Desgaste superficial do esmalte dental após microabrasão in vitro

The aim of this study was to investigate the enamel wear permanent teeth after plastic stick or low speed rubber cup microabrasion. Ten permanent molars were selected to evaluate enamel wear which were sectioned into mesial and distal halves. Each half of the molars was randomly assigned to one of two experimental groups (n = 10) according to the enamel microabrasion technique: plastic stick (GE) or rubber cup (GT). In both the groups, the enamel was submitted to 10 applications of an abrasive paste comprised of 35% phosphoric acid and pumice powder. The paste was applied for 20 seconds under a pressure of 30 g using the instrument defined for each group (plastic stick or rubber cup). The specimens were evaluated under a stereomicroscope connected to a computer. The enamel wear no was statistically different between GE and GT, which presented a mean wear of 304.74 µm (21.20%) and 338.35 µm (22.75%). In conclusion, superficial enamel wear was seen for both the groups, independent of the technique used for the accomplishment of the microabrasion.

Accuracy of radiographic examination in determining the depth of approximal carious lesions in primary molars

The purpose of this study was to evaluate the accuracy of the depth of carious lesions on bitewing radiographs. Methods Recently extracted primary molars had their proximal surfaces evaluated visually (EC) and classified as healthy surface (0), signs that suggest the presence of carious lesions in enamel (1), signs of a superficial lesion in dentin (2) and carious lesions in deep dentin (3). Results The results were obtained by consensus between the investigators. The gold standard was determined by histological analysis. The values of sensitivity, specificity, accuracy and area under the ROC (Receiver Operating Characteristic) curve were evaluated. There was equilibrium between sensitivity (76.92% EC and 88.46% ER) and specificity (95.83% EC and 95.83% ER). Accuracy was 86.01% (EC) and 88.46% (ER). The Spearman correlation test was used to prove the correlation between clinical and radiographic examinations (0.886), for clinical and histological (0.736) and for radiographic and histological analysis (0.843).

Digital radiography for determination of primary tooth length: in vivo and ex vivo studies

Background. Methods for determining the root canal length of the primary tooth should yield accurate and reproducible results. In vitro studies show some limitations, which do not allow their findings to be directly transferred to a clinical situation. Aim. To compare the accuracy of radiographic tooth length obtained from in vivo digital radiograph with that obtained from ex vivo digital radiograph. Method. Direct digital radiographs of 20 upper primary incisors were performed in teeth (2/3 radicular resorption) that were radiographed by an intraoral sensor, according to the long-cone technique. Teeth were extracted, measured, and mounted in a resin block, and then radiographic template was used to standardise the sensor-target distance (30 cm). The apparent tooth length (APTL) was obtained from the computer screen by means of an electronic ruler accompanying the digital radiography software (CDR 2.0), whereas the actual tooth length (ACTL) was obtained by means of a digital calliper following extraction. Data were compared to the ACTL by variance analysis and Pearson’s correlation test. Results. The values for APTL obtained from in vivo radiography were slightly underestimated, whereas those values obtained from ex vivo were slightly overestimated. No significance was observed between APTL and ACTL. Conclusion. The length of primary teeth estimated by in vivo and ex vivo comparisons using digital radiography was found to be similar to the actual tooth length.

Cárie oculta extensa: relato de caso clínico

The pattern of caries lesions has been modified over decades. If the presence or absence of a caries lesion is based upon only a visual examination, its diagnosis might become underestimated since dentinal lesions underneath non cavitated or minimally demineralized enamel is highly frequent in dental clinics. The aim of this paper is to report a clinical case of a child with an upper molar with questionable occlusal aspect, presenting asymptomatic pulpal hyperplasia on the distolingual pit. Periapical radiographic examination was essential for diagnosing hidden caries and elaborating the treatment plan. As part of the approach, removal of the decayed tissue and pulpotomy with calcium hydroxide were performed. The association of an accurate visual examination to an adequate oral radiographyis is extremely important in cases which the presence of hidden caries is doubtful. As a result, an early diagnosis and the reduction of more invasive interventions related to the oral health care of pediatric patients can be achieved as well.

Photodynamic antimicrobial chemotherapy for prevention and treatment of dental caries: a critical review

Introduction: Photodynamic antimicrobial chemotherapy studies regarding dental caries have been present more frequently in the literature. However, photodynamic antimicrobial chemotherapy depends on the adjustment of variables such as the type of light source and, photosensitisers target microorganism; this makes it difficult to draw meaningful comparisons. The purpose of this paper was to provide a critical review related to this coadjuvant approach in the prevention and treatment of dental caries. Materials and Methods: A database search was made via Medline/PubMed (keywords: photodynamic therapy and dental caries) and 33 articles were found. Results: Twelve articles were included after using the filter tool, being excluded reviews and manuscripts reporting works not related to the studied area. Conclusion: The manuscripts showed that photodynamic therapy presents optimal results against dental caries, even though better understanding of photodynamic antimicrobial chemotherapy and its components are necessary before the clinical application of this alternative modality in the dental practice.

Immediate and late analysis of dental pulp stem cells viability after indirect exposition to alternative in-office bleaching strategies

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

Dental caries in children participating in a dentistry for infants program

To assess the impact of the "Dentistry for Infants" early dental care program run by Jacareí County (SP) by comparing the caries of individuals participating and not participating in this program. Methods: In total, 300 children between 0 and 48 months old were assessed in the following two groups: infants not participating in the program (G1, n = 100) and infants participating in the program (G2, n = 200). Each group was further divided according to age in subgroups of 0 to 24 months and 25 to 48 months. All children were clinically assessed for carious lesions using the visual-tactile method. The data were statistically analyzed using a paired Student's t-test, Mann-Whitney test, and c 2 test at a 5% significance level. Results: There was a significant difference in the prevalence (P) and mean index of deciduous teeth (deft) (C) that were decayed, indicated for extraction and filled, and the highest values were observed in G1 (p < 0.0001). The values were as follows: PG1, 73%; PG2, 22%; CG1, 3.45 ± 3.84; and CG2, 0.66 ± 1.57. Conclusion: Participating in the program positively impacted the infants' oral health.

Esthetic dental anomalies as motive for bullying in schoolchildren

Facial esthetics, including oral esthetics, can severely affect children's quality-of-life, causing physical, social and psychological impairment. Children and adolescents with esthetic-related dental malformations are potential targets for bullies. This study was aimed to present and discuss patients who suffered from bullying at school and family environment due to esthetic-related teeth anomalies. Providing an adequate esthetic dental treatment is an important step in their rehabilitation when the lack of esthetic is the main source of bullying. After dental treatment, we noted significant improvement in self-esteem, self-confidence, socialization and academic performance of all patients and improvement in parental satisfaction regarding the appearance of their children. It is imperative that both family and school care providers be constantly alert about bullying in order to prevent or interrupt aggressive and discriminatory practices against children and adolescents. Clearly, dental anomalies may be a motive for bullying.

In vitro performance of a pen-type laser fluorescence device and bitewing radiographs for approximal caries detection in permanent and primary teeth

To evaluate the performance of a pen‑type laser fluorescence device (DIAGNOdent 2190; LFpen, KaVo, Germany) and bitewing radiographs (BW) for approximal caries detection in permanent and primary teeth. Materials and Methods: A total of 246 anterior approximal surfaces (102 permanent and 144 primary) were selected. Contact points were simulated using sound teeth. Two examiners assessed all approximal surfaces using LFpen and BW. The teeth were histologically assessed for the reference standard. Optimal cut‑off limits were calculated for LFpen for primary and permanent teeth. Sensitivity, specificity, accuracy and area under the receiver operating characteristic curve (Az) were calculated for D1 (enamel and dentin lesions) and D3 (dentin lesions) thresholds. The reproducibility was assessed by intraclass correlation coefficient (ICC) and Cohen's weighted kappa values. Results: For permanent teeth, the LFpen cut‑off were 0– 27 (sound), 28– 33 (enamel caries) and >33 (dentin caries). For primary teeth, the LFpen cut‑off were 0– 7 (sound), 8– 32 (enamelcaries) and >32 (dentin caries). The LFpen presented higher sensitivity values than BW for primary teeth (0.58 vs. 0.32 at D1 and 0.80 vs. 0.47 at D3) and permanent teeth (0.80 vs. 0.57 at D1 and 0.94 vs. 0.51 at D3). Specificity did not show a significant difference between the methods. Rank correlations with histology were 0.59 and 0.83 (LFpen) and 0.36 and 0.70 (BW) for primary and permanent teeth, respectively, considering all lesions. ICC values for LFpen were 0.71 (inter) and 0.86 (intra) for permanent teeth and 0.94 (inter) and 0.90/0.99 for primary teeth. Kappa values for BW were 0.69 (inter) and 0.68/0.90 (intra) for permanent teeth and 0.64 (inter) and 0.89/0.89 for primary teeth. Conclusion: LFpen presented better reproducibility for primary and permanent teeth and higher accuracy in detecting caries lesions at D1 threshold than BW for permanent teeth. LFpen should be used as an adjunct method for approximal caries detection.

Responses of dental pulp cells to a less invasive bleaching technique applied to adhesive restored teeth

To assess the cytotoxicity of 35% hydrogen peroxide (HP) bleaching gel applied for 15 min to sound or restored teeth with two-step self-etching adhesive systems and composite resin. Materials and Methods: Sound and restored enamel/dentin disks were stored in water for 24 h or 6 months + thermocycling. The disks were adapted to artificial pulp chambers and placed in compartments containing culture medium. Immediately after bleaching, the culture medium in contact with dentin was applied for 1 h to previously cultured odontoblast-like MDPC-23 cells. Thereafter, cell viability (MTT assay) and morphology (SEM) were assessed. Data were analyzed by two-way ANOVA and Tukey's test (a = 5%). Results: In comparison to the negative control group (no treatment), no significant cell viability reduction occurred in those groups in which sound teeth were bleached. However, a significant decrease in cell viability was observed in the adhesive-restored bleached groups compared to negative control. No significant difference among bleached groups was observed with respect to the presence of restoration and storage time. Conclusion: The application of 35% HP bleaching gel to sound teeth for 15 min does not cause toxic effects in pulp cells. When this bleaching protocol was performed in adhesive-restored teeth, a significant toxic effect occurred.

Microbiological analysis of dental casts stored long-term

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Assessment of a new infrared laser transillumination technology (808nm) for the detection of occlusal caries-an in vitro study

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

Efecto del blanqueamiento dental con peroxido de hidrógeno al 35% en la resistencia de unión de dientes restaurados con resina compuesta

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

Effect of different bleaching protocols on dental enamel and composite resin

To evaluate changes in microhardness, roughness and surface morphology of dental enamel and composite resin after different tooth bleaching techniques. Material and Methods: Dental fragments from bovine incisors with composite resin restorations were submitted to different bleaching protocols: G1 – daily 8 hours application of a 10% carbamide peroxide (CP) gel during 21 days; G2: 3 applications of 15 minutes of a 38% hydrogen peroxide (H2O2) gel; G3: 38% H2O2 gel associated to irradiation with LED (470nm) during 6 minutes. The Knoop micro hardness of enamel and composite resin were evaluated at 1, 7, 14 and 21 days for G1, and after 1, 2 and 3 sessions for G2 and G3. The roughness and superficial morphology (atomic force microscopy) were evaluated before and at the end of the bleaching treatment. The data were analyzed by Mann-Whitney and Wilcoxon tests (=5%). Results: Significant reduction on enamel hardness was observed after 2 and 3 sessions for G2 and G3. For composite, the reduction occurred after 21 days for G1, and after 3 sessions for G2 and G3 (p<0.05). Significant reduction on roughness and superficial morphology were observed only for enamel of G1 group (p<0.05). Conclusion: The 10% CP gel promoted only superficial alterations on dental enamel, while the 38% H2O2 gel promoted mineral reduction of this dental tissue. All the bleaching protocols promoted reduction on hardness of composite resin.

The performance of conventional and fluorescence-based methods for occlusal caries detection: an in vivo study with histological validation

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES