Comparative Effect of Calcium Mesoporous Silica Versus Calcium and/or Fluoride Products on the Reduction of Erosive Tooth Wear and Abrasive Enamel Lesion

Abstract Objective: To evaluate the effect of a calcium nanocompound on the reduction of erosive tooth wear and abrasion. Material and Methods: Bovine enamel specimens (BE), were randomly assigned to the following groups (n = 10): G1 = Calcium mesoporous silica nanoparticles (Ca2+MSNs); G2 = casein phosphopeptide-amorphous calcium phosphate (CPP-ACP, 2% CPP-ACP, GC®); G3 = casein phosphopeptide-amorphous calcium fluoride phosphate (CPP-ACFP, 2% CPP-ACP + 900 ppm F-, GC®); G4 = sodium fluoride NaF (900 ppm F-, positive control); and G5 = distilled and deionized water (negative control). Each product was applied to the exposed area for one minute, three times per day for three consecutive days, and followed by the immersion of the specimens in Sprite Zero™ - a low-pH solution (2.58) for five minutes (Coca-Cola™). After the first and last erosive challenges of the day, the specimens were submitted to abrasion in a toothbrush machine for 15 seconds (200 g/BE). The specimens were analysed using 3D non-contact optical profilometry, with tooth structure loss (TSL) measurements and scanning electron microscopy (SEM). TSL values were analysed by Kruskal-Wallis and Mann-Whitney tests (p<0.05). Results: There were no significant differences between G1 (10.95 µm) and G3 (10.80 µm) treatments for TSL values; however both resulted in significantly reduced TSL values compared with the G5 (16.00 µm) (p<0.05). The G4 (12.26 µm) showed no statistically significant difference when compared to the G5 (16.00 µm). The groups G1 and G3 presented higher surface preservation than the G5. Conclusion: Ca2+MSNs was effective for reducing tooth surface loss caused by erosive tooth wear and abrasion.

Assessment of remineralization potential of Theobromine and Sodium Fluoride gels on Artificial Caries like lesions / Avaliação do potencial de remineralização de géis de teobromina e fluoreto de sódio em lesões de cárie artificial

Objective: To compare the remineralization potential of theobromine and sodium fluoride gels on artificial caries like lesion. Materials and Methods: Forty longitudinal halves of human mandibular premolars were equally divided into 4 groups of 10 samples each: control group (C), samples were stored in distilled water during the experiment period. The remaining 30 specimens were subjected to demineralization protocol to create caries like lesions. samples were immersed for three days in a demineralization solution (pH 5.0) containing 0.2% carbopol and 0.1% lactic acid saturated with calcium phosphate tribasic. The samples were subdivided into 3 equal groups according to the treatment applied during the pH cycle. Demineralization group "D": no treatment applied. Group "F" treated with 2000 mg/liter sodium fluoride gel. Group "T" treated with 200 mg/liter theobromine gel. The specimens of the two studies groups were subjected to Demineralization- Remineralization PH Cycle Protocol for 5 days (Alternating four steps: 1: Treatment material, fluoride or theobromine ˜= 3 minutes. 2: Demineralizing solution 3 hours. 3: treatment material ˜= 3 minutes. 4: Remineralizing solution till the next cycle). The samples were investigated by scanning electron microscope (SEM) and energy dispersive x-ray analysis (EDXA). Results: The enamel of the demineralization group was porous with artificial caries like changes exposing the subsurface enamel rods with severe rod core defects. Theobromine gel and fluoride gel groups showed marked improvement in the surface characteristics in the enamel in both groups. Theobromine gel group showed more observable enamel surface improvement than the fluoride gel group. EDXA revealed that the calcium-phosphorus ratio displayed a descending order: (C > T > F > D). The differences between the two tested groups were not statistically significant. Conclusion: Theobromine gel had more effective remineralizing potential than fluoride gel as a result of its effect in improving the enamel surface characteristics of human teeth. (AU)

Objetivo: Comparar o potencial de remineralização dos géis de teobromina e fluoreto de sódio em lesões de cáries artificiais. Materiais e Métodos: Quarenta metades longitudinais de pré-molares inferiores humanos foram igualmente divididas em 4 grupos de 10 amostras cada: grupo controle (C), as amostras foram armazenadas em água destilada durante o período do experimento. As 30 amostras restantes foram submetidas ao protocolo de desmineralização paracriar lesões artificiais de cárie. As amostras foram imersas por três dias em uma solução de desmineralização (pH 5,0) contendo 0,2% de carbopol e 0,1% de ácido lático saturado com fosfato de cálcio tribásico. As amostras foram subdivididas em 3 grupos iguais, de acordo com o tratamento aplicado durante o ciclo do pH. Grupo de desmineralização "D": nenhum tratamento aplicado. Grupo "F" tratado com 2000 mg / litro de fluoreto de sódio em gel. Grupo & quot;T &q uot; tratado com 200 mg / litro de gel de teobromina. As amostras dos dois grupos de estudo foram submetidas ao protocolo de ciclo de desmineralização - remineralização por 5 dias (quatro etapas alternativas: 1: material de tratamento, flúor ou teobromina ˜= 3 minutos. 2: solução desmineralizante 3 horas. 3: material de tratamento ˜= 3 minutos 4: Solução de remineralização até o próximo ciclo). As amostras foram investigadas por microscopia eletrônica de varredura(MEV) e análise de raios-x dispersivos de energia (EDXA). Resultados: O esmalte do grupo de desmineralização era poroso, com cáries artificiais, como alterações que expunham as hastes de esmalte do subsolo com graves defeitos no núcleo da haste. Os grupos gel de teobromina e flúor apresentaram melhora acentuada nas características da superfície do esmalte nos dois grupos. O grupo gel de teobromina mostrou uma melhoria na superfície do esmalte mais observável do que o grupo gel de fluoreto. A EDXA revelou que a razão cálcio-fósforo exibia uma ordem decrescente: (C> T> F> D). As diferenças entre os dois grupos testados não foram estatisticamente significantes. Conclusão: O gel de teobromina teve um potencial remineralizante mais eficaz que o gel de flúor como resultado de seu efeito na melhoria das características da superfície do esmalte dos dentes humanos. (AU)

Eficacia de la arginina al 8% y nitrato potásico al 5% en el tratamiento de la hipersensibilidad dentinaria: ensayo clínico aleatorio / Efficacy of 8% arginine and 5% potassium nitrate in dentin hypersensitivity therapy: a randomized clinical trial

RESUMEN: Objetivo: Comparar la eficacia clínica de dentífricos en base a arginina al 8%/ monofluorfosfato de sodio 1450 ppm versus nitrato de potasio al 5%/fluoruro de sodio 2500 ppm en la terapia de la hipersensibilidad dentinaria (HSD). Materiales y método: Ensayo clínico, aleatorio, controlado, doble ciego, de grupos paralelos. Treinta y cuatro voluntarios de 18 a 70 años, con HSD en escala Visual Análoga (EVA) ≥4 en 2 ó más dientes no molares, fueron distribuidos aleatoriamente en 2 grupos: grupo T1 (n=16): dentífrico de Arginina al 8%/ monofluorfosfato de sodio 1450 ppm; y grupo T2 (n=18): dentífrico de nitrato de Potasio al 5%/fluoruro de sodio 2500 ppm. Se evaluó HSD en EVA con estímulos evaporativos y térmicos, y se compararon sus valores, así como el grado promedio de HSD y su reducción (∆HSD), intra e intergrupal, al inicio y a las 4 semanas de tratamiento. Resultados: Ambos dentífricos disminuyeron el grado promedio de HSD entre el inicio y las 4 semanas de tratamiento (T1: 5.03 ± 1.23 versus 2.60 ± 1.27, p<0.05; T2: 4.73 ± 1.51 versus 2.71 ± 1.17, p<0.05). No hubo diferencias estadísticamente significativas entre ambos dentífricos al comparar el grado promedio de reducción de HSD durante la terapia (∆HSD T1: -2.43 ± 1.22 versus ∆HSD T2: -2.27 ± 1.42). Los datos fueron analizados en Stata versión 11. Conclusiones: Ambos dentífricos fueron clínicamente eficaces en reducir la HSD a las 4 semanas, sin existir diferencias estadísticamente significativas entre ambos.

ABSTRACT: Aim: To compare the clinical efficacy of 8% arginine/1450ppm sodium monofluorophosphate and 5% potassium nitrate/2500 ppm sodium fluoride dentifrices in the treatment of dentin hypersensitivity (DH). Methods: Parallel-design, double-masked, randomized controlled clinical trial. Thirty four volunteers aged 18 to 70 years, with DH and a visual analog scale (VAS) score ≥4 at least in two or more non-molar teeth, were randomized in two groups: T1 (n=16): 8% arginine/1450 ppm sodium monofluorophosphate dentifrice; and T2 (n=18): 5% potassium nitrate/2500 ppm sodium fluoride dentifrice. DH was assessed with evaporative and thermal stimuli; and their VAS measurements, mean DH value and DH reduction (∆DH) were compared, inside and between the groups at baseline and 4-week follow-up. Data were analysed through Stata® V11 program. Results: Both toothpastes decreased mean DH value between baseline and 4 weeks (T1: 5.03 ± 1.23 versus 2.60 ± 1.27, p<0.05; T2: 4.73 ± 1.51 versus 2.71 ± 1.17, p<0.05). There were no statistical differences between both dentifrices in mean DH reduction values during therapy (∆HSD T1: -2.43 ± 1.22 versus ∆HSD T2:-2.27 ± 1.42). Conclusions: Both dentifrices had clinical efficacy in decreasing DH in a 4- week therapy, without statistical differences between both of them.

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.

Effectiveness of a pre-procedural mouthwash in reducing bacteria in dental aerosols: randomized clinical trial

Abstract The aim of this randomized, single blinded clinical trial was to evaluate the effect of a pre-procedural mouthwash containing cetylpyridinium chloride (CPC), zinc lactate (Zn) and sodium fluoride (F) in the reduction of viable bacteria in oral aerosol after a dental prophylaxis with ultrasonic scaler. Sixty systemically healthy volunteers receiving dental prophylaxis were randomly assigned to one of the following experimental groups (15 per group): (i) rinsing with 0.075% CPC, 0.28% Zn and 0.05% F (CPC+Zn+F), (ii) water or (iii) 0.12% chlorhexidine digluconate (CHX), and (iv) no rinsing. Viable bacteria were collected from different locations in the dental office on enriched TSA plates and anaerobically incubated for 72 hours. The colonies were counted and species were then identified by Checkerboard DNA–DNA Hybridization. The total number of colony-forming units (CFUs) detected in the aerosols from volunteers who rinsed with CPC+Zn+F or CHX was statistically significantly (p<0.05) lower than of those subjects who did not rinse or who rinsed with water. When all locations were considered together, the aerosols from the CPC+Zn+F and CHX groups showed, respectively, 70% and 77% fewer CFUs than those from the No Rinsing group and 61% and 70% than those from the Water group. The mean proportions of bacterial species from the orange complex were statistically significantly (p<0.05) lower in aerosols from the CPC+Zn+F and CHX groups compared with the others two groups. In conclusion, the mouthwash containing CPC+Zn+F, is effective in reducing viable bacteria in oral aerosol after a dental prophylaxis with ultrasonic scaler.

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.

Efficacy of two mouthwashes with cetylpyridinium chloride: a controlled randomized clinical trial

Abstract This study aimed to evaluate the anti-plaque and anti-gingivitis effects of two mouthwashes containing cetylpyridinium chloride (CPC), in comparison to negative control mouthwash. One hundred and twenty subjects were randomly assigned to study groups: test (0.075% CPC and 0.28% zinc lactate), positive control (0.07% CPC) and negative control mouthwash without CPC. All volunteers were examined by a calibrated examiner for the Quigley-Hein Plaque Index (Turesky modification) and Löe-Silness Gingival Index (GI). Gingival severity was also measured by the percentage of sites with positive gingival bleeding. During six weeks, oral hygiene consisted of brushing twice daily with a toothbrush and toothpaste and rising with their assigned mouthwash. Plaque and gingival parameters were assessed at baseline, after four and six weeks of product use. Statistical analyses were performed separately for plaque and gingival indices, by ANOVA, paired t-test and ANCOVA (α < 0.05). After 4 and 6 weeks, all mouthwashes groups presented statistically significant reductions in plaque and gingival parameters as compared to baseline. In comparison to the positive control, the test group presented additional reductions in dental plaque of 19.8% and 16.8%, after 4 and 6 weeks, respectively. For GI, the additional reductions in the test group were 9.7% and 14.3%, at 4 and 6 weeks, respectively. The test group showed additional reduction of 35.3% and 54.5% in the gingival severity, at week 4 and 6, respectively. It is concluded that the mouthwash containing CPC and zinc lactate presents significant anti-plaque and anti-gingivitis effects as compared to positive and negative control mouthwashes.

Avaliação in vitro de enxaguatórios experimentais com compostos bioativos na prevenção/remineralização de lesões de mancha branca ativa durante tratamento ortodôntico / In vitro evaluation rinses experiments with bioactive compounds in the remineralization of white spot lesions during orthodontic treatment

O objetivo deste estudo foi avaliar in vitro por meio da Fluorescência de Raios X por Dispersão de Energia (XRF) e Microscopia Eletrônica de Varredura (MEV) o efeito remineralizante de enxaguatórios bucais com compostos bioativos, sendo nanopartículas de hidroxiapatita de cálcio (nanoHAp) associadas ou não a fluoreto, fluoreto de sódio e saliva no esmalte dental bovino. Foram utilizados 15 corpos de prova (CP) a partir de 15 incisivos bovinos que foram divididos aleatoriamente em 3 grupos, com 5 CP cada um. Após colagem dos braquetes, as amostras foram submetidas a um alto desafio de cárie com solução desmineralizante de cloreto de cálcio 2,2 mM, fosfato de sódio monohidratado 2,2 mM e ácido acético 0,05 M, com pH ajustado entre 4,4 e 5,2, permanecendo durante 48 horas em solução desmineralizante, em temperatura ambiente, simulando lesão de mancha branca ativa no esmalte dental bovino ao redor desses braquetes ortodônticos. Em seguida, cada grupo foi denominado conforme os respectivos tratamentos a serem utilizados. Grupo 1 (G1) solução de fluoreto de sódio (0,05%); Grupo 2 (G2) solução aquosa de nanopartículas de hidroxiapatita de cálcio (0,75%) e Grupo 3 (G3) solução aquosa de fluoreto de sódio (0,05%) associada a nanopartículas de hidroxiapatita de cálcio (0,75%). Foram obtidos os valores de XRF e imagens em MEV antes e depois da desmineralização e antes e depois do tratamento. Os dados obtidos foram submetidos à análise estatística pelo teste ANOVA para comparação entre as médias iniciais e finais de cada grupo e para comparação dos grupos de tratamentos distintos com nível de significância de 5% (p ≤ 0,05). Nas leituras por XRF, nenhum dos enxaguatórios testados foram eficientes na remineralização das lesões de mancha branca no período de 5 dias. E nas imagens de MEV, o grupo que recebeu tratamento com a solução de NanoHAp 0,75% (G2) apresentou deposição mineral uniforme na superfície de esmalte desmineralizado, vedando os prismas de esmalte.

The aim of the present study was to assess in vitro, through energy dispersive X-ray fluorescence (XRF) and Scanning Electron Microscopy (SEM), the remineralizing effect of mouth rinses with bioactive compounds, which are calcium hydroxyapatite nanoparticles (nanoHAp) associated or not with fluoride, sodium fluoride and saliva in bovine dental enamel. Fifteen specimens from 15 bovine incisors were used and randomly distributed into three groups, with 5 specimens each. After bonding the brackets, the specimens were subjected to a high caries challenge with 2.2 mM calcium chloride, 2.2 mM sodium phosphatemonohydrate and 0.05 mM acetic acid demineralizing solution, pH adjustedbetween 4.4 to 5.2, kept in demineralizing solution for 48 hours, at room temperature, simulating active white spot lesion on bovine dental enamel around those orthodontic brackets. Then, each group was named according torespective treatments to be used: Group 1 (G1) ­ 0.05% sodium fluoride solution; Group 2 (G2) ­ aqueous solution of 0.75% calcium hydroxyapatite nanoparticles; and Group 3 (G3) ­ aqueous solution of 0.05% sodium fluoride associated with 0.75% calcium hydroxyapatite nanoparticles. The XRF values were obtained and the SEM images were taken before and after the demineralization, and before and after the treatment. Data were submitted to statistical analysis by ANOVA test to compare the initial and final means of each group and to compare the distinct treatment groups with a significance level at 5% (p ≤ 0,05). In the XRF readings, none of the tested mouth rises were efficient in the remineralization of white spot lesions in the period of 5 days. In the SEM images, the group treated with 0.75% NanoHAp solution (G2) showed uniform mineral deposition of the demineralized enamel surface, sealing theenamel prisms

Efeito dos tratamentos de superfície no manchamento e na rugosidade do esmalte após clareamento dentário / Effect of surface treatments on enamel staining and roughness after dental bleaching

O esmalte dentário submetido ao clareamento com peróxidos pode tornar-se mais rugoso e mais susceptível ao manchamento que o esmalte não clareado, especialmente logo após o tratamento clareador. O objetivo deste estudo foi avaliar o efeito de diferentes tratamentos de superfície e do tempo de espera para o contato com pigmentos, na rugosidade e na manutenção da cor do esmalte, após clareamento dentário. Cem espécimes de dentes bovinos foram clareados com peróxido de hidrogênio 35% (Whiteness HP, FGM) e tratados de acordo com a divisão em 5 grupos: G1 saliva artificial (controle), G2 fluoreto de sódio neutro 2% (Flugel, DFL), G3 pasta de fosfopeptídeos da caseína-flúor fosfato de cálcio amorfo (CPP-ACPF, MI Paste Plus, GC), G4 líquido para manutenção dos resultados do clareamento dentário (Keep White Rinse, DMC), G5 polimento coronário com discos de feltro impregnados com óxido de alumínio (Super Buff Disk, Shofu)...

Efficacy of stannous, fluoride and their their combination in dentin erosion prevention in vitro

The aim of this study was to compare the protective effects of solutions containing stannous (Sn), fluoride (F) and their combination in the prevention of dentin erosion. Forty bovine root dentin specimens (4’4’2 mm3) were prepared and randomly assigned to 4 groups (n = 10): SnCl2(800 ppm/6.7 mM Sn), NaF (250 ppm/13 mM F), NaF/SnCl2 (800 ppm/6.7 mM Sn; 250 ppm/13 mM F), and deionized water (DIW) as a negative control. An acquired pellicle was formed on dentin samples by incubation in clarified, pooled, stimulated human saliva for 24 hours. The specimens were subjected to 5 daily cycles, each consisting of 5 of min demineralization (0.3%/15.6 mM citric acid, pH 2.6, 6’/day) and 60 min of re-mineralization in clarified human saliva. Thirty minutes after the 1st, 3rd and 5th demineralization episodes of each day, the specimens were treated with one of the test solutions for 2 min. Surface loss was measured via optical profilometry. Mixed-model ANOVA followed by Tukey’s test were used for the statistical analysis. Sn, F, and their combination significantly reduced the dentin surface loss by 23%, 36%, and 60% compared with DIW, respectively. All groups were significantly different (p < 0.05). The combination of Sn and F significantly reduced the amount of dentin surface loss compared with all other groups. The F group also significantly reduced surface loss compared with Sn and DIW, followed by the Sn group, which showed significantly greater protection compared with the DIW control. The daily use of a combined fluoride and stannous solution is promising for preventing dentin erosion.

The combined use of Er, Cr: YSGG laser and fluoride to prevent root dentin demineralization

The use of erbium lasers to prevent caries in enamel has shown positive results. However, it is not known if Er,Cr:YSGG laser can also be used to increase acid resistance of root dentine, which is another dental tissue susceptible to the action of cariogenic bacteria. Objective: To analyze the effects of the Er,Cr:YSGG laser (λ=2.78 μm, 20 Hz) irradiation associated with 2% neutral sodium fluoride (NaF) to prevent root dentin demineralization. Material and Methods: One hundred human root dentin samples were divided into 10 groups (G) and treated as follows: G1: no treatment; G2: NaF; G3: laser (4.64 J/cm2) with water cooling (WC=5.4 mL/min); G4: laser (4.64 J/cm2) without WC; G5: laser (8.92 J/cm2) with WC; G6: laser (8.92 J/cm2) without WC; G7: laser (4.64 J/cm2) with WC and NaF; G8: laser (4.64 J/cm2) without WC and NaF; G9: laser (8.92 J/cm2) with WC and NaF; G10: laser (8.92 J/cm2) without WC and NaF. The NaF gel was applied alone or after 4 min of irradiation. After 14 days of acid challenge, the samples were sectioned and the Knoop microhardness (KHN) test was done at different depths (30, 60, 90 and 120 μm) from the outer dentin surface. Data were analyzed by one-way ANOVA and Fisher’s test (α=5%). Results: The results showed that G8 and G10 presented higher KHN than the G1 for the depths of 30 and 60 μm, indicating an increase of the acid resistance of the dentin in up to 35% (p<0.05). Conclusions: The use of Er,Cr:YSGG laser irradiation at 4.64 J/ cm2 and 8.92 J/cm2 without water cooling and associated with 2% NaF can increase the acid resistance of human root dentin. .

Sodium fluoride and casein phosphopeptide-amorphous calcium phosphate cream plus sodium fluoride efficacy in preventing enamel erosion in a simulated oral environment study model.

Aim: The aim of this study was to evaluate the effectiveness of dentifrices containing high concentrations of sodium fluoride (NaF) and casein phosphopeptide‑amorphous calcium phosphate cream plus fluoride (CPP‑ACPF) in prevention of the erosion in a simulated oral environment study model. Subjects and Methods: Fifteen flat human enamel specimens were polished and half of the surfaces were protected with adhesive tape. Initial Knoop microhardness (KHN) and surface roughness (SR) were measured, and specimens were assigned to four groups: Control (placebo toothpaste – G1); CPP‑ACPF (G2), NaF 1450 ppm (G3), and NaF 5000 ppm (G4). Enamel surfaces were brushed 3 times daily in association with demineralization‑remineralization cycles (5s in cola drink + 5s in artificial saliva/10 cycles/twice daily) and the specimens were maintained in a salivary flow simulator apparatus. After 14 days, KHN and SR were measured again, and the enamel surfaces were analyzed by scanning electronic microscopy (SEM). Statistical Analysis Used: Data were analyzed using the two‑way ANOVA and Student–Newman– Keuls multiple range test (α =0.05). Results: All the tested groups presented a decrease in KHN after 14 days (P < 0.05). There was no statistical significance among materials tested. Significant increase in SR was observed for all groups. SEM analysis showed morphological alterations with honeycomb structures in enamel surfaces in the four experimental groups. Conclusions: It was concluded that tooth brushing with dentifrices with high concentration of NaF and CPP‑ACPF cream was not able to prevent enamel erosion in simulated oral environment.

Avaliação do potencial remineralizante de pastas e soluções com compostos bioativos no esmalte dental bovino submetido a ciclos de desafio erosivo / Remineralizing effectiveness of different bioactive principles in bovine enamel subjected to acidic challenges

O objetivo deste estudo foi avaliar in vitro por meio da Fluorescência de Raios X por Dispersão de Energia (XRF), Microdureza Vickers (MV) e Microscopia Eletrônica de Varredura (MEV) o efeito remineralizante de diferentes princípios bioativos, tais quais, nanopartículas de hidroxiapatita de cálcio (nanoHAp) associadas ou não a fluoreto, fosfopeptídeos de caseína do leite e fosfato de cálcio amorfo (CPP-ACP) associados ou não a fluoreto, fluoreto de sódio e saliva no esmalte dental bovino submetido a ciclagem des-remineralizante simulando lesão erosiva por alto desafio ácido. Foram obtidos 58 corpos de prova (CP) a partir de 58 incisivos bovinos que foram divididos aleatoriamente em 8 grupos, com 7 CP cada um e 2 CP para obtenção de imagem em MEV do esmalte hígido. Cada grupo foi denominado conforme os respectivos tratamentos a serem utilizados. Grupo 1 (G1) Controle; Grupo 2 (G2) Desensibilize Nano P experimental (nanopartículas de hidroxiapatita de cálcio); Grupo 3 (G3) Desensibilize Nano P (nanopartículas de hidroxiapatita de cálcio e flúor); Grupo4 (G4) GC Tooth Mousse (CPP-ACP, fosfopeptídios de caseína e fosfato de cálcio amorfo –Recaldent ™); Grupo 5 (G5) GC Tooth Mousse Plus (CPP-ACP, fosfopeptídios de caseína e fosfato de cálcio amorfo –Recaldent ™ + 900 ppm de flúor); Grupo 6 (G6) solução aquosa de fluoreto de sódio (0,05%); Grupo 7 (G7) solução aquosa de nanopartículas de hidroxiapatita de cálcio (0,375%) e Grupo 8 (G8) solução aquosa de nanopartículas de hidroxiapatita de cálcio (0,375%) + flúor (0,05%). Foram obtidos os valores de XRF e MV antes e depois do tratamento. Durante um período experimental de 10 dias, os CPs foram submetidos a um processo cíclico de des-remineralização incluindo vários ataques diários com ácido cítrico 0,05M (pH 2,3), 6 vezes de 2 minutos ao dia, bem como as aplicações das soluções teste e períodos de remineralização em saliva artificial. O tempo entre os ciclos ...

The aim of this study was to evaluate in vitro by X-ray fluorescence technique (XRF), surface microhardness (SMH) and SEM the remineralizing effect of different bioactive principles.We used 58bovine incisors that were sectioned into fragments (CP) and randomly divided into 8 groups. All teeth were initially evaluated to obtain the count of elements phosphorus (P) and calcium (Ca) interpreted from a range of X-Ray Fluorescence obtained by Artax ™ 200 and to obtain the initial SMH. Over a 10-day experimental period, the enamel samples weresubjected to erosive demineralization that was performed by immersion in 250 ml 0.05 M citric acid (pH 2.3) for 6 X 2 min per day. Subsequently, the samples were rinsed with distilled water for 1 min and afterwards received the corresponding treatments Group 1 (G1) Positive control; Group 2 (G2) Experimental Desensibilize Nano P (nanoparticles of calcium hydroxyapatite); Group 3 (G3) Desensibilize Nano P (nanoparticles of calcium hydroxyapatite and Fluor); Group 4 (G4) Recaldent: GC Tooth Mousse (CPP-ACP fosfopeptídios casein and amorphous calcium phosphate-Recaldent ™), Group 5 (G5) GC Tooth Mousse (CPP-ACP fosfopeptides casein and amorphous calcium phosphate-Recaldent ™ and 900 ppm Fluor); Group 6 (G6) NaF aqueous solution; (G7) nanoHAp aqueous solution and Group 8 (G8) nanoHAp + NaF aqueous solution. The samples were rinsed again with distilled water for 1 min and stored in artificial saliva. The time between cycles was 1.5 h. In the control group, the samples were eroded 6 X 2 min per day and stored in artificial saliva. All CP were evaluated again. SEM images for surface analysis were obtained after treatment. Through statistical analysis by Student t test ( p = 0.05 ) , the following results were found: control group had a severe demineralization, there was an increase in the count of P in all treated groups except G1 , that was an increase in Ca count in all treated ...

Avaliação do potencial remineralizante de pastas e soluções com compostos bioativos no esmalte dental bovino submetido a ciclos de desafio erosivo / Remineralizing effectiveness of different bioactive principles in bovine enamel subjected to acidic challenges

O objetivo deste estudo foi avaliar in vitro por meio da Fluorescência de Raios X por Dispersão de Energia (XRF), Microdureza Vickers (MV) e Microscopia Eletrônica de Varredura (MEV) o efeito remineralizante de diferentes princípios bioativos, tais quais, nanopartículas de hidroxiapatita de cálcio (nanoHAp) associadas ou não a fluoreto, fosfopeptídeos de caseína do leite e fosfato de cálcio amorfo (CPP-ACP) associados ou não a fluoreto, fluoreto de sódio e saliva no esmalte dental bovino submetido a ciclagem des-remineralizante simulando lesão erosiva por alto desafio ácido. Foram obtidos 58 corpos de prova (CP) a partir de 58 incisivos bovinos que foram divididos aleatoriamente em 8 grupos, com 7 CP cada um e 2 CP para obtenção de imagem em MEV do esmalte hígido. Cada grupo foi denominado conforme os respectivos tratamentos a serem utilizados. Grupo 1 (G1) Controle; Grupo 2 (G2) Desensibilize Nano P experimental (nanopartículas de hidroxiapatita de cálcio); Grupo 3 (G3) Desensibilize Nano P (nanopartículas de hidroxiapatita de cálcio e flúor); Grupo4 (G4) GC Tooth Mousse (CPP-ACP, fosfopeptídios de caseína e fosfato de cálcio amorfo –Recaldent ™); Grupo 5 (G5) GC Tooth Mousse Plus (CPP-ACP, fosfopeptídios de caseína e fosfato de cálcio amorfo –Recaldent ™ + 900 ppm de flúor); Grupo 6 (G6) solução aquosa de fluoreto de sódio (0,05%); Grupo 7 (G7) solução aquosa de nanopartículas de hidroxiapatita de cálcio (0,375%) e Grupo 8 (G8) solução aquosa de nanopartículas de hidroxiapatita de cálcio (0,375%) + flúor (0,05%). Foram obtidos os valores de XRF e MV antes e depois do tratamento. Durante um período experimental de 10 dias, os CPs foram submetidos a um processo cíclico de des-remineralização incluindo vários ataques diários com ácido cítrico 0,05M (pH 2,3), 6 vezes de 2 minutos ao dia, bem como as aplicações das soluções teste e períodos de remineralização em saliva artificial. O tempo entre os ciclos ...

The aim of this study was to evaluate in vitro by X-ray fluorescence technique (XRF), surface microhardness (SMH) and SEM the remineralizing effect of different bioactive principles.We used 58bovine incisors that were sectioned into fragments (CP) and randomly divided into 8 groups. All teeth were initially evaluated to obtain the count of elements phosphorus (P) and calcium (Ca) interpreted from a range of X-Ray Fluorescence obtained by Artax ™ 200 and to obtain the initial SMH. Over a 10-day experimental period, the enamel samples weresubjected to erosive demineralization that was performed by immersion in 250 ml 0.05 M citric acid (pH 2.3) for 6 X 2 min per day. Subsequently, the samples were rinsed with distilled water for 1 min and afterwards received the corresponding treatments Group 1 (G1) Positive control; Group 2 (G2) Experimental Desensibilize Nano P (nanoparticles of calcium hydroxyapatite); Group 3 (G3) Desensibilize Nano P (nanoparticles of calcium hydroxyapatite and Fluor); Group 4 (G4) Recaldent: GC Tooth Mousse (CPP-ACP fosfopeptídios casein and amorphous calcium phosphate-Recaldent ™), Group 5 (G5) GC Tooth Mousse (CPP-ACP fosfopeptides casein and amorphous calcium phosphate-Recaldent ™ and 900 ppm Fluor); Group 6 (G6) NaF aqueous solution; (G7) nanoHAp aqueous solution and Group 8 (G8) nanoHAp + NaF aqueous solution. The samples were rinsed again with distilled water for 1 min and stored in artificial saliva. The time between cycles was 1.5 h. In the control group, the samples were eroded 6 X 2 min per day and stored in artificial saliva. All CP were evaluated again. SEM images for surface analysis were obtained after treatment. Through statistical analysis by Student t test ( p = 0.05 ) , the following results were found: control group had a severe demineralization, there was an increase in the count of P in all treated groups except G1 , that was an increase in Ca count in all treated ...

Impact of Experimental Nano-HAP Pastes on Bovine Enamel and Dentin Submitted to a pH Cycling Model

This in vitro study evaluated the preventive potential of experimental pastes containing 10% and 20% hydroxyapatite nanoparticles (Nano-HAP), with or without fluoride, on dental demineralization. Bovine enamel (n=15) and root dentin (n=15) specimens were divided into 9 groups according to their surface hardness: control (without treatment), 20 Nanop paste (20% HAP), 20 Nanop paste plus (20% HAP + 0.2% NaF), 10 Nanop paste (10% HAP), 10 Nanop paste plus (10% HAP + 0.2% NaF), placebo paste (without fluoride and HAP), fluoride paste (0.2% NaF), MI paste (CPP-ACP, casein phosphopeptide-amorphous calcium phosphate), and MI paste plus (CPP-ACP + 0.2% NaF). Both MI pastes were included as commercial control products containing calcium phosphate. The specimens were treated with the pastes twice a day (1 min), before and after demineralization. The specimens were subjected to a pH-cycling model (demineralization–6-8 h/ remineralization-16-18 h a day) for 7 days. The dental subsurface demineralization was analyzed using cross-sectional hardness (kgf/mm 2 , depth 10-220 µm). Data were tested using repeated-measures two-way ANOVA and Bonferroni's test (p<0.05). The only treatment able to reduce the loss of enamel and dentin subsurface hardness was fluoride paste (0.2% NaF), which differed significantly from the control at 30- and 50-µm depth (p<0.0001). The other treatments were not different from each other or compared with the control. The experimental Nanop pastes, regardless of the addition of fluoride, were unable to reduce dental demineralization in vitro.

Este estudo in vitro avaliou o potencial de pastas experimentais contendo nanopartículas de hidroxiapatita a 10% e 20% (Nano-HAP), com ou sem fluoreto, na prevenção da desmineralização dentária. Espécimes de esmalte (n=15) e de dentina radicular (n=15) bovinos foram divididos em nove grupos de acordo com o valor de dureza superficial: controle (sem tratamento), pasta Nanop 20 (HAP 20%), pasta Nanop 20 plus (HAP 20% + NaF 0,2%), pasta Nanop 10 (HAP 10%), pasta Nanop 10 plus (HAP 10% + NaF 0,2%), pasta placebo (sem F e HAP), pasta fluoretada (NaF 0,2%), pasta MI (CPP-ACP, fosfopeptídio da caseína-fosfato de cálcio amorfo), e pasta MI plus (CPP-ACP + NaF 0,2%). As duas pastas MI foram inclusas como grupos controles comerciais contendo fosfato de cálcio. Os espécimes foram tratados com as pastas duas vezes ao dia (1 min), antes e após a desmineralização. Os espécimes foram submetidos a um modelo de ciclagem de pH (desmineralização 6-8 h/ remineralização 16-18 h por dia) durante sete dias. A desmineralização dentária de subsuperfície foi avaliada através da dureza longitudinal (kgf/mm 2 , profundidade de 10-220 µm). Os dados foram analisados utilizando ANOVA a dois critérios e teste de Bonferroni (p<0,05). O único tratamento capaz de reduzir a perda da dureza de subsuperfície do esmalte e da dentina foi a pasta fluoretada (NaF 0,2%), a qual diferiu significativamente do controle nas profundidades de 30 e 50 µm da superfície (p<0,0001). Os outros tratamentos não foram diferentes entre si ou quando comparados ao controle. As pastas experimentais Nanop, independentemente da presença de fluoreto, não foram capazes de reduzir a desmineralização dentária in vitro.

Eficácia da avaliação audiométrica no tratamento medicamentoso da otospongiose / The effectiveness of audiometric evaluation in drug treatment for otospongiosis

A otospongiose é uma osteodistrofia focal primária da cápsula ótica que acomete indivíduos geneticamente predispostos e promove perda auditiva progressiva. OBJETIVO: Verificar a aplicabilidade da avaliação audiométrica no tratamento medicamentoso da otospongiose. MATERIAL E MÉTODO: Estudo prospectivo, randomizado, controlado, duplo-cego, envolvendo 26 pacientes com diagnóstico clínico, audiométrico e tomográfico de otospongiose. Os pacientes elegíveis para o estudo foram alocados em três grupos (A, B e C) e receberam o tratamento com alendronato de sódio (B), fluoreto de sódio (C) e placebo (A) por 6 meses. Após este período, os mesmos realizaram nova avaliação audiométrica. RESULTADOS: Na análise das diferenças entre as vias aérea e óssea (gap), não houve diferença estatisticamente significante. Também não foram encontradas diferenças em relação ao limiar de reconhecimento da fala (SRT) e a discriminação vocal (IRF) entre os períodos pré e pós-tratamento. CONCLUSÃO: Após seis meses de tratamento medicamentoso, a avaliação audiométrica evidenciou manutenção dos limiares auditivos, sugerindo estabilização da atividade da lesão otospongiótica.

Otospongiosis is a primary osteodystrophy of the otic capsule that affects genetically predisposed individuals and leads to a progressive hearing loss. AIM: To evaluate the applicability of audiometric evaluation during drug treatment for otospongiosis. MATERIALS AND METHODS: A prospective, randomized, controlled, double-blind study involving 26 patients with clinical, audiometric and CT scan image of otosclerosis. Patients eligible for the study were divided into three groups (A, B and C) and received treatment with alendronate sodium (B), sodium fluoride (C) and placebo (A) for 6 months. After this period they were submitted to new tests. RESULTS: There were not statistically significant differences between air and bone conduction (gap). We also found no differences in the speech recognition threshold (SRT) and speech discrimination (IRF) between before and after treatment. CONCLUSION: After six months of drug treatment the audiometric evaluation kept the same hearing thresholds, suggesting stabilization of the otospongiotic lesions.

Comprehensive dental health care program at an orphanage in Nellore district of Andhra Pradesh.

Background: Provision of oral health care in India, especially for the underprivileged is limited due to inadequate finances and manpower. Resources of dental colleges in such a scenario can be utilized to provide prevention oriented oral health care. Aim: To improve the oral health status of children at an institute in Nellore district of Andhra Pradesh, India, through prevention based comprehensive dental health care program (CDHP). Design and Setting: A longitudinal institution based interventional study conducted among the primary grade children (n=162). Materials and Methods: Baseline data collection included (i) basic demographic data (ii) body mass index (BMI) (iii) assessment of the dentition status and treatment needs according to WHO 1997 criteria. The CDHP included group based dental health education, professional oral prophylaxis, weekly (0.2%) sodium fluoride mouth rinse program, biannual application of topical fluoride (1.23% APF), pit and fissure sealants for all first permanent molars and provision of all necessary curative services. Results: Mean treatment requirements per child decreased at 18 months. New caries lesions developed among four children. BMI of children with decay was seen to improve significantly after instituting the CDHP. Conclusion: CDHP is effective in overall improvement of general and oral health. In resource limited countries like India, such programs organized by dental schools can improve oral health.