Comparative Evaluation of Clinical Efficacy of Diode LASER and Cryosurgery for Gingival Pigmentation: A Split-Mouth Randomized Clinical Study

ABSTRACT Objective: To compare and evaluate the clinical efficacy of diode laser and cryosurgery for treating melanin pigmentation of gingiva. Material and Methods: A total of twenty-five subjects with physiological gingival pigmentation on the facial aspect of both maxillary and mandibular anterior arches (50 sites), both male and female, with an average age ranging from 18-35 years, participated in the study. The sites were randomly divided into Group I: depigmentation by Laser and Group II: depigmentation by Cryosurgery. The following parameters were assessed for the evaluation of treatment results: Melanin Oral Pigmentation Index (PI), Visual Analogue Scale (VAS) for pain evaluation and Healing index (HI). The data collected was statistically evaluated. Results: On intergroup comparison, there was no statistical difference in the score from baseline (p>0.05); however, a statistically significant difference was seen at the end of 1 year (p<0.05). Moreover, 57-60% of arches showed recurrence of pigmentation in the laser group whereas; only 12.7-17% recurrence was seen in the cryosurgery group at the end of the first year. Conclusion: Treatment of gingival hyperpigmentation with laser and cryosurgery shows a marked improvement of gingival pigmentation in both groups, but the cryosurgery depigmentation sites showed more sustainability.

A Randomized Triple-Blind Clinical Trial of the Effect of Low-Level Laser Therapy on Infiltration Injection Pain in the Anterior Maxilla

Abstract Objective: To evaluate the level of pain experienced during infiltration anesthesia of the anterior maxilla following low-level laser therapy (LLLT) with 810-980 nm wavelengths. Material and Methods: In the current triple-blind clinical trial, 84 patients received a total of 168 infiltration anesthesia injections (1.8 mL of 2% lidocaine plus 1:100,000 epinephrine) in the anterior maxilla. Each patient received two injections into the buccal mucosa of the right and left central incisors with a two-week interval. One injection was performed after LLLT, while the other injection was administered conventionally without laser. The pain level was measured immediately after injection using a visual analog scale (VAS). Results: There was a significant difference in the pain level experienced with and without LLLT, such that the mean pain score following LLLT was significantly lower than that without LLLT (p<0.05). No significant difference was found in the pain level between laser and no laser groups in males, but the difference in this regard was significant in females (p<0.05) and female patients experienced a significantly lower level of pain following LLLT. Conclusion: The low-level laser therapy can be successfully used to decrease the level of pain experienced during infiltration anesthesia of the anterior maxilla (AU).

Smile Arc Esthetics in Middle-Aged Man from the Layperson's Perspective Via Eye-Tracking

Abstract Objective: To evaluate the perceptions of smile esthetics associated with variations in the vertical plane of the maxillary incisors in the smile arc using eye-tracking software. Material and Methods: An image of a 59-year-old Caucasian male model was adapted and edited to make three changes in the vertical plane, simulating a convex, straight, and reverse smile arc. Four areas of interest were inserted at the right and left eyes, nose, and mouth. Forty laypeople raters between 18 and 45 years of age participated of the study. Eye-tribe hardware and Ogama software were used to perform eye-tracking. Attractiveness and age-perception questions were also incorporated into the study. ANOVA test and Pearson's correlation coefficient, at p < 0.05. Results: The most observed AOI in images with convex, straight, and reverse smiles, as assessed using heatmaps and point maps, was the mouth, followed by the right eye. A significant difference for the eye (p=0.02) was found when comparing convex and reverse smiles, whereas a significant difference for the mouth was observed between the straight and reverse smiles (p=0.03). Conclusion: Convex and straight smile arcs were associated with equal levels of attractiveness; the reverse smile was less attractive. No significant difference was noticed regarding age perception and the smile arcs. However, the reverse smile recorded a more complete fixation time.

A double-blinded randomized clinical trial of pain perception during orthodontic treatment / Ensaio clínico randomizado duplo cego de percepção da dor durante tratamento ortodôntico

Introduction: Orthodontic movement can cause painful symptoms, especially in the early stages of treatment. Objective: This study aimed to compare the performance of chewing gum and ibuprofen in pain control during the initial period of orthodontic treatment. Material and method: A randomized blind clinical trial, with an allocation ratio of 1:1, was developed with patients aged ≥18 years old. The sample size was established considering a significance level of 5% and test power of 80%, resulting in a minimum of 30 volunteers per group (n=90). Participants were paired regarding sex, age, the severity of malocclusion, defined by the Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN), and crowding, determined by Little's irregularity index. The sample was randomly allocated to three groups: Group I (control) placebo; Group II chewing gum; and Group III Ibuprofen. Pain perception was evaluated by the Visual Analog Scale (VAS) in the first 24, 36, and 48 hours after activation of the orthodontic appliance. The data were analyzed by generalized linear models for repeated measures in time. Result: No statistically significant difference (p>0.05) was observed among the groups for the methods of pain therapy evaluated in 24, 36, and 48 hours post-activation. Conclusion: There was no difference among the method used for pain control during the orthodontic treatment.

Introdução: A movimentação ortodôntica pode causar sintomatologia dolorosa, principalmente nas fases iniciais do tratamento. Objetivo: Este estudo teve como objetivo comparar o desempenho da goma de mascar e do ibuprofeno no controle da dor durante o período inicial do tratamento ortodôntico. Material e método: Foi desenvolvido um ensaio clínico randomizado cego, com razão de alocação de 1:1, com pacientes com idade ≥ 18 anos. O tamanho da amostra foi estabelecido considerando um nível de significância de 5% e poder do teste de 80%, resultando em um mínimo de 30 voluntários por grupo (n=90). Os participantes foram pareados quanto ao sexo, idade, gravidade da má oclusão, definida pelo Componente de Saúde Bucal (DHC) do Índice de Necessidade de Tratamento Ortodôntico (IOTN), e apinhamento, determinado pelo índice de irregularidade de Little. A amostra foi distribuída aleatoriamente em três grupos: Grupo I (controle) placebo; Goma de mascar Grupo II; e Grupo III Ibuprofeno. A percepção da dor foi avaliada pela Escala Visual Analógica (EVA) nas primeiras 24, 36 e 48 horas após a ativação do aparelho ortodôntico. Os dados foram analisados por modelos lineares generalizados para medidas repetidas no tempo. Resultado Não foi observada diferença estatisticamente significativa (p>0.05) entre os grupos para os métodos de terapia da dor avaliados em 24, 36 e 48 horas pós-ativação. Conclusão: Não houve diferença entre o método utilizado para controle da dor durante o tratamento ortodôntico.

Avaliação clínica do uso de antibióticos em cirurgias para instalação de implantes dentários: um ensaio clínico randomizado, triplo cego e controlado / Clinical evaluation of the use of antibiotics in surgeries to install dental implants: a randomized, triple-blind, controlled clinical trial

Objetivo: avaliar clinicamente por meio de um ensaio clínico controlado, randomizado e triplo cego, 2 regimes farmacológicos de profilaxia antibiótica, em pacientes submetidos a instalação de implantes dentários de dois estágios, quanto a dor, infecção e perda de implantes. Materiais e métodos: Um total de 61 pacientes receberam 115 implantes dentários. A coleta dos dados foi realizada por um examinador calibrado e cego nos seguintes períodos de acompanhamento pós-operatório: T1 (7 dias), T2 (14 dias), T3 (30 dias) e T4 (120 dias). A randomização foi realizada por meio da função aleatório do Microsoft Excel® (2013), que dividiu os grupos de forma aleatória e os pacientes foram alocados de acordo com a lista gerada pelo programa. Os sujeitos da pesquisa foram divididos em 3 grupos: grupo 1 (G1) formado por 21 pacientes que não utilizaram profilaxia antibiótica, o grupo 2 (G2) formado por 20 pacientes que fizeram uso da profilaxia antibiótica pré-operatória com amoxicilina 1 g por via oral 1 hora antes do procedimento e o grupo 3 (G3), com 20 pacientes que utilizaram profilaxia antibiótica pré-operatória com amoxicilina 1g via oral 1 hora antes do procedimento e manutenção do antibiótico, sendo 500 mg de amoxicilina por 05 dias a cada 08 horas. A variável dor foi analisada utilizando-se de uma escala visual analógica- EVA e do número de analgésicos ingeridos. A infecção foi considerada quando na presença de pus e fístula. Além disso, no tempo T4 foi realizado a reabertura do implante para avaliação do sucesso da osseointegração primária, considerando ausência de mobilidade e dor quando da troca do parafuso de cobertura pelos cicatrizadores. A dor (EVA e número de analgésicos) foi analisada por meio do teste Kruskall Wallis e o pós-teste (Post hoc de Dunn). A infecção foi analisada com o teste Exato de Fisher e a falha, descritivamente. O nível de significância foi estabelecido em 5%, com intervalo de confiança de 95%. Resultados: A análise da dor pós-operatória evidenciou melhores resultados nos grupos que utilizaram antibiótico (G2 e G3) no acompanhamento T1 (7 dias), com os pacientes sentindo menos dor (Teste de Kruskall Wallis- p < 0,05). A avaliação entre os grupos G2 e G3 também evidenciou diferenças (Post hoc de Dunn- p < 0,05) com superioridade para G3. Nos demais períodos não houve diferenças significativas. A infecção esteve presente nos grupos G1 (2 casos) e G3 (2 casos), porém não houve diferença estatística entre os grupos (Teste Exato de Fisher- p > 0,05) com evolução para perda (falha) de dois implantes, um no grupo G1 e outro no grupo G3. Conclusões: Os resultados preliminares de estudo evidenciaram melhores resultados quanto a dor, nos pacientes que utilizaram antibiótico profilático, mas não conseguiu demonstrar superioridade quanto a infecção e perda do implante quando comparado ao grupo sem uso de antibióticos. Dessa forma, baseado nos resultados do presente estudo, considerando um número máximo de 4 implantes por procedimento, em pacientes saudáveis, sem procedimentos adicionais, o uso de antibióticos embora tenha melhorado a dor no pós-operatório imediato, não demonstrou benefício em relação a diminuição dos índices de infecção e falha dos implantes (AU).

Objective: conduct a randomized, triple-blind, controlled test to clinically assess 2 pharmacological treatments of antibiotic prophylaxis, in patients submitted to a two-stage dental implant procedure, in terms of pain, infection and implant failure. Materials and methods: A total of 61 patients received 115 dental implants. Data collection was conducted by a blind calibrated examiner during the following postoperative follow-up periods: T1 (7 days), T2 (14 days), T3 (30 days) and T4 (120 days). Randomization was performed using the random function of Microsoft Excel® (2013), which randomly divided patients according to the list generated by the program. The study subjects were divided into 3 groups: group 1 (G1) consisting of 21 patients who did not use an antibiotic prophylaxis, group 2 (G2), with 20 patients who used preoperative antibiotic prophylaxis (1 g of amoxicillin) applied orally 1 hour before the procedure and group 3 (G3), with 20 patients who used preoperative antibiotic prophylaxis (1g of amoxicillin) applied 1 hour before the procedure, maintaining the antibiotic, consisting of 500 mg of amoxicillin, for 5 days every 8 hours. Variable pain was analyzed using a visual analog scale (VAS) and the number of analgesics taken. Infection was considered by the presence of pus and fistula. The implant was reopened at time T4 to evaluate the success of primary osseointegration, considering the absence of mobility and pain while replacing the cover screw with a healing screw. Pain (VAS and number of analgesics) was analyzed using the Kruskal-Wallis and Dunn's post hoc tests. Infection was analyzed with Fisher's Exact test and failure described. A 5% significance level was established, with a 95% confidence interval. Results: Analysis of postoperative pain showed better results in the groups that used antibiotics (G2 and G3) at follow-up T1 (7 days), with patients experiencing less pain (Kruskal Wallis, p < 0.05). Intergroup assessment also demonstrated differences (Dunn's post hoc, p < 0.05), being higher in G3, but there were no significant differences in the other periods. Infection was present in group 1 (2 cases) and G3 (2 cases), with no significant intergroup differences (Fisher's Exact test, p > 0.05), with a loss (failure) of two implants: one in G1 and the other in G3. Conclusions: The preliminary results of the study revealed better pain results in patients who used prophylactic antibiotics, but was not superior in relation to infection or implant failure when compared to the group that did not use antibiotics. Thus, based on the results of the present study, considering a maximum of 4 implants per procedure, in healthy patients with no additional procedures, although antibiotics improved pain in the immediate postoperative, they did not decrease infection indices or implant failure (AU).

Adaptação transcultural da Raghavendra, Madhuri Sujata Pictorial Scale (RMS-PS) para avaliação da ansiedade odontológica em crianças e adolescentes brasileiros / Cross-cultural adaptation of the Raghavendra, Madhuri Sujata Pictorial Scale (RMS-PS) for assessing dental anxiety in Brazilian children and adolescents

A Raghavendra, Madhuri, Sujata Pictorial Scale (RMS-PS) é uma escala que foi criada para mensurar a ansiedade odontológica em crianças e adolescentes indianos. Esta escala é composta por fotografias de crianças reais. Nela são consideradas expressões diferentes que representam sentimentos que variam de nenhuma/pouca até muita ansiedade odontológica. Para sua confecção, foram consideradas fotografias de crianças reais de ambos os sexos em diferentes expressões. Portanto, a RMS-PS original possui uma escala para o sexo feminino com cinco expressões e uma para o sexo masculino com cinco expressões. Na literatura, a mensuração da ansiedade odontológica em crianças e adolescentes pode ser realizada aplicando inúmeras escalas, sejam elas compostas por desenhos simples, desenhos mais elaborados com cores e acompanhadas ou não de uma sequência de perguntas. É importante considerar que falar sobre sentimentos não é algo comumente ensinado a crianças e adolescentes, sendo que muitos na vida adulta podem ainda apresentar dificuldades em verbalizar suas emoções. Sendo assim, lançar estratégias com o intuito de facilitar esta verbalização da ansiedade odontologica é de grande relevância. Conhecer o grau de ansiedade odontológica antes de um tratamento poderá trazer maior confiança ao clínico, uma vez que as estratégias no manejo, a elaboração do plano de tratamento, e as orientações aos responsáveis serão aplicadas de uma forma personalizada e assertiva, pois serão consideradas as particularidades apresentadas por cada criança ou adolescente. Este trabalho consiste em uma adaptação transcultural da RMS-PS para ser aplicável à população brasileira. Em seu processo de adaptação transcultural, todos os itens da escala original foram mantidos, e decidiu-se por incluir também as variações de cor da pele. No processo de adaptação transcultural, inicialmente, foi realizado a confecção das versões brasileiras da RMS-PS, com fotografias de crianças brasileiras: menina negra, menina branca, menino negro, menino branco. Versões com cinco expressões (escala cinco), e outras mais curtas, com três expressões (escala três) foram desenvolvidas. Em seguida, reuniu-se o Comitê de Especialistas que avaliaram as fotografias. As alterações propostas foram realizadas e as novas fotografias foram aplicadas no pré- teste com 25 crianças e adolescentes de Carmópolis de Minas, Brasil, estratificadas por faixa etária: 10 a 14 anos, 7 a 9 anos e 4 a 6 anos. Os participantes foram selecionados por conveniência em clínicas odontológicas particulares. O pré-teste foi realizado de forma virtual ou presencial, utilizando-se as versões da escala de cinco faces e da escala de três faces. Os participantes foram questionados quanto a escala de preferência, e qual expressão representaria sua ansiedade durante a consulta odontológica. O Comitê de Especialistas foi novamente reunido após o pré-teste. Resultados: A expressão neutra foi a mais frequente (44,0%) para escala três, e a expressão feliz (36,0%), para escala cinco. A maioria dos adolescentes preferiu a escala cinco (66,6%), e 75% das crianças preferiu a escala três. Como conclusão, o presente estudo disponibiliza a versão brasileira da escala RMS-PS, contando com quatro variações considerando o sexo e a cor de pele. A preferência por uma escala de três ou cinco expressões variou conforme a idade.

The Raghavendra, Madhuri, Sujata Pictorial Scale (RMS-PS) is a scale that was created to measure dental anxiety in Indian children and adolescents. This scale is composed of photographs of real children. It considers different expressions that represent feelings ranging from no/low to high dental anxiety. For its confection, photographs of real children of both sexes in different expressions were considered. Therefore, the original RMS-PS has a scale for females with five expressions and one for males with five expressions. In the literature, the measurement of dental anxiety in children and adolescents can be performed by applying numerous scales, whether they consist of simple drawings, more elaborate drawings with colors, and whether they are accompanied or not by a sequence of questions. It is important to consider that talking about feelings is not something commonly taught to children and adolescents, and many in adulthood may still have difficulties verbalizing their emotions. Thus, launching strategies to facilitate this verbalization of dental anxiety is of great importance. Knowing the degree of dental anxiety before a treatment may bring more confidence to the clinician, since the strategies in the management, development of treatment plan, and guidelines to those responsible will be applied in a personalized and assertive way, because the particularities presented by each child or adolescent will be considered. This consists of a cross-cultural adaptation of the RMS-PS to be applicable to the Brazilian population. In its cross-cultural adaptation process, all items of the original scale were kept, and it was decided to include also the skin color variations. In the cross-cultural adaptation process, we initially made the Brazilian versions of the RMS-PS, with photographs of Brazilian children: black girl, white girl, black boy, white boy. Versions with five expressions (scale five), and shorter ones, with three expressions (scale three) were developed. Next, the Committee of Experts met to evaluate the photographs. The proposed changes were made and the new photographs were applied in the pre-test with 25 children and adolescents from Carmópolis de Minas, Brazil, stratified by age group: 10 to 14 years, 7 to 9 years, and 4 to 6 years. The participants were selected by convenience in private dental clinics. The pre-test was performed virtually or face-to-face, using the five-sided scale and the three-sided scale versions. Participants were asked which scale they preferred, and which expression represented their anxiety during a dental appointment. The Expert Committee was reconvened after the pre-test. Results: The neutral expression was the most frequent (44.0%) for scale three, and the happy expression (36.0%), for scale five. Most adolescents preferred scale five (66.6%), and 75% of children preferred scale three. As a conclusion, the present study provides the Brazilian version of the RMS-PS scale, counting on four variations considering sex and skin color. The preference for a scale of three or five expressions varied according to age

Efficacy of Oil Pulling in the Management of Oral Submucous Fibrosis: A Preliminary Study

ABSTRACT Objective: To evaluate the effectiveness of oil pulling in the management of oral submucous fibrosis (OSMF). Material and Methods: A total of 62 patients clinically and histopathologically diagnosed as OSMF were incorporated in the present study. The subjects are randomly divided equally into two groups, Group A (oil pulling group) and Group B (placebo group). Subjects in Group A were asked to perform OP with sesame oil on an empty stomach in the morning for 3 months and Group B was given placebo capsules for 3 months. Assessment of various clinical parameters was done regularly, and data were analyzed using the Chi-square test. Results: Eighty-two percent had a habit of betel nut chewing, while 18% of the patients had tobacco chewing habits, which were among the main causative factors for OSMF. Clinical improvements in mouth opening, tongue protrusion, difficulty in speech and deglutition, and burning sensation were significant in the Group A. None of the patients reported any discomfort or side effects. The symptoms were not severe in nature and resolved in few days without stopping the therapy. Conclusion: Oil pulling can bring about significant clinical improvements in the symptoms like a mouth opening and tongue protrusion.

Difference in Orthodontic Patients' Perceptions of Essix and Hawley Retainers

Abstract Objective: To determine differences in how orthodontic patients perceive the aesthetics relating to the use of Essix and Hawley retainers. Material and Methods: Photographs of a female patient using an Essix retainer and a Hawley retainer, respectively, were assessed by 70 orthodontic patients aged between 21 and 55 years. All participants were provided with the same images of the two retainer types being worn and were asked to grade the aesthetics of each retainer using a visual analog scale. The significance of differences in orthodontic patient perceptions of aesthetics in the use of Essix and Hawley Retainers in the young adult and adult age groups were tested using the Mann-Whitney test with assumed significance p<0.01. Results: There were differences in participants' perceptions between the two retainers that were statistically significant, with responses varying between young adults aged 21 to 35 years and adults aged 36 to 55 years. According to the VAS, the two retainers' average scores in the total population are 82 for Essix Retainer and 60 for Hawley Retainer in both groups. Conclusion: The Essix retainer as a retention appliance is considered more aesthetically pleasing than the Hawley retainer among both young and middle-aged adults.

Efficacy of Higher Gauged Needles or Topical Pre-Cooling for Pain Reduction during Local Anesthesia Injection: A Split-Mouth Randomized Trial

ABSTRACT Objective: To evaluate the efficacy of pre-cooling and the use of higher gauged needles in reducing pain during local anesthetic infiltration. Material and Methods: We conducted a split-mouth randomized controlled trial among 70 patients who require bilateral maxillary local anesthetic (LA) injections for dental treatment. After applying the topical anesthetic, each participant received four local anesthetic injections, two on buccal and two palatal sides. At each visit, the participants received one buccal and one palatal infiltration based on the randomization. On the buccal aspect, participants received LA with a 26G needle injection on one side (control) and a 31G needle (test) on the contralateral side. On the Palatal aspect, participants either received LA with a 31G needle on one side (control). In contrast, the opposite side was preceded by topical ice application (iced cotton swab) before LA with a 31G needle (test). Both the visits were spaced with a gap of 7-10 days based on the participants' feasibility. Participants were asked to rate the pain on a visual analog scale independently for buccal and palatal LA injections. Results: On the Buccal aspect, the mean pain scores were 2.74 ± 1.26 and 2.11 ± 1.26 for control and test groups, respectively (p=0.002). On the Palatal aspect, the mean pain scores were 4.14 ± 1.49 and 4.3 ± 1.80 for control and test groups, respectively (p=0.295). Conclusion: Significant lower pain scores were reported with higher gauge needles (31G) when compared to traditional (26G) needles on the buccal aspect. No significant difference was seen with pre-cooling the injection site on the palatal aspect when used with higher gauged needles (31G).

Efficacy of Higher Gauged Needles or Topical Pre-Cooling for Pain Reduction during Local Anesthesia Injection: A Split-Mouth Randomized Trial

ABSTRACT Objective: To evaluate the efficacy of pre-cooling and the use of higher gauged needles in reducing pain during local anesthetic infiltration. Material and Methods: We conducted a split-mouth randomized controlled trial among 70 patients who require bilateral maxillary local anesthetic (LA) injections for dental treatment. After applying the topical anesthetic, each participant received four local anesthetic injections, two on buccal and two palatal sides. At each visit, the participants received one buccal and one palatal infiltration based on the randomization. On the buccal aspect, participants received LA with a 26G needle injection on one side (control) and a 31G needle (test) on the contralateral side. On the Palatal aspect, participants either received LA with a 31G needle on one side (control). In contrast, the opposite side was preceded by topical ice application (iced cotton swab) before LA with a 31G needle (test). Both the visits were spaced with a gap of 7-10 days based on the participants' feasibility. Participants were asked to rate the pain on a visual analog scale independently for buccal and palatal LA injections. Results: On the Buccal aspect, the mean pain scores were 2.74 ± 1.26 and 2.11 ± 1.26 for control and test groups, respectively (p=0.002). On the Palatal aspect, the mean pain scores were 4.14 ± 1.49 and 4.3 ± 1.80 for control and test groups, respectively (p=0.295). Conclusion: Significant lower pain scores were reported with higher gauge needles (31G) when compared to traditional (26G) needles on the buccal aspect. No significant difference was seen with pre-cooling the injection site on the palatal aspect when used with higher gauged needles (31G) (AU).

Ferric Sulfate Versus Calcium-Enriched Mixture Cement in Pulpotomy of Primary Molars: A Randomized Clinical Trial

ABSTRACT Objective: To evaluate the postoperative pain and clinical and radiographic success of pulpotomized primary molars using two materials, Ferric Sulfate (FS) and Calcium-Enriched Mixture (CEM) cement, over a period of 3 and 6 months. Material and Methods: This randomized clinical trial was conducted on a total of 38 teeth selected from 19 patients aged 3-9 years. FS 15.5% and CEM cement were used as pulpotomy agents. Permanent restorations were Stainless Steel Crowns (SSCs) in both groups. Patients were recalled for follow-up at 3 and 6 months intervals for clinical and radiographic assessment. Postoperative pain was recorded by using Visual Analogue Scale up to ten days following the treatment. The data were statistically analyzed using chi-square test and repeated measures ANOVA. Results: At 6 months, a 100% clinical success rate was observed in the FS and CEM cement groups. The radiographic success rate in the FS group was 94.7%, whereas 100% in the CEM cement group at 6 months. No statistically significant difference was found between the two groups (p>0.05). There was no significant difference in postoperative pain between the teeth that received either FS or CEM cement as pulpotomy agents following the procedure (p>0.05). Conclusion: There were favorable outcomes of FS and CEM cement in pulpotomy of primary molar teeth.

An eye-tracking and visual analogue scale attractiveness evaluation of black space between the maxillary central incisors

ABSTRACT Objective: To study the influence of black space between the maxillary central incisors on the aesthetic visual perception of the face, via eye-tracking and visual analogue scale (VAS). Methods: Black space between the central incisors was created, for both sexes, as follows: control, 1-mm black space, 2-mm black space and 3-mm black space. Ninety raters participated in this study, divided into three groups: 30 laypeople, 30 nonorthodontists, and 30 orthodontists. After the visual calibration of each observer, eight photographs were presented in the Ogama® software concomitant with the use of the hardware The Eye Tribe®. Ogama generated information depending on the eye-tracking of each rater, regarding the time until the first fixation, time of fixation, heatmap, scanpath, and total time of fixation, to evaluate the areas deemed to be of interest according to the raters. Later on, the VAS was used, where each rater evaluated the images in an album on a scale of zero to 10 points. Results: The eyes and mouth were the areas more often noticed by the raters according to the heatmaps, while no significant difference was observed in time until the first fixation between the three groups of raters (p> 0.05). However, regarding the time of fixation on the mouth, a significant difference was observed (p< 0.05) when comparing the three groups. Conclusion: Black space has a negative effect on the aesthetic perception of the face. The amount of attention on the mouth is correspondent to the size of the black space.

RESUMO Objetivo: Avaliar a percepção visual e estética do espaço negro entre os incisivos centrais superiores, via rastreamento do olhar e escala visual analógica (EVA). Métodos: Manipulou-se o espaço negro entre os incisivos centrais superiores, para ambos os sexos, da seguinte forma: imagem controle, espaço negro de 1 mm, espaço negro de 2 mm e espaço negro de 3 mm. Participaram desse estudo noventa avaliadores, divididos em três grupos: 30 leigos, 30 cirurgiões-dentistas e 30 ortodontistas. Após a calibração visual de cada observador, foram projetadas oito fotografias no software OGAMA® em conjunto com o hardware The Eye Tribe®. O OGAMA gerou informações do rastreamento do olhar de cada avaliador com relação ao tempo até a primeira fixação, mapa de calor, trajetória do olhar e tempo total de fixação para avaliar as áreas consideradas de interesse, de acordo com os avaliadores. Posteriormente, utilizou-se a EVA para avaliar as imagens a partir de um álbum, em uma escala de 0 a 10 pontos. Resultados: Os olhos e a boca foram as áreas com maior fixação pelos avaliadores, de acordo com os mapas de calor. Os resultados estatísticos não apresentaram diferença estatisticamente significativa entre os três grupos de avaliadores (p> 0,05), quanto ao tempo até a primeira fixação. Porém, em relação ao tempo de fixação na boca, observou-se diferença estatisticamente significativa (p< 0,05) na comparação dos três grupos. Conclusão: O espaço negro apresentou um efeito negativo na percepção estética da face. O aumento de fixação na boca correspondeu ao aumento do tamanho do espaço negro.

Evaluation of Masticatory Performance and Patient Satisfaction Before and After Posterior Implant Restoration

ABSTRACT Objective: To evaluate the improvement in masticatory performances two weeks after posterior implant restoration. Material and Methods: Nine patients with missing first and second molars were included in the study. Masticatory performances were evaluated using subjective and objective methods utilizing color-changeable chewing gum and the visual analog scale (VAS) assessment. The subjects were asked to chew the color-changeable chewing gums before and two weeks after the posterior implant restoration. Their expectations regarding aesthetics and function were verified on the VAS before implant placement. Additionally, the VAS was used for the posttreatment completion rating two weeks after the implant restoration. Results: Significant differences in masticatory performance were noted at baseline (before implant posterior restoration) and two weeks after implant restoration (p<0.05). The posttreatment aesthetic and functional expectations ratings significantly exceeded the expectations (p<0.05). Conclusion: Masticatory performances were improved two weeks after implant restoration. In addition, the significant posttreatment ratings of the patients exceeded their initial expectations. In particular, patients with poor masticatory functions demonstrated significant improvements and satisfaction following implant restoration compared to those with good mastication. These findings indicate that a posterior implant restoration can increase the masticatory performance.

Avaliação do tempo clínico, laboratorial, e do conforto de placas oclusais convencionais e digitais: um ensaio clínico piloto / Evaluation of clinical, laboratory time and comfort of conventional and digital occlusal splints: a pilot clinical trial

As placas oclusais são indicadas para o manejo da disfunção temporomandibular (DTM) e bruxismo do sono. Ainda existe pouca evidência cientifica que compare as placas confeccionadas por CAD/CAM e as convencionais em relação ao tempo de ajuste para instalação das placas, e tempo de confecção clínico e laboratorial, assim como em relação ao conforto. O presente estudo objetivou comparar o tempo clínico e laboratorial de confecção de placas convencionais (PC) com resinas termopolimerizáveis e as confeccionadas por CAD/CAM fresada (PF) em pacientes com bruxismo do sono. Além disso, comparou-se o tempo de instalação e conforto dos pacientes usuários das placas. Para isso foi realizado um ensaio clínico com 20 pacientes (7 PC; 13 PF) que apresentaram um diagnóstico provável de bruxismo através da aplicação de questionários e avaliação clínica. Foram cronometrados os tempos para as respectivas etapas clínicas e laboratoriais. O conforto foi avaliado através de uma escala visual numérica durante as etapas de confecção clínica e após 30 dias de uso. Foi realizada uma análise descritiva e inferencial dos resultados. Os resultados preliminares mostraram uma média de tempo de confecção clínica e instalação de 58% e 33% menor para PF em comparação com as PC, respectivamente. O tempo laboratorial 7% menor para PF. Foi relatado que a PF foram 24% e 17% mais confortáveis que a PC durante as etapas de confecção clínica e após 30 dias de uso, respectivamente. A partir dos resultados foi possível observar uma grande diminuição do tempo de confecção clínica ao empregar o fluxo digital que é utilizado para a confecção das PF e uma considerável diminuição do tempo de instalação clínica. O tempo laboratorial se mostrou similar, porém o método convencional demandou mão de obra direta na maior parte das etapas. Além disso, as placas "digitais" proporcionaram maior conforto na confecção e utilização das mesmas (AU).

The Occlusal Splints (OS) are indicated for the management of temporomandibular disorders (TMD) and sleep bruxism. There is still little scientific evidence comparing the OS made by CAD / CAM and the conventional ones in relation to the adjustment time for installing the splints, and the clinical and laboratory confection time, as well as regarding comfort. The present study aimed to compare the clinical and laboratory time of confection of conventional splints (CS) with thermopolymerizable resins and those milled (MS) by CAD / CAM systems in patients with sleep bruxism. In addition, the installation time and comfort of patients using the plates were compared. A clinical trial was carried out with 20 patients (7 CS; 13 MS) who had a probable diagnosis of bruxism through the application of questionnaires and clinical evaluation. The clinical and laboratory confection times for the respective stages were timed. Comfort was assessed using a visual analog scale after the stages of clinical confection and after 30 days of splint use. A descriptive and inferential analysis of the results was performed. Preliminary results showed an average time of clinical preparation and installation of 58% and 33% less for MS compared to CS, respectively. Laboratory time 7% shorter for MS. It was reported that MS were 24% and 17% more comfortable than CS during the stages of clinical confection and after 30 days of use, respectively. From the results it was possible to observe a great decrease in the time of clinical preparation when employing the digital flow that is used for the preparation of MS and a considerable decrease in the time of clinical installation. The laboratory time proved to be similar, but the conventional method required direct labor in most stages. In addition, the "digital" plates provided greater comfort in clinical confection and usage (AU).

Influence of photobiomodulation on pain perception during initial orthodontic tooth movement / Influência do fotobiomodulação na percepção da dor durante o movimento ortodôntico inicial

Introduction: Laser in low intensity (LLI) has been used to reduce the discomfort and pain that is triggered by the forces applied during orthodontic treatment. Objective: To evaluate the effect of LLI application in the pain perception of periodontal ligament initial compression, during orthodontic tooth movement; and to compare the effect of this therapy between men and women. Material and method: The sample consisted of 30 volunteers, who needed orthodontic band placement on mandibular first molars. After insertion of the elastic separators, LLI was applied to the mesial and distal apical region (wavelength 808nm, energy 2J, time 20s and fluency of 8.32J/cm2) and at three points on the root region (wavelength 808nm, energy 1J, time 10s and fluency of 4.16J/cm2) of the first molar (irradiated side) and compared to the contralateral first molar (non-irradiated side), in three time intervals: 0hs, 24hs and 48hs. Pain perception was evaluated by the Visual Analog Scale (VAS), at 0hs, 24hs and 48hs after insertion, with significance of 5%. Result: The pain level was observed to be significantly lower (p<0.05) on the irradiated side, irrespective of gender and time. Women presented a significantly higher pain level (p<0.05) than men, irrespective of time and side. There were no significant differences between the time intervals (p>0.05). Conclusion: It was concluded that LLI reduced the perception of initial pain in patients in whom compression of the periodontal ligament was promoted by elastic separation, and that women had a greater perception of pain sensitivity in the time intervals studied.

Introdução: O tratamento com Laser em Baixa Intensidade (LBI) tem sido utilizado para reduzir o desconforto e a dor desencadeados pelas forças aplicadas durante o tratamento ortodôntico. Objetivo: Avaliar o feito da aplicação de LBI na percepção da dor na compressão inicial do ligamento periodontal durante o movimento dentário ortodôntico; e comparar o efeito desta terapia entre os sexos. Material e método: A amostra foi composta por 30 voluntários, que necessitavam de bandagem dos primeiros molares inferiores. Após a instalação dos elásticos separadores, aplicou-se o LBI infravermelho na região apical mesial e distal (comprimento de onda 808nm, energia 2J, tempo 20s e fluência de 8,32J/cm2) e em três ponto na região radicular (comprimento de onda 808nm, energia 1J, tempo 10s e fluência de 4,16J/cm2) no lado irradiado e comparou-se com o primeiro molar contralateral não irradiado (lado controle), em três tempos: 0hs, 24hs e 48hs. A percepção de dor foi avaliada pela interpretação da Escala Visual Analógica (EVA) em 0hs, 24hs e 48hs após a instalação, com nílvel de significância de 5%. Resultado: Observou-se que o nível de dor foi significativamente menor (p<0,05) no lado irradiado, independentemente do sexo e do tempo. O sexo feminino apresentou nível de dor significativamente maior (p<0,05) que o sexo masculino, independentemente do tempo e do lado. Não houve diferença significativa entre os tempos (p>0,05). Conclusão: Concluiu-se que o LBI diminui a percepção de dor inicial em pacientes onde se promoveu a compressão do ligamento periodontal por meio de separação elástica, e que o sexo feminino apresentou maior percepção da sensibilidade dolorosa nos tempos observados.

Influência do intermediário protético sobre a estética e a satisfação de pacientes reabilitados com próteses unitárias provisórias sobre implantes: um ensaio clínico / Influence of the prosthetic intermediary on the aesthetics and satisfaction of patients rehabilitated with temporary single prostheses on implants: a clinical trial

Objetivos: Avaliar a influência do tipo de intermediário protético e do condicionamento tecidual sobre a estética de coroas unitárias provisórias sobre implantes instalados na região do sorriso. Material e Métodos: Trinta implantes foram alocados sequencialmente: 15 foram reabilitados provisoriamente sobre um intermediário protético pré-fabricado em titânio (GT) e 15 sobre um intermediário protético preparável provisório (GP). Em ambos os grupos foi realizado condicionamento tecidual (CT) pela técnica não-cirúrgica de pressão gradual e a estética periimplantar foi avaliada antes e após esse processo, por meio do Pink Esthetic Score (PES). O PES também foi aplicado no dente homólogo à reabilitação. A satisfação estética foi analisada pela escala visual analógica (EVA) após o procedimento de CT. Dados clínicos da mucosa gengival também foram coletados. Resultados: 22 pacientes, totalizando 24 implantes, concluíram o estudo, sendo 14 implantes do GT e 10 do GP. A estética periimplantar antes e após o CT, bem como a satisfação dos pacientes foi semelhante entre os grupos, p>0,05. Diferenças significativas foram encontradas para os valores de PES antes e após o CT, e para a comparação com o dente homólogo em ambos os grupos, p<0,05. O processo de condicionamento tecidual não foi influenciado pelo tempo de implantação, tempo de carga e fenótipo periimplantar, p>0,05. Conclusão: O intermediário protético não influenciou nem no processo de condicionamento tecidual e nem na satisfação dos pacientes. A etapa de condicionamento tecidual foi capaz de melhorar os resultados estéticos periimplantares, entretanto, a estética gengival dos dentes naturais homólogos apresenta resultados significativamente superior (AU).

Objective: To evaluate the influence of prosthetic abutment and tissue conditioning on the esthetics of single implants' temporary crowns. Materials and Methods: Thirty implants were allocated sequentially: fifteen implants were provisionally rehabilitated with a titanium prefabricated prosthetic abutment (GT) and 15 with a provisional preparable prosthetic abutment (GP). In both groups, tissue conditioning (TC) was performed by the non-surgical gradual pressure technique and peri-implant aesthetics were assessed before and after this process, using the Pink Esthetic Score (PES). PES was also applied on homologous tooth. Aesthetic satisfaction was assessed using the visual analog scale (EVA) after the conditioning process. Clinical data on the gingival mucosa were also collected. Results: 22 patients (24 implants) completed this study, 14 implants from GT and 10 from GP. Peri-implant aesthetics before and after TC, as well as patient satisfaction was similar between groups, p> 0.05. Significant differences were found for PES values before and after TC, and for comparison with the homologous tooth in both groups, p <0.05. The TC process seems not be influenced by the implantation time, loading time and peri-implant biotype, p> 0.05. Conclusion: The prosthetic abutment seems not influence neither the TC process nor patient satisfaction. The TC step is able to improve the peri-implant aesthetic results, however, the gingival aesthetics of the natural teeth is still significantly greater (AU).

Desempenho clínico de coroas monolíticas posteriores de cerâmica infiltrada por polímero: ensaio clínico controlado e randomizado duplo cego / Clinical performance of posterior monolithic polymer-infiltrated ceramic crowns: double-blind randomized controlled clinical trial

Objetivo: avaliar por meio de um ensaio clínico controlado, randomizado e duplo-cego, o desempenho clínico de coroas monolíticas unitárias posteriores confeccionadas em cerâmica infiltrada por polímero, bem como o impacto da reabilitação na satisfação estética e qualidade de vida dos pacientes. Materiais e Métodos: Um total de 20 pacientes que receberam 36 coroas foram incluídos neste estudo. Todos os pacientes assinaram o termo de consentimento livre e esclarecido (TCLE). Os dentes sob reabilitação foram alocados por meio de um sorteio simples entre os grupos: Grupo Controle: (LD- dissilicato de lítio) e grupo Experimental (PIC -Vita Enamic/Vita Zahnfabrik). Registros fotográficos, radiográficos e informações clínicas foram coletados antes, durante e após a reabilitação. As coroas foram avaliadas quanto à taxa de sobrevida clínica (Critérios de USPSH modificados), satisfação estética (escala visual analógica- EVA), qualidade de vida (Oral Impacts on Daily Performances -OIDP), e tipo de falhas (biológicas e técnicas). A coleta de dados foi realizada por um único examinador calibrado e cego para o tipo de material, nos tempos de seguimento T0 (antes do início do tratamento), T1 (1 mês), T2 (6 meses) e T3 (12 meses). O OIDP e os critérios de USPHS foram analisados descritivamente. A satisfação estética foi analisada com MannWhitney/Teste de Friedman/ pós-testes de Wilcoxon. A análise de sobrevivência foi feita usando Kaplan-Meier seguido do teste de log-rank. O nível de significância foi estabelecido em (5%). Resultados: 36 coroas foram colocadas em 20 pacientes com uma média de idade de 47.17 anos (±13,91), sendo 22 (56,4%) coroas do grupo controle (LD) e 14 (35,9%) para o grupo experimental (PIC). A análise de Kaplan-Meier revelou uma taxa de sobrevida de 83,5% para PIC e de 86,2% para LD sem diferenças significativas entre eles (P>0.05). Quatro falhas foram registradas, 2 em cada grupo, sendo dois descolamentos, uma de PIC após 1 mês e uma de LD após 6meses. Houve também uma fratura do dente (LD) e mobilidade grau III (PIC) após 12 meses de acompanhamento. Não houve diferença significativa na satisfação estética, entre o grupo controle e grupo experimental (Mann-Whitney - P>0.05). A satisfação estética foi significativamente maior após 1(T1), 6(T2) e 12(T3) meses quando comparado ao baseline (T0) (Teste de Friedman - P<0.05). A reabilitação com coroas unitárias impactou positivamente na qualidade de vida dos pacientes. Conclusão: Este estudo demonstra que coroas monolíticas unitárias de PIC apresentaram desempenho clínico, estético e um impacto positivo na qualidade de vida dos pacientes após 12 meses, similar ao LD (AU).

Objective: To evaluate, through a controlled, randomized and double-blind clinical trial, the clinical performance of posterior single monolithic crowns made ceramic infiltrated polymer, as well as the impact of rehabilitation on patients' aesthetic satisfaction and quality of life. Materials and Methods: A total of 20 patients who received 36 crowns were included in this study. All patients signed an informed consent form. The teeth under rehabilitation were allocated using a simple draw between the groups: Control Group: (LD- lithium disilicate) and Experimental group (PIC -Vita Enamic). Photographic, radiographic, and clinical information records were collected before, during, and after rehabilitation. The crowns were assessed for clinical survival rate (modified USPSH criteria), aesthetic satisfaction (visual analog scale - VAS), quality of life (Oral Impacts on Daily Performances - OIDP), and type of failures (biological and technical). Data collection was performed by a single examiner calibrated and blinded to the type of material, at the follow-up times T0 (before the start of treatment), T1 (1 month), T2 (6 months), and T3 (12 months). The OIDP and USPHS criteria were analyzed descriptively. Aesthetic satisfaction was analyzed with the Man-Whitney/Friedman test/Wilcoxon post-tests. Survival analysis was performed using Kaplan-Meier followed by the log-rank test. The level of significance was set at (5%). Results: 36 crowns were placed on 20 patients (17 women and 3 men) with a mean age of 47.17 years (± 13.91), with 22 (56.4%) crowns from the control group (LD) and 14 (35.9%) for the group experimental (PIC). The Kaplan-Meier analysis revealed a survival rate of 83.5% for PIC and 86.2% for LD with no significant differences between them (P>0.05). Four failures were recorded, 2 in each group, two detachments after 1(PIC) and 6 months (LD), a tooth fracture (LD), and grade III mobility after (PIC) 12 months of follow-up. There was no significant difference in aesthetic satisfaction between the control group and the experimental group (Mann-Whitney, P>0.05). Aesthetic satisfaction was significantly higher after 1 (T1), 6 (T2), and 12 (T3) months when compared to baseline (T0) (Friedman test - P <0.05). Rehabilitation with single crowns had a positive impact on patients' quality of life. Conclusion: This study demonstrates that single monolithic crowns of PIC presented a good clinical, aesthetic performance and a positive impact on patients' quality of life after 12 months, similarly to PIC (AU).

Avaliação de dois diferentes agentes dessensibilizantes no tratamento da hipersensibilidade dentinária: relato de caso / Evaluation of two different desensitizing agents in the treatment of dentin hypersensitivity: case report

Objetivos: O seguinte trabalho relatou por meio de um caso clínico a eficácia do dessensibilizante Nano-P® e do Flúor acidulado em um paciente com hipersensibilidade dentinária. Métodos: a boca da paciente foi dividida para a aplicação de cada tratamento. Nos quadrantes 1 e 3 foi utilizado o dessensibilizante Nano P® e nos quadrantes 2 e 4 foi utilizado o flúor acidulado, com aplicações semanais por 4 semanas. A hipersensibilidade dentinária foi avaliada através da Escala Visual Analógica (EVA) e por meio de estímulos osmótico e tátil. Resultados: Para ambos os tratamentos realizados, foi constatado a diminuição no grau de hipersensibilidade relatado pela paciente ao longo das consultas, com tempos de ação diferentes para cada agente dessensibilizante, devido à suas características e mecanismos de ação diferenciados, bem como diferenças em relação ao conforto relatado nas duas técnicas pela paciente participante do estudo. Conclusões: Os agentes dessensibilizantes avaliados neste estudo foram eficazes na redução da sensibilidade dentinária após 5 consultas de avaliação(AU)

Aim: The following work reported in a clinical case the efficacy of Nano-P® desensitizer and acidulated fluoride in a patient with dentin hypersensitivity. Methods: the patient's mouth was divided for the application of each treatment. In the quadrants 1 and 3 the Nano P® desensitizer was used and in the 2 and 4 quarters the acidulated fluoride was used, with weekly applications for 4 weeks. Density hypersensitivity was evaluated by the Visual Analogue Scale (VAS) through osmotic and tactile stimulation. Results: For both treatments, it was observed a decrease in the degree of Hypersensitivity reported by the patient during the consultations, with different action times for each desensitizing agent, due to its differentiated characteristics and mechanisms of action, as well as differences in relation to the comfort reported in the two techniques by the patient participating in the study. Conclusions: The desensitizing agents evaluated in this study were effective in reducing dentin sensitivity after 5 evaluation visits(AU)

Effect of Pharyngeal Pack on Postoperative Nausea and Throat Pain in Patients Undergoing Rhinoplasty

Objective: To evaluate the effect of pharyngeal pack on postoperative throat pain and nausea in rhinoplasty patients. Material and Methods: Twenty-eight patients were randomly selected and divided into two groups (n=14). The participants were randomly divided into two groups: G1 - the pharyngeal pack was used (Intervention group) and G2: not used (Control group). Both groups were anesthetized by the same protocol. Throat pain was measured by visual analog scale and nausea by presence / absence. Fischer's exact test, ANOVA, Friedman and Wilcoxon test were used. Results: There was no significant difference in mean pain and presence or absence of nausea between the two groups (p>0.05). But there was a significant difference in mean pain and the presence or absence of postoperative nausea with the intervals (p<0.05). Mean pain had a significant difference 2 hours postoperatively with other times, 6 hours postoperatively with 24 and 72 hours postoperatively, and 24 hours postoperatively with 72 hours (p<0.05). There was no significant difference in the presence or absence of postoperative nausea, between 2 hours and 6 hours postoperatively (p>0.05). The presence or absence of postoperative nausea had a significant difference between 2 hours postoperatively with 24 and 72 hours postoperatively and 6 hours postoperatively with 24 and 72 hours postoperatively (p<0.05). There was no significant difference in nausea between 24 hours and 72 hours postoperatively (p>0.05). Conclusion: None of the two groups were significantly superior in terms of reduction of pain and nausea, but because of the possible effectiveness of the pharyngeal pack in preventing aspiration of objects and tissues during the operation, the use of pharyngeal pack is recommended in patients.

Evolução da autoconfiança e segurança de estudantes após aprendizagem utilizando manequins em Periodontia / Evolution of students' self-confidence and trust after learning in periodontics manikins

A simulação no ensino em saúde é uma ferramenta que permite ao estudante uma aprendizagem em ambiente protegido e controlado, livre de intercorrências e com devolutiva instantânea da tarefa desempenhada. Na simulação, o docente pode intervir a qualquer momento, o que o auxilia na avaliação e instrução do estudante. O objetivo deste estudo foi avaliar a evolução da autoconfiança e segurança de estudantes após aprendizagem simulada utilizando manequim em um componente curricular de Periodontia e sua correlação com desempenho prático. Questionários utilizando escala visual analógica (EVA), escala numérica de 101 pontos (NRS-101) e escala verbal de 4 pontos (VRS4) foram aplicados aos estudantes da Disciplina de Periodontia I da Universidade Federal do Paraná no primeiro semestre de 2018, em três momentos: 1) antes do início das atividades práticas; 2) após a fase laboratorial; e 3) após a fase clínica. Os dados obtidos foram comparados entre si pelo tempo de aplicação e correlacionados com a nota prática final. Os estudantes demonstraram maior autoconfiança e segurança no final do que no início do período (Friedman; p<0,05). Essa evolução foi notada principalmente entre a primeira e segunda aplicações dos questionários, ou seja, após a fase laboratorial simulada em manequim. Houve correlação entre autoconfiança e segurança aferidas pela NRS-101 e o desempenho prático (Spearman; r=0,3948 e r=0,3771, respectivamente; p<0,05). Observou-se aumento de autoconfiança e segurança dos estudantes após aprendizagem simulada em manequim, que se mostrou ligeiramente mais valiosa para evolução desses quesitos em comparação à experiência clínica (AU).

Simulation in health education is a tool that allows the student to learn in a protected and controlled environment, free from intercurrences and with instant feedback of the task performed. Simulation assists the instructor to evaluate the procedure performed and allows them to intervene at any moment, warning or instructing the student. This study aimed to evaluate the evolution of students' self-confidence and trust after simulated learning in a manikin during a curricular component of Periodontics and its correlation with practical performance. Questionnaires using visual analog scale (VAS), 101-point numeric rating scale (NRS-101) and 4- point verbal rating scale (VRS-4) were applied to students enrolled in Periodontics I course at the Federal University of Paraná, Curitiba, Brazil, in the first term of 2018, in three different moments: 1) before the beginning of the practical activities; 2) after the laboratory phase; and 3) after the clinical phase. The data from the questionnaires were correlated with the final practical performance. Students reported being more selfconfident and secure at the end than the beginning of the term (Friedman; p<0.05). This evolution was noted mainly between the first and second questionnaire applications, after the laboratory phase with simulation. There was a correlation between self-confidence and trust measured in NRS-101 and the practical performance (Spearman; r=0.3948 and r=0.3771, respectively; p<0.05). Students' self-confidence and trust increased after simulated learning, which was slightly more valuable for the evolution of these aspects in comparison to the clinical experience (AU).