Produtos clareadores de venda livre: uma revisão de literatura / Over-the-counter whitening products available in Brazil: a literature review

Objetivo: Revisar a literatura quanto aos efeitos dos produtos de venda livre destinados ao clareamento dental disponíveis no mercado brasileiro. Revisão de literatura: Foram consultadas as bases de dados PubMed, Scielo e Google Scholar, além de busca manual de referências. A incessante busca pelo sorriso perfeito aumenta a procura por procedimentos estéticos, como o clareamento dental, recomendado por cirurgiões-dentistas devido à sua segurança e eficácia comprovadas. Contudo, em meio à demanda por alternativas mais acessíveis e que dispensem o acompanhamento profissional, surgiram no mercado os produtos clareadores de venda livre ou OTC (do inglês over-the-counter), que são opções alternativas ao clareamento profissional. Discussão: A predominância de estudos laboratoriais destaca que a eficácia dos produtos OTC difere dos tratamentos profissionais. Os dentifrícios branqueadores contendo peróxido demonstram eficácia na redução de manchas extrínsecas, com desgaste semelhante ou inferior aos dentifrícios regulares, dependendo do substrato avaliado. Já os enxaguatórios clareadores apresentam evidências limitadas de eficácia em comparação aos produtos de concentrações mais elevadas de peróxido. As receitas caseiras e produtos naturais para clareamento dental mostraram-se ineficazes em comparação aos tratamentos profissionais, levantando preocupações sobre sua segurança devido ao potencial de causar danos irreversíveis à estrutura dental. O carvão ativado não possui efeito clareador, apresenta potencial abrasivo e causa manchamento em mucosa bucal. Conclusão: Produtos clareadores OTC, embora atrativos pela autonomia oferecida, não demonstram, em sua maioria, eficácia significativa, devendo seu uso ser recomendando com cautela, preferencialmente com orientação profissional. Salienta-se a importância da educação contínua para que cirurgiões-dentistas acompanhem as tendências nesse campo.

Aim: To review the literature regarding the effects of over-the-counter (OTC) dental whiteningproducts available in the Brazilian market.Literature review: PubMed, Scielo, and Google Scholar databases were consulted, along with a manual reference search. The relentless pursuit of the perfect smile has led to an increased demand for aesthetic procedures, such as dental whitening, recommended by dentists due to their proven safety and efficacy. However, amid the demand for more affordable alternatives that do not require professional supervision, over-the-counter whitening products have emerged in the market as alternative options to professional whitening. Discussion: The prevalence of laboratory studies highlights that the efficacy of OTC products differs from professional treatments. Whitening toothpaste containing peroxide demonstrates effectiveness in reducing extrinsic stains, with wear similar to or lower than regular toothpaste, depending on the evaluated substrate. On the other hand, whitening mouthwashes show limited evidence of efficacy compared to products with higher concentrations of peroxide. Home remedies and natural whitening products have proven ineffective compared to professional treatments, raising concerns about their safety due to the potential for causing irreversible damage to dental structure. Activated charcoal lacks whitening effects, has potential abrasiveness, and causes staining on the oral mucosa.Conclusion: Although OTC whitening products may be appealing for their autonomy, they generally do not demonstrate significant efficacy. Their use should be recommended with caution, preferably under professional guidance. Emphasizing the importance of continuous education, dentists should stay abreast of trends in this field.

Esthetic outcomes of socket-shield technique for immediate implantation in the maxillary anterior zone and its effect on gingival morphology / 中国基层医药

Objective:To investigate the esthetic outcomes of socket-shield technique (SST) for immediate implantation in the maxillary anterior zone and its effect on gingival morphology.Methods:This case-control study included 75 patients with maxillary anterior tooth defects who were treated at Huzhou Central Hospital between January 2019 and September 2021. Based on their respective treatment methods, these patients were divided into two groups: SST implantation ( n = 30) and immediate implantation ( n = 45). All patients were followed up for 1 year. During this period, the thickness of the labial plate, pink esthetic score, probing depth, and patient satisfaction were compared between the two groups. Results:At 6 and 12 months post-surgery, the SST group exhibited significantly lower labial plate bone resorption [(0.24 ± 0.07) mm, (0.41 ± 0.10) mm] compared with the immediate implantation group [(0.56 ± 0.11) mm, (0.86 ± 0.15) mm, t = 14.12, 14.41, both P < 0.001]. Furthermore, at both time points, the SST group scored significantly higher in curvature, height, color, and texture of the labial gingival margin using the pink esthetic score scale ( t6 months = 7.13, 6.38, 5.45, 4.92; t12 months = 3.43, 2.92, 7.50, 6.25, all P < 0.05). The mesial and distal papilla scores did not differ significantly between the SST and immediate implantation groups at various time points (all P > 0.05). However, at 6 months post-surgery, the periodontal probing depth in the SST group was (1.21 ± 0.06) mm, which was significantly lower than the corresponding value of (1.92 ± 0.07) mm in the immediate implantation group ( t = 45.49, P < 0.001). By 12 months post-surgery, no significant difference in periodontal probing depth was observed between the two groups ( P > 0.05). Additionally, there was no significant difference in patient satisfaction between the SST and immediate implantation groups ( P > 0.05). Conclusion:SST effectively addresses insufficient labial bone mass and prevents bone resorption. Additionally, it is advantageous for restoring the morphology of the labial alveolar process and soft tissue level. Clinically, its application produces similar results to immediate implantation.

Reliability of the color measurement of resin composites using images obtained using a stereoscopic loupe

Abstract This study assessed the reliability of a color measurement method using images obtained from a charge-coupled device (CCD) camera and a stereoscopic loupe. Disc-shaped specimens were created using the composite Filtek Z350 XT (shades DA1, DA2, DA3, and DA4) (n = 3). CIELAB color coordinates of the specimens were measured using the spectrophotometer SP60 over white and black backgrounds. Images of the same specimens were taken using a CCD camera attached to a stereoscopic loupe. The color of the image was measured (red-green-blue [RGB]) using an image processing software and converted to CIELAB coordinates. For each color coordinate, data from images were adjusted using linear regressions predicting those values from SP60. The whiteness index for dentistry (WID) and translucency parameter (TP00) of the specimens as well as the color differences (ΔE00) among pairwise shades were calculated. Data were analyzed via repeated-measures analysis of variance and Tukey's post hoc test (α = 0.05). Images obtained using the loupe tended to be darker and redder than the actual color. Data adjustment resulted in similar WID, ΔE00, and TP00 values to those observed for the spectrophotometer. Differences were observed only for the WID of shade DA3 and ΔE00 for comparing DA1 and DA3 over the black background. However, these differences were not clinically relevant. The use of adjusted data from images taken using a stereoscopic loupe is considered a feasible method for color measurement.

Facetas em resina composta com fechamento de diastemas para harmonização do sorriso: relato de caso / Composite resin veneers with diastema closure for smile harmonization: A case report / Facetas de resina compuesta con cierre de diastemas para harmonización de la sonrisa: Informe de caso

Introdução:A estética do sorriso é um aspecto valorizado pela sociedade atual, o que demanda que os profissionais de odontologia estejam atualizados sobre materiais dentários e novas técnicas para alcançar resultados estéticos restauradores de alta qualidade. A resina composta é frequentemente utilizada para simplificar a reabilitação oral, pois oferece facetas dentárias que combinam excelente estética e durabilidade. Objetivo:Este artigo tem como objetivo relatar um caso clínico de reabilitação estética utilizando facetas em resina composta com fechamento de diastemas.Relato de caso:Uma paciente do sexo feminino, com 24 anos de idade, procurou a clínica escola de odontologia com insatisfação em relação à estética do seu sorriso. A pacienteapresentava diastemas, restauração defeituosa e desproporção no tamanho dos dentes anteriores. O tratamento consistiu em um clareamento caseiro prévio, seguido pela confecção de facetas diretas em resina composta para fechamento dos diastemas e correção da desproporção dentária. Foram utilizados um Jig Estético e o software Digital Smile Design (DSD)para o planejamento, além de um mock-up em resina bisacrílica. Após a confecção das facetas, foi obtido um resultado estético final satisfatório. O caso incluiu um total de oito facetas,dos dentes 14 ao 24. Conclusão:O tratamento utilizando restaurações em resina composta proporcionou à paciente uma reabilitação estética, funcional e biológica (AU).

Introduction:Smile aesthetics is an aspect valued by today's society, which demands that dental professionals are up to date on dental materials and new techniques to achieve high-quality restorative aesthetic results. Composite resin is often used to simplify oral rehabilitation, as it offers dental veneers which combine excellent aesthetics and durability. Objective:This article aims to report a clinical case of aesthetic rehabilitation using composite resin veneers with diastema closure. Case report:A24-year-old female patient came to the dental school clinic with dissatisfaction regarding the aesthetics of her smile. The patient had diastemas, defective restoration and disproportionate anterior teeth size. The treatment consisted of prior at-home tooth bleaching, followed by creating direct composite resin veneers to close the diastemas and correct tooth disproportion. An Aesthetic Jig and the Digital Smile Design (DSD) software program were used for planning, in addition to a mock-up in bisacrylic resin. After treatment, a satisfactory final aesthetic result was obtained. The case included a total of eight veneers, from teeth 14 to 24. Conclusion:Treatment using composite resin restorations provided the patient with aesthetic, functional and biological rehabilitation (AU).

Introducción: La estética de la sonrisa es un aspecto valorado por la sociedad actual, hecho que demanda de los profesionales de odontología actualización constante sobre los materiales dentarios y nuevas técnicas para alcanzar resultados estéticos restauradores de altacualidad. La resina compuesta es frecuentemente utilizada para simplificar la rehabilitación oral, pues ofrece facetas dentarias que combinan excelente estética y durabilidad.Objetivo: Este artículo tiene como objetivo relatar un caso clínico de rehabilitación estética a partir de la utilización de facetas en resina compuesta con cierre de diastemas. Informe de caso: Una paciente, del sexo femenino, con 24 años de edad, buscó la clínica-escuela de odontología insatisfecha con la estética de su sonrisa. La paciente presentaba diastemas, restauración dentaria defectuosa y desproporción en el tamaño de los dientes anteriores. El tratamiento consistió en un blanqueamiento casero previo, seguido por la confección de facetas directas de resina compuesta para cierre de los diastemas y corrección de la desproporción dentaria. Fueron utilizados un Jig Estético y el software Digital Smile Design(DSD) para el planeamiento, además de un mock-upen resina bisacrílica. Tras la confección de las facetas, fue obtenido un resultado estético final satisfactorio. El caso incluyó un total de ocho facetas, de los dientes 14 al 24.Conclusión: El tratamiento a partir de restauraciones en resina compuesta proporcionó a la paciente una rehabilitación estética, funcional y biológica (AU).

Utilidad de la tecnología CAD/CAM en la fabricación de prótesis dentales

La tecnología CAD/CAM es una forma innovadora relacionada con la implementación de técnicas digitales para mejorar las restauraciones prostéticas en un paciente, entre ellas, las destinadas a la estética dental. El presente estudio tiene el objetivo de describir la utilidad de la tecnología CAD/CAM en la fabricación de prótesis dentales. Para ello se realizó una revisión de la literatura médica disponible en las bases de datos PubMed/Medline, Scopus y SciELO, mediante fórmulas de búsqueda avanzada; se seleccionaron artículos en idioma español e inglés. En la actualidad, con esta tecnología se ha logrado combinar estética, resistencia y precisión en la restauración directa, además de garantizarse una mayor duración y años de funcionalidad para cada una de las prótesis, coronas e implantes. La calidad de vida y satisfacción referidas por los pacientes portadores de piezas producidas con esta tecnología, es superior a las manifestadas por aquellos tratados con piezas de fabricación tradicional. El uso de técnicas de inteligencia artificial y biomateriales representará un cambio cualitativo y cuantitativo en el uso de los sistemas CAD/CAM.

CAD/CAM technology is an innovative way related to the implementation of digital techniques to improve prosthetic restorations in a patient, including those intended for dental aesthetics. The objective of this study is to describe the usefulness of CAD/CAM technology in the dental prostheses manufacture. A review of the medical literature available in the PubMed/Medline, Scopus and SciELO databases was carried out, using advanced search formulas; Articles in Spanish and English were selected. Currently, with this technology it has been possible to combine aesthetics, resistance and precision in direct restoration, in addition to guaranteeing greater duration and years of functionality for each of the prostheses, crowns and implants. The quality of life and satisfaction reported by patients wearing parts produced with this technology is higher than those reported by those treated with traditionally manufactured parts. The use of artificial intelligence and biomaterials techniques will represent a qualitative and quantitative change in the use of CAD/CAM systems.

Tratamiento de la transposición de incisivos inferiores / Treatment of transposition of lower incisors

La transposición es el intercambio de la posición de dos dientes adyacentes durante los primeros años de la dentición mixta. El objetivo de la investigación fue evaluar los cambios clínicos de un caso con transposición parcial bilateral de incisivos laterales mandibulares. Se atendió una paciente de 8 años de edad, femenina, de raza blanca, síndrome de Clase II división 1, con transposición de los incisivos laterales con caninos inferiores. Fue tratada con un arco lingual de cierre horizontal, de alambre 0,032 y dos muelles de NiTi comprimidos desde el cierre horizontal del arco hasta una armella soldada a la banda que se colocó en ambos incisivos laterales. Se recuperó el espacio necesario para la erupción de los caninos inferiores y así mejoró la estética dental y facial de la paciente.

Transposition is the exchange of the position of two adjacent teeth during the first years of the mixed dentition. The objective of this research is to evaluate the clinical changes of a case with partial bilateral transposition of mandibular lateral incisors. We present an 8-year-old white female patient with Class II Division 1 malocclusion and transposition of the lateral incisors with lower canines. She was treated with a 0.032 wire horizontal closure lingual arch and two NiTi springs compressed from the horizontal closure of the arch to an eyebolt welded to the band that was placed on both lateral incisors. The necessary space for the eruption of the lower canines was recovered, thus improving her dental and facial aesthetics.

Prevalence and influence of dental development anomalies in smile esthetics: a cross-sectional analysis

Aim: To determine the prevalence of dental development anomalies and type of influence on the smile of adolescent students. Method: This was a cross-sectional and analytical study carried out in two public (A1) and two private (A2) schools chosen by lot in the city of Parnaíba-Piauí. The sample calculation was based on the target population: number of people enrolled in public and private schools between 15 and 19 years, in the city of Parnaíba-PI, which totaled 6209 students in 2020, according to a survey carried out by the Brazilian Institute of Geography and Statistics ­ IBGE. A questionnaire on epidemiological data and aesthetic self-perception of the smile was applied to 160 adolescents between 15 and 19 years old, from August 2020 to July 2021. The clinical examination was carried out under natural light, to check for the presence of anomaly(s) in the dental development. Students who presented only one pathology would be called group 1 (G1), those who presented two would be called group 2 (G2) and those who presented 3 or more would be called group 3 (G3). On the other hand, adolescents in whom no anomaly was evidenced would participate in the control group (CG), both in A1 and A2. Results: It was observed that 37.5% of the sample had only a type of dental anomaly, corresponding to 60 individuals. The most prevalent were enamel hypoplasia, fusion, transposition, agenesis, ectopic eruption, microdent and dens-in-dent. It was possible to verify a higher prevalence in the maxilla, private schools (76.6%) and females (86.6%). In 45% of adolescents with dental anomalies, embarrassment was observed when smiling. Conclusion: The prevalence was relatively high, highlighting the enamel hypoplasia, influencing the smile esthetics of a reasonable number of adolescents, whether for acquaintances, strangers or even for photographs

Background and surrounding colors affect the color blending of a single-shade composite

Abstract This study evaluated the background and effect of surrounding colors on the color blending of a single-shade composite used in a thin layer. Disc-shaped specimens (1.0 mm thickness) were built with the Vittra APS Unique composite surrounded (dual specimens) or not surrounded (simple specimens) by a control composite (shade A1, A2, or A3). Simple specimens were also built with only control composites. The specimen color was measured against white and black backgrounds with a spectrophotometer (CIELAB system). The whiteness index for dentistry (WID) was calculated for simple specimens. Differences (ΔE00) in color and translucency parameters (ΔTP00) between the simple/dual specimens and the controls were calculated. The translucency adjustment potential (TAP) and color adjustment potential (CAP) were estimated based on the ratios between data from simple and dual specimens. The Vittra APS Unique composite showed higher WID values than the controls. No differences between ΔTP00_SIMPLE and ΔTP00_DUAL were observed for any of the shades. The composite shade did not affect TAP values. The lowest values of ΔE00_SIMPLE and ΔE00_DUAL were observed for shade A1 regardless of the background color. For the white background, ΔE00_SIMPLE values did not differ from those of ΔE00_DUAL for all shades. Only A1 showed ΔE00_DUAL values lower than ΔE00_SIMPLE when the black background was used. The highest modulus of CAP (negative values for the white background) was observed when shade A1 surrounded the Vittra APS Unique composite. The color blending ability of the single-shade resin composite used in a thin layer was affected by both the surrounding shade and background color.

Efetividade da ação clareadora dos dentifrícios no clareamento dental: uma revisão Integrativa / Effectiveness of teeth whitening action in dental bleaching: an Integrative review

Objetivo: Avaliar a efetividade dos dentifrícios categorizados como do tipo clareadores no clareamento dental, por meio de um levantamento da evidência científica. Métodos: Foram utilizadas as bases de dados eletrônicas Pubmed, Embase, Web of Science e Scopus para a busca dos estudos até o mês de agosto de 2021. Estudos clínicos que compararam os dentifrícios mencionados como clareadores com os dentifrícios não clareadores na mudança de cor dos dentes foram incluídos. As palavras-chaves utilizadas na estratégia de busca foram: "whiteningtoothpastes", "whiteningdentifrice", "toothpastes", "dentifrice", "color change", "colorationanalysis" e "toothbleaching". Os dados foram analisados por meio de uma síntese qualitativa, detalhando os principais resultados dos estudos incluídos. Após a etapa de leitura e seleção dos artigos, foram incluídos 5 artigos para essa revisão integrativa. Resultados: O creme dental mais utilizado foi o Close Up White Now (n = 3). A metodologia de cor mais utilizada foi a espectrofotometria, o tipo de estudo que predominou foi o ensaio clínico randomizado, avaliando o esmalte dental humano. No que se refere ao RDA (Relative Dentin Abrasitity), os dentifrícios clareadores apresentam um índice entre 60-100, por vezes superior à 100, sendo considerados abrasivos. Conclusão: Nos resultados de alguns estudos incluídos, os dentifrícios clareadores não apresentaram efeito de clareamento intrínseco, apenas o efeito de remoção de manchas extrínsecas foi observado.

Aim: To evaluate the effectiveness of dentifrices categorized as whitening in tooth whitening, through a survey of scientific evidence. Methods: The Pubmed, Embase, Web of Science, and Scopus electronic databases were used to search for studies up to August 2021. Clinical studies that compared dentifrices mentioned as whitening with non-whitening dentifrices in the change of tooth color were also included. The keywords used in the search strategy were: "whiteningtoothpastes", "whiteningdentifrice", "toothpastes", "dentifrice", "color change", "colorationanalysis", and "toothbleaching". Data were analyzed using a qualitative synthesis, detailing the main results of the included studies. After reading and selecting the articles, five articles were included in this integrative review. Results: The most used widely toothpaste was Close Up White Now (n = 3). The most commonly used color methodology was spectrophotometry, while the predominant type of study was the randomized clinical trial, evaluating human dental enamel. Regarding the RDA (Relative Dentin Abrasitity), whitening toothpastes have an index between 60-100, sometimes higher than the 100, and are considered abrasive. Conclusion: In the results of some of the included studies, whitening dentifrices did not have an intrinsic whitening effect; only the effect of removing extrinsic stains was observed.

Prevalence and factors associated with gummy smile in adolescents: a cross-sectional analysis

Aim: To evaluate the prevalence and factors associated with gummy smiles in adolescents aged between 15 and 18 years attending high school. Methods: The cross-sectional and quantitative study was carried out during the Covid-19 pandemic, with 160 adolescents, from two public (A1) and two private (A2) schools chosen by lottery, divided into two groups: G1 (with gummy smile) and G2 (no gummy smile). A clinical examination was carried out on the adolescents, investigating the presence or absence of a gummy smile (GS), by analyzing the variables (interlabial distance at rest, upper incisor exposure at rest, smile arc, measurement from the subnasal to the upper lip philtrum, upper lip length, upper lip thickness, hypermobility and lower/middle third ratio). Means and dispersion were obtained, and the Chi-square association test was applied, to compare the results between A1 and A2 and between G1 and G2. Results: The prevalence of GS was 33.8% (=54). It was found that no statistically significant associations were found (p > 0.05), regarding the type of school and gender with the presence of GS in adolescents. There was no statistically significant difference (χ² = 1.82; p = 0.07) between the groups and the age of adolescents. There was a significant association between the studied variables and GS (p < 0.05). Conclusion: The prevalence was high with a predominance of females. There were no statistically significant associations regarding the type of school and gender, but there was a significant association between gummy smile and lip dimensions

A clinical evaluation of zirconia reinforced lithium silicate glass-ceramic CAD/CAM onlay: a two-year case report / Avaliação clínica de onlay cerâmica do tipo CAD / CAM de silicato de lítio reforçado com zircônia: um relato de caso de dois anos

ABSTRACT The CAD/CAM technology arose from the need to develop materials with better mechanical and optical properties that could be used for making monolithic restorations. Several materials have been used for milling indirect restorations in prefabricated blocks. Among them, lithium silicate reinforced with zirconia. Due to its recent introduction in the market, this case report aimed to present a detailed clinical protocol for the execution of a ceramic onlay of this material using CAD/CAM technology. A 57-year-old female patient sought care with extensive restoration in composite resin (BOMD) of tooth 15 maintained for almost two years. However, due to bruxism, constant dental tightening, the extension of the direct restoration and the need for improved esthetics, it was proposed to replace it with an indirect ceramic onlay restoration. Prophylaxis and choice of the color of the patient's dental substrate were performed. Afterwards, the dental preparation was made and polished. Subsequently, the molding was made with addition silicone and the provisional restoration confectioned. Once the stone model was obtained, it was scanned and the ceramic onlay restoration was milled using CAD/CAM technology. Finally, the restoration was stained and cemented over the preparation. After 2 years, the restoration remained stable, with no evidence of color mismatch, marginal discoloration, marginal cleft, caries or fracture, proving the effectiveness of the treatment in this time interval. The correct indication of the ceramic material combined with the use of CAD/CAM technology facilitated the restorative process, restoring function and the esthetics desired by the patient.

RESUMO A tecnologia CAD/CAM surgiu da necessidade de desenvolvimento de materiais com melhores propriedades mecânicas e ópticas que pudessem ser utilizados para confecção de restaurações monolíticas. Diversos materiais têm sido utilizados para fresagem de restaurações indiretas em blocos pré-fabricados. Dentre eles, o silicato de lítio reforçado com zircônia. Devido a sua recente introdução no mercado, este relato de caso objetivou apresentar um protocolo clínico detalhado para a execução de uma onlay cerâmica desse material utilizando a tecnologia CAD/CAM. Paciente, 57 anos, sexo feminino, procurou atendimento com extensa restauração em resina composta envolvendo as faces (MODV) do dente 15 mantida por quase dois anos. Contudo, em virtude do bruxismo, do apertamento dental constante, da extensão da restauração direta e da necessidade de melhora na estética, foi proposto a substituição por uma restauração indireta em cerâmica do tipo onlay. Foi realizada a profilaxia e escolha da cor do substrato dental da paciente. Em seguida o preparo dental foi confeccionado e polido. Posteriormente foi feita a moldagem com silicone de adição e a confecção do provisório. Com a obtenção do modelo, este foi escaneado e fresada a onlay cerâmica pela tecnologia CAD/CAM, que posteriormente foi maquiada e cimentada sobre o preparo. Após 2 anos, a restauração permaneceu estável, sem evidência de incompatibilidade de cor, descoloração marginal, fenda marginal, cárie ou fratura, comprovando a eficácia do tratamento neste intervalo de tempo. A correta indicação do material cerâmico aliada ao uso da tecnologia CAD-CAM facilitou o processo restaurador devolvendo função e a estética desejada pela paciente.

Facetas estéticas e lentes de contato: aspectos éticos e legais a partir da análise de redes sociais / Aesthetic facets and contact lenses: ethical and legal aspects from the analysis of social networks

A crescente busca pelo fator estético por meio de procedimentos odontológicos, junto ao impacto das redes sociais na atuação do profissional e no processo de tomada de decisão do paciente, provoca questionamentos sobre a conduta ética e legal do cirurgião-dentista. Dessa maneira, o objetivo deste trabalho foi analisar os aspectos éticos e legais relacionados à conduta profissional na abordagem e proposta de tratamento odontológico com facetas estéticas e lentes de contato dental divulgados por meio da ferramenta digital YouTube®. O estudo foi realizado em duas etapas: a primeira, a partir da análise de 10 vídeos de relatos de caso de pacientes que realizaram tratamento com facetas estéticas e lentes de contato dental, e, na segunda etapa, foram analisados 10 vídeos com o tema relacionado à apresentação que os cirurgiões-dentistas (CD) fazem sobre os tratamentos estéticos. Em estudo quantitativo-qualitativo, procedeu-se a análise das percepções do profissional (que oferta serviços) e do paciente (consumidor), confrontadas em seu conteúdo, tendo como referência aspectos éticos e legais vigentes. Como resultado, tem-se que nos vídeos de CD, 3 (30%) não abordam limitações e riscos, e nenhum trata sobre Termo de Consentimento Livre e Esclarecido (TCLE) e contrato. Apesar disto, nos vídeos de pacientes foram observadas poucas reclamações sobre as informações prestadas (10%) e nenhuma menção a processos. Logo, percebe-se, a partir deste estudo, que, os vídeos analisados frequentemente ferem normas éticas e legais da categoria profissional, sendo de realização arriscada, ainda que aparentemente os pacientes não estejam queixando-se de prática abusiva, os conselhos profissionais podem agir de ofício e instaurar processos éticos contra os profissionais

The crescent search for the aesthetic factor through dental procedures, coupled with the impact of social media on professional activities and the patient's decision making process, raises questions about the dentists ethical and legal conduct. The objective of this study was analyzing the ethical and legal aspects related to the professional's conduct in their approach and proposal of dental treatment with aesthetic dental facets and contact lenses in the digital means of YouTube®. The study was performed in two stages: the first one through the analysis of 10 YouTube® videos, related to case studies from the perspective of patients who had been subject to treatment with aesthetic dental facets and contact lenses; and the second stage analyzing 10 videos related to how dentists present the aesthetic treatments through this media. In a quantitative-qualitative study the two perspectives were analyzed, the professional as treatment offered and the patient as consumer, confronted through their content, referring back to current ethical and legal aspects, observed or disregarded, and the implied risks to the professional, serving as reading reference to critical, alert, competent and responsible practice. The results show that, in the dentists videos, 3 of them (30%) do not tackle the limitations and risks, and none mention informed consent forms (ICF). Despite this, the patient videos show few complaints about the information given beforehand (10%) and no mention of lawsuits. Therefore it is noted through this study that, although publicity in health services has its risks, the professionals apparently are not incurring in abusive practices

Short-term effect of adhesive system on clinical performance of bulk fill composite: randomized clinical trial

Aim: Although bulk fill composites have been widely used as restorative material, there is no consensus regarding the best clinical protocol in terms of composite technique and adhesive system. Therefore, this clinical trial evaluated the clinical performance of bulk fill composites for class I restorations under different protocols. Methods: A randomized clinical trial including 155 class I restorations was conducted using different adhesive systems: conventional technique (phosphoric acid + conventional three-step adhesive system) (Group 1, 2 and 3); or self-etching adhesive system (Groups 4, 5 and 6). Control groups 1 and 4 were restored with conventional composite; groups 2 and 5 with low viscosity bulk fill and conventional composite as occlusal coverage; groups 3 and 6 with high viscosity bulk fill. The FDI criteria was used for clinical evaluation at baseline and after 6 months. Results: All groups showed good clinical performance. At baseline, the adhesive system did not affect postoperative hypersensitivity. After 6 months, group 5 showed a significant reduction in color and translucency; group 6 a reduction in terms of anatomical form and for postoperative sensitivity and an improvement in patient satisfaction (p<0.05). Considering the same restorative technique, the use of the self-etching adhesive system showed a significant decrease in color and translucency (p<0.05). Conclusion: All groups showed favorable clinical performance, and promising results were found for the conventional adhesive system and high viscosity bulk fill protocol

Restabelecimento estético de incisivos laterais conóides e amplas restaurações em resina composta com laminados cerâmicos: relato de caso / Aesthetic recovering of conoid side incisives and wide restoration in composed resin with ceramic laminates: case report

Introdução: As cerâmicas odontológicas são amplamente utilizadas na Odontologia, desfrutando de grande popularidade devido a sua capacidade de mimetizar as características ópticas do esmalte e da dentina. O constante desenvolvimento de pesquisas tem desencadeado o lançamento de novos sistemas cerâmicos com propriedades aprimoradas e melhores resultados clínicos em longo prazo. Objetivo: O relato de caso aqui apresentado descreve uma reabilitação da zona estética do sorriso com laminados cerâmicos por meio de uma abordagem minimamente invasiva. Relato de caso: Paciente do gênero feminino, compareceu à clínica odontológica relatando insatisfação com a aparência do seu sorriso. Durante avaliação foram observadas, na região anterossuperior, restaurações extensas em resina composta deficientes nos incisivos, com proporção, volume, forma e texturização insatisfatórias, que em conjunto comprometia a zona estética do sorriso. Diante disso, após fotografias extra e intraorais, o tratamento proposto foi a reabilitação com laminados cerâmicos nas unidades 1.2 ao 2.2. Assim, foi realizado o enceramento e o mock-up, os quais serviram de orientação para os preparos dentários, a seguir, foram moldados e as restaurações confeccionadas no sistema IPS e.max. Após prova de cor e adaptação, os preparos e a superfície interna dos laminados cerâmicos foram tratados e cimentados com cimento resino fotopolimerizável. Conclusão: Instituindo uma abordagem conservadora, o plano de tratamento realizado através da reabilitação com laminados cerâmicos nas unidades dentárias anterossuperiores, permitiu o restabelecimento da função e estética, com reprodução das características dos dentes naturais e promoção do equilíbrio, da jovialidade e da harmonia no sorriso(AU)

Introduction: Dental ceramics are widely used in dentistry, enjoying great popularity due to the ability to mimic both enamel and dentin optical characteristics. The constant research development has triggered the launch of new ceramic systems with improved properties and better long-term clinical results. Objective: The case report presented here describes the zone rehabilitation of the aesthetic smile with ceramic laminates through a minimally invasive approach. Case report: Female patient, attended the dental clinic reporting dissatisfaction with the appearance of her smile. During the evaluation, extensive restorations in composite resin were observed in the incisors in the anterosuperior region, with unsatisfactory proportion, amount, shape and texturing, which together compromised the aesthetic zone of the smile. Faced with this, after extra and intraoral photographs, the proposed treatment was the restoration with the ceramic laminates in units 1.2 to 2.2. Thus, waxing and mock-up were performed, which served as guidance for the dental preparations, then they were molded and restorations fabricated in the IPS e.max system. After shade and adaptation proof, the preparations and the inner ceramic laminates surface were treated and cemented with light-cured resin cement. Conclusion: Adopting a conservative approach, the treatment plan carried out through restoration with ceramic laminates on the upper anterior teeth allowed the recovering function and aesthetics, reproducing characteristics of natural teeth and promoting balance, joviality and harmony in the smile(AU)

Smile Transformation with Composite Resin by Semi-Direct Technique: a Case Report / Transformação Do Sorriso Com Resina Composta Por Técnica Semi-Direta: Relato De Caso

Composite veneers stand out in modern dentistry for their practicality, time-saving and excellent optical properties. This work describes the operative steps for the realization of veneers in composite resin in an academic clinical environment using a semi-direct technique. A 21-yearold female patient attended the clinic-school complaining of aesthetic dissatisfaction with her smile. In the clinical dental evaluation, multiple diastemas were observed in the upper anterior teeth, and resin cement residues from orthodontic bracket bonding. In addition, the patient expressed an interest in having bigger and whiter teeth. In view of the complaints reported by the patient, the following treatment sequence was proposed: 1. Removal of residual resin cement from all teeth; 2. Tooth whitening; 3. Confection of composite resin veneers using the semi-direct technique on the upper teeth (canine to canine). The die stone that had already been made for the home bleaching procedure was used for esthetic rehabilitation. The 6 veneers were made using a nanoparticulate resin. The veneers were cemented and adjusted. The 12-month follow-up showed an excellent marginal adaptation and an excellent aesthetic and function quality. The semi-direct technique may be considered a therapeutic option based on the conservation of sound tooth structure, minimal emotional stress during clinical work and excellent final optical and mechanical properties. Simplicity and practicality of the technique allow reproducibility and excellent results at a lower cost when compared to dental ceramics. (AU)

As facetas em resina composta destacam-se na odontologia moderna por sua praticidade, economia de tempo e excelentes propriedades ópticas. Este trabalho descreve as etapas operatórias para a realização de facetas em resina composta em ambiente clínico acadêmico utilizando a técnica semi-direta. Paciente do sexo feminino, 21 anos, compareceu à clínica-escola com queixa de insatisfação estética com seu sorriso. Na avaliação clínica odontológica, foram observados múltiplos diastemas nos dentes anteriores superiores e resíduos de cimento resinoso proveniente da colagem de braquetes ortodônticos. Além disso, a paciente manifestou interesse em ter dentes maiores e mais brancos. Diante das queixas relatadas pela paciente, foi proposta a seguinte sequência de tratamento: 1. Remoção do cimento resinoso residual detodos os dentes; 2. Clareamento dental; 3. Confecção de facetas de resina composta pela técnica semi-direta nos dentes superiores (canino a canino). O modelo de gesso já confeccionado para o clareamento caseiro foi utilizado para a reabilitação estética. As 6 facetas foram confeccionadas utilizando resina nanoparticulada. As facetas foram cimentadas e ajustadas. O seguimento de 12 meses mostrou uma excelente adaptação marginal e uma excelente qualidade estética e funcional. A técnica semi-direta pode ser considerada uma opção terapêutica baseada na conservação da estrutura dentária sadia, mínimo estresse emocional durante o trabalho clínico e excelentes propriedades ópticas e mecânicas finais. A simplicidade e praticidade da técnica permitem reprodutibilidade e excelentes resultados a um custo menor quando comparado às cerâmicas odontológicas. (AU)

Do non-clinical subjective factors influence the treatment decisionmaking of Brazilian dentists? / Fatores subjetivos não clínicos influenciam na tomada de decisão do tratamento de cirurgiões-dentistas brasileiros?

ABSTRACT The literature contains little information on several non-clinical factors such as the association between graduate residency programs and the application of minimally invasive dentistry, or on dentists' clinical decision-making processes for replacing restorations for esthetic reasons. This study evaluated whether non-clinical subjective factors influence the treatment decisions made by Brazilian dentists regarding technical and esthetic matters. Dentists were invited to participate in a cross-sectional survey by answering an electronic questionnaire containing clinical cases, regarding what treatment they would select for: T1 - a molar tooth with significant crown destruction and spontaneous pain, and T2 - premolar teeth with extensive amalgam restorations and no carious lesion or associated complaint. The survey also included questions about subjective variants (sociodemographic and professional). Chi Square test and Fischer's Exact test were used to analyze the answers to T1, and one-factor analysis of variance and post-hoc Tamhane were applied to T2. The significance level was set at 5% for all analyses. A total 302 professionals participated in the study. For T1, it was found that clinical decision-making was influenced by the Brazilian region of clinical practice (p=0.005). For T2, a significant association was found between increased loss of patient tooth tissues and whether the professional had completed a residency program in Operative Dentistry (p=0.035), worked in a private practice (p=0.033), or if most of his/her patients belonged to a high estimated socioeconomic level (household income above $4350) (p=0.002). In conclusion, the clinical decision-making of Brazilian dentists varies according to professional profile, mainly with relation to the replacement of restorations due to esthetic concerns.

RESUMO Vários fatores não clínicos, como a associação entre programas de especialização e a aplicação da odontologia minimamente invasiva, ainda são escassos na literatura. Outro aspecto relevante é a tomada de decisão clínica do dentista quanto à substituição de restaurações em função da aparência estética. Este estudo avaliou se fatores subjetivos não clínicos influenciam na tomada de decisão clínica de dentistas brasileiros com base em questões técnicas e estéticas. Foi realizado um estudo transversal com um questionário eletrônico contendo casos clínicos que foram apresentados a uma lista de profissionais. No questionário, interrogou-se o tratamento proposto para um dente molar com destruição coronária significativa e dor espontânea (T1). Também foi questionado o tratamento proposto para dentes prémolares com extensas restaurações de amálgama e sem lesão cariosa ou queixas associadas (T2). Em seguida, foram questionadas as variantes subjetivas (sociodemográfica e profissional). Na análise de T1, foram utilizados os testes Qui Quadrado e Exato de Fischer. Em T2, foi aplicada a análise de variância de um fator e post-hoc Tamhane. Para todas as análises, o nível de significância foi estabelecido em 5%. Um total de 302 profissionais participaram deste estudo. A tomada de decisão clínica para T1 foi influenciada pela região brasileira de prática clínica (p = 0,005). Em T2, realizar especialização em Dentística Operatória (p = 0,035), trabalhar em consultório particular (p = 0,033) e a maioria dos pacientes apresentar nível socioeconômico estimado elevado (renda familiar acima de R$10.000,00) (p = 0,002) aumentou significativamente a perda de tecidos dentários. Em conclusão, a tomada de decisão clínica dos dentistas brasileiros varia de acordo com o perfil dos profissionais, principalmente no que se refere à substituição de restaurações por questões estéticas.

Evaluation of resin composite staining by beverages with acid pH / Avaliação do manchamento de resinas compostas por bebidas de pH ácido

ABSTRACT Introduction: Composite resins are an extensively used esthetic material that has excellent adaptation, reproduces the characteristics of the tooth structure and is suitable for the conditions of the oral environment. However, this material is also very susceptible to staining due to pigmentation coming from the diet and habits of the patient. Objectives: To evaluate the staining of two brands of composite resin, one nanoparticle and a nanohybrid type (Filtek Z350XT® and IPS Empress Direct®), in direct contact with the acid pH of beverages. Methods: In total 40 specimens were made, 20 of each type of resin studied. After being inserted into a Teflon matrix and light activated, the samples were removed, stored in containers with 2 ml of artificial saliva and kept in the refrigerator. Every day 20 of these samples were placed in direct contact with 2 ml Gatorade, and the other 20 samples, in 2 ml of wine, each set for 30 minutes. After 30 minutes, the acid pH substances were removed, and 2 ml of artificial saliva was again placed in the container. This process was repeated every day for 10 days. Results: The results showed that the nanoparticle resin (Filtek Z350XT) was more susceptible to staining than the nanohybrid type (Empress Direct®) when in contact with the wine. When wine and Gatorade were compared, the solution with higher staining capacity was shown to be wine. Conclusion: The two resins tested were susceptible to staining in a 10-day period. Mottling and more staining was visibly detected after samples were immersed in the solution with the higher pH, and nanoparticulate resin was more susceptible to staining.

RESUMO Introdução: As resinas compostas são altamente utilizadas por serem um material estético, com excelente adaptação, reproduz as características da estrutura dental e se adequa ao meio bucal. Porém, este material é muito susceptível à pigmentação por corantes vindos da dieta e de hábitos do paciente. Objetivos: Avaliar o manchamento de duas marcas comerciais de resina composta: Nanoparticulada e Nanohíbrida, em contato direto com bebidas de pH ácido (Filtek Z350XT® e IPS Empress Direct®). Métodos: Foram confeccionados 40 corpos de prova, 20 de cada tipo de resina estudada, depois de inseridas em matriz de teflon e fotoativados, os corpos de prova foram removidos, armazenados em recipientes com 2ml de saliva artificial e mantidos na geladeira. Diariamente 20 dos mesmos eram colocados em contato direto com 20mL Gatorade e os outros 20mL de vinho durante 30 minutos cada. Passados os 30 minutos, as substâncias de pH ácido eram retiradas e novamente, 2 mL de saliva artificial eram colocadas no recipiente. Este processo foi repetido todos os dias durante 10 dias. Resultado: Os resultados mostraram que a resina nanoparticulada (Filtek Z350XT®) é mais susceptível ao manchamento que a nanohíbrida (Empress Direct®) quando em contato com o vinho. Quando comparados vinho e Gatorade, a solução com maior teor de manchamento é o vinho. Conclusão: As duas resinas testadas foram sensíveis ao manchamento num período de 10 dias, esse manchamento foi visivelmente detectado, a solução com o pH mais elevado manchou mais e a resina nanoparticulada é mais susceptível ao manchamento.

Caracterización de los pacientes con defectos oculares atendidos en el Policlínico Universitario Julio Antonio Mella

Introducción: La prótesis bucomaxilofacial constituye la rehabilitación morfofuncional por medios artificiales de las estructuras intrabucales y peribucales en los defectos oculares, orbitales, nasales, auriculares, maxilares, mandibulares, craneales y complejos; con la conservación de modo armónico de las estructuras remanentes ya sean duros o blandos. Objetivo: Caracterizar los pacientes rehabilitados por defectos oculares en el Policlínico Universitario Julio Antonio Mella. Métodos: Se realizó un estudio observacional, descriptivo y transversal desde enero de 2015 a febrero de 2022 en pacientes rehabilitados por defectos oculares en el departamento de Prótesis Estomatológica del Policlínico Universitario Julio Antonio Mella de la ciudad de Camagüey. Se estudiaron 53 pacientes que acudieron en el período de la investigación remitidos del Hospital Universitario Manuel Ascunce Domenech y del Hospital Pediátrico Provincial Docente Eduardo Agramante Piña de la provincia Camagüey. Resultados: Con relación a los pacientes con rehabilitados según edad, sexo y factores etiológicos prevaleció el grupo 35 a 59 años, así como el sexo masculino y el traumatismo ocular. Se constató que la experiencia protésica satisfactoria primó en los periodos evaluados y con respecto a los pacientes rehabilitados según los factores relacionados con la estética, se comprobó que los valores más favorables fueron para el color de la esclera y la apertura palpebral. Conclusiones: Predominó el sexo masculino junto con el grupo de edad de 35 59 años. La causa más frecuente de pérdida ocular fue la traumática. Hubo un alto índice de experiencia satisfactoria con el uso de las prótesis y los factores que determinaron la estética fueron favorables.

Introduction: The bucomaxilofacial prosthesis constitutes the morpho-functional rehabilitation for artificial means of the intraoral and peribucales structures in the ocular defects, orbital, nasal, aural, maxillary, mandibular, cranial and complex; with the harmonic conservation of mode of the remanent structures either be hard or soft. Objetive: To characterize the patients rehabilitated for ocular defects at the Julio Antonio Mella University Polyclinic. Methods: An observational, descriptive and transversal study was carried out from January, 2015 to February, 2022 in patients rehabilitated by ocular defects in the department Dentistry Prosthesis of the Julio Antonio Mella University Polyclinic of the city of Camagüey. 53 patients constituted the universe that attended in the period of the investigation remitted of the Manuel Ascunce Domenech University Hospital and from the Eduardo Agramontes Piña Provincial Pediatric Hospital in the province Camagüey. Results: With respect to the rehabilitated patients according to age, sex and etiologic factors prevailed the group 35 to 59 years, as well as the masculine sex and the ocular traumatism. It was verified that the prosthetic satisfactory experience had priority in the evaluated periods and regarding the patients rehabilitated according to the factors related with esthetics, it was verified that the most favorable values were for the color of the esclera and the palpebral opening. Conclusions: The masculine patients predominated along with the age rank of 35-59 years. The most frequent cause of ocular loose was the traumatic one. There was a tall index of satisfactory experience with the use of the prosthesis and the factors that determined the esthetics were favorable.

Applications of diode laser in periodontal therapy ­ clinical guidelines and tips / Aplicações do laser de diodo na terapia periodontal ­ Orientações e dicas clínicas

Os lasers de diodo tornaram-se ferramentas clínicas populares devido ao seu tamanho compacto, acessibilidade, facilidade de uso e versatilidade. O objetivo deste artigo é apresentar as diversas aplicações de um laser de diodo na prática diária e destacar os aspectos técnicos do uso do laser de diodo para o mesmo. Esta série de casos relata o manejo de seis diferentes situações clínicas com laser de diodo: anquiloglossia, bolsa periodontal, zênites gengivais desiguais, mucocele, hipersensibilidade dentinária e gengiva hiperpigmentada. Os pacientes foram tratados com laser de diodo de 940 nm com potência de 0,5 W a 2 W dependendo do caso. A cicatrização pós-operatória transcorreu sem intercorrências na maioria dos casos e foram observados resultados favoráveis. O laser de diodo ofereceu vantagens cirúrgicas como ­ campo seco, desinfecção do sítio cirúrgico e cirurgia sem sutura. Além disso, os autores observaram melhor satisfação do paciente devido à mínima dor ou edema pós-operatório e alívio imediato em caso de hipersensibilidade dentinária. Este artigo apresenta as aplicações cirúrgicas e não cirúrgicas do laser de diodo juntamente com os aspectos técnicos. Embora a literatura disponível não forneça evidências substanciais para comparação direta do laser de diodo com as técnicas convencionais, é seguro concluir que o laser de diodo é uma ferramenta eficiente para uso rotineiro em odontologia.(AU)

The diode lasers have become popular clinical tools because of their compact size, affordability, ease of use and versatility. The aim of this paper is to put forth the various applications of a diode laser in day to day practice and highlight the technical aspects of diode laser use for the same. This case series reports management of six different clinical situations with diode laser namely ­ ankyloglossia, periodontal pocket, unequal gingival zeniths, mucocele, dentinal hypersensitivity and hyper-pigmented gingiva. The patients were treated with 940 nm diode laser with power settings from 0.5 W to 2 W depending on the case. The post-operative healing was uneventful in most cases and favourable outcomes were observed. The diode laser offered surgical advantages like ­ dry field, disinfection of surgical site and suture-less surgery. In addition, the authors observed better patient satisfaction owing to minimal post-operative pain or swelling and immediate relief in case of dentinal hypersensitivity. This paper presents both surgical and non-surgical applications of diode laser along with the technical aspects. Even though the available literature does not lend substantial evidence for direct comparison of diode laser with conventional techniques, it is safe to conclude that diode laser is an efficient tool for routine use in dentistry.(AU)

A Multivariate Analysis of the Psychosocial Impact of Malocclusion and Self-Esteem in Adolescents

Abstract Objective: To evaluate the psychosocial impact of malocclusion and self-esteem in adolescents in the Amazon region. Material and Methods: A cross-sectional study was carried out with 212 adolescents with 12-year-old enrolled in all public schools in the Boca do Acre (Amazonas, Brazil). Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) assessed the psychosocial impact of malocclusion. The self-perception of the need for orthodontic treatment was evaluated by the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) and Global Negative Self-evaluation (GSE), the adolescent's self-esteem. The malocclusion was clinically evaluated by the Dental Aesthetic Index (DAI). The variables with p<0.20 in the individual analyses were tested in multiple logistic regression models, and those with p<0.10 remained in the model. The adjusted odds ratio (OR) was estimated with a 95% confidence interval (CI). Results: Adolescents with low self-esteem were 2.20 (95% CI: 1.23-3.93) times more likely to have a more significant impact on dental aesthetics (p<0.05). When verified by domains, the adolescents with low self-esteem had 2.33 (95% CI: 1.31-4.17) and 1.93 (95% CI: 1.09-3.42) times more likely to impact the psychological and social domains of the PIDAQ, respectively. Conclusion: Self-esteem influenced adolescents' perception of dental aesthetics in the domains related to psychological and social impact (AU).