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1.
J Periodontal Res ; 2020 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-32167175

RESUMO

OBJECTIVE: To assess the association between weight status and gingivitis in a representative sample of 12-year-old schoolchildren from South Brazil. BACKGROUND: An association between obesity and gingivitis in children and adolescents has been observed; however, the present evidence has major limitations. METHODS: A cross-sectional study was conducted in Porto Alegre, South Brazil, from September 2009 to December 2010 and included a representative sample of 1528 12-year-old schoolchildren attending public and private schools. Data collection included the application of a questionnaire, recording of anthropometric measures (weight and height), and clinical examination (gingival bleeding index, recorded in four sites per tooth). The outcome of the study was the prevalence of gingivitis, defined as the proportion of schoolchildren presenting ≥52% of bleeding sites (based on the median). Weight status was categorized according to body mass index into normal, overweight, or obese. The association between predictor variables and gingivitis prevalence was assessed using Poisson regression models. Unadjusted and adjusted prevalence ratios (PR) and their 95% confidence intervals (95% CI) were estimated. RESULTS: Gingivitis prevalence was 48.7% (95% IC = 33.8-63.6) and, on average, schoolchildren presented 51.8% (95% IC = 46.2-57.5) of bleeding sites. Obese individuals had 13% higher prevalence for presenting gingivitis than did normal-weight ones (PR = 1.13, 95% CI = 1.09-1.18, P < .001). The stratified analysis showed that this association was sex-specific: Obese girls presented a greater chance of having gingivitis (adjusted PR = 1.21, 95% CI = 1.09-1.34, P < .001), but such association was not observed among boys (PR = 1.07, 95% CI = 0.95-1.20, P = .29). CONCLUSION: This study showed sex differences in the association between obesity and gingivitis among 12-year-old South Brazilian schoolchildren.

2.
Caries Res ; : 1-11, 2020 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-32101874

RESUMO

This prospective cohort study investigated the distribution pattern of carious lesions diagnosed by visual tactile and radiographic examinations, assessed the radiographic yield for clinical caries diagnosis, and estimated how accurately commonly used indicators for caries identified young adults who would benefit from radiographs at different thresholds. Overall, 576 patients aged 16-32 years seeking a first consultation were included. Patients were examined for caries and answered a validated questionnaire on sociodemographics and oral health behavior. Almost 10% of clinically sound approximal surfaces presented radiolucency in enamel/dentine. Of the clinically diagnosed noncavitated approximal and occlusal lesions, 22.5 and 17.7%, respectively, presented radiolucency reaching dentine at the radiographic examination. Noncavitated/enamel lesions detected radiographically were mainly at approximal surfaces (73.2%), while at occlusal surfaces these were negligible (0.7%). More than half of approximal dentine lesions were only detected radiographically (61.3%), while more than half of occlusal dentine lesions were only clinically diagnosed (57.1%). The hierarchical logistic regression analysis showed that patient's caries activity, D1MFS scores ≥17, and frequent consumption of soft drinks were significantly associated with detection of approximal enamel/dentine lesions. Also, patient's caries activity and frequent consumption of soft drinks were significantly associated with occlusal dentine caries (p ≤ 0.05). The indicator power of grouping these indicators as a predictor for the presence of radiographically detected lesions showed high sensitivity (0.84-0.91) and moderate specificity (0.64-0.73) for all surfaces and thresholds tested. In conclusion, radiographs increased significantly the number of approximal enamel/dentine and occlusal dentine lesions diagnosed. The ability to identify young adults with approximal lesions from the predictor was satisfactory. Bearing in mind that an essential contribution of bitewing radiographs to clinical examination is the detection of approximal noncavitated/enamel lesions that can be inactivated by nonoperative interventions, our results support the prescription of radiographs in young adults seeking a first consultation. Updating of current guidelines' recommendation of radiographs is warranted.

3.
Caries Res ; 54(1): 7-14, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31590168

RESUMO

A 2-day workshop of ORCA and the IADR Cariology Research Group was organized to discuss and reach consensus on definitions of the most commonly used terms in cariology. The aims were to identify and to select the most commonly used terms of dental caries and dental caries management and to define them based on current concepts. Terms related to definition, diagnosis, risk assessment, and monitoring of dental caries were included. The Delphi process was used to establish terms to be considered using the nominal group method favored by consensus. Of 222 terms originally suggested by six cariologists from different countries, a total of 59 terms were reviewed after removing duplicates and unnecessary words. Sixteen experts in cariology took part in the process of reaching consensus about the definitions of the selected caries terms. Decisions were made following thorough "round table" discussions of each term and confirmed by secret electronic voting. Full agreement (100%) was reached on 17 terms, while the definitions of 6 terms were below the agreed 80% threshold of consensus. The suggested terminology is recommended for use in research, in public health, as well as in clinical practice.

4.
Braz Oral Res ; 33: e056, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31271568

RESUMO

The aim of this study was to assess the association between weight status and ΔDMFS among 12-year-old schoolchildren from South Brazil. A total of 801 12-year-old schoolchildren were followed-up for 2.5 ± 0.3 years. Data collection included questionnaire, recording of anthropometric measures (height and weight), and caries examination. The outcome was the difference between DMFS (number of decayed, missing or filled surfaces) at follow-up and baseline (ΔDMFS). Weight status, based on body mass index-for-age Z-scores, was considered the main predictor variable. Negative binomial regression models were used to model the association, and rate ratios and their 95% confidence intervals were estimated. A multivariable fractional polynomial model was used to further explore the relationship between obesity and dental caries. DMFS increased by 0.86 (95%CI = 0.65-1.07), 0.91 (95%CI = 0.59-1.23), and 0.42 (95%CI = 0.03-0.80) for normal weight, overweight, and obese schoolchildren, respectively. Obese adolescents had significantly lower ΔDMFS than normal weight ones (p < 0.05). No significant association between categories of weight status and ΔDMFS was found (overweight, IRR=0.92, 95%CI = 0.69-1.21, p = 0.54; obese IRR = 0.75, 95%CI = 0.51-1.12, p = 0.16). However, the multivariable fractional polynomial model showed an inverted U shaped relationship with a decreasing ΔDMFS with increasing BMI (p < 0.05). This population-based longitudinal study showed an inverse association between obesity and ΔDMFS over a 2.5-year period among South Brazilian adolescents.


Assuntos
Cárie Dentária/epidemiologia , Cárie Dentária/etiologia , Obesidade/complicações , Obesidade/epidemiologia , Índice de Massa Corporal , Brasil/epidemiologia , Criança , Índice CPO , Métodos Epidemiológicos , Feminino , Humanos , Masculino , Sobrepeso/complicações , Sobrepeso/epidemiologia , Fatores Socioeconômicos
5.
Braz Oral Res ; 33: e036, 2019 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-31141035

RESUMO

The aim of this study was to determine the occurrence of gingivitis and calculus and their predictors in a population of adults in Brazil. A representative sample of 758 adults from 35 to 59 years of age from Porto Alegre city was examined. A structured questionnaire was applied. The Gingival Bleeding Index and the presence of calculus were measured at 4 sites/tooth. Multivariable logistic models were fitted to determine the predictors for gingival bleeding at >20% of sites. Overall, 96.5% (95% confidence interval [CI]=95.1-98.0) of individuals had ≥ 1 bleeding site. The mean percentages of sites with gingivitis and calculus were 26.1% and 44.6%, respectively. The odds of gingivitis decreased by ∼45% for individuals ≥40 years old compared to younger adults. Individuals that never performed interproximal cleaning and non-whites had an approximately two times higher chance of gingivitis. Smokers had lower chances of gingivitis than never-smokers (odds ratio=0.40; 95% CI=0.24-0.68). Higher numbers of missing teeth were associated with higher chances of gingivitis. The percentage of calculus was significantly associated with skin color, education, proximal cleaning, smoking exposure, dental visits, and tooth loss. It can be concluded that the occurrence of gingivitis and calculus was high in this Brazilian population, and it was associated with age, skin color, education, self-reported proximal cleaning, smoking, dental care, and tooth loss.


Assuntos
Cálculos Dentários/epidemiologia , Cálculos Dentários/etiologia , Gengivite/epidemiologia , Gengivite/etiologia , Adulto , Distribuição por Idade , Brasil/epidemiologia , Estudos Transversais , Feminino , Hemorragia Gengival/epidemiologia , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Índice Periodontal , Prevalência , Fatores de Risco , Distribuição por Sexo , Fumar/efeitos adversos , Fumar/epidemiologia , Fatores Socioeconômicos , Escovação Dentária/estatística & dados numéricos
6.
Caries Res ; 53(1): 76-83, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29945138

RESUMO

The aim of this study was to evaluate the cariogenicity of a milk-based drink intended for older adults that was used as part of a governmental initiative in Chile to improve their nutritional conditions. This drink contains a high concentration of sugars, which can contribute to root caries development. To test this hypothesis, an experimental biofilm/caries model was used. Dentin slabs were used to grow biofilms of Streptococcus mutans UA159. Slabs/biofilms were exposed 3× per day to bovine milk with different fat content, the milk-based drink, and the milk-based drink supplemented with 10 g of sucrose added per serving. Slabs exposed to 10% sucrose or 0.9% NaCl were used as positive and negative controls, respectively. Biofilms were analyzed for bacterial counts and acidogenicity. Dentin demineralization was estimated by the loss of surface microhardness and integrated mineral loss. Results were compared by analysis of variance and Tukey's test. The milk-based drink showed higher acidogenicity than milk with its entire (whole) or reduced total fat content (skim). The milk-based drink supplemented with -sucrose had similar acidogenicity as the 10% sucrose positive control (p = 0.506). Whole milk exposure elicited lower bacterial counts than the positive control, the milk-based drink, and the milk-based drink supplemented with sucrose (p = 0.002; 0.006 and 0.014 respectively). Although skim milk induced higher demineralization than whole milk, both milk types produced lower demineralization than the milk-based drink. Regarding integrated mineral loss, demineralization induced by the milk-based drink and the milk-based drink supplemented with sucrose was similar to that induced by the positive control and skim milk (p > 0.05). Sugar-containing milk-based drinks used as dietary supplements for older adults may be highly cariogenic and could represent a potential risk for root caries.


Assuntos
Biofilmes/efeitos dos fármacos , Dentina/efeitos dos fármacos , Dieta Cariogênica , Suplementos Nutricionais/efeitos adversos , Leite/efeitos adversos , Cárie Radicular/etiologia , Streptococcus mutans/fisiologia , Animais , Carga Bacteriana , Bovinos , Chile , Humanos , Saliva , Cloreto de Sódio/efeitos adversos , Estatísticas não Paramétricas , Sacarose/efeitos adversos , Desmineralização do Dente/etiologia
7.
Braz. oral res. (Online) ; 33: e056, 2019. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-1011655

RESUMO

Abstract The aim of this study was to assess the association between weight status and ΔDMFS among 12-year-old schoolchildren from South Brazil. A total of 801 12-year-old schoolchildren were followed-up for 2.5 ± 0.3 years. Data collection included questionnaire, recording of anthropometric measures (height and weight), and caries examination. The outcome was the difference between DMFS (number of decayed, missing or filled surfaces) at follow-up and baseline (ΔDMFS). Weight status, based on body mass index-for-age Z-scores, was considered the main predictor variable. Negative binomial regression models were used to model the association, and rate ratios and their 95% confidence intervals were estimated. A multivariable fractional polynomial model was used to further explore the relationship between obesity and dental caries. DMFS increased by 0.86 (95%CI = 0.65-1.07), 0.91 (95%CI = 0.59-1.23), and 0.42 (95%CI = 0.03-0.80) for normal weight, overweight, and obese schoolchildren, respectively. Obese adolescents had significantly lower ΔDMFS than normal weight ones (p < 0.05). No significant association between categories of weight status and ΔDMFS was found (overweight, IRR=0.92, 95%CI = 0.69-1.21, p = 0.54; obese IRR = 0.75, 95%CI = 0.51-1.12, p = 0.16). However, the multivariable fractional polynomial model showed an inverted U shaped relationship with a decreasing ΔDMFS with increasing BMI (p < 0.05). This population-based longitudinal study showed an inverse association between obesity and ΔDMFS over a 2.5-year period among South Brazilian adolescents.

8.
Braz. oral res. (Online) ; 33: e036, 2019. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-1001607

RESUMO

Abstract: The aim of this study was to determine the occurrence of gingivitis and calculus and their predictors in a population of adults in Brazil. A representative sample of 758 adults from 35 to 59 years of age from Porto Alegre city was examined. A structured questionnaire was applied. The Gingival Bleeding Index and the presence of calculus were measured at 4 sites/tooth. Multivariable logistic models were fitted to determine the predictors for gingival bleeding at >20% of sites. Overall, 96.5% (95% confidence interval [CI]=95.1-98.0) of individuals had ≥ 1 bleeding site. The mean percentages of sites with gingivitis and calculus were 26.1% and 44.6%, respectively. The odds of gingivitis decreased by ∼45% for individuals ≥40 years old compared to younger adults. Individuals that never performed interproximal cleaning and non-whites had an approximately two times higher chance of gingivitis. Smokers had lower chances of gingivitis than never-smokers (odds ratio=0.40; 95% CI=0.24-0.68). Higher numbers of missing teeth were associated with higher chances of gingivitis. The percentage of calculus was significantly associated with skin color, education, proximal cleaning, smoking exposure, dental visits, and tooth loss. It can be concluded that the occurrence of gingivitis and calculus was high in this Brazilian population, and it was associated with age, skin color, education, self-reported proximal cleaning, smoking, dental care, and tooth loss.

9.
Braz Dent J ; 29(3): 290-295, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29972456

RESUMO

The aim of this randomized clinical trial was to compare the remaining microbial load after treatments based on complete and selective caries removal and sealing. Patients with active carious lesions in a permanent molar were randomly allocated into 2 groups: a test group (selective caries removal-SCR; n=18) and a control group (complete caries removal - CCR; n=18). Dentin samples were collected following the excavation and three months after sealing. Streptococcus species, Streptococcus mutans, Lactobacillus species, and total viable microorganisms were cultured to count the viable cells and frequency of species isolation. CCR resulted in significant lower total viable microorganisms counts (p≤0.001), Streptococcus species (p≤0.001) and Lactobacillus species (p≤0.001) initially. However, after sealing, a decrease in total viable microorganisms, Streptococcus species, and Lactobacillus species in the SCR resulted in no difference between the groups after 3 months. In conclusion, selective caries removal is as effective as complete caries removal in reducing dentin bacterial load 3 months after sealing.


Assuntos
Bactérias Anaeróbias/isolamento & purificação , Carga Bacteriana , Cárie Dentária/terapia , Lactobacillus/isolamento & purificação , Dente Molar/microbiologia , Selantes de Fossas e Fissuras , Streptococcus/isolamento & purificação , Adolescente , Adulto , Estudos de Casos e Controles , Criança , Método Duplo-Cego , Feminino , Humanos , Masculino , Dente Molar/diagnóstico por imagem , Adulto Jovem
10.
Caries Res ; 52(6): 588-597, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29730666

RESUMO

There is limited evidence that arginine-containing fluoridated dentifrices (AFD) have a better anticaries effect than regular fluoridated dentifrices (FD), especially in subjects at a higher risk for caries development. This study aimed to assess the effect of AFD on enamel demineralization and on the microbial and biochemical compositions of biofilm formed under different frequencies of sucrose exposure. It consisted of an in situ split-mouth design, where 12 adult volunteers who used FD for at least 2 months prior to the beginning of this study wore acrylic palatal appliances containing 4 bovine enamel specimens (1 pair at each side of the appliance) during 2 phases of 14 days each. FD slurry (3×/day) and 20% sucrose solution (4× and 8×/day) were dripped on the specimens during the first experimental phase. The same volunteers then used AFD during a 2-month washout period, followed by a second experimental phase where the AFD slurry and sucrose solution were applied onto a new subset of specimens. The percentage of enamel surface hardness loss (%SHL), the lesion depth (LD), the integrated mineral loss (IML), microbial counts on biofilms, the biomass, and inorganic and insoluble extracellular polysaccharide (IEPS) biofilm concentrations were determined. Higher %SHL, biomass, and IEPS and lower fluoride values were found at sucrose 8×/day exposure. Lower IEPS were found in the presence of AFD compared to FD. Similar %SHL, LD, and IML values were found between FD and AFD, irrespectively of the cariogenic challenge. The results suggest that AFD have an anticaries effect similar to that of regular FD.


Assuntos
Arginina/uso terapêutico , Cárie Dentária/prevenção & controle , Esmalte Dentário/efeitos dos fármacos , Placa Dentária/prevenção & controle , Dentifrícios/uso terapêutico , Desmineralização do Dente/prevenção & controle , Adulto , Animais , Biofilmes/efeitos dos fármacos , Biofilmes/crescimento & desenvolvimento , Cariogênicos/farmacologia , Bovinos , Cárie Dentária/etiologia , Placa Dentária/química , Fluoretos/uso terapêutico , Humanos , Sacarose/farmacologia , Desmineralização do Dente/etiologia , Adulto Jovem
11.
Braz. dent. j ; 29(3): 290-295, May-June 2018. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-951552

RESUMO

Abstract The aim of this randomized clinical trial was to compare the remaining microbial load after treatments based on complete and selective caries removal and sealing. Patients with active carious lesions in a permanent molar were randomly allocated into 2 groups: a test group (selective caries removal-SCR; n=18) and a control group (complete caries removal - CCR; n=18). Dentin samples were collected following the excavation and three months after sealing. Streptococcus species, Streptococcus mutans, Lactobacillus species, and total viable microorganisms were cultured to count the viable cells and frequency of species isolation. CCR resulted in significant lower total viable microorganisms counts (p≤0.001), Streptococcus species (p≤0.001) and Lactobacillus species (p≤0.001) initially. However, after sealing, a decrease in total viable microorganisms, Streptococcus species, and Lactobacillus species in the SCR resulted in no difference between the groups after 3 months. In conclusion, selective caries removal is as effective as complete caries removal in reducing dentin bacterial load 3 months after sealing.


Resumo O objetivo deste ensaio clínico randomizado foi comparar os microrganismos remanescentes após tratamentos baseados em remoção total de tecido cariado e selamento e a remoção seletiva de tecido cariado e selamento. Pacientes com lesões de cárie ativas em molares permanentes foram divididos aleatoriamente em dois grupos: grupo teste (remoção seletiva de tecido cariado-SCR; n=18), e grupo de controle (remoção total de tecido cariado-CCR; n=18). Amostras de dentina foram obtidas após a remoção da tecido cariado e após 3 meses de selamento das cavidades. Streptococcus spp., Streptococcus mutans, Lactobacillus spp. e microrganismos viáveis totais foram cultivados para contagem de células e frequência de isolamento de espécies. CCR resultou em menores contagens totais de microorganismos viáveis (p≤0,001), Streptococcus spp. (p≤0,001) e Lactobacillus spp. (p≤0,001) inicialmente. Entretanto, após o selamento, uma redução significativa nas contagens totais de microrganismos viáveis, Streptococcus spp. e Lactobacillus spp. resultou em nenhuma diferença entre os grupos após 3 meses. Conclui-se que a remoção seletiva de cárie é tão seletiva quanto a remoção completa de cárie na redução da infecção dentinária após três meses com selamento da lesão.

12.
Caries Res ; 52(6): 463-467, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29669345

RESUMO

This cross-sectional study assessed the relationship between fixed orthodontic treatment duration and caries activity. Two hundred and sixty 10- to 30-year-olds were divided into 4 groups (n = 65): no fixed orthodontic appliances (G0), orthodontic treatment for 1 year (G1), 2 years (G2), or 3 years (G3). Orthodontic treatment duration was significantly associated with active caries: prevalence was 1.5% for G0, 27.7% for G1, and 72.3% for G2 and G3; the median number of lesions was 0 for G0 and G1 and 2 for G2 and G3. No differences were observed between G2 and G3. The longer the duration of orthodontic treatment, the higher the prevalence/extent of active caries lesions.


Assuntos
Cárie Dentária/etiologia , Aparelhos Ortodônticos Fixos/efeitos adversos , Ortodontia Corretiva/efeitos adversos , Adolescente , Adulto , Criança , Estudos Transversais , Cárie Dentária/epidemiologia , Feminino , Humanos , Masculino , Prevalência , Fatores de Tempo , Adulto Jovem
13.
Int Dent J ; 68(3): 144-151, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29313946

RESUMO

AIM: This study aimed to compare the prevalence and extent of dental caries according to the standard World Health Organization (WHO), modified WHO and International Caries Detection and Assessment System (ICDAS) criteria among 12-year-old Brazilian schoolchildren and to assess the impact of these detection criteria on the assessment of sociodemographic risk indicators for dental caries. METHODS: This cross-sectional survey used a multistage probability sampling strategy to select a representative sample of 12-year-old schoolchildren. After tooth cleaning and drying, a single examiner recorded the presence of non-cavitated and cavitated caries lesions. A questionnaire gathered demographic and socio-economic information. Three proposed thresholds for caries detection were used: standard WHO criteria (only cavitated lesions); modified WHO criteria (active non-cavitated lesions and cavitated lesions); and ICDAS (all non-cavitated and cavitated lesions). Prevalence ratios (PR), rate ratios (RR) and 95% confidence intervals (95% CI) were estimated using survey Poisson regression analysis. RESULTS: In total, 1,528 of 1,837 eligible schoolchildren participated. Caries prevalence (standard WHO, 55.23%; modified WHO, 63.33%; ICDAS, 79.82%) and decayed, missing and filled teeth (DMFT) index (standard WHO, 1.39; modified WHO, 1.95; ICDAS, 3.78) increased as the detection criteria became more sensitive. Compared with the standard WHO criteria, ICDAS had a greater impact on caries estimates, mainly in schoolchildren of higher socio-economic background. All socio-economic variables were significantly associated with dental caries, irrespective of the detection criteria. CONCLUSION: The inclusion of non-cavitated lesions impacted estimates of prevalence and extent of dental caries, mainly when ICDAS was used. No impact was observed on the association between caries and socio-economic variables.


Assuntos
Cárie Dentária/diagnóstico , Cárie Dentária/epidemiologia , Inquéritos de Saúde Bucal/métodos , Brasil/epidemiologia , Criança , Estudos Transversais , Índice CPO , Humanos , Prevalência , Medição de Risco , Fatores de Risco , Fatores Socioeconômicos , Organização Mundial da Saúde
14.
Clin Oral Investig ; 22(1): 469-474, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28560502

RESUMO

INTRODUCTION: Infiltration of carious lesion has been claimed as a promising approach for the management of non-cavitated proximal lesions (NCPL). Clinical studies have suggested that this approach may reduce NCPL progression in individuals whose caries risk was not change over the studied period. OBJECTIVE: This study aimed to assess the additional benefit of infiltration of NCPL over a 3-year period in a group of individuals who received treatment and control of carious activity. MATERIALS AND METHODS: Twenty-two caries-active subjects that possessed at least a pair of NCPL in posterior teeth were selected for this study totalizing 36 pairs of lesion. In a split-mouth design, lesions were randomly allocated to test (infiltration) or placebo treatments. At follow-up, lesions were radiographically analyzed, progression was determined by radiographic pair-wise comparison and differences in number of progressing lesions between test, and placebo-treated surfaces were compared. RESULTS: Seventeen subjects (27 pairs of lesions) were followed up. Only four subjects were caries-active at the follow-up. In the test group, 2/27 (7.4%) lesions and in the placebo group 5/27 (18.5%) lesions had progressed. No statistical difference was observed between the studied groups (p = 0.453). CONCLUSION: Subjects under treatment focusing on controlling caries activity presented low progression rates in both infiltrated and non-infiltrated NCPL. As only very few lesions progressed in both groups, no significant additional effect could be found. Further studies with larger sample sizes are necessary. CLINICAL RELEVANCE: Infiltration of NCPL may have limited additional effect if other treatments focused on controlling caries activity are successful.


Assuntos
Cárie Dentária/terapia , Restauração Dentária Permanente/métodos , Resinas Sintéticas/uso terapêutico , Desmineralização do Dente/terapia , Ataque Ácido Dentário , Adolescente , Adulto , Progressão da Doença , Método Duplo-Cego , Feminino , Seguimentos , Humanos , Masculino , Índice Periodontal , Resultado do Tratamento
15.
Am J Orthod Dentofacial Orthop ; 152(4): 477-482, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28962731

RESUMO

INTRODUCTION: In this study, we aimed to assess the effect of the duration of fixed orthodontic treatment on gingival enlargement (GE) in adolescents and young adults. METHODS: The sample consisted of 260 subjects (ages, 10-30 years) divided into 4 groups: patients with no fixed orthodontic appliances (G0) and patients undergoing orthodontic treatment for 1 year (G1), 2 years (G2), or 3 years (G3). Participants completed a structured questionnaire on sociodemographic characteristics and oral hygiene habits. Clinical examinations were conducted by a calibrated examiner and included the plaque index, the gingival index, and the Seymour index. Poisson regression models were used to assess the association between group and GE. RESULTS: We observed increasing means of plaque, gingivitis, and GE in G0, G1, and G2. No significant differences were observed between G2 and G3. Adjusted Poisson regression analysis showed that patients undergoing orthodontic treatment had a 20 to 28-fold increased risk for GE than did those without orthodontic appliances (G1, rate ratio [RR] = 20.2, 95% CI = 9.0-45.3; G2, RR = 27.0, 95% CI = 12.1-60.3; G3 = 28.1; 95% CI = 12.6-62.5). CONCLUSIONS: The duration of orthodontic treatment significantly influenced the occurrence of GE. Oral hygiene instructions and motivational activities should target adolescents and young adults undergoing orthodontic treatment.


Assuntos
Doenças da Gengiva/etiologia , Aparelhos Ortodônticos/efeitos adversos , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Índice Periodontal , Fatores de Tempo , Adulto Jovem
16.
Monogr Oral Sci ; 26: 15-25, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29050017

RESUMO

Variations in organic and inorganic composition and morphology may determine different susceptibilities of root surfaces to caries. Subsequent to gingival recession, root surfaces become exposed and those areas where Sharpey's fibers system was once inserted into the cementum are converted into canals for microbial penetration. In the presence of a cariogenic root biofilm, the fermentable carbohydrate from diet is converted into organic acid, and the root caries lesion is initiated in the exposed root site. We will revisit here the structural, biochemical, and histopathological specificities of root caries. Likewise enamel, the root surface exchange minerals with oral fluids, resulting in a subsuperficial root caries lesion. After mineral loss, the collagen is degraded and the lesion progresses. The specificities regarding the critical pH for demineralization of root hard tissues, the influence of cementum loss for lesion progression, and the organic matrix degradation will be discussed in this chapter. The tissue-related phenomena would create lesion with a unique histopathology. Active and arrested root carious lesions will be discussed through the gradual development from the cementum to dentin.


Assuntos
Cárie Dentária , Cárie Radicular , Cemento Dentário , Esmalte Dentário , Dentina , Humanos
17.
Monogr Oral Sci ; 26: 76-82, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29050024

RESUMO

As the thick biofilm in the presence of fermentable carbohydrates is the main etiological factor of dental caries, the frequent and systematic removal of this colony by means of an effective biofilm control should result in the prevention of caries lesions or in the arrest of the local carious process. However, the role of biofilm control in the management of dental caries has been questioned. This chapter will discuss the biofilm control and oral hygiene practices on root surfaces. Laboratory and clinical studies describing the effect of biofilm control and oral hygiene practices on the arrestment of root carious lesions are described. Epidemiological surveys evaluating the association between oral hygiene and root caries are discussed. Finally, some aspects on chemical biofilm control are also presented.


Assuntos
Cárie Dentária , Higiene Bucal , Biofilmes , Humanos
18.
J Dent Child (Chic) ; 84(2): 52-57, 2017 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-28814363

RESUMO

PURPOSE: The purpose of this study was to evaluate the availability and stability of fluoride in children's toothpastes in Uruguay. METHODS: Six commercial brands of children's toothpaste available in Uruguay were tested. Analyses were made when the dentifrices were purchased (fresh samples) and after one year of storage (aged samples). Total fluoride (TF) and total soluble fluoride (TSF) concentrations were determined using an ion specific electrode. RESULTS: Four of the children's dentifrices showed TF concentration similar to that specified on the package. Three products showed similar concentrations of TF and TSF with no variations after the one-year storage period. Two dentifrices showed an initial insoluble fluoride concentration greater than 50 percent, which increased with toothpaste aging. CONCLUSION: Most tested toothpastes showed a decrease in the soluble fluoride content with aging. The high quantity of insoluble fluoride found in two tested dentifrices may compromise their anti-caries efficacy.


Assuntos
Cariostáticos/análise , Fluoretos/análise , Cremes Dentais/química , Criança , Cárie Dentária/prevenção & controle , Estabilidade de Medicamentos , Armazenamento de Medicamentos , Humanos , Uruguai
19.
Braz Oral Res ; 31: e44, 2017 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-28591240

RESUMO

This randomized clinical trial aimed to assess the efficacy of sealing occlusal carious lesions in permanent teeth. The sample consisted of 54 occlusal carious lesions in permanent molars and premolars of 49 patients aged 8-43 years (median: 19 years). The inclusion criteria comprised the presence of a cavity with no access allowing biofilm control. The maximum depth of the lesion was the middle third of the dentin thickness, as assessed by bitewing radiography. The teeth were randomly assigned to sealant treatment (n = 28) or restorative treatment (n = 26). Clinical and radiographic examinations were performed after 1 year and after 3-4 years. The outcomes depended on the clinical performance of the sealant/restoration and the control of caries progression observed radiographically. Survival analysis was performed to assess success rates. Over the 3-4 years of monitoring, 2 sealants were totally lost, 1 needed repair, and 1 showed caries progression, totaling 4 failures in the sealant group. In the restoration group, 1 failure was observed (in need of repair). The success rates were 76% and 94% in the sealant and the restoration groups, respectively (p > 0.05). The sealing of occlusal carious lesions in permanent teeth succeeded in controlling caries over a 3-4-year period. However, sealed carious lesions require patient compliance in attending regular follow-ups to control the occurrence of clinical failures of the sealants.


Assuntos
Cárie Dentária/terapia , Adesivos Dentinários/uso terapêutico , Dentina/efeitos dos fármacos , Selantes de Fossas e Fissuras/uso terapêutico , Adolescente , Adulto , Criança , Cárie Dentária/diagnóstico por imagem , Esmalte Dentário/diagnóstico por imagem , Esmalte Dentário/efeitos dos fármacos , Falha de Restauração Dentária , Restauração Dentária Permanente/métodos , Dentina/diagnóstico por imagem , Feminino , Seguimentos , Humanos , Masculino , Radiografia Interproximal , Estatísticas não Paramétricas , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
20.
J Clin Periodontol ; 44 Suppl 18: S85-S93, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28266120

RESUMO

BACKGROUND: The non-communicable diseases dental caries and periodontal diseases pose an enormous burden on mankind. The dental biofilm is a major biological determinant common to the development of both diseases, and they share common risk factors and social determinants, important for their prevention and control. The remit of this working group was to review the current state of knowledge on epidemiology, socio-behavioural aspects as well as plaque control with regard to dental caries and periodontal diseases. METHODS: Discussions were informed by three systematic reviews on (i) the global burden of dental caries and periodontitis; (ii) socio-behavioural aspects in the prevention and control of dental caries and periodontal diseases at an individual and population level; and (iii) mechanical and chemical plaque control in the simultaneous management of gingivitis and dental caries. This consensus report is based on the outcomes of these systematic reviews and on expert opinion of the participants. RESULTS: Key findings included the following: (i) prevalence and experience of dental caries has decreased in many regions in all age groups over the last three decades; however, not all societal groups have benefitted equally from this decline; (ii) although some studies have indicated a possible decline in periodontitis prevalence, there is insufficient evidence to conclude that prevalence has changed over recent decades; (iii) because of global population growth and increased tooth retention, the number of people affected by dental caries and periodontitis has grown substantially, increasing the total burden of these diseases globally (by 37% for untreated caries and by 67% for severe periodontitis) as estimated between 1990 and 2013, with high global economic impact; (iv) there is robust evidence for an association of low socio-economic status with a higher risk of having dental caries/caries experience and also with higher prevalence of periodontitis; (v) the most important behavioural factor, affecting both dental caries and periodontal diseases, is routinely performed oral hygiene with fluoride; (vi) population-based interventions address behavioural factors to control dental caries and periodontitis through legislation (antismoking, reduced sugar content in foods and drinks), restrictions (taxes on sugar and tobacco) guidelines and campaigns; however, their efficacy remains to be evaluated; (vii) psychological approaches aimed at changing behaviour may improve the effectiveness of oral health education; (viii) different preventive strategies have proven to be effective during the course of life; (ix) management of both dental caries and gingivitis relies heavily on efficient self-performed oral hygiene, that is toothbrushing with a fluoride-containing toothpaste and interdental cleaning; (x) professional tooth cleaning, oral hygiene instruction and motivation, dietary advice and fluoride application are effective in managing dental caries and gingivitis. CONCLUSION: The prevention and control of dental caries and periodontal diseases and the prevention of ultimate tooth loss is a lifelong commitment employing population- and individual-based interventions.


Assuntos
Cárie Dentária/prevenção & controle , Doenças Periodontais/prevenção & controle , Humanos
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