The influence of final endodontic irrigation techniques and irrigants on the push-out resistance of glass fiber posts.

This study evaluated the influence of different combinations of 3 final endodontic irrigation techniques (positive-pressure irrigation [PPI], passive ultrasonic irrigation [PUI], and continuous ultrasonic irrigation [CUI]) and 2 irrigants (5.25% sodium hypochlorite [NaOCl] and 2% chlorhexidine [CHX]) on the push-out resistance of glass fiber posts. Ninety bovine roots were prepared and divided into 6 groups (n = 15): PPIN, PPI with 5.25% NaOCl; PUIN, PUI with 5.25% NaOCl; CUIN, CUI with 5.25% NaOCl; PPIC, PPI with 2% CHX; PUIC, PUI with 2% CHX; and CUIC, CUI with 2% CHX. In the PPI groups, a 30-gauge needle was used to deliver the irrigating solution. In the PUI groups, a 30-gauge needle was used to deliver the irrigating solution, which was activated for 10 seconds by means of a stainless steel file mounted on an ultrasonic unit. In the CUI groups, delivery and continuous agitation of the irrigating solution for 10 seconds were performed using a stainless steel file mounted on the ultrasonic unit. After canal preparation was completed, glass fiber posts were cemented with a dual-cure resin cement. The roots were sectioned into 1-mm-thick slices (coronal, middle, and apical thirds). After 7 days' storage in distilled water, the slices were submitted to a push-out test. The mean bond strength values were compared using 2-way analysis of variance and Tukey post hoc test (P < 0.05). The mean (SD) overall bond strength values of the specimens were as follows: PPIN, 4.46 (1.43) MPa; PUIN, 6.13 (2.35) MPa; CUIN, 7.41 (1.83) MPa; PPIC, 3.59 (1.70) MPa; PUIC, 5.49 (1.41) MPa; and CUIC, 6.0 (1.63) MPa. Irrespective of the irrigating solution, continuous ultrasonic irrigation achieved significantly greater push-out bond strengths for glass fiber posts, mainly at the apical third of the root specimens (P < 0.05).

Clinical and subjective success of tooth fragment reattachment: a case series.

This case series reports on the clinical and subjective success of tooth fragment reattachment in 2 girls and 2 boys aged 8 to 11 years (mean age of 9.5 years). A total of 7 fractured maxillary central incisors were evaluated, and 5 were treated with tooth fragment reattachment. One of the teeth undergoing the reattachment procedure had a complicated fracture, and 4 had uncomplicated fractures. The period of follow-up ranged from 9 months to 4 years. During the follow-up examinations, the restorations were evaluated clinically and radiographically to verify the position and stability of the dental fragment and signs of endodontic pathosis. The restorations were evaluated clinically according to the Ryge (US Public Health Service) criteria. The oral health-related quality of life (OHRQoL) was the subjective outcome, assessed through the Oral Health Impact Profile-Aesthetic (OHIP-Aes) questionnaire, which was completed before and after treatment. The perceived clinical changes were a small gap, marginal discoloration, or slight color change in 3 of the teeth. In 4 teeth the periodontium and periapical region remained normal, and 1 tooth presented a periapical lesion requiring endodontic treatment. The mean (SD) OHIP-Aes scores were 25.25 (7.14) pretreatment and 3.75 (3.30) posttreatment. The results of this case series suggest that tooth fragment reattachment is an effective, conservative technique that has good long-term clinical outcomes and can improve the patient's OHRQoL.

Effect of hydroelectrolytic and energy beverages on the color stability and fluorescence of composite resins.

The objective of the present study was to assess the influence of energy and hydroelectrolytic beverages on the color stability and fluorescence of composite resins. Three composite resins (Amelogen, Filtek Z350 XT, and Filtek Bulk Fill) were analyzed at 4 different time periods: at baseline (T0) and after 1 (T1), 2 (T2), and 3 (T3) months of storage. Thirty specimens of each material were prepared and divided into subgroups (n = 10) based on the type of solution in which they were immersed for 1 hour a day at 37°C: distilled water (control), Red Bull, and Gatorade. Color stability and fluorescence tests were performed at each timepoint. Three-way repeated-measures analysis of variance (ANOVA) tests were used to evaluate the influences of material, immersion solution, and time on the color stability and fluorescence values (α = 0.05). The Bonferroni test was used as a post hoc test to compare the mean values between the groups (α = 0.05). For color change, ANOVA showed a statistically significant influence of all isolated factors and their interactions. Overall, for all periods of analysis, Amelogen showed significantly higher fluorescence values than the other composite resins after storage in all solutions. In this in vitro study, energy and hydroelectrolytic beverages altered the color stability and fluorescence of the studied materials at all timepoints. The potential for future color alterations should be considered before anterior composite resin restorations are placed in patients who consume high quantities of these beverages.

Análise da pigmentação de cerâmicas odontológicas submetidas a diferentes corantes / Analysis of the pigmentation of dentistry ceramics submitted to different dyes

Objetivo: É mérito deste estudo avaliar a pigmentação de cerâmicas odontológicassubmetidas a diferentes tratamentos de superfície e imersasem soluções corantes.Métodos: Foram confeccionadas 60 amostras de cerâmica, divididas em seis grupos. Os grupos G1, G2 e G3 receberam aplicação prévia de glaze, enquanto G4, G5 e G6 foram submetidos a desgastes e polimento. Os grupos foram mantidos em água destilada, açaí e café por um período de 30 dias. Foram realizadas fotografias digitais, seguidas da mensuração de cor da superfície com o programa mColorMeter, com base no sistema CIELab, antes da imersão, após 15 e 30 dias. Para avaliação quantitativa da variação de cor foi utilizada fórmula de ∆E, onde foram obtidos média e desvio padrão de cada grupo. Os dados foram submetidos à análise estatística ANOVA de dois fatores. Resultados: Após a realização da análise estatística, foram estabelecidos as médias e desvios-padrão para variância de cor (∆E) e foi constatado que não houve resultado estatisticamente significativo, em que p ≤ 0,05, para pigmentação em nenhum dos grupos de cerâmicas. Conclusão: Nesse contexto, infere-se que as substâncias café e açaí não promoveram alterações de cor significativas, bem como o glaze e o polimento mostraram-se igualmente eficientes na manutenção da estabilidade de cor das cerâmicas.

Aim: The present study sought to evaluate the pigmentation of dental ceramics submitted to different surface treatments and immersed in staining solutions. Methods: Sixty ceramic samples were manufactured and divided into six groups. Groups G1, G2, and G3 received a prior glaze application, while groups G4, G5, and G6 were submitted to wear and polishing. The groups were maintained in distilled water, açaí, and coffee for a period of 30 days. Digital photographs were taken, followed by color measurement of the surface with the mColorMeter program, based on system CIELab, before immersion, after 15 and 30 days. For quantitative evaluation of color variation, a formula from ∆E was used, where mean and standard deviation of each group were obtained. The data were submitted to ANOVA statistical analysis of two factors. Result: After the statistical analysis, the means and standard deviations for color variance (∆E) were established, and it was found that there were no statistically significant results, with p ≤ 0.05, for pigmentation in any of the groups of ceramics. Conclusion: Therefore, it can be inferred that coffee and açaí substances did not promote significant color changes. Glaze and polishing also proved equally efficient in maintaining the color stability of the ceramics.

The role of emergence profile in papilla maintenance after diastema closure with direct composite resin restorations.

The dental morphology usually determines the shape and volume of the interdental space, which must be filled by a dense connective tissue covered by oral epithelium to achieve pleasant esthetics. When composite resin restorations are placed to solve esthetic problems, the restorative procedure must be designed to allow the formation of healthy interdental papilla. This case report discusses aspects that should be considered when composite resin restorations are proposed for diastema closure. A 23-year-old man sought treatment for variations of space in the anterior dentition after orthodontic treatment. Direct composite resin restorations were placed in a way that respected the emergence profile, even though "black triangles" were evident immediately after the procedure. At the 45-day follow-up, complete closure of the interdental spaces by healthy papillae was observed. The emergence profile should be identified and respected when restorations are placed to obtain diastema closure because healthy periodontal tissues and acceptable esthetics depend on it.

Effect of whitening dentifrices on the surface roughness of a nanohybrid composite resin.

OBJECTIVES: The present study verified the influence of whitening dentifrices on the surface roughness of a nanohybrid composite resin. MATERIALS AND METHODS: Thirty-two specimens were prepared with Filtek™ Z350 XT (3M/ESPE) and randomly divided into four groups (n = 08) that were subjected to brushing simulation equivalent to the period of 1 month. The groups assessed were a control group with distilled water (G1), Colgate Total 12 Professional Clean (G2), Sensodyne Extra Whitener Extra Fresh (G3), and Colgate Luminous White (G4). A sequence of 90 cycles was performed for all the samples. The initial roughness of each group was analyzed by the Surface Roughness Tester (TR 200-TIME Group Inc., CA, USA). After the brushing period, the final roughness was measured, and the results were statistically analyzed using nonparametric Kruskal-Wallis and Dunn tests for intergroup roughness comparison in the time factor. For intragroup and "Δ Final - Initial" comparisons, the Wilcoxon test and (one-way) ANOVA were, respectively, performed (α = 0.05). RESULTS: The roughness mean values before and after brushing showed no statistically significant difference when the different dentifrices were used. None of the dentifrices analyzed increased significantly the nanohybrid composite resin surface roughness in a 1 month of tooth brushing simulation. CONCLUSIONS: These results suggest that no hazardous effect on the roughness of nanohybrid composite resin can be expected when whitening dentifrices are used for a short period. Similar studies should be conducted to analyze other esthetic composite materials.

Esthetic rehabilitation with tooth bleaching, enamel microabrasion, and direct adhesive restorations.

The aim of this case report is to report esthetic rehabilitation with combined tooth bleaching, enamel microabrasion, and anterior restoration replacement in a 26-year-old man. Clinical examination showed deficient restorations in the maxillary anterior teeth, significant discoloration of the maxillary left central incisor, and hypoplastic stains affecting the maxillary right lateral incisor. A radiograph of the left central incisor showed satisfactory endodontic treatment, allowing preparation for the walking bleach technique. For 3 weeks, 37% carbamide peroxide in the pulp chamber was renewed every week. In-office bleaching with 35% hydrogen peroxide was also performed on the maxillary teeth. After 21 days, all teeth had been bleached to shade A1. After bleaching was completed, enamel microabrasion of the maxillary right lateral incisor was conducted with 6% hydrochloric acid. In later sessions, microhybrid composite resin restorations were placed in all 4 maxillary incisors. A combination of dental bleaching techniques, enamel microabrasion, and resin restorations was a successful and conservative choice for reestablishing the natural appearance of discolored teeth, improving the self-esteem of the patient.

A new methodology for fluorescence analysis of composite resins used in anterior direct restorations.

The aim of this study was to use a new methodology to evaluate the fluorescence of composite resins for direct restorations. Microhybrid (group 1, Amelogen; group 2, Opallis; group 3, Filtek Z250) and nanohybrid (group 4, Filtek Z350 XT; group 5, Brilliant NG; group 6, Evolu-X) composite resins were analyzed in this study. A prefabricated matrix was used to prepare 60 specimens of 7.0 × 3.0 mm (n = 10 per group); the composite resin discs were prepared in 2 increments (1.5 mm each) and photocured for 20 seconds. To establish a control group of natural teeth, 10 maxillary central incisor crowns were horizontally sectioned to create 10 discs of dentin and enamel tissues with the same dimensions as the composite resin specimens. The specimens were placed in a box with ultraviolet light, and photographs were taken. Aperture 3.0 software was used to quantify the central portion of the image of each specimen in shades of red (R), green (G), and blue (B) of the RGB color space. The brighter the B shade in the evaluated area of the image, the greater the fluorescence shown by the specimen. One-way analysis of variance revealed significant differences between the groups. The fluorescence achieved in group 1 was statistically similar to that of the control group and significantly different from those of the other groups (Bonferroni test). Groups 3 and 4 had the lowest fluorescence values, which were significantly different from those of the other groups. According to the results of this study, neither the size nor the amount of inorganic particles in the evaluated composite resin materials predicts if the material will exhibit good fluorescence.

Do conventional glass ionomer cements release more fluoride than resin-modified glass ionomer cements?

OBJECTIVES: The aim of this study was to evaluate the fluoride release of conventional glass ionomer cements (GICs) and resin-modified GICs. MATERIALS AND METHODS: The cements were grouped as follows: G1 (Vidrion R, SS White), G2 (Vitro Fil, DFL), G3 (Vitro Molar, DFL), G4 (Bioglass R, Biodinâmica), and G5 (Ketac Fil, 3M ESPE), as conventional GICs, and G6 (Vitremer, 3M ESPE), G7 (Vitro Fil LC, DFL), and G8 (Resiglass, Biodinâmica) as resin-modified GICs. Six specimens (8.60 mm in diameter; 1.65 mm in thickness) of each material were prepared using a stainless steel mold. The specimens were immersed in a demineralizing solution (pH 4.3) for 6 hr and a remineralizing solution (pH 7.0) for 18 hr a day. The fluoride ions were measured for 15 days. Analysis of variance (ANOVA) and Tukey's test with 5% significance were applied. RESULTS: The highest amounts of fluoride release were found during the first 24 hr for all cements, decreasing abruptly on day 2, and reaching gradually decreasing levels on day 7. Based on these results, the decreasing scale of fluoride release was as follows: G2 > G3 > G8 = G4 = G7 > G6 = G1 > G5 (p < 0.05). CONCLUSIONS: There were wide variations among the materials in terms of the cumulative amount of fluoride ion released, and the amount of fluoride release could not be attributed to the category of cement, that is, conventional GICs or resin-modified GICs.

Adhesive reattachment rehabilitating a nonvital central incisor with a complicated crown-root fracture: 1-year follow-up.

Dental trauma requires immediate treatment. However, some conventional treatments (such as an implant and/or partial fixed denture) will not always be immediately possible, due to the patient's age (mainly in pediatric cases) or lack of immediate financial resources. In such situations, the technique of adhesive reattachment plays an important role as a treatment option in the interim. This case report describes the use of adhesive fragment reattachment in the rehabilitation of a maxillary central incisor with a complicated crown-root fracture. A 1-year follow-up affirmed that the adhesive reattachment efficiently resolved the crown-root fracture, allowing for the retention of the tooth structure. This more conservative multidisciplinary approach restored function, esthetics, and self-esteem to the patient, while preserving all bone and gingival architecture for future implant treatment.

Nanoleakage of fiber posts luted with different adhesive strategies and the effect of chlorhexidine on the interface of dentin and self-adhesive cements.

The aim of this in vitro study was to evaluate the nanoleakage of fiber posts luted using different adhesive strategies and to investigate the effect of 2% chlorhexidine (CHX) on nanoleakage at the resin-dentin interfaces of self-adhesive cements. The self-adhesive and etch-and-rinse adhesive groups tested demonstrated similar results with regard to nanoleakage. Pretreatment with CHX promoted an adequate seal at the resin-dentin interface for self-adhesive cements.

Microleakage evaluation of class V restorations with conventional and resin-modified glass ionomer cements.

The aim of this study was to evaluate in vitro the marginal microleakage of conventional Glass Ionomer Cements (GIC) and Resin Modified Glass Ionomer Cements (RMGIC). The tested materials were grouped as follows: GIC category - G1 (Vidrion R - SSWhite); G2 (Vitro Fill - DFL); G3 (Vitro Molar - DFL); G4 (Bioglass R - Biodinâmica); and G5 (Ketac Fill - 3M/ESPE); and RMGIC category - G6 (Vitremer - 3M/ESPE); G7 (Vitro Fill LC - DFL); and G8 (Resiglass - Biodinâmica). Therefore, 80 class V cavities (2.0X2.0 mm) were prepared in bovine incisors, either in the buccal face. The samples were randomly divided into 8 groups and restored using each material tested according to the manufacturer. The root apices were then sealed with acrylic resin. The teeth were stored for 24 h in 100% humidity at 37°C. After storage, the specimens were polished with extra-slim burs and silicon disc (Soft-lex - 3M/ESPE), then were isolated with cosmetic nail polish up to 1 mm around the restoration. Then, the samples were immersed in 50% AgNO3 solution for 12 h and in a developing solution for 30 min. They were rinsed and buccal-lingual sectioned. The evaluation of the microleakage followed scores from 0 to 3. The Kruskal-Wallis test and Dunn method test were applied (a=0.05). The results showed that there was no difference between the enamel and dentin margins. However, GIC materials presented more microleakage than RMGIC.

Color stability of carious incipient lesions located in enamel and treated with resin infiltration or remineralization.

OBJECTIVE: In this in vitro study, the color change of artificial caries lesions in enamel was evaluated after resin infiltration (Icon(®), DMG, Hamburg, Germany) or remineralization. METHODS: Bovine enamel specimens (n = 72) were randomly divided into four groups: G1 - exposure to demineralizing solution (32 h) and resin infiltration; G2 - immersion in demineralizing solution and remineralization cycles (8 days); G3 - demineralizing solution (negative control); G4 - healthy/non-treated enamel (positive control). The groups were subdivided and immersed in: A (saliva), B (coffee), and C (wine). The baseline color was evaluated by spectrophotometer and repeated after 4 and 8 weeks, and after polishing, at the end of 8 weeks. The variation in color (∆E) and lightness (∆L) was analyzed by anova (two-way) and Tukey tests, and Friedman and Kruskal-Wallis tests, respectively. RESULTS: All specimens underwent color and lightness change, irrespective of immersion medium. In coffee, G2 presented the lowest mean ∆E (P < 0.05), compared with the other groups. In saliva, G3 presented the highest mean ∆E, and G2 and G4 lower ∆E means. CONCLUSION: Lesions infiltrated with Icon(®) underwent greater color change when compared with remineralized lesions, which may represent an esthetic disadvantage for the first-mentioned treatment.

Coronal reconstruction following anterior teeth traumatism: multidisciplinary treatment.

This study describes how periodontology, endodontology, and dentistry were integrated for the coronal reconstruction of anterior teeth extensively destroyed by dental trauma. A 15-year-old girl suffered a bicycle accident that resulted in the fracture of teeth No. 8 and 9. Clinical and radiographic examinations confirmed coronal fracture in both teeth, in addition to compromised pulp vitality, invasion of the biologic periodontal space, and loss of coronal space due to mesialization of the neighboring teeth. The protocol consisted of endodontic treatment for the fractured teeth, periodontal surgery to augment the clinical crown and gingival recontouring, intracanal cementation of esthetic glass fiber posts, and coronal reconstruction with resin composite. At a longitudinal follow-up visit 1 year later, clinical and radiographic examinations revealed successful rehabilitation of the fractured teeth.

Re-establishing esthetics of fluorosis-stained teeth using enamel microabrasion and dental bleaching techniques.

Dental fluorosis manifests itself as white stains on the enamel of teeth exposed to excessive doses of fluoride during their formation. Fluorosis usually occurs as a result of the ingestion of dentifrices, gels and fluoridated solutions. It may be diagnosed as mild, moderate or severe, and in some cases, it may cause the loss of the surface structure of dental enamel. The aim of this study was to report the clinical case of a female patient of 18 years with moderate fluorosis, whose smile was reestablished by the use of an enamel microabrasion technique, followed by in-office bleaching. A microabrasion technique with 6% hydrochloric acid associated with silica carbide showed to be a safe and efficient method for removing white fluorosis stains, while dental bleaching was useful for obtaining a uniform tooth shade. The association of these techniques presented excellent results and the patient was satisfied. Both techniques are painless, fast and easy to perform, in addition to preserving the dental structure. Treatment showed immediate and permanent results; this technique must be divulged among professionals and their patients.

Psychometric properties of the OHIP-14 and prevalence and severity of oral health impacts in a rural riverine population in Amazonas State, Brazil.

The objectives of this study were: (1) test the psychometric properties of OHIP-14 in a rural population; and (2) compare the oral health impacts in two riverine communities in the Brazilian Amazon that were living at different distances from an urban center. Data were obtained from a cross-sectional study in a consecutive sample (n = 126). The validity was assessed through the association of OHIP with clinical and subjective variables, which showed a more significant association with: pain, caries, need of extraction or endodontic treatment; than with tooth loss, periodontal disease or need of prostheses. The stability and internal consistency were good (ICC = 0.97; Cronbach's alpha = 0.89). The prevalence of oral impacts was greater in the community far from the urban center [70.3 (59.9-80.7)] than in the community closer to it [44.3 (30.7-57.7)], and in women [66.7 (56.0-77.3)] in comparison with men [49.1 (35.3-62.7)]. The OHIP-14 adapted to rural populations in Amazonas State was valid, reproducible, and consistent. There was high prevalence of impacts, especially for riverine communities that lived far from urban centers.

Psychometric properties of the OHIP-14 and prevalence and severity of oral health impacts in a rural riverine population in Amazonas State, Brazil / Avaliação das propriedades psicométricas do OHIP-14 e da prevalência dos impactos da saúde bucal, em população rural ribeirinha no Amazonas, Brasil

The objectives of this study were: (1) test the psychometric properties of OHIP-14 in a rural population; and (2) compare the oral health impacts in two riverine communities in the Brazilian Amazon that were living at different distances from an urban center. Data were obtained from a cross-sectional study in a consecutive sample (n = 126). The validity was assessed through the association of OHIP with clinical and subjective variables, which showed a more significant association with: pain, caries, need of extraction or endodontic treatment; than with tooth loss, periodontal disease or need of prostheses. The stability and internal consistency were good (ICC = 0.97; Cronbach's α = 0.89). The prevalence of oral impacts was greater in the community far from the urban center [70.3 (59.9-80.7)] than in the community closer to it [44.3 (30.7-57.7)], and in women [66.7 (56.0-77.3)] in comparison with men [49.1 (35.3-62.7)]. The OHIP-14 adapted to rural populations in Amazonas State was valid, reproducible, and consistent. There was high prevalence of impacts, especially for riverine communities that lived far from urban centers.

Os objetivos do trabalho foram: (1) testar as propriedades psicométricas do OHIP-14 em população rural e (2) comparar os impactos da saúde bucal em duas comunidades ribeirinhas amazônicas, com diferentes distâncias do centro urbano. Os dados foram obtidos de uma amostra consecutiva de pacientes (n = 126) em estudo de corte transversal. A validade do instrumento foi testada pela associação do OHIP com variáveis clínicas e subjetivas, sendo mais significativa para as variáveis: dor, cárie, necessidade de extração e de endodontia que para perda dentária, doença periodontal e necessidade de prótese. Estabilidade e consistência interna foram boas (CCI = 0,97; α Cronbach = 0,89). A prevalência de impactos foi maior na comunidade mais distante do centro urbano [70,3 (59,9-80,7)] que na mais próxima [44,3 (30,7-57,7)], e nas mulheres [66,7 (56,0-77,3)] comparadas aos homens [49,1 (35,3-62,7)]. O OHIP-14 adaptado às populações rurais da Amazônia foi válido, reproduzível e consistente. A prevalência dos impactos foi alta, especialmente para ribeirinhos que vivem distante dos centros urbanos.

[Provision and utilization of dental services in Amazonas State, Brazil: a case study in a riverine population in Coari municipality]. / Oferta e utilização de serviços de saúde bucal no Amazonas, Brasil: estudo de caso em população ribeirinha do Município de Coari.

This case study described the conditions in the provision and utilization of dental services in two riverine populations in the municipality (county) of Coari, Amazonas State, Brazil. Structured questionnaires were applied to individuals 18 years and older to measure dental services utilization rates. Semi-structured interviews were also conducted with key informants to characterize the provision of such services. Although the bivariate analysis did not detect any statistically significant differences, residents of the area farthest from the county seat had gone more time since their last dental visit and received less care from public health services and riverboat clinics. The qualitative analysis showed: no permanent dental services in the communities; sporadic services provided by riverboat clinics, with less frequent visits to the remotest community; high transportation cost for river-dwellers to seek treatment in the county seat; and dental treatment focused on pain control, mainly through tooth extraction. Limited access to dental services for riverine populations highlights the need to implement comprehensive health promotion measures and expand the availability of services.

Oferta e utilização de serviços de saúde bucal no Amazonas, Brasil: estudo de caso em população ribeirinha do Município de Coari / Provision and utilization of dental services in Amazonas State, Brazil: a case study in a riverine population in Coari Municipality

O presente estudo de caso teve o objetivo de descrever a oferta e utilização de serviços odontológicos em duas comunidades ribeirinhas do Município de Coari, Amazonas, Brasil. Para tanto, foram colhidos dados sobre freqüência de utilização de serviços de saúde bucal, por entrevistas estruturadas com indivíduos acima de 18 anos, e dados sobre oferta de serviços obtidos por entrevistas semi-estruturadas com informantes-chave. Nas análises bivariadas, embora sem diferença estatística, os indivíduos da comunidade mais distante da sede do município apresentaram maior tempo decorrido da última consulta, e menor proporção de atendimentos pelo serviço público e por barcos de saúde. A análise qualitativa das entrevistas revelou: ausência de serviço odontológico permanente nas comunidades; oferta esporádica através de barcos da saúde, com menor ocorrência dos serviços na comunidade mais distante; alto custo do deslocamento do ribeirinho à sede do município; e tratamento odontológico voltado para o controle da dor, basicamente se resumindo à extração dentária. O acesso precário dos ribeirinhos aos serviços de saúde bucal aponta para a necessidade de implantação de medidas amplas de promoção de saúde, aliada a maior oferta de serviços.

This case study described the conditions in the provision and utilization of dental services in two riverine populations in the municipality (county) of Coari, Amazonas State, Brazil. Structured questionnaires were applied to individuals 18 years and older to measure dental services utilization rates. Semi-structured interviews were also conducted with key informants to characterize the provision of such services. Although the bivariate analysis did not detect any statistically significant differences, residents of the area farthest from the county seat had gone more time since their last dental visit and received less care from public health services and riverboat clinics. The qualitative analysis showed: no permanent dental services in the communities; sporadic services provided by riverboat clinics, with less frequent visits to the remotest community; high transportation cost for river-dwellers to seek treatment in the county seat; and dental treatment focused on pain control, mainly through tooth extraction. Limited access to dental services for riverine populations highlights the need to implement comprehensive health promotion measures and expand the availability of services.

Adesão de cimentos resinosos a casquetes cerâmicos aluminizados. Revisão da literatura / Resin cements adhesion to the aluminized ceramics cast. Review of literatute

Este estudo teve por objetivo revisar na literatura a adesão de cimentos resinosos à estrutura de sistemas cerâmicos altamente reforçado com partículas de óxido de alumínio, elucidando quais dentre os métodos atualmente descritos seriam mais eficientes para se conseguir tal adesão. O estudo mostrou que a adesão é melhorada quando a superfície interna do casquete é jateada com partículas de óxido de alumínio e o cimento resinoso utilizado foi modificado com monômeros fosfatados