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Dental erosion is a chemical process characterized by acid dissolution of dental hard tissue, and its etiology is multifactorial. Dietary polyphenols can be a strategy for dental erosion management, collaborating to preserve dental tissues through resistance to biodegradation. This study describes a comprehensive review to interpret the effects of polyphenols on dental erosion of pre-clinical models with in situ designs and simulated acid attacks on enamel and dentin samples. We aim to evaluate evidence about Polyphenols' effects in the type of dental substrate, parameters of erosive cycling chosen in the in situ models, and the possible mechanisms involved. An evidence-based literature review was conducted using appropriate search strategies developed for main electronic databases (PubMed, Scopus, Web of Science, LILACS, EMBASE, LIVIVO, CINAHL, and DOSS) and gray literature (Google Scholar). The Joanna Briggs Institute checklist was used to evaluate the quality of the evidence. From a total of 1900 articles, 8 were selected for evidence synthesis, including 224 specimens treated with polyphenols and 224 control samples. Considering the studies included in this review, we could observe that polyphenols tend to promote a reduction in erosive and abrasive wear compared to control groups. However, as the few studies included have a high risk of bias with different methodologies and the estimated effect size is low, this conclusion should not be extrapolated to clinical reality.

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OBJECTIVE: To investigate the influence of different ultra-soft toothbrushes on the progression of erosive tooth wear (ETW). METHODS: Bovine enamel and dentin specimens (n = 10) were submitted to a 5-day erosive-abrasive cycling model (0.3% citric acid for 5 min, artificial saliva for 60 min, 4x/day). Toothbrushing was carried out 2x/day for 15 s, with the different toothbrushes tested (A- Edel White: flexible handle, tapered bristles; B- Oral-B Gengiva Detox: regular handle, criss-cross tapered bristles; C- Colgate Gengiva Therapy: flexible handle, tapered bristles, high tuft density; d- Oral-B Expert Gengiva Sensi: regular handle, round end bristles, high tuft density; E- Oral-B Indicator Plus: soft brush, round end bristles (control). Surface loss (SL, in µm) was assessed by optical profilometry. The toothbrush characteristics were evaluated by a surgical microscope. Data were statistically analyzed (α=0.05). RESULTS: For enamel, toothbrush C showed the highest SL (means±SD: 9.86 ± 1.28) and it did not differ significantly from A (8.60 ± 0.50), both with flexible handles. The lowest SL was observed for the toothbrush Control E (6.76 ± 0.63), which differed significantly from A and C, but not from the other toothbrushes. For dentin, the highest SL was found for toothbrush D (6.97 ± 1.05) and it did not differ significantly from E (6.23 ± 0.71). The lowest SL was observed for B (4.61 ± 0.71) and C (4.85 + 0.83), without significant differences from A (5.01 ± 1.24). CONCLUSIONS: The ultra-soft toothbrushes had different impacts on the progression of ETW on the dental substrates. On enamel, higher ETW values were observed for the flexible handle toothbrushes, while for dentin, round-end bristles (ultra-soft and soft) caused more ETW. CLINICAL SIGNIFICANCE: Knowledge about the effect of different ultra-soft toothbrushes on ETW can help clinicians to recommend the most suitable types for their patients, bearing in mind that toothbrushes can impact enamel and dentin differently.

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Tooth wear is multi-factorial presenting as a combination of abrasion, attrition, and erosion. This case report represents a case of combined tooth wear in a 46-year-old Indo-Trinidadian male, with a predominant erosive component with both the clinical signs and features of intrinsic and extrinsic erosion. This patient case is unique since the wear predominated by dental erosion has occurred rapidly evidenced by the physical clinical appearance of a lack of compensation and the upper left premolars and molars relatively unaffected by the overall effects of tooth wear. This lack of compensation, where opposing teeth have not supra-erupted to maintain inter-arch stability, and the maintenance of occlusal vertical dimension on the left due to the non-worn posterior maxillary teeth, provides the benefit of simplifying subsequent restorative management. The medical and diet history corroborates the diagnoses of intrinsic and extrinsic erosion respectively. Complications noted with rapid tooth wear, such as dentine sensitivity and pulpal necrosis are known sequelae of tooth wear however the patient presented in this case report shows a concomitant high caries experience and poor oral hygiene. Cases such as the one presented here require not only comprehensive dental management, utilizing a restorative approach but also medical referral for confirmation of a diagnosis and management of gastroesophageal reflux disease. Inherent to the management of this patient should be a multidisciplinary medical and dental approach, with confirmation and management of the cause of the intrinsic erosion as well as restorative dental management, together with dietary counseling to mitigate the effect of intrinsic and extrinsic sources of acid on dental hard tissue. A key lesson learned from this case is the importance of history and targeted questioning when trying to determine the cause of tooth wear dominated by intrinsic and extrinsic erosion.

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Dental erosion is a multifactorial condition associated with chemical, biological, and behavioral factors whereby a non-bacterial chemical process leads to an irreversible loss of dental structure. Consequences of this erosive process include painful sensitivity, susceptibility to further erosion, mechanical wear, changes in occlusion, exposure of dental pulp, and poor esthetics. Substantial evidence has revealed new insights to diagnosing early stages of dental erosion and enabling novel preventive approaches to control its progression. In the context of outpatient medical/dental practice, clinicians often encounter patients with progressive dental erosion. This article summarizes published research in this area of dentistry to suggest guidelines that are clinically oriented but scientifically fundamental. It is aimed at helping clinicians effectively integrate this information into their professional evaluations of dental erosion with regard to diagnosis, risk factors, clinical signs, assessment, and clinical preventive strategies and treatment. Clinicians should address patient diet habits, educate patients on prevalence data, and inform them regarding potential acidic interactions, such as medically induced acidic conditions, that may ultimately lead to tooth destruction. Prevention of dental erosion, including the recognition of initial erosive lesions and the implementation of the early intervention, involves the clinical expertise of both the dentist and physician.

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O desgaste erosivo tem sido reconhecido como uma condição frequente nos últimos anos, principalmente devido a mudanças nos hábitos alimentares e comportamentais das populações em geral. Considerando a natureza irreversível desta condição, o diagnóstico precoce e a adoção de medidas preventivas são muito importantes. Dentre elas, a adição de polímeros a produtos de higiene bucal associados ou não a fluoretos apresenta-se como uma alternativa promissora, já que alguns polímeros apresentam compatibilidade com as estruturas dentais e capacidade de formação de um filme protetor. Este estudo foi subdivido em três artigos que visaram, através de diferentes abordagens, investigar o efeito anti- erosivo de polímeros formadores de filme, bem como o efeito da associação destes com fluoretos. O primeiro artigo consistiu em uma revisão da literatura sobre aspectos relacionados ao potencial de utilização dos polímeros para a prevenção da erosão dental. O segundo artigo consistiu em um estudo de varredura para verificar a capacidade de redução da dissolução da hidroxiapatita promovida por soluções contendo quatro polímeros (polioxirano, hidroxipropilmetilcelulose, pectina e um copolímero do polimetacrilato) associadas ou não com fluoreto de sódio -F (225 ppm F- ) e fluoreto de sódio + cloreto de estanho (800 ppm Sn2+) - FS. A mensuração do potencial zeta da hidroxiapatita dispersa tratada com as soluções experimentais foi realizada a fim de complementar a análise. O terceiro artigo consistiu em um estudo de ciclagem erosiva/reendurecedora na presença de película adquirida que se propôs a investigar o potencial de remineralização, potencial de proteção, a perda superficial e a tensão superficial do esmalte após o tratamento com as soluções contendo o copolímero do polimetacrilato. Concluiu- se que a utilização de polímeros formadores de filme, associados ou não a fluoretos, constitui uma abordagem promissora para prevenção da erosão dental. Dentre os polímeros investigados, o copolímero do polimetacrilato é um promissor agente para ser adicionado à produtos de higiene bucal visando a prevenção dos desgastes erosivos(AU)

Erosive wear has been recognized as a frequent condition in recent years, mainly due to changes in the dietary and behavioral habits of the general population. Considering the irreversible nature of this condition, early diagnosis and the adoption of preventive measures are very important. Among them, the addition of polymers to oral care products associated or not with fluorides is a promising alternative, as some polymers have compatibility with dental structures and ability to form a protective film. This study was subdivided into three articles that aimed, through different approaches, to investigate the anti-erosive effect of film- forming polymers, as well as the effect of their association with fluorides. The first article consisted of a literature review about aspects related to the potential use of polymers to prevent dental erosion. The second article consisted of a scanning study to verify the ability to decrease the hydroxyapatite dissolution promoted by solutions containing four polymers (polyoxyrane, hydroxypropyl methylcellulose, pectin and a polymethacrylate copolymer) associated or not with sodium fluoride -F (225 ppm F- ) and sodium fluoride + tin chloride (800 ppm Sn2+ ) -FS. Measurement of the zeta potential of dispersed hydroxyapatite treated with experimental solutions was performed to complement the analysis. The third article consisted of an erosive/rehardening cycling study in the presence of acquired pellicle that aimed to investigate remineralization potential, protection potential, surface loss and surface tension of the enamel after treatment with solutions containing the polymethacrylate. It was concluded that the use of film- forming polymers, associated or not with fluorides, is a promising approach for the prevention of dental erosion. Among the polymers investigated, the polymethacrylate copolymer is a promising agent to be added to oral hygiene products to prevent erosive wear(AU)

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PURPOSE: The purpose of this study was to investigate the impact of gastroesophageal reflux disease (GERD) on dental erosion (DE) in children and analyze the association between dental erosion and diet, oral hygiene, and sociodemographic characteristics. METHODS: This case-control study encompassed 43 two- to 14-year-olds diagnosed positive for GERD by the 24-hour pH monitoring, paired by age group with 136 healthy controls, in Belo Horizonte, Minas Gerais, Brazil. DE was assessed by one calibrated examiner using the O'Sullivan index. A questionnaire was self-administered by parents collecting information regarding sociodemographics, oral hygiene, and dietary habits. Dental erosion experience was compared between the groups, and a stratified analysis was performed (P<0.05). RESULTS: Dental erosion was diagnosed in 10.6 percent (N equals 19) of all the children; 25.6 percent (N equals 11) of GERD children and 5.9 percent (N equals eight) of children without GERD, P=0.001). Dental erosion was not associated with dietary consumption or sociodemographic characteristics in both groups (P≥0.05). Children who used adult toothpaste had a 5.79 higher chance of having dental erosion in the group with GERD. CONCLUSION: Children diagnosed with gastroesophageal reflux disease were at an increased risk of having dental erosion when compared to healthy subjects; among the GERD children, dental erosion was associated with the use of adult toothpaste.

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O objetivo deste estudo foi avaliar se a presença da artrite idiopática juvenil (AIJ) em crianças e adolescentes pode ser considerada como indicador de risco para a erosão dentária. Para tal, foram utilizadas oitenta crianças e adolescentes com diferentes tipos de AIJ e 23 pacientes saudáveis como controle. Os critérios de inclusão foram diagnóstico de AIJ e classificação do subtipo de acordo com os critérios da Liga Internacional das Associações de Reumatologia(ILAR). Os dados sobre variáveis nutricionais, fatores socioeconômicos, vômitos, ingestão de medicamentos, hábitos alimentares e orais foram coletados por meio de questionário estruturado.Todos os pacientes foram submetidos a medição do fluxo salivar e exame clínico usando o índice Exame Básico de Desgaste Erosivo (BEWE). Dezesseis pacientes, todos afetados pelo subtipo oligo articular de AIJ mostraram redução da quantidade de saliva estimulada; dois deles apresentaram erosão e relataram consumo diário de refrigerantes. Foi relatado vômitos (uma vez por dia) por nove pacientes devido à ingestão de metotrexato sem correlação com o subtipo de AIJ. Nenhum deles exibiu erosão. O indicador de risco para a erosão dentária foi o subtipo de AIJ (artrite oligo articular), não havendo correlação significativa da presença de erosão dentária com as variáveis nutricionais, ingestão de medicamentos, hábitos alimentares e orais.

The purpose of this study was evaluate the existence of prevalence and risk indicators of dental erosion in patients affected by juvenile idiopathic arthritis (JIA). Eighty patients (61 females and 19males) with different kinds of JIA and 23 healthy control ones aging from 3 to 19 years were included in the study. The inclusion criteria were diagnosis of JIA and subtype classification according to the International League of Associations for Rheumatology (ILAR) criteria. Data on nutrition al variables, socioeconomic factors, vomiting, drug intake and dietary and oral habits were collected using a questionnaire. All patients underwent saliva measurement and clinical examination using Basic Erosive Wear Examination (BEWE) Index. Sixteen patients, all affected by the oligo articular subtype of JIA showed a reduced quantity of stimulated saliva; two of them showed erosion andre ported a daily soft drink intake. Vomiting (once a day) was reported by nine patients and was dueto methotrexate intake with no correlation with JIR subtype. None of them exhibited erosion. Risk indicator for wear was JIA subtype (oligo articular arthritis). There was no significant correlation of the presence of dental erosion with nutritional variables, drug intake or dietary and oral habits.

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A saliva é um fluido biológico com importante papel nos fenômenos que ocorrem na cavidade bucal. O efeito da sua composição sobre as perdas de estruturas dentais de origem não cariosa, como o desgaste dental, tem sido estudado. No entanto, há conflitos nos resultados apresentados por esses estudos, mostrando uma dificuldade em identificar os fatores salivares que possam proteger ou intensificar a evolução do processo. Assim, o presente estudo se propôs a analisar as características clínicas, comportamentais e de alguns parâmetros salivares em dois grupos experimentais: pacientes que apresentam lesões cervicais não cariosas (LCNCs) (n=20) e um grupo controle (n=20). Foram coletados dados clínicos e comportamentais através de um exame clínico e de uma entrevista, a seguir amostras de saliva estimulada e não-estimulada foram coletadas e analisados: pH, capacidade tampão, fluxo salivar, concentração de proteínas totais, atividade da amilase salivar, concentração de ureia salivar e a concentração dos íons sódio, fósforo, potássio, magnésio e cálcio. A capacidade tampão foi medida pela titulação da saliva com uma solução de HCL 0,01N; o fluxo salivar se deu pela relação entre o volume de saliva e o tempo de coleta (ml/min); as concentrações de proteínas totais, ureia e a atividade da amilase foram determinadas por método colorimétrico; as concentrações dos íons cálcio, fósforo, magnésio, potássio e sódio foram determinadas por espectrometria de emissão óptica com plasma acoplado indutivamente (ICP-OES).

Os resultados foram submetidos aos testes Qui-quadrado, teste t e Mann-Whitney (p<0,05). As características relacionadas aos hábitos de higiene dental, dieta ácida, hábitos parafuncionais, presença de distúrbios gástricos, secura bucal e prévio tratamento periodontal, não mostraram relação com a presença de lesões cervicais não cariosas. Os pacientes portadores de LCNCs se queixaram mais de sensibilidade dental (p=0,0014). Foi observado um maior número de lesões cervicais de pequena profundidade (79%), em formato de cunha (72%), apresentando hipersensibilidade dentinária (HD) (86%), localizados nos dentes posteriores (88,18%) e na maxila (66,14%), sendo os pré-molares os dentes mais afetados (56,69%). Os níveis de cálcio na saliva não-estimulada do grupo de pacientes com LCNCs foi significativamente maior em relação ao controle (p=0,041). A concentração de potássio na saliva estimulada foi significativamente maior no grupo controle (p=0,028). As variáveis fluxo salivar, pH, capacidade tampão, concentração de proteínas totais, ureia, amilase, sódio, magnésio e fósforo não mostraram diferenças estatisticamente significativas entre os dois grupos. Conclui-se que os fatores comportamentais não interferiram no aparecimento das lesões cervicais não cariosas. As LCNCs são pouco profundas, em formato de cunha, acometem mais dentes superiores e pré-molares e são acompanhadas de HD. As concentrações de cálcio e potássio podem interferir na formação das LCNCs.

Saliva is a biological fluid with an important role in the phenomena that occur in the oral cavity. The effect of salivary composition in loss of tooth structure with no carious origin, such as tooth wear, has been studied. However, there are conflicts in the results presented by studies showing a difficulty in identifying the salivary factors which may protect or intensify the development of tooth wear process. The aim of this study was to analyze the clinical, behavioral and some salivary parameters into two groups: patients with non-carious cervical lesions (NCCLs) (n=20) and a control group (n=20). Clinical and behavioral data were collected through a clinical examination and an interview. Saliva samples stimulated and unstimulated were collected and analyzed: pH, buffer capacity, flow rate, total protein, amylase activity, urea, sodium, phosphorus, potassium, magnesium and calcium. The buffer capacity was measured by titration of saliva samples using 0.01N HCl solution; flow rate was the relationship between the volume of saliva and the collection time (ml/min); the concentrations of total protein, urea and amylase activity were determined by colorimetric method; concentrations of calcium, phosphorus, magnesium, potassium and sodium were determined by inductively coupled plasma optical emission spectrometry (ICP-OES). The results were tested to the chi-square test, t-test and Mann-Whitney U test (p<0.05).

The characteristics related to dental hygiene, acidic diet, parafunctional habits, presence of gastric disorders, dry mouth, and previous periodontal treatment did not show relationship to the presence of non-carious cervical lesions. Patients with non-carious cervical lesions complained over tooth sensitivity (p=0.0014). It observed an increased number of cervical lesions small depth (79%), wedge-shaped (72%), with dentin hypersensitivity (86%), located the posterior teeth (88,18%) and maxilla (66,14%), the premolars being the most affected teeth (56,69%). The concentration of calcium in unstimulated saliva of patients with NCCLs was significantly higher compared to control (p=0.041). The concentration of potassium was significantly higher in stimulated saliva in the control group (p=0.028). The results flow rate, pH, buffer capacity, total protein, urea, amylase, sodium, magnesium and phosphorus showed no significant differences between the two groups. It is concluded that behavioral factors do not interfere in the presence of non-carious cervical lesions. The NCCLs are shallow, wedge-shaped, affecting more maxilla and premolars and are accompanied by DH. The calcium and potassium concentrations may interfere with the formation of NCCLs.

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Lesões dentais por erosão têm sido cada vez mais presentes na prática clínica. A restauração direta com resina composta é uma das opções de tratamento para lesões severas, em que há comprometimento estético/funcional. Com o aprimoramento da tecnologia, a utilização do laser para pré-tratamento da superfície dentinária, antes do condicionamento ácido, tem sido considerada como método alternativo para melhorar a adesão das resinas compostas às superfícies erodidas. Assim, o objetivo deste estudo in vitro foi avaliar a influência da irradiação com laser de Er:YAG (2,94 ?m), de pulso super-curto, na adesão da resina composta à superfície dentinária erodida. Quarenta e seis discos de dentina foram obtidos a partir de 46 dentes terceiros molares humanos. A dentina oclusal planificada de 40 molares humanos teve metade de sua face protegida com fita UPVC (dentina hígida), enquanto na outra metade foi produzida uma lesão de erosão através da ciclagem em ácido cítrico (0,05 M, pH 2,3, 10 minutos, 6x/dia) e solução supersaturada (pH 7,0, 60 minutos entre os ataques ácidos). Metade das amostras foi irradiada com o laser de Er:YAG (50 ?s, 2 Hz, 80 mJ, 12,6 J/cm2) e a outra não (grupo controle). Em cada grupo de tratamento (laser ou controle) (n=10), um sistema adesivo autocondicionante foi utilizado e, então, confeccionados 2 cilindros de resina composta, tanto do lado erodido como no hígido (total de 4 cilindros), os quais foram submetidos à avaliação da Resistência de União através do ensaio de microcisalhamento (1 mm/min), após armazenamento em saliva artificial por 24 h. A análise do padrão de fratura foi realizada em microscópio óptico (40x). Por meio da Microscopia Eletrônica

de Varredura (MEV), a morfologia das superfícies dentinárias hígida e submetida ao desafio erosivo, antes e após o tratamento com laser de Er:YAG (n=3), foi avaliada. Os valores obtidos de resistência de união (MPa) foram submetidos ao teste ANOVA e de comparações múltiplas de Tukey (p<0,05) e as análises das eletromicrografias foram feitas de forma descritiva. A análise morfológica da superfície mostrou alterações significativas na dentina hígida irradiada e na submetida à ciclagem erosiva, irradiada ou não. Quanto à resistência de união, houve diferença entre os 4 substratos analisados, sendo: dentina hígida irradiada (12,77±5,09 A), dentina hígida não irradiada (9,76±3,39 B), dentina erodida irradiada (7,62±3,39 C) e dentina erodida não irradiada (5,12±1,72 D). Houve predominância de padrão de fratura do tipo adesiva. Com base nos resultados e nos parâmetros de irradiação utilizados neste estudo, pode-se concluir que a erosão reduz a adesão em dentina e que o tratamento da superfície dentinária com laser de Er:YAG de largura de pulso super curta aumenta a adesão no substrato erodido ou hígido.

Dental erosion injuries have been increasingly present in clinical practice. Direct restoration with composite resin is one of the treatment options for severe injuries, where there is aesthetic/functional impairment. With the improvement of technology, laser-irradiation for pre-treatment of dentin before surface etching has been considered as an alternative method to improve the adhesion of composite resins to eroded surfaces. The objective of this in vitro study was to evaluate the influence of the irradiation with a super-short pulse Er:YAG (2.94 ?m) laser to the adhesion of composite resin to eroded dentin surface. Forty six dentin discs were obtained from 46 third molars. Forty samples of planned occlusal dentine, obtained from human molars, had half of their surface protected with plastic tape (sound dentin), while the other half was submitted to erosive cycles, consisted on immersion on citric acid (0.05 M, pH 2.3, 10 minutes, 6x/day) and supersaturated solution (pH 7.0, 60 minutes of acid attacks). Half of the samples was irradiated with the Er:YAG laser (50 ?s, 2 Hz, 80 mJ, 12.6 J/cm2) and the other was kept as control. In each treatment group (n = 10), a self-etching adhesive system was used and then two cylinders of composite resin were prepared, on both eroded and sound dentin (total of 4 cylinders). Microshear bond strength test was performed (1 mm/min), after 24 hours storage in artificial saliva.

The analysis of the fracture pattern was determined by optical microscopy (40x). The morphology of sound and eroded dentin, before and after treatment with the Er:YAG laser (n = 3) was evaluated under Scanning Electron Microscopy (SEM). Bond strength values (MPa) were subjected to ANOVA and Tukey multiple comparisons test (p<0.05). The analyses of electron micrographs were made descriptively. Morphological analysis of the surface showed significant changes in irradiated and sound dentin subjected to erosive cycling. As for the bond strength, there were differences among the groups, as follows: sound dentin submitted to irradiation (12.77 ± 5.09 A), non-irradiated sound dentin (9.76 ± 3.39 B), eroded dentin submitted to irradiation (7 62 ± 3.39 C) and non-irradiated eroded dentin (5.12 ± 1.72 D). There was a predominance for the adhesive mode of failure. It was concluded that the erosion reduces the adhesion to dentin and that treating the dentin surface with a super-short-pulse Er:YAG laser increases adhesion to both eroded or sound dentin.

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Introdução: A recessão gengival é uma condição de alta prevalência que leva a exposição radicular causando queixas estéticas e sintomáticas e cujo tratamento pode ser de difícil execução caso fatores complicadores estejam associados. Objetivo: Realizar uma revisão da literatura para discutir a influência de determinados fatores sobre os resultados dos procedimentos para recobrimento radicular. Métodos: Artigos foram selecionados nas bases de dados Pubmed, Scopus, Web of Science, Scielo e LILACS. Os critérios de escolha dos artigos foram: escritos em Inglês, Espanhol, Francês ou Português e que fossem classificados como ensaios clínicos. Resultados: A busca resultou em 20 artigos selecionados que avaliaram e discutiram sobre os possíveis fatores influenciadores como fumo (11), lesão cervical não cariosa (5), biótipo periodontal (4) e anatomia local (1). Discussão: O fumo foi o fator mais discutido na literatura cujos resultados mostram que pode interferir negativamente no tratamento cirúrgico da recessão gengival, embora pacientes fumantes possam apresentar bons resultados desde que façam um bom controle do biofilme dentário. Os artigos sobre lesão cervical não cariosa mostram que os resultados do recobrimento radicular são iguais, em curto e em longo prazo, independente da lesão cervical não cariosa estar restaurada ou não ou com qual material restaurador. Indivíduos que apresentam biótipo periodontal espesso apresentaram melhor prognóstico quanto ao recobrimento radicular. Conclusão: O tratamento da recessão gengival é complexo devido estar ligado a vários fatores relacionados ao indivíduo, desde fatores anatômicos a hábitos que o mesmo apresente. A literatura demonstra que o fumo é um dos fatores que limitam a previsibilidade do tratamento das recessões gengivais (AU).

Introduction: Gingival recession is a high prevalence condition that leads to root exposure causing aesthetic and symptomatic complaints and whose treatment can be difficult to perform when factors are associated with. Objective: To perform a literature review to discuss the influence of some factors on the results of root coverage procedures. Methods: Articles were selected in data basis Pubmed, Scopus, Web of Science, Scielo, and LILACS. The inclusion criteria were the language in English, Spanish, French, and Portuguese as well as classified as clinical trials. Results: The search resulted in twenty articles selected which was evaluated and discussed about possible influencing factors such as smoking (11), non-carious cervical lesion (5), periodontal biotype (4), and local anatomy (1). Discussion: Smoking was the most discussed factor whose results demonstrate that it can adversely affect the result of surgical treatment for gingival recession, although smokers can present good results as long as they present a good control of the biofilm. Non-carious cervical lesion articles showed that the results of root coverage are the same, in short and long follow-up, regardless of whether the noncarious cervical lesion was restored or not as well as which restorative material was used. Individuals with thick periodontal biotype have a better prognosis regarding root coverage. Conclusions: The treatment of gingival recession is complex because it is linked to several factors related to the individual, anatomical factors and patients' habits. The literature demonstrates that smoking is one of the factors that limit the predictability of treatment of gingival recessions (AU).

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RESUMO

A erosão dentária é um problema de saúde bucal e seu processo ocorre em uma condição multifatorial. Dentre seus principais fatores, a saliva desempenha importantes funções protetoras contra o desenvolvimento deste problema que afeta principalmente as crianças e jovens. O objetivo do presente estudo foi avaliar o sistema antioxidante e o estresse oxidativo da saliva de crianças de 4 a 6 anos de idade que possuíam erosão dentária comparando com crianças que não apresentavam esse problema de saúde bucal. Um único examinador treinado e calibrado para o diagnóstico de erosão dentária segundo o índice de BEWE (Basic Erosive Wear Examination), selecionou 40 crianças de 4 a 6 anos de idade que freqüentavam a Clinica de Prevenção de Odontopediatria da Universidade de São Paulo, formando 2 grupos, de crianças com erosão (n=22) e crianças sem erosão (n=18). A quantidade do biofilme dental foi obtida utilizando o índice de higiene oral simplificado (IHO-S) e foi feita a coleta de saliva não estimulada para as análises bioquímicas. O fluxo salivar, a capacidade tampão da saliva, o pH salivar e a proteína total da saliva foram avaliados. Também foram determinadas as atividades das enzimas superóxido dismutase (SOD) e catalase (CAT), o ácido úrico, o valor do malodialdeído (MDA) para determinação do estresse oxidativo e o total antioxidante (TAS). A proteína total foi menor no grupo de crianças com erosão dentária (p=0,03) e a quantidade de biofilme também foi menor nas crianças com erosão dentária média (desvio padrão) de 0,76 (0,25) comparadas com as crianças sem erosão dentária 1,18 (0,28). Não houve diferença estatística no sistema antioxidante e no estresse oxidativo da saliva de crianças com erosão dentária. A ação do sistema antioxidante e do estresse oxidativo na saliva, não influenciou na erosão dentária, quando ainda se encontrava em estágios mais iniciais deste problema de saúde bucal.

Dental erosion is a problem of oral health and its process occurs in multifactorial conditions. Among its principal factors, saliva plays an important protection role against the development of this problem, which affects children and youngsters mostly. The goal of this study was assessing the antioxidant system and oxidative stress in the saliva of children between the age of four and six who had dental erosion, comparing it to children who did not present this problem of oral health. One single examiner who was trained and prepared for diagnosing dental erosion according to the BEWE (Basic Erosive Wear Examination) index has selected forty children between the age of four and six who went to the Clinic of Prevention of Pediatric Dentistry of the University of São Paulo. Two groups were formed, one of children with dental erosion (n=22), and another with no dental erosion (n=18). The quantity of dental biofilm was verified using the simplified index of oral hygiene (OHI-S) and unstimulated saliva was collected for biochemical analyses. The salivary flow, the buffering capacity of saliva, salivary pH and the total amount protein in it were assessed. The activity of superoxide dismutase and catalase enzymes was also identified, and so were the uric acid and the amount of malodialdehyde (MDA)for determining oxidative stress and total antioxidant status(TAS). There was less total protein in the group of children with dental erosion (p=0,03) and the quantity of biofilm was also smaller in children with dental erosion (standard deviation) of an average of 0,76 (0,25), comparing with children with no dental erosion 1,18 (0,28). There was no statistic difference as far as the antioxidant system and oxidative stress are concerned in the saliva of children with dental erosion. The activity of the antioxidant system and oxidative stress in saliva have not influenced the dental erosion process while it was still in its early stages.

Assuntos

RESUMO

Apesar de vários estudos terem demonstrado resultados promissores do uso da solução de AmF/NaF/SnCl2 no controle da erosão do esmalte dental, não existem relatos da sua associação com a irradiação do substrato com o laser de CO2, de comprimento de onda de 9,6 ?m. Desta forma, o presente estudo teve como objetivo avaliar o potencial da solução de AmF/NaF/SnCl2, associada ou não ao laser de CO2 (4,5 J/cm2, 20 Hz, 20 ?s), em controlar a erosão em esmalte dental bovino. Treze voluntários participaram desse estudo in situ, de delineamento cruzado, em 02 fases (04 dias cada), onde 04 tratamentos foram testados utilizando réplicas (n = 13): GC - nenhum tratamento (controle negativo); GF - solução de AmF/NaF/SnCl2 (controle positivo); GL - irradiação com laser de CO2 (9,6 ?m); GLF - laser de CO2 associado à solução de AmF/NaF/SnCl2. Os voluntários usaram dispositivos intra-bucais removíveis contendo 08 amostras de esmalte bovino. Na primeira fase, 07 voluntários utilizaram dispositivos intra-bucais contendo amostras dos grupos GC e GL, e outros 06 voluntários utilizaram dispositivos contendo amostras dos grupos GF e GLF. Na segunda fase, os voluntários foram cruzados, permitindo que todos os grupos experimentais fossem avaliados no meio bucal dos 13 voluntários da pesquisa. Os dispositivos intra-bucais foram removidos da boca para ciclagem erosiva ex-situ em ácido cítrico 0,65%, pH 3,6, durante 4 minutos, 2x/dia, em horários pré-determinados. As amostras foram avaliadas em perfilômetro óptico de não-contato (n = 13) para análise da perda de tecido mineral após o desafio erosivo, e um ensaio de ultramicrodureza transversal (n = 13) foi realizado com o objetivo de determinar a profundidade da área de desmineralização abaixo da superfície do esmalte erodido. A análise morfológica foi realizada utilizando microscopia eletrônica de varredura (MEV) (n = 3). Os dados foram analisados estatisticamente por meio do modelo ANOVA 2 fatores para medidas repetidas, com subsequente comparação entre os diferentes tratamentos (? = 0,05). A ciclagem ácida realizada no presente estudo provocou perda de esmalte significativamente maior (p < 0,001) nos grupos GC (4,8 ± 1,4A ?m) e GL (4,4 ± 2,0A ?m). Não houve diferença estatística entre a perda de superfície nos grupos GF (1,9 ± 0,9B ?m) e GLF (1,7 ± 0,9B ?m). Os resultados de ultramicrodureza transversal mostraram que as amostras tratadas com a solução fluoretada (grupo GF) apresentaram uma zona parcialmente desmineralizada com média de dureza semelhante às amostras do grupo que não recebeu qualquer tipo de tratamento (grupo GC), com ambos os grupos apresentando média de dureza significativamente maior que os grupos que foram irradiados com o laser de CO2 (GL e GLF) (p < 0,001). As micrografias mostraram que as características morfológicas superficiais do esmalte nos grupos irradiados com laser de CO2 apresentaram-se semelhantes nos grupos GL e GLF, verificando-se a presença de áreas sugestivas de derretimento, resolidificação, microporos e microtrincas, sem evidências de precipitados fluoretados no grupo GFL. Uma camada amorfa pôde ser observada nas superfícies de esmalte tratadas apenas com a solução fluoretada contendo estanho. Pode-se concluir que o uso do enxaguatório bucal fluoretado contendo estanho (500 ppm F-, 800 ppm Sn2+, pH = 4,5) mostrou potencial de prevenção da erosão de esmalte dental. A irradiação do esmalte dental com o laser associado à solução fluoretada mostrou-se eficaz, mas seu efeito não foi sinérgico. O laser de CO2 (9,6 ?m), nos parâmetros utilizados, não foi capaz de prevenir a erosão em esmalte causada por ácido cítrico.

Although several studies have shown promising results using the AmF/NaF/SnCl2 solution in preventing the erosion of dental enamel, there are no reports of their association with the irradiation of the substrate with the CO2 laser, working at 9.6 ?m. Thus, this study aimed to evaluate the potential of AmF/NaF/SnCl2 solution, associated or not to CO2 laser irradiation (4.5 J/cm2, 20 Hz, 20 ?s), to prevent erosion on dental enamel. Thirteen volunteers participated in this 2-phase (4 days each), crossover study, where 04 treatments were tested using replicas (n = 13): GC - no treatment (negative control); GF - AmF/NaF/SnCl2 solution (positive control); GL - CO2 laser irradiation (9.6 ?m); GLF - CO2 laser irradiation associated with AmF/NaF/SnCl2 solution. The volunteers wore removable intra-buccal appliances containing eight bovine enamel samples. In the first phase, seven volunteers used intra-oral appliances containing samples of groups GC and GL and 6 volunteers, appliances containing samples of groups GF and GLF. In the second phase volunteers were crossed over, allowing all experimental groups were evaluated in the buccal environment of the 13 volunteers. Intra-buccal appliances were removed from the mouth and were exposed to a daily ex-situ erosive cycling (0.65% citric acid, pH 3.6, for 4 minutes, 2x/day) at pre-determined times. Samples were evaluated for surface loss using an optical non-contact profilometer (n = 13) for analysis of loss of mineral after the erosive challenge and a cross-sectional nanohardness test (n = 13) was carried out in order to determine the depth of demineralized area below the erosive lesion. Morphological analysis was carried out using scanning electron microscopy (SEM) (n = 3).

Assuntos

RESUMO

A erosão dentária é um problema de saúde bucal e seu processo ocorre em uma condição multifatorial. Dentre seus principais fatores, a saliva desempenha importantes funções protetoras contra o desenvolvimento deste problema que afeta principalmente as crianças e jovens. O objetivo do presente estudo foi avaliar o sistema antioxidante e o estresse oxidativo da saliva de crianças de 4 a 6 anos de idade que possuíam erosão dentária comparando com crianças que não apresentavam esse problema de saúde bucal. Um único examinador treinado e calibrado para o diagnóstico de erosão dentária segundo o índice de BEWE (Basic Erosive Wear Examination), selecionou 40 crianças de 4 a 6 anos de idade que freqüentavam a Clinica de Prevenção de Odontopediatria da Universidade de São Paulo, formando 2 grupos, de crianças com erosão (n=22) e crianças sem erosão (n=18). A quantidade do biofilme dental foi obtida utilizando o índice de higiene oral simplificado (IHO-S) e foi feita a coleta de saliva não estimulada para as análises bioquímicas. O fluxo salivar, a capacidade tampão da saliva, o pH salivar e a proteína total da saliva foram avaliados. Também foram determinadas as atividades das enzimas superóxido dismutase (SOD) e catalase (CAT), o ácido úrico, o valor do malodialdeído (MDA) para determinação do estresse oxidativo e o total antioxidante (TAS). A proteína total foi menor no grupo de crianças com erosão dentária (p=0,03) e a quantidade de biofilme também foi menor nas crianças com erosão dentária média (desvio padrão) de 0,76 (0,25) comparadas com as crianças sem erosão dentária 1,18 (0,28). Não houve diferença estatística no sistema antioxidante e no estresse oxidativo da saliva de crianças com erosão dentária. A ação do sistema antioxidante e do estresse oxidativo na saliva, não influenciou na erosão dentária, quando ainda se encontrava em estágios mais iniciais deste problema de saúde bucal.

Dental erosion is a problem of oral health and its process occurs in multifactorial conditions. Among its principal factors, saliva plays an important protection role against the development of this problem, which affects children and youngsters mostly. The goal of this study was assessing the antioxidant system and oxidative stress in the saliva of children between the age of four and six who had dental erosion, comparing it to children who did not present this problem of oral health. One single examiner who was trained and prepared for diagnosing dental erosion according to the BEWE (Basic Erosive Wear Examination) index has selected forty children between the age of four and six who went to the Clinic of Prevention of Pediatric Dentistry of the University of São Paulo. Two groups were formed, one of children with dental erosion (n=22), and another with no dental erosion (n=18). The quantity of dental biofilm was verified using the simplified index of oral hygiene (OHI-S) and unstimulated saliva was collected for biochemical analyses. The salivary flow, the buffering capacity of saliva, salivary pH and the total amount protein in it were assessed. The activity of superoxide dismutase and catalase enzymes was also identified, and so were the uric acid and the amount of malodialdehyde (MDA)for determining oxidative stress and total antioxidant status(TAS). There was less total protein in the group of children with dental erosion (p=0,03) and the quantity of biofilm was also smaller in children with dental erosion (standard deviation) of an average of 0,76 (0,25), comparing with children with no dental erosion 1,18 (0,28). There was no statistic difference as far as the antioxidant system and oxidative stress are concerned in the saliva of children with dental erosion. The activity of the antioxidant system and oxidative stress in saliva have not influenced the dental erosion process while it was still in its early stages.

Assuntos

RESUMO

Apesar de vários estudos terem demonstrado resultados promissores do uso da solução de AmF/NaF/SnCl2 no controle da erosão do esmalte dental, não existem relatos da sua associação com a irradiação do substrato com o laser de CO2, de comprimento de onda de 9,6 ?m. Desta forma, o presente estudo teve como objetivo avaliar o potencial da solução de AmF/NaF/SnCl2, associada ou não ao laser de CO2 (4,5 J/cm2, 20 Hz, 20 ?s), em controlar a erosão em esmalte dental bovino. Treze voluntários participaram desse estudo in situ, de delineamento cruzado, em 02 fases (04 dias cada), onde 04 tratamentos foram testados utilizando réplicas (n = 13): GC - nenhum tratamento (controle negativo); GF - solução de AmF/NaF/SnCl2 (controle positivo); GL - irradiação com laser de CO2 (9,6 ?m); GLF - laser de CO2 associado à solução de AmF/NaF/SnCl2. Os voluntários usaram dispositivos intra-bucais removíveis contendo 08 amostras de esmalte bovino. Na primeira fase, 07 voluntários utilizaram dispositivos intra-bucais contendo amostras dos grupos GC e GL, e outros 06 voluntários utilizaram dispositivos contendo amostras dos grupos GF e GLF. Na segunda fase, os voluntários foram cruzados, permitindo que todos os grupos experimentais fossem avaliados no meio bucal dos 13 voluntários da pesquisa. Os dispositivos intra-bucais foram removidos da boca para ciclagem erosiva ex-situ em ácido cítrico 0,65%, pH 3,6, durante 4 minutos, 2x/dia, em horários pré-determinados. As amostras foram avaliadas em perfilômetro óptico de não-contato (n = 13) para análise da perda de tecido mineral após o desafio erosivo, e um ensaio de ultramicrodureza transversal (n = 13) foi realizado com o objetivo de determinar a profundidade da área de desmineralização abaixo da superfície do esmalte erodido. A análise morfológica foi realizada utilizando microscopia eletrônica de varredura (MEV) (n = 3).

Os dados foram analisados estatisticamente por meio do modelo ANOVA 2 fatores para medidas repetidas, com subsequente comparação entre os diferentes tratamentos (? = 0,05). A ciclagem ácida realizada no presente estudo provocou perda de esmalte significativamente maior (p < 0,001) nos grupos GC (4,8 ± 1,4A ?m) e GL (4,4 ± 2,0A ?m). Não houve diferença estatística entre a perda de superfície nos grupos GF (1,9 ± 0,9B ?m) e GLF (1,7 ± 0,9B ?m). Os resultados de ultramicrodureza transversal mostraram que as amostras tratadas com a solução fluoretada (grupo GF) apresentaram uma zona parcialmente desmineralizada com média de dureza semelhante às amostras do grupo que não recebeu qualquer tipo de tratamento (grupo GC), com ambos os grupos apresentando média de dureza significativamente maior que os grupos que foram irradiados com o laser de CO2 (GL e GLF) (p < 0,001). As micrografias mostraram que as características morfológicas superficiais do esmalte nos grupos irradiados com laser de CO2 apresentaram-se semelhantes nos grupos GL e GLF, verificando-se a presença de áreas sugestivas de derretimento, resolidificação, microporos e microtrincas, sem evidências de precipitados fluoretados no grupo GFL. Uma camada amorfa pôde ser observada nas superfícies de esmalte tratadas apenas com a solução fluoretada contendo estanho. Pode-se concluir que o uso do enxaguatório bucal fluoretado contendo estanho (500 ppm F-, 800 ppm Sn2+, pH = 4,5) mostrou potencial de prevenção da erosão de esmalte dental. A irradiação do esmalte dental com o laser associado à solução fluoretada mostrou-se eficaz, mas seu efeito não foi sinérgico. O laser de CO2 (9,6 ?m), nos parâmetros utilizados, não foi capaz de prevenir a erosão em esmalte causada por ácido cítrico.

Although several studies have shown promising results using the AmF/NaF/SnCl2 solution in preventing the erosion of dental enamel, there are no reports of their association with the irradiation of the substrate with the CO2 laser, working at 9.6 ?m. Thus, this study aimed to evaluate the potential of AmF/NaF/SnCl2 solution, associated or not to CO2 laser irradiation (4.5 J/cm2, 20 Hz, 20 ?s), to prevent erosion on dental enamel. Thirteen volunteers participated in this 2-phase (4 days each), crossover study, where 04 treatments were tested using replicas (n = 13): GC - no treatment (negative control); GF - AmF/NaF/SnCl2 solution (positive control); GL - CO2 laser irradiation (9.6 ?m); GLF - CO2 laser irradiation associated with AmF/NaF/SnCl2 solution. The volunteers wore removable intra-buccal appliances containing eight bovine enamel samples. In the first phase, seven volunteers used intra-oral appliances containing samples of groups GC and GL and 6 volunteers, appliances containing samples of groups GF and GLF. In the second phase volunteers were crossed over, allowing all experimental groups were evaluated in the buccal environment of the 13 volunteers. Intra-buccal appliances were removed from the mouth and were exposed to a daily ex-situ erosive cycling (0.65% citric acid, pH 3.6, for 4 minutes, 2x/day) at pre-determined times. Samples were evaluated for surface loss using an optical non-contact profilometer (n = 13) for analysis of loss of mineral after the erosive challenge and a cross-sectional nanohardness test (n = 13) was carried out in order to determine the depth of demineralized area below the erosive lesion. Morphological analysis was carried out using scanning electron microscopy (SEM) (n = 3).

Assuntos

RESUMO

Este estudo analisou o potencial remineralizador de compostos com diferentes princípios bioativos no esmalte dental submetido a desafio erosivo. 40 espécimes de dentes bovinos com dimensões padronizadas (4x4mm2) foram submetidos ao desafio erosivo com ácido cítrico (pH=2,3 durante 1 hora) e submetidos a diferentes tratamentos remineralizadores com compostos bioativos, compondo os grupos experimentais: G1-sem tratamento; G2-fosfato de cálcio amorfo e fosfopeptídeo de caseína (RecaldentTM); G3- fosfato de cálcio nanoestruturado (NANO P); G4-flúor 1,23%. Os fragmentos foram analisados quantitativamente pelo método de fluorescência do tecido dental (QLF) em 4 momentos: baseline, desafio erosivo, 1°dia e 7ºdia. Os dados obtidos pelo método QLF foram submetidos à análise estatística por meio dos testes ANOVA 2 fatores para medidas repetidas e de comparações múltiplas de Bonferroni (α=5%). Não foram encontradas diferenças significantes entre os grupos experimentais tanto para o momento de análise baseline quanto para o momento desafio erosivo. No momento de análise 1°dia o grupo sem tratamento apresentou os maiores valores de Q (valor final da perda mineral do substrato), enquanto os menores foram encontrados para os grupos G2 e G3 que não apresentaram diferença estatística entre si. No momento de análise 7°dia os menores valores foram apresentados pelo grupo G2 e os maiores pelo grupo G1. Os tratamentos realizados acarretaram diferentes graus de remineralização no esmalte dental submetido a desafio erosivo. O composto bioativo RecaldentTM mostrou melhor desempenho nos índices de remineralização após sete dias de tratamento.

The aim of this study was analyze the remineralizing potential of different bioactive compounds on dental enamel submitted to erosive challenge. Forty bovine enamel specimens’ teeth with standardized dimensions (4x4mm2) were subjected to erosive challenge with citric acid (pH = 2.3 for one hour) and to different remineralizing treatments with bioactive compounds, composing the experimental groups: G1-without treatment; G2-amorphous calcium phosphate and casein phosphopeptide (RecaldentTM Plus); G3-calcium phosphate nanocluster (NANO P); G4- fluoride 1.23%. The fragments were quantitatively analyzed by the method of dental tissue fluorescence (QFL) in four different moments: baseline, erosive challenge, first day and seventh day. The data obtained through the QLF method were subjected to statistical analysis using two way ANOVA for repeated measurements and Bonferroni multiple comparison (α= 5%). No statistical differences were identified among the experimental groups in regards to the baseline analysis moment and to the erosive challenge moment. In the first day period analysis without treatment showed the highest values of Q (final value of substrate´s mineral loss) while the lowest values were obtained in the G2 and G3 groups, which did not presented statistical difference among them. During the seventh day analysis moment, the lowest value was presented by the G2 group while the highest value was presented by the G1 group. The tests performed led to different degrees of remineralization in dental enamel subjected to erosive challenge. The bioactive compound RecaldentT presented the highest levels of remineralization after the seventh day of treatment.

Assuntos

RESUMO

BACKGROUND: Eating disorders are associated with the highest rates of morbidity and mortality of any mental disorders among adolescents. The failure to recognize their early signs can compromise a patient's recovery and long-term prognosis. Tooth erosion has been reported as an oral manifestation that might help in the early detection of eating disorders. OBJECTIVES: The aim of this systematic review and meta-analysis was to search for scientific evidence regarding the following clinical question: Do eating disorders increase the risk of tooth erosion? METHODS: An electronic search addressing eating disorders and tooth erosion was conducted in eight databases. Two independent reviewers selected studies, abstracted information and assessed its quality. Data were abstracted for meta-analysis comparing tooth erosion in control patients (without eating disorders) vs. patients with eating disorders; and patients with eating disorder risk behavior vs. patients without such risk behavior. Combined odds ratios (ORs) and a 95% confidence interval (CI) were obtained. RESULTS: Twenty-three papers were included in the qualitative synthesis and assessed by a modified version of the Newcastle-Ottawa Scale. Fourteen papers were included in the meta-analysis. Patients with eating disorders had more risk of tooth erosion (OR = 12.4, 95%CI = 4.1-37.5). Patients with eating disorders who self-induced vomiting had more risk of tooth erosion than those patients who did not self-induce vomiting (OR = 19.6, 95%CI = 5.6-68.8). Patients with risk behavior of eating disorder had more risk of tooth erosion than patients without such risk behavior (Summary OR = 11.6, 95%CI = 3.2-41.7). CONCLUSION: The scientific evidence suggests a causal relationship between tooth erosion and eating disorders and purging practices. Nevertheless, there is a lack of scientific evidence to fulfill the basic criteria of causation between the risk behavior for eating disorders and tooth erosion.

Assuntos

RESUMO

AIM: To evaluate in vitro the erosive effects of beverages in the presence or absence of caries simulation (acidogenic challenge) on the microhardness of primary enamel. METHODS: Forty human primary teeth were submitted to the erosive effects: 3 × 20-min-long daily immersion in fresh orange juice (orange group), strawberry yogurt drink (yog group), or cola soft drink (cola group) separately or in combination with acidogenic challenge (pH cycling for 10 days). Specimens were also submitted to acidogenic challenge alone, and in the negative control group specimens were not submitted to any treatment. Mineral loss was evaluated by cross-sectional microhardness determination. The data (Knoop hardness numbers, KHN) were subjected to 2-way analysis of variance and Tukey's post hoc test (α = 0.05%). RESULTS: All the test beverages significantly reduced the sample cross-sectional enamel hardness (KHN ± SD, 235.93 ± 18.15, 257.23 ± 21.79, and 253.23 ± 13.86 in the orange, yog, and cola groups, respectively) compared to samples in the negative control group (290.27 ± 3.92). In vitro acidogenic challenge exacerbated the mineral loss induced by all beverages (166.02 ± 4.28, 190.43 ± 17.55, and 198.39 ± 21.39 in the orange, yog, and cola groups combined to acidogenic challenge, respectively) compared to acidogenic challenge alone. CONCLUSIONS: All beverages exhibited erosive effects on primary enamel. Simulated caries challenge considerably exacerbated the enamel softening of primary teeth.

Assuntos

RESUMO

The aim of this study was to describe the treatment used in an elderly patient presenting with bruxism and dental erosion, with good gingival health and bone support, but with decreased occlusal vertical dimension (OVD). The oral rehabilitation of elderly patients presenting with bruxism in association with tooth erosion has been a great challenge for dentists. The loss of OVD, the presence of occlusal instability and the absence of an effective anterior guide due excessive dental wear, can damage stomatognathic system (SS) biology, the function and the aesthetics. In the first treatment stage, an overlay removable partial denture (ORPD) was fabricated for the immediate re-establishment of function and aesthetics. After a 2-month follow up, with the patient presenting no symptoms, a second rehabilitation stage was accomplished, with fixed and removable prostheses. Oral rehabilitation with an ORPD was able to re-establish the SS biology, but a correct diagnosis and treatment plan are essential for success. The ORPD is a non-invasive and reversible restoring modality for general dentists that allow the re-establishment of the patient's immediate aesthetics and function at low cost.

Assuntos

RESUMO

OBJECTIVE. Previous in vitro study has shown that TiF(4) varnish might reduce enamel erosion. No data regarding the effect of this experimental varnish on enamel erosion plus abrasion, however, are available so far. Thus, this in vitro study aimed to analyse the effect of TiF(4) compared with NaF varnishes and solutions, to protect against enamel erosion with or without abrasion. METHODS. Enamel specimens were pre-treated with experimental-TiF(4) (2.45% F), experimental-NaF (2.45% F), NaF-Duraphat (2.26% F), and placebo varnishes; NaF (2.26% F) and TiF(4) (2.45% F) solutions. Controls remained untreated. The erosive challenge was performed using a soft drink (pH 2.6) 4 × 90 s/day (ERO) and the toothbrushing abrasion (ERO+ABR) 2 × 10 s/day, for 5 days. Between the challenges, the specimens were exposed to artificial saliva. Enamel loss was measured profilometrically (µm). RESULTS. Kruskal-Wallis/Dunn tests showed that all fluoridated varnishes (TiF(4) -ERO:0.53 ± 0.20, ERO+ABR:0.65 ± 0.19/NaF-ERO:0.94 ± 0.18, ERO+ABR:1.74 ± 0.37/Duraphat-ERO:1.00 ± 0.37, ERO+ABR:1.72 ± 0.58) were able to significantly reduce enamel loss when compared with placebo varnish (ERO:3.45 ± 0.41/ERO+ABR:3.20 ± 0.66) (P < 0.0001). Placebo varnish, control (ERO:2.68 ± 0.53/ERO+ABR:3.01 ± 0.34), and fluoridated (NaF-ERO:2.84 ± 0.09/ERO+ABR:2.40 ± 0.21/TiF(4) -ERO:3.55 ± 0.59/ERO+ABR:4.10 ± 0.38) solutions did not significantly differ from each other. CONCLUSION. Based on the results, it can be concluded that the TiF(4) varnish seems to be a promising treatment to reduce enamel loss under mild erosive and abrasive conditions in vitro.

Assuntos

RESUMO

BACKGROUND: A high prevalence of gastroesophageal reflux (GERD) has been observed in individuals with cerebral palsy (CP). One of the main risks for dental erosion is GERD. This study aimed to evaluate the presence of GERD, variables related to dental erosion and associated with GERD (diet consumption, gastrointestinal symptoms, bruxism), and salivary flow rate, in a group of 46 non-institutionalized CP individuals aged from 3 to 13 years. METHODS: Twenty CP individuals with gastroesophageal reflux (GERDG) and 26 without gastroesophageal reflux (CG) were examined according to dental erosion criteria, drinking habits, presence of bruxism, and salivary flow rate. A face-to-face detailed questionnaire with the consumption and frequency of acid drinks, gastrointestinal symptoms (regurgitation and heart burn), and the presence of bruxism were answered by the caregivers of both groups. Unstimulated whole saliva was collected under slight suction, and salivary flow rate (ml/min) was calculated. RESULTS: The GERDG presented higher percentages of younger quadriplegics individuals compared to CG. The presence of regurgitation, heart burn, and tooth erosion (Grade 1) was significantly more prevalent in GERDG. It was observed difference in the salivary flow rate between the studied groups. On logistic multivariate regression analysis, the unique variable independently associated with the presence of GERD was dental erosion (P = 0.012, OR 86.64). CONCLUSION: The presence of GERD contributes significantly to dental erosion in the most compromised individuals with quadriplegics cerebral palsy individuals, increasing the risk of oral disease in this population.

Assuntos