Envejecimiento dental prematuro en deportistas / Premature dental aging in athletes

El desgaste natural de los dientes ocurre dependiendo de factores como: calidad de la estructura dental, calidad de la saliva, biotipo facial que determina la fuerza de mordida; de acuerdo a estos factores locales bucales se va envejeciendo la dentadura. Pero los deportistas presentan un patrón de desgaste mayor y continuo debido al tipo de deporte que practican, las horas de entrenamiento, el consumo de bebidas con pH ácido, el cepillado dental vigoroso; todos estos factores pueden conducirlos a que desarrollen lesiones no cariosas (AU)

The natural wear of the teeth occurs depending on factors such as: quality of the dental structure, quality of the saliva, facial biotype that determines the bite force, according to these local oral factors, the teeth age. But in athletes they present a pattern of greater and continuous wear due to the type of sport they practice, the hours of training, the consumption of drinks with an acidic pH, vigorous tooth brushing; all these factors can lead them to develop non-carious lesions (AU)

Alternativas de tratamiento para pacientes jóvenes con pérdida de estructura dentaria. Parte 1: caso clínico / Treatment alternatives for young patients with loss of dental structure. Part 1: a clinical Case

El objetivo de este artículo es presentar una alternativa de tratamiento rehabilitador para pacientes jóvenes con gran pérdida de estructura dental vinculada a lesiones de origen no bacteriano. Se presenta el caso clínico de un paciente de 36 años de edad, con reflujo gastroesofágico crónico bajo tratamiento médico, que concurrió a la Cátedra de Odontología Integral Adultos de la Facultad de Odontología de la Universidad de Buenos Aires (FOUBA), en busca de un cambio estético en su sonrisa y relatando sensibilidad al calor, al frío y dolor al masticar. No manifestó sintomatología dolorosa a nivel muscular ni articular. En función de sus posibilidades económicas y de la etiología erosiva de las lesiones existentes en sus piezas dentarias, se llevó a cabo una rehabilitación oral adhesiva con resinas compuestas utilizando la sistematización de atención que sugiere la Cátedra. Las resinas compuestas actuales, en combinación con las técnicas y procedimientos desarrollados en este artículo han demostrado un adecuado comportamiento al ser utilizadas como restauraciones definitivas en pacientes que necesitan rehabilitación oral total debido a la gran pérdida de estructura dental por erosión ácida (AU)

Alternativas de tratamiento para pacientes jóvenes con pérdida de estructura dentaria. Parte 2: caso clínico / Treatment alternatives for young patients with loss of dental structure. Part 2: a clinical case

El objetivo de este artículo es presentar una alternativa de tratamiento rehabilitador para pacientes jóvenes con gran pérdida de estructura dental, vinculada a lesiones de origen no bacteriano. Se presenta el caso clínico de un paciente de sexo masculino, de 39 años de edad, que acudió a la Cátedra de Odontología Integral Adultos de la Facultad de Odontología de la Universidad de Buenos Aires (FOUBA) relatando síntomas compatibles con hipersensibilidad dentaria y fatiga de los músculos masticadores. Al mismo tiempo, manifestó disconformidad con el aspecto estético de su sonrisa. Teniendo en cuenta la gran pérdida de sustancia en sus piezas dentarias producida por hábitos parafuncionales (bruxismo), se realizó una rehabilitación oral adhesiva con cerámicas utilizando el protocolo de abordaje terapéutico sugerido por la Cátedra. En pacientes que presentan severos desgastes (AU)

Validation of an adherence assay to detect group mutans streptococci in saliva samples / Validación del Test de adherencia para el recuento de estreptococcos del grupo mutans en muestras de saliva

The aim of the present study was to validate and establish a cut off point and the predictive value of an adhesion test (AA-MSMG), as a microbiological method for evaluating cariogenic risk. The study is based on a variant (20% sucrose) of a selective medium descripted by Gold et al. (MSMG). This method differentiates mutans group streptococci (MGS) by exacerbating the production of insoluble extracellular polysaccharide which gives adhesion to surfaces such as glass, plastic and dental enamel. Caries assessment according to ICDAS was conducted in 154 patients (aged >21 years) who were attended at Preventive and Community Dentistry Department, School of Dentistry, University of Buenos Aires, Argentina, between August 2017 to August 2018. The study population was assigned to groups according to the presence/ absence of caries lesions: Group A: ICDAS lesion code = 0 (L=0) on all dental surfaces (n=23); and Group B: L>1 (n=131). After mouth-rinsing with distilled water, saliva samples were collected with fasting and hygiene protocol, and sent immediately to the Microbiological Diagnosis Laboratory, Microbiology Department, School of Dentistry, University of Buenos Aires. Samples were homogenized and serially diluted to the tenth. 100 pl of the dilutions were cultured in 25 cm² sterile plastic flasks containing 9.9 ml of modified selective medium described by Gold (MSMG-selective and differential medium). Cultures were incubated in an anaerobic atmosphere at 36 ± 1°C for 48 hours. The supernatants were eluted and the samples washed with sterile distilled water. Colony forming unit counts were performed by calibrated researchers (Kappa >0.75) using a stereoscopic microscope at 50X. Mutans group streptococci (MGS) counts ranged from 1x10(4) to 1x10(5) CFU/ml in group A, and were higher than 1x10(6) CFU/ml in Group B. Statically analysis of results (ROC) showed that the AAMSMG has a satisfactory predictive value (91%) and established a cutoff point in 1.68x10(5) UFC / ml. This would indicate that individuals whose MGS saliva counts are higher than the cutoff value would be 5 times more likely to develop dental caries. Adherence assay could be a useful microbiological predictor of caries risk.

El objetivo del presente estudio fue validar, establecer el punto de corte y valor predictivo de una técnica microbiológica para evaluar el nivel de estreptococos del grupo mutans en saliva. La técnica consiste en un test de adherencia que emplea un medio selectivo modificado (20% sacarosa) descripto por Gold et al. (TA-MSMG). Este método permite diferenciar a los estreptococos del grupo mutans (SGM) exacerbando la producción del polisacárido extracelular insoluble que le confiere adhesión a superficies como vidrio, plástico y esmalte dental. De acuerdo con los criterios de ICDAS se sembraron 154 salivas de pacientes mayores de edad, que asistieron al Servicio de Odontología Preventiva y Comunitaria de la Facultad de Odontología de la Universidad de Buenos Aires entre los meses de agosto de los años 2017 y 2018. La población estudiada fue asignada a dos grupos según la presencia / ausencia de lesiones de caries: Grupo A: código de lesión ICDAS = 0 (L = 0) en todas las superficies dentales (n = 23); y Grupo B: L> 1 (n = 131). Después de realizar un enjuague bucal con agua destilada, las muestras de saliva se recogieron según protocolo (ayuno de 4 horas y suspensión de higiene dental de 12 hs). Las muestras se remitieron de inmediato al Laboratorio de Diagnóstico Microbiológico, Departamento de Microbiología de la Facultad de Odontología, Universidad de Buenos Aires. Para su procesamiento, las muestras fueron homogeneizadas y diluidas al décimo. Se cultivaron 100 pl de las diluciones en botellas de plástico estériles de 25 cm² que contenían 9,9 ml de medio de Gold modificado (MSMG-20% sacarosa). Los cultivos se incubaron en atmósfera anaeróbica a 36 ± 1°C durante 48 horas. El sobrenadante se eluyó y las muestras se lavaron con agua destilada estéril. Los recuentos de unidades formadoras de colonias SGMfueron realizados por investigadores calibrados (Kappa >0.75) utilizando un microscopio estereoscópico a 50X. Los recuentos de SGM presentaron una variación entre 1x10(4)y 1x10(5) UFC/ml en el grupo A, mientras que en el Grupo B fueron superiores a 1x10(6) UFC/ml. El análisis estadístico de los resultados determinó una curva ROC que establece para el TA-MSMG un valor predictivo del 91% y un punto de corte en 1.68x10(5) UFC SGM / ml. Esto indicaría que los individuos cuyos recuentos en saliva de SGM sean superiores al valor de corte, tendrían 5 veces más posibilidades de desarrollar caries (5:1). Este método podría ser un instrumento útil al momento de evaluar (indicador microbiológico) el riesgo cariogénico del paciente.

Prevalencia de lesiones cariosas proximales en molares temporales según ICDAS II y su correlación con el diagnóstico radiográfico, en niños de 4 a 9 años de edad

La caries dental se refiere a una patología que se caracteriza por la desmineralización progresiva, pasando por las primeras manifestaciones clínicas, hasta la pérdida del tejido dental propiamente dicho. El diagnóstico de la caries dental se limitaba únicamente a un punto final, la cavidad y la pérdida dental y no como en la actualidad, que se considera como todo un proceso de enfermedad. Sin embargo actualmente continúa siendo un problema de salud pública. El correcto diagnóstico de la caries dental es fundamental para disminuir este asunto, incluyendo áreas de difícil acceso como son las lesiones cariosas proximales. Realizar el diagnóstico clínico visual en la superficie interproximal es casi imposible, y en muchos casos se dan falsos negativos a la hora de realizar los diagnósticos; por lo tanto, es necesario utilizar métodos complementarios como la radiografía de aleta. En el presente estudio se utilizaron tanto el método clínico visual ICDAS II "(Sistema Internacional para la Detección y Evaluación de Caries), como el método diagnóstico radiográfico. Al realizar el examen clínico visual de las superficies proximales de las molares temporales, se utilizaron separadores de ortodoncia que lograron la separación temporal de las piezas, de manera que permitió un espacio físico para facilitar la valoración clínica y a su vez se implementó el ICDAS II " como instrumento para la evaluación de los niveles de severidad del proceso carioso en las diferentes superficies; de igual manera se tomaron radiografías de aleta en las mismas superficies dentales, valoradas con el examen clínico visual. El objetivo principal fue determinar la prevalencia de lesiones proximales en molares temporales, de acuerdo con los criterios de valoración y detección de caries ICDAS II y su correlación con el diagnóstico de la misma lesión observada con el método radiográfico. De las superficies observadas con el método diagnóstico clínico visual con separadores un 18,7% presentó superficies lesionadas con caries dental, mientras que con el método diagnóstico radiográfico mostró un 22,5% de superficies lesionadas con caries dental; se encontró una asociación fuerte entre el diagnóstico clínico visual y el radiográfico, con una probabilidad de 91,1% de hallar los mismos resultados con significancia estadística.

Tooth decay refers to a condition characterized by progressive demineralization, through the first clinical manifestations, to loss of tooth structure itself. The diagnosis of dental caries was limited only to an endpoint, cavity and at last, tooth loss. Now days it is considered tooth decay as a whole disease process. The disease remains a public health problem. The correct diagnosis of dental caries is essential to diminish this problem, including difficult access areas like the interproximal carious lesions. Performing visual clinical diagnosis in the proximal surface is almost impossible, and in many cases false negatives are given in the diagnosis, so it is necessary to use complementary methods such as x-rays. In this study both the visual clinical method ICDAS II (International Caries Detection and Assessment System) and the radiographic diagnostic method where used. When performing visual clinical examination of the proximal surfaces of molars, orthodontic separators achieved temporary separation of the tooth, so it allowed a physical space to facilitate clinical evaluation andimplemented ICDAS II as an instrument used for evaluating the severity levels of caries process in different areas; x rays were taken on the same tooth surfaces, valued with the visual clinical examination. The main objective was to determine the prevalence of interproximal lesions in molars according to the criteria of assessment and detection of ICDAS II caries and its correlation with the diagnosis of the same injury observed with radiographic method. 18.7% Surfaces observed with clinical diagnostic method with orthodontics separators showed surfaces with carious lesions, while the radiographic diagnosis method presented 22.5% of surfaces with carious lesions; a strong association between visual clinical diagnosis and radiographic diagnosis, with a 91.1% probability of finding the same results with statistical significance, allowing a generalization of the results.

Remineralizing efficacy of Calcarea Fluorica tablets on the artificial carious enamel lesions using scanning electron microscope and surface microhardness testing: In vivostudy.

Context: Remineralization is defined as the process whereby calcium and phosphate ions are supplied from a source external to tooth to promote ion deposition into crystal voids in demineralized enamel to produce net mineral gain. The remineralization produced by saliva is less and also a slow process, therefore remineralizing agents are required. Aims: The study was planned to evaluate the effectiveness of homeopathic Calcarea Fluorica (calc‑f) tablets as remineralizing agents on artificial carious lesions using scanning electron microscope (SEM) and surface microhardness (SMH) testing. Subjects and Methods: A total of 24 patients needing removable orthodontic treatment were included in the study. They were divided into two groups of 12 patients each. The Group I consisted of patients in whom no tablets were given while Group II consisted of patients in whom calc‑f tablets were given in a dosage of 4 tablets twice a day. Four enamel samples with the artificial carious lesions were then embedded in the removable appliance for a period of 6 weeks. After 6 weeks, the enamel samples were retrieved and evaluated by SEM and SMH. Statistical Analysis Used: One‑sample Kolmogorov–Smirnov test and Student’s t‑test were applied to analyze the difference in the Vickers microhardness number (VHN) values of remineralized enamel obtained from control and experimental group. Results: The signs of remineralization such as reduction in depth prismatic holes or decrease in porosity, variable sized uneven distribution of deposits and amorphous deposits were seen in enamel samples of both the groups. The mean SMH of remineralized enamel sample of Group I and Group II were 270.48 and 302.06, respectively, and the difference was statistically significant. Conclusions: (1) Remineralization occurred in both the groups as indicated by SEM and the increase in surface hardness values in both the groups. (2) Remineralization of enamel samples in the control group as indicated by SEM and also by increase in VHN values indicated that the saliva has a tendency of remineralizing the early carious lesions. Conclusions drawn from the study are that the calc‑f tablets can be used as safe and cost effective remineralizing agent.

Contribuição ao estudo da prevalência, do diagnóstico diferencial e de fatores etiológicos das lesões cervicais não-cariosas / Contribution to the study of the prevalence, distinguished diagnosis and etiologic factors of the not carious cervical injuries

As lesões cervicais não-cariosas constituem um grupo de lesões de grande complexidade na prática clínica odontológica, principalmente no que se refere à identificação do agente etiológico e ao tratamento proposto. Elas têm sido pesquisadas com maior interesse em decorrência da perda excessiva de tecido dentário na região cervical (junção amelocementária), que causa sensibilidade dentinária e problemas funcionais e estéticos. O objetivo deste trabalho foi avaliar a prevalência, o diagnóstico diferencial e os fatores etiológicos relacionados co essas lesões. Foram examinados 108 pacientes que se apresentaram na clínica de odontologia do UNICENP. Para participar do exame não houve restrição quanto a sexo, idade, raça, classe social, presença ou não de lesões cervicais. Foram coletados os dados necessários, e aqueles pacientes que apresentavam lesão de abfração severa foram selecionados, totalizando 66%. Para estes, aplicaram-se questionários específicos com abordagem no diagnóstico e nas causa etiológicas, totalizando 341 dentes afetados severamente por essa lesão. Observou-se que as lesões foram mais comuns em mulheres e existiu uma relação direta entre idade e dentes mais cometidos (69%), estando diretamente associada a má oclusão (58%) com hábitos nocivos e parafuncionais - apertamento (49%) e bruxismo (61%). Concluiu-se que a associação de fatores causais está, invariavelmente, presente

The not carious cervical injuries onstitute a group of injuries of great complexity in the dentistry clinic practice, mainly when it comes to the identification of the etiologic agent and to the proposed treatment. These injuries have been searched with greater interest due to teeth tissue extreme loss in the cervical region (amelo-cemental junction), that causes dentin sensitivity and functional and aesthetic problems. The objective of this work was to evaluate the prevalence, the distinguished diagnosis and the etiologic factors related with these injuries. 108 patients, who came to the Unicenp dentistry clinic, have been examined. To participate of the examination there was no sex, age, race, social class, presence or not of cervical injuries restriction. The necessary data have been collected, and that patients who presented injury of severe abfraction have been selected, totalizing (66%). For these, specific questionnaires, with approach in the diagnosis and the etiologic causes, have been applied, totalizing 341 teeth affected severely by this injury. There could be observed that the injuries had been more common in women and there was a more direct relation between age and more affected teeth (69%), being directly associated to the bad occlusion (58%) with harmful and parafunction habits (tightening 49% and bruxism 61%). It was concluded that, the association of causal factors is, invariably, present