Artigos - Clínica Infantil - FOAR

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Three-Dimensional Evaluation of Dental Arches in Individuals with Syndromic Craniosynostosis
(2023-01-01) Pinto, Rayane De Oliveira [UNESP]; Tonello, Cristiano; Peixoto, Adriano Porto; De Jesus, Adriana Souza [UNESP]; Santos-Pinto, Ary Dos [UNESP]; Raveli, Dirceu Barnabé [UNESP]; Universidade Estadual Paulista (UNESP); Universidade de São Paulo (USP)
Objective. Individuals with syndromic craniosynostosis present alterations in the dental arches due to anomalies caused by the early fusion of the craniomaxillary sutures. This study aimed to compare intradental and interdental dimensions between individuals with Apert and Crouzon syndromes and nonsyndromic controls. Materials and Methods. Digital models were obtained from the archive of a public tertiary care hospital. The sample consisted of 34 patients (Apert n = 18, Crouzon n = 16) and 34 nonsyndromic controls matched for gender and age. Measurements of perimeter, length, intercanine and intermolar distances (upper and lower), overjet, and molar ratio were performed. Statistical comparisons were performed using ANOVA and Tukey tests p<0.05. Results. Patients with Apert and Crouzon syndromes have severely reduced maxillary transverse dimensions, perimeter, and length of the upper arch compared to the control group p<0.001. The lower arch is less impacted. Patients with Apert syndrome had an anterior crossbite p<0.001, while patients with Crouzon syndrome had an edge-to-edge bite p< 0.011. Patients with Apert and Crouzon syndromes do not have serious transverse proportion problems when comparing the upper and lower arches. Conclusions. In this sample, both the Apert and Crouzon groups have severely compromised upper arches compared to the control group. Mild dentoalveolar expansion in the maxilla should be sufficient for the transverse adaptation of the dental arches before frontofacial advancement.
Reverse engineering for post-treatment analysis of a surgical-orthodontic case
(2022-10-01) Borsato, Karina Tostes [UNESP]; Parizotto, Julianna de Oliveira Lima [UNESP]; Bianchi, Jonas; Ramos, Adriana Maria Bonadio Lopes; Gonçalves, João Roberto [UNESP]; Universidade Estadual Paulista (UNESP); University of the Pacific
Improved esthetic efficacy and reduced cytotoxicity are achieved with a violet LED irradiation of manganese oxide-enriched bleaching gels
(2023-12-01) Dias, Marlon Ferreira [UNESP]; Martins, Beatriz Voss [UNESP]; de Oliveira Ribeiro, Rafael Antonio [UNESP]; Hebling, Josimeri [UNESP]; de Souza Costa, Carlos Alberto [UNESP]; Universidade Estadual Paulista (UNESP)
Gels with high concentrations of hydrogen peroxide (H2O2) have been associated with cytotoxicity and consequent post-bleaching tooth sensitivity. This study assessed the bleaching efficacy (BE) and cytotoxicity (CT) of bleaching gels with low concentrations of H2O2 containing manganese oxide (MnO2) and photocatalyzed with violet LED (LEDv). The following groups were established: G1: no treatment (negative control, NC); G2: 35% H2O2 (positive control, PC); G3: LEDv; G4: 10% H2O2; G5: 6% H2O2; G6: 10% H2O2 + MnO2 + LEDv; G7: 6% H2O2 + MnO2 + LEDv. To analyze BE, standardized enamel/dentin discs (E/DDs) were subjected to the bleaching procedures for 45 min (1 session). The color change was determined before and after performing the bleaching protocols (ΔE00; ΔWI). To analyze CT, the E/DDs were adapted to artificial pulp chambers, and the extracts (culture medium + diffused gel components) were applied to cultured odontoblast-like MDPC-23 cells. Then, the cells were assessed concerning their viability (VB), oxidative stress (OxS), and Live/Dead. The amount of H2O2 diffused was also determined (ANOVA/Tukey; p < 0.05). Cell viability decreased in all bleached groups compared to G1 (NC; p < 0.05). The cells in G6 and G7 presented higher viability than in G2, G4, and G5 (p < 0.05). The BE in G7 was similar to G2 (PC; p < 0.05). The lowest OxS and H2O2 diffusion values were found in G6 and G7, compared to the other bleached groups (G2, G4, and G5; p < 0.05). The 6% H2O2 bleaching gel (G7) submitted to both methods of catalysis (MnO2 + LEDv) caused only a mild cytotoxicity and maintained the excellent esthetic outcome promoted by in-office conventional tooth bleaching.
A new approach for professional dental bleaching using a polymeric catalyst primer
(2023-03-01) Dias, Marlon Ferreira [UNESP]; Martins, Beatriz Voss [UNESP]; de Oliveira Ribeiro, Rafael Antonio [UNESP]; Leite, Maria Luísa [UNESP]; Ortecho-Zuta, Uxua [UNESP]; Hebling, Josimeri [UNESP]; Costa, Carlos Alberto de Souza [UNESP]; Universidade Estadual Paulista (UNESP)
Objective: Evaluate the influence of a polymeric catalyst primer (PCP) on esthetic efficacy (EE), degradation kinetics of hydrogen peroxide (H2O2), and trans-amelodentinal cytotoxicity (TC) of bleaching gels. Materials and Methods: The following groups were established: G1: No treatment (NC, negative control); G2: PCP; G3: 10% H2O2; G4: PCP + 10% H2O2; G5: 20% H2O2; G6: PCP + 20% H2O2; G7: 35% H2O2 (positive control); G8: PCP + 35% H2O2. To determine EE, enamel/dentin discs (E/DDs) were stained and subjected or not to bleaching protocols for 45 min. To assess TC, the E/DDs were adapted to artificial pulp chambers. The extracts (culture medium + gel components diffused through E/DDs) were applied to odontoblast-like MDPC-23 cells. The viability (VB), oxidative stress (OxS), morphology (SEM), amount of H2O2 diffused and the production of hydroxyl radical (OH•) were assessed (two-way ANOVA/Tukey/paired Student t-test; p < 0.05). Results: The highest EE was found in G8 (p < 0.05), and G4, G6, and G7 did not differ statistically (p > 0.05). In G4, the limited H2O2 diffusion reduced OxS and increased cell VB (p < 0.05). Conclusions: Coating the enamel with PCP containing 10 mg/ml of manganese oxide before applying the 10% H2O2 bleaching gel maintains the EE of conventional in-office bleaching and minimizes the toxic effects of this esthetic therapy. Clinical Significance: Coating the enamel with a PCP before applying the bleaching gel may potentiate the EE of the conventional in-office tooth bleaching and reduce the toxicity of this professional therapy to the dental pulp.
Dental trauma and oral health-related quality of life among 7th-grade students of public elementary schools1
(2023-01-01) Catananti, Isabella Silva [UNESP]; de Abreu-e-Lima, Fabio Cesar Braga [UNESP]; da Silva, Silvio Rocha Corrêa [UNESP]; Pardi, Vanessa; da Silva Tagliaferro, Elaine Pereira [UNESP]; Universidade Estadual Paulista (UNESP); East Carolina University
Dental trauma is a public health problem because of its high prevalence rates and treatment costs and for affecting mainly younger individuals. Aim: This cross-sectional study aimed to investigate the variables associated with dental trauma and its influence on oral health-related quality of life among 7th-grade students of public elementary schools. Methods: The data was collected with semi-structured and self-administered questionnaires and an intraoral clinical examination (n = 204). The variables collected regarded dental trauma, lip coverage, overjet, oral health-related quality of life (Child Perceptions Questionnaire - CPQ11-14 ISF: 8), and sociodemographic profile. Association tests and the Mann-Whitney test were performed at a 5% significance level. Results: Dental trauma occurred in 12.3% of students, 94.6% had adequate lip coverage, and the mean overjet was 2.7 mm (±2.0). Sex was the only variable with a statistically significant association with dental trauma (p = 0.021). There was no statistically significant difference in the CPQ11-14 ISF: 8 score between students with and without dental trauma (p = 0.136). Conclusions: Dental trauma was significantly associated with sex and did not impact the oral health-related quality of life of the students.
Dental changes induced by a modified Herbst appliance followed by fixed appliances: A digital dental model analysis
(2023-06-01) Marchi, Paulo Guilherme Bittencourt [UNESP]; Muñoz, Juan Francisco Mariscal [UNESP]; de Arruda Aidar, Luís Antônio; Marchi, Luiz Carlos; Dominguez, Gladys Cristina; Raveli, Dirceu Barnabé [UNESP]; Universidade Estadual Paulista (UNESP); Santa Cecília University (UNISANTA); West Paraná State University (UNIOESTE); Universidade de São Paulo (USP)
Background: Herbst therapy is an effective treatment for Class II malocclusions. However, the maintenance of the effects after fixed appliances treatment remains questionable. This retrospective study aimed to assess, using digital dental models, the sagittal and transverse dental arch changes in young patients during two Class II Division 1 treatment phases, first with modified Herbst appliance (HA) and then with fixed appliances. Methods: The treated group (TG) comprised 32 patients (17 boys, 15 girls; mean age, 12.85 ± 1.16 years) treated with HA and fixed appliances. The control group comprised 28 patients (13 boys, 15 girls; mean age, 12.21 ± 1.35 years) with untreated Class II malocclusions. Digital models were obtained immediately before and after HA therapy and after fixed appliances. Data were statistically analyzed. Results: Compared with the control group, the TG showed an increase in maxillary and mandibular arch perimeters and in intercanine and intermolar arch widths, a decrease in overjet and overbite, and an improvement in canine and molar relationships. In the time after HA therapy until the end of fixed appliances treatment, the TG showed a decrease in maxillary and mandibular arch perimeters, overjet, upper and lower intermolar widths; an increase in molar Class II relationship; and no changes in canine relationship, overbite, and upper and lower intercanine widths. Conclusions: In this sample of patients treated with HA, on average, there was an improvement in the Class II relationship, which seemed to remain after fixed appliances. The transverse dental changes achieved in HA phase relapsed after treatment with fixed appliances.
Impact of oral comorbidities on incarcerated women: an integrative review
(2022-01-01) Longhi, Maria Tereza de Moraes; Silva, Rafaella Ugrin de Oliveira; Gasque, Kellen Cristina da Silva; de Lima, Daniela Coelho; de Oliveira, Josué Miguel; Caldeira, François Isnaldo Dias [UNESP]; Alfenas Federal University (Unifal-MG); Oswaldo Cruz Foundation (FIOCRUZ-DF); University of Brasília; Universidade Estadual Paulista (UNESP)
Introduction: Oral health care directly impacts the well-being of incarcerated women. It is related to the quality of life, social and economic discrepancies and lack of access to programs that offer free dental services and health promotion for this population. Objectives: This work aimed to understand oral health challenges faced by women incarcerated in Brazil and worldwide. Material and method: The following databases were selected: EMBASE, (Virtual Health Library=LILACS+BDENF), Scielo, Sco-pus, Cochrane-Library and the PubMed search engine. These databases were searched until the closing date of October 2021 with no time limit for the searches. The key words used in the searches were “incarceration”, “prison”, “woman”, and “oral health”. Results: Caries, periodontal disease, tooth pain, and the use of dental prostheses were the most prevalent oral health conditions amongst incarcerated women in Brazil and worldwide. Regarding the level of scientific evidence, the included articles fit level III, according to Melnyk and Fineout. Discussion: Bearing in mind the limitations of the study, oral diseases in the global context showed that the quality of life related to oral and systemic health of women during and after incarceration was negatively affected. It is also essential for further clinical and follow-up studies to be carried out on incarcerated women that address their actual oral health needs.
Evidence Linking PPARG Genetic Variants with Periodontitis and Type 2 Diabetes Mellitus in a Brazilian Population
(2023-04-01) Cirelli, Thamiris [UNESP]; Nicchio, Ingra G. [UNESP]; Bussaneli, Diego G. [UNESP]; Silva, Bárbara R. [UNESP]; Nepomuceno, Rafael [UNESP]; Orrico, Silvana R. P. [UNESP]; Cirelli, Joni A. [UNESP]; Theodoro, Letícia H. [UNESP]; Barros, Silvana P.; Scarel-Caminaga, Raquel M. [UNESP]; University Center—UNIFAE; Universidade Estadual Paulista (UNESP); Union of the Colleges of the Great Lakes—UNILAGO; University of North Carolina at Chapel Hill—UNC
The peroxisome proliferator-activated receptor gamma (PPARG) gene encodes a transcription factor involved in the regulation of complex metabolic and inflammatory diseases. We investigated whether single nucleotide polymorphisms (SNPs) and haplotypes of the PPARG gene could contribute with susceptibility to develop periodontitis alone or together with type 2 diabetes mellitus (T2DM). Moreover, we evaluated the gene–phenotype association by assessing the subjects’ biochemical and periodontal parameters, and the expression of PPARG and other immune response–related genes. We examined 345 subjects with a healthy periodontium and without T2DM, 349 subjects with moderate or severe periodontitis but without T2DM, and 202 subjects with moderate or severe periodontitis and T2DM. PPARG SNPs rs12495364, rs1801282, rs1373640, and rs1151999 were investigated. Multiple logistic regressions adjusted for age, sex, and smoking status showed that individuals carrying rs1151999-GG had a 64% lower chance of developing periodontitis together with T2DM. The CCGT haplotype increased the risk of developing periodontitis together with T2DM. The rs1151999-GG and rs12495364-TC were associated with reduced risk of obesity, periodontitis, elevated triglycerides, and elevated glycated hemoglobin, but there was no association with gene expression. Polymorphisms of the PPARG gene were associated with developing periodontitis together with T2DM, and with obesity, lipid, glycemic, and periodontal characteristics.
An alternative approach for the surgical correction of unilateral crossbite
(2023-04-01) Ledra, Ingrid Müller [UNESP]; Trento, Guilherme dos Santos [UNESP]; Pereira-Filho, Valfrido Antônio [UNESP]; Hochuli-Vieira, Eduardo [UNESP]; Martins, Renato Parsekian [UNESP]; Universidade Estadual Paulista (UNESP)
This case report aims to describe a modified surgically assisted rapid palatal expansion technique to treat an asymmetrical posterior crossbite with no mandibular shift without causing an interincisal diastema. A clinical patient with an asymmetrical crossbite, large tooth-size-arch length, and Bolton discrepancy is used to illustrate the modified technique. Instead of traditional osteotomies, in this technique, the osteotomy is done between the maxillary right canine and lateral incisor (connecting the piriform aperture to the alveolar process) along with a unilateral LeFort I osteotomy. The expansion forces are produced by the activation of a conventional hyrax appliance. The skeletal unilateral crossbite was corrected without major changes to the opposite side and without causing an anesthetic diastema between the maxillary central incisors. A mandibular incisor extraction produced the space needed to treat the tooth size-arch length and corrected the Bolton discrepancy. This allowed a successful treatment of the problems initially presented by the patient.
Molar-Incisor Hypomineralization: Prevalence Comparative Study in 6 Years of Interval
(2022-01-01) Damares Lago, Jéssica [UNESP]; Restrepo, Manuel; Girotto Bussaneli, Diego [UNESP]; Patrícia Cavalheiro, Jéssica [UNESP]; Feltrin De Souza, Juliana; Santos-Pinto, Lourdes [UNESP]; De Cássia Loiola Cordeiro, Rita [UNESP]; Jeremias, Fabiano [UNESP]; Universidade Estadual Paulista (UNESP); Universidad CES; Universidade Federal do Paraná (UFPR)
The aim of this study was to evaluate the prevalence evolution rate of MIH (molar-incisor hypomineralization) after a 6-year period in Araraquara/SP, Brazil. This population-based study evaluated MIH in 545 schoolchildren (6-12 years of age) and other associated alterations, dental caries and dental fluorosis (DF). A semistructured questionnaire was sent to the schoolchildren's parents/guardians with the purpose of identifying the socioeconomic profile. Associations between MIH and the clinical characteristics were analyzed by the Poisson analysis of regression with robust variance, estimating the RPc (crude prevalence ratio) with CI 95%. The level of significance of 5% was adopted. The MIH prevalence in Araraquara/SP in 2016 was 14.3% (n = 78), and at this time, an increase of 2% was observed, in comparison with the data of the first prevalence study conducted in 2010 (12.3%). The mild degree compromise was the most prevalent diagnosis in the affected teeth (82.0%). Among children with MIH, the mean number of affected teeth was 2.78. Of the total number of children with MIH, 32.0% presented alterations in both first permanent molars and permanent incisors. There is no significant association between MIH and dental caries experience on permanent dentition (PRc = 1.141; CI 95% 0.709-1.835) or on primary dentition (PRc = 1.132; CI 95% 0.749-1.709). Children with MIH presented significantly less prevalence of dental fluorosis (PRc = 0.505; CI 95% 0.268-0.950). There is no association between MIH and monthly Brazilian minimal wage income (PRc = 1.130; CI 95% 0.655-1.949). It was concluded that the number of MIH cases had increased, revealing a greater need for defining the etiological factors and establishing a correct diagnosis to make it possible to institute early intervention.
Molar Incisor Hypomineralization in adolescents and adults and its association with facial profile and occlusion
(2023-03-01) Hanan, Simone Assayag [UNESP]; de Farias, Aline Leite [UNESP]; Santos-Pinto, Lourdes [UNESP]; Universidade Estadual Paulista (UNESP); Amazonas Federal University
Objectives: To date, there are no data available in the scientific literature about the diagnosis of Molar Incisor Hypomineralization (MIH) in adults. We aimed to assess the MIH prevalence and clinical characteristics in adolescents and adults and its association with facial profile and occlusion. Materials and methods: In this cross-sectional study, permanent teeth were evaluated in 275 patients between the ages of 12 and 49 at a dental clinic, using intraoral photographs. A calibrated examiner classified enamel hypomineralization using the MIH index. Statistical analyses were performed using chi-square, Fisher’s tests, and ordinal logistic regression. Results: MIH was observed in 12.73% of all patients. The most commonly affected teeth were permanent molars, while incisors, premolars, and canines were less affected. MIH usually appears as demarcated opacities, with less than one-third of the tooth affected. There was no association between severe defects and facial profile and occlusion, but rather with the higher age of the participants. Conclusion: Enamel hypomineralization mainly affects the first and second permanent molars, but it could also be observed in the third molars, although it is not associated with the orthodontic characteristics investigated. Clinical relevance: This is the first study to highlight the prevalence of MIH in adults. This result showed the importance of other specialists beyond Pediatric Dentistry in the diagnosis of this defect. In addition, hypomineralization of other permanent teeth (canines, premolars, and second molars) has been described previously in other studies, but this is the first to identify MIH in third molars.
Cymbopogon citratus Essential Oil Increases the Effect of Digluconate Chlorhexidine on Microcosm Biofilms
(2022-10-01) Mouta, Luís Felipe Garcia Leal [UNESP]; Marques, Raquel Souza [UNESP]; Koga-Ito, Cristiane Yumi [UNESP]; Salvador, Marcos José; Giro, Elisa Maria Aparecida [UNESP]; Brighenti, Fernanda Lourenção [UNESP]; Universidade Estadual Paulista (UNESP); Universidade Estadual de Campinas (UNICAMP)
The aim of this study was to evaluate the effect of the Cymbopogon citratus essential oil and its association with chlorhexidine on cariogenic microcosm biofilm composition and acidogenicity. Minimum inhibitory and bactericide concentrations from the essential oil and chlorhexidine were determined by broth microdilution assay. Microcosms (polymicrobial) biofilms were produced on glass coverslips, using inoculum from human saliva in McBain culture medium (0.5% sucrose exposure for 6 h/day) for 3 days in 24-well plates. The biofilms were treated twice a day and their composition was evaluated by microorganism quantification. The acidogenicity was evaluated by measuring the pH of the spent culture medium in contact with the biofilm. Overall, the association of C. citratus and chlorhexidine reduced total bacterial counts and aciduric bacteria (maximum reduction of 3.55 log UFC/mL) in microcosm biofilms. This group also presented the lowest acidogenicity even when exposed to sucrose-containing medium. C. citratus essential oil increases the effect of digluconate chlorhexidine on microcosm biofilms. Based on these findings, this study can contribute to the development of new formulations that might allow for the use of mouthwashes for a shorter period, which may reduce undesirable effects and increase patient compliance to the treatment.
Calcium silicate-coated porous chitosan scaffold as a cell-free tissue engineering system for direct pulp capping
(2022-11-01) Leite, Maria Luísa; Anselmi, Caroline [UNESP]; Soares, Igor Paulino Mendes [UNESP]; Manso, Adriana Pigozzo; Hebling, Josimeri [UNESP]; Carvalho, Ricardo Marins; de Souza Costa, Carlos Alberto [UNESP]; The University of British Columbia; Universidade Estadual Paulista (UNESP)
Objectives: This study aimed to develop and characterize different formulations of porous chitosan scaffolds (SCH) associated with calcium silicate (CaSi) and evaluate their chemotactic and bioactive potential on human dental pulp cells (hDPCs). Methods: Different concentrations of CaSi suspensions (0.5%, 1.0%, and 2.0%, w/v) were incorporated (1:5; v/v) /or not, into 2% chitosan solution, giving rise to the following groups: SCH (control); SCH+ 0.5CaSi; SCH+ 1.0CaSi; SCH+ 2.0 CaSi. The resulting solutions were submitted to thermally induced phase separation followed by freeze-drying procedures to obtain porous scaffolds. The topography, pH, and calcium release kinetics of the scaffolds were assessed. Next, the study evaluated the influence of these scaffolds on cell migration (MG), viability (VB), proliferation (PL), adhesion and spreading (A&S), and on total protein synthesis (TP), alkaline phosphatase (ALP) activity, mineralized matrix deposition (MMD), and gene expression (GE) of odontogenic differentiation markers (ALP, DSPP, and DMP-1). The data were analyzed with ANOVA complemented with the Tukey post-hoc test (α = 5%). Results: Incorporation of the CaSi suspension into the chitosan scaffold formulation increased pore diameter when compared with control. Increased amounts of CaSi in the CH scaffold resulted in higher pH values and Ca release. In Groups SCH+ 1.0CaSi and SCH+ 2.0CaSi, increased VB, PF, A&S, GE of DSPP/DMP-1 and MMD values were shown. However, Group SCH+ 2.0CaSi was the only formulation capable of enhancing MG and showed the highest increase in TP, MMD, and GE of DMP-1 and DSPP values. Significance: SCH+ 2.0CaSi formulation had the highest chemotactic and bioactive potential on hDPCs and may be considered a potential biomaterial for pulp-dentin complex regeneration.
APPLICATION OF ERGONOMIC PRINCIPLES IN PRE-CLINICAL TRAINING: DENTAL STUDENTS' PERCEPTIONS
(Portuguese Soc Occupational Safety & Hygiene, 2022-01-01) Pazos, Julia Margato [UNESP]; Oliveira, Caroline Anselmi de [UNESP]; Wajngarten, Danielle [UNESP]; Nordi Sasso Garcia, Patricia Petromilli [UNESP]; Arezes, P.; Baptista, J. S.; Melo, R.; Barroso, M.; Branco, J. C.; Carneiro, P.; Colim, A.; Costa, N.; Costa, S.; Duarte, J.; Guedes, J.; Perestrelo, G.; Universidade Estadual Paulista (UNESP)
This study evaluated dental students' perceptions of the application of ergonomic principles during pre-clinical activities. The sample consisted of second-year undergraduate students (n=51). Data was collected using a semi-structured open-ended interview on the challenges to adopting ergonomic posture. The data was analyzed using the discourse of the collective subject (DCS) with QualiQuantiSoft (R). The interviews revealed that most students (54.9%) reported maintaining a distance of 30 to 40 cm between the patient's mouth and the operator's eyes as the most difficult technique to put into practice, particularly when attempting to visualize the operating field (49.0%). The workplace-related factor found to create the greatest risk of developing musculoskeletal disorders was the dental mannequin (31.4%). Most of the students reported that the degree of difficulty of the procedures they were performing negatively influenced their adoption of proper working posture due to the difficulty in visualization (35.3%), to their focus on the work being performed (27.5%), and to their difficulty in accessing the operating field (25.5%). It was concluded that the greatest challenge faced by the students was found to be the ability to maintain an adequate distance between their eyes and the patients' mouths due to the need to visualize the operating field.
Manganese oxide increases bleaching efficacy and reduces the cytotoxicity of a 10% hydrogen peroxide bleaching gel
(2022-01-01) de Oliveira Ribeiro, Rafael Antonio [UNESP]; Zuta, Uxua Ortecho [UNESP]; Soares, Igor Paulino Mendes [UNESP]; Anselmi, Caroline [UNESP]; Soares, Diana Gabriela; Briso, André Luiz Fraga [UNESP]; Hebling, Josimeri [UNESP]; de Souza Costa, Carlos Alberto [UNESP]; Universidade Estadual Paulista (UNESP); Universidade de São Paulo (USP)
Objective: The study aims to assess the effects of a 10% H2O2 bleaching gel with different MnO2 concentrations on the bleaching efficacy (BE), degradation kinetics (DK) of H2O2, and trans-amelodentinal cytotoxicity (TC). Materials and methods: Standardized bovine enamel/dentin disks (n = 96) were placed in artificial pulp chambers, and the bleaching gels were applied for 45 min. Thus, the following groups were established: (G1) no treatment (negative control/NC); (G2) 35% H2O2 (positive control/PC); (G3) 10% H2O2; (G4) 10% H2O2 + 2 mg/mL MnO2; (G5) 10% H2O2 + 6 mg/mL MnO2; and (G6) 10% H2O2 + 10 mg/mL MnO2. After analyzing bleaching efficacy (ΔE00 and ΔWI), the degradation kinetics of H2O2 and trans-amelodentinal cytotoxicity were determined (n = 8, ANOVA/Tukey; p < 0.05). Results: G6 presented BE (ΔE00 and ΔWI) statistically similar to G2, which represented conventional in-office bleaching (p = 0.6795; p > 0.9999). A significant reduction in the diffusion of H2O2 occurred in G3, G4, G5, and G6 compared to G2 (p < 0.0001). The highest DK of H2O2 occurred in G6 (p < 0.0001), which had the lowest TC in comparison with all other bleached groups (p ≤ 0.0186). Conclusion: The addition of 10 mg/mL of MnO2 in a 10% H2O2 bleaching gel potentiates the degradation of this reactive molecule, which increases the BE of the product and decreases TC. Clinical significance: Replacing a 35% H2O2 gel commonly used for conventional in-office dental bleaching by a 10% H2O2 gel containing 10 mg/mL of MnO2 reduces the cytotoxicity of this professional therapy, maintaining its excellent esthetic efficacy.
Inhibitory activity of S-PRG filler on collagen-bound MMPs and dentin matrix degradation
(2022-09-01) Mendes Soares, Igor Paulino [UNESP]; Anselmi, Caroline [UNESP]; Guiné, Isabela [UNESP]; Fernandes, Lídia de Oliveira [UNESP]; Pires, Maria Luiza Barucci Araujo [UNESP]; de Souza Costa, Carlos Alberto [UNESP]; Scheffel, Débora Lopes Salles; Hebling, Josimeri [UNESP]; Universidade Estadual Paulista (UNESP); Universidade Estadual de Maringá (UEM)
Objectives: To evaluate the inhibitory activity of an ion-releasing filler (S-PRG) eluate on dentin collagen-bound metalloproteinases (MMPs) and dentin matrix degradation. Methods: Dentin beams (5 × 2 × 0.5 mm) from human molars were completely demineralized to produce dentin matrix specimens. The dry mass was measured, and a colorimetric assay (Sensolyte) determined the initial total MMP activity to allocate the beams into four treatment groups (n = 10/group): 1) water for 1 min (negative control); 2) 2% chlorhexidine digluconate (CHX – inhibitor control) for 1 min; 3) S-PRG eluate for 1 min; 4) S-PRG eluate for 30 min. After the treatments, the total MMP activity was reassessed. The specimens were stored in simulated body fluid (SBF) at 37 °C for up to 21 days. The dry mass was reassessed weekly. On day 7, the dentin matrix degradation was analyzed for the presence of collagen fragments (CF; Sirius Red) and hydroxyproline (Hyp) in the SBF. Statistical analyses were performed with ANOVA/Tukey, paired t-tests, and RM-ANOVA/Sidak (α = 5%). Results: S-PRG eluate exposure for 1 and 30 min reduced (p < 0.0001) MMP activity. S-PRG exposure for 30 min presented MMP activity inhibition equivalent to CHX (p = 0.061). S-PRG and CHX decreased CF (p ≤ 0.007) and Hyp (p < 0.046) release. After 21 days of storage, S-PRG-treated beams, regardless of exposure time, presented a reduced (p ≤ 0.017) mass loss, intermediate between CHX and control. Conclusion: Treating demineralized dentin with S-PRG eluate for 1 or 30 min reduced matrix-bound MMP activity and dentin matrix degradation for up to 21 days. Clinical significance: S-PRG filler may hinder the progression of dentin carious/erosive lesions and enhance the stabilization of dentin bonding interfaces.
Influence of ceramic veneer on the transdentinal cytotoxicity, degree of conversion and bond strength of light-cured resin cements to dentin
(2022-06-01) Kitagawa, Fernanda Ali [UNESP]; Leite, Maria Luísa [UNESP]; Soares, Igor Paulino Mendes [UNESP]; Anselmi, Caroline [UNESP]; de Oliveira Ribeiro, Rafael Antônio [UNESP]; Hebling, Josimeri [UNESP]; de Souza Costa, Carlos Alberto [UNESP]; Universidade Estadual Paulista (UNESP)
Objectives: To investigate the transdentinal cytotoxicity (TC), degree of conversion (DC), and micro shear bond strength (μSBS) to dentin of light-cured resin cements (LCRCs) photoactivated directly or through a ceramic veneer( ± CV). Materials and methods: The TC was assessed using human dentin discs adapted into artificial pulp chambers. Odontoblast-like cells were seeded on the pulp surface of the discs, then three LCRCs( ± CV) were applied on their etched and hybridized occlusal surface (n = 8/group). The adhesive systems of each LCRCs and sterile phosphate-buffered saline were used as positive and negative controls, respectively. After 24 h, the viability and morphology of cells adhered on discs were assessed. The extracts (culture medium + components of the materials diffused through the discs) were applied on the MDPC-23 to evaluate their viability, adhesion/spreading (A/S), alkaline phosphatase activity (ALP), and mineralized nodule formation (MN). LCRCs( ± CV) specimens were evaluated concerning the DC and μSBS to dentin. Data were analyzed by one-, two-, or three-way ANOVA/Dunnett, Sidak, and Games-Howell tests (α = 5%). Results: All LCRCs( ± CV) reduced cell viability, A/S, ALP, MN, and DC. Except for μSBS, the intensity of reduction was dependent on the LCRC used. LCRCs+CV resulted in lower DC and μSBS but did not increase the TC. Significance: Besides the presence of CV between the light source and LCRCs reduces the degree of conversion and bond strength to dentin, these materials cause variable level of transdentinal toxicity to pulp cells. Thus, the composition and curing protocols of LCRCs should be revisited and reinforced to prevent mechanical and biological drawbacks.
Innovative strategy for in-office tooth bleaching using violet LED and biopolymers as H2O2 catalysts
(2022-06-01) Martins, Beatriz Voss [UNESP]; Dias, Marlon Ferreira [UNESP]; de Oliveira Ribeiro, Rafael Antônio [UNESP]; Leite, Maria Luísa de Alencar e Silva [UNESP]; Hebling, Josimeri [UNESP]; de Souza Costa, Carlos Alberto [UNESP]; Universidade Estadual Paulista (UNESP)
Objective: To assess the influence of coating the enamel with a nanofiber scaffold (NS) and a polymeric catalyst primer (PCP) on the esthetic efficacy, degradation kinetics of hydrogen peroxide (H2O2), and trans-amelodentinal cytotoxicity of bleaching gels subjected or not to violet-LED irradiation. Methodology: The following groups were established (n = 8): G1- No treatment (negative control); G2- NS+PCP; G3- LED; G4- NS+PCP+LED; G5- 35% H2O2 (positive control); G6- NS+PCP+35% H2O2+LED; G7- 20% H2O2; G8- NS+PCP+20% H2O2+LED; G9- 10% H2O2; G10- NS+PCP+10% H2O2+LED. For esthetic efficacy analysis, enamel/dentin discs were stained and exposed for 45 min to the bleaching protocols. To assess the cytotoxicity, the stained enamel/dentin discs were adapted to artificial pulp chambers, and the extracts (culture medium + components diffused through the discs) were collected and applied to MDPC-23 cells, which had their viability, oxidative stress, and morphology (SEM) evaluated. The amount of H2O2 diffused and hydroxyl radical (OH•) production were also determined (two-way ANOVA/Tukey/paired Student t-test; p < 0.05). Results: G6 had the highest esthetic efficacy compared to the other groups (p < 0.05). Besides the esthetic efficacy similar to conventional in-office bleaching (G5; p > 0.05), G10 also showed the lowest toxic effect and oxidative stress to MDPC-23 cells compared to all bleached groups (p < 0.05). Conclusion: Coating the enamel with a nanofiber scaffold and a polymeric catalyst primer, followed by the application of 10%, 20%, or 35% H2O2 bleaching gels irradiated with a violet LED, stimulates H2O2 degradation, increasing esthetic efficacy and reducing the trans-amelodentinal toxicity of the treatment.
Influence of Manganese Oxide on the Esthetic Efficacy and Toxicity Caused by Conventional In-office Tooth Bleaching Therapy
(2022-07-01) Ribeiro, Rao [UNESP]; de Oliveira Duque, C. C. [UNESP]; Ortecho-Zuta, U. [UNESP]; Leite, M. L. [UNESP]; Hebling, J. [UNESP]; Soares, D. G.; de Souza Costa, C. A.; Universidade Estadual Paulista (UNESP); Universidade de São Paulo (USP)
OBJECTIVE: This study aimed to evaluate the esthetic efficacy, cytotoxicity, and kinetics of decomposition of hydrogen peroxide (H2O2) present in a commercial bleaching gel with 35% H2O2 (BG35%) chemically activated with manganese oxide (MnO2). METHODS AND MATERIALS: After incorporating 2 mg/mL, 6 mg/mL, and 10 mg/mL of MnO2 into BG35%, the stability of pH and temperature of the products were analyzed. To assess the esthetic efficacy (ΔE and ΔWI), the BG35%s with MnO2 were applied for 45 minutes on enamel/dentin discs (DiE/D). BG35% or no treatment were used as positive (PC) and negative (NC) controls, respectively. To analyze the cell viability (CV) and oxidative stress (OXS), the same bleaching protocols were performed on DiE/D adapted to artificial pulp chambers. The extracts (culture medium + gel components that diffused through the discs) were applied to pulp cells and submitted to H2O2 quantification. BG35% with MnO2 that showed the best results was evaluated relative to kinetic decomposition of H2O2, with consequent generation of free radicals (FR) and hydroxyl radicals (OH•). The data were submitted to the one-way analysis of variance complemented by Tukey post-test (α=0.05). Data on kinetics of H2O2 decomposition were submitted to the Student's-t test (α=0.05). RESULTS: All the BG35%s with MnO2 showed stability of pH and temperature, and the gel with 10 mg/mL of this activator had an esthetic efficacy 31% higher than that of the PC (p<0.05). Reduction in OXS and trans-amelodentinal diffusion of H2O2 occurred when all the BG35%s with MnO2 were used. The addition of 6 and 10 mg/mL of MnO2 to BG35% increased the CV in comparison with PC, confirmed by the cell morphology analysis. An increase in FR and OH• formation was observed when 10 mg/mL of MnO2 was added to BG35%. CONCLUSION: Catalysis of BG35% with MnO2 minimized the trans-amelodentinal diffusion of H2O2 and toxicity of the product to pulp cells. BG35% containing 10 mg/mL of MnO2 potentiated the decomposition of H2O2, enhancing the generation of FR and OH•, as well as the efficacy of the in-office tooth therapy.
Polymorphisms in risk genes of type 2 diabetes mellitus could be also markers of susceptibility to periodontitis
(2022-11-01) Silva, Arles Naisa Amaral [UNESP]; Nicchio, Ingra Gagno [UNESP]; da Silva, Bárbara Roque [UNESP]; Martelli, Maurício Gandini Giani [UNESP]; Hidalgo, Marco A. Rimachi [UNESP]; Nepomuceno, Rafael [UNESP]; Theodoro, Letícia H. [UNESP]; Cirelli, Joni A. [UNESP]; Orrico, Silvana R.P. [UNESP]; Cirelli, Thamiris [UNESP]; Barros, Silvana P.; Scarel-Caminaga, Raquel M. [UNESP]; Universidade Estadual Paulista (UNESP); Union of the Colleges of the Great Lakes (UNILAGO); University Center of the Associated Faculties; University of North Carolina at Chapel Hill - UNC
Objectives: This study aimed to investigate polymorphisms in genes considered molecular biomarkers of type 2 diabetes mellitus (T2DM) to assess whether they are associated with periodontitis, and relating them to the periodontal status, glycemic and lipid profile of the subjects. Design: We investigated individuals who underwent complete periodontal examination and biochemical evaluation. We categorized them into three groups: (i) periodontitis with T2DM (Periodontitis+T2DM group, n = 206); (ii) periodontitis without T2DM (Periodontitis group, n = 346); and (iii) healthy individuals without Periodontitis or T2DM (Healthy group, n = 345). We investigated three single nucleotide polymorphisms (SNPs) for AGER, RBMS1 and VEGFA genes. We applied multivariate logistic and multiple linear regression models for all groups and stratified the subjects by sex and smoking habits. Results: Compared with RBMS1-rs7593730-CC+CT genotype carriers, RBMS1-rs7593730-TT carriers were more susceptible to periodontitis [odds ratio (OR) = 2.29; 95% confidence interval (CI) = 1.04–5.01; P-value = 0.033]. Among AGER-rs184003-CC carriers, never smokers had reduced risks of periodontitis and Periodontitis+T2DM than ever smokers. For either RBMS1-rs7593730-CC or VEGFA-rs9472138-CC carriers, never smokers had less susceptibility to develop periodontitis than ever smokers. Compared with AGER-rs184003-CC carriers, AGER-rs184003-AA carriers presented fewer remaining teeth. VEGFA-rs9472138-TT carriers showed a lower percentage of sites with characteristics of active periodontal disease (bleeding on pocket probing and interproximal clinical attachment level) compared with VEGFA-rs9472138-CC carriers. Conclusions: In the studied population, AGER rs184003, RBMS1 rs7593730, and VEGFA rs9472138, which are considered genetic markers for T2DM, were associated with periodontitis without T2DM or periodontitis together with T2DM.

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