The use of rubber dam in the survival of RMGIC restorations in primary molars: a 30-month randomized controlled clinical trial.

This study was a randomized controlled clinical trial with two parallel arms and the objective was to compare the survival of resin modified glass ionomer (RMGIC) restorations in primary teeth using rubber dam or cotton roll isolation after a 30-month follow-up period. Ninety-two children (mean age 6.8 ± 1.37) and 200 primary molars with occlusal or occluso-proximal cavitated dentin caries lesions were randomly assigned into two groups: cotton rolls and rubber dam. All lesions were restored using RMGIC (RIVA Light Cure) after selective caries removal. Restorative failure and lesion arrestment were evaluated by two independent, trained, and calibrated examiners through clinical and radiographic examinations. The Kaplan-Meier test was used to assess the survival of restorations and Cox regression was used to assess the association of risk factors with restorative failure. There was no significant difference in survival rates between groups (p = 0.17). Older age (HR = 2.81 [95%CI: 1.47-5.44]) and higher rate of gingival bleeding (HR = 0.47 [95%CI: 0.23-0.99]) were associated with restorative failure. No patient had painful symptoms, pulp outcomes, or radiographic changes compatible with lesion progression. The use of rubber dam isolation did not increase the survival rate of occlusal and occluso-proximal restorations using RMGIC in primary molars after 30 months of follow-up. Since the survival is not influenced by the type of isolation, the professional can safely choose the appropriate technique for each case, considering his experience and preferences, as well as those of the patient.

The use of rubber dam in the survival of RMGIC restorations in primary molars: a 30-month randomized controlled clinical trial

Abstract This study was a randomized controlled clinical trial with two parallel arms and the objective was to compare the survival of resin modified glass ionomer (RMGIC) restorations in primary teeth using rubber dam or cotton roll isolation after a 30-month follow-up period. Ninety-two children (mean age 6.8 ± 1.37) and 200 primary molars with occlusal or occluso-proximal cavitated dentin caries lesions were randomly assigned into two groups: cotton rolls and rubber dam. All lesions were restored using RMGIC (RIVA Light Cure) after selective caries removal. Restorative failure and lesion arrestment were evaluated by two independent, trained, and calibrated examiners through clinical and radiographic examinations. The Kaplan-Meier test was used to assess the survival of restorations and Cox regression was used to assess the association of risk factors with restorative failure. There was no significant difference in survival rates between groups (p = 0.17). Older age (HR = 2.81 [95%CI: 1.47-5.44]) and higher rate of gingival bleeding (HR = 0.47 [95%CI: 0.23-0.99]) were associated with restorative failure. No patient had painful symptoms, pulp outcomes, or radiographic changes compatible with lesion progression. The use of rubber dam isolation did not increase the survival rate of occlusal and occluso-proximal restorations using RMGIC in primary molars after 30 months of follow-up. Since the survival is not influenced by the type of isolation, the professional can safely choose the appropriate technique for each case, considering his experience and preferences, as well as those of the patient.

Knowledge and attitudes related to erosive tooth wear of professional wine tasters: a cross-sectional study / Conhecimentos e atitudes relacionadas ao desgaste dentário erosivo de provadores de vinho profissionais: um estudo transversal

Objective: this study aimed to evaluate knowledge and attitudes of professional wine tasters about erosive tooth wear. Material and Methods: two questionnaires were applied to 56 wine tasters during the 25th National Evaluation of Wines - Safra 2017 in Bento Gonçalves, Rio Grande do Sul. Descriptive data analysis and the Fisher's exact test were performed (p < 0.05). Results: for the analysis, 56 volunteers aged 25-76 years were included. Most of the volunteers reported attending dentist once a year (55.35%) and their teeth become sorer after ingesting liquids or acid foods (32.14%) over time. The majority (82.14%) believe wine tasting may have teeth effects and have already heard about erosive tooth wear (51.78%). However, when asked about symptomatology, more than half (53.57%) reported not to know. Brushing teeth immediately after ingesting something (37.5%) and increasing the brushing frequency (33.92%) were the most cited treatment options. The habit of using mouthwash solutions was significantly associated with the professionals age (p = 0.039). Conclusion: the volunteers reported a high intake of acid substances and, although most of them reported to consult dentist regularly and have already heard about erosive tooth wear, knowledge about this condition is still limited among these professionals. (AU)

Objetivo: o objetivo desse estudo foi avaliar o conhecimento e as atitudes de provadores de vinho profissionais relacionadas ao desgaste dentário erosivo. Material e Métodos: dois questionários foram aplicados a 56 provadores de vinho durante a 25ª Avaliação Nacional de Vinhos - Safra 2017 no município de Bento Gonçalves, Rio Grande do Sul. Foi realizada a análise descritiva dos dados e o teste Exato de Fisher (p < 0.05). Resultados: na análise foram incluídos 56 voluntários com idade entre 25 e 76 anos. A maioria dos voluntários relatou frequentar o dentista uma vez por ano (55,35%) e que seus dentes, com o passar do tempo, tornaram-se mais doloridos ao ingerir líquidos ou alimentos ácidos (32,14%). Mais da metade (82,14%) acreditam que as provas de vinho podem causar algum efeito sobre os dentes e já ouviram falar em desgaste dentário erosivo (51,78%). Porém, quando questionados sobre a sintomatologia, a maioria (53,57%) afirmou não ter conhecimento. Escovar os dentes imediatamente após ingerir algo (37,5%) e aumentar a frequência de escovação (33,92%) foram as opções mais compreendidas como tratamento. Utilizar soluções para bochecho esteve significativamente associado à idade dos profissionais (p=0,039). Conclusão: provadores de vinho profissionais relataram alta ingestão de substâncias ácidas e, embora a maioria consulte pelo menos uma vez por ano o dentista e já tenha ouvido falar a respeito do desgaste dentário erosivo, o conhecimento sobre essa condição ainda é limitado entre esses profissionais. (AU)

Influence of Isolation Technique on the Survival of Resin-Modified Glass-Ionomer Restorations in Primary Molars: A 9-Months Randomized Controlled Trial

ABSTRACT Objective: To compare the survival of occlusal and occlusal-proximal restorations performed with resin-modified glass-ionomer cement (RMGIC) in deciduous molars using rubber dam and cotton rolls isolation. Material and Methods: Ninety-two patients were included and 200 deciduous molars with cavitated occlusal or occlusoproximal dentin caries lesions were randomized into two groups: cotton rolls (n = 100) and rubber dam (n = 100) and RMGIC restorations were placed. At baseline and in the follow-up visit, presence, severity and activity of caries lesions were registered. Two independent, blinded examiners evaluated the treated teeth clinically using the USPHS criteria and radiographically after 9 months. Descriptive analysis, survival curve (log-rank test) and Cox regression were performed to assess risk factors related to failure. Results: Out of the 179 teeth (92 cotton rolls group and 87 rubber dam group) evaluated at 9-month follow-up period. No lesion progression was observed radiographically. The overall treatment success rate was 85.47% (83.47% for cotton rolls and 87.35 rubber dam group). No significant difference between isolation methods was observed in the log-rank test (p = 0.16). Cox regression showed no risk factors related to failure. Conclusion: No difference was found in the survival of occlusal and occlusal-proximal restorations performed with RMGIC in deciduous molars using a rubber dam and cotton rolls isolation after a 9-month follow-up period.

Enamel Subsurface Caries-Like Lesions Induced in Human Teeth By Different Solutions: A TMR Analysis.

This study assessed the effectiveness of models for developing subsurface caries lesions in vitro and verified mineral changes by transverse microradiography (TMR). Enamel blocks from permanent (n=5) and deciduous teeth (n=5) were submitted to lesion induction by immersion in demineralizing solutions during 96 h, followed by pH cycles of demineralization (de) and remineralization (re) for 10 days. Two de-/re solutions were tested. Demineralizing solution "A" was composed by 2.2 mM CaCl2, 2.2 mM KH2PO4, 0.05 M acetic acid, with pH 4.4 adjusted by 1 M KOH. Demineralizing solution "B" was composed by 2.2 mM CaCl2, 2.2 mM NaH2PO4, 0.05 M acetic acid and 0.25 ppmF, with pH 4.5 adjusted by 1M KOH. Solution "A" produced cavitated lesions in permanent teeth, whereas solution "B" led to subsurface lesions in deciduous teeth. Solution "B" was then tested in enamel blocks from permanent teeth (n=5) and subsurface lesions were obtained, so that solution "B" was employed for both substrates, and the blocks were treated with slurries of a fluoride dentifrice (1450 ppm F, as NaF, n=5) or a fluoride-free dentifrice (n=5). Solution "B" produced subsurface lesions in permanent and primary teeth of an average (±SD) depth of 88.4µm (±14.3) and 89.3µm (±15.8), respectively. TMR analysis demonstrated that lesions treated with fluoride-free dentifrice had significantly greater mineral loss. This study concluded that solution "B" developed subsurface lesions after pH cycling, and that mineral changes were successfully assessed by TMR.

Enamel subsurface caries-like lesions induced in human teeth by different solutions: a TMR analysis

Abstract This study assessed the effectiveness of models for developing subsurface caries lesions in vitro and verified mineral changes by transverse microradiography (TMR). Enamel blocks from permanent (n=5) and deciduous teeth (n=5) were submitted to lesion induction by immersion in demineralizing solutions during 96 h, followed by pH cycles of demineralization (de) and remineralization (re) for 10 days. Two de-/re solutions were tested. Demineralizing solution "A" was composed by 2.2 mM CaCl2, 2.2 mM KH2PO4, 0.05 M acetic acid, with pH 4.4 adjusted by 1 M KOH. Demineralizing solution "B" was composed by 2.2 mM CaCl2, 2.2 mM NaH2PO4, 0.05 M acetic acid and 0.25 ppmF, with pH 4.5 adjusted by 1M KOH. Solution "A" produced cavitated lesions in permanent teeth, whereas solution "B" led to subsurface lesions in deciduous teeth. Solution "B" was then tested in enamel blocks from permanent teeth (n=5) and subsurface lesions were obtained, so that solution "B" was employed for both substrates, and the blocks were treated with slurries of a fluoride dentifrice (1450 ppm F, as NaF, n=5) or a fluoride-free dentifrice (n=5). Solution "B" produced subsurface lesions in permanent and primary teeth of an average (±SD) depth of 88.4µm (±14.3) and 89.3µm (±15.8), respectively. TMR analysis demonstrated that lesions treated with fluoride-free dentifrice had significantly greater mineral loss. This study concluded that solution "B" developed subsurface lesions after pH cycling, and that mineral changes were successfully assessed by TMR.

Resumo Este estudo avaliou a efetividade de modelos para o desenvolvimento de lesões de cárie subsuperficiais in vitro e verificou alterações minerais por microradiografia transversal (TMR). Blocos de esmalte de dentes permanentes (n = 5) e decíduos (n = 5) foram submetidos à indução de lesão por imersão em soluções desmineralizadoras durante 96h, seguido de ciclos de pH de desmineralização e remineralização por 10 dias. Duas soluções des-/re foram testadas. A solução desmineralizadora "A" foi composta por 2,2 mM de CaCl2, 2,2 mM de KH2PO4, 0,05 M de ácido acético, com pH de 4,4 ajustado por 1 M de KOH. A solução desmineralizadora "B" foi composta por 2,2 mM de CaCl2, 2,2 mM de NaH2PO4, 0,05 M de ácido acético e 0,25 ppmF, com pH de 4,5 ajustado por 1 M de KOH. A solução "A" produziu lesões cavitadas em dentes permanentes, enquanto a solução "B" apresentou lesões subsuperficiais em dentes decíduos. Portanto, a solução "B" foi posteriormente usada em blocos de esmalte de dentes permanentes (n = 5) e lesões subsuperficiais foram obtidas. Portanto, a solução "B" foi empregada para ambos os substratos, sendo metade deles tratada com dentifrício fluoretado e a outra metade com dentifrício livre de flúor. A solução "B" produziu lesões subsuperficiais de cárie com profundidade de 88.4µm (14.3) em dentes permanentes e com 89.3 µm (15.8) em dentes decíduos e TMR demonstrou que lesões tratadas com dentifrício sem flúor tiveram maior perda mineral. Este estudo concluiu que a solução "B" desenvolveu lesões subsuperficiais após o ciclo de pH e as alterações minerais foram avaliadas com sucesso por TMR.

Erosive tooth wear in an asthmatic child: a case report

Introduction: Erosive tooth wear (ETW) is defined as a mechanical chemical process that results in a cumulative loss of hard tissue without the involvement of bacteria. This process may occur in permanent and deciduous teeth and may also reach the dentin tissue. Patients who report chronic diseases, such as respiratory allergy and bronchial asthma, or recurrent acute diseases, such as tonsillitis, allergic rhinitis, sinusitis, and otitis, commonly use drugs for prolonged periods; thus, more attention should be given to the dental aspects since the drugs may cause undesirable effects. Objective: This paper aims to report and discuss a clinical case of a nine-year-old, male, Caucasian, asthmatic patient who continually uses anti-asthmatic medications and has developed ETW. Case report: According to the patient's needs, oral hygiene instructions (use of fluoride stannous dentifrice, dental floss, and topical fluoride applications), daily use of mouthwash solution containing 0.05% sodium fluoride, and dietary guidance were recommended. Conclusion: An early and accurate diagnosis of ETW lesions and recognition of specific etiological factors allow the professional to elaborate an individualized prevention and control program for ETW progression.

Introdução: O desgaste dentário erosivo é definido como um processo químico mecânico que resulta em uma perda cumulativa de tecido duro, sem o envolvimento de bactérias. Esse processo pode ocorrer em dentes permanentes e decíduos, podendo atingir o tecido dentinário. Pacientes que relatam doenças crônicas, como alergia respiratória e asma brônquica ou doenças agudas recorrentes como amigdalite, rinite alérgica, sinusite e otite, comumente usam medicamentos por períodos prolongados, portanto, mais atenção deve ser dada ao aspecto odontológico, uma vez que os medicamentos podem causar efeitos indesejáveis. Objetivo : Este trabalho tem como objetivo relatar e discutir um caso clínico de um paciente de nove anos, asmático, caucasiano, sexo masculino, que faz uso contínuo de medicamentos anti-asmáticos e desenvolveu o desgate erosivo dentário. Relato do caso: De acordo com as necessidades do paciente foi realizado instruções de higiene oral (uso de dentifrício contendo fluoreto estanhoso, fio dental e aplicações tópicas de flúor). Uso diário de enxaguatório bucal contendo 0,05% de fluoreto de sódio também foi recomendado e orientações dietéticas foram realizadas. Conclusão: O diagnóstico precoce e preciso das lesões de desgaste erosivo e o reconhecimento dos fatores etiológicos específicos permite o profissional elaborar um programa individualizado de prevenção e controle da progressão do desgaste erosivo dentário.

Effect of erosive challenges on deciduous teeth undergoing restorative procedures with different adhesive protocols - an in vitro study.

To evaluate the effect of erosive challenges on the tooth- restoration interface of deciduous teeth treated with different adhesive protocols. Deciduous molars were cut mesiodistally, then embedded, abraded and polished (n=80). Samples were randomly divided according to the adhesive system used into: G1 (Adper Single Bond2®, etch-and-rinse), G2 (Universal Single Bond®, self-etching), G3 (OptibondFL®, etch-and-rinse with Fluoride) and G4 (BondForce®, self-etching with Fluoride). After standardized cavity preparation (2 mm diameter x 2 mm depth), adhesive systems were applied and samples were restored (composite resin Z350®). Half of the samples were exposed to erosive/abrasive cycles (n = 10, each adhesive group), and the other half (control group; n = 10) remained immersed in artificial saliva. For microleakage analysis, samples were submersed in methylene blue and analyzed at 40x magnifications. Cross-sectional microhardness (CSMH) was carried out (50 g/5 s) at 25 µm, 50 µm, and 100 µm from the eroded surface and at 25 µm, 75 µm, and 125 µm from the enamel bond interface. Regarding microleakage, 7.5% of the samples showed no dye infiltration, 30% showed dye infiltration only at the enamel interface, and 62.5% showed dye infiltration through the dentin-enamel junction, with no difference between groups (p≥0.05). No significant difference was observed in CSMH at different depths (two-way ANOVA, p≥0.05). We did not observe significant changes in microleakage or CSMH after erosive/abrasive challenges in deciduous teeth treated with different adhesive protocols (etch-and-rinse and self-etching adhesives, with and without fluoride).

Effect of erosive challenges on deciduous teeth undergoing restorative procedures with different adhesive protocols - an in vitro study

ABSTRACT Objective: To evaluate the effect of erosive challenges on the tooth- restoration interface of deciduous teeth treated with different adhesive protocols. Material and Methods: Deciduous molars were cut mesiodistally, then embedded, abraded and polished (n=80). Samples were randomly divided according to the adhesive system used into: G1 (Adper Single Bond2®, etch-and-rinse), G2 (Universal Single Bond®, self-etching), G3 (OptibondFL®, etch-and-rinse with Fluoride) and G4 (BondForce®, self-etching with Fluoride). After standardized cavity preparation (2 mm diameter x 2 mm depth), adhesive systems were applied and samples were restored (composite resin Z350®). Half of the samples were exposed to erosive/abrasive cycles (n = 10, each adhesive group), and the other half (control group; n = 10) remained immersed in artificial saliva. For microleakage analysis, samples were submersed in methylene blue and analyzed at 40x magnifications. Cross-sectional microhardness (CSMH) was carried out (50 g/5 s) at 25 μm, 50 μm, and 100 μm from the eroded surface and at 25 μm, 75 μm, and 125 μm from the enamel bond interface. Results: Regarding microleakage, 7.5% of the samples showed no dye infiltration, 30% showed dye infiltration only at the enamel interface, and 62.5% showed dye infiltration through the dentin-enamel junction, with no difference between groups (p≥0.05). No significant difference was observed in CSMH at different depths (two-way ANOVA, p≥0.05). Conclusions: We did not observe significant changes in microleakage or CSMH after erosive/abrasive challenges in deciduous teeth treated with different adhesive protocols (etch-and-rinse and self-etching adhesives, with and without fluoride).