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1.
Sci Rep ; 11(1): 15447, 2021 07 29.
Artigo em Inglês | MEDLINE | ID: mdl-34326441

RESUMO

Impacted mandibular third molars (M3M) are associated with the occurrence of distal caries on the adjacent mandibular second molars (DCM2M). In this study, we aimed to develop and validate five machine learning (ML) models designed to predict the occurrence of DCM2Ms due to the proximity with M3Ms and determine the relative importance of predictive variables for DCM2Ms that are important for clinical decision making. A total of 2642 mandibular second molars adjacent to M3Ms were analyzed and DCM2Ms were identified in 322 cases (12.2%). The models were trained using logistic regression, random forest, support vector machine, artificial neural network, and extreme gradient boosting ML methods and were subsequently validated using testing datasets. The performance of the ML models was significantly superior to that of single predictors. The area under the receiver operating characteristic curve of the machine learning models ranged from 0.88 to 0.89. Six features (sex, age, contact point at the cementoenamel junction, angulation of M3Ms, Winter's classification, and Pell and Gregory classification) were identified as relevant predictors. These prediction models could be used to detect patients at a high risk of developing DCM2M and ultimately contribute to caries prevention and treatment decision-making for impacted M3Ms.


Assuntos
Suscetibilidade à Cárie Dentária , Cárie Dentária/complicações , Aprendizado de Máquina , Mandíbula , Dente Serotino/patologia , Colo do Dente/patologia , Dente Impactado/complicações , Adulto , Tomada de Decisão Clínica/métodos , Estudos Transversais , Confiabilidade dos Dados , Feminino , Humanos , Masculino , Estudos Retrospectivos , Fatores de Risco , Sensibilidade e Especificidade , Adulto Jovem
2.
Biomed Res Int ; 2021: 8822804, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33490278

RESUMO

The purpose of this clinical research was to evaluate peri-implant marginal changes around immediate implants placed either with the application of SCTG or XCM or without soft tissue grafting. A total of 48 patients requiring a single implant-supported restoration in the anterior jaw were selected for inclusion. Three surgical procedures were performed, as follows: type 1 implant with subepithelial connective tissue graft (SCTG), type 1 implant with xenogenic collagen matrix (XCM), and type 1 implant without soft tissue augmentation (NG) (control group). The marginal change of peri-implant soft tissue, facial soft tissue thickness (FSTT), peri-implant health status, esthetics, and patient satisfaction were assessed at one year after surgery. All of the placed implants showed a survival rate of 100%. No significant differences in FSTT were recorded between the SCTG group and the XCM group after treatment (P > 0.05), while the NG group presented a significant difference (P < 0.05). Patients in the NG group lost significantly more in the buccal marginal level than did patients in the SCTG group and those in the XCM group (P < 0.05). The favourable success rate recorded in all groups confirmed immediate tooth replacement as a choice of treatment for a missing anterior single tooth. The NG group presented significant changes of FSTT and buccal marginal level, while XCM constituted a viable alternative to SCTG.


Assuntos
Implantação Dentária , Transplantes/transplante , Adulto , Colágeno/uso terapêutico , Tecido Conjuntivo/transplante , Implantação Dentária/efeitos adversos , Implantação Dentária/métodos , Implantação Dentária/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Palato Duro/transplante , Estudos Retrospectivos , Colo do Dente/patologia , Colo do Dente/cirurgia
3.
Niger J Clin Pract ; 23(7): 1026-1029, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32620736

RESUMO

When teeth have responded poorly to conventional endodontic treatment or when they cannot be treated adequately by nonsurgical means, surgical endodontics remains the treatment of choice. Healing of apical lesions occurs by repair, most of the time. "Repair is the healing of a wound by tissue that does not fully restore the architecture or function of the affected unit". Since this is not ideal, newer regenerative procedures that aim to restore lost tissue have been introduced. ß -Tricalcium phosphate is an alloplastic bone graft material that forms a scaffold for closing the bony defect. It is osteoconductive. Platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) are platelet concentrates, rich in growth factors and they promote regeneration by osteoinduction. This article describes cases of bone augmentation with a combination of PRP + ß -TCP and PRF + ß -TCP for treatment of the chronic periapical lesion. The cases were followed for six months and one year and healing was evaluated quantitatively using cone beam computed tomography.


Assuntos
Fosfatos de Cálcio/uso terapêutico , Tomografia Computadorizada de Feixe Cônico/métodos , Fibrina Rica em Plaquetas , Plasma Rico em Plaquetas , Adulto , Regeneração Óssea , Transplante Ósseo , Feminino , Humanos , Radiografia Dentária , Ápice Dentário/diagnóstico por imagem , Ápice Dentário/cirurgia , Colo do Dente/patologia , Resultado do Tratamento , Cicatrização
4.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(5): 323-328, 2020 May 09.
Artigo em Chinês | MEDLINE | ID: mdl-32392974

RESUMO

Non-carious cervical lesion is a common dental disease, which not only affects the aesthetic and function of the teeth, but also leads to dentin sensitivity, pulpitis and other consequences. The main causes of lesions are abrasion, abfraction, acid erosion and so on. The treatment design should depend on the etiology, defect size, location, symptoms and presence or absence of gingival recession.


Assuntos
Retração Gengival , Abrasão Dentária , Colo do Dente/patologia , Erosão Dentária , Humanos
5.
BMC Oral Health ; 20(1): 98, 2020 04 07.
Artigo em Inglês | MEDLINE | ID: mdl-32264864

RESUMO

BACKGROUND: We aimed to investigate the load-induced strain variation in teeth with unrestored and resin-based composite restored non-carious cervical lesions (NCCLs). METHODS: Twelve extracted premolars were provided for measuring buccal-side root NCCLs. Strain gauges were fixed at four measuring sites of each tooth, two at the buccal surface and two at the lingual surface. NCCLs were prepared with occlusal margins at the cemento-enamel junction. A static 9-kg load was applied at seven occlusal loading points: buccal cusp tip (BC), inner inclination of the BC, lingual cusp tip (LC), inner inclination of the LC, center of the mesial marginal ridge or distal marginal ridge, and center of the central groove. The strain was detected at each site in teeth with NCCL depths of 0 (control), 0.5, 1.0, and 1.5 mm. Each NCCL was restored using an adhesive composite resin, and the strains were re-measured. RESULTS: The strains at the NCCL occlusal and gingival margins decreased with increasing defect depths, and the effect was significant when the depth of the defect was 1.5 mm. Loading on the buccal and lingual cusps induced prominent strain variation. The strains at all depth distribution recovered to nearly intact conditions when the NCCLs were restored. CONCLUSIONS: NCCLs at 1.5 mm depth are detrimental, but they can be restored using resin composites. CLINICAL SIGNIFICANCE: The existence of NCCLs should not be ignored. The depth of the NCCL may affect the progression of the lesion. Resin composite restoration is an appropriate method for preventing persistent NCCL deterioration.


Assuntos
Dente Pré-Molar/patologia , Resinas Compostas , Esmalte Dentário/fisiologia , Restauração Dentária Permanente , Abrasão Dentária/terapia , Colo do Dente/patologia , Erosão Dentária/terapia , Dente Pré-Molar/fisiologia , Força Compressiva , Preparo da Cavidade Dentária , Materiais Dentários , Análise do Estresse Dentário , Humanos , Abrasão Dentária/fisiopatologia , Erosão Dentária/fisiopatologia
6.
Clin Oral Investig ; 24(4): 1569-1578, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31468262

RESUMO

AIM: The aim of this clinical trial was to evaluate and compare the performance of a universal adhesive with different adhesive strategies in the restoration of non-carious cervical lesions (NCCLs) over a 36-month period. MATERIAL AND METHOD: One hundred sixty-five NCCLs in 35 patients (13 female, 22 male) with at least 3 lesions each were included in this study. Three groups were formed according to the adhesive strategy used (n = 55): selective-etch mode, etch-and-rinse mode, or self-etch mode of a universal adhesive, Single Bond Universal. The same nanofilled resin composite, Filtek Ultimate, was used for all restorations by a single operator. The restorations were evaluated by two calibrated examiners at baseline and at 6, 12, 18, 24, and 36 months in accordance with the modified USPHS criteria. The chi-square test was used for intergroup comparison and Cochran's Q test for intragroup comparison (∝ = 5%). RESULTS: At 36 months, the recall rate was 98.1% and three restorations, one from each group, had failed because of retention loss (P > 0.05). The self-etch mode group showed 17 bravo scores for both marginal staining and marginal adaptation after 3 years, which was significantly different from the selective-etch and etch-and-rinse groups (P < 0.05). For all groups, the only statistically significant difference was found when baseline and 36-month evaluations were compared in terms of marginal staining (P = 0.000). When the marginal adaptation values at 36 months were compared with those at the baseline, statistically significant differences were found in the etch-and-rinse and self-etch mode groups (P < 0.05). Neither secondary caries nor postoperative sensitivity was observed at any recall. CONCLUSION: All adhesive modes showed similar retention rates. Although all restorations were clinically acceptable, restorations in self-etch mode showed less satisfying performance for marginal staining and marginal adaptation. CLINICAL RELEVANCE: At the end of 36 months, the Single Bond Universal adhesive received acceptable scores according to the modified United States Public Health Service (USPHS) criteria. However, clinicians should be aware that its use in self-etch application mode tends to result in marginal staining and marginal deterioration when compared with etch-and-rinse and selective-etch application modes.


Assuntos
Resinas Compostas , Adaptação Marginal Dentária , Restauração Dentária Permanente , Colo do Dente/patologia , Adulto , Bis-Fenol A-Glicidil Metacrilato , Cárie Dentária , Cimentos Dentários , Adesivos Dentinários , Diagnóstico Bucal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cimentos de Resina , Adulto Jovem
7.
Clin Oral Investig ; 24(3): 1321-1331, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31297659

RESUMO

OBJECTIVES: The purpose of this study was to evaluate the 2-year success of resin composite restorations in non-carious cervical lesions (NCCLs) using the direct or semi-direct techniques. MATERIALS AND METHODS: Thirty volunteers presenting with at least two NCCLs were included. Each participant received one restoration using the direct technique and the other using the semi-direct technique, totaling 60 restorations. Time for completing the treatment was computed. Assessments at baseline, 7 days, and 6, 12, and 24 months were performed using the modified United States Public Health Service criteria. Descriptive analysis was reported as a percentage of successful treatments. For inferential analysis, the Student t test was used to evaluate the differences between extension, depth, and time. The chi-square/Fisher tests were used to compare treatment success after each period (α = 0.05). The results were evaluated by using the Kaplan-Meier survival analysis. RESULTS: Differences were detected regarding mean ± standard deviation time, in which direct and semi-direct procedures were accomplished in 21.8 (± 14.5) and 35.3 (± 19.9) min, respectively. Of the 60 restorations placed, 7 failed in the direct group while 8 failed in the semi-direct group up to 2 years. No differences were detected between restorative protocols. The cumulative survival was 88.5% and 88.4% for the direct technique and semi-direct techniques after 24 months, respectively. CONCLUSION: The tested restorative protocols present similar results for NCCLs within the studied periods. CLINICAL RELEVANCE: The semi-direct technique exhibited clinical performance similar to direct technique for NCCL, demonstrating an alternative for restorations of these lesions.


Assuntos
Resinas Compostas , Restauração Dentária Permanente/métodos , Colo do Dente/patologia , Idoso , Adaptação Marginal Dentária , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
8.
J Dent ; 90: 103219, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31629030

RESUMO

OBJECTIVE: This study aimed to evaluate the addition of copper nanoparticles (CuNp) on the clinical performance of a universal adhesive system used as etch-and-rinse (ER) and self-etch (SE). METHODS: 216 restorations were randomly placed in 36 subjects according to the following groups: ERcu = etch-and-rinse with 0.1% CuNp; ERct = etch-and-rinse without CuNp; SEcu = self-etch with 0.1% CuNp; SEct = self-etch without CuNp. Resin composite was placed incrementally and light-cured. The restorations were evaluated at baseline and 6, 12 and 18 months using the FDI and USPHS criteria. Statistical analyses were performed using appropriate tests (α = 0.05). RESULTS: The addition of CuNp did not increase the clinical performance (FDI / USPHS) of the universal adhesive tested after 18-month when applied in the ER mode (p > 0.05). The addition of CuNp in SE restorations increased the retention rate significantly and decreased the marginal discrepancies after 18 months (p < 0.05). CONCLUSION: The clinical performance of universal adhesive was significantly increased when applied in the SE mode with the addition of copper nanoparticles. CLINICAL RELEVANCE: This is the first study that demonstrates a slight improvement in the clinical performance of universal adhesive systems in non-carious cervical lesions when added CuNp in lower concentration.


Assuntos
Cobre/química , Colagem Dentária , Restauração Dentária Permanente/métodos , Adesivos Dentinários/química , Cimentos de Resina/química , Colo do Dente/patologia , Resinas Compostas/química , Cimentos Dentários , Falha de Restauração Dentária , Método Duplo-Cego , Humanos
9.
J Dent ; 90: 103200, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31562889

RESUMO

OBJECTIVES: To assess the performance of a universal adhesive in different application modes in non-carious cervical lesions clinically and by optical coherence tomography (OCT). METHODS: 55 adult patients with three non-carious cervical lesions (NCCL) each participated in the study. Lesions were restored with Scotchbond™ Universal (SBU, 3 M) applied in the self-etch (SBU-SE) and the selective-enamel-etch mode (SBU-SEE) in combination with Filtek™ Supreme XTE (3 M). OptiBond™ FL (OFL, Kerr) was used as a control. Restorations were clinically assessed (FDI criteria) after 14 days, 6 and 12 months and in parallel imaged by OCT (interfacial adhesive defects), starting immediately after filling placement. Cumulative failure rates (CFR) and means of interfacial adhesive defect were statistically evaluated. RESULTS: After 12 months, CFRs were lower in the SBU groups (0.0% each) than in the OFL group (20.0%, p = 0.001). Clinically, small marginal fractures occurred three times more often in the SBU-SE than in the SBU-SEE group (p = 0.001). Immediately after filling placement and at each reassessment OCT revealed more interfacial defects at enamel interfaces for SBU/SE compared to SBU/SEE and OFL (pi ≤ 0.044). At dentin/cement more defects were seen with OFL compared to SBU/SE and SBU/SEE (pi ≤ 0.001). Before restoration loss, more interfacial defects appeared compared to remaining restorations (pimmediately/6M = 0.132/0.002). CONCLUSIONS: Clinical evaluation and OCT imaging revealed higher interfacial integrity for SBU in both application modes compared to OFL. OCT detected interfacial bond failures prior to clinical deterioration or restoration loss. CLINICAL SIGNIFICANCE: Scotchbond Universal showed an equivalent or improved bonding performance compared to the reference adhesive. Selective enamel etching is recommended. The parameter interfacial adhesive defect seems to be a valuable predictor for evaluation of adhesive restoration systems.


Assuntos
Colagem Dentária , Esmalte Dentário/diagnóstico por imagem , Restauração Dentária Permanente , Adesivos Dentinários/uso terapêutico , Tomografia de Coerência Óptica/métodos , Colo do Dente/diagnóstico por imagem , Doenças Dentárias/terapia , Adulto , Resinas Compostas/química , Cimentos Dentários , Esmalte Dentário/patologia , Adesivos Dentinários/química , Humanos , Cimentos de Resina/química , Colo do Dente/patologia , Resultado do Tratamento
10.
J Biol Regul Homeost Agents ; 33(4): 1013-1018, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31304689

RESUMO

The aim of this study is to develop a decision-making path for the management of non-carious cervical lesions (NCCLs) associated with or without dentin hypersensitivity (DH) This will allow to limit or delay invasive approaches identifying the causes that produced them. The need for this review is because there are no clear guidelines in the current literature for the treatment of NCCLs. Usually, the selection of the best therapy option is postponed to clinical judgment which can be influenced by a patient's demands (aesthetic, symptomatologic reasons or worsening of pre-existing NCCL). To establish a therapeutic plan the young dentist should be able to distinguish the NCCLs that need to be monitored over time from those in need of early treatment. Indeed, the experience of the dentist and the compliance of the patient play a decisive role for the success of the therapy.


Assuntos
Tomada de Decisão Clínica , Sensibilidade da Dentina/terapia , Manejo da Dor , Colo do Dente/patologia , Humanos , Dor
11.
J Endod ; 45(4): 459-470, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30771897

RESUMO

Despite the fact that external cervical resorption (ECR) is a well-known and rather frequently met condition, the driving force of this phenomenon still remains unclear. Recently, hypoxia has been linked to ECR. Thus, the aim of this work was to investigate the existence of hypoxia in ECR and hypothesize on its role at the time of extraction. This work is a case study of a tooth with ECR. ECR diagnosis was based on clinical and radiographic examination with cone-beam computed tomographic imaging. The extracted tooth was further analyzed by using nanofocus computed tomographic imaging and immunohistology. To investigate the 3-dimensional extent and pattern of ECR, in vivo cone-beam computed tomographic imaging and ex vivo nanofocus computed tomographic imaging were used. Different histologic stains were used to investigate the presence of a hypoxic environment and to gain a better insight into the involved cells, neuronal structures, and remodeling process during ECR. A higher distribution of hypoxia-inducible factor 1a-positive cells was found in the apical part of the resorption area when compared with the coronal area of the resorption. In addition, a similar distribution of hypoxia-inducible factor 1a-positive odontoblasts was observed in the pulp. Three-dimensional analysis of the calcification of the pulp revealed the formation of pulp stones in areas with higher hypoxia. Histology showed that remodeling during ECR can occur according to a layered pattern. This investigation confirms the presence of hypoxia in ECR and shows that there is a gradient of hypoxia within the ECR lesion and surrounding tooth structure. The hypoxic environment within the pulp is also indicated by the formation of pulp stones.


Assuntos
Hipóxia/complicações , Reabsorção da Raiz/etiologia , Reabsorção da Raiz/patologia , Colo do Dente/patologia , Adulto , Calcinose , Tomografia Computadorizada de Feixe Cônico , Polpa Dentária/diagnóstico por imagem , Polpa Dentária/patologia , Humanos , Hipóxia/metabolismo , Fator 1 Induzível por Hipóxia/metabolismo , Imageamento Tridimensional , Masculino , Radiografia Dentária , Reabsorção da Raiz/diagnóstico por imagem , Ápice Dentário/diagnóstico por imagem , Ápice Dentário/metabolismo , Ápice Dentário/patologia , Colo do Dente/diagnóstico por imagem , Extração Dentária
12.
Clin Oral Investig ; 23(9): 3551-3556, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30607621

RESUMO

OBJECTIVE: This study investigated the effect of toothbrush stiffness and dentifrice slurry abrasivity on the development and progression of simulated non-carious cervical lesions (NCCLs). MATERIALS AND METHODS: Human maxillary premolars were allocated to 12 groups generated by the association between toothbrushes, soft, medium, and hard stiffness, and simulated dentifrice slurries, lower, medium, and higher; deionized water (DI) served as negative control. Teeth were mounted on acrylic blocks, and their root surfaces partially covered with acrylic resin to simulate gingiva, leaving a 2-mm area apical to the cemento-enamel junction exposed to toothbrushing. Specimens were brushed with the test slurries for 35,000 and 65,000 double strokes. Impressions taken at baseline and after both brushing periods were scanned by a 3D optical profilometer. Dentin volume loss (mm3) was calculated by image subtraction. Data were analyzed using three-way ANOVA and Fisher's PLSD tests. RESULTS: All toothbrushes caused higher volume loss when associated to higher abrasive slurry, compared to medium- and lower-abrasive slurries. Medium caused more volume loss than lower-abrasive slurry, which led to more volume loss than DI. Hard and medium toothbrushes were not different when used with medium- or higher-abrasive slurries. There were no differences among toothbrushes when used with DI and lower-abrasive slurry. Overall, 35,000 brushing strokes resulted in significantly less volume loss than 65,000. CONCLUSIONS: Toothbrush stiffness was an important factor on NCCL development, especially when brushing with medium- and higher-abrasive slurries. CLINICAL RELEVANCE: Medium and hard toothbrushes associated with medium- and high-abrasive toothpastes can yield more severe NCCLs.


Assuntos
Dentifrícios , Abrasão Dentária , Colo do Dente , Escovação Dentária , Humanos , Colo do Dente/patologia , Escovação Dentária/instrumentação , Cremes Dentais
13.
J Oral Rehabil ; 46(1): 65-75, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30252966

RESUMO

OBJECTIVES: To evaluate whether the presence of non-carious cervical lesions (NCCLs) was related to the considered risk factors and to show the corresponding odds ratio in a predictive model. METHODS: The sample was 280 dentistry students. In an initial clinical examination, 140 cases were selected that presented one or more teeth with non-carious cervical wear. For each case, a similar sex and age control without any tooth with non-carious cervical lesions was selected. An occlusal examination and periodontal probing were performed in all cases and controls by skilled dentists. All the subjects answered a questionnaire referring to factors of brushing, bruxism, preferred chewing side, consumption of extrinsic acids and the presence of intrinsic acids. Data were analysed by means of univariate and multivariate logistic regression. RESULTS: Of all the study variables, only the protrusion interferences, interferences on the non-working side, the brushing force, CPITN value and the consumption of salads increase the risk of NCCLs in the univariate regression. The best predictive model was formed by the combination of CPITN variables >1, the consumption of acidic salads, self-reported bruxism, brushing force and attrition. However, it only correctly classifies 68.75% of subjects. CONCLUSIONS: This study supports the multifactorial aetiology of NCCLs, the combination of several factors being necessary to explain their presence. The risk factors that make up the predictive model are not sufficient to explain the appearance of NCCLs. Dentists should take into account all these risk factors in prevention, diagnosis and treatment.


Assuntos
Sensibilidade da Dentina/patologia , Colo do Dente/patologia , Desgaste dos Dentes/patologia , Escovação Dentária/estatística & dados numéricos , Ácido Acético/efeitos adversos , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Razão de Chances , Fatores de Risco , Desgaste dos Dentes/etiologia , Escovação Dentária/efeitos adversos , Adulto Jovem
14.
J Contemp Dent Pract ; 19(9): 1152-1156, 2018 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-30287720

RESUMO

BACKGROUND: Invasive cervical resorption (ICR) is a relatively uncommon form of external tooth resorption, characterized by an invasive nature. It is usually painless and detection of lesions is often made incidentally. Three-dimensional imaging techniques, such as cone beam computed tomography (CBCT), are useful in the diagnosis and management of ICR as the true extent of the defect cannot always be estimated using conventional radiographs. AIM: The aim of this article is to report on the successful treatment of ICR in mandibular first molar by nonsurgical approach and follow-up by means of CBCT. CASE REPORT: An 18-year-old patient was referred with a complaint of unusual radiolucency in the mesial cervical area of tooth #19 with unknown etiology. Cone beam computed tomography was performed to assess the extent of the lesion in three spatial levels and diagnosis of Heithersay class III ICR was made. This case presented with ICR (Heithersay class III) on tooth #19. Nonsurgical root canal treatment and removal of the lesion from the coronal access was performed; the resorptive defect was filled with dual-cure, self-adhesive, resin-modified glass ionomer cement (RMGIC); 6-month follow-up X-ray film showed no changes at the lesion site and tooth was asymptomatic; 1-year follow-up X-ray film showed slight mesial bone loss and a probing depth of 3 mm; finally, 2-year follow-up CBCT images showed no recurrence and no further bone destruction at the lesion site. CONCLUSION: The intraoral radiographs revealed the resorptive changes in two dimensions; therefore, the actual extent and location of the lesions are not fully understood. On the contrary, CBCT is a very useful tool to achieve a proper diagnosis; it detects the extent of the defect more accurately and hence, improves the treatment outcomes of ICR. CLINICAL SIGNIFICANCE: The ICR is usually seen as a late complication to traumatic injuries of the teeth; it is essential, therefore, that the patients who were exposed to situations that can damage the integrity of periodontal tissue need to have careful periodic recalls and X-ray examinations.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Tratamento Conservador/métodos , Dente Molar/diagnóstico por imagem , Radiografia Dentária , Tratamento do Canal Radicular/métodos , Colo do Dente/diagnóstico por imagem , Reabsorção de Dente/diagnóstico por imagem , Reabsorção de Dente/terapia , Adolescente , Seguimentos , Humanos , Mandíbula , Dente Molar/patologia , Fatores de Tempo , Colo do Dente/patologia
15.
J Adhes Dent ; 20(5): 435-452, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30349908

RESUMO

PURPOSE: To compare the the loss of retention and color match of glass-ionomer cements (GIC) and resin-based composites (RC) in noncarious cervical lesions. Other secondary outcomes (surface texture, marginal adaptation, marginal discoloration, and secondary caries) were evaluated in a systematic review and meta-analysis. MATERIALS AND METHODS: A comprehensive search was performed in PubMed, Scopus, Web of Science, LILACS, BBO, and Cochrane. We included only randomized clinical trials. The quality of the evidence for each outcome was assessed using the GRADE tool. RESULTS: A total of 1530 articles were identified, but only 19 reports remained for analysis, all of which were judged to possess "unclear" risk of bias. GIC showed higher retention rates in all follow-ups (1 to 3 years, p < 0.0001; at 5 years, p < 0.00001). No difference was observed for marginal discoloration, marginal adaptation and secondary caries in all follow-ups (p > 0.05). RC showed better color match than GIC only at 2 years (p = 0.03). Higher roughness was observed in GIC in all follow-ups (at 1 year p = 0.0003; at 3 years p = 0.0004). Quality of evidence was graded as moderate or low due to unclear risk of bias and imprecision in some outcomes. CONCLUSION: The loss of retention of RMGIC/GIC was inferior to that of RC, but a higher roughness was observed in the RMGIC/GIC when compared to RC in all follow-ups of the clinical studies evaluated. In addition, the color match was better with RC only in the 2-year follow-up when compared to GIC. The quality of evidence was judged as moderate to low in these two outcomes.


Assuntos
Resinas Compostas/química , Materiais Dentários/química , Restauração Dentária Permanente/métodos , Cimentos de Ionômeros de Vidro/química , Colo do Dente/patologia , Cor , Humanos , Propriedades de Superfície
16.
J Endod ; 44(11): 1749-1754, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30243659

RESUMO

According to the high number of articles published on invasive cervical resorption (ICR), this pathology, as commonly believed, is a more frequent form of cervical resorption. ICR is often misdiagnosed as internal resorption or caries, which leads to inappropriate treatment and even unnecessary tooth loss. Despite a correct diagnosis, the treatment of this type of hyperplastic invasive external resorption poses a challenge for the clinician. The Heithersay classification and the use of cone-beam computed tomographic imaging have increased our knowledge of the pathology and helped improve its prognosis. Nevertheless, there is no standard protocol for the treatment of this type of lesion. This article proposes a treatment protocol for ICR based on the pattern and location of resorption. Three treatment approaches (internal access, external access, and intentional replantation) are presented through 3 clinical cases.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Radiografia Dentária , Colo do Dente/diagnóstico por imagem , Reabsorção de Dente/diagnóstico por imagem , Reabsorção de Dente/terapia , Adolescente , Adulto , Cárie Dentária , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Masculino , Tratamento do Canal Radicular/métodos , Colo do Dente/patologia , Reimplante Dentário , Reabsorção de Dente/classificação , Reabsorção de Dente/patologia , Resultado do Tratamento
17.
J Dent ; 76: 93-97, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29940290

RESUMO

OBJECTIVES: The aim of this study was to evaluate the risk factors associated with noncarious cervical lesions (NCCLs), cervical dentin hypersensitivity (CDH), and gingival recession (GR), besides the relationship among these conditions in a specific Brazilian sample population. METHODS: 185 patients who attended the "Ambulatory Program for Rehabilitation of Patients with Noncarious Cervical Lesions and Cervical Dentin Hypersensitivity" were evaluated, and 5180 teeth were analyzed. The subjects filled out a form and a calibrated examiner performed the clinical exams to determine the presence of NCCLs, CDH, and GR. NCCLs were classified according to their morphology and depth, CDH levels were evaluated according to air stimuli response, and GRs were categorized according to Miller's classification. The association of the risk factors with NCCLs, CDH, and GR was determined with the Mann-Whitney U test and multiple linear regression. For the correlations, the Spearman test was used with a 95%-confidence level. RESULTS: The NCCLs, CDH, and GR distributions within the study were 88.1%, 89.1%, and 59.4%, respectively. Maxillary premolars were the most affected by all three conditions. A positive correlation was found between age, NCCLs, and GR; between NCCLs and CDH; CDH and GR; GR and NCCLs. Age, gender, oral hygiene, gastroesophageal diseases, and occlusal trauma were significantly associated with the presence of all three conditions. CONCLUSIONS: The NCCLs and GR distributions increased with age; NCCLs, CDH, and GR had positive correlation; the lesions' depth and morphology contributed to high levels of sensitivity and severity of recessions; age, gender, gastric disease, and occlusal trauma were relevant factors for the occurrence of NCCLs, CDH, and GR. CLINICAL SIGNIFICANCE: The increasing distribution of NCCLs, CDH, and GR is closely associated with people's lifestyles. Thus, it is important for the clinicians to recognize the etiological factors and their most relevant associations to prevent and control such alterations, in order to improve the population's quality of life.


Assuntos
Sensibilidade da Dentina , Retração Gengival , Colo do Dente , Adulto , Brasil/epidemiologia , Estudos Transversais , Sensibilidade da Dentina/epidemiologia , Feminino , Retração Gengival/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Fatores de Risco , Doenças Estomatognáticas/epidemiologia , Colo do Dente/patologia
18.
Oral Health Prev Dent ; 16(2): 131-136, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29736491

RESUMO

PURPOSE: To assess periodontal parameters of noncarious cervical lesions (NCCLs) restored with glass-ionomer cement (RM-GIC) and composite resin at baseline, three and six months. MATERIALS AND METHODS: Eighteen patients with bilateral lesions were included in the study. Lesions (1 mm in depth) were randomly restored with each type of restorative material. Probing depth (PD), relative gingival recession (rGR), relative clinical attachment level (rCAL), visible plaque index (VPI) and gingival bleeding index (GBI) were measured. RESULTS: No statistically significant differences were found when comparing within groups (p > 0.05). However, the intergroup analysis demonstrated a decrease in GR and rCAL gain for teeth restored with the resin-modified glass-ionomer cement (RM-GIC). CONCLUSION: Both materials behaved similarly when in close contact with periodontal tissues and did not influence periodontal parameters.


Assuntos
Resinas Compostas/uso terapêutico , Restauração Dentária Permanente/métodos , Retração Gengival/cirurgia , Cimentos de Ionômeros de Vidro/uso terapêutico , Colo do Dente/cirurgia , Adulto , Idoso , Índice de Placa Dentária , Feminino , Retração Gengival/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Nanopartículas , Perda da Inserção Periodontal , Índice Periodontal , Colo do Dente/patologia
19.
Int Endod J ; 51(11): 1205-1223, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29704466

RESUMO

External cervical resorption (ECR) is the loss of dental hard tissue as a result of odontoclastic action. It is a dynamic process that involves periodontal, dental and in later stages pulpal tissues. Over the last two decades, ECR has attracted increased interest; this is in part due to novel micro-CT and histopathological techniques for its assessment and also improved radiographic detection using CBCT. This literature review will cover the aetiology, potential predisposing factors, histopathology and diagnosis of ECR. Part 2 will cover the management of ECR.


Assuntos
Reabsorção da Raiz/diagnóstico por imagem , Reabsorção da Raiz/etiologia , Reabsorção da Raiz/patologia , Colo do Dente/diagnóstico por imagem , Colo do Dente/patologia , Perda do Osso Alveolar/patologia , Tomografia Computadorizada de Feixe Cônico/métodos , Bases de Dados Factuais , Cárie Dentária , Polpa Dentária/diagnóstico por imagem , Polpa Dentária/patologia , Humanos , Imageamento Tridimensional/métodos , Radiografia Dentária Digital/métodos , Dente/diagnóstico por imagem , Dente/patologia , Microtomografia por Raio-X/métodos
20.
J Dent ; 69: 60-69, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28962842

RESUMO

OBJECTIVE: This double-blind randomized clinical trial evaluates the influence of dentin roughening (RO) on the clinical behavior of a new universal multi-mode adhesive (Tetric N-Bond Universal; Ivoclar-Vivadent) applied as self-etch and as etch-and-rinse in non-carious cervical lesions (NCCLs). METHODS: A total of 192 restorations were randomly placed in 48 patients according to the following groups: ER - Etch-and-rinse (no preparation); SE - self-etch (no preparation); ER+RO and; SE+RO. The resin composite Empress Direct (Ivoclar-Vivadent) was placed incrementally. The restorations were evaluated after one week (baseline), 6 and 18 months, using the FDI and USPHS criteria. Statistical analyses were performed using appropriate tests (α=0.05). RESULTS: Fifteen restorations were lost at 18 months (3 for SE, 2 for ER, 5 for SE+RO and 5 for ER+RO) (p >0.05 between groups). Post-operative sensitivity wasn't observed in any of the recall periods. Eighty-four restorations were considered to have minor discrepancies in marginal adaptation at the 18-month recall using the FDI criteria (24 for SE, 18 for ER, 22 for SE+RO and 20 for ER+RO; p >0.05 between groups). Nineteen restorations were considered to have minor discrepancies in marginal discoloration at the 18-month recall (10 for SE, 03 for ER, 05 for SE+RO and 01 for ER+RO; p >0.05 between groups). CONCLUSION: The dentin roughening before application of Tetric N-Bond Universal as self-etch and etch-and-rinse didn't affect the clinical behavior of composite restorations placed in NCCLs.


Assuntos
Restauração Dentária Permanente/métodos , Adesivos Dentinários/uso terapêutico , Dentina/patologia , Colo do Dente/patologia , Condicionamento Ácido do Dente/métodos , Resinas Acrílicas , Adulto , Análise de Variância , Resinas Compostas/química , Resinas Compostas/uso terapêutico , Cárie Dentária , Corrosão Dentária/métodos , Adaptação Marginal Dentária , Materiais Dentários , Falha de Restauração Dentária/estatística & dados numéricos , Sensibilidade da Dentina , Método Duplo-Cego , Feminino , Humanos , Masculino , Teste de Materiais , Pessoa de Meia-Idade , Poliuretanos , Cimentos de Resina , Propriedades de Superfície , Fatores de Tempo , Descoloração de Dente , Adulto Jovem
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