Tatiana Kelly da Silva Fidalgo

Mother-to-child transmission of Streptococcus mutans: A systematic review and meta-analysis

OBJECTIVES A systematic review was performed with the aim of determining whether there is scientific evidence of the transmission of Streptococcus mutans from mother to child. DATA The eligibility criteria, based on the PECO strategy, were the following: observational human studies whose subjects were mother and child pairs (P) contaminated by S. mutans (E); comparison according to the presence or absence of S. mutans (C); and whether there is transmission (O). The qualitative analysis was performed by assessing the risk of bias of the included studies, while quantitative synthesis was performed through comprehensive Meta-Analysis software (p<0.05). SOURCES Two reviewers performed the database search of studies published between January 1950 and May 2014. The strategy included observational studies that assessed the vertical transmission of S. mutans from mothers to children through analyzing genetic strains. STUDY SELECTION It was found 166 non-duplicated studies. However, after reviewing the articles in full and applying the eligibility criteria, 36 papers were selected for qualitative analysis and 19 for quantitative analysis. The cumulative meta-analysis demonstrated vertical transmission of S. mutans from mother to child (p<0.001). CONCLUSIONS The present systematic review and meta-analysis demonstrated evidence of vertical transmission of S. mutans from mother to child because there was an association between S. mutans n mothers and their respective children. CLINICAL SIGNIFICANCE The knowledge of the S. mutans strains is important because the virulence of the microorganisms is varied; also, the virulence affects the dental caries evolution rate, being more or less aggressive.

Effectiveness of varnish with CPP-ACP in prevention of caries lesions around orthodontic brackets: an OCT evaluation

OBJECTIVE To evaluate the in vitro efficiency of applying varnish containing casein phosphopeptide (CPP) and amorphous calcium phosphate (ACP) in prevention of caries lesions around orthodontic brackets. MATERIALS AND METHODS For this purpose, brackets were bonded to the vestibular surface of bovine incisors, and eight groups were formed (n = 15) according to exposure of oral hygiene substances and enamel varnish: 1 (control) brushing only performed, 2 (control) brushing + use of mouth wash with fluoride, 3 Duraphat varnish application only (Colgate-Palmolive Ind. E Com. Ltda, São Paulo, SP, Brazil), 4 Duraphat + brushing, 5 Duraphat + brushing + mouth wash, 6 MI Varnish application (GC America, USA), 7 MI + brushing, and 8 MI + brushing + mouth wash. The experimental groups alternated between pH cycling and the procedures described and were kept in an oven at temperature of 37°C. Both brushing and immersion in solutions was performed in a time interval of 1 minute, followed by washing in deionized water three times a day for 28 days of experimentation. Afterwards, evaluation by optical coherence tomography (OCT) of the special type (Ganymede OCT/Thorlabs, Newton, USA) was performed. In each group, a scanning exam of the white spot lesion area (around the region where brackets were bonded) and depth measurement of caries lesions were performed. RESULTS Groups 1 and 3 were shown to differ statistically from groups 5, 6, 7, and 8 (p = 0.000). MI Varnish was shown to be more effective in diminishing caries lesion depth, compared with Duraphat, irrespective of being associated with brushing and mouth wash, or not. LIMITATIONS The major limitation of this study is that it is a study in which demineralization was obtained with the use of chemical products, and did not occur due to the presence of Streptococcus mutans and its acid byproducts. CONCLUSION Application CPP-ACP-containing varnish irrespective of being associated with brushing and mouthwash, or not, reduced depth of caries lesions around orthodontic brackets.

Inhibitory activity of root canal irrigants against Candida albicans, Enterococcus faecalis and Staphylococcus aureus

The present study evaluated the antimicrobial activity of three root canal irrigants against Enterococcus faecalis, Candida albicans, and Staphylococcus aureus. These microorganisms were incubated in the presence of citric acid (6 and 10%), EDTA (17%), and NaOCl (0.5, 1.0, 2.5, and 5.25%). Agar diffusion tests were performed and redox indicator resazurin was used to evaluate the inhibitory effect of the irrigants on the metabolic activity of these microorganisms. The mean diameters of the inhibition zones for the C. albicans cultures were 11.6 mm (17% EDTA), 5.5 mm (0.5% NaOCl), 12.9 mm (1% NaOCl), 22.1 mm (2.5% NaOCl), and 28.5 mm (5.25% NaOCl). The mean diameters of the inhibition zones for E. faecalis were 2.8 mm (1% NaOCl), 5.4 mm (2.5% NaOCl), and 8.3 mm (5.25% NaOCl). For S. aureus, the mean values were 8.0 mm (17% EDTA), 3.0 mm (1% NaOCl), 8.8 mm (2.5% NaOCl), and 10.0 mm (5.25% NaOCl). Most of the irrigant solutions presented effective antimicrobial activity against C. albicans. A high inhibitory effect on the metabolic activity of E. faecalis was detected when the microorganisms were incubated with 17% EDTA. The same result was reached when S. aureus was incubated in the presence of > 2.5% NaOCl. Altogether, these results indicate that 2.5% and 5.25% NaOCl are microbicides against S. aureus while 0.5% and 1% NaOCl are only microbiostatic against the tested bacteria. The 6% and 10% citric acid as well as 17% EDTA did not affect the viability of any of the assayed microorganisms.

Preventive effect of fluoridated orthodontic resins subjected to high cariogenic challenges.

The aim of the present study was to evaluate the in vitro caries preventive effect of fluoridated orthodontic resins under pH cycling with two types of acid demineralizing saliva. Brackets were bonded to 60 bovine incisors, using either Transbond Plus Color Change (n=30) or Orthodontic Fill Magic (n=30) orthodontic resins. Each group of resin was divided into 3 subgroups (n=10): immersion in remineralizing artificial saliva for 14 days, pH cycling with high cariogenic challenge in acid saliva with pH 5.5, and acid saliva with pH 4.5. After 14 days of pH cycling, the caries preventive effect on the development of white spot lesion was evaluated considering the presence of inhibition zones to white spot lesions using two scores: 0= absence and 1= presence. Kruskal Wallis and Mann-Whitney tests (a=0.05) were used. Formation of white spot lesions was observed only under pH cycling using acid saliva with pH 4.5; with Transbond Plus Color Change being significantly more effective (p<0.05) in preventing the appearance of white spot lesions effect than Orthodontic Fill Magic. The acidity of the demineralizing solution influenced the formation of white spot lesions around orthodontic brackets under highly cariogenic conditions. Transbond Plus Color Change resin presented higher caries preventive effect than Orthodontic Fill Magic.

Friction between different wire bracket combinations in artificial saliva: an in vitro evaluation

Objective The objective this work was to assess the friction coefficient between brackets and wires of different materials under conditions simulating the oral environment. Material and Methods Stainless steel (SS) and titanium-molybdenum alloy (TMA) wires of 0.019x0.025-in diameter (American Orthodontics) and polycarbonate bracket (American Orthodontics), ceramic bracket (American Orthodontics), and metal bracket (3M Unitek) with slots of 0.022x0.030-in were used. The friction coefficient was assessed by means of mechanical traction with the system immersed in artificial saliva. The mean roughness of both wire surface and bracket slots was evaluated by using a surface profilometer. Results The system using TMA wire and polycarbonate bracket had the highest roughness (p<0.05). SS wire with ceramic bracket had the highest friction coefficient, whereas the use of metallic bracket yielded the lowest (p<0.05). However, it was observed a statistically significant difference in the system using TMA wire and ceramic bracket compared to that using TMA wire and polycarbonate bracket (p=0.038). Conclusion Ceramic brackets in association with SS wire should be judiciously used, since this system showed a high friction coefficient.

Effects of citric acid on cultured human osteoblastic cells

We investigated the effects of citric acid (CA) on cultured human osteoblastic (HOB) cells by evaluating cell adhesion, proliferation, and cytotoxicity. (3)H-Thymidine-labeled HOB cells were incubated in culture medium supplemented or not with 4%, 6%, 8%, or 10% CA for 1 minute. After incubation, cell morphology was evaluated by Nomarski interferential light microscopy, cell proliferation was accessed by measurements of (3)H-thymidine associated to the cells, and cell lysis was monitored by measuring the amount of (3)H-thymidine released by cells. We observed that most of the CA-treated cells presented numerous atypical vacuoles, and such cells were also highly polymorphic, exhibiting round-shaped cells. Nonetheless, CA at all concentrations assayed did not yield cytotoxicity as measured by (3)H-containing DNA release, although significant decrease in cell proliferation was observed (P > .05). Furthermore, cells which were treated with CA at the lowest concentration assayed (4%) restored normal proliferation rates 3 days after treatment.

Mechanical properties of one and two-step fluoridated orthodontic resins submitted to different pH cycling regimes

The aim of this study is to assess the in vitro shear bond strength and adhesive remnant index (ARI) of one and two-step fluoridated orthodontic resins under conditions that simulate high cariogenic challenge. Edgewise brackets for maxillary central incisors were randomly bonded to 80 bovine incisors, using either Transbond Plus Color Change orthodontic resin and a self-etching primer adhesive (G1; n = 40) or Orthodontic Fill Magic with a conventional acid-etch technique (G2; n = 40). Each group of resin (n = 10) was divided into: immediate shear (A- pre-cycling control), immersion in artificial remineralizing saliva (neutral saliva) for 14 days (B- post-cycling control) and pH cycling with high cariogenic challenge (C- acid saliva with pH 5.5 and D- acid saliva with pH 4.5). After 14 days of pH cycling, the shear bond strength and ARI were evaluated. Considering the shear bond strength, Transbond Plus Color Change resin was stronger than Orthodontic Fill Magic when it was submitted to high cariogenic challenge (p < 0.05). Also Transbond Plus Color Change resin showed better adhesion to enamel than Orthodontic Fill Magic, in all situations evaluated (p < 0.05). It could be concluded that Transbond Plus Color Change resin presented better shear bond strength and adhesive remnant index when submitted to high cariogenic challenge, in comparison with Orthodontic Fill Magic.

The relationship between unspecific s-IgA and dental caries: a systematic review and meta-analysis.

OBJECTIVES This systematic review and meta-analysis is focused on evaluating the possible association of s-IgA levels and dental caries. DATA The inclusion criteria comprised the clinical investigations with case and control groups, a caries diagnostic method, and evaluation of unspecific s-IgA concentration by using tests for both groups in humans, healthy subjects, and with statistical analyses. Quality assessment and data extraction of the included articles were performed. Meta-analysis of pooled data was performed through RevMan software after a sensitivity analysis. SOURCES An electronic and manual search was performed in PubMed, ISI Web of Science, Scopus, Cochrane Library, and Lilacs, with a supplemental hand search of the references of retrieved articles. STUDY SELECTION From 314 abstracts, 14 fulfilled the inclusion criteria. After reading the full articles, one of them was excluded due to the lack of a control group. Seven studies were included in the meta-analysis, and the heterogeneity among the studies (I(2)) was 41%. The pooled meta-analysis demonstrated higher levels of s-IgA in the caries active group (p<0.00001) than in the control group with a mean difference and confidence interval of 0.27 [0.17-0.38]. CONCLUSIONS Based on these findings, there is evidence that supports the presence of increased s-IgA levels in caries-active subjects. CLINICAL SIGNIFICANCE Dental caries is a multifactorial disease that comprehends intrinsic and extrinsic factors. The risk factors and events related to dental caries are overlooked in the literature. Additionally, it is also important to understand the host response against this disorder. Since the studies are contradictory in this field, we conducted a systematic review followed by meta-analysis to present the immunological host response evidence-based.

Longitudinal evaluation of salivary profile from children with dental caries before and after treatment

Abstract Saliva is a biofluid largely used in metabolomics for the assessment of local and systemic diseases. Our group has previously demonstrated the salivary metabolomic signature of children with dental caries (Fidalgo et al. Metabolomics 9(3):657–666, 2013). The aim of the current study was investigation, using NMR spectroscopy, of the changes observed for metabolite markers for caries lesions before and after dental treatment. Saliva from children with and without dental caries before and after treatment was analyzed by NMR. Partial least squared discriminant analysis (PLS-DA) conducted on the spectroscopic data sets showed a clear separation of saliva metabolic profile of children with and without caries, and multilevel PLS-DA demonstrated difference before and after dental treatment. Our results demonstrate that organic acids are associated with disease activity because their reductions were observed after dental treatment. There was a demonstrated reduction here in the levels of acetate, propionate, fatty acid, butyrate and saccharides. We also observed a drop in the level of microorganisms upon dental treatment. The dental treatment therefore modified the properties of the oral cavity, leading to changes in the salivary profiles after treatment.

Antibacterial properties and compressive strength of new one-step preparation silver nanoparticles in glass ionomer cements (NanoAg-GIC)

OBJECTIVES This work aimed (1) to develop polyacid formulations by the one-step photoreduction of silver nanoparticles (AgNP) in a polyacrylate solution of conventional glass ionomer cement (GIC), imparting antibacterial activity; and (2) to evaluate handling and mechanical properties of experimental ionomers in comparison to a commercially available conventional GIC. METHODS Formulations with increasing sub-stoichiometric amounts of AgNO3 were monitored during continuous UV light exposure by UV-vis spectroscopy and analyzed by transmission electron microscopy. The resulted synthesis of formulations containing small and disperse spherical nanoparticles (∼6 nm) were used to design the experimental nano-silver glass ionomer cements (NanoAg-GIC). The cements were characterized as to net setting time and compressive strength according to ISO 9917-1:2007 specifications. The antibacterial activity of these cements was assessed by Ag+ diffusion tests on nutritive agar plates (E. coli) and by MTT assay (S. mutans). RESULTS The higher concentration of silver (0.50% by mass) in the matrix of NanoAg-GIC allowed viable net setting time and increased in 32% compressive strength of the experimental cement. All groups containing AgNP induced statistically significant E. coli growth inhibition zones (p-value <.05), indicating diffusion of Ag+ ions on the material surroundings. Metabolic activity of S. mutans grown on NanoAg-GIG with higher concentration of silver was significantly affected compared to control (p-value <.01). CONCLUSIONS Silver nanoparticles one-step preparation in polyacrylate solution allowed the production of highly bioactive water-based cements within suitable parameters for clinical use and with large potential of dental and biomedical application.