Jéssica Dias Theobaldo

Oral cavities of healthy infants harbour high proportions of Streptococcus salivarius strains with phenotypic and genotypic resistance to multiple classes of antibiotics

Emerging antibiotic resistance in the oropharyngeal microbiota, of which Streptococcus salivarius is a prominent species, represents a challenge for treating paediatric populations. In this study, we investigated the role of Streptococcussalivarius as a reservoir for antibiotic resistance genes (ARG) in the oral microbiota by analysing 95 Streptococcussalivarius isolates from 22 healthy infants (2-16 months of age). MICs of penicillin G, amoxicillin, erythromycin, tetracycline, doxycycline and streptomycin were determined. ARG profiles were assessed in a subset of 21 strains by next-generation sequencing of genomes, followed by searches of assembled reads against the Comprehensive Antibiotic Resistance Database. Strains resistant to erythromycin, penicillins and tetracyclines were isolated from 83.3, 33.3 and 16.6 %, respectively, of infants aged 2 to 8 months with no prior antibiotic treatment. These percentages were100.0, 66.6 and 50.0 %, by 13 to 16 months of age. ARG or polymorphisms associated with antibiotic resistance were the most prevalent and involved genes for macrolide efflux (mel, mefA/E and macB), ribosomal protection [erm(B), tet(M) and tet(O)] and β-lactamase-like proteins. Phylogenetically related strains showing multidrug-resistant phenotypes harboured multidrug efflux ARG. Polymorphic genes associated with antibiotic resistance to drugs affecting DNA replication, folate synthesis, RNA/protein synthesis and regulators of antibiotic stress responses were detected. These data imply that Streptococcussalivarius strains established during maturation of the oral microbiota harbour a diverse array of functional ARG, even in the absence of antibiotic selective pressures, highlighting a potential role for this species in shaping antibiotic susceptibility profiles of oropharyngeal communities.

Effect of Cigarette Smoke on Resin Composite Bond Strength to Enamel and Dentin Using Different Adhesive Systems.

OBJECTIVE To evaluate the microshear bond strength of composite resin restorations in dental blocks with or without exposure to cigarette smoke. METHOD Eighty bovine dental blocks were divided into eight groups (n=10) according to the type of adhesive (Scotchbond Multi-Purpose, 3M ESPE, St Paul, MN, USA [SBMP]; Single Bond 2, 3M ESPE [SB]; Clearfil SE Bond, Kuraray Medical Inc, Okayama, Japan [CSEB]; Single Bond Universal, 3M ESPE [SBU]) and exposure to smoke (no exposure; exposure for five days/20 cigarettes per day). The adhesive systems were applied to the tooth structure, and the blocks received a composite restoration made using a matrix of perforated pasta. Data were statistically analyzed using analysis of variance and Tukey test (α<0.05). RESULTS For enamel, there was no difference between the presence or absence of cigarette smoke (p=0.1397); however, there were differences among the adhesive systems (p<0.001). CSEB showed higher values and did not differ from SBU, but both were statistically different from SB. The SBMP showed intermediate values, while SB demonstrated lower values. For dentin, specimens subjected to cigarette smoke presented bond strength values that were lower when compared with those not exposed to smoke (p<0.001). For the groups without exposure to cigarette smoke, CSEB showed higher values, differing from SBMP. SB and SBU showed intermediary values. For the groups with exposure to cigarette smoke, SBU showed values that were higher and statistically different from SB and CSEB, which presented lower values of bond strength. SBMP demonstrated an intermediate value of bond strength. CONCLUSION The exposure of dentin to cigarette smoke influenced the bonding strength of adhesives, but no differences were noted in enamel.

Esthetic smile rehabilitation of anterior teeth by treatment with biomimetic restorative materials: a case report

Background In daily clinical practice, esthetics of anterior teeth is a common presenting complaint of patients. Objective This case report discusses the management of asymmetric smile associated with unsatisfactory extensive composite restorations and describes a clinical protocol using the direct composite resin for smile enhancement to restore the dental harmony of anterior teeth. Methods The treatment planning was based on a diagnostic wax-up and cosmetic mock-up. After clinical and patient approvals were obtained, the patient was subjected to direct and indirect restorative treatment. Conclusion Nanocomposites are an effective alternative for anterior teeth restorations. Additionally, good planning enables satisfactory esthetic results, leading to the correction of an inappropriate axial inclination of incisors.

Influence of successive light-activation on degree of conversion and knoop hardness of the first layered composite increment

Abstract Purpose: To evaluate the influence of light-activation of second, third and fourth increments on degree of conversion (DC) and microhardness (KHN) of the top (T) and bottom (B) surface of the first increment. Materials and methods. Forty samples (n = 5) were prepared. In groups 1–4, after each increment light-activation (multiple irradiation), T and B of the first increment were measured in DC and KHN. In groups 5–8, only the first increment was made (single irradiation) and measurements of DC and KHN were taken at 15 min intervals. The light-activation modes were (XL) 500 mW/cm2 × 38 s (G1/G5); (S) 1000 mW/cm2 × 19 s (G2/G6), (HP) 1400 mW/cm2 × 14 s (G3/G7); (PE) 3200 mW/cm2 × 6 s (G4/G8). Data for DC and KHN were analyzed separately by using PROC MIXED for repeated measures and Tukey-Kramer test (α = 0.05). Results. For KHN, B showed lower values than T. PE resulted in lower values of KHN in B surface. For single and multiple irradiations, T and B of first measurement showed the lowest KHN and the fourth measurement showed the highest, with significant difference between them. For single irradiation, first and second increments presented similar KHN, different from the third and fourth increment, which did not differ between them. For multiple irradiations, the second light-activation resulted in KHN similar to first, third and fourth increments. For DC, except QTH, T presented higher DC than B. Conclusion. The light-activation of successive increments was not able to influence the KHN and DC of the first increment.

Effect of preheating and light-curing unit on physicochemical properties of a bulk fill composite

Objective The aim of this study is to evaluate the effect of composite preheating and polymerization mode on degree of conversion (DC), microhardness (KHN), plasticization (P), and depth of polymerization (DP) of a bulk fill composite. Methods Forty disc-shaped samples (n = 5) of a bulk fill composite were prepared (5 × 4 mm thick) and randomly divided into 4 groups according to light-curing unit (quartz–tungsten–halogen [QTH] or light-emitting diode [LED]) and preheating temperature (23 or 54 °C). A control group was prepared with a flowable composite at room temperature. DC was determined using a Fourier transform infrared spectrometer, KHN was measured with a Knoop indenter, P was evaluated by percentage reduction of hardness after 24 h of ethanol storage, and DP was obtained by bottom/top ratio. Data were statistically analyzed by analysis of variance and Tukey’s test (α = 0.05). Results Regardless of light-curing, the highest preheating temperature increased DC compared to room temperature on bottom surface. LED showed a higher DC compared to QTH. Overall, DC was higher on top surface than bottom. KHN, P, and DP were not affected by curing mode and temperature, and flowable composite showed similar KHN, and lower DC and P, compared to bulk fill. Conclusion Composite preheating increased the polymerization degree of 4-mm-increment bulk fill, but it led to a higher plasticization compared to the conventional flowable composite evaluated.