ART is an alternative for restoring occlusoproximal cavities in primary teeth - evidence from an updated systematic review and meta-analysis.

BACKGROUND: A previous systematic review showed that atraumatic restorative treatment (ART) can be an option to restore the occlusoproximal cavities in primary teeth; however, few studies fulfilled the criteria of inclusion to generate a high level of evidence. AIM: To update the existing systematic review and address questions regarding survival rate of ART restorations compared to the conventional approach in occlusoproximal cavities in primary molars. DESIGN: The search was extended beyond the original search through the PubMed/MEDLINE database up to February 2016. Furthermore, Web of Science and EMBASE were searched. The inclusion criteria were subjects related to the scope of the systematic review. After selection by title and abstract, potentially eligible articles were read in full and included in accordance with exclusion criteria. Meta-analysis was carried out with the outcome being the survival rate of restorations. RESULTS: The search strategy identified 560 potentially relevant studies, in addition to 127 from the original systematic review. A total of four articles were included in the qualitative and quantitative analyses. Meta-analysis showed no statistically significant difference between ART and conventional approaches in survival rate of occlusoproximal cavities (OR = 0.887, 95% CI: 0.574-1.371). CONCLUSION: ART restorations have similar survival rate compared to conventional treatment and can be considered an option to restore occlusoproximal cavities in primary molars.

Influence of ultrasound or halogen light on microleakage and hardness of enamel adjacent to glass ionomer cement.

BACKGROUND: The use of external sources of energy may accelerate the setting rate of glass ionomer cements (GICs) allowing better initial mechanical properties. AIM: To investigate the influence of ultrasound and halogen light on the microleakage and hardness of enamel adjacent to GIC restorations, after artificial caries challenge. DESIGN: Cavities were prepared in 60 primary canines, restored with GIC, and randomly distributed into three groups: control group (CG), light group (LG) - irradiation with a halogen light-curing unit for 60s, and ultrasonic group (UG) - application of ultrasonic scaler device for 15s. All specimens were then submitted to a cariogenic challenge in a pH cycling model. Half of sample in each group were immersed in methylene blue for 4h and sectioned for dye penetration analysis. The remaining specimens were submitted to Knoop cross-sectional microhardness assessments, and mineral changes were calculated for adjacent enamel. RESULTS: Data were compared using Kruskal-Wallis test and two-way ANOVA with 5% significance. Higher dye penetration was observed for the UG (P<0.01). No significant mineral changes were observed between groups (P=0.844). CONCLUSION: The use of halogen light-curing unit does not seem to interfere with the properties of GICs, whereas the use of ultrasound can affect its marginal sealing.

Liberação e reincorporação de fluoreto de cimentos de ionômero de vidro utilizados no tratamento restaurador atraumático / Fluoride release and uptake of glass ionomer cements indicated for atraumatic restorative treatment

Objetivo: avaliar a capacidade de liberação e reincorporação de fluoreto dos CIVs de alta viscosidade. Métodos: Corpos de prova cilíndricos preparados com 5 materiais diferentes (n=3) - Vidrion R (controle), Vidrion N, Chem Flex, Fuji IX e Ketac Molar ART - foram mantidos em recipientes contendo água deionizada por 28 dias, trocados a cada 24 horas. Passado este período, foram mergulhados por 3 minutos em recipientes com dentifrício fluoretado (1100 ppm) diluído em água deionizada, voltando para novos recipientes com água deionizada. Esse procedimento repetiu-se durante 3 dias, totalizando 31 dias de experimento. A quantidade de íons flúor foi medida em cada um dos recipientes utilizados durante o experimento por meio de eletrodo específico para detecção do íon, acoplado a potenciômetro. Os dados foram submetidos à análise de variância e ao teste LSD, com 5% de significância. Resultados: o material que liberou a maior quantidade de íons flúor no período estudado foi o Vidrion R, apresentando diferença estatisticamente significante em relação aos demais materiais em todos os dias (p < 0,05). Entre o 28o e 31o dias, o material que liberou a maior quantidade de fluoreto foi o Vidrion R e o que liberou menor quantidade foi o Ketac Molar ART (p < 0,05). O material Vidrion N foi o único que não conseguiu absorver o fluoreto advindo do dentifrício. Conclusão: os cimentos indicados para o uso no ART parecem liberar menor quantidade de íons fluoreto quando comparados ao cimento convencional.

Objective: This study aimed to evaluate the fluoride release and uptake capability of high-viscous glass ionomer cements. Methods: Cylindrical specimens prepared with five different materials (n=3) - Vidrion R (control), Vidrion N, Chem Flex, Fuji IX and Ketac Molar ART - were maintained in individual containers with deionized water for 28 days. Every 24 hours, the water was changed, and after that, the specimens were immersed for 3 minutes in containers with 1100 ppm fluoridated dentifrice diluted in deionized water, before turning to new containers with deionized water. This procedure was repeated for 3 days, totalizing 31 days of experiment. The amount of fluoride ions was measured in the containers used during the experiment with specific electrode for ion detection coupled to a potentiometer. Data were submitted to analysis of variance and LSD test, (alpha=5%). Results: Vidrion R presented the highest level of fluoride release during the studied period and this difference was statistically significant for all days of experiment. Between the 28th and 31st days, the material which released the highest amount of fluoride was also Vidrion R and the one which released the smaller amount of fluoride was Ketac Molar ART. Vidrion N was not able to be recharged with fluoride from the fluoridated dentifrice. Conclusion: Glass ionomer cements suitable for use in ART seem to release fewer amounts of fluoride ions when compared to conventional (low strength) glass ionomer cement.