Ação clareadora e microbiológica do enxaguante bucal com peróxido de hidrogênio: ensaio clínico / Whitening and microbiological action of mouthwash with hydrogen peroxide: clinical trial

Introdução: os enxaguantes bucais clareadores tem sido muito utilizados, porém sua eficiência e efeitos colaterais trazem questionamentos. Objetivo: este ensaio clínico teve como objetivo avaliar se o enxaguante bucal clareador, contendo peróxido de hidrogênio a 1,5%, apresenta ação clareadora e se há algum efeito secundário na cavidade bucal. Metodologia: foram selecionados 10 voluntários com idade média de 21,5 anos, submetidos a avaliação da cor dos dentes com auxílio do espectrômetro em 3 momentos: inicial; com 15 e com 30 dias de uso do enxaguante. A avaliação dos efeitos colaterais foi realizada a partir da coleta de saliva estimulada em 4 momentos: antes e depois ao primeiro uso do produto, com 15 e com 30 dias, e realizadas as análises laboratoriais: fluxo salivar; pH; quantidade de Streptococcus mutans e de Lactobacillus. A normalidade dos dados foi verificada pelo teste de Shapiro-Wilk, comparação de cor pelo teste t dependente, comparação dos microrganismos pelos testes ANOVA de medidas repetida e Tukey. Resultados: as análises de cor dos dentes não evidenciaram nenhuma alteração significativa em nenhum dos tempos investigados. No fluxo salivar, pH e Lactobacillus não houveram alterações significativas. Na quantidade de Streptococcus mutans notou-se um aumento significativo quando comparado os valores após o primeiro uso e com 30 dias. Conclusão: a solução de enxague bucal contendo peróxido de hidrogênio a 1,5% não apresentou alteração significativa na coloração dos dentes e nenhum efeito colateral significativo na atividade cariogênica de acordo com os testes e períodos avaliados.

Introduction: whitening mouthwashes have been widely used, but their efficiency and side effects raise questions. Objective: this clinical trial aimed to assess whether the bleaching mouthwash, containing 1.5% hydrogen peroxide, has a bleaching action and whether there are any side effects in the oral cavity. Methods: 10 volunteers were selected, with a mean age of 21.5 years, who underwent tooth color evaluation with the aid of a spectrometer in 3 moments: initial; with 15 and 30 days of using the washes. The evaluation of side effects was performed from the collection of stimulated saliva in 4 moments: before and after the first use of the product, at 15 and 30 days, and laboratory analyzes were carried out: salivary flow; pH; the number of Streptococcus mutans and Lactobacillus. Normal distribution was verified with Shapiro-Wilk test, comparisons of color were performed with t-test, comparisons of the microorganisms were performed with repeated measures ANOVA and Tukey tests. Results: the analysis did not show any significant changes in any of the investigated times. There were no significant changes in the salivary flow, pH and Lactobacillus. The number of Streptococcus mutans, was noted a significant increase when comparing the values after the first use and with 30 days. Conclusion: the mouthwash containing 1.5% hydrogen peroxide was not shown any significant alterations in the color teeth. There were not significant collateral effects on the cariogenic activity according to the tests and periods evaluated.

Sensitivity and Specificity of Different Diagnostic Methods in Occlusal Caries Detection of Permanent Teeth Among Paediatric Patients

ABSTRACT@#Dental caries is a commonly progressive disease that proceeds through various degrees of severity that a dentist can detect. The aims of the in vivo study were to assess the accuracy of the individual model (near-infrared light transillumination [NILT] device, visual and radiographic examinations) in detecting occlusal caries, and to evaluate the performance of visual and NILT device combination for occlusal caries detection in deciding the treatment options. Fifty-two non-cavitated occlusal surfaces from 16 patients were assessed with three different diagnostic devices in random order. Identified lesions were prepared and validated. Logistic regression analysis was performed for each method. The sensitivity and specificity values for each method and the combined models were statistically measured using RStudio version 0.97.551. At the enamel level, visual detection was the most sensitive method (0.88), while NILT was the most specific (0.93). NILT scored the highest for sensitivity (0.93) at the dentine level and visual detection scored the highest for specificity (0.88). Visual detection + NILT model was significantly better (p = 0.04) compared to visual detection or NILT alone (df = 1). The visual-NILT combination is a superior model in detecting occlusal caries on permanent teeth. The model provided surplus value in caries detection hence improving the treatment decision-making in occlusal surfaces.

Cárie Dentária: considerações clínicas e radiográficas para seu diagnóstico / Dental Caries: clinical and radiographic considerations for diagnosis

Introdução: O diagnóstico correto da cárie dentária é fundamental para o estabelecimento do seu tratamento. Ele pode ser realizado por diferentes métodos, os mais comuns são por meio da inspeção visual e do exame radiográfico. Objetivo: Discutir, a partir de uma revi-são de literatura, o diagnóstico clínico-radiográficoda doença cárie e a sua importância na instituição do tratamento correto para tal doença. Materiais e métodos: oi realizada uma revisão da literatura nas bases de dados eletrônicos: PubMed, BVS e Scielo, através do ras-treio de artigos relevantes publicados no período de Janeiro de 2015 à Junho 2020. Foram incluídos ainda na bibliografia selecionada 2 livros e 1 tese de doutorado, que fazem consi-derações relevantes sobre o assunto estudado. Resultados: Na inspeção visual, a apresen-tação da superfície dentária é bastante importante na determinação da atividade da lesão de cárie, devem ser considerados o aspecto, o brilho e a coloração da superfície dental para tal determinação. A radiografia é um complemento usado para auxiliar no diagnóstico forne-cendo mais visibilidade e detecção das lesões cariosas permitindo melhor visualização das superfícies proximais em dentes posteriores, auxiliando no diagnóstico das lesões nessas superfícies. Conclusão: O diagnóstico correto exige bastante conhecimento do examina-dor, pois manchas opacas presentes no esmalte nem sempre são lesões cariosas e podem refletir uma perda de mineral na estrutura desse tecido que se desenvolveu por diferentes causas, sendo elas pré ou pós-eruptivas. O diagnóstico precoce e preciso da cárie dentária é fundamental, pois essa doença ainda é a principal causa de perda dentária.

Introduction:The correct diagnosis of dental caries is fundamental for the establishment of its treatment. It can be carried out by different methods and the most common is through visual inspection and radiographic examination.Objective:to discuss, based on a litera-ture review, the clinical and radiographic diagnosis of caries disease and its importance in establishing the correct treatment for this disease.Materials and methods:a literature review was carried out on the electronic databases: PubMed, BVS and Scielo, by a search of relevant articles published from January 2015 to June 2020. Also, 2 books and 1 PhD thesis were included in the selected bibliography, since they bring relevant considerations on the subject studied.Results:In the visual inspection, the presentation of the dental sur-face is very important in determining the activity of the caries lesion, the aspect, the bri-ghtness, and the coloring of the dental surface must be considered for such determination. Radiography is a complement used to assist in diagnosis by providing more visibility and detection of carious lesions, allowing a better visualization of proximal surfaces in poste-rior teeth, helping in the diagnosis of lesions on these surfaces.Conclusion:The correct diagnosis requires a lot of knowledge from the examiner because opaque stains present in the enamel are not always carious lesions and can reflect a loss of mineral in the structure of this tissue that has developed for different causes, whether pre- or post-eruptive. Early and accurate diagnosis of tooth decay is essential, as this disease is still the main cause of tooth loss.

Tooth decay detection using a fiber optic sensor / Detección de caries dental usando un sensor de fibra óptica

ABSTRACT Introduction: tooth decay has become one of the most prevalent diseases worldwide, but ironically it is one of the most neglected. Currently, adequate and effective caries treatment is based on early diagnosis and procedures such as sealants, crowns, and root canal treatment. Methods: This study examined the behavior of carious and non-carious areas of critical dental units (premolars and molars) subjecting them to a wavelength of 830 nm in adult humans who agreed to a dental exam and had at least one tooth affected by dental caries. Underage persons and patients in medical treatment were excluded. After finding a behavior that helped differentiate decayed tissue from healthy areas, the used experimental system was characterized and tested in volunteers. The implemented system contains a fiber optic sensor comprised of a trifurcated fiber and a photodetector to perform optical power measurements. Results: This sensor detected 100% of dental caries samples on premolar and molar occlusal surfaces. It also showed the ability to diagnose buccal cavities. Conclusions: The results showed that caries can be identified in dental units by means of a fiber optic sensor and infrared light at 830 nm.

RESUMEN. Introducción: la caries se ha manifestado como una de las enfermedades con mayor prevalencia mundial, pero paradójicamente es una de las más desatendidas. En la actualidad, el tratamiento adecuado y eficaz contra la caries se basa en el diagnóstico temprano y en procedimientos como obturaciones, coronas y tratamiento de conductos. Métodos: esta investigación se centró en examinar el comportamiento de zonas cariadas y no cariadas de piezas dentales vitales (premolares y molares) al someterlas a una longitud de onda de 830 nm en seres humanos mayores de edad que aceptasen una revisión odontológica y que presentaran al menos un caso de caries dental. Fueron excluidos menores de edad y personas bajo tratamientos médicos. Tras encontrar un comportamiento que permitió diferenciar entre zonas cariadas y sanas, se caracterizó el sistema experimental usado y se probó en voluntarios. El sistema implementado se basa en un sensor de fibra óptica compuesto por una fibra trifurcada y un fotodetector para realizar mediciones de potencia óptica. Resultados: este sensor detectó el 100% de las muestras de caries dental en superficies oclusales de premolares y molares. Asimismo, exhibió indicios de la capacidad de diagnosticar caries vestibulares. Conclusiones: los resultados mostraron que se puede establecer la presencia de caries en piezas dentales mediante la implementación de un sensor de fibra óptica y luz infrarroja de 830 nm.

Effect of Repeated Oral Health Education on the Oral Health of Preschool Children / 치위생과학회지

This study aimed to investigate the effect of repeated oral health education on the oral health of preschool children. This study classified the control group of children of 5~6 years of age where the oral health education was conducted one time, and the experiment group where the oral health education was conducted 4 times. The oral health conditions of each group and their risk of developing dental caries were also assessed. No significant difference was observed in the participants in terms of general characteristics, oral health conditions, risk of developing dental caries, and oral health behavior after oral health education. The two groups did not show a significant difference (p<0.001) in dental plaque index before and after oral health education, and showed a significant difference (p<0.001) according to the number of education sessions. Before oral health education, the participants in both groups were brushing their teeth incorrectly. However, after the third session, 56.7% of the participants in the experimental group and 9.4% in the control group used the correct method of tooth brushing. A significant difference was observed between the two groups (p<0.05). In addition, when the tooth-brushing time was compared, the two groups showed a significant difference (p<0.001), and a significant difference was observed in terms of the number of education sessions (p<0.05). In summary, repeated oral health education had significant influences on the dental plaque index, tooth-brushing method, brushing occlusal surfaces, and tooth-brushing time. Therefore, when oral health education is carried out, repeated oral health education in children is more effective than one-time oral health education as reflected in the changes in dental plaque index and oral health behavior. Moreover, oral health education is considered effective in changing the oral health behavior of children when conducted at least 3 times.

Clinical performance of fluorescence-based methods for detection of occlusal caries lesions in primary teeth

Abstract We aimed to investigate the performance of fluorescence-based methods (FBMs), compared to visual inspection after histological validation, in detecting and assessing the activity status of occlusal carious lesions in primary teeth. One examiner evaluated 50 primary molars close to exfoliation in 24 children. Teeth were assessed using quantitative light-induced fluorescence (QLF) and pen-type laser fluorescence (LFpen). After exfoliation, histological validation was performed. Teeth were cut and sections were evaluated for lesion depth and activity status (after utilization of a pH indicator) under a stereomicroscope. Parameters related to the performance of the methods in detecting caries lesions at two thresholds (initial and dentin lesions) were calculated. Regarding the activity status, lesions were classified into sound+inactive or active, and the area under the ROC curve and the diagnostic odds ratio values of the methods were calculated and compared. Evaluation of red fluorescence using QLF presented higher sensitivity but lower specificity than visual inspection in detecting dentin caries lesions. However, QLF considering different parameters and LFpen had similar performance to that obtained with visual inspection. Regarding activity assessment, all FBMs and visual inspection also presented similar performance. In conclusion, FBMs did not prove advantageous for the detection and activity assessment of occlusal caries lesions in primary molars when compared to visual inspection.

Comparación del diagnóstico de lesiones de caries en la dentición decidua con el índice OMS y el índice ICDAS II ­ actividad de caries en pacientes infantes / Comparison of diagnosis to decay in deciduos teeth with who index and the index ICDAS II and caries activity in patients infants

OBJETIVO: El propósito del presente estudio fue comparar la prevalencia de lesiones de caries dental cavitadas, no cavitadas y su actividad en pacientes infantes que acuden al Servicio de Odontopediatría de la Clínica de Odontología de la Escuela de Estomatología de la Universidad Científica del Sur utilizando el sistema de odontograma OMS y compararlo con el registro en el odontograma según Criterios Sistema (ICDS II-actividad de caries). MATERIAL Y MÉTODOS: Se realizó un estudio observacional, transversal, descriptivo, prospectivo de comparación. Se seleccionó para el estudio a todos los pacientes infantes nuevos de 2 a 5 años de edad de ambos sexos que lleguen a atenderse en la Clínica de Odontología, Servicio de Odontopediatría de la Universidad Científica del Sur, período febrero a mayo del 2013,el tamaño de la mues-tra estuvo conformada por 34 pacientes infantes de 2 a 5 años de edad, que cumplieron los requisitos de inclusión y que sus tutores autorizaron a participar del estudio. RESULTADOS: del total de evaluados, 19 (57.88 %) fueron mujeres y 14 (42.42%) fueron varones. Con los criterios OMS 28 (84.85 %) se registró lesiones de caries dental y 5 (15.15%) no se registró lesiones de caries dental, se encontró una Media de 5.45 (+/- 3.97) IC 95% [4.04 a 6.86]. Con los criterios ICDAS II-actividad de caries 33 (100 %) registró lesiones de caries dental, se encontró una Media de 9.40 (+/- 3.48) IC 95% [8.15 a 10.63].La distribución de las edades fue de 3 evaluados de 2 años (7.02%), 4 evaluados de 3 años (19.85%), 14 evaluados de 4 años (42.42%) y 12 evaluados de 5 años (36.36%). CONCLUSIONES: la detección de las lesiones iniciales de caries es compleja, debido al hecho que se tradicionalmente se ha usado el sistema de detección de la OMS, los profesionales odontólogos no están instruidos a detectar lesiones no cavitadas,la inclusión de lesiones de caries no cavitadas es necesaria en los registros de caries, ya que estas lesiones pueden detenerse a través de un manejo pre-ventivo, este hecho reduce significativamente los costos económicos y biológicos de los tratamientos restauradores, debe promoverse la difusión de los nuevos sistemas de evaluación de caries dental en las universidades y en los cursos de actualización para profesionales. (AU)

The purpose of this study was to compare the prevalence of dental caries lesions cavitated and non-cavitated and activity in patients pre-senting at the Pediatric Dentistry Clinic of University Southern Scientific Lima Perú, using the odontogram system provided by the faculty and compare the dental registration according Criteria system (ICDS II ­ caries activity) . Methods : we conducted an observational , cross-sectional , descriptive , prospective comparison, Population : was selected for the study all new infant patients 2-5 years of age of both sexes reach addressed in Clinical Pediatric Dentistry Scientific University of the South, between February and May 2013 , the size of the sample consisted of 34 patients infants 2-5 years of age, who met the inclusion criteria and their guardians authorized to participate in the estudio. Results : among tested, 19 ( 57.88 % ) were female and 14 ( 42.42 % ) were male. WHO criteria 28 ( 84.85 % ) was recorded dental caries , and 5 (15.15 %) were not registered dental caries lesions , we found a 5.45 Mean ( + / - 3.97 ) 95% CI [ 4.04 to 6.86 ] . With the criteria ICDAS II ­ caries activity , 33 ( 100 %) had dental caries , there was a 9.40 Mean ( + / - 3.48 ) 95% CI [ 8.15 to 10.63 ] . The age distribution was 3 evaluated 2 years ( 7.02% ), 4 evaluated at 3 years ( 19.85 %) , assessed 14 4 years ( 42.42 %) and 12 evaluated -5 ( 36.36 %). Conclusions : the detection of initial caries lesions is complex , due to the fact that traditionally has been used detection system WHO. , Dental professionals are not trained to detect non-cavitated lesions , including non- carious lesions is necessary cavitated caries records , as these lesions can be stopped through preventive management , this reduces significantly the economic costs and biological restorative treat-ments , should promote the dissemination of new assessment systems of dental caries in universities and refresher courses for professionals. (AU)

Modelo experimental de cárie dentária como ferramenta educativa em escolares / Experimental model of tooth decay as an educational tool for school-age children / Modelo experimental de caries dentarias como herramienta educativa en escolares

Objetivo Objetivou-se a constituiu na construção de um modelo educativo sobre o desenvolvimento da Cárie Dentária por meio de uma adaptação do experimento de Miller. Método Em um recipiente de vidro esterilizado e fechado coletou-se a saliva de doadores e acrescentou-se substrato à base de açúcar (sacarose). Somou-se ao conjunto um dente humano extraído pelo tratamento odontológico com a coroa dental hígido. A fase I teve o controle negativo (dente + saliva sem aporte de sacarose) e sendo os demais abertos especificamente após 01, 02, 03 e 04 meses da incubação, e esta serviu de parâmetro para delineamento da etapa seguinte. Na fase II foram necessários dois doadores de saliva. Nesta fase utilizaram-se doadores de saliva com baixos níveis de higiene bucal. A incubação dos dentes (definida pela fase I) foi 02 e 03 meses para cada doador. Resultado O registro do experimento fomenta um trabalho educativo sobre os riscos de desenvolvimento de cárie dentária, etiologia e evolução, de modo que possibilite a construção de uma cartilha explicativa sobre como reproduzir tal modelo experimental a ser trabalhada em escolares do ensino médio. Conclusão A realização desse tipo de trabalho juntos a escolares pode contribuir para diminuir as iniquidades em saúde bucal, especialmente porque há uma aproximação dos discursos, facilitando o processo de disseminação da informação.(AU)

Objective This work consisted of the construction of an educational in vitro model of dental caries that started with an adaptation of Miller's classic experiment. Methods In a sterilized and sealed glass jar, a sample paste of human saliva was collected and a substrate of manufactured sugar (sucrose) was added. In addition, a human tooth with healthy dental crown extracted in dental treatment but otherwise healthy was added. Research phase I had the negative control sample test (tooth + saliva without added) and the others were opened after 1, 2, 3 and 4 months of incubation. This phase was essential for the next experimental time development. In phase II, two saliva donors with poor levels of oral health habits were recruited. The incubation time (defined by phase I) was 2 and 3 months for each donor. Results This research data gives the possibility of building educational materials about the etiology of tooth decay and its clinical evolution. It also makes possible the production of an explanatory sheet about how to reproduce this experimental model to be used by school children in secondary education. Conclusions Doing this kind of work together at school can help reduce inequities in oral health, especially since there is an approximation toward the discourses, facilitating the process of information dissemination.(AU)

Objetivo El objetivo es la construcción de un modelo educativo en el desarrollo de la caries dental por medio de una adaptación del experimento de Miller. Métodos En recipientes de vidrio estériles sellados, se recoge saliva donada y se añade sustrato a base de azúcar (sacarosa). Después, se añade a la gama un diente humano extraído por el tratamiento dental con corona dental por lo demás sanos. La Fase I fue el control negativo (diente + saliva sin ingesta de sacarosa) y los demás se abrieron específicamente después de 01, 02, 03 y 04 meses de incubación. Esto sirvió como parámetro para la siguiente etapa del diseño. En la fase II tomó dos donaciones de saliva. En esta etapa se usan donantes de saliva con bajos niveles de higiene oral. La incubación de los dientes (definido por fase I) fue 2 y 3 meses por donante. Resultado El experimento promueve el trabajo educativo sobre el riesgo de desarrollar caries dental y su etiología y evolución con el fin de hacer posible la construcción de un folleto explicativo sobre cómo un modelo tan experimental para ser trabajado por los estudiantes de secundaria. Conclusión La realización de este tipo de trabajo juntos en la escuela puede ayudar a reducir las desigualdades en la salud bucal, sobre todo porque no es una aproximación de los discursos, lo que facilita el proceso de difusión de la información.(AU)

Caries prediction using the caries activity test with a sulfisomidine mixture: a 3-year follow-up study / 대한구강보건학회지

OBJECTIVES: The purpose of this study was to evaluate the prediction validity of the caries activity test with a sulfisomidine mixture (SAHS test). METHODS: This longitudinal follow-up study was conducted for 3 years. The subjects were 155 elementary schoolchildren. Oral examination was performed by examining each tooth surface of the subjects. The number of teeth with new caries lesions was calculated by comparing between the baseline data of the initial oral examination and the results of the second oral examination performed after 3 years. The Dentocult SM test was used as the reference in the analysis of the caries prediction validity of the SAHS test. The items of the validity test for carries prediction were as follows: sensitivity, specificity, predictive value, and likelihood ratio. RESULTS: The correlation between new caries lesions and the SAHS test scores was greater than that between new caries lesions and the Dentocult SM test scores. The receiver-operating analysis revealed that the area under the curve of the SAHS test was higher than that of the Dentocult SM test. The caries prediction validity of the SAHS test (grade 12) was as follows: sensitivity, 0.71-0.70; specificity, 0.60-0.58; positive predictive value, 0.79-0.78; negative predictive value, 0.49 (screening criterion 5). The SAHS test scores were similar to or higher than the scores in the items of the Dentocult SM test. CONCLUSIONS: The SAHS test is considered useful for clinical applications.

Detection of proximal caries using digital radiographic systems with different resolutions.

Background: Dental radiography is an important tool for detection of caries and digital radiography is the latest advancement in this regard. Spatial resolution is a characteristic of digital receptors used for describing the quality of images. Aim: This study was aimed to compare the diagnostic accuracy of two digital radiographic systems with three different resolutions for detection of noncavitated proximal caries. Settings and Design: Diagnostic accuracy. Materials and Methods: Seventy premolar teeth were mounted in 14 gypsum blocks. Digora® Optime and RVG Access were used for obtaining digital radiographs. Six observers evaluated the proximal surfaces in radiographs for each resolution in order to determine the depth of caries based on a 4‑point scale. The teeth were then histologically sectioned, and the results of histologic analysis were considered as the gold standard. Data were entered using SPSS version 18 software and the Kruskal–Wallis test was used for data analysis. P <0.05 was considered as statistically significant. Results: No significant difference was found between different resolutions for detection of proximal caries (P > 0.05). RVG access system had the highest specificity (87.7%) and Digora® Optime at high resolution had the lowest specificity (84.2%). Furthermore, Digora® Optime had higher sensitivity for detection of caries exceeding outer half of enamel. Judgment of oral radiologists for detection of the depth of caries had higher reliability than that of restorative dentistry specialists. Conclusion: The three resolutions of Digora® Optime and RVG access had similar accuracy in detection of noncavitated proximal caries.

Diagnosing non-cavitated lesions in epidemiological studies: practical and scientific considerations

Over the last decade, there has been growing interest in diagnosing non-cavitated lesions in epidemiological studies involving large numbers of preschool children, schoolchildren and young adults. In this context, assessment of lesions characteristics indicating whether or not there is ongoing mineral loss is also considered relevant. The reasoning sustained by these studies is that diagnosis of the caries process limited to the cavitated level is no longer in accordance with current state-of-the-art knowledge in cariology. This paper highlights one topic of the lecture entitled "Caries Process: Evolving Evidence and Understanding," presented at the 18th Congress of the Brazilian Association for Oral Health Promotion (Associação Brasileira de Odontologia de Promoção de Saúde - ABOPREV) in April 2013. In the framework of epidemiological studies, the interest in diagnosing active and inactive non-cavitated lesions was elucidated. However, relevant questions associated with the diagnosis of non-cavitated lesions that might raise concerns among researchers and health administrators were not addressed. The present paper aims to bring these questions into discussion. The contribution of this discussion in terms of developing the understanding of caries decline is analyzed by using data from a caries trends study of Brazilian preschool children residing in the Federal District of Brazil as an example. The inclusion of active and inactive non-cavitated lesions in the diagnosis of the caries process allowed us to demonstrate that, in Brazilian 1- to 5-year-old children, caries prevalence decreased significantly from 1996 to 2006, simultaneously with a reduction in the rate of caries progression.

Parafunciones y caries dentales en preescolares de comunidades pehuenches / Parafunctions and decay in preschool children from pehuenches communities

Introducción: las parafunciones bucales son consideradas uno de los factores causales de los trastornos temporomandibulares que han tomado mucha relevancia en las últimas décadas, especialmente en poblaciones infanto-juveniles, aunque la evidencia en preescolares es escasa y nula en grupos indígenas. El objetivo del presente estudio es determinar la prevalencia de parafunciones bucales y presencia de caries en preescolares de comunidades pehuenches, de la comuna de Alto Biobio, la más pobre de Chile, así como su posible relación con características etnodemográficas y socioeconómicas. Métodos: se tomó una muestra que estuvo conformada por 71 niños de 2 a 5 años los cuales asisten a jardín infantil. Se contó con la autorización de las autoridades locales y el consentimiento informado de los padres. Se evaluaron variables socio-etnodemográficas, presencia de caries en dientes temporales (índice ceod) de acuerdo con los criterios de la Organización Mundial de la Salud y la presencia de 8 parafunciones bucales: succión digital, de objetos, de mamadera, de chupete, labial, interposición lingual, onicofagia y respiración bucal mediante encuesta a las educadoras de los jardines. Resultados: el 9,86 por ciento de preescolares estaba libre de caries y el ceod fue 6,83 ± 4,65, lo que aumenta con la edad, 2,8 (a los 2 años) y 8,23 (a los 5 años). El promedio de parafunciones bucales por preescolar fue 1,73 ± 1,06, significativamente mayor en mujeres, pehuenches y preescolares de extrema pobreza. La prevalencia para alguna de las 8 parafunciones bucales fue de 90,86 por ciento y 77,46 por ciento para las asociadas a succión. Las más prevalentes son succión de mamadera y labial (26,76 por ciento), onicofagia (29,58 por ciento) y succión digital (47,89 por ciento). Conclusiones: la presencia de caries en estos preescolares es muy alta, mientras que la prevalencia de parafunciones bucales es similar a otras poblaciones, lo que afecta más a preescolares de extrema pobreza y pehuenches, posiblemente relacionado con las condiciones de vulnerabilidad social de la comuna. Estos resultados resaltan la urgencia de implementar medidas promocionales, preventivas y terapéuticas en esta población(AU)

Introduction: Oral parafunctions are considered one of the causal factors of temporomandibular disorders and have gained importance in recent decades, especially in child and young populations, although evidence is scarce in the preschool children and nonexistent in the indigenous groups. The objectives of this study were to determine the prevalence of oral parafunctions and the presence of caries in pehuenche preschool children, from Alto Biobio commune , the poorest one in Chile, as well as the possible association of the ethnodemographic and the socioeconomic characteristics. Methods: A sample comprised 71 children from 2 to 5 years attending kindergarten; the permission of local authorities and the informed consent of parents were granted. Socio-ethno-demographic variables, decay presence in primary teeth (dmft index) according to WHO criteria and the presence of 8 oral parafunctions: finger sucking, object sucking, sucking on bottle, pacifier and lip sucking, tongue thrust, onychophagia and mouth breathing, were all evaluated through a survey made to kindergarten educators. Results: Of the studied children, 9.86 percent were caries-free and the dmft index was 6.83 ±4.65, increasing with the age, hence, it was 2.8 at age 2 and 8.23 at age 5. Oral parafunctions average was 1.73 ±1.06 per child, significantly higher in women, pehuenches and extremely poor children. Prevalence for any of the 8 oral parafunctions was 90.86 percent and for those associated with non-nutritive sucking was 77.46 percent. The most prevalent were bottle and labial sucking (26.76 percent), onychophagia (29.58 percent) and finger sucking (47.89 percent). Conclusions: Decay presence in these preschool children is very high, whereas the prevalence of oral parafunctions is similar to that of other populations, affecting more children in extreme poverty setting and pehuenches. All this is possibly related to the social vulnerability of the commune. These results highlighted the urgent need of implementing preventive, promotional and therapeutic strategies in this population(AU)

Métodos de detecção de cárie / Methods of caries detection

A Odontologia contemporânea não deve restringir-se a identificar cavidades, mas, também, despertar para um diagnóstico precoce das lesões cariosas iniciais. Os mais diversos e modernos métodos de detecção de cárie vêm sendo desenvolvidos com objetivo de tornar mais preciso o diagnóstico de cárie dental. Os métodos de detecção mais utilizados são os convencionais, porém a associação dos métodos proporciona melhores resultados ao exame clínico tradicional isolado. Este estudo teve como propósito a revisão de literatura sobre os métodos de detecção da doença cárie disponíveis atualmente, baseados nos métodos radiográficos, fluorescência a laser e corrente elétrica.

The contemporary Odontology cannot be restricted to just identify cavities, but must be interested in an early diagnosis of caries lesions. Varied and modern methods of caries detection are being developed, aiming to turn the diagnosis of dental caries more accurate. The conventional methods are most used for detection, however, the association of methods offer better results to the clinician. The purpose of this paper was to do a literature review and to compare the methods of caries detection, based on radiographic methods, laser fluorescence and electric chain.

[Clinical comparison of dental caries by DMFT and ICDAS systems]

The common method of caries status evaluation is the number of decayed, missed and filled teeth [DMFT] index. Recently the International Caries Diagnosis and Assessment System [ICDAS] has been introduced for a detailed evaluation of the dental caries. The aim of this study was to evaluate the caries status with this new system while comparing it with the DMF index as a common method. A total of 110 dental students were selected randomly and examined. Examination was done in the dental unit under good light circumstances. First, all surfaces of the teeth were cleaned with a brush, rubber cup and prophylaxis paste and then rinsed. Subsequently, examination was performed in each person by two calibrated examiners according to DMFT system and ICDAS [evaluation of teeth status in occlusal and smooth surfaces in dry and wet situations according to codes of this system] and the information forms were completed. Chi square statistical test was used for data analysis. The mean DMFT was 7.16. According to ICDAS system nobody had 00 code meaning that at least one surface of 182 dental surfaces had a lesion. Only seven cases had codes 00-02. The results for codes 03 through 06 were as follow, respectively: 51, 49, 34, 2. Ninety nine cases had extracted or non-examinable teeth. The interexaminer kappa coefficient was 0.916. The new system, ICDASl, provides more accurate information than DMF for the investigators and epidemiologists. The DMFT number does not show any details about the dental status of the cases

Evaluation of caries-affected dentin with optical coherence tomography

The purpose of this study was to evaluate the degree of demineralization of artificially induced caries-affected human dentin by an in vitro microbiological method. The occlusal surfaces of 6 human molar teeth were abraded until a flat surface was obtained, and the enamel was removed to expose the occlusal dentin surface. These teeth were sectioned in 12 halves in the vestibular-lingual direction and divided into 3 groups according to the period length of the microbiological essay (n = 4): G1, 7 days; G2, 14 days; and G3, 21 days. The surfaces of all specimens were protected by an acid-resistant nail varnish, except for a window where the caries lesion was induced by a Streptoccocus mutans biofilm in a batch-culture model supplemented with 5 percent sucrose. The specimens were then analyzed by optical coherence tomography (OCT) with a super-luminescent light diode (Λ = 930 nm) with 6.0-µm lateral and longitudinal resolution (in the air). Qualitative and quantitative results (images and average dentin demineralization, respectively) were obtained. The mean demineralization depths were (µm) 235 ± 31.4, 279 ± 14, and 271 ± 8.3 in groups 1, 2, and 3, respectively. In addition, no significant change was observed in the lesion mean depth from 7 days of cariogenic challenge on. In conclusion, OCT was shown to be an efficient and non-invasive method to detect the depths of lesions caused by demineralization. Further, a seven-day demineralization time was considered sufficient for caries-affected dentin to be obtained.

Efficacy of CPP-ACP and CPP-ACPF on enamel remineralization - An in vitro study using scanning electron microscope and DIAGNOdent®.

Introduction: Remineralization as a treatment procedure has received a lot of attention both from clinicians as well researchers. The objective of this in vitro study was to find out the efficacy of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF) in remineralizing enamel surface on which artificial caries lesion had been created. The changes were analyzed using DIAGNOdent® (KaVo) and scanning electron microscope (SEM). Materials and Methods: Ninety maxillary premolars were selected and divided into three groups of 30 teeth each: A (artificial saliva), B (CPP-ACP), and C (CPP-ACPF). All the samples were assessed using DIAGNOdent® at the baseline and after demineralization and remineralization. Three samples were randomly selected from each group after remineralization for surface evaluation using SEM. Results: Statistical analysis showed that group B {CPP-ACP (4.1±1.8)} and group C {CPP-ACPF (4.8±1.2)} had a significantly higher amount of remineralization than group A (1.7±0.7). Conclusion: All the three groups showed a statistically significant amount of remineralization. However, because of the added benefit of fluoride (NaF 0.2%), CPP-ACPF (Tooth Mousse-Plus®) showed marginally more amount of remineralization than CPP-ACP (Tooth Mousse®).

Therapeutic potential of Brazilian fluoride varnishes: an in vivo study

The aim of this study was to assess in vivo the therapeutic effect of three fluoride varnishes available in the Brazilian market on the performance of white spot lesions (WSL). The sample included 36 children aged 7 to 13 years old, with a total of 67 active WSL in permanent anterior teeth. The children were randomly divided into 3 groups, according to fluoride varnish used: FL- Fluorniz (n=24), DUO - Duofluorid XII (n=22) and DF - Durafluor (n=21). Maximum WSL dimensions (mesiodistal and incisogingival) were measured in millimeters by a previously calibrated single examiner using a periodontal probe. WSL were also assessed regarding lesion activity. Initial and final S-OHI (Simplified Oral Hygiene Index) scores were recorded. Pearson's chi-square test revealed no statistically significant differences (p>0.05) in the performance of the varnishes. At the end of the 5th week, FL had 6 active and 18 inactive WSL; DUO had 7 active and 15 inactive WSL; and DL had 6 active and 15 inactive WSL. Taking into account all lesions, there was a 45.7 percent reduction in WSL dimensions. Paired Student's t-test revealed a statistically significant difference (p<0.05) between the initial size (1.88) and final size (1.02). After four applications, all varnishes obtained similar clinical results.

O propósito do presente estudo foi avaliar in vivo o efeito terapêutico de 3 vernizes fluoretados disponíveis no mercado brasileiro em lesões de mancha branca (MB). A amostra foi composta de 36 crianças entre 7 e 13 anos, portadoras de 67 MB ativas em elementos dentários permanentes anteriores. As crianças foram divididas aleatoriamente em 3 grupos FL - Fluorniz (n=24), DUO - Duofluorid XII (n=22) e DF - Durafluor (n=21). A dimensão máxima da MB (mésio-distal e cérvico-incisal) foi mensurada em milímetros por um único examinador previamente calibrado através de uma sonda periodontal. Em adição, foi verificada a atividade da MB. O IHO-S (Índice de Higiene Oral Simplificado) inicial e final foi registrado. O teste do qui-quadrado de Pearson mostrou não existir diferença estatisticamente significante (p>0,05) no comportamento dos vernizes estudados. No final da 5ª semana o FL apresentava 6 MB ativas e 18 inativas, DUO 7 MB ativas e 15 inativas e DF 6 MB ativas e 15 inativas. Levando em consideração o grupo total, houve uma redução de 45,7 por cento da dimensão das manchas brancas. O teste T pareado revelou uma diferença estatisticamente significante (p<0,05) entre o tamanho inicial (1,88) e final (1,02). Após 4 aplicações, todos os vernizes apresentaram resultados clínicos semelhantes.

Correlação entre a avaliação microscópica e a leitura por laser fluorescência de lesões de manchas brancas em dentes bovinos: estudo in vitro / Correlation between the microscopic evaluation and reading by laser fluorescence of enamel decalcification in bovine teeth: in vitro study

Objetivo: avaliar a correlação entre as leituras de descalcificação artificial de esmalte in vitro por meio do DIAGNOdent® e pela microscopia óptica com luz polarizada. Metodologia: foram utilizados 25 dentes bovinos que foram expostos a um meio artificial de cáries por uma hora, duas vezes ao dia, por 35 dias. Em seguida, procedeu-se as leituras das fluorescências utilizando o aparelho laser DIAGNOdent®. Foram registradas as leituras das áreas sem descalcificação (para calibração) e as áreas desmineralizadas artificialmente. Após as leituras da fluorescência, as regiões de leitura por laser foram cortadas em secções de aproximadamente 400μm e avaliadas por meio da microscopia de luz polarizada. Resultados: demonstraram que, embora com algum grau de variação, o sistema DIAGNOdent® foi capaz de detectar as descalcificações semelhantemente àqueles reconhecidos por microscopia de luz polarizada, estabelecendo um padrão razoável de equivalência de leituras. Conclusão: os valores médios encontrados para o DIAGNOdent® demonstraram um coeficiente de correlação de Pearson de 0,63 com relação aos valores das leituras microscópicas.

Aim: evaluate the correlation between the artificial in vitro enamel decalcification through DIAGNOdent® laser and through optic microscopic with polarized light. Methodology: for this research, 25 bovine teeth had been exposed to an artificial decay environment during one hour, two times a day, for 35 days. After wards, DIAGNOdent® laser has been used to read the fluorescence from the enemel areas without decalcification (for calibration) and to evaluate the non-mineralized artificially. After the fluorescence readings regions of laser read were cut into sections of about 400μm and evaluated by polarized light microscopy. Results: the results had demonstrated that, even with some degree of variation, the DIAGNOdent® system was capable of recognizing the decalcification, establishing regular equivalence of standard readings such as light polarized microscopy. Conclusion: the average values found for DIAGNOdent® laser had demonstrated a 0,63 coefficient of correlation of Pearson to the values of microscopically readings.

Validity and reliability of methods for the detection of secondary caries around amalgam restorations in primary teeth

Secondary caries has been reported as the main reason for restoration replacement. The aim of this in vitro study was to evaluate the performance of different methods - visual inspection, laser fluorescence (DIAGNOdent), radiography and tactile examination - for secondary caries detection in primary molars restored with amalgam. Fifty-four primary molars were photographed and 73 suspect sites adjacent to amalgam restorations were selected. Two examiners evaluated independently these sites using all methods. Agreement between examiners was assessed by the Kappa test. To validate the methods, a caries-detector dye was used after restoration removal. The best cut-off points for the sample were found by a Receiver Operator Characteristic (ROC) analysis, and the area under the ROC curve (Az), and the sensitivity, specificity and accuracy of the methods were calculated for enamel (D2) and dentine (D3) thresholds. These parameters were found for each method and then compared by the McNemar test. The tactile examination and visual inspection presented the highest inter-examiner agreement for the D2 and D3 thresholds, respectively. The visual inspection also showed better performance than the other methods for both thresholds (Az = 0.861 and Az = 0.841, respectively). In conclusion, the visual inspection presented the best performance for detecting enamel and dentin secondary caries in primary teeth restored with amalgam.

Detecção e avaliação da atividade de lesões de cárie primária e secundária em superfícies oclusais: estudos in vitro e in vivo / Detection and activity assessment of primary and secondary caries on occlusal surfaces. In vitro and in vivo studies

O objetivo do presente estudo foi avaliar a efetividade de métodos empregados na detecção e na avaliação da atividade de lesões de cárie primárias e secundárias em superfícies oclusais de dentes decíduos e permanentes. Para tanto, foram realizadas quatro pesquisas. (1) O objetivo desta pesquisa foi avaliar in vitro a influência de métodos de profilaxia profissional nas medidas de fluorescência e no desempenho de três aparelhos baseados na captação da fluorescência induzida por luz na detecção de lesões de cárie oclusal em dentes permanentes. Os exames foram realizados em 110 dentes permanentes por dois examinadores no início, após a profilaxia profissional e lavagem e após uma segunda lavagem. Foram utilizados os aparelhos DD (DIAGNOdent 2095, KaVo, Alemanha), DDpen (DIAGNOdent 2190, KaVo, Alemanha) e VP (VistaProof, Dürr Dental, Alemanha). Os dentes foram aleatoriamente distribuídos de acordo com o método de profilaxia profissional empregado: jato de bicarbonato de sódio ou pasta profilática. Pode-se concluir que a escolha do método de profilaxia professional pode influenciar significativamente as medidas de fluorescência e o desempenho de métodos baseados na captação da fluorescência induzida por luz na detecção de lesões de cárie oclusal. (2) O objetivo deste estudo in vivo foi determinar os pontos de corte ideais para o DD, o DDpen e a VP, e avaliar a validade clínica de métodos convencionais e de métodos baseados na captação da fluorescência induzida por luz na detecção de lesões de cárie oclusal em dentes permanentes. Foram selecionados 105 dentes permanentes posteriores indicados para extração em 88 pacientes adultos. Um examinador experiente avaliou os dentes usando métodos baseados na captação da fluorescência induzida por luz (DD, DDpen e VP), ICDAS e exame radiográfico (Rx). Pode ser concluído que o ICDAS...

The aim of this study was to evaluate the effectiveness of methods for caries detection and caries activity assessment on occlusal surfaces of primary and secondary caries in deciduous and permanent teeth. For this reason, four studies were carried out: (1) The aim of this study was to evaluate the effects of professional prophylaxis procedures on fluorescence measurements and on three fluorescence-based devices in detecting occlusal caries in permanent teeth. All assessments were performed in 110 permanent teeth by two examiners at baseline, after professional prophylaxis and rinsing, and after a second rinsing. The devices LF (DIAGNOdent 2095, KaVo, Germany), LFpen (DIAGNOdent 2190, KaVo, Germany) and FC (VistaProof, Dürr Dental, Germany) were used. The teeth were randomly divided according to the professional prophylaxis used: sodium bicarbonate jet or prophylaxis paste. It can be concluded that the choice of professional prophylaxis method can significantly influence the fluorescence measurements and the performance of fluorescence-based methods for detection of occlusal caries. (2) This in vivo study proposed clinical cut-off limits for three fluorescence based methods and evaluated the validity of conventional and fluorescencebased methods for occlusal caries detection in permanent teeth. A total of 105 posterior permanent teeth with an indication for extraction were selected in 88 adult patients. One experienced examiner assessed the teeth using fluorescence-based methods (LF, LFpen and FC), ICDAS and bitewing radiographs (BW). It can be concluded that ICDAS, LF and LFpen demonstrated good validity in detecting occlusal caries in vivo. However, BW and FC showed the lowest validity to detect all lesions and dentin lesions, respectively. Besides, the fluorescence-based methods cut-off limits should not be considered as exact thresholds for dentists’...