Is immediate dentin sealing a mandatory or optional clinical step for indirect restorations?

OBJECTIVE: The use of immediate dentin sealing (IDS) following tooth preparation for indirect restorations is well-supported by laboratory studies. The inclusion of IDS as a mandatory clinical step, it must be firmly supported by evidence from randomized clinical trials (RCT). The objective of this study is to assess whether IDS should be added as a mandatory procedure in all indirect restorations, taking into consideration clinically significant outcomes for the patient, such as restoration longevity and hypersensitivity. MATERIALS AND METHODS: A bibliographic search was carried out in the PubMed. In addition, a manual search was conducted in the references of literature reviews. RESULTS: Data from four RCT were included. Two studies assessed preparations for full crowns, and two assessed preparations for partial restorations. Data from full crown preparations were subjected to a meta-analysis, revealing a reduction in hypersensitivity incidence in the IDS group 1 week after restoration cementation. With respect to hypersensitivity, IDS seems to offer advantages exclusively during the provisional phase and up to 1 week following the cementation of the final restoration. One study has shown no difference on longevity. CONCLUSION: The use of IDS should be considered as an elective clinical step during the rehabilitation with indirect restorations. CLINICAL SIGNIFICANCE: IDS is an elective clinical step that should be considered in patients and preparations with a higher risk of sensitivity between appointments.

Influence of the incorporation of titanium dioxide nanofibers net on bond strength and morphology of a total etching adhesive system.

Background: The aim of this study was to evaluate the nanoleakage and microtensile bond strength (µTBS) of an ethanol based-adhesive containing Titanium dioxide (TiO2) nanofibers to dentin. Material and Methods: TiO2 nanofiber was produced by electrospinning and it was inserted in an ethanol-based adhesive in 0.5, 1.5 and 2.5% by weight. The original adhesive did not receive nanofiber. The middle dentin was exposed by diamond saw under water-cooling and dentin was polished with wet 600-grit SiC abrasive paper. Resin composite build-ups were applied incrementally to the dentin after adhesive application. After storage in distilled water (24 hours/37°C) the teeth were sectioned perpendicularly to the bonded interface and sticks were obtained. Twenty-five sticks per group were tested by µTBS with a crosshead speed of 0.5mm/minute. The average values (MPa) obtained in each substrate were subjected to one-way ANOVA (α=0,05) with the tooth being considered the experimental unit. The nanoleakage pattern was observed in ten sticks per group and analyzed by Chi-square test (α=0,05). Results: There was no difference in µTBS among the experimental groups. However, there was a statistically significant difference among 2.5 % nanofiber adhesive, 0.5 % nanofibers and control groups, (p=0,028) in relation to nanoleakage. Conclusions: TiO2 nanofibers in 2.5% of weight inserted in dental adhesive reduced the nanoleakage, but did not improve the µTBS to dentin. Key words:Dentin-bonding agents, nanoleakage, tensile bond strength.

Cytotoxicity assessment of Bio-C Repair Íon+: A new calcium silicate-based cement.

Background. Direct pulp capping is a method designed to preserve the exposed dental pulp. Due to good biological, physical, and mechanical properties, new versions of calcium silicate-based materials have been developed as pulp capping materials. The present study aimed to evaluate the cytotoxic effects of four calcium silicate-based pulp capping materials, of which the Bio-C Repair Íon+ is still in an experimental phase. Methods. Biodentine, MTA Repair HP, Bio-C Repair, and Bio-C Repair Íon+ cements were dispensed in a metallic matrix to produce 125-mm3 specimens, which were immersed in Dulbecco's Modified Eagle Medium (DMEM) to obtain extracts. NIH 3T3 cells were cultured and exposed to the extracts for 24 hours and seven days. Cell viability was assessed by the methyl tetrazolium test (MTT). The mean values for the experimental and control groups (without treatment) were compared by analysis of variance (ANOVA) and post hoc Tukey tests, considering a significance level of 5%. Results. All the tested materials demonstrated a reduction in cell viability (P < 0.05). According to ISO 10993-5: 2009 (E), Bio-C Repair Íon+ exhibited mild and moderate cytotoxicity in the 24- hour and 7-day analyses, respectively. Bio-C Repair and Biodentine showed mild cytotoxicity, and MTA Repair HP exhibited moderate cytotoxicity at both intervals. Conclusion. The highest cell viability was demonstrated by Biodentine, MTA, and Repair HP, in descending order. Bio-C Repair and Bio-C Repair Íon+ showed moderate cytotoxicity, similar to MTA Repair HP in the 7-day analysis.

Restoration of occlusal vertical dimension in dental erosion caused by gastroesophageal reflux: case report.

The authors describe a minimally invasive procedure for occlusal rehabilitation in a young patient presenting with mild mandibular prognathism and loss of occlusal vertical dimension caused by dental erosion from chronic gastroesophageal reflux.

Effect of heat treatment on cytotoxicity and polymerization of universal adhesives.

To assess, in vitro, the influence of heat air treatment on cytotoxicity and degree of conversion (DC) of universal self-etch adhesives (Ambar Universal APS, Scotchbond Universal Adhesive, and Tetric N-Bond Universal) in an NIH/3T3 fibroblast cell culture. Samples were divided into three groups: 1) no heat treatment (control), 2) 37°C and 3) 60°C heat treatment before photopolymerization. Cytotoxicity was analyzed by MTT assay and the DC by FTIR. All adhesives heated at 60°C showed reduced cytotoxicity levels when compared with those heated at 37°C. In general, DC of Ambar Universal APS presented the highest DC than Scotchbond Universal Adhesive and Tetric N-Bond Universal, and the hot air treatment do not influence the conversion. Heat treatment at 60°C was able to reduce the cytotoxicity of universal self-etch adhesives, even, the heat treatment does not enhances the DC.

Hot air stream reduces cytotoxicity of light-cured calcium hydroxide based cements.

BACKGROUND: The light-cured calcium hydroxide based cements have incomplete polymerization and unconverted monomers can cause pulp cell damage. The aim of this study was to evaluate the influence of a warm and hot air stream on the cytotoxicity of light-cured calcium hydroxide based cements. MATERIAL AND METHODS: The materials Dycal (conventional cement), Biocal, Hidrox-Cal, and Ultra-Blend Plus (light-cured calcium hydroxide cements) were submitted to cytotoxicity analysis after polymerization, without vs. with previous heat treatment with a warm (37°C) and a hot (60°C) air stream. Following polymerization, cements were maintained in culture medium for 24 hours and 7 days, and subjected to the MTT test. Data were analyzed using analysis of variance (ANOVA) followed by post-hoc Student-Newman-Keuls (<0.05). RESULTS: The results indicated significant differences between the materials according to their composition, i.e., light-cured cements treated with a jet of warm air showed similar cytotoxicity levels to those observed for conventional cement, suggesting that they may be considered alternatives in cases requiring pulp-capping treatment. CONCLUSIONS: Application of a hot air stream reduced cytotoxicity of materials tested. Key words:Dental pulp capping, dental cements, calcium hydroxide, cell survival.

Influence of the internal conditioning of indirect restorations of resin composite in relation to microleakage using LEDs and QTH units.

The current study evaluated in-vitro microleakage of indirect composite inlays fixed with flowable composite and resinous cement and cured by LEDs and QTH units, thus modifying the internal conditioning of the inlays. Thirty-two non-carious teeth were selected and 64 cavity preparations were performed in both enamel and cementum. These teeth were divided into four groups: I--Elipar FreeLight appliance and Filtek Flowable composite; II--Ultralux appliance and Filtek Flowable composite; III--Elipar FreeLight appliance and RelyX cement and IV--Ultralux appliance and RelyX cement. The inlays were internally sandblasted with aluminum oxide, etched with 37% phosphoric acid, washed and silanized. The dental etching was carried out with 37% phosphoric acid for 15 seconds in dentin and 30 seconds in enamel. After being washed and dried, Single Bond dentinal adhesive was then applied, and the inlays were fixed with their respective luting agents, cured in close contact with their surfaces for 60 seconds, thermocycled and immersed in 0.5% basic fuchsine solution. The teeth were then washed and sectioned through the center of the restoration in order for the microleakage readings to be performed using the Image Tool Software. Then, ANOVA and Tukey's statistical tests were applied. In enamel, there was no significant difference for both groups with regard to microleakage; in cementum, the significant difference was 5% (p > 0.005). In agreement with the results, the inlays can be fixed with RelyX and Filtek Flowable resins.

Color variation of composite resins in relation to the Vita Classical shade guide: colorimetric analysis

Aim: The aim of this study was to verify the color variation between different composite resins and the Vita Classical Shade Guide. Methods: Two-millimeter thickness samples were made (n = 6) from eight commercial brands of composite resin (shade A2): Charisma (Kulzer), Forma (Ultradent), Harmonize (Kerr), Luna (SDI), Opallis (FGM), Oppus Bulk Fill (FGM), Vittra (FGM) and Filtek Z250 XT (3M ESPE). Specimens were stored in distilled water for 7 days and then polished. Color measurements of samples and A2 shade of the Vita Classical Shade Guide were performed using the Vita Easy Shade Advance 4.0 spectrophotometer on a black background. Color variations were calculated using the CIEDE2000 formula, considering values ≥0.81 being noticeable by the human eye and ≥1.77 being clinically unacceptable. Results were statistically analyzed with a 5% significance level. Results: Color variation (ΔE) of composite (E1 ) compared to the Vita Classical Shade Guide (E0 ) was greater than clinically acceptable for all the materials evaluated in this study. Forma (ΔE=2.08 ± sd=0.47) and Filtek Z250 XT (2.50 ± 0.20) had the smallest amount of color variation values found in the results. Harmonize (3.32 ± 0.63) presented values similar to Filtek Z250 XT, but it was worse than Forma. Vittra (3.51 ± 0.28), Charisma (3.80 ± 0.20), Opallis (4.24 ± 0.30) and Luna (5.67 ± 0.20) did not differ among each other and presented higher color variation than Forma, Filtek Z350XT and Harmonize. Oppus Bulk Fill (13.94 ± 1.12) was the composite with the greatest color variation. Conclusions: The findings in this study show that attention should be taken when using the Vita Color Shade Guide for composite shade selection

Repairing ceramic restorations: final solution or alternative procedure?

This article provides an overview of dental ceramics. It addresses possible modes of failure and factors that may influence the decision to either repair or replace ceramic restorations. The authors' intention was to present ceramic repair as a reliable, low-cost, low-risk technique.

Orthodontic space closure of lost traumatized anterior teeth - case report.

This case report refers to an 11-year-old boy with avulsion of the upper left central and lateral incisors. The teeth were replanted after 4 h, splinted with a semi-rigid splint for 12 days, and then endodontically treated. Severe progressive root resorption was seen after 2 years and the teeth were extracted. The boy had a normal occlusion with spacing in both jaws and slight protrusion of the anterior teeth. The treatment objectives were to close some of the spaces by mesial movement of the buccal segments in the upper jaw to minimize bone loss for a future single osseointegrated implant. Fixed appliance in combination with a removable plate was used for the mesial movements, levelling, and alignment of the upper jaw. Fixed appliance in the lower jaw and Class II traction were used for the final adjustment of the occlusion. A good occlusion with coincident upper and lower midlines and up-righted anterior teeth were achieved. A Maryland bridge was performed as a temporary solution for a future osseointegrated implant.

Experiências e percepções de discentes e docentes de odontologia sobre as aulas remotas durante a pandemia de COVID-19 / Experiences and perception of dentistry students and professors regarding online classes during the COVID-19 pandemic

O presente estudo objetivoudescrever a percepção de docentes e discentes de Odontologia sobre as atividades desenvolvidas nos ambientes virtuaisde aprendizagemdurante o período de isolamento social. Professores e estudantes dequatro cursosde Odontologia foram convidados a responderaum questionário autoaplicável, contendo questões objetivas e subjetivas arespeito de suas experiências e sensações em relação às atividades.Tanto docentes quanto discentes consideram que o aprendizado nesse período foi inferior ao presencial, contudo, concordam com a manutenção das aulas virtuais durante o período da pandemia (AU).

The present study aimed to describe the perception of Dentistry professors and students regarding the activities developed in virtual environments during the period of social isolation. Through self-administered questionnaires, professors and students from four Dentistry courses were invited to answer objective and subjective questions about their experiences and sensations during the period. Both professors and students consider that the learning in this period was inferior to the face-to-face, however, they agree with the maintenance of the virtual classes during the pandemic period (AU).

Evaluation of Tensile Bond Strength of Metallic Prefabricated Posts Cemented with Different Luting Agents

Abstract Objective: To assess the tensile bond strength of prefabricated metal posts cemented with different luting agents. Material and Methods: Fifty single-rooted endodontically treated human teeth had their crowns cut, mounted into acrylic-resin blocks and then an 8mm depth post space were prepared. Prefabricated cylindrical metal posts were cemented using different luting agents: a zinc phosphate cement (SS White), a conventional glass ionomer cement (Vidrion C), two resin-modified glass ionomer cements (Vitremer and RelyX Luting 2) and a resin cement (RelyX ARC). Samples were stored in distilled water for seven days and then submitted to a tensile bond strength test until complete dislocation of the post. One-way analysis of variance and Tukey test for pairwise multiple comparisons were used to evaluate differences between luting agents. Results: Tensile bond strength was 563.88±203.41 N for zinc phosphate cement, 336.86 ± 137.64 N for Vidrion C, 515.24 ± 239.48 N for Vitremer, 828.47±433.99 N for RelyX Luting 2 and 1262.51 ± 356.29 for RelyX ARC. The Relyx ARC presented the highest tensile bond strength regard the luting agent tested (p< 0.05). Conclusion: RelyX ARC presented the higher tensile bond strength compared to the other luting agents evaluated.

Influência do polimento na estabilidade de cor de uma resina composta após imersão em diferentes substâncias corantes / Influence of polishing on color stability of a composite resin after immersion in different coloring substances

Objetivo: Avaliar o grau de pigmentação da resina composta imersa em água destilada, molho shoyu e vinho tinto, submetida a diferentes métodos de polimento. Método: Foram confeccionadas 90 espécimes de resina composta cor A2 esmalte (4 mm de diâmetro de topo, 3 mm de diâmetro de fundo e 2 mm de espessura), divididos igualmente em três grupos, de acordo com o tratamento superficial realizado (sem polimento, polimento com Diamond Pro e polimento com lixa). As 30 amostras de cada grupo foram divididas em três subgrupos (n=10) e imersas em diferentes soluções (água, molho shoyu e vinho tinto). A análise colorimétrica foi realizada previamente, 7 e 15 dias após a imersão das amostras nas soluções, com o auxílio de um colorímetro. Os dados foram submetidos aos testes de ANOVA/Tukey considerando um nível de significância de 5%. Resultados: Amostras imersas em água apresentaram pequena variação de cor (E=2,2), com exceção das que não receberam polimento (E=7,8). O vinho tinto apresentou significativo maior potencial de pigmentação (E=15), independente do método de polimento, enquanto o molho shoyu (E=11) demonstrou pigmentar com maior intensidade as amostras polidas com discos de lixa. Conclusões: É necessário fazer um acabamento e um polimento adequado na restauração de resina composta para que o grau de pigmentação seja o menor possível. Sobre os alimentos corantes, conclui-se que tanto o molho shoyu quanto o vinho tinto pigmentam a resina composta, porém o vinho pigmenta com uma intensidade maior(AU)

Objective: To evaluate the degree of pigmentation of composite resin immersed in distilled water, shoyu sauce and red wine, with different polishing methods. Method: 90 specimens of A2 enamel composite resin (4 mm of top diameter, 3 mm of bottom diameter and 2 mm of thickness) were made, equally divided into three groups, according to the surface treatment carried out (without polishing, polishing with Diamond Pro and polishing with sandpaper). The 30 samples from each group were divided into three subgroups (n = 10) and immersed in different solutions (water, shoyu sauce and red wine). The colorimetric analysis was performed previously, 7 and 15 days after the samples immersion in the solutions, with the aid of a colorimeter. The data were submitted to ANOVA/Tukey tests considering a significance level of 5%. Results: Samples immersed in water showed little color variation (E = 2.2), with the exception of those that did not receive polishing (E = 7.8). Red wine showed a significant higher pigmentation potential (E = 15), regardless of the polishing method, while shoyu sauce (E = 11) demonstrated to pigment the polished samples with sandpaper with greater intensity. Conclusion: It is necessary to finish and polish the composite resin properly so that the degree of pigmentation is as low as possible. Regarding coloring foods, it is concluded that both shoyu sauce and red wine pigment the composite resin, but the wine pigments with greater intensity(AU)

Customized and low-cost aspirator device for intra-oral sandblasting.

This paper presents a simple technique that uses a novel device made of low-cost materials and is very helpful in routine clinical activity. This device plays an important role in reducing the suspension of particles in the air when a sandblaster of aluminum oxide powder is used intraorally to create additional micromechanical retention prior to applying a bonded restoration.

Rehabilitative treatment after unsuccessful teeth replantation: a case report.

A nine-year-old boy suffered a severe facial trauma in a bicycle crash, which resulted in the avulsion and subluxation of upper central incisors. Teeth were repositioned and stabilized, attempting to achieve a successful replantation. Root resorption occurred, teeth were extracted, followed by orthodontic treatment, and esthetic procedures, modifying laterals and canines. This article reports an attempt and failure of replantation, providing alternatives for achieving patient's satisfaction, applying a variety of techniques and areas of dental profession.

O papel das mídias sociais na construção do conhecimento em Odontologia / The role of social media in the construction of knowledge in Dentistry

Este artigo, de cunho teórico, discute a construção do conhecimento em Odontologia no contexto da Sociedade em Rede, aproximando essa temática ao ponto de vista de alguns autores das Ciências Sociais Contemporâneas em voga. A bibliografia especializada aponta que a sociedade vive em uma constante transformação. Prova disso é que a construção de conhecimento pedagógico em Odontologia se dá hoje com maior intensidade na internet, principalmente nas mídias sociais, do que através da busca em livros. Por essa nova forma de agregar conhecimento ser uma realidade, é de fundamental importância que pessoas qualificadas sejam vetores de transmissão desses conhecimentos, de uma forma didática e com embasamento científico. Além disso, cabe aos professores se adaptarem ao novo estilo de construção do conhecimento pedagógico, elaborando aulas mais interativas e com o auxílio de ferramentas que chamem a atenção dos seus alunos e, concomitante a isso, ofereçam-lhes informações de qualidade.

This theoretical article discusses the construction of knowledge in dentistry in the context of the Network Society, bringing this theme closer to the point of view of some contemporary Social Science writers, nowadays in vogue. The specialized bibliography indicates that the society lives in a constant transformation, proof of this is that the construction of pedagogical knowledge in dentistry occurs today with greater intensity in the internet, mainly in the social media, than through the search in books. Because this new form of knowledge aggregation is a reality, it is of fundamental importance that qualified people are vectors of transmission of this knowledge, in a didactic and scientific basis. In addition, it is up to teachers to adapt to the new style of construction of pedagogical knowledge, developing more interactive classes and with the help of tools that attract the attention of their students and, at the same time, offer them quality information.

Restauração de dentes tratados endodonticamente com resinas bulk-fill: revisão integrativa / Endodontically treated teeth restored with bulk-fill resins: integrative review

Objetivo: realizar uma revisão de literatura sobre o uso de resinas bulk-fill para restaurar dentes tratados endodonticamente. Materiais e método: a busca dos estudos, clínicos ou laboratoriais, foi realizada no portal PubMed, utilizando os descritores "bulk fill" e "endodontically treated". Os dados extraídos da literatura foram agrupados em um quadro, que apresenta as características metodológicas e os principais resultados de cada estudo. Resultados: Sete estudos foram incluídos na revisão. Dentre eles, cinco avaliaram a resistência à fratura dos dentes após a restauração, um avaliou a adaptação da resina ao assoalho da câmara pulpar, e um realizou um ensaio clínico com acompanhamento de três anos, comparando o uso de resina bulk-fill com resina convencional. Considerações finais: o desempenho das resinas bulk-fill mostrou-se semelhante ao das resinas convencionais nas características de resistência à fratura dos dentes (in vitro) e longevidade (in vivo). A economia de tempo clínico proporcionada pelas resinas bulk-fill pode justificar o seu emprego para a restauração de dentes tratados endodonticamente. (AU)

Objective: the aim of this study was to review the literature regarding the use of bulk-fill resin to restore endodontically treated teeth. Materials and method: the search was performed at PubMed, using the descriptors "bulk fill" AND "endodontically treated". Clinical and laboratorial studies were included. The extracted data was presented on a table showing the methodological features and results of each study. Results: seven studies evaluated the bulk-fill resin on direct restoration. Five of these seven evaluated the resistance to fracture, one assessed the resin adaptation to the floor chamber, and one was a randomized clinical trial comparing the bulkfill resin to conventional resin. Final considerations: the performance of bulk-fill resins was similar to the conventional resins when compared to the in vitro studies on tooth fracture resistance and in vivo study on longevity of restorations. The economy of clinical time may justify its use to restore endodontically treated teeth. (AU)

Validation method of research instruments for Dental Radiology curriculum study / Método de validação de instrumentos de pesquisa para estudo do currículo de Radiologia Odontológica

Dental radiology is an important subject to Dental undergraduate education. Along with other disciplines, it plays a key role in diagnostics, the starting point for patient care. In this way, a specific international guideline for Dental Radiology curriculum was published in 2007. The aim of this study was to develop and validate two distinct instruments, a self-administered online survey, and an interview script, both designed for dental radiology education research. The processes for developing and validating the instruments are described, and the final documents are presented. There were several steps in the validation process of the research instruments in this study, such as translation, cultural adaptation, expert evaluation, read-aloud sessions and pilot testing. This detailed process guarantees control of the variables and helps to avoid bias in regard to the interview and the quantitative/qualitative method analysis (AU).

Camouflage treatment for class III malocclusion combined with traction of an impacted maxillary central incisor.

This case report describes the treatment of a patient with an unerupted maxillary left central incisor, class III malocclusion with crossbite of the maxillary posterior teeth and lateral open bite. Treatment consisted of rapid maxillary expansion followed by anterior space opening, maxillary protraction and traction of the unerupted teeth with a light force system. Favorable results were obtained in terms of correcting incisor position and class III malocclusion. The results achieved remained stable throughout a 4-year retention period.

Scanning electron microscopy evaluation of the hard tissue barrier after pulp capping with calcium hydroxide, mineral trioxide aggregate (MTA) or ProRoot MTA.

The aim of this study was to investigate the morphology and localisation of calcium hydroxide- and mineral trioxide aggregate (MTA)-induced hard tissue barriers after pulpotomy in dogs' teeth. Pulpotomies were performed on maxillary and mandibular premolars of five dogs. The teeth were assigned into three groups according to the pulp-capping agent used. The pulpal wounds were capped with calcium hydroxide (Ca(OH)(2)- control), MTA or ProRoot MTA, and the cavities were restored with amalgam. After a 90-day follow-up period, the dogs were euthanised and the teeth were examined under scanning electron microscopy (SEM). An image-processing and analysis software was used to delimit the perimeters of the root canal area and the hard tissue barrier to determine the percentage of root canal obliteration. SEM data were used to assess the morphology, localisation and extension of the reparative hard tissue barriers. ProRoot MTA was statistically different from MTA and Ca(OH)(2) (P < 0.05) regarding tissue barrier morphology. Localisation data showed that ProRoot MTA was significantly different from Ca(OH)(2) (P < 0.05) and similar to MTA (P > 0.01; P > 0.05). No statistically significant difference (P > 0.01; P > 0.05) was observed between MTA and Ca(OH)(2). A larger number of complete (centroperipheral) hard tissue barriers with predominance of dentinal tubules was observed to the ProRoot MTA when compared with the Ca(OH)(2) group.