It has been suggested that fluoride products are able to reduce erosive tooth wear. Thus, the purpose of this in vitro study was to evaluate the effect of dentifrices with different fluoride concentrations as well as of a low-fluoridated dentifrice supplemented with trimetaphosphate (TMP) on enamel erosion and abrasion. One hundred twenty bovine enamel blocks were assigned to the following experimental dentifrices: placebo, 1,100 µg F/g, 500 µg F/g plus 3% TMP and 5,000 µg F/g. The groups of enamel blocks were additionally subdivided into conditions of erosion (ERO) and of erosion plus abrasion (ERO + ABR). For 7 days, the blocks were subjected to erosive challenges (immersion in Sprite® 4 times a day for 5 min each time) followed by a remineralizing period (immersion in artificial saliva between erosive challenges for 2 h). After each erosive challenge, the blocks were exposed to slurries of the dentifrices (10 ml/sample for 15 s). Sixty of the blocks were additionally abraded by brushing using an electric toothbrush (15 s). The alterations of the enamel were quantified using the Knoop hardness test and profilometry (measurements in micrometers). The data were analyzed using a 2-way ANOVA test followed by a Bonferroni correction (p < 0.05). In in vitro conditions, the 5,000 µg F/g and 500 µg F/g plus 3% TMP dentifrices had a greater protective effect when compared with the 1,100 µg F/g dentifrice, under both ERO and ERO + ABR conditions. The results suggest that dentifrices alone are not capable of completely inhibiting tooth wear.

Resin-based materials that show promising effects for preventing the progression of erosion have been studied. This in vitro study evaluated the effects of applying resin-based materials, including resin infiltration, on previously eroded enamel subjected to erosive challenges. The influence of enamel surface etching prior to application of the material was also studied. Bovine enamel blocks were immersed in hydrochloric acid (HCl), 0.01 M (pH 2.3), for 30 seconds in order to form a softened erosion lesion. The blocks were then randomly divided into nine groups (n=12) and treated as follows: C = control without treatment; Hel = pit & fissure resin sealant (Helioseal Clear); Adh = two-step self-etching adhesive system (AdheSe); Tet = two-step conventional adhesive system (Tetric N-bond); and Inf = infiltrant (Icon). The Helno, Adhno, Tetno, and Infno groups received the same materials without (or with no) surface conditioning. The depth of the material's penetration into softened erosion lesions was qualitatively analyzed using reflection and fluorescence confocal microscopy. After application of the materials, the blocks were immersed in HCl for two minutes; this step was followed by immersion in artificial saliva for 120 minutes four times a day for five days (erosive cycling). Both the enamel alteration and material thickness were analyzed using profilometry, and the results were submitted to Kruskal-Wallis and Dunn tests (p>0.05). Images from the confocal microscopy showed minimal penetration of Adh/Adhno and deep penetration of Inf/Infno into the erosive lesions. The groups Hel, Adh, Inf, Tetno, and Infno resulted in the formation of a layer of material over the enamel, which was effective in inhibiting the progression of erosion. In conclusion, the infiltrant, with or without etching, was able to penetrate and protect the enamel against dental erosion. The other resin-based materials, except for the two-step conventional adhesive, were able to penetrate and inhibit the progression of erosive lesions only when they were applied after enamel etching.

TMP significantly enhanced the effects of F on enamel wear after erosive challenges, followed or not by abrasion.

No abstract

The application of resin-based materials is an alternative of treatment for eroded lesions. Nevertheless, there are no studies about the penetration of these materials into eroded lesion, which might affect its adhesion. Therefore, this study evaluated the penetration of four resin-based materials, with and without enamel etching. By using an in vitro protocol, types of treatment were studied at five levels (AdheSE(®) , Tetric N-Bond(®) , Single Bond 2(®) , Helioseal Clear(®) , Icon(®) ) and types of enamel etching in two levels (with and without). Materials were stained with 0.02 mg/mL ethanolic solution of tetramethylrhodamine isothiocyanate. Bovine enamel samples (4 × 4 mm) were immersed in 0.01 M HCl, pH 2.3, for 30 seconds to produce initial eroded lesions. Afterward, the materials were applied on half of sample enamel surface following the manufacturer's instructions. On the other half of sample, the materials were applied without etching the enamel. Materials penetration into the enamel was assessed by Confocal Laser Scanning Microscopy on reflection and fluorescence modes. The penetration depth (PD) was measured using ImageJ software. Data were analyzed by two-way ANOVA and Tukey test (P < 0.05). Regardless of the material, etched enamel resulted in higher PD than non-etched (P < 0.05). Icon(®) showed the highest PD in enamel followed by Helioseal Clear(®) (P < 0.05), with significant difference between them (P < 0.05) and no difference was found among AdheSE(®) , Tetric N-Bond(®) , and Single Bond 2(®) (P > 0.05). It can be concluded that prior enamel etching increased the materials penetration into eroded enamel and the Icon(®) -infiltrant presented highest penetration.

Descrita em 1836 como sendo uma celulite tóxica por Wilhelm Frederick Von Ludwig, a Angina de Ludwig pode ser uma celulite extremamente fatal se não houver um diagnóstico preciso e precoce. Tendo vários fatores causal sendo o principal às infecções odontológicas dentre outras como: traumatismos e lacerações dos tecidos bucais, infecções das glândulas salivares, picada de insetos no queixo, neoplasias bucais infectadas, linfadenites, osteonecrose da mandíbula relacionada com o uso de bisfosfonatos. Afetando os espaços fasciais do pescoço, espaço submandibular, espaço submentoniano assim tendo o comprometimento principal as vias aéreas, pacientes imunossuprimidos e com comprometimento na condição sistêmica tendem a ser mais suscetível a Angina de Ludwig. Tendo tratamento a internação imediata e em seguida a prescrição de antibióticos para o controle da infecção e a drenagem cirúrgica para a remoção do material purulento e em seguida a remoção da causa da infecção como extrações e tratamento endodôntico, devido ao comprometimento das vias aéreas em alguns casos mais graves deve se realizar uma traqueostomia ou intubação endotraqueal. Este trabalho visa o melhor entendimento sobre o manejo de pacientes com Angina de Ludwig oferecendo ao leitor um conhecimento sobre a etiologia, diagnóstico e tratamento, bem como o prognostico relativo ao tratamento estabelecido.

This in vitro study evaluated the protective effect of fluoride varnishes containing sodium trimetaphosphate (TMP) against dentin erosion and abrasion. Specimens of coronal dentin were divided into: placebo, 2.5% NaF, 5% NaF, 2.5% NaF + 5% TMP, and 5% NaF + 5% TMP groups (<i>n =</i>24/group). After single application of the varnishes, the samples were immersed in citric acid (0.05 mol/L, pH = 3.2, 5 min) followed or not by brushing, and the dentin wear was assessed after 5 days. Varnishes containing fluoride + TMP led to the lowest wear. TMP varnishes showed a superior effect against dentin erosive wear.

The effect of mucin in artificial saliva on rehardening (RE-experiment) and inhibition (DE-experiment) of erosion was evaluated. The treatment groups were: artificial saliva with mucin, artificial saliva without mucin, human saliva, and water. For the RE-experiment, after immersion of enamel blocks in citric acid (4 min), hardness was measured and blocks were subjected to treatment for 2 h. For the DE-experiment, sound blocks were subjected to treatment for 2 h and immersed in citric acid (4 min). Percentages of hardness recovery (RE) and loss (DE) were analyzed (ANOVA/Tukey's test). The salivas promoted similar rehardening, but only the saliva with mucin was similar to human saliva with regard to enamel protection against erosion.