Impact of different fluoride concentrations and pH of dentifrices on tooth erosion/abrasion in vitro

Background: This in vitro study analysed the effect of different fluoride concentrations in acidic or neutral liquid dentifrices in protecting enamel and dentine from erosive and abrasive wear. Methods: Bovine enamel and dentine specimens (n = 132) were randomly allocated to 11 groups (each n = 12): experimental liquid dentifrices with 550 ppm F, 1100 ppm F, 5000 ppm F or 0 ppm F/placebo (each at pH 4.5 and pH 7.0); and commercial dentifrices with 550 ppm F (Colgate Baby, pH 7.0), 1100 ppm F (Crest, pH 7.0) and 5000 ppm F (Duraphat, pH 7.0). The specimens were subjected to erosion for 90 seconds, 4 times/day, over 7 days. Immediately after the first and last erosion, the specimens were brushed for 15 seconds using one of the dentifrices. Tooth wear was measured profilometrically (lm) and analysed by ANOVA (p < 0.05). Results: All fluoridated liquid dentifrices significantly reduced enamel wear compared to the placebo and commercial dentifrices. Only liquid dentifrices with 1100 and 5000 ppm F significantly reduced dentine wear compared to placebo dentifrice. The pH had no effect, but the consistency had a significant impact on the effect of dentifrices. Conclusions: Liquid dentifrices with high F concentration appear to be a good option to prevent tooth wear

Role of CCR2 in orthodontic tooth movement

Introduction: Cytokines and chemokines regulate bone remodeling during orthodontic tooth movement. CC chemokine ligand 2 (CCL2) is involved in osteoclast recruitment and activity, and its expression is increased in periodontal tissues under mechanical loading. In this study, we investigated whether the CC chemokine receptor 2 (CCR2)-CCL2 axis influences orthodontic tooth movement. Methods: A coil spring was placed in CCR2-deficient (CCR2(-/-)), wild-type, vehicle-treated, and P8A-treated (CCL2 analog) mice. In a histopathologic analysis, the amounts of orthodontic tooth movement and numbers of osteoclasts were determined. The expression of mediators involved in bone remodeling was evaluated by real-time polymerase chain reaction. Results: Orthodontic tooth movement and the number of TRAP-positive cells were significantly decreased in CCR2(-/-) and P8A-treated mice in relation to wild-type and vehicle-treated mice, respectively. The expressions of RANKL, RANK, and osteoblasts markers (COL-1 and OCN) were lower in CCR2(-/-) than in wild-type mice. No significant difference was found in osteoprotegerin levels between the groups. Conclusions: These data suggested a reduction of osteoclast and osteoblast activities in the absence of CCR2. The CCR2-CCL2 axis is positively associated with osteoclast recruitment, bone resorption, and orthodontic tooth movement. Therefore, blockage of the CCR2-CCL2 axis might be used in the future for modulating the extent of orthodontic tooth movement. (Am J Orthod Dentofacial Orthop 2012;141:153-60)

Effect of whitening toothpaste on titanium and titanium alloy surfaces

Dental implants have increased the use of titanium and titanium alloys in prosthetic applications. Whitening toothpastes with peroxides are available for patients with high aesthetic requirements, but the effect of whitening toothpastes on titanium surfaces is not yet known, although titanium is prone to fluoride ion attack. Thus, the aim of the present study was to compare Ti-5Ta alloy to cp Ti after toothbrushing with whitening and conventional toothpastes. Ti-5Ta (%wt) alloy was melted in an arc melting furnace and compared with cp Ti. Disks and toothbrush heads were embedded in PVC rings to be mounted onto a toothbrushing test apparatus. A total of 260,000 cycles were carried out at 250 cycles/minute under a load of 5 N on samples immersed in toothpaste slurries. Surface roughness and Vickers microhardness were evaluated before and after toothbrushing. One sample of each material/toothpaste was analyzed by Scanning Electron Microscopy (SEM) and compared with a sample that had not been submitted to toothbrushing. Surface roughness increased significantly after toothbrushing, but no differences were noted after toothbrushing with different toothpastes. Toothbrushing did not significantly affect sample microhardness. The results suggest that toothpastes that contain and those that do not contain peroxides in their composition have different effects on cp Ti and Ti-5Ta surfaces. Although no significant difference was noted in the microhardness and roughness of the surfaces brushed with different toothpastes, both toothpastes increased roughness after toothbrushing.

Effectiveness of Tooth Wipes in Removing Babies' Dental Biofilm

Purpose: To assess the effectiveness of tooth wipes in removing dental biofilm from babies' anterior teeth, as well as to evaluate the babies' behaviour and the guardians' preference concerning hygiene methods. Materials and Methods: In this random blind cross-over study, 50 high caries risk babies, from 8 to 15 months old, were divided into two groups: babies with oral hygiene performed by caregivers (n = 25) or by their mothers (n = 25). The caregivers and mothers removed biofilm using three methods of oral hygiene (tooth wipes, toothbrushes and gauze), one in each experimental phase. Professional cleaning was done before each phase, which had 2 days of biofilm accumulation and 1 experimental day, when caregivers and mothers used one method to remove biofilnn. Examiners blinded to the study design assessed the biofilm index at baseline, prior to and following biofilm removal using each method. The babies' behaviour and the mothers'/caregivers' preference were assessed. Results: The tooth wipes, toothbrushes and gauze significantly reduced the amount of biofilm (P < 0.001). The mothers' group removed more biofilm than the caregivers' group, using toothbrushes or tooth wipes (P < 0.05). Babies in the mothers' group had better behaviour using tooth wipes than toothbrushes (P < 0.05). Mothers and caregivers preferred to use tooth wipes. Conclusions: Tooth wipes are effective in removing biofilrn from babies' anterior teeth and are the method best accepted by mothers, caregivers and babies.

Effect of NaF and TiF4 varnish and solution on bovine dentin erosion plus abrasion in vitro

Objectives. This in vitro study aimed to analyze the effect of TiF4 compared to NaF varnishes and solutions, to protect against dentin erosion associated with abrasion. Materials and methods. Bovine dentin specimens were pre-treated with NaF-Duraphat (2.26% F), NaF/CaF2-Duofluorid (5.63% F), experimental-NaF (2.45% F), experimental-TiF4 (2.45% F) and placebo varnishes; NaF (2.26% F) and TiF4 (2.45% F) solutions. Controls remained untreated. The erosive pH cycling was performed using a soft drink (pH 2.6) 4 x 90 s/day and the toothbrushing-abrasion 2 x 10 s/day, in vitro for 5 days. Between the challenges, the specimens were exposed to artificial saliva. Dentin tissue loss was measured profilometrically (mu m). Results. ANOVA/Tukey's test showed that all fluoridated varnishes (Duraphat, 7.5 +/- 1.1; Duofluorid, 6.8 +/- 1.1; NaF, 7.2 +/- 1.9; TiF4, 6.5 +/- 1.0) were able to significantly reduce dentin tissue loss (40.7% reduction compared to control) when compared to placebo varnish (11.2 +/- 1.3), control (11.8 +/- 1.7) and fluoridated (NaF, 9.9 +/- 1.8; TiF4, 10.3 +/- 2.1) solutions (p < 0.0001), which in turn did not significantly differ from each other. Conclusion. All fluoridated varnishes, but not the solutions, had a similar performance and a good potential to reduce dentin tissue loss under mild erosive and abrasive conditions in vitro. Risk patients for erosion and abrasion, especially those with exposed dentin, should benefit from this clinical preventive measure. Further research has to confirm this promising result in the clinical situation.

Retrospective Clinical Study of 988 Dual Acid-Etched Implants Placed in Grafted and Native Bone for Single-Tooth Replacement

Purpose: To evaluate the influence of sex, implant characteristics, and bone grafting on the survival rate of dual acid-etched (DAE) implants. Materials and Methods: Patients treated with internal-hex DAE implants for single-tooth replacement in a military dental clinic between January 2005 and December 2010 were included in this study. Clinical data related to implant characteristics, implant location, presence of grafted bone, and implant failures were collected. The primary outcome was implant loss. The survival rate was analyzed using the Kaplan-Meier method. Cox regression modeling was used to determine which factors would predict implant failure. Results: DAE implants were evaluated in a total of 988 patients (80.3% men). Twenty-four (2.4%) implants failed, most were cylindric (54.2%) with regular platforms (70.8%) and were 10 mm long (58.3%). The failure rate was 2.4% for the anterior maxilla, 3.3% for the posterior maxilla, 1.6% for the anterior mandible, and 2.0% for posterior mandible. The cumulative survival rate was 97.6%. The failure rate was 8.8% in implants placed after sinus augmentation, 7.3% in bone block-grafted areas, and 1.6% in native bone. Based on multivariable analysis (Cox regression), sinus augmentation and bone block grafting had a statistically significant effect on implant failure; the hazard ratios were 5.5 and 4.6, respectively. Conclusion: The results revealed that DAE implants had high survival rates, and no influence of sex, location, shape, diameter, or length on failure rates could be observed. However, a significant association was observed between failure and presence of bone graft in the implant area. Int J Oral Maxillofac Implants 2012;27:1243-1248

Multiple Tooth Agenesis in Non-syndromic Patient: a rare case report

Dental agenesis is a term referred to the absence of one or more teeth. However, oligodontia is a severe type of tooth agenesis involving six or more congenitally missing teeth, excluding the third molars. Oligodontia has a low prevalence and is a very rare condition. The aim was to show this case report of a 13-year-old female patient who presented oligodontia with absence of eight permanent teeth and condylar atrophy on left side. The patient had no history of any syndrome or systemic disease according to the anamnesis. Is very important to know oligodontia features to perform a carefully treatment plan.

Celecoxib treatment does not alter recruitment and activation of osteoclasts in the initial phase of experimental tooth movement

In a previous study, we reported that the short-term treatment with celecoxib, a nonsteroidal anti-inflammatory drug (NSAID) attenuates the activation of brain structures related to nociception and does not interfere with orthodontic incisor separation in rats. The conclusion was that celecoxib could possibly be prescribed for pain in orthodontic patients. However, we did not analyze the effects of this drug in periodontium. The aim of this follow-up study was to analyze effects of celecoxib treatment on recruitment and activation of osteoclasts and alveolar bone resorption after inserting an activated orthodontic appliance between the incisors in our rat model. Twenty rats (400420 g) were pretreated through oral gavage with celecoxib (50 mg/kg) or vehicle (carboxymethylcellulose 0.4%). After 30 min, they received an activated (30 g) orthodontic appliance, set not to cause any palate disjunction. In sham animals, the appliance was immediately removed after introduction. All animals received ground food and, every 12 h, celecoxib or vehicle. After 48 h, they were anesthetized and transcardiacally perfused through the aorta with 4% formaldehyde. Subsequently, maxillae were removed, post-fixed and processed for histomorphometry or immunohistochemical analyses. As expected, incisor distalization induced an inflammatory response with certain histological changes, including an increase in the number of active osteoclasts at the compression side in group treated with vehicle (appliance: 32.2 +/- 2.49 vs sham: 4.8 +/- 1.79, P<0.05) and celecoxib (appliance: 31.0 +/- 1.45 vs sham: 4.6 +/- 1.82, P<0.05). The treatment with celecoxib did not modify substantially the histological alterations and the number of active osteoclasts after activation of orthodontic appliance. Moreover, we did not see any difference between the groups with respect to percentage of bone resorption area. Taken together with our previous results we conclude that short-term treatment with celecoxib can indeed be a therapeutic alternative for pain relieve during orthodontic procedures.

Mini-implant insertion based on tooth crown references: a guide-free technique

Mini-implant insertion requires accurate surgical technique. This study shows an insertion technique using only tooth crown references; its scientific basis is evaluated radiographically. The sample consisted of 213 inter-radicular septa, evaluated in 53 bitewing radiographs. The proximal contour of adjacent tooth crowns was used to define septum width. The midpoint of the septum width was linked to the interdental contact point to determine septum midline. The distances from septum midline to "mesial and distal teeth were measured to evaluate the septum midline centralization degree in two different septum heights. The difference between mesial and distal distances represented the septum midline deviation degree. The mesial and distal distances were compared by t-tests, and the septum midline deviation was correlated with septum height using Pearson's correlation test. The mesial and distal distances were not statistically different in the midpoint of the septum height, but they were different at the apical septum height. There was a moderate correlation (r = 0.45) between septum midline deviation and septum height. The tooth crown references evaluated on interproximal radiographs determine a high centralization degree of the septum midline on which the insertion site could be defined. The greater centralization degree was observed at the coronal septum area.

Experimental model of tooth movement in mice: A standardized protocol for studying bone remodeling under compression and tensile strains

During orthodontic tooth movement (OTM), alveolar bone is resorbed by osteoclasts in compression sites (CS) and is deposited by osteoblasts in tension sites (TS). The aim of this study was to develop a standardized OTM protocol in mice and to investigate the expression of bone resorption and deposition markers in CS and TS. An orthodontic appliance was placed in C57BL6/J mice. To define the ideal orthodontic force, the molars of the mice were subjected to forces of 0.1 N, 0.25 N, 0.35 N and 0.5 N. The expression of mediators that are involved in bone remodeling at CS and TS was analyzed using a Real-Time PCR. The data revealed that a force of 0.35 N promoted optimal OTM and osteoclast recruitment without root resorption. The levels of TNF-alpha, RANKL, MMP13 and OPG were all altered in CS and TS. Whereas TNF-a and Cathepsin K exhibited elevated levels in CS. RUNX2 and OCN levels were higher in TS. Our results suggest that 0.35 N is the ideal force for OTM in mice and has no side effects. Moreover, the expression of bone remodeling markers differed between the compression and the tension areas, potentially explaining the distinct cellular migration and differentiation patterns in each of these sites. (C) 2012 Elsevier Ltd. All rights reserved.

Gingival Papilla Dimensions in Anterosuperior Regions Adjacent to Single-Tooth Implants

This study compared the dimensions of gingival papillae in anterosuperior areas presenting at natural teeth (teeth sites) or single-tooth implants adjacent to natural teeth (implant-tooth sites) by analyzing determined distances. A total of 45 teeth and 46 implant-tooth sites were carefully selected. Clinical evaluation consisted of visual and quantitative analyses with millimeter grids on radiographs. Implant-tooth sites showed a smaller gingival papilla dimension than tooth sites (P < .01). Both evaluated distances (contact point to bone crest and between the roots of adjacent teeth or implant platform to root of adjacent tooth) in all groups significantly influenced the presence/absence of gingival papillae (P < .01). (Int J Periodontics Restorative Dent 2012;32:93-100.)

Identification of a Tooth-Like Foreign Body in Swine Sausage

A tooth-like foreign body (FB) was found inside a sausage bread. Analysis aimed to investigate whether the FB was a tooth and its origin. The FB was measured, weighed, photographed, and radiographed. Macroscopic findings were suggestive of an anterior tooth. Histological slides of undecalcified cross-sections of the FB and samples of human and swine teeth were prepared. Histological features of the FB (in light microscopy, 125X magnification) were discrepant from human tissues. Compared histological analysis displayed majority of features consistent with a hypsodont swine tooth, probably a canine. Cellularized cementum in crown region, adjacent to the enamel, and shape of the cementocytes were the main criteria excluding the possibility of human origin of the FB. Scanning electronic microscopy and energy-dispersive spectroscopy were not performed because of fewer features to be analyzed and FB size. It was concluded that the FB may have been incorporated during meat grinding of the sausage.

The erosion and abrasion-inhibiting effect of TiF4 and NaF varnishes and solutions on enamel in vitro

Objective. Previous in vitro study has shown that TiF(4) varnish might reduce enamel erosion. No data regarding the effect of this experimental varnish on enamel erosion plus abrasion, however, are available so far. Thus, this in vitro study aimed to analyse the effect of TiF4 compared with NaF varnishes and solutions, to protect against enamel erosion with or without abrasion. Methods. Enamel specimens were pre-treated with experimental-TiF4 (2.45% F), experimentalNaF (2.45% F), NaF-Duraphat (2.26% F), and placebo varnishes; NaF (2.26% F) and TiF4 (2.45% F) solutions. Controls remained untreated. The erosive challenge was performed using a soft drink (pH 2.6) 4 u 90 s / day (ERO) and the toothbrushing abrasion (ERO+ ABR) 2 u 10 s / day, for 5 days. Between the challenges, the specimens were exposed to artificial saliva. Enamel loss was measured profilometrically (lm). Results. Kruskal-Wallis / Dunn tests showed that all fluoridated varnishes (TiF4-ERO: 0.53 +/- 0.20, ERO+ ABR: 0.65 +/- 0.19/ NaF-ERO: 0.94 +/- 0.18, ERO+ ABR: 1.74 +/- 0.37 / Duraphat-ERO: 1.00 +/- 0.37, ERO+ ABR: 1.72 +/- 0.58) were able to significantly reduce enamel loss when compared with placebo varnish (ERO: 3.45 +/- 0.41 / ERO+ ABR: 3.20 +/- 0.66) (P < 0.0001). Placebo varnish, control (ERO: 2.68 +/- 0.53 / ERO+ ABR: 3.01 +/- 0.34), and fluoridated (NaF-ERO: 2.84 +/- 0.09 / ERO+ ABR: 2.40 +/- 0.21 / TiF4-ERO: 3.55 +/- 0.59 / ERO+ ABR: 4.10 +/- 0.38) solutions did not significantly differ from each other. Conclusion. Based on the results, it can be concluded that the TiF4 varnish seems to be a promising treatment to reduce enamel loss under mild erosive and abrasive conditions in vitro.

Clinical strategies for esthetic excellence in anterior tooth restorations: understanding color and composite resin selection

Direct composite resin restorations have become a viable alternative for patients that require anterior restorative procedures to be integrated to the other teeth that compose the smile, especially for presenting satisfactory esthetic results and minimum wear of the dental structure. Technological evolution along with a better understanding of the behavior of dental tissues to light incidence has allowed the development of new composite resins with better mechanical and optical properties, making possible a more artistic approach for anterior restorations. The combination of the increasing demand of patients for esthetics and the capacity to preserve the dental structure resulted in the development of different incremental techniques for restoring fractured anterior teeth in a natural way. In order to achieve esthetic excellence, dentists should understand and apply artistic and scientific principles when choosing color of restorative materials, as well as during the insertion of the composite resin. The discussion of these strategies will be divided into two papers. In this paper, the criteria for color and material selection to obtain a natural reproduction of the lost dental structures and an imperceptible restoration will be addressed.

Intranasal tooth and associated rhinolith in a patient with cleft lip and palate

We report the case of a 9-year-old girl who presented with a complaint of a malodorous bloody discharge from the left naris. The patient had previously undergone a complete repair of left-sided cleft lip and palate. Clinical examination revealed hyperplasia of the nasal mucosa on the left side. X-ray examination of the nasal cavity demonstrated a radiopaque structure that resembled a tooth and a radiopaque mass similar to an odontoma that was adherent to the root of the suspected tooth. With the patient under general anesthesia, the structure was removed. On gross inspection, the structure was identified as a tooth with a rhinolith attached to the surface of its root. Microscopic examination revealed normal dentin and pulp tissue. A nonspecific inflammatory infiltrate was observed around the rhinolith, and areas of regular and irregular mineralization were seen. Some mineralized areas exhibited melanin-like brownish pigmentation. Areas of mucus with deposits of mineral salts were also observed. Rare cases of an intranasal tooth associated with a rhinolith have been described in the literature. We believe that this case represents only the second published report of an intranasal tooth associated with a rhinolith in a patient with cleft lip and palate