Restauração transcirúrgica: passo a passo / Transsurgical restoration: step by step

Sabe-se que para uma restauração ser considerada um sucesso clínico é preciso que haja uma concomitância saudável entre a estrutura dentária, o material restaurador e as estruturas biológicas periodontais. As restaurações transcirúrgicas caracterizam-se como procedimentos alternativos para possibilitar a restauração de dentes com cárie dentária extensa, restaurações subgengivais desadaptadas e fraturas. O presente estudo teve como objetivo realizar um relato de caso de um procedimento cirúrgico-restaurador, através de uma técnica de restauração transcirúrgica. Este estudo tem como justificativa relatar um caso clínico, colaborando com maiores informações sobre a escolha da técnica a ser empregada, mostrando em quais situações devemos escolher uma restauração transcirúrgica e quais seus benefícios. Também, salientar se devemos fazer a recuperação do espaço biológico do periodonto ou não(AU)

It is known that for a restoration to be considered a clinical success, there must be a healthy concomitance between the tooth structure, the restorative material and the periodontal biological structures. Transsurgical restorations are characterized as alternative procedures to enable the restoration of teeth with extensive dental caries, maladapted subgingival restorations and fractures. The present study aims to carry out a case report of a surgical-restorative procedure, using a transsurgical restoration technique. This study is justified by reporting a clinical case, providing more information on the choice of technique to be used, showing in which situations we should choose a transsurgical restoration and what its benefits are. Also, highlight whether we should recover the biological space of the periodontium or not(AU)

Restauração indireta em resina composta: um relato de prontuário / Indirect resin composite restoration: a dental record report

Restaurações diretas em resina composta são amplamente utilizadas em odontologia para restaurar dentes posteriores. Todavia, quando há grande destruição coronária, onde a distância do istmo excede dois terços da distância intercuspídea, as restaurações indiretas em resina composta são indicadas. O presente estudo teve como objetivo relatar a análise de um prontuário de um paciente que recebeu uma restauração indireta em resina composta em dente posterior amplamente destruído. Através da análise de prontuários de pacientes atendidos nas disciplinas de Estágios Supervisionados do Curso de Odontologia da FSG Centro Universitário no ano de 2023, foi selecionado um prontuário de um paciente que compareceu a clínica odontológica da FSG com uma restauração em amálgama fraturada com reparo em resina composta que apresentou sintomatologia dolorosa. O procedimento diagnóstico ocorreu através de exame clínico e radiográfico, que constatou a indicação de substituição da restauração insatisfatória e realização de uma restauração indireta em resina composta. Os resultados estéticos e funcionais apresentados demostraram a viabilidade da técnica restauradora indireta em resina composta para reabilitar dentes posteriores com ampla destruição coronária(AU)

Direct composite resin restoration are widely used in dentistry to restore posterior teeth. However, when there is large coronary destruction, that the distance from the isthmus exceeds two- thirds of the intercuspal distance, indirect composite resin restorations are indicated. This study aimed to report the analysis of a dental record of a patient who received an indirect restoration in composite resin in a badly destroyed posterior tooth. Through the analysis of dental records of patients seen in the disciplines of Supervised Internship of the Dentistry Course at FSG Centro Universitário in the year 2023, the dental record of a patient who attended the FSG dental clinic with fractured amalgam restoration with composite resin repair was selected who had painful symptoms. The diagnostic procedure took place through clinical and radiographic examination, which revealed the indication of replacing the unsatisfactory restoration and carrying out an indirect restoration in composite resin.The aesthetic and functional results presented demonstrated the viability of the indirect composite resin restoration technique for rehabilitating posterior teeth with extensive coronal destruction(AU)

Utilização de pilares personalizados CAD/CAM em implantodontia: relato de caso clínico / Use of personalized pillars CAD/CAM in implantology: clinical case report

Os pilares personalizados são usados em reabilitações protéticas sobre implantes quando há exigências de angulação, perfil de emergência e margem gengival, em que os pilares convencionais não conseguem reabilitar de forma correta os conceitos de forma, função e estética. Através de um relato de caso clínico, onde houve a reabilitação dos elementos 21 e 22, com o uso de implante e próteses, usando o pilar personalizado em zircônia sobre o implante do 22, confeccionado com a tecnologia CAD/CAM. Esse sistema de pilares personalizados oferecem o desenho mais próximo do ideal e o ajuste mais perfeito em relação ao implante e ao tecido gengival, além de considerar as vantagens e desvantagen em relação aos pilares convencionais pré-fabricados nas questões de tempo de tratamento, custos e resultado estético e biológico. Concluimos que a reabilitação com pilares personalizados CAD/CAM confere uma excelente alternativa reabilitadora, devolvendo função e estética aos pacientes, desde que haja conhecimento adequado por parte dos profissionais envolvidos(AU)

Custom abutments are used in prosthetic rehabilitation on implants when angulation, emergence profile and gingival margin are used, where abutments are not recovered in a correct way to rehabilitate the concepts of shape, functions and aesthetics. Through a clinical case, where the elements 21 and 22 were rehabilitated, with the use of implants and practices, using the personalized abutments in zirconia, made with CAD / CAM technology. This customized system and abutments offers the closest ideal design and the most perfect fit in relation to the implant and gingival tissue, in addition to considering advantages and disadvantages in relation to the prefabricated applied abutments in terms of treatment time, costs and results aesthetic and biological. Conclude that a rehabilitation with customized CAD / CAM abutments provides an excellent rehabilitation alternative, returning function and aesthetics to patients, as long as there is adequate knowledge for part of the professionals involved(AU)

Avaliação de ph externo utilizando diferentes soluções irrigantes e medicações intracanais / External ph evaluation using different irrigation solutions and intracanal medications

O objetivo do presente estudo foi mensurar o pH externo radicular de dentes bovinos que foram desinfetados em solução de cloramina por 7 dias. Neste estudo foram utilizadas soluções irrigadoras, hipoclorito de sódio 1%, clorexidina 0,12% e hipoclorito de sódio 2,5% associadas ao edta e as medicações intracanais, hidróxido de cálcio, hidróxido de cálcio com PMCC e clorexidina gel 2%. O preparo químico mecânico foi realizado com as limas easy logic e as soluções foram agitadas com ultrassom durante 3 minutos e após os dentes foram imersos em água deionizada em eppendorfs estéreis e mantidos em estufa a 37°C. O pH externo foi analisado utilizando as fitas medidoras de pH no período de 24 horas, 48 horas, 7 dias, 10 dias e 15 dias. A normalidade dos valores obtidos de cada ensaio foi testada através do teste Kolmogorof- Smirnov, e o teste estatístico foi ANOVA de uma via e comparações múltiplas de Tukey. Os resultados mostraram que houve diferença estatística nos valores de pH nos grupos avaliados dentro dos tempos (p< 0,05). Concluiu-se que mesmo com as variações de pH nos períodos avaliados, as medicações e as soluções irrigantes podem ser utilizadas de forma associadas na endodontia, com o intuito de eliminar o maior número de microrganismos dos canais radiculares(AU)

The objective of the present study was to measure the external root pH of bovine teeth that were disinfected in chloramine solution for 7 days. Irrigating solutions, 1% sodium hypochlorite, 0.12% chlorhexidine and 2.5% sodium hypochlorite associated with edta and intracanal medications, calcium hydroxide, calcium hydroxide with PMCC and chlorhexidine gel 2%. The mechanical chemical preparation was performed with the easy logic files and the solutions were shaken with ultrasound for 3 minutes and after the teeth were immersed in deionized water in eppendorfs and kept in an oven at 37 ° C. The external pH was analyzed using the pH measuring tapes in the period of 24 hours, 48 hours, 7 days, 10 days and 15 days. The normal values obtained from each test were tested using the Kolmogorof-Smirnov test, and the statistical test was one-way ANOVA and Tukey's multiple comparisons. The results showed that there was a statistical difference in pH values in the groups evaluated within the times (p< 0.05). It was concluded that even with pH variations in the evaluated periods, medications and irrigating solutions can be used in an associated way in endodontics, in order to eliminate the largest number of microorganisms in the root canals(AU)

Four-year clinical prospective follow-up of resin composite restoration after selective caries removal using Er:YAG laser.

OBJECTIVES: The aim of this study was to longitudinally evaluate, after a 4-year period, the clinical longevity of composite resin restoration compared to the baseline, after selective caries removal in permanent molars using Er:YAG laser or bur preparation with biomodification of dentin with the use of chlorhexidine. METHODS: Selective caries removal was performed on 80 teeth of 20 individuals who each had at least four active carious lesions. These lesions, located on occlusal surfaces of permanent molar counterparts, were removed using (i) Er:YAG laser biomodified with chlorhexidine, (ii) Er:YAG laser and application of deionized water, (iii) bur preparation biomodified with chlorhexidine, and (iv) bur preparation and application of deionized water. At the end of 4 years, 64 of the 80 restorations were evaluated in 16 individuals (n = 16). The restorations were evaluated, both clinically and photographically, using scanning electron microscopy (SEM) and pulp vitality analysis. The experimental data were statistically evaluated by kappa, Fisher's, and chi-square tests, with a significance level of 5%. The Kaplan-Meier test and the Cox regression analysis were used to evaluate the survival of the restorations. RESULTS: After 4 years of follow-up, there was a statistically significant difference in marginal discoloration criteria for all of the groups evaluated. For marginal adaptation criteria, there was a statistically significant difference for the Er:YAG laser group biomodified with chlorhexine (p = 0.050). For clinical and radiographic evaluation of pulp vitality, there were no statistically significant differences among the groups (p = 0.806). CONCLUSION: Er:YAG laser can be used for selective caries removal, regardless of dentin biomodification with chlorhexidine or application of deionized water, once it produced promising results in composite resin restorations after 4 years of follow-up, according to the criteria evaluated. The selective caries removal using Er:YAG laser or bur and the biomodification of dentin with the use of chlorhexidine did not influence the survival of composite resin restorations after the 4-year follow-up period. CLINICAL RELEVANCE: Composite resin restorations applied after selective caries removal using Er:YAG laser or burs, regardless of dentin biomodification with the use of chlorhexidine or application of deionized water, showed adequate clinical behavior after 4 years of follow-up.

Effects of a potentially erosive antiasthmatic medicine on the enamel and dentin of primary teeth: An in situ study.

This study evaluates, in situ, the effect of an anti-asthmatic medicine on the enamel and dentin of primary teeth. Twenty-eight specimens of enamel and dentin were prepared, selected, sterilized, and stored. Microhardness, microscopic morphology, and initial surface roughness were evaluated. Fourteen volunteers wore palatal devices containing two dentin specimens and two enamel specimens. Volunteers underwent surface treatment three times a day for 5 days, with the dripping of 5 ml of salbutamol sulfate for 1 min, only on specimens from one side of the device. At the end of the experiment the microscopic morphology, roughness, surface loss, and microhardness were ascertained. For enamel surfaces exposed to the medicine, erosion was observed in the microscopy images, along with a significant increase in roughness (p = .0325) and tissue loss (p = .03251) and a significant decrease in microhardness (p = .0325). For the dentin surfaces, erosion was observed in the microscopy images, but there was no significant increase in roughness (p = .593) or tissue loss (p = .285) nor any decrease in microhardness (p = .1088). In conclusion, the salbutamol sulfate had an in situ erosive effect on primary teeth enamel and this effect was observed morphologically on primary dentin. RESEARCH HIGHLIGHTS: Asthma is considered a global health problem, and its prevalence has increased in many countries, especially among children, as well as dental erosion. This study has clinical relevance because provides data on the erosive effect of a commonly prescribed anti asthmatic drug on deciduous teeth.

Clinical evaluation of composite restorations in Er:YAG laser-prepared cavities re-wetting with chlorhexidine.

OBJECTIVES: The objective of this study was to evaluate longitudinally the composite restorations, performed in cavities prepared by Er:YAG or conventional bur, and dentin re-wetting with water or chlorhexidine. MATERIALS AND METHODS: Twenty individuals with four active caries with cavitation reaching the dentin located on the occlusal surface of molars counterparts are selected. The teeth of each individual were randomly assigned into four groups: (I) Er:YAG laser (260 mJ/4 Hz) re-wetting with chlorhexidine, (II) Er:YAG laser (260 mJ/4 Hz) re-wetting with deionized water, (III) conventional method re-wetting with chlorhexidine, and (IV) conventional method re-wetting with deionized water. The teeth were isolated, prepared cavities, phosphoric acid etching, and re-wetting according to previously assigned method. Restoration was performed employing the Single Bond 2 and Z350XT resin. Clinical follow-up was held after the polishing of the restoration (baseline) and 6 and 12 months of the making of the restoration using the modified USPHS criteria. The restorations were qualitatively analyzed by means of photographs. In the evaluation period, replicas of the restorations were analyzed by SEM. Data were analyzed by statistics using chi-square test (p < 0.05). RESULTS: After 12 months of clinical evaluation, groups prepared with laser and re-wetting with chlorhexidine and water showed the lowest marginal staining value. There was no statistical difference between the groups for other factors. SEM analysis revealed that a non-expressive amount of restorations showed gaps and irregularities of tooth-restoration interface after 6 and 12 months compared to the baseline. CONCLUSION: The restorations performed in laser-prepared cavities, regardless of the re-wetting, presented the best clinical performance over the evaluated period. CLINICAL RELEVANCE: Laser-prepared teeth, regardless of re-wetting, showed greater resistance to marginal discoloration.

Effect of Metalloproteinase Inhibitors on the Microtensile Bond Strength of Composite Resin to Er:YAG Laser-Irradiated Dentin.

This study evaluated the effect of matrix metalloproteinase (MMP) inhibitors - 2% (CHX) and sodium fluoride (NaF) (5000 ppm) - on microtensile bond strength (µTBS) of composite resin to Er:YAG laser-irradiated dentin after chemical degradation of the bond interface. The occlusal surface of forty sound human molars was removed exposing the dentin surface (n=10), which was polished, irradiated with Er:YAG laser, acid etched and dried. Twenty specimens were rewetted with 2% CHX (control group) and 20 were rewetted with NaF (5000 ppm). The adhesive system was applied and a 4-mm-high plateau of light-cured composite resin was built up. Resin-dentin sticks were obtained with a rectangular cross-sectional area (0.8-1 mm2) and were either stored in water at 37 ?#61616;C for 24 h or submitted to chemical degradation. For chemical degradation, they were immersed in 10% NaOCl aqueous solution for 5 h and rinsed in water for 1 h. The sticks were submitted to microtensile test in a mechanical testing machine at 0.5 mm/min until failure. Fracture pattern was analyzed using SEM. µTBS values were calculated in MPa and submitted to analysis of variance ANOVA (α=0.05). The variance analysis showed that the 'MMP inhibitor' and 'degradation' factors (p=0.214 and p=0.093, respectively) and interaction between the factors were not statistically significant (p=0.143). Mixed failure predominated in all groups. In conclusion, the 2% CHX and NaF 5000 ppm presented similar µTBS of composite resin to laser-irradiated dentin before and after chemical degradation.

Estudo comparativo entre a produção de fosfolipases extracelulares e proteinases do gênero Candida isoladas a partir de infecções de cavidade oral / Comparative study between extracellular phospholipase and proteinase production in clinically important of the genus Candida isolated in oral candidiasis patients

Introdução: A habilidade da Candida spp. em produzir enzimas proteolíticas, tais como fosfolipase e proteinases, tem um papel importante na patogenicidade destas leveduras. Objetivo: Determinar as espécies causadoras das infecções orais por Candida spp., além de investigar a atividade in vitro das fosfolipases e proteinases em isolados clínicos do gênero Candida, provenientes de pacientes com candidíase oral. Material e método: Isolados de Candida spp., pertencentes à Coleção de Cultivos Fúngicos do Laboratório de Microbiologia e Patologia Oral do Departamento de Odontologia da Faculdade da Serra Gaúcha, foram analisados. Produção de fosfolipases foi analisada utilizando-se Ágar gema de ovo. Liberação de proteinases foi medida utilizando-se extrato de levedura adicionado à albumina bovina. Resultado: Um total de 35 isolados clínicos do gênero Candida foi testado. C. albicans foi a espécie predominante (77%). Os demais isolados identificados foram: C. parapsilosis (20%) e C. tropicalis (2%). Ao comparar a atividade de fosfolipase do grupo C. albicans com o grupo Candida não-albicans, foi encontrada diferença significativa (P=0,04). Não foi encontrada diferença significativa entre a C. albicans e a C. não-albicans, para a produção de proteinase. A liberação de proteinase foi significativamente maior quando comparada à produção de fosfolipase para o gênero Candida (P=0,04). Diferença estatisticamente significativa foi encontrada quando a atividade de fosfolipase e proteinase da C. albicans foi comparada à atividade das espécies de C. não-albicans (P=0,02). Conclusão: Diferentes quantificações de fosfolipase extracelular e atividade de proteinase têm sido atribuídas aos isolados clínicos de C. albicans quando comparados a outras espécies de Candida.

Introduction: The ability of the genus Candida to produce secretory enzimes such as proteinase and phospholipases to play an important role in the patogenicity of these yeasts. Objective: To determine the Candida species isolates from oral cavity infections and to investigate in vitro phospholipase and protease activities in clinically important of the genus Candida isolated in oral candidiasis patients. Material and method: Candida species isolated of the Fungal Culture Collection of Oral Microbiology and Pathology Testing Service Laboratory of the Dentistry Departament of Faculdade da Serra Gaúcha were evaluated. The phospholipases detection was assayed using the egg yolk agar plate method. Determination of protease production was performed in agar plates containing bovine serum albumine and yeasts extract. Result: A total of 35 isolates of the genus Candida were tested. C. albicans was the species predominant (77% of isolates), followed by C. parapsilosis (20%) and C. tropicalis (2%). When compared the phospholipase activity of the C. albicans group with the non-albicans Candida species types group was observed significant difference among of this groups (P=0.04). No statiscally significant difference between the C.albicans and non-albicans Candida species types when was compared to proteinase production. Proteinase production was higher and statiscally significant when compared to phospholipase activity in the genus Candida isolates (P=0.04). Statiscally significant differences were found between phosphoplipases and proteases activity for C. albicans when compared to non-albicans Candida species types (P=0.02). Conclusion: Differences in the secretion rates of phospholipase extracellular and proteases activity have been attributed to clinical strains of C. albicans when compared to others Candida species types.

Effect of Metalloproteinase Inhibitors on the Microtensile Bond Strength of Composite Resin to Er: YAG Laser-Irradiated Dentin

Abstract This study evaluated the effect of matrix metalloproteinase (MMP) inhibitors - 2% (CHX) and sodium fluoride (NaF) (5000 ppm) - on microtensile bond strength (μTBS) of composite resin to Er:YAG laser-irradiated dentin after chemical degradation of the bond interface. The occlusal surface of forty sound human molars was removed exposing the dentin surface (n=10), which was polished, irradiated with Er:YAG laser, acid etched and dried. Twenty specimens were rewetted with 2% CHX (control group) and 20 were rewetted with NaF (5000 ppm). The adhesive system was applied and a 4-mm-high plateau of light-cured composite resin was built up. Resin-dentin sticks were obtained with a rectangular cross-sectional area (0.8-1 mm2) and were either stored in water at 37 ?#61616;C for 24 h or submitted to chemical degradation. For chemical degradation, they were immersed in 10% NaOCl aqueous solution for 5 h and rinsed in water for 1 h. The sticks were submitted to microtensile test in a mechanical testing machine at 0.5 mm/min until failure. Fracture pattern was analyzed using SEM. μTBS values were calculated in MPa and submitted to analysis of variance ANOVA (α=0.05). The variance analysis showed that the 'MMP inhibitor' and 'degradation' factors (p=0.214 and p=0.093, respectively) and interaction between the factors were not statistically significant (p=0.143). Mixed failure predominated in all groups. In conclusion, the 2% CHX and NaF 5000 ppm presented similar μTBS of composite resin to laser-irradiated dentin before and after chemical degradation.

Resumo Este estudo avaliou o efeito dos inibidores de metaloproteinase, clorexidina 2% e fluoreto de sódio (5000 ppm), na resistência de união entre a dentina irradiada por laser Er:YAG e a resina composta após a degradação química da interface de união. A superfície oclusal de quarenta molares humanos hígidos (n=10) foi removida expondo uma superfície de dentina, que foi polida, irradiada com laser Er:YAG, condicionada com ácido e seca. Vinte espécimes foram re-umedecidos com clorexidina 2% (Grupo controle) e 20 com fluoreto de sódio (5000 ppm). O sistema adesivo foi aplicado e um platô de resina composta fotopolimerizável de 4 mm de altura foi construído. Palitos de resina-dentina foram obtidos com secção transversal retangular (0,8-1 mm2). Eles foram armazenados em água (24 h a 37 ?#61616;C) ou submetidos a degradação química. Para a degradação química, foram imersos em solução aquosa de hipoclorito de sódio a 10% durante 5 horas e lavados em água durante 1 h. Os palitos foram submetidos ao teste de microtração em uma máquina de ensaios mecânicos a 0,5 mm/min até a fratura. O padrão de fratura foi analisado em MEV. Os valores de resistência de união foram calculados em MPa e submetidos à análise de variância ANOVA (α=0,05). A análise de variância mostrou que os fatores inibidor de metaloproteinases e degradação (p=0,214 e p=0,093, respectivamente), e a interação entre os fatores não foram estatisticamente significantes (p=0,143). A predominância de falha mista foi detectada para todos os grupos. Em conclusão, a clorexidina a 2% e fluoreto de sódio (ppm 5000) apresentaram resistência de união entre dentina irradiada e resina composta semelhante antes e após a degradação química.

Análise do desvio apical promovido por três tipos de sistemas endodônticos: manual, rotatório e reciprocante / Analysis of apical deviation promoted by three endodontic systems: manual, rotary and reciprocating

INTRODUÇÃO: o presente estudo teve como objetivo analisar a ocorrência de desvio apical após o preparo com três tipos de sistemas endodônticos (manual, rotatório e reciprocante). MÉTODOS: foram utilizados 30 canais simulados com 16mm de comprimento e com curvatura de 35 graus. Os canais foram divididos em três grupos — manual, rotatório e reciprocante. Os canais do grupo manual foram preparados usando-se a técnica crown-down, o instrumento memória foi o #30 de aço inoxidável. Nos grupos rotatório e reciprocante, os canais foram instrumentados com sistemas rotatório e reciprocante, respectivamente (WizardNavigator® e Unicone®), acionados por um motor elétrico. Para realização da análise do desvio, antes e após o preparo, os canais foram preenchidos com tinta nanquim e fotografados de forma padronizada em uma plataforma. As imagens obtidas foram manipuladas no software Adobe Photoshop®, sobrepondo-se as imagens pré- e pós-operatória e, com a ferramenta régua, foi realizada a medição dos desvios a 1 e 3mm do comprimento de trabalho (CT). Os dados obtidos foram submetidos à Análise de Variância (ANOVA), seguida do teste de Tukey, com nível de significância de 5%.RESULTADOS: a ocorrência de desvios apicais no grupo manual foi significativamente maior, quando comparado aos demais grupos. Nos três grupos, a média de desvio a 1mm do CT foi significativamente maior que a 3mm do CT. CONCLUSÃO: a técnica manual promoveu maior quantidade de desvio apical, quando comparada com os sistemas rotatório e reciprocante. Elevado número de desvios foi observado a 1mm do CT.

Calcium hypochlorite as a dentin deproteinization agent: Microleakage, scanning electron microscopy and elemental analysis.

PURPOSE: This study investigated the influence of collagen removal with calcium hypochlorite on the surface morphology of acid-etched dentin and on the microleakage of composite restorations. In addition, the elemental composition (EC) of dentin after removal of the collagen fibrils was analyzed. MATERIALS AND METHODS: Forty third molars received two cavities and were divided into four groups according to dentin treatment: CTRL-no pre-treatment; Na10-10% NaOCl for 30 s; Ca10-10% CaOCl for 30 s, and Ca15-15% CaOCl for 30 s. The cavities were filled using an acetone-based adhesive system and a resin composite; they were then subjected to thermal cycling for 5,000 cycles, immersed in methylene blue for 4 h and sectioned into 1-mm thick slabs. Two examiners evaluated two slices per tooth using a stereomicroscope and assigned the degree of infiltration (scores 0-3). The data were analyzed using the Kruskal-Wallis (α = 0.05). Four teeth received surface treatment according to the groups and were submitted to SEM and EDS to carry at the EC. RESULTS: There was no significant difference between the experimental groups (P = 0.533). CaOCl alters the morphology and surface composition of the dentin, resulting in an increase in the amount of calcium in the interface. CONCLUSIONS: When used prior to an acetone-based adhesive system, CaOCl did not produce any differences in microleakage when compared to the CTRL group or to the Na10 group.

Hardness and modulus of elasticity of primary and permanent teeth after wear against different dental materials.

OBJECTIVES: The purpose of this study was to determine the Young's modulus and the hardness of deciduous and permanent teeth following wear challenges using different dental materials. MATERIALS AND METHODS: Wear challenges were performed against four dental materials: A resin-based fissure sealant (Fluoroshield(®)), a glass ionomer based fissure sealant (Vitremer(®)), and two microhybrid composite resins (Filtek Z250 and P90(®)). Using the pin-on-plate design, a deciduous or a permanent tooth was made into a pin (4 mm × 4 mm × 2 mm) working at a 3 N vertical load, 1 Hz frequency, and 900 cycles (15 min) with Fusayama artificial saliva as a lubricant. Before and after the tribological tests, the hardness and elasticity modulus of the tooth samples were measured by creating a nanoindentation at load forces up to 50 mN and 150 mN. All of the results were statistically analyzed using ANOVA and post-hoc Duncan's tests (P < 0.05). RESULTS: No difference in hardness was encountered between deciduous and permanent teeth (P < 0.05) or modulus of elasticity (P < 0.05) before or after the wear challenges for all of the dental materials tested. CONCLUSIONS: Wear challenges against the studied dental materials did not alter the properties of permanent or deciduous teeth after the application of a 3 N load.

In vitro erosive effect of pediatric medicines on deciduous tooth enamel.

This study evaluated, in vitro, the erosive potential of pediatric liquid medicines in primary tooth enamel, depending on the exposure time. Sixty deciduous incisors were randomly assigned to 4 groups (n=15), according to the immersion solutions: guaifenesin; ferrous sulfate; salbutamol sulfate and artificial saliva. The immersion cycles in the medicines were undertaken under a 1-min agitation, which wasperformed three times daily, during 28 days. Surface microhardness was measured at 7,14, 21 and 28 days. The titratable acidity and buffering capacity of the immersion media were determined. Data were analyzed by Analysis of Variance and Tukey's test (α=0.05). Salbutamol sulfate caused a gradual loss in enamel microhardness deciduous, observed at all times (p<0.005). Exposure to guaifenesin or ferrous sulfate resulted in significant decrease of enamel microhardness only after 28 days (p<0.005). In the control group (artificial saliva), microhardness did not changed (p>0.005) at any of the studied times. Scanning Electron Microscopy (SEM) images revealed that after 28 days the surfaces clearly exhibited structural loss, which was unlike those immersed in artificial saliva. Erosion of deciduous enamel was dependent on the type of medicine and exposure time.

In Vitro Erosive Effect of Pediatric Medicines on Deciduous Tooth Enamel

This study evaluated, in vitro, the erosive potential of pediatric liquid medicines in primary tooth enamel, depending on the exposure time. Sixty deciduous incisors were randomly assigned to 4 groups (n=15), according to the immersion solutions: guaifenesin; ferrous sulfate; salbutamol sulfate and artificial saliva. The immersion cycles in the medicines were undertaken under a 1-min agitation, which wasperformed three times daily, during 28 days. Surface microhardness was measured at 7,14, 21 and 28 days. The titratable acidity and buffering capacity of the immersion media were determined. Data were analyzed by Analysis of Variance and Tukey's test (α=0.05). Salbutamol sulfate caused a gradual loss in enamel microhardness deciduous, observed at all times (p<0.005). Exposure to guaifenesin or ferrous sulfate resulted in significant decrease of enamel microhardness only after 28 days (p<0.005). In the control group (artificial saliva), microhardness did not changed (p>0.005) at any of the studied times. Scanning Electron Microscopy (SEM) images revealed that after 28 days the surfaces clearly exhibited structural loss, which was unlike those immersed in artificial saliva. Erosion of deciduous enamel was dependent on the type of medicine and exposure time.

Este estudo avaliou, in vitro, o potencial erosivo de medicamentos líquidos pediátricos em esmalte de dentes decíduos, em função do tempo de exposição. Sessenta incisivos decíduos foram divididos aleatoriamente em 4 grupos (n=15), de acordo com a solução de imersão: guaifenesina, sulfato ferroso, sulfato de salbutamol e saliva artificial. Os ciclos de imersão nos medicamentos foram realizados sob agitação por 1 min, três vezes ao dia, durante 28 dias. As medidas de microdureza superficial foram realizadas após 7, 14, 21 e 28 dias. A acidez titulável e capacidade tampão dos meios de imersão foram determinadas. Os dados foram submetidos à Análise de Variância e teste de Tukey (α=0,05). O sulfato de salbutamol causou uma perda gradual na microdureza do esmalte decíduo, em todos os tempos verificados (p<0,005). A exposição à guaifenesina ou ao sulfato ferroso levou à diminuição significante da microdureza do esmalte, apenas após 28 dias (p<0,005). No grupo controle (saliva artificial) não houve alteração (p>0,005) da microdureza em nenhum dos tempos estudados. As imagens de microscopia eletrônica de varredura (MEV) revelaram que após 28 dias, as superfícies expostas aos medicamentos apresentaram perda estrutural, diferindo dos que foram imersos em saliva artificial. A erosão do esmalte decíduo foi dependente do tipo de medicamento e do tempo de exposição.

Long-term chlorhexidine effect on bond strength to Er:YAG laser irradiated-dentin.

This study evaluates the bond strength of dentin prepared with Er:YAG laser or bur, after rewetting with chlorhexidine on long-term artificial saliva storage and thermocycling. One hundred and twenty human third molars were sectioned in order to expose the dentin surface (n = 10). The specimens were randomly divided in 12 groups according to treatment and aging: Er:YAG laser rewetting with deionized water (LW) and 24 h storage in artificial saliva (WC); LW and 6 months of artificial saliva storage + 12.000 thermocycling (6M), LW and 12 months of artificial saliva storage + 24.000 thermocycling (12M), Er:YAG laser rewetting with 2% chlorhexidine (LC) and WC, LC and 6M, LC and 12M, bur on high-speed turbine rewetting with deionized water (TW) and WC, TW6M, TW12M, bur on high-speed turbine + 2% chlorhexidine (TC) and WC, TC and 6M, TC and 12M. The specimens were etched with 35% phosphoric acid, washed, and dried with air. Single Bond 2 adhesive was applied and the samples were restored with a composite. Each tooth was sectioned in order to obtain 4 sticks, which were submitted to microtensile bond strength test (µTBS). The two-way ANOVA, showed no significant differences for the interaction between the factors and for the aging factor. Tukey 5% showed that the LC group had the lowest µTBS. The rewetting with chlorhexidine negatively influenced the bond strength of the preparation with the Er:YAG laser. The artificial saliva aging and thermocycling did not interfere with dentin bond strength.

Effect of endodontic irrigants on microtensile bond strength to dentin after thermocycling and long-term water storage.

OBJECTIVE: The bond strength of adhesives in irrigated dentin behaves differently over time. The aim of this study was to evaluate the influence of long-term water storage and thermocycling on the microtensile bond strength of adhesive systems to dentin irrigated with endodontic solutions. MATERIALS AND METHODS: Sixty human molars were used after removal of the occlusal portion and exposure of the dentin by grinding. The specimens were irrigated with 2.5% NaOCl for 30 minutes and then 17% EDTA for 5 minutes and assigned to six groups according to the adhesive system (n=10): G1 and G2-Clearfil SE Bond; G3 and G4-Single Bond 2; and G5 and G6-XP Bond. The teeth were restored with composite and were subjected to water storage for different time periods. G1, G3 and G5 were stored for 24 h; G2, G4 and G6 were stored for 6 months and were subjected to thermocycling (12,000 cycles, 5°C to 55°C, 500 cycles per week for 6 months). After storage, the tooth/restoration assembly was sectioned to obtain four sticks of approximately 1 mm(2), for microtensile bond strength testing. The results were analyzed by two-way ANOVA and Tukey's test. RESULTS: Significant differences were observed among the adhesives (p<0.01). No significant differences were observed in the microtensile bond strength between samples after 24 hours of storage without thermocycling and after 6-month storage with 12,000 cycles (p<0.05). CONCLUSION: The bond strengths of G5 and G6 after irrigation with 2.5% NaOCl and 17% EDTA were significantly different from those of other groups. Long-term water storage/thermocycling had no effect on bond strength to dentin.

Influência da potência de luz de refletores odontológicos na polimerização precoce de compósitos / Dental light potency influence on the precocious polymerization of composites

O objetivo deste trabalho é avaliar a influência de diferentes potências dos refletores de luzaplicadas no campo operatório e sua relação com a polimerização precoce de resinas compostas em diversas opacidades, empregando-se iluminadores com tecnologia LED e com luz halógena. Para a confecção dos corpos de prova foram utilizadas as resinas compostas nanohíbrida Esthet X HD (Dentsply, Caulk - Milford, DE). nas tonalidades de cor A20; A2 e YE apresentados em corpos de prova 5mm de diâmetro e 1 mm de espessura. Os corpos de prova foram então expostos aos refletores LED (Gnatus Equipamentos Médico-Odontológicos Ltda/SP - Brasil) e Halógeno (Gnatus Equipamentos Médico-Odontológicos Ltda/SP - Brasil) durante 2 minutos, para cada tipo de lâmpada (LED e Halógena) e nas potências de luz (15.000 e 35.000 lux). A análise do grau de conversão dos monômeros em polímeros foi obtida com o uso de um espectrofotômetro (FTIR640, Varian) por meio de espectroscopia de infravermelho. A Análise de Variância (Anova Two Way) revelou diferenças estatisticamente significantes para as duas potências de luz avaliadas (p<0.001). Comparações pareadas foram realizadas através da aplicação dos testes Tukey, revelando diferenças nas potências testadas para cada opacidade de resina. Conclui-se baseado nos resultados encontrados que existe uma relação de dependência na densidade da potenciade luz empregada nos refletores de iluminação da cavidade bucal durante os procedimentos clínicos que se reflete no grau de conversão de compostos fotoativados.

The goal of this study was to evaluate the influence of different light potencies irradiated on the dentistry operative field and its relation with the precocious polymerization of composite resin in various opacities, employing LED and Halogen Dentallights. Specimens were prepared using nanohíbrid composites HD Esthet X (Dentsply Caulk - Milford, DE), in shades A20, A2 and YE submitted in samples 1 mm thick and 5 mm in diameter then exposed to LEDs (Gnatus Medical Dental Equipment Ltd I SP - Brazil) and Halogen Dental Light (Gnatus Medical Dental Equipment Ltd I SP - Brazil) irradiated for 2 min, for each type of lamp (LED and Halogen) and power light of 15.000 and 35.000 lux. The conversion degree of monomers into polymers was obtained by means of infrared spectroscopy (FTIR). Analysis ofVariance (ANOVA-Two way) revealed significant differences for the different powers of tested light (p <0.001). Pairwise comparisons were performed using the Tukey tests, revealing statistically significant differences for the different tested light potencies for each resin opacity. So, based on obtained results it can be stated that there is a dependency relation of light potency density used in illuminationof thé oral cavity during the clinical procedures which is reflected in the degree conversion of photo activated compounds.

Effect of potential remineralizing agents on acid softened enamel.

PURPOSE: To assess whether pastes containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and calcium sodium phosphosilicate (CSP) protect acid softened enamel against further erosive episodes. METHODS: Enamel slabs of bovine teeth with preformed erosion-like lesions were randomly assigned to five treatment groups (n = 15): A) CPP-ACP (MI Paste, GC America); B) CPP-ACP+Fluoride (CPP-ACP+F, MI Plus Paste, GC America); C) CSP (Tooth Revitalizing Paste, Oravive); D) fluoridated dentifrice (FD, Sensodyne Cool Gel, GSK); E) control (CO, unexposed to any product). Paste treatments (1:3 slurry in deionized water or undiluted product in the case of the CPP-ACP formulae) were performed between five cycles of alternating erosive challenge (0.3% citric acid, pH = 3.2) and remineralization in artificial saliva. Specimens were analyzed by Knoop surface microhardness (SMH). RESULTS: ANOVA indicated a significant (P< 0.0001) difference among the SMH values attained by acid softened enamel following the exposure to the pastes interspersed with erosion-remineralization cycles. Tukey's test ascertained that SMH values observed for the CPP-ACP+F and CSP groups did not differ from that of FD group, which were significantly higher than that found for the CO group. Specimens treated with CPP-ACP did not differ from any of the other groups.

Tratamento de recessões gengivais múltiplas e lesões cervicais não cariosas através de técnica cirúrgica associada a restaurações com cimento de ionômero de vidro / Treatment of multiple gingival recessions and non-carious cervical lesions by surgical technique associated to restorations with glass ionomer cement

A integração entre diferentes especialidades é, hoje, uma tendência no consultório odontológico e tratamentos onde se associam a Periodontia e Dentística têm ganhado espaço. Em Odontologia, é um consenso que a estética não remete apenas à cor e forma dos elementos dentários. A chamada estética vermelha é também uma exigência colocada pelos pacientes quanto à sua expectativa do resultado do tratamento, principalmente quando são encontradas situações de recessão gengival. Esse trabalho visa ilustrar um tratamento integrado relacionando as possibilidades de recobrimento radicular na presença de lesões cervicais não cariosas, por meio de cirurgia periodontal associada a restaurações com cimento de ionômero de vidro.