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J. res. dent ; 11(2): 20-24, Oct 2023.
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1513035


Aims: This article present alternatives of bioactive materials use for direct pulp capping in immature teeth and for apexogenesis.Case report: Two case reports with the application of bioactive cementsare presented here: one in a tooth with pulp exposure and another with deep carious lesion, pulp exposure and open apex.Results: In both cases, the treatment was performed in one visit and a favorable clinical and radiographic follow-up was achieved.Conclusion: The use of bioactive materials ledto the formation of a dentin bridge and healing process in the pulp tissue exposure, without the need for conventional endodontic treatment

Photodiagnosis Photodyn Ther ; 44: 103813, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37748699


OBJECTIVE: To evaluate in vitro the effect of dental bleaching using high concentration hydrogen peroxide (HP) photoactivated with violet LED on fracture strength and hybrid layer formation. METHODS: forty endodontically-treated bovine teeth were randomized into four groups (n = 10): C - Control, HP - 35% hydrogen peroxide, HP-BL - 35% hydrogen peroxide photoactivated with blue LED, HP-VL - 35% hydrogen peroxide photoactivated with violet LED. Three bleaching sessions with an interval of 7 days between them were performed. After 10 days of the last bleaching session, the dental crowns were restored and submitted to the fracture strength test. Five specimens from each group were used to evaluate the hybrid layer formation by scanning electron microscope (SEM) images. One-way ANOVA and Kruskal-Wallis test were used for parametric and non-parametric data, respectively. Significance level of 5% was adopted to all the tests. RESULTS: No differences on fracture strength among the groups were observed (p > 0.05). HP and HP-BL showed alterations on hybrid layer formation compared to C group (p < 0.05), but not for HP-VL (p > 0.05). No differences on hybrid layer formation were observed among HP, HP-VL and HP-BL groups (p > 0.05). CONCLUSION: Dental bleaching, photoactivated or not, did not affect the fracture strength of endodontically-treated teeth. Regardless of the protocol used, hydrogen peroxide altered the hybrid layer formation at some level when the restoration was placed after 10 days of the last bleaching session.

Fotoquimioterapia , Clareadores Dentários , Clareamento Dental , Dente não Vital , Animais , Bovinos , Humanos , Peróxido de Hidrogênio , Clareamento Dental/métodos , Resistência à Flexão , Fármacos Fotossensibilizantes , Fotoquimioterapia/métodos , Ácido Hipocloroso
J Esthet Restor Dent ; 35(8): 1249-1256, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37218614


OBJECTIVE: To evaluate the effect of etch-and-rinse (ER) versus self-etch (SE) strategies of a universal adhesive applied with a manual brush (MB) or rotary brush (RB) on the bonding interface of fiber post cementation. METHODS: Forty bovine incisor roots were prepared and divided into four groups according to the methods of application and strategy of universal adhesive use (MB-ER, RB-ER, MB-SE and RB-SE). After 6 months, specimens from different thirds of the post space were evaluated of push-out strength, analysis of adhesive failure patterns, and extent of tags. RESULTS: The RB-ER and RB-SE groups showed the highest bond strength values in the cervical and middle thirds of the post space. Cohesive adhesive failure had the highest incidence in the different thirds of the post space in the ER strategy, regardless of the adhesive application method. The RB-ER group showed the highest tag extensions. CONCLUSIONS: The protocols of universal adhesive application with RB provided the greater bond strength, but only the ER strategy favored the formation of a greater extension of tags at the adhesive interface. CLINICAL SIGNIFICANCE: The application of universal adhesive with RB into the post space increases the strength of the post-cemented fiber bond.

Cimentação , Colagem Dentária , Animais , Bovinos , Cimentos Dentários , Adesivos Dentinários/química , Cimentos de Resina/química , Dentina , Teste de Materiais
Photodiagnosis Photodyn Ther ; 42: 103561, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37037401


BACKGROUND: To evaluate the efficacy of dental bleaching protocols using 35% hydrogen peroxide photoactivated with violet LED on color and microhardness of endodontically treated teeth. METHODS: Forty specimens were selected and randomized into 4 groups (n = 10): C - Control, HP - 35% hydrogen peroxide, HP + BL - 35% hydrogen peroxide + blue LED, HP + VL - 35% hydrogen peroxide + violet LED. Three bleaching sessions were performed for each group. Color analysis was performed 7 days after each bleaching session. Two-way repeated measure ANOVA and Bonferroni test were used to evaluate the effect of different bleaching protocols and evaluation times on the dependent variables (∆E and ∆L). Dentin microhardness was measured 24 h after the third bleaching session. Data were evaluated by ANOVA and Tukey's test at a significance level of 5%. RESULTS: Differences on ∆E and ∆L were verified after the first and second bleaching sessions (p < 0.05) and showed stability after the third one, for all the groups. No differences were observed among HP, HP + BL, and HP + VL groups, regardless of the evaluation time (p > 0.05). HP and C showed the greatest and smallest reduction in dentin microhardness (p < 0.05), respectively. No difference between HP + BL and HP + VL protocols (P > 0.05) was observed. CONCLUSIONS: High concentration hydrogen peroxide (35%) photoactivated with violet LED bleached endodontically treated teeth effectively. However, the same protocol negatively affected the dentin microhardness, but not in the same level of 35% HP solely used.

Fotoquimioterapia , Clareadores Dentários , Clareamento Dental , Dente não Vital , Humanos , Cor , Peróxido de Hidrogênio , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes , Clareamento Dental/métodos , Clareadores Dentários/farmacologia , Dente não Vital/tratamento farmacológico
Photodiagnosis Photodyn Ther ; 42: 103329, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36758735


BACKGROUND: Few studies have investigated the effect of violet LED irradiation associated or not with bleaching agents on blood-stained teeth. This in vitro study aimed to evaluate the whitening efficacy and color stability of non-vital dental bleaching using 35% hydrogen peroxide (HP) photoactivated with violet LED (VL) compared to 35% HP alone and 35% HP photoactivated with blue LED (BL). METHODS: Fifty bovine dental crowns were used to obtain specimens of 5 × 5 × 2 mm. After selection based on a previous colorimetric analysis, the specimens were blood-stained and randomly assigned into five groups (n = 10): control (no treatment); 35% HP, 35% HP/BL; 35% HP/VL; and VL. Three bleaching sessions were performed and the colorimetric analysis (∆Eab, ∆L, and ∆WID) was recorded after 7 days, 30 days, and 9 months of the last bleaching session. Two-way repeated measures ANOVA followed by Bonferroni post-hoc test was used at a significance level of 5%. RESULTS: 35% HP, 35% HP/BL, and 35% HP/VL showed higher values of ∆Eab, ∆L, e ∆WID (P < 0.05), without intra- and intergroup differences (P > 0.05). C and VL were similar in all the evaluation times (P > 0.05), showing lower values of ∆Eab, ∆L, and ∆WID (P < 0.05). CONCLUSIONS: 35% HP/VL can be a viable alternative for dental bleaching in endodontically-treated teeth, showing bleaching efficacy similar to 35% HP solely used, even after a 9-month follow-up. VL used alone was not effective to bleach blood-stained teeth.

Fotoquimioterapia , Clareadores Dentários , Clareamento Dental , Animais , Bovinos , Cor , Peróxido de Hidrogênio , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes
Am J Dent ; 31(2): 107-112, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29630796


PURPOSE: To evaluate sealed amalgam and resin-based composite restorations after 12 years to determine whether sealing minor defects (micro-repairs) enhanced the longevity of restorations. METHODS: 34 subjects aged 18-80 were recruited. This sample group underwent 137 restorations, including 51 resin-based composite (RC) and 86 amalgam (AM) restorations. Existing restorations with localized, marginal defects were assigned to one of two groups: (a) the Sealing group (n=48, 27 AM; 21 RC) or (b) the Control group (n=89, 59 AM; 30 RC). The quality of each restoration was scored according to the modified USPHS criteria by two examiners at the beginning of the study and after 1-5, 10, and 12 years. Kaplan Meier survival curves were created and a Cox regression was applied to investigate survival variables. Mantel Cox, Wilcoxon, and Friedman tests were performed for comparisons within groups. RESULTS: After 12 years, no statistically significant differences were observed for the variables "restorative material" (P= 0.538) or "sealing yes/no" (P= 0.136) with respect to the longevity of the restorations. All groups behaved similarly with regard to marginal adaptation, secondary caries, and tooth sensitivity (P≥ 0.05). Cumulatively, after a 12-year observation period, sealing minor restoration defects did not affect the longevity of the restorations. CLINICAL SIGNIFICANCE: Sealing minor marginal defects for resin composites or amalgam restorations did not affect their longevity. This intervention may be considered over-treatment for patients with low-to-medium risks for developing dental caries.

Amálgama Dentário , Cárie Dentária , Restauração Dentária Permanente , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Resinas Compostas , Adaptação Marginal Dentária , Falha de Restauração Dentária , Humanos , Pessoa de Meia-Idade , Adulto Jovem
J Endod ; 44(1): 173-178, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29246374


INTRODUCTION: The aim of this study was to evaluate the effects of photodynamic therapy (PDT) on the bond strength and dentinal penetrability of cementation protocols using conventional resin cement (Relyx ARC; 3M ESPE, St Paul, MN) or self-adhesive (Relyx U200, 3M ESPE) after the glass fiber post cementation. METHODS: Forty human canine roots were endodontically treated and prepared for a fiber post. The roots were divided into 4 groups according to the cementation protocol and PDT use: conventional cement (CC), Relyx ARC; self-adhesive cement (SAC), Relyx U200 cement; PDT/CC, PDT + Relyx ARC; and PDT/SAC, PDT + Relyx U200. After cementation of the fiber posts, the roots were cross sectioned, and then specimens from the cervical, middle, and apical thirds of the prosthetic space were obtained. The specimens were submitted to the pushout test and dentinal penetration evaluation of the cementation protocol using laser confocal microscopy. RESULTS: PDT/CC presented the lowest bond strength to root dentin in the cervical third (P < .05). In the middle and apical thirds, all groups presented a similar bond strength (P > .05). PDT/CC presented the lowest dentinal penetration of the adhesive system in the cervical and apical thirds (P < .05). CONCLUSIONS: PDT presented negative effects on the bond strength to dentin in the cervical third after cementation using Relyx ARC and on the dentinal penetrability of the etch-and-rinse adhesive system in the cervical and apical thirds of the prosthetic space.

Colagem Dentária , Cimentos Dentários , Dentina , Fotoquimioterapia , Humanos , Técnicas In Vitro
Rev. odontol. UNESP (Online) ; 46(3): 131-137, May-June 2017. tab, ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-902652


Introdução: A evolução dos sistemas adesivos permitiu que os fabricantes desenvolvessem materiais com técnicas cada vez mais simplificadas, porém que, ainda assim, promovessem adequados valores de resistência de união imediata. Sugere-se que alguns tratamentos da superfície dentinária podem favorecer esse processo de adesão. Objetivo: Avaliar os efeitos de diferentes tratamentos, em superfície dentinária plana condicionada, sobre a resistência de união à microtração de sistemas adesivos do tipo "condiciona-e-lava" de dois passos. Material e método: Noventa e seis terceiros molares humanos foram divididos em 12 grupos (n=8), aleatoriamente, de acordo com o sistema adesivo utilizado (GI: Adper Single Bond 2 - 3M ESPE; GII: Prime & Bond 2.1 - Dentsply; GIII: Excite - Ivoclar Vivadent) e o tipo de tratamento do substrato dentinário condicionado (a: água; b: clorexidina + água; c: etanol; d: clorexidina + etanol). Todos os dentes foram restaurados com resina Charisma na cor A2 (Heraeus - Kulzer, Germany) e submetidos a ensaio mecânico de microtração (EMIC DL-2000). O teste estatístico realizado foi ANOVA a um fator, completado com teste de Tukey. Resultado: Os grupos GIIc, GIIIc e GIId apresentaram aumento significativo estatisticamente na resistência de união à microtração imediata. Conclusão: Os diferentes tratamentos da dentina condicionada não afetaram de maneira negativa a resistência de união para todos os sistemas adesivos testados e a utilização da técnica com etanol, associado ou não à clorexidina, parece ser uma interessante abordagem quando associada a sistemas adesivos "condiciona-e-lava" de dois passos.

Introduction: The development of adhesive systems allow manufacturers to develop materials with increasingly simplified techniques, but that still would promote adequate resistance values of immediate union. It is suggested that some treatments of dentin surface can facilitate the process of accession. Objective: To evaluate the effects of different treatments in conditioned flat dentin surface on bond strength to microtensile 2-step etch-and-rinse adhesive systems. Material and method: Ninety-six human third molars were divided into twelve groups (n = 8) randomly according to the used adhesive system (GI: Single Bond 2 - 3M ESPE; GII: Prime & Bond 2.1 - Dentsply; GIII: Excite - Ivoclar Vivadent) and type of treatment of the conditioned dentin (a: water; b: water + chlorhexidine; c: ethanol; d: chlorhexidine + ethanol). All teeth were restored with Charisma color A2 (Heraeus - Kulzer, Germany) and subjected to mechanical testing microtensile (EMIC DL-2000). The statistical test performed was ANOVA 1 factor supplemented with Tukey test. Result: GIIc groups GIIIc and GIId showed statistically significant increase in bond strength to immediate microtensile. Conclusion: The different treatments of dentin did not affect negatively the bond strength for all tested adhesive systems and the use of the technique with ethanol, with or without chlorhexidine, appears to be an interesting approach when combined with 2-step etch-and-rinse adhesive systems.

Clorexidina , Adesivos Dentinários , Resistência ao Cisalhamento , Dentina , Etanol , Dente Molar , Análise de Variância
Rev. odontol. UNESP (Online) ; 44(5): 299-304, set.-out. 2015. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: lil-763342


Introdução: A halitose é uma condição em que o hálito se apresenta de forma desagradável, acometendo milhares de pessoas e causando impacto negativo para as mesmas. Objetivo: A presente pesquisa em campo buscou avaliar a percepção pessoal em relação à condição de halitose por meio de aplicação de questionário específico e confirmação clínica. Material e método: A amostra foi composta por 59 indivíduos entre 20 e 60 anos de idade, usuários de Unidades Básicas de Saúde de Araraquara, que foram selecionados de forma aleatória. A metodologia empregada constituiu-se de: i) Assinatura do Termo de Consentimento Livre e Esclarecido; ii) Aplicação de questionário especialmente elaborado para esta pesquisa; iii) Confirmação clínica, com a aplicação do teste com halímetro (Tanita Breath Alert CHC-212S). Após o experimento, todos receberam folhetos informativos com dados gerais sobre halitose. Os resultados obtidos foram agrupados em tabelas de contingência, construídas pelo Microsoft Excel, sendo então analisados pelo teste do Qui-quadrado. Resultado e conclusão: Após análises, conclui-se que as pessoas perderam a capacidade de perceber o próprio hálito quando tinham halitose; não tiveram condições de se autoavaliarem de forma eficaz; os fatores de riscos que influenciaram na halitose foram: idade superior aos 40 anos, uso de alguns tipos de medicamentos, algumas patologias, frequência de visita ao Dentista e falhas em procedimentos de higiene bucal, tais como escovação dentária, uso do fio dental, limpeza da língua e limpeza de próteses. Os outros fatores pesquisados não se mostraram estatisticamente suficientes para estabelecerem relação de influência na halitose.

Introduction: Halitosis is a condition characterized by unpleasant breath,affecting thousands of people and causing a negative impact on them. Objective: The aim of this study was to evaluate self-perception of halitosis condition by applying a specific questionnaire and having clinical evaluation. Material and method: The sample was composed by 59 randomly selected voluntaries between the ages of 20 and 60 years old who were users of Basic Health Units of Araraquara. The methodologies applied were: 1. Signature of informed consent; 2. Application of standardized questionnaire specially designed for this research; 3. Clinical confirmation through halimeter (Tanita Breath Alert CHC-212S). After the experimental phase, all the volunteers received a document with general information about halitosis (causes and treatment). The results were grouped in Microsoft Excel tables and analyzed by Chi-square test. Result and conclusion: After the analyses, it was concluded that people had lost the ability to perceive their own breath when they had halitosis and they are unable to evaluate themselves effectively; the risky factors that influenced the halitosis were: people over the age of 40, the use some types of drugs, some diseases, frequency of visit to the dentist and poor oral hygiene including bad-technique procedures such as teeth brushing, flossing, tongue cleaning and dentures cleaning. Other factors studied were not statistically sufficient to influence halitosis.

Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Higiene Bucal , Centros de Saúde , Distribuição de Qui-Quadrado , Inquéritos e Questionários , Halitose , Língua , Escovação Dentária , Prótese Dentária , Dispositivos para o Cuidado Bucal Domiciliar
J Contemp Dent Pract ; 16(3): 167-71, 2015 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-26057912


The aim of this study was evaluate the dental enamel after whitening treatment with Opalescence Boost PF™ 38%, correlating the structural alterations in the surface of the enamel with its respective pH and verify if whitened teeth submitted to different finishing and polishing techniques show similar surface texture to healthy teeth (control group). Sixty premolars were divided in 6 groups (n = 10), which had been immersed in artificial saliva during all the experiment. Protocol whitening was performed according to the manufacturer recommendations, and then the specimens were submitted to different polishing technique with Sof-Lex Pop On™ disks, Flex Diamond™ felt disks using two different micrometric polishing pastes (Enamelize™ and Diamond Polish™) and two nanometric polishing pastes (Lummina-E Diamond and Lummina-E Alumina), according to the groups. Representative specimens were analyzed in scanning electronic microscopy (SEM). Whitening gel used in this experiment had modified the morphologic aspect of the enamel surface. It was found that two nanometric polishing pastes (G5 and G6) promoted a less rough surface compared to control group even after the whitening process.

Esmalte Dentário/ultraestrutura , Profilaxia Dentária/métodos , Peróxido de Hidrogênio/uso terapêutico , Clareadores Dentários/uso terapêutico , Óxido de Alumínio/química , Diamante/química , Humanos , Concentração de Íons de Hidrogênio , Teste de Materiais , Microscopia Eletrônica de Varredura , Nanopartículas/química , Distribuição Aleatória , Saliva Artificial/química , Clareamento Dental/métodos
Rev. odontol. UNESP (Online) ; 44(3): 169-174, May-Jun/2015. tab
Artigo em Português | LILACS, BBO - Odontologia | ID: lil-749892


Objetivo: Avaliar o efeito da dentina sobre o pH e a atividade antimicrobiana de formulações com hidróxido de cálcio. Material e método: O pH e a atividade antimicrobiana das formulações (G1- polietilenoglicol, G2- glicerina e paramonoclorofenol canforado ou G3- clorexidina) foram analisados nas formulações puras (G1A, G2A e G3A) ou acrescidas de dentina em pó (G1B, G2B e G3B). Tubos de polietileno foram preenchidos com uma das formulações e imersos em água destilada. O pH foi analisado após 24 horas, 7, 14 e 21 dias. A atividade antimicrobiana foi avaliada sobre Enterococcus faecalis (ATCC 29212), através do teste de difusão em ágar. Os resultados foram submetidos aos testes de ANOVA e Tukey (p=0,05). Resultado: A dentina não exerceu efeito sobre o pH das formulações, exceto ocasionando a redução em G1, no período de 24 horas (p<0,05). Nas demais formulações, não houve interferência da dentina sobre o pH (p>0,05). Quando comparados entre os grupos, em 24 horas e 7 dias, G1A e G1B apresentaram menor pH (p<0,05). Em 14 dias, G2A, G2B, G3A e G3B demonstraram similar pH (p>0,05), assim como entre G3B e G1A (p>0,05). Em 21 dias, todas as formulações demonstram semelhante pH (p>0,05). Os resultados em ordem decrescente da atividade antimicrobiana foram G2A=G2B>G3A=G3B>G1A=G1B (p<0,05). Conclusão: A dentina não interferiu no pH e na atividade antimicrobiana das diferentes formulações com hidróxido de cálcio, exceto na associação com o polietilenoglicol, em que ocasionou a redução do pH apenas no período de 24 horas. A formulação com paramonoclorofenol canforado apresentou maior atividade antimicrobiana, seguida da clorexidina e do polietilenoglicol. .

Objective: To evaluate the dentin effect on pH and antimicrobial activity of the calcium hydroxide chemical formulations. Material and method: pH and antimicrobial activity of calcium hydroxide formulations were evaluated (G1-polyethyleneglycol, G2-glycerin and camphorated paramonochlorophenol and G3-chlorhexidine). The formulations were evaluated alone (G1A, G2A e G3A) or with dentin powder (G1B, G2B and G3B). Polyethylene tubes were filled with the formulation and immersed in distilled water. After 24 hours, 7, 14 and 21 days, pH was evaluated. The antimicrobial activity was evaluated against Enterococcus faecalis by agar diffusion test. All data were submitted to ANOVA and Tukey tests (p=0.05). Result: None effect was observed on pH and antimicrobial activity by dentin on different chemical formulations, except the reduction occurred in G1 at 24 hours (p <0.05). When compared between the groups at 24 hours and 7 days, G1A and G1B had a lower pH (p <0.05). At 14 days, G2A, G2B, G3A and G3B showed similar pH (p<0.05) and between G3B and G1A (p>0.05). At 21 days, all formulations were similar (p>0.05). Regarding antimicrobial activity G2B G2A => = G3A G3B> = G1A G1B (p<0.05). Conclusion: The dentin did not affect the pH and antimicrobial activity of different formulations containing calcium hydroxide, except in association with polyethylene glycol, which caused the reduction of pH, within 24 hours. The formulation with paramonochlorophenol camphor showed higher antimicrobial activity, followed by chlorhexidine and polyethylene glycol. .

Hidróxido de Cálcio , Análise de Variância , Enterococcus faecalis , Dentina , Concentração de Íons de Hidrogênio , Clorexidina , Endodontia
J Contemp Dent Pract ; 16(12): 977-83, 2015 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-27018033


The objective of this study was to describe the main lesions that simulate clinically and propose a treatment protocol for acute endodontic infection. Signs and clinical symptoms of periodontal abscess, gingival abscess, odontoma, herpes simplex, pericoronitis, acute pulpitis and necrotizing ulcerative gingivitis/periodontitis (NUG/NUP) were described and compared with acute endodontic infections. A treatment protocol was described by optimizing the procedures in access cavity, microbial decontamination and detoxification of the root canal, apical debridement, intracanal and systemic medication and surgical drainage procedures. The convenience of the use of 5.25% sodium hypochlorite, root canal instrumentation using a crown-down technique, intracanal medication with 2% chlorhexidine or triple antibiotic paste and the convenience of the use of antibiotics, analgesics, and surgical drainage to solve cases of acute dentoalveolar abscess was discussed.

Cavidade Pulpar , Abscesso Periapical/diagnóstico , Periodontite Periapical/diagnóstico , Diagnóstico Diferencial , Humanos , Abscesso Periapical/terapia , Periodontite Periapical/tratamento farmacológico , Irrigantes do Canal Radicular/uso terapêutico , Preparo de Canal Radicular , Tratamento do Canal Radicular
ImplantNews ; 12(4): 462-468, 2015. ilus, tab
Artigo em Português | LILACS, BBO - Odontologia | ID: lil-764276


O tratamento reabilitador com utilização de implantes em áreas estéticas, muitas vezes, necessita de procedimentos de enxertia óssea prévia para o restabelecimento das estruturas anatômicas reabsorvidas. O aumento ósseo horizontal do rebordo alveolar tem sido indicado para correção de rebordos com espessura insuficiente para instalação de implantes. Neste tipo de cirurgia, o uso de telas de titânio como mantenedoras tridimensionais de espaços para formação óssea tem se mostrado uma modalidade segura e previsível. Neste trabalho, foi reportada a reabilitação protética de um caso clínico em que o restabelecimento ósseo anatômico na região de pré-maxila edêntula foi realizado utilizando-se osso autógeno particulado e tela de titânio. Após seis meses da cirurgia inicial foram instalados dois implantes e, após o período cicatricial de seis meses, foram carregados com prótese provisória, sendo acompanhados por um ano através de parâmetros clínicos e radiográficos. A partir de então, foi confeccionada a prótese definitiva. De maneira geral, este caso clínico demonstra o sucesso obtido na reconstrução do rebordo alveolar residual parcialmente edêntulo, por meio de enxerto ósseo autógeno associado à malha de titânio, permitindo a osseointegração de implantes e o suporte de cargas mastigatórias.

Implant-supported dental rehabilitation in aesthetic areas often requires bone-grafting procedures in order to reconstruct the previously resorbed anatomic structures. Horizontal augmentation has been indicated in the presence of insufficient bone thickness prior to the installation of implants. The use of titanium meshes as a tridimensional space-maintaining structure for bone growth has been reported as a safe and predictable procedure. In this paper we report the prosthetic rehabilitation of a clinical case in which the bone anatomy of an edentulous anterior maxilla was re-established through the use of particulate autologous bone graft and titanium mesh. Six months after the grafting surgery two dental implants were installed. After the six-month osseointegration period the implants were loaded with provisional prostheses and followed-up through clinical and radiographic parameters for one more year, period after which definitive prosthesis were installed. This report demonstrates that dental implants are able to successfully osseointegrate and withstand mid-term masticatory forces when installed in a partially edentulous residual alveolar ridge, which was previously reconstructed using a titanium mesh and particulate autologous bone graft.

Humanos , Feminino , Adulto , Regeneração Óssea , Transplante Ósseo , Implantes Dentários
Full dent. sci ; 6(21): 112-117, dez. 2014. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: lil-750190


O restabelecimento da harmonia do sorriso atrav‚s das cerƒmicas odontol¢gicas, quando realizado com crit‚rio e dentro de indica‡ães espec¡ficas, traz resultados extremamente previs¡veis. Para a reabilita‡Æo funcional e est‚tica, muitos materiais cerƒmicos podem ser empregados, como zirc“nia, leucita, alumina, feldspato e dissilicato de l¡tio. Dentre esses materiais, destaca-se o dissilicato de l¡tio que tem como caracter¡sticas: resistˆncia ao desgaste, ao ataque qu¡mico, … oxida‡Æo e a altas temperaturas; baixa condutividade el‚trica; dilata‡Æo t‚rmica pr¢xima do zero; boas propriedades ¢pticas e biocompatibilidade com o periodonto; excelente est‚tica; estabilidade de cor e refor‡o da estrutura dental. As indica‡ães para o uso do dissilicato de l¡tio sÆo m£ltiplas e nÆo limitadas para facetas em casos de dentes onde nÆo houve resposta favor vel ao clareamento dental, dentes com restaura‡ães m£ltiplas, fechamento de diastemas, altera‡Æo de forma e contorno dental, restitui‡Æo de dentes ausentes ou fraturados, entre outras. A versatilidade da cerƒmica de dissilicato de l¡tio faz com que possa ser utilizado em diferentes situa‡ães cl¡nicas. Seu uso concomitante tanto para facetas como sobre n£cleos met licos fundidos ‚ apresentado aqui com um resultado est‚tico bastante satisfat¢rio, sendo indicado para situa‡ães onde h  necessidade de aliarmos est‚tica e resistˆncia como atributos indispens veis.

The reestablishment of a harmonious smile through dental ceramics, when properly conducted and with specific indications, can achieve extremely predictable results. For aesthetic and functional rehabilitation, many ceramic materials can be used such as zirconia, leucite, alumina, feldspar, and lithium disilicate. Among these materials the lithium disilicate stands out due to the following characteristics: its resistance to wear, to chemical attack, high tem peratures and oxidation; low electrical conductivity; near zero thermal expansion; good optical properties and biocompatibility with periodontal; excellent esthetics; color stability and reinforcement of tooth structure. The indications for the use of lithium disilicate are not limited to multiple facets of teeth in cases where there was no favorable response to tooth whitening, and also comprehend teeth with multiple restorations, diastema closure, shape alteration, and dental contouring, replacement of missing or fractured teeth, among others. The versatility of lithium disilicate ceramics allows its utilization in several clinical situations. The concomitant use of lithium disilicate for veneers and over metal has satisfactory aesthetic results, as reported in the present studying cases that require both aesthetics and resistance.

Humanos , Feminino , Pessoa de Meia-Idade , Cerâmica/uso terapêutico , Facetas Dentárias , Lítio/química , Reabilitação Bucal , Sorriso , Protocolos Clínicos , Estética Dentária , Fotografia Dentária/instrumentação , Radiografia Dentária/instrumentação
J Contemp Dent Pract ; 15(3): 283-7, 2014 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-25307807


UNLABELLED: Ideally projected to be applied on soft tissues, infrared lasers were improved by restorative dentistry to be used in hard dental tissues cavity preparations--namely enamel and dentin. This paper evidentiates the relevant aspects of infrared Erbium laser's action mechanism and its effects, and characterizes the different effects deriving from the laser's beams emission. The criteria for use and selection of optimal parameters for the correct application of laser systems and influence of supporting factors on the process, such as water amount and its presence in the ablation process, protection exerted by the plasma shielding and structural factors, which are indispensable in dental tissues cavity preparation related to restorative technique, are subordinated to optical modifications caused by the interaction of the energy dissipated by these laser light emission systems in the targeted tissue substrate. CLINICAL RELEVANCE: Differences in the action of infrared Erbium laser system in regard to the nature of the ablation process and variations on the morphological aspects observed in the superficial structure of the target tissue irradiated, may be correlated to the structural optical modifications of the substrate produced by an interaction of the energy propagated by laser systems.

Esmalte Dentário/ultraestrutura , Dentina/ultraestrutura , Terapia a Laser/métodos , Lasers de Estado Sólido/uso terapêutico , Absorção Fisico-Química , Cristalografia , Preparo da Cavidade Dentária/métodos , Esmalte Dentário/química , Esmalte Dentário/cirurgia , Dentina/química , Dentina/cirurgia , Radiação Eletromagnética , Humanos , Microscopia Eletrônica de Varredura , Gases em Plasma/química , Radiometria , Temperatura , Termodinâmica , Volatilização , Água/química
J Contemp Dent Pract ; 15(3): 331-5, 2014 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-25307816


This study sought to assess the use of chlorhexidine with several excipients as a dentin surface treatment and its effect on marginal adaptation of class V restorations with current-generation dentin bonding agents. A total of 120 human third molars were selected and allocated into 12 groups, with standardized buccal class V restorations randomly divided into preconditioned dentin rinsed with: water; water + chlorhexidine; ethanol; or ethanol + chlorhexidine. After rinsing of dentin (previously conditioned with 35% phosphoric acid) with the test solutions, the Adper single bond 2, prime and bond 2.1, and Excite bonding systems were applied randomly. Restorations were performed with Filtek™ Z350 XT composite resin. The resulting specimens were subjected to thermal and mechanical load cycling. Quantitative analysis of marginal adaptation was performed on epoxy replicas by means of scanning electron microscopy. Results were assessed by means of the Kruskal-Wallis test (percentages of continuous margins) and Wilcoxon test (differences between percentages of continuous margins before and after thermal cycling and mechanical loading), at a significance level of p < 0.05. Outcomes in the chlorhexidine-treated groups were not superior to those obtained with other treatments.

Colagem Dentária/métodos , Adaptação Marginal Dentária , Restauração Dentária Permanente/classificação , Adesivos Dentinários/química , Dentina/ultraestrutura , Acetona/química , Condicionamento Ácido do Dente/métodos , Clorexidina/farmacologia , Resinas Compostas/química , Cimentos Dentários/química , Esmalte Dentário/ultraestrutura , Polimento Dentário/métodos , Dentina/efeitos dos fármacos , Etanol/farmacologia , Humanos , Metacrilatos/química , Microscopia Eletrônica de Varredura , Ácidos Fosfóricos/química , Ácidos Polimetacrílicos/química , Técnicas de Réplica , Camada de Esfregaço , Solventes/farmacologia , Estresse Mecânico , Propriedades de Superfície , Temperatura , Água
Case Rep Dent ; 2014: 702630, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24955259


When dental implants are malpositioned in relation to the adjacent teeth and alveolar bone or in an excessive buccal or lingual position, the final prosthesis rehabilitation impairs the peri-implant health of the gingival tissues and the aesthetics of the patient. Thus, the purpose of this case was to report and discuss a multidisciplinary protocol for the treatment of a compromised maxillary tooth in a patient with an abscess in his right central incisor due to an excessive buccal implant position. The patient presented with an implant-supported provisional restoration on his right maxillary central incisor and a traumatic injury in his left central incisor. The treatment protocol consisted in (i) abutment substitution to compensate the incorrect angulation of the implant, (ii) clinical crown lengthening, (iii) atraumatic extraction of the left central incisor, and (iv) immediate implant placement. Finally, (v) a custom abutment was fabricated to obtain a harmonious gingival contour around the prosthetic crown. In conclusion, when implants are incorrectly positioned in relation to the adjacent teeth, associated with soft-tissue defects, the challenge to create a harmonious mucogingival contours may be achieved with an interdisciplinary approach and with the placement of an appropriate custom abutment.

Clín. int. j. braz. dent ; 10(2): 146-154, abr. -jun. 2014. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: lil-724746


O avanço no desenvolvimento de novos materiais odontológicos ampliou as modalidades terapêuticas, garantindo excelência nos tratamentos restauradores estéticos. Sendo assim, os procedimentos restauradores diretos têm sido utilizados em casos de reanatomização dentária, possibilitando tratamento eficaz, de baixo custo, além de preservar estrutura dentária sadia. No entanto, domínio clínico do material e das técnicas a ser realizadas é necessário pra garantir longevidade e sucesso no procedimento restaurador direto. O objetivo do artigo é descrever, após a finalização dos procedimentos cirúrgicos periodontais, a etapa restauradora direta realizada para reanatomização dentária e fechamento das diastemas presentes. A integração entre a Odontologia Restauradora e a Periodontia possibilitou o restabelecimento da harmonia do sorriso de forma conservadora, garantindo estética e satisfação da paciente

The development of new dental materials has expanded dental therapeutic modalities ensuring excellence in aesthetic restorative treatments. Thus, the direct restorative procedures have been used in cases of dental reconstruction allowing an effective treatment with a low cost, while preserving healthy tooth structure. However, the clinician must be used to the techniques and the material in order to ensure longevity and success in the direct restorative procedure. The aim of this paper is to describe, after completion of periodontal surgical procedures, the direct restorative step performed for dental reconstruction and diastema closure. The integration between Restorative Dentistry and Periodontics enabled the restoration of a harmonious smile in a conservative manner, ensuring aesthetics and patient satisfaction

Humanos , Feminino , Adulto , Aumento da Coroa Clínica , Estética Dentária , Periodontia , Sorriso
Ortodontia ; 47(3): 250-256, maio.-jun.2014. ilus, tab
Artigo em Português | LILACS | ID: lil-760046


O tratamento “precoce” das más-oclusões tem despertado interesse crescente da comunidade ortodôntica. Dentre estes, destaca-se a extração seriada que visa conciliar as diferenças entre a quantidade conhecida do material dentário e a deficiência permanente do osso de suporte. A técnica é aplicada na dentadura mista, por meio de uma sequência pré-determinada de exodontias entre dentes decíduos e permanentes, na busca do alinhamento imediato, de preferência espontâneo, dos dentes permanentes remanescentes com uma terapia ortodôntica mecânica mínima. Será relatado um caso clínico no qual foi realizada a extração seriada em um paciente com má-oclusão de Classe I, em crescimento, com apinhamento severo e biprotruso. Todos os objetivos estéticos e funcionais foram alcançados...

The early malocclusion treatment has increased interest of orthodontic community. Among these is the serial extraction that harmonizes the differences between the amount of dental material and permanent deficiency of supporting bone. The technique is applied in mixed dentition through a predetermined sequence of extractions between deciduous and permanent teeth, in order to reach spontaneous immediately alignment of remaining permanent teeth with a minimum orthodontic mechanics. It will be reported a case where the serial extraction was performed in a growing patient with biprotrusion, Class I malocclusion and severe crowding. All functional and aesthetics goals were reached...

Humanos , Masculino , Criança , Dentição Mista , Extração Seriada/efeitos adversos , Extração Seriada , Má Oclusão Classe I de Angle/terapia