Randomized, double-blind, placebo-controlled clinical trial on the effects of propolis and chlorhexidine mouthrinses on gingivitis.

OBJECTIVE: The aim of this study was to compare the effects of typified propolis and chlorhexidine mouthrinses on gingival health in a randomized double-blind placebo-controlled clinical trial. MATERIAL AND METHODS: Sixty participants were randomized to 3 mouthrinse study groups: 1) 2% typified propolis (n = 20); 2) 0.12% chlorhexidine (n = 20), and 3) placebo (n = 20). Participants rinsed unsupervised twice a day for 28 days. The Papillary Bleeding Score (PBS) was measured on the mesio-buccal surfaces of all teeth at baseline and 28 days thereafter. Co-variance analysis was employed to compare PBS average values and the number of sites with PBS ≥ 2 among study groups. Sub-group analysis was further applied to participants who were < 40 years-old. RESULTS: The results show efficacy of propolis mouthrinse when comparing before and after treatment protocols significantly for a reduction of mean PBS scores. For younger participants propolis mouthrinse was superior to all groups in reducing mean PBS scores and significant when compared to 0.12% chlorhexidine mouthrinse. CONCLUSION: The efficacy of 2% typified propolis mouthrinse was demonstrated in reducing the levels of gingival inflammation. These results need to be duplicated by other investigators under similar study protocols.

Randomized, double-blind, placebo-controlled clinical trial on the effects of propolis and chlorhexidine mouthrinses on gingivitis / Ensaio clínico duplo-cego randomizado e placebo-controlado dos efeitos de enxaguatórios a base de própolis e clorexidina na saúde gengival, para análise

Objective: The aim of this study was to compare the effects of typified propolis and chlorhexidine mouthrinses on gingival health in a randomized double-blind placebo-controlled clinical trial. Material and Methods: Sixty participants were randomized to 3 mouthrinse study groups: 1) 2% typified propolis (n = 20); 2) 0.12% chlorhexidine (n = 20), and 3) placebo (n = 20). Participants rinsed unsupervised twice a day for 28 days. The Papillary Bleeding Score (PBS) was measured on the mesio-buccal surfaces of all teeth at baseline and 28 days thereafter. Co-variance analysis was employed to compare PBS average values and the number of sites with PBS ≥ 2 among study groups. Sub-group analysis was further applied to participants who were < 40 years-old. Results: The results show efficacy of propolis mouthrinse when comparing before and after treatment protocols significantly for a reduction of mean PBS scores. For younger participants propolis mouthrinse was superior to all groups in reducing mean PBS scores and significant when compared to 0.12% chlorhexidine mouthrinse. Conclusion: The efficacy of 2% typified propolis mouthrinse was demonstrated in reducing the levels of gingival inflammation. These results need to be duplicated by other investigators under similar study protocols.

Objetivos: O propósito deste estudo foi o de comparar os efeitos de enxaguatórios a base de própolis tipificada e clorexidina na saúde gengival, empregando-se um ensaio clínico duplo cego, randomizado, e placebo-controlado. Material e Métodos: Sessenta participantes foram randomizados em 3 grupos de enxaguatórios, a saber: própolis tipificada 2% (n = 20), clorexidina 0,12% (n = 20) e placebo (n = 20). Os participantes bochecharam duas vezes ao dia por 28 dias os respectivos enxaguatórios. Medidas do índice de sangramento papilar (PBS) foram feitas na superfície mésio-bucal de todos os dentes dos participantes no tempo basal e após 28 dias. Análise de co-variância foi empregada permitindo comparações entre os grupos das médias do PBS e do número de sítios ≥ 2. Análise de sub-grupo foi efetuada em participantes com idade < 40 anos. Resultados: Constataram-se os efeitos positivos do enxaguatório de própolis a 2% na reducão da inflamação gingival após uso não supervisionado por 28 dias. Análise no sub-grupo de parcipantes com idade < 40 anos constatou superioridade do enxaguatório de própolis quando comparado com o enxaguatório de clorexidina a 0,12%. Conclusão: Este ensaio clínico demonstrou a eficácia de enxaguatório de própolis tipificada a 2% na redução da inflamação gengival. Estes resultados necessitam ser duplicados por outros investigadores.

Effects of typified propolis on mutans streptococci and lactobacilli: a randomized clinical trial.

OBJECTIVE: The aim of this study was to determine in a randomized, double-blind, placebo-controlled clinical trial the effects of typified propolis and chlorhexidine rinses on salivary levels of mutans streptococci (MS) and lactobacilli (LACT). METHODS: One hundred patients were screened for salivary levels of MS >100,000 CFUs/mL of saliva. All patients presented with at least one cavitated decayed surface. Sixty patients met entry criteria. Subjects were adults 18-55 years old. After restoration of cavitated lesions patients were randomized to 3 experimental groups: 1) PROP-alcohol-free 2% typified propolis rinse (n = 20); 2) CHX- 0.12% chlorhexidine rinse; 3) PL-placebo mouthrinse. Patients rinsed unsupervised 15 mL of respective rinses twice a day for 1 min for 28 days. Patients were assessed for the salivary levels of MS (Dentocult SM) and LACT (Dentocult LB) at baseline, 7-day, 14-day, and at 28-day visits (experimental effects) and at 45-day visit (residual effects). General linear models were employed to analyze the data. RESULTS: PROP was superior to CHX at 14-day and 28-day visits in suppressing the salivary levels of MS (p < .05). PROP was superior to PL at all visits (p < .01). The residual effects of PROP in suppressing the salivary levels of MS could still be observed at the 45-day visit, where significant differences between PROP and CHX (p < .05), were demonstrated. PROP was significantly superior than CHX in suppressing the levels of salivary LACT at the 28-day visit (p < .05). CONCLUSION: Typified propolis rinse was effective in suppressing cariogenic infections in caries-active patients when compared to existing and placebo therapies.

Effects of typified propolis on mutans streptococci and lactobacilli: a randomized clinical trial / Efeitos da própolis tipificada nos estreptococcos do grupo mutans e lactobacilos: ensaio clínico randomizado

Objective: The aim of this study was to determine in a randomized, double-blind, placebo-controlled clinical trial the effects of typified propolis and chlorhexidine rinses on salivary levels of mutans streptococci (MS) and lactobacilli (LACT). Methods: One hundred patients were screened for salivary levels of MS >100,000 CFUs/mL of saliva. All patients presented with at least one cavitated decayed surface. Sixty patients met entry criteria. Subjects were adults 18-55 years old. After restoration of cavitated lesions patients were randomized to 3 experimental groups:1) PROP-alcohol-free 2% typified propolis rinse (n= 20); 2) CHX- 0.12% chlorhexidine rinse; 3) PLplacebo mouthrinse. Patients rinsed unsupervised 15 mL of respective rinses twice a day for 1 min for 28 days. Patients were assessed for the salivary levels of MS (Dentocult SM) and LACT (Dentocult LB) at baseline, 7-day, 14-day, and at 28-day visits (experimental effects) and at 45-day visit (residual effects). General linear models were employed to analyze the data. Results: PROP was superior to CHX at 14-day and 28-day visits in suppressing the salivary levels of MS (p < .05). PROP was superior to PL at all visits (p < .01). The residual effects of PROP in suppressing the salivary levels of MS could still be observed at the 45-day visit, where significant differences between PROP and CHX (p < .05), were demonstrated. PROP was significantly superior than CHX in suppressing the levels of salivary LACT at the 28-day visit (p < .05). Conclusion: Typified propolis rinse was effective in suppressing cariogenic infections in caries-active patients when compared to existing and placebo therapies.

Objetivo: O objetivo deste estudo foi determinar, em um estudo randomizado, duplo-cego, placebo-controlado os efeitos da própolis tipificada e clorexidina sobre os níveis salivares de estreptococos do grupo mutans (EM) e lactobacilos (LACT). Métodos: Cem pacientes foram selecionados para níveis salivares de MS > 100.000 UFC/mL de saliva. Todos os pacientes apresentaram pelo menos uma superfície cariada com cavitação. Sessenta pacientes preencheram os critérios de inclusão. Os indivíduos eram adultos com 18-55 anos de idade. Após a restauração das lesões cavitadas, os pacientes foram randomizados para três grupos experimentais: 1) PROP- bochecho livre de álcool de 2% de própolis tipificada (n = 20), 2) CHX- bochecho de clorexidina 0,12%, 3) PL- bochecho placebo. Os participantes bochecharam sem supervisão 15 mL dos enxaguatórios duas vezes por dia, durante 1 minuto, durante 28 dias. Os pacientes foram avaliados para os níveis salivares de MS (Dentocult SM) e LACT (Dentocult LB) na linha de base, e após 7 dias, 14 dias, 28 dias (efeitos experimentais) e 45 dias (efeitos residuais). Modelos lineares foram utilizados para analisar os dados. Resultados: PROP foi superior ao CHX nas visitas de 14 dias e de 28 dias na supressão dos níveis salivares de SM (p < 0,05). PROP foi superior ao PL em todas as visitas (p < 0,01). Os efeitos residuais de PROP na supressão dos níveis salivares de MS ainda foi observado na visita de 45 dias, onde diferenças significativas entre PROP e CHX (p < 0,05) foram demonstradas. PROP foi significativamente superior a CHX na supressão dos níveis salivares de LACT na visita de 28 dias (p < 0,05). Conclusão: O enxaguatório de própolis tipificada foi eficaz na supressão de infecções cariogênicas em pacientes com atividade de cárie quando comparado a terapias existentes e ao placebo

Hardness, polymerization depth, and internal adaptation of Class II silorane composite restorations as a function of polymerization protocol.

OBJECTIVES: To evaluate the influence of various photoactivation techniques on the internal gap, Knoop-hardness, and polymerization depth of silorane- and methacrylate-based composites in Class II restorations. METHODS: Preparations were made in third molars (n = 10), according to composites (Filtek P60: methacrylate; Filtek P90: silorane) and photoactivation techniques (OC: occlusal photoactivation (control); OBL: occlusal+buccal+lingual photoactivation; and BLO: buccal+lingual+occlusal photoactivation (transdental)). Composites were inserted in two increments, both individually photoactivated for 20s. After 24h, specimens were sectioned and the ratio of internal gaps to interface length (%) recorded. Hardness was tested across the transversal section of restorations (1-4 mm below the surface). RESULTS: Silorane restorations showed significantly lower gaps compared with methacrylate, regardless of polymerization technique (P<.05). Supplementary energy dose in OBL and BLO protocols caused significant increase in gaps in silorane restorations (P<.05). For methacrylate restorations, OBL activation caused significantly higher gap formation (P<.05). Significantly lower hardness values were seen for silorane than for methacrylate composites (P<.05), regardless of depth and photoactivation. Significantly higher hardness values were seen in BLO activation for methacrylate restorations compared with control (P<.05); for silorane, no differences were observed. Significantly higher hardness values were observed at 1 and 3 mm compared to 2 and 4 mm for both composites. CONCLUSIONS: Internal gaps and hardness are affected by composite type and photoactivation. Despite the reduced values, hardness of silorane is not influenced by photoactivation or by depth. Internal gaps are dependent on the energy dose for both composites, with silorane showing lower internal gaps.

Comparative study of bond strength to human and bovine dentine at three different depths / Estudo comparativo da resistência adesiva à dentina humana e bovina em três diferentes profundidades

The aim of this study was to compare the bond strength to three different depths of remaining human and bovine dentin, through shear bond strength test, and to establish a possible relationship among the depths of the substrates to contribute for the replacement of human dentin in bond strength tests. Forty-eight human teeth (H) and forty-eight bovine teeth (B), freshly extracted, stored in distilled water and frozen at -18 ° C for at most four weeks were used in this study. 240-, 400-, 600- and 800-grit sandpapers were used to expose the dentin and standardize the smear layer at 0.5, 1.0 and 2.0mm of dentin thickness. Scotchbond Multi-Purpose Plus adhesive system was used following the manufacturer’s instructions, on a standardized area of 4mm, followed by the incrementally application of Z100 resin composite (3M). The shear bond test was performed in the Instron Universal machine at cross-head speed of 0.5mm/min. Statistical analysis was performed by ANOVA (p <0.05). There were significant differences in bond strength between H and B teeth, with the highest values for H teeth. There was a significant difference in bond strength to the depths analyzed but there was similarity in behavior between H (0.5mm) and B (2mm) substrates. Bovine substrate can be used for laboratory studies of bond strength as indicative of the initial performance of new products, although the differences related to human substrate should be observed.

O objetivo do presente estudo foi comparar a resistência adesiva da dentina humana e bovina em três diferentes espessuras de remanescente, frente ao teste de cisalhamento, a fim de estabelecer uma possível relação de profundidade entre os substratos visando contribuir para a substituição da dentina humana em testes de adesão. Empregaram-se 48 dentes humanos (H) e 48 dentes bovinos (B), recém-extraídos, armazenados em água destilada e congelados a –18°C, por no máximo quatro semanas. Foram utilizadas lixas de granulação 240, 400, 600 e 800, para expor a dentina e padronizar a smear layer, com espessura de dentina de 0,5, 1,0 e 2,0mm. O sistema adesivo Scotchbond Multi-Uso Plus foi utilizado seguindo instruções do fabricante, em uma área padronizada de 4mm, seguido da aplicação incremental da resina Z100 (3M). O ensaio de cisalhamento foi realizado em máquina Instron Universal à velocidade de 0,5mm/min. Foi realizada análise estatística pelo teste ANOVA a dois critérios (p < 0,05). Houve diferença significativa entre a resistência adesiva em dentes H e B, sendo os maiores valores para H; houve diferença significativa de resistência para as profundidades analisadas; houve semelhança de comportamento entre os substratos H 0,5mm e B 2mm. O substrato B pode ser empregado em estudos laboratoriais de resistência adesiva como indicativos da performance inicial de novos produtos, observando-se as diferenças existentes entre eles.

Estudo in vivo do manchamento dental causado pela ingestão de café associada ao clareamento profissional / In vivo study of dental discoloration caused by coffee ingestion associated within-office dental bleaching

Objective: The present study aims to verify the effectiveness of in-office dental bleaching using 35% hydrogen peroxide in patients with or without a habit of consuming coffee at least three times per day at different time intervals (pre-bleaching or baseline;48 hours post-bleaching or start; and 90 days post-bleaching or recall). Methods and Material - Forty patients with superior and inferior vital teeth from canine to canine participated in this study. The optical measurements with SpectroShade Microspectrophotometer (MHT, Verona, Italy) determined the pre-bleaching status (baselinemeasurement), the status at 48 hours post-bleaching (start measurement), and thestatus at 90 days post-bleaching (recall measurement). The Delta E (ΔE) value was determined, and the difference between the pre- and post-bleaching luminosity was used as an indicator of the degree of chromogenic alteration. The patients were divided into four groups according to the presence or absence of a coffee ingestion habit and according to different post-bleaching time intervals. These data were analyzed by ANOVA and in case of significant differences the mean values were compared usingthe Tukey test (p < 0.05). Results and Conclusions - In conclusion, it was possible to confirm that professional dental bleaching is an effective technique that can be usedboth in patients who drink and do not drink coffee. However, the maintainability of this treatment was significantly reduced in the group of patients who habitually drink coffee within a period of only 90 days

Objetivos: O presente estudo visa verificar a efetividade do clareamento dental profissional utilizando o peróxido de hidrogênio a 35% em pacientes com e sem o hábito de ingestão de café por pelo menos três vezes ao dia em diferentes intervalosde tempo (pré-clareamento ou baseline; 48 horas pós-clareamento ou start; e 90 diaspós-clareamento ou recall). Material e Métodos - Quarenta pacientes com dentes naturais inferiores e superiores participaram deste estudo. As tomadas de cor com o espectrofotômetro SpectroShade (MHT, Verona, Itália) determinaram a condição pré clareamento(medição baseline), a condição em 48 horas pós-clareamento (medição start),e a condição após 90 dias (medição recall). O valor de Delta E (ΔE) foi determinado, e a diferença entre a luminosidade na condição pré e pós-clareamentos foram utilizadas como o indicador do grau de alteração cromatogênica. Os pacientes foram divididos em quatro grupos de acordo com a presença ou ausência de hábitos de ingestão de café e dos diferentes períodos pós-clareamento. Os dados foram analisados via ANOVA e, quando necessário, os valores médios foram comparados utilizando o teste de Tukeya 5% de significância (p < 0.05). Resultados e Conclusões - Como conclusão foi possível confirmar que clareamento dental profissional é uma técnica efetiva e que pode ser utilizada tanto em pacientes que ingerem como nos que não ingerem café. Contudo, a durabilidade deste tratamento clareador é significativamente reduzida no grupo de pacientes que habitualmente bebem café dentro de um período relativamente curto, ou seja, de apenas 90 dias

Effect of oxalate desensitizer on the durability of resin-bonded interfaces.

Potassium oxalate desensitizers were previously shown to effectively reduce the immediate permeability of resin-bonded dentin. The current study evaluated whether the effect of the combined application of oxalate with etch-and-rinse adhesives interferes with the durability of resin-dentin bonds when using etch-and-rinse adhesives. The bond strength of resin-bonded dentin specimens composed of two-step or three-step etch-and-rinse adhesives (Single Bond, One-Step and Scotchbond Multi-Purpose, respectively) was tested immediately (24 hours) and after 12 months of water storage. The adhesives were used either according to the manufacturers' instructions (control groups) or after treating acid-etched dentin with a potassium oxalate gel (BisBlock, BISCO, Inc). The treatment of dentin with potassium oxalate was shown to negatively affect the baseline bond strength of resin-bonded dentin specimens, regardless of the adhesive used (p < 0.05). After storage, the bond strength of the resin-bonded interfaces was significantly reduced for all the tested groups (p < 0.001). Nevertheless, the rate of decreasing bond strength was significantly lower for oxalate-treated specimens than for the controls (p < 0.05).

Permeability of Dental Adhesives - A SEM Assessment.

OBJECTIVES: To morphologically evaluate the permeability of different commercial dental adhesives using scanning electron microscopy. METHODS: SEVEN ADHESIVE SYSTEMS WERE EVALUATED: one three-step system (Scotchbond Multi-Purpose - MP); one two-step self-etching primer system (Clearfil SE Bond - SE); three two-step etch-and-rinse systems (Single Bond 2 - SB; Excite - EX; One-Step - OS); and two single-step self-etching adhesives (Adper Prompt - AP; One-Up Bond F - OU). The mixture of primer and bond agents of the Clearfil SE Bond system (SE-PB) was also tested. The adhesives were poured into a brass mold (5.8 mm x 0.8 mm) and light-cured for 80 s at 650 mW/cm2. After a 24 h desiccation process, the specimens were immersed in a 50% ammoniac silver nitrate solution for tracer permeation. Afterwards, they were sectioned in ultra-fine slices, carbon-coated, and analyzed under backscattered electrons in a scanning electron microscopy. RESULTS: MP and SE showed slight and superficial tracer permeation. In EX, SB, and OS, permeation extended beyond the inner superficies of the specimens. SE-PB did not mix well, and most of the tracer was precipitated into the primer agent. In AP and OU, "water-trees" were observed all over the specimens. CONCLUSIONS: Different materials showed distinct permeability in aqueous solution. The extent of tracer permeation varied according to the composition of each material and it was more evident in the more hydrophilic and solvated ones.