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RGO (Porto Alegre) ; 68: e20200036, 2020. tab, graf
Article in English | LILACS, BBO, BNUY, BNUY-Odon | ID: biblio-1136039


ABSTRACT Objective The aim of this study was to evaluate the availability and stability of soluble fluoride fraction in commercial fluoride toothpastes available in Uruguay. Methods Fourteen fluoride toothpastes from four different manufacturers were analyzed. Randomized and blinded analyses were performed in duplicate for each dentifrice at the time of purchase (fresh samples) and after 12 months of storage at room temperature (aged samples). Total fluoride and total soluble fluoride concentrations were measured using a fluoride specific electrode. Results Total fluoride concentrations in all of the products were lower than the F levels specified by the manufacturers. Total soluble fluoride fractions were lower than the total fluoride concentrations in fresh samples of five toothpastes and in aged samples of ten toothpastes (p < 0.05). Three toothpastes had insufficient and unstable total soluble fluoride fractions (< 60%) and five toothpastes had only unstable total soluble fluoride fractions (<1000 ppm) after 12 months. Conclusion Based on theresults of this study, it can be concluded that from fourteen Uruguayan commercial fluoride toothpastes analyzed in this study, three toothpastes have insufficient and unstable chemically active F fractions and five other toothpastes have the lack of stability which may compromise their efficacies. Review the guidelines on fluoride dentifrices in Uruguay is necessary, in order to ensure optimum benefit for population.

RESUMO Objetivo O objetivo deste estudo foi avaliar a disponibilidade e a estabilidade da fração solúvel de flúor nos dentifrícios fluoretados comercialmente disponíveis no Uruguai. Métodos Quatorze dentifrícios fluoretados de quatro diferentes fabricantes foram analisados. Análises randomizadas e cegas foram realizadas em duplicata para cada dentifrício no momento da aquisição (amostras frescas) e depois de 12 meses de armazenamento em temperatura ambiente (amostras envelhecidas). As concentrações de flúor total e flúor solúvel total foram determinadas usando um eletrodo específico para flúor. Resultados As concentrações de flúor total de todos os produtos testados foram menores do que os níveis de flúor especificados pelos fabricantes. Os valores das frações de flúor solúvel total foram menores do que as concentrações de flúor total nas amostras frescas de cinco dentifrícios e nas amostras envelhecidas de 10 dentifrícios (p < 0.05). Três dentifrícios apresentaram as frações de flúor solúvel total insuficientes e instáveis (< 60%) e cinco dentifrícios tiveram apenas frações instáveis de flúor solúvel total (<1000 ppm) após 12 meses. Conclusão Baseado nosresultados deste estudo pode-se concluir que dos quatorze dentifrícios fluoretados comercialmente disponíveis no Uruguai analisados neste estudo, três produtos apresentaram insuficientes e instáveis frações quimicamente ativas de flúor e cinco outros dentifrícios tiveram falta de estabilidade o que pode comprometer suas eficácias. É necessário revisar as orientações sobre dentifrícios fluoretados no Uruguai a fim de garantir um benefício ótimo para a população.

Toothpastes , Dentifrices , Fluorides , Uruguay , Dental Caries
J. appl. oral sci ; 28: e20190578, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1101256


Abstract Objective This study sought to analyze the gene expression of Candida albicans in sound root surface and root caries lesions, exploring its role in root caries pathogenesis. Methodology The differential gene expression of C. albicans and the specific genes related to cariogenic traits were studied in association with samples of biofilm collected from exposed sound root surface (SRS, n=10) and from biofilm and carious dentin of active root carious lesions (RC, n=9). The total microbial RNA was extracted, and the cDNA libraries were prepared and sequenced on the Illumina Hi-Seq2500. Unique reads were mapped to 163 oral microbial reference genomes including two chromosomes of C. albicans SC5314 (14,217 genes). The putative presence of C. albicans was estimated (sum of reads/total number of genes≥1) in each sample. Count data were normalized (using the DESeq method package) to analyze differential gene expression (using the DESeq2R package) applying the Benjamini-Hochberg correction (FDR<0.05). Results Two genes (CaO19.610, FDR=0.009; CaO19.2506, FDR=0.018) were up-regulated on SRS, and their functions are related to biofilm formation. Seven genes ( UTP20 , FDR=0.018; ITR1 , FDR=0.036; DHN6 , FDR=0.046; CaO19.7197 , FDR=0.046; CaO19.7838 , FDR=0.046; STT4 , FDR=0.046; GUT1 , FDR=0.046) were up-regulated on RC and their functions are related to metabolic activity, sugar transport, stress tolerance, invasion and pH regulation. The use of alternative carbon sources, including lactate, and the ability to form hypha may be a unique trait of C. albicans influencing biofilm virulence. Conclusions C. albicans is metabolically active in SRS and RC biofilm, with different roles in health and disease.

Humans , Tooth Root/microbiology , Candida albicans/genetics , DNA, Fungal/genetics , Root Caries/microbiology , Biofilms/growth & development , Candida albicans/isolation & purification , Candida albicans/growth & development , Gene Expression , Gene Expression Regulation, Fungal , Up-Regulation , Sequence Analysis, RNA , Transcriptome , Morphogenesis
Braz. oral res. (Online) ; 33: e056, 2019. tab, graf
Article in English | LILACS | ID: biblio-1011655


Abstract The aim of this study was to assess the association between weight status and ΔDMFS among 12-year-old schoolchildren from South Brazil. A total of 801 12-year-old schoolchildren were followed-up for 2.5 ± 0.3 years. Data collection included questionnaire, recording of anthropometric measures (height and weight), and caries examination. The outcome was the difference between DMFS (number of decayed, missing or filled surfaces) at follow-up and baseline (ΔDMFS). Weight status, based on body mass index-for-age Z-scores, was considered the main predictor variable. Negative binomial regression models were used to model the association, and rate ratios and their 95% confidence intervals were estimated. A multivariable fractional polynomial model was used to further explore the relationship between obesity and dental caries. DMFS increased by 0.86 (95%CI = 0.65-1.07), 0.91 (95%CI = 0.59-1.23), and 0.42 (95%CI = 0.03-0.80) for normal weight, overweight, and obese schoolchildren, respectively. Obese adolescents had significantly lower ΔDMFS than normal weight ones (p < 0.05). No significant association between categories of weight status and ΔDMFS was found (overweight, IRR=0.92, 95%CI = 0.69-1.21, p = 0.54; obese IRR = 0.75, 95%CI = 0.51-1.12, p = 0.16). However, the multivariable fractional polynomial model showed an inverted U shaped relationship with a decreasing ΔDMFS with increasing BMI (p < 0.05). This population-based longitudinal study showed an inverse association between obesity and ΔDMFS over a 2.5-year period among South Brazilian adolescents.

Humans , Male , Female , Child , Dental Caries/etiology , Dental Caries/epidemiology , Obesity/complications , Obesity/epidemiology , Socioeconomic Factors , Brazil/epidemiology , Body Mass Index , DMF Index , Epidemiologic Methods , Overweight/complications , Overweight/epidemiology
Braz. dent. j ; 29(3): 290-295, May-June 2018. tab, graf
Article in English | LILACS | ID: biblio-951552


Abstract The aim of this randomized clinical trial was to compare the remaining microbial load after treatments based on complete and selective caries removal and sealing. Patients with active carious lesions in a permanent molar were randomly allocated into 2 groups: a test group (selective caries removal-SCR; n=18) and a control group (complete caries removal - CCR; n=18). Dentin samples were collected following the excavation and three months after sealing. Streptococcus species, Streptococcus mutans, Lactobacillus species, and total viable microorganisms were cultured to count the viable cells and frequency of species isolation. CCR resulted in significant lower total viable microorganisms counts (p≤0.001), Streptococcus species (p≤0.001) and Lactobacillus species (p≤0.001) initially. However, after sealing, a decrease in total viable microorganisms, Streptococcus species, and Lactobacillus species in the SCR resulted in no difference between the groups after 3 months. In conclusion, selective caries removal is as effective as complete caries removal in reducing dentin bacterial load 3 months after sealing.

Resumo O objetivo deste ensaio clínico randomizado foi comparar os microrganismos remanescentes após tratamentos baseados em remoção total de tecido cariado e selamento e a remoção seletiva de tecido cariado e selamento. Pacientes com lesões de cárie ativas em molares permanentes foram divididos aleatoriamente em dois grupos: grupo teste (remoção seletiva de tecido cariado-SCR; n=18), e grupo de controle (remoção total de tecido cariado-CCR; n=18). Amostras de dentina foram obtidas após a remoção da tecido cariado e após 3 meses de selamento das cavidades. Streptococcus spp., Streptococcus mutans, Lactobacillus spp. e microrganismos viáveis totais foram cultivados para contagem de células e frequência de isolamento de espécies. CCR resultou em menores contagens totais de microorganismos viáveis (p≤0,001), Streptococcus spp. (p≤0,001) e Lactobacillus spp. (p≤0,001) inicialmente. Entretanto, após o selamento, uma redução significativa nas contagens totais de microrganismos viáveis, Streptococcus spp. e Lactobacillus spp. resultou em nenhuma diferença entre os grupos após 3 meses. Conclui-se que a remoção seletiva de cárie é tão seletiva quanto a remoção completa de cárie na redução da infecção dentinária após três meses com selamento da lesão.

Humans , Male , Female , Child , Adolescent , Adult , Young Adult , Pit and Fissure Sealants , Bacteria, Anaerobic/isolation & purification , Dental Caries/therapy , Bacterial Load , Lactobacillus/isolation & purification , Molar/microbiology , Streptococcus/isolation & purification , Case-Control Studies , Double-Blind Method , Molar/diagnostic imaging
Braz. oral res. (Online) ; 31: e44, 2017. tab, graf
Article in English | LILACS | ID: biblio-839538


Abstract This randomized clinical trial aimed to assess the efficacy of sealing occlusal carious lesions in permanent teeth. The sample consisted of 54 occlusal carious lesions in permanent molars and premolars of 49 patients aged 8–43 years (median: 19 years). The inclusion criteria comprised the presence of a cavity with no access allowing biofilm control. The maximum depth of the lesion was the middle third of the dentin thickness, as assessed by bitewing radiography. The teeth were randomly assigned to sealant treatment (n = 28) or restorative treatment (n = 26). Clinical and radiographic examinations were performed after 1 year and after 3–4 years. The outcomes depended on the clinical performance of the sealant/restoration and the control of caries progression observed radiographically. Survival analysis was performed to assess success rates. Over the 3-4 years of monitoring, 2 sealants were totally lost, 1 needed repair, and 1 showed caries progression, totaling 4 failures in the sealant group. In the restoration group, 1 failure was observed (in need of repair). The success rates were 76% and 94% in the sealant and the restoration groups, respectively (p > 0.05). The sealing of occlusal carious lesions in permanent teeth succeeded in controlling caries over a 3–4-year period. However, sealed carious lesions require patient compliance in attending regular follow-ups to control the occurrence of clinical failures of the sealants.

Humans , Male , Female , Child , Adolescent , Adult , Young Adult , Dental Caries/therapy , Dentin-Bonding Agents/therapeutic use , Dentin/drug effects , Pit and Fissure Sealants/therapeutic use , Dental Caries/diagnostic imaging , Dental Enamel/diagnostic imaging , Dental Enamel/drug effects , Dental Restoration Failure , Dental Restoration, Permanent/methods , Dentin/diagnostic imaging , Follow-Up Studies , Radiography, Bitewing , Statistics, Nonparametric , Time Factors , Treatment Outcome
RFO UPF ; 20(1)jan.-abr. 2015.
Article in Portuguese | LILACS-Express | LILACS | ID: lil-758378


Objetivos: o objetivo deste estudo foi avaliar a efetividade da remoção parcial de tecido cariado (RPTC) de lesões de cárie profundas e restauração em uma única sessão de forma comparativa ao tratamento expectante (TE) em seis anos de acompanhamento. Materiais e método: o estudo foi realizado em Porto Alegre e Brasília. A amostra incluiu pacientes com molares permanentes com lesões de cárie profundas (metade interna de dentina), sem lesão periapical ao exame radiográfico, resposta positiva ao teste de frio, negativa à percussão e ausência de dor espontânea. Esses foram randomicamente atribuídos ao grupo teste (RPTC), recebendo remoção incompleta de tecido cariado e restauração em uma sessão, ou controle (TE). Após, os dentes foram restaurados com resina composta ou amálgama. O desfecho avaliado foi vitalidade pulpar (sensibilidade ao teste térmico, sensibilidade à percussão e ausência de alteração periapical). Análises de sobrevivência foram realizadas para estimar as taxas de sucesso do tratamento e definir variáveis associadas, utilizando o modelo de regressão de Weibull. Foram executados 299 tratamentos, sendo 152 RPTC e 147 TE. Resultados: somente o acompanhamento dos tratamentos realizados em Porto Alegre foi realizado. Após 6 anos, 127 dentes foram avaliados. Foram observadas taxas de sucesso de 60% para RPTC e 32% para TE (p<0,05). Dentre as variáveis analisadas, somente a tipo de tratamento apresentou associação significativa à manutenção da vitalidade pulpar, sendo favorável à RPTC. Conclusão: RPTC pode ser alternativa viável no tratamento de lesões profundas de cárie, mostrando melhora significativa em relação à manutenção da vitalidade pulpar quando comparado ao TE.

Clín. int. j. braz. dent ; 9(2): 186-191, abr.-jun. 2013. ilus
Article in Portuguese | LILACS, BBO | ID: lil-764862


O aumento na ocorrência de fluorose dentária, observado nos últimos anos, tende a promover maior procura pela resolução estética dos manchamentos, o que é geralmente feito com a aplicação de técnicas de erosão-abrasão. Pode-se supor que a abrasão fisiológica e a erosão ácida que ocorrem ao longo da vida atuem no sentido de atenuar a severidade das manchas de fluorose. O presente artigo apresenta um caso de atenuação de manchamentos por fluorose dentária nos dentes anteriores de um paciente de 36 anos que aos 15 havia recebido tratamento erosivo-abrasivo apenas em seus incisivos 11 e 21. Isso permitiu que, após duas décadas, fosse possível comparar os dentes tratados com aqueles que sofreram apenas desgaste fisiológico e a constatação de que, embora as manchas ainda permaneçam, o aspecto de ambos é estético e socialmente aceitável.

The increased prevalence of dental fluorosis observed in recent years tends to promote an increased demand for esthetic resolution of tooth staining, which is usually made by erosion-abrasion techniques. It can be assumed that the physiological abrasion and acid erosion that occur throughout life act to mitigate the severity of fluorosis. This article presents a case of mitigation of fluorosis stains in the anterior teeth of a 36-year-old patient who had received, at 15 years, erosive/abrasive treatment only on his incisors 11 and 21. After two decades, it was possible to compare the treated teeth with those who suffered only physiological wear. It was possible to find that in spite the stains were still present, their clinical aspect is esthetic and socially acceptable.

Humans , Male , Adolescent , Adult , Dentifrices , Enamel Microabrasion , Esthetics, Dental , Fluorosis, Dental
Clín. int. j. braz. dent ; 8(2): 206-211, abr.-jun. 2012. ilus
Article in Portuguese | LILACS, BBO | ID: lil-716626


O presente artigo discute a indicação do tratamento restaurador para lesões cariosas, utilizando como exemplo o caso de uma paciente com atividade de doença cárie durante o período de erupção dos molares permanentes. O diagnóstico precoce da lesão permitiu sua inativação, por meio de abordagem não invasiva. O controle longitudinal do caso foi possível por 18 meses. Após 10 anos sem contato com a paciente, ela retornou com o dente em questão restaurado. O “selamento biológico”, o estabelecimento da oclusão funcional e a superficialidade e amplitude da restauração permitem questionar a indicação do procedimento restaurador executado

This paper discusses the indication of restorative treatment for carious lesions considering a young patient with caries active disease, treated during the period of eruption of permanent molars. Early diagnosis led to caries inactivation by means of a non-invasive approach. Longitudinal control of the disease was possible for 18 months. After 10 years without contact, the patient returned and it was possible to observe that the tooth has been restored. The quality of the “biological sealing”, the occlusal function and the thinness and extension of the restoration led us to question the indication of the restorative procedure executed

Dental Caries , Dental Restoration, Permanent , Molar
Rev. Fac. Odontol. Porto Alegre ; 53(1): 21-26, jan.-abr. 2012. tab
Article in English | LILACS, BBO | ID: lil-719542


Aim: To compare different methods for evaluating composite resin restorations in posterior teeth and to evaluate the reliability of each method by determining the intraobserver agreement. Material and methods: 136 class I resin composite restorations were evaluated by a trained examiner using modified Ryge criteria to assess selected restoration characteristics with three different methods: clinical, photographic and dental cast models.Results: The results showed that intraexaminer agreement was better on dental cast models evaluations for marginal integrity and anatomic form and was similar between photographic and clinical evaluations for marginal integrity and marginal discoloration. Surface texture showed the lowest degree of intraexaminer agreement with all the methods tested. Direct clinical method and the two indirect methods were significantly different for all the characteristics assessed (p<0.05). Photographs and dental cast models methods gave higher mean ranks than direct clinical method for marginal integrity and anatomic form. Photographs and dental cast models evaluations were similar for all the characteristics assessed, except for surface texture (p<0.05). Conclusion: All of the methods were different for all the characteristics assessed. The highest Intraexaminer agreement was obtained from dental cast models evaluation. All the methods showed that are not adequate to evaluate surface texture.

Objetivo: Comparar diferentes métodos para avaliação de restaurações de resina composta em dentes posteriores e avaliar a confiabilidade de cada método através da determinação deconcordância intraexaminador.Materiais e Métodos: 136 restaurações Classe I de resina composta foram avaliadas por um examinador treinado utilizando o critério de Ryge modificado através três métodos diferentes: clínico, fotográfico e modelos de gesso.Resultados: Os resultados mostraramque a concordância intraexaminador foi melhor em avaliação em modelos de gesso para integridade marginal e forma anatômica, e foi similar entre fotografiase avaliação clínica para integridade marginal e descoloração marginal. A textura superficial mostrou a menor concordância intraexaminador para todos os métodos testados. O método clínico direto e os dois métodos indiretos foram diferentes significativamentepara todas as características analisadas (p<0,05). Fotografias e modelos de gesso forneceram maio res médias ranqueadas do que o método clínico direto para integridade marginal e forma anatômica. As avaliações através de fotografias e modelos de gesso foram similares para todas as categorais avaliadas, exceto para textura superficial (p<0,05). Conclusões: Todos os métodos foram diferentes para as características avaliadas. A maior concordância intraexaminador foiobtida com a avaliação através de modelos de gesso. Nenhum dos métodos foi adequado para avaliação da textura superficial.

Humans , /methods , Composite Resins , Dental Restoration, Permanent , Reproducibility of Results
Rev. Fac. Odontol. Porto Alegre ; 52(1/3): 33-37, jan.-dez. 2011. tab
Article in English | LILACS, BBO | ID: lil-719551


Objetivo: Comparar o material restaurador indicado no tratamento de dentes posteriores de acordo com o ensino e realização dos tratamentos em duas Faculdades de Odontologia (UFRGS e ULBRA) e em 8 unidades básicas de saúde (UBS) do Sistema de Saúde Pública em Porto Alegre, Brasil. Materiais e Métodos: Os dados referentes ao ensino de procedimentos restauradores utilizando amálgama (AM) ou resina composta (RC) foram obtidos através da análise de prontuários de pacientes a questionários aplicados aos estudantes de Odontologia do último ano. Informações sobre os procedimentos restauradores nas UBS foram obtidas através de prontuários de pacientes e de questionários aplicados aos dentistas. O tipo de material restaurador utilizado nas Faculdade de Odontologia e nas UBS forma comparados através de teste Qui-quadrado. Resultados: Na UFRGS, 327 restaurações foram realizadas, sendo 78,28% RC e 21,72% AM; na ULBRA, 366 restaurações foram efetuadas, sendo 92,63% RC e 7,37% AM. Nas UBS, 1664 restaurações foram realizadas, sendo 35,93% RC e 64,07% AM. Uma maior proporção de restaurações de AM foram realizadas no Serviço Público de Saúde em comparação às Faculdades de Odontologia, nas quais restaurações com RC foram mais prevalentes (p=0.000). Conclusões: A mudança de AM para RC na escolha do material restaurador para dentes posteriores em Faculdades de Odontologia não foi seguida pelo Sistema Público de Saúde, onde o AM ainda é largamente utilizado.

Aim: To compare the restorative material used in the treatment of posterior teeth taught and performed in two Dental Schools (UFRGS and ULBRA) and in 8 basic health units (BHU) from the Public Health System in Porto Alegre, Brazil. Materials and methods: Data referring the teaching of restorative procedures using amalgam (AM) or resin (R) were obtained through the analysis of patient’s files and questionnaires applied to final year dental students. Information regarding restorative procedures at BHU was obtained through patient’s records and a questionnaire applied to the dentists. The type of restorative material used in both BHU and Dental Schools were compared by chi-square test. Results: At UFRGS, 327 restorations were performed, 78.28% R and 21.72% AM, and at ULBRA 366 restorations, 92.63% R and 7.37% AM. At BHU, 1664 restorations were performed (35.93% R and 64.07% AM). A major proportion of AM restorations was performed in the Public Health Service in comparison to both Dental Schools, in which resin restorations prevailed (p=0.000). Conclusion: The change from AM to R in the dental material choice for posterior teeth at Dental Schools was not followed by the Public Health System, where the AM is still widely used in posterior teeth.

Composite Resins , Dental Amalgam , Dental Restoration, Permanent , Schools, Dental , Unified Health System
Rev. odonto ciênc ; 26(1): 30-34, 2011. tab
Article in English | LILACS, BBO | ID: lil-588598


PURPOSE: This investigation evaluated in a randomized controlled study the effect of different 1 percent chlorhexidine varnish (1 percentCHX-V) regimens on biochemical composition of the dental biofilm. METHODS: Subjects with mutans streptococci > 10(5) CFU/mL saliva, were allocated into 4 groups: A - single 1 percent CHX-V application; B - 1 percent CHX-V was applied once daily on 3 consecutive days; C - 1 percent CHX-V was applied 3 times with an interval of 4 days between each application; and D - placebo varnish was applied once daily on 3 consecutive days. Dental biofilm samples were collected at baseline and 1, 4, and 8 weeks after the final varnish application and evaluated for inorganic phosphate and insoluble polysaccharide concentrations. RESULTS: No difference was observed between all groups during the different experimental periods in relation to biochemical composition. After 1 week, a significant increase was observed in inorganic phosphate concentration, returning to baseline values after 4 weeks. All groups showed a significant decrease in insoluble polysaccharide concentration for more than 8 weeks after treatment. CONCLUSION: Varnish application resulted in modification of the dental biofilm toward a less cariogenic one.

OBJETIVO: Este estudo avaliou o efeito de diferentes posologias do verniz de clorexidina a 1 por cento (V-CHX1 por cento) na composição bioquímica do biofilme dental. METODOLOGIA: Voluntários com níveis de Streptococcus mutans > 10(5) UFC/mL saliva, foram divididos em 4 grupos: A - uma única aplicação do V-CHX1 por cento; B - aplicações de 1x/dia do V-CHX1 por cento durante 3 dias consecutivos; C - 3 aplicações de 1x/dia do V-CHX1 por cento com intervalos de 4 dias entre elas; D - aplicações de 1x/dia do verniz placebo durante 3 dias consecutivos. Amostras de biofilme dental foram coletadas, no início e após 1, 4 e 8 semanas das aplicações dos vernizes, e analisadas quanto às concentrações de fosfato inorgânico (Pi) e polissacarídeos insolúveis (PI). RESULTADOS: Não foram observadas diferenças, em relação à composição bioquímica, entre os grupos durante os diferentes períodos experimentais. Foi observado, após 1 semana, um aumento significativo nas concentrações de Pi, retornando aos valores iniciais após 4 semanas. Todos os grupos apresentaram uma redução significativa na concentração de PI por mais de 8 semanas após os tratamentos. CONCLUSÃO: A aplicação do verniz resultou em uma modificação do biofilme dentário tornando-o menos cariogênico.

Humans , Male , Female , Chlorhexidine/administration & dosage , Dental Plaque/chemistry , Streptococcus mutans
Braz. oral res ; 24(4): 388-393, Oct.-Dec. 2010. tab
Article in English | LILACS | ID: lil-569215


The effect of a combination of topical fluoridation methods for inhibition of enamel demineralization in the face of a cariogenic challenge has not been clearly established. This in situ crossover study aimed to assess whether the addition of daily use of fluoride mouthrinse (FR) to that of fluoride dentifrice (FD) is equivalent to increasing the frequency of FD application in terms of the effect on enamel demineralization and fluoride content. Over 3 phases of 14 days each, 12 volunteers wore appliances containing enamel blocks exposed to a 20 percent sucrose solution 8 times/day. During each phase the blocks underwent one of the following treatments: 2x/day FD, 2x/day FD + 1x/day FR, and 3x/day FD. The blocks were assessed for hardness and fluoride content. Three x/day FD did not differ from 2x/day + 1x/day FR, however it enhanced demineralization protection when compared to 2x/day FD. All treatments produced an increase in enamel fluoride content compared to no treatment (sound blocks) (p < 0.05), but the differences between them were not significant. The results of this study suggest that the daily use of fluoride mouthrinse combined with that of fluoride dentifrice has similar effects on enamel demineralization and fluoride content when compared to increasing the frequency of fluoride dentifrice use.

Humans , Young Adult , Cariostatic Agents/administration & dosage , Dental Caries/prevention & control , Dental Enamel/drug effects , Dentifrices/administration & dosage , Fluorides, Topical/administration & dosage , Mouthwashes/administration & dosage , Analysis of Variance , Cross-Over Studies , Hardness Tests , Single-Blind Method , Surface Properties , Time Factors , Tooth Demineralization/etiology , Young Adult
Rev. Fac. Odontol. Porto Alegre ; 51(3): 23-29, set.-dez. 2010. ilus, tab, graf
Article in English | LILACS, BBO | ID: lil-719576


Objetivo: O objetivo deste estudo foi analisar as características de cárie secundária e sua relação com a presença de restaurações com defeitos marginais como gap, degrau negativa (NL, a falta de material restaurador) e degrau positiva (PL, saliência). Materiais e Métodos: Oitenta superfícies proximais de restaurações de resina classe II foram fotografados e analisados utilizando um microscópio estereoscópico (X40). Foi registrada a presença de cáries secundárias externas, gaps, NL, PL e após a remoção de restaurações, a presença de lesão interna. Todos os exames foram realizados em 10 pontos bem definidos. Resultados: A prevalência de cárie secundária e gap foram associados com margem gengival. As restaurações com defeitos marginais (NL e PL) não foram associados a qualquer local específico (vestibular, lingual ou gengival). Observou-se uma relação entre esses defeitos com a prevalência de cárie secundária. A presença da lesão interna foi associada com lesão externa. Embora, em 141 pontos foi observada lesão interna, sem a presença de lesão externa. A maioria destas lesões mostraram envolvimento de esmalte interno. Apenas 8 por cento tinham desmineralização restrito a dentina, que poderia sugerir cárie residuais.

Objective: The aim of this study was to analyze the features of secondary caries and their relationship with the presence of restorations marginal defects as gap, negative ledge (NL, lack of restorative material) and positive ledge (PL, overhang). Materials and methods: Eighty proximal surfaces of Class II resin restorations were photographed and analyzed using a stereomicroscope (X40). It was recorded the presence of external secondary caries, gaps, NL, PL and after the restorations removal, the presence of internal lesion. All the exams were done in 10 welldefined points. Results: The prevalence of secondary caries and gap were associated with gingival margin. The restorations marginal defects (NL and PL) were not associated with any specific location (buccal, lingual or gingival). It was observed a relationship between these defects with secondary caries prevalence (gap: p= 0.004; NL and PL: p= 0.017). This association could be explained by the biofilm accumulation usually observed in the interface tooth surface/ restoration marginal defects. The presence of internal lesion was associated with external lesion. Although, in 141 points was observed internal lesion without the presence of external lesion. The majority of these lesions showed internal enamel involvement. Only 8 percent had demineralization restricted to dentine, which could suggest residual caries. Conclusion: The results of this study showed that secondary caries lesion frequently began externally on the interface tooth/restoration, where diagnose, control and arrestment of the lesions is possible.

Composite Resins , Dental Caries , Microscopy , Dental Restoration, Permanent/adverse effects , Surface Properties
Rev. Fac. Odontol. Porto Alegre ; 51(2): 15-18, maio-ago. 2010. ilus, tab
Article in English | LILACS, BBO | ID: lil-719559


O objetivo deste estudo foi analisar morfologicamente o início da lesão de cárie secundária. Trinta e três superfícies proximais adjacentes a restaurações de resina classe II foram examinadas ao estereomicroscópio (40x) para a presença de carie e gap. Sessenta sítios (39 sadios, 7 com lesões, 14 adjacentes a lesões) foram preparados para exame utilizando microscopia de luz polarizada. As lesões foram observadas em 52,7% dos corte úmidos e 85,0% dos cortes secos. Os cortes secos demonstraram lesões maiores. Analises posteriores foram realizadas nos cortes secos. Cem por cento das secções observadas no estereomicroscópio, 87,2% das lesões hígidas, e 71,4% dos sítios adjacentes a lesões demonstraram áreas desmineralizadas. A análise morfológica indicou que a lesão cariosa inicia na superfície de esmalte externa na interface entre dente e restauração. Dois padrões distintos de desenvolvimento de carie foram observados, relacionados à direção dos prismas de esmalte: (1) a direção dos prismas no esmalte adjacente foi paralela à parede da cavidade (a parte mais profunda da penetração da cárie foi localizada na parede da cavidade), e (2) a direção dos prismas corria na direção apical (a parte mais profunda da penetração da cárie foi obliqua à parede da cavidade). O padrão 1 pode ser confundido por uma parede da lesão. A prevalência de lesões adjacentes às restaurações foi similar em sítios com (85,7%) e sem (84,0%) gaps. Os achados suportam o pressuposto de que o inicio da lesão de cárie secundária in vivo não está relacionado à presença de um gap e segue a direção dos prismas de esmalte.

The aim was to analyze morphologically the initiation of secondary caries lesion. 33 proximal surfaces adjacent to Class II resin restorations were examined by stereomicroscope (x40) for the presence of caries and gap. 60 sites (39 sound, 7 with lesions, 14 adjacent to lesions) were prepared for examination using polarized light microscopy. Lesions were observed in 52.7% of the wet sections and 85.0% of the dried sections. Dried ground sections displayed larger lesions. Further analyses were performed on dried sections. 100% of ground sections from the stereomicroscope carious sites, 87.2% from sound sites, and 71.4% from sites adjacent to lesions displayed demineralized areas. Morphological analysis indicated that caries lesion initiates at the external enamel surface in the interface between tooth and restoration. Two distinct patterns of caries development were observed, related to the direction of enamel rods: (1) the direction of the rods in the adjacent enamel was parallel to the cavity wall (the deepest part of caries penetration was located at the cavity wall), and (2) the direction of the rods ran in the apical direction (the deepest part of caries penetration was oblique to the cavity wall). The pattern 1 could be mistaken for a wall lesion. The prevalence of lesions adjacent to restorations was similar in the sites with (85.7%) and without (84.0%) gaps. The findings support the assumption that secondary caries initiation in vivo is not related to the presence of a gap and follows the direction of the enamel rods.

Composite Resins , Dental Caries , Histology , Microscopy , Dental Restoration, Permanent/adverse effects
Rev. Fac. Odontol. Porto Alegre ; 51(1): 20-23, jan.-abr. 2010. tab
Article in English | LILACS, BBO | ID: lil-719566


O objetivo deste ensaio clínico controlado randomizado multicêntrico foi avaliar a efetividade da remoção parcial de dentina cariada seguida de restauração em única sessão (RPDC) em lesões de cárie profundas no Brasil (Porto Alegre e Brasília) após dois anos de acompanhamento. Critérios de inclusão: pacientes com ≥ seis anos de idade apresentando molares permanentes com lesões profundas primárias, ausência de alteração periapical, sensibilidade pulpar, ausência de dor espontânea e sensibilidade à percussão negativa. Os indivíduos foram randomicamente atribuídos ao grupo teste - RPDC, ou grupo controle - tratamento expectante (TE). O TE consistiu na remoção parcial de dentina cariada, capeamento pulpar indireto com cimento de hidróxido de cálcio, restauração provisória com cimento de óxido de zinco e eugenol, reabertura da cavidade após 60 dias, remoção da dentina cariada remanescente amolecida e restauração. Cada grupo foi dividido de acordo com o material restaurador: amálgama ou resina. Avaliações clínicas e radiográficas foram realizadas anualmente. Os desfechos considerados foram sensibilidade pulpar ao teste frio e ausência de alteração periapical. Foram executados 299 tratamentos, 153 RPDC e 146 TE. Não houve diferença entre os grupos em relação às características basais. Após dois anos de acompanhamento, foram avaliadas 181 restaurações e a taxa de sobrevivência dos tratamentos RPDC e TE foram 95,45% e 80,85%, respectivamente (p=0,001). Razões dos insucessos: pulpites, osteíte, hiperemia, necroses, extração e fratura da restauração. Nenhuma variável foi significativamente associada ao desfecho. A partir destes resultados, é possível concluir que a RPDC é um tratamento mais efetivo que o TE.

The aim of this multicenter randomized controlled clinical trial was to evaluate the effectiveness of partial caries removal followed by restoration in a single session (PDR) for deep caries lesions in Brazil (Porto Alegre and Brasilia) after 2-year follow-up. Inclusion criteria: patients with ≥ six years old presenting permanent molars with primary deep lesion, absence of periapical alterations, pulp sensitivity, absence of spontaneous pain and negative percussion test. The subjects were randomly assigned to test group - PDR, or control group - stepwise excavation (SW). SW consisted of partial removal of carious dentine, indirect pulp capping with calcium hydroxide cement, temporary filling, cavity re-opening after 60 days, removal of the remaining soft carious dentine and filling. Each group was divided according to the filling material: amalgam or resin. Clinical and radiographic evaluations were performed in annual basis. The outcomes were considered as pulp sensibility to cold test and absence of periapical alterations. There were performed 299 treatments, 153 PDR and 146 SW. There were no differences between the groups regarding baseline characteristics. After 2 years of follow-up, 204 restorations were evaluated and the therapy survival rates of PDR and SW were 95.45% and 80.85%, respectively (p=0.001). Reasons for failure: pulpitis, osteitis, hyperemia, necrosis, extraction and restoration fracture.. None variable was significantly associated with the outcome. From these results, it is possible to conclude that the PDR is a more successful treatment than SW.

Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Composite Resins , Dental Amalgam , Dental Caries , Dental Restoration, Permanent , Dental Restoration, Temporary , Dentin
Braz. oral res ; 24(supl.1): 18-25, 2010.
Article in English | LILACS | ID: lil-557862


The central idea of the Brazilian health system is to prevent the establishment of disease or detect it as early as possible. Prevention and treatment of dental caries are related to behavioral factors, including dietary and oral hygiene habits, which are related to many chronic diseases. Dental health promotion therefore should be fully integrated into broadly based health-promoting strategies and actions such as food and health policies, and general hygiene (including oral hygiene), among others. For decades, a linear relationship between sugar consumption and caries has been observed. Recent data has indicated that this relationship is not as strong as it used to be before the widespread use of fluoride. However, diet is still a key factor acting in the carious process. Oral hygiene is a major aspect when it comes to caries, since dental biofilm is its etiological factor. Oral hygiene procedures are effective in controlling dental caries, especially if plaque removal is performed adequately and associated with fluoride. An alternative to a more efficient biofilm control in occlusal areas is the use of dental sealants, which are only indicated for caries-active individuals. If a cavity is formed as a consequence of the metabolic activity of the biofilm, a restorative material or a sealant can be placed to block access of the biofilm to the oral environment in order to prevent caries progress. The prevention of dental caries based on common risk-factor strategies (diet and hygiene) should be supplemented by more disease-specific policies such as rational use of fluoride, and evidence-based dental health care.

Humans , Diet, Cariogenic , Dental Caries/prevention & control , Dental Plaque/prevention & control , Health Promotion , Oral Hygiene , Biofilms , Brazil , Dental Caries/etiology , Feeding Behavior , Fluorides/therapeutic use , Oral Health , Primary Health Care , Risk Factors
Braz. oral res ; 23(supl.1): 17-22, 2009. graf, tab
Article in English | LILACS | ID: lil-528425


This literature review reports the history and the current market of oral home-care products. It provides information extending from the products used by our ancestors to those currently available, as well as on the changes in the supply and consumption of these products. Although the scientific knowledge about oral diseases has improved greatly in recent years, our ancestors had already been concerned with cleaning their teeth. A variety of rudimentary products and devices were used since before recorded history, like chewing sticks, tree twigs, bird feathers, animal bones, tooth powder and home-made mouth rinses. Today, due to technological improvements of the cosmetic industry and market competition, home-use oral care products available in the marketplace offer a great variety of options. An increase in the consumption of oral care products has been observed in the last decades. Estimates show that Latin America observed a 12 percent increase in hygiene and beauty products sales between 2002 and 2003, whereas the observed global rate was approximately 2 percent. A significant increase in the per capita consumption of toothpaste, toothbrush, mouthrinse and dental floss has been estimated from 1992 to 2002, respectively at rates of 38.3 percent, 138.3 percent, 618.8 percent and 177.2 percent. Pertaining to this increased supply and consumption of oral care products, some related questions remain unanswered, like the occurrence of changes in disease behavior due to the use of new compounds, their actual efficacy and correct indications, and the extent of the benefits to oral health derived from consuming more products.

History, 17th Century , History, 18th Century , History, 19th Century , History, 20th Century , History, 21st Century , History, Ancient , History, Medieval , Humans , Dental Devices, Home Care/history , Mouthwashes/history , Oral Hygiene/history , Toothpastes/history , Commerce/history , Commerce/statistics & numerical data , Cosmetics/supply & distribution , Dental Devices, Home Care/supply & distribution , Dental Devices, Home Care , Drug Industry/history , Drug Industry/statistics & numerical data , Mouthwashes/supply & distribution , Oral Health , Oral Hygiene , Toothbrushing/history , Toothbrushing , Toothpastes/supply & distribution
Braz. oral res ; 22(2): 139-144, 2008. graf, tab
Article in English | LILACS | ID: lil-485953


The aim of the present study was to evaluate the effect of two chlorhexidine rinsing solutions (0.12 percent and 0.2 percent) on plaque and gingival bleeding. Ten dental students participated in this double-blind, cross-over study, rinsing twice a day, for one minute, with each one of the tested solutions for fourteen days. A wash-out period of one week between treatments was observed. In order to assess gingival bleeding, the van der Weijden et al.¹ (1994) index was used. The plaque indexes used were those of Quigley, Hein² (1962) and Silness, Löe³ (1964). In the pre-experimental period, subjects received oral hygiene instructions and dental prophylaxis. The results revealed no significant differences between both concentrations in relation to plaque and gingival bleeding. Mean values (± standard deviation) of the Quigley & Hein index were 0.25 ± 0.16 for the 0.12 percent solution and 0.23 ± 0.26 for the 0.2 percent solution (p = 0.4838). Mean values (± standard deviation) of the Silness-Löe index were 0.12 ± 0.10 for the 0.12 percent solution and 0.11 ± 0.11 for the 0.2 percent solution (p = 0.7592). The bleeding index mean values at the end of the study were not different for both concentrations with mean values (± standard deviation) of 14.93 percent ± 6.68 percent and 13.95 ± 9.24 percent for the 0.12 percent and 0.2 percent solutions, respectively. Although an increase in gingival bleeding was observed, both concentrations were able to control dental plaque.

Adult , Female , Humans , Male , Young Adult , Anti-Infective Agents, Local/administration & dosage , Chlorhexidine/administration & dosage , Dental Plaque/prevention & control , Gingival Hemorrhage/prevention & control , Mouthwashes/administration & dosage , Cross-Over Studies , Dental Plaque Index , Double-Blind Method , Gingivitis/prevention & control , Periodontal Index , Statistics, Nonparametric , Young Adult
Rev. Fac. Odontol. Porto Alegre ; 46(1): 64-69, jul. 2005.
Article in Portuguese | LILACS, BBO | ID: lil-436355


A estrutura mineral dentária depende do ambiente oral. Quando exposta ao meio bucal, alterações de temperatura, capacidade tampão e pH da placa podem levar à solubilização dos cristais de hidroxiapatita. Valores de pH inferiores a 5,5 criam condições para que haja aumento da solubilidade e dissolução dos cristais do esmalte. Quando episódios de redução do pH são intercalados por períodos maiores de retorno ao pH fisiológico, há um retorno ao equilíbrio entre os íons provenientes da saliva e do esmalte dentário. No entanto, quando períodos de pH crítico tornam-se mais freqüentes, pode ocorrer o predomínio da saída de íons do dente, formando uma lesão de cárie. O controle desse desequilíbrio entre os processos de des e remineralização, levando à paralisação do desenvolvimento da lesão, pode ser obtido através da modificação de fatores locais, como alterações na dieta, no padrão de higiene bucal e com o uso de fluoretos. A compreensão do processo de formação e paralisação da lesão possibilita o diagnóstico de estágios mais precoces de perda mineral, assim como o estabelecimento de medidas de controle de progressão da lesão. Este trabalho se propõe a revisar o conhecimento sobre o papel do flúor no processo de formação e controle da lesão de cárie. Para tanto, é fundamental o entendimento prévio dos fenômenos que ocorrem durante os estágios de formação de lesão (lesão ativa) e de seu controle (lesão inativa)

Acidulated Phosphate Fluoride , Dental Caries/prevention & control , Dentifrices , Fluorides , Tooth Demineralization , Tooth Remineralization