Preparation and characterization of NaF/Chitosan supramolecular complex and their effects on prevention of enamel demineralization.

Fluoridated mouthrinse is indicated for individuals with high risk of caries. Chitosan (Chit) exhibits antibacterial properties, but little is known about its effects on enamel when combined with sodium fluoride (NaF) to form NaF/Chit supramolecular complexes. In our study, NaF/Chit supramolecular complexes structured as microparticles were synthetized and characterized, and their effects on human enamel were evaluated after cariogenic challenge simulating the daily mouthrinse use. Initially, NaF/Chit complex formation was investigated based on several titrations by measuring the zeta potential, electrical conductivity (κ), hydrodynamic diameter (Dh), viscosity (η) and heat flow (by isothermal titration calorimetry) against the molar ratio [NaF]/[Chitmonomer], which allowed us to identify the interactions between Chit-NaF with a stoichiometry of approximately 0.68. Spontaneous microparticle formation was observed. Samples of enamel blocks were prepared and divided into eight groups (n = 10/group): (i) 0.2% Chit; (ii) 0.2% NaF; (iii) 0.2% NaF/Chit suspension; (iv) 0.2% acetic acid; (v) 0.05% Chit; (vi) 0.05% NaF; (vii) 0.05% NaF/Chit suspension; and (viii) 0.05% acetic acid. Cariogenic challenge was performed in each sample by cycling in demineralization and remineralization solutions for 7 days. Before each demineralization cycle, the corresponding substances were passively applied daily for 90 s, even in groups with 0.02% concentration. After 7 days, samples were examined for Knoop hardness (KHN) measurements. The data were analyzed by repeated-measures ANOVA and Tukey tests (α = 0.05). The 0.2% NaF and 0.2% NaF/Chit groups showed higher KHNpost-challenge values than the other groups. The 0.2% NaF/Chit microparticle suspension reduced the enamel hardness loss after cariogenic challenge as effectively as the 0.2% NaF solution and demonstrated potential for use in a formulation with anti-caries effects.

Association of Oral Health-Related Quality of Life with the Longevity of ART-Restorations in Children

ABSTRACT Objective: To evaluate the association of oral health-related quality of life (OHRQoL) with the longevity of ART-restorations in children after 18 months. Material and Methods: A longitudinal clinical study with 62 six- to seven-year-old children, both genders, 31 of whom underwent four weeks of oral health education strategy (OHES) followed by ART (GOHES+ART) and the others only ART (GART). The Brazilian short-version of the Child Perceptions Questionnaire (16-CPQ8-10) was used to evaluate the OHRQoL and the perception of change in oral health was assessed by a single question. Data was analyzed using Mann-Whitney, Wilcoxon and Friedman's tests. Results: After 18 months, GOHES+ART reported a greater impairment on OHRQoL, mainly in oral symptoms domain (p<0.05). In this period, greater impairment of oral symptoms was reported in children with failed restorations and with treatment considered to have a minor failure (p<0.05). In inter-group analysis, the GOHES+ART, with 2 to 4 restorations, Class I, of small size, located in the upper arch and with a smaller failure, reported more oral symptoms than the GART. Conclusion: In the long-term, children submitted to OHES followed by ART reported more oral symptoms. Factors such as number, class, size and location of the restorations need to be considered for the implementation of an efficient and effective oral health program, as well as for greater longevity of ART-restorations.

Risk Factors for the Incidence of Dental Caries in Low, Very Low, and Extremely Low Birth Weight Children: A Cohort Study

Abstract Objective: To assess the incidence of caries in a two-year period among low birth weight (LBW), very low birth weight (VLBW), and extremely low birth weight (ELBW) children considering socioeconomic indicators, dietary factors and oral hygiene. Material and Methods: A convenience sample was formed of 42 low birth weight children aged two to five years at baseline. Two examiners diagnosed caries using the World Health Organization criteria. Birth weight, socioeconomic indicators and diet were collected from medical records and questionnaires. Binomial models were used to estimate unadjusted and adjusted rate ratios (RR) and respective 95% confidence intervals for the factors evaluated. Results: Thirty-six children were re-examined after two years. The incidence of dental caries was 36.7%. The dmft index was 0.44 (±1.25) at baseline and increased to 1.36 (±3.85) at follow-up. VLBW children (1,000 to 1,500 g) (RR=0.23; 95%CI: 0.08-0.72) and LBW children (1,500 to 2,500 g) (RR=0.06; 0.01-0.55) had fewer carious lesions compared to ELBW children (<1,000 g). Carious lesions were more frequent among children with a lower income (RR=6.05; 1.05-34.84) and less frequent among those who did not consume sweetened juice, tea or yogurt (RR: 0.21; 0.07-0.62). Conclusion: An inverse dose-response relation was found between birth weight and the incidence of caries. A lower income and the consumption of sweetened beverages were risk factors for the development of caries (AU).

Synthesis of a chitosan nanoparticle suspension and its protective effects against enamel demineralization after an in vitro cariogenic challenge.

OBJECTIVE: Our study aims to synthesize, characterize, and determine the effects of a ChNPs suspension on human enamel after cariogenic challenge via pH-cycling. METHODOLOGY: ChNPs were synthesized by ion gelation and characterized by Transmission Electron Microscopy (TEM) and Dynamic Light Scattering. Forty enamel blocks were divided into four groups (n=10/group): (i) ChNPs suspension; (ii) chitosan solution; (iii) 0.05% sodium fluoride (NaF) solution; and (iv) distilled water. Specimens were exposed to cariogenic challenge by cycling in demineralization solution (3 h) and then remineralized (21h) for 7 days. Before each demineralization cycle, the corresponding solutions were passively applied for 90 s. After 7 days, specimens were examined for surface roughness (Ra) and Knoop hardness (KHN) before and after the cariogenic challenge; % KHN change (variation between initial and final hardness), and surface topography by an optical profilometer. The data were analyzed by repeated-measures ANOVA, One-way ANOVA, and Tukey tests (α=0.05). RESULTS: TEM images showed small spherical particles with diameter and zeta potential values of 79.3 nm and +47.9 mV, respectively. After the challenge, all groups showed an increase in Ra and a decrease in KHN values. Optical profilometry indicated that ChNPs- and NaF-treated specimens showed uneven roughness interspersed with smooth areas and the lowest %KHN values. CONCLUSION: The ChNPs suspension was successfully synthesized and minimized human enamel demineralization after a cariogenic challenge, showing an interesting potential for use as an oral formulation for caries prevention.

A higiene bucal de bebês edêntulos e sua influência na microbiota bucal: os profissionais de saúde devem preconizá-la? ­ revisão crítica / Oral hygiene in edentulous infants and its influence on oral microbiota: should the health professionals recommend it? ­ a critical review

Introdução: A indicação de higiene bucal em bebês edêntulos entre os profissionais de saúde ainda é controversa, sendo necessária a busca científica sobre esta indicação e a padronização da informação. Objetivo: Investigar criticamente as evidências relacionadas a indicação da higiene bucal para bebês edêntulos. Métodos: A busca de artigos foi realizada nas bases de dados PubMed, LILACS e Google Scholar, de modo a avaliar a seguinte pergunta: "A higienização da cavidade bucal de bebês edêntulos pode influenciar a microbiota bucal?". Uma busca em 8 livros de Odontopediatria também foi realizada. Resultados: Foram encontrados 317 artigos (167-PubMed, 146-Google Scholar e 4-LILACS). Não foram encontrados estudos primários que avaliaram o efeito da higiene bucal em bebês edêntulos na microbiota, impossibilitando a condução de revisão sistemática. Assim, para a revisão foram incluídos 6 estudos que investigaram micro-organismos na cavidade bucal de bebês edêntulos e o papel das imunoglobulinas salivares. Dentre os livros avaliados, somente 4 indicaram a higiene bucal em bebês edêntulos. Conclusão: Diante dos dados analisados, não existem estudos primários que avaliaram o efeito da higienização na microbiota bucal de bebês edêntulos. Torna-se relevante a condução de estudos clínicos para obtenção de evidências científicas sobre a indicação ou não da higienização da cavidade bucal de bebês edêntulos.

Introduction: The indication of oral hygiene in edentulous babies is still controversial among health professionals, being necessary the search of this recommendation and the standardization of information. Objective: To inves-tigate critically the evidence related to the indication of oral hygiene for edentulous babies. Methods: The search for articles was performed in the PubMed, LILACS and Google Scholar databases, in order to assess the following question: "Can oral cavity hygiene of edentulous babies influence oral microbiota?" A search in 8 books of Pediatric Dentistry was also performed. Results: 317 articles were found (167-PubMed, 146-Google Scholar and 4-LILACS). There were no primary studies that evalu-ated the effect of oral hygiene of edentulous infants on microbiota, which impair the conduction of a systematic review. Thus, it was included for this review six studies that investigated microorganisms in the oral cavity of edentulous infants and the role of salivary immunoglo- bulins. Among the textbooks evaluated, only 4 indicated the oral hygiene in edentulous infants. Conclusion:According to the data, there are no primary studies that assessed the effect of oral hygiene in the oral microbiota of edentulous babies. It is relevant to conduct clinical studies in order to obtain scientific evidence about the indication or no of the oral hygiene in edentulous babies

Effectiveness of Secondary Alveolar Bone Graft on Canine Eruption: Systematic Review.

There are controversies related to the effects of bone grafts on tooth eruption and impaction in patients with cleft lip and palate. The aim of this systematic review was to evaluate the effectiveness of bone grafting on eruption of canines in patients with unilateral cleft lip and palate (UCLP). An electronic search was conducted in six electronic databases and gray literature, without limitations on year of publication or language. The primary outcome was the increase in rate of canine eruption; the secondary outcomes were success of the bone graft, canine impaction due to agenesis of the lateral incisor, and effect of orthodontic treatment before and after bone grafting. The risk of bias was analyzed by means of the tool Cochrane risk of bias in nonrandomized controlled trials (NRCTs) of interventions (ROBINS-I). The certainty of the evidence was assessed for outcomes reported through a narrative synthesis using grading of recommendations, assessment, development and evaluation (GRADE) approach. Four NRCTs were included, with a total of 360 patients, 283 UCLP and 77 bilateral cleft lip and palate (BCLP). The studies reported association between the increase in the rate of tooth eruption and bone graft with very low certainty of evidence, and greater experience of surgical success, with low certainty of evidence. The majority of the studies found an association between increase in the rate of canine impaction and agenesis of the lateral incisor, with very low certainty of evidence. There was very low certainty of the efficacy of secondary alveolar bone grafting for increasing the rates of eruption and reducing impaction of the maxillary canine.

Weight-loss and surface roughness of enamel after microabrasion procedure with different agents / Perda de peso e rugosidade da superfície do esmalte após procedimento de microabrasão com diferentes agentes

Introduction: Enamel microabrasion is achieved by abrasion of the enamel surface and it is a quick, practical and efficient procedure. Objective It was assessed the weight loss and surface aspect of enamel after microabrasion procedures with commercial and mixtures made in-office. Material and method Eighty bovine incisors were divided into four groups (n=10): OpalustreTM (6.6% HCl + silicon carbide); Whiteness RMTM (6% HCl + silicon carbide); 37% H3PO4 + pumice and 10% HCl + pumice. Treatment was performed by 15 applications of 10s duration. The enamel weight loss was determined by the difference in weight before and after the microabrasion. The surfaces were analyzed by a surface roughness equipment and scanning electron microscopy. Data were submitted to paired-T test, one-way ANOVA and Tukey tests (α=0.05). Result It was observed significantly weight loss for all groups. The difference in weight loss ranged from 0.037±0.012 for group 37% H3PO4 and from 0.054±0.009 for group 6,6% HCl. There was a significant increase in surface roughness for all groups and 10% HCl group showed the lower results (0.65±0.09). It was observed different patterns of enamel morphology by SEM images. Conclusion The in-office mixtures resulted in the lowest enamel structure loss (37% H3PO4) and the lowest surface roughness (10% HCl).

Introdução: A microabrasão do esmalte é realizada através da abrasão da superfície do mesmo, apresentando-se como um procedimento rápido, prático e eficiente. Objetivo Avaliar a perda de peso e o aspecto superficial do esmalte após procedimentos de microabrasão com agentes comerciais e não comerciais. Material e método Oitenta incisivos bovinos foram divididos em quatro grupos (n = 10): OpalustreTM (6,6% HCl + carboneto de silício); Whiteness RMTM (6% HCl + carboneto de silício); 37% H3PO4 + pedra-pomes e 10% HCl + pedra-pomes. O tratamento foi realizado em 15 aplicações de 10s de duração. A perda de peso do esmalte foi determinada pela diferença de peso antes e depois da microabrasão. As superfícies foram analisadas por equipamento de rugosidade superficial e microscopia eletrônica de varredura. Os dados foram submetidos ao teste T-pareado, ANOVA one-way e teste de Tukey (α = 0,05). Resultado Foi observada perda de peso significativa para todos os grupos, a diferença na perda de peso variou de -0,037±0,012 para o grupo 37% H3PO4 a -0.054±0.009 para o grupo 6.6% HCl. Houve um aumento significativo na rugosidade da superfície para todos os grupos e o grupo 10%HCl apresentou os resultados mais baixos (0,65±0,09). Foram observados diferentes padrões de morfologia do esmalte por meio de imagens MEV. Conclusão Os agentes não comerciais resultaram na menor perda de estrutura do esmalte (37% H3PO4) e na rugosidade superficial (10% HCl).

Synthesis of a chitosan nanoparticle suspension and its protective effects against enamel demineralization after an in vitro cariogenic challenge

Abstract Objective Our study aims to synthesize, characterize, and determine the effects of a ChNPs suspension on human enamel after cariogenic challenge via pH-cycling. Methodology ChNPs were synthesized by ion gelation and characterized by Transmission Electron Microscopy (TEM) and Dynamic Light Scattering. Forty enamel blocks were divided into four groups (n=10/group): (i) ChNPs suspension; (ii) chitosan solution; (iii) 0.05% sodium fluoride (NaF) solution; and (iv) distilled water. Specimens were exposed to cariogenic challenge by cycling in demineralization solution (3 h) and then remineralized (21h) for 7 days. Before each demineralization cycle, the corresponding solutions were passively applied for 90 s. After 7 days, specimens were examined for surface roughness (Ra) and Knoop hardness (KHN) before and after the cariogenic challenge; % KHN change (variation between initial and final hardness), and surface topography by an optical profilometer. The data were analyzed by repeated-measures ANOVA, One-way ANOVA, and Tukey tests (α=0.05). Results TEM images showed small spherical particles with diameter and zeta potential values of 79.3 nm and +47.9 mV, respectively. After the challenge, all groups showed an increase in Ra and a decrease in KHN values. Optical profilometry indicated that ChNPs- and NaF-treated specimens showed uneven roughness interspersed with smooth areas and the lowest %KHN values. Conclusion The ChNPs suspension was successfully synthesized and minimized human enamel demineralization after a cariogenic challenge, showing an interesting potential for use as an oral formulation for caries prevention.

Effect of Orthodontic Treatment on Tooth Autotransplantation: Systematic Review of Controlled Clinical Trials.

This systematic review was focused on evaluating tooth autotransplantation, considering its impacts on the teeth, bone, soft tissues, and aesthetics in orthodontic patients. A bibliographic search was conducted without limitations on year of publication or language in the databases of PubMed, Web of Science, Scopus, Medline Complete, Cochrane, Clinical Trials, and Trials Central. For triage of articles, indications, surgical planning, orthodontic movement, risk factors for treatment, and long-term follow-ups were considered. For outcomes, the results with reference to teeth, alveolar bone, periodontal tissues, and esthetic satisfaction were considered. Risk of bias was evaluated using the methodological index for nonrandomized studies-MINORS. The results showed 10 controlled clinical trials, and no randomized clinical trials were found. The selected studies included 715 patients and 934 autotransplanted teeth among which there were premolars, molars, and anterior teeth evaluated in the long term, indicating that orthodontics associated with autotransplantation indicated a result that was generally clinically acceptable. The quality of the set of evidence was considered medium due to the presence of different methodological problems, risk of bias, and significant heterogeneity in the evaluated studies. There was a sufficient body of evidence that justified autotransplantation in patients who needed orthodontic movement. In teeth, there was an increase in root resorption influenced by orthodontics, but without impacting on the general clinical result in the long term. Bone and periodontal tissue do not appear to be affected by orthodontics. The patient's aesthetic satisfaction was not considered in the studies.

In Vivo Biocompatibility, Mechanical, and Antibacterial Properties of Cements Modified with Propolis in Different Concentrations.

OBJECTIVES: The focus of this triple-blind randomized study was to evaluate the mechanical properties, antibacterial effect, and in vivo biocompatibility of glass ionomer cements (GICs) modified with ethanolic extracts of propolis (EEP). MATERIALS AND METHODS: For biocompatibility tests, 135 male Wistar rats were used and divided into nine groups: Group C (control, polyethylene), Groups M, M10, M25, M50 (Meron; conventional, and modified with 10%, 25%, 50% EEP, respectively), Groups KC, KC10, KC25, KC50 (Ketac Cem; conventional, and modified with 10%, 25%, 50% EEP, respectively). The tissues were analyzed under an optical microscope for different cellular events in different time intervals. Shear bond strength test (SBST) on cementation of metal matrices (n = 10, per group), adhesive remnant index (ARI) in bovine incisors (n = 10, per group), and antibacterial properties by the agar diffusion test (n = 15, per group) were analyzed. STATISTICAL ANALYSIS: Data were analyzed by Kruskal-Wallis test followed by Dunn, and one-way analysis of variance test followed by Tukey's test (p < 0.5). RESULTS: Morphological evaluation demonstrated intense inflammatory infiltrate in Groups M10 and KC10 in the time intervals of 7 (p = 0.001) and 15 (p = 0.006) days. Multinucleated giant cells were shown to be more present in Group M1, with statistical difference from Control and KC50 Groups in the time interval of 7 days (p = 0.033). The SBST showed no statistical significance among the groups (p > 0.05). Antibacterial property showed a statistically significant difference between Meron and Meron 50%-EEP Groups, and between Ketac and Ketac 50%-EPP Groups (p = 0.001). CONCLUSIONS: The intensity of histological changes resulting from the cements was shown to be inversely proportional to the concentration of propolis added; Ketac 50%-EPP was the concentration that had the most favorable biocompatibility results. Addition of EEP to GIC did not negatively change the SBST and ARI. Antibacterial property demonstrated a concentration-dependent effect.

In Vitro Effect of Acidic Challenges on the Physical Properties of Dental Prosthesis Artificial Teeth

Abstract Objective: To evaluate the effect of immersion and acid challenge with cola drink on color change (ΔE), Vickers hardness (VHN) and surface roughness (Ra) of artificial acrylic resin teeth. Material and Methods: The artificial teeth were divided into 6 groups (n= 8): TC (Trilux/Control), BC (Biotone/Control), TAC (Trilux/Acid challenge), BAC (Biotone/Acid challenge), TI (Trilux/Immersion) and BI (Biotone/Immersion). The teeth were embedded in acrylic resin and the labial side was serially polished to provide appropriate flat surface. The samples of TC, BC, TI, BI groups were immersed in artificial saliva and cola drink (coke) for 7 days, respectively. The acid challenge was performed with immersion of samples in coke for 5 min, and subsequently immersion in artificial saliva for 2h. This cycle was repeated at 4 times/day, during 7 days. The tests of VHN, ΔE and Ra were analyzed before and after the challenge and immersion groups. Data was analyzed by ANOVA, Tukey and T test (α = 0.05). Results: There was no difference in Ra values between groups after treatments. However, there was a decrease in VHN for all groups. BI (19.2 ± 0.3) presented significantly lower hardness than BAC (19.5 ± 0.9) and BC (20.2 ± 0.5). Groups BI (2.18 ± 0.41) and TI (1.50 ± 0.43) had statistically higher ΔE compared to the other groups. Conclusion: The hardness of resin teeth decreased after acid challenges, but the roughness surface was not affected. The color was more affected by the times of exposure in cola beverage and remineralization in artificial saliva, which were associated to the material degradation (AU).

Os medicamentos infantis podem causar erosão na superfície de dentes decíduos? Revisão sistemática da literatura / Can child medications cause erosion on the surface of deciduous teeth? A systematic review of literature

Introdução: A erosão dentária é caracterizada por uma perda progressiva e irreversível dos tecidos dentários mineralizados que ocorre sem envolvimento bacteriano. Acredita-se que o uso frequente de medicamentos líquidos orais, em crianças, possa desenvolver erosão dentária visto que esses medicamentos apresentam, em sua maioria, pH ácido, que pode atuar como fator predisponente ao desenvolvimento da erosão dentária. Objetivo: O presente estudo avaliou os efeitos do uso de medicamentos líquidos orais na estrutura de dentes decíduos por meio de revisão sistemática da literatura. Material e Métodos: Foi realizada pesquisa de artigos científicos, em março de 2018, nas bases de dados PubMed e Web of Science utilizando descritores específicos para a pesquisa, de modo a avaliar, descritivamente, a seguinte pergunta "Os medicamentos infantis de uso contínuo podem causar erosão na superfície de dentes decíduos?" Foram encontrados 278 artigos na base de dados Pubmed e 41 na base Web of Science, dos quais 18 artigos eram coincidentes, assim 301 títulos e resumos foram lidos e analisados. Destes, 293 foram excluídos de modo que 8 artigos foram selecionados para análise crítica. Resultados: Os medicamentos líquidos de uso contínuo, geralmente utilizados para o tratamento de condições crônicas em crianças, promovem efeito erosivo sobre a estrutura dentária, principalmente quando relacionado ao pH e acidez titulável dos medicamentos, por avaliação de estudos conduzidos "in vitro". Conclusão: Torna-se necessária a realização de estudos clínicos para avaliação mais adequada do efeito erosivo de medicamentos infantis na superfície de dentes decíduos.

Introduction: Dental erosion is characterized by a progressive and irreversible loss of mineralized dental tissues that occurs without bacterial involvement. It is believed that the frequent use of oral liquid medicines in children can develop dental erosion since the majority of these medications has acidic pH, which can act as a predisposing factor for dental erosion development. Objective: The present study evaluated the effects of the use of liquid oral medications on the structure of deciduous teeth by a systematic review of literature. Material and Methods: We conducted a survey of scientific articles in PubMed and Web of Science databases on March 2018, using specific descriptors for the research, in order to evaluate descriptively the following question: "Children's medicines for continuous use may cause erosion on the surface of deciduous teeth?". We found 278 articles in the PubMed database and 41 in the Web of Science database, of which 18 articles were matched, so 301 titles and abstracts were read and analyzed. Of these, 293 were excluded. Thus, 8 articles were selected for the critical analysis. Results: Liquid medications of continuous use, generally used for the treatment of chronic conditions in children, promoted erosive effect on dental structure, especially when related to pH and titratable acidity of the drugs in in vitro studies. Conclusion:It is necessary to carry out clinical studies for a more adequate evaluation of the erosive effect of children's medicines on the surface of deciduous teeth.

TiF4 varnish protects the retention of brackets to enamel after in vitro mild erosive challenge.

The effect of fluoride agents on the retention of orthodontic brackets to enamel under erosive challenge is little investigated. The aim of this study was to evaluate the effect of titanium tetrafluoride (TiF4) and sodium fluoride (NaF) agents on the shear bond strength of brackets to enamel and on the enamel microhardness around brackets under erosive challenge. Brackets were bonded to bovine incisors. Five groups were formed according to fluoride application (n=10): TiF4 varnish, TiF4 solution, NaF varnish, NaF solution and control (without application). The specimens were submitted to erosive challenge (90 s cola drink/2h artificial saliva, 4x per day for 7 days). Solutions were applied before each erosive cycle and varnishes were applied once. Vickers Microhardness (VHN) was obtained before and after all cycles of erosion and the percentage of microhardness loss was calculated. Shear bond strength, adhesive remnant index and polarized light microscopy were conducted after erosion. The data were analyzed by ANOVA, Tukey, Kruskal-Wallis and Mann-Whitney U tests (α=0.05). The %VHN had no statistically significant differences among the experimental groups. However, considering the comparisons of all groups with the control group, TiF4 varnish showed the highest protection from enamel demineralization (effect size of 2.94, while the effect size for the other groups was >2.4). The TiF4 varnish group had significantly higher shear bond strength compared to other groups. There was no difference among groups for adhesive remnant index. Polarized light microscopy showed higher demineralization depth for the control group. Application of NaF and TiF4 agents during mild erosive challenge minimized the enamel mineral loss around brackets, however only the experimental TiF4 varnish was able to prevent the reduction of shear bond strength of brackets to enamel.

TiF4 varnish protects the retention of brackets to enamel after in vitro mild erosive challenge

Abstract The effect of fluoride agents on the retention of orthodontic brackets to enamel under erosive challenge is little investigated. Objective: The aim of this study was to evaluate the effect of titanium tetrafluoride (TiF4) and sodium fluoride (NaF) agents on the shear bond strength of brackets to enamel and on the enamel microhardness around brackets under erosive challenge. Methods: Brackets were bonded to bovine incisors. Five groups were formed according to fluoride application (n=10): TiF4 varnish, TiF4 solution, NaF varnish, NaF solution and control (without application). The specimens were submitted to erosive challenge (90 s cola drink/2h artificial saliva, 4x per day for 7 days). Solutions were applied before each erosive cycle and varnishes were applied once. Vickers Microhardness (VHN) was obtained before and after all cycles of erosion and the percentage of microhardness loss was calculated. Shear bond strength, adhesive remnant index and polarized light microscopy were conducted after erosion. The data were analyzed by ANOVA, Tukey, Kruskal-Wallis and Mann-Whitney U tests (α=0.05). Results: The %VHN had no statistically significant differences among the experimental groups. However, considering the comparisons of all groups with the control group, TiF4 varnish showed the highest protection from enamel demineralization (effect size of 2.94, while the effect size for the other groups was >2.4). The TiF4 varnish group had significantly higher shear bond strength compared to other groups. There was no difference among groups for adhesive remnant index. Polarized light microscopy showed higher demineralization depth for the control group. Conclusions: Application of NaF and TiF4 agents during mild erosive challenge minimized the enamel mineral loss around brackets, however only the experimental TiF4 varnish was able to prevent the reduction of shear bond strength of brackets to enamel.

Influence of Different Dentin Substrate (Caries-Affected, Caries-Infected, Sound) on Long-Term µTBS.

The aim of this study was to evaluate the µTBS in different dentin substrates and water-storage periods. Twenty-four dentin blocks obtained from sound third molars were randomly divided into 3 groups: Sound dentin (Sd), Caries-affected dentin (Ca) and Caries-infected dentin (Ci). Dentin blocks from Ca and Ci groups were subjected to artificial caries development (S. mutans biofilm). The softest carious tissue was removed using spherical drills under visual inspection with Caries Detector solution (Ca group). It was considered as Ci (softer and deeply red stained dentin) and Ca (harder and slightly red stained dentin). The Adper Single Bond 2 adhesive system was applied and Z350 composite blocks were built in all groups. Teeth were stored in deionized water for 24 h at 37 ºC and sectioned into beams (1.0 mm2 section area). The beams from each tooth were randomly divided into three storages periods: 24 h, 6 months or 1 year. Specimens were submitted to µTBS using EZ test machine at a crosshead speed of 1.0 mm/min. Failure mode was examined by SEM. Data from µTBS were submitted to split plot two-way ANOVA and Tukey's HSD tests (a=0.05). The µTBS (MPa) of Sd (41.2) was significantly higher than Ca (32.4) and Ci (27.2), regardless of storage. Ca and Ci after 6 months and 1 year, presented similar µTBS. Mixed and adhesive failures predominated in all groups. The highest µTBS values (48.1±9.1) were found for Sd at 24 h storage. Storage of specimens decreased the µTBS values for all conditions.

Influence of Different Dentin Substrate (Caries-Affected, Caries-Infected, Sound) on Long-Term muTBS

Abstract The aim of this study was to evaluate the μTBS in different dentin substrates and water-storage periods. Twenty-four dentin blocks obtained from sound third molars were randomly divided into 3 groups: Sound dentin (Sd), Caries-affected dentin (Ca) and Caries-infected dentin (Ci). Dentin blocks from Ca and Ci groups were subjected to artificial caries development (S. mutans biofilm). The softest carious tissue was removed using spherical drills under visual inspection with Caries Detector solution (Ca group). It was considered as Ci (softer and deeply red stained dentin) and Ca (harder and slightly red stained dentin). The Adper Single Bond 2 adhesive system was applied and Z350 composite blocks were built in all groups. Teeth were stored in deionized water for 24 h at 37 ºC and sectioned into beams (1.0 mm2 section area). The beams from each tooth were randomly divided into three storages periods: 24 h, 6 months or 1 year. Specimens were submitted to µTBS using EZ test machine at a crosshead speed of 1.0 mm/min. Failure mode was examined by SEM. Data from µTBS were submitted to split plot two-way ANOVA and Tukey’s HSD tests (a=0.05). The µTBS (MPa) of Sd (41.2) was significantly higher than Ca (32.4) and Ci (27.2), regardless of storage. Ca and Ci after 6 months and 1 year, presented similar µTBS. Mixed and adhesive failures predominated in all groups. The highest µTBS values (48.1±9.1) were found for Sd at 24 h storage. Storage of specimens decreased the µTBS values for all conditions.

Resumo O objetivo neste estudo foi avaliar a resistência de união à microtração (RUµT) de um sistema adesivo convencional (Adper Single Bond 2 - SB) em diferentes substratos dentinários e períodos de armazenagem. Vinte e quatro blocos de dentina foram obtidos de terceiros molares hígidos e separados aleatoriamente em 3 grupos (n=8): dentina sadia (Ds), dentina afetada (Da) e dentina infectada (Di). A Da e a Di foram submetidas ao desenvolvimento biológico artificial de cárie (S. mutans). O tecido cariado amolecido foi removido usando broca esférica sob inspeção visual com a solução Caries Detector (grupo Da). Considerou-se como Di a dentina amolecida e fortemente pigmentada de vermelho e como Da, a dentina hígida e levemente pigmentada de vermelho. O sistema adesivo SB foi aplicado de acordo com as recomendações do fabricante e blocos da resina composta Z350 foram construídos (6 mm de altura). O conjunto (dente/bloco de resina) foi armazenado em água deionizada por 24 horas a 37 °C. Estes foram seccionados em palitos (1,0 mm2 de área), que foram separados aleatoriamente em 3 períodos de armazenagem: 24 horas, 6 meses e 1 ano. Os palitos foram submetidos ao ensaio de resistência de união à microtração na máquina EZ teste a uma velocidade de 1,0 mm/min. Dados de RUµT foram submetidos à Análise de Variância 2 fatores em esquema de parcela subdividida e ao teste de Tukey (a=0,05). Os valores de resistência (MPa) da Ds (41,2) foram significativamente maiores do que os da Da (32,4) e Di (27,2), independente do tempo de armazenagem. Di e Da, 6 meses e 1ano, apresentaram valores similares de resistência de união. As falhas adesivas e mistas foram predominantes para todos os grupos. Em conclusão, os maiores valores de RUµT (48,1±9,1) foram verificados para a Ds e 24 h de armazenagem. A armazenagem diminuiu os valores de RUµT para todas as condições.

Effect of Different Concentrations of Chlorhexidine in Glass-ionomer Cements on In Vivo Biocompatibility.

PURPOSE: To examine whether a difference exists between the in vivo biocompatibility of glass-ionomer cements (GICs) containing chlorhexidine (CHX) in different concentrations. MATERIALS AND METHODS: Eighty-four male Wistar rats were distributed into 7 groups (n = 12) and received subcutaneous implants of small tubes containing different materials, as follows: Ketac control (K), Ketac-CHX 10% (K10), Ketac-CHX 18% (K18), Resilience control (R), Resilience-CHX 10% (R10), Resilience-CHX 18% (R18), Control (polyethylene). The animals were then sacrificed on post-insertion days 7, 15 and 30, and tissues were examined under an optical microscope for inflammatory infiltrate, edema, necrosis, granulation tissue, multinucleated giant cells, and collagen fibers. The results were statistically analyzed using Kruskal-Wallis and Dunn's tests (p < 0.05). RESULTS: Groups K18 and R18 showed larger areas of intense inflammatory infiltrate, with significant differences between group C and groups K18 and R18 (p = 0.007) at 7 days, and between groups C and K18 (p = 0.017) at 15 days. In terms of tissue repair, groups K18 and R18 demonstrated a lower quantity of collagen fibers with significant differences from group C (p = 0.019) at 7 days, and between group K18 and group C (p = 0.021) at 15 days. CONCLUSION: The 18% concentration of CHX was shown to have a toxic effect. The 10% concentration of CHX was shown to be suitable for tissue contact. The addition of CHX to the glass-ionomer cements is a highly promising method for obtaining of an antibacterial GIC for use in clinical practice.

Thickness and nanomechanical properties of protective layer formed by TiF4 varnish on enamel after erosion.

The layer formed by fluoride compounds on tooth surface is important to protect the underlying enamel from erosion. However, there is no investigation into the properties of protective layer formed by NaF and TiF4 varnishes on eroded enamel. This study aimed to evaluate the thickness, topography, nanohardness, and elastic modulus of the protective layer formed by NaF and TiF4 varnishes on enamel after erosion using nanoindentation and atomic force microscopy (AFM). Human enamel specimens were sorted into control, NaF, and TiF4 varnish groups (n = 10). The initial nanohardness and elastic modulus values were obtained and varnishes were applied to the enamel and submitted to erosive challenge (10 cycles: 5 s cola drink/5 s artificial saliva). Thereafter, nanohardness and elastic modulus were measured. Both topography and thickness were evaluated by AFM. The data were subjected to ANOVA, Tukey's test and Student's t test (α = 0.05). After erosion, TiF4 showed a thicker protective layer compared to the NaF group and nanohardness and elastic modulus values were significantly lower than those of the control group. It was not possible to measure nanohardness and elastic modulus in the NaF group due to the thin protective layer formed. AFM showed globular deposits, which completely covered the eroded surface in the TiF4 group. After erosive challenge, the protective layer formed by TiF4 varnish showed significant properties and it was thicker than the layer formed by NaF varnish.

Effects of erosive challenge on the morphology and surface properties of luting cements / Efeito do desafio erosivo na morfologia e propriedades de superfície de agentes cimentantes

Introduction: Few studies investigated the surface properties of luting cements after erosive challenge. Objective: To evaluate the surface roughness (Ra), Vickers hardness (VHN) and morphology of 4 luting cements after erosive challenge. Material and method: Twenty specimens of each cement were prepared (4×2mm) and divided into experimental (erosive challenge) and control (artificial saliva) groups (n=10): Rely X U200 (U200); Rely X ARC (ARC); Ketac Cem Easy Mix (Ketac) and Zinc phosphate (ZnP). The erosive challenge was performed by four daily erosive cycles (90s) in a cola drink and 2 h in artificial saliva over 7 days. Ra and VHN readings were performed before and after erosion. The percentage of hardness loss (%VHN) was obtained after erosion. The surface morphology was analyzed by scanning electron microscopy (SEM). ANOVA, Tukey and Student-T tests were used (α=0.05). Result: After erosion, all luting cements had increase in Ra values and U200 and ZnP groups had the highest %VHN. After saliva immersion, only U200 and ZnP groups had significant increases in Ra values and there were no significant differences among the groups in %VHN. SEM analysis showed that Ketac and ZnP groups had rough and porous surfaces, and U200 group had higher resin matrix degradation than ARC group. Conclusion: Erosive challenge with a cola drink affected the surface properties of all luting cements.

Introdução: Poucos estudos investigaram as propriedades de superfície de cimentos após desafio erosivo. Objetivo: Avaliar a rugosidade da superfície (Ra), dureza Vickers (VHN) e morfologia de superfície de 4 cimentos após desafio erosivo. Material e método: Vinte amostras de cada cimento foram preparadas (4×2mm) e divididas em grupo experimental (desafio erosivo) e controle (saliva artificial) (n=10): Rely X U200 (U200); Rely X ARC (ARC); Ketac Cem Easy Mix (Ketac) e Fosfato de Zinco (ZnP). O desafio erosivo foi realizado com quatro ciclos erosivos diárias (90s) em bebida à base de cola e 2h em saliva artificial durante 7 dias. As leituras de Ra e VHN foram realizadas antes e após erosão. A porcentagem de perda de dureza (%VHN) foi obtida depois da erosão. A morfologia de superfície foi analisada por microscopia eletrônica de varredura (MEV). Foram utilizados testes de ANOVA, Tukey e T-Student (α=0,05). Resultado: Após a erosão, foi observado aumento dos valores de Ra em todos os cimentos testados, e os grupos U200 e ZNP tiveram a maior %VHN. Após imersão em saliva, apenas os grupos U200 e ZnP tiveram aumento significativo nos valores de Ra e não houve diferenças significativas entre os grupos quanto à %VHN. A análise em MEV mostrou que os grupos Ketac e ZNP apresentaram superfícies rugosas e porosas, e o grupo U200 apresentou maior degradação da matriz comparado ao grupo ARC. Conclusão: O desafio erosivo com bebida a base de cola afetou as propriedades de superfície de todos os cimentos.

Thickness and nanomechanical properties of protective layer formed by TiF4 varnish on enamel after erosion

Abstract The layer formed by fluoride compounds on tooth surface is important to protect the underlying enamel from erosion. However, there is no investigation into the properties of protective layer formed by NaF and TiF4 varnishes on eroded enamel. This study aimed to evaluate the thickness, topography, nanohardness, and elastic modulus of the protective layer formed by NaF and TiF4 varnishes on enamel after erosion using nanoindentation and atomic force microscopy (AFM). Human enamel specimens were sorted into control, NaF, and TiF4 varnish groups (n = 10). The initial nanohardness and elastic modulus values were obtained and varnishes were applied to the enamel and submitted to erosive challenge (10 cycles: 5 s cola drink/5 s artificial saliva). Thereafter, nanohardness and elastic modulus were measured. Both topography and thickness were evaluated by AFM. The data were subjected to ANOVA, Tukey's test and Student's t test (α = 0.05). After erosion, TiF4 showed a thicker protective layer compared to the NaF group and nanohardness and elastic modulus values were significantly lower than those of the control group. It was not possible to measure nanohardness and elastic modulus in the NaF group due to the thin protective layer formed. AFM showed globular deposits, which completely covered the eroded surface in the TiF4 group. After erosive challenge, the protective layer formed by TiF4 varnish showed significant properties and it was thicker than the layer formed by NaF varnish.