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No. of bitstreams: 1 Dissertacao-Sheila K Caetano.pdf: 1781146 bytes, checksum: c20bac62f8cbce97febac4d11e616420 (MD5) Previous issue date: 2014-08-09 / Não Informada / Libidibiaferreaknownpopularlyas “Jucá”or“pau-ferro”isused in traditional medicineto treatbruises, breathing problems, anemia anddiabetes.Pharmacological studiesdemonstrateanti-inflammatory action, anti-ulcer, antimicrobialandanticarcinogenicagainst pathogensin the oral cavity. Suchspeciesarecatalogedin the National FormularyandHerbal Medicineslistedin the National Listof Medicinal Plantsof Interestto SUS. The aim of this workis obtain a dentifriceprepared with a spray dried extract of LibidibiaferreaMartiusvar. ferreapresented antimicrobial activityagainstoral pathogens. Firstly the studies werecarried out with spraydried extractobtained from thebarkand seedless fruitofL.ferrea and it was identified theminimum inhibitoryconcentration (MIC) of both dried extracts evaluated. The studiesdemonstrated thatthebark spray dried extractshowed betterantimicrobial activity, being chosenfor incorporation inplasticsformulations. Thedosage formsselectedfor dry extractincorporation were gel and pastes, the proportionsof 2.5%and 5% (w/w) in the geland5% to10% (w / w) in the paste,boththe pharmaceuticalforms it was obtainedwithcarboxymethylcellulose. The antimicrobial activityof allformulations was evaluated against the strainsof Streptococcusoralis, Streptococcus salivarius, Streptococcus mutans, Lactobacillus caseiand Candidaalbicansemploying themicrodilution method. The results showedthatall formulationsoftoothpastescontainingdryextractshowedantimicrobial activity againstoral pathogensevaluated, and thisactivity was higher ingel formulationscontaining 2.5% of DEalsogreater than thedry extractwhen assessedin isolation, demonstratingpossibleactivity of somecomponentsof the formulations, which when analyzed separately, it was verified thatthesodium lauryl sulfatewasthe onlypharmaceuticaladjuvantto demonstrateantimicrobial activity by diffusion methodon solid medium, withinhibition zonesrangingfrom 12 to 28mm.Thus, the study demonstrates thatthere may be asynergism betweenpharmaceuticaladjuvant and substances present into the L. ferrea spray dried extractused in this work. / A espécie vegetal Libidibia ferrea denominada, popularmente, como Jucá ou pau-ferro é utilizada na medicina tradicional para tratamento de contusões, problemas respiratórios, anemias e diabetes. Estudos farmacológicos demonstram ação anti-inflamatória, antiúlcera, anticarcinogênica e antimicrobiana contra patógenos da cavidade bucal. A referida espécie está catalogada no Formulário Nacional de Fitoterápicos e consta na Relação Nacional de Plantas Medicinais de Interesse ao SUS. O presente trabalho refere-se à obtenção de um dentifrício a partir do extrato seco por aspersão de Libidibia ferrea Martius var.ferrea com atividade antimicrobiana contra patógenos bucais. Osensaios foram realizados a partir de extratos secos por aspersão obtidos das entrecascas dos frutos e das cascas de L. ferrea, onde foi identificada a concentração inibitória mínima (CIM). Os estudos realizados demonstraram que o extrato da casca apresentou melhor atividade antimicrobiana, sendo escolhido para incorporação nas formulações semissólidas. As formas farmacêuticas selecionadas para incorporação do extrato seco (ES) foram gel e pasta,nas proporções de 2,5% e 5% (m/m) no gele de 5% e 10% (m/m) na pasta, ambas as formas farmacêuticas obtidas à base de carboximetilcelulose. A atividade antimicrobiana de todas as formulações obtidas foi demonstrada frente às cepas de Streptococcus oralis, Streptococcus salivarius, Streptococcus mutans, Lactobacillus caseie Candida albicans empregando-se o método da microdiluição.Os resultados obtidos demonstraram que todas as formulações dos dentifrícios,contendo o extrato seco,apresentaram atividade antimicrobiana frente aos patógenos bucais avaliados, sendo que esta atividade foi maior nas formulações em gelcontendo 2,5%de ES, também, maior que o extrato seco quando avaliado de forma isolada, demonstrando possível atividade de alguns componentes das formulações, que quando analisados isoladamente, foi verificado queo lauril sulfato de sódio foi o único adjuvante farmacêuticoa demonstrar atividade antimicrobiana pelo método de difusão em meio sólido, com halos de inibição variando de 12 a 28 mm. Dessa forma, o estudo demonstra que pode haver um sinergismo entre os adjuvantes farmacêuticos e as substâncias presentes no extrato seco por aspersão de L. ferrea utilizado no presente trabalho.

Utilisé dans l’entretien et le soin des gencives et des dents, le produit Gencix® (SAS Esprit d’éthique) a montré, d’après les observations cliniques des dentistes, une action anti-inflammatoire et nettoyante des dents. Ce dentifrice incorpore un extrait aqueux de feuilles de papayer. Afin d’en comprendre le mécanisme d’action en termes de métabolites actifs, un fractionnement bioguidé et une étude déréplicative associant LCUV- MSn et RMN du 13C ont été menés. L’activité relevée en clinique ne semble pas liée à un effet antibiofilm. Une activité anti-inflammatoire (anti-TNF-alpha) serait liée aux flavonoïdes plus ou moins glycosylés présents dans l’extraits. Nous avons en effet pu identifier quelques-uns des actifs comme la quercétine et le kaempferol, déjà décrits comme inhibiteurs de la libération du TNF- alpha. D'autres flavonols libres ou conjugués tels que la rutine, identifiés dans les fractions actives, peuvent également contribuer à l'activité anti-inflammatoire globale. Plus notablement, au cours de ce travail, des esters des acide malique et hydroxycinnamique ont pour la première fois été associés à une activité anticalcaire, en particulier l’acide caféoylmalique. Ce dernier agit sans doute en synergie avec d’autres composés analogues. Les différents groupements acides carboxyliques et hydroxyles présents dans ces dérivés agissent vraisemblablement en complexant les ions Ca2+. Au-delà de ces résultats, ces anticalcaires nouvellement identifiés apparaissent comme des actifs « verts » (non toxiques, n’entraînant pas de bioaccumulation et biodégradables), respectueux de l'environnement. Cette activité anticalcaire remarquable a fait l’objet d’un dépôt de brevet. / Gencix® (SAS Esprit d’Ethique) is used for the maintenance and care of gums and teeth. Clinical observations reported from dentists showed that this product-integrating anaqueous Carica papaya leaf extract- showed teeth cleaning and anti-inflammatory properties. In order to understand the mechanism of action and the role of the metabolites of the plant extract, a bioguided fractionation and a dereplicative study associating LC-UV-MSn and 13C NMR were conducted. Clinical activity does not appear to be related to an antibiofilm effect. The anti-inflammatory (anti-TNF-alpha) activity is most probably associated with glycosylated flavonoids. We have been able to identify some of the active ingredients such as quercetin and kaempferol which are already known to inhibit the release of TNF-α. Other free or conjugated flavonols such as rutin, identified in the active fractions, may also contribute to the overall anti-inflammatory activity. Most notably, esters of malic and hydroxycinnamic acids were described for the first time as scaling inhibitors, particularly caffeoyl malate. This compounds probably acts in synergy with other analog compounds. The various hydroxyl and carboxylic groups present in these compounds are probably responsible for this activity by complexing Ca2+ ions. Beyond these results, these metabolites, which are newly identified as anti-scalant, appear as "green" (i. e. non-toxic, non-bioaccumulative and biodegradable) as well as environmentally friendly. Therefore, this outstanding scaling inhibition property was subjected to patent application.

El presente proyecto lleva el nombre de “Naturessa”, el cual es una empresa que ofrece al público la alternativa de adquirir una pasta dental ecológica elaborada con insumos naturales y con envase eco amigable; esto con la finalidad de brindar beneficios a la salud del consumidor y colaborar con el cuidado del medio ambiente. Para la realización de este proyecto se identificaron dos incertidumbres que existen en el mercado de salud bucal. Por un lado, identificamos que las pastas dentales tradicionales contienen insumos que son dañinos para la salud humana, ya que causan problemas como irritaciones, afecciones en los huesos, cáncer, entre otros. Asimismo, los consumidores no se encuentran informados de estos males. Por otro lado, las pastas dentales tradicionales son causantes de contaminación ambiental, ya que son producidos con micro plásticos que funcionan como agentes para eliminar la suciedad dental y están contenidos en envases de plástico. Naturessa está dirigido a hombres y mujeres del nivel socioeconómico A y B de la zona 7 de la ciudad de Lima, los cuales comprende los distritos de Miraflores, San Isidro, San Borja, Surco y La Molina. Además, estas personas se preocupen por utilizar insumos naturales y por el cuidado del medio ambiente. Para llevar a cabo el presente trabajo de investigación, se analizó factores internos y externos de la industria. Además, se desarrollaron estrategias para lograr impulsar nuestro proyecto. Para finalizar, se mostrará el plan financiero para sustentar la viabilidad de nuestro negocio. / This project is called "Naturessa", which is a company that offers the public the alternative of acquiring an organic toothpaste made with natural supplies and with an eco-friendly packaging; this with the purpose of providing benefits to the health of the consumer and collaborating with the care of the environment. For the realization of this project, two uncertainties that exist in the oral health market were identified. On the one hand, we identify that traditional toothpastes contain supplies that are harmful to human health, since they cause problems such as irritations, bone conditions, cancer, among others. Likewise, consumers are not informed of these evils. On the other hand, traditional toothpastes are causing environmental pollution, since they are produced with microplastics that work as agents to remove tooth dirt and are contained in plastic containers. Naturessa is aimed at men and women of socioeconomic level A and B of zone 7 of the city of Lima, which includes the districts of Miraflores, San Isidro, San Borja, Surco and La Molina. In addition, these people worry about using natural inputs and caring for the environment. To carry out this research work, internal and external factors of the industry were analyzed. In addition, strategies were developed to boost our project. Finally, the financial plan will be shown to support the viability of our business. / Trabajo de investigación

Objetivo: Comparar in vitro la microdureza superficial del esmalte de dientes de bovino al ser expuestos a tres suplementos a base de caseína, creatina y leucina. Materiales y Métodos: Estudio de tipo experimental in vitro. Se evaluó la microdureza superficial inicial y final de 30 especímenes de esmalte bovino al ser expuestos a tres suplementos a base caseína, creatina y leucina. Se midió la microdureza superficial con un microdurómetro (Hv1000 LG - Corea del Sur) en los especímenes bovinos antes y después de la exposición. Dichos especímenes fueron almacenados a temperatura ambiente entre cada exposición. El análisis bivariado fue evaluado mediante la prueba de Wilcoxon para comparar la microdureza inicial y final de cada grupo y se utilizó la prueba de Kruskal Wallis para comparar la diferencia de microdureza en los diferentes tiempos y entre los suplementos. Además, se realizó la prueba de Dunn para verificar si existían similitudes entre los grupos analizados. El nivel de significancia se estableció como p<0.05. Resultados: El porcentaje de pérdida de la microdureza superficial con cada suplemento fue: caseína 2.63%, creatina 4.69% y leucina con 27.95% observándose diferencias estadísticamente significativas (p= 0.005) solo entre los grupos de creatina y leucina. Además, se encontraron diferencias estadísticamente significativas al comparar la diferencia de microdureza superficial inicial y final de los especímenes al ser expuestos a los tres suplementos. Conclusiones: En el presente estudio se observó que, la microdureza del esmalte bovino se ve reducida al ser expuesto a suplementos a base de caseína, leucina y creatina. Asimismo, se hallaron diferencias estadísticamente significativas en las pruebas realizadas las cuales concluyeron que la mayor pérdida en la microdureza superficial fueron en los especímenes expuestos al suplemento a base de leucina. / Objective: Compare in vitro the superficial microhardness of bovine tooth enamel when exposed to three supplements based on casein, creatine, and leucine. Materials and Methods: Experimental in vitro study. The initial and final surface microhardness of 30 bovine enamel specimens was evaluated when exposed to three supplements based on casein, creatine, and leucine. Surface microhardness was measured with a micro durometer (Hv1000 LG - South Korea) in the bovine specimens before and after challenge. Bivariate analysis was evaluated using the Wilcoxon test to compare the initial and final microhardness of each group and the Kruskal Wallis test was used to compare the difference in microhardness at different times and between the protein supplements. In addition, Dunn's test was performed to verify if there were similarities between the groups analyzed. The significance level was established as p <0.05. Results: The percentage of loss of surface microhardness with each supplement was: casein 2.63%, creatine 4.69% and leucine with 27.95%, observing statistically significant differences (p = 0.005) only between the creatine and leucine groups. In addition, statistically significant differences were found when comparing the initial and final surface microhardness difference of the specimens when exposed to the three supplements. Conclusions: In the present study it was observed that the microhardness of bovine enamel is reduced when exposed to supplements based on casein, leucine, and creatine. Likewise, statistically significant differences were found in the tests carried out which concluded that the greatest loss in surface microhardness was in the specimens exposed to the leucine-based supplement. / Tesis

Objetivo: Evaluar in vitro el potencial de hidrógeno y el grado abrasivo de las pastas dentales post-blanqueamiento. Materiales y métodos: El diseño del estudio fue experimental in vitro. La unidad de análisis estuvo constituida por un fragmento de pasta dental indicada post-blanqueamiento. La muestra fue conformada por 28 fragmentos de pastas dentales dividida en 7 grupos (n=4), a los cuales se evaluó el potencial de hidrógeno a través de un pH metro electrónico (Hanna® HI2221-01, USA) durante 10 minutos. Para ello, se depositaron 20gr de pasta dental en su estado original en un vaso beacker. Asimismo, para determinar el grado abrasivo se empleó la clasificación de la relatividad abrasiva de la dentina (RDA) obtenido de la ficha técnica del producto de las pastas dentales indicadas post-blanqueamiento. Para comparar los valores de pH se utilizó la prueba de Kruskal Wallis (p<0,05). Resultados: Las medias registradas para la pasta dental con el pH más alcalino fue 8.315 ±0.05 (Sensodyne® blanqueadora) y 5.86 ±0.02 el más ácido (Vitis® Sensible). En relación al grado abrasivo, la pasta Oral B® Pro Salud obtuvo el valor más alto (140), y la pasta Vitis® sensible el más bajo (40). Conclusiones: En la evaluación, la pasta dental con pH más ácido resultó ser la Vitis sensible con 5.86; mientras que la pasta con valor de grado abrasivo alto fue la Oral B Pro salud con un RDA de 140. / Objective: To evaluate in vitro the potential of hydrogen and the abrasive degree of post-whitening toothpastes. Materials and methods: The study design was experimental in vitro. The analysis unit consisted of a fragment of toothpaste indicated post-whitening. The sample was made up of 28 toothpaste fragments divided into 7 groups (n = 4), to which the hydrogen potential was evaluated through an electronic pH meter (Hanna® HI2221-01, USA) for 10 minutes. To do this, 20gr of toothpaste in its original state was placed in a beacker glass. Likewise, to determine the abrasive degree, the classification of the abrasive relativity of dentin (RDA) obtained from the technical data sheet of the toothpaste product indicated after bleaching was used. To compare the pH values, check the Kruskal Wallis test (p <0.05). Results: The means registered for toothpaste with the most alkaline pH were 8,315 ± 0.05 (Sensodyne® whitening) and 5.86 ± 0.02 at the most acidic (Vitis® Sensitive). A statistically significant difference (p <0.05) was considered in the comparison of these. In the evaluation of abrasive degree, the Oral B® Pro Salud paste obtained the highest value (140), and the sensitive Vitis® paste the lowest (40). Conclusions: In the evaluation, the toothpaste with the most acidic pH proved to be sensitive Vitis with 5.86; while the paste with a high abrasive grade value was Oral B Pro health with 140 RDA. / Tesis

Objective: The aim of this study was to investigate the direct and indirect influence of fluoridated toothpastes and fluoride-free toothpaste with hydroxyapatite (HAP) as active ingredient on initial bacterial colonization on enamel in situ. Methods: For this clinical-experimental pilot study, eight subjects were instructed to brush their teeth with three different toothpastes (Elmex®: 1400 ppm AmF, Meridol®: 1400 ppm AmF +SnF2, Karex®: HAP), using each for two consecutive days. As a control, brushing without toothpaste was performed. To evaluate bacterial colonization, subject wore splints with buccally placed bovine enamel platelets overnight. Two modes were tested. In a first pass (regimen A), the splints were inserted after toothbrushing to examine the indirect effects of the dentifrices. In order to investigate the direct effects, the specimens were brushed in situ in a second pass (regimen B). Biofilm formation was visualized and quantified using fluorescence microscopy (DAPI and BacLight) and transmission electron microscopy (TEM). Results: For brushing regimen A (indirect effect of dentifrices), no statistical differences were detected between any of the tested dentifrices or the control. Likewise, no statistically significant differences were recorded for brushing regimen B (direct effect of dentifrices). Furthermore, no differences between the different brushing techniques were determined with regard to the ultrastructure of the overnight biofilm. Conclusion: Within the limitations of the present pilot study, it can be concluded that in patients with good oral hygiene, dentifrices and their chemical composition have no statistically significant effect on the initial bacterial colonization of enamel platelets in situ, irrespectively of the mode of application.

Made available in DSpace on 2015-05-14T12:56:03Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 2131747 bytes, checksum: 29f26f35febbc01863dacd7a6d17e909 (MD5) Previous issue date: 2013-10-28 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The aim of this clinical trial was to evaluate the efficacy, safety and acceptability of whitening toothpaste containing blue covarine in the treatment of tooth discoloration. It is a parallel controlled double-blind randomized clinical trial which followed the guidelines published by CONSORT. Seventy-five subjects with shade mean C1 or darker for the six maxillary anterior teeth were randomized in three treatment groups (n= 25): G1- conventional fluoridated toothpaste, G2- whitening toothpaste containing a silica system and blue covarine, and G3- bleaching with 10% carbamide peroxide. Subjects from G1 and G2 were instructed to brush their teeth for 90 seconds, twice per day during 2 weeks. Subjects from G3 used 10% carbamide peroxide gel in a tray for 4h/night also for two weeks. Shade evaluations were done with a spectrophotometer (Vita Easyshade® Advance) at baseline, after first application and at 2 and 4 weeks. Subjects perception about tooth color appearance was assessed by a visual analog scale (VAS). Tooth sensitivity (TS) and gingival irritation (GI) were measured daily using a scale ranging from 1 (no sensitivity) to 5 (severe sensitivity) during three weeks, and the acceptability of products was measured with a questionnaire that included questions about subjects opinion regarding the treatment regimen. At all evaluations periods, there was not statistical difference between G1 and G2 groups considering the CIEL*a*b* color parameters (p> 0.3) or the tooth shade means (p> 0.7). At 2-week evaluation, &#916;E* value for G3 was statistically higher (9.2) than for G1 (2.3) and G2 (2.1) (p= 0.0001). G1 and G2 reported a major dissatisfaction with tooth color appearance than G3 (p= 0.0001).Tooth sensitivity and gingival irritation were reported by 12% of subjects from G2, while the same symptoms were perceived by 84% and 80% of G3. At first and second weeks of treatment, G2 experienced tooth sensitivity and gingival irritation similarly to G1 group and statistically lower than G3 (p< 0.01). It was observed a negative correlation between TS/GI and day of evaluation (r= -0.08 and r= -0.91) in G3. Within the limitations of this study, it could be concluded that the whitening toothpaste containing a silica system and blue covarine resulted in no significant changes on tooth color, as the conventional toothpaste. These groups did not show whitening effect as the group treated with 10% carbamide peroxide. However, all could be considered safe and acceptable to be used daily for a short term. / O objetivo do presente estudo foi avaliar a eficácia, segurança e aceitabilidade de um dentifrício branqueador contendo partículas azuis no tratamento da descoloração dentária. Trata-se de um ensaio clínico randomizado duplo-cego controlado e paralelo, cujo delineamento seguiu o guia publicado pelo CONSORT. Setenta e cinco participantes com média de cor C1 ou mais escura para os seis dentes ântero-superiores foram randomizados em três grupos de tratamento (n=25): G1- dentifrício fluoretado convencional, G2- dentifrício branqueador contendo um sistema de sílica e partículas azuis, e G3- clareamento dentário com peróxido de carbamida a 10%. Os participantes dos grupos G1 e G2 foram instruídos a escovarem seus dentes por 90 segundos, duas vezes ao dia durante duas semanas. Os participantes do grupo G3 usaram o gel clareador peróxido de carbamida a 10% em moldeira personalizada 4h/noite também por duas semanas. Avaliações de cor dentária foram realizadas por meio de espectrofotômetro digital (Vita Easyshade® Advance) nos tempos baseline, após primeira aplicação e com duas e quatro semanas. A percepção estética dos participantes quanto à aparência da cor dentária foi avaliada por meio de escala analógica visual (EAV). Sensibilidade dentinária (SD) e Irritação Gengival (IG) foram mensuradas usando uma escala que variou de 1 (nenhuma sensibilidade) a 5 (severa sensibilidade) durante três semanas, e a aceitabilidade dos produtos foi avaliada com um questionário o qual incluiu questões sobre a opinião dos participantes quanto aos regimes de tratamento propostos. Em todos os períodos de avaliação não houve diferença estatisticamente significante entre os grupos G1 e G2, considerando os parâmetros de cor do CIEL*a*B* (p> 0,3) e as medidas de cor da escala Vita (p>0,7). Na segunda semana de avaliação, o valor de &#916;E* para o G3 foi estatisticamente maior (9,2) do que para o G1 (2,3) ou para G2 (2.1) (p=0,0001). Sensibilidade dentinária e irritação foram reportadas por 12% dos participantes do G2, enquanto os mesmos sintomas foram percebidos por 84% e 80% do G3. Na primeira e segunda semana de tratamento, G2 apresentou sensibilidade gengival e irritação gengival similares ao grupo G1 e estatisticamente menores que o G3 (p< 0,01). Observou-se uma correlação negativa entre SD/IG e dia de avaliação (r= -0,08 e r= -0,91) no grupo G3. Dentro das limitações desse estudo, pôde-se concluir que o dentifrício branqueador contendo um sistema de sílica e partículas azuis resultou em nenhuma mudança significante na cor dentária, assim como o dentifrício convencional. Tais grupos não mostraram efeito clareador como o grupo tratado com peróxido de carbamida a 10%. Entretanto, todos foram considerados seguros e aceitáveis para serem utilizados diariamente em um curto período de tempo.

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No. of bitstreams: 1 Dissertação - Franklin Barbosa da Silva.pdf: 1792996 bytes, checksum: 029a67d8de8f162c50ece7cd6561fd52 (MD5) Previous issue date: 2014-08-21 / CNPq - Conselho Nacional de Desenvolvimento Científico e Tecnológico / The objective of this study was to evaluate the effectiveness of a program to promote oral health on caries control of adolescents in riverine communities in the Amazonas State. This is a prospective longitudinal experimental study, whose interventions were allocated for population groups (schools) and the outcome was measured at the individual level. The test interventions were based: education for oral health and daily tooth brushing with fluoride toothpaste, supervised by teachers on a school routine. The control intervention included oral health education and periodic distribution of toothbrushes and fluoride toothpaste. The schools were divided into test and control groups, and the data were collected before (baseline) and six months after the beginning of the interventions. There were included students in the age group of 15 to 19 years enrolled in state schools in the city of Careiro da Várzea / AM. For outcome evaluation, the clinical variables collected were: Nyvad criteria for caries activity evaluation, bleeding index and plaque index; being complemented by a socioeconomic questionnaire. Clinical examination and data collection were performed by a previously calibrated dentist [Kappa Coefficient for Nyvad criteria: k = 0.72 (95% CI: 0.69 to 0.76)]. The associations between the outcome (caries activity) and clinical and socioeconomic variables were tested in multivariate logistic regression, estimating the brute and adjusted odds ratio. After six months of interventions, 51.7% of the non-cavitated active lesions in the test group and 37.8% of these lesions in the control group became inactive or health surfaces. Individuals in the control group had 1.93 (95% CI: 1.07 to 3.49) more chance to have no improvement in caries activity than the individuals in the test group (p=0.0289). Demonstrating that daily supervised brushing with fluoride toothpaste (test intervention) was more effective than the simple distribution of toothbrushes and fluoride toothpaste (control intervention) in the caries control. / O objetivo deste trabalho foi avaliar a efetividade de um programa de promoção de saúde bucal, no controle da cárie em adolescentes de comunidades ribeirinhas no Estado do Amazonas. Trata-se de um estudo experimental longitudinal prospectivo, cujas intervenções foram alocadas para grupos populacionais (escolas) e o desfecho foi mensurado no nível individual. A intervenção teste teve como base: educação para saúde bucal e escovação diária com dentifrício fluoretado, supervisionada por professores, numa rotina escolar. A intervenção controle incluiu: educação para saúde bucal e distribuição periódica de escovas e dentifrício fluoretado. As escolas foram alocadas em grupos teste e controle, e os dados foram coletados antes (baseline) e seis meses após o início das intervenções. Foram incluídos alunos na faixa etária de 15 a 19 anos regularmente matriculados nas escolas estaduais do Município de Careiro da Várzea/AM. Para avaliação do desfecho, as variáveis clínicas coletadas foram: critério Nyvad para avaliação da atividade de cárie, índice de sangramento gengival e índice de placa; sendo complementadas com o preenchimento de questionário socioeconômico. Os exames clínicos e a coleta dos dados foram realizados por um cirurgião-dentista calibrado previamente [Coeficiente Kappa para o critério Nyvad: k=0.72 (IC95%: 0,69-0,76)]. As associações entre o desfecho (atividade de cárie) e as variáveis clínicas e socioeconômicas foram testadas na análise de regressão logística múltipla, estimando-se os odds ratio, brutos e ajustados. Após seis meses de intervenção, 51,7% das lesões não cavitadas ativas no grupo teste, e 37,8% destas lesões no grupo controle, se tornaram inativas ou superfícies sadias. Os indivíduos do grupo controle apresentaram 1,93 (IC95%: 1,07-3,49) vezes mais chance de não melhora, para a atividade de cárie, que os indivíduos do grupo teste (p=0,0289), demonstrando que a escovação supervisionada diária com dentifrício fluoretado (intervenção teste) foi mais efetiva que a simples distribuição de escovas e de dentifrícios fluoretados (intervenção controle) no controle da doença cárie.

Objetivo: Evaluar la asociación entre mayor uso de cepillo dental, pasta dental y frecuencia de cepillado en los niños menores de 12 años afiliados al programa Qali Warma en el Perú durante el 2018. Metodología: Se realizó un estudio observacional, retrospectivo, transversal y analítico de 17556 niños < 12 años que participaron de la Encuesta Nacional Demográfica y de Salud Familiar 2018. Las variables dependientes fueron el uso de cepillo dental, pasta dental y la frecuencia de cepillado, e independiente fue la afiliación al programa Qali Warma. Se utilizó el programa STATA® v16 para el análisis descriptivo, bivariado y multivariado con pesos estadísticos. Se compararon las variables categóricas, calculando prevalencias con la prueba chi cuadrado y para las numéricas, las medias mediante la prueba T student. Para la asociación de variables, se calcularon las razones de prevalencia e intervalos de confianza al 95% utilizando modelos de regresión de Poisson. Resultados: La prevalencia de niños afiliados a Qali Warma que se cepillan dos veces o más al día fue de 82.3%. No se encontró una asociación entre el uso del cepillo dental, pasta dental ni frecuencia de cepillado con la afiliación de los niños menores de 12 años al programa Qali Warma al controlar por todas las covariables. Conclusiones: El estar afiliado al programa Qali Warma no tiene asociación sobre el uso de cepillo dental, pasta dental y el cepillado de dos veces o más al día en los niños peruanos menores de 12 años. / Objective: To evaluate the association between greater use of toothbrush, toothpaste, and frequency of brushing in children under 12 years old affiliated to the Qali Warma program in Peru during 2018. Methodology: An observational, retrospective, cross-sectional and analytical study was carried out on 17,556 children < 12 years old who participated in the 2018 National Demographic and Family Health Survey. The dependent variables were the use of toothbrush, toothpaste and brushing frequency and the independent, affiliation to the Qali Warma program. The STATA® v16 program was used to perform descriptive, bivariate, and multivariate analysis with statistical weights. Categorical variables were compared, calculating prevalence with the chi square test and for numerical variables, the means were calculated using the T student test. For the association of variables, prevalence ratios and 95% confidence intervals were calculated using Poisson regression models. Results: The prevalence of children affiliated to Qali Warma brushing 2 or more times a day was 82.3%. No association was found between the use of toothbrush, toothpaste or brushing frequency with the affiliation of children under 12 years old to the Qali Warma program when controlling for all covariates. Conclusions: Being affiliated to the Qali Warma program has no association with the use of toothbrush, toothpaste, and brushing twice or more a day in Peruvian children under 12 years old. / Tesis

Objective: Toothbrushing with fluoride toothpaste followed by rinsing with mouthwash is a routine procedure to maintain good oral hygiene. It is unknown to what extent these rinses can modulate the effect of fluoride in its ability to prevent erosion/abrasion.The aim of this in-vitro study was to investigate and compare the impact of chlorhexidine (CHX), essential oils (EO) and cetylpyridinium chloride (CPC) mouthrinses on erosive tooth wear protection afforded by conventional fluoride toothpastes. Materials and Methods: The following experimental factors were considered: five rinses: CHX, EO, CPC, a fluoride rinse, and deionized water, two fluoride toothpastes: stannous fluoride (SnF2) or sodium fluoride (NaF) and two models: (erosion/ erosion+abrasion). Slabs of bovine enamel and dentin were prepared and embedded in resin blocks and generated 10 enamel and dentin testing groups (n = 8). UPVC tapes were placed on the sides of each slab leaving 1mm area exposed in the center. The blocks were subjected to a five-day cycling model. Then, the blocks were placed in a brushing machine and exposed to fluoride toothpaste slurry (one side was brushed and the other wasn’t). The blocks were then exposed to rinse treatments. Artificial saliva was used to remineralize the specimens after erosions and treatment challenges, and as storage media. After the fifth day of cycling, surface loss (in micrometers) was determined by profilometer. Data were analyzed using ANOVA (α = 0.05). Results: There was no interaction among the three factors (type of toothpaste, mouthrinse and abrasion or not (dentin p = 0.0520, enamel p = 0.4720). There were no significant two-way interactions as SL was only affected by toothpaste and mouthrinse. NaF caused less SL than SnF2 (4.60 vs. 5.83 μm; p < 0.0001) in dentin, whereas the opposite was found in enamel (5.20 vs. 3.56 μm; p < 0.0001). Toothbrushing abrasion caused comparatively more SL in enamel (6.53 vs. 2.23 μm; p < 0.0001) than in dentin (6.06 vs. 4.38 μm; p < 0.0001). None of the tested mouthrinses affected SL. Conclusion: Commonly used mouthrinses containing antimicrobial agents or additional fluoride, do not impair the erosion/abrasion protection afforded by fluoride toothpastes. Tested SnF2 dentifrice offered greater protection against enamel surface loss and NaF dentifrices showed more protection for the dentin surface. Clinical relevance: The understanding of the interaction between commonly used rinses and fluoride dentifrices will help dentists provide better recommendations to patients with erosive lesions.