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Rev Clin Periodoncia Implantol Rehabil Oral 2009;2:167-170
TRABAJO DE INVESTIGACIÓN [PDF]

Barnices Preventivos en Rehabilitación Oral

Preventive Varnishes in Full mouth Restored Patients

Dreyer E1, Jorquera G1, Córdova C2

1Facultad de Odontología, Universidad de Chile. Chile.
2Facultad de Odontología, Universidad de Los Andes. Chile.

Resumen

Propósito
Evaluar el efecto de una aplicación única de barnices preventivos sobre el recuento semicuantitativo de S mutans y L acidophilus en pacientes que poseen toda su dentición restaurada ya sea con resina compuesta o cerámica.

Método
Se seleccionaron 33 pacientes bruxómanos, desdentados parciales y portadores protésicos (14 hombres y 19 mujeres, de edades entre 51 y 59 años, promedio 57,8) que necesitaban rehabilitación oral de toda su dentición. Antes de iniciar el tratamiento, toda la cohorte recibió instructivo de higiene oral con dentífrico fluorado. Fueron rehabilitados según sus necesidades de reemplazo mediante resinas compuestas (RC) o prótesis fija de porcelana fundida sobre metal (PFSM) y prótesis fija sobre Implantes. La cohorte posteriormente se dividió aleatoriamente en tres grupos iguales. Grupo A se le enseño técnica de higiene oral con cepillo interproximal. Grupo B se le aplico barniz de flúor (Duraphat®, Colgate – Palmolive, fluoruro de sodio al 5%) además del instructivo de higiene oral con cepillo interproximal. Grupo C se le aplico barniz de clorhexidina (Cervitec Plus®, Vivadent, Clorhexidina al 1%), y el mismo instructivo de higiene. Para el recuento semicuantitativo de S.mutans y L. acidophilus antes (basal) y 30 días después (experimental) de la aplicación de barnices preventivos se utilizó CRT®. Además se relacionó el recuento bacteriano con los biomateriales utilizados en las rehabilitaciones: RC y PFM. Los resultados fueron analizados mediante las pruebas de Mc Nemar y Kruscal-Wallis.

Resultados
Resultados de la comparación del recuento basal con el experimental de S.mutans: Grupo A: 90,9%, (n=10), Grupo B: 100% (n=11) y Grupo C: 63,6% (n=7), no mostraron ningún cambio en su recuento (Mc Nemar Symmetry test S.mutans p = 0,655). Para L.acidofilus: Grupo A: 90,9%, (n=10), Grupo B: 72,7% (n=8) y Grupo C: 45,4% (n=5), no mostraron ningún cambio en su recuento (p=0,058). Asociación entre el recuento microbiano y los biomateriales utilizados fue para S. mutans/PFM p=:0.864 (Kruscal-Wallis One –way test), 0.243 para S. mutans/ RC. L.acidofilus / PFM p=0.678 y 0.440 para L.acidofilus /RC.

Conclusiones
Treinta días después de una aplicación única de barnices preventivos sobre pacientes que presentan su dentición restaurada con RC o PFSM, no se reduce la microbiota cariogénica al recuento semicuantitativo de ella.

Palabras clave: Barnices preventivos, bruxismo, materiales dentales.

Abstract

Objective
The purpose of this preliminary study was to determine the influence of a single application of preventive varnishes over S. mutans and L. acidophilus flora, after oral rehabilitation and its correlation with the dental materials used.

Methods
33 patients (14 male and 19 female), ages 51-59 years (mean=57.8) bruxers, partially edentulous and removable prosthesis users were selected. They underwent full mouth restoration with composites resin reconstructions (CRR), fixed (PFM), removable and/or implanted prosthesis. After treatment all patients received oral hygiene instructions, including the use of interproximal brushes. Patients were randomly divided in 3 equal groups. Group A: Without any other preventive program; Group B: With one application of Duraphat® (Colgate-Palmolive); and Group C: With one application of Cervitec Plus ® (Ivoclar - Vivadent).Before (control) and 30 days after these applications (experimental), CRT bacteria® (Ivoclar- Vivadent) was applied. Data were statistically analyzed by the Mc Nemar Symmetry test and by the Kruscal-Wallis One -way test.

Results
Counts at Baseline/one month later of S. mutans p = 0,655 y L. acidophilus p =0,058. P values were: 0.864 for S. Mutans/PFM, 0.243 for S. Mutans/ CRR, 0.678 for Lactobacilli/ PFM and 0.440 for Lactobacilli/ CRR.

Conclusions
In full mouth restored patients, only one application of fluoride or clorhexidine varnishes did not affect the cariogenic flora after one month. There is no influence from PFM or CRR on bacterial counts.

Keywords: Preventive varnishes, bruxism, dental materials.

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CORRESPONDENCIA AUTOR
Erik Dreyer.
erikmda@yahoo.com

Trabajo recibido el 11/10/2009 /
Aprobado para su publicación el 30/11/2009.

Copyright © 2009.
Sociedad de Periodoncia de Chile, Sociedad de Implantología Oral de Chile y Sociedad de Prótesis y Rehabilitación Oral de Chile.