Effect of Light Curing Modes on the Color Stability of a Nanohybrid Composite Immersed in Different Beverages / Efecto de diferentes modos de fotopolimerización en la estabilidad del color de una resina compuesta nanohíbrida inmersa en diferentes bebidas

Abstract: Aim: Sufficient polymerization remains as crucial for composites to prevent discoloration. Both LEDs and halogen units are used for polymerization and different curing modes are improved to overcome inadequate polymerization. This in vitro study investigated staining susceptibility of a nano-hybrid resin composite light-cured in different modes and immersed in different staining media. Methods: Disc-shaped specimens were prepared from nano-hybrid resin composite (Filtek Z550) and light- cured according to following modes: Halojen (GI), LED standard (GII), LED pulse (GIII) or LED ramp (GIV). Half of the specimens of each group (n=7) were stored in one of the staining media (red wine or coffee) for 10 min/day during experimental period. Measurements were performed using spectrophotometer according to CIEL*a*b system at baseline and on 7, 28 and 56 days. Colour differences (∆E) between groups were submitted to statistical analysis. Results: Regarding 7-day evaluation, colour change values of specimens immersed in coffee revealed no remarkable difference among curing modes (p>0.05); whereas specimens in GIV were significantly less stained compared to specimens in GII and GIII when immersed in red wine. Regarding 56- days of evaluation, specimens of GIV showed statistically significant colour change in red wine compared to other groups. However specimens in GI revealed the least staining after 56-days of coffee immersion, and this result was statistically different from LED groups. Conclusion: This study suggest that light-curing mode influences the staining susceptibility of the tested composite. Composites polymerized with halogen unit showed lower staining than all LED modes. Despite novel light sources, halogen units may still used reliably at clinics.

Resumen: Objetivo: La polimerización suficiente sigue siendo crucial para que los compuestos eviten la decoloración. Tanto los LED como las unidades halógenas se utilizan para la polimerización y se mejoran los diferentes modos de curado para superar la polimerización inadecuada. Este estudio in vitro investigó la susceptibilidad a la tinción de un compuesto de resina nano-híbrida curado a la luz en diferentes modos y se sumergió en diferentes medios de tinción. Métodos: Las muestras en forma de disco se prepararon a partir de un compuesto de resina nano-híbrida (Filtek Z550) y se curaron con luz de acuerdo con los siguientes modos: Halojen (GI), estándar de LED (GII), pulso de LED (GIII) o rampa de LED (GIV). La mitad de las muestras de cada grupo (n = 7) se almacenaron en uno de los medios de tinción (vino tinto o café) durante 10 minutos / día durante el período experimental. Las mediciones se realizaron utilizando un espectrofotómetro de acuerdo con el sistema CIEL * a * b en la línea de base y en 7, 28 y 56 días. Las diferencias de color (∆E) entre los grupos se sometieron a análisis estadístico. Resultados: Con respecto a la evaluación de 7 días, los valores de cambio de color de las muestras sumergidas en café no revelaron diferencias notables entre los modos de curado (p> 0.05); mientras que las muestras en GIV se tiñeron significativamente menos en comparación con las muestras en GII y GIII cuando se sumergieron en vino tinto. Con respecto a los 56 días de evaluación, las muestras de GIV mostraron un cambio de color estadísticamente significativo en el vino tinto en comparación con otros grupos. Sin embargo, las muestras en GI revelaron la menor tinción después de 56 días de inmersión en el café, y este resultado fue estadísticamente diferente de los grupos LED. Conclusión: este estudio sugiere que el modo de fotopolimerización influye en la susceptibilidad de tinción del material compuesto probado. Los compuestos polimerizados con una unidad halógena mostraron una tinción más baja que todos los modos LED. A pesar de las nuevas fuentes de luz, las unidades halógenas todavía pueden usarse de manera confiable en las clínicas.

Discromia en Incisivo central superior derecho / Dischromya in Upper righ central incisive

Paciente masculino de 52 años de edad, tez blanca, residente en una comunidad urbana en La Habana, sin antecedentes patológicos referidos; que acude a consulta estomatológica preocupado por su estética; al examen bucal se observa cambio de color en el diente 11 (Incisivo central superior derecho) hacia carmelita oscuro que evidencia una discromía. A la imagen de una radiografía periapical se observa previo tratamiento pulpo radicular (TPR), por lo que se decide comenzar un tratamiento de recromia; en 5 consultas a intervalos con posterior restauración del diente en cuestión. Después del tratamiento se observó recuperación del color normal del diente, mejoría en la estética y gran satisfacción nuestra y del paciente.

A 52 years old male patient of white race, resident in an urban community of Habana City, he does not suffer from any disease; he was worried because his aesthetic, the oral examination shows a different colour on tooth 11 (upper righ central incisive) to dark brown that confirm a diagnosis of dischromya. The periapical x-ray disclosed a previous root canal treatment, according to the signs the treatment to recover from the disease is a rechromya, in 5 appointment with a dental restoration the patient presents good evolution and report a better appearance and a great satisfaction from ours and the patient.

Habilidade dos odontopediatras e clínicos gerais em diagnosticar e tratar defeitos do esmalte / Ability of pediatric and general dentists to diagnose and treat enamel defects

Objetivo: Fazer um levantamento, frente aos odontopediatras e clínicos gerais, quanto ao conhecimento do diagnóstico e tratamento dos defeitos do esmalte em pacientes na cidade de João Pessoa, Paraíba. Métodos: Foram entrevistados 25 odontopediatras e 56 clínicos gerais inscritos no Conselho Regional de Odontologia de João Pessoa, onde foram apresentados dois casos clínicos para serem relatados o diagnóstico e o tratamento dos mesmos. Resultados: Ao se observar a relação entre os diagnósticos corretos nos referidos casos clínicos, verificou-se que apenas 4,9% dos entrevistados acertaram o diagnóstico da opacidade e 19,8% o da hipoplasia (p>0.05). Com relação ao tratamento indicado, em cada caso, pelos profissionais, observou-se que 4,07% acertaram o da opacidade e 87,7% o da hipoplasia (p>0.05). Conclusão: Os conceitos de diagnóstico e tratamento dos defeitos do esmalte necessitam ser atualizados entre os profissionais da odontologia que lidam com crianças, em virtude de representarem fatores de grande relevância na predisposição ao desenvolvimento da cárie precoce na infância.

Objective: The objective of this study was to determine the knowledge of pediatric dentists and general practitioners on the diagnosis and treatment of enamel defects in patients from the city of João Pessoa, state of Paraíba. Methods: A total of 25 pediatric dentists and 56 general dentists registered at the Regional Dental Council of João Pessoa were interviewed. Two clinical cases were presented to them for them to diagnose and suggest treatment. Results: The percentage of correct diagnoses for the clinical cases presented to the dentists was low: only 4.9% of the dentists correctly diagnosed opacity and 19.8% correctly diagnosed hypoplasia (p>0.05). As for treatment, only 4.07% of the interviewed dentists proposed a correct treatment for opacity and 87.7% proposed a correct treatment for hypoplasia (p>0.05). Conclusion: Dental care professionals that work with children need to update their knowledge on the diagnosis and treatment of enamel defects because these are very relevant factors that predispose the child early to caries lesions.

Use of diagnodent® for diagnosis of non-cavitated occlusal dentin caries

The purpose of this study was to evaluate the use of a laser fluorescence device for detection of occlusal caries in permanent teeth. One hundred and ninety-nine non-cavitated teeth from 26 patients aged 10 to 13 years were selected. After dental prophylaxis, two previously calibrated dentists examined the teeth. Visual inspection, radiographic examination and laser measurements were performed under standardized conditions. The validation method was cavity preparation with a small cone-shaped diamond bur, when the two examiners agreed about the presence of dentin caries. It was found that the laser detection method produced high values of sensitivity (0.93) and specificity (0.75) and a moderate positive predictive value (0.63). The laser device showed the lowest value of likelihood ratio (3.68). Kappa coefficient showed good repeatability for all methods. Although the laser device had an acceptable performance, this equipment should be used as an adjunct method to visual inspection to avoid false positive results.

Tetraciclinas y esmalte dental / Tetracyclines and dental enamel

Las tetraciclinas son antibióticos de amplio espectro frecuentemente usadas en dermatología por sus acciones antiinflamatorias en acné vulgar y en rosácea. Uno de los efectos secundarios más temidos es la alteración del esmalte dental, por lo que no se recomienda su uso en menores; sin embargo, la edad exacta no ha sido claramente determinada. Las tetraciclinas provocan manchas permanentes en el esmalte dental definitivo por su gran afinidad con el calcio y el hierro, aunque el mecanismo exacto esta en discusión. La odontogénesis para la dentadura definitiva termina a los ochos años, excepto para los terceros molares, y es durante la odontogénesis donde se produce la alteración del esmalte, secundario a estas drogas. Por ende, se puede emplear las tetraciclinas con seguridad en pacientes mayores de ocho años. Numerosos otros agentes pueden causar daños similares al esmalte. Existen diversos tratamientos de resorte odontológico para blanquear el esmalte.

Tetracyclines are broad spectrum antibiotics that are frequently used in dermatology because of their anti-inflammatory effects in acne vulgaris and rosacea. One of their worst side effects is the alteration in dental enamel, which is why it is not recommended for children; nevertheless, the exact age has not been clarified. Tetracyclines can stain permanent dental enamel for life due to their great affinity with calcium and iron; however, that exact mechanism is still under discussion. Odontogenesis for permanent teeth finishes at age 8, except for 3rd molars, and it during the odontogenesis that these drugs cause the aforementioned effects. Therefore, tetracyclines can be used in patients older than 8 years without fear of damaging the enamel. Numerous other agents can cause similar damage. There are many whitening treatments and procedures carried out by dentists.

Clareamento caseiro em dentes vitais / Night-Guard dental bleaching

Na Odontologia atual, o clareamento dental caseiro tem sido requisitado com maior freqüência por pacientes que desejam uma estética melhorada. O Cirurgião-Dentista, como peça fundamental para o sucesso do tratamento, deve empregar a melhor técnica de acordo com a indicação e contra-indicação, levando-se em conta o diagnóstico da alteração de cor e conservação das estruturas dentais, orientando corretamente o paciente, antes, durante e após o tratameto e saber agir adequadamente em casos de sensibilidade. Possibilitar uma correta indicação, aletar para possíveis efeitos adversos e limitações, discutir riscos e benefícios do clareamento de dentes vitais é o objetivo deste trabalho.