Natural Crown Bonding of Anterior Fractured Teeth at Different Levels of Complexity: A 14-Month Follow-up.

Dental fractures comprise the most frequent form of traumatic dental injury and often require an immediate procedure for their treatment. The repositioning of fractured crown fragments using the bonding fragment technique offers several advantages, including the reestablishment of function, esthetics, shape, shine, and surface texture, in addition to the maintenance of the original contour and alignment of the teeth. The aim of this article is to describe a therapeutic approach used with a patient who suffered varying degrees of crown fractures in three teeth that were treated with adhesive fragment reattachment. The natural crown bonding technique, using tooth fragments and a direct composite resin, successfully restored all of the fractured anterior teeth. The clinical examinations showed good esthetics and periodontal health after a 14-month follow-up, proving that the technique is a good option for tooth fractures.

Fusion of permanent teeth as post-traumatic sequelae of trauma in primary dentition: A case report with fifteen years of follow-up.

Traumatic dental injuries in primary dentition present risk of sequelae in the permanent dentition. In this case report, we describe the management and long term follow-up of sequelae affecting permanent central incisor due to prior intrusive luxation and subluxation of the corresponding primary tooth. A 5-year-boy was referred for treatment, with history of fall by the age of 21 months, which caused subluxation of the primary maxillary right and left central incisors, and intrusion of the maxillary right lateral incisor. Radiographic and clinical monitoring was regularly performed. Hypoplasia and crown dilaceration of the permanent maxillary right central incisor was detected, as well as an enamel bridge between the central and lateral right incisors was diagnosed by cone bean tomography. Gingevectomy followed by the breaking of the enamel junction between the crowns of lateral and central incisors and indirect facet in composite resin were used to treat the sequelae. A precise diagnosis, involving a multidisciplinary team, contributed to the success of treatment. Key words:Case reports, follow-up studies, pediatric dentistry, tooth, deciduos, complications.

Reestablishing the Function and Esthetics in Traumatized Permanent Teeth with Large Apical Lesion.

Dental trauma is a challenge for dental integrity and can lead to pulp necrosis. The clinical case reports the diagnosis of a maxillary right central incisor traumatized and its multidisciplinary treatment. Calcium hydroxide material was used to perform the processing apexification. An apical surgery was carried out to remove the apical periodontitis and to return the aesthetics to the patient; internal and external tooth whitening in maxillary right central incisor was performed. We conclude that surgery associated with the root filling in the central incisor led to a successful completion. Moreover, it is of utmost importance to demonstrate the interaction between the various areas of dentistry.

Anterior composite restorations in clinical practice: findings from a survey with general dental practitioners

Objectives: The aim of this study was to assess technical preferences of general dental practitioners when restoring anterior composite restorations. How the level of clinical experience or post-graduate training infuenced their options was also tested. Material and Methods: A cross-sectional study was performed using a questionnaire with general dental practitioners (GDPs) (n=276) in Southern Brazil. Information regarding post graduation training (specialization, master's or PhD degree) and linical experience (years since completing graduation) were gathered. The options regarding anterior composite restorations (type of composite, adhesive system, light curing unit, polishing procedures and rubber dam use) were collected. Data were submitted to descriptive analysis and associations were tested. Results: Response rate was 68% (187). GDPs selected microhybrid composite (52%) and 2-step total etch adhesive system (77%). LED was the preferred method of activation for 72.8%. Immediate polishing was preferred by 75%, using a combination of techniques. Most of the respondents (74.3%) did not use rubber dam. More experienced clinicians used more halogen lights (p<0.022), performed more light monitoring (p<0.001) and were resistant to use rubber dam (p<0.012). Dentists with post-graduation training used 3-etch-and-rinse system more frequently (p<0.04), usually monitored light intensity (p<0.014) and placed rubber dam more frequently (p<0.044). Conclusions: Hybrid composite, simplifed adhesives, LED units and immediate polishing were preferred by Southern Brazilian dentists for anterior composite restorations. Few dentists used rubber dam to perform composite restorations in anterior teeth. Clinical experience and post-graduation training infuenced the dentists' choices. .

Anterior composite restorations in clinical practice: findings from a survey with general dental practitioners.

OBJECTIVES: The aim of this study was to assess technical preferences of general dental practitioners when restoring anterior composite restorations. How the level of clinical experience or post-graduate training infuenced their options was also tested. MATERIAL AND METHODS: A cross-sectional study was performed using a questionnaire with general dental practitioners (GDPs) (n=276) in Southern Brazil. Information regarding post graduation training (specialization, master's or PhD degree) and linical experience (years since completing graduation) were gathered. The options regarding anterior composite restorations (type of composite, adhesive system, light curing unit, polishing procedures and rubber dam use) were collected. Data were submitted to descriptive analysis and associations were tested. RESULTS: Response rate was 68% (187). GDPs selected microhybrid composite (52%) and 2-step total etch adhesive system (77%). LED was the preferred method of activation for 72.8%. Immediate polishing was preferred by 75%, using a combination of techniques. Most of the respondents (74.3%) did not use rubber dam. More experienced clinicians used more halogen lights (p<0.022), performed more light monitoring (p<0.001) and were resistant to use rubber dam (p<0.012). Dentists with post-graduation training used 3-etch-and-rinse system more frequently (p<0.04), usually monitored light intensity (p<0.014) and placed rubber dam more frequently (p<0.044). CONCLUSIONS: Hybrid composite, simplifed adhesives, LED units and immediate polishing were preferred by Southern Brazilian dentists for anterior composite restorations. Few dentists used rubber dam to perform composite restorations in anterior teeth. Clinical experience and post-graduation training infuenced the dentists' choices.

Fechamento de diastema entre incisivos centrais permanentes com tratamento ortodôntico associado à restauração adesiva / Central incisors diastema closure using orthodontic treatment associated with ashesive restoration

O fechamento de diastema tem sido um procedimento desafiador na clínica ortodôntica, uma vez que requer habilidades, tais como a percepção visual do problema e planejamento. Nesse sentido, este trabalho tem como objetivo descrever, mediante um caso clínico, o fechamento de diastema através de procedimento ortodôntico, finalizando com utilização de restauração adesiva direta.

Reabilitação estética em dentes anteriores com lesões de cárie proximais: relato de caso / Esthetic rehabilitation in anterior teeth with proximal carious lesions: case report

O objetivo do presente trabalho é o de descrever um caso de reabilitação estética na região dentária anterior. Paciente queixando-se das manchas escuras nos dentes anteriores superiores apresentava lesões de cárie nos dentes ântero-superiores, causando uma desarmonia estética no seu sorriso. Dentro do plano de tratamento reabilitador da paciente, realizaram-se restaurações classe III dos elementos dentários 11 e 12, classe IV do 21 e classe V do 13 e do 14. Frente ao caso clínico exposto, conclui-se que a reabilitação restauradora, além de promover saúde, pode proporcionar uma aparência estética mais favorável do sorriso, elevando a autoestima do paciente.

The aim of this study is to describe a case of esthetic rehabilitation in the maxillary incisive. Patient complaining of black stain on the maxillary teeth had carious lesions in teeth that cause great disharmony of your smile. Within the rehabilitation plan of patient, took place Class III restorations of the teeth 11 and 12, class IV of 21 and class V of the 13 and 14. It was concluded that, the present approach, allowed the anterior restorative rehabilitation, promote health and provide a more favorable aesthetic appearance of the smile, raising self-esteem of the patient.

Radiographic view of adhesive layer andrelationship with marginal leakage in class II composite resin restorations

This study assessed the influence of the application of bonding agents prior to or after matrix and wedge placement in the radiographic view of the adhesive layer in cervical walls of Class II composite resin restorations and correlated the findings with marginal leakage. Standard cavities were prepared in the mesial and distal faces of human molars, with cervical margins placed in dentin/cementum. Restorations were made using metallic matrix bands and wooden wedges. The microhybrid composite Filtek Z250 (3M ESPE) and two adhesive systems – Single Bond 2 (SB-3M ESPE) and Scotchbond Multi-Purpose (SMP-3M ESPE) – were used, thus defining five groups (n= 12): [SB1] and [SMP1]- matrix and wedge placed after bonding application; [SB2] and [SMP2]-matrix and wedge placed prior to bonding application; [Control] – restorations without adhesive system. Bitewing radiographs from each tooth were obtained and the view or not of the adhesive layer in the cervical wall of each restoration was observed under magnification (40x). Specimens were thermalcycled and dye penetration (0.5% basic fuchsine) evaluated under magnification (40x). Data were submitted to Kruskal-Wallis and Spearman correlation tests (p=0.05). The placement of matrix and wedge before bonding agent application increased the view of the adhesive layer only for SB (p<0.001). Matrix did not influence marginal leakage, and no significant relationship between radiographic view of adhesive layerand marginal leakage (r=-0.020; p =0.877) could be observed. In conclusion, SB presented better sealingability than SMP (p<0.01).

Infiltração marginal em restaurações de resina composta com diferentes materiais adesivos intermedißrios / Marginal leakage in resin composite restorations lined with different adhesive materials

Este estudo avaliou a capacidade de selamento de restaurações de resina composta com diferentes materiais adesivos intermedißrios. Cavidades Classe V padronizadas, com margens em esmalte e dentina/cemento, foram confeccionadas em incisivos bovinos. A resina de alto escoamento Fill Magic (Vigodent) e o cimento ionomérico Vitremer (3M ESPE) foram empregados como intermedißrios de restaurações com os compósitos Charisma e Solitaire (Heraeus Kulzer), formando 6 grupos (n = 14): [C1] - compósito microhíbrido Charisma; [C2] - Fill Magic + Charisma; [C3] - Vitremer + Charisma; [S1] - compósito condensßvel Solitaire; [S2] - Fill magic + Solitaire; [S3] - Vitremer + Solitaire. Após acabamento e polimento, as amostras foram armazenadas em solução fisiológica a 37ºC, por 30 dias, e então imersas em solução de fucsina bßsica a 0,5% por 24h. Os dentes foram longitudinalmente seccionados e a penetração do corante avaliada sob magnificância (40×), por dois examinadores, com escores padronizados. Os dados foram submetidos ao teste estatístico não-paramétrico de Kruskal-Wallis. Nas margens em esmalte, diferenças significativas foram verificadas apenas para a associação de intermedißrios à resina Solitaire, com os grupos S2 (p < 0,05) e S3 (p < 0,001) apresentando escores de infiltração significativamente maiores em relação aos demais. As margens em dentina/cemento apresentaram maior penetração em relação às margens em esmalte (p < 0,001). Apenas a associação do Vitremer às duas resinas melhorou o selamento deste substrato, com os grupos C3 (p < 0,001) e S3 (p < 0,05) apresentando os menores escores de infiltração.

Avaliaçäo clínica de restauraçöes de resina composta e amálgama em dentes posteriores - 5 anos / The clinical evaluete of the composite resins and amalgam restorations in molars and premolars

Noventa e seis restauraçöes de Classe I e II foram realizadas em 26 pacientes, com três materiais diferentes: amálgama, resina composta P50 e Herculite. Em cada paciente foram colocados os três materiais. Todas as restauraçöes após acabamento e polimento eram moldadas com optosil + xantopren, construídos modelos em gesso especial, para posteriores avaliaçöes comparativas. Decorridos cinco anos, os pacientes foram rechamados e um total de 63 restauraçöes foram moldadas. A ordenaçäo foi feita em cinco grupos, de acordo com as falhas apresentadas, e a análise estatística demonstrou näo haver ocorrido diferenças entre os materiais no tempo avaliado

Avaliação clínica de 5 anos das resinas compostas em dentes posteriores / Five year clinical evaluation of composite resins on posterior teeth

A proposta do presente estudo foi avaliar o comportamento de diferentes tipos de resinas compostas em cavidade de Classe I e II, em dentes posteriores, em "vivo". Cento e vinte e seis restaurações foram executadas, em cada paciente foram colocados os 3 materiais e após a colocação de rodas as restaurações, elas foram moldadas com optisil + xantopren, confeccionados modelos de gesso, "baseline", os quais seriam confrontados com as avaliações posteriores, ou seja de 4 a 5 anos. Na avaliação de 5 anos foram avaliadas 86 restaurações, as quais foram classificadas de acordo com um ranking de "qualidade" e após os resultados foram submetidos a análise estatística. Os resultados demonstraram ter ocorrido diferenças entre os materiais avaliados no que tange a forma anatômica

Restauraöes de resina composta em dentes posteriores com reforço oclusal / The restoration at the composite resins in posterior teeth with reforced oclusal

As restauraçöes de resina composta säo hoje uma realidade. Inúmeras pesquisas tem demonstrado um significativo aumento na qualidade de restauraçöes de resina composta, em funçäo, principalmente do aumento da qualidade de carga orgânica e da distribuiçäo homogênea destas partículas na massa restauradora. A resistência ao desgaste e a harmonia de cor, säo razöes que justificam o crescente uso de materias estéticos em dentes posteriores. Mesmo que se reconheça que o desgaste oclusal só se manifestará em torno de 6 anos esta capacidade pode ser aumentada-se a área de contato oclusal for reforçada. Este trabalho mostra a possibilidade de se criar reforços oclusais com esmalte de dente natural, as chamadas "ilhas" ou se confeccionar restauraçöes de amálgama nos contatos