Transferring Conditioned Partially Edentulous Ridge Form to a Master Cast.

Gingival conditioning techniques in prosthodontics aim to overcome bone and soft-tissue defects that often compromise the outcome of restorations in terms of esthetics, function, and biocompatibility. Whatever the technique used, it is essential to reproduce a regular concave gingival outline in order to recreate the natural aspect of the relationship between teeth and gingiva, eliminating black triangles. Transferring the details of the conditioned soft tissue to the laboratory technician with precision may be challenging. The authors hereby propose a novel technique to transfer the clinical aspect of the conditioned soft tissue to the master cast, using a customized metal framework to help ensure accuracy.

Evaluation of mercury contamination in patients and water during amalgam removal.

AIM: The aim of this study was to evaluate mercury levels in wastewater and in patients during the removal of dental amalgam restorations. MATERIALS AND METHODS: To test for mercury levels, patients were tested before and after amalgam restoration removal. To test for mercury emissions, samples of constant volume of wastewater from high-speed drills were collected before and during amalgam restoration removal. RESULTS: Although the systemic mercury levels were lower than the limit of biological tolerance, all patients had increased levels after dental restorations. All samples of wastewater had increased mercury levels too. CONCLUSION: The urinary levels of mercury increased with dental amalgam removal using a high-speed drill. During the process of amalgam removal, water used for cooling the dental drill was contaminated with mercury. CLINICAL SIGNIFICANCE: The mercury released by the physical action of the drill, the replacement material and especially the final destination of the amalgam waste can increase contamination levels that can be a risk for human and environment health.

Vascular leiomyoma in the oral cavity.

The aim of this study was to examine a case report of vascular leiomyoma located in the oral mucosa of the oral cavity. Vascular leiomyoma is a benign tumor arising from smooth muscle. One factor that makes vascular leiomyomas in the oral cavity rare is that there is little smooth muscle in the mouth. The most common histological subtype in the oral cavity is the vascular subtype. The greatest difficulty in histological diagnosis of this entity is the similarity in morphology with other malignancies, particularly of neural or fibroblastic lineage. Wide surgical resection is the only treatment reported in the literature with good results. The recurrence rate is very low if complete resection is achieved. The study of rare or unusual lesions is very important for the clinical diagnosis of vascular leiomyoma.

Assessment of acid neutralizing capacity in cola-based drinks and energy beverages by artificial saliva.

OBJECTIVE: To assess the pH of regular and light cola-based drinks and energy drinks, and examine the acid neutralizing capacity by the addition of artificial saliva. MATERIALS AND METHODS: Ten packages of each product purchased locally at different stores were evaluated. The pH was measured by a pH-electrode calibrated in standard buffer solutions. To assess the pH neutralizing capacity, 1 ml/min of artificial saliva was added until a pH of 5.5 set as a cutoff point was reached in the tested solution. The data were subjected to analysis of variance (ANOVA), at the 0.05 significance level. RESULTS: The surveyed beverages had an initial acidic pH, ranging between 2.3 and 3.4. The average amount of saliva required to raise the pH of the cola-based drinks above 5.5 ranged between 6.0 and 6.8 ml. Energy drinks used volumes between 11.3 and 12.5 ml; however, it was not possible to achieve a pH of 5.5. CONCLUSION: According to the methodology used, it was concluded that: (1) All beverages analyzed showed an initial acidic pH. (2) There was no statistical difference between the initial pH level and acid neutralization by the addition of artificial saliva in both regular and light drinks. It was not possible to reach the appropriate pH, set as the cutoff point, for the energy drinks.

Histometric study of resorption on replanted teeth with enamel matrix-derived protein.

BACKGROUND: Enamel matrix-derived proteins (Emdogain) stimulate the proliferation of periodontal ligament cells, contributing to their regeneration. AIM: This study was to perform histometric assessment of root surface resorption in replanted teeth with the use of Emdogain®. MATERIALS AND METHODS: Male Wistar rats (Rattus norvegicus), weighing 180 to 200 gm, were anesthetized, subjected to extraction of the upper right incisor tooth, which was then replanted into the alveoli with the following treatment: (a) control group--tooth with root canal filled with calcium hydroxide paste and (b) treated group--tooth with root canal filled with enamel matrix-derived protein. The animals were sacrificed 25 days after tooth replantation. The maxilla was processed to obtain thin sections (6 µ) and stained with hematoxylin and eosin. The resorption volume percentage of each dental element was calculated from the cementoenamel junction to the apex. RESULTS: Quantification of resorption revealed that Emdogaintreated teeth showed a lower percentage of resorption (31.58%) compared to controls (80.48%) (statistically significant values--t-test p-value=0.0431). CONCLUSION: It was concluded that Emdogain used as root canal filling has properties capable of showing a lower percentage of resorption in replanted teeth.

Sleep bruxism and anxiety level in children.

This study evaluated the association of level of anxiety in children with and without sleep bruxism (SB). The study was performed with 84 six- to eigth-years-old children, divided into two groups: with bruxism (BG) and without bruxism (CG). Following the criteria purposed by American Academy of Sleep Medicine (AASM) to determine SB, the presence of tooth wear has been verified through clinical examinations, and the parents have answered a questionnaire about their children's behavior and habits. Additionally, the State-Trait Anxiety Inventory for Children (STAIC) was applied to parents of the selected patients. Data analysis revealed a statistical significant difference between the groups (Student's t-test, p = 0.0136). Based on the results, anxiety assessment revealed that children with bruxism have reached higher levels in the STAIC scale than the non-bruxism group. Therefore, it indicates a direct relationship between the presence of anxiety disorder and the onset of bruxism in children.

Evaluaton of hexagon deformation of dental implant regarding to the insertion force

The aim of this study is to evaluate hexagon deformation of dental implant regarding to the insertion force, verifying the external hexagon platforms before and after each torque performed. Thereunto, 25 implants were selected and divided into 5 groups with 5 implants each one; every group received different torque 10N, 20N, 30N, 40N and 100N. A Surgical torque wrench was used, with the implant installation key, what established the insertion force for each group. The platform measurements were carried out before and after apply the torque by analyses of images acquired through implant platforms. We conclude, by this study methodology, 100N forces were able to cause changes on hexagon dimensions; however, it did not damage the prosthesis platform adaptation.

Effects from exposure to dental amalgam on systemic mercury levels in patients and dental school students.

OBJECTIVES: The purpose of this study was to evaluate the systemic mercury levels in urine of patients and dental school students caused by exposure to silver amalgam. It is currently believed that occupational exposure shows the highest rate of potential for poisoning by mercury. Dental professionals are part of that quota, introducing concerns regarding the handling of dental amalgam. MATERIALS AND METHODS: The study comprised 40 urine samples from 20 subjects, which were divided into four sampling groups: G1A (n = 10) composed of students before their first occupational contact; G1B (n = 10) composed of the same G1 students after their first contact; G2A (n = 10) composed of patients who needed to have dental restorations before amalgam removal; and G2B (n = 10) composed of patients who needed to have dental restoration after amalgam removal. Cold-vapor atomic absorption spectrophotometry (CVAAS) was used as the evaluation method. RESULTS: A statistically significant difference was found among dependent groups 1 and 2 (p = 0.0038), whereas mercury levels increased considerably after the first occupational contact of all subjects. CONCLUSIONS: Occupational exposure to dental amalgam poses a potential risk of increasing systemic mercury levels, although urine mercury levels in all the sample participants were below the limits of biologic tolerance.

Sleep bruxism and anxiety level in children

This study evaluated the association of level of anxiety in children with and without sleep bruxism (SB). The study was performed with 84 six- to eigth-years-old children, divided into two groups: with bruxism (BG) and without bruxism (CG). Following the criteria purposed by American Academy of Sleep Medicine (AASM) to determine SB, the presence of tooth wear has been verified through clinical examinations, and the parents have answered a questionnaire about their children’s behavior and habits. Additionally, the State-Trait Anxiety Inventory for Children (STAIC) was applied to parents of the selected patients. Data analysis revealed a statistical significant difference between the groups (Student’s t-test, p= 0.0136). Based on the results, anxiety assessment revealed that children with bruxism have reached higher levels in the STAIC scale than the non-bruxism group. Therefore, it indicates a direct relationship between the presence of anxiety disorder and the onset of bruxism in children.

Influence of hormonal variation on periodontal tissues during premenstrual and preovulatory periods

The aim of this work was to evaluate the hormonal influence on periodontal tissues in two moments: premenstrual and preovulatory, in women whose are in the reproductive phase between 18 and 45 years. The sample is composed by 30 women, who were analyzed following the inclusion criteria as: not pregnant women, who are not using contraceptive or other means of hormonal replacement, who were not in the menopause and who did not present systemic diseases. The periodontal exams were accomplished in two periods: premenstrual and preovulatory, when it was verified blee din gon probing (BOP) and probing depth (PD) indexes. The premenstrual period obtained greater bleeding on probing index when compared with preovulatory period, showing a statistically significant difference. However, in spite of the probing depth measurements have been greater in the premenstrual period (1.684±0.4728) than in the preovulatoryone (1.679 ± 0.4749); the differences were not statistically significant. Basin gon the resultsand according to the methodology used, it was possible conclude that the hormonal variation influences on periodontal tissues.

Avaliação do uso de membranas na infiltração de tecido conjuntivo em alvéolos de dentes recém-extraídos / Comparison of the use of membranes in conjunctive infiltration in alveoli freshly extracted teeth

O objetivo deste estudo foi avaliar o desempenho da membrana de celulose impregnada em doxiciclina e comparar esta com as membranas existentes na infiltração de tecido conjuntivo em alvéolos de ratos pós-exodontia. Utilizaram-se 36 ratos divididos em quatro grupos (controle - GC, membrana teflon - GT, membrana de polipropileno - GP e membrana de celulose impregnada com doxiciclina - GCD). Não houve diferença estatisticamente significante entre os grupos (p = 0,0856). Todas as membranas apresentaram um comportamento semelhante. Destaque- se o menor grau de infiltração observado no grupo das membranas de teflon.

The aim of this study was to evaluate the behavior of new membrane comparing to others trademarks available in the market as for decrease conjunctive tissue infiltration in the rat's alveoli after extractions. 36 rats were randomly divided in four groups (control - GC, Teflon membrane (Gore-tex) -GT, polypropylene membrane (bone heal) - GP, Test membrane (cellulose impregnated doxycycline - GCD). Anova test showed no statistic difference between groups (p value = 0,0852). Despite no statistical difference all the membranes showed similar behavior and was possible noticed that have been reduced the depth of tissue infiltration.

Histometric analysis of alveolar bone regeneration with expanded polytetrafluoroethylene (e-PTFE) and latex membranes

AIM: To investigate the amount of connective tissue migrated into the extraction socket using EPTFE and latex membranes. METHODS: Seventeen rats were selected and randomly divided into 3 groups: e-PTFE membrane (n = 6), Latex membrane (n = 6) and Control (no membrane, n=5). After extraction of the maxillary right incisor, the animals of the test groups were subjected to alveolar guided bone regeneration (GBR) surgery and received an expanded polytetrafluoroethylene (e-PTFE) and a latex membrane, respectively. Thirty days after surgery, the animals were killed and histometric analysis was done to evaluate the migration of connective tissue. Data were analyzed statistically by one-way ANOVA and multiple-comparison Tukey's test at 5% significance level. RESULTS: There was statistically significant difference between groups e-PTFE and Latex (p=0.001), and between groups e-PTFE and Control (p=0.012), but no significant difference was found between groups Latex and Control (p=0.416). CONCLUSIONS: The e-PTFE membrane showed better results and appeared more adequate for GBR therapy, forming a barrier to prevent the migration of connective tissue into the extraction socket. The latex membrane, on the other hand, did not show benefits over the control group.

Uso da membrana de látex em alvéolos de dentes recém-extraídos: relato de caso / Use of latex membrane in alveolar wound of following tooth extraction: a case report

O objetivo deste estudo foi relatar a avaliação feita radiograficamente no reparo alveolar de dentes extraídos, associados à utilização da membrana de látex. Foram selecionados pacientes sistemicamente saudáveis, com indicação para exodontia de segundo molar inferior direito onde se utilizou membrana de látex para estabilização do coágulo sanguíneo sobre o alvéolo dental. Deste foram tomadas radiografias pré e pós-operatórias onde se mensurou a perda óssea vertical. Não foi observado qualquer tipo de incômodo adicional pela presença da membrana de látex. Houve minimização da perda óssea vertical. Concluiu-se que a biomembrana de látex foi bem tolerada pelo paciente e auxiliou no processo cicatricial e de manutenção das dimensões do rebordo alveolar.

The aim of this study was to report a radiographical follow up of the reparation of sockets in recently extracted teeth using latex membranes. A group of systemical healthy patients with indication for extraction of lower right second molar were chosen and latex membrane to stabilize the blood clot on the dental socket were used. These radiographs were taken on pre and post-operative and vertical bone loss was measured. As results a minimization of vertical bone loss was noticed and we conclude that the latex membrane was well tolerated by the patients and helped with the healing and maintenance of the dimensions of the alveolar ridge.

Influência da variação do tempo de polimerização na resistência de união ao cisalhamento em diferentes cimentos para bráquetes ortodônticos / Influence of variation on polymerization time in the shear bond strength for different cements to orthodontic brackets

O objetivo foi avaliar a influência do tempo de fotopolimerização na resistência de união ao cisalhamento de diferentes agentes cimentantes. Utilizaram-se 32 pré-molares humanos do banco de dentes da Unisul. Após planificadas as faces vestibulares, cimentaram-se bráquetes ortodônticos (Abzil Standard Edgewise Agile, Abzil3M) utilizando-se para tal: Orthocem (FGM) e Transbond XT(3M) de acordo com as recomendações dos fabricantes, variando-se o tempo de polimerização em 20 e 40 segundos. Aplicando-se a nova one way aos resultados não houve diferença significativa ( p = 0 ,317122). Os cimentos testados apresentaram resultados de resistência de união ao cisalhamento sem diferença entre si. Não se observou influência da variação de tempo entre 20 e 40 segundos sobre a resistência de união ao cisalhamento nos cimentos testados.

This study evaluated the influence of curing time on shear bond strength of different cements activating them in times of 20 and 40s. We used 32 premolars recently extracted embedded in acrylic resin. After had flatted vestibular surface, orthodontics braces (Abzil Standard Edgewise Agile, Abzil3M) were cemented using to that Orthocem (FGM) and Transbond XT(3M) cements as recommended by manufacturers, just variation the polymerization time in 20 a nd 40 seconds. A nova one way showed no differences between groups (p value = 0,317122). The tested cements showed similar results between them. No polymerization time influence could be observed.

Incidência de lesões bucais na Universidade do Sul de Santa Catarina (Unisul) / Incidence of oral lesions in University of Southern Santa Catarina (Unisul)

Um dos maiores dilemas que o clínico encontra com respeito ao diagnóstico de lesões bucais é a variedade de possíveis condições que podem ocorrer, visto que se depara com um número extenso de diagnósticos diferenciais. Os objetivos deste estudo foram avaliar a incidência de lesões bucais encontradas na clínica de Estomatologia da Unisul, Tubarão - SC; analisar prontuários, observando sexo, idade, hábito de tabagismo ou não e alterações sistêmicas dos pacientes, correlacionando com o tipo de lesão que apresentarem; definir as lesões intrabucais mais frequentes no estudo e relatar suas características clínicas. As informações clínicas dos pacientes e as informações dos resultados foram obtidas por meio de consulta aos respectivos prontuários arquivados no serviço da disciplina, tendo sido pesquisados 64 laudos anatomopatológicos. As lesões mais frequentes foram a hiperplasia fibrosa inflamatória, a leucoplasia e o cisto periodontal apical.

Oxygen release, microleakage and shear bond strength of composite restorations after home dental bleaching / Liberação de oxigênio, microinfiltração e resistência de união ao cisalhamento em restaurações com resina composta após clareamento dental caseiro

PURPOSE: This in vitro study evaluated the effect of home dental bleaching on oxygen release, shear bond strength to enamel, and microleakage of direct composite restorations. METHODS: Forty bovine incisors were used for oxygen dissolved titration by means of iodometric methods modified by azide iodine and 26 for the shear bond strength and microleakage tests. For titration the teeth were divided into four groups: T1 - bleached and titrated after 24 h; T2 - bleached and titrated after 48 h; T3 - unbleached and titrated after 24 h; T4 - unbleached and titrated after 48 h. T5 group served as control for the initial oxygen release rate. To analyze shear bond strength and microleakage, the teeth were randomly divided into two groups: CM1 - bleached; CM2 - unbleached. The bleaching agent Opalescence 15 percent (Ultradent, South Jordan, UT, USA) was applied for 8 h per day for three weeks. Z 250 (3M-ESPE, St. Paul, MN, USA) composite and Single Bond (3M-ESPE, St. Paul, MN, USA) adhesive were used for the composite restoration procedures. RESULTS: There was an increase in oxygen release during the first 24 h post bleaching (ANOVA, P=0.0001). The bleached teeth showed a decrease in shear bond strength (Student's t test, P=0.0001). The microleakage scores increased with bleaching independently from the examiner (Wilcoxon's test: 1. P=0.0003; 2 P=0.0023; 3. P=0.0029). CONCLUSION: Considerable variation was noticed in the results of oxygen release, as well as in the results of shear bond strength and microleakage on bleached teeth.

OBJETIVO: Avaliaram-se os efeitos do clareamento dental caseiro na liberação de oxigênio a partir de dentes clareados, na resistência de união ao cisalhamento e microinfiltração de restaurações com resina composta. METODOLOGIA: Foram selecionados 40 incisivos bovinos para titulação dos níveis de oxigênio pelo método iodométrico e 26 dentes para resistência de união e microinfiltração. Para titulação os dentes foram divididos em 4 grupos: T1- clareado e titulado após 24 h; T2- clareado e titulado após 48 h; T3- não clareado e titulado após 24 h; T4- não clareado e titulado após 48 h. No grupo T5 não se usaram dentes, servindo como controle inicial do teor de oxigênio. Para cisalhamento associado a microinfiltração dividiram-se aleatoriamente os dentes em 2 grupos: CM1- clareado; CM2- não clareado. O regime de tratamento clareador (Opalescense a 15 por cento, Ultradent, South Jordan, UT, USA) foi de 8 h por dia durante 3 semanas. Para as restaurações utilizou-se a resina Z250 (3M-ESPE, St. Paul, MN, USA) com adesivo Single Bond (3M-ESPE, St. Paul, MN, USA). RESULTADOS: Houve aumento significativo na liberação de oxigênio durante nas primeiras 24 h pós clareamento (ANOVA, P=0,0001). O teste t de Student confirmou diminuição da resistência de união para o grupo clareado (P=0,0001). Houve significante aumento na microinfiltração no grupo clareado, independentemente do examinador (teste de Wilcoxon: 1. P=0,0003; 2. P=0,0023; 3. P=0,0029). CONCLUSÃO: Há considerável variação nos resultados de liberação de oxigênio, resistência de união e microinfiltração em dentes submetidos a clareamento dental caseiro.

Avaliação da resistência ao cisalhamento por extrusão (push-out) de pinos de fibra de vidro cimentados com diferentes cimentos resinosos em um ambiente úmido: Estudo Piloto / Evaluation of shear bond strength (push-out) of glass fiber posts cemented with different resin cements in humid ambient. Pilot study

Objetivo: O objetivo deste trabalho foi analisar a resistência ao cisalhamento por extrusão de diferentes cimentos empregados na cimentação de pinos de fibra de vidro em ambiente úmido. Material e métodos: Para tanto, 21 caninos humanos tiveram suas coroas removidas, de modo que se obtiveram 15 mm de remanescente radicular. Depois de tratados endodonticamente, os dentes foram preparados para receber pinos de fibra de vidro. Os dentes selecionados foram divididos aleatoriamente em sete grupos: Grupo I - RelyX ARC, Grupo II - Enforce, Grupo III - BISCEM, Grupo IV - DUO-LINK, Grupo V - Cemente Post, Grupo VI - Variolink II e Grupo VII - RelyX U100. Cada dente foi seccionado perpendicularmente ao longo do eixo do pino com disco diamantado de alta concentração, obtendo-se uma fatia de cada profundidade com espessura de, aproximadamente, 1 mm, retiradas a partir de 1 mm, 5 mm e 9 mm do limite cervical de cada raiz, totalizando-se 63 espécimes. A análise microscópica foi realizada nesses três níveis: superficial, médio e profundo. Após análise, os espécimes foram avaliados pelo teste de push-out. Resultados: O teste Anova a dois critérios mostrou diferenças estatisticamente significativas entre os terços, cimentos e interação entre eles (p < 0,05). O teste de Tukey mostrou que os cimentos resinosos autoadesivos (Biscem e U100) e o terço cervical radicular apresentaram resultados significativamente superiores no teste de push-out (p < 0,05). As fotomicrografias mostraram que houve fendas maiores nas regiões médias e apicais do que nas regiões cervicais. Conclusão: Os resultados deste estudo mostraram que os cimentos autoadesivos apresentaram resultados superiores quando comparados aos cimentos adesivos. A região radicular cervical apresentou os melhores resultados no teste de cisalhamento.

Aparelhos ortodônticos removíveis – passado, presente e futuro / Removable orthodontic appliances – past, present and future

Os aparelhos removíveis não constituem tema frequentemente abordado em debates ou artigos científicos atualmente, embora sejam amplamente utilizados no tratamento ortodôntico contemporâneo. De certa forma, este fato ocorre devido a uma tendência da Ortodontia em dedicar mais tempo e atenção às abordagens mecânicas que envolvam aparelhos fixos com bráquetes ou outros dispositivos mais “modernos”. Entretanto, atualmente movimentações ortodônticas tidas como mais dificultosas conseguem ser obtidas de modo satisfatório com o uso dos alinhadores, que constituem aparelhos ortodônticos removíveis sequenciais, confeccionados a partir de tecnologia computadorizada. Neste contexto, o presente artigo procura fazer uma revisão histórica sobre os aparelhos ortodônticos removíveis, buscando dados referentes desde o surgimento dos primeiros dispositivos, as evoluções sofridas pelos mesmos, bem como apresentar um caso clínico de disjunção maxilar com o uso de um aparelho removível, com sistema de retenção GCS, demonstrando sua eficácia na substituição dos grampos de retenção convencionais

Removable appliances are not an often topic of orthodontic discussion nowadays, although they are widely used in contemporary treatment. That occurs due to a tendency in Orthodontics according to which greater time and attention are given to mechanical approaches using fixed appliances with brackets or “modern” techniques. However, now even more troublesome orthodontic movement can be achieved with the use of aligners, which are sequential removable orthodontic appliances manufactured using computer technology. In this context, this article aims to make a historical review about the theme of removable appliances, seeking data since the appearance of the first devices, the enhancements, as well as presenting a case report of a rapid maxillary expansion realized with a removable appliance with a fixation system called GCS, showing its efficacy in replacing conventional orthodontic clasps.

Avaliação clínica do desempenho de TRA (tratamento restaurador atraumático) associado a um agente químico de remoção de cárie / Clinical performance of ART associated with a chemical agent for caries removal

Objetivo: O objetivo deste trabalho foi verificar o desempenho de tratamento restaurador atraumático (TRA) associado a um agente químico para remoção de cárie dentária. Metodologia: Foram selecionados 60 molares decíduos de crianças de 6 a 9 anos de ambos os sexos. Os dentes foram aleatoriamente divididos em dois grupos. Nas cavidades do grupo 1 foi aplicado o gel de papaína (Papacárie, Belo Horizonte, Brasil) previamente aos escavadores de dentina, enquanto no grupo 2 removeu-se a cárie somente com escavadores de dentina. Os grupos 1 e 2 foram subdivididos em 4 grupos (n=15 cada): grupos G1Mx e G2Mx restaurados com cimento de ionômero de vidro Maxion R (FGM, Joinville, Brasil) e grupos G1Me e G2Me restaurados com cimento de ionômero de vidro Meron (VOCO, Berlin, Alemanha). Após seis meses os dentes foram avaliados quanto a recidiva de cárie, sensibilidade, fístula e integridade da restauração. Resultados: Não houve diferença estatisticamente significativa entre os grupos para todos os critérios avaliados, independentemente do cimento usado (teste de Kruskal Wallis, P=0,055). Conclusão: Pode-se concluir que o gel de papaína não afetou negativamente os resultados da TRA.

Purpose: The aim of this study was to assess the clinical performance of ART associated with a chemical agent used for removal of dental caries. Methods: The sample consisted of 60 deciduous molars of children aged from 6 to 9 year-old. The teeth were randomly divided into two groups. In group 1 the cavities were treated with papain gel (Papacárie, Belo Horizonte, Brazil) before caries removal with dentine excavators, while in group 2 caries was removed only with manual instruments. Groups 1 and 2 were divided into 4 groups (n=15 each): groups G1Mx and G2Mx were restored with Maxion R glass-ionomer cement (FGM, Joinville, Brazil) and groups G1Me and G2Me were restored with Meron glass-ionomer cements (VOCO, Berlin, Germany). After six months the restored teeth were examined to evaluate the presence of recurrent caries, sensitivity, fistula, and integrity of the restoration. Results: No statistically significant difference was found among groups for all criteria evaluated, regardless of the cement material used (Kruskal Wallis test, P = 0.055). Conclusion: It can be concluded that the papain gel did not have a negative effect on clinical performance of ART.

Ausência de incisivos laterais superiores: o que observar para obter excelência no fechamento de espaço / Absence of upper lateral incisors: what to observe to achieve excellence for space closure

A estética do sorriso é determinada por critérios objetivos e subjetivos. A subjetividade está relacionada a fatores determinados pela própria sociedade, dentre os quais se destacam os padrões determinados pela mídia. Já os critérios objetivos podem e devem ser determinados como metas ou limitações da terapia escolhida. A terapia da agenesia de incisivos laterais superiores envolve duas principais alternativas de tratamento: o fechamento ortodôntico dos espaços e a abertura e manutenção dos espaços, os quais podem ser seguidos por procedimentos restauradores, protéticos e cirúrgicos periodontais ou de implantes

Smile esthetics is determined by subjective and objective criteria. Subjectivity is related to factors determined by the society, where standards set forth by the media stand out. Objective criteria not only may, but also should be determined by the expectations and limitations of the chosen alternative of treatment. The therapy of this case of agenesia of maxillary lateral incisors involved two main alternatives of treatment: orthodontic space closure and opening or maintenance of space, for future restoration, prosthetic rehabilitation or periodontal/implant surgical procedures