ABSTRACT
ABSTRACT Saliva and external agents containing different concentrations of sodium fluoride (NaF) promote the dental remineralization process. However, these resources may not be sufficient to counteract the multiple factors involved in the process of dental caries, especially in high-risk patients. There are alternatives that have been extensively researched, such as casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) which provides essential ions, like phosphate and calcium, acting as an adjuvant in the remineralization process. Manufacturers of CPP-ACP-based products also suggest that it can produce desensitizing effects. This nanocomplex has been used experimentally with some dental cements and adhesive systems, but it is important to clarify the effects of this procedure, and the remineralizing/desensitizing advantages it offers. The objective of this topic review was to present the state of the art on CPP-ACP nanocomplex. In terms of dental caries prevention, this remineralizing option is not better than NaF. CPP-ACP provides a dental desensitizing action, but it is temporary, similar or less effective than other alternatives such as potassium nitrate or NaF. The experimental incorporation of CPP-ACP into dental cements should be controlled for not to compromise the physico-chemical properties of the material. The use of dental products based on this nanocomplex as dental surface pretreatment may decrease the bond strength of adhesive materials, but this effect is material dependent.
RESUMEN La saliva y agentes externos que contienen diferentes concentraciones de fluoruro de sodio (NaF) favorecen el proceso de remineralización dental. No obstante, estos recursos podrían no ser suficientes para contrarrestar los múltiples factores involucrados en el proceso de caries dental, especialmente en pacientes con alto riesgo. Existen alternativas que han sido ampliamente investigadas, como el fosfopéptido de caseína-fosfato de calcio amorfo (CPP-ACP) que aporta iones esenciales como fosfato y calcio, actuando como coadyuvante en el proceso de remineralización. Los fabricantes de productos basados en CPP-ACP también sugieren que este es capaz de generar efectos desensibilizantes. Este nanocomplejo ha sido utilizado de forma experimental con algunos cementos dentales y sistemas adhesivos, pero es importante esclarecer los efectos de dicha incorporación y las ventajas remineralizantes/desensibilizantes que ofrece esta alternativa. El objetivo del presente artículo de revisión de tema consistió en presentar el estado del arte sobre el nanocomplejo CPP-ACP. En términos de prevención de caries dental, esta opción remineralizante no es superior al NaF. El nanocomplejo ejerce acción desensibilizante dental, pero esta es transitoria, similar o inferior a otras alternativas como nitrato de potasio o NaF. La incorporación experimental de CPP-ACP en cementos dentales debe ser controlada para no comprometer las propiedades fisicoquímicas del material. La utilización de productos dentales a base de este nanocomplejo como pretratamiento de la superficie dental puede disminuir la resistencia de unión de materiales adhesivos, pero este efecto es material-dependiente.
Subject(s)
Tooth Demineralization , Phosphopeptides , Dental CariesABSTRACT
Aim: To evaluate the effectiveness of an educational preventive program in oral health on preschoolers. Methods: The final sample was 71 children in the test group and 48 in the control group. Intraoral exams were conducted for caries experience (dmf-s), white spot lesions (WSL) diagnosis, dental biofilm and treatment needs (before and after intervention- the interval was 18 months). Caregivers answered a questionnaire about socioeconomic data and health behavior. The educational preventive program consisted of supervised brushing, education in oral health, fluoride application and lectures to caregivers. Mann Whitney and Wilcoxon tests (p <0.05) were used to compare data between groups. Results: Mean caries experience was 0.94 (± 3.42) and 0.94 (± 2.87) in test and control groups, respectively. Baseline mean for dental biofilm was 4.95, and final mean was 0.21 in test group (p = 0.047). Conversely, the same variables were 4.11 and 0.84 in the control group (p = 0.047). The program was evaluated as very good (54.9% of caregivers), improvement of brushing was related by 62%, and more children went to the dentist (p <0.01). Conclusion: The educational preventive program seems to be effective for dental biofilm reduction, improved brushing and dental visits, being an important strategy for oral health maintenance in children