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Doctoral Thesis
DOI
https://doi.org/10.11606/T.25.2015.tde-28102015-092917
Document
Author
Full name
Maria Cristina Carvalho de Almendra Freitas
Institute/School/College
Knowledge Area
Date of Defense
Published
Bauru, 2015
Supervisor
Committee
Wang, Linda (President)
Alonso, Roberta Caroline Bruschi
Fagundes, Ticiane Cestari
Navarro, Maria Fidela de Lima
Prakki, Anuradha
Title in Portuguese
Efeito de um infiltrante resinoso no tratamento de lesões de mancha branca: análise in vitro e in situ
Keywords in Portuguese
In vitro
Cárie dentária
Desmineralização
Resinas
Testes de dureza
Abstract in Portuguese
Dentre as estratégias de tratamento de lesões incipientes de cárie, no estágio de mancha branca ativa, o infiltrante resinoso tem sido empregado, preenchendo os poros do esmalte e impedindo a sua progressão. O objetivo deste trabalho foi avaliar o efeito do infiltrante de cárie (Icon®) sobre lesões cariosas artificiais produzidas por diferentes protocolos e a eficiência deste tratamento após novo desafio ácido por modelos experimentais in vitro e in situ, utilizando a microdureza de superfície (MS) e longitudinal (ML). Na fase in vitro, lesões cariosas artificiais foram produzidas em 45 espécimes de esmalte bovino (6x4mm) através de três diferentes protocolos (ciclagem DES-RE, gel MC e solução MHDP). Os espécimes foram tratados com o infiltrante e submetidos a novo desafio ácido por ciclagem DES-RE. Este delineamento resultou em 4 condições em um mesmo espécime: hígida (H), após a desmineralização (D), após o tratamento com o infiltrante (I) e após o novo desafio ácido (N). Na fase in situ, 15 voluntários usaram dispositivos palatinos contendo dois espécimes por 14 dias, induzindo a lesão por meio de gotejamento de solução de sacarose 8x/dia. Nas duas fases, a MS e ML foram avaliadas em todas as condições dos espécimes até 220μm. Os dados foram coletados e processados pela porcentagem da diferença com os valores iniciais da condição hígida para serem analisados estatisticamente de acordo com ANOVA (medidas repetidas) e teste de Tukey (p<0,05). No estudo in vitro e in situ todos os protocolos de desmineralização foram capazes de produzir lesões de cárie de subsuperfície. Todos os protocolos in vitro promoveram perda de dureza de superfície maior que 75%, enquanto o protocolo in situ promoveu quase 40%. Há uma redução da perda de dureza à medida que a profundidade aumenta em todos os casos, sendo as particularidades mais observadas até 50 μm. O infiltrante avaliado em todas as condições foi capaz de re-equilibrar parcialmente a dureza interna, entretanto sua resistência e efeito após o novo desafio ácido apresentou-se limitado.
Title in English
Efffect of a resinous infiltrant on the tratment of white spot lesions: in vitro and in situ analysis
Keywords in English
In vitro
Demineralization
Dental caries
Hardness tests
Resins
Abstract in English
Among the strategies for early caries lesions treatment as active white spot, the resin infiltrant has been employed filling the enamel pores and preventing their progression. The aim of this study was to evaluate the effect of caries infiltrant (Icon®) on artificial carious lesions produced by different protocols, and the efficiency of this treatment after new challenge acid by in vitro and in situ experimental models, using the surface microhardness (SH) and cross-sectional microhardness (CSH). In the in vitro phase, artificial carious lesions were performed on 45 enamel bovine specimens (6x4mm) by three different protocols (DE-RE cycling, MC gel and MHDP solution). The specimens were treated with the infiltrant and subjected to a new challenge by DE-RE cycling. This design resulted in four conditions at the same specimen: sound (S), after demineralization (D), after the treatment with infiltrant (I) and after the new acid challenge (N). In the in situ phase, 15 volunteers wore intraoral appliances containing two specimens for 14 days, inducing the lesion formation by sucrose solution dripping 8x/day. In both models, SH and CSH were evaluated in all conditions of the specimens up to 220μm. Data were collected and processed as percentage from the difference to each condition compared to sound stage to be statistically analyzed with ANOVA (repeated measures) and Tukey test (p <0.05). For all tested conditions, demineralization protocols were able to produce subsurface carious lesions. All in vitro protocols promoted hardness loss higher than 75% while in situ protocol promoted almost 40%. There is a reduction in the hardness loss as the depth increases, in which the main differences can be noticed up to 50μm. The infiltrant evaluated in all conditions was able to partially re-balance the internal hardness, however its strength and effect after the new challenge acid had been limited.
 
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Publishing Date
2015-10-28
 
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