Evaluation of intensity standards of tungsten-halogen and led curing units / Evaluación de estándares de intensidad de unidades de curado tugsteno-halógenas y leds

Current evidence indicates that the minimum light intensity of photo curing units required to polymerize in a reliable way a composite resin, in increments of 2mm, is 300mW/cm2. The recent introduction of new generations of composite resin materials for large volume increments, partially contrasts with ISO 4049 (2009), calling for the use of light intensity of 1,000mW/cm2. Therefore, it is considered relevant to carry out periodic measurements of the emission intensity of light-curing units of clinical use. The aim of this study was to test the intensity [mW/cm2] of a representative sample of tungsten-halogen and LED photopolymerization units used in private and public health service in different areas of the Valparaíso Region in Chile. This was achieved through the use of dental radiometers, without considering the variables of intensity modification over time (either spontaneously, by undesirable inherent characteristics of the device, or by programs of intensity modification in time), or the density of accumulated power needed. This in vitro diagnostic test, evaluated a sample of 507 units, 107 halogen and 400 LED, for a period of around one month, using two radiometers as measuring instruments. For LED units the Bluephase Meter® radiometer, from Ivoclar-VivadentTM was used, and for halogen units we used the Coltolux® from ColténeTM. As a result, 85% of the LED and halogen units achieved the minimum requirements of intensity needed for the polymerization of conventional dental biomaterials. However, only 25% from the tested units achieved a power density of 1,000mW/cm2.

[Diagnossis and treatment of complicated anterior teeth esthetic defects by combination of whole-process digital esthetic rehabilitation with periodontic surgery].

OBJECTIVE: To explore a new method of whole-process digital esthetic prosthodontic rehabilitation combined with periodontic surgery for complicated anterior teeth esthetic defects accompanied by soft tissue morphology, to provide an alternative choice for solving this problem under the guidance of three-dimensional (3D) printing digital dental model and surgical guide, thus completing periodontic surgery and digital esthetic rehabilitation of anterior teeth. METHODS: In this study, 12 patients with complicated esthetic problems accompanied by soft tissue morphology in their anterior teeth were included. The dentition and facial images were obtained by intra-oral scanning and three-dimensional (3D) facial scanning and then calibrated. Two esthetic designs and prosthodontic outcome predictions were created by computer aided design /computer aided manufacturing (CAD/CAM) software combined with digital photography, including consideration of white esthetics and comprehensive consideration of pink-white esthetics. The predictive design of prostheses and the facial appearances of the two designs were evaluated by the patients. If the patients chose the design of comprehensive consideration of pink-white esthetics, they would choose whether they would receive periodontic surgery before esthetic rehabilitation. The dentition design cast of those who chose periodontic surgery would be 3D printed for the guide of periodontic surgery accordingly. RESULTS: In light of the two digital designs based on intra-oral scanning, facing scanning and digital photography, the satisfaction rate of the patients was significantly higher for the comprehensive consideration of pink-white esthetic design (P<0.05) and more patients tended to choose priodontic surgery before esthetic rehabilitation. The 3D printed digital dental model and surgical guide provided significant instructions for periodontic surgery, and achieved success transfer from digital design to clinical application. The prostheses were fabricated by CAD/CAM, thus realizing the whole-process digital esthetic rehabilitation. CONCLUSION: The new method for esthetic rehabilitation of complicated anterior teeth esthetic defects accompanied by soft tissue morphology, including patient-involved digital esthetic analysis, design, esthetic outcome prediction, 3D printing surgical guide for periodontic surgery and digital fabrication is a practical technology. This method is useful for improvement of clinical communication efficiency between doctor-patient, doctor-technician and doctors from different departments, and is conducive to multidisciplinary treatment of this complicated anterior teeth esthetic problem.

Digital model planning and computerized fabrication of orthognathic surgery wafers.

Conventional orthognathic wafers are made by a process involving manual movement of stone dental models and acrylic laboratory fabrication. In addition, a facebow record and semi-adjustable articulator system are required for maxillary osteotomy cases. This paper introduces a novel process of producing both intermediate and final orthognathic surgical wafers using a combination of computerized digital model simulation and three-dimensional print fabrication, without the need for either a facebow record or the additional ionizing radiation exposure associated with cone beam computerized tomography.

Advancing wellness in the dental office through use of screening and diagnostic technology.

Implementing an oral health/systemic health wellness plan for patients can be an important part of a dental practice's proactive approach to healthcare that emphasizes early detection and treatment of disease. As an adjunct to clinical observations, medical history, and patient information gathered and assessed by the practitioner, utilization of screening and diagnostic technology, including oral cancer screening devices, salivary diagnostic tests, and caries detection devices, can aid in the early detection of disease. These tests, which are usually billable, can aid in providing timely, effectual wellness services to patients by enabling practitioners to supply these services more effectively and at an early stage to the benefit of the patient's overall health.

Comparative efficacy of a specially engineered sonic powered toothbrush with unique sensing and control technologies to two commercially available power toothbrushes on established plaque and gingivitis.

OBJECTIVE: To evaluate the efficacy on plaque and established gingivitis of a new specially engineered sonic powered toothbrush with unique sensing and control technologies as compared to two commercially available power toothbrushes. METHODS: This examiner-blind, three-treatment, parallel clinical study assessed plaque reduction via the comparison of pre- to postbrushing after a single use, and following four weeks' use measured by the Rustogi Modification of the Modified Navy Plaque Index. This study also assessed gingivitis using the Löe and Silness Gingival Index after four weeks' use. Qualifying adult male and female subjects from the northern New Jersey area reported to the study site after refraining from all oral hygiene procedures for 24 hours, and from eating, drinking, or smoking for four hours. Following an examination for gingivitis and plaque (pre-brushing), they were randomized into three balanced groups, each group using one of the three study toothbrushes in the order specified by a predetermined randomization plan. Subjects were instructed to brush their teeth for two minutes under supervision with their assigned toothbrush according to the manufacturers' instructions and a commercially available toothpaste (Colgate Cavity Protection), after which they were once again evaluated for plaque (post-brushing). Subjects were then dismissed from the study site with the toothpaste and their assigned toothbrush to use at home twice daily for the next four weeks. They again reported to the study site at which time they were evaluated for plaque and gingivitis. RESULTS: One-hundred eighty-four subjects complied with the protocol and completed the clinical study. Relative to the two commercially available toothbrushes, the new specially engineered sonic powered toothbrush with unique sensing and control technologies provided statistically significantly (p < 0.05) greater reductions in whole mouth plaque index scores (21.9 and 25.8%, respectively), gingival margin plaque index scores (14.5% and 18.9%, respectively), interproximal plaque index scores (160.0% and 136.4%, respectively), facial plaque index scores (17.9% for both), lingual plaque index scores (29.2% for both), and interproximal lingual plaque index scores (200.0% and 350.0%, respectively) after a single tooth brushing. Relative to the two commercially available toothbrushes, the new sonic powered toothbrush also provided statistically significantly (p < 0.05) greater reductions in whole mouth plaque index scores (47.4% and 40.0%, respectively), gingival margin plaque index scores (46.2% and 40.7%, respectively), interproximal plaque index scores (650% and 1400%, respectively), facial plaque index scores (47.6% and 40.9%, respectively), lingual plaque index scores (47.1% and 31.6%, respectively), and interproximal lingual plaque index scores (350.0% and 500.0%, respectively) after four weeks. There was no statistically significant (p > 0.05) difference between the two commercially available toothbrushes for any plaque index score comparison. Relative to one of the commercially available toothbrushes, the new sonic powered toothbrush provided statistically significant reductions (p < 0.05) in gingival index scores (25.0%) and gingivitis severity scores (33.3%) after four weeks of product use. There were no statistically significant (p > 0.05) differences in gingivitis or gingivitis severity index scores between the new sonic powered toothbrush and the other commercially available toothbrush. CONCLUSION: A new specially engineered sonic powered toothbrush with unique sensing and control technologies provides significantly greater levels of efficacy on the removal of dental plaque after a single tooth brushing and after four weeks' use when compared to two commercially available power toothbrushes. The new sonic powered toothbrush also provides significantly greater levels of efficacy on the reduction of gingivitis and gingival bleeding when compared to one of the commercially available power toothbrushes.

A clinical study comparing the supragingival plaque and gingivitis efficacy of a specially engineered sonic powered toothbrush with unique sensing and control technologies to a commercially available manual flat-trim toothbrush.

OBJECTIVE: This study was designed to evaluate the efficacy of a new specially engineered sonic powered toothbrush with unique sensing and control technologies, as compared to a manual flat-trim toothbrush on supragingival plaque and established gingivitis. METHODS: This examiner-blind, two-treatment, parallel clinical research study assessed plaque removal via the comparison of pre- to post-brushing after a single use, and again after four- and 12-weeks' use using the Rustogi Modification of the Modified Navy Plaque Index. This study also assessed gingivitis at four and 12 weeks using the Löe and Silness Gingival Index. Qualifying adult male and female subjects from the southern Florida area reported to the study site after refraining from any oral hygiene procedures for 24 hours, and from eating, drinking, and smoking for four hours. Following an examination for plaque (pre-brushing) and gingivitis, they were randomized (for both plaque and gingivitis) into two balanced groups, each group using one of the two study toothbrushes. Subjects were instructed to brush their teeth for two minutes under supervision with their assigned toothbrush according to the manufacturer's instructions, and commercially available toothpaste (Colgate Cavity Protection Toothpaste), after which they were again evaluated for plaque (post-brushing). Subjects were then dismissed from the study site with the toothpaste and their assigned toothbrush to use at home twice daily for the next 12 weeks. They again reported to the study site after four and 12 weeks of product use, at which time they were evaluated for plaque and gingivitis. RESULTS: Seventy-six out of 82 enrolled subjects complied with the protocol and completed the clinical study. The new specially engineered sonic powered toothbrush with unique sensing and control technologies provided statistically significant reductions in gingival and gingivitis severity index scores after four and 12 weeks of product use. The manual toothbrush provided a statistically significant reduction in gingival index score only at the 12-week time point. Relative to the manual toothbrush group, after a single tooth brushing and after four and 12 weeks, the new sonic powered toothbrush provided statistically significantly greater reductions in whole mouth plaque index scores (1.6, 2.05, and 1.9 times, respectively), gingival margin plaque index scores (12.0, 90.0, and 8.2 times, respectively), and interproximal plaque index scores (2.0, 3.2, and 2.1 times, respectively). Relative to the manual toothbrush group after four and 12 weeks, the new sonic powered toothbrush provided statistically significant reductions in gingival index scores of 11.0 and 7.0 times, respectively, and in gingivitis severity index scores of 3.0 and 3.5 times, respectively. All statistically significant reductions were at the p < or = 0.05 level. CONCLUSION: The new specially engineered sonic powered toothbrush unique sensing and control technologies provides statistically significant and clinically relevant levels of efficacy in the removal of supragingival dental plaque after a single tooth brushing, and after four and 12 weeks' use. The new sonic powered toothbrush also provides statistically significantly greater levels of efficacy in the reduction of supragingival plaque, gingivitis, and gingival bleeding when compared to a manual flat-trim toothbrush.

Próteses obturadoras para pacientes maxilarectomizados: estado atual da tecnologia e necessidades de aprimoramentos / Obturator prostheses for maxillectomized patients: inventory of the existing technology and the need for improvements

Pacientes portadores de comunicação oronasal necessitam de dispositivo protético obturador, para o restabelecimento da sua função, estética e qualidade de vida perdida, devido à remoção ou ausência da maxila. Esta tecnologia reabilitadora vem se desenvolvendo há alguns séculos, com aprimoramentos das técnicas de confecção e materiais odontológicos que auxiliem na elaboração de obturadores cada vez mais eficientes, principalmente no que se refere a sua adaptação. Esta tecnologia é fortemente dependente tanto do domínio das técnicas laboratoriais, quanto de habilidades específicas na arte da reconstrução da face (manuais, sensitivas e tácitas), pois sua confecção é artesanal, personalizada e individualizada, determinando que a disponibilidade e distribuição dos recursos humanos qualificados para a sua elaboração constituam-se em obstáculo significativo para um acesso mais amplo e equânime. O trabalho em tela teve por objetivo examinar o estado da arte relativo às diferentes técnicas de moldagens e confecção das próteses obturadoras utilizadas no cuidado reabilitador de pacientes maxilarectomizados, buscando subsidiar proposições para o seu aprimoramento. Este estudo teórico-exploratório utilizou dois caminhos metodológicos complementares. O primeiro tomou por base uma revisão de literatura científica nacional e internacional e acadêmica, publicada sob a forma de artigos, teses e dissertações, utilizando as bases bibliográficas MEDLINE, BBO, LILACS, SCIELO, Biblioteca Virtual de Saúde e Colaboração Cochrane, e as bases de dissertações e teses da CAPES – Banco de Teses; Base Thesis e Biblioteca Digital de Teses e Dissertações (BDTD), do Instituto Brasileiro de Informação em Ciência e Tecnologia (IBICT)...

Patients with oral-nasal connection due to the absence or extirpation of themaxilla need a prosthetic obturator for esthetical reasons, to restore function, and to partially regain the lost quality of life. This technology has evolved in the course of many centuries in conjunction with the improvement in manufacturing techniques and odontological materials that play a role in the elaboration and design of more efficient obturators, especially regarding their adaptation. This technology is exceedinglydependent on the mastery of laboratorial methods as well as specific skills in the art of facial reconstruction because its confection is artisanal, personalized, and customized. The existence and distribution of suitable human resources are an evident obstacle to the evenly access to this technology. The aim of this work was toscrutinize the “state of the art” regarding different moulding and manufacturing techniques of prosthetic obturators employed in the rehabilitation process of maxillectomized patients, intending to make a contribution for its improvement. This theoretical-exploratory study used two complementary methodological instruments. One was a broad review of the national and international scientific literature published as articles, doctoral thesis and dissertations, utilizing different bibliographical databases: MEDLINE, BBO, LILACS, SCIELO, Biblioteca Virtual de Saúde (Virtual Health Library), and The Cochrane Collaboration, as well as the doctoral thesis and dissertations included in the CAPES database - Base Thesis andDigital Library of thesis and dissertations, from the Brazilian Institute of Information in Science and Technology...

Influence of light-curing units on the flexural strength and flexural modulus of different resin composites

Aim: This study aimed to evaluate the flexural strength and flexural modulus of different resin composites (MasterFill, Opallis, Z250, Supreme) after photoactivation with quartz-tungsten-halogen (QTH - XL2500) or light-emitting diode (LED - Radii and Ultrablue Is) light-curing units (LCUs). Methods: The irradiance and spectral emission of each unit were evaluated using a power meter and a spectrometer. Flexural strength (MPa) was determined in a three-point bending test in accordance with the ISO4049 standard specifications. Flexural modulus (GPa) was measured from the linear-elastic range on the stress-deformation profile. Data were submitted to two-way ANOVA and Tukey’s test (p<0.05). Results: Different values for irradiance (850, 780 and 590 mW/cm2) and peak of emission (484, 456, 467 nm) were detected for XL2500, Radii and Ultrablue Is, respectively. Flexural strength and modulus were dependent on both material and LCU. Among the resins, Z250 and Supreme showed significantly higher strength and modulus than MasterFill and Opallis. Comparing the LCUs, Ultrablue Is showed significantly lower flexural strength and modulus than the others. Conclusion: Flexural strength and modulus were dependent on the irradiance and the spectral emission of the curing units, as well on the resin composite tested.

Technological devices in the diagnosis of temporomandibular disorders.

Claims have been made that certain diagnostic devices should be routinely used to differentiate between jaw dysfunction and normal variation and between various pathologic conditions of the temporomandibular joint. The claims that jaw-tracking devices have diagnostic value for detecting TMD are not well supported by the scientific evidence. The clinical usefulness of electromyography devices is limited because of technical, methodologic, and data interpretation problems, as well as significant overlap between asymptomatic and symptomatic groups. Claims for the use of sonography and vibratography machines to discriminate between various intracapsular TMJ conditions have not been substantiated by well-designed research. Until acceptable levels of technical and diagnostic validity have been clearly established, these diagnostic devices cannot be relied on as aids in differential diagnosis or in clinical decision making in the TMD field.

Influence of different light curing units on the bond strength of indirect resin composite restorations

The aim of this study was to evaluate the influence of different light sources on the bond strength of indirect resin composite restorations cemented with a dual-cure resin cement. The superficial dentin of human third molars was exposed and acid-etched and an adhesive system was applied (Single Bond 2). Four-mm-thick indirect resin composite restorations (Gradia) were fabricated and cemented using a dual-cure resin cement (Rely X). Four light sources were used to polymerize the cement: QTH - Optilux 401; LED1 - L.E.Demetron 1; LED2 - Optilight CL; and LED3 - Ultralume 5. The teeth were stored for 24 h and then sectioned, yielding stick-shaped specimens for each group with a bonded area of 1.0 mm². The specimens were then tested in a universal testing machine, at a crosshead speed of 1 mm/min. Data were analyzed using ANOVA. Bond strength mean values were: QTH: 22.5 (± 8.4); LED1: 22.7 (± 9.4); LED2: 21.4 (± 10.2); and LED3: 27.3 (± 13.8). No statistically significant difference was observed among the experimental groups. The bond strength values when the cement was polymerized using different LED lights were equivalent to the values when the QTH light was used. It can be concluded that the variety of light sources used in the present study did not influence the bond strength of indirect resin composite restorations cemented with a dual-cure resin cement.

Influence of composite restorative materials and light-curing units on diametrical tensile strength

O objetivo deste estudo foi avaliar a resistência à tracão diametral (DTS) de três compósitos fotoativados com dois aparelhos de fotoativacão (LCU). Os compósitos utilizados neste estudo foram: resina de micropartículas A110 (3M Espe); P60 (3M Espe), indicada para restauracões posteriores, e micro-híbrida Charisma (Heraeus-Kulzer). As fontes de luz foram: halógena (HAL) - Degulux (Degussa) e luz emitida por diodos (LED) - Ultrablue (DMC). As amostras foram confeccionadas através de dois incrementos inseridos em uma matriz de Teflon bipartida medindo 3 mm de profundidade e 6 mm de diâmetro interno e foram fotoativadas pelas LCUs (n = 10). As amostras foram armazenadas dentro de recipientes escuros contendo água destilada a 37ºC por 7 dias. O ensaio de DTS foi realizado com a Máquina de Ensaio Universal Instron com velocidade de 0,5 mm/min. Os dados obtidos foram submetidos à Análise de Variância e ao teste de Tukey. Os resultados foram (MPa): A110/HAL: 276,50 n 62,94a; A110/LED: 306,01 n 65,16a; P60/HAL: 568,29 n 60,77b e P60/LED: 543,01 n 83,65b; Charisma/HAL: 430,94 n 67,28c; Charisma/LED: 435,52 n 105,12c. Desta forma, os resultados indicaram que não houve diferenca significativa de DTS em relacão aos aparelhos para uma mesma resina. Entretanto, entre os materiais ocorreram diferencas significativas nos valores de DTS.