<p>Aim: To determine whether there was any significant difference in the antimicrobial activity of 4 herbal toothpastes against cultures of 3 primary plaque colonizers (Streptococcus mutans, Streptococcus sanguinis and a non-specific &alpha / -heamolytic streptococcus).</p>

Diss. (sammanfattning) Göteborg : Göteborgs universitet, 2010. / Härtill 4 uppsatser.

Magister Scientiae Dentium - MSc(Dent) / Aim: To determine whether there was any significant difference in the antimicrobial activity of 4 herbal toothpastes against cultures of 3 primary plaque colonizers (Streptococcus mutans, Streptococcus sanguinis and a non-specific alpha;-heamolytic streptococcus). / South Africa

Philosophiae Doctor - PhD / Introduction: Untreated caries of the permanent dentition is the most prevalent condition worldwide. Ongoing globalisation and the heightened exposure to a refined, westernised diet against a backdrop of deficient health services and inadequate implementation of preventive public health measures, means that dental caries remains pervasive, especially in emerging economies. In South Africa, an estimated 90% of caries remains untreated, disproportionately affecting the poor and detrimentally impacting on the economy. The use of an effective fluoridated toothpaste is regarded as the best clinical practice available today in caries management. Aim: The aim of the present study was to evaluate the availability, pricing and affordability of fluoridated toothpastes marketed to South African households and to identify mechanisms to improve financial access among low-income households. Methods: A cross-sectional survey of fluoridated toothpastes, retail price and unit weight/volume was undertaken. Following calculation of a median reference price for each paste, affordability relative to household income brackets was assessed using a modification of the WHO/HAI’s essential medicines pricing protocol. Affordability was expressed in terms of the number of days of disposable household income required to purchase the annual, household therapeutic dosage of a fluoridated toothpaste. Results: Despite the wide availability (n=142) of fluoridated toothpastes, of those assessed for affordability (n=130), none and 49% were affordable to households located in the first and second lowest income brackets, collectively termed low-income earners. Accessibility (±96%) increased sharply for low emerging middle income households and upwards. In general, as household income declined, the proportion of daily, disposable income required to purchase the annual, household therapeutic dosage increased. Households located in the lowest income bracket spent 104.3% of daily income on the annual dosage of the lowest priced toothpaste in contrast to 0.23% spent by the wealthiest households. Horizontal disparity in terms of affordability between household income brackets differed significantly (p<0.00001). Conclusion: Stark inequity in affordability of fluoridated toothpastes exists between low income and affluent households with dire implications in terms of oral health and economic hardship suffered by the poor. To redress this social injustice, a number of price regulatory policies and funding mechanisms are suggested to stimulate dialogue and urge all relevant entities (clinical, legal, industrial, and governmental) to take action urgently.

Identification of an appropriate material capable of enamel remineralization to fill a cavity after the removal of dental tissue is a new field of dental research. Elucidation of the associated factors involved in enamel defects remain in question including the mechanisms of enamel hypoplasia as well as improvement needed in our current treatment models. The purpose of this thesis is to evaluate the factors associated with enamel defects, to understand the mechanism by which they evolve, as well as look into a new method of treatment called, fluorapatite cement. This new treatment has shown promising affects to improve our current treatment to restore enamel defects, however, to find the best treatment we must understand the foundations of enamel and how defects arise. Enamel is the strongest tissue in the body because it must maintain resistance to factors such as bacterial adhesion, acidity, and temperature. Enamel defects can present as white spots, discoloration, or deep fissures in the enamel due to a disturbance that occurred during tooth oogenesis. Enamel hypoplasia provides favorable conditions for the early development of caries and the retention of plaque, which can progress and reach deep into the enamel and the dentin and cause sensitivity. Our current treatment is efficient and has been used for decades, however, requires the surrounding health enamel to be removed. This is a disadvantage and has encouraged scientists to continue researching for an effective way to remineralize enamel and avoid the loss of healthy enamel. Diseases such as coeliac disease have an influence on the formation of enamel that lead to defects. A recent study investigated if dentists can play a role in early diagnosis of diseases including coeliac disease by examining patients for enamel defects. The study discovered that there was not a significant difference in oral evaluations to determine upon early diagnosis, however, they did conclude that there was pattern in the types of defects that were found in coeliac patients. Specifically, grade I and II defects were found on the anterior teeth of coeliac patients, therefore, the study still recommends seeing the dentist for oral exams as well as supports further study. To understand the mechanism of how defects arise, scientists studied first permanent molars in children during their first three years of life with factors including, institutionalization, gender, medications, and diseases. Studies showed that females have a two-fold risk for enamel defects over males and institutionalized children have a three-to-four-fold risk of enamel defects. To improve our current treatment and avoid loss of healthy enamel and a costly procedure, scientists are looking into the use of hydroxyapatite (HA), a natural occurring mineral in our body, to create a possible new synthetic enamel called fluorapatite (FA) cement. Research analyzed fluorapatite cement compared to natural enamel and found that FA cement has a stronger resistance to acidity with a weight loss of 0.75% wt% compared to enamel with 1.2% and greater resistance to bacterial adhesion than natural enamel by three times. FA cement was also found to have more stability and higher cellular activity than hydroxyapatite. As for safety for dental application, FA cement and HA were placed in simulated body fluid to test for cytotoxicity levels, and none were present. Therefore, FA cement has a promising approach to restore enamel defects effectively and conveniently. Further research is recommended to understand the association of females and institutionalized children with enamel defects versus all children in a larger study group. The current reported results from fluorapatite cement are very promising. This cement can allow an inexpensive and more efficient method of treatment due to its abilities to remineralize enamel that even stronger than natural enamel. The recent hydroxyapatite and fluoride toothpaste products show the growing research that is being put into this idea of creating a synthetic enamel with our current mineral hydroxyapatite. This thesis supports the idea that FA cement has the potential as an alternative to current treatment for enamel defects and hopefully will be ready to undergo a clinical trial in the near future.

Submitted by Jadson Francisco de Jesus SILVA (jadson@uefs.br) on 2018-07-10T22:51:13Z No. of bitstreams: 1 Santos, Cristiane Brand?o.pdf: 1618648 bytes, checksum: 207f755363fb3b9a7dca89df5c0b2fbc (MD5) / Made available in DSpace on 2018-07-10T22:51:13Z (GMT). No. of bitstreams: 1 Santos, Cristiane Brand?o.pdf: 1618648 bytes, checksum: 207f755363fb3b9a7dca89df5c0b2fbc (MD5) Previous issue date: 2017-06-02 / Funda??o de Amparo ? Pesquisa do Estado da Bahia - FAPEB / Introduction: Dental fluorosis is an alteration in dental enamel mineralization, related to fluoride (F?) intake. Objectives: To investigate the impact of F? addition in toothpaste on the prevalence of dental fluorosis and to compare methods for F? determination in samples of diet and toothpaste. Methods: Two studies were developed: 1) systematic review of the literature, with meta-analysis, performed by two reviewers independently searching the four electronic databases (MEDLINE / PubMed; MEDLINE / Ovid; Bireme and Web of Science). The quality of articles eligible for Strengthening the Reporting of Observational Studies in Epidemiology (STROBE), and by the classification modified by Irani (2013); 2) a laboratory study that determined the F? concentration in the diet and dentifrice samples using two extraction methods: HMDS facilitated microdiffusion and hydrolysis in 0.01M HCl at times 30, 60 and 120 min of incubation. For analysis of the data, the one-way ANOVA test was applied. Results: 1) In the systematic review, eleven articles were eligible, and, when STROBE was applied, the number of items included ranged from 14 and 19, with an average of 16.3 and a standard deviation of 4.03; in the analysis of the classification modified by Irani (2013), two articles were classified as high quality and the rest of intermediate quality; 2) the method of extraction using 0.01M HCl, in the time 30 min, resulted in similar values to that expected by inactivation of 50% of the dentifrice?s F?. And in time 120 min resulted in similar values to HMDS facilitated microdiffusion. Conclusion: The majority of eligible articles in the systematic review found an association between the age of fluoride toothpaste use and dental fluorosis, but the prevalent severity of fluorosis was very mild, ie it does not imply dental fluorosis as a public health problem. It's the method of F? extraction using 0.01M HCl, in the experimental study, was promising to be used in evaluation of F? in dietary intake and dentifrices. / Introdu??o: Fluorose dent?ria ? uma altera??o na mineraliza??o do esmalte dental relacionada ? ingest?o de fluoreto (F?). Objetivos: Investigar o impacto da adi??o de F? aos dentifr?cios na preval?ncia de fluorose dent?ria e comparar metodologias para a determina??o da concentra??o de F? em amostras de dieta e dentifr?cio. M?todos: Dois estudos foram desenvolvidos: 1) revis?o sistem?tica da literatura, realizada por dois revisores que buscaram, de forma independente, os estudos em quatro bases de dados eletr?nicas (MEDLINE/PubMed; MEDLINE/Ovid; Bireme e Web of Science). Avaliou-se a qualidade dos artigos eleg?veis pelo Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) e pela classifica??o modificada por Irani (2013); 2) experimento laboratorial que determinou a concentra??o de F- nas amostras de dieta e dentifr?cio utilizando-se dois m?todos de extra??o: microdifus?o facilitada por HMDS e hidr?lise em HCl 0,01M com tempos 30, 60 e 120 minutos de incuba??o. Para an?lise dos dados foi aplicada o teste ANOVA um crit?rio. Resultados: 1) Na revis?o sistem?tica, onze artigos foram eleg?veis, e quando aplicado o STROBE o n?mero de itens inclu?dos variou entre 14 e 19, com m?dia de 16,3 e desvio padr?o 4,03; na an?lise da classifica??o modificada por Irani (2013), dois artigos foram classificados como de alta qualidade e o restante de qualidade intermedi?ria. 2) A t?cnica de extra??o em HCl 0,01M no tempo 30 minutos resultou em valores semelhantes ao esperado pela inativa??o de 50% do F? do dentifr?cio. E o tempo de 120 minutos resultou em resultados semelhantes ? t?cnica de microdifus?o facilitada por HMDS. Conclus?o: A maoiria dos artigos eleg?veis da revis?o sistem?tica encontraram associa??o entre idade do uso do dentifr?cio fluoretado e fluorose dental, por?m a severidade prevalente da flurose foi o grau muito leve, ou seja, n?o implica considerar fluorose dental como um problema de sa?de p?blica. E o estudo laboratorial sugere que o m?todo de extra??o de F? em HCl 0,01M ? promissor para ser utilizado em trabalhos de avalia??o da ingest?o de F? pela dieta e dentifr?cios.

Introdução - O uso do creme dental, da escova dental, a frequência de escovação e ingestão de água e bebidas representam exposições relacionadas à saúde bucal. Essa frequência em populações tem sido estimada por meio de medidas indiretas; entretanto, a validade dessa forma de mensuração não é conhecida e há carência de instrumentos para sua mensuração em nível populacional. Objetivos - Revisar as evidências empíricas sobre a relação entre a frequência de uso de creme dental e os diferentes níveis de renda e escolaridade. Determinar a validade da medida indireta da quantidade de creme dental utilizado, do tamanho da cabeça da escova e da frequência de escovação com creme dental. Comparar uma medida autoaplicável sobre ingestão de água e bebidas por adolescentes com Recordatórios de 24 horas. Procedimentos Metodológicos - Uma revisão sistemática da literatura foi realizada utilizando-se as bases de dados Pubmed e Embase, buscando evidências empíricas sobre a relação entre a frequência de uso de creme dental e os diferentes níveis de renda e escolaridade. Uma subamostra de escolares na faixa etária de 13 a 16 anos de idade, em 2011, residentes no município de Piracicaba (SP), foi selecionada a partir de uma amostra representativa da população que participou de um estudo transversal sobre risco de obesidade em adolescentes (FAPESP 06/61085-0). Com este procedimento assegurou-se as mesmas características da amostra na subamostra de adolescentes participantes do estudo de validade. Após pré-teste dos instrumentos, um estudo de validação dividido em três momentos em intervalos de 15 dias foi conduzido com cada sujeito da pesquisa. No primeiro momento foram coletados os dados de peso/estatura, foi entregue um tubo de creme dental e também foi aferida a quantidade de creme dental habitualmente colocada na escova. No segundo momento, o tubo de creme dental usado foi recolhido e foi aferida pela segunda vez a quantidade de creme dental colocada na escova. No terceiro momento, uma medida com perguntas foi aplicada. Nos três momentos foram aplicados Recordatórios de 24 horas (R24h). Os dados obtidos a partir das perguntas contidas na medida indireta, R24h, e medidas diretas relacionadas ao consumo de creme dental foram comparados. Para isso, foram calculados os valores ponderados da estatística Kappa. Resultados - Os dados obtidos a partir das perguntas contidas na medida indireta foram comparados com as estimativas produzidas pela medida direta. Frequência de escovação correspondente a três ou mais vezes ao dia, aferida por meio da medida indireta, foi indicada por 73,7 por cento dos adolescentes, enquanto por meio da medida direta, 55,3 por cento dos adolescentes foram incluídos nessa categoria, uma estimativa 18,4 por cento menor. Por meio dos dados coletados em três R24h, verificou-se que o líquido mais ingerido entre os adolescentes foi a água, seguido respectivamente de refrigerante, leite, suco/bebida artificial, chá/café e o suco natural. Tanto para a água quanto para o refrigerante, observou-se ligeira concordância e uma nítida tendência de superestimação da ingestão aferida pela medida autoaplicável de seis itens. Conclusões - Pode-se afirmar que as evidências empíricas sustentam a hipótese de que a frequência de uso de creme dental depende do nível de escolaridade de um dos pais ou de ambos, e a maior porcentagem dos usuários de creme dental fluoretado pertence a um grupo socioeconomicamente mais favorecido. A medida indireta pode levar a uma superestimação dos valores de frequência de escovação e valores de água e bebidas ingeridas. Recomenda-se que as estimativas produzidas por medida indireta semelhante à testada neste estudo sejam consideradas com cautela / Background - The use of toothpaste, toothbrush, toothbrushing frequency, water and beverage intake represent exposures to oral health. This frequency has been estimated at population level by means of indirect assessment instruments, however, their validity is not known, and there is a lack of instruments. Objective - To analyze the empirical evidence found on the association between the frequency of toothpaste use and the different levels of income and education; to determine the validity of indirect instruments of the amount of toothpaste used, the size of the brush head and the toothbrushing frequency using toothpaste; to compare a self-administered instrument used to measure water and beverage intake by teenagers with 24-hour dietary recalls. Methods - A systematic review of the literature was conducted using the PubMed and Embase databases looking for empirical evidence on the association between the frequency of toothpaste usage and the different levels of income and education. In 2011, a sub-sample of school teenagers between the ages of 13 to 16 years, residents in the city of Piracicaba (SP), was selected from a representative sample of the population that participated in a cross-sectional study on the risk of obesity in adolescents (FAPESP 06/61085-0). This procedure ensured the same characteristics of the sample for the sub-sample of teenagers participating in the study. After pre-testing the instruments, a validation study, divided into three time periods at 15 day intervals, was conducted with each participant. Firstly, weight and height data were collected, participants received a tube of toothpaste and the amount of toothpaste usually placed on the brush was measured. Secondly, the toothpaste tube was collected and the amount of toothpaste on the brush was measured again. Thirdly, a questionnaire was used. During these time periods, 24-hour dietary recalls were applied. Data obtained from both direct and indirect instruments were compared. To do so, the values of weighted Kappa were calculated. Results - Data provided by the questions contained in the indirect instrument were compared to those produced by the direct instrument. Frequency of toothbrushing three or more times a day calculated by an indirect instrument was referred to by 73.7 per cent of teenagers; 55.3 per cent of teenagers were included in this category using an indirect instrument (18.4 per cent lower). Data provided by the three 24-hour recalls showed that water was the most ingested liquid among teenagers, followed by milk, juice/soft drinks, tea/coffee and natural juices. For both water and soft drinks, there was a slight agreement and a significant trend for overestimation of intake calculated by a 6-item self-administered instrument. Conclusion - The empirical evidence supports the hypothesis that the frequency of toothpaste usage depends on the level of education of one parent or both, and the highest percentage of fluoride toothpaste users belong to those groups with the highest socioeconomic status. An indirect instrument can overestimate the values of toothbrushing frequency and those of water and drink intake. The estimates provided by the indirect instrument, similar to that tested in this study, should be considered with caution

Introdução - O uso do creme dental, da escova dental, a frequência de escovação e ingestão de água e bebidas representam exposições relacionadas à saúde bucal. Essa frequência em populações tem sido estimada por meio de medidas indiretas; entretanto, a validade dessa forma de mensuração não é conhecida e há carência de instrumentos para sua mensuração em nível populacional. Objetivos - Revisar as evidências empíricas sobre a relação entre a frequência de uso de creme dental e os diferentes níveis de renda e escolaridade. Determinar a validade da medida indireta da quantidade de creme dental utilizado, do tamanho da cabeça da escova e da frequência de escovação com creme dental. Comparar uma medida autoaplicável sobre ingestão de água e bebidas por adolescentes com Recordatórios de 24 horas. Procedimentos Metodológicos - Uma revisão sistemática da literatura foi realizada utilizando-se as bases de dados Pubmed e Embase, buscando evidências empíricas sobre a relação entre a frequência de uso de creme dental e os diferentes níveis de renda e escolaridade. Uma subamostra de escolares na faixa etária de 13 a 16 anos de idade, em 2011, residentes no município de Piracicaba (SP), foi selecionada a partir de uma amostra representativa da população que participou de um estudo transversal sobre risco de obesidade em adolescentes (FAPESP 06/61085-0). Com este procedimento assegurou-se as mesmas características da amostra na subamostra de adolescentes participantes do estudo de validade. Após pré-teste dos instrumentos, um estudo de validação dividido em três momentos em intervalos de 15 dias foi conduzido com cada sujeito da pesquisa. No primeiro momento foram coletados os dados de peso/estatura, foi entregue um tubo de creme dental e também foi aferida a quantidade de creme dental habitualmente colocada na escova. No segundo momento, o tubo de creme dental usado foi recolhido e foi aferida pela segunda vez a quantidade de creme dental colocada na escova. No terceiro momento, uma medida com perguntas foi aplicada. Nos três momentos foram aplicados Recordatórios de 24 horas (R24h). Os dados obtidos a partir das perguntas contidas na medida indireta, R24h, e medidas diretas relacionadas ao consumo de creme dental foram comparados. Para isso, foram calculados os valores ponderados da estatística Kappa. Resultados - Os dados obtidos a partir das perguntas contidas na medida indireta foram comparados com as estimativas produzidas pela medida direta. Frequência de escovação correspondente a três ou mais vezes ao dia, aferida por meio da medida indireta, foi indicada por 73,7 por cento dos adolescentes, enquanto por meio da medida direta, 55,3 por cento dos adolescentes foram incluídos nessa categoria, uma estimativa 18,4 por cento menor. Por meio dos dados coletados em três R24h, verificou-se que o líquido mais ingerido entre os adolescentes foi a água, seguido respectivamente de refrigerante, leite, suco/bebida artificial, chá/café e o suco natural. Tanto para a água quanto para o refrigerante, observou-se ligeira concordância e uma nítida tendência de superestimação da ingestão aferida pela medida autoaplicável de seis itens. Conclusões - Pode-se afirmar que as evidências empíricas sustentam a hipótese de que a frequência de uso de creme dental depende do nível de escolaridade de um dos pais ou de ambos, e a maior porcentagem dos usuários de creme dental fluoretado pertence a um grupo socioeconomicamente mais favorecido. A medida indireta pode levar a uma superestimação dos valores de frequência de escovação e valores de água e bebidas ingeridas. Recomenda-se que as estimativas produzidas por medida indireta semelhante à testada neste estudo sejam consideradas com cautela / Background - The use of toothpaste, toothbrush, toothbrushing frequency, water and beverage intake represent exposures to oral health. This frequency has been estimated at population level by means of indirect assessment instruments, however, their validity is not known, and there is a lack of instruments. Objective - To analyze the empirical evidence found on the association between the frequency of toothpaste use and the different levels of income and education; to determine the validity of indirect instruments of the amount of toothpaste used, the size of the brush head and the toothbrushing frequency using toothpaste; to compare a self-administered instrument used to measure water and beverage intake by teenagers with 24-hour dietary recalls. Methods - A systematic review of the literature was conducted using the PubMed and Embase databases looking for empirical evidence on the association between the frequency of toothpaste usage and the different levels of income and education. In 2011, a sub-sample of school teenagers between the ages of 13 to 16 years, residents in the city of Piracicaba (SP), was selected from a representative sample of the population that participated in a cross-sectional study on the risk of obesity in adolescents (FAPESP 06/61085-0). This procedure ensured the same characteristics of the sample for the sub-sample of teenagers participating in the study. After pre-testing the instruments, a validation study, divided into three time periods at 15 day intervals, was conducted with each participant. Firstly, weight and height data were collected, participants received a tube of toothpaste and the amount of toothpaste usually placed on the brush was measured. Secondly, the toothpaste tube was collected and the amount of toothpaste on the brush was measured again. Thirdly, a questionnaire was used. During these time periods, 24-hour dietary recalls were applied. Data obtained from both direct and indirect instruments were compared. To do so, the values of weighted Kappa were calculated. Results - Data provided by the questions contained in the indirect instrument were compared to those produced by the direct instrument. Frequency of toothbrushing three or more times a day calculated by an indirect instrument was referred to by 73.7 per cent of teenagers; 55.3 per cent of teenagers were included in this category using an indirect instrument (18.4 per cent lower). Data provided by the three 24-hour recalls showed that water was the most ingested liquid among teenagers, followed by milk, juice/soft drinks, tea/coffee and natural juices. For both water and soft drinks, there was a slight agreement and a significant trend for overestimation of intake calculated by a 6-item self-administered instrument. Conclusion - The empirical evidence supports the hypothesis that the frequency of toothpaste usage depends on the level of education of one parent or both, and the highest percentage of fluoride toothpaste users belong to those groups with the highest socioeconomic status. An indirect instrument can overestimate the values of toothbrushing frequency and those of water and drink intake. The estimates provided by the indirect instrument, similar to that tested in this study, should be considered with caution

Made available in DSpace on 2014-06-11T19:27:47Z (GMT). No. of bitstreams: 0 Previous issue date: 2004Bitstream added on 2014-06-13T19:35:56Z : No. of bitstreams: 1 brighenti_fl_me_araca.pdf: 987889 bytes, checksum: 1a2019e663f5ac02591b6b455a4163a8 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Fgm Produtos Odontologicos Ltda. / Pelo fato dos dentifrícios fluoretados serem um fator de risco para fluorose dentária, produtos com concentrações reduzidas de flúor poderiam oferecer maior segurança, desde que sua efetividade seja mantida. O objetivo deste estudo in vitro foi avaliar dentifrícios com 412 e 550 ?g F/g e pH acidulado, comparando-os com os de pH neutro. Blocos de dentes bovinos, selecionados a partir da sua dureza superficial inicial, foram submetidos à ciclagem de pH e tratamento diário (2x) com dentifrícios placebo, 275, 412, 550 e 1100 ?g F/g em dois diferentes pH (7,0 e 5,5) e com dentifrícios comerciais Crest® (controle positivo) e Colgate Baby® (500? ?g F/g). Em seguida, foi calculada a variação da microdureza de superfície (%AMDS) e a perda mineral (?Z) e determinado o conteúdo de F no esmalte e de íons flúor, cálcio e fosfato nas soluções após a ciclagem de pH. Em comparação ao dentifrício neutro, os dentifrícios acidulados tiveram menor %AMDS em todas as concentrações, mas não houve diferenças estatísticas com relação ao conteúdo de F no esmalte (p<0,05). Foi encontrada maior quantidade de íon F e menor de Ca e P nas soluções para os dentifrícios acidulados. Para ?Z, somente os dentifrícios Crest®, 1100 acidulado e neutro?não foram diferentes estatisticamente. Conclui-se que houve uma relação dose-reposta e que o dentifrício com 550 ??g F/g acidulado possui uma ação anticariogênica semelhante ao 1100? ?g F/g neutro. / Fluoride dentifrices are a risk factor for the development of dental fluorosis. Products with low-fluoride content offer a higher security, but their effectiveness must be proven. The aim of this study was to evaluate in vitro two low fluoride (412 and 550 æg F/g) acidulated toothpastes in comparison with the neutral ones. Enamel bovine blocks were selected through surface microhardness and submitted to pH cycling and daily treatment (2x) with toothpastes placebo, 275, 412, 550 and 1,100 æg F/g in two different pH (7.0 and 5.5) and the market toothpastes Crest® (positive control) and Colgate Baby® (500 æg F/g). The calculation of surface microhardness change (%SMHC), mineral loss (?Z) and the assessment of fluoride in enamel and fluoride, calcium and phosphate content in solutions after the pH cycling were then performed. Compared to neutral dentifrices, the acidulated toothpastes reduced the %SMHC in all F concentrations but there were no statistical differences regarding F content in enamel (p<0.05). More F and less Ca and P content were found in solutions for the acidulated toothpastes. Regarding mineral loss, only the groups Crest®, 1,100 acidulated and neutral were not statistically different. A dose-response relationship was observed. The 550 æg F/g pH 5.5 dentifrice had similar anticariogenic action when compared to the 1100 æg F/g pH 7.0 dentifrice.

Submitted by LUHANA SANTOS GONZALES GARCIA null (luhanagarcia@gmail.com) on 2018-02-21T14:29:52Z No. of bitstreams: 1 Tese Luhana Garcia 2018.pdf: 3564229 bytes, checksum: 01cd5d31429809862bb89d390b0412ab (MD5) / Approved for entry into archive by Claudio Hideo Matsumoto null (claudio@foa.unesp.br) on 2018-02-21T17:58:18Z (GMT) No. of bitstreams: 1 garcia_lsg_dr_araca.int.pdf: 3564229 bytes, checksum: 01cd5d31429809862bb89d390b0412ab (MD5) / Made available in DSpace on 2018-02-21T17:58:18Z (GMT). No. of bitstreams: 1 garcia_lsg_dr_araca.int.pdf: 3564229 bytes, checksum: 01cd5d31429809862bb89d390b0412ab (MD5) Previous issue date: 2018-02-02 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / O objetivo geral deste estudo foi avaliar o efeito de um dentifrício fluoretado convencional (1100 ppm F), contendo nanopartículas de hexametafosfato de sódio (HMPnano) sobre a remineralização de lesões artificiais de cárie e desmineralização do esmalte in situ e biofilme. O estudo de remineralização, foi duplo-cego cruzado, realizado em quatro fases de três dias cada. Voluntários (n=12) usaram dispositivos palatinos contendo quatro blocos de esmalte bovino com lesões artificiais de cárie. A seguir foram distribuídos aleatoriamente nos seguintes grupos de tratamento: sem F/HMP/HMPnano (Placebo); 1100 ppm F (1100F); 1100F associado a 0,5% HMP microparticulado e nanoparticulado (1100F/HMP; 1100F/HMPnano). Os voluntários foram instruídos a escovar seus dentes naturais com os dispositivos palatinos na boca durante 1 min (3x/dia), de modo que os blocos foram tratados com slurry de dentifrícios. Após cada fase, determinou-se a porcentagem de recuperação de dureza de superfície (%SHR), recuperação integrada de dureza de subsuperfície (ΔIHR), recuperação mineral integrada (ΔIMR) e concentração de fluoreto (F) no esmalte. Os resultados foram submetidos a análise de variância de medidas repetidas seguido pelo teste Student-Newman-Keuls (p < 0,001). A superfície do esmalte tornou-se 68% mais remineralizada quando tratada com 1100F/HMPnano em comparação com 1100F (p < 0,001). O tratamento com 1100F/HMP e 1100F/HMPnano promoveu um aumento em ~ 23% e ~ 87% da ΔIHR quando comparado ao 1100F (p < 0,001). Além disso, ΔIMR foi de ~ 75% e ~ 33% maior para 1100F/HMPnano quando comparado a 1100F e 1100F/HMP, respectivamente (p < 0,001). O estudo de desmineralização foi duplo-cego cruzado, e consistiu em quatro fases (7 dias cada). Voluntários (n=12) usaram aparelhos palatinos contendo quatro blocos de esmaltes bovinos. O desafio cariogênico foi realizado pela solução de sacarose a 30% (6x/dia). Os tratamentos com os dentífricios (3x/dia) foram os seguintes: sem F/ HMP/HMPnano (Placebo); 1100 ppm F (1100F); 1100F associado a 0,5% HMP microparticulado e nanoparticulado (1100F/HMP; 1100F/HMPnano). Após sete dias determinou-se a porcentagem de perda de dureza de superfície (%SH), perda integrada de dureza subsuperfície (ΔKHN), cálcio (Ca), fósforo (P) e fluoreto (F) no esmalte. Além disso, no biofilme formado sobre os blocos analisou-se as concentrações de polissacarídeos extracelulares (EPS), F, Ca, P. Os resultados foram submetidos a análise de variância de medidas repetidas seguido pelo teste Student-Newman-Keuls (p < 0,001). Resultados: 1100F/HMPnano promoveu menor %SH e ΔKHN quando comparado aos demais grupos (p < 0,001). A adição de HMPnano a 1100F não aumentou a absorção de F e P no esmalte, mas aumentou significativamente as concentrações de Ca (p < 0,001). O grupo 1100F/HMPnano apresentou valores mais baixos de concentração de EPS quando comparado com 1100F (~ 70%) (p < 0,001). Todos os grupos foram supersaturados em relação a hidroxiapatita (HA). Somente, o grupo 1100F/HMPnano foi supersaturado em relação ao fluoreto de cálcio (CaF2) (p < 0,05). As atividades iônicas de íon fluoreto de cálcio (CaF+) e fluoreto de hidrogênio neutro (HF0) para o grupo 1100F/HMPnano foram significativamente maiores quando comparadas aos demais grupos (p < 0,001). Conclui-se que a adição de HMPnano a um dentifrício convencional promoveu um efeito remineralizador significantemente maior em lesões artificiais de cárie e demonstrou um maior efeito protetor contra a desmineralização e variáveis do biofilme in situ. / The aim of this study was to evaluate the effect of a conventional fluoride toothpaste (1100 ppm F) containing nano-sizeds of sodium hexametaphosphate (HMPnano) on the remineralization of artificial caries lesions and enamel demineralization and biofilm in situ. The remineralization study was double-blinded crossed, performed in 4 phases of 3 days each. Volunteers (n = 12) used palatal devices containing four blocks of bovine enamel with artificial lesions of caries. They were then randomly assigned to the following treatment groups: without F/ HMP/HMPnano (Placebo); 1100 ppm F (1100F); 1100F associated with 0.5% HMP microparticulate and nano-sized (1100F/HMP; 1100F/ HMPnano). The volunteers were instructed to brush their natural teeth with the palatine devices in the mouth for 1 min (3x/day), so that the blocks were treated with slurry of toothpastes. After each phase, the percentage of surface hardness recovery (%SHR), integrated recovery of subsurface hardness (ΔIHR), integrated mineral recovery (ΔIMR) and fluoride (F) concentration in the enamel were determined. The results were subjected to analysis of variance of repeated measures followed by Student-Newman-Keuls test (p < 0.001). The enamel surface became 68% more remineralized when treated with 1100F/ HMPnano compared to 1100F (p < 0.001). Treatment with 1100F/HMP and 1100F/ HMPnano promoted an increase in ~ 23% and ~ 87% of ΔIHR when compared to 1100F (p < 0.001). In addition, ΔIMR was ~ 75% and ~ 33% higher for 1100F/HMPnano when compared to 1100F and 1100F/HMP, respectively (p < 0.001). The study of demineralization was double-blinded crossed, and consisted of four phases (7 days each). Volunteers (n = 12) used palatal appliances containing four blocks of bovine enamel. The cariogenic challenge was accomplished by the solution of sucrose 30% (6x/day). Treatments with the toothpaste (3x/day) were as follows: without F/HMP/HMPnano (Placebo); 1100 ppm F (1100F); 1100F associated with 0.5% HMP microparticulate and nano-sized (1100F/HMP; 1100F/HMPnano). After 7 days the percentage of surface hardness loss (%SH), integrated loss of subsurface hardness (ΔKHN), calcium (Ca), phosphorus (P) and fluoride (F) in the enamel were determined. The results were submitted to analysis of variance of repeated measurements followed by the Student-Newman-Keuls test (p < 0.001). The results were analyzed using the Student-Newman-Keuls test (p < 0.001). Results: 1100F/HMPnano promoted lower %SH and ΔKHN when compared to the other groups (p < 0.001). Addition of HMPnano to 1100F did not increase the absorption of enamel F, but significantly increased enamel Ca concentrations (p < 0.001). The 1100F/HMPnano group had lower values of EPS concentration when compared to 1100F (~ 70%) (p < 0.001). All groups were supersaturated with respect to hydroxyapatite (HA). Only, the 1100F/HMPnano group was supersaturated relative to calcium fluoride (CaF2) (p < 0.05). The ionic activities of calcium fluoride ion (CaF+) and neutral hydrogen fluoride (HF0) for the 1100F/HMPnano group were significantly higher when compared to the other groups (p < 0.001). It was concluded that the addition of HMPnano to a conventional toothpaste promoted a significantly greater remineralizing effect on artificial caries lesions and demonstrated a greater protective effect against demineralization and biofilm in situ. / 16/03148-7