Hipoclorito de Sodio como Agente Desproteinizante para Mejorar la Adhesión en Esmalte Hipomineralizado en Ortodoncia. Una Revisión Narrativa

Obtener una buena adhesión entre esmalte y bracket es un aspecto fundamental para el éxito del tratamiento en Ortodoncia. Algunos casos presentan desafíos en esta adhesión, especialmente cuando nos enfrentamos ante un esmalte con alteraciones como hipomineralizaciones, hipoplasias o fluorosis dental. Para sobreponer esta dificultad en la unión adhesiva se han propuesto diversas estrategias terapéuticas como es el uso de agentes desproteinizantes. El objetivo de esta revisión narrativa es describir el uso de hipoclorito de sodio como agente desproteinizante en dientes con alteraciones de esmalte para mejorar la adhesión en Ortodoncia. Se realizó una búsqueda bibliográfica en PubMed de los últimos 5 años. Se encontraron 116 artículos, de los cuales 23 cumplieron con los criterios requeridos y fueron seleccionados para la revisión. La desproteinización del esmalte con hipoclorito de sodio como paso previo al grabado ácido, es una estrategia útil en el proceso de cementación de aparatología de ortodoncia fija en dientes con alteraciones del esmalte. El uso de hipoclorito de sodio al 5,25 % es una alternativa de bajo co sto, no invasiva y eficiente para mejorar la fuerza de adhesión en pacientes con alteraciones del esmalte.

Obtaining good adhesion between enamel and bracket is a fundamental aspect for success in Orthodontics. Some cases present challenges in this adhesion, especially when we are faced with enamel with alterations such as hypomineralization, hypoplasia or dental fluorosis. To overcome this difficulty in adhesive bonding, various therapeutic strategies have been proposed, such as the use of deproteinizing agents. The objective of this study is to describe the use of sodium hypochlorite as a deproteinizing agent in teeth with enamel alterations to improve adhesion in Orthodontics. A bibliographic search was carried out in PubMed for articles within the last 5 years. In this study 116 articles were found, of which 23 met the required criteria and were selected for the review. Deproteinization of the enamel with sodium hypochlorite as a prior step to acid etching is an important stage in the cementation process of fixed appliances in orthodontics. The use of 5.25% sodium hypochlorite is a low-cost, non-invasive and efficient alternative to improve adhesion strength in patients with anomalies of tooth enamel.

Screening and analysis of differentially expressed genes for calcium homeostasis in ameloblasts with high fluoride intervention / 中国组织工程研究

BACKGROUND:Fluorosis is a disorder of enamel development caused by long-term intake of large amounts of fluoride during enamel development. OBJECTIVE:To further explore the molecular mechanism of dental fluorosis formation by screening the differentially expressed genes associated with calcium homeostasis in ameloblasts by transcriptome sequencing technology. METHODS:LS8 cells were treated with 0,0.4,0.8,1.6,3.2 and 6.4 mmol/L sodium fluoride(NaF)for 24,48 and 72 hours to observe the effects of different concentrations of NaF on the morphology,cell activity and intracellular Ca2+ concentration of LS8 cells.The differentially expressed genes were screened by transcriptome sequencing and validated. RESULTS AND CONCLUSION:After 24 hours of treatment,the cells treated with 0,0.4,and 0.8 mmol/L NaF were in good growth condition,with increased cell number and clear cell outline.When the NaF concentration was≥1.6 mmol/L,the cells were gradually shrunken and became smaller and the number of cells decreased with the increase of NaF concentration.After 48 and 72 hours of treatment,the number of cells increased in the 0,0.4 mmol/L NaF groups,while gradually decreased in the 0.8,1.6,3.2 mmol/L NaF groups,with rounded and smaller cell morphology.The cells in the 6.4 mmol/L NaF group were shrunken,rounded and suspended in the medium,with almost no adherent cells.When treated with the same concentration of NaF,LS8 cells were in optimal growth after 24 hours of treatment.Results from cell counting kit-8 assay showed that when treated with the same concentration of NaF,the cell activity decreased with the increase of treatment time;when the treatment time was the same,the cell activity decreased with the increase of NaF concentration.After 24 hours of treatment,the intracellular Ca2+ concentration increased with the increase of NaF concentration.Transcriptome sequencing analysis identified genes involved in the regulation of cellular calcium homeostasis:Hsp90b1,Canx,Calr,and Hspa5 that were significantly upregulated(P＜0.05)and Cacna1a that was significantly downregulated(P＜0.05).To conclude,the inhibitory effect of NaF on LS8 cell proliferation may be related to the abnormal increase in intracellular Ca2+ concentration,and the mechanism may be caused by the upregulation of the expression of protein processing and synthesis pathways Hsp90b1,Canx,Calr,and Hspa5 and the downregulation of the expression of calcium signaling pathway Cacna1a.

Monitoring results of drinking water-type endemic fluorosis in Xinjiang Production and Construction Corps in 2022 / 中华地方病学杂志

Objective:To investigate the control situation of drinking water-type endemic fluorosis (hereinafter referred to as drinking water fluorosis) in Xinjiang Production and Construction Corps (hereinafter referred to as the Corps), identify weak links in prevention and control, and provide reference for precise prevention and control of drinking water fluorosis in the Corps.Methods:Monitoring data of drinking water fluorosis areas in the Corps from January to December 2022 were collected from the Corps Center for Disease Control and Prevention, the level of fluoride in drinking water and the prevalence of dental fluorosis in children aged 8 - 12 were analyzed retrospectively.Results:In 2022, the qualified rate of water fluoride in the disease affected TuanChang of the Corps was 100.00% (62/62), and the qualified rate of water fluoride in the disease affected company was 99.44% (705/709). The prevalence of dental fluorosis in children aged 8 - 12 in the disease affected TuanChang was 3.38% (1 412/41 714), and there was no statistically significant difference in the prevalence of dental fluorosis among different age groups (χ 2 = 6.07, P = 0.194). The prevalence of dental fluorosis in children aged 8 - 12 in the TuanChang where the company with water fluoride exceeding standard was located (6.00%, 106/1 768) was higher than that in the TuanChang where the company with qualified water fluoride was located (3.27%, 1 306/39 946, χ 2 = 38.47, P < 0.001). Conclusion:In 2022, the drinking water fluorosis in the Corps has reached the control standard, but attention still should be paid to the water improvement situation and maintenance of water improvement projects in some water fluoride exceeding standard companies, in order to prevent sustained dental fluorosis damage to children in the affected areas, and consolidate the achievements of prevention and control.

Growth and development status and related factors of children in drinking-water-borne endemic fluorosis area after water improvement in Xi'an / 中华地方病学杂志

Objective:To investigate the current situation and related factors of children's growth and development in drinking-water-borne endemic fluorosis areas after water improvement, and provide a basis for improving the control strategies.Methods:The stratified random sampling method was used to select children aged 7 to 13 in villages with different years of water improvement in Xi'an from November 2019 to June 2020. The height and weight of children were measured, and body mass index (BMI) was calculated. The height development level of children was graded according to the "Standard for Height Level Classification among Children and Adolescents Aged 7 - 18 Years" (WS/T 612-2018), and the physical development (BMI) level of children was determined according to the "Comprehensive Evaluation of Development Level for Children and Adolescents" (GB/T 31178-2014). At the same time, according to the standard of "Diagnosis of Dental Fluorosis" (WS/T 208-2011), the diagnosis of dental fluorosis in children was performed. The serum fluoride level was determined by ion selective electrode method, and the levels of other chemical elements (calcium, iron, magnesium, copper, zinc, iodine, selenium, lead, arsenic, cadmium, chromium, mercury, nickel) in blood were determined by inductively coupled plasma mass spectrometry.Results:A total of 469 children were included in the investigation. After water improvement, 67.38% (316/469) of the children in the disease area were at the moderate level of height development, 7.89% (37/469) were at the medium to upper and upper levels, and 24.73% (116/469) were at the medium to lower and lower levels. The BMI of the children in the emaciation group was 8.53% (40/469), while it was 10.87% (51/469) in the overweight group and 8.74% (41/469) in the obesity group. There was statistically significant difference in the distribution of height development level of children in areas with different water improvement years ( P = 0.005), but no statistically significant difference in BMI distribution ( P = 0.154). There was no significant difference in height development level and BMI distribution of children with or without dental fluorosis ( P > 0.05). There were significant differences in serum levels of iron and zinc among children with different height development levels ( P < 0.05). There were significant differences in serum levels of magnesium, copper, iodine and chromium among children with different BMI ( P < 0.05). Conclusion:The growth and development of children in drinking-water-borne endemic fluorosis area after water improvement are not correlated with the prevalence of dental fluorosis, but may be related to the levels of chemical elements such as iron, magnesium, copper, and iodine in the body.

Research progress on histone acetylation/methylation in oral diseases / 口腔疾病防治

@#Histone acetylation and methylation can affect chromatin conformation and regulate a variety of biological activities. Abnormal histone acetylation and methylation modifications are related to the occurrence and development of a variety of oral diseases. Histone acetylation and methylation increase or decrease in an orderly manner to regulate the development of teeth. Fluoride ions can destroy the balance between histone acetylation and methylation, which may be related to the occurrence of dental fluorosis. In addition, histone acetylation and methylation are involved in the regulation of oral inflammatory diseases. In the inflammatory microenvironment, the expression of histone acetyltransferase GCN5 decreases, and the expression of Dickkopf 1 (DKK1) decreases, activating the Wnt/β-catenin pathway and ultimately inhibiting the osteogenic differentiation of periodontal ligament stem cells. Enhancer of zeste homolog 2 (EZH2) and H3K27me3 levels were decreased in inflamed dental pulp tissues and cells. EZH2 inhibition inhibited the expression of interleukin (IL)-1b, IL-6 and IL-8 in human dental pulp cells under inflammatory stimulation. Histone acetylation/methylation modifications can interact with multiple signaling pathways to promote the occurrence and development of oral tumors and are related to the high invasiveness of salivary gland tumors. Small molecule drugs targeting histone acetylation and methylation-related enzymes can regulate the level of histone methylation/acetylation and have shown potential in the treatment of oral and maxillofacial diseases. For example, the histone deacetylase inhibitor vorinostat can inhibit the secretion of inflammation-related cytokines; it also promotes the maturation of odontoblasts and the formation of dentin-related matrix, demonstrating its potential in pulp preservation. Understanding the role of histone acetylation/methylation modifications in the occurrence and development of oral diseases will help promote research on epigenetic modifications in oral diseases and provide new perspectives for disease diagnosis and treatment.

Epidemiologia de la Fluorosis Dental en adolescentes de 12 años: Revisión sistemática

La prevalencia de fluorosis dental presenta una gran variabilidad a nivel mundial. Es necesario su análisis como parte de la vigilancia epidemiológica. Objetivo: Conocer la literatura disponible sobre prevalencia de fluorosis dental a la edad de 12 años en relación con el método de fluoruración comunitario utilizado. Metodología: Dos investigadoras realizaron una revisión sistemática de la literatura sin límites temporales siguiendo las pautas PRISMA, utilizando las bases de datos Pubmed, Cochrane, Scopus, BVS y Google Schoolar en idioma inglés, español, portugués e italiano. Resultados: Fueron incluidos 19 artículos de diseño transversal, 16 pertenecientes a comunidades que utilizan agua fluorurada, uno que utiliza sal fluorurada y 2 que comparan resultados entre comunidades que utilizan agua o sal fluorurada. Conclusiones: existe gran variabilidad en los reportes de prevalencia de fluorosis dental. Independientemente del método de fluoruración comunitario utilizado las lesiones de fluorosis de severidad leve son las más prevalentes.

Os relatos sobre a prevalência de fluorose dentária aos 12 anos apresentam grande variabilidade, não havendo unificação quanto ao uso dos índices. Independentemente do meio comunitário de fluoretação e do índice utilizado, a fluorose dentária leve é ​​a mais prevalente. Objetivo: Conhecer a literatura disponível sobre prevalência de fluorose dentária aos 12 anos em relação ao método comunitário de fluoretação utilizado. Metodologia: Dois pesquisadores realizaram uma revisão sistemática da literatura sem limites de tempo seguindo as diretrizes PRISMA, utilizando as bases de dados Pubmed, Cochrane, Scopus, BVS e Google Schoolar em inglês, espanhol, português e italiano. Resultados: Foram incluídos 19 artigos transversais, sendo 16 pertencentes a comunidades que utilizam água fluoretada, un sal fluoretada e 2 que comparam resultados entre comunidades que utilizam água fluoretada ou salgada. Conclusões: Há grande variabilidade nos relatos de prevalência de fluorose dentária. Independentemente do método de fluoretação comunitária utilizado, as lesões de fluorose de gravidade leve são as mais prevalentes.

The prevalence of dental fluorosis presents great variability worldwide. Its analysis is necessary as part of epidemiological surveillance Objective: To know the available literature on the prevalence of dental fluorosis among 12 years-old in relation to the community fluoridation method used. Methodology: Two researchers carried out a systematic review of the literature without time limits following the PRISMA guidelines, using the Pubmed, Cochrane, Scopus, BVS and Google Schoolar databases in English, Spanish, Portuguese and Italian. Results: 19 cross-sectional articles were included, 16 belonging to communities that use fluoridated water, one that use fluoridated salt and 2 that compare results between communities that use fluoridated water or salt. Conclusions: there is great variability in the reports of prevalence of dental fluorosis. Regardless of the community fluoridation method used, fluorosis lesions of mild severity are the most prevalent.

Fluorosis dental en adolescentes de instituciones educativas de Lima, Perú / Dental fluorosis in adolescents from Educational Institutions in Lima, Peru

Introducción: La fluorosis dental es una patología endémica causada por la ingestión excesiva de fluoruros que pueden producir una alteración durante el desarrollo del esmalte, y es considerado un importante problema de salud pública porque afecta la salud bucal y sistémica de la población. Objetivo: Este estudio tuvo como idea principal determinar la frecuencia y los niveles de fluorosis dental en escolares de 12 a 15 años pertenecientes a dos instituciones educativas de Lima - Perú. Método: Se realizó un estudio descriptivo de tipo transversal, la muestra estuvo conformada por 252 estudiantes, entre 12 y 15 años de dos centros educativos de Lima. El muestreo fue por selección sistemática de elementos muestrales. La fluorosis dental se evalúo mediante el Índice de Dean. Para determinar la frecuencia y los niveles de fluorosis dental, se realizó un examen clínico bucal y se desarrolló un cuestionario validado previamente. Resultados: La frecuencia de fluorosis dental fue de 44,8% (n=113) afectando más a los varones en un 27,39% (n=69) y a los adolescentes de 13 años (15,1%). En relación con los niveles de fluorosis, predominó el tipo "muy leve" (34,9%). También se encontró una asociación entre la presencia y el nivel de fluorosis con el número de aplicaciones de flúor (p<0,05). Además, se dijo que el índice comunitario de fluorosis de Dean fue de 0,43. Conclusiones: En la población escolar evaluada, la frecuencia de fluorosis fue de 44,8% y el nivel predominante de fluorosis fue muy leve. Además, el índice comunitario fue de 0,43, el cual mostró un nivel límite de importancia para la salud pública. Por lo que se puede considerar que el número de aplicaciones tópicas de flúor recibido por la población sin una planificación adecuada se podría convertir en un factor de riesgo para causar fluorosis dental.

Introduction: Dental fluorosis is an endemic pathology caused by the excessive ingestion of fluorides that can produce an alteration during the development of the enamel and is considered an important public health problema because it affects the oral and systemic health of the population. Objective: The objective of this study was to determine the frequency and levels of dental fluorosis in school children between 12 and 15 years of age belonging to two educational institutions in Lima, Peru. Method: A descriptive cross-sectional study was carried out, the sample consisted of 252 students between 12 and 15 years of age from two educational centers in Lima. Sampling was by systematic selection of sample elements. Dental fluorosis was evaluated using the Dean Index. To determine the frequency and levels of dental fluorosis a clinical oral examination was carried out and a previously validated questionnaire was developed. Results: The frequency of dental fluorosis was 44.8% (n=113) affecting more males by 27.39% (n=69) and adolescents aged 13 years (15.1%). In relation to the levels of fluorosis, the "very mild" type predominated (34.9%). An association was also found between the presence and level of fluorosis with the number of fluoride applications (p<0.05). In addition, Dean's community fluorosis index was reported to be 0.43. Conclusions: In the school population evaluated, the frequency of fluorosis was 44.8% and the predominant level of fluorosis was very mild. In addition, the community index was 0.43, which indicated a borderline level of public health importance. Therefore, it can be considered that the number of topical fluoride applications received by the population without adequate planning could become a risk factor for causing dental fluorosis.

Bond strength comparison among 10-MDP-containing and non-10-MDP-Containing adhesives in different degrees of dental fluorosis / Comparación de fuerza de unión entre adhesivos que contienen y no contienen 10-MDP en diferentes grados de fluorosis dental

Dental fluorosis can cause changes in the enamel surface, conditioning its functionality and esthetics. The application of dental adhesives is a treatment option; however, their use on fluorotic teeth can result in limitations. The aim of this study was to compare the shear bond strength of two different adhesives, one with 10-MDP and one without 10-MDP, in different degrees of dental fluorosis.This is an in vitro study on dental enamel samples, a total of 180 samples with the inclusion criteria were treated, randomly divided into two groups of 90, according to the type of dental adhesive, where each group was again divided into three groups of 30 samples, representing different degrees of dental fluorosis according to the Thylstrup-Fejerskov index (Group I: TF1 and TF2; Group II: TF3; Group III: TF4). Normality tests, two-factor ANOVA, and post-hoc tests were used to determine differences between the groups, with a significance level of 95%. As results, a statistically significant difference was shown between the use of dental adhesive with 10-MDP and the three groups of dental fluorosis (p=0.011), in addition, a Tukey post-hoc test on the groups treated with 10-MDP adhesive revealed a statistically significant difference between group I versus group II, and group I versus group III, (p=<0.05). It is concluded that the use of adhesive systems with 10-MDP presents a better shear bond strength on enamel with dental fluorosis grades I and II in the Thylstrup-Fejerskov index.

La fluorosis dental puede ocasionar cambios en la superficie del esmalte, condicionando su funcionalidad y estética, la aplicación de adhesivos dentales es una opción de tratamiento, sin embargo, su uso en dientes fluoroticos puede resultar en limitaciones. El objetivo de este estudio consistió en comparar la fuerza de adhesión a la cizalladura de dos diferentes adhesivos, uno con 10-MDP y otro sin 10-MDP, en diferentes grados de fluorosis dental. Se trata de un estudio in vitro en muestras de esmalte dental, un total de 180 muestras con los criterios de inclusión fueron tratadas, aleatoriamente divididas en dos grupos de 90, de acuerdo al tipo de adhesivo dental, donde cada grupo fue dividido nuevamente en tres grupos de 30 muestras, representando diferentes grados de fluorosis dental según el índice de Thylstrup- Fejerskov (Grupo I: TF1 y TF2; Grupo II: TF3; Grupo III: TF4). Para determinar diferencias entre los grupos se utilizaron pruebas de normalidad, ANOVA de dos factores, y pruebas post-hoc, con un nivel de significancia de 95%. Como resultados, se mostró una diferencia estadísticamente significativa entre el uso de adhesivo dental con 10- MDP y los tres grupos de fluorosis dental (p=0.011), además, una prueba post hoc de Tukey sobre los grupos tratados con adhesivo 10-MDP revelaron una diferencia estadísticamente significativa entre el grupo I frente al grupo II, y el grupo I frente al grupo III, (p=<0.05) Se concluye que el uso de sistemas adhesivos con 10-MDP presentan una mejor resistencia de adhesión al cizallamiento en esmalte con grados de fluorosis dental I y II en el índice de Thylstrup-Fejerskov

Fluorosis dental en la primera infancia: estado del arte

La fluorosis dental se caracteriza por una hipomineralización de la estructura dental causada por ingesta excesiva de flúor sistémico. En la dentición decidua, su diagnóstico precoz es importante, dado que será un predictor para la aparición de lesiones en la dentición permanente. El objetivo de esta revisión fue describir la evidencia científica sobre la fluorosis dental en dentición decidua reportando su etiología y factores relacionados, prevalencia, diagnóstico y tratamiento. Se realizaron búsquedas electrónicas en las bases de datos Pub-Med/Medline, EbscoHost y ScienceDirect (noviembre/2020), utilizando las palabras clave "dental fluorosis", "deciduous teeth", "primary tooth", "primary teeth". El desarrollo de fluorosis dental en dentición decidua se relacionó con la ingesta de múltiples fuentes de flúor principalmente, agua potable, alimentos de la dieta, fórmulas infantiles, suplementos y uso de dentífricos fluorados en dosis inadecuadas. Algunos factores prenatales, como vivir en terrenos montañosos o de gran altitud y habitar en lugares cercanos a minas de combustión de carbón, también fueron asociados. La prevalencia de fluorosis dental reportada en los estudios varió entre 6,2 y 96,6 %, dependiendo principalmente de la concentración de flúor en agua potable. Para el diagnóstico de la fluorosis dental en la dentición decidua se deben considerar características como la localización, aspecto, extensión y color de la lesión, realizando diagnóstico diferencial con otro tipo de defectos en esmalte y dentina. Así mismo, el tratamiento de las lesiones dependerá de la severidad del defecto y condiciones individuales del paciente.

Dental fluorosis is characterized by a hypomineralization of the tooth structure caused by excessive intake of systemic fluoride. In the deciduous dentition, its early diagnosis is important since it will be a predictor for the appearance of lesions in the permanent dentition. The objective of this review was to describe the scientific evidence on dental fluorosis in deciduous dentition, reporting its etiology and related factors, prevalence, diagnosis and treatment. Electronic searches were conducted PubMed / Medline, EbscoHost and ScienceDirect (November / 2020) databases, using the keywords "dental fluorosis", "deciduous teeth", "primary tooth", "primary teeth". The development of Dental fluorosis in deciduous dentition was related to the intake of multiple sources of fluoride mainly; drinking water, diet foods, infant formulas, supplements and the use of luoridated toothpastes in inadequate doses. Some prenatal factors such as living in mountainous or high altitude terrain and living in places near coal-burning mines were also associated. The prevalence of dental fluorosis in early childhood reported in the studies varied between 6.2% and 96.6%, depending mainly on the concentration of fluoride in drinking water. For the diagnosis of dental fluorosis in the deciduous dentition, characteristics such as the location, appearance, extension and color of the lesion must be considered, making a differential diagnosis with other types of enamel and dentin defects. Evenly, the treatment of lesions will depend on the severity defects and individual patient conditions.

Investigation on influencing factors of dental fluorosis in children in 4 towns of Inner Mongolia Autonomous Region in 2020 / 中华地方病学杂志

Objective:To study the effects of water fluoride and tea fluoride on the occurrence of dental fluorosis in children, and to provide a basis for scientific prevention and control of the disease.Methods:From April to September 2020, Baolongshan Town with qualified water fluoride but no habit of drinking brick tea, Xingyao Town with qualified water fluoride and habit of drinking brick tea, Baokang Town with exceeded water fluoride but no habit of drinking brick tea, and Wuliyasitai Town with exceeded water fluoride and habit of drinking brick tea were selected as survey sites in Inner Mongolia Autonomous Region based on historical monitoring data. In all Gacha (villages) of 4 towns, a survey was carried out on residents' drinking water, brick tea drinking habits and children's dental fluorosis detection, and the water fluoride, tea fluoride exceeding standard rates, daily per capita intake of brick tea fluoride and the detection rate of children's dental fluorosis were calculated. At the same time, multivariate logistic regression was used to analyze the influencing factors affecting the occurrence of dental fluorosis in children.Results:In 2020, a total of 165 water samples were collected in 4 towns of Inner Mongolia Autonomous Region, and the total water fluoride exceeding standard rate was 38.18% (63/165). A total of 320 tea samples were collected, the tea fluoride exceeding standard rates in Xingyao Town and Wuliyasitai Town were 96.38% (213/221) and 89.90% (89/99), respectively; the daily per capita intake of brick tea fluoride was 5.67 and 7.35 mg, respectively. A total of 1 652 children were examined for dental fluorosis, and 639 cases were detected, the detection rate was 38.68%. The detection rates of dental fluorosis in boys and girls were 37.18% (322/866) and 40.33% (317/786), respectively, with no significant difference between sexes (χ 2 = 1.72, P = 0.104); the detection rates of dental fluorosis in children aged 8 - 12 years were 43.93% (105/239), 40.50% (147/363), 46.57% (163/350), 30.56% (88/288) and 33.01% (136/412), respectively, with statistical significant difference among ages (χ 2 = 26.07, P < 0.001); the detection rates of dental fluorosis in children in Baolongshan, Baokang, Xingyao and Wuliyasitai towns were 0.68% (2/293), 14.09% (31/220), 24.79% (89/359) and 66.28% (517/780), respectively, with statistical significant differences among regions (χ 2 = 213.05, P < 0.001). Multivariate logistic regression analysis showed that when the fluoride content in water was 1.2 - < 2.0, 2.0 - < 2.5, and ≥2.5 mg/L, the risk of dental fluorosis in children was 3.93, 6.60, and 9.02 times of water fluoride content < 1.2 mg/L; when the daily per capita intakes of brick tea fluoride was 3.6 - 7.0 and > 7.0 mg, the risk of dental fluorosis in children was 2.94 and 3.90 times of daily per capita intakes of brick tea fluoride ≤3.5 mg; the risk of dental fluorosis in children aged 10 years was 1.81 times of children aged 8 years; the risk of dental fluorosis in children in Xingyao, Baokang, and Wuliyasitai towns was 22.35, 40.93, and 151.58 times of Baolongshan Town, respectively. Conclusions:The prevalence of dental fluorosis in children still exists in Inner Mongolia Autonomous Region, and the detection rate of dental fluorosis is high. High water fluoride and high tea fluoride are the main risk factors for dental fluorosis in children.

Epidemic status of drinking water-borne endemic fluorosis in Inner Mongolia Autonomous Region / 中华地方病学杂志

Objective:To investigate the distribution of fluoride content in water and dental fluorosis in children and skeletal fluorosis in adults in drinking water-borne endemic fluorosis areas of Inner Mongolia Autonomous Region.Methods:From April to November 2021, all natural villages in the drinking water-borne endemic fluorosis areas of Inner Mongolia Autonomous Region were investigated on the status quo of water improvement and water fluoride monitoring. At the same time, all children aged 8 - 12 and adults aged 18 and older were examined for dental fluorosis and skeletal fluorosis, respectively, and the detection rates were calculated.Results:There were 9 465 villages in drinking water-borne endemic fluorosis areas in Inner Mongolia Autonomous Region, among which 8 920 villages had completed the water improvement, with a water improvement rate of 94.24% (8 920/9 465); 8 664 villages had completed the water improvement with qualified water fluoride, and the qualified rate of water improvement was 97.13% (8 664/8 920). A total of 80 915 children aged 8 - 12 in the villages underwent dental fluorosis examination, and 4 868 children were diagnosed with dental fluorosis, with a detection rate of 6.02%. A total of 3 545 915 adults aged 18 and older in the villages were examined for skeletal fluorosis, and 3 567 adults were diagnosed with skeletal fluorosis, with a detection rate of 0.10%.Conclusion:The water improvement rate and qualified rate of water improvement in drinking water-borne endemic fluorosis areas in Inner Mongolia Autonomous Region are high, while both of the detection rates of dental fluorosis in children and skeletal fluorosis in adults are relatively low.

Fluoride in Mozambique: retrospective study / Flúor em Moçambique: estudo retrospectivo

ABSTRACT Objective: The study aims to analyse the fluoride concentration in the water supply of the capital of each province of Mozambique, 2019 and compare with previous data 1978 and 2008. Methods: The water supply in cities of Mozambique were analysed in 1978, 2008 and 2019 and water from Tete's River in 1978 and 2019. The fluoride concentration of the water samples was determined in duplicate, using the ion-sensitive electrode (Orion 9609), coupled to a potentiometer (Procyon, model 720), adopting a significance level of 5%. Results: The average fluoride concentration found in the years 1978, 2008 and 2019 was 0.31, 0.33 and 0.14 mg F/L, respectively. The fluoride concentrations collected from household taps in 1978, 2008 and 2019 were: Cabo Delgado/Pemba (0.62, 0.28 and 0.07 mg F/L), Niassa/Lichinga (0.18, 0.98 and 0.07 mg F/L), Nampula/Nampula (0.18, 0.01 and 0.06 mg F/L), Zambézia/Quelimane (0.81, 0.37 and 0.15 mg F/L), Tete/Tete (1.00, 0.97 and 0 .46 mg F/L), Sofala/Beira (0.00, 0.01 and 0.10mg F/L), Manica/Chimoio (0.04, 0.01 and 0.07 mg F/L), Inhambane/Inhambane (0.00, 0.05 and 0.19 mg F/L), Gaza/Xai-Xai (0.01, 0.06 and 0.06 mg F/L) and Maputo (0.23, 0.36 and 0.23 mg F/L), respectively. In the waters of the Zambeze River was 5.5 mg F/L in 1978 and 0.12 mg F/L in 2019. There was no significant change between the fluoride concentrations in the water collected from the taps during the periods studied (p=0.83), however there was a significant difference in the water collected from the river (p<0.05). Conclusion: Tete' River showed a significant reduction in fluoride concentration, and in the piped water collected in all municipalities, the fluoride content was below optimum.

RESUMO Objetivo: O estudo visa analisar a concentração de flúor no abastecimento de água da capital de cada província de Moçambique, 2019 e comparar com dados anteriores de 1978 e 2008. Métodos: A água de abastecimento das cidades de Moçambique foi analisada em 1978, 2008 e 2019 e a água do Rio Tete em 1978 e 2019. A concentração de flúor das amostras de água foi determinada em duplicata, utilizando o eletrodo íon-sensível (Orion 9609), acoplado a um potenciômetro (Procyon, modelo 720), adotando-se nível de significância de 5%. Resultados: A concentração média de flúor encontrada nos anos de 1978, 2008 e 2019 foi de 0,31, 0,33 e 0,14 mg F/L, respectivamente. As concentrações de flúor recolhidas nas torneiras das casas em 1978, 2008 e 2019 foram: Cabo Delgado/Pemba (0,62, 0,28 e 0,07 mg F/L), Niassa/Lichinga (0,18, 0,98 e 0,07 mg F/L), Nampula/Nampula (0,18, 0,01 e 0,06 mg F/L), Zambézia /Quelimane (0,81, 0,37 e 0,15 mg F/L), Tete/Tete (1,00, 0,97 e 0,46 mg F/L), Sofala/Beira (0,00, 0,01 e 0,10 mg F/L), Manica/Chimoio (0,04, 0,01 e 0,07 mg F/L), Inhambane/Inhambane (0,00 , 0,05 e 0,19 mg F/L), Gaza/Xai-Xai (0,01, 0,06 e 0,06 mg F/L) e Maputo (0,23, 0,36 e 0,23 mg F/L), respectivamente. Nas águas do rio Zambeze foi de 5,5 mg F/L em 1978 e 0,12 mg F/L em 2019. Não houve alteração significativa entre as concentrações de flúor na água coletada das torneiras durante os períodos estudados (p=0,83), porém houve diferença significativa na água captada no Rio (p<0,05). Conclusão: O Rio Tete apresentou redução significativa na concentração de flúor, e na água das torneiras coletada em todas as cidades, o teor de flúor estava abaixo do ideal.

Fluorotic Enamel Susceptibility to Dental Erosion and Fluoride Treatment

Abstract The purpose of this in vitro study was to test the hypothesis that fluoride treatment can prevent dental erosion on fluorotic enamel of different severities. It followed a 3×2 factorial design, considering a) fluorosis severity: sound (TF0, Thylstrup-Fejerskov Index), mild (TF1-2), moderate (TF3-4); and b) fluoride treatment: 0 (negative control) and 1150ppmF. Human molars with the three fluorosis severities (n=16, each) were selected and randomly assigned to the two fluoride treatments (n=8). Enamel blocks (4×4mm) were prepared from each tooth and subjected to a dental erosion cycling model, for 10 days. The daily cycling protocol consisted of erosive challenges (1% citric acid, pH 2.4), interspersed by periods of immersion in artificial saliva, and three 2-minute treatments with either 0 or 1150ppm F. The enamel volume loss (mm3) was calculated by subtracting values obtained by microtomography before and after cycling. Two-Way ANOVA showed no significant interaction between fluorosis severity and fluoride treatment (p=0.691), and no significant effect for either fluorosis severity (TF0 mean±standard-deviation: 13.5(10-2±0.42(10-2, TF1-2: 1.50(10-2±0.52(10-2, TF3-4: 1.24(10-2±0.52(10-2, p=0.416) or treatment (0ppmF: 1.49(10-2±0.53(10-2; 1150ppmF: 1.21(10-2±0.42(10-2; p=0.093), when evaluated independently. Considering the limitations of this in vitro study, the presence and severity of fluorosis in enamel do not appear to affect its susceptibility to dental erosion. Fluoride treatment was not effective in preventing the development of dental erosion in both sound and fluorotic enamel substrates under our experimental conditions.

Resumo Este estudo in vitro foi testou a hipótese de que o tratamento com flúor pode prevenir a erosão dentária no esmalte fluorótico de diferentes severidades. O objetivo deste estudo foi: investigar o efeito protetor dos fluoretos contra a erosão e abrasão simuladas no esmalte fluorótico. Seguiu um desenho fatorial 3×2, considerando a) severidade da fluorose em 3 níveis: hígido (TF0, Índice Thylstrup-Fejerskov), suave (TF1-2), moderada (TF3-4); b) tratamento com flúor: 0 (controle negativo) e 1150ppmF. Molares humanos com as três severidades de fluorose (n=16, cada) foram selecionados e distribuídos aleatoriamente para os dois tratamentos com flúor (n=8). Blocos de esmalte (4×4mm) foram preparados a partir de cada dente e submetidos a um modelo de ciclo de erosão dentária, por 10 dias. O protocolo de ciclagem diária consistiu em seis desafios erosivos de 5 minutos (1% de ácido cítrico, pH 2,4), intercalados por seis períodos de imersão em saliva artificial e três tratamentos de 2 minutos com 0 ou 1150ppmF. O volume do esmalte perdido foi calculado subtraindo o perfil superficial 3D obtido por microtomografia antes e depois da ciclagem. A ANOVA de dois fatores não mostrou interação significativa entre a severidade da fluorose e o tratamento com flúor (p = 0,691) e nenhum efeito significativo para a severidade da fluorose (TF0 média+/desvio padrão: 13,5(10-2±0,42(10-2, TF1-2: 1,50(10-2±0,52(10-2, TF3-4: 1,24(10-2±0,52(10-2, p=0,416) ou tratamento (0: 1,49(10-2±0,53(10-2; 1150ppmF: 1,21(10-2±0,42(10-2, p=0,093), quando avaliados independentemente. Considerando as limitações deste estudo in vitro, a presença e severidade da fluorose no esmalte não parece afetar sua suscetibilidade à erosão dentária. O tratamento com flúor não foi eficaz na prevenção do desenvolvimento da erosão dentária em esmalte hígido e fluorótico, sob as condições experimentais utilizadas.

Fluorose dentária e determinantes sociais da saúde: Revisão integrativa / Dental fluorosis and social determinants of health: Integrative review / Fluorosis dental y determinantes sociales de la salud: revisión integradora

Objetivo: verificar o desenvolvimento da fluorose dentária e sua relação com os Determinantes Sociais da Saúde (DSS) através de uma revisão integrativa. Método: trata-se de uma revisão integrativa de estudos que abordam os aspectos dos DSS e sua relação com a fluorose dentária. A coleta de dados foi realizada entre o período de agosto de 2020 a abril de 2021. Resultados: dos estudos selecionados de língua portuguesa e inglesa observou-se que o Fluorose Dentária é um problema de saúde pública, de âmbito mundial. Conclusão: Assim, é oportuno pensar que a fluorose dentária pode ser influenciada pelo meio ao qual o indivíduo se insere, suas condições sociais, econômicas, psicológicas e comportamentais devem ser consideradas, conforme o olhar dos DSS.

Objective: to verify the development of dental fluorosis and its relationship with the Social Determinants of Health (SDH) through an integrative review. Method: this is an integrative review of studies that address aspects of DSS and its relationship with dental fluorosis. Data collection was carried out between August 2020 and April 2021. Results: from selected studies in Portuguese and English, it was observed that Dental Fluorosis is a public health problem, worldwide. Conclusion: Thus, it is opportune to think that dental fluorosis can be influenced by the environment in which the individual is inserted, their social, economic, psychological and behavioral conditions must be considered, according to the perspective of the DSS.

Objetivo: verificar el desarrollo de la fluorosis dental y su relación con los determinantes sociales de la salud (DE) a través de una revisión integradora. Método: se trata de una revisión integradora de estudios que abordan los aspectos de las SD y su relación con la fluorosis dental. Los datos fueron recolectados entre agosto de 2020 y abril de 2021. Resultados: a partir de los estudios seleccionados de portugués e inglés, se observó que la fluorosis dental es un problema de salud pública en todo el mundo. Conclusión: Por lo tanto, es oportuno pensar que la fluorosis dental puede estar influenciada por el entorno al que se incluye al individuo, se deben considerar sus condiciones sociales, económicas, psicológicas y de comportamiento, de acuerdo con la mirada del SSD.

Endemic dental fluorosis in children from a brazilian slave-descendent community: a cross-sectional study / Fluorose dentária endêmica em crianças de uma comunidade quilombola brasileira: um estudo transversal

Although fluoride (F) is required for the normal growth and development of several human organs and tissues, excessive exposure to it may be potentially toxic. Groundwater may present ranging levels of F; however, the appearance, taste, and smell are not altered. Thus, the present study aimed to evaluate dental fluorosis in children from a Brazilian slave-descendent community, as well as to assess F levels in the drinking water supplies available in that area. For that, 21 children aged from 6 to 14 years living in Rincão dos Martimianos were invited to participate. Thylstrup and Fejerskov index (a 0­9 scale) was used to assess dental fluorosis on permanent teeth. Furthermore, the F concentration of two water samples (from the artesian well and a tank) was determined by using a potentiometric method. All children presented dental fluorosis to some degree, ranging from score 2 to 9. About 81% of them had dental fluorosis scores equal to or over 5. Scores lower than 5 were observed only in children younger than 8 years; on the other hand, all children older than 8 years presented scores higher than 5. Moreover, artesian well water had an F concentration of 5 mg/L and tank water 0.8 mg/L. It is suggested that the F-rich groundwater supply was most probably responsible for dental fluorosis in that area. Brazilian slave-descendent communities, therefore, should receive constant attention from their local authorities in order to guarantee a proper water supply for consumption, as well as to provide public health education(AU)

Embora o flúor (F) seja necessário para o crescimento e desenvolvimento normal de vários órgãos e tecidos humanos, a exposição excessiva pode ser potencialmente tóxica. As águas subterrâneas podem apresentar níveis variados de F; no entanto, a aparência, o sabor e o cheiro não são alterados. Desta forma, o presente estudo teve como objetivo avaliar a fluorose dentária em crianças de uma comunidade brasileira descendente de escravos, bem como avaliar os níveis de F na água potável disponível nessa área. Para isso, 21 crianças de 6 a 14 anos residentes no Rincão dos Martimianos foram convidadas a participar da pesquisa. O índice de Thylstrup e Fejerskov (uma escala de 0 a 9) foi usado para avaliar a fluorose dentária em dentes permanentes. Além disso, a concentração de F de duas amostras de água (do poço artesiano e de um tanque) foi determinada pelo método potenciométrico. Todas as crianças apresentaram algum grau de fluorose dentária, variando de 2 a 9. Cerca de 81% delas apresentaram escores de fluorose dentária iguais ou superiores a 5. Escores inferiores a 5 foram observados apenas em crianças menores de 8 anos; por outro lado, todas as crianças maiores de 8 anos apresentaram escores superiores a 5. Além disso, a água do poço artesiano tinha concentração de F de 5 mg/L e a água do tanque 0,8 mg/L. Desta forma, acredita-se que a fonte de água subterrânea rica em F foi provavelmente responsável pela fluorose dentária na região avaliada. As comunidades quilombolas brasileiras, portanto, devem receber atenção constante de suas autoridades locais, a fim de garantir o abastecimento adequado de água para consumo, bem como proporcionar educação em saúde pública(AU)

Resinas infiltrativas como tratamiento para la fluorosis dental. Una revisión de literatura / Infiltrative resins as a treatment for dental fluorosis. A literature review

RESUMEN En los últimos años se ha desarrollado un nuevo enfoque más conservador para detener y controlar las lesiones cariosas iniciales, usando la técnica con resinas infiltrativas, desarrollada con la finalidad de aportar a los tratamientos no invasivos siendo utilizadas como método para el diagnóstico de lesiones cariosas no cavitadas; aunque, actualmente su uso se ha expandido para tratar otro tipo de lesiones que afectan al esmalte como la fluorosis dental. Para este artículo de revisión fueron seleccionados artículos originales, investigaciones in vitro, in vivo, reportes de casos, revisiones sistemáticas y de literatura; llevándose a cabo la búsqueda en 6 bases de datos: PubMed, Google Académico, ScienceDirect, Wiley, EBSCO, Springer, de las cuales se obtuvo información acerca de la eficacia, beneficios, aplicaciones clínicas y, técnica de aplicación de las resinas infiltrativas.

ABSTRACT In recent years, a new standard of resins called infiltrative resins has been generated, which were developed with the aim of contributing to non-invasive treatments, being used as a treatment for the diagnosis of non-cavitated carious lesions; although, currently its use has expanded to treat other types of lesions that affect the enamel such as dental fluorosis. For this review article, original articles, in vitro and in vivo research, case reports, systematic and literature reviews were selected; carrying out the search in 6 databases: PubMed, Google Scholar, ScienceDirect, Wiley, EBSCO and Springer, from which information was obtained about the efficacy, benefits, clinical applications and application technique of the infiltrative resins.

Nivel de conocimiento de los padres sobre el uso de pastas dentales en asociación con la ingesta estimada de fluoruro en niños / Level of knowledge in parents about the use of toothpaste in association with estimated fluoride intake in children

Resumen Introducción: Diversos estudios han demostrado que los padres aún no cuentan con el conocimiento suficiente sobre el uso de pastas dentales que deben consumir sus hijos. Muchos de ellos desconocen desde que edad se debe empezar con el uso de pastas dentales, la cantidad exacta que se debe colocar en el cepillo y sobre todo con qué frecuencia se deben cepillar. Objetivo: Asociar el nivel de conocimiento de los padres sobre el uso de pastas dentales con las características asociadas a la ingesta estimada de fluoruro en niños entre los 6 meses a 8 años de Lima Metropolitana y Callao. Materiales y métodos: Estudio de tipo observacional, descriptivo y transversal. Se realizó el cuestionario a 264 padres de familia residentes en Lima Metropolitana y Callao durante los meses de julio a septiembre del 2020. Se calcularon las frecuencias absolutas y relativas. Para el análisis bivariado, se utilizó la prueba de Chi cuadrado de El nivel de significancia estadística fue de 0.05. Resultados: Se observa que el 52.94% de los padres, así como el 60.41% de las madres presentan un nivel medio de conocimiento sobre el uso de pastas dentales con flúor. Además, se obtuvo que el 56.25% de los padres que afirmaron que sus hijos no se enjuagan con agua después del cepillado presentan un nivel alto de conocimiento sobre el uso de pastas dentales con flúor. Conclusión: Se obtuvo que el 57.58% de los padres tenían un nivel medio de conocimiento sobre el uso de pastas dentales con flúor. Se encontró asociación entre el nivel de conocimiento sobre el uso de pastas dentales con flúor y las características asociadas a la ingesta estimada de fluoruro.

Abstract Introduction: Various studies have shown that parents still do not have sufficient knowledge about the use of toothpastes that their children should consume. Many of them do not know from what age to start using toothpastes, the exact amount to be placed on the brush and especially how often they should be brushed. Aim: To associate the level of knowledge of parents about the use of toothpastes with the characteristics associated with the estimated intake of fluoride in children between 6 months to 8 years of Metropolitan Lima and Callao. Materials and methods: An observational, descriptive, and crosssectional study. The questionnaire was carried out on 264 parents residing in Metropolitan Lima and Callao during the months of July to September 2020. The absolute and relative frequencies were calculated. For the bivariate analysis, the Chi-square test of the level of statistical significance was used was 0.05. Results: It is observed that 52.94% of the fathers, as well as 60.41% of the mothers present a medium level of knowledge about the use of fluoride toothpastes. In addition, it was found that 56.25% of parents who stated that their children do not rinse with water after brushing have a high level of knowledge about the use of fluoride toothpastes. Conclusion: It was found that the 57.58% of parents had a median level of knowledge about the use of fluoride toothpastes. An association was found between the level of knowledge about the use of fluoride toothpastes and the characteristics associated with the estimated fluoride intake.

Prevalence of dental fluorosis and dental caries in fluoride endemic areas of Rohtak district, Haryana

Objectives: This study investigates the estimation of the fluoride concentration in drinking water in Rohtak district, Haryana, and quantifies its effect on the prevalence of dental fluorosis and dental caries. Materials and Methods: A cross-sectional survey was conducted among 1262 school children in endemic fluoride areas of Haryana. Using simple random sampling, thirty villages from five blocks of Rohtak districts were selected, and children 6–12 years of age were examined. A questionnaire survey form was filled out to record the demographic details of the samples. Dental caries was recorded according to DMFT (D = Decayed, M = Missing due to caries only, F = Filled, T = Teeth)/deft index (d = decayed, e = extracted due to caries, f = filled, t = teeth). Assessment of Dental Fluorosis was done according to Dean's Fluorosis index, modified in 1942. The data were analyzed using SPSS version 19, and nonparametric tests were used to assess the significance. Results: The study participants included 615 males and 647 females among which Mean DMFT in the area of study ranged from 0.32 to 1.90. Mean deft in the area of study ranged from 0.34 to 1.91. The fluoride concentrations in groundwater are in the range of 0.532–8.802. Out of 1262 children examined, 655 (51.90%) children were having dental fluorosis. 607 (48.10%) of the subjects were free from fluorosis. 16.09%, 13.39%, 9.11%, and 8.16% and 5.15% were having questionable, very mild, mild, moderate, and severe form of fluorosis, respectively. Conclusion: It can be concluded that in Rohtak district, the fluoride levels in drinking water and the prevalence of dental fluorosis are high, so requiring an urgent need to improve the quality of water and institute de-fluoridation of drinking water in affected areas to lower the burden of dental fluorosis in the community.

Acute toxicity of fluoride and aluminium on the freshwater fish, Cyprinus carpio L

Fluoride is a trace element which has beneficial effect at lower concentration but detrimental at higher concentration. The fluoride contamination in ground water is a major global problem. Similarly, aluminium is the most abundant metal of the earth, highly toxic to all organisms. In the present study, we investigated the acute toxicity of fluoride and aluminium on three month old fingerlings of Cyprinus carpio L. in hard water (Hardness 125 mg/L of CaCO3) under static renewal bioassay. The 96 h LC50 value of the fluoride and aluminium were 675.615 and 224.214 mg/L, respectively. There was a significant correlation (P <0.01) between mortality rate of C. carpio with all concentrations of fluoride as well as aluminium. The exposure time (24, 48, 72 and 96 h) and different concentration of fluoride (680, 684, 686 and 692 mg/L) and aluminium (228, 229, 231 and 232 mg/L) was also significantly correlated (P <0.05). The different abnormal behaviour displayed by the fluoride and aluminium exposed fishes were erratic swimming movements, rapid opercular activity and excessive secretion of mucous. The safe level of concentrations of fluoride and aluminium were 6.75 and 2.24 µg/L, respectively. The LC50 values of fluoride and aluminium of the present study may be useful in deriving water quality standards in West Bengal.

Microabrasión e infiltración como alternativa de tratamiento para Fluorosis Dental severa: reporte de caso / Microabrasão e infiltração como tratamento alternativo para Fluorose Dentária severa: relato de caso / Microabrasion and resin infiltration for treatment of severe Dental Fluorosis: a case report

Resumen La Fluorosis Dental (FD) es un defecto del desarrollo del esmalte tipo hipomineralización atribuido a la exposición crónica y excesiva de fluoruro durante el período de amelogénesis. Clínicamente, en los casos más leves se pueden observar finas líneas blancas y opacas, mientras que en casos moderados y severos las líneas se pueden fundir y formar bandas más gruesas comprometiendo toda la superficie del diente pudiendo estar asociadas con pérdidas de estructura y cambios de color. El tratamiento de la FD puede incluir desde microabrasión, infiltración, aclaramiento y restauraciones con resina compuesta hasta carillas y coronas. El objetivo de este caso clínico fue asociar la técnica de microabrasión e infiltración como alterantiva de tratamiento estético para el manejo de la FD. Paciente de sexo femenino y 9 años que presentaba opacidades blancas en forma de bandas gruesas y pérdidas de estructura dental en los incisivos superiores permanentes (FD severa). Para el tratamiento se optó por realizar microabrasión con ácido clorhídrico, seguido de infiltración con resina de baja viscosidad, logrando un resultado estético favorable y estable a tres meses. Se concluye que la combinación de estas dos técnicas micro-invasivas es una estrategia viable y efectiva para enmascarar efectivamente opacidades producidas por la FD.

Resumo A Fluorose Dentária (FD) é um defeito de desenvolvimento do esmalte do tipo hipomineralização atribuído à exposição crônica e excessiva de fluoreto durante a amelogênese. Clinicamente, os casos leves apresentam finas linhas brancas que acompanham a formação dentária, enquanto casos moderados ou severos apresentam faixas brancas mais amplas acometendo toda a superfície e podem estar associados à perdas estruturais e pigmentações. O tratamento da FD inclui desde microabrasão, infiltração e aclaramento até restaurações com resina composta, facetas e coroas. O objetivo deste caso clínico foi associar as técnicas de microabrasão e infiltração como alternativa de tratamento estético para a abordagem da FD. Paciente do sexo feminino de 9 anos que apresentava nos incisivos superiores permanentes áreas brancas opacas e perda de estrutura (FD severa). Para o tratamento, optou-se por realizar microabrasão com ácido clorídrico, seguido de infiltração com uma resina de baixa viscosidade, atingindo um resultado estético e favorável. Conclui-se que a combinação da microabrasão e da infiltração é uma estratégia viável e efetiva para mascar efetivamente opacidades produzidas pela FD.

Abstract Dental Fluorosis (DF) is a developmental defect of the enamel type hypomineralization attributed to chronic and excessive fluoride exposure during the period of amelogenesis. Clinically, in the mildest cases fine white and opaque lines can be observed, while in moderate and severe cases the lines can melt and form thicker bands, compromising the entire tooth surface, which may be associated with loss of structure and color changes. Treatment of DF can range from microabrasion, infiltration, dental whitening, and composite resin restorations to veneers and crowns. The objective of this clinical case was to associate the microabrasion and infiltration technique as an alternative to aesthetic treatment for the management of dental fluorosis. A 9-year-old female patient presented white opacities in the form of thick bands and loss of tooth structure in the permanent upper incisors (severe dental fluorosis). For the treatment, it was decided to perform microabrasion with hydrochloric acid, followed by infiltration with low viscosity resin, achieving a favorable and stable aesthetic result after three months. It is concluded that the combination of these two micro-invasive techniques is a viable and effective strategy to effectively mask opacities produced by DF.