RESUMO
To determine the efficacy of fluoride varnish (5% NaF, Duraphat, Colgate) added to caregiver counseling to prevent early childhood caries, we conducted a two-year randomized, dental-examiner-masked clinical trial. Initially, 376 caries-free children, from low-income Chinese or Hispanic San Francisco families, were enrolled (mean age +/- standard deviation, 1.8 +/- 0.6 yrs). All families received counseling, and children were randomized to the following groups: no fluoride varnish, fluoride varnish once/year, or fluoride varnish twice/year. An unexpected protocol deviation resulted in some children receiving less active fluoride varnish than assigned. Intent-to-treat analyses showed a fluoride varnish protective effect in caries incidence, p < 0.01. Analyzing the number of actual, active fluoride varnish applications received resulted in a dose-response effect, p < 0.01. Caries incidence was higher for 'counseling only' vs. 'counseling + fluoride varnish assigned once/year' (OR = 2.20, 95% CI 1.19-4.08) and 'twice/year' (OR = 3.77, 95% CI 1.88-7.58). No related adverse events were reported. Fluoride varnish added to caregiver counseling is efficacious in reducing early childhood caries incidence.
Assuntos
Cariostáticos/administração & dosagem , Cárie Dentária/prevenção & controle , Fluoreto de Sódio/administração & dosagem , Pré-Escolar , Índice CPO , Relação Dose-Resposta a Droga , Feminino , Fluoretos Tópicos , Educação em Saúde Bucal , Humanos , Lactente , Modelos Lineares , Masculino , Método Simples-Cego , Estatísticas não ParamétricasRESUMO
The extensibility of rabbit and human corneas was measured by raising the pressure within the intact globe of the eye and measuring the displacements of two very small mercury drops on the corneal surface. The human cornea showed a negligible extensibility under low stresses. The rabbit tissue, however, underwent a 9% strain under low pressures with a curvilinear relationship between stress and strain. At higher pressures the relationship was linear, and the tissue showed some creep. The low pressure stress-strain relationship of the rabbit could not be explained on the basis that the collagen fibrils were being straightened out from an initial set in a sinusoidal wave. When the stroma was isolated from Descemet's membrane, it showed a negligible low pressure extensibility in rabbit and man. On the other hand, isolated Descemet's membrane was very extensible in both species. The difference between them in the behavior of the intact cornea seems to lie in the relative initial strain in the stroma and Descemet's membrane.
