Action of the salivary microorganisms having sorbitol as substratum

Microorganisms living in the saliva are able to ferment some sweetener types and to promote the fall of pH that has its critical point around 5.5; in this situation, they equal the input and the calcium output in the processes of remineralization and demineralization. For iteration of the three essential factors to the installation of the dental caries (microorganism, host and diet) suggested the accomplishment of a work that involved one of these factors. This work aims to study this issue, through the indication of substitute sweetener of the saccharose, whenever possible, it solved to evaluate pH of the saliva, exposed to sorbitol.

Application of Er:YAG and Er, Cr:YSGG lasers in cavity preparation for dental tissues: a literature review

The laser has been widely used in many specialties of dentistry and several wavelengths have been investigated as a substitute for high-speed handpiece. The purpose of this paper is to review the literature about the use of Er:YAG and Er,Cr:YSGG lasers in cavity preparation for dental tissues. Despite the differences in wavelength, pulse duration and energy, the morphological characteristics of the irradiated dentin surface with these lasers are comparable, as well as its effects as methods of dental caries prevention. Thus, Er:YAG and Er,Cr:YSGG lasers prepared cavities with similar effects on the dental tissue, however, further investigations about ideal irradiation conditions are needed for both lasers.

Can repair increase the longevity of composite resins? Results of a 10-year clinical trial

The aim of this double-blind clinical trial was to assess the longevity of repairs to localized clinical defects in composite resin restorations that were initially planned to be treated with a restoration replacement. Methods Twenty-eight patients aged 18–80 years old with 50 composite resin restorations (CR) were recruited. The restorations with localized, marginal, anatomical deficiencies and/or secondary caries adjacent to CR that were “clinically judged” to be suitable for repair or replacement according to the USPHS criteria were randomly assigned to Repair (n = 25) or Replacement (n = 25) groups, and the quality of the restorations was scored according to the modified USPHS criteria. The restorations were blind and two examiners scored them at baseline (Cohen Kappa agreement score 0.74) and at ten years (Cohen Kappa agreement score 0.87) restorations. Wilcoxon tests were performed for comparisons within the same group (95% CI), and Friedman tests were utilized for multiple comparisons between the different years within each group. Results Over the decade, the two groups behaved similarly on the parameters of marginal adaptation (MA) (p > 0.05), secondary caries (SC) (p > 0.05), anatomy (A) (p < 0.05), and colour (C) (p > 0.05). Conclusions Given that the MA, SC, A and C parameters behaved similarly in both groups, the repair of composite resins should be elected when clinically indicated, because it is a minimally invasive treatment that can consistently increase the longevity of restorations. Clinical significance The repair of defective composite resins as an alternative treatment to increase their longevity proved to be a safe and effective treatment in the long term.

Evaluation of dental restorations: a comparative study between clinical and digital photographic assessments

The aim of this study was to compare the efficacy of a direct clinical evaluation method with an indirect digital photographic method in assessing the quality of dental restorations. Seven parameters (color, occlusal marginal adaptation, anatomy form, roughness, occlusal marginal stain, luster, and secondary caries) were assessed in 89 Class I and Class II restorations from 36 adults using the modified US Public Health Service/Ryge criteria. Standardized photographs of the same restorations were digitally processed by Adobe Photoshop software, separated into the following four groups and assessed by two calibrated examiners: Group A: The original photograph displayed at 100%, without modifications (IMG100); Group B: Formed by images enlarged at 150% (IMG150); Group C: Formed by digital photographs displayed at 100% (mIMG100), with digital modifications (levels adjustment, shadow and highlight correction, color balance, unsharp Mask); and Group D: Formed by enlarged photographs displayed at 150% with modifications (mIMG150), with the same adjustments made to Group C. Photographs were assessed on a calibrated screen (Macbook) by two calibrated clinicians, and the results were statistically analyzed using Wilcoxon tests (SSPS 11.5) at 95% CI. Results: The photographic method produced higher reliability levels than the direct clinical method in all parameters. The evaluation of digital images is more consistent with clinical assessment when restorations present some moderate defect (Bravo) and less consistent when restorations are clinically classified as either satisfactory (Alpha) or in cases of severe defects (Charlie). Conclusion: The digital photographic method is a useful tool for assessing the quality of dental restorations, providing information that goes unnoticed with the visual-tactile clinical examination method. Additionally, when analyzing restorations using the Ryge modified criteria, the digital photographic method reveals a significant increase of defects compared to those clinically observed with the naked eye. Photography by itself, without the need for enlargement or correction, provides more information than clinical examination and can lead to unnecessary overtreatment.

Longitudinal results of a 10-year clinical trial of repair of amalgam restorations

The aim of this prospective, blind, and randomized clinical trial was to assess the effectiveness of repair of localized clinical defects in amalgam restorations that were initially scheduled for replacement. A cohort of 20 patients with 40 (Class I and Class II) amalgam restorations that presented one or more clinical features that deviated from the ideal (Bravo or Charlie) according to US Public Health Service criteria, were randomly assigned to either the repair or the replacement group—A: repair, n = 19; and B: replacement, n = 21. Two examiners who had calibration expertise evaluated the restorations at baseline and 10 years after according to seven parameters: marginal occlusal adaptation, anatomic form, surface roughness, marginal staining, contact, secondary caries, and luster. After 10 years, 30 restorations (75%) were evaluated (Group A: n = 17; Group B: n = 13). Repaired and replaced amalgam restorations showed similar survival outcomes regarding marginal defects and secondary caries in patients with low and medium caries risk, and most of the restorations were considered clinically acceptable after 10 years. Repair treatment increased the potential for tooth longevity, using a minimally interventional procedure. All restorations trend to downgrade over time.

Sealing composite with defective margins, good care or over treatment? results of a 10-year clinical trial

Purpose: The objective of this study was to clinically evaluate sealed composite restorations after 10 years and compare their behavior with respect to controls. Methods and Materials: The cohort consisted of 20 patients aged 18 to 80 years with 80 composite restorations. All participants in the sealing and no-treatment groups presented with clinical features for the marginal adaptation that deviated from the ideal and were rated Bravo (United States Public Health Service criteria). Composites with Alfa values for the marginal adaptation were used as the positive control. Results: The marginal adaptation behavior was similar between the sealing and control (+) groups, with a high frequency of Bravo values in the 10th year (80% and 51%, respectively). Most of the no-treatment (-) group maintained the Bravo values (91%) for 10 years, although some restorations (9%) progressed to Charlie values. The anatomy parameter differed significantly between the first and 10th years, with deterioration in all three groups (p,0.05). The secondary caries parameter had a similar behavior in the three groups (p.0.05). Conclusions: Sealing the margins of the composite resin restorations had no significant effect compared with the control groups, under the conditions of this study. Sealing the restorations substantially improved the marginal staining and marginal adaptation parameters, although by the tenth year they were similar to the group without intervention.

Matriz oclusal para restauração com resina composta de baixa contração: simplificação eficiência

The composite resin is the material of election for direct restorations in posterior teeth currently. The restorative dentistry aims to improve each day the material and facilitate the restorative technique. This paper describes the technique of occlusal matrix made to speed up and preservation the occlusal surface of a first molar tooth affected by caries lesion. A new resin-based composite was used called Silorane, which may be placed in larger increments due the material has low shrinkage and polymerization stress. The use of occlusal matrix associated with a low shrinkage resin composite can simplify the clinical work, and result in a restoration with excellent reproduction of anatomical.

Associação da cárie dentária com indicadores antropométricos do estado nutricional em pré-escolares

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

Aspectos epidemiológicos da saúde bucal de crianças em um município brasileiro

The Health Sciences, prior to the planning of prevention programs, adopt the tools to analyze the population profile, entitled epidemiological surveys, to obtain data on the need for heathcare and the possibility of treating health events. The aim of this study was to evaluate dental conditions in schoolchildren, aged five to fourteen, enrolled in public schools in Américo Brasiliense, SP Brazil. The dmft and DMFT index, caries experience, and prevalence of fluorosis were analyzed. For this epidemiological study, 1,137 children were selected. Four calibrated dentists performed oral exams according to WHO criteria (1997). The data were collected using descriptive analyses. The results showed that 94% of the five-year-old children were caries free, and the value of dmft was 1.44. DMFT was 1.19 in 12-year-olds. The lowest and the highest fluorosis prevalence could be observed in eight and fourteen-year-olds, respectively. It could be concluded that the city of Américo Brasiliense has developed respectful educational and preventive oral health programs which presented satiosfactory results in the present epidemiological study.

Conhecimento de cárie dental e doença periodontal de professores do ensino fundamental segundo o tipo de instituição (pública ou privada)

Aim: observe the knowledge of dental caries and periodontal disease of primary schoolteachers, according to type of institution (public and private) from Araraquara city. methodology: for that participants were 113 teachers from public schools and 57 from private schools. The instrument of analysis was based on a questionnaire with closed and open questions concerning the etiology, prevention and development of dental caries and periodontal disease. Results: 97,3% of public ́s schoolteachers and 91,2% of private ́s schoolteachers answered that they knows what is dental caries, but they didn ́t answer correctly about the caries etiology as being multifactorial and about methods of prevention. Both of schoolteachers (public and private) had more sucessful when answered about bacterial plaque than periodontal disease and yours manifestation. Conclusion: the dental knowledge of schoolteachers in public and private school was evaluated and limited educational programs should be directed to both public and private schoolteachers, in order to increase the level of dental knowledge of them, so that they can act as educational agents with the children.

Elaboração de um Jogo Digital Educacional sobre Saúde Bucal Direcionado para a População Infantil

Objective: The aim of this study was to develop an educational oral health digital game for 5-to-7-year-old children. Method: The game, called “Dr. Trata Dente”, was based on the approach to three different oral health-related topics: a) bacterial plaque and the main diseases caused by it; b) oral hygiene methods for bacterial plaque control; c) dental caries and preventive measures for this disease. These topics were discussed in sequential order in three different stages of the game. Dr. Trata Dente is represented by the figure of a little super-hero dentist, who talks to the children about oral health during the game. The game is sub-divided according to its propositions to the children, into an association game, a memory game and a coloring game. After its development, the game was evaluated by three professionals of each of the following areas: Dentistry, Pedagogy and Psychology (n=9), who verified the suitability of the concepts presented in the game as regards oral health, linguistic abilities worked with the children, fulfillment of the intended didactic criteria, and the playful aspect of the game. Results: According to the dentists, the dental concepts presented in the game are adequate. According to the pedagogues, the choice of a super-hero was correct and the given explanations are well elaborated, organized and have accessible language, although long. For the psychologists, the game has a potential positive effect on the children’s learning, but there should be more interaction of the character with the children. After this evaluation, changes were made in the game according to the professionals’ suggestions. Conclusion: It was concluded that in spite of the suggested alterations, the game is suitable for teaching oral health by means of children’s play.

Conhecimento odontológico de adultos atendidos em uma unidade de saúde da família do município de São Carlos, Brasil

The Family Health Strategy is a primary care public policy that is becoming a decisive step towards the transformation of the Brazilian healthcare model. This study evaluated the dental knowledge among individuals who attended a Family-Health Unit (FHU) in the city of São Carlos, SP, Brazil. Methods: The evaluation was based on a questionnaire with 20 questions about oral health, prevention and development of dental caries and periodontal disease. The questionnaire was given to 168 individuals, over 18 years of age and both sexes, to fill out under the supervision of a trained dentist. After data collection, the answers contained in the original questionnaires were entered into a database built using the program Excel® (Microsoft Corporation, USA) and a descriptive statistical analysis was done. Results: 66.67% of the subjects reported having received information about dental caries and periodontal disease before attending the FHU, and dentists were cited as the main source of such information (60.71%). With regard to dental caries, 70.24% of the individuals stated that they knew about the subject, but the majority of answers revealed incorrect explanation of it. The multifactorial etiology (bacteria/sugar/poor hygiene) was not mentioned. A low percentage of subjects (24.40%) claimed to know what periodontal disease is, and of these, the highest percentage of responses was related to gingivitis (26.83%) and gingival bleeding (12.20%). Out of all subjects, 80.36% affirmed that oral hygiene is important, and among them, the main reasons cited were the maintenance of oral health (29.63%), to avoid diseases (16.30%) and to preserve and prevent disease (14.81%). Conclusion: Responses from the questionnaires revealed deficient dental knowledge among the individuals. To improve the understanding about this issue, the information obtained through the questionnaire can be used to develop educational programs that will focus specifically on the major deficiencies found.

Promoção de Saúde Bucal em Bebês

This study is a literature review about promotion of oral health in babies and it discusses the importance of early preventive treatment. The conclusions are: 1 - The early treatment aims to reduce the dental caries prevalence in babies and to make familiar the dentistry´s office. It is important the creation of oral habits in children and in their parents. 2 - The high prevalence of dental caries in babies shows the necessity of programs with health promotion in the first infancy. The aim is to keep the oral health of these children. 3 - The success of the oral health promotion in babies depends on the awareness of the parents about the importance of oral hygiene. This fact must be considered during the planning and development of programs to this age.

Impacto dos problemas de saúde bucal na qualidade de vida de gestantes

Objectives: 1) to evaluate the impact of oral health problems on the quality of life of pregnant women by the simplified Oral Health Impact Profile (OHIP-14) questionnaire as well by the presence of dental caries, periodontal disease and denture use/need; 2) to correlate the sociodemographic variables and the oral health conditions revealed in the clinical examinations with the OHIP-14. Method: In addition to the application of the OHIP-14 questionnaire, clinical examination of the oral conditions (CPI - community periodontal index, DMFT and prosthetic evaluation) was performed on 51 pregnant women, who sought dental treatment between April 2008 and August 2010 at the Preventive Dentistry Clinic. Descriptive analyses were made for sample characterization, bivariate analysis (chi-square or Fisher’s exact tests) and multiple logistic regressions at a 5% significance level to assess the correlation between the impact of oral health on the quality of life of pregnant women and the socio-demographic and clinical variables. Results: The OHIP-14 data showed a lesser impact of oral health on the women’s quality of life. The mean DMFT was 12.8; 70.6% of the pregnant women presented dental calculus and 58.8% needed prostheses. The association between OHIP-14 data and last dental visit and DMFT remained in the final regression model (p<0.05). Conclusion: Caries experience of the pregnant women was considered high. Most of them needed prostheses and presented dental calculus. The OHIP-14 presented a low impact on this population and was significantly influenced by the last dental visit and the DMFT index.

Avaliação do perfil de risco de cárie dentária em gestantes de Araraquara, Brasil

The knowledge of risk of carried during pregnant is essential for an appropriate treatment using educational and preventives actions to mother for a good care of their oral health and that of children. The main objective of present retrospective study was to identify the risk of caries of pregnants (aged 15-44, mean= 25 years) came to clinic of Preventive Odontology of Araraquara-UNSEP from 1999 to 2007, using 166 medical records obtained by the third pregraduate year students, following the pre-established guidelines. The information collected includes: classification of caries risk diagnosis, pregnancy trimester, carbohydrates ingestion (between or during foods), dental plaques (O'Leary's plaque control registry) and the number of teeth with caries. The statistical analysis used the Chi2 and ANOVA tests. Most of patients showed a 25 % or more of teeth surfaces with dental plaques (92.1 %) and carbohydrates consumption among foods (89.2 %). The mean (SD) of carried and restores teeth was of 7.9 (5.1) and 4.0 (3.4), respectively and the posterior teeth were the more involved by caries/restorations. As regards the diagnosis of caries risk, classification of high risk was observed in the 38.5 % of pregnants, moderate in the 47.6 %) and low in the 13.9 %. There was a statistically significant association (p= 0.001) between the carbohydrates consumption and the diagnosis of caries risk. The plaque's rate was similar in the different trimesters of pregnancy (f= 0.223; p= 0.803). The caries risk of most pregnant women was high or moderate and it was associated with the consumption of carbohydrates.