Design and evaluation of dental pastes Containing anti-inflammatory drugs

Abstract Periodontitis is an oral disease associated with inflammation and pain with swollen and bleeding gums. In the present study, dental pastes containing NSAIDs, namely, diclofenac sodium and nimesulide (1 % w/w) were prepared to treat periodontitis. Dental pastes of diclofenac sodium and nimesulide (1 % w/w) were prepared with/without mucoadhesive hydrocolloid polymers such as sodium carboxy methyl cellulose (NaCMC), hydroxyl ethyl cellulose (HEC) and methyl cellulose (MC) by conventional trituration method. The pH, drug content, viscosity, tube spreadability and tube extrudability of these prepared dental pastes were measured. These dental pastes of diclofenac sodium and nimesulide (1 % w/w) were characterized by FTIR analyses for drug-excipient compatibility. The in vitro drug releases from these dental pastes in 6.4 pH phosphate buffer solution displayed sustained release over longer period and the drug release rate was found to be decreased when the concentration of mucoadhesive polymer was increased. These dental pastes displayed good adhesion to the oral mucosa revealing more retention time in mouth when tested for ex vivo mucoadhesion using bovine cheek pouch. The stability study results reveal that the DC3 and NC3 dental paste formulations were found stable enough over a longer period in different storage conditions. The present study revealed that the prepared mucoadhesive dental pastes of diclofenac sodium and nimesulide (1 % w/w) had good adhesion with the oral mucosa to maintain consistent release of drugs over prolonged time.

Fluoride toothpaste, sanitary surveillance and the SUS: the case of Manaus-AM, Brazil / Dentifrício fluoretado, vigilância sanitária e o SUS: o caso de Manaus-AM

ABSTRACT OBJECTIVE To determine the anticaries potential of toothpastes distributed by the primary health care public clinics (UBS) of Manaus, AM. METHODS Ninety-nine tubes of toothpaste from four commercial brands were collected from October 7, 2019 to October 11, 2019 in 16 UBS. They were assigned a code by brand and source UBS. According to the information on the packaging, the four brands and their batches were formulated with sodium monofluorophosphate (Na2FPO3) and most (91%) had calcium carbonate (CaCO3) as an abrasive. We determined the concentrations of total fluoride (TF = TSF + InsF) and total soluble fluoride (TSF = F ions- or FPO32-), to certify whether they were in compliance with resolution ANVISA RDC No. 530 (maximum of 1,500 ppm TF) and whether they had anticaries potential (minimum of 1,000 ppm TSF). The analyses were performed with a ion- specific electrode. RESULTS The concentrations (ppm F) of TF [mean; standard deviation (SD); n] found in toothpaste brands A (1,502.3; SD = 45.6; n = 33), B (1,135.5; SD = 52.7; n = 48) and D (936.8; SD = 20.5; N = 8) were close to those stated on the package, 1,500, 1,100 and 1,000 ppm F, respectively. In toothpaste C, we found a mean of 274.1 ppm (SD = 219.7; n = 10) of TF, which diverges from the declared concentration of 1,500 ppm F. In addition, the five tubes of lot no. 11681118 of toothpaste C did not contain fluoride. Regarding TSF, with the exception of toothpaste D (937.9; SD = 40.29), the others had a lower concentration than their respective TF. CONCLUSION We found serious problems of quantity and quality of fluoride in toothpaste distributed by the SUS in Manaus, which shows the need for surveillance of these products and confirms the urgency of revising resolution RDC No. 530.

RESUMO OBJETIVO Determinar o potencial anticárie dos dentifrícios distribuídos pelas unidades básicas de saúde (UBS) de Manaus-AM. MÉTODOS Noventa e nove bisnagas de dentifrícios de quatro marcas comerciais foram coletadas de 7 de outubro de 2019 a 11 de outubro de 2019 em 16 UBS, que foram codificados por marca e UBS de origem. De acordo com a embalagem, os dentifrícios das quatro marcas e seus lotes foram formulados com monofluorofosfato de sódio (Na2FPO3) e a maioria (91%) tinha carbonato de cálcio (CaCO3) como abrasivo. Foram determinadas as concentrações de fluoreto total (FT = FST + Fins) e de fluoreto solúvel total (FST = íons F- ou FPO32-), para certificar se atendiam à resolução ANVISA RDC Nº 530 (máximo de 1.500 ppm de FT) e se tinham potencial anticárie (mínimo de 1.000 ppm de FST). As análises foram feitas com eletrodo íon específico. RESULTADOS As concentrações (ppm F) de FT [média; desvio padrão (DP); n] encontradas nos dentifrícios A (1.502,3; DP = 45,6; n = 33), B (1.135,5; DP = 52,7; n = 48) e D (936,8; DP = 20,5; n = 8) foram próximas ao descrito na embalagem, 1.500, 1.100 e 1.000 ppm F, respectivamente. No dentifrício C, foi encontrada média de 274,1 ppm (DP = 219,7; n = 10) de FT, divergindo da concentração declarada de 1.500 ppm F. Em acréscimo, as cinco bisnagas do lote no 11681118 do dentifrício C não foram fluoretadas. Quanto ao FST, à exceção do dentifrício D (937,9; DP = 40,29), os demais apresentaram concentração inferior ao seu respectivo FT. CONCLUSÃO Observou-se problemas graves de quantidade e qualidade do fluoreto nos dentifrícios distribuídos pelo SUS em Manaus, mostrando a necessidade de vigilância desses produtos e ratificando a urgência da revisão da resolução ANVISA RDC Nº 530.

In vitro efficacy of five pediatric toothpastes in the inhibition of streptococcus mutans ATCC 25175 / Eficacia in vitro de cinco pastas dentales pediátricas en la inhibición de streptococcus mutans ATCC 25175

The present in vitro study compared the inhibitory action of five pediatric toothpastes against Streptococcus mutans ATCC 25175. Materials and Methods: Cross-sectional, comparative and experimental study. The microorganism Streptococcus mutans ATCC 25175 was inoculated onto solid culture medium of Müeller-Hinton supplemented with blood, then the plates were inoculated with five pediatric toothpastes: Oral B Stages, Colgate Smiles, Aquafresh My Little Teeth, Dentito and Denture Kids. Samples were incubated at 37°C for 48 hours. Subsequently the inhibition halos were measured; the experiment was repeated 20 times for each sample. Statistical analysis was performed with ANOVA complemented with Tukey's test. Results: Oral B Stages yielded a mean inhibitory halo of 23.2mm, Colgate Smiles an average of 21.7mm, Aquafresh My Little Teeth of 13.6mm, Dentito of 18.5mm, and Denture Kids a mean of 23.0mm. When performing the ANOVA test, it was found that there was a significant difference in the inhibitory action of pediatric toothpastes (p<0.005) and when using Tukey's multiple comparison test, Oral B and Denture Kids presented similar inhibitory action. Conclusion: All toothpastes presented inhibitory action against Streptococcus mutans ATCC 25175. A significant difference between their effectiveness was observed. Oral B Stages showed the greatest degree of inhibition.

El presente estudio in vitrocomparo la eficacia inhibitoria de cinco pastas dentales pediátricas frente a la bacteria Streptococcus mutansATCC25175. Material y Métodos: El estudio fue transversal, comparativo y experimental. Se inoculó Streptococcus mutansATCC 25175 en un medio de cultivo Müeller-Hinton complementado con sangre, luego a las placas cultivadas se le inocularon cincopastas dentales pediátricas: Oral B Stages, Colgate Smiles, Aquafresh My LittleTeeth, Dentito y Denture Kids. Se incubó a 37ºC por 48 horas y posteriormente semidió los halos de inhibición, se replicó el experimento 20 veces para cada uno. El análisis estadístico se realizó con el test de ANVA complementado con el test de Tukey. Resultado: Oral B Stages generó una media inhibitoria de 23,2mm, ColgateSmiles una media de 21,7mm, Aquafresh My Little Teeh de 13,6mm, Dentitode 18,5mm y finalmente Denture Kids una media de 23,0mm. Al realizar laprueba ANOVA se encontró que hay diferencia significativa en la acción inhibitoriade las pastas dentales pediátricas (p<0.005) y al emplear la prueba Tukey (comparación de múltiples) la pasta Oral B y Denture Kids presentaron acción inhibidora similar. Conclusión:Todas las pastas presentaron acción inhibitoria sobre Streptococcus mutansATCC 25175 existiendo diferencia significativa entre la efectividad de estas, con la pasta Oral B Stages demuestrando mayor acción inhibitoria.

El desarrollo de la primera pasta dental con fluoruro. Semblanza histórica: en los 50 años del Oral Health Research Institute (OHRI) / Development of the first fluoridated toothpaste. Historical review:the 50th year of the Oral Health Research Institute (OHRI)

Siempre es importante el poder llevar a cabo algún tipo de reconocimiento a las personas involucradas en haber dejado aun el más mínimo tipo de legado en nuestra profesión. A título muy personal, la utilización de los fluoruros y, muy en especial su incorporación en la formulación de pastas dentales, ha sido el factor más importante y preponderante en la disminución del índice de riesgo de caries dental en las actuales generaciones. El presente artículo pretende hacer una narración histórica sobre los eventos más sobresalientes por los que pasó el trío de científicos en las Escuelas de Química y de Odontología de la Universidad de Indiana en sus respectivos campus de Bloomington e Indianápolis para lograr el desarrollo de la primera pasta dental con fluoruro. Más que un recuento histórico, la intención principal de este escrito es hacer una semblanza y un reconocimiento al trabajo del bioquímico Harry Day, quién trabajaba en su campo especializado sobre el valor nutricional de algunos elementos y que, junto con el trabajo del dentista Joseph C. Muhler y del especialista en Química inorgánica William Nebergall, logró producir un prototipo de pasta dental en el año de 1952 y que después de los excelentes resultados de los estudios clínicos liderados por Muhler tanto en niños como en adultos, llamaron la atención de Procter and Gamble para poder lanzar al mercado la primera pasta dental con Fluoristán, a la que se llamó Crest (AU)

It is always important to express some type of acknowledgement to people that were involved on leaving any form of legacy in our profession. As a personal view, the use of fluorides and specially the implementation of it in the formulation of toothpastes have been the key and preponderant factor in the decrease on the risk of dental caries in the current generations. This article pretends to be a historic narrative of the remarkable events in the group of the three scientists of the School of Chemistry and the School of Dentistry at both campuses of Bloomington and Indianapolis of Indiana University to fulfill the goal on the development of the first fluoridated toothpaste. More than a historical narrative, the main intention of this paper is to make a resemblance and an acknowledgement to the work of Biochemist Harry Day, who worked in his field of expertise on the nutrimental value of certain trace elements and that together with the work by dentist Joseph C. Muhler and the specialist in Inorganic Chemistry William Nebergall, could produced in year 1952 a prototype of a toothpaste that after several clinical studies in children and adults conducted by Muhler showed excellent results on caries prevention, and that took the attention of Procter and Gamble to be able to put on the market the first toothpaste with Fluoristan that was called Crest (AU)

Fluoride content in children's dentifrices marketed in Lima, Peru

Abstract The aim of the present study was to determine the concentration of total fluoride (TF) and total soluble fluoride (TSF) in children's dentifrices marketed in the city of Lima, Peru. Three samples of 23 dentifrices (4 without fluoride and 19 with fluoride) were purchased in different pharmacies in Lima, Peru. The TF and TSF concentrations found in the dentifrices were determined by ion-selective electrode, expressed in ppm F (μg F/g of dentifrice). The TF concentration in the majority of the fluoride toothpastes matched that shown on the label, except for one declared as 1450 ppm F by the manufacturer, whereas only 515.1 ppm F was found. The concentration of TSF found in the fluoride toothpastes ranged from 457.5 to 1134.8 ppm F. All the dentifrices were formulated with silica, but one also presented calcium carbonate. In conclusion, 83% of the children's dentifrices marketed in Lima, Peru, were fluoridated, but only 53% contained a TSF concentration greater than 1000 ppm F, the minimum concentration required to provide an anticaries effect.

Efetividade de dentifrícios clareadores sobre esmalte de dentes bovinos / Effectiveness of whitening dentifrices on bovine teeth enamel

Introdução: devido à insatisfação relatada pelos pacientes com a coloração dos dentes e a busca por procedimentos que envolvam estética do sorriso associado com o desenvolvimento de técnicas e materiais amplamente propagados na mídia, as empresas responderam com a oferta no mercado de uma variedade de opções de dentifrícios que propõem efeito clareador prático e rápido. Objetivo: avaliar a efetividade de dentífricos clareadores em diferentes formas de apresentação sobre esmalte de dentes bovinos. Material e Métodos: quinze dentes bovinos foram imersos diariamente por um período de 1 hora em refrigerante a base de cola e em seguida foram divididos equitativamente em três grupos, onde cada grupo foi escovado com um dentifrício especifico por 2 minutos. O grupo A foi escovado com dentifrício Colgate Luminous White (Colgate ­ Palmolive), em forma de pasta, o grupo B com dentifrício Closeup Diamond Attraction Delicate White (Unilever) em forma de gel e o grupo C com dentifrício Oral-B Complete (Procter & Gamble) em forma de pasta. Resultados: as diferentes formas de apresentação estudadas foram efetivas na remoção das manchas extrínsecas em dentes bovinos; O dentifrício Colgate Luminous White na forma de apresentação pasta clareador apresentou-se mais efetivo na remoção das manchas extrínsecas; O dentifrício Oral ­ B Complete na forma de pasta foi efetivo, porém em menor intensidade em comparação aos dentifrícios clareadores estudados. Conclusão: as diferentes formas de apresentação dos dentifrícios utilizados foram efetivas na remoção de manchas extrínsecas.

Introduction: due to dissatisfaction reported by patients with tooth staining and the search for procedures involving smile aesthetics associated with the development of techniques and materials widespread on social medias, companies responded by offering to the market a variety of toothpaste choices in order to provide practical and fast bleaching effects. However, these dentifrices appear to have a limited efficiency since they only contain abrasives for the removing of extrinsic tooth stain. Objective: his research aimed to assess the effectiveness of different forms of presentation of bleaching agents on bovine teeth enamel. Methods: daily, fifteen bovine teeth were immersed in cola soft drink for a period of 1 hour and then they were divided into three groups (each group containing five bovine teeth). Each group was brushed with a specific dentifrice for 2 minutes: the group A was brushed with Colgate Luminous White in paste form (Colgate ­ Palmolive); the Group B with Diamond Closeup Attraction Delicate White in gel form (Unilever), and the group C with Oral-B complete in paste form (Procter & Gamble). Results: color change was observed through photographs and analysis of the interpreted samples based on the theoretical background. Conclusion: the dentifrices used were able to remove extrinsic stains and the bleaching dentifrice Colgate Luminous White was more effective as a result in this connection.

Necessity to review the Brazilian regulation about fluoride toothpastes / Necessidade de revisão da regulamentação brasileira sobre dentifrícios fluoretados

The aim of this study was to evaluate the adequacy of the Brazilian legislation about fluoride toothpaste. A search was conducted in LILACS, Medline and SciELO databases about the fluoride concentration found in Brazilians toothpastes, using descriptors on health. Publications since 1981 have shown that some Brazilian toothpastes are not able to maintain, during their expiration time, a minimum of 1,000 ppm F of soluble fluoride in the formulation. However, the Brazilian regulation (ANVISA, Resolution 79, August 28, 2000) only sets the maximum total fluoride (0.15%; 1,500 ppm F) that a toothpaste may contain but not the minimum concentration of soluble fluoride that it should contain to have anticaries potential, which according to systematic reviews should be 1,000 ppm F. Therefore, the Brazilian regulation on fluoride toothpastes needs to be revised to assure the efficacy of those products for caries control.

O presente estudo analisou a adequação da regulamentação brasileira vigente sobre dentifrícios fluoretados. Foi realizada busca da literatura sobre a concentração de flúor nos dentifrícios brasileiros, tendo como fontes Lilacs, Medline e SciELO, com uso de descritores em saúde. Publicações sobre a composição de dentifrícios fluoretados brasileiros têm mostrado desde 1981 que nem todos os dentifrícios são capazes de manter durante o prazo de validade uma concentração mínima de 1.000 ppm F. Esse problema ocorre não só com dentifrícios adquiridos no mercado como com aqueles distribuídos por serviços públicos de saúde. Entretanto, a legislação brasileira (Resolução 79, Anvisa, 28/8/2000) apenas estabelece que um dentifrício não pode conter mais que 0,15% (1.500 ppm F) de flúor total, sem estabelecer o mínimo de flúor solúvel que ele deveria conter para ter potencial anticárie, a qual de acordo com revisões sistemáticas deve ser igual ou maior que 1.000 ppm F. Concluiu-se que a regulamentação brasileira sobre dentifrícios fluoretados necessita ser revisada, garantindo a eficácia desses produtos para o controle da cárie.

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.

Estimation of Toothpaste Fluoride Intake in Preschool Children

The objective of this study was to estimate the intake of toothpaste fluoride used by children aged 2 to 6 years (n=87) treated at a hospital of a medium-sized city (Campina Grande, PB) in the Northeastern region of Brazil. Data regarding sociodemographic characteristics of families and children's toothbrushing were collected from questionnaire-based interviews with parents/guardians, and the amount of fluoride used during toothbrushing was estimated using a precision scale for assessment of the risk of dental fluorosis, considering a cutoff value of 0.07 mgF/kg body weight/day. Fluoride content in the toothpastes was analyzed using a specific fluoride electrode. Data were analyzed using descriptive and inferential statistics using the chi-square and Fisher's exact tests (α=0.05). Considering the use of the derice, the risk of fluorosis in the children was 19.5%. There was significant association (p<0.05) between the risk of fluorosis, brushing frequency, type of derice and who performed the child's oral hygiene. It was concluded that a high percentage of children in the studied sample used toothpaste inappropriately and were at risk of developing dental fluorosis.

Resumo O objetivo do presente trabalho foi estimar a ingestão de flúor de derícios utilizados por crianças de 2 a 6 anos de idade (n=87) atendidas em um hospital de médio porte (Campina Grande, PB) na região nordeste do Brasil. Os dados envolveram características sócio-demográficas e escovação dentária das crianças através de uma entrevista com formulário específico, aplicado aos pais/responsáveis, e a quantidade de flúor utilizada na escovação da criança, por meio de balança de precisão, para avaliação do risco de fluorose dentária, considerando o ponto de corte 0,07 mgF/kg peso corporal/dia. O conteúdo de flúor nos cremes dentais foi analisado utilizando eletrodo específico. Os dados foram trabalhados sob a forma de estatística descritiva e inferencial usando o testes do Qui-quadrado de Pearson e Exato de Fisher (α= 0,05). Levando-se em consideração o uso do derício, o risco de fluorose das crianças pesquisadas foi 19,5%. Houve associação significativa entre o risco de fluorose, a frequência de escovação, o tipo de derício e quem realiza a higiene bucal da criança (p<0,05). Concluiu-se que elevada parcela das crianças usavam o derício de forma inadequada e apresentaram risco de fluorose. .

Avaliação clínica do uso de dois novos cremes dentais no tratamento da hipersensibilidade dentinária / Clinical evaluation of the use of two toothpastes in the treatment of dentin hypersensitivity

O objetivo desse estudo foi avaliar clinicamente a eficácia de dois novos cremes dentais no tratamento dos sintomas causados pela hipersensibilidade dentinária. Foram avaliados 86 dentes com lesões cervicais não cariosas em 29 pacientes de ambos os sexos. Os pacientes foram divididos em dois grupos: G1 - (n = 42) Colgate® Sensitive Pro-Alívio; G2 - (n = 44) Sensodyne® Rápido Alívio. O método de avaliação utilizado para quantificar a sensibilidade foi o teste evaporativo utilizando-se a seringa tríplice, e os escores de dor foram registrados pela escala visual analógica (VAS) antes e imediatamente após a aplicação tópica do dentifrício. Os dados obtidos foram analisados utilizando os teste t pareado e t independente de Student. Os resultados foram significativos (p<0,001) na média de redução da dor após a aplica-ção dos cremes dentais nos dois grupos. Não houve diferenças estatisticamente significativas entre G1 e G2. Concluiu-se com esse estudo que os dois novos cremes dentais avaliados promoveram um alívio imediato da hipersensibilidade dentinária, podendo ser indicados para o tratamento dessa condição.

Available fluoride in toothpastes used by Brazilian children

Toothpastes should have a minimum concentration of 1000 ppm of fluoride (F) to control caries and also the active F agent must be chemically free (soluble) in the formulation. Thus, the aim of this study was to evaluate the concentration of soluble F in dentifrices used by 206 Brazilian children. The concentrations of total fluoride (TF), total soluble fluoride (TSF) and fluoride ion were determined. From these analyses, the concentrations of F as sodium monofluorophosphate (MFP) and percent of insoluble F were calculated. F was analyzed with an ion specific electrode in duplicates. The majority of dentifrices used (96 percent) contained F and in 84 percent of them, TF concentration was according to that declared by the manufacturers. In the F-toothpastes, 78 percent showed TSF concentration ≥1000 ppm, varying from 422.3 to 1432.3 ppm F (mean ± SD of 1017.6 ± 239.4). These findings suggest that most dentifrices used by Brazilian children present available fluoride concentration for caries control.

O requerimento mínimo para que um creme dental tenha potencial anticárie é ele ter fluoreto (F) na concentração de 1000 ppm, o qual porém deve estar solúvel na formulação. Assim, este estudo teve como objetivo conhecer a concentração de F solúvel em dentifrícios usados por 206 crianças brasileiras. Foram determinadas as concentrações de flúor total (FT), o qual representa a soma das concentrações de flúor solúvel (iônico e ionizável) mais o insolúvel (ligado ao abrasivo); de flúor solúvel total (FST), representando o iônico mais o ionizável na forma de monofluorfosfato de sódio (MFP) e de flúor solúvel na forma iônica (FI). A partir destas análises foram calculadas as concentrações de MFP e a por cento de F insolúvel (Fins). As análises foram feitas em duplicatas com eletrodo específico. A maioria dos dentifrícios usados (96 por cento) continham fluoreto e em 84 por cento desses a concentração de FT encontrada estava de acordo com a declarada na embalagem. Em 78 por cento dos cremes dentais fluoretados, a concentração de FST encontrada foi igual ou superior a 1000 ppm, variando de 422,3 a 1432,3 ppm F (média ± DP de 1017,6 ± 239,4). Os dados mostram que a maioria dos cremes dentais usados pela amostra de crianças brasileiras possui concentração de F potencialmente ativo para controlar cárie.

Fingernail may not be a reliable biomarker of fluoride body burden from dentifrice

Fingernail has been suggested as a biomarker of fluoride (F) body burden, but there is no consensus if it would be a reliable indicator of F exposure from dentifrice. Therefore, the present study was conducted to investigate if fingernails would have sensitivity to detect F exposure from dentifrice in young children. Twenty-three 1-3-year-old children living in the city of Piracicaba (0.72 ppm F in water), Brazil, were enrolled in two phases of different F exposure: in phase A (1st to 11th week), they were exposed to the combination of F from diet (solids and liquids) and dentifrice (1,500 µg F/g as MFP), and in phase B (12th to 29th week), only to F from diet (the use of F dentifrice was interrupted). Fingernails were weekly clipped during 35 weeks for F determination. F intake from diet and dentifrice in each phase was also determined. Both analyses were made with ion-specific electrode. F intake (Mean ± SD) was significantly higher (p<0.01) when the children were exposed to F from diet+dentifrice than only to F from diet (0.086 ± 0.032 and 0.040 ± 0.009 mg F/day/kg body weight, respectively). However, F concentrations in nails collected during the whole experimental period of 35 weeks presented great variation with no trend of decreasing after F dentifrice intake interruption. The findings suggest that fingernail may not be a reliable F biomarker of body burden from dentifrice.

As unhas têm sido consideradas um biomarcador para a exposição ao flúor (F), mas não há consenso se é um indicador confiável para exposição ao F a partir do dentifrício. Vinte e três crianças, com idade entre 1 a 3 anos, moradoras de Piracicaba (0,72 ppm F na água), Brasil, foram submetidas a duas fases de diferentes exposição ao F: fase A (1a a 11a semanas), as crianças foram expostas à combinação de F a partir da dieta (sólidos e líquidos) e dentifrício (1500 µg F/g como MFP); e na fase B (12ª a 29ª semanas), apenas ao F da dieta, uma vez que usaram dentifrício não fluoretado. As unhas das mãos foram coletadas semanalmente durante 35 semanas para determinação de F. A exposição ao F a partir da dieta e dentifrício foi também determinada. Ambas análises foram feitas com eletrodo específico para F. A exposição ao F foi significativamente maior (p<0,001) quando as crianças foram expostas ao F da dieta + dentifrício que ao F da dieta (0,086 ± 0,032 e 0,040 ± 0,009 mg F/kg corpóreo/dia, respectivamente). Entretanto, a concentração de F nas unhas coletadas durante todo o período experimental não diminuiu após a interrupção da ingestão do F a partir do dentifrício. Os resultados sugerem que as unhas das mãos não são um biomarcador confiável para refletir a exposição ao F pelo dentifrício.

Antibacterial activity of propolis-based toothpastes for endodontic treatment / Atividade antibacteriana de pastas dentífricas com base de própolis para tratamento endodôntico

This study evaluated the antibacterial activity of propolis-based toothpastes used as intracanal medication in endodontic treatment. The propolis-based toothpastes were prepared using an extract established in previous studies (identified as A70D and D70D). Calcium hydroxide paste was used as a control. The bacteria employed were Streptococcus mutans (ATCC 25175), Staphylococcus aureus (ATCC 6538), Staphylococcus aureus (ATCC 25923), Kocuria rhizophila (ATCC 9341), Escherichia coli (ATCC 10538), Pseudomonas aeruginosa (ATCC 27853), Enterococcus hirae (ATCC 10541), Streptococcus mutans (ATCC 25175). Five field strains isolated from saliva were used: Staphylococcus spp. (23.1 - coagulase positive), Staphylococcus spp. (23.5 - coagulase negative), Staphylococcus spp. (26.1 - coagulase positive), Staphylococcus spp. (26.5 - coagulase negative) and Staphylococcus epidermidis (6epi). The diffusion-well method on double-layer agar was used in a culture medium of Tryptic Soy Agar. The plates were kept at room temperature for two hours to allow the diffusion of pastes in the culture medium, and then incubated at 35º C for twenty-four hours in aerobiosis and in microaerophilia (S. mutans). After this period, the total diameter of the inhibition halo was measured. The results were analyzed by ANOVA analysis of variance, followed by the Tukey test at p<0.05. The propolis-based toothpastes presented antibacterial activity against 83.3 percent of the analyzed bacteria. For 66.7 percent of these bacteria, the propolis-based toothpastes exhibited greater antibacterial activity than calcium hydroxide. The present results allow us to conclude that the experimental pastes A70D and D70D showed good activity against aerobic bacteria, proving more effective than calcium hydroxide.

O objetivo deste estudo foi avaliar a atividade antibacteriana de formas farmacêuticas a base de própolis para uso no tratamento endodôntico como medicação intracanal. As formulações de própolis, em forma de pastas, foram preparadas a partir de um extrato pré-estabelecido em estudos anteriores e identificadas como A70D e D70D. Como controle, foi utilizado pasta de hidróxido de cálcio. As bactérias utilizadas foram: Streptococcus mutans (ATCC 25175), Staphylococcus aureus (ATCC 6538), Staphylococcus aureus (ATCC 25923), Kocuria rhizophila (ATCC 9341), Escherichia coli (ATCC 10538), Pseudomonas aeruginosa (ATCC 27853), Enterococcus hirae (ATCC 10541), Streptococcus mutans (ATCC 25175) e 5 cepas de campo isoladas da saliva: Staphylococcus spp. (23.1 - coagulase positiva), Staphylococcus spp. (23.5 - coagulase negativa), Staphylococcus spp. (26.1 - coagulase positiva), Staphylococcus spp. (26.5 - coagulase negativa) e Staphylococcus epidermidis (6epi). Foi utilizado o método poço difusão em camada dupla de ágar, em meio de cultura Tryptic Soy Agar. As placas foram mantidas à temperatura ambiente por 2 h para permitir a difusão das pastas no meio de cultura, e então incubadas a 35 ºC por 24 h em aerobiose e em microaerofilia (S. mutans). Após este período, foi medido o diâmetro total do halo de inibição. Os resultados foram submetidos ao teste de análise de variância ANOVA seguido do teste de Tukey com p<0,05. As pastas a base de própolis apresentaram atividade antibacteriana contra 83,3 por cento das bactérias analisadas. Para 66,7 por cento das bactérias, as pastas de própolis apresentaram maior atividade antibacteriana que o hidróxido de cálcio, e este foi mais efetivo apenas para Streptococcus mutans (ATCC 25175), Staphylococcus aureus (ATCC 25923) e Pseudomonas aeruginosa (ATCC 27853). De acordo com a metodologia utilizada, pode-se concluir que as pastas experimentais A70D e D70D apresentam boa atividade contra bactérias aeróbias...

In vitro evaluation of the abrasiveness of a commercial low-abrasive dentifrice and an experimental dentifrice containing vegetable oil

Toothpastes usually contain detergents, humectants, water, colorant, fluoride and thickeners (e.g.: silica). Tooth wear has a multi-factorial etiology and the use of abrasive dentifrices is related to abrasion of dental tissues during toothbrushing. This study evaluated in vitro the abrasiveness of a commercial silica gel low-abrasive dentifrice compared to an experimental dentifrice containing vegetable (almond) oil. Distilled water served as a control group. Acrylic specimens (8 per group) were submitted to simulated toothbrushing with slurries of the commercial dentifrice, experimental dentifrice, almond oil and water in an automatic brushing machine programmed to 30,000 brush strokes for each specimen, which is equivalent to 2 years of manual toothbrushing. Thereafter, surface roughness (Ra) of the specimens was analyzed with a Surfcorder SE 1700 profilometer. Data were analyzed statistically by ANOVA and Tukey’s test at 5% significance level. There was no statistically significant difference (p>0.05) in the surface roughness after brushing with water, almond oil or experimental dentifrice. The commercial dentifrice produced rougher surfaces compared to the control and abrasive-free products (p<0.05). Further studies are necessary to confirm the potential benefits of using vegetable oil in toothpastes as an alternative to abrasives in an attempt to minimize the tooth wear caused by toothbrushing.

Prevalencia de fluorosis dental y fuentes adicionales de exposición a fluoruro como factores de riesgo a fluorosis dental en escolares de Campeche, México / Prevalence of dental fluorosis and additional sources of exposure to fluoride as risk factors to dental fluorosis in schoolchildren of Campeche, Mexico

Objective. To determine the prevalence and severity of dental fluorosis, and to evaluate supplementary fluoride sources as potential risk factors to fluorosis in school children aged 6-9. Material and methods. A cross-sectional study was carried out in 320 children attending elementary schools protected by a public preventive dental program in the city of Campeche, Mexico. A self-administered questionnaire directed to the mothers was delivered through the schools and collected in the same way. The examiners were trained and calibrated (kappa > 0.90) in modified Dean's Index. The fluorosis community index (FCI) was calculated. Bivariate analyses were made with test; odds ratios (OR) and 95% confidence intervals were calculated. Logistic regression was used in the final model. Results.Fluorosis prevalence was 56.3%, with very mild fluorosis present in 45% of children, mild in 10%, and severe in just 1.3%. The FCI was 0.7. The multivariate model showed that the effect of the supplementary fluoride sources was different between children that started brushing with toothpaste before two years of age (OR = 6.15;IC95% = 2.03-18.67) and after (OR =2.14;IC95% =1.16-3.94). Conclusions.Fluorosis prevalence was high for mild modalities, and low for more severe levels. According to FCI the dental fluorosis constitute a public health problem in the studied sample. Exposure to diverse fluoride sources -above and beyond the fluoridated salt program- was a risk factor for dental fluorosis in this community. Results suggest that toothpaste use in children two years of age and younger should be cautious, limited to follow current guidelines, and supervised by parents to minimize the risk of dental fluorosis.

Objetivo. Determinar la prevalencia y severidad de fluorosis dental en escolares de seis-nueve años de edad y evaluar fuentes adicionales de exposición a fluoruro como factor de riesgo a fluorosis dental. Material y métodos. Se realizó un estudio transversal en escolares de escuelas primarias públicas de la ciudad de Campeche, México, que se encuentran bajo un programa de odontología preventiva. El total de niños fue de 320. Para la recolección de los datos se empleó un cuestionario dirigido a las madres. Una exploración clínica a los niños fue realizada por tres examinadores capacitados y estandarizados (Kappa > 0.90). El índice empleado para el diagnóstico de fluorosis fue el de Dean modificado. Se realizó el cálculo para el índice comunitario de fluorosis (ICF). En el análisis estadístico se utilizaron pruebas de , para el modelo final se empleó regresión logística binaria. Resultados. La prevalencia de fluorosis fue 56.3%, siendo 45% muy leve, 10% leve y 1.3% severa. El ICF fue de 0.7. El modelo multivariado mostró que el efecto de las fuentes adicionales de fluoruros es diferente en los niños que comenzaron el uso de pasta dental antes (RM = 6.15; IC 95% = 2.03-18.67) o después de los dos años (RM = 2.14; IC 95% = 1.16-3.94). Conclusiones. La prevalencia de fluorosis dental fue alta para los niveles más leves, y baja para los niveles severos. De acuerdo con el ICF la fluorosis dental constituye un problema de salud pública en la muestra estudiada. La exposición a diversas fuentes de fluoruro -adicionales a la sal de mesa- fue un factor de riesgo para el desarrollo de fluorosis en esta comunidad. Los resultados sugieren que el uso de pasta dental en los niños menores de dos años debe ser cauteloso, limitado de acuerdo con las recomendaciones actualizadas, y supervisado por los padres para minimizar el riesgo de fluorosis.

Dentifrícios fluoretados: risco de fluorose e seu impacto na prevençäo da cárie dentária / Fluoridated toothpastes through time its impact on dental caries prevention

O objetivo deste estudo é revisar a literatura sobre dentifrícios, sua composiçäo e o impacto na prevençäo da doença cárie. Nos países industrializados, houve um decréscimo substancial na prevalência de cárie, coincidindo com políticas de promoçäo de saúde, utilizaçäo de métodos preventivos de autocuidado e uso de dentifrícios fluoretados. Principalmente em regiöes sem água de abastecimento fluoretada ou que utilizam a água de mananciais naturais, tais dentifrícios säo eficazes na prevençäo da cárie. As crianças menores, ou nos primeiros oito anos de vida, devem ter a escovaçäo supervisionada pelos responsáveis, devido à toxicidade do flúor e risco de fluorose

Avaliaçäo microbiológica do preparo biomecânico e de uma pasta obturadora de canais de dentes decíduos necrosados / Microbiologic evaluation of biomecanical preparation and of root canals filing past of the primay teeth

O presente trabalho foi realizado com o objetivo de observar por meio de cultura microbiológica a eficiência do preparo biomecânico e da pasta constituida de iodofórmio, paramonoclorofenol canforado e rifocort utilizada na obturaçäo de dentes decíduo necrosados. Os resultados obtidos nos permitiu concluir que: 1) a cultura foi positiva em 100 por cento das amostras antes e após o preparo biomecânico; 2) após a obturaçäo dos canais (7 dias) com a pasta, a cultura foi positiva em 52 por cento e negativa em 48 por cento dos casos

Determinación potenciométrica de fluoruros en dentríficos y aguas de abasto / Potenciometric determination of fluorides in toothpastes and water supplying

Se presentan las metodologías de determinación de fluoruros en dentríficos y aguas de abasto. En la determinación del flúor tanto en dentríficos como en aguas de abasto se utilizó el método potenciométrico y un electrodo específico para fluoruros. La metodología utilizada para dentríficos permite identificar y cuantificar tanto tipos como formas de fluoruros, donde a través de una extracción acuosa y una posterior hidrólisis ácida es posible conocer el flúor iónico total soluble y los tipos de fluoruro (NaF y NaMFP). El método para determinación de flúor en aguas permite analizar muestras en forma directa la concentración de 1,4 ppm, y en form indirecta aguas con menos 0,6 ppm

Concentración de flúor en fluoruros de empleo tópico en odontología / Fluor concentration in topic used fluorides in odontology

En muestras de fluoruros tópicos de uso odontológico empleados en el país de diversos tipo, origen y formas farmacéuticas se analizó su condición de expendio de acuerdo a las normas entregadas por el Instituto de Salud Pública, se determinó la concentración de flúor total soluble que ellas presentan mediante un método potenciométrico, y se cuantificó el pH de los productos. Los resultados nos indican que la mayoría de los fluoruros tópicos de procedencia extranjera no presentan registro sanitario. El relación a la determinación de pH casi todos los productos presentan carácter ácido y las determinaciones de fluoruro indican coincidencia entre lo declarado y lo encontrado para los productos tópicos de baja concentración de fluoruro, pero no para los de alta concentración. Se recomienda una mayor fiscalización de la comunidad odontológica sobre los fluoruros de uso tópico sobre todo en los de origen foráneo, porque se podrían estar usando productos que no cumplen los requisitos necesarios de concentración de flúor

Micro-determination of fluoride by means of metallic sodium fusion and using fluoride-sensitive electrode.

A simple and accurate method to determine the content of fluoride in non-volatile organofluoro compounds or in biological samples has been developed. The method includes the metallic sodium fusion followed by quantitative estimation of fluoride using fluoride-sensitive electrode.