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Abstract Background The effect of an immune-boosting beverage (SAM) containing Sambucus Nigra, an energy beverage (ENE), an in-office bleaching (BLE) agent with 25% hydrogen peroxide superior, glazing (GLA) or polishing (POL) methods, and professional dental prophylaxis (PDP) on the color of CAD-CAM restorative materials is unknown. Methods In total 210 specimens were prepared, consisting of CAD-CAM feldspathic (FC), zirconia-reinforced lithium disilicate ceramic (ZLS) and hybrid ceramic (HC). The ceramic specimens were divided according to the polishing methods of glazing (GLA) and mechanical polishing (POL). All materials were divided into two groups: with and without BLE. A 25% hydrogen peroxide superior (HPS) gel was used for BLE. After the baseline (BAS) measurement, the specimens were immersed in 3 different beverages (distilled water (DIS), SAM, ENE). After 28 days, a fine-grained (RDA 7) prophylaxis paste was applied. Statistical analysis of ∆E00 color difference values was performed by 3-way ANOVA and Bonferroni test (α = 0.05). Results The effect of all other actions except material-BLE-beverage on color for BAS-Day 28 was statistically different (p

Abstract Background The risk assessment of dental erosion among children and adolescents is an important aspect of dental care, as dental erosion constitutes a rapidly growing, global problem. Dental professionals rely solely on their own perception, as the current risk assessment process is not completely automatized, which affects the risk assessment reliability. Aim To explore dental professionals’ experiences with risk assessment of dental erosion among children and adolescents. Method In-depth interview was used as data collection method. A total of 11 dental professionals were interviewed. The interviews were analyzed using qualitative content analysis. Results The findings were summarized in the categories Professionals’ responsibility, Systematic approach , and Collaboration and communication. Dental staff perceived that their basic knowledge regarding erosion should be improved, and skills development was desired to reduce the knowledge gaps around the risk assessment of dental erosion. They alleged that the systematic approach could be improved by reducing workplace stress, implementing a universal dental erosion index, improving the existing risk assessment software, and automating the risk assessment of the condition. Dental professionals also experienced a need to calibrate and collaborate with each other and with other healthcare professionals to improve patient care. Conclusion Dental professionals experienced their basic knowledge of dental erosion and their risk assessment as good, but a more advanced skill development was required. Furthermore, they experienced the risk assessment software as a good tool that should be improved to compile more objective risk assessment. A universal erosion index was also requested.

Introduction: Guidelines regarding postsurgical dental care have been common in adult total joint arthroplasty patients despite limited supporting evidence in the literature. There is anecdotal evidence that similar precautions are implemented frequently in postoperative pediatric orthopaedic patients without any published evidence to guide clinicians. Methods: A survey of the Active Members of the Pediatric Orthopaedic Society of North America (POSNA) was performed to assess the use of postsurgical guidelines regarding dental care (procedures and prophylaxis) in pediatric patients. A 20-question survey regarding this subject was developed with the input of, and approved by, the Evidence-Based Practice Committee of POSNA, and a link to participate was distributed to the Active Membership. Results: One hundred seventy-three POSNA Members opened the link to the survey. One hundred sixty-three respondents self-identified as Active, for a response rate of 19.8%. One hundred fifty-seven (96.3%) reported direct involvement in surgical and postsurgical care of pediatric orthopaedic patients. Sixty-two (39.4%) indicated use of a postoperative protocol regarding dental interventions. Forty percent of those indicating use of guidelines were uncertain of the specifics of the protocol(s) used at their institution. Eighty-five percent of those utilizing protocols felt that the use of guidelines was a valuable topic for investigation. Conclusions: These results demonstrate that many of the active Members of POSNA utilize postsurgical guidelines for dental care, particularly for those patients who have undergone spinal surgery with permanent implants. This is despite the fact that there is limited evidence to support their use in adult total joint patients and no literature regarding use of such guidelines in pediatric orthopaedic patients. Key Concepts: (1) There is limited and contradictory evidence that postsurgical dental guidelines are indicated in adult orthopaedic patients. (2) There is no published evidence supporting postsurgical dental guidelines in pediatric orthopaedic patients. (3) Almost 40% of active Pediatric Orthopaedic Society of North America Members responding to a survey appear to utilize postsurgical dental care guidelines in pediatric patients, particularly after spinal procedures utilizing implants. Level of Evidence: Level V

IntroductionGingivitis is a common intraoral disease in patients with chronic kidney disease (CKD), which poses a particular interdisciplinary challenge. We aimed to determine the influence of an intensive oral prophylaxis program (OPP) compared to standard prevention measures on the tongue microbiome of young patients with CKD.MethodsThirty patients with CKD (mean age 14.2 ± 5.2 years) and generalized gingivitis were included. The effects of the intensive OPP were compared with standard prophylaxis according to statutory health insurance (treatment as usual, TAU) as a control. Tongue swabs were taken from the patients at baseline (t1) and after 3 (t2) and 6 (t3) months. Next-generation sequencing of 16S rDNA genes was used to quantitatively characterize microbial communities.ResultsThere were no differences in the abundance, richness, or diversity of the observed genera and species between the two study groups at baseline or after 3 or 6 months. Furthermore, no change in predefined gingivitis and oral health bacterial clusters were found. At the phylum level, Firmicutes were decreased after intervention in the TAU group (t2TAU 42.9 ± 7.1 to t3TAU 34.8 ± 4.7 (npairs=14), p=0.003; false discovery rate 0.02). The decrease of Firmicutes was not significant in the OPP group.ConclusionsDespite the intensity of dental prophylaxis and decreasing clinical signs of inflammation and decreasing plaque amount, no clinically relevant changes in the tongue microbiome were observed. Our results confirm the conserved and stable nature of the tongue microbiome, even in children with CKD.

(1) Background: Periodontal instrumentation with dental curettes is associated with discomfort, fatigue, and musculoskeletal diseases. The goal of this study was to compare comfort, fatigue, and muscle work using three different curettes. (2) Methods: Eight hygienists each scaled three typodonts using the three different curettes. Curette A was a prototype with a novel adaptive design, Curette B had a conventional stainless-steel design, and Curette C featured a conventional silicon-covered handle. Time-based work in four muscles, comfort, fatigue, tactile feedback, grip and blade position, and pinch and grasp strength were recorded. Statistical analysis was performed using a General Linear Model (GLIM) and Tukey’s post hoc test. The level of significance was set at p < 0.05. (3) Results: Comfort, correct grasp, fingertip placement, and blade-to-tooth adaptation were significantly better with Curette A (p < 0.05). While pinch and grasp strength were significantly reduced post-instrumentation for Curettes B and C (p < 0.05), they remained unchanged for Curette A. Curette A required significantly less total muscle work and work in individual muscles, resulting in significantly less post-instrumentation fatigue than for Curettes B and C, but similar levels of tactile feedback (p < 0.05). (4) Conclusions: The ergonomic performance of a prototype adaptive periodontal curette was significantly better than that of two conventional instruments with rigid handle designs.

Abstract Background Achieving sufficient professional mechanical biofilm removal (PMPR) can be challenging in supportive periodontal therapy (SPT), particularly in patients with prosthetic restorations. This experimental study aimed to simulate five years of SPT with periodic PMPR near the luting gap of ceramic restorations using a rubber cup with polishing paste (RCP), air polishing with two different low-abrasive powders (LAPA-1: glycine powder, LAPA-2: erythritol powder), and non-professional mechanical cleaning (control group) to measure the extent of volume loss in the luting gap after baseline (∆V = Vbaseline-V1-5; in µm3). Methods Two operators randomly performed PMPR ten times for thirty seconds on one of four sides of 30 crown replicas fixed with glass-ionomer cement (CGIZ: n = 15) or adhesive bonding (CAB: n = 15). The replicas were separated in a template during PMPR, and afterward, cleaned for five seconds per side with a sonic brush under flowing water. The artificial aging process between two PMPRs simulated a 5-year SPT with two PMPRs per year. Profilometric measurements were performed at baseline and after each second PMPR to obtain the mean change of ∆V. The statistical evaluation of the data was carried out using nonparametric tests with Bonferroni correction applied for multiple tests. Results Ninety-six out of 120 sides could be included in the analysis. PMPR methods showed a loss of substance in the luting gap with a ∆V (mean(standard deviation)) of -4.35 × 106(4.8 × 106)µm3 versus 8.79 × 104(1.05 × 106)µm3 for control at V5 (p ≤ 0.001). No significant differences of ∆V1-5 values could be identified in the control (p > 0.05), whereat all PMPRs showed a significant increasing loss of substance per simulated year (p ≤ 0.001). Intergroup comparison identified LAPA-1 as having the highest significant loss of substance determined on CAB (∆V: -1.05 × 107 (7,2 × 106) µm3), followed by LAPA-2 on CAB (∆V: -6.29 × 106 (4,24 × 106) µm3), LAPA-1 on CGIZ (∆V: -4.15 × 106 (3,25 × 106) µm3), LAPA-2 on CGIZ (∆V: -3.0 × 106 (2,23 × 106) µm3), RCP on CAB (∆V: -1.86 × 106 (2,23 × 106) µm3) and CGIZ (∆V: -1.2 × 106 (1,31 × 106) µm3; p ≤ 0.001)). Conclusions Within study limitations, all PMPRs caused a significantly higher loss of substance in the luting gap versus control without professional intervention, with the highest values in the CAB group for LAPA-1, LAPA-2 and RCP. Similar findings were observed for CGIZ, although the loss values were lower.

This study aimed to evaluate the effectiveness of a patient-centered standardized prophylaxis process in improving patient satisfaction and intentions to return to dental clinics. Conducted in a first-tier city in China from 9 June to 26 July 2023, the cross-sectional survey included 826 patients from 38 dental clinics. Among the respondents, 438 received standardized prophylaxis services, while 388 were in the non-standardized group, with a mean age of 38.2 ± 12.1 years and 50.24% male participation. The results revealed that patients in the standardized prophylaxis group reported significantly higher satisfaction scores (average 4.74 vs. 3.34, p < 0.0001) and greater intentions to return (average 4.77 vs. 4.10, p < 0.0001) compared to those receiving non-standardized care. The ordinal logistic regression analysis identified patient satisfaction as a strong predictor of return intention, with an odds ratio of 24.487, while the standardized service group had an odds ratio of 16.063, indicating a substantial positive effect on satisfaction. Age was also found to significantly affect return intention, reflected in an odds ratio of 0.969. Furthermore, the model showed strong predictive accuracy, which was supported by a Somers’ D value of 0.806. Additionally, an impressive 89.9% of the observations were correctly ordered, which strengthens the reliability of the findings. These outcomes highlight the significant contribution of patient-centered, standardized practices to the satisfaction of the patients as well as the development of their desire to return for follow-up care. However, the findings should be interpreted with caution due to the study’s cross-sectional nature, which limits causal inferences, and the specific demographic characteristics that may affect the general applicability of the results. Further research is needed to explore these dynamics across diverse populations and settings.

Plaque-induced gingivitis is one of the most widely distributed periodontal disorder during childhood. The control of the pathogenic potential of the plaque is associated with oral hygiene status at individual, group, and population levels. We hypothesize that regular application of complex oral hygiene-prophylaxis could beneficially modulate salivary amino acids profile in children with different stage of plaque-induced gingivitis. Therefore, we aimed to study the salivary amino acids’ profile in relation to certain clinical indicators and environmental variables for plaque-induced gingivitis in children.

Recurrent aphthous stomatitis (RAS) is an inflammatory disease of the oral mucosa, which has a chronic course with periods of remission and exacerbations. RAS requires adequate diagnosis for the purposes of properly treating. The study on RAS remains relevant over many years and continues to be a priority in modern dentistry. The aim of the work is to analyze the information in the professional literature on pathogenetic variants of RAS and approaches to its treatment and prevention. Despite the variety of studies, the etiology and pathogenesis of the disease remain the subject of numerous discussions. This article provides a review of current research on the main etiopathogenetic mechanisms of the disease development and progression, specifies current recommendations for therapeutic approaches to treatment and prevention. Conclusions. To date, there is no definitive therapeutic tactic for recurrent aphthous stomatitis, so it is advisable to systematize and study methods for the prevention and treatment of this pathology, including pain relief, acceleration of ulcer healing and reduction of its episode frequency and severity. Considering the etiopathogenetic variant of the disease development (metabolic disorders, stress, allergies, etc.), preventive measures should be comprehensive and include oral hygiene, a sparing diet, multivitamin and micro-, macroelement complexes, etc.

With the global population undergoing demographic shift towards aging, the prevalence of Alzheimer’s disease (AD), a prominent neurodegenerative disorder that primarily afflicts individuals aged 65 and above, has increased across various geographical regions. This phenomenon is accompanied by a concomitant decline in immune functionality and oral hygiene capacity among the elderly, precipitating compromised oral functionality and an augmented burden of dental plaque. Accordingly, oral afflictions, including dental caries and periodontal disease, manifest with frequency among the geriatric population worldwide. Recent scientific investigations have unveiled the potential role of oral bacteria in instigating both local and systemic chronic inflammation, thereby delineating a putative nexus between oral health and the genesis and progression of AD. They further proposed the oral microbiome as a potentially modifiable risk factor in AD development, although the precise pathological mechanisms and degree of association have yet to be fully elucidated. This review summarizes current research on the relationship between oral bacteria and AD, describing the epidemiological and pathological mechanisms that may potentially link them. The purpose is to enrich early diagnostic approaches by incorporating emerging biomarkers, offering novel insights for clinicians in the early detection of AD. Additionally, it explores the potential of vaccination strategies and guidance for clinical pharmacotherapy. It proposes the development of maintenance measures specifically targeting oral health in older adults and advocates for guiding elderly patients in adopting healthy lifestyle habits, ultimately aiming to indirectly mitigate the progression of AD while promoting oral health in the elderly.

Aim: This study evaluated the effect of two prophylaxis methods over the surface roughness of different resin composites. Materials and Methods: Ten disc-shaped specimens (7 mm x 2 mm) were made for each composite tested: MH - microhybrid composite with regular viscosity (Opallis); NH – nanohybrid composite with regular viscosity (Vittra APS); BF – high-viscosity bulk fill composite (Opus Bulk Fill); MHF - microhybrid flowable composite (Opallis flow); and OS – nanohybrid one-shade composite with regular viscosity (Vittra Unique). Initial roughness (Ra) values were obtained from each sample, and then they were divided into two groups (n = 5) following the prophylaxis method: SB – prophylaxis with sodium bicarbonate powder (125µm grain) using an air-powder polishing device (30 s application distanced 10 mm with 2 bar); and PP – prophylaxis with pumice paste and rotatory brush (30 s, 3000 rpm and pressure of 150 g). After that, a new Ra measurement (Raf) was obtained, and the difference was calculated (ΔRa). Data were compared using Three-way ANOVA followed by Bonferroni teste and the Ra difference (ΔRa) was analyzed by Two-way ANOVA followed by the Tukey test (p

Context: Gingivitis is among the most prevalent periodontal disease occurring in the oral cavity, which is plaque induced and if untreated, can progress to periodontitis. Various adjunct chemotherapeutic agents are available for plaque control with their own pros and cons. Hence, a plaque-controlling therapeutic agent which is readily available at low cost and without any side effects is the need of the hour. According to the ancient texts, Ayurveda and the traditional culture of India, Curcuma longa is used externally for inflammation of skin and mucosa. Aims: To evaluate the therapeutic effect of curcuma gel on gingival health and its possible usage in the treatment of gingivitis. Settings and Design: This study comprises hundred participants with gingivitis which were divided randomly in two groups. Subjects and Methods: Experimental group – Scaling and topical application of curcuma gel and control group – Scaling alone without the topical application of curcuma gel. Clinical parameters (Gingival Index, Gingival Bleeding Index, and Plaque Index) were assessed at different time intervals (0, 7, 14, and 21 days) in both experimental and control groups. Statistical Analysis Used: Within groups, a repeated measures ANOVA model was used for repeated observations over a period which is followed by the Dunnett test for multiple comparisons. Experimental and control groups were compared for normally distributed data by Student's t-test. Whereas for skewed data, the Wilcoxon test or Mann–Whitney U-test was employed. Results: Statistically significant improvement of gingival health parameters was seen in the group which received topical curcuma oral gel application after scaling compared with the control group. Conclusions: Significant improvement in clinical parameters of gingivitis on the application of Curcuma oral gel after scaling with no obvious adverse effects suggesting its possible use as a topical adjunct treatment in clinical or community level prevention as well as treatment programs in the future.

Background: Aerosols released during ultrasonic scaling can cause cross-contaminations. Infections like hepatitis and SARS-CoV-2 can spread through these aerosols. Preprocedural rinse is a cost-effective method to reduce aerosol contami-nation produced during ultrasonic scaling. Materials and Methods: This was a double-blinded randomised trial on 105 subjects diagnosed with chronic generalised periodontitis which was randomly allocated into three groups: Group I received 0.12% chlorhexidine (CHX), Group II received 5% Morinda citrifolia (noni) mouthrinse, Group III received distilled water. Participants were advised to mouthrinse for 60 seconds just before the start of ultrasonic scaling. The aerosols released during ultrasonic scaling were gathered on blood agar plates placed at three locations. Colony forming units (CFUs) were counted after 48 hours of incubation. Results: The highest CFU values were observed in the distilled water group and the lowest in chlorhexidine group (p

Abstract Background As the need for care increases with higher age, so does the need for assistance with oral hygiene. A recent study analyzed the clinical effectiveness of oral hygiene assistance provided by caregivers. The current secondary analysis of this study aimed to assess pleasant and unpleasant perceptions of patients while being brushed and to investigate whether these perceptions depend on the qualification of the person brushing and the type of toothbrush used (manual vs. powered). Methods First, a qualitative study was conducted. This aimed at developing the questionnaire. Items were extracted on the basis of qualitative interviews with a sample of 6. A delphi process ensured the content validity of the final instrument. The main study comprised 39 periodontitis patients with reduced oral hygiene capability randomized to one of four groups: brushing carried out by trained laypeople or dental professionals, each using a manual or powered toothbrush at three different time points during anti-infective periodontal therapy. Patient perceptions of the third-party toothbrushing were assessed immediately after brushing. Results Patients reported mainly positive feelings regarding being brushed by a third person and the interaction with this person during brushing. Neither the professional background of the brushing person nor the type of brush had a significant influence on pleasant and unpleasant perceptions (all F 0.07, all η2

Background/Aim. There is no scientific evidence that the prophylactic use of antibiotics as a part of the mandibular third molar surgery is effective in suppressing postoperative pain, edema, trismus, and dry socket. The aim of the study was to investigate the effects of antibiotics from the fluoroquinolone (moxifloxacin) and cephalosporin (cefixime) groups in reducing postoperative inflammatory sequelae (pain, edema, and trismus), as well as in possibly reducing the incidence of dry socket after mandibular third molar surgery. Methods. This double-blind study was completed by 157 subjects, comprising two study groups (who received the aforementioned antibiotics) and a control group, who received placebo tablets. Subjects were assessed on the first, second, and seventh day following surgery. In the postoperative course, patients were monitored for the occurrence, intensity, and duration of postoperative inflammatory sequelae and dry socket. Results. Both antibiotics, especially moxifloxacin, had a pronounced effect on reducing all inflammatory sequelae (pain, edema, and trismus) as the most common postoperative complaints following mandibular third molar surgery, and also contributed to reducing the incidence of dry socket. Conclusion. Antibiotic prophylaxis with cefixime and, especially moxifloxacin, reduced the occurrence of postoperative inflammatory sequelae and alleviated discomfort. It is interesting, that both antibiotics, especially moxifloxacin, also contributed to reducing the incidence of postoperative dry socket, which is not provoked by inflammation. Therefore, further research into the underlying mechanisms behind such an effect is warranted.

Background: Prosthetic joint infection (PJI) of total hip (THA) or total knee arthroplasty (TKA) after dental procedures is uncommon, and antibiotic prophylaxis remains controversial. For high-risk patients, the American Academy of Orthopedic Surgeons recommends amoxicillin prophylaxis. However, no systematic review of the literature of PJIs associated with dental procedures explores if amoxicillin is suitable for the reported organisms. Methods: A librarian-assisted search of the major databases (PubMed, Medline, Embase, Scopus) identified 954 articles. Only case reports, case series, and reviews with patient level data were included. After exclusions, 79 articles were fully reviewed. Results: Forty-four PJIs after dental procedures were identified, 22 in primary THA, 20 in primary TKA, one in revision THA, and one in a hip resurfacing procedure. Antibiotic prophylaxis was documented for 5 patients. The dental procedure was invasive in 35 (79.5%). Comorbidities were present in 17 patients (38.7%). The organisms reported were Streptococcus spp. in 44%, other aerobic gram-positives in 27%, anaerobic gram-positives in 18%, and gram-negative organisms in 11%. An estimated 46% of organisms may be resistant to amoxicillin. The outcomes of treatment were reported for 35 patients (79.5%). Twenty-seven patients (61.4%) had no clinical signs of PJI at the final follow-up visit. Conclusions: Lower extremity PJI associated with dental procedures is often caused by organisms unlikely to be prevented with amoxicillin. Additional studies are warranted to determine the choice and efficacy of antibiotic prophylaxis to prevent dental-associated PJI in the highest risk patients. Insufficient data exist to recommend the optimal treatment for patients with PJI in THA and TKA associated with dental procedures.

Objective:Sonic and ultrasonic instrumentations generate vibrations that may influence debonding characteristics. The objective of this in vitro study was to assess the direct and indirect effects of sonic and ultrasonic periodontal instrumentations on the shear bond strength (SBS) and the adhesive remnant index (ARI) scores of metallic orthodontic brackets.Methods:Metallic brackets were bonded to 75 extracted mandibular central incisors that were embedded in acrylic resin. Instrumentations around the bracket base performed with ultrasonic (UltrasonicB group, n=15) and sonic (SonicB group, n=15) scalers were used to evaluate the direct effects on the SBS of brackets. Lingual surface instrumentations with ultrasonic (UltrasonicL group, n=15) and sonic (SonicL group, n=15) scalers were performed to assess the indirect effects. The control group (n=15) did not have any treatment. Instrumentations were performed for 30 s with 0° scaler tip angulations with settings recommended by manufacturers. The SBS of the brackets tested with a universal testing machine and ARI scores were recorded. Data were analyzed by Kruskal–Wallis and Mann–Whitney U tests.Results:The mean SBS of the control group was significantly higher than that of the UltrasonicB and SonicB groups (p=0.008). The UltrasonicL and SonicL group instrumentations also decreased the SBS, although the difference was statistically insignificant. UltrasonicB instrumentations caused significantly higher frequency of ARI scores than the control group.Conclusion:The decrease of the SBS of metallic brackets indicates the influence of ultrasonic and sonic instrumentations on the breakage behavior at the bracket–resin interface. Instrumentations around the bracket base should be conducted with caution to decrease the bond failure risk of metallic brackets.

Abstract Introduction Root-scaling procedures on the root surface show to increase root surface roughness during instrumentation. The use of a prophylactic paste reduces the roughness. Objetive This study evaluated the influence of prophylaxis paste on the surface roughness of root dentin after hand instruments (HI), ultrasonic scalers (US) and rotational instruments (RI) were applied to root surfaces. Material and method Fifty bovine roots were prepared and randomly divided into 10 groups (n=5) in which instrumentation with HI, US, or RI was carried out with or without prophylaxis using either conventional or 3% hydroxyapatite paste; additionally, a control group without treatment was included. The Ra and Rz roughness values were measured using a perfilometer. The morphological aspects of the root surfaces were analysed qualitatively by scanning electron microscopy (SEM). Data were analysed using two-way ANOVA followed by Tukey’s test (α = 0.05). Result The scaling method and the prophylaxis procedure significantly influenced (p < 0.05) root surface roughness. Treatment with US and prophylaxis with 3% hydroxyapatite paste resulted in lower values of Ra (0.14 μm ± 0.02 μm) and Rz (0.89 μm ± 0.18 μm) compared to the other groups. SEM analysis showed smoother and more homogeneous surfaces in the groups with prophylaxis compared to the groups without prophylaxis. There were no substantial differences between the results of applying different pastes. Conclusion The prophylaxis procedure performed with the experimental paste containing 3% hydroxyapatite reduced the roughness of root surfaces treated with HI, US and RI at the same level as the conventional prophylactic paste.

Background. This study evaluated the effect of two prophylaxis techniques on the marginal gap of CI V resin-modified glass-ionomer restorations. Methods. Standard Cl V cavities were prepared on the buccal surfaces of 48 sound bovine mandibular incisors in this in vitro study. After restoration of the cavities with GC Fuji II LC resin-modified glass-ionomer, the samples were randomly assigned to 3 groups of 16. In group 1, the prophylactic procedures were carried out with rubber cup and pumice powder and in group 2 with air-powder polishing device (APD). In group 3 (control), the samples did not undergo any prophylactic procedures. Then the marginal gaps were measured. Two-way ANOVA was used to compare marginal gaps at the occlusal and gingival margins between the groups. Post hoc Tukey test was used for two-by-two comparisons. Statistical significance was set at P < 0.05. Results. There were significant differences in the means of marginal gaps in terms of prophylactic techniques (P < 0.001), with significantly larger marginal gaps in the APD group compared to the pumice and rubber cup group, which in turn exhibited significantly larger marginal gaps compared to the control group (P < 0.0005). In addition, the means of marginal gaps were significant in terms of the margin type (P < 0.001), with significantly larger gaps at gingival margins compared to the occlusal margins (P < 0.0005). Conclusion. The prophylactic techniques used in this study had a negative effect on the marginal gaps of Cl V resin-modified glass-ionomer restorations.

Ya-Ling Lee,1,2 Hsiao-Yun Hu,2,3 Pesus Chou,2 Dachen Chu2,4,5 1Department of Dentistry, Taipei City Hospital, 2Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, 3Department of Education and Research, Taipei City Hospital, 4Department of Health Care Management, National Taipei University of Nursing and Health Sciences, 5Department of Neurosurgery, Taipei City Hospital, Taipei, Taiwan Purpose: To investigate the association between periodontal disease (PD) and acute ­myocardial infarction (AMI), and evaluate the effect of dental prophylaxis on the incidence rate (IR) of AMI.Methods: The Longitudinal Health Insurance Database 2000 from the National Health Insurance program was used to identify 511,630 patients with PD and 208,713 without PD during 2000–2010. Subjects with PD were grouped according to treatment (dental prophylaxis, intensive treatment, and PD without treatment). The IRs of AMI during the 10-year follow-up period were compared among groups. Cox regression analysis adjusted for age, sex, socioeconomic status, residential urbanicity, and comorbidities was used to evaluate the effect of PD treatment on the incidence of AMI.Results: The IR of AMI among subjects without PD was 0.19%/year. Among those with PD, the IR of AMI was lowest in the dental prophylaxis group (0.11%/year), followed by the intensive treatment (0.28%/year) and PD without treatment (0.31%/year; P

Aim: Resin infiltration of proximal lesions is a new approach to stopping caries progression. Therefore, the aim of the present study was to evaluate four-year efficacy of proximal infiltrates in adolescents. Materials and methods: In ten adolescents, a total of 21 proximal infiltrates (ICON® (DMG, Germany) were applied to initial proximal lesions of permanent incisors and premolars according to the manufacturer’s instruction. The clinical quality of resin infiltration was assessed at 1 week, 1, 2, 3 and 4 years after the treatment and the evaluation of the therapeutic effect was analyzed by radiographs. Results: Ten patients were followed up clinically for four years. The majority of the infiltrated lesions were located on permanent incisors. Teeth which were proximally infiltrated did not exhibit dental plaque and gingival bleeding in most cases. At annual recalls, plaque scores remained constant. The gingival status remained steady and no differences in tooth shape and contour were detected. Discoloration was detected in four teeth (19%) in 1st year recall and was constant at annual intervals. The radiographic evaluation of the bitewing radiographs showed no progression in 21 lesions (100%) from baseline to the 4-year recall. Overall oral hygiene of the patients was satisfactory. Conclusion: In conclusion, proximal infiltration is an effective prophylactic measure in adolescents.

The aim of this study was to assess the frequency of routine use of dental prophylaxis prior to visual inspection, in order to diagnose caries, by dentists with different lapses of time after graduating time. One hundred and fifty one Brazilian dentists were interviewed in 3 Brazilian cities to determine if they usually remove dental plaque prior to visual inspection for caries diagnosis. The dentists were stratified according to year of graduation. The association between the lapse of time after graduating and the practice of routinely removing dental plaque before clinical examination was tested using the chi-square test with a significance level of 5%. Only 28.5% of the dentists reported that they usually remove dental plaque prior to clinical examination. The dentists who graduated in the last 15 years presented the lowest percentages of plaque removal prior to clinical examination (15.1%), whereas the more experienced dentists reported that they perform prophylaxis more frequently. Of the professionals who graduated from 1960-1975, 23.9% reported that they performed dental plaque removal prior to diagnosis, whereas the figure for those graduating from 1976-1990 was 46.2%. Most of the dentists interviewed reported that they did not remove dental plaque prior to performing visual diagnosis of caries.

Considering the importance of professional plaque control for caries prevention, this study comprised an in vitro evaluation of wear by two prophylaxis methods (sodium bicarbonate jet - Profident and pumice and brush) on sound bovine enamel and with artificial carious lesions. Sixty enamel fragments were employed (4x4mm), which were divided into 4 groups: GI - 15 sound blocks treated with pumice and brush; GII - 15 sound blocks treated with Profident; GIII - 15 demineralized blocks treated with pumice and brush, and GIV - 15 demineralized blocks treated with Profident. In the fragments of Groups III and IV, artificial carious lesions were simulated by immersion in 0.05M acetic acid solution 50% saturated with bovine enamel powder at 37ºC for 16h. The specimens were submitted to the prophylactic treatments for 10 seconds. Wear analysis was performed by profilometer and revealed the following results: 0.91µm - GI; 0.42µm - GII; 1.6µm - GIII, and 0.94µm - GIV. The two-way ANOVA and Tukey's test (pTendo em vista a importância do controle profissional da placa na prevenção da cárie, este estudo avaliou in vitro o desgaste de dois métodos de profilaxia (jato de bicarbonato de sódio-Profident e escova de Robinson com pasta de pedra pomes) sobre o esmalte bovino hígido e com lesões artificiais de cárie. Foram utilizados 60 fragmentos de esmalte (4 X 4mm), divididos em 4 grupos: GI- 15 blocos hígidos tratados com escova de Robinson e pasta de pedra pomes; GII- 15 blocos hígidos tratados com Profident; GIII- 15 blocos desmineralizados tratados com escova de Robinson e pedra pomes e GIV- 15 blocos desmineralizados tratados com Profident. Nos fragmentos dos grupos III e IV foram simuladas lesões artificiais de cárie através da imersão em solução de ácido acético 0,05M, 50% saturada com pó de esmalte bovino, a 37ºC por 16 h. Os espécimes foram submetidos aos tratamentos profiláticos durante 10 segundos. A análise do desgaste foi feita por meio de perfilometria, encontrando-se os seguintes resultados: 0,91µm-GI; 0,42µm-GII; 1,6µm-GIII e 0,94µm-GIV. Através do teste ANOVA a dois critérios e do teste de Tukey (p

An in situ evaluation of the potential rehardening effect of fluoridated and non-fluoridated toothpastes with or without air polishing was conducted. Ten volunteers, using acrylic palatal appliances containing two bovine enamel blocks with artificial carious lesions, took part in this study. Four times a day, after the main meals and at night, the volunteers, in a habitual way, brushed their natural teeth with the dentifrice indicated to the experimental design and after that the appliances were put again into the mouth. They were divided into 4 different groups: G1 - control - non-fluoridated dentifrice; G2 - fluoridated dentifrice; G3 - non-fluoridated dentifrice, but having a previous prophylaxis using air polishing; G4 - fluoridated dentifrice and previous air polishing. The effects of treatments on enamel rehardening were evaluated in the blocks that were assessed by surface microhardness, and the percentage of surface microhardness change (%reh) was calculated in relation to the baseline values. The results showed that %reh was higher in the groups with fluoridated dentifrice, and professional prophylaxis did not have an additional effect in the groups of fluoridated dentifrices (pO objetivo deste estudo foi avaliar, in situ, o potencial de remineralizaçaão do dentifrício fluoretado ou não, isoladamente ou associado à profilaxia profissional com jato de bicarbonato de sódio, em esmalte bovino com lesão superficial artificial de cárie. Utilizou-se 80 blocos de esmalte (4X4X2mm), nos quais foram realizadas medidas de microdureza superficial antes e após a desmineralização artificial e após o tratamento, com um penetrador, Knoop carga de 50/7s, para o cálculo do percentual de recuperação de dureza (%reh). Após as tomadas das 2 medidas de microdureza iniciais (antes e após a desmineralização), os blocos de esmalte foram incluídos em dispositivos intrabucais palatinos (2 blocos/aparelho). Dez jovens voluntários usaram estes dispositivos durante 10 dias com intervalo de 7 dias entre cada fase do experimento (estudo cruzado), realizando higiene bucal habitual (4X/dia, sendo 3 após as refeições e 1 à noite). Estabeleceu-se 4 grupos: G1-controle-escovação com dentifrício sem flúor; G2-escovação com dentifrício fluoretado; G3-antes da instalação do dispositivo realizou-se uma profilaxia com jato de bicarbonato de sódio e escovação com dentifrício sem flúor; G4-profilaxia e dentifrício fluoretado. A análise de variância (ANOVA, p=1,04 x 10-6) e o teste de Student-Newman-Keuls (p

The cleaning of cavity walls aims to improve adhesive restorative procedures and longevity of restorations. This study has compared the effect of three cleaning agents - sodium bicarbonate jet (Profi II, Dabi Atlante, São Paulo, Brazil); pumice paste plus a biologic detergent (Tergestesim, Probem, São Paulo, Brazil); air water spray - on the bond strength between dentin and two different adhesive systems: Clearfil SE Bond (Kuraray, Kioto, Japan) and Scotchbond Multi-Purpose Plus (3M-ESPE, São Paulo, Brazil). Six groups (n:10) of dental fragments obtained from young adult extracted teeth were prepared, and each one received one of the listed surface cleaning techniques. After the adhesive application, a cone-shaped test body was built with AP-X (Kuraray, Kioto, Japan) or Z100 (3M-ESPE, São Paulo, Brazil) composite resins, using a Teflon matrix. The specimens were tested for tensile bond strength after one-week storage in distilled water at 37°C. Two pairs of fractured specimens of each group were randomly chosen and processed for scanning electron microscopy (SEM) analysis. ANOVA test of the bond strength values showed no statistical differences among the cleaning agents and neither between their interactions with the bonding systems. Upon SEM analysis, most surfaces showed mixed fractures of adhesive and cohesive failures in bonding resin to dentin. Based on statistical and SEM analysis, it was concluded that the cleaning agents studied did not interfere with the bond strength of the adhesive systems used to dentin.A limpeza das paredes cavitárias é um passo importante na clínica odontológica e visa otimizar os procedimentos adesivos e a longevidade das restaurações. O presente estudo comparou o efeito de três agentes de limpeza cavitária - jato abrasivo de bicarbonato de sódio/ar/água (Profi II, Dabi Atlante, São Paulo, Brasil); pasta de pedra-pomes e água, somada a um detergente biológico (Tergestesim, Probem, São Paulo, Brasil); e spray de ar/água - na resistência adesiva entre dentina e dois tipos de adesivos dentais: Clearfil SE Bond ("self-etching") (Kuraray, Kioto, Japão) e Scotchbond Multi-Purpose Plus ("all-etching") (3M-ESPE, São Paulo, Brasil). Seis grupos de espécimes (n = 10) obtidos a partir de elementos dentais humanos extraídos por indicação foram preparados e cada um recebeu um dos tratamentos de superfície. Após aplicação dos adesivos, uma porção tronco-cônica de resina composta (AP-X, Kuraray, Kioto, Japão/Z-100; 3M-ESPE, São Paulo, Brasil) foi construída sobre os espécimes, com o auxílio de uma matriz bipartida de teflon e uma mesa metálica adaptadora para adaptação na máquina de ensaio de tração. Após armazenamento em água destilada a 37°C por 7 dias, os mesmos foram submetidos às provas de tração. Dois pares de cada grupo foram escolhidos aleatoriamente e processados para observação ao microscópio eletrônico de varredura (MEV). A análise estatística dos valores obtidos demonstrou que não houve diferenças significantes entre as técnicas de limpeza empregadas e nem entre a interação destas com os adesivos dentais, e as observações ao MEV revelaram uma predominância de fraturas mistas ocorridas na interface dentina/resina. Baseados nas análises estatísticas e nas observações ao MEV, concluiu-se que as técnicas de limpeza empregadas não interferem na resistência adesiva entre a dentina e os sistemas adesivos estudados, nas condições experimentais adotadas.

ABSTRACT Introduction: Debris buildup on brackets and arch surfaces is one of the main factors that can influence the intensity of friction between bracket and orthodontic wire. Objective: This study sought to evaluate the effect of air-powder polishing cleaning on debris levels of self-ligating ceramic brackets at the end of orthodontic treatment, compared to the behavior of conventional brackets. Methods: Debris levels were evaluated in metal conventional orthodontic brackets (n = 42) and ceramic self-ligating brackets (n = 42) on canines and premolars, arranged in pairs. There were brackets with and without air-powder polishing. At the end of orthodontic treatment, a hemiarch served as control and the contralateral hemiarch underwent prophylaxis with air-powder polishing. Debris buildup in bracket slots was assessed through images, and Wilcoxon test was used to analyze the results. Results: The median debris levels were statistically lower in the conventional metal brackets compared to self-ligating ones (p = 0.02), regarding brackets not submitted to air-powder polishing. Polishing significantly reduced debris buildup to zero in both systems, without differences between groups. Conclusions: Ceramic self-ligating brackets have a higher debris buildup in comparison to conventional metal brackets in vivo, but prophylaxis with sodium bicarbonate jet was effective in reducing debris levels in self-ligating and also in conventional brackets.

Abstract Introduction The number of hypertensive patients is increasing and prophylaxis with bicarbonate jet are widely performed in clinical practice using large amounts of this substance in a short period of time, which may lead to increased arterial pressure. In the literature there are several studies that analyze the effect of sodium bicarbonate jet on the biofilm and dental structures, but not report the effect on arterial pressure. Aim Evaluated the change in arterial pressure before and after two procedures of dental prophylaxis, jet baking soda application and conventional prophylaxis, and patient opinion of the comfort of each system was obtained. Material and method We selected 20 patients aged 18 to 30 in need of prophylaxis to remove biofilm. The patients were placed into three different treatment groups: sodium bicarbonate jet (G1), conventional prophylaxis (G2) and control (G3), with a one month interval between treatments. Patients were divided into groups randomly. Measurements were performed immediately before and after the procedure, 15 and 30 minutes after the end of treatment. Patient comfort was measured using a Visual Analog Scale (VAS) at the end of each treatment. Data were analyzed by analysis of variance. Result There was a statistically significant difference in the comfort of the procedures, with G2 and G3 being better than G1. Additionally, an increase in the diastolic blood pressure was observed in sodium bicarbonate jet group evaluated just after the procedure. Conclusion The conventional prophylaxis is more comfortable from the patient stand point and does not alter arterial pressure.