Effects of cervical restorations on the periodontal tissues: 5-year follow-up results of a randomized clinical trial.

OBJECTIVE: This study evaluated the effect of resin composite restorations of non-carious cervical lesions (NCCLs) on the occurrence/progression of gingival recession (GR), considering different tooth isolation techniques. METHODS: A randomized controlled split-mouth and blinded trial was carried out. Patients (n = 38) with at least two NCCLs were included. Before the cervical restoration placement, the NCCLs (181 teeth) were randomly allocated into two treatment groups according to the tooth isolation techniques: cotton roll or rubber dam. Experienced, trained, blinded, and calibrated examiners performed periodontal evaluations at baseline and 5-year follow-up, using a periodontal probe. Restorations were assessed with the FDI criteria. Thirty-two patients (154 teeth) were evaluated at 5 years. The occurrence/progression of GR between baseline and follow-up was considered the primary outcome. The relative risk (RR) and 95 % confidence interval (95 %CI) were calculated by Poisson regression (α < 0.05). RESULTS: After 5 year, 31 teeth (13.6 %) presented occurrence/progression of GR. In the multivariate analyses, the occurrence/progression of GR was associated with the use of rubber dam isolation (RR; 95 %CI: 2.65; 1.01-7.00) and a lack of marginal adaptation of the restoration (RR; 95 %CI: 10.98; 2.31-52.30). Toothbrush stiffness, use of abrasive dentifrice, tooth type, and the presence of biofilm or gingivitis did not present a statistically significant higher risk for occurrence/progression of GR. CONCLUSION: The use of rubber dam isolation associated with retraction clamp and the lack of a proper marginal adaptation of the composite restorations are risk indicators for the occurrence/progression of GR in individuals who received a restoration for an NCCL. CLINICAL SIGNIFICANCE: Isolation with a rubber dam and dental clamps may promote GR in sites with restored NCCLs. Moreover, clinical examinations for lack of marginal adaptations of the restorations may be included in a clinical setting.

Factors influencing dental appearance satisfaction in adolescents: a cross-sectional study conducted in Southern Brazil

The perception of dental aesthetic appearance may affect social interaction and psychologicalstatus, influencing dental needs and the search for treatments. Aim: To investigate the satisfactionwith dental appearance and influencing factors among adolescents. Methods: The study was carriedout among adolescents aged 14 to 19 years attending a private high school in Brazil. Data ondemographic information, the perception of dental appearance, previous aesthetic treatments andwish to perform dental treatments were collected in the school. Data were analyzed using Pearson’schi-square test or Linear Trend. Multivariate analysis was performed using the Poisson regression.Results: A total of 531 adolescents (Response rate = 98.3%) answered the questionnaire. Theprevalence of dissatisfaction with dental appearance was 17.4%. Almost 65% had history of previousorthodontic treatment and 16% performed dental bleaching. Approximately 45% of children wishedto undergo orthodontics and 54.8% to bleach their teeth. Dissatisfaction with dental appearancewas associated with individuals unsatisfied with dental color (95% IC[1.73;4.32]), those perceivingpoor dental alignment (PR3.16 95% IC[2.11;4.72]) and those wishing orthodontic treatment (PR2.9;95% IC[1.79; 4.70]). Conclusions: The prevalence of dissatisfaction was considerable and wasassociated with aesthetic concerns such as tooth color, dental alignment and with the wish fororthodontics. In this young population, a large part of adolescents had already performed orthodonticand bleaching treatments and wished to perform those treatments again. Satisfaction with dentalappearance could affect the adolescents’ behavior regarding search for dental treatment, thuscausing possible overtreatment.

Effect of pre-treatment with chlorhexidine on the retention of restorations: a randomized controlled trial.

This study aimed to evaluate the effect of chlorhexidine (CHX) application on etched dentin on the 6-month retention of restorations placed on non-carious cervical lesions (NCCLs). A randomized controlled split-mouth and triple blind trial was carried out. Patients (n=42) with at least two non-carious cervical lesions were included. NCCLs were randomly assigned to two groups: control (placebo solution) or test group (2% CHX solution for 60 s after acid etching and before the adhesive application). Class V restorations (n=169) were performed with an etch-and-rinse adhesive system and composite resin by 10 trained operators. A calibrated examiner evaluated the restorations at 1 week (baseline) and at 6 months using the FDI criteria. The primary outcome was retention of the restorations. The analysis of factors associated to failure of restorations was carried out by Fisher's exact test (α=0.05). After 6 months of follow-up, 3.4% (CI 95% 1.3-7.3) of the restorations failed. There was no statistically significant difference between control and CHX (p=0.920). Regarding the cavity variables, deeper (p=0.04), wider (p=0.004) and wedge-shaped (p=0.033) cavities failed more. Both treatments provided acceptable clinical performance of the restorations. The use of CHX as a adjuvant in dentin adhesion did not influence the retention of Class V restorations after 6 months of follow-up.

Effect of Pre-treatment with Chlorhexidine on the Retention of Restorations: A Randomized Controlled Trial

This study aimed to evaluate the effect of chlorhexidine (CHX) application on etched dentin on the 6-month retention of restorations placed on non-carious cervical lesions (NCCLs). A randomized controlled split-mouth and triple blind trial was carried out. Patients (n=42) with at least two non-carious cervical lesions were included. NCCLs were randomly assigned to two groups: control (placebo solution) or test group (2% CHX solution for 60 s after acid etching and before the adhesive application). Class V restorations (n=169) were performed with an etch-and-rinse adhesive system and composite resin by 10 trained operators. A calibrated examiner evaluated the restorations at 1 week (baseline) and at 6 months using the FDI criteria. The primary outcome was retention of the restorations. The analysis of factors associated to failure of restorations was carried out by Fisher's exact test (α=0.05). After 6 months of follow-up, 3.4% (CI 95% 1.3-7.3) of the restorations failed. There was no statistically significant difference between control and CHX (p=0.920). Regarding the cavity variables, deeper (p=0.04), wider (p=0.004) and wedge-shaped (p=0.033) cavities failed more. Both treatments provided acceptable clinical performance of the restorations. The use of CHX as a adjuvant in dentin adhesion did not influence the retention of Class V restorations after 6 months of follow-up.

O objetivo deste estudo foi avaliar o efeito da aplicação de clorexidina (CRX) em dentina condicionada na retenção de restaurações confeccionadas em lesões cervicais não-cariosas (LCNC) após 6 meses. Ensaio clínico randomizado triplo cego do tipo boca dividida foi conduzido. Pacientes (n=42) com no mínimo duas LCNC foram incluídos. LCNC foram randomizadas em dois grupos: controle (solução placebo) ou grupo teste (aplicação de CRX 2% por 60 s após o condicionamento e antes da aplicação do adesivo). Restaurações Classe V (n=169) foram realizadas com adesivo de condicionamento ácido total e resina composta, por 10 operadores treinados. Um examinador calibrado avaliou as restaurações após 1 semana (base) e 6 meses usando os critérios da FDI. O desfecho primário foi retenção das restaurações. A análise dos fatores associados à falha das restaurações foi conduzida com Teste Exato de Fisher (α=0,05). Após 6 meses de acompanhamento, 3,4% (IC 95% 1,3-7,3) das restaurações falharam. Não houve diferença estatística entre os grupos CRX e controle (p=0,920). Com relação às variáveis das cavidades, cavidades mais profundas (p=0,024), largas (p=0,004) e em formato de cunha (p=0,033) falharam mais. Ambos os tratamentos (CRX e controle) proporcionaram performance clínica aceitável das restaurações. O uso de CRX como coadjuvante na adesão à dentina não influenciou a retenção das restaurações Classe V após 6 meses de acompanhamento. .

Risk factors for gingivitis in a group of Brazilian schoolchildren.

OBJECTIVE: Studies on gingivitis in children and adolescents are scarce and the results are inconclusive. The aim of this study was to assess the prevalence and extension of gingivitis and associated factors in Brazilian schoolchildren. METHODS: Cross-sectional data from 1,211 schoolchildren 8 to 12 years old from Southern Brazil in 20 public and private schools were analyzed. Socioeconomic, demographic, and oral hygiene habits were assessed by questionnaires answered by parents and children. Buccal examination assessed presence of plaque, crowding, and gingivitis. Data were analyzed using Poisson regression [prevalence ratio (PR); 95% confidence interval (CI)]. RESULTS: Prevalence of visible plaque was 89.7% (95% CI 88.0-91.3) and gingival bleeding on probing was 78.4% (95% CI 76.1-81.0). The mean and median numbers of sites with gingival bleeding were 3.10 and 2 (SD ± 3.22), respectively. In multivariate adjusted analysis, the presence of a greater number of sites with plaque was significantly associated with gingivitis (PR 1.26; 95% CI 1.07-1.47) and its extension (PR 1.96; 95% CI 1.53-2.51). Lighter-skinned black children had a lower probability of having severe gingivitis (PR 0.69; 95% CI 0.48-0.98) compared with white children. This association was observed after adjusting for other variables. CONCLUSIONS: Gingivitis was associated with higher number of sites with plaque and with skin color, reflecting the influence of biological and demographic factors on this oral condition.

Dental esthetic self-perception of Brazilian dental students

Introduction: Esthetics in dentistry aims to improve the patients' self-esteem and satisfaction regarding how beautiful and attractive they feel. However, patients and dental professionals may perceive the concept of esthetics differently instead, which may cause the dissatisfaction of the patient with the results of the treatment. Objective: This cross-sectional observational study aimed to verify the esthetic self-perception of undergraduate dental students regarding their own smile. Material and methods: A questionnaire, designed by Goldstein 10 to measure the patients' self-perception and satisfaction, regarding their smiles, was applied to undergraduate students of different semesters of the School of Dentistry of the Federal University of Pelotas. Results: Our results showed that women are more dissatisfied with their smiles than men. Students attending different semesters worried somehow about the esthetics of their smiles and revealed the wish of having whiter teeth. Most students are satisfied with the shape of their teeth. Ninety two percent of the students feel self-confident regarding to smile, 90% believe someone else has a better smile, 87% look at the smile of models in fashion magazines, 71% wish to have whiter teeth and 80% wish to have rather a bigger or smaller teeth. Conclusion: Undergraduate dental students have a positive self-perception of their smile. Women are less satisfied than men. Students of the earlier semesters wish to have whiter teeth than students from the later semesters.

Mandibular molar rehabilitation using orthodontic extrusion associated with odontoplasty.

The aim of this clinical report is to describe the successful treatment of a mandibular first molar presenting an extensive fracture at the buccal aspect in a young patient. The extension of the fracture was a negative prognostic factor for tooth maintenance. An alternative clinical treatment was proposed since the patient was young and presented with good oral hygiene and periodontal health. The treatment was based on orthodontic forced eruption associated with odontoplasty. A 3-year follow-up after the surgical procedure demonstrated the maintenance of periodontal health and good plaque control. It can be concluded that orthodontic forced eruption associated with odontoplasty promoted favorable conditions for prosthetic rehabilitation and is a feasible procedure in the treatment of tooth fracture extended below the cementoenamel junction.

Periodontal surgery associated with odontoplasty in the esthetic functional rehabilitation of a fractured anterior tooth.

Anterior dental fractures often require a multidisciplinary approach. This article presents a case in which an extensive fracture with palatal biological width invasion was treated successfully through clinical crown lengthening with odontoplasty. This procedure was a simple direct technique that restored the tooth without damaging the dental esthetics, the gingival contour, or the papillae.

Clareamento dental caseiro por meio de fitas adesivas: relato de caso / Home bleaching using whitening strips: a case report

O clareamento caseiro, com peróxido de carbamida a 10%, aplicado por meio de moldeiras personalizadas, ainda é o protocolo de tratamento mais utilizado, quando se quer branquear os dentes. No entanto, está disponível técnica mais recente, que consiste na utilização de fitas adesivas pré-contornadas, impregnadas com agente clareador, que contêm diferentes concentrações de peróxido de hidrogênio. Aplicadas uma ou duas vezes ao dia, as fitas são facilmente adaptadas aos dentes anteriores. O objetivo deste artigo é apresentar relato de clareamento dental caseiro com utilização de fitas adesivas impregnadas com peróxido de hidrogênio a 6%, abordando suas principais características, indicações e limitações.

Vital bleaching using 10% Carbamide Peroxide and custom-made trays is still the most used technique for dental bleaching. However, there is a novel technique for bleaching vital teeth using whitening strips containing different concentrations of hydrogen peroxide. The strips are easily adapted in a QD or BID regimen over the anterior teeth. The aim of this paper is to present a clinical case where 6% hydrogen peroxide strips were used, and to discuss the main characteristics, indications and limitations.

Rehabilitation to crown-root fracture by fragment reattachment with resin-modified glass ionomer cement and composite resin restoration.

Tooth fragment reattachment in cases of enamel/dentin fracture is based on adhesive protocols and is indicated because of its technique simplicity. Complex cases of root fracture or extensive coronal damage demand the integration of biological properties with the mechanical characteristics of the restorative materials. This paper is a report from one patient with a favourable result that addresses the clinical procedures involved in the association of resin-modified glass ionomer cement and composite resin for cases of coronal fracture of anterior teeth with invasion of the periodontal biological space and/or proximity with the pulp tissue. The research-based background for establishment of the treatment plan is discussed and a case of crown fracture with root involvement in a maxillary central incisor illustrates the operative technique of tooth fragment reattachment. After 1 year of follow up, the clinical and radiographic findings demonstrate that the adopted clinical protocol was successful and yielded an excellent pulp and periodontal response as well as maintenance of function and aesthetics.

Over-the-counter whitening agents: a concise review.

Tooth discoloration is commonly found in the dental clinic and tooth bleaching has been considered the preferred esthetic alternative, being more conservative, safe and with predictable results. Supervised home-use of 10% Carbamide Peroxide (CP) bleaching with custom-trays is the most common bleaching procedure dispensed by dentists to their patients. The good results obtained with this technique stimulated the flourishing of new products and techniques. Over-the-counter (OTC) bleaching products appeared as a low-cost alternative to bleach discolored teeth without dentist supervision. Different OTC products are available in supermarkets, drug stores or on the Internet, including rinses, paint-on brushes, toothpastes, chewing guns, dental floss, and whitening strips. There is lack of clinical evidence regarding the safety and effectiveness of these products, being most of the studies supported by the manufacturers'. Basically, toothpastes, chewing gums, and dental floss are removal agents of superficial stains. Rinses and paint-on brushes with low levels of hydrogen peroxide have some whitening effect, but without clinical relevance. Strips present similar esthetic results and side-effects, compared to bleaching with 10% CP using trays; however, the studies have financial support from the manufacturers and were based on short term evaluations. Legislation varies widely in different countries regarding OTC dental bleaching. Concerns have appeared due to the potential abusive use of these self-medication agents, especially in young patients, with potential harmful results. Dentists should be acquainted with this kind of products to be able to inform their patients. In conclusion, there is a need for independent clinical trials to provide sufficient evidence regarding the use of OTC bleaching products.

Avaliação clínica do efeito de duas técnicas de clareamento dental em consultório utilizando peróxido de hidrogênio / Clinical evaluation of the efectiveness of two in-office bleaching techniques using a hydrogen peroxide based product

O objetivo deste estudo foi avaliar in vivo o efeito da utilização das lâmpadas halógenas como catalisadoras de um gel à base de peróxido de hidrogênio a 37,5% utilizado para o clareamento dental em consultório. Treze pacientes foram submetidos ao tratamento clareador em consultório com peróxido de hidrogênio a 37,5% (Whiteness HP Maxx, FGM/ Joinvile, SC, Brasil). A arcada superior de cada paciente foi dividida, e então em um dos hemiarcos o tratamento clareador foi realizado com a aplicação do peróxido de hidrogênio associado à iluminação com lâmpada halógena e no outro hemiarco o peróxido de hidrogênio foi utilizado sem nenhuma fonte de luz. Fotografias pré e pós operatórias foram realizadas nas mesmas condições de iluminação e submetidas à análise através de um software para comparar o grau de clareamento obtido nos hemiarcos esquerdo e direito. Os dados foram analisados utilizando o teste t-student (p≤0.05). Os resultados mostraram que não houve diferença significativa no clareamento obtido quando as duas técnicas foram comparadas. Estes resultados possibilitaram concluir que a iluminação com lâmpadas halógenas não melhorou o resultado final da técnica de clareamento dental em consultório quando um gel à base de peróxido de hidrogênio a 37,5% foi utilizado.

Purpose: To clinically evaluate the capacity of a halogen curing-light to act as a catalyst of a 37.5% hydrogen peroxide based product used to lightening teeth.Materials and Methods: Thirteen human subjects had their upper-arches (premolar to premolar) bleached and evaluated. Split-arch design using centrals, laterals, canines and premolars on one side treated with bleach (Whiteness HP Maxx, FGM, Joinvile, SC/Brazil) plus light, was compared with contralateral teeth using bleach alone. Pre and pos-operatory pictures were taken under the same light conditions. Then the pictures were analyzed with commercial software to compare the degree of lightening obtained on the right and left cervical area of the upper central incisors. Data were analyzed using paired Student-T test (p≤0.05).Results: Pairs of means for brightness and RGB blue channel showed no statistically significance differences at baseline and immediately after the third session of bleaching, despite of the use of the halogen light for gel activation.Clinical significance: The halogen curing-light does not improve the final result of the in-office bleaching technique using a 37.5% hydrogen peroxide gel.

Over-the-counter whitening agents: a concise review

Tooth discoloration is commonly found in the dental clinic and tooth bleaching has been considered the preferred esthetic alternative, being more conservative, safe and with predictable results. Supervised home-use of 10 percent Carbamide Peroxide (CP) bleaching with custom-trays is the most common bleaching procedure dispensed by dentists to their patients. The good results obtained with this technique stimulated the flourishing of new products and techniques. Over-the-counter (OTC) bleaching products appeared as a low-cost alternative to bleach discolored teeth without dentist supervision. Different OTC products are available in supermarkets, drug stores or on the Internet, including rinses, paint-on brushes, toothpastes, chewing guns, dental floss, and whitening strips. There is lack of clinical evidence regarding the safety and effectiveness of these products, being most of the studies supported by the manufacturers'. Basically, toothpastes, chewing gums, and dental floss are removal agents of superficial stains. Rinses and paint-on brushes with low levels of hydrogen peroxide have some whitening effect, but without clinical relevance. Strips present similar esthetic results and side-effects, compared to bleaching with 10 percent CP using trays; however, the studies have financial support from the manufacturers and were based on short term evaluations. Legislation varies widely in different countries regarding OTC dental bleaching. Concerns have appeared due to the potential abusive use of these self-medication agents, especially in young patients, with potential harmful results. Dentists should be acquainted with this kind of products to be able to inform their patients. In conclusion, there is a need for independent clinical trials to provide sufficient evidence regarding the use of OTC bleaching products.

Influence of dentin surface pre-treatment on microtensile bond strength of a single-bottle adhesive / Influência do pré-tratamento superficial da dentina na resistência de união à microtração de um sistema adesivo de frasco único

Purpose: This study evaluated the influence of different methods of dentin surface pre-treatment on microtensile bond strength and failure mode of a single-bottle adhesive. Methods: Twenty-four third molars were embedded in acrylic resin and ground until exposure of occlusal dentin. Six groups were tested according to the dentin surface pre-treatment: G1) 35% phosphoric acid (pa) (positive control); G2) slurry of pumice + pa; G3) air-abrasion with 25μm-aluminum oxide + pa; G3) air abrasion with 50μm-aluminum oxide + pa; G5) air abrasion with sodium carbonate + pa; G6) no treatment (negative control). The adhesive Single Bond (3M-ESPE) was applied on the dentin surface and photoactivated before a 6mm-height composite restoration was built (Z250, 3M-ESPE). After storage in distilled water at 37ºC for 24h, all specimens (sectional area of 1mm²) were subjected to a microtensile bond strength test at a crosshead speed of 0.5mm/min. Results: Bond strength mean values (MPa) were: G1=29.28, G2=21.04, G3=21.66, G4=18.94, G5=19.90, and G6=19.03. Only G1 was statistically different from the other groups (ANOVA and Tukey's test, α=0.05). SEM images of the adhesive interface after rupture showed prevalence of mixed failure type (adhesive fracture between dentin and adhesive agent plus partial cohesive fracture in the composite restoration or dentin) for all groups but G6. Conclusion: The use of cleaning agents on dentin surface might not be necessary for adhesive procedures with dentin total acid-etching.

Objetivo: Este estudo avaliou a influência de diferentes métodos de pré-tratamento da superfície dentinária sobre a resistência de união à microtração e modo de falha de um sistema adesivo de frasco único. Metodologia: Vinte e quarto terceiros molares foram incluídos em resina acrílica e desgastados até exposição da dentina oclusal. Seis grupos foram testados de acordo com o pré-tratamento da dentina: G1) ácido fosfórico a 35% (pa) (controle positivo); G2) pasta de pedra- pomes + pa; G3) jateamento com óxido de alumínio 25μm + pa; G3) jateamento com óxido de alumínio 50μm + pa; G5) jateamento com carbonato de sódio + pa; G6) sem tratamento (controle negativo). O sistema adesivo Single Bond (3M-ESPE) foi aplicado na superfície dentinária e fotoativado antes da simulação de uma restauração de resina de 6mm de altura (Z250, 3M-ESPE). Após armazenamento em água destilada a 37ºC por 24h, todos os espécimes (área transversal de 1mm²) foram submetidos ao teste de microtração à velocidade de 0,5mm/min. Resultados: Os valores médios de resistência de união (MPa) foram: G1=29,28; G2=21,04; G3=21,66; G4=18,94; G5=19,90; e G6=19,03. Somente o G1 foi estatisticamente diferente dos demais grupos (ANOVA e teste de Tukey, α=0,05). A observação em MEV da interface adesiva após ruptura mostrou prevalência de falha do tipo mista (fratura adesiva entre dentina e agente adesivo associada à fratura coesiva parcial na restauração de resina ou dentina) para todos os grupos, exceto G6. Conclusão: O uso de agentes de limpeza na superfície dentinária pode não ser necessário para procedimentos adesivos com condicionamento ácido total da dentina.

Cimento de ionômero de vidro: uso atual e perspectivas em odontologia restauradora / Glass ionomer cement: actual use and perspectives in restorative dentistry

Os cimentos de ionômero de vidro apresentaram uma diminuição em seu uso clínico como conseqüência de sua limitação estética e mecânica em relação às resinas compostas. Porém, devido à intensa discussão sobre a efetiva biocompatibilidade e resistência de união a longo prazo dos sistemas adesivos, tem-se intensificado novamente o interesse pelos cimentos ionoméricos. Em relação à resistência de união, apesar dos valores imediatos apresentados pelos sistemas adesivos serem mais elevados que os de cimentos de ionômero de vidro, estes tendem a diminuir significativamente quando avaliados a longo prazo, enquanto a resistência dos cimentos de ionômero de vidro se mantém. Por este motivo, alguns autores têm classificado este cimento como um agente de união. Quanto à sua biocompatibilidade, os trabalhos mais recentes demonstram a possibilidade de sua utilização como substituto dos cimentos de hidróxido de cálcio para proteção pulpar indireta e como material restaurador em locais de íntima relação com tecidos periodontais, em função da boa tolerância destes aos cimentos de ionômero de vidro.

The glass ionomer cements (GIC) have presented a less clinical usage along the past years as a consequence of limitations on esthetics and mechanical properties when compared with composites. But the recent and intense discussion involving biocompatibility of composites and degradation of adhesive systems turned over the interests on GIC again. Perhaps the fact that GIC present lower immediate bond strength when compared with composite adhesive system, their values stay stable along the time. For this reason some authors have been considering the GIC as an adhesive system. The biocompatibility research have demonstrated that GIC can be an excellent substitute for calcium hydroxide cements on indirect pulp capping and can be safe used as an restorative material on intimate periodontal region.

Capacidade dessensibilizante do flúor tópico durante clareamento caseiro: estudo clínico duplo-cego / Double blind clinical trial of the topic fluorid dessentizing effect during at-home bleaching

A sensibilidade dentária é um efeito colateral considerado comum e indesejável durante o clareamento dentário, sendo o flúor tópico indicado como um dos meios de evitar esta ocorrência. O presente trabalho, realizado sob a forma de um estudo clínico duplo-cego, teve por objetivo investigar a capaciade dessensibilizante do flúor tópico a 0,05 por cento e 5 por cento durante clareamento caseiro com peróxido de carbamida a 10 por cento. Um total de 33 pessoas (idade entre 18 a 30 anos) foi selecionado, os quais utilizaram durante 1,5 horas, Peróxido de Carbamida a 10 por cento (Opalescence), por 14 dias. Estes foram divididos em três grupos de 11 (placebo, flúor a 0,05 por cento, flúor a 5 por cento) aleatoriamente, recebendo em esquema duplo-cego um dos três tratamentos suplementares para utilização em moldeira individual durante 1 minuto. Terminado o tratamento, os pacientes responderam um questionário sobre sensibilidade. A análise das fichas sobre sensibilidade demonstrou que, para o grupo placebo, houve um índice de 63,63 por cento dos pacientes com sensibilidade e, para os grupos que utilizaram gel de flúor a 0,05 por cento e 5 por cento, respectivamente, 80 por cento e 60 por cento. O cruzamento de variáveis com Teste do Qui-quadrado e Prova Exata de Fisher (p < 5 por cento) quanto ao índice de sensibilidade durante o clareamento, demonstrou não haver dependência entre a variável em questão com relação ao grupo. Este protocolo de uso do flúor tópico não demonstrou ser eficaz na atenuação de sensibilidade dentária durante clareamento caseiro

Resistência de união à dentina de um sistema adesivo convencional após aplicação de dessensibilizantes dentinários / Bond strength of a conventional adhesive system after use of dentinal desensitizers

Para testar a influência da utilização de dessensibilizantes dentinários na resistência adesiva entre dentina e resina composta, usando o sistema adesivo convencional Scotchbond Multi-uso Plus - 3M, foram expostas as superfícies dentinárias de terceiros molares recém-extraídos e sobre estas foram aplicados os dessensibilizantes Gluma- Heraeus Kulzer (GL) ou Oxa-gel - Art-Dent (OX), seguidos do sistema adesivo e da restauração com resina composta Z250 - 3M. Foi também confeccionado um grupo de controle (CO), sem a aplicação de dessensibilizantes. Os dentes, devidamente preparados e restaurados, foram cortados longitudinalmente em palitos com área de união de aproximadamente 1,4 mm². Os palitos foram adaptados a um paquímetro modificado e este a uma máquina de ensaios universal EMIC DL2000, que realizou os testes de tração. As resistências adesivas expressas em MPa foram 29,63 ± 5,09 (CO), 29,08 ± 5,31 (GL) e 26,13 ± 6,56 (OX). Os dados foram submetidos a análise estatística pelo teste de análise de variância, que demonstrou não haver diferença estatisticamente significativa entre os grupos. Os resultados permitem concluir, dentro da metodologia deste estudo "in vitro", que a aplicação prévia de dessensibilizantes dentinários a um sistema adesivo convencional não altera a resistência adesiva entre dentina e resina composta

Restaurações indiretas em resisna composta laboratorial em dentes posteriores: passos de execução clínica/laboratorial e apresentação de um novo sistema / Laboratorial composite indirect restorations in posterior teeth: clinical laboratorial steps and presentation of a new system

Este artigo revisa as características dos sistemas de resina composta laboratorial, propondo uma seqüência de aplicação de resinas com o sistema Belleglass (Kerr), detalhando sua técnica