In vitro effect of sodium trimetaphosphate additives to conventional toothpastes on enamel demineralization

The aim of this study was to evaluate the ability of conventional toothpastes (1100 ppm F) supplemented with sodium trimetaphosphate (TMP) in demineralization. Blocks of enamel were selected and then divided into seven experimental groups of 12: toothpaste without F and TMP (placebo), toothpaste with 1100 ppm F (1100), and toothpaste with 1100 ppm F supplemented with TMP-1 % (1100 1 % TMP), 3 % (1100 3 % TMP), 4.5 % (1100 4.5 % TMP), 6 % (1100 6 % TMP), and 9 % (1100 9 % TMP). Blocks were subjected to five pH cycles (demineralizing/remineralizing solutions) at 37 °C and treated with toothpaste slurries twice daily, after which the blocks were maintained for 2 days in fresh remineralizing solution. Following treatments, surface hardness (SHf) and cross-sectional hardness were determined for calculating the integrated loss of subsurface hardness (ΔKHN). The fluoride present in the enamel was also measured. The SHf and ΔKHN measurements showed that supplementation with 3 % TMP was the most effective (p < 0.001) and showed greater concentration of F in the enamel (p < 0.001). Addition of 3 % TMP to a conventional toothpaste (1100 ppm F) showed greater efficacy in reducing enamel demineralization. Fluoride toothpastes containing trimetaphosphate possess good anticaries potential required to reduce the prevalence of dental caries in high-risk patients.

In situ remineralizing effect of fluoride varnishes containing sodium trimetaphosphate

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Synergistic effect of fluoride and sodium hexametaphosphate in toothpaste on enamel demineralization in situ

To evaluate the effect of a fluoride dentifrice containing sodium hexametaphosphate (HMP) on enamel demineralization in situ. This double-blind and cross-over study consisted of 3 phases (7 days each) in which 12 volunteers wore intraoral appliances containing four enamel bovine blocks. Specimens were treated (3×/day) with placebo (no F or HMP), 1100ppm F (1100F) and 1100F plus HMP1% (1100F-HMP1%) toothpastes, and the cariogenic challenge was performed using a 30% sucrose solution (6×/day). Final surface hardness, the percentage of surface hardness loss (%SH), the integrated loss of subsurface hardness (ΔKHN), as well as enamel calcium (Ca), phosphorus (P) and firmly-bound fluoride (F) were determined. Also, biofilm formed on the blocks were analyzed for F, Ca, P and insoluble extracellular polysaccharide (EPS) concentrations. Data were submitted 1-way ANOVA, followed by Student-Newman-Keuls' test (p<0.05). 1100F-HMP1% promoted the lowest %SH and ΔKHN among all groups (p<0.001). The addition of HMP1% to 1100F did not enhance enamel F uptake, but significantly increased enamel Ca concentrations (p<0.001). Similar EPS concentrations were seen for 1100F-HMP1% and 1100F groups (p>0.05). All the groups were supersaturated with respect to HA. However, only 1100F-HMP1% group was supersaturated with respect to CaF2 (p<0.05). The ionic activities of F(-), CaF(+) and HF(0) for the 1100F-HMP1% group were the highest among all groups (p<0.001). The addition of HMP1% to a conventional toothpaste significantly reduces enamel demineralization in situ when compared to 1100F. This dentifrice could be a viable alternative to patients at high risk of caries.

Demineralization and hydrogen peroxide penetration in teeth with incipient lesions

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

Longitudinal evaluation of the structural integrity of teeth affected by molar incisor hypomineralisation

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

Effectiveness of a toothpaste with low fluoride content combined with trimetaphosphate on dental biofilm and enamel demineralization in situ

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Seal, replacement or monitoring amalgam restorations with occlusal marginal defects? Results of a 10-year clinical trial

The aim of this prospective and blind clinical trial was to assess the effectiveness of sealing localized marginal defects of amalgam restoration that were initially scheduled to be replaced. A cohort of twenty six patients with 60 amalgam restorations (n=44Class I and n=16Class II), that presented marginal defects deviating from ideal (Bravo) according to USPHS criteria, were assigned to either sealing or replacement groups: A: sealing n=20, Replacement n=20, and no treatment (n=20). Two blind examiners evaluated the restorations at baseline (K=0.74) and after ten years (K=0.84) according with USPHS criteria, in four parameters: marginal adaptation (MA), secondary caries (SC), marginal staining (MS) and teeth sensitivity (TS). Multiple comparison of restorations degradation/upgrade was analyzed by Friedman test and the comparisons within groups were performed by Wilcoxon test. After 10 years, 44 restorations were assessed (73.3%), Group A: n=14 and Group B: n=16; and Group C: n=14 sealing and replacement amalgam restorations presented similar level of quality in MA (p=0.76), SC (p=0.25) and TS (p=0.52), while in MS (p=0.007) presented better performance in replacement group after 10-years. Most of the occlusal amalgam restorations with marginal gaps showed similar long term outcomes than the restorations were sealed, replaced, or not treated over a 10-year period. Most of the restorations of the three groups were clinically acceptable, under the studied parameters. All restorations had the tendency to present downgrade/deterioration over time.

Effects of pH and fluoride concentration of dentifrices on fluoride levels in saliva, biofilm, and biofilm fluid in vivo

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

Comportamento do esmalte de dentes decíduos após desafio desmineralizante em função de materiais restauradores: estudo ao microscópio de luz polarizada

Pós-graduação em Biopatologia Bucal - ICT

Effect of Er:YAG laser on CaF2 formation and its anticariogenic action on human enamel: An in vitro study

Objective: The objective of this study was to evaluate the effect of Er: YAG laser on the formation of CaF2, after the application of acidulated phosphate fluoride (APF), and its influence on the anti-cariogenic action in human dental enamel. Background Data: Er:YAG laser was designed to promote ablation of the enamel. However, the possibility of using this energy to increase the enamel's resistance to caries has hardly been explored, and neither has its interaction with the use of fluorides. Materials and Methods: One hundred and twenty blocks of enamel were allocated to four groups of 30 blocks each: (1) C, control group; (2) Er:YAG, laser; (3) APF; and (4) Er:YAG+APF. Of these, 80 blocks were submitted to pH cycling for 14 days. In the other 40 blocks, fluoride (CaF2) was measured before cycling. After pH cycling, surface microhardness (SMH), microhardness in cross-section (converted to mineral contents % vol. min.), and fluoride after cycling (40 blocks) were also determined. Results: SMH decreased in all groups. The control group showed the highest decrease, and Er:YAG+APF showed the lowest decrease (p < 0.05). Groups APF and Er:YAG showed the same results (p > 0.05). Mineral content at depths 10, 20, and 40 μm was lower in the control and Er:YAG groups, and higher in groups APF and Er:YAG+APF. CaF2 (μgF/cm2) deposited before pH cycling was higher in the APF group when compared to the Er:YAG+APF group. Control and Er:YAG groups showed the lowest values (p > 0.05). Conclusion: It was concluded that Er:YAG laser influenced the deposition of CaF2 on the enamel and showed a superficial anti-cariogenic action, but not in depth.

Comparação de dois tipos de retalho para enxerto de tecido conjuntivo no tratamento de recessões gengivais: estudo clínico controlado randomizado

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

Condições de saúde bucal de crianças e adolescentes portadores de síndrome de Down

Patients with Down syndrome have shown different conditions of oral health, and there is a low occurrence of dental caries and a higher susceptibility to periodontal diseases. Thus, this study aimed to evaluate the prevalence of dental caries and periodontal diseases in subjects with Down syndrome. The population was composed of 40 patients with the syndrome, aged 6 to 18 years, of both genders, and an equal number of non-syndromic patients. The periodontal conditions were evaluated by mean of the criteria of PSR and dental conditions were registered following indexes dmft and DMFT. It was found that in children with Down syndrome, the dmft index was 1.17 and DMFT 3.53 while the control group was verified dmft 1.97 and DMFT 2.77. The results of PSR evidenced that 32.5% of children with Down syndrome were periodontally healthy, 65% were gingivitis patients and 2.5% were periodontitis patients, while in the control group, 50% healthy and 50% were gingivitis patients. The results evidenced similar populations of cariogenic cocci between patients with Down syndrome and non-syndromic subjects. It was concluded that the incidence of caries in children with Down syndrome was higher in permanent teeth compared with the control group, while in the occurrence of deciduous teeth caries was slightly higher in the control group, so when children with Down syndrome are subjected to periodic examinations, they present themselves periodontally healthy.

An effective technique to posterior resin composite restorations

AIM: The aim of this study is to present a clinical case in which an occlusal matrix device was used in a patient who needed to restore a posterior tooth. MATERIAL AND METHODS: A direct duplicate occlusal appliance was used (biteperf) in a patient who needed an occlusal restoration in two posterior teeth. RESULTS: Using the matrix helps having fast and accurate reproduction of the original anatomical details of the occlusal surface. The final result surprised with the presented restoration in terms of esthetic quality, despite the simplicity of the technique. CONCLUSION: Posterior teeth with initial lesions were confined to the occlusal surface of anatomically complex or fissured anatomy with or without signs of proximal caries wich are ideal candidates for this technique. The overlying enamel surface must be relatively intact; lesions of hidden or occult caries. CLINICAL SIGNIFICANCE: The aesthetic and time-saving benefits of the occlusal device (biteperf) are immediately clear. The matrix allows the fast and accurate reproduction of the anatomic details of the original occlusal surface of the tooth. The professionals who lack an artistic penchant and marked manual ability will be able to carry out excellent posterior resin composite restorations.

A experiência da saúde coletiva na formação profissional: retrato da extensão universitária

The guidelines of National Curriculum for Dental courses highlights the necessity in providing for the professional the ability to analyze and assess community’s problems and needs, and to create solutions for the society. The continuing education may be considered a useful tool for the teaching and learning because it favors the diversification of learning environments, which allows the insertion of undergraduate and graduate students into the real scenarios. This current study aimed to assess the Public Health projects and programs of the UNESP – Araçatuba Dental School, by describing the interaction experiences between faculty and health services in the professional career development. Historical, documentary and descriptive searches were performed based on the faculty archives such as official documents, reports, databases from the Pro-rector of continuing education and published papers in the period between 1964 and 2011. The following experiences were noted: the Extra-Muro Dental Service (SEMO), established in 1964, that focused in providing dental treatment to the rural population, highlighted the social inclusion of discriminated society groups since that time. In 1972, this service was expanded to several specific populations living in the urban areas. In the '60s, many educational campaigns were performed as homemade water filter and construction of wells and septic tanks which demonstrate the concern with the determinants of healthdisease process. At that time, the campaign of fluoridation of public water supplies in several counties started as Araçatuba, Birigui, Penápolis, Guararapes, Valparaíso and so on. The Campaign of “Good Teeth” from the '70s became wider over time and it was transformed in the "Oral Health Education Program" and it was continuously developed in all public schools of Araçatuba and some neighboring towns, benefiting children aged from 6 to 10 years-old. Several epidemiological studies of caries, periodontal diseases, malocclusion and fluorosis were conducted in cooperation with local governments, and counted with the participation of undergraduate and graduate students. Pereira Barreto – SP was the precursor city in Brazil to carry out fluorosis study. Currently, 12 projects of Public Health from the Institution of Higher Education in the Pro-rector of continuing education are being developed. The concern in qualifying the human resources in health is confirmed with the development of training courses and workshops for professionals, highlighting the training for people enrolled in the Family Health program; Community Health Agent training - Solidarity University, and Municipal Health Counselors training. The Graduate Program in Social and Preventive Dentistry, created in 1993, has an important role to train several professionals for the Unified Health System, and provides education to create researchers, professors and administrators, and enucleates research groups in several Brazilian states. In all activities showed herein, a dynamic participation of undergraduate and graduate students has been observed, and several books, guidelines, articles, brochures and booklets have been published as a result of the continuing education activities.. It was concluded that different projects and programs have been developed by the Public Health of UNESP –Araçatuba Dental School, which allow the exchange of experience between the university and health services, and benefit all participants enrolled in these activities.

Fluoretação das águas de abastecimento público em um município com diferentes fontes de captação

Maintaining the levels of fluoride ion in public water supply within the parameters of adequacy it becomes essential so the measure carries a greater impact on caries prevention and control, without increasing the prevalence of dental fluorosis. Thus, it is necessary a rigorous control of the process, avoiding the undesired effects at levels above recommended levels, as well as avoiding levels below the recommended that do not offer the highest benefit. The aim of this study was to analyze the content of fluoride in public water supply in the city of Birigui, SP, with different sources of supply, checking if the fluoride levels are within the recommended. The samples were collected monthly from points previously established, with the knowledge of the distribution network of water and identifying the amount and location of supply sources and water treatment plant. Analyses were performed in duplicate in the period from January to December of 2009, in the laboratory - NEPESCO - of the Dental School of Araçatuba, Univ Estadual Paulista – UNESP, using an ion analyzer coupled to a specific electrode for fluoride. Of the total samples (n = 512), 44% (n = 224) had adequate levels and 56% (n = 288) inadequate levels, 10% (n = 49) lower levels and 46% (n = 239) showed levels above the recommended. There were differences in results when comparing the analysis of different sources. The fluoride concentration in the majority of the samples from deep wells was classified as inadequate not offering the desired benefit, or exposing the population to the risk of dental fluorosis.