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El objetivo de la odontología preventiva es reducir al máximo el riesgo de desarrollar enfermedades bucodentales; para lograrlo, existen múltiples métodos como la aplicación de flúor, así como la colocación de selladores de fosas y fisuras. Los selladores son materiales resinosos capaces de cubrir y eliminar las retenciones de las fosas y fisuras características de la anatomía oclusal. Si bien los selladores son ampliamente utilizados en pacientes pediátricos, erróneamente se cree que su colocación está contraindicada en adultos. Los selladores son métodos preventivos capaces de beneficiar a cualquier paciente que los necesite, independientemente de su edad. El objetivo de este artículo es analizar y esclarecer las indicaciones y contraindicaciones de los selladores de fosas y fisuras en pacientes adultos (AU)

The objective of preventive dentistry is to minimize the risk of developing oral diseases and to achieve this there are multiple methods such as the application of fluoride, as well as the placement of pit and fissure sealants. Sealants are resinous materials capable of covering and eliminating retentions in pits and fissures characteristic of occlusal anatomy. Although sealants are widely used in pediatric patients, it is erroneously believed that their placement is contraindicated in adult patients. Sealants are preventive methods capable to benefiting any patient who needs them regardless of age. The aim of this article is to analyze and clarify the indications and contraindications of pit and fissure sealants in adult patients (AU)

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AIM: To assess the effect of the daily ingestion of a mixture of probiotics on the amount of Streptococcus mutans in the oral cavity of preschool-age patients with a high risk of caries. MATERIALS AND METHODS: Forty patients, aged between 4 and 6 years, with a high risk of dental caries were included in this pilot study. Patients were randomly assigned to two study groups: the Experimental Group (A) included patients who brushed their teeth and used fluoridated toothpaste in addition to consuming probiotics daily, and the Control Group (B) inclused patients who brushed their teeth and used fluoridated toothpaste but did not consume probiotics. Using the CariScreen, the microorganism count was determined at different times: baseline, 7, 14, 21 and 30 days. To identify the differences between both groups, a Mann-Whitney U test was performed, with a significance level of 0.05. RESULTS: It was observed that both groups showed similar microbial counts at the beginning of the trial (p>0.05), and a significant decrease in the count at the end of the study was found in the experimental group (p<0.05) 15 days after suspending ingestion. CONCLUSION: We found a significant reduction of RLU values in preschool children who ingested the tested probiotics in relation to the baseline values and 15 days after ceasing consumption.

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PURPOSE: To evaluate the effect of a 1.23% acidulated phosphate fluoride (APF) gel combined with CO2 laser in protecting carious root dentin against further cariogenic challenges. METHODS: After a 7-day lead-in period, 12 volunteers wore an intraoral palatal device containing four carious root dentin slabs, treated with APF and APF+CO2 or placebo and placebo+CO2. After a 14-day wash-out period, volunteers were crossed-over to the other treatment arm. During both intraoral phases, specimens were submitted to cariogenic challenges and then evaluated for cross-sectional Knoop microhardness. RESULTS: Two-way ANOVA demonstrated that there was significant effect for both main factors: CO2 laser irradiation (P < 0.0001) and gel treatment (P < 0.0001), and that there was no interaction between them (P = 0.4706). Protection of carious root dentin against further cariogenic challenges may be provided by APF fluoride gel and CO2 laser, but no additive benefit was found by combining such strategies.

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OBJECTIVE: To assess the influence of dental bleaching on the susceptibility of developing carieslike lesions. METHOD AND MATERIALS: Enamel slabs obtained from recently extracted human third molars were submitted to different bleaching techniques: at-home, with 10% and 16% carbamide peroxide (G1 and G2, respectively; Whiteness Perfect); and in-office, with 37% carbamide peroxide (G3; Whiteness Super) and 35% hydrogen peroxide (G4; Whiteness HP), activated by light-emitting diode and laser. The control groups G5 and G6 were not bleached. Afterward, all specimens, with the exception of G6, were exposed to a highly cariogenic challenge by means of pH cycling. G6 served as the control for the artificial caries development methodology. Assessment of the enamel carieslike lesions was made visually by 3 independent examiners, who attributed scores representing the severity of white spot lesions (0 to 3). Statistical analysis was performed with the Kruskal-Wallis (P .001) and multiple paired comparison tests. RESULTS: Interrater reliability was expressed in a range of 0.70 to 0.82 kappa values. The median scores per group were as follows: G1 and G2 = 1; G3, G4, and G5 = 2; and G6 = 0. CONCLUSION: Home bleaching reduced the susceptibility to dental caries, while in-office bleaching did not influence the development of caries lesions.

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INTRODUCTION: Previous investigations have demonstrated improved enamel caries resistance after laser irradiation. The purpose of this in vitro study was to assess the caries-preventive potential of 809 nm diode laser treatment of the enamel of primary teeth compared to topical fluoride application. METHODS: Eighty samples of sound primary teeth were embedded in plastic and stored in saline solution. The enamel surface of 80 samples was polished in an area of 2 x 2 mm. These tooth specimens were randomly assigned to one control and three test groups: (1) no treatment/control; (2) application of 0.1 mg of fluoride varnish (Duraphat) for 6 h; (3) diode laser application (809 nm, 140 mJ, 50 Hz, Ø 600 micro m fibre, contact mode, absorber, 1 min; ORA-LASER01 I.S.T.); and (4) combined application - laser/fluoride varnish. Caries-like lesions were created by pH-cycling. After lesion formation, longitudinal sections were taken and examined by polarized light microscopy. RESULTS: In the control group, all samples showed lesions up to 30 micro m in depth. After laser application, lesions could be identified in 15 out of 20 samples. Topical fluoride treatment in groups 2 (varnish) and 4 (laser/varnish) completely inhibited the development of caries-like lesions in all samples. CONCLUSION: In this in vitro investigation, topical fluoride treatment enhances the resistance of sound enamel of primary teeth more effectively than diode laser application.

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PURPOSE: To evaluate the effect of time of fluoride application gel, acidulated or neutral, on in vitro enamel resistance to demineralization and fluoride uptake. MATERIALS AND METHODS: One hundred and ninety-two human enamel blocks were used in this study and 144 were treated with fluoride gel, acidulated or neutral, for 1 or 4 minutes. Ninety-six blocks treated with fluoride and 24 control blocks were submitted to a high cariogenic challenge. After the pH-cycling, enamel demineralization was assessed by surface and cross-sectional microhardness. Fluoride in the enamel blocks was also determined after removing an enamel layer by etching acid. RESULTS: Acidulated fluoride gel formed more fluoride in enamel than neutral gel (P<0.05), and it was also more efficient in reducing the demineralization of the enamel blocks submitted to a cariogenic challenge than the neutral one (P<0.05). It was found that the time of application was significant in terms of fluoride uptake, but it did not render the enamel more resistant to demineralization.

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This investigation was performed to evaluate, comparatively, the effect of topical application of Duraphat, Flulak, Fluor-Protector, Bifluorid 12, Profilac, Fluoro-gel-P and Fluocal-gel. Colorimetric technique was used for such purposes. It was found that 67.5% of 283 children treated with those different treatments increased their enamel resistance to acid dissolution, although notable differences were found in the use of these products. Average of increase ranged between 10.7 and 23.5%. Lacs and varnishes provide best results than gels with regard to acid dissolution rate of enamel. Behave of the two national products evaluated (Flulak and Profilac) was similar to the rest of lacs and varnishes, justifying their use at national level for the prevention of caries, avoiding in that way unnecessary importations.

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An investigation was carried out in hypercaries-producing children, who had have previously curative treatment. Twenty three children were treated with semestral applications of fluorine-chlorhexidine varnish and daily brushing for 15 days every three months, with dental creme with chlorhexidine, while 21 children were selected as control group. Four analysis of Str. mutants in saliva (Matsukubo technique) were performed to each child in both groups, during a year. It was found that children treated reduced, remarkably, the degree of infection by Str. mutans, while degree of infection did not suffer modification in those children of the control group. The final examination performed after one year showed that 15 children of the control group resulted affected by caries (71.4%) with an incidence of 27 caries (1.29 index), while in the group under treatment only a child resulted affected with a caries. Reduction found in the incidence of caries was 96.9%. Problematic of hypercaries-producing child is analyzed and it is concluded that it is necessary to control and record him, and that investment in a strict treatment, such as that successfully assayed by us, should be rentable, since it should reduce amount of extractions of teeth and to contribute in that way to a real promotion of oral health with the infantile population.

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