Toothbrushing effects on the surface roughness and cement volume loss of bonded enamel-ceramic interface

Abstract This study evaluated the effect of toothbrushing on enamel-cementing material-ceramic bonded interfaces, using different cementing materials. Materials and Methods: Thirty enamel and thirty ceramic blocks were bonded with cementing materials to produce the samples that were bonded with three types of cementing materials: 1- RelyX Ultimate resin cement (REXU), 2- RelyX Unicem 2 self-adhesive resin cement (REU2) and 3- heated Z100 restorative composite (60°C). Bonded interfaces of the samples were toothbrushed and the surfaces of the 3 cementing materials were evaluated for roughness (RG, in µm), roughness profile (RP, in µm), and volume loss (VL, in µm3) (baseline and after 20,000 and 60,000 toothbrushing cycles). Data were evaluated by Generalized Linear Analysis (two factors: "material" and "toothbrushing cycle") and Bonferroni test (α=0.05). Results: REXU and Z100 exhibited lower RG than that presented by REU2, except after 60,000 toothbrushing cycles when only Z100 differed from REU2. The increase in toothbrushing cycles increased the RG and RP for all materials. REU2 also showed higher RP than those showed by REXU and Z100 when it was analyzed regarding the enamel. The VL of Z100 was the lowest with 20,000 toothbrushing cycles, regarding the enamel and ceramic. For 60,000 cycles, REXU showed the lowest VL regarding the ceramic, and REU2 had the highest VL regarding the enamel and ceramic. Conclusion: In general, REXU and Z100 showed the best results regarding the evaluations performed and the REU2 exhibited the highest RG, RP, and VL.

Resumo Este estudo avaliou o efeito da escovação nas interfaces de união esmalte-material cimentante-cerâmica, utilizando diferentes materiais cimentantes. Materiais e Métodos: Trinta esmaltes e trinta blocos cerâmicos foram unidos com materiais de cimentação para produzir as amostras que foram unidas com três tipos de materiais de cimentação: 1- cimento resinoso RelyX Ultimate (REXU), 2- cimento resinoso autoadesivo RelyX Unicem 2 (REU2) e 3-compósito restaurador aquecido Z100 (60°C). As interfaces coladas das amostras foram escovadas e as superfícies dos 3 materiais cimentantes foram avaliadas quanto à rugosidade (RG, em µm), perfil de rugosidade (RP, em µm) e perda de volume (VL, em µm3) (baseline e após 20.000 e 60.000 ciclos de escovação). Os dados foram avaliados por Análise Linear Generalizada (dois fatores: "material" e "ciclo de escovação") e teste de Bonferroni (α=0,05). Resultados: REXU e Z100 apresentaram menor RG do que REU2, exceto após 60.000 ciclos de escovação, quando Z100 diferiu apenas de REU2. O aumento dos ciclos de escovação aumentou o RG e RP para todos os materiais. O REU2 também apresentou PR maior que o REXU e Z100, quando analisado em relação ao esmalte. O VL de Z100 foi o menor com 20.000 ciclos de escovação em relação ao esmalte e cerâmica. Para 60.000 ciclos, o REXU apresentou o menor VL em relação à cerâmica e o REU2 o maior VL em relação ao esmalte e à cerâmica. Conclusão: De maneira geral, REXU e Z100 apresentaram os melhores resultados nas avaliações realizadas e o REU2 apresentou os maiores RG, RP e VL..

Effect of whitening toothpastes and activated charcoal powder on enamel wear and surface roughness

Abstract This study aimed to evaluate surface roughness (Sa), roughness profile (Rv), and enamel wear after brushing with different whitening toothpastes and charcoal powders. Sixty (n = 10) bovine enamel blocks (6 × 6 × 3 mm) were randomly distributed into six groups according to toothpaste type: regular toothpaste (CONT), toothpaste containing 2% hydrogen peroxide (HP), toothpaste containing titanium dioxide (TiO2), toothpaste containing charcoal (COAL), toothpaste containing charcoal and TiO2 (COAL+TiO2), and activated charcoal powder (COAL_PWD). Each block was subjected to 30,000 reciprocal cycles at a 1:3 proportion slurry. After brushing, the blocks were analyzed using an optical profilometer to determine Sa, Rv, and enamel wear. In addition, representative 3D images of each group and wear profiles were obtained. Sa was analyzed using generalized linear models followed by Bonferroni correction, whereas Rv was analyzed using one-way analysis of variance. After brushing, COAL and COAL+TiO2 showed higher Sa values than COAL_PWD. However, no significant difference was observed in Sa between whitening toothpaste and COAL_PWD, and CONT (p > 0.05). In addition, no differences were observed among the groups in Rv (p > 0.05). Conversely, enamel wear was higher for TiO2, COAL, COAL+TiO2, and COAL_PWD than for CONT. CONT showed the least enamel wear, whereas HP showed intermediate values. Representative 3D images and line profiles showed lower step-height and lower mean surface losses for the CONT and HP groups than for the other groups. Whitening toothpastes and COAL_PWD did not increase Sa or Rv compared with CONT, while CONT demonstrated lower enamel wear.

Association between toothbrushing frequency and dental caries and tooth loss in adolescents: a cohort study

Abstract This cohort study assessed the association between toothbrushing frequency and the increment of dental caries and tooth loss in a population-based sample of southern Brazilian adolescents, to investigate whether there is any additional benefit in performing a third daily brushing. At baseline, 1,528 12-year-old schoolchildren attending 42 schools were examined for gingivitis and dental caries, and answered a questionnaire. After a mean period of 2.5 years, 801 schoolchildren were re-examined. Dental caries and tooth loss increment were outcomes of the study. The main predictor variable was toothbrushing frequency (≥3 times/day vs. twice/day or ≤1 time/day). Poisson regression models were used to estimate the risk for caries and tooth loss increment. Incidence risk ratios (IRR) and 95% confidence intervals (CI) were estimated. The final model adjusted for sociodemographic, behavioral, and clinical variables showed that brushing twice/day afforded 40% greater risk (IRR = 1.40; 95%CI: 1.02-1.92) for caries increment than ≥3 times/day. Regarding the tooth loss increment, adolescents who brushed their teeth twice/day had a fourfold greater risk (IRR = 3.92; 95%CI: 1.23-12.49) than those who brushed ≥ 3 times/day. Sex, school type, and gingivitis were found to act as effect modifiers, inasmuch as a third daily brushing presented advantages against tooth loss only for girls, public school attendees, and those with ≥ 50% of bleeding sites. This study suggests that adolescents benefit from a third daily toothbrushing. Increasing brushing frequency to 3 times/day may be a suitable strategy to control dental caries and tooth loss among high-risk adolescents.

Bathroom Behaviors Regarding Oral Hygiene Items During COVID-19 Home Isolation: A Cross-Sectional Study in Southern Brazil

ABSTRACT Objective: To describe behaviors with oral hygiene items in single-bathroom households during the domiciliary isolation of individuals with positive 'Reverse transcriptase polymerase chain reaction' (RTPCR+) in southern Brazil. Material and Methods: Cross-sectional study was conducted with Research and Monitoring Sector of COVID-19 data from Palhoça, Brazil, of individuals aged ≥18 years, living in a singlebathroom household, who had an RT-PCR positive. A link of Google Forms was used. Socio-demographic information, characteristics during the home isolation, oral hygiene, and behaviors with oral hygiene items in the bathroom were collected. Descriptive stratified analyses according to age were conducted (<40 and ≥40 years). Results: Among 524 individuals, 36% were aged ≥40 years. During isolation, according to the behaviors with oral hygiene items in the household single-bathroom, 70% (95%CI 64.9-75.5) of the youngest participants reported sharing toothbrushes in the same container and 30% (95%CI 24.4-35.1) of the oldest; use of the same toothpaste was reported by 67% (95%CI 62.8-71.7) of the youngest and 33% (95%CI 28.337.3) of the oldest participants. For the outcome of sharing the same toothpaste, the chances for the youngest and the oldest to share the same toothbrush container was 11 times and 6 times more, respectively. Conclusion: The individuals related good oral hygiene habits; however, behaviors with oral hygiene items in the bathroom were neglected, especially by the younger individuals.

Characterization of whitening toothpastes and their effect on the physical properties of bulk-fill composites

Abstract Objective To characterize activated charcoal and 2% hydrogen peroxide-based toothpastes and investigate their effects on roughness, color change, and gloss of bulk-fill composite resin. Methodology Composite resin specimens (Aura Bulk Fill, SDI) were subjected to 5,000 brushing cycles with regular toothpaste (Colgate Total 12, [RT]), activated charcoal toothpaste (Bianco Dental Carbon, [AC]), or hydrogen peroxide-containing toothpaste (Colgate Luminous White Advanced, [HP]), with or without coffee exposure. The pH, particle characterization by scanning electron microscopy (SEM), and weight% of solid particles in the toothpaste were assessed. Roughness (Ra) was evaluated using a surface profile-measuring device, color change (∆Eab/∆E00) by reflectance spectrophotometer, and gloss unit (GU) by glossmeter. Kruskal-Wallis, Dunn, Friedman, and Nemenyi tests were used, and the correlation coefficient test was performed between Ra and GU (α=0.05). Results RT presented a higher Ra after brushing and did not change after staining with coffee; moreover, the ∆Eab/∆E00 values were higher for RT than HP. Regarding gloss, AC and HP obtained higher values compared to RT. A significant negative correlation between gloss and Ra was found for RT exposed to coffee. All toothpastes had a neutral pH; however, RT had the largest percentage of solids by weight. SEM images showed particles of many sizes: irregular shape (RT), more regular particles (AC), and spherical clusters (HP). Although surface roughness, color change, and gloss may compromise the longevity of restorations, the whitening toothpastes tested did not promote more morphology changes than regular toothpastes.

Influence of pH-cycling and abrasion wear on the mechanical properties of conventional and bulk fill resin composites

The objective of this study was to evaluate the effect of abrasion wear on surface roughness and microhardness of different commercially available resin composites simulating pH-challenges of the oral cavity. Methods: Three resin composites (RC) were used in this study: one conventional: Z250; and two bulk fill resin composites (BRC): Tetric N-Ceram (TNC) and Sonic Fill (SF). The RC was inserted in a prefabricated mold (15mm wide x 4mm thickness) in two layers, or in a single layer for BRC. Thirty samples were prepared and surface roughness (Ra) and Knoop microhardness (KHN) test were performed at three different time-points of evaluation: baseline (24h after sample preparation); partial (after pH cycling); and final (after simulated toothbrushing procedure). Two samples of each group were selected after different treatments and analyzed descriptively on a scanning electron microscopy (SEM). Data from Ra and KHN were analyzed by two-way repeated-measures ANOVA and Bonferroni's post-hoc test with a significance level set at 5%. Results: Ra increased for all groups (p<0.001), at the final time-point, Z250 and TNC groups present the highest values. Oppositely, KHN decreased for all groups (p<0.001), Z250 group showed the highest KHN values for all time-points (p<0.001). The SEM imagens showed a regular surface for samples cycled and irregular with inorganic particles exposed for samples toothbrushed. Conclusion: pH-cycling and simulated toothbrushing affected the superficial properties (roughness and Knoop microhardness), as observed at SEM imagens, with irregular surface with inorganic particles exposure

Effectiveness of “Oral Health Care for Children with Autism Spectrum Disorder Module” in Improving Tooth-Brushing Practice among Children with Autism Spectrum Disorder in Hospital Universiti Sains Malaysia

@#Introduction: Autism spectrum disorder (ASD) is associated with behavioural problems which may affect children’s oral health statuses. Caregivers have crucial roles in caring for these children’s oral health. Thus, this study is aimed to evaluate the effectiveness of the Oral Health Care for Children with ASD (OHASD) Module in improving caregivers’ tooth-brushing difficulties in children ASD. Methods: Quasi-experimental study on caregivers of children with ASD aged 7 to 12 years who were registered at the Psychiatry Clinic Hospital Universiti Sains Malaysia (USM), Kelantan. The sociodemographic data obtained, and behavioural problems were assessed. Tooth-brushing difficulties were evaluated at pre- and six months post-intervention using OHASD Module. Data were analysed using IBM SPSS 26.0. Results: A total of 32 Malay children with ASD including their caregivers participated in this study. Caregivers were mostly mothers (78.1%) and children were mostly boys (84.4%), with mean age (SD) of 39.1 (4.19) and 8.8 (1.52) years respectively. Parent-reported questionnaire using the Modified Checklist for Autism in Toddlers (M-CHAT) showed 65.6% of children were highly sensitive to noises, 53.1% sometimes stared at nothing or wandered without purpose and 59.4% were unable to imitate caregivers’ faces. Significant differences between pre- and post-intervention for items; children who liked to close their mouths, turn their heads in different directions, did not understand the purpose of tooth-brushing (P<0.05). Conclusion: OHASD Module is useful in assisting caregivers in practising daily tooth-brushing of children with ASD.

Effect of modeling liquids on resin composite roughness and color parameters after staining and toothbrushing

Abstract This study evaluated surface roughness, color stability, whitening index, and opacity of different types of modeling liquids for resin composite coating after exposure to staining and toothbrushing. Disc-shaped resin composite (Vittra APS, FGM) specimens were fabricated and divided into four groups (n = 10 each): control group, Composite Wetting resin (Ultradent Products), Adper Scotchbond Multipurpose adhesive (3M ESPE), and Adper Universal adhesive (3M ESPE). Surface roughness (Ra) was measured using a rugosimeter, while color stability (∆E00), whitening index (WI), and opacity (%) were measured using a spectrophotometer. Assessments were made at four time points: after polishing (baseline, T1), after immersion in red wine for 24 h (T2), and after 5,000 (T3) and 10,000 (T4) cycles of toothbrushing. Scanning electron microscopy images were captured to analyze the scratches created. The data were statistically analyzed by two-way repeated-measures analysis of variance and Tukey's honestly significant difference tests (α = .05). Modeling with the Wetting resin resulted in higher surface roughness (p < 0.05) and low color stability, which were attributable to porosities. Higher color change values were observed in the control group after staining. Both adhesives showed the lowest mean ΔE00 values (p < 0.005). WI decreased after staining, except with the use of the Universal adhesive (p < 0.005). The lowest opacity values were observed at baseline for all groups (p < 0.005). The Universal and Scotchbond adhesives had lower surface roughness, better color stability, higher WI, and the lowest opacity values after staining with red wine and toothbrushing.

Effectiveness of Chewable Toothbrushes Compared to ManualToothbrushes in Removing Dental Plaque - A Systematic Review andMeta?Analysis

Objective: Chewable toothbrushes (CT) are considered an effective tool for dental plaque removal; however, their effectiveness is still uncertain compared to Manual toothbrushes (MT). Aim: To evaluate the effectiveness of CT compared to MT in dental plaque removal. Methods: Studies comparing the efficiency of CT and MT in dental plaque removal measured by Turesky Modification of Quigley-Hein Plaque Index (TMQHI), Quigley-Hein Plaque Index (QHI), or Silness Loe Plaque Index (SLPI) were identified in PubMed, Medline Web of Science, Google Scholar, and the CENTRAL. Results and effect sizes estimate are presented as mean difference, and subgroup analysis is presented separately for non?randomised interventional studies and randomised intervention studies. Risk of bias was assessed using the Cochrane risk of bias tool (ROBINS?I and ROB2 tool). Results: A total of 10 studies were included in the systematic review, whereas six out of 10 studies were included in the meta?analysis. Both CT and MT were effective in plaque reduction over time when compared individually using the TMQHI and SLPI scores. The overall pooled summary showed no difference in CT and MT’s dental plaque removal ability when measured using the TMQHI score. Similarly, there was no difference in CT and MT’s dental plaque removal ability when measured using the SLPI score. Conclusion: There is no significant difference in CT and MT’s plaque removal ability. Therefore, CT should only be recommended for children and individuals with a disability or manual dexterity.

Ação de dentifrícios antiplaca e anticálculosobre esmalte dentário bovino / The action of antiplaque and anticalculus dentifrices in bovine dental enamel

Introdução: os dentifrícios antiplaca e anticálculo contêm, em sua composição, agentes específicos para o controle e a redução do biofilme dentário, como o citrato de zinco, o óxido de zinco e o pirofosfato tetrassódico, dentre outros. Objetivo: avaliar in vitroa ação de dentifrícios antiplaca e anticálculo na variação da massa e da rugosidade superficial do esmalte bovino submetido à escovação simulada por 6 e 12 meses.Metodologia: 40 corpos de prova (CP) foram randomizados e divididos aleatoriamente em 4 grupos (n=10): grupo controle (GC- água) e 3 grupos teste (GT1 ­ Colgate-Total® 12 Clean Mint, GT2 ­ Colgate-Total® 12 Anti-Tártaro, GT3 ­ Prevent® Antiplaca). Os CP foram submetidos à escovação simulada por 6 e 12 mesese as avaliações da massa e da rugosidade foram realizadas após cada período de escovação. Resultados: a análise da variação da massa demonstrou que não houve diferença significativa entre os grupos e os tempos. A avaliação da rugosidade demonstrou que, após 12 meses de escovação, o GT1 apresentou aumento significativo da rugosidade, quando comparado aos grupos controle e testes, enquanto os grupos GT2 e GT3 apresentaram comportamento semelhante após um ano de escovação, promovendo o polimento superficial do esmalte bovino. Conclusão: a escovação com os dentifrícios antiplaca ou anticálculo não promoveu perda significativa da massa no esmalte bovino e promoveu seu polimento.

Introduction: Antiplaque and anticalculus dentifrices contain in their composition specific agents for the control and reduction of dental biofilm, such as zinc citrate, zinc oxide, tetrasodium pyrophosphate, among others. Objective: To evaluate in vitro the action of antiplaque and anticalculus dentifrices on the variation of mass and surface roughness of bovine enamel submitted to simulated brushing for 6 and 12 months. Metodology: 40 specimens (PB) were randomized and randomly divided into 4 groups (n=10): control group (GC ­ water) and 3 test groups (GT1 ­ Colgate-Total® 12 Clean Mint, GT2 ­ Colgate-Total® 12 Anti-Tartar, and GT3 ­ Prevent®Antiplaque). The PB were submitted to simulated brushing for 6 and 12 months and the mass and roughness evaluations were performed after each brushing period. Results: The analysis of mass variation showed that there was no significant difference between groups and times. The roughness evaluation showed that after 12 months of brushing, GT1 showed a significant increase in roughness when compared to the control and test groups, while the GT2 and GT3 groups showed similar behavior after one year of brushing, promoting the surface polishing of bovine enamel. Conclusion: Brushing with antiplaque or anticalculus dentifrices did not promote significant mass loss in bovine enamel and promoted its polishing.

Whitening efficacy of popular natural products on dental enamel

Abstract The objective of this study was to evaluate the effect of natural bleaching products on the color, whiteness, and superficial properties of dental enamel. Seventy fragments of bovine teeth were obtained (6mm x 6mm x 2mm). Initial surface roughness (Surfcorder SE1700, Kosakalab), microhardness (HMV-2, Shimadzu), color (EasyShade, VITA), and surface gloss (Micro-Gloss 45º BYK, Gardner) readings were done. Samples were separated into five groups (n=14) according to the treatments used: CT-conventional toothpaste (negative control); CH-charcoal; TU-turmeric; BP-banana peel, and CP16%-16% carbamide peroxide gel (positive control, 4 h/day for 14 days), and then brushed for 560 cycles (T1) and 1200 cycles (T2), equivalent to 14 and 30 days of brushing. New measurements were performed after T1 and T2. The whiteness index for dentistry change (∆WID) and Weight loss (Wl) were calculated. CP16% demonstrated the highest (p<.05) color change (ΔE00) and ∆WID (2-way ANOVA, Bonferroni, p<.05). Surface gloss alterations were lower for TU, CP16%, and BP. CT and CH increased surface roughness (p<.05). CP16% decreased enamel microhardness. CH presented medium abrasiveness, and CT and TU, low abrasiveness. The popular bleaching products were not efficient for tooth whitening. Furthermore, brushing with charcoal increased the enamel surface roughness, and CP16% decreased enamel microhardness over time

Resumo O objetivo deste estudo foi avaliar o efeito de produtos clareadores naturais na cor, efeito clareador e propriedades superficiais do esmalte dentário. Setenta fragmentos de dente bovino foram obtidos (6mm x 6mm x 2mm). Foram realizadas leituras iniciais de rugosidade de superfície (Surfcorder SE1700, Kosakalab), microdureza (HMV-2, Shimadzu), cor (EasyShade, VITA) e brilho (Micro-Gloss 45º BYK, Gardner). As amostras foram separadas em cinco grupos (n=14), de acordo com os tratamentos utilizados: DC - dentifrício convencional (controle negativo); CA - carvão ativado; CM - cúrcuma; CB - casca de banana e PC16% - gel de peróxido de carbamida a 16% (controle positivo, 4h/dia por 14 dias), foram então escovadas por 560 ciclos (T1) e 1200 ciclos (T2), equivalente a 14 e 30 dias de escovação. Novas leituras foram realizadas após T1 e T2. A alteração do whiteness index for dentistry (∆WID) e perda de massa (Pm) foram calculadas. PC16% demonstrou a maior (p<0,05) alteração de cor (ΔE00) e ∆WID (2-way ANOVA, Bonferroni, p<0,05). A alteração de brilho foi menor para CM, PC16% e CB. DC e CA aumentaram a rugosidade de superfície (p<0,05). PC16% diminuiu a microdureza do esmalte. CA apresentou abrasividade média, e DC e CM, baixa abrasividade. Os produtos clareadores populares não foram eficientes para clareamento dental. Ademais, a escovação com carvão ativado aumentou a rugosidade de superfície do esmalte dentário, e com maior tempo PC16% diminuiu a microdureza do esmalte.

Effect of oral health intervention program on the self oral care of children attending childcare facilities: a quasi-experimental study

This study aimed to conduct a quasi-experimental study for assessing the effects of an oral health intervention program (OHIP), on the self-management of oral health in children attending childcare centers. The participants recruited were 83 children from two childcare centers, who were allocated to the intervention and control groups. The intervention group received the OHIP. At baseline, a self-reported survey of parents was conducted. In addition, the oral status of the children at baseline and at 5 weeks was evaluated. Their brushing behavior was assessed once a week and every day during the OHIP intervention period and at home, respectively. After the follow-up at 12 weeks, dental plaque index (PI) was measured and two-way repeated measures analysis of variance was performed. The PI of the intervention group significantly decreased at week 5, compared to the baseline (1.90 ± 0.53, p < 0.001). Despite a substantial increase in week 12 (2.67 ± 0.08, p < 0.001), the PI was significantly lower than that of the control group (3.37 ± 0.60). The OHIP was effective in reducing the PI and modifying the brushing behavior among children. It is necessary to develop and expand a systematic oral health education program to promote self-management of oral health in children.

Association between Oral Health Knowledge, Attitude and Practice with Dental Plaque Maturity Status among Adolescents in Kota Bharu, Kelantan

@#Introduction: School students are young adolescents who are in a period of acquiring good oral hygiene habits that are practised as they grow up. This study aimed to determine the association between oral health knowledge, attitude and practices (KAP) of the adolescents and their dental plaque maturity status. Methods: A cross-sectional study was conducted among 174 school students aged 13 to 14 years in Kota Bharu, Kelantan. The oral health knowledge, attitude and practices were assessed by self-administered questionnaires, while the dental plaque maturity status was assessed using GC Tri Plaque ID gel TM (TPID). The data were analysed using IBM SPSS version 24.0. Results: The mean (SD) for knowledge and attitude score of the students were 4.69 (1.44) and 3.63 (0.63), respectively. The mean (SD) dental plaque maturity score (DPMS) of the students was 1.02 (0.55). Students who had answered correctly on sugar and practised tooth brushing twice daily had significantly lower mean DPMS as compared to those who had answered incorrectly and practised tooth brushing less than twice daily (p<0.05). Conclusion: Adolescents participated in this study had moderate oral health knowledge and good oral health attitude. Correct knowledge regarding sugar and toothbrushing routines of at least twice a day significantly associated with the dental plaque maturity status.

Long-term effects of simulated gastric juice alternated with brushing on hardness, substance loss, flexural strength and reliability of CAD-CAM monolithic materials

Abstract Objectives: The purpose of this study is to evaluate, over a simulated 5-year period, the effect of simulated gastric juice alternated with brushing on CAD-CAM monolithic materials considering microhardness, substance loss, flexural strength, and reliability of the materials. Methodology: Blocks from Lava Ultimate (LU), Vita Enamic (VE), IPS Empress CAD (EMP), IPS e.max CAD (EMAX), and Vita Suprinity (VS) were milled into cylinders and sliced into disks. The EMAX and VS were crystallized, and all specimens were polished with silicon carbide papers and allocated as follows: 1) artificial saliva + brushing or 2) simulated gastric juice (0.113% hydrochloric acid (HCl) solution in deionized water, pH 1.2) + brushing, simulating 1, 3, and 5 years of clinical function. Each year of clinical function was simulated by three repetitions of immersion for 3 hours in artificial saliva or simulated gastric juice followed by 1,217 brushing cycles. The microhardness and substance loss were evaluated at baseline (T0) and at each year by using a Vickers hardness tester and an analytical balance. The biaxial flexural strength (BFS) test was performed in a mechanical testing machine at the end of the 5th year. Weibull modulus was calculated from the BFS data. Results: The microhardness of the LU was not influenced by the treatment, whereas that of the other materials, in certain years, was significantly lower in the gastric juice + brushing groups in comparison with artificial saliva + brushing groups. In general, the materials did not present a significant change in microhardness over time, for either of the treatments. The LU alone showed greater substance loss in the gastric juice + brushing groups for every year. In both treatments, the LU, VE, and EMP exhibited a significant increase in the substance loss over time. The treatment did not affect the BFS of the materials. The gastric juice + brushing decreased the reliability of the VE. Conclusions: All materials were somehow impaired by the gastric juice + brushing in at least one of the evaluated parameters, except for the BFS. However, in a deeper analysis, the LU would be the least indicated materials, followed by VE, for patients with eating disorders.

Effect of desensitizing dentifrices on eroded dentin wettability / Efeito de dentifrícios dessensibilizantes na molhabilidade da dentina erodida

Objective: To analyze the wettability on the surface of eroded dentin in teeth submitted to abrasive wear with desensitizing dentifrices. Material and Methods: Bovine dentin specimens were polished and immersed in 10 mL of citric acid (pH=3.2) for 2 h. The eroded specimens were submitted to mechanic brushing according to the 4 dentifrices adopted: Colgate Total (control); Colgate Sensitive Pro-Relief; Sensodyne Repair & Protect; or Sensodyne Rapid Relief. Afterwards, it was conditioned in 37% aqueous phosphoric acid solution. Wettability of 80 specimens (n=10) brushed for 7 or 21 days was evaluated by measuring the contact angle between the dentin surface and a drop of the adhesive Single Bond Universal® (3M) with a goniometer. Changes in the surface morphology of 12 specimens (n = 3) brushed for 21 days were followed by confocal laser scanning microscopy (CLSM). Data were analyzed by two-way ANOVA and Tukey test (p > 0.05). Results: Groups treated with desensitizing dentifrices did not differ significantly (p ≤ 0.05). Surface treatment and abrasive wear did not interact significantly (p ≤ 0.05). Brushing along 7 days gave the smallest contact angle value (p ≥ 0.05). CLSM images showed morphological changes for all the groups. Conclusion: The desensitizing dentifrices did not interfere in eroded dentin wettability after brushing along 7 or 21 days. Brushing with any of the dentifrices along 21 days promoted open dentinal tubules.(AU)

Objetivo: Analisar a aplicação de um adesivo na superfície de dentina erodida em dentes submetidos ao desgaste abrasivo com agentes dessensibilizantes. Material e Métodos: Espécimes de dentina bovina foram polidos e imersos em 10 mL de ácido cítrico (pH=3,2) por 2 h. Os espécimes erodidos foram submetidos à escovação mecânica de acordo com os 4 dentifrícios adotados: Colgate Total (controle); Colgate Sensitive Pro-Alívio; Sensodyne Repair & Protect; ou Sensodyne Rápido Alívio. Em seguida, foram condicionados em ácido fosfórico a 37%. A molhabilidade de 80 espécimes (n=10) escovados por 7 ou 21 dias foi avaliada medindo-se o ângulo de contato entre a superfície dentinária com uma gota do adesivo Single Bond Universal® (3M) por um goniômetro. Alterações na morfologia da superfície de 12 espécimes (n = 3) escovados por 21 dias foram seguidos por Microscopia Confocal de Varredura a Laser (MCVL). Os dados foram analisados por ANOVA dois fatores e teste de Tukey (p > 0,05). Resultados: Os grupos tratados com dentifrícios dessensibilizantes não diferiram significativamente (p ≤ 0,05). O tratamento de superfície e o desgaste abrasivo não interagiram significativamente (p ≤ 0,05). A escovação ao longo de 7 dias apresentou o menor valor de ângulo de contato (p ≥ 0,05). As imagens do MCVL mostraram alterações morfológicas para todos os grupos. Conclusão: Os dentifrícios dessensibilizantes não interferiram na molhabilidade da dentina erodida após escovação ao longo de 7 ou 21 dias. A escovação com qualquer um dos dentifrícios ao longo de 21 dias promoveu a abertura dos túbulos dentinários (AU)

Visual Inspection and Toothbrush Care: A Mother-Baby Paired Cross-Sectional Study

ABSTRACT Objective To evaluate the physical conditions and presence of residues of toothbrushes used by mothers and their babies and mothers' knowledge about toothbrush care. Material and Methods This was a cross-sectional study comprising a convenience sample represented by 60 mother-baby pairs. The mothers answered a questionnaire to evaluate their knowledge of toothbrush care. A calibrated dentist performed a visual inspection of the toothbrushes. Statistical analysis was performed using the chi-square and Fisher's exact tests, with a significance level of 5%. Results It was found that 82% of the mothers had never received instructions regarding the care of toothbrushes after use (p=0.024). Most of them believed that their toothbrushes (70%) and their children's toothbrushes (88%) were in good condition to use (p=0.043). However, most mother's toothbrushes presented an unacceptable deformity of the bristles (65%) and the presence of residues (60%). In addition, babies' toothbrushes also presented unacceptable deformities of the bristles (52%) and residues (55%). There was an association between the lack of instructions received by the mother and the presence of deformity and residues on the mother's toothbrush bristles (p=0.037 and p=0.003, respectively). Conclusion Most mothers had never received instructions regarding toothbrush care, which is reflected in the condition of their and their baby's toothbrushes, which presented unacceptable physical conditions concerning deformation and presence of residues.

Association of children's toothbrushing and fine motor skills: a cross-sectional study

Abstract Fine motor skills (FMS) allow for the control and coordination of the distal musculature of hands and fingers, a skill required to brush teeth. The objective of this study was to investigate the association between FMS and toothbrushing efficacy. This cross-sectional study included 42 low-income Latino children aged 5 to 9 years from Pasto, Colombia. Toothbrushing efficacy was determined by the children's dental plaque Quigley-Hein Index (QH-I) mean-score difference from before and after toothbrushing. FMS were evaluated using the 5-15R parent evaluation, the spiral drawing Archimedes test, and a neurodevelopmental assessment of movements and prehension patterns during toothbrushing. A descriptive analysis was performed to assess the characteristics of FMS and children's toothbrushing, and a generalized linear model was used to determine associations between these skills and toothbrushing efficacy. Eighty-six percent of the children had at least one difficulty with FMS, and in 7%, they interfered with daily activities. Fourteen percent presented a moderate pattern in the Archimedes test, and 43% had inefficient prehension patterns. Toothbrushing reduced the QH-I by a mean of 1.45 (SD = 0.78-2.12) (p < 0.001). Toothbrushing efficacy was only significantly associated with age (mean-difference = -0.315, 95%CI: -0.481 to -0.148, p < 0.001). FMS and toothbrushing efficacy were not significantly associated. Other components of fine motor control should be analyzed to understand the kinetics of toothbrushing.

Effect of electric, ultrasonic and manual toothbrushes on biofilm removal and gingivitis control: in vitro and parallel randomized controlled clinical trial study

Aim: To evaluate the effect of manual (M), electric (E) and ultrasonic (US) toothbrushes on the removal of oral biofilm and control of gingivitis. Also, the roughness and tooth wear production were evaluated in vitro. Methods: For the in vitro analyses, thirty bovine dentin specimens were submitted to a 3-month brushing simulation (9 minutes) with the three types of toothbrushes (n = 10). Subsequently, a randomized controlled clinical trial was performed with 36 patients divided into 3 groups according to the toothbrushes used (n = 12). Gingival index, visible plaque index and the volume of crevicular fluid were evaluated at baseline and 3 months after the beginning of the toothbrush use. Furthermore, the performance of the biofilm removal per brushing cycle of 1 and 3 minutes with each toothbrush was made monthly until the end of the experiment. Results: The US group had the highest dentin wear. Clinically, the US group had a lower plaque index at 3 months than the M group. The M group also showed less biofilm removal efficiency from the second month of follow-up and more worn bristles at the end of the 3 month period than the E and US groups. Conclusion: The ultrasonic, electric and manual toothbrushes showed no differences in gingivitis control in the present study. The ultrasonic and electric toothbrushes had a more significant effect on biofilm removal than a manual toothbrush, but the ultrasonic toothbrush promoted greater dentin tissue wear

Diagnóstico de la higiene bucal en pacientes con aparatos de ortodoncia / Diagnosis of oral hygiene in patients with orthodontic appliances

RESUMEN Fundamento: una adecuada higiene bucal es necesaria en los pacientes que portan aparatos de ortodoncia. Objetivo: identificar conocimientos, actitudes, prácticas e higiene bucal en pacientes con aparatos de ortodoncia. Métodos: se realizó un estudio con diseño no experimental, descriptivo y transversal en la Clínica Estomatológica Docente Provincial de Sancti Spíritus en el período entre septiembre de 2018 y julio de 2019. Se utilizaron métodos del nivel teórico, empírico (encuesta, entrevista, observación y estadístico). La población estuvo constituida por 30 pacientes de esta institución con tratamiento de ortodoncia. Se midieron las variables: edad y sexo del paciente, tipo de aparato de ortodoncia, nivel de conocimiento sobre salud bucodental, actitud y prácticas del paciente de higiene bucal, frecuencia, forma y eficiencia del cepillado dental, así como el cepillado o no después de la ingestión de alimentos azucarados. Resultados: el 100 % de los pacientes presentó conocimientos deficientes sobre salud bucal y prácticas desfavorables, aunque se constató actitudes favorables en el 63,3 % de los pacientes. Predominó una higiene bucal regular en la población estudiada antes de iniciar el tratamiento y después de instalar los aparatos, de manera similar en los grupos con aparatos removibles, funcionales y fijos. Conclusiones: los pacientes de la población estudiada necesitan educación para apropiarse de conocimientos suficientes para mantener actitudes, prácticas e higiene bucal saludables.

ABSTRACT Background: adequate oral hygiene is necessary in patients who wear orthodontic appliances. Objective: to identify knowledge, attitudes, practices and oral hygiene in patients with orthodontic appliances. Methods: a study with a non-experimental, descriptive and cross-sectional design was carried out in the Provincial Teaching Dentistry Clinic of Sancti Spíritus in the period between September 2018 and July 2019. Methods from the theoretical, empirical (survey, interview and observation) and statistical level were used. The population consisted of 30 patients from this institution with orthodontic treatment. The measured variables were: age and sex of the patient, type of orthodontic appliance, level of knowledge about oral health, attitude and oral hygiene practices of the patient, frequency, form and efficiency of tooth brushing, as well as brushing or not after the ingestion of sugary foods. Results: 100% of the patients presented poor knowledge about oral health and unfavorable practices, although favorable attitudes were found in 63.3% of the patients. Regular oral hygiene predominated in the population studied before starting treatment and after installing the appliances, similarly in the groups with removable, functional and fixed appliances. Conclusions: the studied population patients need education to acquire sufficient knowledge to maintain healthy attitudes, practices and oral hygiene.

Análisis Comparativo de la Eficacia, Comodidad y Seguridad del Cepillo Eléctrico Oscilante-Rotatorio Oral-B en Pacientes Portadores de Ortodoncia Fija: Un Ensayo Clínico Aleatorizado

RESUMEN: La higiene oral es fundamental en pacientes en tratamiento de ortodoncia. Actualmente hay una oferta amplia de cepillos eléctricos con este fin. El objetivo del presente estudio, fue determinar la eficacia y la comodidad del cep illo eléctrico Oral-B® Professional Care 500 en pacientes portadores de ortodoncia. Se realizó un ensayo clínico, randomizado, doble ciego, unicéntrico, con una muestra de 90 pacientes, divididos en dos grupos: 45 pacientes utilizaron cepillo eléctrico y 45 sujetos utilizaron cepillos manuales durante 90 días. Se determinó la efectividad con los índices O'leary, índice de placa de bracket e índice de Eastman al inicio, a los 30 y a los 90 días de uso de los cepillos y se evaluó la comodidad del cepillo eléctrico mediante una encuesta de satisfacción al término del estudio. Al analizar los datos, se observó una disminución significativa en los índices de O'leary y de placa de bracket en ambos grupos,mientras que se observó una disminución significativa en el índice de Eastman sólo en el grupo que utilizó el cepillo eléctrico. El resultado de la encuesta, indica qu e, en opinión de los participantes del estudio, el cepillo eléctrico es cómodo, fácil de usar y recomendable para pacientes con aparatología fija. En conclusión, el cepillo eléctrico Oral-B® Professional Care 500 resultó ser efectivo y cómodo al ser usado por pacientes portadores de ortodoncia fija y puede ser recomendado para este tipo de pacientes.

ABSTRACT: Oral hygiene is essential in patients undergoing orthodontic treatment. Currently there is a wide offer of electric brushes for this purpose. The objective of this study is to determine the efficacy and comfort of the Oral-B® Professional Care 500 electric toothbrush in orthodontic wearers. A double-blind, single-center clinical trial was carried out, in which the sample was 90 patients, these were randomized into two groups: 45 patients with electric toothbrush treatment and 45 subjects with manual toothbrush treatment. The effectiveness was determined with the O'leary indexes, the bracket plate index and the Eastman index. For the evaluation of comfort, a survey was used. Statistical analysis was performed with the Shapiro-Wilks test and the Mann-Whitney U test, in which a significant decrease was found in the O'leary index and bracket plate index in the group that used the electro-oscillating brush rotary and a greater decrease in the Eastman index was observed in the same group. In conclusion, the electric toothbrush is comfortable and easy to use, recommended for patients with fixed appliances.