Efficiency of different protocols for oral hygiene combined with the use of chlorhexidine in the prevention of ventilator-associated pneumonia

Objective:

In ICU patients on mechanical ventilation (MV), ventilator-associated pneumonia (VAP) is a common infection. However, such infection can be prevented through oral care protocols. The objective of this study was to compare the efficiency of the use of chlorhexidine and oral hygiene protocols (brushing and clinical procedures) with that of the use of chlorhexidine alone (intervention group and control group, respectively) in decreasing the prevalence of VAP in patients ≥ 18 years of age admitted to the ICU and requiring MV.

Methods:

In this systematic review and meta-analysis, studies were identified through searches of various national and international databases, as well as of the gray literature, and were selected in accordance with eligibility criteria.

Results:

We evaluated six studies, involving a collective total of 1,276 patients. We classified the risk of bias as low in three studies, high in two, and uncertain in one; among the six risk domains evaluated, a low risk of bias was predominant in five. The results for random risks were similar in terms of direction and statistical magnitude-chi-square = 6.34; risk difference: −0.06 (95% CI: −0.11 to −0.02); I² = 21%; p = 0.007. There was a decrease in the prevalence of VAP in the intervention group (n = 1,276) included in the meta-analysis.

Conclusions:

Protocols that include the mechanical removal of oral biofilm in combination with the use of chlorhexidine can reduce the incidence of VAP among ICU patients requiring MV.

Evaluation of The Erosive Potential of Soft Drinks

Objectives: This in vitro study evaluated the capability of different soft drinks (Coca-Cola® -C, Coca- Cola Light® -CL, Guaraná® -G, Pepsi Twist® -P and Sprite Light® -SL) to erode dental enamel, relating the percentage of superficial microhardness change (%SMHC) to concentrations of fluoride and phosphate, buffering capacity and pH of these drinks.

Methods: The soft drinks were evaluated in respect to concentration of phosphate and fluoride spectrophotometrically using Fiske, Subarrow method and by specific electrode (Orion 9609), respectively. The pH and the buffering capacity were determined by glass electrode and by estimating of the volume of NaOH necessary to change the pH of the drink in one unit, respectively. One hundred specimens of bovine enamel were randomly assigned to 5 groups of 20 each. They were exposed to 4 cycles of demineralisation in the beverage and remineralisation in artificial saliva. The softening of enamel was evaluated by %SMHC.

Results: The mean %SMHC was:C=77.27%, CL= 72.45%, SL=78.43%, G=66.65% and P=67.95%. Comparing the %SMHC promoted by 5 soft drinks, SL = C > CL > P = G (P<.05). There was not significant correlation between %SMHC and the other variables tested for the five drinks (P>>.05)

Conclusions: The five soft drinks caused surface softening of enamel (erosion). In respect to the chemical variables tested, despite not statistically significant, the pH seems to have more influence on the erosive potential of these drinks. (Eur J Dent 2007;1:10-13)

Assessment of Oral Conditions and Quality of Life in Morbid Obese and Normal Weight Individuals: A Cross-Sectional Study

The aim of this study was to identify the impact of oral disease on the quality of life of morbid obese and normal weight individuals. Cohort was composed of 100 morbid-obese and 50 normal-weight subjects. Dental caries, community periodontal index, gingival bleeding on probing (BOP), calculus, probing pocket depth, clinical attachment level, dental wear, stimulated salivary flow, and salivary pH were used to evaluate oral diseases. Socioeconomic and the oral impacts on daily performances (OIDP) questionnaires showed the quality of life in both groups. Unpaired Student, Fisher’s Exact, Chi-Square, Mann-Whitney, and Multiple Regression tests were used (p<0.05). Obese showed lower socio-economic level than control group, but no differences were found considering OIDP. No significant differences were observed between groups considering the number of absent teeth, bruxism, difficult mastication, calculus, initial caries lesion, and caries. However, saliva flow was low, and the salivary pH was changed in the obese group. Enamel wear was lower and dentine wear was higher in obese. More BOP, insertion loss, and periodontal pocket, especially the deeper ones, were found in obese subjects. The regression model showed gender, smoking, salivary pH, socio-economic level, periodontal pocket, and periodontal insertion loss significantly associated to obesity. However, both OIDP and BOP did not show significant contribution to the model. The quality of life of morbid obese was more negatively influenced by oral disease and socio-economic factors than in normal weight subjects.

Periodontal status and pathogenic bacteria after gastric bypass: a cohort study

AIM

The aim this study was to evaluate the influence of gastric bypass surgery (GBS) on periodontal disease and quantify the periodontopathogenic bacteria in patients undergoing this surgery.

MATERIAL AND METHODS

This prospective study was composed of 50 patients who underwent bariatric surgery and the data collection was performed in three periods pre-operative, 6 (6M) and 12 months (12 M) postoperative. The oral clinical examination to assess periodontal disease; gingival fluid sample collection for quantification of the periodontopathogenic bacteria Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Prevotella intermedia using q-PCR; body mass index (BMI) and for collection of the individual's health-related data from medical files.

RESULTS

There was a significant reduction in serum C-reactive protein (CRP) and glucose levels after surgery. The mean probing pocket depth (PPD) and clinical attachment level (CAL) increased significantly in the postoperative period of 6 months (p = 0.001). In the same period, the amount of P. gingivalis increased (p = 0.028) and the other bacteria decreased slightly (p > 0.050). In the presence of P. gingivalis, T. forsythia, T. denticola and P. intermedia, a poor periodontal condition was observed.

CONCLUSION

The periodontal disease increased in severity and P. gingivalis increased after GBS. A systemic inflammation resolution due to bariatric surgery in obese subjects does not seem to affect the course of periodontal disease.

Prevalence, severity and etiology of dental wear in patients with eating disorders

OBJECTIVE

The purpose of this study was to evaluate the prevalence, distribution and associated factors of dental wear among patients with eating disorders (EDs).

MATERIALS AND METHODS

An epidemiological cross-sectional survey was conducted by trained, calibrated examiners, using the dental wear index. The sample was composed of 30 patients with EDs (experimental group - G1) and 30 control patients without current or previous history of EDs (G2). A questionnaire was used to assess the etiological factors of dental wear. The univariate analyses using the Chi-square (χ(2)) test were used to compare the tooth wear prevalence between groups according to the surface and tooth (P > 0.05).

RESULTS

The dental wear was similar for both group; however, the G1 presented more moderate wear in molars when compared with G2 (P = 0.048). The majority of EDs patients related have one or more oral habits (n = 26; 86.6%) and only 13.4% (n = 4) affirmed did not have oral habits. The etiological factors of tooth wear related with dental wear were biting objects (P = 0.04) and pain in temporomandibular disorders (P = 0.03).

CONCLUSION

The highest prevalence of dental wear was observed in the molars teeth. Differences in the extent and pattern of dental wear were found in an individual, emphasized the relevance of clinical parameter.

Effect of natural gel product on bovine dentin erosion in vitro

Objective

To evaluate the efficacy of Neem (Azadirachta indica) experimental gel for the prevention of erosive wear on bovine dentin, in vitro.

Material and Methods

One hundred dentin blocks were allocated into 5 experimental groups (20 samples each): C (control group, without gel); CG (control group, only base gel); F (fluoride gel, 1.23% NaF; pH 4.1, Dentsply; Brazil); N (Neem gel, 10% neem extract; pH 4.1, manipulation); NF (Neem+fluoride gel, 10% Neem extract and 1.23% NaF; pH 4.1, manipulation). The blocks were stored in artificial saliva for 24 hours. After this, they were submitted to six alternating re- and demineralization cycles. The blocks were analyzed for wear (profilometry). The results were submitted to statistical analysis by ANOVA and Tukey tests (P<0.05).

Results

The mean wear (±SD, µm) was shown as follows in groups: C (13.09±0.99), CG (10.60±1.99), F (10.90±1.44), N (12.68±1.13) and NF (10.84±1.65). All gels showed some preventive action when compared with control group. However, significant differences were found only between Neem+fluoride gel and fluoride gel.

Conclusion

A single application of a neem-containing fluoride gel reduced dentin erosion, thus it is a possible alternative in reducing dental wear. Further research should investigate the action mechanism and the synergism between them.

Impact of bariatric surgery on oral health conditions: 6-months cohort study

OBJECTIVES

We evaluate oral health conditions before and after bariatric surgery.

METHODS

The sample was composed of 59 patients who had undergone Roux-en-Y gastric bypass (RYGB). Salivary flow, periodontal pocket depth and dental wear were evaluated before and after 6 months of surgery. Body mass index (BMI), C-reactive protein (CRP) and glucose levels were obtained from the patient's medical files. A t-test was used for dependent samples.

RESULTS

The mean BMI decreased from 49.31 ± 8.76 to 35.52 ± 8.12 kg/m(2) in 6 months after surgery (P < 0.000). Before surgery, 67% of patients had high levels of CRP and 38% higher blood glucose levels and after surgery there were significant reductions in these levels (P < 0.001). Salivary flow ranged from 0.84 to 0.95 ml/min. There was increased prevalence of periodontal pockets (P = 0.022) and mean pocket depth increased to about 0.5 mm (P < 0.001). The percentage of surfaces with dental wear in dentine was significantly higher after bariatric surgery (P = 0.002), while dental wear in enamel decreased (P = 0.019).

CONCLUSIONS

Bariatric surgery may improve systemic conditions. However, it had a negative impact on oral health conditions because of an increase in periodontal disease and dental wear.

Manifestações bucais em pacientes portadores de Diabetes Mellitus: uma revisão sistemática

OBJETIVO: O objetivo deste estudo foi realizar uma revisão sistemática da literatura sobre a associação entre o Diabetes Mellitus e as manifestações bucais. MÉTODO: Os métodos aplicados incluíram estratégia de busca na literatura e critérios de inclusão e exclusão para a seleção dos artigos a serem adotados. As bases de dados incluídas foram PubMed, SciElo, BBO e LILACS, até setembro de 2011. Os artigos selecionados investigaram a associação ou não do Diabetes Mellitus com manifestações bucais, excluindo a doença periodontal. RESULTADO: De 1164 artigos encontrados, 30 deles estavam de acordo com os critérios de inclusão, podendo permanecer no estudo. As manifestações bucais foram associadas com Diabetes Mellitus em 20 estudos. Os desfechos relacionados foram candidíase, hipossalivação, líquen plano bucal, estomatite por dentadura e lesões linguais. CONCLUSÃO: Os pacientes portadores de Diabetes Mellitus estão mais predispostos a apresentar candidíase e hipossalivação, podendo agravar muito determinadas condições de saúde bucal.

Dental fluorosis in the primary dentition and intake of manufactured soy-based foods with fluoride

BACKGROUND & AIMS

To identify manufactured soy-based products more recommended by pediatricians and nutritionists; to determine fluoride concentrations in these products; to evaluate children concerning fluorosis in primary teeth and its association with the consumption of soy-based products.

METHODS

Pediatricians and Nutritionists answered a questionnaire about soy-based products they most recommended to children. Fluoride concentrations of the 10 products more cited were analyzed with the ion-specific electrode. Dental fluorosis exams were performed in 315 4-6-year-old children. Dean's Index was used to assess fluorosis. Among the children examined, 26 had lactose intolerance. Their parents answered a questionnaire about children's and family's profile, besides permitting the identification of soy-based products use. Chi-squared and Multivariable Logistic Regression tests were used (p < 0.05).

RESULTS

Fluoride content in the analyzed products ranged from 0.03 to 0.50 μg F(-)/mL. Dental fluorosis was detected in 11% of the children, with very mild and mild degrees. Dental fluorosis in primary teeth was associated with lactose intolerance (p < 0.05), but there was no significant association with the use of manufactured soy-based products.

CONCLUSIONS

Isolated consumption of soy-based products recommended by health professionals to children do not offer risk of dental fluorosis in primary teeth, which had a low prevalence and severity.

Tamanho de amostra e estimativa de custo em levantamento epidemiológico de cárie dentária

O objetivo do presente estudo foi analisar como a prevalência e a distribuição da cárie dentária influenciam o tamanho da amostra em levantamentos epidemiológicos, e os custos para sua realização. Foram utilizados dados de levantamentos realizados em escolares de 12 anos em Bauru nos anos de 1976, 1984, 1990, 1994 e 2001, e em Piracicaba nos anos de 2001 e 2005. Os tamanhos amostrais foram dimensionados considerando-se a média e o desvio padrão obtidos, fixando-se erro amostral em 1%, 2%, 5% e 10%. Os custos foram estimados considerando material permanente, de consumo e recursos humanos. Verificou-se aumento no tamanho das amostras em ambos os municípios, variando de 119 em 1976 para 1.118 em 2001 em Bauru, e de 954 em 2001 para 1.252 em 2005 em Piracicaba, considerando-se um erro amostral de 10%. Considerando-se diferentes erros amostrais, verificou-se o custo para o levantamento, sendo que o mesmo depende do quanto o pesquisador se permite errar em relação ao verdadeiro valor da média da população. Conclui-se que a diminuição da prevalência da cárie dentária determinou o aumento no tamanho das amostras e a elevação dos custos para realização dos levantamentos.

Oral manifestations in HIV+ children in Mozambique

The scope of this study was to identify the prevalence of oral manifestations in HIV+/AIDS patients at the DIA Pediatric Hospital of Maputo. All 90 patients were included in the research. Data on dental caries (dmft/DMFT index), soft tissues and saliva flow were analyzed. Information on diet and hygienic habits was obtained in a semi-structured questionnaire. The t- student and chi-square tests were used for statistical assessment. The most frequent oral lesion was candidiasis (5.5%) and upon further oral examination the prevalence of parotid enlargement was 23.0%. The mean dmft 2.6 (SD 3.6) was considerably higher in relation to DMFT of 0.6 (SD 1.6), and the differences between them were statistically significant (P<0.05). The occurrence of mucosal lesions was higher in children who did not take antiretroviral therapy (ART) (p= 0.026). The use of ART is associated with reduced prevalence of oral lesions in HIV+ patients; however, rampant caries were highest in this group. Primary dentition of HIV+ patients should be considered high risk for caries.

[Terms of informed consent for users of dental clinics in Brazil: legal and ethical issues]

The consent of patient before the beginning of any procedure has to be a respected condition, without any exception. It is necessary the patients to be aware of their health status, their specific needs, the intention of each treatment, the alternatives plans (including no treatment), to know their prognostic, risks, consequences, limitations, and to be aware of their responsibilities and those of your dentist, resulting in the success of the treatment. The Informed Consent (TCLE) aims to fortify and to clarify the position of the patient, being established the rights and duties of both parts - patient and professional. The integral knowledge of the treatment will minimize the anxiety of the patient and treatment complications, and promote greater quality of dental services and improve the satisfaction of both dentist and patient. However, there are few articles in Brazil about this, but there are some ethics problems involving dental clinics regarding this document of information for the patient. Therefore, the aim of this work is to carry through a critical revision on the subject demonstrating the importance of the TCLE in the Brazilian dental clinics.

Effect of iron gel on dentin permeability

This study evaluated in vitro the effect of an experimental gel containing iron on the reduction of hydraulic conductance of dentin. Thirty-six 1-mm-thick dentin discs obtained from extracted human third molars were divided into 3 groups of 10 specimens each. The groups corresponded to the following experimental materials: 1.23% acidulated phosphate fluoride gel, pH 4.1; 3% potassium oxalate gel, pH 4.1 (Oxa-Gel®); and iron sulfate gel (10 mmol/L FeSO4), pH 4.1. The gels were applied to dentin under the following conditions: after 37% phosphoric acid and before 6% citric acid. Data were analyzed statistically by ANOVA and Tukey's test at 5% significance level. There was no significant differences (p<0.05) among the groups in any of the conditions for hydraulic conductance reduction, except for smear layer presence. The active agents reduced dentin permeability, but they produced significantly lower (p<0.05) reduction in hydraulic conductance when compared to presence of smear layer. The effectiveness in reducing dentin permeability was not significantly different (p>0.05) among the gels. This study suggests that the iron gel promoted reduction in dentin permeability comparable to that of the other agents and thus may be considered a good clinical alternative for the treatment of dentin hypersensitivity.

Prevalência de sobrepeso e obesidade e fatores associados em adolescentes na região centro-oeste do estado de São Paulo (SP, Brasil)

Objetivou-se avaliar a relação entre o Índice de Massa Corporal (IMC) e o índice CPOD em 207 adolescentes de 12 anos, de 8 escolas públicas e particulares da região centro-oeste do estado de São Paulo. A amostra foi constituída por 380 adolescentes aos 12 anos, de ambos os gêneros, sendo examinados 207. Utilizou-se o índice CPOD, IMC para peso, medida de estatura, e aplicou-se questionário sobre hábitos alimentares, características antropométricas e atividade física. Quanto ao peso corpóreo, 55,93% apresentaram normal (G4), 35,59% de baixo peso (G3), 8,47% de pré-obesos (G2), nas escolas particulares. Nas públicas, 52,03% apresentaram normal, baixo peso 41,22%, pré-obesos 4,73% e obesos (G1) 2,03%; não houve diferença significativa (p=0,45). Verificou-se que o CPOD nas escolas públicas foi 2,16 e nas particulares, 0,23 (p<0,05), sendo que 39,2% das crianças estavam livres de cárie nas municipais e nas particulares, 88,1%. Não houve correlação do maior IMC com o incremento de CPOD. Houve correlação negativa entre condições socioeconômicas e índice de cárie dentária. Concluiu-se que os grupos pré-obesos e obesos, embora houvesse maior frequência de ingestão de alimentos, não apresentaram correlação com o incremento de cárie dentária, mas as condições socioeconômicas foram determinantes para essa ocorrência.

Tooth-wear patterns in adolescents with normal occlusion and Class II Division 2 malocclusion

INTRODUCTION

In this study, we investigated tooth-wear patterns in adolescents with either normal occlusion or Class II Division 2 malocclusion.

METHODS

The sample consisted of dental casts from 165 subjects that were divided into 2 groups: 115 normal occlusion subjects (mean age, 14.3 years) and 50 complete Class II Division 2 subjects (mean age, 13.9 years). Dental wear was assessed by using a modified version of the tooth wear index. The 2 groups were compared with the Mann-Whitney test for the frequency and severity of wear on each surface of each group of teeth. The level of statistical significance was set at 5%.

RESULTS

The normal occlusion group statistically had greater tooth wear on the incisal surfaces of the maxillary lateral incisors and the incisal surfaces of the maxillary canines than did the Class II Division 2 malocclusion group. The malocclusion group showed statistically greater tooth wear on the labial surfaces of the mandibular lateral incisors, the occlusal surfaces of the maxillary premolars and first molars, the occlusal surfaces of the mandibular premolars, the palatal surfaces of the maxillary second premolars, and the buccal surfaces of the mandibular premolars and first molars than did the normal occlusion group.

CONCLUSIONS

Subjects with normal occlusion and those with complete Class II Division 2 malocclusions have different tooth-wear patterns. Tooth wear on the malocclusion subjects should not be considered pathologic but, rather, the consequence of different interocclusal arrangements.

Análise de diferentes estudos epidemiológicos em Audiologia realizados no Brasil

TEMA: a audição, responsável pela aquisição e desenvolvimento da linguagem, é um dos sentidos que permitem a ocorrência das relações interpessoais e com o meio ambiente. Desta forma, o levantamento epidemiológico da prevalência de deficientes auditivos em uma comunidade é de extrema importância para a adequação das medidas de saúde pública nos vários níveis de prevenção. OBJETIVO: verificar na literatura científica, estudos que tiveram por interesse a busca de conhecimento no âmbito epidemiológico relacionados à perda auditiva no Brasil. Foram utilizados um total de 13 artigos sendo, 11 de estudos transversais, um estudo caso-controle, e outro estudo de coorte. CONCLUSÃO: Os trabalhadores expostos a ruído ocupacional têm recebido maior atenção por parte dos estudos epidemiológicos, diferentemente da população idosa e neonatal. Apenas um estudo com base populacional, seguindo o Protocolo sugerido pela OMS, foi realizado. É importante a realização de mais estudos relacionados à deficiência auditiva no país a fim de elaborar ações de saúde e assistência adequadas às necessidades locais.

Tooth-wear patterns in subjects with Class II Division 1 malocclusion and normal occlusion

INTRODUCTION

The aim of this study was to investigate the prevalence of tooth wear in adolescents with Class II malocclusion, compared with those with normal occlusion.

METHODS

The sample consisted of dental casts obtained from 310 subjects, divided into 3 groups: group 1, 110 subjects with normal occlusion (mean age, 13.51 years); group 2, 100 complete Class II Division 1 patients (mean age, 13.44 years); and group 3, 100 half-cusp Class II Division 1 patients (mean age, 13.17 years). Dental wear was assessed by using a modified version of the tooth-wear index. The 3 groups were compared by means of the Kruskal-Wallis and Dunn tests, considering the frequency and the severity of wear on each surface of each group of teeth. The level of statistical significance was set at 5%.

RESULTS

The normal occlusion group had statistically greater tooth wear on the palatal surfaces of the maxillary central incisors and the incisal surfaces of the maxillary canines than the corresponding surfaces in both Class II malocclusion groups. The complete and half-cusp Class II Division 1 malocclusion groups had statistically greater tooth wear on the occlusal surfaces of the maxillary second premolar and first molar, the occlusal surfaces of the mandibular premolars, and the buccal surfaces of the mandibular posterior teeth compared with the normal occlusion group. The half-cusp Class II Division 1 malocclusion group had significantly greater tooth wear on the incisal surfaces of the mandibular incisors compared with the complete Class II Division 1 malocclusion group.

CONCLUSIONS

Subjects with normal occlusion and complete or half-cusp Class II Division 1 malocclusions have different tooth-wear patterns. Tooth wear on the malocclusion subjects should not be considered pathologic but rather consequent to the different interocclusal tooth arrangement.

Use of DNA technology in forensic dentistry

The established importance of Forensic Dentistry for human identification, mainly when there is little remaining material to perform such identification (e.g., in fires, explosions, decomposing bodies or skeletonized bodies), has led dentists working with forensic investigation to become more familiar with the new molecular biology techniques. The currently available DNA tests have high reliability and are accepted as legal proofs in courts. This article presents a literature review referring to the main studies on Forensic Dentistry that involve the use of DNA for human identification, and makes an overview of the evolution of this technology in the last years, highlighting the importance of molecular biology in forensic sciences.

Effect of iron on the dissolution of bovine enamel powder in vitro by carbonated beverages

OBJECTIVES

The aim of this study was to evaluate, in vitro, the effect of iron on the dissolution of bovine enamel powder, when added to two carbonated beverages.

DESIGN

Powdered enamel was produced by griding enamel fragments of bovine incisor in a steel pestle and mortar. Particles between 75 and 106 microm were selected using appropriated meshes. At time zero, the carbonated beverage (Coke or Sprite Zero) was added to powdered enamel (1 mg enamel powder/10 microL of beverage) and vortexed for 30 s. The sample was immediately centrifuged (11,000 rpm) for 30 s and the supernatant was removed at 1 min 40 s. This procedure was repeated five times with the beverage containing increasing ferrous sulphate concentrations (1.25, 2.5, 5, 10, 15, 30 and 60 mmol/L). The phosphate released in the medium was analysed spectrophotometrically. Data were analysed using ANOVA and Tukey's test (p<0.05).

RESULTS

When iron at 30 and 60 mmol/L was added to Coke, a significant reduction in the dissolution of powdered enamel was observed when compared to control (11 and 17%, respectively), while lower iron concentrations did not have any effect on enamel powder dissolution. Regarding Sprite Zero, iron concentrations up to 10 mmol/L had no significant effect, while higher concentrations significantly increased enamel powder dissolution.

CONCLUSIONS

The results suggest that iron can interfere with the dissolution of dental enamel powder in the presence of acidic beverages and the type of acid in these beverages seems to modulate this effect.

Effect of iron on acid demineralisation of bovine enamel blocks by a soft drink

OBJECTIVES

The aim of this study was to evaluate, in vitro, the effect of iron on the acid demineralisation of bovine enamel blocks by a soft drink.

DESIGN

Twenty-four blocks of bovine enamel were randomly assigned to two groups (experimental and control), which were exposed to 4 cycles of demineralisation in Coke containing or not 10 mmol/L of iron, respectively, and another 4 cycles of remineralisation in artificial saliva. The softening of enamel was evaluated by % superficial microhardness change (SMHC) and wear analysis. Data were analysed using t-test (p<0.05).

RESULTS

With regard to %SMHC, the experimental group presented average values (+/-S.E.) of -85.3+/-0.9, that were significantly higher (t=4.7, p<0.01) than the ones observed for control group (-76.7+/-1.6). The experimental group presented a mean wear (+/-S.E.) of 2.3+/-0.2 microm, that was significantly lesser (t=3.7, p<0.01) than the one observed for the control group (3.5+/-0.2 microm).

CONCLUSIONS

According to this protocol, iron at 10 mmol/L significantly reduced the wear, but significantly enhanced the %SMHC of enamel blocks submitted to erosion by Coke.

Effect of iron supplementation on the erosive potential of carbonated or decarbonated beverage

This study evaluated, in vitro, the effect of iron (previously exposed with enamel powder or added directly to the beverage) on the erosive potential of carbonated or decarbonated beverage. Four sets of experiments were done. For groups E1 and E3, a solution containing 30 mmol/L FeSO4 was added to bovine enamel powder (particles between 75-106 mm) before exposure to the carbonated or decarbonated beverage (Sprite Zero(R)), respectively. For groups E2 and E4, 15 mmol/L FeSO4 was added directly to the carbonated or decarbonated beverage, respectively. Control groups were included for comparison. In controls C1 and C3, the experiments E1 and E3 were repeated, but the iron solution was replaced by deionized water. For controls C2 and C4, the carbonated and decarbonated beverage, respectively, was used, without addition of iron. After addition of the beverage to the powdered enamel (40 mg enamel powder/400 mL of final volume), the sample was vortexed for 30 s and immediately centrifuged for 30 s (11,000 rpm). The supernatant was removed after 1 min 40 s. This procedure was repeated in quintuplicate and the phosphate released was analyzed spectrophotometrically. The results were analyzed by Student's t-test (p<0.05). E2 presented the best results with a significant inhibition (around 36%) of phosphate released. For E3 and E4 a non-significant inhibition (around 4 and 12%, respectively), was observed. For E1 an increase in phosphate loss was detected. Thus, the protective effect of iron seems to be better when this ion is directly added to the carbonated beverage.

Evaluation of the erosive potential of soft drinks

OBJECTIVES

This in vitro study evaluated the capability of different soft drinks (Coca-Cola(R)-C, Coca-Cola Light(R)-CL, Guaraná(R)-G, Pepsi Twist(R)-P and Sprite Light(R)-SL) to erode dental enamel, relating the percentage of superficial microhardness change (%SMHC) to concentrations of fluoride and phosphate, buffering capacity and pH of these drinks.

METHODS

The soft drinks were evaluated in respect to concentration of phosphate and fluoride spectrophotometrically using Fiske, Subarrow method and by specific electrode (Orion 9609), respectively. The pH and the buffering capacity were determined by glass electrode and by estimating of the volume of NaOH necessary to change the pH of the drink in one unit, respectively. One hundred specimens of bovine enamel were randomly assigned to 5 groups of 20 each. They were exposed to 4 cycles of demineralisation in the beverage and remineralisation in artificial saliva. The softening of enamel was evaluated by %SMHC.

RESULTS

The mean %SMHC was: C=77.27%, CL= 72.45%, SL=78.43%, G=66.65% and P=67.95%. Comparing the %SMHC promoted by 5 soft drinks, SL = C > CL > P = G (P<.05). There was not significant correlation between %SMHC and the other variables tested for the five drinks (P>.05).

CONCLUSIONS

The five soft drinks caused surface softening of enamel (erosion). In respect to the chemical variables tested, despite not statistically significant, the pH seems to have more influence on the erosive potential of these drinks. (Eur J Dent 2007;1:10-13).

[An epidemiological profile of dental caries in 12-year-old children residing in cities with and without fluoridated water supply in the central western area of the State of São Paulo, Brazil]

This study aimed to analyze the epidemiological profile of dental caries in the central western region of the State of São Paulo, Brazil, focusing on 12-year-old children by gender, comparing the DMFT index in fluoridated and non-fluoridated cities. The study used data from the Epidemiological Surveys in the State of São Paulo, 1998, pertaining to the 10th Regional Health Directorate, including 8 cities. The sample consisted of 485 schoolchildren, both boys and girls, distributed by city. In Pederneiras (a medium-sized city with a fluoridated water supply), DMFT was 7.06, higher than the Brazilian national mean for 1986. Boys showed a higher prevalence of dental caries than girls, showing a new trend for dental caries in the region. There was no statistically significant difference between DMFT in municipalities of the same size, regardless of the presence or absence of fluoride in the water supply, thus suggesting a "convergence" phenomenon, possibly due to the intake of other sources of fluoride and the presence of a "halo" effect. Prevalence of caries in the region was "high", with a DMFT of 4.82, thus failing to reach the goals set for the year 2000.