Magister Chirurgiae Dentium (MChD) / Chlorhexidine has been established as the gold standard against which new chemical plaque control agents are tested (Jones, 1997). The addition of alcohol in a chlorhexidine mouthwash had been widely used, however the comparative efficacy of alcohol free chlorhexidine mouthwash had not fully been explored in this study, two chlorhexidine mouthwash preparations were tested to evaluate their comparative efficacy in the treatment of periodontal disease. Aims: To assess the efficacy of alcohol-free chlorhexidine mouth wash in comparison to alcohol containing chlorhexidine mouth wash. Objectives: To determine pre- and post- operative clinical parameters and microbial load in the management of patients with chronic periodontitis. Methodology: A double blinded randomised control trial was conducted. Patients diagnosed with active chronic periodontitis were included in the study and randomised to either a test (chlorhexidine without alcohol) or control group (chlorhexidine with alcohol). A total of 50 patients were selected for the study. Results: The Wilcoxon Signed Rank test was used to test the difference between the pre-post pair per clinical indicator and Bana-Zyme. The differences between before and after treatment per indicator were significant at P<0.001 for respectively Paroex and Peridex. These values demonstrated the difference between the clinical parameters taken before the treatment and six weeks post treatment. Conclusion: Both mouth wash solutions with and without alcohol had proven to reduce the microbial load as shown by the BANA-Zyme test, with the alcohol containing solution having been more effective.

Visto que o esmalte erodido é mais susceptível ao desgaste pela abrasão por escovação, e considerando que os fluoretos (F), ou a combinação de fluoretos com o estanho (F+Sn), promove precipitados que são relativamente resistentes à escovação, o objetivo desse estudo foi o avaliar se o uso de enxaguatórios bucais fluoretados, contendo ou não estanho, previamente à escovação poderia reduzir a magnitude do desgaste do esmalte erodido. Adicionalmente, buscou-se verificar se o armazenamento em saliva artificial antes dos tratamentos influenciaria a perda de superfície do esmalte erodido. Cento e quarenta espécimes de esmalte (com 4mmx4mmx2mm) foram obtidos de incisivos bovinos, incluídos em resina acrílica, planificados, polidos e aleatoriamente alocados em 14 grupos experimentais (n=10), de acordo com os seguintes tratamentos, os quais foram aplicados imediatamente ou 30min após a erosão: controle- escovação com saliva artificial; E(F)- escovação com dentifrício F (1400 ppm F, como AmF); E+B(F)- escovação com o dentifrício F seguido de bochecho com um enxaguatório F (250 ppm F, como AmF e NaF); B+E(F)- bochecho com enxaguatório F seguido de escovação com dentifrício F; E(F+Sn)- escovação com dentifrício F+Sn (1400 ppm F, como AmF e NaF + 3500 ppm Sn, como SnCl2); E+B(F+Sn)- escovação com dentifrício F+Sn seguido de bochecho com enxaguatório F+Sn (500 ppm F, como AmF e NaF + 800 ppm Sn, como SnCl2); B+E(F+Sn)- bochecho com enxaguatório F+Sn seguido de escovação com dentifrício F+Sn. Os tratamentos foram testados em um modelo de erosão-abrasão, que consistia de 2min de imersão em solução de ácido cítrico a 0,3%, seguido de 60min de exposição a saliva artificial. Esse procedimento foi repetido 4x/dia, por 5 dias. Os tratamentos foram realizados imediatamente ou 30min após o primeiro e o último desafios erosivos. A escovação foi conduzida com escova elétrica, por 15s, com um período total de exposição à suspensão dentifrício/saliva artificial (1:3) de 2min. A exposição aos enxaguatórios foi feita por 30s. Ao final, a perda de superfície (PS, em ?m) foi determinada com um perfilômetro ótico. Os dados foram estatisticamente analisados (?=0,05). Para os grupos com exposição à saliva antes dos tratamentos, a menor PS foi observada para B+E(F) e B+E(F+Sn), que obtiveram uma diferença significativa em relação ao controle, porém não em relação a E+B(F) e E+B(F+Sn). E+B(F), E+B(F+Sn) e os outros grupos não diferiram significativamente em relação ao controle. Para os grupos sem exposição à saliva, a menor PS foi observada para B+E(F) e B+E(F+Sn), sendo significativamente diferente do controle. Todos os outros grupos não exibiram PS diferente do controle. Para B+E(NaF), a menor PS foi observada na condição sem exposição à saliva antes dos tratamentos, e para E+B(Sn), a menor PS foi observada com exposição à saliva. Não houve diferença entre exposição ou não à saliva para os outros grupos. Conclui-se que, tanto para F como para F+Sn, o uso do enxaguatório antes da escovação foi capaz de reduzir o desgaste do esmalte erodido. A exposição à saliva antes da escovação somente mostrou um efeito benéfico para F+Sn quando a escovação foi realizada antes do enxaguatório. A combinação de F+Sn não apresentou resultado superior ao uso de apenas F. / Considering that the eroded enamel is more susceptible to be wear off by toothbrushing abrasion, and that fluoride, or the combination between fluoride and stannous, would induce precipitates that are relatively resistant to toothbrushing, the objective of this study was to evaluate whether the use of fluoridated oral rinses, containing or not stannous, could reduce the magnitude of wear of the eroded enamel. In addition, it sought to verify if storage in artificial saliva before treatments would influence the loss of the eroded enamel. One hundred and forty enamel specimens (with 4mmx4mmx2mm) were cut from bovine incisors, embedded in acrylic resin, flattened, polished, and randomly allocated into 14 experimental groups (n=10), according to the following treatments, which were applied immediately or 30min after erosion: control- toothbrushing with artificial saliva; E(F)- toothbrushing with F dentifrice (1400 ppm F, as AmF); E+B(F)- toothbrushing with F dentifrice, followed by rinse with F solution (250 ppm F, as AmF and NaF); B+E(F)- rinse with F solution, followed by toothbrushing with F dentifrice; E(F+Sn)- toothbrushing with F+Sn dentifrice (1400 ppm F, as AmF and NaF + 3500 ppm Sn, as SnCl2); E+B(F+Sn)- toothbrushing with F+Sn dentifrice, followed by rinse with F+Sn solution (500 ppm F, as AmF and NaF + 800 ppm Sn, as SnCl2); B+E(F+Sn)- rinse with F+Sn solution, followed by toothbrushing with F+Sn dentifrice. The treatments were tested in an erosion-abrasion model, consisting of 2min immersion in 0.3% citric acid solution, followed by 60min exposure to artificial saliva. This procedure was repeated 4x/day, for 5 days. The treatments were performed immediately or 30min after the first and the last erosive challenges. Toothbrushing was performed with electric toothbrushes, for 15s, with a total exposure time to the dentifrice slurries (1:3) of 2 min. Exposure to the rinse solutions were performed for 30s. At the end of cycling, enamel surface loss (SL, in ?m) was measured by optical profilometry. Data were statiscally analyzed (?=0.05). For the groups with saliva exposure before treatments, the lowest SL was observed for B+E(F) and B+E(F+Sn), which were significantly different when compared to the control, but not in relation to E+B(F) and E+B(F+Sn). E+B(F), E+B(F+Sn) and the other groups did not significantly differ from the control. For the groups without saliva exposure, the lowest SL was observed for B+E(F) and B+E(F+Sn), being significantly different from the control. The other groups did not exhibit SL different from the control. For B+E(NaF), the lowest SL was observed without saliva exposure, and for +B(Sn), the lowest SL was observed with saliva exposure. There was no significantly difference between the conditions of exposure or not to saliva for the other groups. It was concluded that, either for F as for F+Sn, rinsing with a fluoridated solution before toothbrushing was able to reduce the wear of the eroded enamel. Saliva exposure before toothbrushing showed a positive effect only for F+Sn when toothbrushing was performed before the rinse. The combination of F+Sn did not present superior results to the use of only F.

Background: A multitude of studies suggest an association between periodontal disease and adverse birth outcomes. Although the evidence is controversial, it is biologically plausible, and the key link maybe inflammation. Purpose: To correlate levels of periodontal disease as measured by conventional methods with PMN counts from an oral rinse in pregnant women. Methods: Sixty-three pregnant women were recruited. Periodontal examinations were carried out. Fifteen-second saline rinses were collected. ABTS, a colour changing redox agent was added to each rinse. The intensity of the colour reaction was measured by absorbance to count the oral PMNs. Results: A statistically significant difference in oral PMN counts was observed between those with periodontal disease and the healthy patients (P < .05). The sensitivity and specificity using the bleeding index was 0.94 and 0.76 respectively. Conclusions: The rinse assay can be used as a screening tool for periodontal disease and oral inflammation in pregnant women.

Background: A multitude of studies suggest an association between periodontal disease and adverse birth outcomes. Although the evidence is controversial, it is biologically plausible, and the key link maybe inflammation. Purpose: To correlate levels of periodontal disease as measured by conventional methods with PMN counts from an oral rinse in pregnant women. Methods: Sixty-three pregnant women were recruited. Periodontal examinations were carried out. Fifteen-second saline rinses were collected. ABTS, a colour changing redox agent was added to each rinse. The intensity of the colour reaction was measured by absorbance to count the oral PMNs. Results: A statistically significant difference in oral PMN counts was observed between those with periodontal disease and the healthy patients (P < .05). The sensitivity and specificity using the bleeding index was 0.94 and 0.76 respectively. Conclusions: The rinse assay can be used as a screening tool for periodontal disease and oral inflammation in pregnant women.

Visto que o esmalte erodido é mais susceptível ao desgaste pela abrasão por escovação, e considerando que os fluoretos (F), ou a combinação de fluoretos com o estanho (F+Sn), promove precipitados que são relativamente resistentes à escovação, o objetivo desse estudo foi o avaliar se o uso de enxaguatórios bucais fluoretados, contendo ou não estanho, previamente à escovação poderia reduzir a magnitude do desgaste do esmalte erodido. Adicionalmente, buscou-se verificar se o armazenamento em saliva artificial antes dos tratamentos influenciaria a perda de superfície do esmalte erodido. Cento e quarenta espécimes de esmalte (com 4mmx4mmx2mm) foram obtidos de incisivos bovinos, incluídos em resina acrílica, planificados, polidos e aleatoriamente alocados em 14 grupos experimentais (n=10), de acordo com os seguintes tratamentos, os quais foram aplicados imediatamente ou 30min após a erosão: controle- escovação com saliva artificial; E(F)- escovação com dentifrício F (1400 ppm F, como AmF); E+B(F)- escovação com o dentifrício F seguido de bochecho com um enxaguatório F (250 ppm F, como AmF e NaF); B+E(F)- bochecho com enxaguatório F seguido de escovação com dentifrício F; E(F+Sn)- escovação com dentifrício F+Sn (1400 ppm F, como AmF e NaF + 3500 ppm Sn, como SnCl2); E+B(F+Sn)- escovação com dentifrício F+Sn seguido de bochecho com enxaguatório F+Sn (500 ppm F, como AmF e NaF + 800 ppm Sn, como SnCl2); B+E(F+Sn)- bochecho com enxaguatório F+Sn seguido de escovação com dentifrício F+Sn. Os tratamentos foram testados em um modelo de erosão-abrasão, que consistia de 2min de imersão em solução de ácido cítrico a 0,3%, seguido de 60min de exposição a saliva artificial. Esse procedimento foi repetido 4x/dia, por 5 dias. Os tratamentos foram realizados imediatamente ou 30min após o primeiro e o último desafios erosivos. A escovação foi conduzida com escova elétrica, por 15s, com um período total de exposição à suspensão dentifrício/saliva artificial (1:3) de 2min. A exposição aos enxaguatórios foi feita por 30s. Ao final, a perda de superfície (PS, em ?m) foi determinada com um perfilômetro ótico. Os dados foram estatisticamente analisados (?=0,05). Para os grupos com exposição à saliva antes dos tratamentos, a menor PS foi observada para B+E(F) e B+E(F+Sn), que obtiveram uma diferença significativa em relação ao controle, porém não em relação a E+B(F) e E+B(F+Sn). E+B(F), E+B(F+Sn) e os outros grupos não diferiram significativamente em relação ao controle. Para os grupos sem exposição à saliva, a menor PS foi observada para B+E(F) e B+E(F+Sn), sendo significativamente diferente do controle. Todos os outros grupos não exibiram PS diferente do controle. Para B+E(NaF), a menor PS foi observada na condição sem exposição à saliva antes dos tratamentos, e para E+B(Sn), a menor PS foi observada com exposição à saliva. Não houve diferença entre exposição ou não à saliva para os outros grupos. Conclui-se que, tanto para F como para F+Sn, o uso do enxaguatório antes da escovação foi capaz de reduzir o desgaste do esmalte erodido. A exposição à saliva antes da escovação somente mostrou um efeito benéfico para F+Sn quando a escovação foi realizada antes do enxaguatório. A combinação de F+Sn não apresentou resultado superior ao uso de apenas F. / Considering that the eroded enamel is more susceptible to be wear off by toothbrushing abrasion, and that fluoride, or the combination between fluoride and stannous, would induce precipitates that are relatively resistant to toothbrushing, the objective of this study was to evaluate whether the use of fluoridated oral rinses, containing or not stannous, could reduce the magnitude of wear of the eroded enamel. In addition, it sought to verify if storage in artificial saliva before treatments would influence the loss of the eroded enamel. One hundred and forty enamel specimens (with 4mmx4mmx2mm) were cut from bovine incisors, embedded in acrylic resin, flattened, polished, and randomly allocated into 14 experimental groups (n=10), according to the following treatments, which were applied immediately or 30min after erosion: control- toothbrushing with artificial saliva; E(F)- toothbrushing with F dentifrice (1400 ppm F, as AmF); E+B(F)- toothbrushing with F dentifrice, followed by rinse with F solution (250 ppm F, as AmF and NaF); B+E(F)- rinse with F solution, followed by toothbrushing with F dentifrice; E(F+Sn)- toothbrushing with F+Sn dentifrice (1400 ppm F, as AmF and NaF + 3500 ppm Sn, as SnCl2); E+B(F+Sn)- toothbrushing with F+Sn dentifrice, followed by rinse with F+Sn solution (500 ppm F, as AmF and NaF + 800 ppm Sn, as SnCl2); B+E(F+Sn)- rinse with F+Sn solution, followed by toothbrushing with F+Sn dentifrice. The treatments were tested in an erosion-abrasion model, consisting of 2min immersion in 0.3% citric acid solution, followed by 60min exposure to artificial saliva. This procedure was repeated 4x/day, for 5 days. The treatments were performed immediately or 30min after the first and the last erosive challenges. Toothbrushing was performed with electric toothbrushes, for 15s, with a total exposure time to the dentifrice slurries (1:3) of 2 min. Exposure to the rinse solutions were performed for 30s. At the end of cycling, enamel surface loss (SL, in ?m) was measured by optical profilometry. Data were statiscally analyzed (?=0.05). For the groups with saliva exposure before treatments, the lowest SL was observed for B+E(F) and B+E(F+Sn), which were significantly different when compared to the control, but not in relation to E+B(F) and E+B(F+Sn). E+B(F), E+B(F+Sn) and the other groups did not significantly differ from the control. For the groups without saliva exposure, the lowest SL was observed for B+E(F) and B+E(F+Sn), being significantly different from the control. The other groups did not exhibit SL different from the control. For B+E(NaF), the lowest SL was observed without saliva exposure, and for +B(Sn), the lowest SL was observed with saliva exposure. There was no significantly difference between the conditions of exposure or not to saliva for the other groups. It was concluded that, either for F as for F+Sn, rinsing with a fluoridated solution before toothbrushing was able to reduce the wear of the eroded enamel. Saliva exposure before toothbrushing showed a positive effect only for F+Sn when toothbrushing was performed before the rinse. The combination of F+Sn did not present superior results to the use of only F.

>Magister Scientiae - MSc / Different chlorhexidine (CHX) preparations and formulations are available in local markets. Some preparations contain anti-discoloration systems (ADS), additional antimicrobials like cetylpyridinium chloride (CPC), or alcohol. The aim of this study was to compare the antimicrobial efficacies of 3 different CHX preparations (Corsodyl®, Curasept® and GUM® Paroex®)

Magister Chirurgiae Dentium - MChD (Oral Medicine and Periodontics) / The aim of this study was to assess whether a mouthwash containing carbohydrate derived fulvic acid, is effective in reducing the salivary microbial count pre-operatively. Endeavours have been made to reduce the risk of infection, bacteraemia and cross-contamination during dental procedures by the application of topical antimicrobial agents. To date chlorhexidine is the most widely evaluated and efficacious agent against oral biofilms but there have been reports of adverse effects ranging from contact dermatitis to severe anaphylactic shock. A new mouth rinse containing carbohydrate derived fulvic acid are reported to have broad spectrum antimicrobial activity against specific oral microbes and Candida albicans with no side effects.