Gláucia Maria Bovi Ambrosano

In vitro antimicrobial activity of propolis and Arnica montana against oral pathogens

Arnica and propolis have been used for thousands of years in folk medicine for several purposes. They possess several biological activities such as anti-inflammatory, antifungal, antiviral and tissue regenerative, among others. Although the antibacterial activity of propolis has already been demonstrated, very few studies have been done on bacteria of clinical relevance in dentistry. Also, the antimicrobial activity of Arnica has not been extensively investigated. Therefore the aim here was to evaluate in vitro the antimicrobial activity, inhibition of adherence of mutans streptococci and inhibition of formation of water-insoluble glucan by Arnica and propolis extracts. Arnica montana (10%, w/v) and propolis (10%, w/v) extracts from Minas Gerais State were compared with controls. Fifteen microorganisms were used as follows: Candida albicans--NTCC 3736, F72; Staphylococcus aureus--ATCC 25923; Enterococcus faecalis--ATCC 29212; Streptococcus sobrinus 6715; Strep. sanguis--ATCC 10556; Strep. cricetus--HS-6; Strep. mutans--Ingbritt 1600; Strep. mutans--OMZ 175; Actinomyces naeslundii--ATCC 12104, W 1053; Act. viscosus OMZ 105; Porphyromonas gingivalis; Porph. endodontalis and Prevotella denticola (the last three were clinical isolates). Antimicrobial activity was determined by the agar diffusion method and the zones of growth inhibition were measured. To assess cell adherence to a glass surface, the organisms were grown for 18 h at 37 degrees C in test-tubes at a 30 degree angle. To assay water-insoluble glucan formation, a mixture of crude glucosyltransferase and 0.125 M sucrose was incubated for 18 h at 37 degrees C in test-tubes at a 30 degree angle. Arnica and propolis extracts (20 microl) were added to these tubes to evaluate the % of inhibition of cell adherence and water-insoluble glucan formation. The propolis extract significantly inhibited all the microorganisms tested (p < 0.05), showing the largest inhibitory zone for Actinomyces spp. The Arnica extract did not demonstrate significant antimicrobial activity. Cell adherence and water-insoluble glucan formation were almost completely inhibited by the propolis extract at a final concentration of 400 microg/ml and 500 microg/ml, respectively. The Arnica extract showed slight inhibition of the adherence of the growing cells (19% for Strep. mutans and 15% for Strep. sobrinus) and of water-insoluble glucan formation (29%) at these same concentrations. Thus, the propolis extract showed in vitro antibacterial activity, inhibition of cell adherence and inhibition of water-insoluble glucan formation, while the Arnica extract was only slightly active in those three conditions.

Effect of a Mouthrinse Containing Selected Propolis on 3-Day Dental Plaque Accumulation and Polysaccharide Formation

The aim of this study was to evaluate the effect of a mouthrinse containing propolis SNB-RS on 3-day dental plaque accumulation. Six volunteers took part in a double-blind crossover study performed in two phases of 3 days. During each phase the volunteers refrained from all oral hygiene and rinsed with 20% sucrose solution 5 times a day to enhance dental plaque formation and with mouthrinse (placebo or experimental) twice a day. On the 4th day, the plaque index (PI) of the volunteers was scored and the supragingival dental plaque was analyzed for insoluble polysaccharide (IP). The PI (SD) for the experimental group was 0.78 (0.17), significantly less than for the placebo group, 1.41 (0.14). The experimental mouthrinse reduced the IP concentration in dental plaque by 61.7% compared to placebo (p < 0.05). An experimental mouthrinse containing propolis SNB-RS was thus efficient in reducing supragingival plaque formation and IP formation under conditions of high plaque accumulation.

Effect of light curing tip distance and resin shade on microhardness of a hybrid resin composite

Resin composite shades and resin composite polymerization performed with a distanced light tip are factors that can affect polymerization effectiveness. This in vitro study aimed to evaluate the influence of curing tip distance and resin shade on the microhardness of a hybrid resin composite (Z250-3M ESPE). Forty-five resin composite specimens were randomly prepared and divided into nine experimental groups (n = 5): three curing tip distances (2 mm, 4 mm, and 8 mm) and three resin shades (A1, A3.5, and C2). All samples were polymerized with a continuous output at 550 mW/cm(2). After 24 hours, Knoop microhardness measurements were obtained on the top and bottom surfaces of the sample, with a load of 25 grams for 10 seconds. Five indentations were performed on each surface of each sample. Results showed that bottom surface samples light-cured at 2 mm and 4 mm presented significantly higher hardness values than samples light-cured at 8 mm. The resin shade A1 presented higher hardness values and was statistically different from C2. The resin shade A3.5 did not present statistical differences from A1 and C2. For the top surface, there were no statistical differences among the curing tip distances. For all experimental conditions, the top surface showed higher hardness values than the bottom surface. It was concluded that light curing tip distance and resin shade are important factors to be considered for obtaining adequate polymerization.

Effect of a new variety of Apis mellifera propolis on mutans streptococci.

The effects of a new variety of propolis, from Northeastern Brazil (BA), on growth of mutans streptococci, cell adherence, and water-insoluble glucan (WIG) synthesis were evaluated. Propolis from Southeastern (MG) and Southern (RS) Brazil were also tested as an extension of our previous work. Ethanolic extracts of propolis (EEP) were prepared and analyzed by reversed-phase HPLC. For the antibacterial activity assays, minimum inhibitory concentrations (MIC) and minimum bactericidal concentrations (MBC) of EEPs against Streptococcus mutans, S. sobrinus, and S. cricetus were determined. Cell adherence of S. mutans and S. sobrinus to a glass surface was measured spectrophotometrically at 550 nm. WIG synthesized from sucrose by glucosyltransferase (Gtf) was extracted and quantified by the phenol-sulfuric method. The HPLC profile of the new variety of propolis was entirely different from Southeastern and Southern propolis. Neither flavonoid aglycones nor p-coumaric acid were detected in EEP BA. All EEPs demonstrated biological activities against mutans streptococci; EEP BA showed the highest potency in all in vitro parameters evaluated in this study. The ranges of MIC values were 50 (EEP BA)–400 μg/ml (MG), for S. mutans; and 25 (BA)–400 μg/ml (MG), for S. sobrinus and S. cricetus. The bactericidal concentration of EEPs was four to eight times the MIC values. The adherence of S. mutans and S. sobrinus cells and WIG synthesis were markedly inhibited by EEPs, demonstrating significant inhibition at all concentrations compared with the control (80% ethanol) (p < 0.05). EEP BA showed 80% inhibition of cell adherence and WIG synthesis at concentrations as low as 12.5 and 7.8 μg/ml, respectively. The results show that the new variety of propolis was exceptionally effective in all in vitro parameters tested against mutans streptococci; biological effects of propolis are likely not to be due solely to flavonoids and (hydroxy)cinnamic acid derivatives.

An In Vitro Evaluation of Rigid Internal Fixation Techniques for Sagittal Split Ramus Osteotomies: Advancement Surgery

PURPOSE This in vitro investigation was developed with the purpose of comparing the biomechanical features of 3 different methods of rigid internal fixation for sagittal split ramus osteotomies for mandibular advancement. MATERIALS AND METHODS Rigid internal fixation techniques included a 4-hole plate and 4 monocortical screws (miniplate group), a 4-hole plate and 4 monocortical screws with 1 additional bicortical positional screw (hybrid group), and 3 bicortical positional screws in a traditional inverted-L pattern (inverted-L group). Screws and miniplates were made of titanium and from a 2.0-mm system (MDT, Rio Claro, SP, Brazil). Sixty polyurethane replicas of human hemimandibles (Nacional, Jaú, SP, Brazil) were used as substrates, simulating a 5-mm advancement surgery by a sagittal split ramus osteotomy. They were adapted to a test support, and were submitted to lateral torsional forces on the buccal molar surface and vertical cantilever loading on the incisal edge by an Instron 4411 mechanical testing unit (Instron, Norwood, MA) for recording peak loading at 1 mm, 3 mm, 5 mm, and 10 mm of displacement. Each group was formed by 10 replicas, subjected to a linear noncyclical testing only once. Means and standard deviation were analyzed using analysis of variance and Tukey tests, with a 5% level of significance. Testing failures were also recorded. RESULTS The miniplate group showed lowest load peak scores (P < .01) when compared with the other fixation techniques, irrespective of the direction of force. The inverted-L group showed higher resistance (P < .01) than the hybrid group when vertical forces were applied. For molar load, the hybrid and inverted-L groups showed no significant difference. CONCLUSIONS For mandibular advancement surgery of 5 mm, it was concluded that the rigid internal fixation technique for sagittal split ramus osteotomies based on 3 bicortical screws in the inverted-L pattern was the most stable in a laboratory environment. Furthermore, the results suggested that installation of a bicortical positional screw in the retromolar region may significantly optimize the resistance of the miniplate and monocortical screw fixation.

The effects of filling techniques and a low-viscosity composite liner on bond strength to class II cavities

OBJECTIVE The aim of this study was to test the hypothesis that the effects of filling technique, cavity configuration and use of a low-viscosity composite liner influence resin bond strength to the dentin of class II cavities gingival floor; and analyze the failure modes of fractured specimens. METHODS Standardized class II cavities were prepared in the proximal surfaces of freshly extracted third molars, which were randomly assigned to 10 experimental groups. All prepared surfaces were acid-etched, bonded with Single Bond adhesive system and restored with TPH composite, according to each technique: G1 and G2-horizontal layering, G3 and G4-faciolingual layering, G5 and G6-oblique layering, G7 and G8-bulk filling, G9 and G10-control (flat dentin surfaces). Groups were tested, with or without a low-viscosity composite liner (Tetric Flow Chroma). After storage in water for 24h, teeth were vertically serially sectioned to yield a series of 0.8mm thick slabs. Each slab was trimmed into an hourglass shape of approximately 0.8mm(2) area at the gingival resin-dentin interface. Specimens were tested in tension at 0.5mm/min until failure. Fractured specimens were analyzed in an SEM to determine the failure modes. RESULTS No significant difference was found between groups restored with and without a low-viscosity composite liner (p>0.05). Among filling techniques, the bulk filling groups presented the lowest bond strength values (p<0.05), while incremental filling groups did not differ from control (flat dentin surfaces). Failure modes varied significantly among groups restored with and without the low-viscosity composite liner. SIGNIFICANCE Bond strengths were not improved when a low-viscosity composite liner was applied, but it remarkably influenced the failure modes. Incremental techniques improved bond strength.

THE RELATIONSHIP BETWEEN TEMPOROMANDIBULAR DYSFUNCTION AND HEAD AND CERVICAL POSTURE

Objective: This study aimed to evaluate the possibility of any correlation between disc displacement and parameters used for evaluation of skull positioning in relation to the cervical spine: craniocervical angle, suboccipital space between C0-C1, cervical curvature and position of the hyoid bone in individuals with and without symptoms of temporomandibular dysfunction. Material and Methods: The patients were evaluated following the guidelines set forth by RDC/TMD. Evaluation was performed by magnetic resonance imaging for establishment of disc positioning in the temporomandibular joints (TMJs) of 30 volunteer patients without temporomandibular dysfunction symptoms and 30 patients with symptoms. Evaluation of skull positioning in relation to the cervical spine was performed on lateral cephalograms achieved with the individual in natural head position. Data were submitted to statistical analysis by Fishers exact test at 5% significance level. To measure the degree of reproducibility/agreements between surveys, the kappa (K) statistics was used. Results: Significant differences were observed between C0-C1 measurement for both symptomatic (p=0.04) and asymptomatic (p=0.02). No statistical differences were observed regarding craniocervical angle, C1-C2 and hyoid bone position in relation to the TMJs with and without disc displacement. Although statistically significant difference was found in the C0-C1 space, no association between these and internal temporomandibular joint disorder can be considered. Conclusion: Based on the results observed in this study, no direct relationship could be determined between the presence of disc displacement and the variables assessed.

In vitro evaluation of the effectiveness of bleaching agents activated by different light sources.

PURPOSE This study evaluated the efficacy of tooth whitening and color stability at different time periods after treatment. MATERIALS AND METHODS Blocks obtained from human molars were divided into 15 groups (n = 5) by bleaching agents: 35% hydrogen peroxide (Whiteness HP and Opalescence Xtra) and 37% carbamide peroxide (Whiteness Super); and light sources: halogen lamp and plasma arc lamp (bleach mode), LED/diode laser, argon laser, and no light source. The efficacy of bleaching was measured using a spectrophotometer. Six bleaching sessions were performed (times 1 to 6). The specimens were submitted to another reading 7, 15, and 30 days after the end of bleaching (times 7, 8, and 9). The results were submitted to ANOVA followed by Tukey test and polynomial regression (p < 0.05). RESULTS Carbamide peroxide significantly differed from hydrogen peroxide, presenting low reflectance values. Activated versus non-activated bleaching did not differ significantly for any gel tested, except for Whiteness HP activated by argon laser, which presented the lowest mean reflectance values. The results obtained with hydrogen peroxide revealed a decrease in reflectance values one month after the end of treatment. For carbamide peroxide, this decrease was not observed. CONCLUSION The halogen lamp presented the same or higher efficacy than non-activated bleaching, which had a longer gel contact period. When hydrogen peroxide was used, a decrease in reflectance values was observed 30 days after the end of bleaching.

Full-Mouth Ultrasonic Debridement Associated With Amoxicillin and Metronidazole in the Treatment of Severe Chronic Periodontitis

BACKGROUND The purpose of this study was to evaluate the adjunctive clinical, microbiologic, and immunologic effects of the systemic administration of amoxicillin and metronidazole in the full-mouth ultrasonic debridement of patients with severe chronic periodontitis. METHODS Twenty-five patients presenting at least eight teeth with probing depth (PD) > or =5 mm and bleeding on probing (BOP) were selected and randomly assigned to full-mouth ultrasonic debridement + placebo (control group) or full-mouth ultrasonic debridement + amoxicillin and metronidazole (test group). The clinical outcomes evaluated were visible plaque index, BOP, position of the gingival margin, relative attachment level (RAL), and PD. Real-time polymerase chain reaction (PCR) was used for quantitative analysis of Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), Porphyromonas gingivalis, and Tannerella forsythia (previously T. forsythensis). The enzyme-linked immunosorbent assay (ELISA) technique permitted the detection of prostaglandin E(2,) interleukin-1beta, and interferon-gamma levels in gingival crevicular fluid. All parameters were evaluated at baseline and at 3 and 6 months post-treatment. RESULTS At 6 months, the test treatment resulted in lower BOP and an additional reduction (0.83 mm) in PD (P <0.05). Data also showed RAL gain > or =2 mm at 43.52% of sites in control patients compared to 58.03% of sites in test patients (P <0.05). However, both groups had similar mean RAL gain (1.68 and 1.88 mm for the control and test groups, respectively). Real-time PCR and ELISA failed to identify significant differences between the groups. CONCLUSIONS Both treatments resulted in significant clinical improvements; however, there was a slight, but significantly greater, improvement in BOP and the percentage of sites with PD > or =5 mm exhibiting RAL gain > or =2 mm in the test group. Nevertheless, no improvement in the microbiologic or immunologic outcome was observed with the adjunctive use of systemic amoxicillin and metronidazole.

In Vitro evaluation of microleakage of different materials used as pit-and-fissure sealants

The aim of this study was to evaluate in vitro the marginal microleakage of different materials used as pit-and-fissure sealants (Delton, Filtek Flow, Dyract Flow and Vitremer). Fifty-six extracted sound human third molars were randomly assigned to 4 groups (n=14). After sealant placement, the teeth were thermocycled (500 cycles; 5 degrees C, 37 degrees C and 55 degrees C), isolated, immersed in 2% buffered methylene blue dye for 4 h, included in acrylic resin and sectioned longitudinally in a buccolingual direction. The sections were analyzed for leakage using an stereomicroscope. A 4-criteria ranked scale was used to score dye penetration. All materials exhibited dye penetration to some extension and no statistically significant difference was observed among the groups (p>0.05). In conclusion, the findings of this study showed that a flowable composite resin, a flowable compomer and resin-modified glass ionomer placed on occlusal pits and fissures had similar marginal sealing as the unfilled self-cured resin-based sealant.