Effects of different toothpaste formulations on erosive tooth wear prevention: systematic review / Efeitos de diferentes dentifrícios na prevenção do desgaste dentário erosivo: revisão sistemática de literatura

Objective: erosive tooth wear is a multifactorial condition that results in loss of dental hard tissue, caused by a chemical and mechanical process. This paper aims to carry out a systematic review presenting the effects of different toothpaste formulations on the loss of dental enamel surface in vitro. Material and Methods: the searches were performed in the databases PubMed, Web of Science, LILACS and Scielo. Articles published from 2010 to 2020 were filtered, without language restriction. Articles that included abrasion and erosion protocols were searched, as they were more similar to clinical reality, since toothpaste is applied through tooth brushing. The searches with descriptors and free terms on the topic resulted in 992 articles, however only 12 were within the search criteria. Results: the selected studies appointed that association of conventional fluorides (NaF) with metallic fluorides can be a promising strategy for the reduction of surface loss by erosive tooth wear. Toothpastes containing sodium fluoride, as well as tin without chitosan, showed a reduction in surface loss, considered sufficient for individuals with medium exposure to acids. In children's toothpastes, the one containing sodium fluoride showed a reduction in surface loss when compared to non-fluoride dentifrices. Conclusion: different protocols may result in less or greater loss of enamel surface, and methodological differences should be considered. To clarify the effects of dentifrices on erosive tooth wear, other properties of dentifrices should be investigated. (AU)

Objetivo: o desgaste erosivo é uma condição multifatorial que resulta em perda de tecido duro dentário, causado por um processo químico e mecânico. Este trabalho tem como objetivo realizar uma revisão sistemática de literatura apresentando os efeitos de diferentes formulações de dentifrícios na perda de superfície de esmalte dentário in vitro. Material e Métodos: a busca foi realizada nas bases de dados PubMed, Web of Science, LILACS e Scielo. Foram filtrados artigos publicados no intervalo de 2010 a 2020, sem restrição de idioma. Buscou-se artigos que incluíssem protocolos de abrasão e erosão, por mais se assemelhar a realidade clínica, uma vez que o dentifrício é aplicado através da escovação dentária. A busca com descritores e termos livres sobre o tema encontrou 992 artigos, entretanto somente 12 estavam dentro dos critérios da pesquisa. Resultados: os estudos selecionados apontaram que associação dos fluoretos convencionais (NaF) com os metálicos pode ser uma estratégia promissora para a redução de perda de superfície pelo desgaste dentário erosivo. Dentifrícios contendo fluoreto de sódio, assim como estanho sem quitosana, apresentaram redução na perda de superfície, sendo considerada suficiente para indivíduos com exposição média aos ácidos. Em dentifrícios infantis, aquele que continha fluoreto de sódio apresentou uma redução de perda de superfície quando comparado com dentifrícios sem fluoreto. Conclusão:diferentes protocolos podem resultar em menor ou maior perda de superfície de esmalte e as diferenças (AU)

Do Parents' Oral Health Literacy Levels Influence Their Response to Interventions to Improve Their Knowledge of Traumatic Dental Injuries?

Abstract Objective: To measure the influence of oral health literacy (OHL) level in the improvement of knowledge about traumatic dental injuries (TDI) after an educational intervention. Material and Methods: A total of 257 parents of children aged 0-12 years had their OHL level evaluated (BREALD-30). A leaflet with information about how to respond to TDI Emergency was developed and delivered to the parents. A questionnaire about attitudes towards TDI was administered before (TDIQ1) and after (TDIQ2) parents read the educational leaflet. The hypotheses were evaluated by non-parametric tests, correlation analysis and logistic regression. Results: The mean OHL score was 21.6. The means of correct answers in TDIQ1 were 5.5 and 5.9 (p = 0.066) and in TDIQ2 were 6.6 and 7.7 (p=0.003) between the groups with inadequate and marginal/adequate OHL, respectively. In the logistic regression, the total score of BREALD-30 and the maximum number of correct answers in TDIQ2 maintained statistical association when adjusted for schooling, gender, age of the parents, family income and the number of correct answers in the first application of the questionnaire. Conclusion: The level of OHL influenced the improvement of parents' knowledge about emergency care in cases of TDI in children from an educational intervention using a leaflet, and this intervention was more effective for parents with adequate OHL.

Erosive tooth wear-why clinicians should be aware of this condition

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.

Effect of erosive challenges on deciduous teeth undergoing restorative procedures with different adhesive protocols - an in vitro study

ABSTRACT Objective: To evaluate the effect of erosive challenges on the tooth- restoration interface of deciduous teeth treated with different adhesive protocols. Material and Methods: Deciduous molars were cut mesiodistally, then embedded, abraded and polished (n=80). Samples were randomly divided according to the adhesive system used into: G1 (Adper Single Bond2®, etch-and-rinse), G2 (Universal Single Bond®, self-etching), G3 (OptibondFL®, etch-and-rinse with Fluoride) and G4 (BondForce®, self-etching with Fluoride). After standardized cavity preparation (2 mm diameter x 2 mm depth), adhesive systems were applied and samples were restored (composite resin Z350®). Half of the samples were exposed to erosive/abrasive cycles (n = 10, each adhesive group), and the other half (control group; n = 10) remained immersed in artificial saliva. For microleakage analysis, samples were submersed in methylene blue and analyzed at 40x magnifications. Cross-sectional microhardness (CSMH) was carried out (50 g/5 s) at 25 μm, 50 μm, and 100 μm from the eroded surface and at 25 μm, 75 μm, and 125 μm from the enamel bond interface. Results: Regarding microleakage, 7.5% of the samples showed no dye infiltration, 30% showed dye infiltration only at the enamel interface, and 62.5% showed dye infiltration through the dentin-enamel junction, with no difference between groups (p≥0.05). No significant difference was observed in CSMH at different depths (two-way ANOVA, p≥0.05). Conclusions: We did not observe significant changes in microleakage or CSMH after erosive/abrasive challenges in deciduous teeth treated with different adhesive protocols (etch-and-rinse and self-etching adhesives, with and without fluoride).

Effect of an erosive challenge on the enamel-composite resin interface in primary teeth: an in vitro study

AIM: The aim of this study was to evaluate whether different adhesive systems (etch-and-rinse or self-etch) render enamel-composite resin interface in primary teeth more susceptible to erosive challenge. MATERIAL AND METHODS: Thirty enamel specimens from caries-free primary incisors were selected and cavities were prepared for restoration. According to adhesive protocols, specimens were divided into groups: G1 (Adper Single Bond 2), G2 (Adper SE Plus), and G3 (35% phosphoric acid + Adper SE Plus). After restorative procedures, half of the surface of enamel and restorative material was protected with nail varnish, thus, only half of the sample was subjected to the erosive challenge (immersion in Coca-Cola®, 3 cycles of 5 minutes, for 5 days). Samples were analysed quantitatively through Knoop microhardness, the indentations were made on enamel-composite interface. Data were submitted to statistical analysis (Student's t test, two-way ANOVA, p<0.05). RESULTS: It showed that different adhesive systems did not significantly affect the percentage of superficial microhardness change after an erosive challenge (p=0.387). However, although no significant difference was observed, G2 (self-etch system) showed the lowest percentage of superficial microhardness change. CONCLUSION: The use of different adhesive systems did not influence superficial microhardness of enamel-composite interface after an erosive challenge. The incomplete removal of the smear layer, though self-etch systems, suggests a greater ability to withstand the erosive challenge on the enamel-resin interface.

Hipomineralização de molar-incisivo [HMI): relato de caso e acompanhamento de tratamento restaurador / Molar incisor hypomineratization (MIH): case report and restorative tratment follow-up

Introdução: Hipomineralização molar incisivo (HMI) é a displasia do esmalte dos dentes que afeta um ou mais primeiros molares permanentes frequentemente associados aos incisivos permanentes. Pacientes com essa alteração apresentam vários problemas clínicos, que podem incluir um desgaste dentário acentuado, perda do esmalte, aumento da suscetibilidade à cárie e sensibilidade dentária. O tratamento da hipomineralização molar-incisivo dependerá da gravidade do dente afetado, abrangendo desde medidas preventivas até procedimentos restauradores complexos. Objetivos: Relatar um caso de um paciente infantil, 7 anos, gênero feminino, diagnosticada com HMI. Além, disso, descrever a abordagem terapêutica, tratamento restaurador e acompanhamento de 28 meses. Conclusão: Pacientes com hipomineralização molar-incisivo necessitam de acompanhamento longitudinal para prevenir perda de estrutura dentária e manutenção do tratamento restaurador.

Introduction: Molar incisor hypomineralization (MIH) is defined as the enamel dysplasia that affects one or more first permanent molars and frequently permanent incisors. These patients have several oral health problems that may include increased tooth wear, loss of enamel, higher susceptibility to dental caries and tooth sensitivity. The treatment of molar incisor hypomine-ralization depends on the severity of the affected teeth, including preventive measures as well as extensive restorative procedures. Objectives: To present a case report of a patient, female, diagnosed at 7 years old with MIH and to describe restorative procedures with a 28-months follow-up period. Conclusion: MIH Patients require longitudinal follow-up to prevent loss of tooth structure and maintenance of restorative treatment.

A map of Brazilian dental research in the last decade

The aim of the present study was to analyze dental research trends in Brazil over the past nine years. All abstracts presented at the 26th Annual Meeting of the Brazilian Society for Dental Research in 2009 (n = 2648) were classified based on field of knowledge, home institution and geographic region. Data were compared with those previously published based on abstracts presented at various meetings. Between 2001 and 2006, five fields of knowledge had a greater than 10 percent representation among the total number of studies. These fields included restorative dentistry/dental materials (RD/DM), periodontics, endodontics, pediatric dentistry and population-based oral health. In 2009, only RD/DM maintained a greater than 10 percent proportion of meeting abstracts, and basic fields comprised the second position among those fields with greater representation (9.8 percent). The majority of research studies were performed at public institutions, and the number of abstracts per state increased significantly in 2009 (Wilcoxon test, p < 0.001). The southeastern region of Brazil submitted the greatest number of abstracts; however, other regions also demonstrated increased participation in research (11 percent). The percentage distribution of abstracts between states remained constant (Wilcoxon test, p = 0.255; r s = 0.873). The results of the present study suggest a slight shift in the scientific research profile in Brazilian dentistry: fields related to professional disciplines have declined in relative research participation, while increasing interest has been observed in basic fields and new specialties.

Tetralogia de Fallot e sua repercussão na saúde bucal / Repercussion of tetralogy of Fallot on oral health

OBJETIVO: Relatar o caso de um paciente com tetralogia de Fallot e sua condição bucal. DESCRIÇÃO DO CASO: Paciente do gênero masculino atendido no Curso de Especialização em Odontopediatria da Escola de Aperfeiçoamento Profissional da Associação Brasileira de Odontologia da seção Paraná dos cinco aos sete anos de idade. O exame clínico intrabucal inicial revelou quadro de cárie severa da infância. Durante o acompanhamento, verificou-se a erupção dos primeiros molares permanentes com a presença de defeitos de desenvolvimento de esmalte e perda de estrutura dental. À anamnese, a mãe relatou que o paciente foi portador de tetralogia de Fallot e que a cirurgia corretora foi realizada com um ano e 11 meses de idade. COMENTÁRIOS: A formação do esmalte dental dos primeiros molares permanentes ocorre a partir do primeiro mês de vida e é finalizada entre dois e quatro anos de idade. Neste caso, tal etapa coincidiu com o período anterior à cirurgia para correção da tetralogia de Fallot, fato que pode ter interferido negativamente no processo de mineralização dos primeiros molares permanentes. Os defeitos de desenvolvimento do esmalte podem levar a perda de estrutura dental, favorecendo o aparecimento da cárie dentária. Dessa forma, o odontopediatra deve realizar um diagnóstico precoce dessas alterações e intervir preventivamente para evitar a perda de tais dentes. Uma anamnese bem detalhada e a maior interação entre pediatras e odontopediatras podem proporcionar melhor acompanhamento de crianças com fatores de risco para apresentar defeitos de desenvolvimento do esmalte dentário.

OBJECTIVE: To report a case of a child with tetralogy of Fallot and his oral conditions. CASE DESCRIPTION: A male patient was assisted at the Pediatric Dentristry Specialization Course of the Brazilian Dentistry Association in the State of Paraná, Brazil, from five to seven years old. At the first intrabucal examination, the child presented a severe caries disease. During their treatment, enamel developmental defects were detected in the first permanent molar tooth, with loss of enamel structure. His mother reported that the patient had a surgical correction of tetralogy of Fallot cardiac malformation when he was 23 months old. COMMENTS: The enamel development of the first molar starts in the first month of life and ends around two to four years old. In this patient, the period of mineralization of the first molar was coincident with the period prior to the surgical correction of the cardiac problem. Probably, the development of dental enamel was impaired by the systemic repercussion of this congenital anomaly. Enamel developmental defects can present loss of dental structure, increasing the risk of caries. Therefore, the pediatric dentists should diagnose dental enamel developmental defects early, in order to prevent serious damages to the teeth. A detailed anamnesis and a good interaction between pediatricians and pediatric dentists will provide a better follow-up of children at risk of having dental enamel developmental defects.