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1.
J Dent ; 103: 103499, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-33068711

RESUMO

OBJECTIVE: To answer the following research question: "Dolow/medium hydrogen peroxide (HP) concentrations used for in-office bleaching in patients with permanent dentition have similar color change and bleaching sensitivity (BS) to high HP concentrations?" DATA: Randomized controlled trials that compared low/medium vs. high concentrate HP were included. The risk of bias (RoB) was evaluated using the Cochrane Collaboration tool. Meta-analyses were conducted for color change (ΔE*ab, ΔSGU/SGU), risk, and intensity of BS, using the random-effects model. Heterogeneity was assessed with the Cochrane Q test, I2 statistics, and prediction interval. The GRADE assessed the certainty of the evidence. SOURCES: Search was performed in PubMed, Cochrane Library, BBO, LILACS, Scopus, Web of Science and grey literature on 15th September 2018 (updated on 13th May 2020). STUDY SELECTION: 25 studies remained. Five were at low RoB; thirteen were at unclear RoB, and seven were at high RoB. The risk of having BS was, on average, 33 % lower (RR = 0.67; 95 % CI 0.51 to 0.86) for low/medium concentrate HP than high HP. No significant difference in color change was detected among groups, except from the subgroup low vs. high HP for the immediate color change, but this difference is not clinically relevant. The certainty of evidence for color change was low and very low, and moderate for the BS. CONCLUSIONS: Low and medium hydrogen peroxide concentrate products for in-office bleaching have lower risk and intensity of bleaching sensitivity than the high concentrate hydrogen peroxide group, with no difference in color change efficacy. CLINICAL SIGNIFICANCE: The use of low concentrate hydrogen peroxide products may produce the same color change efficacy with the bonus of having lower risk and intensity of bleaching sensitivity. However, the ideal concentration at which this occurs is yet unknown and deserves further investigations. No funding. PROSPERO CRD42018108266.

2.
Dent Mater ; 2020 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-32933775

RESUMO

OBJECTIVE: To evaluate the five-year clinical performance of Scotchbond Universal Adhesive (SU; 3M Oral Care, St. Paul, MN, USA) in non-carious cervical lesions (NCCLs) using two evaluation criteria. METHODS: Thirty-nine patients participated in this study. Two hundred restorations were assigned to four groups: SU-ERm: etch-and-rinse + moist dentin; SU-ERd: etch-and-rinse + dry dentin; SU-Set: selective enamel etching; and SU-SE: self-etch. A nanofilled composite resin was placed incrementally. The restorations were evaluated at baseline and after 5 years using both the World Dental Federation (FDI) and the United States Public Health Service (USPHS) criteria. The survival rates (retention/fractures) were calculated with the Kaplan-Meier and the log-rank test. For the secondary outcomes, Friedman repeated measures analysis of variance by rank was applied (α = 0.05). RESULTS: After 5 years the recall rate was 86%. The retention/fracture rates were 93% for Erm and ERd, 88.4% for SEet and 81.4% for SE. A significant difference was observed for SE vs. ERd and SE vs. ERm (p = 0.01). Also, marginal discoloration and adaptation showed significant differences with ERm and ERd resulting in fewer marginal discrepancies than SE (p < 0.05). SIGNIFICANCE: After 5 years, the clinical behavior of the universal adhesive in the etch-and-rinse strategy was better when compared to the self-etch strategy. The use of selective enamel etching is highly recommended for the self-etch strategy. The FDI and USPHS evaluation criteria showed similar results after 5 years.

3.
Quintessence Int ; 51(10): 788-797, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32901243

RESUMO

OBJECTIVES: This split-mouth study assessed the bleaching sensitivity (risk and intensity) and color change after in-office bleaching using a desensitizing-containing (5% potassium nitrate) and a desensitizing-free 35% hydrogen peroxide gel. The null hypothesis was that there would be no differences between study groups regarding bleaching sensitivity. METHOD AND MATERIALS: Sixty patients participated in this split-mouth study. The subjects received desensitizing-containing hydrogen peroxide in half of the maxillary arch, and the other half received a desensitizing-free hydrogen peroxide, defined by random sequence, in two dental bleaching sessions. The bleaching sensitivity was evaluated during bleaching and from 1 h to 48 h after each bleaching session using a visual analog scale and numeric rating scale; the McNemar test, the Wilcoxon signed-rank test, and the Student-Newman-Keuls test were used for statistical analysis. The color was measured at baseline and 30 days post-bleaching, evaluated with paired t tests (P = .05). RESULTS: Statistically similar risks of bleaching sensitivity were observed (P = 1.000), but the intensity of bleaching sensitivity was lower (P < .011) on average by 1.32 visual analog scale units in the group bleached with the desensitizer-containing gel during up to 24 h assessment times. No statistical difference in color change was observed between groups (P > .321). CONCLUSION: The incorporation of 5% potassium nitrate into in-office bleaching gels does not reduce the risk of bleaching sensitivity, but it reduces its intensity slightly without jeopardizing color change.


Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Sensibilidade da Dentina/induzido quimicamente , Método Duplo-Cego , Géis , Humanos , Peróxido de Hidrogênio , Clareadores Dentários/efeitos adversos , Resultado do Tratamento
4.
J Esthet Restor Dent ; 2020 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-32949453

RESUMO

OBJECTIVE: This study evaluated the hydrogen peroxide (HP) penetration inside the pulp cavity and the color change of teeth submitted to the 15% carbamide peroxide (CP) nanoparticle bleaching gel at several application times. MATERIALS AND METHODS: Premolars were divided into nine groups (n = 6) according to 15% CP bleaching agents (nanoparticle and commercial) and to application times (15, 30, 45, and 60 minutes). A negative control was exposed to ultra-purified water. After a whitening procedure, the HP concentration (µg/mL) inside the pulp cavity was assessed via spectrophotometry. The color change (ΔE* and ΔE00*) was evaluated with a spectrophotometer. Data were analyzed via two-way ANOVA and Tukey (α = 0.05). RESULTS: A lower concentration of HP was detected for CP nanoparticle gel after 30 and 45 minutes of whitening procedure (P = .001). The bleaching groups promoted a higher color change (ΔE* and ΔE00*) regardless of the application time (P = .0001). CONCLUSIONS: The CP nanoparticle gel reduced HP inside the pulp cavity, and showed effective bleaching compared with CP commercial gel. CLINICAL SIGNIFICANCE: Using 15% carbamide peroxide nanoparticle bleaching gel decreased the HP penetration inside the pulp cavity and may decrease bleaching-induced tooth sensitivity in at-home bleaching.

5.
J Appl Oral Sci ; 28: e20200332, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32813842

RESUMO

Objectives This randomized, split-mouth, single-blinded trial assessed whether the use of reservoirs in at-home bleaching trays is equivalent to non-reservoir trays. Our choice of an equivalence trial was based on the expectation that a non-reservoir tray is sufficient to produce a color change. Secondary outcomes such as tooth sensitivity (TS) and gingival irritation (GI) were also assessed. Methodology Forty-six patients were selected with canines shade A2 or darker. In half of the patient's arch, bleaching trays were made with reservoirs and the other half, without reservoirs. At-home bleaching was performed with carbamide peroxide (CP) 10% (3 h daily; 21 days). Color change was evaluated with a digital spectrophotometer (ΔE, ΔE00, and Whiteness Index) and shade guide units (ΔSGU) at baseline, during and one-month post-bleaching. TS and GI were assessed with a numeric scale (NRS) and a visual analog scale (VAS). Results After one month, the equivalence of reservoir and non-reservoir groups were observed in all color instruments (p>0.05). Fifteen and sixteen patients presented pain (absolute risk: 33% and 35%, 95%, confidence interval (CI) 21-46% and 23-49%) in the reservoir and non-reservoir side, respectively. The odds ratio for pain was 0.8 (95%CI 0.2-3.0) and the p-value was non-significant (p=1.0). TS intensity was similar between both groups in any of the pain scales (p>0.05). No difference in the GI was observed (p>0.05). Conclusions The protocol with reservoirs is equivalent in color change to the non-reservoir, although no superiority of the latter was observed in terms of reduced TS and GI with at-home 10% carbamide peroxide bleaching. Clinical Relevance The presence of reservoirs in a bleaching tray did not improve color change or affect tooth sensitivity and gingival irritation.


Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Peróxido de Carbamida , Humanos , Peróxido de Hidrogênio , Peróxidos , Método Simples-Cego , Resultado do Tratamento , Ureia
6.
Am J Dent ; 33(4): 206-212, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32794396

RESUMO

PURPOSE: This double-blind, randomized clinical trial evaluated the influence of dentin moisture on postoperative sensitivity (POS) in posterior restorations using a simplified etch-and-rinse adhesive, until 12 months of clinical service. METHODS: 90 restorations were inserted in 45 patients to treat carious lesions or to replace existing posterior restorations with a depth ≥ 3 mm. After cavity preparation, the simplified etch-and-rinse adhesive (Adper Single Bond 2) was applied on dry or wet dentin followed by a bulk-fill resin composite (Filtek Bulk Fill) under rubber dam isolation. The patient's spontaneous and stimulated POS was evaluated at baseline and after 7 days, 6 months, and 12 months of clinical evaluation. The secondary parameters (marginal discoloration, marginal adaptation, fracture and recurrence of caries) were evaluated by World Dental Federation (FDI) criteria after 7 days, 6 and 12 months of clinical evaluation. RESULTS: No significant spontaneous and stimulated POS was observed when dry and wet dentin were compared (P> 0.05). A significant and higher risk of spontaneous POS (18.6%; 95% CI 9.7 to 32.6) occurred up to 48 hours after restoration placement for both groups when compared to all evaluation times (P< 0.03). However, the intensity of POS was mild at up to 48 hours with a difference between the dry and wet dentin groups (P> 0.79). When secondary parameters were evaluated, no significant difference between the groups were observed (P> 0.05). CLINICAL SIGNIFICANCE: The moisture level of the dentin substrate in posterior restorations does not influence POS in bulk-fill resin composite posterior restorations when associated with an etch-and-rinse ethanol-based adhesive system.


Assuntos
Cárie Dentária , Sensibilidade da Dentina , Resinas Compostas , Adaptação Marginal Dentária , Restauração Dentária Permanente , Dentina , Adesivos Dentinários , Método Duplo-Cego , Humanos , Cimentos de Resina
7.
Braz Dent J ; 31(3): 236-243, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32667516

RESUMO

This study aimed to quantify the penetration of hydrogen peroxide, color change evaluation, surface morphology, and composition after application of desensitizing agents before in-office bleaching. Fifty premolars were sectioned, an acetate buffer was placed in the pulp chamber and divided into five groups (n=10). In the positive control group, only the in-office bleaching gel was used, and in the negative control group, no treatment was used. Three different desensitizing agents were applied: Desensibilize KF2%® group; Mi Paste® group, and Desensibilize Nano-P® group. The bleaching procedure was carried out with 35% HP. The absorbance of the resulting solution was determined in a spectrophotometer. Color change was assessed by using a digital spectrophotometer. Four additional premolars were assigned to the same groups above for analysis under scanning electron microscope, as well as to evaluate the elemental composition with X-ray dispersive energy spectrometry. Data were subjected to ANOVA and Tukey's test (α=0.05). All products reduced the penetration of HP in the pulp chamber. Mi Paste and Nano P were the products that yielded the lowest HP penetration, which was similar to the negative control group (p<0.001). No significant difference was detected in color change (p<0.001). Concerning enamel morphology, the groups that were analyzed after bleaching were observed a greater deposition of desensitizing agents on the surface. The use of desensitizing agents before tooth bleaching seems to be an alternative to reduce adverse effects of the tooth.


Assuntos
Clareadores Dentários , Clareamento Dental , Esmalte Dentário , Cavidade Pulpar , Peróxido de Hidrogênio
8.
J Adhes Dent ; 22(4): 353-363, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32666061

RESUMO

PURPOSE: To evaluate the influence of type and viscosity of composite resins used for root reinforcement in the adhesion of glass-fiber posts to flared root canals. MATERIALS AND METHODS: The crowns of 78 uniradicular permanent teeth were removed and the teeth were endodontically treated. After one week, the roots were prepared for root reinforcement and randomly divided into 6 groups (n = 13): positive control group ([PCG] the root canals were not enlarged), negative control group ([NCG] root canals were enlarged, no reinforcement), and in the remaining 4 groups, root canals were enlarged to receive root reinforcement according to a combination of the factors composite resin type (bulk-fill or conventional) and viscosity (flowable or regular). After fiber post cementation, six slices were obtained from each root (2 each from the cervical, middle, and apical thirds). For each group, 7 teeth underwent push-out bond strength testing, and 6 teeth were evaluated for nanoleakage and Vickers microhardness. Bond strength and nanoleakage data were submitted to two-way ANOVA and Tukey's test (α = 0.05), and microhardness data to one-way ANOVA and Tukey's test (α = 0.05). RESULTS: The root reinforcement groups with regular and flowable bulk-fill composite resins showed statistically superior adhesion results (higher bond strength and less nanoleakage) compared to the negative control in all root regions. Microhardness values were higher in the cervical third followed by the middle third. CONCLUSION: Regular or flowable bulk-fill composite resins should be chosen for root reinforcement of flared root canals prior to fiber post cementation.


Assuntos
Colagem Dentária , Técnica para Retentor Intrarradicular , Resinas Compostas , Cavidade Pulpar , Análise do Estresse Dentário , Vidro , Teste de Materiais , Cimentos de Resina
9.
J Evid Based Dent Pract ; 20(2): 101406, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32473797

RESUMO

OBJECTIVE: To evaluate if the topical application of 10% potassium nitrate applied before in-office bleaching is effective to reduce the risk and intensity of tooth sensitivity (TS), as well as to evaluate if its application can jeopardize color change. MATERIALS AND METHODS: A randomized, split-mouth triple-blind clinical trial was conducted on 43 young patients with incisors A2 or darker. Half of the patient's upper arch received either the application of a 10% potassium nitrate or placebo gel for 10 min in a university setting. In-office bleaching was performed in three 15-min applications in two clinical sessions (1-week interval) using 35% hydrogen peroxide. Risk and intensity of TS was recorded with a 0-4 Numeric Rating Scale and a 0-10 Visual Analogue Scale during bleaching, 1 hour, 24 hours, and 48 hours after bleaching. Color was evaluated before and 1 month after bleaching with shade guides (Vita Classical and Vita Bleachedguide) and a spectrophotometer. The risk of TS (McNemar's test) and intensity of TS (Wilcoxon signed-rank for Numeric Rating Scale and paired t-test for Visual Analogue Scale) were statistically evaluated. Color change was compared using paired t-test. Significant level was set at 5%. RESULTS: No significant difference was observed in the absolute risks of TS between groups (RR = 1.11; 95% CI 0.97 to 1.27; P = .12), which exceeded 87% for both groups. Similarly, no difference in TS intensities was detected (P > .05). Significant whitening was observed with all color measurement instruments with no difference between groups (P > .05). CONCLUSION: The topical application of 10% potassium nitrate, before in-office bleaching, did not reduce the risk and intensity of TS and did not jeopardize color change.


Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Humanos , Nitratos , Compostos de Potássio , Resultado do Tratamento
10.
Equine Vet J ; 2020 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-32484928

RESUMO

BACKGROUND: Physical exercise is an essential factor in preventing and treating metabolic diseases by promoting systemic benefits throughout the body. The molecular factors involved in this process are poorly understood. Micro RNAs (miRNAs) are small non-coding RNAs that inhibit mRNA transcription. MiRNAs, which can participate in the benefits of exercise to health, circulate in plasma in extracellular particles (EP). Horses that undergo endurance racing are an excellent model to study the impact of long-duration/low intensity exercise in plasma EP miRNAs. OBJECTIVES: To evaluate the effects of 160 km endurance racing on horse plasma extracellular particles and their miRNA population. STUDY DESIGN: Cohort study. METHODS: We collected plasma from five Arabian horses during five time-points of an endurance ride. Extracellular particles were purified from plasma and characterised by electron microscopy, resistive pulse sensing (qNano) and western blotting. Small RNAs were purified from horse plasma EP, and sequencing was performed. RESULTS: Endurance racing increased EP concentration and average diameter compared to before the race. Western blotting showed a high concentration of extracellular vesicles proteins 2 hours after the race, which returned to baseline 15 hours after the race. MicroRNA differential expression analysis revealed increasing levels of eca-miR-486-5p during and after the race, and decreasing levels of eca-miR-9083 after the end. CONCLUSIONS: This study adds new data about the variation in plasma EP concentrations after long-distance exercise and brings new insights about the roles of exercise-derived EP miRNAs during low-intensity endurance exercise.

11.
J Dent ; 99: 103407, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32526348

RESUMO

OBJECTIVE: A systematic review and a meta-analysis were performed to answer the following research question: Are there differences in the color match and surface texture of nanofilled/nanohybrid and hybrid composite in patients with direct posterior restorations? DATA: Randomized clinical trials that compared nanofilled/nanohybrid and hybrid composite in direct restoration in posterior teeth were included. For the analysis of the bias the risk of bias tool (RoB) was used. Meta-analyses of different pairs (nanofilled vs. hybrid and nanohybrid vs. hybrid composite) were conducted for surface texture and color match and other secondary outcomes at different follow-ups, using a random effects model. Heterogeneity was assessed with the Cochran Q test and I2 statistics. GRADE was used to assess the quality of the evidence. SOURCES: A search was performed in PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library and SIGLE, without restrictions. IADR abstracts (2001-2019), unpublished and ongoing trials registries, dissertations and theses were also searched. STUDY SELECTION: 28 studies remained. No study was considered to be at low RoB; four studies were judged to have high RoB, and the remaining were judged to have unclear RoB. RESULTS: For the primary and secondary outcomes variables no significant differences were detected between nanofilled/nanohybrid restorations and hybrid composite restorations in any of the study follow-ups (p > 0.08). The body of evidence for surface texture and color match was classified as moderate or low. CONCLUSION: No evidence of difference was found between nanofilled/nanohybrid and hybrid composite in any of the clinical parameters evaluated.

12.
J Adhes Dent ; 22(2): 161-172, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32322837

RESUMO

PURPOSE: To evaluate 1. the microtensile bond strength (µTBS) and in situ degree of conversion (DC) of adhesives applied using two bonding strategies after silver diamine fluoride (diamine) application on carious dentinal lesions, and 2. dentin etching patterns using SEM and energy dispersive x-ray spectroscopy. MATERIALS AND METHODS: Human molars were randomly divided into 12 experimental groups according to: 1. application of a silver diamine fluoride solution (carious dentinal lesion without silver diamine fluoride treatment [control], with 12% silver diamine fluoride [diamine 12%] or 38% silver diamine fluoride [diamine 38%]); 2. adhesives (Clearfil Universal Bond Quick [CUQ] and Scotchbond Universal [SBU]); 3. adhesive strategy (etch-and-rinse [ER] and self-etch [SE]). After restoration, the specimens were sectioned and submitted to µTBS testing. Sticks from each tooth were used for DC evaluation. To examine the changes induced by diamine before and after phosphoric acid treatment, SEM/EDX analysis was performed. Data from the µTBS and DC tests were analyzed using three-way ANOVA and Tukey's test (α = 0.05). RESULTS: Both concentrations of diamine resulted in a statistically significantly higher mean µTBS compared to the control (p < 0.0001). Diamine 38% showed a statistically significantly higher mean µTBS for both adhesives in SE mode compared to diamine 12% (p < 0.0001). The application of diamine to carious dentinal lesions did not significantly influence the mean DC values for either adhesive (p = 0.72). SBU showed a higher mean DC compared to CUQ (p = 0.03). After diamine treatment, there was an increase in the Ca peak intensity and the presence of residual silver ions mainly when diamine 38% was applied along with the SE approach. CONCLUSION: Independent of the adhesive application approach, the use of diamine may be a promising alternative to increase µTBS without jeopardizing the DC of the two adhesives in carious dentinal lesions.


Assuntos
Colagem Dentária , Cimentos Dentários , Dentina , Fluoretos Tópicos , Humanos , Compostos de Amônio Quaternário , Compostos de Prata , Resistência à Tração
13.
Dent Mater ; 36(5): 672-680, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32284197

RESUMO

OBJECTIVE: The present study investigated the ability of a chlorhexidine (CHX)-containing primer (0.2% aqueous solution) to inhibit dentinal enzymes, preserve the hybrid layer (HL) and remain within the HL, after 10 years of aging in artificial saliva at 37°C. METHODS: Non-carious extracted molars were assigned to two groups, cut into slabs exposing middle/deep dentin, etched and bonded with Adper Scotchbond 1XT (SB1XT) with or without 0.2% CHX aqueous solution pretreatment. Composite build-ups were made, and the specimens were cut in 1-mm thick bonded sticks. In situ zymography was performed on freshly prepared specimens (T0) and specimens aged for 10 years (T10-yr) at 37°C in artificial saliva, to investigate endogenous gelatinolytic activity within the HL. At T10-yr, specimens were also decalcified and embedded in epoxy resin for TEM analysis. Micro-Raman spectroscopy was performed at T0 and T10-yr to evaluate the chemical profiles in intertubular dentin and the HL. RESULTS: In situ zymography showed less pronounced enzymatic activity in the CHX-pretreated group (p<0.05) regardless of aging, maintaining a similar level of fluorescence at T0 and T10-yr (p>0.05). TEM results showed that 98% of the HL had been degraded in the control group, while 95% of the HL was intact in the experimental group. Moreover, all the Raman spectra peaks assigned to CHX could be identified only in the CHX-pretreated group (T0 and T10-yr). SIGNIFICANCE: In vitro, CHX remains in the HL after 10 years with its inhibitory effect preserved. This may be the underlying factor for HL preservation after this long aging period.

14.
J Dent ; 96: 103325, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32205201

RESUMO

OBJECTIVES: This double-blind randomized clinical trial evaluated the influence of pre-treatment with proanthocyanidins (PA) from grape seed extract on the clinical behavior of a simplified etch-and-rinse adhesive placed in non-carious cervical lesions (NCCLs) over 6- and 24-months. MATERIALS AND METHODS: A total of 135 restorations were randomly inserted in 45 subjects. The NCCLs were etched with 37 % phosphoric acid for 15 s and distributed into 3 groups: Control (PA0) - adhesive ExciTE F applied as per the manufacturer's recommendations; PA2 and PA5 groups - 2 wt% and 5 wt% PA solution, respectively, were applied for 60 s and washed for 30 s prior to application of the adhesive. The resin composite was placed incrementally and light-cured. The restorations were evaluated at baseline, 6 months (6 m) and 24 months (24 m) using both the FDI and USPHS criteria. Statistical analyses were carried out using Friedman repeated-measures analysis of variance by rank and the Wilcoxon test (α = 0.05). RESULTS: The retention rates were 98 % (PA0), 98 % (PA2) and 83 % (PA5) after 6 m and 93 % (PA0), 89 % (PA2) and 70 % (PA5) after 24 m. Only PA5 resulted in a significant lower retention rate at 6 m and at 24 m compared with that of baseline (p = 0.03). All groups resulted in a significantly worse marginal adaptation and marginal staining for the FDI criteria when the baseline vs. the 24 m recall data were compared. These differences were considered clinically acceptable under the FDI criteria. CONCLUSIONS: The application of PA as a primer did not result in clinical advantages after 24 m of clinical service, regardless of the concentration used. CLINICAL RELEVANCE: It has been reported that PA, a collagen crosslinking agent, increases the durability of the dentin-resin interface. However, no effects were found clinically after 24 months.

15.
J Am Dent Assoc ; 151(2): 87-97.e4, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31813471

RESUMO

BACKGROUND: The authors of this systematic review and meta-analysis aimed to evaluate the effect of different anesthetics on the efficacy of inferior alveolar nerve block (IANB) in patients with irreversible pulpitis. TYPES OF STUDIES REVIEWED: The authors conducted a search of MEDLINE databases (PubMed, Scopus, Web of Science, Cochrane Central Register of Controlled Trials, Latin American and Caribbean Health Sciences Literature, and Brazilian Library of Dentistry). There was no restriction on publication year or idiom. The gray literature was also explored. The authors included only randomized clinical trials that compared different anesthetics in the efficacy of IANB in patients with irreversible pulpitis. The risk of bias was evaluated by using the Cochrane Collaboration's tool. A random-effects Bayesian mixed treatment comparison model was used to compare different anesthetic solutions in randomized clinical trials with low or unclear risk of bias. Heterogeneity was assessed by using Cochran Q test and I2 statistics. Quality of evidence was assessed by using the Grading of Recommendations Assessment, Development and Evaluation approach. RESULTS: A total of 7,981 studies were identified; only 16 met the eligibility criteria, and they were all meta-analyzed. A significant difference was observed in the pair lidocaine versus articaine, with higher success with articaine (risk ratio, 0.76; 95% confidence interval, 0.63 to 0.88) in the mixed treatment comparison analysis, as this comparison was graded as high-quality evidence. The probability of success for each treatment was 73% for articaine, 57% for prilocaine, 55% for mepivacaine, 53% for bupivacaine, and 12% for lidocaine. This ranking was considered high quality of evidence. CONCLUSIONS AND PRACTICAL IMPLICATIONS: The use of articaine can increase the IANB success rate in patients with irreversible pulpitis. Among the anesthetic solutions, lidocaine was the least effective.


Assuntos
Anestesia Dentária , Bloqueio Nervoso , Pulpite , Anestésicos Locais , Teorema de Bayes , Brasil , Método Duplo-Cego , Humanos , Lidocaína , Nervo Mandibular
16.
Clin Oral Investig ; 24(1): 385-394, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31104111

RESUMO

OBJECTIVES: This randomized triple-blind clinical trial, split-mouth design, evaluated the application effect of the desensitizing gel before and after in-office bleaching on tooth sensitivity. MATERIALS AND METHODS: In one group, the desensitizing gel was applied for 10 min before the bleaching with 35% hydrogen peroxide, and then application of placebo gel after (n = 90). In the other group, the desensitizing gel was applied before and after the bleaching procedure for 10 min (n = 90). The primary outcome was pain intensity assessed with a numeric rating scale and a visual analog scale. Color was evaluated by means of a digital spectrophotometer and a shade guides. RESULTS: The proportion of patients that experienced pain in the side of before application was 90% (95% CI 82 to 94.6%), while the side of before and after was 93% (95% CI 86.2 to 96.9%), without significant difference between groups (OR = 0.25; 95% CI 0.005 to 2.52; p = 0.37). Pain was correlated in both groups, for the NRS scale (p < 0.0001) and the VAS scale (p < 0.0001) in all assessment periods. Significant whitening was detected, and no significant difference of color change was observed between groups (p > 0.45). CONCLUSIONS: The application of the desensitizing agent did not influence the effectiveness of bleaching, but it was not efficient in reducing the sensitivity, when applied before the procedure, or before and after. CLINICAL RELEVANCE: The use of a desensitizing gel before or after in-office bleaching does not reduce incidence or intensity of tooth sensitivity.


Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Descoloração de Dente , Sensibilidade da Dentina/etiologia , Sensibilidade da Dentina/prevenção & controle , Feminino , Humanos , Peróxido de Hidrogênio , Clareamento Dental/efeitos adversos , Resultado do Tratamento
17.
Clin Oral Investig ; 24(2): 809-822, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31190231

RESUMO

OBJECTIVES: The aim of this study was to investigate the effects of collagen cross-linking agents on nanomechanical and bonding properties of eroded dentin (ED), 24 h and 2 years after water storage. MATERIALS AND METHODS: Human molar dentin surfaces, eroded by soft drinks or citric acid, were acid-etched and treated with primers containing proanthocyanidin (PA) and riboflavin (RI) or were untreated (control) and tested after 24 h and 2 years. After acid etching and adhesive application (Prime&Bond Elect (PBE); Scotchbond Universal (SBU); Tetric n-bond Universal (TEU)), specimens were sectioned into beams and tested for microtensile bond strength (µTBS) and silver nitrate deposition (NL) after 24 h and 2 years. The beams were used to evaluate the 24-h in situ conversion of degree (DC). Nanohardness (NH) and Young's modulus (YM) were evaluated via resin-bonded dentin slices after 24 h and 2 years. A three-way ANOVA and Tukey's test were used for statistical analysis (5%). RESULTS: For both storage times, ED with citric acid resulted in lower µTBS, NH, and YM and higher NL for each adhesive system than soft drink ED (p < 0.05). After 2 years of water storage, cross-linking primers maintained the µTBS, NH, and YM (p < 0.05) when compared with the control group. Althougth, the NL values decreased for all groups after 2 years of water storage, PA and RI treatments showed NI values lower than control group (p < 0.001). No significant differences were observed between PA and RI treatments (p > 0.05). Cross-linking primers maintain or improve DC (p < 0.03). In general, TEU and SBU yielded higher µTBS, DC, NH, and YM and lower NL than PBE. CONCLUSION: Cross-linking agents improved the results and maintained the resin-ED interface bonding and nanomechanical properties, without jeopardizing adhesive polymerization. CLINICAL RELEVANCE: Cross-linking agents are a viable alternative for improving and maintaining resin-ED interface bonding and nanomechanical properties.


Assuntos
Colagem Dentária , Colágeno , Resinas Compostas , Dentina , Adesivos Dentinários , Humanos , Teste de Materiais , Cimentos de Resina , Resistência à Tração , Água
18.
Braz. j. oral sci ; 19: e206155, jan.-dez. 2020. ilus
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1116428

RESUMO

Aim: The roughness and micromorphology of various surface treatments in aged metal-free crowns and the bond strength of these crowns repaired with composite resin (CR) was evaluated in vitro. Methods: A CR core build-up was confectioned in 60 premolars and prepared for metal-free crowns. Prepared teeth were molded with the addition of silicone, and the laboratory ceromer/fiber-reinforced crowns (SR Adoro/Fibrex Lab) were fabricated. Subsequently, the crowns were cemented and artificially aged in a mechanical fatigue device (1.2 X 106 cycles), then divided into 4 groups (n = 15) according to the surface treatment: 1) phosphoric acid etching (PA); 2) PA + silane application; 3) roughening with a diamond bur + PA; and 4) sandblasting with Al2O3 + PA. After the treatments, the crowns (n = 2) were qualitatively analyzed by scanning electron microscope (SEM) and surface roughness (n = 5) was analyzed before and after the surface treatment (Ra parameter). The remaining crowns (n = 8) received standard repair with an adhesive system (Tetric N-Bond) and a nanohybrid CR (Tetric N-Ceram), and the microshear bond strength (SBS) test was performed (0.5 mm/min). Roughness and SBS data were analyzed by one- and two-way ANOVA, respectively, as well as Tukey's post-test (α = 0.05). Results: Sandblasting with Al2O3 + PA resulted in the highest final roughness and SBS values. The lowest results were observed in the PA group, whereas the silane and diamond bur groups showed intermediate values. Conclusion: It may be concluded that indirect ceromer crowns sandblasted with aluminum oxide prior to PA etching promote increased roughness surface and bond strength values


Assuntos
Propriedades de Superfície , Cerâmica , Resinas Compostas , Resistência ao Cisalhamento , Tomografia com Microscopia Eletrônica
19.
Braz. dent. sci ; 23(2): 1-8, 2020. tab, ilus
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1096444

RESUMO

Objective: This study's aim was to quantify the hydrogen peroxide (HP) penetration into the pulp chamber of teeth submitted to different protocols of bleaching. Material and Methods: Ninety premolars were randomly divided into nine groups according to the bleaching agent protocol (n = 10): control (no bleaching), carbamide peroxide 10% [10% CP], carbamide peroxide 16% [16% CP], carbamide peroxide 22% [22% CP], hydrogen peroxide 4% [4% HP], hydrogen peroxide 6% [6% HP], hydrogen peroxide 7.5% [7.5% HP], hydrogen peroxide 10% [10% HP] and hydrogen peroxide 35% [35% HP]. The penetration of HP was measured via spectrophotometric analysis of the acetate buffer solution from the pulp chamber. The absorbance of the resulting solution was determined in a spectrophotometer and converted into equivalent concentration of HP (µg/ mL). To analyze the concentration of HP, the titration of bleaching agents with potassium permanganate was used. Data were subjected to ANOVA and Tukey's test for pairwise comparison (α = 0.05). Results: Higher concentration of HP in the pulp chamber was found in the HP 35% group (p < 0.0001). No significant difference between at-home protocols were observed (p = 0.64). Titration values showed that the concentration of the products was similar to that claimed by the manufacturer. Conclusion: It follows that the amount of HP that reaches the pulp chamber is not proportional to the concentration of whitening gels, but depends on the application time recommended by the manufacturers (AU)


Objetivo: o objetivo deste estudo foi quantificar a penetração do peróxido de hidrogênio (PH) na câmara pulpar dos dentes submetidos a diferentes protocolos de clareamento. Material e Métodos: Noventa pré-molares foram divididos aleatoriamente em nove grupos, de acordo com o protocolo do agente clareador (n = 10): controle (sem clareamento), peróxido de carbamida 10% [PC 10%], peróxido de carbamida 16% [PC 16%], peróxido de carbamida 22% [PC 22%], peróxido de hidrogênio 4% [PH 4%], peróxido de hidrogênio 6% [PH 6%], peróxido de hidrogênio 7,5% [PH 7,5%], peróxido de hidrogênio 10% [PH 10%] e peróxido de hidrogênio 35% [PH 35%]. A penetração de PH foi medida por análise espectrofotométrica da solução de tampão de acetato da câmara pulpar. A absorvância da solução resultante foi determinada em um espectrofotômetro e convertida em concentração equivalente de PH (µg / mL). Para analisar a concentração de PH, foi utilizada a titulação de agentes clareadores com permanganato de potássio. Os dados foram submetidos à ANOVA e teste de Tukey para comparação pareada (α = 0,05). Resultados: Foi encontrada maior concentração de PH na câmara pulpar no grupo PH 35% (p < 0,0001). Não foi observada diferença significativa entre os protocolos domiciliares (p = 0,64). Os valores de titulação mostraram que a concentração dos produtos era semelhante à reivindicada pelo fabricante. Conclusão: Conclui-se que a quantidade de PH que atinge a câmara pulpar não é proporcional à concentração de géis clareadores, porém depende do tempo de aplicação recomendado pelos fabricantes.(AU)


Assuntos
Clareamento Dental , Permeabilidade do Esmalte Dentário , Clareadores , Peróxido de Carbamida , Peróxido de Hidrogênio
20.
J Adhes Dent ; 21(6): 497-508, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31802065

RESUMO

PURPOSE: To compare the retention rates of non-carious cervical restorations (NCCLs) constructed using the sandwich technique (a lining of glass-ionomer cement [GIC] or resin-modified glass-ionomer cement [RMGIC] and composite resin [CR]) with CR-only restorations. MATERIALS AND METHODS: The search was performed in various databases, including the Cochrane Library, PubMed, Scopus, and Web of Science. Gray literature was inspected, as were ongoing and unpublished abstracts from the IADR (1990-2017). Study quality was evaluated using the Cochrane Collaboration bias risk tool. Data from primary and secondary outcomes were meta-analyzed at 1-, 2- and 3-year follow-ups using the random effects model. The quality of the body of evidence was assessed using the GRADE approach. RESULTS: Initially, a total of 3645 articles were selected. After selection by titles, abstracts, and full texts, 6 articles were retrieved, but three were follow-ups of the same RCT. Therefore, a total of four studies remained for analysis. All studies were at unclear risk for bias. Among all outcomes, only loss of retention was lower for the sandwich technique at the 3-year follow-up (risk ratio [RR]: 7.5; 95% CI: 2.1 to 27.2; p = 0.002). CONCLUSIONS: Based on the limited number of available studies, higher retention rates in NCCL restorations were observed with the sandwich technique compared to CR-only restorations at the 3-year follow-up. Secondary outcomes were not influenced by the restorative technique. Except for retention rates, which were of moderate quality, the evidence quality of all secondary outcomes was low.


Assuntos
Cárie Dentária , Restauração Dentária Permanente , Resinas Compostas , Falha de Restauração Dentária , Cimentos de Ionômeros de Vidro , Cimentos de Resina
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