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.

Antimicrobial activity of Uncaria tomentosa against oral human pathogens

Uncaria tomentosa is considered a medicinal plant used over centuries by the peruvian population as an alternative treatment for several diseases. Many microorganisms usually inhabit the human oral cavity and under certain conditions can become etiologic agents of diseases. The aim of the present study was to evaluate the antimicrobial activity of different concentrations of Uncaria tomentosa on different strains of microorganisms isolated from the human oral cavity. Micropulverized Uncaria tomentosa was tested in vitro to determine the minimum inhibitory concentration (MIC) on selected microbial strains. The tested strains were oral clinical isolates of Streptococcus mutans, Staphylococcus spp., Candida albicans, Enterobacteriaceae and Pseudomonas aeruginosa. The tested concentrations of Uncaria tomentosa ranged from 0.25-5% in Müeller-Hinton agat. Three percent Uncaria tomentosa inhibited 8% of Enterobacteriaceae isolates, 52% of S. mutans and 96% of Staphylococcus spp. The tested concentrations did not present inhibitory effect on P. aeruginosa and C. albicans. It could be concluded that micropulverized Uncaria tomentosa presented antimicrobial activity on Enterobacteriaceae, S. mutans and Staphylococcus spp. isolates.

In vitro evaluation of marginal leakage in bonded restorations, with mechanical or chemical-mechanical (Carisolv) removal of carious tissue

This study carried out an in vitro evaluation and comparison of the occurrence of marginal leakage in bonded restorations using mechanical or chemical-mechanical (Carisolv) removal of carious tissue. For that purpose, 40 extracted decayed human molars were divided into 4 groups: GI (burs + Prime & Bond NT + TPH), GII (Carisolv + Prime & Bond NT + TPH), GIII (burs + SBMP + Z100) and GIV (Carisolv + SBMP + Z100). After accomplishment of the restorations and thermal cycling, the teeth were exposed to dye, sectioned and qualitatively evaluated. The results demonstrated that the system of removal of carious tissue did not influence the results of microleakage at any of the cavity margins. At dentinal margins, use of the Prime & Bond NT + TPH restorative system allowed the occurrence of less microleakage than the SBMP + Z100 system.

Anticariogenic effect of fluoride-releasing elastomers in orthodontic patients

This in vivo experimental study evaluated the efficacy of fluoride-releasing elastomers in the control of Streptococcus mutans levels in the oral cavity. Forty orthodontic patients were recruited and divided into two groups of 20. Fluoride-releasing elastomeric ligature ties (Fluor-I-Ties, Ortho Arch Co. Inc., USA) were used in the experimental group, and conventional elastomeric ligature ties (D. Morelli, Brazil), in the control group. Two initial samples of saliva were collected at a 14-day interval to determine the number of colony forming units (CFU) of Streptococcus mutans. Immediately after collecting the second sample, fluoride-releasing elastomeric ligature ties were placed in the patients of the experimental group, and conventional ligature ties, in the patients of the control group. Seven, 14 and 28 days after placement of the elastomeric ligature ties, saliva and plaque surrounding the orthodontic appliance were collected for microbiologic analysis. There were no significant differences in the number of Streptococcus mutans CFUs in saliva or plaque in the area surrounding the fluoride-releasing or conventional elastomeric ligature ties. Thus, fluoride-releasing elastomeric ligature ties should not be indicated to reduce the incidence of enamel decalcification in orthodontic patients. Since there was no significant reduction in S. mutans in saliva or plaque, other means of prevention against enamel decalcification should be indicated for these patients.

Scanning electron microscopic study of the in situ effect of salivary stimulation on erosion and abrasion in human and bovine enamel

This in situ study investigated, using scanning electron microscopy, the effect of stimulated saliva on the enamel surface of bovine and human substrates submitted to erosion followed by brushing abrasion immediately or after one hour. During 2 experimental 7-day crossover phases, 9 previously selected volunteers wore intraoral palatal devices, with 12 enamel specimens (6 human and 6 bovine). In the first phase, the volunteers immersed the device for 5 minutes in 150 ml of a cola drink, 4 times a day (8h00, 12h00, 16h00 and 20h00). Immediately after the immersions, no treatment was performed in 4 specimens (ERO), 4 other specimens were immediately brushed (0 min) using a fluoride dentifrice and the device was replaced into the mouth. After 60 min, the other 4 specimens were brushed. In the second phase, the procedures were repeated but, after the immersions, the volunteers stimulated the salivary flow rate by chewing a sugar-free gum for 30 min. Enamel superficial alterations of all specimens were then evaluated using a scanning electron microscope. Enamel prism core dissolution was seen on the surfaces submitted to erosion, while on those submitted to erosion and to abrasion (both at 0 and 60 min) a more homogeneous enamel surface was observed, probably due to the removal of the altered superficial prism layer. For all the other variables - enamel substrate and salivary stimulation the microscopic pattern of the enamel specimens was similar.

Estatística de levantamentos epidemiológicos sobre cárie dentária, publicados no brasil e no exterior, de 1960 a 2001

The epidemiological surveys are important to the deployment, implementation and evaluation of projects and health actions in a community. The planning, goals, samples, team training/calibration, carrying out and publication of results are extremely important in the epidemiological surveys. Thus, the care with the sample and statistical analysis is fundamental for the results to be consistent and trustworthy in order to be able to be inferred for all the population. The aims of this study is to investigate the statistical methodology used in papers on dental caries epidemiological surveys published from 1960 to 2001. A bibliographical survey was carried out in BBO, MEDLINE and SCIELO databases. The papers found were analyzed with regards to the statistical methodology applied in the whole study, from the sampling to the tabling of data. Most studies (72.6%) only presented the number of elements that composed the sample, without explaining the planning involved in obtaining it.

Técnica do grupo focal como método de avaliação do conhecimento de adolescentes sobre saúde bucal

This study aims to the understanding of adolescents regarding oral health, using the Focus Group technique. The study was conducted at three public schools in the city of Araçatuba, São Paulo State, Brazil, with ten students in each. In order to conduct the focus groups, the following words, which featured high error levels, were addressed in survey questions on oral health: oral health; plaque, permanent teeth; fluoride; gum bleeds?; dental floss; transmission of cavities. During the discussions in the focus groups, it was observed that many teenagers were surprised at the situation to which they were submitted and at the topic they were discussing. The word 'oral health' was associated with the condition of cleanliness of the oral cavity, not identifying oral health as part of general health. The term 'transmission of cavities' did not have a sufficient understanding. The term 'permanent tooth' was well understood and was associated with a type of tooth that would not be replaced. The word 'fluoride' had more association with the task of cleaning than protection of the teeth. It is concluded that the use of the focus group technique is of great importance in the interpretation of the knowledge of adolescents on oral health and the appropriateness of the terminology of questionnaires on the same subject.