Associação de diferentes cirurgias periodontais como alternativa de restabelecimento de harmonia gengival / Association of different periodontial surgeries as an alternative of restoration of gengival harmony

Este trabalho tem como objetivo apresentar um relato de caso no qual a paciente se queixava de desarmonia do sorriso, desta forma o aumento de coroa clínica estética e o retalho reposicionado coronalmente, foram escolhidos juntamente com a reanatomização em resina composta, para restabelecer a harmonia gengival e dentária. A paciente apresentava contorno gengival desigual, no qual uma recessão gengival no dente 22 e coroas curtas e desproporcionais nos demais incisivos anteriores foram observadas, assim como uma vestibularização de todos os dentes superiores anteriores, no qual ela se recusou a tratar com Ortodontia. Foram reanatomizadas e restabelecidas por meio do uso de resina composta pela "técnica de facetas direta". Este caso clínico evidenciou a importância da associação de técnicas de cirurgia periodontal e do trabalho multidisciplinar para que todas as queixas pudessem ser devidamente sanadas e o caso concluído com sucesso dentro dos anseios e expectativas da paciente. (AU)

This work aims to present a case report in which the patient complained of smile disharmony, and in this way the aesthetic clinical crown increase and the coronally repositioned flap were chosen together with composite resin reanatomization to restore harmony gingival and dental. The patient had an unequal gingival contour, in which a gingival recession on tooth 22 and short and disproportional crowns on the other anterior incisors were observed, as well as a vestibularization of all the anterior superior teeth, in which she refused to treat with orthodontics. They were reanatomized and restored through the use of resin composed by the "direct facet technique". This clinical case evidenced the importance of the association of techniques of periodontal surgery and of the multidisciplinary work so that all the complaints could be duly remedied and the case concluded successfully within the patient's expectations and expectations. (AU)

Randomized clinical trial of encapsulated and hand-mixed glass-ionomer ART restorations: one-year follow-up.

This prospective, randomized, split-mouth clinical trial evaluated the clinical performance of conventional glass ionomer cement (GIC; Riva Self-Cure, SDI), supplied in capsules or in powder/liquid kits and placed in Class I cavities in permanent molars by the Atraumatic Restorative Treatment (ART) approach. A total of 80 restorations were randomly placed in 40 patients aged 11-15 years. Each patient received one restoration with each type of GIC. The restorations were evaluated after periods of 15 days (baseline), 6 months, and 1 year, according to ART criteria. Wilcoxon matched pairs, multivariate logistic regression, and Gehan-Wilcoxon tests were used for statistical analysis. Patients were evaluated after 15 days (n=40), 6 months (n=34), and 1 year (n=29). Encapsulated GICs showed significantly superior clinical performance compared with hand-mixed GICs at baseline (p=0.017), 6 months (p=0.001), and 1 year (p=0.026). For hand-mixed GIC, a statistically significant difference was only observed over the period of baseline to 1 year (p=0.001). Encapsulated GIC presented statistically significant differences for the following periods: 6 months to 1 year (p=0.028) and baseline to 1 year (p=0.002). Encapsulated GIC presented superior cumulative survival rate than hand-mixed GIC over one year. Importantly, both GICs exhibited decreased survival over time. Encapsulated GIC promoted better ART performance, with an annual failure rate of 24%; in contrast, hand-mixed GIC demonstrated a failure rate of 42%.

Randomized clinical trial of encapsulated and hand-mixed glass-ionomer ART restorations: one-year follow-up

Abstract Objective This prospective, randomized, split-mouth clinical trial evaluated the clinical performance of conventional glass ionomer cement (GIC; Riva Self-Cure, SDI), supplied in capsules or in powder/liquid kits and placed in Class I cavities in permanent molars by the Atraumatic Restorative Treatment (ART) approach. Material and Methods A total of 80 restorations were randomly placed in 40 patients aged 11-15 years. Each patient received one restoration with each type of GIC. The restorations were evaluated after periods of 15 days (baseline), 6 months, and 1 year, according to ART criteria. Wilcoxon matched pairs, multivariate logistic regression, and Gehan-Wilcoxon tests were used for statistical analysis. Results Patients were evaluated after 15 days (n=40), 6 months (n=34), and 1 year (n=29). Encapsulated GICs showed significantly superior clinical performance compared with hand-mixed GICs at baseline (p=0.017), 6 months (p=0.001), and 1 year (p=0.026). For hand-mixed GIC, a statistically significant difference was only observed over the period of baseline to 1 year (p=0.001). Encapsulated GIC presented statistically significant differences for the following periods: 6 months to 1 year (p=0.028) and baseline to 1 year (p=0.002). Encapsulated GIC presented superior cumulative survival rate than hand-mixed GIC over one year. Importantly, both GICs exhibited decreased survival over time. Conclusions Encapsulated GIC promoted better ART performance, with an annual failure rate of 24%; in contrast, hand-mixed GIC demonstrated a failure rate of 42%.

Planejamento integrado periodontal e restaurador – relato de caso clínico / Integrated Periodontal and Restorative Planning – Case report

A aparência dos dentes e do tecido gengival ao redor dos mesmos tem um papel muito importante na estética da região anterior da maxila tendo em vista que, anormalidades na simetria e no contorno podem afetar significativamente a harmonia de uma dentição natural. O aumento de coroa clínica estético seguido de reanatomização dos dentes vem se tornando uma opção viável para pacientes com discrepâncias gengivais e dentárias. O objetivo do presente trabalho é apresentar o planejamento integrado periodontal e restaurador proposto em um caso clínico. O paciente foi diagnosticado com alterações na linha gengival do sorriso e presença de discrepâncias dentárias. Ele foi submetido à instrução de higiene bucal e rigoroso controle de placa bacteriana. Após o estudo do caso com auxílio de modelos de gesso, optou-se pela realização do aumento de coroa clínica estética e reanatomização dos dentes antero-superiores com resina composta. Este trabalho evidenciou a necessidade de um conhecimento multidisciplinar do cirurgião-dentista para realização de um plano de tratamento adequado, visando maior harmonia e estética do sorriso, buscando a satisfação do paciente para o sucesso final do tratamento.

The appearance of the teeth and the soft tissue around them have an important role in aesthetics of the maxillary anterior region since abnormalities in symmetry and contour can significantly affect the harmony of a natural dentition. The surgical crown lengthening and reconstruction of anterior teeth are becoming a viable option for patients with dento-gingival discrepancies. The aim of the present study is to show the integrated Periodontal and Restorative treatment planning porposed for the patient. The one showed excessive gingival display and tooth discrepancies. First of all the patient got oral hygiene instruction and underwent a rigorous plaque control. After analysing the case with the aid of study models, aesthetics crown lengthening was perfomed and reconstruction of anterior teeth with composite resin restorations were done. This paper has highlighted the need for a multidisciplinary knowledge of the dentist to suggest an appropriate treatment plan, seeking greater harmony and aesthetics of the smile and patients’ satisfaction for the success of treatment.

Curing depth of a silorane-based resin composite

Introduction: The silorane-based resin appears aiming to minimize the effects of polymerization shrinkage, but other properties must be studied. Objective: To evaluate the polymerization depth of two composites with different organic matrix. Material and methods: 80 cylindrical specimens were prepared using a metallic matrix, with three layers (top, middle and bottom), 1 mm high and 5 mm in diameter. The specimens were divided into eight groups (n = 10) according to the composite resins: Filtek P90 (3M/ESPE); Filtek Z250 (3M/ESPE), light-cured with a LED device with different irradiance and times (600mW/cm2 x 40s, 1000mW/cm2 x 40s, 1000mW/cm2 x 20s; 1400mW/cm2 x 20s). The irradiance was controlled by placing plastic rings coupled to the device's tip. Immediately after polymerization, the specimens' layers were separated and five Knoop microhardness readings (initial hardness) were performed on each one of the four layers (0, 1, 2, and 3 mm). After 7 day storage in water at 37ºC, new readings were performed (final microhardness). The data were analyzed by four-way ANOVA (resin, energy density, depth and time) and Tukey test (α = 0.05). Results: The microhardness decreased with the depth increasing both in the initial and 7 day readings. The hardness increased with the highest power densities. The resin P90 had lower hardness values. Conclusion: The silorane-based resin showed Knoop microhardness values significant smaller than those of methacrylate-based resin in almost all evaluated parameters. However, both presented similar behaviors in relation to the curing depth.

Efeito da variação da densidade de energia da ponta e da frequência na resistência de união à dentina de sistema adesivo convencional irradiado com diferentes laseres de alta potência / Variation of the effect of the energy density of the fiber tip and frequency in bond strength to irradiated conventional dentin bonding system with different high-power LASERs

O objetivo deste estudo foi comparar o efeito da irradiação de dois tipos de laser (laser Nd:YAG e de Diodo) sobre um sistema adesivo convencional de três passos, utilizando três diferentes densidades de energia da ponta, na resistência de união imediata e após 1 ano. Foram selecionados 70 dentes humanos e cada um teve sua coroa seccionada, expondo a superfície da dentina necessária para os procedimentos adesivos e restauradores. Após o preparo dos dentes, os mesmos foram aleatoriamente subdivididos em 7 grupos (n=10), sendo 6 grupos-teste e um grupo controle. Na sequência, foi aplicado o sistema adesivo Scotchbond™ Multi- Purpose Plus e, antes de sua fotoativação, em três grupos, o laser Nd:YAG foi utilizado com 3 diferentes densidades de energia (1 509,55 J/cm2, 2 254,77 J/cm2 e 3 127,38 J/cm2), o mesmo procedimento com as mesmas densidades foi realizado nos três demais grupos com o laser de Diodo. Após a irradiação seguida da fotoativação, os dentes foram restaurados com incrementos de resina composta Filtek™ Z250. Os dentes restaurados foram então imersos em água deionizada e mantidos em estufa a 37oC por um período de 7 dias. Após o armazenamento, os espécimes foram seccionados de modo que se obtivessem palitos com área transversal de aproximadamente 1mm2. De forma aleatória, estes palitos foram separados em 2 grupos: o primeiro submetido imediatamente a testes de microtração em uma máquina de ensaio universal INSTRON 3342 e segundo submetido ao mesmo processo após 1 ano de armazenamento. Os valores de resistência de união foram submetidos aos testes ANOVA e post hoc de Tukey, para que comparações individuais pudessem ser realizadas. Não houve diferença estatisticamente significante entre os lasers utilizados. Os grupos irradiados com ambos os lasers apresentaram resultados similares ao grupo controle, com exceção ao grupo que utilizou o laser de Diodo com menor densidade de energia da (GD3), no qual o resultado foi inferior ao...

The aim of this work was to compare the effect of the irradiation of two types of laser (Nd:YAG and diode laser) on a conventional three-step adhesive system, using three different energy densities of the fiber tip in bond strength immediately and after 1 year. 70 human teeth were selected, and each one had the crown sectioned, exposing the dentin surface for the adhesive and restorative procedures. After teeth preparation, they were randomly divided into 7 groups (n = 10), being 6 test-groups and one control group. Thus, the bonding system Scotchbond™ Multi-Purpose Plus was applied, and before light cured, the Nd:YAG laser was used in three groups, with three different energy densities of the fiber tip (1 - 509.55 J/cm2, 2 - 254.77 J/cm2 and 3 - 127.38 J/cm2), the same procedures with the same energy densities of the fiber tip were performed for the diode laser. After irradiation followed by light cured, the teeth were restored with composite resin increments (Filtek™ Z250). The restored teeth were immersed in deionized water and maintained in oven at 37oC for 7 days. After storage, the specimens were sectioned in order to obtain sticks with crosssectional area of approximately 1mm2. Randomly, these sticks were divided into 2 groups: the first one was submitted immediately to microtensile tests in a universal testing machine INSTRON 3342, and the second group was submitted to the same procedure after one year of storage. The bond strength values were submitted to ANOVA and Tukey post hoc tests for individual comparisons. There was no statistically significant difference between the laser s. Irradiated groups showed similar results to the control group, except for the group that used the diode laser with lower energy density of the fiber tip (GD3), in which the results were lower than the control group in the immediate moment. Significant reduction in the values of bond strength were observed, except for the groups that used the diode laser...

Efeito da variação da densidade de energia da ponta e da frequência na resistência de união à dentina de sistema adesivo convencional irradiado com diferentes laseres de alta potência / Variation of the effect of the energy density of the fiber tip and frequency in bond strength to irradiated conventional dentin bonding system with different high-power LASERs

O objetivo deste estudo foi comparar o efeito da irradiação de dois tipos de laser (laser Nd:YAG e de Diodo) sobre um sistema adesivo convencional de três passos, utilizando três diferentes densidades de energia da ponta, na resistência de união imediata e após 1 ano. Foram selecionados 70 dentes humanos e cada um teve sua coroa seccionada, expondo a superfície da dentina necessária para os procedimentos adesivos e restauradores. Após o preparo dos dentes, os mesmos foram aleatoriamente subdivididos em 7 grupos (n=10), sendo 6 grupos-teste e um grupo controle. Na sequência, foi aplicado o sistema adesivo Scotchbond™ Multi- Purpose Plus e, antes de sua fotoativação, em três grupos, o laser Nd:YAG foi utilizado com 3 diferentes densidades de energia (1 509,55 J/cm2, 2 254,77 J/cm2 e 3 127,38 J/cm2), o mesmo procedimento com as mesmas densidades foi realizado nos três demais grupos com o laser de Diodo. Após a irradiação seguida da fotoativação, os dentes foram restaurados com incrementos de resina composta Filtek™ Z250. Os dentes restaurados foram então imersos em água deionizada e mantidos em estufa a 37oC por um período de 7 dias. Após o armazenamento, os espécimes foram seccionados de modo que se obtivessem palitos com área transversal de aproximadamente 1mm2. De forma aleatória, estes palitos foram separados em 2 grupos: o primeiro submetido imediatamente a testes de microtração em uma máquina de ensaio universal INSTRON 3342 e segundo submetido ao mesmo processo após 1 ano de armazenamento. Os valores de resistência de união foram submetidos aos testes ANOVA e post hoc de Tukey, para que comparações individuais pudessem ser realizadas. Não houve diferença estatisticamente significante entre os lasers utilizados. Os grupos irradiados com ambos os lasers apresentaram resultados similares ao grupo controle, com exceção ao grupo que utilizou o laser de Diodo com menor densidade de energia da (GD3), no qual o resultado foi inferior ao...

The aim of this work was to compare the effect of the irradiation of two types of laser (Nd:YAG and diode laser) on a conventional three-step adhesive system, using three different energy densities of the fiber tip in bond strength immediately and after 1 year. 70 human teeth were selected, and each one had the crown sectioned, exposing the dentin surface for the adhesive and restorative procedures. After teeth preparation, they were randomly divided into 7 groups (n = 10), being 6 test-groups and one control group. Thus, the bonding system Scotchbond™ Multi-Purpose Plus was applied, and before light cured, the Nd:YAG laser was used in three groups, with three different energy densities of the fiber tip (1 - 509.55 J/cm2, 2 - 254.77 J/cm2 and 3 - 127.38 J/cm2), the same procedures with the same energy densities of the fiber tip were performed for the diode laser. After irradiation followed by light cured, the teeth were restored with composite resin increments (Filtek™ Z250). The restored teeth were immersed in deionized water and maintained in oven at 37oC for 7 days. After storage, the specimens were sectioned in order to obtain sticks with crosssectional area of approximately 1mm2. Randomly, these sticks were divided into 2 groups: the first one was submitted immediately to microtensile tests in a universal testing machine INSTRON 3342, and the second group was submitted to the same procedure after one year of storage. The bond strength values were submitted to ANOVA and Tukey post hoc tests for individual comparisons. There was no statistically significant difference between the laser s. Irradiated groups showed similar results to the control group, except for the group that used the diode laser with lower energy density of the fiber tip (GD3), in which the results were lower than the control group in the immediate moment. Significant reduction in the values of bond strength were observed, except for the groups that used the diode laser...

Idiopathic Osteosclerosis of the Jaw in a Brazilian Population: a Retrospective Study.

OBJECTIVES: To report cases of idiopathic osteosclerosis (IO), to review the literature on the subject, and to discuss its main characteristics, diagnosis, differential diagnosis, and treatment. MATERIAL AND METHODS: Retrospective analysis of 354 panoramic radiographs, searching for IO, its size, shape, location, and noting patients' demographic information. Literature review used Medline and Lilacs databases and the terms idiopathic osteosclerosis OR bone sclerosis OR dense bone island AND jaws. RESULTS: IO was identified in 5.6% of the radiographs (n=20 patients, 22 foci). Patients were healthy, with an age ranging from 5 to 51 years (mean=29.8), with male-female ratio of 3:2. IOs were found mainly in the premolar/molar region, at root apices, between roots, away from the teeth, laterally to the tooth, and in edentulous areas. The distribution between right and left sides of the jaw was equal for the 22 foci, with only one case in the maxilla. IOs were localized, well-defined, radiopaque, mostly round or ovoid in shape, but sometimes irregular. In some cases, IOs were similar to condensing osteitis, but differential diagnosis also considered complex odontoma, focal cemento-osseous dysplasia, and residual roots. Twenty studies on the topic were reviewed. CONCLUSIONS: Incidence of IO in the Brazilian sample was 5.6%, with age ranging from 5 to 51 years (mean=29.8), and male-female ratio of 3:2. The radiopacities occurred in different locations, with significant prevalence in the mandible. The findings and the literature review corroborate the hypothesis that IO should be considered developmental variation of normal bone that does not require treatment.

Avaliação da profundidade de polimerização através de testes de microdureza de duas resinas compostas de matrizes distintas em diferentes densidades de energia e períodos, utilizando LED como fonte fotoativadora / valuation of depth of cure by testing microhardness of two resin composites of different matrices in different energy densities and periods, using LED as a source photopolymerization

O presente estudo objetivou avaliar a profundidade de polimerização através de testes de microdureza em dois tipos de resina composta com matrizes distintas utilizando um aparelho fotoativador do tipo LED, empregando-se diferentes densidades de energia, sendo avaliados no período inicial (baseline) e após 7 dias. O método utilizado foi o teste de dureza Knoop em amostras de dois compósitos fotoativáveis (P 90, 3M/ESPE, cor A2; Z 250, 3M/ESPE, cor A2). Os corpos-de-prova foram subdivididos em 8 grupos (n=10), metade realizado com cada resina testada. Cada grupo foi definido através de diferentes densidades de energia (600 mW/cm2 x 40s; 1000 mW/cm2 x 40s; 1000 mW/cm2 x 20s; 1400 mW/cm2 x 20s), cada corpo-de- prova obtinha 4 medidas, diferentes profundidades (0, 1, 2 e 3 mm). Cada corpo-de-prova foi confeccionado com o auxilio de uma matriz metálica, constituída por 3 partes, superior, intermediaria e inferior, cada uma com 1 mm de espessura e orifício central com diâmetro de 5 mm. Sobre cada parte preenchida com resina, era colocado um pedaço de tira de poliéster, sobre o qual, com uma lâmina de vidro era exercida uma pressão para promover uma superfície lisa e plana. A unidade fotoativadora utilizada foi LED, para conseguir as diferentes densidades de potência, anéis de plástico foram acoplados na ponta do aparelho fotoativador. A fotoativação foi realizada com a ponta da unidade fotoativadora em contato com a tira de poliéster colocada na parte superior do corpo-de-prova (0 mm). Assim , cada espécime era composto por três partes, cada uma com 1 mm de espessura. Logo após a fotoativação, as partes dos espécimes eram separadas e realizavam-se 5 impressões de dureza Knoop (dureza inicial), com carga de 50g durante 30s, em 4 superfícies, que eram: 1ª) superfície superior da parte superior do espécime, voltada para a fonte de luz (0 mm); 2ª) superfície inferior da parte superior do espécime (1 mm); 3ª) superfície inferior da parte intermediária do espécime (2 mm)...

This study aimed to evaluate the depth of cure through microhardness tests on two types of resin composite with different matrices using LED curing unit, using different energy densities and are assessed during the initial (baseline) and after 7 days. Knoop hardness test was performed in samples made of two light cured composites (P 90, 3M/ESPE, A2; Z 250, 3M/ESPE, A2). The specimens were divided into 8 groups (n=10), and half of them were made with each composite resin tested. Each group was defined by different power densities (600 mW/cm2 x 40s, 1000 mW/cm2 x 40s, 1000 mW/cm2 x 20s; mW/cm2 1400 x 20s), each specimens obtained four measures, different depths (0, 1, 2 and 3 mm). Each specimens was made with the aid of a metal matrix, consisting of 3 parts, superior, intermediate and bottom, each with 1 mm thickness and center hole diameter of 5 mm. On each side filled with resin, was placed a piece of polyester strip, on which, with a glass slide was exerted pressure to promote a flat surface. A unit LED curing was used and to achieve different power densities, plastic rings were attached at the tip of the curing unit. The polymerization was carried out with the tip of the curing unit in contact with the polyester strip placed on top of the specimen (0 mm). Thus, each specimen was composed of three parts, each part with 1 mm thick. Immediately after curing, the parts of the specimens were separated and held up five impressions of Knoop hardness (initial hardness), with a load of 50g for 30s on 4 surfaces, which were: 1) the upper surface of the upper specimen directed to the light source (0 mm), 2) lower surface of the upper specimen (1 mm); 3) lower surface of the middle section of the specimen (2 mm) and 4) lower surface of the bottom of the specimen (3 mm). After 7 days of storage in an oven at 37°C, new hardness re adings were made (final hardness). It was found that: 1) The composite P 90 had lower average values of Knoop hardness in...