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Showing papers in "Brazilian Oral Research in 2011"


Journal ArticleDOI
TL;DR: Clinical management includes oral approaches, especially periodontal treatment and oral hygiene instructions, including the tongue, when oral strategies are not successful, and referral to physicians is warranted.
Abstract: Halitosis is an unpleasant condition that causes social restraint. Studies worldwide indicate a high prevalence of moderate halitosis, whereas severe cases are restricted to around 5% of the populations. The etiological chain of halitosis relates to the presence of odoriferous substances in exhaled air, especially the volatile sulphur compounds (VSC) produced by bacteria. The organoleptic diagnosis is the gold standard and clinical management includes oral approaches, especially periodontal treatment and oral hygiene instructions, including the tongue. When oral strategies are not successful, referral to physicians is warranted.

91 citations


Journal ArticleDOI
TL;DR: Lower levels of microleakage were recorded with self-adhesive resin cement, while CAD/CAM-fabricated ZrO2 copings showed smaller marginal discrepancy and less microle leakage in comparison to cast Cr-Co.
Abstract: The purpose of this study was to evaluate the effects of both marginal fit and cementing with different luting agents on the microleakage of all-ceramic crown systems. Thirty-six extracted upper central incisors were prepared for full-coverage crowns and were divided into three groups. Group 1: CAD/CAM-fabricated ZrO2, Group 2: Heat-pressed lithium-disilicate, and Group 3: Cast Cr-Co copings as the control group. Copings were made following standard techniques, and groups were assigned cementation with either self-adhesive resin cement (A) or glass-ionomer luting cement (B). The specimens were subjected to thermocycling, immersed in basic fuchsin solution, sectioned mesiodistally and buccolingually. The surface of each section was digitally photographed under a stereomicroscope. Microleakage was scored using a five-point scale, and the marginal gap was measured using image analysis software. Data were statistically analyzed using 2-way ANOVA, Kruskal-Wallis, and Mann-Whitney U tests (α: 0.05). The marginal discrepancy of each group was 82.7 ± 7 µm, 92.6 ± 4 µm and 96.5 ± 7 µm respectively. Group 1 showed significantly smaller gaps than Group 3 (P = 0.042). Self-adhesive resin cement (A) showed a lower level of microleakage than glass-ionomer luting cement (B) in all groups (P = 0.029). Microleakage scores of '0' were 83% for 1A, 50% for 1B, 50% for 2A, 16% for 2B, 33% for 3A and none for 3B. Marginal discrepancy and cement type both had significant effects on microleakage. Lower levels of microleakage were recorded with self-adhesive resin cement, while CAD/CAM-fabricated ZrO2 copings showed smaller marginal discrepancy and less microleakage in comparison to cast Cr-Co.

90 citations


Journal ArticleDOI
TL;DR: Inequalities in the distribution of dental caries were observed and socioeconomic factors were found to be strong predictors of the prevalence of oral disease in children of this age group.
Abstract: We assessed the inequality in the distribution of dental caries and the association between indicators of socioeconomic status and caries experience in a representative sample of schoolchildren. This study followed a cross-sectional design, with a sample of 792 schoolchildren aged 12 years, representative of this age group in Santa Maria, RS, Brazil. Guardians answered questions on socioeconomic status and a dental examination provided information on the dental caries experience (DMF-T). Inequality in dental caries distribution was measured by the Gini coefficient and the Significant Caries Index (SiC). The assessment of association used Poisson regression models. Socioeconomic factors were associated with prevalence of dental caries for the whole sample and also for individuals with a high-caries level. Children from low-income households had the highest prevalence of dental caries. The Gini coefficient was 0.7 and the SiC Index 2.5. The percentage of caries prevalence was 39.3% (95% CI: 35.8%-42.8%) and the mean for DMF-T was 0.9 (± SD 1.5). Inequalities in the distribution of dental caries were observed and socioeconomic factors were found to be strong predictors of the prevalence of oral disease in children of this age group.

86 citations


Journal ArticleDOI
TL;DR: The high hTERT immunoexpression in all three lesions indicates that telomerase is present in clinically altered oral mucosa but does not differentiate hyperplastic from dysplastic oral epithelium.
Abstract: Oral carcinogenesis is a multi-step process. One possible step is the development of potentially malignant disorders known as leukoplakia and erytroplakia. The objective of this study was to use immunohistochemistry to analyze the patterns of expression of the cell-cycle regulatory proteins p53 and p16(INK4a) in potentially malignant disorders (PMD) of the oral mucosa (with varying degrees of dysplasia) and in oral squamous cell carcinomas (OSCC) to correlate them with the expression of telomerase (hTERT). Fifteen PMD and 30 OSCC tissue samples were analyzed. Additionally, 5 cases of oral epithelial hyperplasia (OEH) were added to analyze clinically altered mucosa presenting as histological hyperplasia without dysplasia. p53 positivity was observed in 93.3% of PMD, in 63.3% of OSCC and in 80% of OEH. Although there was no correlation between p53 expression and the grade of dysplasia, all cases with severe dysplasia presented p53 suprabasal immunoexpression. p16(INK4a) expression was observed in 26.7% of PMD, in 43.3% of OSCC and in 2 cases of OEH. The p16(INK4a) expression in OEH, PMD and OSCC was unable to differentiate non-dysplastic from dysplastic oral epithelium. hTERT positivity was observed in all samples of OEH and PMD and in 90% of OSCC. The high hTERT immunoexpression in all three lesions indicates that telomerase is present in clinically altered oral mucosa but does not differentiate hyperplastic from dysplastic oral epithelium. In PMD of the oral mucosa, the p53 immunoexpression changes according to the degree of dysplasia by mechanisms independent of p16(INK4a) and hTERT.

71 citations


Journal ArticleDOI
TL;DR: It is suggested that acupuncture focused in a preventive approach can be a useful therapy in the management of patients with head and neck cancer undergoing RT and significantly minimized the severity of radiation-induced xerostomia.
Abstract: The aim of this study was to evaluate the effectiveness of acupuncture in minimizing the severity of radiation-induced xerostomia in patients with head and neck cancer. A total of 24 consecutive patients receiving > 5000 cGy radiotherapy (RT) involving the major salivary glands bilaterally were assigned to either the preventive acupuncture group (PA, n = 12), treated with acupuncture before and during RT, or the control group (CT, n = 12), treated with RT and not receiving acupuncture. After RT completion, clinical response was assessed in all patients by syalometry, measuring the resting (RSFR) and stimulated (SSFR) salivary flow rates, and by the visual analogue scale (VAS) regarding dry mouth-related symptoms. Statistical analyses were performed with repeated-measures using a mixed-effect modeling procedure and analysis of variance. An alpha level of 0.05 was accepted for statistical significance. Although all patients exhibited some degree of impairment in salivary gland functioning after RT, significant differences were found between the groups. Patients in the PA group showed improved salivary flow rates (RSFR, SSFR; p < 0.001) and decreased xerostomia-related symptoms (VAS, p < 0.05) compared with patients in the CT group. Although PA treatment did not prevent the oral sequelae of RT completely, it significantly minimized the severity of radiation-induced xerostomia. The results suggest that acupuncture focused in a preventive approach can be a useful therapy in the management of patients with head and neck cancer undergoing RT.

69 citations


Journal ArticleDOI
TL;DR: It is concluded that the mouthwashes containing hydrogen peroxide and/or alcohol decrease the microhardness of the resins tested; however, the mouthwash containing hydrogenperoxide had a higher deleterious effect on roughness.
Abstract: The aim of this in vitro study was to evaluate the effect of different mouthwashes on superficial roughness and Knoop hardness of two resin composites. Eighty specimens (6 mm O and 2 mm height) were prepared and divided into eight experimental groups (n = 10) according to the resin composites (4 Seasons and Esthet X), and storage solutions (G1 - Distilled water; G2 - Colgate Plax Overnight; G3 - Colgate Plax Alcohol Free; and G4 - Colgate Plax Whitening). The initial hardness and roughness readings (T1) were measured and then the specimens were stored in 2 mL of mouthwash for 12 h (T2) and 24 h (T3). The data were analyzed with repeat-measures two-way ANOVA and Tukey's test (α = 5%). Regardless of the type of solution and time of exposure, there was no statistical difference for roughness between the resins (p = 0.44). G4 and G8 presented higher roughness means than G1, G3, G5 and G7, after 12 and 24 hours of immersion. For Knoop microhardness analysis, there was a significant reduction for all groups after 12 hours and 24 hours. We conclude that the mouthwashes containing hydrogen peroxide and/or alcohol decrease the microhardness of the resins tested; however, the mouthwash containing hydrogen peroxide had a higher deleterious effect on roughness.

69 citations


Journal ArticleDOI
TL;DR: The passion fruit group underwent the greatest microhardness change, while the mustard group suffered the greatest color alteration, and significant positive correlation was found between the two variables for the groups deionized water, grape juice, soy sauce and ketchup.
Abstract: Composite resins might be susceptible to degradation and staining when in contact with some foods and drinks. This study evaluated color alteration and changes in microhardness of a microhybrid composite after immersion in different colored foods and determined whether there was a correlation between these two variables. Eighty composite disks were randomly divided into 8 experimental groups (n = 10): kept dry; deionized water; orange juice; passion fruit juice; grape juice; ketchup; mustard and soy sauce. The disks were individually immersed in their respective test substance at 37 oC, for a period of 28 days. Superficial analysis of the disk specimens was performed by taking microhardness measurements (Vickers, 50 g load for 45 seconds) and color alterations were determined with a spectrophotometer (CINTRA 10- using a CIEL*a*b* system, 400-700 nm wavelength, illuminant d65 and standard observer of 2o) at the following times: baseline (before immersion), 1, 7, 14, 21 and 28 days. Results were analyzed by ANOVA and Tukey's test (p < 0.05). Both variables were also submitted to Pearson's correlation test (p < 0.05). The passion fruit group underwent the greatest microhardness change, while the mustard group suffered the greatest color alteration. Significant positive correlation was found between the two variables for the groups deionized water, grape juice, soy sauce and ketchup. Not all color alteration could be associated with surface degradation.

64 citations


Journal ArticleDOI
TL;DR: This in vitro study evaluated the physical-chemical characteristics of whitening toothpastes and their effect on bovine enamel after application of a bleaching agent (16% carbamide peroxide).
Abstract: This in vitro study evaluated the physical-chemical characteristics of whitening toothpastes and their effect on bovine enamel after application of a bleaching agent (16% carbamide peroxide). Physical-chemical analysis was made considering mass loss by desiccation, ash content and pH of the toothpastes. Thirty bovine dental enamel fragments were prepared for roughness measurements. The samples were subjected to bleaching treatments and simulated brushing: G1. Sorriso Dentes Brancos (Conventional toothpaste), G2. Close-UP Whitening (Whitening toothpaste), and G3. Sensodyne Branqueador (Whitening toothpaste). The average roughness (Ra) was evaluated prior to the bleaching treatment and after brushing. The results revealed differences in the physical-chemical characteristics of the toothpastes (p < 0.0001). The final Ra had higher values (p < 0.05) following the procedures. The mean of the Ra did not show significant differences, considering toothpaste groups and bleaching treatment. Interaction (toothpaste and bleaching treatment) showed significant difference (p < 0.0001). The whitening toothpastes showed differences in their physical-chemical properties. All toothpastes promoted changes to the enamel surface, probably by the use of a bleaching agent.

60 citations


Journal ArticleDOI
TL;DR: The presence of DED may cause negative impacts on a child's perception of oral health and on their daily performance, and this condition was associated with an impact on the functional limitation domain.
Abstract: This cross-sectional study assessed the impact of Developmental Enamel Defects (DED) on Child Oral Health-Related Quality of Life (COHRQoL). A sample of 944 11- to 14-year-old Brazilian schoolchildren was examined for the prevalence and severity of DED. The children completed the Child Perceptions Questionnaire (CPQ11-14), and socioeconomic status was also collected using a questionnaire. Poisson regression models were used to assess the association between DED and overall and domain-specific CPQ11-14 scores. The prevalence of DED was 19.7%. In general, children with DED did not indicate any decrease in self-perception. However, this condition was associated with an impact on the functional limitation domain. The presence of DED may cause negative impacts on a child's perception of oral health and on their daily performance.

56 citations


Journal ArticleDOI
TL;DR: It is demonstrated that periodontal ligament and gingival fibroblasts when challenged by LPS from P. gingialis with 24 h may play a critical role in producing TGF-β and IL-8 but not IL-10.
Abstract: The aim of this study was to quantify and compare the production of transforming growth factor beta (TGF-β), interleukin (IL)-8 and IL-10 by human cultured periodontal ligament and gingival fibroblasts both obtained from the same donors challenged with lipopolysaccharide (LPS) from Porphyromonas gingivalis. Fibroblasts were exposed to 0.1-10 µg/mL of LPS from P. gingivalis and after 24 h the supernatants were collected and analyzed by enzyme-linked immunosorbent assay (ELISA). TGF-β protein production was upregulated in a concentration-dependent manner, mainly in gingival fibroblasts, which was statistically significant when challenged by 10 µg/mL LPS. Additionally, at this concentration, gingival fibroblasts had almost a two-fold increase in the amount of TGF-β when compared to periodontal ligament fibroblasts. Both periodontal ligament and gingival fibroblasts showed an increase in IL-8 production when challenged with 1 µg/mL and 10 µg/mL LPS. IL-10 production remained unaffected when challenged by any of the LPS concentrations tested in either periodontal ligament or gingival fibroblasts. Our results demonstrate that periodontal ligament and gingival fibroblasts when challenged by LPS from P. gingivalis with 24 h may play a critical role in producing TGF-β and IL-8 but not IL-10.

52 citations


Journal ArticleDOI
TL;DR: There is a linear relationship of pulp/root width ratio at mid-root level and pulp/tooth area ratio of the right maxillary canine with chronological age in the Indian population, and age of subjects can be estimated with a good degree of accuracy using regression equations.
Abstract: The aim of this study was to develop a method for estimating the chronological age of Indian adults based on the relationship between age and various morphological variables of canine teeth, obtained using orthopantomographs. Orthopantomographs of 120 selected patients were digitized, and radiographic images of the right maxillary canine in each case were processed using a computer aided drafting program. Pulp/tooth area ratio, pulp/root length ratio, pulp/tooth length ratio, pulp/root width ratio at the cemento-enamel junction level, pulp/root width ratio at midroot level, and pulp/root width ratio at the midpoint between the cemento-enamel junction and the midroot of the canine were calculated by measuring various features on the images. Pearson's correlation, multiple linear regression, one way analysis of variance (ANOVA), and Student's t-test were used for statistical analysis. Regression equations were developed to estimate age from morphological variables. The observed minus the estimated age in the total study sample ranged from -2.2 to +1.5 years, in males from -0.9 to +0.8 years, while in females it was from -1 to +0.8 years. Differences between observed and estimated ages of subjects were not statistically significant. In conclusion there is a linear relationship of pulp/root width ratio at mid-root level and pulp/tooth area ratio of the right maxillary canine with chronological age in the Indian population. Age of subjects can therefore be estimated with a good degree of accuracy using regression equations.

Journal ArticleDOI
TL;DR: In conclusion, ST patterns vary depending on gender; ST in the midline region occurred more often in males whereasST in the incisor region were more common in females.
Abstract: The presence of supernumerary teeth (ST) is a dental developmental anomaly of patterning and morphogenesis. Its variability of morphology, location and developmental timing can shed light on its etiology. In this work we report ST patterns. Orthopantomograms of 1,166 pediatric subjects were examined and the morphology, location and timing of the formation of ST were determined. The frequency of supernumerary teeth in the studied population was 2.3% (n = 27). Twenty-five subjects presented one ST. Maxilla midline was the most commonly affected region (nine cases). We noted high incidence of conical morphology in the midline region. Only teeth with tuberculate morphology presented delayed formation. ST in the midline region occurred more often in males whereas ST in the incisor region were more common in females. In conclusion, ST patterns vary depending on gender.

Journal ArticleDOI
TL;DR: The results demonstrated that the tested antifungal agents showed good activity for most isolates from both groups; however, variability in MIC values among isolates was observed.
Abstract: Oropharyngeal candidiasis is the most common fungal infection among HIV-positive patients. This condition can be treated with either systemic or topical antifungal agents; treatments are usually indicated empirically on the basis of clinical data. The knowledge of in vitro antifungal susceptibility is important to determine correct therapeutic guides for the treatment of fungal infections. Therefore, the objective of this study was to determine the antifungal susceptibility profile of oral Candida isolates from HIV-positive patients and control individuals. Amphotericin B, fluconazole, flucytosine, nystatin and ketoconazole were tested according to the methodology of microdilution proposed by the Clinical and Laboratory Standards Institute (CLSI); results were recorded in values of minimal inhibitory concentration (MIC). A total of 71 Candida isolates from HIV-positive patients were examined with the following species represented: C. albicans (59), C. tropicalis (9), C. glabrata (1), C. guilliermondii (1) and C. krusei (1). A total of 15 Candida isolates were evaluated from control individuals comprised of 11 C. albicans and 4 C. tropicalis samples. Our results demonstrated that the tested antifungal agents showed good activity for most isolates from both groups; however, variability in MIC values among isolates was observed.

Journal ArticleDOI
TL;DR: Sucking habits, posterior crossbite and tooth wear facets were identified as being directly associated with the clinical manifestations of bruxism.
Abstract: Studies have found a higher prevalence of sleep bruxism (SB) in individuals with cognitive impairment. The aim of this study was to identify the prevalence and factors associated with the clinical manifestation of SB in children with and without cognitive impairment. The sample was made up of 180 individuals: Group 1 - without cognitive impairment; Group 2 - with Down syndrome; Group 3 - with cerebral palsy. Malocclusions were assessed based on the Dental Aesthetic Index (DAI); lip competence was assessed based on Ballard's description. The bio-psychosocial characteristics were assessed via a questionnaire and clinical exam. Statistical analysis involved the chi-square test (p < 0.05) and multivariate logistic regression. The prevalence of bruxism was 23%. There were no significant differences between the groups (p = 0.970). Individuals with sucking habits (OR [95% CI] = 4.44 [1.5 to 13.0]), posterior crossbite (OR [95% CI] = 3.04 [1.2 to 7.5]) and tooth wear facets (OR [95% CI] = 3.32 [1.2 to 8.7]) had a greater chance of exhibiting SB. Sucking habits, posterior crossbite and tooth wear facets were identified as being directly associated with the clinical manifestations of bruxism.

Journal ArticleDOI
TL;DR: The results showed that PDT was effective in reducing the number of viable cells of all clinical Staphylococcus isolates studied, and a decreasing susceptibility to treatment of S. aureus, S. schleiferi, and S. lentus.
Abstract: Staphylococcus spp. are opportunistic microorganisms known for their capacity to develop resistance against antimicrobial agents. The objective of this study was to evaluate the effect of photodynamic therapy (PDT) on 20 Staphylococcus strains isolated from the human oral cavity, including S. aureus, S. schleiferi, S. epidermidis, S. capitis, S. haemolyticus, and S. lentus. A suspension of each Staphylococcus strain (10(6) cells/mL) was submitted to PDT using methylene blue and a low power laser. The isolated effects of methylene blue, laser treatment and ciprofloxacin were also evaluated. After the experimental treatments, 0.1 mL aliquots of the suspensions were seeded onto BHI agar for determination of the number of colony-forming units (CFU/mL). The results were analyzed by analysis of variance and Tukey's test (p < 0.05). The mean reduction in bacterial counts of the strains submitted to PDT ranged from 4.89 to 6.83 CFU (log10)/mL, with the observation of a decreasing susceptibility to treatment of S. schleiferi, S. haemolyticus, S. epidermidis, S. capitis, S. aureus, and S. lentus. The results showed that PDT was effective in reducing the number of viable cells of all clinical Staphylococcus isolates studied.

Journal ArticleDOI
TL;DR: It can be concluded that craniofacial dimensions play a role in asymmetry of bite force within the limitations of this study.
Abstract: Craniofacial dimensions influence oral functions; however, it is not known whether they are associated with function asymmetry. The objective of this study was to evaluate chewing side preference and lateral asymmetry of occlusal contact area and bite force of individuals with different craniofacial patterns. Seventy-eight dentate subjects were divided into 3 groups according to the VERT index as follows: (1) mesofacial, (2) brachyfacial and (3) dolichofacial. Chewing side preference was evaluated using jaw tracking equipment, occlusal contact area was measured by silicon registration of posterior teeth, and bite force was measured unilaterally on molar regions using 2.25 mm-thick sensors. Statistical analysis was performed using ANOVA on Ranks, Student's t-test, and Mann-Whitney tests at a 5% significance level. Mesofacial, brachyfacial, and dolichofacial subjects presented more occlusal contact area on the left side. Only dolichofacial subjects showed lateral asymmetry for bite force, presenting higher force on the left side. No statistically significant differences were found for chewing side preference among all groups. Within the limitations of this study, it can be concluded that craniofacial dimensions play a role in asymmetry of bite force. ClinicalTrials.gov ID: NCT01286363.

Journal ArticleDOI
TL;DR: It is concluded that, although obstetricians were aware of the association between gingival inflammation and adverse obstetric outcomes, the attitudes of these professionals were not in agreement with their apparent knowledge regarding periodontal diseases and their possible repercussions.
Abstract: There is little information about the knowledge and attitudes of physicians regarding oral care. This study aimed to assess the knowledge and attitudes of obstetricians about the relationship between periodontal disease and preterm/low birth weight. A questionnaire was emailed to members of the Brazilian Federation of Gynecology and Obstetrics (FEBRASGO). The questionnaire elicited both personal information and knowledge and attitudes regarding the relationship between periodontal diseases and preterm labor. A total of 875 obstetricians responded to the questionnaire. The majority of respondents were female (54.1%), resided in the Southeast (45.6%), worked in both the public and private sectors (61.4%), and had over 15 years of experience in obstetrics (48.9%). A large proportion of obstetricians (93.4%) stated that bacteria were associated with periodontal disease, and 94% reported that periodontitis was a condition more severe than gingivitis. In total, over 80% of participating obstetricians reported smoking, preeclampsia, bacterial vaginosis and periodontal disease as risk factors or possible risk factors for preterm birth or low birth weight. A correlation between the experience of the obstetricians and referral of their patients for dental examinations (p < 0.001) was observed. Also, obstetricians who had had their own dental visits more recently were more likely to recommend the same for their patients (p < 0.001). It is concluded that, although obstetricians were aware of the association between gingival inflammation and adverse obstetric outcomes, the attitudes of these professionals were not in agreement with their apparent knowledge regarding periodontal diseases and their possible repercussions.

Journal ArticleDOI
TL;DR: It may be concluded that the shear bond strength of dentin is dependent on material (adhesive system), substrate depth and adhesive/depth interaction.
Abstract: The purpose of this study was to evaluate the dentin shear bond strength of four adhesive systems (Adper Single Bond 2, Adper Prompt L-Pop, Magic Bond DE and Self Etch Bond) in regards to buccal and lingual surfaces and dentin depth. Forty extracted third molars had roots removed and crowns bisected in the mesiodistal direction. The buccal and lingual surfaces were fixed in a PVC/acrylic resin ring and were divided into buccal and lingual groups assigned to each selected adhesive. The same specimens prepared for the evaluation of superficial dentin shear resistance were used to evaluate the different depths of dentin. The specimens were identified and abraded at depths of 0.5, 1.0, 1.5 and 2.0 mm. Each depth was evaluated by ISO TR 11405 using an EMIC-2000 machine regulated at 0.5 mm/min with a 200 Kgf load cell. We performed statistical analyses on the results (ANOVA, Tukey and Scheffe tests). Data revealed statistical differences (p < 0.01) in the adhesive and depth variation as well as adhesive/depth interactions. The Adper Single Bond 2 demonstrated the highest mean values of shear bond strength. The Prompt L-Pop product, a self-etching adhesive, revealed higher mean values compared with Magic Bond DE and Self Etch Bond adhesives, a total and self-etching adhesive respectively. It may be concluded that the shear bond strength of dentin is dependent on material (adhesive system), substrate depth and adhesive/depth interaction.

Journal ArticleDOI
TL;DR: It was concluded that only MTA is able to improve the secretion of IL-1β, and all materials tested increased IL-8 secretion, indicating that it could be considered the material of choice for dental pulp capping.
Abstract: Pulp repair is a complex process whose mechanisms are not yet fully understood. The first immune cells to reach the damaged pulp are neutrophils that play an important role in releasing cytokines and in phagocytosis. The objective of this study was to analyze the effect of different pulp-capping materials on the secretion of interleukin-1 beta (IL-1β) and interleukin-8 (IL-8) by migrating human neutrophils. Neutrophils were obtained from the blood of three healthy donors. The experimental groups were calcium hydroxide [Ca(OH)(2)], an adhesive system (Single Bond), and mineral trioxide aggregate (MTA). Untreated cells were used as control. Transwell chambers were used in performing the assays to mimic an in vivo situation of neutrophil chemotaxis. The pulp-capping materials were placed in the lower chamber and the human neutrophils, in the upper chamber. The cells were counted and the culture medium was assayed using ELISA kits for detecting and quantifying IL-1β and IL8. The data were compared by ANOVA followed by Tukey's test (p < 0.05). The secretion of IL-8 was significantly higher in all groups in comparison to the control group (p < 0.05). The adhesive system group showed higher IL-8 than the MTA group (p < 0.05). The secretion of IL-1β was significantly greater only in the MTA group (p < 0.001). It was concluded that only MTA is able to improve the secretion of IL-1β, and all materials tested increased IL-8 secretion. These results combined with all the other biological advantages of MTA indicate that it could be considered the material of choice for dental pulp capping.

Journal ArticleDOI
TL;DR: Evaluating the influence of applying 2% chlorhexidine for 30 seconds after phosphoric acid conditioning of dentin on the immediate and long-term bond strengths in deciduous teeth found it necessary to prevent hybrid layer degradation and positively affect bond strength over time.
Abstract: The aim of this study was to evaluate the influence of applying 2% chlorhexidine for 30 seconds after phosphoric acid conditioning of dentin on the immediate and long-term bond strengths in deciduous teeth. The occlusal enamel was removed from 40 human sound deciduous molars, which were exfoliated by natural means, and the dentin was conditioned with 37% phosphoric acid for 15 seconds and washed with running water. The specimens were divided into two groups of 20 teeth. The test group received an application of 2% chlorhexidine for 30 seconds prior to a three-step etch-and-rinse adhesive system, whereas the control group received only the adhesive system. Three cylindrical restorations were made with a composite resin for each tooth. Ten teeth in each group were submitted to a microshear bond strength test after 24 hours, while the remaining teeth were stored in distilled water at 37 °C for 6 months before testing the microshear bond strength. The test group had a higher bond strength than did the control group after 6 months of storage. No statistical differences were found when groups with the same dentin treatment were compared at different times. Short applications of chlorhexidine at low concentrations prevent hybrid layer degradation and positively affect bond strength over time.

Journal ArticleDOI
TL;DR: Clinical, socioeconomic, and psychosocial factors were strong predictors for the utilization of dental care services by schoolchildren and the better-off children were less likely to have used the public service.
Abstract: The influence of socioeconomic factors and self-rated oral health on children's dental health assistance was assessed. This study followed a cross-sectional design, with a multistage random sample of 792 12-year-old schoolchildren from Santa Maria, a city in southern Brazil. A dental examination provided information on the prevalence of dental caries (DMFT index). Data about the use of dental service, socioeconomic status, and self-perceived oral health were collected by means of structured interviews. These associations were assessed using Poisson regression models (prevalence ratio; 95% confidence interval). The prevalence of regular use of dental service was 47.8%. Children from low socioeconomic backgrounds and those who rated their oral health as "poor" used the service less frequently. The distribution of the kind of oral healthcare assistance used (public/private) varied across socioeconomic groups. The better-off children were less likely to have used the public service. Clinical, socioeconomic, and psychosocial factors were strong predictors for the utilization of dental care services by schoolchildren.

Journal ArticleDOI
TL;DR: Repairs with the proposed surface treatments were viable on both recent and aged restorations; however, phosphoric acid + adhesive alone were effective only on recent restoration.
Abstract: The purpose of the present study was to assess the bond strength of composite resin repairs subjected to different surface treatments and accelerated artificial aging. 192 cylindrical samples (CSs) were prepared and divided into 24 groups (n = 8). Half of the CSs were stored in water for 24 h, and the other half were subjected to C-UV accelerated aging for non-metallic specimens. The treatments were phosphoric acid + silane + adhesive (PSA); phosphoric acid + adhesive (PA); diamond bur + phosphoric acid + silane + adhesive (DPSA); diamond bur + phosphoric acid + adhesive (DPA); air abrasion + phosphoric acid + silane + adhesive (APSA); and air abrasion + phosphoric acid + adhesive (APA). The repair was performed and the specimens were again aged as described above. A control group (n = 8) was established and did not receive any type of aging or surface treatment. The specimens were loaded to failure in shear mode with a crosshead speed of 0.5 mm/min until fracture. Data were analyzed by one-way ANOVA/Tukey's test (p < 0.05). No statistically significant differences were found among DPSA, DPA, APSA, APA, and the control group. The aged PSA and PA achieved low bonding values and were statistically different from the control group, whereas the non-aged PSA and PA presented no statistically significant difference from the control group. Repairs with the proposed surface treatments were viable on both recent and aged restorations; however, phosphoric acid + adhesive alone were effective only on recent restorations.

Journal ArticleDOI
TL;DR: It may be suggested that bottle feeding alone is not directly associated with higher prevalence rates of increased overjet and Class 2 canine relationship in the primary dentition, compared to those without a history of nonnutritive sucking behavior.
Abstract: The aim of this study was to investigate the association between bottle feeding and prevalence rates of increased overjet and Class 2 primary canine relationship. The sample consisted of 911 children (461 boys, 450 girls) aged 3 (13.9%), 4 (40.8%), 5 (34%) and 6 (11.3%) years, with complete primary dentition. Information about nutritive and nonnutritive (pacifier and/or digit) sucking habits was collected through questionnaires. Three calibrated dentists (κ: 0.9-1.0 and Rs > 0.90) performed the clinical assessments. The children were divided into four groups: G1 - not bottle-fed; G2 - exclusively bottle-fed; G3 - breast- and bottle-fed, bottle feeding ceased before 3 years of age; and G4 - breast- and bottle-fed, bottle feeding ceased between 3 and 4 years of age. Associations between nutritive and nonnutritive sucking behaviors and the malocclusions studied were analyzed by multiple binary logistic regression (α= 0.05). The frequencies of increased overjet were: 25.3% (G1), 38.8% (G2), 39.2% (G3) and 47.8% (G4). The percentages of Class 2 canine relationship were: 27.9% (G1), 48.8% (G2), 43.4% (G3) and 43% (G4). No significant effect of bottle feeding was found. The chances of diagnosing increased overjet (O.R. = 4.42, p < 0.001) and Class 2 canine relationship (O.R. = 4.02, p < 0.001) were greater for children with pacifier and/or digit-sucking habits, compared to those without a history of nonnutritive sucking behavior. It may be suggested that bottle feeding alone is not directly associated with higher prevalence rates of increased overjet and Class 2 canine relationship in the primary dentition.

Journal ArticleDOI
TL;DR: The prevalence of dental trauma among individuals with cerebral palsy was high and a lack of lip seal was identified as a factor directly associated to this prevalence.
Abstract: The aim of the present study was to determine the prevalence of dental trauma and associated factors among a sample of patients with severe cerebral palsy. The sample was made up of 120 individuals equally divided into two groups. The group with cerebral palsy was made up of 60 patients diagnosed with the spastic form of the disease. The control group was made up of 60 individuals with no mental impairment. Questionnaires were used to collect information on individual, socioeconomic and behavioral characteristics. Dental trauma was assessed based on the clinical chart of each participant, on a questionnaire and on a clinical evaluation to determine past injuries. Mouth mirrors and millimeter periodontal probes (Community Periodontal Index probe) were used to measure overjet. Lip seal and breathing type were determined during the clinical exams and interviews. Statistical analysis involved the chi-square test (p < 0.05) and multivariate logistic regression (forward stepwise procedure). The prevalence of dental trauma was greater among individuals with cerebral palsy (18%) than in the control group (5%), with the difference achieving statistical significance (p = 0.023). Individuals with lip incompetence had a greater chance of exhibiting dental trauma (OR [CI 95%] = 3.81 [1.19-12.24]). The prevalence of dental trauma among individuals with cerebral palsy was high. A lack of lip seal was identified as a factor directly associated to this prevalence.

Journal ArticleDOI
TL;DR: The high observed prevalence of melanotic maculae and Fordyce's granules suggests that these alterations could be considered typical characteristics of the population of the Vale do Jequitinhonha, Brazil, and may be related to the socioeconomic deprivation in the region.
Abstract: This study aimed to evaluate the prevalence and factors associated with oral mucosa alterations in patients from Vale do Jequiti-nhonha, Brazil. The sample consisted of 511 patients of both genders. Questionnaires were used to obtain information about patient gender, age, race, systemic disease state, medication use, cigarette use and alcohol consumption. Physical examinations were then performed to identify lesions of the oral mucosa. Descriptive analyses, Chi-squared tests and logistic regressions were then used to analyze the results (p < 0.05, 95% CI). In this population, 84.9% (434/511) of patients were found to have alterations in their oral mucosa. The most common alterations were melanotic maculae (36.0%), linea alba (33.9%), traumatic ulcers (21.5%), Fordyce's granules (20.4%), coated tongue (12.5%) and fissured tongue (10.0%). Melanotic maculae were more frequently observed in black patients, with an odds ration (OR) of 7.51. Being female was a statistically significant predictive factor for having a visible linea alba (OR: 1.90) and a fissured tongue (OR: 2.11). No statistically significant association was found between the presence of oral lesions and systemic disease, medication use, alcohol use and smoking. The high observed prevalence of melanotic maculae and Fordyce's granules suggests that these alterations could be considered typical characteristics of the population of the Vale do Jequitinhonha. Coated tongue may be related to the socioeconomic deprivation in the region. Furthermore, the high prevalence of traumatic ulcers may be associated with the traumatic agents that caused patients to seek dental care.

Journal ArticleDOI
TL;DR: It was concluded that the 2% peracetic acid solution was effective against the biofilms of the tested microorganisms on gutta-percha cones at 1 minute of exposure.
Abstract: Univ Estadual Paulista UNESP, Sao Jose dos Campos Dent Sch, Dept Biosci & Oral Diag, Sao Jose Dos Campos, SP, Brazil

Journal ArticleDOI
TL;DR: OCT was shown to be an efficient and non-invasive method to detect the depths of lesions caused by demineralization of artificially induced caries-affected human dentin.
Abstract: The purpose of this study was to evaluate the degree of demineralization of artificially induced caries-affected human dentin by an in vitro microbiological method. The occlusal surfaces of 6 human molar teeth were abraded until a flat surface was obtained, and the enamel was removed to expose the occlusal dentin surface. These teeth were sectioned in 12 halves in the vestibular-lingual direction and divided into 3 groups according to the period length of the microbiological essay (n = 4): G1, 7 days; G2, 14 days; and G3, 21 days. The surfaces of all specimens were protected by an acid-resistant nail varnish, except for a window where the caries lesion was induced by a Streptoccocus mutans biofilm in a batch-culture model supplemented with 5% sucrose. The specimens were then analyzed by optical coherence tomography (OCT) with a super-luminescent light diode (Λ = 930 nm) with 6.0-µm lateral and longitudinal resolution (in the air). Qualitative and quantitative results (images and average dentin demineralization, respectively) were obtained. The mean demineralization depths were (µm) 235 ± 31.4, 279 ± 14, and 271 ± 8.3 in groups 1, 2, and 3, respectively. In addition, no significant change was observed in the lesion mean depth from 7 days of cariogenic challenge on. In conclusion, OCT was shown to be an efficient and non-invasive method to detect the depths of lesions caused by demineralization. Further, a seven-day demineralization time was considered sufficient for caries-affected dentin to be obtained.

Journal ArticleDOI
TL;DR: More luxation injuries were found in younger children, predominantly in boys, with subluxation as the most common type of trauma.
Abstract: The purpose of this study was to analyze luxation injuries in children between the ages of 0 and 5 years treated at an emergency service department. A total of 1,703 records, corresponding to a period of 10 years at the Emergency Center of the Baby Clinic at Londrina State University, Brazil, were analyzed. The age, gender, etiologic factors, type of injury, injured teeth, treatment and time interval between injury and treatment were determined for each patient. Of the examined records, 409 patients met the study criteria and included a total of 679 injured teeth. Statistical analyses were carried out using the chi-square test with the level of significance set at 5%. Trauma incidence was higher in boys (57.0%) and in children less than two years of age (40.3%). Falling while walking or running was the most predominant etiologic factor (37.7%), and the most prevalent type of injury was subluxation (32.6%). Luxation injuries decreased with increasing age (p = 0.045). Treatment usually occurred within the first 1-15 days and was significantly associated with the type of trauma (p = 0.041). "Monitor only" was the treatment most frequently observed (74.0%). In conclusion, more luxation injuries were found in younger children, predominantly in boys. Falls resulting from walking or running were the etiologic factor most observed, with subluxation as the most common type of trauma. Treatment usually occurred within the first 15 days after the injury. Despite the severity of these injuries, "monitor only" was the eligible treatment.

Journal ArticleDOI
TL;DR: It was found that iliac and pubic bones present different bone densities, iliAC bone being less dense considering BMD and TBA values, however, the miniscrew primary stability was not different when varying the bone type (P < 0.05).
Abstract: Primary stability is absence of mobility in the bone bed after mini-implant placement and depends on bone quality among other factors. Bone quality is a subjective term frequently considered as bone density. The aim of this preliminary study was to evaluate bone density in two bovine pelvic regions and verify the primary stability of miniscrews inserted into them. Forty bone blocks were extracted from bovine pelvic bones, 20 from iliac and 20 from pubic bone, all of them containing cortical bone about 1 mm thick. Half of the sections extracted from each bone were designated for histological evaluation of bone density (trabecular bone area - TBA) and the other half for bone mineral density (BMD) evaluation by means of central dual-energy X-ray absorptiometry (DEXA). Then, twenty self-drilling miniscrews (INPO, Sao Paulo, Brazil) 1.4 mm in diameter and 6 mm long were inserted into the bone blocks used for BMD evaluation. Peak implant insertion torque (IT) and pull-out strength (PS) were used for primary stability evaluation. It was found that iliac and pubic bones present different bone densities, iliac bone being less dense considering BMD and TBA values (P > 0.05). However, the miniscrew primary stability was not different when varying the bone type (P < 0.05). IT and PS were not influenced by these differences in bone density when cortical thickness was about 1 mm thick.

Journal ArticleDOI
TL;DR: All groups presented clinically acceptable standard gap values, and the SCS group showed no statistical difference in relation to the CG (control group), demonstrating more accuracy and fidelity to transfer implants.
Abstract: The aim of this study was to evaluate the accuracy of three implant transfer impression techniques Four groups (n = 5) were defined, according to the technique: TC - tapered copings without splint; SC - square copings without splint; SCS - square copings splinted with dental floss and acrylic resin, and CG (control group) - master model with four external hexagonal implants and a superstructure Individual trays and polyether were used for the impression All casts were checked for their fit into the master superstructure; for this, all four screws were placed in the implants Digital photos were taken and images were analyzed using UTHSCSA ImageTool software Statistical analyses were performed using one-way analysis of variance and Student’s t test (p < 005) The means and standard deviation were (µm): CG = 203 ± 000, TC = 1474 ± 341, SC = 1208 ± 256, and SCS = 651 ± 009 The control group was found to be statistically different from the TC and SC groups Within the limitations of this study, all groups presented clinically acceptable standard gap values, and the SCS group showed no statistical difference in relation to the CG (control group), demonstrating more accuracy and fidelity to transfer implants