Effect of Different Preparations of Fluoride Gel on Salivary pH of Albino Rats

Abstract Objective: To evaluate the effect of different preparations of fluoride gels on the salivary pH of albino rats. Material and Methods: This experimental study consisted of 40 Albino rats randomly divided into four equal groups. Group A was the control group and received no intervention. Experimental group B received a topical application of 0.2% sodium fluoride gel. Experimental group C received topical application of stannous fluoride gel 0.4%. Experimental group D received topical application of APF gel (1.23% acidulated phosphate fluoride gel). The different preparations of the gels were applied once daily for 4 minutes on the occlusal surface of the right maxillary molars for 14 days. Salivary pH values were recorded immediately after the application of gels with the help of pH paper on day 1 and day 14. Results: There was a significant difference in the pH level of groups B, C and D after 14 days of fluoride application (p < 0.05). The non-parametric Kruskal Wallis test was applied for the comparison between the groups. Conclusion: This study concluded that all the fluoride gels after administration caused the acidic pH of saliva with the most acidic effect produced by APF gel (AU).

Efficacy of 1. 23% acidulated phosphate fluoride gel on non-cavitated enamel lesions: a randomized clinical trial

Abstract: A randomized controlled parallel clinical trial was conducted to evaluate the efficacy of the association of 1.23% topical professional acidulated phosphate fluoride (APF) gel with oral hygiene and dietary instructions on the arrest of active non-cavitated lesions in permanent, mixed, and temporary dentition in children between 3 and 12 years of age. Ninety-eight caries-active children were randomly divided into two groups: a fluoride gel group (n = 49) and a non-fluoridated gel group (n = 49). Each group received up to eight weekly applications of gel, weekly professional toothbrushing with oral hygiene instructions and dietary counselling. Caries lesions were assessed qualitatively through visual-tactile criteria performed in three stages: initial, intermediate, and final. Regression models were applied to identify risk indicators for caries control. Between-group comparison regarding the time taken to arrest the lesions was performed using Chi-squared and Fisher's exact tests. Seventeen children did not receive the allocated intervention, and one was lost to follow-up (n = 80). There was no difference between the control and placebo groups regarding the time to the arrest of the lesion (p >.05). The treatments showed similar results without significant statistical difference (p = 0.33; 95%CI: 0.32-1.48). No adverse effects were observed. It can be concluded that no additional effect of the association of 1.23% APF gel with oral hygiene using fluoride dentifrice and dietary instructions on the arrest of active non-cavitated lesions could be established. We can also confirm the importance of toothbrushing frequency and, consequently, the visible plaque reduction in the control of caries activity. RBR-37V5S3

Análise da rugosidade superficial de uma resina composta tratada com gel fluoretado em diferentes pH / Surface roughness analysis of a composite treated with fluoridated gel at different pH

Objetivo: O flúor acidulado é utilizado no controle da doença cárie, mas seus efeitos na superfície de resinas compostas são controversos. O objetivo do estudo é avaliar a rugosidade superficial de uma resina composta após a aplicação tópica de flúor in vitro. Métodos: Espécimes de resina Vittra (FGM) foram preparados (8mmx1mm) e polidos. Após avaliação do pH de produtos fluoretados, o de maior e menor pH foram selecionados para os ex-perimentos. Foram testados três grupos experimentais (n = 15): grupo 1 ­ flúor gel acidulado a 1,23% (Nova DFL) (menor pH:4,48±0,32), grupo 2 ­ flúor gel neutro a 2% (Nova DFL) (maior pH:7,03±0,40), grupo 3 ­ sem exposi-ção ao flúor (controle negativo). O experimento simulou o protocolo padrão clínico de aplicação de flúor (uma aplicação por semana, durante um minuto, por quatro semanas). A rugosidade superficial foi mensurada antes e após o tratamento através de microscopia confocal e a característica superficial avaliada por imagens reconstru-ídas. Foi realizado teste ANOVA (post-hoc de Bonferroni) para comparar médias da rugosidade superficial entre grupos. Resultados: O grupo exposto ao flúor gel acidu-lado apresentou os maiores valores de rugosidade (Ra: 0,29±0,08), sendo maior que o grupo exposto ao gel neutro (Ra: 0,21±0,08) e controle (Ra: 0,23±0,05) (p < 0,05), que não apresentaram diferença estatística entre si. Conclusão: O grupo exposto ao flúor acidulado mostrou rugosidade superficial maior que o controle, porém essa diferença pode ser clinicamente irrelevante. Novos estudos são necessários para avaliar se tal alteração aumenta a adesão bacteriana e se a resina deve ser polida após aplicações tópicas de flúor.

Aim: Acidulated fluoride is widely used to control dental caries, however, its effects on composites surfaces are controversial. This study aimed to evaluate the surface roughness of a composite af-ter a fluoride topical application in vitro. Methods: Vittra (FGM) composite specimens were made (8mmx1mm) and polished. After pH evaluation of fluoridated products, the ones with the highest and lowest pH were selected for the experiments. Three experimental groups (n = 15) were tested: group 1 - 1.23% acidulated fluoride gel (Nova DFL) (pH: 4.48±0.32), group 2 - 2% neutral fluoride gel (Nova DFL) (pH: 7.03±0.40), group 3 - no fluoride exposure (negative control). The experiment simulated the standard clinical fluoride application protocol (one application of one minute per week,in four weeks). Surface roughness was measured before and after treatment by confocal microscopy and the surface characteristic evaluated by reconstructed images. ANOVA (Bonferroni post-hoc) test was performed to compare means of surface roughness between groups. Results: The group exposed to acidulated fluoride gel presented the highest values of roughness (Ra: 0.29±0.08), being larger than the group exposed to neutral fluoride gel (Ra: 0.21±0.08) and control (Ra: 0.23±0.05) (p < 0.05), which showed no statistical difference between them. Conclusion: It was concluded that the group exposed to acidula-ted fluoride showed greater surface roughness than the control group, but this difference appears to be clinically irrelevant. Further studies are needed to assess whether this change increases bacterial adhesion and whether the resin should be polished after topical fluoride applications.

Effect of different clinical applications on physico-mechanical properties of composite resins / Efeito de diferentes aplicações clínicas nas propriedades físico-mecânicas de resinas compostas

Although clinicians use fluoride agents to reduce the occurrence of caries, and surface sealing agents to protect composite restorations, the effects of these agents on composite resins have not yet been investigated. The goal of this study was to determine the effect of different surface applications (fluoride or surface sealant) on resin composites with different organic structures (Siloranes, Sonicfill, 3M Z550, Kalore). In this study, 120 discs and 120 bars made of composite resin were stored in water for three months before being thermally aged by cycling between 5°C and 55°C for 10,000 cycles. The discs were 15 mm in diameter and 1 mm thick; the bars were 25 × 2 × 2 mm. The surface sealant and fluoride were applied to the specimens, and evaluations were performed after 24h. Initial and final calculations were performed for flexural strength, microhardness, roughness, gloss, water sorption, and solubility. Silorane composite showed the lowest water sorption levels (p < 0.05) for both initial and aged groups. Silorane and SonicFill composite groups showed the lowest solubility (p < 0.05). Both before and after aging, the SonicFill group showed the highest values of flexural strength and microhardness. Silorane showed the highest roughness and lowest gloss values. Lower water sorption and solubility rates were seen on materials fabricated from hydrophobic monomers. High water sorption and solubility degrades the mechanical and surface properties. Fluoridation and surface sealant application can alter the surface properties but do not have any effect on the mechanical properties.

Embora os clínicos utilizem agentes de flúor para reduzir a ocorrência de cáries e agentes de vedação de superfície para proteger restaurações compostas, os efeitos desses agentes sobre as resinas compostas ainda não foram investigados. O objetivo deste estudo foi determinar o efeito de diferentes aplicações de superfície (fluoreto ou selante de superfície) em resinas compostas com diferentes estruturas orgânicas (Siloranes, Sonicfill, 3M Z550, Kalore). Neste estudo, 120 discos e 120 barras de resina composta foram armazenados em água por três meses antes de serem envelhecidos termicamente por ciclos alternados entre 5 °C e 55 °C por 10.000 ciclos. Os discos tinham 15 mm de diâmetro e 1 mm de espessura; as barras eram 25 × 2 × 2 mm. O selante de superfície e o flúor foram aplicados nos espécimes e as avaliações foram realizadas após 24 horas. Cálculos iniciais e finais foram realizados para resistência à flexão, microdureza, rugosidade, brilho, sorção de água e solubilidade. O compósito de silorano apresentou os menores níveis de sorção de água (p <0,05) para os grupos inicial e envelhecido. Os grupos compostos Silorane e SonicFill apresentaram a menor solubilidade (p <0,05). Tanto antes quanto depois do envelhecimento, o grupo SonicFill apresentou os maiores valores de resistência à flexão e microdureza. Silorane apresentou a maior rugosidade e menores valores de brilho. Baixas taxas de sorção e solubilidade da água foram observadas em materiais fabricados a partir de monômeros hidrofóbicos. A alta sorção e solubilidade da água degrada as propriedades mecânicas e de superfície. A fluoretação e a aplicação de selante de superfície podem alterar as propriedades da superfície, mas não afetam as propriedades mecânicas.

Effect of Fluoride Recharging on Fluoride Release and Surface Properties of Orthodontic Bracket Adhesives / 치위생과학회지

The aim of this study was to compare fluoride release and surface changes according to different orthodontic bracket adhesives the application of fluoride products. We used non-fluoridated composite resin Transbond fluoridated composite resins Blugloo and LightBond, resin-modified glass ionomer Rely XTM Luting 2, and conventional glass ionomer Fuji I®. Fluoride release of five orthodontic bracket adhesives and fluoride release ability after application of three fluoride products (1.23% acidulated phosphate fluoride gel, Tooth Mousse Plus®, Fluor Protector, and a toothbrush with sodium fluoride-containing toothpaste) were measured using a fluoride electrode that was connected to an ion analyzer. After 4 weeks of fluoride application, the surface roughness and surface morphology were examined using a surface roughness tester and field emission scanning electron microscopy. The amounts of fluoride release were observed not only on application of Tooth Mousse Plus® and Fluor Protector on resin-modified glass ionomer Rely XTM Luting 2 and Fuji I®, but also during tooth brushing using fluoride-containing toothpaste. After application of Tooth Mousse Plus®, except Transbond XT, the surface roughness increased, and all orthodontic adhesives showed a partial drop of micro-particle filler. On application of 1.23% acidulated phosphate fluoride gel on all orthodontic bracket adhesives, their surface roughness increased. To bond the orthodontic bracket, resin-modified glass ionomer Rely XTM Luting 2 and Fuji I® adhesives are highly recommended if the amount of fluoride release is considered to confer a preventative effect on dental caries, and among the fluoride products, Tooth Mousse Plus® and Fluor Protector are better than 1.23% acidulated phosphate fluoride gel, and these are expected to prevent dental caries even during tooth brushing with fluoride-containing toothpaste.

Comparison in Demineralization Resistance of Resin Infiltration and 1.23% Acidulated Phosphate Fluoride in Bovine Teeth / 대한소아치과학회지

The aim of this study is to compare the differences of the demineralization resistance of resin infiltration and 1.23% acidulated phosphate fluoride in bovine teeth with artificial caries. We applied 1.23% Acidulated phosphate fluoride (APF) gel and Icon® caries infiltrant on the artificial bovine enamel carious lesion and then demineralized all samples. The depth of demineralization was measured by using Confocal Laser Scanning Microscope (CLSM) and observed the roughness and irregularity of the enamel was observed by Scanning Electron Microscope (SEM).In this experiment with demineralization resistance on smooth artificial carious lesion, less depth of demineralization, roughness, and irregularity of enamel was observed in APF gel and Icon® group than in the control group. There was no significant difference between the depth of demineralization of 1.23% APF gel and Icon® caries infiltrant group. However, resin infiltration is beneficial as less roughness and irregularity was observed on the enamel surface than when 1.23% APF gel is applied.

Effect of a Bioactive Glass Ceramic on the Control of Enamel and Dentin Erosion Lesions

Abstract This study evaluated the effect of a bioactive glass ceramic for the control of erosion and caries lesions. Fragments (n=10) of bovine enamel and root dentin received daily application of different treatments (Biosilicate; Acidulated Phosphate Fluoride- APF; Untreated - control) during the performance of erosive cycles. Surfaces were analyzed with 3D optical profilometry to quantify the superficial loss in four periods (1, 7, 14 and 21 days), as well as the lesion depth with confocal laser scanning microscopy. For caries progression assessment, initial Knoop microhardness was measured on enamel bovine fragments. Initial carious lesions were developed and specimens were divided into three groups (n=10), according to the daily topical application (Biosilicate; APF; no application - control), during the de-remineralization cycles for 14 days. Final microhardness was obtained to calculate the change of surface microhardness. Subsurface demineralization was analyzed using cross-sectional microhardness (depths 10, 30, 50, 70, 90, 110 and 220 µm). Data were tested using ANOVA and Tukey's test (a=5%). Results of erosive evaluation showed that Biosilicate promoted the lowest (p<0.05) values of surface loss, regardless of time, for both enamel and dentin; APF promoted lower (p<0.05) surface loss than control; analyzing different periods of time, APF did not show difference (p>0.05) between 14 and 21 days of demineralization. Results of enamel caries assessment showed that Biosilicate resulted in higher (p<0.05) surface and subsurface microhardness than both APF and control-applications. It may be concluded that Biosilicate application showed a higher potential to reduce surface loss and development of erosion and caries lesions.

Resumo Este estudo avaliou o efeito de uma vitrocerâmica bioativa para o controle de lesões de erosão e cárie. Fragmentos (n=10) de esmalte bovino e dentina radicular receberam aplicação diária de diferentes tratamentos (Biosilicato; Fluoreto de Fosfato Acidulado - APF; não tratado - controle) durante a realização de ciclos erosivos. As superfícies foram analisadas com profilometria óptica 3D para quantificar a perda superficial em quatro períodos (1, 7, 14 e 21 dias), bem como a profundidade da lesão com microscopia confocal de varredura a laser. Para a avaliação da progressão de cárie, foi obtida a microdureza Knoop inicial de fragmentos de esmalte bovino. As lesões cariosas iniciais foram desenvolvidas e os espécimes foram divididos em três grupos (n =10), de acordo com a aplicação tópica diária (Biosilicato; APF; sem aplicação - controle) durante os ciclos de desmineralização por 14 dias. A microdureza final foi obtida para calcular a perda da microdureza superficial. A desmineralização sub-superficial foi analisada utilizando microdureza transversal (profundidades 10, 30, 50, 70, 90, 110 e 220 μm). Os dados foram testados utilizando ANOVA e teste de Tukey (α=5%). Os resultados da avaliação erosiva mostraram que o Biosilicato promoveu os menores valores (p <0,05) de perda superficial, independente do tempo, tanto para o esmalte como para a dentina; APF promoveu menor (p <0,05) perda de superfície do que controle; analisando os períodos de tempo, APF não mostrou diferença (p>0,05) entre 14 e 21 dias de desmineralização. Os resultados da avaliação da cárie no esmalte mostraram que o Biosilicato resultou em maiores (p<0,05) valores de microdureza superficial e subsuperficial do que as aplicações APF e controle. Pode-se concluir que a aplicação de Biosilicato apresentou maior potencial de redução da perda superficial e desenvolvimento de lesões de erosão e cárie.

CO2 laser and/or fluoride enamel treatment against in situ/ex vivo erosive challenge

ABSTRACT Objective This in situ/ex vivo study investigated the effect of CO2 laser irradiation and acidulated phosphate fluoride gel (APF) application, separately and in combination, on enamel resistance to erosion. Material and Methods During 2 experimental 5-day crossover phases, 8 volunteers wore intraoral appliances containing bovine enamel blocks which were submitted to four groups: 1st phase - control, untreated and CO2 laser irradiation, 2nd phase - fluoride application and fluoride application before CO2 laser irradiation. Laser irradiation was performed at 10.6 µm wavelength, 5 µs pulse duration and 50 Hz frequency, with average power input and output of 2.3 W and 2.0 W, respectively (28.6 J/cm2). APF gel (1.23%F, pH 3.5) was applied on enamel surface with a microbrush and left on for 4 minutes. Then, the enamel blocks were fixed at the intraoral appliance level. The erosion was performed extraorally 4 times daily for 5 min in 150 mL of cola drink. Enamel loss was measured profilometrically after treatment and after the in situ phase. The data were tested using one-way Repeated Measures Anova and Tukey's test (p<0.05). Results CO2 laser alone (2.00±0.39 µm) did not show any significantly preventive effect against enamel erosion when compared with the control group (2.41±1.20 µm). Fluoride treated enamel, associated (1.50±0.30 µm) or not (1.47±0.63 µm) with laser irradiation, significantly differed from the control. Conclusion The APF application decreased enamel wear; however, CO2 laser irradiation did not enhance fluoride ability to reduce enamel wear.

Corrosion behavior of zirconia in acidulated phosphate fluoride

ABSTRACT Objective The corrosion behavior of zirconia in acidulated phosphate fluoride (APF) representing acidic environments and fluoride treatments was studied. Material and Methods Zirconia rods were immersed in 1.23% and 0.123% APF solutions and maintained at 37°C for determined periods of time. Surfaces of all specimens were imaged using digital microscopy and scanning electron microscopy (SEM). Sample mass and dimensions were measured for mass loss determination. Samples were characterized by powder X-ray diffraction (XRD) to detect changes in crystallinity. A biosensor based on electrochemical impedance spectroscopy (EIS) was used to detect ion dissolution of material into the immersion media. Results Digital microscopy revealed diminishing luster of the materials and SEM showed increased superficial corrosion of zirconia submerged in 1.23% APF. Although no structural change was found, the absorption of salts (sodium phosphate) onto the surface of the materials bathed in 0.123% APF was significant. EIS indicated a greater change of impedance for the immersion solutions with increasing bathing time. Conclusion Immersion of zirconia in APF solutions showed deterioration limited to the surface, not extending to the bulk of the material. Inferences on zirconia performance in acidic oral environment can be elucidated from the study.

Effect of fluoride-containing gel on the roughness of a titanium surface and the promotion of bacterial growth

PURPOSE: The aim of this study was to evaluate whether fluorides at various pH cause changes in the surface roughness of titanium implants that alter the adherence of bacterial biofilms. MATERIALS AND METHODS: The titanium disks were assigned randomly to the following seven groups according to the fluoride agents and application time (1 minute or 30 minute) used: control (no treatment); group 1 (1.23% acidulated phosphate fluoride [APF] at pH 3.5 for 1 minute); group 2 (1.23% APF at pH 3.5 for 30 minute); group 3 (1.23% APF at pH 4.0 for 1 minute); group 4 (1.23% APF at pH 4.0 for 30 minute); group 5 (2% NaF gel at pH 7.0 for 1 minute); group 6 (2% NaF gel at pH 7.0 for 30 minute). The surface roughness of the titanium disks and the amount of adherent bacteria were measured. RESULTS: Group 2 showed a significantly greater surface roughness than the control group (P < 0.0001). No significant differences in the amount of surface bacteria were observed between the treated samples and the controls. In addition, there were no significant differences in bacterial adherence relative to the incubation period between the treated samples and the controls. CONCLUSION: The surface roughness of the titanium disks was significantly greater after treatment with APF at pH 3.5 for 30 min compared with that of the controls. In addition, we found that the amount of Porphyromonas gingivalis, Fusobacterium nucleatum, and Aggregatibactor actinomycetemcomitans was similar among all groups.

Una década de monitoreo de plomo en sangre en niños escolares del área metropolitana de Monterrey, NL / A decade of lead monitoring in schoolchildren in the metropolitan area of Monterrey NL, Mexico

Objetivo. Establecer las concentraciones de plomo (Pb) en sangre en niños escolares de 1998 y 2008, así como su asociación con factores de riesgo. Material y métodos. Se llevó a cabo un monitoreo de Pb en sangre de niños de entre 6 y 12 años que cursan educación primaria en 17 escuelas diferentes, ubicadas en distintas zonas del área metropolitana de Monterrey, de 1998 a 2008. Resultados. Se obtuvieron niveles séricos de 9.6 ± 3.0 (µg/dL rango de 3.18 a 20.88) en 1998 y de 4.5±4.8 µg/dL (rango de 3.3 a 53.7) en 2008, lo que mostró una disminución de 2.1 veces en nivel de Pb (p<0.01). Conclusiones. La reducción de los niveles séricos de Pb demuestran los mejores controles ambientales e industriales y probablemente el éxito de retirar el Pb de la gasolina durante los años noventa.

Objective. To establish the blood lead concentration and associated risk factors in schoolchildren during 1998 and 2008. Materials and methods. A blood lead screening was conducted in schoolchildren of 6-12 years of age, enrolled in 17 elementary schools of the metropolitan area of Monterrey, México, during 1998 and 2008. Results. The mean blood lead level were 9.6 ± 3.0 (µg/dL range of 3.18 to 20.88) in 1998 and 4.5±4.8 µg/dL (range of 3.3 to 53.7) showing a 2.1-times reduction in blood lead levels (p<0.01). Conclusions. This reduction in blood lead levels demonstrate environmental and industrial control improvements and the benefits of fading out the leaded gasoline during the 1990's.

Surface micromorphological changes of glass ionomer following application of 1.23% acidulated phosphate fluoride: A scanning electron microscope study.

Objectives: The purpose of this study was to evaluate the surface micromorphological changes of conventional glass ionomer cement (GIC) (Fuji II, GC Corporation, Tokyo, Japan) and high strength, high viscosity GIC (Fuji IX GP, GC Corporation) subjected to 1.23% acidulated phosphate fluoride (APF) gel for 4 min. It also evaluated the surface micromorphological changes that occurred in these materials when they were coated with a layer of glass ionomer varnish prior to the application of 1.23% APF gel. Materials and Methods: A total of 60 uniform glass ionomer cylinders were prepared (30 of each Fuji II and Fuji IX) and stored in distilled water for 48 h, following which they were divided into six groups depending on the surface treatment. Group 1: Fuji II alone, Group 2: Fuji IX alone, Group 3: Fuji II + 1.23% APF gel for 4 min, Group 4: Fuji IX + 1.23% APF gel for 4 min, Group 5: Fuji II + varnish + 1.23% APF gel for 4 min, and Group 6: Fuji IX + varnish + 1.23% APF gel for 4 min. After the required surface treatment had been done, the specimens were mounted, coated, and evaluated under scanning electron microscope. Statistical Analysis: Kruskal–Wallis test applied to compare the level of degradation among the groups subjected to treatment was highly significant (P < 0.001). Mann–Whitney test was applied to test the association between glass ionomer varnish and level of surface degradation and was also statistically significant (P = 0.001). Results: The results indicated that APF gel etched the surface of both Fuji II and Fuji IX. However, Fuji IX showed to possess better resistance to the erosive effect of APF than Fuji II. It was also observed that application of glass ionomer varnish prior to APF gel application protected the glass ionomer from the erosive effect of APF gel. Conclusion: APF gel caused erosive wear of the GICs esp. Fuji II. Hence, it is advisable to avoid the use of APF containing preparations for regular home use especially in children having glass ionomer restoration. If APF gel is indicated or preferred for professional application, it is recommended to apply glass ionomer varnish on the restored teeth prior to the APF gel application.

Efeito do gel de TiF4 no controle da progressão da lesão de erosão em dentina humana estudo in situ / Effect of TiF4 gel in the control of the progression of erosion in human dentin an in situ study

Com o aumento na prevalência das lesões de erosão, medidas preventivas e de controle das mesmas vêm sendo propostas. Dentre elas, encontram-se os produtos fluoretados e, mais recentemente, os compostos contendo cátions metálicos polivalentes, como o tetrafluoreto de titânio (TiF4). Este estudo in situ visou avaliar os efeitos do gel de TiF4 na inibição da progressão da erosão em dentina humana erodida e abrasionada. Para tanto, foram obtidas oitenta e quatro amostras de dentina (3 x 3 x 1 mm) a partir de terceiros molares humanos hígidos. Setenta e duas amostras foram erodidas in vitro previamente a etapa in situ e divididas aleatoriamente em 6 grupos (n=12) de acordo com o tratamento e com o número de ciclos erosivos/abrasivos a serem executados durante a etapa in situ. Os grupos controle foram submetidos a apenas 1 (C1), 2 (C2) e 3 (C3) ciclos erosivos/abrasivos. Já os grupos experimentais receberam 1 (TiF4 1), 2 (TiF4 2) e 3 (TiF4 3) aplicações de gel de TiF4 (4%) seguidos de 1, 2 e 3 ciclos erosivos/abrasivos, respectivamente. Um sétimo grupo controle (n=12) foi incluído, sendo que amostras sem erosão in vitro foram submetidas a 3 ciclos erosivos/abrasivos. Cada ciclo erosivo/abrasivo correspondeu a 2 dias de desafios erosivos (ácido cítrico 0,5%, pH 2,6, 6x/dia) e abrasivos (1x/dia). Para realização da etapa in situ, as amostras foram posicionadas em dispositivos intra-orais removíveis utilizados por 12 voluntários. Os espécimes foram avaliados em perfilometria (n=12), microscopia eletrônica de varredura ambiental (MEV ambiental) (n=12) e microscopia de força atômica (AFM) (n=3) para avaliar as alterações causadas pelo fluoreto sobre a superfície da dentina. A ANOVA a dois critérios para medidas repetidas mostrou que o desgaste superficial foi afetado pelos tratamentos avaliados (p<0,001).

O teste de Tukey demonstrou que o grupo TiF4 2, que não diferiu dos grupos TiF4 1 e TiF4 3, apresentou redução significativa no desgaste quando comparado aos grupos C1, C2, C3 e controle sem erosão in vitro. Os grupos TiF4 1 e TiF4 3 não revelaram diferença significativa em relação ao grupo C1, porém ambos os grupos de tratamento demonstraram desgaste significativamente menor que C2 e C3. Os maiores desgastes foram verificados para C3 e controle sem erosão in vitro. As micrografias obtidas em MEV ambiental e AFM sugeriram a manutenção do glaze sobre a superfície da dentina tratada com o gel de TiF4, mesmo após os desafios ácidos. A superfície passou a apresentar um aspecto mais liso que as amostras dos grupos controles, com redução dos diâmetros dos lúmens dos túbulos dentinários, justificando o efeito protetor do TiF4. Portanto, o TiF4 demonstrou potencial em reduzir a progressão das lesões de erosão in situ, independente do número de aplicações avaliado.

With the increase in the prevalence of erosion lesions, preventive and control measures for them have been proposed. Among them are the fluoride products and, more recently, compounds containing polyvalent metal ions such as titanium tetrafluoride (TiF4). This in situ study aimed to evaluate the effects of the TiF4 gel on the erosion progression inhibition in human eroded and abraded dentin. For this purpose, eighty-four dentin samples (3 x 3 x 1 mm) were prepared from undamaged human third molars. Seventy-two samples of previously eroded dentin in vitro were allocated into 6 groups (n=12) according to the treatment to be received during the in situ phase and the number of erosive/abrasive cycles. Control groups were subjected to 1 (C1), 2 (C2) and 3 (C3) erosive/abrasive cycles only. Experimental groups had TiF4 gel (4%) applied once (TiF41), twice (TiF42) or three times (TiF43) followed by 1, 2 and 3 erosive/abrasive cycles, respectively. A seventh group (n=12) comprised in vitro uneroded samples that were subjected to 3 erosive/abrasive cycles. Each cycle corresponded to 2 days of erosive (citric acid 0.5%, pH 2,6, 6x/day) and abrasive (1x/day) challenges. To perform the in situ stage, the samples were placed in removable intra-oral devices used by 12 volunteers Specimens were evaluated in profilometry (n=12), environmental scanning electron microscopy (ESEM) (n=12) and atomic force microscopy (AFM) (n=3) to evaluate the changes caused by fluoride on the surface of the dentin.

The two-factor ANOVA for repeated measures showed that, after profilometric analysis, the surface loss was affected by the treatments evaluated (p<0.001). Tukeys test showed that TiF4 2 group, which did not differ from TiF4 1 and TiF4 3 groups showed a significant reduction in surface loss compared to C1, C2, C3 and in vitro-uneroded control. The TiF4 1 and TiF4 3 groups showed no significant difference from C1, but both treatment groups demonstrated significantly smaller surface loss than C2 and C3. The greatest losses were observed for C3 and in vitro-uneroded control. The micrographs by ESEM and AFM suggested the maintenance of the glaze on the dentin surface treated with the TiF4 gel, even after acid challenge. The surface started to show a smoother appearance than samples from control groups, with reduced diameters of the dentinal tubules lumens, explaining the protective effect of TiF4. Therefore, the TiF4 demonstrated potential to reduce the progression of erosion lesions, regardless of the number of applications evaluated.

Análise da superfície de cerâmicas de dissilicato de lítio após imersão em soluções ácidas e a base de flúor / Surface analysis of lithium disilicate ceramic after immersion in acid and fluoride solutions

A degradação de cerâmicas odontológicas acontece na cavidade oral e em contato com soluções erosivas. Duzentos e vinte discos de cerâmica de dissilicato de lítio foram divididos em 4 grupos. As amostras do Grupo Controle (Co) foram imersas em diferentes bebidas ácidas ou em saliva artificial. Os grupos que foram expostos em fluoreto de sódio 0,05% (NaF 0,05%) e 0,2% (NaF 0,2%) ou em gel de fluoreto fosfatado acidulado a 1,23% (FFA 1,23%), foram imersos em uma dessas soluções, para em seguida serem imersos nas bebidas ácidas testadas. As amostras foram imersas nas bebidas ácidas de uso comum durante 4 horas/dia, seguido da imersão em saliva artificial, durante 21 dias. De forma contínua, as amostras dos grupos NaF 0,05%, NaF 0,2%, FFA 1,23% foram imersas nas respectivas soluções a base de flúor durante 12, 73 e 48 horas, respectivamente. A superfície das amostras foi analisada por meio da microdureza Vicker’s, rugosidade, microscopia eletrônica de varredura associada à espectroscopia de energia dispersiva (MEV/EDS) e microscopia de força atômica (AFM). Os dados de microdureza e rugosidade superficial foram submetidos à nested-ANOVA e Tukey (α = 0,05). As análises de MEV/EDS e AFM foram comparadas visualmente entre os grupos. Como resultados, pode-se observar que a imersão nas bebidas ácidas de uso comum (Grupo Co) diminuiu os valores de microdureza e aumentou os de rugosidade. A solução de fluoreto de sódio a 0,2% foi capaz de produzir reduções estatisticamente significativas nos valores de microdureza. Além disso, quando as amostras foram imersas posteriormente nas bebidas ácidas de uso comum tanto o Grupo NaF 0,05% quanto o Grupo NaF 0,2% apresentaram reduções significativas na microdureza. Não foi possível realizar leituras de microdureza na superfície das amostras do Grupo FFA 1,23% devido à intensa degradação, observada pela análise de MEV e AFM. Independente da solução utilizada, as amostras do Grupo Co apresentaram aumento significativo nos valores...

The degradation of dental ceramics occurs in oral cavity and in contact with erosive solutions. Two hundred lithium disilicate ceramic disks were divided on 4 groups. The disks of Control Group (Co) were immersed in common acid beverages or in artificial saliva. The groups that were exposed to sodium fluoride 0.05% (NaF 0.05%) and 0.2% (NaF 0.2%) or in acidulated phosphate fluoride gel 1.23% were immersed in one of these solutions followed by the immersion in common acid beverages. Specimens were immersed in the common acid beverages for 4 h day-1 followed by the immersion in artificial saliva for the remaining 20 h for 21 days. Continuously, the disks of the Groups NaF 0.05%, NaF 0.2% and APF 1.23% were immersed in each fluoride solutions for 12, 73 and 48 hours, respectively. The surface of the disks was analyzed by Vicker’s microhardness (HV), surface roughness (μm), scanning electronic microscopy associated with X-ray dispersive spectroscopy (SEM)-EDS and atomic force microscopy (AFM). Quantitative data were analyzed by ANOVA and Tukey’s test (α = 0.05). SEM and AFM images were visually compared among groups. The immersion of the disks in test common acid beverages (Co Group) affected hardness and surface roughness results. Sodium fluoride 0.2% promoted a significant decrease in hardness results. NaF 0.05% and NaF 0.2% Groups showed significant reductions in hardness results after immersion in the common acid beverages. SEM and AFM images revealed dramatic changes in the disks of APF Group which enable the hardness test. Regardless of the solution, the disks of Co Group showed a significant increase in surface roughness when comparing them with the initial results. Superior significant results of surface roughness were observed in NaF 0.2% and APF 1.23 Groups corroborated by MEV and AFM images. The association of fluoride solutions and common acid beverages promoted more alterations in hardness and surface results. It was possible to conclude that...

Efficacy of 1.23% APF gel applications on incipient carious lesions: a double-blind randomized clinical trial

The aim of this double-blind randomized clinical trial was to evaluate the efficacy of 1.23% APF gel application on the arrest of active incipient carious lesions in children. Sixty 7- to 12-year-old children, with active incipient lesions were included in the study. Children were divided randomly into 2 groups: 1.23% APF gel and placebo gel applications. Each group received 8 weekly applications of treatment. The lesions were re-evaluated at the 4th and 8th appointments. Poisson regression analysis was used to estimate relative risks of the presence of active white spot lesions. Groups showed similar results (PR = 1.67; CI 95% 0.69–3.98). The persistence of at least 1 active lesion was associated with a higher number of lesions in the baseline (PR = 2.67; CI 95% 1.19–6.03), but not with sugar intake (PR = 1.06; CI 95% 0.56–2.86) and previous exposure to fluoride dentifrice (PR = 1.26; CI 95% 0.49–2.29). The trial demonstrates the equivalence of the treatments. The use of the APF gel showed no additional benefits in this sample of children exposed to fluoridated water and dentifrice. The professional dental plaque removal in both groups may also account for the resulting equivalence of the treatments.

Salivary retention after application of fluoride gel using toothbrush or tray: a crossover trial

Currently, there are no studies in the literature evaluating salivary fluoride retention after small amounts of fluoride gel are applied to children's teeth. Therefore, the objective of the present study was to compare salivary retention after gel application using a toothbrush or by traditional application with trays. In this crossover study, children with active caries (n = 10) were randomized into one of the following treatment groups: a) application of fluoride gel using a tray (control), or b) application of fluoride gel with a toothbrush (treatment). After a 7-day washout period, the treatments were inverted. Unstimulated saliva samples were collected at baseline and 0.5, 5, 15, 30, 60 and 120 minutes after acidulated phosphate fluoride (APF) gel application in order to analyze fluoride retention in saliva. The area under the curve (AUC) was also calculated. There were no differences in fluoride retention after application of small amounts of APF with a toothbrush compared to traditional gel application using trays at all time points studied, and no differences in AUC were observed (Student t-test, p > 0.05). These results suggest that application of fluoride gel in children using a toothbrush can be utilized as an option rather than traditional trays, since the same salivary retention of fluoride is obtained using a lower dose.

Effect of Nd:YAG laser combined with fluoride on the prevention of primary tooth enamel demineralization

Most studies dealing with the caries preventive action of Nd:YAG laser have been done in permanent teeth and studies on primary teeth are still lacking. The aim of this study was to evaluate in vitro the effect of Nd:YAG laser combined or not with fluoride sources on the acid resistance of primary tooth enamel after artificial caries induction by assessing longitudinal microhardness and demineralization depth. Sixty enamel blocks obtained from the buccal/lingual surface of exfoliated human primary molars were coated with nail polish/wax, leaving only a 9 mm² area exposed on the outer enamel surface, and randomly assigned to 6 groups (n=10) according to the type of treatment: C-control (no treatment); APF: 1.23% acidulated phosphate fluoride gel; FV: 5% fluoride varnish; L: Nd:YAG laser 0.5 W/10 Hz in contact mode; APFL: fluoride gel + laser; FVL: fluoride varnish + laser. After treatment, the specimens were subjected to a des-remineralization cycle for induction of artificial caries lesions. Longitudinal microhardness data (%LMC) were analyzed by the Kruskal-Wallis test and demineralization depth data were analyzed by oneway ANOVA and Fisher’s LSD test (á=0.05). APFL and APF groups presented the lowest percentage of microhardness change (p<0.05). Demineralization depth was smaller in all treated groups compared with the untreated control. In conclusion, Nd:YAG laser combined or not with fluoride gel/varnish was not more effective than fluoride alone to prevent enamel demineralization within the experimental period.

A maioria dos estudos que utilizam o laser Nd:YAG com ação preventiva são em dentes permanentes, e são escassos os estudos em dentes decíduos. Desta forma, o objetivo do presente estudo foi avaliar in vitro o efeito do laser Nd: YAG combinado ou não com flúor na resistência ácida do esmalte decíduo após a indução de cárie artificial, através da avaliação de microdureza longitudinal e profundidade da desmineralização. Para tanto, foram selecionados 60 fragmentos de esmalte obtidos a partir da superfície bucal / lingual de molares decíduos irrompidos, os quais foram isolados com esmalte de unha e cera, deixando uma área exposta de 9 mm² na superfície do esmalte. Os espécimes foram divididos aleatoriamente em 6 grupos (n = 10) de acordo com o tipo de tratamento: C- Controle: sem tratamento; APF: aplicação de gel flúor fosfato acidulado 1,23%; FV: aplicação de verniz fluoretado 5%; L: aplicação do Laser Nd:YAG 0,5 W/10 Hz no modo contato; APFL: aplicação de gel flúor fosfato acidulado + Laser Nd:YAG; FVL: aplicação de verniz fluoretado 5% + Laser Nd:YAG. Após os tratamentos, os espécimes foram submetidos a um ciclo de desremineralização para a indução de lesão de cárie artificial. Os dados de microdureza longitudinal (%LMC) foram avaliados pelo teste de Kruskal-Wallis e os dados de profundidade da desmineralização foram avaliados pelos testes ANOVA e Fisher’s LSD (α=5%). Observou-se que os grupos APFL e APF apresentaram menor percentual de perda de dureza (p<0,05). A profundidade de desmineralização foi menor em todos os grupos tratados em comparação com o controle. Em conclusão, o laser Nd: YAG associado ou não com flúor/verniz não foi mais efetivo do que o flúor sozinho para prevenir a desmineralização do esmalte durante o período experimental.

Effects of demineralizaton-inhibition procedures on the bond strength of brackets bonded to demineralized enamel surface / 대한치과교정학회지

OBJECTIVE: To study and compare the effects of different demineralization-inhibition methods on the shear bond strength (SBS) and fracture mode of an adhesive used to bond orthodontic brackets to demineralized enamel surfaces. METHODS: Eighty freshly extracted, human maxillary premolars were divided into 4 equal groups and demineralized over the course of 21 days. Brackets were bonded to the demineralized enamel of teeth in Group 1. In Group 2, bonding was performed following resin infiltration (ICON(R), DMG, Hamburg, Germany). Before bonding, pre-treatment with acidulated phosphate fluoride (APF) or solutions containing casein phosphopeptide-amorphous calcium phosphate with 2% neutral sodium fluoride (CPP-ACP/wF) was performed in Groups 3 and 4, respectively. The SBS values of the brackets were measured and recorded following mechanical shearing of the bracket from the tooth surface. The adhesive remnant index (ARI) scores were determined after the brackets failed. Statistical comparisons were performed using one-way ANOVA, Tukey's post-tests, and G-tests. RESULTS: Significant differences were found in some of the intergroup comparisons of the SBS values (F = 39.287, p < 0.001). No significant differences were found between the values for the APF-gel and control groups, whereas significantly higher SBS values were recorded for the resin-infiltrated and CPP-ACP/wF-treated groups. The ARI scores were also significantly different among the 4 groups (p < 0.001). CONCLUSIONS: Tooth surfaces exposed to resin infiltration and CPP-ACP/wF application showed higher debonding forces than the untreated, demineralized surfaces.

Effect of fluoride solutions on the shear bond strength of orthodontic brackets

The aim of this in vitro study was to evaluate the shear bond strength of brackets after pre-treatment with different fluoride solutions. This study used 48 freshly extracted sound bovine incisors that were randomly assigned to 4 experimental groups (n=12). CG: (control) without treatment; NF: 4 min application of neutral fluoride; APF: application of 1.23% acidulated phosphate fluoride (APF) for 4 min; and SFV: application of 5% sodium fluoride varnish for 6 h. For each group, after surface treatment, prophylaxis of enamel and bracket bonding with Transbond XT composite resin (3M) were performed following the manufacturer's specifications. The shear bond strength was performed with a universal testing machine 24 h after fixing the brackets. The tooth surfaces were analyzed to verify the adhesive remnant index (ARI). Data were analyzed statistically by ANOVA and Tukey's test (α=0.05). There was statistically significant difference among the groups (p<0.0001). CG and NF groups presented significantly higher bond strength than APF and SFV. There was no significant difference between CG and NF or between APF and SFV (p>0.05). The analysis of ARI scores revealed that most failures occurred at the enamel-resin interface. It may be concluded that the pre-treatment of enamel with 1.23% APF and 5% SFV prior to fixing orthodontic brackets reduces shear bond strength values.

O objetivo deste estudo foi o de avaliar in vitro a resistência adesiva de bráquetes após o pré-tratamento do esmalte com diferentes soluções fluoretadas. Foram utilizados 48 incisivos bovinos hígidos recém-extraídos que foram aleatoriamente divididos em 4 grupos experimentais (n=12). CG (controle): sem tratamento; FN: aplicação de flúor neutro por 4 min; FFA: aplicação de flúor fosfato acidulado (FFA) a 1,23% por 4 min; e VFS: aplicação de verniz de fluoreto de sódio a 5% por 6 h. Após o tratamento dos grupos, foi realizada a profilaxia do esmalte e os bráquetes foram fixados utilizando o compósito Transbond XT (3M), seguindo as especificações do fabricante. A resistência adesiva foi verificada através do teste de cisalhamento, realizado na Máquina de Ensaio Universal DL-2000 24 h após a fixação dos bráquetes. As superfícies dos dentes foram analisadas para verificação do índice de adesivo remanescente (IAR). Por meio dos testes estatísticos ANOVA e Tukey (α=5%), observou-se diferença estatisticamente significante entre os grupos estudados (p<0,0001), sendo que GC e FN, apresentaram valores superiores de resistência adesiva quando comparados aos grupos FFA e VFS, porém GC-NF e FFA-VFS não apresentaram diferenças estatisticas entre si (p>0,05). A análise dos escores do IAR revelou que grande parte das falhas ocorreram na interface esmalte-resina. Conclui-se que o tratamento do esmalte com FFA 1,23% e VFS a 5%, previamente à fixação de bráquetes ortodônticos, reduziu os valores de resistência adesiva ao cisalhamento.