Publications by authors named "Marília Pacífico Lucisano"

26 Publications

  • Page 1 of 1

Periodontal ligament repair after active splinting of replanted dogs' teeth.

Dent Traumatol 2021 Jul 1. Epub 2021 Jul 1.

Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.

Background/aim: The high rate of root resorption resulting from tooth replantation represents a serious clinical problem. In order to prevent ankylosis and replacement resorption, the contemporary literature highlights the importance of using a flexible stabilization for traumatized teeth. For this purpose, orthodontic devices may be promising for obtaining a better prognosis and periodontal repair. The aim of this study was to evaluate the effect of an active splinting protocol with controlled force in dog's teeth following replantation.

Material And Methods: Sixty premolar roots from three dogs were used. They were submitted to endodontic treatment, hemisected, atraumatically extracted and subsequently replanted. They were divided into four groups: Passive Stabilization (n = 20)-after 20 min in a dry medium; Active Stabilization (n = 20)-after 20 min in a dry medium; Negative control (n = 10)-immediate replantation and passive Stabilization; and Positive control (n = 10)-90 min of extra-alveolar time and passive Stabilization. The samples were collected and submitted to histologic processing. They were then evaluated for the count of inflammatory cells, expression of neurotrophin 4, osteoclasts, apoptotic cells and collagen fibres. The results were submitted to ANOVA or Kruskal-Wallis statistical tests followed by Tukey or Dunn post-tests (α = 5%).

Results: Passive Stabilization with orthodontic brackets without traction used after replantation had the highest number of inflammatory cells (p = .0122), osteoclasts (p = .0013) and percentage of collagen fibres in the periodontal ligament (p < .0001) when compared to Active Stabilization with orthodontic brackets applying amild tensile force. Neurotrophin 4 had no statistically significant difference (p = .05), regardless of the treatment. The apoptotic cells count revealed statistical differences (p < .0001) between Active Stabilization (189.70 ± 47.99) and Positive Control (198.90 ± 88.92) when compared to Passive Stabilization (21.19 ± 32.94).

Conclusion: The active splinting protocol using orthodontic appliances generating a light and controlled force favoured periodontal ligament repair of replanted teeth.
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http://dx.doi.org/10.1111/edt.12698DOI Listing
July 2021

Alteration of the oral microbiota may be a responsible factor, along with estrogen deficiency, by the development of larger periapical lesions.

Clin Oral Investig 2021 Jun 14;25(6):3651-3662. Epub 2020 Nov 14.

Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brasil.

Objectives: To answer the questions: (1) Does reducing estrogen levels influence the microbial composition of the oral cavity? (2) Does the presence of periapical lesion (PL) cause changes in the oral microbiota? (3) Since estrogen deficiency alters the oral microbiota, can this be one of the factors that contribute to the increase of the PL?

Materials And Methods: Thirty-six rats were divided into four groups: sham (control), ovariectomy (OVX), control with PL (Sham + PL), and OVX + PL. After 9 weeks of OVX, the lower first molars were submitted to PL induction. After 21 days, the microbiological collection of the oral cavity was performed, and the animals were euthanized. The contents were evaluated by the checkerboard DNA-DNA hybridization method, to verify the prevalence of 40 bacterial species (divided into 7 microbial complexes). The blocks containing the lower first molars were submitted to histotechnical processing and staining with hematoxylin and eosin (HE), for the measurement of the periapical lesion area. The results were submitted to ANOVA and Kruskal-Wallis tests and Tukey and Dunn post-tests, with a significance level of 5%.

Results: In conditions of estrogen deficiency, there was alteration of the oral microbiota. The OVX groups had a higher amount of bacteria compared to the SHAM group in most of the microbial complexes (p < 0.001). The animals in the control group (with or without lesion) did not present a statistically significant difference (p > 0.001) in any of the microbial complexes. The PLs in OVX animals were significantly higher compared to SHAM animals (p < 0.001).

Conclusions: Hypoestrogenicity conditions interfere in the oral microbiota by increasing the amount of bacteria in the saliva and influencing the progression of periapical lesions.

Clinical Relevance: This inedited study shows that deficiency of estrogen leads to alteration of the oral microbiota.
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http://dx.doi.org/10.1007/s00784-020-03688-5DOI Listing
June 2021

Root canal conicity estimation of primary maxillary central and lateral incisors-A study by Nano-CT.

Int J Paediatr Dent 2020 Nov 20;30(6):764-774. Epub 2020 Apr 20.

Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.

Aim: The objective of the study was to estimate the conicity of the root canals of maxillary central and lateral incisors by computed nanotomography (Nano-CT).

Design: This in vitro study included nine extracted primary maxillary central incisors and 12 maxillary lateral incisors, which were subjected to Nano-CT analysis. The resulting images of each tooth were reconstructed using the OnDemand3D software, and root canal area, volume, and taper analysis were performed using the free FreeCAD 0.18 software for the 3D computer-aided design (CAD) model. Data were statistically analysed using the Stata v14.0 software, adopting a significance level of 5%.

Results: The results presented the mean value of the diameter and area of the root canal of primary central and lateral incisors. In addition, the taper values for both dental groups between points D0-D5, D5-D7, and D7-D10 were determined. Considering the diameters obtained over the entire length of the root, with a length of 12 mm, a conical model was constructed.

Conclusion: Detailed knowledge of root morphology of maxillary central and lateral incisors of primary dentition by means of Nano-CT is important to achieve faster, more accurate, and efficient endodontic treatments.
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http://dx.doi.org/10.1111/ipd.12642DOI Listing
November 2020

Negative Pressure Irrigation Presents Mineralizing Potential in Dogs' Immature Teeth with Periapical Lesion.

Braz Dent J 2020 Jan-Feb;31(1):37-43

Department of Pediatric Dentistry, University of Washington and Private Practice Limited to Endodontics in Everett WA, USA.

The objective of this in vivo study was to assess the effect of the root canal irrigation by negative and positive apical pressure on the expression of molecules that are an indicative of cell differentiation with mineralizing phenotype in teeth of dogs with incomplete rhizogenesis and induced periapical lesion. A total of 30 teeth (60 roots) were distributed into 3 groups (n=20): EndoVac®, Conventional and Control. After 90 days, the routine histotechnical procedures were performed and the sections were submitted to immunohistochemical technique for the staining of osteopontin (OPN), alkaline phosphatase (ALP) and the RUNX2 transcription factor in the apical and periapical regions of the roots. A semi-quantitative analysis of the positive immunostaining was performed and the intensity of the expression was classified in absent (0), mild (1), moderate (2), or intense (3). Scores data were statistically analyzed by the Kruskal-Wallis non-parametric test and Dunn post-test, and the significance level was set at 5%. RUNX2 immunostaining revealed that in the negative pressure group there was a significantly stronger (p<0.05) immunostaining in comparison to the control group. Regarding the OPN expression, it was not possible to detect a statistically significant difference between the groups (p>0.05). After analyzing ALP immunostaining, a statistically significant difference was observed between the groups (p<0.05), and the negative pressure group showed a markedly stronger mark immunostaining than the control group. The results of the present in vivo study allowed concluding that negative apical pressure irrigation presents mineralizing potential in immature teeth with apical periodontitis.
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http://dx.doi.org/10.1590/0103-6440201802764DOI Listing
March 2020

Clinical, microbiological, and immunological evaluation of patients in corrective orthodontic treatment.

Prog Orthod 2020 Feb 17;21(1). Epub 2020 Feb 17.

Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Avenida do Café S/N, Ribeirão Preto, SP, 14040-904, Brazil.

Background: The objective was to analyze clinical, microbiological, and immunological periodontal parameters in patients in corrective orthodontic treatment.

Materials And Methods: Twenty-eight patients were selected. Plaque index (PI), bleeding on probing (BOP), width of keratinized gingiva, levels of 40 bacterial species, and of 3 cytokines (IL-1β, MMP-8, and TNF-α) in gingival crevicular fluid (GCF) were evaluated at T0, before orthodontic treatment; T1, 6 months; and T2, 12 months post-treatment. Non-parametric, Friedman, Wilcoxon, ANOVA, and Spearman correlation coefficient tests were used for statistical analyses, with the significance level of 5%.

Results: No significant difference was found for the width of keratinized gingiva, but PI presented a significant increase at T1 and T2 (p < 0.05) when compared with T0. The percentage of sites with BOP increased significantly from T0 to T1 (p < 0.05); however, at T2, the values decreased and did not differ anymore from T0 (p > 0.05). In the microbiological analysis, red complex pathogens were in significantly greater proportions in T2 compared with T0 (p < 0.05). There was no statistically significant difference in the cytokine levels between the periods but there was a positive correlation between BOP and IL-1β (r = 0.49 p = .01) and TNF-α (r = 0.39 and p = .05).

Conclusion: In conclusion, corrective orthodontic treatment caused clinical periodontal alterations regarding biofilm accumulation and gingival bleeding, with alteration of periodontopathogens.
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http://dx.doi.org/10.1186/s40510-020-00307-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7024686PMC
February 2020

Morphological identification of Streptococcus mutans and Streptococcus sobrinus in SB-20M culture medium has efficiency comparable to proteomic identification by the MALDI-TOF mass spectrometry technique.

Arch Oral Biol 2020 Feb 31;110:104595. Epub 2019 Oct 31.

Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.

Objectives: The objective of this study was to evaluate the efficiency of SB-20 M culture medium to perform differential morphological identification of S. mutans and S. sobrinus compared to biochemical identification and to proteomic identification by the MALDI-TOF mass spectrometry technique.

Material And Methods: Unstimulated saliva samples from 266 dental students were seeded on SB-20 M culture medium by the wooden spatula technique. After incubation, S. mutans and S. sobrinus colonies were identified by stereomicroscopy based on their differential morphological characteristics. Following these procedures, 135 colonies with characteristic morphology of S. mutans (89 colonies) and S. sobrinus (46 colonies) were randomly selected, submitted to biochemical identification (biotyping) and proteomic identification by the MALDI-TOF mass spectrometry technique. The results were compared using the Kappa test, with a 5% significance level.

Results: All (100%) S. mutans colonies were correctly identified after culture in SB-20 M medium compared to biotyping and proteomic identification. For S. sobrinus, morphological identification in SB-20 M medium was correct for 43 colonies (93.5%) compared to biotyping and proteomic identification. However, there was no statistically significant difference when comparing the capacity to identify S. mutans and S. sobrinus of the three techniques (p < 0.001; K = 0.951).

Conclusions: It was concluded that the SB-20 M culture medium for morphological identification of S. mutans and S. sobrinus was highly reliable, being comparable to the MALDI-TOF mass spectrometry technique.

Clinical Relevance: The efficiency evaluation of identification methods of S. mutans and S. sobrinus is clinically relevant in order to determine caries risk and activity of patients.
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http://dx.doi.org/10.1016/j.archoralbio.2019.104595DOI Listing
February 2020

Comparison of apical periodontitis repair in endodontic treatment with calcium hydroxide-dressing and aPDT.

Braz Oral Res 2019 26;33:e092. Epub 2019 Sep 26.

Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Pediatric Dentistry, Ribeirão Preto, SP, Brazil.

This study evaluated the effect of antimicrobial photodynamic therapy (aPDT) on the endodontic treatment of apical periodontitis (AP). AP was induced in 48 premolars of 6 dogs. After biomechanical preparation, the teeth were divided into 4 groups: Calcium-Hydroxide (CH)/120d and CH/180d: root canals filled with CH-based dressing for 15 days before obturation; aPDT/120d and aPDT/180d: conditioning with phenothiazine photosensitizer (10 mg/mL) for 1 minute and irradiation with diode laser in the same session as obturation. Root filling was performed with AH Plus sealer. After the experimental periods, animals were euthanized and teeth were submitted for histology. HE staining was performed for descriptive analysis of the periapical region, measurement of apical periodontitis and for inflammatory cells, and blood vessels count. Immunohistochemistry was performed for osteopontin (OPN) and alkaline phosphatase (ALP). Data were analyzed statistically by two-way ANOVA and chi-square test (α = 5%). Teeth in Group CH/120d presented only a slightly enlarged periodontal ligament (PL) with advanced repair. Group aPDT/120d presented the PL moderately enlarged, with moderate inflammatory infiltrate and few collagen fibers. The same pattern was observed at 180 days. AP lesions in CH-treated groups were smaller than those in aPDT-treated groups (p < 0.001) with more blood vessels (p < 0.0001), regardless of the evaluation period, without significant differences in the number of inflammatory cells (p > 0.05). CH-treated groups showed significantly more intense immunostaining for ALP and OPN (p < 0.001) in both periods. Although aPDT stimulated angiogenesis and expression of bone formation markers, the two-session endodontic treatment with CH-based dressing promoted better apical periodontitis repair.
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http://dx.doi.org/10.1590/1807-3107bor-2019.vol33.0092DOI Listing
October 2019

Mechanical, chemical and antimicrobial properties of a bisphenol A-free pit-and-fissure sealant.

Am J Dent 2018 Dec;31(6):279-284

Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil,

Purpose: To evaluate, in vitro, mechanical, chemical and antimicrobial properties of Embrace Wetbond bisphenol A (BPA)-free pit-and-fissure sealant.

Methods: For the shear bond strength and microleakage tests, 135 healthy third molars were randomly divided into six groups, according to sealant [Fluroshield (FS) and Embrace Wetbond (EWB)] and contamination conditions (no contamination, contamination with saliva and contamination with water). In addition, EWB sealant was subjected to the following analyses: fluoride release using direct potentiometry, antimicrobial activity using the agar well diffusion method and quantification of BPA using gas chromatography and mass spectrometry. Data were analyzed statistically by ANOVA, Kruskal-Wallis test, Tukey's post-test, Dunn's post-test and Bonferroni post-test (α= 0.05).

Results: For shear bond strength, there was a statistically significant difference among the groups (P< 0.05), and FS presented the best results. Analysis of the microleakage results showed statistically significant differences among the groups (P< 0.05), except for EWB non-contaminated, contaminated with saliva, and contaminated with water (P> 0.05). FS without contamination presented the lowest microleakage of all groups (P< 0.05), followed by FS contaminated with saliva, and three groups in which EWB was used under different conditions. FS contaminated with water presented the highest microleakage (P< 0.05). EWB showed higher fluoride release in water and artificial saliva on the first day (P< 0.05). EWB had greater antimicrobial activity than FS. BPA and Bis-GMA were not detected in EWB. When used according to the manufacturer's instructions (i.e., under conditions of moisture contamination), EWB showed high fluoride release, high antimicrobial activity, no release of BPA or Bis-GMA and shear bond strength close to the minimum acceptable value. However, this sealant presented statistically significantly more microleakage than the other tested materials.

Clinical Significance: Knowing the adverse effects of BPA in the body, the present study has clinical relevance since it demonstrates some mechanical, chemical and antimicrobial properties of a BPA-free pit-and-fissure sealant.
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December 2018

Comparative Molecular Analysis of Gram-Negative Bacteria in Primary Teeth with Irreversible Pulpitis or Periapical Pathology.

Pediatr Dent 2018 Jul;40(4):259-264

Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.

The purpose of this study was to compare the Gram-negative pathogens identified in the root canals of primary teeth with irreversible inflammatory pulpitis and in teeth showing apical periodontitis. Samples were collected from 123 root canals of primary teeth from three- to seven-year-old patients. Root canals were assigned to either group one (irreversible inflammatory pulpitis; n equals 63) or group two (pulp necrosis and apical periodontitis; n equals 60). Total number of cells of selected Gram-negative microorganisms was determined by the checkerboard DNA-DNA hybridization technique. Demographic data were compared using either chi-squared or t tests. Total numbers of microorganisms were compared using the Mann-Whitney test ( equals 0.05). There were no significant intergroup differences in gender, age, and tooth group distribution (P>0.05). Among the 123 samples, 17 were discarded due to salivary contamination. The total numbers of Prevotella nigrescens, Treponema denticola, Fusobacterium nucleatum polymorphum, Fusobacterium nucleatum spp nucleatum, Aggregatibacter actinomycetemcomitans serotype a, Aggregatibacter actinomycetemcomitans serotype b, Porphyromonas gingivalis, Prevotella intermedia, and Prevotella melaninogenica were higher in teeth with apical periodontitis compared to those with irreversible inflammatory pulpitis (P<0.05). Higher numbers of Gram-negative bacteria were found in teeth with apical periodontitis compared to teeth with irreversible in- flammatory pulpitis.
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July 2018

Radiotherapy Activates and Protease Inhibitors Inactivate Matrix Metalloproteinases in the Dentinoenamel Junction of Permanent Teeth.

Caries Res 2019 26;53(3):253-259. Epub 2018 Sep 26.

Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil,

The objectives of this study were to investigate changes in the activity and expression of matrix metalloproteinase (MMP)-2 and MMP-9 in permanent teeth with or without exposure to radiotherapy, and the role of proteinase inhibitors in their inactivation. In situ zymography and immunofluorescence assays were performed to evaluate the activity and expression of two key gelatinases (MMP-2 and MMP-9) in sections of permanent molars, assigned to irradiated and nonirradiated subgroups. Dental fragments were exposed to radiation at a dose of 2 Gy fractions for 5 consecutive days until a cumulative dose of 60 Gy was reached. To evaluate the effect of protease inhibitors on MMPs, teeth were immersed in 0.5 mL of 0.12% chlorhexidine digluconate (CHX), 0.05% sodium fluoride (NaF), 400 μM polyphenol epigallocatechin-3-gallate (EGCG), or distilled water (control) for 1 h. Fluorescence in the dentinoenamel junction (DEJ) was evaluated in 3 areas of the tooth: cervical, cuspal, and pit. These regions were photographed using a fluorescence microscope at 1.25× and 5× magnifications. Results were analyzed using the D'Agostino-Person normality test, and the Kruskal-Wallis, Dunn, and Wilcoxon tests for intergroup and paired comparisons (α = 0.05). The fluorescence intensity/mm2 in the DEJ at the three regions studied was higher in the irradiated teeth (p < 0.05) than in the nonirradiated teeth, revealing regions of expression of MMP-2 and MMP-9 by immunofluorescence. Postradiotherapy treatment with different solutions (CHX, NaF, and EGCG) led to lower fluorescence intensity/mm2 in irradiated teeth than in the control group (distilled water; p < 0.05), as a result of MMP inactivation. In conclusion, irradiation increased gelatinase activity in all regions of the DEJ. Treatment with 0.12% CHX, 0.05% NaF, and 400 μM polyphenol EGCG postradiotherapy inactivated enzyme activity.
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http://dx.doi.org/10.1159/000492081DOI Listing
July 2020

Effect of ultrasonic, sonic and rotating-oscillating powered toothbrushing systems on surface roughness and wear of white spot lesions and sound enamel: An in vitro study.

Am J Dent 2018 Apr;31(2):76-80

Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.

Purpose: To evaluate the effect of ultrasonic, sonic and rotating-oscillating powered toothbrushing systems on surface roughness and wear of white spot lesions and sound enamel.

Methods: 40 tooth segments obtained from third molar crowns had the enamel surface divided into thirds, one of which was not subjected to toothbrushing. In the other two thirds, sound enamel and enamel with artificially induced white spot lesions were randomly assigned to four groups (n=10) : UT: ultrasonic toothbrush (Emmi-dental); ST1: sonic toothbrush (Colgate ProClinical Omron); ST2: sonic toothbrush (Sonicare Philips); and ROT: rotating-oscillating toothbrush (control) (Oral-B Professional Care Triumph 5000 with SmartGuide). The specimens were analyzed by confocal laser microscopy for surface roughness and wear. Data were analyzed statistically by paired t-tests, Kruskal-Wallis, two-way ANOVA and Tukey's post-test (α= 0.05).

Results: The different powered toothbrushing systems did not cause a significant increase in the surface roughness of sound enamel (P> 0.05). In the ROT group, the roughness of white spot lesion surface increased significantly after toothbrushing and differed from the UT group (P< 0.05). In the ROT group, brushing promoted a significantly greater wear of white spot lesion compared with sound enamel, and this group differed significantly from the ST1 group (P< 0.05). None of the powered toothbrushing systems (ultrasonic, sonic and rotating-oscillating) caused significant alterations on sound dental enamel. However, conventional rotating-oscillating toothbrushing on enamel with white spot lesion increased surface roughness and wear.

Clinical Significance: None of the powered toothbrushing systems (ultrasonic, sonic and rotating-oscillating) tested caused significant alterations on sound dental enamel. However, conventional rotating-oscillating toothbrushing on enamel with white spot lesion increased surface roughness and wear.
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April 2018

MMP2 and MMP9 are Associated with Apical Periodontitis Progression and Might be Modulated by TLR2 and MyD88.

Braz Dent J 2018 Jan-Feb;29(1):43-47

Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, USP - Universidade de São Paulo, Ribeirão Preto, Brazil.

The aim of this study was to evaluate the expression of MMP2 and MMP9 during apical periodontitis (AP) progression in TLR2 (TLR2 KO) and in MyD88 (MyD88 KO) knockout mice compared to wild type (WT) mice. AP was induced in mandibular first molars of TLR2 KO (n= 18), MyD88 KO (n= 18), and WT mice (n= 18). After 7, 21, and 42 days, the animals were euthanized and the jaws were dissected and subjected to histotechnical processing. Subsequent sections were stained by immunohistochemistry and evaluated for detection of MMP2 and MMP9. Statistical analysis of the semi-quantitative analysis of immunohistochemistry was performed using chi-square test (α = 0.05). In the initial periods of AP progression, an increased expression of MMP9 in the TLR2 KO and MyD88 KO mice was observed. In the final periods of AP progression, a reduction of MMP2 expression and an increase of MMP9 expression in the TLR2 KO mice were observed. MMP2 and MMP9 production was modulated for TLR2 and MyD88 during apical periodontitis progression.
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http://dx.doi.org/10.1590/0103-6440201801731DOI Listing
July 2018

Does the CO2 laser reduce bond strength in different types of ceramic brackets?

Dental Press J Orthod 2017 Mar-Apr;22(2):55-60

Full professor, Universidade de São Paulo, Ribeirão Preto Dental School, Department of Pediatric Clinics, Ribeirão Preto/SP, Brazil.

Objective:: The aim of this study was to assess in vitro the influence of the CO2 laser and of the type of ceramic bracket on the shear bond strength (SBS) to enamel.

Methods: : A total of 60 enamel test surfaces were obtained from bovine incisors and randomly assigned to two groups, according to the ceramic bracket used: Allure (A); Transcend (T). Each group was divided into 2 subgroups (n = 15): L, laser (10W, 3s); C, no laser, or control. Twenty-four hours after the bonding protocol using Transbond XT, SBS was tested at a crosshead speed of 0.5 mm/min in a universal testing machine. After debonding, the Adhesive Remnant Index (ARI) was evaluated at 10 x magnification and compared among the groups. Data were analyzed by one-way ANOVA, Tukey's, Mann-Whitney's and Kruskal-Wallis tests (α = 0.05).

Results: : Mean SBS in MPa were: AL = 0.88 ± 0.84; AC = 12.22 ± 3.45; TL = 12.10 ± 5.11; TC = 17.71 ± 6.16. ARI analysis showed that 73% of the specimens presented the entire adhesive remaining on the tooth surfaces (score 3). TC group presented significantly higher SBS than the other groups. The lased specimens showed significantly lower bond strength than the non-lased groups for both tested brackets.

Conclusion: : CO2 laser irradiation decreased SBS values of the polycrystalline ceramic brackets, mainly Allure.
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http://dx.doi.org/10.1590/2177-6709.22.2.055-060.oarDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5484270PMC
May 2018

Furcation Perforation: Periradicular Tissue Response to Biodentine as a Repair Material by Histopathologic and Indirect Immunofluorescence Analyses.

J Endod 2017 Jul 2;43(7):1137-1142. Epub 2017 May 2.

Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.

Introduction: The purpose of this study was to evaluate the in vivo response of periradicular tissues after sealing of furcation perforations with Biodentine, mineral trioxide aggregate (MTA), and gutta-percha by means of histopathologic and indirect immunofluorescence analyses.

Methods: Thirty teeth of 3 dogs were divided into 3 groups: Biodentine (n = 14 teeth), MTA (negative control, n = 10 teeth), and gutta-percha (positive control, n = 6 teeth). After endodontic treatment, perforations were made on the center of the pulp chamber floor and filled with the materials. After 120 days, the animals were killed, and blocks containing the teeth and periradicular tissues were processed histotechnically for histopathologic semiquantitative (new mineralized tissue formation and bone resorption at the perforation site) and quantitative (thickness and area of newly formed mineralized tissue and number of inflammatory cells) analyses and RUNX2 immunofluorescence assay. Data were analyzed by χ, Fisher exact test, Mann-Whitney test, one-way analysis of variance, Kruskal-Wallis test, and Dunn posttest (α = 0.05).

Results: MTA and Biodentine induced the formation of significantly more new mineralized tissue (P < .0001) than gutta-percha, which did not induce the formation of mineralized tissue in any case. Complete sealing of the perforations was more frequent with MTA, which formed mineralized tissue with greater thickness and area. Biodentine and MTA exhibited no bone resorption in the furcation region, fewer inflammatory cells, and greater RUNX2 immunostaining intensity than gutta-percha.

Conclusions: Although MTA presented higher frequency of complete sealing and greater thickness and area of newly formed mineralized tissue, Biodentine also had good histopathologic results and can be considered as an adequate furcation perforation repair material.
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http://dx.doi.org/10.1016/j.joen.2017.02.001DOI Listing
July 2017

Apical Revascularization after Delayed Tooth Replantation: An Unusual Case.

Case Rep Dent 2016 2;2016:2651643. Epub 2016 Nov 2.

Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.

The aim of this paper is to present the clinical and radiological outcome of the treatment involving a delayed tooth replantation after an avulsed immature permanent incisor, with a follow-up of 1 year and 6 months. An 8-year-old boy was referred after dental trauma that occurred on the previous day. The permanent maxillary right central incisor (tooth 11) had been avulsed. The tooth was hand-held during endodontic therapy and an intracanal medication application with calcium hydroxide-based paste was performed. An apical plug with mineral trioxide aggregate (MTA) was introduced into the apical portion of the canal. When the avulsed tooth was replanted with digital pressure, a blood clot had formed within the socket, which moved the MTA apical plug about 2 mm inside of the root canal. These procedures developed apical revascularization, which promoted a successful endodontic outcome, evidenced by apical closure, slight increase in root length, and absence of signs of external root resorption, during a follow-up of 1 year and 6 months.
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http://dx.doi.org/10.1155/2016/2651643DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5110882PMC
November 2016

Comparison between one-session root canal treatment with aPDT and two-session treatment with calcium hydroxide-based antibacterial dressing, in dog's teeth with apical periodontitis.

Lasers Med Sci 2016 Sep 7;31(7):1481-91. Epub 2016 Jul 7.

Department of Bucco-Maxilo-Facial Surgery and Traumatology and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirao Preto, SP, Brazil.

To evaluate one-session endodontic treatment with aPDT and two-session treatment with calcium hydroxide (CH)-based dressing in dog's teeth with apical periodontitis. After experimental induction of apical periodontitis, 48 teeth were randomly assigned to the following groups: groups OS/aPDT120d and OS/aPDT180d (one-session treatment with aPDT) and groups TS/CH120d and TS/CH180d (two-session treatment with CH-based dressing-control groups). The animals were euthanized after 120 and 180 days. After histotechnical processing, microscopic and radiographic analyses were performed. Data were analyzed by Kruskal-Wallis and Fisher's exact tests (α = 0.05). Groups TS/CHs presented repaired resorbed cemental areas, with collagen bundles and few inflammatory cells. In groups OS/aPDTs, the areas of cemental resorption were not repaired with reduced presence of cells and fibers. In the analysis of the apical closure, fluorescence microscopy and percentage of radiographic reduction of lesions, there was significant difference between groups TS/CH120d and OS/aPDT120d and between TS/CH180d and OS/aPDT180d (p < 0.05). Groups TS/CHs had weak RANKL expression and positive immunostaining for RANK and OPG. In OS/aPDT120d, there was positive immunostaining for RANKL. In OS/aPDT180d, the three osteoclastogenesis markers were expressed. The results using aPDT were worse than those obtained with two-session endodontic treatment using a CH-based dressing in teeth with apical periodontitis.
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http://dx.doi.org/10.1007/s10103-016-2014-8DOI Listing
September 2016

Correlation Between Bacterial Endotoxin Levels in Root Canals of Primary Teeth and the Periapical Lesion Area.

J Dent Child (Chic) 2016 ;83(1):9-15

Professor, in the Department of Pediatric Dentistry, School of Dentistry, at the University of São Paulo-Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil.

Purpose: The purposes of this study were (1) to assess the endotoxin levels in root canals of primary teeth with necrotic pulps and periapical lesions; and (2) to evaluate the correlation of endotoxin levels with the periapical lesion size.

Methods: Twenty primary molars with necrotic pulps and periapical lesions were selected. Standardized radiographs were obtained and the lesions were measured. Material from each root canal was collected to quantify the bacterial endotoxin. The results were analyzed using Pearson's correlation, student's t test, and Fisher's exact test (α equals five percent).

Results: The initial amount of bacterial endotoxin in the root canals ranged from 0.089 to greater than 50.00 endotoxin units (EU)/mL and was detected in 100 percent of the samples. A positive but not significant correlation was observed between the amount of endotoxin and periapical lesion size in primary molars.

Conclusion: Endotoxin was observed in 100 percent of root canals of primary teeth with a periapical lesion. However, there was no statistical significance between bacterial endotoxin levels and the periapical lesion area.
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June 2017

Evaluation of Chair-Side Assays in High Microbiological Caries-Risk Subjects.

Braz Dent J 2015 Nov-Dec;26(6):592-5

Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, USP - Universidade de São Paulo, Ribeirão Preto, SP, Brazil.

The aim of this study was to evaluate the commercial chair-side assays Saliva-Check Mutans and ClinproTM Cario L-PopTM in high microbiological caries-risk dental students compared with conventional semi-quantitative colony counting culture-based technique as the reference method. Saliva samples from 93 subjects of both sexes aged 18-26 years were seeded (Köhler and Bratthall method) on plates containing SB-20M culture medium method and 12 subjects with high caries risk were selected. These 12 individuals were subjected to determination of caries risk using two commercial rapid detection chair-side assays (Saliva-Check Mutans and ClinproTM Cario L-PopTM) according to the manufacturers' instructions. The results were analyzed by the Kappa correlation test using SAS statistical software. There was a perfect agreement (Kappa=1) among the three caries risk evaluation methods - chair-side assays and semi-quantitative CFU count (control) - in all subjects. The results suggest that the commercial chair-side assays evaluated in this study may be practical and useful to identify high microbiological caries-risk subjects.
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http://dx.doi.org/10.1590/0103-6440201300389DOI Listing
February 2017

Enamel permeability and resistance to acid challenges after systemic use of sodium alendronate: a study in rat teeth.

Clin Oral Investig 2016 Sep 10;20(7):1647-54. Epub 2015 Nov 10.

Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.

Objectives: To evaluate the enamel resistance and permeability of rat teeth to acid challenges after systemic use of sodium alendronate.

Materials And Methods: Eighteen Wistar rats (36 teeth), aged 36-42 days (200-230 g), were assigned into two groups: alendronate group (n = 20 teeth), which received two weekly doses of 1 mg/kg of alendronate, via gavage; and a non-alendronate group (n = 16 teeth), which received only distilled water. After 60 days, the animals were killed, the maxillary incisors were extracted and used for the artificial induction of the caries lesion (pH cycling regimen) and erosion area (immersion cycles in cola-type soft drink) and for the enamel permeability test (dye penetration). The teeth were divided into alendronate group (n = 10) or non-alendronate group (n = 8) for each test. The quantitative response variables were the percent longitudinal change in Knoop microhardness (%LMC), the enamel carious/erosion lesion area (CELA) and enamel permeability.

Results: Groups were not significantly different (p > 0.05) with regard to the %LMC and enamel permeability (25.58 μm ± 12.73 and 25.40 μm ± 4.6 for the experimental and control groups, respectively). For CELA, it was not observed significant difference (p > 0.05) between the non-alendronate group (24.08 ± 1.36 and 25.22 ± 1.60, for caries and erosion, respectively) and the alendronate group (25.46 ± 1.60 and 25.0 ± 1.26) for caries and erosion, respectively).

Conclusions: Based on the methodological conditions and the presented results of this study, sodium alendronate did not affect the longitudinal microhardness, demineralisation lesion area or permeability of the enamel after acid challenge; therefore, alendronate did not become the enamel of rats more resistant.

Clinical Relevance: The systemic alendronate treatment for 60 days did not change the enamel of rats regarding the susceptibility to acids.
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http://dx.doi.org/10.1007/s00784-015-1647-5DOI Listing
September 2016

Microbial contamination and disinfection methods of pacifiers.

J Appl Oral Sci 2015 Oct;23(5):523-8

Departamento de Odontopediatria, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.

Objectives: To evaluate the microbial contamination of pacifiers by Mutans Streptococci(MS) and the efficacy of different methods for their disinfection.

Methods: Twenty-eight children were assigned to a 4-stage changeover system with a 1-week interval. In each stage, children received a new pacifier and the parents were instructed to maintain their normal habits for 1 week. After this time, the pacifiers were subjected to the following 4 disinfection methods: spraying with 0.12% chlorhexidine solution, Brushtox or sterile tap water, and immersion in boiling tap water for 15 minutes. Microbiological culture for MS and Scanning Electron Microscopy (SEM) were performed. The results were analyzed statistically by Friedman's non-parametric test (a=0.05).

Results: The 0.12% chlorhexidine spray was statistically similar to the boiling water (p>0.05) and more effective than the Brushtox spray and control (p<0.05). The analysis of SEM showed the formation of a cariogenic biofilm in all groups with positive culture.

Conclusions: Pacifiers become contaminated by MS after their use by children and should be disinfected routinely. Spraying with a 0.12% chlorhexidine solution and immersion in boiling water promoted better disinfection of the pacifiers compared with a commercial antiseptic toothbrush cleanser (Brushtox).
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http://dx.doi.org/10.1590/1678-775720150244DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4621945PMC
October 2015

Mutans streptococci remained viable on toothbrush bristles, in vivo, for 44 h.

Int J Paediatr Dent 2014 Sep;24(5):367-72

Background: Toothbrushes harbor a high number of cariogenic microorganisms.

Aim: To investigate the viability of mutans streptococci (MS) on toothbrushes bristles and the production of extracellular polysaccharide (ECP) related to drying time.

Design: Twenty children were submitted to brushing without dentifrice. Toothbrushes were kept at room temperature from 0 to 48 h and then submitted to microbiological processing. The number of MS colonies/biofilms was expressed according to scores: 0=no colonies were detected; 1=1 to 50; 2=51 to 100; 3=over 100. The amount of ECP was evaluated according to scores: 0=absence; 1=ECP recovering until 50% of the surface; 2=ECP recovering more than 50% of the surface. Data were analyzed by Wilcoxon test (α=5%).

Results: At the periods of 0 to 16 h, the toothbrushes had intense bacterial contamination (score 3). From the 18-h, there was a statistically significant decrease in the MS viability (P=0.0078), with predominance of score 1 on periods of 20 to 44 h. The most detected ECP amount was at 0- and 12-h period (P<0.05) with reduction until 32-h period.

Conclusions: Mutans streptococci remained viable on toothbrushes bristles, in vivo, for 44 h.
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http://dx.doi.org/10.1111/ipd.12079DOI Listing
September 2014

Radiodensitometric and DXA analyses for the measurement of bone mineral density after systemic alendronate therapy.

Braz Oral Res 2013 May-Jun;27(3):252-7

Department of Pediatric Clinics, Preventive and Community Dentistry, School of Dentistry of Ribeirão Preto, Univ de São Paulo, Ribeirão Preto, SP, Brazil.

Precise techniques for the measurement of maxillary bone mineral density (BMD) are useful for the early diagnosis of systemic diseases. The aim of this study was to compare in vivo the efficacy of dual-energy x-ray absorptiometry (DXA) and radiographic densitometry for the measurement of BMD after systemic administration of sodium alendronate. Wistar rats were randomly allocated to a control group (n = 5), which received distilled water, and a sodium alendronate group (n = 8), which received two doses of chemically pure sodium alendronate (1 mg/kg) per week. After 8 weeks, the animals were euthanized, the tibias were removed, and the BMD of the proximal tibial metaphysis was analyzed radiographically and by DXA. The data were subjected to statistical analysis by the Kruskal-Wallis test at a significance level of 5%. Both of the techniques revealed that the alendronate-treated group had a significantly higher BMD (p < 0.05) than the control group after 8 weeks of treatment. Comparing the groups with and without alendronate therapy revealed increases of 14.9% and 29.6% in BMD, as detected radiographically and by DXA, respectively. In conclusion, both of the methods were able to detect an increase in BMD of the proximal tibial metaphysis after alendronate therapy.
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http://dx.doi.org/10.1590/S1806-83242013000300005DOI Listing
January 2014

Dental findings and special care in patients with Angelman syndrome: a report of three cases.

Spec Care Dentist 2013 Jan-Feb;33(1):40-5. Epub 2012 Nov 22.

Department of Pediatric Clinics, Preventive and Community Dentistry, School of Dentistry of Riberão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.

Angelman syndrome (AS) is a neurogenetic disorder, characterized by intellectual disability, movement or balance disorders, specific abnormal behaviors, and severe speech and language limitations. Due to its low incidence and the nonspecifity of developmental problems in newborns and young children, AS is not easily identified by clinical pediatricians. The aim of this paper is to present three cases of AS, reporting the orofacial characteristics and requisite dental care in these patients. Interestingly, this investigation found that certain typical features of mouth breathing syndrome, such as long and narrow faces, open mouth, shortened upper lip, lowered mandible position, shadows under the eyes (infraorbital cyanosis), muscular hypotonia, and enlarged and anteriorized tongue, were present in the three studied AS patients.
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http://dx.doi.org/10.1111/j.1754-4505.2012.00292.xDOI Listing
December 2013

Systemically alendronate was incorporated into dental tissues but did not cause morphological or mechanical changes in rats teeth.

Microsc Res Tech 2012 Sep 17;75(9):1265-71. Epub 2012 Apr 17.

Department of Pediatric Clinics, Preventive and Community Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.

This study evaluated the effect of the systemic use of sodium alendronate in rats in vivo. Forty-five Wistar rats aged 36 to 42 days and weighing 200 to 230 g were randomly assigned to a control group (n = 20), which received distilled water, and an experimental group (n = 25), which received 2 weekly doses of 1 mg/kg of chemically pure sodium alendronate. The animals were killed after 60 days of treatment. The tibias were removed for analysis of bone mineral density by dual-energy X-ray absorptiometry (DXA). Then, the maxillary incisors were extracted for analysis of the mineralized dental tissues using fluorescence spectroscopy (FS), scanning electron microscopy (SEM), bright field microscopy (BFM), and cross-sectional microhardness (CSMH) testing. DXA and CSMH data were subjected to statistical analysis by Kruskal-Wallis test (5% significance level). The experimental group presented higher bone mineral density than the control group by DXA. FS analysis revealed presence of alendronate in the mineralized dental tissues of the specimens of the experimental group. Significant morphological differences were not found by SEM and BFM. Enamel and dentin (100 and 300 μm from the dentinoenamel junction) CSMH data did not show significant difference between the control and experimental groups. Based on the obtained results, we conclude that while alendronate increased the bone mineral density and was incorporated into the mineralized dental tissues it did not cause significant alterations in the morphology and microhardness of rat incisor enamel and dentin.
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http://dx.doi.org/10.1002/jemt.22059DOI Listing
September 2012

Ex vivo accuracy of an apex locator using digital signal processing in primary teeth.

Pediatr Dent 2009 Jul-Aug;31(4):320-2

Department of Pediatric Clinic, Preventive and Community Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.

Purpose: The purpose of this study was to evaluate ex vivo the accuracy an electronic apex locator during root canal length determination in primary molars.

Methods: One calibrated examiner determined the root canal length in 15 primary molars (total=34 root canals) with different stages of root resorption. Root canal length was measured both visually with the placement of a K-file 1 mm short of the apical foramen or the apical resorption bevel, and electronically using an electronic apex locator (Digital Signal Processing). Data were analyzed statistically using the intraclass correlation (ICC) test.

Results: Comparing the actual and electronic root canal length measurements in the primary teeth showed a high correlation (ICC=0.95).

Conclusions: The Digital Signal Processing apex locator is useful and accurate for apex foramen location during root canal length measurement in primary molars.
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December 2009

Influence of water flow rate on shear bond strength of resin composite to Er:YAG cavity preparation.

Am J Dent 2008 Apr;21(2):124-8

Department of Operative Dentistry, School of Dentistry, University of São Paulo, Ribeirão Preto, SP, Brazil.

Purpose: To evaluate in vitro the influence of water flow rate on shear bond strength of a resin composite to enamel and dentin after Er:YAG cavity preparation.

Methods: Ten bovine incisors were selected and roots removed. Crowns were sectioned in four pieces, resulting in 40 samples that were individually embedded in polyester resin (n = 10), and ground to plane the enamel and expose the dentin. The bonding site was delimited and samples were randomly assigned according to cavity preparation: (1) Er:YAG/1.0 mL/minute; (2) Er:YAG/1.5 mL/minute; (3) Er:YAG/2.0 mL/minute and (4) High speed handpiece/bur (control group). Samples were fixed to a metallic device, where composite resin cylinders were prepared. Subsequently, they were stored for 24 hours and subjected to a shear bond strength test (500N at 0.5 mm/minute).

Results: Means (MPa) were: enamel: 1: 12.8; 2: 16.8; 3: 17.5; 4: 36.0 and Dentin: 1: 13.6; 2: 18.7; 3: 12.1; 4: 21.3. Data were submitted to ANOVA and Tukey's test. Adhesion to enamel was more efficient than for dentin. The cavities prepared with conventional bur (control) presented higher statistically significant bond strength values (P < 0.05) than for Er:YAG laser for both enamel and dentin. No significant differences were observed between water flow rates employed during enamel ablation. For dentin, the shear bond strength of 2.0 mL/minute water flow rate was lower than for 1.5 mL/minute and 1.0 mL/minute rates. The Er:YAG laser adversely affected shear bond strength of resin composite to both enamel and dentin, regardless of the water flow rate used.
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April 2008
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