Efficacy of articaine anesthesia with needle-free/Comfort-in method and conventional needle injection in dental patients with irreversible pulpitis: a randomized clinical trial.

OBJECTIVE: To assess the anesthetic efficacy of articaine with the needle-free/Comfort-in™ method compared to the conventional needle method. To assess pain during anesthesia application, onset of anesthesia and patient`s self-reported quality of life-related to oral health after the dental emergency appointment. MATERIALS AND METHODS: This parallel, randomized clinical trial was conducted by a single operator/dentist in the state of Maranhao, northeast of Brazil. Included participants were adult dental patients with one molar (maxillary) or premolar (maxillary or mandibular) tooth diagnosed with symptomatic irreversible pulpitis. The primary outcome was the anesthetic efficacy, measured using a combination of electrical and cold pulp tests (cold + EPT) and the Numerical Rating Scale (NRS). Secondary outcomes were pain during anesthesia application, onset of anesthesia, and patient`s quality-of-life (measured with the OHIP-14). RESULTS: 62 patients were randomized in the anesthesia needle-free group and Comfort-in group (34.26 ± 10.786 × 33.29 ± 8.399 years old, respectively). The group of patients in the Comfort-in group had 71.0% success. Patients from the Comfort-in group reported statistically lower pain during the anesthesia application than patients from the conventional group (2.13 ± 2.172 × 6.03 ± 3.146 NRS scores, respectively) as well as immediately after the anesthetic procedure. Patients self-reported negative impact in quality of life was similar between groups before (p > 0.05) and after (p > 0.05) the dental emergency. CONCLUSIONS: Comfort-in™ had similar efficacy to the conventional needle method. CLINICAL RELEVANCE: This trial showed that it is possible to anesthetize patients with tooth pulpits without using needles to provide comfort mainly to anxious patients.

Apical Sealing and Bioactivity of an Experimental Gutta-Percha Containing Niobium Phosphate Bioglass.

This study evaluated the apical sealing ability and bioactivity of an experimental gutta-percha containing niobium phosphate bioglass. Thirty-six human premolars were endodontically prepared and divided into three groups: GPC-filling with conventional gutta-percha; GBC-filling with bioceramic gutta-percha (EndoSequence BC); GNB-filling with experimental gutta-percha containing niobophosphate. Teeth were stored in tubes containing 2 mL of simulated body fluid (SBF) solution in an oven for 30 days. Then, the samples were immersed in lanthanum nitrate solution and analyzed for apical nanoleakage (NI) with a scanning electron microscope (SEM/EDS) and transmission electron microscope (TEM). Gutta-percha specimens were immersed for 28 days (SBF) and analyzed in SEM/EDS and X-ray diffraction (XRD) to assess bioactivity. NI data originated from the SEM/EDS were analyzed using the Kruskal-Wallis test (α = 5%). NI data originated from TEM and bioactivity were descriptively reported. Statistical analysis did not detect a significant difference between groups (p = 0.13) for NI. In the bioactivity analysis, an abundant layer of hydroxyapatite was identified only in the surface of the GNB group samples. The gutta-percha containing niobophosphate bioglass promoted an apical sealing similar to EndoSequence BC, in addition to demonstrating bioactivity through the deposition of hydroxyapatite on the surface of the material after immersion in SBF.

Dentin Microhardness and Sealer Bond Strength to Root Dentin are Affected by Using Bioactive Glasses as Intracanal Medication.

This study investigated the human dentin microhardness (MH) and the MTA Fillapex® (Fillapex) and AH Plus®(AH) bond strength (BS) to dentin after using calcium hydroxide (Ca(OH)2) and bioactive glasses (45S5 and an experimental niobium phosphate bioactive glass (NbG)) as intracanal medications. For the MH test dentin slices were filled with medications and were submitted to Knoop MH (KHN) test (at day-0 (baseline data/without medication) and at day-15 (after using medication)). For the BS test, after medications had remained for 15 days in the roots, dentin slices were obtained and filled with the sealers. Seven days later, sealer BS to dentin was measured by push-out test (MPa). Data were statistically analyzed. Failure mode was visually assessed. The use of NbG, 45S5 for 15 days, increased the dentin MH and reduced the BS between AH sealer and dentin, but did not interfere with the Fillapex BS.

Estudo comparativo da resistência ao cisalhamento de diferentes tipos de bráquetes estéticos / Comparative study of the shear bond strength of different aesthetic brackets

Devido à crescente busca por tratamento ortodôntico por adultos, que desaprovam a utilização de aparelhos metálicos, a indústria ortodôntica tem desenvolvido materiais para oferecer alternativas de tratamento estético. Este estudo objetivou avaliar a resistência ao cisalhamento de bráquetes estéticos de policarbonato e cerâmica. A presente pesquisa foi realizada somente após aprovação pelo Comitê de Ética em Pesquisa (N° da aprovação 46115315.4.4.0000.5211). Quarenta pré-molares foram adequadamente armazenados, preparados e divididos em quatro grupos: Grupo A (bráquetes metálicos), Grupo B (bráquetes de monocristalina), Grupo IC (bráquetes de policristalina) e Grupo D (bráquetes de policarbonato). Os espécimes foram submetidos a testes de cisalhamento à velocidade de 0,5 mm por minuto. Os resultados foram obtidos em MPa e importados para o software estatístico SPSS, no qual procedeu-se com a análise de variância (ANOVA), com o post hoc de Tukey (p ≤ 0,05). Foi observado que o grupo controle apresentou resistência média (15,1 MPa) comparado com o grupo monocristalino (13,6 MPa), grupo policristalino (11,1 MPa) e grupo policarbonato (6,5 MPa). Houve diferenças estatísticas (p<0,01) entre o grupo controle e policarbonato, entre o grupo monocristalino e policarbonato, sendo que este obteve menor resistência. O grupo de bráquetes monocristalinos apresentou maior resistência ao cisalhamento comparado aos demais bráquetes estéticos testados, no entanto apresentou resistência menor em relação ao grupo de bráquete metálico. (AU)

Due to the increasing search for orthodontic treatment by adults, who disapprove the use of metallic brackets, the orthodontic industry has been developing materials to offer alternative aesthetic treatments. This study aimed to evaluate the shear bond strength of polycarbonate and ceramic aesthetic brackets. The research was carried out only after the Research Ethics Committee approved it (Approval No. 46115315.4.4.0000.5211). Forty premolars were adequately stored, prepared and, divided into four groups: Group A (metal brackets), Group B (monocrystalline brackets), Group IC (polycrystalline brackets), and Group D (polycarbonate brackets). The specimens were subjected to shear bond strength test at a speed of 0.5 mm per minute. The results were obtained in MPa and imported into the statistical software SPSS for statistical analysis through variance analysis (ANOVA), with Tukey post hoc (p ≤ 0.05). It was observed that the control group presented average resistance (15.1 MPa) compared to the monocrystalline group (13.6 MPa), polycrystalline group (11.1 MPa), and polycarbonate group (6.5 MPa). There were statistical differences (p <0.01) between the control and polycarbonate groups, between the monocrystalline and polycarbonate group, which obtained lower resistance. The group of monocrystalline brackets presented higher shear bond strength compared to the other aesthetic brackets tested, however presented lower resistance in relation to the metallic bracket group.(AU)

Estudo comparativo da resistência ao cisalhamento utilizando diferentes bráquetes metálicos colados em incisivos bovinos / Comparative study of shear strength using different metal brackets bonded to bovine incisors

A correta seleção de materiais, especificamente os bráquetes, é requisito importante para o êxito da terapia ortodôntica. Esse estudo tem como objetivo avaliar a resistência ao cisalhamento empregando-se três grupos de bráquetes metálicos de marcas comerciais nacionais diferentes em dentes incisivos bovinos. Foi encaminhado ao Comitê de Ética no Uso de Animais (CEUA) e somente após sua aprovação iniciou-se os testes. Foram utilizados 24 dentes incisivos inferiores bovinos, divididos em três grupos aleatoriamente, contendo 8 dentes em cada grupo: 1) Morelli; 2) Orthometric e 3) Eurodonto. Os dentes foram limpos com curetas periodontais e armazenados em água destilada à temperatura de 4°C. Após a estocagem, os dentes foram inclusos em tubos de PVC, de maneira centralizada e com as faces vestibulares perpendiculares ao solo, utilizando como auxílio um esquadro justaposto à superfície de colagem. Em cada amostra foram feitas marcações nos tubos de PVC identificando os grupos e a sequência. As amostras foram submetidas à profilaxia, condicionamento ácido, aplicação do primer e resina fotopolimerizável Transbond XT. Os dentes foram novamente armazenados e toda a amostra submetida ao teste de cisalhamento em máquina de ensaio universal, com velocidade de 0,5 mm por minuto. Os resultados obtidos, após execução do teste, foram armazenados em uma planilha eletrônica (software Excel®) e, posteriormente, submetidos aos testes estatísticos ANOVA e Teste de Tukey. Concluiu-se que os bráquetes metálicos das marcas Morelli, Orthometric e Eurodonto não têm diferenças estatisticamente significativas (p = 0,317) e todas as marcas testadas estão situados em uma faixa de resistência mecânica que possibilite sua utilização clínica.(AU)

Correct selection of materials, specifically the brackets, is an important requirement for orthodontic therapy success. This study aims to evaluate the shear strength employing three metal brackets groups of different national trademarks in bovine teeth incisors. It was referred to the Ethics Committee on Animal Use (CEUA) and only after approval tests began. Twenty-four bovine mandibular incisor teeth were used and randomly divided into three groups containing 8 teeth in each one: 1) Morelli; 2) Orthometric and 3) Eurodonto. The teeth were cleaned with periodontal curettes and stored in distilled water at 4°C. After storage, the teeth were inserted in PVC tubes, centrally and with the buccal surfaces perpendicular to the ground, using as an aid a square juxtaposed to the bonding surface. In each sample signs were made in the PVC tubes identifying groups and sequence. The samples were submitted o prophylaxis, etching, primer application, and Transbond XT photopolymerizable resin. The teeth were stored again and the whole sample was submitted to the shear test in a universal testing machine with speed of 0.5 mm per minute. The results obtained after test execution were stored in a spreadsheet (Excel software), and then submitted to statistical tests ANOVA and Tukey test. It was concluded that metal brackets of the trademarks Morelli, Orthometric and Eurodonto have statistically significant differences (p = 0.317) and all trademarks tested are situated in a strength range which allows their clinical use.(AU)

Resistência ao cisalhamento de bráquetes ortodônticos metálicos em dentes submetidos ao clareamento dentário / Orthodontic metal brackets resistance in whitened teeth subjected to shear strength

Introdução: pacientes adultos estão mais exigentes na busca pela estética oral, com isso, tem-se aumentando o uso de sistemas clareadores. Alguns estudos demonstram que há uma diminuição da resistência dos bráquetes após o clareamento. Objetivo: analisar a resistência as forças de cisalhamento de bráquetes em dentes submetidos ao tratamento clareador com peróxido de hidrogênio (H2O2). Metodologia: foram utilizados 30 dentes pré-molares, divididos aleatoriamente entre os três grupos: Grupo I: colagem direta dos bráquetes em dentes não clareados; Grupo II: colagem direta dos bráquetes em dentes clareados e submetidos ao teste de cisalhamento 15 dias após o clareamento, Grupo III: colagem direta dos bráquetes em dentes 24 horas dias após o clareamento. A colagem foi feita com o sistema Transbond XT. Os resultados obtidos nesse estudo foram registrados em Megapascal (MPa) e submetidos ao teste estatístico de Tukey segunda as normas da ANOVA. Resultados e Discussão: o grupo II não obteve diferença estatística significante em relação ao grupo I (controle), porém houve redução na resistência adesiva entre o grupo I e grupo III clareado com peróxido de hidrogênio à 35% na qual a colagem dos bráquetes foi realizada 24 horas após o clareamento dentário. Conclusão: recomenda-se um período de espera para a colagem dos bráquetes na superfície do esmalte submetido ao clareamento dentário.

Introduction: adult patients are demanding in regard of oral aesthetics. Therefore, there is increasing use of bleaching systems. Some studies show that there is a decrease in resistance of the brackets after dental bleaching. Objective: to analyze the strength of brackets shear strength in teeth submitted to bleaching treatment with hydrogen peroxide (H2O2). Method: a total of 30 premolars were randomly divided among the three groups. Group I: direct bonding of brackets on non-whitened teeth; Group II: direct bonding of brackets on whitened teeth and subjected to shear strength test 15 days after bleaching, Group III: direct bonding of brackets 24 hours days after bleaching. The bonding was performed with Transbond XT system. The results of this study were reported in Megapascal (MPa) and subjected to statistical Tukey test according to the ANOVA guidelines. Results and Discussion: group II did not presented difference statically significant compared to the group control (group I). However, there were reduction on the adhesion resistance between the group I and Group III, in which the brackets bonding was performed 24 hours after the dental bleaching with 35% hydrogen peroxide. There was a reduction in statistically significant bond strength between groups I and III. Conclusion: it is recommended a resting period to be done the placement of brackets on the surface of the enamel whitening submitted.