Salivary factors associated with noncarious cervical lesions: A systematic review.

OBJECTIVE: This study aimed to carry out a systematic review of observational studies searching the association between salivary factors (amount and quality of saliva) and noncarious cervical lesions (NCCL) in individuals with permanent dentition. DESIGN: Cross-sectional, case-control, and cohort studies performed in humans with permanent dentition (population) and considering noncarious cervical lesions (outcome) in association with salivary characteristics (exposure) were included. PubMed, Web of Science, Cochrane, LILACS/BBO, Scopus, Embase, IBCT, NICE, OpenGrey, and Google Scholar were searched, with no language or date restrictions. Of 6561 potentially eligible studies, 142 were selected for full-text analysis. Three reviewers independently selected the studies, performed data extraction, and quality analysis through the Newcastle-Ottawa Scale. RESULTS: Finally, ten references were included in the review, four case-control and six cross-sectional studies. Several salivary parameters were evaluated. Some parameters were considered associated with the presence of noncarious cervical lesions: salivary buffering capacity, salivary pH, citric acid, and calcium and potassium levels. The methodological quality varied across studies, with high heterogeneity among them. CONCLUSIONS: Some associations between saliva and NCCL suggesting protective factors and others risk factors were found. However, the evidence is sparse and comes from a few studies with great heterogeneity. New scientific evidence, with standardized methods, should be encouraged. Understanding salivary parameters that influence the occurrence of NCCL is important to guide dentists in relation to etiological factors that could potentially be neglected. The results may help in the development of new and early diagnostic methods and treatments for noncarious cervical lesions.

A new way of analyzing tooth movement using universal coordinate system geometry single point superposition in a 3D model.

INTRODUCTION: Superposing 3D models is an imminent need. However, current methods rely on marking multiple points on the maxilla and mandible, which could increase point marking and overlapping errors. OBJECTIVE: This study aimed at developing a method for superimposing 3D models of the maxillary and mandibular arches with Autodesk Inventor® engineering software, using a single universal coordinate system (UCS) point superposition. METHODS: A total of 104 STL (stereolithography) models of the maxillary and mandibular arches exported from My iTero® platform were retrospectively selected, in which T0 and T1 were the initial and refinement periods, respectively (n=26 per group). The X, Y, and Z coordinates associated with a single point in each arch were inserted into the models with SlicerCMF® software for model orientation. The arch models with UCS registration were transferred to Autodesk Inventor® for superimposition and to measure tooth movements performed during Invisalign® treatment. Arch expansion, intrusion and rotation were analyzed by two examiners. The statistics were performed using intraclass correlation coefficients (ICC), Dahlberg's formula, and t-test (p<0.05). RESULTS: A reliable method of superimposing 3D digital models using a single UCS point in the maxilla and mandible was developed. ICC showed excellent intra- and inter-examiner correlation (ICC>0.90). A systematic error was not found concerning linear and angular measurements (<1mm and <1.5°, respectively). Digital dental movements could be analyzed, including arch expansion, dental intrusion, and tooth rotation. CONCLUSIONS: The developed method was proven reliable and reproducible for superimposing 3D models of the maxillary and mandibular arches by using UCS system.

A new way of analyzing tooth movement using universal coordinate system geometry single point superposition in a 3D model

ABSTRACT Introduction: Superposing 3D models is an imminent need. However, current methods rely on marking multiple points on the maxilla and mandible, which could increase point marking and overlapping errors. Objective: This study aimed at developing a method for superimposing 3D models of the maxillary and mandibular arches with Autodesk Inventor® engineering software, using a single universal coordinate system (UCS) point superposition. Methods: A total of 104 STL (stereolithography) models of the maxillary and mandibular arches exported from My iTero® platform were retrospectively selected, in which T0 and T1 were the initial and refinement periods, respectively (n=26 per group). The X, Y, and Z coordinates associated with a single point in each arch were inserted into the models with SlicerCMF® software for model orientation. The arch models with UCS registration were transferred to Autodesk Inventor® for superimposition and to measure tooth movements performed during Invisalign® treatment. Arch expansion, intrusion and rotation were analyzed by two examiners. The statistics were performed using intraclass correlation coefficients (ICC), Dahlberg's formula, and t-test (p<0.05). Results: A reliable method of superimposing 3D digital models using a single UCS point in the maxilla and mandible was developed. ICC showed excellent intra- and inter-examiner correlation (ICC>0.90). A systematic error was not found concerning linear and angular measurements (<1mm and <1.5°, respectively). Digital dental movements could be analyzed, including arch expansion, dental intrusion, and tooth rotation. Conclusions: The developed method was proven reliable and reproducible for superimposing 3D models of the maxillary and mandibular arches by using UCS system.

RESUMO Introdução: A sobreposição de modelos 3D é uma necessidade iminente. No entanto, os métodos atuais dependem da marcação de múltiplos pontos na maxila e na mandíbula, o que pode aumentar a incorporação de erros no processo de sobreposição. Objetivo: O objetivo desse estudo foi desenvolver um método para sobrepor modelos 3D das arcadas superior e inferior utilizando o software de engenharia Autodesk Inventor®, por meio da marcação de um único ponto em cada arcada, usando o sistema de coordenadas universal (UCS). Métodos: No total, 104 modelos STL das arcadas superior e inferior exportados da plataforma My iTero® foram selecionados retrospectivamente, onde T0 foi o período inicial e T1, o de refinamento (n=26 por grupo). As coordenadas X, Y e Z associadas a um único ponto em cada arcada foram inseridas nos modelos usando o software SlicerCMF®. Os modelos com os pontos UCS demarcados foram transferidos para o software Autodesk Inventor® para realizar a sobreposição e medir os movimentos dentários realizados durante o tratamento com Invisalign®. Os movimentos de expansão, intrusão e rotação foram analisados por dois examinadores. A análise estatística foi realizada usando os coeficientes de correlação intra-classe (ICC), fórmula de Dahlberg e teste t (p<0,05). Resultados: Foi desenvolvido um método confiável de sobreposição de modelos digitais 3D usando um único ponto UCS na maxila e mandíbula. O ICC apresentou excelente correlação intra e inter-avaliadores (ICC>0,90). Não foi encontrado erro sistemático nas medidas lineares e angulares (<1mm e <1,5°, respectivamente). Os movimentos dentários puderam ser analisados por meio do método proposto, incluindo expansão da arcada, intrusão e rotação dentária. Conclusão: O método desenvolvido provou ser confiável e reprodutível para sobreposição de modelos 3D das arcadas superior e inferior usando o sistema UCS com marcação de ponto único.

Enhanced mechanical properties, anti-biofilm activity, and cytocompatibility of a methacrylate-based polymer loaded with native multiwalled carbon nanotubes.

OBJECTIVES: We aimed to optimize the mechanical and biological properties of a conventional methacrylate-based dental polymer by loading it with double- and triple-walled carbon nanotubes as growth (DTWCNTG). METHODS: A formulation of bisphenol A-glycidyl methacrylate and triethylene glycol dimethacrylate (mass ratio = 2:1) was mixed with DTWCNTG at concentrations of 0.0% (control), 0.001%, 0.005%, and 0.010%. The concentrations were physicochemical and morphologically evaluated, and antibacterial activity was assessed by seeding a Streptococcus mutans strain (ATCC 25175) on the experimental polymeric surfaces. Cellular survival and osteodifferentiation were evaluated in epithelial (HaCat) and preosteoblast cells (MC3T3-E1). RESULTS: The 0.001% DTWCNTG concentration yielded higher compressive strength, elastic modulus, flexural strength, flexural modulus, water sorption, and solubility than the control. The degree of conversion and color did not significantly change with a low amount of DTWCNTG incorporated into the polymer. Antibacterial activity significantly improved when tested on the 0.001% DTWCNTG discs. No groups showed cytotoxicity in a short-term analysis and adding DTWCNTG favored MC3T3-E1 mineralization over the control, particularly in the 0.001% formulation. SIGNIFICANCE: The micro-addition of 0.001% DTWCNTG confers mechanical resistance, antimicrobial properties, and bioactivity to methacrylate-based polymers without significantly compromising color. Incorporating DTWCNTG improved dental composite properties and could be a biomodified material for minimally invasive procedures.

Effect of ethanol-wet bonding on porosity and retention of fiberglass post to root dentin.

This in vitro study aimed to assess the effects of different pretreatments used to adapt glass-fiber posts cemented to root canals with different resin cements, regarding porosity percentage and bond strength. Twelve bovine incisor roots were prepared with Largo drills. After post space preparation, the specimens were randomized into two types of pretreatment groups (n = 3): water-wet bonding and ethanol-wet bonding. After the post were cemented, the roots were stored in 100% humidity at room temperature for 7 days. The samples were scanned by microcomputed tomography (micro-CT). Images were reconstructed by NRecon software, and CTAn software was used to analyze the porosity percentage (%) at the luting interface. Evaluation of the push-out bond strength was performed by serially cutting the roots, and submitting the slices to testing. Additionally, the resin cement post-gel shrinkage values (%) were measured using the strain-gauge method (n = 10). Data were analyzed by two-way ANOVA, Tukey's test and Student's t test (a = 0.05). The roots prepared with ethanol-wet bonding using RelyX™ U200 had significantly lower porosity in the coronal and apical thirds (p < 0.05). The group prepared with ethanol-wet bonding using RelyX™ ARC presented better bond strength results in the coronal and apical thirds (p < 0.05). RelyX™ ARC (0.97%) produced a higher post-gel shrinkage value than RelyX™ U200 (0.77%). Canals pretreated with ethanol-wet bonding presented better outcomes in regard to porosity percentage and push-out bond strength.

Avaliação da alteração de cor de uma resina composta "beautiful bulk" submetida à imersão em soluções pigmentantes / Color change evaluation of a composite resin "beautiful bulk" submitted to immersion in pigmentant solutions

Objetivo:O objetivo do estudo foi verificar, in vitro, a alteração de cor da resina composta Beautiful-Bulk®, exposta aos líquidos pigmentantes. Métodos:Foram confeccionados 60 espécimes da resina (15,0 mm de diâmetro e 1,0 mm de espessura, n = 5) nas cores A2, B2 e C2. Os espécimes foram mantidos em uma sala escura por sete dias, em ambiente seco, a 37 °C e, em seguida, foram fotografados com aparelho celular iPhone 6S®. Os espécimes foram divididos aleatoriamente e submetidos a ciclos de imersão em quatro líquidos: água destilada (controle), suco de açaí, Coca-Cola® e molho de tomate. As imersões foram realizadas em sete e quatorze dias de forma cíclica, após a confecção dos espécimes, três vezes ao dia, durante 20 minutos. Ao fim de cada ciclo, novas fotografias foram realizadas. As imagens foram analisadas no programa Adobe Photoshop® e os dados convertidos em L*a*b através de um histograma. A variação de cor (∆E) foi analisada pela escala CIE-Lab. Resultados:A análise dos resultados (One-way ANOVA, Teste de Tukey, p < 0,05) demonstrou que o grupo controle produziu maior alteração de cor (p < 0,05) em sete e quatorze dias na cor A2. A cor B2, no ciclo de quatorze dias, apresentou maior alteração de cor (p < 0,05) para os espécimes imersos em molho de tomate sem diferença estatística (p > 0,05) do controle. Para a cor C2, os espécimes imersos em molho de tomate tiveram maior alteração de cor (p < 0,05) em sete dias. Conclusão:Conclui-se que todas as substâncias pigmentantes e a água destilada foram capazes de produzir grandes alterações de cor na resina Beautifil Bulk®. Existe uma interação significativa entre a cor da resina e agentes pigmentantes.

Aim: This study sought to verify, in vitro, the color change of the nanoparticle composite resin, Beautiful Bulk®, exposed directly to pigmented liquids. Methods: Sixty test specimens were made in a Metal matrix (15.0 mm X 1.0 mm) using composite resin (n = 5) in colors A2, B2, and C2. The specimens were photographed with a smartphone (iPhone 6S®) seven days after the preparation. The specimens were kept in the dark for seven days, dry, at 37°C. The specimens were then randomly divided and immersed in four liquids: distilled water (control), açaí juice, Coca-Cola®, and tomato sauce. The immersions were performed in seven and fourteen days cyclically, three times a day, for 20 minutes. At the end of each immersion cycle, new photographs were taken with the same smartphone. The images were analyzed in the Adobe Photoshop® program, and the data was converted to L* a* b* through a histogram. The color variation (∆E) was analyzed by the CIE-Lab scale. Results: Analysis of the results (Tukey's test, p < 0.05) showed that the control group produced a greater color change (p < 0.05) in seven and fourteen days in the A2 shade. The B2 shade, in fourteen days, showed a greater color change (p < 0.05) for the specimens immersed in tomato sauce with no statistical difference (p > 0.05) of the control. For the C2 shade, the specimens immersed in tomato sauce presented a greater color change (p < 0.05) at seven days. Conclusion: It could therefore be concluded that there is a significant interaction between the composite resin and pigment agents. All pigmented substances produced color changes in the composite resin.

Comparison of Clinical Efficacy of Pro-Argin and NovaMin Toothpastes in Relieving Dentin Hypersensitivity: A Systematic Review and Meta-analysis.

PURPOSE: To compare the clinical efficacy of toothpastes containing Pro-Argin and NovaMin as dentin hypersensitivity (DH) treatment. MATERIALS AND METHODS: A systematic review and meta-analysis based on PRISMA was conducted (PROSPERO registration CRD42018095367). Electronic searches were performed in Pubmed, Scopus, Cochrane Library, Web of Science, Virtual Health Library and Open Grey until June 2018, with the terms [pro-argin OR arginine] AND [novamin OR calcium sodium phosphosilicate OR calcium sodium phospho silicate]. Randomised and non-randomised clinical trials comparing DH reduction in adults given Pro-argin-containing toothpastes and NovaMin-containing toothpastes were included. Study selection and quality assessment with Cochrane tool were performed. In the meta-analysis, the comparison between desensitising toothpastes was assessed by standardised mean difference (SMD) with 95% confidence intervals (CI). Certainty of evidence was evaluated with GRADE. RESULTS: Five studies fulfilled the inclusion criteria. In four included studies, a reduction in the DH under tactile stimulus between baseline and post-application times for both toothpastes was demonstrated. Three studies were suitable for meta-analysis. No statistically significant difference between the two toothpastes for DH reduction was observed at immediate (SMD = -1.05, CI = -3.52;1.41), 2-week (SMD = -0.55, CI = -2.59;1.48) and 4-week (SMD = -0.49, CI = -2.78;1.81) follow-up. Certainty of the evidence was very low. Included studies presented a high risk of bias. CONCLUSIONS: Pro-argin-containing and NovaMin-containing toothpastes showed effectiveness for DH reduction. No statistically significant difference between the two toothpastes was found. Thus, both can be prescribed to treat DH in adults with equivalent effectiveness up to four weeks.

Viability of Bovine Teeth as a Substrate in Bond Strength Tests: A Systematic Review and Meta-analysis.

PURPOSE: To assess whether bovine teeth can be used as viable alternatives for human teeth in tensile and shear bond strength testing. MATERIALS AND METHODS: Articles were selected from Web of Science, PubMed, Scopus, LILACS-Bireme, and BBO electronic databases using keywords obtained from Medical Subject Headings (MeSH). Of 1540 potentially eligible studies, 157 were selected for full text analysis. Five independent reviewers (Kappa = 0.89) selected the studies, abstracted information, and assessed quality based on standardized scales. After the analysis, 78 studies comparing bovine teeth to human teeth were found. Only 18 studies comparing bovine and human substrates in bond strength tests were included in the systematic review and 13 in the meta-analysis. Two authors independently selected the studies, extracted the data and assessed the risk of bias. Mean differences were obtained by comparing tensile and shear bond strengths between human and bovine teeth (permanent and deciduous) and considering enamel and dentin separately (subgroup analysis). Statistical analysis was performed using RevMan5.1, with a random-effect model, at a 5% significance level. RESULTS: No significant difference was found between human and bovine teeth in tensile tests (p = 0.41) for dentin (p = 0.86), but there was a difference for enamel (p = 0.01). Regarding shear bond strength, no significant difference was found between human and bovine teeth (p = 0.16) either for enamel (p = 0.07) or dentin (p = 0.68). Regarding shear bond strength on deciduous teeth, no significant difference was found between human and bovine substrates (p = 0.54), either for enamel (p = 0.42) or dentin (p = 0.05). Most studies were at high (low or unclear) risk of bias. CONCLUSIONS: In shear bond strength testing, bovine teeth can be a suitable alternative for permanent and deciduous human teeth, for both enamel and dentin substrates. However, they may not be suitable for enamel tensile bond strength testing. The findings are based on low quality studies (considerable heterogeneity) and should be interpreted with caution.

Anxiety in patients attending dental university clinics / Ansiedade em pacientes atendidos em clínicas odontológicas universitárias

This study aimed to investigate anxiety in patients attended at a university dental clinic. The present cross-sectional study included 49 patients recruited at the undergraduate dental clinics, Federal University of Juiz de Fora, Governador Valadares campus, Minas Gerais, Brazil, from September 2016 to August 2017. Information regarding gender, age, family income, educational level, frequency of dental consultations and dental procedure causing discomfort were collected using a questionnaire. The level of anxiety was evaluated by the Dental Anxiety Scale. A mild level of anxiety (median=6) was observed, with a minimum level of 4 (not anxious) and a maximum level of 19 (extremely anxious). Women had higher anxiety than men (p=0.047). Individuals with 9-11 years of schooling presented a lower level of dental anxiety than those with 0-8 years of schooling (p=0.025). Participants who attributed a greater discomfort to surgeries and the use of high-speed burs had a greater anxiety (p=0.002). Light anxiety is present in patients undergoing dental treatment in university clinics, and women are more anxious than men. Patients with higher education were less anxious than lower education level. The report of a greater discomfort with surgeries and procedures with high-speed burs were associated with a greater anxiety (AU).

Este estudo objetivou investigar a ansiedade em pacientes atendidos em clínicas odontológicas universitárias. O presente estudo transversal incluiu 49 pacientes recrutados nas clínicas odontológicas da Universidade Federal de Juiz de Fora, campus Governador Valadares, Minas Gerais, Brasil, de setembro de 2016 a agosto de 2017. Informações sobre sexo, idade, renda familiar, escolaridade, frequência de consultas odontológicas e procedimentos odontológicos causadores de desconforto foram coletadas por meio de questionário. O nível de ansiedade foi avaliado pela Dental Anxiety Scale. Observou-se um nível de ansiedade leve (mediana = 6), com mínimo de 4 (não ansioso) e máximo de 19 (extremamente ansioso). As mulheres apresentaram maior ansiedade que os homens (p = 0,047). Indivíduos com 9 a 11 anos de escolaridade apresentaram menor nível de ansiedade odontológica do que aqueles com 0 a 8 anos de estudo (p = 0,025). Os participantes que atribuíram maior desconforto às cirurgias e ao uso de alta rotação apresentaram maior ansiedade (p = 0,002). Conclui-se que a ansiedade leve está presente em pacientes submetidos a tratamento odontológico em clínicas universitárias, sendo as mulheres mais ansiosas do que os homens. Pacientes com maior grau de instrução foram menos ansiosos. O relato de maior desconforto com cirurgias e procedimentos alta rotação pode estar associado a uma maior ansiedade (AU).

Ultramorphology of pre-treated adhesive interfaces between self-adhesive resin cement and tooth structures / Ultramorfologia de interfaces adesivas entre cimento resinoso auto-adesivo e estruturas dentárias pré-tratadas

Introduction: Convencional resin cements can be used in combination with a total-etch system in a conventional mode or as self-adhesive resin cements. The latter are less technique sensitive and able to bond to dental tissues without previous treatment or adhesive layer and requires only a single step to be applied to dental structures. Objective: To compare qualitatively the adhesive interfaces of two self-adhesive resin cements and one conventional resin cement after different tooth surface treatments under scanning electron microscopy. Material and method: 42 crowns of bovine incisors were sectioned and flattened exposing enamel (E) or dentine (D) substrate. Subgroups were defined according to conditioning type and time: E1—no treatment, E2—37% phosphoric acid for 15 seconds, E3—37% phosphoric acid for 30 seconds; D1—no treatment, D2—37% phosphoric acid for 5 seconds; D3—11.5% polyacrylic acid for 15 seconds. A resin block was bonded to each substrate using the self-adhesive resin cements RelyX U100 (3M ESPE) and RelyX U200 (3M ESPE). As a reference hybrid layer, six resin blocks were luted with RelyX ARC and Scotchbond Multi-Purpose adhesive system (3M ESPE) (enamel—EA; dentine—DA). After aging for 7 days in a moist environment at 37±1°C, samples were prepared for microscopy analysis. Result and Discussion: In the ARC specimens, there was hybrid layer formation in both EA and DA. U100 E1 showed gaps at the adhesive interface, while E2 and E3 showed interaction for both self-adhesive cements. There was superficial interaction with bothU100 and U200 in D1, while in D2 and D3, resin tags were only observed in the case of U100. Conclusion: It was concluded that substrate conditioning may enhance the interaction between self-adhesive resin cements and dental tissues, although this is not the case for RelyX U200 and dentine.

Introdução: Restaurações estéticas indiretas são preferencialmente cimentadas utilizando-se cimentos resinosos convencionais e sistema adesivo de condicionamento total ou cimentos resinosos autoadesivos. Estes últimos são tecnicamente menos sensíveis e aderem aos tecidos dentários sem tratamento prévio ou aplicação de adesivo, com um único passo para sua aplicação aos tecidos dentários. Objetivo: Comparar qualitativamente as interfaces adesivas de dois cimentos resinosos autoadesivos e um cimento resinoso convencional, sob microscopia eletrônica de varredura. Material e método: 42 coroas de incisivos bovinos foram seccionadas e as faces vestibulares planificadas expondo esmalte (E) ou dentina (D). Os subgrupos foram definidos de acordo com o tipo e tempo de condicionamento: E1-sem tratamento, E2-37% de ácido fosfórico por 15 segundos, E3-37% de ácido fosfórico por 30 segundos; D1-sem tratamento, D2-37% de ácido fosfórico durante 5 segundos; D3-11,5% de ácido poliacrílico durante 15 segundos. Um bloco de resina foi unido a cada substrato usando os cimentos resinosos autoadesivos RelyX U100 e RelyX U200 (3M ESPE) (n=3). Como referência de camada híbrida, foram cimentados seis blocos de resina com RelyX ARC e o sistema adesivo Scotchbond Multi-Purpose(esmalte-EA, dentina-DA). Após armazenamento (7 dias, umidade, 37±1°C), as amostras foram preparadas para análise microscópica. Resultado: Nos espécimes ARC, houve formação de camada híbrida em EA e DA. U100 E1 mostrou lacunas na interface adesiva, enquanto E2 e E3 apresentaram boa interação para ambos os cimentos autoadesivos. Houve interação superficial com U100 e U200 em D1, enquanto em D2 e ​​D3, foram observadas tags de resina apenas para U100. Conclusão: Concluiu-se que o condicionamento do substrato pode aumentar a interação entre cimentos resinosos autoadesivos e os tecidos dentários, embora este não seja o caso do RelyX U200 e da dentina.

LED and Halogen Light Transmission through a CAD/CAM Lithium Disilicate Glass-Ceramic

The effect of thickness, shade and translucency of CAD/CAM lithium disilicate glass-ceramic on light transmission of light-emitting diode (LED) and quartz-tungsten-halogen units (QTH) were evaluated. Ceramic IPS e.max CAD shades A1, A2, A3, A3.5, high (HT) and low (LT) translucency were cut (1, 2, 3, 4 and 5 mm). Light sources emission spectra were determined. Light intensity incident and transmitted through each ceramic sample was measured to determine light transmission percentage (TP). Statistical analysis used a linear regression model. There was significant interaction between light source and ceramic translucency (p=0.008) and strong negative correlation (R=-0.845, p<0.001) between ceramic thickness and TP. Increasing one unit in thickness led to 3.17 reduction in TP. There was no significant difference in TP (p=0.124) between shades A1 (ß1=0) and A2 (ß1=-0.45) but significant reduction occurred for A3 (ß1=-0.83) and A3.5 (ß1=-2.18). The interaction QTH/HT provided higher TP (ß1=0) than LED/HT (ß1=-2.92), QTH/LT (ß1=-3.75) and LED/LT (ß1=-5.58). Light transmission was more effective using halogen source and high-translucency ceramics, decreased as the ceramic thickness increased and was higher for the lighter shades, A1 and A2. From the regression model (R2=0.85), an equation was obtained to estimate TP value using each variable ß1 found. A maximum TP of 25% for QTH and 20% for LED was found, suggesting that ceramic light attenuation could compromise light cured and dual cure resin cements polymerization.

Resumo Avaliou-se o efeito da espessura, cor e translucidez de uma cerâmica vítrea a base de dissilicato de lítio para CAD / CAM sobre a transmissão da luz de unidades de diodos emissores de luz (LED) e de quartzo-tungstênio-halogênio (QTH). Cerâmica IPS e.max CAD nas cores A1, A2, A3, A3.5 de translucidez alta (HT) e baixa (LT) foram cortadas (1, 2, 3, 4, 5 mm). Os espectros de emissão das fontes de luz foram determinados. A intensidade da luz incidente e transmitida através de cada espécime de cerâmica foi medida para determinar a percentagem de transmissão de luz (TP). Um modelo de regressão linear foi utilizado para a análise estatística. Houve interação significativa entre a fonte de luz e translucidez cerâmica (p = 0.008) e forte correlação negativa (r = -0.845, p <0.001) entre a espessura da cerâmica e TP. O aumento da espessura em uma unidade levou a uma redução média de 3.17 em TP. Não houve diferença significativa em TP (p = 0.124) entre as cores A1 (ß1 = 0) e A2 (ß1 = -0.45), mas ocorreu redução significativa para as cores A3 (ß1 = -0.83) e A3.5 (ß1 = -2.18). A interação QTH/HT proporcionou maior TP (ß1 = 0) do que LED/HT (ß1 = -2.92), QTH/LT (ß1 = -3.75) e LED/LT (ß1 = -5.58). A transmissão de luz foi mais eficaz utilizando QTH e cerâmica de alta translucidez, diminuiu à medida que a espessura de cerâmica aumentou, e foi maior para as cores A1 e A2. A partir do modelo de regressão (R2 = 0.85), obteve-se uma equação para estimar o valor de TP utilizando os valores de ß1 encontrado. Foi observada TP máxima de 25% para QTH e 20% para LED, sugerindo que a atenuação promovida pela cerâmica pode comprometer a ativação de um cimento resinoso fotoativado e de ativação dupla.

Effect of chlorhexidine varnish on gingival growth in orthodontic patients: a randomized prospective split-mouth study.

INTRODUCTION: Fixed orthodontic appliances patients suffer limitations on the effective control of biofilm by mechanical methods, bringing the need of a coadjutant in the control of inflammation and oral health improvement. OBJECTIVE: The aim of this prospective split-mouth blind study was to analyze the effect of a 40% chlorhexidine (CHX) varnish on gingival growth of patients with orthodontic fixed appliances. METHODS: Healthy teenage patients with fixed orthodontic appliances and increased gingival volume were recruited (n = 30). Each individual was his own control, having in the maxilla one control side and one treatment side. An application of varnishes occurred on the vestibular area of the upper premolars and first molar crowns, on the control side (placebo varnish) and on the experimental side (EC40(r) Biodentic CHX varnish). The varnishes and sides were randomly chosen and its identification and group was kept by a third party observer and it was not revealed to the researchers and participants until the end of study. In order to establish a baseline registration, digital photographs were taken by a trained photographer before varnish application at baseline (T0), as well as 14 days (T14) and 56 days (T56) after the application. The gingival volume was calculated indirectly using the vestibular areas (mm2) of the upper second premolars' clinical crowns by RapidSketch(r) software, at all study times. The data were analyzed using ANOVA and the Turkey-Krammer test. RESULTS: It was observed, in the final sample of 30 individuals, that at T0, the control and treatment groups were similar. At T14 and T56, a progressive reduction of the clinical crown area was seen in the control group, and an increase in the average area was detected in the experimental group (p < 0,05). CONCLUSIONS: The use of 40% CHX varnish decreases the gingival overgrowth in patients undergoing orthodontic treatment. Further studies are necessary to set the action time and frequency of application.

Effect of chlorhexidine varnish on gingival growth in orthodontic patients: a randomized prospective split-mouth study

Introduction: Fixed orthodontic appliances patients suffer limitations on the effective control of biofilm by mechanical methods, bringing the need of a coadjutant in the control of inflammation and oral health improvement.Objective: The aim of this prospective split-mouth blind study was to analyze the effect of a 40% chlorhexidine (CHX) varnish on gingival growth of patients with orthodontic fixed appliances. Methods: Healthy teenage patients with fixed orthodontic appliances and increased gingival volume were recruited (n = 30). Each individual was his own control, having in the maxilla one control side and one treatment side. An application of varnishes occurred on the vestibular area of the upper premolars and first molar crowns, on the control side (placebo varnish) and on the experimental side (EC40(r) Biodentic CHX varnish). The varnishes and sides were randomly chosen and its identification and group was kept by a third party observer and it was not revealed to the researchers and participants until the end of study. In order to establish a baseline registration, digital photographs were taken by a trained photographer before varnish application at baseline (T0), as well as 14 days (T14) and 56 days (T56) after the application. The gingival volume was calculated indirectly using the vestibular areas (mm2) of the upper second premolars' clinical crowns by RapidSketch(r) software, at all study times. The data were analyzed using ANOVA and the Turkey-Krammer test.Results:It was observed, in the final sample of 30 individuals, that at T0, the control and treatment groups were similar. At T14 and T56, a progressive reduction of the clinical crown area was seen in the control group, and an increase in the average area was detected in the experimental group (p < 0,05).Conclusions: The use of 40% CHX varnish decreases the gingival overgrowth in patients undergoing orthodontic treatment. Further studies are necessary to set the action time and frequency of application.

Introdução: pacientes com aparelhos ortodônticos fixos sofrem limitações no controle efetivo de biofilme por métodos mecânicos, trazendo a necessidade de um coadjuvante no controle na inflamação e melhora na saúde bucal.Objetivo:esse estudo cruzado prospectivo randomizado teve como objetivo analisar o efeito do verniz de clorexidina (CHX) a 40% no crescimento gengival de pacientes com aparelhos ortodônticos fixos.Métodos:indivíduos adolescentes com aparelhos ortodônticos fixos e aumento de volume gengival foram recrutados para a pesquisa (n = 30). Cada participante atuou como seu próprio controle, tendo, na maxila, um lado controle e um tratamento. No lado controle, aplicou-se verniz placebo e no lado experimental, o verniz EC40(r) Biodentic CHX, ambos na face vestibular das coroas dos pré-molares e primeiro molar superiores. Os vernizes e lados foram escolhidos de forma aleatória e a identificação deles e a que grupo pertenciam foi mantida por um terceiro observador, não sendo revelada aos pesquisadores nem aos participantes até o final do estudo. Fotografias digitais foram tiradas por um fotógrafo treinado, antes da aplicação do verniz no tempo inicial (T0), bem como 14 dias (T14) e 56 dias (T56) após a aplicação. O volume gengival foi calculado indiretamente, por meio das áreas vestibulares (mm2) das coroas dos segundos pré-molares superiores, com o softwareRapidSketch(r), em todos os tempos de estudo. Os dados foram analisados usando ANOVA e teste de Turkey-Krammer.Resultados:na amostra final de 30 indivíduos, observou-se que, em T0, os grupos controle e tratamento foram semelhantes. Já em T14 e T56, foi observada uma progressiva redução na área da coroa clínica no grupo controle, e um aumento na área média do grupo experimental (p< 0,05).Conclusão:o uso do verniz de CHX a 40% diminui o excessivo crescimento gengival em pacientes sob tratamento ortodôntico. Estudos futuros são necessários para se determinar o tempo de ação e a frequência de aplicação.

Review of follow-up of clinical success of implant-supported complete dental prostheses / Revisão do sucesso clínico longitudinal dos implantes pilares de prótese total

OBJECTIVE: The aim of this study was to assess the clinical success rate of implant-supported complete dental prostheses, which are being used as a feasible alternative in planning of oral rehabilitation. Over the years, the two-stage surgical protocol has increasingly been replaced by immediate loading procedures, especially in the mandibular anterior region in cases of rehabilitation of completely edentulous patients. This procedure has become feasible due to the high success rate of the technique with very satisfactory results. METHODS: By means of a literature review focused on published articles with clinical follow-up between 8 and 15 years. RESULTS: Implants placed in the mandible had higher success rates than those inserted in the maxilla. Cases with longer follow-up periods, 15 years, showed higher success rates in comparison with follow-up periods of 8 and 10 years. CONCLUSION: Success rates of implant-supported complete dental prostheses are very high. .

OBJETIVO: Avaliar o índice de sucesso clínico dos implantes pilares de próteses totais implantossuportadas. As próteses implantossuportadas vêm sendo utilizadas como uma alternativa viável ao planejamento de reabilitação oral. O protocolo de dois estágios cirúrgicos, ao passar dos anos, vem sendo cada vez mais substituídos pelos procedimentos de carga imediata, principalmente na região anterior inferior, nos casos de reabilitação de pacientes totalmente desdentados. Tal procedimento torna-se viável devido ao alto índice de sucesso da técnica com resultados bastante satisfatórios. MÉTODOS: Por meio de uma revisão de literatura focada em trabalhos publicados com acompanhamento clínico entre 8 e 15 anos. RESULTADOS: Os implantes instalados em mandíbula apresentaram índices de sucesso maiores que os instalados em maxila. Os casos com acompanhamento mais longos, com 15 anos, apresentaram índices de sucesso maiores do que quando comparados aos acompanhamentos de 8 e 10 anos. CONCLUSÃO: O índice de sucesso dos implantes pilares de prótese total é bastante alto. .

Silorane-based composite as repair material: a six-month randomizedclinical trial / Resina composta à base de silorano como material de reparo: estudo clínico randomizado de seis meses

Objective: This study investigated the clinical performance of a silorane-based composite resin when used for repairing conventional composite restorations. Methods: Defective dimethacrylate-based composite resin restorations were randomly assigned to one of two treatment groups: Control group - Adper SE Plus + Filtek P60 (3M/ESPE, St. Paul, EUA) and Test Group - P90 Adhesive System + Filtek P90 (3M/ESPE, St. Paul, EUA). All repaired restorations were evaluated at baseline, and at six-month recall. The parameters examined were marginal adaptation, anatomic form, surface roughness, marginal discoloration, post-operative sensitivity and secondary caries. The restorations were classified according to modified USPHS criteria. Mann-Whitney and Wilcoxon tests were used to compare the groups. Results: Of the 100 restorations repaired in this study, 93 were reexamined at baseline and 91 at 6-month recall. Drop-out was about 9%. No statistically significant differences were found between the materials for all clinical criteria, at baseline and at 6-month recall (p > 0.05). No statistically significant differences were registered (p > 0.05) for each material when compared for all clinical criteria, at baseline and at 6-month recall. The hypothesis tested in this randomized controlled clinical trial was accepted. Conclusion: After the six-month evaluations, silorane-based composite exhibit a similar performance compared to dimethacrylate-based composite when used as repair material.

Objetivo: Investigar o desempenho clínico de uma resina de baixa contração à base de silorano quando utilizada para reparar restaurações convencionais de resina composta. Métodos: Restaurações defeituosas de resina composta à base de dimetacrilato foram aleatoriamente reparadas por um de dois grupos de tratamento: Grupo Controle - Adper SE Plus + Filtek P60 (3M/ESPE, St. Paul, EUA) e Grupo Teste - Sistema adesivo P90 + Filtek P90 (3M/ESPE, St. Paul, EUA). Todas as restaurações reparadas foram avaliadas em baseline e ao longo de 6 meses. Os parâmetros analisados foram a adaptação marginal, forma anatômica, rugosidade superficial, descoloração marginal, sensibilidade pós-operatória e lesões de cárie. As restaurações foram classificadas de acordo com os critérios do Serviço de Saúde Público dos Estados Unidos modificados. Os testes de Mann-Whitney e Wilcoxon foram utilizados para comparar os grupos. Resultados: Das 100 restaurações reparadas neste estudo, 93 foram examinadas uma semana após terem sido reparadas - baseline e 91 após 6 meses. A perda foi de aproximadamente 9%. Nenhuma diferença estatisticamente significativa foi encontrada entre os materiais para todos os critérios clínicos, em baseline e ao longo de 6 meses (p> 0,05). Conclusão: A hipótese testada neste ensaio clínico controlado randomizado foi aceita. Após 6 meses de avaliações, resinas compostas à base de silorano apresentaram desempenho clínico semelhante às resinas compostas à base de dimetacrilato quando utilizadas para reparar restaurações de resina composta à base de dimetacrilato.

Uso de dentes humanos extraídos e os bancos de dentes nas instituições brasileiras de ensino de odontologia / Use of extracted human teeth and the human tooth bank in brazilian dental schools

Objetivo: Avaliar aspectos relacionados ao uso de dentes humanos extraídos nos cursos de graduação e pós-graduação do Brasil e a existência de Banco de Dentes Humanos (BDH) nas Instituições de Ensino Superior (IES) em Odontologia. Método: Foi realizado um estudo transversal, por meio de um questionário semiestruturado enviado, via endereço eletrônico, aos Coordenadores e/ou Diretores dos Cursos de Odontologia cadastrados no Ministério da Educação (MEC). Após envio do questionário, no caso da não-resposta após três tentativas, o instrumento impresso foi enviado às IES pelo correio. O instrumento foi testado por um coordenador de um curso de Odontologia de uma instituição diferente daquela na qual o projeto foi desenvolvido, para verificação de problemas de entendimento e formatação. Os dados foram analisados por meio da estatística descritiva (distribuições absolutas e percentuais). Resultados: Das 187 instituições localizadas junto ao MEC, 57 (30,48%) responderam. Os dentes humanos são utilizados para treinamento em 55 IES (96,5%): (87,70% em Endodontia; 63,20% em Dentística; 56,10% em Prótese, 47,40% em Anatomia Dental e 5,30% em Periodontia). A Endodontia é a disciplina que utiliza maior número de dentes (1.299 dentes/semestre). Em 42% das IES, os dentes foram fornecidos pelo BDH; em 44% pelos alunos; em 12% por ambos. O BDH foi também a principal fonte de dentes humanos para pesquisa para 64,3% de 46 IES (19.570 dentes/ano). Das 50 IES com cursos de Pós-graduação, 21 relataram utilizar dentes extraídos. Declararam conhecer a origem dos dentes 44 instituições e oito utilizam termo de doação, quando o dente não é proveniente do BDH. Possuem BDH 37 (64,91%) IES com 3,1±2,5 anos de existência. O BDH foi considerado autossuficiente em 16 delas. Conclusão: Embora o uso de dentes extraídos seja frequente no ensino e na pesquisa, nas diferentes áreas da Odontologia, a existência de BDH é fenômeno recente e incompletamente difundido nas IES.

Objective: The purpose of this study was to evaluate aspects related to the use of extracted human teeth in Brazilian undergraduate and graduate dental courses and the existence of a Human Tooth Bank (HTB) at the higher education institutions. Method: A semi-structured questionnaire was sent by e-mail to the coordinators and/or directors of dental courses registered with the Ministry of Education (MEC). In case of no response after three attempts, the questionnaire was sent to the institutions by mail. To check if there were understanding and formatting problems, the questionnaire was tested by a coordinator from a different institution from the one where it was designed. The data were analyzed and reported descriptively. Results: Out of the 187 institutions listed by MEC, 57 (30.48%) responded. Human teeth are used for training in 55 (96.5%) institutions (87.70% in endodontics; 63.20% in dentistry, in prosthodontics 56.10%, 47.40% in dental anatomy and 5.30% in periodontics). Endodontics is the discipline that uses the largest number of teeth (1,299 teeth/semester). In 42% of the institutions, the teeth were supplied by HTB, 44% by students; 12% by both. The HTB was also the main source for 64.3% of the 46 institutions that conduct research with human teeth (19,570 teeth/year). Out of the 50 institutions with graduate courses, 21 reported using extracted teeth. Forty-four institutions affirmed to know the origin of the teeth and 8 use a donation form, when the tooth is not coming from HTB. Thirty-seven institutions (64.91%) have HTB that are 3.1 ± 2.5 years old. The HTB was considered to be self-sufficient by 16 of them. Conclusion: Although the use of extracted teeth is common in teaching and research activities in the different s of dentistry, the existence of HTB is a new phenomenon, but yet not sufficiently disseminated among the higher education institutions.

Standard of disocclusion in complete dentures supported by implants without free distal ends: analysis by the finite elements method.

OBJECTIVE: The occlusal patterns are key requirements for the clinical success of oral rehabilitation supported by implants. This study compared the stresses generated by the disocclusion in the canine guide occlusion (CGO) and bilateral balanced occlusion (BBO) on the implants and metallic infrastructure of a complete Brånemark protocol-type denture modified with the inclusion of one posterior short implant on each side. MATERIAL AND METHODS: A three-dimensional model simulated a mandible with seven titanium implants as pillars, five of them installed between the mental foramen and the two posterior implants, located at the midpoint of the occlusal surface of the first molar. A load of 15 N with an angle of 45° was applied to a tooth or distributed across three teeth to simulate the CGO or BBO, respectively. The commercial program ABAQUS® was used for the model development, before and after the processing of the data. The results were based on a linear static analysis and were used to compare the magnitude of the equivalent stress for each of the simulations. RESULTS: The results showed that the disocclusion in CGO generated higher stresses concentrated on the working side in the region of the short implant. In BBO, the stresses were less intense and more evenly distributed on the prosthesis. The maximum stress found in the simulation of the disocclusion in CGO was two times higher than that found in the simulation of the BBO. The point of maximum stress was located in the neck of the short implant on the working side. CONCLUSIONS: Under the conditions of this study, it was concluded that the BBO pattern was more suitable than CGO for the lower complete denture supported by implants without free distal ends.

Standard of disocclusion in complete dentures supported by implants without free distal ends: analysis by the finite elements method

OBJECTIVE: The occlusal patterns are key requirements for the clinical success of oral rehabilitation supported by implants. This study compared the stresses generated by the disocclusion in the canine guide occlusion (CGO) and bilateral balanced occlusion (BBO) on the implants and metallic infrastructure of a complete Brånemark protocol-type denture modified with the inclusion of one posterior short implant on each side. MATERIAL AND METHODS: A three-dimensional model simulated a mandible with seven titanium implants as pillars, five of them installed between the mental foramen and the two posterior implants, located at the midpoint of the occlusal surface of the first molar. A load of 15 N with an angle of 45° was applied to a tooth or distributed across three teeth to simulate the CGO or BBO, respectively. The commercial program ABAQUS® was used for the model development, before and after the processing of the data. The results were based on a linear static analysis and were used to compare the magnitude of the equivalent stress for each of the simulations. RESULTS: The results showed that the disocclusion in CGO generated higher stresses concentrated on the working side in the region of the short implant. In BBO, the stresses were less intense and more evenly distributed on the prosthesis. The maximum stress found in the simulation of the disocclusion in CGO was two times higher than that found in the simulation of the BBO. The point of maximum stress was located in the neck of the short implant on the working side. CONCLUSIONS: Under the conditions of this study, it was concluded that the BBO pattern was more suitable than CGO for the lower complete denture supported by implants without free distal ends.

Validity of two occlusal indices for determining orthodontic treatment needs of patients treated in a public university in Belo Horizonte, Minas Gerais State, Brazil.

The aim of the present study was to validate the dental aesthetic index (DAI) and index of complexity, outcome and need (ICON) based on the opinions of a panel of Brazilian orthodontists. A comparison of these two orthodontic treatment need indices was carried out based on the consensus of a panel of 20 experienced orthodontists. A set of 108 study casts representing the full spectrum of malocclusions was selected. A calibrated examiner scored the casts for both indices. The orthodontists individually rated the casts regarding the degree of orthodontic treatment need. The panel's mean rating of the need for treatment was used as the gold standard for evaluating the validity of the indices. The accuracy of the indices, as reflected in the area under receiver-operating characteristic curves, was high: DAI = 81.83% (95%CI: 71.21-92.44); ICON = 88.75% (95%CI: 78.57-98.92). Although the accuracy of the ICON was higher than that of the DAI, both indices are recommended for determining orthodontic treatment need in Brazil.

Atenção odontológica e práticas de higiene bucal em instituições de longa permanência geriátricas / Dental care and oral hygiene practices in long-term geriatric care institutions

Este estudo avaliou a atuação de cirurgiões-dentistas (CD) nas instituições de longa permanência de Belo Horizonte (MG) e as práticas de higiene bucal adotadas. Questionários semiestruturados foram entregues aos coordenadores das 37 instituições filantrópicas e trinta privadas e coletados após uma semana. Os resultados foram comparados pelos testes Qui-quadrado e Exato de Fisher (p<0,05). Houve retorno de 81 por cento dos questionários. A maioria das instituições privadas (74,2 por cento) e filantrópicas (87 por cento) não possui CD na equipe de saúde (p=0,21). A localização da instituição, o tempo de fundação, o tipo e o número de residentes não interferiram na presença de CD (p>0,05). Nas instituições filantrópicas com consultório, 67 por cento possuíam CD, e nenhum CD trabalhava onde não havia consultório. Mesmo sem consultório, 13 por cento das instituições privadas possuíam CD. 69,6 por cento das filantrópicas encaminhavam o idoso em caso de necessidade para centros de saúde e, nas privadas, 58,1 por cento direcionavam ao familiar (p=0,00). Maior percentual de instituições privadas adotava medidas sistematizadas de higiene bucal (p=0,01), com grande variabilidade nas condutas relatadas. Há necessidade da incorporação do CD na equipe de saúde das instituições e da sistematização das práticas de higiene bucal.

This study evaluated the activities of dentists, dental care and oral hygiene practices in the long-term care institutions of Belo Horizonte (Minas Gerais, Brazil). A semi-structured questionnaire was handed out to the coordinators of 37 philanthropic and 30 private institutions. The data was compared by the chi-square and Fisher's Exact Tests. 81 percent of the questionnaires were answered. The majority of the private (74.2 percent) and philanthropic institutions (87 percent) do not have a dentist (p=0.21). The location, period of existence, type institution kind and number of residents weren't factors regarding the presence of a dentist (p>0.05). 67 percent of the philanthropic institutions with equipped consultation rooms had dentists, though there were none when there was no consultation room. Even without consultation rooms, 13 percent of the private institutions had dentists. When necessary, 69.6 percent of the philanthropic institutions refer the elderly to public health centers, while 58.1 percent of the private institutions refer them to their family dentists. A higher percentage of the private institutions adopted systematic oral hygiene procedures (p=0.01), with a considerable divergence of treatment reported. There is a need to include a dentist on the health staff in the institutions and for systematization of oral hygiene practices.