Abstract Sources of calcium and phosphate have been added to dental restorative materials to improve their anticaries effect. Objective This study evaluated the effect of adding calcium glycerophosphate (CaGP) to resin-modified glass ionomer cement (RMGIC) on the physico-mechanical properties, ion release, and enamel demineralization. Material and Methods: Specimens were fabricated for each experimental group: RMGIC without CaGP (Control), RMGIC with 1, 3 and 9% CaGP. To determine the release of fluoride (F), calcium (Ca) and phosphorus (P), six specimens were immersed in demineralization and remineralization solutions for 15 days. In another experimental trial, the following physico-mechanical properties were evaluated at time intervals of 1 and 7 days after fabrication: compressive strength (n=12), diametral tensile strength (n=12), surface hardness of material (n=6) and the degree of conversion of monomers (n=8). To study enamel demineralization, specimens (n=12) were attached to enamel blocks and submitted to pH-cycling. Subsequently, surface and cross-sectional hardness and the concentration of F, Ca and P in enamel were determined. Results The addition of CaGP to RMGIC led to higher mean release of F, Ca and P when compared with control (p<0.001). Mechanical properties were within the range of those of the ionomer cements after addition of 1% and 3% CaGP. The degree of conversion did not differ between groups at the 1st and the 7th day (p>0.439). The addition of 3% and 9% CaGP reduced mineral loss and increased F, Ca and P in the enamel when compared with control (p<0.05). Conclusion The addition of 3% CaGP in RMGIC increased the release of F, P and Ca, reduced enamel demineralization, and maintained the physico-mechanical properties within the parameters for this material.

Abstract Objectives This study evaluated the evolution of cases of concussion and subluxation through a retrospective study of 20 years. Material and Methods Were examined clinical and radiographic records of 1,309 patients who underwent treatment of dentoalveolar trauma in the discipline of Integrated Clinic of the School of Dentistry of Araçatuba, UNESP, of which we selected 137 whose patients had concussion and subluxation injuries, with average age of 23.3 (SD – 10.96). The variables collected were: gender, age, history of previous and actual trauma, treatments performed, the presence of necrotic pulp, and time elapsed until the same trauma. The concussion and subluxation groups were subjected to statistical analyses using the SPSS 16.0 version software (α=0.05), Chi-square, and t-tests. Results Of the 301 teeth involved, 49 (16.3%) suffered concussion and 252 (83.7%), subluxation, being the upper anterior teeth the most affected (75.1%) for both conditions. Subluxation and concussion traumas were more prevalent in men aged 10 to 20 years, most caused by cycling accidents (36.2%). There was a concomitant presence of crown fracture in 21% of cases of concussion and 34.7% of subluxation. Pulp necrosis was detected in 16.3% (concussion) and 27.1% (subluxation) (p=0.12), and most occurred within 6 months after the trauma (p=0.29). The pulp necrosis shows a positive correlation with motorcycle accidents (p=0.01), direct impact (p≤0.0001), crown fracture with pulp exposure (p≤0.0001), darkening of the crown (p=0.004) and spontaneous pain (p≤0.0001); and negative correlation with indirect impact (p≤0.0001). Conclusions Although concussion and subluxation traumas are considered of minor degrees, they must be monitored, since the possibility of pulp necrosis exists, and its early treatment favors a good prognosis.

This study investigated the level of knowledge held by dentists about the possible treatment plan procedures for periodontal ligament injuries after dentoalveolar trauma. A 5-item self-applied questionnaire was prepared with questions referring to the professional profile of the interviewees and to the treatment plan they would propose for periodontal ligament injuries secondary to dentoalveolar trauma. The questionnaires were filled out by 693 dentists attending the 23rd Annual Meeting of the Brazilian Society for Dental Research, and the data obtained were subjected to descriptive analysis. Either the chi-square test or Fisher's exact test was applied to assess associations among variables, at a 5% level of significance. The results revealed that dentists experienced difficulty in establishing a treatment plan for subluxation, and for extrusive, lateral and intrusive luxations. In general, holding a dental specialty degree had no influence on the knowledge about treatment plan procedures for the most severe injuries. It could be concluded that the dentists participating in this study, whether specialists or not, did not have sufficient knowledge to treat most of the periodontal ligament injuries resulting from dentoalveolar trauma adequately.

Este trabalho propôs um modelo de ciclagem de pH verificando a relação dose-resposta de materiais que liberam flúor na remineralização in vitro. Foram selecionados 60 blocos de esmalte bovino pelo teste de microdureza de superfície (SMH1). Realizou-se indução de cárie e microdureza de superfície pós-cárie (SMH2). Corpos-de-prova (n=48) dos grupos Z 100, Fluroshield, Vitremer e Vitremer diluído ¼ foram fabricados e submetidos à ciclagem de pH para promover a remineralização. Após, avaliou-se a microdureza de superfície final (SMH3) para cálculo da porcentagem de recuperação da microdureza de superfície (%SMHR). Determinou-se o flúor presente no esmalte (μg F/mm3) e nas soluções de ciclagem (μg F). O teste de microdureza em secção longitudinal foi realizado para cálculo do conteúdo mineral (∆Z). Entre os grupos controle e Z100 não houve diferença significativa nas análises realizadas - %SMHR, ∆Z, μg F e μg F/mm3 (p>0,05). Houve correlação positiva entre a %SMHR e μg F/mm3 (r=0,9770; p=0,004), %SMHR e μg F (r=0,9939; p=0,0000001), ∆Z e μg F/mm3 (r=0,9853; p=0,0002), ∆Z e μg F (r=0,9975; p=0,0000001) e também entre μg F/mm3 e μg F (r=0,9819; p=0,001). O modelo de ciclagem de pH proposto foi adequado para verificar relação dose-resposta in vitro de materiais que liberam flúor na remineralização.

This study proposes a pH-cycling model for verifying the dose-response relationship in fluoride-releasing materials on remineralization in vitro. Sixty bovine enamel blocks were selected for the surface microhardness test (SMH1). Artificial caries lesions were induced and surface microhardness test (SMH2) was performed. Forty-eight specimens were prepared with Z 100, Fluroshield, Vitremer and Vitremer ¼ diluted - powder/liquid, and subjected to a pH-cycling model to promote remineralization. After pH-cycling, final surface microhardness (SMH3) was assessed to calculate percent recovery of surface microhardness (%SMHR). Fluoride present in enamel (μg F/mm3) and in the pH-cycling solutions (μg F) was measured. Cross-sectional microhardness was used to calculate mineral content (∆Z). There was no significant difference between Z 100 and control groups on analysis performed on - %SMHR, ∆Z, μg F and mg F/mm3 (p>0.05). Results showed a positive correlation between %SMHR and μg F/mm3 (r=0.9770; p=0.004), %SMHR and μg F (r=0.9939; p=0.0000001), ∆ and μg F/mm3 (r=0.9853; p=0.0002), ∆ and μg F (r=0.9975; p=0.0000001) and between μg F/mm3 and μg F (r=0.9819; p=0.001). The pH-cycling model proposed was able to verify in vitro dose-response relationship of fluoride-releasing materials on remineralization.

The purpose of this retrospective study was to analyze the cases of traumatic dental injuries involving root fracture and/or periodontal ligament injury (except avulsion) treated at the Discipline of Integrated Clinic, School of Dentistry of Araçatuba, São Paulo State University (UNESP), Brazil, from January 1992 to December 2002. Clinical and radiographic records from 161 patients with 287 traumatized teeth that had sustained root fracture and/or injuries to the periodontal ligament were examined. The results of this survey revealed that subluxation (25.09%) was the most common type of periodontal ligament injury, followed by extrusive luxation (19.86%). There was a predominance of young male patients and most of them did not present systemic alterations. Among the etiologic factors, the most frequent causes were falls and bicycle accidents. Injuries on extraoral soft tissues were mostly laceration and abrasion, while gingival and lip mucosa lacerations prevailed on intraoral soft tissues injuries. Radiographically, the most common finding was an increase of the periodontal ligament space. The most commonly performed treatment was root canal therapy. Within the limits of this study, it can be concluded that traumatic dental injuries occur more frequently in young male individuals, due to falls and bicycle accidents. Subluxation was the most common type of periodontal ligament injury. Root canal therapy was the type of treatment most commonly planned and performed.

Este estudo avaliou as propriedades de microdureza de superfície e liberação de flúor de 5 materiais restauradores (Ketac-Fil Plus, Vitremer, Fuji II LC, Freedom e Fluorofil) em dois meios de imersão: água destilada/deionizada e modelo de ciclagem de pH (4,6). Doze corpos-de-prova de cada material foram confeccionados e tiveram a microdureza de superfície inicial (MSI) determinada utilizando o microdurômetro Shimadzu HMV-2000 Micro Hardness Tester (carga estática Knoop). Os corpos-de-prova foram submetidos a ciclos de 6 e 18 h para os dois meios de imersão. A cada final de ciclo as soluções foram substituídas e armazenadas. Após 15 dias de imersão, a microdureza de superfície final (MSF) e a liberação de flúor foram determinadas. A dosagem de flúor foi feita com um eletrodo específico combinado para íon flúor (9609 BN - Orion) e analisador de íons digital (Orion 720 A). As variáveis MSI, MSF e liberação de flúor foram submetidas à análise de variância e teste de Tukey (p<0,05). Houve diferença estatisticamente significante na MSF entre os meios de imersão para o Vitremer (pH 4,6 = 40,2 ± 1,5; água = 42,6 ± 1,4), Ketac-Fil Plus (pH 4,6 = 73,4 ± 2,7; água = 58,2 ± 1,3) e Fluorofil (pH 4,6 = 44,3 ± 1,8; água = 38,4 ± 1,0). O Ketac-Fil Plus (9,9 ± 18,0) e o Fluorofil (4,4 ± 1,3) liberaram mais flúor na água; o Vitremer (7,4 ± 7,1), Fuji II LC (5,7 ± 4,7) e o Freedom (2,1 ± 1,7) no pH 4,6. A microdureza e liberação de flúor dos materiais restauradores estudados variaram de acordo com o meio de imersão.

This study evaluated the surface microhardness and fluoride release of 5 restorative materials - Ketac-Fil Plus, Vitremer, Fuji II LC, Freedom and Fluorofil - in two storage media: distilled/deionized water and a pH-cycling (pH 4.6). Twelve specimens of each material, were fabricated and the initial surface microhardness (ISM) was determined in a Shimadzu HMV-2000 microhardness tester (static load Knoop). The specimens were submitted to 6- or 18-h cycles in the tested media. The solutions were refreshed at the end of each cycle. All solutions were stored for further analysis. After 15-day storage, the final surface microhardness (FSM) and fluoride release were measured. Fluoride dose was measured with a fluoride-specific electrode (Orion 9609-BN) and digital ion analyzer (Orion 720 A). The variables ISM, FSM and fluoride release were analyzed statistically by analysis of variance and Tukey's test (p<0.05). There was significant difference in FSM between the storage media for Vitremer (pH 4.6 = 40.2 ± 1.5; water = 42.6 ± 1.4), Ketac-Fil Plus (pH 4.6 = 73.4 ± 2.7; water = 58.2 ± 1.3) and Fluorofil (pH 4.6 = 44.3 ± 1.8; water = 38.4 ± 1.0). Ketac-Fil Plus (9.9 ± 18.0) and Fluorofil (4.4 ± 1.3) presented higher fluoride release in water, whereas Vitremer (7.4 ± 7.1), Fuji II LC (5.7 ± 4.7) and Freedom (2.1 ± 1.7) had higher fluoride release at pH 4.6. Microhardness and fluoride release of the tested restorative materials varied according to the storage medium.

Avaliou-se a liberação de flúor de materiais restauradores (Vitremer, Ketac-Fil, Fuji II LC e Freedom) durante 2 períodos de 15 dias, antes e após a aplicação tópica de fluorfosfato acidulado (FFA). Foram confeccionados, para cada material, 6 corpos-de-prova que foram imersos em 2 ml de água deionizada. As dosagens da concentração de flúor das soluções foram realizadas em intervalos de 24 horas durante 15 dias. Após esse período, os corpos-de-prova de cada material receberam tratamento com gel de FFA durante 4 minutos. O flúor liberado foi analisado em intervalos de 24 horas durante 15 dias. A análise de variância e o teste de Tukey (p < 0,05) mostraram que a média total de flúor liberado durante os 15 dias iniciais foram maiores para o Vitremer e o Ketac-Fil e menores para o Fuji II LC e Freedom; e nos 15 dias finais apresentaram diferença de liberação, com maior valor para o Vitremer, seguido pelo Fuji II LC, Ketac-Fil e Freedom. A comparação dos resultados entre o 1º dia e o 16º dia (após aplicação do gel) mostrou uma maior liberação de flúor no 16º para o Vitremer, Fuji II LC e Freedom e igual para o Ketac-Fil. Embora todos os materiais avaliados tenham ganhado flúor pela aplicação de fluorfosfato acidulado, os dados sugerem que os cimentos de ionômero de vidro modificados por resina são mais eficientes para liberar o flúor do que os outros materiais.

The release of fluoride from restorative materials (Vitremer, Ketac-Fil, Fuji II LC and Freedom) was evaluated during two 15-day periods, before and after a topical application of acidulated phosphate fluoride gel (APF). For each material, 6 specimens were made, which were immersed in 2 ml of deionized water. The fluoride concentration dosages in the solutions were read at intervals of 24 hours for 15 days. After this period, the specimens of each material received treatment with APF gel for 4 minutes and the fluoride released was analyzed at 24-hour intervals during the following 15 days. The analysis of variance and the Tukey test (p < 0.05) showed that the total mean fluoride released during the initial 15 days was greater for Vitremer and Ketac-Fil and lower for Fuji II LC and Freedom; and in the final 15 days there was a difference in release readings, with the greatest value for Vitremer, followed by Fuji II LC, Ketac-Fil and Freedom. The comparison of the results between the 1st day and the 16th day (after gel application) showed a greater fluoride release on the 16th day for Vitremer, Fuji II LC and Freedom and was equal for Ketac-Fil. Although all the materials evaluated gained fluoride with the application of APF, the data suggest that the resin-modified ionomers are more efficient in releasing fluoride to the medium than the other materials.

A cárie secundária representa problema de saúde pública e socioeconômico no mundo. A restauração de dentes acometidos por cárie pode criar condições favoráveis à proliferação microbiana na superfície do material restaurador ou na interface dente/restauração, criando ambiente propício para o estabelecimento de cárie secundária. O objetivo deste estudo foi avaliar a capacidade de retenção de placa bacteriana em cimentos de ionômero de vidro convencionais (Chelon-Fil e Vidrion R) e modificados por resina (Vitremer e Fuji II LC) e de resina composta híbrida (Z100), utilizada como controle. Nos testes de retenção de microrganismos, in situ, 12 voluntários utilizaram, por 7 dias, placa de Hawley contendo corpos-de-prova de todos os materiais. A seguir, os corpos-de-prova foram transferidos para tubos contendo 2,0 ml de Ringer-PRAS e os microrganismos presentes em sua superfície foram cultivados em placa com ágar-sangue e ágar Mitis Salivarius Bacitracina, os quais foram incubados, a 37ºC, em anaerobiose (90% N2, 10% CO2), por 10 e 2 dias, respectivamente. Os ionômeros modificados por resina retiveram quantidade de bactérias similar àquela mostrada pela resina testada. Os ionômeros modificados por resina também apresentaram menor número de estreptococos do grupo mutans do que a resina e os cimentos ionoméricos convencionais. Os ionômeros de vidro convencionais apresentaram menor número de estreptococos do grupo mutans que a resina, sendo que essa diferença não foi estatisticamente significativa.

Secondary caries are a worldwide public and socioeconomic problem. The placement of restorations can lead to the development of environmental conditions favorable to microbial colonization, especially on the tooth/restoration interface, which is a predisposing factor for secondary caries. The aim of this study was to evaluate microbial retention on conventional (Chelon-Fil and Vidrion R) and resin-modified (Vitremer and Fuji II LC) glass-ionomer cements, in situ, using a hybrid composite resin (Z100) as a control. Twelve volunteers wore Hawley appliances with specimens made of all tested filling materials for 7 days. The specimens were then removed from the appliances and transferred to tubes containing 2.0 ml of Ringer-PRAS. Microorganisms from the samples were inoculated onto blood agar and Mitis Salivarius Bacitracin agar and incubated under anaerobiosis (90% N2, 10% CO2), at 37°C, for 10 and 2 days, respectively. The resin-modified glass-ionomer cements and the composite resin retained the same levels of microorganisms on their surfaces. The resin-modified glass-ionomers retained less mutans streptococci than the composite resin and conventional glass-ionomer cements. The conventional glass-ionomer cements retained less mutans streptococci than the composite resin, but that difference was not statistically significant.

Os cimentos ionoméricos representam importante opção de material restaurador em Odontologia e sua adesão à estrutura dental, diminuindo a infiltração marginal, somada à liberação de flúor, inibindo o metabolismo de microrganismos acidogênicos e favorecendo a remineralização dental, podem diminuir a ocorrência de cárie secundária. A aplicação tópica de géis acidulados ou neutros contendo flúor tem sido largamente utilizada em Odontologia. No entanto, este procedimento pode afetar a integridade dos materiais restauradores, aumentando sua rugosidade e a retenção de placa bacteriana. Dessa forma, o presente estudo avaliou o período de tempo no qual o cimento ionomérico Vitremer mantém sua capacidade inibitória sobre Streptococcus mutans ATCC 25175 e a adesão dos mesmos sobre a superfície do material, bem como a influência da aplicação tópica de flúor acidulado e neutro sobre esses parâmetros microbiológicos e as características superficiais daquele material. Verificou-se que a atividade antimicrobiana do cimento ionomérico Vitremer se mantém por aproximadamente quatro dias e não é recuperada com o uso de flúor gel acidulado ou neutro. Observou-se, também, que Streptococcus mutans ATCC 25175 adere ao material restaurador testado sendo que a aplicação tópica de flúor não influenciou esta adesão. As características superficiais desses materiais não se alteraram com a aplicação dos géis.

Glass ionomer cements are important options in restorative and preventive dentistry due to their adhesion to the tooth surface and to fluoride release, which can decrease the risk of recurrent caries. The topical use of acidulated and neutral fluoride gels has been frequent in dentistry. However, this procedure can adversely affect the surface of restorative materials, increasing their roughness and the retention of dental plaque. Thus, this study evaluated the period in which Vitremer glass ionomer cement maintains its antimicrobial activity over Streptococcus mutans ATCC 25175, as well as the effects of topical application of acidulated and neutral fluoride gels on these microbiological parameters and on the superficial characteristics of the restorative material. It was verified that the antimicrobial activity of Vitremer is very transient, decreasing to an undetectable level after four days, and the topical application of fluoride gel did not restore this activity. It was observed that S. mutans ATCC 25175 adheres to this restorative material, and the topical fluorides did not affect this event. The surface of Vitremer was not altered by the application of fluoride gels.

O fumo é considerado importante fator predisponente para muitas doenças, incluindo-se as periodontopatias. Desde que as doenças periodontais representam a inter-relação entre os fatores de virulência da microbiota subgengival sobre um hospedeiro susceptível, foi objetivo avaliar a freqüência de isolamento de três periodontopatógenos em indivíduos sadios e pacientes com doença periodontal, fumantes ou não, com níveis variados de higiene bucal; verificar a relação entre o número de microrganismos produtores de sulfeto de hidrogênio na placa subgengival de fumantes e não fumantes e sua condição clínica. Foram examinados 189 pacientes e indivíduos sadios, dos quais 60 foram selecionados para análise microbiológica. O índice de placa foi registrado de acordo com o índice de O'Leary e os espécimes de placa subgengival coletados e processados de acordo com SLOTS35 (1982). A identificação dos isolados foi obtida pelas suas características morfocelulares, morfocoloniais e bioquímico-fisiológicas. Verificou-se que a freqüência de isolamento dos bastonetes anaeróbios produtores de pigmento negro, Fusobacterium nucleatum e bactérias produtoras de sulfeto de hidrogênio foi similar entre fumantes e não fumantes, sendo mais elevada nos pacientes com doença periodontal. Já Actinobacillus actinomycetemcomitans foi isolado mais freqüentemente em sadios fumantes do que sadios não fumantes.

Smoking is one of the most relevant risk factors for many diseases, including periodontal diseases. These periodontal pathologies result from the action of host defenses and from microbial virulence factors on a susceptible host. Thus, the aim of this study was to evaluate the frequency of periodontopathogens in healthy individuals and in patients with periodontal disease. Both smoking and non-smoking patients were included. The number of bacteria that produce sulfur compounds in subgengival plaque samples of smokers and non smokers with different clinical conditions was also assessed. One hundred and eighty-nine patients were clinically and radiographically examined. The sample included patients with periodontal disease and healthy individuals. Sixty subjects were selected for microbiological evaluation. The isolation of periodontopathogens was carried out according to the methodology described by SLOTS35 (1982). The identification of the isolates was performed through biochemical tests. The isolation of black pigmented Bacteroides, Fusobacterium nucleatum and hydrogen sulfide producing bacteria was similar in smokers and non-smokers and higher among periodontal patients than among healthy subjects. However, the frequency of isolation of Actinobacillus actinomycetemcomitans in smokers with no periodontal pathologies was higher than in healthy individuals who do not use tobacco.