Efectul sinergic al fluorurilor si al

hexametafosfatului de sodiu din

pastele de dinti asupra
demineralizarilor in situ ale
smaltului 12/18/20
18
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 ABSTRACT
• OBIECTIVE

Evaluarea efectului produs de o dentifrice cu fluor si hexametafosfat de sodiu

(HMP) la nivelul demineralizarilor in situ ale smaltului

• METODE

Studiu de tip dublu-orb incrucisat cu ajutorul a 12 voluntari in 3 faze diferite

• ?? REZULTATE

• CONCLUZIE ??

• ?? RELEVANTA CLINICA 12/18/2018 2

 CUPRINS
1. Introducere
2. Materiale si metode
3. Rezultate
4. Discutii
5. Concluzie

Referinte/Bibliografie
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• Dentifricele cu fluor – cea mai eficienta metoda preventiva publica
• DAR!! Dentifricele conventionale (1000 – 1100 ppm F) au EFECT LIMITAT ptr pacientii
cu RISC MARE (*bioflm, *ingestii de zahar ↑)

• SOLUTIE: adaugarea sarurilor de polifosfati la produsele fluorurate = alternativa

eficienta atat in vitro cat si in situ

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• HMP = fosfat ciclic anorganic; ↑permeabilitatea mb
MOO => efect antimicrobian, inhibitor in formarea
biofilmului (*hamsteri cu dieta crescuta in sucroza)
• In vitro: HMP + 250 ppm F = 1100 ppm F
• ?? HMP + 1100 ppm F ??
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 MATERIALE SI METODE
SCOP
• Evaluarea efectului HMP
+ dentifrice conventionala
1100 ppm F
Observarea:
• demineralizarii in smaltul
bovinelor in situ
• compozitiei minerale a
smaltului si a biofilmului
IPOTEZA
• Consideram ca o dentifrice
imbogatita cu HMP =
dentifrice fara HMP
REZULTATE
* Efecte anticarie IDENTICE
sau SUPERIOARE??
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 MATERIALE SI METODE

MATERIALE – BLOCURI DE
PARTICIPANTI SMALT
• Studiu dublu-orb incrucisat • Aplicatii palatinale : blocuri
• 12 voluntari: 2 ♀ si 10 ♂, studenti la de smalt bovin obtinute din
medicina dentara (20-30 ani)
• 3 faze a cate 7 zile fiecare incisivi (4 x 4 x 2 mm) In
• Stare de sanatate generala si orala buna prealabil lustruite, cate 4
• Flux salivar normal, fara aparate orto blocuri/faza
• Exclus gravide, femei ce alapteaza,
fumat si orice boala sistemica sau
• Spatiu de 1 mm creat ->
medicatie asociata care sa interfere cu acumularea biofilmului
fluxul salivar
dentar
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 TRATAMENTE – PROCEDURI
INTRAORALE
• Solutii proaspete de sucroza 30% preparate la fiecare 48
de h
• Voluntarii instruiti sa indeparteze aplicatiile si sa aplice 2
PICATURI in spatiul de 1 mm de 6 ori/zi la ore
predeterminate: 8:00 am, 11:00 am, 2:00 pm, 5:00
pm, 7:00 pm, 9:00 pm
• Dupa picurare, aplicatiile sunt lasate in afara cavitatii orale
5 min inainte sa fie reintroduse
• Aplicatiile sunt purtate 24/24 h

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TRATAMENTE – PROCEDURI INTRAORALE
• Dentifricele
1. Fara F si HMP (grup control negativ)
2. Cu F 1100 ppm (grup control pozitiv)
3. Cu F 1100 ppm si HMP 1%

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 TRATAMENTE – PROCEDURI INTRAORALE
• 3 ori/zi: 8:00 am, 13:00 pm, 21:30 pm
• Periaj la nivel dentar cu aplicatiile in cavitatea orala
• Timp: 2 minute
• Se permite salivei incarcate cu pasta sa vina in contact
cu aplicatiile
• Aplicatiile sunt indepartate, spalate sub jet de apa de
la robinet
• Voluntarii isi continua rutina spalatului
• Ulterior aplicatiile sunt reintroduse in cav orala
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EXAMINARE/ANALIZA
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 REZULTATE 1100F-HMP1
1100F-HMP1%

1100 F PLACEBO

%SH = percentage of ↓ 25% ↓64%

surface hardness
ΔKHN = integrated loss ↓ 25% ↓69%
of subsurface hardness
C% F Efect similar ↓↓

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 REZULTATE 1100F-HMP1
1100F-HMP1% 1100F PLACEBO

Ca ↑↑↑ ↑↑ ↑

P Fara diferente Fara diferente -

notabile notabile

C% Ca biofilm ↓↓↓ ↓↓ ↓

C% F biofilm ↑↑↑ ↑↑ ↑

C% P biofilm Fara diferente Fara diferente -

notabile notabile

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Adaugarea a 1% HMP a dus la
1. Protectie anticarie superioara
2. Pierderea minerala a fost ↓ cu 25% fata de 1100F
3. ++ remineralizarea dupa ce pH-ul biofilmului ajunge la
valori neutrale
4. Sustine revenirea pH-ului biofilmului la valori neutrale si
smalt mult mai rezistent (prin C% mult ↑in Ca la nivelul
smaltului)
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• Adaugarea a 1% HMP NU a dus cresterea C% in fluoruri sau
fosfati la nivelul smaltului, rezultatele fiind asemanatoare cu cele
obtinute prin folosirea dentifricelor cu 1100 ppm F

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Adaugarea 1% HMP la o dentifrice 1100 ppm F produce un
EFECT INHIBITOR mai MARE impotriva demineralizarii
smaltului in comparatie cu o dentifrice conventionala.
Alternativa sigura pentru:
• ↑ efectelor anticarie a unei dentifrice conventionale
• ↓ incidentei la carie a populatiei generale
mai ales la pacientii cu RISC MARE la carie

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Tudor Andra Mihaela – grupa 33
Visan Elena – grupa 33
Vladulescu Dumitru-Emanuel - grupa 33

12/18/2018 17
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