Impact of the COVID-19 pandemic on oral health care use in the United States through December 2021.

BACKGROUND: The purpose of this study was to assess the effects of the COVID-19 pandemic on oral health care provided from July 2020 through December 2021 using national claims data. METHODS: Deidentified quarterly claims from 2017 through 2021 were analyzed (2017-2019 provided prepandemic data). Data were sorted into multiple treatment categories. Analyses compared prepandemic with postpandemic procedure volumes and were stratified according to age groups (0-5 years, 6-18 years, 19-64 years, ≥ 65 years). RESULTS: For children aged 0 through 5 years, use of sealants and topical fluorides other than varnish were considerably lower in 2021, as were direct operative and palliative procedures from 2020 through 2021. Only use of silver diamine fluoride, prefabricated crowns, and oral surgery increased significantly (P < .05) in some quarters. For children aged 6 through 18 years, diagnostic, direct operative, periodontic, oral surgery, and palliative procedures were significantly lower in most of 2020 through 2021, and only prefabricated crowns and indirect operative procedures increased significantly in more than 3 quarters. For adults aged 19 through 64 years, diagnostic and preventive procedures were significantly lower in 3 quarters, and direct operative, gingival surgery, endodontic, and palliative procedures were significantly lower in most of 2020 through 2021. Only occlusal guards and scaling and root planing increased significantly in more than 3 quarters. For adults 65 years and older, direct operative, gingival and osseous surgery, and palliative procedures were significantly lower in more than 3 quarters; all other procedures increased significantly in more than 3 quarters. CONCLUSIONS: The pandemic was associated with changes in the provision of oral health care that persisted for more than 1 year. PRACTICAL IMPLICATIONS: Reductions in preventive procedure volumes across age groups younger than 65 years may have implications for longer-term effects of the pandemic.

Real-world effectiveness of national pit and fissure sealants program in Taiwan.

OBJECTIVES: This study investigated the effectiveness of a national population-based pit and fissure sealants (PFS) program in Taiwan. METHODS: Part 1 (effectiveness of national PFS program) involved children who had participated in the PFS program from 2015 to 2019. After propensity score matching, 670,840 children were selected for analysis until the end of 2019. During follow-up, the permanent first molars of the participants were assessed for caries-related treatments by employing multilevel Cox proportional hazards models. In Part 2 (effectiveness of retained sealants), which involved 1,561 children, sealant retention was evaluated 3 years after placement. A structured questionnaire was employed to collect information on family and individual factors. The endpoints were the same as in Part 1. RESULTS: In Part 1, the adjusted hazard ratios (HRs) for caries-related treatments among participants in the PFS program were 0.90 (95% confidence interval [CI] = 0.89, 0.91) for dental restoration, 0.42 (95% CI = 0.38, 0.46) for initiation of endodontic treatment, 0.46 (95% CI = 0.41, 0.52) for completion of endodontic treatment, and 0.25 (95% CI = 0.18, 0.34, all Ps < 0.0001) for extraction. In Part 2, the adjusted HR for dental restoration of teeth with retained sealants was 0.70 (95% CI = 0.58, 0.85), significantly lower than that for teeth without retained sealants (P = 0.0002). CONCLUSIONS: Participation in the national PFS program was associated with a significant reduction of at least 10% in the risk of caries-related treatments, and an additional 30% risk reduction may have been attributed to sealant retention. CLINICAL SIGNIFICANCE: In a real-world setting, schoolchildren in the national PFS program were associated with a significant reduction of at least 10% in the likelihood of caries-related treatments. The program provided moderate protection against caries for the study population and could be improved by increasing the sealant retention rate.

Comparison of two obturation techniques on adhesion and proliferation of human periodontal ligament fibroblasts / Comparación de la adhesión y proliferación de fibroblastos periodontales humanos en dos técnicas de obturación endodóntica

The present study aimed to compare the adhesion and proliferation of human periodontal ligament fibroblasts (hPDL) in transverse sections of the teeth sealed with two different obturation techniques, BioRoot RCS/hydraulic obturation (HO) and AH-Plus/continuous-wave condensation (CWC). The techniques were tested using an in vitro model to simulate the interaction between periodontal tissues and the materials. The root canals were instrumented and sterilized. A total of 15 samples were obturated with BioRoot RCS/HO and 15 samples with AH-Plus/CWC. Then, roots were sectioned to obtain obturated teeth slices, and hPDL cells were seeded onto the root slices. The results were obtained at intervals of 4 and 24h for cell adhesion; and at 3,7,14, and 21 days for cell proliferation. Empty cell culture plates were use as controls. The cell adhesion was increased at 4 and 24h for both groups, with an increased response observed in the BioRoot RCS/HO group (p<0.05). The difference in cell proliferation was also found between experimental groups. After 14 days of culture, BioRoot RCS/HO group showed an increase response than control and AH-Plus/CWC groups (p<0.05), and after 21 days both groups behaved better than control group, with an increased response observed in the BioRoot RCS/HO group. This study demonstrated that both root canal sealers allow the attach and growth of periodontal ligament fibroblasts, with an increased biological response in the BioRoot RCS/HO group.

El presente estudio se enfocó en comparar la adhesión y proliferación de fibroblastos de ligamento periodontal humano (hPDL) en secciones transversales de raíces previamente obturadas con dos técnicas de obturación diferentes: obturación hidráulica empleando cono único de gutapercha y BioRoot RCS como sellador (HO), y obturación de condensación de onda continua y AH-Plus como sellador (CWC). Los selladores se usaron en un modelo in vitro que simula la interacción entre los tejidos periodontales y los materiales de obturación. Los conductos radiculares fueron instrumentados, esterilizados y obturados. La muestra se compuso de un total de 15 raíces con la técnica BioRoot RCS/HO y 15 raíces con la técnica AH-Plus/CWC. Las células de hPDL fueron sembradas en condiciones estándar de cultivo sobre las raíces seccionadas. Los resultados fueron obtenidos a intervalos de 4 y 24h para adhesión celular, y a los 3,5,7,14 y 21 días de cultivo para proliferación celular. La adhesión celular a las 4 y 24 horas mostró ser diferente para ambas técnicas en comparación con el grupo control, siendo más importante en el grupo BioRoot RCS/HO. La diferencia en la proliferación entre grupos se observó a los 14 días de cultivo, únicamente para el grupo BioRoot RCS/HO; Sin embargo para el día 21 ambas técnicas mostraron mayor proliferación celular que el grupo control, con mejor respuesta para el grupo BioRoot RCS/HO. Este estudio ha demostrado que ambos selladores de conductos permiten la adhesión y crecimiento de fibroblastos de ligamento periodontal, siendo el grupo BioRoot RCS/HO el que mostró mayor biocompatibilidad.

Efecto del tratamiento de la morfología oclusal con materiales para restauraciones preventivas / Effect of treating occlusal morphology with materials for preventive restorations

Introducción: las fosas y fisuras son áreas formadas por delgadas irregularidades de la capa del esmalte de la superficie oclusal. La compleja morfología en dientes posteriores es un determinante biológico asociado al desarrollo de caries. Objetivo: evaluar el efecto de diversas formas de tratar la morfología oclusal en la adaptación y penetración de materiales utilizados en restauraciones preventivas. Material y métodos: diseño experimental e in vitro. Sesenta terceros molares fueron distribuidos aleatoriamente en dos grupos: surco sin ameloplastia y con ameloplastia; además, contaban con acondicionamiento del esmalte que se subdividió en tres subgrupos: 1) sellador de fosas y fisuras, 2) adhesivo/sellador de fosas y fisuras y 3) adhesivo/ resina Flow. Resultados: los subgrupos adhesivo/sellador y adhesivo/ Flow alcanzaron mayores valores de adaptación íntima a las paredes del surco. Las diferencias fueron significativas entre los materiales (p = 0.0009). Las mayores zonas de desadaptación resultaron para el sellador sin y con ameloplastia. La penetración de los materiales fue mayor en los surcos con ameloplastia. En los surcos tratados con ameloplastia, el adhesivo/Flow reveló el mayor porcentaje de penetración y la mejor adaptación a las paredes del surco. Conclusiones: la penetración del material está positivamente correlacionada con la profundidad del surco. El sellador con y sin ameloplastia mostró pobre adaptación a las paredes del surco (AU)

Introduction: pits and fissures are areas formed by fine irregularities in the enamel layer of the occlusal surface. The complex morphology in posterior teeth are biological determinants associated with the development of caries. Objective: to evaluate the effect of various ways of treating occlusal morphology on the adaptation and penetration of materials used in preventive restorations. Material and methods: experimental design, in vitro. Sixty third molars were randomly distributed into two groups: groove without ameloplasty and with ameloplasty, with enamel conditioning with three subgroups: 1) pit and fissure sealer, 2) adhesive/pit and fissure sealer, 3) adhesive/resin flow. Results: the adhesive/sealant and adhesive/flow subgroups reached higher values of intimate adaptation to the furrow walls. The differences were significant between the materials (p = 0.0009). The largest areas of maladjustment were found for the sealant without and with ameloplasty. The penetration of the materials was greater in the grooves with ameloplasty. In the grooves treated with ameloplasty, the adhesive/flow revealed the highest percentage of penetration and the best adaptation to the walls of the groove. Conclusions: the penetration of the material is positively correlated with the depth of the furrow. The sealant with and without ameloplasty showed poor adaptation to the sulcus walls (AU)

Desenvolvimento e caracterização fisico-química de um selante resinoso com propriedades antimicrobianas associadas à incorporação do extrato do caule de Schinopsis brasiliensis (Braúna) / Development and physicochemical characterization of a resinous sealant with antimicrobial properties associated with the incorporation of Schinopsis brasiliensis (Braúna) stem extract

Introdução: os selantes resinosos possuem atividade preventiva e terapêutica da cárie dentária oclusal através da criação de uma barreira física que impede a adesão de biofilme. Não existem relatos destes materiais com propriedades antimicrobianas e, neste ensejo, a adição de princípios ativos obtidos de fitoterápicos configura como uma opção possível para resolver esta limitação. Objetivos: avaliar o potencial antimicrobiano do selante Fluroshield® enriquecido com o extrato do caule de Schinopsis brasiliensis (Braúna), bem como, a liberação do princípio ativo, grau de conversão, resistência de união imediata ao esmalte e padrão de falha dos materiais experimentais. Metodologia: trata-se de um estudo experimental in vitro. As cascas da Braúna foram secas a 40 ± 1 °C e o extrato etanólico foi obtido por percolação do pó da casca da Schinopsis brasiliensis. O selante comercial Fluroshield® (Dentsply) foi enriquecido com as proporções em massa (g) [0% (Controle), 20%, 10%, 5%, 2,5% e 1,25%]. Foi realizada a avaliação da Atividade antimicrobiana, a liberação do princípio ativo foi aferida através de Ultra Cromatografia Líquida de Alta Performance (UHPLC), o grau de conversão (GC) através do Micro-Raman, a resistência de união (RU) imediata ao esmalte foi avaliada através do microcisalhamento e padrão de fratura através de análise em estereomicroscópio. Os valores finais foram submetidos aos testes de normalidade Shapiro-Wilky (p > 0,05) e Levene. Os dados paramétricos foram submetidos a análise de variância (ANOVA one-way) com pós-teste de Tukey (p <0,05) e os não paramétricos através do teste de Kruskal-Wallis com pós-teste de Dunn's através do software GraphPad Prism 8 e Microsoft Excel 2018. Resultados: materiais com maior % de extrato apresentaram menor GC, não houve diferença estatisticamente significativa para RU entre os diferentes grupos, o padrão de fratura predominante foi adesiva, houve liberação do princípio ativo em meio aquoso em todos os materiais e os grupos com 20% e 10% de extrato em massa foram capazes de inibir a formação de biofilme de maneira semelhante ao controle positivo (clorexidina 0,12%). Conclusão: a adição do extrato de Schinopsis brasiliensis em concentrações entre 10% e 20% apresenta-se como uma alternativa promissora para a obtenção de propriedades antimicrobianas em selantes resinosos (AU).

Introduction: dental sealants have a preventive and therapeutic activity in the prevention and treatment of dental caries. However, there are no reports of these materials with antimicrobial properties and the addition of phytotherapy molecules would be an option to solve this limitation. Objectives: to evaluate the antimicrobial properties of the Fluroshield™ sealant with the addition of the stem extract of Schinopsis brasiliensis (Braúna), as well as the potential for releasing the active ingredient, degree of conversion and immediate enamel bond strength. Methodology: this is an experimental in vitro study. Braúna barks were dried at 40 ± 1 °C and the ethanolic extract was obtained by percolation of Schinopsis brasiliensis bark powder. The commercial sealant Fluroshield™ was enriched with the proportions by mass (g) [0% (Control), 20%, 10%, 5%, 2.5% and 1.25%]. The evaluation of the Inhibition of Biofilm Formation was carried out, the release of the active principle was measured with Ultra High Performance Liquid Chromatography (UHPLC), the immediate bond strength (BS) to the dental tissue was evaluated with microshear and the degree of conversion (DC) with Micro-Raman. Final values were submitted to Shapiro-Wilky (p > 0.05) and Levene normality tests. Parametric data were submitted to analysis of variance (one-way ANOVA) with Tukey's post-test (p <0.05) and nonparametric data through the Kruskal-Wallis test with Dunn's post-test using the GraphPad Prism software 8 and Microsoft Excel 2018. Results: materials with a higher % of extract had a lower DC, there was no statistically significant difference for BS between the different groups, there was release of the active principle in all materials and groups with 20% and 10 % of extract by mass were able to inhibit biofilm formation similarly to the positive control (0.12% chlorhexidine). Conclusion: the addition of Schinopsis brasiliensis extract in concentrations between 10% and 20% is a promising alternative for obtaining antimicrobial properties in resin sealants (AU).

Adhesion of a sealant with pre-reacted glass ionomer particles under salivary contamination: an in vitro study

Objective: this in vitro study compared the adhesive strengths of the resin sealant with the Giomer technology sealant under salivary contamination. Materials and Methods: fifty-two bovine incisors were randomly divided into four groups (n=13): GI, a resin sealant (Fluroshield®) without salivary contamination (control of GII); GII, Fluroshield sealant + salivary contamination; GIII, a Giomer technology sealant (BeautiSealant®) without salivary contamination (control of GIV); and GIV, BeautiSealant® sealant + salivary contamination. In the salivary contamination groups, artificial saliva was used through a pipette, and after 20 s, it was air-dried and the sealant was applied. Shear strength tests were performed using a universal testing machine. One-way ANOVA variance and Tukey's test were used for multiple comparisons. The fracture types were analyzed using a stereomicroscope with 40X magnification. Results: the means and standard deviations (SD) of adhesion for Fluroshield® and BeautiSealant® in the group without salivary contamination were 15.27 (±0.96) and 11.90 (±0.94), and for the group with salivary contamination, 13.14 (±1.03) and 8.95 (±1.33), respectively, indicating a statistically significant difference between GI and GII p=0.020, GIII and GIV p=0.041. Mixed failures were detected in GI (38%), GII (44%), GIII (38%), and GIV (62%). Conclusion: there was a statistically significant decrease in the adhesive strength values in the groups with salivary contamination for both the sealants studied. However, no significant difference was observed between the two sealants when the materials used were compared.

Objetivo: este estudo in vitro comparou as forças adesivas do selante resinoso com o selante da tecnologia Giomer sob contaminação salivar. Materiais e Métodos: cinquenta e dois incisivos bovinos foram divididos aleatoriamente em quatro grupos (n=13): GI, um selante resinoso (Fluroshield®) sem contaminação salivar (controle do GII); GII, selante Fluroshield + contaminação salivar; GIII, um selante com tecnologia Giomer (BeautiSealant®) sem contaminação salivar (controle do GIV); e GIV, selante BeautiSealant® + contaminação salivar. Nos grupos de contaminação salivar, a saliva artificial foi utilizada por meio de uma pipeta e, após 20 s, foi seca ao ar e aplicado o selante. Os testes de resistência ao cisalhamento foram realizados usando uma máquina de teste universal. A variância ANOVA de uma via e o teste de Tukey foram usados para comparações múltiplas. Os tipos de fratura foram analisados em estereomicroscópio com aumento de 40X. Resultados: as médias e desvios padrão (DP) de adesão para Fluroshield® e BeautiSealant® no grupo sem contaminação salivar foram 15,27 (±0,96) e 11,90 (±0,94), e após contaminação salivar foram 13,14 (±1,03) e 8,95 (±1,33), respectivamente, indicando haver diferença estatisticamente significante entre GI e GII p=0.020, GIII e GIV p=0.041. Falhas mistas foram detectadas em GI (38%), GII (44%), GIII (38%) e GIV (62%). Conclusão: houve diminuição estatisticamente significativa dos valores de resistência adesiva nos grupos com contaminação salivar para ambos os selantes estudados. No entanto, não foi observada diferença significativa entre os dois selantes quando comparados os materiais utilizados.

Assessment of influence of LED curing units used on microhardness of resin-modified glass ionomer sealants

Aim: Resin modified glass ionomer (RMGI) is class of material that can be used as sealant for preventing and arresting the progression of caries in pits and fissures. As these are hybrid materials, their properties can be affected by factors related to the polymerization process. Therefore, this study aimed to evaluate the influence of different generations of LED curing units (Elipar DeepCure-L and VALO Grand) on Knoop microhardness values (KHN) of RMGI sealants (Clinpro XT and Vitremer). Methods: Forty cylindrical specimens (6mm ø x 1 mm high) were prepared according to the manufacturer's instructions and divided into four groups (n=10) according to the type of RMGI and LED used. The KHN of the top surface of each sample was calculated 7 days after light-curing. Data were submitted to two-way ANOVA (α = 0.05). Results: Vitremer had higher KHN values than Clinpro XT after using both LEDs (p<0.0001), but especially when light-cured with the use of VALO Grand (p<0.0001). Whereas the KHN value of Clinpro was not influenced by the LED device (p>0.05). Conclusions: Top surface microhardness values of RGMI sealants were affected by both material composition and generations of LED curing units used. Third generation LED curing units seemed to be more efficient for the polymerization of RMGI-based sealants

Bioremediation of bisphenol A found in industrial wastewater using Trametes versicolor (TV) laccase nanoemulsion-based bead organogel in packed bed reactor.

Bisphenol A (BPA) is one of the toxic chemicals, which is widely used for manufacturing epoxy, polyester resin, and polycarbonates. These materials are extensively used in manufacturing of reusable bottles, baby bottles, dental sealants, various medical devices, and so forth. Moreover, canned and packaged foods are sources of bisphenol A, which is unknowingly consumed by many people worldwide. Its endocrine disrupting and teratogenic properties impose potential risk to the wildlife and human health. BPA has been linked to reproductive, metabolic, and immunity disorders in humans. Regardless of BPA ban in reusable and baby bottles, annually, 15 billion pounds of BPA still being produced. BPA pollution and its cleanup are major challenges. Therefore, it is essential to develop a suitable strategy to bioremediate BPA. The Trametes versicolor (TV) laccase-based nanoemulsion calcium alginate bead organogel was able to transform 94% of BPA within 2 h of treatment. Organogel showed 60% of BPA removal from actual industrial wastewater in packed bed batch reactor and 67% of BPA removal in continuous flow packed bed reactor. The biological oxygen demand (BOD) of treated industrial effluent was 14 mg/L, which is very much less than untreated effluent's BOD, which was 48 mg/L. The chemical oxygen demand of industrial effluent was 1240 mg/ml, and treated effluent was 248 mg/L, respectively. Hence, application of nanoemulsion-based organogel in packed bed reactor found to be a potential candidate for the bioremediation of industrial effluent containing BPA. PRACTITIONER POINTS: The TV laccase-based nanoemulsion calcium alginate bead organogel was able to transform 94% of BPA. Organogel showed 67% of BPA removal from industrial wastewater in continuous flow packed bed reactor. The nanoemulsion-based organogel in packed bed reactor found to be potential candidate for the bioremediation of industrial effluent containing BPA.

Evaluation of the dentinal tubule penetration of an endodontic bioceramic sealer after three final irrigation protocols

Introduction: This study aimed to evaluate the dentinal tubule penetration of an endodontic bioceramic sealer, Sealer Plus BC, after three final irrigation protocols. Methods: Thirty distobuccal roots of maxillary molars were selected. Root canal preparation was performed up to an #40.06 instrument (X1 Blue) under 2.5% sodium hypochlorite irrigation. Specimens were randomly divided into three groups (n=10), according to the final irrigation protocol: G-NaOCl (2.5% sodium hypochlorite + PUI), G-SS (0.9% saline solution + PUI) and G-H20 (Deionized water + PUI). After final irrigation protocols, all specimens were irrigated with phosphate buffer solution. Root canal obturation was performed using the single cone technique and Sealer Plus BC, stained with a specific fluorophore. Specimens were transversely sectioned and each root third was evaluated in a confocal scanning laser microscopy. Images obtained were analyzed for sealer penetration in the dentinal tubules. Results: Dentinal tubule penetration of Sealer Plus BC was not observed in any root third, regardless of the final irrigation protocol investigated. Conclusions: Sealer Plus BC dentinal tubule penetration was not observed after none of the protocols tested. Dentinal tubule penetrability of Sealer Plus BC may be related to other factors rather than the final irrigation protocol.

Sellado de lesiones de caries: reporte de caso / Selamento de lesões de cárie: relato de caso / Sealing of caries lesions: case report

El objetivo de este estudio fue informar un caso clínico de sellado de lesiones activas de caries, puntuación 5 del Sistema Internacional de Detección y Evaluación de Caries - ICDAS, en los primeros molares permanentes de un chico de 9 años. En el examen clínico, se identificaron lesiones activas, código 5 y 3 en los dientes 16 y 26, respectivamente. Sin embargo, en el examen radiográfico se observó que la lesión del diente 26 también se encontraba en la mitad externa de la dentina. Por lo tanto, ambas lesiones fueron consideradas como código 5. Así, para el sellado de las lesiones, se realizó un tratamiento de intervención mínima, usando sellante resinoso con capa intermedia de adhesivo. Después de 6 meses de acompañamiento, se observó la pérdida de la integridad del sellado del diente 16 realizándose la reparación del mismo; después de un año ambas lesiones estaban inactivas. Por lo tanto, el sellado de las lesiones de caries parece ser adecuado para las lesiones del esmalte que alcanzan la mitad exterior de la dentina

O objetivo deste estudo foi relatar um caso clínico de selamento de lesões de cárie ativas, escore 5 do International Caries Detection and Assessment System- ICDAS, em primeiros molares permanentes de um menino de 9 anos. Ao exame clínico, foram identificadas lesões ativas, escore 5 e 3 nos elementos 16 e 26, respectivamente. Entretanto, no exame radiográfico observou-se que a lesão do dente 26 também estava em metade externa de dentina. Dessa forma, ambas as lesões eram escore 5. O tratamento de mínima intervenção com o selamento das lesões de cárie foi realizado, usando selante resinoso com camada intermediária de adesivo. Em 6 meses de acompanhamento, observou-se perda de integridade do selante no dente 16, sendo realizado o reparo; após um ano, as lesões estavam paralisadas. Portanto, o selamento de lesão de cárie parece ser adequado para lesões em esmalte atingindo metade externa de dentina

The aim of this study was to report a clinical case of sealing active caries lesions, score 5 of the International Caries Detection and Assessment System- ICDAS, in the first permanent molars of a 9-year-old boy. On clinical examination, active lesions were identified, score 5 and 3 in molars 16 and 26, respectively. However, radiographic examination determined that the lesion of tooth 26 was also in the external half of dentin. Thus, both lesions were score 5. The minimal intervention treatment with the sealing of the carious lesions was performed, using resinous sealant with an intermediate layer of adhesive. In 6 months of follow-up, loss of integrity of the sealant was observed on tooth 16, and the repair was carried out; after one year, the lesions were paralyzed. Therefore, the sealing of caries lesions seems to be suitable for enamel lesions reaching the external half of dentin

Fracture Resistance of Teeth Restored with Bulk-Fill and Fiber-Reinforced Composites in Class II Cavities / Resistencia a la fractura de dientes restaurados con resinas de relleno y resinas reforzadas con fibra en cavidades clase II

ABSTRACT: This study aimed to evaluate the fracture resistance of teeth restored with conventional, bulk-fill, and fiber-reinforced composite materials regarding intact teeth. Standard cavities were prepared on 70 sound third molar teeth. The teeth were randomly divided into six groups: intact teeth, conventional Bis-GMA based composite, fiber-reinforced composite, Bis-GMA based bulk-fill composite, ormocer based bulk-fill composite, glass containing resin-based bulk-fill composite. The data was obtained by a Universal Testing Machine and analyzed statistically. Fracture resistance of the teeth restored with conventional composite was significantly lower than the other groups (p0.05). The obtained data showed that restoring teeth with bulk-fill and fiber-reinforced composites could be recommended in Class II cavities.

RESUMEN: El objetivo del presente estudio fue evaluar la resistencia a la fractura de los dientes restaurados con materiales compuestos convencionales, de relleno y reforzados con fibras, en relación con los dientes intactos. Se prepararon cavidades estándar en 70 dientes de terceros molares sanos. Los dientes se dividieron al azar en seis grupos: dientes intactos, compuesto convencional basado en Bis-GMA, compuesto reforzado con fibra, compuesto de relleno a base de Bis-GMA, compuesto de relleno a base de ormocer, compuesto de relleno a base de vidrio que contiene resina. Los resultados fueron obtenidos utilizando una máquina universal de pruebas y analizados estadísticamente. La resistencia a la fractura de los dientes restaurados con el composite convencional fue significativamente menor que la de los otros grupos (p0,05). Los datos obtenidos mostraron que la restauración de dientes con composites de relleno y reforzados con fibra podría ser recomendada en cavidades de Clase II.

UV-curable hyperbranched polyester sealant with tunable mechanical properties.

Different types of wounds have different requirements of a wound sealant. One of the requirements of concern is the adaptability of the mechanical properties of biomaterials to native tissues. However, the mechanical properties of current sealant are untunable or adjustable in a small range normally. Therefore, the scope of application of these sealant is limited. In this study, we developed hyperbranched polyester (HBP)-based UV-curable sealant with tunable mechanical properties. This sealant was cured under UV-light for 2 minutes and exhibited strong adhesion with tissues. The shear adhesive strength of it to the porcine skin ranged between 20-30 kPa, which was higher than the fibrin glue (∼10 kPa). Moreover, the elastic modulus of the sealant in a tensile test ranged between 27-54 MPa, depending on the degree of acrylation of the HBPs. Additionally, we assessed the biocompatibility of the sealant by co-culturing it with mouse mesenchymal stem cells (mMSCs) for 7 days and discovered that the cell viability was unaffected. This sealant with a tunable elastic modulus might be a promising candidate for treating wounds with different elastic moduli.

Generalised hypomineralisation of enamel in oculodentodigital dysplasia: comprehensive dental management of a case.

Oculodentodigital dysplasia (ODDD) is a rare congenital disorder characterised by developmental abnormalities of the eye, dentition and digits of the hands and feet, with neurological symptoms reported in 30% of individuals. Dental anomalies associated with ODDD include enamel hypoplasia and subsequent caries, microdontia, missing teeth, amelogenesis imperfecta, pulp stones and delayed tooth development. Here, we describe the comprehensive dental management of a 3-year-old girl who presented with rapid deterioration of the primary dentition due to generalised enamel hypomineralisation. Conservative, comprehensive restorative management was performed under general anaesthesia. Within 6 months, further breakdown of the remaining unrestored enamel was noted. This case documents the challenges of conservative management in dental anomalies that are not well documented due to the extreme rarity of the disorder.

Clinical evaluation of hydrophobic and hydrophilic pit and fissure sealants among 7-10 year old school children: a split mouth study design / Avaliação clínica de fóssulas e físsuras com selantes hidrofóbicos e hidrofílicos entre crianças de 7 a 10 anos de idade: estudo intervencional

Introdução: O estudo foi realizado para comparar a eficácia da retenção hidrofóbica e hidrofílica de selante de fóssulas e fissuras entre crianças de 7 a 10 anos de idade escolar. Material e métodos: O presente estudo randomizado de boca dividida foi realizado nas superfícies oclusais dos primeiros molares inferiores permanentes para comparação e avaliação da retenção junto com outras variáveis de resultado, como a cor, descoloração marginal, adaptação marginal, forma anatômica, sensibilidade pós-operatória, formação de cárie e rugosidade de superfícia de selantes hidrofóbicos e hidrofílicos de fóssulas e fissuras no 3º e 6º mês de aplicação. Os dados foram analisados usando o software SPSS e os resultados foram obtidos. Resultados: No presente estudo, entre as 50 restaurações com selantes hidrofóbico de fóssulas e fissuras (Grupo I), 48 (96%) das restaurações ficaram retidas no final do terceiro mês e 45 (90%) ficaram retidas no final do sexto mês. Entre as 50 restaurações nos selantes de fóssulas e fissuras hidrofílicas (Grupo II), 49 (98%) restaurações ficaram retidas no final do terceiro mês e 46 (92%) no final do sexto mês ficaram retidas. Não houve diferença significativa no número de restaurações totalmente retidas ao final de seis meses (p = 1,00) entre os dois grupos. A avaliação de todas as outras variáveis entre as duas intervenções mostrou que a diferença não foi estatisticamente significativa. Conclusão: O estudo concluiu que o selante de fóssulas e fissuras hidrofílico era semelhante ao selante de fóssulas e fissuras hidrofóbicas em termos de retenção, combinação de cor, descoloração marginal, adaptação marginal, forma anatômica e rugosidade de superfície. (AU)

Introduction: The study was done to compare the effectiveness of hydrophobic and hydrophilic pit and fissure sealant retention among 7-10 year old school children. Material and Methods: The present split mouth randomized trial was conducted on the occlusal surfaces of permanent first mandibular molars to compare and assess the retention along with other outcome variables like colour match, marginal discolouration, marginal adaptation, anatomic form, post-operative sensitivity, caries formation and surface roughness properties of Hydrophobic and Hydrophilic pit and fissure sealants at 3rdand 6th month. The data was compiled and analyzed using SPSS software and results were generated. Results: In the present study among the 50 restorations in the hydrophobic pit and fissure sealants (Group I), 48 (96%) restorations were retained at the end of third month and 45(90%) were retained at the end of sixth month. Among the 50 restorations in the hydrophilic pit and fissure sealants (Group II), 49(98%) restorations were retained at the end of third month, and 46(92%) at the end of sixth month were retained. There was no significant difference in the number of completely retained restorations at the end of six months (p = 1.00) among both the groups. The assessment of all the other outcome variables between both the interventions showed that the difference was not statistically significant. Conclusion: The study concluded that the hydrophilic pit and fissure sealant was similar to the hydrophobic pit and fissure sealant in terms of retention, colour match, marginal discolouration, marginal adaptation, anatomic form and surface roughness properties with (AU)

Non-invasive and micro-invasive treatments to arrest active occlusal carious lesions in erupting permanent molars: A randomized clinical trial

Abstract: This study aimed to evaluate the efficacy of non-invasive and micro-invasive treatments on the arrest of occlusal enamel carious lesions in erupting permanent molars. This two-arm randomized clinical trial included 27 subjects, aged 5-11 years, with 64 erupting permanent molars presenting active occlusal enamel carious lesions (as assessed by the International Caries Detection and Assessment System [ICDAS]; scores 1-3). The sample was randomly assigned into two treatment groups: 1) resin-modified glass ionomer cement sealant (Clinpro XT Varnish; 3M ESPE) and 2) 4-week topical fluoride varnish application (Duraphat; Colgate). All children and parents received oral hygiene and dietary instructions. Teeth were evaluated at baseline and 3, 6, 9, and 12 months regarding the eruption stage, biofilm accumulation, as well as severity and activity of the carious lesions. The Kaplan-Meier method was used to evaluate the survival estimates for inactivation of the carious lesions for both treatment groups. Multivariate Cox regression models with shared frailty were performed to identify factors associated with the outcome (p < 0.05). After 12 months, 22% and 3% of the lesions treated with topical fluoride varnish and sealant, respectively remained active. The adjusted model demonstrated that younger children had a higher probability of active enamel carious lesions arresting (hazard ratio [HR] 0.42, 95% confidence interval [CI] 0.22-0.78; p=0.01). However, the probability of active enamel carious lesions arresting after sealant application was 8.85 times higher compared with fluoride varnish applications (p=0.01). Sealing is a more effective approach than fluoride varnish for arresting occlusal enamel carious lesions in erupting permanent molars.

Procedimientos libres de aerosol ante COVID-19 en odontología pediátrica / Aerosol-free procedures against COVID-19 in pediatric dentistry

A finales de 2019 se identificó el virus SARS-CoV-2 (por su significado en inglés Severe Acute Respiratory Syndrome Coronavirus 2) como agente etiológico de la COVID-19 (por su significado en inglés coronavirus disease 2019) en la ciudad de Wuhan, China. Debido a su rápida propagación al resto del mundo durante el primer trimestre del año 2020, la Organización Mundial de la Salud (OMS) la declaró pandemia mundial en marzo del mismo año. Por el potencial de contagio de COVID-19 se ha considerado que el entorno clínico en el que se desenvuelve la odontología puede ser de alto riesgo para el paciente, el odontólogo y sus asistentes si no se tienen las medidas de bioseguridad adecuadas. En un principio se vieron suspendidas las consultas regulares; sin embargo, al volver a la actividad laboral se han adaptado protocolos para el control de infecciones como reforzar el uso de barreras de protección y minimizar tratamientos que involucren aerosoles. La caries es uno de los principales motivos de consulta en la odontología pediátrica, por lo que en este escrito se sugieren algunos protocolos basados en la mínima invasión que prescinden de instrumental rotatorio para salvaguardar al paciente en riesgo de contagio, reduciendo el número de visitas y tiempo en consulta e incluso controlando algunos aspectos de salud bucal fuera de consulta clínica por medio de estrategias preventivas que pueden llevarse a cabo desde casa. Esto significa también mantener la tranquilidad por parte de los tutores del paciente ante la pandemia que se vive actualmente (AU)

At the end of 2019, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was identified as the etiological agent of COVID-19 in the city of Wuhan China. Due to its rapid spread to the rest of the world during the first trimester of 2020, the WHO declared a global pandemic in March of the same year. Due to the contagion potential of COVID-19, it has been considered that the clinical environment in which dentistry operates may be in high risk for the patient if the appropriate biosafety measures are not taken, initially clinical practices were suspended. However, when returning to work, protocols have been adapted to the infection control procedures, reinforced the use of protective barriers, and minimize treatments that involve aerosols. Caries is one of the main reasons for consultation in Pediatric Dentistry, this article suggests some protocols based on minimal invasion that dispense with rotating instruments to safeguard the patient from the risk of contagion, reducing the number of visits and time in consultation and even controlling some aspects of the oral health outside the dental visit through preventive strategies that can be carried out from home. Modifications to Dental Home. This should include maintaining tranquility and calm on the part of the patient's tutors in the face of the pandemic that we are currently experiencing (AU)

Effect of endodontic sealer in young molars treated by undergraduate students - a randomized clinical trial

Abstract The progression of caries in permanent molar teeth of young patients, frequently result in endodontic treatment. This randomized blinded clinical trial assessed the effect of two endodontic sealers (Sealer 26 and AH Plus) on the incidence of pain and apical repair after endodontic treatment of young molar teeth, and secondly identify factors associated with the outcomes. Endodontic treatment was performed by undergraduate students in molar teeth (n=69) of young patients (n=54) at the Endodontic and Restorative Public Extension Clinic Service. Protaper Next was used and the endodontic sealers were allocated which were restored with direct composite resin. Two primary clinical outcomes - apical repair and postoperative pain, were assessed after 12 and 24 months for blinded operators. Description of incidence rates and mixed-model regression using Generalized Estimation Equations (GEE). After 2 years 69 molar teeth of 54 patients were evaluated. No effect of the endodontic sealer was observed irrespective of period of evaluation. Apical repair incidences and asymptomatic teeth were, respectively, 90.5 and 89.3, 96.8 and 90.0% during 1 and 2 years of follow-up. Failed apical repair was associated with unsatisfactory pulpectomy (p=0.003) and periapical conditions (p=0.007) as well as their interaction (p=0.016). None of these independent variables was able to predict the occurrence of pain in both periods. Prognosis of apical repair is dependent on the initial conditions. Endodontic treatment of young molars associated with composite resin restorations performed by undergraduate students have satisfactory results after 2 years and was effective to prevent the risk of permanent teeth loss.

Resumo A rápida progressão das lesões de cárie nos dentes molares permanentes de pacientes jovens, frequentemente resulta no tratamento endodôntico. Este ensaio clinico randomizado cego avaliou o efeito de dois cimentos endodônticos (Sealer 26 e AH Plus) na incidência de dor e reparo apical após tratamento endodôntico de dentes molares jovens e identificar fatores associados aos desfechos do tratamento. O tratamento endodôntico foi realizado por estudantes de graduação em dentes molares permanentes (n=69) de pacientes jovens (n=54) na Clínica de Extensão Endodôntica e Restauradora da Universidade Federal de Uberlândia, Brasil. Protaper Next foi usado e os dois cimentos foram distribuídos aleatoriamente nas amostras, as quais foram restauradas com resina composta direta. Dois desfechos clínicos primários - reparo apical e dor pós-operatória foram avaliados após 12 e 24 meses por operadores de forma cega. Análise longitudinal dos dados incluiu a descrição das taxas de incidência e modelo de regressão misto usando Equações de Estimativa Generalizadas (GEE). As incidências (%) do reparo apical e dos dentes assintomáticos foram respectivamente 90,5/89,3 e 96,8/90,0 nos períodos de 1 e 2 anos de acompanhamento. Ausência de reparo apical foi associada com pulpectomia insatisfatória (p=0,003) e condições periapicais (p=0,007), bem como sua interação (p=0,016). Nenhuma dessas variáveis independentes foi capaz de prever a ocorrência de dor nos períodos de acompanhamento. O tratamento endodôntico mostrou resultados satisfatórios após 2 anos. O prognóstico do reparo apical depende das condições iniciais. Nenhum efeito do cimento endodôntico foi observado. O tratamento endodôntico de molares jovens associado com restaurações em resina composta realizado por estudantes de graduação tem um papel relevante na redução do risco de perda do dente permanente.

Lasers to prevent dental caries: a systematic review.

OBJECTIVE: To assess the effectiveness of lasers (at sub-ablative parameters) in reducing caries incidence compared with traditional prophylactic interventions (TPIs) when used alone or together with other TPIs such as pits and fissures sealant or fluoride gels or varnishes. DESIGN: A systematic review. Data sources include Medline (via PubMed), Embase, Web of Science and the Cochrane Library (December 2019). ELIGIBILITY CRITERIA: Only randomised trials (RCTs) and controlled clinical trials (CCTs) dealing with prophylactic lasers use (vs TPI or untreated teeth) were considered as eligible. We excluded in vitro and ex vivo studies. DATA EXTRACTION: Eligible studies were selected and data extracted independently by two reviewers. Risk of bias was assessed adopting the Cochrane Risk of Bias tool. Data on caries incidence, sealant retention, fluoride uptake, adverse events, treatment duration, patients' discomfort and cost-effectiveness ratio was extracted. DATA ANALYSIS: Extracted data were presented narratively due to the heterogeneity of included studies. RESULTS: Seven RCTs and two CCTs, all with an evident risk of bias, met inclusion criteria, pooling together 269 individuals and 1628 teeth. CO2, neodymium-doped yttrium aluminium garnet, erbium-doped yttrium aluminum garnet (Er:YAG), erbium, chromium: yttrium scandium gallium garnet (Er,Cr:YSGG) and Argon lasers were used. In the permanent dentition, lasers only when used in combination with TPIs were effective in reducing caries when compared with untreated teeth (risk ratio (RR)=0.44 (0.20-0.97); Er:YAG laser) or with TPIs used alone (RR=0.39 (0.22-0.71); CO2 laser). Moreover, Argon laser significantly improved the fluoride uptake into the enamel surfaces (ANalysis Of VAriance (ANOVA) tests: 95%, p<0.0001). Likewise, sealant retention improved when acid etching was performed on previously irradiated enamel fissures by CO2 laser (RR=0.63 (0.38-1.04)) or Er:YAG laser (RR=0.54 (95% CI: 0.34 to 0.87)). In addition, laser resulted safe and well tolerated by patients. CONCLUSION: Despite some positive indications, an inadequate level of evidence was found in the included studies concerning the lasers' effectiveness in preventing caries. Further studies with a higher methodological quality level are required.

Solving color irregularities with a bioactive bulk-fill restorative system: case report and 24-months follow up / Resolución de irregularidades de color con un sistema restaurador bulk-fill bioactivo: reporte de caso y seguimiento de 24 meses

Bulk-fill resin composites represent an excellent alternative to the conventional incremental layering technique for the reduction of polymerization stress on the adhesive interface. Marginal seal can be further improved by the incorporation of bioactive fillers, such as those encountered in Giomers. However, the high translucency required for the adequate polymerization of bulk-fill materials can seriously jeopardize the final aesthetic outcome of the restorations, especially in the presence of inhomogeneous or stained dentin substrates. The aim of this case report was to present the combined use of two bulk-fill Giomer materials (Beautifil Bulk Flowable and Beautifil II LS, Shofu) for the restoration of three posterior maxillary teeth displaying a black stained dentin substrate due to amalgam corrosion products. This technique allowed completion of the restorations with a satisfactory aesthetic and biomimetic outcome. The adequate preservation of the anatomy and function of the three restorations after 24-months follow-up, provides evidence of the enhanced marginal sealing capacity of these bioactive materials and the success of bulk-fill techniques over time.

Las resinas compuestas de tipo bulk-fill representan una excelente alternativa a la técnica incremental para la reducción de la tensión de polimerización sobre la interfaz adhesiva. La incorporación de rellenos bioactivos, como los que se encuentran en los materiales con tecnología giomer, refuerzan aún más el sellado marginal de estas restauraciones. Sin embargo, la alta translucidez, necesaria para la adecuada polimerización de los materiales tipo bulk-fill, puede comprometer seriamente el resultado estético final de las restauraciones, especialmente en presencia de sustratos dentarios no homogéneos u oscurecidos. El objetivo de este reporte de caso fue presentar el uso combinado de dos materiales giomer tipo bulk-fill (Beautifil Bulk Flowable y Beautifil II LS, Shofu) para la restauración de tres dientes maxilares posteriores con un sustrato dentinario ennegrecido debido a productos de corrosión de amalgama. Esta técnica permitió completar las restauraciones con un resultado estético y biomimético satisfactorio. La adecuada conservación de la anatomía y la función de las tres restauraciones tras un período de 24 meses, aporta evidencia sobre la adecuada capacidad de sellado marginal de estos materiales bioactivos y el éxito de las técnicas de restauración tipo bulk-fill en el tiempo.

Efecto antibacteriano de los selladores endodónticos en los conductos radiculares / Antibacterial effect of endodontic sealers in root canals

RESUMEN Introducción: Los selladores endodónticos desempeñan un papel crucial en la obturación, dado que dichos materiales, no solo actúan en el momento de su aplicación, sino que continúan haciéndolo con posterioridad, protegiendo al periodonto apical contra los organismos microbianos presentes. Precisamente, una de las propiedades deseadas en los selladores endodónticos es que posean acción antimicrobiana, para eliminar las bacterias remanentes después de la irrigación e instrumentación. Objetivo: Realizar una revisión sistemática del efecto antibacteriano de diferentes selladores endodónticos más utilizados en odontología contra Enterococcus faecalis (E. faecalis). Métodos: Esta revisión sistemática se llevó a cabo siguiendo los lineamientos PRISMA. La búsqueda se realizó en las bases de datos PubMed y Science Direct. Se revisaron los artículos de estudios antimicrobianos in vitro de selladores endodónticos y se excluyeron aquellos de fuente secundaria, como los de revisión de la literatura, así como artículos sobre cementos para otros usos. Desarrollo: Los cementos a base de hidróxido de calcio, resina o biocerámicos son biocompatibles y presentan algún porcentaje de actividad antimicrobiana; sin embargo, se puede apreciar que existe variabilidad en los resultados obtenidos en los estudios incluidos en la revisión, debido al uso de condiciones diferentes para la evaluación antibacteriana, excepto en los selladores endodónticos a base de silicona, los cuales tuvieron, de forma consistente, un efecto antibacterial nulo contra E. faecalis. Conclusión: De acuerdo a la bibliografía revisada, los selladores AH Plus, AH 26, TotalFill, BC Sealer y MTA Fillapex exhibieron efecto antimicrobiano, sin embargo, algunos de ellos mostraron escasa actividad contra E. faecalis(AU)

ABSTRACT Introduction: Endodontic sealers play a crucial role in sealing, for they not only act at the moment of their application, but continue to do so later, protecting the apical periodontium against microbial organisms. One of the properties desired in endodontic sealers is precisely their antimicrobial action against bacteria remaining after irrigation and instrumentation. Objective: Carry out a systematic review about the antibacterial effect of the endodontic sealers most commonly used in dental practice against Enterococcus faecalis (E. faecalis). Methods: The systematic review was based on PRISMA guidelines. The search was conducted in the databases PubMed and Science Direct. Papers were reviewed which dealt with in vitro antimicrobial studies about endodontic sealers, excluding secondary sources such as literature reviews and papers about cements used for other purposes. Discussion: Cements based on calcium hydroxide, resin or bioceramic are biocompatible and display some percentage of antimicrobial activity. However, variability was observed in the results obtained by the studies in the review, due to the use of different conditions for antibacterial evaluation, except for silicone-based endodontic sealers, which consistently displayed no antibacterial activity against E. faecalis. Conclusion: According to the bibliography reviewed, the sealers AH Plus, AH 26, TotalFill, BC Sealer and MTA Fillapex had an antimicrobial effect. However, some of them displayed scant activity against E. faecalis(AU)