Influence of alveolar bone height on the biomechanical behavior of roots restored with custom-made posts-and-cores.

OBJETIVE: This study evaluated the influence of alveolar bone height and post type on compressive force resistance, fracture pattern, and stress distribution in endodontically treated teeth. MATERIALS AND METHODS: Bovine roots were endodontically treated and divided into eight groups (n = 10) according to alveolar bone height (normal alveolar bone and alveolar bone loss - 2 and 5 mm from the margin of the crown, respectively) and post type (prefabricated glass fiber post, anatomic glass fiber post, customized milled glass fiber post-and-core and customized milled polyetheretherketone (PEEK) post-and-core). Mechanical fatigue was simulated (300.000 cycles/50 N/1.2 Hz). Compression force resistance (N) was analyzed by two-way ANOVA and Tukey test (α = 0.05). Fracture patterns were described as percentages. Stress distribution was analyzed by finite element analysis. RESULTS: Significant diferences were found for alveolar bone height (P < 0.0001): normal alveolar bone groups showed higher mean values of compression force resistance compared to alveolar bone loss groups, while no significant differences were found for post type (P = 0.4551), and there was no double interaction between them (P = 0.5837). Reparable fractures were more predominant in normal alveolar bone groups, especially in the milled glass fiber and PEEK post-and-core groups. Stress distribution was similar in groups with prefabricated glass fiber posts and milled PEEK posts-and-cores, and the alveolar bone loss condition significantly increased stress concentration and strain values, mainly on apical dentin. CONCLUSIONS: Alveolar bone loss due to physiological aging and/or periodontal disease may lead to increased risk of restored tooth failure, although milled glass fiber and PEEK posts-and-cores provide more reparable fractures. CLINICAL SIGNIFICANCE: Custom-made glass fiber and PEEK post-and-cores are interesting options, since they enable clinicians to work with a single-body post-and-core system that avoid several materials interfaces and fits well in the root canal provided promising results to improve the failure behavior of restored roots, as they offer more reparable fractures even in situations of alveolar bone loss.

PEEK and fiberglass intra-radicular posts: influence of resin cement and mechanical cycling on push-out bond strength.

OBJECTIVES: To evaluate the bond strength of four types of posts (pre-fabricated fiberglass post, fiberglass post anatomized with composite resin, milled fiberglass post, and milled polyetheretherketone (PEEK) post), and two types of resin cements (conventional and self-adhesive) by assessing immediate bond strength and post-mechanical aging at each root third. MATERIALS AND METHODS: Bovine endodontically treated roots (16 groups, n = 8) were prepared and the posts were produced and luted; the specimens of aging groups were cycled (300,000 cycles under 50 N load at 1.2 Hz frequency); six slices of each root were obtained; push-out test was performed by using a universal testing machine (500 N load at 1 mm/min cross speed); fracture pattern was classified into five levels. The statistical analyses used were three-way ANOVA, Tukey's test (for bond strength), and Fisher's test (for fracture pattern) (α < 0.05). RESULTS: Differences were found between the cements for posts (conventional: p < 0.001; self-adhesive: p = 0.002), whereas no difference was found for root region (p = 0.941; p = 0.056, respectively); analysis of each root showed significant differences for cements (p < 0.001), posts (p < 0.001), and mechanical cycling (p = 0.001); in terms of double interaction, differences were found for posts and mechanical cycling (p = 0.005); no other interactions were observed (double or triple); the fracture pattern showed difference between the groups for both cements. CONCLUSIONS: Milled PEEK posts seem to be a good clinical option, but they require improvement of CAD-CAM technology and advances towards their adhesion. CLINICAL RELEVANCE: Milled posts are promising and can reduce clinical time for rehabilitation of extensively destroyed teeth.

The association of inadequate lip coverage and malocclusion with dental trauma in Brazilian children and adolescents - A systematic review and meta-analysis.

BACKGROUND/AIM: Dental trauma (DT) occurs frequently in children and adolescents. Therefore, understanding the factors associated with its occurrence in these age groups is important to establish specific preventive measures. The aim of this study was to investigate the relationships of lip coverage, overjet, and open bite to dental trauma in Brazilian children and adolescents. MATERIAL AND METHODS: The review protocol was registered in the PROSPERO database (CRD42020156290) and the bibliographic search was performed in nine electronic databases until July 2020. The studies included were observational, performed in Brazil, with healthy children and adolescents (0-19 years old), and without the restriction of date or language. Two reviewers assessed the individual risk of bias of the eligible studies with a standardized checklist. The meta-analyses were stratified by dentition stage and age range using fixed or random effects, odds ratio (OR) as the effect measure, and 95% confidence interval. The heterogeneity across studies was assessed with the I² test and the GRADE approach assessed the certainty of evidence. RESULTS: The search presented 2493 initial results, from which 55 met the eligibility criteria and were included. Most studies (67%) presented a low risk of bias and were published between 2000 and 2019. Children and adolescents with inadequate lip coverage are 1.86-2.36 times more likely to suffer from DT, while those with increased overjet are 1.94-3.11 times more likely. Children with primary dentitions and anterior open bites are 1.76 (95% CI: 1.20-2.59) times more likely to suffer from DT. The certainty of evidence varied from very low to moderate. CONCLUSIONS: Inadequate lip coverage, increased overjet, and anterior open bite are associated with the occurrence of dental trauma in Brazilian children and adolescents.

Flexural strength and microhardness of bulk-fill restorative materials.

BACKGROUND: Bulk-fill materials can facilitate the restorative procedure mainly for deep and wide posterior cavities. The purpose of this study was to evaluate flexural strength (biaxial flexural strength [BFS]) and microhardness (Knoop microhardness [KHN]) at different depths of bulk-fill materials. METHODS: Five bulk-fill materials were tested: two light-curable composite resins, one dual-cure composite, one bioactive restorative, and a high-viscosity glass ionomer. A conventional composite was used as control. BFS and KHN were tested at different depths. Data was analyzed by two- and one-way ANOVAs, respectively and Tukey's post-hoc (α=0.05). RESULTS: The high-viscosity glass ionomer material presented the lowest BFS at all depths. KHN for the two light-curable and the dual-cure bulk-fill resin composites was reduced following an increase in restoration depth, while the conventional composite, the bioactive material, and the high-viscosity glass ionomer were not affected. CONCLUSION: There are differences in the properties of the tested materials at 4 mm depth, showing that the studied properties of some materials vary according to the cavity depth, although the results are material dependent. CLINICAL SIGNIFICANCE: Mechanical properties of light-cured, bulk-fill materials may be affected by inadequate polymerization. Clinicians should consider complementary strategies to achieve adequate polymerization at high-increment depths.

Effects of gastric acid and mechanical toothbrushing in CAD-CAM restorative materials: Mechanical properties, surface topography, and biofilm adhesion.

OBJECTIVE: To evaluate the effects of simulated gastric acid erosion combined with mechanical toothbrushing abrasion on the mechanical properties, surface topography, and biofilm adhesion of different CAD/CAM materials. MATERIAL AND METHODS: Specimens of zirconia-reinforced lithium silicate glass-ceramic (ZLS), polymer-infiltrated ceramic network (PICN), feldspathic glass-ceramic (FE), and two nanoceramic resins (RK, RG), were submitted to the following challenges: erosion (E), abrasion (A), erosion combined with abrasion (E + A), or remained untreated (control - C). After challenges, flexural strength was evaluated, while microhardness (KHN) and surface roughness (Ra) were tested before and after treatments. The biofilm adhesion (Streptococcus mutans ATCC 700610, Streptococcus sanguinis ATCC 10556 e Candida albicans MYA 2876) was determined by the counting of colonies forming units per milliliters (UFC/mL) after erosive and abrasive challenges. RESULTS: FE showed the lowest flexural strengths, while ZLS and RG exhibited the highest, while PICN and RK, had intermediate values. PICN, ZLS, and FE showed lower microhardness after E and E + A challenges than polymer-based materials (RG and RK). FE surface roughness increased after E and E + A challenges and after A and E + A challenges for RK. Biofilm formation after erosive/abrasive challenges was higher on ZLS than FE, RK, and RG, but no different than PICN. RK and RG exhibited the lowest biofilm formation among the groups. Furthermore, E + A challenges held significant changes in the surface of the materials, which were more severe on the surface of glass ceramics and hybrid materials. CONCLUSION: Erosive challenges combined with abrasion negatively influenced the mechanical properties and surface topography of most CAD/CAM materials and increased the biofilm adhesion on ZLS. Besides, the severity of the damage is related to the type and composition of each material.

Influence of Adhesion Promoter Primers on Polymerization Kinetics and Long-term Bond Strength of Composite Cements to Zirconia.

PURPOSE: To investigate the influence of primers on polymerization kinetics of resin-based luting and its effect on the microhardness and bond strength to zirconia. Materials and Methods: Panavia V5 (PV; Kuraray Noritake) with Tooth Primer (TPprimer; Kuraray Noritake) or Clearfil Ceramic Primer (CPprimer; Kuraray Noritake), and RelyX Ultimate (RU; 3M Oral Care) with Scotchbond Universal (SUadhesive; 3M Oral Care) were evaluated. Polymerization kinetics of luting materials with or without primers (TPprimer or SUadhesive) were evaluated using Fourier transform near-infrared (FT-NIR) spectroscopy in self- and dual-curing modes (n = 5). Microhardness of luting materials was evaluated after 1, 12, and 24 h (n = 5). Shear bond strengths to zirconia ceramics (Katana Zirconia, Kuraray Noritake; and Lava Esthetic, 3M Oral Care) after 24 h and 1 year (n = 8) were assessed to determine the effect of the following surface treatments: no treatment, non-thermal atmospheric plasma, primer (CPprimer or SUadhesive), and the combination of plasma + primers. Statistical analyses were performed at a 5% significance level. RESULTS: PV achieved a significantly higher degree of conversion (DC) when TPprimer was used, while there was no increase in conversion for RU combined with SUadhesive. Light activation significantly improved polymerization, which also produced greater microhardness. CPprimer and SUadhesive significantly improved immediate bond strength to zirconia ceramics. However, after 1 year, only SUadhesive with RU was able to maintain the bond strength. Plasma surface treatment did not improve bonding to zirconia. CONCLUSION: The use of primers improved the DC for PV only. Light curing produced higher conversion and microhardness for both resin-based luting materials. Bond strength to zirconia was improved when primers were used. However, only RU demonstrated reliable long-term adhesion to zirconia.

TiO2 nanotube-containing glass ionomer cements display reduced aluminum release rates.

Titanium dioxide nanotubes (TiO2-nts) were incorporated into a glass ionomer cement (GIC) with improved mechanical properties and antibacterial activity. The aims of the present in vitro study were to define the elemental characterization, aluminum (Al) release rate, and initial working time for GIC reinforced with TiO2-nts, in an experimental caries model. TiO2-nts were incorporated into GIC powder components at 5% by weight, and compared with unblended GIC. Experimental approaches used energy-dispersive spectrometry (EDS), atomic absorption spectrophotometry (AAS), and brightness loss to define surface element properties, Al release rates, and initial working time, respectively. Statistical analysis was performed by 2-way ANOVA, Tukey's test, generalized linear models, and Student's t test (a = 0.05). EDS data analysis revealed that TiO2-nts incorporated into GIC had no significant impact on the typical elemental composition of GICs in an in vitro caries model. Regarding the demineralizing solution, GIC with TiO2-nt significantly decreased the Al release rate, compared with the control group (p < 0.0001). Moreover, TiO2-nt incorporated into GIC did not alter the initial working time of the material (p > 0.05). These findings add information to our scientific body of knowledge concerning the potential impact of TiO2-nt on the performance of conventional GICs.

Antibacterial efficacy of non-thermal atmospheric plasma against Streptococcus mutans biofilm grown on the surfaces of restorative resin composites.

The aim of this study was to evaluate the antimicrobial efficacy of non-thermal atmospheric plasma (NTAP) against Streptococcus mutans biofilms. Resin discs were fabricated, wet-polished, UV sterilized, and immersed in water for monomer extraction (37 °C, 24 h). Biofilms of bioluminescent S. mutans strain JM10 was grown on resin discs in anaerobic conditions for (37 °C, 24 h). Discs were divided into seven groups: control (CON), 2% chlorhexidine (CHX), only argon gas 150 s (ARG) and four NTAP treatments (30 s, 90 s, 120 s, 150 s). NTAP was applied using a plasma jet device. After treatment, biofilms were analyzed through the counting of viable colonies (CFU), bioluminescence assay (BL), scanning electron microscopy (SEM), and polymerase chain reaction (PCR). All NTAP-treated biofilm yielded a significant CFU reduction when compared to ARG and CON. BL values showed that NTAP treatment for 90 s, 120 s or 150 s resulted in statistically significantly lower metabolic activity when compared to the other groups. CHX displayed the lowest means of CFU and BL. SEM showed significant morphological changes in NTAP-treated biofilm. PCR indicated damage to the DNA structure after NTAP treatment. NTAP treatment was effective in lowering the viability and metabolism of S. mutans in a time-dependent manner, suggesting its use as an intraoral surface-decontamination strategy.

Prevalence of dental trauma in Brazilian children and adolescents: a systematic review and meta-analysis.

This study aimed to investigate the prevalence of dental trauma in Brazilian children and adolescents. A systematic review was conducted considering eight databases: MEDLINE (via PubMed), LILACS, BBO, Scopus, Embase, Web of Science, Open Access Theses and Dissertations, and OpenThesis. Only prevalence studies that used a probabilistic sampling method were included, without restriction on year or language of publication. The JBI critical appraisal tools for prevalence studies were used to assess the individual risk of bias. The individual studies were combined in the meta-analysis using the random-effects model. The heterogeneity between the studies was analyzed by Cochran's Q and the I-square statistics. A meta-regression analysis was performed to evaluate the sources of heterogeneity. The GRADE approach assessed the certainty of evidence across included studies. The search resulted in 2,069 records, of which 36 were included in the study. The eligible studies were published from 2000 to 2021, with a total sample of 40,194 children and adolescents. Most studies (75%) had a low risk of bias. In permanent teeth, the prevalence of dental trauma was 21% (95%CI: 16.0; 26.0) and in deciduous teeth; 35% (95%CI: 26.0; 44.0). The prevalence of dental trauma among boys was higher than among girls for both dentitions. Based on a low certainty, the prevalence of traumatic dental injuries in Brazilian children and adolescents is higher than that found worldwide both in deciduous and permanent teeth. Also, the prevalence of dental trauma among boys is higher than among girls.

TiO2 nanotubes improve physico-mechanical properties of glass ionomer cement.

OBJECTIVES: The aim of this study was to determine the physico-mechanical properties of a high viscosity glass ionomer cement (GIC) reinforced with TiO2 nanotubes (TiO2-nt). METHODS: TiO2-nt was incorporated into the GIC powder components (Ketac Molar EasyMix™) in concentrations of 0% (control group), 3%, 5%, 7% by weight. Compressive strength (n = 10/group), three point bending for flexural strength (n = 18/group), microshear bond strength to dentin and failure mode (n = 20/group), and surface roughness and weight loss before and after brushing simulation (30,000 cycles) (n = 8/group) were evaluated. Data were submitted to Shapiro-Wilk, ANOVA, Tukey and Chi-square tests (α ≤ 0.05). RESULTS: Addition of 5% of TiO2-nt into GIC presented the highest values for compressive strength and differed from the control, 3% and 7% groups (p = 0.023). There were no significant differences in flexural strength (p = 0.107) and surface roughness before and after the dental brushing (p = 0.287) among the groups. GIC added with 5% TiO2-nt showed the lowest weight loss values (p = 0.01), whereas the control, 3% or 5% TiO2-nt groups presented similar microshear bond strength values (p ≥ 0.05). The 5% TiO2-nt group featured higher microshear bond strength than the 7% TiO2-nt group (p = 0.034). Cohesive in material was the most representative failure mode for all groups. SIGNIFICANCE: The incorporation of TiO2-nt did not affect GIC's adhesiveness to dentin, but improved its compressive strength at 5%. Furthermore, TiO2-nt decreased the percentage of weight loss after GIC's surface wear.

TiO2 nanotube-containing glass ionomer cements display reduced aluminum release rates

Abstract Titanium dioxide nanotubes (TiO2-nts) were incorporated into a glass ionomer cement (GIC) with improved mechanical properties and antibacterial activity. The aims of the present in vitro study were to define the elemental characterization, aluminum (Al) release rate, and initial working time for GIC reinforced with TiO2-nts, in an experimental caries model. TiO2-nts were incorporated into GIC powder components at 5% by weight, and compared with unblended GIC. Experimental approaches used energy-dispersive spectrometry (EDS), atomic absorption spectrophotometry (AAS), and brightness loss to define surface element properties, Al release rates, and initial working time, respectively. Statistical analysis was performed by 2-way ANOVA, Tukey's test, generalized linear models, and Student's t test (a = 0.05). EDS data analysis revealed that TiO2-nts incorporated into GIC had no significant impact on the typical elemental composition of GICs in an in vitro caries model. Regarding the demineralizing solution, GIC with TiO2-nt significantly decreased the Al release rate, compared with the control group (p < 0.0001). Moreover, TiO2-nt incorporated into GIC did not alter the initial working time of the material (p > 0.05). These findings add information to our scientific body of knowledge concerning the potential impact of TiO2-nt on the performance of conventional GICs.

Evaluation of effectiveness of cranial morphological characteristics for sex estimation in a Brazilian sample

Forensic physical anthropometry allows the determination of animal species and estimates sex, ancestry, age and height. Aim: To analyze the effectiveness of a cranioscopic/ morphological evaluation for sex estimation with a sample of the Brazilian mixed-race population by conducting a qualitative visual assessment without prior knowledge of sex. Methods: This is a blind cross-sectional study that evaluated 30 cranial characteristics of 192 skulls with mandible, 108 male and 84 female individuals, aged 22 to 97 years, from the Osteological and Tomographic Biobank. The qualitative characteristics were classified and compared to the actual sex information of the Biobank database. The statistical analysis was used to calculate de Cohen's kappa coefficient, total percentage of agreement, sensitivity and specificity of visual sex classification. Results: Of the 30 cranial variables analyzed, 15 presented moderate degree of agreement, achieving value of Kappa test between 0.41­0.60: Glabella (Gl), Angle and lines (At), Mental eminence (Em), Mandible size (Tm), Cranial base (Bc), Mouth depth (Pb), Nasal aperture (Anl), Supraorbital region (Rs), Orbits (Orb), Mastoid processes (Pm), Alveolar arches (Aa), Zygomatic arch (Az), Orbital edge (Bo), Supraorbital protuberances (Pts), and Supramastoid crests and rugosity (Crsm). The Facial physiognomy (Ff) presented substantial reliability (0.61-0.80) with 89.8% sensitivity for male sex and 70.2% specificity. Conclusions: Cranial morphological characteristics present sexual dimorphism; however, in this study only 15 variables showed moderate degree of agreement and can be used in sex estimation. Only one variable (Ff) 81.2% total agreement with substantial reliability. Quantitative methods can be associated for safe sex estimation

Prevalence of dental trauma in Brazilian children and adolescents: a systematic review and meta-analysis / Prevalência de lesões dentárias traumáticas em crianças e adolescentes brasileiros: uma revisão sistemática e metanálise / Prevalencia de lesiones dentales traumáticas en niños brasileños y adolescentes: una revisión sistemática y metaanálisis

Abstract: This study aimed to investigate the prevalence of dental trauma in Brazilian children and adolescents. A systematic review was conducted considering eight databases: MEDLINE (via PubMed), LILACS, BBO, Scopus, Embase, Web of Science, Open Access Theses and Dissertations, and OpenThesis. Only prevalence studies that used a probabilistic sampling method were included, without restriction on year or language of publication. The JBI critical appraisal tools for prevalence studies were used to assess the individual risk of bias. The individual studies were combined in the meta-analysis using the random-effects model. The heterogeneity between the studies was analyzed by Cochran's Q and the I-square statistics. A meta-regression analysis was performed to evaluate the sources of heterogeneity. The GRADE approach assessed the certainty of evidence across included studies. The search resulted in 2,069 records, of which 36 were included in the study. The eligible studies were published from 2000 to 2021, with a total sample of 40,194 children and adolescents. Most studies (75%) had a low risk of bias. In permanent teeth, the prevalence of dental trauma was 21% (95%CI: 16.0; 26.0) and in deciduous teeth; 35% (95%CI: 26.0; 44.0). The prevalence of dental trauma among boys was higher than among girls for both dentitions. Based on a low certainty, the prevalence of traumatic dental injuries in Brazilian children and adolescents is higher than that found worldwide both in deciduous and permanent teeth. Also, the prevalence of dental trauma among boys is higher than among girls.

Resumo: O estudo buscou investigar a prevalência de trauma dentário em crianças e adolescentes brasileiros. Foi realizada uma revisão sistemática em oito bases de dados: MEDLINE (via PubMed), LILACS, BBO, Scopus, Embase, Web of Science, Open Access Theses and Dissertations e OpenThesis. Foram incluídos apenas estudos de prevalência que usavam métodos de amostragem probabilística, sem limitação de ano ou idioma de publicação. Para avaliar o risco individual de viés, foram utilizadas as ferramentas de avaliação crítica da JBI para estudos de prevalência. Os estudos individuais foram combinados na metanálise com o uso do modelo de efeitos aleatórios. A heterogeneidade entre os estudos foi analisada pelas estatísticas Q de Cochran e I-quadrado. A análise de metarregressão foi realizada para avaliar as fontes de heterogeneidade. A abordagem GRADE avaliou a certeza das evidências entre os estudos incluídos. A busca resultou em 2.069 registros, dos quais 36 foram incluídos no estudo. Os estudos elegíveis foram publicados entre 2000 e 2021, com uma amostra total de 40.194 crianças e adolescentes. A maioria dos estudos (75%) teve baixo risco de viés. Nos dentes permanentes, a prevalência de trauma dentário foi de 21% (IC95%: 16,0; 26,0) e nos dentes decíduos foi de 35% (IC95%: 26,0; 44,0). A prevalência de trauma dentário foi mais alta no sexo masculino que no feminino, para ambas as dentições. Com base na baixa certeza, a prevalência das lesões dentárias traumáticas em crianças e adolescentes brasileiros é mais alta que no resto do mundo, tanto nos dentes decíduos quanto nos permanentes. Além disso, a prevalência de trauma dentário é mais alta em meninos que em meninas.

Resumen: Este estudio tuvo como meta investigar la prevalencia de trauma dental en niños y adolescentes brasileños. Se realizó una revisión sistemática considerando ocho bases de datos: MEDLINE (via PubMed), LILACS, BBO, Scopus, Embase, Web of Science, Open Access Theses and Dissertations y OpenThesis. Solamente se incluyeron estudios de prevalencia que usaron un método de muestreo probabilístico, sin restricción sobre el año o lengua de publicación. Se usó las herramientas de evaluación crítica del JBI para estudios de prevalencia studies para evaluar el riesgo individual de sesgo. Los estudios individuales se combinaron en metaanálisis, usando un modelo de efectos aleatorios. La heterogeneidad entre los estudios se analizó mediante las estadísticas de Cochran Q e I-cuadrado. Se realizó un análisis de meta-regresión para evaluar las fuentes de heterogeneidad. El enfoque GRADE evaluó la certidumbre de evidencia a través de los estudios incluidos. La búsqueda resultó en 2.069 registros, de los cuales treinta y seis se incluyeron en el estudio. Los estudios elegibles se publicaron entre 2000 y 2021, con una muestra total de 40.194 niños y adolescentes. La mayoría de los estudios (75%) tenían un bajo riesgo de sesgo. En los dientes permanentes la prevalencia de trauma dental fue 21% (IC95%: 16,0; 26,0) y en los dientes deciduos la prevalencia de trauma dental fue 35% (IC95%: 26,0; 44,0). La prevalencia trauma dental entre niños fue más alta que entre niñas en ambas denticiones. Basado en una baja certidumbre, la prevalencia de lesiones traumáticas dentales en niños y adolescentes brasileños es más alta que la encontrada en el resto del mundo, tanto en dientes deciduos como en dientes permanentes. Asimismo, la prevalencia de trauma dental entre niños es más alta que entre niñas.

Sexual dimorphism of mandibular measures from computed tomographies / Dimorfismo sexual de medidas mandibulares a partir de tomografias computadorizadas

ABSTRACT Objetive: The objective of this study was to analyze mandibular measurements obtained from 225 computed tomography scans of the Osteological and CT Biobanks of Faculdade de Odontologia de Piracicaba Universidade Estadual de Campinas, aiming to verify the existence of a relationship between these measures and sexual dimorphism and ancestry. Methods: We sought to establish a mathematical model capable of estimating sex and ancestry. Of these scans, 126 were male, 94 were female and 5 were unidentified, aged 15 to 100 years, and ancestry known for the skin color phenotype (white, black, brown and yellow). Measurements were made between the following points: right lateral condylion and left lateral condylion; right lateral condylion and pogonion; left lateral condylion and pogonion; mesial border of right mental foramen and mesial border of left mental foramen. The area delimited by the triangle formed by the measurements between right lateral condylion and left lateral condylion was also analyzed; right lateral condylion and pogonion; and left lateral condylion and pogonion. Student t test for homogeneous variances showed that there was statistical difference in the means as a function of sex, except for the area measure, which was not used in the model. Results: It was possible to establish a mathematical model with accuracy of 69.2%. There was no statistical difference in the averages as a function of ancestry. Conclusion: It is concluded that the measures investigated help in the process of estimating sex, but were not adequate to estimate ancestry. The proposed methodology should be expanded to other population groups so that it can be improved.

RESUMO Objetivo: Analisar medidas mandibulares obtidas de 225 tomografias computadorizadas do "Biobanco Osteológico e Tomográfico da Faculdade de Odontologia de Piracicaba Universidade Estadual de Campinas", visando verificar a existência de relação entre essas medidas, o dimorfismo sexual e a ancestralidade. Métodos: Buscou-se estabelecer um modelo matemático capaz de estimar sexo e ancestralidade. Destas tomografias, 126 eram do sexo masculino, 94 do sexo feminino e 5 estavam sem identificação, com idades entre 15 e 100 anos, e ancestralidade conhecida para o fenótipo cor da pele (branco, negro, pardo e amarelo). Foram realizadas medidas entre os pontos: kondylion lateral direito e kondylion lateral esquerdo; kondylion lateral direito e pogônio; kondylion lateral esquerdo e pogônio; borda mesial do forame mentoniano direito e borda mesial do forame mentoniano esquerdo. Analisou-se também a área delimitada pelo triângulo formado pelas medidas entre kondylion lateral direito e kondylion lateral esquerdo; kondylion lateral direito e pogônio; e kondylion lateral esquerdo e pogônio. O teste t de Student para variâncias homogêneas demonstrou que houve diferença estatística nas médias em função do sexo, à exceção da medida de área, que não foi utilizada no modelo. Resultados: Foi possível estabelecer um modelo matemático com acurácia de 69,2%. Não houve diferença estatística nas médias em função da ancestralidade. Conclusão: Conclui-se que as medidas investigadas auxiliam no processo de estimativa do sexo, porém não foram adequadas para estimar a ancestralidade. A metodologia proposta deve ser expandida para outros grupos populacionais para que possa ser aperfeiçoada.

Diagnosis and esthetic functional rehabilitation of a patient with amelogenesis imperfecta.

Amelogenesis imperfecta is a hereditary disease that causes structural anomalies in dental enamel of both the primary and permanent dentition. The anomaly may present a variety of clinical forms and appearances, with its main characteristics being the loss of tooth structure, compromised esthetic appearance, and dental sensitivity. The aim of this study was to present the clinical report of a 16-year-old patient with severely compromised esthetics as a result of amelogenesis imperfecta of the hypocalcified type who was rehabilitated with composite resin and ceramic crowns.

Uso de pontas CVD acopladas ao ultrassom para preparo cavitário / Use of CVD tips coupled to the ultrasound for cavity preparation

As pontas diamantadas CVD produzidas por método de deposição de uma camada única de diamantes sobre uma haste de molibdênio foram desenvolvidas para o acoplamento ao ultrassom para a realização de preparos cavitários. Assim, o objetivo desse caso clínico foi apresentar a utilização das pontas CVD para preparo cavitário e acabamento da restauração em resina composta. A ponta CVD permite a realização de preparos cavitários conservativos, tendo como vantagens menor ruído e sensibilidade durante o porcedimento, o que aumenta o conforto do paciente. Com a técnica é possível confeccionar uma cavidade com preservação dos substratos dentinários, causando menores danos às estruturas subjacentes, prevenindo iatrogenias, levando a um preparo com melhor acabamento das paredes. Observou-se que o preparo cavitário apresentou-se conservativo, indicando o uso de sistemasadesivos e resina composta. Entretanto, verificou-se maior tempo empregado para a remoção da restauração de amálgama antiga, regularização do preparo cavitário e para o acabamento da restauraçãode resina composta. Pode-se concuir que as pontas diamantadas CVD acopladas em ultrassom podem ser empregadas para preparo cavitário e nos procedimentos de acabamento de restaurações em resina compsota, trazendo benefícios à preservação das estruturas dentárias hígidas e conforto ao paciente

CVD diamond tips produced by deposition of a single layer of diamond on a molybdenum rod were developed for coupling to the ultrasound to cavity preparation. Thus, the purpose of this clinical case was to report the use of CVD diamond tips for cavity design and resin composite finishing procedures. The CVD tip allows conservative cavity preparations, with the advantage of lesser noise and sensitivity during the procedure, which increases the comfort of the patient. It provides cavity designs with dental structure preservation, causing minor damage to underlying structures, preventing iatrogenic complications, leading to a cavity preparation with a better finishing. It was observed a conservative cavity design, allowing the use of adhesive system and resin composite restoration. However, a higher preparation time was necessary to remove the previous amalgam restoration, to regularize the cavity design and for resin composite restoration finishing procedures. It can be concluded that CVD diamond tips coupled in ultrasound device may be used for cavity design and for resin composite restoration finishing procedures, bringing benefits for preservation of healthy dental structures and for patient comfort

Permeabilidade dos sistemas adesivos simplificados e incompatibilidade com cimentos resinosos / Simplified adhesive systems permeability and incompatibility with resin cements

O objetivo desta revisão de literatura foi estudar a permeabilidade dos sistemas adesivos simplificados e sua incompatibilidade com as resinas de polimerização química ou dual (cimentos resinosos). O estudo discute artigos relacionados às reações químicas adversas entre os monômeros ácidos dos adesivos simplificados, principalmente os convencionais de dois passos e os autocondicionantes de um passo, e as aminas terciárias básicas das resinas de polimerização química ou dual (cimentos resinosos); relaciona outros fatores que contribuem na incompatibilidade entre esses materiais, como: permeabilidade, acidez desses sistemas adesivos e durabilidade da interface dentina/adesivo. O uso de coiniciadores químicos e aplicações de camadas extras de resina hidrofóbica foram sugeridos como alternativas para reduzir a incompatibilidade entre esses materaisi. A maioria dos estudos compartilha com a conclusão de que os adesivos convencionais de dois passos e os autocondicionantes de um passo não devem ser utilizados juntamente com cimentos resinosos de presa química ou dual e, especificamente, os autocondicionantes de um passo ainda devem ser utilizados, devido à alta permeabilidade desses adesivos, que irá prejudicar a durabilidade da interface dentina/adesivo.

The aim of this review was to study the permeability of simplified adhesive systems and their incompatibility with the chemical or dual resin polymerization (resin cements). The study discusses articles related to adverse chemical reactions between the acidic monomers of simplified adhesives, especially the conventional two-step and the self-etching all in one adhesives, and the basic tertiary amine resins for chemical or dual polymerization (resin cements). This study lists other factors that contribute to the incompatibility between these materials: permeability, acidity of these adhesives and durability of the dentin/adhesive interface. The use of chemical co-initiators and applications of extra layers of hydrophobic resin were suggested as alternatives to reduce the incompatibility between these materials. Most studies shares the conclusion that the conventional two-step and self-etching all in one adhesives should not be used with chemical or dual resin cements, and, specifically the all in one adhesives should be used with caution even associated to light cured resins due to the high permeability of these adhesives, which will impair the durability of the dentin/adhesive interface.