Ellagic acid on the quality of the adhesive interface of class I composite resin restorations after aging

To evaluate the effect of ellagic acid on the inhibition of matrix metalloproteinase by analyzing the quality of the adhesive interface with bond strength measures in periods of 24 hours and six months of storage. Method: 40 healthy human third molars were prepared with class I cavities (5x4x3mm). The teeth were divided into four experimental groups: Group 1- without application of ellagic acid and storage time of 24 hours; Group 2- with ellagic acid/24 hours; G3- without ellagic acid/six months; Group 4- with ellagic acid/six months. Then, the cavities were restored with Single Bond Universal adhesive and Z350 composite resin, with and without the previous application of ellagic acid. Subsequently, hourglass-shaped specimens were obtained and subjected to the bond strength (BS) test (n = 10) in a universal testing machine. The bond test was performed after 24 hours and six months of storage. For the standard evaluation (n = 3) the samples were infiltrated with silver nitrate and placed in a developing solution for analysis in a Scanning Electron Microscope (SEM). The data obtained were analyzed with the Kruskal-Wallis non-parametric test, showing a statistically significant difference. Results: The highest bond strength values were found for the 24-hour groups followed by the groups with six months of storage. For nano-infiltration, groups G1 and G2 showed lower infiltration than groups G3 and G4. Conclusion: The previous application of ellagic acid did not affect the BS of the adhesive interface of the adhesive system analyzed, regardless of storage time.

Influence of the volume of restorative material on the concentration of stresses in the restorative interface.

BACKGROUND: To evaluate the microtensile strength in the adhesive interface depending on the volume of the composite resin used to restore class I cavities. MATERIAL AND METHODS: Forty-eight human third molars received a standardized class I cavity preparation and they were separated into six experimental groups: G1 - single-bottle adhesive system; G2 - bonding system with load; G3 - single-bottle adhesive associated with low-viscosity composite resin; G4 - loaded adhesive associated with low-viscosity composite; G5 - resin-modified glass ionomer associated with single-bottle adhesive; and G6 - resin-modified glass ionomer associated with loaded adhesive. All cavities were restored with a universal restorative composite. After completing the restorations, the samples were stored for seven days in a stove (37°C) and the microtensile bond strength was evaluated by producing slices and applying axial loading in an Instron universal testing machine at a speed of 0.5 mm/min. The thickness of the intermediate layer formed on the cavity floor to verify the relationship between the volume of restorative composite and the concentration of stresses in the buccal wall. With the data obtained in the microtensile strength test, an Analysis of Variance (ANOVA) was performed entirely at random. RESULTS: Duncan's test showed that group 4 (Filtek Flow/Optibond Solo Plus) obtained the highest mean of microtensile strength with no statistically significant difference to groups 3 (Filtek Flow/Single Bond), 5 (Vitremer/Single Bond), and 6 (Vitremer/Optibond Solo Plus). It also showed a statistically significant difference to groups 2 (Optibond Solo Plus) and 1 (Single Bond), with no statistical difference between the other groups studied. CONCLUSIONS: The highest mean of microtensile strength was obtained when the volume of the restorative material decreased through the interposition between the material and the adhesive system of a base with low elasticity modulus. Key words:Adhesion, microtensile, composite resin.

Minimally invasive aesthetic treatment of white spots by dental fluorosis in children: case report

The presence of white spots due to dental fluorosis can cause aesthetic discomfort, being one of the factors for a search for dental treatment. Objective: Report a clinical case in which the aesthetic complaint was solved through the association of the dental bleaching to the microabrasion technique. Case report: Male patient, 13 years, attended to the Integrated Clinic of the School of Dentistry of the Federal University of Rio de Janeiro, with fluorosis, mainly in the antero-superior teeth and aesthetic complaint. Initially, it was made an immediate bleaching with hydrogen peroxide at 35%, in 3 sessions of 15 minutes each, to soften the disparity of shades between tooth-stain. The result was insufficient and the dental microabrasion technique was adopted. A pumice paste was applied together with gel of phosphoric acid at 37% under relative isolation, in a total of 8 applications (1 minute each). At the end of each application, it was made an abundant water washing, microengine mounted fine-grained disc polishing and topical application of neutral NaF2 in gel (4 minutes each application) to eliminate possible postoperative sensitivity. Conclusion: The dental bleaching and the microabrasion technique promoted satisfactory immediate clinical results that increased self-esteem of the patient in a minimally invasive way to dental structure.

Introdução: A presença de manchas brancas por fluorose dentária pode causar desconforto estético, sendo um dos fatores para busca de tratamento odontológico. Objetivo: Relatar um caso clínico em que a queixa estética foi resolvida através da associação do clareamento dentário à técnica de microabrasão. Relato do caso: Paciente do sexo masculino, 13 anos, compareceu a Clínica Integrada da Faculdade de Odontologia da UFRJ, com fluorose, principalmente nos dentes ântero-superiores e queixa estética. Inicialmente, realizou-se clareamento imediato com peróxido de hidrogênio a 35%, em 3 sessões de 15 minutos, para suavizar a disparidade de tons entre mancha-dente. O resultado obtido foi insuficiente e a técnica de microabrasão dentária foi adotada. Uma pasta de pedra pomes foi aplicada juntamente com gel de ácido fosfórico a 37% sob isolamento relativo, perfazendo um total de 8 aplicações (1 minuto cada). Ao final de cada aplicação, foi realizada lavagem abundante com água, polimento com disco de granulação fina montado em micromotor e aplicação tópica de NaF2 neutro em gel (4 minutos cada aplicação) para eliminar possível sensibilidade pós-operatória. Conclusão: O clareamento dentário e a técnica de microabrasão promoveram resultados clínicos imediatos satisfatórios que elevaram a autoestima do paciente, de maneira minimamente invasiva para estrutura dentária.

Multidisciplinar aesthetic dental rehabilitation using prefabricated composite resin veneers after orthodontic treatment

Introduction: Cosmetic dentistry is one of the primary factors in dental planning, influencing people to obtain imperceptible restorations and increasingly clear teeth. Several disorders, such as discrepancies between the teeth size and the arch size, which cause multiple anterior diastemas, can generate aesthetic issues. In some situations, orthodontic treatment is not sufficient to meet the patient's aesthetic expectations, which may require additional restorative and periodontal procedures. The prefabricated facets of composite resin are prepolymerized composite facets that have appeared on the market to simplify the restorative procedure, reducing working time. Objective : This paper aims to present a clinical case in which prefabricated composite resin veneers were used to treat diastemas for oral rehabilitation after orthodontic treatment and periodontal surgery in order to achieve aesthetic excellence. It also aimed to discuss indications, advantages, and limitations of the technique. Case report : The treatment plan was divided into two phases. In the first one, an orthodontic treatment was performed to aligned and leveled the teeth. This was followed by the periodontal surgery, to correct the gingival margin. The second phase was the cementation of costumized direct composite veneers, in order to achieve an esthetical pleasing result. Conclusion : The association of treatments was successful and proved to be a minimally invasive, with minimum dental abrasion and preservation of anatomic structures, resulting improved patient health and satisfaction.

Introdução: A odontologia cosmética apresenta-se como um dos fatores primordiais no planejamento odontológico, influenciando as pessoas em obter restaurações imperceptíveis e dentes cada vez mais claros. Muitas são as alterações que podem ocasionar problemas estéticos, dentre elas, as discrepâncias entre o tamanho dos dentes e do arco, causando diastemas anteriores múltiplos. Em algumas situações, o tratamento ortodôntico não é suficiente para atender as exigências e expectativas estéticas do paciente que podem necessitar de procedimentos restauradores e periodontais adicionais. As facetas pré-fabricadas de resina composta, são facetas pré polimerizadas de compósito, que surgiram no mercado para simplificar o procedimento restaurador, reduzindo o tempo de trabalho. Objetivo : Este artigo teve por objetivo apresentar um caso clínico no qual facetas pré-fabricadas de resina composta foram utilizadas para o tratamento de diastemas para uma reabilitação oral após o tratamento ortodôntico e cirurgia periodontal de forma a alcançar excelência estética. Ele também visa discutir indicações, vantagens e limitações da técnica. Relato do caso : O plano de tratamento foi dividido em duas fases. No primeiro, foi realizado um tratamento ortodôntico para alinhar e nivelar os dentes. Isto foi seguido pela cirurgia periodontal, para corrigir a margem gengival. A segunda fase foi a cimentação de facetas compostas diretas, a fim de obter um resultado estético agradável. Conclusão : A associação entre os tratamentos foi bem sucedida e provou ser minimamente invasivo, com um mínimo de abrasão dental e preservação das estruturas anatômicas, resultando em melhoria da saúde e satisfação do paciente.

Conhecimento geral e específico entre médicos, dentistas e enfermeiros da doença periodontal e sua associação a outras doenças / Specific and general knowledge of physicians, dentists and nurses about periodontal disease and its association to other diseases

O objetivo do presente estudo foi avaliar o conhecimento geral e específico entre médicos, dentistas e enfermeiros da doença periodontal (DP) e sua associação à outras doenças. Foi utilizado um questionário estruturado, incluindo questões sobre a DP, sua associação com outras doenças e o grau de comprometimento dos profissionais de saúde com o paciente periodontal. As respostas foram determinadas de acordo com revisões sistemáticas e metanálises consultadas. Duzentos e sessenta e nove profissionais da Polícia Militar do Rio de Janeiro responderam o questionário, sendo 87 dentistas, 123 médicos e 59 enfermeiros, com idade média de 39,5 (±7,2) anos. Cinquenta e seis (20,8%) profissionais eram docentes enquanto 200 (74,3%) eram especialistas. O percentual de acertos para os sinais e sintomas de doenças periodontais variou de 87,7% a 97,4% para sangramento gengival, recessão gengival e mobilidade dentária, enquanto 7,8% dos profissionais acertaram o item perda dentária. Com relação aos fatores de risco, o percentual de acertos variou entre 91,4% e 96,7% para diabetes e fumo. Por outro lado, o percentual de acertos foi de 22,3% e 24,2% para idade e escolaridade. Os profissionais relacionaram DP como fator de risco para doença cardiovascular (81,4%). Os dentistas responderam com mais frequência que DP estava associada a um aumento de risco para diabetes, parto prematuro e bebês com baixo peso. Com relação à associação de DP e pré-eclâmpsia, síndrome metabólica e doença renal crônica, os percentuais de acertos variaram entre 17,1% e 41,2%. O grau de instrução e docência influenciou significativamente a possibilidade de acertar as respostas. Em relação ao tratamento periodontal para as doenças acima citadas, o percentual de acertos variou de 2,6% a 20,8%, e o grau de instrução e docência influenciaram significativamente no percentual de acertos. A frequência de acertos sobre a comprovação científica de que o tratamento periodontal melhorou o controle metabólico de pacientes diabéticos variaram de 40.7% (enfermeiros) a 50,4% (médicos). A frequência de médicos e enfermeiros que quase sempre/sempre diagnostica, examina e orienta seus pacientes sobre os riscos e efeitos da DP na saúde geral variou entre 0% e 20,3%. Apenas 23,6% encaminham os pacientes para avaliação e tratamento periodontal. Concluindo, o conhecimento sobre DP e sobre DP ser fator de risco para outras doenças foi reduzido entre médicos e enfermeiros. As três categorias de profissionais mostraram desconhecimento sobre a ausência de comprovação científica do tratamento periodontal como fator de prevenção para doenças sistêmicas. O grau de instrução e docência aumentava significativamente a possibilidade de acertar as respostas corretas. Médicos e enfermeiros não costumam encaminhar o paciente periodontal ao especialista

The aim of this study was to evaluate among physicians, dentists and nurses the general and specific knowledge of periodontal disease (PD) and its association with other diseases. A structured questionnaire including questions about periodontal disease, its association with other diseases, and the degree of commitment of health professionals with periodontal patient was used. Responses were determined according to systematic reviews and meta-analyzes consulted. Two hundred and sixty-nine health professionals at the Military Police of Rio de Janeiro answered the questionnaire, including 87 dentists, 123 doctors and 59 nurses with a mean age of 39.5 (± 7.2) years. Fifty-six (20.8%) professionals were teachers, while 200 (74.3%) were specialists. The percentage of correct answers for questions regarding the signs and symptoms of PD ranged from 87.7% to 97.4% for gingival bleeding, gingival recession and tooth mobility. However, only 7.8% of the professionals correctly answered questions regarding tooth loss. With regard to questions pertaining risk factors, the percentage of correct answers ranged between 91.4% and 96.7% for diabetes and smoking. On the other hand, the percentages of correct answers to questions regarding age and education as risk factors were 22.3% and 24.2%. Periodontal disease was correctly identified as a risk factor for cardiovascular disease by 81.4% of the professionals. Dentists recognized more often that PD was associated with an increased risk for diabetes, premature birth and low birth weight babies. Regarding the association between PD and pre-eclampsia, metabolic syndrome and chronic kidney disease, the percentage of correct answers ranged between 17.1% and 41.2%. The level of education and teaching of health professionals significantly influenced the percentage of correct answers chosen. In relation to questions regarding periodontal treatment for the aforementioned diseases, the percentage of correct answers ranged from 2.6% to 20.8%. Once again, the educational background significantly influenced the percentage of correct answers. The recognition of scientific evidence that periodontal treatment may improve metabolic control in diabetic patients ranged from 40.7% (nurses) to 50.4% (physicians). The frequency of physicians and nurses who often/always diagnose, examine and advise patients about the risks and effects of PD in general health ranged from 0% to 20.3%. Only 23.6% refer patients for evaluation and periodontal treatment. In conclusion, knowledge about PD and PD as a risk factor for other diseases was reduced between physicians and nurses. All three categories of professionals investigated ­physicians, dentists and nurses- showed reduced knowledge about the lack of scientific evidence of periodontal treatment as prevention factor for other diseases. A high degree of education and teaching significantly increased the likelihood of identifying the correct answers. Physicians and nurses do not usually refer patients to periodontal specialists

A endocardite infecciosa e o tratamento periodontal em pacientes de risco / The infective endocarditis and the treatment periodontal in patients at risk

O presente trabalho enfoca o tratamento periodontal de pacientes em situação de risco para endocardite infecciosa. Os autores discutem a relação existente entre a patologia e a Periodontia, além dos principais conceitos que devem ser considerados para proporcionar o maior grau possível de proteção ao paciente em situação de risco durante o tratamento.

Using Delphi technique in a consensual curriculum for periodontics.

Periodontics has experienced several important conceptual changes in the last few decades. As such, it is important to have a periodontics curriculum built upon the expertise of specialists in that discipline and reflecting those changes. The main goal of this study was to attain a consensus, through the use of the Delphi technique, on the topics that should be included in a periodontics curriculum for undergraduate dental students. A sample of periodontics lecturers from nine dental schools in two Brazilian cities was used, and a Delphi technique approach was followed to investigate sample member perceptions on the subject. Participants received four postal mail questionnaires asking them to rate and rerate eighty-nine topics for possible inclusion in the curriculum. A descriptive analysis was conducted, and topic frequencies were calculated. Topics rated as highly important for inclusion were the following: health, ailment, prevention, etiology, epidemiology, diagnosis, and treatment. The Delphi technique approach proved successful in involving periodontics lecturers in the design of a periodontics curriculum for undergraduate dental students.

A cirurgia ortognática integrada à prótese e à periodontia / Orthognathic surgery integrated to prosthetic and periodontal treatment

Apresentamos um caso de uma paciente portadora de deformidade dentofacial severa que foi tratada através de cirurgia ortognática, integrada ao tratamento periodontal e protético. A importância deste relacionamento interdisciplinar, na busca de melhores resultados é discutida em detalhes