<p>The American Academy of Pediatric Dentistry (2005/06) defines Early Childhood Caries (ECC) as the presence of 1 or more decayed (noncavitated or cavitated lesions), missing (due to caries), or filled tooth surfaces in any primary tooth in a child 71 months of age or younger. ECC can cause significant problems in preschool children and is a source of considerable societal costs. The South African national oral health survey conducted between the year 1999 and 2002 reported on the caries prevalence in young children. The caries prevalence was 50% in 4-5 year old children with a mean dmft of 2.4 (van Wyk and van Wyk, 2004).The aim of the study is to assess early childhood caries in children 12-24 months in the Mitchell's Plain district of the Western Cape.Objectives are to determine: a) The prevalence and pattern of early childhood caries. b) The relation between early childhood caries and infant feeding practices. c) The relation between early childhood caries and oral hygiene practices of the child.</p> <p>This study is a cross sectional study of ECC of children 12-24 months of age. Parent/child pair attending the Well Baby Clinic at Eastridge/Mitchell's Plain were informed about the study and invited to participate on a voluntary basis. The data collected consisted of a dental examination of 120 children (stratified by age: 60 in 12-18 months age group and 60 in 19-24 months age group) and a questionnaire completed by the accompanying parent/guardian. The dental examination was conducted using the WHO guidelines (Geneva 1997). Child age, tooth status (sound, decayed, filled, extracted, unerupted), and visible dental plaque on maxillary incisors (Spitz et al, 2006) were recorded.The prevalence of ECC for the sample was 23.3% (dmft =0.88). The maxillary incisors had the highest prevalence of decay (14%) followed by the maxillary molars (4%). There was a significant association (p=.006) between duration (12 months and more) of bottle use and presence of caries (40% caries prevalence). There is no significant difference between the different feeding practices (breast, bottle or both) and the presence of caries. There is a high prevalence of Early Childhood Caries (23.3%) in the 12-24 month age group. Early Childhood Caries was related to prolonged (&gt / 12 months) bottle feeding. The association between the presence of dental plaque and ECC was the most significant factor (p= .000).</p>

<p>The American Academy of Pediatric Dentistry (2005/06) defines Early Childhood Caries (ECC) as the presence of 1 or more decayed (noncavitated or cavitated lesions), missing (due to caries), or filled tooth surfaces in any primary tooth in a child 71 months of age or younger. ECC can cause significant problems in preschool children and is a source of considerable societal costs. The South African national oral health survey conducted between the year 1999 and 2002 reported on the caries prevalence in young children. The caries prevalence was 50% in 4-5 year old children with a mean dmft of 2.4 (van Wyk and van Wyk, 2004).The aim of the study is to assess early childhood caries in children 12-24 months in the Mitchell's Plain district of the Western Cape.Objectives are to determine: a) The prevalence and pattern of early childhood caries. b) The relation between early childhood caries and infant feeding practices. c) The relation between early childhood caries and oral hygiene practices of the child.</p> <p>This study is a cross sectional study of ECC of children 12-24 months of age. Parent/child pair attending the Well Baby Clinic at Eastridge/Mitchell's Plain were informed about the study and invited to participate on a voluntary basis. The data collected consisted of a dental examination of 120 children (stratified by age: 60 in 12-18 months age group and 60 in 19-24 months age group) and a questionnaire completed by the accompanying parent/guardian. The dental examination was conducted using the WHO guidelines (Geneva 1997). Child age, tooth status (sound, decayed, filled, extracted, unerupted), and visible dental plaque on maxillary incisors (Spitz et al, 2006) were recorded.The prevalence of ECC for the sample was 23.3% (dmft =0.88). The maxillary incisors had the highest prevalence of decay (14%) followed by the maxillary molars (4%). There was a significant association (p=.006) between duration (12 months and more) of bottle use and presence of caries (40% caries prevalence). There is no significant difference between the different feeding practices (breast, bottle or both) and the presence of caries. There is a high prevalence of Early Childhood Caries (23.3%) in the 12-24 month age group. Early Childhood Caries was related to prolonged (&gt / 12 months) bottle feeding. The association between the presence of dental plaque and ECC was the most significant factor (p= .000).</p>

Background There is a transition towards minimally invasive restorative techniques in restorative dentistry based upon reducing bacterial viability and encouraging remineralization of caries infected tissue. To improve the predictability of the antibacterial and remineralization potential of carious dentine by either the application of medicaments or placement of restorative materials that encourage remineralization would be a significant benefit in disease management. Materials and Methods An experimental model was developed using a chemostat for in vitro analysis of the effects of silver fluoride followed by potassium iodide (AgF/KI) and ozone treatment on non demineralized and demineralized dentine. Electron Probe Micro Analysis (EPMA) and Scanning Electron Microscopy (SEM) on the treated dentine were conducted to investigate ion transfer, and biofilm formation. Bacteria growth was measured by optical density. An in vitro caries model using a chemostat was developed to determine the ability of glass ionomer cement and composite resin to inhibit dentinal degradation in adjacent dentine and to measure ion exchange at the restorative interface. Tests were made to determine the bond strength between dentine and glass ionomer cement after application of silver fluoride to the surface of the dentine. Results S. mutans migrated through all dentine samples. Samples treated with AgF/KI had significantly lower optical densities than the corresponding controls. Optical density readings were significantly lower in demineralized dentine treated with AgF/KI than non demineralized dentine. There were lower but not significant differences in the optical density readings between ozonated and non ozonated dentine. An S. mutans biofilm covered all control discs. No biofilm was detected on discs treated with AgF/KI and these discs were significantly more resistant to further demineralization than the control discs. Detectable amounts of silver and fluoride were found up to 450 μm in the AgF and AgF/KI sections. Ozone infusion prevented S. Mutans and L. acidophilus biofilm formation on all the treated dentine samples, biofilm was present on all control specimens. There was calcium and phosphorus present in all auto cure glass ionomer cements to a depth beyond 50 microns. Aluminium and strontium ions were also present in dentine except strontium subjacent to Ketac Molar restorations. Fluoride uptake was significantly higher under glass ionomer cement restorations where the dentine was pretreated with AgF/KI compared to non treated specimens. Silver and iodine deposits were present in demineralized dentine treated with AgF/KI. Calcium and phosphorus levels up to 130 microns from the restorative interface were similar to non demineralized dentine adjacent to auto cure glass ionomer cements and half that adjacent to composite resin. There was significant surface degradation in auto cure glass ionomer cements compared to composite resin. Washing away the AgF/KI precipitate produced higher bond strengths to dentine than samples where the precipitate remained. Conclusions Under the conditions of these in vitro studies, the application of AgF/KI and ozone pharmacologically reduces the initiation and rate of dentine caries. Glass ionomer cements were shown to protect dentine from experimental carious degradation and assist with remineralization. AgF/KI application enhances remineralization beneath glass ionomers and does not interfere with bond strengths. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1344616 / Thesis (Ph.D.) - University of Adelaide, Dental School, 2008

Made available in DSpace on 2014-06-11T19:28:38Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-03-25Bitstream added on 2014-06-13T18:58:04Z : No. of bitstreams: 1 pellizzaro_d_me_arafo.pdf: 501665 bytes, checksum: 45c7da463c0ecbc1bda09d0615a81f92 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A Candida albicans tem sido considerada o principal agente etiológico da estomatite protética, uma das infecções mais comumente observadas em pacientes usuários de próteses removíveis. A adesão de C. albicans à superfície das próteses é o primeiro passo para o desenvolvimento da estomatite protética. Assim, uma adequada higienização das próteses é essencial para prevenir a formação de biofilme microbiano sobre a superfície protética e, conseqüentemente, o início e propagação desta infecção. O objetivo deste estudo foi avaliar a efetividade da escovação com diferentes soluções (água destilada, dentifrício, digluconato de clorexidina a 2%, hipoclorito de sódio a 1% e Polident fresh cleanse®) na redução da viabilidade de um biofilme maduro de C. albicans, desenvolvido sobre uma resina termopolimerizável para base de prótese. Para isso, 90 corpos-de-prova circulares foram confeccionados, esterilizados e inoculados com uma suspensão de 107 células/mL de C. albicans. Para a formação do biofilme, todos os corpos-de-prova foram incubados por 48 h a 37 °C sob agitação. A seguir, os corpos-de-prova foram aleatoriamente divididos (n=9) e individualmente submetidos à escovação ou exposição por 90 s nas diferentes soluções avaliadas. Os espécimes imersos em água destilada pelo mesmo período de tempo foram utilizados como controle positivo. Para verificar a efetividade da escovação e dos agentes de limpeza, os corpos-de-prova foram submetidos à avaliação da atividade metabólica das células não removidas de C. albicans por meio do teste do XTT. Os resultados obtidos foram analisados estatisticamente pelos testes de Mann-Whitney e Kruskal-Wallis (α=0.05). A escovação com todos os agentes de limpeza apresentou redução significativamente superior (p<0,0001) na viabilidade do biofilme quando comparada à exposição dos corpos-de-prova... / The adhesion of C. albicans to surfaces is the prerequisite for occurrence of denture stomatitis, a common disease diagnosed among denture wearers. Therefore, a strict routine of denture cleansing is essential to prevent biofilm formation on the acrylic denture surface and the onset of this infection. Thus, the aim of the current study was to investigate the effectiveness of combining toothbrushing and cleansing agents (dentifrice, 2% chlorhexidine gluconate, 1% sodium hypochlorite, and Polident fresh cleanse®) in inactivating C. albicans biofilm. Circular specimens (10 x 2 mm) of acrylic resin denture base material were made, sterilized, and individually inoculated with C. albicans (1x107 colony-forming units/mL). After incubation (37 °C/48 h), the specimens were divided into 10 experimental groups (n=9): 5 subjected to toothbrushing with different cleansing agents and 4 exposed to the cleansing agents without toothbrushing. Non–cleansed specimens were used as positive controls. The viability of cells was evaluated by XTT reduction method. Mann-Whitney and Kruskal-Wallis tests were used for comparative analysis between the two methods of cleansing and the cleansing agents, respectively (α=0.05). Toothbrushing with all agents was significantly more effective (p<0.0001) in reducing biofilm viability than exposure to the cleansing agents only. Exposure to all cleansing agents reduced significantly (p<0.0001) the biofilm viability, with 2% chlorhexidine gluconate being most effective (p<0.0001). Toothbrushing with 2% chlorhexidine gluconate and 1% sodium hypochlorite resulted in 100% inactivation of the biofilm. The use of cleansing agents as an adjunct to toothbrushing is an effective method to reduce C. albicans biofilm viability on denture base resins.

The aim of this work was to evaluate the influence of pre-brushing mouthwashes on plaque removal on adolescents. The study was conducted following a double-blinded crossover model, for 25 days, with 4-day interval between phases. The study protocol was previously approved by the Human Research Ethics Committee of UFSM. Thirty-eight adolescents (mean age 13 years) from a school in Santa Maria- RS randomly used two pre-brushing mouthwashes commercially available (Magic Colgate Plax and Listerine Agent Cool Blue) and two solutions used as control (water + dye and water). A single trained and calibrated examiner (kappa = 0.8) carried out the evaluation of plaque index (PI) (Silness and Löe, 1964) before and after the use of mouthwashes and tooth brushing, assigned as initial and final IP, respectively. The mean IP values were similar between experimental groups at the initial and final (Wilcoxon rank test, p> 0.05) also between buccal and lingual surfaces (Wilcoxon rank test, p> 0.05). Similarly, the plaque reduction (final IP - initial IP) was not statistically different among the solutions (Friedman test, p = 0.782). The use of commercially available and free acquisition pre brushing mouthwash solutions does not influence dental plaque removal in adolescents / Este trabalho teve como objetivo avaliar a influência do uso de enxaguantes bucais pré-escovação na remoção da placa bacteriana por adolescentes. Foi realizado um estudo seguindo o modelo cruzado, de duplo mascaramento, com duração total de 25 dias, com 4 dias de intervalo entre as fases. O protocolo da pesquisa obteve aprovação pelo Comitê de Ética em pesquisa da UFSM. Trinta e oito adolescentes (idade média de 13 anos) de uma escola estadual da cidade de Santa Maria RS, utilizaram dois enxaguantes bucais pré-escovação disponíveis comercialmente (Colgate Plax Magic e Listerine Agente Cool Blue) e duas soluções controle (água+corante e água), em ordem aleatória. Um único examinador previamente treinado e calibrado (kappa = 0,8) realizou a avaliação dos índices de placa (IP) antes e após o uso dos enxaguantes bucais e escovação dentária, considerados IP inicial e IP final (Silness e Löe, 1964). Os valores médios do IP foram similares entre os grupos experimentais nos momentos inicial e final (Wilcoxon rank test, p>0,05) assim como entre as superfícies vestibulares e linguais/palatinas (Wilcoxon rank test, p>0,05). Da mesma forma, a redução de placa (IP final IP inicial) não foi estatisticamente diferente entre as soluções testadas (Friedman test, p=0,782). O uso de soluções enxanguantes pré-escovação disponíveis comercialmente e de livre aquisição não influencia a remoção de placa dentária em adolescentes.

Made available in DSpace on 2014-06-11T19:27:47Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-02-24Bitstream added on 2014-06-13T18:56:30Z : No. of bitstreams: 1 ferreira_l_me_araca.pdf: 1328677 bytes, checksum: e8654f5c6e3eb77d8eb2d430f398667d (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Muito tem se avaliado a respeito das propriedades físicas e químicas dos selantes de fóssulas e fissuras, mas pouco sobre seus efeitos no biofilme dentário. O objetivo deste estudo foi analisar as características bioquímicas e microbiológicas do biofilme dentário formado in situ sobre materiais que liberam flúor ou cálcio e fosfato. Dez voluntários utilizaram dispositivo intrabucal palatino contendo corpos-de-prova de materiais (Fuji IX GP, Auralay XF e Aegis) ou blocos de esmalte bovino. A fase experimental consistiu de 4 etapas de 8 dias cada e a utilização de sacarose para formação do biofilme. No 7º dia dos períodos experimentais foi determinado o pH do biofilme e no 8º dia, o biofilme dentário formado foi coletado para determinação de flúor (F), cálcio (Ca), fósforo (P) e polissacarídeos extracelulares insolúveis (PEI) além da microbiota. Verificou-se a liberação de F, Ca e P de cada material e dos blocos de esmalte após ciclagem de pH. Após a verificação da homogeneidade dos dados, testes paramétricos e não-paramétricos foram realizados para análise dos resultados (p<0,05). O biofilme dentário formado sobre os materiais que liberam flúor apresentou maior presença de F, Ca e P e menor número de estreptococos do grupo mutans quando comparado ao bloco de esmalte. Após o uso da sacarose (7º dia), o pH do biofilme foi maior na presença do material ionomérico. O biofilme sobre o material que contém fosfato de cálcio amorfo mostrou similar concentração de Ca e P, quando comparado aos materiais que contém flúor, e uma ação tamponante no meio, sem efeito na microbiota. Concluiu-se que os materiais que liberam flúor aumentaram as concentrações de F, Ca e P e diminuíram a de PEI e a microbiota cariogênica do biofilme dentário; e o que contém fosfato de cálcio amorfo aumentou as concentrações de Ca e P / The chemical and physical properties of the pit and fissures sealants have been widely evaluated but rare researches focus on the effects on dental plaque. The aim of this study was to evaluate the biochemical and microbiological characteristics of the in situ dental plaque formed on materials that release fluoride or calcium and phosphate. Ten volunteers wore an intraoral palatal device containing specimens of materials (Fuji IX GP, Auralay XF and Aegis) or bovine enamel blocks. The experimental phase consisted of 4 stages with duration of 8 days each and use of sucrose to form the dental plaque. The dental plaque pH was determined at the 7th day of the experimental periods and the dental plaque was collected at the 8th day to determine the fluoride (F), calcium (Ca), phosphorus (P), insoluble extracellular polysaccharides (EPS) and microbiota. It was observed release of F, Ca and P from each material and from the enamel blocks after pH cycling. After verification of data homogeneity, parametric and non-parametric tests were performed (p<0.05). The dental plaque formed on the materials that release fluoride presented more F, Ca and P and reduced number of Streptococcus mutans in comparison to the enamel block. After use of sucrose (7th day), the dental plaque pH was higher with the presence of ionomeric material. The dental plaque on the material containing amorphous calcium phosphate exhibited similar Ca and P concentration compared to the ones on fluoride materials, and buffering action with no effect on the microbiota. It was concluded that the materials that release fluoride increased F, Ca and P concentrations, decreased EPS concentration and the cariogenic microbiota of the dental plaque; the amorphous calcium phosphate material increased concentrations of Ca and P

Made available in DSpace on 2014-12-17T14:13:26Z (GMT). No. of bitstreams: 1 EduardoJGS.pdf: 119973 bytes, checksum: dbdb322fee12ba3edd9d72e5446d9c91 (MD5) Previous issue date: 2009-09-23 / The science of Dentistry wishes obtains the ideal solution for the dental plaque chemical control. This research evaluated antimicrobial action capacity in calcium hydroxide and tergentol various solutions starting for the CHD 20, a root canals irrigating solution with a reason of 80% calcium hydroxide saturated solution and 20% tergentol detergent with the aim of evaluate this drug mouth rinse indication with prevention or combat objective for dental caries and periodontal diseases. Antibiogram disks and biofilm tests were accomplished for the microorganisms: Streptococcus mutans, Streptococcus sanguis, Streptococcus sobrinus and Lactobacillus casei. Different reasons of detergent for the calcium hydroxide saturated solution, tergentol and distillated water solution, 0,12% clorhexydine digluconate solution was positive control and distillated water was negative control. The results showed better performance of clorhexydine in relation to calcium hydroxide directing to not accept this (CHD20) as mouth rinse solution / Na busca pela ci?ncia odontol?gica de se chegar ao composto que possa ser considerado o agente ideal para o controle qu?mico do biofilme dental foi idealizado este estudo. Avaliou-se a capacidade antimicrobiana in vitro de diferentes solu??es a base de hidr?xido de c?lcio e tergentol partindo em princ?pio do HCT 20, solu??o irrigadora dos canais radiculares composta por 80% da solu??o saturada de hidr?xido de c?lcio (?gua de cal) e 20% do detergente tergentol buscando verificar sua poss?vel indica??o como solu??o para bochechos, visando preven??o ou combate a doen?as como c?rie dent?ria e doen?a periodontal. No laborat?rio de microbiologia do Departamento de Odontologia da UFRN, foram realizados testes em discos de antibiograma para os microrganismos: Streptococcus mutans, Streptococcus sanguis, Streptococcus sobrinus e Lactobacillus casei. Bem como em bact?rias formadoras de biofilme para os mesmos, ? exce??o do L. casei. Estipulou-se diferentes concentra??es de tergentol para a ?gua de cal, al?m do tergentol em ?gua destilada, usou-se digluconato de clorexidina a 0,12% como controle positivo e ?gua destilada como controle negativo. Os resultados mostraram desempenho inferior das solu??es a base de Ca(OH)2 em rela??o ? clorexidina frente a estes microrganismos e ? metodologia empregada, direcionando pois, para a n?o indica??o do uso do HCT 20 como colut?rio bucal

FundaÃÃo Cearense de Apoio ao Desenvolvimento Cientifico e TecnolÃgico / CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / Over the past few years, there has been increasing evidence of the effect of the oral health over the general health of individuals, supported by a series of biological and epidemiological studies that show a relation between the mouth and many diseases, including cardiovascular diseases. Structural deficiencies and functional abnormalities of heart valves represent an important cause of cardiovascular morbidity and mortality in Brazil, and a few defects have been recently associated with infectious agents. The aim of this study was to identify cariogenic and periodontopathogenic bacteria in dental plaque, saliva and heart valves, without clinical endocarditis, of patients with heart valve diseases, and correlate these findings with the oral health status of the patients. Oral exams using the DMTF (decayed, missing and filled teeth) and PSR (Periodontal Screening and Recording) indexes to evaluate caries and periodontal disease, respectively, were performed. Samples of supragingival and subgingival dental plaque, saliva and cardiac valves were evaluated, through Real Time Polymerase Chain Reaction, for the presence of DNA of Streptococcus mutans (S. mutans), Prevotella intermedia (P. intermedia), Porphyromonas gingivalis (P. gingivalis) and Treponema denticola (T. denticola). A total of 114 samples were collected from 42 patients with a mean age of 55.6  13.8 years. The average number of missing teeth due to caries was 23.52  9.41 teeth per patient, and according to the highest score of periodontal disease observed for each patient, excluding edentulous patients (44.0%), periodontal pockets over 4mm (43.4%) and dental calculus (34.7%) were detected in a higher number of patients. The molecular analysis of the oral samples revealed high frequency of S. mutans and P. intermedia in supragingival dental plaques, subgingival dental plaques and saliva of dentate and edentulous patients (variation 60.0% - 100.0%), while P. gingivalis and T. denticola were detected in a smaller number of oral samples (variation 17.6% - 64.0%). The microorganism most frequently detected in heart valve samples was the S. mutans (89.3%), followed by P. intermedia (19.1%), P. gingivalis (4.2%) e T. denticola (2.1%). Significant difference was observed between the frequency of P. intermedia, P. gingivalis and T. denticola in the heart valve and dental plaque, as oposed to S. mutans. The identification of oral bacteria, especially S. mutans, in heart valves of patients with a previous history of dental caries and gingivitis/periodontitis suggests the possible involvement of these pathogens in the etiopathogenesis of heart valve diseases. / Atualmente, cada vez mais se tem evidÃncias do efeito da condiÃÃo oral na saÃde geral dos indivÃduos, atravÃs de uma sÃrie de estudos epidemiolÃgicos e biolÃgicos que mostram uma relaÃÃo entre a boca e diversas doenÃas, incluindo as doenÃas cardiovasculares. Desordens estruturais e nas funÃÃes das vÃlvulas cardÃacas representam uma importante causa de morbidade e mortalidade cardiovascular no Brasil, sendo alguns processos, como a estenose aÃrtica degenerativa, mais recentemente associados a agentes infecciosos. O objetivo desta pesquisa foi identificar bactÃrias cariogÃnicas e periodontopatogÃnicas na placa dental, saliva e vÃlvulas cardÃacas, sem endocardite clÃnica, de pacientes com doenÃa valvar, correlacionando esses achados à condiÃÃo bucal dos indivÃduos. AvaliaÃÃo, quanto Ãs doenÃas cÃrie e periodontal, foi realizada, atravÃs dos Ãndices CPO-D (Dentes Permanentes Cariados, Perdidos e Obturados) e PSR (Registro Periodontal Simplificado), respectivamente. Amostras de placa dental supragengival, subgengival, saliva e vÃlvula cardÃaca foram coletadas para investigaÃÃo da presenÃa de DNA, atravÃs de PCR (ReaÃÃo em Cadeia de Polimerase) em tempo real, de Streptococcus mutans (S. mutans), Prevotella intermedia (P. intermedia), Porphyromonas gingivalis (P. gingivalis) e Treponema denticola (T. denticola). Um total de 114 amostras foi coletado de 42 pacientes com mÃdia de idade de 55.6  13.8 anos. A mÃdia de dentes perdidos devido à cÃrie, por paciente, foi em torno de 23.52  9.41 e, segundo o maior grau de doenÃa periodontal observado no indivÃduo, excluindo-se os pacientes desdentados totais (44.0%), bolsa superior a 4 mm (43.4%) e o cÃlculo dental (34.7%) esteve presente em um maior nÃmero de pacientes. A anÃlise molecular das amostras bucais revelou alta frequÃncia de S. mutans e P. intermedia nas placas supragengival, subgengival e saliva de pacientes dentados e desdentados (variando entre 60.0% e 100.0%), enquanto que P. gingivalis e T. denticola estiveram presentes em menor nÃmero de amostras bucais (variando entre 17.6% e 64.0%). O micro-organismo mais frequentemente encontrado nas amostras valvares foi o S. mutans (89.3%), seguido da P. intermedia (19.1%), P. gingivalis (4.2%) e T. denticola (2.1%). DiferenÃa significativa foi encontrada entre a presenÃa de P. intermedia, P. gingivalis e T. denticola na vÃlvula e na placa dental, diferentemente do S. mutans. A identificaÃÃo de bactÃrias orais, principalmente S. mutans, em vÃlvulas cardÃacas de pacientes com elevada experiÃncia prÃvia de cÃrie e ocorrÃncia de gengivite/periodontite, sugere o possÃvel envolvimento desses patÃgenos nas doenÃas valvares.

Neste estudo foi avaliado o efeito de uma formulação de dentifrício líquido com pH acidulado e baixa concentração de flúor (F) na prevenção de novas lesões cariosas e na incorporação de F no biofilme dentário e nas unhas. Foram selecionadas 1.402 crianças com idade inicial de 4 anos e experiência de cárie, as quais foram divididas em 4 grupos que diferiram em relação ao dentifrício utilizado por 20 meses: G1dentifrício líquido (1100 ppmF, NaF, pH 4,5, n=345), G2 - dentifrício líquido (1100ppmF, NaF, pH 7,0, n=343), G3 - dentifrício líquido (550 ppmF, NaF, pH 45, n=354), G4 pasta comercial Sorriso Fresh (controle -1100 ppmF, NaF, pH 7,0, n=360. A pasta comercial e os dentifrícios experimentais foram dispensados na escova usando as técnicas transversal e da gota , respectivamente. A progressão de cárie (ceo-s) foi avaliada no início do estudo e após 12 e 20 meses de uso contínuo dos dentifrícios. Uma subamostra de cada grupo participou na segunda etapa do estudo, conduzida 15 meses após o início da primeira etapa. Após as unhas das mãos e dos pés terem sido deixadas crescer por 14 dias, foram coletadas unhas das mãos e dos pés em duas ocasiões separadas (n=15 para cada grupo). Amostras de biofilme dentário foram coletadas 1 h após a última utilização dos respectivos dentifrícios (n=21 por grupo). Biofilme e unhas foram analisados para o F com eletrodo, após difusão facilitada por HMDS. Os dados de ceo-s foram analisados pelo teste Kruskal-Wallis (p <0,05). Os dados do biofilme foram analisados por ANOVA e teste de Tukey, ao passo que os dados das unhas foram analisados por ANOVA a dois critérios de medidas repetidas e teste de Bonferroni (p <0,05). Após 20 meses, 1053 escolares (G1=271, G2=262, G3=250 e G4=270) completaram o estudo. As médias (±DP) do ceo-s no baseline e após 20 meses, e do respectivo incremento para cada grupo foram, respectivamente: G1) 5,07±5,11, 7,13±6,53 e 30,8%; G2) 4,80±5,00, 6,88±6,78 e 31,9%; G3) 5,24±5,37, 7,29±7,27 e 30,5%; G4) 5,05±4,89, 7,13±6,35 e 31,1%. Não houve diferença significativa entre os grupos para nenhuma dessas variáveis. A média (±EP, unidade mmol / Kg de peso seco) das concentrações de F no biofilme foram 3,091±0,984a, 1,667±0,410a, 1,448±0,303a e 0,405±0,103b para G1, G2, G3 e G4, respectivamente. As [F]s nas unhas das mãos foram significativamente mais elevadas quando comparadas às dos pés. As mais altas concentrações de F foram encontradas para a pasta comercial, diferindo significativamente dos dentifrícios líquidos. As menores [F]s foram encontradas para o dentifrício de 550 ppm F, diferindo significativamente dos demais dentifrícios. Os dentifrícios líquidos de 1100 ppm F levaram a [F]s intermediárias nas unhas e não diferiram significativamente um do outro. Os resultados sugerem que o dentifrício de baixa concentração de F (550 ppm) e pH acidulado tem a mesma eficácia anti-cáries que os dentifrícios convencionais (1100 ppm F). A redução do pH do dentifrício aumenta a incorporação de F no biofilme sem afetar a concentração de F nas unhas. Portanto, o uso do dentifrício de baixa concentração de F e pH acidulado parece ser uma boa alternativa para prevenir cárie dentária e reduzir a ingestão de F a partir do dentifrício em crianças pequenas. / The purpose of this study was to evaluate the efficacy of a liquid dentifrice with reduced pH and low fluoride concentration for the prevention of new carious lesions and fluoride uptake in dental biofilm and nails. One thousand four hundred and two 4-year-old schoolchildren with caries experience were randomly allocated to 4 groups, differing according to the dentifrice used for 20 months: G1liquid dentifrice (1,100 ppmF, NaF, pH 4.5, n=345), G2-liquid dentifrice (1,100 ppmF, NaF, pH 7.0, n=343), G3-liquid dentifrice (550 ppmF, NaF, pH 4.5, n=354), G4-commercial toothpaste (control-1,100 ppmF,NaF, pH 7.0, n=360). The liquid dentifrices and toothpaste were applied to the toothbrush using the drop and transverse techniques, respectively. Caries progression (dmfs) was evaluated at baseline and after 12 and 20 months of continuous use of the dentifrices. A subsample of each group participated in the second section. Fingernails and toenails were clipped in two separate occasions, after being allowed to grow for 14 days (n=15 for each group). Plaque samples were collected 1 hr after the last use of the respective dentifrices (n=21 for each group). Plaque and nails [F]s were analyzed with the electrode, after HMDS-facilitated diffusion. dmfs data were analyzed by Kruskal-Wallis test (p<0,05).Plaque data were tested by ANOVA and Tukey\'s test, while nails data were analyzed by two-way repeated-measures ANOVA and Bonferroni\'s test (p<0.05). Results: 1,053 children were examined after 20 months (271, 262, 250 and 270 children for G1, G2, G3 and G4, respectively). Mean dmfs(±SD) at baseline, after 20 months and % increment were, respectively: G1) 5.07±5.11, 7.13±6.53 and 30.8%; G2) 4.80±5.00, 6.88±6.78 and 31.9%; G3) 5.24±5.37, 7.29±7.27 and 30.5%; G4) 5.05±4.89, 7.13±6.35 and 31.1%. No significant differences were found among the groups for all the variables tested. Mean (±se, unit mmol/Kg dry weight) plaque [F]s were 3.091±0.984a, 1.667±0.410a, 1.448±0.303a 0.405±0.103b for G1, G2, G3 and G4, respectively. Fingernails [F]s were significantly higher when compared to toenails. The highest [F]s were found for that significantly differed from the experimental liquid dentifrices, except for A (toenails only). The lowest [F]s were found for C, which significantly differed from all the other dentifrices. The experimental 1,100 ppm F dentifrices led to intermediary [F]s in nails and did not significantly differ from each other. Conclusions: The results suggest that the low-fluoride (550 ppm F) acidic dentifrice has the same anticaries effectiveness as the conventional 1,100 ppm F dentifrices. The reduction of the dentifrice pH increases the F uptake in dental plaque and does not affect nails [F]s. Thus, the use of low-fluoride acidic dentifrices seems to be a good alternative to prevent dental caries and reduce the F intake from dentifrice in small children.

Orientador: Marines Nobre dos Santos Uchoa / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-13T08:04:08Z (GMT). No. of bitstreams: 1 Steiner-Oliveira_Carolina_D.pdf: 11802864 bytes, checksum: 338ee3278fb157bb1cb37edb2e6d1a5d (MD5) Previous issue date: 2009 / Resumo: Os efeitos causados pelas modificações promovidas pela irradiação com laser de CO2 podem inibir a desmineralização dos tecidos dentários e podem ser potencializados quando associados ao fluoreto. Apesar de amplo uso do fluoreto e da redução da prevalência de cárie, essa doença ainda acomete grupos de alto risco. Por outro lado, tem sido observado um aumento da prevalência da erosão dentária. Os objetivos dessa tese, composta por 4 manuscritos, foram: (1) descrever as características do laser de CO2 e seus mecanismos de ação na inibição da desmineralização do esmalte; (2) desenvolver um modelo microbiológico, in vitro, de produção de lesão de cárie em dentina e testar duas hipóteses: (a) de que não há diferença na produção de cárie artificial em dentina utilizando um modelo microbiológico com regimes de 3 e 6 imersões ao dia em sacarose, avaliados por contagem bacteriana da dentina (UFC), análise microrradiográfica (AM) e análise de polissacarídeo insolúvel (API); (b) de que não há diferença no pH do biofilme antes e após sua imersão em sacarose; (3) avaliar, in vitro, a efetividade do laser de CO2 (? = 10,6 µm) pulsado, associado ou não ao fluoreto, na redução da desmineralização da dentina radicular usando um modelo microbiológico, avaliado por AM; (4) avaliar, in vitro, o efeito do mesmo laser, associado ou não ao fluoreto, na redução da desmineralização do esmalte e da dentina submetidos a um desafio erosivo, pela mensuração da perda de superfície e análise da concentração de cálcio, fósforo e fluoreto das soluções desmineralizadoras. Os dados foram analisados quanto à normalidade e testes apropriados foram realizados com nível de significância de 5%. No estudo 1, os efeitos do laser no esmalte, seu mecanismo de ação na redução da desmineralização, combinados ou não ao fluoreto, foram discutidos. No estudo 2, o pH do biofilme diminuiu imediatamente após a imersão em sacarose, mas aumentou novamente 5 min depois. Lesões em dentina foram produzidas com sucesso e a adição de sacarose mostrou as maiores perdas minerais, no entanto não diferiu entre os dois regimes de sacarose. A UFC não mostrou nenhuma diferença e a API dos tratamentos foram maiores que a do grupo controle. No estudo 3, os espécimes radiculares foram tratados ou não com laser de CO2 e com ou sem fluoreto antes ou após a irradiação com laser. O modelo microbiológico utilizado foi efetivo em produzir lesões dentinárias e as terapias combinadas mostraram as lesões dentinárias mais rasas. No estudo 4, espécimes de esmalte e dentina foram tratados com fluoreto, laser e fluoreto/laser e submetidos a um desafio erosivo. Os resultados de desgaste indicaram que o tratamento combinado interferiu com as perdas minerais do esmalte e da dentina, mesmo sem mostrar efeito sinérgico. Houve uma tendência de retenção de fluoreto no esmalte pelo tratamento combinado e também de liberação de menores quantidades de cálcio, fósforo e fluoreto para as soluções desmineralizadoras. Em conclusão, o mecanismo de ação do laser de CO2 na inibição da desmineralização do esmalte ainda não está completamente esclarecido e seu efeito pode ser aumentado quando associado ao fluoreto. O modelo microbiológico foi efetivo em produzir lesões de cárie dentinária. A irradiação da dentina radicular com laser inibiu a desmineralização dessa superfície apenas quando associado com o fluoreto; no entanto, não foi observado efeito sinérgico. O tratamento isolado com laser não foi capaz de prevenir a perda de superfície do esmalte e da dentina devido à erosão. Sua combinação com fluoreto mostrou alguma proteção, mas principalmente devido ao efeito do fluoreto. Não foi observada interação sinérgica significativa ou proteção duradoura com a terapia de laser. / Abstract: The effects caused by the modifications promoted by the CO2 laser irradiation can inhibit the dental tissues demineralization and may be enhanced when associated with fluoride. Despite the widespread use of the fluoride and the reduction of the caries prevalence, this disease still occurs in the high risk groups. On the other hand, an increase of the dental erosion prevalence was observed. This thesis, comprised by 4 manuscripts, aimed: (1) to describe the CO2 laser characteristics and its action mechanisms in the enamel demineralization inhibition; (2) to develop an in vitro microbial model to produce dentin caries lesions and test two hypotheses - (a) that there is no difference in the artificial caries production in dentin using a microbial model with 3 and 6 sucrose bath immersions, as assessed by bacterial counts on the dentin (CFU), microradiographic analysis (TMR) and extracellular polysaccharide analysis (EPS); (b) that there is no difference in the biofilm pH before and after each sucrose bath; (3) to assess, in vitro, the effectiveness of a pulsed CO2 laser (? = 10.6 µm) associated or not with fluoride, in reducing the root demineralization using a microbial model, as assessed by TMR; (4) to assess, in vitro, the effect of the same laser, associated or not with fluoride, on the prevention of the enamel and dentin erosions by means of surface loss measurement and analysis of the calcium, phosphorus and fluoride concentrations in the demineralizing solutions. The data were checked for normality and appropriated tests were performed with a significance level of 5%. In study 1, the laser effects on the enamel and its action mechanisms in the demineralization reduction, combined or not with fluoride, were discussed. In study 2, the biofilm pH decreased immediately after the sucrose bath but increased again after 5 min. Dentin lesions were successfully produced, and the sucrose addition showed the highest mineral losses, even though there was no difference between the sucrose regimens. The CFU did not show any difference and the EPS from the treatment groups were higher than for the control. In study 3, root specimens were treated with/without CO2 laser and with/without fluoride prior or after the laser irradiation. The microbial model utilized was effective in developing dentin lesions and the combined therapies showed the shallowest dentin lesions. In study 4, specimens of enamel and root dentin were treated with fluoride, laser and fluoride/laser and submitted to an erosive challenge. The wear results indicated that the combined treatment interfered with the enamel or dentin surface losses, although no synergistic effect was observed. There was a trend for the combined treatment to retain more fluoride in enamel and release lower amounts of calcium and phosphorus into the demineralizing solutions. In conclusion, the CO2 mechanism action on the enamel demineralization reduction is still not elucidated and its effects can be increased when associated with fluoride. The microbial model was effective in producing dentin caries lesions. However, it did not reproduce the remineralizing phase of the caries process. Irradiation of the root dentin with laser inhibited the root surface demineralization only when associated with fluoride; however, no synergic effect was observed. The laser treatment alone was not able to prevent enamel or dentin surface losses due to erosion. Its combination with fluoride showed some protection, but mostly due to the fluoride effect. No significant synergistic interaction or lasting protection could be observed for the laser therapy. / Doutorado / Odontopediatria / Doutor em Odontologia