Influence of different application protocols of universal adhesive system on the clinical behavior of Class I and II restorations of composite resin - a randomized and double-blind controlled clinical trial.

BACKGROUND: Multimode adhesives incorporate the versatility of adapting to various clinical situations by its capacity to be used in different protocols. This study aimed to evaluate the clinical behavior of composite resin direct restorations (Class I and II) performed with different universal dentin adhesive application protocols comparing adapted FDI and adapted USPHS criteria. METHODS: The current study is a randomized, double-blind, split-mouth, and convenience sample controlled clinical trial. The participants (age ≥ 18 years) had restorative need of Class I and/or II due to the presence of carious lesions and/or unsatisfactory restorations in at least three dental elements. Each participant received three application protocols for Scotchbond Universal adhesive (3M ESPE), one in each tooth to be restored: ER = etch-and-rinse + adhesive (n = 50); SEE = selective enamel etch + adhesive (n = 50) and SE = self-etch adhesive (n = 50). All teeth were restored in a similar way using Filtek™ Supreme composite resin (3M ESPE). Restorations were evaluated using the adapted FDI and adapted USPHS criteria, at baseline after 7 to 21 (12.02 ± 5.68) days (T1; n = 50 per group) and after 12 to 20 (15.8 ± 2.7) months (T2; n = 46 per group) by two previously calibrated evaluators (Kappa > 0.80). The statistical tests were performed between groups (Friedman), intragroup (Wilcoxon), and between the criteria considering acceptable and not acceptable restorations (McNemar), α = 0.05. RESULTS: A statistically significant difference was observed only for the property "superficial staining", between groups at T2 (p = 0.01) for ER (n = 13 with score 2 or more) and SEE (n = 3 with score 2 or more) and intragroup for ER (T1, n = 1 with score 2 or more; T2, n = 13 with score 2 or more, p = 0.001) and SE (T1, n = 0 with score 2 or more; T2, n = 8 with score 2 or more p = 0.007). For the other comparisons between groups, intragroup, and between the adapted FDI and adapted USPHS criteria, there were no statistically significant differences (p ≥ 0.05). CONCLUSIONS: It can be concluded that the different application protocols of the universal adhesive resulted in clinically "acceptable" restorations after 15.8 ± 2.7 months of follow-up. Adapted FDI and adapted USPHS criteria provided similar results to each other. TRIAL REGISTRATION: Number in Brazilian Registry of Clinical Trials (ReBEC): RBR-9p3hdp. Registered 24 May 2015.

Expected and perceived burdens in patients receiving mandibular overdentures retained by one or two implants.

PURPOSE: This study aimed to assess patients' expected burdens before treatment and their perceived burdens after the surgical and prosthodontic procedures of mandibular overdenture treatment and to evaluate factors influencing patients' perceptions. METHODS: Data were collected from 47 participants enrolled in a randomized clinical trial comparing mandibular overdentures retained by one or two implants. A 20-item questionnaire measured on a four-point Likert scale covering the surgical and prosthetic treatment procedures was used to assess the patients' perception of the procedural burdens before (expected burdens) and immediately after (experienced burdens) each procedure. Operators' perceptions of intercurrences associated with the procedures were also assessed as an independent variable. RESULTS: Low levels of perceived burdens were observed both before and after treatment. The mean overall scores of 1.65 ± 0.46 and 1.53 ± 0.33 for expected and experienced burdens, respectively, indicated that most items ranged between "not burdensome at all" and "somewhat burdensome." Significant differences between expected and experienced burdens were found for eight items (P < 0.001). Considering the treatment stages, expected burdens scored higher in the pre-surgical, surgical, and prosthetic stages and lower in the post-surgical phase than experienced burdens. Overall, the experienced burdens were significantly affected by the expected burdens (P < 0.001) and operator's perceived burdens(P = 0.045). CONCLUSIONS: Treatments were associated with low levels of perceived burdens related to surgical and prosthodontic procedures and were highly correlated with the expected burdens before treatment. However, patients tend to overestimate the expected burdens before treatment, especially for surgical procedures.

Estudo radiográfico da inter-relação dos guias condiliana e anterior em pacientes com oclusão fisiológica / Radiographic study of inter-relationship of condylar guidance and anterior guidance in patients with physiological occlusion

Objetivo: O presente trabalho busca avaliar radiograficamente a possível inter-relação dos guias condiliana e anterior em pacientes com oclusão fisiológica. Material e métodos: Para tal, foram selecionadas telerradiografias laterais de 74 pacientes que foram divididos em dois grupos distintos, denominados grupo Um e grupo Dois. O grupo Um, constituído de 56 pacientes, apresentou trespasse horizontal igual a zero e oclusão fisiológica. Já o grupo Dois, composto de 18 participantes, apresentou trespasse horizontal diferente de zero. Foi realizada uma análise cefalométrica avaliada por meio da relação entre o plano de Frankfurt e a parede anterior da superfície articular do osso temporal e da face palatina dos incisivos superiores. Utilizou-se um transferidor de plástico, com variação de 0 a 180o, adaptado com um ponteiro fixado no seu centro e móvel, por meio do qual obteve-se as mensurações pela movimentação do ponteiro, cujos os dados foram anotados em uma ficha. Resultado: Do grupo Um, 52 (92,86%) apresentaram coincidência entre o guia condiliana guia anterior, e somente 4 pacientes (7,14%) não tiveram os guias coincidentes. Já o grupo Dois 17 pacientes (94,44%) apresentou guia anterior diferente da guia condiliana, e um paciente (5,56%) apresentou coincidência entre os guias. Conclusão: Com base nos resultados obtidos pode-se concluir que os guias condiliana e anterior apresentaram uma interrelação direta, que constituem parâmetros para a reconstrução e/ou posicionamento da guia anterior em tratamentos reabilitadores.

Objective: This study aims to evaluate radiographically the possible inter-relation of the condylar and previous guidances in patients with physiological occlusion. Methods: For this purpose, lateral cephalometric radiographs were selected from 74 patients who were divided into two distinct groups, called group one and group two. The group one consisting of 56 patients, showed overjet equal to zero and physiological occlusion. While group two, made up of 18 patients presented different overjet zero. The cephalometric analysis was evaluated through the relationship between the Frankfurt plane and the front surface wall joint of the temporal bone and the palatal face of the upper incisors was performed. It were used a plastic measuring protractor, ranging from 0 to 180o, fitted with a fixed pointer at its center and mobile, through which were obtained measurements by moving the pointer, whose data were recorded on a card. Results: From a group, 52 (92.86%) had coincidence between the condylar guidance and the previous guidance, and only 4 patients (7.14%) did not have the matching guidances. Already the group two 17 patients (94.44%) had different previous guide condylar guide, and one patient (5.56%) had coincidence between the guides. Conclusion: Based on the results it can be concluded that the condylar guidances and earlier had a direct inter-relation, which are parameters for reconstruction and / or positioning of the previous guidance rehabilitation treatments.