Immediate Insertion of Dental Implants Immediate Insertion in Bilateral Traumatic Bone Cysts With or Without a Bone Grafting Material: A 5-Year Follow-Up Case Report.

This case report describes the rehabilitation of a patient who received dental implants in traumatic bone cyst areas (TBC). A 24-year-old male patient sought dental treatment for the bilateral absence of the mandibular second premolars. Radiographic examination revealed bilateral large radiolucent images in the mandible body. Surgical exploration confirmed the diagnosis of TBC. Rehabilitation with dental implants was performed using different approaches on each side. One cystic cavity was filled with blood clot and allogenic bone graft; the other was filled only with blood clot. After 5 years, the implants are osseointegrated and functioning. The filling of the traumatic bone cyst cavity with local blood clot in contact with the implant presented clinical and radiographic success similar to that obtained with filling with bone graft in the same patient. Thus, in this patient, the blood clot-only approach can be considered as a viable, safe-low cost alternative to blood clot and grafting material.

Shear Bond Strength of Orthodontic Brackets Fixed with Remineralizing Adhesive Systems after Simulating One Year of Orthodontic Treatment.

The objective of this study is to assess, in vitro, the shear bond strength of orthodontic brackets fixed with remineralizing adhesive systems submitted to thermomechanical cycling, simulating one year of orthodontic treatment. Sixty-four bovine incisor teeth were randomly divided into 4 experimental groups (n = 16): XT: Transbond XT, QC: Quick Cure, OL: Ortholite Color, and SEP: Transbond Plus Self-Etching Primer. The samples were submitted to thermomechanical cycling simulating one year of orthodontic treatment. Shear bond strength tests were carried out using a universal testing machine with a load cell of 50 KgF at 0.5 mm/minute. The samples were examined with a stereomicroscope and a scanning electron microscope (SEM) in order to analyze enamel surface and Adhesive Remnant Index (ARI). Kruskal-Wallis and Mann-Whitney (with Bonferroni correction) tests showed a significant difference between the studied groups (p < 0.05). Groups XT, QC, and SEP presented the highest values of adhesive resistance and no statistical differences were found between them. The highest frequency of failures between enamel and adhesive was observed in groups XT, QC, and OL. Quick Cure (QC) remineralizing adhesive system presented average adhesive resistance values similar to conventional (XT) and self-etching (SEP) adhesives, while remineralizing system (OL) provided the lowest values of adhesive resistance.

Toothpaste prevents debonded brackets on erosive enamel.

UNLABELLED: This study evaluated the effect of high fluoride dentifrice on the bond strength of brackets after erosive challenge. Eighty-four enamel specimens were divided into seven groups (n = 12): WN (distilled water/no acid challenge), W3C (distilled water/3 cycles of acid challenge), and W6C (distilled water/6 cycles of acid challenge) were not submitted to dentifrice treatment. Groups RF3C (regular fluoride dentifrice/3 cycles of acid challenge) and RF6C (regular fluoride dentifrice/6 cycles of acid challenge) were treated with dentifrices containing 1450 µg F(-)/g and HF3C (high fluoride dentifrice/3 cycles of acid challenge) and HF6C (high fluoride dentifrice/6 cycles of acid challenge) were with 5000 µg F(-)/g. Acid challenges were performed for seven days. After bond strength test, there was no significant difference among groups submitted to 3 cycles of acid challenge (P > 0.05). Statistically significant difference was found between the regular and high fluoride dentifrices after 6 cycles of acid challenge (<0.05). Similar areas of adhesive remaining were found among control groups and among groups W6C, RF3C, RF6C, HF3C, and HF6C. The high fluoride dentifrice was able to prevent the reduction of bond strength values of brackets submitted to acid challenge. CLINICAL RELEVANCE: the high fluoride toothpaste prevents debonded brackets on erosive enamel.

Sealing ability of root-end filling materials.

BACKGROUND: The aim of this research was to compare the apical sealing ability of different root-end filling materials (SuperEBA(®), ProRoot MTA(®), thermoplasticized gutta-percha + AH-Plus(®), thermoplasticized RealSeal(®)), by means of microbial indicators. MATERIALS AND METHODS: Thus, 50 human single-rooted teeth were employed, which were shaped until size 5 0, retro - prepared with ultrasonic tips and assigned to 4 groups, retro-filled with each material or controls. A platform was employed, which was split in two halves: upper chamber-where the microbial suspension containing the biological indicators was introduced (E. faecalis + S. aureus + P. aeruginosa + B. subtilis + C. albicans); and a lower chamber containing the culture medium brain, heart influsion, where 3 mm of the apical region of teeth were kept immersed. Lectures were made daily for 60 days, using the turbidity of the culture medium as indicative of microbial contamination. Statistical analyses were carried out at 5% level of significance. RESULTS: The results showed microbial leakage at least in some specimens in all of the groups. RealSeal(®) has more microbial leakage, statistically significant, compared to ProRoot(®) MTA and SuperEBA(®). No significant differences were observed when compared ProRoot(®) MTA and SuperEBA(®). The gutta-percha + AH Plus results showed no statistically significant differences when compared with the other groups. CONCLUSIONS: All the tested materials showed microbial leakage. Root-end fillings with Super-EBA or MTA had the lowest bacterial filtration and RealSeal shows highest bacterial filtration.

Chemical and structural characterization of glass ionomer cements indicated for atraumatic restorative treatment.

Glass ionomer cements (GICs) are restorative materials, which clinical use has increased significantly during the last decade. The aim of the present study was to analyze the chemical constitution and surface morphology of four glass ionomer cements: Maxxion R, VitroFill, Vidrion R and Vitremer. Twelve polyethylene tubes with an internal diameter of 3 and 3 mm in length were prepared, filled and then transferred to a chamber with 95% relative humidity and a temperature of 37°C. The surface morphology of the tested materials was examined by scanning electron microscopy (SEM) and main components were investigated by energy-dispersive X-ray microanalysis (EDX). Scanning electron microscopy revealed irregular and rough external surface. Cracking was not observed. The main constituents were found to be aluminum, silicon, calcium, sodium and fluoride. Phosphorus, sulfur and barium were only observed in Vidrion R, while chlorine were only observed in Maxxion R. Elemental mapping of the outer surface revealed high concentration of aluminum and silicon. Significant irregularities on the surface of the tested materials were observed. The chemical constitution of all GIC was similar.

In vivo Evaluation of Proximal Resin Composite Restorations performed using Three Different Matrix Systems.

OBJECTIVE: The aim of this in vivo study was to radiographically evaluate the proximal contour of composite resin restorations performed using different matrix systems. MATERIALS AND METHODS: Patients with premolars needing class II type resin composite restorations involving the marginal ridge were selected. Thirty premolars were selected and randomly divided into three groups (n = 10 each) to receive restorations using different matrix systems: group 1: metal matrix coupled to a carrier matrix and wood wedge (G1-MMW); group 2: sectioned and precontoured metal matrix and elastic wedge (G2-SME); and group 3: a polyester strip and reflective wedge (G3-PMR). After the restorative procedure, bitewing radiographs were performed and analyzed by three calibrated professionals. The quality of the proximal contact and marginal adaptation of the proximal surfaces was classified as either correct or incorrect (undercontour/overcontour). RESULTS: The Pearson Chi-square statistical test (α = 5%) revealed a statistically difference between frequencies of correct and incorrect restorations (α(2) = 6.787, p < 0.05). The group G2 SME produced a higher frequency of correct proximal contours (90%), while G1-MMW and G3-PMR had a ratio of 40% correct and 60% incorrect contours respectively. CONCLUSION: None of the matrix systems was able to prevent the formation of incorrect proximal contours; however, the sectioned and precontoured metal matrix/elastic wedge configuration provided better results as compared to the other groups.

Deflection Evaluation of Thermoactivated Nickel-Titanium Archwires after Heat Treatment on their Distal Ends.

OBJECTIVE: This study evaluated in vitro the mechanical changes of 0.018" (0.45 mm) and 0.016 × 0.022" (0.40 × 0.55 mm) thermoactivated nickel-titanium archwires subjected to heat treatment on their distal ends. MATERIALS AND METHODS: Ten archwires in diameters 0.018" and 0.016 × 0.022" by different manufacturers Ormco, Morelli, Orthometric and Unitek were tested. Each tested archwire had an experimental side, submitted to heat treatment, and an annealing-free control. Tests for load/deflection were performed using a universal testing machine, with temperature control in the austenitic transformation phase through tempe rature-controlled chamber. The variables showed normal distribution (Kolmogorov-Smirnov), the t-student test was applied in order to observe the difference between the experi mental and control groups. Statistical significance was set at p < 0.05. RESULTS: There were no statistically significant differences between the groups. CONCLUSION: Heat treatment carried out in the region corresponding to the first molar distal region on thermoactivated nickel-titanium archwires did not influence the load/deflection values in adjacent portion.

Analysis of metal contents in Portland Type V and MTA-based cements.

The aim of this study was to determine, by Atomic Absorption Spectrometry (AAS), the concentration levels of 11 metals in Type V gray and structural white PC, ProRoot MTA, and MTA Bio. Samples, containing one gram of each tested cement, were prepared and transferred to a 100 mL Teflon tube with a mixture of 7.0 mL of nitric acid and 21 mL of hydrochloric acid. After the reaction, the mixture was filtered and then volumed to 50 mL of distilled water. For each metal, specific patterns were determined from universal standards. Arsenic quantification was performed by hydride generator. The analysis was performed five times and the data were statistically analyzed at 5% level of significance. Only the cadmium presented concentration levels of values lower than the quantification limit of the device. The AAS analysis showed increased levels of calcium, nickel, and zinc in structural white PC. Type V PC presented the greatest concentration levels of arsenic, chromium, copper, iron, lead, and manganese (P < 0.05). Bismuth was found in all cements, and the lowest concentration levels were observed in Portland cements, while the highest were observed in ProRoot MTA. Both PC and MTA-based cements showed evidence of metals inclusion.

Physicochemical properties and surfaces morphologies evaluation of MTA FillApex and AH plus.

The solubility, pH, electrical conductivity, and radiopacity of AH Plus and MTA FillApex were evaluated. In addition, the surfaces morphologies of the sealers were analyzed by using scanning electron microscopy. For pH test, the samples were immersed in distilled water at different periods of time. The same solution was used for electrical conductivity measurement. The solubility and radiopacity were evaluated according to ANSI/ADA. Statistical analyses were carried out at 5% level of significance. MTA FillApex presented higher mean value for solubility and electrical conductivity. No significant difference was observed in the mean values for pH reading. AH Plus presented higher radiopacity mean values. MTA FillApex presented an external surface with porosities and a wide range of sizes. In conclusion, the materials fulfill the ANSI/ADA requirements when considering the radiopacity and solubility. AH Plus revealed a compact and homogeneous surface with more regular aspects and equal particle sizes.

Using cone beam computed tomography images to diagnose multiple taurodontisms.

Taurodontism is a developmental anomaly that manifests as an alteration in a patient's internal morphology and is characterized by the lack of constriction at the level of the cementoenamel junction, which results in an apical extension of the pulp chamber that extends into the root area of a multiradicular tooth. This report presents a case of an otherwise healthy patient with 12 hypertaurodontic teeth, which were detected by using cone beam computed tomography (CBCT). It is essential to emphasize the importance of routine imaging examinations for diagnosing developmental dental anomalies such as taurodontism, as this condition is generally not found by routine oral examination, and is not necessarily restricted to syndromic patients. CBCT images contribute to the diagnosis of and treatment plan for taurodontism.

Prevalence of impacted teeth in a Brazilian subpopulation.

The objective of this study was to estimate the prevalence of impacted teeth in a subpopulation of Brazilian patients based on the retrospective analysis of panoramic radiographs obtained at an oral radiology clinic. Out of 1,977 panoramic radiographs, 1,352 fulfilled inclusion criteria, and 22,984 teeth were assessed. Data were statistically analyzed using Kolmogorov-Smirnov's and Levene's tests; significance was set at 5%. The number of impacted teeth was assessed using analysis of variance and Tukey's post-hoc test. Our results showed significant differences for tooth type and patient age when analyzed separately (p < 0.05); gender did not show significant results (p > 0.05). Correlations between age and gender showed significant differences (p < 0.05), as did the correlations between age, gender and tooth type (p < 0.05). Mandibular molars were the teeth most frequently affected (p < 0.05), followed by maxillary molars (p < 0.05). Other tooth types did not present significant differences among themselves (p > 0.05). Patients aged 22 years or younger were the most frequent ones (p < 0.05). No significant differences were observed between age groups 37 and 51 years and 52+ (p > 0.05). According to the methodology here employed, gender did not affect tooth impaction, whereas age (22-36 years) and tooth type (mandibular third molars) strongly influenced results.

Marginal adaptation of class V restorations with current-generation dentin-bonding agents: effect of different dentin surface treatments.

This study sought to assess the use of chlorhexidine with several excipients as a dentin surface treatment and its effect on marginal adaptation of class V restorations with current-generation dentin bonding agents. A total of 120 human third molars were selected and allocated into 12 groups, with standardized buccal class V restorations randomly divided into preconditioned dentin rinsed with: water; water + chlorhexidine; ethanol; or ethanol + chlorhexidine. After rinsing of dentin (previously conditioned with 35% phosphoric acid) with the test solutions, the Adper single bond 2, prime and bond 2.1, and Excite bonding systems were applied randomly. Restorations were performed with Filtek™ Z350 XT composite resin. The resulting specimens were subjected to thermal and mechanical load cycling. Quantitative analysis of marginal adaptation was performed on epoxy replicas by means of scanning electron microscopy. Results were assessed by means of the Kruskal-Wallis test (percentages of continuous margins) and Wilcoxon test (differences between percentages of continuous margins before and after thermal cycling and mechanical loading), at a significance level of p < 0.05. Outcomes in the chlorhexidine-treated groups were not superior to those obtained with other treatments.

Effect of chronic stress on ligature-induced periodontitis in inbred and noninbred rats: a radiographic study.

AIM: The aim was to compare the effect of chronic stress on ligature-induced periodontitis in inbred and noninbred female rats by means of a radiographic study. MATERIALS AND METHODS: Adult Lewis (inbred) and Wistar (non-inbred) rats were used and divided into the following groups: Ligature/Stress Lewis Group (LSLG, n = 8); Ligature/Stress Wistar Group (LSWG, n = 8); Ligature Lewis Group (LLG, n = 8) and Ligature Wistar Group (LWG, n = 8). The animals were anesthetized and a silk thread was continuously kept around their second upper right molar. Then, groups LSLG and LSWG were subjected to physical stress test (physical restraint for 12 hours). After 15 days of ligature placement, the animals were euthanized. The right hemimaxilla was kept in formalin solution for 48 hours. Radiographs of the hemimaxillae were obtained using the parallelism technique and subsequently submitted to a standardized radiographic processing. The examiner was blinded to the groups and calibrated. The bone height level was measured and the data were subjected to statistical analysis (ANOVA, Tukey, p < 0.05). RESULTS: LSWG showed bone destruction significantly higher than that of LSLG (32.1 ± 1.45 mm and 23.6 mm ± 2.13, respectively). Similarly, LWG showed bone destruction significantly higher than that of LLG (28.6 ± 1.18 mm and 25.2 ± 2.76 mm, respectively). CONCLUSION: Inbred rats (Lewis) are less susceptible to the effects of chronic stress than are noninbred rats (Wistar) in relation to ligature-induced periodontitis. CLINICAL SIGNIFICANCE: Epidemiological studies have shown a relationship between stress and periodontitis. One of the major difficulties of this type of research is the bias of the exact diagnosis of the patient's emotional state. Inbred lines animals have standards-specific neuroendocrine, this allows answers about the susceptibility of periodontal disease, making knowledge applicable in future clinical trials.

Evaluation of Antimicrobial Properties, Cell Viability, and Metalloproteinase Activity of Bioceramic Endodontic Materials Used in Vital Pulp Therapy.

This study aimed to evaluate the antimicrobial properties, cell viability, and matrix metalloproteinase (MMP) inhibition capacity of several endodontic materials aimed at vital pulp therapy: Pro Root MTA®, EndoSequence®, Biodentine®, MTA Angelus®, TheraCal LC®, and BioC Repair®. The materials were prepared according to the manufacturer's instructions. Antimicrobial tests were conducted using a microcosm biofilm model, cell viability was assessed using murine fibroblasts (L929), and MMP activity was analyzed through electrophoresis. The results showed that BioC Repair®, Biodentine®, and EndoSequence® exhibited similar antimicrobial properties, while MTA Angelus® and ProRoot MTA® had inferior results but were comparable to each other. In terms of cell viability, no significant differences were observed among the materials. EndoSequence® demonstrated the highest MMP inhibition capacity. In conclusion, BioC Repair®, Biodentine®, EndoSequence®, and TheraCal® showed better antimicrobial properties among the tested materials. The materials did not exhibit significant differences in terms of cytotoxicity. However, EndoSequence® displayed superior MMP inhibition capacity.

Comparative analysis between three methods of bone estimating age in individuals with down syndrome by mode of the hand and wrist ray.

The wrist and hand region has been the most commonly used for estimating age and osseous development due to the great number of ossification centers. The aim was to determine which method, Tanner & Whitehouse's (TW3), Greulich & Pyle's (GP) or Eklof & Ringertz's, more closely relates to the chronological age in subjects with Down syndrome with chronological ages between 61 and 180 months, using wrist and hand radiographs. The sample consisted of 85 radiographs, 52 of males and 33 of females. Eklof & Ringertz's method was computerized (Radiomemory). Greulich & Pyle's atlas was used and compared with the wrist and hand radiographs. For the TW3 method, 13 ossification centers were evaluated; for each one of them, there are seven or eight development stages to which scores are assigned; these scores are then added and the results are transformed into osseous age values. No statistically significant differences were observed between the male and female genders for methods TW3 and GP, contrasting with the observed differences for the Eklof & Ringertz method. Correlation (r2) between osseous and chronological ages was 0.8262 for TW3 and 0.7965 for GP, while for the method of Eklof & Ringertz, it was 0.7656 for females and 0.8353 for males. The author concluded that the osseous age assessment method that better related to the chronological age was the TW3, followed by Greulich & Pyle's and Eklof & Ringertz's.

Degree of conversion of polymer-matrix composite assessed by FTIR analysis.

AIMS AND OBJECTIVES: The behavior of polymer-matrix composite is dependent on the degree of conversion. The aim of this study was to evaluate the degree of conversion of two resin cements following storage at 37°C immediately, 24 and 48 hours, and 7 days after light-curing by FTIR analysis. MATERIALS AND METHODS: The specimens were made in a metallic mold and cured with blue LED with power density of 500 mW/ cm(2) for 30 seconds. The specimens were pulverized, pressed with KBr and analyzed with FTIR following storage times. STATISTICAL ANALYSIS USED: ANOVA (two-way) and Tukey's post hoc. RESULTS: To the polymer-matrix composites between 24 and 48 hours does not show a significant increase (p > 0.05), however, the highest values were found after 7 days. CONCLUSION: The polymer-matrix composites used in this study showed similarity on the degree of conversion and increased of according to the time of storage.

Degree of conversion and hardness of two different systems of the Vitrebond™ glass ionomer cement light cured with blue LED.

This study investigated the physicochemical properties of the new formulation of the glass ionomer cements through hardness test and degree of conversion by infrared spectroscopy (FTIR). Forty specimens (n = 40) were made in a metallic mold (4 mm diameter x 2 mm thickness) with two resin-modified glass ionomer cements, Vitrebond™ and Vitrebond™ Plus (3M/ ESPE). Each specimen was light cured with blue LED with power density of 500 mW/cm(2) during 30 s. Immediately after light curing, 24h, 48h and 7 days the hardness and degree of conversion was determined. The Vickers hardness was performed by the MMT-3 microhardness tester using load of 50 gm force for 30 seconds. For degree of conversion, the specimens were pulverized, pressed with KBr and analyzed with FT-IR (Nexus 470). The statistical analysis of the data by ANOVA showed that the Vitrebond™ and Vitrebond™ Plus were no difference significant between the same storage times (p > 0.05). For degree of conversion, the Vitrebond™ and Vitrebond™ Plus were statistically different in all storage times after light curing. The Vitrebond™ showed higher values than Vitrebond™ Plus (p < 0.05). The performance of Vitrebond™ had greater results for degree of conversion than Vitrebond™ Plus. The correlation between hardness and degree of conversion was no evidence in this study.

Influence of artificial aging in marginal adaptation of mixed class V cavities.

The aim of this study was to investigate whether the artificial aging by thermal cycling had influenced the marginal adaptation of class V restorations with/without chlorhexidine application in the bond process. Twelve intact human third molars were used. Class V cavity preparations were performed on the buccal surface and the teeth received 35% phosphoric acid-etching procedure (Ultradent Products Inc., South Jordan, Utah, USA). Subsequently, the samples were divided in two groups: Untreated acid-etched dentin and chlorhexidine application as an adjunct in the bond process. The adhesive Single Bond 2 (3M ESPE, St. Paul, MN, USA) was used after 2% chlorhexidine application, and the restorations were performed with Filtek™ Z350 XT (3M ESPE) composite resin. The specimens were submitted to artificial aging by thermal cycling with 3,000 cycles. Analyzes were performed on scanning electron microscopy using replicas of marginal adaptation in percentage of continuous margin before and after the artificial aging. The data were analyzed by paired test and the results showed statistically significant differences in the percentage of continuous margin with/without chlorhexidine treatment before and after thermal cycling. This study concluded that the artificial aging by thermal cycling influenced the marginal adaptation of mixed class V composite restorations.

Influence of nicotine and cotinine impregnation on the first step of periodontal regeneration: clot stabilization.

This study analyzes the clot stabilization on root surfaces of teeth impregnated with cotinine and nicotine and the influence of the scaling in the adhesion of blood components, observing the influence of new exposition to nicotine and/or cotinine after scaling. Fifteen human teeth extracted due to periodontal disease of non-smokers patients were selected and manually scaled. Four dentin blocks were obtained from each tooth (n = 60). Samples received blood application or reimpregnation with nicotine and/or cotinine, depending on the groups. Group 1: PBS immersion + root scaling + blood; group 2: nicotine + root scaling + blood; group 3: nicotine + root scaling + nicotine reapplication + blood; group 4: cotinine + root scaling + blood; group 5: cotinine + root scaling + cotinine reapplication+ blood; group 6: nicotine and cotinine + root scaling + nicotine and cotinine + blood. Samples were kept in 2 ml of each substance for 24 hours. Each group received a blood drop and was analyzed by SEM. The higher amount of blood components was present in teeth exposed to cotinine and the groups submitted to scaling and blood application in comparison with groups that received reapplication of toxic substances after scaling. The greater toxic effect on root dentin surface was after the exposure to nicotine and cotinine. Results suggest that periodontal healing may be delayed in smokers due to the direct inhibition of clot stabilization on the root surface when nicotine and cotinine are present concomitantly.

Effects of Brown and Green Propolis on Bond Strength of Fiberglass Posts to Root Canal Dentin.

Introduction: The purpose of this study was to evaluate the effect of brown and green propolis on bond strength of the fiberglass posts to root canal dentin, and to compare it with conventional endodontic irrigants. Methods and Materials: Sixty bovine teeth were selected, decoronated and randomly distributed into six groups (n=10), according to the irrigation solution: 0.9% saline solution (Control); 2% chlorhexidine (CHX); 5% malic acid (MA); 0.5% ethanolic extract of brown propolis (BP); 0.25% ethanolic extract of green propolis (GP); 2.5% sodium hypochlorite (NaOCl). After root canal treatment, fiber posts were cemented into prepared root canals with a self-adhesive resin cement. The roots were cross-sectioned to obtain two discs from each third and submitted to the micro push-out test. Failure patterns were evaluated under optical microscopy. The influence of irrigants agents was analyzed using one-way ANOVA followed by Games-Howell's test (α=0.05). Failure modes were analyzed using Fischer's exact test (α=0.05). Results: There were statistically significant differences among the groups (P<0.05). The control, NaOCl and BP groups showed the highest bond strength with no statistically significant difference between them (P>0.05). Adhesive failure type was the predominant in all groups. Conclusion: Based on this in vitro study, the use of 0.5% brown propolis did not influence the bond strength of fiberglass posts to root canal dentin, while the use of 0.25% green propolis did affect it negatively.