Analysis by confocal laser scanning microscopy of the MDPB bactericidal effect on S. mutans biofilm CLSM analysis of MDPB bactericidal effect on biofilm

Since bacteria remain in the dentin following caries removal, restorative materials with antibacterial properties are desirable to help maintaining the residual microorganisms inactive. The adhesive system Clearfil Protect Bond (PB) contains the antibacterial monomer 12-methacryloyloxydodecylpyridinium bromide (MDPB) in its primer, which has shown antimicrobial activity. However, its bactericidal effect against biofilm on the dentin has been little investigated. Objective: The aim of this study was to analyze by confocal laser scanning microscopy (CLSM) and viable bacteria counting (CFU) the MDPB bactericidal effect against S. mutans biofilm on the dentin surface. Material and methods: Bovine dentin surfaces were obtained and subjected to S. mutans biofilm formation in BHI broth supplemented with 1% (w/v) sucrose for 18 h. Samples were divided into three groups, according to the primer application (n=3): Clearfil Protect Bond (PB), Clearfil SE Bond, which does not contain MDPB, (SE) and saline (control group). After the biofilm formation, Live/ Dead stain was applied directly to the surface of each sample. Next, 10 µL of each primer were applied on the samples during 590 s for the real-time CLSM analysis. The experiment was conducted in triplicate. The primers and saline were also applied on the other dentin samples during 20, 90, 300 and 590 s (n=9 for each group and period evaluated) and the CFU were assessed by colonies counting. Results: The results of the CLSM showed that with the Se application, although non-viable bacteria were detected at 20 s, there was no increase in their count during 590 s. In contrast, after the PB application there was a gradual increase of non-viable bacteria over 590 s. Conclusions: The quantitative analysis demonstrated a significant decrease of S. mutans CFU at 90 s PB exposure and only after 300 s of Se application. Protect Bond showed an earlier antibacterial effect than Se Bond

Risk Factors for the Incidence of Dental Caries in Low, Very Low, and Extremely Low Birth Weight Children: A Cohort Study

Objective: To assess the incidence of caries in a two-year period among low birth weight (LBW), very low birth weight (VLBW), and extremely low birth weight (ELBW) children considering socioeconomic indicators, dietary factors and oral hygiene. Material and Methods: A convenience sample was formed of 42 low birth weight children aged two to five years at baseline. Two examiners diagnosed caries using the World Health Organization criteria. Birth weight, socioeconomic indicators and diet were collected from medical records and questionnaires. Binomial models were used to estimate unadjusted and adjusted rate ratios (RR) and respective 95% confidence intervals for the factors evaluated. Results: Thirty-six children were re-examined after two years. The incidence of dental caries was 36.7%. The dmft index was 0.44 (±1.25) at baseline and increased to 1.36 (±3.85) at follow-up. VLBW children (1,000 to 1,500 g) (RR=0.23; 95%CI: 0.08-0.72) and LBW children (1,500 to 2,500 g) (RR=0.06; 0.01-0.55) had fewer carious lesions compared to ELBW children (<1,000 g). Carious lesions were more frequent among children with a lower income (RR=6.05; 1.05-34.84) and less frequent among those who did not consume sweetened juice, tea or yogurt (RR: 0.21; 0.07-0.62). Conclusion: An inverse dose-response relation was found between birth weight and the incidence of caries. A lower income and the consumption of sweetened beverages were risk factors for the development of caries

TiF4 varnish protects the retention of brackets to enamel after in vitro mild erosive challenge

The effect of fluoride agents on the retention of orthodontic brackets to enamel under erosive challenge is little investigated. Objective: The aim of this study was to evaluate the effect of titanium tetrafluoride (TiF4) and sodium fluoride (NaF) agents on the shear bond strength of brackets to enamel and on the enamel microhardness around brackets under erosive challenge. Methods: Brackets were bonded to bovine incisors. Five groups were formed according to fluoride application (n=10): TiF4 varnish, TiF4 solution, NaF varnish, NaF solution and control (without application). The specimens were submitted to erosive challenge (90 s cola drink/2h artificial saliva, 4x per day for 7 days). Solutions were applied before each erosive cycle and varnishes were applied once. Vickers Microhardness (VHN) was obtained before and after all cycles of erosion and the percentage of microhardness loss was calculated. Shear bond strength, adhesive remnant index and polarized light microscopy were conducted after erosion. The data were analyzed by ANOVA, Tukey, Kruskal-Wallis and Mann-Whitney U tests (α=0.05). Results: The %VHN had no statistically significant differences among the experimental groups. However, considering the comparisons of all groups with the control group, TiF4 varnish showed the highest protection from enamel demineralization (effect size of 2.94, while the effect size for the other groups was >2.4). The TiF4 varnish group had significantly higher shear bond strength compared to other groups. There was no difference among groups for adhesive remnant index. Polarized light microscopy showed higher demineralization depth for the control group. Conclusions: Application of NaF and TiF4 agents during mild erosive challenge minimized the enamel mineral loss around brackets, however only the experimental TiF4 varnish was able to prevent the reduction of shear bond strength of brackets to enamel.

TiF 4 varnish protects the retention of brackets to enamel after in vitro mild erosive challenge

The effect of fluoride agents on the retention of orthodontic brackets to enamel under erosive challenge is little investigated. Objective: The aim of this study was to evaluate the effect of titanium tetrafluoride (TiF<i>4</i>) and sodium fluoride (NaF) agents on the shear bond strength of brackets to enamel and on the enamel microhardness around brackets under erosive challenge. Methods: Brackets were bonded to bovine incisors. Five groups were formed according to fluoride application (n=10): TiF<i>4</i> varnish, TiF<i>4</i> solution, NaF varnish, NaF solution and control (without application). The specimens were submitted to erosive challenge (90 s cola drink/2h artificial saliva, 4x per day for 7 days). Solutions were applied before each erosive cycle and varnishes were applied once. Vickers Microhardness (VHN) was obtained before and after all cycles of erosion and the percentage of microhardness loss was calculated. Shear bond strength, adhesive remnant index and polarized light microscopy were conducted after erosion. The data were analyzed by ANOVA, Tukey, Kruskal-Wallis and Mann-Whitney U tests (α=0.05). Results: The %VHN had no statistically significant differences among the experimental groups. However, considering the comparisons of all groups with the control group, TiF<i>4</i> varnish showed the highest protection from enamel demineralization (effect size of 2.94, while the effect size for the other groups was >2.4). The TiF<i>4</i> varnish group had significantly higher shear bond strength compared to other groups. There was no difference among groups for adhesive remnant index. Polarized light microscopy showed higher demineralization depth for the control group. Conclusions: Application of NaF and TiF<i>4</i> agents during mild erosive challenge minimized the enamel mineral loss around brackets, however only the experimental TiF<i>4</i> varnish was able to prevent the reduction of shear bond strength of brackets to enamel

A higiene bucal de bebês edêntulos e sua influência na microbiota bucal: os profissionais de saúde devem preconizá-la? – revisão crítica

Introduction: The indication of oral hygiene in edentulous babies is still controversial among health professionals, being necessary the search of this recommendation and the standardization of information. Objective: To investigate critically the evidence related to the indication of oral hygiene for edentulous babies. Methods: The search for articles was performed in the PUBMED, LILACS and GOOGLE SCHOLAR databases, in order to assess the following question: "Can oral cavity hygiene of edentulous babies influence oral microbiota? A search in 8 books of Pediatric Dentistry was also performed. Results: 317 articles were found (167-PUBMED, 146-GOOGLE SCHOLAR and 4-LILACS). There were no primary studies that evaluated the effect of oral hygiene of edentulous infants on microbiota, which impair the conduction of a systematic review. Thus, it was included for this review six studies that investigated microorganisms in the oral cavity of edentulous infants and the role of salivary immunoglobulins. Among the textbooks evaluated, only 4 indicated the oral hygiene in edentulous infants. Conclusion: According to the data, there are no primary studies that assessed the effect of oral hygiene in the oral microbiota of edentulous babies. It is relevant to conduct clinical studies in order to obtain scientific evidence about the indication or no of the oral hygiene in edentulous babies.Introdução: A indicação de higiene bucal em bebês edêntulos entre os profissionais de saúde ainda é controversa, sendo necessária a busca científica sobre esta indicação e a padronização da informação. Objetivo: Investigar criticamente as evidências relacionadas a indicação da higiene bucal para bebês edêntulos. Métodos: A busca de artigos foi realizada nas bases de dados PUBMED, LILACS e GOOGLE SCHOLAR, de modo a avaliar a seguinte pergunta: “A higienização da cavidade bucal de bebês edêntulos pode influenciar a microbiota bucal?”. Uma busca em 8 livros de Odontopediatria também foi realizada. Resultados: Foram encontrados 317 artigos (167-PUBMED, 146-GOOGLE SCHOLAR e 4-LILACS). Não foram encontrados estudos primários que avaliaram o efeito da higiene bucal em bebês edêntulos na microbiota, impossibilitando a condução de revisão sistemática. Assim, para a revisão foram incluídos 6 estudos que investigaram micro-organismos na cavidade bucal de bebês edêntulos e o papel das imunoglobulinas salivares. Dentre os livros avaliados, somente 4 indicaram a higiene bucal em bebês edêntulos. Conclusão: Diante dos dados analisados, não existem estudos primários que avaliaram o efeito da higienização na microbiota bucal de bebês edêntulos. Torna-se relevante a condução de estudos clínicos para obtenção de evidências científicas sobre a indicação ou não da higienização da cavidade bucal de bebês edêntulos

Synthesis of a chitosan nanoparticle suspension and its protective effects against enamel demineralization after an in vitro cariogenic challenge

Objective: Our study aims to synthesize, characterize, and determine the effects of a ChNPs suspension on human enamel after cariogenic challenge via pH-cycling. Methodology: ChNPs were synthesized by ion gelation and characterized by Transmission Electron Microscopy (TEM) and Dynamic Light Scattering. Forty enamel blocks were divided into four groups (n=10/group): (i) ChNPs suspension; (ii) chitosan solution; (iii) 0.05% sodium fluoride (NaF) solution; and (iv) distilled water. Specimens were exposed to cariogenic challenge by cycling in demineralization solution (3 h) and then remineralized (21h) for 7 days. Before each demineralization cycle, the corresponding solutions were passively applied for 90 s. After 7 days, specimens were examined for surface roughness (Ra) and Knoop hardness (KHN) before and after the cariogenic challenge; % KHN change (variation between initial and final hardness), and surface topography by an optical profilometer. The data were analyzed by repeated-measures ANOVA, One-way ANOVA, and Tukey tests (α=0.05). Results: TEM images showed small spherical particles with diameter and zeta potential values of 79.3 nm and +47.9 mV, respectively. After the challenge, all groups showed an increase in Ra and a decrease in KHN values. Optical profilometry indicated that ChNPs- and NaF-treated specimens showed uneven roughness interspersed with smooth areas and the lowest %KHN values. Conclusion: The ChNPs suspension was successfully synthesized and minimized human enamel demineralization after a cariogenic challenge, showing an interesting potential for use as an oral formulation for caries prevention

Association of Oral Health-Related Quality of Life with the Longevity of ART-Restorations in Children

Objective: To evaluate the association of oral health-related quality of life (OHRQoL) with the longevity of ART-restorations in children after 18 months. Material and Methods: A longitudinal clinical study with 62 six- to seven-year-old children, both genders, 31 of whom underwent four weeks of oral health education strategy (OHES) followed by ART (GOHES+ART) and the others only ART (GART). The Brazilian short-version of the Child Perceptions Questionnaire (16-CPQ8-10) was used to evaluate the OHRQoL and the perception of change in oral health was assessed by a single question. Data was analyzed using Mann-Whitney, Wilcoxon and Friedman\u27s tests. Results: After 18 months, GOHES+ART reported a greater impairment on OHRQoL, mainly in oral symptoms domain (p<0.05). In this period, greater impairment of oral symptoms was reported in children with failed restorations and with treatment considered to have a minor failure (p<0.05). In inter-group analysis, the GOHES+ART, with 2 to 4 restorations, Class I, of small size, located in the upper arch and with a smaller failure, reported more oral symptoms than the GART. Conclusion: In the long-term, children submitted to OHES followed by ART reported more oral symptoms. Factors such as number, class, size and location of the restorations need to be considered for the implementation of an efficient and effective oral health program, as well as for greater longevity of ART-restorations

Cárie dentária e fatores relacionados em crianças Brasileiras de região com água fluoretada e não fluoretada

PURPOSE: To compare the caries prevalence, saliva buffering capacity (SBC), oral hygiene (OH), dietary habits, family income (FI) and frequency of visits to a dental office (Do) between Brazilian children living in areas with and without fluoridated public water supply. METHODS: Forty-six 5-7-year-old preschoolers were selected in Itatiba, SP, Brazil; 19 were from a fluoridated area, and 27 were from a non-fluoridated area. The caries index was determined according to the World Health Organization criteria, and the SBC was assessed by titration with hydrochloric acid. The FI, frequency of OH and visits to Do were estimated by questionnaire. The dietary habits were assessed with a diet chart. The differences between the groups were analyzed with Mann-Whitney-U tests (α=0.05). RESULTS: Children from the non-fluoridated area showed significantly higher dmft/DMFT than those from the fluoridated area, but they showed significantly lower SBC, OH frequency and FI. No significant differences were observed between the areas for dietary habits and visits to Do. CONCLUSION: Children from fluoridated areas showed higher salivary buffering capacity, family income and oral hygiene frequency as well as lower caries prevalence, supporting the beneficial effect of fluoride in the tap water for caries prevention.OBJETIVO: Comparar prevalência de cárie, capacidade tamponante da saliva (CTS), higiene bucal (HB), hábitos dietéticos, renda familiar (RF) e frequência de visita a consultórios odontológicos (Co) entre crianças brasileiras residentes em áreas de água de abastecimento público fluoretadas e não fluoretadas. METODOLOGIA: Quarenta e seis crianças entre 5-7 anos foram selecionadas em Itatiba-SP-Brasil, sendo 19 pertencentes à área fluoretada e 27 à área não fluoretada. O índice de cárie foi determinado de acordo com o critério da Organização Mundial de Saúde e a CTS foi medida por titulação com ácido clorídrico. A RF, frequência de HB e visita ao Co foram estimadas por questionário. Os hábitos dietéticos foram avaliados com diário de dieta. As diferenças entre as variáveis foram analisadas pelo teste de Mann Whitney (α=0,05). RESULTADOS: As crianças da área não fluoretada apresentaram significativamente maior ceod/CPOD que àquelas da área fluoretada, porém significativamente menor CTS, HB e RF. Com relação a hábitos dietéticos e visitas ao Co, não foi observada diferença significativa entre as áreas. CONCLUSÃO: As crianças da área fluoretada apresentaram maior capacidade tamponante da saliva, renda familiar e frequência de higiene bucal, assim como menor prevalência de cárie, reforçando o efeito benéfico do flúor nas águas de abastecimento para prevenir a cárie

Effect of hydrochloric acid commercial presentation for microabrasion technique on loss of enamel structure and surface

Introdução: A técnica de microabrasão pode ser realizada através de pasta pronta para uso, disponível comercialmente, ou o profissional pode manipulá-la no consultório. Objetivo: Verificar o efeito da apresentação comercial do ácido clorídrico a 10% na manipulação de pasta para microabrasão sobre a superfície do esmalte. Metodologia: Foram selecionados incisivos bovinos e divididos em dois grupos, de acordo com a apresentação comercial do ácido clorídrico (líquido ou em gel). O tratamento foi realizado através de dez aplicações com 10s de duração cada, intercaladas por lavagem de 10s. Vinte incisivos (n=10) foram utilizados para se determinar a perda de estrutura do esmalte. Cada amostra foi pesada, em balança analítica, antes e após submissão à microabrasão. Outras 20 amostras (n=10) foram utilizadas para determinação da rugosidade superficial média (Ra) utilizando-se um rugosímetro. Três amostras de cada grupo do experimento anterior foram selecionadas, aleatoriamente, e outras três amostras adicionais foram preparadas como controle (baseline) para análise em MEV. Resultados: Verificou-se diferença estatística significativa entre a massa final e a inicial e rugosidade superficial das amostras, independente da apresentação comercial do ácido. Nas imagens de MEV observou-se presença de superfície regular para o grupo controle (baseline). Nas demais imagens verificou-se superfície com considerável irregularidade e dissolução discreta do esmalte. Conclusões: O tratamento realizado causou perda significativa de estrutura e aumentou a rugosidade superficial dos espécimes, independente da apresentação comercial do ácido e sem apresentar diferença entre os grupos ao final. A apresentação comercial do ácido não parece ser um fator a interferir no tratamento.Introduction: The microabrasion technique can be performed using a commercially available paste, or the dentist can prepare it in his office. Objective: To verify the effect of hydrochloric acid commercial presentation in the handling of microabrasion paste on the enamel surface. Methodology: Bovine incisors were divided into two groups, according to the commercial presentation of 10% hydrochloric acid (liquid or gel). The treatment was carried out through ten applications of 10 s duration each, intercalated with a 10s wash. Twenty teeth (n=10) were used to determine the loss of enamel structure. Each sample was weighed on an analytical balance before and after submission to microabrasion. Another 20 teeth (n=10) were used to determine the average surface roughness (Ra) using a rugosimeter. Three samples from each group of the previous experiment were selected, randomly, and another three additional samples were repared as a control (baseline) for SEM analysis. Results: There was a statistically significant difference between the final and initial mass and the surface roughness of the samples, regardless of the acid commercial presentation. In the SEM images, a regular surface was observed for the control group (baseline). In the other images, there was a surface with considerable irregularity and a slight dissolution of the enamel. Conclusions: The treatment carried out

Association of Oral Health-Related Quality of Life with the Longevity of ART-Restorations in Children

Objective: To evaluate the association of oral health-related quality of life (OHRQoL) with the longevity of ART-restorations in children after 18 months. Material and Methods: A longitudinal clinical study with 62 six- to seven-year-old children, both genders, 31 of whom underwent four weeks of oral health education strategy (OHES) followed by ART (GOHES+ART) and the others only ART (GART). The Brazilian short-version of the Child Perceptions Questionnaire (16-CPQ8-10) was used to evaluate the OHRQoL and the perception of change in oral health was assessed by a single question. Data was analyzed using Mann-Whitney, Wilcoxon and Friedman's tests. Results: After 18 months, GOHES+ART reported a greater impairment on OHRQoL, mainly in oral symptoms domain (p<0.05). In this period, greater impairment of oral symptoms was reported in children with failed restorations and with treatment considered to have a minor failure (p<0.05). In inter-group analysis, the GOHES+ART, with 2 to 4 restorations, Class I, of small size, located in the upper arch and with a smaller failure, reported more oral symptoms than the GART. Conclusion: In the long-term, children submitted to OHES followed by ART reported more oral symptoms. Factors such as number, class, size and location of the restorations need to be considered for the implementation of an efficient and effective oral health program, as well as for greater longevity of ART-restorations