Made available in DSpace on 2014-12-17T14:13:37Z (GMT). No. of bitstreams: 1 CiceroFF.pdf: 3167978 bytes, checksum: d9de3f0c1f071f112b7a1ab53a79b32c (MD5) Previous issue date: 2008-08-14 / The objective of this clinical study was to evaluate the effectiveness of the toothbrushing with and without fluoride and the daily fluoride rinse (NaF 0.05%) on produced white spot, in vivo. This was a clinical study, controlled, randomized and triple blind. Thirty patients were selected for orthodontics reasons from Orthodontics Specialization Course at the Brazilian Dental Association - Section of Rio Grande do Norte. In this study it was used 4 bicuspid upper and lower. They had orthodontic reason for extractions, in 35 days, at least. The sample had one hundred and twenty teeth that received orthodontic bands. The bands were fixed with polycarboxylate cement, and there was a space standardized between bands and one surface of teeth. The four bicuspid of each patients were randomized and nominated as A, B, C and D. These nominations determinated the sequence of the extractions and what was done in each tooth. All the patients had been submitted to the toothbrushing with or without fluoride for 35 days. After this period, the A tooth of each patient was extracted to serve as control. The others teeth (B, C and D) were extracted one by each week. The entire sample was analyzed through the clinical examination and by laser fluorescence (DIAGNOdent?) in three different times: before orthodontic bands, 28 days after fixed and then removed the bands and, the last one, 07 days after one of the three treatments (toothbrushing with or without fluoride, tooth paste with fluoride and mouth rinse with fluoride). At the beginning all groups (A, B, C and D) had the same conditions, no significant difference was found. The same situation was found in a clinical examination. The results of the DIAGNOdent? for the groups that used tooth paste without fluoride, with fluoride and mouth rinse with fluoride, after 28 days, there was no significant difference. Clinically, the white spot was formed in all teeth after 28 days. When it was compared the three treated groups, the group without fluoride in tooth paste had worst result than the others groups. But there was no significant association between the number of active and inactive white spots and the type of treatment that the teeth had received. The demineralization of the enamel surface, under the orthodontic bands, it happened in a few weeks. The exposition of the white spots in oral environmental resulted in an improvement, but it was not enough to return to the values from the base line, either for the toothbrushing and/or the use of fluorite mouth rinse. Mouth rinse and toothpaste with fluoride have showed to reduce the incidence of demineralization in the enamel, but none seems to be superior to another one in an in vivo study / O objetivo desse estudo cl?nico foi avaliar a efetividade da escova??o com e sem dentifr?cio fluoretado e o enxaguat?rio bucal fluoretado na forma de bochecho di?rio (NaF 0,05%) associado a escova??o com dentifr?cio fluoretado sobre as les?es brancas de esmalte produzidas in vivo. Este estudo se constituiu em um ensaio cl?nico controlado e randomizado. Para tanto, foram selecionados 32 pacientes do Curso de Especializa??o em Ortodontia da Associa??o Brasileira de Odontologia Sec??o do Estado do Rio Grande do Norte, que necessitavam como parte do tratamento de exodontias. Os cento e vinte e oito dentes receberam an?is ortod?nticos, cimentados com cimento de policarboxilato, com espa?o padronizado na superf?cie vestibular, S?tio Cariog?nico . Os quatro premolares de cada paciente foram aleatorizados individualmente, em dente A, B, C e D, com a finalidade de se determinar a seq??ncia das exodontias e os tipos de procedimentos a serem realizados para cada dente. Todos os pacientes foram submetidos ? escova??o com dentifr?cio sem fl?or por um per?odo de 35 dias. Ap?s esse per?odo, o dente A de cada paciente foi extra?do para servir como controle. Os demais dentes B, C e D foram extra?dos ap?s uma, duas e tr?s semanas, respectivamente. Os esp?cimes foram analisados atrav?s do exame cl?nico e da fluoresc?ncia a laser (DIAGNOdent?) antes da cimenta??o dos an?is ortod?nticos, 28 dias ap?s o desafio cariog?nico e 07 dias ap?s ter sido submetido a um dos tr?s tratamentos (escova??o com dentifr?cio sem fl?or, dentifr?cio com fl?or e bochecho com enxaguat?rio bucal fluoretado associado a escova??o com dentifr?cio com fl?or) institu?dos nesse estudo. Clinicamente, a les?o branca foi formada em todos os elementos dent?rios analisados ap?s 28 dias do desafio cariog?nico. Observou-se que n?o houve diferen?a estat?sticamente significativa entre as medianas para os valores do DIAGNOdent? e para os valores dos escores relacionados ao exame cl?nico entre os grupos de tratamentos ap?s 07 dias. Quando comparou-se os tr?s grupos tratados, o grupo dentifr?cio sem fl?or apresentou um n?mero de les?es brancas ativas maior que os grupos dentifr?cio com fl?or e bochecho com fl?or, nos quais ocorreu um predom?nio do n?mero de les?es brancas inativas. No entanto, n?o houve associa??o significativa entre o n?mero de les?es brancas ativas e inativas e o tipo de tratamento que os dentes receberam. A desmineraliza??o do esmalte subjacente aos an?is ortod?nticos mal adaptados ? um processo r?pido e ocorre dentro de poucas semanas. A exposi??o das les?es brancas de esmalte, ativas ao meio bucal, resulta em uma r?pida inativa??o das mesmas, mas n?o o suficiente para retornar aos valores da linha base, seja por dist?rbios mec?nicos da escova??o e/ou a utiliza??o de enxaguat?rio bucal fluoretado associado ao dentifr?cio fluoretado. Os dentifr?cios a base de fl?or e os enxaguat?rios bucais fluoretados t?m mostrado reduzir a incid?ncia de desmineraliza??o do esmalte, mas nenhum parece ser superior ao outro tomando como base o modelo de c?rie in vivo