Infiltrantes para tratamiento estético de lesiones de manchas blancas por fluorosis: Reporte de caso / Infiltrants for Aesthetic Treatment of White Spots Lesions by Fluorosis: Case Report

Resumen La fluorosis dental es una anomalía en el desarrollo del esmalte debido a la excesiva ingesta de flúor durante la formación de los tejidos dentales, y se caracteriza principalmente por la hipomineralización y mayor porosidad de la estructura del esmalte. Muchas veces las manchas ocasionadas por la fluorosis dental pueden comprometer la estética del paciente y afectar su autoestima. En años recientes ha sido desarrollado una nueva generación de materiales odontológicos conocida como infiltrantes resinosos, que básicamente son resinas de baja viscosidad que infiltran y paralizan la progresión de las lesiones cariosas incipientes no cavitadas. Cuando infiltrantes resinosos han sido utilizados para detener las lesiones cariosas se ha verificado que también producen cambios en la apariencia de la mancha blanca, atenuándola o tornándola imperceptible. El presente artículo describe un reporte de caso del uso de infiltrantes resinosos para tratamiento estético de lesiones de manchas blancas ocasionadas por fluorosis.

Abstract Dental fluorosis is an abnormality in the development of enamel due to the excessive intake of fluoride during formation of dental tissues, mainly characterized by hypomineralization and increased porosity of the enamel structure. Oftenly the spots caused by dental fluorosis can compromise the aesthetics of the patient and affect their self-esteem. In recent years a new generation of dental materials has been developed, known as resin infiltrants, which are basically low viscosity resins that infiltrate and paralyze the progression of incipient non cavitated carious lesions. When resin infiltrants have been used to stop carious lesions it has been verified that they also produce changes in the appearance of white spots, masking or making them imperceptible. The present article describes a case report of the use of resin infiltrants for aesthetic treatment of white spot lesions caused by fluorosis.

Effect of fermented milk with kefir grains on the in vitro demineralization of bovine tooth enamel / Efecto de la leche fermentada con granos de kéfir sobre la desmineralización in vitro del esmalte dental bovino

The dental caries is a progressive destruction of the teeth tissue due to the disbalance in the normal molecule interactions between the enamel and the bio!lm, which alters the demineralization-remineralization process. Milk fermentation produces caseinphosphopeptides with proved remineralizing capacity of the enamel. The presence of these peptides in fermented milk with ke!r grains has been described. The purpose of this work was to evaluate in vitro the capacity of milk ke!r to prevent the demineralization of dental enamel. Bovine incisors (n=68, 17 per group) were treated for 72 h with different solutions: I: artificial saliva at pH 7.2 , II: demineralizing solution at pH 4.5, III: supernatant of kefir fermented milk at pH 4.5, IV: milk supernatant at pH 4.5. The effects of treatments were evaluated by the change in the weight of the specimens, calcium concentration in the solution and by scanning electron microscopy (SEM) of the enamel. Kefir milk supernatant prevented the demineralization process, that was evidenced by a change in weight and calcium concentration that were not different from group I, although the pH was 4.5. In contrast, group IV showed a decrease in weight and an increase in calcium concentration, compared with group I (one way ANOVA, p<0.05). Images of SEM agree with the values of weight and calcium concentration. These results indicate that kefir milk supernatant has a protective effect on enamel demineralization in vitro. (AU)

La caries dental es una patología debido a un desequilibrio en las interacciones moleculares normales entre el esmalte y la biopelícula, que altera el proceso de desmineralización remineralización. La fermentación de la leche produce fosfopéptidos de caseína con probada capacidad remineralizante del esmalte, y se ha descripto la presencia de estos péptidos en la leche fermentada con granos de kéfir. El propósito de este trabajo fue evaluar in vitro la capacidad del kéfir de leche para prevenir la desmineralización del esmalte dental. Sesenta y ocho incisivos bovinos (17 por grupo) fueron tratados durante 72 h con diferentes soluciones: I: saliva artificial, pH 7.2, II: solución desmineralizante, pH 4.5, III: sobrenadante de leche fermentada con kefir, pH 4.5, IV: sobrenadante de leche, pH 4.5. El proceso de desmineralización se evaluó mediante el cambio en el peso de las muestras, la concentración de calcio en la solución y microscopía electrónica de barrido (SEM) del esmalte. El sobrenadante de leche fermentada con kéfir impidió el proceso de desmineralización, que se evidenció por un cambio en el peso y la concentración de calcio que no discreparon del grupo I, a pesar de haber tenido un pH de 4.5. En contraste, el grupo IV mostró una disminución en el peso y un aumento en la concentración de calcio, en comparación con el grupo I (ANOVA a un criterio, p<0.05). Las imágenes SEM concuerdan con los cambios en el peso y la concentración de calcio en los grupos estudiados. Los datos obtenidos demuestran que el sobrenadante de la leche tratada con kéfir tiene un efecto protector sobre la desmineralización del esmalte in vitro, inducida por el pH ácido. (AU)

Six month follow-up of two bulk-fill composites in non-carious cervical lesions: double blind randomized clinical trial / Evaluación clínica a 6 meses de restauraciones cervicales en lesiones no cariosas con resinas compuestas bulk-fill: estudio aleatorio doble ciego

Objective: To assess the six-month clinical outcome of restorations of non-carious cervical lesions (NCCL) with two composite resins: Bulk-Fill and nanohybrid resin. Materials and methods: Fifty-one patients, with three NCCLs each, were randomly allocated into three restoration groups: Tetric-N-Ceram Bulk-Fill (TB); Filtek Bulk-Fill (FB); y Filtek Z350XT (Z350). Adhesive techniques and restorative procedures were performed according to the manufacturers' instructions for the different materials. A 4mm increment was applied in TB and FB, and increments of ≤2mm depth were applied in Z350. Restorations were assessed by two calibrated examiners at baseline and at six months according to the FDI World Dental Federation guidelines (1: excellent, 2: acceptable, 3: sufficient, 4: unsatisfactory, 5: unacceptable) in Marginal Staining (MS), Fracture-Retention (FR), Marginal Adaptation (MA), Postoperative Sensitivity (S) and Caries (C). Wilcoxon test was used for the comparison between baseline and 6 months, and Kruskal-Wallis for the comparison of the three groups at six months (95% significance). Results: Forty-six patients with a total of 138 restorations attended a check-up at six months and were evaluated with excellent clinical outcome. In MS, 91.2% for Z350 and 97.8% for FB and TB; in FR, 97.8% for Z350 and 100% for FB and TB; in MA, 95.6% for Z350, 97.8% for FB and 100% for TN; in S, 95.6% for all three groups; and 100% for C. No statistically significant differences were found between the three groups nor in the comparison between the baseline and 6 months (p>0.05) Conclusion: No significant differences are observed between the three groups of resins in the parameters of MS, MA, S, FR and C regarding clinical outcome at six months.

Objetivo: Evaluar el comportamiento clínico a 6 meses en restauraciones de lesiones cervicales no cariosas (LCNC) con dos resinas compuestas Bulk-Fill y una resina nanohíbrida. Materiales y métodos: En 51 pacientes se restauraron 3 LCNC distribuidas aleatoriamente en 3 grupos, TB: Tetric-N-Ceram Bulk-Fill, FB: Filtek Bulk-Fill y Z350: Filtek Z350XT. Las técnicas adhesivas y procedimientos restauradores fueron realizados según las instrucciones de los fabricantes para los diferentes materiales. En TB y FB se aplicó un incremento de 4mm y en Z350 se aplicó incrementos ≤2mm de profundidad. Dos operadores calibrados evaluaron las restauraciones al baseline y 6 meses mediante los criterios clínicos FDI (1: excelente, 2: aceptable, 3: suficiente, 4: insatisfactorio, 5: inaceptable) en Tinción Marginal (TM), Fractura-Retención (FR), Adaptación Marginal (AM), Sensibilidad Postoperatoria (S) y Caries (C). Se utilizó Wilcoxon para la comparación entre baseline ­ 6 meses y Kruskal-Wallis para la comparación de los 3 grupos a 6 meses (significancia de 95%). Resultados: A los 6 meses asistieron 46 pacientes con un total de 138 restauraciones siendo evaluados con comportamiento clínico excelente; en TM 91,2% para Z350 y 97,8% para FB y TB; en FR, Z350 presentó 97,8% y en FB y TB el 100%; en AM, 95,6% para Z350, 97,8% para FB y 100% para TN; en S presentó 95,6% para los tres grupos; en C se presentó el 100%. No hubo diferencias estadísticamente significativas entre los 3 grupos y en la comparación de baseline - 6 meses (p>0.05). Conclusión: No existen diferencias significativas en el comportamiento clínico a 6 meses entre los 3 grupos de resinas en los parámetros TM, AM, S, FR Y C.

Microhardness and Ultrastructure of Demineralized Gamma-Irradiated Human Enamel after Diode Laser (980 nm) and Fluoride Surface Treatment

Abstract Quality of life drastically diminished after radiotherapy due to radiation induced oral complications. Fluoride was found to be helpful in decreasing the incidence of radiation caries; however it has not led to elimination of dental caries. Thus, new techniques containing low fluoride concentration or not containing fluoride at all, as laser irradiation, have been studied to prevent the beginning or progression of caries. So the purpose of this study is to investigate the effect of laser surface treatment with or without fluoride on microhardness and ultrastructure of demineralized gamma irradiated enamel; Thirty enamel slabs were allocated into three groups (n=10): G slabs were subjected to gamma irradiation only; GL slabs were subjected to gamma irradiation followed by diode laser and GFL slabs were subjected to gamma irradiation followed by fluoride then diode laser. Slabs were then exposed to demineralizing solution for 72 hours. Examination of slabs was performed using vickers microhardness test and scanning electron microscope; The lowest microhardness was recorded in group G, while inGL and GFL groups it significantly increased. Scanning electron microscope revealed a pronounced loss of central prism core and retention of prism peripheries in group G. Confluence of prismatic and interprismatic structures in GL slabs and irregular rough surface with prismatic boundaries conservation in GFL slabs were detected. Applying laser improved the microhardness and counteracted the adverse effect of gamma radiation. Adding fluoride before laser irradiation had a marked effect on microhardness..

Abordaje Terapéutico de la Hipomineralización Molar - Incisal. Revisión Narrativa / Peripheral Odontogenic Fibroma: Case Report

RESUMEN: Hipomineralización Molar-Incisal (MIH) es un trastorno del desarrollo dentario asociado a factores sistémicos, producido por una incompleta mineralización y maduración del esmalte. La prevalencia en niños, a nivel mundial, varía en la literatura entre el 2,4 % y el 40,2 %. Este trastorno que implica al menos un primer molar permanente, pudiendo también verse afectados los incisivos, dependiendo del momento, la duración, la susceptibilidad del individuo y la gravedad de la injuria prenatal, perinatal o postnatal. El esmalte presenta un grado variable de alteración en la translucidez, siendo éste de un espesor normal y de color blanco, o café-amarillo. Si bien se encuentra intacto en el momento de la erupción, puede sufrir fracturas post eruptivas debido a las fuerzas de la masticación, dejando límites definidos. Por lo general, los molares gravemente afectados son extremadamente hipersensibles, propensos a lesiones de caries de rápida progresión, y pueden ser difíciles de tratar en pacientes jóvenes. La atención debe abordar el comportamiento y la ansiedad del niño, con el objetivo de proporcionar restauraciones duraderas en condiciones libres de dolor. La ejecución de medidas preventivas individuales puede posponer el inicio del tratamiento restaurador y reducir la incomodidad del paciente a largo plazo. El diagnóstico precoz permitirá el seguimiento y la instauración de dichas medidas preventivas tan pronto las superficies afectadas sean accesibles. Pese a que los enfoques de tratamiento para MIH han comenzado a ser más claros y los avances en los materiales dentales han proporcionado soluciones clínicas en los casos que se consideraban sin posibilidad de restauración en el pasado, deben llevarse a cabo ensayos clínicos a largo plazo para facilitar aún más el manejo clínico de este cuadro.

ABSTRACT: Molar Incisor Hypomineralization (MIH) is a tooth development disorder, which is associated with systemic factors, produced by incomplete enamel mineralization and maturation below the enamel surface that is intact at the time of eruption. In literature, the prevalence in children worldwide varies between 2.4 % and 40.2 %. This disorder which involves at least one first permanent molar, and depending on duration, the child's susceptibility as well as the severity of prenatal, perinatal or postnatal insult may also compromise incisors. The defect reveals a variable degree of alteration in the translucency of the enamel, that has initially normal thickness and can be white, yellow or brown. Enamel surface may breakdown after eruption, due to masticatory forces, leaving sharp borders. Usually, severely affected molars are extremely hypersensitive, prone to rapid caries development, and can be difficult to manage in young patients. The complex care involved must address the child's behavior and anxiety, aiming to provide pain free treatment and durable restorations. Intensive individually prescribed preventive programs may postpone the onset of restorative treatment and reduce patient discomfort in the long term. Early identification of such children will allow monitoring and implementation of preventive measures as soon as affected surfaces are accessible. Although treatment approaches for MIH have become more clear, and advances in dental materials have provided clinical solutions in cases that in the past were regarded as unrestorable, long-term clinical trials should be realized to further facilitate clinical management of this dental defect.

Infiltration of white-spot-lesions and developmental enamel defects

ABSTRACT: Purpose: To provide an overview of different indications suitable for treatment with the technique of resin infiltration (Icon, DMG), such as white-spot lesions (WSL), enamel fluorosis, and molar-incisor hypomineralisation (MIH), and to propose a valid and strategy feasible in dental surgeries for screening of dental color improvement and -stability. Method: A non-systematic review of the literature was performed to characterise inhibition of lesion progression, and the esthetic effects induced by resin infiltration of decalcified enamel, enamel fluorosis, and molar-incisor hypomineralisation (MIH), using the online database Pubmed and a suitable search strategy. Database search was complemented by a hand-search of references of retrieved articles. Results: Of 34 retrieved articles, 29 were included in the review. Evidence of an assimilation of WSL color to surrounding enamel following infiltration is available on the level of RCTs, and the results were found to be stable in color with no significant changes over at least twelve months. Evidence of an esthetic improvement of fluorotic or MIH affected teeth is available on the level of case reports and case control studies. Conclusion: As a micro-invasive approach to infiltrate and seal different types of enamel lesions, with a subsequent improvement of the esthetic appearance, resin infiltration is considered to be a useful complementation of the dental therapeutic specter.

Modified glass ionomer and orthodontic band: an interim alternative for the treatment of molar incisor hypomineralization: a case report

Introduction: Molar incisor hypomineralization (MIH) is a developmental condition resulting in defects in the enamel characterized by demarcated opacities mainly affecting first permanent molars and occasionally permanent incisors in 1 of every 6 children worldwide. Affected molars have greater susceptibility to post eruptive breakdown, extensive caries and, in severe cases, are difficult to restore. When the MIH-affected molar presents severe crown destruction, it is necessary to perform an intermediate restoration to preserve the remaining dental structure in order to maintain occlusion, proper hygiene and periodontal health. The case of an 11-year-old patient with severe MIH is reported. The patient had extensive crown destruction by caries in tooth 1.6 without clinical or radiographic signs of pulp pathology. After an initial preventive intervention, enamel without dentin support and carious dentin were removed from tooth 1.6. Subsequently, crown restoration was performed with resin-modified glass ionomer, followed by the cementation of an orthodontic band. After 18 months of follow-up, the patient reported no pain or discomfort. The restoration was preserved intact, maintaining occlusal functionality, pulp and gingival health. Conclusion: The interim treatment, cementing an orthodontic band over a tooth restored with glass ionomer seems to favor retention and compressive strength, keeping the MIH-affected molar asymptomatic for at least 18 months. Further studies evaluating this treatment option in similar clinical situations are recommended.

Effectiveness of different removal methods of artificially demineralized dentin / Efetividade de diferentes métodos de remoção de dentina desmineralizada artificialmente

Objective: This study aimed to evaluate the effectiveness of different mechanical methods for the removal of demineralized dentin. Methods: Healthy human third molars were prepared in such a way that the flat occlusal surfaces of the dentin were exposed and longitudinally sectioned in a vestibular-lingual direction. One section of each tooth was submitted to the pH-cycling model, while the other section was kept intact. The tooth sections were joined, and a single operator performed dentin removal using a steel bur, a hand instrument,or a polymer bur. The tooth’s sections were then separated, and digital images were obtained. The depth of the prepared cavities and the microhardness measurements were checked and analyzed statistically using the Kruskal-Wallis One-Way ANOVA in Ranks, the Tukey test, while desmineralized dentin were comparedusing the One-Way ANOVA, and the Holm-Sidak method (p < 0.05). Results: The steel bur produced the deepest cavities in mineralized and demineralized dentin. The polymer bur generated the shallowest cavitiesin demineralized dentin. The measurements of microhardness of the deepest surfaces of the cavities prepared in demineralized dentin indicated that the steel bur and hand instrument presented similar values, while those values produced by polymer burs proved to be lower. Conclusion: The effectiveness of the removalof demineralized dentin varied among the three methods used in this study. The polymer bur proved to bethe most conservative of the methods used. By contrast, the steel bur and hand instrument showed a similareffectiveness in the removal of dentin, according to the microhardness of the remaining dentin, even thoughthey produced different cavity depths.

Molar incisor hypomineralization: three case reports and discussion of etiology, diagnosis, and management strategies / Hipomineralização de molar e incisivo: três relatos de caso e discussão sobre etiologia, diagnóstico e estratégias de tratamento

O objetivo deste artigo, que inclui três relatos de caso, é discutir brevemente a etiologia, o diagnóstico e as estratégias de tratamento de três pacientes com hipomineralização de molares e incisivos. Nos três casos apresentados, a etiologia estava relacionada a fatores sistêmicos que ocorreram durante o primeiro ano de vida, especialmente deficiência do sistema respiratório e episódios de febre alta. O diagnóstico foi realizado com base em exame clínico de características específicas como mudanças na cor e opacidade e perda de estrutura dentária. Decisões de tratamento foram tomadas de acordo com a severidade da hipomineralização em cada paciente, variando desde conduta expectante/acompanhamento até a restauração estética de incisivos permanentes. Nossos relatam indicam que a hipomineralização de molares e incisivos pode ocorrer, predominantemente, em crianças com história de deficiência respiratória e episódios de febre alta durante o primeiro ano de vida. O diagnóstico inicial normalmente é determinado pelo exame visual, e a decisão de tratamento dependerá da severidade da hipomineralização.

The aim of this article including three case reports is to briefly discuss the etiology, diagnosis, and treatment of patients with molar incisor hypomineralization. In all three cases presented, the etiology was related to systemic factors that occurred in the first year of life, especially respiratory deficiency and episodes of high fever. Diagnosis was based on clinical examination of specific characteristics such as changes in color and opacity and loss of tooth structure. Treatment decisions were made according to severity of hypomineralization in each patient, ranging from expectant management/follow-up to esthetic restoration of permanent incisors. Our reports suggest that molar incisor hypomineralization occur predominantly in children with a history of respiratory deficiency and episodes of high fever in the first year of life. Early diagnosis is usually determined by visual examination and treatment decision is dependent on condition severity.

Prevención y tratamiento de las manchas blancas post-ortodóncicas - métodos y tecnologías emergentes basados en la evidencia (trad) / Prevention and treatment of post-orthodontic white spot lesions - evidence-based methods and emerging technologies

El propósito de este trabajo fue la revisión de la evidencia para el tratamiento de las lesiones de mancha blanca (LMB) adyacentes a la aparatología de ortodoncia fija. En la búsqueda de trabajos clínicos relevantes publicados en inglés entre 2004 y marzo de 2011, 23 trabajos cumplieron con el criterio de inclusión. Los trabajos se evaluaron por acción preventiva y/o disminución del riesgo absoluto cuando fue posible. Los resultados muestran el uso de fluoruros tópicos agregado al de pastas dentales como la mejor estrategia basada en la evidencia para prevenir las LMB. La aplicación profesional de barnices de fluoruro alrededor de los brackets durante el tratamiento ortodóntico aportó la mayor fuerza de la evidencia en los estudios de prevención de la LMB. La aplicación en el hogar de crema remineralizante de caseína fosfopéptica -fosfato amorfo de calcio estable como adjunto al dentífrico conteniendo fluoruros, para el tratamiento post-ortodóntico de las LMB, resultó favorable pero los resultados de los estudios no son del todo concluyentes. Las nuevas tecnologías como los azúcares de alcoholes y los probióticos, aún se encuentran en estudio. Es necesario desarrollar trabajos estandarizados con buen diseño y conclusiones para recomendar juicios basados en la evidencia.

A preliminary study of enamel remineralization by dentifrices based on RecaldentTM (CPP-ACP) and NovaMin® (calcium-sodium-phosphosilicate)

The purpose of this study was to investigate the enamel remineralization potential of two toothpastes, one of which was based on RecaldentTM (CPP- ACP) and the other on NovaMin® (Calcium-sodium-phosphosilicate). Human permanent molar teeth were subjected to three consecutive demineralization cycles. These cycles were followed by remineralization of the experimental groups by toothpastes containing RecaldentTM and NovaMin® respectively. The samples were analyzed by Scanning Electron Microscope, (SEM) and energy-dispersive X-ray spectroscopy analysis (EDX). Extensive demineralization was noted in the control group (without remineralization) while the groups treated with the dentifrices demonstrated various degrees of remineralization, as shown by formation of different types of deposits on the enamel surface. The EDX analysis showed increased amounts of Ca, P, Si and Zn in the enamel of the experimental groups, compared to the control one. Toothpastes containing RecaldentTM and especially NovaMin® have the potential to remineralize enamel, a property which might be important in finding a substitute to pit and fissure sealing.

El objetivo del trabajo fue investigar el potencial de remineralizacion del esmalte de dos pastas dentifricos, una de ella con formulacion basada en RecaldentTM (CPP- ACP) y la otra en NovaMin® (phosphosilicato de calcio y sodio). Se realizaron tres ciclos cosecutivos de desmineralizacion en molares permanentes humanos, seguidos de remineralizacion, en los grupos experimentales con los denti fricos que contenian RecaldentTM y NovaMin® respectivamente. Se analizaron las muestras con microscopia electronica de barrido (SEM) y analisis espectroscopico por dispersion de rayos X (EDX). En el grupo control (sin remineralizacion) se observo una extensa demineralizacion mientras que los grupos tratados con los dentifricos mostraron varios grados de remineralizacion, evidenciados por la formacion de diferentes tipos de depositos sobre la superficie del esmalte. El analisis EDX mostro cantidades aumentadas de Ca, P, Si y Zn en los grupos tratados en comparacion con el grupo control. Los dentifricos conteniendo RecaldentTM y especialmente Nova- Min®, tienen potencial de reminalizacion del esmalte, una propiedad que puede resultar importante como substituto del sellado de fosas y fisuras.

Hipomineralização molar-incisivo / Molar incisor hypomineralization

A hipomineralização-molar incisivo (HMI) é um defeito de origem sistêmica no esmalte dentário de primeiros molares e incisivos permanentes. Nesta condição, o esmalte hipomineralizado é frágil e pode se destacar facilmente, deixando a dentina exposta e causando, assim, problemas como sensibilidade dentária e maior risco ao estabelecimento de lesões de cárie. A HMI é freqüentemente confundida com fluorose ou amelogênese imperfeita e sua prevalência varia de 3,6 a 25%. Vários fatores etiológicos são citados para a condição e estão freqüentemente relacionados com doenças na infância nos primeiros três anos de vida. O tratamento envolve desde a restauração dos dentes afetados com materiais adesivos ou até mesmo a extração dos mesmos, dependendo da severidade do caso.

Molar-Incisor Hypomineralization (MIH) is a hypomineralization of systemic origin of first permanent molars and incisors. In this condition, hipomineralized dental enamel is fragile and soft and can break easily, leading the dentin exposed and causing problems like dental sensitivity and progression of caries lesions. MIH is frequently misinterpreted as fluorosis or amelogenesis imperfecta and the prevalence ranges from 3,6 to 25%. Several aetiological factors are mentioned as the cause of the condition and they are frequently associated with childhood diseases during the first three years of life. The treatment includes the use of adhesive materials for restorative procedures, or even the extraction of the teeth, according to the severity of the case.

Caries dental: actualización de conceptos sobre la base de las últimas publicaciones sobre el tema / Dental caries: an update of concepts on the basis of the last publications on this subject

La caries dental es un proceso dinámico que tiene lugar en la interfase placa-diente y es consecuencia de la pérdida del equilibrio en ciclo fisiológico des-remineralización. La calidad de la placa dental es modificada por factores del medio ambiente, dadno como resultado la proliferación de agentes patógenos acidúricos y acidogénicos. Se necesita la presencia de placa sobre la superficie dentaria, más un conjunto de factores modificantes, para que se inicie el proceso de caries. Las variaciones de pH de la placa determinan el ritmo del proceso o sea, las variaciones en la magnitud de la pérdida mineral. El objetivo del tratamiento de la enfermedad será lograr la inactivación del proceso, lográndose a consecuencia de ello, la remineralización del tejido remanente

Estudio "in vitro" sobre remineralización y desmineralización de lesiones incipientes, al comparar dentífricos de diferente formulación y procedencia / An in vitro study on remineralization and demineralization of incipient lesions, comparing dentifrices of different formulation and origin

Usando elmodelo de pH cíclico se midió la eficacia de cuatro dentífricos de procedencia y formulación diferentes, para remineralizar "in vitro" caries incipientes y determinar posteriormente su resistencia a la desmineralización. Cuarenta y ocho muestras de esmalte con lesiones artificiales fueron divididas al azar en cuatro grupos experimentales: a) 0,243 por ciento FNa (USA); b) 0,243 por ciento FNa (Chile); c) 0,76 por ciento Na2FPO3 (USA) y d) 0,0 por ciento FNa (placebo). Los cambios en la dureza superficial (VHN) se determinaron antes y después de los períodos de remineralización y después de diferentes períodos de desmineralización. En remineralizar, los resultados no muestran difefencias significativas en los A VHN entre los grupos a) y b) o c) y d). No obstante, todos los dentífricos con flúor fueron más efectivos que el placebo (p > 0,05) en remineralizar. En cuanto a prevenir la desmineralización subsecuente (4 y 36 horas), los grupos a) y b) fueron significativamente superiores a los grupos c) y d). Los resultados en base a FNa de USA y Chile son similares en promover la remineralización de lesiones incipientes del esmalte y significativamente superiores a los formulados en base a Na2FPO3 en prevenir su posterior desmineralización