Influence of different adhesion strategies on glass fiber post retention.

Background: Failures in glass fiber post (GFP) retention may be associated with low adhesion achieved in root dentin. Material and Methods: 55 single-rooted premolars were endodontically treated and distributed according to different adhesion strategies (n=11): G1: RelyX ARC (3M ESPE; etch-rinse strategy); G2: Relyx Ultimate (3M ESPE; etch-rinse strategy); G3: AllCem (FGM; etch-rinse strategy); G4: Relyx Ultimate (3M ESPE; self-etching strategy); G5: RelyX U200 (3M ESPE; self-adhesive strategy). For Bonding Strength (BS) analysis, the roots were sectioned in slices (1.0mm thickness) corresponding to each root third and submitted to push-out test. The type of failure was assessed by scanning electron microscopy (SEM). Results: The highest BS averages were found in G2 and G3. However, in the middle and apical root thirds, G3 showed statistically similar results to G4 and G5. In the cervical and middle third, G1 was statistically similar to G4 and G5. The mixed type of failure was the most common in all groups. Conclusions: Self-etching (G4) and self-adhesive resin (G5) cements, showed similar BS results of immediate bonding in the cementation of GFP compared to conventional resin cements (G1, G2, G3). Key words:Dental Cements, Dentin-Bonding Agents, Post and Core Technique, Dental Bonding.

Conservative smile enhancement: a case report and brief review on multidisciplinary approach in aesthetic dentistry / Tratamento conservador de sorriso: um relato de caso e breve revisão sobre abordagem multidiscplinar na odontologia estética

ABSTRACT The gingival contour, the color of the teeth and the presence of interincisal diastema are seen as unsightly factors, being highly harmful from a social point of view. The present study aimed to report a comprehensive and conservative esthetic treatment executed with a multidisciplinary approach in a 20-year-old female patient that presented darkened teeth with poor spacing and excessive gingival display while smiling, as well as present a brief literature review on multidisciplinary approach in esthetic dentistry. After clinical examination and diagnosis, a treatment plan was elaborated to meet the patient's expectations with a conservative approach. After patient consent, therapy began with supervised home-based tooth whitening with 22% carbamide peroxide applied one hour/daily for 14 days, followed with gingival recontouring surgery and, after a healing period of 30 days, diastemas closure with direct composite resin technique, occlusal adjustment, finishing, and polishing. The multidisciplinary approach was fundamental for the accomplishment of the proposed treatment, achieving satisfactory esthetic and functional results.

RESUMO O contorno gengival, a cor dos dentes e a presença de diastemas interincisivos são vistos como fatores antiestéticos, sendo altamente prejudicial do ponto de vista social. O presente estudo teve como objetivo relatar um tratamento estético conservador executado com abordagem multidisciplinar em uma paciente do sexo feminino de 20 anos que apresentava dentes escurecidos com pouco espaçamento e exposição gengival excessiva ao sorrir, bem como apresentar uma breve revisão de literatura sobre à abordagem multidisciplinar em odontologia estética. Após exame clínico e diagnóstico, foi elaborado um plano de tratamento para atender as expectativas do paciente com abordagem conservadora. Após consentimento do paciente, foi iniciada o clareamento dental supervisionado com peróxido de carbamida 22% aplicado uma hora/dia por 14 dias, seguido de cirurgia de recontorno gengival e, após um período de cicatrização de 30 dias, fechamento de diastemas com técnica de resina composta direta. Neste caso, a abordagem multidisciplinar foi fundamental para a realização do tratamento proposto, alcançando resultados estéticos e funcionais satisfatórios.

Impact of socioeconomic vulnerability on Covid-19 outcomes and social distancing in Brazil / Impacto da vulnerabilidade socioeconômica nos resultados da Covid-19 e no distanciamento social no Brasil / Impacto de la vulnerabilidad socioeconómica en los resultados del Covid-19 y el distanciamiento social en Brasil

Due to the persistently high cases and deaths, Brazil became one of the worst countries affected by the COVID-19 pandemic. Understanding the possible health inequities is essential, given the population's diversity and the country's fragile socioeco- nomic situation. Thus, this study aimed to assess the impact and correlation of socioeco- nomic vulnerability on COVID-19 outcomes and social distancing in Brazil. The Gini Coefficient (GC), the Social Vulnerability Index (SVI), epidemiological data on the CO- VID-19 epidemic in Brazil, and the Social Distancing Index (SDI) were retrieved from online databases and assessed for each Brazilian state. Data was statistically analyzed through non-parametric tests and multiple linear regressions. The mean values for the GC and SVI were 0.495 and 0.261, respectively. A positive statistically significant correlation was found between the socioeconomic indicators and the three variables related to the COVID-19 outbreak. States with very low social vulnerability presented fewer deaths per 100 thousand inhabitants due to COVID-19 than states with moderate social vulnerability. SVI was a predictor of accumulated cases, confirmed deaths, and social distancing. The COVID-19 outcomes and SDI in Brazilian states are correlated to socioeconomic condi- tions. The pandemic impacts are more severe on less favored communities.

Devido ao número persistentemente alto de casos e mortes, o Brasil se tornou um dos países mais afetados pela pandemia da COVID-19. Compreender as possíveis desigualdades em saúde é essencial, dada a diversidade da população e a frágil situação socioeconômica do país. Assim, este estudo teve como objetivo avaliar o impacto e a correlação da vulnerabilidade socioeconômica sobre os resultados da COVID-19 e o dis- tanciamento social no Brasil. O Coeficiente de Gini (CG), o Índice de Vulnerabilidade Social (IVS), os dados epidemiológicos sobre a epidemia de COVID-19 no Brasil e o Índice de Distanciamento Social (IDS) foram recuperados de bancos de dados on-line e avaliados para cada estado brasileiro. Os dados foram analisados estatisticamente por meio de testes não paramétricos e regressões lineares múltiplas. Os valores médios para o GC e o SVI foram 0,495 e 0,261, respectivamente. Foi encontrada uma correlação po- sitiva estatisticamente significativa entre os indicadores socioeconômicos e as três variá- veis relacionadas ao surto de COVID-19. Os estados com vulnerabilidade social muito baixa apresentaram menos mortes por 100 mil habitantes devido à COVID-19 do que os estados com vulnerabilidade social moderada. O IVS foi um preditor de casos acumula- dos, mortes confirmadas e distanciamento social. Os resultados da COVID-19 e o SDI nos estados brasileiros estão correlacionados às condições socioeconômicas. Os impactos da pandemia são mais graves nas comunidades menos favorecidas.

Debido a la persistencia de un elevado número de casos y muertes, Brasil se convirtió en uno de los países más afectados por la pandemia de COVID-19. Compren- der las posibles desigualdades sanitarias es esencial, dada la diversidad de la población y la frágil situación socioeconómica del país. Así, este estudio tuvo como objetivo evaluar el impacto y la correlación de la vulnerabilidad socioeconómica en los resultados del CO- VID-19 y el distanciamiento social en Brasil. El Coeficiente de Gini (CG), el Índice de Vulnerabilidad Social (IVS), datos epidemiológicos sobre la epidemia de COVID-19 en Brasil y el Índice de Distanciamiento Social (IDS) fueron recuperados de bases de datos en línea y evaluados para cada estado brasileño. Los datos se analizaron estadísticamente mediante pruebas no paramétricas y regresiones lineales múltiples. Los valores medios del CG y del IVS fueron 0,495 y 0,261, respectivamente. Se encontró una correlación estadísticamente significativa positiva entre los indicadores socioeconómicos y las tres variables relacionadas con el brote de COVID-19. Los estados con vulnerabilidad social muy baja presentaron una mayor vulnerabilidad social. Los estados con muy baja vulne- rabilidad social presentaron menos muertes por cada 100 mil habitantes debidas al CO- VID-19 que los estados con vulnerabilidad social moderada. El IVS fue un predictor de casos acumulados, muertes confirmadas y distanciamiento social. Los resultados de la COVID-19 y el IVS en los estados brasileños están correlacionados con las condiciones socioeconómicas. Los impactos de la pandemia son más severos en las comunidades me- nos favorecidas.

Evaluation of different composite resin finishing and polishing protocols by confocal laser scan microscopy

Aim This study aimed to analyze the influence of finishing and polishing (F/P) protocols on resin surface through roughness (Ra) values and laser scan microscopy observations. Methods Forty-eight (n=48) resin specimens were sorted into four groups (n=12), according to the type of resin used: Filtek Z250 (Z250), Filtek Z350 (Z350), Filtek One Bulk Fill (BF), Filtek P60 (P60). The specimens were sorted into six groups according to the type of F/P system used (n=2/group): Control group, Diamond bur (KG Sorensen), Soflex Pop-On Discs (3M ESPE), Soflex Spiral (3M ESPE), Dura Gloss (American Burs), and Praxis (TDV). Results The highest roughness values (Ra) were attributed to BF group for all F/P systems, except for the Soft-Lex PopOn discs. The Soft-Lex PopOn, Spiral, and Praxis discs presented a better performance for the surface treatment of the tested composite resins. Regardless of the restorative material, the use of diamond bur or single-step abrasive rubber (Dura Gloss) were associated with the highest Ra values. Conclusion The effect of F/P systems on Ra is material-dependent and instrument or system-dependent.

Dental Whitening: Self-Referred Needs versus Professional Indication

Abstract Objective: To analyze the self-reported need of patients compared to professional indications for tooth whitening. Material and Methods: Initially, 58 undergraduate students responded to a form that highlighted the question: "Do you think you need to have your teeth whitened?" Among those who answered positively to the previous question, ten individuals were photographed with their smiles. In addition, they were asked to point out, on the Vita 3D-Master scale, which color they believed their teeth had, a value that was compared to the actual color obtained by a spectrophotometer. Finally, the photographs were presented to dentists, who were asked about the indication or not of the whitening treatment. Results: Most interviewees (63.8%) self-reported the need for whitening, as well as there was a greater incidence of a positive indication among professionals (53.9%). Pearson's Chi-square test revealed a relationship between patient gender and the training course on the desire to have teeth whitened. Among the professionals, the specialty, as well as time since graduation, interfered in the indication for whitening. Conclusion: Professionals and patients share the aesthetic ideal directly related to light teeth; most patients self-perceive the color of their teeth darker than it actually is; the opinion about the color of the teeth has an extremely subjective character and varies greatly from one professional to another (AU).

Oral Health Care of Children and Adolescents with Different Impairments of Cerebral Palsy: Barriers and Challenges

Abstract Objective: To evaluate the barriers to access and oral health care faced by children and adolescents with Cerebral Palsy (CP) according to their motor impairment through the perception of caregivers. Material and Methods: A case series study was carried out at three health institutions in Pernambuco, Brazil. The study sample consisted of 94 caregivers of 5-to-18-year-old patients with CP, according to GMFCS (The Gross Motor Function Classification System). Data were collected using a semi-structured form to evaluate the barriers to access and analyzed statistically by the chi-square and Fisher exact tests, adopting a 5% level of significance. In addition, binary logistic regression was performed to determine the weight of the variables in explaining the outcome variable. Results: There were major difficulties involving transportation (p=0.04) and structural accessibility to dental services (p<0.01) among children and adolescents with severe CP. In addition, the more severe the CP, the greater the difficulty of accessibility (OR=4.09,) and the lower the income (OR=8.80), the greater the motor impairment. Conclusion: Despite the availability of access to dental services, low-income families have more severe CP patients, contributing to the daily difficulties already faced by them in oral health care.

Aspectos clínicos e demográficos de pessoas com deficiência atendidas em uma clínica-escola de Odontologia / Clinical and demographic characteristics of people with disabilities attending a dental teaching clinic

O objetivo deste artigo foi descreveras característicasclínicase demográficasde pessoas com deficiência atendidas em uma clínica-escolade Odontologia do Nordeste brasileiro, relacionando estes perfis àsnecessidades acumuladas e aos tratamentos realizados no período de marçoa julho de 2019. Tratou-se de um estudode análise de banco de dados no qualforam avaliadosos prontuários em relação a sexo, idade, diagnóstico médico, uso de medicamentos, motivo da consulta e tratamentos realizados. Foi utilizada uma amostra deconveniência de 55 prontuários,referentes aos indivíduos em atendimento neste período.Os testes Qui-quadrado e exato de Fisher foram utilizados para verificar associação entre as variáveis estudadas. Foi adotado o intervalo de confiança de 95% e a margem de erro de 5%.Verificou-se queamaioria dos pacientes erado sexo masculino(52,7%)e possuíaentre20 e59 anos(54,5%).As patologias de base de maior prevalênciaforam as doenças sistêmicas (34,5%)e deficiência intelectual (32,7%). Em relação às medicações, 80% faziamuso contínuo de algum fármaco. A respeito das consultas odontológicas, a procurade 60% da amostrafoi por motivo de dor e os procedimentos mais realizados, os restauradores (63,6%).Além disso, a estabilização física e sedação medicamentosa foram amplamente utilizadas nos pacientes com deficiência intelectual.Oatendimento odontológico incluiu pacientes com diversas necessidades especiais e, apesar da clínica-escola em questão priorizar a conduta preventiva, a maior parte dos procedimentos executados foi curativo, podendo estar relacionado com a procura tardia pelo tratamento odontológicoe dificuldades de acesso (AU).

The aim of this article was to describe the clinical and demographic characteristics of people with disabilities attending a dental teaching clinic in northeastern Brazil, and to associate these profiles with the cumulative needs and treatments performed from March to July 2019. This was a database study in which sex, age, medical diagnosis, medication use, reason for consultation, and previous treatments obtained from the medical records were evaluated. A convenience sample of 55 records from patients seen during this period was used. The chi-square test and Fisher's exact test were applied to evaluate the association between the variables studied, adopting a 95% confidence interval and an error margin of 5%. Most patients were male (52.7%) and were between 20 and 59 years old (54.5%). The most prevalent underlying diseases were systemic diseases (34.5%) and intellectual disability (32.7%). Regarding medications, 80% of the patients continuously used some drug. The reason for consultation was pain in 60% of the sample and restorative procedures were the most frequently performed (63.6%). Moreover, patients with intellectual disability commonly required physical restraint and sedatives. The dental consultations comprised patients with different special needs. Although the teaching clinic prioritizes preventive management, most of the procedures performed were curative, a fact that might be related to the late seeking of dental treatment and difficulties of accessing health services (AU).

Evaluation of dental trauma in inmates of the most highly populated Brazilian prison complex.

BACKGROUND/AIM: Due to the increase in incarceration rates, the prison community has attracted much concern in the recent past. Although people in prison are often socially disadvantaged and vulnerable to a range of health problems, there is a lack of information on the oral health conditions of prisoners. Thus, the aim of this study was to survey the oral problems of a sample of the male incarcerated population of Brazil, focusing on dental trauma. MATERIAL AND METHODS: The research was undertaken over a three-month period in 2017. It was a cross-sectional study of 756 prisoners of the Curado Prison Complex, located in Recife, PE. Using a previously calibrated examiner, dental trauma was measured with the Andreasen index. Etiology of dental trauma and socio-demographic data were collected with questions developed for this survey. Standard descriptive statistics were used to report frequency estimates. The chi-square test, Fisher's exact test, and Mann-Whitney U-test were used to compare groups. In addition, a binary logistic regression was performed to identify whether the studied variables could predict the occurrence of dental trauma. RESULTS: The prevalence of dental trauma in the sample was 10.8% and most of the cases (42.7%) occurred due to violent events. A higher frequency of violent etiology was observed in cases that occurred during imprisonment (p = 0.037). Individuals that suffered dental trauma during incarceration were more likely to have been incarcerated for longer periods of time (p = 0.043). The main type of injury found was enamel and dentin fracture without pulp exposure (68%). The most affected tooth was the upper right central incisor (40%). CONCLUSION: These results underline the high prevalence of dental trauma experienced by men in prison.

Color stability of Bulk-Fill composite restorations.

BACKGROUND: The color stability of the composite resin is an important property that influences its clinical longevity, which remains an inherent challenge to the material. Thus, the purpose of this study was to evaluate the color stability of bulk-fill resins when exposed to dye. MATERIAL AND METHODS: Cavities were prepared in 80 bovine incisors, which were randomly assigned into 4 groups (n = 20) according with the resin composite used: P60 (Control Group - Filtek P60, 3M/ESPE), FP (Filtek Bulk-Fill Posterior, 3M/ESPE), SDR (SDR, Dentsply) and FF (Filtek Bulk Fill Flow, 3M/ESPE). All restorations were performed according to the protocol of each manufacturer, the control group was restored using the incremental technique, and the other groups using single-increment technique. The color of each restoration was measured using a portable digital spectrophotometer (Easyshade-Vita) according to the CIELab system, and then the teeth were submerged in red wine for 07 days, kept in a biological oven at 37ºC. New color registration was performed to measure the ΔE index of color variation. RESULTS: The P60 group had the lowest average ΔE (16.96), while the FF group had the highest average (28.09) and ranged from 21.19 to 26.28 in the FP and SDR groups. CONCLUSIONS: Analysis of the color variation showed that the control group had better color stability than the Bulk-Fill resins evaluated. Key words:Dental restoration failure, Food coloring agents, polymerization.

The influence of violet LED light on tooth bleaching protocols: In vitro study of bleaching effectiveness.

BACKGROUND: Employing violet LED on tooth bleaching is a recent but promising technique. This study aimed to assess the bleaching effectiveness of violet light-emitting diodes (LEDs) associated or not with bleaching gels containing hydrogen peroxide (HP) or carbamide peroxide (CP). METHODS: seventy bovine incisors were randomly assigned into 7 groups (n = 10) according to the technique and whitening product used. Group C: Artificial saliva (placebo); Group HP L-: three sessions of HP at 35 % without light activation; Group CP L-: three weeks of CP at 16 % for 4 h/day; Group HP CP L-: three sessions of HP at 35 % without light activation + 2 weeks of CP at 16 %, for 4 h/day; Group LED: four sessions with violet LED; Group HP L+: three sessions with HP at 35 % + violet LED; Group CP L+: three weeks with CP at 16 % for 4 h/day + violet LED. Color changes (ΔE and ΔL) were measured with a portable digital spectrophotometer. RESULTS: The results were similar between the groups of bleaching protocols, demonstrating that the use of the violet LED did not influence bleaching effectiveness when using HP 35 % or CP 16 % after 3 sessions. In addition, the use of the violet LED alone obtained ΔE values ​​similar to the protocols with the use of peroxides, however less variation of ΔL was observed for this group. CONCLUSIONS: The use of violet LEDs associated or not with bleaching gels was effective for tooth whitening. In addition, it was also concluded that the physical lightening technique with violet LED used alone produced less variation in dental brightness.

Influence of different thermopolymerization methods on composite resin microhardness.

BACKGROUND: Additional heat polymerization in composite resins allows greater effective-ness of microhardness, flexural strength, fracture tough-ness, wear resistance, and increased color stability. MATERIAL AND METHODS: 150 composite resin specimens were made using a 4 mm diameter and 2 mm thick bipartite steel matrix. Five resins composed of different compositions were tested (Brilliant Everglow/Coltene, Filtek One BulkFill/3M, Filtek P60/3M, Filtek Z350XT/3M, Filtek Z250XT/3M), and for each of them three types of polymerization were tested: light curing only (n=50); photopolymerization + autoclave thermopolymerization (n=50) and photopolymerization + microwave thermopolymerization (n=50). Each specimen was submitted to three indentations by means of the Vickers microhardness test, applying a load of 300gf, associated with the time of 15s. Data were analyzed descriptively by means of statistics, standard deviation and coefficient of variation and inferentially by the F test (ANOVA) in the comparison between groups. The margin of error used in statistical test decisions was 5%. RESULTS: The highest vicker microhardness averages were from the Control group (light curing only) on P60 (82.16) and Z250 XT (79.61) resins. The lowest averages were all verified on Brilliant Everglow resin in all polymerization methods studied: Photopolymerization (37.32), with microwave (43.80) and autoclave (45.12), followed by Bulk Fill 3M resin, ranged from 52.23 to 59.15. CONCLUSIONS: Both autoclave and microwave thermopolymerization methods showed similar behavior on the microhardness of the composites studied. Considering the resin type, there was a varied behavior compared to thermopolymerization, which increased the microhardness values for Brilliant Everglow resins (Coltene) and Filtek One Bulkfill (3M) and decreased for Filtek P60, Filtek Z350XT and Filtek Z250XT resins. Key words:Dentistry, composite resins, polymerization.

Does comsumption of staining drinks compromise the result of tooth whitening?

BACKGROUND: After dental bleaching procedures dentists commonly advise patients to reduce the consumption of beverages that may cause the teeth to stain, however, the effectiveness of teeth whitening may not be directly affected by diet. MATERIAL AND METHODS: It was evaluated through in vitro study whether contact with dyes through in-office bleaching sessions with 35% hydrogen peroxide would influence the effectiveness of treatment. Sixty bovine incisors were randomly assigned into 5 groups (n = 12) according to contact frequency and type of dye solutions. All dental elements received three in-office bleaching sessions with 35% hydrogen peroxide one week apart. Except for GCTRL (control), all experimental groups were submerged in dyes (coffee or wine) for 5 min once a day. In groups GC24 and GW24 contact with the dyes was made from 24 hours after each bleaching session, while in groups GC72 and GW72, from 72 hours. The color was measured with a digital spectrophotometer. Data were expressed as statistics: mean and standard deviation. RESULTS: Contact with dyes during in-office bleaching treatment with 35% hydrogen peroxide did not influence the staining averages after three bleaching sessions. The speed of the whitening effect was influenced by contact with coffee from 24 hours after the sessions and with wine from 24 hours and 72 hours after the whitening session. The whitening result was reversed after one week for all groups, especially for groups that came in contact with red wine either 24 hours or 72 hours after session and coffee after 24 hours. CONCLUSIONS: Contact with dyes during in-office bleaching treatment did not influence the final staining averages after three bleaching sessions although there was influence on speed of the whitening effect between the sessions. Key words:Tooth bleaching, hydrogen peroxide, spectrophotometry.

Do Dentistry and physical education students know the importance of mouthguard usage in sports practice? / Os alunos da Odontologia e Educação Física conhecem a importância do uso de protetores bucais na prática desportiva?

ABSTRACT Objective The purpose of the present study was to evaluate the knowledge of Dentistry and Physical Education students on mouthguard usage in sports practice. Methods A form containing questions that demonstrated participants' knowledge about the use of mouthguards was applied. Inclusion criteria were: individuals older than 18 years who were attending Dentistry or Physical Education courses from the sixth period and who agreed to participate in the study, and the exclusion criteria for dentistry students were: attended the discipline of Dental Materials II of UFPE and already participated in internships in schools or academies for the participants of the Physical Education course. Results it was possible to observe that 97% of the interviewees know what a mouthguard is, but none of the participants would be able to indicate a specific type of mouthguard to sportsmen. Conclusion It was possible to conclude that a large number of the interviewees know what a mouthguard is, but not enough to indicate which is the safest protector.

RESUMO Objetivo Avaliar o conhecimento dos alunos do curso de Odontologia e Educação Física sobre os protetores bucais nos desportos. Métodos Aplicação de formulário avaliando conhecimento dos participantes sobre o uso de protetores bucais. Os critérios de inclusão foram: indivíduos maiores de 18 anos que estivessem cursando os cursos de Odontologia ou Educação Física a partir do sexto período e que concordassem em participar da pesquisa, já os critérios de exclusão para os alunos do curso de Odontologia foram: não ter cursado a disciplina de Materiais Dentários II da UFPE e já ter participado de estágios em escolas ou academias no caso dos participantes do curso de Educação Física. Resultados: foi possível observar que 97% dos entrevistados sabem o que é um protetor bucal, porém, nenhum dos participantes saberiam indicar um tipo específico de protetor bucal aos desportistas. Conclusão que uma grande parcela dos entrevistados conhece o que é um protetor bucal, porém, não o suficiente para poder indicar qual o protetor mais seguro.