Ivan Balducci

Effectiveness of Six Different Disinfectants on Removing Five Microbial Species and Effects on the Topographic Characteristics of Acrylic Resin

PURPOSE The aim of this study was to evaluate the effectiveness of disinfectant solutions (1% sodium hypochlorite, 2% chlorhexidine digluconate, 2% glutaraldehyde, 100% vinegar, tabs of sodium perborate-based denture cleanser, and 3.8% sodium perborate) in the disinfection of acrylic resin specimens (n = 10/group) contaminated in vitro by Candida albicans, Streptococcus mutans, S. aureus, Escherichia coli, or Bacillus subtilis as measured by residual colony-forming unit (CFU). In a separate experiment, acrylic resin was treated with disinfectants to monitor potential effects on surface roughness, Ra (microm), which might facilitate microbial adherence. MATERIALS AND METHODS Three hundred fifty acrylic resin specimens contaminated in vitro with 1 x 10(6) cells/ml suspensions of standard strains of the cited microorganisms were immersed in the disinfectants for 10 minutes; the control group was not submitted to any disinfection process. Final counts of microorganisms per ml were performed by plating method for the evaluation of microbial level reduction. Results were compared statistically by ANOVA and Tukeys test (p< or = 0.05). In a parallel study aiming to evaluate the effect of the tested disinfectant on resin surface, 60 specimens were analyzed in a digital rugosimeter before and after ten cycles of 10-minute immersion in the disinfectants. Measurements of superficial roughness, Ra (mum), were compared statistically by paired t-test (p< or = 0.05). RESULTS The results showed that 1% sodium hypochlorite, 2% glutaraldehyde, and 2% chlorhexidine digluconate were most effective against the analyzed microorganisms, followed by 100% vinegar, 3.8% sodium perborate, and tabs of sodium perborate-based denture cleanser. Superficial roughness of the specimens was higher after disinfection cycles with 3.8% sodium perborate (p= 0.03) and lower after the cycles with 2% chlorhexidine digluconate (p= 0.04). CONCLUSION Within the limits of this experiment, it could be concluded that 1% sodium hypochlorite, 2% glutaraldehyde, 2% chlorhexidine, 100% vinegar, and 3.8% sodium perborate are valid alternatives for the disinfection of acrylic resin.

Cytotoxicity and Genotoxicity of Root Canal Sealers Based on Mineral Trioxide Aggregate

INTRODUCTION MTA has good biological properties, and it is a mineralization-inducing material with different indications in endodontics. Initially this material was not recommended as root canal sealer. However, a resin sealer based on mineral trioxide aggregate (MTA Fillapex) was recently released with this indication. Because MTA is in contact with the periodontal tissues, bone, and pulp, it is important to know its cytotoxic and genotoxic effects. The purpose of this study was to evaluate the cytotoxicity and genotoxicity of MTA canal sealer (Fillapex) compared with white MTA cement and AH Plus. METHODS Chinese hamster fibroblasts (V79) were placed in contact with different dilutions of culture media previously exposed to such materials. Cytotoxicity was evaluated by methol-thiazol-diphenyl tetrazolium assay in spectrophotometer to check the viability rate and cell survival. The genotoxicity was accessed by the micronucleus formation assay. Cell survival rate and micronuclei number were assessed before and after exposure to cement extracts, and the results were statistically analyzed by Kruskal-Wallis and Dunn tests (P < .05). RESULTS The results showed that the cell viability remained above 50% in white MTA group for all dilutions. AH Plus induced an intermediate cytotoxicity in a dilution-dependent manner, followed by Fillapex MTA. CONCLUSIONS White MTA group was the less cytotoxic material in this study. Both AH Plus and Fillapex MTA sealer showed the lowest cell viability rates and caused an increased micronucleus formation when compared with control untreated group.

The influence of ovariectomy, simvastatin and sodium alendronate on alveolar bone in rats

Bisphosphonates are currently used in the treatment of many diseases involving increased bone resorption such as osteoporosis. Statins have been widely used for the treatment of hypercholesterolemia and recent studies have shown that these drugs are also capable of stimulating bone formation. The purpose of this study was to evaluate the influence of an estrogen deficient state and the effects of simvastatin and sodium alendronate therapies on alveolar bone in female rats. Fifty-four rats were either ovariectomized (OVX) or sham operated. A month later, the animals began to receive a daily dose of simvastatin (SIN - 25 mg/kg), sodium alendronate (ALN - 2 mg/kg) or water (control) orally. Thirty-five days after the beginning of the treatment, the rats were sacrificed and their left hemimandibles were removed and radiographed using digital X-ray equipment. The alveolar radiographic density under the first molar was determined with gray-level scaling and the values were submitted to analysis of variance (alpha = 5%). Ovariectomized rats gained more weight (mean +/- standard deviation: 20.06 +/- 6.68%) than did the sham operated animals (12.13 +/- 5.63%). Alveolar radiographic density values, expressed as gray levels, were lowest in the OVX-water group (183.49 +/- 6.47), and differed significantly from those observed for the groups receiving alendronate (sham-ALN: 193.85 +/- 3.81; OVX-ALN: 196.06 +/- 5.11) and from those of the sham-water group (193.66 +/- 4.36). Other comparisons between groups did not show significant differences. It was concluded that the ovariectomy reduced alveolar bone density and that alendronate was efficient for the treatment of this condition.

Oral lichen planus: A retrospective study of 110 Brazilian patients

BackgroundOral lichen planus (OLP) is a chronic autoimmune disease characterized by multiple clinical presentations and a relatively high prevalence in the population. This retrospective patient record study investigated the profile of OLP in a group of Brazilian patients seen between 1989 and 2009.FindingsThe clinical records were analyzed and data such as gender, age, race, clinical presentation of OLP, site affected, presence of symptoms and extraoral manifestations of the disease, smoking habit, and consumption of alcoholic beverages were obtained. Among the 1822 records of patients with oral mucosal lesions, OLP was identified in 6.03%. Of these, 76.36% were females, with a mean age of 54 years, and 85% were whites. The reticular form was the most frequent (81.81%). Extraoral lesions were observed in 32.72% of the patients and painful symptoms were reported by 50.90%. The cheek mucosa was the site most affected (92.72%) and multiple oral lesions were observed in 77.27% of the patients. Among patients with OLP, 18.18% reported a smoking habit and 29.09% the consumption of alcoholic beverages.ConclusionsThis retrospective study showed a relatively high prevalence of OLP in the population studied, with a predominance of the disease among middle-aged white women and bilateral involvement of the cheek mucosa. Reticular lesions were the most frequent, followed by the erosive form which is mainly associated with painful symptoms. No relationship with tobacco or alcohol consumption was observed.

Oral manifestations of diabetes mellitus in complete denture wearers

STATEMENT OF PROBLEM The oral mucosa has been reported to show a variety of changes in subjects with diabetes mellitus. PURPOSE The purpose of this study was to compare diabetic and nondiabetic subjects wearing complete dentures with regard to salivary flow, salivary buffering capacity, denture retention, and oral mucosal lesions. MATERIAL AND METHODS Sixty subjects, 30 with and 30 without a diagnosis of diabetes, were matched for gender, race, and age. Salivary flow, salivary buffering capacity, glycemia, blood pressure, presence of mucosal lesions, denture retention, use of medications, and behavioral factors (controlled or uncontrolled diet, alcohol consumption, and smoking) reported by the subjects, were evaluated. For the salivary buffering capacity test, 1 mL of saliva was pipetted into a test tube containing 3 mL 0.005 N of hydrochloric acid, and the pH was measured with indicator strips. Group differences were statistically analyzed using the Student t test and the Mann-Whitney test for quantitative variables and the chi-square test for qualitative variables (alpha =.05). RESULTS Mean (SD) salivary flow was 1.14 (0.87) mL/min in the nondiabetic subjects and 0.95 (0.61) mL/min in the diabetic subjects. Evaluation of self-reported denture retention revealed no significant difference between groups. Denture retention was observed in 66.7% (20/30) of the control group and in 50% (15/30) of the diabetic group. The prevalence of mucosal lesions was 90% (27/30) in the control group and 83.3% (25/30) in the diabetic group. Salivary buffering capacity was 5.80 (0.85) in the control group and 5.26 (0.83) in the diabetic group (P=.017). CONCLUSIONS Within the limitations of this study, no significant differences were observed in salivary flow, denture retention, or oral lesions in diabetic and nondiabetic subjects.

Mucus extravasation and retention phenomena: a 24-year study

BackgroundMucoceles are benign lesions related to the minor salivary glands and their respective ducts frequently affecting oral structures which are generally asymptomatic. Mucoceles are generally characterized by swollen nodular lesions preferentially located on the lower lip and differ from the so-called ranulas, which are lesions located on the floor of the mouth and related to the sublingual or submandibular glands.MethodsThe objective of the present study was to analyze data such as age, gender, race and site of the lesion of 173 mucocele cases diagnosed at the Discipline of Stomatology, São José dos Campos Dental School, UNESP, over a period of 24 years (April 1980 to February 2003).ResultsOf the 173 cases analyzed, 104 (60.12%) were females and 69 (39.88%) were males. Age ranged from 4 to 70 years (mean ± SD: 17 ± 9.53) and most patients were in the second decade of life (n = 86, 49.42%); white (n = 124, 71.68%). The lower lip was the site most frequently affected by the lesions (n = 135, 78.03%), whereas the lowest prevalence was observed for the soft palate, buccal mucosa, and lingual frenum.ConclusionIn this study, mucoceles predominated in white female subjects in the second decade of life, with the lower lip being the most frequently affected site.

Influence of simvastatin on bone regeneration of tibial defects and blood cholesterol level in rats

The purpose of this study was to evaluate the effects of simvastatin, by oral or subcutaneous administration, on tibial defects regeneration and blood cholesterol level in rats. A surgical defect was made on the right tibia of 40 male animals assigned to 4 groups (n=10), based on two routes of administration and on the use or not of simvastatin: subcutaneous injection of simvastatin (7 mg/kg) (group AT) or only the vehicle of drug suspension (group AC), above the defect area, for 5 days; and 20 mg/kg of simvastatin macerated on water (group BT) or only water (group BC), orally, daily, during the whole observation period. The animals were sacrificed after 15 or 30 days, when blood samples were analyzed to check plasma cholesterol levels. Tibiae were removed and, after decalcification and routine laboratorial processing, histological and histomorphometrical analyses were carried out. ANOVA was used for statistical analysis at 5% significance level. The histological and histomorphometrical analyses showed significant differences only between the experimental periods (p<0.05). Animals sacrificed after 30 days showed better bone repair (p<0.05). There was no statistically significant difference (p>0.05) for blood cholesterol levels between the groups. In conclusion, simvastatin administration either orally or subcutaneously did not improve bone repair of experimental tibial defects and did not alter blood cholesterol levels in rats.

Prevalence and antifungal resistance profile of Candida spp. oral isolates from patients with type 1 and 2 diabetes mellitus

OBJECTIVE The goal of the study was to measure the prevalence of Candida spp. in the oral cavity of patients with diabetes types 1 and 2 when compared to healthy individuals and to study antifungal resistance profile of the isolates. DESIGN There were 162 subjects in the study: diabetes type 1 (n=39); control group 1 (n=50): healthy individuals matched in gender, age, and oral conditions to diabetes type 1 patients; diabetes type 2 (n=37); control group 2 (n=36) who were matched to each patient of the diabetes type 2 group. Stimulated saliva was collected and isolates were identified with phenotypic tests. The presence of C. dubliniensis was determined by multiplex PCR. RESULTS There were no statistically significant differences in Candida spp. frequency between the diabetes 1 group and its control (p=0.443) nor between the diabetes 2 group and its control (p=0.429). C. albicans was the most frequently isolated yeast in all groups. In the diabetes groups, C. stellatoidea, C. parapsilosis, C. tropicalis, C. lipolytica, C. glabrata, and C. krusei were also identified. Additionally, in control groups, C. kefyr was also detected. None of the isolates were resistant to amphotericin B and flucytosine. A low percentage of the isolates were resistant to ketoconazole. CONCLUSIONS No differences were detected in colonization of Candida spp. oral isolates from type 1 and type 2 diabetes when compared to matched controls. The antifungal resistance of Candida spp. isolates for ketoconazole from type 1 diabetes patients was significantly higher than that of its matched control.

Ex vivo evaluation of the effectiveness of bleaching agents on the shade alteration of blood-stained teeth

AIM To evaluate ex vivo effectiveness of the three formulations of bleaching materials for intracoronal bleaching of root filled teeth using the walking bleach technique. METHODOLOGY Extracted premolar teeth were stained artificially with human blood. After biomechanical preparation, the root canals were filled and a 3-mm thick intermediate base of zinc phosphate cement was placed at the level of the cementoenamel junction. The teeth were divided into four groups (n = 12): C (control, without bleaching material), A1 (sodium perborate + distilled water), A2 (sodium perborate + 10% carbamide peroxide) and A3 (sodium perborate + 35% carbamide peroxide). The bleaching materials were changed at 7 and 14 days. Evaluation of shade was undertaken with aid of the VITA Easyshadetrade mark (DeltaE*ab) and was performed after tooth staining and at 7, 14 and 21 days after bleaching, based on the CIELAB system. Data were analysed by anova for repeated measurements, Tukey and Dunnett tests (alpha = 0.05). RESULTS The Tukey test revealed that group A1 (10.58 +/- 4.83 DeltaE*ab) was statistically different from the others (A2, 19.57 +/- 4.72 DeltaE*ab and A3, 17.58 +/- 3.33 DeltaE*ab), which were not different from each other. At 7 days: A1 was significantly different from A2; at 14 and 21 days: A2 and A3 were significantly better than A1; the Dunnett test revealed that the control group was different from A1, A2 and A3 at all periods (P < 0.05). CONCLUSION Sodium perborate associated with both 10% and 35% carbamide peroxide was more effective than when associated with distilled water.

Bond strength durability of self-etching adhesives and resin cements to dentin

Objectives: To evaluate the microtensile bond strength (μTBS) of one- (Xeno III, Dentsply) and two-step (Tyrian-One Step Plus, Bisco) self-etching adhesive systems bonded to dentin and cemented to chemically cured (C&B Metabond) or light-cured paste of a dual-cure resin cement (Variolink II, Ivoclar) within a short (24 h) and long period of evaluation (90 days). Material and Methods: Forty recently extracted human molars had their roots removed and their occlusal dentin exposed and ground wet with 600-grit SiC paper. After application of one of the adhesives, the resin cement was applied to the bonded surface and a composite resin block was incrementally built up to a height of 5 mm (n=10). The restored teeth were stored in distilled water at 37°C for 7 days. The teeth were then cut along two axes (x and y), producing beam-shaped specimens with 0.8 mm2 cross-sectional area, which were subjected to μTBS testing at a crosshead speed of 0.05 mm/min and stressed to failure after 24 h or 90 days of storage in water. The μTBS data in MPa were subjected to three-way analysis of variance and Tukeys test (α= 0.05). Results: The interaction effect for all three factors was statistically significant (three-way ANOVA, p<0.001). All eight experimental means (MPa) were compared by the Tukeys test (p<0.05) and the following results were obtained: Tyrian-One Step Plus/C&B/24 h (22.4±7.3); Tyrian-One Step Plus/Variolink II/24 h (39.4±11.6); Xeno III/C&B/24 h (40.3±12.9); Xeno III/Variolink II/24 h (25.8±10.5); Tyrian-One Step Plus/C&B/90 d (22.1±12.8) Tyrian-One Step Plus/VariolinkII/90 d (24.2±14.2); Xeno III/C&B/90 d (27.0±13.5); Xeno III/Variolink II/ 90 d (33.0±8.9). Conclusions: Xeno III/Variolink II was the luting agent/adhesive combination that provided the most promising bond strength after 90 days of storage in water.