Biomechanical, operative and biological aspects of the cervical margin relocation: a case report / Aspectos biomecânicos, operatórios e biológicos da recolocação da margem cervical com resina composta em cavidades classe II com margens profundas: um relato de caso

The clinical success of tooth-colored indirect restorations has been confirmed in several studies. However, inlays and onlays restorations in Class II cavities with deep gingival margins can still be considered a clinical challenge. With the purpose of facilitating the execution of the operative procedures in intrasulcular margins and reducing the risk of restorative failures, the technique of cervical margin relocation has been explored as a noninvasive alternative to surgical crown lengthening. This work aims at discussing through a case report the biomechanical, operative and biological aspects in the treatment of teeth with deep gingival margins. Therefore, given the therapy applied in the clinical case presented, it is concluded that the cervical margin relocation with composite resin is advantageous since it eliminates the need for surgery, allowing the implementation of indirect restorations in fewer clinical sessions, not causing damage to periodontal tissues once it provided good finishing and polishing with the establishment of a correct emergence profile, allowing flawless maintenance of gingival health after one year. (AU)

Sucesso clínico das restaurações indiretas livres de metal tem sido confirmado em diversos estudos. No entanto, restaurações parciais indiretas em cavidades do tipo classe II com margens profundas ainda podem ser consideradas um desafio clínico. Com a proposta de facilitar a execução dos procedimentos operatórios em margens intra-sulculares e reduzir a ocorrência de falhas, a técnica de elevação da margem gengival em resina composta tem sido explorada como alternativa não invasiva à cirurgia de aumento de coroa clínica. Este trabalho tem a intenção de discutir através de um relato de caso clínico os aspectos biomecânicos, operatórios e biológicos no tratamento de dentes com margens cervicais profundas. Sendo assim, conclui-se que a técnica de elevação da margem gengival com resina composta é vantajosa, pois elimina a necessidade de cirurgia permitindo a execução de restaurações indiretas em menos sessões clínicas, não gerando danos aos tecidos periodontais, desde que haja um bom acabamento e polimento, com estabelecimento de um correto perfil de emergência. (AU)

Correction of Vertical Smile Discrepancy through Ceramic Laminate Veneers and Surgical Crown Lengthening.

In cases where malocclusion is associated with intrinsic discoloration and/or discrepancies in tooth size and shape, such as peg-shaped laterals, orthodontics alone may not improve the aesthetics. In these situations, veneers may be considered as an adjunct to orthodontic treatment to improve the overall aesthetics. The aim of this study is to report a clinical case where an uneven occlusal plane was corrected, and the positioning of gingival zeniths, color, shape, and size of the dental elements involved were improved by means of gingivectomy and rehabilitation with 10 ceramic laminate veneers. It was possible to conclude that multidisciplinary treatment, when properly planned and indicated, respecting the limits and established techniques of periodontics, prosthesis, and dentistry, makes small occlusal leveling predictable and possible through these tools.

Oval Versus Circular-Shaped Root Canals: Bond Strength Reached with Varying Post Techniques.

The aim of this study was to compare the bond strength (BS) of glass fiber posts (GFP) luted to oval and circular-shaped root canals rehabilitated using varying post techniques, at different intraradicular levels. Ninety 16-mm-long roots of human mandibular premolars, classified either as having oval or circular-shaped canals, were endodontically treated and prepared for restoration using one of three different post techniques (n=15): 1) single GFP; 2) resin-relined GFP; 3) main GFP associated with accessory posts. GFPs were luted with a dual polymerizing resin cement (RelyX ARC) after the canal had been treated with a 3-step etch-and-rinse adhesive system (Adper Scothbond Multipurpose). The samples were sectioned into three 1-mm-thick sections, which were differentiated by the root level (cervical, middle and apical) and tested for push-out BS. Assessment of failure mode was made under a stereomicroscope. Data were analyzed using repeated measures three-way ANOVA and Tukey's test. The root canal cross-section had a significant influence on BS (p<0.001), with the lowest values being observed in oval-shaped canals. The post technique also significantly affected the BS (p=0.018), with the resin-relined GFPs providing the highest BS values in both oval and circular-shaped canals. Irrespective of the cross-section of the root canal and post technique, there was no significant difference in BS in the cervical, middle and apical third of the root canal (p=0.084). In oval-shaped canals, the BS to intraradicular dentin at cervical, middle or apical level could be increased when the GFPs posts were relined.

Oval versus circular-shaped root canals: bond strength reached with varying post techniques

Abstract The aim of this study was to compare the bond strength (BS) of glass fiber posts (GFP) luted to oval and circular-shaped root canals rehabilitated using varying post techniques, at different intraradicular levels. Ninety 16-mm-long roots of human mandibular premolars, classified either as having oval or circular-shaped canals, were endodontically treated and prepared for restoration using one of three different post techniques (n=15): 1) single GFP; 2) resin-relined GFP; 3) main GFP associated with accessory posts. GFPs were luted with a dual polymerizing resin cement (RelyX ARC) after the canal had been treated with a 3-step etch-and-rinse adhesive system (Adper Scothbond Multipurpose). The samples were sectioned into three 1-mm-thick sections, which were differentiated by the root level (cervical, middle and apical) and tested for push-out BS. Assessment of failure mode was made under a stereomicroscope. Data were analyzed using repeated measures three-way ANOVA and Tukey's test. The root canal cross-section had a significant influence on BS (p<0.001), with the lowest values being observed in oval-shaped canals. The post technique also significantly affected the BS (p=0.018), with the resin-relined GFPs providing the highest BS values in both oval and circular-shaped canals. Irrespective of the cross-section of the root canal and post technique, there was no significant difference in BS in the cervical, middle and apical third of the root canal (p=0.084). In oval-shaped canals, the BS to intraradicular dentin at cervical, middle or apical level could be increased when the GFPs posts were relined.

Resumo O objetivo deste estudo foi comparar a resistência de união (RU) de pinos de fibra de vidro (PFV), cimentados a condutos com secção transversal ovalada ou circular reabilitados com diferentes técnicas de restauração com PFVs, em função do nível intrarradicular. Noventa raízes de pré-molares inferiores humanos, com 16 mm de altura, classificadas como possuindo canais ovais ou circulares, foram tratadas endodonticamente e preparadas para serem reabilitadas com uma das três técnicas de restauração com PFVs (n=15): 1) PFV único, 2) PFV reembasado com resina composta, e 3) PFV principal associado a pinos acessórios. Os PFVs foram cimentados com um agente resinoso de polimerização dupla (RelyX ARC), após o canal ter sido tratado com um sistema adesivo de condicionamento total de três passos (Adper Scothbond Multiuso). As amostras foram seccionadas em três fatias de 1 mm de espessura, de acordo com o nível da raiz (cervical, médio e apical)e foram submetidas ao teste de RU por push-out. A análise do modo de falha foi realizada com auxílio de um estereomicroscópio. Os dados foram analisados utilizando-se a ANOVA a três critérios para medidas repetidas e o teste de Tukey. A secção do conduto apresentou influência na RU (p<0,001), com os menores valores sendo observados nos condutos ovalados. A técnica de restauração com PFVs afetou significativamente a RU (p=0,018), tendo o PFV reembasado proporcionado os maiores valores de RU, tanto em condutos ovais quanto circulares. Independentemente da secção transversal do conduto radicular e da técnica de restauração com PFV, não houve diferença significativa na RU nos terços cervical, médio e apical (p=0,084). Nos canais de secção transversal ovalada, a RU à dentina intrarradicular nos níveis cervical, médio ou apical aumentou com o emprego de PFVs reembasados.

A importância do planejamento reverso na preservação de estrutura dental em casos de laminados cerâmicos / The importance of reverse planning for tooth preservation in ceramic laminate cases

Os avanços na tecnologia dos materiais odontológicos têm permitido o desenvolvimento de técnicas mais conservadoras e aumentaram as chances de obter resultados estéticos mais previsíveis. Considerando as particularidades de cada técnica, a cerâmica tem sido usada devido à sua biocompatibilidade, longevidade e semelhança com a aparência natural do dente. O objetivo deste trabalho foi utilizar uma técnica minimamente invasiva previsível tanto esteticamente quanto funcionalmente para a confecção de dez laminados cerâmicos. Foi possível concluir que a proposta deste trabalho cumpriu com os requisitos para que uma reabilitação seja adequada nos quesitos de estética, função e estabilidade em longo prazo.

Technology advances in dental materials has allowed the development of more conservative techniques and increased the chances of more predictable aesthetics results. Considering the particularities of each technique, ceramics have been used due to its biocompatibility, longevity and likeness with the tooth natural appearance. The aim of this study was to use a predictable minimally invasive technique both aesthetically and functionally to fabricate 10 ceramic laminate veneers. It was concluded that the proposed technique in this work met the requirements for an esthetic, functional, and stable long-term rehabilitation.

Intraosseous Mucoepidermoid Carcinoma in the Mandible.

Although it is a rare neoplasm, intraosseous mucoepidermoid carcinoma is the most common and well-recognized intraosseous salivary gland tumor. Usually, it presents as an asymptomatic volume increase and most patients perceive the presence of the lesion within a year or less of evolution. They are more common in middle-aged adults and have a slight female predilection. They are three times more common in the mandible than in the maxilla and are most often found in the area of the molars and mandibular ramus. The most frequently present symptom is cortical bulging, although some lesions may be discovered as an accidental finding on radiographs. The main modality of treatment for patients with this neoplasm is radical surgical resection, offering a greater chance of cure than the more conservative procedures, such as enucleation or curettage, due to the great possibility of recurrence and tumor metastasis. This paper reports a rare case of intraosseous mucoepidermoid carcinoma occasionally discovered after panoramic radiography of the jaws, which was treated with segmental resection through hemimandibulectomy.

Conhecimento dos cirurgiões-dentistas sobre o uso de bifosfonatos e sua repercussão no tratamento no programa de atenção básica em Patos (PB) / Dentists knowledge about the use of bisphosphonates and its repercussion on dental treatment in the basic care program in Patos (PB)

Objetivo: avaliar o grau de conhecimento dos cirurgiões-dentistas que atuam na atenção básica do município de Patos (PB) sobre os bifosfonatos e sua repercussão no tratamento odontológico. Material e métodos: neste estudo observacional transversal, 34 cirurgiões-dentistas responderam ao questionário sobre conhecimentos gerais dessa medicação. Resultados: os resultados do estudo evidenciaram um baixo conhecimento acerca dos bifosfonatos (52,9%). De modo geral, o estudo apontou o desconhecimento acerca da droga e sua repercussão no tratamento odontológico pelos cirurgiões-dentistas do município de estudo. Conclusão: é necessária a aquisição de conhecimentos por parte dos profi ssionais da Odontologia em relação a esses fármacos, a fi m de oferecerem aos seus pacientes um tratamento mais amplo e completo, com todas as informações e alternativas necessárias

Objective: to evaluate the degree of dental surgeons knowledge who work in the basic care of the municipality of Patos (PB) on bisphosphonates and its repercussion in dental treatment. Material and methods: in this cross-sectional observational study, 34 dental surgeons answered the questionnaire about the general knowledge of this medication. Results: the results of the study showed low knowledge about bisphosphonates (52.9%). In general, the study pointed out the unknowledge about the drug and its repercussion on dental treatment by the dental surgeons of the study municipality. Conclusion: it is necessary to acquire knowledge from dental professionals in relation to these drugs, so that they can offer their patients a wider and complete treatment, with all the necessary information and alternatives.