Otosporin reduz reação pulpar inflamatória após clareação dentária de molares de ratos / Otosporin reduces pulp inflammatory reactions after dental bleaching of rat molars

Pacientes submetidos à clareação dentária relatam sensibilidade pós-operatória relacionada ao peróxido de hidrogênio (H2 O2 ) que penetra no tecido pulpar. Objetivo: Avaliar o efeito anti-inflamatório do ibuprofeno, Otosporin® e gel de curcumina na polpa dentária de ratos após procedimento clareador. Métodos: Cinquenta ratos foram divididos em GC ­ controle (gel placebo); CLA ­ clareação (H2 O2 35%, 30 minutos); CLA-I ­ clareação e administração oral de ibuprofeno (duas vezes a cada 12 horas, 2 dias sucessivos); CLA-O ­ clareação seguida da aplicação de Otosporin® nas superfícies dos molares (10 minutos); e CLA-C ­ sessão clareadora seguida do gel de curcumina (10 minutos). Após dois dias, os ratos foram mortos para análise histológica e testes estatísticos foram realizados(p<0,05). Resultados: CLA, CLA-I e CLA-C apresentaram inflamação severa ou necrose no terço oclusal da polpa coronária (p>0,05); CLA-O apresentou inflamação leve e foi semelhante ao GC (p>0,05) e dife- rente dos outros grupos (p<0,05). No terço médio, o grupo CLA-O apresentou menor infiltrado inflamatório e permaneceu diferente do grupo CLA (p<0,05); CLA, CLA-I e CLA-C foram semelhantes (p>0,05). No terço cervical, CLA, CLA-I e CLA-C tiveram redução da inflamação, sem diferença entre os grupos clareados (p>0,05). Conclusões: O Otosporin® pode reduzir a inflamação na polpa após clareação dentária; esse resultado não foi observado utilizando ibuprofeno ou gel de curcumina. Portanto, esse estudo mostra uma nova possibilidade de pós-tratamento em dentes clareados por meio do uso de Otosporin®, que minimiza a inflamação gerada ao tecido pulpar pelo gel clareador. Consequentemente, poderá haver redução da sensibilidade pós-operatória (AU).

Introduction: Patients undergoing dental bleaching relate to postoperative sensitivity, that is linked to hydrogen peroxide (H2 O2 ) penetrating on the dental pulp. This study evaluated the anti-inflammatory effect of ibuprofen, Otosporin®, and curcumin gel on the pulp of the rats' teeth after bleaching. Methods: Fifty rats were divided into CG: controlplacebo gel; BLE: bleached (35% H2O2, 30 minutes); BLE-I: bleached and ibuprofen oral administration (twice every 12 hours in 2 successive days); BLE-O: bleached followed by Otosporin® application in the molar surfaces (10 minutes); and BLE-C: bleaching session followed curcumin gel (10 minutes). After two days, the rats were killed for histological analysis. Statistical tests were performed (P<.05). Results: BLE, BLE-I, and BLE-C had severe inflammation or necrosis in the occlusal third of coronal pulp (P>.05); BLE-O had mild inflammation and was similar from CG (P>.05) and different from other groups (P<.05). In the middle third, BLE-O group had lower inflammatory infiltration and remained different from BLE group (P<.05); BLE, BLE-I, and BLE-C were similar (P>.05). In the cervical third, BLE, BLE-I, and BLE-C had a reduction of inflammation, without difference between bleached groups (P>.05). Conclusions: Otosporin® can reduce the inflammation in the pulp after dental bleaching; this result was not observed using ibuprofen or curcumin gel. Therefore, this study shows a new teeth bleaching posttreatment possibility using Otosporin®, which minimizes the inflammation generated to the pulp tissue by the bleaching gel. This could consequently minimize the postoperative sensitivity (AU).

Influence of skin cold sensation threshold in the occurrence of dental sensitivity during dental bleaching: a placebo controlled clinical trial

Abstract Objective This study verified the occurrence of dental sensitivity in patients submitted to a 35% hydrogen peroxide based product (Whiteness HP Maxx 35% - FGM), skin cold sensation threshold (SCST) and its influence on dental sensitivity. Material and Methods Sixty volunteers were divided into 4 groups (n = 15), according to SCST (low: GI and GIII, and high: GII and IV) and bleaching treatment (hydrogen peroxide: GI and GII, and placebo: GIII and GIV). SCST was determined in the inner forearm for 6 different times using a neurosensory analyzer, the TSA II (Medoc Advanced Medical Systems, Ramat Yishai, Northern District, Israel). Dental sensitivity measurements were performed 10 different times using a thermal stimulus and an intraoral device attached to TSA II, positioned in the buccal surface of the upper right central incisor. Spontaneous dental sensitivity was also determined using the Visual Analogue Scale (VAS). Data were submitted to Student's t-test and Pearson's Correlation Test (α=0.05). SCST remained the same during bleaching treatment. Results Distinct responses of dental sensitivity were found in patients with low and high SCST during the first and third bleaching session (p≤0.05). The teeth submitted to the bleaching treatment became more sensitive to cold than those treated with placebo. Moreover, data obtained with TSA and VAS presented moderate correlation. Conclusions Bleaching treatment increased dental sensitivity and skin cold sensation threshold might represent a determining factor in this occurrence, since low and high SCST patients had different responses to the thermal stimulus in the teeth.

Neurosensory analysis of tooth sensitivity during at-home dental bleaching: a randomized clinical trial

Abstract Objective The objective of this study was to evaluate dental sensitivity using visual analogue scale, a Computerized Visual Analogue Scale (CoVAS) and a neurosensory analyzer (TSA II) during at-home bleaching with 10% carbamide peroxide, with and without potassium oxalate. Materials and Methods Power Bleaching 10% containing potassium oxalate was used on one maxillary hemi-arch of the 25 volunteers, and Opalescence 10% was used on the opposite hemi-arch. Bleaching agents were used daily for 3 weeks. Analysis was performed before treatment, 24 hours later, 7, 14, and 21 days after the start of the treatment, and 7 days after its conclusion. The spontaneous tooth sensitivity was evaluated using the visual analogue scale and the sensitivity caused by a continuous 0°C stimulus was analyzed using CoVAS. The cold sensation threshold was also analyzed using the TSA II. The temperatures obtained were statistically analyzed using ANOVA and Tukey's test (α=5%). Results The data obtained with the other methods were also analyzed. 24 hours, 7 and 14 days before the beginning of the treatment, over 20% of the teeth presented spontaneous sensitivity, the normal condition was restored after the end of the treatment. Regarding the cold sensation temperatures, both products sensitized the teeth (p<0.05) and no differences were detected between the products in each period (p>0.05). In addition, when they were compared using CoVAS, Power Bleaching caused the highest levels of sensitivity in all study periods, with the exception of the 14th day of treatment. Conclusion We concluded that the bleaching treatment sensitized the teeth and the product with potassium oxalate was not able to modulate tooth sensitivity.

A utilização do DSD (Digital Smile Design) para a otimização da estética dental / The use of DSD (Digital Smile Design) for the optimization of the dental esthetics

Atualmente, o DSD (digital smile design) tem sido utilizado como um recurso de grande destaque para a Odontologia Estética. O uso de um software pode facilitar e implementar através de simulações o tratamento reabilitador estético, fazendo com que haja maior entendimento do paciente sobre o procedimento e seus resultados, bem como evitando equívocos que possam ocorrer durante o tratamento. A técnica consiste em analisar as proporções faciais e dentárias de cada paciente e suas relações com dentes, lábios e gengivas por meio de fotografias digitais e vídeos. Com isso, são realizados desenhos seguindo métodos específicos que podem ser apresentados de maneira simples, compreensível e cativante para o paciente(AU)

Nowadays, the DSD (digital smile design) has been used as a great resource for aesthetic restorative dentistry. Through simulations, the use of a software can facilitate and implement aesthetics rehabilitation treatment, helping the patient to have a better understanding of the procedure and its outcomes, and also avoiding misunderstandings that may occur during the treatment. This technique consists in analyzing facial and dental proportions of each patient and the relations with their teeth, lips and gum through digital photograph and movies. Therefore, designs are made following specific methods that can be presented in a simple way, understandable and engaging for the patient(AU)

Effect of Dental Pigmentation Intensity on the Transenamel and Transdentinal Penetration of Hydrogen Peroxide

Abastract This study aimed to evaluate the transenamel and transdentinal penetration of hydrogen peroxide (H202) applied to bovine teeth pigmented with black tea at different intensities. The following groups were formed DW: immersion in distilled water; BT100: immersion in an infusion of 1.6 g of black tea per 100 mL distilled water; BT10: immersion in an infusion of 1.6 g black tea per 10 mL distilled water. All groups were immersed for 6 days. To quantify the penetration of H202, the specimens were placed in artificial pulp chambers (APCs) and subjected to bleaching treatment with 38% H2O2 once per week for 3 weeks. After bleaching treatment, the acetate buffer solution of APCs with peroxidase enzyme was evaluated in a reflection spectrophotometer. The transenamel and transdentinal penetration of H2O2 and the L* values obtained at T1, T2 and T3 were subjected to Kruskal-Wallis and Friedman statistical tests. At T1, the H2O2 diffusion in DW was higher than that in BT100 and BT10. At the other evaluation times, the penetration values in BT100 and BT10 increased and remained similar. The L* values increased significantly in all groups at T1. At T2, the L* values were higher in DW, while the values in BT100 and BT10 were similar to each other. At the end of the experiment, BT10 showed the lowest L* values. The pigmentation level did not affect the penetration of H2O2 through the enamel and dentin and the bleaching agent effectively changed the color of the teeth.

Resumo Este estudo teve como objetivo avaliar a penetração trans-amelodentinária do peróxido de hidrogênio (H2O2) aplicados em dentes bovinos pigmentados com chá preto em diferentes intensidades. Divisão dos grupos: AD em água destilada; CP100 em uma infusão de 1,6 g de chá preto para 100 mL de água destilada; CP10 em uma infusão de 1,6 g de chá preto para 10 mL de água destilada. Todos os grupos foram imersos por 6 dias. Para quantificar a penetração de H2O2, as amostras foram colocadas em câmaras pulpares artificiais (CPAs) e submetidas a um tratamento clareador com PH a 38%, uma vez por semana durante 3 semanas. Após o tratamento clareador, a solução tampão de acetato das CPAs com a enzima da peroxidase, foi avaliada num espectrofotômetro de reflexão. A penetração trans-amelodentinária de PH e os valores de L* obtidos em T1, T2 e T3 foram submetidos ao teste estatístico de Kruskal-Wallis e Friedman. Em T1, a difusão de H2O2 no AD foi mais elevada do que em CP100 e CP10. Nos outros tempos de avaliação, os valores de penetração no CP100 e CP10 aumentaram e permaneceram semelhantes. Os valores L* aumentaram significativamente em todos os grupos no T1. No T2, os valores L* foram maiores no AD e os valores em CP100 e CP10 foram semelhantes entre si. No último tempo, o CP10 apresentou os menores valores de L*. Diferentes níveis de pigmentação não afetaram a penetração de H2O2 através do esmalte e dentina e o agente de clareador foi eficaz na alteração cromática.

Penetration Capacity, Color Alteration and Biological Response of Two In-office Bleaching Protocols

Abstract Hydrogen peroxide (H2O2) penetrates into the dental hard tissues causing color alteration but also alterations in pulpal tissues. Hard-tissue penetration, color alteration and the pulp response alterations were evaluated for two in-office bleaching protocols with H2O2. For trans-enamel/dentin penetration and color alteration, discs of bovine teeth were attached to an artificial pulp chamber and bleached according to the groups: BLU (20% H2O2 - 1x50 min, Whiteness HP Blue); MAX (35% H2O2 - 3x15 min, Whiteness HP Maxx); Control (1x50 min, placebo). Trans-enamel/dentin penetration was quantified based on the reaction of H2O2 with leucocrystal violet and the color analyzed by CIELab System. Twenty Wistar rats were divided into two groups (BLU and MAX) and their maxillary right molars were treated according to the same protocols of the in vitro study; the maxillary left molars were used as controls. After 2 days, the animals were killed and their maxillae were examined by light microscopy. The inflammation of pulp tissue was scored according to the inflammatory infiltrate (1, absent; 2, mild; 3, moderate; 4, severe/necrosis). Data were analyzed by statistical tests (α=0.05). MAX showed higher trans-enamel/dentinal penetration of H2O2 (p<0.05). The color alteration was similar for both groups (p>0.05), and different when compared to Control group (p<0.05). MAX showed severe inflammation in the upper thirds of the coronal pulp, and BLU showed moderate inflammation (p<0.05). In-office bleaching protocols using lower concentrations of hydrogen peroxide should be preferred due to their reduced trans-enamel/dentinal penetration since they cause less pulp damage and provide same bleaching efficiency.

Resumo O peróxido de hidrogênio (H2O2) é capaz de penetrar pelos tecidos dentários, alterando a coloração destes, e causar danos a polpa. Este estudo avaliou a penetração por esmalte e dentina, a alteração de cor e a reposta tecidual pulpar, provocadas pelo uso de duas concentrações de H2O2 em protocolos de clareação dentária de consultório. Discos de dentes bovinos em câmaras pulpares artificiais receberam géis clareadores para avaliação da penetração por esmalte e dentina e da alteração de cor, formando os grupos: BLU (H2O2 20% - 1x50 min, Whiteness HP Blue); MAX (H2O2 35% - 3x15 min, Whiteness HP Maxx); e Controle (gel placebo - 1x50 min). A penetração por esmalte e dentina foi quantificada baseada na reação do H2O2 com o corante violeta leucocristal, e a alteração de cor foi analisada pelo sistema CIELab. Vinte ratos Wistar foram divididos em dois grupos (BLU e MAX), e tiveram os molares direito superiores tratados com os mesmos protocolos do estudo in vitro; os molares superiores do lado esquerdo serviram de controle. Após 2 dias, os animais foram eutanasiados e as maxilas examinadas por microscopia de luz. Foram atribuídos escores ao infiltrado inflamatório (1, ausente; 2, leve; 3, moderado; 4 severo ou necrose). Os dados foram submetidos a testes estatísticos (=0,05). O grupo MAX apresentou maior penetração de H2O2 por esmalte e dentina (p<0,05). A alteração de cor foi semelhante nos grupos clareados (p>0,05), mas diferente quando comparados grupos clareados com controle (p<0,05). MAX apresentou inflamação severa nos terços superiores da polpa coronária, e BLU apresentou inflamação moderada (p<0,05). Assim, protocolo para procedimento clareador de consultório utilizando baixas concentrações de H2O2 deve ser de escolha na clínica, por reduzir a penetração por esmalte e dentina, causando menos danos à polpa, e proporcionar mesma eficiência clareadora.

Evaluation of an experimental rat model for comparative studies of bleaching agents

ABSTRACT Dental materials in general are tested in different animal models prior to the clinical use in humans, except for bleaching agents. Objectives To evaluate an experimental rat model for comparative studies of bleaching agents, by investigating the influence of different concentrations and application times of H2O2 gel in the pulp tissue during in-office bleaching of rats’ vital teeth. Material and Methods The right and left maxillary molars of 50 Wistar rats were bleached with 20% and 35% H2O2 gels, respectively, for 5, 10, 15, 30, or 45 min (n=10 rats/group). Ten animals were untreated (control). The rats were killed after 2 or 30 days, and the maxillae were examined by light microscopy. Inflammation was evaluated through histomorphometric analysis with inflammatory cell count in the coronal and radicular thirds of the pulp. Fibroblasts were also counted. Scores were attributed to odontoblastic layer and vascular changes. Tertiary dentin area and pulp chamber central area were measured histomorphometrically. Data were compared by analysis of variance and Kruskal-Wallis test (p<0.05). Results After 2 days, the amount of inflammatory cells increased in the coronal pulp occlusal third up to the 15-min application groups of each bleaching gel. In the groups exposed to each concentration for 30 and 45 min, the number of inflammatory cells decreased along with the appearance of necrotic areas. After 30 days, reduction on the pulp chamber central area and enlargement of the tertiary dentin area were observed, without the detection of inflammation areas. Conclusion The rat model of extracoronal bleaching showed to be adequate for studies of bleaching protocols, as it was possible to observe alterations in the pulp tissues and tooth structure caused by different concentrations and application periods of bleaching agents.

Evaluation of an experimental rat model for comparative studies of bleaching agents

ABSTRACT Dental materials, in general, are tested in different animal models prior to their clinical use in humans, except for bleaching agents. Objectives To evaluate an experimental rat model for comparative studies of bleaching agents by investigating the influence of different concentrations and application times of H2O2 gel in the pulp tissue during in-office bleaching of rats’ vital teeth. Material and methods The right and left maxillary molars of 50 Wistar rats were bleached with 20% and 35% H2O2 gels, respectively, for 5, 10, 15, 30, or 45 min (n=10 rats/group). Ten animals (control) were untreated. The rats were killed after 2 or 30 days, and the maxillae were examined by light microscopy. Inflammation was evaluated by histomorphometric analysis with inflammatory cell counting in the coronal and radicular thirds of the pulp. The counting of fibroblasts was also performed. Scores were attributed to the odontoblastic layer and to vascular changes. The tertiary dentin area and the pulp chamber central area were histomorphometrically measured. Data were compared by the analysis of variance and the Kruskal-Wallis test (p<0.05). Results After 2 days, the amount of inflammatory cells increased in the occlusal third of the coronal pulp until the time of 15 min for both concentrations of bleaching gels. In 30 and 45 min groups of each concentration, the number of inflammatory cells decreased along with the appearance of necrotic areas. After 30 days, a reduction in the pulp chamber central area and an enlargement of tertiary dentin area were observed without the detection of inflammation areas. Conclusion The rat model of extra coronal bleaching showed to be adequate for bleaching protocols studies, as it was possible to observe alterations in the pulp tissues and in the tooth structure caused by different concentrations and periods of application of bleaching agents.

Teste sensorial quantitativo no estudo da sensibilidade dentária decorrente de tratamentos clareadores / Dental sensitivity assessment dfuring dental bleaching using quantitative sensory testing

Depois de reconhecido como uma terapia esteticamente eficaz, o clareamento dental tem sido comumente procurado pela maioria dos pacientes na busca por um sorriso mais harmonioso e agradável. No entanto, o surgimento da sensibilidade dentária em decorrência do uso de peróxidos faz com que muito pacientes tornem-se insatisfeitos com o tratamento clareador. Neste contexto, estudos relacionados a essa sintomatologia são frequentes, porém, baseados em metodologias limitadas e imprecisas. Por isso, torna-se necessário empregar um método recente no campo odontológico a fim de enriquecer cientificamente as análises de sensibilidade dentária. Objetivos: Assim, o presente estudo objetivou analisar e quantificar a ocorrência de sensibilidade dentária por meio do Teste Sensorial Quantitativo (QST) com a utilização de um equipamento de análise neurosensorial em diferentes momentos do tratamento clareador e mesmo após o uso de dessensibilizantes. Além disso, relacionar o limiar de sensação dos pacientes com tal ocorrência para que se estabeleça um protocolo de indicação individual adequado. Materiais e Métodos: Inicialmente, sessenta voluntários foram divididos em 4 grupos de acordo com o limiar de sensação da pele (baixo - GI e GIII e alto - GII e GIV), classificado por meio do QST, e o tratamento clareador (peróxido de hidrogênio - GI e GII e placebo - GIII e GIV). A sensibilidade dental mensurada por meio do QST, em 10 tempos de estudo. Como estudo complementar, foi realizada a segunda etapa desta pesquisa, onde os dez pacientes restantes receberam o tratamento clareador com peróxido de hidrogênio a 35% (Whiteness HP Maxx) e após a sessão clareadora foi realizada a aplicação de um dessensibilizante tópico no hemiarco esquerdo da maxila. No hemiarco direito foi aplicada uma solução salina a temperatura ambiente (controle). O QST foi realizado antes do clareamento (AC), imediatamente depois do clareamento (DC) e imediatamente após a aplicação do dessensibilizante (DD)...

After being considered as an esthetically efficient technique, dental bleaching has been frequently sought by patients that look forward to a harmonious and pleasant smile. Nevertheless, dental sensitivity due to the use of peroxides makes patients become very unsatisfied with the bleaching treatment. In this context, studies related to this issue are very common, but based on limited and inaccurate methodologies. Therefore, we improved a recent method in dentistry in order to contribute to the enrichment of these scientific analyses. Objectives: Hence, the present study aimed to perform a Quantitative Sensory Testing (QST), using a neurosensory analyzer to verify and quantify the occurrence of dental sensitivity, in different periods of evaluation, during bleaching treatment and after the use of a desensitizer agent. Additionally, we related the patients’ sensation threshold with this occurrence in order to establish an appropriate personal protocol statement. Materials and Methods: Seventy volunteers were criteriously selected and sixty from them were divided into 4 study groups according to the skin cold sensation threshold (low - GI and GIII and high - GII and GIV), obtained using QST, and the bleaching treatment (hydrogen peroxide - GI and GII and placebo - GIII e GIV). After the classification according to the skin cold sensation threshold, bleaching treatment was performed and dental cold sensation threshold was measured using QST in 10 different times. As a complementary study, we conducted the second part of this research. Ten patients underwent bleaching treatment using 35% hydrogen peroxide (Whiteness HP Maxx). After the bleaching session, a topical desensitizer was applied to the teeth of the left maxillary hemi-arch. A saline solution at ambient temperature was applied in the right maxillary hemi-arch (control). QST was performed before bleaching (BB), immediately after bleaching (AB), and immediately after the desensitizer (AD)...

Teste sensorial quantitativo no estudo da sensibilidade dentária decorrente de tratamentos clareadores / Dental sensitivity assessment dfuring dental bleaching using quantitative sensory testing

Depois de reconhecido como uma terapia esteticamente eficaz, o clareamento dental tem sido comumente procurado pela maioria dos pacientes na busca por um sorriso mais harmonioso e agradável. No entanto, o surgimento da sensibilidade dentária em decorrência do uso de peróxidos faz com que muito pacientes tornem-se insatisfeitos com o tratamento clareador. Neste contexto, estudos relacionados a essa sintomatologia são frequentes, porém, baseados em metodologias limitadas e imprecisas. Por isso, torna-se necessário empregar um método recente no campo odontológico a fim de enriquecer cientificamente as análises de sensibilidade dentária. Objetivos: Assim, o presente estudo objetivou analisar e quantificar a ocorrência de sensibilidade dentária por meio do Teste Sensorial Quantitativo (QST) com a utilização de um equipamento de análise neurosensorial em diferentes momentos do tratamento clareador e mesmo após o uso de dessensibilizantes. Além disso, relacionar o limiar de sensação dos pacientes com tal ocorrência para que se estabeleça um protocolo de indicação individual adequado. Materiais e Métodos: Inicialmente, sessenta voluntários foram divididos em 4 grupos de acordo com o limiar de sensação da pele (baixo - GI e GIII e alto - GII e GIV), classificado por meio do QST, e o tratamento clareador (peróxido de hidrogênio - GI e GII e placebo - GIII e GIV). A sensibilidade dental mensurada por meio do QST, em 10 tempos de estudo. Como estudo complementar, foi realizada a segunda etapa desta pesquisa, onde os dez pacientes restantes receberam o tratamento clareador com peróxido de hidrogênio a 35% (Whiteness HP Maxx) e após a sessão clareadora foi realizada a aplicação de um dessensibilizante tópico no hemiarco esquerdo da maxila. No hemiarco direito foi aplicada uma solução salina a temperatura ambiente (controle). O QST foi realizado antes do clareamento (AC), imediatamente depois do clareamento (DC) e imediatamente após a aplicação do dessensibilizante (DD)...

After being considered as an esthetically efficient technique, dental bleaching has been frequently sought by patients that look forward to a harmonious and pleasant smile. Nevertheless, dental sensitivity due to the use of peroxides makes patients become very unsatisfied with the bleaching treatment. In this context, studies related to this issue are very common, but based on limited and inaccurate methodologies. Therefore, we improved a recent method in dentistry in order to contribute to the enrichment of these scientific analyses. Objectives: Hence, the present study aimed to perform a Quantitative Sensory Testing (QST), using a neurosensory analyzer to verify and quantify the occurrence of dental sensitivity, in different periods of evaluation, during bleaching treatment and after the use of a desensitizer agent. Additionally, we related the patients’ sensation threshold with this occurrence in order to establish an appropriate personal protocol statement. Materials and Methods: Seventy volunteers were criteriously selected and sixty from them were divided into 4 study groups according to the skin cold sensation threshold (low - GI and GIII and high - GII and GIV), obtained using QST, and the bleaching treatment (hydrogen peroxide - GI and GII and placebo - GIII e GIV). After the classification according to the skin cold sensation threshold, bleaching treatment was performed and dental cold sensation threshold was measured using QST in 10 different times. As a complementary study, we conducted the second part of this research. Ten patients underwent bleaching treatment using 35% hydrogen peroxide (Whiteness HP Maxx). After the bleaching session, a topical desensitizer was applied to the teeth of the left maxillary hemi-arch. A saline solution at ambient temperature was applied in the right maxillary hemi-arch (control). QST was performed before bleaching (BB), immediately after bleaching (AB), and immediately after the desensitizer (AD). Results: In the...

Microabrasão do esmalte associada ao clareamento dentinário em pacinte com fluorose / Enamel microabrasion associated with dental bleaching in patient with fluorosis

A fluorose dentária é uma das causas frequentes de alterações cromáticas e irregulares superficiais do esmalte que comprometem a estética do sorriso. As terapias clareadora e microabrasiva são opções seguras e conservativas para melhorar a cor e a textura dos dentes. O objetivo deste trabalho é apresentar e discutir um caso clínico em que a correção cromática e a remoção das irregularidades superficiais de dentes afetados por fluorose de grau leve foram obtidas com a associação de técnicas de microabrasão e clareamento dentário.

Correlation of the hybrid layer thickness and resin tags length with the bond strength of a self-etching adhesive system / Correlação da espessura da camada híbrida e do comprimento dos prolongamentos resinosos com a resistência de união de um adesivo autocondicionante

The objective of this study was to measure the thickness of the hybrid layer (HLT), length of resin tags (RTL) and bond strength (BS) in the same teeth, using a self-etching adhesive system Adper Prompt L Pop to intact dentin and to analyze the correlationbetween HLT and RTL and their BS. Ten human molars were used for the restorative procedures and each restored tooth was sectioned in mesio-distal direction. One section was submitted to light microscopy analysis of HLT and RTL (400×). Another section was prepared and submitted to the microtensile bond test (0.5 mm/min). The fractured surfaces were analyzed using scanning electron microscopy to determine the failure pattern. Correlationbetween HLT and RTL with the BS data was analyzed by linear regression. The mean values of HLT, RTL and BS were3.36 μm, 12.97 μm and 14.10 MPa, respectively. No significant relationship between BS and HLT (R2= 0.011, p>0.05) and between BS and RTL (R2= 0.038) was observed. The results suggested that there was no significant correlation between the HLT and RTL with the BS of the self-etching adhesive to dentin.

O objetivo dessa pesquisa foi mensurar a espessura da camada híbrida de adesão (CH), o comprimento dos prolongamentos resinosos (Tags) e a resistência de união (RU) em um mesmoespécime e analisar a correlação entre esses fatores, usando o adesivo autocondicionante Adper Prompt L Pop em dentina hígida. Dez molares humanos foram utilizados e após a realização dos procedimentos restauradores, de acordo com osfabricantes, cada espécime foi cortado ao meio no sentido mésio/distal. Em uma hemi-secção dental os espécimes foram descalcificados para análise e mensuração dos tags e da camadahíbrida de adesão em microscopia óptica comum (AXIOPHOT, 400X). Na outra hemi-secção, foi realizado o testede microtração em uma velocidade de 0,5 mm/min até sua ruptura. A superfície fraturada foi mensurada e classificada de acordo com o tipo de fratura observada em microscopia eletrônica de varredura. Os valores obtidos para os fatores em análise, correspondentes a cada espécime foram submetidos a um teste de correlação. As médias correspondentes a CH, Tagse RU foram 3,36μm, 12,97 μm 14,10 MPa, respectivamente. Não foi observado correlação entre a CH e RU (R2= 0,011, p>0,05) e entre os Tags e RU (R2= 0,038). Diante dos resultados,observamos não haver correlação entre a camada híbrida e a resistência à tração, assim como entre os tags e a resistência à tração do sistema adesivo autocondicionante empregado.

Biological response of pulps submitted to different capping materials / Resposta biológica de polpas submetidas a diferentes materiais capeadores

Pulp capping is a procedure that comprises adequate protection of the pulp tissue exposed to the oral environment, aiming at the preservation of its vitality and functions. This study evaluated the response of the dental pulps of dog teeth to capping with mineral trioxide aggregate (MTA) or calcium hydroxide P.A. For that purpose, 37 teeth were divided into two groups, according to the capping material employed. Two dogs were anesthetized and, after placement of a rubber dam, their pulps were exposed in a standardized manner and protected with the experimental capping materials. The cavities were then sealed with resin-modified glass ionomer cement and restored with composite resin. After sixty days, the animals were killed and the specimens were processed in order to be analyzed with optic microscopy. It was observed that MTA presented a higher success rate compared to calcium hydroxide, presenting a lower occurrence of infection and pulp necrosis.

O capeamento pulpar é um procedimento que consiste na adequada proteção do tecido pulpar exposto ao meio oral, objetivando a preservação de sua vitalidade e suas funções. O objetivo deste trabalho foi observar a resposta da polpa dental de cães ao capeamento com o agregado de trióxido mineral (MTA) ou hidróxido de cálcio P.A. Para tanto, 37 dentes foram divididos em dois grupos, de acordo com o material capeador utilizado. Dois cães foram anestesiados e após o isolamento absoluto do campo operatório, realizou-se exposição padronizada da polpa, proteção com os materiais capeadores testados e selamento das cavidades com cimento modificado de ionômero de vidro. Os dentes foram então restaurados com resina composta. Após sessenta dias, os animais foram sacrificados e as peças foram processadas para a análise microscópica dos dentes. Observou-se que o MTA apresentou maior índice de sucesso em relação ao hidróxido de cálcio, evidenciando menor ocorrência de infecção e necrose pulpar.