Do irrigation solutions used during root canal instrumentation influence the adhesion of glass fiber posts? A systematic review / As soluções de irrigação usadas durante a instrumentação do canal radicular influenciam a adesão de pinos de fibra de vidro? Uma revisão sistemática

Statement of problem: the bond strength between adhesive cement and root dentin can be affected by irrigation protocols. Purpose: therefore, the objective of this systematic review was to answer the following question: Do irrigation solutions used during root canal instrumentation influence the adhesion of glass fiber posts to root dentin? Material and Methods: this study followed the recommendations of PRISMA 2020 for writing. PubMed, Scopus, Web of Science, and LILACS databases were searched for articles published until 26 January, 2022. Grey literature and a manual search were also performed. The inclusion criteria were based on the PICO strategy: permanent human or animal teeth (P), which were irrigated during root canal instrumentation with endodontic substances (I) and compared to irrigation with sodium hypochlorite at various concentrations (C) to analyze the bond strength of glass fiber posts (O). Two authors independently performed data extraction and the risk of bias. Results: eight articles were included. Four articles were classified as having a high risk of bias, where the others as medium risk. Studies have reported conflicting results regarding the influence of irrigating solutions and the different concentrations of sodium hypochlorite on the adhesion of glass fiber posts to root dentin. Conclusion: the heterogeneity between studies did not allow the conclusion of a true estimate regarding this topic, and further well-designed studies are needed to clarify this issue. Register: CRD42020221835. (AU)

Definição do problema: a resistência de união entre o cimento adesivo e a dentina radicular pode ser afetada pelos protocolos de irrigação. Objetivo: portanto, o objetivo desta revisão sistemática foi responder à seguinte questão: As soluções de irrigação usadas durante a instrumentação do canal radicular influenciam a adesão de pinos de fibra de vidro à dentina radicular? Material e Métodos: este estudo seguiu as recomendações do PRISMA 2020 para sua redação. As bases de dados PubMed, Scopus, Web of Science e LILACS foram pesquisadas para artigos publicados até 26 de janeiro de 2022. A literatura cinza e uma pesquisa manual também foram realizadas. Os critérios de inclusão foram baseados na estratégia PICO: dentes humanos ou animais permanentes (P), que foram irrigados durante a instrumentação do canal radicular com substâncias endodônticas (I) e comparados à irrigação com hipoclorito de sódio em várias concentrações (C) para analisar a resistência de união de pinos de fibra de vidro (O). Dois autores realizaram independentemente a extração de dados e o risco de viés. Resultados:oito artigos foram incluídos. Quatro artigos foram classificados como de alto riscode viés, enquanto os demais como de médio risco. Estudos relataram resultados conflitantes sobre a influência de soluções irrigadoras e as diferentes concentrações de hipoclorito de sódio na adesão de pinos de fibra de vidro à dentina radicular. Conclusão: a heterogeneidade entre os estudos não permitiu a conclusão de uma estimativa verdadeira sobre este tópico, sendo necessários mais estudos bem delineados para esclarecer esta questão. Registo: CRD42020221835 (AU)

Evaluation of composite restorations in primary molars subjected to selective caries removal associated with antimicrobial photodynamic therapy: A randomized controlled trial.

BACKGROUND: Antimicrobial photodynamic therapy (aPDT) has been used as an adjunct treatment of deep caries lesions; however, studies on the effects of aPDT on the longevity of restorations are still limited. AIM: To evaluate the clinical performance of composite restorations in primary molars subjected to selective caries removal (SCR) associated with aPDT. DESIGN: A randomized clinical trial was designed. Primary molars of patients (mean age 6.15 years) with deep caries lesions without signs and symptoms of pulpal involvement were selected. A total of 64 teeth were randomly divided into groups G1 (SCR, 32 teeth) and G2 (SCR + aPDT, 32 teeth) for treatment, restored with composite, and evaluated after a week (T0 ), 6 months (T1 ), and 12 months (T2 ) according to the criteria of FDI. Groups were compared using the Rao-Scott chi-squared test and the logistic regression analysis for complex designs to account for multiple observations per subject (alpha = 0.05). RESULTS: From all FDI criteria evaluated, the marginal adaptation for the SCR + aPDT group was significantly better in comparison with the SCR group at T0 and T2 in the logistic regression analysis (T0: OR = 0.151; 95% CI = 0.03-0.068, P = .015; and T2: OR = 0.201; 95% CI = 0.05-0.79, P = .022). CONCLUSION: The marginal adaptation of primary molar resin restorations was positively affected by aPDT after 12 months of follow-up.

Does selective caries removal in combination with antimicrobial photodynamic therapy affect the clinical performance of adhesive restorations of primary or permanent teeth? A systematic review with meta-analysis.

Antimicrobial photodynamic therapy (aPDT) is an adjunct to a selective caries removal (SCR) technique for deep caries lesion treatment. The knowledge about chemical and structural changes affecting the remaining dentin surface after the use of this therapy is still unknown. OBJECTIVE: to answer the following question: Does the SCR technique in combination with aPDT affect the clinical performance of adhesive restorations in deep carious lesions of primary or permanent teeth? STUDY DESIGN: a systematic review was conducted. Five databases, supplemented by trial registers, google scholar, manual search, personal communications, and grey literature were investigated. Randomized clinical trials were included. Two independent reviewers selected the studies, extracted qualitatively the data, and evaluated the risk of bias (using Cochrane Collaboration's tool and Robot Reviewer program). The certainty of the evidence was accessed based on The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. A meta-analysis of comparable data was performed with RevMan software 5.3. RESULTS: A total of 39 articles and 3 studies were found. The final selection included 3 articles with a total of 82 participants. No studies were found on permanent teeth. The studies presented low risk of bias. Considering the treatment in the experimental (SCR + aPDT) or control groups (SCR), no difference on clinical performance of adhesive restorations in deep caries of primary teeth was observed after 6 months (p = 0.78; CI -0.01 (-0.09, 0.07)) or 12 months (p =0.75; CI -0.02 (-0.12, 0.08)). All outcomes presented moderate certainty of evidence mainly due to the small sample size that downgrade the GRADE scores. CONCLUSIONS: based on moderate certainty of the evidence, the clinical use of aPDT as an adjuvant of SCR has potential indication for treatment in deep caries of primary teeth. However, studies with more follow up and on permanent teeth are missing with the necessity for further research.

Influence of thickness, color, and polishing process of ethylene-vinyl-acetate sheets on surface roughness and microorganism adhesion.

BACKGROUND/AIM: The surface roughness of dental materials can make cleaning difficult, thus facilitating retention of food debris and accumulation of microorganisms. The aim of this study was to assess whether thickness, color, and the polishing process influence the surface roughness of ethylene-vinyl-acetate (EVA) sheets and the amount of microorganisms that adhere to them. MATERIALS AND METHODS: A total of 180 samples of EVA (5 × 5 mm) were divided into 9 groups according to thickness (G1 = 2 mm; G2 = 3 mm; and G3 = 4 mm), color (G4 = black and G5 = white), and type of polishing (G6 = Scheu™; G7 = Scheu™ associated with hot-air burner; G8 = Erkodent™ and G9 = Erkodent™ associated with hot-air burner). Mean value of 3 roughness parameters was assessed: Ra, Rq, and Rz (one-way ANOVA test and Tukey's test, P < .05). Seven samples of each group (n = 63) were inoculated with saliva for 2 hours to promote microbial adhesion and count the number of colony-forming units (CFUs) (one-way ANOVA test, P < .05). Scanning electron microscopy (SEM) of microbial adhesion and the effects of the polishing process on the surface was assessed. RESULTS: Only the polishing parameter presented less roughness (G2, G7 and G9; P < .05) as also observed on SEM. SEM characterized microbial adhesion but the CFU count was not statistically significant, independent of the assessed parameters. CONCLUSION: The polishing systems, Scheu™ and Erkodent™ in association with a hot-air burner, were effective in decreasing the surface roughness without influencing the amount of adhered microorganisms.

Dental Care for an adolescent with chromosome pentasomy: rare case report with a two year follow-up / Atenção Odontológica a jovem com pentassomia cromossômica: relato de caso raro com acompanhamento de 2 anos

Pentasomy of the x chromosome is a rare syndrome of unknown incidence and there are few reports in the scientific literature, especially in terms of dental care for patients with this syndrome. The aim of this study was to report the dental care given to an adolescent with pentasomy of the X chromosome. The patient presented a cleft palate, impacted teeth, malocclusion, high caries activity, gingivitis and multiple tooth loss due to caries. Despite the difficulties of carrying out the dental work due to involuntary movements and the initial lack of collaboration from the patient the overall dental care was completed on an outpatient basis. The therapeutic success of the treatment was strongly supported by the significant cooperation and relationship that grew up along the period of the treatment, as well as the desire to have the treatment done by both the patient and her parents.

A pentassomia do cromossomo x é uma síndrome rara, de incidência desconhecida e com poucos relatos na literatura científica, especialmente no que diz respeito à atenção odontológica para pacientes portadores da mesma. O objetivo deste estudo foi relatar um caso de atenção odontológica a uma jovem com pentassomia do cromossomo x, que apresentava fenda palatina, dentes inclusos, má-oclusão, alta atividade de cárie, gengivite e múltiplas perdas dentárias devido à cárie. Apesar das dificuldades de se realizar o tratamento dentário devido aos movimentos involuntários e a não colaboração inicial da paciente, houve total viabilidade da atenção odontológica em âmbito ambulatorial, observando-se significativa cooperação, formação de vínculo e adesão ao tratamento pela mesma e seus responsáveis, o que gerou sucesso terapêutico.

Mucus Extravasation Phenomenon in a Newborn: An Uncommon Case.

The occurrence of mucoceles in children younger than one year of age is uncommon and, in some cases, a challenge for the dental professional to treat and to determine its etiology. The purpose of this report is to present a case of mucocele in a five- month-old infant and discuss the main aspects related to its diagnosis, treatment, and etiology.

Influence of the operatory field isolation technique on tooth-colored direct dental restorations.

PURPOSE: To evaluate, through a systematic review, the influence of the operatory field isolation technique on the longevity of dental restorations performed with tooth-colored materials. METHODS: An electronic search of the scientific databases (MEDLINE, SCIRUS, VHL and SIGLE) and reference lists of the selected articles was conducted to identify randomized controlled clinical trials with a follow-up period of at least 12 months. The selected articles evaluated the effects of the operatory field isolation techniques (rubber dam or cotton rolls/saliva ejector) on the longevity of direct restorations performed with tooth-colored materials (e.g. resin composites, compomers and glass-ionomer cements) in primary or permanent posterior teeth. The selected studies were analyzed and categorized using a checklist proposed by the National Institute for Health and Clinical Excellence of the United Kingdom. RESULTS: 484 studies were identified on the scientific databases. After applying the exclusion criteria and removal of duplicates, a total of nine studies were considered as potentially eligible. From these, five studies were included in the final analysis by two evaluators. In four studies analyzed, the use of rubber dam did not influence the longevity of restorations in comparison to cotton rolls/saliva ejector. Only two studies were considered as low risk of bias.

Influência do grau de umidade da dentina decídua na infiltração marginal da interface formada com três sistemas adesivos / Influence of primary tooth dentin moisture on the marginal infiltration at the interface of three adhesive systems

Objetivo: Avaliar a infiltração marginal na interface formada com trêssistemas adesivos convencionais (XP Bond®, Single Bond 2® eScotchbond Multi-Uso®), segundo o grau de umidade da dentinadecídua. Métodos: Trinta preparos classe V foram alocados em seis grupos,segundo o tipo de adesivo e modo de secagem da dentina (seca ou úmida). Após restauração e envelhecimento artificial por 30 dias, os corpos de prova foram imersos em nitrato de prata a 50% por 24h. O grau de infiltração marginal foi medido através de escores relacionados à penetração do traçador pelas margens da restauração. Testes nãoparamétricos de Kruskal-Wallis e Mann-Whitney (α=5%) foramutilizados. Resultados: Menores escores para infiltração marginal foramencontrados para o XP Bond® comparado aos outros adesivos. Segundoo tipo de dentina, não observou-se diferença entre dentina úmida eseca nos grupos XP Bond® e Single Bond 2®, porém neste, 55% dosespécimes apresentaram algum grau de infiltração. Para o ScotchbondMulti-Uso®, melhores resultados foram encontrados para dentina seca.Segundo grupos com o mesmo grau de umidade na dentina, não houvediferença entre XP Bond® e Single Bond 2® em dentina úmida. Em dentina seca, escores mais baixos de infiltração foram encontrados para o XP Bond®. Não foram detectadas diferenças entre XP Bond® e Scotchbond Multi-Uso® tanto em dentina úmida quanto em dentinaseca. Para a comparação Single Bond 2® vs. Scotchbond Multi-Uso® nãoforam encontradas diferenças em dentina úmida, porém, em dentinaseca, menor grau de infiltração foi obtida para o Scotchbond Multi-Uso®. Conclusão: Quanto à infiltração marginal, o XP Bond® apresentoueficiência na adesão em dentina decídua úmida ou seca. O ScotchbondMulti-Uso® pode apresentar indicação em dentina decídua seca, enquanto que o Single Bond 2® não foi eficiente para ambos os tipos de dentina decídua...

Objective: To evaluate marginal infiltration at the interface formed by three etch-and-rinse adhesive systems (XP Bond®, Single Bond 2® and Scotchbond Multi-Purpose®), according to the moisture of primary tooth dentin.Method: Thirty class V cavities were assigned to 6 groups according to the adhesive system and dentin condition (dry or moist). After restoration and artificial ageing for 30 days, the specimens were immersed in 50% silver nitrate for 24 h. The intensity of marginal infiltration was determined by scores related to the tracer penetration through the dentin/restoration margins. Non-parametric Kruskal-Wallis and Mann-Whitney tests were used for statistical analysis (?=5%).Results: Lower marginal infiltration scores were found for XP Bond® compared with the other adhesive systems. Regarding dentin condition, there was no difference between dry and moist dentin for XP Bond® and Single Bond 2®, but 55% of the specimens treated with latter exhibited some degree of infiltration. For Scotchbond Multi-Purpose®, the best results were obtained with dry dentin. Comparing the groups with the same dentin condition (dry or most), there was no difference between XP Bond® and Single Bond 2® for moist dentin. Lower infiltration scores were obtained for XP Bond® in dry dentin. No differences were found between XP Bond® and Scotchbond Multi-Purpose®, ® for both dry and moist dentin. In the comparison Single Bond 2® vs Scotchbond Multi-Purpose®, no differences were found in moist dentin, but lower infiltration was obtained for Scotchbond Multi-Purpose ® in dry dentinConclusion: Regarding marginal infiltration, XP Bond® was efficient for adhesion in both dry and moist primary tooth dentin. Scotchbond Multi-Purpose® may be indicated for dry primary tooth dentin, while Single Bond 2® was not efficient in either type of dentin...

Estudo Comparativo da Microinfiltração Marginal em CavidadesClasse II Restauradas com Cimentos de Ionômero de VidroConvencionais e Resinosos / Marginal Microleakage in Class II Cavities Restored with Conventional and Resin-Modified Glass Ionomer Cements: a Comparative Study

Objetivo: Avaliar o grau de microinfiltração em cavidades classe IIpreparadas em molares decíduos humanos, restauradas com doiscimentos de ionômero de vidro convencional (Maxxion R e VidrionR) e dois resinosos (Vitremer e Vitro Fill LC).Método: Foram selecionados dezenove molares decíduoshumanos a partir de um Banco de Dentes. Nas faces mesial e distalde cada dente foram preparadas, com brocas diamantadascilíndricas, cavidades classe II com dimensões padronizadas. Aseguir, as cavidades foram restauradas com dois cimentos deionômero de vidro convencionais: Maxxion R (G1) e Vidrion R (G2);e dois cimentos de ionômero de vidro resinosos Vitremer (G3) eVitro Fill LC (G4). Depois de restaurados, os dentes foram cobertoscom dupla camada de esmalte (Colorama®), e, após a secagem domesmo, imersos em solução de nitrato de prata a 50% por vinte equatro horas. Em seguida, todos foram seccionadoslongitudinalmente através do centro das restaurações e observadosem lupa estereoscópica, sendo a microinfiltração avaliada segundocritério qualitativo baseado na atribuição de escores.Resultados: Todos os materiais testados apresentaram grausvariáveis de microinfiltração, no entanto, o Vitremer (G3) apresentouos melhores resultados. Não foram observadas diferençasestatisticamente significantes entre os seguintes materiais:MaxxionR (G1), Vidrion R (G2) e Vitro Fill LC (G4).Conclusão: Nenhum dos cimentos testados foi capaz de impedircompletamente a microinfiltração, no entanto, o Vitremer destacousepor apresentar os menores escores de microinfiltração, enquantoque os materiais Vidrion R, Maxxion R e Vitro Fill LC nãoapresentaram diferenças estatisticamente significantes entre si.

Remoção química-mecânica da cárie: revisão de literatura / Chemomechanical caries removal: literature review

O princípio básico da remoção químico-mecânica da cárie consiste na aplicação de agentes químicos específicos que promovam o amolecimento seletivo da dentina degradada durante o processo carioso, seguido de uma leve escavação usando instrumentos manuais especialmrnete adaptados, restando ao final do processo apenas a dentina sadia. O primeiro sistema chegaria ao mercado na década de 80, com o nome de Caridex, contudo, devido a uma série de desvantagens ele sairia de circulação no início da década de 90. O atual sistema, o Carisolv, mostra-se bem mais vantajoso que o sistema anterior, tendo como principais características: ser indolor, dispensando deste modo a anestesia local, ser mais econômico e bem mais simples. O sistema é especialmente indicado para pacientes pediátricos, pacientes com fobia, pacientes sistematicamente comprometidos e para pacientes especiais. O objetivo deste artigo é, através da revisão de literatura, tratar sobre a evolução deste método e suas principais particularidades.