The influence of methodology on the comparison of cytotoxicity of total-etch and self-etch adhesive systems.

OBJECTIVES: The present study aimed to compare the in vitro cytocompatibility of two etch-and-rinse (Adper Scothbond, Optibond) and two self-etch (Clearfill SE Bond and Single Bond Universal) dental adhesives through a dentin-barrier model with human pulp fibroblasts. METHODS: Human fibroblasts were placed on a plastic device containing 500µm human dentin discs treated with each adhesive or without treatment (control). Other groups were directly exposed to media conditioned with adhesive samples according to ISO 10993-5:2009. After 24h exposure, cell viability was assessed by XTT, and released inflammatory mediators were detected with a multiparametric immunoassay. RESULTS: The standardized test without barrier indicated both etch-and-rinse adhesives and self-etch as cytotoxic, promoting viabilities under 70% of the control group (p<0.05). The dentin-barrier model identified increased cell viability for self-etch adhesives, with Clearfill SE Bond identified as non-cytotoxic. The immunoassay evidenced high rates of cytokines by cells exposed to the conditioned media of Adper Scotchbond, Optibond S, and Single Bond Universal. CONCLUSIONS: The use of a dentin-barrier in vitro model detected a better biocompatibility for self-etching adhesives and, in the case of Clearfill SE Bond, with a reversion from cytotoxic to biocompatible when compared to the indirect standardized test. CLINICAL SIGNIFICANCE: The use of a dentin-barrier in vitro model was able to detect a better biocompatibility for self-etching adhesives when compared to the indirect standardized test and presents itself as a predictive in vitro method for assessing the cytotoxicity of dental restorative materials that may simulate the clinical condition more accurately.

Association of DNA sequence-independent genetic regulatory mechanisms with apical periodontitis: A scoping review.

OBJECTIVE: Different studies in the last decade have proposed that gene expression alterations that are independent of the DNA sequence may also play an important role in periapical disease. The present study aimed to assess the available evidence supporting a relationship between these alterations and apical periodontitis through a scoping review. DESIGN: Specific strategies were developed for different databases (MEDLINE via PubMed, Cochrane Library, Scopus, Web of Science, and Virtual Health Library) and a search performed by March 1st, 2019. The evidence sources were selected according to the eligibility criteria and underwent a critical appraisal of methodological quality. RESULTS: The initial search retrieved 212 references, with eight eligible articles after the removal of replicates and application of exclusion criteria. Five studies identified altered DNA methylation on inflammatory response genes (FOXP3, CXCL3, FADD, MMP2, MMP9, IFNG, IL4, IL12) on AP patients. Three others identified the alterations on the expression of several microRNAs (miR-29b, 106b, 125b, 143, 146a, 155, 198) during AP. No evidence was identified regarding mechanisms of histone methylation, or of epigenetic heritability or stability. CONCLUSIONS: There is available evidence for the involvement of different genetic regulatory mechanisms independent of changes in DNA sequence in the development or severity of apical periodontitis. However, due to methodological limitations, further research must be performed before novel therapies and diagnostic tools for AP may arise from these data.

Structural Analysis of NiTi Endodontic Instruments: A Systematic Review.

Introduction: Irregularities and defects on NiTi endodontic instruments originating from the manufacturing process can lead to the structural collapse and fracture of these instruments during treatment. To assess the cause of instrument wear and fracture, as well as increasing fracture incidence, destructive and non-destructive methods have been used for the analysis of surfaces and internal structures of new and used NiTi instruments. The aim of this systematic review was to undertake a detailed analysis of the methods used to evaluate the surface and internal microstructure of endodontic instruments. Methods and Materials: The scientific literature was comprehensively and systematically searched in the MEDLINE (PubMed), Web of Science, Cochrane Library, Scopus, and LILACS/BBO databases for studies published up to June 9, 2019. The eligibility criteria was based on the PICO (Patient, Intervention, Comparison, and Outcome) strategy with the question "What is the best method for structural analysis of endodontic files?" Two aspects were considered for inclusion in this study: (i) endodontic instruments and (ii) methods for structural analysis of NiTi instruments. . The systematic review was performed according to the PRISMA statement. Results: Based on the inclusion criteria, 94 articles were selected. The results showed that although specific methods have been used for qualitative and/or quantitative structural analysis of NiTi instruments, no study addressed both the surface and internal structure of the instruments at the same time. According to this review, the need to compare the methodologies used in the selected articles has been identified; however, each type of method used has its own limitation on the analysis of both the surface and the internal structure of the instruments. Conclusions: The comparison between the different types of methodologies used in the studies revealed the reliability and the limitations of the methods employed for structural analysis of endodontic instruments; thus assisting us in determining their validity.

In vitro cytotoxicity of dental adhesives: A systematic review.

OBJECTIVES: The increased demand for esthetics and minimally invasive tooth restorations resulted in a rapid development of adhesive dentistry. However, much controversy remains about the safe use and cytotoxic effects of different groups of dental adhesives. The present study performed a systematic review to identify the answer to the following question: are self-etch adhesives more cytotoxic than those employing the etch-and-rinse system? METHODS: This systematic review was performed in accordance with the PRISMA statement; a quality assessment for in vitro studies was conducted using the ToxRTool. Specific search strategies were developed and performed in the electronic databases MEDLINE via PubMed, Cochrane Library, Scopus, Web of Science, and LILACS/BBO. After removal of duplicated studies and application of the exclusion criteria, ten eligible articles were selected and submitted to a qualitative descriptive analysis comparing both groups of dental adhesives. Most in vitro test systems employed pulp cells or gingival fibroblasts. RESULTS: The methodologies presented great variability regarding the exposure to the test materials. Only four studies assessed the role of the degree of conversion of the materials in their toxicity, with conflicting results. SIGNIFICANCE: While the lack of methodological standardization among the studies still hinders the establishment of a relationship between type of dental adhesive and toxicity, studies employing dentin barrier systems indicate greater cytotoxicity for etch-and-rinse adhesives.

In Vitro Analysis of the Cytotoxicity of Indirect Restorative Materials.

This study aimed to compare the cytotoxicity of the Vita AC12, Lava Ultimate, Vita Enamic and InSync indirect restorative materials. Extracts of each material were prepared by incubation for 1, 7 and 40 days, with daily washing. Human gingival fibroblasts were exposed to the extracts, and cell viability was evaluated by sequential assessment of mitochondrial activity (XTT), membrane integrity (NRU) and cell density (CVDE). Extracts of polystyrene beads and latex fragments were used as negative and positive controls, respectively. Differences between groups and experimental times were evaluated by analysis of variance. At the 24 h extraction, significant differences between the control and both Vita AC-12 and InSync were observed in the XTT assay (p<0.05), and between the control and both Enamic and Lava Ultimate, in the CVDE assay (p<0.05). AC12, Lava Ultimate, and InSync presented significantly lower cell viability than Enamic and the control group, in the NRU assay (p<0.05). The Vita Enamic and Lava Ultimate hybrid ceramic-like materials presented better biocompatibility at the 24 h extraction time point than the AC12 and InSync ceramic materials. However, a simulation of the removal of toxic components by biological fluids, conducted by using longer extraction times and daily washing, led to the absence of cytotoxicity in all the tested restorative materials. These findings can be viewed as positive for the clinical indication of these restorative materials, considering their contact with adjacent soft tissues for extended periods of time.

In vitro analysis of the cytotoxicity of indirect restorative materials

Abstract This study aimed to compare the cytotoxicity of the Vita AC12, Lava Ultimate, Vita Enamic and InSync indirect restorative materials. Extracts of each material were prepared by incubation for 1, 7 and 40 days, with daily washing. Human gingival fibroblasts were exposed to the extracts, and cell viability was evaluated by sequential assessment of mitochondrial activity (XTT), membrane integrity (NRU) and cell density (CVDE). Extracts of polystyrene beads and latex fragments were used as negative and positive controls, respectively. Differences between groups and experimental times were evaluated by analysis of variance. At the 24 h extraction, significant differences between the control and both Vita AC-12 and InSync were observed in the XTT assay (p<0.05), and between the control and both Enamic and Lava Ultimate, in the CVDE assay (p<0.05). AC12, Lava Ultimate, and InSync presented significantly lower cell viability than Enamic and the control group, in the NRU assay (p<0.05). The Vita Enamic and Lava Ultimate hybrid ceramic-like materials presented better biocompatibility at the 24 h extraction time point than the AC12 and InSync ceramic materials. However, a simulation of the removal of toxic components by biological fluids, conducted by using longer extraction times and daily washing, led to the absence of cytotoxicity in all the tested restorative materials. These findings can be viewed as positive for the clinical indication of these restorative materials, considering their contact with adjacent soft tissues for extended periods of time.

Resumo Este estudo teve como objetivo comparar a citotoxicidade dos materiais restauradores indiretos Vita AC12, Lava Ultimate, Vita Enamic e InSync. Extratos de cada material foram preparados por incubação por 1, 7 e 40 dias, com lavagem diária. Fibroblastos gengivais humanos foram expostos aos extratos e a viabilidade celular foi medida por avaliação sequencial da atividade mitocondrial (XTT), integridade da membrana (NRU) e densidade celular (CVDE). Extratos de esferas de poliestireno e fragmentos de látex foram utilizados como controles negativos e positivos, respectivamente. As diferenças entre os grupos e os tempos experimentais foram avaliadas por análise de variância. Na extração de 24 h, observaram-se diferenças significativas entre o controle e Vita AC-12 e InSync no teste do XTT (p<0,05) e entre o controle e os materiais Enamic e Lava Ultimate, no teste CVDE (p<0,05 ). AC12, Lava Ultimate e InSync apresentaram viabilidade celular significativamente menor do que o Enamic e o grupo controle, no ensaio NRU (p<0,05). Os materiais cerâmicos híbridos Vita Enamic e Lava Ultimate apresentaram melhor biocompatibilidade no ponto de tempo de extração de 24 h do que os materiais cerâmicos AC12 e InSync. No entanto, uma simulação de remoção de componentes tóxicos por fluidos biológicos, realizada com o uso de tempos de extração mais prolongados e lavagem diária, levou à ausência de citotoxicidade em todos os materiais restauradores testados. Esses achados podem ser vistos como positivos para a indicação clínica desses materiais restauradores, considerando seu contato com tecidos macios adjacentes por longos períodos de tempo.

Recursos estéticos para reabilitação de dentes anteriores em zircônia: relato de caso clínico / Esthetic resources for rehabilitation of anterior teeth using zirconia restorations: clinical case report

Atualmente, na odontologia restauradora, os sistemas cerâmicos têm se desenvolvido com o intuito de atender à demanda por reabilitações protéticas estéticas. Assim, as cerâmicas puras tornaram-se uma alternativa à subestrutura metálica, devido a suas propriedades, em que cada sistema apresenta características e indicações. Com a utilização da tecnologia CAD-CAM, os sistemas reforçados com alto conteúdo de zircônia apresentam propriedades mecânicas confiáveis e também possibilitam restaurações com estética adequada. O objetivo deste trabalho é descrever uma reabilitação do arco superior com coroas anteriores e prótese parcial fixa (PPF), em que se utilizou uma subestrutura de zircônia.

Currently, the use of ceramic systems in restorative dentistry has been developed in order to meet the demand for esthetics. Thus, metal-free ceramics have become an alternative to metal infrastructures because of their properties, with varying features and properties. With the introduction of CAD-CAM systems, high content zirconia systems are now available with greater resistance and life-like results. This article describes the rehabilitation of the maxillary arch with anterior crowns and a fixed partial denture using zirconia infrastructures.

Restauração de dente posterior com resina à base de silorano utilizando-se matriz oclusal / Restoration of posterior tooth using silorane-based composite resin with the aid of an occlusal matrix

O avanço de novas tecnologias contribui para o desenvolvimento de materiais restauradores recentemente introduzidos no mercado odontológico, dentre eles, a resina composta à base de silorano. Essa resina composta apresenta matriz orgânica derivada de duas moléculas constituintes: siloxanos e oxiranos. Essa combinação oferece biocompatibilidade, hidrofobia e baixa contração de polimerização. O propósito deste trabalho é descrever um caso clínico com o uso da resina composta Filtek P90 (3M ESPE, EUA) em uma cavidade de classe I no elemento 36, com restauração em amálgama de prata deficiente, utilizando-se matriz em resina acrílica para mimetizar a anatomia oclusal com previsibilidade e segurança. Sendo assim, o procedimento restaurador obteve resultado satisfatório, a partir da remoção da restauração deficiente e utilizando-se o protocolo restaurador de acordo com as recomendações do fabricante.

Advancement of new technologies have contributed to the development of new dental restorative materials, including silorane-based composite resins. This innovative composite presents an organic matrix derived from two molecules: oxiranes and siloxanes. This combination offers biocompatibility, hydrophobicity and low polymerization shrinkage. The purpose of this paper is to describe a clinical case using a composite resin (Filtek P90, 3M ESPE, EUA) in a Class I cavity of tooth #36 with a defective amalgam restoration, using an acrylic resin matrix for faithful reproduction of the occlusal anatomy with predictability and safety. Thus, the restorative procedure was carried out with a satisfactory result, starting from the removal of the defective restoration and the use of a restorative protocol according to the manufacturer’s recommendations.

A utilização de resinas bisacrílicas no planejamento estético: relato de caso clínico / The use of bis-acryl composite in esthetic planning: case report

Para o sucesso do tratamento odontológico, é fundamental realizar um correto diagnóstico, planejamento e execução do trabalho. Os materiais utilizados para restaurações provisórias são de grande importância na reabilitação estética anterior, pois são os guias para escolha da cor, forma e contorno da restauração final, proporcionando maior previsibilidade do resultado, tanto para o paciente quanto para o profissional. As resinas provisórias bisacrílicas tornaram-se uma escolha cada vez mais popular devido às suas melhores propriedades mecânicas, resultados estéticos e facilidade de manuseio. O presente artigo objetiva demonstrar um caso clínico onde foi utilizada resina bisacrílica para reabilitação estética provisória. Tal técnica propiciou a esse caso um satisfatório resultado parcial funcional e estético, respeitando os anseios da paciente e facilitando o sucesso final do trabalho

Introduction: For the success of dental treatment it is vital a correct diagnosis, planning and execution of work. The materials used for provisional restorations are of great importance in the anterior esthetic rehabilitation, as they are guides for choosing the color, shape and contour of the fnal restoration, proportionating greater predictability of the outcome for both patient and professional. The provisional bisacryl composite became an increasingly popular choice due to its better mechanical properties, cosmetic results and ease of handling. Objective: This article aims to demonstrate a clinical case in which it was used a bis-acrylic resin for provisional esthetic rehabilitation. Conclusion: This technique used in this case provided a satisfactory partial result, as functional as esthetic, respecting the wishes of the patient and facilitating the ultimate success of the work.

Pinos de fibra associados a restaurações indiretas em cerâmica pura: simetria X harmonia / Glass fiber posts associated to all-ceramic restorations: symmetry and harmony

Muitas vezes, na clínica odontológica, pacientes buscam a reabilitação de dentições que sofreram alterações funcionais e estéticas significativas, porém, sem perder sua identidade. Atualmente, técnicas com cerâmicas reforçadas e sistemas de pinos não-metálicos permitem a realização de restaurações livres de metal em dentes anteriores severamente comprometidos, mas é preciso realizar corretos diagnóstico, planejamento e execução para o sucesso do tratamento. Este relato de caso clínico descreve a restauração de incisivos centrais superiores, tratados endodonticamente e esteticamente comprometidos, com pinos de fibra e coroas em cerâmica pura, que proporcionaram naturalidade, sem alterar a identidade do paciente...

Patients usually seek for the rehabilitation of teeth with significant functional and esthetic alterations, while maintaining personal characteristics. Today, techniques using strengthened ceramics and non-metal post systems allow for the esthetic metal-free restorations of severely compromised anterior teeth, provided that proper diagnostic, treatment planning and thoughtful execution are performed. This article is a case report of the restoration of two endodontically treated maxillary central incisors with esthetic compromise. Glass fiber posts and metal-free crowns were used to achieve a natural aspect, without changing patient´s characteristics...