Color alteration with ceramic veneers according to the tooth type and preparation step: A clinical analysis.

STATEMENT OF PROBLEM: Achieving accurate tooth color is important in esthetic dental treatments; however, clinical studies evaluating how ceramic veneer procedures affect color alterations are lacking. PURPOSE: The purpose of this clinical study was to assess the color alteration during treatment with ceramic veneers and to correlate these changes with the tooth treated and veneer thickness. MATERIAL AND METHODS: Ten patients who underwent esthetic treatment were enrolled as participants. Color analysis with the VITA spectrophotometer was performed at baseline, after tooth preparation, immediately after cementation (Final 1), and after 6 to 12 months of follow-up (Final 2). Data of L∗, a∗, b∗, shade guide unit (SGU), ΔEab, ΔE00, and variation in SGU (ΔSGU) were obtained. Thickness of the veneer was also recorded. Each participant was considered as a statistical block, and the mean results for each tooth (maxillary central incisors, lateral incisors, and canines) were presented. Data were evaluated by the mixed model for repeated measures and Tukey-Kramer post hoc test (L∗, a∗, b∗), generalized linear models (thickness, ΔEab, ΔE00, SGU), Friedman test (ΔSGU), and the Pearson test was used to correlate veneer thickness and color change (ΔEab, ΔE00, ΔSGU) (α=.05). RESULTS: Among the teeth treated, no differences were found in ceramic thicknesses. The mean thickness was 1.03 mm for central incisors, 0.96 for lateral incisors, and 0.89 for canines. The b∗ values increased significantly after preparation and decreased after cementation (P<.001). For ΔEab, ΔE00, and ΔSGU, there was no statistically significant difference between the types of tooth at each respective time of analysis (P>.05). Regardless of the tooth, a decrease in the SGU score was detected after cementation (P=.015). After tooth preparation, there was significant correlation (P<.05) between ceramic thickness and ΔSGU (r=0.36). CONCLUSIONS: Treatment with ceramic veneers resulted in color change, mainly with respect to the b∗ axis (yellow), producing objective differences in the ΔE analysis. Although ceramic thickness correlated with the VITA scale change (ΔSGU) after tooth wear or preparation, ceramic thickness did not differ among tooth types and did not correlate with changes in color parameters after cementation. (P>.05).

Effect of botulinum toxin on quality of life of patients with chronic myofascial pain.

Aim: This prospective controlled clinical study aimed to evaluate the effect of botulinum toxin Type A (BTX-A) on pain control and quality of life (QoL) in patients with chronic myofascial pain. Materials & methods: Patients with chronic myofascial pain were randomly divided into two groups (n = 20): counseling and self-care and Michigan-type occlusal splint (MOS) (CG-control group) or BTX-A injection (BTX-AG). The pain was evaluated with visual analogue scale and QoL with the oral health impact profile-14 (OHIP-14) questionnaire. Results: In both groups, the pain was reduced, and QoL improved after 30 days. The results of social disability and handicap were better for patients treated with counseling and self-care and MOS. Conclusion: Minimally invasive strategies and BTX-A application improved QoL and alleviated myofascial pain.

Mechanical Behavior and Fracture Loads of Screw-Retained and Cement-Retained Lithium Disilicate Implant-Supported Crowns.

PURPOSE: To evaluate the fatigue survival, fracture loads and failure modes of monolithic lithium disilicate screw-retained crowns, attached to titanium insert, and cement-retained crowns. MATERIALS AND METHODS: Internal tapered connection implants, embedded in acrylic resin at 30° inclination, were restored with lithium disilicate restorations, simulating a maxillary premolar (n = 20), with different designs: screw-retained titanium base abutment-crowns, and cement-retained crowns. The specimens were submitted to cyclic mechanical loading (1.2 × 106 cycles with a load of 0-250 N at 2 Hz). Surviving specimens were subjected to single load to fracture in a universal testing machine and failure modes were determined with the aid of an optical microscope. Maximum load values were analyzed statistically using the t-test and differences in failure modes were analyzed using the chi-squared test (α = 0.05). RESULTS: All specimens survived the cyclic mechanical loading. Fracture load was significantly higher for screw-retained crowns (821.69 ±196.71 N) than the cement-retained crowns (577.03 ± 137.75 N) (p = 0.005). Ceramic failure was the predominant mode, with no statistical difference between groups. CONCLUSIONS: Screw-retained and cement-retained lithium disilicate crowns survived the cyclic mechanical loading. The use of titanium inserts to support a monolithic restoration enhances the fracture strength of the crown/abutment system.

Dental Care during COVID-19 Outbreak: A Web-Based Survey.

OBJECTIVE: This survey aimed to assess the effects of coronavirus disease 2019 (COVID-19) on elective and urgency/emergency dental care and dentists concerned. MATERIALS AND METHODS: A web-based survey was performed using Google forms questionnaire sent to dentists in Brazil. Questions included: personal information, type of dental care provided during quarantine, if emergencies increased, the dental office biosafety routine, among others. The levels of concern about the impact of quarantine on dental care and patient oral health conditions and the economic impact on dental practices were evaluated using a 0- to 10-point scale. Statistical analysis included descriptive, percentages, one-way ANOVA, Tukey, and chi-square tests. RESULTS: During quarantine, 64.6% of the dentists attended only urgency/emergency treatments, while 26.1% maintained routine appointments, and 9.3% closed the dental offices. A higher percentage of dentists from the least affected states continued routine dental treatment; dentists were younger and presented a significantly lower level of concern about dental treatments and oral health conditions of their patients. An increase in urgency/emergency procedures was reported by 44.1% of the dentists, mostly due to the unavailability of routine/elective dental care and increased patient anxiety and stress. The main causes of urgency/emergency appointments were toothache, dental trauma, and broken restorations, besides the breakage of orthodontic appliances and temporomandibular disorders. Dentists reported a high level of concern about the economic impact caused by quarantine. CONCLUSIONS: The pandemic/quarantine has negatively affected the clinical routine. Personal protection/hygiene care must be adopted and reinforced by dental professionals/staff to make dental procedures safer.

Notes from the Field: Concerns of Health-Related Higher Education Students in Brazil Pertaining to Distance Learning During the Coronavirus Pandemic.

This survey aimed to assess the concerns of students of health-related higher education in Brazil regarding distance learning during the coronavirus pandemic. A Google Forms anonymous questionnaire was sent by WhatsApp Messenger to students at a private university. Seven hundred and four students answered the questionnaire (566 female, 138 male, mean age = 23.09 years), reflecting approximately a third of the students in health-related disciplines. Students reported feeling anxious due to the pandemic. Most of the students agreed with having the ability to continue education through distance learning, but relatively few of them enjoyed it. Also, students were concerned that learning of clinical material and professional training would be impaired, and they were afraid of failing the year of education. Health-related higher education private institutions in Brazil should focus on reassessing and prioritizing their policies and protocols and include a detailed plan for the future.

How does the quarantine resulting from COVID-19 impact dental appointments and patient anxiety levels?

The present study sought to evaluate the impact of quarantine resulting from the coronavirus disease 2019 (COVID-19) pandemic on dental appointments and patients' positions and concerns regarding their ongoing dental treatment. Patients from private dental clinics answered an online questionnaire anonymously regarding their treatment, availability and willingness to attend dental appointments, and concerns about contamination. Descriptive statistics of the responses were performed with percentages and responses were compared between sexes, regions, and other aspects using the chi-squared test. Five hundred ninety-five patients (412 females and 183 males; mean age: 38.21 years) answered the questionnaire. Most patients reported they were receiving dental treatment (orthodontics) and would attend to a dental appointment; meanwhile, those patients not receiving treatment would not attend or would visit only in the case of an emergency. Males reported to be calmer than females, who were more anxious and afraid; as such, males reported more willing to go a dental appointment while, in general, females were not worried about how quarantine could affect dental treatment. Patients actively undergoing treatment and orthodontic patients were more concerned about a delay in treatment. There was a significant association between feelings about the COVID-19 pandemic and the level of willingness to attend a dental appointment. The quarantine recommended due to the COVID-19 pandemic was shown to have an impact on dental appointments and the anxiety levels of patients, since there was a significant association between patients' feelings and their willingness to attend a dental appointment. Overall, patients undergoing dental treatment and orthodontics were more willing to attend an appointment and were more concerned about an increase in treatment duration.

How does the quarantine resulting from COVID-19 impact dental appointments and patient anxiety levels?

Abstract The present study sought to evaluate the impact of quarantine resulting from the coronavirus disease 2019 (COVID-19) pandemic on dental appointments and patients' positions and concerns regarding their ongoing dental treatment. Patients from private dental clinics answered an online questionnaire anonymously regarding their treatment, availability and willingness to attend dental appointments, and concerns about contamination. Descriptive statistics of the responses were performed with percentages and responses were compared between sexes, regions, and other aspects using the chi-squared test. Five hundred ninety-five patients (412 females and 183 males; mean age: 38.21 years) answered the questionnaire. Most patients reported they were receiving dental treatment (orthodontics) and would attend to a dental appointment; meanwhile, those patients not receiving treatment would not attend or would visit only in the case of an emergency. Males reported to be calmer than females, who were more anxious and afraid; as such, males reported more willing to go a dental appointment while, in general, females were not worried about how quarantine could affect dental treatment. Patients actively undergoing treatment and orthodontic patients were more concerned about a delay in treatment. There was a significant association between feelings about the COVID-19 pandemic and the level of willingness to attend a dental appointment. The quarantine recommended due to the COVID-19 pandemic was shown to have an impact on dental appointments and the anxiety levels of patients, since there was a significant association between patients' feelings and their willingness to attend a dental appointment. Overall, patients undergoing dental treatment and orthodontics were more willing to attend an appointment and were more concerned about an increase in treatment duration.

Accuracy evaluation of tridimensional images performed by portable stereophotogrammetric system / Avaliação da acurácia de imagens tridimensionais realizadas em sistema de estereofotogrametria portátil

Abstract Introduction Human facial characteristics vary according to individual dental occlusion, facial harmony, orofacial musculature and the format and configuration of craniofacial structures. Traditionally, anthropometric measurements have been acquired through direct evaluation of subjects in a clinical environment using calipers and metric tapes to measure distances between arches and landmarks. Scientific breakthroughs have enabled the digitization of data and introduced the possibility of quick, precise, radiation-free acquisitions; details can be archived for future analysis and easily shared with patients and colleagues. Among new facial analysis methods, the stereophotogrammetry technique has emerged, which uses a group of cameras to take many photographs of a subject in rapid succession from multiple angles. Nowadays, portable stereophotogrammetric systems are being proposed, as they are more practical and easier to use. Objective The aim of this work was to analyze the accuracy and reproducibility of a portable 3D stereophotogrammetric system (Vectra H1, Canfield, Fairfield, NJ, USA) in measuring soft facial tissues of 30 participants, defining measures of a cube and comparing these measurements with those obtained by a set 3D stereophotogrammetric system (Vectra M3, Canfield, Fairfield, NJ, USA) with previously validated accuracy and reproducibility through quantitative analysis of possible errors. Material and method Thirty temporary landmarks were used to measure (in mm) 34 distances in 30 participants (n = 30). Regarding the cube, 12 angles and 9 linear distances were evaluated. Result The results obtained by the established methodology indicated that the Vectra H1 portable system has shown accuracy and reproducibility equal to that of the Vectra M3 set system. Conclusion Data analysis and correlation to literature findings show Vectra H1's capability to reliably capture tridimensional images, which makes it practical for use in diverse clinical applications.

Resumo Introdução A configuração e o formato das estruturas craniofaciais, a oclusão dentária, a musculatura orofacial bem como a harmonia facial são determinantes para as características próprias da face humana. Instrumentos manuais como paquímetro e fitas métricas têm sido tradicionalmente utilizados para realizar as medidas antropométricas, diretamente de um sujeito em ambiente clínico. O avanço tecnológico possibilitou transformar a aquisição destas medidas analógicas em medições digitais, tornando possível aquisições rápidas, precisas e sem radiação. Tais informações podem, ainda, ser arquivadas para futuras análises e compartilhamento de informações com colegas e pacientes. A estereofotogrametria tem se destacado dentre as novas técnicas de captação de imagens tridimensionais, onde um grupo de câmeras de rápida captura fotografam a imagem do indivíduo a partir de variadas angulações. Atualmente, sistemas portáteis de estereofotogrametria vêm sendo propostos no mercado por apresentarem maior praticidade e simplicidade no manuseio. Objetivo A proposta do presente estudo foi avaliar a precisão e a reprodutibilidade de um sistema de estereofotogrametria 3D portátil (Vectra H1, Canfield Scientific, Fairfield, NJ, EUA) em medições dos tecidos moles faciais de 30 participantes e de um cubo de medidas definidas, comparando tais medidas com as obtidas por um sistema de estereofotogrametria 3D fixo (Vectra M3, Canfield Scientific, Fairfield, NJ, EUA), de precisão e reprodutibilidade estabelecidas e validadas, através de análise quantitativa dos possíveis erros. Material e método Foram realizadas marcações craniométricas transitórias em tecido mole da face nos 30 participantes do estudo (n=30), sendo estes submetidos à aquisição de imagens pela técnica da estereofotogrametria, tanto pelo sistema fixo Vectra M3, quanto pelo sistema portátil Vectra H1. Trinta pontos de referência (landmarks) foram utilizados para realizar as medidas (em mm) de 34 distâncias. Quanto ao cubo, foram avaliados, no total, 20 ângulos, 20 áreas e 9 distâncias lineares. Resultado Os resultados obtidos pela metodologia estabelecida mostraram que o sistema portátil Vectra H1 apresentou precisão e repetibilidade comparáveis com o sistema fixo Vectra M3. Conclusão A análise dos dados, juntamente com a correlação aos achados da literatura, evidenciam a capacidade do Vectra H1 de capturar imagens tridimensionais de modo eficaz, o que torna viável seu uso nas mais diversas aplicações clínicas.

Susceptibility to Coffee Staining during Enamel Remineralization Following the In-Office Bleaching Technique: An In Situ Assessment.

PURPOSE: To assess in situ the enamel mineralization level and susceptibility to coffee staining after in-office bleaching. MATERIALS AND METHODS: Thirty-six human dental fragments assembled into intraoral devices were bleached with 35% hydrogen peroxide and treated as follows: (group 1) no contact with coffee; (group 2) immersion in a coffee solution for 30 minutes daily for 7 days, starting 1 week after bleaching; and (group 3) immersion in a coffee solution for 30 minutes daily for 14 days, starting immediately after bleaching. Enamel mineralization and color were assessed before bleaching (T1), immediately after bleaching (T2), and after 7 (T3) and 14 days (T4). The CIE whiteness index (W*) and closeness to white (ΔW*) following bleaching and/or immersion in coffee were calculated. Data were analyzed with Friedman and Wilcoxon tests or Kruskal-Wallis and Mann-Whitney U-tests (α = 0.05). RESULTS: Significant differences in the mineralization levels were observed as a function of time. No significant differences in W* were observed between groups, nor was W* significantly different at T3 and T4. Similar ΔW* was observed between groups after 7 or 14 days. CONCLUSIONS: The mineral loss after in-office bleaching was progressively reversed by contact with saliva for 14 days. The whiteness index was not affected by contact with coffee during the remineralization period. CLINICAL SIGNIFICANCE: The results of this in situ study suggest that the mineral loss caused by in-office dental bleaching is minimal and is partly compensated by remineralization due to contact with saliva. Additionally, whiteness was not affected by daily exposition to coffee during the enamel remineralization, which indicates that avoiding the consumption of coffee immediately following in-office bleaching is unnecessary. (J Esthet Restor Dent 28:S23-S31, 2016).

Influence of educational materials on the hygiene and utilization habits of denture wearers.

The objective of this study was to investigate the influence of educational materials on the denture hygiene and utilization habits of 70 adult volunteers who had been using complete dentures for at least 5 years. On the day they received new dentures, 32 patients were provided with an illustrated leaflet and verbal instructions on oral hygiene and utilization habits, while the remaining 38 participants were advised to continue cleaning and wearing their new dentures as they had their previous dentures. After a 6- to 10-week period, 66 of 70 subjects were interviewed about socioeconomic factors, denture hygiene, and utilization habits. The percentage of patients with a proper denture care routine was low in both groups, suggesting that patients had a tendency not to change old habits. However, statistical analysis showed a positive correlation between receiving instruction and performing denture care in a way that is closer to the recommended method: brushing without toothpaste, using a specific brush; soaking in a sodium hypochlorite solution; and removing the prosthesis at night. Within the limitations of this study, it was concluded that this approach to patient education could be applied to improve the hygiene and utilization habits of denture wearers as well as encourage the correct use of complete dentures.

Prótese dentária na saúde pública: resultados de um centro de especialidades odontológicas no município de Maringá - PR / Dental prostheses in public health: results from a dental specialities center in the city of Maringá - PR

Objetivos: Avaliar a prevalência de aceitação do tratamento reabilitador protético por parte dos usuários do Centro de Especialidades Odontológicas (CEO) de Maringá - PR e analisar o perfil demográfico e socioeconômico dos mesmos. Material e método: A amostra consistiu de 39 pacientes atendidos entre março de 2006 e março de 2007. Os dados foram coletados dos prontuários e por meio de questionário estruturado. Para fins de análise, foi utilizada estatística descritiva e análise multivariada. Resultado: Em relação à aceitação do tratamento, 49% dosusuários ainda utilizavam as próteses confeccionadas pelo CEO, 36% as utilizavam parcialmente (apenas a superior ou a inferior) e 15% desistiram do tratamento. Da amostra, 57% tinham idade entre 61,8 e 76,6 anos. Mulheres representaram 67% e homens, 33%. Casados e viúvos representaram 67 e 31%, respectivamente. A renda mensal de 90% era de até três salários mínimos e 67% tinham o Primeiro Grau incompleto. Conclusão: Apesar do benefício oferecido à população estudada por meio dos CEO, grande parte desta não encontrou total resolutividade nosserviços oferecidos.

Objective: To evaluate the patient´s acceptance prevalence of the prosthetic treatment made in one of the Dental Specialties Center (DSC) of Maringá - PR and to analyze the demographic and socioeconomic profile of this population. Material and method: The sample consisted of 39 patients treated wihtin March 2006 and March 2007. The data were collected from the patient´s file, it was applied a structured questionnaire. In order to analyze the data, It was used the descriptive and multivariate analysis. Result: Concerning the treatment acceptance, 49% of thesample still used the prostheses made by the CEO, 36% used the prostheses partially (just upper or lower) and 15% gave up the treatment. From the sample, 57% were 61.8 to 76.6 years old. Women represented 67% of the sample and men 33%. Married and widows represented 67 and 31%, respectively. Most of patients (90%) had a three minimumsalaries income, and 67% had a lower level of education. Conclusion: Beside the benefits offered to the studied population, great part of them still haven´t found totally resolution to their problems.