Sensitivity and specificity of assessment scales of dentin hypersensitivity - an accuracy study

Abstract The aim of the present study was to compare the sensitivity and specificity of pain scales used to assess dentin hypersensitivity (DH). The preferred scale, and toothbrushing habits of participants were also investigated. This cross-sectional study was conducted with students and employees of a Brazilian Federal University who presented DH. The participants answered a questionnaire about their toothbrushing and drinking habits. Hypersensitive and non-sensitive teeth were submitted to tactile and ice stick stimuli. Then, the subjects marked their pain level in the visual analogue (VAS), numeric scale (NS), faces pain scale (FPS) and verbal evaluation scale (VES). DH was also assessed by Schiff scale (SS). The data were analyzed by Wilcoxon and Chi-Square tests, as well as by ROC curve. The mean age of the sample (56 women, 16 men) was 27.8 years. The most prevalent acidic beverage was coffee (36.0%) and the most preferred scale was the NS (47.2%). The pain level was statistically higher in teeth with DH compared to teeth without DH (p < 0.05). The accuracy ranged from 0.729 (SS) to 0.750 (NS). The highest sensitivity value was 81.9% for NS. The SS presented the highest specificity (91%). The visual analog, numerical, verbal evaluation, faces pain, and Schiff scales were accurate for DH diagnosis. The Schiff scale was the preferred scale for DH assessment.

Do commercial whitening dentifrices increase enamel erosive tooth wear?

Abstract Objective This in vitro study evaluated the effect of commercial whitening dentifrices on erosive tooth wear (ETW) of bovine enamel samples, in comparison with commercial regular dentifrices. Methodology Sixty bovine crowns were embedded in acrylic resin, polished and then had their baseline profile determined. They were randomly assigned to 5 groups (n=12/group), according to the type of commercial dentifrice to be tested: GI - Crest Anti-cavity Regular; GII - Crest 3D White; GIII - Colgate Total 12 Clean Mint; GIV - Colgate Optic White; GV - Placebo (negative control, fluoride-free dentifrice). The samples were submitted to daily erosive and abrasive challenges for 3 days. The erosive challenges were performed 3 times a day by immersing the specimens in 0.1% citric acid solution (pH 2.5) for 90 s. Each day after the first and last erosive challenges, the specimens were subjected to the abrasive challenge for 15 s, using a toothbrushing machine (Biopdi, São Carlos, SP, Brazil), soft toothbrushes and slurry (1:3 g/ml) of the tested toothpastes (1.5 N). The specimens were kept in artificial saliva between the challenges. The final profile was obtained and the ETW (µm) was calculated. Data were analyzed by Kruskal-Wallis and Dunn's tests (p<0.05). Results All dentifrices tested significantly reduced the enamel wear in comparison with the Placebo, except GIII. The median (95% CI) ETW was 1.35 (1.25-1.46)bc for GI, 1.17 (1.01-1.34)cd for GII, 1.36 (1.28-1.45)ab for GIII, 1.08 (1.04-1.14)d for GIV and 2.28 (2.18-2.39)a for GV. Conclusion When dentifrices from the same manufacturer were compared, the whitening dentifrices led to similar or less wear than the regular ones.

Prevalence of Gingival Recession in Dental Students from the Federal University of Juiz de Fora - Brazil / Prevalencia de Recesión Gingival en Estudiantes de Odontología de la Universidad Federal de Juiz de Fora - Brasil

ABSTRACT: Gingival recessions are characterized by partial denudation of the root surface due to apical displacement of the gingival margin from the amelocemental junction and may be localized or generalized. The aim of this study was evaluate the prevalence of gingival recession and dentine hypersensitivity of dental students of Federal University of Juiz de Fora, Brazil. Were examined 80 students with on average age of 22.9, randomly selected to assess the prevalence, level of gingival recession and the presence of dentinal hypersensitivity. Fifty students had at least one gingival recession and dentine hypersensitivity was observed in 28 students. Buccal surface was the most prevalent (86.6 %), with measures mostly between 1 and 2 mm (92 %) and classified as Class I Miller (96.25 %). The pre-molars were the group most frequently affected teeth (37.35 %). Gingival recession with small measures is a very common condition in young patients.

RESUMEN: Las recesiones gingivales se caracterizan por una denudación parcial de la superficie radicular debido al desplazamiento apical del margen gingival, desde la unión amelocemental y puede ser localizada o generalizada. El objetivo de este estudio fue evaluar la prevalencia de la recesión gingival y la hipersensibilidad dentinaria en estudiantes de Odontología de la Universidad Federal de Juiz de Fora, Brasil. Se examinaron 80 estudiantes con una edad promedio de 22,9, seleccionados al azar para evaluar la prevalencia, el nivel de recesión gingival y la presencia de hipersensibilidad dentinal. En cincuenta estudiantes se observó al menos una recesión gingival y se reportó hipersensibilidad a la dentina en 28 estudiantes. La superficie oral fue la más prevalente (86,6 %), con medidas principalmente entre 1 y 2 mm (92 %) y clasificada como Clase I Miller (96,25 %). Los premolares fueron el grupo de dientes afectados con mayor frecuencia (37,35 %). La recesión gingival con medidas pequeñas es una condición muy común en pacientes jóvenes.

Multiple-peak and single-peak dental curing lights comparison on the wear resistance of bulk-fill composites

Abstract: The effects of tooth brushing could affect the long-term esthetic outcome of composite restorations. This study evaluated the effect of two different emission spectrum light-curing units on the surface roughness, roughness profile, topography and microhardness of bulk-fill composites after in vitro toothbrushing. Valo (multiple-peak) and Demi Ultra (single-peak) curing lights were each used for 10s to polymerize three bulk-fill resin composites: Filtek Bulk Fill Posterior Restorative (FBF), Tetric EvoCeram Bulk Fill (TET) and Surefil SDR Flow (SDR). After 30,000 reciprocal strokes in a toothbrushing machine, the roughness profile, surface roughness, surface morphology, and microhardness were examined. Representative SEM images were also obtained. When light-cured with the Demi Ultra, SDR showed the most loss in volume compared to the other composites and higher volume loss compared to when was light-cured with Valo. The highest surface roughness and roughness profile values were found in SDR after toothbrushing, for both light-curing units tested. FBF always had the greatest microhardness values. Light-curing TET with Valo resulted in higher microhardness compared to when using the Demi Ultra. Confocal and SEM images show that toothbrushing resulted in smoother surfaces for FBF and TET. All composites exhibited surface volume loss after toothbrushing. The loss in volume of SDR depended on the light-curing unit used. Toothbrushing can alter the surface roughness and superficial aspect of some bulk-fill composites. The choice of light-curing unit did not affect the roughness profile, but, depending on the composite, it affected the microhardness.

Lesiones cervicales no cariosas en pacientes del área de salud Eléctrico, municipio Arroyo Naranjo, 2015 / Non carious cervical lesions in patient of the area of health Electric, Arroyo Naranjo municipality, 2015

Introducción: las lesiones cervicales no cariosas son la pérdida patológica de la estructura dentaria localizada en el límite amelo-cementario, que no responden a un agente causal bacteriano. Teniendo en cuenta la incidencia de esta afección en la salud bucal, resulta una necesidad su estudio más detallado, que permita conocer mejor su comportamiento clínico-epidemiológico para favorecer su prevención y tratamiento de una forma más eficaz. Objetivo: determinar la distribución y características de lesiones cervicales no cariosas en pacientes pertenecientes al área de salud Eléctrico del municipio Arroyo Naranjo de la provincia La Habana. Métodos: se realizó una investigación descriptiva transversal en un total de 153 pacientes con lesiones cervicales no cariosas. Fue considerada una lesión cervical no cariosa cuando el paciente presentara alguna de las variantes erosión, abrasión y/o abfracción, o la combinación de estas. Se asumieron para la investigación otras variables como: sexo, edad, grupo de diente, localización y factores de riesgo. Se utilizó la prueba estadística de chi cuadrado para la asociación de variable. Resultados: predominaron el sexo masculino con 52,9 por ciento y el grupo de edad de 37 a 47 años con el 30,7 por ciento. Los premolares resultaron el grupo dentario más afectado con el 38,9 por ciento; se destacó al bruxismo y al cepillado traumático con el 43,8 por ciento y 35,3 por ciento respectivamente. Conclusiones: las lesiones cervicales no cariosas se manifestaron entre los 37 a 47 años, específicamente en los hombres, y afectaron fundamentalmente a los premolares superiores con un promedio de 4 dientes por paciente. El bruxismo y el cepillado traumático constituyeron los factores de riesgo que más se correspondieron con el desarrollo de este tipo de lesión no cariosa a nivel cervical del diente(AU)

Introduction: non-carious cervical lesions are the pathological loss of dental structure located in the amelocementum junction, which do not result from a bacterial causative agent. Given the incidence of this condition in the oral health, it is necessary to study it in detail in order to better know its clinical and epidemiological behavior and to prevent it and treat it more effectively. Objective: to determine the distribution and the characteristics of non-carious cervical lesions in patients from the Electrico health area in Arroyo Naranjo municipality in Havana province. Methods: a cross-sectional descriptive study was conducted on a sample of 153 patients with non-carious cervical lesions. The classification of a non-carious cervical lesion was considered when a patient presents with some of the variants called erosion, abrasion and/or abfraction, or their combination. Other variables were also taken for this study, that is, sex, age, tooth group, location and risk factors. The Chi square test was used for the association of variables. Results: in the study, males with 52.9 percent of the total number and the 37-47 year age group with 30.7 percent predominated. Premolars represented the most affected dental group with 38.9 percent; bruxism and harmful brushing were present in 43.8 percent and 35.3 percent of cases, respectively. Conclusions: non carious cervical lesions occur in the 37-47 age group, mainly in men and fundamentally affect upper premolars and 4 teeth per patient as average. Bruxism and harmful brushing were the most related risk factors to this type of non-carious lesion(AU)

Combined effect of end-rounded versus tapered bristles and a dentifrice on plaque removal and gingival abrasion

Abstract Two previous clinical studies evaluated the effect of end-rounded versus tapered bristles of soft manual brushes on the removal of plaque and gingival abrasion. However, the combined effect of an abrasive dentifrice on these outcomes has yet to be understood. The purpose of the present study was to compare the incidence of gingival abrasion and the degree of plaque removal obtained after the use of toothbrushes with tapered or end-rounded bristles in the presence or absence of an abrasive dentifrice. The study involved a randomized, single-blind, crossover model (n = 39) with a split-mouth design. Subjects were instructed to refrain from performing oral hygiene procedures for 72 hours. Quadrants were randomized and subjects brushed with both types of toothbrushes using a dentifrice (relative dentin abrasion = ± 160). Plaque and gingival abrasion were assessed before and after brushing. After 7 days, the experiment was repeated without the dentifrice. The average reduction in plaque scores and the average increase in the number of abrasion sites were assessed by repeated-measures ANOVA and Bonferroni's post-hoc tests. End-rounded bristles removed significantly more plaque than tapered bristles, regardless of the use of a dentifrice. The dentifrice did not improve plaque removal. In the marginal area (cervical free gingiva), no difference in the incidence of gingival abrasion was detected between toothbrush types when used with a dentifrice (p ≥ 0.05). However, the dentifrice increased the incidence of abrasion (p < 0.001), irrespective of the toothbrush type tested. End-rounded bristles therefore removed plaque more effectively without causing a higher incidence of gingival abrasion when compared with tapered bristles. An abrasive dentifrice can increase the incidence of abrasion, and should be used with caution by individuals who are at risk of developing gingival recession.

Efeito da escovação dentária no manchamento de braquetes estéticos cerâmicos / Effect of brushing on color stability of ceramic brackets

Avaliar, in vitro, o efeito da escovação no manchamento de braquetes cerâmicos quando imersos em soluções corantes. Material e Métodos: sete braquetes cerâmicos de incisivo central superior direito de quatro marcas comerciais foram testados: dois monocristalinos e dois policristalinos. Os braquetes foram imersos por 21 dias em soluções de café, vinho tinto, Coca-Cola, chá preto e em saliva artificial. A mensuração da cor inicial e após 21 dias foi realizada por espectrofotômetro de reflectância de acordo com o sistema CIE L*a*b*, e a mudança de cor (∆E*) foi calculada. Outro grupo foi constituído por uma amostra de sete braquetes de cada marca comercial, que foram imersos nas mesmas soluções e no tempo igual ao anterior, porém, com intervalos diários de escovação realizados pela máquina de escovação Mavtec. Os dados obtidos foram avaliados pela análise de variância (Anova), teste de comparação múltipla de médias e teste t de Student. Resultados: as médias do ∆E* do grupo de braquetes sem escovação variaram de 0,46 a 7,61, enquanto que no grupo com escovação essas médias variaram de 0,36 a 2,50, exceto para o Radiance quando imerso no café, e para o chá preto em todos os braquetes, onde o manchamento ainda permaneceu perceptível (∆E* > 3,7). Conclusão: a escovação diária ajudou significativamente na estabilidade de cor dos braquetes cerâmicos, reduzindo a alteração de cor a níveis considerados não visíveis a olho humano, exceto para a solução de chá preto, cujo manchamento permaneceu relevante...

This study aimed to analyze the in vitro effect of brushing on the color stability of ceramic brackets immersed in dye solutions. Materials and Methods: seven ceramic brackets of four commercial brands were tested: two monocrystalline and two polycrystalline. The parameters of color were obtained by spectrophotometer before and after 21 days of immersion of the brackets in coffee, red wine, Coca-Cola, black tea and artificial saliva. Another group of brackets of each brand were also immersed in the same solutions and for an equal time to the previous group, but with intervals of daily brushing performed by a toothbrushing machine (Mavtec). The data were evaluated by analysis of variance, multiple comparison tests for means and Student's t-test. Results: the mean color change of the brackets without brushing ranged from 0.46 to 7.61, while in the group with brushing these means ranged from 0.36 to 2.50. The staining still remained noticeable (change of color greater than 3.7) for all brackets when immersed in black tea. Conclusion: daily brushing helped significantly in the color stability of ceramic brackets, maintaining the color change to levels considered not visible to the human eye, except for the solution of black tea in which the staining remained relevant...

Abrasion resistance of direct and indirect resins as a function of a sealant veneer.

Background: Abrasive wear is one of the most common type of wear that not only affect teeth, as also dental restorations. Thus to investigate one of the etiological factors as tooth brushing procedure is clinical relevant in order to select the best material combination that may prevent damage of resin dental restoration's abrasion. Aims: This study evaluated the influence of tooth brushing on mass loss and surface roughness of direct Venus (Vs) and indirect Signum (Sg) resin composites, with and without a surface sealant, Fortify (F). Materials and Methods: Twenty‑four specimens were prepared with each resin composite, using their proprietary curing units, according to manufacturer’s instructions. All the specimens were polished and ultrasonically cleaned in distilled water for 5 minutes. Half of the specimens of each resin (n = 12) were covered with F (VsF and SgF), except for the control (C) specimens (VsC and SgC), which were not sealed. Mass loss (ML) as well as surface roughness (Ra) was measured for all the specimens. Then, the specimens were subjected to toothbrush–dentifrice abrasion, using a testing machine for 67.000 brushing strokes, in an abrasive slurry. After brushing simulation, the specimens were removed from the holder, rinsed thoroughly and blot dried with soft absorbent paper. The abrasion of the material was quantitatively determined with final measurements of ML and surface roughness, using the method described above. Results: ML data were analyzed by two‑way analysis of variance (ANOVA) and the analysis indicated that resin composites were not statistically different; however, the specimens sealed with F showed higher ML. Ra mean values of the groups VsF and SgF significantly increased. Conclusion: Tooth brushing affects mainly the roughness of the direct and indirect resin composites veneered with a sealant.

Use of dentifrices to prevent erosive tooth wear: harmful or helpful?

Dental erosion is the loss of dental hard tissues caused by non-bacterial acids. Due to acid contact, the tooth surface becomes softened and more prone to abrasion from toothbrushing. Dentifrices containing different active agents may be helpful in allowing rehardening or in increasing surface resistance to further acidic or mechanical impacts. However, dentifrices are applied together with brushing and, depending on how and when toothbrushing is performed, as well as the type of dentifrice and toothbrush used, may increase wear. This review focuses on the potential harmful and helpful effects associated with the use of dentifrices with regard to erosive wear. While active ingredients like fluorides or agents with special anti-erosive properties were shown to offer some degree of protection against erosion and combined erosion/abrasion, the abrasive effects of dentifrices may increase the surface loss of eroded teeth. However, most evidence to date comes from in vitro and in situ studies, so clinical trials are necessary for a better understanding of the complex interaction of active ingredients and abrasives and their effects on erosive tooth wear.

Influencia de los tipos de anclaje de los filamentos en la retención de streptococcus mutans en cepillos dentales: estudio preliminar / Influence of the types of filaments anchoring in the retention of streptococcus mutans on toothbrushes: preliminary study

Este estudio evaluó la retención del S. mutans (ATCC 25175) en los cepillos dentales Oral B Complete® y Sensodyne Esmalte Care®, que poseen distintas características de fijación y anclaje de los filamentos en sus partes activas. Nueve cepillos dentales de cada marca comercial fueron esterilizados en autoclave y, a continuación, inoculados con S. mutans (ATCC 25175), previamente desarrollado en caldo Brain Heart Infusion (BHI). Los análisis de retención bacteriana se realizaron en los tempos de 04, 12 y 24 horas de incubación, a 37ºC y en microaerofilia, en triplicata. En esas etapas, los cepillos fueron lavados con agua esterilizada e introducidos en tubos Falcon con caldo BHI, del cual fueron preparadas diluciones decimales hasta 10-3 para las cuatro primeras horas, hasta 10-4 para 12 horas, y hasta 10-5 para 24 horas de incubación. Alícuotas de esas diluciones fueron sembradas en la superficie del Ágar BHI, siendo las placas incubadas en microaerofilia por 24h a 37ºC. Tras la incubación, fue realizado un recuento de las unidades formadoras de colonia por mL (UFC/mL) y el análisis estadístico (Tests de Tukey pareado, p?0,05). Fueron observadas diferencias estadísticamente significantes (p?0,05) entre lo tiempos de evaluación de 12 horas. Concluyese que el cepillo dental Oral B Complete® presentó, comparativamente a Sensodyne Esmalte Care®, mayor retención del S. mutans (ATCC 25175).

This work evaluated the retention of S. mutans ATCC 25175 in the Oral B Complete and Sensodyne Esmalte Care toothbrushes that have distinct characteristics of insertion and anchorage of the filaments in its active parts. Nine toothbrushes of each trademark were sterilized in autoclave and, following this procedure, inoculated with S. mutans ATCC 25175, previously developed in Brain Heart Infusion (BHI).The analyses of bacterial retention occurred in the times of 04, 12 and 24 hours after incubation, at 37ºC and in microaerophilic, in triplicate. In these stages, the toothbrushes were washed with sterilized water and enclosed in Falcon tubes with BHI broth, of which decimal dilutions up to 10-3 were made for the four first hours, up to 10-4 for 12 hours, and up to 10-5 for 24 hours of incubation. Aliquots of these dilutions were sown in the surface of agar BHI, and the Petri dishes were incubated in microaerophilic for 24 hours, in a temperature of 37ºC. After the incubation, the counting of the colony forming units and the statistical analysis (Tukey Test paired, p?0.05) were performed. Significant statistical differences were observed (p?0.05) between the times of evaluation of 12 hours. It was concluded that the Oral B Complete toothbrush presents, compared with Sensodyne Esmalte Care, greater retention of S. mutans ATCC 25175.

Comparação de duas técnicas de enxerto para recobrimento radicular em recessões classe II de Miller / Comparison of two graft materials for recover root recessions in miller Class II deffects

O objetivo do presente trabalho foi demonstrar, através de um caso clínico, o recobrimento radicular de recessões gengivais provocadas por escovação traumática, comparando-se dois materiais de uso subepitelial. Foram realizadas as cirurgias de recobrimento radicular em lados diferentes, na arcada superior, com diferença de dois meses entre um procedimento e outro. Em um dos lados utilizou-se uma membrana de colágeno reabsorvível e, no outro lado, utilizou-se um enxerto de tecido conjuntivo posicionado abaixo do retalho. Após a cirurgia, a paciente foi acompanhada, periodicamente, para observação da cicatrização, avaliação do controle de placa e acompanhamento dos métodos de higiene bucal. Os resultados mostraram a recuperação e o recobrimento radicular 12 meses após os procedimentos. Os percentuais de recobrimento variaram de 50% a 83% no lado que recebeu o tecido conjuntivo subepitelial, e de 33% a 83% no lado que recebeu a membrana reabsorvível de colágeno. Em relação à avaliação da paciente, houve melhora em sua aparência e diminuição na sensibilidade dos dentes. Concluiu-se que o recobrimento radicular é um procedimento eficaz e previsível para o recobrimento das recessões gengivais, sendo capaz de melhorar a estética do sorriso e reduzir a hipersensibilidade dentinária.

Impact of filler size and distribution on roughness and wear of composite resin after simulated toothbrushing

OBJECTIVES: Nanofilled composite resins are claimed to provide superior mechanical properties compared with microhybrid resins. Thus, the aim of this study was to compare nanofilled with microhybrid composite resins. The null hypothesis was that the size and the distribution of fillers do not influence the mechanical properties of surface roughness and wear after simulated toothbrushing test. MATERIAL AND METHODS: Ten rectangular specimens (15 mm x 5 mm x 4 mm) of Filtek Z250 (FZ2), Admira (A), TPH3 (T),Esthet-X (EX), Estelite Sigma (ES), Concept Advanced (C), Grandio (G) and Filtek Z350 (F) were prepared according to manufacturer's instructions. Half of each top surface was protected with nail polish as control surface (not brushed) while the other half was assessed with five random readings using a roughness tester (Ra). Following, the specimens were abraded by simulated toothbrushing with soft toothbrushes and slurry comprised of 2:1 water and dentifrice (w/w). 100,000 strokes were performed and the brushed surfaces were reanalyzed. Nail polish layers were removed from the specimens so that the roughness (Ra) and the wear could be assessed with three random readings (µm). Data were analyzed by ANOVA and Tukey's multiple-comparison test (α=0.05). RESULTS: Overall outcomes indicated that composite resins showed a significant increase in roughness after simulated toothbrushing, except for Grandio, which presented a smoother surface. Generally, wear ofnanofilled resins was significantly lower compared with microhybrid resins. CONCLUSIONS: As restorative materials suffer alterations under mechanical challenges, such as toothbrushing, the use of nanofilled materials seem to be more resistant than microhybrid composite resins, being less prone to be rougher and worn.

Um alerta sobre os potenciais riscos da escovação inadequada: novas responsabilidades para a profissão / A warning about potential risks of inadequate toothbrushing: new concerns for the profession

Dentre todas as ações educativas e de promoção de saúde que a odontologia realiza, o estímulo à escovação dos dentes sempre assumiu capital importância. Assim, há décadas a profissão veicula a informação da importância desse ato. Não há duvida de que essa política foi uma das responsáveis pelo declínio da cárie (principalmente porque se escova com dentifrício com flúor) e das doenças periodontais. Entretanto, toda prática, se realizada de forma inadequada ou em excesso, pode gerar eventos adversos. Essa é uma realidade em relação à escovação. A recessão gengival e suas decorrências de conforto e estética e a perda de substância dentária são os efeitos adversos mais comuns na escovação. O presente artigo faz uma breve reflexão sobre os potenciais eventos adversos relacionados à escovação, e destaca a importância de utilizar força controlada, escovas com cerdas macias ou extra-macias e, também, relembra os potenciais eventos adversos da escovação após ingestão de alimentos ácidos, para que os profissionais possam orientar seus pacientes e as comunidades.

Toothbrushing supervision is one of the most important measures for education and health promotion performed in Dentistry. Therefore, dental profession has given information about the importance of toothbrushing for decades. There is no doubt that this policy was one of the responsible for decline of caries (especially due to fluoridate dentifrices) and periodontal diseases. However, all habit can generate adverse effects, if is performed inadequately or in excess, and this occurs for toothbrushing. Gingival recession and the associated discomfort and esthetic related problems, as well as loss of tooth substance are the most common side effects of toothbrushing. This article reports recent thoughts on the potential side effects related to toothbrushing and outlines the relevance of controlling brushing force, the use of toothbrushes with soft or extra-soft bristles, and the risks when toothbrushing is performed immediately after the ingestion of acidic foods or drinks, so that the professionals may inform their patients and communities.

Non-inflammatory destructive periodontal disease: a clinical, microbiological, immunological and genetic investigation

Periodontitis comprises a group of multifactorial diseases in which periodontopathogens accumulate in dental plaque and trigger host chronic inflammatory and immune responses against periodontal structures, which are determinant to the disease outcome. Although unusual cases of non-inflammatory destructive periodontal disease (NIDPD) are described, their pathogenesis remains unknown. A unique NIDPD case was investigated by clinical, microbiological, immunological and genetic tools. The patient, a non-smoking dental surgeon with excessive oral hygiene practice, presented a generalized bone resorption and tooth mobility, but not gingival inflammation or occlusion problems. No hematological, immunological or endocrine alterations were found. No periodontopathogens (A. actinomycetemcomitans, P. gingivalis, F. nucleatum and T. denticola) or viruses (HCMV, EBV-1 and HSV-1) were detected, along with levels of IL-1β and TNF-a in GCF compatible with healthy tissues. Conversely ALP, ACP and RANKL GCF levels were similar to diseased periodontal sites. Genetic investigation demonstrated that the patient carried some SNPs, as well HLA-DR4 (*0404) and HLA-B27 alleles, considered risk factors for bone loss. Then, a less vigorous and diminished frequency of toothbrushing was recommended to the patient, resulting in the arrest of alveolar bone loss, associated with the return of ALP, ACP and RANKL in GCF to normality levels. In conclusion, the unusual case presented here is compatible with the previous description of NIDPD, and the results that a possible combination of excessive force and frequency of mechanical stimulation with a potentially bone loss prone genotype could result in the alveolar bone loss seen in NIDPD.

Desgaste abrasivo de uma resina composta, através de três diferentes métodos (disco retificado, escovação e nanodurômetro) / Abrasive wear of a composite resin, using three different methods (ground disc, toothbrushing and nanodurometer)

Neste estudo, foi avaliada a resistência ao desgaste abrasivo de uma resina composta, através de três diferentes métodos: do disco retificado, por escovação e do nanodurômetro. Nos dois primeiros métodos, foram utilizados 20 espécimes da resina Filtek Z250 (10 da cor Incisal e 10 da cor C4, ambos fotopolimerizados por 30 segundos cada) e 10 de polimetilmetacrilato (PMMA), atuando estes últimos como padrão de referência. Para os ensaios com o nanodurômetro, foi utilizado apenas um espécime de cada cor, assim como um único de PMMA, em cujas superfícies planas foram efetuadas sete medições, o que foi considerado equivalente a sete espécimes. No método do disco retificado, cada espécime de resina composta era confeccionado diretamente numa cavidade semicircular, localizada na periferia de um disco-suporte; os espécimes de PMMA consistiam em discos constituídos exclusivamente por este material; o desgaste de cada espécime era promovido por um disco de porcelana e seu conseqüente deslocamento era detectado por um palpador; assim, a taxa de desgaste era estabelecida, expressa em milímetros cúbicos por newton por segundo (mm3/N.s). No método de escovação, cada espécime cilíndrico ficava preso numa placa metálica, a qual era fixada no interior da máquina de escovação; sua perda de massa (em miligramas) era verificada através de uma balança analítica. No método do nanodurômetro, existiu apenas um espécime ci líndrico para cada condição, em cuja face plana superior eram feitos sete sulcos (equivalentes a sete espécimes); o coeficiente de atrito permitia estabelecer a respectiva resistência ao desgaste. Para cada método utilizado, os dados foram tratados estatisticamente, através de análise de variância (ANOVA) e de teste de Tukey. Pôde-se concluir que, através do disco retificado, a taxa de desgaste (em mm3/N.s) dos materiais foi: Incisal (0,6807) > C4 (0,5012) > PMMA (0,1439); que, através da escovação, a taxa de desgaste (em mg) foi de 5,40 para...

Abrasive wear of a composite resin, using three different methods (ground disc, toothbrushing and nanodurometer). The aim at this study was to evaluate the resistance to abrasive wear of a composite resin, using three different methods: ground disc, toothbrushing and nanodurometer. At the first two methods were employed 20 specimens of Filtek Z250 composite resin (10 of Incisal and 10 of C4, both the colors cured for 30 seconds each one) and 10 of polymethylmethacrylate (PMMA), the latter acting as a reference standard. For the tests with the nanodurometer it was used only one specimen of each color, as well as just one of PMMA, in whose flat surfaces seven measurements were made, what was considered equivalent to seven specimens. At the ground disc method, each composite resin specimen was directly made on a semicircular cavity located on the periphery of a supporting disc; PMMA specimens consisted of discs made up exclusively with this material; the wear of each specimen was promoted by a ceramic disc and its consequent displacement was detected by a sensor; thus, the wear rate was established, expressed in cubic millimeters per newton per second (mm3/N.s). At the toothbrushing method, each cylindrical specimen was trapped in a metal plate, which was fixed inside the machine brushing; its weight loss (in milligrams) was verified by an analytical balance. At the nanodurometer method, there was only one cylindrical specimen for each condition, in whose flat upper face seven grooves were made (what was equivalent to seven specimens); the coefficient of friction was used to establish its wear resistance. For each method, data were statistically analyzed by ANOVA and Tukey's test. It could be concluded that, by ground disc method, materials wear rate (in mm3/N.s) was Incisal (0.6807) > C4 (0.5012) > PMMA (0.1439); by brushing method, materials wear rate (in mg) was 5.40 for Incisal, 9.35 for C4 and 5.88 for PMMA, without significant difference...

Lesões cervicais não cariosas na prática odontológica atual: diagnóstico e prevenção / Cervical non carious lesions in contemporary dental practice: diagnosis and prevention

Na prática odontológica atual, é comum observar as perdas nas estrutura cervical do dente, denominadas lesões cervicais não cariosas, tais como abrasão, erosão e abfração. Seu diagnóstico, porém, muitas vezes é complexo, já que essas lesões podem estar associadas entre si. O objetivo do presente estudo foi realizar uma revisão atualizada sobre as lesões cervicais não cariosas, com o intuito de divulgar suas etiologias, seus diagnósticas e sua prevenção. Foram observados fatores intrínsecos e extrínsecos associados à lesões. Verificou-se que o principal fator etiológico é o trauma oclusal, que predispõe o aparecimento de lesões cervicais não cariosas. Além disso, a escovação não tem sido determinada como principal fator etiológico das lesões de abrasão, mas sim a associação dela com o pH ácido bucal. Concluiu-se que tais lesões tornaram-se um problema de saúde pública devido ao desconhecimento pela classe odontológica do seu diagnóstico e prevenção

Degradação dos materiais restauradores utilizados em lesões cervicais não cariosas / Degradation of the restorative materials used in non-carious cervical lesions

OBJETIVO: Avaliar o efeito de bebidas ácidas e da escovação em materiais utilizados em lesões cervicais não cariosas. MÉTODOS: Três resinas compostas, um compômero e um cimento de ionômero resino-modificado foram testados. Para cada material, cinco espécimes foram imersos em uma das soluções teste (suco de laranja, coca-cola, uísque ou água destilada) por 10 dias a 37ºC. Em seguida, os espécimes foram submetidos à escovação (20000 ciclos, 200g de carga). O peso e a rugosidade superficial foram avaliados antes e após a imersão nas soluções e escovação. Os dados foram analisados pela ANOVA/Teste Tukey (p<0,05). RESULTADOS: As imersões em suco de laranja e coca-cola seguida de escovação causaram significativamente maior perda de peso para o compômero e cimento de ionômero de vidro resino-modificado comparado às resinas compostas. O maior aumento de rugosidade superficial foi observado no cimento de ionômero de vidro resino-modificado após imersão em suco de laranja seguida de escovação. CONCLUSÃO: A imersão em bebidas ácidas seguida de escovação causou degradação nos materiais restauradores avaliados, com perda de material e aumento na rugosidade superficial.

OBJECTIVE: Evaluate the effect of acidic beverages and brushing on the restorative materials used in non-carious cervical lesions. METHODS: Three composite resins, one compomer and one resin-modified glass ionomer were tested. Five specimens of each material were immersed in each of the test solutions (orange juice, Coca-Cola, whisky and distilled water) for a 10-day period at 37ºC. Next, the specimens were brushed (20000 cycles with a load of 200g). Weight and surface roughness were measured before and after immersion and brushing. The data were analyzed by ANOVA/Tukey Test (p<0.05). RESULTS: The compomer and resin-modified glass ionomer lost significantly more weight after immersion in orange juice and Coca-Cola followed by brushing than the composite resins. The resin-modified glass-ionomer presented the highest increase in surface roughness after orange juice immersion and brushing. CONCLUSION: Immersion in acidic beverages followed by brushing degraded the restorative materials tested, causing loss of material and increased surface roughness.

Effect of chemical degradation followed by toothbrushing on the surface roughness of restorative composites

OBJECTIVES: The aim of the present study was to assess the effect of the exposure to food-simulating liquids prior to brushing simulation on the surface roughness of five composite materials (Quixfil, Filtek Supreme, Esthet-X, Filtek Z250, Tetric Ceram). Material and METHODS: Twenty cylinders (5 mm diameter and 4 mm height) of each composite were randomly allocated to 4 groups (n=5), according to the food-simulating liquid in which they were immersed for 7 days at 37°C: artificial saliva, heptane, citric acid, and ethanol. After this period, the top surface of composite cylinders was submitted to 7,500 brushing cycles (200 g load). Measurements of the surface roughness (Ra, »m) were carried out before and after the exposure to the chemicals/brushing simulation. Changes on the morphology of composite surfaces were observed through scanning electron microscopy (SEM). RESULTS: The statistical analysis (ANOVA with cofactor / Tukey's test, α=5 percent) detected a significant interaction between solutions and composite resins. Esthet-X, Filtek Z250 and Tetric Ceram were not affected by the food-simulating liquids/toothbrushing. Citric acid and ethanol increased the surface roughness of Quixfil and Filtek Supreme, respectively. SEM images corroborate the surface roughness findings, demonstrating the negative effect from chemical solutions and mechanical abrasion. CONCLUSIONS: The surface roughness of composite resin materials are differently affected by the food-simulating solutions, depending on the immersion media.

Effect of toothbrushing with different manual toothbrushes on the shear bond strength of orthodontic brackets

The aim of this study was to evaluate the effect of brushing with a Colgate 360º or Oral B Indicator 35 toothbrush on the shear bond strength of orthodontic brackets bonded to extracted human teeth. The bristle wear and bristle tip morphology were also examined after simulated tooth-brushing. Orthodontic brackets (Roth-P/1st and 2nd premolar S/D- Slot 0.18") were bonded (Transbond XT®) to the smoothest surface of each of 45 extracted human molar and premolar teeth. Test specimens were randomly divided into three groups: Group 1, control group with no brushing; Group 2, brushing with the Oral B Indicator 35; Group 3, brushing with the Colgate 360º. Samples were adapted to a machine that simulated tooth-brushing. The bond strength of each bracket to each tooth was assessed with a mechanical testing machine. The bristle wear and bristle tip morphology indices were also assessed. Statistically significant differences were defined for p < 0.05. The average bond strengths (range: 90.18-90.89 kgf/cm²) did not differ among the three groups. The Colgate 360º showed less bristle wear and a better bristle tip morphology than the Oral B Indicator 35 toothbrush. However, use of either toothbrush did not decrease the bond strength of the orthodontic brackets. Therefore, patients undergoing orthodontic therapy can safely use either toothbrush.

Toothbrush injury in an adult.

Tooth brushing is an oral hygiene measure. Keeping the toothbrush in the mouth and doing other works with both arms may lead to injury of the oral tissues. We hereby report a case of severe injury to the oral mucosal tissues caused by the toothbrush, which was treated surgically.