Preventive Effect of CPP-ACPF Paste and Fluoride Toothpastes Against Erosion and Erosion Plus Abrasion In Vitro - A 3D Profilometric Analysis.

PURPOSE: To evaluate the effect of CPP-ACPF paste and fluoride toothpastes on enamel subjected to erosion and erosion plus abrasion in vitro. MATERIALS AND METHODS: A total of 220 human enamel blocks were divided into eleven groups (n = 20): CPP-ACPF paste (MPP), potassium nitrate/sodium fluoride toothpaste (PE), sodium fluoride toothpaste (FD), fluoride-free toothpaste (SO) and control (erosion only with no paste or toothpastes; CO) according to the experimental design: erosion or erosion plus abrasion immediately after erosion (ERO+I-ABR) or 30 min after erosion (ERO+30min-ABR). For 5 days, the specimens were subjected to: (1) erosive challenge (EC) (cola drink, 4 x 5 min/day), topical application of the undiluted paste or diluted toothpastes (1:2 w/w) (4 x 1 min/ day) plus 1 h in artificial saliva (AS) between cycles and overnight; or (2) EC plus abrasion (4 x /60 s/day) performed with the diluted toothpastes (no MMP) plus 1 h in AS between cycles and overnight. Erosion depth was quantified through a 3D profilometer. Data were analysed using Kruskal-Wallis, Mann-Whitney and Wilcoxon tests (p = 0.05). RESULTS: CPP-ACPF paste and NaF toothpaste showed lowest enamel wear among groups and reduced tissue loss by 89% in erosion challenge. Abrasion led to higher enamel wear than erosion only (p = 0.030). ERO+30min-ABR had no protective effect when compared to ERO+I-ABR (p > 0.05). CONCLUSION: A high frequency of CPP-ACPF paste application (4x daily) is effective in reducing the effects of erosion. A waiting period before performing toothbrushing does not protect enamel against erosion regardless the composition of the toothpastes.

Sialolito de grandes dimensões no ducto da glândula submandibular / Large sialolith in the submandibular gland duct

O objetivo deste trabalho é descrever o caso de um sialolito de grandes dimensões em glândula submandibular. Paciente do sexo feminino, leucoderma, 53 anos, procurou o cirurgião-dentista queixando-se de xerostomia, dor e inchaço na região de assoalho bucal, principalmente observado durante as refeições. O exame físico revelou uma tumefação em região submandibular esquerda, sensível a palpação, além de aumento de volume intra-oral firme, na região sublingual esquerda. Ao ordenhar a glândula submandibular, houve saída de pus. A radiografia oclusal inferior evidenciou extensa imagem radiopaca extensa, bem delimitada, cilíndrica e alongada. A associação dos exames clínicos e radiográficos levou ao diagnóstico de cálculo salivar. Foi realizada excisão cirúrgica da lesão sob anestesia local, com preservação da glândula submandibular. O exame anatomopatológico do cálculo revelou, na macroscopia, uma peça cirúrgica de consistência dura e cor amarela medindo 2,2 cm de diâmetro e, na microscopia, a presença de laminações concêntricas de material calcificado. A paciente encontra-se em acompanhamento há 2 anos e 8 meses, sem queixas de função glandular ou fluxo salivar, sem aumento de volume e exame radiográfico sem alterações. Apesar das grandes dimensões do sialolito, sua localização próxima à saída do dueto permitiu um tratamento conservador com bons resultados para a paciente.

This paper aims to describe a case of a large submandibular sialolith. A 53-year-old Caucasian female looked for for her dentist complaining of xerostomia, pain and swelling in the floor of the mouth, mainly observed during meals. The physical exam revealed a tender swelling on palpation in the left submandibular region, and also a firm intraoral swelling was detected in the left sublingual region. It was possible to draw pus from the submandibular gland. Mandibular occlusal radiography showed an extensive cylindrical and elongated, well-defined radiopaque image in the floor of the mouth. The association of clinical and radiographic findings led to the diagnosis of salivary calculus. The lesion was submitted to surgical excision under local anesthesia and the submandibular gland was maintened. Macroscopic analysis revealed a yellow and hard in consistency specimen, measuring 2.2 cm in length, and microscopic analysis revealed the presence of concentric laminations of calcified material associated with . The patient is being followed up for 2 years and 8 months, with no complaints of salivary flow or gland dysfunction, without gland swelling and no radiographic changes. Despite it being a large sialolith, its location near the exit of the duct allowed a conservative treatment with satisfactory aesthetic and functional results for the patient.

Métodos de detecção de cárie / Methods of caries detection

A Odontologia contemporânea não deve restringir-se a identificar cavidades, mas, também, despertar para um diagnóstico precoce das lesões cariosas iniciais. Os mais diversos e modernos métodos de detecção de cárie vêm sendo desenvolvidos com objetivo de tornar mais preciso o diagnóstico de cárie dental. Os métodos de detecção mais utilizados são os convencionais, porém a associação dos métodos proporciona melhores resultados ao exame clínico tradicional isolado. Este estudo teve como propósito a revisão de literatura sobre os métodos de detecção da doença cárie disponíveis atualmente, baseados nos métodos radiográficos, fluorescência a laser e corrente elétrica.

The contemporary Odontology cannot be restricted to just identify cavities, but must be interested in an early diagnosis of caries lesions. Varied and modern methods of caries detection are being developed, aiming to turn the diagnosis of dental caries more accurate. The conventional methods are most used for detection, however, the association of methods offer better results to the clinician. The purpose of this paper was to do a literature review and to compare the methods of caries detection, based on radiographic methods, laser fluorescence and electric chain.