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.

Direct composite resin restorations for teeth with dental erosion: a case report.

Acid erosion should be treated according to its multifactorial etiology. This case report describes a patient with tooth wear caused by daily intake of acidic carbonated beverages. After meticulous clinical and radiographic analysis, the clinician restored the teeth temporarily with chemically cured glass ionomer cement. Afterward, the patient underwent basic periodontal therapy with scaling and coronal polishing. The patient received guidance regarding daily oral hygiene and eating habits to control the ingestion of acidic drinks. After reestablishing adequate oral conditions, the clinician placed direct composite resin restorations on the maxillary anterior teeth that displayed dental erosion. The clinical procedures improved the patient's oral health as well as the form, esthetics, and function of the worn teeth.

Effect of experimental resin cements containing thio-urethane oligomers on the durability of ceramic-composite bonded interfaces.

Thio-urethane oligomers improve conversion and mechanical properties of resin cements. The objective of this study was to evaluate the effect of resin cements formulated with thio-urethane (TU) oligomers on microtensile bond strength (µTBS) of ceramics to composites subjected to thermal/mechanical cycling. Methods: BisGMA/UDMA/TEGDMA (50/30/20 wt%) containg 0 (control, EC) or 20 wt% aliphatic or aromatic thiourethane (HDDI and BDI, respectively) were mixed with CQ/amine (0.2/0.8 wt%) and 25 wt% 0.7um Ba glass. Rely X Ultimate (RU-3M ESPE) was used as the commercial control. The cements were sandwiched between ceramic (IPS e.max Press) and resin composite blocks (Filtek Supreme, 3 M-ESPE). Eight bonded blocks were produced per experimental group. Prior to bonding, ceramic surfaces were etched (20 s - 10% HF) and silanized. Composite surfaces were treated with Single Bond Universal (3 M ESPE). Specimens were stored for 24 h in distilled water at 37 °C, and then either tested immediately, or subjected to thermal (10,000, 5 °C and 55 °C) or mechanical cycling (300,000 cycles). Sticks (1 mm2, average of 25 sticks per block) were cut and tested for µTBS (1.0 mm/min). Data were analyzed with two-way ANOVA/Tukey's test (α = 5%). Fracture surfaces were analyzed to determine failure modes. Results: The µTBS for HDDI and RU was significantly higher than BDI and EC cements. BDI led to significantly higher µTBS than EC after 24 h, Tc and Mf. µTBS decreased significantly after thermal/mechanical cycling for all groups. Failure modes were predominantly adhesive or mixed. Significance: The use of selected thio-urethane oligomers was able to increase the µTBS of composite-cement-ceramic specimens. Tc and Mf reduced µTBS for all resins cements.

Two-Year Clinical Evaluation of a Nanofilled Etch-and-Rinse and a Self-Etch Adhesive System Containing MDPB and Fluoride in Non-carious Cervical Lesions.

OBJECTIVES: The aim of this clinical study was to evaluate the performance of restorations for non-carious cervical lesions performed with a two-step etch-and-rinse or with a two-step self-etch adhesive. MATERIALS AND METHODS: The teeth to be restored (15 patients, N = 90 restorations) were randomly assigned into 3 groups (n = 30), according to the adhesive system: group 1 (G1): Peak LC Bond; group 2 (G2): Clearfil Protect Bond; and group 3 (G3): prior selective acid etching of the enamel margins before bonding with Clearfil Protect Bond. The NCCLs were restored with Amelogen Plus composite resin. Two calibrated examiners evaluated the restorations using modified US Public Health Service criteria. The data of retention, marginal integrity, and marginal discoloration were analyzed using the Kruskal-Wallis and Wilcoxon tests. RESULTS: There were no significant differences in clinical performance among the groups for the variables: retention, marginal integrity, and marginal discoloration after 1 year and 2 years. The alpha rates after 2 years were: 93.3% for G1 and 96.7% for G2 and G3 for retention; 93.3%, 100%, and 90% for G1, G2, and G3 for marginal discoloration; 86.7%, 96.7%, and 90% for G1, G2, and G3 for marginal integrity, respectively. CONCLUSIONS: The adhesives presented similar clinical performance at the end of 2 years. Also, the prior etching with phosphoric acid did not significantly improve the clinical performance of self-etch adhesive.

Enamel microabrasion: An overview of clinical and scientific considerations.

Superficial stains and irregularities of the enamel are generally what prompt patients to seek dental intervention to improve their smile. These stains or defects may be due to hypoplasia, amelogenesis imperfecta, mineralized white spots, or fluorosis, for which enamel microabrasion is primarily indicated. Enamel microabrasion involves the use of acidic and abrasive agents, such as with 37% phosphoric acid and pumice or 6% hydrochloric acid and silica, applied to the altered enamel surface with mechanical pressure from a rubber cup coupled to a rotatory mandrel of a low-rotation micromotor. If necessary, this treatment can be safely combined with bleaching for better esthetic results. Recent studies show that microabrasion is a conservative treatment when the enamel wear is minimal and clinically imperceptible. The most important factor contributing to the success of enamel microabrasion is the depth of the defect, as deeper, opaque stains, such as those resulting from hypoplasia, cannot be resolved with microabrasion, and require a restorative approach. Surface enamel alterations that result from microabrasion, such as roughness and microhardness, are easily restored by saliva. Clinical studies support the efficacy and longevity of this safe and minimally invasive treatment. The present article presents the clinical and scientific aspects concerning the microabrasion technique, and discusses the indications for and effects of the treatment, including recent works describing microscopic and clinical evaluations.

Microabrasion in tooth enamel discoloration defects: three cases with long-term follow-ups.

Superficial irregularities and certain intrinsic stains on the dental enamel surfaces can be resolved by enamel microabrasion, however, treatment for such defects need to be confined to the outermost regions of the enamel surface. Dental bleaching and resin-based composite repair are also often useful for certain situations for tooth color corrections. This article presented and discussed the indications and limitations of enamel microabrasion treatment. Three case reports treated by enamel microabrasion were also presented after 11, 20 and 23 years of follow-ups.

Microabrasion in tooth enamel discoloration defects: three cases with long-term follow-ups

Superficial irregularities and certain intrinsic stains on the dental enamel surfaces can be resolved by enamel microabrasion, however, treatment for such defects need to be confined to the outermost regions of the enamel surface. Dental bleaching and resin-based composite repair are also often useful for certain situations for tooth color corrections. This article presented and discussed the indications and limitations of enamel microabrasion treatment. Three case reports treated by enamel microabrasion were also presented after 11, 20 and 23 years of follow-ups.

Dental bleaching with a 10% hydrogen peroxide product: a six-month clinical observation.

CONTEXT: The possibility of bleaching vital teeth with peroxide-based products considerably revolutionized esthetic dentistry. AIM: The aim of this clinical study was to evaluate tooth color change and dental sensitivity after exposure to preloaded film containing a 10% hydrogen peroxide whitening system (Opalescence Trθswhite Supreme). MATERIALS AND METHODS: A total of 13 volunteers, aged 18 to 25 years, participated in this study. The patients used the whitening system once a day for 60 minutes during the 8-day study. For maxillary incisors and canines, the color change was visually evaluated with the Vita color scale before, immediately, and six months after the treatment. Tooth sensitivity was evaluated during the daily gel applications. All whitening applications were done in office and under the supervision of a dental professional. STATISTICAL ANALYSIS USED: The results were analyzed using the Friedman Test (nonparametric repeated measures ANOVA) at a level of 5%, and Dunn's Multiple Comparison Test at the level of 5%. RESULTS: It was verified that the original mean color values observed at the baseline analysis differed significantly from those observed immediately after bleaching, as well as from those seen in the analysis at six months ( P = 0.001). There was no significant difference between the mean color values observed in the immediate time and in the analysis at six months ( P = 0.474). No tooth sensitivity was observed in any patients. CONCLUSION: It was concluded that the bleaching technique using the 10% hydrogen peroxide system was effective in a short period of time without tooth sensitivity during applications.

Conservative reconstruction of the smile by orthodontic, bleaching, and restorative procedures.

The following is a clinical case report of a patient whose chief complaint was the presence of generalized spacing in the maxillary anterior segment following orthodontic treatment. After meticulous clinical analyses and discussions of the clinical procedures to be adopted, dental bleaching was performed in both arches with 10% hydrogen peroxide (Opalescence Trèswhite Supreme 10% Hydrogen Peroxide - Ultradent Products, Inc., South Jordan, USA) after the conclusion and stabilization of orthodontic treatment. Then, the orthodontic appliance was removed and the diastemas in the maxillary anterior teeth were closed with Amelogen Plus (Ultradent Products, Inc., South Jordan, USA) resin composite. It was observed that the association of orthodontic, bleaching, and restorative procedures was capable of restoring dental shape, function, and esthetics, allowing the patient to smile without hesitation.

Smile restoration through use of enamel microabrasion associated with tooth bleaching.

Enamel microabrasion can eliminate enamel irregularities and discoloration defects, improving the appearance of teeth. This article presents the latest treatment protocol of enamel microabrasion to remove stains on the enamel surface. It has been verified that teeth submitted to microabrasion acquire a yellowish color because of the thinness of the remaining enamel, revealing the color of dentinal tissue to a greater degree. In these clinical conditions, correction of the color pattern of these teeth can be obtained with a considerable margin of clinical success using products containing carbamide peroxide in custom trays. Thus, patients can benefit from combined enamel microabrasion/tooth bleaching therapy, which yields attractive cosmetic results. Esthetics plays an important role in contemporary dentistry, especially because the media emphasizes beauty and health. Currently, in many countries, a smile is considered beautiful if it imitates a natural appearance, with clear, well-aligned teeth and defined anatomical shapes. Enamel microabrasion is one technique that can be used to correct discolored enamel. This technique has been elucidated and strongly advocated by Croll and Cavanaugh since 1986, and by other investigators who suggested mechanical removal of enamel stains using acidic substances in conjunction with abrasive agents. Enamel microabrasion is indicated to remove intrinsic stains of any color and of hard texture, and is contraindicated for extrinsic stains, dentinal stains, for patients with deficient labial seals, and in cases where there is no possibility to place a rubber dam adequately during the microabrasion procedure. It should be emphasized that enamel microabrasion causes a microreduction on the enamel surface, and, in some cases, teeth submitted to microabrasion may appear a darker or yellowish color because the thin remaining enamel surface can reveal some of the dentinal tissue color. In these situations, according to Haywood and Heymann in 1989, correction of the color pattern of teeth can be obtained through the use of whitening products containing carbamide peroxide in custom trays. A considerable margin of clinical success has been shown when diligence to at-home protocols is achieved by the patient and supervised by the professional. Considering these possibilities, this article presents the microabrasion technique for removal of stains on dental enamel, followed by tooth bleaching with carbamide peroxide and composite resin restoration, if required.

Considerations about enamel microabrasion after 18 years.

PURPOSE: To review of the current status of enamel microabrasion method and its results 18 years after the development and application of this method. METHODS: A technique performing enamel microabrasion with hydrochloric acid mixed with pumice and other techniques employing a commercially available compound of hydrochloric acid and fine-grit silicon carbide particles in a water-soluble paste have been described. Much has been learned about the application of this esthetic technique, long-term treatment results and microscopic changes to the enamel surface that has significant clinical implications. The latest treatment protocol is presented and photographic case histories document the treatment results. Clinical observations made over 18 years are discussed. RESULTS: According to our findings, the dental enamel microabrasion technique is a highly satisfactory, safe and effective procedure.