[evaluation Of The Incidence Of Dental Caries In Patients With Down Syndrome After Their Insertion In A Preventive Program].

The objective of this work was to verify the incidence of dental caries by means of the CPO-D, CPO-S, ceo-d and ceo-s indexes in patients with Down syndrome regularly enrolled in a preventive program. Twenty four Down syndrome patients of both sexes age range of one to 48 years were examined. The prevalence (initial experimental situation) and incidence (final experimental situation) of dental caries were verified using of the initial and final CPO-D, CPO-S, ceo-d and ceo-s indexes of the participants. From 24 individual examined, 10 (42.0%) were free of caries. The prevalence of dental caries showed values of CPO-D= 2.33; CPO-S= 3.60; ceo-d= 1.75 e ceo-s= 2.80; while the incidence of caries showed values of 2.33; 3.80; 1.10 e 1.90, respectively. Down syndrome individuals evaluated in this study presented low level of caries and small incidence of new lesions, emphasizing the importance of the maintenance of these patients at preventive programs.15 Suppl 23249-5

Protective effect of experimental mouthrinses containing NaF and TiF4 on dentin erosive loss in vitro

Objective This in vitro study assessed the anti-erosive effect of experimental mouthrinses containing TiF4 and NaF on dentin erosive loss.Material and Methods Bovine dentin specimens were randomly allocated into the groups (n=15): 1) SnCl2/NaF/AmF (Erosion Protection®/GABA, pH 4.5, positive control); 2) experimental solution with 0.0815% TiF4(pH 2.5); 3) 0.105% NaF (pH 4.5); 4) 0.042% NaF+0.049% TiF4 (pH 4.4); 5) 0.063% NaF+0.036% TiF4 (pH 4.5); 6) no treatment (negative control). Each specimen was cyclically demineralized (Sprite Zero, pH 2.6, 4x90 s/day) and exposed to artificial saliva between the erosive challenges for 7 days. The treatment with the fluoride solutions was done 2x60 s/day, immediately after the first and the last erosive challenges of the day. Dentin erosive loss was measured by profilometry (μm). The data were analyzed using Kruskal Wallis/Dunn tests (

Doxycycline-containing glass ionomer cement for arresting residual caries: an in vitro study and a pilot trial

In a previous study, we demonstrated that the incorporation of doxycycline hyclate (DOX) into resin-modified glass ionomer cement (RMGIC) inhibited important cariogenic microorganisms, without modifying its biological and mechanical characteristics. In this study, we keep focused on the effect of that experimental material as a potential therapy for arresting residual caries by analyzing other in vitro properties and conducting a pilot clinical trial assessing the in vivo effect of DOX-containing RMGIC on residual mutans streptococci after partial carious removal in primary molars. Specimens of the groups RMGIC (control); RMGIC + 1.5% DOX; RMGIC + 3% DOX; and RMGIC + 4.5% DOX were made to evaluate the effect of DOX incorporation on surface microhardness and fluoride release of RMGIC and against biofilm of Streptococcus mutans. Clinical intervention consisted of partial caries removal comparing RMGIC and RMGIC + 4.5% DOX as lining materials. After 3 months, clinical and microbiologic evaluations were performed. Data were submitted to ANOVA/Tukey or Wilcoxon/Mann-Whitney set as α=0.05. Fluoride release and surface microhardness was not influenced by the incorporation of DOX (p>0.05). There was a significant reduction of S. mutans biofilm over the material surface with the increase of DOX concentration. After clinical trial, the remaining dentin was hard and dry. Additionally, mutans streptococci were completely eliminated after 3 months of treatment with RMGIC + 4.5% DOX. The incorporation of DOX provided better antibiofilm effect, without jeopardizing fluoride release and surface microhardness of RMGIC. This combination also improved the in vivo shortterm microbiological effect of RMGIC after partial caries removal

In vitro and in vivo evaluations of glass-ionomer cement containing chlorhexidine for Atraumatic Restorative Treatment

Objectives: Addition of chlorhexidine has enhanced the antimicrobial effect of glass ionomer cement (GIC) indicated to Atraumatic Restorative Treatment (ART); however, the impact of this mixture on the properties of these materials and on the longevity of restorations must be investigated. The aim of this study was to evaluate the effects of incorporating chlorhexidine (CHX) in the in vitro biological and chemical-mechanical properties of GIC and in vivo clinical/ microbiological follow-up of the ART with GIC containing or not CHX. Material and Methods: For in vitro studies, groups were divided into GIC, GIC with 1.25% CHX, and GIC with 2.5% CHX. Antimicrobial activity of GIC was analyzed using agar diffusion and anti-biofilm assays. Cytotoxic effects, compressive tensile strength, microhardness and fluoride (F) release were also evaluated. A randomized controlled trial was conducted on 36 children that received ART either with GIC or GIC with CHX. Saliva and biofilm were collected for mutans streptococci (MS) counts and the survival rate of restorations was checked after 7 days, 3 months and one year after ART. ANOVA/Tukey or Kruskal-Wallis/ Mann-Whitney tests were performed for in vitro tests and in vivo microbiological analysis. The Kaplan-Meier method and Log rank tests were applied to estimate survival percentages of restorations (

Biological and mechanical properties of a glass ionomer cement with chorhexidine or doxycycline

Orientador: Regina Maria Puppin-RontaniTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: Procedimentos de remoção parcial de cárie, indicados para os dentes com lesão de cárie profunda, utilizam-se do preceito de retirar a dentina mais amolecida e infectada,deixando-se uma fina camada de dentina afetada por cárie, sobre a câmara pulpar, evitandoseassim, exposição pulpar mecânica. Contudo, algumas bactérias cariogênicas podem permanecer na dentina por indeterminados períodos de tempo, podendo ocasionar progressão da lesão. Assim, estudos conduzidos com o propósito de melhorar a propriedade antibacteriana de materiais restauradores, sem, contudo produzir efeitos citotóxicos em células odontoblastóides e capaz de manter as propriedades básicas do material pode ser uma alternativa no tratamento de lesões de cárie profundas, uma vez que não existe um produto comercialmente disponível que associe todas estas características. No intuito de facilitar a apresentação desta Tese, a mesma foi dividida em dois capítulos, como descrito nas proposições seguintes. Capítulo 1: avaliar in vitro as propriedades biológicas (ação antibacteriana contra Streptococcus mutans, Lactobacillus acidophilus, Lactobacillus casei e Actinomyces viscosus, e cito toxicidade em células de linhagem odontoblástica MDPC-23)e mecânicas (resistência à compressão e à tração diametral) de um cimento de ionômero de vidro modificado por resina (Fuji Lining LC), contendo digluconato de clorexidina em diferentes concentrações (0,2%, 0,5%, 1,25% e 2,5%) e assim determinar a concentração terapêutica para utilização desta substância em tratamentos restauradores. Capítulo 2:verificar in vitro o comportamento de um cimento de ionômero de vidro modificado por resina (Fuji Lining LC) contendo hiclato de doxiciclina nas concentrações 1,5%, 3% e 4,5%frente a diferentes patógenos cariogênicos (Streptococcus mutans, Lactobacillusacidophilus, Lactobacillus casei e Actinomyces viscosus), células odontoblástóides MDPC-23 e quando submetidos aos ensaios mecânicos de resistência à compressão e à tração diametral. Os resultados observados em ambos os estudos mostraram que a incorporação de antimicrobianos ao cimento de ionômero de vidro, é capaz de melhorar significativamente efeito inibitório do cimento contra microrganismos criogênicos. A adição de dig luconato de clorexidina a 2,5% promoveu ligeira alteração no metabolismo e morfologia das células MDPC-23. O hiclato de doxiciclina, quando incorporado ao ionômero de vidro mesmo em maiores concentrações, não causou efeitos tóxicos em cultura de células odontoblásticas MDPC-23. Além disso, o cimento de ionômero de vidro contendo digluconato declorexidina a 2,5% apresentou resistência à compressão reduzida, sem alteração da propriedade de resistência a tração diametral do cimento. A adição de hiclato de doxiciclina não alterou as propriedades mecânicas do cimento. Assim, a adição de hiclato de doxiciclina e de digluconato de clorexidina nas concentrações estudadas produziu aumento na atividade antimicrobiana sem efeitos citotóxicos e alteração nas propriedades mecânicas da mistura, exceto para o digluconato de clorexidina a 2,5%, que apresentou o menor resistência a compressão e alterações no metabolismo e morfologia de células pulpares.Abstract: Partial caries removal approaches are indicated to the management of deep caries. It consists of the incomplete removal of softened carious dentine during cavity preparation, leaving a soft dentine layer over the pulp, so that it is not mechanically exposed. However, some viable cariogenic bacteria have been found in the remaining affected dentine, which may promote caries lesion progression. Therefore, studies aimed to improve inhibitory effect of the restorative materials, without cytotoxic effects on odontoblast cells and able to keep properties of material could be an alternative to the treatment of deep caries lesions. Nevertheless, the disposal-marketed products do not associate all those features. In order to facilitate the accomplishment of this Thesis, it was divided into two chapters, as described on the following descriptions. Chapter 1: to evaluate in vitro biological properties (antibacterial effect against Streptococcus mutans, Lactobacillus acidophilus, Lactobacillus casei and Actinomyces viscosus, and cytotoxicity at odontoblast cell line MDPC-23) and mechanical properties (compressive strength and diametral tensile strength) of a resin-modified glass ionomer cement (Fuji Lining LC) containing different concentrations of chlorhexidine digluconate (0.2%, 0.5%, 1.5% and 2.5%) and, thus to determine the therapeutic concentration of it for using in restorative dental treatment. Chapter 2: to verify in vitro the performance of a resin-modified glass ionomer cement (Fuji Lining LC) containing the antibiotic doxycycline hyclate at 1.5%, 3% and 4.5% against some cariogenic pathogens (Streptococcus mutans, Lactobacillus acidophilus, Lactobacillus casei and Actinomyces viscosus); to analyze it indirect contact with odontoblast-like MDPC-23 cells; and, to reveal the mechanical properties under compressive strength and diametral tensile strength. Results of both studies proved that the incorporation of antimicrobials at adequate proportions into the glass ionomer cement have the ability to become better inhibitory effects of the cement against cariogenic bacteria. The 2.5% chlorhexidine digluconate added to glass ionomer cement promoted slight alteration on the mebolism and morfology of MDPC-23 cells. The incorporation of doxycycline hyclate to glass ionomer cement, even in the highest concentration, did not cause toxic effects on culture of odontoblast-like MDPC-23 cells. In addition, 2.5% chlorhexidine digluconate-containing glass ionomer cement decreased the compressive strength of cement, although there was no difference to diametral tensile strength. The adding of doxycycline hyclate did not alter mechanical properties of cement. It was concluded that doxycycline hyclate and chlorhexidine digluconate in the studied concentrations produced increased antimicrobial activity without cytotoxic effects and changes in mechanical properties of the mixture, except for the 1.25% chlorhexidine digluconate that presented the lowest compressive strength and alterations on metabolism and morphology of pulp cells.DoutoradoOdontopediatriaDoutor em Odontologi

Caries prevalence, level of mutans streptococci, salivary flow rate, and buffering capacity in subjects with Down syndrome

The aim of this study was to correlate caries experience and physiological and microbiological profiles. The study group comprised 60 individuals with Down syndrome, both genders, aged from one to 48 years. The prevalence of caries was analyzed by DMFT/DMFS and dmft/dmfs indexes. Physiological factors such as flow rate, and buffer capacity and microbiological factor such as mutans streptococci counts were observed. The average DMFT and DMFS were, respectively, 4.53 and 6.85, whereas the mean dmft and dmfs values were 1.55 and 2.55, respectively. Ninety-four percent of 18 individuals that saliva was possible to collected presented low flow rate and only 6% of them had normal flow rate; 44% percent had low buffer capacity, 39% had limited buffer capacity and 16% had normal buffer capacity. Sixty percent of individuals had high values of CFU/mL (>1.000.000 S. mutans); while 40% presented low values of microorganisms (<100.000 S. mutans). Data of clinical, physiological and microbiological characterization were statistically analyzed through Pearson’s correlation and Chi-square test. A p-value d” 0.05 was considered significant. DMFT/DMTS and dmft/dmfs indexes increased with age. Pearson’s correlation showed significant values to DMFT/DMFS x age (r= 0.80 and r= 0.82; p < 0.01). Flow rate and buffering capacity were low. Individuals had high mutans streptococci counts (CFU/mL). DMFT/DMFS did not present significant correlation with flow rate, buffering capacity and mutans streptococci counts and no association with gender. The prevalence of dental caries increased with age at individuals with Down syndrome. As caries is a multifactor disease, other factors, which were not evaluated in the present study, such as diet, host and oral hygiene might be influencing the development of dental caries in these individuals

Influência do ambiente familiar sobre a saúde bucal de crianças: uma revisão sistemática Influence of family environment on children's oral health: a systematic review

OBJETIVO: Envolver modelos atuais e comprovações científicas sobre a influência de comportamentos de saúde bucal dos pais na cárie dentária de suas crianças. FONTES: Artigos do MEDLINE publicados entre 1980 e junho de 2012. Foram analisados artigos de pesquisa originais tratando do comportamento dos pais quanto à saúde bucal. Um total de 218 citações foi analisado e 13 artigos foram incluídos na análise. Os estudos foram considerados elegíveis para análise se atendessem aos seguintes critérios de inclusão: (1) avaliassem uma possível associação entre cáries dentárias e o comportamento dos pais relacionado à saúde bucal; e (2) se a metodologia do estudo incluísse exame clínico bucal. Os principais termos de pesquisa foram "saúde bucal", "atitudes dos pais", "conhecimento dos pais" e "cáries dentárias". RESUMO DOS ACHADOS: Ao todo, 13 estudos experimentais contribuíram com dados para a síntese. Também foram considerados trabalhos, revisões e capítulos originais em livros didáticos. CONCLUSÃO: Os hábitos de saúde dental dos pais influenciam a saúde bucal de seus filhos. São necessários programas de educação em saúde bucal com ações preventivas para proporcionar não apenas saúde bucal adequada às crianças, mas também uma melhor qualidade de vida. Deve ser dada atenção especial a toda a família, com relação a seu estilo de vida e hábitos relacionados à saúde bucal.<br>OBJECTIVE: To review current models and scientific evidence on the influence of parents' oral health behaviors on their children's dental caries. SOURCES: MEDLINE articles published between 1980 and June, 2012. Original research articles on parents' oral health behavior were reviewed. A total of 218 citations were retrieved, and 13 articles were included in the analysis. The studies were eligible for review if they matched the following inclusion criteria: (1) they evaluated a possible association between dental caries and parents' oral-health-related behaviors, and (2) the study methodology included oral clinical examination. The main search terms were "oral health", "parental attitudes", "parental knowledge", and "dental caries". SUMMARY OF THE FINDINGS: 13 experimental studies contributed data to the synthesis. Original articles, reviews, and chapters in textbooks were also considered. CONCLUSIONS: Parents' dental health habits influence their children's oral health. Oral health education programs aimed at preventive actions are needed to provide children not only with adequate oral health, but better quality of life. Special attention should be given to the entire family, concerning their lifestyle and oral health habits