Potential risk of dental fluorosis associated with different baby formulas and water brands marketed in Spain.

Despite efforts to promote breastfeeding, many babies aged <6 months receive only baby formula reconstituted with bottled water. The intake of high levels of fluoride during amelogenesis has been associated with hypomineralization of the tooth enamel, with aesthetic and mechanical repercussions. The objective of this study was to determine the potential risk of dental fluorosis associated with baby formulas marketed in Spain. We measured 26 baby formulas frequently consumed in Spain; 17 brands for babies aged <6 months, 5 for those aged >6 months, and 4 ready-to-use brands. They were prepared with 4 types of water: distilled water and three brands of bottled water with different levels of fluoride. The fluoride concentration (mg/L or ppm F) was measured with an ion-specific electrode coupled to an ion analyzer. Each sample was prepared according to the manufacturer's instructions and analyzed in triplicate. A descriptive analysis was carried out. The minimum fluoride level found was 0.04 mg/L and the maximum was 1.02 mg/L. Considering the daily intake of these formulas, none exceeded the clinically-acceptable daily dose limit risk for fluorosis (0.07 mg F/day/kg body weight) when mixed with bottled water with a low level of fluoride (0.1 mg/L). However, when the same brands of formula were reconstituted with bottled water with a higher fluoride content (0.99 mg/L), they all exceeded the daily dose limit for the risk of fluorosis. As the potential risk of dental fluorosis associated with the formulas tested depends exclusively on the fluoride concentration of the waters used for reconstitution, formula packaging should contain a warning.

Deep Sedation for Dental Care Management in Healthy and Special Health Care Needs Children: A Retrospective Study.

BACKGROUND: Very young children, and those with disabilities and extensive oral pathology, who cannot be treated in the dental chair, require deep sedation or general anesthesia for dental treatment. OBJECTIVE: The aim of this study is to describe and compare the oral health status in healthy and SHCN children and the treatments performed under deep sedation on an outpatient basis with a minimal intervention approach, and their impact on quality of life. METHODS: A retrospective study between 2006 and 2018 was made. A total of 230 medical records of healthy and SHCN children were included. The data extracted were age, sex, systemic health status, reason for sedation, oral health status before sedation, treatments administered during sedation, and follow-up. The quality of life after deep sedation of 85 children was studied through parental questionnaires. Descriptive and inferential analyses were made. RESULTS: Of the 230 children, 47.4% were healthy and 52.6% were SHCN. The median age was 7.10 ± 3.40 years (5.04 ± 2.42 in healthy children and 8.95 ± 3.09 in SHCN children). The main reason for sedation was poor handling in the dental chair (99.5%). The most frequent pathologies were caries (90.9%) and pulp pathology (67.8%). Healthy children had more teeth affected by decay and with pulp involvement. Patients aged < 6 years received more pulpectomies and pulpotomies. After treatment, parents stated that children were more rested and less irascible, ate better, increased in weight, and had improved dental aesthetics. CONCLUSIONS: Differences in treatments carried out did not depend on the general health status or the failure rate but on age, with more pulp treatments in healthy children who were younger, and more extractions near to the age of physiological turnover in children with SHCN who were older. Intervention under deep sedation with a minimally invasive treatments approach met the expectations of parents and guardians, as it improved the children's quality of life.

Orthodontic and dentofacial orthopedic treatments in patients with ectodermal dysplasia: a systematic review.

OBJECTIVE: The objective of this systematic review was to determine the orthodontic and dentofacial orthopedic treatments carried out in patients with ectodermal dysplasia to facilitate functional and aesthetic rehabilitation. METHODS: The systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement. We systematically searched PubMed, Web of Science, Scopus, Scielo, LILACS, EBSCOhost and Embase databases up to 6 January 2022. We included articles describing patients with any type of ectodermal dysplasia who received orthodontic or dentofacial orthopedic treatment to facilitate functional and aesthetic oral rehabilitation. The search was not restricted by language or year of publication. The quality of the studies was assessed using the Joanna Briggs Institute Quality Assessment Scale of the University of Adelaide for case series and case reports. The review was registered at the University of York Centre for reviews (CRD42021288030). RESULTS: Of the initial 403 studies found, 29 met the inclusion criteria. After applying the quality scale, 23 were left for review-21 case reports and 2 case series. The initial age of patients ranged from 34 months to 24 years. Thirteen studies were on hypohidrotic and/or anhidrotic ectodermal dysplasia, of which two were X-chromosome linked. In one study, the patient had Wiktop syndrome, and in nine the type of ectodermal dysplasia was not specified. The duration of treatment was 7 weeks to 10 years. The treatments described were: fixed orthodontic appliances or simple acrylic plates designed for tooth movement, including leveling and aligning, closing of diastemata, retraction of impacted teeth in the dental arch; clear aligners; fixed and/or removable appliances for the correction of skeletal and/or dentoalveolar relationships; palatal expanders in combination with face masks for orthopedic traction of the maxilla; and orthognathic surgery. Only three studies provided cephalometric data. CONCLUSION: The level of evidence of the articles reviewed was low and most orthopedic and dentofacial orthodontic treatments described were focused on correcting dental malpositioning and jaw asymmetries and not on stimulating growth from an early age. Studies with greater scientific evidence are needed to determine the best treatment for these patients.

Prevention and Treatment of Oral Complications in Hematologic Childhood Cancer Patients: An Update.

Cancers have a highly negative impact on the quality of life of paediatric patients and require an individualised oral treatment program for the phases of the disease. The aim of this study was to update existing research on oral care in children diagnosed with cancer. We carried out a literature search (in English, Spanish and Portuguese) in the Pubmed, Cochrane Library, EBSCO, WOS, SciELO, Lilacs, ProQuest, and SCOPUS databases and the websites of hospitals that treat childhood cancers. We found 114 articles and two hospital protocols. After review, we describe the interventions necessary to maintain oral health in children with cancer, divided into: phase I, before initiation of cancer treatment (review of medical record and oral history, planning of preventive strategies and dental treatments); phase II, from initiation of chemo-radiotherapy to 30-45 days post-therapy (maintenance of oral hygiene, reinforcement of parent/patient education in oral care, prevention and treatment of complications derived from cancer treatment); phase III, from 1 year to lifetime (periodic check-ups, maintenance, and reinforcement of oral hygiene, dental treatments, symptomatic care of the effects of long-term cancer treatment). The use of standardised protocols can avoid or minimise oral cancer complications and the side effects of cancer therapies.

Developmental Dental Defects in Permanent Teeth Resulting from Trauma in Primary Dentition: A Systematic Review.

The objective was to determine whether trauma in primary dentition causes alterations in the development of permanent dentition. Searches were made in May 2020 using PubMed, MEDLINE, MEDES, Scopus, Lilacs, and Embase. Papers in English, German, and Spanish, without restrictions in the year of publication, were included. The quality of the studies was analyzed using the NOS Scale. The search retrieved 537 references, and seven studies were included for a qualitative analysis. The results showed that trauma to a deciduous tooth can damage the bud of the permanent tooth. Enamel discoloration and/or hypoplasia were the most common sequelae in the permanent teeth after trauma to the primary predecessor. The type and severity of sequelae in the permanent tooth are associated with the development phase of the bud. Children with trauma of their primary teeth should receive checkups until the eruption of the permanent teeth for the early diagnosis and treatment of possible sequelae. Intrusion of the primary tooth was the trauma that caused the most damage and enamel alterations the most frequent sequelae.

Effects of Fluoride and Calcium Phosphate-Based Varnishes in Children at High Risk of Tooth Decay: A Randomized Clinical Trial.

BACKGROUND: The aim of this study was to investigate the effect of the application of two varnishes-MI Varnish (5% sodium fluoride with CPP-ACP) and Clinpro White Varnish (5% sodium fluoride with fTCP)-applied every three months in children with high caries risk for 12 months on plaque indexes, salivary pH, salivary lactic acid and chemical elements concentrations. METHODS: We included 58 children aged 4-12 years, assigned to control (placebo), Clinpro and MI groups. Baseline and three-month saliva samples were taken. We assessed changes in pH, lactic acid concentrations and chemical elements in saliva. RESULTS: At 12 months, all groups showed a nonsignificant increase in pH levels and a reduction in lactic acid, which was greatest in the placebo group. There was a significant reduction in 24Mg (p = <0.001), 31P (p = 0.033) and 66Zn (p = 0.005) levels in the placebo group (p ≤ 0.05), but not in the other elements studied: 23Na, 27Al, 39K, 44Ca, 52Cr, 55Mn, 57Fe, 59Co, 63Cu, 75As, 111Cd, 137Ba, 208Pb and 19F. CONCLUSIONS: Neither pH, lactic acid concentrations or most salivary chemical elements were useful in defining patients at high risk of caries or in monitoring the effect of MI Varnish and Clinpro White Varnish after three-month application for 12 months. However, the appearance of new cavities was stopped, and the hygiene index improved, probably due to hygienic and dietary measures and the use of fluoridated toothpaste. TRIAL REGISTRATION: ISRCTN registry, ISRCTN13681286.

[Total and soluble fluoride concentration in children´s toothpastes in Spain.] / Concentración de fluoruro total y soluble en pastas dentales de uso infantil en España.

OBJECTIVE: The use of fluoridated toothpastes is considered the most rational method in dental caries control, and it is recommended for all ages people, but for this they must be established at a minimum concentration of 1,000 ppm of total soluble fluoride, in pediatric patients. The objective of the study was to determine the concentration of total and soluble fluoride present in toothpastes marketed in Spain for pediatric use. METHODS: A descriptive and cross-sectional study was carried out throughout 2019, analyzing 11 toothpastes for pediatric use marketed in Murcia, Spain. The concentration of fluoride (ppm F=mg F/Kg) total (FT), soluble (FTS) and fluoride ion (F) and MFP (FPO32-) was analyzed using an ion-specific electrode coupled to an ion analyzer. A descriptive study was carried out to determinate mean and standard deviations for each variable analyzed. RESULTS: Among the analyzed toothpastes, 45% contained NaF (sodium fluoride), 45% MFP (sodium monofluorophosphate) and 10% both types of salts. The abrasive used was silica. 98% of the analyzed toothpastes showed total fluoride contents similar to those described by the manufacturer, only 3 toothpastes had fluoride concentrations lower than those described. The range obtained from FT oscillated between 398 -1,474.6 ppm F, and 100% of the toothpastes did not show differences between values of total fluoride and soluble fluoride. CONCLUSIONS: Most of the analyzed toothpastes contain a concentration of soluble fluoride between 1,000-1,500 ppm Fluoride, corresponding to the values described by the manufacturers However, there are still toothpastes with values lower than those recommended, minimum 1,000 ppm F, that do not allow effective anticaries activity from a public health point of view.

OBJETIVO: El uso de pastas dentales fluoradas es considerado el método más racional en el control de caries dental, y es recomendado para personas de todas las edades, pero para ello han de establecerse en una concentración mínima de 1.000 ppm de fluoruro total soluble, en pacientes pediátricos. El objetivo del estudio fué determinar la concentración de fluoruro total y soluble presente en pastas dentales comercializadas en España para uso pediátrico. METODOS: Se realizó un estudio descriptivo y transversal durante el año 2019, analizando 11 pastas dentales de uso pediátrico comercializadas en Murcia, España. Se analizó la concentración de fluoruro (ppm F=mg F/kg) total (FT), soluble (FTS) e ión de Flúor (F) y de MFP (FPO32-) mediante un electrodo ion-específico acoplado a un analizador de iones. Se llevó a cabo un estudio descriptivo determinando las medias y desviaciones estándar para cada variable. RESULTADOS: Entre las pastas dentales analizadas, el 45% contenían NaF (fluoruro sódico), 45% MFP (monofluorofosfato de sodio) y un 10 % ambos tipos de sales. El abrasivo de todas era sílice. El 98% de las pastas dentales analizadas mostraban contenidos de flúor total similares a los descritos por el fabricante, solamente 3 pastas presentaban concentraciones de flúor inferiores a las descritas por el fabricante. El rango obtenido de FT oscilaba entre 398-1.474,6 ppm F, y el 100% de las pastas dentales no mostraron diferencias entre valores de flúor total y flúor soluble. CONCLUSIONES: La mayoría de las pastas dentales analizadas contienen una concentración de flúor soluble entre 1.000-1.500 ppm F, correspondiéndose con los valores descritos por los fabricantes. Sin embargo, todavía existen pastas dentales con valores inferiores a los recomendados de mínimo de 1.000 ppm F que no permiten tener la actividad anticaries efectiva desde el punto de vista de salud pública.

Influence of Fluoride Varnish Application on Enamel Adhesion of a Universal Adhesive.

Purpose: To study the effect of the varnish type, application time and surface polishing on the shear bond strength (SBS) of a universal adhesive in healthy and demineralized bovine enamel. Materials and Methods: 432 bovine primary central incisors were assigned to 18 groups according to enamel mineralization [healthy and demineralized], topical varnish [Clinpro White Varnish (CWV; 3M Oral Care) and Profluorid (PFV, Voco)], remineralization time [24 h or 21 days] and polishing or not of the enamel surface. Adhesion was tested using Futurabond M (Voco)+ and GrandioSO (Voco). Sheer bond strength (SBS) was measured and the fracture mode studied. The statistical analysis was performed using two-way ANOVA, Tukey's test, and Pearson's chi-squared test. Results: In healthy bovine enamel, CWV reduced SBS at 24 h and 21 days; polishing significantly improved SBS. PFV increased SBS in healthy enamel at 21 days and demineralized enamel at 24 h and 21 days; polishing had no effect on SBS. The application time and polishing of the enamel surface affected the behavior of varnishes with respect to SBS. There was a correlation between the type of fracture and the degree of mineralization as well as the timepoint of varnish application. Conclusions: Remineralization of demineralized enamel with fluoride varnishes permits the recovery of the bond strength obtained in healthy enamel. Of the two varnishes studied, PFV had the highest SBS and more uniform behavior, regardless of the application timepoint, degree of mineralization, and surface treatment of the enamel..

La concentración de fluoruro en las aguas consumidas en la Región de Murcia no es suficiente para prevenir la caries dental / Fluoride concentrations in water consumed in the Region of Murcia are not sufficient to prevent dental caries

INTRODUCCIÓN: La caries sigue siendo la enfermedad crónica más frecuente en el niño y es considerada un problema de salud pública. El flúor es la principal medida protectora contra la caries dental y el agua de consumo es la principal fuente de ingesta de flúor. Objetivo El objetivo de nuestro trabajo fue calcular la concentración de ión fluoruro en el agua de abastecimiento de 10 zonas y en 10 aguas embotelladas comercializadas en la Región de Murcia. MATERIAL Y MÉTODOS: La concentración de fluoruro en las aguas se determinó con un electrodo ion-selectivo para flúor previamente calibrado con patrones de fluoruro preparados con TISAB II. RESULTADOS: En el agua de abastecimiento, se detectaron concentraciones de fluoruro entre 0.09 y 0.18 mgF/L (ppm) en las aguas embotelladas la concentración de fluoruro varió desde 0.04 a 0.50 ppm. CONCLUSIONES: El fluoruro está presente en aguas consumidas en la Región de Murcia pero en concentraciones que no alcanzan niveles preventivos para la caries dental. Es necesario prescribir suplementos de flúor en niños con alto riesgo de caries y para ello se deben contabilizar todas las fuentes externas de flúor, incluido el agua

INTRODUCTION: Dental caries remains the most frequent chronic disease in childhood and is considered a public health problem. Fluoride has proven effectiveness in the prevention of caries and drinking water is the main source of fluoride intake. The objective of this study was to determine fluoride concentrations in tap water from 10 areas and in 10 bottled waters sold in the Region of Murcia. MATERIALS AND METHODS: The concentration of fluoride in water was determined using a fluoride ion-selective electrode with a direct technique previously calibrated with standard fluoride concentrations prepared with TISAB II. RESULTS: In tap water, fluoride concentrations from 0.09 to 0.18 mgF/L (ppm) were detected; in bottled waters the concentration of fluoride varied from 0.04 to 0.50 ppm. CONCLUSION: Fluoride is present in the water consumed in the Region of Murcia but in concentrations that do not prevent dental caries. Fluoride supplements should be prescribed in children at high risk of caries, and for this, all external sources of fluoride intake, including water, must be accounted for

Perception, knowledge, and attitudes towards molar incisor hypomineralization among Spanish dentists: a cross-sectional study.

BACKGROUND: Molar incisor hypomineralization (MIH) is a growing health problem, and its treatment is a challenge. The purpose of the present study was to evaluate and compare the perceptions, knowledge, and clinical experiences of MIH in general dental practitioners (GDPs) and paediatric dentists (PDs) in Spain. METHODS: All dentists belonging to the College of Dentists of the Region of Murcia, in the South-East of Spain, were invited to participate in a cross-sectional survey. They were asked to complete a two-part questionnaire including sociodemographic profiles and knowledge, experience, and perceptions of MIH. Data were analysed using Pearson's chi-square test, Fisher's exact test and Cramer's V test. RESULTS: The overall response rate was 18.6% (214/1147). Most respondents were aged 31-40 years (44.86%), with more than 15 years of professional experience (39.72%). They worked mainly in the private sector (84.58%) and were licensed in dentistry (74.30%): 95.45% of PDs had detected an increase in the incidence of MIH in recent years (p <  0.001). Only 23.80% of GDPs claimed to have made a training course on MIH. With respect to the aetiology, chronic medical conditions (p = 0.029) and environmental pollutants (p = 0.008) were the only factors that showed significant between-group differences. Durability (p = 0.009) and remineralization potential (p = 0.018) were the factors where there was a between-group difference in the choice of the restoration material. In the case of post-eruptive fractures and opacities, the preferred material for both groups was resin-modified glass ionomer (RMGIC). However, in incisor lesions, composite was the material of choice for both groups, with significant differences (p = 0.032) in the use of glass ionomer. Most respondents expressed a need for continuing education on MIH. CONCLUSION: Spanish dentists perceived an increase in the incidence of MIH. The material of choice was RMGIC for non-aesthetic sectors and composite for incisors. Dentists believe it is difficult or very difficult to manage MIH, since the long-term success of restorations of MIH lesions is compromised because resin adhesion is not good. Both GDPs and PDs believe they need more training on the aetiology, diagnosis, and treatment of MIH.

Second primary molar hypomineralisation and drugs used during pregnancy and infancy. A systematic review.

OBJECTIVES: Hypomineralised second primary molars (HSPM) are due to idiopathic hypomineralisation that affects from 1- to 4-s primary molars, and its aetiology remains unclear. Our objective was to systematically review studies in which the investigators had studied the association between HSPM and drug use during pregnancy and the first year of life. MATERIALS AND METHODS: A systematic search for publications until July 2018 was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. No restrictions were placed on year of publication. The PECO Question was as follows: P, children exposed to drugs during pregnancy and the first year of life; E, drugs to which mothers, during pregnancy and their offspring were exposed; C, control groups from studies with the same characteristics not exposed to drugs during pregnancy and the first year of life; and O, relationship between drug exposure during pregnancy and the first year of life and HSPM. Two reviewers extracted the data and assessed the risk of bias using the Newcastle-Ottawa Scale criteria. RESULTS: We initially identified 986 articles, or which seven were selected for review: two case-control studies, one cross-sectional studies and four cohort studies. Four studies reported data on drug consumption during pregnancy and four investigated drug use during the first year of life and the occurrence of enamel defects in primary dentition. CONCLUSIONS: There is no clear evidence that the use of drugs during pregnancy and during the first year of life is associated with HSPM. Further well-designed prospective studies are needed. CLINICAL RELEVANCE: Determining the etiological factors related to the development of HSPM would help to establish preventive protocols in patients at potential risk. As HSPM is predictive of molar incisor hypomineralisation (MIH), the application of preventive protocols would avoid complications in both the primary and permanent dentition.

[Fluoride and heavy metals concentration in bottled waters: barrier measures against dental caries and fluorosis]. / Concentración de flúor y metales pesados en aguas embotelladas: medidas barrera frente a caries dental y fluorosis.

OBJECTIVE: The daily consumption of fluoridated water is one of the most beneficial measures in dental caries prevention. The objective of this paper was to analyze the content of fluorine and heavy metals in the bottled natural mineral water available in stores in Spain. METHODS: A descriptive and transversal study was done throughout 2019. Analysing a total of 20 bottled waters marketed in Spain during this year. Mainly, fluoride concentration (ppm/ml) was analyzed with an ion-specific electrode (Orion model 96-09, Orion Research, Cambridge, MA) coupled to an ion analyzer (Orion EA-940). The heavy metals were analyzed by ICP-MS (Agilent model 7900). A descriptive statistical study of the data was carried out. RESULTS: The minimum value of fluorine found was 0.05 ppm and the maximum 0.95ppm. 80% of the brands analyzed contain less than 0.6 ppm F. Only 1 brand exceeds 0.8 ppm F. Chromium and arsenic were the heavy metals present in all brands, without exceeding the maximum dose. No brand of bottled water indicated heavy metals on the label, and only 1 mark indicated the fluoride concentration on the label. CONCLUSIONS: There is a great variability in the chemical composition of bottled waters marketed in Spain. Most have a fluoride concentration lower than that recommended to prevent tooth decay, which would require an extra supply of fluoride. In the bottled waters analyzed there are heavy metals but they did not exceed the maximum doses established by legislation.

OBJETIVO: El consumo diario de agua fluorada es una de las medidas mas beneficiosas en la prevención de la caries dental. El objetivo de este estudio fue analizar el contenido de flúor y metales pesados en el agua mineral natural embotellada disponible en los comercios de España. METODOS: Se realizó un estudio descriptivo y transversal a lo largo de 2019, analizando 20 marcas de aguas embotelladas comercializadas en España en ese año. Se midió principalmente la concentración de flúor (partes por millón/mililitro) (ppm/ml), que fue analizada con un electrodo ion-específico (modelo Orión 96-09, Orion Research, Cambridge) acoplado a un analizador de iones (Orion EA-940). Los metales pesados se analizaron mediante ICP-MS (Agilent modelo 7900). Se realizó un estudio estadístico descriptivo de los datos. RESULTADOS: El valor mínimo de flúor encontrado fue de 0,05 ppm y el máximo de 0,95 ppm. El 80% de las marcas analizadas contenían menos de 0,6 ppm F. Solamente una marca superó las 0,8 ppm F. Cromo y arsénico fueron los metales pesados presentes en todas las marcas, sin superar la dosis máxima. Ninguna marca de agua embotellada indicaba los metales pesados en la etiqueta, y solo una marca indicó la concentración de flúor en la etiqueta. CONCLUSIONES: Existe una gran variabilidad en la composición química de las aguas embotelladas comercializadas en España. La mayoría tienen una concentración de fluoruro inferior a la recomendada para prevenir la caries dental, por lo que se necesitaría un aporte extra de flúor. En las aguas embotelladas analizadas existen metales pesados, pero no superan las dosis máximas establecidas por la legislación.

Concentración de flúor y metales pesados en aguas embotelladas: medidas barrera frente a caries dental y fluorosis / Fluoride and heavy metals concentration in bottled waters: barrier measures against dental caries and fluorosis

FUNDAMENTOS: El consumo diario de agua fluorada es una de las medidas mas beneficiosas en la prevención de la caries dental. El objetivo de este estudio fue analizar el contenido de flúor y metales pesados en el agua mineral natural embotellada disponible en los comercios de España. MÉTODOS: Se realizó un estudio descriptivo y transversal a lo largo de 2019, analizando 20 marcas de aguas embotelladas comercializadas en España en ese año. Se midió principalmente la concentración de flúor (partes por millón/mililitro) (ppm/ml), que fue analizada con un electrodo ion-específico (modelo Orión 96-09, Orion Research, Cambridge) acoplado a un analizador de iones (Orion EA-940). Los metales pesados se analizaron mediante ICP-MS (Agilent modelo 7900). Se realizó un estudio estadístico descriptivo de los datos. RESULTADOS: El valor mínimo de flúor encontrado fue de 0,05 ppm y el máximo de 0,95 ppm. El 80% de las marcas analizadas contenían menos de 0,6 ppm F. Solamente una marca superó las 0,8 ppm F. Cromo y arsénico fueron los metales pesados presentes en todas las marcas, sin superar la dosis máxima. Ninguna marca de agua embotellada indicaba los metales pesados en la etiqueta, y solo una marca indicó la concentración de flúor en la etiqueta. CONCLUSIONES: Existe una gran variabilidad en la composición química de las aguas embotelladas comercializadas en España. La mayoría tienen una concentración de fluoruro inferior a la recomendada para prevenir la caries dental, por lo que se necesitaría un aporte extra de flúor. En las aguas embotelladas analizadas existen metales pesados, pero no superan las dosis máximas establecidas por la legislación

BACKGROUND: The daily consumption of fluoridated water is one of the most beneficial measures in dental caries prevention. The objective of this paper was to analyze the content of fluorine and heavy metals in the bottled natural mineral water available in stores in Spain. METHODS: A descriptive and transversal study was done throughout 2019. Analysing a total of 20 bottled waters marketed in Spain during this year. Mainly, fluoride concentration (ppm/ml) was analyzed with an ion-specific electrode (Orion model 96-09, Orion Research, Cambridge, MA) coupled to an ion analyzer (Orion EA-940). The heavy metals were analyzed by ICP-MS (Agilent model 7900). A descriptive statistical study of the data was carried out. RESULTS: The minimum value of fluorine found was 0.05 ppm and the maximum 0.95 ppm. 80% of the brands analyzed contain less than 0.6 ppm F. Only 1 brand exceeds 0.8 ppm F. Chromium and arsenic were the heavy metals present in all brands, without exceeding the maximum dose. No brand of bottled water indicated heavy metals on the label, and only 1 mark indicated the fluoride concentration on the label. CONCLUSIONS: There is a great variability in the chemical composition of bottled waters marketed in Spain. Most have a fluoride concentration lower than that recommended to prevent tooth decay, which would require an extra supply of fluoride. In the bottled waters analyzed there are heavy metals but they did not exceed the maximum doses established by legislation

Microleakage of conventional light-cure resin-based fissure sealant and resin-modified glass ionomer sealant after application of a fluoride varnish on demineralized enamel.

BACKGROUND: International guidelines on the prevention of caries recommend sealing of the pits and fissures of the permanent molars. There is no evidence on which type of material is most effective on demineralized enamel. AIM: To evaluate the microleakage of a conventional light-cured, resin-based fissure sealant (LCRBS), GrandiO Seal, and a resin-modified glass ionomer sealant (RMGIS), Vitremer, after application of a fluoride varnish, Bifluorid 12, on demineralized enamel. DESIGN: 80 human third molars were divided into eight groups. The groups combined the three study factors (1) type of enamel (intact or demineralized); (2) enamel non-varnished or varnished with Biflourid12; and (3) type of sealant (GrandiO Seal or Vitremer). The percentage of microleakage after thermocycling was measured using imaging analysis software. The Kruskal-Wallis plus Dunn tests were used to compare differences in microleakage in the different groups. RESULTS: The lowest microleakage was in the unvarnished groups, and was the same for GrandiO Seal and Vitremer. When varnish was applied, microleakage was greater in demineralized enamel than in intact enamel for both LCRBS and RMGIS. CONCLUSION: The application of fluoride varnish on demineralized enamel increases the microleakage of both GrandiO Seal and Vitremer.

Effect of antibiotics and NSAIDs on cyclooxygenase-2 in the enamel mineralization.

The objective of this study was to determine whether the use of the most commonly prescribed antibiotics and non-steroidal anti-inflammatory drugs in childhood could disturb enamel mineralization. Forty-two Swiss mice were divided into seven groups: controls; amoxicillin; amoxicillin/clavulanate; erythromycin; acetaminophen; ibuprofen and celecoxib, to inhibit cyclooxygenase 2 (COX2). SEM-EDX analysis was conducted on all cusps of the third molars. Calcium (Ca), phosphorus (P), aluminum, potassium, sodium, magnesium and chlorine were quantified. The stoichiometric Ca/P molar ratios were calculated. Immunohistochemical quantification of COX2 in incisors was carried out by image analysis using COX2-specific immunostaining. Groups treated with antibiotics showed no significant differences in the content of the chemical elements. Only acetaminophen and celecoxib showed a significant decrease in Ca and P compared with the control samples. Ca/P ratios showed no difference. Groups treated with amoxicillin, amoxicillin/clavulanate, erythromycin and acetaminophen showed significantly lower amounts of immunoreactive COX2 at the enamel organ maturation stage of the mouse incisors. Our results suggest that COX2 is involved in the maturation stage of the enamel organ and that its inhibition would appear to alter amelogenesis, producing hypomineralization.