dental caries (rats) and a systemic infection model (Galleria mellonella larvae). Results: Fewer carious lesions were observed on smooth and sulcal surfaces of enamel and dentin of the rats infected with ∆lytS, ∆dltD, and ΔgtfB (vs. the parental strain). Moreover, strains carrying gene deletions prevented the killing of larvae (vs. the parental strain). Conclusions: Altogether, these findings indicate that inactivation of lytST and dltAD impaired S. mutans cariogenicity and virulence in vivo.

Color Stability and Gloss of Esthetic Restorative Materials after Chemical Challenges.

This study evaluated gloss and color changes of esthetic restorative materials subjected to different acidic beverages. Specimens of resin composites (Z350XT (Z350), IPS Empress Direct (ED), Charisma Diamond (CD)) were prepared and the initial surface gloss and color (ΔE) were measured (n=10). Then, the specimens were immersed in 4 mL of each of the different beverages (cranberry juice; Coca-Cola; coffee or artificial saliva) during 15 min, 3x/day for 14 days and new gloss and color readings were obtained. Color change was evaluated with the ΔE formula and gloss change values were obtained by the formula: (final gloss - initial gloss). Data was submitted to two-way ANOVA followed by Tukey's post hoc test (a=0.05). CD showed the lowest color change among resin composites. The highest ΔE values were obtained after immersion in coffee and cranberry juice. Coffee promoted the highest gloss change (worst gloss retention), followed by cranberry juice, Coca-cola and artificial saliva (p<0.05). The type of beverage significantly influenced the gloss of resin composites. Coca-cola reduced gloss of the three resin composites in a similar manner. Coffee affected the ED gloss more than that of Z350 and CD, while cranberry juice affected Z350 more than ED and CD. Saliva had a more pronounced effect on the gloss retention of CD than ED. The beverages used in this study influenced the optical surface properties of the composites studied.

Color stability and gloss of esthetic restorative materials after chemical challenges

Abstract This study evaluated gloss and color changes of esthetic restorative materials subjected to different acidic beverages. Specimens of resin composites (Z350XT (Z350), IPS Empress Direct (ED), Charisma Diamond (CD)) were prepared and the initial surface gloss and color (ΔE) were measured (n=10). Then, the specimens were immersed in 4 mL of each of the different beverages (cranberry juice; Coca-Cola; coffee or artificial saliva) during 15 min, 3x/day for 14 days and new gloss and color readings were obtained. Color change was evaluated with the ΔE formula and gloss change values were obtained by the formula: (final gloss - initial gloss). Data was submitted to two-way ANOVA followed by Tukey's post hoc test (a=0.05). CD showed the lowest color change among resin composites. The highest ΔE values were obtained after immersion in coffee and cranberry juice. Coffee promoted the highest gloss change (worst gloss retention), followed by cranberry juice, Coca-cola and artificial saliva (p<0.05). The type of beverage significantly influenced the gloss of resin composites. Coca-cola reduced gloss of the three resin composites in a similar manner. Coffee affected the ED gloss more than that of Z350 and CD, while cranberry juice affected Z350 more than ED and CD. Saliva had a more pronounced effect on the gloss retention of CD than ED. The beverages used in this study influenced the optical surface properties of the composites studied.

Resumo O objetivo foi avaliar as alterações de brilho e cor de materiais restauradores estéticos submetidos ao armazenamento em diferentes bebidas ácidas. Foram preparados espécimes de compósitos de resina (Z350XT (Z350), IPS Empress Direct (ED), Charisma Diamond (CD) e o brilho e a cor (ΔE) de superfície mensurados (n=10). Em seguida, os espécimes foram imersos em 4 mL de cada uma das diferentes bebidas (suco cranberry, Coca-Cola, café, ou saliva artificial) durante 15 min, 3x/dia durante 14 dias e o brilho e a cor novamente mensurados. A alteração de cor foi avaliada pela fórmula ΔE e os valores de alteração de brilho foram obtidos pela fórmula: (brilho final - brilho inicial). Os dados foram submetidos à ANOVA e Tukey (a = 0,05). CD apresentou menor alteração de cor quando comparado aos demais compósitos e maiores valores de ΔE foram obtidos após imersão em suco de café e cranberry. O café promoveu maior perda de brilho, seguido pelo suco cranberry, Coca-cola e saliva artificial (p <0,05). O tipo de bebida influenciou significativamente no brilho dos compósitos resinosos. Coca-cola reduziu o brilho dos três compósitos de maneira similar. O café promoveu maior alteração do brilho do ED, quando comparado ao Z350 e CD, enquanto o suco de cranberry afetou mais o Z350 do que o ED e o CD. A saliva teve efeito mais significativo na perda do brilho do CD do que o ED. As bebidas utilizadas neste estudo influenciaram as propriedades ópticas de superfície dos compósitos.

Doxycycline-containing glass ionomer cement for arresting residual caries: an in vitro study and a pilot trial.

In a previous study, we demonstrated that the incorporation of doxycycline hyclate (DOX) into resin-modified glass ionomer cement (RMGIC) inhibited important cariogenic microorganisms, without modifying its biological and mechanical characteristics. In this study, we keep focused on the effect of that experimental material as a potential therapy for arresting residual caries by analyzing other in vitro properties and conducting a pilot clinical trial assessing the in vivo effect of DOX-containing RMGIC on residual mutans streptococci after partial carious removal in primary molars. Specimens of the groups RMGIC (control); RMGIC + 1.5% DOX; RMGIC + 3% DOX; and RMGIC + 4.5% DOX were made to evaluate the effect of DOX incorporation on surface microhardness and fluoride release of RMGIC and against biofilm of Streptococcus mutans. Clinical intervention consisted of partial caries removal comparing RMGIC and RMGIC + 4.5% DOX as lining materials. After 3 months, clinical and microbiologic evaluations were performed. Data were submitted to ANOVA/Tukey or Wilcoxon/Mann-Whitney set as α=0.05. Fluoride release and surface microhardness was not influenced by the incorporation of DOX (p>0.05). There was a significant reduction of S. mutans biofilm over the material surface with the increase of DOX concentration. After clinical trial, the remaining dentin was hard and dry. Additionally, mutans streptococci were completely eliminated after 3 months of treatment with RMGIC + 4.5% DOX. The incorporation of DOX provided better antibiofilm effect, without jeopardizing fluoride release and surface microhardness of RMGIC. This combination also improved the in vivo shortterm microbiological effect of RMGIC after partial caries removal.

Enhancing bond strength on demineralized dentin by pre-treatment with selective remineralising agents.

Bonding to demineralized dentin of a diseased tooth has shown to be a significant clinical issue. This study evaluated the effect of 0.2% NaF-(NaF), MI Paste™-(CPP-ACP) and the self-assembling peptide 'P11-4' (Ace-QQRFEWEFEQQ-NH2) contained in Curodont™ Repair, have on microtensile bond strength-(µTBS) of two different adhesive systems (Adper™ Single Bond-(SB) or Clearfil™ SE Bond (CSE)) and wettability of demineralized dentin slices after remineralising agents were applied. The highest µTBS were found for the demineralized dentin-(DD) treated with CPP-ACP; both adhesives systems (p < 0.05) did not significantly difference from P11-4 treatment associated with SB, and also presented higher values than sound dentin-(SD/SB) (p < 0.01). DD treated with P11-4 associated with CSE did not differ from DD/CSE (p > 0.05). The NaF treatment associated with CSE recovered the bond strength values of SD/CSE and associated with CSE demonstrated lower µTBS than other groups, although significantly higher than DD (p < 0.05). P11-4 and CPP-ACP increased significantly the wettability of demineralized dentin (p < 0.05); etching acid improved wettability for all groups (p < 0.05), whilst NaF did not affect the wettability of demineralized dentin (p > 0.05). Morphological analysis of the dentin surface and dentin-resin interface revealed unique features of the applied remineralizing agent. The results indicated that self-assembling peptide P11-4 associated with SB and CPP-ACP associated with SB or CSE significantly enhanced the bond strength to demineralized dentin (p < 0.05). We conclude that by modifying the dentine surface and restoring conditions found on sound dentin, this can enhance the interfacial bonding.

Antibacterial activity against cariogenic bacteria and cytotoxic and genotoxic potential of Anacardium occidentale L. and Anadenanthera macrocarpa (Benth.) Brenan extracts.

OBJECTIVES: The present study aimed to assess the antibacterial activity against bacteria with cariogenic relevance, toxic and genotoxic potential of the plants Anacardium occidentale L. and Anadenanthera macrocarpa (Benth.) Bernam. DESIGN: Using a microdilution technique, the extracts were submitted to minimum inhibitory concentration (MIC) testing against Streptococcus mitis (ATCC 903), Streptococcus mutans (ATCC 25175), Streptococcus oralis (ATCC 10557), Streptococcus salivarius (ATCC 7073), Streptococcus sanguinis (ATCC 15300) and Streptococcus sobrinus (ATCC 27609). The toxicity of the extracts was then verified against eukaryotic cells. Additionally, a micronucleus assay was performed to investigate the potential mutagenic effects of the extracts on rat erythrocytes. The Student's t-test, Bonferroni test, and one-way ANOVA followed by Tukey's tests were used for statistical analysis, at a significance level of 5%. RESULTS: While the A. occidentale extract was able to inhibit all of the tested strains, with S. mutans and S. mitis being the most susceptible to that extract́s action, the A. macrocarpa did not show antimicrobial activity. Interestingly, the hemolytic, oxidant and antioxidant activities were slightly observed for either extract, even at high concentrations (1000mg/mL). The micronucleus assay showed no significant changes in the cells exposed to the extracts. CONCLUSION: The A. occidentale extract has potential as an antimicrobial agent with low eukaryotic cell toxicity or mutagenic activity. The A. macrocarpa extract, although absent of antibacterial activity might as well be a safe and effective phytotherapeutic alternative.

Doxycycline-containing glass ionomer cement for arresting residual caries: an in vitro study and a pilot trial

Abstract In a previous study, we demonstrated that the incorporation of doxycycline hyclate (DOX) into resin-modified glass ionomer cement (RMGIC) inhibited important cariogenic microorganisms, without modifying its biological and mechanical characteristics. In this study, we keep focused on the effect of that experimental material as a potential therapy for arresting residual caries by analyzing other in vitro properties and conducting a pilot clinical trial assessing the in vivo effect of DOX-containing RMGIC on residual mutans streptococci after partial carious removal in primary molars. Specimens of the groups RMGIC (control); RMGIC + 1.5% DOX; RMGIC + 3% DOX; and RMGIC + 4.5% DOX were made to evaluate the effect of DOX incorporation on surface microhardness and fluoride release of RMGIC and against biofilm of Streptococcus mutans. Clinical intervention consisted of partial caries removal comparing RMGIC and RMGIC + 4.5% DOX as lining materials. After 3 months, clinical and microbiologic evaluations were performed. Data were submitted to ANOVA/Tukey or Wilcoxon/Mann-Whitney set as α=0.05. Fluoride release and surface microhardness was not influenced by the incorporation of DOX (p>0.05). There was a significant reduction of S. mutans biofilm over the material surface with the increase of DOX concentration. After clinical trial, the remaining dentin was hard and dry. Additionally, mutans streptococci were completely eliminated after 3 months of treatment with RMGIC + 4.5% DOX. The incorporation of DOX provided better antibiofilm effect, without jeopardizing fluoride release and surface microhardness of RMGIC. This combination also improved the in vivo shortterm microbiological effect of RMGIC after partial caries removal.

In vitro and in vivo evaluations of glass-ionomer cement containing chlorhexidine for Atraumatic Restorative Treatment.

OBJECTIVES: Addition of chlorhexidine has enhanced the antimicrobial effect of glass ionomer cement (GIC) indicated to Atraumatic Restorative Treatment (ART); however, the impact of this mixture on the properties of these materials and on the longevity of restorations must be investigated. The aim of this study was to evaluate the effects of incorporating chlorhexidine (CHX) in the in vitro biological and chemical-mechanical properties of GIC and in vivo clinical/ microbiological follow-up of the ART with GIC containing or not CHX. MATERIAL AND METHODS: For in vitro studies, groups were divided into GIC, GIC with 1.25% CHX, and GIC with 2.5% CHX. Antimicrobial activity of GIC was analyzed using agar diffusion and anti-biofilm assays. Cytotoxic effects, compressive tensile strength, microhardness and fluoride (F) release were also evaluated. A randomized controlled trial was conducted on 36 children that received ART either with GIC or GIC with CHX. Saliva and biofilm were collected for mutans streptococci (MS) counts and the survival rate of restorations was checked after 7 days, 3 months and one year after ART. ANOVA/Tukey or Kruskal-Wallis/ Mann-Whitney tests were performed for in vitro tests and in vivo microbiological analysis. The Kaplan-Meier method and Log rank tests were applied to estimate survival percentages of restorations (p<0.05). RESULTS: Incorporation of 1.25% and 2.5% CHX improved the antimicrobial/anti-biofilm activity of GIC, without affecting F release and mechanical characteristics, but 2.5% CHX was cytotoxic. Survival rate of restorations using GIC with 1.25% CHX was similar to GIC. A significant reduction of MS levels was observed for KM+CHX group in children saliva and biofilm 7 days after treatment. CONCLUSIONS: The incorporation of 1.25% CHX increased the in vitro antimicrobial activity, without changing chemical-mechanical properties of GIC and odontoblast-like cell viability. This combination improved the in vivo short-term microbiological effect without affecting clinical performance of ART restorations.

In vitro and in vivo evaluations of glass-ionomer cement containing chlorhexidine for Atraumatic Restorative Treatment

Abstract Objectives: Addition of chlorhexidine has enhanced the antimicrobial effect of glass ionomer cement (GIC) indicated to Atraumatic Restorative Treatment (ART); however, the impact of this mixture on the properties of these materials and on the longevity of restorations must be investigated. The aim of this study was to evaluate the effects of incorporating chlorhexidine (CHX) in the in vitro biological and chemical-mechanical properties of GIC and in vivo clinical/ microbiological follow-up of the ART with GIC containing or not CHX. Material and Methods: For in vitro studies, groups were divided into GIC, GIC with 1.25% CHX, and GIC with 2.5% CHX. Antimicrobial activity of GIC was analyzed using agar diffusion and anti-biofilm assays. Cytotoxic effects, compressive tensile strength, microhardness and fluoride (F) release were also evaluated. A randomized controlled trial was conducted on 36 children that received ART either with GIC or GIC with CHX. Saliva and biofilm were collected for mutans streptococci (MS) counts and the survival rate of restorations was checked after 7 days, 3 months and one year after ART. ANOVA/Tukey or Kruskal-Wallis/ Mann-Whitney tests were performed for in vitro tests and in vivo microbiological analysis. The Kaplan-Meier method and Log rank tests were applied to estimate survival percentages of restorations (p<0.05). Results: Incorporation of 1.25% and 2.5% CHX improved the antimicrobial/anti-biofilm activity of GIC, without affecting F release and mechanical characteristics, but 2.5% CHX was cytotoxic. Survival rate of restorations using GIC with 1.25% CHX was similar to GIC. A significant reduction of MS levels was observed for KM+CHX group in children saliva and biofilm 7 days after treatment. Conclusions: The incorporation of 1.25% CHX increased the in vitro antimicrobial activity, without changing chemical-mechanical properties of GIC and odontoblast-like cell viability. This combination improved the in vivo short-term microbiological effect without affecting clinical performance of ART restorations.

Antifungal potential of Sideroxylon obtusifolium and Syzygium cumini and their mode of action against Candida albicans.

Context The emergence of resistant pathogens and toxicity of antifungals have encouraged an active search for novel candidates to manage Candida biofilms. Objective In this study, the little known species Sideroxylon obtusifolium T.D. Penn (Sapotacea) and Syzygium cumini (L.) Skeels (Myrtaceae), from the Caatinga biome in Brazil were chemically characterized and explored for their antifungal potential against C. albicans. Materials and methods We determined the effects of hydroalcoholic extracts/fractions upon fungal growth (minimum inhibitory and fungicidal concentrations, MIC/MFC), biofilm morphology (scanning electron microscopy) and viability (confocal laser scanning microscopy), proposed their mode of action (sorbitol and ergosterol assays), and finally investigated their effects against macrophage and keratinocyte cells in a cell-based assay. Data were analysed using one-way analysis of variance with Tukey-Kramer post-test (α = 0.05). Results The n-butanol (Nb) fraction from S. obtusifolium and S. cumini extract (Sc) showed flavonoids (39.11 ± 6.62 mg/g) and saponins (820.35 ± 225.38 mg/g), respectively, in their chemical composition and demonstrated antifungal activity, with MICs of 62.5 and 125 µg/mL, respectively. Nb and Sc may complex with ergosterol as there was a 4-16-fold increase in MICs in the presence of exogenous ergosterol, leading to disrupted permeability of cell membrane. Deleterious effects were observed on morphology and viability of treated biofilms from concentrations as low as their MICs and higher. Sc was not toxic to macrophages and keratinocytes at these concentrations (p > 0.05), unlike Nb. Conclusions Nb and Sc demonstrated considerable antifungal activity and should be further investigated as potential alternative candidates to treat Candida biofilms.

Protective effect of experimental mouthrinses containing NaF and TiF4 on dentin erosive loss in vitro.

OBJECTIVE: This in vitro study assessed the anti-erosive effect of experimental mouthrinses containing TiF4 and NaF on dentin erosive loss. MATERIAL AND METHODS: Bovine dentin specimens were randomly allocated into the groups (n=15): (1) SnCl2/NaF/AmF (Erosion Protection/GABA, pH 4.5, positive control); (2) experimental solution with 0.0815% TiF4(pH 2.5); (3) 0.105% NaF (pH 4.5); 4) 0.042% NaF+0.049% TiF4 (pH 4.4); (5) 0.063% NaF+0.036% TiF4 (pH 4.5); (6) no treatment (negative control). Each specimen was cyclically demineralized (Sprite Zero, pH 2.6, 4x90 s/day) and exposed to artificial saliva between the erosive challenges for 7 days. The treatment with the fluoride solutions was done 2x60 s/day, immediately after the first and the last erosive challenges of the day. Dentin erosive loss was measured by profilometry (µm). The data were analyzed using Kruskal Wallis/Dunn tests (p<0.05). RESULTS: Mouthrinses containing TiF4or Sn/F were able to show some protective effect against dentin erosive loss compared to negative control. The best anti-erosive effect was found for experimental solution containing 0.0815% TiF4 (100% reduction in dentin loss), followed by 0.042% NaF+0.049% TiF4 (58.3%), SnCl2/NaF/AmF (52%) and 0.063% NaF+0.036% TiF4 (40%). NaF solution (13.3%) did not significantly differ from control. CONCLUSION: The daily application of experimental mouthrinse containing TiF4 and NaF has the ability to reduce dentin erosion, as well as Erosion Protection and TiF4 alone.

Protective effect of experimental mouthrinses containing NaF and TiF4 on dentin erosive loss in vitro

Objective This in vitro study assessed the anti-erosive effect of experimental mouthrinses containing TiF4 and NaF on dentin erosive loss.Material and Methods Bovine dentin specimens were randomly allocated into the groups (n=15): 1) SnCl2/NaF/AmF (Erosion Protection®/GABA, pH 4.5, positive control); 2) experimental solution with 0.0815% TiF4(pH 2.5); 3) 0.105% NaF (pH 4.5); 4) 0.042% NaF+0.049% TiF4 (pH 4.4); 5) 0.063% NaF+0.036% TiF4 (pH 4.5); 6) no treatment (negative control). Each specimen was cyclically demineralized (Sprite Zero, pH 2.6, 4x90 s/day) and exposed to artificial saliva between the erosive challenges for 7 days. The treatment with the fluoride solutions was done 2x60 s/day, immediately after the first and the last erosive challenges of the day. Dentin erosive loss was measured by profilometry (μm). The data were analyzed using Kruskal Wallis/Dunn tests (p<0.05).Results Mouthrinses containing TiF4or Sn/F were able to show some protective effect against dentin erosive loss compared to negative control. The best anti-erosive effect was found for experimental solution containing 0.0815% TiF4 (100% reduction in dentin loss), followed by 0.042% NaF+0.049% TiF4 (58.3%), SnCl2/NaF/AmF (52%) and 0.063% NaF+0.036% TiF4 (40%). NaF solution (13.3%) did not significantly differ from control.Conclusion The daily application of experimental mouthrinse containing TiF4and NaF has the ability to reduce dentin erosion, as well as Erosion Protection® and TiF4 alone.

Relação entre fatores socioeconômicos, clínicos e saúde bucal em escolares da zona rural: um estudo longitudinal / Relationship among socioeconomic and clinical factors with oral health, in schoolchildren from rural areas: a longitudinal study

Objetivos: Este estudo longitudinal avaliou: a) o impacto de ações bimestrais de atenção básica em saúde bucal no incremento da cárie e mancha branca em uma população rural; b) associações entre variáveis sociais, econômicas e cárie e mancha branca. Materiais e método: exames (baseline, após 6 e 12 meses) e ações educativas e preventivas bimestral (baseline, 2, 4, 6, 8, 10, 12 meses) foram realizados em 161 crianças. A análise univariada (Qui-Quadrado) utilizou CPOD, ceod e mancha branca como variáveis de desfecho (p<0,05). Resultados: a mancha branca estava presente em 42,82%, 33,33% e 28,03% das crianças no baseline, após 6 e 12 meses, respectivamente. No baseline, houve associação significativa entre grau de escolaridade da mãe (p=0,0040) e número de pessoas na família (p=0,0068), para os desfechos CPOD e ceod, respectivamente. Após seis meses, houve associação entre CPOD e grau de escolaridade da mãe (p=0,0059), ceod e número de pessoas na família (p=0,0173) e grau de escolaridade do pai (p=0,0412), além de associação entre mancha branca e água ingerida (p=0,0350). Após doze meses, apenas o grau de escolaridade da mãe (p=0,0049) foi estatisticamente associado ao CPOD. Conclusão: apesar da alta experiência de cárie, houve diminuição substancial das manchas brancas após implementaçãodo programa preventivo.

Influence of family environment on children's oral health: a systematic review.

OBJECTIVE: To review current models and scientific evidence on the influence of parents' oral health behaviors on their children's dental caries. SOURCES: MEDLINE articles published between 1980 and June, 2012. Original research articles on parents' oral health behavior were reviewed. A total of 218 citations were retrieved, and 13 articles were included in the analysis. The studies were eligible for review if they matched the following inclusion criteria: (1) they evaluated a possible association between dental caries and parents' oral-health-related behaviors, and (2) the study methodology included oral clinical examination. The main search terms were "oral health", "parental attitudes", "parental knowledge", and "dental caries". SUMMARY OF THE FINDINGS: : 13 experimental studies contributed data to the synthesis. Original articles, reviews, and chapters in textbooks were also considered. CONCLUSION: Parents' dental health habits influence their children's oral health. Oral health education programs aimed at preventive actions are needed to provide children not only with adequate oral health, but better quality of life. Special attention should be given to the entire family, concerning their lifestyle and oral health habits.

Influência do ambiente familiar sobre a saúde bucal de crianças: uma revisão sistemática / Influence of family environment on children's oral health: a systematic review

OBJETIVO: Envolver modelos atuais e comprovações científicas sobre a influência de comportamentos de saúde bucal dos pais na cárie dentária de suas crianças. FONTES: Artigos do MEDLINE publicados entre 1980 e junho de 2012. Foram analisados artigos de pesquisa originais tratando do comportamento dos pais quanto à saúde bucal. Um total de 218 citações foi analisado e 13 artigos foram incluídos na análise. Os estudos foram considerados elegíveis para análise se atendessem aos seguintes critérios de inclusão: (1) avaliassem uma possível associação entre cáries dentárias e o comportamento dos pais relacionado à saúde bucal; e (2) se a metodologia do estudo incluísse exame clínico bucal. Os principais termos de pesquisa foram "saúde bucal", "atitudes dos pais", "conhecimento dos pais" e "cáries dentárias". RESUMO DOS ACHADOS: Ao todo, 13 estudos experimentais contribuíram com dados para a síntese. Também foram considerados trabalhos, revisões e capítulos originais em livros didáticos. CONCLUSÃO: Os hábitos de saúde dental dos pais influenciam a saúde bucal de seus filhos. São necessários programas de educação em saúde bucal com ações preventivas para proporcionar não apenas saúde bucal adequada às crianças, mas também uma melhor qualidade de vida. Deve ser dada atenção especial a toda a família, com relação a seu estilo de vida e hábitos relacionados à saúde bucal.

OBJECTIVE: To review current models and scientific evidence on the influence of parents' oral health behaviors on their children's dental caries. SOURCES: MEDLINE articles published between 1980 and June, 2012. Original research articles on parents' oral health behavior were reviewed. A total of 218 citations were retrieved, and 13 articles were included in the analysis. The studies were eligible for review if they matched the following inclusion criteria: (1) they evaluated a possible association between dental caries and parents' oral-health-related behaviors, and (2) the study methodology included oral clinical examination. The main search terms were "oral health", "parental attitudes", "parental knowledge", and "dental caries". SUMMARY OF THE FINDINGS: 13 experimental studies contributed data to the synthesis. Original articles, reviews, and chapters in textbooks were also considered. CONCLUSIONS: Parents' dental health habits influence their children's oral health. Oral health education programs aimed at preventive actions are needed to provide children not only with adequate oral health, but better quality of life. Special attention should be given to the entire family, concerning their lifestyle and oral health habits.

In vitro and in vivo investigation of the biological and mechanical behaviour of resin-modified glass-ionomer cement containing chlorhexidine.

OBJECTIVES: To evaluate: (1) the in vitro antibacterial, cytotoxic and mechanical properties of a resin-modified glass ionomer cement (RMGIC) containing different concentrations of chlorhexidine (CHX) and (2) the in vivo microbiologic action of the best concentration of CHX associated with the RMGIC applied on remaining dentine after indirect pulp treatment (IPT). METHODS: For the in vitro studies, RMGIC was associated with 0.2, 0.5, 1.25 and 2.5% CHX. Microbiologic evaluation consisted of an agar diffusion test on cariogenic bacteria for 24h. Odontoblast-like cell metabolism and morphology analyses measured the cytotoxic effects of the RMGIC groups after 24h. The same groups were submitted to compressive and diametral tensile strength. The in vivo treatment consisted of IPT using an RMGIC associated with the best CHX concentration. Clinical and microbiologic evaluations were performed before and after 3 months. RESULTS: The use of 1.25% CHX significantly improved the antibacterial effects of the evaluated RMGIC, without causing any detrimental effects to the odontoblast-like cells and on the mechanical properties. This RMGIC and CHX combination completely eliminated mutans streptococci after 3 months of IPT. CONCLUSION: The RMGIC and 1.25% CHX mixture showed great biological and mechanical behaviour and could be a good treatment against caries progression. CLINICAL SIGNIFICANCE: The association of CHX with a liner RMGIC opens a new perspective for arresting residual caries after IPT.