Bacterial Contamination of Gutta-Percha Points From Different Brands and the Efficacy of a Chairside Disinfection Protocol.

OBJECTIVE: To evaluate the bacterial contamination of different brands of Gutta-Percha (GP) points routinely used in clinical practice and the efficacy of a chairside disinfection protocol with sodium hypochlorite. METHODS: GP points (n=240), in sizes A, B, C, D, K15, K20, K25, K30, K35, K40, F1, F2, F3 (Dentsply®, Proclinic®, ProTaper® and R&S®), were randomly sampled from commercial packages already in use. These were added directly to Fluid Thioglycolate Medium (one GP point per tube) and incubated at 37ºC for 21 days. During this period, the presence/absence of turbidity was evaluated. To evaluate the efficacy of a chairside disinfection protocol, all detected contaminated GP points were immersed for 1 minute in 10 mL of 5.25% sodium hypochlorite, followed by 5 minutes in 10 mL of detergent solution (3% Tween 80 and 5% sodium thiosulfate) and a final rinse with 10 mL of sterile distilled water and incubated. The data was analysed using the chi-square test and differences between characteristics of dichotomic variables were performed using the binomial test. The significance level was set at P<0.05. RESULTS: Bacterial growth was observed in 22.9% of the total study samples. Dentsply® and R&S® showed the highest level of contamination, 47.3% each, although without significant differences to the other commercial brands. The most contaminated GP point size was K30 (16.4%). The chairside disinfection protocol was effective in disinfection of 76.4% of GP points (P<0.001). CONCLUSION: A real small number of GP points in clinical use harboured bacteria, including after the Chairside Disinfection Protocol that, anyway, proved to be effective. No significant difference was observed between tested commercial brands.

Prenatal or Childhood Serum Levels of Vitamin D and Dental Caries in Paediatric Patients: A Systematic Review.

PURPOSE: To assess the association between low prenatal or childhood levels of 25-hydroxyvitamin D (25(OH) D) and dental caries experience in children. MATERIALS AND METHODS: PubMed, B-On, Web of Science, Scopus, and Cochrane Library databases were searched. The inclusion criteria were randomised controlled trials, cohort and cross-sectional studies published between 1998 and 2019; caries outcomes expressed as prevalence or based on the decayed missing and filled index for primary and permanent teeth/surfaces; and vitamin D levels assessed by laboratory analysis. Two authors independently selected studies, collected data, and assessed risk of bias. The quality of the studies was also assessed. A narrative synthesis of the studies was performed without quantitative pooling of data due to clinical and methodological heterogeneity. RESULTS: Out of 399 studies identified, 13 were included in the data synthesis. Even though many of the included studies had a cross-sectional design, 11 were considered high quality. The studies indicated that vitamin D has an important role in caries experience, but also revealed that vitamin D levels equal to or above 75 nmol/l seem to be more closely related to caries experience than the reference value of the Institute of Medicine. CONCLUSION: Evidence of an association exists between low 25(OH) D levels (<75 nmol/l) and caries experience in children. Hence, low vitamin D levels should be considered a potential factor associated with caries in children. Clinicians should be aware that good prenatal nutrition and early childhood diet might influence caries experience.