Development of a dual-cure mineral trioxide aggregate-based cement: Biological, physical, and mechanical properties.

PURPOSE: The purpose of this study is to compare the physical, mechanical, and biocompatibility properties of a new dual-cure white mineral trioxide aggregate (D-W-MTA) and a commercial W-MTA. MATERIALS AND METHODS: Diametral tensile strength (DTS), water sorption (WSp), and water solubility (WSl) tests were performed. Cytotoxicity was observed in primary culture of human pulp fibroblasts (HPFs) and mouse 3T3/NIH fibroblast lineage. Specimens of both materials were embedded in 1 mL of Dulbecco's modified essential medium for 24 h. Cells were incubated for 24 h with the eluates. Cytotoxicity was evaluated by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and genotoxicity by micronucleus (MN) formation. Data were analyzed by ANOVA and Kruskal-Wallis tests considering P < 0.05. RESULTS: D-MTA and W-MTA not showed cytotoxic effect on the two cell lines. However, D-MTA stimulated HPF growth. The MN count was similar to that of the control group for D-MTA and W-MTA. D-MTA presented lower DTS and WSl. Nevertheless, WSp was similar in the two groups. CONCLUSION: The results suggest that D-MTA is a promising material for pulp capping. Thus, in vivo tests should be performed to evaluate the performance of this material.

Genotoxic potential of 10% and 16% carbamide peroxide in dental bleaching.

Dental bleaching has become one of the most frequently requested esthetic treatments in dental offices. Despite the high clinical success observed with this procedure, some adverse effects have been reported, including a potential for developing premalignant lesions, root resorption and tooth sensitivity, especially when misused. The aim of this study was to evaluate the genotoxic response using a micronucleus (MN) assay, after the application of two concentrations of carbamide peroxide. Thirty-seven patients were divided into two groups and randomly received either a 10% carbamide peroxide (CP) (19) or a 16% carbamide peroxide (18) concentration for 21 days in individual dental trays. Gingival margin cells were collected immediately before the first use (baseline), and then 15 and 45 days after baseline. The cells were placed on a histological slide, stained by the Feulgen technique, and evaluated by an experienced blinded examiner. One thousand cells per slide were counted, and the MN rate was determined. The two groups were analyzed by the Wilcoxon rank-sum test and the Kruskal-Wallis equality-of-populations rank test. A slight increase in MN was observed for both groups, in comparison with the baseline, at 15 days. However, no difference was observed between the two groups (10% and 16%), at either 15 or 45 days (p = 0.90). When bleaching is not prolonged or not performed very frequently, bleaching agents containing carbamide peroxide alone will not cause mutagenic stress on gingival epithelial cells.

Genotoxic potential of 10% and 16% Carbamide Peroxide in dental bleaching

Dental bleaching has become one of the most frequently requested esthetic treatments in dental offices. Despite the high clinical success observed with this procedure, some adverse effects have been reported, including a potential for developing premalignant lesions, root resorption and tooth sensitivity, especially when misused. The aim of this study was to evaluate the genotoxic response using a micronucleus (MN) assay, after the application of two concentrations of carbamide peroxide. Thirty-seven patients were divided into two groups and randomly received either a 10% carbamide peroxide (CP) (19) or a 16% carbamide peroxide (18) concentration for 21 days in individual dental trays. Gingival margin cells were collected immediately before the first use (baseline), and then 15 and 45 days after baseline. The cells were placed on a histological slide, stained by the Feulgen technique, and evaluated by an experienced blinded examiner. One thousand cells per slide were counted, and the MN rate was determined. The two groups were analyzed by the Wilcoxon rank-sum test and the Kruskal-Wallis equality-of-populations rank test. A slight increase in MN was observed for both groups, in comparison with the baseline, at 15 days. However, no difference was observed between the two groups (10% and 16%), at either 15 or 45 days (p = 0.90). When bleaching is not prolonged or not performed very frequently, bleaching agents containing carbamide peroxide alone will not cause mutagenic stress on gingival epithelial cells.

Fechamento de diastemas empregando restaurações adesivas diretas / Diastema closure using adhesive composite resins restorations

Na estética do sorriso a arquitetura dos dentes anterossuperiores é determinante, porém alguns fatores podem contribuir para prejudicar esta harmonia. Este trabalho apresenta a descrição de um caso clínico com abordagem estética na região de incisivos laterais superiores que apresentavam severos diastemas. Os incisivos laterais evidenciavam-se dos demais dentes anteriores pela sua posição no arco dentário e também pelo consequente diastema formado, o que motivou a realização da reanatomização dos incisivos laterais com resina composta, possibilitando uma nova arquitetura estética da zona frontal. A abordagem empregada permitiu a realização do procedimento restaurador com adequado contorno e polimento, além de solucionar o problema da papila incisal, sem prejuízos para a estética e para a saúde dos tecidos periodontais.

Maxillary anterior teeth are very important for the smile aesthetics' but there are some factors that may compromise this harmony. This study describes a clinical case with aesthetic approach on the upper lateral incisors that presented severe diastema. Lateral incisors stood out from the other anterior teeth due to their position in the dental arch and consequent diastema. Therefore, an esthetic recontouring of lateral incisors was performed using composite resins, resulting on a harmonic aesthetic of anterior teeth. This approach enabled restoration with proper shape and polishing and solved the problem of incisive papilla without compromising the aesthetic and health of periodontal tissue.

Reanatomização de incisivos centrais superiores para fechamento de diastema e modelagem gengival / Recontouring of maxillary central incisors for closure of a diastema and gingival modeling

O objetivo deste trabalho é descrever a técnica restauradora utilizada na região de incisivos centrais superiores que apresentavam severo diastema. Em vista do espaço existente, a papila incisal apresentava-se quase plana. A reanatomização dos incisivos centrais com adequado contorno e polimento possibilitou nova arquitetura da zona papilar, melhorando a estética do sorriso. Na avaliação de quatro meses, a abordagem empregada no caso clínico exposto solucionou o problema da papila incisal sem prejuízo à estética vermelha e a saúde dos tecidos periodontais

The aim of this paper is to describe the restorative treatment of a patient presented severe diastema in the region of the maxillary central incisors. In view of this space by diastema, the incisal papilla presented almost flat. Recontouring of the central incisives with appropriate shape and polishing, enabled a new architecture of the papilla zone improving the esthetics of the smile. Four-month clinical evaluation revealed that the approach solved the problem of incisal papilla without impairment to the red esthetics and the health of periodontal tissues

Reabilitação estética em dentes anteriores com lesões de cárie proximais: relato de caso / Esthetic rehabilitation in anterior teeth with proximal carious lesions: case report

O objetivo do presente trabalho é o de descrever um caso de reabilitação estética na região dentária anterior. Paciente queixando-se das manchas escuras nos dentes anteriores superiores apresentava lesões de cárie nos dentes ântero-superiores, causando uma desarmonia estética no seu sorriso. Dentro do plano de tratamento reabilitador da paciente, realizaram-se restaurações classe III dos elementos dentários 11 e 12, classe IV do 21 e classe V do 13 e do 14. Frente ao caso clínico exposto, conclui-se que a reabilitação restauradora, além de promover saúde, pode proporcionar uma aparência estética mais favorável do sorriso, elevando a autoestima do paciente.

The aim of this study is to describe a case of esthetic rehabilitation in the maxillary incisive. Patient complaining of black stain on the maxillary teeth had carious lesions in teeth that cause great disharmony of your smile. Within the rehabilitation plan of patient, took place Class III restorations of the teeth 11 and 12, class IV of 21 and class V of the 13 and 14. It was concluded that, the present approach, allowed the anterior restorative rehabilitation, promote health and provide a more favorable aesthetic appearance of the smile, raising self-esteem of the patient.

Clareamento em dentes vitalizados empregando-se o Sistema Twist Pen: relato de caso / Vital tooth bleaching using the Twist Pen System: a case report

Este trabalho descreve o tratamento clareador em dentes vitalizados, empregando-se o sistema Twist Pen. Foi utilizado o peróxido de hidrogênio a 35%, com caneta aplicadora, e monitorou-se a mudança cromática da cor dos dentes, de acordo com a escala Vitapan 3D-Master. Conclui que, desde que sejam tomados os devidos cuidados clínicos e de diagnóstico e planejamento, o clareamento de consultório com o sistema Twist Pen é excelente opção estética e conservadora, para tratamento de dentes cromaticamente alterados...

The aim of this paper is to describe the vital tooth bleaching using the Twist Pen system. This product is a 35% hydrogen peroxide bleaching agent delivered by a pen applicator. Tooth color changes were recorded according to a Vitapan 3D-Master shade guide. It was concluded that, provided that proper diagnosis and treatment planning are made and the product is thoughtfully applied, bleaching using this approach is an excellent option for esthetic and conservative treatment of discolored teeth...

Preservação da estética vermelha por meio de reparo transcirúrgico associado à plastia radicular / Preservation of red esthetics using trans-surgical repair associated to root plasty

Este trabalho descreve o tratamento restaurador trans-cirúrgico de um dente incisivo central superior que apresentava margens subgengivais nas faces vestibular e mesial. Uma cirurgia ressectiva de aumento de coroa clínica e posterior restauração levaria a desarmonia entre as margens gengivais e perda de papila. Em vista disso, realizou-se acesso cirúrgico às margens dentais associado a plastia da superfície radicular. Conclui-se, pelo caso clínico exposto, que a abordagem empregada permitiu realizar o procedimento restaurador com adequado contorno e polimento, além disso, solucionou o problema restaurador, sem prejuízos para a estética vermelha e para a saúde dos tecidos periodontais.

The aim of this paper is to describe the trans-surgical restorative treatment of an upper central incisor with subgingival restorative margins. A ressective surgery of clinical crown lengthening would negatively affect the esthetics, creating black spaces and discrepancies of the gingival margin. The restorative margins were accessed after sulcular incisions and a full thickness flap. It was concluded that this approach allowed a restoration with good shape and polishing. In addition, no sequels of the periodontal surgery were observed, and consequently, the red esthetics was preserved.