Attitudes of dentists toward maintaining, repairing, or replacing direct composite resin restorations.

This study aimed to report the reasons for replacement of direct composite resin restorations in dental practices in Brazil. The study used a convenience sample of 213 dentists. A questionnaire was developed from previously validated instruments and sent electronically to prospective participants. The questions pertained to professional characteristics; criteria most frequently used in determining whether a direct composite resin restoration warranted replacement; and respondents' choice of treatment options (maintain, repair, or replace the restoration) in various clinical scenarios based on FDI World Dental Federation evaluation criteria, which are categorized into 3 groups: esthetic, functional, and biological properties. The descriptive statistical analysis was conducted using percentage frequencies, and associations between variables were tested using chi-square tests (α = 0.05). According to 47.9% of respondents, staining was the esthetic property that most often warranted replacement. For the functional property, 53.8% of respondents reported that fracture of material and retention was the most important factor indicating the need for replacement. For the clinical scenarios, 41.7% of respondents chose restoration replacement when evaluating esthetic properties, 59.8% when evaluating functional properties, and 64.4% when evaluating biological properties. Replacement, rather than maintenance or repair, was the most frequently reported clinical decision, and the dentists' professional profiles influenced treatment recommendations, with specialists exhibiting a slightly lower frequency of recommendations for replacement of direct composite resin restorations.

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.

Resin Cement: Correspondence with Try-In Paste and Influence on the Immediate Final Color of Veneers.

PURPOSE: To assess the correspondence of shades between try-in pastes and resin cements and their influence on the final color of veneers. MATERIALS AND METHODS: Bovine teeth (n = 140) were prepared and divided into 2 groups (a or b) according to ceramic veneer thickness (0.35 or 0.70 mm). Seventy teeth (n = 70) were distributed in 7 groups (groups 1 to 7a and groups 1 to 7b; n = 10). Try-in pastes and their corresponding resin cements were used according to the value: groups 1a and 1b (value -3); groups 2a and 2b (-2); groups 3a and 3b (-1); groups 4a and 4b (0); groups 5a and 5b (+1); groups 6a and 6b (+2); groups 7a and 7b (+3). Color measurements were performed with spectrophotometer, and the coordinates L* , a* , and b* were obtained. The final color change (ΔE) was calculated from these coordinates: ΔE0 (trial - substrate), ΔE1 (cementation - substrate), and ΔE2 (cementation - trial). The data were analyzed using the Kolmogorov-Smirnov test, the Wilcoxon test, or t-test for paired samples and repeated-measures ANOVA, post hoc Bonferroni, or the Friedman test (p < 0.05). RESULTS: The results indicated no statistically significant difference between the groups comparing ΔE0 and ΔE1 for 0.35 mm thickness laminate veneers, except for groups 2a and 5a. For 0.70 mm thickness laminate veneers, no statistically significant differences were observed between the groups comparing ΔE0 and ΔE1. ΔE2 values for 0.35 mm and 0.70 mm thickness laminate veneers ranged from 1.77 ± 0.81 to 4.99 ± 3.80 and from 1.01 ± 0.73 to 4.66 ± 2.96, respectively. CONCLUSIONS: Try-in pastes correspond with their respective resin cements for most colors investigated. The color of the resin cement may influence the final color of laminate veneers. Thickness of the ceramic was the most relevant variable for color change.

Case Report: a 5-Year Follow-up of Proximal Caries Lesion Diagnosis / Diagnóstico de Lesões Cariosas Proximais - Relato de Caso: 5 Anos de Acompanhamento

This clinical case was aimed at reporting and discussing diagnostic methods for early detection and preventive treatment of proximal carious lesions. The patient presented to the dental clinic seeking treatment of a problem she reported as being "dental caries". The patient's orthodontist diagnosed dental caries, by means of radiographic exam. There was no evidence of any proximal carious lesion in the intraoral examination. The bitewing radiographs presented a radiolucent area limited to enamel in the mesial of maxillary left-second-bicuspid. For the purpose of confirming the intraoral diagnosis, an immediate tooth separation was performed. The immediate separation was unable to provide sufficient access; thus, the slow separation approach was performed. After 24-hours, tooth separation of 1mm was obtained, providing enough access for clinical examination. The proximal areas were evaluated by transillumination and impression taking. During the visual inspection, an area of enamel staining was observed, with no roughness due to tactile inspection and the evaluation by transillumination and impression showed no cavitation. The following preventive treatment plan was endorsed: oral hygiene instructions with emphasis to the importance of flossing the proximal areas, and healthy dietary habits. After a 5-years period of follow-up, the enhanced oral hygiene and heathy dietary habits were observed. A clinical examination with immediate tooth separation and bitewing radiographs was performed and showed no cavitation. The combination of methods for detecting carious lesions in proximal surfaces was effective in obtaining a diagnosis of caries in the permanent dentition. The absence of cavitated lesions must be indicative of preventive treatment. (AU).

Este caso clínico objetivou relatar e discutir os métodos diagnósticos para detecção e tratamento preventivo de lesões cariosas proximais. A paciente procurou atendimento restaurador com queixa de cárie diagnosticada por exame radiográfico realizado após término de seu tratamento ortodôntico. Ao exame clínico não havia suspeita de lesão cariosa. A avaliação radiográfica revelou, na face mesial do dente 25, presença de área radiolúcida limitada à metade externa do esmalte. Para confirmação do diagnóstico realizou-se a separação interdentária imediata, porém como a mesma não permitiu adequada visualização foi realizada a separação mediata e após 24 horas obteve-se adequada separação (1 mm) para o exame clínico. Em seguida, a superfície proximal foi avaliada por transiluminação e moldagem. Durante a inspeção visual foi constatada área de manchamento do esmalte, com ausência de rugosidade pela inspeção tátil e a avaliação tanto por transiluminação da superfície proximal, quanto por moldagem revelou ausência de cavitação. Devido o diagnóstico obtido o seguinte tratamento preventivo foi indicado: reforço de higiene oral com ênfase na importância do uso do fio dental e hábitos dietéticos saudáveis. Após 5 anos de acompanhamento melhoria da higiene oral e hábitos dietéticos foram constatados. O exame clínico com separação interdentária imediata e exame radiográfico revelaram ausência de cavitação. Conclui-se que a combinação de métodos de detecção de lesões cariosas proximais foi efetivo no diagnóstico da cárie dentária na dentição permanente. O resultado deste relato de caso mostrou que a ausência de lesões cariosas cavitadas deve ser um indicativo de tratamento preventivo.(AU).

Implantes de zircônia na odontologia: revisão de literatura / Zirconia dental implants - a review

Diante da crescente expectativa quanto à estética em Odontologia e da necessidade de tratamentos metal free para casos específicos em regiões estéticas, o uso de implantes cerâmicos tem se tornado objeto de estudo e investimentos desde a década de 70, tornando-se hoje uma possível alternativa aos implantes de titânio. Assim, o objetivo deste estudo foi sistematizar o conhecimento disponível a respeito de implantes dentários de zircônia, avaliando sua viabilidade na implantodontia e a capacidade deste material em responder às exigências mecânicas e biológicas. Uma busca eletrônica foi realizada por meio do banco de dados PubMed utilizando a combinação das seguintes palavras- -chave: "zirconia", "dental implant", "zirconia implant" e "zirconia dental implant", sem restrição de idioma ou data de publicação. Esta pesquisa resultou em 801 trabalhos de potencial interesse. A seleção de artigos para inclusão no estudo com restrição de acordo com o objetivo proposto levou a seleção de 85 artigos relevantes para a revisão de literatura deste trabalho. De acordo com essa revisão, os resultados das pesquisas a respeito do uso da zircônia como matéria base na fabricação de implantes são promissores, embora a documentação científica disponível seja limitada pelas poucas e curtas experiências clínicas, principalmente em termos de longevidade. Estudos biológicos, mecânicos e clínicos publicados até a data parecem indicar que a zircônia pode ser uma excelente opção para os implantes de titânio, principalmente pelas suas propriedades mecânicas, aparência estética e menor adesão bacteriana.

Due to increasing demand for higher aesthetic in dentistry followed by the necessity of metal free rehabilitation for specific cases in esthetic regions, the use of ceramic implants has been object of study since the 70's, becoming today a possible alternative to titanium implants. The aim of this study was to systematize the knowledge available of zirconia implants, evaluating their viability and the ability of this material to respond to the mechanical and biological requirements. An electronic search was performed using the PubMed database and the combination of the following keywords: "zirconia", "dental implant", "zirconia implant" and "zirconia dental implant", without restriction of language or publication date. Eighty five articles were considered relevant to this study and the selection was fulfilled according to the proposed objective. According to this review, the results of research on the use of zirconia as the base material in implant manufacturing are promising, although available scientific documentation is limited by the few short clinical experiences, especially in terms of longevity. Biological, mechanical, and clinical studies published to date suggest that zirconia may be an excellent choice for titanium implants, mainly because of their mechanical properties, aesthetic appearance and lower bacterial adhesion.

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.

Prótese sobre implantes tipo protocolo associada à overdenture ­ relato de caso / Implant-supported protocol-type prosthesis associated with overdenture ­ case report

Como forma de tratamento para o edentulismo, a Odontologia dispõe de várias alternativas, como próteses totais convencionais mucossuportadas e as próteses sobre implantes. O tratamento com próteses implantossuportadas, por proporcionar maior retenção, tem sido a escolha da maioria dos profissionais e pacientes. Adicionalmente, esses tratamentos têm revolucionado a reabilitação oral por proporcionar melhor conforto, estética, eficiência mastigatória, confiança ao falar em público, resultando na melhora da qualidade de vida. Assim, o presente trabalho tem como objetivo relatar um caso clínico de um paciente do sexo masculino reabilitado inicialmente, após perca de todos os dentes remanescentes por doença periodontal grave, com próteses overdentures em ambos os arcos. Em seguida, devido à evolução de um quadro clínico de hiperplasia tecidual, a prótese superior foi substituída por prótese total fixa implantossuportada (AU).

Dentistry has several alternatives to treat edentulism, such as conventional and implantsupported prostheses. The treatment with implant-supported prostheses, by providing greater retention, has been the choice of the majority of professionals and patients. Additionally, these treatments have revolutionized oral rehabilitation since they provide better comfort, aesthetics, masticatory efficiency and public speaking confidence, which results in improved quality of life. Thus, the aim of this study is to report a clinical case of a male patient initially rehabilitated with overdentures in both arches. Then, due to the evolution of a clinical hyperplasic tissue, the superior prosthesis was replaced by implanted-supported fixed total prosthesis (AU).

Influence of curing mode of resin luting cements on bond strength to dentin

Self-adhesive, dual-polymerizing resin cements require no treatment to the prepared tooth surfaces before cementation. Aim: The aim of this study was to evaluate the influence of curing mode on bond strength (BS) of three cementing systems to bovine dentin. Methods: The buccal enamel surfaces of 50 bovine incisors were removed to expose dentin and to flat the surface. The teeth were divided into five groups (n=10), which consisted of two resin cements (Multilink and Clearfil SA Cement) that were tested in dual- (halogen light for 40 s) and self-cured modes, and a control (RelyX ARC). Two cylinders of resin cements (1.0 mm X 0.75 mm) were prepared on each bonded dentin surface. After 24h at 37oC, resin cylinders were subjected to micro-shear testing in a universal testing machine (4411/Instron - 0.5 mm/min). Data were statistically analyzed by two-way ANOVA, Tukey and Dunnett`s test (5%). Results: Multilink showed higher BS than those observed on Clearfil SA. Light-curing resulted in higher BS for both Multilink and Clearfil SA. When Multilink was light-cured, no significant difference on BS was demonstrated between it and RelyX ARC. Conclusions: The highest BS values were obtained in control group and light-cured Multilink resin cement (AU)

Inflammatory response of human dental pulp to at-home and in-office tooth bleaching.

OBJECTIVE:: This study evaluated the inflammatory responses of human dental pulp after the use of two bleaching techniques. MATERIAL AND METHODS:: Pulp samples were collected from human third molars extracted for orthodontic reasons and divided into three groups: control - no tooth bleaching (CG) (n=7); at-home bleaching with 15% carbamide peroxide (AH) (n = 10), and in-office bleaching with 38% hydrogen peroxide (IO) (n=12). Pulps were removed and stained with hematoxylin-eosin for microscopic analysis of inflammation intensity, collagen degradation, and pulp tissue organization. Immunohistochemistry was used to detect mast cells (tryptase+), blood vessels (CD31+), and macrophages (CD68+). Chi-square, Kruskal-Wallis, and Mann Whitney tests were used for statistical analysis. The level of significance was set at p<.05. RESULTS:: The inflammation intensity and the number of macrophages were significantly greater in IO than in AH and CG (p<0.05). The results of CD31+ (blood vessels per mm2) were similar in CG (61.39±20.03), AH (52.29±27.62), and IO (57.43±8.69) groups (p>0.05). No mast cells were found in the pulp samples analyzed. CONCLUSION:: In-office bleaching with 38% hydrogen peroxide resulted in more intense inflammation, higher macrophages migration, and greater pulp damage then at-home bleaching with 15% carbamide peroxide, however, these bleaching techniques did not induce migration of mast cells and increased the number of blood vessels.

Silver nanoparticles in resin luting cements: Antibacterial and physiochemical properties.

BACKGROUND: Silver has a long history of use in medicine as an antimicrobial and anti-inflammatory agent. Silver nanoparticles (NAg) offer the possibility to control the formation oral biofilms through the use of nanoparticles with biocidal, anti-adhesive, and delivery abilities. This study aims to evaluate the antibacterial effect of resin luting cements with and without NAg, and their influence on color, sorption and solubility. MATERIAL AND METHODS: NAg were incorporated to two dual-cured resin cements (RelyX ARC (RA) color A1 and RelyX U200 (RU) color A2) in two concentrations (0.05% and 0.07%, in weight), obtaining six experimental groups. Disc specimens (1x6mm) were obtained to verify the antibacterial effect against Streptococcus mutans in BHI broth after immersion for 1min, 5min, 1h, 6h, and 24h (n=3), through optical density readings. Specimens were evaluated for color changes after addition of NAg with a spectrophotometer (n=10). Sorption and solubility tests were also performed, considering storage in water or 75% ethanol for 28 days (n=5), according to ISO 4049:2010. Data were subjected to statistical analysis with ANOVA and Tukey (p=0.05). RESULTS: The optical density of the culture broths indicated bacterial growth, with and without NAg. NAg produced significant color change on the resin cements, especially in RA. Solubility values were very low for all groups, while sorption values raised with NAg. The cements with NAg did not show antibacterial activity against S. mutans. They also showed perceptible color change and higher sorption than the materials without NAg. CONCLUSIONS: The resin luting cements with NAg addition did not show antibacterial activity against SS. mutans. They also showed perceptible color change and higher sorption than the materials without NAg. Key words:Silver, resin cements, products with antimicrobial action, solubility, color perception tests.

Inflammatory response of human dental pulp to at-home and in-office tooth bleaching

ABSTRACT Tooth bleaching is a technique of choice to obtain a harmonious smile, but bleaching agents may damage the dental pulp. Objective: This study evaluated the inflammatory responses of human dental pulp after the use of two bleaching techniques. Material and Methods: Pulp samples were collected from human third molars extracted for orthodontic reasons and divided into three groups: control - no tooth bleaching (CG) (n=7); at-home bleaching with 15% carbamide peroxide (AH) (n = 10), and in-office bleaching with 38% hydrogen peroxide (IO) (n=12). Pulps were removed and stained with hematoxylin-eosin for microscopic analysis of inflammation intensity, collagen degradation, and pulp tissue organization. Immunohistochemistry was used to detect mast cells (tryptase+), blood vessels (CD31+), and macrophages (CD68+). Chi-square, Kruskal-Wallis, and Mann Whitney tests were used for statistical analysis. The level of significance was set at p<.05. Results: The inflammation intensity and the number of macrophages were significantly greater in IO than in AH and CG (p<0.05). The results of CD31+ (blood vessels per mm2) were similar in CG (61.39±20.03), AH (52.29±27.62), and IO (57.43±8.69) groups (p>0.05). No mast cells were found in the pulp samples analyzed. Conclusion: In-office bleaching with 38% hydrogen peroxide resulted in more intense inflammation, higher macrophages migration, and greater pulp damage then at-home bleaching with 15% carbamide peroxide, however, these bleaching techniques did not induce migration of mast cells and increased the number of blood vessels.

Cytotoxicity of glass ionomer cements containing silver nanoparticles.

BACKGROUND: Some studies have investigated the possibility of incorporating silver nanoparticles (NAg) into dental materials to improve their antibacterial properties. However, the potential toxic effect of this material on pulp cells should be investigated in order to avoid additional damage to the pulp tissue. This study evaluated the cytotoxicity of conventional and resin-modified glass ionomer cements (GIC) with and without addition of NAg. MATERIAL AND METHODS: NAg were added to the materials at two different concentrations by weight: 0.1% and 0.2%. Specimens with standardized dimensions were prepared, immersed in 400 µL of culture medium and incubated at 37°C and 5% CO2 for 48 h to prepare GIC liquid extracts, which were then incubated in contact with cells for 48 h. Culture medium and 0.78% NAg solution were used as negative and positive controls, respectively. Cell viability was determined by MTT and Trypan Blue assays. ANOVA and the Tukey test (α=0.05) were used for statistical analyses. RESULTS: Both tests revealed a significant decrease in cell viability in all groups of resin modified cements (p<0.001). There were no statistically significant differences between groups with and without NAg (p>0.05). The differences in cell viability between any group of conventional GIC and the negative control were not statistically significant (p>0.05). CONCLUSIONS: NAg did not affect the cytotoxicity of the GIC under evaluation. KEY WORDS: Glass ionomer cements, totoxicity, cell culture techniques, nanotechnology, metal nanoparticles.

Effect of Instrumentation Techniques, Irrigant Solutions and Artificial accelerated Aging on Fiberglass Post Bond Strength to Intraradicular Dentin.

OBJECTIVE: To evaluate the effect of instrumentation techniques, irrigant solutions and specimen aging on fiberglass posts bond strength to intraradicular dentine. MATERIALS AND METHODS: A total of 120 bovine teeth were prepared and randomized into control and experimental groups resulting from three study factors (instrumentation techniques, irrigant solutions, specimen aging). Posts were cemented with RelyX U100. Samples were submitted to push-out test and failure mode was evaluated under a confocal microscope. RESULTS: In specimens submitted to water artificial aging, nickel-titanium rotary instruments group presented higher bond strength values in apical third irrigated with NaOCl or chlorhexi-dine. Irrigation with NaOCl resulted in higher bond strength than ozonated water. Artificial aging resulted in significant bond strength increase. Adhesive cement-dentin failure was prevalent in all the groups. CONCLUSION: Root canal preparation with NiTi instruments associated with NaOCl irrigation and ethylenediaminetetra acetic acid (EDTA) increased bond strength of fiberglass posts cemented with self-adhesive resin cement to intraradicular dentine. Water artificial aging significantly increased post-Clinical significance: The understanding of factors that may influence the optimal bond between post-cement and cement-dentin are essential to the success of endodontically treated tooth restoration.

Shade evaluation of ceramic laminates according to different try-in materials.

The porcelain laminate replaces the visible portion of enamel with a ceramic, which is attached to the dental surface. To enhance cosmetic results, a preliminary color matching procedure is performed prior to cementing the veneers. This procedure can be performed using water, water-soluble gel, or try-in paste. The different shades of cement and try-in pastes are intended to obtain better color and esthetics of the final restoration. This study sought to evaluate the shade of ceramic veneers produced by different try-in materials. Forty bovine teeth and 40 ceramic discs (0.6 mm thick) were prepared. The samples were divided into 4 groups (n = 10). For Group 1 samples, no material was used between the tooth and the ceramic, Group 2 interposed samples with water, Group 3 used a water-soluble gel, and Group 4 used try-in paste (value 0). The color was measured with a spectrophotometer, obtaining L*, a*, and b* values to calculate the color difference (ΔE*). The data were subjected to normality tests and 1-way ANOVA. No significant statistical differences were found among the groups, indicating that the different try-in materials had similar effects on the color of the ceramic laminates.

Unilateral fusion of maxillary lateral incisor: diagnosis using cone beam computed tomography.

Objective. The objective of this paper is to report a dental fusion case focusing on clinical and radiographic features for the diagnosis. Method. To report a case of right maxillary lateral incisor fusion and a supernumerary tooth, the anatomy of the root canal and dental united portion were assessed by cone beam computed tomography (CBCT). Results. The clinical examination showed dental juxtaposition with the absence of interdental papilla and esthetic impairment in the right maxillary lateral incisor region. The periapical radiography did not provide enough information for the differential diagnosis due to the inherent limitations of this technique. CBCT confirmed the presence of tooth fusion. Conclusion. CBCT examination supports the diagnosis and provides both the identification of changes in tooth development and the visualization of their extent and limits.

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.

Multidisciplinary approach to the establishment and maintenance of an esthetic smile: a 9-year follow-up case report.

In addition to providing functionality to patients, contemporary dentistry strives for esthetic excellence. Patients with anterior impairments, such as shape, size, and position alterations, have compromised smile harmony. A multidisciplinary orthodontic-operative dentistry approach has improved the treatment of these patients, since the use of orthodontic appliances in association with direct composite restorations can solve many esthetic problems. Although this treatment strategy is rather widespread, professional skills are necessary for the correct reproduction of the main features of teeth. Moreover, treatment success is directly related to its longevity. With the aid of a 9-year follow-up case report, a simple direct technique associated with an orthodontic treatment for restoring the esthetic appearance of an impaired smile, with good short- and long-term outcomes, based on minimal but essential esthetic repair interventions is discussed. Such coordinated treatment proved to be effective for the establishment and maintenance of an esthetic and pleasant smile.

Three-dimensional image contribution for evaluation of operative procedural errors in endodontic therapy and dental implants.

Acceptable therapeutic protocol in dentistry depends on the outcomes obtained with follow up. Operative procedural errors (OPE) may occur and they represent risk factors able to compromise a tooth or a dental implant. The aim of this study was to detect the OPE in endodontically treated teeth and dental implants, using cone beam computed tomography (CBCT).Eight hundred and sixteen CBCT exams were performed between January 2009 and October 2010, and only those which presented endodontically treated teeth and/or dental implants were selected. The sample was as follows: 195 CBCT exams (n=200 teeth and 200 dental implants), 72 male, 123 female, with mean age of 51 years.In endodontically treated teeth, OPE included underfilling, overfilling, and root perforation; OPEin dental implants were thread exposures, contact with anatomical structures, and contact with adjacent teeth. Kolmogorov-Smirnov test was used for statistical analysis, with significance level set at α=0.05. Underfilling, overfilling, and root perforations were detected in 33.5%, 8% and 4.5% of the teeth, respectively. Dental implants with thread exposures, contact with important anatomical structures and contact with adjacent teeth were seen in 37.5%, 13% and 6.5% of the cases, respectively. OPE were detected in endodontically treated teeth and dental implants, and underfilling and thread exposures were the most frequent occurrences, respectively.

Effect of light sources and curing mode techniques on sorption, solubility and biaxial flexural strength of a composite resin.

UNLABELLED: Adequate polymerization plays an important role on the longevity of the composite resin restorations. OBJECTIVES: The aim of this study was to evaluate the effect of light-curing units, curing mode techniques and storage media on sorption, solubility and biaxial flexural strength (BFS) of a composite resin. MATERIAL AND METHODS: Two hundred and forty specimens were made of one composite resin (Esthet-X) in a stainless steel mold (2 mm x 8 mm Ø), and divided into 24 groups (n=10) established according to the 4 study factors: light-curing units: quartz tungsten halogen (QTH) lamp and light-emitting diodes (LED); energy densities: 16 J/cm² and 20 J/cm²; curing modes: conventional (CM) and pulse-delay (PD); and permeants: deionized water and 75% ethanol for 28 days. Sorption and solubility tests were performed according to ISO 4049:2000 specifications. All specimens were then tested for BFS according to ASTM F394-78 specification. Data were analyzed by three-way ANOVA followed by Tukey, Kruskal-Wallis and Mann-Whitney tests (α=0.05). RESULTS: In general, no significant differences were found regarding sorption, solubility or BFS means for the light-curing units and curing modes (p>0.05). Only LED unit using 16 J/cm² and PD using 10 s produced higher sorption and solubility values than QTH. Otherwise, using CM (16 J/cm²), LED produced lower values of BFS than QTH (p<0.05). 75% ethanol permeant produced higher values of sorption and solubility and lower values of BFS than water (p<0.05). CONCLUSION: Ethanol storage media produced more damage on composite resin than water. In general the LED and QTH curing units using 16 and 20 J/cm² by CM and PD curing modes produced no influence on the sorption, solubility or BFS of the tested resin.

Three-dimensional image contribution for evaluation of operative procedural errors in endodontic therapy and dental implants

Acceptable therapeutic protocol in dentistry depends on the outcomes obtained with follow up. Operative procedural errors (OPE) may occur and they represent risk factors able to compromise a tooth or a dental implant. The aim of this study was to detect the OPE in endodontically treated teeth and dental implants, using cone beam computed tomography (CBCT).Eight hundred and sixteen CBCT exams were performed between January 2009 and October 2010, and only those which presented endodontically treated teeth and/or dental implants were selected. The sample was as follows: 195 CBCT exams (n=200 teeth and 200 dental implants), 72 male, 123 female, with mean age of 51 years.In endodontically treated teeth, OPE included underfilling, overfilling, and root perforation; OPEin dental implants were thread exposures, contact with anatomical structures, and contact with adjacent teeth. Kolmogorov-Smirnov test was used for statistical analysis, with significance level set at α=0.05. Underfilling, overfilling, and root perforations were detected in 33.5%, 8% and 4.5% of the teeth, respectively. Dental implants with thread exposures, contact with important anatomical structures and contact with adjacent teeth were seen in 37.5%, 13% and 6.5% of the cases, respectively. OPE were detected in endodontically treated teeth and dental implants, and underfilling and thread exposures were the most frequent occurrences, respectively.

Protocolos terapêuticos aceitáveis em odontologia dependem de resultados observados com a proservação. Erros de procedimentos operatórios podem ocorrer e representam fatores de risco capazes de comprometer um dente ou um implante dentário. O objetivo deste artigo é detectar os erros de procedimentos operatórios em dentes tratados endodonticamente e implantes dentários por meio de tomografia computadorizada de feixe cônico. Oitocentos e dezesseis (816) exames tomográficos foram realizados entre Janeiro de 2009 e Outubro de 2010, e apenas aqueles que apresentaram dentes tratados endodonticamente e/ou implantes dentários foram selecionados. A amostra final envolveu 195 exames tomográficos (n=200 dentes e 200 implantes dentários), 72 do gênero masculino, 123 do gênero feminino, com idade média de 51 anos. Em dentes tratados endodonticamente os erros de procedimentos operatórios incluídos foram: subobturação, sobreobturação, e perfuração radicular; enquanto que, para implantes dentários foram incluídos: roscas de implantes expostas, implantes em contato com estruturas anatômicas, e em contato com dentes adjacentes. O nível de significância foi estabelecido em α=5%. Subobturações, sobreobturações e perfurações radiculares foram detectadas em 33,5%, 8% e 4,5%, respectivamente. Implantes dentários com roscas expostas, em contato com estruturas anatômicas, e em contato com dentes adjacentes apresentaram valores de 37,5%, 13% e 6,5%, respectivamente. Erros de procedimentos operatórios foram detectados em dentes tratados endodonticamente e implantes dentários. Os erros mais frequentes foram subobturação em dentes tratados endodonticamente, e roscas expostas em implantes dentários.