RESUMO

OBJECTIVE: This in situ study aimed to investigate the efficacy of CO2 laser at a 10.6-µm wavelength combined with 1.23% acidulated phosphate fluoride (APF) and fluoridated dentifrice with 1100 µg F/g (FD) to control enamel caries progression. MATERIALS AND METHODS: Sixteen volunteers wore palatal appliances containing eight demineralized enamel specimens for four 14-day phases under sucrose exposure. These specimens were submitted to CO2 laser irradiation and APF alone or combined with FD. Treatment groups were non-fluoridated dentifrice-NFD, NFD + CO2 laser, NFD + APF, NFD + CO2 laser + APF, FD, FD + CO2 laser, FD + APF, and FD + CO2 laser + APF. Mineral loss, calcium fluoride (CaF2), fluorapatite (FAp), and fluoride in the biofilm were analyzed by analysis of variance followed by the Student-Newman-Keuls test, p < 0.05. RESULTS: The highest mineral loss inhibition was noted when FD and CO2 laser irradiation were combined, which did not significantly differ from the FD + CO2 laser + APF group. The CaF2, FAp, and F in the biofilm were more pronounced when the FD and APF were combined. The CO2 laser irradiation promoted a slightly higher concentration of CaF2 in the enamel and F in the biofilm. CONCLUSION: Although APF promotes the high formation of CaF2 and FAp, the combined use of FD with CO2 laser overcomes the APF effect in inhibiting the progression of artificial caries-like lesions in situ. CLINICAL SIGNIFICANCE: Under the in situ design of this study, remineralization of white spot lesions was achieved through CO2 laser irradiation and daily use of fluoridated dentifrice. Future clinical trials are encouraged to substantiate this finding.

Assuntos

RESUMO

OBJECTIVE: Oral candidiasis is a common fungal infection that affects the oral mucosa, and happens when Candida albicans interacts with bacteria in the oral microbiota, such as Streptococcus mutans, causing severe early childhood caries. C. albicans and S. mutans mixed biofilms are challenging to treat with conventional antimicrobial therapies, thus, new anti-infective drugs are required. This study aimed to test a drug delivery system based on chitosan microparticles loaded with geranium and lemongrass essential oils to inhibit C. albicans and S. mutans mixed biofilms. METHODOLOGY: Chitosan microparticles loaded with essential oils (CM-EOs) were obtained by spray-drying. Susceptibility of planktonic were performed according CLSI at 4 to 2,048 µg/mL. Mixed biofilms were incubated at 37ºC for 48 h and exposed to CM-EOs at 256 to 4,096 µg/mL. The antimicrobial effect was evaluated using the MTT assay, with biofilm architectural changes analyzed by scanning electron microscopy. RAW 264.7 cell was used to evaluate compound cytotoxicity. RESULTS: CM-EOs had better planktonic activity against C. albicans than S. mutans. All samples reduced the metabolic activity of mixed C. albicans and S. mutans biofilms, with encapsulated oils showing better activity than raw chitosan or oils. The microparticles reduced the biofilm on the slides. The essential oils showed cytotoxic effects against RAW 264.7 cells, but encapsulation into chitosan microparticles decreased their toxicity. CONCLUSION: This study demonstrates that chitosan loaded with essential oils may provide an alternative method for treating diseases caused by C. albicans and S. mutans mixed biofilm, such as dental caries.

Assuntos

RESUMO

Abstract Oral candidiasis is a common fungal infection that affects the oral mucosa, and happens when Candida albicans interacts with bacteria in the oral microbiota, such as Streptococcus mutans, causing severe early childhood caries. C. albicans and S. mutans mixed biofilms are challenging to treat with conventional antimicrobial therapies, thus, new anti-infective drugs are required. Objective This study aimed to test a drug delivery system based on chitosan microparticles loaded with geranium and lemongrass essential oils to inhibit C. albicans and S. mutans mixed biofilms. Methodology Chitosan microparticles loaded with essential oils (CM-EOs) were obtained by spray-drying. Susceptibility of planktonic were performed according CLSI at 4 to 2,048 µg/mL. Mixed biofilms were incubated at 37ºC for 48 h and exposed to CM-EOs at 256 to 4,096 µg/mL. The antimicrobial effect was evaluated using the MTT assay, with biofilm architectural changes analyzed by scanning electron microscopy. RAW 264.7 cell was used to evaluate compound cytotoxicity. Results CM-EOs had better planktonic activity against C. albicans than S. mutans. All samples reduced the metabolic activity of mixed C. albicans and S. mutans biofilms, with encapsulated oils showing better activity than raw chitosan or oils. The microparticles reduced the biofilm on the slides. The essential oils showed cytotoxic effects against RAW 264.7 cells, but encapsulation into chitosan microparticles decreased their toxicity. Conclusion This study demonstrates that chitosan loaded with essential oils may provide an alternative method for treating diseases caused by C. albicans and S. mutans mixed biofilm, such as dental caries.

RESUMO

Abstract Objective: To evaluate in vitro erosive effect of analgesics on primary tooth enamel. Material and Methods: The pH and the titratable acidity measurements of the medicines were performed in triplicate using a digital pH meter. Enamel slabs of primary teeth flat and polished were selected by initial surface microhardness analysis. Medications were selected and specimens were assigned into five groups (n=12): Dalsy; Magnopyrol; Paracetamol; Tylenol; and distilled water (negative control). Specimens were immersed in 5 ml of each group solution for 30 min, 4x/day for three days and stored in artificial saliva at 37 °C between immersions and at night. Final microhardness was determined. The data were submitted to Oneway ANOVA and Tukey's test. Scanning electron microscopy (SEM) analysis was performed in three specimens of each group. Results: Medicines showed acidic pH and mean values of titratable acidity ranged from 1.46 to 11.66 ml of 0.1N NaOH. The mineral loss of Magnopyrol was statistically significant in relation to the control group (p<0.01). Magnopyrol showed higher values when compared to Tylenol (p<0.05). SEM images displayed microstructure alterations in the Paracetamol group. Conclusion: Despite the low pH values, only Magnopyrol showed greater enamel softening. Paracetamol demonstrated morphological changes in primary tooth enamel (AU).

Assuntos

RESUMO

O objetivo deste estudo foi determinar a prevalência de sobrepeso/obesidade em pré-escolares e investigar a relação entre o índice de massa corporal (IMC) das crianças e o de seus pais. Para tanto, conduziu-se uma pesquisa transversal com 968 crianças, de 3-5 anos, regularmente matriculadas em pré-escolas públicas. O estado nutricional infantil foi definido pelo IMC após aferição do peso e estatura no próprio ambiente escolar, considerando-se o sexo e a idade em meses. De acordo com os critérios da Organização Mundial da Saúde (OMS), as crianças foram classificadas em eutróficas, baixo peso, risco de sobrepeso, sobrepeso ou obesas. O IMC dos pais foi calculado com os dados de peso e estatura obtidos por meio de questionário. Observou-se que 1% de crianças tinham baixo peso, 62% eram eutróficas, 17% apresentavam risco de sobrepeso, 12% sobrepeso e 8% obesidade. O IMC infantil mostrou-se positivamente correlacionado com o IMC materno e paterno (p < 0,05). Concluiu-se que a prevalência de obesidade e sobrepeso infantil na população estudada é alarmante e que o IMC da criança foi correlacionado ao dos pais. Tais achados devem ser motivo de preocupação das autoridades, reforçando a necessidade de estratégias de atenção à saúde abrangendo todo o núcleo familiar.

This study aimed to determine the prevalence of overweight/obesity in preschoolers and to investigate the relationship between the body mass index (BMI) of the children and of their parents. Therefore, a cross-sectional study was conducted with 968 children aging 3-5 years old from public preschools. The children's nutritional status was defined by the BMI, after measuring their weight and height at the preschool, considering sex and age in months. According to the World Health Organization (WHO) criteria, the children were classified as eutrophic, thin, at risk of being overweight, overweight or obese. The parents' BMI was calculated using weight and height data obtained through a questionnaire. One percent of children were thin, 62% eutrophic, 17% at risk of overweight, 12% were overweight and 8% obese. Children's BMI was positively correlated with maternal and paternal BMI (p <0.05). It was concluded that the prevalence of obesity and overweight in the population studied is alarming, and the child's BMI was correlated to their parents' BMI. Such findings should be of concern for the authorities, reinforcing the need for health care strategies covering the entire family.

RESUMO

BACKGROUND: Considering that the Lactobacillus casei group is strongly associated with caries progression, the use of lactobacilli as probiotics must be balanced due to their possible involvement in dental caries. OBJECTIVE: This study aimed to detect and quantify L. paracasei, L. rhamnosus, and L. casei group species in the active and arrested dentinal lesions of preschoolers. It also aimed to determine the expression profiles of lactobacilli genes related to adhesion, extracellular polymeric substance regulation, and pyruvate oxidation. METHODS: Total ribonucleic acid (RNA) was extracted from dentinal lesion samples (25 active, 13 arrested) of children between 2 and 5 years of age. The samples were converted to complementary deoxyribonucleic acid (cDNA), and quantitative polymerase chain reaction (qPCR) analyses were performed to quantify and determine the relative abundance (measured by percentage of total bacteria) of L. paracasei, L. rhamnosus, and L. casei group species. The expression profiles of L. paracasei/casei genes (spaC and spxB) and L. rhamnosus genes (spaE and wzb) were assessed. The Student t-test and the Mann-Whitney U test were used for comparisons. RESULTS: The L. casei group species were found to be part of the viable microbial community in dentinal caries. L. paracasei (p = 0.001), L. rhamnosus (p = 0.022), and L. casei (p = 0.004) group species were abundant in the active dentinal lesions compared to the arrested dentinal lesions. Only the wzb gene (p = 0.006) exhibited a statistically significant difference between the active and arrested lesions in terms of its expression profile; it was expressed to a higher extent in the active dentinal lesions. CONCLUSIONS: The L. casei group species presented in large numbers in the active dentinal caries lesions, indicating that these microorganisms are related to caries activity, and the wzb gene may play an important role in caries progression.

RESUMO

OBJECTIVE: This longitudinal study aimed to investigate if the plaque fluoride (PF) concentration can predict the early childhood caries onset. Design: As part of a larger study, 188 preschoolers were clinically evaluated for early childhood caries diagnosis, at baseline and after 1-year follow-up. After that, the final sample comprised: 1. children who had already caries at baseline (decayed, missing or filled surfaces, as well as white chalky white spot lesions adjacent to gingival margins) and developed at least one more cavitation after one year (n=16), and 2. children who never had or developed any caries lesions, including active white spots lesions (n=15). Before the clinical examinations, dental plaque was collected. PF concentration was determined with an ion-specific electrode. A chart was used to estimate the mean daily sugar exposure. The results were statistically analyzed by Spearman correlation and logistic regression analyses (α=0.05). RESULTS: After one year, a positive significant correlation between caries development and liquid sucrose, total sugar and total sucrose consumption increments was found (p<0.05). Moreover, the solid sugar, solid sucrose and total sugar exposure at baseline were positively correlated with the presence of dental plaque at follow-up (p<0.05). To top it all, children with PF concentrations ≤0.1 µg/mg at baseline were 10 times more likely to develop caries. CONCLUSION: In conclusion, this study demonstrated for the first time in vivo that low PF concentration is a predictor of caries development in primary teeth.

RESUMO

OBJECTIVES: This study aimed to systematically review the literature regarding the risk of selective removal-in comparison with stepwise and nonselective removal-of carious tissue in permanent teeth. MATERIALS AND METHODS: Controlled clinical trials and cohort studies involving patients with dental caries in permanent teeth were included. Databases used were PubMed, Embase, and Scopus. The test group should be composed of patients undergoing selective removal of carious tissues, and the control group should comprise patients undergoing nonselective removal and/or stepwise removal of carious tissue. Laboratory tests, studies on primary teeth, and studies that used temporary restorations were excluded, as were literature reviews. The primary outcome was overall success of maintaining pulpal health (both clinically and radiographically). Quality of the restoration, pulp exposure, dentin deposition, and microbiological examination were also assessed. A meta-analysis, using the pooled risk ratio (RR) and its 95% confidence interval (CI), was performed to assess the success of maintaining pulpal health, using the different control treatments as a subgroup analysis. RESULTS: A total of 2333 articles were retrieved, of which 10 were included in the systematic review and four in the meta-analysis. In the qualitative evaluation, the control groups presented a higher risk of pulp exposure in relation to the selective removal. In the meta-analysis, the selective carious tissue removal showed significantly higher overall success (RR, 95% CI 1.11, 1.02-1.21). CONCLUSIONS: The selective carious tissue removal presented higher success of maintaining pulpal health. CLINICAL RELEVANCE: In permanent teeth, selective carious tissue removal should be performed, as this technique results in lower numbers of pulp complications, such as pulp exposure, as compared with nonselective removal.

Assuntos

RESUMO

Objective: This study aimed to investigate if ß-cyclodextrin nanoparticles potentiate the photodynamic antimicrobial chemotherapy (PACT) effects in single and microcosm oral biofilms using methylene blue (MB) and a red laser. Background data: Studies of PACT have demonstrated promising effects; however, the association of nanoparticles with photosensitizers could enhance the antimicrobial result. Materials and methods: Biofilms were grown on enamel blocks either with Streptococcus mutans or in a microcosm model (salivary microorganisms) supplemented with sucrose. PACT using 50 µM MB associated or not with 32 µM encapsulated ß-cyclodextrin with MB for 5 min, followed by irradiation with red laser (λ = 660 nm, 320 J/cm2), was conducted and the counts of viable microorganisms in proper selective media were determined. Data were analyzed by one-factor ANOVA, followed by Tukey's test, or Kruskal-Wallis test, followed by Dunn's post hoc test, all with a significance level of 5%. Results: In the single-species biofilm model, a significant reduction in S. mutans counts was found for all groups when light was present. In the microcosm biofilm model, no significant difference was found among the groups for total streptococci, but a significant reduction of S. mutans was observed for the PACT group of encapsulated ß-cyclodextrin+MB. However, no statistically significant difference was observed among the PACT groups. Conclusions: PACT with ß-cyclodextrin mediated with MB associated with a red laser reduced S. mutans in microcosm biofilms. However, the presence of ß-cyclodextrin nanoparticles did not potentiate the PACT effects in single or microcosm oral biofilms.

Assuntos

RESUMO

Objective: The goals of this investigation were to compare the effect of photodynamic antimicrobial chemotherapy (PACT) with two different red lights on in vitro Streptococcus mutans biofilms, as well as to assess the temperature variances caused by PACT on human teeth. Methods: S. mutans biofilms (n = 3) were grown on hydroxyapatite disks, and the antimicrobial effect of PACT was evaluated using toluidine blue O (100 µg/mL) associated with Laserbeam® (LB 56.6 J/cm2) and LumaCare™ (LC -56.6, 158.5, 317.0, and 475.6 J/cm2). Pulpal temperature variances were analyzed using a digital thermocouple placed into the pulp chamber and positioned at the cement-enamel junction level of five teeth samples during irradiation times of 300, 600, and 900 sec for LB, and 22, 60, 120, and 180 sec for LC. The mean average temperature variance was calculated for each group. All data were analyzed through analysis of variance. Results: LB (900 sec) and LC (22 sec) induced similar reductions in the viability of microorganisms. LB did not cause statistically significant increase of temperature, regardless of experimental time, and LC caused temperature increase within the safe spectrum up to 60 sec. Conclusions: PACT seems to be a minimal invasive approach for reducing the viability of cariogenic bacteria. Thus, when applied in vitro for times equal or inferior to 900 and 60 sec for LB and LC, respectively, these light sources might be considered harmless to tooth structures.

Assuntos