Saliva substitute in combination with high-concentrated fluoride toothpaste: Effects on demineralised dentin in vitro

Objectives: The aim of this in vitro study was to assess the effects of saliva substitutes (modified with respect to calcium, phosphates, and fluorides) in combination with a high-concentrated fluoride toothpaste on demineralised dentin.Methods: Before and after demineralisation of bovine dentin specimens (subsurface lesions; 37 degrees C, pH 5.0, 5 d), one-quarter of each specimen's surface was covered with nail varnish (control of sound/demineralised tissue). Subsequently, specimens were exposed to original Saliva natura (saturation with respect to octacalciumphosphate [S(OCP)]: 0.03; SN 0), or to three lab-produced Saliva natura modifications (S(OCP): 1, 2, and 3; SN 1-3) for 2 and 5 weeks (37 degrees C). An aqueous solution (S(OCP): 2.5) served as positive control (PC). Two times daily (2 min each), Duraphat toothpaste (5000 ppm F(-); Colgate)/saliva substitute slurry (ratio 1:3) was applied gently. Differences in mineral losses (Delta Delta Z) and lesion depths (Delta LD) between values before and after exposure were microradiographically evaluated.Results: After both treatment periods specimens immersed in SN 0 revealed significantly higher mineral losses (lower Delta Delta Z values) and lesion depths (lower Delta LD) compared to PC (p < 0.05; ANOVA). After 5 weeks, specimens stored in SN 1 and 2 showed significantly higher mineral losses compared to PC (p < 0.05), while those stored in SN 3 showed similar results (p > 0.05). No differences in mineral loss could be observed between SN 2 and 3 (p > 0.05).Conclusions: Under the conditions of this limited protocol, the combination of Saliva natura solutions slightly saturated with respect to OCP in combination with a high-concentrated fluoride toothpaste enabled remineralisation of dentin in vitro. Crown Copyright (c) 2009 Published by Elsevier Ltd. All rights reserved.

The influence of daily application of fluoride products on subsurface bovine enamel lesions stored in saliva substitutes

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Oral bisphosphonate-related osteonecrosis of the jaws in rheumatoid arthritis patients: a critical discussion and two case reports

Background: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a clinical condition characterized by the presence of exposed bone in the maxillofacial region. Its pathogenesis is still undetermined, but may be associated with risk factors such as rheumatoid arthritis (RA). The aim of this paper is to report two unpublished cases of BRONJ in patients with RA and to conduct a literature review of similar clinical cases with a view to describe the main issues concerning these patients, including demographic characteristics and therapeutic approaches applied.Methods: Two case reports of BRONJ involving RA patients were discussedResults: Both patients were aging female taking alendronate for more than 3 years. Lesions were detected in stage II in posterior mandible with no clear trigger agent. The treatment applied consisted of antibiotics, oral rinses with chlorhexidine, drug discontinuation and surgical procedures. Complete healing of the lesions was achieved.Conclusions: This paper brings to light the necessity for rheumatologists to be aware of the potential risk to their patients of developing BRONJ and to work together with dentists for the prevention and early detection of the lesions. Although some features seem to link RA with oral BRONJ and act as synergistic effects, more studies should be developed to support the scientific bases for this hypothesis.

Epidemiological aspects of rheumatoid arthritis patients affected by oral bisphosphonate-related osteonecrosis of the jaws

This literature review aims to evaluate the epidemiologic profile of patients with rheumatoid arthritis (RA) that developed a bisphosphonate-related osteonecrosis that affect the jaws (BRONJ), including demographic aspects, as well as clinical and therapeutic issues. A search of PUBMED/MEDLINE, Scopus, and Cochrane databases from January 2003 to September 2011 was conducted with the objective of identifying publications that contained case reports regarding oral BRONJ in RA patients. Patients with RA who develop oral BRONJ are usually women above 60 years taking steroids and long-term alendronate. Most of them have osteoporosis, and lesions, triggered by dental procedures, are usually detected at stage II in the mandible. Although there is no accepted treatment protocol, these patients seem to have better outcomes with conservative approaches that include antibiotic therapy, chlorhexidine, and drug discontinuation.

Antimicrobial activity of disinfectant agents incorporated into type IV dental stone

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Hardness of heat-polymerized acrylic resins after disinfection and long-term water immersion

Statement of the problem. In selecting a disinfectant for dental prostheses, compatibility between the disinfectant and the type of denture base material must be considered to avoid adverse effects on the hardness of the acrylic resin.Purpose. This study investigated the hardness of 2 denture base resins after disinfection and long-term water immersion.Material and methods. Thirty-two disk-shaped specimens (13 mm in diameter and 8 mm thick) were fabricated from each resin (Lucitone 550 and QC-20), polished, stored in water at 37degreesC for 48 hours, and submitted to hardness tests (Vickers hardness number [VHN]) before disinfection. Disinfection methods included scrubbing with 4% chlorhexidine gluconate for 1 minute, immersion for 10 minutes in I of the tested disinfectant Solutions (n=8) (3.78% sodium perborate, 4% chlorhexidine gluconate, or 1% sodium hypochorite), and immersion in water for 3 minutes. The disinfection procedures were repeated 4 times, and 12 hardness measurements were made on each specimen. Control specimens (not disinfected) were stored in water for 56 minutes. Hardness tests (VHN) were also performed after 15, 30, 60, 90, and 120 days of storage in water. Statistical analyses of data were conducted with a repeated measures 3-way analysis of variance (ANOVA) and Tukey post-hoc test (alpha=.05).Results. Mean values +/- SD for Lucitone 550 (16.52 +/- 0.94 VHN) and QC-20 (9.61 +/- 0.62 VHN) demonstrated a significant (P<.05) decrease in hardness after disinfection, regardless of material and disinfectant solutions used (Lucitone 550: 15.25 +/- 0.74; QC-20: 8.09 +/- 0.39). However, this effect was reversed after 15 days of storage in water. Both materials exhibited a continuous increase (P<.05) in hardness values for up to 60 days of water storage, after which no significant change was observed.Conclusion. Within the limitations of this in vitro study, QC-20 and Lucitone 550 specimens exhibited significantly lower hardness values after disinfection regardless of the disinfectant solution used.

The effect of disinfectant solutions on the hardness of acrylic resin denture teeth

This investigation studied the effects of disinfectant solutions on the hardness of acrylic resin denture teeth. The occlusal surfaces of 64 resin denture teeth were ground flat with abrasives up to 400-grit silicon carbide paper. Measurements were made after polishing and after the specimens were stored in water at 37 degreesC for 48 h. The specimens were then divided into four groups and immersed in chemical disinfectants (4% chlorhexidine; 1% sodium hypochlorite and sodium perborate) for 10 min. The disinfection methods were performed twice to simulate clinical conditions and hardness measurements were made. Specimens tested as controls were immersed in water during the same disinfection time. Eight specimens were produced for each group. After desinfection procedures, testing of hardness was also performed after the samples were stored at 37 degreesC for 7, 30, 60, 90 and 120 days. Data were analysed using two-way analysis of variance (anova) and Tukey's test at 95% confidence level. According to the results, no significant differences were found between materials and immersion solutions (P > 0.05). However, a continuous decrease in hardness was noticed after ageing (P < 0.05). It was conclude that the surfaces of both acrylic resin denture teeth softened upon immersion in water regardless the disinfecting solution.

Peel bond strength of resilient liner modified by the addition of antimicrobial agents to denture base acrylic resin

In order to prolong the clinical longevity of resilient denture relining materials and reduce plaque accumulation, incorporation of antimicrobial agents into these materials has been proposed. However, this addition may affect their properties. Objective: This study evaluated the effect of the addition of antimicrobial agents into one soft liner (Soft Confort, Dencril) on its peel bond strength to one denture base (QC 20, Dentsply). Material and Methods: Acrylic specimens (n=9) were made (75x10x3 mm) and stored in distilled water at 37 degrees C for 48 h. The drug powder concentrations (nystatin 500,000U - G2; nystatin 1,000,000U - G3; miconazole 125 mg - G4; miconazole 250 mg - G5; ketoconazole 100 mg - G6; ketoconazole 200 mg - G7; chlorhexidine diacetate 5% - G8; and 10% chlorhexidine diacetate - G9) were blended with the soft liner powder before the addition of the soft liner liquid. A group (G1) without any drug incorporation was used as control. Specimens (n=9) (75x10x6 mm) were plasticized according to the manufacturers' instructions and stored in distilled water at 37 degrees C for 24 h. Relined specimens were then submitted to a 180-degree peel test at a crosshead speed of 10 mm/min. Data (MPa) were analyzed by analysis of variance (alpha=0.05) and the failure modes were visually classified. Results: No significant difference was found among experimental groups (p=0.148). Cohesive failure located within the resilient material was predominantly observed in all tested groups. Conclusions: Peel bond strength between the denture base and the modified soft liner was not affected by the addition of antimicrobial agents.

The effect of long-term disinfection procedures on hardness property of resin denture teeth

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Effect of Incorporation of Disinfectant Solutions on Setting Time, Linear Dimensional Stability, and Detail Reproduction in Dental Stone Casts

Purpose: The aim of this paper was to analyze the influence of incorporation of disinfectants during the cast die stone-setting time. Setting time, linear dimensional stability, and reproduction details on casts were measured.Materials and Methods: Die stone type IV specimens with disinfection solutions (sodium hypochlorite 1%, glutaraldehyde 2%, chlorhexidine 2%) were incorporated in two concentrations (50%, 100%). The detail reproduction, dimensional stability, and setting time were tested in accordance with ADA recommendations.Results: Disinfecting solutions promoted an increase in setting time compared to control; sodium hypochlorite was responsible for the highest setting time. The addition of undiluted sodium hypochlorite 1.0% led to contraction during setting, but the groups with 50% diluted sodium hypochlorite 1.0% and undiluted chlorhexidine 2.0% resulted in intermediate values compared to the other groups, thus matching the control. The others did not demonstrate any effect on expansion. For detail reproduction, it was observed that the control group presented results similar to the others, except those where sodium hypochlorite was added.Conclusions The addition of sodium hypochlorite in both dilutions significantly altered, negatively, all the evaluated properties. But the addition of glutaraldehyde and chlorhexidine did not promote any significant alterations in the evaluated properties.

Effectiveness of two disinfectant solutions and microwave irradiation in disinfecting complete dentures contaminated with methicillin-resistant Staphylococcus aureus

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Color stability of relined dentures after chemical disinfection. A randomised clinical trial

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Antibacterial effectiveness of peracetic acid and conventional endodontic irrigants

Este estudo avaliou, in vitro, a atividade antibacteriana de soluções irrigadoras convencionais e experimentais sobre Enterecoccus faecalis. As seguintes substâncias foram avaliadas por teste de contato direto: hipoclorito de sódio (NaOCl) a 2,5%, clorexidina (CHX) a 2%, ácido peracético a 1%. Após diferentes períodos de contato (30 s, 1, 3 e 10 min), um agente neutralizante foi empregado. Diluições decimais seriadas foram realizadas e semeadas em placas de tryptic soy agar (TSA). O número de unidades formadoras de colônia por mililitro (UFC/mL) foi determinado. Solução salina foi utilizada como controle negativo. Ambos, NaOCl a 2,5% e CHX a 2%, eliminaram E. faecalis após 30 s de contato. O ácido peracético reduziu a contagem bacteriana em 86% após 3 min e eliminou completamente E. faecalis após 10 min. Estes resultados permitem concluir que o ácido peracético a 1% é efetivo sobre E. faecalis, apesar de sua ação mais lenta quando comparado ao NaOCl a 2,5% e CHX a 2%.

Release and diffusion of hydroxyl ion from calcium hydroxide-based medicaments

The release and diffusion of hydroxyl ions (OH-) of calcium hydroxide (Ca(OH)2)-based intracanal medications may be affected by the association with other substances. The aim of this study was to evaluate the diffusion of OH- ions through root dentin by the medications: G1, Ca(OH)2/saline; G2, Calen; G3, Calen/camphorated p-monochlorophenol (CMCP); and G4, Calen/0.4% chlorhexidine (CHX). Root canals from bovine teeth were prepared in a standardized manner. A cavity until dentin was prepared in the middle third of the root surface of each specimen. The external surface of the root was made impermeable using a layer of adhesive, except the prepared cavity. The root canals were filled with different medications, and teeth were individually stored in flasks containing 10 ml distilled water at 37 degrees C. The water pH was measured at 1, 3, 7, 14, 21, 30, and 60 days. Data obtained were subjected to anova and Tukeys tests. Increase in pH was observed at 3 days for Calen/CHX and from 7 to 14 days for the other mixtures. Calen paste promoted pH increase up to 21 days. Calen/CMCP had the highest pH up to 21 days, and all groups had similar results at 30 days. At 60 days, the greatest pH values were observed for Calen/CMCP and Calen alone. All different formulations of Ca(OH)2-based medications tested release hydroxyl ion that can diffuse through the dentin.

Evaluation of pH and Calcium Ion Release of Calcium Hydroxide Pastes Containing Different Substances

Introduction: The objective of this study was to evaluate the pH and calcium ion release of calcium hydroxide pastes associated with different substances. Methods: Forty acrylic teeth with simulated root canals were divided into 4 groups according to the substance associated to the calcium hydroxide paste: chlorhexidine (CHX) in 2 formulations (1% solution and 2% gel), Casearia sylvestris Sw extract, and propylene glycol (control). The teeth with pastes and sealed coronal accesses were immersed in 10 mL deionized water. After 10 minutes, 24 hours, 48 hours, and 7, 15, and 30 days, the teeth were removed to another container, and the liquid was analyzed. Calcium ion release was measured by atomic absorption spectrophotometry, and pH readings were made with a pH meter. Data were analyzed statistically by analysis of variance and Tukey test (alpha = 0.05). Results: Calcium analysis revealed significant differences (P < .05) for 1% CHX solution and 2% CHX gel at 10 minutes. After 24 hours, 2% CHX gel x Control and 2% CHX gel x 1% CHX solution differed significantly (P < .05). After 48 hours, there were significant differences (P < .05) for 2% CHX gel x Control and Extract x Control. No differences (P > .05) were observed among groups in the other periods. Regarding the pH, there were significant differences (P < .05) for 2% CHX gel x Control and 2% CHX gel x 1% CHX solution after 48 hours and for 2% CHX gel x Control after 15 days. In the other periods, no differences (P > .05) were observed among groups. Conclusions: All pastes behaved similarly in terms of pH and calcium ion release in the studied periods. (J Endod 2009;35:1274-1277)