Noncarious cervical lesions in the aging population analyzed through digital scanning: occlusal risk factors, dimensions, and morphology.

OBJECTIVES: To evaluate noncarious cervical lesions (NCCL) in older adults by analyzing each lesion's morphology, dimension, and occlusal risk factors using intraoral scanning and clinical evaluation. MATERIALS AND METHODS: Individuals over 60 treated at the School of Dentistry in Minas Gerais, Brazil, were invited to participate in this cross-sectional study. We clinically evaluated 1245 teeth for the presence of NCCL and dentin hypersensitivity (DH) in 53 individuals. Three-dimensional models were obtained using Omnicam, and occlusal risk factors were evaluated through the presence of wear facets, intense occlusal contacts, and interferences. The 3Shape 3DViewer software was used to classify NCCL morphology and to measure their height. NCCL depth, width, and area measurements were determined using ImageJ. Descriptive analyses were performed. The Kolmogorov-Smirnov test showed that quantitative data exhibited non-normal distribution. For bivariate analyses of quantitative data, the Mann-Whitney test was employed. The results were reported with mean, standard deviation, median, minimum, and maximum. For bivariate analyses of categorical data, the Pearson chi-square test was used. The results were reported with frequencies (counts) and percentages. A regression model evaluating the association between occlusal risk factors and the absence/presence of NCCL was built. RESULTS: Most participants were female (58.5%), with a mean age of 66. The frequency of NCCL was 28.27%, corresponding to 352 teeth. Of these, 68.18% exhibited saucer morphology and 31.82% wedge-shaped morphology. The frequency of DH was 13.92% in teeth with NCCL. Saucer NCCL exhibited significantly greater height (p = 0.02), while wedge-shaped lesions showed greater depth (p < 0.001). Also, teeth with NCCL had a higher proportion of wear facets (66.8%; p < 0.001), intense occlusal contacts (39.8%; p = 0.008), and occlusal interferences (21.9%; p = 0.05). The regression model showed that teeth with wear facets were 1.50 times more likely to exhibit NCCL than teeth without wear facets (p < 0.001). Teeth with intense occlusal contact were 1.22 times more likely to exhibit NCCL than teeth without intense occlusal contact (p = 0.031). CONCLUSIONS: NCCL is a common dental condition in the older adults evaluated in this study. Wedge-shaped NCCL exhibited greater depth, while saucer NCCL had more expressive height. Occlusal risk factors may represent a crucial mechanism for the occurrence of NCCL in this population. CLINICAL RELEVANCE: Understanding the mechanisms involved in developing NCCL is helpful in diagnostic and preventive practices. The study showed the importance of dental occlusion and characteristics of different NCCL morphologies that help the clinician in decision-making.

Evaluation of the clinical performance of GIOMERs and comparison with other conventional restorative materials in permanent teeth: a systematic review and meta-analysis.

Aim The aim of this systematic review and meta-analysis was to analyse the clinical performance of GIOMER restorative composites and compare them with other conventional restorative materials in permanent teeth.Methods Searches in PubMed, Web of Science, Scopus, Ovid and Cochrane Library were conducted. Grey literature search was also performed. Clinical trials that evaluated the clinical performance of restorations with GIOMER restorative composites in permanent teeth compared to those using composite resin, glass ionomer cement, resin-modified glass ionomer cement (RMGIC) and other GIOMERs were included. Meta-analyses comparing GIOMER restorative composites with RMGIC at 6- and 12-month follow-ups and comparing two types of GIOMER were feasible.Results Ten studies fulfilled the inclusion criteria. In these studies, GIOMER was compared to different types of dental restoration materials. Dental restorations were evaluated by United States Public Health Service criteria in all included studies. Four studies were suitable for meta-analysis, which showed significant differences between GIOMER and RMGIC surface roughness at 6-month (odds ratio [OR] = 6.56; 95% confidence interval [CI] = 2.38-18.13) and 12-month (OR = 8.76; CI = 3.19-24.07) follow-ups. No significant differences between GIOMER restorative composites and RMGIC for marginal adaptation were found at 6- and 12-month follow-ups. When comparing two GIOMERs, significant differences were seen between Beautifil II and Beautifil Flowable Plus F00 for marginal staining (OR = 2.58; CI = 1.42-23.27; I2 = 0%) and surface roughness (OR = 4.59; CI = 1.11-18.97; I2 = 0%) at the 36-month follow-up. No significant differences between Beautifil II and Beautifil Flowable Plus F00 were seen for marginal adaptation and anatomic form at 6-, 18- and 36-month follow-ups.Conclusions GIOMER restorative composites presented similar performance concerning marginal adaptation and better surface roughness when compared to RMGIC. GIOMER Beautifil II presented similar performance to GIOMER Beautifil Flow Plus F00 concerning marginal adaptation and anatomic form and worse marginal staining and surface roughness when compared to Beautifil Flowable Plus F00.

Is dental caries associated with liver transplantation? A systematic review and meta-analysis.

OBJECTIVE: The aim of this systematic review and meta-analysis was to evaluate the experience of dental caries in individuals pre- or postliver transplant. MATERIALS AND METHODS: Searches in PubMed, Scopus, Web of Science, Ovid, and Lilacs from databases' inception date up to April 2020 were undertaken. Gray literature and manual searches were also conducted. Observational studies were eligible. The retrieved references were evaluated by two independent reviewers. Meta-analysis and risk of bias assessment using the University of Adelaide tool were conducted. The strength of the evidence was assessed with GRADE. RESULTS: The search retrieved 1990 references. Twenty-four cross-sectional studies were included. One subgroup analysis demonstrated no significant difference in the number of teeth with dental caries between pre-liver transplant and healthy individuals (mean difference = 1.65, confidence interval = -0.87 to 4.17). The prevalence of dental caries among pre-liver transplant individuals was 73.82% and in the post-transplant individuals was 72.83%. In the included studies, the main concern regarding risk of bias was the absence of control for confounding variables. The strength of the evidence was very low. CONCLUSIONS: Dental caries may be a relevant issue in pre- and postliver transplant individuals. Oral health counseling should be included in the care of pre- and/or postliver transplant individuals.

Dental caries and developmental defects of enamel in individuals with chronic kidney disease: Systematic review and meta-analysis.

OBJECTIVE: To evaluate studies assessing the prevalence of dental caries and developmental defects of enamel (DDE) in individuals with chronic kidney disease (CKD) in comparison with individuals without CKD. MATERIALS AND METHODS: Electronic searches were performed in PubMed, Web of Science, Scopus, Medline via Ovid, and ProQuest databases from their inception date until February 2018. Two review authors independently selected the studies, extracted data, and assessed the methodological quality. Meta-analysis was performed. RESULTS: Twenty-seven studies were included in this study. For permanent teeth, 14 studies found that individuals without CKD had higher dental caries scores than those with CKD. However, only five studies presented results with a statistically significant difference between groups. Among the studies evaluating primary teeth, five showed that individuals without CKD had higher dental caries scores than those with CKD. Five studies showed that individuals with CKD had a significantly higher prevalence of DDE than individuals without CKD. The meta-analyses showed that individuals without CKD had significantly higher scores of dental caries teeth and surfaces than individuals with CKD. For DDE, no statistical difference between groups was observed. CONCLUSIONS: Individuals with CKD present lower dental caries scores and a higher prevalence of DDE in comparison with individuals without CKD.

Biomechanical Behavior of Tooth-Implant Supported Prostheses With Different Implant Connections: A Nonlinear Finite Element Analysis.

PURPOSE: Biomechanical behavior of tooth-implant-supported prostheses (TISPs) with external and internal implants was compared. MATERIALS AND METHODS: Two 3-D models of TISP were designed by varying the implant: external (Model EH) and internal hexagons (Model IH). After loading, von Mises stresses were obtained in implants, abutments, and screws. Principal maximum (σmax) and minimum (σmin) stresses were analyzed in periodontal ligament (PL), alveolar bone, and periimplant bone. RESULTS: Model IH showed lower stress peaks in axial loading in the implant and in the screw but higher in abutment. In oblique loading, Model IH had lower stresses in the implant, but higher in the abutment and in the screw. In the σmax analysis for axial and oblique loads, stress peaks in Model IH were lower in PL, alveolar bone, and periimplant bone. In the σmin analysis for axial load, stress peaks in Model IH were lower in PL, but higher in alveolar bone and in periimplant bone. In oblique load, Model IH showed lower stress peaks in PL and alveolar bone, but higher stress peaks in periimplant bone. CONCLUSIONS: TISPs with IH implants do present lower risk of biomechanical failure.

Effects of Screw- and Cement-Retained Implant-Supported Prostheses on Bone: A Nonlinear 3-D Finite Element Analysis.

PURPOSE: To compare the stresses and displacements on perimplant bone generated by screw- and cement-retained prostheses using the finite element method. MATERIALS AND METHODS: Two models were constructed: partial fixed implant-supported prostheses with three elements retained by screws (SFP) or cement (CFP). Vertical and oblique loads of 100 N were applied on the models. Bone was analyzed by the principal stresses σ1 and σ3. The displacement between the implant and the bone was identified by the penetration and gap. RESULTS: Results showed a similar pattern in the distribution of the principal stresses between both prostheses. Under the σ1 stresses, the SFP showed similar values in the bone compared with the CFP. The analysis of the σ3 showed stress peaks 28% higher in the SFP, considering vertical and oblique loads. Displacement analysis showed a similar pattern and similar values between the prostheses for penetration and gap under both loads. CONCLUSIONS: There were no important differences in the σ1 analysis and the displacement between the SFP and CFP. The differences in marginal bone level reported between SFP and CFP in some clinical studies may not be related to a mechanical factor.

Two-year clinical performance of dimethacrylatebased composite restorations repaired with a silorane-based composite.

PURPOSE: To investigate the clinical performance of a silorane-based composite resin used for repairing dimethacrylate- based composite restorations. MATERIALS AND METHODS: One operator repaired defective dimethacrylate-based resin restorations that were randomly assigned to one of two treatment groups: control (n=50), repaired with Adper SE Plus and Filtek P60 Posterior Restorative (3M ESPE); or test (n=50), repaired with P90 System Adhesive Self-Etch Primer and Bond and Filtek P90 Low Shrink Posterior Restorative (3M ESPE). After 1 week, restorations were finished and polished. Two calibrated examiners (weighted Kappa≥0.78) evaluated the repaired restorations, blindly and independently, at baseline, after 6 months, 1 and 2 years. The parameters examined were marginal adaptation, anatomic form, surface roughness, marginal discoloration, postoperative sensitivity, and secondary caries. The restorations were classified as Alfa, Bravo, or Charlie, according to modified US Public Health Service criteria. Variation in the levels of clinical parameters over time was evaluated by Friedman's ANOVA (α=0.05). The Mann-Whitney test assessed the differences between the materials for all clinical criteria at baseline, 6-month, 1- and 2-year recalls (α=0.05). The Wilcoxon test compared each composite resin for all clinical criteria at the same recalls (α=0.05). RESULTS: After two years, 79 repaired restorations were re-examined. No statistically significant differences were found between the materials at baseline or at the 2-year recall (p>0.05). Comparing baseline and 2-year recall, there was a statistically significant difference for marginal discoloration (p=0.029) in silorane-based composite restorations. CONCLUSION: After two years, the clinical performance of the silorane-based composite was similar to that of the dimethacrylate-based composite when used to make repairs.

Biomechanical evaluation of screw- and cement-retained implant-supported prostheses: a nonlinear finite element analysis.

STATEMENT OF PROBLEM: The mechanical stability of the prosthetic components in the implant-prosthesis complex is essential to the long-term success of the restorations. However, little is known about the differences in the biomechanical behavior of screw- and cement-retained prostheses. PURPOSE: The purpose of this study was to compare the preload maintenance, stresses, and displacements of prosthetic components of screw- and cement-retained implant-supported prostheses by using the finite element method in a nonlinear analysis. MATERIAL AND METHODS: Two 3-dimensional models were constructed: implant-supported fixed partial prostheses with 3 elements retained either by screws (SFP) or cement (CFP). After the simulation of screw tightening, the preload was calculated for both prostheses. Then vertical and oblique loads (100 N) were applied on the models. The preload was identified, the maximum von Mises equivalent stresses (SEQV) were obtained on the screws, and the displacement among the abutment, the implant, and screw was identified by observing the penetration and gap in the contact interfaces. RESULTS: Under vertical load, there was a higher decrease in the preload and in the SEQV on the screw in the SFP. Under oblique load, the SEQV was 24% higher on the screw of the SFP. In the displacement analysis under vertical load, penetration was concentrated in the threads of the screw in the SFP and between the abutment and implant in the CFP. The gap was 118% greater for the SFP and was concentrated on the abutment extension. Under oblique load, the displacement pattern was similar for both prostheses, but with values 66% higher for penetration and 96% higher for gap for the SFP. CONCLUSIONS: The SFP showed a higher biomechanical risk of failure than the CFP.

Impact of aesthetic restorative treatment on anterior teeth with fluorosis among residents of an endemic area in Brazil: intervention study.

BACKGROUND: Endemic dental fluorosis has already been described in some regions of the world. The aim of this study was to evaluate the functional and psychosocial impact of direct aesthetic restorative treatments in endemic fluorosis patients in the northern state of Minas Gerais, Brazil. Was a quasi-experimental intervention study. METHODS: The reference population consisted of individuals between 9 and 27 years of age that were served by a project intended to recover the smiles of patients with severe fluorosis. The questionnaires were administered on two occasions, 24 months apart (before and after dental treatment). Initially, descriptive analyses were conducted. Prevalence and severity, as well as the extent of the functional and psychosocial impact of oral disorders were estimated based on the Oral Health Impact Profile instrument (OHIP-14). Comparisons between baseline and follow-up and between treatment techniques were carried out using the McNemar, Wilcoxon, and Mann-Whitney tests. RESULTS: The study involved 53 individuals, with a mean age of 15.9 years, treated with microabrasion, dental composite, or a combination of both techniques. The treatments performed proved to be competent for reducing the functional and psychosocial impact of oral disorders as measured by the OHIP-14, pointing to the possibility of establishing protocols to be used in programs aimed at restoring the aesthetics and functionality of the anterior teeth in large populations. CONCLUSIONS: After performing the direct aesthetic restorative treatments in patients with endemic fluorosis, a significant improvement was observed in the prevalence and severity, as well as the extent of the functional and psychosocial impact of oral disorders.

Knowledge and attitudes of dentists regarding ageing and the elderly.

OBJECTIVE: This study was aimed to identify the knowledge and attitudes of dentists regarding ageing and the elderly. BACKGROUND: As the population ages, there is a greater demand for differentiated care from health professionals. However, the treatment needs of the elderly population are not sufficiently addressed, particularly in developing countries. MATERIALS AND METHODS: An official list of all dentists registered in the city of Belo Horizonte, Brazil, was obtained from the Regional Dentistry Council. A questionnaire was delivered to 276 randomly selected dentists; the survey contained questions designed to characterise the sample and identify dentists' conduct towards elderly patients. A Likert scale was used to identify knowledge regarding care for the elderly and attitudes towards ageing. RESULTS: Women demonstrated more positive attitudes towards the elderly. Graduates who worked in the public sector demonstrated a greater knowledge of geriatric dentistry (p < 0.05). Attending specific continuing education courses had no influence over the dentists' willingness to treat the elderly population. Significant associations were not found between attitudes and knowledge regarding the elderly. CONCLUSION: Dentists who worked in the public sector demonstrated a greater knowledge regarding the elderly. This knowledge did not influence attitudes towards ageing. Women demonstrated a more positive attitude regarding ageing and dental care.

Adjunctive therapies for in vitro carious lesions: Antimicrobial activity, activation of dentin metalloproteinases and effects on dental pulp cells.

BACKGROUND: Adjunctive therapies used before dental restorative procedures may encourage carious tissue removal. Beyond promising antimicrobial properties, treatments could positively modulate the dentin-pulp complex while not interfering with restoration survival. Herein, we evaluated a set of substances and their effects on carious lesions and the underlying dentin or pulp cells. METHODS: Artificial caries lesions were developed in bovine teeth cavities immersed in Streptococcus mutans and Lactobacillus casei co-cultures. The cavities were treated according to the following groups: Phosphate Buffer Saline (PBS), Chlorhexidine (CHX), Papacárie® (Papain gel), Ozone (O3), and antimicrobial Photodynamic Therapy (aPDT). After treatments, samples were cultivated to count isolated microbial colonies. The zymography assay evaluated the activity of dentin metalloproteinases (MMP-2 and MMP-9). Cell viability was indirectly assessed on human dental pulp cells after 24, 72, or 120 h, whereas the odontodifferentiation potential was evaluated after ten days of cell culture. RESULTS: CHX and aPDT led to around 1 log bacterial load reduction. PBS, CHX, and aPDT showed the eventual expression of MMP-2 and MMP-9. Cell viability was reduced (< 30%) after 120 h for all groups compared to the control. CHX, O3, and aPDT induced greater odontodifferentiation (≈ 20% higher) than PBS and papain gel. CONCLUSION: Adjunctive therapies presented little or no biological significance in reducing bacterial load in artificial carious lesions. Although the activation of endogenous metalloproteinases may represent a possible concern for adhesive restorations, some of these treatments may have a positive role in dental pulp tissue repair.

Metallization and Ar-O plasma effects on dental enamel roughness evaluated with SEM and MeX™ for 3D reconstruction.

The MeX™ software is a useful tool for tridimensional data collection for surface evaluation and could be relevant to evaluate the same specimen in different phases of the study, assuming repeated measures of dental enamel roughness. The aim of this study was to evaluate the influence of sample metallization for dental enamel roughness analysis with 3D images reconstructed using MeX™ software from Scanning Electron Microscopy (SEM) images. The influence of 74.98% (%mol/mol) argon-oxygen plasma for carbon layer removal on surface roughness of the metallized specimen was also evaluated. Dental enamel specimens were prepared for SEM analysis with and without carbon metallization using conventional or environmental modes. Argon-oxygen plasma for carbon layer removal was used and surface roughness was re-evaluated. Roughness obtained by SEM and MeX™ reconstructed images, with or without metallization, did not differ. No significant alteration on surface roughness after carbon layer removal using plasma was found. SEM baseline evaluation using conventional mode without sample preparation and in environmental mode were not comparable. Roughness of enamel 3D images reconstructed with MeX™ software from SEM images, with or without metallization was similar. The 74.98% (%mol/mol) argon-oxygen plasma removed the carbon layer with no effect on enamel roughness.

Anxiety and pain perception in patients undergoing mandibular autogenous block bone surgery.

BACKGROUND: The aim of the present study was to investigate pain perception and anxiety within the context of surgery for the placement of mandibular block bone and to evaluate the causality effect between theses variables. MATERIAL AND METHODS: A total of 13 patients were recruited for the study and were submitted to mandibular autogenous block bone surgery. Demographic data were collected and the anxiety level was determined using the State-Trait Anxiety Inventory (STAI). The STAI was administered on the day of surgery and on the 14th postoperative day. Pain was determined using the visual analogue scale (VAS) and limitation of daily activities and postoperative symptoms were also reported. Data were analyzed using parametric tests (α=0.05) and cross-lagged analysis was performed to verify a causality effect. RESULTS: Few patients reported interference with daily activities or the presence of postoperative symptoms. A significant association of bad breath/taste with STAI-State was detected on the 14th postoperative day. No evidence of causality between STAI and VAS was detected. CONCLUSIONS: The patient's self-evaluation indicates that the pain and anxiety level felt during treatment was not directly associated with the clinical aspects of the surgical procedure or with postoperative activities/symptoms limitations. Key words:Anxiety pain, questionnaires, autogenous bone block, treatment, outcomes.

Complete removable prostheses: from expectation to (dis)satisfaction.

OBJECTIVE: The purpose of this survey was to increase our knowledge on the experience and feelings of edentulous people, 6 months after having acquired and worn a pair of complete removable prostheses. BACKGROUND: The incorporation of conventional, complete removable prostheses may be an appropriate treatment which can result in an improvement in the quality of life of people who have lost their teeth. METHODS: The 12 patients of the sample were interviewed individually according to a semi-structured questionnaire so as to create an atmosphere for open conversation regarding the subject matter. For each participant, photographs, before dental treatment and after the use of the prostheses, were taken. The images of the prostheses were reviewed and impressions were collected. RESULTS: The analysis of participant's statements allowed one to verify if the complete removable prostheses improved the quality of life; however, difficulties encountered could lead users to abandon their prostheses. CONCLUSION: Appropriate investment on the part of health professionals, together with the clarification of information and the monitoring of patients, may well minimise these difficulties.

Rehabilitation with Fixed Prosthodontics Associated with Removable Partial Prosthesis: A 5-Year Follow-Up Clinical Evaluation.

Dental implants are a common and successful option for the rehabilitation of edentulous areas. However, there are some limitations to their use. The present clinical report describes a 5-year follow-up of maxillary rehabilitation using an attachment-retained removable partial denture (RPD) associated with fixed partial denture (FPD) units as an alternative to orthodontic treatment associated with orthognathic surgery and dental implant placement. Rehabilitation with fixed prosthodontics associated with a removable partial prosthesis was proposed. For greater precision and stability, a gold attachment was prepared. The patient was very satisfied with the rehabilitation and has been clinically followed for 5 years. In cases where the use of dental implants and/or conventional FPDs is limited or not indicate the association between an FPD and an RPD by means of attachments remains an important alternative to conventional clasp-retained RPDs.

Evaluation of Vertical Misfit of CAD/CAM Implant-Supported Titanium and Zirconia Frameworks.

PURPOSE: This study compared the vertical misfit of fixed implant-supported titanium (Ti6Al4V) and yttria-stabilized tetragonal zirconia frameworks milled using the computer-aided design/computer-aided manufacturing (CAD/CAM) Zirkonzahn system. MATERIALS AND METHODS: An aluminum mandibular master cast was used, and four analogs of the Regular CrossFit implant for straight multibase titanium alloy abutments (Institut Straumann) were fixed with self-curing acrylic resin in mandibular canine and second premolar tooth locations with the aid of a parallelometer. Scan abutments were placed over the four straight multibase Regular CrossFit abutments to determine their correct three-dimensional (3D) positioning in the virtual model. Implant frameworks were designed virtually, and five frameworks of each material (titanium alloy or yttria-stabilized tetragonal zirconia) were milled using the CAD/CAM system. Scanning electron microscope (SEM) images, with magnifications of 50×, 250×, and 1,000×, were obtained from three points on the buccal surface, three points on the lingual surface, and three points on the mesial surface of each abutment. The measurements were performed in the center of each of the thirds, thus defining points one, two, and three. The degree of vertical misfit at the framework-abutment interface was determined using ImageJ software and analyzed using the Student t test (P = .05). RESULTS: The mean misalignment value was 6.011 ± 0.750 µm for the titanium group and 9.055 ± 3.692 µm for the zirconia group. CONCLUSION: Within the limitations of this study, there was no significant difference in vertical misfit between the titanium and zirconia implant frameworks produced using the CAD/CAM system. Regardless of the material used, the CAD/CAM frameworks achieved an adequate vertical fit.

LED and Halogen Light Transmission through a CAD/CAM Lithium Disilicate Glass-Ceramic.

The effect of thickness, shade and translucency of CAD/CAM lithium disilicate glass-ceramic on light transmission of light-emitting diode (LED) and quartz-tungsten-halogen units (QTH) were evaluated. Ceramic IPS e.max CAD shades A1, A2, A3, A3.5, high (HT) and low (LT) translucency were cut (1, 2, 3, 4 and 5 mm). Light sources emission spectra were determined. Light intensity incident and transmitted through each ceramic sample was measured to determine light transmission percentage (TP). Statistical analysis used a linear regression model. There was significant interaction between light source and ceramic translucency (p=0.008) and strong negative correlation (R=-0.845, p<0.001) between ceramic thickness and TP. Increasing one unit in thickness led to 3.17 reduction in TP. There was no significant difference in TP (p=0.124) between shades A1 (ß1=0) and A2 (ß1=-0.45) but significant reduction occurred for A3 (ß1=-0.83) and A3.5 (ß1=-2.18). The interaction QTH/HT provided higher TP (ß1=0) than LED/HT (ß1=-2.92), QTH/LT (ß1=-3.75) and LED/LT (ß1=-5.58). Light transmission was more effective using halogen source and high-translucency ceramics, decreased as the ceramic thickness increased and was higher for the lighter shades, A1 and A2. From the regression model (R2=0.85), an equation was obtained to estimate TP value using each variable ß1 found. A maximum TP of 25% for QTH and 20% for LED was found, suggesting that ceramic light attenuation could compromise light cured and dual cure resin cements polymerization.

Influence of storage regime prior to abrasion on surface topography of restorative materials.

This investigation was carried out to evaluate the effect of storage conditions prior to brushing simulation on surface texture of restorative materials. One resin-modified glass ionomer (Fuji II LC Improved/GC Corp.), one polyacid-modified composite resin (Dyract AP/Denstply), one microfill composite (Durafill VS/Kulzer), and one hybrid (Filtek-Z250/3M) composite were tested. Forty-five standardized cylindrical specimens of each material were made and randomly divided into three groups according to their subsequent storage conditions: distilled deionized water, artificial saliva, or pH-cycling regime. After 24 h, the experimental units were finished and polished and the surface roughness was measured to obtain Ra baseline values (Bv). Samples were subjected to their assigned storage regime and brushed afterwards. By the end of 10 repetitions of this protocol, final surface roughness readings (Fv) were taken. The analysis of covariance (alpha = 0.05), considering the covariate Bv showed a significant interaction between restorative material and storage condition (p(value) = 0.0002). Tukey's test revealed that the pH-cycling model provided a significantly lower surface roughness for Fuji II LC and Dyract AP than did the other media. For both composites no significant difference among storage regimes was detected. Under a condition simulating dynamic variation in pH prior to abrasion, the resultant surface texture may be either smoothed down or unchanged, depending on the restorative material, when compared to the effect provided by artificial saliva and distilled deionized water.

[Dental care and oral hygiene practices in long-term geriatric care institutions]. / Atenção odontológica e práticas de higiene bucal em instituições de longa permanência geriátricas.

This study evaluated the activities of dentists, dental care and oral hygiene practices in the long-term care institutions of Belo Horizonte (Minas Gerais, Brazil). A semi-structured questionnaire was handed out to the coordinators of 37 philanthropic and 30 private institutions. The data was compared by the chi-square and Fisher's Exact Tests. 81% of the questionnaires were answered. The majority of the private (74.2%) and philanthropic institutions (87%) do not have a dentist (p=0.21). The location, period of existence, type institution kind and number of residents weren't factors regarding the presence of a dentist (p>0.05). 67% of the philanthropic institutions with equipped consultation rooms had dentists, though there were none when there was no consultation room. Even without consultation rooms, 13% of the private institutions had dentists. When necessary, 69.6% of the philanthropic institutions refer the elderly to public health centers, while 58.1% of the private institutions refer them to their family dentists. A higher percentage of the private institutions adopted systematic oral hygiene procedures (p=0.01), with a considerable divergence of treatment reported. There is a need to include a dentist on the health staff in the institutions and for systematization of oral hygiene practices.

Radiographic parameters of quality of root canal fillings and periapical status: a retrospective cohort study.

INTRODUCTION: The aim of this study was to radiographically evaluate the relationship between the quality parameters of root canal fillings (apical extension, homogeneity, and taper) and periapical status. In addition, groups of teeth and complicating factors of endodontic treatment were assessed. METHODS: This retrospective cohort study assessed the quality and periapical status of root-filled canals in a 4- to 7-year follow-up period. Each parameter was dichotomized into ideal and altered conditions. A root-filled canal with an ideal condition for all 3 parameters was considered perfect, whereas the loss of 1 or more ideal conditions defined satisfactory or deficient fillings, respectively. The periapical statuses at baseline and follow-up were classified as normal, slight widening of the apical periodontal ligament, or periapical lesion. RESULTS: A total of 291 root-filled canals were evaluated. The prevalence of perfect, satisfactory, and deficient fillings was 54.6%, 37.5%, and 7.9%, respectively (P < .05). The periapical status at follow-up showed normal, slight widening of the apical periodontal ligament, or periapical lesion in 69.8%, 19.2%, and 11% of the roots, respectively (P < .05). The multivariate logistic regression showed that only preoperative periapical lesions (odds ratio, 2.99; 95% confidence interval, 1.27-7.03) and altered tapers (odds ratio, 3.73; 95% confidence interval, 1.51-9.24) were significantly associated with postoperative periapical lesions. CONCLUSIONS: Radiographic parameters of the quality of root-filled canals showed a significant relationship with the periapical status. Nevertheless, an altered taper was the main factor associated with the maintenance or development of periapical lesions after 4- to 7-year follow-up period.