Infiltrantes para tratamiento estético de lesiones de manchas blancas por fluorosis: Reporte de caso / Infiltrants for Aesthetic Treatment of White Spots Lesions by Fluorosis: Case Report

Resumen La fluorosis dental es una anomalía en el desarrollo del esmalte debido a la excesiva ingesta de flúor durante la formación de los tejidos dentales, y se caracteriza principalmente por la hipomineralización y mayor porosidad de la estructura del esmalte. Muchas veces las manchas ocasionadas por la fluorosis dental pueden comprometer la estética del paciente y afectar su autoestima. En años recientes ha sido desarrollado una nueva generación de materiales odontológicos conocida como infiltrantes resinosos, que básicamente son resinas de baja viscosidad que infiltran y paralizan la progresión de las lesiones cariosas incipientes no cavitadas. Cuando infiltrantes resinosos han sido utilizados para detener las lesiones cariosas se ha verificado que también producen cambios en la apariencia de la mancha blanca, atenuándola o tornándola imperceptible. El presente artículo describe un reporte de caso del uso de infiltrantes resinosos para tratamiento estético de lesiones de manchas blancas ocasionadas por fluorosis.

Abstract Dental fluorosis is an abnormality in the development of enamel due to the excessive intake of fluoride during formation of dental tissues, mainly characterized by hypomineralization and increased porosity of the enamel structure. Oftenly the spots caused by dental fluorosis can compromise the aesthetics of the patient and affect their self-esteem. In recent years a new generation of dental materials has been developed, known as resin infiltrants, which are basically low viscosity resins that infiltrate and paralyze the progression of incipient non cavitated carious lesions. When resin infiltrants have been used to stop carious lesions it has been verified that they also produce changes in the appearance of white spots, masking or making them imperceptible. The present article describes a case report of the use of resin infiltrants for aesthetic treatment of white spot lesions caused by fluorosis.

Direct resin composite restoration of endodontically-treated permanent molars in adolescents: bite force and patient-specific finite element analysis

Abstract Objective To evaluate the influence of three levels of dental structure loss on stress distribution and bite load in root canal-treated young molar teeth that were filled with bulk-fill resin composite, using finite element analysis (FEA) to predict clinical failure. Methodology Three first mandibular molars with extensive caries lesions were selected in teenager patients. The habitual occlusion bite force was measured using gnathodynamometer before and after endodontic/restoration procedures. The recorded bite forces were used as input for patient-specific FEA models, generated from cone-beam computed tomographic (CT) scans of the teeth before and after treatment. Loads were simulated using the contact loading of the antagonist molars selected based on the CT scans and clinical evaluation. Pre and post treatment bite forces (N) in the 3 patients were 30.1/136.6, 34.3/133.4, and 47.9/124.1. Results Bite force increased 260% (from 36.7±11.6 to 131.9±17.8 N) after endodontic and direct restoration. Before endodontic intervention, the stress concentration was located in coronal tooth structure; after rehabilitation, the stresses were located in root dentin, regardless of the level of tooth structure loss. The bite force used on molar teeth after pulp removal during endodontic treatment resulted in high stress concentrations in weakened tooth areas and at the furcation. Conclusion Extensive caries negatively affected the bite force. After pulp removal and endodontic treatment, stress and strain concentrations were higher in the weakened dental structure. Root canal treatment associated with direct resin composite restorative procedure could restore the stress-strain conditions in permanent young molar teeth.

Efeito do tratamento de superfície e condição de armazenamento sobre a resistência de união resina-cerâmica / Effect of surface treatment and storage condition on the ceramic-resin bond strength

Uma superfície de cada um de quatro blocos foi polida e submetida aos seguintes tratamentos de superfície: bloco A (HF+S) - microjateamento com Al2O3 de 50 μm (15 s), condicionamento com ácido HF a 9,5% (20 s) e aplicação de silano (3 min); bloco B (HF) - microjateamento e condicionamento com ácido HF; bloco C (S) - microjateamento e silano; e bloco D (CJ) - microjateamento com CoJet Sand e aplicação de silano. O adesivo Scotchbond Multi-Purpose Plus foi aplicado sobre a superfície dos blocos A, B e C, e o adesivo Visio-Bond do sistema CoJet, no D, todos polimerizados, e resina composta (Filtek Z250) foi adicionada em quatro incrementos de 1 mm e fotopolimerizada. Os blocos de resina-cerâmica foram, então, seccionados em dois eixos perpendiculares, produzindo cada um aproximadamente 40 corpos de prova, divididos em dois grupos: grupo “Imediato”, dividido em quatro subgrupos: HF+S/I (n = 19), HF/I (n = 19), S/I (n = 20) e CJ/I (n = 16), armazenados por 24 h em água destilada; e grupo “12m+Tc”, dividido em quatro subgrupos: HF+S/12m (n = 20), HF/12m (n = 20), S/12m (n = 20) e CJ/12m (n = 17), armazenados por 12 meses em saliva artificial, seguidos por termociclagem (800 ciclos). Os valores médios obtidos (HF+S/I = 56,85±16,52(a), HF/I = 51,69±11,34(ab), S/I = 50,73±12,37(ab), CJ/I = 40,13±9,27(bc), HF+S/12m = 42,29±17,34(b), HF/12m = 21,03±7,02(d), S/12m = 13,72±6,24(d), CJ/12m = 26,77±21,07(cd)) foram analisados estatisticamente (ANOVA 2). Observou-se interação entre tratamento de superfície e condição de armazenamento. Condicionamento da superfície cerâmica com ácido HF combinado com silanização propiciou maior μ-TBS à resina após 12 meses de armazenamento em saliva artificial e termociclagem...

One surface of each out of four blocks was polished and subjected to the following surface treatments: A: (HF + S) – sandblasting with AL2O3 50 μm (15 s), etching with 9.5% HF (20 s) and silane application (3 min); B:(HF) - sandblasting and etching with HF; C: (S) – sandblasting and silane; D: (CJ) – sandblasting with CoJet Sand and silane application. A three-step total-etch adhesive was applied (ScotchBond Multi-Purpose Plus) on the surface of the blocks A, B, and C, and the light-cured bonding material, proprietary of the CoJet system (Visio-Bond) on block D, light-cured, and composite resin (Filtek Z250) was added in four 1 mm increments and light cured. The ceramic-resin blocks were then sectioned into two perpendicular axes, each producing approximately 40 specimens, divided into two groups: “immediate” group divided into four subgroups: HF + s / i (n = 19) , HF / i (n = 19), S / I (n = 20) and cj / i (n = 16), stored for 24 h in distilled water; and group “12m + tc”, divided into four subgroups: s/12m + HF (n = 20) HF/12m (n = 20) s/12m (n = 20) and CJ/12m (n = 17) stored for 12 months in artificial saliva followed by thermocycling (800 cycles). The obtained average values (HF + s / i = 56.85 ± 16.52 (a) HF / i = 51.69 ± 11.34 (ab) s / i = 50.73 ± 12.37 (ab), CJ/ i = 40.13 ± 9.27 (bc) + HF s/12m = 42.29 ± 17.34 (b), HF/12m = 21.03 ± 7.02 (d), s / 12m = 13.72 ± 6.24 (d), 26.77 ± 21.07 CJ/12m = (cd)) were statistically analyzed (2-way ANOVA). Interaction between surface treatment and storage conditions were observed. Conditioning of the ceramic surface with HF associated with silanization provided greater μ-TBS values to resin after 12 months of storage in artificial saliva and thermocycling...

A Case of Radiolucent Foreign Body (Temporary Resin Bridge) Aspiration Accompanied by Inflammatory Polyps / 결핵및호흡기질환

This case demonstrates the rare occurrence of a radiolucent temporary resin bridge aspiration in adults while they are in a conscious and awaken state and the resultant formation of inflammatory polyps. Although no unique findings were noted in a chest x-ray, careful history taking accompanied by physical examinations can lead to clinical suspicion of foreign body aspiration in an earlier stage. Moreover, flexible bronchoscopy is a tool useful not only for the evaluation process but also for managing the aspirated foreign material.