The effect of an experimental 4% TiF(4) varnish compared to NaF varnishes and 4% TiF(4) solution on dental erosion in vitro

This in vitro study assessed the effect of an experimental 4% TiF(4) varnish compared to commercial NaF and NaF/CaF(2) varnishes and 4% TiF(4) solution on enamel erosion. For this, 72 bovine enamel specimens were randomly allocated to the following treatments: NaF varnish (2.26% F), NaF/CaF(2) varnish (5.63% F), 4% TiF(4) varnish (2.45% F), F-free placebo varnish, 4% TiF(4) solution (2.45% F) and control (not treated). The varnishes were applied in a thin layer and removed after 6 h. The solution was applied to the enamel surface for 1 min. Then, the specimens were alternately de- and remineralized (6 times/day) in an artificial mouth for 5 days at 37 degrees C. Demineralization was performed with the beverage Sprite (1 min, 3 ml/min) and remineralization with artificial saliva (day: 59 min, 0.5 ml/min; during the night: 0.1 ml/min). The mean daily increment of erosion and the cumulative erosion data were tested using ANOVA and ANCOVA, respectively, followed by Tukey's test (alpha = 0.05). The mean daily erosion increments and cumulative erosion (micrometers) were significantly less for the TiF(4) varnish (0.30 +/- 0.11/0.65 +/- 0.75) than for the NaF varnish (0.58 +/- 0.11/1.47 +/- 1.07) or the NaF/CaF(2) varnish (0.62 +/- 0.10/1.68 +/- 1.17), which in turn showed significantly less erosion than the placebo varnish (0.78 +/- 0.12/2.05 +/- 1.43), TiF(4) solution (0.86 +/- 0.11/2.05 +/- 1.49) and control (0.77 +/- 0.16/2.06 +/- 1.49). In conclusion, the TiF(4) varnish seems to be a promising treatment to reduce enamel loss under mild erosive conditions. Copyright (C) 2008 S. Karger AG, Basel.

Sexual harassment in Dentistry: prevalence in dental school

Objective: Sexual harassment is unlawful in all work and educational environments in most nations of the world. The goals of this study were to describe the sexual harassment prevalence and to evaluate the experiences and attitudes of undergraduate students in one dental school in Brazil. Material and Methods: An 18-item questionnaire was administered to 254 dental students with a completion rate of 82% (208). Students were requested to respond to questions about their background and academic level in dental school, their personal experiences with sexual harassment and their observation of someone else being sexually harassed. Bivariate statistical analyses were performed. Results: Fifteen percent of the students reported being sexually harassed by a patient, by a relative of a patient or by a professor. Male students had 3 times higher probability of being sexually harassed than female student [OR = 2.910 (1.113-7.611)]. Additionally, 25.4% of the students reported witnessing sexual harassment at the school environment. The majority of students did not feel professionally prepared to respond to unwanted sexual behaviors. Conclusion: These findings demonstrate that sexual harassment can occur in a dental school setting. There is a need for ongoing sexual harassment education programs for students and university staff. Increased knowledge of sexual harassment during graduation can better prepare dental professionals to respond to sexual harassment during their practice.

Socio-behavioral factors influence prevalence and severity of dental caries in children with primary dentition

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

Validation of Fingernail Fluoride Concentration as a Predictor of Risk for Dental Fluorosis

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Dental Practice and Musculoskeletal Disorders Association: A Look at the Evidence

Disorders localized to the musculoskeletal system are a common problem among dental personnel. This study has the aim of surveying epidemiological studies reporting positive associations between dental practice and musculoskeletal disorders (MSKDs). The focus was to evaluate the size of reported risk increase and the extent to what alternative causal explanations were considered. Reports with significant links (p value .05) were systematically selected from 2 electronic databases. Twenty-five studies were identified. Risk measures were reported in 8 studies, and all of them presented weak associations. The impact of at least 1 competing explanations was analyzed in 32% of studies, but adjustment was considered not adequate in half of them. The evidence on dentistry as a profession with potential risk for development of MSKDs remains questionable. Further research is needed to more carefully elucidate the risk and the impact of MSKDs in this particular occupational group.

Dental students' knowledge of ergonomic postural requirements and their application during clinical care

Aim:To examine how much final-year undergraduate dental students know about postural dental ergonomic requirements, and how well they apply these requirements clinically.Background:Dentists are vulnerable to diverse mechanical (e.g. postural) and non-mechanical occupational risks.Materials and Methods:Eight postural requirements found in normalising documents were identified, reproduced, photographed, and analysed to develop a test of visual perception (TVP). Photographs of the 69 participating students were taken during their clinical care to ascertain ergonomics compliance, after which the students were administered the TVP. Pearson's test was used to correlate the level of knowledge (TVP) and its clinical application (photographic analysis) among the 552 observations made for each test (total of 1104 observations).Results:65.7% of the TVP questions were answered correctly and 35% of the photographic cases were in compliance with ergonomic requirements (+ 0.67, P < 0.0001).Conclusion:The knowledge of ergonomics postural requirements and their clinical application among the dental students surveyed were not satisfactory. The reasons for the learning difficulties encountered by the students should be identified to improve the learning process. The didactic use of digital images in this study may help in this endeavour.

Effect of 4% titanium tetrafluoride solution on dental erosion by a soft drink: An in situ/ex vivo study

Objective: This in situ/ex vivo study assessed the effect of titanium tetrafluoride (TiF4) on permanent human enamel subjected to erosion.Design: Ten volunteers took part in this study performed in two phases. In the first phase (ERO), they wore acrylic palatal appliances containing two enamel blocks, divided into two rows: TiF4 (F) and no-TiF4 (no-F). During the 1st day, the formation of a salivary pellicle was allowed. In the 2nd day, the TiF4 solution was applied on one row (ERO + F), whereas on the other row no treatment was performed (ERO + no-F). From 3rd until 7th day, the blocks were subjected to erosion, 4x per day. In the 2nd phase (no-ERO), the volunteers wore acrylic palatal appliances containing one enamel block, during 2 days, to assess the effect of TiF4 only (no-ERO + F). Enamel alterations were determined using profilometry (wear), microhardness (%SMHC) tests, scanning electron microscope and microprobe analysis. The %SMHC and wear were tested using ANOVA and Tukey's post hoc tests (p < 0.05).Results: The mean of %SMHC and wear ( mu m) values ( +/- S.D.) were, respectively: ERO + F -73.32 +/- 5.16(A)/2.40 +/- 0.60(a); ERO + no-F -83.49 +/- 4.59B/1.17 +/- 0.48(b) and no-ERO + F -67.92 +/- 6.16(A)/0.21:E 0.09(c). In microscope analysis, the no-F group showed enamel with honeycomb appearance. For F groups, it was observed a surface coating with microcracks. The microprobe analysis revealed the presence of the following elements (%) in groups ERO + F, ERO + no-F and no-ERO + F, respectively: Ca (69.9, 72.5, 66.25); P (25.9, 26.5, 26.06); Ti (3.0, 0, 5.93).Conclusions: The TiF4 was unable to reduce dental erosion. (c) 2007 Elsevier Ltd. All rights reserved.

Facial and dental injuries due to dog bite in a 15-month-old child with sequelae in permanent teeth: a case report

This article reports a longitudinal follow-up of a 15-month-old child with dental trauma resulting from an attack by a dog. The injury consisted of laceration of the facial tissues and loss of the upper central deciduous incisors, in addition to loss of bone tissue in the same area. A malformation of the crown of the right central permanent incisor and complete change of the shape of the left central permanent incisor were observed. The etiological factors of childhood injuries as well as the importance of dental emergency care are discussed and the 14-year clinical and radiographic follow up of the case is presented.

Dental caries of lifetime residents in Baixo Guandu, Brazil, fluoridated since 1953: a brief communication

Objectives: This study aimed to verify the dental caries prevalence in Baixo Guandu, the first Brazilian city to fluoridate its public water supplies; to compare the findings with the data from the national survey; and also to compare the prevalence in the 12-year-old age group with the data obtained before the beginning of the fluoridation. Methods: All the lifetime residents aged 5, 12, 15 to 19, and 35 to 44 years old were clinically examined (World Health Organization). Results: The means of dmft/DMFT were lower than in the Brazilian population living in fluoridated communities. The DMFT Index in 12-year-old residents decreased between 1953 and 2005 from 8.61 to 1.55. Conclusions: The addition of fluoride to public water supplies was an important ally in the improvement of the oral health of Baixo Guandu inhabitants.

Effect of Calcium Pre-rinse and Fluoride Dentifrice on Enamel and on Dental Plaque Formed In Situ

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

The association between prune belly syndrome and dental anomalies: a case report

Background: Prune belly syndrome is a rare condition produced by an early mesodermal defect that causes abdominal abnormalities. However, the literature indicates that disturbances related to ectodermal development may also be present. This is the first case report in the literature to suggest that dental abnormalities are part of the broad spectrum of clinical features of prune belly syndrome. Because the syndrome causes many serious medical problems, early diagnosis of abnormalities involving the primary and permanent dentitions are encouraged.Case presentation: The authors report the clinical case of a 4-year-old Caucasian boy with prune belly syndrome. In addition to the triad of abdominal muscle deficiency, abnormalities of the gastrointestinal and urinary tracts, and cryptorchidism, a geminated mandibular right central incisor, agenesis of a mandibular permanent left incisor, and congenitally missing primary teeth (namely, the mandibular right and left lateral incisors) were noted.Conclusion: This original case report about prune belly syndrome highlights the possibility that dental abnormalities are a part of the broad spectrum of clinical features of the syndrome. Therefore, an accurate intra-oral clinical examination and radiographic evaluation are required for patients with this syndrome in order to provide an early diagnosis of abnormalities involving the primary and permanent dentitions.

Enamel microabrasion followed by dental bleaching for patients after orthodontic treatment - Case reports

This article reports clinical procedures used to remove residual bonded resin and enamel stains following bracket debonding at the conclusion of orthodontic treatment. A water-cooled fine-tapered diamond bur was used for resin removal, followed by enamel surface finishing using a commercially available microabrasion paste. It was noted that residual tooth coloration remained yellowish because of enamel translucency; the yellow dentin shade showed through. Additional tooth shade lightening was achieved using carbamide peroxide dental bleaching solution in custom-formed trays. This report describes a safe and effective technique that optimizes tooth appearance at the conclusion of orthodontic therapy. Mechanical resin removal, enamel microabrasion, and tooth bleaching are employed.

Short-term evaluation of the pulpo-dentin complex response to a resin-modified glass-ionomer cement and a bonding agent applied in deep cavities

Objectives. To evaluate the response of the pulpo-dentin complex following application of a resin-modified glass-ionomer cement or an adhesive system in deep cavities performed in human teeth.Methods. Deep class V cavities were prepared on the buccal surface of 26 premolars. In Group I the cavity walls (dentin) and enamel were conditioned with 32% phosphoric acid and the dentin adhesive system One Step (Bisco, Inc., Itasca, IL, USA) was applied. In Groups 2 and 3, before total etching and application of bonding agent, the cavity floor was lined with the resin-modified glass-ionomer cement-Vitrebond (3M ESPE Dental Products Division, St. Paul, MN, USA) or the calcium hydroxide cement-Dycal (control group, Dentsply, Mildford, DE, USA), respectively. The cavities were restored using light-cured Z-100 composite resin (3M ESPE). The teeth were extracted between 5 and 30 days and prepared for microscopic assessment. Serial sections were stained with H/E, Masson's trichrome, and Brown and Brenn techniques.Results. In Group 1, the inflammatory response was more evident than in Groups 2 and 3. Diffusion of dental material components across dentinal tubules was observed only in Group 1, in which the intensity of the pulp response increased as the remaining dentin thickness decreased. Bacteria were evidenced in the lateral walls of two samples (Group 2) which exhibited no inflammatory response or tissue disorganization.Conclusions. Based on the experimental conditions, it was concluded total acid etching followed by application of One Step bonding agent cannot be recommended as adequate procedures. In this clinical condition the cavity walls should be lined with a biocompatible dental material, such as Vitrebond or Dycal. 2003 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Biocompatibility of resin-based materials used as pulp-capping agents

Aim To evaluate and compare the response of pulps of rats capped with resin-modified glass-ionomer cement (RMGIC) or self-etching adhesive system.Methodology Class I cavities were prepared on the occlusal surface of 54 maxillary first molars of 27 rats. Pulp exposure was performed on the cavity floor. The following resin-based materials were applied as pulp-capping agents: G1, Clearfil Liner Bond 2V (CLB 2V; Kuraray Co., Japan); G2, Vitrebond (VIT; 3M/ESPE, USA). In group 3 (control group), a calcium hydroxide/saline paste (CH; Labsynth, Brazil) was used. The cavities were restored with amalgam. After 7, 30 and 60 days, the animals were sacrificed and the jaws were processed for microscopic evaluation.Results Despite the inflammatory response caused by the experimental and the control materials at 7 days, pulpal healing associated with calcified barrier formation was observed at 60 days following the pulp therapy. Both resin-based materials promoted a large zone of cell-rich fibrodentine matrix deposition on the pulp horn related to the pulp exposure site, which was larger to VIT than to CLB 2V specimens. Tertiary dentine underneath the fibrodentine matrix was deposited by a layer of elongated pulpal cells. The remaining pulpal tissue exhibited normal histological characteristics. In the control group, healing and dentine-bridge formation was observed at 30 days. Pulpal breakdown occurred only when bacterial infection occurred.Conclusion Both experimental pulp-capping agents allowed pulpal healing characterized by cell-rich fibrodentine and tertiary dentine deposition as well as calcified barrier formation.