Reduced salivary flow rate and high levels of oxidative stress in whole saliva of children with Down syndrome.

AIM: To investigate salivary parameters between children with Down Syndrome (DS) and without DS. MATERIALS AND METHODS: Stimulated whole saliva was collected from 18 children with DS and 23 without DS. Salivary flow rate, pH, and salivary buffering capacity were determined. Cariogenic microorganisms were quantified by culture, and periodontopathogens by quantitative real-time polymerase chain reaction. The antioxidant profile was quantified spectrophotometrically, while malondialdehyde (MDA) was quantified by high-performance liquid chromatography. Data were analyzed by Mann-Whitney test and Spearman correlation (α = 0.05). RESULTS: Salivary flow rate was significantly lower in DS than in controls (p < 0.0001). Significant higher difference was observed for total protein dosage (p < 0.0001), superoxide dismutase activity (SOD) (p = 0.0002), and MDA (p < 0.001) in DS group. CONCLUSIONS: Reduced salivary flow rate might be an important factor in oral diseases development. High salivary levels of SOD and MDA show the significant influence of the oxidative stress and the early-onset periodontal disease in DS people.

Bond strength of a composite resin to glass ionomer cements using different adhesive systems / Resistência de união de uma resina composta a cimentos de ionômeros de vidro utilizando diferentes sistemas adesivos

Introduction: Glass ionomer cements are often used as a base or cavity lining prior to restorative material. Objective: To evaluate the bond strength of a composite resin to different glass ionomer cements, when using a two-step conventional and self-etching adhesive systems. Material and method: Three glass ionomer cements (Ketac Molar Easymix, Vitremer and Vitrebond), the composite resin Filtek Z350 XT and the adhesive systems Adper Single Bond 2, Clearfil SE Bond and Adper Easy One were used. As negative control, resin was bonded to cement without using an adhesive system. Holes (4 mm diameter, 2 mm deep) prepared in acrilic bloks were filled with the glass ionomer cements (n=12/group). On the surface, an area of 1mm in diameter was delimited, the adhesive system was applied, and a specimen of composite resin with 1 mm height was made. After 24 hours storage (37 °C and 100% humidity), the microshear test was performed. Data were analyzed using two-way ANOVA and Tukey test for comparison between groups (α=0.05). Result: The adhesive systems significantly improved the bond strenght of composite resin to glass ionomer cements (p≤0.001). There was no significant difference in bond strength when self-etching adhesive systems were compared with the simplified etch-and-rinse adhesive, except for Vitrebond where Clearfil SE Bond determined higher bond strength when compared to Adper Single Bond 2 (p=0.003). Conclusion: Self-etching adhesive systems are a good option for establishing the bond between the composite resin and the glass ionomer cement.

Introdução: Os cimentos de ionômero de vidro são frequentemente usados como base ou forramento cavitário, previamente ao material restaurador. Objetivo: Avaliar a resistência de união da resina composta a diferentes cimentos de ionômero de vidro, utilizando sistemas adesivos convencional simplificado e auto-condicionantes. Material e método: Foram utilizados três cimentos (Ketac Molar Easymix, Vitremer e Vitrebond), a resina Filtek Z350 XT e os sistemas adesivos Adper Single Bond 2, Clearfil SE Bond e Adper Easy One. Como controle negativo, a resina foi aplicada sobre o cimento sem a utilização de sistema adesivo. Cavidades (4 mm de diâmetro e 2 mm de profundidade), confeccionadas em blocos acrílicos, foram preenchidas com os cimentos ionoméricos (n=12/grupo). Na superfície foi delimitada uma área de 1mm de diâmetro, aplicado o sistema adesivo e confeccionado um espécime de resina composta com 1 mm de altura. Após 24 horas de armazenamento (37 °C e 100% de umidade), foi realizado o ensaio de microcisalhamento. Os dados foram analisados usando ANOVA a dois fatores, e teste de Tukey para comparação entre grupos (α=0,05). Resultado: Os sistemas adesivos melhoraram significativamente a resistência de união resina/cimento de ionômero de vidro (p≤0,001). Não houve diferença significativa na resistência de união quando os sistemas adesivos auto-condicionantes foram comparados com o convencional simplificado, com exceção no Vitrebond onde o Clearfil SE Bond determinou maior resistência de união quando comparado com o Adper Single Bond 2 (p=0,003). Conclusão: Os sistemas adesivos auto-condicionantes constituem uma boa opção para estabelecer a união entre resina composta e cimento de ionômero de vidro.

Comparison of the indentation strength and single-edge-v-notched beam methods for dental ceramic fracture toughness testing

Aim: To study influence of the cooling rate after sintering a veneering porcelain (Vita VM9) on fracture toughness by indentation strength (IS) and single-edge-v-notched beam (SEVNB) methods. Methods: Vita VM9 bars were sintered according to the manufacturer's recommendation and cooled under three conditions: Slow (inside the furnace from sintering temperature to room temperature); Normal (inside the furnace from sintering temperature to 500 ºC and outside the furnace from 500 ºC to room temperature); and Fast (outside the furnace from sintering temperature to room temperature). Fracture toughness was measured by IS (n=10) and SEVNB (n=10) methods. Data were analyzed by two-way ANOVA (α=0.05). Results: The fracture toughness obtained from SEVNB (slow - 1.02±0.10; normal - 1.09±0.13; and fast - 1,02±0.18 MPa.m1/2 cooling techniques) was significantly lower than IS (slow - 1.19±0.13; normal - 1.17±0.07; and fast - 1.16±0.06 MPa. m1/2 cooling techniques). There was no significant influence of the cooling technique (p=0.012). Conclusions: The measurement technique influenced the fracture toughness values . IS method overestimated the fracture toughness values. Irrespective of the measuring method, cooling rate did not influence the Vita VM9 veneering porcelain fracture toughness (Au)

Caracterização dos pacientes e procedimentos executados no serviço de atendimento a pacientes com necessidades especiais da Faculdade de Odontologia de Araraquara - UNESP / Characterization of patients and procedures performed in the service to patients with special needs of Araraquara School of Dentistry - UNESP

Objetivo: Caracterizar os pacientes atendidos e os procedimentos realizados no Serviço de Atendimento a Pacientes com Necessidades Especiais da Faculdade de Odontologia de Araraquara (FOAr) - UNESP. Metodologia: A partir dos prontuários odontológicos dos pacientes atendidos em nível ambulatorial entre 2007 e 2013, foram obtidas informações em relação a idade no início do tratamento, tipo de deficiência, medicamentos usados, número de sessões de atendimento e número e tipo de procedimentos odontológicos realizados. Resultado: Dos 232 prontuários analisados, observou-se que mais da metade dos pacientes (56,0%) apresentava deficiência mental, paralisia cerebral ou anomalias congênitas determinadas por agentes infecciosos, com deficiência mental associada. Entre as anomalias congênitas, a mais prevalente foi a Síndrome de Down (9,9%). Apenas 20% dos pacientes iniciaram o tratamento antes dos dez anos de idade e 62,0% faziam uso de anticonvulsivantes, antipsicóticos, ansiolíticos, antiepilépticos e antidepressivos. Foram realizados 4.506 procedimentos odontológicos, sendo 37,6% preventivos e 62,4% curativos (Restauradores, 28,0%; Periodontais, 13,9%; Endodônticos, 9,7%; Cirúrgicos, 9,1%; Protéticos, 1,7%). Observou-se também que, para a maior parte dos pacientes (63%), foram necessárias até dez sessões para a realização do tratamento. Conclusão: Os pacientes que procuraram tratamento odontológico no Serviço de Atendimento a Pacientes com Necessidades Especiais da FOAr apresentavam, na sua maioria, deficiências com envolvimento neurológico. Apesar de esse serviço priorizar os procedimentos preventivos, a maior parte dos procedimentos executados foi curativa, o que está diretamente relacionado com a procura tardia pelo tratamento odontológico.

Objective: To characterize the patients and dental procedures performed in Service to Patients with Special Needs of Araraquara School of Dentistry (FOAr) - UNESP. Methodology: From the dental records of patients treated at outpatient basis between 2007 and 2013, information regarding age at the beginning of treatment, type of disability, controlled medications used, number of dental sessions, and number and type of dental procedures performed was obtained. Result: Of the 232 records analyzed, more than half of the patients (56.0%) had mental retardation, cerebral palsy or congenital abnormalities caused by infectious agents associated with mental retardation. Among the congenital abnormalities, the most prevalent was the Down syndrome (9.9%). Only 20% of patients started treatment before the age of ten and 62.0% used anticonvulsants, antipsychotics, anxiolytics, antidepressants and antiepileptics. A total of 4,506 dental procedures were performed, 37.6% were preventive procedures and 62.4% curative procedures (restorative, 28.0%; periodontal, 13.9%; endodontic, 9.7%; surgical, 9.1%, and prosthetic 1.7%). Also was observed that for most patients (63%) up to 10 sessions were required for the completion of treatment. Conclusion: Most patients with special needs who sought dental treatment at FOAr presented neurological involvement. Despite this service prioritize preventive procedures; most of the procedures carried out were curative, fact directly linked to late search for the dental treatment.