Efectividad de bioceramicos en el mantenimiento de la vitalidad pulpar en recubrimiento pulpar directo en denticion primaria y permanente: revisión sistemática con metaanálisis

Introducción: Se han desarrollado materiales bioactivos para el recubrimiento pulpar directo con el objetivo de preservar la pulpa dentaria y mantener el diente por mayor tiempo en la cavidad oral. Objetivo: El objetivo de esta revisión fue evaluar la efectividad del uso de bioceramicos como material de recubrimiento directo pulpar para mantener la vitalidad pulpar en dientes primarios y permanentes con pulpitis reversible. Metodología: Se realizó una revisión sistemática con meta análisis. Se estudió el éxito en el tratamiento del mantenimiento de la vitalidad, el dolor postoperatorio y la decoloración. Se realizó una búsqueda Electrónica en las bases de datos: MEDLINE, EMBASE, COCHRANE, SCOPUS, LILACS, BBO. Se extrajeron los datos y se analizaron con Rev Man. Resultados: Se incluyeron ensayos clínicos aleatorizados en la cual se realizaron recubrimiento pulpar directo con silicatos tricalcicos comparado con otros materiales de recubrimiento. Comparando tres biocerámicos no se encontraron diferencias significativas en el mantenimiento de la vitalidad pulpar. En cuanto a la decoloración se observaron diferencias estadísticamente significativas a favor de Biodentine (p <0,001). Discusión: la relevancia clínica de estos hallazgos es discutible debido a su pequeña magnitud general y al alto riesgo de sesgo de los estudios incluidos.

Introduction: Bioactive materials have been developed for direct pulp capping in order to preserve the dental pulp and keep the tooth longer in the oral cavity. Objective: The objective of this review was to evaluate the effectiveness of the use of bioceramics as direct pulp capping material to maintain pulp vitality in primary and permanent teeth with reversible pulpitis. Methods: A systematic review with meta-analysis was performed. Success in treating vitality maintenance, postoperative pain, and discoloration was studied. An electronic search was carried out in the databases: MEDLINE, EMBASE, COCHRANE, SCOPUS, LILACS, BBO. Data were extracted and analyzed with Rev Man. Results: Randomized clinical trials in which direct pulp capping with tricalcium silicates was performed compared with other capping materials were included. Comparing three bioceramics, no significant differences were found in the maintenance of pulp vitality. Regarding discoloration, statistically significant differences were observed in favor of Biodentine (p <0.001). Discussion: the clinical relevance of these findings is debatable due to their small overall magnitude and the high risk of bias of the included studies.

Carica papaya mouthrinse as an inhibitor of Streptococcus mutans: Randomized controlled clinical trial.

PURPOSE: To evaluate the effect of Carica papaya mouthrinse as an inhibitor of Streptococcus mutans. METHODS: This was a double blind (subject and evaluator) randomized controlled trial in 40 subjects distributed in two groups: Carica papaya mouthrinse intervention (n= 20) or chlorhexidine (n= 20). The antibacterial effect was determined by counting colony-forming units per milliliter (CFU/ml) of S. mutans in saliva sample cultures; taken both before mouthrinse, immediately after 10 minutes mouthrinsing, and 8 days after mouthrinsing. The data was statistically analyzed with Student's t-test (P ≤ 0.05). RESULTS: The difference before and immediately after (10 minutes) use of Carica papaya mouthrinse was of 764 CFUs. After 8 days use the difference was 212 CFUs. For the control group (0.12% chlorhexidine) the difference before and immediately after use (10 minutes) was 683 CFUs. After 8 days use the difference was 455 CFU. When comparing between groups applying t-test, no statistical differences were found in the (CFU/ml) of S. mutans before and after 10 minutes mouthrinse (P= 0.8060), 10 minutes and 8 days after mouthrinsing (P= 0.7104) before and 8 days after mouthrinsing (P= 0.4419). CLINICAL SIGNIFICANCE: Carica papaya could be an alternative mouthrinse for the inhibition of Streptococcus mutans.

Antibacterial effect of green tea infusion used as a mouthwash on saliva and bacterial plaque: a randomized controlled trial.

The objective of this study was to evaluate the antibacterial effect of a green tea infusion used as a mouthwash. In this double-blind, randomized controlled study, simple randomization was used to divide 28 students, 18 to 40 years of age, into 2 groups (n = 14): green tea (intervention) or distilled water (placebo). A 13% green tea infusion was prepared with 13 g of green tea (commercially fractionated) in 100 mL of saline solution at a temperature of approximately 90°C. The liquid was poured into sterile glass containers, as was the distilled water for the control group. The antibacterial effect was determined by counting the colony-forming units in cultures of plaque and saliva samples, which were obtained before and immediately after the students rinsed their mouth once with 10 mL of the green tea or control solution. The data were subjected to t tests to analyze differences before and after the intervention and between groups (green tea versus distilled water) (P < 0.05). The analysis showed statistically significant differences between the groups (P < 0.05), with participants in the green tea group demonstrating greater reductions in the numbers of colony-forming units. Green tea mouthwash had an antibacterial effect on saliva and bacterial plaque, suggesting that green tea mouthwash could be a beneficial addition to standard oral hygiene measures. Trial registration: ClinicalTrials.gov Identifier NCT04410666.

Use of povidone as a mouthrinse to decrease the viral load of Covid-19 before dental care: Review of the literature.

PURPOSE: To review the literature on the use of povidone prior to dental treatment for the reduction of viruses in the oral cavity. METHODS: PubMed and Cochrane databases published from January 2019 to June 2020 were reviewed. Studies that met the inclusion criteria were reviewed by two authors separately. A qualitative review of the data was performed. RESULTS: There were no randomized controlled trials or clinical observation studies on the curative or preventive effect of povidone against COVID-19, but there are clinical trial protocols in the recruitment process. The use of a dose between 0.2% to 2.5% is recommended four times a day for 15-30 seconds. CLINICAL SIGNIFICANCE: Povidone mouthwash could be a viable solution before dental care that should be studied to reduce the viral load off COVID-19.