In vitro and in situ caries-preventive effect of a new combined fluoride and calcium experimental nanocomposite solution

Abstract To assess the in vitro and in situ effect of experimental combined fluoride and calcium nanocomposite solutions on dental caries prevention. Nanocompound mesoporous silica (MS) with calcium (Ca) and sodium fluoride (NaF) - (MSCaNaF); MS with NaF (MSNaF), NaF solution (positive control), and deionized water (negative control - CG) were studied. The specimens (n=130) were submitted in vitro to a multispecies biofilm in the presence of 2% sucrose. After 24 h and 48 h, the culture medium pH, the percent of surface mineral loss (%SML), and lesion depth (ΔZ) were analyzed. In the in situ study, 10 volunteers participated in four phases of 7-days each. The products were applied on the specimens (n=240) before 20% sucrose solution drips. The polysaccharides (SEPS and IEPS), %SML and roughness (Sa) were evaluated. There was an in vitro decrease in pH values in 24h and 48h, compared to baseline. The MSCaNaF and MSNaF groups obtained lower values of %SML and ΔZ (p < 0.05) than CG and NaF after 24h and were similar to NaF after 48h (p<0.05). In situ results showed similar SEPS and IEPS among all groups after 48h. An after 7-days, the nanocomposites had similar values (p>0.05), while NaF was similar to CG (p>0.05). After 48h, the MSCaNaF and MSNaF reduced the %SML (p<0.05). After 7-days, both experimental nanocomposites were similar to NaF (p>0.05). Regarding Sa, MSCaNaF was better than NaF for both periods (p<0.05). The nanocomposites controlled the in vitro and in situ enamel demineralization, mainly in the initial periods.

In-vitro effect of a single application of CPP-ACP pastes and different fluoridated solutions on the prevention of dental caries around orthodontic brackets

ABSTRACT Objective: To assess the in-vitro effect of single applications of CPP-ACP pastes and different fluoridated solutions on the prevention of dental caries around orthodontic brackets. Material and Methods: Tooth/bracket sets (n=65) were immersed in artificial saliva (1h at 37ºC) and randomly subjected to single applications (100µL; 1min) of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP emulsion), CPP-ACP with fluoride (CPP-ACPF emulsion), solutions of titanium tetrafluoride (TiF4) or sodium fluoride (NaF), or no treatment (CG). Multispecies biofilm (5 x 105 CFU/mL) was formed in the presence of 2% sucrose. After 24 h, the pH and the concentration of total soluble fluoride (TSF) were analyzed by culture medium. The presence of active white spot lesions (WSL) evaluated by macroscopic examination and the percent surface mineral loss (%SML) were analyzed. Also, the topography of enamel was detected by analysis of scanning electron microscopy (SEM). The data was assessed by chi-square, Kruskal-Wallis, and Mann-Whitney tests (p < 0.05). Results: Fluoride-containing compounds led to a smaller pH reduction than did CPP-ACP and CG (p<0.05). There was difference in TSF between the groups (p<0.05), denoted as TiF4> NaF > CPP-ACPF > CPP-ACP > CG. Regarding the presence of WSL and %SML, the NaF group obtained lower values (p<0.05), while TiF4 and CPP-ACPF were similar (p>0.05). SEM demonstrated that fluoride-free groups had a larger surface dissolution. Conclusion: Fluoridated groups including solutions and CPP-ACPF were more effective than CPP-ACP in reducing enamel demineralization around orthodontic brackets after a single application.

RESUMO Objetivo: Avaliar in-vitro o efeito de uma aplicação única de cremes dentais de CPP-ACP e diferentes soluções fluoretadas na prevenção da cárie dentária ao redor de braquetes ortodônticos Material e Métodos: O conjunto dentes/braquetes (n=65) foi imerso em saliva artificial (1h em 37°C) randomizado e submetido a tratamento único (100µL; 1 min) de emulsão de fosfopeptídeo de caseína-fosfato de cálcio amorfo (CPP-ACP) e CPP-ACP associado ao flúor (CPP-ACPF); soluções de tetrafluoreto de titânio (TiF4) e fluoreto de sódio (NaF); e ausência de tratamento (GC). Biofilmes multiespécie (5 x 105 CFU/mL) foram formados na presença de sacarose a 2%. Após 24h, o pH e a concentração de fluoreto solúvel total (FST) foram analisados pelo meio de cultura. Foram avaliadas a presença de lesões de mancha branca (LMB), por meio da análise de macroscopia visual, e a porcentagem de perda de dureza (%PD). Também foi verificada a topografia do esmalte, usando microscopia eletrônica de varredura (MEV). Os dados foram analisados pelos testes Qui-quadrado, Kruskal-Wallis e Mann-Whitney (p < 0,05). Resultados: Os compostos contendo flúor levaram a uma redução do pH menor do que o CPP-ACP e GC (p<0,05). Houve diferença no FST entre os grupos (p <0,05), sendo TiF4> NaF > CPP-ACPF > CPP-ACP > GC. Quanto à presença de LMB e à %PD, o grupo NaF obteve os menores valores (p<0,05), enquanto TiF4 e CPP-ACPF foram semelhantes (p> 0,05). A MEV demonstrou que os grupos sem flúor tiveram uma dissolução superficial maior. Conclusão: Os grupos fluoretados, incluindo soluções e CPP-ACPF, foram mais eficazes do que o CPP-ACP sem flúor na redução da desmineralização do esmalte ao redor dos braquetes ortodônticos após uma única aplicação.

The Xylitol Applicability and its Effects in Health Area Worldwide: A Bibliometric Analysis Based on Randomized Controlled Trials

ABSTRACT Objective To describe and evaluate the xylitol products' applicability and its effects in the health area worldwide utilizing a bibliometric analysis from randomized controlled trials (RCT) with humans. Material and Methods Electronic searches were carried out in Medline/PubMed, Scopus, Cochrane Library, Web of Science, and VHL databases. The main data extracted were: year, area of applicability, type of treatment, country, journal, xylitol posology and concentration, presentation form, outcomes, and effects. Results From 1476 studies, 257 were included. These studies were published between 1973-2021. The majority was carried out in dentistry (73.9%) and under preventive treatment (67.4%). These studies were developed in the USA (15.4%) and published in Caries Research (6.6%). The posology and concentration ranged between 0.004-67 g/day and 0.002-100%, respectively. The xylitol is usually used in the chewing gum form (44.0%), and for antimicrobial activity evaluation (38.5%). A positive effect was observed in 204 studies (79.3%) and was associated with xylitol concentration ≥ 15(p=0.007). Side effects were reported in 8.2and were associated with posology ≥ 5 g/day (p=0.03). Conclusion Most studies with xylitol were conducted to prevent diseases in the dentistry field. The chewing gum form and antimicrobial activity evaluation were more frequent. Most xylitol products have a positive effect, and few studies report side effects.

Types of Feeding and Presence of Harmful Oral Habits in Children with Cleft Lip and/or Palate: A Pilot Study

Abstract Objective: To verify the relationship between the types of feeding and presence of harmful oral habits (HOH) in children with cleft lip (CL), palate (CP) and cleft lip and palate (CLP), as well as to compare the different types of cleft to each other. Material and Methods: A form was applied to the parents of 162 children (3-5 years old), addressing the following variables: gender, cleft type, age, socioeconomic conditions, type of breastfeeding, presence of HOH, and the parents' knowledge about the consequences of oral habits. The data obtained were analyzed by chi-square test (p<0.05). Results: The majority of children (83.3%) were bottle-fed and 12.3% were exclusively maternal breastfed. The main reason for weaning was the presence of cleft (59.9%). Breastfeeding was significantly higher in children with CL (75%) in comparison with CP (20%) and CLP (5%) (p<0.001). Children with CLP were 12 times more likely to be bottle-fed than children with CL (OR=12.21; CI=4.09-36.45). The prevalence of HOH was 37%. Sociodemographic characteristics were not associated with the presence of HOH (p>0.05). The type of feeding and cleft were not decisive to present some type of HOH (p>0.05) and 87% of parents stated that HOH could lead to serious complications of tooth misalignment. Conclusion: The type of feeding and fissure did not determine the acquisition of harmful oral habits in children with cleft. However, the greater the fissure's complexity, the lesser the chance of children receiving exclusive breastfeeding.

In Vitro Evaluation of Fluoride in Saliva After Topical Application of Professional Use Products

Objective: To evaluate in vitro the presence of fluoride in saliva after applying professional use products on the surface of dental enamel. Material and Methods: Experimental groups were composed by: Cariostatic 12% (CA), Fluoridated Varnish 5% (FV), Fluorine Acidulate Gel 1.23% (AG) and Fluorine Neutral Gel 2% (NG). Fluoridated dentifrice (FD) and Artificial Saliva (AS) were used as controls. Products (10 µL) were applied to the surface of bovine enamel blocks (4×4×1 mm, n = 18) and immersed in 10 mL of artificial saliva at room temperature. Aliquots of artificial saliva (750 µL) of each sample were collected 1, 2, 4, 8, 24 and 48 hours after application of the products. Analyses were performed in triplicate, using a fluoride ion-specific electrode coupled to a potentiometer. The equipment was calibrated using a standard curve for fluoride analysis from 0.125 to 64 µgF-/mL. Results: Greater fluoride concentration (µgF-/mL) was observed after 1h application, as follows: 197.40 (NG), 172.21 (AG), 20.25 (CA), 14.49 (FV) e 11.81 (FD). Fluoride concentration increased overtime for all groups. After 48h, the following fluoride concentrations were assessed: 428.12 (AG), 267.25 (NG), 65.36 (FV), and 62.52 (CA). Conclusion: Greater fluoride release was observed for AG and NG groups, mostly after 1h application.

Antibacterial and Cytotoxic Potential of a Brazilian Red Propolis

Objective: To evaluate in vitro the effect of a red propolis ethanolic extract (RPE) in the prevention of growth of a cariogenic biofilm and its cytotoxic potential. Material and Methods: Minimum inhibitory and bactericidal concentrations (MIC and MBC) of RPE against Streptococcus mutans and Lactobacillus casei were determined. The cytotoxic potential of 0.4% RPE in oral fibroblasts was observed after 1, 3 and 5 min of contact. Cellulose membrane disks (13 mm, N=12) were used for biofilm formation (24 h) of S. mutans and L. casei, which were treated (1 min) with 0.4% RPE or 0.12% Chlorhexidine (CHX). The control group of biofilm formation was not submitted to any treatment. Serial dilutions were then made to evaluate microbial viability. Descriptive data analysis and, for microbial viability, Mann Whitney test were performed (p≤0.05). Results: RPE showed similar MIC and MBC (4.46 mg/mL) against S. mutans and, for L. casei, they were 8.92 mg/mL (MIC) and 17.85 mg/mL (MBC). CHX presented MIC and MBC <0.00002 mg/mL for S. mutans and 0.00047 mg/mL for L. casei. After 1, 3 and 5 min, the RPE exhibited, respectively, 69.38%, 43.91% and 40.36% of viable cells. The RPE (6.55) and CHX (6.87) presented similar efficacy to reduce the total number of viable bacteria (p>0.05). Regarding the total number of viable bacteria (Log10 CFU/mL), the RPE (6.55) and CHX (6.87) presented similar efficacy (p>0.05). Conclusion: Red propolis extract showed antibacterial activity against the tested strains, exhibited acceptable cytotoxicity and reduced the colonization of S. mutans and L. casei in a biofilm membrane model.

Factors Associated with the Caregivers' Perception of the Oral Health of Individuals with Cerebral Palsy

Abstract Objective: To evaluate factors associated with the caregivers' perception of the oral health of children and adolescents with cerebral palsy. Material and Methods: A cross-sectional study was carried out with 80 children and adolescents with cerebral palsy aged 2-18 years, registered at a reference institution and their respective caregivers. Caregivers provided socioeconomic, systemic and health perception and access to dental services data. A calibrated researcher (Kappa=0.75-0.98) performed oral examinations using DMF-T, dmf-t, dental trauma, gingival bleeding index, community periodontal index, malocclusion index and the dental aesthetic index. The Poisson Regression was used (α=0.05) Results: According to the caregivers' perception, the oral health reports of children and adolescents with cerebral palsy considered good and poor was 73.8% and 26.3%, respectively. The poor oral health perception is associated with the presence of dental caries in anterior teeth (PR 1.34, 95% CI=1.11-1.63) and bleeding during tooth brushing (PR 1.20, 95% CI=1.04-1.40) Conclusion: Children and adolescents with cerebral palsy who presented lesions of caries in the anterior teeth and gingival bleeding during tooth brushing, more frequently, had poor oral health by their caregivers.

Multidisciplinaridade no cuidado e atenção à saúde bucal do idoso / Multidisciplinarity in the care and attention for the oral health of elderly individuals

Este artigo tem como objetivo revisar a literatura acerca da importância da equipe multidisciplinar no cuidado e atenção à saúde bucal do idoso. Foram realizadas buscas bibliográfi cas nas seguintes bases de dados: Bireme, SciELO, LILACS, PubMed e MedLine utilizando os seguintes descritores: "Odontologia geriátrica", "Assistência integral à saúde do idoso" e "Reabilitação bucal", assim como os respectivos termos em inglês: "Geriatric dentistry", "Comprehensive health care" e "Mouth reabilitation". Foram incluídos artigos científicos em inglês e português, bem como documentos de entidades públicas nacionais e internacionais, publicados entre 2000 e 2016. Foram excluídas as teses, dissertações e estudos que não abordavam a temática principal da presente pesquisa. Como resultado, a partir da revisão de literatura realizada, verificou-se que os idosos fazem parte de um grupo populacional que apresenta, frequentemente, alterações fisiológicas e patológicas diversas, tanto relacionadas à saúde geral como à saúde bucal, podendo estar associadas ao uso crônico de medicamentos, aos hábitos de alimentação e higiene e à própria motivação do paciente. Portanto, conclui-se ser necessária uma abordagem multidisciplinar em todas as fases de atendimento do idoso, desde o diagnóstico precoce, assim como durante o planejamento e tratamento integrado, para contribuir na melhoria de sua qualidade de vida.

To review the literature about the importance of multidisciplinary teams in the care and attention for the oral health of elderly people. The following databases were searched: Bireme, SciELO, LILACS, PubMed and MedLine, using specific keywords: "Geriatric dentistry", "Comprehensive health care" and "Mouth rehabilitation". Scientific articles both in English and Portuguese were included, and documents of national and international public entities, published between 2000 and 2016. Theses, dissertations and studies that did not address the main topic of this research were excluded. From the literature review, it was verified that the elderly represent a population group that often presents a high level of physiological and pathological alterations, both related to general health and oral health, and may be associated to the chronic use of medications, dietary and hygiene habits, and the patient's own motivation. A multidisciplinary approach is required in all stages of care for elderly patients, from early diagnosis to an integrated planning and treatment, contributing to the improvement of their quality of life.

The fluoride concentration of the public water supply in the urban zone and indigenous villages of Baía da Traição, Paraíba, Brazil

Introduction: It is known that the municipality of Baía da Traição, Brazil, has a system for fluoridation of the water supply. Objective: To evaluate the fluoride concentration (F-) of the public water supply in the city of Baía da Traição-PB. Methods: Public water samples were collected in 13 sites, being one in the urban zone (downtown) and 12 in the rural zone (indigenous villages). In each site, three distinct collection points were selected for convenience between November 2015 and January 2016. The analysis was performed in duplicate using a fluoride ion- specific electrode coupled to a potentiometer, previously calibrated. The samples (750 µL) were added to 750 µL of TISAB II solution, considered on a calibration curve with concentrations of 0.2 to 1 mg/L. Results: In November, December and January, respectively, concentrations of F- in the downtown area were 0.32, 0.11 and 0.09 mg/L, while the average concentrations in the indigenous villages were 0.08 (± 0.02), 0.08 (± 0.03) and 0.07 (± 0.02) mg/L. All samples had concentrations below the recommended levels (<0.60 mg/L) by the Ministry of Health for the anticaries benefit. Conclusion: The public water supply of Baía da Traição presented concentrations of F- insufficient to prevent dental caries at the population level.

Introdução: É sabido que o município de Baía da Traição possuía sistema de fluoretação de águas de abastecimento. Objetivo: Avaliar a concentração de fluoreto (F-) na água de abastecimento público do município de Baía da Traição-PB. Métodos: Amostras de água de abastecimento público foram coletadas em 13 locais, sendo um na zona urbana (Centro) e 12 distribuídas na zona rural (aldeias indígenas). Para cada local, três pontos de coleta distintos foram selecionados por conveniência entre novembro de 2015 e janeiro de 2016. A análise foi realizada em duplicata, utilizando-se um eletrodo íon-específico para fluoreto acoplado a um potenciômetro, previamente calibrados. As amostras (750 µL) foram adicionadas a 750 µL de solução TISAB II, consideradas a uma curva de calibração com concentrações de 0,2 a 1 mg/L. Resultados: Em novembro, dezembro e janeiro, respectivamente, as concentrações de F- no Centro foram 0,32, 0,11 e 0,09 mg/L, e a média das aldeias indígenas, 0,08 (±0,02), 0,08 (±0,03) e 0,07 (±0,02) mg/L. Todas as amostras apresentaram concentrações abaixo do recomendado (<0,60 mg/L) pelo Ministério da Saúde para o benefício anticárie. Conclusão: Portanto, as águas de abastecimento público de Baía da Traição apresentaram concentrações de F- insuficientes para prevenir a cárie dentária em nível populacional.

Antibacterial Activity of Melaleuca alternifolia (tea tree essential oil) on Bacteria of the Dental Biofilm

Objective: To evaluate the antibacterial activity of tea tree EO on Streptococcus mutans (ATCC 25175), S. salivarius (ATCC 7073) and Lactobacillus rhaminosus (ATCC 9595). Material and Methods: The antibacterial activity of M. alternifolia EO was evaluated by the broth dilution method, by which minimum inhibitory and bactericidal concentrations (MIC and MBC) were determined. Serial dilutions range from 70243.90 µg/mL to 26.14 µg/mL. The MIC evaluation was performed in 96-well microplates, in which 100 µL of Brain Heart Infusion (BHI), 100 µL of the EO dilution and 5 µL of the inoculum (final concentration = 5x105 CFU/mL) were inserted. After 24 h of incubation, MIC was determined as the lowest concentration capable of inhibiting microbial growth, identified by the resazurin reaction (100 µg/mL). CBM was identified by the absence of subculture growths (50 µL) of dilutions equal to or greater than MIC. Tests were performed in triplicate and at three different times (n = 9). Pharmacological controls (0.05% and 0.12% Chlorhexidine), growth and sterility were used to validate the results. Results: The MIC of M. alternifolia compared to S. mutans, S. salivarius and L. rhaminosus was 1940.16 µg/mL, 3977.34 µg/mL and 3977.34 µg/mL, respectively. The MBC values were 70243.90 µg/mL, 3977.34 µg/mL and 34265.31 µg/mL, respectively. Conclusion: The essential oil of M. alternifolia presented antibacterial activity against the microorganisms evaluated when in high concentration.

Participação do Projeto de Extensão SaBuComu na Formação de Graduandos da Área da Saúde / Participation of the SaBuComu Extension Project on the Formation of Undergraduate Health Students

Construir um perfil quantitativo da participação dosextensionistas e avaliar o impacto do SaBuComu na formaçãoem saúde com ênfase nas percepções sobre humanização,cidadania, habilidades de organização e protagonismoestudantil. Metodologia: Utilizou-se uma abordagem indutiva,com procedimento histórico e técnica documental por meiode diários de campo e de questionário com perguntas abertas.Resultados: Observou-se nos diários de campo (n=45) que asfrequências dos registros e o número de atividades registradasvariaram, respectivamente, de 25-108 e de 21-99 porextensionista, predominando os relatos de reuniões (22,0). Asatividades registradas com maior frequência foram: campanhasde vacinação contra hepatite B (13,0%), desenhos e pinturas(9,0%) e corte e colagem (7,7%). Os tipos de participaçãomais observados foram: interação com crianças (19,3%),explicação sobre o tema abordado na atividade (16,8%) edivulgação da campanha de vacinação contra hepatite B(10,7%). Os problemas abordados mais frequentemente foram:problemas de saúde (9,5%), descontrole das crianças (9,1%) ebriga entre crianças (7,0%). Entre os 273 problemas registrados,48,7% não apresentou registro de solução. A partir dosquestionários (n=6), verificou-se que o projeto contribui paraampliar o conceito de saúde, formar profissionais maishumanizados, incentivar a participação em pesquisascientíficas e desenvolver a autonomia estudantil. Conclusão:Houve variação no número de registros por extensionista, assimcomo uma diversidade dos tipos de atividades e de participaçãonas mesmas, além da pluralidade dos problemas encontrados.O projeto contribui na formação em saúde, modificando apercepção de conceitos e realidades por meio de vivências.Há o incentivo à pesquisa científica, entretanto algunsextensionistas relataram dificuldades em desenvolver aautonomia no projeto...

To outline a quantitative profile of the studentsparticipating of SaBuComu extension project and evaluate itsimpact on health training focused on humanization, citizenshipvalues, organizational skills and student leadership. Materialand Methods: This study used an inductive approach, withhistorical procedure and documentary technique by means offield diaries and questionnaires with open questions. Results:According to the field diaries (n=45), the frequencies of recordsand the number of registered activities of each student rangedbetween 25-108 and 21-99, respectively. There was apredominance of reports about the meetings (22). The mostfrequently reported activities were: vaccination campaignsagainst hepatitis B (13.0%), drawings and paintings (9.0%),and collages (7.7%). The most frequent types of participationincluded interaction with children (19.3%), explanation on thetopics addressed in the activities (16.8%) and advertising ofthe hepatitis B vaccination campaign (10.7%). The problemsaddressed more often were: health issues (9.5%), uncontrolledchildren (9.1%) and fight among children (7.0%). Among the273 registered issues, 48.7% remained unsolved. Based onthe questionnaires (n = 6), it was found that the projectcontributes to extend the concept of health, form more humaneprofessionals, encourage participation in scientific research,and develop student autonomy. Conclusion: There was avariation in the number of records by each student, as well asa diversity of types of activities and participation beyond theplurality of the problems found. The project contributes tohealth education, changing the perception of concepts andrealities through experiences. It is reported to encourage theinvolvement of students in scientific research, although someof them reported difficulties in developing autonomy in theproject...

Uso de Fitoterápicos Associadosa Próteses Dentárias / Use of Herbal Medicines Associated with Dental Prosthesis

Objetivo: Realizar uma revisão das pesquisas que utilizaramsubstâncias fitoterápicas contra microorganismos dacavidade oral e da superfície de próteses dentárias e verificarse a eficácia destes fitoterápicos tem sido investigada.Material e Métodos: Foi realizada uma revisão de literaturaatravés de uma busca bibliográfica nas seguintes bases dedados: BBO, BIREME, LILACS, Portal de Periódicos CAPES,PUBMED, SCIELO e Google Acadêmico. Resultados: Osfitoterápicos quando associados às próteses dentárias, emsua maioria, foram estudados quanto a sua ação antifúngica,in vitro, sobre cepas de C. albicans no tratamento deestomatite protética. Conclusão: Os fitoterápicos utilizadoscom maior frequência nestes estudos foram a Uncariatomentosa L., o Ricinus communis e a própolis, sendo quea última dentre estes, quando em forma de gel, apresentouresultados discordantes, enquanto que a Ricinus communis,na sua apresentação em dentifrício, não apresentou efeitoantimicrobiano frente a E. coli, C. albicans e C. glabrata.Portanto, a eficácia dos diversos fitoterápicos deve sermelhor estudada para obtenção dos resultados esperadosquando associados às próteses dentárias...

Objective: Conduct a review of research that used herbalsubstances against microorganisms of the oral cavity andthe surface of dental prostheses and verify if theeffectiveness of these herbal medicines have been studied.Material and Methods: The survey was conducted in thedatabases: BBO, BIREME, LILACS, Portal of periodicalsCAPES, PUBMED, SCIELO and Academic Google. Results:Herbal when associated with dentures, mostly, they werestudied for their antifungal activity in vitro of C. albicansstrains in the treatment of denture stomatitis. Conclusion:Herbal frequently used in these studies were Uncariatomentosa L., Ricinus communis and propolis, with the lastof these, when in gel form, showed conflicting results, whileRicinus communis, in its dentifrice presentation didn’tshowed antimicrobial effect against E. coli, C. albicans andC. glabrata. Therefore, the effectiveness of several herbalmedicines should be better studied to obtain the expectedresults when associated with dentures...