Abstract Objective: To evaluate the effectiveness of chewing gums containing CPP-ACP in remineralisation of demineralised enamel around orthodontic brackets. Material and Methods: Enamel blocks from 120 bovine incisors were used. The blocks were flattened and polished, followed by the development of incipient subsurface caries. The blocks have been subjected to a baseline microhardness analysis. Orthodontic brackets were bonded to the exposed area of the blocks, reserving an area for hardness analysis. An in situ crossover (three-way crossover phases of 21 days with an interval of one week between them), controlled, randomised and blind experimental model was used, with the participation of 12 volunteers divided into groups: G1 – negative control group, without chewing gum; G2 – conventional sugar-free chewing gum, without CPP-ACP (placebo); and G3 – sugar-free chewing gum with CPP-ACP. The following parameters were analysed: superficial linear (Ra), volumetric roughness (Sa), and superficial structural loss, which was indicated by Gap measurement (difference between the healthy and treated area). Statistical tests used were the Friedman, Wilcoxon and Shapiro-Wilk, Kruskal Wallis' nonparametric tests and ANOVA. Results: There was a significant reduction in enamel microhardness after demineralisation in all the groups (p<0.05). This deleterious effect was attenuated in the three groups after the final evaluation, although there were no statistical differences (p<0.05); however, the final values did not return to the baseline values (p<0.05). Conclusion: Chewing gum containing CPP-ACP did not promote in situ remineralisation of demineralised enamel around orthodontic brackets.

Abstract The aim of this study was to characterize the salivary metabolomic profile in adolescents with juvenile systemic lupus erythematosus (jSLE). A total of 24 adolescents with jSLE (15.92 ± 2.06 years) and 12 systemically healthy controls (15.25 ± 2.7 years) were included in the study. Participants underwent rheumatologic testing and periodontal examination, with the recording of plaque index (PI), probing depth (PD), clinical attachment level (CAL), and bleeding on probing index (BPI). Unstimulated whole saliva was collected from both groups and stored at -80 ºC. The salivary proton nuclear magnetic resonance (1H-NMR) spectra were acquired in a spectrometer operating at 500 MHz. Partial least squared discriminant analysis (PLS-DA) and orthogonal PLS-DA (O-PLS-DA) were used for statistical analysis. Mean CAL and PI were significantly increased in the group with jSLE (p < 0.01). Patients with jSLE presented a significantly different salivary metabolic profile (accuracy = 0.54; R2 = 0.86; Q2 = -0.293), significantly higher salivary levels of N-acetyl sugars, and significantly reduced levels of phenylalanine, glycine, taurine, hydroxybutyrate, and valerate compared with healthy controls (p < 0.05). It is suggested that the salivary metabolomic profile analyzed by 1H NMR in patients with jSLE presents a different fingerprint that the systemically healthy subjects. Integrating the variation of metabolites with the identification of the metabolic pathways involved seems to provide a better understanding of the influence of systemic disease on salivary metabolites.

ABSTRACT Objective: To evaluate the prevalence of caries stages and interventions on first permanent molars (FPM) in Brazilian children. Material and Methods: Data from FPM were extracted from dental records of children aged 5-14 years of age that attended the UERJ Pediatric Dentistry Clinic. Data include patient age, sex, biofilm index, presence of carious lesions in all stages, and the treatments. Data was analyzed using the SPSS® 20.0 program. Results: A total of 158 dental records were analyzed, 587 registers were related to the caries stage and 601 related to the interventions; mean age of 8.26 (±1.4 years) and 53.2% were girls. The prevalence of active/inactive white spot(AWS/IWS) varied from 14.3% to 21.6% in right upper and lower left FPM, respectively. Enamel/dentin lesions without pulp involvement were also more prevalent in the lower arch and ranged from 3.4% for the right upper to 11.5% for the lower right FPM. Cavities with pulp involvement or indicated extraction ranged from 0% to 1.4%. Treatment included dental sealants, varying from 17.1 to 24.0% (n=126) and restorations, varying from 1.3 to 11.8% (n=38). The lower right were the most affected teeth. Conclusion: First permanent molars presented a higher prevalence of dental caries in early stages and the most prevalent treatment was related to the initial carious process, fluor therapy and sealants.

Abstract This study tested the null hypothesis that antihistamine-containing syrup does not change salivary metabolites in vitro and in vivo. For the in vitro experiments, saliva from 10 volunteers was mixed with a syrup or pill suspension of loratadine (1 mg/ml Claritin®, Schering-Plough, Rio de Janeiro, Brazil). For the in vivo experiment, 10 volunteers performed a mouth rinse with 10 mL of antihistamine syrup (Claritin®; Schering-Plough, Rio de Janeiro, Brazil) for 20 seconds and then discarded the rinse water. After 20 seconds, 5 mL of unstimulated whole saliva was spit into a plastic tube kept on ice. The protein profile of in vitro and in vivo experiments was analyzed using 12% sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The samples were also analyzed by nuclear magnetic resonance (NMR) spectroscopy, followed by Principal Component Analysis and Wilcoxon test (p < 0.05). There were differences in salivary metabolites after syrup interaction. The salivary concentrations of acetate, n-caproate, arginine, glutamate, and lysine among other metabolites were reduced with the syrup in both in vivo and in vitro experiments (p < 0.05), but no differences were observed when the pill suspension was used (p > 0.05). Similar changes in metabolite profiles were observed in both in vitro and in vivo experiments. Electrophoresis revealed no difference in the salivary protein pattern. The null hypothesis was rejected because the intake of syrup medicine changes the salivary composition and influences oral homeostasis and susceptibility to oral diseases.

Abstract: Accumulated hard tissue debris (AHTD) in root canal irregularities may negatively impact adequate root canal disinfection. In light of this, the efficacy of passive ultrasonic irrigation (PUI) to reduce AHTD has been largely studied in in vitro studies, which have adopted different analytic methods of varying accuracy to determine the extent of AHTD more correctly. Therefore, the aim of this study was to compare how well PUI and non-activated irrigation (NAI) systems perform in reducing AHTD during final irrigation protocols, based exclusively on studies whose analyses used microCT scanning. A systematic search of the studies published up to April 2020 was performed using MeSH terms and free terms, in the following databases: PubMed, Scopus, Web of Science, BVS (Lilacs and BBO) and Embase. The inclusion criteria consisted of laboratory studies that evaluated the amount of AHTD, and compared PUI with NAI protocols using microCT analysis. The risk of bias in the selected studies was assessed critically by two reviewers. A meta-analysis was performed using the RevMan software program (P<0.05), and included studies providing the standardized mean difference (SMD), using a fixed effect model, and adopting a confidence interval of 95%. In all, 3495 studies were identified, three of which met the inclusion criteria. All three were considered as having a low risk of bias. The meta-analysis comparing the ability of PUI and NAI protocols to remove hard tissue debris showed a higher percentage of AHTD reduction (P<0.01) for PUI, with a confidence interval of 1.41 [0.79, 2.02]. The heterogeneity among the studies was 82% (I2). Considering the limitations of the present study, this systematic review and meta-analysis showed that PUI was more effective than NAI in removing hard tissue debris, based exclusively on studies that used microCT scanning to provide a more precise analysis of the two techniques used. The findings presented in the present study reinforce the concept that PUI can increase residue removal and improve the cleanliness of the root canal in endodontic treatments.

Abstract: The aim of the present study was to evaluate the microtensile bond strength and the microleakage of a bulk-fill composite resin compared with a conventional incremental composite resin, in permanent molars and under cariogenic challenge using a Streptococcus mutans model. Permanent human third molars (n = 60) with an occlusal cavity of 5×3×2 mm were randomly allocated into four subgroups of restorative treatments: conventional composite resin with (n = 15) and without (n = 15) cariogenic challenge (Z350-E and Z350-C experimental and control groups, respectively), and bulk-fill composite resin with (n = 15) and without (n = 15) cariogenic challenge (Bulk Fill-E and Bulk Fill-C, respectively). Ten specimens from each subgroup were submitted to microtensile strength, and 5, to microleakage. The cariogenic challenge was conducted using the Streptococcus mutans strain (ATCC) for 7 days. The stickers obtained (1 × 1 × 2 mm) were submitted to a microtensile strength test, followed by classification of the fracture mode. Microleakage was performed using a scoring system. The data were analyzed by Kruskal-Wallis and Mann-Whitney tests (p < 0.05). Filtek Z350 XT resin presented higher microtensile bond strength than Bulk Fill resin without (19.02 ± 4.90 and 8.76 ± 3.94MPa, respectively; p < 0.001) and with cariogenic challenge (22.69 ± 7.86 and 13.31 ± 3.38MPa, respectively; p < 0.02). Z350-C and Bulk Fill-C resins presented a higher prevalence of mixed fractures (23 and 14%, respectively) in the specimens submitted to cariogenic challenge than those of the control groups, whereas microleakage was similar (p = 0.85). The conventional composite resin had higher microtensile bond strength than the bulk-fill resin, but both resin types had similar adhesion quality and microfiltration scores.

Abstract This study aimed to perform a systematic review and meta-analysis to evaluate the effectiveness of chlorhexidine varnish on the reduction of caries incidence during fixed orthodontic treatment. The literature searches involved The Cochrane Library, Medline, Scopus, OpenSigle databases and manual searches. The search on OpenSigle did not produce any additional articles. Clinical studies conducted in patients with orthodontic fixed appliances that used professional application of chlorhexidine varnish were included. The effect-size was calculated and a meta-analysis was performed. From 182 abstracts, a total of six articles fulfilled the inclusion criteria. After reading the full articles, one was excluded because of lack of a control group. Three articles were used for continuous data analysis, and two articles were used for the dichotomous data analysis. The pooled meta-analysis with continuous data demonstrated chlorhexidine varnish effectiveness on caries reduction (p = 0.003), with a mean difference and confidence interval of −1.49 [−2.47, −0.51]. On the basis of the pooled meta-analysis of continuous data, we were able to conclude that professional application of chlorhexidine varnish is effective in caries incidence reduction during fixed orthodontic treatment.

This study evaluated the ion exchange at the material/enamel interface and the preventive effect of restorative materials submitted to cariogenic challenge against white spot. Restorations in enamel/dentin of bovine teeth were performed with composite resin (Filtek™ Z250 – control group) and glass-ionomers cements - GICs (Ionomaster R™ and Fuji IX™ - experimental groups). Samples were grouped and submitted to neutral saliva (n = 15) or pH-cycling regimen (n = 15). After eight days of pH cycling, material/enamel interfaces were analyzed by EDX in order to determine the differences (p < 0.05) in ionic exchange (Ca, P, F, Al, Sr, and Si) between restorative materials and teeth. In addition, enamel white spot lesion formation was evaluated macroscopically (p < 0.05). Sr content was higher in the enamel of the control group (p > 0.05) versus the experimental groups. Ca and P content were higher in enamel than in restorative materials. After pH cycling, the GIC enamel bulk showed a significantly higher Sr content compared with the composite resin (p < 0.05). Filtek™ Z250 was not able to prevent white spot formation around restorations in comparison with Ionomaster R™ (p < 0.001) and Fuji IX™ (p = 0.004). GICs reduced white spot formation and presented a preventive effect (p = 0.051). GICs presented a greater percentage of fluoride, aluminum, and strontium, and proved effective in white spot lesion prevention around restorations.

O objetivo do presente estudo foi avaliar o efeito do flúor na prevenção da erosão do esmalte circunjacente a braquetes ortodônticos sob desafio erosivo. Braquetes edgewise foram colados com resina TransbondTM XT na superfície vestibular de 40 incisivos bovinos. Os dentes foram divididos em 4 grupos (n = 10): G1: Saliva remineralizadora; G2: Desafio erosivo; G3: Grupo experimental submetido à aplicação tópica de flúor gel neutro (NaF a 2%) antes do desafio erosivo; G4: Grupo experimental submetido à três aplicações diárias de dentifrício fluoretado (1500 ppmF PFM) durante o desafio erosivo. Após 14 dias de desafio erosivo, foi realizado exame visual e táctil por dois examinadores calibrados e treinados (Kappa = 0,867). Os escores utilizados foram: 0 = Esmalte hígido, 1 = Esmalte desmineralizado sem cavidade, 2 = Esmalte desmineralizado com cavidade, 3 = Esmalte remineralizado sem cavidade, 4 = Esmalte remineralizado com cavidade. Foram utilizados os testes de Kruskal-Wallis e Mann-Whitney para determinar os níveis de erosão, estabelecendo um intervalo de confiança de 95% (p<0,05). O G2 e G3 apresentaram 100% de grau 2, com grandes cavidades, apresentando superfície rugosa e opaca. O G4 apresentou 50% de escore 3 e 50% de escore 4. Considerando as condições estudadas, verificou-se uma diferença significativa entre G2 e G4 e entre G3 e G4 (p<0,01). Diferentemente da aplicação única de gel fluoretado neutro, a elevada frequência de utilização de dentifrício com flúor em baixa concentração apresentou grande influência durante a dinâmica de erosão.

The aim of the present study was to evaluate the effect of fluoride in prevention of tooth erosion around orthodontic brackets under erosive challenge. Edgewise brackets were bonded with TransbondTM XT composite on vestibular surface of 40 bovine incisors. The teeth were assigned to 4 groups (n=10): G1: Remineralizing saliva; G2: Erosive challenge; G3: Experimental group submitted to topical application of neutral fluoride gel (2% NaF) before erosive challenge; G4: Experimental group submitted to three daily applications of fluoride dentifrice (PFM 1500 ppmF) during erosive challenge. After 14 days of erosive challenge, direct visual and tactile examination were performed by two calibrated and trained examiners (Kappa = 0.867). The following scores were used: 0 = Intact enamel, 1 = Demineralized enamel without cavity, 2 = Demineralized enamel with cavity, 3 = Remineralized enamel without cavity, 4 = Remineralized enamel with cavity. Kruskal-Wallis and Mann-Whitney tests were applied to determine erosion levels, establishing a confidence interval of 95% (p<0.05). G2 and G3 presented 100% of score 2, with large cavities, presenting rough and opaque surface. G4 showed 50% of score 3 and 50% of score 4. Considering the studied conditions, it was found a significant difference between G2 and G4 and between G3 and G4 (p<0.01). By contrast to single application of neutral fluoride gel, the high frequency of use of fluoride at low concentration had a great influence during the dynamics of erosion.

OBJECTIVE: The objective this work was to assess the friction coefficient between brackets and wires of different materials under conditions simulating the oral environment. MATERIAL AND METHODS: Stainless steel (SS) and titanium-molybdenum alloy (TMA) wires of 0.019x0.025-in diameter (American Orthodontics) and polycarbonate bracket (American Orthodontics), ceramic bracket (American Orthodontics), and metal bracket (3M Unitek) with slots of 0.022x0.030-in were used. The friction coefficient was assessed by means of mechanical traction with the system immersed in artificial saliva. The mean roughness of both wire surface and bracket slots was evaluated by using a surface profilometer. RESULTS: The system using TMA wire and polycarbonate bracket had the highest roughness (p<0.05). SS wire with ceramic bracket had the highest friction coefficient, whereas the use of metallic bracket yielded the lowest (p<0.05). However, it was observed a statistically significant difference in the system using TMA wire and ceramic bracket compared to that using TMA wire and polycarbonate bracket (p=0.038). CONCLUSIONS: Ceramic brackets in association with SS wire should be judiciously used, since this system showed a high friction coefficient.

The present study evaluated the antimicrobial activity of three root canal irrigants against Enterococcus faecalis, Candida albicans, and Staphylococcus aureus. These microorganisms were incubated in the presence of citric acid (6 and 10%), EDTA (17%), and NaOCl (0.5, 1.0, 2.5, and 5.25%). Agar diffusion tests were performed and redox indicator resazurin was used to evaluate the inhibitory effect of the irrigants on the metabolic activity of these microorganisms. The mean diameters of the inhibition zones for the C. albicans cultures were 11.6 mm (17% EDTA), 5.5 mm (0.5% NaOCl), 12.9 mm (1% NaOCl), 22.1 mm (2.5% NaOCl), and 28.5 mm (5.25% NaOCl). The mean diameters of the inhibition zones for E. faecalis were 2.8 mm (1% NaOCl), 5.4 mm (2.5% NaOCl), and 8.3 mm (5.25% NaOCl). For S. aureus, the mean values were 8.0 mm (17% EDTA), 3.0 mm (1% NaOCl), 8.8 mm (2.5% NaOCl), and 10.0 mm (5.25% NaOCl). Most of the irrigant solutions presented effective antimicrobial activity against C. albicans. A high inhibitory effect on the metabolic activity of E. faecalis was detected when the microorganisms were incubated with 17% EDTA. The same result was reached when S. aureus was incubated in the presence of > 2.5% NaOCl. Altogether, these results indicate that 2.5% and 5.25% NaOCl are microbicides against S. aureus while 0.5% and 1% NaOCl are only microbiostatic against the tested bacteria. The 6% and 10% citric acid as well as 17% EDTA did not affect the viability of any of the assayed microorganisms.

The aim of this study is to assess the in vitro shear bond strength and adhesive remnant index (ARI) of one and two-step fluoridated orthodontic resins under conditions that simulate high cariogenic challenge. Edgewise brackets for maxillary central incisors were randomly bonded to 80 bovine incisors, using either TransbondTM Plus Color Change orthodontic resin and a self-etching primer adhesive (G1; n = 40) or Orthodontic Fill Magic with a conventional acid-etch technique (G2; n = 40). Each group of resin (n = 10) was divided into: immediate shear (A- pre-cycling control), immersion in artificial remineralizing saliva (neutral saliva) for 14 days (B- post-cycling control) and pH cycling with high cariogenic challenge (C- acid saliva with pH 5.5 and D- acid saliva with pH 4.5). After 14 days of pH cycling, the shear bond strength and ARI were evaluated. Considering the shear bond strength, TransbondTM Plus Color Change resin was stronger than Orthodontic Fill Magic when it was submitted to high cariogenic challenge (p < 0.05). Also TransbondTM Plus Color Change resin showed better adhesion to enamel than Orthodontic Fill Magic, in all situations evaluated (p < 0.05). It could be concluded that TransbondTM Plus Color Change resin presented better shear bond strength and adhesive remnant index when submitted to high cariogenic challenge, in comparison with Orthodontic Fill Magic.

O objetivo do presente estudo foi avaliar in vitro o efeito preventivo a cárie de resinas ortodônticas fluoretadas submetidas à ciclagem de pH utilizando dois tipos de saliva desmineralizadora. Bráquetes de incisivos centrais foram colados em 60 incisivos bovinos, utilizando a resina ortodôntica Transbond Plus Color Change (n=30) ou Fill Magic (n=30). Cada grupo foi dividido em 3 subgrupos (n=10): imersão em saliva artificial remineralizante por 14 dias e simulação de alto desafio cariogênico com ciclagem de pH em saliva ácida com pH 5,5 ou pH 4,5. Após 14 dias de ciclagem de pH, o efeito preventivo de cárie foi avaliado por meio da formação de halo de inibição da mancha branca, adotando-se os escores: 0-ausência e 1-presença. Os testes Kruskal Wallis e Man-Whitney (a=0,05) foram aplicados. A formação de lesões de mancha branca foi observada somente na ciclagem de pH com saliva ácida a pH 4,5; sendo o Transbond Plus Color Change significantemente mais efetivo na prevenção ao desenvolvimento de mancha branca quando comparados ao Fill Magic (p<0,05). O pH da solução desmineralizante influenciou na formação de lesões de mancha branca circunjacentes aos bráquetes em condições de alto desafio cariogênico. A Transbond Plus Color Change apresentou maior efeito preventivo de cárie em relação ao Fill Magic.

The aim of the present study was to evaluate the in vitro caries preventive effect of fluoridated orthodontic resins under pH cycling with two types of acid demineralizing saliva. Brackets were bonded to 60 bovine incisors, using either Transbond Plus Color Change (n=30) or Orthodontic Fill Magic (n=30) orthodontic resins. Each group of resin was divided into 3 subgroups (n=10): immersion in remineralizing artificial saliva for 14 days, pH cycling with high cariogenic challenge in acid saliva with pH 5.5, and acid saliva with pH 4.5. After 14 days of pH cycling, the caries preventive effect on the development of white spot lesion was evaluated considering the presence of inhibition zones to white spot lesions using two scores: 0= absence and 1= presence. Kruskal Wallis and Mann-Whitney tests (a=0.05) were used. Formation of white spot lesions was observed only under pH cycling using acid saliva with pH 4.5; with Transbond Plus Color Change being significantly more effective (p<0.05) in preventing the appearance of white spot lesions effect than Orthodontic Fill Magic. The acidity of the demineralizing solution influenced the formation of white spot lesions around orthodontic brackets under highly cariogenic conditions. Transbond Plus Color Change resin presented higher caries preventive effect than Orthodontic Fill Magic.