Deep occlusal carious lesions clinical management by Brazilian dentists: a nationwide e-survey / Manejo clínico de lesões cariosas oclusais profundas por cirurgiões-dentistas brasileiros: uma pesquisa eletrônica nacional

Objective: To investigate the clinical management of deep occlusal carious lesions in permanent teeth by Brazilian dentists. Material and Methods: This cross-sectional study included a sample of 732 Brazilian dentists who responded to an electronic questionnaire composed of 20 questions addressing socio-demographic information, training and professional activity characteristics, and clinical management of deep carious lesions. Descriptive analysis was performed, considering relative and absolute frequencies and 95% confidence intervals. The association between the dentists' variables of interest (age group, type of higher education institution, years in practice, highest academic degree completed and main sector of professional activity) and the mean number of incorrect answers regarding deep carious lesions management was analyzed by Analysis of Variance (ANOVA), followed by the Bonferroni post-test (p<0.005). Results: Stepwise removal was the strategy pointed out by most dentists (42.8%). However, 16% of the dentists selected nonselective carious tissue removal. Furthermore, 45.6% of the dentists disagreed with maintaining carious tissue over the pulp in deep lesions with a risk of pulpal exposure. When using instruments to remove carious dentine, 17% of the dentists chose a diamond burn while 13% preferred tungsten carbide burs. Dentists who graduated from public institutions had a lower mean of non-conservative decisions than those from private institutions. Dentists with master's or doctoral degrees were more conservative, as well as dentists from public service compared to those from the private sector. Conclusion: The dissemination of conservative approaches in the management of deep carious lesions needs to be strengthened and increasingly based on updated scientific literature.(AU)

Objetivo: Investigar o manejo clínico de lesões cariosas oclusais profundas em dentes permanentes por cirurgiões-dentistas brasileiros. Material e Métodos: Este estudo transversal incluiu uma amostra de 732 dentistas brasileiros que responderam a um questionário eletrônico composto por 20 questões abordando informações sociodemográficas, formação, características da atividade profissional e manejo clínico de lesões cariosas profundas. Foi realizada análise descritiva, considerando frequências relativas e absolutas, e intervalos de confiança de 95%. A associação entre as variáveis de interesse (faixa etária, tipo de instituição de ensino superior, anos de prática, maior titulação acadêmica concluída e principal setor de atividade profissional) dos cirurgiões-dentistas e a média de acertos no manejo de lesões cariosas profundas foi analisada pela Análise de Variância (ANOVA), seguida do pós-teste de Bonferroni (p<0,005). Resultados: A remoção seletiva foi a estratégia apontada pela maioria dos cirurgiões-dentistas (42,8%). No entanto, 16% dos dentistas selecionaram a remoção não seletiva do tecido cariado. Além disso, 45,6% dos dentistas discordaram da manutenção de tecido cariado sobre a polpa em lesões profundas com risco de exposição pulpar. Ao usar instrumentos para remover a dentina cariada, 17% dos dentistas escolheram uma broca diamantada, enquanto 13% preferiram brocas de carboneto de tungstênio. Cirurgiões-dentistas formados em instituições públicas apresentaram menor média de decisões não conservadoras do que os de instituições privadas. Os cirurgiões-dentistas com mestrado ou doutorado foram mais conservadores, assim como os cirurgiões-dentistas do serviço público em relação aos do setor privado. Conclusão: A disseminação de abordagens conservadoras no manejo de lesões cariosas profundas precisa ser fortalecida e cada vez mais baseada em literatura científica atualizada (AU)

Cashew nut shell liquids: Antimicrobial compounds in prevention and control of the oral biofilms.

OBJECTIVE: The aim was to evaluate the antibacterial and antibiofilm activity of natural (n-CNSL) and technical (t-CNSL) cashew nut shell liquid against streptococci and enterococci related to dental caries and chronic apical periodontitis, respectively. MATERIAL AND METHODS: Minimum inhibitory concentrations (MIC) and minimal bactericidal concentration (MBC) were determined to assess the antimicrobial effect of both CNSLs (n-CSNL and t-CNSL) against S. oralis ATCC 10557, S. sobrinus ATCC 6715, S. parasanguinis ATCC 903, S. mutans UA 159 and E. faecalis ATCC 19433. The antibiofilm activity was evaluated by total biomass quantification, colony forming unit (CFU) counting and scanning electron microscopy (SEM). Furthermore, cytotoxic effect of the substances was evaluated on L929 and HaCat cell lines by MTS assay. RESULTS: The n-CNSL and t-CNSL showed inhibitory and bactericidal effect against all strains tested in this study, with MIC and MBC values ranging from 1.5 to 25 µg/mL. Overall, both CNSLs showed significant reduction in biomass quantification and enumeration of biofilm-entrapped cells for the strains analyzed, in biofilm formation and preformed biofilms (p < 0.05). In biofilm inhibition assay, the t-CNSL and n-CNSL showed reduction in biomass and CFU number for all bacteria, except in cell viability of S. parasanguinis treated with t-CNSL (p > 0.05). Indeed, SEM images showed a reduction in the amount of biomass, bacterial cells and changes in cellular morphology of S. mutans. CONCLUSION: In conclusion, both substances showed effective antibacterial and antibiofilm activity against the strains used in the study, except in viability of S. parasanguinis cells treated with t-CNSL.

Intraradicular Dentin Biomodification with Natural Agents for Bonding Glass-fiber Posts.

PURPOSE: To evaluate the effects of pretreatment with different crosslinking agents on glass-fiber-post adhesive luting. MATERIALS AND METHODS: Single-rooted human teeth (n = 20) were randomly assigned to four groups: proanthocyanidins (PA) from grape-seed extract, cardol and cardanol (separated from cashew nut-shell liquid) and negative control (hydroethanolic solution). The solutions were applied on 37% phosphoric acid-etched dentin for 60 s. Glass-fiber posts were cemented using a three-step etch-and-rinse adhesive (Scotchbond Multi-Purpose, 3M Oral Care) and composite cement (RelyX ARC, 3M Oral Care). Slices for the push-out bond strength test were cut and tested after 24-h or 6-month storage in distilled water. The dentin underlying the adhesive layer was analyzed by micro-Raman spectroscopy to evaluate vibrational formation of collagen crosslinks. Three additional slices per group were also made and the adhesive in-situ degree of conversion (DC) was analyzed by micro-Raman spectroscopy. The results were analyzed using two-way ANOVA and Tukey's test (p < 0.05). RESULTS: No statistically significant changes in bond strength were found over time for any of the groups, except with cardol, which increased bond strength (8.4 ± 3.9 MPa at 24 h to 15.0 ± 2.9 MPa after 6 months, p < 0.001) after aging. The formation of peaks at 1117 cm-1 and 1235 cm-1 showed the presence of collagen crosslinks for all three biomodification agents. The DC outcomes showed no statistically significant differences between groups (p = 0.514). CONCLUSION: Biomodification agents did not impair adhesive polymerization. Cardol demonstrated a positive influence on intraradicular dentin bonding for glass-fiber post luting.