Castilho Aline Rogéria Freire de, Duque Cristiane, Kreling Paula Fernanda, Pereira Jesse Augusto, Paula Andreia Bolzan de, Sinhoreti Mario Alexandre Coelho, Puppin-Rontani Regina Maria
Departamento de Odontologia Infantil, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba, SP, Brasil.
Departamento de Odontologia Infantil e Social, Faculdade de Odontologia de Araçatuba, Universidade Estadual Paulista, Araçatuba, SP, Brasil.
J Appl Oral Sci. 2018;26:e20170116. doi: 10.1590/1678-7757-2017-0116. Epub 2018 May 7.
In a previous study, we demonstrated that the incorporation of doxycycline hyclate (DOX) into resin-modified glass ionomer cement (RMGIC) inhibited important cariogenic microorganisms, without modifying its biological and mechanical characteristics. In this study, we keep focused on the effect of that experimental material as a potential therapy for arresting residual caries by analyzing other in vitro properties and conducting a pilot clinical trial assessing the in vivo effect of DOX-containing RMGIC on residual mutans streptococci after partial carious removal in primary molars. Specimens of the groups RMGIC (control); RMGIC + 1.5% DOX; RMGIC + 3% DOX; and RMGIC + 4.5% DOX were made to evaluate the effect of DOX incorporation on surface microhardness and fluoride release of RMGIC and against biofilm of Streptococcus mutans. Clinical intervention consisted of partial caries removal comparing RMGIC and RMGIC + 4.5% DOX as lining materials. After 3 months, clinical and microbiologic evaluations were performed. Data were submitted to ANOVA/Tukey or Wilcoxon/Mann-Whitney set as α=0.05. Fluoride release and surface microhardness was not influenced by the incorporation of DOX (p>0.05). There was a significant reduction of S. mutans biofilm over the material surface with the increase of DOX concentration. After clinical trial, the remaining dentin was hard and dry. Additionally, mutans streptococci were completely eliminated after 3 months of treatment with RMGIC + 4.5% DOX. The incorporation of DOX provided better antibiofilm effect, without jeopardizing fluoride release and surface microhardness of RMGIC. This combination also improved the in vivo shortterm microbiological effect of RMGIC after partial caries removal.
在之前的一项研究中，我们证明将盐酸多西环素（DOX）加入树脂改性玻璃离子水门汀（RMGIC）中可抑制重要的致龋微生物，且不会改变其生物学和机械性能。在本研究中，我们继续关注该实验材料作为一种潜在治疗方法用于阻止残余龋的效果，通过分析其他体外性能并开展一项初步临床试验，评估含DOX的RMGIC在乳牙部分龋损去除后对残余变形链球菌的体内效果。制备了RMGIC（对照组）、RMGIC + 1.5% DOX、RMGIC + 3% DOX和RMGIC + 4.5% DOX组的样本，以评估加入DOX对RMGIC表面显微硬度、氟释放以及对变形链球菌生物膜的影响。临床干预包括比较RMGIC和RMGIC + 4.5% DOX作为衬层材料时的部分龋损去除情况。3个月后，进行了临床和微生物学评估。数据采用α = 0.05的方差分析/ Tukey检验或Wilcoxon / Mann - Whitney检验。DOX的加入对氟释放和表面显微硬度没有影响（p>0.05）。随着DOX浓度的增加，材料表面的变形链球菌生物膜显著减少。临床试验后，剩余牙本质坚硬且干燥。此外，用RMGIC + 4.5% DOX治疗3个月后，变形链球菌被完全清除。DOX的加入提供了更好的抗生物膜效果，而不会损害RMGIC的氟释放和表面显微硬度。这种组合还改善了RMGIC在部分龋损去除后的体内短期微生物学效果。
