Fuentes de luz de uso clínico en el pre grado: 7 años de seguimento / Light curing units in the undergraduate dental clinics: 7 years of follow-up

RESUMEN Objetivo: Realizar, durante siete años ininterrumpidos, un control y seguimiento de las fuentes de luz disponibles en las clínicas odontológicas de pre graado de una Institución de Enseñanza Superior Pública Brasileña. Material y métodos: Durante el período comprendido entre 2011-2017 se evaluó el control de calidad de las fuentes de luz de la Facultad de Odontología de la Universidad Federal de Goiás a través del análisis de su estado de conservación y de su densidad de potencia (mW/cm2). Los datos obtenidos se sometieron a un análisis estadístico descritpivo y a las pruebas de Levene, Shapiro-Wilk, Kruskal-Wallis, Dunn y Chi-cuadrado (P<0,05). Resultados: No se observaron diferencias estadísticas significativas del estado de conservación de las fuentes de luz entre los años 2012, 2016 y 2017 (p>0,05). Sí se observaron diferencias estadísticas significativas entre los valores de densidad de potência entre dichos años (p<0,0001). En las comparaciones por pares, los valores de densidad de potencia para los años 2011 (p<0,01) y 2012 (p<0,05) fueron estadísticamente diferentes de los años 2015, 2016 y 2017. Conclusiones: Comparativamente se observó una mejora sustancial del estado de conservación de las fuentes de luz en los cuatro años iniciales de evaluaciones, con una disminución en el quinto año y una estabilización en los dos últimos años. Durante los siete años de estudio de la densidad de potencia de las fuentes de luz se observó en un aumento gradual de la misma con una estabilización de los resultados a partir del quinto año de control de calidad.

SUMMARY Objetive: To monitor the light curing units available at undergraduate dental clinics of a Brazilian Public Higher Education Institution for seven uninterrupted years. Materials and methods: In the period between 2011-2017, the quality control of light curing units at the Faculty of Dentistry, Federal University of Goiás, was evaluated by analyzing their state of conservation and power density (mW/cm2). Data obtained were subjected to descriptive statistical analysis and Levene, Shapiro-Wilk, Kruskal-Wallis, Dunn and Chi-square tests (P <0.05). Results: Regarding the conservation status of the light curing units, comparatively, there was no statistically significant difference between the years 2012, 2016 and 2017 (p> 0.05). Statistically significant differences were found for power density values between years (p <0.0001). In pairwise comparisons, the power density values for the years 2011 (p <0.01) and 2012 (p <0.05) were statistically different from the years 2015, 2016 and 2017. Conclusions: A significant improvement in the state of conservation of light curing units was observed in the initial four years of evaluations, with a decline in the fifth year and stabilization in the last two years. Regarding the power density of the light curing units, a gradual increase was observed in the seven years of study, with stabilization of the results after the fifth year of quality control.

Influence of different application protocols of universal adhesive system on the clinical behavior of Class I and II restorations of composite resin - a randomized and double-blind controlled clinical trial.

BACKGROUND: Multimode adhesives incorporate the versatility of adapting to various clinical situations by its capacity to be used in different protocols. This study aimed to evaluate the clinical behavior of composite resin direct restorations (Class I and II) performed with different universal dentin adhesive application protocols comparing adapted FDI and adapted USPHS criteria. METHODS: The current study is a randomized, double-blind, split-mouth, and convenience sample controlled clinical trial. The participants (age ≥ 18 years) had restorative need of Class I and/or II due to the presence of carious lesions and/or unsatisfactory restorations in at least three dental elements. Each participant received three application protocols for Scotchbond Universal adhesive (3M ESPE), one in each tooth to be restored: ER = etch-and-rinse + adhesive (n = 50); SEE = selective enamel etch + adhesive (n = 50) and SE = self-etch adhesive (n = 50). All teeth were restored in a similar way using Filtek™ Supreme composite resin (3M ESPE). Restorations were evaluated using the adapted FDI and adapted USPHS criteria, at baseline after 7 to 21 (12.02 ± 5.68) days (T1; n = 50 per group) and after 12 to 20 (15.8 ± 2.7) months (T2; n = 46 per group) by two previously calibrated evaluators (Kappa > 0.80). The statistical tests were performed between groups (Friedman), intragroup (Wilcoxon), and between the criteria considering acceptable and not acceptable restorations (McNemar), α = 0.05. RESULTS: A statistically significant difference was observed only for the property "superficial staining", between groups at T2 (p = 0.01) for ER (n = 13 with score 2 or more) and SEE (n = 3 with score 2 or more) and intragroup for ER (T1, n = 1 with score 2 or more; T2, n = 13 with score 2 or more, p = 0.001) and SE (T1, n = 0 with score 2 or more; T2, n = 8 with score 2 or more p = 0.007). For the other comparisons between groups, intragroup, and between the adapted FDI and adapted USPHS criteria, there were no statistically significant differences (p ≥ 0.05). CONCLUSIONS: It can be concluded that the different application protocols of the universal adhesive resulted in clinically "acceptable" restorations after 15.8 ± 2.7 months of follow-up. Adapted FDI and adapted USPHS criteria provided similar results to each other. TRIAL REGISTRATION: Number in Brazilian Registry of Clinical Trials (ReBEC): RBR-9p3hdp. Registered 24 May 2015.

Forças de contração de polimerização em resinas compostas constituídas com novas matrizes orgânicas e fotoativadas por diferentes técnicas / Polymerization shrinkage stress of composite resins containing new organic matrices and photocured by different techniques

Objetivo: Verificar a força de contração de polimerização de três diferentes resinas compostas em função de dois métodos de fotopolimerização (convencional e pulso tardio). Foram selecionados para o estudo três materiais, com diferentes matrizes orgânicas: Bis-GMA ­ Filtek Z250 XT (3M-ESPE, Saint Paul, Minnesotta, EUA); Silorano ­ Filtek P90 (3M-ESPE, Saint Paul, Minnesotta, EUA) e TCD-Uretano - Charisma Diamond (Heraeus Kulzer, São Paulo, São Paulo, Brasil). Material e Método: Os corpos de prova foram confeccionados a partir de uma matriz retangular de aço inoxidável (6mm x 1mm x 2mm), posicionados em uma máquina de ensaios universal (Instron, Modelo 5965) para registro da força de contração de polimerização (Newtons). A fotoativação foi executada em cada grupo com fonte de luz do tipo LED (600mW/cm2) sob dois protocolos de fotoativação: contínuo - 40s (600mW/cm2) e pulso tardio - 5s (600mW/cm2) + 1 min sem luz + 35s (600mW/ cm2). Considerou-se como força de contração o valor registrado pela máquina de ensaios 2 minutos após o início da aplicação da luz no espécime. Os valores obtidos foram submetidos à análise de variância (ANOVA), seguido pelo teste de Tukey (p=0,05). Resultados: Não houve diferença estatística significativa entre as duas técnicas de polimerização testadas nas resinas compostas à base de silorano e TCD-Uretano, porém, houve diferença para a resina à base de Bis-GMA. Conclusão: A técnica de pulso influenciou positivamente na redução da força de contração em matriz polimérica à base de Bis-GMA, entretanto, não promoveu benefícios para as resinas à base de silorano e TCD-Uretano. PALAVRAS-CHAVE: Contração; Fotopolimerização

Purpose: To evaluate the polymerization shrinkage stress of three different composite resins cured with two methods photopolymerization (conventional and pulse delay). Three materials were selected for the study, with different organic matrices: Bis- GMA - Filtek Z250 XT (3M-ESPE, Saint Paul, Minenesotta, USA); Silorano - Filtek P90 (3M-ESPE, Saint Paul, Minenesotta, USA) e TCD-Uretane - Charisma Diamond (Heraeus Kulzer, São Paulo, São Paulo, Brazil). Materials and Method: The samples were made from a stainless steel matrix with rectangular internal geometry (6mm x 1mm x 2mm), which was mounted in an universal testing machine (Instron, Model 5965) in order to register the polymerization shrinkage stress (Newtons). The photoactivation was performed in each group with a LED (600mW/cm) light source, under two photoactivation protocols: continuous - 40s (600mW/cm) and pulse delay - 5s (600mW/cm) + 1 min with no light + 35s (600mW/cm). It was considered as shrinkage stress the value registered by the testing machine two minutes after the start of the specimen's cure. The values obtained were subjected to Analysis of Variance (ANOVA), followed by the Tukey test (p=0.05). Results: There was no significant statistical difference between the two polymerization techniques tested in the composite resins based on silorane and TCD-Urethane, but there was difference in the resin based on Bis-GMA. Conclusion: The pulse delay technique positively influenced in reducing the shrinkage stress in the polymeric matrix made of Bis- GMA, but did not provide benefits to resins made of silorane and TCD-Urethane.

Resinas compostas: alterações dimensionais em função da composição e do método de irradiação de luz / Resin composites: dimensional changes in relation to composition and polymerization methods

Objetivo: Avaliar e comparar a força de contração de polimerização de duas resinas compostas (microhíbrida e de preenchimento em bloco "bulk fill") utilizando dois métodos de polimerização (uniforme contínua "convencional" e pulso tardio). Material e método: Quarenta corpos de prova (CP) foram confeccionados (6x1x2mm), sendo 20 CP com a resina composta de preenchimento em bloco "bulk fill" x-tra fil (VOCO) e 20 CP com a resina micro-híbrida Filtek Z250 (3M ESPE). Para cada resina composta a ser testada metade dos corpos de prova (10 CP) foram fotopolimerizados pela técnica convencional [40s contínuos] e a outra metade (10 CP) com a técnica de irradiação pulso tardio [5s, seguida de 1 min de intervalo e mais 35s]. A fotopolimerização foi realizada com fonte de luz LED com 1250 mW/cm². A força de contração, em Newtons (N) foi considerada como o valor registrado pela máquina de ensaios, 2 min após o início da aplicação da luz no CP. Os dados obtidos foram submetidos à análise estatística descritiva, ANOVA a dois critérios e Tukey (P<0,05). Resultados: Diferenças estatisticamente significativas foram observadas para as resinas compostas testadas (P<0,001) e para os métodos de polimerização (P=0,001). Conclusões: A técnica de fotopolimerização convencional e a resina composta microhíbrida produziram menor força de contração de polimerização.

Objective: Evaluating and comparing the polymerization contraction force of two composite resins (microhybrid and bulk fill) using two different methods of polymerization (conventional - continuous uniform and late pulse). Material and methods: 40 specimens (CP) were made (6x1x2mm). 20 CP were made with the bulk fill composite resin x-tra fil (VOCO) and 20 CP with the FiltekZ250 (3M ESPE) microhybrid resin. For each composite resin to be tested half of the specimens (10 CP) was photopolymerized by the conventional technique [40s continuous] and the other half (10 CP) by the late pulse irradiation technique [5s, followed by 1 min interval, and 35s]. The photopolymerization was performed with a 1250 mW/cm² LED light source. The force of contraction, in Newtons (N) was considered as the value recorded by the test machine, 2 min after the beginning of the application of the light in the CP. Data were submitted to descriptive statistical analysis, ANOVA at two criteria, and Tukey (P <0.05). Results: Statistically significant differences were observed for the composite resins tested (P <0.001) and for the polymerization methods (P = 0.001). Conclusion: The conventional photopolymerization technique and the microhybrid composite resin produced a smaller polymerization contraction force.

Estudo radiográfico da inter-relação dos guias condiliana e anterior em pacientes com oclusão fisiológica / Radiographic study of inter-relationship of condylar guidance and anterior guidance in patients with physiological occlusion

Objetivo: O presente trabalho busca avaliar radiograficamente a possível inter-relação dos guias condiliana e anterior em pacientes com oclusão fisiológica. Material e métodos: Para tal, foram selecionadas telerradiografias laterais de 74 pacientes que foram divididos em dois grupos distintos, denominados grupo Um e grupo Dois. O grupo Um, constituído de 56 pacientes, apresentou trespasse horizontal igual a zero e oclusão fisiológica. Já o grupo Dois, composto de 18 participantes, apresentou trespasse horizontal diferente de zero. Foi realizada uma análise cefalométrica avaliada por meio da relação entre o plano de Frankfurt e a parede anterior da superfície articular do osso temporal e da face palatina dos incisivos superiores. Utilizou-se um transferidor de plástico, com variação de 0 a 180o, adaptado com um ponteiro fixado no seu centro e móvel, por meio do qual obteve-se as mensurações pela movimentação do ponteiro, cujos os dados foram anotados em uma ficha. Resultado: Do grupo Um, 52 (92,86%) apresentaram coincidência entre o guia condiliana guia anterior, e somente 4 pacientes (7,14%) não tiveram os guias coincidentes. Já o grupo Dois 17 pacientes (94,44%) apresentou guia anterior diferente da guia condiliana, e um paciente (5,56%) apresentou coincidência entre os guias. Conclusão: Com base nos resultados obtidos pode-se concluir que os guias condiliana e anterior apresentaram uma interrelação direta, que constituem parâmetros para a reconstrução e/ou posicionamento da guia anterior em tratamentos reabilitadores.

Objective: This study aims to evaluate radiographically the possible inter-relation of the condylar and previous guidances in patients with physiological occlusion. Methods: For this purpose, lateral cephalometric radiographs were selected from 74 patients who were divided into two distinct groups, called group one and group two. The group one consisting of 56 patients, showed overjet equal to zero and physiological occlusion. While group two, made up of 18 patients presented different overjet zero. The cephalometric analysis was evaluated through the relationship between the Frankfurt plane and the front surface wall joint of the temporal bone and the palatal face of the upper incisors was performed. It were used a plastic measuring protractor, ranging from 0 to 180o, fitted with a fixed pointer at its center and mobile, through which were obtained measurements by moving the pointer, whose data were recorded on a card. Results: From a group, 52 (92.86%) had coincidence between the condylar guidance and the previous guidance, and only 4 patients (7.14%) did not have the matching guidances. Already the group two 17 patients (94.44%) had different previous guide condylar guide, and one patient (5.56%) had coincidence between the guides. Conclusion: Based on the results it can be concluded that the condylar guidances and earlier had a direct inter-relation, which are parameters for reconstruction and / or positioning of the previous guidance rehabilitation treatments.

Sintomatologia dolorosa na articulação temporomandibular após o uso do mecanismo de avanço mandibular para tratar apneia do sono / Symptomatology painful assessment in joint temporomandibular after advancing mechanism using mandibular for treating sleep apnea

Introdução: a apneia obstrutiva do sono é uma síndrome que provoca surtos de parada respiratória devido à obstrução das vias aéreas superiores durante o sono e pode ser tão severa que o tempo sem respiração pode superar a respiração normal durante o período de uma hora. Objetivo: avaliar a sintomatologia da dor na ATM após o uso do Mecanismo de Avanço Mandibular (MAD) como parte do tratamento da apneia do sono. Material e métodos: foram avaliados 21 pacientes, todos usuários de placa reposicionadora da mandíbula para anterior e com apneia do sono, que foram orientados a utilizá-la no período noturno, durante seis meses. Cada paciente foi avaliado mensalmente, cujos dados da anamnese foram anotados em ficha apropriada. Resultados: de todos os pacientes avaliados na consulta inicial nenhum apresentou dor à palpação nas ATM. Durante o período de avaliação observou-se que os pacientes apresentaram sintomatologia dolorosa em graus variados com o uso da placa. Conclusão: constatou-se que esta modalidade de tratamento desencadeou dor nas articulações temporomandibulares.

Introduction: Obstructive sleep apnea is a syndrome that causes respiratory arrest outbreaks due to obstruction of the upper airway during sleep and can be so severe that the time without breathing can overcome the normal breathing during the period of one hour. Objective: To evaluate the symptoms of TMJ pain after using the Mandibular Advancement Mechanism (MAD) as part of the treatment of sleep apnea. Methods: 21 patients were evaluated, all repositioning splints users jaw to previous and sleep apnea, which were instructed to use it at night for six months. Each patient was evaluated monthly, whose interview data were recorded in appropriate form. Results: all patients evaluated in the initial consultation showed no pain on palpation in the ATM. During the trial period, it was observed that the patients had a painful symptoms in varying degrees by using the plate. Conclusion: it was found that this treatment triggered pain in the temporomandibular joints.

Utilização da metodologia "problem based learning" na disciplina de oclusão, na FO/UFG / Use of the methodology "problem based learning" in the discipline of occlusion, in FO/UFG

Objetivo: Este estudo constituiu-se na aplicação da metodologia PBL (Problem-Based Learning) na disciplina de Oclusão. Material e métodos: a amostra constituiu-se de 59 estudantes matriculados na disciplina de Oclusão da FO-UFG, do ano letivo em curso, que foram divididos em seis grupos, sendo cinco composto de 10 alunos e um com 9 alunos. Cada conteúdo da disciplina foi realizado por meio de casos clínicos previamente elaborados e discutidos sequencialmente e de acordo com o grau de complexibilidade do assunto, em módulos, orientados por um tutor. Na última etapa aplicou-se um questionário, por meio do qual observou-se as percepções dos acadêmicos acerca da metodologia utilizada, cujos resultados foram tabulados e analisados estatisticamente por porcentagem simples. Resultados: verificou-se que o método foi eficaz (61%), despertou o interesse pela disciplina e a busca de conhecimento na literatura (52%), possibilitou aferir o conhecimento do estudante (86,4%) ao passo que 5,1% afirmaram que esse método não foi capaz de aferir conhecimento. Conclusões: constatou-se que o método utilizado de ensino-aprendizagem estimulou o estudante a aprender a aprender possibilitando que ele tenha uma visão integral da disciplina dentro do contexto do curso de odontologia.

Objective: This study consisted in the application of PBL methodology (Problem-Based Learning) in the discipline of occlusion. Methods: the show consisted of 59 students enrolled in the course Occlusion FO-UFG, the school year, which were divided into six groups, five composed of 10 students and one with 9 students. Each content of the course was conducted through clinical cases previously prepared and discussed sequentially and according to the degree of complexity of the subject, in modules, guided by a tutor. In the last step was applied a questionnaire, through which there was the perceptions of academics about the methodology used, the results were statistically analyzed using percentages. Results: it was found that the method was effective (61%), aroused the interest of discipline and the pursuit of knowledge in the literature (52%), made possible to assess the student's knowledge (86.4%) whereas 5.1 % stated that this method was not able to assess knowledge. Conclusions: it was found that the method of teaching and learning encouraged students to learn to learn enabling it to have a comprehensive view of the subject within the dentistry course content.

Verificação do uso de próteses dentárias em servidores da UFG / Evaluation of the use of the dental prosthesis among UFG employees

Objetivo: O presente trabalho tem como objetivo a verificação do uso de próteses dentárias em servidores da Universidade Federal de Goiás. Material e Método: Trata-se de uma pesquisa documental por meio de levantamento retrospectivo do uso de próteses dentárias qualitativa e quantitativamente no meio dos servidores técnico-administrativos da Universidade Federal de Goiás no período de cinco anos. As estratégias de coleta de dados foram, pelo preenchimento dos dados contidos em uma ficha apropriada, embasados na literatura pertinente. Resultados: A amostra constituiu de 5 prontuários analisados, sendo que 26% não são usuários de próteses e os outros 74% são portadores de próteses, dos quais 57% são mulheres e 43% são homens. Dessa amostra analisada, observou-se que 56,76% apresentaram-se com prótese parcial fixa; 5,41% prótese sobre implante; 2,70% prótese total bimaxilar; 29,73% prótese total associada à prótese parcial removível; 2,70% próteses total, fixa e removível; 2,70% prótese total. Conclusão: Com base nesses resultados, sugere-se que incremente subsídios e programas para o provável redirecionamento de serviço, bem como, de se estabelecer políticas de promoção e prevenção da saúde.

Objective: This study aims to verify the use of dental prostheses on servers at the Federal University of Goiás Methods: It is this work of documentary research through a retrospective survey of the use of qualitative and quantitative dentures among the technical and administrative staff of the Federal University of Goiás in the five-year period. Data collection strategies were at filling the data in an appropriate form, grounded in the literature. Results: The sample consisted of 50 charts analyzed, of which 26% are non users of prosthesis and the other 74% are carriers of prostheses, of which 57% are women and 43% are men. This sample analyzed, it was found that 56.76% showed with fixed partial denture; 5.41% prosthesis over the implant; 2.70% Total prosthesis bimaxilar; 29.73% Total prosthesis associated with a removable partial denture; 2.70% Total dentures, fixed and removable; 2.70% dentures. Conclusion: Based on these results, it is suggested that increases subsidies and programs for the probable redirection service, as well as to establish promotion and health prevention policies.

Clinical effectiveness of light-curing units of the School of Dentistry of the Federal University of Goias

Introduction: The clinical longevity of the procedures is directly associated to the adequate activation (photopolymerization) of adhesive restorative materials. Objective: To evaluate and compare by allocation the conservation status and power density of the light-curing units available at the School of Dentistry of the Federal University of Goias (FO/FUG) for clinical care. Material and methods: The following information and specific techniques of all light sources existing at FO/UFG, available for clinical care in 2011, were collected: dental/ambulatory clinic where they are located, type of source [device of halogen light and light-emitting diode (LED)], brand, parallelism test (halogen light sources), state of conservation of the light transmitter tip, density of the potency/intensity/irradiance in mW/cm2 and acquisition date. The data obtained were submitted to one-way ANOVA (Analysis of Variance) and Turkey test for multiple comparisons (P < 0.05). Results: In the second half of 2011, FO/UFG had 20 light sources (04 halogens and 16 LEDs), of which 90% were found in inadequate condition and 55% of those with power density less than 300 mW/cm2. There was no statistically significant difference in the power density between halogen and LED sources tested (P = 0.526). Likewise, no statistical difference was observed between the power density of the light sources (LED) placed at the Clinic II and III (P = 0.479). Also there was no statistically significant difference between the light sources (LED Halogen X) at the Clinic I (P = 0.943). Conclusion: The light sources regardless of the clinic in which they were located presented mostly with inadequate clinical effectiveness in terms of their conservation status and power density.

Uma revisão para colagem direta de braquetes ortodônticos / A review of direct bonding of orthodontics brackets

A aparente simplicidade do procedimento de colagem de braquetes pode levar a erros. Essa etapa pode, indubitavelmente, ser mal realizada, até por ortodontistas experientes que não realizam os procedimentos com cuidado e a técnica adequada. O propósito dessa revisão de literatura foi aperfeiçoar os resultados e, portanto, melhorar o tratamento ao paciente. Em um levantamento bibliográfico, procurou-se descrever as melhores soluções obtidas em experimentos prévios, nos vários passos clínicos que envolvem a colagem de braquetes em superfície de esmalte, metálica, porcelana entre outras.

Influence of ceramic surface treatment on shear bond strength of ceramic brackets.

OBJECTIVE: To compare four different surface treatment methods and determine which produces adequate bond strength between ceramic brackets and facets of porcelain (feldspathic), and evaluate the Adhesive Remnant Index (ARI) scores. MATERIALS AND METHODS: Ten facets of porcelain specimens with glazed surfaces were used for each group. The specimens were randomly assigned to one of the following treatment conditions of the porcelain surface: (1) no surface treatment (control group), (2) fine diamond bur + orthophosphoric acid gel 37%, (3) hydrofluoric acid (HFL) 10%, and (4) HFL 10% + silane. Ceramic brackets were bonded with the adhesive cement Transbond XT. The shear bond strength values were measured on a universal testing machine at a crosshead speed of 0.5 mm/min. RESULTS: There was a significant difference (P<0.05) between the control group and all other groups. There was no significant difference (P<0.05) between treated porcelain surface with diamond bur + orthophosphoric acid gel 37% (4.8 MPa) and HFL 10% (6.1 MPa), but the group treated with HFL 10% had clinically acceptable bond strength values. The group treated with HFL 10% + silane (17.5 MPa) resulted in a statistically significant higher tensile bond strength (P<0.05). In group 4, 20% of the porcelain facets displayed damage. CONCLUSION: Etching of the surface with HFL increased the bond strength values. Silane application was recommended to bond a ceramic bracket to the porcelain surface in order to achieve bond strengths that are clinically acceptable.

Influência do modelo experimental na atividade antimicrobiana do MTA e cimento portland / Influence of experimental model on antmicrobial activity of mineral trioxide agregate and portland cement

Estudou-se a influência do modelo experimental no efeito antimicrobiano do MTA (Cinza e Branco) e do cimento Portland (Cinza e Branco). Utilizou-se o Enterococcus faecalis, isoladamente ou associado a uma mistura com outros microrganismos: Staphylococcus aureus, Pseudomonas aeruginosa e Bacillus subitilis e um fungo, a Candida albicans. Para o teste por contato direto, 108 cones de papel foram contaminados e expostos aos materiais seladores por 24, 48 e 72 horas. Os cones de papel foram imersos em 10 mL de Letheen Broth e incubados a 37°C por 48 horas. Na seqüência, um inóculo de 0,1 mL do Letheen Broth foi transferido para 10 mL de Brain Heart Infusion sob as mesmas condições de incubação, para posterior avaliação do crescimento microbiano. Para o teste de difusão em ágar, 24 placas de Petri com 20 mL de BHI ágar foram inoculados com 0,1 mL das suspensões microbianas descritas. Para cada placa, cinco cavidades com 4 mm de profundidade e 4 mm de diâmetro foram preparadas e preenchidas com um dos seladores testados (n=10). As placas foram pré-incubadas por uma hora em temperatura ambiente e, a seguir, incubadas a 37ºC por 48 horas. As zonas de inibição microbiana foram medidas em milímetros. O modelo experimental empregado influenciou nos resultados. Os agentes seladores testados apresentaram efetividade antimicrobiana decorridas 24 horas de exposição por contato direto e inefetivos por meio de difusão em Agar.

The antimicrobial effect of MTA (gray and white) and of Portland cement (gray and white) was studied through two experimental methods. For this purpose, it was used Enterococcus faecalis, isolated or associated to a mixture of three microorganisms: Staphylococcus aureus, Pseudomonas aeruginosa, Bacillus subitilis, and Candida albicans. For direct contact test, 108 paper points were contaminated and exposed to sealer materials for 24, 48 and 72 hours. The paper points were immersed in 10 mL of Letheen Broth and incubated at 37 Celsius degrees for 48 hours. After that, an inoculum of 0,1 mL of Letheen Broth was transferred to 10,0 mL of Brain Heart Infusion under the same incubation conditions, and then microbial growth was evaluated. For agar diffusion test, 24 Petri plates with 20 mL of BHI agar were inoculated with 0,1 mL of microbial suspension using sterilized swabs. For each plate, five holes 4 mm deep and with 4 mm of diameter were prepared and filled with one of the tested sealers (n = 10). Plates were preincubated for one hour in room temperature and then incubated at 37 Celsius degrees for 48 hours. Microbial inhibition zones were measured in millimeters. The experimental model influenced in the results. All sealer agents tested were effective after 24 hours in direct contact with E. faecalis and the microbial mixture. The agar diffusion test showed that no agent presented antimicrobial effectiveness on biological indicators.

Escultura progressiva e estratificação de cores em dentes posteriores: passo a passo / Progressive sculpture and shade stratification in posterior teeth: step-by-step

Este trabalho descreve uma sequencia clínica de restauração de cavidade de classe I, em que se utiliza a técnica de escultura progressiva com estratificação de cor. O dente selecionado para realização da sequencia é um primeiro molar inferior direito (46), com restauração de amálgama deficiente. Foram utilizadas as resinas A2D para dentina, W para caracterização das vertentes, A2E e CT para esmalte, todas Filtek Supreme (3M ESPE). Ao restaurar diretamente os dentes posteriores com resina composta, os cirurgiões-dentistas devem ter compreensão integral da morfologia do dente, combinada com as técnicas apropriadas, esboçadas no caso clínico, a fim de obter uma restauração estética aceitável. A técnica apresenta-se como ferramenta útil para os profissionais, pois fornece restaurações de alta qualidade, que reproduzem as propriedades ópticas e morfológicas dos tecidos dentários.

The aim of this article is to describe the clinical protocol of a Class I cavity restoration using the progressive sculpture with shade stratification. A right mandibular first molar (46) presenting a defective amalgam restoration was selected, and the shades were selected (A2D for dentin, W (white) for characterization, and A2E and CT for enamel, Filtek Supreme®, 3M ESPE). Dentists must have an integral understanding of tooth morphology when making direction restorations in posterior teeth using composite resin. This knowledge should be associated with appropriate techniques, to produce acceptable esthetic restorations which reproduce the optical and morphological properties of dental tissues.

Hipoplasia do esmalte: tratamento restaurador estético / Enamel hipoplasia: aesthetic restorative treatment

A hipoplasia do esmalte é uma formação incompleta ou deficiente da matriz orgânica do esmalte. Clinicamente, apresenta-se como manchas esbranquiçadas, rugosas, sulcos ou ranhuras, bem como, outras alterações na estrutura do esmalte, comprometendo a estética do sorriso. De acordo com o grau de severidade dessa anomalia, vários protocolos de tratamento podem ser realizados, desde clareamento, microabrasão, restaurações estéticas diretas e coroas unitárias. Desta forma, objetiva-se apresentar o diagnóstico e o tratamento restaurador estético de um caso clínico de hipoplasia do esmalte. Paciente gênero feminino procurou a FO-UFG queixando-se de manchas brancas nos dentes anteriores. Clinicamente, observou-se nos terços médio e incisal dos incisivos centrais superiores a presença de manchas esbranquiçadas profundas e leve alteração do contorno incisal, adotando-se um tratamento estético restaurador direto. As estruturas hipoplásicas nos dentes 11 e 21 foram desgastadas limitando-se à remoção da estrutura dentária afetada. Após o condicionamento ácido e aplicação do sistema adesivo, realizou-se a restauração com resina composta micro-híbrida pela estratificação da dentina e esmalte, seguido pelo acabamento e polimento das restaurações. A partir do tratamento pôde restabelecer a harmonia estética, propiciando significativo impacto positivo à auto-estima da paciente.

The enamel hypoplasia is an incomplete or deficient formation of the enamel organic matrix. It can appear by hereditary origin or by a consequence of systemic or local events that happen during teeth development. It comes as whitish, wrinkled, sulcus and grooves stains, as well as, other alterations in the enamel structure. Clinically, it appears with no enamel or just part of it, presenting an unsatisfactory aesthetics. In agreement with this anomaly degree of severity, several treatment protocols can be realized since whitening and microabrasion, until conservative aesthetic restorations and artificial crown. Therefore, the aim of this study is to present a clinical case that reports an option of enamel hypoplasia treatment. Female patient, 9, accompanied by her mother, sought the FO-UFG complaining about white stains in her permanents teeth. During the anamnesis the mother told that white stains just appeared in the moment of permanent incisors eruption. Clinically, it was observed in the middle and incisal thirds of the upper central incisors the presence of whitish spots profound and light alteration of the contour incisal, adopting a treatment is direct aesthetic restorative. The structures hypoplastic in 11 and 21 teeth were worn only to the removal of the affected tooth structure. After etching and application of adhesive system, there was the restoration with micro-hybrid resin composite by stratification of the enamel and dentin, followed by finishing and polishing of restorations. From the treatment could restore the aesthetic harmony, providing significant positive impact on self-esteem of the patient.

Influence of pulse-delay curing on sorption and solubility of a composite resin

The purpose of this study was to evaluate the sorption and solubility of a composite resin (TPH³; Dentsply) cured with halogen light due to different storage media and curing modes. The methodology was based on the ISO 4049 standard. Two independent groups were established according to the storage time (7 days-G1; 60 days-G2). A stainless steel mould (2 mm x 8 mm Ø) was used. The selected curing modes were: I (Conventional - C): 40s - 600 mW/cm²; II (Pulse I - PD): 3 s - 200 mW/cm² + 2 min (delay) + 39 s - 600 mW/cm²; III (Pulse II): 10 s - 200 mW/cm² + 2 min (delay) + 37 s - 600 mW/cm²; IV (Pulse III): 3 s- 600 mW/cm² + 2 min (delay) + 37 s -600 mW/cm². The media used were: distilled water, 75 percent ethanol and 100 percent chlorophorm. Five repetitions were made for each group. The specimens were placed in a desiccator at 37ºC for 24 h and, after that, at 23ºC for 1 h to be weighed until a constant mass (m1) was obtained. The discs were immersed separately into the 3 media for 7 days (G1) and 60 days (G2), and thereafter reweighed (m2). The reconditioning in the desiccator was done until a constant mass (m3) was obtained. Sorption and solubility were calculated and the data of G1 and the sorption data of G2 were subjected to two-way ANOVA and Tukey's tests (p=0.05). The solubility data of G2 were analyzed by Kruskal-Wallis test (p=0.05). For G1 and G2, no statistically significant differences were found in sorption among curing techniques (p>0.05). The solubility values were negative, which means that there was mass gain. Regarding the storage media, in G2 chlorophorm had the highest sorption values. It may be concluded that the curing modes (C and PD I, II and III) did not affect the sorption of the tested composite resin. However, different storage media influenced sorption behavior. The solubility test demonstrated negative data, masking the real solubility.

Influence of pulse-delay curing on sorption and solubility of a composite resin.

The purpose of this study was to evaluate the sorption and solubility of a composite resin (TPH(3); Dentsply) cured with halogen light due to different storage media and curing modes. The methodology was based on the ISO 4049 standard. Two independent groups were established according to the storage time (7 days-G1; 60 days-G2). A stainless steel mould (2 mm x 8 mm Ø) was used. The selected curing modes were: I (Conventional - C): 40s - 600 mW/cm(2); II (Pulse I - PD): 3 s - 200 mW/cm(2) + 2 min (delay) + 39 s - 600 mW/cm(2); III (Pulse II): 10 s - 200 mW/cm(2) + 2 min (delay) + 37 s - 600 mW/cm(2); IV (Pulse III): 3 s- 600 mW/cm(2) + 2 min (delay) + 37 s -600 mW/cm(2). The media used were: distilled water, 75% ethanol and 100% chlorophorm. Five repetitions were made for each group. The specimens were placed in a desiccator at 37 masculineC for 24 h and, after that, at 23 masculineC for 1 h to be weighed until a constant mass (m1) was obtained. The discs were immersed separately into the 3 media for 7 days (G1) and 60 days (G2), and thereafter reweighed (m2). The reconditioning in the desiccator was done until a constant mass (m3) was obtained. Sorption and solubility were calculated and the data of G1 and the sorption data of G2 were subjected to two-way ANOVA and Tukey's tests (p=0.05). The solubility data of G2 were analyzed by Kruskal-Wallis test (p=0.05). For G1 and G2, no statistically significant differences were found in sorption among curing techniques (p>0.05). The solubility values were negative, which means that there was mass gain. Regarding the storage media, in G2 chlorophorm had the highest sorption values. It may be concluded that the curing modes (C and PD I, II and III) did not affect the sorption of the tested composite resin. However, different storage media influenced sorption behavior. The solubility test demonstrated negative data, masking the real solubility.

Análise legal de embalagens de limas tipo Kerr. Parte I : informações sobre fabricantes, importadores e características do produto / Legal analysis of K-File package. Part I: information about manufacturers, importers and product features

O presente trabalho tem como objetivo analisar os dados dispostos nas embalagens, rótulos e instruções de uso das limas endodônticas tipo Kerr, com vistas a verificar se há adequação das informações sobre fabricantes, importadores e características do referido produto às normasvigentes da ANVISA, ao Código de Defesa do Consumidor e a outras regulamentações correlatas, com ênfase nas repercussões de interesse legal. Para tanto, foram visitados 29 estabelecimentos de comércio varejista de produtos odontológicos e adquiridas 11 amostras de diferentes marcas comerciais de limas tipo Kerr da primeira série completa (15-40), confrontando as informações disponibilizadas com as determinações legais. Verificou-se ausência e/ou insuficiência deinformações legalmente exigidas, com variações quanto ao tipo de dado faltante ou inadequado conforme as diferentes marcas. Destacam-se aspectos sobre registro do produto na ANVISA, prazo de validade e forma de disponibilização dos dados. Quanto ao registro, 3 marcas não oexibiam, em descumprimento da norma vigente. Sobre o prazo de validade, 6 marcas apresentavam validade indeterminada, apenas 1 exibia um prazo de nove anos e as demais não indicavam informação sobre este item. Quanto à forma de disponibilização, verificou-se que o maior número de informações vem impresso em adesivos ou gravados diretamente sobre a embalagem comercial, com insuficiência de dados, em detrimento de instruções de uso mais completas. Sendo as limasendodônticas classificadas pela ANVISA como produto médico invasivo cirurgicamente, de uso transitório e reutilizável, torna-se fundamental que contenham as mínimas informações necessárias que garantam sua utilização adequada, para a segurança do profissional e do assistido.

The present paper aims at analyzing data disposed in packages, labels and instructions for use of endodontic K-files, in order to verify if the information on manufacturers, importers and product features observe the current norms by ANVISA, the Consumer's Defense Code andother related regulations, emphasizing legal repercussions. Twenty-nine dental business stores were visited and eleven samples of different trademarks of K-files first series (15-40) were acquired and338 Silva et al. Revista de Odontologia da UNESP submitted to an analysis based on legal orders. Lack and/or failure of legally required informationwere verified, with changes in relation to the type of missing or inadequate data according to the different trademarks. Aspects about product registration, expiry date and the way data is presentedin the product must be highlighted as some of the important results of this study. About registration, three trademarks did not show this item, violating current rules. Concerning expiry date, six trademarks showed undetermined validity, only one displayed a nine-year limit and there was no mention about this aspect on the others. Also, a great number of information is presented in the product on adhesive tapes or printed directly on the package surface, but insufficiently, insteadof more complete instructions for use. Since endodontic K-files are classified by ANVISA as surgically invasive medical products, for transitory use and as reusable items, they must containthe minimum necessary information to guarantee its adequate use, on behalf of both professional and patient.

Removal of the smear layer from flattened canals using different chemical substances.

This study used scanning electron microscopy to evaluate the flattened root canals of human mandibular incisors cleaned with nickel-titanium instruments and different chemical substances. Teeth were selected and divided randomly into five groups (n = 10) according to the chemical substances used in the biomechanical preparation: 5.25% sodium hypochlorite (Group 1), 5.25% sodium hypochlorite plus a final irrigation with 17% EDTAC (Group 2), EDTA gel combined with 5.25% sodium hypochlorite (Group 3), 2% chlorhexidine gel (Group 4), and 5.25% sodium hypochlorite combined with Glyde File Prep gel (Group 5). Data analysis showed a statistically significant difference (p < 0.001) among groups. Groups 1 and 5 were similar statistically (p > 0.001) and displayed a higher amount of smear layer on canal walls. Samples from Groups 2, 3, and 4 revealed root canal walls without smear layer and exposed dentin tubules. Among the associations tested in this study, 5.25% sodium hypochlorite solution combined with 17% EDTAC, 5.25% sodium hypochlorite combined with EDTA gel, and 2% chlorhexidine gel all were effective substances for removing the smear layer from flattened root canals.

Importância pericial dos registros odontológicos decorrentes de tratamento restaurador / Forensic relevance of dental records obtained from the restorative treatment

Durante a execução dos diversos tipos de tratamentos odontológicos, o cirurgião-dentista tem a necessidade e obrigação de registrar adequadamente, no prontuário odontológico, todos os procedimentos realizados na cavidade bucal, além das particularidades que o paciente já apresenta. A importância destes registros está relacionada a uma finalidade primordialmente clínica, visando propiciar o acompanhamento adequado dos tratamentos efetuados, a qualquer tempo. Entretanto, esta mesma documentação pode subsidiar relevantemente nos casos de identificação humana, principalmente nas situações em que os cadáveres encontram-se irreconhecíveis. Neste contexto, o presente trabalho tem como objetivo relatar um caso pericial em que um indivíduo encontrado carbonizado, em decorrência de acidente automobilístico seguido de incêndio, foi positivamente identificado com base nas anotações clínicas referentes à realização de um tratamento odontológico restaurador. A adequada qualidade dos registros odontológicos associada à resistência dos dentes remanescentes à ação do fogo permitiram que diversas particularidades odontológicas fossem identificadas, associando a pessoa desaparecida ao corpo carbonizado. Portanto, ressalta-se a importância dos registros odontológicos nos casos de identificação humana, evidenciando a necessidade do cirurgião-dentista atuar junto dos Institutos Médico-Legais, colaborando para esclarecimentos à justiça.