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AIM This prospective cohort study aimed to investigate whether orthodontic appliances removal (OAR) combined with caries-preventive strategies and fluoride varnishes alters salivary physicochemical properties, changes the activity of carbonic anhydrase VI (CA VIACT ) and α-amylase (α-AMLACT ), and favors the regression of active carious lesions (ACL). DESIGN Twenty-two individuals aged between 13 and 24 years old were assessed for the presence of visible biofilm, daily sugar exposure, caries activity, salivary flow rate (SFR), pH, buffering capacity (BC), and CA VIACT and α-AMLACT activity at baseline, and 1, 5 and 13 weeks after OAR. Variables were assessed using repeated-measures analysis of variance, Cochran's Q and McNemar's test, and Pearson's correlation. RESULTS We verified a significant decrease in the number of ACL at the 5-week (29% reduction) and at the 13-week follow-up (58% reduction). At the 5 and 13-week follow-up, the percentage of visible biofilm and sugar exposure decreased, whereas the salivary pH and α-AMLACT activity significantly increased. BC and CA VIACT remained unchanged throughout the follow-up. CONCLUSION OAR combined with caries-preventive strategies and fluoride varnishes favored the regression of active carious lesions and increased salivary pH and α-AMLACT activity, whereas buffering capacity and CA VIACT remained stable.

Saliva is a rich-bodily fluid with recognized clinical diagnosis roles and this research aimed at investigating if there is any change in the salivary proteome signatures of MIH children with distinct degrees of severity. Fifty schoolers (6–10 years) were equally assigned into the following groups: G1 (Control group - Healthy teeth), G2 (Mild MIH with white/creamy opacity and free of caries), G3 (Mild MIH with yellow/brown opacity and free of caries), G4 (Severe MIH with white/creamy, yellow/brown opacities including post-eruptive fracture and free of caries), G5 (Severe MIH with white/creamy, yellow/brown opacities, post-eruptive fracture, and caries). Unstimulated saliva samples were collected and later explored using mass spectrometry analysis. In total, 6,471 proteins were found, 5,073 exclusively from MIH children, and 778 overlapping among the different degrees of the disturb. The Biological Pathways displayed distinct patterns among the groups, being different according to the degrees of MIH. Gene-Odontology differences might not be verified regarding the biological processes and cellular components. Conversely, with respect to molecular function, alterations among groups were evident, with the presence of proteins that would contribute to MIH in children with the severe condition (i.e, calcium ion binding, microtubule binding, platelet-derived growth factor binding). In conclusion, the results of this study support important salivary proteomic changes in MIH children, according to distinct degrees of severity, reinforcing the interplay between the clinical characteristics and changes in the salivary proteome.

This study tested the effect of photodynamic antimicrobial chemotherapy (PACT) on single-species biofilm grown in a flow-cell system using methylene blue associated with nanoparticles of β-cyclodextrin and light sources of red laser or light-emitting diode (LED). The flow-cell system comprised chambers for biofilm cultivation with S. mutans under continuous hydrodynamic conditions containing BHI supplemented with 1% sucrose (w/v). Biofilms were divided into six groups (n = 6): C (control), P (photosensitizer + β-cyclodextrin), L (laser), LED (light-emitting diode), LP (laser + photosensitizer + β-cyclodextrin), and LEDP (LED + photosensitizer + β-cyclodextrin). Groups irradiated with laser were exposed to a low power light (λ = 660 nm, 320 J/cm2, 0.1 W, 9 J, 90 s). Groups irradiated with LEDs were exposed to 12 LEDs (λ = 660 nm, 8.1 J/cm2, 0.09 W/cm2, and 8.1 J for 90 s). The antibacterial potential of treatments was assessed by viable S. mutans counts of biofilm in selective medium. The vitality of intact biofilms was qualitatively evaluated by confocal laser scanning microscopy analysis (CLSM). The data were analyzed by Welch’s one-way ANOVA followed by Scheffe´s post-hoc tests (p 0.05). The number of S. mutans was significantly reduced in LP and LEDP groups (p

This study aimed to investigate whether combined exposure to starch and sucrose modifies the activity of carbonic anhydrase VI (CA VI) in saliva (Study 1) and biofilm (Study 2) of children with early childhood caries (ECC). For Study 1 and Study 2, respectively, 54 and 46 preschoolers aged 4 to 5 were allocated into two groups: caries-free (CF) and with ECC. Children were exposed to rinses with sucrose, starch, and sucrose plus starch solutions. CA VI activity, pH, and buffering capacity (BC) were evaluated in saliva and biofilm. In Study 1, a significant reduction in saliva pH was observed after sucrose and sucrose plus starch rinses. CA VI activity was influenced by ECC independently of the type of carbohydrate to which children were exposed. CA VI activity was higher in children with ECC; however, after rinses, CA VI activity was reduced. In Study 2, biofilm pH and BC were reduced after rinses with sucrose and sucrose plus starch. CA VI activity was significantly high before rinse in ECC group when compared with CF group; however, no difference was observed between groups after rinses. In saliva, exposure to starch and sucrose (isolated or combined) induced a reduction in CA VI activity in children with ECC. In biofilm, the combination of starch and sucrose did not modify CA VI activity in ECC children. The responsivity of the CA VI reflects directly in important parameters related to the pH maintenance on the oral cavity.

Objective This longitudinal study aimed to investigate if the plaque fluoride (PF) concentration can predict the early childhood caries onset. Design: As part of a larger study, 188 preschoolers were clinically evaluated for early childhood caries diagnosis, at baseline and after 1-year follow-up. After that, the final sample comprised: 1. children who had already caries at baseline (decayed, missing or filled surfaces, as well as white chalky white spot lesions adjacent to gingival margins) and developed at least one more cavitation after one year (n=16), and 2. children who never had or developed any caries lesions, including active white spots lesions (n=15). Before the clinical examinations, dental plaque was collected. PF concentration was determined with an ion-specific electrode. A chart was used to estimate the mean daily sugar exposure. The results were statistically analyzed by Spearman correlation and logistic regression analyses (α=0.05). Results After one year, a positive significant correlation between caries development and liquid sucrose, total sugar and total sucrose consumption increments was found (p

This quasi-experimental study aimed at investigating the combined effect of biofilm accumulation and 20% sucrose rinse on the modulation of calcium (Ca2+), phosphate (Pi), and fluoride (F-) bioavailability in saliva of children with early childhood caries (ECC). In-that, fifty-six preschoolers of both genders were evaluated according to caries experience and activity: caries-free (CF, n=28) and with ECC (n=28) and then, submitted to biofilm intervention (biofilm accumulation or no biofilm accumulation). In each situation, saliva samples were collected before and five minutes after a 20% sucrose rinse to determine the concentrations of Ca2+, Pi, and F−. Calcium concentration was significantly lower in the biofilm accumulation situation compared to the situation of biofilm mechanical control, except for children CF after sucrose rinse. Biofilm accumulation increased salivary calcium concentration in children with ECC after sucrose rinse, whereas mechanical biofilm control reduced it in both groups. The phosphate concentration was influenced by mechanical control of the biofilm in CF children. The fluoride bioavailability was reduced by sucrose rinse and biofilm accumulation in CF and ECC children. In conclusion, the combined effect of biofilm accumulation and sucrose rinse modifies the bioavailability of calcium and fluoride in the saliva of children with early childhood caries.

The present cross-sectional study investigated whether Firmicutes (F) and Bacteroidetes (B) levels in the mouth reflected the gut condition in obesity and early childhood caries (ECC). Eighty preschoolers (3-5 years) were equally assigned into four groups: 1. obese + ECC, 2. obese + caries-free (CF), 3. eutrophic + ECC, and 4. eutrophic + CF. Nutritional status and ECC were assessed based on the WHO criteria. Dental biofilm and fecal samples were collected for F and B quantification using RT-PCR analysis. Data were evaluated using three-way-ANOVA and Pearson’s correlation (α = 0.05). Regardless of the anatomical location effect (p = 0.22), there were higher values for F in the obese children + ECC compared with those in obese + caries-free (CF) in both mouth and gut (p < 0.05). The correlation for F at these sites was negative in obese children + ECC (r = −0.48; p = 0.03) and positive in obese children + CF (r=0.50; p = 0.03). Bacteroidetes were influenced by ECC (p = 0.03) and the anatomical location (p = 0.00), and the levels tended to be higher in the mouth of the obese children + ECC (p = 0.04). The F/B ratio was higher in the gut and was affected by the anatomical location (p = 0.00). This preliminary study suggested that modulated by ECC, counts of oral Firmicutes reflected corresponding condition in the gut of obese preschoolers. In addition, we first evidenced that the Firmicutes phylum behave differently according to the nutritional status and caries experience and that supragingival biofilm and gut could share levels of similarity.

Objective: This study aimed to investigate if β-cyclodextrin nanoparticles potentiate the photodynamic antimicrobial chemotherapy (PACT) effects in single and microcosm oral biofilms using...

This quasi-experimental study sought to investigate if the mechanical control of biofilm (3-times-a-day) modifies the saliva’s ability to buffer the oral environment after 20% sucrose rinse (SR20%) in children with early childhood caries (ECC). Here, SR20% reduced the saliva’s pH in both groups and the mechanical control of biofilm had a greater effect on this parameter after SR20% in CF children. The mechanical control of biofilm evidenced a higher buffering capacity in CF children before SR20%, which was not observed after SR20%. Otherwise, the absence of mechanical control of biofilm showed that buffering capacity was comparable in the two groups before SR20%, whereas after SR20% the saliva’s buffering capacity of CF children was higher than ECC children. When biofilm was mechanically controlled, carbonic anhydrase VI activity did not change after SR20% whereas the absence of mechanical control of biofilm reduced this enzyme activity after SR20%. In conclusion, the mechanical control of biofilm did not change saliva’s ability to buffer the oral environment after SR20% in children with ECC. On the other hand, CF children appeared to regulate more effectively the saliva’s pH than ECC children while the absence of mechanical control of biofilm mediated their pH-modifying ability after SR20%.

Objective To test the effect of antimicrobial photodynamic therapy (A-PDT) on the oral biofilm formed with early colonizing microorganisms, using the photosensitizer methylene blue coupled with β-cyclodextrin nanoparticles and red light sources laser or LED (λ =660 nm). Methods The groups were divided into (n = 3, in triplicate): C (negative control, 0.9 % NaCl), CX (positive control, 0.2 % chlorhexidine), P (Photosensitizer/Nanoparticle), L (Laser), LED (light-emitting diode), LP (Laser + Photosensitizer/Nanoparticle) and LEDP (LED + Photosensitizer/Nanoparticle). A multispecies biofilm composed ofS. gordonii, S. oralis, S. mitis, and S. sanguinis was grown in microplates containing BHI supplemented with 1% sucrose (w/v) for 24 h. Light irradiations were applied with a laser at 9 J for 90 s (320 J/cm2), or with LED, at 8.1 J for 90 s (8.1 J/cm2). The microbial reduction was assessed by counting viable biofilm microorganisms in selective culture media, before and after the treatments. Data normality was assessed by the Shapiro-Wilk test, and the results were submitted to Kruskal-Wallis analysis, followed by Dunn's test, with a significance level of 5%. Results The groups LP and LEDP were able to significantly reduce the biofilm microorganism counts by as much as 4 log10 times compared to the negative control group (p 0.05). Conclusion The A-PDT mediated by encapsulated β-cyclodextrin methylene blue irradiated by Laser or LED was effective in the microbial reduction of multispecies biofilm composed of early colonizing microorganisms.

Aim This study aimed to investigate whether carbonic anhydrase VI activity (CA VIACT ), pH, and buffering capacity (BC) in saliva and biofilm could predict the number of lesion occurrence and early childhood caries (ECC). Design A cross-sectional study was performed in a sample of 44 children aged 4 to 5 years who were examined regarding their caries status (dmfs + active white spot lesions-WSL) and allocated into two groups: ECC and caries-free (CF). Saliva and biofilm were collected to determine pH, BC, and CA VIACT . Data were analyzed using the Student t test, and multiple linear regression and logistic regression analyses followed by the ROC curve. Results Children with ECC exhibited lower pH and BC in saliva and a higher CA VIACT in both saliva and biofilm. Only saliva pH could predict the dmfs + active WSL. In biofilm, if CA VIACT is increased by one pixel/µg, 0.85 ± 0.28 increase is expected in the number of active WSL. Salivary pH and CA VIACT in saliva and biofilm had the power to predict ECC occurrence. Conclusion Changes in saliva pH and CA VIACT in biofilm predicted the number of lesion occurrence. Furthermore, CA VIACT in both saliva and biofilm can predict propensity for ECC.

This study sought to explore if the effect of 20% sucrose rinse (SR) on the salivary electrolytic concentration of calcium (Ca2+), phosphate (Pi) and fluoride (F−) in children with Early Childhood Caries (ECC) is different from healthy children. Here, fifty-eight preschoolers aged 3 to 5 years were divided into 2 groups: caries-free (CF) and with ECC. Changes in saliva flow rate, pH and buffering capacity (BC), as well as in concentrations of Ca2+, Pi, and F−, and the degree of saturation in relation to hydroxyapatite (DSS HAp) and fluorapatite (DSS FAp) were evaluated. The pre-rinse [Ca2+] was higher in the ECC group in the CF group. A significant increase in [Ca2+] was demonstrated after SR in the CF group (p = 0.05). The [Pi] was reduced by 18% after SR in the ECC group (p = 0.007). The [F-] reduced in both groups after SR (p 2+] and the DSS HAp and DSS FAp. Multivariate analysis showed that children with a higher [Ca2+] in pre-rinse saliva are more likely to have ECC. In conclusion, the effect of a 20% sucrose rinse on the electrolytic concentration of Ca2+, Pi and F- was different when children with ECC were compared with CF children.

Background This research aimed to evaluate the salivary concentrations of fluoride (F-), calcium (Ca2+), and phosphate (Pi) after brackets bonding, and to identify the role of [F-], [Ca2+], and [Pi] on the development of active caries lesion (ACL) in individuals under fixed orthodontic treatment. Material and Methods A longitudinal investigation with twenty-two individuals from 11 to 22 years of age was performed in four phases (baseline and after 1, 3, and 6 months). Analyses were carried out considering the salivary concentration of [F-], [Ca2+], and [Pi], as well as the caries index. Data were analyzed using the Friedman test, followed by the Wilcoxon test and the multivariate Cox model (p≤0.05). Results 1 and 3 months after appliance bonding, the [Ca2+] was statistically lower than after 6 months (p

Objective: We aimed to evaluate whether radiotherapy causes changes in the mineral composition, hardness, and morphology of enamel and dentin of primary teeth. Materials and Methods: Thirty specimens of primary teeth were subjected to radiotherapy. At baseline and after 1,080, 2,160, and 3,060 cGy, the specimens were subjected to microhardness, FT-Raman spectroscopy, and scanning electron microscopy (SEM) analysis. The pH of artificial saliva was determined, as were the calcium and phosphate concentrations. The data were subjected to the Shapiro-Wilk normality test, showed a nonnormal distribution, and were compared by the Kruskal-Wallis test. Results: The results showed that the microhardness of the enamel surface decreased after 2,160 cGy (281.5 ± 58 kgf/mm2) when compared to baseline (323.6 ± 59.5 kgf/mm2) (p = 0.045). For dentin, the surface hardness decreased after 1,080 cGy (34.9 ± 11.4 kgf/mm2) and 2,160 cGy (26 ± 3.5 kgf/mm2) when compared to baseline (56.5 ± 7.7 kgf/mm2) (p < 0.0001). The mineral and organic contents of phosphate (p < 0.0001), carbonate (p < 0.0001), amide (p = 0.0002), and hydrocarbons (p = 0.0031) of enamel decreased after 3,060 cGy (5,178 ± 1,082, 3,868 ± 524, 999 ± 180, and 959 ± 168 kgf/mm2, respectively). For dentin, we noticed a growing increase in phosphate v2, amide, and hydrocarbon content after 1,080 cGy (8,210 ± 2,599, 5,730 ± 1,818, and 6,118 ± 1,807 kgf/mm2, respectively) and 2,160 cGy (1,0071 ± 2,547, 7,746 ± 1,916, and 8,280 ± 2,079 kgf/mm2, respectively) and a reduction after 3,060 cGy (6,782 ± 2,175, 3,558 ± 1,884, and 3,565 ± 1,867 kgf/mm2, respectively) (p < 0.0001). SEM images showed cracks on enamel and degradation of peritubular dentin. Conclusion: We concluded that radiotherapy caused a reduction in surface hardness, changed mineral and organic composition, and promoted morphological changes on the enamel and dentin of primary teeth.

Objetivo: Abordar aspectos de interesse clínico relacionados ao uso do diamino fluoreto de prata (DFP) no controle da cárie na primeira infância (CPI) durante a pandemia da COVID-19. Métodos: A busca para revisão de literatura foi executada na base de dados PubMed. Os descritores foram escolhidos pela importância na delimitação do tema e a síntese da literatura foi realizada de acordo com os tópicos: (1) efetividade clínica, indicações e limites do DFP e (2) uso clínico do DFP no contexto da COVID-19. Resultados: A pandemia da COVID-19 afeta todos os setores da sociedade, e, especialmente para o odontopediatra, impõe desafios em um cenário de difícil tomada de decisão e passível de contaminação. O tratamento da doença cárie com DFP ganha uma conotação importante pela sua eficácia na paralização da atividade de cárie, prevenção de novas lesões, segurança, facilidade de uso e baixo custo. Além disso, o DFP é considerado uma terapia minimamente invasiva que dispensa uso de instrumentos rotatórios (que tem alto potencial contaminante via dispersão de aerossol), e reduz complicações como pulpite e perda dentária e, portanto, o número de consultas. O DFP é também uma opção clínica na qual há uma maior aceitação comportamental pela criança. Como ponto negativo, o DFP pode causar insatisfação estética devido ao escurecimento da superfície afetada. Conclusão: O controle de lesões de cárie em crianças com CPI utilizando DFP, durante a pandemia da COVID-19, é uma opção eficaz, barata, de fácil aplicação e que oferece menos riscos de contaminação pelo coronavírus.

Objective: This study aimed to analyze the concentration and activity of carbonic anhydrase (CA) VI in the saliva of school children. We investigated the relationship among caries, CA VI concentration/activity, flow rate, pH, and buffering capacity. Materials and Methods: Seventy-four school children were divided into a caries-free group and a caries group. Clinical examinations were conducted by one examiner according to World Health Organization criteria + early caries lesions. Salivary flow rate, pH, and buffering capacity were analyzed. Salivary CA VI concentration and activity were evaluated by ELISA and zymography, respectively. The data were analyzed using Student's t test and the Mann-Whitney test, and Pearson and Spearman correlation analyses were also done. In multivariate modeling, associations between variables were expressed as odds ratios. Results: The results showed that salivary flow rate, salivary pH, and BC were significantly higher in the saliva of caries-free children. Also, the salivary CA VI concentration was significantly higher in the saliva of caries-free children. The salivary CA VI activity was higher in children with caries. We found a negative correlation between BC and dental caries. Also, in the caries group we found a positive correlation between the concentration and the activity of CA VI and a negative correlation between BC and CA VI activity. A negative correlation between salivary pH and CA VI concentration was observed in the caries-free group. A high activity of CA and a low salivary flow rate were associated with dental caries. Conclusion: These results support the conclusion that dental caries is highly affected by the activity of CA VI in saliva as well as by the salivary flow rate.

This study aimed to evaluate whether radiotherapy with gamma radiation changes the susceptibility of primary teeth to a cariogenic challenge. Specimens of primary teeth (n = 18) were subjected to gamma radiation simulating the radiotherapy treatment, and 18 specimens were used as control group. A microbiological model of caries induction by S. mutans was used to evaluate the susceptibility of these irradiated specimens to the caries development. The depth, area and volume of caries lesion formed were evaluated using microcomputer tomography analysis (μ-CT) and changes occurring on the enamel surface were evaluated using scanning electron microscopy (SEM). Data of the lesion depth, lesion area and volume were submitted to independent t test with a 5% of significance limit. The lesion depth and the area of caries in the irradiated group (196.61 ± 60.41 µm and 564.52 ± 343.37 µm2, respectively) were significantly higher (p = 0.02 and p = 0.03, respectively) than those in the nonirradiated group (151.70 ± 32.16 µm and 386.64 ± 169.75 µm2, respectively). However, the lesion volume did not differ (p = 0.15) between the groups (7797.89 ± 3675.69 µm3 for irradiated and 6509.03 ± 2902.65 µm3 for nonirradiated group). The SEM images show greater enamel breakdown in the group of irradiated specimens. The present study results reveal that the gamma radiation protocol used for cancer treatment renders primary teeth more susceptible to a cariogenic challenge.

Objective This study evaluated the effect of hydrogen peroxide addition on β-cyclodextrin-conjugated methylene blue in antimicrobial photodynamic therapy(a-PDT) in S. mutans biofilm model using laser or light emitting diode (LED) (λ = 660 nm). Methods A preliminary assay was performed to evaluate the cytotoxicity of hydrogen peroxide in oral fibroblasts by the colorimetric method (MTT). Afterwards, groups were divided into (n = 3, in triplicate): C (negative control), CX – chlorhexidine 0.2% (positive control), P (methylene blue/β-cyclodextrin), H (Hydrogen Peroxide at 40 μM), PH, L (Laser), LP, LH (Laser+Hydrogen Peroxide), LPH, LED, LEDP, LEDH, and LEDPH. The biofilm was formed in 24 h with BHI + 1% sucrose (w/v). Light irradiations were conducted with laser, 9 J, 323 J/cm2, 113 s or with LED, 8.1 J, 8.1 J/cm2 for 90 s. Microbial reduction was evaluated by counting the viable microorganisms of the biofilm after the respective treatments, in a selective culture medium, and laser confocal microscopy evaluation. Results LP, LH, LPH, LEDP, LEDH, and LEDPH groups statistically reduced the counts of S.mutans compared with the C group and the log reductions were of 1.87, 1.94, 2.19, 0.91, 0.92, and 1.33, respectively; the addition of hydrogen peroxide did not potentiate the microbial reductions (LPH and LEDPH) compared with the LP and LEDP groups. Conclusion The association of hydrogen peroxide with the conjugated β-cyclodextrin nanoparticle as photosensitizer did not result in an enhanced effect of a-PDT; hydrogen peroxide behaved as a photosensitizer, since it reduced the number of S. mutans when associated with laser light.

This study investigated pH, activity and concentration of carbonic anhydrase VI (CA VI) in dental biofilm of caries and caries-free children of 7–9 years old. Seventy-four children were selected and divided into two groups. The caries diagnosis was performed according to the WHO criteria, including the early caries lesion. After biofilm collection and pH determination, CA VI concentration and activity were determined by ELISA and Zimography respectively. The data were submitted to a Mann-Whitney test and to Pearson and Spearman correlation analyses. Means and standard deviations of dental caries for the caries group were of 3.162 ± 1.385. The biofilm pH was significantly higher in the caries-free group. The CA VI activity was significantly higher in biofilm of children with caries. The CA VI concentration was significantly higher in biofilm of caries-free children. In caries-free children, there was a moderate negative correlation between CA VI activity and concentration in dental biofilm as well as between pH and CA VI activity. A negative correlation between biofilm pH and CA VI concentration was found in the caries group. In conclusion, CA VI was shown to be more active in the biofilm of school children with caries in order to contribute to neutralization of biofilm acid.

This study evaluated if Carbon dioxide (CO2) (λ 10.6 μm) laser irradiation combined with acidulated phosphate fluoride gel application (APF gel) enhances "CaF2" uptake by demineralized enamel specimens (DES) and inhibits enamel lesion progression. Thus, two studies were conducted and DES were subjected to APF gel combined or not with CO2 laser irradiation (11.3 or 20.0 J/cm(2), 0.4 or 0.7 W) performed before, during, or after APF gel application. In study 1, 165 DES were allocated to 11 groups. Fluoride as "CaF2 like material" formed on enamel was determined in 100 DES (n = 10/group), and the surface morphologies of 50 specimens were evaluated by scanning electron microscopy (SEM) before and after "CaF2" extraction. In study 2, 165 DES (11 groups, n = 15), subjected to the same treatments as in study 1, were further subjected to a pH-cycling model to simulate a high cariogenic challenge. The progression of demineralization in DES was evaluated by cross-sectional microhardness and polarized light microscopy analyses. Laser at 11.3 J/cm(2) applied during APF gel application increased "CaF2" uptake on enamel surface. Laser irradiation and APF gel alone arrested the lesion progression compared with the control (p

This research aimed to determine the influence of fluoridated groundwater and 1,100 ppm fluoride dentifrice on biomarkers of exposure to fluoride in preschoolers. A cross-sectional study was performed on thirty preschoolers recruited from naturally fluoridated and non-fluoridated areas (n=15). Total Daily Fluoride Intake (TDFI) from diet and dentifrice, and Daily Urinary Fluoride Excretion (DUFE) was measured over 24 h. Nails samples were collected twice during 30 days. Fluoride analyses were performed using a fluoride-ion-specific electrode. Data were evaluated using the Student and paired t-test, Pearson correlation analysis, multiple linear regression analysis (α≤0.05). Fluoridated groundwater and dentifrice were the dominant sources (r2 > 0.83) of TDFI in children from a naturally fluoridated and a non-fluoridated area, respectively. A positive correlation between TDFI and DUFE (r=0.50), and between [F] in fingernails and toenails (r=0.60) were found in children from a naturally fluoridated area. The [F] in nails of finger and toe were not correlated to TDFI. The consumption of fluoridated groundwater influenced the fluoride concentration in urine. In addition, the use of 1,100 ppm fluoride dentifrice did not influence the fluoride concentration in urine and fingernails.

Background Insoluble polysaccharide (IP) has been associated with caries prevalence in young children. However, the power of IP to predict ECC needs to be demonstrated. Aims To assess the relationships between early childhood caries (ECC) and extracellular insoluble polysaccharides (IP) in dental plaque, sugar exposure and cariogenic microorganisms. Design Visible plaque on maxillary incisors was recorded, followed by caries diagnosis in 65 preschoolers (3–4 years) at baseline and after 1 year. Plaque was collected for mutans streptococci (MS), total microorganism (TM) and lactobacilli (LB) enumerations in selective media, as well as for IP analysis, which was later assessed by colorimetry. Sugar/sucrose exposure was assessed by a diet chart. Results Positive correlations were found among the prevalence of caries and MS, TM, LB, solid sucrose and visible dental plaque. Additionally, children with IP concentrations in dental plaque higher than 2.36 μg/mg (odds ratio-OR = 6.8), with visible plaque on maxillary incisors (OR = 4.3), harbouring LB (OR = 13) and exposed to solid sugar more than twice/day (OR = 5) showed higher risk of developing caries ( p Conclusion Extracellular insoluble polysaccharides, solid sugar/sucrose, visible dental plaque and cariogenic microorganisms could predict caries development, partially explaining the ECC pattern.

BACKGROUND Previous studies have shown during the orthodontic treatment, the prevalence of active caries lesions (ACL) in 30 to 70% of patients. AIM To evaluate the effect of orthodontic treatment on salivary properties considering caries development. DESIGN Twenty two individuals (11-22 years) were assessed regarding caries, oral hygiene, sugar exposure, salivary flow rate (SFR), buffering capacity, pH, carbonic anhydrase VI (CA VI) and amylase activity, at baseline, 1, 3 and 6 months after the orthodontic appliances placement. Caries index was determined by Nyvad criteria. CA VI and amylase activities were performed by zymography and ELISA, respectively. RESULTS Buffering capacity decreased after 3 months (P < 0.0001) and showed positive correlation with pH at baseline and after 1 month in individuals who did not develop active caries lesions. Amylase activity decreased after 1 and 6 months (P = 0.0003) and presented positive correlation with CA VI in patients who developed ACL. SFR increased after 1 month (P = 0.0283) and showed positive correlation with CA VI activity after 3 months in individuals who did not develop ACL. Salivary pH showed negative correlation with CA VI after 1 month in patients who did not develop ACL. ACL were firstly diagnosed after 3 months. CONCLUSIONS The present study demonstrated that saliva of individuals under orthodontic treatment is subjected to changes in properties that have implications on the onset of ACL.

Objective To evaluate the association between oral conditions, masticatory performance (MP) and oral health-related quality of life (OHRQoL) in 8–12 year-old children. Design 150 Brazilian scholars were examined for caries and malocclusions. MP was evaluated based on the ability to comminute an artificial test food followed by the determination of the median particle size (X50) and particle distribution in different-sized sieves (“b”). OHRQoL was measured using the Brazilian versions 8–10 and 11–14 of the child perceptions questionnaire (CPQ), considering the following domains: oral symptoms (OS), functional limitations (FL), emotional well-being (EW) and social well-being (SW). Higher scores indicated worse OHRQoL. Data were submitted to Spearman's correlation test and multiple linear regression analysis. Results There were significant positive correlations between the psychosocial and OS domains scores of the CPQ8–10 and the number of decayed and missing teeth, respectively. The number of decayed teeth positively correlated with the number of missing teeth and the CPQ11–14 scores. The number of decayed and missing teeth was significantly associated with higher CPQ8–10 scores. Higher CPQ11–14 overall scores were associated with female gender, higher FL domain scores were associated with the number of missing teeth, and higher X50 values and EW domain scores were associated with female gender and the number of decayed teeth. Conclusions A higher number of missing teeth correlated with an inferior MP in older children. Children with a higher number of caries rated their oral health less favourably. Older females and those who broke the test material into smaller sizes were also more likely to report a worse OHRQoL, suggesting that the time allowed to reduce food appears to be a more influential factor on children’ perception of oral health than their ability to break down the test material into smaller sizes. Moreover, the subjectivity of functional domain and artificial nature of chewable test material could have influenced the test sensitivity.

Aim This longitudinal study investigated the relationship among early childhood caries (ECC), α amylase, carbonic anhydrase VI (CA VI), and the presence of visible biofilm, besides detecting if these variables could predict risk for ECC. Design One hundred children were divided into two groups: caries group (n = 45) and caries-free group (n = 55). Visible biofilm on maxillary incisors was recorded, followed by caries diagnosis in preschoolers at baseline and at follow-up. Saliva samples were collected, and activities of CA VI and α amylase were determined. Data normality was assessed by Shapiro–Wilk test and then Mann–Whitney, Spearman correlation, and chi-square tests followed by multiple logistic regression analysis (α = 0.05, 95% confidence interval). Results CA VI activity was significantly higher in saliva of children with caries (P ≤ 0.05), and α amylase activity was significantly higher in saliva of caries-free children (P < 0.0001). Children with α amylase activity in saliva lower than 122.8 U/mL (OR = 3.33 P = 0.042) and visible biofilm on maxillary incisors (OR = 3.6 P = 0.009) were more likely to develop ECC than caries-free children. A negative correlation between caries and α amylase activity was found (P = 0.0008). Conclusions The presence of visible biofilm and low salivary activity of α amylase may be considered risk predictors for ECC.

International Journal of Paediatric Dentistry 2012; 22: 92–99 Background. The prevalence of early childhood caries (ECC) is high in developing countries; thus, sensitive methods for the early diagnosis of ECC are of prime importance to implement the appropriate preventive measures. Aim. To investigate the effects of the addition of early caries lesions (ECL) into WHO threshold caries detection methods on the prevalence of caries in primary teeth and the epidemiological profile of the studied population. Design. In total, 351 3- to 4-year-old preschoolers participated in this cross-sectional study. Clinical exams were conducted by one calibrated examiner using WHO and WHO + ECL criteria. During the exams, a mirror, a ball-ended probe, gauze, and an artificial light were used. The data were analysed by Wilcoxon and Mc-Nemar’s tests (α = 0.05). Results. Good intra-examiner Kappa values at tooth/surface levels were obtained for WHO and WHO + ECL criteria (0.93/0.87 and 0.75/0.78, respectively). The dmfs scores were significantly higher (P

The complexity of the oral environment and ethical issues have prompted the development of an in vitro bacterial model to evaluate the effect of frequency of sucrose exposure on dentin caries formation, biofilm composition, and pH changes. In the experiment, dentin specimens (n=45) were randomly divided into four groups: control (C), negative control (0S), 3S (three sucrose baths), and 6S (six sucrose baths). The specimens then were inoculated with Streptococcus mutans and treated according to the protocol described below. Dentin demineralization and lesion depth were assessed by transverse microradiography. Extracellular polysaccharides that formed in the biofilm were analyzed and counts of microorganisms in the carious dentin were measured. After a 7-day period of growth, the biofilm pH was assessed before and after sucrose baths (n=5). The addition of sucrose led to dentin caries development regardless of the number of sucrose baths performed. The number of colony forming units (cfu) from the carious dentin did not differ among the treatment groups, though the extracellular polysaccharides from both 3S and 6S differed from 0S. The pH decreased immediately after the sucrose bath but increased again after 5 min. We demonstrate here that the in vitro microbial model for the study of dentin caries formation is reproducible and able to produce dentin caries, irrespective of the frequency of sucrose exposure.

An increase in the dental caries prevalence on root surfaces has been observed mainly in elderly. This research assessed, in vitro, the effectiveness of a pulsed CO2 (λ = 10.6 μm) laser associated or not with fluoride, in reducing human root dentine demineralization in conditions that mimic an oral high cariogenic challenge. After sterilization, root dentine specimens were randomly assigned into 6 groups (n = 30), in triplicate. The groups were Control (C), Streptococcus mutans (SM), Fluoride (F), Laser (L), Fluoride + laser (FL), and Laser + fluoride (LF). Except for the control group, all the specimens were inoculated with SM and immersed 3 times a day in a 40% sucrose bath. After a 7-day cariogenic challenge, the mineral loss and lesion depth were evaluated by transverse microradiography and fluoride in the biofilm was determined using an ion-selective electrode. Results were statistically analyzed by analysis of variance, at 5% of significance level. For groups C, SM, F, L, FL and LF, the means (standard-deviation) of mineral loss were 816.3 (552.5)a, 3291.5 (1476.2)c, 2508.5 (1240.5)bc, 2916.2 (1323.7)c, 1839.7 (815.2)b and 1955.0 (1001.4)b, respectively; while lesion depths were 39.6 (22.8)a, 103.1 (38.9)c, 90.3 (44.6)bc, 91.7 (27.0)bc, 73.3 (26.6)b, 75.1 (35.2)b, respectively (different superscript letters indicate significant differences among groups). In conclusion, irradiation of root dentine with a pulsed CO2 laser at fluency of 12.0 J/cm2 was able to inhibit root surface demineralization only when associated with fluoride. No synergy effect on the inhibition of root dentine mineral loss was provided by the combination of fluoride application and laser irradiation.

Photo-disinfection of deep dentin caries lesions may be a useful tool for preserving tooth structure. However, increase of pulpal temperature higher than 5.5°C may put pulp vitality in danger.

The development of a method to ensure bacterial-free substrates without extensive cavity preparation would be highly useful to dentistry, since there is no currently available effective method for killing residual bacteria in dentinal tissue. This randomized in vitro study determined parameters for using toluidine blue O (TBO) with a light-emitting diode (LED) for dentine caries disinfection and monitored intrapulpal/periodontal temperatures during irradiation. Occlusal human dentine slabs were immersed in Streptococcus mutans culture for demineralization induction. Slabs were allocated to 10 groups (n = 15), which were treated with 0.1 mg ml−1 TBO with 5 min of incubation time or 0.9% NaCl solution for 5, 10 or 15 min, and submitted or not to irradiation for 5, 10 or 15 min (47, 94, and 144 J/cm2). Before and after treatments, dentine samples were analyzed with regard to S. mutans counts. In whole teeth, temperature in pulp and periodontium was measured by thermocouples during irradiation. Kruskal-Wallis/Student-Newman-Keuls, and ANOVA/Tukey test were respectively utilized to compare log reductions and temperature rises between groups. Bacterial reduction was observed when dentine was exposed to both TBO and LED at all irradiation times, as well as to LED alone for 10 and 15 min. Temperature increases lower than 2°C were observed for either pulp or periodontium. Concluding, LED combined with TBO is a safe and effective approach for dentine caries disinfection. Nevertheless, additional studies should be conducted to determine the influence of the irradiation in S. mutans viability in dentinal surface/tubules.

This cross-sectional study aimed to investigate the relationship among microbiological composition of dental plaque, sugar exposure and social factors, as well as the presence of visible plaque in preschoolers with different stages of early childhood caries.A total of 169 children were clinically examined according to the World Health Organisation criteria + early caries lesions and were divided into three groups: caries-free (n=53), early caries lesions-ECL (n=56), and cavitated caries lesions-CCL (n=60). The presence of clinically visible dental plaque on maxillary incisors was recorded. After that, dental plaque from all buccal and lingual smooth surfaces was collected and the number of colony-forming units of mutans streptococci and total microorganism, as well as the presence of lactobacilli was determined. Daily frequency of meals containing sugar was assessed by a diet chart whereas social factors were evaluated by a questionnaire. The data were analysed by chi-square test followed by multiple logistic regressions (alpha=0.05, confidence interval=95%).High levels of mutans streptococci (OR=2.28), high total sugar exposure (OR=5.45) and presence of dental plaque (OR=2.60) showed significant association with ECL (p0.05). High total microorganism count (OR=5.18), high solid sugar exposure (OR=2.50) and the presence of lactobacilli (OR=24.99) revealed significant association with CCL (p0.05).These results support the conclusion that dietary sugar experience influenced the microbiological composition of dental plaque. Moreover, the early stage of caries is highly affected by mutans streptococci and visible dental plaque on maxillary incisors whereas cavities are strongly related to lactobacilli and total microorganism.

Objective The hypotheses of this study was that pulsed CO 2 laser ( λ = 10.6 μm) treatment in combination (or not) with previous fluoride gel application could increase the resistance of enamel and dentine to erosion, throughout successive erosive challenges. Design Thirty-two bovine specimens of enamel and of root dentine were flattened, polished and randomly assigned to the following treatments ( n = 8): fluoride (F), laser (L), fluoride + laser (FL) or no treatment as negative control (C). The treated specimens were submitted to demineralization (0.3% citric acid, pH 2.45, for 5 min) and remineralization (artificial saliva, for 60 min) cycles, three times a day, for 3 days. Dental surface loss as well as the concentration of calcium, phosphorus and fluoride in the demineralizing solutions were determined after each cycling day. Enamel and dentine were analysed separately using repeated measures ANOVA for ranks ( α = 0.05). Results The association between fluoride and laser (FL) resulted in the lowest enamel and dentine surface loss values throughout the cycles, differing significantly from the control group. No clear benefit of FL over the F or L treatments was observed. There was a non-significant trend ( p > 0.05) for FL to release less calcium, phosphorus and fluoride into the demineralizing solutions when compared to the other groups. Conclusions Pulsed CO 2 laser ( λ = 10.6 μm) alone was not able to prevent enamel or dentine surface losses due to erosion. Laser treatment in combination with fluoride showed some protection, but the effect does not appear to be synergistic.

Although the cariostatic effects of CO2 laser on enamel have been shown, its effects on root surface demineralization remains uncertain. The objectives of this in vitro research was to establish safe parameters for a pulsed 10.6 μm CO2 laser and to evaluate its effect on morphological features of the root surface, as well as on the reduction of root demineralization. Ninety-five human root surfaces were randomly divided into five groups: G1-No treatment (control); G2—2.5 J/cm2; G3—4.0 J/cm2; G4—5.0 J/cm2; and G5—6.0 J/cm2. Intrapulpal temperature was evaluated during root surface irradiation by a thermocouple and morphological changes were evaluated by SEM. After the surface treatment, the specimens were submitted to a 7-day pH-cycling model. Subsequently, the cross-sectional Knoop microhardness values were measured. For all irradiated groups, intrapulpal temperature changes were less than 1.5°C. Scanning electron microscopy images indicated that fluences as low as 4.0 J/cm2 were sufficient to induce morphological changes in the root surface. Additionally, for fluences reaching or exceeding 4.0 J/cm2, laser-induced inhibitory effects on root surface demineralization were observed. It was concluded that laser energy density in the range of 4.0 to 6.0 J/cm2 could be applied to a dental root to reduce demineralization of this surface without compromising pulp vitality.

This study investigated the effect of CO2laser irradiation on the inhibition of secondary caries on root surfaces adjacent to glass ionomer cement (GIC) or composite resin (CR) restorations. 40 dental blocks were divided into 4 groups: G1 (negative control): cavity preparation + adhesive restoration with CR; G2: (positive control) cavity preparation + GIC restoration; G3: equal to group 1 + CO2laser with 6 J/cm2; G4: equal to group 2 + CO2laser. The blocks were submitted to thermal and pH cycling. Dental demineralization around restorations was quantified using microhardness analyses and Light-Induced Fluorescence (QLF). The groups showed no significant differences in mineral loss at depths between 20 μm and 40 μm. At 60 μm, G2 and G3 ≠ G1, but G4 = G1, G2 and G3. At 80 μm, G4 ≠ G1, and at 100 μm, G4 = G2 = G1. At 140 and 220 μm, G2, G3, and G4 = G1. The averages obtained using QFL in groups 1, 2, 3, and 4 were 0.637, 0.162, 0.095, and 0.048, respectively. QLF and microhardness analyses showed that CO2laser irradiation reduced mineral loss around the CR restorations but that it did not increase the anticariogenic effect of GIC restorations.

In this in vitro study we evaluated the enamel mineral loss effect of fluoride-containing and non-fluoride-containing materials at different distances from the sealant margin, and verified the fluoride-releasing capability of these materials.Extracted molars were randomly assigned into nine groups (n = 12): Concise (C), FluroShield (F), Helioseal Clear Chroma (H), Vitremer (V), Fuji II-LC (FII), Ketac Molar (KM), Fuji IX (FIX), Single Bond (SB), and Clearfil Protect Bond (CF). All groups were subjected to thermo and pH cycling. Enamel mineral loss was evaluated by cross-section micro-hardness analysis at distances: -100 microm, 0 microm, 100 microm, 200 microm. The mineral loss data were analyzed using a multi-factor ANOVA with split-plot design, and fluoride-released data were submitted to ANOVA and Tukey tests.FIX demonstrated a lower mineral loss than C, F, and H, but did not differ from the SB, CF, V, FII, and KM groups, which also demonstrated no difference among them. C, F, H, and V presented the highest mineral loss, with no difference among them. V did not differ from the other groups (p0.05). Regarding the different distances from the sealant margin, -100 microm presented the lowest mineral loss. FIX showed the highest fluoride release on the 7th and 14th days of evaluation, while CF showed high fluoride release only on the 7th day.Resin sealant did not prevent enamel mineral loss, contrary to glass-ionomer cement, which showed the highest capacity for fluoride release. It is not exclusively the presence of fluoride in a material's composition that indicates its capability to interfere with the development of enamel caries-like lesions.

This in vitro study aimed to evaluate whether laser irradiation of cavity margins reduces enamel demineralization around composite restoration. Enamel cavities were prepared in 33 human enamel slabs, which were randomly divided into three groups. One group was kept as a control, and the cavosurface margin of the cavities of the other groups were irradiated, using a CO(2) laser (lambda = 10.6 microm), at 8 J.cm(-2) or 16 J.cm(-2). The cavities were restored with a resin-based composite, according to the manufacturer's specifications. Before restoration, scanning electron microscopy was performed on one specimen of each group. The remaining slabs were submitted to thermal and pH-cycling models. Enamel mineral loss, at 50 and 100 microm from the restoration margin, was assessed by cross-sectional microhardness analyses. Fusion and melting were observed in the irradiated groups. Mineral loss at 50 microm from the restoration margin was significantly inhibited in the irradiated groups compared to the control group, but at 100 microm from the restoration margin, mineral loss at only the highest laser energy density differed statistically from the control group. The difference between the irradiated groups was not statistically significant at either 50 or 100 microm from the restoration margin. In conclusion, irradiation of the cavosurface margin of cavities, using a pulsed CO(2) laser, is able to inhibit enamel demineralization around composite restorations, and an energy density of 16 J.cm(-2) is efficient, even at 100 microm from the cavity margin.

Objectives . To describe CO 2 laser characteristics and to review the literature regarding its effects on caries inhibition in enamel and dentin. Another aim of this review is to discuss the effects of CO 2 laser in combination with fluoride. Data and sources . The literature was searched for review and original research papers relating CO 2 laser characteristics, CO 2 laser effects on enamel and dentin, use of CO 2 laser in dental caries prevention and the effects of CO 2 laser in combination with fluoride. The articles have been selected using Medline and manual tracing of references cited in key papers otherwise not elicited. Study selection . Dental studies pertinent to key aspects of review, and those that focus on CO 2 laser. Conclusions . Irradiation of dental enamel by specific wavelengths and fluencies of CO 2 laser alters the hydroxyapatite crystals reducing the acid reactivity of the mineral; CO 2 laser irradiation in combination with fluoride treatment is more effective in inhibiting caries-like lesions than CO 2 laser irradiation or fluoride alone; When laser and fluoride are combined, it is possible to reduce laser energy density and fluoride levels; If this laser technology becomes available at a reasonable cost and the results can be applied in clinical practice, there will be a promising future for this laser in caries prevention.

This study aimed at investigating if CO2 laser irradiation (λ =10.6μm - 11.3 J/cm 2 ) combined with fluoridated products, enhances the CaF 2 formation on enamel surface and inhibits lesion progression of demineralized primary enamel. Thus, 135 demineralized primary enamel specimens (DES) were allocated to 9 groups (n=15) as follows: 1- DES only, 2- DES + pH cycling (control), 3- 1.23% acidulated phosphate fluoride gel (APF), 4- 1.23% fluoride foam (FF), 5- 5% fluoride varnish (FV), 6- CO 2 Laser (L), 7 - Laser during APF application, 8-Laser during FF application and 9-Laser during FV application. Except for the demineralized enamel group, all specimens were submitted to a 7 day pH cycling regime. The knoop hardness number (KHN) was determined by cross-sectional microhardness analysis. After treatments application, three specimens of each group had their surface examined for CaF 2 formation by scanning electron microscopy (SEM). The data was analyzed by ANOVA and Student's t-test (α= 0.05). Enamel mineral loss (ΔS) for groups 1 to 9 were respectively,(8,676.28±1,077.46b),(12,419.54±1,050.21a),(8,156.80±1,279.90b),(8,081.32±1,019.69b),(8,820.86±1,805. 99b),(8,723.45±1,167.14b),(9,003.17±796.90b),(8.229,03±961.25b),(9,023.32±1,1069b). The results showed statistically significant difference between control and all treatments groups (p0.05). SEM observations showed evidences of melting, fusion and calcium fluoride formation on enamel surface. In conclusion, laser irradiation alone or combined with fluoridated products inhibited lesion progression of demineralized primary enamel surface. However, no synergistic effect was observed when CO 2 laser irradiation and fluoridated products application were combined.