Preventive effect of remineralizing materials on dental erosion lesions by speckle technique: An in vitro analysis.

The aim of this in vitro study was to evaluate the preventive effect of different materials on dental erosion lesions by speckle coherent light scattering analysis. Forty bovine teeth were divided in the following groups (n = 10): 1) DURA- Preventive Treatment with Fluoride Varnish (Duraphat, Colgate-Palmolive); 2) ELX- Preventive treatment with Elmex® Erosion Protection Toothpaste (GABA International AG, Therwil, Switzerland); 3) MP- Preventive treatment with MI Paste® (GC America); and 4) REG- Preventive Treatment with Regenerate Enamel Science™ (Unilever). For all groups, each sample was divided into 3 areas: non-treatment (control); preventive treatment + erosive challenge; non-treatment + erosive challenge. The erosive challenge was carried out using Sprite® Zero soft drink (pH 2.58). After the erosive challenge, the samples were evaluated by speckle coherent light scattering method in the eroded area compared to the sound area. The results showed that there was a statistically significant difference between eroded area with and without preventive treatment, however, there was no statistically significant difference among the different preventive materials tested.

Evaluation of the use of photobiomodulation following the placement of elastomeric separators: Protocol for a randomized controlled clinical trial.

BACKGROUND: Pain stemming from the placement of elastomeric separators and the exchanging of wires and accessories is the greatest reason for abandoning orthodontic treatment. Indeed, discomfort related to treatment exerts a negative impact on quality of life due to the difficulty chewing and biting. This paper proposes a study to evaluate the analgesic effects of photomiobodulation (PBM) on individuals undergoing orthodontic treatment. METHODS: The sample will be composed of 72 individuals who receiving elastomeric separators on the mesial and distal faces of the maxillary first molars. The patients will be randomly allocated to 2 groups: an experimental group irradiated with low-level laser and a sham group submitted to simulated laser irradiation. Upon the placement of the separators, the experimental group will receive a single application of PBM on the mesial and distal cervical portion and apical third of the molars. Perceived pain will be analyzed after one hour using the visual analog scale in both groups. Samples will be taken of the gingival crevice with absorbent paper for 30 seconds for the analysis of cytokines using ELISA and the results of the 2 groups will be compared. The patients will sign a statement of informed consent. Statistical analysis will be performed with the Student's t test and analysis of variance (ANOVA). DISCUSSION: The expectation is that the patients in the irradiated group will have a lower perception of pain and lower quantity of cytokines compared to those in the sham group. The purpose of the study is to establish an effective method for PBM with the use of low-level infrared laser (Ga-Al-As with a wavelength of 808 nm and output power of 100 mW) for reductions in pain and inflammatory cytokines related to orthodontic treatment. TRIAL REGISTRATION: This protocol was registered in ClinicalTrial.gov, under number NCT03939988. It was first posted and last updated in May 6, 2019.

Remineralization of early enamel caries lesions induced by bioactive particles: An in vitro speckle analysis.

This study aimed at evaluating the remineralization effect promoted by different bioactive fillers on simulated early caries lesions in enamel (ECLE). Forty sound bovine incisors were used to prepare buccal enamel specimens (6 × 6 × 2 mm). The specimens were divided into two areas (3 × 3 mm²): control (CTR) and experimental (EXP). All the enamel specimens were then submitted to a specific protocol for a period of 48 h to induce simulated caries lesions. Subsequently, the specimens were treated for 7 days (2 min, twice a day) with a slurry pastes containing different bioactive particles (P/L ratio: 1 g/mL). All the specimens were analyzed by laser speckle before and after treatments. The results showed after the first analysis that the ECLE had very low average intensity (back-scattered light). Conversely, after application of the bioactive pastes, higher average intensity was always detected; this was comparable to CTR sound specimens. In conclusion, innovative pastes/gels developed for enamel remineralization should contain bioactive particles that when applied daily on early caries lesions may "boost" the remineralization process to reestablish a sound enamel.

Controlled clinical trial addressing teeth whitening with hydrogen peroxide in adolescents: a 12-month follow-up.

OBJECTIVES:: To evaluate the colorimetric change in incisors and canines of adolescents aged 12 to 20 years submitted to at-home whitening and to evaluate satisfaction, sensitivity and discomfort during the procedures through a questionnaire. METHOD:: Thirty adolescents were randomly assigned to the following groups: 1) 6.0% hydrogen peroxide (White Class with calcium - FGM); 2) 7.5% hydrogen peroxide (White Class with calcium - FGM); 3) 10% hydrogen peroxide (Oral B 3D White - Oral-B); 4) Control group - placebo. Assessments were performed prior to treatment as well as at 7, 30, 180 and 360 days after treatment. Friedman's ANOVA was used to analyze color. The Kruskal-Wallis test followed by Dunn's post hoc test was used to compare the groups at the different evaluation times. Answers on the questionnaires were ranked, and non-parametrical tests were employed. The groups were compared in each period using the Kruskal-Wallis test followed by the Student-Newman-Keuls test. Categorical data were analyzed using Fisher's exact test, and the Wilcoxon test was used for the analysis of different periods. P-values were corrected using the Hyan-Holm step-down Bonferroni procedure. Clinicaltrials.gov: NCT01998386. RESULTS:: Similar results were obtained one month after treatment with both tooth whitening gels and whitening strips. Patients were partially satisfied with the treatment after the first and second weeks and would recommend it. All products demonstrated color stability after 12 months of follow-up. CONCLUSIONS:: The bleaching procedure was efficient, and the patients could perceive its result. Further investigations are needed to determine the effects of bleaching on young teeth.

Diagnosis of occlusal caries lesions in deciduous molars by coherent light scattering pattern speckle.

BACKGROUND: This study presents the correlation between laser speckle images and detection of incipient caries lesions from changs in the microstructure of the surface of tooth enamel. METHODS: We used 30 healthy deciduous molar teeth collected from the Biobank Human Teeth, Faculty of Dentistry, University of São Paulo who had carious lesions induced by the pH cycling method. The samples were evaluated for the diagnosis of caries by two methods ICDAS and speckle pattern of coherent light scattering after 5, 10 and 15days and the results were statistically analyzed using α=0.05 significance level. RESULTS: A significant difference was observed between the image of the speckle scattering of healthy and injured areas within the 3 study groups, but not when comparing the three groups, showing us that it is an innovative technique that needs further study, but can be used as a diagnostic method for the detection of early caries lesions. CONCLUSION: It can be concluded that the analysis of scattering speckle pattern is a diagnostic technique that provides information on the microstructure of the surface of tooth enamel which has sensitivity for detection of incipient caries lesions.

Controlled clinical trial addressing teeth whitening with hydrogen peroxide in adolescents: a 12-month follow-up

OBJECTIVES: To evaluate the colorimetric change in incisors and canines of adolescents aged 12 to 20 years submitted to at-home whitening and to evaluate satisfaction, sensitivity and discomfort during the procedures through a questionnaire. METHOD: Thirty adolescents were randomly assigned to the following groups: 1) 6.0% hydrogen peroxide (White Class with calcium - FGM); 2) 7.5% hydrogen peroxide (White Class with calcium - FGM); 3) 10% hydrogen peroxide (Oral B 3D White - Oral-B); 4) Control group - placebo. Assessments were performed prior to treatment as well as at 7, 30, 180 and 360 days after treatment. Friedman’s ANOVA was used to analyze color. The Kruskal-Wallis test followed by Dunn’s post hoc test was used to compare the groups at the different evaluation times. Answers on the questionnaires were ranked, and non-parametrical tests were employed. The groups were compared in each period using the Kruskal-Wallis test followed by the Student-Newman-Keuls test. Categorical data were analyzed using Fisher's exact test, and the Wilcoxon test was used for the analysis of different periods. P-values were corrected using the Hyan-Holm step-down Bonferroni procedure. Clinicaltrials.gov: NCT01998386. RESULTS: Similar results were obtained one month after treatment with both tooth whitening gels and whitening strips. Patients were partially satisfied with the treatment after the first and second weeks and would recommend it. All products demonstrated color stability after 12 months of follow-up. CONCLUSIONS: The bleaching procedure was efficient, and the patients could perceive its result. Further investigations are needed to determine the effects of bleaching on young teeth.

Case Report of Photodynamic Therapy in the Treatment of Dental Caries on Primary Teeth.

INTRODUCTION: The partial removal of dental caries aiming to maintain the integrity of the pulp has been considered the therapy of choice in the treatment of deep carious lesions, as long as certain principles of diagnosis are respected. Dentists are always looking for techniques to remove the decayed tissue with biosafety, what provides more comfort to the patient especially when it comes to children. Photodynamic therapy (PDT) is an antimicrobial treatment. PapacárieMblue is a modification of the regular Papacárie, with a photosensitizer added to it. CASE REPORT: PapacárieMblue was used in a patient who had deep carious lesions in a primary molar. After 5 minutes of application, the soft and infected tissues were removed from the side walls of the cavity and, after, PDT was held in the pulp wall with red laser (660 nm), energy of 30 J, output power of 100 mW and 5 minutes of exposure time. This caused a reduction in the amount of dental tissue removed, what favored the prognosis of the dental element. After a period of 3 months, a control of the case was done and we discovered that the tooth that received the PDT was not painful and the x-ray showed an absence of lesions in the furcation. CONCLUSION: PDT with PapacárieMblue has been effective in the removal of a deep carious lesion that had a risk of pulp exposure.

Evaluation of the effectiveness of photodynamic therapy for the endodontic treatment of primary teeth: study protocol for a randomized controlled clinical trial.

BACKGROUND: The elimination of pathogenic microorganisms from the root canal system is one of the major steps required for successful endodontic treatment. The aim of the proposed study is to conduct a randomized, controlled, clinical trial for the clinical and radiographic evaluation of the effectiveness of photodynamic therapy during the endodontic treatment of primary teeth. METHODS: Thirty primary anterior teeth in children aged 3 to 6 years old will be randomly divided into 2 groups: a control group, which will receive conventional treatment, and an experimental group, which will be subjected to photodynamic therapy. Microbiological evaluations will be performed before and after endodontic treatment. Moreover, clinical and radiographic evaluations will be performed on the day of treatment as well as 1, 3 and 6 months after treatment. Comparisons will be made of the two study groups. The data will be tabulated and presented in a descriptive, analytical fashion. Depending on the distribution (normal or non-normal), either the t test, ANOVA or the Mann-Whitney test will be used for analysis of the variables. The Wilcoxon test will be used for comparisons before and after treatment. P values<0.05 (95% significance level) will be considered indicative of statistically significant differences. DISCUSSION: As successful endodontic treatment is directly related to intra-canal bacterial disinfection and considering the difficult task of endodontic treatment in primary teeth, often due to difficulties in controlling young children, the internal anatomy of root canals and root resorption, the alternative of using PDT is a painless,easy-to-administer method that does not lead to microbial resistance and can assist in the achievement of successful endodontic treatment in primary teeth by eliminating the pain children can experience due to retreatment as well as premature tooth loss. TRIAL REGISTRATION: The protocol for this study was registered with Clinical Trials number NCT02485210 on 30 july 2015.

Tooth whitening with hydrogen peroxide in adolescents: study protocol for a randomized controlled trial.

BACKGROUND: Technological innovations in dental materials have been fueled by the desire of patients to improve the esthetics of their teeth. This emphasis on esthetics has led dentists to seek resources that respect the standards established by society, but without compromising the integrity of the teeth. METHODS/DESIGN: The aim of the proposed controlled clinical trial will be to assess colorimetric changes and increased dental sensitivity in adolescent patients submitted to tooth whitening with 6% and 7.5% hydrogen peroxide using home kits with whitening strips. Adolescents aged 12 to 20 years will be allocated to different groups based on treatment (n = 16 per group): (1) placebo; (2) 6.0% hydrogen peroxide (White Class with Calcium, FGM); (3) 7.5% hydrogen peroxide (White Class with Calcium, FGM); and (4) 7.5% hydrogen peroxide (Oral B 3D White, Oral-B). After the whitening procedures, the participants will be evaluated using a visual analog scale for tooth sensitivity and digital spectrophotometry to measure changes in color. Descriptive analysis of the data will be performed. Either the chi-squared test or Fisher's exact test will be used for the determination of associations among the categorical variables. Student's t-test and analysis of variance will be used to compare mean colorimetric data. Pearson's correlation coefficients will be calculated to determine the strength of correlations among the continuous variables. DISCUSSION: This randomized trial will provide an opportunity to evaluate products such as whitening strips in comparison to other self-administered methods, especially in adolescents. TRIAL REGISTRATION: The protocol for this study was submitted to Clinical Trials in November 2013 with registration number NCT01998386.

Subjective well-being in heart failure patients: influence of coping and depressive symptoms.

BACKGROUND: Psychological factors play a crucial role in the well-being of chronically ill patients. PURPOSE: This research examined coping, depressive symptoms and subjective well-being (SWB) in patients with heart failure (HF). The study also analysed whether depressive symptoms mediated the association between coping strategies and SWB. METHOD: Participants (N = 60, 68.3 % men, aged between 40 and 89 years old) diagnosed with HF were recruited from the cardiology service of a general hospital. Coping strategies were assessed with 16 items of the Brief COPE Scale. The items were organised, according to theoretical and empirical data, into four types of coping: task-focused, seeking social support, maladaptive emotion-focused and acceptance coping. Depressive symptoms were assessed with the corresponding subscale of the Hospital Anxiety and Depression Scale. SWB was assessed considering the Satisfaction with Life Scale and the Positive and Negative Affect Schedule. RESULTS: The multiple regression analyses carried out indicated that SWB was positively associated with task-focused coping and inversely related to maladaptive strategies and depressive symptoms. Gender was also a significant predictor of SWB, with male patients reporting higher well-being than female patients. The mediational analysis showed that depressive symptoms partially mediated the relationships between task-focused coping and SWB. CONCLUSION: Results were discussed in the light of the importance of gender, depression and coping in patients with HF since these factors may affect subjective well-being and contribute to severe physical impairment.