Color evaluation of white spot lesions treated with resin infiltration after water or grape juice storage

Aim: To evaluate the color stability of bovine enamel with artificial white spot lesions treated with resin infiltration (ICON) or remineralization with fluoride using two storage methods. Methods: Sixty incisors were submitted to artificial white spot lesion induced by demineralization-remineralization (DE-RE) cycling. Initial color was evaluated with CIE-Lab to measure ΔEab. Demineralized teeth were divided according to the treatment of the white spot lesion (n = 20): 1) Remineralization with 2% neutral fluoride gel for 4min (control); 2) ICON application following manufacturer's recommendations; and 3) ICON with decreased drying time after the application of ethanol. After 24h, color was evaluated and samples were subdivided (n = 10) according to storage: 1) distilled water for 1 month; 2) grape juice for 10min daily. After storage, color was evaluated. L*, a* and b* data were analyzed by one-way ANOVA and ∆Eab data by two-way ANOVA followed by Tukey's HSD (α = 0.05). Results: L* was affected by juice storage, and decreased when ICON was applied with decreased drying time after the ethanol application. The same behavior occurred with a* (increase with reduced drying time), while b* was not affected. For ∆Eab significant differences were observed between groups (p = 0.0219) and storage methods (p = 0.0007). There was no interaction effect (p = 0.1118). Remineralization with fluoride presented the lowest color changes after storage in water. Conclusion: Treatment of artificial carious lesions with resin infiltration presented greater color changes than fluoride remineralization after storage in both solutions in vitro

Analysis of the antimicrobial and anti-caries effects of TiF4 varnish under microcosm biofilm formed on enamel

Abstract Titanium tetrafluoride (TiF4) is known for interacting with enamel reducing demineralization. However, no information is available about its potential antimicrobial effect. Objectives This study evaluated the antimicrobial and anti-caries potential of TiF4 varnish compared to NaF varnish, chlorhexidine gel (positive control), placebo varnish and untreated (negative controls) using a dental microcosm biofilm model. Material and Methods A microcosm biofilm was produced on bovine enamel previously treated with the varnishes, using inoculum from human saliva mixed with McBain saliva, under 0.2% sucrose exposure, for 14 days. All experiments were performed in biological triplicate (n=4/group in each experiment). Factors evaluated were: bacterial viability (% dead and live bacteria); CFU counting (log10 CFU/mL); and enamel demineralization (transverse microradiography - TMR). Data were analysed using ANOVA/Tukey's test or Kruskal-Wallis/Dunn's test (p<0.05). Results Only chlorhexidine significantly increased the number of dead bacteria (68.8±13.1% dead bacteria) compared to untreated control (48.9±16.1% dead bacteria). No treatment reduced the CFU counting (total microorganism and total streptococci) compared to the negative controls. Only TiF4 was able to reduce enamel demineralization (ΔZ 1110.7±803.2 vol% μm) compared to both negative controls (untreated: ΔZ 4455.3±1176.4 vol% μm). Conclusions TiF4 varnish has no relevant antimicrobial effect. Nevertheless, TiF4 varnish was effective in reducing enamel demineralization under this model.

Diagnóstico diferencial entre periodontite apical e cisto do ducto nasopalatino: relato de caso / Differential diagnosis of apical periodontitis and nasopalatine duct cyst: case report

A presença de uma alteração óssea periapical na região anterior da maxila, mais precisamente entre os incisivos superiores, pode ser erroneamente confundida com uma periodontite apical (AP) ou um cisto do ducto nasopalatino (CDNP). O diagnóstico diferencial é de suma importância para definir o tratamento adequado. O exame clínico, mais especificamente o teste de sensibilidade pulpar, é de suma importância, pois dentes portadores de periodontite apical não respondem ao teste, diferentemente dos casos de cisto do ducto nasopalatino. Uma paciente com 48 anos de idade, sexo feminino, compareceu à clínica de Endodontia com inchaço na região de palato e fundo de sulco anterior, relatando dor aguda ao redor dos incisivos centrais, sendo submetida a exames clínicos e radiográficos. Os exames clínicos mostraram ausência de vitalidade pulpar e as radiografias evidenciaram uma área radiolúcida simétrica na região de linha média, que poderia ser uma lesão endodôntica ou um CDNP. Durante o tratamento endodôntico, foi observada comunicação entre o canal radicular e a lesão periapical, sugerindo uma lesão de origem endodôntica. O tratamento endodôntico foi realizado e, após oito meses de acompanhamento, foi possível observar regressão da lesão. Este caso evidencia a importância de um diagnóstico diferencial preciso entre PA e CDNP, para planejar o tratamento adequado e favorecer o reparo dos tecidos periodontais.