Orthodontic bracket bonding techniques and adhesion failures: A systematic review and meta-analysis.

Background: This systematic review compared the bonding failures of orthodontic brackets bonded by indirect or direct techniques. Data sources: The searched databases were Cochrane Library, LILACS, BBO, PubMed, Scopus, Web of Science. Material and Methods: A search for randomized clinical trials comparing the two techniques was carried out to answer the research question: When considering orthodontic bracket bonding on permanent teeth, does the indirect technique reduce the number of bonding failures compared to the direct one over time? The quality of the included papers was assessed with Cochrane risk of bias tool and the quality of evidence with GRADE. Results: From 3096 articles identified, seven were included in the systematic review (five at unclear; two at low risk of bias). Meta-analysis was carried out according to the follow-up periods (0-6 months and 12-15 months). Results: In the first period, bonding techniques were similar with regard to adhesion failures (RR = 0.59; 95% CI 0.10-3.62; p = 0.00001; I2 = 92%); in the 12-to-15-month period, the direct bonding technique proved to be superior (RR = 1.44; 95% CI 1.05 - 1.99; p = 0.41; I2 = 0%). The quality of evidence was classified as low for the 0-6 months follow-up and high for the 12 months. Conclusions: Based on the absence of heterogeneity and the high quality of evidence, it is concluded that the direct bracket bonding technique has a lower failure rate than the indirect technique in the long term (12-15 months). Key words:Orthodontic brackets, fixed orthodontics, systematic review.

Avaliação da sorção e solubilidade de água em cimentos de ionômero de vidro com e sem agente de proteção / Evaluation of water sorption and solubility in glass ionomer cements with and without protective agent

Objetivo: Avaliar o efeito de um protetor de superfície na sorção e solubilidade de cimentos de ionômero de vidro. Materiais e Métodos: Quatro materiais foram selecionados: ionômero modificado por resina encapsulado (Riva Light Cure); modificado por resina pó/líquido (Vitremer); convencional encapsulado (Equia Forte) e convencional pó/líquido (Fuji IX). Foram confeccionados 20 espécimes de cada, sendo metade com proteção superficial do Equia Forte Coat. As amostras foram mantidas em estufa a 37°C em repouso por 5 dias. Em seguida, esses foram pesados em intervalos de 24 horas. A espessura e o diâmetro foram medidos com um paquímetro digital para o cálculo do volume. Novas pesagens foram realizadas para a obtenção da massa intermediária. Em seguida, as amostras foram mantidas em repouso por 5 dias a 37°C e realizada nova pesagem. Resultados: Os dados obtidos de sorção e solubilidade foram submetidos à análise de variância (ANOVA dois fatores, material e protetor de superfície) e teste Tukey ( =0,05). Para sorção, houve diferença significativa apenas para o fator material (p<0,05), Vitremer > Equia Forte > Riva Light Cure > Fuji IX. O ionômero Fuji IX apresentou os menores valores de sorção, diferindo significativamente dos demais materiais, independentemente do uso do protetor superficial. Não houve diferença significativa para o fator proteção de superfície (p>0,05). Para solubilidade não houve diferença significativa no fator material, protetor de superfície ou interação material*protetor. Conclusão: O uso do protetor superficial não influenciou nos valores de sorção e solubilidade dos ionômeros avaliados e o ionômero convencional Fuji IX apresentou menores taxas de sorção.

Objective: evaluate the effect of a surface coating agents on the sorption and glass ionomer cements solubility. Materials and Methods: Four materials were selected: Encapsulated resin-modified ionomer (Riva Light Cure); Powder/liquid Encapsulated resin-modified (Vitremer); Encapsulated conventional (Equia Forte) and powder/ liquid conventional (Fuji IX). Twenty samples of each were made, half with surface protection of Equia Forte Coat. The samples were kept in an oven for 5 days. These were then weighed at 24-hour intervals. The thickness and diameter were measured using a digital caliper to calculate their volume. New weightings were performed to obtain the intermediate mass. Then, the samples were kept at rest for 5 days and weighed again. Results: The sorption and solubility data obtained were subjected to analysis of variance (two-way ANOVA, material and surface coating agents) and Tukey test ( =0.05). For sorption, there was a significant difference only for the material factor (p<0.05), Vitremer > Equia Forte > Riva Light Cure > Fuji IX. The Fuji IX ionomer showed the lowest sorption values, differing significantly from the other materials, regardless of the use of surface coating agents. There was no significant difference for the surface protection factor (p>0.05). For solubility there was no significant difference for the material factor, surface coating agents or material*surface coating agent interaction. Conclusion: The use of surface coating agents did not influence the sorption and solubility values of the evaluated ionomers and the conventional Fuji IX ionomer showed lower sorption rates.

New Dual-cure Resin-based Material in Occlusal and Occluso-proximal Restorations of Primary Teeth: Results of a Randomized Clinical Trial.

Background: The clinical performance of new restorative materials must be evaluated before recommending its use in primary teeth. Aim: This randomized clinical trial evaluated the survival rates of restorations in single and occluso-proximal cavities of primary teeth performed with a new dual-cure resin-based material in comparison with a resin-modified glass ionomer cement after 12 months of follow-up. Materials and methods: A total of 107 restorations were placed in 27 children by one experienced pediatric dentist. Two materials were tested: Vitremer and a dual-cure resin-based material with (CentionN+Adh) and without (Cention N-Adh) adhesive system application. Two calibrated and blinded examiners evaluated the restorations at 3, 6, and 12-month. The longevity of the restorations was analyzed using Kaplan-Meier survival curves and Log-rank test (α = 5%). Results: The overall survival rates after 12-month were 81.9% for Vitremer, 70.4% for Cention N+Adh, and 66.7% for Cention N-Adh, which had the poorer performance (HR = 0.54; 95% CI= 0.31-0.95; p = 0.031). When considering the type of the cavities, the difference was significant only for occluso-proximal cavities when Cention N-Adh was used (HR = 0.46; CI = 0.26-0.81; p = 0.008). Conclusion: All evaluated materials are suitable for restoring occlusal cavities after selective caries removal. However, Cention N needs to be used with adhesive in occluso-proximal cavities. Clinical significance: Cention-N can be used for deciduous teeth restorations, with similar longevity rates as resin modified glass ionomer cements.Trial registration number RBR-9nqszr. How to cite this article: da Cunha CM, Wambier LM, Paris Matos TD, et al. New Dual-cure Resin-based Material in Occlusal and Occluso-proximal Restorations of Primary Teeth: Results of a Randomized Clinical Trial. Int J Clin Pediatr Dent 2022;15(1):38-46.

Adherence to the CONSORT statement of randomized clinical trials on ART restorations in children: current status and reporting characteristics.

Appropriate research reports are important to facilitate the evaluation of studies and the decision-making by dentists and policymakers. This meta-research study assessed the conformity of randomized clinical trials (RCTs) on atraumatic restorative treatment (ART) restorations with the CONSORT recommendations and their risk of bias (RoB). Cochrane Library, MEDLINE, BBO, LILACS, Scopus, and Web of Science databases were searched from April 2019 to June 2021 for RCTs that assessed the longevity of ART restorations in children. A specific tool was used to assess adherence to the CONSORT recommendations; RoB was evaluated with the Cochrane risk-of-bias tool. Descriptive analyses included the number of studies by journal, follow-up period, country, and quality assessments. A total of 2,181 papers were retrieved and 36 of them were analyzed qualitatively. The overall CONSORT mean score (CONms) was 22.52 ± 6.17 out of 32 points. The best described items were intervention and outcomes, whereas allocation concealment was described in only 22% of the papers. Significant differences in CONms were detected in the analysis by country and publication dates. High CONms were observed in recently published papers (26.7 ± 3.1) when compared to first ART studies (18.1 ± 4.6; p < 0.001). RoB was low in four studies, unclear in 11, and high in 21. Adherence of the papers to the CONSORT recommendations was not fully achieved and most of the papers had unclear and high RoB (PROSPERO registration #CRD42020201460).

Adherence to the CONSORT statement of randomized clinical trials on ART restorations in children: current status and reporting characteristics

Abstract: Appropriate research reports are important to facilitate the evaluation of studies and the decision-making by dentists and policymakers. This meta-research study assessed the conformity of randomized clinical trials (RCTs) on atraumatic restorative treatment (ART) restorations with the CONSORT recommendations and their risk of bias (RoB). Cochrane Library, MEDLINE, BBO, LILACS, Scopus, and Web of Science databases were searched from April 2019 to June 2021 for RCTs that assessed the longevity of ART restorations in children. A specific tool was used to assess adherence to the CONSORT recommendations; RoB was evaluated with the Cochrane risk-of-bias tool. Descriptive analyses included the number of studies by journal, follow-up period, country, and quality assessments. A total of 2,181 papers were retrieved and 36 of them were analyzed qualitatively. The overall CONSORT mean score (CONms) was 22.52 ± 6.17 out of 32 points. The best described items were intervention and outcomes, whereas allocation concealment was described in only 22% of the papers. Significant differences in CONms were detected in the analysis by country and publication dates. High CONms were observed in recently published papers (26.7 ± 3.1) when compared to first ART studies (18.1 ± 4.6; p < 0.001). RoB was low in four studies, unclear in 11, and high in 21. Adherence of the papers to the CONSORT recommendations was not fully achieved and most of the papers had unclear and high RoB (PROSPERO registration #CRD42020201460).

Clinical performance of a micro invasive treatment based on demineralization-remineralization for dental fluorosis: case report

Introduction: Dental fluorosis manifests clinically as white to brown spots on the enamel teeth that were exposed to excessive fluoride during the formation process. Esthetic treatments were described in the literature to reduce or eliminate the fluorotic stains on the enamel surface. Objective: The aim of this study is to present an alternative treatment for fluorosis-stained teeth. Case report: This case report describes the clinical performance of a treatment of a 12-year-old male patient whose teeth presented moderate fluorosis. This treatment is based on tooth demineralization and remineralization. The material has an acid phase made by hydrochloric acid with tricarboxylic acid, and an alkaline phase made by Calcium Hydroxide. Results: This pain less and fast treatment presented good results. The treatment eliminated the spots during the follow-up and preserved most of the dental structure, improving the appearance of the patient's teeth. Conclusion: The appearance of the treated enamel showed a surface almost completely free of fluorotic stains, demonstrating the satisfactory results of this treatment.

Introdução: A fluorose dentária manifesta-se clinicamente como manchas brancas a marrons no esmalte de dentes expostos ao excesso de flúor durante o processo de formação. Tratamentos estéticos foram descritos na literatura para reduzir ou eliminar as manchas fluoróticas na superfície do esmalte. Objetivo: Apresentar uma alternativa de tratamento para dentes manchados por fluorose dentária. Relato do caso: Este relato de caso descreve o desempenho clínico do tratamento para dentes com fluorose moderada em um paciente de 12 anos. Esse tratamento foi baseado numa técnica de desmineralização e remineralização do dente. O material possui uma fase ácida composta por ácido clorídrico com ácido tricarboxílico, e uma fase alcalina composta por Hidróxido de Cálcio. Resultados: Observou-se que esse tratamento, sem dor e rápido, apresentou resultados satisfatórios, pois eliminou as manchas durante o acompanhamento. Além disso, preservou ao máximo a estrutura dentária, beneficiando o paciente com uma melhor aparência dos seus dentes. Conclusão: O aspecto do esmalte tratado mostrou uma superfície quase sem manchas fluoróticas, demonstrando resultados satisfatórios deste tratamento.

Adhesive restoration of molars affected by molar incisor hypomineralization: a randomized clinical trial.

OBJECTIVE: This randomized clinical trial evaluated the survival of direct restorations on first permanent molars (FPMs) with molar incisor hypomineralization (MIH) and its impact on self-reported dental pain and dental anxiety. MATERIAL AND METHOD: FPMs with MIH of 35 patients aged 7 to 16 years were included. The FPMs were randomized into the following two groups: total-etch (TE-37% phosphoric acid etching) and self-etch (SE-no prior etching). The FPMs were restored with universal adhesive and bulk-fill resin composites. The restoration survival was evaluated according to USPHS criteria modified by a blinded examiner. Dental anxiety (Venham picture test) and dental pain (Faces pain scale-revised) were evaluated before treatment and at 1, 6, and 12 months post-treatment. Survival rates were analyzed by the Kaplan-Meier method and the log-rank test. Nonparametric tests compared pain and anxiety in the follow-up periods. RESULTS: A total of 64 FPMs were restored (TE = 33; SE = 31). Survival rates were 96.9% (TE) and 96.7% (SE) after 1 month, 90.5% (TE) and 80.6% (SE) after 6 months, and 80.8% (TE) and 62.3% (SE) after 12 months (p > 0.05). Self-reported dental pain and anxiety level decreased after treatment in both groups (p < 0.05). Self-reported pain decreased after 1 month in SE, but it occurred at 6 months in TE. CONCLUSION: Both restorative protocols presented similar longevity, decreasing self-reported pain and anxiety levels. CLINICAL RELEVANCE: A universal adhesive could be appropriate for restoration of MIH-affected teeth, and the survival of restorations could be higher in the total-etch technique, reducing dental pain and anxiety.

Are glass carbomer sealants more efficient in preventing carious lesions in children's permanent molars when compared to other sealant materials? A systematic review and meta-analysis

Objective: This systematic review was performed to evaluate the efficacy of glass carbomer when compared with other sealant materials in preventing carious lesions in children and retention in pit and fissures. Sources of data: The paper included only randomized clinical trials that compared pit and fissure sealants with glass carbomer and other sealant materials in children's permanent molars with at least six-monthfollow-up. A systematic search was performed in PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library and Grey literature (December 2020/January 2021). The risk of bias tool from the Cochrane Collaboration was used for quality assessment of the studies and GRADE approach for the quality of the evidence. Meta-analysis was performed on studies from which data could be achieved. Synthesis of data: A total of 1685 papers were identified, 54 were selected for review. From these, 40 articles were excluded after the reading of the abstract and 14 articles were put aside for assessment. Eight papers were included in qualitative and quantitative synthesis. The prevalence of caries-free pit and fissures did not show differences after six (p=0.77; I2= 0%) or 12 months (p=0.60; I2= 0%) and the quality of the evidence was judged as low; after 24 months, other sealant materials performed better (p=0.30; I2=7%) and the quality as moderate. There were no differences in the retention rates of the different materials after six-month (p<0.0001; I2= 96%), 12-month follow-up (p<0.0001; I2= 99%) and 24 months (p<0.00001; I2= 100%); the quality of the evidence was considered very low. Conclusion: Glass carbomer sealants have a similar performance to other sealant materials when retention is considered. For the development of new carious lesions, other sealant materials performed better over time. However, new clinical trials are needed to corroborate these findings since it still lacks quality to the evidence raised.

Objetivo: Esta revisão sistemática foi realizada para avaliar a eficácia de selantes de fóssulas e fissuras em carbômero de vidro comparados a outros materiais seladores na prevenção de lesões cariosas em crianças e retenção em fóssulas e fissuras. Fontes dos dados: Este estudo incluiu apenas estudos clínicos randomizados que compararam selantes em carbômero de vidro com selantes em outros materiais em molares permanentes em crianças com um acompanhamento mínimo de 6 meses. Uma busca sistemática foi realizada nas bases de dados PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library e literatura cinzenta. Resumos de IADR, registros de triagens clínicas não publicadas, bases de dissertações e teses também foram pesquisados. O risco de viés dos estudos foi avaliado por meio da ferramenta Cochrane e a qualidade da evidência com o GRADE. Metanálises foram realizadas com os estudos que permitiram a coleta de dados. Síntese dos dados: Um total de 1685 artigos foram identificados e 54 selecionados para revisão. Destes, 40 artigos foram excluídos depois da leitura do resumo e 8 foram incluídos na análise qualitativa e quantitativa. A prevalência de fóssulas e fissuras livres de cárie foi similar após 6 (p=0,77; I2= 0%) e 12 meses (p=0,60; I2= 0%) e qualidade da evidência foi considerada baixa; após 24 meses, os outros materiais tiveram melhor desempenho (p=0,30; I2=7%) com evidência moderada. Não houve diferença nas taxas de retenção dos diferentes materiais após 6 (p<0,0001; I2= 96%), 12 meses (p<0,0001; I2= 99%), ou 24 meses (p<0,0001; I2= 100%) de acompanhamento; a qualidade foi considerada muito baixa. Conclusão: Selantes de carbômero de vidro tem retenção similar aos outros materiais seladores utilizados. Em relação ao desenvolvimento de novas lesões de cárie, os outros materiais apresentaram melhor desempenho ao longo do tempo. Todavia, novos estudos clínicos devem ser desenvolvidos para corroborar estes achados, uma vez que há falta de qualidade na evidência obtida.

Caries Prevalence in Preschool Children in a City of Southern Brazil According to Two Diagnostic Criteria: dmf-t and ICDAS II

Objective: This cross-sectional research evaluated caries prevalence and treatment need in preschool children using different indexes. Material and Methods: A sample of 931 children (3-5 years old) attending public schools were examined by two calibrated researchers, who recorded the caries prevalence using dmf-t and ICDAS II. The clinical records obtained directed the decision regarding the treatment needs, which were divided into non-invasive and invasive procedures according to the scores registered in the different caries indexes. Descriptive statistics were used to present the data related to each index; qui-square test was used to compare the need of invasive and non-invasive treatment in the different ages. Results: The mean dmf-t was 1.8 ± 2.9, with a 42.9% caries prevalence. Using cut-off points of ICDAS II (≥1, ≥3 and ≥4), the caries prevalence values found were 50.7%, 40.8% and 30.7%, respectively. Fiveyear- old children exhibited the highest caries prevalence, assessed with dmf-t or ≥3 and ≥4 cutoff points of ICDAS II (≥3: p=0.032; ≥4: p=0.015). The percentages of caries-free children were 49.1% and 57.1%, respectively for ICDAS II and dmf-t. Restorative treatment in at least one tooth was required by 30.7% and 40% of the children for ICDAS II and dmf-t. Only ICDAS II could establish the percentage of non-invasive treatments (20%). Both indices pointed out the expressive need of restorative treatment. Conclusion: The use of dmf-t in epidemiological surveys may underestimate caries prevalence whereas the ICDAS II allowed the identification of early carious lesions and the viability of the use of non-invasive procedures as caries control measures in a child population.

Tratamento Restaurador Atraumático: evolução do conhecimento e aceitação entre Cirurgiões-Dentistas da Estratégia Saúde da Família de Ponta Grossa - Paraná, Brasil ao longo de 5 anos / Atraumatic Restorative Treatment: evolution of knowledge and acceptance among Doctor of Dental Surgery of the Family Health Strategy of Ponta Grossa - Paraná, Brazil over 5 years

Objetivo: este estudo avaliou as possíveis modificações no conhecimento teórico/técnico e na aceitação da técnica restauradora atraumática (ART) entre Cirurgiões-Dentistas (CDs) da Estratégia Saúde da Família (ESF) de Ponta Grossa ­ PR, Brasil ao longo de 5 anos. Material e Métodos: foram utilizados dois instrumentos de avaliação: entrevistas em profundidade e questionários semiestruturados, aplicados ao mesmo grupo de 14 CDs que atuam na ESF. Durante este período, houve momentos de capacitação oferecidos pela Secretaria de Saúde do Município e Secretaria de Saúde do Estado. Resultados: Os CDs afirmaram, nas duas etapas da pesquisa, conhecer o ART e julgaram-no útil em Saúde Pública, fazendo uso das restaurações atraumáticas (RA) rotineiramente. Houve modificações nas percepções referentes ao caráter definitivo das RA; na indicação da técnica de acordo com a característica da lesão cariosa e de acordo com a idade do paciente; na utilização do ácido poliacrílico e de agentes de proteção para o cimento de ionômero de vidro (CIV), entre outras. Além disso, os dentistas passaram a reconhecer o CIV como material essencial à técnica e a aceitar a manutenção da dentina cariada. Houve modificação no hábito da leitura científica sobre o ART entre os profissionais avaliados, além do aumento do número de indivíduos que receberam capacitações sobre ART no serviço. Conclusão: concluiu-se que houve modificações positivas no conhecimento teórico/técnico e na aceitação da técnica ART entre os profissionais entrevistados, reconhecendo assim a importância das capacitações oferecidas no serviço

Objective: this study evaluated the possible modifications in the theoretical / technical knowledge and the acceptance of the atraumatic restorative technique (ART) among Doctor of Dental Surgery (DDS) of the Family Health Strategy (FHS) of Ponta Grossa ­ PR, Brazil over 5 years. Material and Methods: for this purpose two instruments were used: in-depth interviews and semi-structured questionnaires, applied to the same group of 14 DDS that work at the FHS. During this period of time, there were moments of empowerment offered by the Health Department of the Municipality and State Health Secretariat. Results: the DDS affirmed, in the two stages of the research, to know the ART and they considered it useful in Public Health, making use of atraumatic restorations (AR) routinely. There were modifications in the perceptions regarding the definitive nature of AR; in the indication of the technique according to the characteristic of the carious lesion and according to the age of the patient; in the use of polyacrylic acid and protective agents for glass ionomer cement (GIC), among others. In addition, dentists have come to recognize GIC as essential material for the technique and to accept the maintenance of carious dentin. There was a change in the habit of scientific reading about ART among the evaluated professionals, in addition to the increase in the number of individuals who received ART training in the service. Conclusion: we can conclude that there were positive changes in the theoretical/ technical knowledge and acceptance of the ART technique among the professionals interviewed, thus acknowledging the importance of the training offered in the service

Didática no ensino superior: desafios e perspectivas dos docentes de Odontologia da Universidade Estadual de Ponta Grossa / Didactics in higher education: challenges and perspectives of Dentistry teachers of the State University of Ponta Grossa

O objetivo deste trabalho foi avaliar a percepção de docentes do curso de Odontologia quanto as principais dificuldades enfrentadas e as habilidades imprescindíveis para o exercício do magistério superior. Para tal, foi realizada uma pesquisa qualitativa com 47 professores do curso de Odontologia da Universidade Estadual de Ponta Grossa, divididos em dois grupos: a) tempo de atuação docente inferior a 5 anos; b) tempo de atuação docente maior que 5 anos. Após a validação do questionário, este foi encaminhado para os participantes da pesquisa responderem questões abertas sobre o exercício do magistério no ensino superior. Posteriormente à coleta dos dados, foi feita a análise descritiva das informações, exploração do material e interpretação dos resultados. Nos desafios enfrentados, os docentes com mais de 5 anos de atuação citaram a responsabilidade em formar um profissional, dificuldade em motivar os alunos e aquisição de segurança para docência como os principais. Por outro lado, docentes com atuação inferior a 5 anos apontaram o relacionamento com o aluno, insegurança profissional e obtenção do equilíbrio entre a teoria e a prática como principais desafios. Com relação às dificuldades enfrentadas atualmente, as respostas foram semelhantes para os dois grupos, sendo a falta de interesse dos alunos, falta de infraestrutura e de material de apoio para ministrar as aulas, as mais citadas. As habilidades mais mencionadas pelos professores como essenciais para o exercício da profissão incluíram a paciência, didática e necessidade de constante atualização. Pôde-se concluir que os professores enfrentam dificuldades na prática docente, independentemente do tempo de atuação (AU).

The objective of this study was to evaluate the perception of teachers of the Dentistry course regarding the main difficulties faced and the skills essential for the exercise of the higher education teaching profession. For that, a qualitative research was carried out with 47 professors of the Dentistry course at the State University of Ponta Grossa, divided into two groups: a) less than 5-year teaching experience; b) over 5-year teaching experience. After the validation of the questionnaire, it was sent to the participants of the research to answer open questions about teaching in higher education. After data collection, a descriptive analysis of the information, exploration of the material and interpretation of the results were carried out. Among the challenges faced, teachers with more than 5 years of work experience cited the responsibility to train a professional, difficulty motivating students and developing selfconfidence for teaching as the main points. On the other hand, teachers with less than 5 years of experience pointed out the relationship with the student, professional insecurity and obtaining a balance between theory and practice as the main challenges. With regard to the difficulties currently faced, the responses were similar for the two groups, namely, students' lack of interest, lack of infrastructure and support material to teach classes were the most cited. The most mentioned skills by the teachers as essential to the practice of the profession included patience, didactics and the need for constant updating. The results led to the conclusion that teachers face difficulties in teaching practice regardless of the time of performance (AU).

A Randomized Clinical Trial Evaluating Rubber Dam Clamp Pain Reduction from a New Topical Liposomal Anesthetic Gel.

PURPOSE: Discomfort during rubber dam clamp often occurs in pediatric dentistry. The purpose of this randomized, triple-blind, clinical trial was to evaluate the effect of pain reduction using a new topical liposomal thermo-sensitive gel (TLTG) or a placebo gel during rubber dam clamp isolation for sealants in children. METHODS: Eighty-one children (eight to 12 years old) had LTSG or the placebo gel with random assignment placed around the gingival tissue of their permanent mandibular first molars. A clamp was placed after two minutes on the teeth, and intensity of pain was registered using a Wong-Baker FACES scale and an 11-point numerical scale. The data were evaluated using McNemar's test and Wilcoxon signed rank test. RESULTS: The odds ratio for pain (OR equals 0.7; 95 percent confidence interval equals 0.3 to 1.8) was not statistically significant (P=0.52). However, there was a small difference in the pain intensity between liposomal and placebo groups for both scales (P<0.05). CONCLUSION: The liposomal thermo-sensitive anesthetic gel may reduce, to a small extent, the pain intensity in children submitted to rubber dam isolation before resin sealant placement.

A didática no ensino odontológico: percepções de docentes / Didactics in Dental education: professors' perceptions

Durante a trajetória acadêmica, os docentes são expostos a diversos desafios e dificuldades. A fim de superá-los, necessitam desenvolver habilidades específicas, em especial, a capacidade didática. O objetivo desta pesquisa exploratória descritiva foi investigar as perspectivas dos docentes de Odontologia, considerando momentos distintos de suas carreiras. A amostra constituiu-se de professores da Universidade Estadual de Ponta Grossa com até cinco anos de experiência universitária e com experiência superior a cinco anos. Do número total de participantes (53), apenas seis possuíam até 5 anos de atuação, portanto, foi sorteado, aleatoriamente, o mesmo número de questionários de professores com mais de 5 anos, para manter a similaridade entre os grupos. Os voluntários receberam um questionário aberto, semiestruturado e autoaplicável sobre a temática "Didática no ensino superior: desafios e perspectivas". Para a compilação e análise dos dados foram realizadas as técnicas do Discurso do Sujeito Coletivo (DSC) e nuvens de palavras. Observou-se que os assuntos que receberam maior ênfase pelos professores foram o processo de ensino-aprendizagem e o relacionamento professor-aluno, principalmente quando associados a dificuldades. Conclui-se que, apesar de semelhantes, as perspectivas quanto ao exercício da docência no curso de Odontologia divergem em alguns pontos. Suas preocupações possuem diferentes focos, porém ambos os grupos revelaram sentir as mesmas dificuldades (AU).

Professors at higher education programs are exposed to challenges and obstacles. In order to overcome them, they need to develop specific skills, especially the art of teaching. The aim of this exploratory descriptive study was to investigate the perspectives of professors of Dentistry, considering different moments of their careers. The sample consisted of professors with up to five years or more than five years of teaching experience at the Ponta Grossa State University. 53 volunteers were interviewed, but from these, only six professors had up to five years of experience. Therefore, the same number of questionnaires from the group with more than five years of practice was randomized, to keep both groups similar. Participants answered an open, semi-structured and self-administered questionnaire on "Teaching in higher education: challenges and perspectives". The Discourse of the Collective Subject method (DCS) and word clouds were used for data compilation and analysis. The results showed that the questions regarding the relationship between professor and student and the teaching-learning process were highlighted. We conclude that, despite being similar, the perspectives around the teaching practice diverge in some points. Professors' concerns have different approaches, however, they face the same difficulties, no matter how experient they are (AU).

Randomized Clinical Trial of ART Class II Restorations Using Two Glass Ionomer Cements: One-Year Follow-Up.

PURPOSE: The purpose of this study was to compare the survival rate of ART (atraumatic restorative treatment) Class II restorations in primary teeth, performed with glass carbomer cement and a high-viscosity glass ionomer cement, after 12 months. METHODS: One pediatric dentist placed 59 Class II ART restorations in 33 children (eight plus/minus two years old) of both genders. Two calibrated examiners, blinded to the type of material and not involved in the placement, evaluated the restorations at baseline, six, and 12 months. RESULTS: The overall success rate (95 percent confidence interval) at the six-month follow-up for the GP Glass Fill and Equia Fil was 69 percent (51 to 83) and 83 percent (66 to 93), respectively. No significant difference was detected between the study groups (Fisher's exact test, P=0.20). However, at 12 months, the overall success rates of both materials were 56 percent (37 to 73) and 86 percent (69 to 94), and this difference was statistically significant (Fisher's exact test, P=0.03). CONCLUSION: Class II ART restorations with glass carbomer showed lower survival rates after 12 months compared to those with high-viscosity glass ionomer cement.

Fluoride release and surface roughness of a new glass ionomer cement: glass carbomer / Liberação de flúor e rugosidade superficial de um novo cimento de ionômero de vidro: glass carbomer

Objective: This study analyzed the fluoride release/recharge and surface roughness of glass carbomer compared to other encapsulated glass ionomer cements (GICs). Material and method: The GICs tested were Glass Fill® (GC-GCP Dental), Riva Self Cure® (RS-SDI), Riva Light Cure® (RL-SDI), Equia Fil® (EF-GC Europe). The composite resin Luna® (LU-SDI) was used as control. Five samples of each material were prepared and kept in a humidifier for 24 hours (37 °C, 100% relative humidity). Fluoride release was measured in two times: before (T1: days 1, 2, 7, 14) and after topical application of fluoride (T2: days 15, 16, 21 and 28). The surface roughness was also measured in both times (T1: days 1 and 14; T2: days 15 and 28). All samples were submitted to a single topical application of acidulated fluoride phosphate (Fluor Care - FGM). Two-way ANOVA with repeated measures and Tukey's post-test (p <0.05) were used in the statistical analysis. Result: Equia Fil presented the highest fluoride release in both evaluation periods, with a higher release in T1 (p <0.05). The other materials tested, including glass carbomer presented similar release in both periods (T1 and T2). Regarding surface roughness, no significant differences were observed in the interaction between the material × time factors (T1 and T2) (p=0.966). Conclusion: The GICs tested presented fluoride release and recharge ability and showed no surface roughness increase by topical application of fluoride.

Objetivo: Este estudo analisou a liberação/recarga de flúor e a rugosidade superficial do carbômero de vidro em comparação a outros cimentos de ionômero vidro (CIVs) encapsulados. Material e método: Os CIVs testados foram o Glass Fill® (GC-GCP Dental), Riva Self Cure® (RS-SDI), Riva Light Cure® (RL-SDI), Equia Fil® (EF-GC Europe). A resina composta Luna® (LU-SDI) foi empregada como controle. Cinco amostras de cada material foram confeccionadas e mantidas em um umidificador durante 24h (37 °C, 100% de umidade relativa). A liberação de flúor foi aferida em dois tempos: antes (T1: dias 1, 2, 7 e 14) e após aplicação tópica de flúor (T2: dias 15, 16, 21 e 28). A rugosidade superficial também foi aferida nos dois tempos (T1: dias 1 e14; T2: dias 15 e 28). Todas as amostras foram submetidas a uma única aplicação tópica de flúor fosfato acidulado (Flúor Care - FGM). ANOVA dois fatores com medidas repetidas e pós-teste de Tukey (p<0,05) foram empregados na analise estatística. Resultado: O Equia Fil apresentou a maior liberação de flúor em ambos os períodos de avaliação, com liberação maior no T1 (p<0,05). Os demais materiais testados, incluindo o carbômero de vidro, apresentaram liberação semelhante em ambos os períodos (T1 e T2). Em relação à rugosidade superficial não foram observadas diferenças significativas na interação entre os fatores material × tempo (T1 e T2) (p=0,966). Conclusão: Os CIVs testados apresentaram capacidade de liberação e recarga de flúor e não mostraram aumento de rugosidade superfícial pela aplicação tópica de flúor.

Silver Diamine Fluoride Has Efficacy in Controlling Caries Progression in Primary Teeth: A Systematic Review and Meta-Analysis.

A systematic review was performed to evaluate the efficacy of silver diamine fluoride (SDF) in controlling caries progression in children when compared with active treatments or placebos. A search for randomized clinical trials that evaluate the effectiveness of SDF for caries control in children compared to active treatments or placebos with follow-ups longer than 6 months was performed in PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, and grey literature. The risk of bias tool from the Cochrane Collaboration was used for quality assessment of the studies. The quality of the evidence was evaluated using the GRADE approach. Meta-analysis was performed on studies considered at low risk of bias. A total of 5,980 articles were identified. Eleven remained in the qualitative synthesis. Five studies were at "low," 2 at "unclear," and 4 studies at "high" risk of bias in the key domains. The studies from which the information could be extracted were included for meta-analysis. The arrestment of caries at 12 months promoted by SDF was 66% higher (95% CI 41-91%; p < 0.00001) than by other active material, but it was 154% higher (95% CI 67-85%; p < 0.00001) than by placebos. Overall, the caries arrestment was 89% higher (95% CI 49-138%; p < 0.00001) than using active materials/placebo. No heterogeneity was detected. The evidence was graded as high quality. The use of SDF is 89% more effective in controlling/arresting caries than other treatments or placebos. The quality of the evidence was graded as high.

The influence of the lining material on the repair of the infected dentin in young permanent molars after restoration: A randomized clinical trial.

AIM: This study evaluated the impact of liner material on the fluorescence, morphological and mineral characteristics of permanent carious dentin after cavity sealing. METHODS: Thirty children (11.0 ± 2.7 years old) presenting at least one active deep carious lesion in permanent molars were selected. Fragments of carious dentin were removed from teeth before lining the cavity (baseline samples) with high-viscosity glass ionomer cement (G1) or an inert material (wax - G2). Cavities were restored with composite resin and reopened 60 days later, and other fragments were removed (60-day sample). The laser fluorescence (LF) readings and morphological and mineral changes of both groups were compared. RESULTS: After 60 days, forty teeth were available for evaluation. Lower LF means were obtained (Wilcoxon signed-rank test; P < 0.05), and enhanced calcium and phosphorus levels were detected for both groups (t-test, P < 0.05). An uptake of fluorine was observed only in G1 (t-test; P < 0.05). Regardless of the group, baseline samples exhibited clear signs of bacterial invasion, and the collagen fibers were exposed; the 60-day samples showed a better-organized tissue with a more compact intertubular dentin. CONCLUSION: Caries arrestment with dentin reorganization occurs regardless of the lining material placed in contact with the infected dentin.

Análise da dureza de um novo material restaurador para ART: Glass Carbomer / Analysis of the hardness of a new restorative material for ART: Glass Carbomer

Objetivo: Este estudo avaliou a microdureza de dois materiais ionoméricos - Glass Carbomer (GC-GCP Dental) e Riva Light Cure (RL-SDI) - em combinação com quatro unidades fotopolimerizadoras (Carbo LED lamp, GCP-Dental; Demi LED curing light, Kerr; Poli Wireless, Kavo; Radii Plus, SDI). Material e método: Foram confeccionados 80 corpos de prova seguindo a orientação dos fabricantes, sendo 40 para cada material ionomérico e, para cada 10 corpos de prova, uma das unidades fotopolimerizadoras foi utilizada. Após sete dias de armazenamento em água destilada e temperatura ambiente, os 80 corpos de prova foram submetidos ao teste de microdureza Vickers (microdurômetro HMV 2T). Cinco indentações foram realizadas em cada corpo de prova (centro, extremidades direita e esquerda, e superior e inferior). O ensaio foi realizado sob uma carga de 100 gramas, com tempo de penetração de dez segundos. Resultado: Independentemente da unidade fotopolimerizadora, o Riva Light Cure (RL-SDI) apresentou menor microdureza que o material Glass Carbomer (GC-GCP-Dental). A microdureza do Glass Carbomer (GC-GCP-Dental) foi influenciada pelo tipo de unidade fotopolimerizadora utilizada como fonte de calor. A análise de variância e o Teste de Tuckey (p< 0,05) mostraram que a interação dos fatores material vs.unidade fotopolimerizadora (p< 0,001) e os fatores principais material (p< 0,001) e unidade fotopolimerizadora (p=0,002) foram estatisticamente significantes. Conclusão: O material ionomérico Glass Cabomer (GCP- Dental) apresentou valor de microdureza significativamente superior quando comparado com o cimento de ionômero de vidro modificado por resina Riva Light Cure (SDI), independentemente da unidade fotopolimerizadora utilizada.

Objective: This study evaluated the microhardness of two encapsulated ionomer materials - Glass Carbomer (GC-GCP Dental) and Riva Light Cure (RL-SDI) in combination with four light curing units (Carbo LED lamp, GCP-Dental, Demi LED curing light, Kerr, Poli Wireless, Kavo, Radii Plus, SDI). Material and method: Eighty specimens were prepared following the manufacturer's guidelines, 40 for each ionomer material and for 10 specimens, one light curing unit was used. After 7 days of storage in distilled water and at room temperature, 80 specimens were tested with the Vickers hardness (microhardness HMV 2T, Shimadzu, Japan). Five indentations were performed on each specimen (center, right, left, top and bottom). The test was carried out under a load of 100 g, with a 10 second penetration time. Result: Independent of the curing unit the Riva Light Cure (RL-SDI) obtained the lower hardness than the material Glass Carbomer (GC-GCP-Dental). The microhardness of Glass Carbomer (GC-GCP-Dental) was influenced by the type of curing unit used as a heat treatment. The analysis of variance and Tukey test (p< 0.05) showed that the interaction of factors material vs. curing unit (p< 0.001), the main factor material (p< 0.001) and curing unit (p=0.002) were statistically significant. Conclusion: The ionomeric material Glass Carbomer (GCP-Dental) had significantly higher hardness value when compared with glass ionomer modified by resin Riva Light Cure (SDI), regardless of the light curing unit used.

Clinical, mineral and ultrastructural changes in carious dentin of primary molars after restoration.

INTRODUCTION: Partial caries removal has been shown to be an effective method to treat deep carious lesions in deciduous teeth. Nevertheless, the possibility of keeping infected dentin in the cavity still requires additional investigation. The objective of this research was to describe changes in primary infected dentin after restoration with glass ionomer cement. METHODS: Dentin from 45 primary molars with deep and active carious lesions was evaluated using clinical and laboratory criteria, before and 60 days after restoration. The clinical analysis evaluated dentin colour (CO), dentin consistency (COS) and laser fluorescence (LF). The laboratory procedures assessed bacterial contamination and mineral content (MC), and evaluated the dentin ultrastructure and collagen content. Data on CO, COS, LF and colony forming units were analysed using the Wilcoxon signed-rank test; MC, bacterial counts and collagen evaluations were evaluated using the Student's t-test. RESULTS: After 60 days, lower values of LF were observed, together with a lower bacterial count, and a higher COS was found, with an increase in calcium, phosphorus and collagen contents. Differences were not detected for CO or for fluorine content. Baseline samples showed enlarged tubules with bacterial invasion; 60-day samples showed better organised tissue, with a more compact intertubular dentin and narrower tubules. CONCLUSION: It is concluded that appropriate cavity sealing can promote beneficial changes in deep carious lesions of primary teeth, even in the presence of infected dentin.

The hardness and chemical changes in demineralized primary dentin treated by fluoride and glass ionomer cement / As mudanças químicas e de dureza na dentina decidua desmineralizada tratada com fluoreto e cimento de ionômero de vidro

Background: Fluoride plays an important role in the control of dental caries. Aim: To evaluate the chemical exchange between restoration of glass ionomer cement of high viscosity (GIC) and primary dentin with application of sodium fluoride (NaF) 2% through changes in hardness from uptake of calcium, phosphate and fluoride. Material and method: Class I cavities were prepared in 40 sound primary molars, and the sample was divided into two groups (n=20) according to dentin condition: sound (1) and demineralized (2). Sub-groups (n=10) were formed to investigate the isolated action of the GIC or the association with NaF (F). This in vitro study examined the chemical exchange under two conditions, sound and demineralized dentin (pH cycling), to simulate the occurrence of mineral loss for the caries lesion. G1 and G2 received GIC restoration only; groups G1F and G2F received NaF before GIC restoration. The specimens were prepared for Knoop hardness test and micro-Raman spectroscopy. A two-way ANOVA test (alfa = 0.05) was used for statistical analysis. Micro-Raman data were qualitatively described. Result: Increased hardness was observed in all the sites of direct contact with GIC in sound and demineralized dentin for all groups (p<0.001); no difference was observed in microhardness after application of NaF (p>0.05). In the evaluation of micro-Raman, direct contact between GIC and dentin for sound and demineralized dentin resulted in increased peaks of phosphate. Conclusion:The exchange between GIC and demineralized dentin may induce changes of mechanical properties of the substrate, and uptake of mineral ions (phosphate) occurs without the influence of NaF.

Introdução: O fluoreto desempenha importante papel no controle da cárie dental. Objetivo: Avaliar as trocas químicas entre cimentos de ionômero de vidro de alta viscosidade (CIV) e dentina decídua com aplicação de fluoreto de sódio (NaF) a 2% em alterações de dureza dentinária a partir da incorporação de cálcio, fosfato e fluoreto. Material e método: Cavidades Classe I foram preparadas em 40 molares hígidos divididos em 2 grupos (n=20), de acordo com a condição dentinária: hígida (1) e desmineralizada (2). Subgrupos (n=10) foram formados para avaliar a ação isolada do CIV ou associado com NaF (F). Este estudo in vitro avaliou as trocas químicas sob duas condições: dentina hígida e desmineralizada (ciclagem de pH) para simular a perda mineral que ocorre em lesões de cárie. Grupo G1 e G2 receberam restaurações de CIV; Grupos G1F e G2F receberam NaF antes do CIV. Os espécimes foram preparados para microdureza Knoop e Micro-Raman. Para análise estatística foi utilizada Anova 2 fatores (alfa = 0.05). Os dados do Micro-Raman foram descritos qualitativamente. Resultado: O aumento de dureza foi observado em todos os sítios de contato direto com CIV, em ambas dentinas em todos os grupos (p<0.001); não foi observado diferença em microdureza após aplicação do NaF (p>0.05). Na avaliação do Micro-Raman, o contato direto do CIV/dentina tanto hígida quanto desmineralizada resultou em um aumento do pico do fosfato dentinário. Conclusão: As trocas químicas entre o CIV e dentina desmineralizada podem induzir mudanças das propriedades mecânicas do substrato e a captação de íons minerais (fosfato) ocorre sem a influência do NaF.