RESUMO
Objective: This study investigates the association between the prevalence and severity of dental fluorosis, the socio-economic status (SES) and area of residence among 12-year-old schoolchildren in Uruguay.Material and methods: The study was descriptive, cross-sectional, explanatory and observational. Subjects considered eligible were born in 1999 and had their parents' or guardian's prior consent. A questionnaire was used to identify SES according to Centro de Investigaciones Económicas Institute on four levels. Dental fluorosis was determined using the Thylstrup-Fejerskov (TF) index.Results: Of the 1544 students examined, 45.0% showed dental fluorosis. A TF index 1-2 was recorded in 29.3% of the subjects, TF 3 in 20.9%, TF 4 in 6.7% and TF 5-9 in 2.1%. In area 1 (the capital Montevideo city), 84.8% of the subjects had dental fluorosis, a value that was significantly higher than in the inland region (area 2, 24.4%) and border departments (area 3, 22.5%) (x2 = 27.92, p < .0001). Students from families with a low socio-economic level showed less prevalence of dental fluorosis than those with a high level (x2 = 14.58, p = .002).Conclusion: Significant differences exist in the prevalence of dental fluorosis in relation to place of residence and socio-economic level.
Assuntos
Fluoretos/efeitos adversos , Fluorose Dentária/epidemiologia , Características de Residência , Classe Social , Estudantes/estatística & dados numéricos , Criança , Estudos Transversais , Humanos , Prevalência , Índice de Gravidade de Doença , Uruguai/epidemiologia , Abastecimento de ÁguaRESUMO
OBJECTIVES: The objective of this study was to evaluate the efficiency of SB-20 M culture medium to perform differential morphological identification of S. mutans and S. sobrinus compared to biochemical identification and to proteomic identification by the MALDI-TOF mass spectrometry technique. MATERIAL AND METHODS: Unstimulated saliva samples from 266 dental students were seeded on SB-20 M culture medium by the wooden spatula technique. After incubation, S. mutans and S. sobrinus colonies were identified by stereomicroscopy based on their differential morphological characteristics. Following these procedures, 135 colonies with characteristic morphology of S. mutans (89 colonies) and S. sobrinus (46 colonies) were randomly selected, submitted to biochemical identification (biotyping) and proteomic identification by the MALDI-TOF mass spectrometry technique. The results were compared using the Kappa test, with a 5% significance level. RESULTS: All (100%) S. mutans colonies were correctly identified after culture in SB-20 M medium compared to biotyping and proteomic identification. For S. sobrinus, morphological identification in SB-20 M medium was correct for 43 colonies (93.5%) compared to biotyping and proteomic identification. However, there was no statistically significant difference when comparing the capacity to identify S. mutans and S. sobrinus of the three techniques (p < 0.001; K = 0.951). CONCLUSIONS: It was concluded that the SB-20 M culture medium for morphological identification of S. mutans and S. sobrinus was highly reliable, being comparable to the MALDI-TOF mass spectrometry technique. CLINICAL RELEVANCE: The efficiency evaluation of identification methods of S. mutans and S. sobrinus is clinically relevant in order to determine caries risk and activity of patients.
Assuntos
Cárie Dentária , Proteômica , Streptococcus mutans , Streptococcus sobrinus , Cárie Dentária/microbiologia , Humanos , Saliva , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Streptococcus mutans/isolamento & purificação , Streptococcus sobrinus/isolamento & purificaçãoRESUMO
OBJECTIVE: The aim of this split-mouth, randomized controlled clinical trial was to evaluate the efficacy of proximal sealing for avoiding the development of new caries lesions or arresting incipient caries lesions on the mesial surface of first permanent molars (6m) abutting lesions on the distal surface of second primary molars (05d) in children at high caries risk. METHODS: A total of 61 children 8-10 years old were selected based on the caries status of the proximal sites of 05d and 6m. Children with caries on 05d and caries-free 6m were placed in the preventive sealing group and children with caries on both 05d and 6m in the therapeutic group. The children in each group had one 6m surface pair and in each pair one 6m surface was randomly allocated to receive a preventive or therapeutic sealing. Using a split-mouth design, the other 6m surface in the pair served as control. RESULTS: After 3.5 years, standardized follow-up radiographs were obtained for the 45 children who remained. In the preventive sealing group, 4 out of 30 (13.3%) sealed and 16 out of 30 (53.3%) unsealed sound 6m surfaces had developed new caries lesions (p = 0.004, McNemar test). In the therapeutic sealing group, the progression of the carious lesions on 6m was observed in 3 out of 15 sealed (20.0%) and 8 out of 15 (53.3%) unsealed caries control surfaces (p = 0.06). CONCLUSIONS: Preventive sealing on sound 6m surfaces abutting 05d lesions in children at high caries risk efficaciously prevents the development of caries lesions. Therapeutically sealing active non-cavitated caries lesions reduces the progression.
Assuntos
Cárie Dentária/terapia , Selantes de Fossas e Fissuras/uso terapêutico , Criança , Cárie Dentária/prevenção & controle , Feminino , Seguimentos , Humanos , Masculino , Fatores de TempoRESUMO
OBJECTIVE: The recovery of mutans streptococci in saliva and dental biofilm samples depends, in part, on the culture medium used. In this study, we compared (i) the culture media Sucrose-Bacitracin agar (SB-20), Modified SB-20 (SB-20M) and Mitis Salivarius Bacitracin agar (MSB) in the count of colony forming units (cfu) of mutans streptococci and (ii) in the morphological and biochemical differentiation between Streptococcus mutans and Streptococcus sobrinus. DESIGN: Samples of non-stimulated saliva from 20 children were plated on SB-20, SB-20M and MSB, and incubated in microaerophilia at 37°C for 72h. Identification of microorganisms was based on analysis of colony morphology under stereomicroscopy. The biochemical identification of colonies was done by biochemical tests using sugar fermentation, resistance to bacitracin and hydrogen peroxide production. RESULTS: There was no significant difference (p>0.05) in the number of cfu of mutans streptococci recovered on SB-20 and SB-20M agar. Comparing the media, SB-20 and SB-20M yielded a larger number of mutans streptococci colonies (p<0.05) and were more effective than MSB in the identification of S. sobrinus (p<0.05), but not of S. mutans (p>0.05). CONCLUSION: There was no significant difference between SB-20 and SB-20M culture media in the count of mutans streptococci, demonstrating that the replacement of sucrose by coarse granular cane sugar did not alter the efficacy of the medium. Compared with MSB, SB-20 and SB-20M allowed counting a larger number of mutans streptococci colonies and a more effective morphological identification of S. sobrinus.
Assuntos
Ágar/classificação , Técnicas Bacteriológicas , Meios de Cultura/classificação , Streptococcus mutans/isolamento & purificação , Streptococcus sobrinus/isolamento & purificação , Antibacterianos/farmacologia , Bacitracina/farmacologia , Carga Bacteriana , Técnicas de Tipagem Bacteriana , Biofilmes , Criança , Pré-Escolar , Farmacorresistência Bacteriana , Fermentação , Humanos , Saliva/microbiologia , Sacarose/metabolismoRESUMO
Due to the major role of Streptococcus mutans and Streptococcus sobrinus in the etiology of dental caries, it is important to use culture media that allow for differentiating these bacterial species. The aim of this study was to evaluate the suitability of a modified SB-20 culture medium (SB-20M) for the isolation and morphological differentiation of S. mutans and S. sobrinus, compared to biochemical identification (biotyping). Saliva samples were collected using the spatula method from 145 children, seeded on plates containing the SB-20M, in which sucrose was replaced by coarse granular cane sugar, and incubated in microaerophilia at 37°C during 72 h. Identification of the microorganisms was performed under stereomicroscopy based on colony morphology of 4904 colonies. The morphological identification was examined by biochemical tests of 94 randomly selected colonies with the macroscopic characteristic of S. mutans and S. sobrinus using sugar fermentation, resistance to bacitracin and production of hydrogen peroxide. There was no statistically significant difference (p>0.05) between morphological identification in the SB-20M medium and biochemical identification (biotyping). Biotyping confirmed that S. mutans and S. sobrinus colonies were correctly characterized in the SB-20M in 95.8% and 95.5% of the cases, respectively. Of the mutans streptococci detected in the children 98% were S. mutans and 2% S. sobrinus. The SB-20M medium is reliable for detection and direct morphological identification of S. mutans and S. sobrinus.
Assuntos
Técnicas de Tipagem Bacteriana/métodos , Meios de Cultura , Streptococcus mutans/classificação , Streptococcus sobrinus/classificação , Criança , Cárie Dentária/microbiologia , Humanos , Saliva/microbiologia , Streptococcus mutans/citologia , Streptococcus mutans/isolamento & purificação , Streptococcus sobrinus/citologia , Streptococcus sobrinus/isolamento & purificaçãoRESUMO
PURPOSE: To study the microstructure of sealant penetration in the enamel of in vivo sealed approximal noncavitated incipient caries lesions with and without a preceding bonding step. MATERIALS AND METHODS: A total of 26 proximal noncavitated caries lesions were sealed in vivo, using a sealant in 13 premolars with orthodontic indication of extraction. Each tooth was randomly assigned to mesial or distal surface application of a sealant in the lesion area and in surrounding sound enamel, with or without a bonding system. Four groups were analyzed: a nonbonding group in the lesion area (NBL); a nonbonding group in sound enamel (NBS); a bonding group in the lesion area (BL) and a bonding group in sound enamel (BS). The premolars were extracted after two weeks. All sealed areas were cut and demineralized with 37% hydrochloric acid for 24 h. For each group, the resin tags were observed and measured by scanning electron microscopy. RESULTS: The lesion areas showed a very irregular resin network with twisted and curved tags in contrast to the sound enamel where a regular etching pattern was observed. The length of resin tags in microns for each group (mean +/-SD) was: NBG-L = 4.19 +/- 1.59; NBG-S = 5.49 +/- 2.49; BG-L = 4.57 +/- 1.99; and BG-S = 4.21 +/- 1.87. The differences between the groups were not statistically significant (p = 0.34). CONCLUSION: The use of a bonding system prior to the application of a pit and fissure sealant on both lesion and sound enamel areas does not increase the resin penetration length under non-contaminated conditions.
Assuntos
Cárie Dentária/patologia , Esmalte Dentário/ultraestrutura , Selantes de Fossas e Fissuras/química , Condicionamento Ácido do Dente , Adolescente , Dente Pré-Molar/ultraestrutura , Bis-Fenol A-Glicidil Metacrilato/química , Cariostáticos/uso terapêutico , Resinas Compostas/química , Técnica de Descalcificação , Colagem Dentária/métodos , Cárie Dentária/prevenção & controle , Adesivos Dentinários/química , Método Duplo-Cego , Feminino , Fluoretos Tópicos , Humanos , Ácido Clorídrico/química , Masculino , Microscopia Eletrônica de Varredura , Organofosfonatos/química , Selantes de Fossas e Fissuras/uso terapêutico , Fluoreto de Sódio/uso terapêutico , Propriedades de Superfície , Fatores de TempoRESUMO
OBJECTIVE: To evaluate the prevalence of caries in the permanent 1st molars of a group of 9 to 10-year-old children, and to determine the long-term effect of a mother-child preventive dental program (PDP) that started when the women were pregnant and continued until the children were 6 years of age. MATERIAL AND METHODS: The permanent 1st molars of 37 children in the PDP group were evaluated for caries, both clinically and radiographically, and compared with those of a control group of 42 children who had not participated in the PDP. RESULTS: Of children in the PDP group, 70% were caries free compared to 33% in the control group (p<0.001). Of permanent 1st molars in the PDP group, 87% were caries-free compared to 61% in the control group (p<0.001). The mean DFS of the PDP children 10 years of age was 0.519+/-0.93 versus 1.57+/-1.38 for the control children (p=0.002). CONCLUSIONS: Examination of children 4 years after discontinuation of a caries preventive program reflected a long-term reduction in the DFS score of permanent 1st molars.
Assuntos
Cárie Dentária/prevenção & controle , Educação em Saúde Bucal , Centros de Saúde Materno-Infantil , Odontologia Preventiva/métodos , Estudos de Casos e Controles , Criança , Estudos de Coortes , Índice CPO , Feminino , Humanos , Masculino , Dente MolarRESUMO
The objective was to evaluate the clinical performance of a therapeutic sealant to arrest the progression of noncavitated approximal posterior carious lesions. The study population comprised 50 adolescents in whom bitewing radiographs had been taken for diagnosis of caries. Approximal noncavitated lesions in premolars and molars (4d-7m) were selected. One group (n=17) had a sealant placed after tooth separation on all enamel lesions. A second group (n=7) received sealant and fluoride varnish in a split-mouth design. A control group (n=26) received a standard fluoride varnish treatment without tooth separation. Follow-up radiographs were taken after 2 years and were analyzed together with the baseline radiographs in a blind study setting. About 93% of the sealed initial carious lesions showed no progression. The corresponding value for the fluoride varnish control group was 88%. In the split-mouth study, 92 and 88% of the surfaces with enamel caries showed no progression after sealant or fluoride varnish treatment, respectively. The difference between the two treatment procedures was not statistically significant. The incidence rate for the transition from enamel caries to dentin caries or fillings was 3.5-3.9 surfaces/100 years in the sealant groups and 5.9-6.1 surfaces/100 years in the fluoride varnish groups. The results show the potential of sealants to act as a noninvasive treatment of early approximal enamel lesions.