4 research outputs found
Selamento de lesões cariosas oclusais : um ensaio clĂnico randomizado
As evidĂŞncias mostram uma redução ou eliminação significativa na quantidade de bactĂ©rias viáveis sob selantes e restaurações e consequente diminuição na progressĂŁo da cárie quando as bactĂ©rias se encontram separadas do meio bucal. O objetivo deste ensaio clĂnico controlado randomizado foi avaliar a eficácia de duas estratĂ©gias de tratamentos: 1) selamento de lesões de cárie oclusal e 2) tratamento restaurador convencional com remoção total da dentina cariada em dentes permanentes. A amostra foi constituĂda de 52 dentes com lesões de cárie na superfĂcie oclusal (prĂ©-molares e/ou molares) de 47 pacientes com idade entre 8 a 43 anos. Todas as lesões de cárie apresentaram necessidade de tratamento restaurador de acordo com os seguintes critĂ©rios: presença de cavidade e impossibilidade de controle do biofilme. A profundidade máxima das lesões foi atĂ© a metade externa de dentina avaliada atravĂ©s de radiografias interproximais. Os dentes foram divididos aleatoriamente em um grupo teste - tratamento selante, ou grupo controle - tratamento restaurador convencional. Dados iniciais referentes Ă experiĂŞncia de cárie (CPOD) e Ăndice de sangramento gengival (ISG) foram avaliados. Radiografias interproximais foram realizadas apĂłs 12 meses para avaliar a integridade das restaurações e a zona radiolĂşcida (ZR) sob os selantes/restaurações. Os desfechos analisados foram o desempenho clĂnico dos tratamentos selante e restauração e a prevalĂŞncia de regressĂŁo, inativação e progressĂŁo da cárie com exames radiográficos. A presença de dentina terciária tambĂ©m foi observada. Os dados foram avaliados por meio do teste exato de Fisher. Um total de 26 selantes e 26 restaurações foram realizadas. NĂŁo houve diferença entre os grupos quanto Ă s caracterĂsticas iniciais - idade, sexo, CPOD e ISG. ApĂłs um ano, foram avaliados 49 dentes, apresentando taxas de sucesso de 95,8% e 100% nos grupos selante e restauração convencional, respectivamente (p>0,05). Houve uma falha em um dos tratamentos (perda total no grupo selante) observada durante o estudo. A avaliação radiográfica (progressĂŁo, inativação, regressĂŁo e presença de dentina terciária) nĂŁo demonstrou diferença entre os grupos. Nenhum dos dentes apresentou progressĂŁo de cárie; a regressĂŁo foi observada em apenas um caso (grupo do selante) e a presença de dentina terciária foi encontrada em 12,5% da amostra (5 selantes e 1 restauração). Selantes podem ser utilizados como tratamento terapĂŞutico para lesões de cárie incipientes em dentes permanentes, uma vez que impedem a progressĂŁo das lesões de cárie, preservando a estrutura do dente, quando comparado ao tratamento restaurador convencional.There is a significant decrease in the number of viable microorganisms under sealants and restorations and a consequent decrease in caries progression when bacteria are separated from the oral environment. The aim of this randomized controlled clinical trial was to evaluate the efficacy of two treatments strategies: 1) sealing of carious lesions and 2) operative restorative treatment of occlusal carious lesions in permanent teeth. The sample consisted of 52 carious posterior teeth (premolars and molars) from 47 patients aged 8 - 43 years. In all lesions restorative treatment was necessary according to the following current strategies: presence of cavity and impossibility to perform biofilm control. The maximum depth of lesions was halfway through the dentine assessed by bitewing radiograph. The teeth were randomly assigned to test group – sealant treatment or control group - conventional restorative treatment. Baseline caries experience (DMFT) and gingival bleeding index (GBI) was assessed. Bitewing radiographs were performed after 12 months to evaluate the integrity of the restorations and the radiolucent zone (ZR) beneath the sealants/restorations. Outcomes were defined as clinical performance of sealant and restoration and the prevalence of regression, inactivation and progression of carious lesion by radiographic examinations. Presence of tertiary dentine was also evaluated. The data were submitted to Fisher`s exact test. A total of 26 sealants and 26 restorations were performed. There were no differences between the two groups regarding baseline characteristics – age, gender, DMFT and GBI. After one year, 49 evaluations had been performed, showing 95.8% and 100% of success rates in test and control group respectively (p>0.05). There was one therapeutic failure (total loss in the sealant group) observed during the study. No difference in the radiographic evaluation (progression, inactivation, regression and tertiary dentin deposition) was observed between the groups (p>0.05). No teeth showed caries progression; regression was observed in only one case (sealant group) and tertiary dentin was founded in 12.5% of the sample (5 sealants and 1 restoration). Sealants can be used as a therapeutic treatment for incipient carious lesions in permanent teeth, since they prevent the progression of carious lesions, while preserving tooth structure when compared to conventional restorative treatment
El Eco de Santiago : diario independiente: Año V Número 1769 - 1900 Noviembre 19
The aim of this study was to evaluate the effect of a commercial lactose-containing stevioside sweetener on biofilm acidogenicity in vivo. Nine volunteers refrained from brushing their teeth for 3 days in five phases. On the 4th day of each phase, the pH of the biofilm was measured by the “Strip method”. Interproximal plaque pH was measured before and up to 60 minutes after a 10 mL mouthrinse for 1 minute with the test solutions: I - sweetener with 93% lactose and 7% stevioside; II - sweetener with 6.8% saccharin, 13.6% cyclamate, and 0.82% stevioside; III - 18% sucrose solution (positive control); IV - mineral water (negative control); and V- 93% lactose solution. The results revealed that the most pronounced pH fall was found with sucrose (positive control), followed by the 93% lactose solution, the sweetener with lactose + stevioside, the sweetener with saccharin + cyclamate + stevioside, and finally water (negative control). According to the area under the curve, the two sweeteners containing stevioside were significantly different, and the sweetener with lactose + stevioside was significantly different from water but not from sucrose. The critical pH for dentin demineralization (pH ≤ 6.5) was reached by all volunteers after rinsing with sucrose solution, lactose solution, and the stevioside + lactose sweetener. Analysis of the data suggests that lactose-containing stevioside sweeteners may be cariogenic, especially to dentin
A randomized clinical trial on the sealing of occlusal carious lesions : 3–4-year results
This randomized clinical trial aimed to assess the efficacy of sealing occlusal carious lesions in permanent teeth. The sample consisted of 54 occlusal carious lesions in permanent molars and premolars of 49 patients aged 8–43 years (median: 19 years). The inclusion criteria comprised the presence of a cavity with no access allowing biofilm control. The maximum depth of the lesion was the middle third of the dentin thickness, as assessed by bitewing radiography. The teeth were randomly assigned to sealant treatment (n = 28) or restorative treatment (n = 26). Clinical and radiographic examinations were performed after 1 year and after 3–4 years. The outcomes depended on the clinical performance of the sealant/restoration and the control of caries progression observed radiographically. Survival analysis was performed to assess success rates. Over the 3-4 years of monitoring, 2 sealants were totally lost, 1 needed repair, and 1 showed caries progression, totaling 4 failures in the sealant group. In the restoration group, 1 failure was observed (in need of repair). The success rates were 76% and 94% in the sealant and the restoration groups, respectively (p > 0.05). The sealing of occlusal carious lesions in permanent teeth succeeded in controlling caries over a 3–4-year period. However, sealed carious lesions require patient compliance in attending regular follow-ups to control the occurrence of clinical failures of the sealants