Fluorosis dental en adolescentes de instituciones educativas de Lima, Perú / Dental fluorosis in adolescents from Educational Institutions in Lima, Peru

Introducción: La fluorosis dental es una patología endémica causada por la ingestión excesiva de fluoruros que pueden producir una alteración durante el desarrollo del esmalte, y es considerado un importante problema de salud pública porque afecta la salud bucal y sistémica de la población. Objetivo: Este estudio tuvo como idea principal determinar la frecuencia y los niveles de fluorosis dental en escolares de 12 a 15 años pertenecientes a dos instituciones educativas de Lima - Perú. Método: Se realizó un estudio descriptivo de tipo transversal, la muestra estuvo conformada por 252 estudiantes, entre 12 y 15 años de dos centros educativos de Lima. El muestreo fue por selección sistemática de elementos muestrales. La fluorosis dental se evalúo mediante el Índice de Dean. Para determinar la frecuencia y los niveles de fluorosis dental, se realizó un examen clínico bucal y se desarrolló un cuestionario validado previamente. Resultados: La frecuencia de fluorosis dental fue de 44,8% (n=113) afectando más a los varones en un 27,39% (n=69) y a los adolescentes de 13 años (15,1%). En relación con los niveles de fluorosis, predominó el tipo "muy leve" (34,9%). También se encontró una asociación entre la presencia y el nivel de fluorosis con el número de aplicaciones de flúor (p<0,05). Además, se dijo que el índice comunitario de fluorosis de Dean fue de 0,43. Conclusiones: En la población escolar evaluada, la frecuencia de fluorosis fue de 44,8% y el nivel predominante de fluorosis fue muy leve. Además, el índice comunitario fue de 0,43, el cual mostró un nivel límite de importancia para la salud pública. Por lo que se puede considerar que el número de aplicaciones tópicas de flúor recibido por la población sin una planificación adecuada se podría convertir en un factor de riesgo para causar fluorosis dental.

Introduction: Dental fluorosis is an endemic pathology caused by the excessive ingestion of fluorides that can produce an alteration during the development of the enamel and is considered an important public health problema because it affects the oral and systemic health of the population. Objective: The objective of this study was to determine the frequency and levels of dental fluorosis in school children between 12 and 15 years of age belonging to two educational institutions in Lima, Peru. Method: A descriptive cross-sectional study was carried out, the sample consisted of 252 students between 12 and 15 years of age from two educational centers in Lima. Sampling was by systematic selection of sample elements. Dental fluorosis was evaluated using the Dean Index. To determine the frequency and levels of dental fluorosis a clinical oral examination was carried out and a previously validated questionnaire was developed. Results: The frequency of dental fluorosis was 44.8% (n=113) affecting more males by 27.39% (n=69) and adolescents aged 13 years (15.1%). In relation to the levels of fluorosis, the "very mild" type predominated (34.9%). An association was also found between the presence and level of fluorosis with the number of fluoride applications (p<0.05). In addition, Dean's community fluorosis index was reported to be 0.43. Conclusions: In the school population evaluated, the frequency of fluorosis was 44.8% and the predominant level of fluorosis was very mild. In addition, the community index was 0.43, which indicated a borderline level of public health importance. Therefore, it can be considered that the number of topical fluoride applications received by the population without adequate planning could become a risk factor for causing dental fluorosis.

Aceites esenciales con actividad antibacteriana: posible aplicación y administración en odontología / Essential oils with antibacterial activity: possible uses and administration in the dental practice

Resumen Introducción la caries dental es una de las enfermedades de mayor prevalencia a escala mundial, cuyas consecuencias clínicas se encuentran relacionadas directamente con la calidad de vida de los individuos. Asimismo, la atención odontológica exige un elevado costo y muchas veces lejos del alcance de ciertas comunidades. Si bien esta enfermedad se produce por la confluencia de distintos factores, uno de ellos es el económico, por lo que se busca una opción medicinal de bajo costo, y el abordaje a su vez de otro factor, tal vez el más importante, que implica el desarrollo y multiplicación del microorganismo iniciador de esta enfermedad, que es Streptococcus mutans. Actualmente se conoce el consumo de medicinas de origen natural para el tratamiento de algunas enfermedades, entre ellas, la caries. El uso y mecanismo de acción de aceites esenciales que impidan el desarrollo de S. mutans en el biofilm dental está siendo investigado. El objetivo de este trabajo es actualizar los conocimientos sobre la acción biocida de aceites esenciales y sus posibles aplicaciones en odontología. Resultados. Los aceites esenciales provenientes de los cítricos como limón, mandarina, naranja, como así también de eucalipto y orégano, presentan actividad bacteriostática, y en algunos casos, bactericida frente a bacterias Gram + y Gram -. Conclusión de acuerdo con la información recopilada, el uso de estos aceites mediante la biotecnología sería beneficioso y contribuiría al manejo de la salud bucal sin alterar la microflora oral normal del ser humano.

Abstract Dental caries is one of the most prevalent diseases worldwide, whose clinical consequences are directly related to the quality of life of individuals. Likewise, dental care requires a high cost and is often beyond the reach of certain communities. Although this disease is produced by the confluence of different factors, one of them is the economic factor, which is why a low-cost medicinal alternative is sought, and the approach in turn of another factor, perhaps the most important, which implies the development and multiplication of the initiating microorganism of this disease that is Streptococcus mutans. Currently, the consumption of medicines of natural origin is known for the treatment of some diseases, including tooth decay. The use of essential oils that prevent the development of St. mutans in dental biofilm is being investigated and the objective of this work is to update the knowledge about its biocidal action and its applications in dentistry. The objective of this work is to update the knowledge on the biocidal action of essential oils and their possible applications in dentistry. Results The essential oils from citrus fruits such as lemon, mandarin, orange, as well as eucalyptus and oregano, show bacteriostatic activity, and in some cases, bactericidal against Gram + and Gram - bacteria. Conclusion according to the information collected, the use of these oils through biotechnology would be beneficial and would contribute to the management of oral health without altering the normal oral microflora of the human being.

Actividad antibacteriana de un extracto etanólico de propóleo peruano frente a Streptococcus mutans / Antibacterial activity of a Peruvian propolis ethanolic extract against Streptococcus mutans

Introducción: Los derivados del propóleo poseen propiedades antimicrobianas importantes y presentan un potencial uso para la prevención y tratamiento de la caries dental. Objetivo: Evaluar la actividad antibacteriana de un extracto etanólico de propóleo peruano frente a Streptococcus mutans. Métodos: Se obtuvo el extracto etanólico de propóleo por maceración en alcohol al 70 por ciento durante 15 días. El extracto etanólico de propóleo fue diluido con agua destilada para obtener concentraciones de 75 por ciento, 50 por ciento y 25 por ciento. La actividad antibacteriana se evaluó mediante la prueba de difusión en disco sobre medio agar cerebro-corazón inoculado con S. mutans ATCC® 25175™, se empleó clorhexidina (CHX) al 0,12 por ciento como control. Las placas de Petri fueron incubadas por 48 horas a 37 ºC en condiciones de microaerofilia. Posteriormente se realizó la medición de los halos de inhibición con un compás Vernier. Resultados: Todas las concentraciones del extracto etanólico de propóleo presentaron actividad antibacteriana frente al S. mutans (25 por ciento = 17,582 ± 2,578 mm; 50 por ciento = 16,906 ± 1,892 mm; 75 por ciento = 16,881 ± 2,013 mm; 100 por ciento = 17,201 ± 1,305 mm). Sin embargo, fueron menores que la CHX al 0,12 por ciento (24,543 ± 2,486 mm) (p < 0,05). Según la escala de Duraffourd, S. mutans fue sensible (+) y muy sensible (++) para todas las concentraciones del extracto etanólico de propóleo, mientras que para CHX al 0,12 % fue sumamente sensible (+++) (p < 0,05). Conclusiones: El extracto etanólico de propóleo peruano presenta actividad antibacteriana significativa considerada como sensible y muy sensible frente a S. mutans(AU)

Introduction: Due to their important antimicrobial properties, propolis by-products are potentially useful for the prevention and treatment of dental caries. Objective: Evaluate the antibacterial activity of a Peruvian propolis ethanolic extract against Streptococcus mutans. Methods: The propolis ethanolic extract was obtained by maceration in 70 percent alcohol for 15 days. The extract was diluted in distilled water to obtain concentrations of 75 percent , 50 percent and 25 percent . Antibacterial activity was evaluated by the disk diffusion test in brain heart agar medium inoculated with S. mutans ATCC® 25175™. Chlorhexidine (CHX) 0.12 percent was used as control. The Petri plates were incubated for 48 hours at 37ºC in microaerophilic conditions. The inhibition haloes were then measured with a Vernier caliper. Results: All the concentrations of the propolis ethanolic extract displayed antibacterial activity against S. mutans: 25 percent = 17.582 ± 2.578 mm; 50 percent = 16.906 ± 1.892 mm; 75 percent = 16.881 ± 2.013 mm; 100 percent = 17.201 ± 1.305 mm. However, values were lower than those of 0.12 percent CHX: 24.543 ± 2.486 mm (p < 0.05). According to the Duraffourd scale, S. mutans was sensitive (+) and very sensitive (++) to all propolis ethanolic extract concentrations, and highly sensitive to 0.12 percent chlorhexidine (+++) (p < 0.05). Conclusions: The Peruvian propolis ethanolic extract displays significant antibacterial activity against S. mutans. Such activity was evaluated as sensitive and very sensitive(AU)

O uso de selantes de fossas e fissuras no tratamento de lesões cariosas cavitadas: uma revisão de literatura / The use of pits and fissures sealants in the treatment of cavitated carious injuries: a literature review

Introdução: Os selantes são considerados uma opção terapêutica minimamente invasiva no tratamento de lesões cariosas limitadas à metade externa da dentina. Nesta técnica, o tecido cariado é mantido coberto com um selante, promovendo a paralisação da lesão. Objetivo: analisar a utilização de selantes no tratamento de lesões de cárie, a sua eficácia, qual tipo de material é o mais ideal para essa finalidade e observar se essa terapêutica é a mais indicada para tratar lesões cariosas já cavitadas. Métodos: uma revisão da literatura foi realizada por meio de artigos científicos publicados nos últimos cinco anos (2015-2020) presentes em bases de dados eletrônicos, como PubMED/Medline, Lilacs e BBO. Resultados e discussão: a utilização dos selantes, antigamente, era apenas voltada para a prevenção, porém houve uma progressão nesse entendimento, passando a ser utilizado no tratamento de lesões cariosas que apresentam microcavidades oclusais de até três milímetros de perda da integridade superficial. Neste trabalho, todos os estudos descritos afirmaram que essa técnica é eficaz em paralisar o processo carioso, sendo indicada, principalmente, para crianças, pois reduz o tempo clínico e gera menos ansiedade. Em relação ao tipo de selante mais indicado para essa finalidade, as evidências científicas ainda são inconclusivas. Conclusão: o uso de selantes é um método eficiente na interrupção da lesão cariosa, porém depende da adequada retenção do material e da colaboração do paciente em continuar o acompanhamento pelo profissional. Além disso, é necessária a realização de estudos mais criteriosos que comparem os tipos de selantes e indiquem a opção mais adequada para obter o melhor selamento das lesões cavitadas.

Introduction: Sealants are considered a minimally invasive therapeutic option in the treatment of carious lesions limited to the outer half of the dentin. In this technique, the decayed tissue is kept covered with a sealant, promoting the paralysis of the lesion. Objective: to analyze the use of sealants in the treatment of caries lesions, their effectiveness, what type of material is most ideal for this purpose and observe whether this therapy is the most suitable for treating carious lesions already cavitated. Methods: a literature review was carried out through scientific articles published in the last five years (2015-2020) submitted to electronic databases, such as PubMED / Medline, Lilacs and BBO. Results and discussion: the use of sealants, in the past, was only aimed at prevention; however there was a progression in this understanding, being used in the treatment of carious lesions that present occlusal microcavities of up to three millimeters of surface integrity loss. In this research, all the studies described stated that this technique is effective in paralyzing the carious process, being indicated, mainly, for children, because it reduces the clinical time and generates less anxiety. Regarding the type of sealant most suitable for this purpose, the scientific evidence is still inconclusive. Conclusion: the use of sealants is an efficient method to interrupt the carious lesion; however, it depends on the adequate retention of the material and on the patient's collaboration in continuing the follow-up by the professional. In addition, it is necessary to carry out more careful studies that compare the types of sealants and indicate the most appropriate option to obtain the best sealing of cavitated lesions.

Actividad antimicrobiana in vitro del Camu Camu (Myrciaria Dubia) contra microorganismos orales: una revisión sistemática / Antimicrobial activity in vitro of Camu-Camu (Myrciaria Dubia) against oral microorganisms: a systematic review

RESUMEN Objetivos. Evaluar la actividad antimicrobiana de la Myrciaria dubia sobre microorganismos orales. Materiales y métodos . Se realizó una revisión sistemática de la literatura siguiendo las recomendaciones PRISMA mediante búsquedas en Pubmed, LILACS, SciELO, ProQuest, EBSCO y Google Scholar, de estudios publicados durante 2008 y 2018. Resultados . Se recopilaron 11 estudios, in vitro, todos los estudios evidenciaron actividad antimicrobiana positiva, principalmente por cada una de las partes de sus frutos, sobre grampositivos. Sin embargo, dicha actividad fue comparada con clorhexidina en solo dos estudios y en otro resultó ser mejor que un antibiótico. Se detectó un alto riesgo de sesgo en la mayoría de estudios. Los compuestos fenólicos incluidos polifenoles y acilfloroglucinoles fueron señalados como los responsables de su actividad. Conclusiones . Existe evidencia sobre la actividad antimicrobiana de M. dubia. Su estudio como antimicrobiano contra microorganismos orales es aún incipiente, pero se advierte un gran potencial debido a los fitoquímicos potentes que posee. Además, se necesita más estudios de calidad, que comparen su actividad versus antisépticos orales y sobre más microorganismos asociados a caries dental y enfermedad periodontal.

ABSTRACT Objectives. To evaluate the antimicrobial activity of Myrciaria dubia on oral microorganisms. Materials and Methods. A systematic review of the literature following PRISMA guidelines was conducted through searches of studies published between 2008 and 2018 in Pubmed, LILACS, SciELO, ProQuest, EBSCO, and Google Scholar. Results. Eleven (11) in vitro studies were gathered; all the studies showed positive antimicrobial activity on gram-positives, mainly by each of the parts of its fruits. However, such activity compared to chlorhexidine in only two studies, and, in another study, it was better than an antibiotic. A high risk of bias was detected in most studies. Phenolic compounds, including polyphenols and acylphloroglucinols, were identified as responsible for its activity. Conclusions. There is evidence of antimicrobial activity in M. dubia. Its study as an antimicrobial against oral microorganisms is still incipient, but there is great potential thanks to the potent phytochemicals it contains. Also, additional quality studies are required: comparing their activity versus oral antiseptics and on microorganisms associated with dental caries and periodontal disease.

Remineralizing effect of commercial fluoride varnishes on artificial enamel lesions

Abstract: The aim of this study was to evaluate soluble and insoluble fluoride concentrations in commercial varnishes, and their remineralization effect on artificial caries enamel lesions using surface and cross-sectional microhardness evaluations. Forty bovine enamel blocks were separated into four groups (n=10): control (no treatment), Enamelast (Ultradent Products), Duraphat (Colgate-Palmolive) and Clinpro White Varnish (3M ESPE). Surface enamel microhardness evaluations were obtained, artificial enamel caries lesions were developed by dynamic pH-cycling, and the varnishes were then applied every 6 days, after which the enamel blocks were submitted to dynamic remineralization by pH cycles. After removal of the varnishes, the enamel surfaces were reassessed for microhardness. The blocks were sectioned longitudinally, and cross-sectional microhardness measurements were performed at different surface depths (up to 300 μm depth). Polarized light microscopy images (PLMI) were made to analyze subsurface caries lesions. The fluoride concentration in whole (soluble and insoluble fluoride) and centrifuged (soluble fluoride) varnishes was determined using an extraction method with acetone. The data were analyzed to evaluate the surface microhardness, making adjustments for generalized linear models. There was a significant decrease in enamel surface microhardness after performing all the treatments (p<0.0001). Enamelast and Duraphat showed significantly higher enamel microhardness values than the control and the Clinpro groups (p = 0.0002). Microhardness loss percentage was significantly lower for Enamelast (p = 0.071; One-way ANOVA). PLMI showed that subsurface caries lesions were not remineralized with the varnish treatments. No significant differences in the in-depth microhardness levels (p = 0.7536; ANOVA) were observed among the treatments. Enamelast presented higher soluble and insoluble fluoride concentrations than the other varnishes (p < 0.0001; Kruskal-Wallis and Dunn tests). Enamelast and Duraphat varnishes promoted enamel surface remineralization, but no varnish remineralized the subsurface lesion body. Although insoluble and soluble fluoride concentration values did not correspond to those declared by the manufacturer, Enamelast presented higher fluoride concentration than the others.

The in vitro remineralizing effect of CPP-ACP and CPP-ACPF after 6 and 12 weeks on initial caries lesion

Abstract Objective: The aim of this in vitro study was to determine the effects of remineralization promoting agents containing casein phosphopeptide-stabilized amorphous calcium phosphate (CPP-ACP), or CPP-ACP in combination with fluoride (CPP-ACPF) on artificial white spot lesions (WSLs) after 6 and 12 weeks. Methodology: White spot lesions were created on 123 sectioned premolars (246 specimens) with a demineralization solution during a 96 hours pH-cycling regime. Two experimental groups were created: a CPP-ACP group (Tooth Mousse™), and a CPP-ACPF group (Mi Paste Plus™). Additionally, two control groups were created, one using only a conventional toothpaste (1450 ppm fluoride) and another one without any working agents. All teeth were also daily brushed with the conventional toothpaste except the second control group. Tooth Mousse™ and Mi Paste Plus™ were applied for 180 seconds every day. The volume of demineralization was measured with transverse microradiography. Six lesion characteristics regarding the lesion depth and mineral content of WSLs were also determined. Results: The application of CPP-ACP and CPP-ACPF had a significant regenerative effect on the WSLs. Compared to Control group 1 and 2 the volume of demineralization after 6 weeks decreased significantly for CPP-ACP (respectively p<0.001 and p<0.001) and CPP-ACPF (respectively p=0.001 and p=0.003). The same trend was observed after 12 weeks. For the CPP-ACPF group, WSL dimensions decreased significantly between 6 and 12 weeks follow-up (p=0.012). The lesion depth reduced significantly after application of CPP-ACP and CPP-ACPF but increased significantly in the Control groups. Mineral content increased for CPP-ACP and CPP-ACPF after an application period of 12 weeks, but this was only significant for CPP-ACP. Conclusions: Long-term use of CPP-ACP and CPP-ACPF in combination with a conventional tooth paste shows beneficial effects in the recovery of in vitro subsurface caries lesions.

Doxycycline-containing glass ionomer cement for arresting residual caries: an in vitro study and a pilot trial

Abstract In a previous study, we demonstrated that the incorporation of doxycycline hyclate (DOX) into resin-modified glass ionomer cement (RMGIC) inhibited important cariogenic microorganisms, without modifying its biological and mechanical characteristics. In this study, we keep focused on the effect of that experimental material as a potential therapy for arresting residual caries by analyzing other in vitro properties and conducting a pilot clinical trial assessing the in vivo effect of DOX-containing RMGIC on residual mutans streptococci after partial carious removal in primary molars. Specimens of the groups RMGIC (control); RMGIC + 1.5% DOX; RMGIC + 3% DOX; and RMGIC + 4.5% DOX were made to evaluate the effect of DOX incorporation on surface microhardness and fluoride release of RMGIC and against biofilm of Streptococcus mutans. Clinical intervention consisted of partial caries removal comparing RMGIC and RMGIC + 4.5% DOX as lining materials. After 3 months, clinical and microbiologic evaluations were performed. Data were submitted to ANOVA/Tukey or Wilcoxon/Mann-Whitney set as α=0.05. Fluoride release and surface microhardness was not influenced by the incorporation of DOX (p>0.05). There was a significant reduction of S. mutans biofilm over the material surface with the increase of DOX concentration. After clinical trial, the remaining dentin was hard and dry. Additionally, mutans streptococci were completely eliminated after 3 months of treatment with RMGIC + 4.5% DOX. The incorporation of DOX provided better antibiofilm effect, without jeopardizing fluoride release and surface microhardness of RMGIC. This combination also improved the in vivo shortterm microbiological effect of RMGIC after partial caries removal.

Chemical Composition and Antibacterial Activity of the Essential Oil of Vitex agnus-castus L. (Lamiaceae)

ABSTRACT Abnormal multiplication of oral bacteria causes dental caries and dental plaque. These diseases continue to be major public health concerns worldwide, mainly in developing countries. In this study, the chemical composition and antimicrobial activity of the essential oil of Vitex agnus-castus leaves (VAC‒EO) collected in the North of Brazil against a representative panel of cariogenic bacteria were investigated. The antimicrobial activity of VAC-EO was evaluated in terms of its minimum inhibitory concentration (MIC) values by using the broth microdilution method in 96-well microplates. The chemical constituents of VAC-EO were identified by gas chromatography (GC‒FID) and gas chromatography‒mass spectrometry (GC‒MS). VAC‒EO displayed some activity against all the investigated oral pathogens; MIC values ranged from 15.6 to 200 μg/mL. VAC-EO had promising activity against Streptococcus mutans (MIC= 15.6 μg/mL), Lactobacillus casei (MIC= 15.6 μg/mL), and Streptococcus mitis (MIC= 31.2 μg/mL). The compounds 1,8-cineole (23.8%), (E)-β-farnesene (14.6%), (E)-caryophyllene (12.5%), sabinene (11.4%), and α-terpinyl acetate (7.7%) were the major chemical constituents of VAC‒EO. VAC-EO displays antimicrobial activity against cariogenic bacteria. The efficacy of VAC-EO against S. mutans is noteworthy and should be further investigated.

Impact of vitamin d on development of early childhood caries

Objective: To compare the levels of vitamin D in children with early childhood caries and children with healthy sound dentition

Study Design: Cross sectional study

Place and Duration of study: The study was conducted at Islamic International Medical College from September 2015 to March 2016

Material and Methods: Eighty children, between 2-8 years of age, were recruited after fulfilling a questionnaire from their parents or care giver. The sample population was divided into two groups. Group 1 consisted of children suffering from dental caries and was comprised of 60 patients. Group 2 consisted of children with sound healthy teeth and was comprised of 20 children. Questions assessing children s socioeconomic background, dietary habits particularly frequency of sweet and milk intake, outdoor activity and dental hygiene related behavior were included. The diagnosis of childhood caries was based on oral health diagnostic criteria defined by World Health Organization [WHO] Overall total caries score [decayed missing filled teeth index] was obtained

Levels of 25-hydroxyvitamin D [25[OH] D] was measured from serum samples of the children participating in this study using enzyme linked immunosorbent assay [ELISA]. Correlation analysis was done with Pearson correlation and t-test was applied

Results: Results have established association of Vitamin D levels in children with early childhood caries. Pearson correlation and t-test have revealed that total decayed, missing, filled primary teeth [dmft] caries score was also associated with 25[OH] D concentrations less than 30ng/ml, decreased oral hygiene, lower monthly income, increased sugar consumption, decreased milk intake and decrease outdoor activities. This cross-sectional study showed that carries and lower serum vitamin D are closely related with each other

Conclusion: Data from this cross-sectional study showed that dental caries and lower serum vitamin D were closely related. Improving children's vitamin D status may be an additional preventive consideration to lower the risk for caries

Effect of green tea extract on bonding durability of an etch-and-rinse adhesive system to caries-affected dentin

ABSTRACT Objective Green tea extract has been advocated as a matrix metalloproteinase (MMP) inhibitor; however, its effect on bond durability to caries-affected dentin has never been reported. Thus, the aim of this in vitro study was to evaluate the effect of two MMP inhibitors (2% chlorhexidine and 2% green tea extract), applied after acid etching, on bond durability of an etch-and-rinse adhesive system to caries-affected dentin. Material and Methods Occlusal enamel was removed from third molars to expose the dentin surface, and the molars were submitted to a caries induction protocol for 15 days. After removal of infected dentin, specimens were conditioned with 37% phosphoric acid (15 seconds) and randomly divided into three groups, according to the type of dentin pretreatment (n=10): NT: no treatment; GT: 2% green tea extract; CLX: 2% chlorhexidine. The etch-and-rinse adhesive system (Adper™ Single Bond 2, 3M ESPE, St. Paul, MN, USA) was applied according to the manufacturer's instructions, and composite resin restorations were built on the dentin. After 24 hours, at 37°C, the resin-tooth blocks were sectioned perpendicularly to the adhesive interface in the form of sticks (0.8 mm2 of adhesive area) and randomly subdivided into two groups according to when they were to be submitted to microtensile bond strength (μTBS) testing: immediately or 6 months after storage in distilled water. Data were reported in MPa and submitted to two-way ANOVA for completely randomized blocks, followed by Tukey’s test (α=0.05). Results After 24 hours, there was no significant difference in the μTBS of the groups. After 6 months, the GT group had significantly higher μTBS values. Conclusion It was concluded that the application of 2% green tea extract was able to increase bond durability of the etch-and-rinse system to dentin. Neither the application of chlorhexidine nor non-treatment (NT - control) had any effect on bond strength after water storage.

Differential diagnosis of dental fluorosis made by undergraduate dental students / Diagnóstico diferencial de fluorose dentária por discentes de odontologia

ABSTRACT Objective To check knowledge of undergraduate dental students to make diagnosis of dental fluorosis with varying degrees of severity and choose its appropriate treatment. Methods Data were collected using a semi-structured questionnaire addressing knowledge of undergraduates based on ten images of mouths presenting enamel changes. Results Only three images were correctly diagnosed by most undergraduates; the major difficulty was in establishing dental fluorosis severity degree. Conclusion Despite much information about fluorosis conveyed during the Dentistry training, as defined in the course syllabus, a significant part of the students was not able to differentiate it from other lesions; they did not demonstrate expertise as to defining severity of fluorosis and indications for treatment, and could not make the correct diagnosis of enamel surface changes.

RESUMO Objetivo Verificar o conhecimento de discentes de um curso de graduação em Odontologia ao diagnosticar casos de fluorose dentária nos diversos graus de severidade, bem como escolher seu tratamento adequado. Métodos O levantamento dos dados foi realizado por meio um questionário semiestruturado, que abordou o conhecimento dos acadêmicos sobre as imagens de bocas contendo alterações do esmalte dentário. Resultados Apenas três imagens foram diagnosticadas corretamente pela maioria dos acadêmicos; a maior dificuldade foi o diagnóstico da severidade da fluorose dentária. Conclusão Apesar das informações sobre fluorose repassadas no decorrer do curso de Odontologia, definidas pelos conteúdos abordados na matriz curricular, expressiva parte dos alunos ainda não soube diferenciá-la de outras lesões, não demonstrando domínio sobre a severidade e as indicações de tratamento, o que indicou desconhecimento no diagnóstico correto das alterações de superfície de esmalte.

Efecto antimicrobiano de una solución de superoxidación con pH neutro para desinfección de cavidades clase I / Effectiveness of a neutral pH super-oxidized solution for antimicrobial disinfection of class I cavities

Objetivo: determinar la disminución de la carga bacteriana en dentina de cavidades clase I posterior a la aplicación de clorhexidina 2 por ciento en comparación con la aplicación de solución de superoxidación con pH neutro. Material y métodos: Se realizó un estudio transversal clínico, a 30 pacientes en el Área de Clínicas de la Facultad de Estomatología en la Universidad Autónoma de San Luis Potosí, de los cuales se obtuvieron 60 muestras en cavidades clase I en primeros y segundos molares inferiores permanentes, previas al tratamiento y 60 posteriores que se dividieron en tres grupos, grupo control (n = 20), grupo A correspondiente a clorhexidina al 2 por ciento (n = 20) y grupo B correspondiente a solución de superoxidación con pH neutro (n = 20), posteriormente las muestras fueron llevadas al laboratorio donde se realizó una dilución seriada, para posteriormente sembrar las muestras en placas de agar soya tripticaseina y hacer el conteo de UFC después de haber sido incubadas 24 horas. Resultados: Se realizó una comparación de todos los grupos en cuanto a la disminución de carga bacteriana pretratamiento y postratamiento. Se observó diferencia es tadística significativa en el grupo tratado con clorhexidina al 2 por ciento (p < 0.01) mientras que en los grupos tratados con agua destilada y solución de superoxidación con pH neutro no fueron significativas, ambas con una (p > 0.05) entre las muestras pretratamiento y postratamiento. Conclusiones: Se logró obtener muestras en primeros y segundos molares inferiores en las que se cuantificaron microorganismos previos y posteriores al tratamiento mediante la cuantificación de UFC. Se encontraron diferencias significativas entre grupos, por lo que podemos decir de acuerdo con nuestros resultados que la clorhexidina al 2 por ciento tiene mayor efecto antimicrobiano en la desinfección de cavidades clase I que la solución de superoxidación con pH neutro.

background: Dental caries is a disease characterized by demineralization of the hard tissues of the tooth. If left untreated, it leads to cavitation, discomfort, pain, and the eventual loss of the tooth. A range of antiseptics have been used to eliminate microorganisms from cavities, one of the most common being chlorhexidine, due to the advantages it offers. Nowadays there are products available that offer not only the same microbicidal capacity, but also a greater half-life and superior tissue compatibility. One new option for cavity disinfection is pH neutral super-oxidation solution. Objective: To determine the decrease in bacterial load in the dentin of class I cavities following the application of 2% chlorhexidine compared to a neutral pH over-super-oxidized solution. Material and methods:A clinical cross-sectional study was conducted involving a total of 30 patients at the Faculty of Stomatology Clinics of the Autonomous University of San Luis Potosí, from whom 60 samples were obtained from class I cavities in first and second permanent lower molars prior to treatment and 60 following...

Papacarie: A Chemomechanical Caries Removal Agent.

Chemomechanical caries removal (CMCR) is a noninvasive technique eliminating infected dentine via a chemical agent. Th e objective of CMCR is to eliminate the outer layer or infected dentin, leaving the aff ected layer or partly demineralized dentin, which can be remineralized and repaired. As this process based on minimally invasive dentistry, it not only removes infected tissues, also preserves healthy dental structure, avoiding pulp irritation and patient discomfort. Th is is a method of caries removal based on dissolution. Instead of drilling, this method uses a chemical agent assisted by an a traumatic mechanical force to remove soft carious structure. Th e chemomechanical method for caries removal is most outstanding among other alternative methods. Th is paper reviews one of the chemomechanical removal agent, Papacarie.

Efeito de um infiltrante resinoso no tratamento de lesões de mancha branca: análise in vitro e in situ / Efffect of a resinous infiltrant on the tratment of white spot lesions: in vitro and in situ analysis

Dentre as estratégias de tratamento de lesões incipientes de cárie, no estágio de mancha branca ativa, o infiltrante resinoso tem sido empregado, preenchendo os poros do esmalte e impedindo a sua progressão. O objetivo deste trabalho foi avaliar o efeito do infiltrante de cárie (Icon®) sobre lesões cariosas artificiais produzidas por diferentes protocolos e a eficiência deste tratamento após novo desafio ácido por modelos experimentais in vitro e in situ, utilizando a microdureza de superfície (MS) e longitudinal (ML). Na fase in vitro, lesões cariosas artificiais foram produzidas em 45 espécimes de esmalte bovino (6x4mm) através de três diferentes protocolos (ciclagem DES-RE, gel MC e solução MHDP). Os espécimes foram tratados com o infiltrante e submetidos a novo desafio ácido por ciclagem DES-RE. Este delineamento resultou em 4 condições em um mesmo espécime: hígida (H), após a desmineralização (D), após o tratamento com o infiltrante (I) e após o novo desafio ácido (N). Na fase in situ, 15 voluntários usaram dispositivos palatinos contendo dois espécimes por 14 dias, induzindo a lesão por meio de gotejamento de solução de sacarose 8x/dia. Nas duas fases, a MS e ML foram avaliadas em todas as condições dos espécimes até 220μm. Os dados foram coletados e processados pela porcentagem da diferença com os valores iniciais da condição hígida para serem analisados estatisticamente de acordo com ANOVA (medidas repetidas) e teste de Tukey (p<0,05). No estudo in vitro e in situ todos os protocolos de desmineralização foram capazes de produzir lesões de cárie de subsuperfície. Todos os protocolos in vitro promoveram perda de dureza de superfície maior que 75%, enquanto o protocolo in situ promoveu quase 40%. Há uma redução da perda de dureza à medida que a profundidade aumenta em todos os casos, sendo as particularidades mais observadas até 50 μm. O infiltrante avaliado em todas as condições foi capaz de re-equilibrar parcialmente a dureza interna...

Among the strategies for early caries lesions treatment as active white spot, the resin infiltrant has been employed filling the enamel pores and preventing their progression. The aim of this study was to evaluate the effect of caries infiltrant (Icon®) on artificial carious lesions produced by different protocols, and the efficiency of this treatment after new challenge acid by in vitro and in situ experimental models, using the surface microhardness (SH) and cross-sectional microhardness (CSH). In the in vitro phase, artificial carious lesions were performed on 45 enamel bovine specimens (6x4mm) by three different protocols (DE-RE cycling, MC gel and MHDP solution). The specimens were treated with the infiltrant and subjected to a new challenge by DE-RE cycling. This design resulted in four conditions at the same specimen: sound (S), after demineralization (D), after the treatment with infiltrant (I) and after the new acid challenge (N). In the in situ phase, 15 volunteers wore intraoral appliances containing two specimens for 14 days, inducing the lesion formation by sucrose solution dripping 8x/day. In both models, SH and CSH were evaluated in all conditions of the specimens up to 220μm. Data were collected and processed as percentage from the difference to each condition compared to sound stage to be statistically analyzed with ANOVA (repeated measures) and Tukey test (p <0.05). For all tested conditions, demineralization protocols were able to produce subsurface carious lesions. All in vitro protocols promoted hardness loss higher than 75% while in situ protocol promoted almost 40%. There is a reduction in the hardness loss as the depth increases, in which the main differences can be noticed up to 50μm. The infiltrant evaluated in all conditions was able to partially re-balance the internal hardness, however its strength and effect after the new challenge acid had been limited.

Efeito de um infiltrante resinoso no tratamento de lesões de mancha branca: análise in vitro e in situ / Efffect of a resinous infiltrant on the tratment of white spot lesions: in vitro and in situ analysis

Dentre as estratégias de tratamento de lesões incipientes de cárie, no estágio de mancha branca ativa, o infiltrante resinoso tem sido empregado, preenchendo os poros do esmalte e impedindo a sua progressão. O objetivo deste trabalho foi avaliar o efeito do infiltrante de cárie (Icon®) sobre lesões cariosas artificiais produzidas por diferentes protocolos e a eficiência deste tratamento após novo desafio ácido por modelos experimentais in vitro e in situ, utilizando a microdureza de superfície (MS) e longitudinal (ML). Na fase in vitro, lesões cariosas artificiais foram produzidas em 45 espécimes de esmalte bovino (6x4mm) através de três diferentes protocolos (ciclagem DES-RE, gel MC e solução MHDP). Os espécimes foram tratados com o infiltrante e submetidos a novo desafio ácido por ciclagem DES-RE. Este delineamento resultou em 4 condições em um mesmo espécime: hígida (H), após a desmineralização (D), após o tratamento com o infiltrante (I) e após o novo desafio ácido (N). Na fase in situ, 15 voluntários usaram dispositivos palatinos contendo dois espécimes por 14 dias, induzindo a lesão por meio de gotejamento de solução de sacarose 8x/dia. Nas duas fases, a MS e ML foram avaliadas em todas as condições dos espécimes até 220μm. Os dados foram coletados e processados pela porcentagem da diferença com os valores iniciais da condição hígida para serem analisados estatisticamente de acordo com ANOVA (medidas repetidas) e teste de Tukey (p<0,05). No estudo in vitro e in situ todos os protocolos de desmineralização foram capazes de produzir lesões de cárie de subsuperfície. Todos os protocolos in vitro promoveram perda de dureza de superfície maior que 75%, enquanto o protocolo in situ promoveu quase 40%. Há uma redução da perda de dureza à medida que a profundidade aumenta em todos os casos, sendo as particularidades mais observadas até 50 μm. O infiltrante avaliado em todas as condições foi capaz de re-equilibrar parcialmente a dureza interna...

Among the strategies for early caries lesions treatment as active white spot, the resin infiltrant has been employed filling the enamel pores and preventing their progression. The aim of this study was to evaluate the effect of caries infiltrant (Icon®) on artificial carious lesions produced by different protocols, and the efficiency of this treatment after new challenge acid by in vitro and in situ experimental models, using the surface microhardness (SH) and cross-sectional microhardness (CSH). In the in vitro phase, artificial carious lesions were performed on 45 enamel bovine specimens (6x4mm) by three different protocols (DE-RE cycling, MC gel and MHDP solution). The specimens were treated with the infiltrant and subjected to a new challenge by DE-RE cycling. This design resulted in four conditions at the same specimen: sound (S), after demineralization (D), after the treatment with infiltrant (I) and after the new acid challenge (N). In the in situ phase, 15 volunteers wore intraoral appliances containing two specimens for 14 days, inducing the lesion formation by sucrose solution dripping 8x/day. In both models, SH and CSH were evaluated in all conditions of the specimens up to 220μm. Data were collected and processed as percentage from the difference to each condition compared to sound stage to be statistically analyzed with ANOVA (repeated measures) and Tukey test (p <0.05). For all tested conditions, demineralization protocols were able to produce subsurface carious lesions. All in vitro protocols promoted hardness loss higher than 75% while in situ protocol promoted almost 40%. There is a reduction in the hardness loss as the depth increases, in which the main differences can be noticed up to 50μm. The infiltrant evaluated in all conditions was able to partially re-balance the internal hardness, however its strength and effect after the new challenge acid had been limited...

Obtaining the essential oil of Syzygium aromaticum, identification of eugenol and its effect on Streptococcus mutans / Obtención del aceite esencial de Syzygium aromaticum, identificación del eugenol y su efecto sobre Streptococus mutans

Dental caries is a disease which affects the human oral cavity. Currently, the search for active principles of plants with antimicrobial effect seems promising for dental therapy. In this article the activity of the essential oil of Syzygium aromaticum (clove) was evaluated with an emphasis on its antimicrobial properties. The oil was obtained by hydrodistillation, characterized by thin layer chromatography and chemical tests. The main compound was identified in the oil obtained from the flower buds and its antibacterial activity against plank¬tonic cells Streptcoccus mutans ATCC700611 was assessed by performing serial dilutions, from 15 up to 1000 ug/mL, compared with 0.12 percent chlorhexidine and dimethylsulfoxide. MIC was also determined. Subsequently, UFC was analyzed and compared with CMR Test Ivoclar Vivadent. The efficiency in obtaining the oil was 2.20 percent. By using the CCD technique, a fraction was revealed by UV light, corresponding to eugenol. It had a good response for triterpenoids and flavonoids. It showed greater antimicrobial activity at concentrations of 1000, 500 and 250ug/ ml. The MIC and MBC of the oil was 125 to 250ug/mL, respectively. Eugenol was found as an active principle in the oil obtained. Currently, the impact of using plant extracts has favored the evaluation of alternative, effective and biocompatible antibacterial agents for the formulations of oral hygiene products applied to the prevention or treatment of oral diseases.

La caries dental es una enfermedad que afecta la cavidad oral en los humanos. Actualmente la búsqueda de principios activos de plantas con efecto antimicrobiano representa una promesa en la terapia Odontológica. El presente trabajo, evaluó la actividad, del aceite esencial de Syzygium aromaticum (clavo) con énfasis en su propiedad antimicrobiana. El aceite fue obtenido por hidrodestilación, caracterizado por cromatografía en capa delgada y pruebas químicas. Se iden¬tificó el compuesto principal en el aceite obtenido de los botones florales y se evaluó su actividad antibacteriana contra células plantónicas de Streptcoccus mutans ATCC (700611) realizándose diluciones seriadas; desde 15 hasta 1000ug/mL, comparándose con clorhexidina al 0.12 por ciento y dimetilsulfóxido, además se determinó la CMI. Posteriormente, se analizó las UFC, comparándose con el Test CMR® Ivoclar Vivadent. La eficiencia en la obtención del aceite fue de 2.20 por ciento. Por la técnica de CCD se identificó una fracción al revelado UV, corres¬pondiente al eugenol. Presentó respuesta positiva para flavonoides y triterpenos. Mostró mayor actividad antimicrobiana a las concentraciones de 1000, 500 y 250 ug/mL. La CMI y CMB del aceite, resultó a 125 y 250 ug/mL respectivamente. Se comprobó la presencia del eugenol como principio activo en el aceite obtenido. Actualmente la proyección del uso de extractos de plantas ha favorecido la evaluación de agentes antibacterianos alternos, eficaces y biocompatibles para su empleo en las formulaciones de productos de higiene bucal aplicados a la prevención o tratamiento de enfermedades orales.

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.