LED photobiomodulation effect on the bleaching-induced sensitivity with hydrogen peroxide 35%-a controlled randomized clinical trial.

OBJECTIVES: The aim of this study was to evaluate the effect of a protocol of photobiomodulation (PBM) with light-emitting diodes (LED) on the clinical risk of bleaching-induced sensitivity. MATERIALS AND METHODS: Sixty-four volunteers were selected and randomly divided in two groups, placebo (PG) and LED (LG). The LG received PBM irradiation and tooth bleaching, while the PG received tooth bleaching and simulation of the irradiation. The occurrence of painful sensitivity was recorded during the dental bleaching; immediately after bleaching; and 24, 48, and 72 h after tooth bleaching. At the same measurement times, data were collected on the intensity of sensitivity (VAS and NRS scale) and teeth affected by bleaching-induced sensitivity. A questionnaire sought to measure how the painful sensitivity influenced basic daily activities. Tooth color measures were performed using subjective and objective methods. RESULTS: LED irradiation decreased the occurrence of sensitivity at all studied evaluation times as well as its intensity, with the exception of the 72-h data when both groups presented no difference. Teeth affected by bleaching-induced sensitivity were significantly greater in the PG. Color measurements presented no differences between the groups in the recently after and later measures. CONCLUSIONS: PBM with LED decreases sensitivity risk and sensibility intensity during and after office bleaching and causes no influence on the shade degree of whitening achieved. The decrease in tooth sensitivity provided more comfort and less suffering while drinking. CLINICAL RELEVANCE: LED irradiation is a promising intervention in the control of bleaching-induced sensitivity. TRIAL REGISTRATION: RBR-7hpfwj. Sensitivity intensity measured by the VAS scale (0-10) in the first whitening session (Graphic A) and second whitening session (Graphic B). Significance level set at ≤ 5%. *Mann-Whiteney U test. Columns followed by the same letter are significant different (ap < 0.001; bp < 0.001; cp < 0.001; dp =0.013; ep < 0.001; fp < 0.001; gp < 0.001; hp = 0.002).

Opalescence and color stability of composite resins: an in vitro longitudinal study.

OBJECTIVES: This study aims to evaluate the opalescence (OP) and color stability of composite resins over a period of 180 days and to compare composite resins' OP with enamel's OP. MATERIALS AND METHODS: Twenty human enamel specimens (5.0 × 0.3 mm) and 9 specimens (10.0 × 1.0 mm) of 10 colors of 4 different composite resins (3 M ESPE, FGM, Ivoclar-Vivadent, Miscerium) and one brand of adhesive (3 M ESPE) were made. The results were obtained by measuring the reflectance and transmittance spectra in the visible region. After baseline measurement, composites and adhesive were analyzed after 2, 7, 30, 60, 120, and 180 days. The Lab color coordinates were used in the calculations of the OP parameter and color differences in the CIELab and CIEDE2000 methods. The data were analyzed statistically. RESULTS: The materials tested showed variation and an increase in OP over time. The OP found for enamel was 18.06 ± 2.99, and some resins showed higher results. There was a strong correlation between the coordinate b*T and the OP over time. Enamel Plus was the only one material that presented no color changes during all periods in both color analyses. Filtek Z350 XT, AT, and BT did not show differences in any time when analyzed by CIELAB. CONCLUSIONS: The OP of most composite resins changed during the period of 180 days and was different from the OP of tooth enamel. In general, composites demonstrated small color changes over the period tested, being this characteristic material dependent. CLINICAL RELEVANCE: Natural teeth present different optical properties. Composite resins restorations should present properties similar to natural teeth and it is important that characteristics like color and opalescence remain stable over time.

Heating and preheating of dental restorative materials-a systematic review.

OBJECTIVES: To perform a review on the influence of preheating and/or heating of resinous and ionomeric materials on their physical and mechanical properties and to discuss the benefits and methods of preheating/heating that have been used. MATERIAL AND METHODS: A search was performed in the Pubmed, Scopus, Scielo, and gray literature databases. In vitro studies published from 1980 until now were searched using the descriptors "composite resins OR glass ionomer cements OR resin cements OR adhesives AND heating OR preheating." Data extraction and quality of work evaluation were performed by two independent evaluators. RESULTS: At the end of reading the search titles and abstracts, 74 articles were selected. Preheating of composite resins reduces viscosity, facilitates adaptation to cavity preparation walls, increases the degree of conversion, and decreases the polymerization shrinkage. Preheating of resin cements improves strength, adhesion, and degree of conversion. Dental adhesives showed good results such as higher bond strength to dentin. However, unlike resinous materials, ionomeric materials have an increase in viscosity upon heating. CONCLUSIONS: Preheating improves the mechanical and physical properties. However, there is a lack of clinical studies to confirm the advantages of preheating technique. CLINICAL RELEVANCE: Preheating of dental restorative materials is a simple, safe, and successful technique. In order to achieve good results, agility and training are necessary so the material would not lose heat until the restorative procedure. Also, care is necessary to avoid bubbles and formation of gaps, which compromises the best restoration performance.

Diacetylcurcumin: a new photosensitizer for antimicrobial photodynamic therapy in Streptococcus mutans biofilms.

This study evaluated the effect of antimicrobial photodynamic therapy (aPDT) on S. mutans using diacetylcurcumin (DAC) and verified DAC toxicity. In vitro, S. mutans biofilms were exposed to curcumin (CUR) and DAC and were light-irradiated. Biofilms were collected, plated and incubated for colony counts. DAC and CUR toxicity assays were conducted with Human Gingival Fibroblast cells (HGF). In vivo, G. mellonella larvae were injected with S. mutans and treated with DAC, CUR and aPDT. The hemolymph was plated and incubated for colony counts. Significant reductions were observed when DAC and CUR alone were used and when aPDT was applied. HGF assays demonstrated no differences in cell viability for most groups. DAC and CUR reduced the S. mutans load in G. mellonella larvae both alone and with aPDT. Systematic toxicity assays on G. mellonella demonstrated no effect of DAC and CUR or aPDT on the survival curve.

Susceptibility to Coffee Staining during Enamel Remineralization Following the In-Office Bleaching Technique: An In Situ Assessment.

PURPOSE: To assess in situ the enamel mineralization level and susceptibility to coffee staining after in-office bleaching. MATERIALS AND METHODS: Thirty-six human dental fragments assembled into intraoral devices were bleached with 35% hydrogen peroxide and treated as follows: (group 1) no contact with coffee; (group 2) immersion in a coffee solution for 30 minutes daily for 7 days, starting 1 week after bleaching; and (group 3) immersion in a coffee solution for 30 minutes daily for 14 days, starting immediately after bleaching. Enamel mineralization and color were assessed before bleaching (T1), immediately after bleaching (T2), and after 7 (T3) and 14 days (T4). The CIE whiteness index (W*) and closeness to white (ΔW*) following bleaching and/or immersion in coffee were calculated. Data were analyzed with Friedman and Wilcoxon tests or Kruskal-Wallis and Mann-Whitney U-tests (α = 0.05). RESULTS: Significant differences in the mineralization levels were observed as a function of time. No significant differences in W* were observed between groups, nor was W* significantly different at T3 and T4. Similar ΔW* was observed between groups after 7 or 14 days. CONCLUSIONS: The mineral loss after in-office bleaching was progressively reversed by contact with saliva for 14 days. The whiteness index was not affected by contact with coffee during the remineralization period. CLINICAL SIGNIFICANCE: The results of this in situ study suggest that the mineral loss caused by in-office dental bleaching is minimal and is partly compensated by remineralization due to contact with saliva. Additionally, whiteness was not affected by daily exposition to coffee during the enamel remineralization, which indicates that avoiding the consumption of coffee immediately following in-office bleaching is unnecessary. (J Esthet Restor Dent 28:S23-S31, 2016).

Association of Oral Health Teams implantation with collective actions and extractions in Paraná State, Brazil. / Associação da implantação de Equipes de Saúde Bucal com ações coletivas e exodontia no Estado do Paraná, Brasil.

This article aims to monitor the indicators of outpatient production of Dentistry and to evaluate the association of collective action and extraction indicators with the number of Oral Health Teams (OHT) between 2006 and 2015 in Paraná. In this longitudinal ecological study, consolidated secondary data were analyzed (collective actions of supervised brushing-SB, topical application of fluoride-TAF, fluoride mouthwash-FM, oral examination for epidemiological purposes-OE and extractions of permanent teeth-EX) from the Ambulatory Information System (SIA-SUS) and OHT numbers from the National Registry System of Health Establishments. Descriptive analyzes and Pearson's correlation were performed, with significance level of p<0.05. It was verified the increase of the OHT implantation over time and a strong positive correlation with collective procedures of SB (r=0.78; p=0.007) and FM (r=0.76; p=0.011) and moderate negative correlation with EX (r=-0.53). It was concluded that the evaluated indicators showed that the implementation of Oral Health Teams may have contributed to changes to the healthcare model, with an increase in preventive collective procedures and reduction of tooth loss in Paraná.

O artigo tem por objetivo monitorar a produção ambulatorial em Odontologia e avaliar a associação de indicadores de ação coletiva e exodontia com o número de Equipes de Saúde Bucal (ESB) entre 2006 e 2015, no Paraná. Neste estudo ecológico longitudinal foram analisados dados secundários consolidados (ações coletivas de escovação supervisionada-ES, aplicação tópica de flúor-ATF, bochecho fluorado-BF, exame bucal com finalidade epidemiológica-EB e exodontia de dente permanente-EXO) do Sistema de Informação Ambulatorial e números de ESB no Sistema de Cadastro Nacional de Estabelecimentos de Saúde. Foram realizadas análises descritivas e correlação de Pearson, com nível de significância de p<0,05. Verificou-se um aumento de ESB implantadas ao longo do tempo e correlação forte positiva com procedimentos coletivos de ES (r=0,78; p=0,007) e BF (r=0,76; p=0,011) e correlação moderada negativa com EXO (r=-0,53). Conclui-se que os indicadores avaliados demonstraram que a implantação de Equipes de Saúde Bucal pode ter contribuído para mudanças no modelo de atenção, com aumento dos procedimentos coletivos preventivos e redução de perdas dentárias no Paraná.

Evaluation of the influence of light-curing units on the degree of conversion in depth of a bulk-fill resin.

BACKGROUND: It is known that bulk-fill have been widely studied and used by dentists in the clinic. However, the use of light-curing units that do not have the ability to adequately light-cure these materials at the appropriate depth can affect their clinical performance. The aim of this study was evaluating the influence of 5 different light curing units (LCUs) on the degree of conversion (DC) of a bulk-fill resin at depths of 0 to 4 mm and determined the effect of using 20s exposure and 40s. MATERIAL AND METHODS: Cylinders of composite were made in a stainless steel matrix (n=10). The specimens were exposed from the top surface using 5 LCUs: Valo® Cordless (VA); Radii Plus (RA); Emitter.D (EM), Biolux Plus (BI), Woodpecker® (WO). The emission wavelength and the power density was determined. After the photoactivation, the Raman vibrational modes were calculated taking as reference the peaks at 1,601 (aromatic bonds C=C) and 1,640 cm-1 (aliphatic bonds C=C). RESULTS: The largest difference in DC in 20s, comparing the values obtained in the first and last layer is for BI, with a variation from 61.24% to 53.86%. Comparing the LCUs, the last layer in 40s DC values are 57.40% (BI), 58.21% (WO), 58.97% (VA), 60.90% (RA) and 62.42% (EM). The higher the dose (J/cm²) and the close the λmax is to the maximum CQ absorption length (λmax ~ 470 nm) the better the DC value. CONCLUSIONS: There was a significant difference in the DC values between the LCUs with increasing depth of the bulk-fill increments. Results indicate significant differences in DC among the different LCUs as well as enhanced DC when using 40s exposure compared to 20s. It is suggested that for DC improvement using lower power photoactivator increase the exposure time the exposure time should be 20s to 40s. Key words:Polymerization, Composite Resins, Raman spectroscopy.

System dynamics modeling for tooth decay treatment in Brazilian children.

Prevention and health promotion are considered important strategies to control oral diseases. Dental caries is preventable disease and remains the most common chronic disease that affects mainly low income children and still considered the main cause of tooth loss in adulthood in Brazil. The aim of this study is to present a System Dynamics model (SDM) specifically developed with the Stella Architect software to estimate the cost and clinical hours required to control the evolution of dental caries in preschool children in Maringá, Brazil. Two main strategies to control caries were considered in the model: the application of fluoride varnish on teeth presenting white spots, and the use of Atraumatic Restorative Treatment (ART) in cavitated carious lesions without pulp involvement. The parameters used in the model were: number of people covered by a local oral health team = 4,000; number of children up to 5 years = 7% of the population; children's decayed, missing, filled teeth (dmft) index = 2.4; time/cost of 4 applications of fluoride varnish = 5 minutes/US$ 0.716; and time/cost of each ART restoration = 15 minutes/US$ 1.475. The SDM generated an estimated total cost of US$698.00, and a total of 112 clinical hours to treat the population in question. The use of the SDM presented here has the potential to assist decision making by measuring the material and human resources required to prevent and control dental caries at an early age.

In vitro evaluation of composite resin fluorescence after natural aging.

BACKGROUND: Some composite resins contain luminophorous agents in order to reproduce tooth fluorescence. The objective of this study was to compare the fluorescence spectra emitted by composite resins with those of human enamel and dentin, and their emission behaviour after a 90-day natural aging period. MATERIAL AND METHODS: Nine shades of the composite resins Z350XT/3M (XT), Opallis/FGM (OP) and Empress Direct/Ivoclar-Vivadent (ED) were analyzed. Five specimens (10.0 mm x 2.0mm) were fabricated for each shade. Enamel (5.0 mm x 0.30 mm) and dentin (5.0 mm x 1.0 mm) specimens were obtained from sound human third molars. Fluorescence spectra of human dentin and enamel as well as the composite specimens immediately after fabrication were measured at the excitation peaks of 375, 395 and 410 nm. To assess composite resin fluorescence intensity changes over time, measurements were conducted after 30, 60 and 90 days, at 395 nm. Differences in fluorescence intensity over time were analyzed with ANOVA and Tukey's test (p<0.05). RESULTS: Fluorescence spectra baseline values of composites demonstrated no differences in intensity among the excitation peaks tested, with maximum emission found at the peak of 450 nm. Enamel and dentin spectra varied with different excitations, and the greater the excitation, the longer the wavelength in comparison to composite resins. After 90 days, XT presented an increase in fluorescence intensity, while OP and ED showed a reduction when compared with baseline values. CONCLUSIONS: Fluorescence intensity of composite resins changed during the period analyzed, with an emission behavior different from that of human enamel and dentin. The main changes occurred in the first 30 days. Key words:Composite resins, dental materials, fluorescence, fluorescence spectrometry.

Meta-analysis of the clinical behavior of posterior direct resin restorations: Low polymerization shrinkage resin in comparison to methacrylate composite resin.

Polymerization shrinkage of resin composite can compromise the longevity of restorations. To minimize this problem, the monomeric composition of composites have been modified. The objective of this study was to conduct a meta-analysis to assess the clinical behavior of restorations performed with low polymerization shrinkage resin composite in comparison with traditional methacrylates-based resin composite. This systematic review was registered at Prospero data system (CRD42015023940). Studies were searched in the electronic databases PubMed, Web of Science, Scopus, Lilacs and EMBASE according to a predefined search strategy. The inclusion criteria were as follow: (1) randomized controlled clinical trials with at least six months of follow-up; (2) studies investigating composites with monomers designed to reduce polymerization shrinkage; (3) studies conducted with class I or II restorations in the permanent dentition; and (4) studies that assessed at least one of the following criteria: marginal integrity/adaptation, marginal discoloration, recurent caries, retention of composite restorations, and postoperative sensitivity. Two independent reviewers analyzed the articles to determine inclusion and risk of bias. The search conducted in the databases resulted in a total of 14,217 studies. After reviewing the references and citations, 21 articles remained. The longest clinical follow-up time was 60 months. The meta-analysis of the data in the included studies demonstrated that only one variable (marginal adaptation after 12 months) showed statistically significant outcomes, in which methacrylates-based composites presented significantly better results than resin composites containing modified monomers. The good level of the scientific evidence as well as the overall low risk of bias of the included studies indicate that composites with silorane, ormocer or bulk-fill type modified monomers have a clinical performance similar to conventional resin composites.

Evaluation of photosensitizer penetration into sound and decayed dentin: A photoacoustic spectroscopy study.

BACKGROUND: Photodynamic therapy (PDT) may have topical indications. In those cases it is important for a topical photosensitizer to penetrate into the tissue to which it has been applied. This study aimed to compare the penetration of two different concentrations of erythrosine into intact and in vitro decayed dentin samples. METHODS: This in vitro study evaluated erythrosine (0.3 and 5%) penetration into sound (intact) and decayed dentin. A total of 11 dentin discs were prepared and divided into two equal halves, in order to keep one half sound while the other half was submitted to sterilization and an in vitro demineralization model for 5 days. Before erythrosine application, the organic and inorganic composition of all samples was evaluated by Fourier Transform Raman spectroscopy, and after erythrosine application for 30 min, the penetration depth was determined by Photoacoustic spectroscopy technique. RESULTS: The results indicated that 0.3% erythrosine showed a higher penetration depth into sound dentin (p = 0.002); and 5% erythrosine higher penetration into decayed dentin (p < 0.001). However considering clinical parameters, no statistically significant difference was found between any of the conditions tested. CONCLUSIONS: Erythrosine demonstrated ability to penetrate into dentin, irrespective of sound or decayed condition. Photoacoustic spectroscopy can be considered a method for estimating the penetration into hard tissues, and in conjunction with Raman spectroscopy, these are effective methods for evaluating the spectral response of dentin. Considering that erythrosine is capable of penetrating into decayed dentin, clinical trials are needed to test the effectiveness of this photosensitizer in Photodynamic therapy and Antimicrobial Photodynamic therapy.

Oral healthcare management practices in Brazil: systematic review and metasummary

Universal health coverage is a global target included in the United Nations Sustainable Development Goals agenda for 2030. Healthcare in Brazil has universal coverage through the Unified Health System (SUS), which guarantees health as basic right to the Brazilian population. Considering the principles of SUS, public oral healthcare management is a huge challenge. Aim: To identify good management practices for quality care adopted by local public oral healthcare managers and teams around Brazil. Methods: This study was registered with PROSPERO (CRD42017051639). Five databases (PubMed, Embase, Web of Science, Scopus and Lilacs) as well as the reference lists and citations of the included publications were searched according to PRISMA guidelines. Results:A total of 30,895 references were initially found, which were evaluated according to the defined eligibility criteria. Twenty qualitative studies, eight surveys and two mixed-model studies were selected. The practices (codes) were organized into three main groups (families), and the Frequency of the Effect Size (FES) of each code was calculated. Among the 20 codes identified, the most relevant ones were: Diagnosis and Health Planning (FES=80%) and Family Health Strategy(FES=66,7). The Intensity of the Effect Size of each study was also calculated to demonstrate the individual contribution of each study to the conclusions. Conclusion: The evidence emerging from this review showed that healthcare diagnosis, planning, and performance based on the family health strategy principles were the most relevant practices adopted by public oral healthcare managers in Brazil. The widespread adoption of these practices could lead to improved oral healthcare provision and management in Brazil

Radiographic Follow-Up during Orthodontic Treatment for Early Diagnosis of Sequential Supernumerary Teeth.

Most supernumerary teeth are impacted and asymptomatic. Objective. The aim of this paper is to describe two cases of sequential development of supernumerary teeth in the mandibular premolar region, identified during orthodontic treatment. Reports. The first case describes the radiographic follow-up of a female patient that presented a supernumerary tooth at the age of 9 years and 10 months in the right mandibular premolar region, followed by a further supernumerary tooth in the left mandibular premolar region identified at the age of 11 years and 3 months. In the second case, the radiographic follow-up of a male patient demonstrated 3 supernumerary teeth in the premolar region at the age of 16 years. During orthognathic surgery planning at the age of 20 years and 5 months, a supplemental supernumerary tooth was found in the left mandibular region. Conclusion. Considering the late developing of supernumerary premolars, appropriate follow-up with panoramic radiographs of patients with previous experience of supernumerary teeth is essential for early diagnosis of supplemental premolars to prevent possible complications.

Singlet oxygen production by combining erythrosine and halogen light for photodynamic inactivation of Streptococcus mutans.

BACKGROUND: Photodynamic inactivation of microorganisms is based on a photosensitizing substance which, in the presence of light and molecular oxygen, produces singlet oxygen, a toxic agent to microorganisms and tumor cells. This study aimed to evaluate singlet oxygen quantum yield of erythrosine solutions illuminated with a halogen light source in comparison to a LED array (control), and the photodynamic effect of erythrosine dye in association with the halogen light source on Streptococcus mutans. METHODS: Singlet oxygen quantum yield of erythrosine solutions was quantified using uric acid as a chemical-probe in an aqueous solution. The in vitro effect of the photodynamic antimicrobial activity of erythrosine in association with the halogen photopolimerizing light on Streptococcus mutans (UA 159) was assessed during one minute. Bacterial cultures treated with erythrosine alone served as negative control. RESULTS: Singlet oxygen with 24% and 2.8% degradation of uric acid in one minute and a quantum yield of 0.59 and 0.63 was obtained for the erythrosine samples illuminated with the halogen light and the LED array, respectively. The bacterial cultures with erythrosine illuminated with the halogen light presented a decreased number of CFU mL(-1) in comparison with the negative control, with minimal inhibitory concentrations between 0.312 and 0.156mgmL(-1). CONCLUSIONS: The photodynamic response of erythrosine induced by the halogen light was capable of killing S. mutans. Clinical trials should be conducted to better ascertain the use of erythrosine in association with halogen light source for the treatment of dental caries.

Fluoride concentrations in the water of Maringá, Brazil, considering the benefit/risk balance of caries and fluorosis.

Current Brazilian law regarding water fluoridation classification is dichotomous with respect to the risks of and benefits for oral diseases, and fluoride (F) concentrations less than 0.6 or above 0.8 mg F/L are considered outside the normal limits. Thus, the law does not consider that both caries and fluorosis are dependent on the dosage and duration of fluoride exposure because they are both chronic diseases. Therefore, this study evaluated the quality of water fluoridation in Maringá, PR, Brazil, considering a new classification for the concentration of F in water the supply, based on the anticaries benefit and risk of fluorosis (CECOL/USP, 2011). Water samples (n = 325) were collected monthly over one year from 28 distribution water networks: 20 from treatment plants and 8 from artesian wells. F concentrations were determined using a specific ion electrode. The average F concentration was 0.77 mg F/L (ppm F), ranging from 0.44 to 1.22 mg F/L. Considering all of the water samples analyzed, 83.7% of them presented from 0.55 to 0.84 mg F/L, and according to the new classification used, they would provide maximum anticaries benefit with a low risk of fluorosis. This percentage was lower (75.4%) in the water samples supplied from artesian wells than from those distributed by the treatment plant (86%). In conclusion, based on the new classification of water F concentrations, the quality of water fluoridation in Maringá is adequate and is within the range of the best balance between risk and benefit.

System dynamics modeling for tooth decay treatment in Brazilian children

Abstract Prevention and health promotion are considered important strategies to control oral diseases. Dental caries is preventable disease and remains the most common chronic disease that affects mainly low income children and still considered the main cause of tooth loss in adulthood in Brazil. The aim of this study is to present a System Dynamics model (SDM) specifically developed with the Stella Architect software to estimate the cost and clinical hours required to control the evolution of dental caries in preschool children in Maringá, Brazil. Two main strategies to control caries were considered in the model: the application of fluoride varnish on teeth presenting white spots, and the use of Atraumatic Restorative Treatment (ART) in cavitated carious lesions without pulp involvement. The parameters used in the model were: number of people covered by a local oral health team = 4,000; number of children up to 5 years = 7% of the population; children's decayed, missing, filled teeth (dmft) index = 2.4; time/cost of 4 applications of fluoride varnish = 5 minutes/US$ 0.716; and time/cost of each ART restoration = 15 minutes/US$ 1.475. The SDM generated an estimated total cost of US$698.00, and a total of 112 clinical hours to treat the population in question. The use of the SDM presented here has the potential to assist decision making by measuring the material and human resources required to prevent and control dental caries at an early age.

Clinical evaluation of the ART technique using high density and resin-modified glass lonomer cements.

PURPOSE: The aim of this study was to evaluate the performance of two different glass ionomer cements using the Atraumatic Restorative Treatment (ART) technique in permanent teeth. MATERIALS AND METHODS: A total of 473 ART restorations were placed in 208 schoolchildren (7-12 years of age) by two previously trained operators, using high density and resin-modified glass ionomer cements. All the restorations were photographed at baseline and the patients were asked about postoperative sensitivity. After a period of 8 months, 193 patients were present after recall and 428 restorations were evaluated and photographed. Two independent examiners carried out the evaluation. RESULTS: The results showed a success rate of 86.2% for occlusal restorations with Fuji IX and 88.4% for those restored with Fuji Plus. A total of 86.7% of the approximal restorations with Fuji Plus were also judged to be successful after 8 months. No association was found between the materials and the clinical performance of the ART restorations in class I cavities. CONCLUSION: The type of restorative material did not influence the success or failure rates in class I cavities within this period. Fuji IX showed promising performance for occlusal ART restorations and Fuji Plus is also a promising material for occlusal and approximal ART restorations.

Avaliação da solubilidade e sorção em água de alguns materiais restauradores diretos / Evaluation of solubility and sorption in water of some direct restorative materials

Resumo Introdução A solubilidade e sorção dos materiais restauradores são considerados fatores críticos, pois podem interferir na qualidade e durabilidade das restaurações. Objetivo Avaliar a solubilidade e sorção de água de alguns materiais restauradores. Material e método Foram confeccionados quatorze espécimes de cada um dos seguintes materiais: Equia® Forte, Z100, Fuji IX/ e Vidrion R, os quais foram levados a uma dessecadora e pesados diariamente até estabilização. Em seguida, foram inseridos em recipientes individuais contendo 40 mL de água destilada cada e divididos em dois grupos de acordo com o tempo de armazenagem: 7 ou 30 dias. Ao final de cada período, os espécimes foram retirados da água, pesados, levados à dessecadora e pesados novamente até estabilização. Os resultados foram analisados estatisticamente utilizando os testes ANOVA 2 critérios e Tukey. Resultado Com exceção do Equia® Forte e Z100, os demais materiais, apresentaram uma variação significativa da solubilidade ao longo do tempo. Quanto à sorção, observa-se que apenas o material Z100 não apresentou diferença significativa em relação ao tempo de armazenagem, mas, na comparação entre os materiais, todos apresentaram diferenças significativas em ambos os períodos. Conclusão Após os períodos de armazenagem de 7 e 30 dias em água, os materiais restauradores Equia® Forte e Z100 não apresentam variação significativa da solubilidade, sendo mais estáveis que os materiais Fuji IX e Vidrion R. Os materiais à base de ionômero de vidro, Equia® Forte, Fuji IX e Vidrion R, sofrem mais sorção em água quando comparados ao material Z100 em ambos os períodos.

Abstract Introduction The solubility and sorption parameters of restorative materials are considered critical factors since they may interfere with the quality and durability of restorations. Objective The aim of this study was to evaluate the solubility and water sorption of some restorative materials. Material and method Fourteen specimens were made (10.0 mm x 2.0 mm) of each of the following material: Equia® Forte, Z100, Fuji IX/ e Vidrion R, then taken to a desiccator and weighed daily until stabilized. They were then placed in individual containers with 40mL of distilled water each and divided into two groups according to the storage time: 7 or 30 days. At the end of each period, the specimens were removed from the water, weighed, taken to the desiccator and weighed again until stabilized. The results were analyzed statistically with two-way ANOVA and Tukey. Result Except for Equia® Forte and Z100, the other materials presented a significant variation of solubility over time. As for sorption, it was noticed that only Z100 presented no significant difference in relation to the storage time, but in comparison of the materials, all had significant differences in both 7 and 30 days periods. Conclusion After storage periods of 7 and 30 days in water, the restorative materials Equia® Forte and Z100 do not present significant variation of solubility, being more stable than the materials Fuji IX and Vidrion R. The glass ionomer-based materials, Equia® Forte, Fuji IX and Vidrion R, suffer more sorption in water when compared to Z100 material in both periods.

Factors that drive dentists towards or away from dental caries preventive measures: systematic review and metasummary.

BACKGROUND: Dental caries is a serious public health concern. The high cost of dental treatment can be avoided by effective preventive measures, which are dependent on dentists' adherence. This study aimed to evaluate the factors that drive dentists towards or away from dental caries preventive measures. METHODS AND FINDINGS: This systematic review was registered in PROSPERO (CRD42012002235). Several databases as well as the reference lists and citations of the included publications were searched according to PRISMA guidelines, yielding 18,276 titles and abstracts, which were assessed to determine study eligibility. Seven qualitative studies and 41 surveys (36,501 participants) remained after data extraction and interpretation. A total of 43 findings were abstracted from the reports and were grouped together into 6 categories that were judged to be topically similar: education and training, personal beliefs, work conditions, remuneration, gender, place of residence and patients. The main findings for adherence based on their calculated frequency effect sizes (ES) were teamwork (21%) and post-graduation (12%), while for non-adherence were biologicism (27%), and remuneration for preventive procedures (25%). Intensity ES were also calculated and demonstrated low prevalence of the findings. Quality assessment of the studies demonstrated that the methodological quality, particularly of surveys, varied widely among studies. CONCLUSIONS: Despite the questionable quality of the included reports, the evidence that emerged seems to indicate that further education and training coupled with a fairer pay scheme would be a reasonable approach to change the balance in favor of the provision of dental caries preventive measures by dentists. The results of this review could be of value in the planning and decision making processes aimed at encouraging changes in professional dental practice that could result in the improvement of the oral health care provided to the population in general.

Influence of exposure time to saliva and antioxidant treatment on bond strength to enamel after tooth bleaching: an in situ study.

OBJECTIVES: This study evaluated the influence of different exposure times to saliva in situ in comparison with an antioxidant treatment on composite resin bond strength to human enamel restored after tooth bleaching. MATERIAL AND METHODS: Forty human teeth specimens measuring 5x5 mm were prepared and randomly allocated into 5 groups with 8 specimens each: Gct (control group, restored on unbleached enamel); Gbl (restored immediately after bleaching); Gsa (bleached, treated with 10% sodium ascorbate gel for 60 min and restored); G7d (bleached, exposed to saliva in situ for 7 days and restored); and G14d (bleached, exposed to saliva in situ for 14 days and restored). Restored samples were cut into 0.8 mm2 sticks that were tested in microtensile. Specimens were microscopically analyzed and failure modes were classified as adhesive, cohesive, or mixed. Pretest and cohesive failures were not considered in the statistical analysis, which was performed with one-way ANOVA and Tukey's post-hoc test (α=0.05), with the dental specimen considered as the experimental unit. RESULTS: Mean bond strength results found for Gbl in comparison with Gct indicated that bleaching significantly reduced enamel adhesiveness (P<0.01). However, no statistically significant differences were found between Gct, Gsa and G7d (P>0.05). Bond strength found for G14d was significantly higher than for Gsa (P<0.01). Fractures modes were predominantly of a mixed type. CONCLUSIONS: Bonding strength to bleached enamel was immediately restored with the application of sodium ascorbate and exposure to human saliva in situ for at least 7 days. Best results were obtained with exposure to human saliva in situ for 14 days. Treatment with sodium ascorbate gel for 60 min may be recommended in cases patients cannot wait for at least 7 days for adhesive techniques to be performed.