Urinary fluoride output in children following the use of a dual-fluoride varnish formulation

OBJECTIVE: This study evaluated the bioavailability of fluoride after topical application of a dual-fluoride varnish commercially available in Brazil, when compared to DuraphatTM. MATERIAL AND METHODS: The urinary fluoride output was evaluated in seven 5-year-old children after application of the fluoride varnishes, in two different phases. In the first phase (I), children received topical application of the fluoride varnish Duofluorid XII (2.92 percent fluorine, calcium fluoride + 2.71 percent fluorine, sodium fluoride, FGM TM). After 1-month interval (phase II), the same amount (0.2 mL) of the fluoride varnish Duraphat (2.26 percent fluorine, sodium fluoride, ColgateTM) was applied. Before each application all the volunteers brushed their teeth with placebo dentifrice for 7 days. Urinary collections were carried out 24 h prior up to 48 h after the applications. Fluoride intake from the diet was also estimated. Fluoride concentration in diet samples and urine was analyzed with the fluoride ion-specific electrode and a miniature calomel reference electrode coupled to a potentiometer. Data were tested by ANOVA and Tukey's post hoc test (p<0.05). RESULTS: There were significant differences in the urinary fluoride output between phases I and II. The use of Duofluorid XII did not significantly increase the urinary fluoride output, when compared to baseline levels. The application of Duraphat caused a transitory increase in the urinary fluoride output, returning to baseline levels 48 h after its use. CONCLUSIONS: The tested varnish formulation, which has been shown to be effective in in vitro studies, also can be considered safe.

Urinary fluoride excretion in children exposed to fluoride toothpaste and to different water fluoride levels in a tropical area of Brazil

The aim of this study was to evaluate the urinary fluoride excretion of 2- to 7-year-old children exposed to different water fluoride concentrations in the city of Catolé do Rocha, PB, Brazil. Forty-two children were allocated to 3 groups according to the concentration of fluoride in the water: G1 (n=10; 0.5-1.0 ppm F), G2 (n=17; 1.1-1.5 ppm F) and G3 (n= 15; >1.51 ppm F). The study was carried out in two 1-week phases with 1-month interval between the moments of data collection: in the first phase, the children used a fluoride toothpaste (FT) (1,510 ppm F) for 1 week, whereas in the second phase a non-fluoride toothpaste (NFT) was used. The urine was collected in a 24-h period in each week-phase according to Marthaler's protocol. The urinary fluoride excretion data expressed as mean (SD) in µg/24 h were: G1-FT= 452.9 (290.2); G1-NFT= 435.1 (187.0); G2-FT= 451.4 (224.0); G2-NFT= 430.3 (352.5); G3-FT=592.3 (390.5); and G3-NFT=623.6 (408.7). There was no statistically significant difference between the water fluoride groups, and regardless of the week phase (ANOVA, p>0.05). The use of fluoride toothpaste (1,510 ppmF) did not promote an increase in urinary fluoride excretion. There was a trend, though not significant, as to the increase of urine fluoride concentration in relation to fluoride concentrations in the water. The excretion values suggest that some children are under risk to develop dental fluorosis and information about the appropriate use of fluoride is necessary in this area.

O objetivo desse estudo foi verificar o padrão de excreção urinária de fluoretos em crianças de 2 a 7 anos, de ambos os gêneros, moradoras do Sertão da Paraíba, divididas em três grupos conforme concentração de fluoretos nas águas: G1 (0,5-1,0 ppmF); G2 (1,1-1,5 ppmF) e G3 (>1,51 ppmF). O estudo foi desenvolvido em duas etapas: a primeira (n=42) com a utilização de dentifrício fluoretado (1510 ppmF) (DF) durante uma semana e a segunda (n=34) com dentifrício sem fluoretos (DSF), com intervalo de um mês entre as coletas. A urina foi coletada em 24 horas seguindo a metodologia de Marthaler. Não foi observada diferença significante entre os grupos estudados e excreção urinária de fluoretos em ambas etapas. A excreção urinária de fluoretos em µg/24 h (média e desvio padrão) foram: G1-DF= 452,9 (290,2); G1-DSF= 435,1 (187,0); G2-DF= 451,4 (224,0); G2-DSF= 430,3 (352,5); G3-DF= 592,3 (390,5); G3-DSF= 623,6 (408,7). Observou-se uma tendência, embora não significativa, quanto ao aumento nas concentrações de fluoretos na urina em relação as concentrações na água de consumo. Os valores de excreção sugerem que algumas crianças estão sob o risco de desenvolver fluorose dentária e orientação sobre o uso apropriado de flúor é necessária nesta área.

Urinary fluoride excretion in children aged 3 to 5 years exposed to fluoridated salt at 60 to 90 mgF/Kg in two Venezuelan cities: a pilot study

Streptococcus mutans es el principal microorganismo asociado a la caries dental, esta bacteria se une al esmalte a través de su interacción con las proteínas de la película adquirida yla proteína de superficie celular comúnmente denominada PAc. Por lo menos dos sitios de PAc interactúan in vitro con los receptores salivales, uno está dentro de la región más conservadade esta proteína que comprende los residuos de 816-1213 y el otro dentro de la secuencia rica en Alanina, residuos186-469. El objetivo del presente trabajo fue establecer similitudes o diferencias en la interacción de péptidos de PAc con los componentes salivales de individuos con y sin experiencia de caries, para lo cual se tomaron muestras de saliva por salivación espontánea de 20 individuos con caries y 20 sin caries. A partir de las muestras de saliva se extrajeron las proteínas de la película adquirida (PA) utilizando hidroxilapatitasintética y fueron sometidas a la interacción con tres péptidos sintéticos de los segmentos de unión de PAc con loscomponentes salivales: PAc (301-319), PAc (365-377) y PAc (1024-1044). Los resultados muestran una baja interacción entre los componentes de la PA y los péptidos en todos losindividuos, sugiriendo que con base en las similitudes entre los individuos sanos y los individuos con la enfermedad lospéptidos de PAc estudiados no son relevantes en la adhesión inicial de S. mutans.

Urinary fluoride levels in children in a single school in Trinidad and Tobago: a preliminary investigation

OBJECTIVE: To determine urinary fluoride levels in school children in a non-fluoridated area in Trinidad and Tobago. METHOD: Morning urine samples were requested from 750 children aged 5 to 14 years, attending a primary school in the area of St Joseph, north west Trinidad. Urine was collected at home and brought to school in labelled plastic bottles. Urinary fluoride concentration (ppm) was measured using an ion-specific electrode. RESULTS: Urine samples were available for 500 children (67). Mean age was 8.5 years. Overall mean fluoride concentration was 0.5 ppm +/- standard deviation (SD) 0.27; males (n = 263) were 0.58 ppm +/- 0.28 and females (n = 237) 0.55 ppm +/- 0.27. Children in the 5 to 7-year age group had the highest levels (0.64 ppm +/- 0.33). CONCLUSION: Mean urinary fluoride levels in this sample of school children were low indicating a fluoride intake below the optimum level for caries prevention. Fluoridation programmes may need to be implemented to increase fluoride intake among school children in the study area.

Urinary fluoride levels and prevalence of dental fluorosis in children of Jhajjar District, Haryana.

A study was conducted in the Jhajjar district of Haryana to assess the fluoride excretion in the population exposed to environmental fluoride and efforts were being made to correlate the results with dental fluorosis. The mean fluoride concentration in drinking water samples of Bahadurgarh, Beri, Jhajjar, Matanhail and Sahalawas blocks of Jhajjar district were 2.05 mg/L, 2.14 mg/L, 2.05 mg/L, 2.14 mg/L and 1.93 mg/L respectively. The mean urinary fluoride concentration was 1.58 mg/L in Bahadurgarh, 1.48 in Beri, 1.50 in Jhajjar, 1.51 in Matanhail and 1.56 in Sahalawas. The mean prevalence of fluorosis on the basis of stage of dental fluorosis was highest of yellowish brown type and on the basis of TSIF score, score 4 type fluorosis was highest in most of the blocks of Jhajjar district. The study revealed that more than 50% of the individuals were found to be affected with flurosis in this district.

Fluorosis en dentición temporal en un área con hidrofluorosis endémica / Dental fluorosis in primary dentition in an endemica hydrofluorosis area

Objetivo. Determinar la prevalencia de fluorosis dental en la población infantil de la ciudad de San Luis Potosí, y su asociación con la concentración de flúor en agua de consumo y de orina. Asimismo, desarrollar, validar y probar un índice específico para fluorosis en dentición temporal. Material y métodos. Se efectuó un estudio transversal analítico, de mayo de 1997 a enero de 1999, en tres jardines de niños, seleccionados al azar, en tres áreas de riesgo en San Luis Potosí. Se seleccionaron 100 niños de edades entre tres y seis años. El índice específico de fluorosis para dientes temporales fue validado mediante la cuantificación de concentraciones de flúor en esmalte de dientes con y sin fluorosis. Para estimar la asociación entre las concentraciones de flúor en agua y orina y el grado de fluorosis dental se utilizó la prueba estadística Kruskal-Wallis. En el caso de la asociación entre el área de riesgo y el desarrollo de fluorosis dental se utilizó c2 de Mantel-Haenszel. Resultados. La prevalencia de fluorosis en dentición temporal fue de 78 por ciento, la cual tuvo patrones diferentes de presentación, siendo los dientes posteriores los más afectados en ambos maxilares y la coloración predominante fue blanco mate. Se encontró una correlación (r=0.93) entre la concentración de flúor en esmalte de dientes temporales y el índice de fluorosis para dentición temporal (IFDDT). Se encontraron asociaciones entre la concentración de flúor en el agua de consumo y orina con el grado de fluorosis dental (Kruskal-Wallis, p=0.00001) y entre el área de riesgo y el grado de fluorosis (c2 de Mantel-Haenszel p=0.00001). Conclusiones. El IFDDT identifica y gradúa adecuadamente la fluorosis en dentición temporal. Es importante detectar el primer efecto tóxico de exposición a flúor para ser usado como predictor de fluorosis en dentición permanente y fluorosis esquelética.

Concentração de fluoreto da urina em função da presença de cimento de ionômero de vidro na cavidade bucal / Urine fluoride concentration in the presence of glass ionomer cement in oral cavity

O presente estudo procurou verificar se há alteração da razão fluoreto/creatinina a nível urinário de 23 crianças, com idades compreendidas entre 7 a 12 anos, que tiveram seus dentes obturados, conforme a técnica do tratamento restaurador atraumático (ART). A média das superfícies obturadas foi de 0,761 ± 0,571 cm². Durante o período do estudo, as crianças mantiveram seus hábitos de higiene bucal e de alimentação, não fazendo uso de produtos fluoretados utilizados em aplicação profissional. Para a avaliação da concentração do fluoreto, de cada participante do estudo, foi colhido o volume total da primeira urina do dia anterior à restauração dos seus dentes, e do terceiro, do sétimo e do trigésimo dia após este ato. Os métodos do Eletrodo-Ion-Seletivo e da Cromatografia de Ion foram utilizados para a análise dos níveis de fluoreto; enquanto que para a análise dos teores de creatinina, utilizou-se a espectrofotometria. O teste não paramétrico de Kruskal-Wallis foi aplicado na avaliação dos resultados, não sendo detectada qualquer alteração dos níveis do fluoreto urinário, em função da presença de cimento de ionômero de vidro na cavidade bucal dos respectivos participantes. Diante desta conclusão é reconhecida a necessidade de um estudo nesta área, particularmente com vistas à ocorrência de fluorose

Haemodynamic, early recovery and renal function effects of desflurane anasesthesia in renal transplant

Twenty adult patients scheduled for liver related renal transplant with ASA physical status III were randomly allocated into two groups; desflurane and isoflurane, each of 10 patients. All patients were optimized pre-operatively by haemodialysis, homeostasis and control of all reversible pathological parameters as high blood pressure, blood sugar and serum electrolytes. They were given midazolam i.m. premedication and received either desflurane or isoflurane in N2O/O2-fentanyl during inaintenance. Atracurium in mcremental doses was given as a muscle relaxant. Full haemodynamic monitoring started in the pre-anaesthesia room and continue perioperatively every 3min NIBP, 5-chest leads ECG, CVP [every 5-10 min], HR., Sp O2, end-t-CO2 and neuromuscular transmission. Patients were ventilated to normocarbic with a closed circuit using soda lime. Anaesthesia and operative times were recorded as well as recovery parameters times. Urine was examined for organic and inorganic fluorides and blood inorganic fluorides was measured also [at 0. 4, 24, 72h] and I, as well as full renal functions and urine volume and osmolarity were measured [at 0, 4, 24 and 192 h]. There was a significant early recovery in desflurane than isoflurane group, Heamodynamically there were no significant differences between the two groups although the response to surgical stimulation was better controlled in desflurane than isoflurane groups. Renal function was markedly improved after transplantation without significant differences between groups. There was a slight insignificant increase of serum inorganic and urinary organic and inorganic fluorides in isoflurane than desflurane groups. The low solubility and very minimal metabolism of desflurane make it a safe and reliable inhalational anaesthetic agent compared to isoflurane specially in high risk patients as renal transplant patients

Exposiçäo profissional aos anestésicos voláteis: 2. monitorizaçäo ambiental e monitorizaçäo biológica / Occupational exposure as volatile anesthetics: 2. physiologic and environmental monitoring

Säo apresentados vários aspectos da monitorizaçäo ambiental e monitorizaçao biológica, valores-limites propostos e resultados laboratoriais de amostras coletadas durante a realizaçäo de cirurgias.

Ingestión diaria de fluoruros en niños de 10 a 12 años de un internado de primaria y su relación con la excreción urinaria / Daily fluoride intake in children aged 10-12 years in a primary school and its relation with urinary excretion

Se determinaron los niveles de fluoruros ingeridos mediante el agua y alimentos por 5 niños de 10 a 12 años de un internado de primaria en Ciudad de la Habana durante 3 días, y se midió la excreción urinaria de fluoruros en 3 grupos de niños utilizando 3 métodos diferentes para la colección de las muestras de orina. Se compararon entre sí los resultados obtenidos en los diferentes métodos y estos con los niveles de ingestión de fluoruros mediante el agua y los alimentos. Se concluyó que el nivel de ingestión diaria de fluoruros en la población estudiada es bajo y que los resultados de las muestras de orina están influidos por el momento del día en que se toman

Avaliaçäo toxico-epidemiológica da exposiçäo ambiental da populaçäo infantil do município de Cubatäo (Säo Paulo, Brasil) ao fluoreto / Toxico-epidemiological evaluation of environmental exposure of the infantilee population in Cubatäo District (Säo Paulo, Brazil) to fluoride

Foram analisadas, no período de outubro a dezembro de 1983, amostras de urina de 271 crianças, com idades variando de 4 a 5 anos, matriculadas em Escolas de Educaçäo Infantil (EMEIs) de Cubatäo, a fim de se determinar a concentraçäo do íon fluoreto (F) urinário. As análises foram processadas separadamente; por escola, visando-se correlacionar entre sí os níveis de exposiçäo ambiental aos fluoretos dos diferentes grupos populacionais tomados, pelo fato de as fontes emissoras do agente químico se localizarem a distâncias distintas das EMEIs e estas refletirem as áreas de moradia das crianças. Os valores médios de fluorúria variaram de 0,23 mg/L na EMEI- Estado do Rio de Janeiro I (Cota 200) a 1,26 mg/L na EMEI-Jardim Casqueiro (Jardim Casqueiro). A variaçäo dos valores individuais foi de 0,12 mg/L na EMEI- Estado do Rio de janeiro I a 2,60 mg/L na EMEI- Jardim Casqueiro. Os resultados säo amplamente discutidos