Effect of the association between fluoridated dentifrice and fluoridated mouthwash use on the inhibition of root dentin demineralization : in vitro study

O uso de flúor desempenha um papel fundamental no controle e prevenção da doença cárie. Enxaguatório fluoretado (EF) pode ser indicado para tratamento de pacientes cárie ativos. Porém, não existe um consenso se o uso de EF pode trazer um benefício adicional em termos de redução de perda de minerais á indivíduos que fazem uso regular de dentifrício fluoretado (DF).O objetivo do estudo foi avaliar o efeito da associação entre uso de DF 2X/dia e EF 1X/dia na inibição da desmineralização da dentina radicular em comparação com o uso de DF 2 ou 3 x/dia usando um modelo microbiano in vitro de desmineralização. Foram utilizados 48 blocos de dentina radicular (4x4x2 mm) obtidos a partir do terço cervical de raízes de incisivos bovinos com dureza de superfície conhecida. A dureza inicial de superfície foi determinada através da média de 5 indentações usando um indentador tipo Knoop, com carga de 10g por 5 segundos. Biofilmes formados por Streptococcus mutans e Lactobacillus casei foram crescidos na superfície dos blocos de dentina previamente recobertos com película salivar. Esses blocos foram transferidos para uma placa de 24 poços contendo meio de cultura acrescido de inóculo de duas espécies e incubados em microaerofilia por 8 horas. Após essas 8 horas, os blocos de dentina foram transferidos para uma nova placa de 24 poços contendo meio de cultura suplementado com 0,12% de sacarose e incubados a 37ºC sob microaerofilia durante aproximadamente 16 horas. Diariamente, os blocos foram submetidos aos seguintes tratamentos (6 blocos/ grupo): Grupo 1- controle, água destilada e deionisada 3x/dia; Grupo 2 - DF 2x/dia; Grupo 3 - DF 3x/dia; Grupo 4 - associação entre DF 2x/dia + EF 1x/dia. Este regime de tratamento ocorreu durante 3 dias. O experimento foi realizado em duplicata. A porcentagem de perda de dureza de superfície foi determinada para cada condição avaliada. A porcentagem de perda de minerais no grupo exposto a DF 3x/dia foi estatisticamente menor comparada ao grupo exposto a DF 2x/dia, entretanto não foi diferente quando comparada ao grupo tratado com DF 2x/dia+EF 1x/dia. Os resultados do presente estudo sugerem que a associação entre uso de DF+ EF mostrou-se tão eficiente quanto o uso de DF 3X dia na inibição da dentina radicular.The use of fluoride plays a key role in the control and prevention of caries. Fluoridated mouthwash (FM) may be prescribed to caries active subjects in an effort to control dental mineral loss. However, there is no consensus whether FM can bring additional benefits to individuals who regularly use fluoridated dentifrice (FD). The aim of this study was to evaluate the association between the use of FD 2X/day and FM 1x/day on the inhibition of root dentin demineralization compared with the use of FD 2 or 3 x / day using an in vitro microbial model. A total of 48 root dentin slabs (4x4x2 mm) were obtained from the cervical third of the roots of bovine incisors. Initial hardness of the slabs was determined using a Knoopmicrohardness (KNH) load of 10 g for 5 sec. Biofilms formed by Lactobacillus casei and Streptococcus mutans were grown on the surface of dentin slabs coated with salivary pellicle. These slabs were transferred to a 24-well plate containing culture medium plus two species inoculum and incubated in microaerophilic conditions for 8 hours. The dentin slabs were then transferred to a new plate 24-well plate containing culture medium supplemented with 0.12% sucrose and incubated at 37°C under microaerophilic conditions for approximately 16 hours. Every day, the slabs were subjected to the following treatments (6 slabs / group): Group 1 - control, distilled and deionized water 3x/day, Group 2 - FD 2x/day, Group 3 - FD 3x/day, Group 4 - association between FD 2x/day + FM 1x/day. This treatment regimen was followed for 3 days. The experiment was done in duplicate. The percentage of surface mineral change was determined for each evaluated condition. There was a statistically greater mineral loss in the control group. Mineral loss found in the presence of FD 3X/day was lower than in the presence of dentifrice 2X/day but it was not statistically different compared with the slabs subjected to FD + FM. The results of this study suggest that the association between the use of FD + FM is as effective as the use of FD 3X/day in the inhibition of root dentin demineralization

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