Fluoride concentrations in the water of Maringa, Brazil, considering the benefit/risk balance of caries and fluorosis

Current Brazilian law regarding water fluoridation classification is dichotomous with respect to the risks of and benefits for oral diseases, and fluoride (F) concentrations less than 0.6 or above 0.8 mg F/L are considered outside the normal limits. Thus, the law does not consider that both caries and fluorosis are dependent on the dosage and duration of fluoride exposure because they are both chronic diseases. Therefore, this study evaluated the quality of water fluoridation in Maringá, PR, Brazil, considering a new classification for the concentration of F in water the supply, based on the anticaries benefit and risk of fluorosis (CECOL/USP, 2011). Water samples (n = 325) were collected monthly over one year from 28 distribution water networks: 20 from treatment plants and 8 from artesian wells. F concentrations were determined using a specific ion electrode. The average F concentration was 0.77 mg F/L (ppm F), ranging from 0.44 to 1.22 mg F/L. Considering all of the water samples analyzed, 83.7% of them presented from 0.55 to 0.84 mg F/L, and according to the new classification used, they would provide maximum anticaries benefit with a low risk of fluorosis. This percentage was lower (75.4%) in the water samples supplied from artesian wells than from those distributed by the treatment plant (86%). In conclusion, based on the new classification of water F concentrations, the quality of water fluoridation in Maringá is adequate and is within the range of the best balance between risk and benefit.Current Brazilian law regarding water fluoridation classification is dichotomous with respect to the risks of and benefits for oral diseases, and fluoride (F) concentrations less than 0.6 or above 0.8 mg F/L are considered outside the normal limits. Thus, the law does not consider that both caries and fluorosis are dependent on the dosage and duration of fluoride exposure because they are both chronic diseases. Therefore, this study evaluated the quality of water fluoridation in Maringá, PR, Brazil, considering a new classification for the concentration of F in water the supply, based on the anticaries benefit and risk of fluorosis (CECOL/USP, 2011). Water samples (n = 325) were collected monthly over one year from 28 distribution water networks: 20 from treatment plants and 8 from artesian wells. F concentrations were determined using a specific ion electrode. The average F concentration was 0.77 mg F/L (ppm F), ranging from 0.44 to 1.22 mg F/L. Considering all of the water samples analyzed, 83.7% of them presented from 0.55 to 0.84 mg F/L, and according to the new classification used, they would provide maximum anticaries benefit with a low risk of fluorosis. This percentage was lower (75.4%) in the water samples supplied from artesian wells than from those distributed by the treatment plant (86%). In conclusion, based on the new classification of water F concentrations, the quality of water fluoridation in Maringá is adequate and is within the range of the best balance between risk and benefit2911

Evaluation of the influence of light-curing units on the degree of conversion in depth of a bulk-fill resin

It is known that bulk-fill have been widely studied and used by dentists in the clinic. However, the use of light-curing units that do not have the ability to adequately light-cure these materials at the appropriate depth can affect their clinical perfor

Heterocontrole da fluoretação da água de abastecimento público da 15ª Regional de Saúde do Paraná

Objetivou-se conhecer o processo de fluoretação das águas de abastecimento público e realizar o heterocontrole do fluoreto nas águas dos 30 municípios que compõem a 15ª Regional de Saúde do Paraná. Um questionário contendo dados relativos a fluoretação dos municípios foi aplicado e cinco coletas de água em Unidades Básicas de Saúde ou poços artesianos foi realizado em todos esses municípios, no período de 12 meses. Dos 30 municípios que compõem esta regional, em 77% dos municípios a água utilizada é proveniente de poços, 77% relatam ter água fluoretada e 40% dos municípios realizaram levantamento epidemiológico para fluorose dental. Das 335 amostras de água, 79,5% foram classificadas como máximo benefício contra cárie e mínimo risco para fluorose dentária. Conclui-se que apesar da maioria dos municípios pesquisados realizarem a fluoretação das águas de abastecimento, o heterocontrole não é prática comum nos mesmos

Advances In Dental Veneers: Materials, Applications, And Techniques.

Laminate veneers are a conservative treatment of unaesthetic anterior teeth. The continued development of dental ceramics offers clinicians many options for creating highly aesthetic and functional porcelain veneers. This evolution of materials, ceramics, and adhesive systems permits improvement of the aesthetic of the smile and the self-esteem of the patient. Clinicians should understand the latest ceramic materials in order to be able to recommend them and their applications and techniques, and to ensure the success of the clinical case. The current literature was reviewed to search for the most important parameters determining the long-term success, correct application, and clinical limitations of porcelain veneers.49-1

In vitro evaluation of composite resin fluorescence after natural aging

Some composite resins contain luminophorous agents in order to reproduce tooth fluorescence. The objective of this study was to compare the fluorescence spectra emitted by composite resins with those of human enamel and dentin, and their emission behaviour after a 90-day natural aging period. Nine shades of the composite resins Z350XT/3M (XT), Opallis/FGM (OP) and Empress Direct/Ivoclar-Vivadent (ED) were analyzed. Five specimens (10.0 mm x 2.0mm) were fabricated for each shade. Enamel (5.0 mm x 0.30 mm) and dentin (5.0 mm x 1.0 mm) specimens were obtained from sound human third molars. Fluorescence spectra of human dentin and enamel as well as the composite specimens immediately after fabrication were measured at the excitation peaks of 375, 395 and 410 nm. To assess composite resin fluorescence intensity changes over time, measurements were conducted after 30, 60 and 90 days, at 395 nm. Differences in fluorescence intensity over time were analyzed with ANOVA and Tukey?s test (p<0.05). Fluorescence spectra baseline values of composites demonstrated no differences in intensity among the excitation peaks tested, with maximum emission found at the peak of 450 nm. Enamel and dentin spectra varied with different excitations, and the greater the excitation, the longer the wavelength in comparison to composite resins. After 90 days, XT presented an increase in fluorescence intensity, while OP and ED showed a reduction when compared with baseline values. Fluorescence intensity of composite resins changed during the period analyzed, with an emission behavior different from that of human enamel and dentin. The main changes occurred in the first 30 days

Clínica ampliada em Odontologia: experiência precursora avaliada pelos usuários

Objetivou-se analisar a atenção em saúde bucal prestada pela Clínica Ampliada (CA) da Universidade Estadual de Maringá, bem como avaliar satisfação com atendimento odontológico e autonomia do paciente sob percepção de usuários. Trata-se de estudo observacional, transversal, descritivo, retrospectivo, com usuários que frequentaram o serviço odontológico da CA. Foi aplicado questionário estruturado sobre variáveis socioeconômicas, humanização, autonomia, acesso, encaminhamento e satisfação sobre atenção odontológica da CA. Os dados descritivos foram analisados no Programa EpiInfo. O principal motivo de procura da CA foi dor (37,8%), sendo escolhida principalmente pela gratuidade do atendimento (43,4%). Todos pacientes citaram que os dentistas os escutaram com atenção, tiveram um bom relacionamento e confiança no seu trabalho. A maioria dos pacientes mudou seu comportamento sobre hábitos saudáveis em relação à sua saúde, aumentando autonomia e sua responsabilização com manutenção da saúde bucal. A maioria dos pacientes avaliou satisfatoriamente a CA em relação aos recursos humanos, estrutura e limpeza. Todos avaliaram o atendimento odontológico como muito bom/bom, sendo que acharam que o dentista fez bom trabalho e recomendariam a CA. Conclui-se que esta experiência pioneira está sendo positiva, qualificando a atenção odontológica em relação à humanização, aumentando autonomia do paciente e satisfação do usuário com serviço prestado

Mapeamento da variação regional da resistência adesiva em superfícies planas de dentina.

O presente trabalho avaliou a influência das variações morfológicas do substrato dentinário na resistência de união à microtração de três sistemas adesivos resinosos: Clearfil Liner Bond 2V, One-Step e Single Bond, empregando como substrato superfícies planas de dentina. Para o preparo e exposição da superfície de dentina, o esmalte oclusal foi desgastado com lixas de carbureto de silício de granulação 320 e 600. Doze dentes foram tratados com um dos sistemas adesivos e foi aplicada uma camada de 1 centímetro de altura em resina composta Z100, pela técnica incremental. Após armazenagem em água destilada em estufa a 37ºC por 24 horas, os espécimes foram preparados para serem submetidos ao teste de microtração. Utilizando-se uma máquina de cortes seriados, os dentes foram fatiados em espessuras de aproximadamente 0,8 mm nos sentidos mésiodistal e vestíbulo-lingual, obtendo-se médias de áreas de adesão de 0,7 mm2. Foram obtidos, em média, 23 espécimes por dente. Identificando-se cada espécime através de um código de cores, a superfície de cada dente foi mapeada. Para a leitura da resistência de união, cada espécime em forma de palito" foi afixado individualmente em um dispositivo de microtração, Bencor Multi-T, de modo a posicionar a área de adesão perpendicularmente ao longo eixo do espécime. Após o teste, o modo de fratura da interface adesiva foi avaliado. Os resultados obtidos permitiram concluir que existe uma variação regional da resistência de união em superfícies planas de dentina. Independentemente do sistema adesivo empregado, a variação da resistência de união encontrada em superfícies planas de dentina foi determinada por variações no substrato dentinário.Comparando-se a resistência de união entre os materiais, os sistemas One-Step (53,97 ± 12,58 MPa) e Single Bond (52,59 ± 17,67 MPa) apresentaram uma resistência semelhante e estatisticamente superior ao sistema Clearfil Liner Bond 2V (32,90 ± 12,43 MPa). Comparando-se a resistência de união à dentina central e à dentina periférica, os três materiais não apresentaram uma diferença estatisticamente significante.The present work evaluated the influence of morphological variations of the dentinal substrate in the microtensile adhesive strength of three adhesive systems: Clearfil Liner Bond 2V, One-Step and Single Bond, using flat dentin surfaces. For the preparation and exposure of the dentin surface, the occlusal enamel was ground with 320 and 600 grit SiC paper. The teeth were treated with one of the adhesive systems and a 1cm thick layer of Z100 resin composite was built up on the surface. After storage in distilled water at 37ºC for 24 hours, the specimens were prepared to be subjected to the microtensile test. With the aid of a micrometer the teeth were serially sectioned in both x" and y" directions to result in several bonded sticks of approximately 0.7 mm2 of cross-sectional area. Approximately twenty-three specimens per tooth were obtained. Each specimen was identified by a color code and the flat dentin surface was mapped. For the reading of the adhesive strength, each bonded stick was individually gluded to a Bencor Multi-T microtensile device with the adhesive area perpendicularly oriented to the long axis of the device. After testing, the mode of fracture of the adhesive interface was evaluated. The conclusions of this study were: there is a regional variance in the adhesive strenght on a flat dentin surface; regardless of the adhesive system used, the variation of the adhesive strength found on flat dentin surfaces was determined by variations in the dentinal substrate; when comparing the adhesive strength among the materials, One-Step (53,97 MPa ± 12,58) and Single Bond (52,59 MPa ± 17,67) systems presented a adhesive strength similar and statistically higher than the Clearfi Liner Bond 2V (32,90 MPa ± 12,43) system; when comparing the adhesive strength to both central and peripheral dentin, the three materials did not present any statistically significant differences

Mapeamento da variação regional da resistência adesiva em superfícies planas de dentina.

O presente trabalho avaliou a influência das variações morfológicas do substrato dentinário na resistência de união à microtração de três sistemas adesivos resinosos: Clearfil Liner Bond 2V, One-Step e Single Bond, empregando como substrato superfícies planas de dentina. Para o preparo e exposição da superfície de dentina, o esmalte oclusal foi desgastado com lixas de carbureto de silício de granulação 320 e 600. Doze dentes foram tratados com um dos sistemas adesivos e foi aplicada uma camada de 1 centímetro de altura em resina composta Z100, pela técnica incremental. Após armazenagem em água destilada em estufa a 37ºC por 24 horas, os espécimes foram preparados para serem submetidos ao teste de microtração. Utilizando-se uma máquina de cortes seriados, os dentes foram fatiados em espessuras de aproximadamente 0,8 mm nos sentidos mésiodistal e vestíbulo-lingual, obtendo-se médias de áreas de adesão de 0,7 mm2. Foram obtidos, em média, 23 espécimes por dente. Identificando-se cada espécime através de um código de cores, a superfície de cada dente foi mapeada. Para a leitura da resistência de união, cada espécime em forma de palito" foi afixado individualmente em um dispositivo de microtração, Bencor Multi-T, de modo a posicionar a área de adesão perpendicularmente ao longo eixo do espécime. Após o teste, o modo de fratura da interface adesiva foi avaliado. Os resultados obtidos permitiram concluir que existe uma variação regional da resistência de união em superfícies planas de dentina. Independentemente do sistema adesivo empregado, a variação da resistência de união encontrada em superfícies planas de dentina foi determinada por variações no substrato dentinário.Comparando-se a resistência de união entre os materiais, os sistemas One-Step (53,97 ± 12,58 MPa) e Single Bond (52,59 ± 17,67 MPa) apresentaram uma resistência semelhante e estatisticamente superior ao sistema Clearfil Liner Bond 2V (32,90 ± 12,43 MPa). Comparando-se a resistência de união à dentina central e à dentina periférica, os três materiais não apresentaram uma diferença estatisticamente significante.The present work evaluated the influence of morphological variations of the dentinal substrate in the microtensile adhesive strength of three adhesive systems: Clearfil Liner Bond 2V, One-Step and Single Bond, using flat dentin surfaces. For the preparation and exposure of the dentin surface, the occlusal enamel was ground with 320 and 600 grit SiC paper. The teeth were treated with one of the adhesive systems and a 1cm thick layer of Z100 resin composite was built up on the surface. After storage in distilled water at 37ºC for 24 hours, the specimens were prepared to be subjected to the microtensile test. With the aid of a micrometer the teeth were serially sectioned in both x" and y" directions to result in several bonded sticks of approximately 0.7 mm2 of cross-sectional area. Approximately twenty-three specimens per tooth were obtained. Each specimen was identified by a color code and the flat dentin surface was mapped. For the reading of the adhesive strength, each bonded stick was individually gluded to a Bencor Multi-T microtensile device with the adhesive area perpendicularly oriented to the long axis of the device. After testing, the mode of fracture of the adhesive interface was evaluated. The conclusions of this study were: there is a regional variance in the adhesive strenght on a flat dentin surface; regardless of the adhesive system used, the variation of the adhesive strength found on flat dentin surfaces was determined by variations in the dentinal substrate; when comparing the adhesive strength among the materials, One-Step (53,97 MPa ± 12,58) and Single Bond (52,59 MPa ± 17,67) systems presented a adhesive strength similar and statistically higher than the Clearfi Liner Bond 2V (32,90 MPa ± 12,43) system; when comparing the adhesive strength to both central and peripheral dentin, the three materials did not present any statistically significant differences

Radiographic Follow-Up during Orthodontic Treatment for Early Diagnosis of Sequential Supernumerary Teeth

Most supernumerary teeth are impacted and asymptomatic. Objective. The aim of this paper is to describe two cases of sequential development of supernumerary teeth in the mandibular premolar region, identified during orthodontic treatment. Reports. The first case describes the radiographic follow-up of a female patient that presented a supernumerary tooth at the age of 9 years and 10 months in the right mandibular premolar region, followed by a further supernumerary tooth in the left mandibular premolar region identified at the age of 11 years and 3 months. In the second case, the radiographic follow-up of a male patient demonstrated 3 supernumerary teeth in the premolar region at the age of 16 years. During orthognathic surgery planning at the age of 20 years and 5 months, a supplemental supernumerary tooth was found in the left mandibular region. Conclusion. Considering the late developing of supernumerary premolars, appropriate follow-up with panoramic radiographs of patients with previous experience of supernumerary teeth is essential for early diagnosis of supplemental premolars to prevent possible complications

In vitro effect of energy drinks on human enamel surface

Abstract Introduction Energy drinks (ED) possess low pH and citric acid in their composition, making them potentially erosive beverages that can contribute to the high dental erosion rates found currently in the general population and also in young people. Objective To evaluate the mean pH and titratable acidity of commercial ED and the influence of a brand of ED on the superficial microhardness of human enamel. Material and method Ten commercial ED were selected and the pH of two lots of each ED with and without gas was obtained. Acid titration was conducted with the addition of NaOH aliquots until the pH 7 was reached. Eighteen human enamel specimens were allocated in three groups (N=6), Red Bull (RB), Red Bull Light (RBL) and distilled water (C), submitted to an acid challenge with the ED, six consecutive times, with 12 hours intervals, during three days. Knoop microhardness was measured before and after the acid challenge. Result All ED brands tested presented low pH levels ranging from 2.1 to 3.2. Regarding titratable acidity, it was found that the amount of base required promoting the neutralization of the solutions ranged from 1200μL to 3750μL. Samples of human enamel in the RB and RBL groups submitted to the acid challenge presented significantly decreased Knoop microhardness when compared with the group C. Conclusion All ED examined have potential to promote mineral loss due to the low pH and high titratable acidity. The ED analyzed promoted significant mineral losses on the dental enamel surface