Prevalence of enamel white spots and risk factors in children up to 36 months old

The aim of this study was to determine the prevalence of enamel white spots and the quality of oral hygiene in children up to 36 months old, in municipalities with different fluoride levels in the water supply, analyzing the contribution of several variables. After approval of the Ethics Committee, the parents signed an informed consent form and were interviewed about their educational level, economic classification of the family, nursing habits, use of toothpaste, access to dental service and other information. The children were clinically examined using the same codes and criteria established by the WHO (World Health Organization) and ADA (American Dental Association). The data were processed and analyzed with the Epi-info software program, version 3.2, and Microsoft Excel. Fisher's exact test (p<0.05) was applied to assess the association among the variables. The enamel white spot prevalence was 30.8% and the age group, duration of the bedtime milk feeding habit, age of initial practice of oral hygiene and presence of caries lesions with cavitation were considered statistically significant with regard to enamel white spot prevalence (p < 0.05). No association was found between oral hygiene quality and the study variables. © 2009 Sociedade Brasileira de Pesquisa Odontológica.

Evaluation of some properties of fermented milk beverages that affect the demineralization of dental enamel

The aim of this in vitro study was to evaluate the erosive capacity of fermented milk beverages, as well as some of their properties that affect the demineralization of dental enamel (pH, buffering capacity, fluoride, calcium and phosphorus contents). Three different batches of 6 commercial brands of fermented milk beverages were analyzed. pH evaluation was accomplished using a potentiometer. The buffering capacity was measured by adding 1 mol L -1 NaOH. Fluoride concentration was assessed by an ion specific electrode after hexamethyldisiloxane-facilitated diffusion, and calcium and phosphorus concentrations were assessed by a colorimetric test using a spectrophotometer. Sixty specimens of bovine enamel were randomly assigned to 6 groups (n = 10). They were exposed to 4 cycles of demineralization in the fermented milk and remineralization in artificial saliva. Enamel mineral loss was determined by surface microhardness (%SMHC) and profilometric tests. The samples' pH ranged from 3.51 to 3.87; the buffering capacity ranged from 470.8 to 804.2 μl of 1 mol L -1 NaOH; the fluoride concentration ranged from 0.027 to 0.958 μgF/g; the calcium concentration ranged from 0.4788 to 0.8175 mgCa/g; and the phosphorus concentration ranged from 0.2662 to 0.5043 mgP/g. The %SMHC ranged from-41.0 to -29.4. The enamel wear ranged from 0.15 μm to 0.18 μm. In this in vitro study, the fermented milk beverages did not promote erosion of the dental enamel, but rather only a superficial mineral loss.

Effect of zoledronic acid used in the root surface treatment of late replanted teeth: A study in rats

This study evaluated the use of zoledronic acid, a resorption inhibitor, as a medication for root resorption treatment of late replanted teeth. Twenty-four maxillary right central incisors of rats were avulsed and kept dry for 30 min. Then, the teeth were divided into 2 groups. In group I, root surface was treated with 2% sodium fluoride for 20 min; in group II, 10-6M zoledronic acid solution was used for 20 min. All root canals were filled with calcium hydroxide. Next, teeth were replanted in their respective sockets. After 15 and 60 days post-replantation, the animals were killed and the anatomic pieces were obtained and prepared for microscopic and morphometric analyses. The results showed that zoledronic acid was capable of limiting the occurrence of root resorption and preserving cementum resorption. Further research must be performed to confirm the use of zoledronic acid in root surface treatment of late replanted teeth.

Topical use of fluorides for caries control

Since the early findings on the protective effects of fluoride present in drinking water upon caries incidence and prevalence, intensive research has been conducted in order to determine the benefits, safety, as well as the cost-effectiveness of other modalities of fluoride delivery. The present chapter reviews the various forms of topical fluoride use - professionally and self-applied - with special emphasis on clinical efficacy and possible side effects. The most widely used forms of fluoride delivery have been subject of several systematic reviews, providing strong evidence supporting the use of dentifrices, gels, varnishes and mouth rinses for the control of caries progression. Dentifrices with fluoride concentrations of 1,000 ppm and above have been shown to be clinically effective in caries prevention when compared to a placebo treatment, but the evidence regarding formulations with 450-550 ppm is still subject of debate. Therefore, the recommendation for low-fluoride dentifrice use must take into account both risks and benefits. The evidence for the combined use of two modalities of fluoride application in comparison to a single modality is still inconsistent, implying that more studies with adequate methodology are needed to determine the real benefits of each method. Considering the currently available evidence and risk-benefit aspects, it seems justifiable to recommend the use of fluoridated dentifrices to individuals of all ages, and additional fluoride therapy should also be targeted towards individuals at high caries risk. © 2011 S. Karger AG, Basel.

Interdisciplinary approach to the management of Ewing sarcoma: A case report

Ewing sarcoma is a common primary bone malignancy occurring in childhood and adolescence. This case report describes a 4-year-old female patient who had Ewing sarcoma in the left clavicular region. The patient underwent total excision of the left clavicle and subsequently developed periodontitis and multiple carious lesions after chemotherapy. Caries risk and salivary flow rate tests were performed, followed by periodontal treatment, topical fluoride application, restoration of caries, and oral hygiene instruction. The care of this patient demonstrates that an interdisciplinary approach is essential to eliminate all foci of infection, minimize morbidity, and improve the patient's general health before, during, and after oncological treatment. © 2012 Special Care Dentistry Association and Wiley Periodicals, Inc.

Expression of opg, rank, and rankl proteins in tooth repair processes after immediate and delayed tooth

This study evaluated the immunohistochemical expression of OPG, RANK, and RANKL proteins in the repair after immediate and delayed replantation of rat teeth. Fifty-six Wistar rats (Rattus norvegicus albinus) had their maxillary right lateral incisor extracted and then replanted, according to the following conditions: group I (control; n = 8), teeth were not extracted; group II (n = 16), immediate replantation; group III (n = 16), delayed replantation without treatment; and group IV (n = 16), delayed replantation after root surface treatment (periodontal ligament removal and immersion in 2% acidulated-phosphate sodium fluoride) and calcium hydroxide intracanal dressing. Rats in group I were euthanized on the first day of the experiment, while the animals in the other groups were euthanized 10 and 60 days after replantation (n = 8/period). Hematoxylin and eosin-stained sections were obtained for histological analysis. The immunohistochemical analysis revealed expression of OPG and RANKL proteins in all groups and both postreplantation times, except for group II at 60 days. In the experimental groups, RANK expression was observed only at 10 days. In conclusion, there was strong immunostaining for the OPG-RANK-RANKL system at the earlier postreplantation time, suggesting a more effective participation of these proteins at the start of the healing process, as their expression decreased at 60 days. Copyright © 2013 by Mutaz B. Habal, MD.

Water fluoridation in 40 Brazilian cities: 7 year analysis.

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.

Efficacy of mouth rinses and toothpaste on tooth whitening.

People increasingly desire tooth whitening. Considering the wide range of whitening products on the market, this study evaluated the efficacy of whitening toothpastes and mouth rinses compared with the 10% carbamide peroxide (CP) whitening gel. We obtained 120 cylindrical specimens from bovine teeth, which were darkened for 24 hours in a coffee solution. The color measurement was performed by a spectrophotometer using the CIE L*a*b* system, and specimens were divided into six groups according to the use of the following agents: group 1, conventional fluoridated toothpaste; group 2, Close Up White Now; group 3, Listerine Whitening; group 4, Colgate Plax Whitening; group 5, experimental mouth rinse with Plasdone; and group 6, 10% CP Whiteness Perfect. After the simulation of 12 weeks of treatment for groups 1 to 5 and 14 days of treatment for group 6, the specimens were subjected to a new color reading. Data were subjected to one-way analysis of variance (α=0.05), which showed significant differences among groups after 12 weeks for ΔE (p=0.001). Results of the Tukey test revealed that groups 3, 4, and 6 presented significantly higher color alteration than groups 1, 2, and 5. The whitening toothpaste Close Up White Now and the experimental mouth rinse with Plasdone showed similar color alteration as conventional toothpaste after a 12-week treatment simulation. These groups presented significantly lower color alteration compared with whitening mouth rinses Listerine and Colgate Plax Whitening, which showed similar results to those observed after 14 days of bleaching with 10% CP treatment.

Effect of controlled conductivity on thermal sensing property of 0-3 pyroelectric composite

Composite films made of lead zirconate titanate ceramic particles coated with polyaniline and poly(vinylidene fluoride) - PZT-PAni/PVDF were produced by hot pressing the powder mixtures in the desired ceramic volume fraction. The ceramic particles were coated during the polyaniline synthesis and the conductivity of the conductor polymer was controlled by different degrees of protonation. Composites were characterized by Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), ac and dc electrical measurements, the longitudinal d33 piezo coefficient and the photopyroelectric response. Results showed that the presence of PAni increased the dielectric permittivity of the composite and allowed better efficiency in the poling process, which increased the piezo- and pyroelectric activities of the composite film and reduced both the poling time and the poling electric field. The thermal sensing of the material was also analyzed, showing that this composite can be used as pyroelectric sensor. © 2013 IOP Publishing Ltd.

Evaluation of the anti-resorptive ability of an experimental acetazolamide paste for the treatment of late replanted teeth: A study in rats

When late replantation is performed, the root surface and root canal should be treated. Notwithstanding failures still occur, because of the high rates of root resorption, evidencing the need to search for substances that may inhibit root resorption. The acetazolamide is a known anti-resorptive agent, and its use as root canal dressing may increase the success rates in the treatment of root resorption. Therefore, this study evaluated the effect of an acetazolamide paste used as root canal dressing in late replanted teeth. The study was conducted on 24 maxillary right incisors of rats, which were avulsed and divided in two groups. In group I, the teeth were kept dry for 30min, had their root surfaces rubbed with a blade, and were treated with 2% sodium fluoride at pH 5.5 for 20min; the root canals were instrumented and filled with acetazolamide paste; and then the teeth were replanted. In group II, the treatment was similar to group I, except for the root canal dressing, with utilization of calcium hydroxide in group II. At 15 and 60days after replantation, the animals were killed and the specimens were processed in a histotechnical laboratory for microscopic and morphometric analysis. The results demonstrated the ability of both intracanal substances to limit root resorption, yet they were unable to completely inhibit the root resorption. Replacement resorption lacunae were present in greater proportion in group II, at 60days. It was concluded that the acetazolamide paste was effective to limit the root resorption, being more effective in limiting the replacement resorption compared with calcium hydroxide. © 2012 John Wiley & Sons A/S.

Growth of calcium phosphate coating on Ti-7.5Mo alloy after anodic oxidation

Titanium and its alloys are widely used as biomaterials due to their mechanical, chemical and biological properties. To enhance the biocompatibility of titanium alloys, various surface treatments have been proposed. In particular, the formation of titanium oxide nanotubes layers has been extensively examined. Among the various materials for implants, calcium phosphates and hydroxyapatite are widely used clinically. In this work, titanium nanotubes were fabricated on the surface of Ti-7.5Mo alloy by anodization. The samples were anodized for 20 V in an electrolyte containing glycerol in combination with ammonium fluoride (NH4F, 0.25%), and the anodization time was 24 h. After being anodized, specimens were heat treated at 450 °C and 600°C for 1 h to crystallize the amorphous TiO2 nanotubes and then treated with NaOH solution to make them bioactive, to induce growth of calcium phosphate in a simulated body fluid. Surface morphology and coating chemistry were obtained respectively using, field-emission scanning electron microscopy (FEG-SEM), AFM and X-ray diffraction (XRD). It was shown that the presence of titanium nanotubes induces the growth of a sodium titanate nanolayer. During the subsequent invitro immersion in a simulated body fluid, the sodium titanate nanolayer induced the nucleation and growth of nano-dimensioned calcium phosphate. It was possible to observe the formation of TiO2 nanotubes on the surface of Ti-7.5Mo. Calcium phosphate coating was greater in the samples with larger nanotube diameter. These findings represent a simple surface treatment for Ti-7.5Mo alloy that has high potential for biomedical applications. © (2013) Trans Tech Publications, Switzerland.

Avaliação da liberação de íon fluoreto de cimentos ionoméricos antes e após a recarga e com proteção da superfície

Objective: To evaluate fluoride ion release from two anhydrous glass ionomer cements (GICs) and two resin-modified GICs (RMGICs) before and after recharge with 2% neutral sodium fluoride for 4 min and after surface protection of the Maxxion R GIC with an adhesive system, a cavity varnish and a colorless nail polish. Method: A stainless steel 2x6 mm matrix was used for fabricating 5 specimens of each material, which were immersed in 5 mL of deionized water, renewed every 24 h. Measurements with a potentiometer were performed on days 1, 2, 9 and 17, in the 1st and 2nd phases, and the specimens were buffered with a TISAB III solution. In the 2nd phase, the specimens were subjected to recharge and immersed again in 5 mL of deionized water. In the 3rd phase, the GIC surfaces were protected and readings were made at 5 min, 24 h, 48 h and 72 h. Tukey's post-hoc and Student's t tests were used for statistical analyses (p<0.05). Results: There was statistically significant difference in the comparison between the 1st and 2nd phases for all materials, except at day 2 for Vidrion R and VitroFil LC. In the 3rd phase, it was observed that for all materials, comparison of the first 5 min with the other times revealed statistically significant differences among the means of fluoride ion release. In the comparison with the other times, both the varnish and the colorless nail polish presented statistically significant difference between 24 and 48 h as well as between 24 and 72 h. Conclusion: The anhydrous GICs were more effective in fluoride ion release and recharge compared with the RMGICs. Maxxion R presented a homogeneous and statistically significant behavior in both phases. All materials for surface protection were efficient and the colorless nail polish had the best behavior.

Effect of sodium trimetaphosphate on hydroxyapatite solubility: An in vitro study

This study evaluated the effect of different concentrations of sodium trimetaphosphate (TMP) with and without fluoride (F) on the concentration of calcium (Ca), phosphorus (P) and F in hydroxyapatite (HA). Synthetic HA powder (0.15 g) was suspended (n=6) in solutions (75 mL) of TMP at 0%, 0.1%, 0.2%, 0.4%, 0.6%, 0.8%, 1.0%, 2.0%, 4.0%, 6.0%, 8.0% and 10% concentrations in the presence and absence of 100 ppm F and subjected to a pH-cycling process. The precipitates were filtrated, dried at 70° C for 24 h and ground onto a fine powder. The concentrations of F (KOH (CaF2) and HCl (FA) soluble), Ca (Arsenazo III), and P (molybdate method) in HA were determined. The Ca P, and Ca/P ratio data were subjected to Tukey's test and the F data were subjected to Student-Newman-Keuls test (p<0.05). The addition of TMP to the samples reduced F deposition to 98% (p<0.001). The groups containing 100 ppm F and 0.4% or 0.6% TMP exhibited a higher Ca concentration than the group containing only 100 ppm F (p<0.05). Furthermore, the HA treated with 0.2% and 0.4% TMP and 100 ppm F showed a higher Ca/P ratio than the other groups (p<0.001). In conclusion, TMP at 0.2%, 0.4% and 0.6% concentrations combined with F seemed to be able to precipitate HA with low solubility. However, especially at high concentrations, TMP interferes with F deposition on HA.

In vitro evaluation of the effect of mouth rinse with trimetaphosphate on enamel demineralization

Objective: The aim of this study was to investigate the effectiveness of sodium trimetaphosphate (TMP) addition to mouth rinses to inhibit enamel demineralization. Design: Bovine enamel blocks (n = 88) were selected by surface hardness and divided into eight treatment groups (n = 11 per group): placebo, 100 or 225 μg F/ml; the rinses with 100 μg F/ml had differing TMP concentrations (range 0-0.6%). The blocks were subjected to pH cycling for 5 days and treated twice a day with mouth rinses. After that, surface and cross-sectional hardness as well as fluoride in enamel were measured. Results: The groups containing both 100 μg F/ml and 0.4% TMP inhibited demineralization most effectively (p < 0.001). This formulation yielded lower values of lesion areas than the formulations containing 100 or 225 μg F/ml but no TMP. The addition of 0.4% TMP increased the fluoride in enamel. Conclusion: It is possible to improve the effectiveness of a mouth rinse with 100 μg F/ml by addition of TMP, this being superior in inhibiting enamel demineralization compared with mouth rinses containing 225 μg F/ml. © 2013 S. Karger AG, Basel.