Eficacia de la musicoterapia para reducir la ansiedad dental en niños con discapacidad / Eficacia da musicoterapia para redução da ansiedade dental em crianças com discapacidades / Effectiveness of Music Therapy in reducing dental anxiety in children with disabilities

Objetivo: Evaluar la eficacia de la musicoterapia para la reducción de la ansiedad dental en niños entre 5 a 12 años con discapacidad durante la atención odontológica. Materiales y métodos: Estudio cuasi experimental. Se evaluaron 40 pacientes, divididos aleatoriamente en 2 grupos: grupo de expuestos y no expuestos a musicoterapia. El nivel de ansiedad fue registrado por la escala de imagen facial antes y después de la atención clínica, el comportamiento durante la atención a través de la escala de Frankl y el nivel de ansiedad de los padres a través de la escala modificada de Corah. Se registraron las funciones vitales de ambos grupos antes y después de dicha atención. El análisis de los datos se realizó análisis descriptivo (media ± desviación estándar) y análisis inferencial: Test de T-Student y Chi cuadrado (p<0,05). Resultados: Se encontró que la presión arterial inicial/ final en el grupo expuesto fue (Sístole: 108.75 ± 8.56/ 95.50 ± 6.86, Diástole: 67.75 ± 7.15 / 57.75 ± 6.38), y en el grupo no expuesto (Sístole: 101.75 ± 8.77/ 110.15 ± 13.31, Diástole: 59.20 ± 6.08) respectivamente, y la frecuencia cardiaca inicial/final en el grupo expuesto (72.30 ± 7.18 / 63.95 ± 6.12); y en el grupo no expuesto (66.50 ± 9.88 / 73.90 ± 11.46). Se encontraron diferencias estadísticamente significativas en los valores de la presión arterial (sístole, p<0,001 y diástole, p=0,007) y frecuencia cardiaca final (p=0,001), así como una reducción de los niveles de ansiedad final en el grupo expuesto a musicoterapia (p=0,001).

Objetivo:Avaliar a eficacia da musicoterapia para redução da ansiedade dental em crianças com discapacidades entre 5 a 12 anos durante o atendimento odontológico. Materiais e métodos: Estudo quase experimental. Avaliou-se 40 pacientes divididos aleatoriamente em dois grupos: grupos de expostos e não expostos a musicoterapia. O nível de ansiedade foi registrado pela escala de imagem facial antes e durante o atendimento odontológico, o comportamento durante o atendimento foi através da escala de Frankl e o nível de ansiedade dos padres através da escala modificada de Corah. As funções vitais foram registradas antes e depois do atendimento. O análises de dados foi realizado através análises descritivas (média ± ds) e análises inferenciais: Teste de T-Student e Chi Quadrado (p<0,05). Resultados: A pressão arterial inicial/final no grupo exposto foi (Sístole: 108.75 ± 8.56/95.50 ± 6.86, Diástole: 67.75 ± 7.15/ 57.75 ± 6.38), e no grupo não exposto (Sístole: 101.75 ± 8.77/110.15 ± 13.31, Diástole: 59.20 ± 6.08) respetivamente, e a frequência cardíaca inicial/final no grupo exposto (72.30 ± 7.18/ 63.95 ± 6.12); e no grupo não exposto (66.50 ± 9.88 / 73.90 ± 11.46). Se encontraram diferenças estatisticamente significativas nos valores da pressão arterial (sístole, p=0,000 e diástole, p=0,007) e frequência cardíaca final (p= 0,001), assim como na redução dos níveis de ansiedade final no grupo exposto à musicoterapia (p=0,001). Conclusão: O uso da musicoterapia diminuiu significativamente os níveis da ansiedade durante o atendimento odontológico nos pacientes com discapacidades

Objective: To evaluate the effectiveness of music therapy in reducing dental anxiety in children with disabilities between 5 and 12 years old during dental care. Materials and methods: Quasi-experimental study. 40 patients were evaluated, randomly divided into 2 groups: a group exposed to music therapy and a group not exposed to it. The levels of anxiety were registered using the Facial Image Scale before and after the dental care, the behaviour during dental care using the Frank Scale and the level of anxiety of the parents using the Modified Corah Scale. The vital functions of both groups were registered before and after the dental care. The data analysis was performed using descriptive analysis (media ± standard deviation) and inferential analysis: T- Student test and Chi square (p<0,05). Results: It was found that the initial/final blood pressure in the exposed group was (Systole: 108.75 ± 8.56/ 95.50 ± 6.86, Diastole: 67.75 ± 7.15/ 57.75 ± 6.38), and in the unexposed group (Systole: 101.75 ± 8.77/ 110.15 ± 13.31, Diastole: 59.20 ± 6.08), and the initial/final heart rate in the exposed group was (72.30 ± 7.18/ 63.95 ± 6.12); and in the unexposed group (66.50 ± 9.88/ 73.90 ± 11.46). Statistically significant differences were found in the values of blood pressure (systole, p=0,000 y diastole, p=0,007) and heart rate (p= 0,001), as well as a reduction in the levels of anxiety in the exposed group to music therapy (p=0,001). Conclusion: The use of Music therapy significantly reduces levels of anxiety during dental care in patients with disabilities.

Dimension and morphology of the mandibular condyle in class I patients in cone beam computed tomography / Dimensión y morfología del cóndilo mandibular en pacientes de clase I en tomografía computarizada de haz cónico

To evaluate the anterior-posterior (A-P)/medial-lateral (M-L) dimension, and morphology of the mandibular condyle in patients aged 18 to 65 years with Class I skeletal pattern on Cone Beam CT scans. Materials and Methods: Seventy one scans were evaluated using RealScan 2.0 software. The dimension was determined by points A (most anterior in the sagittal plane), P (most posterior in the sagittal plane), M (most interior in the coronal plane), L (most exterior in the coronal plane). The morphology of the condyle was evaluated in two coronal and sagittal planes, being classified as: round, flat, convex or mixed. The size of the condyle was analyzed by descriptive statistics and the morphology by frequency distribution. For the bivariate analysis, the Student's t-test was applied. Results: Measurements were obtained for the A-P diameter of the right condyle (RC) (8.72mm ± 1.25mm) and the left condylar (LC) (8.50mm ± 1.50mm), the M-L diameter of the RC (19.24mm ± 2.03mm) and the LC (18.97mm ± 1.87mm). There were significant differences in the male M-L dimension of the LC compared to the female (p=0.002). The most prevalent morphology of RC (35.21) and IQ (23.94) in the coronal plane was round. Conclusion: The A-P dimension of the right and left condyle is similar in both genders; however, there are differences in the M-L dimension of the left male condyle. The most prevalent morphology of the right and left condyle was round in the sagittal plane with the exception of the coronal plane.

Evaluar la dimensión antero- posterior (A-P)/medio-lateral (M­L), y la morfología del cóndilo mandibular en pacientes de 18 a 65 años con patrón esquelético Clase I en tomografías computarizadas Cone Beam. Material y Métodos: 71 tomografías fueron evaluadas mediante el software RealScan 2.0. La dimensión fue determinada por los puntos A (más anterior en el plano sagital), P (más posterior en el plano sagital), M (más interno en el plano coronal), L (más externo en plano coronal). Se evaluó la morfología del cóndilo en dos planos coronal y sagital, clasificándose en: redonda, aplanada, convexa y mixta. La dimensión del cóndilo fue analizada por estadística descriptiva y la morfología mediante distribución de frecuencias. Para el análisis bivariado, se aplicó la prueba de t de Student. Resultado: Se obtuvieron las medidas del diámetro A-P del cóndilo derecho (CD) (8,72mm ± 1,25mm) y el izquierdo (CI) (8,50mm ± 1,50mm), el diámetro M-L del CD (19,24mm ± 2,03mm) y el CI (18,97mm ± 1,87mm). Hubo diferencias significativas en la dimensión M-L del CI del sexo masculino en comparación al femenino (p=0.002). La morfología más prevalente del CD (35,21) y CI (23,94) en plano coronal fue de tipo redonda. Conclusión: La dimensión A-P del cóndilo derecho e izquierdo es similar en ambos sexos; sin embargo, existen diferencias en la dimensión M-L del cóndilo izquierdo del sexo masculino. La morfología del cóndilo derecho e izquierdo más prevalente fue la redonda en plano sagital a excepción del plano coronal.

Prevalencia de erosión dental en estudiantes de 12 a 16 años utilizando Basic Erosive Wear Examination (BEWE) en una institución educativa pública peruana / Prevalência da erosão dental em estudantes de 12 a 16 anos de idade utilizando Basic Erosive Wear Examination (BEWE) numa escola pública peruana / Dental erosion in 12 to 16 years old school students using Basic Erosive Wear Examination (BEWE) index

Introducción: El objetivo de este estudio fue determinar la prevalencia y la distribución de erosión dental en estudiantes de 12 a 16 años de edad de la institución educativa pública María Auxiliadora del distrito de Chorrillos, Lima-Perú. Materiales y métodos: Se evaluaron 382 estudiantes de una institución educativa pública peruana con el índice de diagnóstico de erosión dental Basic Erosive Wear Examination (BEWE). Después de la evaluación clínica, se obtuvieron los puntajes por sextantes, y posteriormente fueron sumados para obtener en un puntaje acumulativo total. Los datos fueron analizados mediante estadística descriptiva y para relacionar la erosión con las variables género y edad Originalse aplicó la prueba de Chi cuadrado y Anova (una cola) (p<0,05). Resultados: La prevalencia de erosión dental fue de 12.04%. En cuanto a su distribución, la edad más representativa fue el grupo de 16 años (28.26%), el género femenino fue el más frecuente (54.3%), y en cuanto a la localización por maxilar, el inferior resultó predominante (54.35%) en los dientes posteriores, (56.52%) y caras oclusales (65%). Conclusión: Del total de estudiantes evaluados, el 12.04% presentó erosión dental. Asimismo, se encontró mayor distribución de erosión dental en el género femenino y en los estudiantes de 16 años de edad, sin embargo no hubo significancia estadística.

Introdução: O objetivo deste estudo foi determinar a prevalência e a distribuição da erosão dental em estudantes de 12 a 16 anos de idade de uma escola pública Maria Auxiliadora (Distrito Chorrillos), Lima-Perú. Materiais e métodos: 382 estudantes de uma escola pública peruana foram avaliados com o Basic Erosive Wear Examination (BEWE), índice de diagnóstico de erosão dental. Após da avaliação clínica, a pontuação foi obtido por sextantes, e posteriormente foram somados para obter a pontuação total. Os dados foram analisados mediante a análise estatística descritiva. Para erosão dentária, as variaveis gênero e idade aplicou-se o teste Chi quadrado Introdução: O objetivo deste estudo foi determinar a prevalência e a distribuição da erosão dental em estudantes de 12 a 16 anos de idade de uma escola pública Maria Auxiliadora (Distrito Chorrillos), Lima-Perú. Materiais e métodos: 382 estudantes de uma escola pública peruana foram avaliados com o Basic Erosive Wear Examination (BEWE), índice de diagnóstico de erosão dental. Após da avaliação clínica, a pontuação foi obtido por sextantes, e posteriormente foram somados para obter a pontuação total. Os dados foram analisados mediante a análise estatística descritiva. Para erosão dentária, as variaveis gênero e idade aplicou-se o teste Chi quadrado

Introduction: The aim of this study was to determine the prevalence and distribution of dental erosion in 12 to 16 year old students from "María Auxiliadora" public school at Chorrillos, Lima-Perú. Materials and methods: A total of 382 students were clinically exanimated for dental erosion using the Basic Erosive Wear Examination (BEWE). After the clinical examination, scores were obtained by sextants. They were then summed to produce in a accumulative score. The data was analyzed by descriptive statistics to relate the erosion with the sex and age. The Chi squared and Anova test (oneway) were used (p<0,05). Results: The prevalence of dental erosion was 12.04% and as to its distribution, the most representative age was the group of 16 years (28.26%), female were most frequent (54.3%), the predominant location was the lower maxilary (54.35%) posterior teeth (56.52%) oclusal surfaces (65%). Conclusions: Of the total number of students evaluated, 12.04% had dental erosion. A greater distribution of dental erosion in the female and in students of 16 years of age was found, but there was no statistical significance.

In vitro comparison of the immediate adhesive strength in dentin of three universal adhesive systems

Objective: to compare the adhesive strength in dentin of three universal adhesive systems in vitro by means of the shear test. materials and methods: seventy-five bovine teeth were selected and cut. dentin was exposed from the buccal surface of the crowns with 220 grit sandpaper, and samples were then inserted in transparent acrylic bases (15x10mm). the samples were randomly divided in 3 groups (n=25): G1-universal adhesive system Scotchbond Universal (3M ESPE-USA); G2- Universal adhesive system Peak Universal Bond (Ultradent); G3-Universal adhesive system Tetric N-Bond (Ivoclar Vivadent). the adhesive procedures were carried out according to the instructions of each manufacturer and the restorative procedures were carried out with micro-cylinders (made of Tygon type tubing 0.79x1.5mm) of the composite resin Filtek Z350XT-A2 (3M ESPE-USA). the samples were incubated at 37ºC (+/-5ºC) for 24 hours. adhesive strength was evaluated in a universal test machine by means of the shear test (0.5mm/min, 500N) and the resulting fracture type was evaluated with a Dinolite digital microscope (x200). the results were analyzed by descriptive statistics (Mean±SD), and inferential statistics by a one-way ANOVA. results: no statistically significant differences were found between the universal adhesive systems evaluated G1 (14.91±4.76), G2 (16.90±4.11) and G3 (17.34±4.04)/(p=0.114). conclusions: the shear test resulted in similar values of immediate adhesive strength of the three universal adhesive systems used.

Mandibular condyle dimensions in Peruvian patients with class II and class III skeletal patterns

OBJECTIVE: to compare condylar dimensions of young adults with class II and class III skeletal patterns using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: 124 CBCTs from 18-30 year-old patients, divided into 2 groups according to skeletal patterns (Class II and Class III) were evaluated. skeletal patterns were classified by measuring the ANB angle of each patient. the anteroposterior diameter (A and P) of the right and left mandibular condyle was assessed from a sagittal view by a line drawn from point A (anterior) to P (posterior). the coronal plane allowed the evaluation of the medio-lateral diameter by drawing a line from point M (medium) to L (lateral); all distances were measured in mm. RESULTS: In class II the A-P diameter was 9.06±1.33 and 8.86±1.56 for the right and left condyles respectively, in class III these values were 8.71±1.2 and 8.84±1.42. in class II the M-L diameter was 17.94±2.68 and 17.67±2.44 for the right and left condyles respectively, in class III these values were 19.16±2.75 and 19.16±2.54. CONCLUSION: class III M-L dimensions showed higher values than class II, whereas these differences were minimal in A-P.

Uso de dos técnicas alternativas de manejo de conducta: musicoterapia y distracción audiovisual, en el control y manejo de ansiedad en pacientes pediátricos de 5 a 10 años / Uso de duas técnicas alternativas de manejo da conduta: musicoterapia e distração audiovisual no controle e manejo da ansiedade em pacientes pediátricos de 5 a 10 anos / Use of two alternative techniques for the management of behavior: music therapy and audiovisual distraction, for the control and management of anxiety and child's behavior

En la actualidad, se ha demostrado que la ansiedad influye significativamente en la conducta de los niños durante la consulta dental ocasionando un rechazo total del niño a la atención odontológica, optándose por el uso de técnicas no farmacológicas para el control y manejo de la ansiedad, así conseguir un comportamiento receptivo. Objetivo: Comparar dos técnicas no farmacológicas (musicoterapia y distracción audiovisual) en el control de la ansiedad antes, durante y después del tratamiento dental de niños entre 5 y 10 años atendidos en el Centro Universitario de Salud (UPC). Materiales y métodos: Se realizó un estudio cuasi experimental, comparándose los niveles de ansiedad obtenidos con el Test de Dibujos de Venham (1 -8) y la Escala de Ansiedad de Venham (0-5) a un total de 60 pacientes pediátricos bajo las técnicas no farmacológicas musicoterapia y audio visual. Resultados: El promedio de puntaje obtenido antes de la consulta dental con el Test de Dibujos de Venham para el grupo control fue de 2, para el grupo musicoterapia fue de 1,4 y de 1,45 para el grupo audio visual; el promedio de la escala de Ansiedad durante la consulta para el grupo control fue de 1,4 y de 0,2 para musicoterapia y audiovisual. Por último, el puntaje después de la consulta dental para el grupo control fue de 1,95, para musicoterapia fue de 0,45 y para el grupo audio visual fue de 0,3. Sí se encontraron diferencias significativas para la evaluación de la ansiedad con la Escala de Ansiedad de Venham aplicada durante el tratamiento dental entre los tres grupos de estudio (p=0,001). Conclusiones: Se concluye que existe una reducción de los niveles de ansiedad durante y después de emplear ambas técnicas no farmacológicas.

Atualmente pode-se adotar por técnicas não farmacológicas para o controle e manipulação dos problemas de ansiedade em crianças, já que afeta significativamente na conduta delas durante o atendimento odontológico, além terá um efeito negativo na saúde oral, já que um elevado nível de ansiedade produz a rejeição total do tratamento dental. Objetivo: Comparar duas técnicas não farmacológicas (musicoterapia e distração audiovisual) no controle da ansiedade antes, durante e após o tratamento dental em crianças de 5 a 10 anos de idade atendidas no Centro Universitário de Saúde (UPC). Materiais e Métodos: Realizou-se um estudo quase experimental e compararam-se os niveles de ansiedade obtidos pelos desenhos de teste de Venham (1 -8) e a escala de ansiedade Venham (0-5) num total de 60 pacientes pediátricos sob técnicas não farmacológicas musicoterapia e audiovisual. Resultados: A média da porcentagem obtido antes da atenção odontológica utilizando os desenhos de teste de Venham para o grupo controle foi 2, para o grupo musicoterapia 1,4 e de 1,45 para o grupo audiovisual; por outro lado a media após da atenção odontológica para o grupo controle foi 1,95, para musicoterapia 0,45 e para o grupo audiovisual 0,3. A media da escala da Ansiedade durante a consulta para o grupo controle foi de 1,4 e de 0,2 para musicoterapia e audiovisual. Houve diferença significativa entre os três grupos de estudo para avaliação da ansiedade (p=0,001). Conclusões: Os resultados indicam que houve redução dos níveis de ansiedade após empregar ambas as técnicas não farmacológicas na população estudada.

It has been shown that anxiety has a significant influence on a child's behavior during a dental appointment and consequently a negative impact on their oral health. It may cause the child to reject their dental treatment. Today, dentists can choose non-pharmacological techniques for the management and control of anxiety to achieve a receptive patient behaviour. Objectives: The aim of this study was to compare two non-pharmacological techniques and for managing anxiety before, during and after dental treatment in 5 to 10 year-old children treated at the university health center. Material and Methods: A quasi experimental study was carried out and the anxiety levels obtained with the Venham Picture Test (1-8) Venham Anxiety Scale (0-5), were applied in 60 pediatric patients in total, using the non-pharmacological techniques: music therapy and audiovisual distraction. Results: The mean score obtained before the dental appointment with the Venham Picture Test was 2 for the control group; 1.4 for the music therapy group and 1.45 for the audiovisual group. The mean score of Venham Anxiety scale during a dental appointment was 1.4 for the control group and 0.2 for the music therapy and audiovisual group. Lastly, the score after dental appointment was 1.95 for the control group, 0.45 for the music therapy group and 0.3 for the audiovisual group. There is a significant difference among the three groups (p=0,001) for anxiety. Conclusions: We conclude that there was a reduction of anxiety levels during and after using both non-pharmacological techniques in the studied population.

Prevalencia de hábitos orales y alteraciones dentoalveolares en niños de 6 a 12 años / Prevalence of oral habits and dentoalveolar alterations in children 6 to 12 years

El objetivo del presente estudio fue evaluar la prevalencia de hábitos orales y alteraciones dentoalveolares en niños de 6 a 12 años atendidos en una Clínica Docente. Material y Métodos: Estudio descriptivo y transversal, utilizando una muestra de 1006 historias clínicas de niños entre las edades de 6 a 12 años usando la base de datos del software U-smile. Resultados: Manifestándose una predisposición al hábito de deglución atípica (19,48%); succión digital (2.19%) y respiración bucal (0.20%). La prevalencia de las alteraciones dentoalveolares mordida cruzada anterior (8.65%) y posterior(5.27%); mordida abierta anterior (9.74%) y posterior (0.89%); relaciones molares derecha según Angle clase I (57.95%),clase II (19.98%) y clase III (10.64%); relaciones molares izquierda según Angle clase I (55.86%), clase II (18.39%) y claseIII (14.61%); plano terminal derecho escalón mesial (6.66%), plano terminal recto (0.89%) y escalón distal (0.40%); planoterminal izquierdo escalón mesial (6.16%), plano terminal recto (0.99%) y escalón distal (0.70%); overjet de 1mm a 4mm(70.78%), mayor a 4mm (11.93%) y menor a 4mm (6.26%); el overbite de 10% a 40% (45.03%), mayor a 40% (16.60%) ymenor a 10% (11.43%)...

This study aimed to assess the prevalence of oral habits and dentoalveolar alterations among 6- to-12-yearoldchildren treated at the Teaching Private Hospital. It is a descriptive, cross- sectional study with a sample size of 1,006 medical records of 6- to-12-year-old children, using the U-smile software database. It was found a predisposition towardsan atypical swallowing habit (19.48%); digit sucking (2.19%); and mouth breathing (0.20%). The prevalence of dentoalveolar alterations was: anterior crossbite (8.65%), and posterior crossbite (5.27%); anterior open bite (9.74%) and posterioropen bite (0.89%); Angle´s Class I (57.95%), Class II (18.98%) and class III (10.64%) right molar relationship; Angle´s Class I(55.86%), Class II (18.39%) and Class III (14.61%) left molar relationship; terminal plane right with mesial step (6.66%), flush terminal plane (0.89%) and distal step (0.40%); terminal plane left with mesial step (6.16%), flush terminal plane (0.99%)and distal step (0.70%); overjet of 1mm to 4mm (70.78%), greater than 4mm (11.93%) and less than 4mm (6.26%); overbite of 10% to 40% (45.03%), greater than 40% (16.60%) and less than 10% (11.43%)...

Influence of Erosive and Abrasive Cycling on Bonding of Different Adhesive Systems to Enamel: An In situ Study

Abstract This study evaluated the impact of orange juice on the bond strength (BS) of dentin bonding systems (DBSs) to enamel surface after simulation with an in situ/ ex vivo erosive cycling. One hundred and ninety two bovine enamel fragments (4x4x2mm) were obtained and randomized regarding superficial microhardness and distributed to palatal devices for 8 volunteers, in three phases (one for each DBS), containing 8 blocks, which were, allocated in 4 pairs. Daily, these pairs were subjected extraorally to the following conditions: CONT- neither erosive nor abrasive challenge; ERO- erosive challenge only; ABR- abrasive challenge only and ERO + ABR- with erosive and abrasive challenges. Erosive cycles (immersion in orange juice, 3 times/day/5 min/5 days) or/and abrasive challenges (electric toothbrush, 3 times/day/1 min/5 days) were performed. After these cycles, all specimens were restored with the adhesive systems Adper Scotchbond Multi Purpose (MP), Adper Single Bond 2 (SB) or Clearfil SE Bond (SE), and the composite resin Filtek Z250. After 7 days, sticks (area ≅1 mm2) were obtained and subjected to the microtensile bond strength test (μTBS) at 0.5 mm/min. Data was statistically analyzed by ANOVA and Tukey tests (a=0.05). Failure modes were determined using a digital microscope (40´). DBS was the only statistical significant factor. SE was the unique DBS not affected in any challenge, whereas MP and SB performed according to the scenario. The adhesive and mixed failures were predominant in all groups. Overall performance suggested that BS to enamel after erosive /abrasive challenged by orange juice was not affected and it was material-dependent.

Resumo Este estudo avaliou o impacto de suco de laranja na resistência de união (RU) de sistemas adesivos dentinários (SAD) à superfície do esmalte após a simulação com uma ciclagem erosiva in situ/ex vivo. Cento e noventa e dois fragmentos de esmalte bovino (4x4x2mm) foram obtidos e randomizados considerando a microdureza superficial, e distribuídos em dispositivos palatinos para 8 voluntários, em três fases (uma para cada SAD), contendo 8 blocos, os quais foram alocados em 4 pares. Diariamente, esses pares eram submetidos às seguintes condições extraoralmente: CONT- sem desafio erosivo ou abrasivo; ERO- desafio erosivo somente; ABR- desafio abrasivo somente; e ERO+ABR- com desafio erosivo e abrasivo. A ciclagem erosiva (imersão em suco de laranja, 3 vezes/dia/5 min/5 dias) e/ou ciclagem abrasiva (escova dentária elétrica, 3 vezes/dia/1 min/5 dias) foram feitas. Após estas ciclagens, todos os espécimes foram restaurados com os sistemas adesivos Adper Scotchbond Multi Purpose (MP), Adper Single Bond 2 (SB) ou Clearfil SE Bond (SE), e com a resina composta Filtek Z250. Após 7 dias, palitos (área ≈1 mm) eram obtidos e submetidos ao teste de resistência de união por microtração (μTBS) a 0,5 mm/min. Os dados foram estatisticamente analisados por ANOVA e teste de Tukey (a=0,05). Os modos de fratura foram determinados utilizando um microscópio digital (40×). SAD foi o único fator estatisticamente significante. SE foi o único SAD não afetado por qualquer desafio, enquanto o MP e o SB apresentaram um desempenho de acordo com o cenário. As fraturas do tipo mista e adesiva foram predominantes em todos os grupos. O desempenho geral sugeriu que RU ao esmalte após desafio erosivo/abrasivo por suco de laranja não foi afetada e foi material-dependente.

Comparación de la resistencia compresiva de resinas convencionales vs resinas tipo Bulk fill

Objetivo: El propósito de este estudio fue comparar la resistencia compresiva de 2 resinas tipo Bulk fill y 2 resinas convencionales. Materiales y métodos: 136 muestras cilíndricas (2mm y 4mm), divididos en 8 grupos (n=17); G1 SonicFill™ (4x2mm), G2 SonicFill™ (4x4mm), G3 Tetric® N-Ceram Bulk Fill (4x2mm), G4 Tetric® N-Ceram Bulk Fill (4x4mm), G5 Filtek™ Z250 XT (4X2mm), G6 Filtek™ Z250 XT (4x4mm), G7 Te-Econom Plus® (4x2mm) y G8 Te-Econom Plus® (4x4mm). La resistencia compresiva fue evaluada con la máquina Instron® a una velocidad de desplazamiento fijo de 1,0mm/min. Los test de ANOVA, Kruskall Wallis, t Student y U de Mann Whitney fueron empleados para el análisis estadístico. Resultados: para las resinas Bulk Fill, Tetric® N-Ceram Bulk Fill (310,06- 4x2mm, 303,87-4x4mm) mostró mayor resistencia compresiva que SonicFill™. Para las resinas convencionales, Filtek™ Z250 XT (295,9-4x2mm, 289,7-4x4mm) obtuvo mayor resistencia compresiva que Te-Econom Plus®. A la comparación de todos los grupos, Tetric® N-Ceram Bulk Fill presentó los valores compresivos más altos en ambos espesores 4x2mm(0,122) y 4x4mm(0,333), con diferencias estadísticas significativas (p<0,001*-4x2mm, p=0,004- 4x4mm). Conclusión: Tetric® N-Ceram Bulk Fill puede ser una buena opción para restauraciones posteriores, ya que su propiedad mecánica de resistencia compresiva es superior en relación con las otras evaluadas.

Objective: The aim of this study was compare the compressive strength of 2 Bulk fill resin composites and 2 conventional resin composites. Materials and methods: one hundred and thirty six cylindrical samples (2mm and 4mm), divided in 8 groups (n = 17); G1 SonicFill™ (4x2mm), G2 SonicFill™ (4x4mm), G3 Tetric® N-Ceram Bulk Fill (4x2mm), G4 Tetric® N-Ceram Bulk Fill (4x4mm), G5 Filtek™ Z250 XT (4x2mm), G6 Filtek™ Z250 XT (4x4mm), G7 Te-Econom Plus® (4x2mm) and G8 Te-Econom Plus® (4x4mm). Specimens were evaluated to compressive stress test using Instron® machine at crosshead speed of 1.0 mm/min. One way Anova, Kruskall Wallis, Student's t and U Mann Whitney tests were employed for statistical analyses. Results: For Bulk resin composites, Tetric® N-Ceram Bulk Fill (310.06-4x2mm, 303.87-4x4mm) showed higher compressive strength than SonicFill™. For conventional resin composites, Filtek™ Z250 XT (295.9-4x2mm, 289.7-4x4mm) showed higher compressive strength than Te-Econom Plus®. For comparison,Tetric® N-Ceram Bulk Fill was higher compressive strength in both thickness 4x2mm (p=0.122) and 4x4mm (p=0.333) and it was statistically significant (<0.001*- 4x2mm, 0.004-4x4mm) among them. Conclusion: Tetric® N-Ceram Bulk Fill offers a good mechanical property like a compressive strength which is better in comparison to the others resin composites evaluated in this study.

Effect of resin-modified glass-ionomer cement lining and composite layering technique on the adhesive interface of lateral wall

Interface integrity can be maintained by setting the composite in a layering technique and using liners. Objective The aim of this in vitro study was to verify the effect of resin-modified glass-ionomer cement (RMGIC) lining and composite layering technique on the bond strength of the dentin/resin adhesive interface of lateral walls of occlusal restorations. Material and Methods Occlusal cavities were prepared in 52 extracted sound human molars, randomly assigned into 4 groups: Group 2H (control) – no lining + two horizontal layers; Group 4O: no lining + four oblique layers; Group V-2H: RMGIC lining (Vitrebond) + two horizontal layers; and Group V-4O: RMGIC lining (Vitrebond) + four oblique layers. Resin composite (Filtek Z250, 3M ESPE) was placed after application of an adhesive system (Adper™ Single Bond 2, 3M ESPE) dyed with a fluorescent reagent (Rhodamine B) to allow confocal microscopy analysis. The teeth were stored in deionized water at 37oC for 24 hours before being sectioned into 0.8 mm slices. One slice of each tooth was randomly selected for Confocal Laser Scanning Microscopy (CLSM) analysis. The other slices were sectioned into 0.8 mm x 0.8 mm sticks to microtensile bond strength test (MPa). Data were analyzed by two-way ANOVA and Fisher's test. Results There was no statistical difference on bond strength among groups (p>0.05). CLSM analysis showed no significant statistical difference regarding the presence of gap at the interface dentin/resin among groups. Conclusions RMGIC lining and composite layering techniques showed no effect on the microtensile bond strength and gap formation at the adhesive interface of lateral walls of high C-factor occlusal restorations. .

Erosive cola-based drinks affect the bonding to enamel surface: an in vitro study

Objective: This study aimed to assess the impact of in vitro erosion provoked by different cola-based drinks (Coke types), associated or not with toothbrushing, to bonding to enamel. Material and methods: Forty-six bovine enamel specimens were prepared and randomly assigned into seven groups (N=8): C- Control (neither eroded nor abraded), ERO-RC: 3x/1-minute immersion in Regular Coke (RC), ERO-LC: 3x/1-minute immersion in Light Coke (LC), ERO-ZC: 3x/1-minute immersion in Zero Coke (ZC) and three other eroded groups, subsequently abraded for 1-minute toothbrushing (EROAB-RC, EROAB-LC and EROAB-ZC, respectively). After challenges, they were stored overnight in artificial saliva for a total of 24 hours and restored with Adper Single Bond 2/Filtek Z350. Buildup coronal surfaces were cut in 1 mm2 -specimens and subjected to a microtensile test. Data were statistically analyzed by two-way ANOVA/Bonferroni tests (α=0.05). Failure modes were assessed by optical microscopy (X40). The Interface of the restorations were observed using Confocal Laser Scanning Microscopy (CLSM). Results: All tested cola-based drinks significantly reduced the bond strength, which was also observed in the analyses of interfaces. Toothbrushing did not have any impact on the bond strength. CLSM showed that except for Zero Coke, all eroded specimens resulted in irregular hybrid layer formation. Conclusions: All cola-based drinks reduced the bond strength. Different patterns of hybrid layers were obtained revealing their impact, except for ZC. .

Associação de técnicas conservadoras para otimizar a estética do sorriso: clareamento dental e microabrasão do esmalte / Association of conservative techniques an aesthetically optimization smile: dental bleaching and microabrasion

As várias opções para a realização de tratamentos estéticos conservadores permitem ao profissional a escolha de materiais e técnicas apropriados, que melhor se enquadrem nas características individuais de cada paciente e na realidade de seu consultório. No caso clínico apresentado, a técnica de clareamento dental em consultório com peróxido de hidrogênio a 35% (Total Blanc Office, DFL), ativado com luz híbrida LED/LASER e a microabrasão de esmalte com pasta de acido fosfórico a 37% e pedra pomes, foram associados. Os resultados com o clareamento em consultório são imediatos, de forma que o profissional dispõe de total controle sobre aplicação do gel clareador em áreas e dentes específicos. A microabrasão do esmalte é um tratamento simples e custo relativamente baixo, remove as manchas superficiais do esmalte com preservação de estrutura dental. No caso apresentado, a associação das duas técnicas proporcionou a obtenção de excelente resultado estético em apenas uma sessão de atendimento

Since there are several options of conservative aesthetic treatments the dentist may choose the most appropriate material and technique according to each patient’s needs. In the present case report, an in office bleaching procedure using 35% of hydrogen peroxide (Total Blanc Office, DFL), activated with a hybrid light source (LED/Diode laser) associated to enamel microabrasion using a 37% phosphoric acid and a pumice, was performed as a conservative treatment. Clinical results of in office bleaching technique are immediate, since the professional can apply the gel in specific areas. The enamel abrasion is a simple and low-cost dental treatment that removes superficial dental stains preserving the dental structure. In the reported case, the association of these two techniques has reached an excellent aesthetic result in one single session of treatment

Efeito da solução de clorexidina a 2% na adesão de um sistema restaurador adesivo à dentina previamente erodida com refrigerante tipo cola regular e light / Effect of 2% chlorhexidine solution on adhesive bond strength to eroded dentin by regular and light cola drinks

Os refrigerantes são potentes agentes erosivos que podem provocar perda de estrutura dentária e requerer o tratamento restaurador adesivo, dependendo do grau de comprometimento. Pelas diferentes propriedades apresentadas, estas bebidas podem afetar a adesão à dentina de diferentes formas. Este estudo teve como objetivo avaliar a resistência de união (RU) em dentina erodida tratada com solução de clorexidina a 2%. Sessenta terceiros molares tiveram a superfície dentinária do terço oclusal exposta e foram distribuídos em 3 grupos, de acordo com o protocolo erosivo: controle, sem desafio (C), desafio erosivo com Coca-Cola (CC) e desafio erosivo com Coca-Cola Light (CL). As ciclagens erosivas foram por ciclos de 5-min de imersão 3x/dia durante 5 dias. Em seguida, metade dos dentes foi tratado com solução de clorexidina a 2% (1,5ul) e o restante com água deioinizada (1,5ul) e o processo adesivo realizado com Adper Single Bond 2® e resina composta Filtek Z350®. Os espécimes foram mantidos em estufa a 37oC por 24 horas. Após esse período, todos os espécimes foram seccionados em palitos (0,80mm2 a 1mm2). Um terço dos palitos obtidos de cada grupo foi testado imediatamente (I-24 h) pelo teste de microtração. Os espécimes remanescentes foram envelhecidos em saliva artificial por 6 meses (6m) e 1 ano (1a) antes do teste. Os dados obtidos da microtração foram analisados por meio dos testes de ANOVA a três critérios e Tukey (p<0,05). O modo de fratura foi analisado e classificado em adesivo, misto e coesivo em dentina ou resina composta. Simultaneamente, uma fatia (mesiodistal) de cada espécime foi analisado por microscopia confocal para análise da interface resina/dentina e formação de tag nos tempos de envelhecimento. Os valores médios de resistência adesiva (MPa ± dp; 24 horas/6 meses /1 ano) foram: C(38,57 ± 15,36/26,67 ± 19,37/12,21 ± 11,24); C-Chx2%(41,93 ± 9,97/31,12 ± 17,02/11,86 ± 10,4); CC(21,80 ± 7,09/8,33 ± 10,71/4,70 ± 9,04)...

Soft drinks are potent erosive agents, which can provoke loss of dental structure and require adhesive restorative treatment, depending on the compromising level. Due to the different properties, these beverages can affect bonding to dentin in different manners. The aim of this study was to evaluate the bond strength (BS) to eroded dentin treated with 2% chlorhexidine solution. Sixty third human molars had their oclusal thirds removed to expose flat dentin and were divided into three groups, according to erosive protocol: Control (C) with no surface treatment, erosive challenge with Regular Coke (CC), erosive challenge with Light Coke (CL). The erosive challenge was performed by cycles of 5-min immersions, 3x/day during 5 days. After that, half of the teeth were treated with 2% chlorhexidine solution (1,5ul) and the remaining with deionized water (1,5ul) before adhesion procedure with Adper Single Bond 2® and FiltekTMZ350®. Specimens were stored at 37oC in deionized water for 24 hours. After this period, all specimens were sectioned into sticks (≈0.81 mm2 to 1mm2). A third of the specimens were tested immediately (I-24 h), for microtensile test. The remaining sticks aged in artificial saliva for 6 months (6m) and 1 year (1y) before testing. The failure mode was analyzed and classified as adhesive, mixed and cohesive in dentin or resin. Bond strength data was analyzed by three-way ANOVA and Tukey tests (p<0.05). Simultaneously, one slice (mesial-distal) of each specimen was analyzed by confocal microscopy for analysis of the interface resin/dentin and tag formation over the aging time. Means and standard-deviation (MPa) of each group (I, 6m and 1y) were: C (38.57±15.36, 26.67±19.37, 12.21±11.24), C-Chx 2% (41.93±9.97, 31.2±17.02, 11.86±10.4), CC (21.80±7.09, 8.33±10.71, 4.70±9.04), CC-Chx 2% (19.85±7.87, 24.32±11.7, 6.19±12.37) CL (22.70±9.63, 10.25±15.6, 4.93±5.54) and CL-Chx 2% (22.40±7.34, 20.94±14.68, 16.05±13.91). Adhesive and/or mixed failures were...

Efeito da solução de clorexidina a 2% na adesão de um sistema restaurador adesivo à dentina previamente erodida com refrigerante tipo cola regular e light / Effect of 2% chlorhexidine solution on adhesive bond strength to eroded dentin by regular and light cola drinks

Os refrigerantes são potentes agentes erosivos que podem provocar perda de estrutura dentária e requerer o tratamento restaurador adesivo, dependendo do grau de comprometimento. Pelas diferentes propriedades apresentadas, estas bebidas podem afetar a adesão à dentina de diferentes formas. Este estudo teve como objetivo avaliar a resistência de união (RU) em dentina erodida tratada com solução de clorexidina a 2%. Sessenta terceiros molares tiveram a superfície dentinária do terço oclusal exposta e foram distribuídos em 3 grupos, de acordo com o protocolo erosivo: controle, sem desafio (C), desafio erosivo com Coca-Cola (CC) e desafio erosivo com Coca-Cola Light (CL). As ciclagens erosivas foram por ciclos de 5-min de imersão 3x/dia durante 5 dias. Em seguida, metade dos dentes foi tratado com solução de clorexidina a 2% (1,5ul) e o restante com água deioinizada (1,5ul) e o processo adesivo realizado com Adper Single Bond 2® e resina composta Filtek Z350®. Os espécimes foram mantidos em estufa a 37oC por 24 horas. Após esse período, todos os espécimes foram seccionados em palitos (0,80mm2 a 1mm2). Um terço dos palitos obtidos de cada grupo foi testado imediatamente (I-24 h) pelo teste de microtração. Os espécimes remanescentes foram envelhecidos em saliva artificial por 6 meses (6m) e 1 ano (1a) antes do teste. Os dados obtidos da microtração foram analisados por meio dos testes de ANOVA a três critérios e Tukey (p<0,05). O modo de fratura foi analisado e classificado em adesivo, misto e coesivo em dentina ou resina composta. Simultaneamente, uma fatia (mesiodistal) de cada espécime foi analisado por microscopia confocal para análise da interface resina/dentina e formação de tag nos tempos de envelhecimento. Os valores médios de resistência adesiva (MPa ± dp; 24 horas/6 meses /1 ano) foram: C(38,57 ± 15,36/26,67 ± 19,37/12,21 ± 11,24); C-Chx2%(41,93 ± 9,97/31,12 ± 17,02/11,86 ± 10,4); CC(21,80 ± 7,09/8,33 ± 10,71/4,70 ± 9,04)...

Soft drinks are potent erosive agents, which can provoke loss of dental structure and require adhesive restorative treatment, depending on the compromising level. Due to the different properties, these beverages can affect bonding to dentin in different manners. The aim of this study was to evaluate the bond strength (BS) to eroded dentin treated with 2% chlorhexidine solution. Sixty third human molars had their oclusal thirds removed to expose flat dentin and were divided into three groups, according to erosive protocol: Control (C) with no surface treatment, erosive challenge with Regular Coke (CC), erosive challenge with Light Coke (CL). The erosive challenge was performed by cycles of 5-min immersions, 3x/day during 5 days. After that, half of the teeth were treated with 2% chlorhexidine solution (1,5ul) and the remaining with deionized water (1,5ul) before adhesion procedure with Adper Single Bond 2® and FiltekTMZ350®. Specimens were stored at 37oC in deionized water for 24 hours. After this period, all specimens were sectioned into sticks (≈0.81 mm2 to 1mm2). A third of the specimens were tested immediately (I-24 h), for microtensile test. The remaining sticks aged in artificial saliva for 6 months (6m) and 1 year (1y) before testing. The failure mode was analyzed and classified as adhesive, mixed and cohesive in dentin or resin. Bond strength data was analyzed by three-way ANOVA and Tukey tests (p<0.05). Simultaneously, one slice (mesial-distal) of each specimen was analyzed by confocal microscopy for analysis of the interface resin/dentin and tag formation over the aging time. Means and standard-deviation (MPa) of each group (I, 6m and 1y) were: C (38.57±15.36, 26.67±19.37, 12.21±11.24), C-Chx 2% (41.93±9.97, 31.2±17.02, 11.86±10.4), CC (21.80±7.09, 8.33±10.71, 4.70±9.04), CC-Chx 2% (19.85±7.87, 24.32±11.7, 6.19±12.37) CL (22.70±9.63, 10.25±15.6, 4.93±5.54) and CL-Chx 2% (22.40±7.34, 20.94±14.68, 16.05±13.91). Adhesive and/or mixed failures were...

Odontoma complejo extenso asociado a tercer molar retenido en base de mandíbula: relato de caso clínico / Extensive complex odontoma associated with an unerupted third molar in the mandible base: case Report

Los odontomas son tumores odontogénicos mixtos, diferenciados según sus características anatómicas en odontoma compuesto y complejo. El odontoma complejo es el más raro y normalmente se presenta con un curso evolutivo asintomático, puede ocasionar retención, mal posición dentaria y el aumento de volumen local. La terapéutica incluye exéresis completa de lesión. La evaluación histológica es importante, debido a la rara posibilidad de tratarse de un odontoma ameloblástico. El presente trabajo presenta un caso de una paciente de 18 años, transferida por un odontólogo para la evaluación de una lesión en la mandíbula del lado derecho. En la imagen radiográfica panorámica, se observó un área extensa radiopaca irregular, de evolución indeterminada, con aproximadamente 5 centímetros de diámetro, en la región del cuerpo y ángulo mandibular derecho. El tercer molar inferior derecho retenido y orientado hacia la base de la mandíbula, circunscrito por un área radiolúcida y el segundo molar inferior derecho ausente. Al examen físico intrabucal, observamos una tumefacción dura a la palpación en la superficie lingual de esta región. El diagnóstico presuntivo fue de odontoma complejo y quiste dentígero envolviendo el tercer molar. El examen microscópico reveló la presencia de folículos pericoronarios envolviendo el diente tercero molar inferior derecho y, en el interior de la masa removida, presencia de conglomerado irregular de esmalte, dentina, cemento y tejido pulpar. El diagnóstico final fue de odontoma complejo. La paciente se encontraba en observación de 5 años, sin signos clínicos y radiográficos de recidiva

Odontomas are mixed tumors which can be divided into two types: the complex and the compound odontoma. Complex odontoma is rare, and usually presents an asymptomatic course, being able to cause dental impaction, wrong teeth position and local volume increase. Surgical treatment of these lesions consists of local removal and curettage. The microscopic evaluation is important, because of the possibility of an ameloblastic odontoma. We report a case of an 18-year-old woman with a lesion involving the right mandible. In panoramic radiography we observed an extensive irregular radiopaque area with unknown evolution and approximately 5cm of diameter, in molar mandible region. Teeth 48 impacted and displaced to the mandible base, involved for a radiolucid area and absence of 47 tooth. The previous diagnosis was complex odontoma and dentigerous cyst involving the third molar. The microscopic examination showed a dental follicle surrounding tooth 48 and in the removed mass, haphazard fashion with enamel, dentin, cementum and pulp. Final microscopical diagnosis was complex odontoma. The patient is being followed-up for five years and no clinical and radiological evidences of recurrence were found

Cytotoxicity and biocompatibility of direct and indirect pulp capping materials

There are several studies about the cytotoxic effects of dental materials in contact with the pulp tissue, such as calcium hydroxide (CH), adhesive systems, resin composite and glass ionomer cements. The aim of this review article was to summarize and discuss the cytotoxicity and biocompatibility of materials used for protection of the dentin-pulp complex, some components of resin composites and adhesive systems when placed in direct or indirect contact with the pulp tissue. A large number of dental materials present cytotoxic effects when applied close or directly to the pulp, and the only material that seems to stimulate early pulp repair and dentin hard tissue barrier formation is CH.