Case Report: a 5-Year Follow-up of Proximal Caries Lesion Diagnosis / Diagnóstico de Lesões Cariosas Proximais - Relato de Caso: 5 Anos de Acompanhamento

This clinical case was aimed at reporting and discussing diagnostic methods for early detection and preventive treatment of proximal carious lesions. The patient presented to the dental clinic seeking treatment of a problem she reported as being "dental caries". The patient's orthodontist diagnosed dental caries, by means of radiographic exam. There was no evidence of any proximal carious lesion in the intraoral examination. The bitewing radiographs presented a radiolucent area limited to enamel in the mesial of maxillary left-second-bicuspid. For the purpose of confirming the intraoral diagnosis, an immediate tooth separation was performed. The immediate separation was unable to provide sufficient access; thus, the slow separation approach was performed. After 24-hours, tooth separation of 1mm was obtained, providing enough access for clinical examination. The proximal areas were evaluated by transillumination and impression taking. During the visual inspection, an area of enamel staining was observed, with no roughness due to tactile inspection and the evaluation by transillumination and impression showed no cavitation. The following preventive treatment plan was endorsed: oral hygiene instructions with emphasis to the importance of flossing the proximal areas, and healthy dietary habits. After a 5-years period of follow-up, the enhanced oral hygiene and heathy dietary habits were observed. A clinical examination with immediate tooth separation and bitewing radiographs was performed and showed no cavitation. The combination of methods for detecting carious lesions in proximal surfaces was effective in obtaining a diagnosis of caries in the permanent dentition. The absence of cavitated lesions must be indicative of preventive treatment. (AU).

Este caso clínico objetivou relatar e discutir os métodos diagnósticos para detecção e tratamento preventivo de lesões cariosas proximais. A paciente procurou atendimento restaurador com queixa de cárie diagnosticada por exame radiográfico realizado após término de seu tratamento ortodôntico. Ao exame clínico não havia suspeita de lesão cariosa. A avaliação radiográfica revelou, na face mesial do dente 25, presença de área radiolúcida limitada à metade externa do esmalte. Para confirmação do diagnóstico realizou-se a separação interdentária imediata, porém como a mesma não permitiu adequada visualização foi realizada a separação mediata e após 24 horas obteve-se adequada separação (1 mm) para o exame clínico. Em seguida, a superfície proximal foi avaliada por transiluminação e moldagem. Durante a inspeção visual foi constatada área de manchamento do esmalte, com ausência de rugosidade pela inspeção tátil e a avaliação tanto por transiluminação da superfície proximal, quanto por moldagem revelou ausência de cavitação. Devido o diagnóstico obtido o seguinte tratamento preventivo foi indicado: reforço de higiene oral com ênfase na importância do uso do fio dental e hábitos dietéticos saudáveis. Após 5 anos de acompanhamento melhoria da higiene oral e hábitos dietéticos foram constatados. O exame clínico com separação interdentária imediata e exame radiográfico revelaram ausência de cavitação. Conclui-se que a combinação de métodos de detecção de lesões cariosas proximais foi efetivo no diagnóstico da cárie dentária na dentição permanente. O resultado deste relato de caso mostrou que a ausência de lesões cariosas cavitadas deve ser um indicativo de tratamento preventivo.(AU).

Implantes de zircônia na odontologia: revisão de literatura / Zirconia dental implants - a review

Diante da crescente expectativa quanto à estética em Odontologia e da necessidade de tratamentos metal free para casos específicos em regiões estéticas, o uso de implantes cerâmicos tem se tornado objeto de estudo e investimentos desde a década de 70, tornando-se hoje uma possível alternativa aos implantes de titânio. Assim, o objetivo deste estudo foi sistematizar o conhecimento disponível a respeito de implantes dentários de zircônia, avaliando sua viabilidade na implantodontia e a capacidade deste material em responder às exigências mecânicas e biológicas. Uma busca eletrônica foi realizada por meio do banco de dados PubMed utilizando a combinação das seguintes palavras- -chave: "zirconia", "dental implant", "zirconia implant" e "zirconia dental implant", sem restrição de idioma ou data de publicação. Esta pesquisa resultou em 801 trabalhos de potencial interesse. A seleção de artigos para inclusão no estudo com restrição de acordo com o objetivo proposto levou a seleção de 85 artigos relevantes para a revisão de literatura deste trabalho. De acordo com essa revisão, os resultados das pesquisas a respeito do uso da zircônia como matéria base na fabricação de implantes são promissores, embora a documentação científica disponível seja limitada pelas poucas e curtas experiências clínicas, principalmente em termos de longevidade. Estudos biológicos, mecânicos e clínicos publicados até a data parecem indicar que a zircônia pode ser uma excelente opção para os implantes de titânio, principalmente pelas suas propriedades mecânicas, aparência estética e menor adesão bacteriana.

Due to increasing demand for higher aesthetic in dentistry followed by the necessity of metal free rehabilitation for specific cases in esthetic regions, the use of ceramic implants has been object of study since the 70's, becoming today a possible alternative to titanium implants. The aim of this study was to systematize the knowledge available of zirconia implants, evaluating their viability and the ability of this material to respond to the mechanical and biological requirements. An electronic search was performed using the PubMed database and the combination of the following keywords: "zirconia", "dental implant", "zirconia implant" and "zirconia dental implant", without restriction of language or publication date. Eighty five articles were considered relevant to this study and the selection was fulfilled according to the proposed objective. According to this review, the results of research on the use of zirconia as the base material in implant manufacturing are promising, although available scientific documentation is limited by the few short clinical experiences, especially in terms of longevity. Biological, mechanical, and clinical studies published to date suggest that zirconia may be an excellent choice for titanium implants, mainly because of their mechanical properties, aesthetic appearance and lower bacterial adhesion.

Forças de contração de polimerização em resinas compostas constituídas com novas matrizes orgânicas e fotoativadas por diferentes técnicas / Polymerization shrinkage stress of composite resins containing new organic matrices and photocured by different techniques

Objetivo: Verificar a força de contração de polimerização de três diferentes resinas compostas em função de dois métodos de fotopolimerização (convencional e pulso tardio). Foram selecionados para o estudo três materiais, com diferentes matrizes orgânicas: Bis-GMA ­ Filtek Z250 XT (3M-ESPE, Saint Paul, Minnesotta, EUA); Silorano ­ Filtek P90 (3M-ESPE, Saint Paul, Minnesotta, EUA) e TCD-Uretano - Charisma Diamond (Heraeus Kulzer, São Paulo, São Paulo, Brasil). Material e Método: Os corpos de prova foram confeccionados a partir de uma matriz retangular de aço inoxidável (6mm x 1mm x 2mm), posicionados em uma máquina de ensaios universal (Instron, Modelo 5965) para registro da força de contração de polimerização (Newtons). A fotoativação foi executada em cada grupo com fonte de luz do tipo LED (600mW/cm2) sob dois protocolos de fotoativação: contínuo - 40s (600mW/cm2) e pulso tardio - 5s (600mW/cm2) + 1 min sem luz + 35s (600mW/ cm2). Considerou-se como força de contração o valor registrado pela máquina de ensaios 2 minutos após o início da aplicação da luz no espécime. Os valores obtidos foram submetidos à análise de variância (ANOVA), seguido pelo teste de Tukey (p=0,05). Resultados: Não houve diferença estatística significativa entre as duas técnicas de polimerização testadas nas resinas compostas à base de silorano e TCD-Uretano, porém, houve diferença para a resina à base de Bis-GMA. Conclusão: A técnica de pulso influenciou positivamente na redução da força de contração em matriz polimérica à base de Bis-GMA, entretanto, não promoveu benefícios para as resinas à base de silorano e TCD-Uretano. PALAVRAS-CHAVE: Contração; Fotopolimerização

Purpose: To evaluate the polymerization shrinkage stress of three different composite resins cured with two methods photopolymerization (conventional and pulse delay). Three materials were selected for the study, with different organic matrices: Bis- GMA - Filtek Z250 XT (3M-ESPE, Saint Paul, Minenesotta, USA); Silorano - Filtek P90 (3M-ESPE, Saint Paul, Minenesotta, USA) e TCD-Uretane - Charisma Diamond (Heraeus Kulzer, São Paulo, São Paulo, Brazil). Materials and Method: The samples were made from a stainless steel matrix with rectangular internal geometry (6mm x 1mm x 2mm), which was mounted in an universal testing machine (Instron, Model 5965) in order to register the polymerization shrinkage stress (Newtons). The photoactivation was performed in each group with a LED (600mW/cm) light source, under two photoactivation protocols: continuous - 40s (600mW/cm) and pulse delay - 5s (600mW/cm) + 1 min with no light + 35s (600mW/cm). It was considered as shrinkage stress the value registered by the testing machine two minutes after the start of the specimen's cure. The values obtained were subjected to Analysis of Variance (ANOVA), followed by the Tukey test (p=0.05). Results: There was no significant statistical difference between the two polymerization techniques tested in the composite resins based on silorane and TCD-Urethane, but there was difference in the resin based on Bis-GMA. Conclusion: The pulse delay technique positively influenced in reducing the shrinkage stress in the polymeric matrix made of Bis- GMA, but did not provide benefits to resins made of silorane and TCD-Urethane.

Influence of curing mode of resin luting cements on bond strength to dentin

Self-adhesive, dual-polymerizing resin cements require no treatment to the prepared tooth surfaces before cementation. Aim: The aim of this study was to evaluate the influence of curing mode on bond strength (BS) of three cementing systems to bovine dentin. Methods: The buccal enamel surfaces of 50 bovine incisors were removed to expose dentin and to flat the surface. The teeth were divided into five groups (n=10), which consisted of two resin cements (Multilink and Clearfil SA Cement) that were tested in dual- (halogen light for 40 s) and self-cured modes, and a control (RelyX ARC). Two cylinders of resin cements (1.0 mm X 0.75 mm) were prepared on each bonded dentin surface. After 24h at 37oC, resin cylinders were subjected to micro-shear testing in a universal testing machine (4411/Instron - 0.5 mm/min). Data were statistically analyzed by two-way ANOVA, Tukey and Dunnett`s test (5%). Results: Multilink showed higher BS than those observed on Clearfil SA. Light-curing resulted in higher BS for both Multilink and Clearfil SA. When Multilink was light-cured, no significant difference on BS was demonstrated between it and RelyX ARC. Conclusions: The highest BS values were obtained in control group and light-cured Multilink resin cement (AU)

Inflammatory response of human dental pulp to at-home and in-office tooth bleaching

ABSTRACT Tooth bleaching is a technique of choice to obtain a harmonious smile, but bleaching agents may damage the dental pulp. Objective: This study evaluated the inflammatory responses of human dental pulp after the use of two bleaching techniques. Material and Methods: Pulp samples were collected from human third molars extracted for orthodontic reasons and divided into three groups: control - no tooth bleaching (CG) (n=7); at-home bleaching with 15% carbamide peroxide (AH) (n = 10), and in-office bleaching with 38% hydrogen peroxide (IO) (n=12). Pulps were removed and stained with hematoxylin-eosin for microscopic analysis of inflammation intensity, collagen degradation, and pulp tissue organization. Immunohistochemistry was used to detect mast cells (tryptase+), blood vessels (CD31+), and macrophages (CD68+). Chi-square, Kruskal-Wallis, and Mann Whitney tests were used for statistical analysis. The level of significance was set at p<.05. Results: The inflammation intensity and the number of macrophages were significantly greater in IO than in AH and CG (p<0.05). The results of CD31+ (blood vessels per mm2) were similar in CG (61.39±20.03), AH (52.29±27.62), and IO (57.43±8.69) groups (p>0.05). No mast cells were found in the pulp samples analyzed. Conclusion: In-office bleaching with 38% hydrogen peroxide resulted in more intense inflammation, higher macrophages migration, and greater pulp damage then at-home bleaching with 15% carbamide peroxide, however, these bleaching techniques did not induce migration of mast cells and increased the number of blood vessels.

Clinical effectiveness of light-curing units of the School of Dentistry of the Federal University of Goias

Introduction: The clinical longevity of the procedures is directly associated to the adequate activation (photopolymerization) of adhesive restorative materials. Objective: To evaluate and compare by allocation the conservation status and power density of the light-curing units available at the School of Dentistry of the Federal University of Goias (FO/FUG) for clinical care. Material and methods: The following information and specific techniques of all light sources existing at FO/UFG, available for clinical care in 2011, were collected: dental/ambulatory clinic where they are located, type of source [device of halogen light and light-emitting diode (LED)], brand, parallelism test (halogen light sources), state of conservation of the light transmitter tip, density of the potency/intensity/irradiance in mW/cm2 and acquisition date. The data obtained were submitted to one-way ANOVA (Analysis of Variance) and Turkey test for multiple comparisons (P < 0.05). Results: In the second half of 2011, FO/UFG had 20 light sources (04 halogens and 16 LEDs), of which 90% were found in inadequate condition and 55% of those with power density less than 300 mW/cm2. There was no statistically significant difference in the power density between halogen and LED sources tested (P = 0.526). Likewise, no statistical difference was observed between the power density of the light sources (LED) placed at the Clinic II and III (P = 0.479). Also there was no statistically significant difference between the light sources (LED Halogen X) at the Clinic I (P = 0.943). Conclusion: The light sources regardless of the clinic in which they were located presented mostly with inadequate clinical effectiveness in terms of their conservation status and power density.

Three-dimensional image contribution for evaluation of operative procedural errors in endodontic therapy and dental implants

Acceptable therapeutic protocol in dentistry depends on the outcomes obtained with follow up. Operative procedural errors (OPE) may occur and they represent risk factors able to compromise a tooth or a dental implant. The aim of this study was to detect the OPE in endodontically treated teeth and dental implants, using cone beam computed tomography (CBCT).Eight hundred and sixteen CBCT exams were performed between January 2009 and October 2010, and only those which presented endodontically treated teeth and/or dental implants were selected. The sample was as follows: 195 CBCT exams (n=200 teeth and 200 dental implants), 72 male, 123 female, with mean age of 51 years.In endodontically treated teeth, OPE included underfilling, overfilling, and root perforation; OPEin dental implants were thread exposures, contact with anatomical structures, and contact with adjacent teeth. Kolmogorov-Smirnov test was used for statistical analysis, with significance level set at α=0.05. Underfilling, overfilling, and root perforations were detected in 33.5%, 8% and 4.5% of the teeth, respectively. Dental implants with thread exposures, contact with important anatomical structures and contact with adjacent teeth were seen in 37.5%, 13% and 6.5% of the cases, respectively. OPE were detected in endodontically treated teeth and dental implants, and underfilling and thread exposures were the most frequent occurrences, respectively.

Protocolos terapêuticos aceitáveis em odontologia dependem de resultados observados com a proservação. Erros de procedimentos operatórios podem ocorrer e representam fatores de risco capazes de comprometer um dente ou um implante dentário. O objetivo deste artigo é detectar os erros de procedimentos operatórios em dentes tratados endodonticamente e implantes dentários por meio de tomografia computadorizada de feixe cônico. Oitocentos e dezesseis (816) exames tomográficos foram realizados entre Janeiro de 2009 e Outubro de 2010, e apenas aqueles que apresentaram dentes tratados endodonticamente e/ou implantes dentários foram selecionados. A amostra final envolveu 195 exames tomográficos (n=200 dentes e 200 implantes dentários), 72 do gênero masculino, 123 do gênero feminino, com idade média de 51 anos. Em dentes tratados endodonticamente os erros de procedimentos operatórios incluídos foram: subobturação, sobreobturação, e perfuração radicular; enquanto que, para implantes dentários foram incluídos: roscas de implantes expostas, implantes em contato com estruturas anatômicas, e em contato com dentes adjacentes. O nível de significância foi estabelecido em α=5%. Subobturações, sobreobturações e perfurações radiculares foram detectadas em 33,5%, 8% e 4,5%, respectivamente. Implantes dentários com roscas expostas, em contato com estruturas anatômicas, e em contato com dentes adjacentes apresentaram valores de 37,5%, 13% e 6,5%, respectivamente. Erros de procedimentos operatórios foram detectados em dentes tratados endodonticamente e implantes dentários. Os erros mais frequentes foram subobturação em dentes tratados endodonticamente, e roscas expostas em implantes dentários.

Effect of light sources and curing mode techniques on sorption, solubility and biaxial flexural strength of a composite resin

Adequate polymerization plays an important role on the longevity of the composite resin restorations. OBJECTIVES: The aim of this study was to evaluate the effect of light-curing units, curing mode techniques and storage media on sorption, solubility and biaxial flexural strength (BFS) of a composite resin. MATERIAL AND METHODS: Two hundred and forty specimens were made of one composite resin (Esthet-X) in a stainless steel mold (2 mm x 8 mm Ø), and divided into 24 groups (n=10) established according to the 4 study factors: light-curing units: quartz tungsten halogen (QTH) lamp and light-emitting diodes (LED); energy densities: 16 J/cm² and 20 J/cm²; curing modes: conventional (CM) and pulse-delay (PD); and permeants: deionized water and 75% ethanol for 28 days. Sorption and solubility tests were performed according to ISO 4049:2000 specifications. All specimens were then tested for BFS according to ASTM F394-78 specification. Data were analyzed by three-way ANOVA followed by Tukey, Kruskal-Wallis and Mann-Whitney tests (α=0.05). RESULTS: In general, no significant differences were found regarding sorption, solubility or BFS means for the light-curing units and curing modes (p>0.05). Only LED unit using 16 J/cm² and PD using 10 s produced higher sorption and solubility values than QTH. Otherwise, using CM (16 J/cm²), LED produced lower values of BFS than QTH (p<0.05). 75% ethanol permeant produced higher values of sorption and solubility and lower values of BFS than water (p<0.05). CONCLUSION: Ethanol storage media produced more damage on composite resin than water. In general the LED and QTH curing units using 16 and 20 J/cm² by CM and PD curing modes produced no influence on the sorption, solubility or BFS of the tested resin.

Abordagens sobre o ozônio no tratamento de lesão cariosa e em procedimento restaurador adesivo / Approaches on ozone in the treatment of carious lesion and adhesive restorative procedure

O ozônio é uma variedade alotrópica do oxigênio constituída por uma molécula triatômica desse elemento. Tem sido considerado um potente oxidante que pode ser usado na Odontologia. O seu uso apresenta-se como nova alternativa no tratamento de lesões de cárie, uma vez que sua eficácia clínica tem sido comprovada por diversos estudos relacionados à inativação de vírus, bactérias e fungos. Em função de apresentar propriedade comprovada na inibição e/ou destruição de muitas bactérias da cavidade bucal - tais como Streptococcus mutans, Streptococcus sanguis e Actinomyces odontolyticus -, o seu uso no tratamento das lesões cariosas é baseado em sua atividade antimicrobiana, com diminuição da acidez do biofilme, possibilitando a difusão de íons cálcio e fosfato nas lesões cariosas e permitindo a remineralização da dentina e esmalte afetados. Atualmente, a ozonioterapia é considerada uma alternativa promissora pelo seu baixo custo de investimento e manutenção, facilidade de aplicação e resultados clínicos satisfatórios. Porém o ozônio decompõe-se rapidamente e a presença de radicais de oxigênio pode interferir na polimerização de materiais adesivos. Dessa forma, o objetivo deste trabalho é apresentar uma revisão de literatura sobre a utilização do ozônio no tratamento de lesões cariosas e seu efeito sobre procedimentos restauradores adesivos.

Escultura progressiva e estratificação de cores em dentes posteriores: passo a passo / Progressive sculpture and shade stratification in posterior teeth: step-by-step

Este trabalho descreve uma sequencia clínica de restauração de cavidade de classe I, em que se utiliza a técnica de escultura progressiva com estratificação de cor. O dente selecionado para realização da sequencia é um primeiro molar inferior direito (46), com restauração de amálgama deficiente. Foram utilizadas as resinas A2D para dentina, W para caracterização das vertentes, A2E e CT para esmalte, todas Filtek Supreme (3M ESPE). Ao restaurar diretamente os dentes posteriores com resina composta, os cirurgiões-dentistas devem ter compreensão integral da morfologia do dente, combinada com as técnicas apropriadas, esboçadas no caso clínico, a fim de obter uma restauração estética aceitável. A técnica apresenta-se como ferramenta útil para os profissionais, pois fornece restaurações de alta qualidade, que reproduzem as propriedades ópticas e morfológicas dos tecidos dentários.

The aim of this article is to describe the clinical protocol of a Class I cavity restoration using the progressive sculpture with shade stratification. A right mandibular first molar (46) presenting a defective amalgam restoration was selected, and the shades were selected (A2D for dentin, W (white) for characterization, and A2E and CT for enamel, Filtek Supreme®, 3M ESPE). Dentists must have an integral understanding of tooth morphology when making direction restorations in posterior teeth using composite resin. This knowledge should be associated with appropriate techniques, to produce acceptable esthetic restorations which reproduce the optical and morphological properties of dental tissues.

Hipoplasia do esmalte: tratamento restaurador estético / Enamel hipoplasia: aesthetic restorative treatment

A hipoplasia do esmalte é uma formação incompleta ou deficiente da matriz orgânica do esmalte. Clinicamente, apresenta-se como manchas esbranquiçadas, rugosas, sulcos ou ranhuras, bem como, outras alterações na estrutura do esmalte, comprometendo a estética do sorriso. De acordo com o grau de severidade dessa anomalia, vários protocolos de tratamento podem ser realizados, desde clareamento, microabrasão, restaurações estéticas diretas e coroas unitárias. Desta forma, objetiva-se apresentar o diagnóstico e o tratamento restaurador estético de um caso clínico de hipoplasia do esmalte. Paciente gênero feminino procurou a FO-UFG queixando-se de manchas brancas nos dentes anteriores. Clinicamente, observou-se nos terços médio e incisal dos incisivos centrais superiores a presença de manchas esbranquiçadas profundas e leve alteração do contorno incisal, adotando-se um tratamento estético restaurador direto. As estruturas hipoplásicas nos dentes 11 e 21 foram desgastadas limitando-se à remoção da estrutura dentária afetada. Após o condicionamento ácido e aplicação do sistema adesivo, realizou-se a restauração com resina composta micro-híbrida pela estratificação da dentina e esmalte, seguido pelo acabamento e polimento das restaurações. A partir do tratamento pôde restabelecer a harmonia estética, propiciando significativo impacto positivo à auto-estima da paciente.

The enamel hypoplasia is an incomplete or deficient formation of the enamel organic matrix. It can appear by hereditary origin or by a consequence of systemic or local events that happen during teeth development. It comes as whitish, wrinkled, sulcus and grooves stains, as well as, other alterations in the enamel structure. Clinically, it appears with no enamel or just part of it, presenting an unsatisfactory aesthetics. In agreement with this anomaly degree of severity, several treatment protocols can be realized since whitening and microabrasion, until conservative aesthetic restorations and artificial crown. Therefore, the aim of this study is to present a clinical case that reports an option of enamel hypoplasia treatment. Female patient, 9, accompanied by her mother, sought the FO-UFG complaining about white stains in her permanents teeth. During the anamnesis the mother told that white stains just appeared in the moment of permanent incisors eruption. Clinically, it was observed in the middle and incisal thirds of the upper central incisors the presence of whitish spots profound and light alteration of the contour incisal, adopting a treatment is direct aesthetic restorative. The structures hypoplastic in 11 and 21 teeth were worn only to the removal of the affected tooth structure. After etching and application of adhesive system, there was the restoration with micro-hybrid resin composite by stratification of the enamel and dentin, followed by finishing and polishing of restorations. From the treatment could restore the aesthetic harmony, providing significant positive impact on self-esteem of the patient.

A retrospective study of Traumatic Dental Injuries in a Brazilian dental urgency service

Epidemiologic aspects of traumatic dental injuries (TDI) were evaluated in the permanent dentition in a sample of 847 patients treated at the Dental Urgency Service of the Dental School of the Federal University of Goiás, Brazil, between May 2000 and May 2008. The statistical treatment analyzed data from frequency distribution and chi-square test. The level of significance was set at 5 percent for all analyses. The results showed a higher incident among males (610; 72.01 percent) with mean age of 6-10 year-old. Uncomplicated crown fracture (without pulp exposure) (502; 26.95 percent), avulsion (341; 18.30 percent) and complicated crown fracture (with pulp exposure) (330; 17.71 percent) were the most prevalent TDI. The prevalence of trauma throughout the years showed proportionality, being observed a larger number of cases between July and September (249; 29.39 percent). The most affected teeth were the maxillary central incisors (65.65 percent), followed by the maxillary left lateral incisors (19.67 percent). In 311 participants (18.25 percent), only one tooth was involved, while in most patients (536; 81.75 percent), TDI occurred in more than one tooth. Significant proportion (82.27 percent) of traumatized teeth presented completely formed root apex. The main etiologic factors involved in TDI were falls (51.71 percent), traffic accidents (22.90 percent) and violence (5.67 percent). Based on the obtained data, it may be concluded that accurate policies of TDI prevention must be established, capable of stimulating the exposure of appropriate protocols for management of these lesions. The prevalence of TDI in Goiânia subpopulation is compared to the prevalence reported in epidemiological studies in others populations.

Nexte estudo, avaliou-se os aspectos epidemiológicos das injúrias traumáticas na dentição permanente em uma amostra de 847 pacientes atendidos pelo Serviço de Urgência da Faculdade de Odontologia da Universidade Federal de Goiás, entre os anos de 2000 e 2008. O tratamento estatístico analisou os dados frente à distribuição de freqüência e qui-quadrado. O nível de significância foi de p<0,05. Os resultados mostraram uma maior ocorrência entre os indivíduos do gênero masculino (72,01 por cento), na faixa etária 6-10 anos. A fratura coronária sem exposição do tecido pulpar (502; 26,95 por cento), avulsão (341; 18,30 por cento) e fratura coronária com exposição pulpar (330; 17,71 por cento) constituíram nas injúrias traumáticas mais prevalentes. A prevalência das injúrias traumáticas ao longo dos meses do ano mostrou-se proporcional, sendo observado um maior número de casos entre os meses de julho a setembro (249; 29,39 por cento). afetado foi o incisivo central superior (65,65 por cento), seguido pelo incisivo lateral superior esquerdo (19,67 por cento). Em 311 participantes (18,25 por cento) apenas um dente estava envolvido, enquanto que a maioria dos pacientes (536; 81,75 por cento), injúrias dentárias ocorreram em mais de um dente. Significativa proporção (82,27 por cento) dos dentes traumatizados apresentava os ápices radiculares completamente formados. Os principais fatores etiológicos envolvidos nos traumatismos dentários foram as quedas (51,71 por cento), acidentes automobilísticos (22,90 por cento), e violência (5,67 por cento). Adequadas políticas de prevenção de traumatismos dentários devem ser institucionalizadas, capaz de divulgar protocolos apropriados para o manejo destas lesões. A prevalência de traumatismos dentários em uma subpopulação de Goiânia é comparável a prevalência reportada em estudos epidemiológicos de outras populações.

Sorption, solubility and residual monomers of a dental adhesive cured by different light-curing units

The aim of this study was to assess polymerization ability of three light-curing units by evaluating the influence of the light source, curing regimen and permeant (water or ethanol) on sorption, solubility and amount of residual monomers of a dental adhesive. Specimens of Adper Single Bond 2 were fabricated using a stainless steel circular matrix (8 mm x 1 mm). One quartz-tungsten-halogen (QTH) lamp and two light-emitting diode (LED) device at three different curing regimes (L1 = 12 J; L2 = 24 J; L3 = 24 J) were used to cure the specimens. Specimens were stored in two types of permeants - deionized water or 75 percent ethanol - for two storage times (G1 =7 days; G2 = 30 days). The specimens underwent water sorption and solubility tests, according to ISO 4049:2000 standard. After storage, residual monomers were identified and quantified by high performance liquid chromatography (HPLC). For sorption, L1 showed the highest values and QTH, the lowest. For solubility, in ethanol-stored groups, L1 had also the highest values, and QTH, the lowest, and findings were significantly different from the other curing regimens. L1 leached significantly more monomers than the others, and QTH had the lowest results. In conclusion, the type of light source, the curing regimen and the permeant affected sorption, solubility and amount of residual monomers of the adhesive under study.

O objetivo deste estudo foi avaliar a capacidade de polimerização de três unidades fotopolimerizadoras por meio da análise da influência das fontes de luz, regimes de cura (QTH, L1, L2 e L3) e diferentes permeantes (água e etanol) na sorção, solubilidade e quantidade de monômeros residuais de um adesivo dentário. Espécimes de AdperTM Single Bond 2 foram feitos utilizando uma matriz circular de aço inoxidável (8 mm x 1 mm). Três fontes de luz, uma a base de luz halógena (QTH) e duas a base de diodos emissores de luz (LED), em três diferentes regimes de cura (L1 = 12J; L2 = 24J; L3 = 24J) foram usados para fotoativar os espécimes. Os espécimes foram armazenados em dois tipos de permeantes (água deionizada ou etanol a 75 por cento), por dois diferentes períodos de armazenamento (G1 =7 dias; G2 = 30 dias). Os espécimes foram submetidos a testes de sorção e solubilidade de acordo com a ISO 4049:2000. Após o período de armazenamento, os monômeros residuais foram identificados e quantificados por cromatografia líquida de alta eficiência (HPLC). Para sorção, L1 apresentou os maiores valores significantes e QTH os menores. Para solubilidade, nos grupos do etanol, L1 apresentou os maiores valores e QTH os menores e os achados foram estatisticamente diferentes dos outros regimes de cura. L1 extraiu significantemente mais monômeros do que os outros regimes e QTH teve os menores resultados. As fontes de luz, os regimes de polimerização e os diferentes permeantes influenciaram na sorção, solubilidade e quantidade de monômeros residuais extraídos do adesivo em estudo.

Reparo pulpar frente ao Mineral Trioxide Aggregate / Pulp repair with Mineral Trioxide Aggregate

Avaliou-se estudos longitudinais relacionados ao reparo biológico do tecido pulpar frente ao Mineral Trioxide Aggregate, por meio de revisão sistemática. Utilizou-se pesquisa manual e fontes de catalogação bibliográfica identificadas eletronicamente por MEDLlNE, EMBASE e Cochrane Library - CENTRAL, a partir de 1966 até 30 de julho de 2008, com o termo mineral trioxide aggregate. De 180 estudos in vivo, apenas seis estudos satisfizeram os critérios de inclusão. Em todos os estudos in vivo, em animais e humanos, observou-se que o MTA favorece o processo de reparo do tecido pulpar após o tratamento conservador.

It was evaluated longitudinal studies of the biological repair of the pulpal tissue front to the Mineral Trioxide Aggregate, through systematic revision. It was used of handsearching and sources of bibliographical cataloguing identified electronically by MEDLlNE, EMBASE and Cochrane Library - CENTRAL, starting from 1966 until July 30,2008. As search strategy was used the terms - mineral trioxide aggregate - as word-key. Of the 180 studies in vivo, six studies satisfied the inclusion criteria. In all of the studies in alive, in animals and humans, and in those that satisfied the inclusion criteria, it was observed that MTA favors the repair process of the pulpal tissue after the conservative treatment.

Influence of pulse-delay curing on sorption and solubility of a composite resin

The purpose of this study was to evaluate the sorption and solubility of a composite resin (TPH³; Dentsply) cured with halogen light due to different storage media and curing modes. The methodology was based on the ISO 4049 standard. Two independent groups were established according to the storage time (7 days-G1; 60 days-G2). A stainless steel mould (2 mm x 8 mm Ø) was used. The selected curing modes were: I (Conventional - C): 40s - 600 mW/cm²; II (Pulse I - PD): 3 s - 200 mW/cm² + 2 min (delay) + 39 s - 600 mW/cm²; III (Pulse II): 10 s - 200 mW/cm² + 2 min (delay) + 37 s - 600 mW/cm²; IV (Pulse III): 3 s- 600 mW/cm² + 2 min (delay) + 37 s -600 mW/cm². The media used were: distilled water, 75 percent ethanol and 100 percent chlorophorm. Five repetitions were made for each group. The specimens were placed in a desiccator at 37ºC for 24 h and, after that, at 23ºC for 1 h to be weighed until a constant mass (m1) was obtained. The discs were immersed separately into the 3 media for 7 days (G1) and 60 days (G2), and thereafter reweighed (m2). The reconditioning in the desiccator was done until a constant mass (m3) was obtained. Sorption and solubility were calculated and the data of G1 and the sorption data of G2 were subjected to two-way ANOVA and Tukey's tests (p=0.05). The solubility data of G2 were analyzed by Kruskal-Wallis test (p=0.05). For G1 and G2, no statistically significant differences were found in sorption among curing techniques (p>0.05). The solubility values were negative, which means that there was mass gain. Regarding the storage media, in G2 chlorophorm had the highest sorption values. It may be concluded that the curing modes (C and PD I, II and III) did not affect the sorption of the tested composite resin. However, different storage media influenced sorption behavior. The solubility test demonstrated negative data, masking the real solubility.

Effect of light-curing units and activation mode on polymerization shrinkage and shrinkage stress of composite resins

The aim of this study was to evaluate the polymerization shrinkage and shrinkage stress of composites polymerized with a LED and a quartz tungsten halogen (QTH) light sources. The LED was used in a conventional mode (CM) and the QTH was used in both conventional and pulse-delay modes (PD). The composite resins used were Z100, A110, SureFil and Bisfil 2B (chemical-cured). Composite deformation upon polymerization was measured by the strain gauge method. The shrinkage stress was measured by photoelastic analysis. The polymerization shrinkage data were analyzed statistically using two-way ANOVA and Tukey test (p<0.05), and the stress data were analyzed by one-way ANOVA and Tukey's test (p<0.05). Shrinkage and stress means of Bisfil 2B were statistically significant lower than those of Z100, A110 and SureFil. In general, the PD mode reduced the contraction and the stress values when compared to CM. LED generated the same stress as QTH in conventional mode. Regardless of the activation mode, SureFil produced lower contraction and stress values than the other light-cured resins. Conversely, Z100 and A110 produced the greatest contraction and stress values. As expected, the chemically cured resin generated lower shrinkage and stress than the light-cured resins. In conclusion, The PD mode effectively decreased contraction stress for Z100 and A110. Development of stress in light-cured resins depended on the shrinkage value.

Análise in vitro da atividade microbiana do Papacárie sobre Stretococcus mutans / In vitro evaluation of antimicrobial activity of papacarie against Streptococcus mutans

O Papacárie é um gel para remoção químico-mecânica da cárie, composto basicamente por papaína, cloramina e azul de toluidina. O objetivo da pesquisa foi analisar a susceptibilidade de cepas de Streptococcus mutans frente à formulação do Papacárie por meio do teste de difusão em ágar. Discos de papel filtro banhados com o produto comercial foram colocados sobre o meio de cultura previamente inoculado com Streptococcus mutans em placas de Petri. Gel de clorexidina a 0,12% foi utilizado no Grupo Controle. Os resultados indicaram ausência de atividade bactericida do gel Papacárie, pois não houve formação de halo de inibição em nenhum dos meios. Porém, todos os discos contendo gel de clorexidina apresentaram halos de inibição. Concluiu-se que as cepas de Streptococcus mutans não apresentaram sensibilidade ao Papacárie.

Papacárie is a gel for chemo-mechanical removal of caries. The main components of the gel are papayn, chIoramina and blue toluidine. The objective of the present research was to analyze the susceptibility of Streptococcus mutans to the Papacárie gel by using the agar diffusion test. Disks of filter paper were soaked with the commercial product and placed along with the agar plate previously inoculated with Streptococcus mutans in Petri dishes. Gel of clorexidina 0.12% was used in the control group. The results indicated absence of bactericidal activity of Papacárie, since it did not produce inhibition zones in none of the inoculated agar plates. On the other hand, all the samples of the control group produced large inhibition zones. It can be concluded that cepas of Streptococcus mutans did not exhibit sensitivity to Papacárie.

Evaluation of internal adaptation of Class V resin composite restorations using three techniques of polymerization

OBJECTIVE: The purpose of this in vitro study was to evaluate the internal adaptation of Class V composite restorations to the cavity walls using three different techniques of polymerization. METHODS: Standard cavities were prepared on the buccal and lingual surfaces of 24 extracted human third molars with margins located above and below the cementoenamel junction. Restorations were placed in one increment using two restorative systems: 3M Filtek A110/ Single Bond (M) and 3M Filtek Z250/ Single Bond (H) in the same tooth, randomly in the buccal and lingual surfaces. Resin composites were polymerized using three techniques: Group 1 - Conventional (60 s - 600 mW/cm²); Group 2 - Soft-start (20 s - 200 mW/cm² , 40 s - 600 mW/cm²); Group 3 - Pulse Activation (3 s - 200 mW/cm², 3-min hiatus, 57 s - 600 mW/cm²). Buccolingual sections were polished, impressions taken and replicated. Specimens were assessed under scanning electron microscopy up to X1000 magnification. Scores were given for presence or absence of gaps (0 - no gap; 1 - gap in one wall; 2 - gap in two walls; 3 - gap in three walls). RESULTS: The mean scores of the groups were (±SD) were: G1M-3.0 (± 0.0); G2M-2.43 (± 0.8); G3M- 1.71 (± 0.9); G1H- 2.14 (± 1.2); G2H- 2.00 (± 0.8); G3H- 1.67 (± 1.1). Data were analyzed using Kruskal-Wallis and Dunnet's tests. No statistically significant difference (p>0.05) was found among groups. Gaps were observed in all groups. CONCLUSIONS: The photocuring technique and the type of resin composite had no influence on the internal adaptation of the material to the cavity walls. A positive effect was observed when the slow polymerization techniques were used.

Evidências e perspectivas das fontes de luz LED na fotoativação de materiais resinosos / Evidences and perspectives of the LED sources in the photocuring of resinous materials

A qualidade da luz emitida pela unidade fotopolimerizadora é fator primordial para uma maior longevidade clínica das restaurações adesivas. Neste contexto, os aparelhos à base de LED (Luz Emitida por Diodo) aparecem como uma nova opção dentre os diversos sistemas de polimerização disponíveis atualmente. Apesar da falta de homogeneidade nas conclusões obtidas quanto a sua viabilidade na cura de materiais fotossensíveis, há evidências científicas que o caracterizam como uma alternativa promissora para a efetivação da polimerização. Desta maneira, propõe-se neste estudo elucidar características concernentes ao LED, ressaltando-se as limitações, vantagens e possíveis controvérsias provenientes do seu uso, por intermédio de análise bibliográfica e interpretação dos resultados obtidos na literatura consultada.

The clinical performance of light polymerized dental composites is greatly influenced by the quality of the light curing unit used. A recent number of studies proposes and demonstrates the use of LED (Light Emitting Diodes) as an alternative source for curing resins. However, its effectiveness is still unclear and controversial. The present review investigated evidence for application of blue LED technology on cure dental materials.

Profundidade de polimerização de resinas híbrida, micro e nanoparticuladas utilizando luz halógena ou de segunda geração / Curing depth of hybrid, microfilled and nanofilled composites cured with halogen lights or second generation led

As propriedades físicas e biológicas das resinas compostas vêm sendo otimizadas com a adoção de um adequado protocolo de polimerização. Neste contexto, novas tecnologias surgiram como opções dentre os diversos sistemas disponíveis. Desta maneira, objetivou-se analisar, por intermédio de teste de profundidade de polimerização, resinas compostas híbrida (Z100), microparticulada (Filtek A110) e denanopartículas (Filtek Supreme), quando fotoativadas com Luz Visível Convencional e LED de segunda geração. Para tanto, foram confeccionados dez corpos-de-prova padronizados para cada condição, a partir da inserção da resina em uma matriz de aço (10mm de altura X 5mm de diâmetro). Os espécimes foram submetidos ao teste de raspagem da porção não polimerizada, obtendo-se os valores de profundidade de polimerização conforme norma da ISO n.4049. Os dados obtidos (mm) com luzhalógena, Z100- 2,27±0,23; A110- 2,42±0,18; Filtek Supreme- 2,48±0,37, e os obtidos com o LED,Z100- 2,45±0,18;A110- 2,05±0,10; Filtek Supreme- 2,45±0,20, foram submetidos à análise de variância, seguido pelo teste de Tukey (p=0,05). Dados concludentes suscitaram não haver diferenças estatisticamente significantes entre as fontes de luz para Filtek Supreme e Z100, exceto para a resinaA110, cujos valores revelaram-se menores para o LED. Portanto, o uso da fonte LED foi viável para as resinas Z100 e Filtek Supreme

The physical and biological properties of the composite resins have been improved with an adequate polymerization protocol of application. Thus, new technolgies became as options among the others curing units. The aim of this study was to evaluate the cure depth using a standardised technique (ISO4049) of differents composite, hybrid (Z100), microfilled (A110) and nanofilled (Filtek Supreme), when photo-cured with conventional visible light and second generation LED. Ten specimens per group were prepared by insertion of composite into a cilindrical steel matrix (10mm depht X 5mm diameter). The specimens were submited to scrapping test to remove uncured material, resulting in the deph of cure values according to ISO 4049 specification. The data obtained (mm) by halogen light, Z100- 2.27±0.23;A110- 2.42±0.18; Filtek Supreme- 2.48±0.37, and by LED unit, Z100- 2.45±0.18;A110- 2.05±0.10; Filtek Supreme- 2.45±0.20, were perfomed using two way ANOVA e Tukey test (p=0.05). There were not significant differences between light units for Z100 and Filtek Supreme, except A110 composite resin when cured by LED unit, which demonstrated the lowest results. Hence, the LED unit was viable for Z100and Filtek Supreme