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1.
Lasers Med Sci ; 34(3): 449-455, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30215185

RESUMO

To evaluate the effect of Er,Cr:YSGG laser, associated with fluoride application, on the prevention/control of dentin erosion. Dentin slabs were embedded in acrylic resin, flattened, and polished. Half of the specimens were previously eroded (10 min immersion in 1% citric acid solution) and half were kept sound. The specimens (n = 10 each substrate) were randomly allocated into the experimental groups, according to the following treatments: control (no treatment); APF gel (1.23% F, 1 min); Er,Cr:YSGG laser irradiation (P1: 0.25 W, 20 Hz, 2.8 J/cm2, tip S75, beam diameter of 750 µm, 1 mm away from the surface); Er,Cr:YSGG laser irradiation (P2: 0.50 W, 20 Hz, 5.7 J/cm2, tip S75, beam diameter of 750 µm, 1 mm away from the surface); APF gel + Er,Cr:YSGG laser P1 and; APF gel + Er,Cr:YSGG laser P2. Afterwards, the specimens underwent an erosion-remineralization cycling, consisting of a 5-min immersion into 0.3% citric acid, followed by 60-min exposure to artificial saliva. This procedure was repeated 4×/day, for 5 days. Surface loss (SL, in µm) was determined by optical profilometry. Specimens from each group were analyzed by environmental scanning electron microscopy (n = 3). Data were statistically analyzed (α = 0.05). For the eroded specimens, APF gel presented the lowest SL, being different from the control. For the sound specimens, none of the groups differed from the control, except for Er,Cr:YSGG laser P2, which presented the highest SL. When substrates were compared, only the eroded specimens of the control and APF + Er,Cr:YSGG laser P1 Groups showed higher SL. Selective structure removal was observed for the laser-treated groups. None of the Er,Cr:YSGG laser parameters were effective in the prevention/control dentin erosion. The laser was also unable to enhance the protection of fluoride against dentin erosion.


Assuntos
Fluoreto de Fosfato Acidulado/uso terapêutico , Dentina/efeitos dos fármacos , Progressão da Doença , Lasers de Estado Sólido/uso terapêutico , Erosão Dentária/tratamento farmacológico , Erosão Dentária/prevenção & controle , Animais , Bovinos , Dentina/ultraestrutura , Microscopia Eletrônica de Varredura
2.
J Clin Pediatr Dent ; 41(1): 22-26, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28052211

RESUMO

OBJECTIVES: There is some evidence that water rinsing immediately after topical fluoride therapy has the potential to reduce the effectiveness of fluoride. The aim was to determine if covering fluoridated teeth with a layer of mousse containing CPP-ACP could prevent the adverse effect of rinsing on fluoride and consequently its buffering effect on dental plaque pH during cariogenic challenge. STUDY DESIGN: This randomized, controlled, crossover, in situ study was conducted on 25 participants. The participants were subjected to acidulated phosphate fluoride (APF) application followed by five treatment protocols: (1) water rinsing after 30 minutes (APF-30) or (2) immediate water rinsing (APF-0); (3) using CPP-ACP immediately before water rinsing (F-CPP-ACP); and two control groups: (4) no fluoride therapy (No-F) and (5) using CPP-ACP and immediate water rinsing (CPP-ACP-0). After 48 hours, teeth were rinsed with 10% sucrose solution and plaque pH was measured before and after 5, 10, 15, 20 and 30 minutes. RESULTS: The least pH changes, the lowest pH drop, and the quickest pH recovery were found in the APF-30 and F-CPP-ACP groups. APF-0 ranked in the middle and the highest values were in the control groups. CONCLUSIONS: The results show that in the case using CPP-ACP on fluoridated teeth, water rinsing immediately after topical fluoride therapy did not seem to influence the inhibitory effect of fluoride on plaque acidity.


Assuntos
Fluoreto de Fosfato Acidulado/uso terapêutico , Cariostáticos/uso terapêutico , Caseínas/uso terapêutico , Placa Dentária/química , Fluoretos Tópicos/uso terapêutico , Água/administração & dosagem , Adulto , Estudos Cross-Over , Feminino , Humanos , Concentração de Íons de Hidrogênio , Masculino , Adulto Jovem
3.
J Appl Oral Sci ; 24(3): 223-8, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27383703

RESUMO

OBJECTIVE: This in situ/ex vivo study investigated the effect of CO2 laser irradiation and acidulated phosphate fluoride gel (APF) application, separately and in combination, on enamel resistance to erosion. MATERIAL AND METHODS: During 2 experimental 5-day crossover phases, 8 volunteers wore intraoral appliances containing bovine enamel blocks which were submitted to four groups: 1st phase - control, untreated and CO2 laser irradiation, 2nd phase - fluoride application and fluoride application before CO2 laser irradiation. Laser irradiation was performed at 10.6 µm wavelength, 5 µs pulse duration and 50 Hz frequency, with average power input and output of 2.3 W and 2.0 W, respectively (28.6 J/cm2). APF gel (1.23%F, pH 3.5) was applied on enamel surface with a microbrush and left on for 4 minutes. Then, the enamel blocks were fixed at the intraoral appliance level. The erosion was performed extraorally 4 times daily for 5 min in 150 mL of cola drink. Enamel loss was measured profilometrically after treatment and after the in situ phase. The data were tested using one-way Repeated Measures Anova and Tukey's test (p<0.05). RESULTS: CO2 laser alone (2.00±0.39 µm) did not show any significantly preventive effect against enamel erosion when compared with the control group (2.41±1.20 µm). Fluoride treated enamel, associated (1.50±0.30 µm) or not (1.47±0.63 µm) with laser irradiation, significantly differed from the control. CONCLUSION: The APF application decreased enamel wear; however, CO2 laser irradiation did not enhance fluoride ability to reduce enamel wear.


Assuntos
Fluoreto de Fosfato Acidulado/uso terapêutico , Esmalte Dentário/efeitos dos fármacos , Esmalte Dentário/efeitos da radiação , Lasers de Gás/uso terapêutico , Erosão Dentária/prevenção & controle , Adulto , Animais , Cariostáticos/uso terapêutico , Bovinos , Terapia Combinada , Método Duplo-Cego , Feminino , Géis , Humanos , Masculino , Estudos Prospectivos , Reprodutibilidade dos Testes , Estatísticas não Paramétricas , Propriedades de Superfície , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
4.
J. appl. oral sci ; 24(3): 223-228, tab, graf
Artigo em Inglês | LILACS | ID: lil-787539

RESUMO

ABSTRACT Objective This in situ/ex vivo study investigated the effect of CO2 laser irradiation and acidulated phosphate fluoride gel (APF) application, separately and in combination, on enamel resistance to erosion. Material and Methods During 2 experimental 5-day crossover phases, 8 volunteers wore intraoral appliances containing bovine enamel blocks which were submitted to four groups: 1st phase - control, untreated and CO2 laser irradiation, 2nd phase - fluoride application and fluoride application before CO2 laser irradiation. Laser irradiation was performed at 10.6 µm wavelength, 5 µs pulse duration and 50 Hz frequency, with average power input and output of 2.3 W and 2.0 W, respectively (28.6 J/cm2). APF gel (1.23%F, pH 3.5) was applied on enamel surface with a microbrush and left on for 4 minutes. Then, the enamel blocks were fixed at the intraoral appliance level. The erosion was performed extraorally 4 times daily for 5 min in 150 mL of cola drink. Enamel loss was measured profilometrically after treatment and after the in situ phase. The data were tested using one-way Repeated Measures Anova and Tukey's test (p<0.05). Results CO2 laser alone (2.00±0.39 µm) did not show any significantly preventive effect against enamel erosion when compared with the control group (2.41±1.20 µm). Fluoride treated enamel, associated (1.50±0.30 µm) or not (1.47±0.63 µm) with laser irradiation, significantly differed from the control. Conclusion The APF application decreased enamel wear; however, CO2 laser irradiation did not enhance fluoride ability to reduce enamel wear.


Assuntos
Humanos , Animais , Masculino , Feminino , Adulto , Bovinos , Adulto Jovem , Erosão Dentária/prevenção & controle , Fluoreto de Fosfato Acidulado/uso terapêutico , Esmalte Dentário/efeitos dos fármacos , Esmalte Dentário/efeitos da radiação , Lasers de Gás/uso terapêutico , Propriedades de Superfície , Fatores de Tempo , Cariostáticos/uso terapêutico , Método Duplo-Cego , Estudos Prospectivos , Reprodutibilidade dos Testes , Resultado do Tratamento , Terapia Combinada , Estatísticas não Paramétricas , Géis
5.
J Clin Dent ; 26(2): 44-9, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26349125

RESUMO

OBJECTIVE: To determine the relative ability of various F-containing products to protect enamel against the initiation and progression of tooth surface loss due to erosive acid challenges. METHODS: Cores of enamel were prepared from extracted human teeth, soaked in pooled human saliva (pellicle formation), and then treated in a 1:3 slurry (product:saliva) of either OTC level (1100 ppm F) or prescription level (5000 ppm F) products, followed by a standardized erosion cycling procedure (five days of cycling) that included 10-minute challenges with an erosive dietary acid (1% citric acid at pH 2.3) applied 60 minutes after each dentifrice treatment (repeated four times per day). Enamel surface loss was measured using transverse microradiography. Two studies were conducted. Study 1 included: A) 1100 ppm F as NaF; B) 1100 ppm F as stabilized SnF; C) 5000 ppm F as NaF; and D) 5000 ppm F as NaF + acidulated phosphate. Study 2 included: 1) 1100 ppm F as stabilized SnF; 2) 5000 ppm F as NaF + tricalcium phosphate; and 3) 1100 ppm F as NaF. RESULTS: Study 1: Treatment B (1100 ppm F as SnF), where specimens lost only 8.0 µm of the enamel surface, was significantly more effective than Treatments A, C, and D at protecting enamel against the initiation and progression of erosive acid damage (p < 0.05). Specimens treated with product A exhibited 22.8 (1.25) µm (mean ± sem) of enamel loss; 20.0 (0.71) µm of enamel loss with treatment C and 24.0 (1.4) µm of enamel loss with Treatment D. Study 2 also demonstrated significantly greater erosion protection with the stabilized SnF2 dentifrice (p < 0.05), with only 5.8 (1.93) µm of tooth surface loss, while groups 2 and 3 lost 19.8 (0.75) µm and 18.0 (2.16) µm, respectively. CONCLUSION: Results from both studies demonstrated the OTC dentifrice formulated with stabilized SnF2 provides significantly greater protection against erosive acid attack compared to some of the most popular prescription level (5000 ppm F) fluoride treatments available.


Assuntos
Cariostáticos/uso terapêutico , Dentifrícios/uso terapêutico , Medicamentos sem Prescrição/uso terapêutico , Fluoreto de Sódio/uso terapêutico , Fluoretos de Estanho/uso terapêutico , Erosão Dentária/prevenção & controle , Fluoreto de Fosfato Acidulado/uso terapêutico , Fosfatos de Cálcio/uso terapêutico , Ácido Cítrico/efeitos adversos , Esmalte Dentário/efeitos dos fármacos , Esmalte Dentário/patologia , Película Dentária/fisiologia , Progressão da Doença , Humanos , Concentração de Íons de Hidrogênio , Teste de Materiais , Microrradiografia/métodos , Substâncias Protetoras/uso terapêutico , Fatores de Tempo , Erosão Dentária/patologia
6.
Photomed Laser Surg ; 33(5): 266-73, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25954828

RESUMO

OBJECTIVE: The aim of this study was to assess any long-term chemical and morphological Nd:YAG laser modifications on irradiated primary enamel. BACKGROUND DATA: Previous studies on irradiated primary human enamel employed methodologies that evaluated the short-term effects only. METHODS: One hundred and eighty-six irradiated (with and/or without fluoride) primary enamel teeth from high-caries-risk children, which were exfoliated over a 1-year period, were collected, and the sample surface area was submitted for scanning electron microscopy (SEM), Fourier transform infrared (FTIR) spectroscopy, and X-ray energy-dispersive spectrometry (EDS). The subsurface was analyzed by Knoop microhardness and light microscopy (LM). Data were analyzed by one way ANOVA and Tukey tests (α=0.05) and Kruskall-Wallis and Tukey tests (α=0.05). RESULTS: FTIR analysis revealed a higher concentration of phosphate and carbonate in the irradiated (0.987±0.064) and lower concentration in the control groups (1.477±0.310). SEM analysis showed that the control samples exhibited a slightly smoother surface than the irradiated groups. The EDS analysis did not show any differences in the amount of calcium, phosphorus, or fluoride among the groups. The microhardness analysis revealed that sealant (249.86±7.15) and laser irradiation (262.44±22.69) led to higher hardness values than the negative control group (128.35±25.19). LM indicated significantly reduced caries formation in the laser (5.35±5.38%) and the laser plus acidulated phosphate fluoride (APF) groups (10.35±0.88%) compared with the negative control group (72.56±12.86%). CONCLUSIONS: Even with the limitations of the present study, these results suggest that Nd:YAG irradiation clinically modified the chemical composition of the enamel surface regardless of fluoride concentration, which successfully inhibited demineralization of primary tooth enamel over a 1-year period without significant morphological changes.


Assuntos
Cárie Dentária/prevenção & controle , Esmalte Dentário/patologia , Esmalte Dentário/efeitos da radiação , Lasers de Estado Sólido/uso terapêutico , Terapia com Luz de Baixa Intensidade , Fluoreto de Fosfato Acidulado/uso terapêutico , Criança , Cárie Dentária/patologia , Feminino , Humanos , Masculino , Dente Decíduo/patologia , Dente Decíduo/efeitos da radiação
7.
Int J Paediatr Dent ; 25(6): 393-8, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25327581

RESUMO

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.


Assuntos
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
8.
Int J Esthet Dent ; 9(4): 526-35, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25289387

RESUMO

The aim of this article was to report the clinical case of a male patient of 20 years with hyperpigmented gingiva and moderate fluorosis, whose smile was reestablished by the use of a laser assisted depigmentation procedure, an enamel microabrasion technique, followed by at-home bleaching and subsequent remineralization therapy. The association of these techniques presented excellent results and the patient was satisfied. All techniques are painless, fast and easy to perform, in addition to preserving the hard and soft dental structure. Treatment showed immediate and permanent results; these techniques must be divulged among professionals and their patients.


Assuntos
Microabrasão do Esmalte/métodos , Fluorose Dentária/terapia , Doenças da Gengiva/cirurgia , Hiperpigmentação/cirurgia , Terapia a Laser/métodos , Fluoreto de Fosfato Acidulado/uso terapêutico , Peróxido de Carbamida , Caseínas/uso terapêutico , Misturas Complexas/uso terapêutico , Profilaxia Dentária/instrumentação , Dentifrícios/uso terapêutico , Microabrasão do Esmalte/instrumentação , Seguimentos , Humanos , Terapia a Laser/instrumentação , Lasers Semicondutores/uso terapêutico , Masculino , Satisfação do Paciente , Peróxidos/uso terapêutico , Clareamento Dental/instrumentação , Clareamento Dental/métodos , Clareadores Dentários/uso terapêutico , Remineralização Dentária/métodos , Ureia/análogos & derivados , Ureia/uso terapêutico , Adulto Jovem
11.
Pediatr Dent ; 36(1): 56-60, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24717711

RESUMO

PURPOSE: This study's purpose was to determine whether rinsing with water or cleansing teeth after topical fluoride therapy affected plaque acidity. METHODS: This randomized, controlled, crossover, in situ study was conducted on 25 dental students who wore an acrylic mandibular appliance containing one enamel block. The patients were subjected to four treatment protocols involving acidulated phosphate fluoride (APF) application followed by rinsing the mouth with water: (1) after 30 minutes (APF-30); (2) after 15 minutes (APF-15); (3) immediately (APF-0); after cleansing the teeth with a cotton roll immediately following APF (APF-cotton); or (4) no fluoride therapy (control). After 48 hours, plaque pH was measured before and five, 10, 15, 20, and 30 minutes after rinsing with 10 percent sucrose solution. RESULTS: The least pH changes, the lowest pH drop, and the fastest pH recovery were found in the APF-30 and APF-15 groups, followed by the APF-0 and APF-cotton groups. CONCLUSIONS: Rinsing with water or cleansing the teeth with a cotton roll immediately after acidulated phosphate fluoride application can reduce its effect on dental plaque acidity; however, the inclusion of a controlled water rinse 15 minutes after APF gel application did not seem to influence the inhibitory effect of fluoride on plaque acidity.


Assuntos
Fluoreto de Fosfato Acidulado/uso terapêutico , Cariostáticos/uso terapêutico , Placa Dentária/fisiopatologia , Fluoretos Tópicos/uso terapêutico , Antissépticos Bucais/uso terapêutico , Água/administração & dosagem , Ácidos , Adulto , Cariogênicos/farmacologia , Estudos Cross-Over , Esmalte Dentário/efeitos dos fármacos , Feminino , Seguimentos , Géis , Humanos , Concentração de Íons de Hidrogênio , Masculino , Sacarose/farmacologia , Fatores de Tempo , Adulto Jovem
12.
Int Dent J ; 64(1): 1-11, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24460589

RESUMO

OBJECTIVES: The aim of this study was to examine non-cavitated approximal caries using non-invasive treatment methods. MATERIALS AND METHODS: Molar and premolar teeth with approximal caries were used in this in vivo study. Approximal caries lesions were evaluated with visual and radiographic inspection and with the DIAGNOdent device. Five groups were formed to study non-invasive treatment, and each had at least 25 early approximal carious lesions. Patients in the control group were not treated. After the separation, either ozone application, acidulated phosphate fluoride gel, CPP-ACP-containing material (Tooth Mousse), or an antibacterial bonding agent (Clearfil Protect Bond) was used. For 18 months after the non-invasive treatment, radiological controls were used to observe the progress of the initial and approximal caries in the 1st, 3rd, 6th and 12th months of follow-up. A Mann-Whitney U-test was used to perform the statistical analysis; in-group comparisons were made with the Wilcoxon signed-rank test, and a quantitative assessment was performed using a chi-squared test. RESULTS: At the end of 18 months, the caries lesions in the control group were observed to progress (P < 0.01). The lesions that were scored as 1a during a visual inspection recovered by using non-invasive treatments. CONCLUSION: Approximal caries lesions that were detected at the early stages remained stationary when using antibacterial agents and materials that promoted remineralisation. CLINICAL RELEVANCE: Antibacterial agents and remineralisation materials can be used in treatment of early approximal caries lesions.


Assuntos
Cárie Dentária/terapia , Remineralização Dentária/métodos , Fluoreto de Fosfato Acidulado/uso terapêutico , Antibacterianos/uso terapêutico , Dente Pré-Molar/efeitos dos fármacos , Dente Pré-Molar/patologia , Cariostáticos/uso terapêutico , Caseínas/uso terapêutico , Cárie Dentária/diagnóstico , Esmalte Dentário/efeitos dos fármacos , Esmalte Dentário/patologia , Adesivos Dentinários/uso terapêutico , Progressão da Doença , Seguimentos , Humanos , Lasers , Dente Molar/efeitos dos fármacos , Dente Molar/patologia , Oxidantes Fotoquímicos/uso terapêutico , Ozônio/uso terapêutico , Radiografia Interproximal , Coroa do Dente/efeitos dos fármacos , Coroa do Dente/patologia , Resultado do Tratamento
13.
Quintessence Int ; 44(6): 443-51, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23534046

RESUMO

OBJECTIVE: This randomized, single-controlled study was performed to validate in vivo the efficacy of single Fluorinex treatment by examining fluoride incorporation into enamel using electron microscopy. METHOD AND MATERIALS: Twenty healthy participants referred for routine dental treatment which also required extractions of at least two teeth as part of their treatment plan were included in this study. For each participant, one randomly selected tooth was extracted and sent for blind electron microscopic fluoride assay (control, C). Next, following a single Fluorinex treatment, the second (test, T) tooth was extracted and sent for the same assay. Intra-individual and intergroup fluoride content comparisons were performed, between control and test teeth. RESULTS: Highly significant intra-individual and intergroup differences were found between the treated and untreated teeth. Fluoride atomic percent (at%) and weight percent (wt%) estimated least squares means of untreated group were found to be 0.56 and 0.48, and in the treated group 17.35 and 14.35. This increase in fluoride at% [16.78 ± 2.3 (SE)], was also significant statistically (P < .0001); likewise, the increase in fluoride wt % [13.86 ± 1.97 (SE)] was similarly significant (P < .0001). The system was well tolerated by the participants with minimal transitional mild side effects. CONCLUSION: In vivo fluoride application using the active Fluorinex system resulted in a significant increase of fluoride content in the enamel of adult permanent teeth compared to untreated internal controls.


Assuntos
Cariostáticos/uso terapêutico , Esmalte Dentário/efeitos dos fármacos , Fluoretos Tópicos/uso terapêutico , Fluoreto de Fosfato Acidulado/análise , Fluoreto de Fosfato Acidulado/farmacocinética , Fluoreto de Fosfato Acidulado/uso terapêutico , Adulto , Idoso , Cariostáticos/análise , Cariostáticos/farmacocinética , Esmalte Dentário/química , Esmalte Dentário/metabolismo , Eletroquimioterapia/instrumentação , Eletroquimioterapia/métodos , Feminino , Fluoretos/análise , Fluoretos Tópicos/análise , Fluoretos Tópicos/farmacocinética , Humanos , Masculino , Microscopia Eletrônica de Varredura , Pessoa de Meia-Idade , Dente Molar/química , Dente Molar/efeitos dos fármacos , Método Simples-Cego
14.
Dent Mater J ; 32(2): 241-7, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23538759

RESUMO

This study aimed to evaluate the potential of a new device (Cariotester) for monitoring of incipient carious lesion remineralization in root dentin by topical fluoride in vitro. Demineralized bovine dentin specimens were treated by fluoride solutions (APF or neutral NaF) and remineralized for 4 weeks. Cariotester was used to measure penetration depth (CTR depth) of the indenter into the de- and remineralized specimen surface. The specimens were assessed by transverse microradiography (TMR) to determine lesion parameters (depth: LD, mineral loss: ΔZ). Pearson's correlation analysis showed an overall significant relationship between CTR depth and both TMR parameters. CTR depth appeared to distinguish the positive effect that topical fluoride application had on the remineralization of the outer zone of dentin lesions. Cariotester had the potential to serve as a quantitative tool for monitoring of incipient carious lesion remineralization in root dentin.


Assuntos
Dentina/efeitos dos fármacos , Desmineralização do Dente/tratamento farmacológico , Remineralização Dentária/instrumentação , Fluoreto de Fosfato Acidulado/uso terapêutico , Animais , Cloreto de Cálcio/uso terapêutico , Cariostáticos/uso terapêutico , Bovinos , Dentina/patologia , Fluoretos Tópicos/uso terapêutico , Dureza , Processamento de Imagem Assistida por Computador/métodos , Microrradiografia , Minerais/análise , Nitrogênio/uso terapêutico , Fosfatos/uso terapêutico , Compostos de Potássio/uso terapêutico , Cloreto de Sódio/uso terapêutico , Fluoreto de Sódio/uso terapêutico , Fatores de Tempo , Desmineralização do Dente/patologia , Remineralização Dentária/métodos , Raiz Dentária/efeitos dos fármacos , Raiz Dentária/patologia
15.
Am J Dent ; 25(2): 114-7, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22779286

RESUMO

PURPOSE: To evaluate the effect of a 1.23% acidulated phosphate fluoride (APF) gel combined with CO2 laser in protecting carious root dentin against further cariogenic challenges. METHODS: After a 7-day lead-in period, 12 volunteers wore an intraoral palatal device containing four carious root dentin slabs, treated with APF and APF+CO2 or placebo and placebo+CO2. After a 14-day wash-out period, volunteers were crossed-over to the other treatment arm. During both intraoral phases, specimens were submitted to cariogenic challenges and then evaluated for cross-sectional Knoop microhardness. RESULTS: Two-way ANOVA demonstrated that there was significant effect for both main factors: CO2 laser irradiation (P < 0.0001) and gel treatment (P < 0.0001), and that there was no interaction between them (P = 0.4706). Protection of carious root dentin against further cariogenic challenges may be provided by APF fluoride gel and CO2 laser, but no additive benefit was found by combining such strategies.


Assuntos
Fluoreto de Fosfato Acidulado/uso terapêutico , Dentina/efeitos dos fármacos , Lasers de Gás/uso terapêutico , Terapia com Luz de Baixa Intensidade/métodos , Cárie Radicular/prevenção & controle , Adulto , Anatomia Transversal , Cariogênicos/efeitos adversos , Estudos Cross-Over , Suscetibilidade à Cárie Dentária/efeitos dos fármacos , Suscetibilidade à Cárie Dentária/efeitos da radiação , Dentina/efeitos da radiação , Progressão da Doença , Método Duplo-Cego , Géis , Dureza , Humanos , Placebos , Sacarose/efeitos adversos , Adulto Jovem
16.
Caries Res ; 46(5): 441-51, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22739669

RESUMO

This study evaluated the effect of Er,Cr:YSGG laser irradiation and professional fluoride application on enamel demineralization and on fluoride formation and retention. In a blind in vitro study, 264 human enamel slabs were distributed into 8 groups: G1--untreated; G2--treated with acidulated phosphate fluoride gel (APF gel, 1.23% F) for 4 min; G3, G4 and G5--irradiated with Er,Cr:YSGG at 2.8, 5.6 and 8.5 J/cm2, respectively; G6, G7 and G8--preirradiated with Er,Cr:YSGG at 2.8, 5.6 and 8.5 J/cm2, respectively, and subjected to APF gel application. Twenty slabs of each group were submitted to a pH-cycling regimen, and enamel demineralization was evaluated in 10 slabs of each group. In the other 10 slabs, CaF2-like material was determined. To evaluate F formed, 10 additional slabs of each group, not subjected to the pH cycling, were submitted to analysis of CaF2-like material and fluorapatite, while the other 3 slabs of each group were evaluated by scanning electron microscopy. The F content was also measured in all pH-cycling solutions. Laser at 8.5 J/cm2 and APF treatment reduced enamel demineralization compared to the control (p < 0.05), but the combination of these treatments was not more efficient than their isolated effect. A higher concentration of retained CaF2-like material was found in laser groups followed by APF in comparison with the APF gel treatment group. The findings suggest that laser treatment at 8.5 J/cm2 was able to decrease hardness loss, even though no additive effect with APF was observed. In addition, laser treatment increased the formation and retention of CaF2 on dental enamel.


Assuntos
Cariostáticos/uso terapêutico , Esmalte Dentário/efeitos da radiação , Fluoretos/uso terapêutico , Lasers de Estado Sólido/uso terapêutico , Desmineralização do Dente/prevenção & controle , Fluoreto de Fosfato Acidulado/análise , Fluoreto de Fosfato Acidulado/uso terapêutico , Apatitas/análise , Apatitas/efeitos da radiação , Fluoreto de Cálcio/análise , Fluoreto de Cálcio/efeitos da radiação , Cariostáticos/análise , Esmalte Dentário/efeitos dos fármacos , Esmalte Dentário/ultraestrutura , Fluoretos/análise , Dureza , Humanos , Concentração de Íons de Hidrogênio , Eletrodos Íon-Seletivos , Microscopia Eletrônica de Varredura , Método Simples-Cego , Desmineralização do Dente/metabolismo , Remineralização Dentária
17.
Caries Res ; 46(1): 31-7, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22237162

RESUMO

Although the effect of acidulated phosphate fluoride gel (APF gel) on caries reduction in permanent teeth is based on evidence, the relevance of the clinical application time is still under debate. Also, the effect of 4- versus 1-min application has not been evaluated in deciduous enamel. In a blind, crossover, in situ study of 14 days, 16 adult volunteers wore palatal appliances containing slabs of human permanent and deciduous enamel. At the beginning of each phase, the slabs were submitted to one of the following treatments: no APF application (negative control); APF gel (1.23% F) application for 1 or 4 min. Biofilm accumulation on the slab surface was allowed and the slabs were subjected eight times a day to 20% sucrose, simulating a high cariogenic challenge condition. On the 15th day of each phase, fluoride retained as CaF(2) and fluorapatite (FAp) was determined on the enamel of the slabs and demineralization was assessed by cross-sectional microhardness. Fluoride as CaF(2) and FAp, formed by APF gel application on the enamel slabs not subjected to the cariogenic challenge, was also determined. APF gel reduced demineralization in both enamel types (p < 0.05), but the difference between 1 and 4 min was not statistically significant (p > 0.05). CaF(2) and FAp formed and retained on deciduous and permanent enamel was significantly higher in APF gel groups (p < 0.05), but no significant difference was found between 1 and 4 min (p > 0.05). The findings suggest that 1 min of APF gel application provides a similar effect on inhibition of demineralization as 4 min, for both permanent and deciduous enamel.


Assuntos
Fluoreto de Fosfato Acidulado/uso terapêutico , Cariostáticos/uso terapêutico , Esmalte Dentário/efeitos dos fármacos , Fluoretos Tópicos/uso terapêutico , Desmineralização do Dente/prevenção & controle , Dente Decíduo/efeitos dos fármacos , Fluoreto de Fosfato Acidulado/administração & dosagem , Adolescente , Adulto , Apatitas/análise , Apatitas/farmacocinética , Biofilmes/efeitos dos fármacos , Fluoreto de Cálcio/análise , Fluoreto de Cálcio/farmacocinética , Cariogênicos/farmacologia , Cariostáticos/administração & dosagem , Estudos Cross-Over , Esmalte Dentário/metabolismo , Sacarose na Dieta/farmacologia , Fluoretos Tópicos/administração & dosagem , Géis , Dureza , Humanos , Método Simples-Cego , Fatores de Tempo , Desmineralização do Dente/metabolismo , Dente Decíduo/metabolismo , Adulto Jovem
19.
Community Dent Health ; 29(4): 302-8, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23488214

RESUMO

AIM: This study aims to estimate the cost-effectiveness from a societal perspective of seven dental caries prevention programmes among schoolchildren in Chile: three community-based programmes: water-fluoridation, salt-fluoridation and dental sealants; and four school-based programmes: milk-fluoridation; fluoridated mouthrinses (FMR); APF-Gel, and supervised toothbrushing with fluoride toothpaste. METHODS: Standard cost-effectiveness analysis methods were used. The costs associated with implementing and operating each programme, using a societal perspective, were identified and estimated. The comparator was non-intervention. Health outcomes were measured as dental caries averted over a 6-year period. Costs were estimated as direct treatment costs, programmes costs and costs of productivity losses as a result of each dental caries prevention programme. Incremental cost-effectiveness ratios were calculated for each programme. Sensitivity analyses were conducted over key parameters. RESULTS: Primary cost-effectiveness analysis (discounted) indicated that four programmes showed net social savings by the DMFT averted. These savings encompassed a range of values per diseased tooth averted; US$16.21 (salt-fluoridation), US$14.89 (community water fluoridation); US$14.78 (milk fluoridation); and US$8.63 (FMR). Individual programmes using an APF-Gel application, dental sealants, and supervised tooth brushing using fluoridated toothpaste, represent costs for the society per diseased tooth averted of US$21.30, US$11.56 and US$8.55, respectively. CONCLUSION: Based on cost required to prevent one carious tooth among schoolchildren, salt fluoridation was the most cost-effective, with APF-Gel ranking as least cost-effective. Findings confirm that most community/school-based dental caries interventions are cost-effective uses of society's financial resources. The models used are conservative and likely to underestimate the real benefits of each intervention.


Assuntos
Cárie Dentária/prevenção & controle , Promoção da Saúde/economia , Fluoreto de Fosfato Acidulado/uso terapêutico , Animais , Cariostáticos/administração & dosagem , Cariostáticos/uso terapêutico , Criança , Chile , Odontologia Comunitária/economia , Redução de Custos , Efeitos Psicossociais da Doença , Análise Custo-Benefício , Índice CPO , Cárie Dentária/economia , Eficiência , Fluoretação/economia , Fluoretos/administração & dosagem , Fluoretos/uso terapêutico , Custos de Cuidados de Saúde , Humanos , Leite , Modelos Econômicos , Antissépticos Bucais/uso terapêutico , Selantes de Fossas e Fissuras/uso terapêutico , Odontologia Preventiva/economia , Serviços de Odontologia Escolar/economia , Cloreto de Sódio na Dieta/administração & dosagem , Escovação Dentária/métodos , Cremes Dentais/uso terapêutico
20.
Am J Dent ; 24(2): 119-23, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21698993

RESUMO

PURPOSES: (1) To determine the effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and acidulated phosphate fluoride (APF) on S. mutans viability, (2) to observe their effects on biofilm structure, and (3) to examine the element content of the hydroxyapatite (HA) surfaces after exposure to CPP-ACP and APF. METHODS: HA discs were coated with: CPP-ACP (GC Tooth-Mousse), APF, CPP-ACP+APF (1/1). Uncoated HA discs were used as control. Following application of the materials, the discs were immersed in human saliva and incubated with S. mutans ATCC (27315) for 24 hours. Growth of bacteria on the discs was evaluated by microbial culturing methods. The structure of the biofilm was examined with confocal laser scanning microscope (CLSM). The change in element content of HA surfaces (without biofilm) was evaluated with energy-dispersive x-ray spectroscopy (EDS). The values were statistically analyzed using Kruskal-Wallis and Dunn's test. RESULTS: The total number of bacteria of APF and CPP-ACP+APF applied groups were found significantly lower than the control group (P< 0.05). All specimens showed similar microbial colonization structure. No statistically significant differences were observed in O, F, Na, P, Ca content on HA surfaces after exposure to the tested agents, although fluoride concentration of the APF treated HA surfaces were increased compared to CPP-ACP, CPP-ACP +APF.


Assuntos
Fluoreto de Fosfato Acidulado/farmacologia , Biofilmes/efeitos dos fármacos , Cariostáticos/farmacologia , Caseínas/farmacologia , Placa Dentária/tratamento farmacológico , Streptococcus mutans/efeitos dos fármacos , Fluoreto de Fosfato Acidulado/uso terapêutico , Adulto , Cariostáticos/uso terapêutico , Caseínas/uso terapêutico , Combinação de Medicamentos , Durapatita/química , Humanos , Masculino , Viabilidade Microbiana/efeitos dos fármacos , Microscopia Confocal , Saliva , Espectrometria por Raios X , Estatísticas não Paramétricas , Remineralização Dentária/métodos
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