Avaliação de escova ultrassônica em pacientes sob terapia ortodôntica. Estudo in vitro, clínico e microbiológico

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efficiency of cares over toothbrush storage to prevent contamination

This study evaluated the efficiency of a toothbrush holder to prevent contamination of toothbrushes used by preschool children. For that, the sample was composed by children 6 years old, enrolled in an educational and recreational center in Araraquara/SP, and divided into 3 groups: G1: same continuing routine storage toothbrushes, G2: children received only a new toothbrush holder for storage; G3: they received new toothbrushes holder for storage and solution of chlorhexidine digluconate to 0.12% to dabble in the toothbrush after use. After brushing their teeth, toothbrushes were collected for microbiological analysis. The data were analyzed using the distribution of frequencies. It was observed that, in general, higher prevalence of the microorganism in the toothbrushes was Streptococcus viridans (58.97%), followed by Estafilococcus (35.90%), the bacillus of air (28.21%) and Neisseria mucosa (5.13%). Evaluating frequency, it was noted that the contamination presented by Streptococcus is higher in G1 when compared to G2 and G3, while for Estafilococcus, the presence was more significant in G3. Thus, it was concluded that the use of new toothbrushes holder able to avoid direct contact between brushes and allow drying without smothering could be an excellent alternative to educational institutions that require the storage group.

Saúde bucal e educação infantil: avaliação do desgaste e do acondicionamento de escovas dentárias utilizadas por pré-escolares

Introduction: Early childhood is an essential phase of life for the future of oral health. The link between educational and health sectors can facilitate incorporating educational and preventive oral health practices in daily teaching in pre-schools. The main measure is manual tooth-brushing, which is the most accessible method for most of the population. Objective: The objective of this study is to evaluate macroscopically the wear on the bristles, form of storage, and identification of tooth brushes. Material and method: 345 toothbrushes used by children between the ages of 2 and 5 were evaluated in 4 pre-schools, by 2 participants from the oral health program. The Rawls et al. index was used to evaluate the bristles. Result: There were statistically significant differences (p = 0.020 - Mann-Whitney U test) between the frequency of toothbrushes, with the highest being (n = 205) stored at participating school; and, between adequate and inadequate brushes (p < 0.05 - X2 test) with 31.7 and 60%, respectively, classified as unfit for tooth-brushing. Of the toothbrush holders evaluated 100% were used collectively. Regarding identification, 18% of the toothbrushes were not identified in participating schools, and 37% in the others. Conclusion: The toothbrushes exhibited marked wear, and storage was inadequate; however, the schools participating in the oral health program showed toothbrushes with bristles less worn. It is suggested that training of educators regarding correct storage and evaluation of toothbrushes for wear of the bristles should be undertaken in all early childhood schools.

Percepção e atitudes de pedagogos sobre aspectos relevantes do uso de escovas dentárias

Objective: To evaluate the perception and attitude of kindergarten teachers in relation to the storage of toothbrushes. Methodology: The analysis instrument used was a structured and previously validated questionnaire. The sample universe of this study was composed of all states and municipals kindergarten school teachers who taught in school year of 2010 at the town of Araçatuba / SP (n = 232). The criteria used to integrate the study were: to have a college degree and agree to participate. Results: 164 teachers participated of the study. The results were analyzed using Epi Info 6.04 and showed that 55% of the teachers had received some information about the proper storage of toothbrushes, and only 35% believed that the toothbrushes were storaged improperly. Most teachers, 97% reported being possible the transmission of microorganisms through the brush, however, there was observed difficulty in identifying which diseases could be transmitted. About the question related to the execute of supervised toothbrushing, 93% of the educators said that they realize supervised toothbrushing and the same percentage was observed for the identification of preschoolers at the toothbrushes. Conclusions: The perception and attitude of the teachers ahead the storage of toothbrushes are weak and limited, so there is a need for educational programs targeted to this group, so that they would have more information and knowledge related to the correct storage of toothbrushes and would continue to perform oral health preventive methods.

Abrasive wear of two glass ionomer cements after simulated toothbrushing

Introduction and objective: Glass ionomer cement, which was first introduced in Dentistry in 1972, presents good qualities such as aesthetics, fluoride release and adhesion to dental tissues. Because of its preventive characteristics regarding to dental caries, glass ionomer cement has been used for Atraumatic Restorative Treatment (ART), as reported by Frencken and Holmgren [6], meeting the principles announced by the World Health Organization (WHO) for application to large population groups without regular access to dental care. Material and methods: In this present study, the abrasive wear strength of two glass-ionomer cements (Vidrion R® and ChemFlex®) was evaluated through toothbrushing machine. Classic® toothbrushes with soft bristles and Sorriso® dentifrice were also used for the study. Results: Student-t test showed significant difference between both groups, with tobs value = 9.4411 at p < 0.05. Conclusion: It can be concluded that the wear rate caused by toothbrush/dentifrice was higher for Vidrion R® (52.00 mg) than ChemFlex® (5.57 mg).

Utilização das tecnologias assistidas na concepção, no desenvolvimento e no projeto de uma escova dental sustentável e ergonômica

The toothbrush is identified as one of the most importants inventions in human history. Most of them are made by polypropylene, a recyclable polymer. Some are made of polypropylene and polyethylene leftovers from others industrial processes. However, the toothbrushes are discarded incorrectly and end up in landfills, which could be avoided by using a material and design suitable for the manufacture of the product. This study aimed, based on research, develop and design a toothbrush model with great features. For the conception of the prototype, was used rapid prototyping technologies. With the intention of improving the product quality, was created an ergonomic, sustainable and environmentally friendly model, seeking maximally reduce the generation of waste and environmental damages. The solution adopted was the use of "interchangeable head", which can be discarded after their useful life, keeping the rest of the body.

Ocorrência de fungos negros em ambientes domésticos

Black fungi are able to adapt to extreme environmental conditions, such as: high temperatures, the presence of toxic chemical substances and lack of nutrients. Besides, they are also potential pathogens to humans. The natural environment of many black fungi is still unknown and some studies are being conducted to evaluate the biodiversity of this group and their different habitats. This study aimed to isolate black fungi in domestic environments and facilities, such as toothbrushes, fridge sealing rubbers, bathroom strainers and divisions, windows, wall tiles and bath sponge. For the collection, material surfaces were scratched with a scalpel and the resulting fragments were sewed in Mycosel agar (DifcoTM), supplemented with actidione to inhibit the growth of highly-sporulating fungi. Plates were incubated at 25ºC for three weeks. The 46 isolated fungi were maintained on MA2% slants at 8ºC and cryopreserved at -80ºC. Fungal identification was performed through the analysis of macro and microscopic features and ITS rDNA sequencing. The following black fungi taxa were found: Ascomycota sp., Cladosporium spp., Dothideomycete sp., Exophiala alcalophila, Ochroconis mirabilis and Rhinocladiella atrovirens. Non-melanized fungi were also found, such as Geosmithia sp., Penicillium sp. and Rhodotorula mucilaginosa. The temperature tests showed that isolated black fungi were not able to grow at 37°C, however, this temperature proved to be fungistatic to 43% of them. According to literature, all black fungi isolated in this study are opportunistic pathogens and additional studies are necessary to evaluate the risk that these micro-organisms offer to health, once they were isolated from domestic environments

Ocorrência de fungos negros em ambientes domésticos

Black fungi are able to adapt to extreme environmental conditions, such as: high temperatures, the presence of toxic chemical substances and lack of nutrients. Besides, they are also potential pathogens to humans. The natural environment of many black fungi is still unknown and some studies are being conducted to evaluate the biodiversity of this group and their different habitats. This study aimed to isolate black fungi in domestic environments and facilities, such as toothbrushes, fridge sealing rubbers, bathroom strainers and divisions, windows, wall tiles and bath sponge. For the collection, material surfaces were scratched with a scalpel and the resulting fragments were sewed in Mycosel agar (DifcoTM), supplemented with actidione to inhibit the growth of highly-sporulating fungi. Plates were incubated at 25ºC for three weeks. The 46 isolated fungi were maintained on MA2% slants at 8ºC and cryopreserved at -80ºC. Fungal identification was performed through the analysis of macro and microscopic features and ITS rDNA sequencing. The following black fungi taxa were found: Ascomycota sp., Cladosporium spp., Dothideomycete sp., Exophiala alcalophila, Ochroconis mirabilis and Rhinocladiella atrovirens. Non-melanized fungi were also found, such as Geosmithia sp., Penicillium sp. and Rhodotorula mucilaginosa. The temperature tests showed that isolated black fungi were not able to grow at 37°C, however, this temperature proved to be fungistatic to 43% of them. According to literature, all black fungi isolated in this study are opportunistic pathogens and additional studies are necessary to evaluate the risk that these micro-organisms offer to health, once they were isolated from domestic environments

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.

Impact of filler size and distribution on roughness and wear of composite resin after simulated toothbrushing

Objectives: Nanofilled composite resins are claimed to provide superior mechanical properties compared with microhybrid resins. Thus, the aim of this study was to compare nanofilled with microhybrid composite resins. The null hypothesis was that the size and the distribution of fillers do not influence the mechanical properties of surface roughness and wear after simulated toothbrushing test. Material and methods: Ten rectangular specimens (15 mm x 5 mm x 4 mm) of Filtek Z250 (FZ2), Admira (A), TPH3 (T), Esthet-X (EX), Estelite Sigma (ES), Concept Advanced (C), Grandio (G) and Filtek Z350 (F) were prepared according to manufacturer's instructions. Half of each top surface was protected with nail polish as control surface (not brushed) while the other half was assessed with five random readings using a roughness tester (Ra). Following, the specimens were abraded by simulated toothbrushing with soft toothbrushes and slurry comprised of 2: 1 water and dentifrice (w/w). 100,000 strokes were performed and the brushed surfaces were re-analyzed. Nail polish layers were removed from the specimens so that the roughness (Ra) and the wear could be assessed with three random readings (mu m). Data were analyzed by ANOVA and Tukey's multiple-comparison test (alpha = 0.05). Results: Overall outcomes indicated that composite resins showed a significant increase in roughness after simulated toothbrushing, except for Grandio, which presented a smoother surface. Generally, wear of nanofilled resins was significantly lower compared with microhybrid resins. Conclusions: As restorative materials suffer alterations under mechanical challenges, such as toothbrushing, the use of nanofilled materials seem to be more resistant than microhybrid composite resins, being less prone to be rougher and worn.

Controlled toothbrush abrasion of softened human enamel

The aim of this in vitro study was to compare toothbrush abrasion of softened enamel after brushing with two (soft and hard) toothbrushes. One hundred and fifty-six human enamel specimens were indented with a Knoop diamond. Salivary pellicle was formed in vitro over a period of 3 h. Erosive lesions were produced by means of 1% citric acid. A force-measuring device allowed a controlled toothbrushing force of 1.5 N. The specimens were brushed either in toothpaste slurry or with toothpaste in artificial saliva for 15 s. Enamel loss was calculated from the change in indentation depth of the same indent before and after abrasion. Mean surface losses (95% CI) were recorded in ten treatment groups: (1) soft toothbrush only [28 (17-39) nm]; (2) hard toothbrush only [25 (16-34) nm]; (3) soft toothbrush in Sensodyne MultiCare slurry [46 (27-65) nm]; (4) hard toothbrush in Sensodyne MultiCare slurry [45 (24-66) nm]; (5) soft toothbrush in Colgate sensation white slurry [71 (55-87) nm]; (6) hard toothbrush in Colgate sensation white slurry [85 (60-110) nm]; (7) soft toothbrush with Sensodyne MultiCare [48 (39-57) nm]; (8) hard toothbrush with Sensodyne MultiCare [40 (29-51) nm]; (9) soft toothbrush with Colgate sensation white [51 (37-65) nm]; (10) hard toothbrush with Colgate sensation white [52 (36-68) nm]. Neither soft nor hard toothbrushes produced significantly different toothbrush abrasion of softened human enamel in this model (p > 0.05).

Efficacy of patient-administered mechanical and/or chemical plaque control protocols in the management of peri-implant mucositis. A systematic review

AIM To systematically assess the efficacy of patient-administered mechanical and/or chemical plaque control protocols in the management of peri-implant mucositis (PM). MATERIAL AND METHODS Randomized (RCTs) and Controlled Clinical Trials (CCTs) were identified through an electronic search of three databases complemented by manual search. Identification, screening, eligibility and inclusion of studies was performed independently by two reviewers. Studies without professional intervention or with only mechanical debridement professionally administered were included. Quality assessment was performed by means of the Cochrane Collaboration's tool for assessing risk of bias. RESULTS Eleven RCTs with a follow-up from 3 to 24 months were included. Definition of PM was lacking or heterogeneously reported. Complete resolution of PM was not achieved in any study. One study reported 38% of patients with complete resolution of PM. Surrogate end-point outcomes of PM therapy were often reported. The choice of control interventions showed great variability. The efficacy of powered toothbrushes, a triclosan-containing toothpaste and adjunctive antiseptics remains to be established. High quality of methods and reporting was found in four studies. CONCLUSIONS Professionally- and patient-administered mechanical plaque control alone should be considered the standard of care in the management of PM. Therapy of PM is a prerequisite for the prevention of peri-implantitis.

Primary prevention of peri-implantitis: managing peri-implant mucositis

AIMS Over the past decades, the placement of dental implants has become a routine procedure in the oral rehabilitation of fully and partially edentulous patients. However, the number of patients/implants affected by peri-implant diseases is increasing. As there are--in contrast to periodontitis--at present no established and predictable concepts for the treatment of peri-implantitis, primary prevention is of key importance. The management of peri-implant mucositis is considered as a preventive measure for the onset of peri-implantitis. Therefore, the remit of this working group was to assess the prevalence of peri-implant diseases, as well as risks for peri-implant mucositis and to evaluate measures for the management of peri-implant mucositis. METHODS Discussions were informed by four systematic reviews on the current epidemiology of peri-implant diseases, on potential risks contributing to the development of peri-implant mucositis, and on the effect of patient and of professionally administered measures to manage peri-implant mucositis. This consensus report is based on the outcomes of these systematic reviews and on the expert opinion of the participants. RESULTS Key findings included: (i) meta-analysis estimated a weighted mean prevalence for peri-implant mucositis of 43% (CI: 32-54%) and for peri-implantitis of 22% (CI: 14-30%); (ii) bleeding on probing is considered as key clinical measure to distinguish between peri-implant health and disease; (iii) lack of regular supportive therapy in patients with peri-implant mucositis was associated with increased risk for onset of peri-implantitis; (iv) whereas plaque accumulation has been established as aetiological factor, smoking was identified as modifiable patient-related and excess cement as local risk indicator for the development of peri-implant mucositis; (v) patient-administered mechanical plaque control (with manual or powered toothbrushes) has been shown to be an effective preventive measure; (vi) professional intervention comprising oral hygiene instructions and mechanical debridement revealed a reduction in clinical signs of inflammation; (vii) adjunctive measures (antiseptics, local and systemic antibiotics, air-abrasive devices) were not found to improve the efficacy of professionally administered plaque removal in reducing clinical signs of inflammation. CONCLUSIONS Consensus was reached on recommendations for patients with dental implants and oral health care professionals with regard to the efficacy of measures to manage peri-implant mucositis. It was particularly emphasized that implant placement and prosthetic reconstructions need to allow proper personal cleaning, diagnosis by probing and professional plaque removal.

Non-sexual household transmission of HCV infection: A cohort study

Objective. This study was designed to determine the prevalence and incidence of HCV infection among non-sexual household contacts of HCV-infected women and to describe the association between HCV infection and potential household risk factors in order to examine whether non-sexual household contact is a route of transmission for HCV infection. ^ Methods. A baseline prevalence survey included 409 non-sexual household contacts of 241 HCV-infected index women in the Houston area from 1994 to 1997. A total of 470 non-sexual household contacts with no evidence of HCV infection at baseline investigation were re-assessed approximately three years after baseline enrollment. Information on potential risk factors was collected through face to face interviews and blood samples were tested for anti-HCV with ELISA-2 and Matrix/RIBA-2. The relationships between HCV infection and potential risk factors were examined by using univariate and multivariate logistic regression analyses. ^ Results. The overall prevalence of anti-HCV positivity among 409 non-sexual household contacts was 4.4%. The highest prevalence of anti-HCV was found in parents (19.5%), followed by siblings (8.1%) and other relatives (5.6%); the children had the lowest prevalence of anti-HCV (1.2%). The univariate analysis showed that IDU, blood transfusion, tattoos, sexual contact with injecting drug users, more than 3 sexual partners in a lifetime, history of a STD, incarceration, previous hepatitis, and contact with hepatitis patients were significantly associated with HCV infection, however, sharing razors, nail clippers, toothbrushes, gum, food or beds with HCV-infected women, and history of dialysis, health care job, body piercing, and homosexual activities were not. Multivariate analysis found that IDU (OR = 221.7 with 95% CI of 22.8 to 2155.7) and history of a STD (OR = 11.7 with 95% CI of 1.2 to 113.1) were the only variables significantly associated with HCV infection. No such associations remained for other risk factors. The three-year cumulative incidence of anti-HCV among 352 non-sexual household contacts of HCV-infected women was zero. ^ Conclusion. This study has provided no evidence that non-sexual household contact is a likely route of transmission for HCV infection. The risk of sharing razors, nail clippers, toothbrushes, gum, food and/or beds with HCV-infected women is not evident and has not been shown to be the likely mode for HCV spread among family members. This study does suggest that IDU is the likely route of transmission for most HCV infection. Association also has been shown independently with a history of STD. The prevalence of anti-HCV among non-sexual household contacts was low. Exposure to common parenteral risk factors and sexual transmission between sexual partners may account for HCV spread among household members of HCV-infected persons. ^

Account book of Andrew Croswell, 1794-1802

Andrew Croswell kept this account book while an undergraduate at Harvard College. It contains entries from 1794, the year he entered, until his graduation in 1798. There is also one entry on the back cover apparently made in 1802. The entries, divided by school term, are very detailed. Croswell indicates the cost of the following, among many other expenses and purchases: transportation, most often to Hingham and Plymouth; payment for "passing the bridge"; candles; hiring a horse; wood and having it cut; laundry; quills and pencils; paper and ink; razors, haircuts, hair ribbons; a trunk; clothing and cloth for trousers; furniture; tickets to the theater; door locks; a bowl and spoon; "batts and balls" and "other necessaries"; tobacco; toothbrushes; shoe and boot repair; fruit; wine, brandy and rum; cheese; coffee and tea; butter; lemons; sugar; and wafers. There are also entries for college-related costs, including the payment of quarter bills, buttery bills, Hasty Pudding Club dues, and a fee to the President of Harvard College related to Croswell's graduation. There are also entries pertaining to the cost of celebrating various special occasions, including Election Day, Christmas Eve, "Independent Day," and George Washington's birthday.