ABSTRACT
Abstract Objectives: Addition of chlorhexidine has enhanced the antimicrobial effect of glass ionomer cement (GIC) indicated to Atraumatic Restorative Treatment (ART); however, the impact of this mixture on the properties of these materials and on the longevity of restorations must be investigated. The aim of this study was to evaluate the effects of incorporating chlorhexidine (CHX) in the in vitro biological and chemical-mechanical properties of GIC and in vivo clinical/ microbiological follow-up of the ART with GIC containing or not CHX. Material and Methods: For in vitro studies, groups were divided into GIC, GIC with 1.25% CHX, and GIC with 2.5% CHX. Antimicrobial activity of GIC was analyzed using agar diffusion and anti-biofilm assays. Cytotoxic effects, compressive tensile strength, microhardness and fluoride (F) release were also evaluated. A randomized controlled trial was conducted on 36 children that received ART either with GIC or GIC with CHX. Saliva and biofilm were collected for mutans streptococci (MS) counts and the survival rate of restorations was checked after 7 days, 3 months and one year after ART. ANOVA/Tukey or Kruskal-Wallis/ Mann-Whitney tests were performed for in vitro tests and in vivo microbiological analysis. The Kaplan-Meier method and Log rank tests were applied to estimate survival percentages of restorations (p<0.05). Results: Incorporation of 1.25% and 2.5% CHX improved the antimicrobial/anti-biofilm activity of GIC, without affecting F release and mechanical characteristics, but 2.5% CHX was cytotoxic. Survival rate of restorations using GIC with 1.25% CHX was similar to GIC. A significant reduction of MS levels was observed for KM+CHX group in children saliva and biofilm 7 days after treatment. Conclusions: The incorporation of 1.25% CHX increased the in vitro antimicrobial activity, without changing chemical-mechanical properties of GIC and odontoblast-like cell viability. This combination improved the in vivo short-term microbiological effect without affecting clinical performance of ART restorations.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Chlorhexidine/pharmacology , Chlorhexidine/chemistry , Dental Atraumatic Restorative Treatment/methods , Glass Ionomer Cements/pharmacology , Glass Ionomer Cements/chemistry , Anti-Infective Agents, Local/pharmacology , Reference Values , Saliva/microbiology , Streptococcus mutans/growth & development , Streptococcus mutans/drug effects , Tensile Strength , Time Factors , In Vitro Techniques , Materials Testing , Candida albicans/growth & development , Candida albicans/drug effects , Colony Count, Microbial , Reproducibility of Results , Analysis of Variance , Treatment Outcome , Statistics, Nonparametric , Biofilms/growth & development , Biofilms/drug effects , Compressive Strength , Fluorides/chemistry , Hardness Tests , Lactobacillus acidophilus/growth & development , Lactobacillus acidophilus/drug effects , Odontoblasts/drug effectsABSTRACT
AIM: To identify the prevalence of dental caries in inland Brazilian adolescents, and to analyze the influence of socio-demographic and clinical variables, and access to dental service on caries experience. METHODS: This study had a non-probabilistic sample comprising 504 adolescents aged 12 years, attending public schools in the city of Nova Friburgo, mountain region of Rio de Janeiro, Brazil. The World Health Organization (WHO, 1997) criterion was used by previously calibrated examiners to report dental caries. Variables were obtained by means of a semi-structured questionnaire applied to the adolescents' parents. RESULTS: The D3MFT mean was 1.90 and the Significant Caries (SIC) Index was 4.54, mainly represented by the carious component. Multiple logistic regression analysis revealed that parents with over 8 years of schooling (OR=0.579), absence of pain (OR=0.396) and not visiting the dentist (OR=0.270) might suggest protective factors against the disease; the possible risk factors were male gender (OR=1.982) and pain, extraction and others were reasons for consultation (OR=2.435). CONCLUSIONS: Although the prevalence of caries was slightly below the national mean, polarization of the disease was clearly observed. Education and no access to the dentist led to protection against the disease. These results may contribute to planning of oral health actions directed towards this target population for the control of caries...
Subject(s)
Humans , Male , Female , Adolescent , Dental Caries/epidemiology , Dental Health Services , Health Services Accessibility , Health Surveys , Oral Health , Risk Factors , Social ClassABSTRACT
O objetivo do estudo foi avaliar os conhecimentos e práticas em saúde bucal (SB) com crianças hospitalizadas com câncer. A amostra foi composta pela equipe de enfermagem, cuidadores e crianças. Foi aplicado um questionário relacionado ao conhecimento geral sobre SB, métodos e instrumentos utilizados para a higiene oral (HO) e dados socioeconômicos. Baseado nos resultados, quem realiza a HO das crianças são os cuidadores (90,7 por cento), que receberam orientações da equipe de enfermagem em 21,4 por cento dos casos. Com relação ao desconforto na cavidade bucal, a equipe de enfermagem reportou que todos apresentaram manifestações clínicas, enquanto apenas 62,8 por cento dos cuidadores reportaram casos. Todos os participantes consideram importante haver um CD no setor de oncologia. Pôde-se concluir que não existe um protocolo de cuidados com a higiene bucal de crianças hospitalizadas com câncer e que as manifestações bucais mais frequentes entre os pacientes em tratamento antineoplásico foram: mucosite, enjoos, vômitos, xerostomia e ausência de paladar.
The aim of this study was to evaluate the knowledge and practices of oral health (OH) in hospitalized children with cancer. The sample was composed by the nurse team, caretakers and children. It was applied a questionnaire concerning the general knowledge about OH, methods and instruments used for oral hygiene (OH). According to the results, the responsible of OH of children are the caretakers (90.7 percent) who receive instructions from the nurse team in 21.4 percent of cases. As for the oral cavity discomfort, the nurse team reported that all patients exhibited clinical manifestations while the caretakers reported a different number, 62.8 percent of cases. All participants considered important having a dentist in the oncology sector. According to the results obtained, it was possible to conclude that there is no oral health protocol for hospitalized children with cancer and that the most frequent oral manifestations among patients going through antineoplastic treatment were: mucositis, nausea, vomit, xerostomy and lack of sense of taste.
Subject(s)
Child, Preschool , Female , Humans , Infant , Male , Health Knowledge, Attitudes, Practice , Hospitalization , Neoplasms , Oral Hygiene , Surveys and QuestionnairesABSTRACT
A infra-oclusão de molares decíduos é uma situação clínica que pode ser encontrada em dentes com anquilose dento-alveolar, e pode causar prejuízos ao desenvolvimento da oclusão. Este artigo apresenta uma revisão de literatura sobre etiologia, diagnóstico e seqüelas da anquilose e conseqüente infra-oclusão de molares decíduos, e um relato de caso clínico utilizando restaurações adesivas indiretas como uma possibilidade de manejo desta situação, proporcionando funcionalidade e buscando evitar a instalação de desarmonias oclusais. No relato são apresentadas as etapas clínicas e laboratoriais envolvidas na confecção das restaurações.
Subject(s)
Tooth Ankylosis/complications , Tooth Ankylosis/diagnosis , Tooth Ankylosis/etiology , Composite Resins , Tooth, DeciduousABSTRACT
Objetivo: avaliar o efeito do tempo de condicionamento ácido e sistemas de união na resistência ao cisalhamento (RUC) em dentes decíduos. Metodologia: 48 molares decíduos, hígidos, doados pelo Banco de dentes da USP, foram seccionados longitudinalmente (mésio-distal) e embutidos em resina epóxica, deixando as superfícies V ou L expostas. As amostras foram lixadas até a obtenção de uma superfície plana em dentina e distribuídas em 3 grupos de acordo com o tempo de condicionamento ácido (7, 15 ou 20 s) e sistemas de união (Scotchbond Multipurpose Plus -SBMP e Prime & Bond 2.1-PB): G1 - 7 s + SBMP; G2 - 15 s + SBMP; G3 - 20 s + SBMP; G4 - 7 s + PB; G5 - 15 s + PB; G6 - 20 s + PB. Confeccionou-se restaurações com compósito Z100, sendo armazenados em água destilada a 37oC, por 72h. Os corpos-de-prova foram submetidos ao ensaio de RUC (Instron - 0,5 mm/min). Os sítios de fratura foram analisados em Microscópio Estereoscópico e MEV e os resultados submetidos à análise estatística ANOVA e Teste de Tukey (p<0,05). Resultados: os maiores valores de RUC foram obtidos por G1 e G4. Não houve diferença estatística entre G1 e G2, enquanto o G4 apresentou maiores valores em relação aos G1 e G2 (p<0,05). A falha adesiva foi a mais freqüente (86,5%). Conclusões: 1 - A interação material*tempo de condicionamento demonstrou que para o SBMP o desempenho do sistema não diferiu em relação do tempo de condicionamento ácido, enquanto que para o PB os melhores resultados foram observados para os menores tempos de condicionamento ácido; 2 - A análise dos sítios de fratura demonstrou que a falha mais freqüentemente observada foi a do tipo adesiva (86,5 por cento); 3 - Quando maior o tempo de condicionamento ácido, menor os valores de resistência da união para o sistema adesivo PB.(au)