Which irrigating provides a better bond strength in glass fiber posts: Chlorhexidine or Sodium Hypochlorite? A systematic review with meta-analysis.

Background: The aim of this systematic review and meta-analysis was to evaluate the influence of the use of chlorhexidine on endodontic instrumentation on the bond strength of glass fiber posts with resin cements. The guiding question of the study was: "Is the bond strength of glass fiber posts greater when using chlorhexidine as an irrigator in endodontic treatment instead of sodium hypochlorite?". Material and Methods: This study was conducted according to Guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). In vitro studies were included that have compared chlorhexidine and sodium hypochlorite as an endodontic irrigator in the chemical-mechanical preparation. Results: Eight studies were included in the qualitative analysis and seven in the meta-analysis. Both the analysis by subgroups and the total analysis, using a random effect model, showed no statistically significant differences between the groups (p> 0.05), either in the specific analysis for cervical root third (p = 0.30; 95% CI = -2.11, 6.91) or medium (p = 0.05; 95% CI = -0.03, 4.56), or nonspecific regarding the third to the root third (p = 0.48; 95% CI = -4.00, 1.86). Conclusions: There are no statistically significant differences in the bond strength of glass fiber posts and resin cements in teeth endodontically treated under irrigation by both chlorhexidine and sodium hypochlorite. Key words:Chlorhexidine, sodium hypochlorite, bond strength, glass fiber post.

Does flossing before or after brushing influence the reduction in the plaque index? A systematic review and meta-analysis.

OBJECTIVES: The purpose of this systematic review was to assess whether flossing before or after influences plaque index reduction. METHODS: This systematic review was conducted according to the guidelines of the preferred reporting items for systematic reviews and meta-analyses and registered with the International prospective register of systematic reviews under number CRD42019126239. The PICO question was, 'does flossing before or after brushing have any effect on reducing dental plaque?'. An electronic search was performed until April 2020 in the following databases: PubMed/MEDLINE, Scopus Web of Science and Cochrane Library. The initial database search resulted in 9679 references, and after detailed analysis of the titles and abstracts of the selected studies, the inclusion/exclusion criteria were applied, and 06 complete articles were downloaded and selected for further analysis. After the complete 02 articles were selected, 60 patients with a mean age of 23.1 years were studied and compared dental flossing before or after dental brushing. RESULTS: The results showed that there was no statistical difference between brush-floss and floss-brush in reducing plaque index (p = 0.91, RR: 0.01, 95% CI: -0.16, 0.18). CONCLUSIONS: Flossing before or after brushing has no significant effect on reducing dental plaque index. However, more clinical studies should be conducted.

Evaluation of bond strength of self-adhesive resin composite repairs / Avaliação da resistência de união de reparos com resina composta auto-adesiva

ABSTRACT Objective: To evaluate the bond strength of repairs with the self-adhering flowable composite Vertise Flow (Kerr) and a conventional composite resin Filtek Z350 (3M ESPE) subjected to different surface treatments. Methods: Forty specimens were divided into four groups: ZV (Filtek Z350 + Vertise Flow, without prior treatment); ZAV (Z350 + Vertise Flow with prior treatment with Single Bond Universal Adhesive System (3M ESPE)); ZAZ (Filtek Z350 + Filtek Z350 with prior treatment with Single Bond Universal Adhesive System (3M ESPE)); VV (Vertise Flow + Vertise Flow, without prior treatment). After 15 days of storage, the specimens were subjected to microtensile tests (Kratos IKCL3-USB, SP, Brazil), with speed of 0.5 mm/min and 20kg load. For statistical analysis, ANOVA with Tukey tests were used (p < 5%). Results: The mean values of the bond strength were highest respectively in the groups: ZV (36.07 ± 37.63); ZAZ (24.04 ± 28.51); VV (19.39 ± 28.24) and ZAV (16.06 ± 15.66). The bond strength of the repairs between the groups presented satisfactory results. Conclusion: The self-adhesive composite resin Vertise Flow seems to be a viable and fast alternative for composite resins repairs.

RESUMO Objetivos: Avaliar a resistência de união dos reparos com resina composta auto-adesiva Vertise Flow (Kerr) e uma resina composta convencional Filtek Z350 (3M ESPE) submetida à diferentes tratamentos de superfície. Métodos: Quarenta amostras foram divididas em quatro grupos: ZV (Filtek Z350 + Vertise Flow, sem tratamento prévio); ZAV (Z350 + Vertise Flow com tratamento prévio com Sistema Adesivo Universal Single Bond (3M ESPE)); ZAZ (Filtek Z350 + Filtek Z350 com tratamento prévio com Sistema Adesivo Universal Single Bond (3M ESPE)); VV (Vertise Flow + Vertise Flow, sem tratamento prévio). Após 15 dias de armazenamento, as amostras foram submetidas ao teste de microtração (Kratos IKCL3-USB, SP, Brasil), com velocidade de 0,5 mm / min e carga de 20kg.Para análise estatística, foram utilizados os testes ANOVA com Tukey (p <5%). Resultados: Os valores médios da resistência de união foram maiores, respectivamente, nos grupos: ZV (36,07 ± 37,63); ZAZ (24,04 ± 28,51); VV (19,39 ± 28,24) e ZAV (16,06 ± 15,66). A resistência de união dos reparos entre os grupos apresentou resultados satisfatórios. Conclusão: A resina composta auto-adesiva Vertise Flow parece ser uma alternativa viável e rápida para reparos em restaurações com resinas compostas.

Photobiomodulation Therapy in the Proliferation and Differentiation of Human Umbilical Cord Mesenchymal Stem Cells: An In Vitro Study.

Introduction: Since photobiomodulation therapy (PBMT) favors in vitro mesenchymal stem cell (MSC) preconditioning before MSC transplantation, increasing the proliferation of these cells without molecular injuries by conserving their characteristics, in the present in vitro study we analyzed the effect of PBMT on the proliferation and osteogenic differentiation of human umbilical cord mesenchymal stem cells (hUCMSCs). Methods: Irradiation with an InGaAIP Laser (660 nm, 10 mW, 2.5 J/cm2 , 0.08 cm2 spot size, and 10 s) was carried out. The cells were divided into four groups: CONTROL [cells grown in Dulbecco's Modified Eagle Medium (DMEM)], OSTEO (cells grown in an osteogenic medium); PBMT (cells grown in DMEM+PBMT), and OSTEO+PBMT (cells grown in an osteogenic medium plus PBMT). The cell proliferation curve was obtained over periods of 24, 48 and 72 hours using the 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay. Osteogenic differentiation was analyzed by the formation of calcium nodules over periods of 7, 14 and 21 days. Morphometric analysis was performed to quantify the total area of nodular calcification. Results: The highest cell proliferation and cell differentiation occurred in the OSTEO+PBMT group, followed by the PBMT, OSTEO and CONTROL groups respectively, at the observed times (P <0.05). Conclusion: PBMT enhanced the osteogenic proliferation and the differentiation of hUCMSCs during the periods tested, without causing damage to the cells and preserving their specific characteristics, a fact that may represent an innovative pretreatment in the application of stem cells.

Physicomechanical and thermal analysis of bulk-fill and conventional composites.

The aim of this study was to evaluate the degree of conversion (DC) and the thermal stability of bulk-fill and conventional composite resins. Eleven composite resin samples were prepared to evaluate the DC, Vickers microhardness (VMH), mass and residue/particle loss, glass transition temperature (Tg), enthalpy, and linear coefficient of thermal expansion (CTE) using infrared spectroscopy (FTIR), microdurometer analyses, thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), and dilatometry (DIL). The data were subjected to statistical analysis, with a significance level of 95%. DC and VMH were not influenced by the polymerized side of the sample, and statistical differences were recorded only among the materials. Decomposition temperature, melting, and mass and residue loss were dependent on the material and on the evaluation condition (polymerized and non-polymerized). Tg values were similar between the composites, without statistically significant difference, and CTE ranged from 10.5 to 37.1 (10-6/°C), with no statistical difference between the materials. There was a moderate negative correlation between CTE and the % of load particles, by weight. Most resins had a DC above that which is reported in the literature. TGA, Tg, and CTE analyses showed the thermal behavior of the evaluated composites, providing data for future research, assisting with the choice of material for direct or semidirect restorations, and helping choose the appropriate temperature for increasing the DC of such materials.

Physicomechanical and thermal analysis of bulk-fill and conventional composites

Abstract The aim of this study was to evaluate the degree of conversion (DC) and the thermal stability of bulk-fill and conventional composite resins. Eleven composite resin samples were prepared to evaluate the DC, Vickers microhardness (VMH), mass and residue/particle loss, glass transition temperature (Tg), enthalpy, and linear coefficient of thermal expansion (CTE) using infrared spectroscopy (FTIR), microdurometer analyses, thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), and dilatometry (DIL). The data were subjected to statistical analysis, with a significance level of 95%. DC and VMH were not influenced by the polymerized side of the sample, and statistical differences were recorded only among the materials. Decomposition temperature, melting, and mass and residue loss were dependent on the material and on the evaluation condition (polymerized and non-polymerized). Tg values were similar between the composites, without statistically significant difference, and CTE ranged from 10.5 to 37.1 (10-6/°C), with no statistical difference between the materials. There was a moderate negative correlation between CTE and the % of load particles, by weight. Most resins had a DC above that which is reported in the literature. TGA, Tg, and CTE analyses showed the thermal behavior of the evaluated composites, providing data for future research, assisting with the choice of material for direct or semidirect restorations, and helping choose the appropriate temperature for increasing the DC of such materials.

Does ferrule thickness influence resistance to fracture of endodontically treated teeth?

BACKGROUND: Teeth with severe crown destruction and endodontically treated may or may not present a circular strip of dental tissue located in the cervical region called ferrule. AIMS: The aims of this study were to evaluate ferrule thickness influence on endodontically treated teeth (ETT) resistance to fracture. MATERIALS AND METHODS: A total of 30 bovine incisor teeth were selected, endodontically treated and randomly distributed, according to the ferrule thickness: G1- no ferrule, G2 - 1 mm, and G3 - 2 mm. All the teeth were restored with prefabricated posts and composite resin. Resistance to fracture was established as the compression strength at 45° tilt at the lingual surface of the crown. STATISTICAL ANALYSIS USED: Data were analyzed using ANOVA and Tukey's test. RESULTS: Resistance to fracture of G1 and G2 were significantly higher than that of G3 (P < 0.001). The pattern of fracture, common to all groups, occurred at the composite resin on the coronary portions. CONCLUSION: Ferrule thickness can influence the resistance to fracture of ETT.

A importância da reabilitação oral estética na alteração de forma e cor dos dentes: relato de caso clínico / The importance of oral aesthetic rehabilitation in changing shape and color of teeth: clinical case report / La importancia de la rehabilitación oral estética en la alteración de forma y color de los dientes: reporte de caso clínico

Com o aumento da exigência estética dos pacientes e o desenvolvimento de materiais e técnicas odontológicas restauradoras problemas como alteração de cor e forma tem sido melhor resolvidos garantindo naturalidade e longevidade aos procedimentos restauradores. Este trabalho objetivou apresentar um relato de caso clínico de reabilitação estética do sorriso, descrevendo protocolo clínico de laminados cerâmicos e coroas totais "metal free" desde o planejamento até a cimentação definitiva. Paciente do gênero feminino, apresentou insatisfação com a estética de seu sorriso, principalmente em relação a coloração de seus dentes. Durante avaliação clínica, constatou-se comprometimento estético dos elementos dentais 11, 12 e 21 com alteração de cor e desequilíbrio dimensional. Esses dentes tinham grande restaurações resina composta, o que os tornava opacos e sem brilho. O tratamento proposto consistiu na realização de clareamento dental e posteriormente laminados cerâmicos nos dentes 12, 13, 14, 22, 23 e 24 e coroas totais "metal-free" nos elementos 11 e 21, utilizando um sistema cerâmico a base de dissilicato de lítio. Após o relato deste caso clínico, pode-se concluir que com o advento das cerâmicas ácido sensíveis e da cimentação adesiva os tratamentos reabilitadores estéticos têm proporcionado um resultado estético e funcional satisfatório(AU)

With increasing aesthetic requirement of patients and the development of materials and restorative dental techniques problems such as alteration of color and shape have been better solved guaranteeing naturalness and longevity to restorative procedures. This paper aimed to present a report of a clinical case of smile aesthetic rehabilitation, describing clinical protocol of ceramic laminates and total crowns "metal free" from planning to final cementation. A female patient, she was dissatisfied with the aesthetics of her smile, mainly in relation to the color of her teeth. During clinical evaluation, it was found aesthetic compromise of dental elements 11, 12 and 21 with color change and dimensional imbalance. These teeth had large composite resin restorations, which made them opaque and lackluster. The proposed treatment consisted of dental bleaching and then ceramic laminates on teeth 12, 13, 14, 22, 23 and 24 and total metal-free crowns on elements 11 and 21 using a ceramic system based on lithium disilicate . After the report of this clinical case, it can be concluded that with the advent of the sensitive acid ceramics and adhesive cementation the aesthetic rehabilitation treatments have provided a satisfactory aesthetic and functional result(AU)

Con el aumento de la exigencia estética de los pacientes y el desarrollo de materiales y técnicas odontológicas restauradoras problemas como alteración de color y forma han sido mejor resueltos garantizando naturalidad y longevidad a los procedimientos restauradores. Este trabajo objetivó presentar un relato de caso clínico de rehabilitación estética de la sonrisa, describiendo protocolo clínico de laminados cerámicos y coronas totales "metal free" desde la planificación hasta la cementación definitiva. Paciente del género femenino, presentó insatisfacción con la estética de su sonrisa, principalmente en relación a la coloración de sus dientes. Durante la evaluación clínica, se constató un compromiso estético de los elementos dentales 11, 12 y 21 con alteración de color y desequilibrio dimensional. Estos dientes tenían grandes restauraciones resina compuesta, lo que los hacía opacos y sin brillo. El tratamiento propuesto consistió en la realización de blanqueamiento dental y posteriormente laminados cerámicos en los dientes 12, 13, 14, 22, 23 y 24 y coronas totales "metal-free" en los elementos 11 y 21, utilizando un sistema cerámico a base de disilicato de litio . Después del relato de este caso clínico, se puede concluir que con el advenimiento de las cerámicas ácido sensibles y de la cementación adhesiva los tratamientos rehabilitadores estéticos han proporcionado un resultado estético y funcional satisfactorio(AU)

Physicomechanical characterization and biological evaluation of bulk-fill composite resin.

The aim of this study was to evaluate the cytotoxic effect, degree of conversion (% DC), Vickers hardness (VH), and surface morphology of composite resins. Eleven resins, nine bulk-fill resins, and two conventional resins were evaluated. Each material was sampled to evaluate DC (using FTIR), VH, cytotoxicity (using MTT and Neutral Red - NR test), surface morphology (using SEM and AFM), and organic filler (using EDS). All statistical tests were performed with SPSS and the level of significance was set at 0.05. MTT revealed that the materials presented low or no cytotoxic potential in relation to the control. Opus was the resin with the lowest cell viability at a 1:2 concentration at 72 h (32%) and at 7 days (43%), but that significantly increased when the NR test was applied at a 1:2 concentration after 7 days. Thickness and surface subjected to polymerization had no influence on DC, and differences were observed only between the materials. In the microhardness test, statistical differences were observed between the evaluated thicknesses. The bulk-fill resins analyzed in this study exhibited low and/or no cytotoxicity to L929 cells, except for Opus, which showed moderate cytotoxicity according to the MTT assay. When the NR test was used, results were not satisfactory for all composites, indicating the need for different methodologies to evaluate the properties of these materials. The assessed resins demonstrated acceptable physicomechanical properties.

Emprego dos cimentos resinosos autoadesivos: uma abordagem sobre a eficácia e os protocolos empregados / Employment of autoadesive resin cements: an approach on effectiveness and protocols employed / Empleo de los cementos resinosos autoadhesivos: un enfoque sobre la eficacia

Com o avanço da Odontologia Adesiva, através da criação dos cimentos resinosos autoadesivos, ocorreu uma melhoria na interação química com os substratos e os procedimentos que necessitam de um material cimentante, os quais passaram a apresentar sensível melhora, tanto na técnica quanto na garantia de longevidade do procedimento restaurador/reabilitador. Entretanto, assim como os cimentos resinosos convencionais, os autoadesivos apresentam limitações, sendo, portanto, imprescindível o conhecimento das recomendações da literatura atual para uma correta utilização do material sem prejudicar seu desempenho. Este trabalho objetivou através de uma revisão de literatura coletar as informações mais atuais sobre os cimentos resinosos autoadesivos bem como elucidar possíveis limitações destes materiais. Para o esmalte as recomendações encontradas são de realização de condicionamento ácido seletivo. Para a dentina, como se trata de um substrato altamente orgânico, onde o condicionamento ácido pode remover a smear layer e promover uma sensibilidade pós- operatória a aplicação do cimento apenas, parece ser a melhor indicação. Para substratos a base de ligas metálicas e a zircônia a criação de micro retenções ou a utilização de agentes de união química ainda é recomendável devido à fraca interação dos ácidos dos cimentos resinosos autoadesivos com estas superfícies(AU)

With the advancement of Adhesive Dentistry, through the creation of self-adhesive resin cements, there was an improvement in the chemical interaction with the substrates and procedures that require a cementing material, which started to show a significant improvement, both in technique and in the guarantee of longevity restorative/rehabilitation procedure. However, like conventional resin cements, the self-adhesives have limitations and it is therefore imperative to know the recommendations of the current literature for a correct use of the material without impairing its performance. This work aimed at collecting the most current information on self - adhesive resin cements as well as elucidating possible limitations of these materials through a literature review. For the enamel the recommendations found are of performing selective acid conditioning. For dentin, because it is a highly organic substrate, where acidic conditioning can remove the smear layer and promote a postoperative sensitivity to cement application only, it seems to be the best indication. For substrates based on metal alloys and zirconia the creation of micro retentions or the use of chemical bonding agents is still recommended due to the poor interaction of the acids of the self-adhesive resin cements with these surfaces(AU)

Con el avance de la Odontología Adhesiva a través de la creación de los cementos resinosos autoadhesivos ocurrió una mejora en la interacción química con los sustratos y los procedimientos que necesitan un material cementante presentaron sensible mejoría tanto en la técnica y en la garantía de longevidad del procedimiento restaurador/rehabilitador. Sin embargo, así como los cementos resinosos convencionales, los autoadhesivos presentan limitaciones, siendo, por lo tanto, imprescindible el conocimiento de las recomendaciones de la literatura actual para una correcta utilización del material sin perjudicar su desempeño. Este trabajo objetivó a través de una revisión de literatura recoger las informaciones más actuales sobre los cementos resinosos autoadhesivos así como elucidar posibles limitaciones de estos materiales. Para el esmalte las recomendaciones encontradas son de realización de condicionamiento ácido selectivo. Para la dentina, como se trata de un sustrato altamente orgánico, donde el condicionamiento ácido puede quitar la smear layer y promover una sensibilidad postoperatoria la aplicación del cemento, apenas, parece ser la mejor indicación. Para sustratos a base de aleaciones metálicas y zirconia la creación de micro retenciones o la utilización de agentes de unión química todavía es recomendable debido a la débil interacción de los ácidos de los cementos resinosos autoadhesivos con estas superficies(AU)

Physicomechanical characterization and biological evaluation of bulk-fill composite resin

Abstract The aim of this study was to evaluate the cytotoxic effect, degree of conversion (% DC), Vickers hardness (VH), and surface morphology of composite resins. Eleven resins, nine bulk-fill resins, and two conventional resins were evaluated. Each material was sampled to evaluate DC (using FTIR), VH, cytotoxicity (using MTT and Neutral Red - NR test), surface morphology (using SEM and AFM), and organic filler (using EDS). All statistical tests were performed with SPSS and the level of significance was set at 0.05. MTT revealed that the materials presented low or no cytotoxic potential in relation to the control. Opus was the resin with the lowest cell viability at a 1:2 concentration at 72 h (32%) and at 7 days (43%), but that significantly increased when the NR test was applied at a 1:2 concentration after 7 days. Thickness and surface subjected to polymerization had no influence on DC, and differences were observed only between the materials. In the microhardness test, statistical differences were observed between the evaluated thicknesses. The bulk-fill resins analyzed in this study exhibited low and/or no cytotoxicity to L929 cells, except for Opus, which showed moderate cytotoxicity according to the MTT assay. When the NR test was used, results were not satisfactory for all composites, indicating the need for different methodologies to evaluate the properties of these materials. The assessed resins demonstrated acceptable physicomechanical properties.

Marginal microleakage in Bulk Fill resins / Microinfiltração marginal em resinas Bulk Fill

Introduction: Despite advances and innovations in restorative dentistry, microleakage remains one of the main problems in this area. Objective: To evaluate in vitro marginal microleakage of Bulk Fill resins in class II cavities, with cervical termination in the dentin. Material and method: Cavities, standardized on the mesial and distal surfaces, were prepared in forty top molars and randomly assigned to four groups (n = 10), according to the resin used. G1 (control): Filtek Z350 (3M/ESPE); G2: Filtek Bulk Fill flow (3M/ESPE); G3: Surefill SDR (Dentsply); G4: X-tra (Voco). These were further subdivided into subgroups according to the strategy used to apply the adhesive (self-etch technique and conventional). After storage for 24 hours in an oven (37 °C), the samples were submitted to the thermocycling test (500 cycles: 5 °C/55 °C). They were later waterproofed, immersed in Basic Fuchsin (0.5%) and sectioned in the mesial-distal direction for evaluation using a stereo magnifying glass at 40X (Coleman) Scores from 0 to 3 were assigned according to the microinfiltration observed. The Mann-Whitney and Kruskal-Wallis tests, with a significance level of 5%, were used for statistical analysis. Result: There was no statistically significant difference between the Bulk Fill resins when the total acid-etching technique was used. Only the Filtek Bulk fill flow resin presented statistically significant results when the application of the adhesive system strategy was considered, with worse results, in relation to other groups, when it the self-etching strategy was considered. Conclusion: The degree of leakage of the bulk fill resins studied, in class II cavities, was not influenced by the method of application of the adhesive system (conventional or two-step self-etching bonding agent), except for the Filtek Bulk fill flow.

Introdução: Apesar dos avanços e inovações na odontologia restauradora, a microinfiltração continua sendo um dos principais problemas nessa área. Objetivo: Avaliar in vitro a microinfiltração marginal das resinas Bulk Fill em cavidade classe II, com terminação cervical em dentina. Material e método: Cavidades padronizados na mesial e distal foram elaboradas em quarenta dentes molares superiores e alocados aleatoriamente em quatro grupos (n=10), de acordo com a resina usada: G1 (controle): Filtek Z350(3M/ESPE); G2: Filtek Bulk Fill flow (3M/ESPE); G3: Surefill SDR (Dentsply); G4: X-tra base (Voco), sendo estes subdivididos em subgrupos considerando a estratégia adesiva aplicada (autocondicionamento e convencional). Após 24h de armazenamento em estufa (37 °C), as amostras foram submetidas ao teste de termociclagem (500 ciclos: 5 ºC/55 ºC). Posteriormente foram impermeabilizados, imersos em Fucsina Básica (0,5%) e seccionados no sentido mésio-distal para avaliação com lupa estereoscópica 40X (Coleman), sendo atribuído escores de 0 a 3 de acordo com a microinfiltração observada. Para análise estatística foi aplicado o teste Mann-Whitney e o Kruskal-Wallis com nível de significância de 5%. Resultado: Não houve diferença estatística significante entre as resinas Bulk Fill, quando utilizada a técnica de condicionamento ácido total. Apenas a resina Filtek Bulk fill flow apresentou resultados estatisticamente significante quando se considerou a estrategia de aplicação do sistema adesivo, com piores resultados, em relação aos outros grupos. Conclusão: O grau de infiltração em cavidades classe II das resinas bulk fill estudadas, não foi influenciado pelo modo de aplicação do sistema adesivo (convencional ou autocondicionante), exceto para Filtek Bulk fill flow.

Durability of the adhesive cementation to the dentin substract / Durabilidade da cimentação adesiva ao substrato dentinário

ABSTRACT Objective The aim of this study was to evaluate, in vitro, the union stability of resin cements to the dental substract through microtensile bond strength (µTBS) analysis and scanning electron microscopy (SEM). Methods Fifty-four third human molars, stored in water for a short (24 hours) and long period of time (1 year) presented a flat oclusal superficial dentin. The teeth were distributed in six different groups: G1- Panavia F2.0/Kuraray; G2- RelyXUnicem/3M ESPE; G3- G-Cem/GC; G4- Biscem/ Bisco; G5- Panavia F2.0/Kuraray without pre-treatment and G6- Multilink Sprint/Ivoclar-Vivadent which were adhered to its respective indirect resin composite restoration, (G1- Clearfil AP-X/Kuraray; G2- Filtek Z350/3M ESPE; G3- Gradia Direct X(tm)/GC; G4- Aelite(tm)/ Bisco; G5- Clearfil AP-X/Kuraray; G6- Tetric Ceram/ Ivoclar-Vivadent). The resin blocks were cemented and the sticks were obtained by tooth, with an area of adhesive interface of 0,8mm² (±0,2). Results The mean values, submitted to Mann-Whitney and Kruskal-Wallis tests (α = 5%) were in MPa after 24 hours: G1 = 9.66 (A), G2 = 13.37 (A); G3 = 15.89 (A); G5 = 4.18 (B); G6 = 11.01 (A) and after 1 year: G1 = 9.75 (A), G2 = 11.73 (A); G3 = 20.10 (B); G5 = 6.80 (A); G6 = 21.09 (B). All G4 group presented pretest failures. Conclusion During the one year period, with the exception of BisCem, the self-adhesive resin cements were a favorable alternative for the adhesive cementation, standing out among these, the G-Cem and Multilink Sprint.

RESUMO Objetivo Avaliar, in vitro, a estabilidade da união de cimentos resinosos ao substrato dental através da resistência de união e análise em microscopia eletrônica de varredura (MEV). Métodos Cinquenta e quatro terceiros molares humanos, armazenados em água por um curto (24 horas) e longo período de tempo (1 ano), tiveram a face oclusal removida expondo a superfície dentinária. Os dentes foram distribuídos em seis grupos distintos: G1- Panavia F2.0 / Kuraray; G2- RelyX Unicem / 3M ESPE; G3- G-Cem / GC; G4- BisCem / Bisco; G5- Panavia F2.0 / Kuraray sem pré-tratamento e G6- Multilink Sprint / Ivoclar-Vivadent que foram aderidas ao seu respectivo restaurações de resina composta indireta, (G1- Clearfil AP-X / Kuraray; G2- Filtek Z350 / 3M ESPE; G3- Gradia Direct X (tm) / GC; G4- Aelite (tm) / Bisco; G5- Clearfil AP-X / Kuraray; G6- Tetric Ceram / Vivadent Ivoclar-). Os blocos de resina foram cimentados e foram obtidos palitos, com área de interface adesiva de 0,8mm² (± 0,2). Resultados Os valores médios, submetidos à Mann-Whitney e Kruskal-Wallis testes (α = 5%) foram em MPa após 24 horas: G1 = 9,66 (A), G2 = 13,37 (A); G3 = 15,89 (A); G5 = 4,18 (B); G6 = 11,01 (A) e depois de 1 ano: G1 = 9,75 (A), G2 = 11,73 (A); G3 = 20,10 (B); G5 = 6,80 (A); G6 = 21,09 (B). O grupo todo G4 apresentou falhas pré-teste. Conclusão Durante o período de um ano de investigação, os cimentos de resinosos auto-adesivos, exceto o Bis Cem, eram uma alternativa favorável para a cimentação adesiva, destacando-se entre estes o G-Cem e Multilink Sprint.

APRIMORANDO A ESTÉTICA COM COROAS "METAL FREE": RELATO DE CASO / Improving the aesthetics with "METAL FREE": a case report

O Introdução: A busca pela estética está cada vez mais presente no dia-a-dia do cirurgião-dentista. Devido a isto a preocupação dos pacientes com as restaurações, especialmente em dentes anteriores, tem aumentado cada vez mais. A utilização de coroas livre de metal responde positivamente a essa preocupação estética. Objetivo: Este artigo tem como objetivo apresentar um relato de caso clínico que mostra a reabilitação de dois dentes com o uso de coroas puras de cerâmica IPS E-MAX. Relato de Caso: O paciente procurou atendimento odontológico se queixando da estética dos elementos 24 e 25, após constatar que os elementos haviam tratamento endodôntico adequado e já haviam núcleos metálicos fundidos (duracast) em condições satisfatórias, foi selecionado o sistema cerâmico dissilicato de lítio IPS E-max (Ivoclar Vivadent), para a confecção das coroas. Conclusão: As coroas em cerâmica metal-free, apresentam-se como uma excelente alternativa restauradora, desde que o protocolo clínico de utilização seja corretamente seguido.clínico, é imprescindível ao profissional fazer opção por parâmetros mais científicos, favorecendo a função mesmo que a estética fique comprometida.

Introduction: The search for aesthetic is becoming increasingly present on the day of the dentist. Due to this the concern of the pacients with restorations, especially in anterior teeth, is increasing more and more. The use of metal free crowns responds positively to this aesthetic concern. Objective: This article aims to present a case report showing the rehabilitation of two teeth using pure ceramic crowns IPS E-MAX. Case report: The patient sought dental care complaining of aesthetic elements 24 and 25, after noting that the elements had appropriate endodontic treatment and had already molten metallic cores (gold /duracast) in satisfactory condition, was chosen lithium disilicate ceramic system IPS E-max (Ivoclar Vivadent), for the manufacture of ceramic crown. Conclusion: Ceramic crowns metal free, are presented as an excellent alternative restoration since the clinical protocol is followed correctly.

Intracanal pain remission in child with amelogenesis imperfecta. Case report / Remissão de dor intracanal em criança com amelogênese imperfeita. Relato de caso

ABSTRACTBACKGROUND AND OBJECTIVES:Amelogenesis imperfecta is characterized by enamel structural defects, which may severely affect dental structure in both dentitions. When accompanied by severe decay, it may impair the pulp complex requiring endodontic treatment and in case of incomplete root formation treatment becomes more complex due to pulp volume and anatomic conditions. This study aimed at reporting a clinical case of patient with amelogenesis imperfecta and with multiple incomplete root formation as a consequence.CASE REPORT:Female patient, 12 years old, leucodermic, with painful symptoms, who has looked for dental assistance. At intraoral clinical evaluation teeth presented with shape and size changes, yellowish color, covered by a thin enamel layer with roughened surface and absent in some areas, with anterior vestibular sulcus fistula and without edema. At radiographic evaluation, both dentitions were affected by the abnormality with delayed chronology of permanent teeth eruption. At the end of all evaluations, patient was diagnosed with amelogenesis imperfecta, and periodontal treatment was started, followed by endodontic treatment.CONCLUSION:Amelogenesis treatment is complex, especially when in more advanced stages of dental structure destruction. However, it is possible to reestablish patient’s functionality and esthetics with good planning and multidisciplinary approach.

RESUMOJUSTIFICATIVA E OBJETIVOS:A amelogênese imperfeita é caracterizada por defeitos estruturais do esmalte, os quais podem acometer gravemente a estrutura dentária, em ambas as dentições. Quando acometida por lesões cariosas graves, pode comprometer o complexo pulpar, necessitando de tratamento endodôntico, e em se tratando de dentes com rizogênese incompleta, o tratamento torna-se mais complexo, em virtude do volume pulpar e das condições anatômicas. O objetivo deste estudo foi relatar um caso clínico de paciente com amelogênese imperfeita e que teve como consequência múltiplos casos de rizogênese incompleta.RELATO DO CASO:Paciente do gênero feminino, 12 anos, leucoderma, com sintomas dolorosos procurou atendimento odontológico. Ao exame clinico intraoral, apresentava dentes com alteração de forma e tamanho, coloração amarelada, recobertos por uma fina camada de esmalte com superfície rugosa e em algumas áreas ausente, com fístula na região do sulco vestibular anterior e sem edema. Ao exame radiográfico ambas as dentições mostraram-se acometidas por anomalia, com retardo na cronologia de erupção dos dentes permanentes. Ao final de todos os exames, recebeu o diagnóstico de amelogênese imperfeita, dando inicio ao tratamento, que começou pelo tratamento periodontal, seguido pelo endodôntico.CONCLUSÃO:O tratamento da amelogênese é complexo, principalmente quando em estágios mais avançados de destruição da estrutura dentária. Contudo é possível restabelecer a funcionalidade e a estética do paciente quando se faz um bom planejamento do caso, com interação multidisciplinar.

Sistema adesivo universal e cimento resinoso universal em coroas cerâmicas: relato de caso / Universal adhesive system and resin cement for all-ceramics crowns: case report

A demanda por restaurações estéticas que mimetizem os dentes naturais é crescente, e as cerâmicas são uns dos materiais que melhor reproduzem as características do esmalte e da dentina. A cimentação adesiva é considerada uma etapa crítica, complexa e sensível. O cimento resinoso RelyX™ Ultimate (3M Espe) apresenta polimerização dual, excelente aderência e fácil manipulação. Sua associação com o Single Bond™ Universal (3M Espe) o torna um material prático e de fácil utilização, pois o adesivo funciona como agente de pré-tratamento para todo tipo de material restaurador, além de possuir ativador de polimerização química, o DCA (3M Espe). O objetivo deste trabalho é ressaltar, por meio de um relato de caso, as vantagens do uso do Cimento RelyX Ultimate associado ao Sistema Adesivo Single Bond Universal, na cimentação de uma coroa cerâmica IPS E-max (Ivoclar Vivadent) e de uma coroa metalocerâmica IPS d’Sign (Ivoclar Vivadent)...

The demand for esthetic restorations that mimic natural teeth is increasing, and ceramic materials best reproduce the characteristics of enamel and dentin. Adhesive cementation is considered a critical, complex and sensitive step. A dual-cure resin cement with excellent bonding properties and easy handling was used (RelyX™ Ultimate, 3M ESPE), associated with an universal adhesive system (Single Bond™ Universal, 3M ESPE). This adhesive system is user-friendly and acts as a pretreatment agent for all types of restorative material, in addition to have a chemical activator (DCA by 3M ESPE). The aim of this case report is to highlight the advantages of using an universal cement associated with an adhesive for cementation of all-ceramic crowns (IPS E-max and IPS d’Sign, Ivoclar Vivadent)...

Bond strength to dentin of total-etch and self-etch adhesive systems / Resistência de união à dentina de sistemas adesivos convencionais e autocondicionante

OBJECTIVE: To assess the bond strength to dentin of the Single Bond (3M ESPE) and XP Bond (Dentsply) total-etch and Adper SE Plus (3M ESPE) self-etch adhesive systems. METHODS: Fifteen healthy human third molars were randomly allocated across three different groups of five teeth each according to the adhesive system. The occlusal portion of each tooth was removed under refrigeration using a flexible diamond disc (EXTEC, Enfield, CT, USA) down to an area of dentin that did not reveal enamel, as confirmed under a 40X stereo microscope (Ramsor, São Paulo, Brazil). A standardized smear layer was created with #600 grit silicon-carbide paper. The adhesive systems were applied as per manufacturer recommendations, with the exception of the Adper SE Plus system, which was triple-polymerized. Composite resin blocks (5 mm) were placed on the dentin surface. The specimens were stored in distilled water for 24 hours at 37ºC. Using a flexible diamond disc (EXTEC, Enfield, CT, USA), toothpick-like specimens with an adhesive area of less than 1 mm² were obtained. A microtensile bond test was then carried out using a universal testing machine (KRATOS) with a crosshead speed of 0.5 mm/min. Analysis of variance (ANOVA) and Tukey's test were used for comparisons. RESULTS: The bond strength values obtained with each adhesive system were as follows: XP Bond, 96.24 MPa; Adper Single Bond, 72.39 MPa; Adper SE Plus, 49.91 MPa. CONCLUSION: In terms of bond strength to dentin, conventional adhesives outperform self-etching systems. .

OBJETIVO: Avaliar o grau de resistência de união à dentina dos sistemas adesivos de condicionamento ácido total Adper Single Bond (3M ESPE) e XP Bond (Dentsply) e autocondicionante Adper SE Plus (3M ESPE). MÉTODOS: Quinze terceiros molares humanos hígidos foram utilizados, divididos aleatoriamente em três grupos de cinco dentes cada, conforme o adesivo que seria utilizado. A porção oclusal foi removida com o auxílio de um disco flexível diamantado sob refrigeração, até expor uma área de dentina que não apresentasse ilhas de esmalte, comprovado em lupa esterioscópica em aumento de 40X. A smear layer foi padronizada em lixa d'água n°600. Na sequência os sistemas adesivos foram aplicados conforme as recomendações do fabricante, exceto o Adper SE Plus que teve seu tempo de polimerização triplicado. Sobre os dentes preparados foram construídos blocos de resina composta com 5mm de altura. As amostras foram armazenadas por 24 horas a 37°C em água destilada. Utilizando o disco flexível diamantado, foram obtidos corpos de prova com formato de palitos com área adesiva menor que 1mm². Em seguida o teste de microtração foi realizado numa Máquina de Ensaios Universal numa velocidade de 0,5 mm/min. Foram utilizados o teste ANOVA e comparações pareadas de Tukey. RESULTADOS: Os valores da resistência de união para cada sistema adesivo em Mpa foram: 96,24 (XP Bond); 72,39 (Adper Single Bond) e 49,91 (Adper SE Plus). CONCLUSÃO: Dessa forma, em relação à resistência de união à dentina, os adesivos convencionais apresentaram desempenho superior ao autocondicionante. .

Improvement of the orthodontic bracket bond strength with pre-heated composite restoratives.

AIM: This study aimed to evaluate the effect of pre-heated composite restoratives on the shear bond strength (SBS) of orthodontic brackets. METHODS: The following materials were tested: a microhybrid composite restorative (Filtek Z250), two nanofilled composite restoratives (Filtek Z350 and NT Premium), a nanohybrid composite restorative (Brilliant) and a conventional orthodontic adhesive (Transbond XT). All materials were stored for 1 h in the incubator either at 25°C (room temperature simulation) or 60°C before bonding 100 orthodontic brackets on bovine lower incisors (n = 10). One Coat Bond SL and Transbond XT were used to bond the composite restoratives and the Transbond XT adhesive paste, respectively. After storage in distilled water for 24 h, the brackets were subjected to SBS test at a speed of 0.5 mm/min until bracket debonding. The Adhesive Remnant Index (ARI) was assigned to the fractured specimens. Data were analyzed using the one-way ANOVA and the Tukey post-hoc test (p < 0.05). The Kruskal-Wallis test was used to compare ARI scores between the groups (p < 0.05). RESULTS: There was no statistically significant difference between the materials at room temperature. Samples bonded with pre-heated materials showed a statistically higher SBS than those bonded with room temperature materials. Samples bonded with the pre-heated orthodontic adhesive showed the highest SBS among all the pre-heated materials. All preheated composite restoratives produced an SBS mean higher than that of Transbond XT stored at room temperature. CONCLUSION: The use of pre-heated composite restoratives and orthodontic adhesives might be an alternative approach to bond orthodontic brackets.

Evaluation of low-level laser therapy in patients with acute and chronic temporomandibular disorders.

The purpose of this study was to address the following question: among patients with acute or chronic temporomandibular disorders (TMD), does low-level laser therapy (LLLT) reduce pain intensity and improve maximal mouth opening? The sample comprised myogenic TMD patients (according Research Diagnostic Criteria for TMD). Inclusion criteria were: male/female, no age limit, orofacial pain, tender points, limited jaw movements and chewing difficulties. Patients with other TMD subtypes or associated musculoskeletal/rheumatologic disease, missing incisors teeth, LLLT contra-indication, and previous TMD treatment were excluded. According to disease duration, patients were allocated into two groups, acute (<6 months) and chronic TMD (≥ 6 months). For each patient, 12 LLLT sessions were performed (gallium-aluminum-arsenide; λ = 830 nm, P = 40 mW, CW, ED = 8 J/cm(2)). Pain intensity was recorded using a 10-cm visual analog scale and maximal mouth opening using a digital ruler (both recorded before/after LLLT). The investigators were previously calibrated and blinded to the groups (double-blind study) and level of significance was 5% (p < 0.05). Fifty-eight patients met all criteria, 32 (acute TMD), and 26 (chronic TMD). Both groups had a significant pain intensity reduction and maximal mouth opening improvement after LLLT (Wilcoxon test, p < 0.001). Between the groups, acute TMD patient had a more significant pain intensity reduction (Mann-Whitney test, p = 0.002) and a more significant maximal mouth opening improvement (Mann-Whitney test, p = 0.011). Low-level laser therapy can be considered as an alternative physical modality or supplementary approach for management of acute and chronic myogenic temporomandibular disorder; however, patients with acute disease are likely to have a better outcome.