Knowledge and practice of dentists in processing polishing points: A cross-sectional study.

BACKGROUND: Adequately processing polishing points used to polish composite resin restorations is necessary for microbiological control in dentistry, but there is no specific protocol to guide professionals. Therefore, this study aimed to assess the knowledge and practice of dentists in processing these instruments. METHODS: This cross-sectional observational study included the application of an online questionnaire via Google Forms and social media promotion. The study evaluated the association of field of activity, time since graduation, age, and sex of professionals with processing practice. The statistical analysis was performed with absolute and relative frequencies and logistic and Poisson regressions at a 5% significance level. RESULTS: Overall, 473 questionnaires were analyzed. A rate of 51% of professionals reported using inadequate processing methods, and almost 68% claimed to have good knowledge of the topic. Both regression analyses were significantly associated, showing a direct effect of age and time since graduation on adequate processing practices. CONCLUSIONS: Although most professionals reported understanding the processing of polishing points, they do not perform it most adequately. CLINICAL SIGNIFICANCE: An expressive number of dentists process polishing points improperly. The topic is significant for representing a semi-critical instrument extensively used in esthetic restorations.

Comparison of Conventional and Pontic Fixed Partial Dentures Over Implants Using the Finite Element Method: Three-Dimensional Analysis of Cortical and Medullary Bone Stress.

Rehabilitation with implant prostheses in posterior areas requires the maximum number of possible implants due to the greater masticatory load of the region. However, the necessary minimum requirements are not always present in full. This project analyzed the minimum principal stresses (TMiP, representative of the compressive stress) to the friable structures, specifically the vestibular face of the cortical bone and the vestibular and internal/lingual face of the medullary bone. The experimental groups were as follows: the regular splinted group (GR), with a conventional infrastructure on 3 regular-length Morse taper implants (4 × 11 mm); and the regular pontic group (GP), with a pontic infrastructure on 2 regular-length Morse taper implants (4 × 11 mm). The results showed that the TMiP of the cortical and medullary bones were greater for the GP in regions surrounding the implants (especially in the cervical and apical areas of the same region) but they did not reach bone damage levels, at least under the loads applied in this study. It was concluded that greater stress observed in the GP demonstrates greater fragility with this modality of rehabilitation; this should draw the professional's attention to possible biomechanical implications. Whenever possible, professionals should give preference to use of a greater number of implants in the rehabilitation system, with a focus on preserving the supporting tissue with the generation of less intense stresses.

Mock-up: previsibilidade e facilitador das Restaurações estéticas em resina composta / Mock-up: predictability and facilitator of restorations aesthetic in composite resin

A reabilitação oral funcional e estética por meio de procedimentos adesivos é uma alternativa para os pacientes insatisfeitos com seu sorriso. O planejamento e a previsibilidade dos tratamentos estéticos são essenciais para o sucesso destas reabilitações. Desta forma, o profissional pode lançar mão de alguns artifícios para auxiliar no planejamento e resultar emmaior previsibilidade. Dentre esses, o enceramento diagnóstico ou wax-up, que possibilita reproduzir as características dentárias, por meio do ensaio restaurador intraoral, denominado mock-up. O wax-up e o mock-up possibilitam a visualização tridimensional do resultado estético final por meio de técnica simples e rápida. Objetivo: apresentar relato de caso clínico mostrando a importância do planejamento reverso na reabilitação estética, realizada por meio de facetas diretas em resina composta. Caso clínico: paciente do gênero feminino, com 21 anos de idade e insatisfeito com a estética do seu sorriso. Ao exame clínico foi observado alteração da cor, forma e alinhamento dos dentes. Após a anamnese, exame clínico e planejamento, por meio de enceramento diagnóstico e ensaio restaurador, foi planejado a realização de clareamento utilizando a técnica de consultório e transformação dos dentes anteriores por meio de facetas diretas em resina composta. Conclusão: o planejamento da reabilitação oral com a utilização do mock-up resultou em motivação do paciente e maior previsibilidade do resultado final, além de maior segurança na execução do caso tanto para o cirurgião dentista quanto para o paciente

The aesthetic and functional rehabilitation by adhesive procedures is an alternative for patients dissatisfied with the smile. Even contemplating a conservative and reversible treatment, the outcome predictability of some aesthetic rehabilitation treatments is extremely important. Thus, the professional can make use of some devices to planning and obtaining predictability. The waxup reproduces the dental characteristics and intra-oral Restorative test is the mock-up. The wax-up or mock-up enables threedimensional visualization of the final restoration. Objective: This article aims clinical case report associating reverse planning and aesthetic rehabilitation by composite resin using stratified technique. Case report: A 21-year-old female patient reported dissatisfaction with the aesthetics of her smile. The clinical examination showed alteration of color, shape and teeth aesthetic. After the anamnesis and clinical examination, it was proposed to perform whitening with office technique and the reshape of the anterior teeth by resin composite veneer. Conclusion: The use of mock-up in reverse planning motivates the patient by generating greater predictability of the final treatment result and provides for the dentist safety execution.

An Experimental Thermally Deposited Coating for Improved Bonding to Glass-fiber Posts.

PURPOSE: To determine whether an experimental thermally deposited siloxane-methacrylate coating for use in industrial scale applications would improve the bond strength of resin-based materials to glass fiber posts (GFPs) without affecting their mechanical properties. MATERIALS AND METHODS: An experimental 5% (w/v) solution of methacryloxypropyltrimethoxysilane was prepared. Two types of GFPs (Exacto, Angelus; White Post DC, FGM) were divided into the following groups: S: silane; SA: silane and adhesive; HS: 35% H2O2 and silane; HSA: 35% H2O2, silane and adhesive; Exp: siloxane-methacrylate coating (Si-O) via post immersion in experimental solution followed by heating; Exp-S: silane after Si-O treatment; Exp-A: adhesive after Si-O treatment; and Exp-SA: silane and adhesive after Si-O treatment. The posts were positioned in a mold to allow insertion of a dual-curing resin core, serially sectioned into beams, and subjected to microtensile bond strength (µTSB) testing. The three-point bending test and SEM/EDX analysis were used to assess the mechanical and surface properties of untreated GFPs that were etched with H2O2 or treated with Si-O. RESULTS: Surface treatments affected the µTSB only for the Exacto GFPs. The highest µTBS (MPa) was observed in Exp-S and Exp-SA groups, whereas H2O2 etching resulted in intermediate values. The mechanical properties were not affected by surface treatments. Exacto GFPs had significantly higher flexural strength (σf) and flexural modulus (Ef) than did the White Post DC GFPs, but the latter were significantly stiffer (S) than Exacto, regardless of the surface treatment tested. H2O2 promoted morphological changes in post surfaces. The experimental treatment promoted deposition of Si onto the post surface, improving bond strengths of Exacto posts. CONCLUSION: The proposed novel coating technique is a viable procedure for fiber post manufacturers to improve the µTSB of resin-based materials.

Minimally invasive approach in esthetic dentistry: composite resin versus ceramics veneers / Abordagem minimamente invasiva em odontologia estética: resina composta versus facetas cerâmicas

Unsatisfactory anatomical shape of anterior tooth promotes disharmony in the smile esthetics. The conservative dental esthetic reestablishment treatments has been improved and evaluated with the development of adhesive materials. The adhesive dentistry allowed minimally invasive preparation through direct treatments with composite resin and indirect ceramic laminates veneers. These two treatments methods present advantages and disadvantages. The aim of this manuscript is to describe two clinical reports and compare alternatives to rehabilitate the smile esthetic appearance by direct and indirect minimally invasive treatments. In the first case, a 24-years-old patient, female, complained of unsatisfactory anterior maxillary size and incisal wear. After the functional and esthetic planning, nanoparticle composite resin by free hand technique was indicated to rehabilitation. In the second case, a 24-years-old patient, male, reported dissatisfied with his anterior central incisive shape. On clinical examination, maxillary anterior conoid teeth were verified. Based on this evaluation, a conservative treatment using minimally invasive ceramic veneers in maxillary central and lateral incisor and ceramic fragments on canine was planed to the smile rehabilitation. It can be concluded that conservative treatment using direct composite resin restorations and minimum thickness ceramic veneers laminate, even with their specific limitations and advantages, provide satisfactory esthetic and functional treatment results, preserving the dental structure.

Dentes com formato anatômico insatisfatório podem causar desarmonia na estética do sorriso. Os tratamentos para restabelecer a estética do sorriso vêm evoluindo concomitantemente com o desenvolvimento dos materiais dentários. A odontologia estética permite um preparo minimamente invasivo através de resinas compostas e laminados cerâmicos. Estes dois métodos de tratamento apresentam algumas vantagens e desvantagens. O objetivo deste artigo é descrever dois relatos de casos clínicos e comparar alternativas para a reabilitação da estética do sorriso pelos tratamentos minimamente invasivos diretos e indiretos. No primeiro caso, paciente de 24 anos do gênero feminino, estava descontente com o tamanho e com o desgaste incisal dos dentes maxilares anteriores. Após o planejamento funcional e estético foi indicado restauração direta com uma resina nanopartículada pela técnica da mão livre. No segundo caso, paciente de 24 anos do gênero masculino relatou insatisfação com a forma dos incisivos centrais superiores. No exame clínico foi observado incisivos conoídes. Baseado no exame clínico foi planejado um tratamento conservador com laminados cerâmicos nos incisivos centrais e laterais, e fragmentos cerâmicos nos caninos. Pode-se concluir que os tratamentos conservadores utilizando resina composta e laminados cerâmicos, mesmo com suas limitações, promove uma estética satisfatória e resultados funcionais preservando a estrutura dental.

Reabilitação estética de dente fraturado û relato de caso / Aesthetic rehabilitation of fractured tooth û case report

Traumatismo em dentes anteriores é queixa comum nos consultórios odontológicos e pode estar associado a fraturas coronárias, o que resulta em comprometimento da função e estética. As principais técnicas para reconstrução de dentes fraturados utilizam materiais restauradores adesivos diretos por possuírem propriedades físicas e mecânicas semelhantes à estrutura dentária, além de ser técnica minimamente invasiva. O presente artigo relata um caso clínico de restauração em dente anterior fraturado, utilizando resina composta nanoparticulada associada ao clareamento dental. O tratamento realizado possibilitou restabelecer função e devolver a harmonia e estética do sorriso...

Traumatic injuries in anterior teeth are a common complaint in the dental office. These traumas can result in crown fractures causing impairment of aesthetics and function. The main techniques for reconstruction of fractured teeth include the use of direct adhesive restorative materials because of their physical and mechanical properties that are similar to the tooth structure and minimally invasive technique. This article reports a clinical case of restoration in fractured anterior teeth using composite resin with dental bleaching. The result was satisfactory because they restored function and a harmonic smile...

Efeito da técnica de polimento na topografia de superfície e na transmitância da resina composta / Effect of polishing technique on the surface topography and transmittance of the composite resin

Introdução: Clinicamente, é comum observar os efeitos de estratificação de restaurações de compósito apenas após o polimento. Objetivo: Avaliar o efeito da técnica de polimento na transmitância de luz e na topografia de superfície de uma resina composta. Material e método: Amostras da resina Filtek Z-350 XT (cor A1E) foram confeccionadas em matriz metálica. Uma das superfícies das amostras recebeu acabamento com brocas de 12 lâminas e polimento através de uma das seguintes técnicas: SL (Sof-Lex), EH (Enhance) e DH (DHPro). Ausência de polimento foi usada como controle. Após o polimento, as amostras deviam apresentar espessura final de 1 mm. A transmitância de luz foi avaliada através do espectrofotômetro, sendo considerada apenas a luz no espectro visível. A topografia de superfície foi avaliada através de interferometria a laser, com os parâmetros Sdq (híbrido), St (amplitude máxima) e As (média de picos e vales). Os dados (n=5) foram submetidos a ANOVA e teste SNK. O teste de correlação de Pearson correlacionou Sdq, St e Sa à transmitância (α=0,05). Resultado: Todos os sistemas de polimento aumentaram a transmitância de luz em relação ao controle, não havendo diferença entre estes. Apenas as amostras polidas com SL e DH apresentaram maiores valores de Sdq que o Controle. Já para os parâmetros St e Sa, EH mostrou menores valores que o controle. Sdq e St mostraram correlação significativa com transmitância. Conclusão: Todos os sistemas de polimento foram efetivos em aumentar a transmitância, sendo a redução dos valores Sdq e St relacionada a esta modificação. .

Introduction: Clinically, it is common to observe the effects of composite restorations stratification only after the polishing. Aim: This study evaluated the effect of polishing technique on light transmittance and surface topography of a composite resin. Material and method: Specimens of the composite resin Filtek Z-350 XT (color A1E) were built-up using a metal matrix. One of the specimens surfaces was finished with 12-blade burs and polished using one of following techniques: SL (Sof-Lex), EH (Enhance) and DH (DHPro). No polishing was used as control. After the polishing procedures, the samples were measured to check the final thickness (1 mm). The light transmittance was measured using a spectrophotometer connected to an integrating sphere, considered only light in the visible spectrum. The surface topography was measured by laser interferometer, assessing the parameters Sdq (hybrid), St (maximum amplitude) and Sa (average of peaks and valleys). Data (n=5) were submitted to ANOVA and SNK's test, while Pearson's correlation test was used to related Ssq, St and Sa to transmittance (α=0,05). Result: All polishing systems increased the light transmittance when compared to control, whereas no difference was observed between them. Only the samples polished with SL and DH showed lower Sdq values than control. Although for St and Sa parameters, EH showed lower values than those observed for control. Sdq and St showed significant correlation with transmittance. Conclusion: All polishing systems were effective to increase the transmittance, while the reduction of Sdq and St values were related to this modification. .

Transformação do sorriso por meio de fechamento de diastema utilizando resina composta nanoparticulada - relato de caso / Smile transformation through diastema closure using composite nanofilled - case report

A presença de diastema entre os dentes anteriores pode gerar desarmonia do sorriso e comprometer a estética do paciente. Com a evolução dos materiais e das técnicas restauradoras, o fechamento de diastema empregando resinas compostas tornou-se alternativa viável para resolução da maioria dos casos clínicos. Este tratamento permite restabelecer a função, possibilitando os contatos interproximais, bem como restabelecimento da estética, proporcionando um sorriso mais harmônico e agradável. Este artigo tem como objetivo relatar um caso clínico de correção de diastemas nos dentes anteriores superiores, utilizando resina composta nanoparticulada pela técnica direta para restabelecimento funcional e estético. O caso foi acompanhado por quatro anos, sendo realizados alguns reparos ao longo desse tempo, demonstrando que o fechamento de diastema com resina composta ‚ uma técnica viável e confiável, além de apresentar boa longevidade

The presence of anterior diastema can result on smile disharmony and compromise the patient’s aesthetic. The evolution of dental materials and techniques has made the use of composite resin for diastema closure a viable option treatment for most clinical cases. It restores function allowing the interproximal contacts, as well as harmony, reestablishing of the smile’s aesthetic. This clinical report aims at demonstrating the clinical correction of an anterior diastema restoring the functional anatomy and especially aesthetic through nanofilled composite resin restorations. The case was followed for 4-years and some repairs were carried out over this time, demonstrating the reliability and viability of the technique, with good longevity of the treatment

Intra-radicular dentin treatments and retention of fiber posts with self-adhesive resin cements

The aim of this study was to evaluate the effect of treating intraradicular dentin with irrigating solutions on the retention of glass-fiber posts luted with self-adhesive resin cement. Bovine incisors were endodontically treated, and 9-mm-deep postholes were prepared. Before inserting the cement, the root canals were irrigated with various solutions: 11.5% polyacrylic acid for 30 s, 17% EDTA for 60 s, or 5% NaOCl for 60 s, respectively. Irrigation with distilled water was used in the control group. After all specimens had been rinsed with distilled water, the excess moisture was removed and the posts were luted using either BisCem (Bisco) or RelyX Unicem clicker (3M ESPE). Seven days after luting, the specimens were sectioned transversally into 1-mm-thick slices, which were submitted to push-out testing on a mechanical testing machine. Bond strength data (n = 6 per group) were analyzed by two-way ANOVA and Student-Newman-Keuls' test (α = 0.05). For Unicem, EDTA showed lower bond strength than the other solutions, which had similar results. For BisCem, EDTA showed higher bond strength than the other treatments, while application of NaOCl yielded higher bond strength than polyacrylic acid whereas the control group had intermediate results. In conclusion, irrigating root canals before insertion of self-adhesive resin cements, especially EDTA, might interfere with retention of the fiber posts.

Intra-radicular dentin treatments and retention of fiber posts with self-adhesive resin cements.

The aim of this study was to evaluate the effect of treating intraradicular dentin with irrigating solutions on the retention of glass-fiber posts luted with self-adhesive resin cement. Bovine incisors were endodontically treated, and 9-mm-deep postholes were prepared. Before inserting the cement, the root canals were irrigated with various solutions: 11.5% polyacrylic acid for 30 s, 17% EDTA for 60 s, or 5% NaOCl for 60 s, respectively. Irrigation with distilled water was used in the control group. After all specimens had been rinsed with distilled water, the excess moisture was removed and the posts were luted using either BisCem (Bisco) or RelyX Unicem clicker (3M ESPE). Seven days after luting, the specimens were sectioned transversally into 1-mm-thick slices, which were submitted to push-out testing on a mechanical testing machine. Bond strength data (n = 6 per group) were analyzed by two-way ANOVA and Student-Newman-Keuls' test (α = 0.05). For Unicem, EDTA showed lower bond strength than the other solutions, which had similar results. For BisCem, EDTA showed higher bond strength than the other treatments, while application of NaOCl yielded higher bond strength than polyacrylic acid whereas the control group had intermediate results. In conclusion, irrigating root canals before insertion of self-adhesive resin cements, especially EDTA, might interfere with retention of the fiber posts.