The effect of a 3% hydroxyapatite paste prophylaxis after different root-scaling procedures in periodontics / Efeito da profilaxia com pasta de hidroxiapatita 3% após diferentes procedimentos de raspagem radicular na periodontia

Abstract Introduction Root-scaling procedures on the root surface show to increase root surface roughness during instrumentation. The use of a prophylactic paste reduces the roughness. Objetive This study evaluated the influence of prophylaxis paste on the surface roughness of root dentin after hand instruments (HI), ultrasonic scalers (US) and rotational instruments (RI) were applied to root surfaces. Material and method Fifty bovine roots were prepared and randomly divided into 10 groups (n=5) in which instrumentation with HI, US, or RI was carried out with or without prophylaxis using either conventional or 3% hydroxyapatite paste; additionally, a control group without treatment was included. The Ra and Rz roughness values were measured using a perfilometer. The morphological aspects of the root surfaces were analysed qualitatively by scanning electron microscopy (SEM). Data were analysed using two-way ANOVA followed by Tukey's test (α = 0.05). Result The scaling method and the prophylaxis procedure significantly influenced (p < 0.05) root surface roughness. Treatment with US and prophylaxis with 3% hydroxyapatite paste resulted in lower values ​​of Ra (0.14 µm ± 0.02 µm) and Rz (0.89 µm ± 0.18 µm) compared to the other groups. SEM analysis showed smoother and more homogeneous surfaces in the groups with prophylaxis compared to the groups without prophylaxis. There were no substantial differences between the results of applying different pastes. Conclusion The prophylaxis procedure performed with the experimental paste containing 3% hydroxyapatite reduced the roughness of root surfaces treated with HI, US and RI at the same level as the conventional prophylactic paste.

Resumo Introdução Procedimentos de raspagem na superfície radicular aumentam a rugosidade superficial durante a instrumentação. O uso de pasta profilática pode reduzir a rugosidade. Objetivo Este estudo avaliou a influência da profilaxia com pasta na rugosidade superficial da dentina radicular após instrumentação manual (IH), ultrassom (US) e instrumentos rotatórios (IR) aplicados em superfícies radiculares. Material e método Cinquenta raízes bovinas foram preparadas e divididas aleatoriamente em 10 grupos (n = 5) nos quais a instrumentação com HI, US ou RI foi realizada com ou sem profilaxia usando pasta convencional ou hidroxiapatita a 3%; adicionalmente, um grupo controle sem tratamento foi incluído. As rugosidades de Ra e Rz foram medidas por um perfilômetro. Os aspectos morfológicos das superfícies radiculares foram analisados ​​qualitativamente por microscopia eletrônica de varredura (MEV). Os dados foram analisados ​​por meio de ANOVA de dois fatores, seguido pelo teste de Tukey (α = 0,05). Resultado O método de raspagem e o procedimento de profilaxia influenciaram significativamente (p <0,05) a rugosidade da superfície radicular. O tratamento com US e a profilaxia com pasta de hidroxiapatita ao 3% resultaram em menores valores de Ra (0,14 µm ± 0,02 µm) e Rz (0,89 µm ± 0,18 µm) em relação aos demais grupos. A análise por MEV mostrou superfícies mais lisas e mais homogêneas nos grupos com profilaxia em comparação aos grupos sem profilaxia. Não houve diferenças substanciais entre os resultados da aplicação das diferentes pastas. Conclusão O procedimento de profilaxia realizado com a pasta experimental contendo 3% de hidroxiapatita reduziu a rugosidade das superfícies radiculares tratadas com HI, US e RI no mesmo nível da pasta profilática convencional.

Effect of time and pH on physical-chemical properties of orthodontic brackets and wires.

OBJECTIVE: To test the hypothesis that treatment time, debris/biofilm, and oral pH have an influence on the physical-chemical properties of orthodontic brackets and arch wires. MATERIALS AND METHODS: One hundred twenty metal brackets were evaluated. They were divided into four groups (n  =  30) according to treatment time: group C (control) and groups T12, T24, and T36 (brackets recovered after 12, 24, and 36 months of treatment, respectively). Rectangular stainless-steel arch wires that remained in the oral cavity for 12 to 24 months were also analyzed. Dimensional stability, surface morphology, composition of brackets, resistance to sliding of the bracket-wire set, surface roughness of wires, and oral pH were analyzed. One-way analysis of variance, followed by a Tukey multiple comparisons test, was used for statistical analysis (P < .05). RESULTS: Carbon and oxygen were shown to be elements that increased expressively and in direct proportion to time, and there was a progressive increase in the coefficient of friction and roughness of wires as a function of time of clinical use after 36 months. Oral pH showed a significant difference between group T36 and its control (P  =  .014). CONCLUSIONS: The hypothesis was partially accepted: treatment time and biofilm and debris accumulation in bracket slots were shown to have more influence on the degradation process and frictional force of these devices than did oral pH.

Genotypic and phenotypic analysis of S. mutans isolated from dental biofilms formed in vivo under high cariogenic conditions.

The oral cavity harbors several Streptococcus mutans genotypes, which could present distinct virulence properties. However, little is known about the diversity and virulence traits of S. mutans genotypes isolated in vivo under controlled conditions of high cariogenic challenge. This study evaluated the genotypic diversity of S. mutans isolated from dental biofilms formed in vivo under sucrose exposure, as well as their acidogenicity and aciduricity. To form biofilms, subjects rinsed their mouths with distilled water or sucrose solution 8 times/day for 3 days. S. mutans collected from saliva and biofilms were genotyped by arbitrarily-primed PCR. Genotypes identified in the biofilms were evaluated regarding their ability to lower the suspension pH through glycolysis and their acid susceptibility and F-ATPase activity. Most subjects harbored only one genotype in saliva, which was detected in almost all biofilm samples at high proportions. Genotypes isolated only in the presence of sucrose had higher acidogenicity than those isolated only in the presence of water. Genotypes from biofilms formed with sucrose were more aciduric after 30 and 60 min of incubation at pH 2.8 and 5.0, respectively. The present results suggest that biofilms formed under high cariogenic conditions may harbor more aciduric and acidogenic S. mutans genotypes.

Genotypic and phenotypic analysis of S. mutans isolated from dental biofilms formed in vivo under high cariogenic conditions

The oral cavity harbors several Streptococcus mutans genotypes, which could present distinct virulence properties. However, little is known about the diversity and virulence traits of S. mutans genotypes isolated in vivo under controlled conditions of high cariogenic challenge. This study evaluated the genotypic diversity of S. mutans isolated from dental biofilms formed in vivo under sucrose exposure, as well as their acidogenicity and aciduricity. To form biofilms, subjects rinsed their mouths with distilled water or sucrose solution 8 times/day for 3 days. S. mutans collected from saliva and biofilms were genotyped by arbitrarily-primed PCR. Genotypes identified in the biofilms were evaluated regarding their ability to lower the suspension pH through glycolysis and their acid susceptibility and F-ATPase activity. Most subjects harbored only one genotype in saliva, which was detected in almost all biofilm samples at high proportions. Genotypes isolated only in the presence of sucrose had higher acidogenicity than those isolated only in the presence of water. Genotypes from biofilms formed with sucrose were more aciduric after 30 and 60 min of incubation at pH 2.8 and 5.0, respectively. The present results suggest that biofilms formed under high cariogenic conditions may harbor more aciduric and acidogenic S. mutans genotypes.

A cavidade oral apresenta vários genótipos de Streptococcus mutans, que podem possuir diferentes capacidades de virulência. Entretanto, pouco se sabe sobre a diversidade e virulência de genótipos de S. mutans isolados in vivo sob uma condição controlada de alto desafio cariogênico. Este estudo avaliou a diversidade genotípica de S. mutans identificados no biofilme dental formado in vivo na presença de sacarose, assim como a acidogenicidade e aciduricidade desses genótipos. Para possibilitar formação de biofilme, voluntários bochecharam com água destilada ou solução de sacarose 8x/dia durante 3 dias. S. mutans isolados da saliva e do biofilme dental foram genotipados por PCR com primers-arbitrários. Genótipos isolados do biofilme foram avaliados em relação à habilidade de reduzir o pH da suspensão devido à glicólise, em relação à susceptibilidade a ácidos e também atividade F-ATPase. A maioria dos voluntários apresentou apenas 1 genótipo na saliva, que foram detectados em quase todas as amostras de biofilme em altas proporções. Genótipos isolados somente na presença de sacarose apresentaram maior acidogenicidade do que aqueles genótipos isolados apenas na presença de água. Genótipos de biofilmes formados na presença de sacarose foram mais acidúricos após 30 e 60 min de incubação em pH 2,8 e 5,0, respectivamente. Os resultados do presente estudo sugerem que biofilmes formados sob condição de alto desafio cariogênico podem apresentar genótipos de S. mutans mais acidúricos e mais acidogênicos.

Oral disease and social class in a random sample of five-year-old preschool children in a Brazilian city.

PURPOSE: The objective of the present study was to determine the association between oral disease, access to dental care and social class in a random sample of five-year-old preschool children in Belo Horizonte, Minas Gerais, Brazil. MATERIALS AND METHODS: A cross-sectional study was carried out on a sample of 551 five-year-old children who were randomly selected from preschools. Oral health status was assessed using the decayed, missing or filled teeth (dmft) index as well as the presence of visible plaque, gingivitis and supragingival calculus. Oral examinations were performed by two examiners (j > 0.80). The clinical outcome variables were dental caries, filled and missing teeth, dental pulp exposure due to caries, dental root fragment, visible plaque, gingivitis and supragingival calculus. Social class was assessed using the City Hall database. RESULTS: Children without caries represented 63.9% of the sample. Mean overall dmft was calculated to be 1.56, and the decayed teeth component was the highest in all of the social classes. Missing teeth, caries with pulp involvement and dental root fragment had higher proportions and the filled teeth component had the lowest proportion in children from the lowest social class. Visible dental plaque was present in 45.4% of the children. Except for the filled teeth component, all of the clinical outcome variables had a significant association with social class status (P < 0.001), regardless of child's gender. CONCLUSIONS: Oral disease in the primary dentition and access to dental treatment are affected by social and cultural factors.

Estudo in vitro da atividade do extrato etanólico de sementes de bacupari (Rheedia gardneriana Planch. & Triana) e das frações no crescimento de Streptococcus mutans / In vitro study of the activity of ethanol extract from bacupari (Rheedia gardneriana Planch. & Triana) seeds and its fractions on Streptococcus mutans growth

Streptococcus mutans, principal microrganismo da cavidade oral, desempenha papel preponderante na formação de placas dentárias, sendo considerado o agente etiológico primário da cárie. Rheedia gardneriana, conhecida popularmente como bacupari, é uma planta utilizada com fins medicinais para o tratamento de diversas patologias, e por apresentar atividade antimicrobiana de compostos das folhas contra bactérias Gram-positivas e Gram-negativas. O objetivo do presente trabalho foi avaliar o efeito de extrato de semente de R. gardneriana sobre a cepa S. mutans UA159. Os testes foram conduzidos com o extrato etanólico bruto e as frações obtidas com os solventes diclorometano, etanol-água, metanol e hexano, em ensaios de inibição in vitro. O extrato bruto (100 por cento) apresentou halos de inibição com diâmetro similar ao obtido com solução de digluconato de clorexidina 0,12 por cento, usada como controle. Os ensaios com a fração diclorometano exibiram atividade inibitória 35 por cento menor comparado com o controle, enquanto nenhum efeito antimicrobiano foi observado com a fração etanol-água. Contrariamente, os resultados obtidos com as frações hexânica e metanólica demonstraram claramente a atividade antimicrobiana por inibição do crescimento bacteriano. Na fração metanólica a formação de halos de inibição foi similar ao do controle. Estes dados apresentam atividade antimicrobiana de R. gardneriana contra S. mutans.

Streptococcus mutans, which is the main microorganism of the oral cavity, plays a preponderant role in dental plaque formation and is considered the primary etiologic agent regarding caries. Commonly known as "bacupari", Rheedia gardneriana is a plant used for medicinal purposes in the treatment of several pathologies; besides, its leaves have compounds that present antimicrobial activity against Gram-positive and Gram-negative bacteria. The aim of this work was to evaluate the effect of R. gardneriana seed extract on S. mutans strain UA159. The tests were carried out with crude ethanol extract and the fractions obtained with the solvents dichloromethane, ethanol-water, methanol, and hexane in in vitro inhibition assays. The crude extract (100 percent) presented inhibition halos with diameter similar to that obtained by using 0.12 percent chlorhexidine digluconate solution as control. Assays with the fraction dichloromethane showed an inhibitory activity 35 percent lower than that of the control, whereas no antimicrobial effect was observed with the ethanol-water fraction. Conversely, the results obtained with the fractions hexane and methanol clearly demonstrated antimicrobial activity by inhibiting the bacterial growth. In the methanol fraction, the formation of inhibition halos was similar to that in the control. These data present antimicrobial activity of R. gardneriana against S. mutans.

Evaluation of the smear layer and hybrid layer in noncarious and carious dentin prepared by air abrasion system and diamond tips.

PURPOSE: To analyze the smear layer and the hybrid layer in noncarious and carious dentin prepared by different cutting instruments and restored with composite resin. STUDY DESIGN: Cavities were randomly prepared in 160 specimens (noncarious and artificial carious dentin) by high-speed diamond tips (KG Sorensen 1013), air abrasion system (Prepstart, Danville Engineering), ultrasonic tip (CVDentus 8.3231-1), and ultrasonic tip associated with ultrasonic cavitation by water for 10 s. Half of the cavities in each group were conditioned with 37% phosphoric acid for 15 s. The amount of smear layer and dentinal tubules present were analyzed using scanning electron microscopy and graded from 0 to 3. Cavities were prepared in another 20 noncarious specimens and 20 carious specimens and restored with adhesive composite resin system. The restorations were hemisected longitudinally and analyzed using scanning electron microscopy to evaluate the hybrid layer and resinous prolongation characteristics, using scores ranging from 1 to 6. RESULTS: The data were statistically analyzed using Kruskal-Wallis and Dunn tests at 5% of significance level. There was evidence that the most efficient smear layer removal was the acid etching in the noncarious dentin and the water ultrasonic cavitation in the carious dentin. The hybrid layer formed on the noncarious and carious dentin prepared by the ultrasonic tip was more regular than in the specimens prepared by high-speed diamond tip, with many resinous prolongations. CONCLUSION: The ultrasonic tip seems to be a promising tool for carious dentin cavity preparation.

Effectiveness of a mouthwash containing Triclosan and Gantrez in the reduction of biofilm and gingivitis: a clinical pilot study.

AIM: The aim of this pilot study was to evaluate the effectiveness of a mouthwash containing Triclosan and Gantrez in the reduction of bacterial biofilm and gingivitis. METHODS AND MATERIALS: Thirty patients were assigned to control and experimental groups. The visible plaque index and the marginal bleeding index were determined at the baseline, and at the second and third months, at which time a percentage of bacterial plaque and bleeding was obtained for each patient. All patients were given unlabeled toothpaste without Triclosan and Gantrez and soft-bristle toothbrushes. Additionally, the experimental group patients used unlabeled mouthwash with Triclosan and Gantrez. The participants were instructed to rinse for 60 seconds after brushing, twice a day. RESULTS: At the baseline, the control and experimental group's bacterial plaque and marginal bleeding indices were close to each other (46.61% and 50.75% respectively; 7.62% and 9.59% respectively). At the third month, the experimental group presented bacterial plaque and marginal bleeding indices of 6.56% and 0.43% respectively, while the control presented 11.37% and 2.41% respectively. There were no significant differences between the two groups (p>0.05), with a discrete tendency to better results in the experimental group for both variables. However, there were significant differences among the experimental periods (p<0.05), except between the second and third months of observation. CONCLUSION: The mouthwash did not bring forth an additional advantage when combined with brushing. Additional studies where the observation period may be prolonged and the number of subjects increased are recommended. CLINICAL SIGNIFICANCE: It is important to understand the role chemical control of supragingival plaque can play as an aid in the treatment of periodontal diseases. Since bacterial biofilm is the primary etiological factor in gingivitis and periodontitis, it is essential to know how to control it in order to provide a more complete therapeutic strategy for patient care.

Clinical and microbiological benefits of systemic metronidazole and amoxicillin in the treatment of smokers with chronic periodontitis: a randomized placebo-controlled study.

AIM: The aim of this study was to evaluate the clinical and microbiological effects of scaling and root planing (SRP) alone or combined with metronidazole (MTZ) or with MTZ and amoxicillin (AMX) in the treatment of smokers with chronic periodontitis. METHODS: A double-blind, placebo-controlled, randomized clinical trial was conducted in 43 subjects who received SRP alone (n=15) or combined with MTZ (400 mg 3 x per day, n=14) or with MTZ+AMX (500 mg 3 x per day, n=14) for 14 days. Clinical and microbiological examinations were performed at baseline and 3 months post-therapy. Subgingival samples were analysed by checkerboard DNA-DNA hybridization. RESULTS: Subjects receiving MTZ+AMX showed the greatest improvements in mean probing depth and clinical attachment level. Both antibiotic therapies led to additional clinical benefits over SRP alone in initially shallow, intermediate, and deep sites. The SRP+MTZ+AMX therapy led to the most beneficial changes in the subgingival microbial profile. These subjects showed significant reductions in the mean counts and proportions of periodontal pathogens such as Tannerella forsythia, Porphyromonas gingivalis and Treponema denticola, and the greatest increase in proportions of host-compatible species. CONCLUSION: Significant advantages are observed when systemic antibiotics are combined with SRP in the treatment of smokers with chronic periodontitis. The greatest benefits in clinical and microbiological parameters are achieved with the use of SRP+MTZ+AMX.

Avaliação do efeito da própolis sobre biofilme dentário, doença gengival e nível de s. mutans em saliva de crianças livres de cárie / Evaluation of effect of propolis on dental plaque, gem disease and mutans levels in saliva of caries free children

Objetivou-se avaliar e comparar o efeito do bochecho de própolis (Apis mellifera) sobre o biofilme dentário, doença gengival e nível de S. mutans na saliva em criançaslivres de cárie. Em um estudo cruzado, 15 crianças (8-9 anos) foram submetidas à solução diária de bochecho de própolis a 6,25 por cento (BP) durante 15 dias consecutivos e após o intervalo de 21 dias, as mesmas bochecharam a solução de clorexidina a 0,12 por cento (BC). Foram mensurados índices de acúmulo de biofilme dentário (PHP e IHOS), doença gengival (ISG e IG) antes (TO) e 24 horas (T1) após o emprego das soluções e contagem de S. mutans na saliva antes (TO), 24 horas (T1), 7 dias (T7), 15 dias (T15) e 21 dias (T21) após o término de ambos os bochechos. Os resultados indicaram, pelo teste de Friedman, redução significativa para S. mutans após o uso tanto do BP qunato do BC em T1 e apenas para BC em T7 (p<0,05). Houve redução significativa no IG e ISG para ambas as soluções (P<0,01). A redução do biofilme dentário foi significativa para BP e BC, segundo PHP, porém apenas o BC obteve redução significativa para IHOS (p<0,05). O teste Mann-Whitney não apontou diferença estatística entre os ítens avaliados em T1, T7, T15 e T21 quando se comparou BP e BC entre eles (p>0,05). Dessa forma concluímos que a solução de própolis foi tão eficaz quanto a clorexidina sobre o biofilme dentário, doença gengival e S. mutans.

Remoção química-mecânica da cárie: revisão de literatura / Chemomechanical caries removal: literature review

O princípio básico da remoção químico-mecânica da cárie consiste na aplicação de agentes químicos específicos que promovam o amolecimento seletivo da dentina degradada durante o processo carioso, seguido de uma leve escavação usando instrumentos manuais especialmrnete adaptados, restando ao final do processo apenas a dentina sadia. O primeiro sistema chegaria ao mercado na década de 80, com o nome de Caridex, contudo, devido a uma série de desvantagens ele sairia de circulação no início da década de 90. O atual sistema, o Carisolv, mostra-se bem mais vantajoso que o sistema anterior, tendo como principais características: ser indolor, dispensando deste modo a anestesia local, ser mais econômico e bem mais simples. O sistema é especialmente indicado para pacientes pediátricos, pacientes com fobia, pacientes sistematicamente comprometidos e para pacientes especiais. O objetivo deste artigo é, através da revisão de literatura, tratar sobre a evolução deste método e suas principais particularidades.

Peripheral ossifying fibroma in a child: report of case.

A typical peripheral ossifying fibroma in the anterior maxilla of an 11-year-old boy is presented. The importance of differential diagnosis and proper treatment for prevention of recurrence is discussed.

Characterization of the binding of delmopinol to salivary precipitates / Caracterização da associação de delmopinol com precipitados salivares

O objetivo do trabalho é determinar a quantidade de delmopinol associado com cada componente salivar de diferente peso molecular. Saliva não estimulada foi coletada com cinco indivíduos e misturada com delmopinol radioativo obtendo-se uma concentração final de 9,7 mM. As misturas de saliva e delmopinol foram analisadas com eletroforese tanto para o pelete como para o supernatante. Cada amostra foi analisada três vezes em eletroforese. A primeira foi corada com corante de prata. A segunda amostra foi preparada para fazer uma auto-radiografia. A terceira fileira foi cortada em pedaços iguais dissolvidos e analisados com cintilografia. O resultado de cintilografia demonstrou que um grande nível de radioatividade foi detectado em alto peso molecular (600-700 kDa). Em todas as amostras dos peletes foram encontradas grandes quantidades de delmopinol. O resultado da auto-radiografia confirmou que o delmopinol interagiu com proteínas de alto peso molecular (600-700 kDa)

Characterization of the binding of delmopinol to salivary precipitates.

The aim of this study was to quantify the amount of delmopinol recovered in different molecular weight ranges of salivary proteins in the supernatant and pellet of delmopinol-saliva mixes. Unstimulated whole saliva was collected from 5 subjects and mixed with radiolabeled delmopinol to obtain a final drug concentration of 9.7 mM. The salivary-delmopinol solutions were incubated and then centrifuged. The resulting pellets and supernatants were studied in an electrophoresis assay. Each individual sample was run in three different electrophoretic gel lanes. The first lane was stained with silver dyes; the second lane was used for electrophoretic blotting and autoradiography; the third lane was cut in standard slices that were dissolved and analyzed with scintillation counting. The scintillation results demonstrated that higher radioactivity levels were detected at high molecular weight ranges (700-600 kDa). Furthermore, pellet samples were found to contain the highest amounts of delmopinol. The autoradiography results confirmed that delmopinol was bound to proteins of high molecular weight (700-600 kDa).

A scanning electron microscope investigation of calcium fluoride-like material deposited during topical fluoride exposure on sound human enamel in vitro.

1. The morphological aspects of globules deposited in vitro when a NaF solution is applied to sound human enamel were studied by scanning electron microscopy. 2. Particles, presumably of calcium fluoride-like material, formed on the surfaces of an unerupted tooth and consisted of subunits showing a "cauliflower" appearance, indicating agglomeration of even smaller particles. The number and size of the crystals increased with time of exposure. 3. These particles represent highly resistant fluoride reservoirs and may be of clinical significance.

A scanning electron microscope investigation of calcium fluoride-like material deposited during topical fluoride exposure on sound human enamel in vitro

1. The morphological aspects of globules deposited in vitro when a NaF solution is applied to sound human enamel were studied by scanning electron microscopy. 2. Particles, presumably of calcium fluoride-like material, formed on the surfaces of an unerupted tooth and consisted of subunits showing a "cauliflower" appearance, idnciating agglomeration of even smaller particles. The number and size of the crystals increased with time of exposure. 3. These particles represent highly resistant fluoride reservoirs and may be of clincial significance

Deposition of alkali-soluble fluoride on enamel surface with or without pellicle.

Deposition of alkali-soluble fluoride on enamel in the presence and absence of an acquired pellicle was studied in vitro during a single topical application of a 2% sodium fluoride solution at neutral pH. Five experimental groups of repeated measures design were established. The amount of alkali-soluble fluoride formed on enamel (i.e., calcium fluoride) was measured by chemical assessments and by SEM. The results showed that there were no differences among the groups demonstrating the incapacity of pellicle to interfere with deposition of alkali-soluble fluoride on enamel. The fluoride ions are thus able to reach the enamel in spite of the presence of the pellicle.