Impact of COVID-19 on theoretical knowledge and clinical practice in dentistry of Piracicaba Dental School students: a cross-sectional study

Aim: To assess the opinion of the students on the impact of COVID-19 pandemic on theoretical knowledge and clinical practice in dentistry at the Piracicaba Dental School ­ FOP/UNICAMP. Methods: A questionnaire was applied using the Google Forms platform, containing 20 questions related to the impacts of the pandemic on knowledge, mental health, and clinical and laboratory practice of dentistry. The satisfaction of the students with teaching was also evaluated. A total of 120 questionnaires were analyzed using R software, through tables and graphs of absolute and relative frequencies distribution. Results: COVID-19 affected the lives of 99% students who participated in the study. Due to distance learning resulting from the COVID-19 pandemic, 50% of the students considered locking or dropping out of college. Operative dentistry was the curricular component most affected by distance and lack of clinical practice. Although most students agreed that the workload of practical disciplines was or would be replaced, 95% felt some kind of deficit in clinical and laboratory practice even with the replacement of the workload. In addition, 93.3% of the students were afraid of not becoming a qualified professional due to the deficiencies on theoretical knowledge and clinical practice caused by the pandemic. Conclusions: Students showed dissatisfaction with the deficiency of clinical and laboratory practice resulting from the pandemic in operative dentistry curricular component. They reported fear and insecurity with their future professional lives. The indication of remote classes for dentistry should only be carried out in emergencies because this is an essentially practical course that suffers losses in learning

Patient care in the restorative clinic of a public dental school after COVID-19 lockdown

Aim: This study, with the aim of checking some of the changes in patients' daily habits and their reasons for needing restorative treatment was conducted at a public university immediately on return to attendance after the COVID-19 pandemic lockdown. Methods: This survey consisted of interviews held by applying 2 questionnaires to students and patients. A single researcher collected data in all the restorative dentistry clinics at the university after the return to face-to-face activities in the period between 02/02/2021 and 07/30/2021. Data obtained by means of the questionnaires were submitted to descriptive analysis. Results: Ninety (90) participants answered the patient questionnaire. When considering possible associations between being in social isolation or not, significant values were found for changed type of diet (p=0.0011), frequency of eating (p=0.011) and toothbrushing (p=0.034). Data about 417 restorations were collected and among the reasons for restorative intervention, 33.03% were restoration replacement, 31.87% treatment of primary caries and 24.40% of dental wear/non-carious lesions. Conclusion: Patients who isolated themselves during the pandemic tended to change their eating habits and frequency of oral hygiene. Toothache was the main reason for seeking dental treatment and the replacement of pre-existing restorations was the main reason for restorative treatments

Conservative smile enhancement: a case report and brief review on multidisciplinary approach in aesthetic dentistry / Tratamento conservador de sorriso: um relato de caso e breve revisão sobre abordagem multidiscplinar na odontologia estética

ABSTRACT The gingival contour, the color of the teeth and the presence of interincisal diastema are seen as unsightly factors, being highly harmful from a social point of view. The present study aimed to report a comprehensive and conservative esthetic treatment executed with a multidisciplinary approach in a 20-year-old female patient that presented darkened teeth with poor spacing and excessive gingival display while smiling, as well as present a brief literature review on multidisciplinary approach in esthetic dentistry. After clinical examination and diagnosis, a treatment plan was elaborated to meet the patient's expectations with a conservative approach. After patient consent, therapy began with supervised home-based tooth whitening with 22% carbamide peroxide applied one hour/daily for 14 days, followed with gingival recontouring surgery and, after a healing period of 30 days, diastemas closure with direct composite resin technique, occlusal adjustment, finishing, and polishing. The multidisciplinary approach was fundamental for the accomplishment of the proposed treatment, achieving satisfactory esthetic and functional results.

RESUMO O contorno gengival, a cor dos dentes e a presença de diastemas interincisivos são vistos como fatores antiestéticos, sendo altamente prejudicial do ponto de vista social. O presente estudo teve como objetivo relatar um tratamento estético conservador executado com abordagem multidisciplinar em uma paciente do sexo feminino de 20 anos que apresentava dentes escurecidos com pouco espaçamento e exposição gengival excessiva ao sorrir, bem como apresentar uma breve revisão de literatura sobre à abordagem multidisciplinar em odontologia estética. Após exame clínico e diagnóstico, foi elaborado um plano de tratamento para atender as expectativas do paciente com abordagem conservadora. Após consentimento do paciente, foi iniciada o clareamento dental supervisionado com peróxido de carbamida 22% aplicado uma hora/dia por 14 dias, seguido de cirurgia de recontorno gengival e, após um período de cicatrização de 30 dias, fechamento de diastemas com técnica de resina composta direta. Neste caso, a abordagem multidisciplinar foi fundamental para a realização do tratamento proposto, alcançando resultados estéticos e funcionais satisfatórios.

Characterization of whitening toothpastes and their effect on the physical properties of bulk-fill composites

Abstract Objective To characterize activated charcoal and 2% hydrogen peroxide-based toothpastes and investigate their effects on roughness, color change, and gloss of bulk-fill composite resin. Methodology Composite resin specimens (Aura Bulk Fill, SDI) were subjected to 5,000 brushing cycles with regular toothpaste (Colgate Total 12, [RT]), activated charcoal toothpaste (Bianco Dental Carbon, [AC]), or hydrogen peroxide-containing toothpaste (Colgate Luminous White Advanced, [HP]), with or without coffee exposure. The pH, particle characterization by scanning electron microscopy (SEM), and weight% of solid particles in the toothpaste were assessed. Roughness (Ra) was evaluated using a surface profile-measuring device, color change (∆Eab/∆E00) by reflectance spectrophotometer, and gloss unit (GU) by glossmeter. Kruskal-Wallis, Dunn, Friedman, and Nemenyi tests were used, and the correlation coefficient test was performed between Ra and GU (α=0.05). Results RT presented a higher Ra after brushing and did not change after staining with coffee; moreover, the ∆Eab/∆E00 values were higher for RT than HP. Regarding gloss, AC and HP obtained higher values compared to RT. A significant negative correlation between gloss and Ra was found for RT exposed to coffee. All toothpastes had a neutral pH; however, RT had the largest percentage of solids by weight. SEM images showed particles of many sizes: irregular shape (RT), more regular particles (AC), and spherical clusters (HP). Although surface roughness, color change, and gloss may compromise the longevity of restorations, the whitening toothpastes tested did not promote more morphology changes than regular toothpastes.

THE POST TRANSFIXED IN THE CORONAL CAVITY INCREASES THE FRACTURE RESISTANCE OF WEAKENED AND DIRECTLY RESTORED TEETH? A SYSTEMATIC REVIEW

Introduction: The objective of this systematic review was to answer the question: Does the intraradicular post transfixed in the dental crown increases the fracture resistance of weakened and directly restored teeth? Methods: Electronic databases (MEDLINE/PubMed, LILACS, SCOPUS, EMBASE, Scientific Electronic Library Online - SCIELO, and Central Register of Controlled Trials - CENTRAL) were searched until March 2021, without language or year restriction. Grey literature was also searched through Google scholar and OpenGrey repository. Only in vitro stud-ies were included that evaluated the influence of the use of intraradicular post trans-fixed in the crown in the buccopalatal/lingual direction in the fracture resistance of the dental crown. Relevant results were summarized and evaluated. The risk of bias was also assessed in the studies. Results: Initial screening of databases resulted in 249 studies, of which 109 were excluded for being duplicates. Of 140 eligible pa-pers, fourteen studies met the inclusion criteria and were selected for full-text read-ing. Of these, two studies were excluded for not having access to the full article. All selected articles were classified as low risk of bias. Conclusion: Based on the studies, it is possible to conclude that the use of a transfixed post in the crown increases the fracture resistance of weakened and directly restored teeth.

Un enfoque digital para restaurar un diente anterior traumatizado durante la pandemia COVID-19: reporte del caso / A digital approach to restore a traumatized anterior tooth during the COVID-19 pandemic: A clinical report

Los profesionales de la salud oral tienen un mayor riesgo de infección con el nuevo coronavirus 2019 (COVID-19), debido a la comunicación cercana a la cavidad oral y la exposición a saliva, sangre y otros fluidos corporales. Los enfoques digitales pueden reducir el tiempo clínico y contribuir a limitar el riesgo de infección. El objetivo del presente trabajo es presentar un enfoque digital para restaurar un diente anterior traumatizado, durante la pandemia de COVID-19. Paciente sexo feminino de 28 años, con movilidad anormal de la pieza 1.1 y antecedente de traumatismo dental en la adolescencia. Se realizó una evaluación inicial para detectar signos y síntomas de una posible infección por COVID-19. Las imágenes de la tomografía computarizada mostraron fractura coronaria y presencia de reabsorción cervical externa en el incisivo central derecho. El plan de tratamiento consistió en la rehabilitación del diente fracturado a través de una restauración retenida con un poste de fibra de vidrio, usando un abordaje digital por medio de un escáner intraoral con diseño y fabricación asistido por computadora (CAD/CAM). Los enfoques digitales en odontología podrían contribuir a reducir el riesgo de infección por COVID-19 en pacientes y dentistas durante los tratamientos restauradores.

Dental professionals are at increased risk of infection with the new coronavirus 2019 (COVID-19) due to face-to-face communication and exposure to saliva, blood and other body fluids. Digital approaches can reduce clinical time and contribute to limiting the risk of infection. The objective of this work was to report a digital approach to restoring a traumatized anterior tooth during the COVID-19 pandemic. A 28-year-old female with abnormal mobility in the crown of an upper anterior tooth with history of dental trauma in the adolescence. An initial screening was performed to check for signs and symptoms of possible COVID-19 infection. Cone Beam Computed Tomography images showed a crown fracture and the presence of external cervical resorption in the right permanent central incisor. The treatment plan consisted of rehabilitation of the fractured tooth through a restoration retained with a fiberglass post with a digital approach using an intraoral scanner, and computer-aided design and fabrication - CAD/CAM. Digital approaches in dentistry including intraoral scanners and CAD/CAM could contribute to reducing the risk of COVID-19 infection in patients and dentists during restorative treatments.

Decisions about the diagnostic and treatment criteria of dental caries among a group of dental students, faculty staff and dentists within the city of Medellin, Colombia / Decisiones sobre los criterios de diagnóstico y tratamiento de la caries dental entre un grupo de estudiantes de odontología, profesores y odontólogos de la ciudad de Medellín, Colombia

Objective: To analyze the criteria for diagnosis and treatment decision-making in relation to dental caries in different participants (teachers of dentistry, dental students at dental schools, and dentists practicing at public oral health services) in the city of Medellin (Colombia). Material and Methods: A cross-sectional study was applied in the period September 2015-december 2016 by means of an international validated questionnaire in 340 participants (dental teachers: 69, dental students: 193, dentists: 78). The survey addressed several topics related to detection and restorative threshold, preferences of preparation type, restorative materials used and opinions about diagnosis and treatment for dental caries. A descriptive analysis was carried out and Chi square tests were applied to observe statistically significant differences between the study variables.Results: 340 participants were surveyed among teachers who teach cariology, health care dentists, and undergraduate final-year students. Most participants were women (70%). The age mean was higher for DDSs (46 ± 9 years). On average, practicing dentists and dental teachers had a work experience of 21 ± 9 years. In case of treatment decisions, the majority of the surveyed would use immediate operative restorative treatment for advanced carious lesions (inner one-third of the dentin for approximal and grade 5 for occlusal). In addition, respondents reported different cavities diagnosis for clinical occlusal cases and some significant statistically differences were found for restorative treatment decisions and type of materials according to the type of participant. Conclusion: Criteria for diagnosis and treatment of dental caries differed among the student, dentist and dental teachers with variety in diagnosis and treatment concepts. However, a conservative tendency for restorative treatment decisions was observed. Strategies for incorporating non-restorative and minimal measures in professional practice should be considered in curricula of universities.

Objetivo: Analizar los criterios para la toma de decisiones diagnósticas y terapéuticas en relación a la caries dental en diferentes participantes (docentes, estudiantes de odontología de las facultades de odontología y odontólogos de los servicios públicos de salud bucal) de la ciudad de Medellín (Colombia). Material y Métodos: Se aplicó un estudio transversal en el período septiembre 2015 - diciembre 2016 mediante cuestionario internacional validado en 340 participantes (profesores de odontología: 69, estudiantes de odontología: 193, odontólogos: 78). La encuesta abordó varios temas relacionados con la detección y el umbral de restauración, las preferencias del tipo de preparación, los materiales de restauración utilizados y las opiniones sobre el diagnóstico y el tratamiento de la caries dental. Se realizó un análisis descriptivo y se aplicaron pruebas de Chi cuadrado para observar diferencias estadísticamente significativas entre las variables de estudio. Resultados: Se encuestó a 340 participantes entre profesores que imparten clases de cariología, odontólogos y estudiantes de último año de pregrado. La mayoría de los participantes eran mujeres (70%). La edad media fue mayor para los odontólogos (46 ± 9 años). En promedio, los odontólogos y los profesores de odontología tenían una experiencia laboral de 21 ± 9 años. En caso de decisiones de tratamiento, la mayoría de los encuestados utilizaría tratamiento restaurador quirúrgico inmediato para lesiones cariosas avanzadas (tercio interno de la dentina para proximal y grado 5 para oclusal). Además, los encuestados informaron diferentes diagnósticos de caries para los casos clínicos oclusales y se encontraron algunas diferencias estadísticamente significativas para las decisiones de tratamiento restaurativo y el tipo de materiales según el tipo de participante. Conclusion: Los criterios para el diagnóstico y tratamiento de la caries dental fueron diferentes entre los estudiantes, odontólogos y profesores de odontología con variedad en los conceptos de diagnóstico y tratamiento. Sin embargo, se observó una tendencia conservadora para las decisiones de tratamiento restaurativo. Las estrategias para incorporar medidas mínimas y no restaurativas en la práctica profesional deben ser consideradas en los planes de estudio de las universidades.

Digital smile design as a tool in the planning of porcelain laminate veneers restoration / Desenho digital do sorriso como ferramenta no planejamento de restaurações de facetas laminadas de porcelana

ABSTRACT Digital smile design is an important tool for esthetic planning in dentistry as it facilitates ease of communication between professionals and patients. This clinical report has the objective of describing a clinical procedure involving digital smile design for the placement of porcelain laminate veneer restorations. The digital smile design included dental and facial analyzes. The smile curve was drawn and a dental ruler was used to delimitate the spaces between each tooth. An approximate simulation of the smile was generated using Adobe Photoshop software. For esthetic and functional evaluation of the digital plan was created a diagnostic waxing and mock-up. The laminate veneers were made with feldspathic porcelain. Digital smile design was essential for successful planning because it enabled better patient contact with the end result. This case demonstrates the importance of this tool in esthetic dentistry.

RESUMO O desenho digital do sorriso é uma importante ferramenta para o planejamento estético em odontologia, pois facilita a comunicação entre profissionais e pacientes. Este relato clínico tem o objetivo de descrever um procedimento clínico envolvendo desenho digital do sorriso para a confecção de restaurações de facetas laminadas de porcelana. O desenho digital do sorriso incluiu análises dentais e faciais. A curva do sorriso foi desenhada e uma régua dentária foi utilizada para delimitar os espaços entre cada dente. Uma simulação aproximada do sorriso foi gerada usando o software Adobe Photoshop. Para a avaliação estética e funcional do planejamento digital foi elaborado um enceramento diagnóstico e mock-up. As facetas laminadas foram confeccionadas em porcelana feldspática. O desenho digital do sorriso foi essencial para um planejamento bem-sucedido, pois possibilitou um melhor contato do paciente com o resultado final. Este caso demonstra a importância desta ferramenta na odontologia estética.

Consensus recommendations from Chinese experts on the standard operation procedure of dental operative microscope in endodontics and operative dentistry / 中华口腔医学杂志

Dental operative microscope has been wildly used in endodontics and operative dentistry for many years. Many progresses have been made by using operative microscope in improving the outcomes of root canal therapy, endodontic surgery and operative dentistry. However, in clinical practice, improper use of the dental operative microscope is not uncommon, the reason related to which is the operator's lack of understanding and mastering not only the properties but also the standard operative procedure of the dental operative microscope. To this end, in October 2019, the vice chairman of the Society of Cariology and Endodontology, Chinese Stomatological Association, professor Liang Jingping, organized a group of professional experts in this field, convened a meeting about the standard operative procedure of dental operative microscope. Experts at the meeting had a very heated discussion and the consensuses were reached.

Protocols to control contamination and strategies to optimize the clinical practice in Restorative Dentistry during the COVID-19 pandemic / Protocolos para controle de contaminação e estratégias para otimizar a prática clínica em Odontologia Restauradora durante a pandemia de COVID-19

The current outbreak of coronavirus 2019 (COVID-19) challenges how professional standards have been defined so far. In Dentistry, biosafety measures already taken by professionals have been intensified, aiming to offer the patient urgent and emergency treatment with safety for both. In this context, Restorative Dentistry is responsible for the care of patients with caries injuries, with or without symptoms and, fractures of teeth and existing restorations. This article guides professionals, during the pandemic period, on the risks involved in adult and pediatric dental care for patients with restorative needs. It also discusses strategies to optimize clinical practice, reducing risks of contamination and virus transmission. (AU)

O atual surto de coronavírus 2019 (COVID-19), fez com que muitos profissionais repensassem sua postura de trabalho. Na Odontologia, medidas de biossegurança já realizadas pelos profissionais, foram intensificadas, com o objetivo de oferecer ao paciente um tratamento de urgência e emergência com segurança para ambos. Neste contexto, a Odontologia Restauradora é responsável pelo atendimento de pacientes com lesões de cárie, com ou sem sintomatologia, e fraturas de dentes e restaurações já existentes. Este trabalho orienta os profissionais quanto aos riscos envolvidos no atendimento odontológico, adulto e pediátrico, de paciente com necessidades restauradoras durante o período de pandemia. O artigo também discute estratégias para otimizar o atendimento, diminuindo riscos de contaminação e transmissão do vírus. (AU)

Is there a correlation between students' performance in dental anatomy and performance in operative dentistry? / ¿Existe una correlación entre el rendimiento de los estudiante de anatomía dental y el rendimiento en odontología operativa?

SUMMARY: Manual skills form only a part of the capabilities required for a future dentist. Nevertheless, they are very important components that should be tested. The aim of this study is to investigate if a correlation exists between dental students' grades in the preclinical courses and their clinical performance. Preclinical/clinical grades were collected for first, fourth, and fifth year students who graduated from the Faculty of Dentistry at the University of Jordan, Amman, Jordan, in 2016, and 2017. Two courses (Dental Anatomy and Operative Dentistry) were selected. Corre-lations comparing the practical grades of Dental Anatomy course for first year students, and the practical grades of Operative Dentistry course for the same students in fourth and fifth years. Statistically significant positive correlation was found between the soap carving grades of first-year dental students and their practical grades in Operative Dentistry course during fourth and fifth years. Also, statistically significant strong positive correlation was found between the grades of fourth-year practical Operative Dentistry and the grades of fifth-year practical Operative Dentistry. The clinical performance of dental students in their practical courses in fourth and fifth years can be predicted from their soap carving grades at their first year in Dental School.

RESUMEN: Las habilidades manuales forman solo una parte de las capacidades requeridas para un futuro dentista. Sin embargo, son componentes muy importantes que deben ser probados. El objetivo de este estudio fue investigar si existe una correlación entre las calificaciones de los estudiantes de odontología en los cursos preclínicos y su desempeño clínico. Los grados preclínicos / clínicos se obtuvieron para los estudiantes de primero, cuarto y quinto año, graduados de la Facultad de Odontología, de la Universidad de Jordania, Amman, Jordania, en 2016 y 2017. Se seleccionaron dos cursos (Anatomía Dental y Odontología Operativa). Correlaciones que comparan los grados prácticos del curso de Anatomía Dental para estudiantes de primer año y las notas de calificación prácticas del curso de Odontología Operativa para los mismos estudiantes en cuarto y quinto año. Se encontró una correlación positiva estadísticamente significativa, entre las notas de tallado de jabón de los estudiantes de primer año de odontología y sus notas de calificación prácticas en el curso de Odontología Operativa durante el cuarto y quinto años. Además, se encontró una fuerte correlación positiva estadísticamente significativa entre las notas de calificación en Odontología Operativa práctica de cuarto año y los grados de Odontología Operativa práctica de quinto año. El rendimiento clínico de los estudiantes de odontología en sus cursos prácticos en cuarto y quinto año se puede predecir a partir de las calificaciones en tallado de jabón durante su primer año en la Escuela de Odontología.

Caries progression in non-cavitated fissures after infiltrant application: a 3-year follow-up of a randomized controlled clinical trial

Abstract Objectives To evaluate the efficacy of a conservative treatment to prevent the progression of caries using an infiltrant on non-cavitated pit and fissures. Material and Methods This controlled clinical trial selected 23 volunteers with clinically and radiographically non-cavitated occlusal caries among patients presenting a "rather low" to "very high" caries risk. Eighty-six teeth were randomly divided into two experimental groups: teeth receiving a commercial pit-and-fissure sealant (Alpha Seal-DFL) and contralateral teeth receiving Icon infiltrant (DMG). Caries progression was monitored by clinical (laser fluorescence caries detection) and radiographic examination at 12-month intervals over a period of 3 years of monitored caries progression. Probing the sealing materials to detect areas of retention was also used to evaluate marginal integrity. Results Statistical analysis showed no difference in caries progression using laser fluorescence caries detection when both materials were compared, regardless of the evaluation times (p>0.05). No significance was observed when the marginal sealant integrity of both materials was compared, regardless of the evaluation time (p<0.05). Marginal integrity significantly reduced after 1 year for both materials (p<0.05), but remained stable after 2 and 3 years of evaluation, compared with 1-year results (p>0.05). SEM analysis exhibited a more homogeneous sealing for the infiltrant than obtained by the sealant. Conclusions The infiltrant was effective to prevent the caries progression in non-cavitated pit-and-fissures after 3 years of clinical evaluation, comparable with the conventional sealant. The infiltrant also presented better results in terms of caries progression at the 3-year evaluation time using the radiographic analysis.

Increased longevity of resins based composite restorations and their adhesive bond: a literature review / Aumento de longevidad de restauraciones de resinas compuestas y de su unión adhesiva: revisión de tema

ABSTRACT. Introduction: the goal of this literature review is to analyze the findings included in the literature concerning different alternatives to increase longevity of resin-based composite restorations and their adhesive bond. Methods: bibliographies in the EBSCO database (Elton B Stephens Company) were reviewed using the following key words: "composite repair bond strength"; "restorations sealing"; composite restorations longevity"; "restorations refurbishment"; "composite bond strategy"; "dental adhesive collagen cross linking"; "proanthocyanidin dentin bond strength"; "multiple layer dentin bond strength", and "dentin adhesive evaporation bond strength". Clinical and laboratory results were analyzed in terms of repairing, sealing, and refurbishing defective restorations, in addition to improvements in impregnation of adhesive surfaces, resistance of adhesive polymers, and the progress recently made concerning resistance to hydrolytic collagen degradation. Results: repairing, sealing, or refurbishing defective restorations allow keeping tooth structure healthy, reducing potential damage to dental pulp, as well as operatory pain, often caused without anesthetics. New bonding management techniques provide adhesive procedures with increased longevity. Conclusions: repairing, refurbishing, or sealing defective composite resins increase the longevity of restorations and restored teeth by using minimally invasive dental techniques. Other methods, such as improving impregnation of adhesive surfaces, increasing adhesive polymers strength, and hydrolytic degradation of collagen are promising advances that modify the management of bonding techniques, providing patients with restorative treatments of increased longevity.

RESUMEN. Introducción: el objetivo de esta revisión es analizar los resultados de las diferentes alternativas que presenta la literatura para incrementar la longevidad de las restauraciones con base a resinas compuestas. Métodos: fueron revisadas las bibliografías en la base de datos EBSCO (Elton B Stephens Company), en idioma inglés bajo los siguientes acrónimos " composite repair bond strengh"; "restorations sealing"; composite restorations longevity; "restorations refurbishment"; "composite bond estrategy"; "dental adhesive collagen cross linking"; "proanthocyanidin dentin bond strength";" multiple layer dentin bond strength"; and "dentin adhesive evaporation bond strength". Se examinan los resultados clínicos y de laboratorio de reparación, sellado y remodelado de restauraciones defectuosas, además de las mejoras en la impregnación de las superficies adhesivas, la resistencia de los polímeros adhesivos y los avances en el aumento de la resistencia a la degradación hidrolítica del colágeno. Resultados: la reparación, sellado y remodelado de restauraciones defectuosas permite la preservación de estructura dentaria sana, reducción del potencial daño a la pulpa dental y reducción del dolor operatorio, la mayoría de las veces efectuado sin uso de anestésicos. Nuevas técnicas para el manejo de la adhesión proporcionan incremento en la longevidad de los procedimientos adhesivos. Conclusiones: la reparación, remodelado y sellado de resinas compuestas defectuosas, incrementa la longevidad de las restauraciones y de los dientes restaurados con la aplicación de técnicas de odontología mínimamente invasiva. Adicionalmente otras metodologías, tales como mejoras en la impregnación de las superficies adhesivas, aumento de la resistencia de los polímeros adhesivos e incremento de la resistencia a la degradación hidrolítica del colágeno constituyen promisorios avances que modifican el manejo de las técnicas adhesivas, que permitirá ofrecer tratamientos restauradores de mayor longevidad a la población.

Influence of photocuring and storage time on the volumetric change of resin modified glass ionomer cements

AIM: This study evaluated the effect of photoativation and storage on the hygroscopic expansion of resin modified glass ionomers (Vitremer-3M/ESPE, Fuji II LC-GC Int., Vitro Fil LC-DFL). MATERIAL AND METHODS: The RMGIC were manipulated according to the manufacturer's instructions, inserted into a mold and kept in a darkness box for 15 minutes. Then, the samples were distributed into four groups (n=5): light-cured for 20s, light-cured for 40s, light-cured for 60s and not light-cured (control group). Each sample was storage in distilled water at 37ºC. The measurements of volumetric changes were made in three different times of storage: 24 hours, 7 days and 30 days. Volumetric changes were determined using Archimedes principle. Means and standard deviations values were analyzed by three-way analysis of variance and Tukey's test to compare significance between the groups (α=0,05). RESULTS: All materials underwent volumetric expansion after 30 days. Vitremer showed the less expansion when no light-cured. The time of light-cure did not influence the volumetric change, except for Fuji II LC, that showed great expansion when activated for 60s. Vitro Fil LC showed some degree of shrinkage after 7 days. CONCLUSION: This study concluded that photocuring can influence the volumetric change of resin modified glass ionomer cement.

Dental esthetic self-perception of Brazilian dental students

Introduction: Esthetics in dentistry aims to improve the patients' self-esteem and satisfaction regarding how beautiful and attractive they feel. However, patients and dental professionals may perceive the concept of esthetics differently instead, which may cause the dissatisfaction of the patient with the results of the treatment. Objective: This cross-sectional observational study aimed to verify the esthetic self-perception of undergraduate dental students regarding their own smile. Material and methods: A questionnaire, designed by Goldstein 10 to measure the patients' self-perception and satisfaction, regarding their smiles, was applied to undergraduate students of different semesters of the School of Dentistry of the Federal University of Pelotas. Results: Our results showed that women are more dissatisfied with their smiles than men. Students attending different semesters worried somehow about the esthetics of their smiles and revealed the wish of having whiter teeth. Most students are satisfied with the shape of their teeth. Ninety two percent of the students feel self-confident regarding to smile, 90% believe someone else has a better smile, 87% look at the smile of models in fashion magazines, 71% wish to have whiter teeth and 80% wish to have rather a bigger or smaller teeth. Conclusion: Undergraduate dental students have a positive self-perception of their smile. Women are less satisfied than men. Students of the earlier semesters wish to have whiter teeth than students from the later semesters.

Direct composite veneer to treat primary teeth with sequela of dental trauma: a case report / Faceta direta de resina composta para tratamento de dente decíduo com sequela de traumatismo dentário: relato de caso

Introduction: Tooth discoloration can be one of the main reasons for parents to seek treatment after dental trauma. When this sequela occurs with no other clinical or radiographic symptoms, a conservative approach is recommended. However, when such alterations can compromise the patient's esthetics and his/her interaction in a social environment, an esthetic treatment may be required. Case report: Here we report the esthetic rehabilitation of a primary maxillary left central incisor presenting coronal darkening in a 5-year-old girl that had been monitored clinically and radiographically due to dental trauma in the maxillary anterior teeth since she was 1 year old. Because of the esthetic complaint, a direct composite resin veneer was performed. Final considerations: After the treatment, a good esthetic result was achieved making the patient and her parents pleased. The esthetic improvement was maintained at the six-month follow-up with no negative impact on the child's social life.

Survival rate of sealed, refurbished and repaired defective restorations: 4-year follow-up

The most common treatment in general dental practice is the replacement of restorations affected by secondary caries or marginal deficiencies. Alternative treatments to replacement of defective restorations, such as marginal sealing, refurbishment and repair, have demonstrated improvement of their clinical properties with minimal intervention. The aim of this clinical study was to estimate the median survival time (MST) of marginal sealing, repair and refurbishment of amalgam and resin-based composite restorations with localized defects as a treatment to increase the restoration longevity. A cohort of 66 patients, with 271 class I and II restorations clinically diagnosed with localized defects was longitudinally assessed. Each restoration was assigned to one of the following 5 groups: Marginal Sealing (n=48), Refurbishment (n=73), Repair (n=27), Replacement (n=42), and Untreated (n=81). Two calibrated examiners assessed the restorations at baseline and annually during 4 years, using the modified Ryge criteria: marginal adaptation, anatomic form, roughness, secondary caries and luster. Fifty-two patients with 208 restorations were assessed after 4 years; the distribution of restorations in the groups was as follows: Marginal Sealing (n=36), Refurbishment (n=63), Repair (n=21), Replacement (n=28) and Untreated (n=60). Kaplan Meier test indicated that the Sealed margins group showed the lowest MST while the Repair group showed the highest MST for restorations examined after 4 years of follow up. Defective amalgam and resin-based composite restorations treated by sealing of marginal gaps, refurbishment of anatomic form, luster or roughness, and repair of secondary caries lesions, had their longevity increased.

Na clínica odontológica geral, o tratamento mais comum é a substituição de restaurações com cárie secundária ou defeitos marginais. Tratamentos alternativos às substituições de restaurações defeituosas, como selamento marginal, recuperação, e reparo, têm proporcionado melhorias das propriedades clínicas, com um mínimo de intervenção. O objetivo deste estudo foi avaliar o tempo médio de sobrevida (median survival time - MST, na sigla em inglês) de selamento marginal, recuperação e reparo de restaurações de amálgama e compósitos resinosos com defeitos localizados, como tratamento para aumentar a longevidade das restaurações. Este foi um estudo longitudinal envolvendo 66 pacientes com 271 restaurações classe I e II, clinicamente diagnosticadas e com defeitos localizados. Cada restauração foi incluída num dos seguintes grupos: Selamento Marginal (n=48), Recuperação (n=73), Reparo (n=27), Substituição (n=42) e Sem tratamento (n=81). Dois examinadores calibrados avaliaram as restaurações no início e anualmente durante 4 anos, usando os critérios de Ryge modificados: adaptação marginal, forma anatômica, rugosidade, cárie secundária e brilho. Cinqüenta e dois pacientes com 208 restaurações foram avaliados após 4 anos; a distribuição das restaurações nos grupos foi a seguinte: Selamento Marginal (n=36), Recuperação (n=63), Reparo (n=21), Substituição (n=28) e Sem tratamento (n=60). O teste de Kaplan Meier mostrou que o grupo do Selamento Marginal apresentou o menor valor de MST, enquanto que o grupo do Reparo mostrou o maior valor, para as restaurações avaliadas após o acompanhamento de 4 anos. As restaurações de amálgama e compósitos tratadas com selamento de fissuras marginais, recuperação da forma anatômica, brilho ou rugosidade e reparo de cárie secundária, tiveram aumento de longevidade.

Isolamento do Campo Operatório: Panorama de Utilização em Consultórios e Clínicas Privadas de Belo Horizonte, MG, Brasil / Rubber Dam: Use in Private Clinics in Belo Horizonte, MG, Brazil

Objetivo: verificar a utilização de isolamento em consultórios e clínicas privadas em Belo Horizonte, observando-se: tipo, procedimentos executados com isolamento e o motivo da escolha; além de fatores como: tempo de formação dos cirurgiões-dentistas (CDs), classe econômica dos pacientes e presença de pessoal auxiliar (ASB). Método: a amostra elegível foi formada por CDs atuantes na região Centro-Sul da cidade. A amostra final de conveniência foi de 115 CDs que responderam a um instrumento de coleta de dados com questões descritivas e objetivas. Os dados foram analisados descritivamente e pelo teste Qui-quadrado (p≤0,05).Resultados: dos CDs que participaram da pesquisa, 55% eram do gênero feminino; 63,5% tinham entre 23 e 35 anos; 39% tinham menos de cinco anos de atividade profissional e 59% eram especialistas. Eram da região Central 69% e Sul 31%; têm ASB 66% dos CDs. Os pacientes foram classificados em classe econômica A (11%), B (30%), C (34%), D (16%) e E (9%). Relataram utilizar algum tipo de isolamento 82% dos CDs (36% relativo; 28% absoluto; e 36% ambos). O grau de aceitação dos pacientes quanto aos métodos de controle de umidade foi considerado alto para 52% dos CDs. O principal motivo para escolha doisolamento absoluto foi o controle de infecção (27%) e para o relativo foi a praticidade (24%). O isolamento absoluto é utilizado principalmente na endodontia (38%) e o relativo em restaurações (33%). Gênero (p=0,6483), tempo de atividade (p=0,2576), especialidade (p=0,0733) e presença de ASB (p=0,4127), não influenciaram significativamente na escolha do tipo de isolamento. Conclusão: a maioria dos CDs relatou utilizar algum tipo de isolamento do campo operatório e aponta como principais vantagens a biossegurança, a praticidade e melhor qualidade dos procedimentos executados

Objective: The aim of this study was to investigate the use of isolation in offices and private clinics in Belo Horizonte, it was observed: the type, procedures performed in isolation and the reason for their choices. In addition to those factors were also observed the duration of the dentistsÆ training, the patientsÆ economic class and the presence of an office assistant.Method: The eligible sample consisted of active dentist in the southcenter region of the town. The final sample of convenience was 115 professionals who answered to an instrument data collection with descriptive and objective questions. The results were analyzed descriptively and by Qui-Square test (p≤0,05).Results: Among the dentist in the survey 55% were female, 63.5% were between 23 and 35 years old, 39% had less than five years of professional activity and 59% were specialists; 69% were from the central region and 31% from the south; 66% of the dentists have assistant in office. Patients were classified according to their economic class; class A (11%), B (30%), C (34%), D (16%) and E (9%). 82% of the dentists reported the use of some type of insulation, (36% relative, 28% absolute, and 36% both). The degree of the patientsÆ acceptance to methods of moisture control was considered high, for 52% of the professionals. The main reason for choosing the absolute isolation was the control of infection (27%) and the relative was the practicality (24%). The rubber dam is mainly used in endodontics (38%) and the relative isolation is used in restorations (33%). The gender (p=0.6483), professional activity time (p=0.2576), training (p=0.0733) and presence of an office assistant (p=0.4127) havenÆt significant influence in the type of isolation choice. Conclusion: The most of dentists reported using some type of isolation of the operative field and indicated that the main advantages are the biosafety, practicality and quality of procedures performed

Futuro de la odontología restauradora / Future of restorative dentistry

La odontología en general viene teniendo cambios en la tecnología, materiales y técnica, el propósito de esta revisión es presentar los cambios que se presentan actualmente en la odontología restauradora con los conceptos de la aplicación de la bioingeniería.

Dentistry in general is having changes in technology, materials and technique, the purpose of this review is to present the changes that have been made in restorative dentistry, with the application of bioengineering.

Análise da microdureza knoop de quatro tipos de resina composta através do microdurômetro HVS-1000 / Analysis of the knoop microhardness of four types of composite resin by HVS-1000 microhardness tester

Objetiva-se avaliar a microdureza de quatro tipos de resina compostas do mesmo fabricante. Seis corpos-de-prova foram distribuídos em 4 grupos, em cada um destes uma resina de 3M ESPE (FiltekTMP60, FiltekTMZ350, FiltekTMP250 e FiltekTMZ100) foi empregada. Para padronizar as amostras, foram utilizados cilindros de resina com 2 milímetros de altura e 5 milímetros de diâmetro como matriz. Para fotoativação, aplicou-se o tempo recomendado pelo fabricante: 20 segundos nas resinas P60, Z350 e Z250 e 40 segundos na Z100. Para uma superfície polida utilizamos uma tira de poliéster pressionada contra a matriz durante a polimerização. A distância para fotoativação foi padronizada por uma lâmina colocada sobre os corpos-de prova, garantindo a mesma distância entre todos. Os corpos foram encaminhados para análise de microdureza knoop em microdurômetro. Cada corpo foi analisado em 3 áreas diferentes em sua superfície, sob tempo de 5 segundos de aplicação de carga (0,49N). Calculou-se a média aritmética para cada grupo, e os dados foram dispostos em quadro para análise. A resina P60 apresentou maior dureza superficial, enquanto que a Z350 mostrou-se com menor dureza. Assim, podemos concluir que a microdureza das resinas está diretamente associada à disposição das partículas e opacidade, interferindo na capacidade de fotoativação.

The objective is to evaluate the microhardness of four types of composite resins from the same manufacturer. Six specimens were divided into 4 groups, where in each one of 3M ESPE resin (FiltekTMP60, FiltekTMZ350, Filtektmz250 and FiltekTMZ100) was used. To standardize the samples, cylinders of resin were used with 2 mm in height and 5 mm in diameter as matrix. Curing was applied for the time recommended by the manufacturer: 20 seconds in resins P60, Z350 and Z250 and, 40 seconds in Z100. To ensure a polished surface using a strip of polyester pressed against the matrix during polymerization. Distance to curing was standardized by a layer placed on the specimens, ensuring the same distance from all. The bodies were sent for analysis of the knoop microhardness tester. Each body was examined in 3 different areas on its surface, in time of 5 seconds of application of load (0.49N). The arithmetic mean for each group was calculate and arranged in the data table for analysis. The P60 showed higher hardness resin surface while the Z350 is shown with lower hardness. So we can conclude that the microhardness of the resins is directly associated with the disposal of particulates and opacity, interfering with the ability of_curing.