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The aim of this study was to assess the effect of different remineralizing agents on enamel microhardness (KHN) and surface topography after an erosive challenge. Forty-eight human enamel specimens (4 × 4 mm) were randomly assigned to 4 groups: control (no treatment), fluoride varnish, calcium nanophosphate paste and casein phosphopeptide-amorphous calcium phosphate paste (CPP-ACP). Both pastes were applied for 5 minutes, and fluoride varnish, for 24 h. Four daily erosive cycles of 5 minutes of immersion in a cola drink and 2 h in artificial saliva were conducted for 5 days. KHN readings were performed at baseline and after 5 days. The percentage of enamel hardness change (%KHN) was obtained after erosion. The surface topography was evaluated by atomic force microscopy (AFM). The data were tested using ANOVA, Tukey's and paired-T tests (p < 0.05). After an erosive challenge, there was no statistically significant difference between the control (96.8 ± 11.4 KHN / 72.4 ± 3.0 %KHN) and the varnish (91.7 ± 14.1 KHN / 73.4 ± 5.5 %KHN) groups. The nanophosphate group showed lower enamel hardness loss (187.2 ± 27.9 / 49.0 ± 7.9 %KHN), compared with the CPP-ACP group (141.8 ± 16.5 / 60.6 ± 4.0 %KHN), and both were statistically different from the varnish and the control groups. AFM images showed a rough surface for the control and the varnish groups, a non-homogeneous layer with globular irregularities for CPP-ACP, and a thick homogeneous layer for the nanophosphate group. None of the agents provided protection against the development of erosion; however, nanophosphate paste was able to reduce enamel surface softening after the erosive challenge.

Abstract:Background. An ipsilateral neck dissection is mandatory during initial treatment stages II-IV oral carcinomas. However, no consensus exists whether or not to perform an elective contralateral neck dissection.Methods. Five hundred thirteen consecutive cases of squamous cell carcinoma (269 tongue, 135 floor of the mouth, 44 inferior gingiva, 65 retromolar trigone) were reviewed. Tumor stages were: 69 T1, 227 T2, 217 T3-T4, 263 N0, 250 N1-N3. A total of 563 neck dissections were performed in 448 patients. Univariate and multivariate analysis of risk factors were performed using logistic regression.Results. Two hundred twenty-three patients (49.8%) had positive nodes in the specimen (182 ipsilateral, 36 bilateral, 5 contralateral). Contralateral neck recurrences occurred in 38 cases (33 not submitted to a contralateral neck dissection initially). Multivariate logistic regression analysis demonstrated that clinical stage (p = .0001), tumor crossing midline (p = .0011), and floor of the mouth involvement (p = .0236) were the most important predictors of contralateral metastasis.Conclusion. The contralateral side of the neck is a common and potentially preventable site of recurrence in tumors of the oral cavity. The multivariate model obtained discriminates patients with low and high risk (more than 20%) of contralateral metastasis. The application of this mathematical model can be useful for the indication of contralateral neck dissections, because not all tumors crossing midline are associated to a high risk (stages I and II tumors not involving the floor of the mouth) and not all tumors not crossing midline are at low risk (stages III and IV tumors involving the floor of the mouth).

Background Carcinoma of the oral cavity presents a high risk for neck metastasis, which reduces the probability of regional control and survival. Objectives The main objective of this study is to analyze prognostic implications of the distribution of neck metastasis in 513 patients with squamous cell carcinoma of the oral cavity. Patients and methods All patients underwent surgery from 1970–1992. Tumor stages were I, 63; II, 120; III, 173; and IV, 157. Neck dissections were performed in 448 patients (115 bilateral). Results By use of multivariate regression techniques the level of lymph node involvement was the most important prognostic factor (relative risks from 1.8 to 2.5). The following variables were also associated with prognosis: mobility of lymph nodes, sex, T stage, age, and tumor thickness. Conclusions The level of ipsilateral lymph node involvement was the most significant prognostic factor patients with in oral cancer who underwent surgical treatment. A significant decrease in survival also was seen with regard to the involvement of multiple contralateral lymph nodes. Our results support the indication of elective neck dissections in high‐risk patients because among the cases that had metastases at follow‐up, 50% were not candidates for salvage treatment. © 2000 John Wiley & Sons, Inc. Head Neck 22: 207–214, 2000.

Objective: To test the hypothesis that treatment time, debris/biofilm, and oral pH have an influence on the physical-chemical properties of orthodontic brackets and arch wires. Materials and Methods: One hundred twenty metal brackets were evaluated. They were divided into four groups (n 5 30) according to treatment time: group C (control) and groups T12, T24, and T36 (brackets recovered after 12, 24, and 36 months of treatment, respectively). Rectangular stainless-steel arch wires that remained in the oral cavity for 12 to 24 months were also analyzed. Dimensional stability, surface morphology, composition of brackets, resistance to sliding of the bracket-wire set, surface roughness of wires, and oral pH were analyzed. One-way analysis of variance, followed by a Tukey multiple comparisons test, was used for statistical analysis (P , .05).Results: Carbon and oxygen were shown to be elements that increased expressively and in direct proportion to time, and there was a progressive increase in the coefficient of friction and roughness of wires as a function of time of clinical use after 36 months. Oral pH showed a significant difference between group T36 and its control (P 5 .014). Conclusions: The hypothesis was partially accepted: treatment time and biofilm and debris accumulation in bracket slots were shown to have more influence on the degradation process and frictional force of these devices than did oral pH. (Angle Orthod. 2015;85:298-304.)

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Objective: To test the null hypothesis that enamel deproteinization with 10% papain gel does not increase the shear bond strength of orthodontic brackets bonded with resin-modified glass ionomer cement (RMGIC). Materials and Methods: One hundred and twenty bovine incisors were used and divided into eight groups: 1) Transbond XT according to the manufacturer's recommendations, 2) Transbond XT deproteinized with 10% papain gel, 3) RMGIC without enamel deproteinization and without etching, 4) RMGIC without enamel etching and with deproteinization with 10% papain gel, 5) RMGIC deproteinized with 10% papain gel and etched with polyacrylic acid, 6) RMGIC deproteinized with 10% papain gel and etched with phosphoric acid, 7) RMGIC deproteinized with 2.5% sodium hypochlorite, and 8) RMGIC etched with polyacrylic acid. After bonding, the mechanical tests were performed in a Universal mechanical test machine. The values obtained were submitted to an analysis of variance and afterward to the Tukey test (P , .05). Results: It was demonstrated that group 2 presented the highest shear bond strength value, and this differed statistically from the others; group 3 presented the lowest value and showed no differences from groups 4, 5, 7, and 8. Regarding the Adhesive Remnant Index, groups 2 and 6 presented the best results and groups 3 and 8 the worst. It could be concluded that enamel deproteinization with 10% papain gel increases the shear bond strength, irrespective of the etching agent. Conclusions: The hypothesis is rejected. Papain gel was shown to be a new ally in the orthodontic clinic. (Angle Orthod. 2012;82:541-545.)