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Pediatr Dent ; 42(1): 47-52, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-32075711


Purpose: Erosive tooth wear often leads to surface loss requiring restoration of primary teeth with adhesive materials. The purpose of this study was to evaluate the microshear bond strength (µSBS) of different adhesive systems to sound and eroded primary enamel and dentin surfaces. Methods: Half of the samples underwent erosion (immersion in Coca-Cola for one minute five times over five days) and abrasion cycles (brushing with an electric toothbrush, fluoride toothpaste slurry, for one minute at 250 g load). Samples were divided into adhesive groups (n equals 12): Adper Single Bond 2 (etch-and-rinse); Single Bond Universal (self-etch); Optibond FL (etch-and-rinse with fluoride); and Bond-Force (self-etch with fluoride). Resin composite was bonded on sample surfaces and subjected to µSBS test. Data were analyzed by two-way analysis of variance, Tukey test, and chi-square test (P<0.05). The failure mode was determined using a stereomicroscope under 20X magnification. Results: No difference was found between the eroded and sound enamel and dentin (P≥ 0.05) on µSBS test. The failure mode evaluation showed significant differences between sound and eroded dentin (P=0.003) but no difference among the adhesives (P=0.177). Conclusions: Micro-shear bond strength in primary enamel and dentin was not affected by erosion/abrasion or type of adhesive system.

Colagem Dentária , Resinas Compostas , Esmalte Dentário , Dentina , Adesivos Dentinários , Teste de Materiais , Cimentos de Resina , Resistência ao Cisalhamento
Int J Paediatr Dent ; 30(2): 136-143, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31630473


Sleep bruxism (SB) is a masticatory muscle activity during sleep that can cause several consequences to the stomatognathic system. This systematic review investigated the impact of SB on oral health-related quality of life (OHRQoL) of 0- to 6-year-old children. Literature search was undertaken through PubMed/MEDLINE, LILACS, Scopus, TRIP, Livivo databases, and grey literature. The search was conducted with no publication year or language limits. Two reviewers independently selected the studies, extracted the data and assessed the risk of bias. The quality of evidence was assessed using GRADE. From 185 potentially eligible studies, three were included in the review. All studies were conducted in Brazil, published between 2015 and 2017, and used the B-ECOHIS instrument to evaluate OHRQoL. Two studies found no association between SB and OHRQoL, whereas one showed a significant negative impact of SB on the OHRQoL of children. SB was associated with respiratory problems, presence of tooth wear, dental caries, malocclusion as well as income and pacifier use. Risk of bias ranged from moderate to high, and the quality of evidence was judged as very low. The evidence is currently insufficient for definitive conclusions about the impact of SB on OHRQoL of children.

Cárie Dentária , Saúde Bucal , Qualidade de Vida , Bruxismo do Sono , Brasil , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido
Int J Med Inform ; 129: 296-302, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31445270


OBJECTIVE: Children are an important portion of the population of the territories covered by Primary Health Care (PHC), with needs and characteristics that can be managed at this level of care. Therefore, it is essential that professionals working in PHC be capable of providing child care. The aim of this study was to evaluate the performance of dentists working in primary healthcare (PHC) in a pediatric dentistry distance learning (DL) course, and to investigate the relationship between the grades earned on questionnaires applied after each course module and features of their personal and professional profile. METHOD: The study used a convenience sample of 201 dentists working in PHC, who enrolled in a DL course offered by a telehealth center in the state of Rio Grande do Sul, Brazil. The course consisted of video classes on restorative dentistry, endodontics, dental trauma, and clinical management in pediatric dentistry. After completing each module, each participant was asked to answer a questionnaire to assess their acquisition of immediate knowledge. Student's t-test and the ANOVA test were used to assess the relationship between the mean grade earned and the variables of sex, age, type of training institution, time since graduation, and years working in PHC. RESULTS: A significant relationship was observed between type of training institution (public) and the grade earned on the restorative dentistry questionnaire, and also between time since graduation and the grade earned on the dental trauma questionnaire (p < 0.05). No relationship was observed between the personal/professional variables and the grades earned on the endodontics and clinical management questionnaires. Grades were significantly lower on the endodontics questionnaire (p < 0.05). DISCUSSION: The large number of dentists enrolled in this DL course is a demonstration that there is great interest in pediatric dentistry contents. Improvement of DL courses may lead to the enhancement of professionals and their skills, and to a significant improvement in the quality of care provided to children in public health networks. CONCLUSION: It was concluded that training in a public institution and a longer time since graduation positively influenced the grades earned on the restorative dentistry and dental trauma questionnaires, respectively.

Educação a Distância , Atenção Primária à Saúde , Adulto , Brasil , Criança , Odontólogos , Endodontia , Feminino , Humanos , Masculino , Odontopediatria , Inquéritos e Questionários , Adulto Jovem
Clin Oral Investig ; 23(1): 273-284, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29721706


AIM: To evaluate the erosive preventive effect of toothpastes in permanent (PT) and deciduous teeth (dt). DESIGN: Enamel samples were divided into five groups (n = 20): G1: placebo toothpaste; G2: NaF toothpaste; G3: AmF-NaF-SnCl2 anti-erosion toothpaste; G4: SnF2-toothpaste; and G5: NaF anti-erosion toothpaste for children. The samples were exposed to five erosion-abrasion cycles (artificial saliva incubation; 3 min in 1% citric acid; 2 min in slurry, toothbrush abrasion, 50 strokes, 200 g). Surface microhardness (SMH), surface specular reflection intensity (SRI), and cumulative surface loss (CSL) were measured. Comparisons among toothpastes were evaluated using Kruskal-Wallis tests and comparisons between PT and dt were evaluated using Wilcoxon's rank sum test. RESULTS: G1 exhibited significantly lower SMH values in PT than the other toothpastes (p < 0.05), with no significant differences among the others groups. In dt, G1 and G4 exhibited significantly different values than the other groups (p < 0.05). G4 exhibited lower values of SRI in both types of teeth. Deciduous teeth presented significantly higher SRI than PT (p < 0.05), except for G3. Deciduous teeth generally presented higher CSL than PT, except for G3. CONCLUSIONS: Deciduous teeth were more prone to mineral loss than permanent teeth. G5 exhibited better efficacy for both teeth, while G3 exhibited a better preventive effect only for deciduous teeth. CLINICAL RELEVANCE: Erosive tooth wear prevalence in children is growing and deciduous teeth are more susceptible than permanent teeth. Considering this, it is important to know the preventive effect of different toothpastes in an initial erosion-abrasion model.

Erosão Dentária/prevenção & controle , Cremes Dentais/farmacologia , Dente Pré-Molar , Ácido Cítrico , Dentição Permanente , Dureza , Humanos , Técnicas In Vitro , Dente Molar , Saliva Artificial , Fluoreto de Sódio/farmacologia , Propriedades de Superfície , Compostos de Estanho/farmacologia , Dente Decíduo , Escovação Dentária
Rev. Cient. CRO-RJ (Online) ; 3(3): 9-18, Sept.-Dec. 2018.
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1021967


Introduction: Erosive tooth wear (ETW) is defined as a chemical-mechanical process leading to the cumulative loss of hard dental tissue without the involvement of bacteria. Objective: to give to clinicians an overview about most important ETW topics. Data source: main scientific data base (PubMed, Lilacs) in the last 10 years, with the keywords: dental erosion, diagnosis and prevention. Classical articles were selected for the realization of an integrative literature review. Data synthesis : the prevalence of ETW has been reported to range from 10% to 80% in children and 4% to 82% in adults. The management of ETW should include early diagnosis, the evaluation of different etiological factors, risk identification and the proposal of preventive measures to avoid the progression of the condition. These measures include fluoride exposure, use of low abrasive toothpastes, clinical monitoring, and in more severe cases sealant application and restorations. Patients suffering from eating disorders with purging behaviour and gastroesophageal reflux disease are considered the most important risk groups. Conclusion : Clinicians should be aware of this condition with growing prevalence, once substance loss is an irreversible condition, providing prompt preventive measures during the early stages that are essential to reduce ETW.

Introdução: O Desgaste Dentário Erosivo é definido como um processo químico- mecânico que leva a uma perda cumulativa de tecido dentário duro, sem que ocorra o envolvimento de bactérias. Objetivo : atualizar os cirurgiões-dentistas sobre os principais tópicos a respeito do Desgaste Dentário Erosivo. Fonte de dados: principais bases científicas (PubMed, Lilacs) nos últimos 10 anos, com as palavras-chave: erosão dentária, diagnóstico e prevenção. Foram selecionados os artigos clássicos sobre o tema para a realização da revisão integrativa de literatura. Síntese de dados : A prevalência de Desgaste Dentário Erosivo tem sido reportada na literatura em porcentagens que variam de 10% a 80% em crianças e de 4% a 82% em adultos. A abordagem clínica do Desgaste Dentário Erosivo deve incluir um diagnóstico precoce, a avaliação dos diferentes fatores etiológicos, a identificação do risco e a proposta de medidas preventivas para retardar a progressão dessa condição. Essas medidas incluem a aplicação de fluoretos, o uso de dentifrícios com baixa abrasividade, monitoramento clínico e, em casos mais graves, a aplicação de selantes e procedimentos restauradores. Pacientes diagnosticados com transtornos alimentares ou com refluxo gastroesofágico são considerados um dos grupos de risco mais importantes para o desenvolvimento dessa condição. Conclusão: Os clínicos devem estar atentos a essa condição de prevalência crescente, uma vez que a perda de estrutura dentária é irreversível, promovendo medidas preventivas eficazes, desde os estágios iniciais, contribuindo assim para o controle e redução do Desgaste Dentário Erosivo entre seus pacientes.

Erosão Dentária , Desgaste dos Dentes/diagnóstico , Desgaste dos Dentes/etiologia , Desgaste dos Dentes/prevenção & controle
Int J Paediatr Dent ; 2018 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-30431200


BACKGROUND: Little is known about fluoride toothpastes effect on primary teeth submitted to erosive tooth wear. OBJECTIVES: To evaluate the preventive effect of different toothpastes on surface loss (SL) after severe erosion/abrasion model and to compare this effect between permanent (PT) and primary teeth (pt). DESIGN: Enamel samples were randomly divided according toothpastes groups (n = 17). G1: placebo; G2: NaF; G3: AmF-NaF-SnCl2 anti-erosion; G4: SnF2 ; and G5: NaF anti-erosion for children. Samples were incubated in artificial saliva (1 hour), submitted to erosive challenge (3 minutes; 1% citric acid; pH3.6; at 25°C) and to toothbrush abrasion (2 minutes slurry immersion; 50 strokes; 200 g) during 30 cycles. Surface loss (µm; mean ± SD) was quantified by contactless profilometry. The effects of the two covariables "tooth" and "toothpaste" were analysed by non-parametric ANOVA, variables with significant effects were tested by Wilcoxon tests. RESULTS: pt showed significantly higher surface loss than PT in all groups (P < 0.001). The mean values of SL of each group were: G1 PT 18.18(±3.98), pt 25.65(±9.21); G2 PT 14.76(±2.82), pt 18.11(±3.92); G3 PT 12.62(±5.29), pt 15.61(±6.70); G4 PT 17.12(±2.24), pt 23.41(±7.9); G5 PT 13.24(±1.29), pt 18.28(±8.96). CONCLUSIONS: In permanent teeth, G3 showed the best preventive effect. In primary teeth, G1, G3, and G5 showed similar effect.

RGO (Porto Alegre) ; 66(3): 239-244, July-Sept. 2018. tab
Artigo em Inglês | LILACS-Express | ID: biblio-984902


ABSTRACT This study sought to provide an overview of current cariology education for undergraduate Brazilian dental students. Data collection was via a Portuguese version of a 12-item questionnaire (Schulte et al., 2011) that was sent to all Brazilian dental schools (n = 219). The response rate was 57.0% (n = 125). Of the schools that returned the questionnaire, 84.8% supported the development of a Brazilian cariology curriculum. The units responsible for teaching cariology were predominantly operative dentistry (49.6%), pediatric dentistry (49.6%), dental public health (44.8%), and cariology (32%). Theoretical teaching of cariology (74.4%) and pre-clinical exercises (63.2%) were cited to occur mainly during the second year of the course, while clinical activities were placed in the third (71.2%) and fourth (64.8%) years. Among respondents, 76.8% of the schools included dental erosion and 86.4% included defects of dental hard tissues, such as abrasion, in teaching cariology. This survey was able to determine the panorama of cariology education in Brazil and to detect some differences among Brazilian geographic areas. The promotion of a workshop to discuss the topics that should be taught to undergraduate dental students and the development of a Brazilian core curriculum in cariology would be likely to reduce the differences in teaching cariology in Brazil.

RESUMO Este estudo teve como objetivo apresentar um panorama do ensino de cariologia nos cursos de graduação em Odontologia no Brasil. A coleta de dados foi realizada por meio de uma versão em Português Brasileiro de um questionário de 12 itens (Schulte et al., 2011) que foi enviado a todas as faculdades de Odontologia brasileiras (n = 219). A taxa de resposta foi de 57,0% (n = 125). Dentre as faculdades que responderam o questionário, 84,8% apoiam o desenvolvimento de um currículo brasileiro de cariologia. As disciplinas responsáveis por lecionar os conteúdos de cariologia são principalmente dentística (49,6%), odontopediatria (49,6%), saúde bucal coletiva (44,8%), e cariologia (32%). O ensino teórico de cariologia (74,4%) e os exercícios de pré-clínica (63,2%) são abordados principalmente durante o segundo ano do curso, enquanto as atividades clínicas ocorrem, em geral, no terceiro (71,2%) e quarto (64,8%) anos. Dentre os respondentes, 76,8% das faculdades incluem erosão dentária e 86,4% incluem defeitos dos tecidos dentários duros, como abrasão, no ensino da cariologia. Essa pesquisa foi capaz de determinar o panorama do ensino da cariologia no Brasil e detectar algumas diferenças de currículo entre as regiões do país. A promoção de um workshop para discutir os assuntos que devem ser ministrados aos estudantes de graduação em Odontologia e para desenvolver um currículo brasileiro de cariologia seria válida para reduzir as diferenças no ensino de cariologia no Brasil.

Rev. Cient. CRO-RJ (Online) ; 3(2): 47-51, May-Aug. 2018.
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1021871


Introduction: Erosive tooth wear (ETW) is defined as a mechanical chemical process that results in a cumulative loss of hard tissue without the involvement of bacteria. This process may occur in permanent and deciduous teeth and may also reach the dentin tissue. Patients who report chronic diseases, such as respiratory allergy and bronchial asthma, or recurrent acute diseases, such as tonsillitis, allergic rhinitis, sinusitis, and otitis, commonly use drugs for prolonged periods; thus, more attention should be given to the dental aspects since the drugs may cause undesirable effects. Objective: This paper aims to report and discuss a clinical case of a nine-year-old, male, Caucasian, asthmatic patient who continually uses anti-asthmatic medications and has developed ETW. Case report: According to the patient's needs, oral hygiene instructions (use of fluoride stannous dentifrice, dental floss, and topical fluoride applications), daily use of mouthwash solution containing 0.05% sodium fluoride, and dietary guidance were recommended. Conclusion: An early and accurate diagnosis of ETW lesions and recognition of specific etiological factors allow the professional to elaborate an individualized prevention and control program for ETW progression.

Introdução: O desgaste dentário erosivo é definido como um processo químico mecânico que resulta em uma perda cumulativa de tecido duro, sem o envolvimento de bactérias. Esse processo pode ocorrer em dentes permanentes e decíduos, podendo atingir o tecido dentinário. Pacientes que relatam doenças crônicas, como alergia respiratória e asma brônquica ou doenças agudas recorrentes como amigdalite, rinite alérgica, sinusite e otite, comumente usam medicamentos por períodos prolongados, portanto, mais atenção deve ser dada ao aspecto odontológico, uma vez que os medicamentos podem causar efeitos indesejáveis. Objetivo : Este trabalho tem como objetivo relatar e discutir um caso clínico de um paciente de nove anos, asmático, caucasiano, sexo masculino, que faz uso contínuo de medicamentos anti-asmáticos e desenvolveu o desgate erosivo dentário. Relato do caso: De acordo com as necessidades do paciente foi realizado instruções de higiene oral (uso de dentifrício contendo fluoreto estanhoso, fio dental e aplicações tópicas de flúor). Uso diário de enxaguatório bucal contendo 0,05% de fluoreto de sódio também foi recomendado e orientações dietéticas foram realizadas. Conclusão: O diagnóstico precoce e preciso das lesões de desgaste erosivo e o reconhecimento dos fatores etiológicos específicos permite o profissional elaborar um programa individualizado de prevenção e controle da progressão do desgaste erosivo dentário.

Ortodontia , Preparações Farmacêuticas , Criança , Doença Crônica , Desgaste dos Dentes
Telemed J E Health ; 24(8): 624-630, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29293415


BACKGROUND: Oral health in childhood is a major problem for global public health. In Brazil, the prevalence of childhood tooth decay varies from 12% to 46%. Dental care treatment in Brazil is almost the exclusive responsibility of primary healthcare (PHC). Therefore, it is essential these professionals are prepared to conduct restorative, endodontic, and exodontic treatments and preventive care in children. INTRODUCTION: Children make up a large proportion of the population in territories requiring advanced dental care provided by PHC in Brazil. To care for these patients, it is necessary to have both manual dexterity and technical knowledge of pediatric dentistry. Accordingly, this study aimed to develop a distance course on pediatric dentistry. MATERIALS AND METHODS: A pretest questionnaire consisting of 15 questions was used to assess initial dental knowledge of participants. After completion of a five-module course, participants retook the same initial dental knowledge questionnaire (post-test). Descriptive statistic and paired t test, one-way analysis of variance, and Pearson and Spearman correlation were used, and a significance level of 5% was set. RESULTS: The majority of participants completing the five-module course were women who earned specialty degrees beyond undergraduate studies and currently worked in PHC (>5 years). Participant performance on the dental knowledge questionnaire after completion of the five-module course improved pre- to post-test. CONCLUSIONS: These data suggest that completion of a distance course on pediatric dentistry can be an effective tool for improving knowledge of pediatric dentistry in PHC professionals.

Assistência Odontológica para Crianças/métodos , Educação a Distância/métodos , Pessoal de Saúde/educação , Odontopediatria/educação , Atenção Primária à Saúde/métodos , Adolescente , Adulto , Brasil , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde
Audiol., Commun. res ; 22: e1801, 2017. tab
Artigo em Português | LILACS | ID: biblio-950624


RESUMO Introdução As doenças e desordens bucais, bem como hábitos orais, podem causar impacto na qualidade de vida das crianças. Objetivo Associar a cárie dentária, maloclusão e hábitos orais com a qualidade de vida de crianças pré-escolares. Métodos Estudo transversal com 93 crianças de 3 a 5 anos de idade, acometidas, ou não, por lesões de cárie não tratadas. Os responsáveis responderam ao questionário sobre hábitos orais e ao Questionário sobre a Qualidade de Vida Relacionada à Saúde Bucal de Crianças na Idade Pré-escolar (B-ECOHIS). Um odontopediatra avaliou a gravidade das lesões de cárie e a presença de alterações oclusais. O nível de significância utilizado foi de 5%. Resultados O B-ECOHIS evidenciou impacto na qualidade de vida, conforme o aumento da idade, nos domínios dos sintomas, aspectos psicológicos, autoimagem e interação social e de função familiar. A cárie dentária apresentou impacto sobre a qualidade de vida das crianças e de seus familiares, especialmente em relação aos domínios dos sintomas e limitações. Hábitos de respiração oronasal e chupeta também evidenciaram efeitos negativos na qualidade de vida das crianças e de seus familiares. Não foi observada associação entre maloclusão e qualidade de vida relacionada à saúde oral. Conclusão A cárie dentária, os hábitos de sução de chupeta e de respiração oronasal demonstraram impacto negativo na qualidade de vida relacionada à saúde oral das crianças.

ABSTRACT Introduction Oral diseases and disorders as well as oral habits can impact the quality of life of children. Purpose To associate the dental caries, malocclusion and oral habits with the quality of life of preschool children. Methods Cross-sectional study with 93 children from three to five years of age who have or have not been affected by untreated carious lesions. Parents answered the questionnaire on oral habits and quality of life instrument related to oral health denominated Early Childhood Oral Health Impact Scale (B-ECOHIS). A pediatric dentist assessed the severity of the carious lesions and the presence of occlusal disorders. The level of significance used was 5%. Results The B-ECOHIS demonstrated impact on quality of life with increasing age in the fields of symptoms, psychological aspects, self-image and social interaction and family function. Dental caries were shown to have an impact on the quality of life of children and their families, especially in relation the domains of symptoms and limitations. Oronasal breathing and pacifier habits negatively impacted the quality of life of children and their families. There was no association between malocclusion and quality of life related to oral health. Conclusion The dental caries, the pacifier suction habits and oronasal breathing demonstrated negative impact on quality of life related to oral health of children.

Humanos , Pré-Escolar , Qualidade de Vida , Cárie Dentária/psicologia , Hábitos , Má Oclusão , Autoimagem , Família , Chupetas/efeitos adversos , Oclusão Dentária , Relações Interpessoais
Rev. odontol. UNESP (Online) ; 45(5): 253-257, Sept.-Oct. 2016. tab
Artigo em Inglês | LILACS-Express | ID: lil-798169


Abstract Introduction Methods of decontamination or sanitization of toothbrushes have been questioned. Objective This study assessed the effectiveness of pomegranate peels infusion as a disinfectant of toothbrushes against Streptococcus mutans. Material and method A sample of 16 schoolchildren aged between 7 and 9 years performed brushing 5 days/week, with a careful brushing once a day. After each day of brushing, the toothbrushes were washed and sprayed with one disinfectant solution. This procedure was repeated for 4 weeks using one of the different solutions per week: distilled water (G1; negative control), pomegranate (Punica granatum Linn) peels infusion (G2), 1% sodium hypochlorite (G3) and 0.12% chlorhexidine digluconate (G4). After the fifth day, toothbrushes were collected for laboratory analysis. Toothbrushes heads were subjected to agitation in saline dilution of 10–1, 10–2,10–3, and 25 μL of each dilution were seeded in mitis salivarius agar culture medium for S. mutans colony-forming unit (CFU) counting. One calibrated examiner (Kappa = 0.91) performed the CFU (mL–1 × 104) counts. Kruskal-Wallis and Dunn Multiple Comparison tests were used at a significance level of 5%. Result G1 presented the highest number of CFU (3.9 ± 8.4), followed by G2 (3.2 ± 4.0). No S. mutans growth was observed in G3 and G4. There was no statistically significant difference between G1 and G2 and between G3 and G4 (p>0.05). Conclusion Pomegranate infusion was completely ineffective for the disinfection of toothbrushes against S. mutans when compared with 1% sodium hypochlorite and 0.12% chlorhexidine digluconate solutions.

Resumo Introdução Os métodos de descontaminação ou desinfecção de escovas dentais têm sido questionados. Objetivo Este estudo avaliou a eficácia da infusão de cascas de romã como um desinfetante de escovas dentais contra Streptococcus mutans. Material e método Uma amostra de 16 escolares com idade entre 7 e 9 anos realizou escovação dentária cuidadosa, uma vez ao dia por 5 dias/semana durante 4 semanas. Após cada dia de escovação, as escovas foram lavadas e pulverizadas com uma solução desinfetante. Este procedimento foi repetido por 4 semanas utilizando uma das diferentes soluções por semana: água destilada (G1; grupo controle), infusão de casca de romã (Punica granatum Linn) (G2), hipoclorito de sódio a 1% (G3) e digluconato de clorexidina a 0,12% (G4). Após o quinto dia, as escovas foram coletadas para análise laboratorial. As cabeças das escovas foram agitadas em solução salina diluída em 10–1, 10–2,10–3, e 25μL de cada diluição foi semeada em meio de cultura agar mitis salivarius para contagem de unidade formadora de colônias (UFC) de S. mutans. Um examinador calibrado (Kappa = 0,91) realizou a contagem de UFC mL–1 × 104. Os testes de Kruskal-Wallis e de Comparações Múltiplas de Dunn foram usados em um nível de significância de 5%. Resultado G1 apresentou o maior número de UFC (3,9 ± 8,4), seguido de G2 (3,2 ± 4,0). Não foi observado crescimento de S. mutans em G3 e G4. Não houve diferença estatisticamente significante entre G1 e G2 e entre G3 e G4 (p>0,05). Conclusão A infusão de romã foi completamente ineficaz para a desinfecção de escovas dentais contra S. mutans quando comparada às soluções de hipoclorito de sódio a 1% e digluconato de clorexidina a 0,12%.

Braz Oral Res ; 30(1)2016 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-27253145


The layer formed by fluoride compounds on tooth surface is important to protect the underlying enamel from erosion. However, there is no investigation into the properties of protective layer formed by NaF and TiF4 varnishes on eroded enamel. This study aimed to evaluate the thickness, topography, nanohardness, and elastic modulus of the protective layer formed by NaF and TiF4 varnishes on enamel after erosion using nanoindentation and atomic force microscopy (AFM). Human enamel specimens were sorted into control, NaF, and TiF4 varnish groups (n = 10). The initial nanohardness and elastic modulus values were obtained and varnishes were applied to the enamel and submitted to erosive challenge (10 cycles: 5 s cola drink/5 s artificial saliva). Thereafter, nanohardness and elastic modulus were measured. Both topography and thickness were evaluated by AFM. The data were subjected to ANOVA, Tukey's test and Student's t test (α = 0.05). After erosion, TiF4 showed a thicker protective layer compared to the NaF group and nanohardness and elastic modulus values were significantly lower than those of the control group. It was not possible to measure nanohardness and elastic modulus in the NaF group due to the thin protective layer formed. AFM showed globular deposits, which completely covered the eroded surface in the TiF4 group. After erosive challenge, the protective layer formed by TiF4 varnish showed significant properties and it was thicker than the layer formed by NaF varnish.

Cariostáticos/química , Esmalte Dentário/efeitos dos fármacos , Fluoretos/química , Fluoreto de Sódio/química , Titânio/química , Erosão Dentária/prevenção & controle , Análise de Variância , Bebidas Gaseificadas , Módulo de Elasticidade , Testes de Dureza , Humanos , Teste de Materiais , Microscopia de Força Atômica , Valores de Referência , Reprodutibilidade dos Testes , Saliva Artificial/química , Estatísticas não Paramétricas , Propriedades de Superfície , Fatores de Tempo
Rev. Assoc. Paul. Cir. Dent ; 70(2): 147-150, abr.-jun. 2016.
Artigo em Português | LILACS, BBO - Odontologia | ID: lil-797065


Objetivo: Estudar o efeito anticárie da adição de trimetafosfato de sódio (TMP) aos compostos fluoretados (dentifrícios, vernizes e soluções) para prevenção e tratamento de lesões de cárie através de uma revisão de literatura. Materiais e Métodos: Foram selecionados artigos de pesquisa e revisões sistemáticas da literatura mais relevantes sobre o assunto publicados na língua inglesa, desde 1968 até 2015, pesquisados no PubMed. As palavras-chave utilizadas foram: trimetafosfato de sódio, cárie dentária e fluoretos.Resultados: Foram apresentados os principais resultados de trabalhos de pesquisa sobre o TMP quando associado aos dentifrícios, vernizes e soluções para bochechos e estudos clínicos longitudinais. Conclusão: Os estudos in vitro e in situ mostram que o trimetafosfato de sódio pode potencializar a eficácia do flúor na prevenção e tratamento da cárie dentária, porém ainda faltam estudos para entender o mecanismo de ação do TMP, além de estudos clínicos para comprovar sua eficácia e indicação.

Objective: The aim of this work was to study the anticaries effect of adding sodium trimeta phosphate (TMP) to fluoride compounds (tooth pastes, varnishes and mouthrinse)for prevention and treatment of caries lesions with a review of the literature. Materials and Methods: The most relevant research articles and systematic reviews on the subject published in English, were selected from 1968 to 2015, browsed on Pubmed. The key words used were: sodium trimetaphosphate, dental caries and fluorides. Results: Themain results of research articles on the TMP associated with dentifrices, varnishes and mouthrinses and longitudinal clinical studies were presented. Conclusion: In situ and in vitro studies have shown that TMP might increase the effectiveness of fluoride in the prevention and treatment of caries, but there are few studies that explain its mechanism of action, as well as clinical studies to demonstrate its anticaries effect and indication.

Cárie Dentária/classificação , Cárie Dentária/complicações , Cárie Dentária/diagnóstico , Fluoretos , Compostos de Flúor , Polifosfatos , Compostos de Sódio
Lasers Med Sci ; 31(6): 1105-12, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27184156


In this study, we analyzed a newly developed optical reflectometer for measuring erosive tooth wear (ETW) in vitro. Three examiners independently assessed the labial surface of 80 deciduous canines and 75 permanent incisors. One examiner performed visual examinations (BEWE), and the other two used the optical pen-size reflectometer to measure surface reflection intensity (SRI) on the same labial surfaces. The examinations were made in duplicate with at least 1 week interval. Intra- and inter-rater agreements were calculated using weighted kappa analysis for BEWE, and intra-class correlation coefficients (ICC) as well as Bland-Altman plots for SRI. The teeth were separated into without (BEWE 0) or with (BEWE 1-3) ETW, and SRI cut-off points were calculated. Intra-rater agreement for the visual examination was 0.46 and 0.82 for deciduous and permanent teeth, respectively. Inter-rater and intra-rater agreement for SRI were good (ICC > 0.7; p < 0.001). SRI measurements produced high specificity values for deciduous and permanent teeth (≥0.74 and ≥ 0.84, respectively), and lower sensitivity values (≥0.37 and ≥ 0.64, respectively), but permanent teeth had generally higher SRI values (p < 0.05). We observed a significant association between BEWE and SRI (p < 0.05). The optical pen-size reflectometer was able to adequately differentiate ETW on permanent teeth, with highly reliable and reproducible measurements, but ETW on deciduous teeth was less accurately differentiated. The reflectometer is a good candidate for clinical research.

Dentição Permanente , Desgaste dos Dentes/diagnóstico , Dente Decíduo , Dente Canino , Humanos , Incisivo , Sensibilidade e Especificidade
Rev. odontol. UNESP (Online) ; 45(1): 47-52, jan.-fev. 2016. tab, graf
Artigo em Português | LILACS-Express | ID: lil-774585


Resumo Introdução Critérios clínicos vêm sendo utilizados para determinação da presença de tecido cariado remanescente, mas geram dúvidas, tornando-se relevante a utilização de métodos que auxiliem na determinação da presença de cárie dentária remanescente. Objetivo Avaliar in vitro a eficácia de métodos de indução de fluorescência no diagnóstico da remoção de tecido cariado artificial dentinário. Material e método O esmalte oclusal de 94 terceiros molares humanos hígidos foi removido, expondo a dentina subjacente, para indução microbiológica de lesão de cárie artificial. Após a remoção do tecido cariado induzido, o remanescente dentinário foi avaliado por dois examinadores com DIAGNOdent, DIAGNOdent pen e Quantitative Light-Induced Fluorescence (QLF). Após todas as avaliações, secções dos dentes foram observadas e fotografadas em lupa estereoscópica com 30× de aumento por um examinador independente. As imagens foram analisadas no software Image J, permitindo a quantificação de tecido remanescente em milímetros quadrados. Foi calculada a reprodutibilidade interexaminador através de coeficiente intraclasse, sensibilidade, especificidade e área sob a curva ROC, e o teste de McNemar (p<0,05) foi aplicado para comparação dos diferentes métodos. Resultado Dos 94 dentes, 51 (54,2%) apresentaram remanescente de tecido cariado. Os valores de sensibilidade, especificidade e área sobre a curva ROC foram semelhantes para os três grupos (p>0,05). Os valores de reprodutibilidade variaram entre 0,952 e 0,978. Conclusão Dentre os métodos utilizados, o DIAGNOdent e o DIAGNOdent pen apresentaram melhor desempenho na avaliação da presença de cárie artificial remanescente quando comparados ao QLF.

Abstract Introduction Clinical criteria have been used for the determination of the presence of residual caries, however in a subjective manner. Then the use of auxiliary methods that assist in determination of the remaining presence of caries can be considered for this purpose. Objective Evaluate the in “in vitro” efficacy fluorescence induction methods in the diagnosis of removing artificial dentinal caries. Material and method Ninety-four thirds sound human molars without occlusal enamel were used for microbiological artificial caries lesion induction. The decayed tissue was removed and the remaining dentin evaluated by two examiners with DIAGNOdent, DIAGNOdent pen and Quantitative Light-Induced Fluorescence - QLF. After all assessments, sections of the specimens were observed and photographed in stereoscopic lens with 30× increase by an independent examiner. These images were analyzed with Image J software, allowing quantitation of remaining caries tissue in mm2. The inter-examiner reliability, sensitivity, specificity, and area under the ROC curve was calculated and the McNemar test (p<0.05) was used to compare the different among methods. Result Of the 94 teeth, 51 (54.2%) had residual caries. The sensitivity, specificity, and area under the ROC curve were similar for the three methods (p>0.05). The inter-examiner agreement ​​ranged between 0.952 and 0.978. Conclusion Among the methods used, the DIAGNOdent, DIAGNOdent pen showed better performance in residual caries detection after dentin caries removal when compared to QLF.

Int J Paediatr Dent ; 26(6): 463-470, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26726753


AIM: To investigate the influence of salivary osmolality on the occurrence of gingivitis in children with cerebral palsy (CP). DESIGN: A total of 82 children with spastic CP were included in this cross-sectional study. Oral motor performance and gingival conditions were evaluated. Unstimulated saliva was collected using cotton swabs, and salivary osmolality was measured using a freezing point depression osmometer. Spearman's coefficient, receiver operating characteristic (ROC), and multiple logistic regression analyses were performed. RESULTS: Strong correlation (r > 0.7) was determined among salivary osmolality, salivary flow rate, visible plaque, dental calculus, and the occurrence of gingivitis. The area under the ROC to predict the influence of salivary osmolality on the occurrence of gingivitis was 0.88 (95% CI 0.81-0.96; P < 0.001). The cutoff value of 84.5 for salivary osmolality presented good sensitivity and specificity, both higher than 77%. The proportion of children presenting salivary osmolality ≤84.5 mOsm/kgH2 O and gingivitis was 22.5%, whereas for the group presenting osmolality >84.5 mOsm/kgH2 O, the proportion of children with gingivitis was 77.5%. Salivary osmolality above 84.5 increased the likelihood of gingivitis fivefold, whereas each additional 0.1 mL of salivary flow reduced the likelihood of gingivitis by 97%. CONCLUSION: Gingivitis occurs more frequently in children with CP showing increased values of salivary osmolality.

Paralisia Cerebral/complicações , Gengivite/etiologia , Saliva/química , Adolescente , Criança , Estudos Transversais , Crianças com Deficiência , Feminino , Humanos , Masculino , Concentração Osmolar , Fatores de Risco , Sensibilidade e Especificidade
Braz. oral res. (Online) ; 30(1): e75, 2016. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-951976


Abstract The layer formed by fluoride compounds on tooth surface is important to protect the underlying enamel from erosion. However, there is no investigation into the properties of protective layer formed by NaF and TiF4 varnishes on eroded enamel. This study aimed to evaluate the thickness, topography, nanohardness, and elastic modulus of the protective layer formed by NaF and TiF4 varnishes on enamel after erosion using nanoindentation and atomic force microscopy (AFM). Human enamel specimens were sorted into control, NaF, and TiF4 varnish groups (n = 10). The initial nanohardness and elastic modulus values were obtained and varnishes were applied to the enamel and submitted to erosive challenge (10 cycles: 5 s cola drink/5 s artificial saliva). Thereafter, nanohardness and elastic modulus were measured. Both topography and thickness were evaluated by AFM. The data were subjected to ANOVA, Tukey's test and Student's t test (α = 0.05). After erosion, TiF4 showed a thicker protective layer compared to the NaF group and nanohardness and elastic modulus values were significantly lower than those of the control group. It was not possible to measure nanohardness and elastic modulus in the NaF group due to the thin protective layer formed. AFM showed globular deposits, which completely covered the eroded surface in the TiF4 group. After erosive challenge, the protective layer formed by TiF4 varnish showed significant properties and it was thicker than the layer formed by NaF varnish.

Microsc Res Tech ; 78(6): 444-51, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25783414


The aim of this study was to compare different bacterial models for in vitro induction of non-cavitated enamel caries-like lesions by microhardness and polarized light microscopy analyses. One hundred blocks of bovine enamel were randomly divided into four groups (n = 25) according to the bacterial model for caries induction: (A) Streptococcus mutans, (B) S. mutans and Lactobacillus acidophilus, (C) S. mutans and L. casei, and (D) S. mutans, L. acidophilus, and L. casei. Within each group, the blocks were randomly divided into five subgroups according to the duration of the period of caries induction (4-20 days). The enamel blocks were immersed in cariogenic solution containing the microorganisms, which was changed every 48 h. Groups C and D presented lower surface hardness values (SMH) and higher area of hardness loss (ΔS) after the cariogenic challenge than groups A and B (P < 0.05). As regards lesion depth, under polarized light microscopy, group A presented significantly lower values, and groups C and D the highest values. Group B showed a higher value than group A (P < 0.05). Groups A and B exhibited subsurface caries lesions after all treatment durations, while groups C and D presented erosion-type lesions with surface softening. The model using S. mutans, whether or not it was associated with L. acidophilus, was less aggressive and may be used for the induction of non-cavitated enamel caries-like lesions. The optimal period for inducing caries-like lesions was 8 days.

Cárie Dentária/microbiologia , Esmalte Dentário/microbiologia , Modelos Biológicos , Animais , Biofilmes , Bovinos , Cárie Dentária/patologia , Esmalte Dentário/patologia , Testes de Dureza , Lactobacillus acidophilus/crescimento & desenvolvimento , Lactobacillus acidophilus/fisiologia , Lactobacillus casei/crescimento & desenvolvimento , Lactobacillus casei/fisiologia , Streptococcus mutans/crescimento & desenvolvimento , Streptococcus mutans/fisiologia , Desmineralização do Dente/microbiologia
Int J Paediatr Dent ; 25(6): 393-8, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25327581


OBJECTIVE: To evaluate the effectiveness of a treatment for non-cavitated occlusal lesions on erupting permanent molars and to verify whether initial eruption stage and final biofilm accumulation are associated with lesions activity after the treatment. METHODS: Forty-eight patients aged from 5 to 13 years old were selected. Molars with active non-cavitated lesions on the occlusal surface were classified according to eruption stage. Patients received a treatment for 4 weeks based on oral health instructions and fluoride applications. Three weeks after the end of the treatment, 39 patients were reassessed and lesion activity status and biofilm accumulation were recorded. Odds ratios were obtained using generalized estimating equations with logistic link function. RESULTS: Partially erupted molars were more prone to remain caries-active than molars in full occlusion (E1: OR = 301.1; E2: OR = 49.0 and E3: OR = 1107.3). High biofilm accumulation was associated with the presence of active lesions. CONCLUSIONS: Biofilm accumulation and eruption stage strongly influenced the effectiveness of a treatment for dental caries.

Fluoreto de Fosfato Acidulado/uso terapêutico , Biofilmes/crescimento & desenvolvimento , Cárie Dentária/terapia , Dente Molar/crescimento & desenvolvimento , Erupção Dentária/fisiologia , Adolescente , Criança , Pré-Escolar , Protocolos Clínicos , Cárie Dentária/microbiologia , Oclusão Dentária , Feminino , Humanos , Masculino , Escovação Dentária