Polishing performance of multiple-use silicone rubber-based polishing instruments with and without disinfection/sterilization.

PURPOSE: To evaluate the effect of the multiple-use of a three-step rubber-based polishing system on the polishing performance with and without a disinfection/sterilization protocol with prolonged disinfection (overnight). METHODS: The three-step polishing system Astropol was applied under standardized contact pressure of 2 N on 320 grit pre-roughened flat composite specimens of Tetric EvoCeram for 10 seconds (F and P disc) and 30 seconds (HP disc) respectively. After each polishing step, the surface gloss and roughness were measured with a glossmeter and an optical sensor (FRT MicroProf), respectively. Material loss of the composite specimens and polishing instruments were measured after each step with a high precision digital scale. For all four variables (surface gloss, surface roughness, composite loss, loss of rubber material) the mean percentage of change compared to the reference was calculated. RESULTS: Already after the first use, the instruments which were used without disinfection or sterilization demonstrated a statistically significantly reduced polishing performance in all polishing steps compared to the reference (new polishing system) (t-test, P < 0.05). In addition, this loss in performance further increased with the second and third re-use. Especially the third component (Astropol HP) was affected by performance loss. By contrast, the multiple-use of the instruments which were subjected to prolonged disinfection did not result in a reduced polishing performance. For the P disc, a statistically significant improvement of the polishing performance could be observed throughout almost all multiple-use sessions (ANOVA, P < 0.05). The improved polishing performance was, however, accompanied by an increased loss of the silicone rubber material of the P and F polishing discs; the HP discs were not affected by this loss. Furthermore, particles of the rubber material also adhered to the composite. The polishing performance of the discs which were only subjected to the sterilization process was not statistically significantly different to the polishing performance of the control group in terms of surface roughness; but the surface gloss was worse than that of the control group. No loss of rubber material or adherence to the composite was observed in this group.

Effectiveness of three different types of electric toothbrushes compared with a manual technique in orthodontic patients / Efetividade de três diferentes tipos de escovas eletricas comparadas com a técnica manual em pacientes ortodônticos

Patients undergoing orthodontic treatment with fixed appliances are at risk of developing carious white spot lesions and gingival inflammtion because of the challenge of oral hygiene. The purpose of this study was to evaluate under home conditions the effectiveness of three different types of electric toothbrushes during active appliance therapy: Interplak (Bausch & Lomb, Berlin, Germany), Rota-dent (Rota-dent, Küsnacht, Switzerland), and Braun Oral-B Plaque Remover (Braun/Oral-B, Kronberg, Germany). A manual technique, which included normal toothbrush, interdental brush, and dental floss, served as reference. The study was structured as a single-blind "Latin square design" study. Thirty-eigth orthodontic patients were randomly allocated to groups who, within the test period, alternately used the toothbrushes. Before getting a new toothbrush that was to be used for a period of 4 weeks, each patient received video and written instructions. For another 4 weeks, the patient returned to the usual oral hygiene procedures before receiving the next new toothbrusch. Oral hygiene was evaluated at the start of a new test period and after 2 and 4 weeks. Clinical scores included a modified O'Leary Plaque Index and Ainamo Gingival Bleeding Index. Wilcoxon rank testing for aggregated surfaces revealed statistically significantly lower plaque scores for Rota-dent than for the manual technique (p<0.01). For all other toothbrushes, no differences were found in comparison to the manual technique. For Plaque Indices of specific sites, statistical analysis revealed all electric toothbrushes to be equal to the manual technique. No differences in Gingival Bleeding Indices were found after 4 weeks with either toothbrush. Patients with poor oral hygiene who used Rota-dent and Braun Oral-B Plaque Remover OD5 had statistically significantly lower plaque scores compared with the manual technique (p<0.01; p<0.05); for patients with good oral hygiene, these differences were neutralized. It may be concluded that eletric toothbrushes of the new generation are a real alternative to the often laborious manual tooth cleaning procedures used during active appliance therapy. Patients with poor oral hygiene may benefit from them especially because plaque removal can be achieved easier and faster

A prevenção primária-primária da cárie: evitar a infecção bacteriana / Primary-primary prevention of caries: to avoid the bacterial infection

A cárie dentária é considerada como uma doença multifatorial na qual a infecção com estreptococos mutans tem grande influência. A interação entre o microrganismo e o hospedeiro na fase inicial da cárie não causa um grande prejuizo, mas com o tempo causa danos irreversíveis ao hospedeiro. Um dos maiores desafios na prevenção da cárie hoje em dia é impedir a adesão de estreptococos mutans aos dentes na fase de erupção dentária. Quanto mais tarde a criança vier ser infeccionada com essas bactérias, menos cárie se desenvolverá. Além disso, como a erupção dos dentes é lenta e acontece em períodos, a colonização e distribuição das bactérias são determinadas por aquelas que já conseguiram estabelecer-se na boca durante a dentição primária. O controle da infecção é a chave de uma prevenção duradoura. Logo, se a microbiota estabelecida, não contiver estreptococos mutans será mínima a possibilidade de mudança de tal situação. Denominamos este quadro de prevenção-primária-primária. O presente artigo trata de vários métodos para alcançar esse objetivo: chupetas que liberam agentes preventivos durante a noite, o fortalecimento do sistema imune, a imunização passiva e ativa. Além disso é discutido o impacto para a saúde bucal no Brasil