Selamento de lesões cariosas em molares decíduos / Sealing of carious lesions in deciduous molars

Objetivo:Investigar a eficácia do selamento de lesão de cárie dentinária em comparação com a remoção parcial de cárie seguida de restauração em molares decíduos. Material e Método: O estudo clínico randomizado foi planejado ser realizado em 60 crianças com idade entre 3 e 8 anos. As crianças foram randomizadas por sorteio, com alocação para os 3 grupos, sendo 20 em cada grupo: Grupo 1 (G1) constituído por crianças que receberam o selamento de cárie com resina fluida; Grupo 2 (G2) com crianças que receberam o selamento de cárie com cimento de ionômero de vidro de alta viscosidade e Grupo controle (G3) com crianças onde a remoção parcial da cárie foi seguida por restauração com cimento de ionômero de vidro resinoso. Foram feitos acompanhamentos clínicos e radiográficos antes e após a intervenção, bem como a cada 4 meses durante 1 ano, investigando-se se houve fratura no selamento ou na restauração (infiltração marginal), paralização, regressão ou evolução do processo carioso nos 3 grupos. Resultados: A amostra foi reduzida para 49 crianças pois durante a fase de controle clínico radiográfico, 11 não foram localizadas por mudança de endereço.O grupo G1 apresentou 50% dos casos com regressão e 50% dos casos em paralização. O grupo G2 apresentou 62,5% dos casos com regressão e 37,5% dos casos com paralização e o grupo G3 com 60% dos casos com regressão e 40% com paralização. Não houve associação estatisticamente significativa entre o tipo de grupo e a progressão da lesão, não havendo diferença entre os grupos (valor de p = 0,74). Conclusão: Não houve diferença entre os grupos quanto à progressão de lesão de cárie quando tratados somente com o selamento com resina fluida ou com cimento de ionômero de vidro de alta viscosidade ou com restauração convencional com cimento de ionômero de vidro resinoso após a remoção do tecido cariado.

Aim: To investigate the effectiveness of sealing a dentin caries lesion compared to the removal of partial caries followed by restoration in deciduous molars. Methods: The randomized clinical trial was planned to be performed on 60 children, aged 3 to 8 years. Children were randomized by lot, with allocation into 3 groups, 20 per group: Group 1 (G1) consisted of children who received a sealing of caries using fluid resin; Group 2(G2) included children who received the sealing of caries performed with high viscosity glass ionomer cement, and Group 3(G3) conducted with children where the removal of partial caries was followed by restoration with resinous glass ionomer cement. Clinical and radiographic follow-ups were performed before and after the intervention, as well as every four months for one year, investigating whether there was a fracture in the sealing or restoration (marginal infiltration), paralysis, regression, or evolution of the carious process in the three groups. Results: The sample was reduced to 49 children given that, during the radiographic clinical control phase, 11 were not located due to a change of address. The G1 group presented 50% cases with regression and 50% cases with paralysis. The G2 group presented 62.5% of the cases with regression and 37.5% of the cases with paralysis, while the G3 group showed 60% of the cases with regression and 40% with paralysis. There was no statistically significant association between the type of group and the progression of the lesion, with no difference found between the groups (p value=0.74). Conclusion: There was no difference between the groups regarding the progression of carious lesions when treated only with fluid resin sealing or with high viscosity glass ionomer cement or with conventional restoration with resinous glass ionomer cement after the removal of decayed tissue.

A 12-month Follow-Up Study of Pulp Oxygen Saturation in Deciduous Molars After Selective and Nonselective Carious-Tissue Removal: A Randomized Pilot Trial

ABSTRACT Objective: To compare the pulp vitality of deciduous molars before and after selective caries removal (SCR) or nonselective caries removal to hard dentin (NSCR) over one year, using oxygen saturation percentage (%SaO2). Material and Methods: Deciduous molars with deep occlusal/proximal-occlusal caries lesions were randomized to SCR (n=22) or NSCR groups (n=22). After the caries removal, the teeth were protected with calcium hydroxide cement and restored with composite resin (Filtek Z250). The pulp condition diagnosis was evaluated at baseline, immediately after caries removal, and follow-up (7 days, 1-, 6- and 12-months) by %SaO2. Pulp exposure and pulp necrosis were primary outcomes, and %SaO2 was secondary. Results: Intraoperative pulp exposure occurred in four teeth of the NSCR group (18.2%) and one tooth of the SCR group (4.5%) (p>0.05). Two cases of pulp necrosis occurred in the NSCR group (10%). No difference in %SaO2 pulp was observed in the inter-and intragroup comparison over time (p>0.05). Conclusion: Advantageously, the %SaO2 minimizes preoperatory pulp vitality diagnosis subjectivity before SCR/ NSCR treatments. Furthermore, the pilot study results suggest the pulp response of deciduous molars, when evaluated by clinical, radiographic, and pulp %SaO2 seems not to differ between teeth treated with SCR or NSCR.

Bond strength of bulk-fill resin composites: the effect of cavity preparation and aging

Aim: Evaluating the resin-dentin bond strength of Class II conventional and bulk-fill composite restorations, using different cavity sizes before and after aging. Methods: Seventy-five human molars were distributed into groups according to the buccolingual width of the cavities, conservative (n=25) and extended (n=50). They were divided according to the restorative material: conventional (Z100/control group) or bulk-fill resin composites (Filtek Bulk Fill/FBF; Tetric N Ceram Bulk Fill/TNCBF; Filtek Bulk Fill Flow/FBFF; Surefill SDR flow/SDR). The restored teeth were sectioned on sticks (n=50 per restorative materials + width cavities group), half were stored in Water/Ethanol 75% for 30 days and the other half were submitted to the immediate microtensile bond strength (µTBS) test. Data were analyzed applying the Three-Way Analysis of Variance (ANOVA), Bonferroni test, test t, and Weibull analyses (p<0.05). Results: SDR and FBF presented lower µTBSvalues for extended preparation when compared to the conservative preparation, before aging. After aging, only for the FBFF, a decrease in the µTBSvalues was observed. Comparing the µTBSvalues, before and after aging, the SDR demonstrated lower µTBSvalues after aging when the conservative cavity was used. A decrease in the µTBSvalues was observed for the Z100, the FBF and, the FBFF, after aging, when the extended cavity was used. Conclusion: The effect of cavity preparation and aging on the resin-dentin of Class II is material dependent. Most of the bulk-fill resin composites evaluated presented a similar performance to the conventional resin composites for all the conditions of this study

Effect of liners on composite resin microleakage after selective carious lesion removal: an experimental study / Efecto de los recubrimiento en la microfiltración de resina compuesta después de la eliminación selectiva de lesiones cariosas: un estudio experimental

Objetive: To evaluate microleakage of composite resins (CR) placed over different cavitary liners after managing deep caries lesions through selective removal of soft carious tissue to soft dentin (SRCT-S). Material and Methods: Fifty four human teeth were collected for microleakage testing. Each assay comprised ICDAS 5 or ICDAS 6 carious lesions and sound teeth for controls. Sound teeth were prepared with cavities that mirrored the carious teeth cavities, which were prepared with SRCT-S. Sound and carious teeth were further randomly assigned to one of the three experimental groups: Group A: universal adhesive (UA) + CR, Group B: glass ionomer cement liner + UA + CR, and Group C: calcium hydroxide + UA+ CR. Occlusal microleakage (OM) and cervical microleakage (CM) was classified within one of 5 depth categories. ANOVA and Chi-square tests were computed (p<0.05). Results: OM and CM were similarly distributed across subgroups (p>0.05). All Group C samples with carious lesions presented some degree of microleakage. However, no statistically significant differences were observed between groups and within each group (p>0.05). Conclusion: Teeth restored with CR after SRCT-S using calcium hydroxide as a liner material seem to exhibit higher microleakage than those restored using glass ionomer or UA alone. Further clinical research is needed to deepen these findings. Clinical significance: The application of calcium hydroxide as a liner under a composite resin may reduce the longevity of a restoration after performing selective or partial removal of carious tissues. Clinicians should rethink the need of using calcium hydroxide for this application, albeit the lack of clinical evidence.

Objetivo: Evaluar la microfiltración de resinas compuestas (RC) colocadas sobre diferentes liners cavitarios después del manejo de lesiones de caries profundas mediante la remoción selectiva de tejido cariado blando hasta dentina blanda (SRCT-S). Material y Métodos: Se recolectaron 54 dientes humanos para pruebas de microfiltración. Cada ensayo comprendía lesiones cariosas ICDAS 5 o ICDAS 6 y dientes sanos para los controles. Se prepararon dientes sanos con cavidades que reflejaban las cavidades de los dientes cariados, que se prepararon con SRCT-S. Los dientes sanos y cariados se asignaron al azar a uno de los tres grupos experimentales: Grupo A: adhesivo universal (AU) + RC, Grupo B: revestimiento de cemento de ionómero de vidrio + AU + RC, y Grupo C: hidróxido de calcio + AU+ RC. La microfiltración oclusal (MO) y la microfiltración cervical (MC) se clasificaron dentro de una de las 5 categorías de profundidad. Se calcularon las pruebas ANOVA y Chi-cuadrado (p<0,05). Resultados: La MO y MC se distribuyeron de manera similar en los subgrupos (p> 0,05). Todas las muestras del Grupo C con lesiones cariosas presentaron algún grado de microfiltración. Sin embargo, no se observaron diferencias estadísticamente significativas entre grupos y dentro de cada grupo (p>0,05). Conclusión: Los dientes restaurados con RC después de SRCT-S usando hidróxido de calcio como material de revestimiento parecen exhibir una mayor microfiltración que aquellos restaurados usando ionómero de vidrio o AU solo. Se necesita más investigación clínica para profundizar estos hallazgos. Relevancia clínica: la aplicación de hidróxido de calcio como revestimiento debajo de una resina compuesta puede reducir la longevidad de una restauración después de realizar la eliminación selectiva o parcial de los tejidos cariados. Los médicos deberían reconsiderar la necesidad de usar hidróxido de calcio para esta aplicación, aunque no haya evidencia clínica.

Research progress on conservative endodontic access cavities and its stress analysis of teeth / 口腔疾病防治

@#Conservative endodontic access cavity (CEC) is the first step of minimally invasive endodontics. After that operation, teeth retain the dental hard tissue, such as crest and peri-cervical dentin, to a large extent. It is of great significance to reduce the tissue excision and achieve a favorable prognosis. There are a variety of approaches and corresponding cavities in CEC. The methods to determine the medullary approach include X-ray localization, micro CT/cone beam CT localization and digital guide plate localization. Among them, X-ray film and micro CT/cone beam CT are simple and commonly used in the clinic. For more complex root canal systems, the use of a digital guide plate can establish a more accurate pulp opening pathway and reduce the unnecessary loss of tooth hard tissue. However, the positioning price of a digital guide plate is high, and it has not been widely used in the clinic. The hole types of CEC include minimally invasive medullary hole type, super conservative minimally invasive medullary hole type, "Truss" hole type and cutting end hole type. The stress analysis of CEC and traditional endodontic access (TEC) cavity are mainly based on the loading of teeth by a universal mechanical testing machine in vitro, finite element analysis and clinical observation. Most scholars’ studies have shown that minimally invasive endodontics can improve the fracture resistance of teeth, but the differential capacities of CEC and TEC remain controversial. How does on balance the purpose of pulp treatment and the maximum retention of tooth tissue? Further exploration is still needed.

Biomechanical, operative and biological aspects of the cervical margin relocation: a case report / Aspectos biomecânicos, operatórios e biológicos da recolocação da margem cervical com resina composta em cavidades classe II com margens profundas: um relato de caso

The clinical success of tooth-colored indirect restorations has been confirmed in several studies. However, inlays and onlays restorations in Class II cavities with deep gingival margins can still be considered a clinical challenge. With the purpose of facilitating the execution of the operative procedures in intrasulcular margins and reducing the risk of restorative failures, the technique of cervical margin relocation has been explored as a noninvasive alternative to surgical crown lengthening. This work aims at discussing through a case report the biomechanical, operative and biological aspects in the treatment of teeth with deep gingival margins. Therefore, given the therapy applied in the clinical case presented, it is concluded that the cervical margin relocation with composite resin is advantageous since it eliminates the need for surgery, allowing the implementation of indirect restorations in fewer clinical sessions, not causing damage to periodontal tissues once it provided good finishing and polishing with the establishment of a correct emergence profile, allowing flawless maintenance of gingival health after one year. (AU)

Sucesso clínico das restaurações indiretas livres de metal tem sido confirmado em diversos estudos. No entanto, restaurações parciais indiretas em cavidades do tipo classe II com margens profundas ainda podem ser consideradas um desafio clínico. Com a proposta de facilitar a execução dos procedimentos operatórios em margens intra-sulculares e reduzir a ocorrência de falhas, a técnica de elevação da margem gengival em resina composta tem sido explorada como alternativa não invasiva à cirurgia de aumento de coroa clínica. Este trabalho tem a intenção de discutir através de um relato de caso clínico os aspectos biomecânicos, operatórios e biológicos no tratamento de dentes com margens cervicais profundas. Sendo assim, conclui-se que a técnica de elevação da margem gengival com resina composta é vantajosa, pois elimina a necessidade de cirurgia permitindo a execução de restaurações indiretas em menos sessões clínicas, não gerando danos aos tecidos periodontais, desde que haja um bom acabamento e polimento, com estabelecimento de um correto perfil de emergência. (AU)

Restorative treatment decisions regarding approximal and occlusal carious lesions among general dental practitioners in Palestine

Aim: To investigate restorative decisions made by dentists and to examine what demographic characteristics are associated with the decisions for managing approximal and occlusal lesions. Methods: A questionnaire was randomly sent to 900 Palestinian dentists. It noted the demographic details of the dentists and the years of experience. The questionnaire evaluated the respondents for their treatment decisions regarding approximal and occlusal carious lesions. The data was analyzed using the IBM SPSS statistics for windows. The associations between gender and years of experience of the respondents and their restorative decisions were assessed. Results: The response rate was 58.2%. For occlusal carious lesions, 93.9% of the respondents would postpone operative treatment until the lesion was in dentine (grade 3 to 5). For approximal lesions, intervention was deemed appropriate by 92.6% of the respondents when there was radiographic evidence of a carious lesion reaching the DEJ or deeper. Around 53% preferred to prepare approximal lesions according to the traditional principles of cavity preparation. For both approximal and occlusal lesions, the participants opted for resin composites. Statistically, there was a significant association between the restorative decisions with the years since graduation and gender. Conclusion: The study showed variations between the treatment decisions of Palestinian dentists. The subjects chose conservative treatment plans but still adhered to traditional learned practices especially when cavity preparation for approximal lesions was concerned. The years since graduation and gender played a significant role in the choice of treatment opted for. Resin composites seemed to be a popular choice for treatment

Remoção seletiva de tecido cariado e proteção pulpar indireta: relato de casos clínicos / Selective caries removal and indirect pulp capping: clinical cases report

Objetivo: este artigo se propõe a discutir o tratamento de lesões profundas de cárie em molares permanentes, através da técnica de remoção seletiva de tecido cariado e restauração de resina composta, em dois casos clínicos, utilizando apenas sistema adesivo (caso 1) ou proteção pulpar indireta com cimento de hidróxido de cálcio (caso 2). Relato de casos: os indivíduos foram diagnosticados com dentes apresentando lesões profundas de cárie, isto é, com mais de 50% em profundidade da dentina, confirmada pelo exame radiográfico interproximal. O conjunto de resultados de testes de sensibilidade pulpar positivo ao frio e teste de percussão horizontal e vertical negativos, juntamente com a ausência de dor espontânea e normalidade do periápice (radiografia periapical), completaram os requisitos exigidos para execução da técnica de remoção seletiva de dentina cariada amolecida. Os dentes receberam restaurações adesivas na mesma sessão, sobre a dentina cariada amolecida da parede pulpar que havia recebido forramento de cimento de hidróxido de cálcio ou não, dependentes de uma randomização. Ambos os casos apresentados mostraram sucesso clínico em acompanhamento de 18 meses, tanto na manutenção da vitalidade pulpar quanto na sobrevivência da restauração. Considerações finais: com base nos casos apresentados, sabendo das limitações deste modelo de estudo, e em concordância com a literatura, a remoção seletiva de tecido cariado pode ser executada com sucesso no tratamento de lesões profundas de cárie, respeitando-se todos os passos da técnica, e parece não haver necessidade de uso de proteção pulpar indireta.(AU)

Objective: this article aims to discuss the treatment of deep caries lesions in permanent molars through the selective caries tissue removal technique and composite resin restoration of two clinical cases, using only an adhesive system (case 1) or an indirect pulp protection of calcium hydroxide cement (case 2). Cases report: the participants were diagnosed with deep caries lesions, that is, more than 50% in depth of the dentin involved, which was confirmed by the interproximal radiography. In both cases, it was obtained positive response to cold test, negative response to horizontal and vertical percussion tests, absence of spontaneous pain and no periapical lesion (periapical radiography), which completed the requirements for performing the selective caries removal of soft dentin. These teeth received adhesive restorations in the same session, under the softened carious dentin of the pulp wall that had received calcium hydroxide cement or not, depending on randomization. Both cases had clinical success in the 18-month follow- -up, showing pulp vitality and restoration survival. Final considerations: based on the clinical cases reported, considering de limitations of this study model, and in agreement with the literature, the selective removal of carious tissue can be successfully performed in the treatment of deep carious lesions, respecting all the steps of the technique and indirect pulp protection seems to be unnecessary.(AU)

Molars Fracture Resistance with Class II Cavities Restored with Different Resin - Based Materials / Resistência à Fratura de Molares com Cavidades Classe II Restauradas com Diferentes Materiais à Base de Resina

The teeth weakening due to the preparation of class II mesio-occluso-distal cavities is a challenge for the clinician. The objective of this study was to evaluate the molars fracture resistance with class II mesio-occluso distal cavities restored with different restorative techniques and materials. Forty extracted molars were divided into 5 groups: Group 1 ­ intact healthy teeth (positive control); Group 2 ­ unrestored teeth with mesio-occluso distal class II cavities (negative control); Groups 3 to 5 ­ restored teeth with standardized dimensions. In groups 3 to 5, the cavities were restored with flow resin only, flow resin coated with a nano-hybrid resin, and nano-hybrid resin only, respectively. All specimens were tested for resistance to fracture using an axial compressive load, a metallic sphere measuring 8 mm in diameter on a universal testing machine EMIC DL-2000. A 10 kN load cell operated at a speed of 5 mm/min until the tooth fracture. Data were subjected to analysis of variance and Tukey's tests (α = 0.05). Group 3 showed higher fracture strength (2243.1 ± 473.7N) when compared to groups 2, 4 and 5. This difference was statistically significant (p<0.05). The fracture strength of teeth restored with flow mesio occluso-distal restorations was similar to that of intact natural teeth. (AU)

O enfraquecimento dos dentes devido às preparações de cavidades mesio-ocluso-distal é um desafio para o clínico. O objetivo deste estudo foi avaliar a resistência à fratura de molares com cavidades mesio-ocluso-distais classe II restauradas com diferentes técnicas e materiais restauradores. Quarenta molares extraídos foram divididos em 5 grupos: Grupo 1 ­ dentes saudáveis intactos (controle positivo); Grupo 2 ­ dentes não restaurados com cavidades mesio-occluso-distais classe II (controle negativo); Grupos 3 a 5 ­ dentes restaurados com dimensões padronizadas. Nos grupos 3 a 5, as cavidades foram restauradas apenas com resina flow, resina flow recoberta com uma resina nanohíbrida e somente resina nano-híbrida, respectivamente. Todas as amostras foram testadas quanto à resistência à fratura usando uma carga compressiva axial, usando uma esfera metálica medindo 8 mm de diâmetro em uma máquina de teste universal EMIC DL-2000. Uma célula de carga de 10 kN operava a uma velocidade de 5 mm/min até a fratura do dente. Os dados foram submetidos à análise de variância e testes de Tukey (α = 0,05). O grupo 3 apresentou maior resistência à fratura (2243,1 ± 473,7N) quando comparado aos grupos 2, 4 e 5. Essa diferença foi estatisticamente significante (p <0,05). A resistência à fratura dos dentes restaurados com resina flow foi semelhante à dos dentes naturais intactos. (AU)

Comunidades ribeirinhas do Amazonas têm conhecimento sobre cárie dentária: resultado da educação em saúde bucal / Knowledge about dental caries among ribeirinhos: result of oral health education / Comunidades ribereñas del Amazonas tienen conocimiento sobre la caries dental: resultado de la educación en salud bucal

O Amazonas é o maior estado brasileiro em extensão territorial, com uma parcela significativa da população vivendo em torno dos rios, as chamadas comunidades ribeirinhas. O acesso aos serviços de saúde por essas comunidades é limitado, levando à criação de projetos de saúde pública para prevenção e tratamento de doenças, assim como ações de educação em saúde. Diversas organizações não governamentais (ONG) e equipes de saúde atuam nessas comunidades com projetos de educação em saúde. Neste artigo, verificou-se a percepção dos pais sobre a saúde bucal de seus filhos e a importância dos cuidados da dentição decídua para prevenção da cárie dentária. Para isso, foram entrevistados trezentos pais ou responsáveis por crianças de zero a sete anos em comunidades ribeirinhas localizadas em três municípios do Amazonas (Parintins, Nhamundá e Barreirinha ­ N = 300, cem em cada município). A partir das entrevistas, pode-se concluir que as mães foram as principais respondentes (80%), cuja renda familiar é de até um salário mínimo (91%). Além disso, a maioria tinha conhecimentos sobre cárie dentária (56%), bem como já recebeu alguma orientação sobre como escovar os dentes (41%). Todas as crianças possuem escova de dentes e 94% delas utilizam dentifrício na escovação. Por fim, os pais foram considerados os principais responsáveis pela escovação dentária supervisionada de seus filhos (87%), embora apenas 44% deles a realize. Portanto, neste artigo, demonstra-se a efetividade das ações e dos projetos aplicados em comunidades ribeirinhas em relação à cárie dentária, ainda que exista a necessidade da continuidade dessas ações para mudanças efetivas de hábitos, impactando positivamente a saúde bucal das crianças ribeirinhas do Amazonas.

Amazonas is the largest Brazilian state in land area, with a significant portion of its population living near rivers, the so-called ribeirinhos. Since access to health care services by these communities is limited, specific public health actions and projects for health prevention, treatment and education are created. Several non-governmental organizations (NGOs) and health care teams work on health education projects on these communities. Given this context, this study investigated how parents perceived their children's oral health and the importance of deciduous dentition care for preventing dental caries. Data was collected by a questionnaire applied to 300 parents or guardians of children aged 0 to 7 years from three municipalities of Amazonas (Parintins, Nhamundá and Barreirinhas ­ 100 each). Mothers (80%) and homes living with a family income of up to 1 minimum wage (91%) comprised most of the sample. Most parents had knowledge about dental caries (56%) and had received some guidance on how to brush their children's teeth (41%). All children have a toothbrush and 94% of them use toothpaste. Finally, parents consider themselves the main responsible for supervised brushing (87%), although only 44% of them perform it. In conclusion, these findings attest to the effectiveness of actions and projects carried out in ribeirinho communities regarding dental caries, although continued actions are needed to change habits and positively impact the oral health of ribeirinho children living in Amazonas.

Amazonas es el estado brasileño más grande en extensión territorial, con una porción significativa de la población que vive alrededor de los ríos, las llamadas comunidades ribereñas. El acceso a los servicios de salud por parte de estas comunidades es limitado, lo que lleva a la creación de acciones y proyectos de salud pública para la prevención y el tratamiento de enfermedades, así como acciones de la educación en salud. Son varias las ONG que trabajan en estas comunidades con proyectos de educación en salud. En este artículo se evaluó la percepción de los padres sobre la salud bucal de sus hijos y la importancia de cuidar la dentición primaria en la prevención de la caries dental. Para ello, se entrevistaron a los padres o tutores de niños de 0 a 7 años, en las comunidades ribereñas de tres municipios de Amazonas (Parintins, Nhamundá y Barreirinhas ­N = 300, cien en cada municipio). Los resultados muestran que la madre fue la principal respondiente de la entrevista (80%), con un ingreso familiar de hasta 1 salario mínimo brasileño (91%). La mayoría tiene conocimiento sobre la caries dental (56%) y ya había recibido alguna orientación sobre cómo cepillarse los dientes (41%). Todos los niños tienen un cepillo de dientes, y el 94% de ellos usa pasta de dientes. Los padres se consideran los principales responsables del cepillado supervisado de sus hijos (87%), aunque solo el 44% de ellos lo realizan en sus hijos. Este artículo demuestra la efectividad de las acciones y proyectos llevados a cabo en comunidades ribereñas con respecto a la caries dental, pero es necesario continuar con estas acciones para que tengamos cambios en los hábitos e impactos positivos en la salud bucal de los niños que viven en las comunidades ribereñas del Amazonas.

Assessment of Marginal Adaptation Before and After Thermo-Mechanical Loading and Volumetric Shrinkage: Bulk Fill versus Conventional Composite / Evaluación de la Adaptación Marginal Antes y Después de la Carga Termomecánica y la Contracción Volumétrica: Relleno Bulk-Fill- versus Compuesto Convencional

ABSTRACT: The objective of the study was to evaluate marginal adaptation of Class II mesial-occlusal-distal (MOD) restorations before and after thermo-mechanical loading and volumetric shrinkage of the bulk-fill vs conventional composite resin. For marginal adaptation assessment, 24 Class II MOD cavities with cervical margins extending 1.0 mm below (distal) and 1.0 mm beyond (mesial) the cement-enamel junction were prepared in extracted human molars. The teeth were filled as follows: Group A - bulk-fill with SureFil SDR flow (first increment, 4 mm; second increment, 2 mm); Group B - bulk-fill with SureFil SDR flow as a base (first increment, 4 mm) and covered with the conventional nanohybrid composite Esthet-X HD (second increment, 2 mm); and Group C - incrementally filled with Esthet-X HD. Marginal adaptation was evaluated by scanning electron microscopy before and after thermomechanical loading (240,000 loading cycles and simultaneous 600 thermal cycles). To evaluate volumetric polymerization shrinkage, a semi-spherical mold was filled with the tested composites and placed in an AccuVol device after light curing. Both before and after loading, marginal adaptation in cervical dentin was superior (p < 0.05) for Groups A and B compared with Group C. In cervical enamel, Group B showed better marginal adaptation than Group C, and Group A presented intermediary results, between Groups B and C. Furthermore, bulk-fill flow resulted in greater shrinkage than Esthet-X HD. A significant improvement of marginal adaptation was observed when bulkfill flow was used instead of conventional composite resin both before and after thermomechanical loading. However, the bulk-fill flow presented higher volumetric polymerization shrinkage than the conventional composite.

RESUMEN: El objetivo de este trabajo consistió en evaluar la adaptación marginal de las restauraciones mesiales-oclusales-distales (MOD) de Clase II antes y después de la carga termo-mecánica y la contracción volumétrica de la carga compuesta de resina "bulk-fill" en comparación con resina convencional. Para la evaluación de adaptación, se prepararon 24 cavidades MOD de Clase II en molares humanos extraídos, los que se restauraron de la siguiente manera: Grupo A: restaurado con resina fluida Bulk-Fill SureFilSDR (primer incremento, 4 mm; segundo incremento, 2 mm); Grupo B: restaurado con resina fluida Bulk-Fill SureFil SDR (primer incremento, 4 mm) y cubierto con resina compuesta nanohíbrida Esthet-X HD (segundo incremento, 2 mm); y Grupo C - rellenado incrementalmente con Esthet-X HD. La adaptación marginal se evaluó mediante microscopía electrónica de barrido antes y después de la carga termomecánica (240.000 ciclos de carga y 600 ciclos térmicos simultáneos). Para evaluar la contracción volumétrica de la polimerización, se llenó un molde semiesférico con los compuestos probados y se colocó en un dispositivo AccuVol después del fotopolimerización. Tanto antes como después de la carga, la adaptación marginal en la dentina cervical fue superior (p <0,05) para los grupos A y B en comparación con el grupo C. En el esmalte cervical, el grupo B mostró una mejor adaptación marginal que el grupo C, y el grupo A presentó resultados intermedios, entre Grupos B y C. Se observó una mejora significativa de la adaptación marginal al utilizar la resina fluida Bulk-Fill en lugar de resina compuesta convencional tanto antes como después de la carga termomecánica. Sin embargo, la resina fluida 'Bulk-Fill' presentó una mayor contracción volumétrica de polimerización que el compuesto convencional.

Influence of cavo superficial enamel acid-etching on the microtensile bond strength of low-shrinkage composite resin / Influência do condicionamento ácido do ângulo cavo superficial na resistência adesiva de restaurações em um compósito de baixa contração de polimerização

Introduction: To prevent the shrinkage stresses produced during polymerization, composite resins of low polymerization shrinkage were developed. Objective: To evaluate the microtensile bond strength in class I cavities restored by acid-etching the cavosurface angle and with composite resins indicated for posterior teeth. Material and method: 48 healthy molars were selected and divided into six groups (n = 8), considering that the cavosurface enamel of three groups was etched with 35% phosphoric acid. The teeth were restored with the Clearfil SE Bond adhesive system and Filtek Z350 XT, Empress Direct, and Charisma Diamond composite resins, which were light-cured for 40 seconds. After 24 hours, the teeth were taken to a cutting machine, which produced sections in the buccolingual and mesiodistal directions. This resulted in toothpicks of 0.9×0.9 mm that were taken to the universal testing machine for the microtensile bond strength test. Statistical analysis was performed with ANOVA and Tukey's test (p < 0.05). Result: There was no statistically significant difference between the groups evaluated. Conclusion: Acid-etching the cavosurface angle did not affect the performance of restorations, probably due to the adhesive system used.

Introdução: Com o intuito de se evitar as tensões geradas durante a contração de polimerização das resinas compostas, foram desenvolvidas as resinas compostas de baixa contração de polimerização. Objetivo: Avaliar a resistência à microtração em cavidades classe I restauradas com tratamento ácido do ângulo cavo superficial e resina composta indicada para dentes posteriores. Material e método: Foram selecionados 48 molares hígidos que foram divididos em 6 grupos (n=8), sendo que 3 desses tiveram o esmalte cavo superficial condicionado com ácido fosfórico a 35%. Os dentes foram restaurados com o sistema adesivo Clearfil SE Bond e as resinas compostas Filtek Z350 XT, Empress Direct e Charisma Diamond, fotoativadas por 40 segundos. Após 24 horas, os dentes foram levados para máquina de corte, na qual foram realizados cortes no sentido vestíbulo-lingual e no sentido mésio-distal obtendo - se palitos de 0,9×0,9 mm que foram levadas para a máquina de ensaio universal para a realização do teste de microtração. Para análise estatística foi realizado análise de variância e teste de Tuckey (p < 0,05). Resultado: Não houve diferença estatística significante entre os grupos avaliados. Conclusão: O condicionamento ácido do ângulo cavo superficial não influenciou no desempenho das restaurações provavelmente devido ao sistema adesivo utilizado.

Microfiltraciones entre ionómero de vidrio y resina compuesta en lesiones clase-V no cariosas / Microfiltration between glass ionomer and composite resin in non-carious class-V injuries / Microfiltrações entre ionômeros de vidro e resina composta em lesões não cariosas de classe V

No se han establecido estándares para el tratamiento de cavidades cervicales no cariosas; un biomaterial adecuado permitirá buena adaptación y longevidad de la restauración. Objetivo: Determinar la microfiltración en cavidades clase V no cariosas restauradas con ionómero de vidrio y resina nanoparticulada. Materiales y métodos: Cavidades clase V realizadas en la superficie vestibular de 80 premolares sanos (1,5 mm de pro-fundidad x 3 mm de altura en sentido ocluso- gingival x 2 mm de ancho en sentido mesio-distal) se restauraron aleatoriamente con dos biomateriales (n = 40): 1) ionómero de vidrio y 2) resina de nano relleno. Después, los especímenes fueron aislados con barniz y sumergidos en azul de metileno por 24 horas. Posteriormente, las muestras se sometieron 500 ciclos de termociclado por 8 horas y 45 minutos con cambios térmicos de 37°, 72° y 75°C, cada ciclo con una duración de 17 segundos. Las muestras fueron lavadas con agua destilada y seccionadas longitudinalmente para determinar el grado de microfiltración utilizando un estereoscopio (Leica M60, Biosystems). Los datos categóricos se analizaron con el test Chi2 en SPSS 24®. Resultados: Se pudo apreciar que la filtración es significativamente menor en resina que con ionómeros de vidrio (p < 0,001). Sin embargo, ninguno de los materiales de restauración probados fue capaz de sellar los márgenes o las paredes de los dientes completamente. Conclusión: como resultado del presente experimento se determina que las restauraciones de clase V obturadas con resina de nano relleno presentan menor microfiltración marginal que las restauradas con ionómero de vidrio.

No standards have been established for the treatment of non-carious cervical cavities; a suitable biomaterial will allow good adaptation and longevity of the restoration. Objective: To determine microfiltration in non-car-ious class V cavities restored with glass ionomer and nanoparticulate resin. Materials and methods: Class V cavities made on the vestibular surface of 80 healthy premolars (1.5 mm deep x 3 mm high in the occlusion-gin-gival direction x 2 mm wide in the mesio-distal direction) were randomly restored with two biomaterials (n = 40): 1) glass ionomer and 2) nano-filled resin. Then, the specimens were isolated with varnish and immersed in methylene blue for 24 hours. Subsequently, the samples were subjected to 500 cycles of thermocycling for 8 hours and 45 minutes with thermal changes of 37°, 72° and 75° C, each cycle with a duration of 17 seconds. The samples were washed with distilled water and sectioned longitudinally to determine the degree of micro-filtration using a stereoscope (Leica M60 Biosystems). Categorical data were analyzed with the Chi2 test in SPSS 24®. Results: It was observed that filtration is significantly lower in resin than in those restored with glass ionomers (p < 0.001). However, none of the restoration materials tested were able to seal the margins or walls of the teeth completely. Conclusion: As a result of the present experiment, it is determined that class V resto-rations sealed with nano-filled resin have less marginal microfiltration than those restored with glass ionomer.

Ainda não foram estabelecidos padrões para o tratamento de cavidades cervicais não cariosas; um biomate-rial adequado permitirá boa adaptação e longevidade da restauração. Objetivo: Determinar a microfiltração em cavidades não cariosas da classe V restauradas com ionômero de vidro e resina nanoparticulada. Materi-ais e métodos: Cavidades de classe V feitas na superfície vestibular de 80 pré-molares saudáveis (1,5 mm de profundidade x 3 mm de altura na direção oclusão-gengival x 2 mm de largura na direção mesio-distal) foram restaurados aleatoriamente com dois biomateriais (n = 40): 1) ionômero de vidro e 2) resina nano-híbrida. Em seguida, as amostras foram isoladas com verniz e imersas em azul de metileno por 24 horas. Posteriormente, as amostras foram submetidas a 500 ciclos de termociclagem por 8 horas e 45 minutos com alterações tér-micas de 37°, 72° e 75° C, cada ciclo com duração de 17 segundos. As amostras foram lavadas com água destilada e seccionadas longitudinalmente para determinar o grau de microfiltração usando um estereoscópio (Leica M60, Biosystems). Os dados categóricos foram analisados com o teste Chi2 no SPSS 24®. Resul-tados: Observou-se que a filtração é significativamente menor na resina do que nos ionômeros de vidro (p <0,001). No entanto, nenhum dos materiais de restauração testados foram capazes de selar completamente as margens ou paredes dos dentes. Conclusão: como resultado do presente experimento, determina-se que restaurações de classe V seladas com resina nano-preenchida possuem menos microfiltração marginal do que aquelas restauradas com ionômero de vidro.

HÁBITOS DE HIGIENE BUCAL, CONDIÇÕES DE SAÚDE BUCAL E ACESSO A SERVIÇOS ODONTOLÓGICOS DE ESCOLARES EM BOZANO, RIO GRANDE DO SUL / ORAL HYGIENE HABITS, ORAL HEALTH CONDITIONS AND ACCESS TO DENTAL SERVICES OF SCHOOL CHILDREN IN BOZANO, ESTATE OF RIO GRANDE DO SUL

Este estudo teve como objetivo descrever hábitos de higiene bucal, condições de saúde bucal e acesso a serviços odontológicos em escolares de Bozano/RS. Tratou-se de estudo descritivo transversal com a aplicação de questionários e realização de exames bucais. Participaram da pesquisa 62 escolares com idades entre 12 e 17 anos e predomínio de classes sociais intermediárias. Todos relataram possuir acesso a escova dental e creme dental e cerca de 90% dispunha também de fio dental no domicílio. A maioria revelou realizar três escovações diárias (59,7%) e utilizar o fio dental uma vez ao dia (41,9%). Verificou-se que 62,9% apresentavam biofilme e 45,2% cálculo dentário visíveis. O CPO-D variou de 0 a 10, sendo a média de 4,26. Aos 12 anos, o CPO-D foi de 3,46 e aos 17 anos, de 5,25. Para 50% dos escolares a última consulta odontológica foi realizada no SUS. A maioria aprendeu a escovação através dos pais (82,3%). Observou-se que 64,6% estavam satisfeitos com seu sorriso. Cerca de 18% referiu presença de dor ou desconforto na cavidade bucal. Constatou-se a necessidade de melhorar hábitos de higiene bucal e melhorar condições de saúde bucal dos escolares. Instiga-se o fortalecimento das ações de promoção de saúde bucal entre os escolares, de modo a fomentar estilos de vida compatíveis com a saúde bucal.

This study aimed to describe oral hygiene habits, oral health conditions and access to dental services in schoolchildren from Bozano, State of Rio Grande do Sul. It was a cross-sectional descriptive study with questionnaires and buccal exams. Sixty-two students between 12 and 17 years of age participated in the study (response rate of 47.7%). There was a predominance of intermediate social classes. Everyone reported having access to toothbrush and toothpaste at home. About 90% also had dental floss. The majority (59.7%) revealed three daily brushings and flossing once per day (41.9%). We verified that 62.9% had visible biofilm and 45.2% tartar. The DMFT ranged from 0 to 10, with an average of 4.26). At age 12, DMFT was 3.46 and at age 17, 5.25. For 50% of the students, the last dental appointment had been performed in the Public Health System. The majority learned how to brush through their parents (82.3%). We observed that 64.6% were satisfied with their smile. About 18% reported presence of pain or discomfort in the oral cavity. There was a need to provide habits of dental hygiene and oral health conditions of schoolchildren. It is instigated that one maximizes oral health promotion actions among schoolchildren, in order to foster lifestyles compatible with oral health.

Influence of Cavity Dimensions on Microleakage of Two Bulk-Fill Composite Resins

Objective: To evaluate the effect of cavity dimensions on the amount of microleakage in two different types of bulk-fill composite resins. Material and Methods: Forty class II cavities were prepared in the mesial and distal surfaces of human molars without any carious lesions. The samples were divided into 4 groups (n=10): Group 1: cavities with 3 mm of buccolingual width (known as the smaller cavity), filled with Tetric N-Ceram Bulk Fill composite resin; Group 2: cavities with 6 mm of buccolingual width (larger cavity), filled with Tetric N-Ceram Bulk Fill composite resin; Group 3: cavities with 3 mm of buccolingual width, filled with X-Tra Base composite resin; and Group 4: cavities with 6 mm of buccolingual width, filled with X-Tra Base composite. After the specimens were thermocycled for 500 cycles at 5/55°C, they were immersed in 1% methylene blue for 24 hours, and then cut into sections mesiodistally in the longitudinal axis of each tooth. Then, the samples were scored regarding the amount of dye penetration in two occlusal and gingival areas under a stereomicroscope (x32). Data was submitted to Kruskal- Wallis and Mann-Whitney tests. Results: The highest degrees of microleakage in larger cavities filled with X-Tra Base among the four groups. There was a significant statistic difference (p=0.012) between large and small cavities filled with X-Tra Base (Groups 3 and 4); however, there was no significant difference between the two cavity sizes of Tetric N-Ceram Bulk-filled groups. Conclusion: Microleakage of composite resins depends on the dimension of the cavity and the type of composite resin used.

Impacto de uma alimentação rica em açúcar e das condições socioeconômicas na experiência da cárie em crianças e adultos jovens / Impact of a high-sugar diet and socioeconomic conditions on caries experience in children and young adults

Objetivo: Avaliar a associação entre a prevalência de cárie dentária em relação a frequência de consumo de alimentos ricos em açúcar, condições socioeconômicas e escolaridade dos pais de crianças e adultos jovens. Material e Métodos: Aplicou-se questionários socioeconômicos com pais e/ou responsáveis de 36 crianças e adolescentes na faixa etária entre 7 e 20 anos de um clube do Município de Alegre - ES. A cárie dentária foi avaliada através do Índice de Dentes Cariados, Perdidos e Obturados (CPO-D) e a placa bacteriana por meio do Índice de Higiene Oral Simplificado (IOHS). Posteriormente, realizaram-se palestras e atividades educativas de higiene bucal e de educação nutricional. Reavaliou-se então índice de placa bacteriana duas semanas após a intervenção. Para avaliação estatística usou-se regressão logística para testar associações e teste t pareado para índice de placa bacteriana. Resultados: Do total de crianças avaliadas, 67% apresentou história pregressa e atual de cárie, na qual a mediana do CPO-D encontrado foi de 2. Para a avaliação do índice de placa bacteriana, observou-se que a intervenção apresentou efetividade (p<0,05) uma vez que IHOS inicial foi de 1,98 e o final foi de 1,43. Conclusão: Foi encontrada alta prevalência de COP-D polarizado na amostra avaliada, e também detectado que as ações de educação em saúde foram efetivas na redução de placa bacteriana

Objective: to evaluate the association between the prevalence of dental caries, sugary food intake and socioeconomic conditions of children and young adults. Material and methods: socioeconomic questionnaires were applied to parents and/or guardians of 36 children and adolescents attending a soccer club in the city of Alegre ­ ES, Brazil, aged between 7 and 20 years. To assess food intake, a Food Frequency Questionnaire (FFQ) was applied. Tooth decay was assessed using the Decayed, Missing, Filled Teeth Index (DMFT) and plaque through the Simplified Oral Hygiene Index (OHI-S). Subsequently, lectures and oral hygiene and nutritional education activities were held. The plaque index was then reevaluated two weeks after the intervention. The presence of caries was expressed using relative frequency. In order to evaluate the factors associated with dental caries, a logistic regression model was used (p <0.05), and to evaluate the effect of the intervention, the paired t-test was used to compare the plaque index. Results: 67% out of the assessed children had past and current history of decay, with a median DMFT of 2. Among the variables assessed 'family income', 'parents' educational level' and 'consumption of high-sugar foods' no statistically significant association (p <0.05) with the presence of dental caries was observed. To evaluate the bacterial plaque index, it was observed that the intervention was effective (p <0.05) with an initial OHI-S of 1.98 and final of 1.43. Conclusion: a high prevalence of polarized DMFT was found in the sample. The health education actions were effective in reducing plaque. Almost all of the sample was found to have the habit of consuming sugary food four or more times a week. No significant associations were found between dental caries and the variables analyzed.

A randomized clinical trial of cavity liners after selective caries removal: one-year follow-up

Abstract Alternatives for the treatment of caries disease, such as minimally invasive approaches, have been developed in recent years. Objective: To carry out clinical and radiographic evaluations of three cavity liners after selective caries removal. Methodology: Thirty-six primary molars with deep occlusal caries lesions without pulp involvement (from children of both genders, aged between 5 and 8 years) were randomly divided into the following groups: calcium hydroxide cement (CHC) group; mineral trioxide aggregate (MTA) group and Portland cement with added zirconium oxide (PCZ) group. The following-up period was 6- and 12-month. The clinical and radiographic success rates were evaluated through chi-square test. The radiographic measurements were compared by ANOVA followed by Tukey's test (p<0.05). Results: Thirty-six patients were included, but thirty-four returned for 12-month follow-up. The overall success rate of the therapy for the three groups was 94.11% and no statistically significant differences occurred in the comparison among groups (p>0.05). Nineteen radiographs were selected to measure the dentin barrier thickness. The intragroup comparison presented a statistically significant increase of the dentin barrier for all groups, at 12-month follow-up. However, the MTA group showed increase of the dentin barrier, over time, 6- to 12-month follow-up. The intergroup comparison revealed no statistically significant differences (p>0.05). Conclusion: The clinical and radiographic data showed that all cavity liners provided effective treatment of primary teeth after selective caries removal.

Assessment of a conservative approach for restoration of extensively destroyed posterior teeth

Abstract Extensive restorations in posterior teeth always bring doubts to the clinicians regarding the best protocol, mainly when structures of reinforcement were lost. Objective This study aimed to evaluate the effect of beveling on the fracture resistance and pattern of class II (MOD) restored teeth. Methodology Ninety human premolars were randomly assigned into 9 groups: CTR (control/sound); NC (cavity preparation, non-restored); RU (restored, unbeveled); RTB (restored, entire angle beveling); RPB (restored, partial/occlusal beveling); EC (endodontic access/EA, non-restored); EU (EA, unbeveled); ETB (EA, entire angle beveling); EPB (EA, partial/occlusal beveling). Teeth were restored with Esthet X resin composite and stored in distilled water for 24 h before the inclusion in PVC cylinders. The axial loading tests were performed with 500 kgF at 0.5 mm/min crosshead speed until fracture of the specimens. Fracture resistance and pattern were accessed and data were analyzed using one-way ANOVA and Tukey's HSD test (α=0.05). Results Mean (±SD) failure loads ranged from 136.56 (11.62) to 174.04 (43.5) kgF in the groups tested without endodontic access. For endodontically accessed teeth, fracture resistance ranged from 95.54 (13.05) to 126.51 (19.88) kgF. Beveling of the cavosurface angle promoted the highest fracture resistance values (p<0.05) and prevented catastrophic fractures. Conclusions Cavosurface angle beveling is capable of improving fracture resistance and pattern for both endodonticaly accessed and non-accessed teeth.

Conocimientos de higiene oral de acudientes y su relación con caries en menores de 5 años / Parent's Knowledge about Oral Hygiene and its Relation with Cavities in Children under 5 Years of Age / Conhecimentos sobre higiene oral que os adultos responsáveis de crianças têm e a sua relação com as cáries em infantes com menos de 5 anos

Resumen Objetivo: Identificar los conocimientos en higiene oral que poseen los acudientes y su relación con la presencia de caries dental de niños menores de 5 años que asisten a un centro de salud de Medellín. Metodología: Se realizó un estudio de casos y controles. El grupo de casos estuvo conformado por los acudientes, cuyos niños tuvieran un índice ceo-d mayor que cero. El grupo control lo conformaron los acudientes cuyos niños tuvieron un índice ceo-d igual a cero. Las fuentes de información fueron la valoración odontológica para determinar la existencia o no de caries cavitacional, la historia clínica y un instrumento sobre los conocimientos de higiene de los acudientes. Se analizó origen, apariencia y formas de prevención de la caries. Resultados: La presencia de caries dental estuvo asociada con falta de control de la cantidad de crema dental por parte de los acudientes, porque creían que dejaba más limpios los dientes (OR 4,29; IC 95 %: 1,74-10,62), porque creían que no hacía daño (OR 3,29; IC 95 %: 1,61-6,75). Conclusiones: se identificó la asociación entre las limitaciones en el conocimiento que sobre higiene oral tienen los acudientes y la existencia de caries dental en relación con la apariencia de la caries y el uso de la crema dental en los niños de la muestra. Los resultados sugieren la necesidad de generar espacios de comunicación e interacción entre los profesionales de la salud y los usuarios, acciones educativas oportunas que generen impacto, la utilización de medios de comunicación y diferentes estrategias de información, educación y comunicación (IEC) que permitan una mayor aprehensión del conocimiento.

Abstract Objective: to identify parent's knowledge about oral hygiene and its relation with dental cavities in their children under 5 years of age, patients of a health center in Medellin. Methodology: Case and control study. The group of cases was composed by parents whose children had a DMFT index higher than zero. The control group was composed by parents whose children had a DMFT index equal to zero. Information was collected through dental evaluations, in order to determine the presence of cavities, clinic records and a document with parents' knowledge about dental hygiene. The origin, appearance and way to prevent the cavities were analyzed. Results: the presence of cavities was associated with lack of control of the amount of toothpaste on the parents' side, because they believed the teeth were kept cleaner (or 4,29; IC 95 %: 1,74-10,62), because they did not find it harmful (or 3,29; ic 95 %: 1,61-6,75). Conclusions: We identified an association between parents' poor knowledge about oral hygiene, the appearance of cavities and toothpaste usage in the sampled children. The results suggests a need to create communication and interaction spaces between health professionals and the users, and timely educational actions that could have an impact, using mass media and other information, education and communication (IEC) strategies that allow a better appropriation of knowledge.

Resumo Objetivo: identificar os conhecimentos sobre higiene oral que têm os adultos responsáveis de crianças e a sua relação com a aparição de cáries dentais em infantes com menos de 5 anos, pacientes de um centro de saúde em Medellín. Metodologia: realizou-se um estudo de casos e controles. O grupo de casos esteve conformado pelos adultos responsáveis, cujas crianças tiveram um índice ceo-d mais alto do que cero. As fontes de informação foram a valoração odontológica para determinar a existência ou não de cáries cavitacional, a história clínica e um instrumento sobre os conhecimentos de higiene dos adultos responsáveis de crianças. Analisou-se a origem, aparência e forma de prevenção de cáries. Resultados: a presencia de cáries dentais associou-se com falta de controle da quantidade de creme dental por parte dos adultos responsáveis, porque achavam que os dentes ficavam mais limpos (or 4,29; IC 95 %: 1,74-10,62), porque achavam que não era nocivo (or 3,29; ic 95 %: 1,61-6,75). Conclusões: identificou-se a associação entre as limitações no conhecimento que tem os adultos responsáveis sobre higiene oral e a existência de cáries dentais em relação com a aparência da cárie e o uso do creme dental nas crianças da amostra. Os resultados sugerem a necessidade de gerar espaços de comunicação e de interação entre os profissionais de saúde e os usuários, ações educativas oportunas que gerem impacto, a utilização de meios de comunicação e diferentes estratégias de informação, educação e comunicação (IEC) que permitam mais apropriação do conhecimento.

Evaluation of calcium release and pH value of light-cured cavity liners for pulp-capping materials / Avaliação da liberação de cálcio e alteração de pH de forradores cavitários fotoativados para capeamento pulpar

Introduction: Cavity liners based calcium hydroxide present low strength and high solubility that is consider a disadvantage. In order to enhance these properties it was developed a light-cured cavity liner based calcium hydroxide containing resin. Objective: The purpose of this study was to evaluate the pH and calcium release of light-cured cavity liners. Material and method: There were prepared specimens (n=10) with the Ultra-Blend ® plus, Biocal® (light cured cements) and Hydro C® (control). The samples were stored in 10 mL of distilled water and maintained at 37 °C. After 24 hours, 7, and 14 days, there were analyzed pH and the release of calcium levels. The data were statistically analyzed by ANOVA and Tukey test (α = 0.05). Result: The results of pH showed Hydro C > Ultra-Blend plus > Biocal. Biocal presented worst calcium release. Conclusion: Light-cured materials present lower calcium release and alteration in pH values.

Introdução: Forradores cavitários à base de hidróxido de cálcio apresentam baixa resistência e alta solubilidade. Para resolver este problema, foi desenvolvido forradores à base de hidróxido de cálcio fotoativáveis contendo resina para melhorar suas propridades. Objetivo: A proposta deste estudo foi avaliar a alteração de pH e liberação de cálcio de forradores fotoativáveis. Material e método: Foram preparadas amostras (n=10) com Ultra-Blend® plus, Biocal ® (cimentos fotoativáveis) e Hydro C® (controle). As amostras foram armazenadas com 10 mL de água destilada e mantidas em estufa à 37 °C. Depois de 24 horas, 7 e 14 dias, foram avaliados os níveis de liberação de cálcio e a alteração de pH. Os dados foram analisados estatisticamente pelo teste ANOVA, seguido do pós teste Tukey (α = 0.05). Resultado: Os resultados de pH mostraram Hydro C > Ultra-Blend plus > Biocal. Biocal apresentou a pior liberação de cálcio. Conclusão: Materiais fotoativados apresentam menor liberação de cálcio e alteração nos valores de pH.