Fluoride concentration in bottled water on the market in the municipality of São Paulo

The objective of the study was to evaluate the fluoride concentration in bottled water available on the market, in comparison with the values printed on the bottle label. Two hundred and twenty-nine water samples were collected from 35 brands available in several supermarkets, grocery stores and snack bars with high turnover in different regions of the municipality of São Paulo, Southeastern Brazil, in 2006. Fluoride concentrations were determined by duplicate analysis using an ion-specific electrode. The fluoride concentrations ranged from 0.01 to 2.04 mg/l, with significant differences between the values stipulated on labels and those found in the analyses. These results emphasize the importance of controls over fluoride levels in bottled water enforced by the sanitary surveillance agency.O objetivo do estudo foi avaliar a concentração de flúor na água engarrafada comercializada, comparando-a aos valores impressos no rótulo da embalagem. Foram coletadas 229 amostras de água das 35 marcas disponíveis em diversos supermercados, mercearias e lanchonetes de grande circulação nas diferentes regiões do município de São Paulo, em 2006. A concentração de flúor foi determinada por análise em duplicata, utilizando o eletrodo íon-específico. A concentração de flúor variou entre 0,01 e 2,04 mg/l, com diferenças significantes entre os valores estipulados nos rótulos e os encontrados com a análise. Esses resultados reforçam a importância do controle dos níveis de flúor na água engarrafada por parte da vigilância sanitária

Avaliação da concentração de flúor e do consumo de água mineral

OBJECTIVE: Considering that water is an importance source of fluoride intake, and that the consumption of mineral water and prevalence of dental fluorosis have been increasing, the aim of this study was to evaluate the consumption of mineral water and its fluoride concentration. METHODS: The study was performed in residential districts of the municipality of Bauru, State of São Paulo, by means of stratified sampling via clusters. Each cluster corresponded to one residential block. For randomization purposes, the residential blocks were numbered within the 17 districts established by the city plan. One thousand homes were thus visited. Mineral water samples were collected using previously labeled 50 ml plastic flasks. Fluoride analysis was done using an ion-sensitive electrode (Orion 9609), after buffering using TISAB II. Information on the consumption of mineral water was obtained by means of applying a questionnaire. RESULTS: Around 29.72% of the city's population was consuming mineral water. In the 260 samples analyzed from 29 different brands of water, the fluoride concentration ranged from 0.045 to 1.515 mg/l. For one brand, the label stated that the fluoride concentration was 0.220 mg/l, but analysis revealed a concentration of 1.515 mg/l. Moreover, some brands did not specify the fluoride concentration on the label and, for these, the analysis showed concentrations ranging from 0.049 to 0.924 mg/l. CONCLUSIONS: The results demonstrated wide variation in fluoride concentrations and reinforce the importance of the control of such waters by the sanitary surveillance agency.OBJETIVO: Considerando a água como importante fonte de ingestão de flúor, o aumento da prevalência de fluorose dentária e do consumo de água mineral, o estudo realizado teve como objetivo avaliar o consumo de água mineral e sua concentração de flúor. MÉTODOS: A pesquisa foi realizada nos bairros do município de Bauru, SP. Foram visitadas mil residências que compunham uma amostra estratificada, obtida por conglomerados. Cada conglomerado correspondia a um quarteirão. Para efeito de sorteio os quarteirões foram numerados dentro das 17 regiões estabelecidas no plano diretor do município. Para coleta das amostras de água mineral foram usados frascos plásticos de 50 ml, previamente identificados. Na análise de flúor utilizou-se eletrodo íon sensível (Orion 9609) após tamponamento com TISAB II. Informações a respeito do consumo de água mineral foram obtidas com a aplicação de um questionário. RESULTADOS: Constatou-se que cerca de 29,7% da população do município consome água mineral. Nas 260 amostras analisadas, das 29 diferentes águas, a concentração de flúor variou de 0,045 a 1,515 mg/l. Em uma das águas, constava no rótulo o valor de 0,220 mg/l, mas na análise constatou-se 1,515 mg/l de flúor. Além disso, algumas águas não traziam especificado a concentração de flúor; e, na análise constataram-se valores variando entre 0,049 e 0,924 mg/l. CONCLUSÕES: Os resultados mostraram uma grande variação na concentração de flúor e reforçam a importância do controle dessas águas por parte da vigilância sanitária

Sagittal, rotational and transverse changes with three intraoral distalization force systems : Jones jig, distal jet and first class

To compare the maxillary dentoalveolar changes of patients treated with three distalization force systems: Jones Jig, Distal Jet and First Class appliances, using digitized models. The retrospective sample comprised 118 digitized models of 59 patients

Class II malocclusion treatment changes with the Jones jig, Distal jet and First Class appliances

Objective: Maxillary molar distalization with intraoral distalizer appliances is a non-extraction orthodontic treatment used to correct molar relationship in patients with Class II malocclusion presenting maxillary dentoalveolar protrusion and minor skeletal discrepancies. This study compares the changes caused by three distalizers with different force systems. Methodology: 71 patients, divided into three groups, were included. The Jones jig group (JJG, n=30; 16 male, 14 female, 13.17 years mean age) was treated with the Jones jig for 0.8 years. The Distal jet group (DJG, n=25; 8 male, 17 female, 12.57 years mean age) was treated with the Distal jet for 1.06 years. The First Class group (FCG, n=16; 6 male, 10 female, 12.84 years mean age) was treated with the First Class for 0.69 years. Intergroup treatment changes were compared using one-way ANOVA, followed by post-hoc Tukey’s tests. Results: Intergroup comparisons showed significantly greater maxillary incisor protrusion in DJG than in FCG (2.56±2.24 mm vs. 0.74±1.39mm, p=0.015). The maxillary first premolars showed progressive and significantly smaller mesial angulation in JJG, FCG and DJG, respectively (14.65±6.31º, 8.43±3.99º, 0.97±3.16º; p<0.001). They also showed greater mesialization in JJG than FCG (3.76±1.46 mm vs. 2.27±1.47 mm, p=0.010), and greater extrusion in DJG compared to JJG (0.90±0.77 mm vs 0.11±0.60 mm, p=0.004). The maxillary second premolars showed progressive and significantly smaller mesial angulation and mesialization in JJG, FCG and DJG, respectively (12.77±5.78º, 3.20±3.94º, -2.12±3.71º and 3.87±1.34 mm, 2.25±1.40 mm, 1.24±1.26 mm, respectively; p<0.001). DJG showed smaller distal angulation of maxillary first molars (-2.14±5.09º vs. -7.73±4.28º and -6.05±3.76º, for the JJG and FCG, respectively; p<0.001) and greater maxillary second molars extrusion (1.17±1.41 mm vs -0.02±1.16 mm and 0.16±1.40 mm, for the JJG and FCG, respectively; p=0.003). Overjet change was significantly larger in DJG compared to FCG (1.79±1.67 mm vs 0.68±0.84; p=0.046). Treatment time was smaller in FCG (0.69±0.22 years vs 0.81±0.33 years and 1.06±0.42 years, comparing it with the JJG and DJG, respectively; p=0.005). Conclusion: The three appliances corrected the Class II molar relationship by dentoalveolar changes. The Distal jet produced smaller molar distal angulation than the Jones jig and First Class. The First Class appliance showed less anchorage loss, greater percentage of distalization and shorter treatment time than the Jones jig and Distal jet

Comparative cephalometric evaluation of Class II malocclusion treatment with First Class distalizer in conventional and skeletal anchorage and cervical headgear followed by fixed orthodontic appliance

O objetivo deste estudo longitudinal foi comparar as alterações dentoesqueléticas e tegumentares de jovens com má oclusão de Classe II não tratados e tratados com distalizador First Class em ancoragem convencional ou esquelética, ou com o aparelho extrabucal cervical (AEB), seguidos do aparelho fixo. A amostra foi composta por 44 pacientes com má oclusão de classe II e divididos em quatro grupos de 11 cada: pacientes tratados com distalizador First Class com ancoragem convencional no botão de Nance (G1), tratados com distalizador First Class com ancoragem esquelética apoiado em 2 mini-implantes no palato (G2), tratados com o aparelho extrabucal (AEB) (G3) e o grupo controle, com pacientes não tratados (G0). Foram obtidas as telerradiografias ao início (Ti) e final (Tf) do tratamento para a realização das análises cefalométricas e avaliação das alterações dentárias, esqueléticas e tegumentares e compará-los com o grupo controle (G0). A análise estatística foi realizada pelo teste t pareado com a finalidade de verificar as alterações ocorridas dentro de um mesmo grupo e pelo teste ANOVA a um critério e teste de Tukey para verificar as diferenças entre os grupos. Observou-se restrição e redirecionamento do crescimento maxilar ao final do tratamento no G1 e G3. Os efeitos esqueléticos na mandíbula só foram significantes no G0. As medidas da relação maxilomandibular diminuíram significantemente no G1 e G3 com significante diminuição das medidas que avaliaram o perfil tegumentar. Quanto ao componente vertical todas as medidas aumentaram no G3. Os primeiros molares superiores angularam distalmente no G2 e os inferiores mesialmente no G3. Os quatro grupos apresentaram extrusão dos dentes superiores e inferiores. Os três grupos experimentais apresentaram diminuição significante nas relações dentárias (relação molar, trespasse horizontal e vertical). Conclui-se que os grupos experimentais corrigiram a má colusão de Classe II de maneira satisfatória, sendo que o uso do AEB mostrou efeitos esqueléticos e dentários na correção e os grupos com distalizadores somente efeitos dentários. O tempo de tratamento no grupo com AEB foi significantemente menor.The aim of this prospective study was to compare the dental, skeletal and soft tissue changes in youngsters with Class II malocclusion untreated and treated with First Class distalizer in conventional or skeletal achorage or with cervical headgear followed by fixed orthodontic appliances. The sample consisted of 44 patients with Class II malocclusion and divided into four groups of 11: patients treated with First Class distalizer with conventional anchorage (Nance button)(G1), treated with First Class distalizer with skeletal anchorage supported in two palatal mini-implants (G2), treated with cervical headgear (G3) and follow-up group with untreated patients (G0). Lateral cephalometrics radiographs were taken before treatment and after treatment in order to cephalometric analysis and evaluate the dental, skeletal and soft tissue changes and to compare with follow-up group (G0). Statistical analysis was performed by dependent t test to verify the changes occurred in the same group and by one-way ANOVA and Tukey test to verify the changes occurred between the groups. It was observed restriction and redirection of maxillary growth after treatment in G1 and G3. Mandibular skeletal effects were significant in G0. The values of skeletal maxilomandibular relationship decreased significantly in G1 and G3 with significant decrease of measurements that evaluated soft facial profile. All measurements of vertical component increased in G3. Maxillary first molars were distal tipping in G2 and lower first molars were mesial tipping in G3. The four groups showed extrusion in the upper and lower teeth. The three experimental groups showed significant decreased in the molar relationship, overjet and overbite. It concluded that experimental groups corrected the Class II malocclusion efficiently, cervical headgear showed skeletal and dental effects and the groups with distalizers showed only dental effects. The mean treatment period was significant lower with cervical headgear

Comparative cephalometric evaluation of Class II malocclusion treatment with First Class distalizer in conventional and skeletal anchorage

O objetivo deste estudo prospectivo foi avaliar as alterações dentoesqueléticas e tegumentares de jovens com má oclusão de Classe II tratados com distalizador First Class em dois tipos diferentes de ancoragem. Foram selecionados 30 pacientes e divididos, aleatoriamente, em dois grupos de 15: G1 (5 masculino e 10 feminino) que recebeu o distalizador com ancoragem convencional no botão de Nance e G2 (10 masculino e 5 feminino) que recebeu o distalizador com ancoragem esquelética apoiado em 2 mini-implantes no palato, com médias de 13,00 e 13,28 anos de idade, respectivamente. As telerradiografias foram obtidas antes e após a distalização dos molares para a realização das análises cefalométricas. A análise estatística foi realizada pelo teste t dependente com a finalidade de verificar as alterações ocorridas dentro de um mesmo grupo e pelo teste t independente para verificar as diferenças entre os grupos. Foi calculado também o erro sistemático e casual. O tempo médio de tratamento foi de 4,51 e 6,28 meses para G1 e G2, respectivamente. Ambos os grupos apresentaram alterações dentárias significantes com distalização (G1=2,39 mm; G2=2,21 mm), angulação distal (G1=10,51º; G2=4,49º) e intrusão (G1=0,53 mm; G2=0,10 mm) dos primeiros molares superiores, sendo apenas sem significância a intrusão em G2. A perda de ancoragem foi semelhante entre os dois grupos, com significante mesialização (G1=2,78 mm; G2=3,11 mm) e angulação mesial (G1=4,95°; G2=4,69°) dos segundos pré-molares, protrusão (G1=1 ,55 mm; G2=1,94 mm) e vestibularização (G1=5,78°; G2=3,13°) significantes dos incisivos superiores e um aumento significante no trespasse horizontal (G1=1,07 mm; G2=0,81 mm). A mecânica de distalização não interferiu nos componentes esqueléticos e tegumentares dos pacientes. Em ambos os grupos, o distalizador First Class promoveu correção da relação molar, porém apresentou efeitos de perda de ancoragem verificada nos pré-molares e incisivos superiores mesmo quando associada à mini-implantes. Não houve diferença significante entre os grupos quanto às alterações dentárias lineares, porém as angulares foram significantemente menores no grupo com ancoragem esquelética.The aim of this prospective study was to evaluate the dental, skeletal and soft tissue changes in youngsters with Class II malocclusion treated with First Class distalizer in two different types of anchorage. Thirty patients were included and divided, randomly, in two groups of 15. G1 (5 boys and 10 girls) that received distalizers with conventional anchorage (Nance button) and G2 (10 boys and 5 girls) that received distalizers with skeletal anchorage supported in two palatal mini-implants, average age of 13.00 and 13.28 years old, respectively. Lateral cephalometric radiographs were taken before and after molar distalization in order to the cephalometric analysis. Statistical analysis was performed by dependent t test to verify the changes occurred in the same group and by independent t test to verify the difference between the groups. The systematic and casual errors were calculated as well. The mean treatment period was 4.51 and 6.28 months for G1 and G2, respectively. Both groups showed significant dental changes with distalization (G1=2.39 mm; G2=2.21 mm), distal tipping (G1=10.51º; G2=4.49º) and intrusion (G1=0.53 mm; G2=0.10 mm) of maxillary first molars, just intrusion in G2 was not significant. Anchorage loss showed similar in both groups with significant mesialization (G1=2.78 mm; G2=3.11 mm) and mesial tipping (G1=4.95°; G2=4.69°) of maxillary second premolars, significant protrusion (G1=1.55 mm; G2=1.94 mm) and proclination (G1=5.78°; G2=3.13°) of maxillary incisors and significant increase in overjet (G1=1.07 mm; G2=0.81 mm). Distalization mechanic did not interfere in skeletal and soft tissue measurements of patients. In both groups, the First Class distalizer corrected the molar relationship, however it showed anchorage loss effects in maxillary premolars and incisors even when associated to mini-implants. There was no significant difference between the groups on dental linear changes, however the dental angular changes were significantly lower in skeletal anchorage group

Distalizador First Class modificado para ancoragem em mini-implantes

FAPESP 2009/04843-7, 2011/17126-

Cephalometric effects of the Jones Jig appliance followed by fixed appliances in Class II malocclusion treatment

OBJECTIVE: The aim of this study was to cephalometrically assess the skeletal and dentoalveolar effects of Class II malocclusion treatment performed with the Jones Jig appliance followed by fixed appliances. METHODS: The sample comprised 25 patients with Class II malocclusion treated with the Jones Jig appliance followed by fixed appliances, at a mean initial age of 12.90 years old. The mean time of the entire orthodontic treatment was 3.89 years. The distalization phase lasted for 0.85 years, after which the fixed appliance was used for 3.04 years. Cephalograms were used at initial (T1), post-distalization (T2) and final phases of treatment (T3). For intragroup comparison of the three phases evaluated, dependent ANOVA and Tukey tests were used. RESULTS: Jones Jig appliance did not interfere in the maxillary and mandibular component and did not change maxillomandibular relationship. Jones Jig appliance promoted distalization of first molars with anchorage loss, mesialization and significant extrusion of first and second premolars, as well as a significant increase in anterior face height at the end of treatment. The majority of adverse effects that occur during intraoral distalization are subsequently corrected during corrective mechanics. Buccal inclination and protrusion of mandibular incisors were identified. By the end of treatment, correction of overjet and overbite was observed. CONCLUSIONS: Jones Jig appliance promoted distalization of first molars with anchorage loss represented by significant mesial movement and extrusion of first and second premolars, in addition to a significant increase in anterior face height

Intraoral distalizer effects with conventional and skeletal Anchorage: a meta-analysis

Introduction: The aims of this meta-analysis were to quantify and to compare the amounts of distalization and anchorage loss of conventional and skeletal anchorage methods in the correction of Class II malocclusion with intraoral distalizers. Methods: The literature was searched through 5 electronic databases, and inclusion criteria were applied. Articles that presented pretreatment and posttreatment cephalometric values were preferred. Quality assessments of the studies were performed. The averages and standard deviations of molar and premolar effects were extracted from the studies to perform a meta-analysis. Results: After applying the inclusion and exclusion criteria, 40 studies were included in the systematic review. After the quality analysis, 2 articles were classified as high quality, 27 as medium quality, and 11 as low quality. For the meta-analysis, 6 studies were included, and they showed average molar distalization amounts of 3.34 mm with conventional anchorage and 5.10 mm with skeletal anchorage. The meta-analysis of premolar movement showed estimates of combined effects of 2.30 mm (mesialization) in studies with conventional anchorage and 4.01 mm (distalization) in studies with skeletal anchorage. Conclusions: There was scientific evidence that both anchorage systems are effective for distalization; however, with skeletal anchorage, there was no anchorage loss when direct anchorage was used