To publish basic and applied research works, as well as articles on current themes and updated information in oral research.
Universidade de São Paulo. Faculdade de Odontologia
Prevalence of microorganisms in root canals of human deciduous teeth with necrotic pulp and chronic periapical lesions
The objective of this study was to evaluate bacterial prevalence in 31 root canals of human deciduous teeth with necrotic pulp and periapical lesions using bacterial culture. After crown access, the material was collected using absorbent paper points for microbiological evaluation and determination of colony forming units (CFU). Anaerobic microorganisms were found in 96.7% of the samples, black-pigmented bacilli in 35.5%, aerobic microorganisms in 93.5%, streptococci in 96.7%, and S. mutans in 48.4%. We concluded that in human deciduous teeth root canals with necrotic pulp and periapical lesions the infection is polymicrobial, with a large number of microorganisms and a predominance of streptococci and anaerobic microorganisms.
Maria Cristina Monteiro de Souza-Gugelmin
Short-term immunosuppressive therapy does not affect the density of the pre-existing bone around titanium implants placed in rabbits
The aim of this study was to evaluate the influence of the administration and withdrawal of cyclosporin A/nifedipine on the bone density in a lateral area adjacent to implants placed in rabbits. Two screw-type titanium implants were placed bilaterally in twenty-eight New Zealand rabbits. The animals were assigned to one of the following groups and received daily subcutaneous injections for 14 days: Groups A and C: vehicle (dimethyl sulfoxide); Groups B and D: CsA (10 mg/kg) plus nifedipine (50 mg/kg). The animals in Groups A and B were sacrificed 14 days postoperatively and, in Groups C and D, 42 days postoperatively. After sacrifice, the tibiae were removed and undecalcified sections were obtained. Bone density was obtained in a 500 mm-wide zone lateral to the implant surface. Intergroup analysis showed no significant difference (p >; 0.05) in the degree of bone density between control and test groups either on day 14 or on day 42. Thus, it appears that a short-term immunosuppressive therapy may not present a negative influence on the density of the pre-existing bone around titanium implants placed in rabbits.
Kinesiographic study of complete denture movement related to mucosa displacement in edentulous patients
The mucosa that covers the residual ridges of edentulous patients may present some distortion or displacement when occlusal loading is applied in complete dentures. This distortion and movement of the denture can result in acceleration of residual ridge resorption and loss of retention and stability. The aim of this study was to analyze the pattern of upper complete denture movement related to underlying mucosa displacement. A sample of 10 complete denture wearers was randomly selected, which had acceptable upper and lower dentures and normal volume and resilience of residual ridges. The kinesiographic instrument K6-I Diagnostic System® was used to measure denture movements, according to the method proposed by Maeda et al.7, 1984. Denture movements were measured under the following experimental conditions: (A) 3 maximum voluntary clenching cycles and (B) unilateral chewing for 20 seconds. The results showed that under physiological load, oral mucosa distortion has two distinct phases: a fast initial displacement as load is applied and a slower and incomplete recovery when load is removed. Intermittent loading such as chewing progressively reduces the magnitude of the denture displacement and the recovery of the mucosa is gradually more incomplete.
Smear layer removal capacity of disinfectant solutions used with and without EDTA for the irrigation of canals: a SEM study
The purpose of this study was to carry out a scanning electron microscopic (SEM) analysis of the cleaning qualities and smear layer removal from root canal walls, instrumented and irrigated with 2.5% NaOCl, 2.0% chlorhexidine and saline solutions. Fifty extracted teeth were used in this study. All teeth were radiographed to determine the existence of a single canal. The crowns were cut at the cervical limit and the root canals were instrumented with K-type files up to size 45. During root canal preparation, irrigations were made with the different solutions being evaluated: Group 1: 2.5% NaOCl (10 roots); Group 2: 2.5% NaOCl and 17% EDTA for 2 minute (10 roots); Group 3: 2.0% chlorhexidine (10 roots); Group 4: 2.0% chlorhexidine and 17% EDTA for 2 minutes (10 roots); Group 5: saline solution (5 roots); Group 6: saline solution and 17% EDTA for 2 minutes (5 roots). After instrumentation, the canals were irrigated with each one of the solutions and the roots were cut in the buccolingual direction for SEM analysis, at the cervical, middle and apical thirds, to ascertain the presence or absence of smear layer and debris. SEM analysis was performed by three calibrated examiners and scores were submitted to Kruskal-Wallis test at the significance level of p = 5%. Results showed that the use of 17% EDTA decreased the smear layer significantly (p < 0.05) for all evaluated solutions in all thirds. When EDTA was not used, a significantly higher quantity of smear layer on the apical third was observed only in the NaOCl groups. The use of 17% EDTA was significant for debris removal except for the chlorhexidine groups. The following conclusion could be drawn: the use of 17% EDTA was necessary to enhance cleanness of the root canals.
Ana Carolina Silveira Cardoso de Menezes
In vitro evaluation of human dental enamel surface roughness bleached with 35% carbamide peroxide and submitted to abrasive dentifrice brushing
The aim of this in vitro study was to evaluate the surface roughness of human enamel bleached with 35% carbamide peroxide at different times and submitted to different superficial cleaning treatments: G1 - not brushed; G2 - brushed with fluoride abrasive dentifrice; G3 - brushed with a non-fluoride abrasive dentifrice; G4 - brushed without dentifrice. Sixty fragments of human molar teeth with 4 x 4 mm were obtained using a diamond disc. The specimens were polished with sandpaper and abrasive pastes. A perfilometer was used to measure roughness average (Ra) values of the initial surface roughness and at each 7-day-interval after the beginning of treatment. The bleaching was performed on the surface of the fragments for 1 hour a week, and the surface cleaning treatment for 3 minutes daily. The samples were stored in individual receptacles with artificial saliva. Analysis of variance and the Tukey test revealed significant differences in surface roughness values for G2 and G3, which showed an increase in roughness over time; G1 and G4 showed no significant roughness differences. The bleaching with 35% carbamide peroxide did not alter the enamel surface roughness, but when the bleaching treatment was performed combined with brushing with abrasive dentifrices, there was a significant increase in roughness values.
Effect of the number of thermocycles on microleakage of resin composite restorations
Thermocycling simulates, in vitro, thermal changes that occur in the oral cavity. The aim of this study was to evaluate the influence of the number of cycles on microleakage. Class V cavities (1.5 mm deep, 3 mm in height and 3 mm in width) were prepared in bovine teeth, restored with a Single Bond/Z250 restorative system (3M/ESPE) and then divided into five groups of ten teeth each: group 1 was not thermocycled (control group), and groups 2, 3, 4 and 5 were thermocycled 500, 1,000, 2,500 and 5,000 times, respectively (5º-55º ± 2ºC, 15 s dwell time). The teeth were immersed in 0.5% basic fuchsin aqueous solution for 24 h, sectioned and the sections with the highest degree of microleakage were selected, scanned and the extent of dye penetration was measured by the ImageTool program. The results submitted to one-way ANOVA showed no significant differences between the groups (p >; 0.05). The averages of microleakage values in millimeters were: group 1 (3.92); group 2 (3.13); group 3 (4.48); group 4 (4.33) and group 5 (3.42). Thus, it was concluded that there is no relation between the increase of the number of cycles and the increase in microleakage.
Effects of oral environment stabilization procedures on counts of Candida spp. in children
The effects of oral environment stabilization procedures on counts of Candida spp. have rarely been discussed, and no conclusive results are found in the literature. The aim of this study was thus to ascertain the effects of oral environment stabilization procedures with glass ionomer and zinc oxide-eugenol cements on counts of Candida spp. in the oral cavity of children. For this purpose, oral rinses of sterile phosphate-buffered saline were initially collected from 30 boys and 30 girls, positive for Candida in the saliva and aged from 4 to 10 years. Data on the initial quantity of CFU/ml of Candida were obtained. Then, the children were randomly divided into two groups and oral environment stabilization procedures were performed using zinc oxide-eugenol cement or glass ionomer cement. One week after the procedures were performed, oral rinses were collected again and final Candida counts were obtained. An expressive reduction in Candida counts was observed in both groups. The zinc oxide-eugenol and glass ionomer cements were efficient in the reduction of Candida counts and statistically significant differences were observed between initial and final counts in both groups. Considering the percentage of reduction, the zinc oxide-eugenol cement presented more favorable results, with a reduction of 70%. A reduction of 46% was observed with the use of the glass ionomer cement. According to the obtained results, we concluded that oral environment stabilization procedures were efficient in reducing Candida spp. counts, especially when the zinc oxide-eugenol cement was employed.
Effect of plaque accumulation and salivary factors on enamel demineralization and plaque composition in situ
This study evaluated the effect of some plaque and salivary factors on caries progression in situ. The salivary secretion rate, buffering capacity and mutans streptococci counts from 13 volunteers were determined. For three distinct periods of time, 4, 7 and 10 days, each of them wore a palatal appliance containing 4 bovine enamel blocks. They used a non-fluoridated dentifrice during the experiment and a 20% sucrose solution was dripped onto the blocks 10 times a day. Mutans streptococci (MS), calcium (Ca), and insoluble polysaccharide (IP) were quantified in the dental plaque formed on the enamel blocks, after each period. Enamel demineralization was assessed by surface microhardness, and the percentage of surface microhardness change (%SMC) in relation to the baseline values was calculated. Enamel demineralization occurred after each period of plaque accumulation (p < 0.05), and the %SMC increased with time (from 13.8 to 48.3%). The concentrations of Ca and IP in plaque were not statistically different among the experimental times, but significant correlations were found between these concentrations and %SMC. Neither the salivary factors assessed initially nor mutans streptococci in plaque presented statistically significant correlations to %SMC. The results suggest that enamel demineralization is time-dependent and is more related to the composition of the biofilm formed than to the salivary factors studied.
Effectiveness of EDTA and EDTA-T brushingm on the removal of root surface smear layer
The purpose of this study was to compare the removal of root surface smear layer following active application of EDTA gel and EDTA-T (texapon) gel in different concentrations (5%, 10%, 15%, 20% and 24%), using scanning electron microscopy. A total of 220 dentin blocks obtained from the root surfaces of extracted teeth were divided into 3 groups: Group I - (control) application of saline solution (n = 20); Group II - EDTA gel (pH 7.0) was applied in the following concentrations: 5%, 10%, 15%, 20% and 24% (n = 100); Group III - EDTA-T gel (pH 7.0) applied in the same concentrations described above (n = 100). The photomicrographs were evaluated by one calibrated examiner using a smear layer removal index and following statistical analysis (Kruskal-Wallis test). The results demonstrated that the specimens treated with EDTA and EDTA-T gel presented a better smear layer removal than the control group (p < 0.01); no statistically significant differences were observed between the EDTA and EDTA-T groups and between the concentrations tested (Mann-Whitney, p >; 0.05). Within the limits of this study, it can be concluded that all treatment modalities effectively removed the smear layer from the root surface. The addition of texapon into the EDTA gel formulation did not increase its effectiveness.
Clinical effect of a herbal dentifrice on the control of plaque and gingivitis: a double-blind study
The aim of this randomized, double-blind clinical trial was to evaluate the effect of the Paradontax dentifrice on the reduction of plaque and gingivitis. Subjects were randomly allocated into either the test group (n = 15, Paradontax) or the control group (n = 15, standard dentifrice with fluoride). Plaque levels were measured using the Turesky modification of the Quigley & Hein Plaque Index (PI), and gingivitis was evaluated with the Gingival Index (GI). Subjects were asked to brush their teeth with the allocated dentifrice, three times a day, for 21 days. There was no significant difference between groups in relation to the PI and GI medians, at baseline and at the end of the 21-day period. There was no significant reduction in PI in either the test or control groups. There was a significant decrease in GI in the test group. The authors concluded that there was no difference between the dentifrices in the reduction of plaque and gingivitis.
The influence of low-level laser therapy on biomodulation of collagen and elastic fibers
The study of low-level laser therapy upon extracellular matrix elements is important to understand the wound healing process under this agent. However, little is known about the interference of laser light in relation to collagen and elastic fibers. Cutaneous wounds were performed on the back of 72 Wistar rats and a Ga-Al-As low-level laser was punctually applied with different energy densities. The animals were killed after 24, 48, 72 hours and 5, 7 and 14 days. Tissues were stained with hematoxilin-eosin, sirius red fast green and orcein and then analyzed. It was observed that the treated group exhibited larger reduction of edema and inflammatory infiltrate. The treated animals presented a larger expression of collagen and elastic fibers, although without statistical significance (p >; 0.05). Treatment with a dosage of 4 J/cm² exhibited more expressive results than that with 8 J/cm². In this study, the authors concluded that low-level laser therapy contributed to a larger expression of collagen and elastic fibers during the early phases of the wound healing process.
Comparison between two experimental protocols to promote osteoporosis in the maxilla and proximal tibia of female rats
The effects of two experimental protocols (ovariectomy associated or not with a low calcium diet) used to promote osteoporosis in the rat maxilla and proximal tibia were compared 5 and 11 weeks after surgery. Female Wistar rats were ovariectomized or sham-operated. Half of the ovariectomized rats were fed a low Ca++ diet (ovx*) and the remaining ovariectomized (ovx) and sham animals received a standard chow. At sacrifice, the proximal metaphysis was excised from the tibia and the molars were extracted from the hemi-maxilla. Dry (60°C overnight) and ash (700°C/14 h) weights were measured and the ashes were used for Ca++ measurement by means of a colorimetric method. After 5 weeks, ovx caused no alteration while ovx* decreased proximal metaphysis (17%) and maxilla (35%) bone mass. After 11 weeks, ovx caused a 14% bone mass reduction in the proximal metaphysis but not in the maxilla, while ovx* caused a comparable bone mass reduction (30%) in both bone segments. Calcium concentration was not altered in any experimental condition. The results show that estrogen deficiency is insufficient to cause maxillary osteoporosis in rats over an 11-week period and a long-term ovariectomy is needed to exert deleterious effect on proximal metaphysis bone mass. When a low Ca++ diet is associated with estrogen deficiency, however, a relatively precocious harmful effect is observed, twice as pronounced in the maxilla than in the proximal metaphysis. On a long-term basis, ovariectomy associated with a low Ca++ diet seems to be equally injurious to both proximal metaphysis and maxilla.
O assessor: personagem central na publicação científica
Centric relation registration: intra- and interexaminer agreement after a calibration program
Centric relation (CR) has been considered a maxillomandibular position of choice for some dental and prosthetic procedures. Although regarded as a fully reproducible relation, there is great controversy about its clinical use and recording technique, especially in patients with signs and symptoms of temporomandibular disorders (TMD). This study aimed at evaluating the effectiveness of a training program on intra- and interexaminer agreement when determining the clinical record of the CR position. Forty individuals constituted the sample, divided into symptomatic (TMD) and asymptomatic groups. Three previously calibrated examiners performed the initial assessment and the second evaluation after 30 days in a blind design, using Dawsons bilateral manipulation technique with and without an anterior stop. The amount of frontal and sagittal deviations in relation to intercuspal position, the presence of pain and discomfort during manipulation, and the first occlusal contact in CR were analyzed. Kendall and Kappa tests with a 5% level of significance were used to determine agreement. Values for both intra- and interexaminer agreement were deemed good. The best results were obtained for frontal deviations and assessment of pain (or absence of it) during manipulation. Sagittal deviations showed the lowest agreement in both examinations. The authors concluded that a calibration program could be effective for intra- and interexaminer agreement when recording centric relation. However, caution is recommended when analyzing some isolated items.
In vitro evaluation of the effects of the interaction between irrigating solutions, intracanal medication and Er:YAG laser in dentin permeability of the endodontic system
The purpose of this study was to evaluate in vitro the effects of different associations between irrigating solutions (EDTA-T and citric acid), intracanal medicament (NDP), and Er:YAG laser irradiation on dentin permeability. Fifty-one extracted single-rooted teeth were instrumented and divided into seven groups. Groups GI and GII had final irrigation with a demineralizing solution only (EDTA-T and citric acid, respectively). Groups GIII and GIV had final irrigation with EDTA-T and citric acid, respectively, plus an association of irrigating solution and Er:YAG laser. Groups GV and GVI had final irrigation with EDTA-T and citric acid, respectively, plus an association of intracanal medication and Er:YAG laser. Group GVII (control group) had final irrigation with distilled water. All root canals were filled with NDP associated with rhodamine B dye. After the experimental period, the samples were transversely cut into six 2.0 mm thick slices for subsequent reading using the ImageLab software. Analysis of the results allowed us to conclude that there were statistically significant differences (p < 0.05) between the groups as to the penetration of the dye-intracanal medication solution. Groups III and IV presented smaller values of dentinal permeability when compared to the other groups. The best results were obtained with the interaction between a demineralizing irrigating solution and the association of intracanal medicament and laser Er:YAG (groups V and VI). In these groups the observed penetration of the intracanal medicament plus dye solution in the apical third was, on average, 29% greater than in the other groups.
Polymerization shrinkage evaluation of three packable composite resins using a gas pycnometer
Modern restorative dentistry has been playing an outstanding role lately since composite resins, allied to adhesive systems, have been widely applied on anterior and posterior teeth restorations. The evolution of composite resins has mostly been verified due to the improvement of their aesthetic behavior and the increase in their compressive and abrasive strengths. In spite of these developments, the polymerization shrinkage inherent to the material has been a major deficiency that, so far, has been impossible to avoid. Using a gas pycnometry, this research investigated the polymerization shrinkage of three packable composite resins: Filtek P60 (3M), Prodigy Condensable (Kerr), and SureFil (Dentsply/Caulk), varying the distance from the light source to the surface of the resins (2 mm or 10 mm). The pycnometer Accupyc 1330 (Micromeritics, USA) precisely records helium displacement, allowing fast and reliable measurements of the volume of composite resin immediately before and after polymerization, without interference of temperature or humidity. Results were not found to be statistically different for the three tested resins, either for 2 mm or 10 mm-distance from the light source to the composite surface.
Evaluation of the bending strength of rigid internal fixation with absorbable and metallic screws in mandibular ramus sagittal split osteotomy: in vitro study
The aim of this study was to evaluate, in vitro, the bending strength of internal fixation with absorbable and metallic screws in mandibular ramus sagittal split osteotomy in sheep hemimandibles. The screws were inserted as lag screws, with an inverted "L" configuration, and the set was submitted to bending strength tests. The load and displacement of the peak and final load averages were, respectively, 18.45 kgf, 8.19 mm and 14.38 kgf for Group I, and 16.67 kgf, 6.73 mm and 13.98 kgf for Group II. The results were submitted to statistical analysis by Students t test and by the Pearson correlation analysis. The groups showed no statistically significant differences, indicating the feasibility of both for osteosynthesis in mandibular ramus sagittal split osteotomies.
The effect of long-term storage on the microleakage of composite resin restorations: qualitative and quantitative evaluation
The aim of this study was to evaluate the influence of storage periods of 24 hours and 3 months on the microleakage of class II cavities. Two methods of assessing microleakage were also compared. Class II cavities were prepared in sound human molars. MO cavities were restored using ABF experimental (Kuraray Medical Inc.) + Z250 composite resin (3M ESPE), and DO cavities were restored using Single Bond (3M ESPE) + Z250. After different storage periods, specimens were thermocycled, immersed in a dye (0.5% methylene blue solution for 4 h) and longitudinally sectioned. Dye penetration was scored according to a 0-4 scale. The extent of microleakage was measured using the ImageLab 2000 program. A statistically significant correlation was verified between both evaluation methods (r = 0.978, p < 0.001). ANOVA revealed a statistically significant difference between the tested adhesive systems regarding microleakage (p < 0.001), although it was not influenced by the different storage periods.
The influence of handling on the elasticity of addition silicone putties
The handling of vinyl polysiloxane (addition silicone) impression putties with latex gloves is said to interfere with the setting of these impression materials. The aim of this study is to evaluate the effect of handling techniques on the setting of vinyl polysiloxane impression putties using several types of gloves. The setting of these materials was evaluated by means of an elasticimeter. Four vinyl polysiloxane putty impression materials and five brands of gloves (one made of vinyl, one of synthetic rubber, and three of natural rubber) were studied. Based on the type of glove, they were previously washed or not, and a spatula was used or not for initial mixing (before handmixing). The vinyl, the synthetic and one of the natural rubber gloves did not require the previous washing procedure and/or the use of a spatula for initial mixing. Two other natural rubber gloves - depending on the silicone -, showed satisfactory results only when the initial mixing was performed with a spatula. It was concluded that setting inhibition depends on the kind of vinyl polysiloxane impression material and the kind of gloves used, but when the initial mixing was performed with the spatula this setting inhibition was overcome. The results of this study also showed that it is possible to associate cross-contamination control and satisfactory performance of addition silicone putty materials. When doubts arise from the compatibility between vinyl polysiloxane impression putties and gloves, the initial mixing should be performed with a spatula.
Evaluation of the fluoride stability of dentifrices sold in Manaus, AM, Brazil
The minimum requirement for the anti-caries effect of a dentifrice is the presence of available and stable fluoride in the formulation. The concentration of available fluoride in the major dentifrices sold in Brazil has been reported, but few data have been published about its stability, which is temperature-dependent. Thus, the aim of this study was to evaluate the concentration and stability of fluoride in dentifrices sold in Manaus, AM, Brazil, which is a typical tropical city. The concentrations of total fluoride, total soluble fluoride, MFP, and of insoluble fluoride of six Brazilian dentifrices and an imported one were analyzed. The analyses were made when the dentifrices were purchased and during a year of storage at room temperature (28.9 ± 1.16°C) and under refrigeration (26.3 ± 0.88°C). The analyses were performed using an ion specific electrode Orion 96-09. At the time of purchase, all the dentifrices analyzed showed more than 1,000 ppm (mug F-/g; w/w) of soluble fluoride. However, in most of them, this form of fluoride was not shown to be stable. The highest loss of soluble fluoride was found for storage at room temperature, reaching up to 40%. Although all dentifrices comply with the Brazilian guidelines with regard to the concentration of total fluoride (maximum of 0.15%), the instability of soluble fluoride observed in some of them can impair their anti-caries effect and this condition is not contemplated in the Governmental rules.
A modified pH-cycling model to evaluate fluoride effect on enamel demineralization
Since in vitro pH-cycling models are widely used to study dental caries, they should allow evaluations of fluoride effect on early stages of caries development. Therefore, acid etching on enamel surface must be avoided, enabling surface microhardness (SMH) analysis. In the present study, the pH-cycling model originally described by Featherstone et al.9 (1986) was modified to preserve the enamel surface and to produce early carious lesions that could be evaluated using SMH and cross-sectional microhardness (CSMH) measurements. In order to validate this modified model, a dose-response evaluation with fluoride was made. Human enamel blocks with known SMH were submitted to such regimen with the following treatments: distilled deionized water (DDW; control) and solutions containing 70, 140 and 280 ppm F. Data from %SMH change and deltaZ (mineral loss) showed a statistically significant negative correlation between F concentration in treatment solutions and mineral loss. In conclusion, the modified pH-cycling model allowed the evaluation of changes on the outermost enamel layer during caries development, and a dose-response effect of fluoride reducing enamel demineralization was observed.
Viability of autogenous bone grafts obtained by using bone collectors: histological and microbiological study
The use of autogenous bone grafts is considered to be the best choice for reconstructive surgery. In the periodontal literature, the utilization of osseous coagulum was suggested by the end of the sixties. The purpose of this study is to consider the use of bone collectors (bone traps) as an alternative method for obtaining material to fill small bone imperfections, such as fenestrations and dehiscences. Thirty samples were obtained from bone drilling during fixture installation in patients (13 men and 17 women, with an average age of 54 years) requiring treatment at the Department of Periodontology and Implant Dentistry, University of Santo Amaro. These samples were fixed in 10% neutral formaldehyde for 24 hours and subjected to histological preparation, in order to evaluate the presence of viable osteoblasts. In addition, the material was placed in a fluid thioglycolate medium and incubated for 24 hours at 36 ± 1°C in aerobiosis and anaerobiosis. Bacterial growth evaluation was made by using six different culture media (MacConkey agar, blood agar base, mannitol salt agar, Anaerokit LTD medium, Anaerokit LTD - bile medium, Anaerinsol). The results show that, if proper care is taken to prevent saliva contamination during the surgical procedure, this method of collecting autogenous bone may be useful in situations where small amounts of bone are required.
Effect of a 0.5% chlorhexidine gel on dental plaque superinfecting microorganisms in mentally handicapped patients
A randomized clinical trial was conducted to investigate the effect of a 0.5% chlorhexidine (CHX) gel on dental plaque superinfecting microorganisms in mentally handicapped patients. Thirty inmates from the institution "Casas André Luiz" were assigned to either test group (CHX gel, n = 15) or control group (placebo gel, n = 15). The gel was administered over a period of 8 weeks. Supragingival plaque samples were collected at baseline, after gel use (8 weeks) and 16 weeks after baseline. The presence of Gram-negative Enterobacteriaceae, Staphylococcus and yeasts was evaluated. No significant growth of any superinfecting microorganism was observed in the CHX group, when compared to the placebo group. The results indicated that the 0.5% chlorhexidine gel did not produce an undesirable shift in these bacterial populations.
Fluorine content of several brands of chocolate bars and chocolate cookies found in Brazil
Chocolate bars and chocolate cookies are foodstuffs highly appreciated by children. The possibility of having fluorine (F) among their components, associated with an excessive consumption, may make them decisive contributors to the total daily F intake. Thus, they could participate in the establishment of dental fluorosis. The aim of this study was to analyze the fluorine concentration [F] of the chocolates bars (CB) Baton, Confeti, Garoto Ball, Kinder Ovo, M&Ms, Milkybar, Nescau, Nescau Ball, Surpresa, Surpresa Bichos, Tortuguita; and of the chocolate cookies (CC) Danyts, Hipopó, Nescau, Passatempo, Pokémon, Sítio do Pica-Pau Amarelo and Trakinas. Samples were purchased in Bauru, São Paulo, Brazil. Three grams of each product were previously ashed at 525°C (CB and cookies fillings) and at 550°C (cookies dough), during 4 hours. Fluorine was separated from the ash by hexamethyldisiloxane (HMDS)-facilitated diffusion. Fluorine analysis was carried out with the specific electrode. Mean [F]s ± SD and amplitude (unit mg/g) were: CB = 0.30 ± 0.45 (0.07 - 1.60, n = 12) and CC = 1.08 ± 2.64 (0.04 - 7.10, n = 7). It was concluded that some of the analyzed foods may be important contributors to the total daily F intake. As for the product that had the highest [F] (Danyts), when only 3 units are consumed just once a day, they may supply up to 40% of the maximum recommended daily F intake (0.07 mg/kg body weight) for a 2-year-old child (12 kg). The [F] in these products should be informed on their labels.
Yeasts from the oral cavity of children with AIDS: exoenzyme production and antifungal resistance
The oral fungal microbiota of 30 children with AIDS, of both genders, aged from two to six years, receiving outpatient treatment, was evaluated and compared with that of a control group composed of 30 healthy subjects with matching ages and genders. Virulence factors, such as exoenzyme production, and susceptibility to five antifungal agents using an E-Test kit were evaluated. C. albicans predominated over other species in the AIDS group, showing a higher production of proteinase and phospholipase when compared with that observed in the control group. In this study few clinical manifestations of and low selectivity for C. albicans (23.3%) were observed in the AIDS group. The enzymatic studies showed that 53.8% of the AIDS strains were strongly positive whereas only 33.3% of the non-AIDS strains were positive. Amphotericin B was the most effective drug among the antifungal agents tested against C. albicans. The frequency, selectivity and level of exoenzyme production by C. albicans suggest a higher pathogenicity in the AIDS children than in the control children.
Evaluation of the permeability of the furcation area of deciduous molars conditioned with Er:YAG laser and cyanoacrylate
The purpose of this study was to evaluate in vitro the dentin permeability of the deciduous pulp chamber floor after employing 2-octyl cyanoacrylate and Er:YAG laser. Twenty four deciduous molars were used, divided into four groups. After chemical-surgical preparation each group received a different treatment: Group 1 - control, without treatment; Group 2 - the floor of the pulp chamber was covered with a fine layer of 2-octyl cyanoacrylate; Group 3 - the floor of the pulp chamber was irradiated with Er:YAG laser (250 mJ, 10 Hz for 30 seconds, 80 J of energy and 320 pulses), and covered with a fine layer of 2-octyl cyanoacrylate; and Group 4 - the floor of the pulp chamber was irradiated with Er:YAG laser set at the parameters already described. After that the specimens received application of 0.5% methylene blue, for 15 minutes. The teeth were cut, photographed, and the digitalized images were analyzed using the ImageLab program. The results obtained were submitted to statistical analysis. Group 4 (Er:YAG) presented the largest averages in percentage of dye penetration area (19.5%), followed by Group 1 (11.1%), Group 3 (1.4%) and Group 2 (0.2%). The experimental model allowed to conclude that the specimens conditioned with 2-octyl cyanoacrylate (Group 2) and Er:YAG laser associated to 2-octyl cyanoacrylate (Group 3) presented a decrease in permeability, and the specimens treated with Er:YAG laser (Group 4) presented an increase in permeability of the analyzed area.
A randomized, controlled, crossover trial of oral midazolam and hydroxyzine for pediatric dental sedation
The effectiveness of oral midazolam in pediatric dentistry is controversial. This randomized, controlled, crossover, double blind clinical trial was conducted in order to study the effect of midazolam, used either alone or in association with hydroxyzine, during child dental treatment. Thirty seven dental sedation sessions were carried out on 11 ASA I uncooperative children less than five years-old. In each appointment children were randomly assigned to groups: P - placebo, M - midazolam (1.0 mg/kg), or MH - midazolam (0.75 mg/kg) plus hydroxyzine (2.0 mg/kg). Vital signs (blood pressure, breathing rate, pulse and oxygen saturation) and behavior parameters (consciousness, crying, movement, overall behavior) were evaluated every 15 minutes. Friedman and Wilcoxon statistical tests were used to compare groups and different moments in the same group. Normal values of vital signs were usually registered. Heart rate increased in groups P and M as the session went on. Group M presented less crying and movement at the first 15 minutes of treatment. Group MH caused more drowsiness at the beginning of the session. Overall behavior was better in group M than in groups P or MH. Group M produced effective sedation in 77% of the cases, and group MH did so in 30.8%. It was concluded that midazolam was effective and safe, and its association with hydroxyzine did not lead to additional advantages in pediatric dental sedation.
Luciane Ribeiro de Rezende Sucasas da Costa