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1.
Braz. dent. sci ; 25(2): 1-8, 2022. tab
Article in English | LILACS, BBO | ID: biblio-1368236

ABSTRACT

Objective: To assess the caries progression and the need for reintervention on occlusal ICDAS 4 lesions after different treatments. Material and Methods: The sample consisted of records of children treated in a public setting who had at least an occlusal ICDAS 4 lesion in primary and/or permanent molars. The radiographic images of ICDAS 4 lesions at the first and last appointments were classified as absence of radiolucency, radiolucent image at the enamel­dentin junction, at the outer half or inner of the dentin. The need for retreatment after different treatments (non-invasive - topical fluoride applications, oral hygiene instructions and dietary guidance, micro-invasive - resin-based sealant, or invasive - restoration) was assessed by reviewing clinical and radiographic records. The need for retreatment was defined as any complication requiring mending (e.g., caries progression, total loss of sealant, or restoration failure). The Poisson regression model was used to investigate the association between individual and tooth-related variables and the outcome. Results: Among the 111 lesions in 81 patients, most (73.0%) lesions were in primary molars. Most lesions (52.3%) did not exhibit radiolucency, whereas 29.7% had radiolucency at the outer half of the dentin. The mean follow-up was 18.8 ± 6.5 months. After follow-up, 82.9% of the lesions did not require retreatment. The prevalence of ICDAS 4 lesions that did not need retreatment was higher among lesions with radiolucency at dentin (p=0.01). Conclusion: Most occlusal ICDAS 4 lesions did not require reintervention, especially those exhibiting radiolucency in the outer half of the dentin (AU)


Objetivo: Avaliar a progressão de cárie e a necessidade de reintervenção em lesões oclusais ICDAS 4 após diferentes tratamentos. Material e Métodos: A amostra consistiu de prontuários de crianças atendidas em ambiente público que apresentavam pelo menos uma lesão oclusal ICDAS 4 em molares decíduos e/ou permanentes. As imagens radiográficas de lesões ICDAS 4 na primeira e última consultas foram classificadas como ausência de radiolucidez, imagem radiolúcida na junção esmalte-dentina, em metade externa ou interna da dentina. A necessidade de retratamento após diferentes tratamentos (não invasivo ­ aplicações tópicas de flúor, orientações de higiene e dieta, micro-invasivo ­ selante resinoso ou invasivo ­ restauração) foi avaliada por meio da revisão dos registros clínicos e radiográficos. A necessidade de retratamento foi definida como qualquer complicação que requer intervenção (por exemplo, progressão da lesão, perda total do selante ou falha na restauração). O modelo de regressão de Poisson foi utilizado para investigar a associação entre as variáveis individuais e dentárias e o desfecho. Resultados: Entre as 111 lesões em 81 pacientes, a maioria (73,0%) das lesões eram em molares decíduos. A maioria das lesões (52,3%) não exibiu radiolucidez, enquanto que 29,7% apresentaram radiolucidez em metade externa de dentina. O tempo de acompanhamento médio foi de 18,8 ± 6,5 meses. Após o acompanhamento, 82,9% das lesões não necessitaram de retratamento. A prevalência de lesões ICDAS 4 que não necessitaram de retratamento foi maior entre as lesões com radiolucidez em dentina (p=0,01). Conclusão: A maioria das lesões oclusais ICDAS 4 não requerem reintervenção, especialmente aquelas que exibem radiolucidez em metade externa da dentina.(AU)


Subject(s)
Humans , Child , Radiography, Dental , Dental Caries , Clinical Decision-Making
2.
Braz. dent. j ; 32(6): 74-82, Nov.-Dec. 2021. tab
Article in English | LILACS-Express | LILACS, BBO | ID: biblio-1355835

ABSTRACT

Abstract The last couple of decades has seen an increasing interest in molar-incisor hypomineralization (MIH) studies. Hypomineralized defects can have several consequences such as hypersensitivity, increased dental plaque accumulation, and consequently higher caries risk. This cross-sectional study aimed to investigate the prevalence of MIH and its association with dental caries in schoolchildren from a city in southern Brazil. A random cluster sample of schoolchildren was selected. Clinical examinations were carried out to collect information on MIH (following the European Academy of Pediatric Dentistry criteria), dental caries (using the DMF-T index) and gingivitis. Socioeconomic, demographic and behavior variables were collected using a standardized questionnaire answered by the children's parents/caregivers. Prevalence ratios (PR) were estimated using Poisson regression analysis with robust variance through a hierarchical approach (p<0.05). A total of 513 schoolchildren were included in the study. MIH and caries prevalence was 19.7% and 31.6%, respectively. The mean age was 11.6 (+1.9) years. Dental caries was more prevalent in children with MIH (PR 1.39; 95% CI 1.05 - 1.85). Older children and children whose families were enrolled in conditional cash transference programs (PR 1.97 95% CI 1.47 - 2.64), and children who did not have their mother or father as the head of the family (PR 1.56 95% CI 1.06 - 2.30) presented a higher prevalence of dental caries. Our findings suggest that children with MIH are more likely to have dental caries.


Resumo Nas últimas duas décadas, observou-se um interesse crescente nos estudos de hipomineralização molar-incisivo (HMI). Os defeitos hipomineralizados podem ter várias consequências, como hipersensibilidade, aumento do acúmulo de placa dentária e, consequentemente, maior risco de cárie. Este estudo transversal teve como objetivo investigar a prevalência de HMI e sua associação com cárie dentária em escolares de um município do sul do Brasil. Uma amostra aleatória de alunos por conglomerado foi selecionada. Os exames clínicos foram realizados para coletar informações sobre HMI (seguindo os critérios da European Academy of Pediatric Dentistry), cárie dentária (usando o índice DMF-T) e gengivite. Variáveis socioeconômicas, demográficas e comportamentais foram coletadas por meio de um questionário padronizado respondido pelos pais / responsáveis pelas crianças. Razões de prevalência (RP) foram estimadas por meio de análise de regressão de Poisson com variância robusta por meio de abordagem hierárquica (p <0,05). Um total de 513 escolares foram incluídos no estudo. A prevalência de MIH e cárie foi de 19,7% e 31,6%, respectivamente. A média de idade foi de 11,6 (± 1,9) anos. A cárie dentária foi mais prevalente em crianças com HMI (RP 1,39; IC 95% 1,05 - 1,85). Crianças mais velhas e crianças cujas famílias estavam matriculadas em programas de transferência condicional de renda (RP 1,97 IC95% 1,47 - 2,64), e crianças que não tinham a mãe ou o pai como chefe da família (RP 1,56 IC95% 1,06 - 2,30) apresentaram maior prevalência de cárie dentária. Nossos resultados sugerem que crianças com HMI são mais propensas a ter cárie dentária.

3.
Braz. oral res. (Online) ; 35: e058, 2021. tab, graf
Article in English | LILACS, BBO | ID: biblio-1285725

ABSTRACT

Abstract: This study aimed to evaluate the efficacy of non-invasive and micro-invasive treatments on the arrest of occlusal enamel carious lesions in erupting permanent molars. This two-arm randomized clinical trial included 27 subjects, aged 5-11 years, with 64 erupting permanent molars presenting active occlusal enamel carious lesions (as assessed by the International Caries Detection and Assessment System [ICDAS]; scores 1-3). The sample was randomly assigned into two treatment groups: 1) resin-modified glass ionomer cement sealant (Clinpro XT Varnish; 3M ESPE) and 2) 4-week topical fluoride varnish application (Duraphat; Colgate). All children and parents received oral hygiene and dietary instructions. Teeth were evaluated at baseline and 3, 6, 9, and 12 months regarding the eruption stage, biofilm accumulation, as well as severity and activity of the carious lesions. The Kaplan-Meier method was used to evaluate the survival estimates for inactivation of the carious lesions for both treatment groups. Multivariate Cox regression models with shared frailty were performed to identify factors associated with the outcome (p < 0.05). After 12 months, 22% and 3% of the lesions treated with topical fluoride varnish and sealant, respectively remained active. The adjusted model demonstrated that younger children had a higher probability of active enamel carious lesions arresting (hazard ratio [HR] 0.42, 95% confidence interval [CI] 0.22-0.78; p=0.01). However, the probability of active enamel carious lesions arresting after sealant application was 8.85 times higher compared with fluoride varnish applications (p=0.01). Sealing is a more effective approach than fluoride varnish for arresting occlusal enamel carious lesions in erupting permanent molars.


Subject(s)
Humans , Child , Pit and Fissure Sealants , Dental Caries/therapy , Fluorides, Topical/therapeutic use , Fluorides , Glass Ionomer Cements , Molar
4.
Braz. oral res. (Online) ; 34: e045, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1132712

ABSTRACT

Abstract This in vitro study aimed to evaluate the effect of a silane-containing universal adhesive used with or without a silane agent on the repair bond strength between aged and new composites. Forty nanohybrid composite resin blocks were stored in distilled water for 14 d and thermo-cycled. Sandpaper ground, etched, and rinsed speciments were randomly assigned into four experimental groups: silane + two-step etch-and-rinse adhesive system, two-step etch-and-rinse adhesive system, silane + silane-containing universal adhesive system, and silane-containing universal adhesive system. Blocks were repaired using the same composite. After 24 h of water storage, the blocks were sectioned and bonded sticks were submitted to microtensile testing. Ten unaged, non-repaired composite blocks were used as a reference group to evaluate the cohesive strength of the composite. Two-way ANOVA and Tukey's tests were used to analyze average µTBS. One-way ANOVA and Dunnet post-hoc tests were used to compare the cohesive strength values and bond strength obtained in the repaired groups (α = 0.05). The µTBS values were higher for the silane-containing universal adhesive compared to the two-step etch-and-rinse adhesive system (p = 0.002). Silane application improved the repair bond strength (p = 0.03). The repair bond strength ranged from 39.3 to 65.8% of the cohesive strength of the reference group. Using universal silane-containing adhesive improved the repair bond strength of composite resin compared to two-step etch-and-rinse adhesive. However, it still required prior application of a silane agent for best direct composite resin repair outcomes.


Subject(s)
Silanes/chemistry , Composite Resins/chemistry , Resin Cements/chemistry , Dental Cements/chemistry , Reference Values , Surface Properties , Tensile Strength , Time Factors , Materials Testing , Reproducibility of Results , Analysis of Variance , Dental Bonding/methods
5.
Braz. oral res. (Online) ; 34: e081, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1132665

ABSTRACT

Abstract The aim of this study was to investigate the influence of shortening of etching time for dentin on the restoration survival after selective carious tissue removal in primary molars. This two-arm randomized clinical trial included sixty-two subjects (5-8 year-old) and 100 primary molars presenting moderate dentin carious lesions on occlusal surface. The sample was randomly assigned into groups previously to adhesive application (Adper Single Bond 2; 3M ESPE): etching time recommended by manufacturer (15 s) or reduced (7 s). Resin composite (Filtek Bulk Fill Posterior Restorative; 3M ESPE) was inserted in a single increment for all restorations. Restorations were evaluated at 1, 6, 12, and 18 months using FDI criteria. Survival estimates for restorations' longevity were evaluated with Kaplan-Meier method. Multivariate Cox regression analysis with shared frailty was used to assess the factors associated with failures (p < 0.05). The etching time did not influence the restorations' survival (HR 0.35 95%CI 0.11-1.12; p = 0.06). Mean estimated time of survival was 17.6 months (95%CI, 17.2-17.9). The survival rates at the 18-month follow-up were 75.7% and 91.4% (AFR: 16.9% and 5.7%) when primary dentin was acid etched for 15 and 7 s, respectively (log-rank p = 0.06). In conclusion, the etching time for dentin did not influence the clinical behavior of adhesives restorations. However, there was a tendency for better clinical outcome when using etching time of 7 s.


Subject(s)
Tooth, Deciduous , Dentin-Bonding Agents , Composite Resins , Dental Restoration, Permanent , Dentin , Molar
6.
Rev. ABENO ; 20(1): 68-79, 2020. ilus, tab
Article in English | LILACS, BBO | ID: biblio-1284606

ABSTRACT

This study investigated the teaching of direct resin composite restoration repair in primary teeth in undergraduate dental programs within Brazil. A questionnaire relating to this topic was developed and e-mailed to 205undergraduate dental schools between May and September 2019.Data obtained were analyzed descriptively. Theresponse rate was 43.4% and out of those responding schools, 82% included this topic within theircurriculum. Two of the most commonly reported reasons for teaching repair of resin composite restorations were dental structure preservation (95.9%), and reduction in the risk of pulp complications (71.2%). With regard to protocol for repair, few schools (24.7%) taught mechanical roughening of the resin portion to be repaired with diamond burs. Conversely, phosphoric acid etching was recommended by 87.7% of schools and 76.7% indicated adhesive application into prepared surface.The most commonly taught material for repair was conventional resin composite.The teaching the repair of failed resin composite restorations has been established within the curriculum of undergraduate dental programs in Brazil. However, there is no consensus for the clinical protocol for repair (AU).


Este estudo investigou o ensino do reparo de restauração direta de resina composta em dentes decíduos nos cursos de graduação em Odontologia no Brasil. Um questionário referente a este tópico foi desenvolvido e enviado por e-mail para 205 cursos de Odontologia entre maio e setembro de 2019. Os dados obtidos foram analisados descritivamente. A taxa de resposta foi de 43,4% e dos cursos respondentes, 82% incluíram esse tópico em seu currículo. As duas razões mais comumente relatadas para o ensino do reparo de restaurações de resina composta foram preservação da estrutura dentária (95,9%) e redução do risco de complicações pulpares (71,2%). No que diz respeito ao protocolo para reparo, poucos instituições(24,7%) ensinaram o desgaste mecânico da porção da resina a ser reparada com pontas diamantadas. Por outro lado, o condicionamento com ácido fosfórico da superfície preparada foi recomendado por 87,7% das instituições e 76,7% indicaram aplicação de adesivo na superfície preparada. O material mais comumente ensinado para reparo foi resina composta convencional. O ensino do reparo de restaurações de resina composta com falhas foi estabelecido dentro do currículo dos cursos de graduação em Odontologia no Brasil. No entanto, não há consenso sobre o protocolo clínico para reparo (AU).


Subject(s)
Students, Dental , Brazil/epidemiology , Composite Resins , Dental Restoration Failure , Education, Dental , Tooth, Deciduous , Clinical Protocols , Surveys and Questionnaires , Pediatric Dentistry , Curriculum/standards , Dentistry
7.
Article in English | LILACS, BBO | ID: biblio-1135490

ABSTRACT

Abstract Objective: To investigate the association between child's daytime caring person and risk for higher early childhood caries (ECC) experience. Material and Methods: The sample consisted of all clinical records (census) of children (0-3 years old) attended in a public dental clinic, which contained information about caries experience and child's daytime caring person (mother, grandmother or others). Caries experience was dichotomized as dmft ≤ 2 or dmft >2. Data were analyzed by the chi-square (α = 0.05). Binary logistic regression models were built. Results: From a total of 310 children, 19% of children had the grandmother as daytime caring person. There was no association between child's daytime caring person and caries experience (p=0.32). Logistic regression analysis showed that low daytime caregiver schooling (OR: 5.76 95%CI 1.18-28.18; p=0.02) and child's age (OR: 1.14 95% CI 1.09-1.19; p=0.00) were risk factors, and breastfeeding duration (> 9 months - OR: 0.38 95% CI 0.21-0.68; p=0.00), no nocturnal feeding (OR: 0.50 95% CI 0.27-0.91; p=0.02), and absence of sugar consumption between main meals (OR: 0.50 95% CI 0.28-0.89; p=0.02) were protection factors for ECC. Conclusion: A higher caries experience in early childhood is not associated to child's daytime caring person. On the other hand, the higher caries experience is associated with low caregiver schooling and older children.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Tooth, Deciduous , Retrospective Studies , Risk Factors , Caregivers , Dental Caries/prevention & control , Brazil/epidemiology , Breast Feeding , Chi-Square Distribution , Logistic Models , Dental Clinics
8.
Article in English | LILACS, BBO | ID: biblio-1101281

ABSTRACT

Abstract Objective: To assess the reproducibility of two clinical criteria for the evaluation of restorations in primary teeth and the impact on treatment decision. Material and Methods: A cross-sectional study was performed selecting 71 resin-based composite restorations placed in primary molars of children who had sought dental treatment at a dental school. Two trained examiners evaluated independently the restorations using modified FDI and USPHS criteria. All restorations were assessed separately with each system in random order to avoid memory bias. Kappa statistics were used to determine inter-examiner reliability considering each parameter of both criteria and score final about treatment decision. McNemar test was used to compare the treatment decision with two criteria. The significance level was set at 5%. Results: Kappa values ranged from 0.28 to 0.93 with USPHS and 0.28 to 0.88 with FDI, considering each parameter separately. Inter-examiner agreement for treatment decision was excellent for both criteria (Kappa: 0.85-0.90). For clinical decision-making, no difference between criteria was found, irrespective of examiner. Conclusion: Low inter-examiner agreement for evaluation of each parameter of USPHS and FDI criteria does not reflect on reproducibility for treatment decision. Both criteria may be suitable for evaluation of composite restorations in primary teeth.


Subject(s)
Humans , Male , Female , Child , Tooth, Deciduous , Dental Care/psychology , Dental Restoration Failure , Clinical Decision-Making , Molar , Schools, Dental , Brazil/epidemiology , Cross-Sectional Studies/methods , Data Interpretation, Statistical , Composite Resins/therapeutic use
9.
Pesqui. bras. odontopediatria clín. integr ; 19(1): 4067, 01 Fevereiro 2019. ilus, tab
Article in English | LILACS, BBO | ID: biblio-997984

ABSTRACT

Objective: To compare the teaching of the pulpectomy in primary teeth among graduate and undergraduate Brazilian dental schools. Material and Methods: From August 2015 to July 2016, an 11-question survey was sent to 44 graduate and 207 undergraduate dental schools. Data obtained were summarized using descriptive statistics. Results: The response rate was higher from graduate (56.8%) than undergraduate (41.1%) courses. Pulpectomy was taught by all participating schools. More than 90% of the undergraduate and graduate courses recommend the use of hand instruments for canals debridement, but the widening of root canals was advised in 69.4% of undergraduate and in 84% of graduate schools. Regarding the irrigatings, 1% sodium hypochlorite as a single irrigating solution was the most taught for both biopulpectomy and necropulpectomy. The iodoform-based Guedes-Pinto paste as the single indication was the preferred root canal filling material in undergraduate schools (30.6%), while the zinc oxidethickened calcium hydroxide paste as the single option was the most recommended in graduate courses (36%). Endodontic hand file associated with lentulo drill for filling root canals was recommended by most courses. Overall, biopulpectomy was performed in one session, while necropulpectomy led two sessions. Periapical radiograph for diagnosis and final obturation was the most adopted conduct by undergraduate (68.2%) and graduate (72%) schools. Gutta-percha and glass ionomer cement were preferred materials to seal the entrance of the pulp chamber. Conclusion: There was variability in the techniques and materials taught to perform pulpectomy in primary teeth among Brazilian graduate and undergraduate dental schools. Calcium hydroxide paste has been used in similar proportion to iodoform-based paste.


Subject(s)
Pulpectomy/methods , Tooth, Deciduous/diagnostic imaging , Brazil , Calcium Hydroxide/analysis , Education, Dental , Surveys and Questionnaires
10.
Braz. oral res. (Online) ; 33: e038, 2019. tab, graf
Article in English | LILACS | ID: biblio-1001609

ABSTRACT

Abstract: This study aimed to evaluate the bond strength of a universal adhesive system to enamel surrounding real-life carious cavities. Twenty-eight permanent molars (n = 7) with carious lesions in dentin were subjected to selective carious tissue removal to firm dentin and had their crowns sectioned longitudinally. A universal adhesive system (Single Bond Universal [SBU] used in either etch-and-rinse and self-etch strategies) was compared with an etch-and-rinse Adper Single Bond 2 (ASB) and a self-etch Clearfil SE Bond (CSE) adhesive systems (control systems). Adhesives were applied on the enamel, assumed demineralized, surrounding the cavity margins and on sound enamel (control substrate). Composite cylinders were built (0.72 mm2) and microshear bond strength (µSBS) test was performed after 24 h of water storage. The µSBS values (MPa) were analyzed using two-way ANOVA and Tukey's post hoc tests (α = 0.05). Bond strength values obtained in demineralized enamel surrounding carious cavity margins were significantly lower than that obtained in sound enamel (distant from carious cavity margins) (p = 0.035). The bonding strategy of the SBU did not influenced the bond strength values, which were higher than that obtained with ASB. CSE showed similar µSBS values to ASB and SBU in the self-etch mode. In conclusion, the bond strength to enamel assumed demineralized is lower than to sound enamel. The enamel surrounding carious cavities jeopardize the bonding of universal adhesive system. The bond strength of universal adhesive is similar, regardless to bonding strategy.


Subject(s)
Humans , Dental Bonding/methods , Bisphenol A-Glycidyl Methacrylate/chemistry , Dental Caries/therapy , Dental Cements/chemistry , Dental Enamel/drug effects , Surface Properties , Materials Testing , Microscopy, Electron, Scanning , Random Allocation , Reproducibility of Results , Analysis of Variance , Bisphenol A-Glycidyl Methacrylate/therapeutic use , Statistics, Nonparametric , Resin Cements/therapeutic use , Resin Cements/chemistry , Dental Cements/therapeutic use , Shear Strength , Dentin/drug effects
11.
Rev. ABENO ; 18(2): 2-12, maio 2018. ilus, graf
Article in Portuguese | LILACS, BBO | ID: biblio-907110

ABSTRACT

O presente estudo propõe um método para o ensino de detecção e avaliação de lesões de cárie, utilizando o Sistema Internacional de Avaliação e Detecção de Cárie (ICDAS) como ferramenta auxiliar. Sessenta e dois estudantes do quarto ano do curso de graduação em Odontologia da Universidade de São Paulo foram submetidos a três atividades de treinamento para uso do ICDAS, aplicadas em diferentes momentos: aula teórica convencional, atividade com projeção de imagens e atividade prática-laboratorial com dentes extraídos. Os estudantes responderam a questionários, antes e após as atividades, para avaliação do conhecimento e da percepção sobre as mesmas. Também foi realizada avaliação prática, com avaliação de dentes extraídos. Após os exercícios laboratoriais, a média de respostas corretas para questões conceituais aumentou significativamente e se manteve até o final da atividade laboratorial. Quem acreditava estar bem preparado no início da atividade teve 3 vezes mais chances de alcançar nota acima de 5 no segundo momento da atividade prática-laboratorial (OR=3,1; 95% IC=1,0 ­ 9,1). Concluiu-se que a atividade prática-laboratorial contribui para o aprendizado de estudantes de graduação na detecção de lesões cárie, inclusive sanando dúvidas conceituais que possam existir após a aula teórica. Todavia, a percepção do estudante pode não ser impactada pela atividade (AU).


The present study proposes a method for the teaching of the detection and evaluation of caries lesions, using the International Caries Detection and Assessment System (ICDAS) as an auxiliary tool. Sixty-two students in the fourth year of the undergraduate course in Dentistry of the University of São Paulo underwent three training activities for the use of the ICDAS, applied in different moments: regular theoretical class, activity with images projection and practicallaboratory activity. The students answered questionnaires, before and after the activities, to evaluate the knowledge and the perception about them. A practical evaluation was also performed, with evaluation of extracted teeth. After the laboratory exercises, the mean number of correct answers to conceptual questions increased significantly and remained until the end of the laboratory activity. Those who believed to be well prepared at the beginning of the activity had three times more chances to reach a score above 5 in the second moment of the practicallaboratory activity (OR = 3.1; 95% CI = 1.0 - 9.1). It was concluded that the practicallaboratory activity contributes to the learning of undergraduate students in the detection of caries lesions, including healing conceptual doubts that may exist after the theoretical class. However, the student's perception may not be impacted by the activity (AU).


Subject(s)
Humans , Dental Caries/diagnosis , Education, Dental , Problem-Based Learning/methods , Students, Dental , Brazil , Linear Models , Logistic Models , Surveys and Questionnaires
12.
Braz. oral res. (Online) ; 32: e10, 2018. tab, graf
Article in English | LILACS | ID: biblio-889487

ABSTRACT

Abstract This study aimed to compare the longevity of different conventional restorative materials placed in posterior primary teeth. This systematic review was conducted following the PRISMA statement and registered in PROSPERO (CRD42016035775). A comprehensive electronic search without date or language restrictions was performed in PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Scopus, Turning Research Into Practice (TRIP) and Clinical Trials databases up to January 2017, selecting randomized clinical trials that assessed the longevity of at least two different conventional restorative materials performed in primary molars. Seventeen studies were included in this systematic review. Pairwise and network meta-analyses were performed and relative risks and 95% confidence intervals (CI) calculated. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias. Restorations of primary molars with conventional glass ionomer cement showed increased risk of failure than compomer, resin-modified glass ionomer cement, amalgam, and composite resin. Risk of bias was low in most studies (45.38% of all items across studies). Pediatric dentists should avoid conventional glass ionomer cement for restoring primary molars.


Subject(s)
Humans , Dental Materials/therapeutic use , Dental Restoration, Permanent/methods , Tooth, Deciduous , Dental Caries/therapy , Dental Restoration Failure , Network Meta-Analysis , Publication Bias , Risk Assessment , Treatment Outcome
13.
Stomatos ; 23(44): [5-12], 20170710.
Article in English | LILACS-Express | LILACS | ID: biblio-846658

ABSTRACT

This study assessed the influence of evaluation methods in the occurrence of foramina in the pulp chamber floor and in the furcation area of molars with complete and incomplete root formation. Methodology: A sample of 360 sound mandibular permanent molars was selected and prepared. A single experienced operator evaluated the whole sample using two methods: clinical inspection (with the naked eye) and dental microscope (at 30x magnification). Chisquare test was used to compare the detection of foramina between evaluation methods in both regions (p<0.05). Results: A limited number of specimens with foramina in the pulp chamber floor was observed, while there were more teeth with foramina in the furcation area, according both methods. The dental microscope identified significantly more molars with foramina in the furcation (p=0.000) and in the pulp chamber floor (p=0.031) than the clinical inspection. Conclusions: The presence of foramina in the furcation region is substantially greater than in the pulp chamber floor, regardless of the evaluation method. The presence of foramina is not influenced by the rhizogenesis stage. The dental microscope is an excellent tool to view dental anatomical details.


Este estudo avaliou a influência dos métodos de avaliação na ocorrência de foraminas no assoalho da câmara pulpar e na área de furca dos molares com formação radicular completa e incompleta. Metodologia: Uma amostra de 360 molares permanentes inferiores hígidos foi selecionada e preparada. Um único operador experiente avaliou toda a amostra utilizando dois métodos: exame clínico (a olho nu) e microscópio odontológico (com aumento de 30x). O teste do qui-quadrado foi utilizado para comparar a detecção de foraminas entre os métodos de avaliação em ambas as regiões (p<0,05). Resultados: Observou-se um número limitado de espécimes com foraminas no assoalho da câmara pulpar, enquanto que havia mais dentes com foraminas na área de furca, de acordo com ambos os métodos. O microscópio odontológico identificou significativamente mais molares com foraminas na furca (p=0,000) e no assoalho da câmara pulpar (p=0,031) do que na inspeção clínica. Conclusões: A presença de foraminas na região de furca é substancialmente maior do que no assoalho da câmara pulpar, independentemente do método de avaliação. A presença de foraminas não é influenciada pelo estágio de rizogênese. O microscópio odontológico é uma excelente ferramenta para ver detalhes anatômicos dentários.

14.
Braz. oral res. (Online) ; 31: e101, 2017. tab, graf
Article in English | LILACS | ID: biblio-952124

ABSTRACT

Abstract: This study aimed to systematically review the literature to address the question regarding the influence of different materials in the clinical and radiographic success of indirect pulp treatment in primary teeth. A literature search was carried out for articles published prior to January 2017 in PubMed/MEDLINE, CENTRAL, Scopus, TRIP and ClinicalTrials databases; relevant articles included randomized clinical trials that compared materials used for indirect pulp treatment in primary teeth. Two reviewers independently selected the studies and extracted the data. The effects of each material on the outcome (clinical and radiographic failures) were analyzed using a mixed treatment comparisons meta-analysis. The ranking of treatments according to their probability of being the best choice was also calculated. From 1,088 potentially eligible studies, 11 were selected for full-text analysis, and 4 were included in the meta-analysis. In all papers, calcium hydroxide liner was used as the control group versus an adhesive system, resin-modified glass ionomer cement or placebo. The follow-up period ranged from 24 to 48 months, with dropout rates of 0-25.7%. The material type did not significantly affect the risk of failure of the indirect pulp treatment. However, calcium hydroxide presented a higher probability of failure. In conclusion, there is no scientific evidence showing the superiority of any material used for indirect pulp treatment in primary teeth.


Subject(s)
Humans , Tooth, Deciduous/drug effects , Calcium Hydroxide/therapeutic use , Dental Pulp/drug effects , Dental Pulp Capping/methods , Glass Ionomer Cements/therapeutic use , Gutta-Percha/therapeutic use , Tooth, Deciduous/diagnostic imaging , Radiography, Dental , Treatment Outcome , Publication Bias , Dental Caries/therapy
15.
Fisioter. pesqui ; 23(4): 448-457, out.-dez. 2016. tab, graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-840578

ABSTRACT

RESUMO Estudos têm demonstrado que, dentre as diversas técnicas que envolvem a fisioterapia respiratória, o treinamento muscular inspiratório (TMI) é essencial na recuperação da função pulmonar e na prevenção de complicações respiratórias. Porém, o efeito do TMI em pacientes submetidos à cirurgia bariátrica ainda é inconclusivo. O objetivo deste estudo foi revisar sistematicamente ensaios clínicos randomizados que avaliaram o efeito do TMI em comparação a TMI sham, fisioterapia convencional (exercícios respiratórios e deambulação precoce) ou nenhuma intervenção na função pulmonar em pacientes submetidos à cirurgia bariátrica. A estratégia de busca foi realizada nas bases de dados PubMed / MEDLINE, Cochrane, TRIP, PEDro e Scopus sem restrição de ano de publicação ou de idioma, conforme a recomendação PRISMA. Dois revisores selecionaram os estudos, extraíram os dados e avaliaram o risco de viés de forma independente. Dos 2.184 estudos potencialmente elegíveis, 2 foram incluídos. O critério do risco de viés foi adaptado e dividido em 9 áreas usando o Handbook da Cochrane. Esta revisão incluiu 62 participantes, sendo 30 alocados para receber dispositivo Threshold® TMI, mas em diferentes períodos, pré-operatório e pós-operatório. O TMI promoveu aumento da pressão inspiratória máxima (PIM) em relação à fisioterapia convencional, mas não foram encontradas diferenças significativas na pressão expiratória máxima (PEM). Os estudos apresentaram baixo e incerto risco de viés. O TMI parece ser o tratamento mais eficaz em comparação à fisioterapia convencional isolada tanto no pré quanto no pós-operatório. No entanto, não há nenhuma evidência sólida para a tomada de decisões clínicas.


ABSTRACT Studies have shown that among the various techniques that involve chest physical therapy, the inspiratory muscle training (IMT) is essential in the recovery of lung function and in preventing respiratory complications. However, the effect of IMT on patients undergoing bariatric surgery is still inconclusive. The aim of this study was to systematically review randomized and controlled trials that assessed the effect of IMT compared with sham IMT, standard physical therapy (breathing exercises and early ambulation) or no intervention in the lung function on patients undergoing bariatric surgery. The search was conducted in PubMed/MEDLINE, Cochrane, TRIP, PEDro and Scopus databases with no publication year or language limits, following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias. From 2,184 potentially eligible studies, two studies were included. Bias risk criteria were adapted and divided into nine main areas using the Cochrane Handbook. This review included 62 participants, being 30 allocated to receive Threshold® IMT device, but in different periods: preoperative and postoperative. IMT promoted increased maximal inspiratory pressure (MIP) in relation to standard physical therapy, but no significant differences were found in maximal expiratory pressure (MEP). The studies showed low and unclear bias risk. IMT seems to be the most effective treatment in comparison with standard physical therapy alone in pre- or postoperative period. However, there is no solid evidence for clinical decision-making.


RESUMEN Investigaciones comprobaron que, entre las varias técnicas relacionadas a la fisioterapia respiratoria, el entrenamiento muscular inspiratorio (TMI) es fundamental para la recuperación de la función pulmonar y en la prevención de complicaciones respiratorias. Pero poco se sabe sobre los resultados del TMI en pacientes sometidos a la cirugía bariátrica. El propósito de este estudio es revisar sistemáticamente los estudios clínicos aleatorios que evaluaron los resultados del TMI comparado al TMI sham, fisioterapia convencional (ejercicios respiratorios y deambulación precoz) o ninguna intervención en la función pulmonar en pacientes sometidos a la cirugía bariátrica. Se buscó textos en las bases de datos PubMed / MEDLINE, Cochrane, TRIP, PEDro y Scopus, sin restricción de fecha de publicación ni de idioma según recomienda la PRISMA. Dos revisores eligieron los estudios, recolectaron datos y evaluaron el riesgo de sesgo de forma independiente. De los 2.184 estudios probablemente elegidos, se excluyeron dos. Se adaptó el criterio de riesgo de sesgo y lo dividió en nueve áreas empleando el Manual de Cochrane. En esta revisión participaron 62 personas, siendo 30 de ellas elegidas para recibir el dispositivo Threshold® TMI, pero en momentos distintos, en el preoperatorio y el posoperatorio. A pesar de que el TMI aumentó la presión inspiratoria máxima (PIM) en relación a la fisioterapia convencional, en la presión espiratoria máxima (PEM) no se encontraron diferencias significativas. Los estudios presentaron bajo e incierto riesgo de sesgo. El TMI puede ser el tratamiento más eficaz en comparación con la fisioterapia convencional aislada tanto en el preoperatorio como en el posoperatorio. Pero no se encontraron evidencias concretas en la toma de decisiones clínicas.

16.
Pesqui. bras. odontopediatria clín. integr ; 16(1): 331-338, jan.-dez. 2016. tab
Article in English | LILACS, BBO | ID: biblio-912872

ABSTRACT

Objective: To investigate the perception and knowledge of dentists regarding use of the Atraumatic Restorative Treatment (ART) in public health services of cities in the central region of Rio Grande do Sul (RS), Brazil. Material and Methods: A crosssectional study was conducted using a self-administered questionnaire with 60 dentists who work with public dentistry services. To evaluate possible associations between the use of ART and the independent variables we used the chi-square test and logistic regression models (α = 0.05). Results: Forty-four questionnaires were completed, resulting in a response rate of 73%. Of the respondents, 70.4% supported the use of ART and 81.8% reported having some training in the technique. However, 72.7% consider ART to be a temporary or urgent treatment. Professionals who do not advocate the use of ART were 76% less likely to use the technique when compared to their colleagues who defend the use of the technique (OR = 0.24, 95% CI = 0.06 to 0.98). Conclusion: While most dentists have knowledge and positive attitude towards ART, greater dissemination is required for this technique can be used effectively on the public service.


Subject(s)
Humans , Male , Female , Adult , Brazil , Dental Atraumatic Restorative Treatment , Dentists , Health Knowledge, Attitudes, Practice , Primary Health Care , Chi-Square Distribution , Cross-Sectional Studies/methods , Perception , Regression Analysis , Surveys and Questionnaires
17.
Clín. int. j. braz. dent ; 11(4): 376-383, out.-dez.2015. ilus, tab
Article in Portuguese | LILACS | ID: lil-790474

ABSTRACT

A técnica da réplica oclusal é indicada nos casos em que há evidências, principalmente radiográficas, de comprometimento dentário sob o esmalte parcialmente íntegro. O objetivo deste estudo foi descrever um caso clínico de tratamento de lesão de cárie em dentina, ICDAS 4, por meio da técnica da réplica oclusal e remoção parcial do tecido cariado. Após 2 anos de acompanhamento clínico e radiográfico não foi observada progressão da lesão de cárie, e os detalhes anatômicos foram preservados, indicando sucesso da terapêutica...


The occlusal replica technique is indicated in cases where there are evidences, mainly radiographic, of dentinal involvement under partially intact enamel. The aim of this study was to describe a clinical case of treatment of “hidden” caries lesion in dentin, ICDAS 4, by occlusal replica technique and partial removal of the carious tissue. After 2 years of clinical and radiographic follow-up, it was not observed progression of the caries lesion and anatomical details were preserved, indicating success of the therapy...


Subject(s)
Humans , Male , Adolescent , Composite Resins , Dental Caries , Dentition, Permanent
18.
RGO (Porto Alegre) ; 63(2): 187-194, Apr.-June 2015. tab, ilus
Article in English | LILACS-Express | LILACS | ID: lil-755129

ABSTRACT

OBJECTIVE:

The purpose of this research was to follow the radiolucent area (pixels) in the furcation area and the behavior of the endodontically treated deciduous molars with different simplified echniques.

METHODS:

The treatments were performed without the duct instrumentation using relative isolation and two drugs were applied, as follows: G1: Guedes-Pinto paste (GP) and G2: CTZ paste (CTZ) for the pulp chamber filling. The radiolucent areas in the furcation region of deciduous molars were obtained from previous x-rays, after 6 and 12 months of the endodontic treatment and was analysed by l Image Tool 3.0 by two blinded examiners. In order to analyse the calibration between the examiners, Kappa test was used and for comparison of the initial radiographic image, analysis of variance was used after 6 and 12 months of each group and Tukey spost-hoc test. T-Student test was used for comparison between groups.

RESULTS:

There was a reduction of radiolucent area after 6 (p<0.01) and 12 months (p<0.01) in the teeth treated with CTZ paste. In the teeth treated with PG there was not reduction of radiolucent area after 12 months. (p= 0,09).

CONCLUSION:

Although the clinical signs were similar in both groups after 12 months of follow up, only teeth treated with CTZ showed reduction of radiolucent area in the furca area after 6 and 12 months.

.

OBJETIVO:

A proposta da pesquisa foi acompanhar a area radiolúcida (pixels) na região de furca e a resposta clínica de molares decíduos tratados endodonticamente com diferentes tecnicas simplificadas.

MÉTODOS:

Os tratamentos foram executados sem instrumentação dos condutos e com isolamento relativo, utilizando-se dois medicamentos: G1:Pasta Guedes-Pinto (PG) e G2: Pasta CTZ (CTZ) no preenchimento da câmara pulpar . As áreas radiolúcidas na região de furca dos molares decíduos obtidas das radiografias antes, após 6 meses e 12 meses do tratamento endodôntico foram analisadas no programa Image Tool 3.0 por 2 examinadores cegos. Para analisar a calibração entre os examinadores foi utilizado o teste Kappa e para comparação da imagem radiográfica inicial, após 6 e 12 meses de cada grupo foi utilizado a Análise de Variância e o teste complementar de Tukey. O teste T Student foi usado para comparação entre os grupos.

RESULTADOS:

A redução da área radiolúcida inicial após 6 (p<0,01) e 12 meses (p<0,01) foi observada somente com o uso da pasta CTZ. O emprego da pasta Guedes não resultou em diminuição da área radiolúcida após 12 meses de acompanhamento (p=0,09).

CONCLUSÃO:

A resposta clínica foi semelhante em ambos os grupos, porém apenas os dentes tratados com a pasta CTZ apresentaram redução da área radiolúcida na região da furca após 6 e 12 meses de acompanhamento.

.

19.
Braz. oral res. (Online) ; 29(1): 1-6, 2015. tab, ilus
Article in English | LILACS | ID: lil-777172

ABSTRACT

This in vitrostudy evaluated the immediate and 6 months microshear bond strength (µSBS) of different adhesive systems to sound and eroded dentin. Sixty bovine incisors were embedded in acrylic resin and ground to obtain flat buccal dentin surfaces. Specimens were randomly allocated into two groups: sound dentin (immersion in artificial saliva) and eroded dentin (erosive challenge following a pH cycling model comprising 4 ×/day Sprite Light® drink for 10 days). Then, specimens were reassigned according to the adhesive system: etch-and-rinse adhesive (Adper Single Bond), two-step self-etch system (Clearfil SE Bond), or one-step self-etch adhesive (Adper Easy One). Polyethylene tubes with an internal diameter of 0.76 mm were placed over pre-treated dentin and filled with resin composite (Z250). Half of the specimens were evaluated by the µSBS test after 24 h, and the other half 6 months later, after water storage at 37°C. Failure mode was evaluated using a stereomicroscope (400×). Data were analyzed by three-way repeated measures analysis of variance and Tukey’s post hoc tests (α = 0.05). After 6 months of water aging, marked reductions in µSBS values were observed, irrespective of the substrate. The µSBS values for eroded dentin were lower than those obtained for sound dentin. No difference in bonding effectiveness was observed among adhesive systems. For all groups, adhesive/mixed failure was observed. In conclusion, eroded dentin compromises the bonding quality of adhesive systems over time.


Subject(s)
Animals , Cattle , Dental Bonding/methods , Dental Cements/chemistry , Dentin/drug effects , Tooth Erosion , Composite Resins/chemistry , Dental Restoration Failure , Materials Testing , Random Allocation , Resin Cements/chemistry , Saliva, Artificial/chemistry , Shear Strength/drug effects , Surface Properties/drug effects , Time Factors , Water/chemistry
20.
São Paulo; s.n; 2013. 85 p. ilus, tab, graf. (BR).
Thesis in Portuguese | LILACS, BBO | ID: lil-710767

ABSTRACT

Este estudo objetivou investigar a influência da redução do tempo de condicionamento na união de sistemas adesivos à dentina hígida e afetada por cárie de dentes decíduos, por meio de testes de microtração, nanoinfiltração e avaliação micromorfológica da interface adesiva. A superfície dentinária de 48 segundos molares decíduos foi exposta e os dentes divididos aleatoriamente em 8 grupos experimentais de acordo com o substrato (dentina hígida e afetada por cárie ciclagem de pH por 14 dias), sistema adesivo (Adper Single Bond 2 adesivo convencional de dois passos e Clearfil SE Bond - sistema autocondicionante de dois passos) e tempo de condicionamento (recomendado pelo fabricante e metade do tempo). Desta forma, o adesivo Adper Single Bond 2 foi aplicado à dentina após condicionamento com ácido fosfórico a 35% por 15 ou 7 segundos e o agente de união do Clearfil SE Bond após 20 ou 10 segundos de aplicação do primer. Blocos de resina composta (Filtek Z250) foram confeccionados e, após 24 horas de armazenamento em água destilada, os dentes foram seccionados para obtenção de espécimes com área de secção transversal de aproximadamente 0,8 mm2. Metade dos espécimes foi submetida imediatamente ao teste de microtração e a outra metade após 12 meses de armazenamento em água destilada. O padrão de fratura foi avaliado em estereomicroscópio com aumento de 400x. Dois espécimes de cada dente nos respectivos períodos de armazenamento foram imersos em nitrato de prata amoniacal por 24 horas e revelados (8 horas) para avaliação da nanoinfiltração em microscopia eletrônica de varredura. Adicionalmente, dois dentes para cada grupo experimental (n=16) foram preparados como descrito para o teste de microtração e seccionados perpendicularmente à interface adesiva, após 24 horas, para análise da micromorfologia e espessura da camada híbrida.


Os valores de resistência de união, expressos em megapascal (MPa), foram submetidos à Análise de Variância (ANOVA) e teste de Tukey ( = 0,05). As demais avaliações foram descritivas. Os sistemas adesivos apresentaram valores similares de resistência de união imediata. Decréscimo dos valores de resistência de união ocorreu após 12 meses de armazenamento em água, exceto para o adesivo Clearfil SE Bond em substrato hígido. A adesão à dentina afetada foi menor em comparação à dentina hígida. A nanoinfiltração também foi mais pronunciada neste substrato. O tempo de condicionamento influenciou apenas a adesão do sistema adesivo Adper Single Bond 2. Maiores valores de resistência de união e menor infiltração de nitrato de prata na interface adesiva foram observados quando o tempo de condicionamento ácido foi reduzido pela metade, independente do substrato. Camadas híbridas mais finas foram produzidas quando a dentina decídua foi condicionada por 7 segundos, especialmente em dentina afetada. Predomínio de fratura adesiva/mista foi observado para todos os grupos experimentais. Em conclusão, o efeito da redução no tempo de condicionamento é material dependente e resulta em maior estabilidade da união de sistema adesivo convencional de dois passos à dentina hígida e afetada de dentes decíduos.


This study aimed to investigate the influence of shortening the etching time on bond of adhesive systems to sound and caries-affected dentin of primary teeth by microtensile and nanoleakage tests, and micromorphological evaluation of the adhesive interface. The dentinal surface of 48 second primary molars was exposed and the teeth were randomly assigned to 8 experimental groups according to substrate (sound and caries-affected dentin - pH-cycling for 14 days), adhesive system (Adper Single Bond 2 two-step etch-and-rinse adhesive system and Clearfil SE Bond two step self-etch adhesive system) and etching time (recommend by manufacturers and half-reduced time). Thus, the adhesive Adper Single Bond 2 was applied to dentin after 35% phosphoric acid etching for 15 or 7 seconds, and the bond of Clearfil SE Bond after 20 or 10 seconds of primer application. Composite resin blocks (Filtek Z250) were built and, after 24 hours of storage in distilled water, the teeth were sectioned to obtain specimens with cross-sectional area of approximately 0.8 mm2. Half of the specimens were immediately subjected to microtensile test and the other half after 12 months of storage in distilled water. The fracture pattern was evaluated with a stereomicroscope at 400x magnification. Two specimens from each tooth in the respective storage periods were immersed in ammoniacal silver nitrate for 24 hours and revealed (8 hours) to evaluate the nanoleakage in scanning electron microscope. Additionally, two teeth for each experimental group (n=16) were prepared as described for the microtensile test and perpendicularly sectioned to the adhesive interface, after 24 hours, for analysis of micromorphology and thickness of the hybrid layer.


Bond strength values, expressed in megapascal (MPa), were submitted to Analysis of Variance (ANOVA) and Tukeys tests ( = 0.05). Other evaluations were descriptive. The adhesive systems presented similar immediate bond strength values. A decrease in bond strength values occurred after 12 months of water storage, except for Clearfil SE Bond in sound substrate. Bonding to caries-affected dentin was lower compared to sound dentin. The nanoleakage was also more pronounced in this substrate. Etching time only influenced the bonding of the adhesive system Adper Single Bond 2. Higher bond strength values and lower infiltration of silver nitrate into adhesive interface were observed when the etching time was half-reduced, irrespective of the substrate. Thinner hybrid layers were produced when the primary dentin was acid etched for 7 seconds, especially in caries-affected dentin.


Subject(s)
Dentin-Bonding Agents/analysis , Dental Caries/pathology , Dentin , Microscopy, Electron, Scanning , Tensile Strength , Tooth, Deciduous
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