Resistência de união e microinfiltração em restaurações de resina composta em função do instrumento de corte / Bond strength and microleakage of composite resin restorations regarding the cutting instrument

Este estudo in vitro avaliou a resistência de união por microtração (RUM) à dentina e a microinfiltração em restaurações de resina composta após preparos cavitários com ponta diamantada ultrassônica e ponta diamantada em alta rotação. Para o teste de RUM, utilizaram-se seis terceiros molares que, após remoção do esmalte oclusal, foram aleatoriamente distribuídos para tratamento da superfície da dentina exposta durante 60 segundos com os dois instrumentos de corte. Blocos de resina composta com 3 mm de altura foram confeccionados sobre a superfície tratada e, após 24 horas, cada dente forneceu espécimes com área de secção transversal de 0,81 mm2, que foram submetidos à microtração para medida de sua resistência de união. Para o teste de microinfiltração, cavidades classe V padronizadas com margens em esmalte e dentina foram preparadas nas faces vestibulares e linguais de 12 terceiros molares distribuídos aleatoriamente entre os dois instrumentos de corte. Após a restauração com resina composta, os dentes foram submetidos à termociclagem, imersos em solução de 50% de nitrato de prata e seccionados para análise em lupa estereoscópica das porcentagens de microinfiltração. Todos os dados foram analisados pelo teste ANOVA e Tukey (p maior ou igual a 0,05). Os resultados evidenciaram que a ponta diamantada ultrassônica promoveu valores de resistência de união significantemente maiores (p = 0,03). A microinfiltração nas margens em esmalte e dentina não foi diferente entre os grupos. A ponta diamantada ultrassônica parece ser um instrumento de corte alternativo promissor no tratamento dentário restaurador.

This in vitro study evaluated microtensile bond strength (MBS) and microleakage of composite resin restorations in cavities prepared with ultrasonic diamond tip and diamond bur coupled to high-speed handpiece. The MBS test used 6 third molars that after enamel occlusal removal were randomly divided in two groups according to the 2 cutting instruments that were applied on dentin surface during 60 seconds. Blocks of 3 mm composite resin were made over the dentin surface treated and after 24 hours each tooth produced sticks with a cross-sectional area of 0.81 mm2 that were submitted to a microtensile test for bond strength measure. To the microleakage test, standardized class V cavities with enamel and dentin margins were prepared on the facial and lingual surfaces of 12 third molars randomly divided in two groups according cutting instruments. After composite resin restoration, the teeth were subjected to thermocycle, immersed in 50% silver nitrate solution and sectioned to evaluate the percentage of microleakage under stereomicroscope. All data were analyzed by ANOVA and Tukey test (p is greater than or equal to 0.05). The results showed that the composite resin restorations made on dentin surface treated by ultrasonic diamond tip presented bond strength values significantly higher (p = 0.03). Microleakage in enamel and dentin margins was not different between groups. The ultrasonic diamond tip seems to be a promising alternative cutting instrument for restorative dental treatment.

The influence of grain size coating and shaft angulation of different diamond tips on dental cutting.

OBJECTIVES: To evaluate the influence of the grain size coating and shaft angulation of ultrasonic and high-speed diamond burs on the dental cutting effectiveness. MATERIALS AND METHODS: For the grain size evaluation, cavities were prepared on 40 incisors using high-speed (1092 and 1093F KG Sorensen(®)) and ultrasonic tips (8.2142 and 6.2142-CVDentus(®)). For the shaft angulation evaluation, cavities were prepared on 40 incisors using uniangulated (T1-CVDentus(®)) and biangulated (T1-A CVDentus(®)) ultrasonic tips. The cavities were bisected and examined at ×50 magnification. The width and depth of cavities were measured by Leica QWin software. Kruskal-Wallis non-parametric test was used for analysis. RESULTS: The grain size did not affect the cutting effectiveness, but the high-speed burs promoted deeper and wider cavities than the ultrasonic tips. The shaft angulation did not affect the cutting effectiveness; both the angulated and biangulated tips had greater cutting efficiency in dentin than in enamel. CONCLUSIONS: Ultrasonic tips promoted more conservative preparations and seemed promising for cavity preparation.

In vitro evaluation of ICDAS and radiographic examination of occlusal surfaces and their association with treatment decisions.

This in vitro study evaluated the performance of visual (International Caries Detection and Assessment System [ICDAS]) and radiographic (bitewing [BW]) examinations for occlusal caries detection and their associations with treatment decision (TD). Permanent teeth (n=104) with occlusal surfaces varying from sound to cavitated were selected. Sites were identified from 10× occlusal surface photographs. Standardized bitewing (BW) radiographs were taken. Four dentists with at least five years of experience scored all teeth twice (one-week interval) for ICDAS (0­6), BW (0=sound, 1=caries restricted to enamel, 2=caries in outer third dentin, 3=caries in inner third dentin), and TD (0=no treatment, 1=sealant, 2=microabrasion and sealant, 3=round bur sealant, 4a=resin, 4b=amalgam). Histological validation was performed by observation under a light microscope, with lesions classified on a five-point scale. Intraexaminer and interexaminer repeatability were assessed using two-way tables and intraclass correlation coefficients (ICCs). Comparisons between percentage correct, specificity, sensitivity, and area under the receiver-operating characteristic (ROC) curve were performed using bootstrap analyses. ICCs for intraexaminer and interexaminer repeatability indicated good repeatability for each examiner, ranging from 0.78 to 0.88, and among examiners, ranging from 0.74 to 0.81. Correlation between ICDAS and TD was 0.85 and between BW and TD was 0.78. Correlation between the methods and histological scores was moderate (0.63 for ICDAS and 0.61 for BW). The area under the ROC curve was significantly greater for ICDAS than for BW (p<0.0001). ICDAS had significantly lower specificity than BW did (p=0.0269, 79% vs 94%); however, sensitivity was much higher for ICDAS than for BW (p<0.0001, 83% vs 44%). Data from this investigation suggested that the visual examination (ICDAS) showed better performance than radiographic examination for occlusal caries detection. The ICDAS was strongly associated with TD. Although the correlation between the ICDAS and BW was lower, it is still valuable in the clinical decision-making process.

Influence of the ICDAS e-learning program for occlusal caries detection on dental students.

The aim of this study was to evaluate the influence of ICDAS training in a group of dental students for occlusal caries detection in permanent teeth. Premolars and molars (N=104) with occlusal surfaces varying from ICDAS scores 0 to 6 were cleaned, one occlusal site per tooth was selected, and a photograph taken to identify the site. Eight senior dental students examined the teeth twice with a one-week interval between examinations during each of two phases: before and after the ICDAS e-learning program. Teeth were histologically assessed for caries extension. Intraclass correlation coefficients for intra- and interexaminer repeatability were high, both before (0.75 and 0.72, respectively) and after e-learning (0.82 and 0.78, respectively). The ICDAS scores decreased significantly from before to after e-learning (p=0.0001). Correlation between ICDAS scores and histology scores was moderate (0.57 before e-learning and 0.61 after). Although the ROC curve shows an improvement in the use of the ICDAS scoring after e-learning, the difference was not significant (p=0.10). Specificity of the ICDAS scores significantly improved after e-learning (77 percent vs. 36 percent), and sensitivity was reduced slightly after e-learning (87 percent vs. 92 percent). The ICDAS e-learning program improved the performance of the diagnostic skills of the investigated students for the detection of occlusal caries lesions.

Desgaste superficial do esmalte dental após microabrasão in vitro / Enamel wear of teeth after microabrasion in vitro

O objetivo do presente estudo foi investigar o desgaste superficial após a realização da técnica de microabrasão com o auxílio de espátula plástica ou taça de borracha em baixa rotação. Dez molares permanentes (superfície vestibular) foram utilizados para a avaliação do desgaste superficial, sendo divididos nos grupos: GE (espátula) e GT (taça). Os grupos foram submetidos a dez aplicações de pasta abrasiva composta de ácido fosfórico a 35% mais pedra pomes, com duração de 20 segundos cada, sob pressão de 30 g, utilizando-se a técnica de acordo com cada grupo experimental. Os espécimes foram avaliados em lupa estereoscópica acoplada a um programa de computador. Pôde-se observar para os grupos GE e GT que o desgaste médio foi de 21,20 e 22,75%, respectivamente, não se apresentando diferença estatística entre eles. Pode-se concluir que houve desgaste superficial de todos os grupos experimentais, independentemente da utilização de espátula plástica ou taça de borracha.

The aim of this study was to investigate the enamel wear permanent teeth after plastic stick or low speed rubber cup microabrasion. Ten permanent molars were selected to evaluate enamel wear which were sectioned into mesial and distal halves. Each half of the molars was randomly assigned to one of two experimental groups (n = 10) according to the enamel microabrasion technique: plastic stick (GE) or rubber cup (GT). In both the groups, the enamel was submitted to 10 applications of an abrasive paste comprised of 35% phosphoric acid and pumice powder. The paste was applied for 20 seconds under a pressure of 30 g using the instrument defined for each group (plastic stick or rubber cup). The specimens were evaluated under a stereomicroscope connected to a computer. The enamel wear no was statistically different between GE and GT, which presented a mean wear of 304.74 µm (21.20%) and 338.35 µm (22.75%). In conclusion, superficial enamel wear was seen for both the groups, independent of the technique used for the accomplishment of the microabrasion.

Desgaste superfcial do esmalte dental após microabrasão in vitro / Enamel wear of teeth after microabrasion in vitro

O objetivo do presente estudo foi investigar o desgaste superficial após a realização da técnica de microabrasão com o auxílio de espátula plástica ou taça de borracha em baixa rotação. Dez molares permanentes (superfície vestibular) foram utilizados para a avaliação do desgaste superficial, sendo divididos nos grupos: GE (espátula) e GT (taça). Os grupos foram submetidos a dez aplicações de pasta abrasiva composta de ácido fosfórico a 35% mais pedra pomes, com duração de 20 segundos cada, sob pressão de 30 g, utilizando-se a técnica de acordo com cada grupo experimental. Os espécimes foram avaliados em lupa estereoscópica acoplada a um programa de computador. Pôde-se observar para os grupos GE e GT que o desgaste médio foi de 21,20 e 22,75%, respectivamente, não se apresentando diferença estatística entre eles. Pode-se concluir que houve desgaste superficial de todos os grupos experimentais, independentemente da utilização de espátula plástica ou taça de borracha.

The aim of this study was to investigate the enamel wear permanent teeth after plastic stick or low speed rubber cup microabrasion. Ten permanent molars were selected to evaluate enamel wear which were sectioned into mesial and distal halves. Each half of the molars was randomly assigned to one of two experimental groups (n = 10) according to the enamel microabrasion technique: plastic stick (GE) or rubber cup (GT). In both the groups, the enamel was submitted to 10 applications of an abrasive paste comprised of 35% phosphoric acid and pumice powder. The paste was applied for 20 seconds under a pressure of 30 g using the instrument defined for each group (plastic stick or rubber cup). The specimens were evaluated under a stereomicroscope connected to a computer. The enamel wear no was statistically different between GE and GT, which presented a mean wear of 304.74 µm (21.20%) and 338.35 µm (22.75%). In conclusion, superficial enamel wear was seen for both the groups, independent of the technique used for the accomplishment of the microabrasion.

O ensino das faculdades de Odontologia brasileiras retrata a Odontopediatria praticada nos consultórios? / Does the teaching of Brazilian Dental Schools reflect the Pediatric Dentistry applied in clinics?

Introdução - Este estudo teve como objetivo comparar o que ensinam as faculdades brasileiras de Odontologia frente a tratamentos restauradores em molares decíduos, com os procedimentos realizados pelos dentistas e seus consultórios. Material e Métodos - Um questionário. endereçado ao professor responsável pela disciplina de Odontopediatria, foi enviado para 70 faculdades de Odontologia brasileiras abordando-se O uso do amalgama e de materiais estéticos em restaurações de cavidades Classe I e II em dentes decíduos, além do tipo de preparo cavitário recomendado para estes materiais e suas contraindicações clínicas. Um questionário semelhante, adaptado para a prática clínica, foi enviado para 334 profissionais de vários Estados brasileiros cadastrados no site www.odonto.com.br. Resultados - Os dados foram tabulados com auxílio do SPSS 10.0 e após análise por meio de estatística descritiva observou-se que tanto o amálgama quanto a resina composta são amplamente recomendados pelas faculdades, porém há maior tendência dos cirurgiões-dentistas em utilizar a resina composta. Em relação ao tipo de preparo cavitário realizado para o amálgama, a maioria das faculdades ensina a cavidade Classe II de Black, enquanto entre os cirurgiões-dentistas esta preferência não foi observada. Para as restaurações estéticas Classe II, faculdades e cirurgiões- dentistas recomendam predominantemente preparo tipo slot. As contraindicações mais citadas por cirurgiões-dentistas e professores na utilização de um material estético foram: margem subgengival, impossibilidade de isolamento absoluto e higiene bucal deficiente. Conclusão- Diante dos resultados pode-se concluir que o ensino das Faculdades de Odontologia Brasileiras nem sempre é reproduzido fielmente pelos profissionais em seus consultórios.

Introduction - The aim of this study was to compare the teaching of Brazilian Dental Schools about molar deciduous restorative treatments with clinical procedutes applied by dentists in their offices. Material and Methods - A questionnaire addressed to the responsible professor by Pediatric Dentistrv disciplines was sent for 70 Brazilian Dental Schools approaching the use of amalgam and aesthetic materials for Class I and II deciduous teeth cavity restorations, type of cavity preparation recommended for these materials and their clinical contraindications. An adapted similar questionnaire for the practical clinic was sent for 334 dentists from different brazilian states that were registered in the site: www.odonto.com.br. Results - The data was tabulated in the SPSS 10.0 program and after descriptive statistical analysis it was observed that both amalgam and composite resin is widelv recommended by dental schools, however lhe dentists presented more tendency in using the composite resin. In relation to the type of cavity preparation for amalgam, the majority of schools teaches the traditional Class I of Black, whereas in the dentists' responses this preference was not observed. For Class II aesthetic restorations, both dental schools and dentists recommended the slot type of cavity preparation. The most cited contraindications by dentists and professors in lhe use of an aesthetic materials was: subgengival margin, impossibílity of absolute isolation and deficient buccal hygiene. Conclusion -According to these results, we concluded that the teaching established by Brazilian Dental School nor always is reproduced faithful by dentists in their offices.

Evaluation of the smear layer and hybrid layer in noncarious and carious dentin prepared by air abrasion system and diamond tips.

PURPOSE: To analyze the smear layer and the hybrid layer in noncarious and carious dentin prepared by different cutting instruments and restored with composite resin. STUDY DESIGN: Cavities were randomly prepared in 160 specimens (noncarious and artificial carious dentin) by high-speed diamond tips (KG Sorensen 1013), air abrasion system (Prepstart, Danville Engineering), ultrasonic tip (CVDentus 8.3231-1), and ultrasonic tip associated with ultrasonic cavitation by water for 10 s. Half of the cavities in each group were conditioned with 37% phosphoric acid for 15 s. The amount of smear layer and dentinal tubules present were analyzed using scanning electron microscopy and graded from 0 to 3. Cavities were prepared in another 20 noncarious specimens and 20 carious specimens and restored with adhesive composite resin system. The restorations were hemisected longitudinally and analyzed using scanning electron microscopy to evaluate the hybrid layer and resinous prolongation characteristics, using scores ranging from 1 to 6. RESULTS: The data were statistically analyzed using Kruskal-Wallis and Dunn tests at 5% of significance level. There was evidence that the most efficient smear layer removal was the acid etching in the noncarious dentin and the water ultrasonic cavitation in the carious dentin. The hybrid layer formed on the noncarious and carious dentin prepared by the ultrasonic tip was more regular than in the specimens prepared by high-speed diamond tip, with many resinous prolongations. CONCLUSION: The ultrasonic tip seems to be a promising tool for carious dentin cavity preparation.

Moebius syndrome: clinical manifestations in a pediatric patient.

Moebius syndrome is a congenital, nonprogressive disorder clinically characterized by loss of facial expression, impaired stomatognathic system functions, incapacity to close the eyelids, and several oral impairments. The purpose of this paper was to present the clinical manifestations and the dental treatment in a 5-year, 2-month-old male Moebius syndrome patient. The child presented with facial asymmetry, difficulty performing facial mimic movements and pronouncing some letters, and compromised suction, mastication, breathing, and deglutition. An intraoral examination revealed hypofunction of the perioral muscles, cheeks and tongue, ankyloglossia, anterior open bite, and absence of carious lesions and dental anomalies. The dental treatment consisted of frenectomy and further placement of a removable orthodontic appliance with a palatal crib for correction of the anterior open bite. After 12 months of follow-up, anterior open bite decreased and speech, deglutition, and mastication improved.

Primary tooth enamel loss after manual and mechanical microabrasion.

PURPOSE: This study's purpose was to assess the amount of dental enamel loss on primary incisors after manual or mechanical microabrasion with a phosphoric acid/pumice paste. METHODS: Ten exfoliated primary maxillary incisors were bisected faciolingually and the resulting 20 halves were randomly assigned to 2 groups: group 1 (N = 10)-manual technique (plastic spatula); and group 2 (N = 10)-mechanical technique (rubber cup attached to a low-speed handpiece). Microabrasion was performed on the buccal surface using an abrasive paste prepared with 37% phosphoric acid and pumice. Ten 20-second applications alternated with 20-second risings were performed in each group. Enamel thickness measurements made under stereomicroscopy before and after microabrasion were analyzed statistically by analysis of variance and pairwise t test. RESULTS: There was a statistically significant difference (P = .003) between the manual and mechanical techniques. The mechanical technique produced a mean enamel loss of 274.16 microm (66% of total enamel thickness), while the mean enamel loss with the manual technique was 152.59 microm (39% of total enamel thickness). CONCLUSION: Manual microabrasion using a plastic spatula removed less enamel, but was sufficient to eliminate most superficial stains and defects, and may be a viable option for the microabrasive technique on primary teeth.

Avaliação da ponta de diamante CVD (Chemical Vapor Deposition) associada ao aparelho de ultra-som / Evaluation of CVD (Chemical Vapor Deposition) diamond tip coupled to ultrasound device

Dentre os instrumentos de corte alternativos aos rotatórios de baixa e alta rotação que foram introduzidos na Odontologia, o uso do ultra-som associado à ponta dediamante CVD (Chemical Vapor Deposition) vem apresentando desempenho positivo, especialmente em relação à preservação da estrutura dentária e à satisfação dos pacientes. Diante de uma tecnologia ainda pouco explorada, o objetivo deste estudo foi avaliar a efetividade da ponta de diamante CVD emultra-som, buscando evidências científicas que suportem a sua utilização no tratamento odontológico, por meio de 3 artigos seqüenciais. Estes artigos abordaram as implicações desta nova técnica de preparo cavitário na efetividade de corte de esmalte e dentina, na resistência de união por microtração e microinfiltração de restaurações de resina composta e na resposta do complexo dentino-pulpar de dentes humanos, tendo como grupo controle a ponta diamantada convencional associada à turbina de alta rotação. Os resultados evidenciaram que os preparos cavitários em esmalte e dentina confeccionados com ponta de diamante CVD em ultra-som foram mais conservadores do que os preparos com a ponta diamantada em alta rotação. As restaurações em resina composta confeccionadas após o preparo cavitário com a ponta de diamante CVD em ultrasom apresentaram valores de resistência de união significantemente maiores, no entanto, a microinfiltração nas margens em esmalte e dentina não foram diferentes entre os instrumentos de corte. Além disso, não foram observadas características de inflamação nas respostas pulpares após a utilização de ambos os instrumentos de corte, apenas uma discreta a moderada desorganização celular.

Avaliação da ponta de diamante CVC (Chemical Vapor Deposition) associada ao aparelho de ultra-som / Evaluation of CVD (Chemical Vapor Deposition) diamond tip coupled to ultrasound device

Dentre os instrumentos de corte alternativos aos rotatórios de baixa e alta rotação que foram introduzidos na Odontologia, o uso do ultra-som associado à ponta de diamante CVD (Chemical Vapor Deposition) vem apresentando desempenho positivo, especialmente em relação à preservação da estrutura dentária e à satisfação dos pacientes. Diante de uma tecnologia ainda pouco explorada, o objetivo deste estudo foi avaliar a efetividade da ponta de diamante CVD em ultra-som, buscando evidências científicas que suportem a sua utilização no tratamento odontológico, por meio de 3 artigos seqüenciais. Estes artigos abordaram as implicações desta nova técnica de preparo cavitário na efetividade de corte de esmalte e dentina, na resistência de união por microtração e microinfiltração de restaurações de resina composta e na resposta do complexo dentino-pulpar de dentes humanos, tendo como grupo controle a ponta diamantada convencional associada à turbina de alta rotação. Os resultados evidenciaram que os preparos cavitários em esmalte e dentina confeccionados com ponta de diamante CVD em ultra-som foram mais conservadores do que os preparos com a ponta diamantada em alta rotação. As restaurações em resina composta confeccionadas após o preparo cavitário com a ponta de diamante CVD em ultrasom apresentaram valores de resistência de união significantemente maiores, no entanto, a microinfiltração nas margens em esmalte e dentina não foram diferentes entre os instrumentos de corte. Além disso, não foram observadas características de inflamação nas respostas pulpares após a utilização de ambos os instrumentos de corte, apenas uma discreta a moderada desorganização celular.

The CVD (Chemical Vapor Deposition) diamond tip coupled in ultrasound device by means of a specific connector has been an alternative to conventional diamond bur in high-speed. Besides the few scientific evidences, this new technology has been used in dental offices with good results, especially regarding the preservation of dental tissues and patient’s satisfaction. The aim of this study was to evaluate the effectiveness of the CVD diamond tip in ultrasound on dental treatment, through 3 sequential articles. These articles evaluated the implications of this new cavity preparation technique in enamel and dentin cutting effectiveness, in microtensile bond strength and microleakage of composite resin restorations, and in dentin-pulp complex response of human teeth, having the high-speed conventional diamond bur as control group. The results showed that the cavity preparations made by CVD diamond tip in enamel and dentin were more conservative than those prepared by conventional diamond bur. The resin composite restorations placed after cavity preparation with CVD diamond tip in ultrasound showed significantly higher bond strength values, however, the microleakage in enamel and dentin margins were similar for both cutting instruments. Besides, pulp response for both instruments did not show inflammatory characteristics, only a discrete or moderate cellular disorganization.

Avaliação da superfície de materiais resinosos expostos ao óxido de alumínio / Evaluation of resinous material surfaces exposed to aluminum oxide powder

O objetivo deste estudo foi avaliar o efeito da deposição de óxido de alumínio sobre restaurações resinosas adjacentes a área tratada pelo sistema de abrasão a ar. Foram utilizados 10 terceiros molares devidamente seccionados e incluído sem cera utilidade deixando exposta a face vestibular. Em cada espécime confeccionou-se com a caneta de alta rotação,4 preparos cavitários de aproximadamente 2mm de diâmetro, eqüidistantes de uma linha central demarcada na cera. As 40 cavidades foram restauradas aleatoriamente com resina composta (Silux-3M) e selante resinoso (Fluoroshield-Dentsply). Em seguida, réplicas de cada espécime foram obtidas pela moldagem com silicone (Imprint II-3M) e modeloem resina epóxi (Stycast 1266- Emerson & Cummings). Na seqüência, foram feitas 2 aplicações de 15s do jato abrasivona parte central dos espécimes, utilizando-se o aparelho PrepStar® regulado a 80 psi, com ponta ativa de 45º e 0,48mmde diâmetro interno posicionada a 5mm da superfície. Ao final de cada aplicação, as superfícies foram lavadas, seca se moldadas novamente. Todas as réplicas foram avaliadas em MEV por 2 examinadores calibrados que fizeram uma avaliação cega quanto ao tipo de restauração. Os dados tabulados em escores foram analisados estatisticamente por análise de variância de Friedman. Os resultados evidenciaram que não houve diferença estatística significativa entre as superfícies das restaurações analisadas antes e após a utilização do jato abrasivo (p>0,05). Uma vez que o jato de óxidode alumínio não foi aplicado diretamente sobre as restaurações, provavelmente a baixa energia cinética das partículas periféricas não foi capaz de produzir alterações em suas superfícies.

Clinical manifestations and oral findings in Fraser syndrome.

This article is the first known case report of Fraser syndrome in the dental literature. Its purpose was to present the clinical manifestations, oral findings, and dental treatment of a 14-year, 10-month-old female patient. Fraser syndrome is a rare recessive autosomal genetic disorder characterized by multisystemic malformation, usually comprising cryptophthalmos, syndactyly, and renal defects. The child presented with: (1) hydrocephaly; (2) face asymmetry; (3) low-inserted ears; (4) flat nose bridge; (5) cryptophthalmos; (6) bilateral absence of eyeballs; (7) hypertelorism; (8) syndactyly on the left fingers and toes; (9) skeletal defects; and (10) lower limb asymmetry. The intraoral examination revealed: (1) complete primary denture; (2) malocclusion; (3) tooth crowding; (4) ogival palate; (5) normal labial frena; (6) absence of lingual frenum (not compromising the tongue movements); (7) parched lips; (8) supragingival calculus adhered to all tooth surfaces; and (9) moderate gingivitis. The dental treatment consisted of periodic monitoring of the patient's oral health status and supragingival scaling associated with topical applications of 0.12% chlorhexidine digluconate gel at 2-week intervals to reduce gingivitis.

Cutting characteristics of dental diamond burs made with CVD technology.

The aim of this study was to determine the cutting ability of chemical vapor deposition (CVD) diamond burs coupled to an ultrasonic dental unit handpiece for minimally invasive cavity preparation. One standard cavity was prepared on the mesial and distal surfaces of 40 extracted human third molars either with cylindrical or with spherical CVD burs. The cutting ability was compared regarding type of substrate (enamel and dentin) and direction of handpiece motion. The morphological characteristics, width and depth of the cavities were analyzed and measured using scanning electron micrographs. Statistical analysis using the Kruskal-Wallis test (p < 0.05) revealed that the width and depth of the cavities were significantly greater when they were prepared on dentin. Wider cavities were prepared when the cylindrical CVD bur was used, and deeper cavities resulted from preparation with the spherical CVD bur. The direction of handpiece motion did not influence the size of the cavities, and the CVD burs produced precise and conservative cutting.

Cutting characteristics of dental diamond burs made with CVD technology

O objetivo deste estudo foi determinar a habilidade de corte das pontas de diamante obtidas pelo processo de deposição química a vapor (CVD) associadas ao aparelho de ultra-som no preparo cavitário minimamente invasivo. Uma cavidade padronizada foi preparada nas faces mesial e distal de 40 terceiros molares, utilizando-se pontas de diamante CVD cilíndrica e esférica. A habilidade de corte foi comparada quanto ao tipo de substrato (esmalte e dentina) e quanto à direção do movimento realizado com a ponta. As características morfológicas, a largura e profundidade das cavidades foram analisadas e medidas em microscopia eletrônica de varredura. A análise estatística pelo teste de Kruskal-Wallis (p < 0,05) revelou que a largura e profundidade das cavidades foram significativamente maiores em dentina. Cavidades mais largas foram obtidas quando se utilizou a ponta de diamante CVD cilíndrica, e mais profundas quando a ponta esférica foi empregada. A direção do movimento da ponta não influenciou o tamanho das cavidades, sendo os cortes produzidos pelas pontas de diamante CVD precisos e conservadores.

Influence of sample type and collection method on Streptococcus mutans and Lactobacillus spp. counts in the oral cavity.

OBJECTIVES: This study compared three methods of Streptococcus mutans and Lactobacillus spp. detection in the oral cavity: saliva swab (SS)-sample of stimulated saliva collected with swab; whole saliva (WS)-sample of 2 ml of stimulated saliva; and the dental plaque method (DP)-plaque sample of all dental surfaces. METHODS: Thirty children were included in this study. In the first 15 children, the SS and WS methods were carried out before the dental plaque collection, and in the following 15, the sequence was inverted to evaluate possible interference of the methods sequence. The samples were diluted and inoculated in SB20 and Rogosa agar, respectively for S.mutans and Lactobacillus spp., at 37 degrees C for 48 h. RESULTS: The results (cfu/mL) of S. mutans were analysed by the statistical Friedman's test. The levels of Lactobacillus spp. were analysed by descriptive statistics due to the high proportion of zero counts in the culture. In the first sequence of methods, the number of S. mutans counted for the SS method was inferior to DP and WS (P<0.05), and the results for the WS and DP methods were similar. The detection of Lactobacillus spp. was observed just by the WS (100%) and SS (14.3%) methods. However, in the second experimental set the number of S. mutans detected by the DP method was similar to those of the SS and WS, however, the WS method showed higher values than SS (P<0.05). A greater number of Lactobacillus spp. was detected by the WS method (100%), followed by SS (55.5%) and DP (33.3%). CONCLUSIONS: The dental plaque collection and the sample of stimulated whole saliva presented similar results in the S. mutans count. The most suitable method to detect the Lactobacillus spp. level in the oral cavity is the stimulated whole saliva method.

Restorative treatment on Class I and II restorations in primary molars: a survey of Brazilian dental schools.

A survey was sent to 70 Brazilian dental schools evaluating techniques and restorative materials being taught for Class I and II preparation in posterior primary teeth by Pediatric Dentistry courses. After a 54% response rate, marked teaching diversity was found among Brazilian dental schools. Amalgam continues to be taught, but a tendency of preference towards more esthetic-like materials was observed.

Aplicação da abrasão a ar em sulcos e fissuras / Air abrasion on pits and fissures

Os sistemas de preparo por abrasão a ar têm como princípio obter corte de estrutura dentária através de um jato de ar associado a um agente abrasivo. Esses sistemas são capazes de remover o mínimo de estrutura dental sadia e reduzir o desconforto pelo paciente, já que estes produzem um corte rápido e eficiente capaz de reduzir a pressão, o calor, a vibração e o ruído, presentes durante o preparo mecânico do dente com brocas. A proposta deste trabalho é apresentar a utilização da abrasão a ar como instrumento auxiliar no diagnóstico de cárie em sulcos e fissuras pigmentados e na remoção de selantes oclusais deficientes, discutindo as vantagens e desvantagens da aplicação dessa técnica em odontopediatria