RESUMO
OBJECTIVES: The aim of this study was to assess the survival of composite restorations after selective (SCR) or total caries removal (TCR) and determine predictors of failures after 36 months. METHODS: 120 teeth with deep occlusal or occlusal-proximal carious lesions were randomly divided into control (TCR; n = 54; 69% Class II) and test (SCR; n = 66; 63% Class II) groups. Clinical evaluation was applied using the USPHS criteria, and the presence of Charlie or Delta scores at the marginal integrity were considered as a failure. RESULTS: The overall survival rate of restorations was 68% after 36 months, 81% for TCR and 57% for SCR (p = 0.004). The multivariable Cox Regression model demonstrated that restorations performed after SCR had 3.44 times greater probability of failure compared to TCR (p = 0.006). The other two predictors for failure of restorations were teeth with Class II cavities (hazard ratio = 3.3) and children with gingival bleeding over 20% (hazard ratio = 2.5). CONCLUSIONS: Performing composite restorations after SCR in primary teeth had success rate significantly lower than restorations performed after TCR. Complex cavities and worst patient´s oral hygiene were found to be predictors of failure of restorations. CLINICAL SIGNIFICANCE: Although SCR has been demonstrating high rates of pulp preservation, clinicians should consider that composite restorations fail in a higher frequency compared to TCR in primary teeth and, in some circumstances, may be preferable in terms of restoration longevity.
Assuntos
Cárie Dentária , Restauração Dentária Permanente , Criança , Resinas Compostas , Falha de Restauração Dentária , Humanos , Dente DecíduoRESUMO
PURPOSE: The purpose of this in vitro study was to evaluate, via scanning electron microscopy, the micromorphology of the dentine walls of primary anterior teeth with focus on the presence of the smear layer after endodontic debridement and final irrigation with different systems. METHODS: Thirty primary maxillary anterior teeth were assigned to 3 groups according to the final irrigant solution. Group 1 received 1% sodium hypochlorite; Group 2 received 17% EDTA followed by 1% sodium hypochlorite; and Group 3 received 6% citric acid followed by 1% sodium hypochlorite. The canals were debrided using 1% sodium hypochlorite to a size 30 file, and the final irrigation was performed with one of the 3 irrigants as assigned. The teeth were prepared for examination of the canal walls by electron microscopy for the presence or absence of the smear layer. RESULTS: Group 1 had significantly higher scores for remaining smear layer than Groups 2 and 3 (P<.01), while Groups 2 and 3 presented similar smear layer score values. CONCLUSIONS: Sodium hypochlorite promoted the formation of a smear layer during shaping, and the use of EDTA and citric acid facilitated smear layer removal.
Assuntos
Ácido Cítrico/farmacologia , Ácido Edético/farmacologia , Irrigantes do Canal Radicular/farmacologia , Preparo de Canal Radicular/métodos , Camada de Esfregaço , Dente Decíduo , Ácido Cítrico/administração & dosagem , Desbridamento , Cavidade Pulpar/efeitos dos fármacos , Cavidade Pulpar/ultraestrutura , Ácido Edético/administração & dosagem , Humanos , Técnicas In Vitro , Maxila , Microscopia Eletrônica de Varredura , Irrigantes do Canal Radicular/administração & dosagem , Hipoclorito de Sódio/administração & dosagem , Hipoclorito de Sódio/farmacologia , Soluções/farmacologia , Estatísticas não Paramétricas , Irrigação TerapêuticaRESUMO
It is known that stem cells from exfoliated deciduous teeth (SHED) can be induced to differentiate into odontoblasts. However, the nature of dentin-derived morphogenic signals required for dental pulp stem cell differentiation remains unclear. The hypothesis underlying this work is that dentin-derived Bone Morphogenetic Proteins (BMP) are necessary for the differentiation of SHED into odontoblasts. We observed that SHED express markers of odontoblastic differentiation (DSPP, DMP-1, MEPE) when seeded in human tooth slice/scaffolds and cultured in vitro, or implanted subcutaneously into immunodeficient mice. In contrast, SHED cultured in deproteinized tooth slice/scaffolds, or scaffolds without a tooth slice, do not express these markers. SHED express the BMP receptors BMPR-IA, BMPR-IB, and BMPR-II. Notably, blockade of BMP-2 signaling inhibited the expression of markers of odontoblastic differentiation by SHED cultured in tooth slice/scaffolds. Collectively, this work demonstrates that dentin-derived BMP-2 is required to induce the differentiation of SHED into odontoblasts.
Assuntos
Proteína Morfogenética Óssea 2/farmacologia , Dentina/enzimologia , Odontoblastos/efeitos dos fármacos , Animais , Anticorpos Neutralizantes/farmacologia , Biomarcadores/análise , Western Blotting , Proteína Morfogenética Óssea 2/antagonistas & inibidores , Proteína Morfogenética Óssea 7/antagonistas & inibidores , Proteína Morfogenética Óssea 7/farmacologia , Receptores de Proteínas Morfogenéticas Ósseas Tipo I/análise , Receptores de Proteínas Morfogenéticas Ósseas Tipo II/análise , Diferenciação Celular/efeitos dos fármacos , Diferenciação Celular/fisiologia , Células Cultivadas , Polpa Dentária/citologia , Proteínas da Matriz Extracelular/análise , Glicoproteínas/análise , Humanos , Camundongos , Camundongos SCID , Fosfoproteínas/análise , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Sialoglicoproteínas/análise , Transdução de Sinais/efeitos dos fármacos , Células-Tronco/efeitos dos fármacos , Células-Tronco/fisiologia , Tela Subcutânea/cirurgia , Alicerces Teciduais , Dente Decíduo/citologiaRESUMO
PURPOSE: The purpose of this study was to investigate dentin rehardening in the remaining carious dentin after indirect pulp treatment (IPT) using microhardness analysis after 37 to 71 months. METHODS: Eighteen teeth submitted to IPT and capped with calcium hydroxide (CH) or gutta-percha (GP) were evaluated (treated group). Ten sound molars and 10 molars with deep acute carious lesions were selected to serve as positive and negative control groups, respectively. In the treated group, restorations and pulp-capping materials were removed. In the positive control group, 3- to 4-mm deep cavities were prepared. In the negative control group, the carious tissue was removed. Microhardness analysis was performed at 10-, 35-, 60-, 85-, and 110-microm depths. Data were analyzed using 1-way analysis of variance (P<.05). RESULTS: Microhardness values for sound, carious, and treated groups at 10-, 35-, 60-, 85-, and 110-microm depths showed a statistically significant difference (PAssuntos
Capeamento da Polpa Dentária/métodos
, Dentina/fisiopatologia
, Hidróxido de Cálcio/uso terapêutico
, Criança
, Cárie Dentária/terapia
, Guta-Percha/uso terapêutico
, Dureza
, Humanos
, Dente Molar
, Esfoliação de Dente
, Remineralização Dentária/métodos
, Dente Decíduo
RESUMO
OBJECTIVES: This study investigated grey levels and radiolucent lesion depth as cavity predictors for approximal dentin caries lesions in primary teeth. METHODS: 51 children (4-10 years old), presenting with radiolucency in the outer half of the dentin on the approximal surfaces of deciduous molar teeth and approximal anatomic contact with the adjacent tooth (without restoration or cavitated caries lesion), participated in the study. Bitewing radiographs were made, and temporary tooth separation was performed and an impression taken to detect cavitation. Radiographs were scanned (300 dpi) and grey levels were measured in carious and sound dentin. Impressions were also scanned and the size of cavity opening was measured in square millimetres. RESULTS: Grey levels of carious dentin (115.27+/-33.52) were significantly lower compared with sound dentin (151.88+/-30.99). No significant differences were observed in the dentin degree of radiolucency between "cavitated" and "non-cavitated" carious dentin. Cavitated lesions showed deeper radiolucent lesions compared with non-cavitated ones (P=0.03). There was no association between the size of cavitation and radiolucent lesion depth. CONCLUSIONS: Grey levels did not indicate cavitation in the outer half of the approximal dentin lesions. However, extension of a radiolucent lesion deep into the outer half of the dentin was associated with cavitated lesions independently of the size of cavitation. A computer-aided image analysis may help clinicians in monitoring caries progression and evaluating the probability of occurrence of cavitated caries lesions.
Assuntos
Cárie Dentária/diagnóstico por imagem , Dentina/diagnóstico por imagem , Dente Decíduo/diagnóstico por imagem , Absorciometria de Fóton , Criança , Pré-Escolar , Esmalte Dentário/diagnóstico por imagem , Técnica de Moldagem Odontológica , Previsões , Humanos , Processamento de Imagem Assistida por Computador , Dente Molar/diagnóstico por imagem , Radiografia Interproximal , Radiografia Dentária Digital , Reprodutibilidade dos TestesRESUMO
CONTEXT: Routine immunization of groups at high risk for influenza has been progressively implemented as a matter of Brazilian public health policy. Although the benefits of the vaccination for healthy young adults are still controversial, it has been offered yearly to hundreds of thousands of Brazilian workers, generally as part of wellness initiatives in the workplace. OBJECTIVE: To study the characteristics of subjects that accepted or refused to be vaccinated against influenza and to report on respiratory symptoms in both groups, one year after the campaign date. DESIGN: A prospective observational study. SETTING: Workers at a subsidiary of an international bank in São Paulo, Brazil. PARTICIPANTS: 124 persons that did not accept and 145 that voluntarily accepted the vaccine completed 12 months of follow-up. MAIN MEASUREMENTS: Data concerning gender, age, tobacco use, and any history of chronic respiratory illness such as asthma, bronchitis, rhinitis, and repetitive upper-respiratory infections, were recorded at the time of vaccination. After that, workers were asked monthly by questionnaire or telephone about respiratory symptoms, days of work lost and medical consultations. RESULTS: The results showed statistically significant differences regarding age (P = 0.004) with the vaccinated group (V) being younger than the non-vaccinated (NV) one, and with reference to previous repetitive upper-respiratory infections being higher among the V group (P < 0.0001). During the follow-up, the V group reported more occurrences of upper respiratory symptoms (P < 0.0001), due to both non-influenza (P < 0.0001) and influenza-like illness (P = 0.045). Differences were also found between V and NV groups concerning days off work and number of medical consultations due to upper-respiratory symptoms and non-influenza illness. Gender and history of repetitive upper-respiratory infections were the best predictors of influenza-like illness-related events. CONCLUSIONS: The making of previous reference to repetitive upper-respiratory infections was a major difference between those who accepted or rejected the vaccine. The vaccination itself was not sufficient to reduce the number of occurrences of respiratory symptoms and related absenteeism to levels similar to those found among non-vaccinated people.
Assuntos
Promoção da Saúde , Vacinas contra Influenza/administração & dosagem , Aceitação pelo Paciente de Cuidados de Saúde , Doenças Respiratórias/epidemiologia , Vacinação , Adulto , Brasil/epidemiologia , Feminino , Seguimentos , Humanos , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Masculino , Estudos Prospectivos , Doenças Respiratórias/prevenção & controle , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/prevenção & controleRESUMO
Bruxism occurs in nearly 60% of children between 3 and 5 years, with important repercussions to the different components of the stomatognathic system. Nevertheless, there is little information in the literature about this topic. The aim of this study was to compare two groups of children with bruxism. One group was not submitted to treatment, serving as a control. To the other group, nocturnal bite plate was made. Cast models were made for both groups, to evaluate the progression of wear facets, during 8 months. The results are as follows: The 4 children of the control group displayed increased wear facets during the study period. On the other hand, of the 5 children that used nocturnal bite plate, showed no increase of wear facets, even after the removal of the device. From this study, we can conclude that the use of nocturnal bite plate is efficient against bruxism in 3- to 5-year-old children.
Assuntos
Bruxismo/prevenção & controle , Placas Oclusais , Abrasão Dentária/prevenção & controle , Bruxismo/complicações , Pré-Escolar , Humanos , Sono , Abrasão Dentária/etiologiaRESUMO
This study determined the shear bond strength of resin composites to primary dentin using three dentin adhesives and the presence or absence of a hybrid zone. The buccal and lingual surfaces of 40 recently extracted noncarious primary teeth were ground flat with SiC paper ending with the 600 grit. The teeth were divided at randomly into eight groups of five teeth (10 surfaces) each: 1) Unetched dentin, dry dentin, All-Bond 2/Bis-Fil P; 2) Unetched dentin, moist dentin, All-Bond 2/Bis-Fil P; 3) Dentin etched for 15 sec with 10% phosphoric acid, dry dentin, All-Bond 2/Bis-Fil P; 4) Dentin etched for 15 sec with 10% phosphoric acid, moist dentin, All-Bond 2/Bis-Fil P; 5) Dentin etched with 10% maleic acid for 15 sec, dry dentin, Scotchbond Multi-Purpose/Z100; 6) Dentin etched with 10% maleic acid for 15 sec, moist dentin, Scotchbond Multi-Purpose/Z100; 7) Dentin etched with 10 citric acid/3% ferric chloride, dry dentin, Amalgambond Plus/Z100; 8) Dentin etched with 10 citric acid/3% ferric chloride, moist dentin, Amalgambond Plus/Z100. All teeth were thermocycled 1000x (5 and 55 degrees C, 30-sec dwell time), and shear bond strength testing was conducted using an Instron (crosshead speed 0.5 mm/min). Failure sites after debonding were examined with the SEM. For each group, one additional tooth was used to prepare two class V cavities (one facial and one lingual) restored according to the specification in each group, sectioned buccolingually and examined with the SEM. The results, in MPa, were: 1) 12.55 +/- 5.97; 2) 10.41 +/- 6.16; 3) 9.94 +/- 7.26; 4) 12.25 +/- 4.70; 5) 13.02 +/- 8.01; 6) 16.51 +/- 8.62; 7) 12.51 +/- 8.95; 8) 17.93 +/- 6.44. ANOVA and Student-Newman-Keuls tests showed no statistically significant differences. SEM evaluation showed that the smear layer was removed in all groups exposing primary dentin tubules infiltrated by resin. A resin-reinforced hybrid layer was readily seen in all specimens.
Assuntos
Compostos Inorgânicos de Carbono , Colagem Dentária , Adesivos Dentinários/química , Dentina/ultraestrutura , Cimentos de Resina , Dente Decíduo/ultraestrutura , Condicionamento Ácido do Dente , Adesivos/química , Análise de Variância , Carbono , Cloretos , Ácido Cítrico/administração & dosagem , Resinas Compostas/química , Preparo da Cavidade Dentária/classificação , Restauração Dentária Permanente , Análise do Estresse Dentário , Compostos Férricos/administração & dosagem , Humanos , Maleatos/administração & dosagem , Teste de Materiais , Metacrilatos/química , Microscopia Eletrônica de Varredura , Ácidos Fosfóricos/administração & dosagem , Compostos de Silício , Dióxido de Silício/química , Camada de Esfregaço , Estresse Mecânico , Propriedades de Superfície , Termodinâmica , Fatores de Tempo , Zircônio/químicaRESUMO
This report describes a young patient with fusion of a maxillary central incisor to a supernumerary tooth. Treatment involved extraction of the fused tooth and orthodontic movement of the lateral incisor to occupy the position of the extracted tooth. A resin composite laminate veneer was placed on the lateral incisor to simulate the appearance of a central incisor. Five years of follow-up revealed that treatment had successfully restored esthetics and function.
Assuntos
Estética Dentária , Dentes Fusionados/terapia , Incisivo/anormalidades , Criança , Resinas Compostas/uso terapêutico , Facetas Dentárias , Seguimentos , Humanos , Masculino , Maxila , Ortodontia Corretiva , Extração DentáriaRESUMO
PURPOSE: To compare the accuracy of clinical examination performed with bitewing radiographs or clinical examination using tooth separation to identify carious lesion activity. MATERIALS AND METHODS: 320 surfaces from 40 bitewing radiographs were examined for approximal caries on the maxillary and mandibular primary molars of 20 patients 3-10 years old. The patients were divided into three groups: (1) Absence of the permanent first molar; (2) Partial eruption of the permanent first molar; and (3) Full eruption of the permanent first molar. Two examiners evaluated the radiographs using a megascope, a magnifying glass (x2), and an amplifying image screen. Approximal radiolucencies were identified on 72 surfaces. Following the radiographic examinations, the two examiners performed conventional clinical inspection using a No. 4 dental mirror, a No. 5 dental explorer, and an air-water syringe, with artificial light and relative isolation. The separation method was performed with elastic bands, which were removed after 24 hours, and the clinical examination conducted as in the non-separation group. RESULTS: The correlation between the extension of interproximal radiolucent lesions in primary dentition and their clinical diagnoses following separation of the teeth, was similar to findings on literature evaluating the permanent dentition. On radiographic findings for enamel lesions, white spots predominated both in the inner (100%) and in the outer (94%) half of enamel upon clinical examination with separation of teeth. For radiolucent lesions in dentin, on the other hand, cavities predominated over white spot lesions (84%). In Groups 1 and 2 (young primary), white spots occurred in cases where the radiolucent lesions reached the dentin (15% and 25%), similar to findings for young permanent teeth. Clinical diagnosis performed with the mechanical separation of teeth cannot be considered conclusive for the primary dentition.
Assuntos
Cárie Dentária/diagnóstico , Dente Molar/diagnóstico por imagem , Dente Decíduo/diagnóstico por imagem , Criança , Pré-Escolar , Diagnóstico Bucal , Estudos de Avaliação como Assunto , Feminino , Humanos , Masculino , Mandíbula , Maxila , Radiografia InterproximalRESUMO
An antioxidant defense system consisting of enzymes and non-enzymatic compounds prevents oxidative damage of lipoproteins in the plasma. When the activity of this system decreases or the reactive oxygen species (ROS) production increases, an oxidative stress may occur. Since fatty acids and triglyceride-rich emulsions can stimulate leukocytes to produce ROS, it is conceivable that raised plasma triglyceride-rich lipoproteins such as very low density lipoprotein (VLDL) may overload the antioxidant system. To test this hypothesis, we selected 14 patients with combined hyperlipidemia (HLP), in whom low density lipoprotein (LDL) and VLDL levels are elevated, as well as 18 hypercholesterolemic patients (HCH) with increased LDL levels and 19 controls (NL) to examine the trend for an imbalance between the production of oxidative species and the antioxidant defense system as challenged by increased plasma lipids. With this goal, plasma lipoprotein lipid fractions were determined and correlated with the release of ROS by leukocytes monitored by luminol-enhanced chemiluminescence. Plasma beta-carotene, alpha-tocopherol, lycopene and the lipoprotein lipid hydroperoxides were determined by high pressure liquid chromatography with electrochemical detection. HLP had lower plasma superoxide dismutase (SOD) activity (0.04 and 0.11 U/mg protein; P < 0.05) as well as lower concentrations of lycopene (0.1 and 0.2 nmol/mg cholesterol; P < 0.05) and beta-carotene (0.8 and 2.7 nmol/mg cholesterol; P < 0.05) in the plasma, as compared with NL. Moreover, HLP showed the highest ROS production by resting mononuclear leukocytes (MN) among the three study groups. When the results of the subjects of the three groups were taken together, the plasma triglyceride concentration was positively correlated to ROS release by resting polymorphonuclear leukocytes (PMN, r = 0.38, P = 0.04) and MN (r = 0.56, P < 0.005). Moreover, ROS release by resting MN was positively correlated with VLDL (r = 0.47, P = 0.02) and LDL (r = 0.57, P = 0.01) triglycerides. There was also a positive correlation between ROS release by stimulated PMN and VLDL (r = 0.44, P = 0.03) as well as LDL (r = 0.53, P = 0.01) triglycerides. High density lipoprotein (HDL) cholesterol showed a negative correlation with ROS release by resting MN (r = -0.48, P = 0.02) and resting PMN (r = -0.49, P = 0.01). VLDL susceptibility to copper (II) oxidation was not different among the three groups. Regarding LDL, there was an increased oxidizability in HLP group.(ABSTRACT TRUNCATED AT 400 WORDS)
Assuntos
Hiperlipidemias/sangue , Leucócitos/metabolismo , Lipoproteínas/sangue , Estresse Oxidativo/fisiologia , Espécies Reativas de Oxigênio/metabolismo , Triglicerídeos/sangue , Adulto , Cromatografia Líquida de Alta Pressão , Feminino , Ferritinas/sangue , Humanos , Medições Luminescentes , Masculino , Pessoa de Meia-Idade , Superóxido Dismutase/sangueRESUMO
OBJECTIVES: Low density lipoprotein (LDL) does not constitute an homogenous fraction and it is known that the heavy LDL subfraction is potentially more atherogenic than the light one. Because concentration of LDL subfractions tend to be different in hyperlipidemias, it was verified whether these subfractions can also differ in sialic acid and neutral sugar content, as well as their resistance to oxidation. DESIGN AND METHODS: Two subfractions of low density lipoprotein (light LDL, density 1.019-1.034 g/mL and heavy LDL, density 1.034-1.063 g/mL) were isolated from the plasma of 17 patients with hypercholesterolemia, 11 with combined hyperlipidemia, 7 with hypertriglyceridemia, and 19 normolipidemic subjects. The content of sialic acids and neutral sugars of apo B was determined, respectively, by the periodate-thiobarbituric acid method and by reaction with phenol. The oxidation of LDL subfractions was determined by exposure to 5 microM copper (II) followed by the measurement of lipid hydroperoxides production by high performance liquid chromatography with electrochemical detection. RESULTS: The study groups did not differ in the neutral sugar content of LDL subfractions. However, compared to normolipidemic subjects, the sialic acid concentration of both LDL subfractions was lower in patients with hypercholesterolemia and hypertriglyceridemia and higher in those with combined hyperlipidemia (p < 0.05). In the hypercholesterolemia and combined hyperlipidemia groups, the lipid hydroperoxide content (microM) of heavy LDL was higher than in normolipidemic subjects (p < 0.05). CONCLUSIONS: The heavy LDL subfraction was more susceptible to oxidation in the patients with combined hyperlipidemia compared to controls and the other hyperlipidemic groups. The effect of sialic acids on heavy LDL oxidizability seems to vary according to the type of hyperlipidemia.
Assuntos
Hiperlipidemias/metabolismo , Lipoproteínas LDL/metabolismo , Ácidos Siálicos/sangue , Adulto , Antioxidantes/farmacologia , Estudos de Casos e Controles , Fracionamento Químico , Feminino , Humanos , Lipoproteínas LDL/química , Lipoproteínas LDL/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Ácido N-Acetilneuramínico , Oligossacarídeos/análise , Oligossacarídeos/química , Oxirredução , Ácidos Siálicos/química , Ácidos Siálicos/farmacologiaRESUMO
The purpose of this study is to evaluate the clinical results obtained with the use of glutaraldehyde in pulpotomies performed on deciduous teeth, in a recall of 24 months. Our results showed a success greater than 90%, similar to other clinical studies.
Assuntos
Exposição da Polpa Dentária/cirurgia , Glutaral/uso terapêutico , Pulpotomia/métodos , Dente Decíduo/cirurgia , Criança , Pré-Escolar , Exposição da Polpa Dentária/terapia , Estudos de Avaliação como Assunto , Seguimentos , Humanos , Resultado do TratamentoRESUMO
One of the alternatives used when the clinical inspection of the fissure is doubtful is the invasive technique. This study used the SEM, to investigate two kinds of burs in doing the invasive technique upon primary molars, as well as to test the suitability of two kinds of sealants (with and without filler particles) to penetrate into such preparations. The points hereby tested revealed to be adequate in obtaining a minimal opening in the enamel, allowing the inspection of the fissure, and at the expense of a slight removal of dubious tissue, permitting a preparation of easy clinical performance. In regard to sealant penetration, no difference was seen between the self-cured sealant and the light-cured sealant.
Assuntos
Preparo da Cavidade Dentária/instrumentação , Fissuras Dentárias/terapia , Restauração Dentária Permanente/métodos , Selantes de Fossas e Fissuras , Pré-Escolar , Preparo da Cavidade Dentária/métodos , Fissuras Dentárias/patologia , Humanos , Microscopia Eletrônica de Varredura , Dente Molar , Dente DecíduoRESUMO
This study compared the accuracy of clinical examination with bitewing radiographs and clinical examination using tooth separation to recognize the carious lesions activity. 336 bitewings were reviewed for approximal caries on the maxillary and mandibular second premolars and first molars of 168 high school students. Three examiners evaluated the radiographs using a megascope, a magnifying glass (x2) and an amplifying image screen. 77 surfaces were identified with approximal radiolucencies. After the radiographic examinations, the three examiners performed a conventional clinical inspection using a No. 4 odontoscope, a No.5 explorer probe and an air-water syringe with artificial light and relative isolation. The variables recorded were: (1) healthy surface; (2) white spot; or (3) carious cavitation. The separation method was performed with elastics. After 24 hours, the elastics were removed and the clinical examination conducted as in the non-separation group.(ABSTRACT TRUNCATED AT 250 WORDS)