O ensino do amálgama na formação odontológica ainda é necessário? Percepção de cirurgiões-dentistas / ¿Sigue siendo necesaria la enseñanza de la amalgama en la carrera odontológica? Percepción de los dentistas / Is the teaching of amalgam in dental training still necessary? Perceptions of dentists

A Odontologia tem vivenciado, nos últimos tempos, um declínio acentuado do uso do amálgama, em consequência da evolução dos materiais e técnicas adesivas e das discussões acerca dos riscos de contaminação pelo mercúrio. Assim, buscou-se identificar a percepção dos cirurgiões-dentistas sobre a necessidade da continuidade do ensino do amálgama nos cursos de Odontologia. Trata-se de um estudo transversal, usando um questionário semiestruturado com aspectos relativos às condições sociodemográficas, capacitação para executar os procedimentos, conhecimento acerca do manejo do material e gerenciamento dos resíduos. As respostas objetivas foram analisadas pela estatística descritiva e as subjetivas processadas no software IRaMuTeQ. Dos 257 respondentes, 60,7%afirmam utilizar esse material, 91,8% usam amálgama encapsulado e 95,7% descartam os resíduos em lixo hospitalar. Sobre a permanência do material, 63,4% acreditam ser necessária e 88% concordam que o ensino deva continuar sobretudo considerando o perfil do egresso sugerido pelas Diretrizes Curriculares Nacionais. Dos dados subjetivos emergiram cinco classes/categorias que retratam a percepção dos profissionais sobre relação custo-benefício, acesso ao serviço, condições de trabalho e longevidade das restaurações. Conclui-se que, mesmo com a evolução dos materiais adesivos, o amálgama ainda é necessário, principalmente no serviço público, onde a demanda por restaurações de baixo custo e grande longevidade é alta. Assim, para essa amostra, enquanto não houver um material restaurador livre de mercúrio, barato, de fácil manuseio e durável, o ensino desse conteúdo deve permanecer nos cursos de graduação em Odontologia (AU).

La odontología ha experimentado recientemente una fuerte disminución en el uso de amalgamas como resultado de las discusiones sobre los riesgos de contaminación por mercurio, así como la evolución de los materiales y las técnicas adhesivas. Así, buscamos identificar la percepción de los odontólogos sobre la necesidad de continuar enseñando amalgama en los cursos de odontología. Se trata de un estudio transversal utilizando un cuestionario semiestructurado con aspectos relacionados con las condiciones sociodemográficas, capacitación para realizar los procedimientos, conocimientos sobre manejo de materiales y gestión de residuos. Las respuestas objetivas se analizaron mediante estadística descriptiva y las respuestas subjetivas se procesaron mediante el software IRaMuTeQ. De los 257 encuestados, el 60,7% afirma utilizar este material, el 91,8% utiliza amalgama encapsulada y el 95,7% desecha los residuos en la basura de hospital. En cuanto a la permanencia del material, el 63,4% cree que es necesario y el 88% está de acuerdo en que la enseñanza debe continuar, sobre todo para la graduación de profesionales que van al servicio público. A partir de los datos subjetivos, surgieron cinco clases/categorías que retratan la percepción de los profesionales sobre la rentabilidad, el acceso al servicio, las condiciones de trabajo y la longevidad de las restauraciones. Se concluye que, aún con la evolución de los materiales adhesivos, la amalgama sigue siendo necesaria, especialmente en el servicio público, donde la demanda de restauraciones de bajo costo y gran longevidad es alta. Así, mientras no exista un material restaurador libre de mercurio, económico, fácil de manejar y duradero, la enseñanza de este contenido O ensino do amálgama na formação odontológica ainda é necessário? Percepção de cirurgiões-dentistas debe permanecer en los cursos de graduación en odontología (AU).

Dentistry has recently experienced a sharp decline in the use of amalgam, as a result of the evolution of adhesive materials and techniques and discussions about the risks of mercury contamination. Thus, we sought to identify the perception of dentists about the need to continue teaching amalgam in dentistry courses. This is a cross-sectional study, using a semi-structured questionnaire with aspects related to sociodemographic conditions, training to perform the procedures, knowledge about material management and waste management. The objective responses were analyzed by descriptive statistics and the subjective ones processed in the IRaMuTeQ software. Of the 257 respondents, 60.7% claim to use this material, 91.8% use encapsulated amalgam and 95.7% dispose of waste in hospital waste. Regarding the permanence of the material, 63.4% believe it is necessary and 88% agree that teaching should continue, especially considering the profile of the graduate suggested by the National Curriculum Guidelines. From the subjective data emerged five classes/categories that portray the perception of professionals about cost-benefit ratio, access to service, working conditions and longevity of restorations. It is concluded that, even with the evolution of adhesive materials, amalgam is still necessary, especially in the public service, where the demand for low cost and high longevity restorations is high. Thus, for this sample, as long as there is no mercury-free, inexpensive, easy to handle and durable restorative material, the teaching of this content should remain in undergraduate courses in Dentistry (AU).

Knowledge and awareness of dental stem cells among dental healthcare professionals - a cross-sectional study.

Objectives: To assess knowledge and awareness of dental healthcare professionals on dental stem cells. METHODS: A questionnaire survey-based study was conducted using Google forms on a sample of 69 dental healthcare professionals (DHCP) from September - October 2022, after obtaining ethical approval. A validated questionnaire was used to assess the knowledge and awareness of dental healthcare professionals on stem cells, which was then divided into three sections. The section A was about demographic statistics, section B assessed knowledge and awareness regarding dental stem cells and section C consisted of 5 score VAS scale to assess the acceptability of future research and increase implication of dental stem cells (DSC) among DHCP. The frequency of each question was reported in percentages. To assess the difference of knowledge and awareness of DSC among different specialties of DHCP, one-way ANOVA test was applied and incase of significant results pairwise comparison was performed by post-hoc Tukey test. RESULTS: Mean scores of knowledge and awareness of DSC among female DHCP were 54.26 ± 11.73 and males were 53.50 ±8.19. There was a statistically significant difference of knowledge (p= 0.02) among different dental healthcare professionals. On pairwise comparison by post-hoc Tukey HSD we found statistically significant difference (p = 0.03) of knowledge and awareness of dental stem cells among general dentists and operative dentistry specialists. CONCLUSIONS: We found poor knowledge and awareness of dental healthcare professionals regarding dental stem cells. However, operative and endodontic specialty had more awareness on dental stem cells as compared to any other specialty. There was positive approach for further future researches on stem cells.

Pediatric morbidity after oral surgery procedures under general anaesthesia: A systematic review.

The aim of this study is to carry out a systematic review of the existing literature on postoperative morbidity after general anaesthesia (GA) in the dental care of paediatric patients, its frequency, characteristics and association with the intervention performed. MATERIAL AND METHODS: An exhaustive search of the literature published up to 23 February 2022 was carried out in PubMed, Web of Science, Cochrane and EBSCO, with the following strategy: (infant OR child OR adolescent) AND (Oral Surgical Procedures OR Dentistry, Operative) AND Anesthesia, General AND Postoperative Complications. RESULTS: The most frequent reason for the indication of general anaesthesia was dental caries and its complications (up to 91.0% of patients), followed by lack of cooperation/anxiety and/or fear for dental procedures in the office (between 39.8 and 47.9%). There is a higher prevalence for treatments in the special patient group reaching 87.7% compared to 63.3% in healthy patients. The main comorbidities recorded were: physical or mental disability, neurological, haematological, cardiac disorders, asthma, Down's syndrome; it was not possible to establish their association with the intervention performed. Regarding complications, complaints occurred between 43.0 and 98.9% of cases within the first 24 hours, the main reason being pain (between 14.0% and 95.0%). CONCLUSIONS: Pediatric dental procedures under GA carry a very low risk of major complications, but have a virtually universal incidence of minor complications.

Do non-clinical subjective factors influence the treatment decisionmaking of Brazilian dentists?

The literature contains little information on several non-clinical factors such as the association between graduate residency programs and the application of minimally invasive dentistry, or on dentists' clinical decision-making processes for replacing restorations for esthetic reasons. This study evaluated whether non-clinical subjective factors influence the treatment decisions made by Brazilian dentists regarding technical and esthetic matters. Dentists were invited to participate in a cross-sectional survey by answering an electronic questionnaire containing clinical cases, regarding what treatment they would select for: T1 - a molar tooth with significant crown destruction and spontaneous pain, and T2 - premolar teeth with extensive amalgam restorations and no carious lesion or associated complaint. The survey also included questions about subjective variants (sociodemographic and professional). Chi Square test and Fischer's Exact test were used toanalyzetheanswers to T1, and one-factor analysis of variance and post-hoc Tamhane were applied to T2. The significance level was set at 5% for all analyses. A total 302 professionals participated in the study. For T1, it was found that clinical decision-making was influenced by the Brazilian region of clinical practice (p=0.005). For T2, a significant association was found between increased loss of patient tooth tissues and whether the professional had completed a residency program in Operative Dentistry (p=0.035), worked in a private practice (p=0.033), or if most of his/her patients belonged to a high estimated socioeconomic level (household income above $4350) (p=0.002). In conclusion, the clinical decision-making of Brazilian dentists varies according to professional profile, mainly with relation to the replacement of restorations due to esthetic concerns.

Vários fatores não clínicos, como a associação entre programas de especialização e a aplicação da odontologia minimamente invasiva, ainda são escassos na literatura. Outro aspecto relevante é a tomada de decisão clínica do dentista quanto à substituição de restaurações em função da aparência estética. Este estudo avaliou se fatores subjetivos não clínicos influenciam na tomada de decisão clínica de dentistas brasileiros com base em questões técnicas e estéticas. Foi realizado um estudo transversal com um questionário eletrônico contendo casos clínicos que foram apresentados a uma lista de profissionais. No questionário, interrogou-se o tratamento proposto para um dente molar com destruição coronária significativa e dor espontânea (T1). Também foi questionado o tratamento proposto para dentes prémolares com extensas restaurações de amálgama e sem lesão cariosa ou queixas associadas (T2). Em seguida, foram questionadas as variantessubjetivas(sociodemográfica eprofissional). Na análise de T1, foram utilizados os testes Qui Quadrado e Exato de Fischer. Em T2, foi aplicada a análise de variância de um fator e post-hoc Tamhane. Para todas as análises, o nível de significância foi estabelecido em 5%. Um total de 302 profissionais participaram deste estudo. A tomada de decisão clínica para T1 foi influenciada pela região brasileira de prática clínica (p = 0,005). Em T2, realizar especialização em Dentística Operatória (p = 0,035), trabalhar em consultório particular (p = 0,033) e a maioria dos pacientes apresentar nível socioeconômico estimado elevado (renda familiar acima de R$10.000,00) (p = 0,002) aumentou significativamente a perda de tecidos dentários. Em conclusão, a tomada de decisão clínica dos dentistas brasileiros varia de acordo com o perfil dos profissionais, principalmente no que se refere à substituição de restaurações por questões estéticas.

Do non-clinical subjective factors influence the treatment decisionmaking of Brazilian dentists? / Fatores subjetivos não clínicos influenciam na tomada de decisão do tratamento de cirurgiões-dentistas brasileiros?

ABSTRACT The literature contains little information on several non-clinical factors such as the association between graduate residency programs and the application of minimally invasive dentistry, or on dentists' clinical decision-making processes for replacing restorations for esthetic reasons. This study evaluated whether non-clinical subjective factors influence the treatment decisions made by Brazilian dentists regarding technical and esthetic matters. Dentists were invited to participate in a cross-sectional survey by answering an electronic questionnaire containing clinical cases, regarding what treatment they would select for: T1 - a molar tooth with significant crown destruction and spontaneous pain, and T2 - premolar teeth with extensive amalgam restorations and no carious lesion or associated complaint. The survey also included questions about subjective variants (sociodemographic and professional). Chi Square test and Fischer's Exact test were used to analyze the answers to T1, and one-factor analysis of variance and post-hoc Tamhane were applied to T2. The significance level was set at 5% for all analyses. A total 302 professionals participated in the study. For T1, it was found that clinical decision-making was influenced by the Brazilian region of clinical practice (p=0.005). For T2, a significant association was found between increased loss of patient tooth tissues and whether the professional had completed a residency program in Operative Dentistry (p=0.035), worked in a private practice (p=0.033), or if most of his/her patients belonged to a high estimated socioeconomic level (household income above $4350) (p=0.002). In conclusion, the clinical decision-making of Brazilian dentists varies according to professional profile, mainly with relation to the replacement of restorations due to esthetic concerns.

RESUMO Vários fatores não clínicos, como a associação entre programas de especialização e a aplicação da odontologia minimamente invasiva, ainda são escassos na literatura. Outro aspecto relevante é a tomada de decisão clínica do dentista quanto à substituição de restaurações em função da aparência estética. Este estudo avaliou se fatores subjetivos não clínicos influenciam na tomada de decisão clínica de dentistas brasileiros com base em questões técnicas e estéticas. Foi realizado um estudo transversal com um questionário eletrônico contendo casos clínicos que foram apresentados a uma lista de profissionais. No questionário, interrogou-se o tratamento proposto para um dente molar com destruição coronária significativa e dor espontânea (T1). Também foi questionado o tratamento proposto para dentes prémolares com extensas restaurações de amálgama e sem lesão cariosa ou queixas associadas (T2). Em seguida, foram questionadas as variantes subjetivas (sociodemográfica e profissional). Na análise de T1, foram utilizados os testes Qui Quadrado e Exato de Fischer. Em T2, foi aplicada a análise de variância de um fator e post-hoc Tamhane. Para todas as análises, o nível de significância foi estabelecido em 5%. Um total de 302 profissionais participaram deste estudo. A tomada de decisão clínica para T1 foi influenciada pela região brasileira de prática clínica (p = 0,005). Em T2, realizar especialização em Dentística Operatória (p = 0,035), trabalhar em consultório particular (p = 0,033) e a maioria dos pacientes apresentar nível socioeconômico estimado elevado (renda familiar acima de R$10.000,00) (p = 0,002) aumentou significativamente a perda de tecidos dentários. Em conclusão, a tomada de decisão clínica dos dentistas brasileiros varia de acordo com o perfil dos profissionais, principalmente no que se refere à substituição de restaurações por questões estéticas.

Patients' Management Patterns for Restorative Treatment Procedures: A 4-Year Overview at the Restorative Clinic of a Tertiary Hospital in Nigeria

Abstract Objective: To determine the patients' management pattern for restorative treatment procedures at the Restorative Dentistry Clinic at the Lagos State University Teaching Hospital (LASUTH). Material and Methods: A descriptive and retrospective study design was employed to determine patients' management patterns for the restorative treatment procedures at the Restorative Dentistry Clinic at LASUTH. Treatment records of patients who attended the Restorative Clinic at the Lagos State University Hospital, Ikeja, Lagos, Nigeria, from 2011 to 2014 were reviewed; the effective treatments during the period under review were recorded as treatment procedures and were recorded as operative, endodontic, fixed prosthodontics, and removable procedures. Results: A total of 14,437 (75%) operative; 1,353 (7.0%) endodontic; and 559 (2.9%) fixed prosthodontics and 2,852 (14.9%) removable prosthodontic procedures were carried out during the period under review. This study showed that operative procedures were the most performed restorative procedures, whereas removable prosthodontics and endodontic procedures ranked second and third, respectively, to operative procedures. Fixed prosthodontics procedures were the least performed restorative procedures. Conclusion: This study showed that more efforts were being expended by dentists on operative services compared to endodontic, removable, and fixed prosthodontics services combined. Comprehensive studies, embracing all disciplines of dentistry, should be carried out to determine the level of demand and clinical relevance of procedures in clinical dental practice and hence to set specific and general objectives of dental education for the populace. Access to dental health Insurance services should also be increased in the country.

Errors in light-emitting diodes positioning when curing bulk fill and incremental composites: impact on properties after aging.

OBJECTIVES: This study aimed to evaluate the effect of improper positioning single-peak and multi-peak lights on color change, microhardness of bottom and top, and surface topography of bulk fill and incremental composites after artificial aging for 1 year. MATERIALS AND METHODS: Bulk fill and incremental composites were cured using multi-peak and single-peak light-emitting diode (LED) following 4 clinical conditions: (1) optimal condition (no angulation or tip displacement), (2) tip-displacement (2 mm), (3) slight tip angulation (α = 20°) and (4) moderate tip angulation (α = 35°). After 1-year of water aging, the specimens were analyzed for color changes (ΔE), Vickers hardness, surface topography (Ra, Rt, and Rv), and scanning electron microscopy. RESULTS: For samples cured by single-peak LED, the improper positioning significantly increases the color change compared to the optimal position regardless of the type of composite (p < 0.001). For multi-peak LED, the type of resin composite and the curing condition displayed a significant effect on ΔE (p < 0.001). For both LEDs, the Vickers hardness and bottom/top ratio of Vickers hardness were affected by the type of composite and the curing condition (p < 0.01). CONCLUSIONS: The bulk fill composite presented greater resistance to wear, higher color stability, and better microhardness than the incremental composite when subjected to improper curing. The multi-peak LED improves curing under improper conditions compared to single-peak LED. Prevention of errors when curing composites requires the attention of all personnel involved in the patient's care once the clinical relevance of the appropriate polymerization reflects on reliable long-term outcomes.

Reabilitação estética com facetas semidiretas: relato de caso / Aestethic rehabilitation with semidirect facets: case report / Rehabilitación estética con facetas semidirectas: reporte de caso

Introdução: É crescente a busca por tratamentos estéticos nas clínicas odontológicas, dentre esta demanda, encontra-se soluções reabilitadoras para casos de diastemas e incisivos laterais superiores com morfologia conoide, pois são tidos como fatores antiestéticos. Objetivo: Apresentar uma abordagem interdisciplinar no tratamento de diastemas e unidades dentárias com morfologia conoide. Relato de caso: O paciente procurou atendimento odontológico especializado para reabilitação provisória da estética e função das unidades anterossuperiores durante finalização do tratamento ortodôntico e posteriormente, após conclusão da ortodontia, a reabilitação final. Durante o exame clínico foram observados incisivos laterais superiores com morfologia conoides, ângulo incisal amplo entre os incisivos centrais, ausência de guia canina e diastemas. Após registro fotográfico, foram realizadas as restaurações provisórias. Finalizado o tratamento ortodôntico, o plano de tratamento consistiu na reabilitação através das facetas semidiretas em resina composta. Após moldagem anatômica, enceramento e clareamento dentário, foram realizados os preparos dentários e moldagem funcional, sendo a seguir realizado o ensaio restaurador. Sobre o modelo, foram confeccionadas as facetas em resina composta e realizado o acabamento inicial. Para a fase de cimentação priorizou-se a utilização de condicionamento ácido seletivo para esmalte, cimento fotopolimerizado e uso de polimerizador de alta potência. Após a cimentação foram realizados os ajustes oclusais e acabamento final, com texturização da superfície, seguido pelo polimento. Conclusão: O tratamento realizado evidenciou a importância do tratamento ortodôntico associado a Odontologia Restauradora para o restabelecimento da estética e função, obtendo resultados que melhoraram as relações entre dentes, posicionamento dos lábios, harmonia e equilíbrio dental e facial(AU)

Introduction: There is a growing demand for aesthetic treatments in dental clinics, among this demand, there are rehabilitation solutions for cases of diastemas and upper lateral incisors with conoidmorphology, as they are considered as anti-aesthetic factors. Objective: Present an interdisciplinary approach in the treatment of diastemas and dental units with conoid morphology. Case report: The patient sought specialized dental care for provisional rehabilitation of the aesthetics and function of the anterosuperior units during the finalisation of the orthodontic treatment and later, after completion of orthodontics, the final rehabilitation. During the clinical examination, upper lateral incisors with conoid morphology, wide incisal angle between the central incisors, absence of canine guide and diastemas were observed. After photographic register, provisional restorations were performed. After orthodontic treatment was completed, the treatment plan consisted of rehabilitation through semi-direct facets in composite resin. After anatomical moulding, waxing and tooth whitening, dental preparations and functional mouldingwere performed, hereinafter the restorative test was performed. In this connection,facets were made in composite resin and the initial finishing was carried out. For the cementation phase, priority was given to the use of selective acid conditioning for dental enamel, photopolymerized cement and the use of high-power polymerizer. After cementation, occlusal adjustments and finishing touch were performed with surface texturing, followed by polishing. Conclusion: The treatment performed showed the importance of orthodontic treatment associated with restorative dentistry for the restorationof aesthetics and function, obtaining results that improved the relationship between teeth, positioning of the lips, harmony and dental and facial balance(AU)

Introducción: Crece la búsqueda de tratamientos estéticos en las clínicas dentales, entre esta demanda se encuentran las soluciones rehabilitadoras para casos de diastema e incisivos laterales superiores con morfología conoide, por considerarse factores antiestéticos. Objetivo: Presentar un abordaje interdisciplinario en el tratamiento del diastema y unidades dentales con morfología conoide. Caso clínico: El paciente buscó atención odontológica especializada para la rehabilitación temporal de laestética y función de las unidades anterosuperiores durante la finalización del tratamiento de ortodoncia y posteriormente, trasla finalización de la ortodoncia, la rehabilitación final. Durante el examen clínico se observaron incisivos laterales superiores con morfología conoide, amplio ángulo incisal entre los incisivos centrales, ausencia de guía canina y diastema. Después del registro fotográfico, se realizaron restauraciones provisionales. Una vez finalizado el tratamiento de ortodoncia, el plan detratamiento consistió en la rehabilitación mediante carillas de resina compuesta semidirectas. Después del moldeado anatómico, encerado y blanqueamiento dental, se realizaron las preparaciones dentales y el moldeado funcional, seguido de la prueba restauradora.Sobre el modelo, las carillas se realizaron en resina compuesta y se realizó el acabado inicial. Para la fase de cementación se priorizó el uso de grabado ácido selectivo para esmalte, cemento fotopolimerizable y el uso de un polimerizador de alta potencia. Después de la cementación, se realizaron ajustes oclusales y acabado final, con texturizado de la superficie, seguido de pulido. Conclusión: El tratamiento realizado mostró la importancia del tratamiento de ortodoncia asociado a la odontología restauradora para la restauración de la estética y función, obteniendo resultados que mejoraron la relación entre los dientes, la posición de los labios, la armonía y el equilibrio dental y facial(AU)

Micro-computed tomography in preventive and restorative dental research: A review.

PURPOSE: The use of micro-computed tomography (micro-CT) scans in biomedical and dental research is growing rapidly. This study aimed to explore the scientific literature on approaches and applications of micro-CT in restorative dentistry. MATERIALS AND METHODS: An electronic search of publications from January 2009 to March 2021 was conducted using ScienceDirect, PubMed, and Google Scholar. The search included only English-language articles. Therefore, only studies that addressed recent advances and the potential uses of micro-CT in restorative and preventive dentistry were selected. RESULTS: Micro-CT is a tool that enables 3-dimensional imaging on a small scale with very high resolution. In this method, there is no need for sample preparation or slicing. Therefore, it is possible to examine the internal structure of tissue and the internal adaptation of materials to surfaces without destroying them. Due to these advantages, micro-CT has been recommended as a standard imaging tool in dental research for many applications such as tissue engineering, endodontics, restorative dentistry, and research on the mineral density of hard tissues and bone growth. However, the high costs of micro-CT, the time necessary for scanning and reconstruction, computer expertise requirements, and the enormous volume of information are drawbacks. CONCLUSION: The potential of micro-CT as an emerging, accurate, non-destructive approach is clear, and the valuable research findings reported in the literature provide an impetus for researchers to perform future studies focusing on employing this method in dental research.

[Photoelastic models applied to dental restorations]. / Modelos fotoelásticos aplicados a la restauración dental.

Objective: To improve the understanding of the changes generated by restorative procedures through photoelastic models. Dental reconstruction should be based on principles of occlusion in order not to cause premature contact points during preparation and restoration procedures that can lead to disorders such as occlusal trauma, temporo-mandibullary joint dysfunction, or fractures. This paper presents a didactic method to objectively visualize occlusal loads and their distribution. Materials and methods: Photoelastic models of teeth and maxillary segments were made to visualize the effects of dental preparations and restorations, as well as the wear of premature contact points. Results: The direction, intensity and distribution of stresses in the crown and bone support were analyzed by photoelasticity. Conclusions: The technique allows visualization of how the structures are affected from the cavity preparation, the different stresses with diamond or carbide burs, in addition to observing how a premature contact point not only affects the organ that contains it but also the surrounding structures.

Prevalência de lesões cervicais não cariosas na dentição decídua / Prevalence of non-carious cervical lesions in the primary dentition

Objetivo: Determinar a prevalência de lesões cervicais não cariosas em crianças na dentição decídua e possíveis fatores etiológicos associados. Métodos:Após a aprovação do Comitê de Ética ­ CEP/UESPI (3.289.732), o estudo transversal foi realizado em 360 crianças com idade entre 2 a 6 anos, de escolas públicas e privadas, divididas em dois grupos: G1 (com lesões cervicais) e G2 (sem lesões cervicais). Foi aplicado um questionário aos pais, seguido do exame clínico das crianças. Foram consideradas lesões detectadas pelo tato e visualmente. Foram realizadas avaliações das médias e dos desvios padrão para variáveis quantitativas. Obteve-se porcentagens e frequências, realizando-se análises de associação entre as variáveis qualitativas a partir do qui-quadrado e comparação da idade média a partir do teste t (p < 0,05). Resultados: Somente lesões do tipo abfração foram encontradas na amostra (5%) e os indivíduos de raça branca apresentaram uma maior prevalência em relação aos demais (55,5%). Houve diferença estatisticamente significativa (p < 0,001) e essas lesões foram identificadas somente em escolas privadas. Quanto ao sexo, em G1, houve diferença estatisticamente significativa, (p = 0,01) com maior prevalência no masculino (66,7%). Os dentes mais acometidos em ordem decrescente foram os caninos e incisivos centrais superiores seguidos dos caninos e incisivos centrais inferiores. Conclusão: A prevalência de lesões cervicais não cariosas, do tipo abfração, em crianças de 2 a 6 anos de idade foi de 5%, tendo sido encontradas somente em escolas privadas, com predominância no sexo masculino. Houve associação entre a abfração e o tipo de escova utilizada na escovação dentária, apresentando maior frequência de lesões quando escovas duras eram utilizadas e escovação forte era executada.

Aim:To determine the prevalence of non-carious cervical lesions in children in the primary dentition and possible associated etiological factors. Method: After approval by the Ethics Committee - CEP / UESPI (3,289,732) ­ this cross-sectional study was carried out on 360 children, from 2 to 6 years of age, from public and private schools, divided into two groups: G1 (with cervical lesions) and G2 (without cervical lesions). A questionnaire was applied to the parents, followed by the children's clinical examination. Lesions detected by touch and visually were considered. Evaluations of means and standard deviations were performed for quantitative variables. Percentages and frequencies were obtained, analyzing the association between qualitative variables based on the chi-square test and comparing the average age using the t test (p < 0.05). Results:Only abfraction-type lesions were found in the sample (5%), and white individuals presented a higher prevalence in relation to the others (55.5%). There was a statistically significant difference (p < 0.001), and these lesions were found only in private schools. As for sex, in G1, there was a statistically significant difference (p = 0.01) with a higher prevalence in males (66.7%). The most affected teeth in decreasing order were the canines and upper central incisors, followed by the canines and lower central incisors. Conclusion: The prevalence of non-carious cervical lesions of the abfraction type in children from 2 to 6 years of age was 5%, which was only found in private schools, with a predominance in males. An association was found between the abfraction and the type of brush used in toothbrushing, with a higher frequency of lesions when hard brushes were used and strong brushing was performed.

A randomized clinical trial of class II composite restorations using direct and semidirect techniques.

OBJECTIVE: This prospective study evaluated the clinical performance of large class II restorations made with different techniques over 24 months. MATERIALS AND METHODS: Thirty patients received two class II restorations (n = 60) using a nanohybrid composite and different restorative techniques (direct (DT), semidirect (SDT)), in a split-mouth randomized design. The same adhesive system was applied for all restorations. For DT, the restorative material was applied directly inside the tooth preparation. For SDT, a tooth preparation impression was obtained using alginate and a silicone flexible die was prepared. The restoration was made chairside on the model and additionally light cured. After that, it was cemented in preparation using resinous cement. All restorations were evaluated using the FDI criteria after 7 days, 6, 12, and 24 months postoperatively. RESULTS: After 24 months, 24 patients attended the recall and 48 restorations were evaluated. Fisher's statistical analysis (5%) showed no difference between the techniques. Nevertheless, Friedman's test showed significant differences for some criteria after 12 months of evaluation for both techniques. Postoperative sensitivity was reported in one DT restoration. Also, after 24 months, one SDT restoration presented marginal fracture, which was deemed unsatisfactory. CONCLUSIONS: After a 24-month follow-up, no significant difference between the tested techniques was detected. The restorations performed with both techniques produced clinically acceptable restorations. CLINICAL RELEVANCE: This study demonstrated the viability of applying two different operatory techniques (direct and semidirect) for class II resin composite restorations.

Are Brazilian dentists and dental students using the ICCC recommendations for caries management?

Abstract The aim of this study was to evaluate whether dentists and dental undergraduate students know the terminology of the International Caries Consensus Collaboration (ICCC), and make their restorative treatment decisions regarding carious tissue removal accordingly. Data collection was performed using an electronic questionnaire, considering: a) profile of the respondent; b) analysis of four clinical cases with respect to possible management strategies; and c) questions on cariology field terminology. Sample size consisted of 175 dentists and 66 last semester dental students. Statistical analyses were performed comparing profile, type of institution and dental specialty of the participants. Results showed students were less conservative and agreed less with the ICCC than dentists, and private schools, less than public institutions. Private institutions were 12% (95%CI = 0.833-0.949; p = 0.000) more likely to be less updated with the ICCC recommendations than public institutions, and dentists were 20% more likely to agree with them than students (95%CI = 1.118-1.302; p = 0.000). Dentists were 66% more likely to be conservative than students (95%CI = 0.203-0.554; p = 0.000); dentists and students who graduated or were graduating from public universities were twice as likely to be conservative as those from private universities (95%CI = 1.336-3.333; p = 0.001). In conclusion, students in the last semester are less conservative than dentists, and respondents who graduated or were graduating from public dental schools were more aligned with the current concepts of the ICCC. Several answers were not aligned with ICCC directives, thus showing that management of deep carious lesions still causes restorative therapeutic insecurity.

Anxiety and dental treatments in a hospital in Lima, Peru / Ansiedad y tratamientos dentales en un hospital de Lima, Perú

Background: The dental treatment anxiety affects patient care consultation, regardless of the dental specialty, each with own treatment acts. Objective: To determine the anxiety level of dental treatment of operative dentistry and oral surgery in a hospital of Lima. Methods: The study was conducted in the specialties of operative dentistry and oral surgery, with 72 patients from each specialty, chosen at random over a period of five months, through their answers at Beck Anxiety Inventory. Results: The level of anxiety of patients was similar in the two specialties (p = 0.402). No statistical significant difference was found between anxiety and the patient's sex (p = 0.06), nor with the age of the patient (p = 0.08), nor with the sex of the operator (p = 0.521). The higher frequency of anxiety was the minimum level, 86.1% in operative dentistry and 79.2% in oral surgery. A difference was found between anxiety levels of patients from each specialty (p < 0.001). Conclusions: The frequency of anxiety before entering the specialty was similar, minimum level. Other research is required to determine whether the degree of anxiety is related to the patient's care to dental specialties services.

Introducción: la ansiedad ante un tratamiento odontológico repercute en la asistencia de los pacientes a consulta, independientemente de la especialidad odontológica, cada una con actos propios de tratamiento. Objetivo: determinar el nivel de ansiedad ante el tratamiento de operatoria dental y de cirugía bucal en un hospital de Lima, Perú. Métodos: el estudio fue realizado en las especialidades de operatoria dental y cirugía bucal, con 72 pacientes de cada especialidad, elegidos de manera aleatoria durante un periodo de cinco meses, quienes respondieron el Inventario de Ansiedad de Beck. Resultados: el nivel de ansiedad de los pacientes fue similar en las dos especialidades (p = 0.402). No hubo diferencias entre ansiedad y sexo del paciente (p = 0.06), entre ansiedad y la edad del paciente (p = 0.08), y tampoco con el sexo del operador (p = 0.521). El nivel de ansiedad predominante en todos los pacientes, fue mínimo, 86.1% en operatoria dental y 79.2% en cirugía bucal. Al comparar por separado los niveles de ansiedad de los pacientes de cada especialidad, hubo diferencias en cada caso (p < 0.001). Conclusiones: el nivel de ansiedad antes de entrar a la especialidad de operatoria dental y cirugía bucal fue similar, mínimo. Se deben realizar otras investigaciones para establecer si el grado de ansiedad se relaciona con la asistencia del paciente a los servicios de especialidades odontológicas.

Factors associated with the number of filled teeth in adolescents from public schools: a cohort study

Abstract This study aimed to assess the association of demographic conditions, socioeconomic status, clinical variables, and psychosocial factors with the number of filled teeth in adolescents from public schools. This cohort study comprised 1,134 12-year-old adolescents enrolled in public schools in Santa Maria, Brazil, in 2012. They were followed-up in 2014, where 743 individuals were reassessed (follow-up rate of 65.52%) for the number of filled teeth. Data were collected via dental examinations and structured interviews. Demographic and socioeconomic characteristics were collected from parents or legal guardians. The psychosocial factor comprised students' subjective measurement of happiness (Brazilian version of the Subjective Happiness Scale - SHS). Dental examinations were performed to assess the number of filled teeth through decay, missing, and filled teeth index (DMF-T). Unadjusted and adjusted Poisson regression analyses were performed to assess the association between baseline variables and filled teeth at follow-up. The number of filled teeth in 2012 and 2014 were 193 (17.02%) and 235 (31.63%), respectively. The incidence of filled teeth in 2014 was 42 (5.65%). Adolescents with untreated dental caries, those who visited the dentist in the last 6 months, those that exhibited being happier, and those who had filled teeth at baseline were associated with a higher number of filled teeth at follow-up. We conclude that the number of filled teeth in adolescents was influenced by clinical and psychosocial factors, emphasizing the need to focus on oral health policies in individuals with higher disease burden and those who feel psychologically inferior.

A importância da reabilitação oral estética na alteração de forma e cor dos dentes: relato de caso clínico / The importance of oral aesthetic rehabilitation in changing shape and color of teeth: clinical case report / La importancia de la rehabilitación oral estética en la alteración de forma y color de los dientes: reporte de caso clínico

Com o aumento da exigência estética dos pacientes e o desenvolvimento de materiais e técnicas odontológicas restauradoras problemas como alteração de cor e forma tem sido melhor resolvidos garantindo naturalidade e longevidade aos procedimentos restauradores. Este trabalho objetivou apresentar um relato de caso clínico de reabilitação estética do sorriso, descrevendo protocolo clínico de laminados cerâmicos e coroas totais "metal free" desde o planejamento até a cimentação definitiva. Paciente do gênero feminino, apresentou insatisfação com a estética de seu sorriso, principalmente em relação a coloração de seus dentes. Durante avaliação clínica, constatou-se comprometimento estético dos elementos dentais 11, 12 e 21 com alteração de cor e desequilíbrio dimensional. Esses dentes tinham grande restaurações resina composta, o que os tornava opacos e sem brilho. O tratamento proposto consistiu na realização de clareamento dental e posteriormente laminados cerâmicos nos dentes 12, 13, 14, 22, 23 e 24 e coroas totais "metal-free" nos elementos 11 e 21, utilizando um sistema cerâmico a base de dissilicato de lítio. Após o relato deste caso clínico, pode-se concluir que com o advento das cerâmicas ácido sensíveis e da cimentação adesiva os tratamentos reabilitadores estéticos têm proporcionado um resultado estético e funcional satisfatório(AU)

With increasing aesthetic requirement of patients and the development of materials and restorative dental techniques problems such as alteration of color and shape have been better solved guaranteeing naturalness and longevity to restorative procedures. This paper aimed to present a report of a clinical case of smile aesthetic rehabilitation, describing clinical protocol of ceramic laminates and total crowns "metal free" from planning to final cementation. A female patient, she was dissatisfied with the aesthetics of her smile, mainly in relation to the color of her teeth. During clinical evaluation, it was found aesthetic compromise of dental elements 11, 12 and 21 with color change and dimensional imbalance. These teeth had large composite resin restorations, which made them opaque and lackluster. The proposed treatment consisted of dental bleaching and then ceramic laminates on teeth 12, 13, 14, 22, 23 and 24 and total metal-free crowns on elements 11 and 21 using a ceramic system based on lithium disilicate . After the report of this clinical case, it can be concluded that with the advent of the sensitive acid ceramics and adhesive cementation the aesthetic rehabilitation treatments have provided a satisfactory aesthetic and functional result(AU)

Con el aumento de la exigencia estética de los pacientes y el desarrollo de materiales y técnicas odontológicas restauradoras problemas como alteración de color y forma han sido mejor resueltos garantizando naturalidad y longevidad a los procedimientos restauradores. Este trabajo objetivó presentar un relato de caso clínico de rehabilitación estética de la sonrisa, describiendo protocolo clínico de laminados cerámicos y coronas totales "metal free" desde la planificación hasta la cementación definitiva. Paciente del género femenino, presentó insatisfacción con la estética de su sonrisa, principalmente en relación a la coloración de sus dientes. Durante la evaluación clínica, se constató un compromiso estético de los elementos dentales 11, 12 y 21 con alteración de color y desequilibrio dimensional. Estos dientes tenían grandes restauraciones resina compuesta, lo que los hacía opacos y sin brillo. El tratamiento propuesto consistió en la realización de blanqueamiento dental y posteriormente laminados cerámicos en los dientes 12, 13, 14, 22, 23 y 24 y coronas totales "metal-free" en los elementos 11 y 21, utilizando un sistema cerámico a base de disilicato de litio . Después del relato de este caso clínico, se puede concluir que con el advenimiento de las cerámicas ácido sensibles y de la cementación adhesiva los tratamientos rehabilitadores estéticos han proporcionado un resultado estético y funcional satisfactorio(AU)

Radiographic analysis of dental implant extensions using bone grafts on dogs.

BACKGROUND: Despite the wide use of dental implants they can bring inconveniences, as the moment one reaches osseointegration, these can no longer be extended. Therefore, if a problem occurs regarding its positioning, the options open are substitution or burial of the implant. With implant substitution, there exists the risk of local bone loss and/or future loss of the new implant. PURPOSE: This study proposes a new device (implant extender) for extending the dental implant. The feasibility of this technique is verified through installing dental implant extensions onto the humerus bone of dogs with autogenous bone grafts. MATERIALS AND METHODS: Implants of 3.3 mm in diameter by 6 mm in length and implant extensions with a 3.3 mm diameter and 2.2 mm length were installed onto humerus of 4 healthy dogs, using an autogenous bone graft in a block made from ilium. The biomechanical percussion tests were performed on the implant extensions and then the implant-extension sets were removed for radiographic analysis. RESULTS: In the biomechanical percussion, none of the extensions present clinical mobility. As for the x-rays, these were analyzed by 20 professionals, who concluded that there was a 100% success rate with bone formation around the implants, 74.1% for bone neoformation of the implant extensions, and 80.1% referring to the adaptation of the implant extension. DISCUSSION AND CONCLUSION: Bone formation occurred in every installed dental implant. In most cases, there occurred bone neoformation of the extensions and adaptation of the extension/implant set, according to the x-ray analysis performed by the evaluators. An absence of clinical mobility in the extensions was also observed. Although the results were promising, these techniques still need to be researched in humans, as an alternative for reducing elongated prosthetic crowns or poorly installed implants, as well as the modification of the type of implants among other applications.

Frequency of Post-Operative Sensitivity in Class II Composite Restorations in Iranian Patients

Objective: To determine the frequency of sensitivity after treatment in composite resin restorations Class II of premolars in Iranian patients. Material and Methods: In this descriptive-cross-sectional study, questionnaires were used which included questions about the extent of post-operative sensitivity in posterior composite resin restorations among 178 patients referred to the restoration section. After restoration of the teeth, the patients were called to record sensitivity after the treatment. Post-operative sensitivity was measured 24 h and 1 month with cold stimulation using Visual Analog Scale (VAS) method. The data were analyzed with the SPSS software, through descriptive statistical methods (frequency and percentage, mean, standard deviation). Group comparisons were evaluated using Mann-Whitney U test and p-value <0.05 was considered to be statistically significant. Results: The mean frequency of sensitivity in terms of gender was 0.75 and 0.76 in males and females, respectively. The mean frequency of sensitivity in terms of type of jaw was 0.59 and 1.1, in the upper and lower jaw, respectively. It was also observed that the frequency of sensitivity is higher in adolescent age group, in comparison with other age groups. No significant association between gender as well as type of jaw and post-operative sensitivity frequency was observed (p>0.05). However, age group has a statistically significant association with the frequency of post-operative sensitivity (p<0.05). Conclusion: There is a significant relationship between extent of sensitivity after treatment in composite resin restorations Class II and the age group of patients.

Effect of filler size and filler loading on wear of experimental flowable resin composites

Abstract The relationship between wear resistance and filler size or filler loading was clarified for the universal resin composite; however, their relationship in flowable resin composites has not been clarified. Objectives: The purpose of this study was to investigate the effect of filler size and filler loading on wear of experimental flowable resin composites by using a cyclic loading device. Material and Methods: Nine experimental flowable resin composites consisting of three different sizes (70, 200 and 400 nm) and loading (50, 55 and 60 wt%) of filler were prepared. Bowl-shaped cavities were prepared on a flat surface of ceramic blocks using a No. 149 regular cut diamond point. The cavities were treated with a silane coupling agent and an all-in-one adhesive and then filled with each experimental flowable resin composite. The restored surfaces were finished and polished with a 1500-grit silicon carbide paper. The specimens were subjected to an in vitro two-body wear test using a cyclic loading device. The localized worn surfaces were evaluated at 10,000, 20,000, 30,000, and 40,000 cycles using a computer-controlled three-dimensional measuring microscope (n=5). The volumetric wear loss of the materials was calculated automatically by the equipment. Data were statistically analyzed with two-way ANOVA and post hoc Tukey test. Results: Two-way ANOVA showed that the filler size significantly influenced wear volume (p<0.003), but the filler loading did not have a significant effect (p>0.05). A post hoc Tukey test detected significant differences in filler size between 70 nm and 400 nm, and 200 nm and 400 nm (p<0.007). Conclusion: The experimental flowable resin composite containing a mean filler size of 400 nm exhibited significantly lower wear resistance in two-body wear compared with those containing mean filler sizes of 200 nm or 70 nm.

Uso de hidróxido de cálcio e MTA na odontolgia: conceitos, fundamentos e aplicação clínica / Use of calcium hydroxide and mta in dentistry: concepts, rationele and clinical practice

Introdução: atualmente os produtos à base de hidróxido de cálcio são amplamente utilizados e difundidos na odontologia em várias situações clínicas, desde capeador em exposição pulpar à pulpotomias, em virtude de suas propriedades físicas, mecânicas, do baixo custo e de seu próprio mecanismo de ação, representando assim, o material mais próximo do ideal. Objetivo: descrever os conceitos, os fundamentos e a aplicação clínica do Hidróxido de Cálcio e do MTA, por meio de uma revisão da literatura. Material e Métodos: foi realizada uma revisão da literatura, por meio de busca bibliográfica nas seguintes bases de pesquisa online: Lilacs, Scielo, PubMED/Medline e Bireme, com uso dos descritores: hidróxido de cálcio (calcium hydroxide); hidróxido de cálcio e MTA (calcium hydroxide and MTA) e MTA, rastreando artigos relevantes publicados entre o período de 2010 a 2015. Resultados e Discussão: materiais a base de hidróxido de cálcio, são biocompatíveis e apresentam propriedades antimicrobianas, anti-inflamatórias, estimulantes da formação de dentina esclerosada, de tecido ósseo mineralizado além de proteger a polpa contra estímulos termoelétricos e tóxicos, provenientes de alguns materiais restauradores, mantendo assim, a integridade pulpar. São amplamente utilizados para: proteção pulpar, pulpotomias, cimentação protética, forramento cavitário, apicificação e em casos de reabsorção radicular. As formas de apresentação desses materiais pode ser produtos na forma de pó, ou na forma de pastas, autoativadas ou fotoativadas. O Agregado Trióxido Mineral (MTA) apresenta muitas propriedades coincidentes com o hidróxido de cálcio, mas uma das suas principais desvantagens é seu alto custo, o que inviabiliza o rotineiro na clínica, esse material é apresentado na forma de pó e líquido, o qual é composto apenas por água destilada. Conclusão: Diante das várias opções de produtos presentes no mercado, recomenda-se ao profissional a escolha do melhor material para cada caso, incluindo seguir protocolos adequados durante a aplicação dos materiais para alcançar resultados clínicos satisfatórios.

Introduction: products of calcium hydroxide are largely used in a variety of dental clinical condition due to its physical and mechanical properties and its low cost as well as its rationelle. In this contexto, it representes a material close to the ideal. Objective: to describe the concepts, fundamentals and clinical application of Calcium Hydroxide and MTA, through a review of the literature. Materials and Methods: a review of the literature was carried out by means of bibliographic search in the following online databases: Lilacs, Scielo, PubMED/Medline and Bireme, using the descriptors: calcium hydroxide; Calcium hydroxide and MTA, and MTA, tracking relevant articles published between the period 2010-2015. Results and Discussion: materials based on calcium hydroxide, are biocompatible and exhibit antimicrobial, anti-inflammatory, stimulating properties of the formation of sclerosed dentin, of mineralized bone tissue, besides protecting the pulp against thermoelectric and toxic stimuli from some restorative materials, thus maintaining pulp integrity. They are widely used for: pulp protection, pulpotomies, prosthetic cementation, cavity lining, apicification and in cases of root resorption. The forms of presentation of such materials may be products in the form of powder, or in the form of pastes, either self-activating or photoactivated. The Mineral Trioxide Aggregate (MTA) has many properties that coincide with calcium hydroxide, but one of its main disadvantages is its high cost, which makes the routine in the clinic unfeasible. This material is presented in the form of powder and liquid, which is Composed only of distilled water. Conclusion: in view of the various product options present in the market, the professional is advised to choose the best material for each case, including following appropriate protocols during the application of the materials to achieve satisfactory clinical results.