Non-Invasive Methods and the Use of Infiltrating Resins for the Control of Caries Progression in Deciduous Teeth: A Systematic Review and Meta-Analysis

ABSTRACT Objective: To evaluate the influence of non-invasive treatment associated with the use of infiltrating resin for managing caries lesions in primary teeth. Material and Methods: A systematic review was performed by selecting articles from 6 online databases, using a search algorithm and eligibility criteria for data extraction and data synthesis for the papers included. Clinical trials involving primary teeth with incipient caries lesions (1/2 of the enamel or 1/3 of the outer dentin) were included, presenting full text and answering the study's guiding question. This study used the RoB 2 tool for the risk of bias assessment and GRADE for certainty of evidence. Random effects meta-analyses were implemented, and lesion progression treatment effects were estimated through relative risk (RR) and associated 95% confidence intervals. Results: A total of 440 studies were found. After analyzing the inclusion criteria and removal of duplicates, eight studies were analyzed for quality evidence. Five of the eight studies included in this review contributed to the meta-analysis, all with some reflections regarding the risk of bias. Overall, the results of the meta-analysis showed that non-invasive treatment, when associated with the use of infiltrating resins, significantly reduced the risk of caries progression in relation to the treatment without this addition for follow-up periods ranging from 12 months to 2 years (RR 0.51 [0.40-0.65]). Conclusion: There is moderate certainty of evidence that the use of infiltrating resins associated with non-invasive treatments decreases the risk of caries progression in primary teeth with incipient caries lesions (1/2 of the enamel or 1/3 of the dentin outer) when combined with non-invasive control methods alone.

Comparación del desempeño técnico-asistencial en programas escolares con diferentes modalidades de implementación / Comparison of technical-assisstance performance in school programs with different implementation modalities

Se comparó el desempeño técnico-asistencial de 2 programas de atención odontológica con iguales protocolos de atención y diferente modalidad de implementación. Ambos programas se caracterizaron por un perfil preventivo-promocional; uso de protocolos validados según riesgo biológico, atención odontológica adaptada a sedes no convencionales, recursos asignados por método de necesidades; ejecución por recurso humano pre-profesional supervisado y modulación por altas. La modalidad de implementación difirió en la densidad/concentración de las actividades realizadas: en el Programa Extensivo (PE) las acciones se implementaron con frecuencia semanal; en el Programa Intensivo (PI) las acciones se concentraron en una semana en el año. Cobertura anual: PE = 120 escolares de 6 a 9 años de edad; PI = 180 escolares y preescolares de 3 a 12 años de edad. Se midió la cantidad de prestaciones, sesiones y tiempo -en minutos- hasta alcanzar el Alta Básica Operativa (ABO). Para comparar grupos (PI y PE) se utilizaron los tests: U de Mann Whitney, t de Student para mues-tras independientes, chi cuadrado y comparación de proporciones. La razón de prestaciones/sesión fue significativamente mayor (p=0,000) en el programa intensivo. El número de prestaciones hasta el alta (ABO) y la razón tiempo/sesión no mostraron diferencias entre programas (p=0,8 p=0,087), mientras que se evidenció una mayor razón tiempo/prestación y tiempo en alcanzar el alta (ABO) en la modalidad extensiva (p=0,000). La modalidad intensiva mostró mayor eficiencia en el desempeño técnico asistencial que la extensiva (AU)

Aim: To compare technical-care performance of 2 dental care programs with the same care protocols and different implementation modalities. Both programs shared the following features: preventive-promotional profile; use of validated clinical protocols according to biological risk, dental care adapted to non-conventional settings, allocation of resources by needs method; supervised pre-professional human resource and modulation by discharges. The implementation mode differed in the density/concentration of the activities: in the extensive program (EP) the actions were implemented on a weekly basis along the year; in the intensive program (IP) the actions were concentrated in one week in the year. Annual coverage of the programs: 180 schoolchildren and preschoolers (3 -12 years old); EP = 120 schoolchildren (6 - 9 years old). We measured the following variables: the number of dental services performed, the number of sessions and the time, in minutes, to reach the basic operating discharge (BOD). We used the following tests to compare groups (IP and EP): Mann Whitney U; Student's t for independent samples, chi square and comparison of proportions test. The action per session ratio was significantly higher (p=0.000) in the intensive program. The number of actions performed until discharge (BOD) and the time per session ratio did not show differences between programs (p=0.8 p=0.087). In the extensive mode, compared to intensive mode, it took longer to reach discharge (BOD) (p=0.000) The program implemented with intensive modality (PI) showed greater efficiency regarding technical-care performance when compared to the extensive mode (AU)

Efficacy of Resin Infiltration and Fluoride Casein Phosphopeptide Amorphous Calcium Phosphate Varnish on Non-cavitated Active White Spot Lesions in Children: A Randomized Clinical Trial

Abstract Objective: To compare the efficacy of resin infiltration and fluoride casein phosphopeptide amorphous calcium phosphate varnish on non-cavitated active white spot lesions in 5-8 years old children. Material and Methods: 60 non-cavitated active white spot lesions in 60 patients with ICDAS II score 2 from both genders in the age range of 5 to 8 years were taken. Thirty lesions were treated by resin infiltration (Group 1) and 30 by Fluoride CPP-ACP varnish (Group 2). Resin infiltration was performed on the same day, while Fluoride CPP-ACP varnish was applied once a week for 4 weeks. The follow-up was done at 3, 6 months, and 12 months. Results: At 3, 6, and 12 months change in mean ICDAS II Score in group 1 was 1.5±0.5,1.13±0.73 and 0.9±0.88, respectively, while in group 2, it was observed to be 0.30±0.59, 0.4±0.89 and 0.06±0.82, respectively (p<0.001). Conclusion: Resin infiltration was more successful than Fluoride CCP-ACP varnish in active non-cavitated white spot lesions (AU).

Non-invasive and micro-invasive treatments to arrest active occlusal carious lesions in erupting permanent molars: A randomized clinical trial

Abstract: This study aimed to evaluate the efficacy of non-invasive and micro-invasive treatments on the arrest of occlusal enamel carious lesions in erupting permanent molars. This two-arm randomized clinical trial included 27 subjects, aged 5-11 years, with 64 erupting permanent molars presenting active occlusal enamel carious lesions (as assessed by the International Caries Detection and Assessment System [ICDAS]; scores 1-3). The sample was randomly assigned into two treatment groups: 1) resin-modified glass ionomer cement sealant (Clinpro XT Varnish; 3M ESPE) and 2) 4-week topical fluoride varnish application (Duraphat; Colgate). All children and parents received oral hygiene and dietary instructions. Teeth were evaluated at baseline and 3, 6, 9, and 12 months regarding the eruption stage, biofilm accumulation, as well as severity and activity of the carious lesions. The Kaplan-Meier method was used to evaluate the survival estimates for inactivation of the carious lesions for both treatment groups. Multivariate Cox regression models with shared frailty were performed to identify factors associated with the outcome (p < 0.05). After 12 months, 22% and 3% of the lesions treated with topical fluoride varnish and sealant, respectively remained active. The adjusted model demonstrated that younger children had a higher probability of active enamel carious lesions arresting (hazard ratio [HR] 0.42, 95% confidence interval [CI] 0.22-0.78; p=0.01). However, the probability of active enamel carious lesions arresting after sealant application was 8.85 times higher compared with fluoride varnish applications (p=0.01). Sealing is a more effective approach than fluoride varnish for arresting occlusal enamel carious lesions in erupting permanent molars.

Procedimientos libres de aerosol ante COVID-19 en odontología pediátrica / Aerosol-free procedures against COVID-19 in pediatric dentistry

A finales de 2019 se identificó el virus SARS-CoV-2 (por su significado en inglés Severe Acute Respiratory Syndrome Coronavirus 2) como agente etiológico de la COVID-19 (por su significado en inglés coronavirus disease 2019) en la ciudad de Wuhan, China. Debido a su rápida propagación al resto del mundo durante el primer trimestre del año 2020, la Organización Mundial de la Salud (OMS) la declaró pandemia mundial en marzo del mismo año. Por el potencial de contagio de COVID-19 se ha considerado que el entorno clínico en el que se desenvuelve la odontología puede ser de alto riesgo para el paciente, el odontólogo y sus asistentes si no se tienen las medidas de bioseguridad adecuadas. En un principio se vieron suspendidas las consultas regulares; sin embargo, al volver a la actividad laboral se han adaptado protocolos para el control de infecciones como reforzar el uso de barreras de protección y minimizar tratamientos que involucren aerosoles. La caries es uno de los principales motivos de consulta en la odontología pediátrica, por lo que en este escrito se sugieren algunos protocolos basados en la mínima invasión que prescinden de instrumental rotatorio para salvaguardar al paciente en riesgo de contagio, reduciendo el número de visitas y tiempo en consulta e incluso controlando algunos aspectos de salud bucal fuera de consulta clínica por medio de estrategias preventivas que pueden llevarse a cabo desde casa. Esto significa también mantener la tranquilidad por parte de los tutores del paciente ante la pandemia que se vive actualmente (AU)

At the end of 2019, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was identified as the etiological agent of COVID-19 in the city of Wuhan China. Due to its rapid spread to the rest of the world during the first trimester of 2020, the WHO declared a global pandemic in March of the same year. Due to the contagion potential of COVID-19, it has been considered that the clinical environment in which dentistry operates may be in high risk for the patient if the appropriate biosafety measures are not taken, initially clinical practices were suspended. However, when returning to work, protocols have been adapted to the infection control procedures, reinforced the use of protective barriers, and minimize treatments that involve aerosols. Caries is one of the main reasons for consultation in Pediatric Dentistry, this article suggests some protocols based on minimal invasion that dispense with rotating instruments to safeguard the patient from the risk of contagion, reducing the number of visits and time in consultation and even controlling some aspects of the oral health outside the dental visit through preventive strategies that can be carried out from home. Modifications to Dental Home. This should include maintaining tranquility and calm on the part of the patient's tutors in the face of the pandemic that we are currently experiencing (AU)

Efectividad bactericida del diamino fluoruro de plata a diferente concentración sobre estreptococos cariogénicos en muestras de saliva y dentina de escolares: un estudio in vitro / Bactericidal effectveness of silver diamine fluoride in different concentrations on cariogenic Streptococcus in salivary and dentinal samples of schoolchildren: an in vitro study

La OMS y la FDI han publicado que entre el 60 y 90% de los escolares padecen caries. En nuestro país, el Sistema de Vigilancia Epidemiológica de Patologías Orales (SIVEPAB) 2012, reporta un 85% de caries a nivel nacional en población pediátrica. Los agentes anticariogénicos como el diamino y el fluoruro de plata son un tratamiento alentador, este agente puede actuar como bactericida o bacteriostático en función de su concentración y su capacidad para inhibir el crecimiento de estreptococos del grupo viridans, y por ende, de la caries. Problema: ¿Cuál es la efectividad bactericida del diamino fluoruro de plata (Saforide®) a diferente concentración sobre la microbiota cariogénica de escolares? Objetivo: Determinar la eficacia bactericida del diamino fluoruro de plata (DFP) a diferentes concentraciones en el crecimiento bacteriano de Streptococcus mitis, S. mutans y S. salivarius en muestras de saliva y dentina en escolares. Material y métodos: Se llevó a cabo un estudio experimental con una variable independiente, el efecto bactericida del diamino fluoruro de plata y se tomó el halo de inhibición como la dependiente. Se utilizaron medidas descriptivas como prueba de comparación y análisis de varianza usando post-hoc Tukey≠ con una confianza del 95%, y análisis de datos exploratorios. Resultados: Se analizaron 100 muestras, de las cuales 48.3% correspondió a S. mutans, 41.4% a S. salivarius y 10.3% a S. mitis, se obtuvo una mayor zona de inhibición para las tres bacterias al 38% mostrando una diferencia estadísticamente significativa 12% (p < 0.05). También se observó un efecto bacteriostático al 12%, no así para el 38%, donde se encontró un efecto bactericida Conclusión: Nuestros resultados sugieren que al 38% de la concentración hay un claro efecto bactericida en el grupo de estreptococos viridans y el 12% no se recomienda para la detención de caries debido al efecto bacteriostático (AU)

WHO and FDI have ruled that 60-90% of schoolchildren are affected by caries. In our country, the System of Epidemiological Surveillance of Oral Pathologies (SIVEPAB) (SIVEPAB) 2012. Report a rate of 85% of caries nationally in pediatric population. Anticariogenic diamino agents such as silver fluoride are an encouraging decrease in treatment for these high rates of tooth decay in our country, this agent can act as bactericidal or bacteriostatic based on their concentration and their ability to inhibit endogenous metalloproteinase (MMP-2, 8, 9). Problem: What will be the bactericidal effectiveness of silver diamine fluoride different concentration on cariogenic Streptococci saliva samples taken from school and dentin? Objective: Determine the bactericidal effectiveness Silver diamine fluoride (SDF) to different concentration on bacterial growth of Streptococcus mitis, S. mutans, and S. salivarius in saliva samples and dentin in school. Material and methods: An experimental study was conducted as an independent variable the bactericidal effect of silver diamine fluoride was taken as dependent inhibition halo. Descriptive measures were used as a comparison test and analysis of variance using Post-hoc Tukey with 95% confidence, and exploratory data analysis. Results: One hundred samples, of which 48.3% corresponded to S. mutans, 41.4% to S. salivarius and 10.3% to S. mitis, were analyzed, we obtained a larger zone of inhibition for all three organisms at 38% showing a statistically significant difference from 12% (p < 0.05). It was also observed that the 12% sample bacteriostatic effect, not to the concentration of 38% was found a bactericidal effect. Conclusion: Our results suggest that 38% concentration has a bactericidal effect on Streptococcus viridans group and 12% showed not recommended for the arrest or detention of dentine caries bacteriostatic effect (AU)

Manejo estomatológico del paciente con osteogénesis imperfecta: presentación de un caso / Dentistry handling patient with osteogenesis imperfecta. Report of a case

La osteogénesis imperfecta es un desorden hereditario que comprende unamplio espectro de presentaciones fenotípicas cuya principal característicaes la fragilidad ósea. La dentinogénesis imperfecta es un trastorno de origen hereditario en el desarrollo de la dentina, cuya incidencia se estimaen alrededor de 1:8,000. Objetivo: Implementar un abordaje estomatoló-gico con enfoque en nuevas tendencias rehabilitadoras y preventivas entratamientos para pacientes con dentinogénesis imperfecta. Presentación del caso: Paciente masculino de tres años de edad que acude al Servicio de Estomatología del Instituto Nacional de Pediatría, diagnosticado con osteogénesis imperfecta tipo IV. Se observan las coronas con coloración ámbar generalizada, atrición y pérdida de la estructura dentaria por caries en diversos órganos dentarios. Se realiza la rehabilitación bucal bajo anestesia general, restaurando los dientes afectados con coronas de acero cromoy colocando selladores de fosetas y fi suras en molares con esmalte íntegro así como fluoruro en barniz al 5 por ciento. Conclusiones: El tratamientode la dentinogénesis imperfecta depende de la severidad que presente elpaciente. Es esencial dar un seguimiento estrecho, resolviendo de manera oportuna las necesidades que vayan surgiendo con un tratamiento no tan radical como se recomendaba anteriormente.

Osteogenesis imperfecta is a hereditary disorder that encompasses abroad spectrum of phenotypic presentations whose main characteristicis bone fragility. Dentinogenesis imperfecta is a disorder in developinghereditary dentin whose incidence is estimated to about 1:8,000.Objective: Implement a focused approach dentistry new trends inrehabilitative and preventive treatments for patients with dentinogenesisimperfecta. Case report: Male patient age three who comes toDentistry Service of the National Institute of Pediatrics, diagnosed withosteogenesis imperfecta type IV. Crowns with generalized amber colorobserved oral rehabilitation is performed under general anesthesia,restoring the aff ected teeth with stainless steel crown and placingsealant in the molar pit and fi ssure enamel integral and placementof fl uoride varnish to 5%. Conclusions: Dentinogenesis imperfectatreatment depends on the severity with which the patient presents. Itis very important to closely monitor, timely meeting the needs as theyarise, conducting a treatment not as radical as it was in the beginning.

Evaluación clínica de barniz de flúor en el manejo de la hipersensibilidad dentinaria / Clinical evaluation fluoride varnish in the management of dentin hypersensitivity

La Hipersensibilidad Dentinaria (HD) se define como un corto y fuerte dolor generado por la exposición de dentina, que surge de un estímulo químico, térmico, táctil u osmótico, el cual no puede catalogarse como una patología dental propiamente tal. La teoría hidrodinámica de Brännström es la más aceptada en la actualidad para explicar la etiopatogenia de esta afección. Muchos productos han sido elaborados con el fin de combatir la HD, pero no todos constan de la efectividad deseada para atenuarla. El objetivo del presente estudio es evaluar la efectividad inmediata y mediata (posterior a 2 semanas), de un barniz de flúor (Flúor Protector®) utilizado en la problemática. El estudio es un ensayo clínico no controlado. La muestra consistió de 30 pacientes, sin distinción de género, de entre 20 a 60 años, atendidos en las clínicas de la Facultad de Odontología de la Universidad Andrés Bello, cuyo diagnóstico fue HD, en al menos un diente, con recesión gingival de al menos 2 mm, la cual presento dentina expuesta desde la unión amelocementaria, y además que respondieron a 3 o más puntos en la Escala Numérica (EN), cuando fue aplicado el estímulo evaporativo. Los datos fueron recogidos, en una ficha diseñada para el estudio, la cual incluyo datos del paciente y 9 EN, con las cuales se cuantifico la percepción de dolor de los pacientes frente a 3 estímulos: evaporativo, táctil y térmico. Estadísticamente se utilizó análisis de tipo descriptivo y de varianza de Friedman. Se obtuvieron resultados estadísticamente significativos (p<0.05) en la disminución casi completa de la HD frente al tratamiento inmediato (mediana< 3), además de la mantenida reducción de la misma en el control posterior a 2 semanas de aplicada la terapia. En conclusión, la terapia con flúor barniz es efectiva en el tratamiento inmediato y mediato de la HD.

Dentin Hypersensitivity (DH) is defined as a short, sharp pain generated by exposure of dentin, which arises from a chemical stimuli, thermal, tactile or osmotic, which can't be categorized as a dental pathology as such. Brännström hydrodynamic theory is widely accepted today to explain the pathogenesis of this condition. Many products have been developed to combat DH, but not all consist of the desired effectiveness to attenuate. The aim of the present study is to evaluate the effectiveness immediate and mediate (after two weeks), a fluoride varnish (Fluor Protector), used in the management of patients with this problem. The present study is an uncontrolled clinical trial. The sample consisted of 30 patients, regardless of gender, aged 20 to 60, treated at the clinics of the Faculty of Dentistry at the "Universidad Andres Bello", whose diagnosis was DH, in a least one tooth with gingival recession at least 2 mm, which exposed dentin present from the CEJ, and also responding to three of more points on the Numeric Scale (NS), when the stimulus was applied evaporative. Data were collected after approval and written informed consent, in a form designed for the study, which included data from the patient and 9 NS, which was quantified with pain perception of patients versus 3 stimuli: evaporative, touch and heat. For statistical analysis we used descriptive analysis and variance of Friedman. Regarding the 3 stimuli under study results were statistically significant (p< 0.05) decrease in the almost complete DH versus immediate treatment (median < 3), besides the maintained reduction thereof in the inspection after 2 weeks of therapy applied. In conclusion, treatment with fluoride varnish is effective in treating the immediate and mediate DH.

Survival of sealants in molars affected by molar-incisor hypomineralization: 18-month follow-up

Abstract The objective of this study was to evaluate the clinical survival of sealants applied in first permanent molars (FPMs) affected by molar-incisor hypomineralization (MIH), at 18 months of follow-up. Forty-one first permanent molars were selected from 21 children, 6–8 years of age. MIH was classified by one calibrated examiner (kappa = 0.80) according to EAPD criteria. The inclusion criteria were fully erupted FPMs with MIH or sound FPMs (without MIH) for which sealant treatment was indicated. The FPMs were assigned to two groups: CG (control group) and HG (MIH group). Both groups were treated with sealant (FluroShield). Clinical follow-up was performed from baseline to 18 months to assess anatomical form, marginal adaptation, retention and presence of caries, according to criteria set by the United States Public Health Service-Modified, and was conducted by a blinded examiner (kappa = 0.80). The actuarial method was used to evaluate the survival of the sealants. The survival rates for the groups were compared using Fisher’s exact test (α = 5%). The cumulative survival rates were 81% at 1 month, 68.8% at 6 months, 68.8% at 12 months, and 62.6% at 18 months for CG, and 88% at 1 month, 84% at 6 months, 76% at 12 months, and 72% at 18 months for HG. No significant difference was found between the groups. The sealants in molars affected by MIH presented a survival rate similar to the sealants in the control, suggesting that sealants may be an adequate approach for preventing carious lesions in MIH-affected molars.

AmF/NaF/SnCl2 solution reduces in situ enamel erosion - profilometry and cross-sectional nanoindentation analysis

Abstract This in situ study aimed to investigate the effect of a tin-containing fluoride solution in preventing enamel erosion. Also, its effects on the partly demineralized zone were assessed for the first time. Thirteen volunteers participated in this 2-phase study, wearing removable intra-oral appliances containing four sterilized bovine enamel slabs, for 8 days, where 2 treatment protocols were tested using samples in replicas (n = 13): CO - no treatment (negative control) and FL - AmF/NaF/SnCl2 solution (500 ppm F-, 800 ppm Sn2+, pH = 4.5). Samples were daily exposed to an erosive challenge (0.65% citric acid, pH 3.6, 4 min, 2x/day). In the 2nd phase, volunteers switched to the other treatment protocol. Samples were evaluated for surface loss using a profilometer (n = 13) and a cross-sectional nanohardness (CSNH) test (n = 13) was carried out in order to determine how deep the partly demineralized zone reaches below the erosive lesion. The data were statistically analyzed by two-way ANOVA. Erosive challenges lead to smaller enamel surface loss (p < 0.001) in the FL group when compared to group CO. Data from CSNH showed that there was no significant difference in demineralized enamel zone underneath erosion lesions between the groups. An amorphous layer could be observed on the surface of enamel treated with tin-containing solution alone. Under the experimental conditions of this in situ study, it can be concluded that AmF/NaF/SnCl2 solution prevents enamel surface loss but does not change the hardness of the partly demineralized zone near-surface enamel.

Evaluación de fluoruro residual en saliva después de la aplicación de barnices fluorados al 2.26 por ciento: estudio comparativo / An evaluation of the residual fluoride in saliva after applying 2.26 per cent fluoride varnishes: a comparative study

El objetivo de este estudio fue comparar la cantidad de fluoruro (F) residual en saliva después de la aplicación de barniz de fluoruro desodio al 5 por ciento y de barniz fluorado con fosfato tricálcico al 5 por ciento en niños de 2 a 5 años de edad. Se recolectó la saliva no estimulada de 24 niños que tenían acceso a sal fluorada diariamente y utilizaban dentífricos infantiles conteniendo 550 ppm F. La primera toma de muestrasalival fue colectada como basal y las siguientes fueron tomadas en diferentes intervalos de tiempo luego de realizar la aplicación del barnizfluorado (15; 30; 60 minutos y 24; 48; 72; 96; 168 horas). Un total de 216 muestras fueron obtenidas, siendo 96 muestras de barniz de Duraphat®, 96 muestras de barniz de ClinproTM WV y 24 muestras muestras basales. Los análisis de laboratorio fueron realizadosen el departamento de Bioquímica de la Facultad de Odontología de Baurú (FOB), Universidad de Sao Paulo. Un electrodo Orión 9409 y un microelectrodo acoplados a un potenciómetro Orion EA 940 se utilizaron para analizar las muestras previa difusión de las muestrascon el método de Taves. La concentración de iones de flúor mostró diferencias estadísticamente significativas entre ambos productos desde las 24 horas (p<0.001), esta característica se repite a las 48 (p=0.003); 96 (p<0.001) y 168 horas (p<0.001). Se utilizó el análisisestadístico de Shapiro Wilks y T de Student. Ambos barnices mostraron un incremento de fluoruro residual en saliva durante los 15; 30 y 60 minutos, sin embargo, posteriormente a estos tiempos, ambos muestran niveles no significativamente diferentes al basal.

The aim of this study was compared the amount of residual fluoride after application of sodium fluoride varnish 5% and application offluoride varnish with phosphate tricalcium 5% in children from 2 to 5 years old. Unstimulated saliva was collected of 24 children who hadaccess to fluoridate salt daily and used children´s tooth pastes containing 550ppm F. The first salivary sample was collected as a base lineand the following were taken at different intervals after making the application of fluoride varnish (15; 30; 60 minutes; 24; 48; 72; 96;168 hours).Children were grouped in two groups according of type of varnish containing fluoride going to be applied. A total of 216samples were obtained, 96 samples from Duraphat® and 96 samples from ClinproTM WV 3M ESPE. The lab analyzes wereconducted in the Department of Biochemistry at the Faculty of Dentistry, Bauru (FOB), University of Sao Paulo. An Orion 9409electrode and a microelectrode coupled to a potentiometer Orion EA 940 analyzed the samples prior dissemination of samples with themethod of work. The fluoride concentration was statistically significant after 24 (p<0.001); 48 (p=0.003); 96 (p<0.001) y 168 hours(p<0.001) for both products. We used Shapiro Wilks and T student test for statistical analysis. Both products showed an increased inresidual fluoride in saliva during the 15; 30 and 60 minutes, however, both showed not differences that baseline levels.

Comparison of amine fluoride and chlorhexidine mouth rinses in the control of plaque and gingivitis – A randomized controlled clinical trial.

Objectives: The objective of this triple blind randomized controlled clinical trial was to compare the efficacy of a mouth rinse containing amine fluoride (AmF) and chlorhexidine in controlling the supragingival plaque accumulation and gingival inflammation during a 4‑week period in patients with chronic gingivitis. Subjects and Methods: A total of 30 patients were participated in this study. Fifteen patients were prescribed an AmF‑containing mouth rinse and 15 were prescribed a chlorhexidine mouth rinse. Plaque index, gingival index, bleeding index, tooth stain, and tongue stain (TS) were recorded at baseline, 15 days and 1‑month. Patients’ perception of odor, taste and any discomfort were recorded. Results: The comparisons between the groups were done using Mann–Whitney U‑test. The comparison within the group at different time visits were done using Wilcoxon signed rank test. Both the mouth rinses resulted in a significant decrease in plaque index, gingival index, bleeding index. However, AmF mouth rinse resulted in a statistically significant decrease in bleeding index and gingival index compared to chlorhexidine group. There was no significant difference in tooth stain and TS in both the groups. Conclusions: The 4 weeks use of AmF containing mouth rinse is effective in reducing the gingival inflammation and plaque.

Métodos preventivos em primeiro molar permanente de crianças com experiência de cárie dentária: estudo clínico comparativo / Preventive methods in permanent first molars of children with caries experience: clinical comparative study

É na infância que os dentes, em geral, são mais vulneráveis, estando mais susceptíveis a contrair cárie dentária, especialmente no período de irrupção, momento em que o elemento dental se encontra em infra oclusão, o que favorece o acúmulo de placa e dificulta sua adequada higienização. Soma-se ainda a pouca habilidade da criança em executar as manobras de uma adequada escovação dentária. O primeiro molar permanente em irrupção, além destes fatores de susceptibilidade citados, é por excelência um nicho de colonização de microrganismo pela sua anatomia oclusal, fato que torna este período de alto risco para o surgimento de novas lesões de cárie dentária. Portanto, partindo da premissa que molares permanente em fase de irrupção, de criança com experiência de cárie dentária, são mais susceptíveis a adquirir a doença, o objetivo desse trabalho foi comparar três métodos preventivos da ocorrência de lesão cariosa neste dente. Participaram do estudo 242 crianças (968 molares), de ambos os gêneros, na faixa etária de 6 a 8 anos, com experiência de cárie dentária, apresentando os quatros primeiros molares permanentes hígidos em fase de irrupção. As crianças foram divididas aleatoriamente em três grupos: grupo com 81 crianças, cujo os 324 molares receberam aplicação única de selante de fossas e fissuras à base de ionômero de vidro (SIV), grupo com 83 crianças (332 molares), com aplicação de verniz fluoretado (VF) em 3 sessões (0, 6 e 12 meses) e grupo com 78 crianças, 312 molares que receberam profilaxia profissional (PP) em 6 sessões (0, 3, 6, 9, 12 e 15 meses). A avaliação clínica pós-operatória foi realizada após 6, 12 e 18 meses, para os pacientes dos três grupos. Quanto ao efeito preventivo o SIV, o VF e a PP apresentaram resultados diferentes, aos 6 meses (99,5%, 96% e 98%), aos 12 meses (99,5%, 96% e 96%) e aos 18 meses (99%, 99,5% e 95%), respectivamente. A lesão cariosa ocorreu em 1, 11 e 5 molares (0,5%, 4% e 2% ) aos 6 meses; 1, 8 e 10 molares...

It is in childhood that the teeth in general, are more vulnerable, are more susceptible to getting tooth decay, especially in the outbreak period, hampering their proper hygiene. Also, it is added to the little child’s ability to perform the maneuvers of proper tooth brushing. The first permanent molar eruption, in addition to cited susceptibility factors, is par excellence a microorganism colonization niche because of its occlusal anatomy, a fact that makes of this period highly risky for the emergence of new lesions of dental caries. Therefore, based on the premise that children with caries experience in the permanent molar eruption phase are more likely to acquire the disease, the goal of this study was to compare three preventive methods of occurrence of carious lesions in the tooth. The study included 242 children (968 molars), of both genders, aged 6-8 years, with caries experience, with the four first permanent molars at the erupting phase. The children were randomly divided into three groups: a group of 81 children, whose 324 molar received a single application of pit and fissure sealant made on the basis of glass ionomer (GIS), a group of 83 children (332 molars), with coating application of fluoride varnish (FV) in 3 sessions (0, 6 and 12 months) and a group of 78 children (312 molars) who received professional prophylaxis (PP) in 6 sessions (0, 3, 6, 9, 12 and 15 months). Patients were clinically evaluated after 6, 12 and 18 months, patients in the three groups. As for the preventive effect the GIS, FV and PP showed different results at 6 months (99.5%, 96% and 98%), at 12 months (99.5%, 96% and 96%) and at 18 months (99%, 99.5% and 95%), respectively. The carious lesion occurred in 1, 11 and 5 molars (0.5%, 4% and 2%) at 6 months; 1, 8 and 10 molars (0.5%, 4% and 4%) at 12 months; 3, 9 and 1 (1%, 0.5%, 5%) at 18 months for the groups GIS, FV and PP, respectively. It was concluded that in children with caries experience the best results for their...

Técnica de desproteinización para el tratamiento de hipoplasias / Collagen removal technique for treating dental enamel hypoplasia

La hipoplasia del esmalte es una anomalía estructural originada por la formación incompleta o defectuosa de la matriz del esmalte dentario. Se manifiesta como defectos macroscópicos que varían desde línas tenues hasta cavidades de diferentes tamaños. Las propuestas terapéuticas son variadas y abarcan desde la remineralización de la lesión hasta la exodoncia de la pieza afectada. Frente a los reiterados fracasos de las restauraciones en molares hipoplásicos debido al pobre patrón de grabado que presentan, el objetivo de este trabajo es mostrar una alternativa para el tratamiento restaurador de estas piezas dentarias, mejorando la adhesión.

Manejo contemporáneo y preventivo de la caries dental en pacientes pediátricos: revisión de literatura / Contemporary and preventive management of dental caries in pediatric patients: literature review

La caries es una enfermedad infecciosa y contagiosa que por tener un a alta prevalencia a nivel mundial afectando tanto a niños como adultos, es necesario buscar y evaluar nuevas alternativas de tratamiento y prevención, que permitan mejorar la salud bucal de toda la población afectada, en donde el profesional debe estar involucrado.En cuanto a los métodos preventivos se encuentran los barnices con fluoruros y los derivados de la caseína, que se hallan en los productos lácteos, dentífricos y chicles, siendo de gran utilidad para pacientes pediátricos.Aunado a ello, se están utilizando actualmente, diversos métodos para la eliminación de la caries dental que permiten realizar procedimientos poco invasivos y que pueden ser aplicados en pacientes pediátricos o con discapacidad debido a que no requieren la utilización de anestesia local, ni instrumental rotatorio, mejorando la adaptación a la consulta y además obteniendo resultados favorables con respecto a las técnicas convencionales.Los diferentes procedimientos pueden ser mecánicos, químicos-mecánicos y de otros tipos como el láser que en conjunto conforman los métodos no invasivos. Ellos permiten una amplia variedad de opciones dependiendo de la población a la cual vayan dirigidos, tomando en cuenta el acceso a servicios de salud, estatus socio-económico, edad y requerimientos a corto plazo para evitar la extensión de las lesiones que implica perdidas tempranas de estructuras dentales que afectan la salud integral del individuo.

Dental caries is an infectious and contagious disease with an elevated prevalence in children and adults around the world. For that reason it is necessary to evaluate the new methods of prevention and treatment to improve bucal health in this population.In relation to the preventive methods, there are the fluoride varnish and casein derivates that can be in the milk, the tooth pastes and chewing gum and can be use to improve children´s bucal health.Nowadays there are many new methods that are using to eliminate caries in a non-invasive way. Many of them do not need the use of local anesthesia or rotatory handpieces and represent a good alternative to the behavibucal management of pediatric patients.The several methods can be mechanical, chemical & mechanical and others like laser that constitute the non-invasive methods. They give to the professional many options depending to some factors of the patients like age, social and economical status, possibility to access to health services and other requirements to avoid the extension of the caries lesions and the dental structure loss.