The Effect of Viscosity and Application Mode of Phosphoric Acid on Bond Strength of GlassFiber Post.

BACKGROUND: When a phosphoric acid is used, before applying an adhesive system, it is known that obtaining an effective adhesion to the root canal walls is a challenge. The aim of the present study was to evaluate the influence of phosphoric acid viscosity and application mode on the push-out bond strength (BS) values of fiberglass post to root dentin. The conditioning pattern on the root dentin was also evaluated. MATERIALS AND METHODS: The roots of 44 endodontically treated premolars were divided into 4 groups, of eleven teeth each, according to the combination of the main factors: phosphoric acid viscosity (liquid or gel) and application mode (passive or sonic). After application of the two-step etch-and-rinse adhesive system, the fiberglass posts were cemented with a dual-cure resin-cement. Roots were sectioned transversely into six 1-mm slices for push-out BS test at 0.5 mm/min. Some roots of each group were selected for evaluation of the conditioning pattern by scanning electron microscopy. BS results (three-way ANOVA and Tukey's test) and the conditioning pattern (Kruskal-Wallis test and Mann-Whitney test) were statistically evaluated (α= 0.05). RESULTS: The highest BS value was observed with a liquid phosphoric acid under sonic application mode (p < 0.05), being all other groups similar to one another (p < 0.05). Also, the highest BS value was observed in the cervical third, followed by the medium and the apical thirds (p < 0.05). The sonic application produced better smear layer removal and opening of dentinal tubules for both viscosities (p = 0.015). CONCLUSION: A better bonding of fiberglass posts to root canals can be achieved when the post spaces are conditioned with a liquid phosphoric acid under sonic application.

Hydrogen peroxide-based products alter inflammatory and tissue damage-related proteins in the gingival crevicular fluid of healthy volunteers: a randomized trial.

Hydrogen peroxide (H2O2)-based products are effective in tooth whitening; however, their safety is controversial as they may harm patient tissues/cells. These effects are suggested to be concentration-dependent; nonetheless, to date, there are no reports on H2O2-mediated oxidative damage in the gingival tissue, and neither whether this can be detected in gingival crevicular fluid (GCF) samples. We hypothesize that H2O2 whitening products may cause collateral oxidative tissue damage following in office application. Therefore, H2O2 and nitric oxide (NO) levels were investigated in GCF samples obtained from patients undergoing dental bleaching with H2O2 at different concentrations, in a randomized, double-blind, split-mouth clinical trial. A proteomic analysis of these samples was also performed. H2O2-based whitening products promoted inflammation which was detected in GCF samples and lasted for longer following 35% H2O2 bleaching. This included time-dependent changes in NO levels and in the abundance of proteins associated with NO synthesis, oxidative stress, neutrophil regulation, nucleic acid damage, cell survival and/or tissue regeneration. Overall, H2O2-based products used in office promote inflammation irrespective of their concentration. As the inflammation caused by 35% H2O2 is longer, patients may benefit better from using lower concentrations of this bleaching product, as they may result in less tissue damage.

Eruption of Impacted Teeth in Cleft Lip and Palate Patients following Alveolar Bone Graft.

INTRODUCTION: This study aimed to assess the eruption of impacted teeth in cleft lip and/or palate (CLP) after alveolar bone graft. MATERIALS AND METHODS: Research was carried out through a cross-sectional study at the Craniofacial Rehabilitation Center of the University General Hospital of the University of Cuiabá, Mato Grosso, Brazil. Variables related to cleft, cleft side, gender, age, laterality of cleft, impacted teeth, and orthodontic traction were analyzed. RESULTS: Forty-two patients treated at the institution from 2004 to 2011 had their charts retrospectively reviewed. They were 54.7% male and 45.2% female. The group aged 9 to 11 years was most affected, representing 59.5% of cases. A unilateral cleft was the most prevalent craniofacial anomaly (85.7%). A total of 57 impacted teeth were observed. Maxillary canines were the most commonly impacted teeth (97.6%) and the most frequently identified in patients with a transforamen incisor cleft (TIC) (76.3%). Orthodontic traction was required for both impacted maxillary canines and impacted lateral incisors (64.3 and 35.7% respectively). The orthodontic traction was required only in patients with a TIC (p = 0.0101). CONCLUSION: The canine teeth were the most commonly impacted teeth, found mainly in patients with a TIC. After placement of the alveolar bone graft in patients with a preforamen incisor cleft (PIC), all impacted teeth erupted spontaneously. CLINICAL SIGNIFICANCE: An impacted tooth can have negative consequences on a patient's quality of life. Thus, a survey evaluating the incidence and prognosis of impacted teeth after an alveolar bone graft for CLP was important.

Eruption of Impacted Teeth after Alveolar Bone Graft in Cleft Lip and Palate Region.

AIM: This study aimed to assess the eruption of impacted teeth in cleft lip and/or palate (CLP) after alveolar bone graft. MATERIALS AND METHODS: Research was carried out through a cross-sectional study at the Craniofacial Rehabilitation Center of the University General Hospital of the University of Cuiaba, Mato Grosso, Brazil. Variables related to cleft, cleft side, gender, age, laterality of cleft, impacted teeth, and orthodontic traction were analyzed. RESULTS: Forty-two patients treated at the institution from 2004 to 2011 were recruited. There were 54.76% males and 45.24% females. The age group between 9 and 11 years was most affected in 59.53% of cases. The unilateral cleft was the most prevalent (85.71%). A total of 57 impacted teeth were observed. Maxillary canine was the most prevalent impacted teeth (97.61%) and more frequent in transforamen incisor cleft (TIC) (76.3%). The orthodontic traction was needed in both maxillary canines and lateral incisor impacted teeth, 64.3 and 35.7% respectively. The orthodontic traction was needed only in TIC (p = 0.0101). CONCLUSION: The canine teeth were the most prevalent, mainly related to the TIC and all impacted teeth erupted spontaneously in the preforamen incisor cleft (PIC) after placement of the bone graft. CLINICAL SIGNIFICANCE: There was spontaneous eruption of impacted teeth after secondary alveolar bone graft in CLP.

Effect of Dental Prophylaxis Techniques on the Surface Roughness of Resin Composites.

AIM: The aim of this study is to evaluate the effect of dental prophylaxis techniques on surface roughness of composite resins. MATERIALS AND METHODS: A total of 36 nanohybrid resin composite test specimens were fabricated and divided into three groups (n = 12). They were kept in distilled water at 37°C for 24 hours and submitted to the finishing and polishing technique. For the prophylactic techniques, in group G1, a mixture of pumice stone and distilled water was used with the aid of a rubber cup; in group G2, Herjos-F prophy paste was used with a rubber cup; and in group G3, a bicarbonate jet spray was used. Afterward, all the samples were repolished using the Soflex pop-on disks. A roughness meter was used to measure surface roughness at three points in time: Before the prophylactic techniques (1st evaluation), afterward (2nd evaluation), and following repeat polishing (3rd evaluation). RESULTS: It was found that roughness values changed significantly between the 1st and 2nd evaluations (p < 0.05) and between the 2nd and 3rd evaluations (p < 0.05), showing that the change in roughness depended on the type of prophylactic treatment. Roughness was significantly higher after the bicarbonate jet (p < 0.05). CONCLUSION: Prophylaxis using the sodium bicarbonate jet significantly altered the roughness of nanoparticle-reinforced resin. CLINICAL SIGNIFICANCE: Dental prophylaxis is the most common practice employed to remove bacterial plaque and other coatings. However, one side effect of the cleaning may be a rougher surface subject to degradation and staining. The correct use of prophylactic devices and avoiding prolonged use on resin restorations reduce surface roughness.

Dentogingival Alterations and Their Influence on Facial and Smile Attractiveness.

AIM: This study aimed to evaluate the influence of labial and dentogingival characteristics on facial and smile attractiveness. MATERIALS AND METHODS: Four different close-up photographs each of six women models with different labial and dentogin-gival characteristics were obtained. One of the models was considered standard. Photographs were arranged in an album were evaluated by 100 laypersons, and 30 dentists who ranked each close-up of the models from according to the degree of attractiveness from first to sixth place, with first being the model considered most attractive and justified the reasons for choosing. RESULTS: The standard model received the best scores for both lips (7.75) and face (5.18). Medium-sized lips were preferred (p < 0.05), and the smile positively or negatively interfered with esthetic perception depending on the dentogingival alteration present. Diastema was the alteration that had the greatest negative influence. CONCLUSION: Not all dentogingival alterations interfere with esthetic evaluation. The lips are not decisive in facial attractiveness. Attraction is assessed significantly differently by laypeople than by dentists. The smile directly influences the analysis of facial beauty. CLINICAL SIGNIFICANCE: Dentogingival alterations may be imperceptible, especially when evaluating the facial joint, so its correction will not always be necessary.

Marginal Fit Metal-Ceramic and In-Ceram Single Crown Cement retained in Implant-supported Abutments.

INTRODUCTION: This study evaluated the cervical fit of cemented metal-ceramic and In-Ceram implant-supported crowns, before and after the cementing procedure. MATERIALS AND METHODS: Twenty crowns cemented on implant abutments are divided into two groups (n = 10): Group 1 -cemented metal-ceramic crowns and group 2 - cemented In-Ceram crowns. The marginal adaptations before and after cementation were evaluated in a comparison microscope with an error of 1 µm. All crowns were cemented with zinc phosphate cement. RESULTS: The cervical misalignment of cemented crowns before cementation (52.65 ± 11.83 and 85.73 ± 14.06 µm) was lower than that after cementation (66.80 ± 15.86 and 89.36 ± 22.66 µm). CONCLUSION: The cementing procedure interferes with the marginal fit of cemented crowns on implant abutments, with the prosthesis having better adaptation before cementation. Cemented metal-ceramic crowns exhibited better cervical adaptation than In-Ceram crowns cemented before and after the cementing procedure. CLINICAL SIGNIFICANCE: The maintenance of gum health and the longevity of prosthetic restorations are closely related to the restoration's marginal integrity.

New Single-bottle Ceramic Primer: 6-month Case Report and Laboratory Performance.

INTRODUCTION: This article presents a 6-month case report and an in vitro evaluation of the performance of the new self-etching glass-ceramic monobond etch and prime (MEP) when applied in a lithium disilicate (LD). The MEP contains in the same bottle, along with acid conditioner and silanes. This simplifies the bonding procedures by reducing not only the number of steps, but also the working time. A 42-year-old female patient sought for esthetic treatment, and the main complaint was the darkened appearance of the upper lateral incisor. The esthetic treatment includes dental bleaching and gingivectomy, all-ceramic zirco-nia crowns, and all-ceramic crown and laminate veneer LD. After 6 months of esthetic treatment, marginal staining, gap, or chip fracturing damaging margins after sharp explorer in the margins was not observed. Furthermore, the inferior etching pattern of MEP was compared with traditional hydrofluoric acid (HF) conditioning. The microshear bond strength to the intaglio surface of LD was statistically similar when HF was compared with MEP. This new self-etching glass-ceramic showed good in vitro and 6 months clinical results in this case report. Future long-term clinical studies with more clinical case need to be done to confirm the performance of the use of this new conditioner. CLINICAL SIGNIFICANCE: The use of a new self-etching glass-ceramic showed a good in vitro and 6 months clinical results. This new product can be an easy, simple, and alternative approach for esthetics bonding procedure.

Status of Endodontic Treatment and the Correlations to the Quality of Root Canal Filling and Coronal Restoration.

INTRODUCTION: This cross-sectional study evaluated the prevalence and quality of root canal treatment in 1,977 digital radiological files. MATERIALS AND METHODS: Data were statistically analyzed using descriptive analysis, and the chi-square test was performed with a 5% significance level. RESULTS: The mean age of the study population was 34.9 years. The endodontic treatment frequency was 6.14%, significantly higher in premolars. Adequate endodontic treatment was observed in 39.7% of analyzed cases. Molars were significantly more frequent with regard to inadequate filling quality. In 47.6% of cases, the filling's apical limit was classified as adequate, and there was a higher incidence of molars that were inadequate. Restorations were classified as adequate in 79.0% of cases, and molars were responsible for the highest frequency of inadequate restorations. The frequency of teeth with endodontic treatment that showed no periapical changes was 47.7%. There was no significant difference in the presence of periapical change according to gender. An increased presence of periapical change was observed with increasing age. The periapical lesions were observed in 45% of cases and related to inadequate filling quality. The apical limit was considered inadequate and related to periapical changes in 42% of cases. Periapical changes were present in 52% of cases, regardless of the quality of the filling and apical limit. Such changes were present in 42% of cases with adequate coronal restoration. CONCLUSION: It can be concluded that apical periodontitis (AP) is associated with the quality of endodontic treatment. The coronal restoration affects significantly the success rate of endodontic treatment. CLINICAL SIGNIFICANCE: The quality of the root filling and coronal restoration is closely related to periapical health.

Assessment of a Synthetic Type IV Cast and a Resin Polyol Used in the Fabrication of Dental Models.

OBJECTIVE: To evaluate the dimensional changes, reproduction of details, and surface roughness of a type IV cast and a resin used to fabricate dental models. MATERIALS AND METHODS: Two commercial brands of materials were evaluated: a type IV synthetic cast (Fuji Rock) and a polyol resin (Novox). Twenty samples were obtained from polyvinyl siloxane molds that reproduced the surface of a metal master model standardized according to the American National Standards Institute/American Dental Association specification no. 19. The materials were used according to the manufacturer's instructions and divided into two groups (n = 10). Each mold was photographed immediately after molding and 1 hour after molding. The obtained models were also photographed and measurements were obtained by using Image J software. The paired t-test was used to compare the molding materials and one-way analysis of variance (ANOVA) was used to compare the dimensional changes between the groups at a significance level of 5%. RESULTS: Statistically significant differences were observed between the models fabricated with the polyol resin and type IV synthetic cast with regard to reproduction of surface details, surface roughness, and dimensional stability (p < 0.05), with the resin providing superior surface detail reproduction and greater dimensional accuracy. CONCLUSION: The polyol resin exhibited superior behavior regarding detail reproduction, surface roughness, and dimensional change compared with the type IV synthetic cast.

Infecção endodôntica como fator de risco para doença coronariana / Endodontic infection as risk factor for coronary diseases

Objetivo: Avaliou-se em estudos longitudinais a influência da infecção endodôntica no desenvolvimento das alterações cardiovasculares. Metodologia: Empregou-se fontes de catalogação bibliográfica identificadas eletronicamente por MEDLINE, a partir de 1966 até 02 de dezembro de 2012 e Cochrane Library. Como estratégia de busca utilizou-se os termos - cardiovascular disease, coronary heart disease, periapical lesion, periapical disease, endodontic infection e root canal infection - diferentes combinações. Os estudos foram selecionados por dois revisores independentes, que também determinaram os critérios de inclusão e exclusão. Resultados: A busca apresentou 191 artigos, sendo que destes, 33 artigos eram de revisão de literatura, 58 artigos relacionavam-se com estudos in vivo (humanos ou animais), 38 estudos eram relatos de casos clínicos e 2 incluíram estudos in vitro. Dos 58 estudos in vivo, 9 estudos satisfizeram os critérios de inclusão, o que possibilitou a análise dos dados. Conclusão: Diante dos resultados obtidos, observou-se ausência de homogeneidade dos protocolos clínicos empregados nos estudos incluídos, o que inviabilizou uma meta-análise. A partir dos estudos incluídos parece oportuno maior número de pesquisas para o estabelecimento com o rigor de evidência das possíveis relações entre estas duas doenças.

Aim: Longitudinal studies about the influence of endodontic infection as a risk factor for cardiovascular disease were studied. Methodology: Bibliographic tabulation sources identified electronically by MEDLINE, since 1966 until December 2nd of 2012 and Cochrane Library, on the same period, were used. As searching strategy the following terms were used in different combinations: cardiovascular disease, coronary heart disease, periapical lesion, periapical disease, endodontic infection e root canal infection. The studies were selected by two independent reviewers, which also determined the inclusion and exclusion criteria. Results: The search presented 191 related articles, and from these, 33 articles were literature reviews, 58 articles wer related to in vivo studies (humans or animals), 38 studies were cases reports, and 2 included in vitro and/or ex vivo studies.From the 58 in vivo studies, 9 studies satisfied the inclusion criteria, what enabled the data analysis. Conclusion: Based on these results, it was observed lack of homogeneity of the clinical protocols used in the included studies, which prevented a meta-analysis. From the included studies seems appropriate to further research to establish with the rigor of evidence of possible relationships between these two diseases.

Erosive potential of energy drinks on the dentine surface.

BACKGROUND: Considering the current high consumption of energy drinks, the aim of the present study is to evaluate the influence of energy drinks in removing the smear layer and exposing dentinal tubules on root surface. METHODS: Dentine root surfaces were exposed using a diamond bur. Forty movements of scaling were performed in the area prepared in order to create a smear layer. One hundred and thirty specimens were obtained from 35 teeth. Specimens were randomly distributed into 12 groups (n = 10) and divided into subgroups according to the application: topical (n = 5) and friction (n = 5). Twelve energy drinks were evaluated: RedBull, Burn, TNT, Flash Power, Flying Horse, Sports Drink, Ionic, Hot Power, Army Power, Gladiator and Bug. Distilled water was used as a control group. The specimens were analysed by scanning electron microscopy. RESULTS: Topical application: a significant influence of energy drinks on smear layer removal was found for FlyingHorse and Bug when compared with the control group. Friction application: significant smear layer removal was found for Burn, FlyingHorse, Gladiator, SportsDrinks, when compared with the control group. Comparing the different application forms, a statistically significant difference was found for Army Power. CONCLUSION: Considering the significant smear layer removal, energy drinks can be an important etiological factor for cervical dentine hypersensitivity.