Short-term Clinical and Microbiological Performance of Resin-modified Glass Ionomer Cement Containing Chlorhexidine for Atraumatic Restorative Treatment.

Aim: This study evaluated the short-term clinical and microbiological performance of resin-modified glass ionomer cement (RM-GIC) cement containing chlorhexidine (CHX) for atraumatic restorative treatment (ART) in primary teeth. Materials and methods: The clinical trial was conducted in 36 children that received ART in primary molars either with GIC (group I, n = 18) or GIC containing 1.25% CHX (group II, n = 18). The survival rate of restorations was checked 7 days, 3, and 6 months after their application when saliva and biofilm were collected for microbiological assessment of mutans streptococci (MS) counts. Data were analyzed using the Kruskal-Wallis/Mann-Whitney U tests for clinical analysis and microbiological evaluations (p < 0.05). Results: The survival rate of restorations was similar comparing groups I with II. Microbiological analysis showed a significant reduction in MS levels 7 days after the treatment in both saliva and biofilm of children treated with RM-GIC containing CHX (group II); however, MS counts at 3 and 6 months did not differ from the initial counts. Conclusion: A total of 1.25% CHX improved the microbiological properties of GIC in the short term without impairing the clinical performance of ART restorations. Clinical significance: Glass ionomer cement (GIC) containing CHX could be an alternative in ART procedures with the objective of promoting an additional antimicrobial effect, which is interesting for children with high counts of MS during the initial phase of adaptation to dental treatment. How to cite this article: da Silva ME, de Sena MD, Colombo NH, et al. Short-term Clinical and Microbiological Performance of Resin-modified Glass Ionomer Cement Containing Chlorhexidine for Atraumatic Restorative Treatment. Int J Clin Pediatr Dent 2023;16(S-1):S27-S32.

Clinical and radiographic analysis of traumatized primary teeth and permanent successors: Longitudinal study.

BACKGROUND: Dental trauma can determine the occurrence of sequelae in the deciduous tooth and due to the anatomical proximity to the germ of the successor permanent tooth, it frequently causes changes to the developing teeth. AIMS: The objective of this study was to analyze clinically and radiographically traumatized primary teeth and permanent successors in children aged 0-8 years. MATERIALS AND METHODS: Initially, a sample selection of medical records was made, designating the patients who fit the requirements; 247 patients were analyzed, totaling 379 traumatized primary teeth and 162 successive permanent teeth. STATISTICAL ANALYSIS: The results were developed using the Proportion Test and the Chi-square test at the 5% significance level. RESULTS: Injuries to hard tissue prevailed (57%), with emphasis on coronary enamel fracture (49.1%). After clinical and radiographic examinations, 78% of traumatized primary teeth maintained pulpal vitality. At the clinical evaluation, the frequency of the developmental disorders observed in permanent successors was 10.5%, with enamel hypocalcification being the most common sequela. 17.3% of the clinical changes in the successor permanent teeth were caused by trauma to the supporting tissue, with the intrusive dislocation being responsible for the largest number of damages (37.5%). CONCLUSION: Based on the results found, it was concluded that the trauma occurring in the primary dentition were recorded and monitored more precisely and about the evaluated successive permanent teeth, except for the prevalence of sequelae found, the other factors are in agreement with the findings in the literature.

Fluoride varnishes containing sodium trimetaphosphate reduce enamel demineralization in vitro.

OBJECTIVE: This study evaluated the effects of fluoride varnishes containing sodium trimetaphosphate (TMP) on bovine enamel demineralization in vitro. MATERIAL AND METHODS: Enamel bovine discs were randomly assigned into six groups (n = 20/group): placebo, 2.5% NaF, 2.5% NaF/5% TMP, 5% NaF, 5% NaF/5% TMP, and a commercial formulation (Duraphat, 5% NaF). Varnishes were applied on all enamel discs and kept for 6 h. Loosely and firmly bound fluoride formed on/in enamel after treatment were analyzed in 10 discs from each group. The other 10 discs were subjected to a pH-cycling regimen for 7 days, and analyzed for surface (SH) and cross-sectional hardness (ΔKHN), as well as for loosely and firmly bound fluoride in/on enamel. Data were analyzed by analysis of variance (ANOVA) followed by Student-Newman-Keuls' test (p < .05). RESULTS: The lowest SH change and ΔKHN were observed for the 5%NaF/5%TMP varnish, which was significantly different from all the other groups. Both fluoridated varnishes containing TMP promoted significantly lower SH change and ΔKHN when compared with their counterparts without TMP. Loosely and firmly bound fluoride was significantly lower in groups treated with varnishes containing TMP. CONCLUSION: TMP and fluoride added to varnishes have a synergistic effect against enamel demineralization in vitro.

Remineralizing Potential of a Low Fluoride Toothpaste with Sodium Trimetaphosphate: An in situ Study.

OBJECTIVE: To evaluate the effect of a low-fluoride (F) toothpaste supplemented with sodium trimetaphosphate (TMP) on enamel remineralization in situ. DESIGN: Bovine enamel blocks were selected on the basis of their surface hardness (SH) after caries-like lesions had been induced, and randomly divided into 4 treatment groups, according to the toothpastes used: without F or TMP (placebo); 500 ppm F; 500 ppm F plus 1% TMP; and 1,100 ppm F. The study design was blinded and crossover and performed in 4 phases of 3 days each. Eleven subjects used palatal appliances containing 4 bovine enamel blocks which were treated 3 times per day during 1 min each time, with natural slurries of saliva and toothpaste formed in the oral cavity during toothbrushing. After each phase, the percentages of surface (%SHR) and subsurface hardness recovery (%ΔKHNR) were calculated. F, calcium (Ca), and phosphorus (Pi) contents in enamel were also determined. Data were analyzed by 1-way, repeated-measures ANOVA, followed by the Student-Newman-Keuls test (p < 0.05). RESULTS: Toothpaste with 500 ppm F + TMP and 1,100 ppm F showed similar %SHR and %ΔKHNR as well as enamel F, Ca, and Pi concentrations. CONCLUSION: The addition of TMP to a low-fluoride toothpaste promoted a similar remineralizing capacity to that of a standard (1,100 ppm F) toothpaste in situ.

Sodium trimetaphosphate enhances the effect of 250 p.p.m. fluoride toothpaste against enamel demineralization in vitro.

This in vitro study investigated the effect of sodium trimetaphosphate (TMP), added to toothpaste containing 250 p.p.m. fluoride, on enamel demineralization. Bovine enamel blocks (n = 96) were subjected to five pH cycles over a 7-d period and treatment with suspensions of toothpastes containing 0, 250, 500, and 1,100 p.p.m. fluoride (as sodium fluoride), as well as with 250 p.p.m. fluoride containing TMP at 0.25, 0.5, 1.0, and 3.0%. Treatment with toothpaste suspensions was performed under agitation twice a day, for 1 min. Surface and cross-sectional hardness, and fluoride firmly bound to enamel, were quantified. Data were subjected to one-way anova, followed by Tukey's test. Low-fluoride toothpastes containing TMP at 0.25-1.0% resulted in enamel mineral loss similar to that seen for the toothpaste containing 1,100 p.p.m. fluoride. Also, the addition of TMP to the toothpaste containing 250 p.p.m. fluoride promoted enamel fluoride concentrations similar to those obtained for the 500 p.p.m. fluoride group. The toothpaste containing 250 p.p.m. fluoride and 0.25% TMP led to the lowest mineral loss among all groups. It was concluded that the addition of as little as 0.25% TMP to a toothpaste containing 250 p.p.m. fluoride can reduce enamel demineralization to levels similar to those seen for a conventional toothpaste containing 1,100 p.p.m. fluoride, in vitro.

Longitudinal evaluation of fluoride levels in nails of 18-30-month-old children that were using toothpastes with 500 and 1100 µg F/g.

OBJECTIVES: This study aimed to evaluate the fluoride concentration in the fingernails and toenails of children aged 18-30 months during use of fluoride-containing toothpastes supplemented with calcium glycerophosphate (CaGP) or sodium trimetaphosphate (TMP). METHODS: According to the toothpaste used, children (n = 56) were randomly assigned into three groups: 500 µg F/g with 1% TMP, 500 µg F/g with 0.25% CaGP, and 1100 µg F/g. Fingernails and toenails were collected monthly over a period of 330 days, from the beginning of toothpaste use. Fluoride concentration in the water consumed by the volunteers and fluoride intake from diet and toothpaste were also determined. Fluoride analyses were performed with the electrode after hexamethyldisiloxane-facilitated diffusion or by the direct method, according to the samples. Data passed normality and homoscedasticity tests and were analyzed by 2-way analysis of variance (anova) and 1-way anova followed by Student-Newman-Keuls test (P < 0.05). RESULTS: Fluoride levels in the fingernails and toenails as well as fluoride intake from toothpaste were similar for the groups treated with 500 µg F/g with 1% TMP and 500 µg F/g with 0.25% CaGP toothpastes, but significantly lower than the 1100 µg F/g group (P < 0.05). No significant differences were noted among the groups regarding fluoride intake from diet and that by water consumed by the volunteers (P > 0.05). CONCLUSION: The results of the longitudinal study suggest that the level of fluoride present in nails was lower with the use of toothpastes with a low fluoride concentration.

A combination of clinical and microbiological management of generalized aggressive periodontitis in primary teeth. A case report.

BACKGROUND: Generalized aggressive periodontitis (GAP) in primary teeth is a rare periodontal disease that occurs during or soon after eruption of the primary teeth. An association with systemic diseases is a possibility. CASE REPORT: A 4-year-old Brazilian girl presented with GAP involving the entire primary dentition. The patient and her parents and sister were subjected to microbiological testing to identify the microorganisms involved in the disease. The patient underwent tooth extraction to eradicate the disease and received a prosthesis for the restoration of masticatory function. After the permanent teeth erupted, fixed orthodontic appliances were place to restore dental arch form and occlusion. CONCLUSIONS: The results show the importance of an early diagnosis of GAP and of a multidisciplinary approach involving laboratory and clinical management to treat the disease and to restore masticatory function, providing a better quality of life for patients.