Treatment options for the occlusal surface of first permanent molars

Restorative dentistry has been increasingly concerned with preservation of the dental structure. For that reason, ultraconservative cavity preparations have been performed with air abrasion systems. The aim of this study was to present treatment options for the occlusal surface of first permanent molars with employment of the conventional method and the air abrasion system for accomplishment of the cavity preparation and a composite occlusal matrix for an accurate reproduction of the tooth surface.

Surgical and clinical management of a patient with Glanzmann thrombasthenia: A case report

A 6-year-old girl with Glanzmann thrombasthenia presented with caries and periapical lesions in the primary mandibular second molars and moderate gingivitis of the maxillary and mandibular anterior teeth. Dental extraction was recommended, and before every surgical intervention, the patient underwent platelet-concentrate transfusion to prevent hemorrhage. Epsilon aminocaproic acid was administered 6 hours before, and 48 hours after every dental procedure to prevent bleeding. In this case, treatment was effective in the prevention of hemorrhagic complications, during the required dental procedures.

The effect of adhesive and flowable composite on postoperative sensitivity: 2-Week results

Objective: To measure 2-week postoperative sensitivity in Class II composite restorations placed with a self-etching adhesive (Clearfil SE Bond) or a total-etch adhesive (Prime&Bond NT) with or without a flowable composite as cervical increment. Method and materials: Upon approval by the University of Guarulhos Committee on Human Subjects, 100 restorations were inserted in 46 patients who required Class II restorations in their molars and premolars. Enamel and dentin walls were conditioned with a self-etching primer (for Clearfil SE Bond) or etched with 34% phosphoric acid (for Prime&Bond NT). A 1- to 2-mm-thick increment of a flowable composite (Filtek Flow) was used in the proximal box in 50% of the restorations of each adhesive. Preparations were restored with a packable composite (Surefil). The restorations were evaluated preoperatively and 2 weeks postoperatively for sensitivity to cold, air, and masticatory forces using a visual analog scale. Marginal integrity of the accessible margins was also evaluated. Statistical analysis used a mixed linear model with subject as a random effect. Results: Ninety-eight teeth from 44 subjects were observed at 2 weeks. The type of adhesive and use of flowable composite had no significant effects or interaction for any of the four outcomes of interest, ie, change from baseline to 2 weeks in sensitivity and response time for the cold or air stimulus. For the air stimulus, the overall average change from baseline was not significant for either sensitivity or response time. For the cold stimulus, the overall average change from baseline was significant for both sensitivity and response time. No case of sensitivity to masticatory forces was observed. Conclusion: No differences in postoperative sensitivity were observed between a self-etch adhesive and a total-etch adhesive at 2 weeks. The use of flowable composite did not decrease postoperative sensitivity.

Clinical evaluation of proximal contacts of Class II esthetic direct restorations

Objective: This study evaluated the effectiveness of proximal contacts in Class II restorations using two types of matrix bands (steel and polyester) with two different restoration techniques (incremental and with prepolymerized particles). Method and materials: Eighty-eight Class II adjacent restorations using Prodigy resin composite were performed: 44 with the incremental technique (22 with steel matrix bands, 22 with polyester matrix bands) and 44 utilizing prepolymerized resin particles (22 steel matrix, 22 polyester matrix). The restorations were clinically evaluated at baseline and at 6, 12, and 18 months. Proximal contacts obtained immediately after restoration procedure in all restorations were satisfactory. Results: No statistically significant alterations were found in 18 months of evaluation. Conclusion: Regardless of the utilized resin composite, there were no differences in the amount of proximal contact variations with respect to tested techniques and matrices.

Arbitrarily primed polymerase chain reaction for fingerprinting the genotype identification of mutans streptococci in children with Down syndrome

This study investigated the possible intrafamilial similarity of mutans streptococcal strains in some families with a child with Down syndrome using chromosomal DNA fingerprinting. The isolates were genotyped using arbitrarily primed polymerase chain reaction with the OPA 02 and OPA 03 primers. The results showed that five children with Down syndrome harbored mutans streptococci genotypes different from those of their mothers. A matching of genotypes was observed within the control pair (mother/child without Down syndrome). After six months, new samples were collected from all participants. Analysis showed that samples from children with Down syndrome were colonized by a new strain of Streptococcus mutans that did not match the previously collected one. The results suggest the S. mutans indigenous bacteria change more than once in children with Down syndrome.

Takayasu's arteritis: What should the dentist know?

Takayasu's arteritis is a chronic inflammatory disease that affects large blood vessels, especially the aorta and/or its major branches. The condition presents with segmental lesions adjacent to normal, apparently unaffected, areas. The lesions include stenosis, occlusion, dilatations or aneurysm formations along the path of the affected artery. Because of the severity of the disease and the possibility of cardiovascular complications, patients with Takayasu's arteritis require medical treatment based on immunosuppressive and antihypertensive drugs, as well as regular follow up and surgical intervention in many instances. The aim of this paper was to describe the characteristics of Takayasu's arteritis, to report dental treatment carried out on an affected patient, and to discuss the main implications and care required during routine treatment for children in the dental office. © 2005 BSPD and IAPD.

Effects of copper vapor laser radiation on the root canal wall of human teeth: A scanning electron microscope study

Objective: The aim of this study is to analyze the effects of copper vapor laser radiation on the radicular wall of human teeth. Materials and Methods: Immediately after the crowns of 10 human uniradicular teeth were cut along the cement-enamel junction, a chemical-surgical preparation of the radicular canals was completed. Then the roots were longitudinally sectioned to allow for irradiation of the surfaces of the dentin walls of the root canals. The hemi-roots were separated into two groups: one (control) with five hemi-roots that were not irradiated, and another (experimental) with 15 hemi-roots divided into three subgroups that were submitted to the following exposure times: 0.02,0.05, and 0.1 s. A copper vapor laser (510.6 nm) with a total average power of 6.5 W in green emission, frequency of 16.000 Hz, and pulse duration of 30 ns was used. Results: The results obtained by scanning electron microscope analysis showed the appearance of a cavity in the region of laser beam impact, with melting, recrystallization, and cracking on the edges of the dentin of the cavity due to heat diffusion. Conclusions: We determined that the copper vapor laser produces significant morphologic changes in the radicular wall of human teeth when using the parameters in this study. However, further research should be done to establish parameters that are compatible with dental structure in order to eliminate thermal damages. © Mary Ann Liebert, Inc.

Restoration of severely decayed primary incisors using indirect composite resin restoration technique

Caries of primary incisors is a common problem in paediatric dentistry in some countries. The restoration of primary incisors which have been severely damaged by early childhood caries or trauma is also a difficult challenge for clinicians. This case report describes an indirect technique for the restoration of primary anterior teeth using composite resin reinforced with a fibreglass post. Over a one-year period, the crowns have demonstrated good retention and aesthetic results. The restorations were provided in two short chair-side sections, with satisfactory patient cooperation. © 2005 BSPD and IAPD.

Mouthwash ingestion by preschool children

Even though fluoride provides a significant contribution in dental caries prevention, it is known that its random employment may lead to enamel alterations such as dental fluorosis, besides the possibility of severe systemic alterations. The aim of this study was to evaluate the ingestion of mouthwashes administered to preschool children. It was concluded that parents and teachers of young children must be very careful during the accomplishment of educational programs comprising fluoridated mouthwashes, because of the high possibility of ingestion.

Assessment of the diet of 0- to 6-year-old children in municipal schools in a Brazilian city

Diet control is one of the important factors in the prevention of dental caries because food functions as substratum for fermentation and, consequently, for the formation of the organic acids that demineralize the tooth surface. This study aims to descriptively assess school diet and the associated caries-preventive methods applied to children in all municipal nursery schools of a Brazilian city (Aragatuba/SP). For this, a questionnaire with open and closed questions was used. The results showed that all schools serve school meal, which is composed mainly of sugar, carbohydrates, and proteins. The students enjoy the meal very much because for most of them, the meal served at school is the only source of food. It was observed that 90% of the schools offer other kinds of food besides the main school meal. The snacks served such as cakes, white hominy, and milk fudge are composed of sweet and highly cariogenic foods. It was also verified that in 13.30% of the schools, the daily supervised dental hygiene, an important procedure that should not be neglected, is not carried out. This procedure introduces the children to healthy habits that are added to those acquired in the family environment. It was concluded that the school diet is potentially cariogenic and, in association with the lack of daily dental hygiene, this potential may become even higher.

Inhibitory activity of glass-ionomer cements on cariogenic bacteria

This study evaluated the antibacterial activity of the glass-ionomer cements Vitrebond (3M ESPE), Ketac Molar (3M ESPE) and Fuji IX (GC America) against S mutans, S sobrinus, L acidophilus and A viscosus, using the agar diffusion test. Inocula were obtained by the seed of indicators cultures in BHI broth incubated at 37°C for 24 hours. Base layers containing 15 mL of BHI agar and 300 μL of each bacteria suspension were prepared in Petri dishes. Six wells measuring 4 mm in diameter were made in each plate and completely filled with one of the testing materials. A 0.2% chlorhexidine solution applied in round filter papers was used as control. Tests were performed 12 times for each material and bacteria strain. After incubation of the plates at 37°C for 24 hours, the zones of bacterial growth inhibition around the wells were measured. Overall, the results showed the following sequence of antibacterial activity: Vitrebond (despite the activation mode) > 0.2% chlorhexidine > Ketac Molar > Fuji IX, according to Kruskal-Wallis and Mann-Whitney statistical tests. This study confirmed significant antibacterial activity for two conventional glass-ionomers and one resin-modified glass-ionomer material. The resin-modified glass-ionomer cement Vitrebond, regardless of the activation mode, presented the best antibacterial activity against S mutans and S sobrinus. The antibacterial activity against A viscosus for Vitrebond was similar to 0.2% chlorhexidine, while light activation reduced its antibacterial activity against L acidophilus. ©Operative Dentistry, 2005.

Interdisciplinary approach to treat dyskeratosis congenita associated with severe aplastic anemia: A case report

This paper reports on a 4-year-old male who had dyskeratosis congenita and who acquired severe aplastic anemia. The patient developed hyperpigmentation of the face, neck and chest region, arms, shoulders and legs. In addition, he had dry skin, deformed fingernails and toenails, sparse hair and eyebrows and hyperkeratosis of the dorsum of the hands and feet. Laboratory and histological analysis revealed severe pancytopenia and dyserythropoiesis of red blood cells, hypocellularity of white blood cells and decreased megakaryocytes with dysplasia. The intraoral examination identified bleeding gums; petechiae of the palate, tongue and cheek mucosa; and an atrophic, smooth and shining dorsal surface of the tongue. There were deep carious lesions in the deciduous mandibular molars and maxillary anterior teeth; as well as mobility of mandibular left canine, which had bone loss. The treatment for oral lesions included diet changes, improved oral hygiene, and extraction of the deciduous teeth destroyed by caries.

Effect of fluoridated varnish and silver diamine fluoride solution on enamel demineralization: pH-cycling study

Objective: In the present investigation, the anticariogenic effect of fluoride released by two products commonly applied in infants was evaluated. Methods: Bovine sound enamel blocks were randomly allocated to each one of the treatment groups: control (C), varnish (V) and diamine silver fluoride solution (D). The blocks were submitted to pH cycles in an oven at 37°C. Next, surface and cross-sectional microhardness were assessed to calculate the percentage loss of surface microhardness (%SML) and the mineral loss (ΔZ). The fluoride present in enamel was also determined. Results: F/Px10 -3 (ANOVA, p<0.05) in the 1 st layer of enamel before pH-cycling were (C, V and D): 1.61 a; 21.59 b and 3.98 c. The %SMH (Kruskal-Wallis, p<0.05) were: -64.0 a, -45.2 b and -53.1 c. %ΔZ values (ANOVA, p<0.05) were: -18.7 a, -7.7 b and -17.3 a. Conclusion: The data suggested that the fluoride released by varnish showed greater interaction with sound enamel and provided less mineral loss when compared with silver diamine solution.

Production of monoclonal antibodies against Streptococcus mutans antigens

Several studies have been conducted in the last decades aiming to obtain an anti-canies vaccine, however some studies have demonstrated cross reactivity between Streptococcus mutans surface antigens and the human cardiac tissue. In this work, the reactivity of five anti-Streptococcus mutans monoclonal antibodies (MoAb) (24A, 56G, G8, E8 and F6) was tested against oral streptococci, cardiac antigens and skeletal and cardiac myosins, aiming to evaluate the specificity of these MoAb. The hybrid producers of immunoglobulins of the IgG 2b class were cloned by limit dilution and expanded in vivo. MoAb were tested by ELISA. The hybrid 24A reacted with S. mutans CCT 1910, S. salivarius CCT 0365 and S. pyogenes T23. No reactivity difference was observed among the tested species. Cross reactivity with heart and cardiac myosin was not confirmed and only reaction with myosin of skeletal muscle was observed (p = 0.0381). The hybrid 56G reacted with all the tested microorganisms and there was statistically significant difference between S. mutans and S. pyogenes T23 (p < 0.001). This hybrid also reacted with myosin of skeletal muscle (p = 0.0095). C8, E8 and F6 presented low reactivity against oral streptococci strains and no reactivity against cardiac antigens. The data of this study showed that the 24A and 56G anti-S. mutans MoAb presented reactivity with S. pyogenes and S. salivarius, reinforcing the occurrence of common antigens between these species. The tested MoAb presented low cross-reactivity with myosin of skeletal muscle, but anti-heart activity could not be confirmed.

Potential anticariogênico de soluções aciduladas com baixa concentração flúor

Objetives: The aim of this study was to verify the anticariogenic effect of acidulate solutions with low NaF concentration, using pH-cycling model and bovine enamel. Material and methods: Enamel blocks were submitted to the surface microhardness (SMH) test and randomly divided in 12 experimental and one placebo groups. The blocks were submitted to pH cycling for 7 days, with daily applications once/day of 0.05% NaF and 0.1% NaF and twice/day of 0.02% NaF solutions. Four different pH: 4.0. 5.0, 6.0 and 7.0 were used. Next, SMH test was again used to determine the surface microhardness percentage change (%SMH). Data obtained for %SMH were homogeneous and passed through variance analyses and Tukey's test (5%) as far as fluoride concentrations and pH. Resulls:The results showed that pH influenced %SMH in 0.02% NaF and 0.05% NaF solutions with pH 4.0, which had less mineral loss compared to pH 7.0 (p̃0.05). The 0.02% NaF - pH 4.0, and 0.05% NaF- pH 7.0 groups showed similar results (p>0.05). A dose-response relationship was observed among the tested solutions, with better anticariogenic effect for the 0.1% NaF solution. Conclusion: The results suggest that the addition of citric acid to acidulate mouth rinses reduce mineral loss.