Influence of coffee and red wine on tooth color during and after bleaching.

OBJECTIVE: The aim of this study was to evaluate the influence of coffee and red wine staining on tooth color during and after bleaching. MATERIALS AND METHODS: Blocks obtained from human molars were divided into 11 groups (n = 5) in accordance with the bleaching treatment-peroxide carbamide 10%, 15% or 20%-and in accordance with the stain therapy-coffee, wine or without staining (control). Color change analysis was performed by photo-reflectance using a spectrophotometer, during (3-times/week) and after (7, 15 and 30 days) the bleaching treatment. During the experiment, the samples were stored in artificial saliva. The results were submitted to statistical analysis with the Dunnet and Tukey tests (p < 0.05). RESULTS: The concentrations of carbamide peroxide (10%, 15% and 20%) did not differ significantly from the control group during bleaching (up to the 22nd day), with (Tukey, p > 0.05) or without storage in pigment solution. After the bleaching, there were statistically significant differences between the groups treated with coffee (30th day) and wine (7th and 30th days) relative to the control, which was treated with whitening agents. CONCLUSION: During bleaching, remineralization of the enamel with artificial saliva and the subsequent bleaching session were effective in preventing enamel staining. After the whitening procedures, both stain therapies-coffee and wine-caused enamel color changes; however, the wine led to greater staining than did coffee.

Digital analysis of anterior dental esthetic parameters in patients with bilateral maxillary lateral incisor agenesis.

OBJECTIVE: To analyze anterior dental esthetic parameters-width/height ratio (WHR), gingival zenith (GZ), and apparent contact dimension (ACD)-in patients with maxillary lateral incisor agenesis (MLIA) bilaterally treated with space closure and recontouring of the canines, or with implant-supported prostheses. METHODS: Fifty-two participants were allocated into three groups as follows: MLIA patients (N = 18) treated with teeth recontouring (RG); MLIA patients (N = 10) treated with implants (IG); and volunteers without agenesis (N = 24), who served as controls (CG). Dental casts of all patients were obtained and electronically scanned. Digital images were analyzed with 3Shape A/S OrthoAnalyser software (Copenhagen, Denmark). Shapiro-Wilk test, Spearman correlation, and Kruskal-Wallis statistical tests (p < 0.05) were used for statistical analysis. RESULTS: Although IG presented smaller means when compared with RG and CG, no statistical differences were found for WHR among groups (p > 0.05). Concerning GZ, RG presented more discrepancies than IG and CG, with statistically significant differences (p = 0.0165). IG presented statistically significant differences for the ACD in comparison with RG and CG (p < 0.05). CONCLUSION: Based on the results of this study, patients treated with space closure and teeth recontouring (RG) were shown to be closest to patients without agenesis (CG) in relation to the anterior dental esthetic parameters evaluated. CLINICAL SIGNIFICANCE: The digital analysis of esthetic principles, such as those investigated in this study involving maxillary incisor agenesis, is paramount to successful esthetic treatment planning. The results of the present study, as well as those found in the literature, indicate that clinicians should use esthetic parameters, such as those investigated herein, when treatment planning extensive oral rehabilitation cases.

Analysis of the golden proportion and width/height ratios of maxillary anterior dentition in patients with lateral incisor agenesis.

OBJECTIVE: The purpose of this study was to assess the presence of the golden proportion (GP) in the facial view tooth-to-tooth width proportion of the six maxillary anterior teeth and to evaluate the width/height (W/H) ratios of the incisors of patients with maxillary lateral incisor (LI) agenesis treated either with implants or orthodontically (by moving canines into the position of the laterals, recontouring them, and placing composite restorations over the repositioned teeth). MATERIALS AND METHODS: Forty-eight patients with LI agenesis were divided into four experimental groups: unilateral recontouring group (N = 10), bilateral recontouring group (BRG, N = 18), unilateral implant group (UIG, N = 10), bilateral implant group (N = 10), and a control group (CG, N = 25) of patients without agenesis. GP ratios were determined on patients' dental casts placed over Levin's grids, whereas W/H ratios were measured directly on the casts and a millimeter ruler to determine these distances. Statistical analysis was performed with Shapiro-Wilk, Kruskal-Wallis, Mann-Whitney, Friedman, and Wilcoxon tests (p < 0.05). RESULTS: The incidence of GP in the tooth-to-tooth width proportions was significantly different between groups and more commonly found between centrals and laterals than between laterals and canines. The GP was more likely to be observed in the BRG, UIG, and CG. The results demonstrated that the GP was not found to be present in the majority of the cases treated with maxillary agenesis, regardless of the method of treatment. The mean W/H ratios of the laterals ranged between 0.75 and 0.90. CONCLUSION: Although the GP may be a useful diagnostic guide, it was not observed in the majority of esthetic outcomes of patients treated with maxillary LI agenesis in this study. CLINICAL SIGNIFICANCE: The assessment of the golden proportion and width/height ratio of upper anterior teeth in patients with upper lateral incisor agenesis treated with either implants or tooth re-contouring may assist dentists and patients in deciding the best treatment option based on the peculiarities of each case.

Restauração extensa de dissilicato de lítio ­ uma abordagem conservadora e multidisciplinar / Extensive lithium dissilicate restoration ­ a conservative multidisciplinary approach

As restaurações indiretas estão sendo muito utilizadas e vêm ganhando grande importância na Odontologia atual. O presente artigo tem o objetivo de relatar a reabilitação de um caso clinico, cujo paciente teve perda parcial da estrutura coronária do segundo pré-molar inferior direito após fratura. No exame clínico e radiográfico se constatou a vitalidade pulpar do referido dente. Posteriormente a uma correta avaliação e diagnóstico, foi realizado um aumento de coroa clínica e, depois, uma restauração indireta (onlay) utilizando-se o sistema IPS e.max. No processo de preparação do remanescente dentário foi realizada a construção de uma caixa oclusal com resina composta, tendo como propósito a preservação da vitalidade do dente, como também a promoção de formas e contornos adequados para receber a peça protética (onlay). Assim, diante desse relato de caso clínico, que conceitua a utilização de restaurações indiretas em dentes posteriores utilizando o sistema IPS e.max, vinculada a um preparo por meio da confecção de uma caixa oclusal em resina composta, pôde-se constatar o sucesso da restauração do tipoonlay, por meio da melhoria na qualidade funcional, estética e longevidade da restauração indireta, além da manutenção da vitalidade da estrutura dentária reabilitada (AU).

Indirect restorations are being widely used and are gaining great importance in current dentistry. This article aims to report the rehabilitation of a clinical case whose patient had partial loss of the coronary structure of the second right lower premolar after fracture. After clinical and radiographic examination the tooth pulp vitality was verified. After correct evaluation and diagnosis, a clinical crown increase and an indirect restoration (onlay) were performed using the IPS e.max system. In the preparation process of the dental remnant, the construction of an occlusal box with a composite resin was carried out, with the purpose of preserving tooth vitality, as well as promoting appropriate shapes and contours to receive the onlay. Thus, in view of this clinical case report, which conceptualizes the use of indirect restorations in posterior teeth using the IPS e.max system, linked to a preparation of an occlusal box in composite resin, we can verify the onlay type restoration success. This is confirmed through observation of the functional quality improvement, aesthetics and indirect restoration longevity, as well as by the vitality of the rehabilitated dental structure maintenance (AU).

Advances in dental veneers: materials, applications, and techniques.

Laminate veneers are a conservative treatment of unaesthetic anterior teeth. The continued development of dental ceramics offers clinicians many options for creating highly aesthetic and functional porcelain veneers. This evolution of materials, ceramics, and adhesive systems permits improvement of the aesthetic of the smile and the self-esteem of the patient. Clinicians should understand the latest ceramic materials in order to be able to recommend them and their applications and techniques, and to ensure the success of the clinical case. The current literature was reviewed to search for the most important parameters determining the long-term success, correct application, and clinical limitations of porcelain veneers.

Esthetic and functional rehabilitation via reattachment of dental fragments.

Anterior teeth fractures are frequently encountered in clinical practice. The reattachment of dental fragments, if possible, is a conservative and effective technique, which is utilized in this case. This case presentation concerns an 18-year-old male patient with a root-crown fracture of the left maxillary central incisor, which involves the periodontal biologic space. The treatment was the reattachment of the dental fragment with a composite resin and adhesive, in association with periodontal surgery. The reattachment technique described in this case report is simple, but it provides long-lasting esthetics and improved function via a very conservative approach.

Microabrasão do esmalte: comparação de técnicas através de relatos de casos clínicos / Enamel microabrasion: Comparison of thechniques through case reports

Atualmente, com a grande quantidade de informação e disponibilidade de produtos fluoretados no mercado, utilizados para prevenção de cárie, tem-se observado um grande aumento na taxa de manchamentos por fluorose e, dessa forma, maior procura dos pacientes por tratamentos estéticos e novas técncias d remoção de manchas do esmalte pelos cirurgiões dentistas. O objetivo desse trabalho é apresentar dois relatos de caso clínico sobre remoção dse manchas de fluorose, nos quais foram utilizados diferentes materiais a fim de comparar sua efetividade através da avaliação de seus resultados. No primeiro caso utilizaou-se ácido clorídrico a 6,6 pr cento associado a carbeto de silício como abrasivo: e, no segundo, ácido fosfórico a 37 por cento associado a pedra-pomes. oram observados resultados clínicos satisfatórios para ambos os materiais empregados.

Currently, with the vast amount of information and availability of fluoridated products on market, used to prevent caries, it has seen a large increase of fluorosis staining of teeth, thus the demand of patients for esthetic treatments. The aim of this paper is to present two clinical case reports about fluorosis staining removal. Different materials were used to compare its effectiveness by results evaluation. In the first case we used hydrochloric acid 6.6% associated with silicon carbide abrasive, and in the second phosphoric acid 37% mixed with pumice. Satisfactory clinical results were observed for both materials used.

Como trabalhar de forma integrada na reabilitação de pacientes com agenesia de incisivo lateral superior, a fim de otimizar o resultado estético, quando a opção é o fechamento de espaço e reanatomizações estéticas? / How to work an integrated manner in the rehabilitation of patients with maxillary lateral incisor agenesis, in order to optimize the aesthetic result, when the option is closing space and aesthetic re-anatomy?

A agenesia dentária é caracterizada pela ausência ou falha na formação de um dente, que pode ocorrer de forma isolada ou não, por influência genética ou ambiental. A agenesia do incisivo lateral superior ocorre entre 0,8 e 2% durante a dentição permanente, com maior frequência no sexo feminino, sendo mais comum a ausência dos incisivos laterais que a unilateral.

Resolução estética: naturalidade com coroas cerâmicas / Esthetic solution: nature-like results with ceramic crowns

A valorização da estética do sorriso favorece o interesse pelos materiais cerâmicos na reabilitação dental, em função de resultados naturais e fáceis de ser alcançados. As propriedades ópticas semelhantes às da estrutura dentária, associadas à capacidade mecânica proporcionada pelas cerâmicas reforçadas (metal free), têm possibilitado resoluções estéticas sem comprometimento funcional. Dessa forma, este relato de caso clínico tem por objetivo descrever uma resolução estética com indicação de coroas cerâmicas metal free para resolução estético-funcional do sorriso, discutindo indicações e características, assim como as técnicas empregadas para o uso desses materiais

The appreciation of the smile esthetics favors the interest for ceramic materials used oral rehabilitation, since the clinician can achieve natural, esthetic results. Optical properties similar to tooth structure in association with the mechanical strength provided by reinforced all-ceramic restorations produce esthetic results without functional impairment. Thus, the aim of this case report is to describe an esthetic indication of all-ceramic crowns to reach esthetic, functional smile resolution and to discuss its indications and characteristics, and the technique used to these materials