COVID-19 outbreak: Should dental and medical practices consider uv-c technology to enhance disinfection on surfaces? - A systematic review.

AIMS: During the COVID-19 pandemic the search for complementary methods to enhance manual disinfection in dental and medical practices raised relevance. We sought evidence for the addition of ultraviolet-C (UV-C) disinfection to manual cleaning protocols -and whether it improves the logarithmic (log) reduction of surface pathogen colonies. METHODS: This review was registered at the International Prospective Register of Systematic Reviews (PROSPERO) under the number CRD420200193961. Six electronic sources were consulted looking for clinical trials performed in healthcare environments in which pathogens were quantified by colony-forming unit (CFU)-enumeration before and after interventions, all databases were last consulted on May 2021. We assessed the risk of bias using an adapted Revised Cochrane Risk of Bias Tool (RoB 2). The certainty of the evidence was qualified according to the Classification of Recommendations, Evaluation, Development, and Evaluation (GRADE) approach. RESULTS: We identified 1012 records and 12 studies fulfilled the inclusion criteria. All included studies reported enhanced disinfection in the UV-C arm; most of them reported 1-log to 2-log reduction in approximately 10 to 25 min. Only three studies reached a 5-log and 6-log reduction. When manual cleaning was performed alone, only two studies reported a 1-log reduction using a chlorine-based disinfectant. We detected a high risk of bias in 1 study. Certainty of evidence was classified as moderate and low. CONCLUSIONS: The evidence points out the effectiveness of UV-C technology in reducing manual cleaning failures, enhancing the logarithmic reduction of surface pathogen colonies. However, the safety and success of these devices will depend on several physical and biological factors. A judicious project must precede their use in clinical and medical offices under the supervision of a physicist or other trained professional.

Postoperative sensitivity in posterior resin composite restorations with prior application of a glutaraldehyde-based desensitizing solution: A randomized clinical trial.

OBJECTIVES: To evaluate the effect of a glutaraldehyde-based desensitizer on the postoperative sensitivity (POS) in posterior resin composite restorations up to 12 months using a universal adhesive (Tetric N-Bond Universal) with selective enamel etching (SE) or an etch-and-rinse (ER) strategy. METHODS: Class I and class II resin composite restorations (n = 220) at least 3 mm deep were inserted in 55 subjects. The universal adhesive was applied using the SE (self-etch strategy on dentin with selective enamel etching) or the ER strategy, with or without prior application of a glutaraldehyde-based desensitizer (Gluma Desensitizer - GL) to form groups SEGL and ERGL. A bulk-fill resin composite (Tetric NCeram Bulk Fill) was used for all restorations. Spontaneous POS was assessed 7 days after the restorative procedure using the Visual Analog Scale (VAS) and the Numeric Rating Scale (NRS). After 7, 14, and 30 days of completing each restoration, the subjects were reassessed to evaluate POS caused by stimulation with an air blast, horizontal and vertical percussion. In addition, marginal discoloration, marginal adaptation, fracture, and recurrence of caries were evaluated using the FDI (World Dental Federation) criteria after 7 days and at 12 months. RESULTS: No significant spontaneous or stimuli-induced POS was observed when restorations with or without GL were compared (p>0.05). A higher risk of spontaneous POS was observed within 7 days (40.0%; 95% CI 28.1 to 53.1), without statistically significant differences among groups. None of the participants reported POS at 12 months, however five restorations were considered clinically unsatisfactory (p > 0.05). CONCLUSIONS: The previous application of GL did not significantly reduce spontaneous or stimuli-induced POS in posterior resin composite restorations at any time, regardless of the adhesive strategy used. CLINICAL SIGNIFICANCE: The use of a glutaraldehyde-based desensitizing agent did not generate lower incidence of postoperative sensitivity in resin composite posterior restorations.

Avaliação do nível de conhecimento de acadêmicos de Odontologia sobre fotopolimerização / Evaluation of the knowledge of dental students on light curing

O sucesso clínico de materiais resinosos é dependente de uma adequada polimerização. Diversos materiais fotoativados são utilizados frequentemente nas clínicas-escola de Odontologia. O objetivo desse estudo foi avaliar o nível de conhecimento dos acadêmicos do 10º período de Odontologia do Centro Universitário Maurício de Nassau, Recife/PE,sobre fotopolimerização, por meio de questionário. Os dados foram tabulados e analisados por meio de estatísticas descritivas, teste Qui-quadrado de Pearson e teste Exato de Fischer, com nível de significância de 5% (p<0,05). Os resultados demonstram que 83,8%dos estudantesnão possuem fotopolimerizador, 72,9% não conhecem a potência do aparelho, 56,2% não sabem qual é a potência mínima ideal e apenas 8,5% sabem o nome do aparelho aferidor da irradiância / potência. Além disso, 48,5% não sabem o comprimento de onda ideal para fotoativação de resina composta e 69,2% desconhecemo tipo de aparelho que utilizam (monowaveou poliwave).Em relação ao tempo de fotopolimerização, 60,8% afirmaram utilizar20 segundos em resinas compostas convencionais e 38,5% utilizam por40 segundos em resinas compostas Bulk-fill. Embora 84,6% afirmem usar aparelhos fotopolimerizadores frequentemente, apenas 26,9% sabem a distância ideal da ponteira à restauração. Além disso, 51,5% relataram que fazem a limpeza e desinfecção com álcool 70GL e 45,4% usam barreira plástica. Nesse contexto, pode-se concluir que o nível do conhecimento dos acadêmicos em relação à fotopolimerização foi insatisfatório, exigindo uma abordagem e avaliaçãomais efetivaspara que os discentes tenham consciência da importância clínica deste procedimento e suas consequências (AU).

The clinical success of resin materials depends on adequate curing. Several light cured materials are frequently used in dental school clinics. This study aimed to assess the knowledge of students from the 10th period of Dentistry at Maurício de Nassau University Center, Recife/PE, about light curing, using a questionnaire. Data were tabulated and analyzed by descriptive statistics, Pearson chi-square test and Fisher exact test, at a significance level of 5% (p<0.05). The results show that 83.8% of studentsdo not have a light curing unit, 72.9% do not know the device power, 56.2% do not know the ideal minimum power and only 8.5% know the name of the device that measures the irradiance/power. Also, 48.5% do not know the ideal wavelength for light curing of composite resin and 69.2% do not know the type of device they use (monowave or polywave). Regarding the light curing time, 60.8% stated they used 20 seconds in conventional composite resins and 38.5% used 40 seconds in bulk-fill composite resins. Although 84.6% stated that they use light curing units frequently, only 26.9% know the ideal distance from the tip to the restoration. Additionally, 51.5% reported performing cleaning and disinfection with 70GL alcohol and 45.4% use a plastic barrier. In this context, it can be concluded that the knowledge of students regarding light curing was unsatisfactory, requiring a more effective approach and evaluation so that the students may be aware of the clinical importance of this procedure and its consequences (AU).

Cyclic Fatigue Resistance of Blue Heat-Treated Instruments at Different Temperatures.

The main aim is to evaluate the cyclic fatigue resistance of blue heat-treated instruments with different kinematics. Twenty-four endodontic instruments of the same brand were used for each of three experimental groups: VB (Vortex Blue 40/0.04), RB (RECIPROC Blue 40/0.06), and XB (X1 Blue 40/0.06). The instruments were randomly distributed and subjected to temperatures of 20°C and 37°C. The fatigue test was performed using a stainless steel device. Data were analysed using the Shapiro-Wilk test, Student's t-test, the F test, and Tukey's and Tamhane tests at significance level P=0.05. The instruments' cyclic fatigue resistance at both temperatures differed significantly for each instrument type (P < 0.001). The RB instruments displayed greater cyclic fatigue resistance at the tested temperatures compared with the VB and XB instruments (P < 0.001). Reciprocating kinematics positively influenced cyclic fatigue resistance. Blue heat-treated instruments showed decreased cyclic fatigue resistance as the temperature increased (P < 0.001).

Lifting facial não cirúrgico com fios de polidioxanona: revisão de literatura / Non-surgical facelift with polydiaxanone threads: literature review

O objetivo deste estudo foi realizar uma revisão de literatura acerca do lifting facial não cirúrgico com fios de PDO, abordando os diferentes tipos, suas indicações, a degradação no organismo, pla no de inserção, contraindicações, vantagens e possíveis complicações. As buscas foram realizadas nas bases de dados Pubmed, Bireme, Scielo, Sumários de Revistas Brasileiras e BVS, selecionan do-se artigos relevantes disponibilizados entre 2005 e 2020. Sendo os descritores utilizados em português e inglês para busca: "Harmonização Facial", "Fios de Sustentação", "Lifting Facial". Após aplicação dos critérios de inclusão e exclusão, dos 44 artigos encontrados, foram selecionados 16 para esse estudo. O uso dos fios de sustentação facial consiste em um método minimamente inva sivo, indolor, de caráter ambulatorial, anestesia local e efeito imediato. Diante dos possíveis riscos que acompanham o lifting cirúrgico, as pessoas estão buscando por alternativas menos invasivas, como os fios de sustentação. Apesar de não poderem ser considerados como alternativa a cirurgia reparadora convencional, os pacientes muitas vezes acabam optando pelo lifting com fios por se sentirem mais seguros, mesmo com resultados mais modestos. Observou-se que a utilização dos fios de PDO tem demostrado eficácia no rejuvenescimento facial quando bem indicados, apesar da possibilidade de ocorrência de efeitos adversos, normalmente pequenos e passageiros... (AU)

The aim of this study is to perform a literature review about non-surgical facial lifting with PDS threads, addressing its variety of types, indications, organism degradation, insertion plan, contrain dications, advantages and possible complications.The researches were conducted in the Pubmed, Bi reme, Scielo, Sumários de Revistas Brasileiras and BVS data bases, selecting relevant articles available between 2005 and 2020. After applying the inclusion and exclusion criteria, of the 44 articles found, 16 were selected for this study. Being used the following descriptors in Portuguese and English for research purposes: "Facial Harmonization", "Supporti Threads", "Face Lift". The use of facial support threads consists in a minimally invasive, painless, outpatient method, local anesthesia and imme diate effect. Faced with the possible risks that accompany the surgical facelift, people are looking for less invasive alternatives, such as the support wires. Although they cannot be considered as an alternative to conventional reparative surgery, patients often end up opting for a facelift because they feel safer, even with more modest results. It was observed that the use of PDO threads has been shown to be effective in facial rejuvenation when well indicated, despite the possibility of adverse effects, usually small and transient... (AU)

Thirty-six-month clinical evaluation of posterior high-viscosity bulk-fill resin composite restorations in a high caries incidence population: interim results of a randomized clinical trial.

OBJECTIVES: This study compared the clinical performance of two bulk-fill (BF) and one conventional resin composite in a population with a high caries incidence. MATERIALS AND METHODS: A total of 138 class I and II restorations were performed and randomly divided into three groups (n = 46) with equal allocation: Filtek BF (FBF; 3M ESPE), Tetric EvoCeram BF (TBF; Ivoclar Vivadent), and control Filtek Z250 (Z250; 3M ESPE). The evaluations were performed using the USPHS and FDI criteria at baseline and after 12 and 36 months by a previously calibrated evaluator. The Friedman and Wilcoxon tests for paired data were used for statistical analysis (α = 0.05). RESULTS: The DMFT index at baseline was 9.44, with 87% from the decayed component. After 36 months, 108 restorations (n = 36) were evaluated. Two failures were observed for TBF at marginal adaptation and recurrence of caries, resulting in a survival rate of 94.44% and an annual failure rate (AFR) of 1.26%. No equivalence was observed between the criteria for surface roughness, marginal adaptation, and discoloration. CONCLUSIONS: The 36-month clinical performance of high-viscosity BF resin composites was comparable to conventional incremental-filled resin composites. The FDI criteria better presented the restorations' clinical success. However, in the case of failure, both criteria provided the same result. CLINICAL RELEVANCE: High-viscosity bulk-fill resin composites showed excellent performance after 36 months in a high caries incidence population. It can be considered a simplified alternative restoration method that reduces operating time and minimizes possible operator errors.

Do Helmet Use and Type Influence Facial Trauma Occurrence and Severity in Motorcyclists? A Systematic Review and Meta-analysis.

PURPOSE: This article consists of a systematic review of the literature, which verified whether the use and types of helmets reduce the occurrence and severity of facial fractures in hospitalized motorcyclists after traffic accidents. MATERIALS AND METHODS: Prevalence studies and cohort studies, published in Latin American languages with no restrictions on publication dates, were considered. Two authors independently screened reference lists for eligible articles, assessed them for inclusion criteria, and extracted the data using a specific form. Twenty-six articles were selected, all prevalence studies. RESULTS: The patients who used a helmet had a lower prevalence and severity of facial fractures, compared to patients who did not wear a helmet. There were no differences in the occurrence of lower third fractures between patients who used or did not wear a helmet at the time of the trauma; as well as in meta-analysis of occurrence and severity of facial trauma between helmet types (open or closed). CONCLUSIONS: It can be concluded that the use of helmet leads to a lower number of fractures and severity of trauma when compared to nonuse. Regarding the type of helmet, there was no difference in the occurrence and severity of facial fracture in individuals who used closed or opened helmets.

Clinical Performance of Bulk-Fill Resin Composite Restorations Using the United States Public Health Service and Federation Dentaire Internationale Criteria: A 12-Month Randomized Clinical Trial.

OBJECTIVE: This study was aimed to compare the 12-month clinical performance of two full-body bulk-fill resin composites Filtek bulk fill/3M ESPE (FBF) and Tetric EvoCeram bulk fill/Ivoclar Vivadent (TBF) and a conventional microhybrid resin composite Filtek Z250/3M ESPE (Z250) using the modified the United States Public Health Service (USPHS) and Federation Dentaire Internationale (FDI) criteria. Also, the agreement between the two evaluation criteria was evaluated at baseline and after 12 months of follow-up. MATERIALS AND METHODS: A total of 138 class I and II restorations were placed in posterior teeth (split-mouth design) of 46 volunteers following manufacturer's instructions and bonded with a self-etching bonding agent (Clear fill SE Bond/Kuraray). The restorations were evaluated at baseline and after 12 months of follow-up by three previously calibrated dentists (Cohen's K = 0.84). STATISTICAL ANALYSIS: Fisher's exact test and Pearson's Chi-squared test were used to evaluating the homogeneity of distribution of the clinical characteristics. Friedman's test was applied to evaluate differences among the resin composites. The results obtained for the USPHS and FDI criteria at the different observation times were compared using the Wilcoxon test. A level of significance of 0.05 was adopted for all tests. RESULTS: After 12 months (recall rate, 78.3%, n = 36 patients), the overall success rate was 99.07% for both criteria. Only one failed restoration (0.93%) was detected for each system during follow-up in the TBF group. CONCLUSION: The bulk-fill resin composites showed satisfactory clinical performance compared with conventional resin composite after 12 months. The percentage of the acceptable scores was significantly higher for the USPHS criteria, due to discrepancies in the score description for each criterion.

Evaluation of microhardness, sorption, solubility, and color stability of bulk fill resins: A comparative study.

BACKGROUND: Due to the increasing popularity of bulk fill resins, there is a concern that their components can be leached; this is because these are inserted in a single 4-5 mm increment. This in vitro study evaluated the microhardness, sorption, solubility, and color stability of three restorative bulk fill resins, namely: Filtek Bulk Fill (FBF), Tetric N-Ceram Bulk Fill (TNC), and Opus Bulk Fill (OBF). MATERIAL AND METHODS: Cylindrical samples were fabricated to be 15 mm in diameter and 1 mm thick (n = 10). For the microhardness test, three random indentations were formulated on the samples using a micro-durometer with a load of 300 gf for 15 s. Sorption and solubility were then evaluated (ISO 4049: 2009). Color stability was analyzed with a digital spectrophotometer three times (initially, after 24 h, and after 7 d) during immersion in coffee and distilled water (control). The Shapiro-Wilk test was applied to analyze normality. The Mann-Whitney and Kruskal-Wallis tests were used to compare the groups and the immersion solution, with a significance level of 5%. RESULTS: There were a significant difference in microhardness (p<0.001), with the FBF group showing a higher value compared to the other groups (56.38). The highest average of sorption scores was observed in the OBF group (16.9 µg / mm3), followed by FBF (16.8 µg / mm3) and TNC (11.3 µg / mm3). Solubility was lowest in the OBF group (-2.83 µg / mm3), with a significant difference (p = 0.031). There was also a significant difference after 24 h in the mean ∆E score of all groups (p<0.005). After one week of immersion, the group that pigmented most was OBF (p = 0.008). CONCLUSIONS: The three bulk fill resins had acceptable hardness, sorption, and solubility values. However, all groups showed a high pigmentation rate after 7 d of immersion in coffee. Key words:Bulk fill, color stability, composite resins, microhardness, solubility, sorption.

In Vitro Evaluation of Physical and Mechanical Properties of Light-Curing Resin Cement: A Comparative Study.

OBJECTIVE: The aim of study was to evaluate in vitro the surface hardness, sorption, solubility, and color stability of three light-cured resin cements, namely RelyX Veneer (RLX), Variolink Veneer (VLK), and All Cem Veneer (ACV). MATERIALS AND METHODS: Cylindrical samples (15 × 1 mm) were made for each group using a metallic mold (n = 10). Vickers microhardness test was performed, and average hardness was calculated from three indentations (300 gf/15s) per sample. The sorption and solubility of the materials were evaluated according to ISO 4049:2009 based on three samples weighing: initial (m 1), after immersion in distilled water for 7 days (m 2), and final (after removal of all moisture [m 3]). The color change was observed using a digital spectrophotometer, at three different time points, baseline, 1 day, and 1 week of immersion in coffee and distilled water (control). STATISTICAL ANALYSIS: Shapiro-Wilk test was used to analyze the normality of the data, and groups were compared using Kruskal-Wallis and Mann-Whitney tests. A significance level of 5% was used. RESULTS: RLX showed the highest microhardness mean values (36.96 VHN), but higher sorption (23.2 µg/mm3) and solubility (2.40 µg/mm3), with statistically significant differences with the other groups. For color stability, higher ∆E was observed for the samples immersed in coffee (p = 0.009). The VLK resin cement presented statistically significant differences from the other groups, with higher color changes in coffee at 1 day (15.14) and after 1 week (23.65). CONCLUSION: RLX resin cement showed better hardness results. All materials tested performed satisfactorily for sorption and solubility according to ISO 4049:2009. All materials showed high-staining values after 1 week of immersion in coffee.

Evaluation of the effect of tooth polishing on color stability after in-office bleaching treatment / Avaliação do efeito do polimento dental na estabilidade de cor após tratamento clareador em consultório

Introduction: One of the most commonly used corrective methods for staining teeth is tooth bleaching. However, subclinical alterations may occur in the micromorphology of dental tissues during the bleaching procedure, such as increases in porosity and surface roughness. Consequently, dental enamel may become more permeable and susceptible to staining. Objective: To evaluate the influence of tooth polishing after in-office bleaching treatment on color stability. Material and method: Thirty-three extracted human molars were used. The teeth were cut in the mesiodistal direction to obtain two samples per tooth (total of 66). The samples were randomly divided into six groups (n=11). Before and after the bleaching treatment, the lightness of the samples and change in lightness (∆L) were determined with a digital spectrophotometer (Easy Shade). The samples were bleached with 35% hydrogen peroxide (three sessions weekly). Three groups were submitted to polishing with felt discs and polishing paste after each session. To simulate the oral conditions during the consumption of colored beverages, the samples were submitted to alternating cycles of immersion in staining solutions (coffee, red wine, and Coca Cola). Result: Polishing resulted in an increase of mean lightness of 4.49 in the red wine group, 2.73 in the coffee group, and 4.08 in the cola group. The difference was significant in the red wine group (p<0.022), but not in the coffee or cola group. Conclusion: Polishing after in-office bleaching using felt discs and polishing paste can reduce the degree of pigment impregnation in patient with red wine rich diet.

Introdução: Um dos métodos mais usados ​​para dentes pigmentados é o clareamento dental. Entretanto, alterações subclínicas podem ocorrer na micromorfologia dos dentes durante procedimentos de clareamento, como aumentos na porosidade e rugosidade superficial. Consequentemente, o esmalte dental pode se tornar mais permeável e suscetível a manchas. Objetivo: Avaliar a influência do polimento dentário após o clareamento em consultório na estabilidade da cor. Material e método: Trinta e três molares humanos extraídos foram utilizados. Os dentes foram cortados na direção mesiodistal para obter duas amostras por dente (total de 66). As amostras foram divididas aleatoriamente em seis grupos (n = 11). Antes e após o tratamento clareador, a luminosidade das amostras e a alteração da luminosidade (∆L) foram determinadas com um espectrofotômetro digital (Easy Shade). As amostras foram clareadas com peróxido de hidrogênio 35% (três sessões com intervalos de 7 dias). Três grupos foram submetidos a polimento com discos de feltro e pasta de polimento após cada sessão. Para simular as condições orais durante o consumo de bebidas pigmentadas, as amostras foram submetidas a ciclos alternados de imersão em soluções (café, vinho tinto e Coca Cola). Resultado: O polimento resultou em um aumento da luminosidade média de 4,49 no grupo vinho tinto, 2,73 no grupo café e 4,08 no grupo cola. A diferença foi significativa no grupo vinho tinto (p <0,022), mas não no grupo café ou cola. Conclusão: O polimento após clareamento em consultório usando discos de feltro e pasta polidora pode reduzir o grau de impregnação em pacientes com dieta rica em vinho tinto.

Escaneamento digital e prototipagem 3d para confecção de laminados cerâmicos: relato de caso clínico / Digital Scanning and 3D Prototyping for Ceramic Laminate Confection: Clinical Case

Introdução:lentes de contato dentais podem ser uma excelente opção para correção de cor, forma, tamanho e posicionamento dental. Entretanto é umtratamentoque requer várias etapas laboratoriais com riscos de distorções nas etapas de moldagem e vazamento do modelo. Desta forma, desadaptações dos laminados em boca podem ser frequentes.Objetivo:relatar um caso clínico de nove laminados cerâmicos em que foi empregado o escaneamento digital, troquelização virtual e prototipagem do modelo em 3D.Método:paciente do gênero feminino, 59 anos, buscou atendimento odontológico queixando-se de desproporcionalidade dentária ao sorrir. Ao exame clínico foi observada uma inclinação maxilar que causava aquela desarmonia. Foi proposta a confecção de laminados cerâmicos para compensar a discrepância óssea bem como melhorar forma, contorno e cromia dentária. Após planejamento digital, confecção do enceramento diagnóstico, mock up, e aceita do planejamento por parte da paciente, iniciaram-se os preparos dentários. Finalizada esta etapa, os dentes foram escaneados (Trios 3Shape), troquelizados e prototipados em impressora 3D. O modelo foi encaminhado ao laboratório que confeccionou as peças protéticas em dissilicato de lítio de forma injetada e maquiada. Por fim, foram realizadas as provas secas, úmidas, ajustes necessários e cimentação dos laminados com cimento resinoso fotopolimerizável.Conclusão:a tecnologia empregada se mostrou eficiente na resolução do caso, sendo uma técnica rápida, que causou pouco desconforto à paciente e oportunizou uma boa adaptação dos laminados cerâmicos (AU).

Introduction:laminates veneers can be an excellent choice for color correction, shape, size and dental positioning. However, it is a technique that requires several laboratory steps with risks of distortion in the molding and casting steps of the model. Thus, maladjustments of laminatesin the mouth may be frequent.Objective:to report a clinical case of nine ceramic laminates through the digital scanning, virtual punching and 3D prototyping of the model.Methods:A 59 years old woman showed up to dental clinic searched dental care complaining of dental disproportionality when smiling. At the clinical examination, a maxillary inclination was observed that caused disharmony. It was proposed the making of ceramic laminates to compensate the bone discrepancy as well as improve shape, contour and dental color. After the digital planning, preparation diagnostic wax-up, mock up, and acceptance of patient planning, the dental preparations were started. After this step, the teeth were scanned (Trios 3Shape), punched and prototyped in a 3D printer. The model was sent to the laboratory to do the prosthetic parts in lithium disilicate in an injected and makeup manner. At last, it were made the tests dry, wet, required adjustments finally cementation of the ceramic laminates with photopolymerizable resin cement. Conclusions:the technology employed was efficient in solving this case, being a fast technique, which caused little discomfort to the patient and provided a good adaptation of the ceramic laminates (AU).

Desgaste dentinário seletivo associado à pino de fibra de vidro: relato de caso / Selective Dentin Removal Associated to the Fiberglass pin: Case Report / Desgaste Dentinario Selectivo Asociado con Pin de Fibra de Vidrio: Reporte de Caso

Introdução:Pigmentação dentináriaintrínseca pode comprometer a estética do sorriso e causar constrangimento ao sorrir. Essas manchas podem ser resultado da presença de materiais restauradores na coroa após tratamento endodôntico, hemorragia intracoronária, decomposição de detritos intrapulpares, medicamentos de uso intracanal e materiais obturadores. Objetivo:relatar um caso clínico dedesgaste dentinário seletivo associado à restauração com resina composta e pino de fibra de vidro. Metodologia:paciente do gênero masculino, 23anos, buscou atendimento odontológico queixando-se depigmentaçãodentáriano incisivo central após tratamento endodôntico e restauração classe IV de resina composta escurecida. Constatada a normalidade do tratamento endodôntico, iniciou-se o tratamento. Foi removida com pontas diamantadas e acesso palatinotoda pigmentação que comprometia a estética do sorriso, bem como a restauração em resina composta de cor e forma insatisfatória.Na sequência, após isolamento absoluto, o canal foi desobturado preservando 4mm de material obturador apical. Foi realizada limpeza do conduto e coroa com pasta de pedra pomes e água, aplicação de ácido fosfórico 37% (15s em dentina e 30s em esmalte), lavagem com spray de água e ar e secagem. Foi aplicado na coroa e no conduto adesivo universal e remoção dos excessos com cones de papel absorvente e polimerização (20s). Na sequência, o canal foi preenchido com cimento resinoso dual, e o pino de fibra de vidro foi inserido com inserção única. Por fim, a restauração foi realizada com resina composta de cor compatível com o remanescente e posteriormente acabamento e polimento. Conclusões:O desgaste dentinário seletivo associado à restauração em resina composta com pino de fibra de vidro favoreceua devolução estética efuncional ao elemento dentário (AU).

Introduction: Intrinsic dentinal pigmentation can compromise the aesthetics of the smile and cause embarrassment when smiling. These spots may be the result of the presence of restorative materials in the crown after endodontic treatment, intracoronary hemorrhage, intrapulpal debris decomposition, intracanal medication and obturator materials. Objective:to report a clinical case of selective dentin removal associated with restoration with composite resin and fiberglass pin. Methodology:male patient, 23 years old, sought dental care complaining of dental pigmentation in the central incisor after endodontic treatment and restoration of class IV of darkened composite resin. Once the endodontic treatment was normal, the treatment was started. It was removed with diamond tips and palatine access all pigmentation that compromised the aesthetics of the smile, aswell as the restoration in composite resin of color and unsatisfactory form. Following, after absolute isolation, the canal was obturated preserving 4mm of apical obturator material. The flue and crown were cleaned with pumice paste and water, 37% phosphoric acid (15s in dentin and 30s in enamel),spray with water and air and drying. It was applied to the crown and the universal adhesive conduit and removal of excesses with absorbent papercones (20s)and polymerization. Subsequently, the channel was filled with dual resin cement, and the fiberglass pin was inserted with single insert. Finally, the restoration was carried out with composite resin of color compatible with the remainder and later finishing and polishing. Conclusions:Selective dentin removal associated with composite resin restoration with fiberglass pin favored aesthetic and functional return to the dental element (AU).

Introducción: La pigmentación intrínseca de la dentina puedecomprometer la estética de la sonrisa y causar vergüenza al sonreír. Estas manchas pueden deberse a la presencia de materiales restauradores en la corona después del tratamiento endodóntico, hemorragia intracoronaria, descomposición de escombros intrapulpales, fármacos intracanales y materiales obturadores.Objetivo:reportar un caso clínico de desgaste selectivo de dentina asociado con resina compuesta y fibra de vidrio. Metodología:un paciente masculino de 23 años buscó atención dental quejándose de pigmentación dental en el incisivo central después del tratamiento endodóntico y la restauración de clase IV de resina compuesta oscura. Una vez que se encontró la normalidad del tratamiento endodóntico, se inició el tratamiento. Se eliminó con puntas de diamante y acceso palatino a toda la pigmentación que comprometía la estética de la sonrisa, así como la restauración en resina compuesta de color y forma insatisfactorios. Luego, después del aislamiento absoluto, se limpió el canal conservando 4 mm de material obturador apical. El conducto y la corona se limpiaron con pasta de piedra pómez, aplicación de ácido fosfórico al 37% (15 segundos en dentina y 30 segundos en esmalte), se lavaron con agua y aire y se secaron. Se aplicó a la corona y al conducto adhesivo universal y se eliminó el exceso con conos de papel absorbente y polimerización (20 s). Posteriormente, el canal se llenó con cemento de resina dual y el pasador de fibra de vidrio se insertó con un solo inserto. Finalmente, la restauración se realizó con resina compuesta de un color compatible con el resto y posteriormente acabado y pulido.Conclusiones:el desgaste selectivo de la dentina asociado con la restauración de resina compuesta con pin de fibra de vidrio favoreció el retorno estético y funcional al elemento dental (AU).

Detection of Incomplete Root Fractures in Endodontically Treated Teeth Using Different High-resolution Cone-beam Computed Tomographic Imaging Protocols.

INTRODUCTION: The purpose of this study was to compare different high-resolution cone-beam computed tomographic (CBCT) imaging protocols in the diagnosis of incomplete root fractures of endodontically treated teeth. METHODS: Twenty single-rooted human teeth were endodontically treated, and an incomplete root fracture was induced. The teeth were scanned with the CBCT unit PreXion 3D (Teracom, San Mateo, CA) operating at 2 different protocols: high resolution/standard (HI-STD) (19 seconds and 512 basis images) and high resolution/high density (HI-HI) (37 seconds and 1024 basis images). Three oral radiologists evaluated all images using multiplanar reconstructions. The diagnostic tests and the receiver operating characteristic (ROC) curve were calculated. RESULTS: The HI-STD and HI-HI protocols presented an accuracy of 0.90 and 0.93, respectively, and both protocols had a sensitivity of 0.97. The HI-HI protocol showed a higher positive predictive value and slightly higher areas under the ROC curve. CONCLUSIONS: Both high-resolution imaging protocols presented high accuracy in the detection of incomplete root fracture of endodontically teeth. Thus, the HI-STD protocol should be indicated this reduces the radiation dose.

Conhecimento sobre uso, conservação e higienização de próteses totais em população desfavorecida socioeconomicamente assistida por um projeto de extensão universitária / Knowledge of use, maintenance and cleaning of dentures in socioeconomically disadvantaged population assisted by a university extension project

Introdução: a prótese dentária total é um órgão artificial que deve promover a saúde e a qualidade de vida. O modo de uso, conservação e higienização é parte fundamental para o sucesso e longevidade da mesma. Uma ferramenta que parece ser eficaz na detecção e disseminação desse tipo de informação é a extensão universitária. Objetivo: analisar o nível de conhecimento sobre o uso, conservação e higienização de próteses totais em uma população de baixa renda, através de estudo epidemiológico transversal. Métodos: a amostra de conveniência foi composta por 37 usuários de próteses totais atendidos em uma ação do programa de extensão universitária Resgatando Sorrisos da Universidade de Pernambuco, que promove ações terapêuticas e informativas sobre as áreas de prótese dentária, dentística, patologia e pacientes com necessidades especiais. Após assinatura do termo de consentimento livre e esclarecido (TCLE), foram coletadas informações sociodemográficas e sobre hábitos de uso e higiene das próteses, através de um questionário aplicado por pesquisadores em ambiente reservado. Os dados foram interpretados por meio de análise descritiva e analítica entre as variáveis com nível de significância considerado, p < 0,05. Resultados e Discussão: dos pacientes, 70,27% dormem com as próteses; sobre frequência de higienização, 43,2% relatam fazer pelo menos 3 vezes ao dia, sendo o uso da escova e creme dental o método mais utilizado (83,78% - 31 entrevistados); características como bases e dentes desgastados, presença de biofilme/tártaro foram encontradas em mais 50% das próteses totais. Não foi observada nenhuma correlação estatisticamente significativa entre as variáveis (p>0,05). Conclusão: o nível de conhecimento sobre o uso, conservação e higienização de próteses totais da população estudada precisa ser melhorado, uma vez parte da população ainda apresenta hábitos de uso e higiene de próteses totais inadequados.(AU)

Introduction: the dental total prosthesis is an artificial organ that should promote health and quality of life. The way of use, conservation and hygiene is fundamental for the success and longevity of it. One tool that seems to be effective in detecting and disseminating this type of information is activities of University extension. Objectives: to analyze the level of knowledge about the use of complete sets of dentures and their conservation in a low-income population through a cross-sectional epidemiological study. Methods: This research had a convenience sample of 37 users of complete sets of dentures. Datawas collected using a questionnaire applied by two trained examiners. The data were interpreted via descriptive and statistical analysis (tests of Kruskal-wallis e Kolmogorov ­ Smirnov/ p =0,05). Results: The average income of the sample was R$ 668.00. The average time of denture use was 7.3 years; 70.27% of the patients sleep with their dentures, and 83.78% of them sanitize the dentures with a toothbrush and toothpaste. Conclusion: Regarding the variables association, we noticed tendencies yet to be explored in the habits of the complete denture wearer. Moreover, we conclude that the population's level of knowledge on the subject needs to be improved. Thereby, once these conditions are detected and transmitted to government officials, the extension project through the research tool will be able to assist government's course of action regarding oral health.(AU)

The influence of composite resin restorations and lining on radiographic diagnosis and decision-making: an in vitro investigation.

The objective of this study was to evaluate the influence of resin-based restorations on the interpretation of digital and conventional radiographic images and to correlate the proposed diagnosis with decision-making. Class II cavities were prepared in one of the proximal surfaces of extracted human molars. Teeth were divided into five groups (n = 10) according to the restoratives used: Natural Flow (NF) and Filtek Supreme (FS); Filtek Flow (FF) and FS; Tetric Flow (TF) and FS; Protect Liner F (PLF) and FS; and FS alone. Bitewing radiographs were taken using conventional and digital systems. Subjective analysis was performed for each surface: no restoration; restored teeth; or restored teeth with gap. Based on the given diagnosis, clinical conduct was then indicated. Material radiopacity was determined according to ISO 4049. A Fisher exact test evaluated the influence of the restoratives on the diagnosis. Means were compared using ANOVA and the Games-Howell test. A Friedman test was used to analyze the influence of the systems on the diagnosis, and a binomial test was used to analyze the association between the presence of gaps and the decision to replace the restoration (P = 0.05). For each system, TF+FS was significantly associated with a high percentage of correct diagnoses. The opposite was the case for PLF+FS, which differed from all other groups. Radiographic systems presented similar behaviors, except for NF+FS. Apart from PLF, adequate radiopacity was observed. Diagnosis was influenced by restorative materials, regardless of the radiographic system used. The low radiopacity of PLF led to a greater number of erroneous diagnoses. Moreover, the decision-making process was influenced strongly by the given diagnosis.

Resistência ao cisalhamento e padrão de condicionamento de sistemas adesivos autocondicionantes em esmalte intacto e preparado / Shear bond strength and etching pattern of self-etching bonding agents on ground and intact enamel

Objective: The aim of this study was to evaluate the shear bond strength of four self-etching adhesive systems on intact and ground enamel, and also to evaluate the morphology of the enamel surface after etching.Methods: A total of 100 bovine central lower incisors were randomly divided into five groups: Single Bond (3M ESPE, St. Paul, USA), Adper Prompt L Pop (3M ESPE, St. Paul, USA), Clearfil SE Bond (Kuraray America, USA), One-up Bond F (Tokuyama Corp., Shibuya-ku, Tokyo, Japan) and AdheSE (Ivoclar/Vivadent, Schaan, Liechtenstein). Each group was subdivided (n=10), according to the surface preparation (intact or ground enamel). For intact enamel, the teeth were pumiced and ground enamel surfaces were obtained with wet 320-grit SiC paper. A circular (4mm) bonding area was demarcated and resin rods (Filtek Z250, 3M ESPE, St. Paul, USA) were built (5mm) for the shear test, followed by failure mode analysis using Scanning Electron Microscopy. In addition, 12 teeth were prepared for the evaluation of the etching pattern by Scanning Electron Microscopy. Statistical analysis of the data was performed with two-way ANOVA and Tukey?s test (p<0.05). Results: Significant differences were observed between the Shear bond strength values for the adhesive systems (p<0.001). No differences were found between the two substrates (p=0.598) nor any interaction between the adhesive systems versus substrate (p=0.404). The etching patterns were generally observed as mild when compared to phosphoric acid, except for Adper Prompt L Pop (3M ESPE, St. Paul, USA), which was similar to phosphoric acid. Conclusion: Shear bond strength was not influenced by the type of substrate (intact or ground enamel), and no correlation was observed between the Shear bond strength values and the etching pattern of the self-etching adhesives studied.

Objetivo: Avaliar a resistência ao cisalhamento e o padrão de condicionamento de quatro sistemas adesivos autocondicionantes em esmalte intacto e preparado. Métodos: Cem incisivos centrais inferiores bovinos foram aleatoriamente divididos em cinco grupos: Single Bond (3M ESPE, St. Paul, USA), Adper Prompt L Pop (3M ESPE, St. Paul, USA), Clearfil SE Bond (Kuraray America, USA), One-up Bond F (Tokuyama Corp., Shibuya-ku, Tokio, Japan) e AdheSE (Ivoclar/Vivadent, Schaan, Liechtenstein). Cada grupo foi subdividido (n=10) de acordo com o tipo de superfície. Os dentes com esmalte intacto foram limpos com pasta de pedra pommes/água e os com esmalte preparado tiveram a superfície do esmalte desgastada com lixas d?água (n.320). Uma área circular (4mm) foi demarcada para adesão e os cilindros de resina (Filtek Z250, 3M ESPE, St. Paul, USA) foram confeccionados (5mm). Após o ensaio resistência ao cisalhamento, foi realizada a avaliação do modo de fratura. Doze dentes foram preparados para avaliação do padrão de condicionamento em Microscopia Eletrônica de Varredura. A análise estatística dos dados foi realizada através do teste ANOVA para 2 fatores e teste de Tukey (p<0.05). Resultados: Diferenças estatisticamente significante foram observadas para a resistência ao cisalhamento entre os sistemas adesivos (p<0.001). Não foram observadas diferenças entre os substratos (p=0.598) ou ainda interações entre o sistema adesivo versus o substrato (p=0.404). Os padrões de condicionamento observados foram classificados em leve em relação ao padrão após o condicionamento com o ácido fosfórico, com exceção do padrão observado para o adesivo Adper Prompt L Pop (3M ESPE, St. Paul, USA). Conclusão: A resistência ao cisalhamento não foi influenciada pelo tipo de substrato, e, nenhuma correlação entre os valores de resistência ao cisalhamento e padrão de condicionamento dos adesivos autocondicionantes estudados foi observado.

Avaliação de propriedades físicas de resinas compostas através de diferentes métodos de análise / Evaluation of physical properties of composites using different analytical methods

Este estudo avaliou a contração de polimerização, resistência flexural e adaptação marginal de resinas compostas. Num primeiro momento, a contração linear de resinas de baixa viscosidade (Admira Flow, Grandio Flow/VOCO; Filtek Z350 Flow/3M ESPE; Tetric Flow/Ivoclar-Vivadent) foi avaliada em MEV através da mensuração das fendas formadas na interface resina/matriz metálica (7x2mm)...

This study evaluated polymerization shrinkage, flexural strength and marginal integrity of resin composites. In a first moment, linear shrinkage (LPS) of low-viscosity resin composites (Admira Flow, Grandio Flow/VOCO; Filtek Z350 Flow/3M ESPE; Tetric Flow/Ivoclar-Vivadent) was evaluated using SEM observations of the gap formed between resin and metallic mold's interface (7x2mm)...

Manchamento por tetraciclina: como tratar? / Tetracycline-stained teeth: how do we treat?

O escurecimento dental de origem medicamentosa pela ingestão da tetraciclina repercute negativamente na aparência do sorriso. Tal alteração causa constrangimento e incômodo ao paciente e preocupa o Cirurgião-Dentista na busca de tratamentos mais conservadores e de menor custo que atendam aos anseios do paciente em possuir um sorriso com harmonia de cor. Para essas situações clínicas são propostas alternativas de tratamento não-invasivas, como o clareamento dental por substâncias químicas, e invasivas, como procedimentos restauradores adesivos. O objetivo deste trabalho é revisar a literatura sobre o mecanismo de ação das tetraciclinas e seus efeitos colaterais nos dentes, bem como discutir as possibilidades de reversão cromática de dentes manchados por tetraciclina através de relato clínico