959 resultados para Caries incipiente
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Tal como se había previsto en el primer boletín conjunto preparado por la Comisión Económica para América Latina y el Caribe (CEPAL); y la Organización Internacional del Trabajo (OIT);, la crisis económica continuó golpeando a los países de América Latina y el Caribe durante el segundo trimestre de 2009. Los mercados internacionales se mantuvieron débiles, lo que afectó las exportaciones regionales de bienes y servicios, las remesas y la inversión extranjera directa continuaron cayendo, el crédito perdió dinamismo y la masa salarial se contrajo, sobre todo por la pérdida de empleo. En consecuencia, las proyecciones de crecimiento de muchos países debieron corregirse a la baja. Por otra parte, desde fines del año pasado, aunque con marcadas diferencias entre los países de la región, se viene implementando una política contracíclica para compensar con el gasto público la debilidad de la inversión y el consumo privados y estimular la reactivación de la demanda agregada.En este segundo boletín, la CEPAL y la OIT señalan cómo se ha profundizado el impacto de la crisis en los mercados de trabajo de la región en el primer semestre de este año y analizan las opciones y los avances de la inversión pública en infraestructura y de los programas de empleo de emergencia para contrarrestar los efectos de la crisis en el mercado de trabajo.Prácticamente en todos los países se registró un aumento de la tasa de desempleo en comparación con el año anterior y esta situación empeoró en el segundo trimestre respecto del primero. En el segundo trimestre, el desempleo urbano superó la tasa del mismo período del año anterior en un punto porcentual (un 8,5% frente a un 7,5%);, mientras que en el primero esta brecha fue de 0,6 puntos porcentuales. Además, algunos indicadores muestran un aumento de la informalidad, un debilitamiento del empleo con protección social y una contracción del empleo de jornada completa.Si se analiza la evolución de los mercados laborales en el primer semestre y se considera la proyección de una caída del producto regional del 1,9% en 2009, se estima que la tasa de desempleo urbano regional rondará el 8,5% en el promedio anual. Esta proyección es ligeramente menos pesimista que la adelantada en el primer boletín, lo que tendría su principal explicación en la caída de la tasa de participación que se observa en el primer semestre y se mantendría vigente durante todo el año. Si no se diera esta reducción de la oferta laboral, que en buena parte se debería a un efecto de "desaliento", el promedio anual de la tasa de desempleo urbano se ubicaría entre el 8,8% y el 8,9%. De esta manera,el número de desempleados abiertos urbanos aumentaría 2,5 millones, pero, si se incluye a los "desalentados", el número de personas adicionales que no encuentran espacio en el mercado laboral urbano crecería a 3,2 millones.Sin embargo, como ocurre a nivel mundial, algunas señales indican que la crisis económica en la región habría tocado fondo a mediados de año. En muchos países se ha detenido la caída de la producción y hay indicios de una incipiente recuperación que motiva un cauto optimismo, ya que esto favorecería la evolución de los mercados laborales en el cuarto trimestre. Sin embargo, consideramos que la recuperación será gradual y no se dará de manera homogénea en todos los países de la región.Es importante destacar que los problemas laborales no se resolverán con el retorno a un sendero ascendente de crecimiento. En primer lugar, es de esperar que la recuperación del empleo se dé con un cierto rezago respecto de la actividad económica. En segundo término, con un crecimiento económico que a corto plazo continuará siendo moderado y no volverá a las tasas registradas entre fines de 2003 y mediados de 2008, la demanda laboral seguirá débil y eso repercutirá en la generación de empleo de buena calidad. Por lo tanto, los países no deben desistir de los esfuerzos para estimular la defensa y la creación de puestos de trabajo decente y deben reforzar la efectividad y eficiencia de los instrumentos disponibles. De esta manera, la región no solo enfrentará mejor los desafíos de la recuperación económica, sino que también fortalecerá las bases para lograr la inclusión social y poder avanzar en mejores condiciones hacia el cumplimiento de los Objetivos de Desarrollo del Milenio.
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Known as one of the ten most important advances on Public Health in the 20th century, fluoridation of public water supply is a measure of wide population coverage, which is effective on caries control. The city of Araçatuba, in the Northwest region of the São Paulo state, Brazil, started public water supply fluoridation in 1972 and, based on the average annual highest temperature, has kept the fluoride concentration between 0.6 to 0.8 mgF/L. The purpose of this study was to analyze monthly the fluoride concentration in public water supply in the city of Araçatuba during 72 months. Water samples were collected monthly on weekdays, directly from the water distribution network, on pre-established locations and analyzed in duplicate between November 2004 and October 2010 at the Research Laboratory of the Nucleus for Public Health (NEPESCO) of the Public Health Graduate Program from Araçatuba Dental School/UNESP, Brazil, using an fluoride-specific electrode connected to an ion analyzer. From the total of samples (n=591), 67.2% (n=397) presented fluoride concentration between 0.6 and 0.8 mgF/L; 20.6% (n=122) below 0.6 mgF/L; 11.5% (n=68) between 0.8 and 1.2 mgF/L and 0.7% (n=4) above 1.2 mgF/L. Most samples showed fluoride levels within the recommended parameters. Minimal variation was observed among the analyzed collection locations, showing that the city has been able to control the fluoride levels in the public water supply and reinforcing the importance of surveillance and constant monitoring to assure the quality of the water delivered to the population.
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Objectives: The aim of this study was to compare cone beam CT (CBCT) in a small field of view (FOV) with a solid-state sensor and a photostimulable phosphor plate system for detection of cavitated approximal surfaces. Methods: 257 non-filled approximal surfaces from human permanent premolars and molars were recorded by two intraoral digital receptors, a storage phosphor plate (Digora Optime, Soredex) and a solid-state CMOS sensor (Digora Toto, Soredex), and scanned in a cone beam CT unit (3D Accuitomo FPD80, Morita) with a FOV of 4 cm and a voxel size of 0.08 mm. Image sections were carried out in the axial and mesiodistal tooth planes. Six observers recorded surface cavitation in all images. Validation of the true absence or presence of surface cavitation was performed by inspecting the surfaces under strong light with the naked eye. Differences in sensitivity, specificity and agreement were estimated by analysing the binary data in a generalized linear model using an identity link function. Results: A significantly higher sensitivity was obtained by all observers with CBCT (p,0.001), which was not compromised by a lower specificity. Therefore, a significantly higher overall agreement was obtained with CBCT (p,0.001). There were no significant differences between the Digora Optime phosphor plate system and the Digora Toto CMOS sensor for any parameter. Conclusions: CBCT was much more accurate in the detection of surface cavitation in approximal surfaces than intraoral receptors. The differences are interpreted as clinically significant. A CBCT examination performed for other reasons should also be assessed for approximal surface cavities in teeth without restorations. © 2013 The British Institute of Radiology.
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Fluoride levels in the public water supplies of 40 Brazilian cities were analyzed and classified on the basis of risk/benefit balance. Samples were collected monthly over a seven-year period from three sites for each water supply source. The samples were analyzed in duplicate in the laboratory of the Center for Research in Public Health - UNESP using an ion analyzer coupled to a fluoride-specific electrode. A total of 19,533 samples were analyzed, of which 18,847 were artificially fluoridated and 686 were not artificially fluoridated. In samples from cities performing water fluoridation, 51.57% (n=9,720) had fluoride levels in the range of 0.55 to 0.84 mg F/L; 30.53% (n=5,754) were below 0.55 mg F/L and 17.90% (n=3,373) were above 0.84 mg F/L (maximum concentration=6.96 mg F/L). Most of the cities performing fluoridation that had a majority of samples with fluoride levels above the recommended parameter had deep wells and more than one source of water supply. There was some variability in the fluoride levels of samples from the same site and between collection sites in the same city. The majority of samples from cities performing fluoridation had fluoride levels within the range that provides the best combination of risks and benefits, minimizing the risk of dental fluorosis while preventing dental caries. The conduction of studies about water distribution systems is suggested in cities with high natural fluoride concentrations in order to optimize the use of natural fluoride for fluoridation costs and avoid the risk of dental fluorosis.
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Ensayo presentado en homenaje a Raúl Prebisch
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Objectives: To evaluate: (1) the in vitro antibacterial, cytotoxic and mechanical properties of a resin-modified glass ionomer cement (RMGIC) containing different concentrations of chlorhexidine (CHX) and (2) the in vivo microbiologic action of the best concentration of CHX associated with the RMGIC applied on remaining dentine after indirect pulp treatment (IPT). Methods: For the in vitro studies, RMGIC was associated with 0.2, 0.5, 1.25 and 2.5% CHX. Microbiologic evaluation consisted of an agar diffusion test on cariogenic bacteria for 24 h. Odontoblast-like cell metabolism and morphology analyses measured the cytotoxic effects of the RMGIC groups after 24 h. The same groups were submitted to compressive and diametral tensile strength. The in vivo treatment consisted of IPT using an RMGIC associated with the best CHX concentration. Clinical and microbiologic evaluations were performed before and after 3 months. Results: The use of 1.25% CHX significantly improved the antibacterial effects of the evaluated RMGIC, without causing any detrimental effects to the odontoblast-like cells and on the mechanical properties. This RMGIC and CHX combination completely eliminated mutans streptococci after 3 months of IPT. Conclusion: The RMGIC and 1.25% CHX mixture showed great biological and mechanical behaviour and could be a good treatment against caries progression. Clinical significance: The association of CHX with a liner RMGIC opens a new perspective for arresting residual caries after IPT. © 2012 Elsevier Ltd. All rights reserved.
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The peptide LYS-[TRP6]-Hy-A1 (Lys-a1) is a synthetic derivative of the peptide Hy-A1, initially isolated from the frog species Hypsiboas albopunctatus. According to previous research, it is a molecule with broad antimicrobial activity. The objective of this study was to evaluate the antimicrobial activity of the synthetic peptide Lys-a1 (KIFGAIWPLALGALKNLIK- NH2) on the planktonic and biofilm growth of oral bacteria. The methods used to evaluate antimicrobial activity include the following: determination of the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) in microtiter plates for growth in suspension and quantification of biomass by crystal violet staining and counting of colony forming units for biofilm growth. The microorganisms Streptococcus oralis, Streptococcus sanguinis, Streptococcus parasanguinis, Streptococcus salivarius, Streptococcus mutans and Streptococcus sobrinus were grown in Brain Heart Infusion broth at 37 °C under atmospheric pressure with 10% CO2. The peptide was solubilized in 0.1% acetic acid (v/v) at various concentrations (500-1.9 μg mL-1). Chlorhexidine gluconate 0.12% was used as the positive control, and BHI culture medium was used as the negative control. The tested peptide demonstrated a remarkable antimicrobial effect, inhibiting the planktonic and biofilm growth of all strains tested, even at low concentrations. Thus, the peptide Lys-a1 is an important source for potential antimicrobial agents, especially for the control and prevention of microbial biofilms, which is one of the most important factors in cariogenic processes. © 2012 Elsevier Inc.
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The purpose of this study was to evaluate specific effects of photodynamic inactivation (PDI) using erythrosine (ER) and Rose Bengal (RB) photosensitizers and a blue light-emitting diode (LED) on the viability of Streptococcus mutans and Streptococcus sanguinis biofilms. Biofilms were grown in acrylic disks immersed in broth to production of biofilms, inoculated with microbial suspension (106 cells/mL) and incubated for 48 h. After the formation of biofilms, the effects of the photosensitizers ER and RB at a concentration of 5 μM for 5 min and blue LED (455 ± 20 nm) for 180 s, photosensitizers alone and conjugated were evaluated. Next, the disks were placed in tubes with sterile physiological solution (0.9 % sodium chloride) and sonicated for to disperse the biofilms. Tenfold serial dilutions were carried and aliquots seeded in brain heart infusion agar which were then incubated for 48 h. Then the numbers colony-forming units per milliliter (CFU/mL; log 10) were counted and analyzed statistically (ANOVA, Tukey test, P ≤ 0.05). Significant decreases in the viability of all microorganisms were observed for biofilms exposed to PDI mediated by both photosensitizers. The reductions with RB and ER were, 0.62 and 0.52 log10 CFU mL -1 for S. mutans biofilms (p = 0.001), and 0.95 and 0.88 log 10 CFU mL-1 for S. sanguinis biofilms (p = 0.001), respectively. The results showed that biofilms formed in vitro by S. mutans and S. sanguinis, were sensitive to PDI using a blue LED associated with photosensitizers ER or RB, indicating its use in the control of caries and periodontal diseases. © 2012 Springer-Verlag London Ltd.
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This study evaluated the capacity of fluoride acidic dentifrices (pH 4.5) to promote enamel remineralization using a pH cycling model, comparing them with a standard dentifrice (1,100 μgF/g). Enamel blocks had their surface polished and surface hardness determined (SH). Next, they were submitted to subsurface enamel demineralization and to postdemineralization surface hardness analysis. The blocks were divided into 6 experimental groups (n=10): placebo (without F, pH 4.5, negative control), 275, 412, 550, 1,100 μgF/g and a standard dentifrice (positive control). The blocks were submitted to pH cycling for 6 days and treatment with dentifrice slurries twice a day. After pH cycling, surface and crosssectional hardness were assessed to obtain the percentage of surface hardness recovery (%SHR) and the integrated loss of subsurface hardness (δKHN). The results showed that %SHR was similar among acidic dentifrices with 412, 550, 1,100 μgF/g and to the positive control (Tukey's test; p>0.05). For ΔKHN, the acidic dentifrice with 550 μg F/g showed a better performance when compared with the positive control. It can be concluded that acidic dentifrice 550 μgF/g had similar remineralization capacity to that of positive control.
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Human oral cavity is colonized by a wide range of microorganisms, often organized in biofilms. These biofilms are responsible for the pathogenesis of caries and most periodontal diseases. A possible alternative to reduce biofilms is the photodynamic inactivation (PDI). The success of the PDI depends on different factors. The time required by the PS to remain in contact with the target cells prior to illumination is determinant for the technique's efficacy. This study aimed to assess the interaction between the PS and the biofilm prior to the PDI. We used confocal microscopy and FLIM to evaluate the interaction between the PS and the biofilm's microorganism during the pre-irradiation time (PIT). The study of this dynamics can lead to the understanding of why only some PSs are effective and why is necessary a long PIT for some microorganisms. Our results showed that are differences for each PIT. These differences can be the determinate for the efficacy of the PDI. We observed that the microorganism needs time to concentrate and/or transport the PS within the biofilm. We presented preliminary results for biofilms of Candida albicans and Streptococcus mutans in the presence of Curcumin and compared it with the literature. We observed that the effectiveness of the PDI might be directly correlated to the position of the PS with the biofilm. Further analyses will be conducted in order to confirm the potential of FLIM to assess the PS dynamics within the biofilms. © 2013 SPIE.