Capital social e qualidade de vida relacionada à saúde bucal de adultos do Sistema Único de Saúde / Social capital and oral health related quality of life in adults of Unified Health System

Objetivo: avaliar a influência do capital social individual na qualidade de vida relacionada à saúde bucal (QVRSB) de adultos do Sistema Único de Saúde (SUS). Métodos: este estudo transversal incluiu adultos adscritos às Estratégias da Saúde da Família (ESFs) de Santa Maria, RS. A coleta de dados foi realizada de novembro de 2019 a março de 2020 em quatro ESFs por examinadores calibrados e treinados. O capital social individual, avaliado pela participação em atividades voluntárias e a confiança em vizinhos e amigos, foi considerado o preditor do estudo. Características sociodemográficas, comportamentais e de saúde periodontal também foram coletadas. A QVRSB, considerada o desfecho, foi mensurada pelo questionário OHIP-14. Modelos de regressão de Poisson avaliaram a associação entre variáveis independentes e QVRSB. Resultados: ao total, 80 adultos foram incluídos. Indivíduos do sexo feminino, da cor da pele não branca, com menor renda familiar mensal, fumantes, que visitaram o serviço odontológico a menos de um ano e que possuíam sangramento gengival apresentaram altos scores totais de OHIP-14 (P<0,05). A não participação em atividades voluntárias [razão de média (RR): 1,24; intervalo de confiança (IC) 95%: 1,03-1,50] e a ausência de confiança em vizinhos e amigos (RR: 1,24; IC 95%: 1,08-1,43) foram associadas a uma pior QVRSB dos adultos. Conclusão: a ausência de um capital social individual influenciou negativamente a QVRSB de adultos usuários do SUS.(AU)

Objective: To evaluate the influence of individual social assets on oral health-related quality of life (OHRQoL) of adult users of the Brazilian Unified Health System (UHS). Methods: This cross-sectional study included adults of the Family Health Strategy (FHS) of Santa Maria, RS. Data collection was performed from November 2019 to March 2020 in four FHSs by calibrated and trained examiners. Individual social capital, assessed by participation in volunteer activities and trust in neighbors and friends, was considered the predictor of the study. Sociodemographic, behavioral, and periodontal health characteristics were also collected. The OHRQoL, considered the outcome, was measured using the OHIP-14 questionnaire. Poisson regression models assessed the association between independent variables and OHRQoL. Results: In total, 80 adults were included. Female subjects, of non-white skin color, with lower monthly family income, smokers, who visited the dental service less than one year ago and who had gingival bleeding had high total OHIP-14 scores (P<0.05). Non-participation in voluntary activities [rate ratio (RR): 1.24; confidence interval (CI) 95%: 1.03-1.50] and the lack of trust in neighbors and friends (RR: 1.24; 95% CI: 1.08-1.43) were associated with a worse OHRQoL of adults. Conclusion: The absence of individual social assets negatively influenced the OHRQoL of adult UHS users.(AU)

Associação entre equipe de saúde bucal da Estratégia de Saúde da Família e qualidade de vida relacionada à saúde bucal em adultos / Association between the dental health team of the Family Health Strategy and oral health related quality of life in adults

Objetivo: avaliar a influência da equipe de saúde bucal (eSB) na qualidade de vida relacionada à saúde bu-cal (QVRSB) de adultos. Métodos: a amostra deste estudo transversal foi composta por adultos adscritos às Estratégias de Saúde da Família (ESFs) de Santa Maria, RS. Variáveis sociodemográficas, como idade, sexo, cor da pele, renda familiar e escolaridade, foram avaliadas através de questionário semiestruturado. Variáveis de serviço odontológico foram mensuradas através do motivo de procura ao serviço e da presença de eSB, avaliada a partir dos dados oficiais do município. Biofilme dental, sangramento gengival e cárie dental foram coletados através de exame clínico odontológico. O desfecho foi a QVRSB mensurada pelo questionário OHIP-14. Modelos foram construídos por meio de regressão de Poisson, para avaliar a associação entre presença de eSB e QVRSB. Resultados: ao total, 80 adultos adscritos a quatro ESF (duas com eSB) foram in-cluídos. A ausência da eSB influenciou negativamente a QVRSB de adultos (razão de média: 1,21; intervalo de confiança de 95%: 1,07-1,36). Além disso, idade, cor da pele não branca, menor renda familiar, menor escolaridade, procura ao serviço odontológico por dor dental e pior saúde bucal foram associados a uma pior QVRSB (P<0,05). Conclusão: indivíduos sem acesso à eSB apresentaram uma pior QVRSB. Estratégias de promoção de saúde devem incluir a ampliação do acesso à ESF, aumentando a equidade no acesso aos cuidados odontológicos.(AU)

Objective: to assess the influence of dental health team (DHT) on the oral health-related quality of life (OHRQoL) of adults. Methods: the sample of this cross-sectional study consisted of adults enrolled in the Family Health Strategy (FHS) in Santa Maria, RS. Sociodemographic variables such as age, sex, skin color, family income and education level were assessed using a semi-structured questionnaire. Dental service variables were measured through the reason for attending for the service and the presence of DHT, evaluated from the official data of the municipality. Dental biofilm, gingival bleeding and dental caries were collected through clinical dental examination. The outcome was OHRQoL, measured by the OHIP- 14 questionnaire. Models were built using Poisson regression to assess the association between the presence of DHT and OHRQoL. On total, 80 adults enrolled in four FHS (two with DHT) were included. The absence of DHT negatively influenced the OHRQoL of adults [mean ratio: 1.21; 95% confidence interval: 1.07-1.36]. In addition, age, non-white skin color, lower family income, less education, attending dental care due to dental pain and poorer oral health were associated with worse OHRQoL (P<0.05). Conclusion: individuals without access to DHT had a worse OHRQOL. Health promotion strategies should include expanding access to FHS, increasing equity in access to dental care.(AU)

Perfil epidemiológico dos casos de toxoplasmose gestacional e congênita decorrentes do surto populacional / Epidemiological profile of gestational and congenital toxoplasmosis cases arising out of the population outbreak

Objetivo: traçar o perfil epidemiológico dos casos de toxoplasmose gestacional e congênita notificados na cidade de Santa Maria ­ RS, decorrentes do surto ocorrido no ano de 2018 e investigar a associação entre as variáveis maternas e o diagnóstico do bebê. Método: foram avaliados retrospectivamente os casos notificados entre o período de março de 2018 a março de 2019. O diagnóstico do bebê e variáveis maternas foram analisados através de estatística descritiva e teste qui-quadrado. Resultados: Durante o período do estudo, foram notificados 206 casos de toxoplasmose gestacional, dos quais 74 foram confirmados como infecção recente. A transmissão vertical foi confirmada em 27% dos casos. Houve maior freqüência de transmissão em gestantes que tiveram o diagnóstico no terceiro trimestre de gestação (p=0,001) e que não realizaram tratamento durante a gestação (p<0,001). Conclusão: A ocorrência da toxoplasmose congênita está associada ao diagnóstico tardio, no último trimestre da gestação, e consequente falta do tratamento adequado. Ainda, houve uma alta prevalência de crianças infectadas por transmissão vertical decorrentes do surto, o que reforça a importância de um acompanhamento pré-natal e a atenção à necessidade da realização do tratamento e cuidado adequados no decorrer do desenvolvimento das crianças infectadas.

Objective: To trace the epidemiological profile of cases of gestational and congenital toxoplasmosis reported in the city of Santa Maria - RS, resulting from the outbreak that occurred in 2018 and to investigate the association between maternal variables and the baby's diagnosis. Method: Cases reported between March 2018 and March 2019 were retrospectively evaluated. The baby's diagnosis and maternal variables were analyzed using descriptive statistics and chi-square test. Results: During the study period, 206 cases of gestational toxoplasmosis were reported, of which 74 were confirmed as a recent infection. Vertical transmission was confirmed in 27% of cases. There was a higher frequency of transmission in pregnant women who were diagnosed in the third trimester of pregnancy (p = 0.001) and who did not undergo treatment during pregnancy (p <0.001). Conclusion: The occurrence of congenital toxoplasmosis is associated with late diagnosis, in the last trimester of pregnancy, and consequent lack of adequate treatment. In addition, there was a high prevalence of children infected by vertical transmission due to the outbreak, which reinforces the importance of prenatal care and attention to the need for adequate treatment and care during the development of infected children.

The benefits of omega-3 fatty acid nanocapsulation for the enrichment of food products: a review / Os benefícios da nanoencapsulação de ácidos graxos da classe ômega-3 para o enriquecimento de produtos alimentícios: uma revisão

ABSTRACT Polyunsaturated fatty acids oxidize easily due to their chemical structure, causing a reduction of their nutritional properties. Nanostructured systems may be an alternative to protect fatty acids against oxidation, improving solubility and stability. Consequently, nutritional value of food is maintained as well as the sensory characteristics (color, flavor, texture, and aroma) when fatty acids are added to food products. The present study is a narrative review to introduce the potential benefits of omega-3 unsaturated fatty acids nanoparticles incorporated in food products. The literature review includes publications in English and Portuguese issued between March 1985 and March 2019, in PubMed, ScienceDirect and Web of Science databases. Manual searches were conducted in the articles references lists of the articles included to identify other relevant studies. There were studies that evaluated the stability of fatty acids in food products such as bread, fruit juice, milk, yogurt, and meat. In this study, the most used nanostructured systems for the incorporation of fatty acids were the nanocapsules and the nanoliposomes. Currently, the nanostructured system demonstrates a potential to improve protection of polyunsaturated fatty acids against oxidization and thermal degradation. In this way, they maintain their functional properties and their bioavailability increases and therapeutic efficacy and sensory properties are improved. There are several methodologies being tested, which makes it difficult to identify the most efficient formulation to protect fatty acids. Nanostructured systems seem to be the best alternative to protect polyunsatured fatty acids from oxidization. The encapsulation efficiency, particle's size and type are relevant factors to be considered to evaluate oxidization. In conclusion, the review showed that currently it is impossible to determine the most efficient methodology. Besides, nanoformulations should follow international guidelines to present more standardized and therefore more efficient particles.

RESUMO Os ácidos graxos poli-insaturados são facilmente oxidados devido à sua estrutura química, o que acarreta a diminuição de suas propriedades nutricionais. Nesse contexto, o sistema nanoestruturado pode ser uma alternativa para protegê-los contra a oxidação, melhorando a solubilidade e estabilidade. Consequentemente, quando são adicionados a produtos alimentares, o valor nutricional é mantido, bem como as características sensoriais (cor, sabor, textura e aroma). O presente estudo é uma revisão narrativa para apresentar os potenciais benefícios das nanopartículas com ácidos graxos insaturados da classe ômega-3 incorporados a produtos alimentícios. A literatura consultada incluiu publicações em inglês e em português, considerando o período entre março de 1985 e março de 2019, utilizando as bases de dados PubMed, ScienceDirect e Web of Science. Foram realizadas buscas manuais nas referências dos artigos incluídos, a fim de identificar outros estudos relevantes. Foram encontradas pesquisas que avaliaram a estabilidade dos ácidos graxos em produtos alimentícios, como pães, suco de fruta, leite, iogurte e carne. Neste estudo, as nanoestruturas mais utilizadas para a incorporação dos ácidos graxos foram as nanocápsulas e os nanolipossomas. Atualmente, o sistema nanoestruturado demonstra um potencial para melhorar a proteção desses ácidos poli-insaturados contra a oxidação e degradação térmica. Dessa forma, eles mantêm suas propriedades funcionais, aumenta-se sua biodisponibilidade e há melhora da eficácia terapêutica e das propriedades sensoriais. Existem diversas metodologias sendo testadas, o que dificulta a identificação de qual seria a formulação mais eficiente nessa proteção, mas os sistemas nanoestruturados parecem ser a melhor alternativa para proteger os ácidos graxos insaturados da oxidação. A eficiência de encapsulação bem como o tamanho e o tipo de partícula são fatores importantes a considerar na avaliação da oxidação. Em conclusão, a revisão demonstrou que atualmente a metodologia mais eficiente não é possível de ser identificada. Ademais, as nanoformulações devem seguir diretrizes do protocolo internacional para apresentar partículas mais padronizadas e, assim, eficientes.

Fracture load and shear stress of prefabricated glass fiber posts

Aim: This study evaluated the fracture load and pattern failure of different prefabricated glass fiber posts (GFPs) of the same diameter. Methods: Seventy-eight (n=13 for six groups) GFPs of 1.6 mm coronal diameter of different brands were evaluated­ Exacto (Angelus), Power Post (BM4), White Post DC (FGM), HiRem (Overfibers), MAQ (Maquira), and SD (Supordont). The posts were subjected to fracture load testing (45° of inclination and 1 mm/min until fracture). Each factor (load (N) and shear stress (MPa)) was analyzed separately using one-way ANOVA followed by the Tukey test (α=0.05). Results: The type of failure was evaluated on a stereomicroscope (×10). The Power Post samples presented higher values of fracture load (p<0.001) followed by Maquira fiber post, White Post , HiRem, Superpost, and the Exacto posts. The failure pattern observed was intralaminar mode II in-plane shear, such as a failure occur parallel to fibers. Conclusion: Despite the same diameter of GFPs, the fracture load and shear resistance were brand-dependent

Survival of Restored Endodontically Treated Teeth in Relation to Periodontal Status

Abstract The aim of the present study was to investigate the success and survival of restored endodontically treated teeth (ETT) in a general practice environment related to periodontal parameters. Data from 360 restored ETT treated between 2000 and 2011 were collected. Dates of interventions like restorations, repairs, replacements and extractions were recorded. Additionally, general information about patients and dentitions as well as periodontal status was recorded. Success was analyzed using Kaplan-Meier statistics and a multivariate Cox regression analysis was performed to assess variables influencing success and survival. After a mean observation time of 4.34 years (range 0.6 - 11.6 years), 19 teeth were extracted and 27 restorations needed repair or replacement. According to the Cox regression, increasing maximum pocket depth of the tooth resulted in a higher risk for failure (p=0.012). In conclusion, periodontal pocket depth was found to be a significant factor in the survival of restored ETT.

Resumo O objetivo do presente estudo foi investigar a taxa de sucesso e de sobrevivência de dentes restaurados e tratados endodonticamente (DTE) em uma clínica privada e relacionar com índices periodontais. Dados de 360 restaurações realizadas em DTE realizadas entre 2000 e 2011 foram coletados. As datas das intervenções, como restaurações, reparos, substituições e extrações foram registradas. Ainda, informações gerais relacionadas aos pacientes, aos dentes envolvidos e ao estado periodontal foram também coletadas. A taxa de sucesso foi analisada utilizando o método estatístico Kaplan-Meier e uma análise multivariada do tipo regressão de Cox foi realizada para avaliar variáveis que influenciaram na taxa de sucesso e de sobrevivência. Depois de um período de observação médio de 4,34 anos (0,6-11,6 anos), 19 dentes foram extraídos e 27 restaurações precisaram de reparo ou substituição. De acordo com a regressão de Cox, o aumento na profundidade de bolsa periodontal do dente resulta em um maior risco de falha (p=0,012). Em conclusão, a profundidade de bolsa periodontal foi considerada como um fator significativo na sobrevivência de dentes restaurados e tratados endodonticamente.

Accuracy of color measurement of endondontically treated teeth after aging / Precisão da medição de cor de dentes tratados endodonticamente após envelhecimento

Objective: The aim of this study was to compare the accuracy of three different modes of a spectrophotometer (Vita Classical, 3D-Master and CIE L*a*b* system) in the evaluation of color alteration in endodontically treated teeth. Material and Methods: The root canal treatment of forty-five sound human canines was performed. Color measurements were performed before the endodontic treatment (baseline), and after 6 months of water storage. Shade matching was performed using a spectrophotometer (Vita Easyshade) in three different modes: Vita Classical, 3D-Master and CIE L*a*b* coordinates. The color change (ΔE value) for the three methods were assessed in each sample and analyzed by multiple linear regression analysis. L*, a* and b* values were analyzed by t-test. The significance level was set at 5%. Results: According to the digital evaluation, no statistically significant differences were found between the CIE L*a*b*,Vita Classical and 3D-Mastermodes. However, a significant difference was found (p < 0.001) for the ΔE values, with the CIE L*a*b* mode presenting greater accuracy to detect color alterations. Conclusion: CIE L *a*b* method properly correlates to Vita Classical and 3D-Master modes. However, Easyshade can easier detect color changes if used in the CIE L*a*b* mode, which leads to more accurate results.

Objetivo: O objetivo deste estudo foi comparar a precisão de três modos diferentes de um espectrofotômetro (Vita Classical, 3D-Master e sistema CIE L*a*b*) na avaliação da alteração de cor em dentes tratados endodonticamente. Materiais e Métodos: O tratamento endodôntico de quarenta e cinco caninos humanos foi realizado. Medições de cor foram realizadas, antes do tratamento endodôntico (imediatamente), e após 6 meses de armazenamento em água. Análise de cor foi realizado utilizando um espectrofotômetro (Vita Easyshade) em três diferentes modos: Vita Classical, 3D-Master e sistema CIE L*a*b*. A mudança de cor (valor ΔE) para os três métodos foram avaliadas em cada amostra e analisados através de análise de regressão linear múltipla. Valores de L*, a* e b* foram analisados através do teste-t. O nível de significância estabelecido foi de 5%. Resultados: De acordo com a avaliação digital, não foram encontradas diferenças significativas entre os métodos CIE L*a*b*,Vita Classical e 3D-Master. No entanto, uma diferença significativa foi encontrada (p < 0,001) para os valores de ΔE, com o modo CIE L*a*b* apresentando uma maior precisão para detectar alterações de cor. Conclusão: O método CIE L *a*b* correlaciona corretamente para os modos Vita Classical e 3D-Master. No entanto, o Easyshade pode detectar alterações de cor, mais facilmente quando utilizado no modo CIE L *a*b*, permitindo resultados mais precisos.

Effect of sodium hypochlorite as dentinal pretreatment on bonding strength of adhesive systems.

Aim: This study aimed to evaluate the effect of sodium hypochlorite (NaOCl) pretreatment on bond strength of adhesive systems to different dentin regions. Materials and Methods: Forty human molars were randomly assigned according to different adhesive systems (Adper Single Bond 2; Clearfil SE Bond; Adper SE Plus; G‑Bond), pretreatments (control and NaOCl ‑ deproteinization) and dentin regions (proximal, superficial occlusal [SO] and deep occlusal [DO]), n = 5. Cylindrical cavities were performed at the proximal and occlusal surfaces of each sample. For deproteinization, 10% NaOCl was applied on conditioned dentin for 60 s before the adhesive systems application. Two occlusal and one proximal slice were obtained from each sample and submitted to the push‑out test. The mode of fracture was analyzed. The data were subjected to three‑way ANOVA and Tukey test (P < 0.05). Results: There was statistically significant difference between the adhesive systems (P < 0.01) and dentin regions (P < 0.01); however, the pretreatment did not significantly affect the bond strength values (P > 0.05). The bond strength values were higher for the proximal surface, followed by SO and later by DO, being influenced by the adhesive system. The two‑step self‑etch adhesive systems presented the highest bond strength results. Conclusion: The deproteinization pretreatment showed similar bonding effectiveness to the conventional adhesive technique. The dentin region plays a rule on the bond strength values.

Impairment of resin cement application on the bond strength of indirect composite restorations

The aims of this study were to evaluate the effect of immediate and delayed resin cement application on the microtensile bond strength of indirect composite resin restorations and, to evaluate adhesive strategies (for regular resin cement or humidity parameters for self-adhesive resin cement). Forty-five enamel/dentin discs (0.5 mm height and 10 mm of diameter) obtained from bovine teeth were divided into nine groups (n = 5). For regular cement, the variation factors were cementation technique at three levels (immediate cementation, 5 or 30 min after adhesive system application); and type of adhesive system at two levels (three- or two-step). For self-adhesive cement, the dentin moisture was the source of variation at three levels (normal, dry, or wet cementation). The specimens were submitted to microtensile bond strength (μTBS) testing using a universal testing machine. Data were analyzed by ANOVA, Tukey’s test, and linear regression. Regular cement and three-step etch-and-rinse adhesive system showed the highest values of bond strength (25.21 MPa–30 min of delay). Only for this condition, three-step adhesive showed higher bond strength than the two-step adhesive. Nevertheless, the linear regression showed that irrespective of the strategy, the use of the two-step approach when compared with three-step adhesive system decreased μTBS (p < 0.001). The failure analysis showed predominant adhesive failures for all tested groups. All groups had comparable values of bond strength to bovine dentin when the same materials were used, even in suboptimal clinical conditions.

A systematic review of factors associated with the retention of glass fiber posts

This study aimed to identify factors that can affect the retention of glass fiber posts to intra-radicular dentin based on in vitro studies that compared the bond strength (BS) of GFPs cemented with resin cements. Searches were carried out in PubMed and Scopus until December 2013. Bond strength values and variables as type of tooth, presence of endodontic treatment, pretreatment of the post, type of bonding agent (if present), type of cement and mode of cement application were extracted from the 34 included studies. A linear regression model was used to evaluate the influence of these parameters on BS. The presence of endodontic treatment decreased the BS values in 22.7% considering the pooled data (p = 0.013). For regular cement, cleaning the post increased BS when compared to silane application without cleaning (p = 0.032), considering cleaning as ethanol, air abrasion, or phosphoric acid application. Applying the cement around the post and into root canal decreased the resistance compared to only around the post (p = 0.02) or only into root canal (p = 0.041), on the other hand, no difference was found for self-adhesive resin cement for the same comparisons (p = 0.858 and p = 0.067). Endodontic treatment, method of cement application, and post pretreatment are factors that might significantly affect the retention of glass-fiber posts into root canals mainly when cemented with regular resin cement. Self-adhesive resin cements were found to be less technique-sensitive to luting procedures as compared with regular resin cements.

Acid foods and soft drinks dental erosive potential: warning messages or not? / Potencial erosivo dental de alimentos acidos y bebidas no alcohólicas: ¿existen mensajes de advertencia?

This Communication aims to present the issue of dental erosion in another point of view. Considering the increasing rate of incidence of this dental injury among children and adults, the narrative raises the question about the danger of indiscriminate intake of certain acidic foods and beverages which are scientifically proven as one of the causes of dental erosion, as well as the complete neglect of information by the food industry about these products. The authors present some points that still remain in doubt in this topic and some approaches, which should be taken to alert the population about the relation between acidity of food and dental erosion

El objetivo del presente estudio es abordar el tema de la erosión dental desde otro punto de vista. Al tener en cuenta la creciente tasa de incidencia de esta lesión dental en niños y adultos, el trabajo plantea la pregunta sobre el peligro de la ingesta indiscriminada de ciertos alimentos ácidos y bebidas que han sido identificados científicamente como una de las causas de la erosión dental, como asimismo, una completa falta de información por parte la industria alimentaria sobre estos productos. Se presentan algunos puntos que aún quedan en duda referente a este tema y algunos enfoques que se deben tomar para alertar a lapoblación acerca de la relación entre la acidez de los alimentos y la erosión dental

Resoluções do Conselho de Saúde: instrumento de controle social ou documento burocrático? / Resolutions of the Health Council: instrument of social control or bureaucratic document?

O presente estudo, de caráter documental, analisa as resoluções registradas em atas de reuniões de um Conselho de Saúde, de forma a caracterizar o controle social em saúde realizado por esta instância. A maioria das resoluções referiam-se à aprovação de programas e projetos, oriundos da Secretaria da Saúde, referentes à reforma, aquisição de material e equipamento para unidades de saúde, qualificação de serviços já existentes ou criação de novos serviços. O estudo sugere que a prática deste conselho parece ser burocratizada, sem que seja visualizada nenhuma proposição de políticas de saúde pelo conselho. A forma como as resoluções vêm sendo formalizadas não caracteriza seu encaminhamento, muito menos a visibilidade das ações para a população em geral. No caso estudado, sinaliza-se que o mero funcionamento regular deste conselho não garante que exista efetivo controle social.

The present study has a documentary character and analyzes the resolutions registered in minutes of meetings of a Health Council, as a form to characterize the social control in health carried through for this instance. The majority of the resolutions were referred to the approval of Programs and Projects, arising from the Secretariat of Health, regarding the reform, material and equipment acquisition for units of health, the qualification of existing services or the creation of new services. The study suggests that the practical one of this council seems to be bureaucratic, without any proposal of politics of health for the council is visualized. The way the resolutions have being legalized does not characterize its guiding not even the visibility of the actions for the population in general. In the studied case, it is signaled that the mere regular functioning of this council does not guarantee that exist effective social control.

Reflections about adhesive systems / Reflexiones acerca de los sistemas adhesivos

The adhesive systems are responsible for an efficient union between teeth and resin, resulting in a longevity restoration. They are organic molecules di or multifunctional that contain reactive groups that interact with dentin and with the resin monomer of composite resin. The adhesive systems are characterized by wet adhesion, which is a result of presence of hidrophylics radicals in their compositions, to promote a better bond and the best properties of the adhesion. Adhesive systems may use two different strategies to interact with the dental structure: total-etching and self-etching technique. The total-etching systems require a conditioning, a rinsing and a priming step in order to allow involvement of collagen fibers by the resin monomers and the formation of the so-called ‘hybrid layer’. The total-etching promotes the cleaning of dentin, also promotes superficial demineralization and delivers collagen fibrils to participate of an interface union mechanism teeth/ adhesive system/restorative material. Self-etching adhesive systems are characterized by demineralization and infiltration of resin monomers simultaneously. This technique is attractive because reduced sensitivity associated with retaining the smear layer and smear plugs, thereby, minimize the possibility of inadvertent contamination of the bonding surface with dentinal surface through dentinal fluid transudate.

Los sistemas adhesivos son responsables de una unión eficaz entre los dientes y la resina, dando como resultado una restauración durable. Son moléculas orgánicas bi o multifuncionales que contienen grupos reactivos que interactúan con la dentina y con el monómero de resina de composite. Los sistemas adhesivos se caracterizan por la adhesión húmeda, que es el resultado de la presencia de radicales hidrofílicos en sus composiciones, para promover una mejor adherencia y las mejores propiedades de la adhesión. Los sistemas adhesivos pueden utilizar dos estrategias diferentes para interactuar con la estructura dental: Técnica de grabado total y auto-grabado. Los sistemas de grabado total requiere un acondicionamiento, un lavado y un paso de priming con el fin de permitir la participación de las fibras de colágeno por los monómeros de resina y la formación de la llamada capa híbrida. El grabado total promueve la limpieza de la dentina, también promueve la desmineralización superficial y condiciona a las fibrillas de colágeno para participar de un mecanismo de interfaz de unión diente/sistema adhesivo /material de restauración. Los sistemas adhesivos autograbantes se caracterizan por la desmineralización y la infiltración de los monómeros de resina de forma simultánea. Esta técnica es atractiva debido a la sensibilidad reducida asociada a conservar la capa de barro dentinario y tapones de barro dentinario, reduciendo al mínimo la posibilidad de contaminación accidental de la superficie de unión con la superficie de la dentina a través del líquido dentinario trasudado.