Are the counts of Streptococcus mutans and Staphylococcus aureus changed in complete denture wearers carrying denture stomatitis? A systematic review with meta-analyses.

STATEMENT OF PROBLEM: Despite the importance of Candida spp. on the etiology of denture stomatitis (DS), information on the role of the bacterial component is still scarce. PURPOSE: The purpose of this systematic review was to evaluate whether the counts of Staphylococcus aureus and Streptococcus mutans were changed in complete denture wearers diagnosed with Candida-associated DS. MATERIAL AND METHODS: The literature search was performed in 8 databases and by hand searching. The risk of bias was assessed according to the Newcastle-Ottawa qualifier. Meta-analyses were performed considering the microorganism evaluated (S. aureus or S. mutans) and the collection area (mucosa or dentures). The certainty of evidence was assessed according to the grading of recommendations assessment, development and evaluations (GRADE) criteria. RESULTS: Participants with DS presented higher counts of S. aureus in the mucosa compared with those from the control group (OR, 3.16 [1.62, 6.15]; P<.001). No significant difference between the groups was observed for samples collected from dentures (OR, 0.73 [0.50, 1.07]; P=.110). Conversely, participants without DS presented higher counts of S. mutans both in the mucosa (OR, 0.19 [0.06, 0.63]; P=.006) and dentures (OR, 0.64 [0.41, 1.0]; P=.050). CONCLUSIONS: Microbial counts in participants with DS changed as a function of the type of microorganism and collection site. The certainty of evidence ranged from very low to low. The findings reinforce the fact that bacteria also play a relevant role in DS and should be more extensively studied. Such information may be useful to guide further therapies to prevent or control DS.

The effect of complete dentures on edentulous patients' oral health-related quality of life in long-term: A systematic review and meta-analysis.

BACKGROUND: To evaluate whether the long-term use of complete dentures (CD) into promotes significant changes in the oral health-related quality of life (OHRQoL) in edentulous patients. METHODS: A systematic review and meta-analysis was conducted. A broad search in Pubmed, Web of Science, Scopus, Cochrane Library, Grey Literature, clinical trials registers and manual search was done. The eligibility criteria were based on population, intervention, comparisons and outcome: (P) edentulous patients, (I) CDs rehabilitation, (C) OHRQoL after CD, (O) change in scores of OHRQoL. Two independent reviewers applied the eligibility criteria, collected qualitative data, performed methodological quality and evaluated the certainty of the evidence (grading of recommendations assessment, development and evaluation). The meta-analysis was analyzed in RevMan 5.4 with 95% confidence intervals (CIs) and P < 0.05. RESULTS: A total of 2452 records were identified. Twenty-four articles were included in qualitative synthesis. Nineteen studies were qualified as good, 3 as fair and 2 as poor quality. Twelve studies were included in quantitative analysis (meta-analysis). The use of CD did not improved OHRQoL in a period of 3 months through the assessment of the Geriatric Oral Health Assessment Index (GOHAI) instrument (P = 0.55; CI; 6.86 [-15.60, 29.31]), and Oral Health Impact Profile-14 (OHIP-14) (P = 0.05; CI; -14.91 [-29.87, 0.04]), with very low certainty of evidence. In a long term, 6 months, GOHAI instrument (P < 0.00001; CI; 16.22 [10.70, 21.74]), OHIP 20 (P = 0.02; CI; -11.09 [-20.54, -1.64]) and OHIP-EDENT (P = 0.0004; CI; -8.59 [-13.32, -3.86]) showed improvement on OHRQoL, with very low and low evidence of certainty, respectively. CONCLUSION: CD has the strong potential to contribute to oral health-related quality of life in long-term.

Probiotic fermented milks: Children's emotional responses using a product-specific emoji list.

This study aimed to develop and validate a product-specific emoji list and use this list to analyse children's emotional responses associated with the consumption of probiotic fermented milks prepared with different probiotic strains. Furthermore, the overall liking of the products was studied during a sensory test. Six formulations were studied: Bifidobacterium BB12 (BB), Lactobacillus acidophilus L3 (LA3), Lactobacillus acidophilus LA 05 (LA5), Lactobacillus delbrueckii subsp. lactis (LL), Lacticaseibacillus casei 01 (LC), and Streptococcus thermophilus and Lactobacillus delbrueckii subsp. bulgaricus (CONV). A total of 132 children (7-14 years old) participated in two study phases: development (n = 32) and validation (n = 100) of the list. Fifteen emoji were selected to be included in the product-specific list, which had a high frequency of citations in the first phase. The formulations with the highest overall liking (LL, BB, LC and CONV) were correlated with positive emoji, while the least-liked formulations (LA3 and LA5) were associated with negative emoji. Furthermore, the utilisation of emoji enabled the differentiation among formulations with similar overall liking. Therefore, this study developed and validated an emoji list to be used in the evaluation of fermented milks by children. The results suggest that the type of probiotic culture impacted the sensory characteristics of fermented milks, supporting the use of Bifidobacterium, L. lactis or L. casei in these products.

Masticatory function improvement with the use of mandibular single-implant overdentures in edentulous subjects: a systematic literature review.

INTRODUCTION: In this systematic review, several masticatory function parameters assessed during mandibular single-implant overdenture (SIO) use were compared to pre- SIO placement values in edentulous patients with aim of contributing to a consensus regarding denture treatment options. EVIDENCE ACQUISITION: This study was registered a priori in the PROSPERO database (CRD42018106567). Two independent reviewers carried out electronic searches in eight databases, without language or time frame limitations, to collate clinical studies comparing masticatory function of edentulous patients before versus after SIO installation with the implant placed on the mandibular midline. Risk of bias was assessed with a before-and-after tool and evidence certainty level was evaluated with the Grading of Recommendations Assessment, Development and Evaluation program. EVIDENCE SYNTHESIS: Eleven studies were included in this review (1 prospective, 3 crossover trials, 4 randomized clinical trials, 2 paired clinical trials, and 1 pilot). Enrolled patients were mostly over 60 years old; all patients were using conventional complete dentures (CD) prior to SIO installation. Masticatory performance, masticatory efficiency, bite force, and muscle activity were improved after the SIO placement compared to during mandibular CD use. Mandibular movement and masticatory ability data were inconclusive. Most of the studies had low risk of bias, but all had very low certainly level ratings due to methodological heterogeneity. CONCLUSIONS: Placement of SIO improves masticatory function, as reflected mostly by masticatory performance and efficiency data, relative to CD use. Further studies comparing dental rehabilitation options, including SIOs, are needed to improve the quality of evidence in the literature.

Cyclodextrin and TiF4 Nanocomplex on Enamel Demineralization.

The aim of this study was to assess the effect of a newly developed nanocomplex formed of hydroxypropyl-b-cyclodextrin and 1% titanium tetrafluoride (TiF4) after distinct complexation periods (12/72 h) on demineralization of bovine enamel in vitro. Enamel blocks (n=60) were allocated in different groups: Mili-Q water, hydroxypropyl-b-cyclodextrin, 1% TiF4, hydroxypropyl-b-cyclodextrin + 1% TiF4 after 12 h of complexation and hydroxypropyl-b-cyclodextrin + 1% TiF4 after 72 h of complexation. The samples were evaluated by surface microhardness, cross-sectional microhardness and micro-CT. Scanning electron microscopy and energy dispersive X-ray spectrometry (SEM/EDX) were also obtained. Hydroxypropyl-b-cyclodextrin + 1% TiF4 after 12 h complexation resulted in lower percentage of surface microhardness loss compared to Mili-Q water, hydroxypropyl-b-cyclodextrin, 1% TiF4 and hydroxypropyl-b-cyclodextrin + 1% TiF4 after 72 h of complexation group, with a large effect size (from 1.307 to 2.943) and high power (84.9 to 99%). All groups resulted in similar integrated mineral loss (ΔZ) obtained by both internal microhardness and micro-CT techniques. Enamel treated with TiF4 and TiF4 + hydroxypropyl-b-cyclodextrin groups showed a TiO2 glaze-layer, while EDX evaluation identified Ti. The solution containing the inclusion complex of hydroxypropyl-b-cyclodextrin + TiF4 with 12 h of complexation period demonstrated a significant ability to reduce surface demineralization of sound enamel under an artificial cariogenic challenge.

Cyclodextrin and TIF4 nanocomplex on enamel demineralization

Abstract The aim of this study was to assess the effect of a newly developed nanocomplex formed of hydroxypropyl-b-cyclodextrin and 1% titanium tetrafluoride (TiF4) after distinct complexation periods (12/72 h) on demineralization of bovine enamel in vitro. Enamel blocks (n=60) were allocated in different groups: Mili-Q water, hydroxypropyl-b-cyclodextrin, 1% TiF4, hydroxypropyl-b-cyclodextrin + 1% TiF4 after 12 h of complexation and hydroxypropyl-b-cyclodextrin + 1% TiF4 after 72 h of complexation. The samples were evaluated by surface microhardness, cross-sectional microhardness and micro-CT. Scanning electron microscopy and energy dispersive X-ray spectrometry (SEM/EDX) were also obtained. Hydroxypropyl-b-cyclodextrin + 1% TiF4 after 12 h complexation resulted in lower percentage of surface microhardness loss compared to Mili-Q water, hydroxypropyl-b-cyclodextrin, 1% TiF4 and hydroxypropyl-b-cyclodextrin + 1% TiF4 after 72 h of complexation group, with a large effect size (from 1.307 to 2.943) and high power (84.9 to 99%). All groups resulted in similar integrated mineral loss (ΔZ) obtained by both internal microhardness and micro-CT techniques. Enamel treated with TiF4 and TiF4 + hydroxypropyl-b-cyclodextrin groups showed a TiO2 glaze-layer, while EDX evaluation identified Ti. The solution containing the inclusion complex of hydroxypropyl-b-cyclodextrin + TiF4 with 12 h of complexation period demonstrated a significant ability to reduce surface demineralization of sound enamel under an artificial cariogenic challenge.

Resumo O objetivo deste estudo foi avaliar o efeito da 1-etil-3- (3-dimetilaminopropil) carbodiimida (EDC) na resistência de união de pinos de fibra de vidro em canais radiculares obturados com diferentes cimentos endodônticos. Setenta e oito pré-molares inferiores foram obturados com três cimentos endodônticos (n=26): Endofill (END), AH Plus (AHP) e Endosequence BC Sealer (EBS). Após o preparo do espaço para pino, dois subgrupos formaram-se conforme a cimentação dos pinos (n=13): com EDC e sem EDC (controle - CON). Os espécimes foram submetidos ao teste pull-out, classificação do modo de falha e avaliação da superfície do canal radicular por microscopia eletrônica de varredura após o deslocamento. Quanto à força de resistência de união, uma diferença estatisticamente significativa ocorreu entre os subgrupos EDC e CON apenas no END (p=0,001). Não foi detectada diferença entre os subgrupos CON (p=0,339). Contudo, no subgrupo EDC, o AHP apresentou maiores valores (END versus AHP: p=0,001; AHP versus EBS: p=0,016). Acerca da classificação dos modos de falha, o escore 1 (≥50% de cimento) foi o mais comumente observado, exceto para END + EDC. Restos de cimentos endodônticos e cimentos resinosos foram encontrados no terço cervical, mas sem diferença estatística (p=0,269), enquanto no terço médio, houve diferença (p=0,004). Em conclusão, o EDC diminui a resistência de união quando associado ao cimento END, sem alterar o modo de falha entre o cimento resinoso e o pino de fibra de vidro. O melhor desempenho foi observado quanto o EDC foi usado com o cimento AHP.

Characterization and effect of nanocomplexed fluoride solutions on the inhibition of enamel demineralization created by a multispecies cariogenic biofilm model.

OBJECTIVES: The aim of this study was to assess the in vitro caries preventive effect of nanocomplexed solutions of hydroxypropyl-ß-cyclodextrin and γ-cyclodextrin associated with titanium tetrafluoride (TiF4) after different complexation times (12 or 72 h). MATERIALS AND METHODS: Enamel blocks were randomly distributed in 9 groups (n = 11): negative control, hydroxypropyl-ß-cyclodextrin, γ-cyclodextrin, TiF4, hydroxypropyl-ß-cyclodextrin:TiF4 12 h, hydroxypropyl-ß-cyclodextrin:TiF4 72 h, γ-cyclodextrin:TiF4 12 h, γ-cyclodextrin:TiF4 72 h, and NaF (positive control). The solutions were applied for 1 min and the blocks were exposed to a biofilm model. Nanocompounds were characterized by differential scanning calorimetry and X-ray powder diffraction. The percentage of surface microhardness loss (%SML), mineral density changes (ΔZ), lesion depth, surface morphology (scanning electron microscopy-SEM), and chemical characterization (energy-dispersive spectroscopy-EDS) were assessed. RESULTS: No oxidation was observed, and the formation of the nanocomplexes was evidenced by changes in the melting point compared to pure cyclodextrins and the loss of crystallinity of the materials. Hydroxypropyl-ß-cyclodextrin:TiF4 72 h resulted in lower %SML than negative control, hydroxypropyl-ß-cyclodextrin, γ-cyclodextrin, and TiF4 (p < 0.05). NaF differed from all groups (p < 0.05), except for hydroxypropyl-ß-cyclodextrin:TiF4 72 h (p = 0.83). ΔZ of hydroxypropyl-ß-cyclodextrin:TiF4 72 h was higher than negative control, hydroxypropyl-ß-cyclodextrin, γ-cyclodextrin, γ-cyclodextrin:TiF4 1 2 h, γ-cyclodextrin:TiF4 72 h, and NaF (p < 0.05) and similar to TiF4 and hydroxypropyl-ß-cyclodextrin:TiF4 12 h (p > 0.05). SEM/EDS detected Ti in the blocks subjected to TiF4-products. CONCLUSION: The hydroxypropyl-ß-cyclodextrin:TiF4 72 h solution showed caries preventive effect on the surface and subsurface of the enamel. CLINICAL RELEVANCE: A hydroxypropyl-ß-cyclodextrin nanosystem, in association with TiF4 after 72 h of complexation, may be a promising agent for the prevention of enamel demineralization.

Association between Psychological Stress and Periodontitis: A Systematic Review.

This systematic review aims to investigate the association between psychological stress and periodontitis through analysis of cortisol levels and periodontal clinical parameters. This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guide and based on PECO (Participants, Exposure, Comparators, Outcomes) question and registered at PROSPERO under the code CRD42017076670. As eligibility criteria, observational studies performed in adult humans presenting periodontitis (P), which evaluated patients exposed (E) and nonexposed to psychological stress (C) and to verify the association between this type of stress and periodontitis (O) were included. The searches were performed until March 2018. The following databases were used: PubMed, Scopus, Web of Science, The Cochrane Library, LILACS, OpenGrey, and Google Scholar. After searches, the duplicate results were removed. The remaining citations were selected according to eligibility criteria in two phases. In the first phase, the title/abstract was evaluated. In the second phase, the articles were chosen previously were assessed by full text. After selection, the studies were submitted to data extraction and risk of bias evaluation by Fowkes and Fulton. A total of 1,386 citations were retrieved. After duplicates removal and selection process, three articles were selected by full text. Among them, two articles reported a positive association between psychological stress and periodontitis. All articles were classified as low risk of bias. Even though two articles highlighted an association between psychological stress and the presence of a possible modulatory pattern of cortisol levels in clinical parameters of periodontitis, more studies are necessary to elucidate this question.

The relationship of previous dental trauma with new cases of dental trauma. A systematic review and meta-analysis.

BACKGROUND/AIMS: Traumatic dental injuries (TDI) are a public health concern with high prevalence and recurrence rate. The aim of this study was to perform a systematic review and meta-analysis to determine whether previous dental trauma is a predictive factor for new episodes of TDI (recurrence or first episodes). MATERIALS AND METHODS: Electronic searches were performed with no language or date restrictions. According to the PECOS strategy, cohort studies that investigated subjects with and without previous TDI, and its association with new TDI episodes, as primary or secondary outcomes, were included. Quality assessment and bias control were carried out according to Fowkes and Fulton guidelines. A meta-analysis was performed by sub-grouping studies into deciduous and permanent dentition, and the risk ratio (RR) was also calculated (P ≤ 0.05). The evidence was quality-tested using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS: After titles and abstracts were examined, and full texts were read, five studies were included in this systematic review. Four studies had high methodological quality, and one presented a risk of bias on confounding factors. No association and a positive association were determined between previous history of TDI and new episodes of TDI in the primary (RR 1.26 [0.99, 1.62], P = 0.06) and in the permanent dentitions (RR 2.68 [1.20, 4.19], I2  = 37%, P < 0.00001), respectively. The pooled results demonstrated a positive association (P < 0.00001) between previous dental trauma and new episodes of TDI (RR 2.17 [1.20, 3.90], P = 0.01, I2  = 83%) with moderate evidence quality level. CONCLUSIONS: Individuals that have suffered previous TDI present a greater risk of suffering new episodes of TDI.

The Effects of Moderate Physical Exercise on Adult Cognition: A Systematic Review.

Background: Physical exercise is a systematic sequence of movements executed with a predefined purpose. This muscular activity impacts not only on circulatory adaptations, but also neuronal integration with the potential to influence cognition. The aim of this review was to determine whether the literature supports the idea that physical exercise promotes cognitive benefits in healthy adults. Methods: A systematic search for relevant articles was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis criteria using available databases (PubMed, LILACS, Scopus, Web of Science, The Cochrane Library, OpenGrey, Google Scholar and CENTRAL). The search terms included "humans" or "adults" or "cognition" or "awareness" or "cognitive dissonance" or "cognitive reserve" or "comprehension" or "consciousness" and "motor activity" or "exercise" or "physical fitness," and not "aged" or "nervous system diseases," with the purpose of finding associations between moderate physical exercise and cognition. A methodological quality and risk of bias unit assessed the eligibility of articles. Results: A total of 7179 articles were identified. Following review and quality assessment, three articles were identified to fulfill the inclusion criteria. An association between moderate physical exercise and cognition was observed. Improvements in cognitive parameters such as reduced simple reaction time, improved response precision and working memory were identified among the included articles. Conclusion: This systematic review found that moderate physical exercise improves cognition.

The effect of bracket slot size on the effectiveness of orthodontic treatment: A systematic review.

OBJECTIVES: To assess, by means of a systematic review, the scientific evidence of the influence of 0.018-inch or 0.022-inch bracket slots on treatment time, efficiency of space closure, efficiency of alignment, quality of orthodontic finishing, level of discomfort, and level of root resorption. MATERIALS AND METHODS: The PubMed, Bireme, Medline, Scopus, Web of Science, Open Grey, and Google Scholar databases were searched, with no date and language restrictions, for randomized clinical trials and controlled clinical trials, using controlled terms related to bracket slots. After the selection and removal of duplicate articles, the risk of bias was assessed, and the data from the included studies were extracted by two independent researchers. RESULTS: The search yielded 2640 studies. After applying the eligibility criteria, eight articles were fully read and four studies were selected for the qualitative systematic review. No randomized clinical trials assessed the duration of treatment in patients treated with 0.018-inch and 0.022-inch bracket slots. Due to heterogeneity of the data available, a meta-analysis could not be conducted. CONCLUSIONS: While most studies indicated a shorter duration of treatment in patients with 0.018-inch bracket slots, no available data confirmed the higher efficiency of one system over the other. The biases in the studies did not allow for a reliable conclusion; therefore, new studies with a better methodologic design are needed.

Is there an Association Between Periodontitis and Atherosclerosis in Adults? A Systematic Review.

BACKGROUND: Atherosclerosis is a multifactorial inflammatory disease of the cardiovascular system. It has been suggested that periodontitis, an infectious disease of oral cavity caused by gramnegative anaerobic bacteria, could be linked to atherosclerosis. OBJECTIVE: The objective of this systematic review was to assess the evidence between the association of periodontitis and atherosclerosis in adults. METHODS: A systematic literature search was conducted in 7 databases up to January 2017, according to the Preferential Reports for Systematic Review and Meta-analysis (PRISMA) guidelines. Studies in humans with atherosclerosis were considered eligible when considering a group exposed to periodontitis and a control group (absence of periodontitis), in which the primary outcome was the association between the 2 diseases (atherosclerosis and periodontitis). The synthesis of the qualitative studies included was evaluated using previously validated checklist for assessing the risk of bias. RESULTS: Among the 2138 studies found, 4 observational studies met the eligibility criteria and were included in the qualitative synthesis. All articles were considered adequate, presenting consistent and valid information. The results of the selected studies show the expected effects, being considered as low risk of bias. CONCLUSION: The available evidence indicates an association between the 2 diseases, with elevated levels of inflammatory markers, mainly C-reactive protein and interleukin 6.

Comparison of efficacy of tray-delivered carbamide and hydrogen peroxide for at-home bleaching: a systematic review and meta-analysis.

OBJECTIVES: The aim of the study was to compare the color change produced by tray-delivered carbamide peroxide [CP] versus hydrogen peroxide products [HP] for at-home bleaching through a systematic review and meta-analysis. MATERIALS AND METHODS: MEDLINE via PubMeb, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database (LILACS), Brazilian Library in Dentistry (BBO), and Cochrane Library and Grey literature were searched without restrictions. The abstracts of the International Association for Dental Research (IADR) and unpublished and ongoing trial registries were also searched. Dissertations and theses were explored using the ProQuest Dissertations and Periodicos Capes Theses databases. We included randomized clinical trials that compared tray-delivered CP versus HP for at-home dental bleaching. The color change in shade guide units (SGU) and ΔE were the primary outcomes, and tooth sensitivity and gingival irritation were the secondary outcomes. The risk of bias tool of the Cochrane Collaboration was used for quality assessment. DATA: After duplicate removal, 1379 articles were identified. However, only eight studies were considered to be at "low" risk of bias in the key domains of the risk bias tool and they were included in the analysis. For ΔE, the standardized mean difference was -0.45 (95 % CI -0.69 to -0.21), which favored tray-delivered CP products (p < 0.001). The color change in ΔSGU (p = 0.70), tooth sensitivity (p = 0.83), and gingival irritation (p = 0.62) were not significantly different between groups. CONCLUSIONS: Tray-delivered CP gels showed a slightly better whitening efficacy than HP-based products in terms of ΔE, but they were similar in terms of ΔSGU. Both whitening systems demonstrated equal level of gingival irritation and tooth sensitivity. CLINICAL SIGNIFICANCE: Tray-delivered CP gels have a slightly better whitening efficacy than HP-based products in terms of ΔE. This should be interpreted with caution as the data of ΔSGU did not show statistical difference between the products.

Memory effects of sedative drugs in children and adolescents--protocol for a systematic review.

BACKGROUND: Some sedatives used in children and adolescents can affect memory function. Memory impairment of traumatic experience can minimize the chance of future psychological trauma. Knowledge about the potential of different sedatives to produce amnesia can help in the decision-making process of choosing a sedative regimen. The aim of this systematic review is to evaluate the effect of different sedatives on memory of perioperative events in children and adolescents. METHODS/DESIGN: Electronic databases and other sources, such as trial registers, gray literature, and conference abstracts will be searched. Randomized controlled trials will be included that assess memory of perioperative events in children and adolescents 2-19 years old receiving sedative drugs as premedication or as agents for procedural sedation in a medical or dental settings. The outcomes will be loss of memory after and before sedative administration (anterograde and retrograde amnesia). Two independent reviewers will perform screening, study selection, and data extraction. Disagreement at all levels will be resolved by consensus or by involving a third reviewer. Assessment of the risk of bias of included studies will be performed according to "Cochrane Collaboration's Tool for Assessing Risk of Bias in Randomized Trials." Clinical and methodological heterogeneity across studies will be evaluated to determine if it is possible to combine or not combine study results in a meta-analysis. DISCUSSION: To the best of our knowledge, there is no systematic review that specifically addresses this question. Findings from the review will be useful in the decision-making process about the best sedative for minimizing recall of the medical/dental event and possible psychological trauma. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42015017559.

Effectiveness of varnish with CPP-ACP in prevention of caries lesions around orthodontic brackets: an OCT evaluation.

OBJECTIVE: To evaluate the in vitro efficiency of applying varnish containing casein phosphopeptide (CPP) and amorphous calcium phosphate (ACP) in prevention of caries lesions around orthodontic brackets. MATERIALS AND METHODS: For this purpose, brackets were bonded to the vestibular surface of bovine incisors, and eight groups were formed (n = 15) according to exposure of oral hygiene substances and enamel varnish: 1 (control) brushing only performed, 2 (control) brushing + use of mouth wash with fluoride, 3 Duraphat varnish application only (Colgate-Palmolive Ind. E Com. Ltda, São Paulo, SP, Brazil), 4 Duraphat + brushing, 5 Duraphat + brushing + mouth wash, 6 MI Varnish application (GC America, USA), 7 MI + brushing, and 8 MI + brushing + mouth wash. The experimental groups alternated between pH cycling and the procedures described and were kept in an oven at temperature of 37°C. Both brushing and immersion in solutions was performed in a time interval of 1 minute, followed by washing in deionized water three times a day for 28 days of experimentation. Afterwards, evaluation by optical coherence tomography (OCT) of the special type (Ganymede OCT/Thorlabs, Newton, USA) was performed. In each group, a scanning exam of the white spot lesion area (around the region where brackets were bonded) and depth measurement of caries lesions were performed. RESULTS: Groups 1 and 3 were shown to differ statistically from groups 5, 6, 7, and 8 (p = 0.000). MI Varnish was shown to be more effective in diminishing caries lesion depth, compared with Duraphat, irrespective of being associated with brushing and mouth wash, or not. LIMITATIONS: The major limitation of this study is that it is a study in which demineralization was obtained with the use of chemical products, and did not occur due to the presence of Streptococcus mutans and its acid byproducts. CONCLUSION: Application CPP-ACP-containing varnish irrespective of being associated with brushing and mouthwash, or not, reduced depth of caries lesions around orthodontic brackets.

Stability of the bond between two resin cements and an yttria-stabilized zirconia ceramic after six months of aging in water.

STATEMENT OF THE PROBLEM: The behavior of the luting cement and the cementation protocol are essential in the clinical success of ceramic restorations. PURPOSE: The purpose of this study was to evaluate the bond stability of 2 resin cements and a yttria-stabilized tetragonal polycrystalline zirconia (Y-TZP) ceramic submitted to 2 surface treatments. MATERIAL AND METHODS: Sixty plates of a Y-TZP ceramic were assigned to 3 groups according to the surface treatments: control, as sintered surface; methacryloxydecyl dihydrogen phosphate (MDP), coated with an MDP-based primer, and tribochemical silica-coating (TSC), coated with tribochemical silica. The plates of each group were further divided into 2 subgroups according to the resin cement as follows: RelyX adhesive resin cement (conventional) and RelyX Unicem (self-adhesive). Cylinders of resin cements (∅=0.75 mm × 0.5 mm in height) were built up on the ceramic surfaces, and the plates stored in distilled water at 37°C for either 24 hours or 6 months before being submitted to a microshear bond strength test. The data were submitted to 3-way ANOVA and the Tukey honestly significant difference test (α=.05). RESULTS: Three-way ANOVA showed statistical significance for the 3 independent factors: resin cement, surface treatment, and period of water immersion (P<.001). Unicem presented the highest microshear bond strength after 24 hours (MDP, 37.4 ±2.3 and TSC, 36.2 ±2.1 MPa). Except for RelyX adhesive resin cement applied on ceramic surfaces treated with TSC, the microshear bond strength of all the other groups decreased after 6 months of aging in water. The microshear bond strength decreased most in the control groups (-81.5% for ARC and -93.1% for Unicem). In the group treated with TSC, the microshear bond strength for Unicem decreased by 54.8% and in that treated with MDP-based primer by -42.5%. In the group treated with MDP-based primer, the microshear bond strength for RelyX ARC decreased by -52.8%. CONCLUSIONS: Irrespective of surface treatments, self-adhesive resin cement was not able to maintain the bond to Y-TZP ceramic after 6 months of aging in water.

Healing complications of traumatized permanent teeth in pediatric patients: a longitudinal study.

BACKGROUND: Traumatic dental injuries (TDI) can affect soft and hard dental tissues and supporting structures in different ways and severity. AIM: This study describes the complications associated with health in traumatized permanent teeth (TPT) over a 12-month period and assesses the relationships between TDI, involved tissues, and root development (RD). DESIGN: The study enrolled 294 patients with 548 TPT. Data were collected on the TDI, RD, and the healing complication (HC) and when they were examined (03, 06, and 12 months). Frequencies are described and analyzed using the chi-squared test, relative risk (RR), and Mantel-Haenszel analysis (P≤0.05). RESULTS: Healing complications were present in 201 (36.68%) teeth and were more frequently diagnosed 3 months (63.68%) after the TDI. Pulp necrosis was the most common HC (38.3%), and it was significantly associated with avulsion (P=0.023). Teeth with complete RD showed a tendency of developing HC over time, independent of TDI (P=0.05). HC in teeth with complete RD related to support tissue trauma (P=0.005) and avulsion (P<0.001) appeared more frequently after 3 months. CONCLUSION: Healing complications are more common in teeth that have suffered trauma in supporting tissues and avulsion, especially in teeth with complete RD. The HC occur more frequently in the first 3 months, and a necrotic pulp was the most common complication.

Assessing the responsiveness of the Brazilian FIS to treatment for traumatic dental injury.

OBJECTIVE: This study aimed to assess the responsiveness of the Brazilian version of the Family Impact Scale (B-FIS) to describe changes in the quality of life (QoL) after treatment for traumatic dental injury (TDI). METHODS: After applying the eligibility criteria, 156 patients from 2 to 14 years old, who were attending a dental trauma center, were selected over an 18-month period. QoL was evaluated at two different appointments: A1 (after TDI) and A2 (after TDI treatment). The B-FIS scores were calculated using the additive method. The responsiveness was analyzed by standardized response means (SRMs). RESULTS: Mean B-FIS scores were 12.1 (7.5 SD) and 2.7 (4.4 SD), while the median scores were 12.0 and 2.0, at A1 and A2 (P < 0.01), respectively. The B-FIS responsiveness scores dropped 9.4 points after TDI treatment. The change was observed as a decrease in the impact after TDI treatment, demonstrating a positive reduction in its absolute number as well as an improvement in the family's QoL. The SRM achieved was as follows: 1.2 total scale, 1.1 parental emotions, 0.5 family conflicts, 0.9 parental/family activity, 0.1 financial burden. The B-FIS scores indicated that TDI has significant impact on the family's QoL in A1 and still has impact in A2. The change was observed as a positive decrease in the impact after TDI treatment. CONCLUSIONS: The responsiveness of the FIS (Brazilian version) in detecting the family's change in QoL after TDI treatment was confirmed by SRM.

Urgent minimal invasive treatment of a dental trauma in a child with Wiskott-Aldrich syndrome.

Wiskott-Aldrich syndrome (WAS) is an X-linked recessive disorder characterized by thrombocytopenia with microplatelets, eczema, recurrent infections, and predisposition to autoimmune disease and malignancy. The aim of this study is to report an urgent minimal invasive treatment of a dental trauma in a pediatric patient with WAS. The conservative management was a success and did not cause any local nor systemic complications.