Triple-blinded randomized clinical trial comparing efficacy and tooth sensitivity of in-office and at-home bleaching techniques.

OBJECTIVE: Our study aims to compare the efficacy and tooth sensitivity following in-office (35% hydrogen peroxide) or at-home (10% carbamide peroxide) bleaching treatments both preceded by 2% potassium nitrate (2%KF) desensitizing gel. METHODOLOGY: 130 volunteers were randomly allocated to a) in-office bleaching and a placebo at-home protocol; or b) in-office placebo and at-home bleaching treatment. 2% KF was applied for 10 min before both treatments. OBJECTIVE: color evaluation was performed (spectrophotometer CIEL*a*b* system and CIEDE2000) to calculate the color change (ΔE00). Subjective evaluation was performed using the VITA classical shade guide followed by shade variation (ΔSGU) at the beginning and end of bleaching treatment and 2 weeks post-bleaching. Tooth sensitivity was daily recorded using a Likert scale varying from 1 (no sensitivity) to 5 (severe sensitivity). Analysis was carried out using non-parametric tests. RESULTS: Regarding the color change, at-home bleaching resulted in significant color improvement compared to in-office treatment for the parameters Δb* (p=0.003) and Δa* (p=0.014). Two weeks post-bleaching, the at-home treatment resulted in significant color improvement compared to in-office treatment for the parameters Δb* (p=0.037) and ΔE00 (p=0.033). No differences were observed in either ΔSGU parameters. Concerning sensitivity, patients treated with in-office bleaching reported more tooth sensitivity than the at-home group only on the first day after bleaching started, without significant differences in the other periods evaluated (p>0.05). CONCLUSIONS: At-home and in-office bleaching, preceded by a desensitizing agent, were effective for vital teeth bleaching and 10% carbamide peroxide produced a higher whitening effect than 35% hydrogen peroxide in the short time evaluation. Tooth sensitivity rates were similar for the two techniques tested.

Impact of tooth bleaching on oral health-related quality of life in adults: A triple-blind randomised clinical trial.

OBJECTIVE: To investigate the impact of tooth bleaching on oral health-related quality of life (OHRQoL) in adults using a randomised clinical trial comparing at-home and in-office bleaching. METHOD: A total of 130 individuals were randomly allocated to two groups (n = 65) according to the type of treatment. At-home treatment was performed using 10 % carbamide peroxide (2 h/day; 3 weeks) and an in-office placebo, while 35 % hydrogen peroxide was used for in-office (1/week; 3 weeks) and an at-home placebo. Colour was assessed using the CIELAB system using a digital spectrophotometer. Objective and subjective colour change was estimated by calculating CIEDE2000 (ΔE00) and shade guide units (ΔSGU), respectively. The OHRQoL was measured using the Brazilian version of the Oral Health Impact Profile (OHIP-14). All assessments were performed at baseline and after 21 days. For bivariate analysis, the chi-square test, Student's t-test, and Wilcoxon test were used. The effects of OHRQoL were assessed using distribution-based responsiveness. RESULTS: Objective colour change was observed at home (p = 0.033), in comparison to in-office (p = 0.429). Mean OHIP-14 scores were similar between groups at baseline (p = 0.368) and after treatment (p = 0.695). Bleaching had a moderate positive effect on the OHRQoL of adults, especially with respect to the psychological discomfort domains, social disability, and total OHIP-14 score. The perception of tooth sensitivity in the group that received at-home treatment was negatively associated with OHRQoL (p = 0.037). CONCLUSION: The bleaching agents were highly effective and demonstrated a moderate influence on the patients' aesthetic perception and psychosocial impact.

Triple-blinded randomized clinical trial comparing efficacy and tooth sensitivity of in-office and at-home bleaching techniques

Abstract Objective Our study aims to compare the efficacy and tooth sensitivity following in-office (35% hydrogen peroxide) or at-home (10% carbamide peroxide) bleaching treatments both preceded by 2% potassium nitrate (2%KF) desensitizing gel. Methodology 130 volunteers were randomly allocated to a) in-office bleaching and a placebo at-home protocol; or b) in-office placebo and at-home bleaching treatment. 2% KF was applied for 10 min before both treatments. Objective color evaluation was performed (spectrophotometer CIEL*a*b* system and CIEDE2000) to calculate the color change (ΔE00). Subjective evaluation was performed using the VITA classical shade guide followed by shade variation (ΔSGU) at the beginning and end of bleaching treatment and 2 weeks post-bleaching. Tooth sensitivity was daily recorded using a Likert scale varying from 1 (no sensitivity) to 5 (severe sensitivity). Analysis was carried out using non-parametric tests. Results Regarding the color change, at-home bleaching resulted in significant color improvement compared to in-office treatment for the parameters Δb* (p=0.003) and Δa* (p=0.014). Two weeks post-bleaching, the at-home treatment resulted in significant color improvement compared to in-office treatment for the parameters Δb* (p=0.037) and ΔE00 (p=0.033). No differences were observed in either ΔSGU parameters. Concerning sensitivity, patients treated with in-office bleaching reported more tooth sensitivity than the at-home group only on the first day after bleaching started, without significant differences in the other periods evaluated (p>0.05). Conclusions At-home and in-office bleaching, preceded by a desensitizing agent, were effective for vital teeth bleaching and 10% carbamide peroxide produced a higher whitening effect than 35% hydrogen peroxide in the short time evaluation. Tooth sensitivity rates were similar for the two techniques tested.

Inter-relação dentística x prótese x periodontia para reabilitação estética e funcional: relato de caso / Interrelationship of restorative dentistry, periodontics and prosthodontics for aesthetic and functional rehabilitation: a case report

Na busca por um sorriso perfeito, laminados cerâmicos têm sido considerados alternativas interessantes, porém, em alguns casos, somente a estética dentária não é suficiente, e intervenções cirúrgicas periodontais podem ser indicadas para melhorar a harmonia do sorriso. No entanto, além do restabelecimento estético, a função é extremamente importante e, por isso, procedimentos protéticos reabilitadores podem ser necessários. Com base nisso, o objetivo do presente relato de caso foi descrever a técnica de execução da cirurgia plástica periodontal em dentes anteriores e a técnica da confecção de facetas laminadas e coroas totais em dissilicato de lítio para restabelecer a harmonia estética e funcional(AU)

In the search for a perfect smile, ceramic veneers are an interesting alternative. However, dental aesthetics is not enough in some cases and periodontal surgery may be indicated to improve the smile harmony. However, apart from aesthetics, function is extremely important and rehabilitation prosthetic procedures may be required. Based on this, the aim of this report was to describe a technique of periodontal plastic surgery for anterior teeth followed by the fabrication of lithium disilicate ceramic veneers and crowns to restore aesthetics and functional harmony(AU)

Reabilitação funcional e estética em dentes anteriores e posteriores: relato de caso / Functional and aesthetic rehabilitation in anterior and posterior teeth: a case report

Hoje há uma relevante busca por parte dos pacientes por alternativas de tratamentos a fim de melhorar ou alterar a aparência do sorriso. Isso ocorre devido à grande valorização atual por um sorriso com uma estética agradável. No entanto, a busca não está restrita somente aos elementos anteriores. Muitos pacientes demonstram a preocupação em melhorar a estética e a função também dos elementos posteriores. Com base nisso, o objetivo deste trabalho foi relatar um caso clínico sobre reabilitação funcional e estética utilizando lentes de contato, facetas, coroas e overlay de cerâmica(AU)

Currently, there is a search for alternative treatments to improve or change the appearance of the smile by the patients. This occurs due to the currently high appreciation for a smile with a pleasing aesthetic. However, the search is not restricted only to the anterior elements, since many patients show the desire to improve the aesthetics as well as the function of the posterior elements. Based on this, the aim of this study was to presente a case report of functional and esthetic rehabilitation using ceramic veneers, crowns and overlay restorations(AU)

In Situ and In Vitro Effects of Two Bleaching Treatments on Human Enamel Hardness.

The aim of this study was to evaluate in vitro and in situ the effects of two bleaching treatments on human enamel surface microhardness. Sixty enamel slabs from recently extracted thirty molars were used. The specimens were polished with sandpapers under water-cooling. The enamel samples were randomly divided in four groups, treated with 10% hydrogen peroxide (HP) or Whitening Strips (WS) containing 10% hydrogen peroxide and using two conditions: in vitro or in situ model. For in situ condition, six volunteers wore an intra-oral appliance containing enamel slabs, while for in vitro condition the specimens were kept in deionized water after the bleaching protocols. The bleaching treatments were applied one-hour daily for 14 days. Similar amounts of bleaching agents were used in both conditions. Before and after bleaching treatments, microhardness was measured. Statistical analysis (ANOVA and Tukey test) showed that in the in situ condition there was no statistically significant microhardness reduction in the bleached enamel (p>0.05). Significant decrease in hardness was observed for enamel slabs bleached with both treatments in the in vitro condition (p<0.05). Regarding the bleaching agents, in situ results showed no difference between HP and WS, while in vitro WS produced the lowest hardness value. It could be concluded that there was no deleterious effect on enamel produced by any of the bleaching protocols used in the in situ model. The reduction of hardness was only observed in vitro.

A importância da interdisciplinaridade no restabelecimento da função e da estética: relato de caso / The importance of interdisciplinarity in the restoration of function and aesthetics: a case report

A crescente busca pelo sorriso perfeito, aliada a um bom desempenho funcional, exige do cirurgião-dentista conhecimento das novas técnicas, mas principalmente a realização de um adequado diagnóstico e planejamento. Em muitos casos, a interação de mais de uma área da odontologia é necessária para restabelecer a estética e especialmente a função dos elementos dentais. Dessa forma, este artigo tem como objetivo relatar um caso no qual houve a interação da ortodontia, periodontia e dentística para o melhor tratamento da paciente...

The growing search for a perfect smile, along with a good functional performance require dentist knowledge of new techniques, but mainly to carry out a proper diagnosis and planning. In many cases, the interaction of more than one area of Dentistry is necessary to restore the appearance and primarily function of the dental elements. Therefore, this article is a case report where Orthodontics, Periodontics and Restorative Dentistry were associated for optimally treating of the patient...

In Situ and In Vitro Effects of Two Bleaching Treatments on Human Enamel Hardness

Abstract The aim of this study was to evaluate in vitro and in situ the effects of two bleaching treatments on human enamel surface microhardness. Sixty enamel slabs from recently extracted thirty molars were used. The specimens were polished with sandpapers under water-cooling. The enamel samples were randomly divided in four groups, treated with 10% hydrogen peroxide (HP) or Whitening Strips (WS) containing 10% hydrogen peroxide and using two conditions: in vitro or in situ model. For in situ condition, six volunteers wore an intra-oral appliance containing enamel slabs, while for in vitro condition the specimens were kept in deionized water after the bleaching protocols. The bleaching treatments were applied one-hour daily for 14 days. Similar amounts of bleaching agents were used in both conditions. Before and after bleaching treatments, microhardness was measured. Statistical analysis (ANOVA and Tukey test) showed that in the in situ condition there was no statistically significant microhardness reduction in the bleached enamel (p>0.05). Significant decrease in hardness was observed for enamel slabs bleached with both treatments in the in vitro condition (p<0.05). Regarding the bleaching agents, in situ results showed no difference between HP and WS, while in vitro WS produced the lowest hardness value. It could be concluded that there was no deleterious effect on enamel produced by any of the bleaching protocols used in the in situ model. The reduction of hardness was only observed in vitro.

Resumo O objetivo deste estudo foi avaliar in vitro e in situ os efeitos de dois tratamentos clareadores sobre a microdureza do esmalte dental humano. Sessenta blocos de esmalte obtidos de trinta molares recentemente extraídos foram utilizados. Os espécimes foram polidos com lixas sob refrigeração com água. As amostras de esmalte foram divididas aleatoriamente em quatro grupos e tratadas com 10% de peróxido de hidrogênio (HP) ou fitas de clareamento (WS) contendo 10% de peróxido de hidrogênio, testadas em duas condições experimentais: in vitro ou in situ. Para o ensaio in situ, seis voluntários foram selecionados e usaram um aparelho intra-oral contendo blocos de esmalte, enquanto que para a condição in vitro, os espécimes foram mantidos em água deionizada após os protocolos de clareamento. Os tratamentos clareadores foram aplicadas durante uma hora/dia durante 14 dias. Quantidades semelhantes de agentes de clareamento foram usadas nas duas condições. Antes e após os tratamentos de clareamento, a análise da microdureza foi realizada. A análise estatística (ANOVA e teste de Tukey) mostrou que, na condição in situ não houve redução estatisticamente significante na microdureza do esmalte clareado (p>0,05). Diminuição significativa na dureza foi observada nos blocos de esmalte clareados, em ambos os tratamentos, na condição in vitro (p <0,05). Em relação aos agentes de clareamento, os resultados in situ não mostraram nenhuma diferença entre a HP e WS, enquanto que in vitro, WS produziu o menor valor de dureza. Conclui-se que não houve nenhum efeito deletério na dureza do esmalte, em nenhum dos protocolos de clareamento ao usar um modelo in situ. A diminuição da dureza foi observada somente na condição in vitro.

Laminados cêramicos para reabilitação estética em dentes com amelogênese imperfeita / Ceramic laminates for aesthetic rehabilitation of teeth with amelogenesis imperfecta

Pacientes que apresentam alterações na estrutura dos elementos dentais que refletem na estética do sorriso estão em constante busca por procedimentos que reabilitem forma, função e principalmente estética. A amelogênese imperfeita é caracterizada por alterações na quantidade e/ou qualidade do esmalte dental e atinge tanto a dentição decídua quanto a permanente, interferindo na estética do sorriso. Para reabilitar pacientes com amelogênese imperfeita, diversos tratamentos estão disponíveis. Desse modo, o presente relato de caso clínico tem por finalidade demonstrar a reabilitação estética em um paciente com amelogênese imperfeita através do uso de laminados cerâmicos minimamente invasivos...

Patients presenting changes of tooth structure which impairs the aesthetics of the smile are consistently searching for procedures to restore form, function and mainly their aesthetics. Amelogenesis imperfecta is a disorder characterized by changes in the amount and/or quality of tooth enamel, affecting primary and permanent dentitions. Several treatments are available to rehabilitate patients with amelogenesis imperfecta. The aim of this case report is to demonstrate the aesthetic rehabilitation of a patient with amelogenesis imperfecta using minimally invasive porcelain laminate veneers...

Remodelação estética do sorriso através de laminados cerâmicos minimamente invasivos / Aesthetic reshaping using minimally invasive ceramic laminates

A demanda por tratamentos estéticos que buscam um sorriso com aparência natural e com adequada longevidade clínica tem aumentado tanto por parte dos pacientes como por parte dos profissionais. O esclarecimento e a disponibilidade de novas técnicas fizeram surgir a preocupação por tratar esteticamente, no entanto mediante tratamentos minimamente invasivos, que não gerem danos à estrutura dental. Nesse contexto, surgiram os laminados cerâmicos minimamente invasivos. Este artigo relata um caso clínico de remodelação estética de dentes anteriores com manchamento por tetraciclina, através de laminados cerâmicos minimamente invasivos...

The demand for aesthetic treatments searching a natural-looking smile and longevity is increasing by patients and dentists. The knowledge and availability of new techniques increased the desire for aesthetic treatments that could be minimally invasive and not generating damage to tooth structure. In this context, minimally invasive ceramic laminates appeared. This paper reports the aesthetic reshaping of anterior teeth with tetracycline staining using minimally invasive ceramic laminates...

Adesão aos substratos dentários e seus principais aspectos: uma revisão da literatura / Bonding to the dental substrates and the main topics: a literature review

Mesmo com o grande aprimoramento dos materiais adesivos nos últimos anos, a adesão aos substratos dentários continua sendo constantemente estudada e permeada por dúvidas. A adesão obtida ao esmalte tem sido considerada como sendo resistente e duradoura, devido ao fato de o esmalte ser um tecido altamente mineralizado e fisiologicamente homogêneo. Por outro lado, a adesão à dentina ainda continua sendo um desafio e tem sido cada vez mais pesquisada, uma vez que esse tecido apresenta grande variação regional, além de umidade, que acaba por dificultar a obtenção de uma adesão consistente. Outro aspecto importante a ser melhor elucidado é a relação existente entre a resistência de união e o selamento marginal. Dessa forma, o objetivo do presente trabalho foi o de analisar e discutir, através de uma revisão de literatura, diversos aspectos e questionamentos que freqüentemente surgem ao se estudar o processo adesivo às estruturas dentárias.

Although the great improvement of the adhesive materials in the last years, the adhesion to the dental tissues still remains a point to be studied. The adhesion to the enamel has been considered as long term resistant, due to the fact that the enamel is a highly mineralized and physiologically homogeneous tissue. On the other hand, the adhesion to the dentin remains a challenge and continues being strongly studied, once this tissue present huge regional variance and humidity, what makes harder the obtainance of a consistent adhesion. Another relationship to be determined is the one between the bond strength and the marginal sealing, yet no well defined in the literature. So, the aim of the present study was to analyze and discuss some aspects that generate doubt when the adhesive process to the tooth structures is studied.

Resin bond strength to a zirconia-reinforced ceramic after different surface treatments.

This study evaluated the microtensile bond strength between a composite resin and a zirconia-reinforced alumina-based glass-infiltrated ceramic after different ceramic surface treatments. Blocks (12 mm x 10 mm x 5 mm3) of a ceramic containing zirconia were fabricated, polished, and divided at random into seven groups, with each group receiving a different surface treatment. The adhesive system and composite resin were applied to the treated ceramic; these composite-ceramic blocks were stored in distilled water (37 degrees C) for seven days. At that point, they were cut along two axes to produce specimens with a cross-sectional area of 1.0 (+/- 0.1) mm2. The specimens (n = 20) were loaded in tension in a universal testing machine with a cross-head speed of 0.5 mm/minute. The microtensile bond strength values were calculated and statistically analyzed using ANOVA and Tukey's test (alpha = 0.05). Among the seven groups, specimens with both a silica coating and a silane coupling agent showed the highest mean microtensile bond strength values. All specimens treated with 9.5% hydrofluoric acid failed during the cutting procedure; among all specimens, the majority of the failures were cohesive. A positive correlation was observed between the fracture type and the microtensile bond strength (r = 0.63).

Influence of thermal stress on marginal integrity of restorative materials.

The aim of this study was to evaluate the influence of thermal stress on the marginal integrity of restorative materials with different adhesive and thermal properties. Three hundred and sixty Class V cavities were prepared in buccal and lingual surfaces of 180 bovine incisors. Cervical and incisal walls were located in dentin and enamel, respectively. Specimens were restored with resin composite (RC); glass ionomer (GI) or amalgam (AM), and randomly assigned to 18 groups (n=20) according to the material, number of cycles (500 or 1,000 cycles) and dwell time (30 s or 60 s). Dry and wet specimens served as controls Specimens were immersed in 1% basic fuchsine solution (24 h), sectioned, and microleakage was evaluated under x40 magnification. Data were analyzed by Kruskal-Wallis and Mann-Whitney tests: thermal cycling regimens increased leakage in all AM restorations (p<0.05) and its effect on RC and GI restorations was only significant when a 60-s dwell time was used (p<0.05). Marginal integrity was more affected in AM restorations under thermal cycling stress, whereas RC and GI ionomer restoration margins were only significantly affected only under longer dwell times.

Influence of thermal stress on marginal integrity of restorative materials

The aim of this study was to evaluate the influence of thermal stress on the marginal integrity of restorative materials with different adhesive and thermal properties. Three hundred and sixty Class V cavities were prepared in buccal and lingual surfaces of 180 bovine incisors. Cervical and incisal walls were located in dentin and enamel, respectively. Specimens were restored with resin composite (RC); glass ionomer (GI) or amalgam (AM), and randomly assigned to 18 groups (n=20) according to the material, number of cycles (500 or 1,000 cycles) and dwell time (30 s or 60 s). Dry and wet specimens served as controls Specimens were immersed in 1 percent basic fuchsine solution (24 h), sectioned, and microleakage was evaluated under x40 magnification. Data were analyzed by Kruskal-Wallis and Mann-Whitney tests: Thermal cycling regimens increased leakage in all AM restorations (p<0.05) and its effect on RC and GI restorations was only significant when a 60-s dwell time was used (p<0.05). Marginal integrity was more affected in AM restorations under thermal cycling stress, whereas RC and GI ionomer restoration margins were only significantly affected only under longer dwell times.

Avaliação da microdureza superficial do esmalte e da dentina de dentes bovinos e humanos (permanentes e decíduos) / Surface microhardness evaluation of enamel and dentin in bovine and human teeth (permanent and deciduous)

O objetivo desse estudo foi testar a microdureza superficial do esmalte (E) e da dentina (D) em molares humanos decíduos (grupo d), molares humanos permanentes (grupo p) e incisivos bovinos (grupo b). Foram selecionados 4 espécimes de cada tipo de dente os quais foram mantidos em solução salina até o teste. Os espécimes foram incluídos em uma matriz com resina e polidos com papel metalográfico (até granulação 600) para planificar o esmalte. O teste de dureza Knoop foi realizado em um microdurômetro com carga de 200 g, sendo realizadas 5 leituras (10 s de endentação) por dente. Os espécimes foram novamente submetidos ao polimento para expor dentina (próxima ao LAD), sendo novas leituras realizadas. Os dados foram submetidos à análise estatística (testes ANOVA e Tukey). Os valores médios de dureza (kg/mm2) e desvio padrão foram os seguintes: Ed 338 ± 30,1; Ep 341 ± 32,8; Eb 326 ± 25,5; Dd 104 ± 9,7; Dp 93,3 ± 8,7; Db 91,2 ± 7,3. A dureza do esmalte foi maior que a da dentina nos três tipos de dentes (p < 0,001). Considerando o tipo de substrato, não houve diferenças estatísticas, ou seja, os valores de dureza para esmalte ou dentina foram similares para dentes humanos decíduos e permanentes e dentes bovinos.

The objective of this study was to evaluate the surface microhardness of enamel (E) and dentin (D) from human deciduous molar teeth (Group d), human permanent molar teeth (Group p) and bovine incisor teeth (Group b). Four specimens were selected for each group and stored in saline solution until testing. The specimens were embedded into a resin matrix and polished to 600 grit SiC paper creating a flat enamel surface. The Knoop hardness test was performed in a microhardness device, using a 200 g load. Five measurements were made in each specimen. After that, specimens were polished to expose dentin (near to dentinenamel junction), and other five microhardness measurements were performed per specimen. The values were calculated and statistically analyzed (ANOVA and Tukey tests). Mean hardness values (kg/mm2) and standard deviations were as follows: Ed 338 ± 30.1; Ep 341 ± 32.8; Eb 326 ± 25.5; Dd 104 ± 9.7; Dp 93.3 ± 8.7; Db 91.2 ± 7.3. The microhardness in enamel (E) was statistically higher than in dentin (D) for the three type of teeth studied (p < 0.001). Considering the type of substrate, there were no statistical differences, meaning that the mean hardness values for either enamel or dentin were not different for the human deciduous teeth, human permanent and bovine teeth.

Class II composite restorations with metallic and translucent matrices: 2-year follow-up findings.

OBJECTIVE: The aim of this randomized, clinical study was to evaluate the performance of composite restorations placed with two matrix and wedge systems after a 2-year follow-up. METHODS: Twenty-three patients were selected, and received at least two Class II restorations, one with metallic matrix and wooden wedge and other with polyester matrix and reflective wedge. One dentist placed all the 109 restorations. All cavities were restored using Single Bond and P-60 (3M ESPE), according to manufacturer's instructions. In the metal matrix group, polymerization was performed from occlusal, and in the polyester group, through the reflective wedge. Restorations were evaluated at baseline and after 12 and 24 months by the modified USPHS criteria, and data were analyzed with Mann-Whitney and Wilcoxon Signed Rank tests (alpha=0.05). RESULTS: Fifteen subjects and 78 restorations were re-evaluated after 24 months. A significant decrease in the quality of cervical adaptation and proximal contacts by radiographic evaluation was evidenced (p<0.05), but no differences between the two matrix systems were detected (p>0.05). In the clinical evaluation there were no significant differences between matrices after 2 years (p>0.05). A compromising of marginal adaptation, marginal staining and proximal contacts aspects for both matrix systems was evidenced, and restorations placed with translucent matrices showed loss of color stability (p<0.05). CONCLUSIONS: Whereas restorations presented some clinical aspects somewhat compromised after 2 years, the matrix and wedge systems evaluated showed similar clinical performance.

Resistência flexural e rugosidade superficial de quatro resinas compostas / Flexural strength and surface roughness of four composite resins

Este estudo comparou a resistência á flexão e a rugosidade superficial de quatro resinas compostas (MF - Master Fill®; CT- Concept®; FM- Fill Magic®; Filtek Z250®), testando a hipótese de que esses compósitos apresentam propreidades similares. Vinte corpos-de-prova de cada material foram confeccionados conforme as instruções do fabricante e as normas da ISO 4049, sendo 10 CP em forma de barras (24 x 2 x 2 mm) para od testes de resistência flexural em 3 - pontos (σ) e 10 CP me forma de discos (7 x 2 mm), para a avaliação da rugosidade superficial média (Ra). A σ dos CP foi testada em máquina de ensaio universal (EMIC-2000®) com velocidade de 1 mm/mm. A Ra foi avaliada em rugosímetro (Surfcoder SE1200®). Os resultados de σ e de Ra foram submetidos á análise estatística (Anova e Tukey). Os valores médios e desvio-padrão de σ (MPa) e Ra (µm) foram, respectivamente: Z250 - 119,9 ± 14,9 e 0,138 ± 0,042: MF - 80,4 ± 13,7 e 0,296 ± 0,096; CT - 80,3 ± 9,4 e 0,212 ± 0,043: FM - 97,3 ± 19,3 ± e 0,229 ± 0,057. A média de σ do Z250 foi mais elevada do que os demais grupos (p <0,05), que não apresentaram diferenças estatísticas significativas entre si. Com relação á Ra, a Z250 também apresentou resultados significativamente melhores que os demais grupos, seguida pela CT e FM, que apresentou a maior média de Ra. Pode-se concluir que o compósito microídico Z250 produziu resultados de σ e Ra estatisticamente melhores que os demais materiais testados.

Concepção dos acadêmicos de Odontologia a respeito da abordagem do paciente infantil / Dental students' understanding on the approach of the infant patient

O comportamento da criança durante tratamento dentário depende, entre outros aspectos, da interação com a conduta do Cirurgião-dentista. O presente estudo, desenvolvido dentro do paradigma naturalístico e considerando a linguagem em sua forma discursiva, teve por objetivo analisar a concepção dos alunos de Odontologia, em diferentes fases do curso, a respeito da disciplina de Odontopediatria e do atendimento do paciente infantil. Os dados foram obtidos a partir de entrevistas com alunos sorteados, regularmente matriculados na Faculdade de Odontologia da UFPel, cursando segundo, quarto, sexto, sétimo e oitavo semestres. As entrevistas semi-estruturadas foram gravadas, transcritas e armazenadas em banco de dados. Utilizou-se uma análise de conteúdo do tipo categorial-temático, de onde emergiram as seguintes categorias: especificidade e desafio diante do paciente infantil; leitura dicotômica da abordagem do paciente odontopediátrico (técnica X psicologia); visão da psicologia como instrumento para transposição de momentos difíceis; superação da insegurança pressentida antes e durante o transcurso da disciplina. O grupo entrevistado e os dados analisados permitem concluir que: a) ao final do curso, o aluno adquire a concepção de integralidade para o atendimento do paciente odontopediátrico; b) deve-se repassar ao aluno a importância de voltar-se para as necessidades do indivíduo; c) deve-se trabalhar com a descentralização dos conteúdos, dissipando a visão de disciplinas estáticas

A clinical evaluation of posterior composite restorations: 17-year findings.

OBJECTIVE: Since an increasing number of composite restorations in posterior teeth are placed as a routine, this study was conducted to evaluate long-term survival of these restorations placed in general practice. METHODS: Patients from a private dental office that received restorations in posterior teeth between 1987 and 1988 with P-50 (3M) or Herculite XR (Kerr) resin composites were selected and invited to participate. Restorations were placed under rubber dam isolation. Dentine walls were covered with glass ionomer cement, and composites were placed according to manufacturer's instructions. Thirty-eight patients agreed to participate and signed an informed consent prior to the evaluation. Two calibrated operators worked independently in the evaluation, using modified USPHS criteria. Survival of restorations or subsets of restorations grouped on the basis of variables (material, tooth, cavity type and size) was determined using Kaplan-Meier survival curves. RESULTS: Ninety-eight failures were recorded among the 282 restorations providing a crude estimate of 34.8% failures. The survival rate was not significant for material (p=0.92) but was significant between tooth (lower premolars and lower molars, p<0.0001), cavity type (p<0.001) and size (p<0.001). The majority of restorations exhibited A or B scores for the evaluated criteria. The main failure cause was fracture of both composites. CONCLUSIONS: The clinical performance of posterior resin composite restorations evaluated was acceptable after 17-year evaluation. However, the probability of failure of resin composite restorations in molars, Class II, and large restorations is higher.

Microdureza do amálgama: influência da liga e do tratamento superficial / Amalgam microhardness: influence of the alloy composition and surface treatment

O objetivo do presente estudo foi avaliar a dureza do amálgama, variando-se o tipo de liga e o tratamento superficial. Foram empregadas duas ligas, uma convencional e outra com alto teor de cobre, sendo confeccionados 15 corpos-de-prova (c.p.) de cada liga, utilizando-se matrizes padronizadas. As duas ligas foram divididas em três grupos (n = 5), os quais foram submetidos a um dos seguintes tratamentos de superfície: brunimento, polimento convencional (pastas abrasivas e escovas) e polimento especial (borrachas abrasivas). O brunimento foi realizado imediatamente após a cristalização do amálgama, enquanto os polimentos foram executados após sete dias. Após os tratamentos, os c.p. foram submetidos ao teste de dureza Knoop, com carga de 200 g, sendo realizadas cinco leituras em cada espécime. Os dados foram submetidos a análise estatística (testes ANOVA e Tukey). A dureza da liga com alto teor de cobre (1.543,88 ± 466,02) foi estatisticamente superior (p < 0,001) àquela da liga convencional (1.083,05 ± 279,31). O brunimento resultou em valores de dureza (1.740,10 ± 359,16) estatisticamente superiores (p < 0,001) que os dos outros grupos. O polimento convencional apresentou valores de dureza (1.017,74 ± 181,70) estatisticamente inferiores (p < 0,05) do que aqueles do polimento especial (1.182,55 ± 394,58). Na interação dos fatores, o brunimento na liga com alto teor de cobre apresentou os maiores valores de dureza (p < 0,05), enquanto o polimento especial na liga com alto teor de cobre e o brunimento na liga convencional produziram performances similares, sendo superiores (p < 0,05) ao polimento convencional em ambas as ligas. Os menores valores de dureza foram encontrados na liga convencional submetida ao polimento especial (p < 0,05)