In situ bacterial accumulation on dental restorative
materials. CLSM/COMSTAT analysis
Gislaine C. Padovani, dds, ms, phd, Suzana B. P. FÚcio, dds,
ms, phd, GlÁucia M. B. Ambrosano, dds, ms, phd,
Abstract: Purpose: To
evaluate the influence of different restorative materials on the biofilm structure accumulated in situ. Methods: 15 discs of each material (ceramic; resin composite;
resin-modified and conventional glass-ionomers; amalgam)
were adapted to palatal devices in order to accumulate biofilm in situ, under a cariogenic challenge (20% sucrose
solution, 10x/day). After 7 days, the specimens were carefully removed and
visualized by confocal laser scanning microscopy
(CLSM). The images were analyzed qualitatively (descriptive analysis about cell
viability and architecture) and quantitatively using COMSTAT software (area,
bio-volume, mean thickness, maximum thickness and roughness coefficient of the biofilm). The statistical analysis was performed by using
the Kolmogorov-Smirnov and Kruskal-Wallis
tests (P≤ 5%). Results: The
medians of the biofilm parameters analyzed showed no
statistical difference regarding different materials. However, qualitatively, glass-ionomer cements and amalgam showed visually a prevalence of
non-viable cells forming small clusters distributed by the biofilm,
and voids were presented in smaller proportion in the biofilm volume compared to composite and ceramic. (Am
J Dent 2015;28:3-8).
Clinical
significance: Different
materials can change biofilm accumulated in situ; glass-ionomer cements and amalgam provide qualitatively higher
non-viable cells and voids compared with composite and ceramic.
Mail: Prof.
Dr. Regina Maria Puppin-Rontani, Piracicaba Dental School, UNICAMP, Pediatric
Dentistry Department, Av: Limeira, no 901, Piracicaba, 13414-900, São Paulo,
Brazil. E-mail: rmpuppin@fop.unicamp.br
Cytokine levels
in plasma and gingival crevicular fluid
Xiao-Tao Chen, mm, Jing-Yi Tan, mm, Li-Hong Lei, mm & Li-Li
Abstract: Purpose: To evaluate the Th1/Th2/Th17
cytokine levels in plasma and gingival crevicular fluid (GCF) from chronic periodontitis patients and
healthy controls. Methods: The
concentration of interleukin-2 (IL-2), IL-4, IL-6, IL-10, IL-17, TNF, and
IFN-γ were determined using a flow cytometric multiplex immunoassay (CBA), and was compared between the periodontitis group and the healthy group. Spearman rho coefficient was used to correlate
cytokines in GCF in the periodontitis group and the
healthy group, respectively. Results: Comparisons of two groups of Th1/Th2/Th17 cytokine levels in plasma and GCF
showed no statistically significant differences (P> 0.05), except Th17 (IL-17)
level in plasma that was higher in the periodontitis group than the healthy group (P< 0.05). A stronger correlation between
IL-17/IL-4 and IL-17/IL-10 was observed in periodontitis patients than in healthy controls. (Am J
Dent 2015;28:9-12).
Clinical significance: The results suggested that IL-17
might be associated with chronic periodontitis by
recruiting immune cells required for the spread of periodontal inflammation.
Mail: Dr. Li-Li Chen, Department of Oral Medicine,
The Second Affiliated Hospital,
Formation of subsurface dentin
lesions using a polymicrobial biofilm model
Kiyoshi Tomiyama, dds, phd, Yoshiharu Mukai, dds, phd, Hidefumi Kumada, phd, Kiyoko Watanabe, phd,
Abstract: Purpose: To simulate an oral demineralization environment by
multiple species of bacteria by inducing subsurface dentin lesions with a polymicrobial biofilm model. Methods: Polymicrobial biofilms consisting of multiple species of bacteria
were generated from stimulated saliva using a high-throughput active attachment
model. Biofilms were grown on dentin specimens in McBain medium containing 0, 0.2 or 2.5 ppm F and on glass without fluoride for 192 hours. The medium was refreshed twice
daily, after 10 and 14 hours, until 72 hours, followed by treatment for 5
minutes with 400 ppm fluoride. Specimens were
recovered after 192 hours. The number of colony forming units (CFU) was
measured, and integrated mineral loss (IML) was determined by transversal micro-radiography. Results: Mineral profiles in
specimens grown with 0.2F and 2.5F revealed surface layers and initial lesions
distinct from those grown with 0F. IML was significantly lower with 0.2F and
2.5F than with 0F (P< 0.05), although CFUs were similar. CFUs of biofilms grown on dentin in medium containing 0F were 10-fold
higher than on glass (P< 0.05). Subsurface lesions on dentin formed
consistently, with their growth progression inhibited by application of
fluoride. To our knowledge, this is the first report describing the induction
of subsurface dentin lesions by a polymicrobial biofilm model, and this model may be useful for studies of
demineralization supporting in situ and in vivo models. (Am J Dent 2015;28:13-17).
Clinical significance: Dentin lesions induced by polymicrobial biofilm reflects
subsurface lesions and the effects of fluoride to microorganisms were
restricted.
Mail: Dr. Yoshiharu Mukai,
Department of Cariology and Restorative Dentistry,
Graduate School of Dentistry, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, Kanagawa 238-8580, Japan. E-mail:
mukai@kdu.ac.jp
In vitro effect
of calcium-containing prescription-strength fluoride toothpastes on bovine
enamel erosion under hyposalivation-simulating
conditions
TaÍs Scaramucci, dds, phd, Alessandra B. Borges, dds, mds, phd, Frank Lippert, msc, phd,
Domenick T. Zero, dds, mds & Anderson T. Hara, dds, msd, phd
Abstract: Purpose: To evaluate the ability of calcium-containing
prescription-strength fluoride (F) toothpastes in preventing enamel erosion
under low salivary flow simulating conditions. Methods: Enamel and dentin bovine specimens were assigned to the
following groups: A – placebo; B - 1,100 ppm F/NaF (Aquafresh Advanced); C -
5,000 ppm F/NaF (Prevident 5000 Booster); D - 5000 ppm F/NaF+calcium sodium phosphosilicate (Topex Renew); and E - 5,000 ppm F/NaF+tri-calcium phosphate (Clinpro 5000). Specimens were positioned in custom-made devices, creating a sealed
chamber on the surface, connected to peristaltic pumps. Citric acid was
injected into the chamber for 2 minutes, followed by artificial saliva (0.05
ml/minute), for 60 minutes, 4×/day, for 3 days. Aquafresh was also tested under normal salivary flow (0.5 ml/minute), as reference (Group
F). Specimens were exposed to the toothpastes for 2 minutes, 2×/day. After
cycling, surface loss (SL) and concentration of loosely- and firmly-bound F
were determined. Data were analyzed by ANOVA. Results: Group A (placebo) presented highest surface loss (SL), while
Group F had the lowest, for both substrates. For enamel, none of the
dentifrices differed from Group B or among each other. For dentin, none of the
dentifrices differed from Group B, but Group E showed greater protection than
Group C. Group E presented the highest F concentrations for both substrates,
only matched by Group D for firmly-bound fluoride on enamel. All fluoridated
dentifrices tested reduced SL, with no additional benefit from higher F
concentrations. Some formulations, especially Clinpro 5000, increased F availability on the dental substrates, but no further erosion
protection was observed. (Am J Dent 2015;28:18-22).
Clinical significance: The tested calcium-containing
prescription-strength toothpastes may not promote further erosion protection
than a conventional 1,100 ppm F toothpaste, under low
salivary flow simulating conditions.
Mail: Dr. Anderson T. Hara, Oral
Health Research Institute, Department of Preventive and Community Dentistry,
Indiana University School of Dentistry, 415 N. Lansing Street, Indianapolis, IN 46202-2876, USA. E-mail: ahara@iu.edu
In vivo evaluation of fluoride dentifrice and diet
control
Vanessa Salvadego de Queiroz, dds,
ms, phd, Paulo Roberto Aranha Nouer, dds, ms, phd,
CÍnthia Pereira Machado Tabchoury, pharmd,
ms, phd, Ynara Bosco de Oliveira Lima-Arsati, dds, ms, phd
Abstract: Purpose: To evaluate, in vivo, the effect
of fluoride dentifrice and diet control on the deminerali-zation/remineralization processes at the margin of bracket/enamel
interface bonded with four different bonding materials, using optical
microscopy and fluorescent laser (DIAGNOdent). Methods: Premolars in 35 subjects (11
to 20 years old) were divided into Group 1 (n= 15) and Group 2 (n= 20). Four
bracket/enamel interfaces (near points) and four points at a distance of 2 mm
(distant points) were observed. Evaluations were made at the following times:
15 days before bracket bonding (T0), on day of bonding (T1), 1 week after
bonding (T2), and 4 weeks after bonding (T3). Subjects received fluoride
dentifrice, and toothbrush and were instructed to brush 3×/day, after main
meals. Group 1 received the instructions at T1 and Group 2 at T0 and these were
reinforced weekly. The Microarch brackets were bonded
with four materials: Transbond XT; Concise Ortodôntico; Fuji Ortho LC and Monolok2. DIAGNOdent laser readouts were used for comparison. Results: Data were statistically
analyzed by Mann-Whitney, Wilcoxon and Friedman tests
(P< 0.05). Higher readouts were found at nearer points than at distant
points; Group 2 presented lower readouts than Group 1; No differences were
observed among bonding materials. (Am J
Dent 2015;28:23-27).
Clinical significance: Fluoride dentifrice and toothbrushing 3×/day, with daily motivation, helped to
reduce enamel demineralization and/or increase enamel remineralization.
Mail: Dr. Vanessa Salvadego de Queiroz, Department
of Clinical Pathology, School of Medical Sciences, FCM State University of
Campinas - UNICAMP. Campinas, São Paulo 13083-970, Brazil. E-mail: vanessasalvadego@gmail.com
Chlorhexidine does not improve but preserves
bond strength to eroded dentin
Luciana FÁvaro Francisconi-dos-Rios, dds,
ms phd, Marcela Pagani Calabria, dds,
ms phd,
Abstract: Purpose: To evaluate the effect of
aqueous solutions of chlorhexidine digluconate (CHX) in different concentrations on bond
strength to eroded dentin up to 6 months, using normal dentin as a control. Methods: Exposed flat dentin of
extracted third molars was only ground with 600-grit SiC paper/1 minute (normal dentin - N), or subsequently eroded by a regular-cola
soft-drink (eroded dentin - E). N and E were acid-etched, washed, dried and
rehydrated with 1.5 µL, respectively, of distillated water (control - NC / EC);
of 0.004% CHX (N0.004% / E0.004%); or of 2% CHX (N2% / E2%). Adper Single Bond 2 was applied in all specimens and resin
composite buildups were constructed with Filtek Z350.
Specimens were sectioned in beams, which were tested (µTBS) immediately or
after 6 months of aging. Results: Microtensile bond strength to eroded dentin was always
significantly lower than that to normal dentin. Application of tested CHX
solutions did not exert a significant effect immediately; however, after aging,
the 2% CHX prevented abrupt bond strength loss both to eroded and normal
dentin. (Am J Dent 2015;28:28-32).
Clinical significance: Contemporary literature pointed
out that chlorhexidine prevents loss of bond strength
to normal or caries-affected dentin. Two percent CHX also proved to preserve
bond strength to eroded dentin, though being unable, at 24 hours or after 6
months, to make it equivalent to that of normal dentin.
Mail:
Dr. Linda Wang, Alameda Octávio Pinheiro Brisolla, 9-75, Bauru/SP -
17012-901, Brazil. E-mail: wang.linda @usp.br; wang.linda@uol.com.br
Evaluation of nanohydroxyapatite-containing toothpaste for occluding
dentin tubules
Bennett T. Amaechi, bds, msc, phd, Sapna M. Mathews, bds, ms, Karthikeyan Ramalingam, bsc, phd
Abstract: Purpose: To compare dentin tubule occlusion by dentifrices
containing either nanohydroxyapatite (10%nHAP and
15%nHAP), sodium monofluorophosphate (Na-MFP) or NovaMin (NovaMin). Methods: All 80 participants wore four
intraoral appliances bearing dentin blocks while using one of the four test
dentifrices (n= 20/dentifrice) twice daily for 14 days. The four appliances
were removed in pairs after 7 and 14 days. One treated block from each of the
test periods (7 and 14 days) and their untreated controls were examined with
SEM to determine the level of tubule occlusion. The remaining two treated
blocks and their controls were used to determine tubule permeability to dye
solution. Effectiveness was compared statistically (ANOVA/Tukey’s)
based on % area covered by deposited precipitate layer (%DPL), % dye
penetration inhibition (%DPI) and percentage of fully-open (%FOT),
partially-occluded (%POT) and completely-occluded (%COT) tubules in each block
calculated relative to the number of tubules in their control blocks. Results: SEM showed increased %COT and
%DPL overtime. After 7 and 14 days, %COT, %POT, %DPL and %DPI were
significantly lower with Na-MFP when compared to 10%nHAP (P < 0.01), NovaMin (P< 0.05) and 15%nHAP (P< 0.001), the three
of which were not significantly different from each other in those four
variables. A reverse trend was observed with %FOT (P< 0.001). Within the
same dentifrice, no difference in %COT, %POT, %FOT, %DPI and %DPL after 7 and
14 days, except with Na-MFP in which %DPL significantly (P< 0.05) increased
with usage. In conclusion, nanohydroxyapatite-containing
and NovaMin-containing toothpastes showed equal and
more effectiveness in occluding dentin tubules than Na-MFP toothpaste. (Am J Dent 2015;28:33-39).
Clinical significance: Nanohydroxyapatite-containing dentifrices caused dentin tubule occlusion
thus showing potential to relieve dentin hypersensitivity.
Mail: Dr.
Bennett T. Amaechi, Department of Comprehensive Dentistry, University of Texas
Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, Texas
78229-3900, USA. E-mail: amaechi@uthscsa.edu
Efficacy of a combined in-office/home-use
desensitizing system containing
Isabela Lima FranÇa, dds, ms, Enilson
Antonio Sallum, dds, phd, Hugo Felipe do Vale, dds, phd,
MÁrcio Zaffalon Casati, dds, phd, Antonio Wilson Sallum, dds, phd & Bernal Stewart, bseng msc
Abstract: Purpose: To determine the efficacy in reducing dentin
hypersensitivity (DHS) of a combined in-office and home-use desensitizing
system, each product containing 8% arginine and
calcium carbonate (Test), following a dental scaling procedure, compared to the
combination of a conventional prophylactic paste and a potassium nitrate
dentifrice (Control), in a group of patients with known dentin
hypersensitivity. Methods: An 8-week
clinical study, with 50 subjects, was conducted in Piracicaba, São Paulo,
Brazil, using a double-blind/two treatment design. Air blast sensitivity
assessments were used to compare the efficacy of the two approaches using both
the Schiff scale as well as a Visual Analogue Scale (VAS). Results: Immediately after prophylaxis, the Test treatment provided
significant reduction in DHS when compared to baseline values (VAS= 26.2% and
Schiff= 29.1%), while for Control treatment this difference was not
statistically significant (VAS= 8.1% and Schiff= 6.6%). The comparison between
groups after prophylaxis showed a greater DHS reduction for the Test treatment
(P< 0.05). The reductions in DHS after 2, 4 and 8 weeks were significant for
both groups, however, when considering Schiff scale, the Test treatment
provided greater DHS reduction after 2 weeks (44.5% for Test versus 27.7% for
Control) and 4 weeks (55.2% for Test and 40.5% for Control), while after 8
weeks there was no significant difference between groups (71.1% for Test versus
61.1% for Control). (Am J Dent 2015;28:45-50).
Clinical significance: The arginine-based
approach (Test) provided significantly greater DHS relief immediately after
prophylaxis (VAS/Schiff) and after 2 and 4 weeks of home use when compared with
the combination of a conventional prophylactic paste and a potassium nitrate
dentifrice (Control). After 8 weeks, no statistically significant differences
were observed between the two approaches and they were both effective in DHS
reduction.
Mail: Dr. Enilson Antonio Sallum, Av. Limeira, 901, Areão,
Piracicaba, São Paulo, Brazil E-mail: easallum@fop.unicamp.br
An in vitro evaluation of the effect of
fluoride products
Agnieszka
Mielczarek, md, phd, Tomasz Gedrange, md, phd & Joanna Michalik, msc
Abstract: Purpose: To compare the
effect of combinations of fluoride (F) products on remineralization of caries-like lesions. Methods: Demineralized human enamel specimens were assessed by
surface microhardness (SMH), stratified and allocated
to five treatments groups: (1) Toothpaste containing 1% nano hydroxyapatite (HAP) + 1,450 ppm F; (2) Tooth mousse containing 10% casein phosphopeptide-amorphous
calcium phosphate (CPP-ACP) + 900 ppm F plus F
toothpaste (1,450 ppm F as NaF);
(3) F varnish containing 22,600 ppm F plus F
toothpaste (1,450 ppm F as NaF);
(4) F toothpaste (1,450 ppm F as NaF);
and (5) placebo - distilled water (P). Each group was treated in a 21-day
pH-cycling model. Groups 1, 4 and 5 were treated 2×/day. In Group 3, the tooth
mousse was administered 1×/day plus 2×/day F toothpaste treatment. In Group 4,
F varnish was administered 1×/week plus 2×/day treatment with F toothpaste.
After cycling, SMH was re-measured and cross-sectional microhardness measurements were taken. Results: Groups 1-4 produced significant rehardening of
enamel. In the superficial layer (25-50 μm deep)
significantly higher mineralization (up to 83%, by Volume (V), P< 0.0001)
was achieved for Groups 2 and 3. In the area of 75-100 μm deep, the highest mineralization was observed for Groups 1 and 4 (V%= 68-83%). (Am J Dent 2015;28:51-56).
Clinical significance: These data suggest that a combination of treatments may
be needed to optimize mineralization patterns. Further studies are needed to
define an optimal sequence of product use.
Mail:
Dr. Agnieszka Mielczarek, Department of Conservative Dentistry, Medical
University of Warsaw, Miodowa 18, 00-246 Warsaw, Poland.
E-mail: agnieszka.mielczarek@wum.edu.pl
Antimicrobial effects of carbamide peroxide against a polymicrobial
Haruhiko Hasegawa, dds, Kiyoshi
Tomiyama, dds, phd, Hidefumi Kumada, phd, Akira Kawata, dds, phd,
Abstract: Purpose: To
investigate the in vitro antimicrobial effects of carbamide peroxide (CP) and CP-based home bleaching agents against polymicrobial (PM) biofilms. Methods: Using a high-throughput active attachment model, PM biofilms were cultured on glass coverslips by diluting the
stimulated saliva of one healthy adult. All experiments were performed anaerobically in McBain medium,
which was refreshed twice daily. After biofilm formation for 24 or 72 hours, the biofilms were
treated with 0.5%, 2.5%, 5%, or 10% CP, 20-fold dilutions of HiLite Shade Up (HS) or Opalescence Regular (OR), 0.2% chlorhexidine digluconate (CHX),
0.2% NaF, or deionized water (n = 10 each). Biofilms were dispersed and the
number of colony forming units (CFU) was measured on tryptic soy agar blood plates. Coverslips containing 72-hour biofilms treated with 0.5% and 10% CP and deionized water were stained and scanned by confocal laser scanning microscopy (CLSM). Results: Treatment of 24- and 72-hour biofilms with HS, OR and CH yielded significantly fewer
colonies than treatment with water or 0.2% NaF. No
growing colonies were observed after treatment with 10% CP. CLSM showed that
the percentage of dead bacteria increased as the concentration of CP increased.
(Am J Dent 2015;28:57-60).
Clinical significance: Home bleaching agents can have
significant antimicrobial effects on dental plaque.
Mail:
Dr. Yoshiharu Mukai, Department of Cariology and
Restorative Dentistry, Graduate School of Dentistry, Kanagawa Dental University
82 Inaoka-cho, Yokosuka, Kanagawa 238-8580, Japan. E-mail:
mukai@kdu.ac.jp
Difference in effectiveness between
strontium acetate and arginine-based
Marcela
BaraÚna Magno, GlÁucia
Cristina Rodrigues Nascimento, Natasha Kiss Santos da Penha,
Abstract: Purpose: To present an overview of
clinical evidence of strontium acetate and arginine-based
toothpastes, in order to determine which of these substances was the most
effective to relieve dentin hypersensitivity (DH). Methods: An electronic search was performed in PubMed,
EMBASE, The Cochrane Library, LILACS, Web of Science and Open Grey databases.
The search strategy included MeSH terms, synonyms and
keywords with no language or date restriction. Randomized controlled clinical
trial studies that compared the effectiveness of arginine/calcium
carbonate and strontium acetate toothpaste were included. The risk of bias in
the included studies was assessed and classified through the Cochrane
Collaboration's common scheme for bias. Data were subgrouped and heterogeneity was tested via comprehensive meta-analysis. Results: A total of 3,883 potentially
relevant studies were identified. After title and abstract examination, only
six studies fulfilled the eligibility criteria and were classified as having a
“low risk of bias”. The majority of
studies found better results for arginine/calcium
carbonate in comparison with strontium acetate in alleviating DH. Only one
study reported superior efficacy of strontium acetate, and only for tactile
stimuli, after 8 weeks of home use. The arginine/calcium
carbonate-based toothpaste provided a higher level of efficacy in terms of DH
relief than the strontium-based toothpaste. (Am J Dent 2015;28:40-44).
Clinical
significance: Arginine-based toothpaste provided an effective level of dentin
hypersensitivity relief in a shorter time period of use than the
strontium-based toothpaste.
Mail:
Dr. Lucianne Cople Maia, Federal University of Rio de Janeiro, Rio de Janeiro,
Brazil, Department of Pediatric Dentistry and Orthodontics, School of
Dentistry, Av Prof. Rodolpho Paulo Rocco, 325 Ilha do Fundão, Rio de Janeiro,
RJ, CEP:21941-617, Brazil. E-mail:
rorefa@terra.com.br