Grey levels and radiolucent lesion depth as cavity predictors for approximal dentin caries lesions in primary teeth.

OBJECTIVES: This study investigated grey levels and radiolucent lesion depth as cavity predictors for approximal dentin caries lesions in primary teeth. METHODS: 51 children (4-10 years old), presenting with radiolucency in the outer half of the dentin on the approximal surfaces of deciduous molar teeth and approximal anatomic contact with the adjacent tooth (without restoration or cavitated caries lesion), participated in the study. Bitewing radiographs were made, and temporary tooth separation was performed and an impression taken to detect cavitation. Radiographs were scanned (300 dpi) and grey levels were measured in carious and sound dentin. Impressions were also scanned and the size of cavity opening was measured in square millimetres. RESULTS: Grey levels of carious dentin (115.27+/-33.52) were significantly lower compared with sound dentin (151.88+/-30.99). No significant differences were observed in the dentin degree of radiolucency between "cavitated" and "non-cavitated" carious dentin. Cavitated lesions showed deeper radiolucent lesions compared with non-cavitated ones (P=0.03). There was no association between the size of cavitation and radiolucent lesion depth. CONCLUSIONS: Grey levels did not indicate cavitation in the outer half of the approximal dentin lesions. However, extension of a radiolucent lesion deep into the outer half of the dentin was associated with cavitated lesions independently of the size of cavitation. A computer-aided image analysis may help clinicians in monitoring caries progression and evaluating the probability of occurrence of cavitated caries lesions.

A 12-month follow-up of an influenza vaccination campaign based on voluntary adherence: report on upper-respiratory symptoms among volunteers and non-volunteers.

CONTEXT: Routine immunization of groups at high risk for influenza has been progressively implemented as a matter of Brazilian public health policy. Although the benefits of the vaccination for healthy young adults are still controversial, it has been offered yearly to hundreds of thousands of Brazilian workers, generally as part of wellness initiatives in the workplace. OBJECTIVE: To study the characteristics of subjects that accepted or refused to be vaccinated against influenza and to report on respiratory symptoms in both groups, one year after the campaign date. DESIGN: A prospective observational study. SETTING: Workers at a subsidiary of an international bank in São Paulo, Brazil. PARTICIPANTS: 124 persons that did not accept and 145 that voluntarily accepted the vaccine completed 12 months of follow-up. MAIN MEASUREMENTS: Data concerning gender, age, tobacco use, and any history of chronic respiratory illness such as asthma, bronchitis, rhinitis, and repetitive upper-respiratory infections, were recorded at the time of vaccination. After that, workers were asked monthly by questionnaire or telephone about respiratory symptoms, days of work lost and medical consultations. RESULTS: The results showed statistically significant differences regarding age (P = 0.004) with the vaccinated group (V) being younger than the non-vaccinated (NV) one, and with reference to previous repetitive upper-respiratory infections being higher among the V group (P < 0.0001). During the follow-up, the V group reported more occurrences of upper respiratory symptoms (P < 0.0001), due to both non-influenza (P < 0.0001) and influenza-like illness (P = 0.045). Differences were also found between V and NV groups concerning days off work and number of medical consultations due to upper-respiratory symptoms and non-influenza illness. Gender and history of repetitive upper-respiratory infections were the best predictors of influenza-like illness-related events. CONCLUSIONS: The making of previous reference to repetitive upper-respiratory infections was a major difference between those who accepted or rejected the vaccine. The vaccination itself was not sufficient to reduce the number of occurrences of respiratory symptoms and related absenteeism to levels similar to those found among non-vaccinated people.

A comparison of three resin bonding agents to primary tooth dentin.

This study determined the shear bond strength of resin composites to primary dentin using three dentin adhesives and the presence or absence of a hybrid zone. The buccal and lingual surfaces of 40 recently extracted noncarious primary teeth were ground flat with SiC paper ending with the 600 grit. The teeth were divided at randomly into eight groups of five teeth (10 surfaces) each: 1) Unetched dentin, dry dentin, All-Bond 2/Bis-Fil P; 2) Unetched dentin, moist dentin, All-Bond 2/Bis-Fil P; 3) Dentin etched for 15 sec with 10% phosphoric acid, dry dentin, All-Bond 2/Bis-Fil P; 4) Dentin etched for 15 sec with 10% phosphoric acid, moist dentin, All-Bond 2/Bis-Fil P; 5) Dentin etched with 10% maleic acid for 15 sec, dry dentin, Scotchbond Multi-Purpose/Z100; 6) Dentin etched with 10% maleic acid for 15 sec, moist dentin, Scotchbond Multi-Purpose/Z100; 7) Dentin etched with 10 citric acid/3% ferric chloride, dry dentin, Amalgambond Plus/Z100; 8) Dentin etched with 10 citric acid/3% ferric chloride, moist dentin, Amalgambond Plus/Z100. All teeth were thermocycled 1000x (5 and 55 degrees C, 30-sec dwell time), and shear bond strength testing was conducted using an Instron (crosshead speed 0.5 mm/min). Failure sites after debonding were examined with the SEM. For each group, one additional tooth was used to prepare two class V cavities (one facial and one lingual) restored according to the specification in each group, sectioned buccolingually and examined with the SEM. The results, in MPa, were: 1) 12.55 +/- 5.97; 2) 10.41 +/- 6.16; 3) 9.94 +/- 7.26; 4) 12.25 +/- 4.70; 5) 13.02 +/- 8.01; 6) 16.51 +/- 8.62; 7) 12.51 +/- 8.95; 8) 17.93 +/- 6.44. ANOVA and Student-Newman-Keuls tests showed no statistically significant differences. SEM evaluation showed that the smear layer was removed in all groups exposing primary dentin tubules infiltrated by resin. A resin-reinforced hybrid layer was readily seen in all specimens.

Esthetic and functional treatment of a fused permanent tooth: a case report.

This report describes a young patient with fusion of a maxillary central incisor to a supernumerary tooth. Treatment involved extraction of the fused tooth and orthodontic movement of the lateral incisor to occupy the position of the extracted tooth. A resin composite laminate veneer was placed on the lateral incisor to simulate the appearance of a central incisor. Five years of follow-up revealed that treatment had successfully restored esthetics and function.

Fluoride release from fluoride-containing materials.

This in vitro study evaluated the amount of fluoride released from fluoride-containing materials over a period of 28 days. Six disk samples (2.06 +/- 0.06 cm2) were prepared of each material and divided at random into seven groups: Group 1: Chelon-Fil; Group 2: Chelon-Silver; Group 3: VariGlass; Group 4: Dyract; Group 5: Vitremer; Group 6: Vitremer + Scotchbond Multi-Purpose; Group 7: Fuji II LC. The cements were mixed according to the manufacturers' recommendations, placed in plastic molds, and pressed between two glass plates. Paraffined dental floss was incorporated into the cements during setting to serve as attachments. The materials in Groups 3, 4, and 5 were light cured (Heliolux) in two different positions for 40 seconds each. In Group 6, the adhesive was light cured in two different positions on both sides for 10 seconds each. The samples were stored at 100% relative humidity for 24 hours. Each sample was then suspended in individual plastic tubes containing 5 ml of deionized water and submitted to constant agitation at 25 degrees C. The water was changed every 24 hours. Fluoride release was determined at 1, 2, 3, 4, 5, 7, 14, and 28 days after buffering the solution with equal volume of TISAB. Fluoride release was measured with a fluoride ion-specific electrode (Orion 96-09) and an ionanalyzer (Orion EA 940) previously calibrated with standard solutions containing 0.05 to 5.00 micrograms F/ml. Fluoride release was expressed as ppm in solution and micrograms F/cm2. ANOVA and Student-Newman-Keuls tests were used to evaluate the data. The results revealed that Chelon-Fil released significantly (P < 0.001) more fluoride for the first 7 days than all the other products. This was followed by Fuji II LC, which exhibited significantly more fluoride release than the rest of the materials for the same 7 days. At days 14 and 28, Chelon-Fil, Dyract, and Fuji II LC released similar amounts of fluoride that were significantly greater than the other products. Group 6 (Vitremer + Scotchbond Multi-Purpose) released significantly less fluoride than the other materials at all time intervals. Fluoride release for all products at days 1 and 2 was significantly greater than the rest of the time intervals, except for Chelon-Silver, which released similar amounts of fluoride for days 2, 3, 4, and 5. Although significance for the remaining time intervals varied for all materials, all fluoride release decreased from day 1 to day 28.

Diagnosis of approximal caries in primary teeth: radiographic versus clinical examination using tooth separation.

PURPOSE: To compare the accuracy of clinical examination performed with bitewing radiographs or clinical examination using tooth separation to identify carious lesion activity. MATERIALS AND METHODS: 320 surfaces from 40 bitewing radiographs were examined for approximal caries on the maxillary and mandibular primary molars of 20 patients 3-10 years old. The patients were divided into three groups: (1) Absence of the permanent first molar; (2) Partial eruption of the permanent first molar; and (3) Full eruption of the permanent first molar. Two examiners evaluated the radiographs using a megascope, a magnifying glass (x2), and an amplifying image screen. Approximal radiolucencies were identified on 72 surfaces. Following the radiographic examinations, the two examiners performed conventional clinical inspection using a No. 4 dental mirror, a No. 5 dental explorer, and an air-water syringe, with artificial light and relative isolation. The separation method was performed with elastic bands, which were removed after 24 hours, and the clinical examination conducted as in the non-separation group. RESULTS: The correlation between the extension of interproximal radiolucent lesions in primary dentition and their clinical diagnoses following separation of the teeth, was similar to findings on literature evaluating the permanent dentition. On radiographic findings for enamel lesions, white spots predominated both in the inner (100%) and in the outer (94%) half of enamel upon clinical examination with separation of teeth. For radiolucent lesions in dentin, on the other hand, cavities predominated over white spot lesions (84%). In Groups 1 and 2 (young primary), white spots occurred in cases where the radiolucent lesions reached the dentin (15% and 25%), similar to findings for young permanent teeth. Clinical diagnosis performed with the mechanical separation of teeth cannot be considered conclusive for the primary dentition.

Invasive technique of pit and fissure sealants in primary molars: a SEM study.

One of the alternatives used when the clinical inspection of the fissure is doubtful is the invasive technique. This study used the SEM, to investigate two kinds of burs in doing the invasive technique upon primary molars, as well as to test the suitability of two kinds of sealants (with and without filler particles) to penetrate into such preparations. The points hereby tested revealed to be adequate in obtaining a minimal opening in the enamel, allowing the inspection of the fissure, and at the expense of a slight removal of dubious tissue, permitting a preparation of easy clinical performance. In regard to sealant penetration, no difference was seen between the self-cured sealant and the light-cured sealant.

Enhancement of fissure sealant penetration and adaptation: the enameloplasty technique.

The purpose of this study was to evaluate with the scanning electron microscope (SEM) the effects of mechanically enlarging the occlusal fissures with a bur in regards to: (1) fissure micromorphology; (2) sealant penetration into fissures; and (3) micromorphology of the fitting surface of sealants. The technique is described as EST, for Enameloplasty Sealant Technique. The conventional sealant technique is referred to as CST. A total of 30 extracted permanent molars were used and divided into four groups: (1) pumice prophylaxis, no sealant; (2) same as Group 1 but with FluoroShield sealant; (3) EST, no sealant; (4) EST followed by FluoroShield. Subgroups were instituted to evaluate the sealant-enamel interface and the sealant fitting surface. The bur used in this, study was specifically designed for this purpose. Some samples were replicated in epoxy resin and all samples were evaluated with the SEM. The results demonstrated that the EST allowed a deeper sealant penetration and a superior sealant adaptation than the CST. An increased surface area for sealant retention was readily evident in all samples treated with the EST.

Diagnosis of approximal caries: radiographic versus clinical examination using tooth separation.

This study compared the accuracy of clinical examination with bitewing radiographs and clinical examination using tooth separation to recognize the carious lesions activity. 336 bitewings were reviewed for approximal caries on the maxillary and mandibular second premolars and first molars of 168 high school students. Three examiners evaluated the radiographs using a megascope, a magnifying glass (x2) and an amplifying image screen. 77 surfaces were identified with approximal radiolucencies. After the radiographic examinations, the three examiners performed a conventional clinical inspection using a No. 4 odontoscope, a No.5 explorer probe and an air-water syringe with artificial light and relative isolation. The variables recorded were: (1) healthy surface; (2) white spot; or (3) carious cavitation. The separation method was performed with elastics. After 24 hours, the elastics were removed and the clinical examination conducted as in the non-separation group.(ABSTRACT TRUNCATED AT 250 WORDS)