Chemical analysis of n-propyl gallate used as pre-treatment for resin-dentin bond strength: In vitro study.

This study aimed to evaluate the effect of n-propyl gallate as pre-treatment for resin-dentin bond strength. The dentin pre-treatments evaluated included propyl gallate of concentrations 0.1% (w/v), 1.0% (w/v), and 10.0% (w/v), as well as glutaraldehyde 5.0% (v/v), and distilled water as a control treatment. Dentin specimens were prepared for Fourier Transformed Infrared Spectroscopy (FT-IR) (n = 3/pre-treatment). Pre-treatments were actively applied to dentin blocks before performing the adhesive procedure to composite resin. Microtensile bond strength to dentin (µTBS) (n = 8/pre-treatment) was determined after 24 h and 6 months of storage. Data were submitted to a two-way ANOVA, followed by Tukey's post hoc test. As for FT-IR, propyl gallate 1%-treated specimens presented higher water, carbonate, collagen, and amide absorbance rates compared to other tested groups, while specimens pre-treated with glutaraldehyde and distilled water presented similar absorbance curves. Regarding µTBS, all concentrations of propyl gallate resulted in statistically significant higher bond strength values than distilled water at 24 h. After 6 months of storage, propyl gallate 0.1% was the only group that maintained µTBS over time. Propyl gallate 0.1% might be a suitable dentinal pre-treatment due to being able to present chemical bonds with demineralized dentin and providing resin-dentin bond stability after 6 months of storage.

Effect of Metalloproteinase Inhibitors on Bond Strength of a Self-etching Adhesive on Erosively Demineralized Dentin.

PURPOSE: To analyze the influence of epigallocatechin-3-gallate (EGCG) and chlorhexidine (CHX) on adhesive-dentin bond strength of a self-etch adhesive to sound dentin (SD) and eroded dentin (ED). MATERIALS AND METHODS: Thirty-six middle-dentin samples were assigned to six groups (n = 6) according to pretreatment (DW: distilled water, control; 0.1% EGCG; or 2% CHX) and erosive challenge (presence or absence). Specimens were subjected to 2-h acquired pellicle formation, then half of them were exposed to 1% citric acid three times a day for five days. SD and ED were treated with the tested solutions for 60 s, and then Clearfil SE Bond was applied before resin composite buildup. Bonded teeth were longitudinally sectioned into sticks and half were immediately tested, while the remaining specimens were tested after six months. The mode of fracture was examined and the microtensile bond strength (µTBS) measured. Statistical analysis was performed with ANOVA and Bonferroni tests. RESULTS: At both time periods, regardless of the dentin substrate, EGCG groups did not show bond strengths that were significantly different from those obtained with DW (p > 0.05), while CHX generated lower values than did DW (p < 0.05). On SD, there was a bond strength reduction only in the CHX groups after six months. However, for ED, the bond strength significantly decreased in all groups. CONCLUSION: CHX negatively affected both dentin substrates, while the pretreatment with EGCG did not affect µTBS over time on SD. µTBS may be influenced by the substrate over time and EGCG can be used as an alternative to CHX to maintain the bond strength of self-etching adhesives.

Ácido tânico como agente biomodificador de dentina / Tanic acid as biomodificator of collagen dentin

Introdução: a utilização de diferentes polifenóis no aumento das propriedades mecânicas do colágeno dentinário tem sido bastante empregada, sendo o ácido tânico um polifenol com propriedade biológica bastante pronunciada. Objetivo: avaliar o potencial biomodificador do ácido tânico (AT) em diferentes concentrações em colágeno dentinário. Métodos: os fatores sob investigação foram módulo de elasticidade, mensurado por meio de um ensaio de flexão de três pontos (n=10) e variação de massa (n=10), aferidos com uma balança de precisão, sendo, para tanto, avaliados os seguintes elementos: ácido tânico (0,1; 1 e 10%), proantocianidina (6,5%) e água destilada (controle). Resultados: quanto ao módulo de elasticidade, os grupos tratados com ácido tânico apresentaram valores, estatisticamente, superiores (p<0,05) aos demais grupos, não sendo observadas diferenças entre suas diferentes concentrações. Para os valores de variação de massa, os grupos que foram imersos em agentes biomodificadores apresentaram valores estatisticamente (p<0,05) superiores ao grupo controle. Conclusão: o ácido tânico se apresenta como um potencial agente biomodificador do colágeno dentinário, independente da concentração utilizada, aumentando o seu módulo de elasticidade e gerando um ganho de massa após uma hora de imersão.

Introduction: The use of different polyphenols in the increase of the mechanical properties of dentin collagen has been widely used, thus, tannic acid being a polyphenol with very pronounced biological proprieties. Objective: to evaluate the biomodifying potential of tannic acid (AT) in different concentrations in dentin collagen. Methods: the factors under investigation were modulus of elasticity, measured by a three-point bending test (n = 10), and mass variation (n = 10), measured by means of a precision scale, being the following substances evaluated: tannic acid (0.1, 1 and 10%), proanthocyanidin (6.5%) and distilled water (control). Results: As for the modulus of elasticity, the groups treated with tannic acid presented statistically higher values (p <0.05) in relation to the other groups, and no differences were observed between the different concentrations. For the values of mass variation, the groups that were immersed in biomodifiers showed statistically (p <0.05) values higher than the control group. Conclusion: tannic acid presents as a potential biomodifying agent of dentin collagen, regardless of the concentration used, increasing its modulus of elasticity and generating a mass gain after one hour of immersion.

Avaliação do efeito de técnicas de acabamento e polimento na rugosidade superficial de resinas compostas / Evaluation of the effect of finishing and polishing techniques on surface roughness of composite resins

Introdução: o acabamento e o polimento das resinas compostas (RC) podem interferir diretamente na rugosidade desses materiais, estando relacionadas com a adesividade de placa bacteriana, manchamento, brilho e lisura. Objetivo: comparar a rugosidade superficial de duas RC, sendo uma micro-híbrida (Filtek Z250) e outra nanoparticulada (Filtek Z350), após a realização dos procedimentos de acabamento e polimento. Métodos: utilizando-se uma matriz metálica, confeccionaram-se quinze discos de cada RC. A lisura superficial proporcionada pela fita de poliéster foi avaliada por meio de um rugosímetro (Hommel Tech-T1000), obtendo-se dados iniciais. Realizou-se a mensuração em triplicata, obtendo-se o valor da rugosidade média (Ra). Lixaram-se as superfícies de topo dos espécimes e seguiu-se nova obtenção da Ra. Os espécimes foram, aleatoriamente, distribuídos em três grupos: GI ­ discos de óxido de alumínio; GII ­ pontas siliconadas e GIII ­ discos de diamante micronizado, sendo obtida a Ra final. Os dados foram analisados pelo teste de Kruskal-Wallis e Qui-quadrado (α=1%). Resultados: a média e o desvio-padrão expresso em µm foram: Z-250 GI - 0,16 (0,09), GII - 0,32 (0,06) e GIII - 0,06 (0,02) e para Z-350 GI - 0,06 (0,01), GII - 0,49 (0,14) e GIII - 0,07 (0,01). Para Z-250, o GIII apresentou melhor polimento, sendo, estatisticamente, diferente de GI e GII (p≤0,01). Para Z-350, não houve diferença estatística entre os GI e GIII, mas eles foram superiores ao GII (p≤0,01). Conclusão: o disco de diamante micronizado proporcionou melhores valores de lisura superficial independente do tipo de resina composta empregada.

Introduction: finishing and polishing of composite resins (CR) can directly interfere with the roughness of these materials, being related to bacterial plaque adhesion, staining, gloss and smoothness. Objective: to compare the surface roughness of two CR, a micro-hybrid (Filtek Z250) and a nanoparticulate (Filtek Z350) after finishing and polishing. Methods: using a metal matrix, fifteen disks of each CR were made. The surface smoothness provided by the polyester tape was evaluated by a rugosimeter (Hommel Tech-T1000) obtaining initial data. Measurements were made in triplicate, and the mean roughness value (Ra) was obtained. The top surfaces of the specimens were sieved and re-obtained the Ra. The specimens were randomly distributed into three groups: GI - aluminum oxide discs; GII - silicone tips and GIII - micronized diamond discs, obtaining the final Ra. Data were analyzed by the Kruskal-Wallis test and chi-square test (α = 1%). Results: the mean and standard deviation expressed in µm were: Z-250 GI - 0.16 (0.09), GII - 0.32 (0.06) and GIII - 0.06 (0.02) and for Z -350 GI - 0.06 (0.01), GII - 0.49 (0.14) and GIII - 0.07 (0.01). For Z-250, the GIII presented better polishing, being statistically different from GI and GII (p≤0.01). For Z-350, there was no statistical difference between GI and GIII, but these were higher than GII (p≤0.01). Conclusion: the micronized diamond disk provided better surface smoothness values independent on the type of composite resin used.

Pretreatment with Sodium Fluoride Maintains Dentin Bond Strength of a Two-Step Self-Etch Adhesive after Thermal Stressing.

PURPOSE: To evaluate the effect of sodium fluoride and chlorhexidine digluconate on the composite-dentin bond strength of a self-etch adhesive after thermocycling. MATERIALS AND METHODS: Eighteen human third molars were prepared to expose a flat dentin surface and were divided into 3 groups (n = 6) according to the 3 cavity cleaning solutions: distilled water, 2% chlorhexidine digluconate (CHX), or 1.23% sodium fluoride (NaF). Solutions were rubbed onto dentin surfaces for 60 s, followed by bonding with Clearfil SE Bond, and a 5-mm-thick composite crown buildup. Bonded teeth were stored in distilled water for 24 h and then longitudinally sectioned to obtain bonded sticks. Half of the specimens were immediately tested in tension at 0.5 mm/min, while the remaining specimens were tested after 60,000 thermal cycles. Data were analyzed using two-way ANOVA and the Holm-Sidak method. RESULTS: There was no significant difference between the groups after 24 h (p > 0.05). Thermocycling resulted in significant bond strength reduction for distilled water and CHX (p < 0.05). When 24 h bond strengths were compared to the thermocycling group, NaF maintained its bond strength (p > 0.05), while significant reductions were observed for distilled water and CHX (p < 0.05). CONCLUSIONS: Pretreatment with NaF maintained the bond strength of Clearfil SE Bond to dentin after 60,000 thermal cycles, but pretreatment with CHX did not.

Uso de contenção com fibra de vidro imersa em resina composta para contenção periodontal ­ relato de caso / Glass fiber-reinforced composite resin for tooth stabilization ­ case report

Este trabalho descreve, por meio de um relato de caso clínico, a aplicação clínica de uma contenção com fibra de vidro trançada impregnada em resina composta para tratamento de periodontite crônica severa associada à oclusão traumática. Paciente do gênero masculino, com 46 anos de idade, apresentou-se com queixa de sangramento gengival e desconforto mastigatório na região anterior superior. A avaliação clínica e a radiográfica demonstraram mobilidade grau 2, perda óssea vertical e aumento do espaço do ligamento periodontal. O tratamento preconizado foi o acesso cirúrgico para raspagem e alisamento radicular associado à contenção com fibra de vidro trançada impregnada em resina composta de canino a canino superior. Os acompanhamentos clínico e radiográfico de 18 meses demonstraram resultados favoráveis com relação à saúde periodontal e manutenção dos aspectos funcionais e estéticos. A contenção por meio de fibra de vidro trançada impregnada em resina composta é uma técnica viável e estável para a estabilização de dentes com perda óssea periodontal (AU).

The present case report describes the clinical application of splinting with glass fiberreinforced composite resin for the treatment of the secondary occlusal trauma in a patient with severe chronic periodontitis. A male patient, 46 years old, presented with gingival bleeding and masticatory discomfort complaints related to the upper anterior region. Clinical and radiographic evaluation showed grade 2 dental mobility, bone loss and increased periodontal ligament space. The proposed treatment was periodontal surgery for scaling and root planning associated to splinting with glass fiber-reinforced composite resin from right upper canine to upper lower canine. The 18 months follow-up showed favorable clinical and radiographic results with respect to periodontal health and maintenance of esthetic and functional aspects. The splinting with glass fiber-reinforced composite resin is a viable technique and stable over time for stabilizing tooth with periodontal bone loss (AU).

Randomized Two-year Clinical Evaluation of Oxalic Acid in Restorations of Noncarious Cervical Lesions.

PURPOSE: To evaluate the use of oxalic acid in restorations of noncarious cervical lesions. MATERIALS AND METHODS: Twenty volunteers of both sexes between 24 and 55 years old, with at least two lesions that were restored with the techniques to be evaluated, were selected. Ninety teeth were randomly divided into two groups: group 1, two-step etch-and-rinse adhesive technique (control) and group 2, pretreatment with oxalic acid followed by the application of a two-step etch-and-rinse adhesive system. The adhesive system used was XP Bond (Dentsply) and the restorative composite resin was Durafill (Heraeus Kulzer). A modified USPHS method was employed for the clinical evaluation, taking into account the following criteria: retention (R), marginal integrity (MI), marginal discoloration (MD), postoperative sensitivity (S), caries (C), and anatomic form (AF). Clinical assessments were conducted by two examiners at baseline and after 6 months, 1 and 2 years. RESULTS: After two years, the results of clinically satisfactory restorations (Alpha and Bravo) obtained for the control and experimental groups were: R (90.9%/93.33%), MI (100%/100%), MD (100%/100%), S (100%/100%), C (100%/100%), AF (100%/100%). CONCLUSION: Over a 2-year period, the use of oxalic acid as an agent of dentin pretreatment did not influence the clinical performance of restorations in noncarious cervical lesions.

Two-year clinical evaluation of resin composite in posterior teeth: A randomized controlled study.

BACKGROUND: Clinical evaluations as fundamental method to prove the efficiency of restorative materials. AIM: This study evaluated the clinical performance of restorative systems during 2 years of clinical service. MATERIALS AND METHODS: This study assessed the clinical performance of restorative systems (Filtek Z250 and P60), during 2 years of clinical service, using the US Public Health Service system. The randomized and double-blind study comprising thirty volunteers. The restorations were evaluated at baseline, 6, 12, and 24 months. It was used the following criteria: marginal discoloration (MD), marginal integrity (MI), superficial texture (ST), wear (W), postoperative sensitivity (PS) and recurrent caries (RC). RESULTS: Statistic analysis was performed using Fisher's and McNemar's exact tests and Pearsons's Chi-square in a significance level of 5%. The results at baseline and 24 months for Group I were: MD - 100, 100%; MI - 100, 88.6%; ST - 100, 94.3%; W - 100, 94.3%; PS - 100, 100%; RC - 100, 100%, of alpha scores; Group II: MD - 100, 97.1%; MI - 100, 91.4%; ST - 100, 94.3%; W - 100, 91.4%; PS - 100, 100%; RC - 100, 100%, of alpha scores. It was observed no statistical difference in the evaluated criteria and period. CONCLUSIONS: After 24 months of evaluation, both restorative systems exhibited acceptable clinical performance.

Four-year randomized clinical trial of oxalic acid pretreatment in restorations of non-carious cervical lesions.

OBJECTIVE: The aim of this study was to evaluate the efficiency of oxalic acid (BisBlock) on restorations of non-carious cervical lesions. MATERIALS AND METHODS: One operator placed 90 restorations randomly divided into two groups in 20 patients under cotton rolls isolation: Control Group-two-step etch-and-rinse adhesive technique; and Experimental Group-two-step etch-and-rinse adhesive technique with oxalic acid pretreatment after acid-etched dentin. The restorative adhesive system used was XP Bond/Durafill. The restorations were directly assessed by two independent examiners, using the modified United States Public Health Service (USPHS) criteria at the baseline and 4 years. Data were statistically analyzed using the Fisher and McNemar tests (p < 0.05). RESULTS: Fifteen patients (75%) were available for recall after 4 years. The McNemar test detected significant differences within the Experimental Group between the baseline and 4-year evaluations for retention (p < 0.05). For the Control Group, there was no significant difference (p > 0.05) between the periods. The Fisher test showed no statistically significant difference between the groups for all other criteria (p > 0.05). CONCLUSION: After 4 years of service, the use of oxalic acid did not influence the clinical performance of restorations when it was used under composite resin restorations.

Ação do gel de clorexidina 2% sobre a formação de biofilme dental e contagem salivar de streptococcus mutans / Effect of 2% chlorhexidine gel on the formation of dental plaque and salivary counts of Streptococcus mutans

O presente estudo teve como objetivo avaliar a ação do gel de clorexidina a 2% sobre a nova formação de biofilme dentário e sobre a contagem salivar de microrganismos do tipo Streptococcus mutans em 39 pacientes na fase de dentadura mista. Os pacientes foram divididos, aleatoriamente, em dois grupos: G1 caso (n=19) e G2 controle (n=20). Os sítios experimentais foram os incisivos inferiores permanentes de cada paciente. A fase experimental teve duração de sete dias. No dia zero foi realizada a coleta salivar (1 ml) e determinado o índice de placa bacteriana (IPL) de todos os participantes. Os pacientes do grupo G1 receberam, após realização de profilaxia, uma aplicação tópica do gel de clorexidina 2%, e os do grupo G2 receberam a aplicação de um gel placebo. No dia sete, nova coleta salivar e exame de IPL foram realizados, sem que novas profilaxias ou géis fossem reaplicados. Após a coleta, nos dois dias em questão, todas as amostras salivares foram encaminhadas ao laboratório de microbiologia, diluídas em solução salina, semeadas em ágar Mitis salivarius e incubadas sob condições de microaerofilia. Observou-se que não houve diferenças entre os grupos (p > 0,05), tanto em relação ao IPL quanto em relação à contagem de unidades formadoras de colônias (UFC), em nenhum dos tempos avaliados. Concluiu-se que gel o de clorexidina a 2% não foi capaz de reduzir a formação de biofilme dental bacteriano sobre as superfícies dentárias avaliadas, e não foi capaz de diminuir a contaminação salivar durante o período avaliado.

Effectiveness of different removal methods of artificially demineralized dentin / Efetividade de diferentes métodos de remoção de dentina desmineralizada artificialmente

Objective: This study aimed to evaluate the effectiveness of different mechanical methods for the removal of demineralized dentin. Methods: Healthy human third molars were prepared in such a way that the flat occlusal surfaces of the dentin were exposed and longitudinally sectioned in a vestibular-lingual direction. One section of each tooth was submitted to the pH-cycling model, while the other section was kept intact. The tooth sections were joined, and a single operator performed dentin removal using a steel bur, a hand instrument,or a polymer bur. The tooth’s sections were then separated, and digital images were obtained. The depth of the prepared cavities and the microhardness measurements were checked and analyzed statistically using the Kruskal-Wallis One-Way ANOVA in Ranks, the Tukey test, while desmineralized dentin were comparedusing the One-Way ANOVA, and the Holm-Sidak method (p < 0.05). Results: The steel bur produced the deepest cavities in mineralized and demineralized dentin. The polymer bur generated the shallowest cavitiesin demineralized dentin. The measurements of microhardness of the deepest surfaces of the cavities prepared in demineralized dentin indicated that the steel bur and hand instrument presented similar values, while those values produced by polymer burs proved to be lower. Conclusion: The effectiveness of the removalof demineralized dentin varied among the three methods used in this study. The polymer bur proved to bethe most conservative of the methods used. By contrast, the steel bur and hand instrument showed a similareffectiveness in the removal of dentin, according to the microhardness of the remaining dentin, even thoughthey produced different cavity depths.

Effect of surface pretreatments on the microtensile bond strength of lithium-disilicate ceramic repaired with composite resin.

The aim of this study was to evaluate the influence of ceramic surface treatments and silane drying temperature on the microtensile bond strength (µTBS) of a resin composite to a lithium disilicate ceramic. Twenty blocks (7x7x5 mm) of lithium disilicate-based hot-pressed ceramic were fabricated and randomly divided into 4 groups: G1: acid etching with 9.5% hydrofluoric acid for 20 s and drying silane with room-temperature air; G2: acid etching with 9.5% hydrofluoric acid for 20 s and drying silane with 45 ± 5 °C warm air; G3: airborne-particle abrasion with 50 µm aluminum oxide particles and drying silane with 45 ± 5 °C warm air; G4: airborne-particle abrasion with 50 µm aluminum oxide particles and drying silane with air at room-temperature. After treatments, an adhesive system (Single Bond 2) was applied, light-cured and direct restorations were built up with a resin composite (Filtek Z250). Each specimen was stored in distilled water at 37 °C for 24 h and cut into ceramic-composite beams with 1 mm2 of cross-sectional area for µTBS testing. Statistical analysis was performed with one-way ANOVA and Student-Newman-Keuls test (α=0.05). µTBS means (S.D.) in MPa were: G1: 32.14 (7.98), G2: 35.00 (7.77) and G3: 18.36 (6.17). All specimens of G4 failed during the cutting. G1 and G2 presented significantly higher µTBS than G3 (p<0.05). There was no statistically significant difference between G1 and G2 (p>0.05). As far as the bond strength is concerned, surface pretreatment of lithium-disilicate ceramic with hydrofluoric acid and silane application can be used as an alternative to repair ceramic restorations with composite resin, while surface pretreatment with sandblasting should be avoided.

Effect of Surface Pretreatments on the Microtensile Bond Strength of Lithium-Disilicate Ceramic Repaired with Composite Resin

The aim of this study was to evaluate the influence of ceramic surface treatments and silane drying temperature on the microtensile bond strength (µTBS) of a resin composite to a lithium disilicate ceramic. Twenty blocks (7x7x5 mm) of lithium disilicate-based hotpressed ceramic were fabricated and randomly divided into 4 groups: G1: acid etching with 9.5% hydrofluoric acid for 20 s and drying silane with room-temperature air; G2: acid etching with 9.5% hydrofluoric acid for 20 s and drying silane with 45 ± 5 °C warm air; G3: airborne-particle abrasion with 50 µm aluminum oxide particles and drying silane with 45 ± 5 °C warm air; G4: airborne-particle abrasion with 50 µm aluminum oxide particles and drying silane with air at room-temperature. After treatments, an adhesive system (Single Bond 2) was applied, light-cured and direct restorations were built up with a resin composite (Filtek Z250). Each specimen was stored in distilled water at 37 °C for 24 h and cut into ceramic-composite beams with 1 mm2 of cross-sectional area for µTBS testing. Statistical analysis was performed with one-way ANOVA and Student-Newman-Keuls test (α=0.05). µTBS means (S.D.) in MPa were: G1: 32.14 (7.98), G2: 35.00 (7.77) and G3: 18.36 (6.17). All specimens of G4 failed during the cutting. G1 and G2 presented significantly higher µTBS than G3 (p<0.05). There was no statistically significant difference between G1 and G2 (p>0.05). As far as the bond strength is concerned, surface pretreatment of lithium-disilicate ceramic with hydrofluoric acid and silane application can be used as an alternative to repair ceramic restorations with composite resin, while surface pretreatment with sandblasting should be avoided.

O objetivo deste estudo foi avaliar a influência dos tratamentos de superfícies e a temperatura de secagem do silano na resistência de união de resina composta à cerâmica de disilicato de lítio. Vinte blocos (7x7x5 mm) de cerâmica à base de disilicato de lítio foram fabricados e aleatoriamente divididos em quatro grupos: G1: condicionamento com ácido fluorídrico a 9,5% por 20 s e secagem do silano com ar à temperatura ambiente; G2: condicionamento com ácido fluorídrico a 9,5% por 20 s e secagem do silano com ar aquecido a 45± 5 °C; G3: jateamento com partículas de óxido de alumínio de 50 µm e secagem do silano com ar aquecido a 45 ± 5 °C; G4: jateamento com partículas de óxido de alumínio de 50 µm e secagem do silano com ar à temperatura ambiente. Após os tratamentos, o adesivo Adper Single Bond 2 foi aplicado, fotoativado e foi construído um platô de resina composta (Filtek Z250). Cada espécime foi armazenado em água destilada a 37 °C por 24 h e cortados em forma de palito de área adesiva de 1 mm2 para a realização do teste de microtração. Os dados foram submetidos à ANOVA e ao teste de Student-Newman-Keuls (α=0,05). As médias (D.P.) dos valores de resistência de união em MPa foram: G1: 32,14 (7,98), G2: 35,00 (7,77) e G3: 18,36 (6,17). G1 e G2 apresentaram maiores valores de resistência de união que G3 (p<0,05). Não houve diferença estatística entre as médias dos valores dos grupos G1 e G2 (p>0,05). Levando-se em consideração a resistência de união, o pré-tratamento de cerâmica de disilicato de lítio com ácido fluorídrico e aplicação de silano pode ser uma alternativa para o reparo de restaurações de cerâmicas com resinas compostas, enquanto que o pré-tratamento de superfície com o jateamento deve ser evitado.

Tratamento interdisciplinar na reconstrução estética do sorriso / Interdisciplinary treatment in the esthetic reconstruction of the smile. Case report

O presente trabalho teve como objetivo relatar um caso clínico de aumento de coroa clínica associado ao clareamento dental, no qual um planejamento integrando entre Periodontia e Dentística foi realizado para a resolução definitiva do desequilíbrio estético. Os resultados clínicos até dois anos demonstraram resolução estética satisfatória do sorriso.

Direct resin composite restorations versus indirect composite inlays: one-year results.

AIM: The aim of this study was to evaluate the clinical performance of direct resin composite restorations (Tetric Ceram-TC) and indirect composite inlays (Targis-TG) after 12 months. METHODS AND MATERIALS: Seventy-six Class I and II restorations (44 direct and 32 indirect) were inserted in premolars and molars with carious lesions or deficient restorations in 30 healthy patients according to the manufacturer's instructions. Each restoration was evaluated at baseline and after 12 months according to the modified USPHS criteria for color match (CM), marginal discoloration (MD), secondary caries (SC), anatomic form (AF), surface texture (ST), marginal integrity (MI), and pulp sensitivity (PS). Data were analyzed by Fisher and McNemar Chi-square tests. RESULTS: No secondary caries and no pulpal sensitivity were observed after 12 months. However, significant changes in marginal discoloration (MD) criteria could be detected between baseline and one-year results for both materials (p<0.05). For marginal integrity (MI) criteria, the differences between baseline and one-year recall were statistically significant (p<0.05). For marginal integrity (MI) criteria, Tetric Ceram (TC) showed results statistically superior to Targis (TG) in both observation periods (p<0.05). No statistically significant changes in color match (CM), anatomic form (AF), or surface texture (ST) appeared during the observation periods (p>0.05). CONCLUSIONS: BDirect resin composite restorations performed better than indirect composite inlays for marginal integrity, but all restorations were judged to be clinically acceptable. CLINICAL SIGNIFICANCE: Tetric Ceram direct restorations and Targis indirect inlays in posterior teeth provide satisfactory clinical performance and the comparison between them showed little difference after one year.

Influência do clareamento dental na infiltração marginal em restaurações de Classe V / Influence of dental bleaching on marginal leakage of Class V restorations

Objetivo: Avaliar in vitro o efeito do clareamento, em consultório, e o tempo de espera no grau de microinfiltração em cavidades classe V com margem em esmalte restaurada com resina composta. Métodos: Utilizou-se 45 terceiros molares humanos, cujas faces vestibulares foram clareadas com peróxido de hidrogênio 35% ativado com LED e as palatinas não clareadas (controle). Os grupos foram divididos aleatoriamente com 15 dentes cada: Grupo 1) restaurado imediatamente após o clareamento; Grupo 2), sete dias após o clareamento; Grupo 3), quatorze dias após clareamento. Após o preparo das cavidades, foram aplicados ácido fosfórico a 35%, adesivo Adper Single Bond 2 (3M ESPE, St. Paul, Mn, USA) e resina composta Filtek Z250 (3M ESPE, St. Paul, Mn, USA). Os dentes foram termociclados e impermeabilizados com esmalte vermelho nas faces clareadas e azul nas não clareadas, exceto a região restaurada a 1mm ao redor. As amostras foram classificadas de acordo com escores: 0 = sem infiltração, 1= mínima infiltração (menos de 1/3 do comprimento da parede), 2= infiltração moderada (de 1/3 a 2/3 da parede) e 3= extensa (mais de 2/3 da parede). Os dados foram submetidos ao teste Kruskal-Wallis a 5% de significância. Resultados: O procedimento restaurador imediatamente após o clareamento, acarretou em valores de microinfiltração estatisticamente superiores (p<0,05) aos do grupo não clareado. De 7 e 14 dias após o clareamento, não foram observadas diferenças estatisticamente significantes entre os grupos experimentais (p>0,05). Conclusão: Com base nos resultados, aconselha-se a aguardar no mínimo de 7 dias após o clareamento para a confecção da restauração definitiva.

Objective: Evaluate the in vitro effect of bleaching performed in the dental office and waiting time on the degree of microleakage in class V cavities with margins in enamel, restored with resin composite. Methods: Forty-five human third molars were used, in which the vestibular faces were bleached with 35% hydrogen peroxide activated with LED and the palatine faces were not bleached (control). The teeth were randomly divided into 3 groups with 15 teeth in each: Group 1, restored immediately after bleaching; Group 2, seven days after bleaching; and Group 3, fourteen days after bleaching. After cavity preparation, 35% phosphoric acid, Adper Single Bond 2 adhesive (3M ESPE, St. Paul, Mn, USA), and resin composite Filtek Z250 (3M ESPE, St. Paul, MN, USA) were applied. The teeth were thermal cycled and sealed with red nail polish on the bleached faces and blue on the non bleached faces, except for 1mm around the restored region. The samples were classified according to the following scores: 0 = no leakage, 1 = minimum leakage (less than 1 / 3 the length of the wall), 2 = moderate leakage (1/3 to 2/3 of the wall) and 3 = extensive leakage (over 2/3 of the wall). The data were submitted to the Kruskal-Wallis test at a level of significance of 5%. Results: The restorative procedure immediately after bleaching resulted in statistically higher microleakage values (p <0.05) than those in the non bleached group. In seven and fourteen days after bleaching, no statistically significant differences were found among the experimental groups (p>0.05). Conclusion: Based on the results, it is advisable to wait at least 7 days after bleaching to make the definitive restoration.

Investigação da presença de recessão gengival e largura de gengiva inserida em pacientes que fizeram uso de aparelhos ortodônticos fixos / Research presence of gingival recession and width of keratinized gingiva in patients who did wear fixed orthodontic appliances

A literatura apresenta vários fatores relacionados à etiologia da recessão gengival, como inflamação gengival, dentes mal alinhados, escovação traumática, tensão muscular, trauma oclusal, como também a movimentação ortodôntica. Por meio deste estudo, observou-se a presença de recessão gengival nos 4 caninos de 70 indivíduos que fizeram uso de aparelho ortodôntico fixo. O tempo de uso do aparelho ortodôntico teve uma média de 3,8 ± 1,9 anos e uma média de término do tratamento de 4,9 ± 3 anos. Observou-se que os pacientes avaliados apresentaram uma média de recessão gengival de 0,3 ± 0,4 mm no dente 13; 0,2 ± 0,4 mm no dente 23; 0,6 ± 0,7 mm no dente 33 e 0,3 ± 0,5 mm no dente 43. Em relação à presença de gengiva inserida observou-se uma média de 4,2 ± 1,5 mm no dente 13; 4,0± 1,3 mm no dente 23; 2,8 ± 1,3 mm no dente 33 e 3,0 ± 1,3 mm no dente 43. A presença de recessão no dente 33 foi estatisticamente significante (p<0,01) em relação aos demais elementos dentários. Diante dos resultados obtidos, esse estudo permite concluir que a presença de recessão gengival localizada é significante, bem como a diferença entre a quantidade de gengiva inserida de caninos superiores e inferiores, em indivíduos que fizeram uso de aparelho ortodôntico fixo, não havendo correlação entre recessão gengival e quantidade de gengiva inserida

The literature contains various related factors in the etiology of gingival recession, and gingival inflammation,mal-aligned teeth, brushing trauma, muscular tension, oclusal trauma, as well as orthodontic movement. Throughthis study, we observed the presence of gingival recession in canine individuals who made use of orthodontic braces. Theduration of use of braces had an average of 3.8 ± 1.9 years and an average from the end of treatment of 4.9 ± 3.0 years. It was observed that the patients had an average gingival recession of 0.3 ± 0.4 mm for tooth 13, 0.2 ± 0.4 mm for tooth 23, 0.6 ± 0.7 mm for tooth 33 and 0.3 ± 0.5 mm fortooth 43. Regarding the presence of keratinized gingiva was observed an average of 4.2 ± 1.5 in the 13 tooth, 4.0 ± 1.3 in the 23 tooth, 2.8 ± 1.3 on tooth 33 and 3.0 ± 1.3 in thetooth 43. Presence of recession on tooth 33 was statistically significant (p<0,01). Based in the results it can be concluded that the presence of localized gingival recession is significant as the difference between the amount of keratinized gingiva of upper and lower canines, in subjects submitted to orthodontic treatment, with no correlation between gingival recession and amount of keratinized gingiva

Clinical evaluation of a 3% potassium oxalate gel and a GaAlAs laser for the treatment of dentinal hypersensitivity.

OBJECTIVES: This study evaluated the immediate and 3 month clinical effects of a low-level gallium-aluminum-arsenide (GaAlAs) laser and a 3% potassium oxalate gel for the treatment of dentinal hypersensitivity. MATERIALS AND METHODS: A total of 164 teeth from 30 patients with clinical diagnoses of dentinal hypersensitivity were selected for this randomized, placebo-controlled, double-blind clinical study. The teeth were randomized to three groups: GaAlAs laser, oxalate gel, and placebo gel. The treatment sessions were performed at 7 d intervals for four consecutive weeks. The degree of sensitivity in response to an air blast and tactile stimuli was assessed according to a visual analogue scale at baseline, immediately after the fourth application, and then 3 months after the fourth application. The reductions in dentinal hypersensitivity from baseline at the two follow-up assessments were evaluated as the main outcome. RESULTS: In both the active and control groups, there were statistically significant reductions in dentinal hypersensitivity immediately after and 3 months after the treatments, when compared with the hypersensitivity at baseline. No significant differences among the three groups could be detected in their efficacy at either the immediate or 3 month evaluations irrespective of the stimulus. CONCLUSIONS: The treatments under study were effective for reducing dentinal hypersensitivity, and longer observational periods could enhance the ability of studies to detect differences between active and placebo groups.

One year clinical evaluation of two different types of composite resins in posterior teeth.

AIM: The aim of this study was to assess the clinical performance of two adhesive restorative systems (Single Bond/Filtek P-60 and Single Bond/Filtek Z-250) in posterior teeth using a modified United States Public Health Service (USPHS) system. METHODS AND MATERIALS: A total of 70 restorations were placed in molars and premolars in 30 patients (14 females and 16 males; 18-40 years) by one operator. All restorations were directly evaluated by two examiners at baseline, six months, and 12 months using the following modified USPHS rating criteria: marginal integrity, marginal discoloration, surface texture, contour, postoperative sensitivity, and recurrent caries. RESULTS: At six and 12 months all restorations were available for evaluation of marginal discoloration, surface texture, contour, postoperative sensitivity, and recurrent caries that remained with 100% Alpha-ratings at recalls for both restorative systems. Marginal integrity for P-60 was scored as 94.3% and 91.4% Alpha at six and 12 months, respectively, and rates for Z-250 were 100% and 97.1% Alpha at six and 12 months, respectively. Statistical analysis was completed with Fisher's exact and McNemar Chi-square tests at a significance level of 5% (P<0.05). CONCLUSION: All restorations were clinically satisfactory and no significant differences were found among them. CLINICAL SIGNIFICANCE: Posterior resin composite restorations placed under appropriate conditions provide a satisfactory clinical performance.

Inter-Relação Periodontia-Dentística na reconstrução estética do sorriso / Periodontics-Dentistry Interrelationship in the esthetic reconstruction of the smile. Case report

O presente trabalho tem como objetivo relatar um caso clínico de fechamento de diastemas envolvendo os dentes anteriores superiores, no qual um planejamento integrando a Periodontia e a Dentística foi realizado para a resolução definitiva dos desequilíbrios funcional e estético