Selamento dentinário imediato em restauração semidireta: relato de caso / Immediate dentin sealing in semi-direct restoration: case report

O selamento dentinário imediato é um procedimento essencial na Odontologia, que envolve a aplicação de agentes de selamento na interface entre a dentina e o material restaurador imediatamente após a remoção da cárie e do preparo da cavidade dentária. Este processo busca selar os túbulos dentinários expostos, proporcionando proteção à polpa dentária. O presente caso foi realizado em um paciente do sexo masculino, 56 anos que se queixou de desconforto no elemento dentário 17. Após avaliação clínica e radiográfica, foi constatado uma ampla restauração desadaptada na porção mesio - oclusal do referido dente, sendo que o elemento em questão não possui tratamento endodôntico. Após planejamento e assinatura do TCLE, os seguintes passos foram realizados: remoção da lesão cariosa do dente 17, seguido da realização do levantamento marginal mesial e a realização do selamento dentinário imediato. Moldagem com silicone de adição do dente em questão e do antagonista, assim como registro da mordida. Foi confeccionada uma restauração semidireta em resina composta sob o modelo de gesso obtido. A cimentação da restauração foi feita na consulta seguinte, cumprindo os requisitos fundamentais para restaurar forma, função e estética, resultando na melhoria da qualidade de vida do paciente(AU)

Immediate dentin sealing is an essential procedure in dentistry, involving the application of sealing agents at the interface between dentin and the restorative material immediately after caries removal and cavity preparation. This process aims to seal exposed dentinal tubules, providing protection to the dental pulp. The present case involved a 56-year-old male patient who complained of discomfort in tooth number 17. After clinical and radiographic evaluation, a wide, maladapted restoration in the mesio-occlusal portion of the tooth was identified, with no endodontic treatment in the affected element. Following planning and informed consent, the following steps were taken: removal of the carious lesion from tooth number 17, followed by the execution of mesial marginal elevation and immediate dentin sealing. Silicone addition molding of the affected tooth and antagonist, along with bite registration, was performed. A semi-direct restoration in composite resin was fabricated based on the obtained gypsum model. The restoration was cemented in the subsequent appointment, meeting the essential requirements to restore form, function, and aesthetics, resulting in an improvement in the patient's quality of life(AU)

Displasia dentinaria tipo I: Manejo clínico y estudio histológico a propósito de dos casos

La displasia dentinaria tipo I (DD-I) corresponde a una alteración dentinaria de heterogeneidad genética y penetrancia completa, en donde se presenta un defecto en el desarrollo de las raíces de los dientes tanto temporales como definitivos. Clínicamente se observan dientes con extrema movilidad junto con antecedentes de exfoliación prematura o espontánea. Los defectos estructurales de los tejidos dentarios, tales como DD-I; implican un desafío ya que son pocos los casos documentados en la literatura que hablan de esta condición. Además implican un tratamiento multidisciplinario y altamente invasivo. El objetivo de este artículo es presentar dos casos de DD-I, enfatizando en su tratamiento y características histopatológicas.

Dentin Dysplasia Type I (DD-I) consists of a pathological dentinary alteration with genetic heterogeneity that results in a defectuous development of dental roots both in primary and secondary dentition. Clinically we can appreciate teeth with extreme pathological mobility and premature or spontaneous exfoliation. Alterations within normal dental structure, such as DD-I imply a challenge for the common practitioner, because of the scarce number of case reports with in the scientific literature regarding this condition and also, because of the need for a highly invasive and multidisciplinary approach they require. The aim of this article is to present two DD-I cases, emphasizing on their treatment and histopathological features.

O uso do laser de alta e baixa intensidade para o tratamento de hipersensibilidade dentinária: uma revisão integrativa

Objetivo: Determinar as evidências científicas sobre a influência do uso de lasers de baixa e alta intensidade no tratamento da hipersensibilidade da dentina. Revisão de literatura: Foram realizadas buscas na Biblioteca Virtual em Saúde (BVS), incluindo as bases de dados: Literatura Latino Americana e do Caribe em Ciências da Saúde (LILACS); Bibliografia Brasileira de Odontologia (BBO); e National Library of Medicine (MEDLINE). A maioria dos estudos destacam a eficácia dos lasers na redução da HD, com o laser Nd:YAG mostrando-se eficaz na obliteração dos túbulos dentinários e proporcionando alívio a longo prazo. Apesar dos benefícios, alguns estudos alertam para possíveis danos à polpa dentária, especialmente com lasers de alta potência. Considerações finais: Embora os lasers tenham se mostrado eficazes na redução da HD, a escolha do laser deve ser personalizada para cada paciente, destacando a necessidade de aprimorar os protocolos clínicos e adquirir experiência relevante por parte dos profissionais especialistas.

Objective: To determine the scientific evidence on the influence of the use of low and high intensity lasers in the treatment of dentin hypersensitivity. Literature review: Searches were carried out in the Virtual Health Library (VHL), including the databases: Latin American and Caribbean Literature in Health Sciences (LILACS); Brazilian Bibliography of Dentistry (BBO); and National Library of Medicine (MEDLINE). Most studies highlight the effectiveness of lasers in reducing HD, with the Nd:YAG laser proving effective in obliterating dentinal tubules and providing long-term relief. Despite the benefits, some studies warn of possible damage to the dental pulp, especially with high-power lasers. Final considerations: Although lasers have been shown to be effective in reducing HD, the choice of laser must be personalized for each patient, highlighting the need to improve clinical protocols and acquire relevant experience on the part of specialist professionals.

Prevalence and Associated Factors to Non-Carious Cervical Lesions in Brazilian University Students: A Cross-Sectional Survey

Abstract Objective: To identify the prevalence, severity, hypersensitivity, and distribution of Non-carious cervical lesions (NCCL) among university students in Brazil. Material and Methods: 179 participants answered an anamnesis with twenty questions about the presence or absence of habits associated with NCCL. The participants' teeth were evaluated to identify the presence or absence of the lesion, its classification, involved surfaces, severity, hypersensitivity, and tooth wear index. A hypersensitivity test was performed with ice water. Data were analyzed using the chi-square test and simple logistic regression (p<0.01). Results: 179 participants answered an anamnesis with twenty questions about the presence or absence of habits associated with NCCL. The participants' teeth were evaluated to identify the presence or absence of the lesion, its classification, involved surfaces, severity, hypersensitivity, and tooth wear index. A hypersensitivity test was performed with ice water. Data were analyzed using the chi-square test and simple logistic regression (p<0.01). Conclusion: The prevalence of NCCL was 15.1% and abfraction was the most frequent lesion. Premolars were the teeth most affected by non-carious cervical lesions.

Clinical Findings Arising from the Use of Silver Diamine Fluoride to Prevent or Treat Caries Lesions and Dentinal Hypersensitivity: A Data Mining Analysis

Abstract Objective: To summarize data of clinical trials that used silver diamine fluoride (SDF) to prevent and treat caries lesions and dentinal hypersensitivity. Material and Methods: Six electronic databases were searched in May 2022. The concentration of SDF, type of usage (alone/combined), dentition, anterior/posterior teeth, tooth region, dental tissue, number of the treated surfaces, the intervention environment, participants' age, frequency and duration of SDF application, purpose, and outcome were the extracted variables. The type of study, year of publication, authors, journals, and country were also investigated. Results: From 8860 articles, S3 were selected. Most were randomized (n=38), that applied 38% SDF (n=43), alone (n=44), on multiple surfaces (n=44), only in dentin (n=36), of the crown (n=46) of anterior and posterior (n=36) primary teeth (n=39). The studies were preferably carried out outside the clinic (n=3l), only in children (n=33), with reapplication of SDF (n=30), but did not inform the duration of application (n= 19). SDF was most used to treat (n=46) only caries lesions (n=50). They were published between 2001 and 2022, mainly in the Journal of Dentistry (n=10). China (n=19) and Lo E.GM (n=19) were the countries and authors that published the most, respectively. Conclusion: The silver diamine fluoride 38% alone was most used to treat caries lesions in the dentin of the crown of all primary teeth, preferably applied on multiple surfaces, requiring re application, and outside the clinic.

Evaluación de la fuerza de unión de sistemas adhesivos universales previa aplicación de clorhexidina al 2 %

Introducción: La influencia de la clorhexidina sobre la fuerza de unión de los sistemas adhesivos es aún muy controversial. Objetivo: Determinar la fuerza de unión de dos adhesivos universales en dentina previa aplicación de la clorhexidina al 2 % en tiempos de aplicación diferentes. Métodos: Se empleó treinta incisivos y se desgastó la superficie vestibular para exponer la dentina. Posteriormente, se dividió aleatoriamente en seis grupos (n = 5). Se emplearon los adhesivos Single Bond Universal (SBU) y All-Bond Universal (ABU) con/sin clorhexidina. Grupo SBU-0: Single Bond Universal; Grupo SBU-30: clorhexidina por 30 segundos + Single Bond Universal; Grupo SBU-60: clorhexidina por 60 segundos + Single Bond Universal; Grupo ABU-0: All-Bond Universal; Grupo ABU-30: clorhexidina por 30 segundos + All-Bond Universal y Grupo ABU-60: clorhexidina por 60 segundos + All-Bond Universal. La resistencia adhesiva se analizó mediante ANOVA mixto de dos factores y post hoc de Tukey (p < 0,05). Resultados: La fuerza de unión para el grupo SBU-60 aumentó significativamente respecto al grupo control (p = 0,032). Igualmente, para los grupos ABU-30 y ABU-60, la fuerza de unión aumentó significativamente respecto al grupo control (p = 0,001) y (p = 0,000), respectivamente. Conclusión: La aplicación previa de clorhexidina al 2 % durante 60 segundos aumenta la fuerza de unión de los sistemas adhesivos Single Bond Universal y All-Bond Universal.

Introduction: The influence of chlorhexidine on the bond strength of adhesive systems is still very controversial. Objective: To determine the bond strength of two universal adhesives on dentin after application of 2% chlorhexidine at different application times. Methods: Thirty incisors were used and the vestibular surface was abraded to expose the dentin. Subsequently, they were randomly divided into six groups (n = 5). Single Bond Universal (SBU) and All-Bond Universal (ABU) adhesives with/without chlorhexidine were used. Group SBU-0: Single Bond Universal; Group SBU-30: chlorhexidine for 30 seconds + Single Bond Universal; Group SBU-60: chlorhexidine for 60 seconds + Single Bond Universal; Group ABU-0: All-Bond Universal; Group ABU-30: chlorhexidine for 30 seconds + All-Bond Universal and Group ABU-60: chlorhexidine for 60 seconds + All-Bond Universal. Adhesive strength was analyzed by two-factor mixed ANOVA and Tukey's post hoc (p < 0.05). Results: The bond strength for the SBU-60 group increased significantly with respect to the control group (p = 0.032). Similarly, for the ABU-30 and ABU-60 groups, the bond strength increased significantly with respect to the control group (p = 0.001) and (p = 0.000), respectively. Conclusion: Pre-application of 2% chlorhexidine for 60 seconds increases the bond strength of Single Bond Universal and All-Bond Universal adhesive systems.

Effect of composite radiopacity and margin location of the restoration on the diagnosis of secondary caries

Abstract This research aimed to evaluate the effect of the radiopacity of a Bulk-Fill composite (X-TraFil, VOCO, Germany) and a Conventional composite (P60, 3M ESPE, USA) and assessment of the margin location in the enamel and dentin on the diagnosis of secondary caries. 76 intact premolars with MOD preparation were divided into two equal groups and filled with the conventional and bulk-fill composite. Four regions were considered to simulate carious lesions (two regions in enamel and two regions in dentin). In each group, half of the regions in the dentin and half in the enamel were randomly selected for secondary caries simulation and filled with a wax-plaster combination while the remaining regions stayed intact. Bitewing imaging was done using the PSP digital sensor. Five examiners reviewed the images, and lesions were recorded. Caries diagnosis indicators and paired-sample t-test were used for statistical analysis. The reproducibility and accuracy of the examiners' responses were evaluated using the kappa and agreement coefficient (α=0.05). The sensitivity, specificity, and accuracy of diagnosing secondary carious lesions in enamel were significantly better under conventional than bulk-fill composite. Similarly, the sensitivity and accuracy of diagnosing secondary caries in dentin were significantly higher under conventional composite than bulk-fill composite (p<0.05). No significant differences were found in the agreement and kappa coefficient between conventional and bulk-fill composites in the enamel and dentin (p>0.05). The diagnostic accuracy of carious lesions was higher under conventional composite than bulk-fill composite. However, the location of the secondary was ineffective in caries diagnosis.

Resumo Essa pesquisa teve como objetivo avaliar o efeito da radiopacidade de resina composta Bulk-Fill (X-TraFil, VOCO, Alemanha) e de resina composta convencional (P60, 3M ESPE, EUA) e a avaliação da localização da margem no esmalte e na dentina no diagnóstico de cárie secundária. 76 pré-molares intactos com preparo MOD foram divididos em dois grupos iguais e restaurados de acordo com o grupo experimental. Quatro regiões foram consideradas para simular lesões de cárie (duas regiões no esmalte e duas regiões na dentina). Em cada grupo, metade das regiões na dentina e metade no esmalte foram selecionadas aleatoriamente para a simulação de cárie secundária e preenchidas com uma combinação de cera e gesso, enquanto as regiões restantes permaneceram intactas. As imagens de bitewing foram feitas usando o sensor digital PSP. Cinco examinadores analisaram as imagens, e as lesões foram registradas. Os indicadores de diagnóstico de cárie e o teste t de amostra pareada foram usados para análise estatística. A reprodutibilidade e a precisão das respostas dos examinadores foram avaliadas usando o kappa e o coeficiente de concordância (α=0,05). A sensibilidade, a especificidade e a precisão do diagnóstico de lesões cariosas secundárias no esmalte foram significativamente melhores com a resina composta convencional do que com a resina composta bulk-fill. Da mesma forma, a sensibilidade e a precisão do diagnóstico de cáries secundárias na dentina foram significativamente maiores com a resina convencional do que com a resina bulk-fill (p<0,05). Não foram encontradas diferenças significativas na concordância e no coeficiente kappa entre as resinas convencionais e bulk-fill no esmalte e na dentina (p>0,05). A precisão do diagnóstico de lesões cariosas foi maior com a resina composta convencional do que com a resina composta bulk-fill. Entretanto, a localização do secundário foi ineficaz no diagnóstico de cárie.

Longitudinal bond strength of a universal adhesive and chemical dentin characterization under different acid etching protocols

Abstract Objective This study aimed to analyze the longitudinal bond strength of a universal adhesive and chemically characterize the dentin substrate under different acid etching protocols. Methodology Dentin samples were etched with polyacrylic acid 25% (PAA) for 10 seconds (n=3) and phosphoric acid 32% (PA) for 15 seconds (n=3) and analyzed by Fourier transform infrared spectroscopy - attenuated total reflectance (FTIR-ATR) before and after treatment. For collagen degradation, samples (n=12) were divided into 3 groups: PAA, PA, and Deionized water (control), and analyzed by the quantity of solubilized type I collagen C-terminal cross-linked telopeptides and solubilized C-terminal peptide in relation to total protein concentration (ICTPtp and CTXtp) and by their ultimate tensile strength (UTS). For the adhesive interface analysis, dentin samples (n=72) were divided into 3 groups: PAA, PA, and Self-etch (SE), and subdivided into 2 groups: 24 h (baseline) and 1 year. The following tests were performed: microtensile bond strength (μTBS) (n=48), scanning electron microscopy (SEM) (n=12), and nanoleakage (n=12). Results The FTIR of PAA showed lower reduction of the peaks in the phosphate group when compared to PA. For ICTPtp, PA showed a significantly higher value. For CTXtp, PA and PAA groups failed to statically differ from each other. UTS was significantly lower for PA. For μTBS, storage time significantly affected bond strength. The results were unaffected by the etching protocol. For SEM, after 1 year, PA had little evidence of degradation in the upper third of the adhesive interface in comparison to the other groups. Nanoleakage showed no considerable silver impregnation after 1 year in the SE group. Conclusion The use of PAA prior to a universal adhesive (when compared to PA) represents a less aggressive type of etching to dentin. However, self-etching still seems to be the best option for universal adhesive systems that have functional monomers in their composition.

Stability of dentin matrix treated with caffeic acid phenethyl ester at different concentrations

Aim: The aim of this study was to investigate the impact of pretreatment with ethanolic solutions of caffeic acid phenethyl ester (CAPE) at varying concentrations on the dentin collagen matrix, specifically focusing on its biomodification potential. This was assessed through evaluations of the modulus of elasticity and changes in mass. Methods: Seventy dentin collagen matrices (demineralized sticks) were prepared to receive treatments with ethanolic solutions of CAPE at concentrations of 0.05%, 0.1%, 0.5%, or 2.5%, or with control treatment solutions (distilled water or ethanol) for one hour. The dentin matrices were evaluated for modulus of elasticity and mass before (baseline), immediately after treatment (immediately), and after storage in Simulated Body Fluid (SBF) for time intervals of 1 and 3 months. Results: Generalized linear models for repeated measures over time indicated no significant differences between groups (p=0.7530) or between different time points (p=0.4780) in terms of the modulus of elasticity. Regarding mass variation, no differences were observed in the time interval between 1 month and the immediate time (p=0.0935). However, at the 3-month mark compared to the immediate time, the 0.1% CAPE group exhibited less mass loss compared to the water group (p=0.0134). Conclusion: This study concludes that various concentrations of CAPE in an ethanolic solution did not affect the modulus of elasticity of dentin, suggesting that CAPE lacks biomodifying potential in this context. However, it was observed that 0.1% CAPE positively influenced the variation in mass over different evaluation time intervals

Research progress on the mechanical compatibility of restorative materials with dental tissue / 口腔疾病防治

@#As the main means of mastication, teeth can withstand countless functional contacts. The mechanical properties of teeth are closely related to their tissue structure. Enamel and dentin have a high hardness and modulus of elasticity, and their graded structure allows them to withstand bite forces without being susceptible to fracture. When tooth tissue is defective, full crown restoration is often needed to restore the normal shape and function of the tooth. Metal materials, ceramic materials, and polyetheretherketone (PEEK) materials are commonly used for crown restoration. Metal materials have certain disadvantages in terms of aesthetics and are relatively rarely used in clinical practice. Ceramic materials with different compositions exhibit differences in performance and aesthetics, but their elastic modulus and hardness are much higher than those of dental tissue, resulting in mismatching mechanical properties. In contrast, the elastic modulus of PEEK is lower than that of tooth tissue and similar to that of bone tissue, but its properties can be improved by fiber reinforcement. Notably, when the mechanical properties of a restoration material and tooth tissue are not fully matched, the interface between them often forms a potential weak link, which ultimately affects the stability and long-term effect of the restoration. This article introduces the mechanical properties and corresponding structural characteristics of enamel and dentin. On this basis, the advantages and limitations of existing restoration materials are analyzed, and the possibility of biomimetic design of full crowns is further explored.

Efeito protetor de enxaguatórios com diferentes fluoretos utilizados previamente aos desafios erosivos/abrasivos em esmalte e dentina / Protective effect of solutions with different fluorides used previously to erosive/abrasive challenges in enamel and dentin

Aim: To evaluate the protection offered by commercial mouthwashes containing sodium fluoride or stannous chloride associated with sodium fluoride to enamel and dentin, prior to erosive and abrasive cycling. Materials and Methods: Enamel and dentin samples were obtained from bovine incisors and subdivided into 3 groups (n=10), according to the fluoridated ingredient tested: FS (sodium fluoride - NaF (225 ppm)); FE (tin fluoride - NaF + SnCl2 (800 ppm Sn2+)); control (distilled water). The samples were submitted to an erosive/abrasive cycle with immersion in citric acid (lemon soda for 5 min, 4×/day, 5 days, with remineralization intervals in artificial saliva for 60 min). Abrasion was carried out with an electric brush (200 g/force) after the first and last cycles, 2x/day, and immediately afterward immersed in the tested solutions. Structure loss was obtained by optical profilometry. The data were subjected to analysis of variance and multiple comparison for each substrate separately. Results: For enamel there was a difference between the groups (p = 0.027), with the FS showing less loss of structure compared to the control 2.02 (±0.48). The FE group showed similar loss to the control and FS 2.32 (±0.58)ab. For dentin there was a difference between the groups (p = 0.011), with FE showing less loss of structure compared to the other groups, 0.82 (25% - 0.34; 75% - 0.95). Discussion: The protection of fluorides in erosive/abrasive challenges depends on the type and dental substrate. Conclusion: Mouthwash with sodium fluoride prior to erosive/abrasive challenges caused less loss of enamel surface, while for dentin, sodium fluoride associated with stannous chloride caused less loss of structure.

Objetivo: Avaliar a proteção oferecida por soluções para bochecho de fluoreto de sódio ou cloreto de estanho associado ao fluoreto de sódio ao esmalte e à dentina, previamente à ciclagem erosiva e abrasiva. Materiais e Métodos: Amostras de esmalte e dentina foram obtidas a partir de incisivos bovinos e subdivididas em 3 grupos (n=10), de acordo com o princípio ativo fluoretado testado: FS (fluoreto de sódio - NaF (225 ppm)); FE (fluoreto de estanho - NaF + SnCl2 (800 ppm Sn2+)); controle (água destilada). As amostras foram submetidas a um ciclo erosivo/abrasivo com imersão em ácido cítrico (refrigerante de limão por 5 min, 4×/dia, 5 dias, com intervalos de remineralização em saliva artificial por 60 min). A abrasão foi realizada com escova elétrica (200 g/força) após o primeiro e o último ciclos, 2×/dia, e logo em seguida imersos nas soluções testadas. A perda de estrutura foi obtida por perfilometria óptica. Os dados foram submetidos à análise de variância e comparação múltipla para cada substrato separadamente. Resultados: Para esmalte houve diferença entre os grupos (p = 0,027), tendo o FS apresentados menor perda de estrutura comparado ao controle 2,02 (±0,48). O grupo FE apresentou perda similar ao controle e ao FS 2,32 (±0,58)ab. Para dentina houve diferença entre os grupos (p = 0,011), sendo que o FE apresentou menor perda de estrutura comparado aos demais grupos 0,82 (25% - 0,34; 75% - 0,95). Discussão: A proteção dos fluoretos em desafios erosivos/abrasivos depende do tipo e do substrato dental. Conclusão: O bochecho com fluoreto de sódio previamente aos desafios erosivos/abrasivos apresentou menor perda de superfície em esmalte, enquanto para dentina o fluoreto de sódio associado ao cloreto de estanho apresentou menor perda de estrutura.

Dental age estimation by assessing the pulp volume of five teeth in a peruvian population using cone beam computed tomography images / Estimación de la edad dental evaluando el volumen pulpar de cinco dientes utilizando imágenes de tomografías computarizadas de haz cónico en una población peruana

Abstract Dental age estimation is very important for individual identification in criminal and civil forensic investigations. One of the methods for age estimation is studying age related changes in pulp volume of teeth. The objective of the current study was to estimate dental age from the pulp volume of five different categories of teeth of a Peruvian sample using cone beam computed tomography (CBCT). Retrospective CBCT records of 231 patients (females (134), males (97), age: 12-60 years) were included in the study, categorized into five different age groups (12-19, 20-29, 30-39, 40-49, 50-59, 60 years and older). Dental pulp volume of five categories of teeth(upper canines, left upper central incisors, left upper first molars, lower left first premolars, first molars) were analyzed using Romexis® 5.3.3.5 software for each patient. There was a reduction in the pulp volume of upper right and left canine with age. The Pulp volume was lowest in people aged 60 years and over. Linear regression analysis of the pulp volume and chronological age showed a coefficient of determination of 30%, suggesting a weak correlation. A weak correlation between dental pulp and age is derived. But, a robust large homogenous sample of teeth in future for different age groups may establish a reliable regression equation.

Resumen La estimación de la edad dental en personas vivas y cadáveres es muy importante para la Odontología Forense, sobre todo en casos de identificación en investigaciones legales y sociales. El objetivo del estudio fue estimación de la edad dental mediante la medición del volumen pulpar de imágenes dentales en tomografía computarizada de haz cónico (TCHC) de pacientes peruanos. Fueron analizadas 231 TCHC de pacientes entre 12 a 60 años a más. (Mujeres (134), hombres (97)) se dividieron en seis grupos de edad (12-19, 20-29, 30-39, 40-49, 50-59, 60 años a más). El análisis volumétrico de la pulpa dental se realizó en un total de 1155 dientes (caninos superiores, incisivos centrales superiores izquierdos, primeros molares superiores izquierdos y primeros premolares inferiores izquierdos), mediante el software Romexis® 5.3.3.5. El análisis de regresión lineal mostró un coeficiente de determinación del 30% que sugiere una correlación débil entre la relación del volumen pulpar de los dientes y la edad. El volumen pulpar de los caninos superiores derecho e izquierdo disminuyó a medida que aumentaba la edad y el volumen pulpar en dientes de personas de 60 años a más fue el más bajo. Sin embargo, se pueden proponer estudios futuros para incluir una gran muestra homogénea de dientes en diferentes categorías y grupos de edad para confirmar la correlación y establecer una ecuación de regresión confiable.

Continuous Wave of Condensation Improves the Filling of Curved Canals: a Micro-CT Study / La condensación de onda contínua mejora el selle de canales curvos: un estudio de micro-CT

Abstract The aim of this study was to compare the filling capacity in curved root canal using a new continuous wave of condensation technique (Termo Pack II, Easy Dental Equipments, Brazil) or lateral compaction. The percentage of voids in the filling of mesial root canals of mandibular molars was assessed by micro-computed tomography (micro-CT). Mesial root canals (n=24) of mandibular molars with a degree of curvature between 20° and 40° were prepared using rotary system (ProDesign Logic, Easy, Brazil) up to #35, .05 taper. The root canals were filled by using the continuous wave of condensation system or lateral compaction and AH Plus sealer (n=12). Scanning at 9 µm was performed after preparation and after filling by using micro-CT SkyScan 1176. The volumetric percentage of filling material and voids (total length and in each root canal third) were calculated. Data were analyzed using ANOVA/ Tukey and Student's t tests (α=0.05). Before the filling techniques, the root canals volume after preparation was similar (p>0.05). The root canals filled by the continuous wave of condensation technique presented the lowest percentage of voids, and the greatest percentage of filling material in total length and thirds (cervical, middle and apical) (p<0.05). Both techniques were not able of completely filling the root canals. The continuous wave of condensation technique Termo Pack II promoted better root canal filling in curved root canals, when compared with lateral compaction.

Resumen El objetivo de este estudio fue comparar la capacidad de obturación en conductos radiculares curvos utilizando una nueva técnica de condensación de onda continua (Termo Pack II, Easy Dental Equipments, Brasil) vs compactación lateral. El porcentaje de brechas en la obturación de los conductos radiculares mesiales de los molares mandibulares se evaluó mediante microtomografía computarizada (micro-CT). Se prepararon conductos radiculares mesiales (n=24) de molares mandibulares con un grado de curvatura entre 20° y 40° utilizando un sistema rotatorio (ProDesign Logic, Easy, Brasil) al #35, conicidad 0,05. Los conductos radiculares se obturaron utilizando un sistema de condensación de onda contínua o compactación lateral y cemento AH Plus (n=12). Se realizó un escaneo de 9 µm después de la preparación y después de la obturación usando el micro-CT SkyScan 1176. Se calculó el porcentaje volumétrico de material de obturación y vacíos (longitud total y en cada tercio del conducto radicular). Los datos se analizaron utilizando las pruebas ANOVA/Tukey y t de Student (α=0,05). Antes de las técnicas de obturación, el volumen de los conductos radiculares después de la preparación fue similar (p>0,05). Los conductos radiculares obturados con la técnica de condensación por onda contínua presentaron el menor porcentaje de vacíos y el mayor porcentaje de material de obturación en longitud total y en tercios (cervical, medio y apical) (p<0,05). Ambas técnicas no fueron capaces de llenar completamente los conductos radiculares. La técnica de condensación de onda contínua Termo Pack II promovió un mejor relleno del conducto radicular en conductos radiculares curvos en comparación con la compactación lateral.

Comparación del grado de microfiltración en tres sistemas restauradores utilizando adhesivos universales: estudio in vitro / Comparison of the degree of microleakage in three restorative systems using universal adhesives: an in vitro study / Comparação do grau de microinfiltração em três sistemas de restauração com adesivos universais: um estudo in vitro

RESUMEN Las resinas compuestas son el material más utilizado para restauraciones en la última década. Para colocarlas es necesario usar un sistema adhesivo que sirva de agente de unión entre la estructura dentaria y la restauración. Es ahí donde se colocan los sistemas adhesivos universales. Sin embargo, uno de los principales problemas en las restauraciones es la microfiltración. Esta se define como el paso de bacterias o fluidos entre el material restaurador y la cavidad preparada. Objetivo: Comparar el grado de microfiltración entre tres sistemas restauradores utilizando adhesivos universales antes y después del proceso de termociclado. Material y métodos: Estudio experimental in vitro cuya muestra fue de 120 piezas anteriores de bovinos. Se utilizaron tres marcas de sistemas restauradores para realizar restauraciones clase V: 3M®, FGM® e Ivoclar®. Cada marca contó con un grupo control y un grupo experimental. Los grupos experimentales fueron sometidos a un proceso de termociclado. Seguido de ello, la totalidad de la muestra fue sumergida en azul de metileno durante 24 horas para su posterior corte y observación en el microscopio. Resultados: El sistema restaurador de la marca Ivoclar® demostró un menor grado de microfiltración en comparación con los sistemas restauradores de las marcas 3M® y FGM®. La prueba de chi-cuadrado demostró diferencia significativa entre los grupos control y experimental. Conclusiones: Existe diferencia significativa en el grado de microfiltración en las restauraciones clase V utilizando tres sistemas restauradores con adhesivos universales antes y después del termociclado.

ABSTRACT Composite resins are the most widely used material for restorations in the last decade. An adhesive system is required to serve as a bonding agent between the tooth structure and the restoration, and universal adhesive systems are used. However, one of the main problems in restorations is microleakage, defined as the passage of bacteria or fluids between the restorative material and the prepared cavity. Objective: To compare the degree of microleakage between three restorative systems using universal adhesives before and after the thermocycling process. Material and methods: Experimental in vitro study with a sample of dental anterior pieces of 120 bovines. Three brands of restorative systems were used for class V restorations: 3M®, FGM®, and Ivoclar®. Each brand had a control group and an experimental group. The experimental groups were subjected to a thermocycling process. After that, the sample was immersed in methylene blue for 24 hours for subsequent cutting and observation under the microscope. Results: The Ivoclar® brand restorative system showed lower microleakage than the 3M® and FGM® brand restorative systems. The chi-square test showed a significant difference between the control and experimental groups. Conclusions: There is a significant difference in the degree of microleakage in Class V restorations using three restorative systems with universal adhesives before and after thermocycling.

RESUMO As resinas compostas são o material mais utilizado para restaurações na última década. Para a sua colocação, é necessário utilizar um sistema adesivo que sirva de agente de ligação entre a estrutura dentária e a restauração. É aqui que são colocados os sistemas adesivos universais. No entanto, um dos principais problemas nas restaurações é a microinfiltração. A microinfiltração é definida como a passagem de bactérias ou fluidos entre o material de restauração e a cavidade preparada. Objetivo: Comparar o grau de microinfiltração entre três sistemas restauradores utilizando adesivos universais antes e depois do processo de termociclagem. Material e métodos: Estudo experimental in vitro com uma amostra de 120 unidades de dentes anteriores de bovinos. Foram utilizadas três marcas de sistemas restauradores para restaurações de classe V: 3M®, FGM® e Ivoclar®. Cada marca tinha um grupo de controlo e um grupo experimental. Os grupos experimentais foram submetidos a um processo de termociclagem. Em seguida, toda a amostra foi imersa em azul de metileno durante 24 horas para posterior corte e observação ao microscópio. Resultados: o sistema restaurador Ivoclar® apresentou um menor grau de microinfiltração em relação aos sistemas restauradores 3M® e FGM®. O teste do Qui-quadrado mostrou uma diferença significativa entre o grupo de controlo e o grupo experimental. Conclusões: Existe uma diferença significativa no grau de microinfiltração em restaurações de classe V utilizando três sistemas de restauração adesivos universais antes e depois da termociclagem.

PREVENTIVE EFFECT OF CRANBERRY GEL ON DENTIN SUBMITTED TO EROSION

Aims: Considering that Cranberry's components might inhibit dentin metalloproteinases exposed to erosive agents, the aim of this study was to evaluate in situeffect of a Cranberry gel application on dentin before an erosive challenge.Materials and methods: This crossover double-blinded study was performed in 2 phases of 5 days each, with 10 healthy volunteers who wore 2 palatal devices (1 for each phase) with 4 dentin specimens (2 specimens for each group). The groups under study were:First Phase: G1 -Erosivechallenge (Coca-cola®) over dentin without any previous treatment (1st negative control group); G2 -Erosive challenge over dentin previously treated with Cranberry gel (test group); and Second Phase: G3 -Erosive challenge over dentin previously treated with a gel without any active principle (2ndnegative control group); G4 -Erosive challenge over dentin previously treated with 0.12% Chlorhexidine gel (positive control group). Each device was immersed into the acid beverage, 3 times daily for 5 minutes during 5 days. Profilometry (µm) was used to quantify the dentin wear. Data were analyzed by Repeated Measures Analysis of Variance followed by Fisher's test (p<0.05).Results: Data (G1: 4.98 ± 1.36a; G2: 3.29 ± 1.16b; G3: 4.38 ± 1.19a; G4: 3.32 ± 1.55b) showed no statistical difference between G1 and G3. There was also no difference between G2 and G4. However, G2 and G4 presented lower wear when compared to G1 and G3, and this difference was statistically significant. Conclusion: The results of this studysuggest a significant efficacy of Cranberry gel in preventing wear of dentin subjected to dental erosion.

The potential of galactomannan from Caesalpinia ferrea on erosive dentin wear reduction in vitro

Abstract Gels containing juca seed galactomannan (JSG) were evaluated for their potential to prevent the progression of dentin erosive wear in an in vitro study with four experimental groups (n = 9). The treatments included distilled water (DW), 0.05% stannous fluoride (121 ppm F), and 0.5% or 1% JSG. The specimens underwent a cycle (3 times/day) consisting of immersion in 1% citric acid (5 minutes), treatment (5 minutes), and artificial saliva exposure (2 hours/overnight) for 5 days. Surface changes were assessed using mechanical profilometry (wear), scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy (EDS). The data were analyzed using ANOVA followed by Tukey's post-test (p < 0.05). The negative control group exhibited the highest wear (6.0 µm ± 3.5), significantly differing from the group treated with 0.05% stannous fluoride gel (p = 0.007), which showed less dentin loss. The groups treated with 0.5% and 1% JSG showed results similar to the negative control (p = 0.661; p = 0.212, respectively) and the stannous fluoride group (p = 0.103; p = 0.379, respectively). In the SEM images, the specimen treated with stannous fluoride showed obliterated tubules, while the JSG gels formed crystals on the dentin surface, as confirmed by the presence of oxygen and calcium in the EDS analysis. Although the JSG gels showed similar results to the stannous fluoride, did not exhibit superior efficacy at the tested concentrations.

Resumo Géis contendo galactomanana da semente de jucá (GSJ) foram avaliados quanto ao seu potencial na prevenção da progressão do desgaste erosivo dentinário em um estudo in vitro com quatro grupos experimentais (n = 9). Os tratamentos incluíram água destilada (AD), 0,05% de fluoreto de estanho (121 ppm F) e 0,5% ou 1% de GSJ. Os espécimes passaram por um ciclo (3 vezes ao dia) que consistia em imersão em ácido cítrico 1% (5 minutos), tratamento (5 minutos) e exposição a saliva artificial (2 horas/durante a noite) por 5 dias. As alterações de superfície foram avaliadas utilizando perfilometria mecânica (desgaste), microscopia eletrônica de varredura (MEV) e espectroscopia de raios-X por dispersão de energia (EDS). Os dados foram analisados por ANOVA, seguida do pós-teste de Tukey (p < 0,05). O grupo controle negativo apresentou o maior desgaste (6,0 µm ± 3,5), diferindo significativamente do grupo tratado com gel de fluoreto de estanho a 0,05% (p = 0,007), que apresentou menor perda de dentina. Os grupos tratados com 0,5% e 1% de GSJ apresentaram resultados semelhantes ao grupo controle negativo (p = 0,661; p = 0,212, respectivamente) e ao grupo de fluoreto de estanho (p = 0,103; p = 0,379, respectivamente). Nas imagens de MEV, o espécime tratado com fluoreto de estanho mostrou túbulos obliterados, enquanto os géis GSJ formaram cristais na superfície da dentina, como confirmado pela presença de oxigênio e cálcio na análise de EDS. Embora os géis GSJ tenham apresentado resultados semelhantes ao fluoreto de estanho, eles não demonstraram eficácia superior nas concentrações testadas.

Qualitative Characterization of the Abrasive Component of Charcoal-Containing Toothpastes and the Effect on Dentin Roughness / Caracterización Cualitativa del Componente Abrasivo de las Pastas Dentales que Contienen Carbón Vegetal y la Rugosidad de la Dentina

This study investigated the effect of commercially available whitening toothpastes containing charcoal on dentin. Nine charcoal-containing toothpastes were compared with 3 whitening toothpastes (positive control) and distilled water (negative control). Periodontally hopeless molars were cleaned and washed and the occlusal table removed to expose dentin. The teeth were mounted in auto-polymerizing resin and exposed dentine surfaces polished with water-cooled decreasing grits of silica carbide paper up to 1500 grit. Baseline average roughness (Ra) measurements were taken. Specimens were then mounted in an automatic tooth-brushing machine and brushed for 5000 cycles. Repeat Ra measurements were taken. Specimens were brushed in 5000-cycle increments up to 25,000 cycles with Ra measurements being taken at each time point. Between abrasive challenges specimens were stored in distilled water. All toothpaste samples were sputter coated and examined under a scanning electron microscope to qualify the shape and size of the abrasive components of the formulations. Data were analyzed using a two-way analysis of variance with post hoc Bonferroni. The results demonstrated that the abrasive effect, in terms of increasing Ra, on dentin was noted as early as 5000 cycles for all the tested toothpastes (p<0.05). The effect of continued brushing showed an overall cumulative effect on dentine roughness up to 25000 cycles. When toothpastes were compared between groups at each time-point, dentin specimens brushed with Pursito were statistically similar to the control group. At 25,000 cycles all dentin samples were significantly rougher compared to Pursito and the control groups. It may be concluded that all the tested toothpastes have an abrasive effect on dentin surfaces.

Este estudio investigó el efecto sobre la dentina de las pastas dentales blanqueadoras disponibles en el mercado que contienen carbón vegetal. Se compararon nueve dentífricos que contenían carbón vegetal con 3 dentífricos blanqueadores (control positivo) y agua destilada (control negativo). Los molares sin material periodontal se limpiaron y lavaron y se retiró la tabla oclusal para exponer la dentina. Los dientes se montaron en resina autopolimerizable y las superficies expuestas de la dentina se pulieron con papel de carburo de sílice de grano decreciente enfriado con agua hasta grano 1500. Se tomaron medidas de rugosidad promedio (Ra) de referencia. Luego, las muestras se montaron en una máquina automática de cepillado de dientes y se cepillaron durante 5000 ciclos. Se tomaron medidas repetidas de Ra. Las muestras se cepillaron en incrementos de 5000 ciclos hasta 25 000 ciclos y se tomaron medidas de Ra en cada punto de tiempo. Entre periodos abrasivos, las muestras se almacenaron en agua destilada. Todas las muestras de pasta de dientes se recubrieron por pulverización catódica y se examinaron bajo un microscopio electrónico de barrido para calificar la forma y el tamaño de los componentes abrasivos de las formulaciones. Los datos se analizaron utilizando un análisis de varianza de dos vías de Bonferroni post hoc. Los resultados demostraron que el efecto abrasivo, en términos de aumento de Ra, sobre la dentina se notó ya en 5000 ciclos para todas las pastas dentales probadas (p<0,05). El efecto del cepillado continuo mostró un efecto acumulativo general sobre la rugosidad de la dentina hasta 25.000 ciclos. Cuando se compararon las pastas dentales entre los grupos en cada momento, las muestras de dentina cepilladas con Pursito fueron estadísticamente similares al grupo de control. A los 25.000 ciclos, todas las muestras de dentina eran significativamente más ásperas en comparación con Pursito y los grupos controles. Se puede concluir que todas las pastas dentales probadas tienen un efecto abrasivo sobre las superficies dentinarias.

Demineralized dentin matrix technique - a comparison of different demineralizing solutions

Abstract This study aimed to evaluate the microstructure formed after the chemical treatment of teeth, for the development of autogenous grafts from the demineralized dentin matrix (DDM) technique, in order to identify the most efficient demineralizing solution. The specimens, originating from the root and coronal portion, were submitted to ultrasonic cleaning and drying in an oven for 1h at 100 ºC. Then, the density was determined by Archimedes' principle for each specimen, using distilled water as immersion liquid. The samples were separated into five groups: Control group: negative control, Distilled water;EDTA group: positive control, trisodium EDTA; NaOCl group: 2.5% sodium hypochlorite; HCl-0.6M group: 0.6M hydrochloric acid; and H2O2/H2SO4 group: hydrogen peroxide and sulfuric acid. Each specimen was immersed for 1h in the corresponding group descaling solution at 60 ºC. Subsequently, the mass loss and density of the treated specimens were determined by Archimedes' principle. Ultimately, the specimens of each group were characterized by microtomography, Scanning Electron Microscopy, and Energy Dispersive Spectrometry X-ray (SEM-EDS). The results demonstrated that the H2O2/H2SO4 solution allowed the formation of interconnected micropores, suggesting better pore structures for application in scaffolds, when compared to the other studied solutions.

Resumo Este estudo teve como objetivo avaliar a microestrutura formada após o tratamento químico em dentes, para o desenvolvimento de enxertos autógenos a partir da técnica de matriz de dentina desmineralizada (DDM), a fim de identificar a solução desmineralizante mais eficiente. Os espécimes, provenientes da raiz e porção coronal, foram submetidos à limpeza ultrassônica e secagem em estufa por 1h a 100 ºC. Em seguida, a densidade foi determinada pelo princípio de Arquimedes para cada espécime, utilizando água destilada como líquido de imersão. As amostras foram separadas em cinco grupos: Controle: controle negativo, Água destilada; EDTA: controle positivo, EDTA trissódico; NaOCl: hipoclorito de sódio 2,5%; HCl-0.6M: ácido clorídrico 0,6M; e H2O2/H2SO4: peróxido de hidrogênio e ácido sulfúrico. Cada espécime foi imerso por 1h na solução descalcificante de grupo correspondente a 60 ºC. Posteriormente, a perda de massa e a densidade dos espécimes tratados foram determinadas pelo princípio de Arquimedes. Por fim, os espécimes de cada grupo foram caracterizados por microtomografia, microscopia eletrônica de varredura e espectrometria de energia dispersiva de raios-X (SEM-EDS). Os resultados demonstraram que a solução H2O2/H2SO4 permitiu a formação de microporos interligados, sugerindo melhores estruturas de poros para aplicação em scaffolds, quando comparada às demais soluções estudadas.

Root filling quality and bond strength of endodontic sealers to human and bovine dentin / Qualidade da obturação e resistência de união de cimentos endodônticos à dentina humana e bovina

Objetivo: Este estudo teve como objetivo comparar a qualidade da obturação e a resistência de união de dois cimentos endodônticos, AH Plus e Bio-C Sealer, em dentes humanos e bovinos. Métodos: Os canais radiculares de 60 dentes unirradiculares [30 humanos (H) e 30 bovinos (B)] foram preparados e obturados por condensação lateral da guta-percha e AH Plus (grupos AP-H e AP-B) ou Bio-C Sealer (grupos BC-H e BC-B). Seis fatias de 1,5 mm de espessura foram obtidas de cada raiz. Os espécimes foram observados em estereomicroscópio para avaliar a qualidade da obturação, considerando possíveis espaços vazios no material obturador. Posteriormente, as fatias radiculares foram avaliadas em termos de resistência de união por push-out e modo de falha. Os dados foram analisados pelos testes de Mann-Whitney e coeficientes de correlação de Spearman (α=5%). Resultados: A qualidade de obturação fornecida por AP e BC foi semelhante em ambos os substratos de dentina. No entanto, ao comparar dentes humanos e bovinos, os escores de espaços vazios foram maiores nas amostras bovinas, para ambos os cimentos. AP teve maior resistência de união à dentina humana e bovina do que BC. No entanto, não houve diferença significativa na resistência de união entre os substratos dentinários, para ambos os cimentos testados. Além disso, houve uma correlação positiva e moderada entre os valores de resistência de união de dentes humanos e bovinos. O modo de falha misto foi o mais prevalente. Conclusão: AP e BC fornecem qualidade de obturação semelhante, mas o primeiro apresenta maiores valores de resistência de união à dentina humana e bovina. A utilização de dentes bovinos como substitutos de amostras humanas parece ser adequada em estudos relacionados à resistência de união, mas não naqueles que testam a qualidade da obturação endodôntica.(AU)

Objective: This study aimed to compare the filling quality and bond strength of two endodontic sealers, AH Plus and Bio-C Sealer, in human and bovine teeth. Methods: The root canals of 60 [30 human (H) and 30 bovine (B)] single-rooted teeth were prepared and filled by lateral condensation of gutta-percha and AH Plus (groups AP-H and AP-B) or Bio-C Sealer (groups BC-H and BC-B). Six 1.5-mm-thick slices were obtained from each root. The specimens were observed under a stereomicroscope to assess filling quality, considering possible voids within the filling material. Subsequently, root slices were evaluated in terms of push-out bond strength and failure mode. Data were analyzed by Mann-Whitney tests and Spearman correlation coefficients (α=5%). Results: The filling quality provided by AP and BC was similar in both dentin substrates. However, when comparing human and bovine teeth, void scores were greater in the bovine samples, for both sealers. AP had higher bond strength to human and bovine dentin than BC. However, there was no significant difference in bond strength between dentin substrates, for both sealers tested. Also, there was a positive and moderate correlation between the bond strength values of human and bovine teeth. The mixed failure mode was the most prevalent. Conclusion: AP and BC provide similar filling quality, but the first presents higher bond strength values to human and bovine dentin. The use of bovine teeth as substitutes for human samples seems adequate in studies related to bond strength, but not in those testing root canal filling quality.(AU)

Effect of voxel size of Micro-CT on the assessment of root canal preparation

The aim of this study was to assess the influence of micro-computed tomography (micro-CT) voxel size on evaluation of root canal preparation using rotary heat-treated nickel-titanium files. Curved mesial root canals of mandibular molars were prepared using ProDesign Logic 30/.05 (PDL) or HyFlex EDM 25/.08 (HEDM) (n=12). The specimens were scanned using micro-CT with 5μm of voxel size before and after root canal preparation. Images with sub-resolution of 10 and 20μm voxel sizes were obtained. The percentage of volume increase, debris and uninstrumented root canal surface were analyzed in the different voxel sizes. Data were compared using unpaired Student's t-test and ANOVA statistical tests (α=0.05). No differences were observed for percentage of volume increase, debris and instrumented surface between the root canals prepared by PDL and HEDM (p>0.05). Both systems promoted higher percentage of debris in the apical third compared to the middle third (p0.05). PDL and HEDM had similar root canal preparation capacity. Micro-CT images using different voxel sizes did not influence the results of volume increase and debris evaluation. However, images at 5µm showed greater accuracy to evaluate the percentage of uninstrumented surfaces.

El objetivo de este estudio fue evaluar la influencia del tamaño de vóxel de la microtomografía computarizada (micro-CT) en la evaluación de la preparación del conducto radicular utilizando limas rotatorias de níquel-titanio tratadas térmicamente. Se prepararon conductos radiculares mesiales curvos de molares mandibulares usando ProDesign Logic 30/.05 (PDL) o HyFlex EDM 25/.08 (HEDM) (n=12). Las muestras se escanearon usando micro-CT con un tamaño de vóxel de 5μm antes y después de la preparación del conducto radicular. Se obtuvieron imágenes con subresolución de vóxeles de 10 y 20μm. Se analizó el porcentaje de aumento de volumen, residuos y superficie del conducto radicular no instrumentado en diferentes tamaños de vóxel. Los datos se compararon usando la prueba t de Student no pareada y las pruebas estadísticas ANOVA (α=0,05). No se observaron diferencias en el porcentaje de aumento de volumen, detritus y superficie instrumentada entre los conductos radiculares preparados por PDL y HEDM (p>0,05). Ambos sistemas promovieron un mayor porcentaje de detritos en el tercio apical en comparación con el tercio medio (p0,05). PDL y HEDM tenían una capacidad de preparación del conducto radicular similar. Las imágenes de micro-CT que utilizan diferentes tamaños de vóxel no influyeron en los resultados de la evaluación del volumen y los desechos. Sin embargo, las imágenes de 5µm mostraron una mayor precisión al evaluar el porcentaje de superficies no instrumentadas.