Qualitative and quantitative evaluation of the formation and treatment of white spot lesions produced in vitro in teeth deciduous

Author(s)

Thais Varanda

• Document type: Master's Dissertation
• Press: Piracicaba, SP.
• Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Odontologia de Piracicaba
• Defense date: 2014-06-16

Examining board members

Fernanda Miori Pascon; Maria Beatriz Duarte Gavião; Ana Flavia Sanches Borges

• Advisor: Regina Maria Puppin Rontani; Fernanda Miori Pascon

Abstract

White spot lesions are commonly observed in primary teeth (PT) and when early diagnosed and treated using with various materials that release fluoride, they have a favorable prognosis. The aims of this study were: (1) to evaluate quantitatively and qualitatively 2 formation times of subsurface carious lesions (SCL) in PT; (2) to evaluate quantitatively and qualitatively the effect of three fluoride varnishes: Duraphat®, MI Varnish¿, Vanish¿ in SCL of PT. For the first aim, 20 PT were selected and divided into 2 groups (n = 10): 8 and 16h. SCL was produced in enamel blocks using demineralizing solution. Depth (quantitative analysis) and homogeneity (qualitative analysis) of the lesions were evaluated in polarized light microscopy (PLM). For depth lesion determination 3 measurements were performed in each lesion (µm) and the average was calculated. For homogeneity the images were classified into scores (0 = no homogeneity, 1 = homogeneity). Quantitative data were subjected to normality test, Shapiro-Wilk and once did not show normal data distribution; they were subjected to the Mann-Whitney test. Regarding lesion depth no significant difference was observed between 8h (75.61±41.46) and 16h (104.53±90.00) (p=0.6831). For homogeneity, 8h promoted formation of homogeneous SCL in 50% compared to 100% in 16h (p<0.01). For the second aim, 36 PT (n = 9) were selected. SCL were produced in enamel blocks for 16h. The materials were applied and after 7 days the specimens were sectioned and analyzed for the depth of the SCL (PLM), mineral loss (Knoop hardness) and calcium (Ca) and phosphorus (P) (energy dispersive spectroscopy - EDS). For PLM the lesion depth was calculated as described above. For microhardness, three rows with 12 impressions each were performed (10, 20, 30, 40, 50, 60, 80, 100, 120, 140, 160 and 180?m) (25g/5s). Knoop microhardness (KHN) was obtained and calculated the KHN variation (?S). For EDS specimens were observed in a scanning electron microscope and the amount of calcium (Ca) and phosphorus (P) was calculated in surface and sub-surface regions. The images obtained in PLM were subjected to descriptive analysis. Quantitative data were subjected to the Shapiro-Wilk test, ANOVA and Tukey's test as post-hoc (? = 5%). No significant differences were observed between groups in relation to the average depths of the SCL analyzed in PLM. The treated groups had similar mean values (39.73±14.20µm; 32.77±11.86µm; 38.13±9.17µm to Duraphat®, MI VarnishTM and VanishTM, respectively), numerically different from the control group (54.10±34.56µm). For the hardness, it was observed that Duraphat® (2022±1071) had the lowest mineral loss compared to the control (5239±2299), MI VarnishTM (4505±1098) and VanishTM (4431±1512) (p<0.001, p=0.0022 and p=0.0036, respectively). For EDS, both for Ca and P, there was no interaction between materials and regions studied, but there was a significant difference to the amount of Ca between regions (p<0.05). The surface region showed a lower content of Ca that the sub-surface region. It can be concluded that 16 hours was the most appropriate time for the formation of SCL in primary teeth; modified fluoride varnishes they were not effective in reducing SCL mineral loss of in primary teeth; Duraphat® was the material that showed effectiveness to reduce SCL mineral loss of in primary teeth (AU)

• FAPESP's process: 12/03036-3 - Qualitative and quantitative evaluation of the remineralizing potential of different fluoride varnishes in white spot lesions produced in vitro in primary teeth
• Grantee: Thais Varanda
• Support Opportunities: Scholarships in Brazil - Master