Area-Level Factors of Dental Caries in Children and Adolescents in European Neighborhoods - a Systematic Review.

The WHO emphasizes the importance of taking area-level factors into account when formulating public health interventions. The aim of this systematic review was to identify which area-level factors are associated with children's dental caries in Europe and might therefore be a suitable starting point for public health interventions. We conducted a systematic review based on a search in PubMed, Web of Science, and Cochrane Library including all European studies on caries in children and their area-level factors published since the year 2000 in English or German. We included 39 studies and identified 13 area-level factors investigated in the literature: degree of urbanization, deprivation, mean housing price, gross-national product, mean level of education, unemployment proportion and income, density of supermarkets, snack bars and dental offices, health, diet, and crime. Rural residency and higher unemployment were weakly associated with poorer oral health regarding dental caries. Deprivation showed a stronger (inverse) association. For income, findings were ambiguous; studies showed associations in both directions. For the other determinants, the included studies found no association. Many studies reported associations between place of residence and children's dental caries, but the mediators on this causal path are still not clearly established. The area-level factors analyzed in this review seem to play a role, but more studies with designs that allow causal interpretation of findings are needed to establish solid robust evidence that can be used in the formulation of future health policies.

Influence of Cavity Lining on the 3-Year Clinical Outcome of Posterior Composite Restorations: A Randomized Controlled Clinical Trial.

The purpose of this randomized, split-mouth-designed controlled and single-blinded clinical study was to evaluate the 3-year clinical performance of Class I and Class II resin composite restorations placed with or without cavity lining with a flowable composite. Fifty patients with treatment needs in two premolars or molars were included. One of the teeth was restored using the nanohybrid composite (Grandio®SO, control group), in the test group a high viscosity flowable composite was additionally applied as a first layer. In both groups, the same self-etch adhesive system was applied. Clinical evaluation after 3 years was carried out using the modified USPHS/Ryge criteria. At the 3-year follow-up the recall rate was 92%. Four restorations failed in the test group (8.7%), three due to the loss of vitality and one after fracture. The control group exhibited a cumulative success rate of 100%, while the test group achieved a success rate of 91.3%. This led to significant differences in the annual failure rate (AFR) between the two groups, with rates of 0% and 2.9% (p < 0.05; Mann-Whitney U-test). After 3 years the cumulative survival rate including all restorations was 95.7%. Statistical analysis revealed significant differences for the parameters: tooth vitality, marginal discoloration, success rate, and AFR. The other parameters exhibited no significant differences. Consequently, the nanohybrid composite demonstrated excellent performance over a 3-year period, whereas the utilization of a flowable composite for the cavity lining did not appear to exert a beneficial influence on clinical outcomes.

The Interaction of Two Widely Used Endodontic Irrigants, Chlorhexidine and Sodium Hypochlorite, and Its Impact on the Disinfection Protocol during Root Canal Treatment.

In recent years, sodium hypochlorite and chlorhexidine digluconate have been the gold standard of irrigation solutions utilized within the disinfection protocol during root canal treatments. Nowadays, it is known that, during chemical disinfection of the root canal, consecutive application of sodium hypochlorite and chlorhexidine digluconate leads to the formation of an orange-brown precipitate. This precipitate is described as being chemically similar to para-chloroaniline, which is suspected to have cytotoxic and carcinogenic effects. Concerns also exist regarding its influence on the leakage of root canal fillings, coronal restorations, and tooth discoloration. The purpose of this article is to review the literature on the interaction of sodium hypochlorite and chlorhexidine digluconate on the tooth and its surrounding tissues, and to discuss the effect of the precipitate formed during root canal treatment. We further address options to avoid the formation of the precipitate and describe alternative irrigation solutions that should not interact with sodium hypochlorite or chlorhexidine digluconate.

Influence of Ascorbic Acid as a Growth and Differentiation Factor on Dental Stem Cells Used in Regenerative Endodontic Therapies.

BACKGROUND: Vitamin C is one of the major extracellular nonenzymatic antioxidants involved in the biosynthesis of collagen. It promotes the growth of fibroblasts, wound healing processes, and enhances the survival and differentiation of osteoblasts. The potential effects of ascorbic acid on human dental pulp cells (DPC) and the cells of the apical papilla (CAP) used in actual regenerative endodontic procedures remain largely unknown. In this study, we investigated the possible employment of ascorbic acid in the differentiation and regenerative therapies of DPC and CAP. METHODS: Nine extracted human wisdom teeth were selected for this study. Subpopulations of stem cells within DPC and CAP were sorted with the mesenchymal stem cell marker STRO-1, followed by treatments with different concentrations (0 mM, 0.1 mM, 0.5 mM, and 1.0 mM) of ascorbic acid (AA), RT-PCR, and Western blot analysis. RESULTS: FACS analysis revealed the presence of cell subpopulations characterized by a strong expression of mesenchymal stem cell marker STRO-1 and dental stem cell markers CD105, CD44, CD146, CD90, and CD29. Treatment of the cells with defined amounts of AA revealed a markedly increased expression of proliferation marker Ki-67, especially in the concentration range between 0.1 mM and 0.5 mM. Further investigations demonstrated that treatment with AA led to significantly increased expression of common stem cell markers OCT4, Nanog, and Sox2. The most potent proliferative and expressional effects of AA were observed in the concentration of 0.1 mM. CONCLUSIONS: AA might be a novel and potent growth promoter of human dental cells. Increasing the properties of human dental pulp cells and the cells of the apical papilla using AA could be a useful factor for further clinical developments of regenerative endodontic procedures.

The influence of application of different desensitisers on root dentine demineralisation in situ.

AIM: To evaluate the influence of three desensitisers on root caries demineralisation in situ. METHODS: The root surfaces of 36 freshly extracted human molars were used to prepare root dentine specimens. These specimens were distributed among the following groups: A: Admira Protect, V: VivaSens, H: Hyposen, C: control group, untreated. Two dentine specimens of each group were inserted into two buccal aspects of intraoral mandibular appliances. The appliances were worn by nine persons for five weeks, day and night. One side was brushed daily with a toothpaste. On the other side, plaque was allowed to grow. Individual oral hygiene techniques were performed without any fluorides. After the in situ period, two slabs were ground. The depth of the demineralised areas was determined using a polarised light microscope. RESULTS: ANOVA revealed significant differences between brushed and non-brushed specimens. Lesion depths in the brushed group were significantly decreased (p < 0.05, Tukey's test). CONCLUSIONS: Within the limitations of an in situ study it can be concluded that the demineralisation of the root surface can be hampered by application of desensitisers under different oral hygiene conditions. The application of clinical proven desensitising agents might have a caries-protective effect on exposed root surfaces.

Efficacy of 8% arginine on dentin hypersensitivity: A multicenter clinical trial in 273 patients over 24 weeks.

OBJECTIVES: To assess the efficacy of 8% arginine containing prophylaxis products over 24 weeks in subjects with dentin hypersensitivity (DH). METHODS: 297 patients with established DH (Schiff score 2, 3) in three European study centers were randomly assigned to either 8% arginine and calcium carbonate in-office prophylaxis paste and the respective toothpaste (test group) or fluoride-free prophylaxis paste and sodium monoflourophosphate toothpaste as a negative control group. Air blast (Schiff Score) and tactile (Visual Analog Scale) sensitivity scores were assessed at baseline (BL_0), after single application of the prophylaxis paste (BL_1) and after 4, 8, and 24 weeks of continuous at-home use of the toothpaste. RESULTS: 273 subjects completed the study. Test and control group presented statistically significant percentage reductions (t-test, p < 0.05) in Schiff Score at BL_1 and at 24 weeks relative to BL_0 (difference in %; test group: -23.6, -44.9, control group: -8.8, -32.7). The pooled Schiff Score for the two evaluated teeth yielded a significantly greater alleviation of DH in the test group than in the control group at all evaluation appointments (Ancova, p < 0.05; difference in %: 15.3, 7.4, 10.6, 17.2). CONCLUSIONS: A significant relief of DH was demonstrated after application of the 8% arginine prophylaxis products over 24 weeks compared to a negative control. CLINICAL SIGNIFICANCE: Whilst DH is influencing patients' eating, drinking and tooth brushing habits as well as social life interactions it is important that clinicians are able to offer evidence based immediate and long-lasting treatment methods in order to manage their patients' discomfort.

Influence of different brazing and welding methods on tensile strength and microhardness of orthodontic stainless steel wire.

The aim of this study was to compare the mechanical strength and microhardness of joints made by conventional brazing and tungsten inert gas (TIG) and laser welding. A standardized end-to-end joint configuration of the orthodontic wire material in spring hard quality was used. The joints were made using five different methods: brazing (soldering > 450 degrees C) with universal silver solder, two TIG, and two laser welders. Laser parameters and welding conditions were used according to the manufacturers' guidance. The tensile strengths were measured with a universal testing machine (Zwick 005). The microhardness measurements were carried out with a hardness tester (Zwick 3202). Data were analysed using one-way analysis of variance and Bonferroni's post hoc correction (P < 0.05). In all cases, brazing joints ruptured at low levels of tensile strength (198 +/- 146 MPa). Significant differences (P < 0.001) between brazing and TIG or laser welding were found. The highest means were observed for TIG welding (699-754 MPa). Laser welding showed a significantly lower mean tensile strength (369-520 MPa) compared with TIG welding. Significant differences (P < 0.001) were found between the original orthodontic wire and the mean microhardness at the centre of the welded area. The mean microhardness differed significantly between brazing (1.99 GPa), TIG (2.22-2.39 GPa) and laser welding (2.21-2.68 GPa). For orthodontic purposes, laser and TIG welding are solder-free alternatives to joining metal. TIG welding with a lower investment cost is comparable with laser welding. However, while expensive, the laser technique is a sophisticated and simple method.

Influence of three different sealants on root dentin demineralization in situ.

PURPOSE: To evaluate in situ the onset of initial demineralization in human dentin pretreated either with two different dentin bonding agents or a desensitizer. METHODS: 28 freshly extracted human molars were included in this study. The root surfaces were thoroughly cleaned, thereby removing the cementum. From each tooth four root dentin specimens were prepared. The specimens were distributed among the following experimental groups: C: control group (untreated), S: Syntac Classic, X: Xeno III, and H: Hyposen. For each subject, one dentin specimen of each group was inserted into both buccal aspects of a bilateral intraoral mandibular appliance. The appliances were worn by 14 subjects for 5 weeks day and night. One side was brushed daily with fluoride-containing toothpaste (Aronal) (B). On the other side, plaque was allowed to grow (NB). Individual oral hygiene techniques were performed without any fluorides. During meals, the appliance was stored in 10% sucrose solution. After the in situ period, slabs (150 microm) were ground and studied using polarized light microscopy. RESULTS: For lesion depth, ANOVA revealed significant differences between brushed and unbrushed specimens. In the brushed groups, the following lesion depths were evaluated (mean values and standard deviation in microns): Group B-C: 74.1 (+/- 18.5), Group B-S: 27.6 (+/- 9.6); Group B-X: 28.7 (+/- 9.6), and Group B-H: 34.3 (+/- 20.6). The non-brushed specimens showed following lesion depths: Group NB-C: 101.7 (+/- 23.9), Group NB-S: 59.9 (+/- 13.1), Group NB-X: 52.5 (+/- 12.1), and Group NB-H: 72.9 (+/- 19.9). Compared to the non-brushed groups, lesion depths in the brushed group were significantly decreased (P < 0.05, Tukey's test). The reduction of lesion depths after application of the three agents was significant in both cases (brushed and non-brushed groups). Within the limitations of an in situ study it can be concluded that the demineralization of the root surface can be inhibited by application of dentin adhesives and desensitizers under different oral hygiene conditions.

Apical sealing ability of 2 epoxy resin-based sealers used with root canal obturation techniques based on warm gutta-percha compared to cold lateral condensation.

OBJECTIVE: To evaluate the apical sealing ability of 2 epoxy resin-based root canal sealers used with 2 different warm gutta-percha obturation techniques and cold lateral condensation. METHOD AND MATERIALS: The root canals of 72 freshly extracted single-root incisors were prepared and randomly assigned to 6 experimental groups. Root canal fillings were performed using either cold lateral condensation, warm vertical condensation, or Thermafil obturators with EndoRez or AH Plus as sealer. After root canal filling, the teeth were stored in 5% methylene blue solution for 7 days. Linear dye penetration was measured in bisected specimens by a calibrated investigator using a light microscope. RESULTS: Statistical analysis revealed significantly higher penetration depths in groups where EndoRez was used (P < .05, Tukey test). Regarding the different obturation techniques, the least amount of dye penetration was observed for AH Plus and EndoRez when warm vertical condensation was used. CONCLUSION: The results of this study indicate that the apical sealing ability of EndoRez is not as effective as that of AH Plus. Thermafil obturators and warm vertical condensation achieved seals with low dye penetration depth. The use of these techniques might decrease the risk of apical leakage.

The influence of human plasma used for dentin perfusion on tensile bond strength of different light-curing materials.

PURPOSE: To evaluate the influence of two perfusion solutions, saline and human plasma, on tensile bond strengths of five different light-curing materials in an in vitro investigation. METHODS: 150 human third molars were used. All teeth were prepared in a special manner allowing the simulation of intrapulpal pressure and dentin perfusion. Dentin specimens with a thickness of 3.5 mm were obtained under standardized conditions. The specimens were randomly assigned to 10 experimental groups. Five groups were perfused with physiologic saline while with the other five with human plasma under constant hydrostatic pressure of 30 cm H2O was used for at least 1 hour. Tensile bond strength of the different dentin bonding agents and composite or compomer materials (A: Syntac/Tetric, B: Prime & Bond NT/Spectrum TPH, C: Solobond Plus/Arabesk, D: Compoglass SCA/Compoglass, E: Dyract PSA/Dyract) was evaluated using an Zwick Universal testing machine 10 minutes after light-curing. RESULTS: Pairwise comparison showed a significant increase of bond strengths in all human plasma perfused subgroups (P< 0.05; Wilcoxon). The influence of the different dentin adhesives was significant (P< 0.001; ANOVA). The significantly highest values were observed for the composite groups Syntac/Tetric and Solobond Plus/Arabesk (P< 0.05; closed test procedure). The compomer Group D (Compoglass SCA/Compoglass) showed significantly decreased values compared to all other groups (P< 0.05; closed test procedure). Within the limitations of an in vitro study, it can be concluded that the use of human plasma might result in higher tensile bond strength compared to saline.

The effect of different desensitizing agents on initial demineralization of human root dentin.

OBJECTIVES: The aim of this study was to determine the caries-protective effect of 3 different desensitizing agents (Seal & Protect 2.0, D/Sense 2, and Gluma Desensitizer) on root dentin in vitro. METHOD AND MATERIALS: The root surfaces of 60 freshly extracted, caries-free human molars were used. After removing the cementum, the teeth were coated with an acid-resistant nail varnish, exposing 2 rectangular windows of 2 X 3 mm each on the root surface. One window served as an untreated control, and the other window was treated with 1 of the desensitizing agents. The specimens were randomly distributed among the following experimental groups: group A, D/Sense 2; group B, Seal & Protect 2.0; and group C, Gluma Desensitizer. Subsequently, all specimens were demineralized for 14 days with acidified gel (HEC, pH 4.8, 37 degrees C). Two dentinal slabs were cut from each window. The slabs were ground to a thickness of 80 microm and immersed in water. The demineralization depth was determined using a polarized light microscope. RESULTS: The nontreated control specimens showed lesions with a mean depth of 84.9 microm (+/- 6.0). In the specimens treated with the desensitizing agents, lesion depth was generally significantly reduced. Statistical analysis revealed significantly lower values for the specimens in group B in comparison with the others. CONCLUSION: Within the limitations of an in vitro investigation, it can be concluded that the demineralization of the root surface can be hampered by applying the desensitizing agents tested.

Push-out bond strength of RealSeal SE and AH Plus after using different irrigation solutions.

INTRODUCTION: The aim of this investigation was to evaluate the influence of different endodontic irrigants (sodium hypochlorite [NaOCl], chlorhexidine [CHX], and EDTA) on the push-out bond strength of the obturation materials RealSeal SE (SybronEndo, Orange, CA) and AH Plus (Dentsply International Inc, York, PA). METHODS: Two hundred human root canals were prepared and divided into 2 groups according to the filling material (RealSeal SE vs AH Plus). Each group was subdivided into 5 groups according to the irrigation protocol (0.9% saline [control], 3% NaOCl, 3% NaOCl with saline, 17% EDTA, and 2% CHX). After obturation, roots were sliced into 1-mm discs for push-out assessment. Compressive loading was performed using an universal testing machine at a speed of 0.5 mm/min. Two-way analysis of variance and the Kruskal-Wallis test were performed for pair-wise comparisons to assess the differences between the experimental groups. RESULTS: AH Plus exhibited a significantly higher bond strength than RealSeal SE (mean = 2.53 and 1.53 MPa, respectively; P < .05), except with saline alone (P > .05). Within the AH Plus groups, no significant differences existed between the irrigants and saline alone (P > .05). The bond strength of RealSeal SE with saline alone or with NaOCl and saline did not differ from that of AH Plus with saline alone (P > .05). However, the push-out bond strength of RealSeal SE decreased by approximately half (P < .05 compared with RealSeal SE with saline alone) after rinsing with NaOCl alone, EDTA, or CHX. CONCLUSIONS: The bond strength of RealSeal SE is highly influenced by the irrigant used.

Maxillary molars with morphologic variations of the palatal root canals: a report of four cases.

INTRODUCTION: The purpose of this article was to show the importance of the knowledge of the anatomy of root canals. Unusual root and root canal morphologies associated with both buccal roots of upper molars have been recorded in several studies in the literature. However, scientific information focusing on variations of the palatal root is rare. METHODS: In this report, four cases are presented involving the root canal treatment of maxillary first and second molars with unusual morphologic configurations of the palatal root canals. RESULTS: During root canal treatment, type IV and V configurations as defined by Vertucci of the palatal canals of two first and two second maxillary molars were identified. After mechanical instrumentation, the canals were obturated. Radiologic and clinical re-evaluation showed no signs of inflammation. CONCLUSIONS: This report describes and discusses the possibility of different root and canal variations of the maxillary molars from a clinical point of view. Anatomic variations can occur in any tooth, and palatal roots of maxillary first and second molars are no exception. Therefore, careful examination of radiographs and internal anatomy of teeth is essential.

The influence of different irradiation doses and desensitizer application on demineralization of human dentin.

The aim of the present study was to evaluate the effect of different irradiation doses after desensitizer application on the onset of initial demineralization of human dentin in situ. The root surfaces of 45 freshly extracted caries-free human molars were cleaned, thereby removing the cementum. From each tooth two root dentin specimens were prepared. The specimens were distributed among the following experimental groups: 0, 0.5, 1, 2 and 5Gy. The irradiation dose was fractionally applied (0.5Gy/day). One dentin specimen of each group was inserted into both buccal aspects of nine intraoral mandibular appliances. On one side the specimens were additionally coated with the desensitizer Hyposen (H). On the other side, the specimens were left untreated (C). The appliances were worn by nine persons for five weeks day and night. During meals, the appliance was stored in 10% sucrose solution. After the in situ period, slabs (150microm) were ground and studied using a polarized light microscope. Concerning radiation dose, significant differences were observed between the control and 5Gy group (p<0.05, Tukey s test). Pairwise comparison showed that lesion depths in groups treated with Hyposen were significantly decreased. Within the limitations of this study it can be concluded that higher radiation doses seem to increase the caries susceptibility of dentin. The additional application of a desensitizer hampers the demineralization and might have a caries-protective effect on exposed irradiated root surfaces.

Influence of pressure application before light-curing on the bond strength of adhesive systems to dentin.

This study evaluated the influence of defined pressure application before light-curing on the tensile bond strength (TBS) of two adhesive systems to wet and perfused dentin. Bonding sites were analyzed by scanning electron microscopy (SEM) to assess morphological changes. Dentin discs from 120 human third molars were prepared in such a way to allow simulation of intrapulpal pressure. The specimens were randomly assigned to 6 groups (n=20) according to different experimental conditions. The adhesive systems (Scotchbond Multi-Purpose and Syntac) were applied either to wet or perfused dentin. In the latter, compression was applied before adhesive light-curing . TBS was recorded using an universal testing machine. Qualitative examination of the bonding sites was performed by SEM after dissolving the dentin with 50% nitric acid. Pressure application prior to light-curing resulted in a remarkable decrease of TBS for Syntac, while no significant change was observed for Scotchbond MP. SEM analysis showed no considerable lengthening of the resin tags after pressure application. These findings suggest that application of adhesive systems to dentin under pressure before light-curing had no positive effect on TBS.

Fracture strength of different soldered and welded orthodontic joining configurations with and without filling material.

The aim of this study was to compare the mechanical strength of different joints made by conventional brazing, TIG and laser welding with and without filling material. Five standardized joining configurations of orthodontic wire in spring hard quality were used: round, cross, 3 mm length, 9 mm length and 7 mm to orthodontic band. The joints were made by five different methods: brazing, tungsten inert gas (TIG) and laser welding with and without filling material. For the original orthodontic wire and for each kind of joint configuration or connecting method 10 specimens were carefully produced, totalizing 240. The fracture strengths were measured with a universal testing machine (Zwick 005). Data were analyzed by ANOVA (p=0.05) and Bonferroni post hoc test (p=0.05). In all cases, brazing joints were ruptured on a low level of fracture strength (186-407 N). Significant differences between brazing and TIG or laser welding (p<0.05, Bonferroni post hoc test) were found in each joint configuration. The highest fracture strength means were observed for laser welding with filling material and 3 mm joint length (998 N). Using filling materials, there was a clear tendency to higher mean values of fracture strength in TIG and laser welding. However, statistically significant differences were found only in the 9-mm long joints (p<0.05, Bonferroni post hoc test). In conclusion, the fracture strength of welded joints was positively influenced by the additional use of filling material. TIG welding was comparable to laser welding except for the impossibility of joining orthodontic wire with orthodontic band.

Fracture strength of different soldered and welded orthodontic joining configurations with and without filling material

The aim of this study was to compare the mechanical strength of different joints made by conventional brazing, TIG and laser welding with and without filling material. Five standardized joining configurations of orthodontic wire in spring hard quality were used: round, cross, 3 mm length, 9 mm length and 7 mm to orthodontic band. The joints were made by five different methods: brazing, tungsten inert gas (TIG) and laser welding with and without filling material. For the original orthodontic wire and for each kind of joint configuration or connecting method 10 specimens were carefully produced, totalizing 240. The fracture strengths were measured with a universal testing machine (Zwick 005). Data were analyzed by ANOVA (p=0.05) and Bonferroni post hoc test (p=0.05). In all cases, brazing joints were ruptured on a low level of fracture strength (186-407 N). Significant differences between brazing and TIG or laser welding (p<0.05, Bonferroni post hoc test) were found in each joint configuration. The highest fracture strength means were observed for laser welding with filling material and 3 mm joint length (998 N). Using filling materials, there was a clear tendency to higher mean values of fracture strength in TIG and laser welding. However, statistically significant differences were found only in the 9-mm long joints (p<0.05, Bonferroni post hoc test). In conclusion, the fracture strength of welded joints was positively influenced by the additional use of filling material. TIG welding was comparable to laser welding except for the impossibility of joining orthodontic wire with orthodontic band.

Influence of pressure application before light-curing on the bond strength of adhesive systems to dentin

This study evaluated the influence of defined pressure application before light-curing on the tensile bond strength (TBS) of two adhesive systems to wet and perfused dentin. Bonding sites were analyzed by scanning electron microscopy (SEM) to assess morphological changes. Dentin discs from 120 human third molars were prepared in such a way to allow simulation of intrapulpal pressure. The specimens were randomly assigned to 6 groups (n=20) according to different experimental conditions. The adhesive systems (ScotchbondTM Multi-Purpose and Syntac®) were applied either to wet or perfused dentin. In the latter, compression was applied before adhesive light-curing . TBS was recorded using an universal testing machine. Qualitative examination of the bonding sites was performed by SEM after dissolving the dentin with 50 percent nitric acid. Pressure application prior to light-curing resulted in a remarkable decrease of TBS for Syntac®, while no significant change was observed for ScotchbondTM MP. SEM analysis showed no considerable lengthening of the resin tags after pressure application. These findings suggest that application of adhesive systems to dentin under pressure before light-curing had no positive effect on TBS.

Este estudo avaliou a influência da aplicação de uma pressão definida antes da polimerização sobre a resistência à tração de dois sistemas adesivos à dentina molhada e perfundida. Os sítios de adesão foram analisados em microscopia eletrônica de varredura (MEV) a fim de determinar a ocorrência de alterações morfológicas. Discos de dentina de 120 terceiros molares humanos foram preparados de tal forma a simular a pressão intrapulpar. Os espécimes foram alocados aleatoriamente em 6 grupos (n=20), de acordo com as diferentes condições experimentais propostas. Os sistemas adesivos (Syntac® e ScotchbondTM Multi-Purpose) foram aplicados sobre a dentina molhada ou perfundida. Nesta última, compressão (7 N) foi aplicada antes da polimerização do sistema adesivo. A resistência à tração foi registrada em máquina universal de ensaios. A análise qualitativa dos sítios de adesão foi realizada em MEV após dissolução da dentina em 50 por cento de ácido nítrico. A aplicação da pressão antes da polimerização do sistema adesivo resultou em diminuição significativa da resistência à tração do Syntac®, ao passo que para o ScotchbondTM MP nenhuma alteração significativa foi observada. A análise em MEV não mostrou aumento considerável do tamanho dos tags de resina após a aplicação da pressão. Esses achados sugerem que a aplicação de sistemas adesivos à dentina sob pressão previamente à polimerização não teve efeito positivo sobre a resistência à tração.