Cytotoxicity and the effect of cationic peptide fragments against cariogenic bacteria under planktonic and biofilm conditions.

This study evaluated the cytotoxicity and effect of fragments derived from three oral cationic peptides (CP): LL-37, D6-17 and D1-23 against cariogenic bacteria under planktonic and biofilm conditions. For cytotoxicity analysis, two epithelial cell lines were used. The minimum inhibitory concentration and the minimal bactericidal concentration were determined for the CP fragments and the control (chlorhexidine-CHX) against cariogenic bacteria. The fractional inhibitory concentration was obtained for the combinations of CP fragments on Streptococcus mutans. Biofilm assays were conducted with the best antimicrobial CP fragment against S. mutans. The results indicated that D6-17 was not cytotoxic. D1-23, LL-37 and CHX were not cytotoxic in low concentrations. D1-23 presented the best bactericidal activity against S. mutans, S. mitis and S. salivarius. Combinations of CP fragments did not show a synergic effect. D1-23 presented a higher activity against S. mutans biofilm than CHX. It was concluded that D1-23 showed a substantial effect against cariogenic bacteria and low cytotoxicity.

Fluoride and sodium trimetaphosphate (TMP) release from fluoride varnishes supplemented with TMP.

This study assessed fluoride (F) and sodium trimetaphosphate (TMP) release into artificial saliva from varnishes containing 0%, 2.5%, and 5% NaF, supplemented or not with 5% TMP. The varnishes were applied on polyester sheets (n = 8/group), and F and TMP released into artificial saliva were measured for up to 24 hours. The amount of F and TMP released were directly related to NaF and TMP concentrations in the varnishes. The highest F release was seen for 5% NaF and 5% NaF + 5% TMP, whereas 5% TMP released the highest amount of TMP. However, the simultaneous addition of NaF and TMP to varnishes significantly reduced the amount of F and TMP released from the products.

Fluoride concentrations of milk, infant formulae, and soy-based products commercially available in Brazil.

OBJECTIVES: To assess the fluoride (F) content in commercially available milk formulae in Brazil and to estimate the F intake in children from this source in the first year of life. METHODS: Samples of cow's milk (n = 51), infant formulae (n = 15), powdered milk (n = 13), and soy-based products (n = 4) purchased in Araçatuba (Brazil) had their F content measured using an ion-specific electrode, after hexamethyldisiloxane-facilitated diffusion. Powdered milk and infant formulae were reconstituted with deionized water, while ready-to-drink products were analyzed without any dilution. Using average infant body masses and suggested volumes of formula consumption for infants 1-12 months of age, possible F ingestion per body mass was estimated. Data were analyzed by descriptive analysis. RESULTS: Mean F content ranged from 0.02 to 2.52 mg/L in all samples. None of the cow's milk provided F intake higher than 0.07 mg/kg. However, two infant formulae, one powdered milk, and one soy-milk led to a daily F intake above the suggested threshold for fluorosis when reconstituted with deionized water. Assuming reconstitution of products with tap water at 0.7 ppm F, two infant formulae, five powdered milk, and four soymilks led to daily F intake ranging from 0.108 to 0.851 mg/kg. CONCLUSIONS: The results suggest that the consumption of some brands of infant formulae, powdered milk, and soy-based milk in the first year of age could increase the risk of dental fluorosis, reinforcing the need for periodic surveillance of the F content of foods and beverages typically consumed by young children.

Fluoride and sodium trimetaphosphate (TMP) release from fluoride varnishes supplemented with TMP

Abstract This study assessed fluoride (F) and sodium trimetaphosphate (TMP) release into artificial saliva from varnishes containing 0%, 2.5%, and 5% NaF, supplemented or not with 5% TMP. The varnishes were applied on polyester sheets (n = 8/group), and F and TMP released into artificial saliva were measured for up to 24 hours. The amount of F and TMP released were directly related to NaF and TMP concentrations in the varnishes. The highest F release was seen for 5% NaF and 5% NaF + 5% TMP, whereas 5% TMP released the highest amount of TMP. However, the simultaneous addition of NaF and TMP to varnishes significantly reduced the amount of F and TMP released from the products.

Association between maternal breastfeeding and the development of non-nutritive sucking habits / Relação entre aleitamento materno e o desenvolvimento de hábito de sucção não nutritiva

To analyze the association of maternal breastfeeding time with the introduction of non-nutritive sucking habits in children attending the Baby Clinic at the Araçatuba College of Dentistry, Universidade Estadual Paulista Júlio de Mesquita.

Analisar a associação do tempo de aleitamento materno na instalação de hábitos de sucção não nutritiva em crianças atendidas na Bebê Clínica da Faculdade de Odontologia de Araçatuba da Universidade Estadual Paulista Júlio de Mesquita Filho.

In vitro effect of sodium trimetaphosphate additives to conventional toothpastes on enamel demineralization.

OBJECTIVE: The aim of this study was to evaluate the ability of conventional toothpastes (1100 ppm F) supplemented with sodium trimetaphosphate (TMP) in demineralization. MATERIAL AND METHODS: Blocks of enamel were selected and then divided into seven experimental groups of 12: toothpaste without F and TMP (placebo), toothpaste with 1100 ppm F (1100), and toothpaste with 1100 ppm F supplemented with TMP-1 % (1100 1 % TMP), 3 % (1100 3 % TMP), 4.5 % (1100 4.5 % TMP), 6 % (1100 6 % TMP), and 9 % (1100 9 % TMP). Blocks were subjected to five pH cycles (demineralizing/remineralizing solutions) at 37 °C and treated with toothpaste slurries twice daily, after which the blocks were maintained for 2 days in fresh remineralizing solution. Following treatments, surface hardness (SHf) and cross-sectional hardness were determined for calculating the integrated loss of subsurface hardness (ΔKHN). The fluoride present in the enamel was also measured. RESULTS: The SHf and ΔKHN measurements showed that supplementation with 3 % TMP was the most effective (p < 0.001) and showed greater concentration of F in the enamel (p < 0.001). CONCLUSION: Addition of 3 % TMP to a conventional toothpaste (1100 ppm F) showed greater efficacy in reducing enamel demineralization. CLINICAL RELEVANCE: Fluoride toothpastes containing trimetaphosphate possess good anticaries potential required to reduce the prevalence of dental caries in high-risk patients.

Condyloma acuminata in the tongue and palate of a sexually abused child: a case report.

BACKGROUND: Condyloma acuminata caused by human papilloma viruses, (HPV) is a sexually transmitted disease (STD) appearing most frequently as soft, pink cauliflower like growths in moist areas, such as the genitalia, mouth and other places. The disease is highly contagious, can appear singly or in groups, small or large. In children, the isolation of a sexually transmitted organism may be the first indication that an abuse has occurred. Although the presence of a sexually transmissible agent from a child beyond the neonatal period is suggestive of sexual abuse, exceptions do exist. CASE PRESENTATION: The authors report the clinical case of a five-year-old Caucasian male with lesions located in the dorsal surfaces of the posterior tongue and palate. Both lesions had a firm consistency, reddish appearance and presence of whitish areas and regions of ulceration. During the interview, the mother reported that the boy had been sexually abused. CONCLUSION: Sexually transmitted disease may occur during sexual abuse. Dentists as well as pediatricians have a role to play in identifying and treating these children. The diagnosis is essentially clinical (anamnesis and physical examination), but also the use of cytology eventually resorts to biopsy of the suspicious lesions for histological examination. The therapeutic option was the excision of the lesions.

Primate pulpal healing after exposure and TheraCal application.

AIM: The purpose of this in vivo study was to compare the effectiveness of a new light cured resin based dicalcium/tricalcium silicate pulp capping material (TheraCalLC, Bisco), pure Portland cement, resin based calcium hydroxide or glass ionomer in the healing of bacterially contaminated primate pulps. STUDY DESIGN: The experiment required four primates each having 12 teeth prepared with buccal penetrations into the pulpal tissues with an exposure of approximately 1.0 mm. The exposed pulps of the primate teeth were covered with cotton pellets soaked in a bacterial mixture consisting of microorganisms normally found in human pulpal abscesses. After removal of the pellet, hemostasis was obtained and the pulp capping agents applied. The light cured resin based pulp capping material (TheraCal LC) was applied to the pulpal tissue of twelve teeth with a needle tip syringe and light cured for 15 seconds. Pure Portland cement mixed with a 2% Chlorhexidine solution was placed on the exposed pulpal tissues of another twelve teeth. Twelve additional teeth had a base of GIC applied (Triage, Fuji VII GC America) and another twelve had a pulp cap with VLC DYCAL (Dentsply), a light cured calcium hydroxide resin based material. The pulp capping bases were then covered with a RMGI (Fuji II LC GC America). The tissue samples were collected at 4 weeks. The samples were deminerilized, sectioned, stained and histologically graded. RESULTS: There were no statistically significant differences between the groups in regard to pulpal inflammation (H = 0.679, P = 1.00). However, both the Portland cement and light cured TheraCal LC groups had significantly more frequent hard tissue bridge formation at 28 days than the GIC and VLC Dycal groups (H = 11.989, P = 0.009). The measured thickness of the hard tissue bridges with the pure Portland and light cured TheraCal LC groups were statistically greater than that of the other two groups (H = 15.849, P = 0.002). In addition, the occurrence of pulpal necrosis was greater with the GIC group than the others. Four premolars, one each treated according to the protocols were analyzed with a microCT machine. The premolar treated with the light cured TheraCal LC demonstrated a complete hard tissue bridge. The premolar treated with the GIC did not show a complete hard tissue bridge while the premolar treated with VLC Dycal had an incomplete bridge. The pure Portland with Chlorhexidine mixture created extensive hard tissue bridging. CONCLUSION: TheraCal LC applied to primate pulps created dentin bridges and mild inflammation acceptable for pulp capping.

Evaluation of tissue reaction, cell viability and cytokine production induced by Sealapex Plus

OBJECTIVE: The aim of this study was to investigate the effects of mineral trioxide aggregate (MTA), Sealapex, and a combination of Sealapex and MTA (Sealapex Plus) on the reaction of subcutaneous connective tissue of rats, and on cell viability and cytokine production in mouse fibroblasts. MATERIAL AND METHODS: The tissue reaction was carried out with dentin tubes containing the materials implanted in the dorsal connective tissue of rats. The histological analysis was performed after 7 and 30 days. Millipore culture plate inserts with polyethylene tubes filled with materials were placed into 24-well cell culture plates with mouse fibroblasts to evaluate the cell viability by MTT assay. ELISA assays were also performed after 24 h of exposure of the mouse fibroblasts to set material disks. RESULTS: Histopathologic examination showed Von Kossa-positive granules that were birefringent to polarized light for all the studied materials at the tube openings. No material inhibited the cell viability in the in vitro test. It was detected IL-6 production in all root-end filling materials. MTA and Sealapex Plus induced a slight raise of mean levels of IL-1β. CONCLUSIONS: The results suggest that Sealapex Plus is biocompatible and stimulates the mineralization of the tissue.

Evaluation of tissue reaction, cell viability and cytokine production induced by Sealapex Plus.

OBJECTIVE: The aim of this study was to investigate the effects of mineral trioxide aggregate (MTA), Sealapex, and a combination of Sealapex and MTA (Sealapex Plus) on the reaction of subcutaneous connective tissue of rats, and on cell viability and cytokine production in mouse fibroblasts. MATERIAL AND METHODS: The tissue reaction was carried out with dentin tubes containing the materials implanted in the dorsal connective tissue of rats. The histological analysis was performed after 7 and 30 days. Millipore culture plate inserts with polyethylene tubes filled with materials were placed into 24-well cell culture plates with mouse fibroblasts to evaluate the cell viability by MTT assay. ELISA assays were also performed after 24 h of exposure of the mouse fibroblasts to set material disks. RESULTS: Histopathologic examination showed Von Kossa-positive granules that were birefringent to polarized light for all the studied materials at the tube openings. No material inhibited the cell viability in the in vitro test. It was detected IL-6 production in all root-end filling materials. MTA and Sealapex Plus induced a slight raise of mean levels of IL-1ß. CONCLUSIONS: The results suggest that Sealapex Plus is biocompatible and stimulates the mineralization of the tissue.

Periodontal tissue engineering after tooth replantation.

BACKGROUND: Blood-derived products, platelet-poor plasma (PPP) and platelet-rich plasma (PRP), constitute an approach in the enhancement of tissue healing. PRP has also been used as a scaffold for bone marrow stem cells in tissue engineering. This study evaluates the effect of PPP, calcium chloride-activated PRP (PRP/Ca), calcium chloride- and thrombin-activated PRP (PRP/Thr/Ca), and bone marrow mononuclear cells and PRP/Ca (BMMCs/PRP/Ca) on the healing of replanted dog teeth. METHODS: After 30 minutes of extraction, teeth were replanted with 1) no material (control); 2) PPP; 3) PRP/Ca; 4) PRP/Thr/Ca; or 5) BMMCs/PRP/Ca. Histologic, histomorphometric, and immunohistochemical analysis was assessed 120 days after replantation. Data from histomorphometric analysis were analyzed statistically (analysis of variance, Tukey; P <0.05). Quantitative immunohistochemical analysis was analyzed by Kruskal-Wallis and Dunn post hoc test (P <0.05). RESULTS: Flow cytometry analysis showed 55.98% of CD34(+) and 32.67% of CD90/Thy-1 for BMMCs sample. BMMCs/PRP/Ca presented the largest areas of replacement resorption characterized by osseous ingrowth into cementum (P <0.05), with intense immunomarcation for tartrate-resistant acid phosphatase. The PRP/Ca group also showed areas of replacement resorption with significant immunomarcation for osteopontin. PRP/Thr/Ca presented no replacement resorption. PPP showed areas of inflammatory resorption, with immunomarcation for tartrate-resistant acid phosphatase. CONCLUSIONS: The results suggest that platelets activated with thrombin play an important role in the healing of tissues after tooth replantation. Additional studies are necessary to test other materials, because PRP/Ca did not present an appropriate scaffold for undifferentiated cells in the treatment of avulsed teeth.

Dental caries experience in children attending an infant oral health program

Aim: To investigate: a) caries experience in 5 year-old children and its relationship to the caries risk evaluation made before 1 year of age; b) compliance of parents to an infant oral health program as well as the abandonment reasons. Methods: Group A (GA) - 242 children (60-71months old) who stayed in the program and had been enrolled since their first year of life under went a clinical examination according to the WHO’s criteria; their parents/caregivers were interviewed to ascertain their compliance to the program. Group B (GB) – parents of 60 children, who had dropped out of the program, were interviewed to check the reasons of withdrawing. The caries risk classification was based on the file at the first appointment. Chi-square test was used (á=0.05) for statistical analyses. Results: Most of the children were free of caries (71.1%). Caries risk evaluation showed low sensibility (34.3%, 95% CI = 22.4–46.1) and high specificity (74.4%, 95% CI =67.6–81.2) to caries experience. Sixty-two mothers (25.6%) reported difficulty to follow the guidelines.The main reason for dropping out was changing to similar health services (40.0%). Conclusions:Caries risk in the first year of life was not efficient to predict dental caries experience at 5 years of age. Educational practice should be improved to increase the compliance of the parents to the program.

Análise microscópica da penetração de dois selantes comparados a dois cimentos de ionômero de vidro: estudo in vitro / Microscopical analysis of penetration of two sealants in comparison two glass ionomer: in vitro study

O presente trabalho teve como objetivo comparar a eficácia de materiais utilizados como selantes de fóssulas e fissuras oclusais (Vitremer, Vitrofill LC, Vitroseal Alpha e Flurosshield) em primeiros e segundos pré-molares humanos, bem como avaliar a sua penetração nos sulcos dos mesmos. Foram utilizados 40 dentes, sendo estes divididos em 4 grupos, um para cada material testado. Após o preparo dos elementos com broca 2137F, através da técnica invasiva, os espécimes foram seccionados e desgastados para análise microscópica e registro de imagens através do Sistema de Captura de Imagens da UFPE (Power VCR II). O material obtido após desmineralização teve seus tags medidos através do software Scion Image. Os valores resultantes foram submetidos à análise de variância, sendo realizado o teste estatístico de Tukey. Verificou-se uma grande variação dos somatórios dos comprimentos de tags em micrômetros. Concluiu-se, então, que o selante Fluroshield apresentou maior média de penetração, seguido do Vitroseal Alpha, dos ionômeros Vitremer e Vitrofill LC.

The present work has as objective to compare the effectiveness of materials used as occlusal pit and fictions selants (Vitremer, Vitrofill LC, Vitroseal Alpha and Fluroshield) in first and second premolars human being, as well as evaluating its adaptation and penetration in the grooves of the same ones. Had been used 40 teeth, which had been divided in 4 groups, one for each tested material. After the preparation of the elements with 2137F drill, through the invasive technique, the specimens had been parted and consumed for microscopical analysis and register of images through the System of Capture of Images of UFPE (Power VCR II). The material gotten after desmineralization had its tags measured through software Scion Image. The resultant values had been submitted to the analysis of variance, being carried through the statistical test of Tukey. A great variation of the somatorys of the lengths of tags in micrometers, was verified. It is concluded, therefore, that the sealant Fluroshield presented the greater average of penetration, followed of the Vitroseal Alpha, of the ionomer Vitremer and Vitrofill LC.

Immediate reimplantation of primary teeth: a histological study in dogs.

Reimplantation of primary teeth has been the subject of various clinical and histological studies, but very little is known about the effect of this treatment on primary teeth. The aim of the present study was to histologically evaluate the biological response of dog primary teeth after immediate reimplantation. Twelve dogs were divided into two groups according to postoperative time: 1 week and 3 weeks. Twenty-one upper and lower intermediate incisors were extracted and submitted to endodontic treatment, reimplantation and splinting. The 21 homologous teeth not submitted to treatment served as controls. The animals were killed after the respective experimental periods, and the obtained specimens were processed for histological analysis. Most dogs of the 1-week group exhibited the following alterations: gingival epithelium was inserted in the cemento-enamel junction, with a small number of chronic inflammatory cells being observed in the gingival corium; the periodontal ligament was partially reestablished, with a more expressive chronic inflammatory infiltrate being observed in the apical third; small root resorption was observed on the palatine/lingual side in the apical third. In contrast, in 3-week animals, gingival epithelial insertion was predominantly absent on the buccal side, and a moderate chronic inflammatory infiltrate was present; the periodontal ligament generally showed no bone-cementum reinsertion especially on the palatine/lingual side, with an expressive inflammatory infiltrate in the apical region, and large root resorption was mainly observed on the palatine and lingual sides. In conclusion, reimplantation causes histological alterations in the tooth and its supporting periodontal structures that suggest the impossibility of its maintenance.

Comparison of visual inspection, radiographic examination, laser fluorescence and their combinations on treatment decisions for occlusal surfaces.

PURPOSE: To compare visual inspection (VI), radiographic examination (RX) and the laser fluorescence device DIAGNOdent (L), as well as their combinations in vitro regarding treatment decisions for occlusal surfaces. METHODS: 72 extracted human permanent teeth (molars and premolars) were used. Treatment decisions were recorded by three calibrated examiners, and the options available were fissure sealant and conservative restoration. For validation of treatment decisions, the teeth were sectioned and examined in a stereomicroscope. Thereafter, dental slices were scanned and the images were edited to facilitate classification of existing carious lesions. Intra and inter-examiner reproducibility for the determination of treatment plans were calculated using Cohen's kappa test (95%-CI). Sensitivity, specificity, positive and negative predictive values, and the area under the ROC curve were also calculated. RESULTS: VI and L provided on average the greatest intra- and inter-examiner reproducibility, respectively. Although the combination of diagnostic methods may decrease both intra- and inter examiners reproducibility, combination of VI, L and RX resulted in the greatest sensitivity, being statistically superior to RX and L. There was more inter-examiner agreement for the option of restorative treatment, while the use of sealants as a treatment option yielded the lowest values. Negative predictive values were numerically inferior to positive predictive values, indicating that the examiners preferred not to restore a carious tooth than to proceed operatively in an intact tooth. The combination of the three methods studied showed the best results in determining treatment plans for occlusal surfaces, when compared to the other types of exams. On the other hand, radiographic examination and laser fluorescence were less efficient when used alone.

Treatment of traumatized primary teeth: a conservative approach.

This retrospective study examined some different types of treatment to primary teeth. The aim of this study was to assess the treatment of traumatized primary teeth and the importance of a long-term follow up. Brazilian children in the age group of 1-4 years from a baby clinic took part in the study. Three hundred and fifteen patients suffered some type of traumatic injury, a total of 338 affected teeth. Data were registered in specific records and submitted to statistic analysis. The most prevalent type of treatment was monitor only (85%) followed by tooth extraction and endodontic procedure. Invasive treatments were performed in case of severe traumas, usually 6 months after the injury. We verified that a careful follow up might be the preferential choice to the treatment of traumatic primary teeth even in some severe cases.

Clinical and radiographic evaluation of pulpotomies employing calcium hydroxide and trioxide mineral aggregate.

This study utilized clinical and radiographic examinations to compare the effectiveness of calcium hydroxide paste and mineral trioxide aggregate (MTA) for pulpotomies of primary molars in children. Ninety primary molars that showed clinical and radiographic indications for pulpotomy treatment were selected. The pulpotomies were performed in two sessions, using a corticosteroid/antibiotic solution as therapeutic dressing. The sample was divided into two groups of 45 teeth, in which the pulpal remains were protected with either calcium hydroxide paste (Group 1) or MTA (Group 2). Radiographs were taken immediately and at 3-, 6-, and 12-month follow-up appointments. Three teeth in Group 1 failed after three months, while two cases failed after six months and one more failed at one year. Two failures were found in Group 2 at the 12-month follow-up. These results indicate that both materials may be utilized for pulpotomies in primary teeth.

Histological evaluation of dog permanent teeth after traumatic intrusion of their primary predecessors.

The aims of this study were to analyze the histomorphology of developing permanent teeth whose primary teeth had suffered traumatic intrusion, as well as to compare the influence of immediate extraction of the intruded tooth to passive re-eruption. Nine dogs from 45 to 50 days old were submitted to the intrusion of the maxillary central and lateral primary incisors using a force applicator adapted to the teeth incisal cuspids. The right side intruded teeth were kept in their sockets and the ones on the left side were extracted 30 min later. After a postoperatory periods of 30 and 60 days, four (group 1) and five (group 2) dogs, respectively, were killed by perfusion. The histological evaluations showed that, in group 1, alterations had occurred in the odontoblastic layer and deposition of the enamel matrix had taken place in some specimens while in group 2, a portion of non-mineralized matrix was observed. We concluded that the morphological changes were because of the immediate trauma of intrusion. No differences were found between the groups where the primary tooth was immediately extracted or left to passively re-erupt.

Histological analysis of the periapical tissues of dog deciduous teeth after root canal filling with diferent materials

O objetivo de encontrar um material ideal para obturar canais radiculares de dentes decíduos ainda não foi alcancado. Esse fato estimulou a realizacão de uma experimentacão para analisar histologicamente a reacão dos tecidos periapicais a 3 materiais obturadores de canal. Assim, oitenta canais radiculares de dentes decíduos anteriores de 6 cães, com 60 dias de idade, fora empregados neste estudo. Após o preparo biomecânico, os canais radiculares foram obturados com os seguintes materiais: pasta lentamente reabsorvível de Maisto, Sealer 26 com iodofórmio, pasta L&C (hidróxido de cálcio com óleo de oliva) e, como grupo controle, dentes cujos canais foram preparados biomecanicamente mas não obturados. Trinta dias após o tratamento os animais foram mortos e as pecas processados para análise histológica. Os resultados permitiram ordenar estatisticamente os materiais do melhor para o pior da seguinte maneira: a- Pasta de Maisto, b- Sealer 26 com iodofórmio, c- grupo controle, d- Pasta L&C. Foi observado diferenca significante (p=0,01) somente quando os resultados dos diferentes grupos foram comparados com o grupo da pasta L&C. Foi também observado que a pasta L&C não foi biologicamente compatível enquanto os outros materiais foram biocompatíveis, porém suas velocidades de reabsorcão não foram a mesma observada com as raízes dos dentes decíduos.