Facetas em resina composta com fechamento de diastemas para harmonização do sorriso: relato de caso / Composite resin veneers with diastema closure for smile harmonization: A case report / Facetas de resina compuesta con cierre de diastemas para harmonización de la sonrisa: Informe de caso

Introdução:A estética do sorriso é um aspecto valorizado pela sociedade atual, o que demanda que os profissionais de odontologia estejam atualizados sobre materiais dentários e novas técnicas para alcançar resultados estéticos restauradores de alta qualidade. A resina composta é frequentemente utilizada para simplificar a reabilitação oral, pois oferece facetas dentárias que combinam excelente estética e durabilidade. Objetivo:Este artigo tem como objetivo relatar um caso clínico de reabilitação estética utilizando facetas em resina composta com fechamento de diastemas.Relato de caso:Uma paciente do sexo feminino, com 24 anos de idade, procurou a clínica escola de odontologia com insatisfação em relação à estética do seu sorriso. A pacienteapresentava diastemas, restauração defeituosa e desproporção no tamanho dos dentes anteriores. O tratamento consistiu em um clareamento caseiro prévio, seguido pela confecção de facetas diretas em resina composta para fechamento dos diastemas e correção da desproporção dentária. Foram utilizados um Jig Estético e o software Digital Smile Design (DSD)para o planejamento, além de um mock-up em resina bisacrílica. Após a confecção das facetas, foi obtido um resultado estético final satisfatório. O caso incluiu um total de oito facetas,dos dentes 14 ao 24. Conclusão:O tratamento utilizando restaurações em resina composta proporcionou à paciente uma reabilitação estética, funcional e biológica (AU).

Introduction:Smile aesthetics is an aspect valued by today's society, which demands that dental professionals are up to date on dental materials and new techniques to achieve high-quality restorative aesthetic results. Composite resin is often used to simplify oral rehabilitation, as it offers dental veneers which combine excellent aesthetics and durability. Objective:This article aims to report a clinical case of aesthetic rehabilitation using composite resin veneers with diastema closure. Case report:A24-year-old female patient came to the dental school clinic with dissatisfaction regarding the aesthetics of her smile. The patient had diastemas, defective restoration and disproportionate anterior teeth size. The treatment consisted of prior at-home tooth bleaching, followed by creating direct composite resin veneers to close the diastemas and correct tooth disproportion. An Aesthetic Jig and the Digital Smile Design (DSD) software program were used for planning, in addition to a mock-up in bisacrylic resin. After treatment, a satisfactory final aesthetic result was obtained. The case included a total of eight veneers, from teeth 14 to 24. Conclusion:Treatment using composite resin restorations provided the patient with aesthetic, functional and biological rehabilitation (AU).

Introducción: La estética de la sonrisa es un aspecto valorado por la sociedad actual, hecho que demanda de los profesionales de odontología actualización constante sobre los materiales dentarios y nuevas técnicas para alcanzar resultados estéticos restauradores de altacualidad. La resina compuesta es frecuentemente utilizada para simplificar la rehabilitación oral, pues ofrece facetas dentarias que combinan excelente estética y durabilidad.Objetivo: Este artículo tiene como objetivo relatar un caso clínico de rehabilitación estética a partir de la utilización de facetas en resina compuesta con cierre de diastemas. Informe de caso: Una paciente, del sexo femenino, con 24 años de edad, buscó la clínica-escuela de odontología insatisfecha con la estética de su sonrisa. La paciente presentaba diastemas, restauración dentaria defectuosa y desproporción en el tamaño de los dientes anteriores. El tratamiento consistió en un blanqueamiento casero previo, seguido por la confección de facetas directas de resina compuesta para cierre de los diastemas y corrección de la desproporción dentaria. Fueron utilizados un Jig Estético y el software Digital Smile Design(DSD) para el planeamiento, además de un mock-upen resina bisacrílica. Tras la confección de las facetas, fue obtenido un resultado estético final satisfactorio. El caso incluyó un total de ocho facetas, de los dientes 14 al 24.Conclusión: El tratamiento a partir de restauraciones en resina compuesta proporcionó a la paciente una rehabilitación estética, funcional y biológica (AU).

Intensidad lumínica de las lámparas de fotocurado LED en los consultorios odontológicos de Piura, Perú / Output intensity of LED light curing units in dental offices of Piura, Peru

Introducción: La lámpara de fotocurado, que utiliza diodos emisores de luz (LED), se emplea en odontología para la conversión polimérica de los materiales de restauración dental. Se ha comunicado que una intensidad lumínica inadecuada de la lámpara no aseguraría la correcta polimerización del material de restauración. Objetivo: Determinar la intensidad lumínica de las lámparas de fotocurado LED en consultorios odontológicos de la ciudad de Piura, Perú, 2020. Métodos: Estudio observacional, descriptivo. Se midió la intensidad lumínica en 70 lámparas de fotocurado LED, usando un radiómetro con una longitud de onda de 400-500 nm, con capacidad de medida de la intensidad lumínica de hasta 3500 mw/cm2. Por debajo de los 400 mw/cm2 indica intensidad baja, de 400 a 800 mw/cm2 intensidad media, de 800 a 1200 mw/cm2 intensidad alta y por encima de los 1200 mw/cm2 indica intensidad muy alta. Resultados: El 48,5 por ciento de las lámparas analizadas presentaban intensidad media, el 22,86 por ciento intensidad alta, mientras que el 15,71 por ciento intensidad baja y finalmente el 12,86 por ciento de las lámparas presentaban intensidad muy alta. Se reportó menor frecuencia de lámparas con mayor uso clínico. Conclusiones: Las lámparas de fotocurado LED, utilizadas en los consultorios dentales de la provincia de Piura durante el 2020, emiten una intensidad lumínica promedio de 778,14 mW/cm2, equivalente a la intensidad media(AU)

Introduction: Light curing lamps that use light-emitting diodes (LED) are used in dentistry for the polymeric conversion of dental restorative materials. It has been reported that inadequate light intensity in the lamp would not ensure the appropriate polymerization of restorative materials. Objective: Determine the output intensity of LED light curing units used in dental offices of the city of Piura, Peru, in the year 2020. Methods: An observational descriptive study was conducted. Measurements were taken of the light output of 70 LED light curing lamps using a radiometer with a wavelength of 400-500 nm and a light intensity measurement capacity of up to 3 500 mw/cm2. Intensity below 400 mw/cm2 was recorded as low, from 400 to 800 mw/cm2 as medium, from 800 a 1 200 mw/cm2 as high and above 1 200 mw/cm2 as very high. Results: Intensity was medium in 48.5 percent of the lamps analyzed, high in 22.86 percent, low in 15.71 percent and very high in 12.86 percent. A lower frequency of lamps with greater clinical use was reported. Conclusions: The LED light curing lamps used in dental offices of the province of Piura during the year 2020 emit an average output intensity of 778.14 mW/cm2, which corresponds to medium intensity(AU)

Proteção da vitalidade dentino-pulpar em odontopediatria: uma revisão de literatura / Dentin-pulp protection in pediatric dentistry: a review

Dentin and pulp are considered interdependent substrates, known as the dentin-pulp complex. In front of injuries such as caries and trauma, this complex should be protected with restorative materials considered to be protective agents. An ideal material should have properties such as biocompatibility, be antimicrobial, be insoluble in the oral environment, be thermal and electrically insulating, have therapeutic potential, and adequate mechanical properties. As these characteristics are not found in all materials, the dentist must know the advantages and disadvantages of those that are available. This study aimed to perform a critical review of the indirect materials indicated for the protection of dentin-pulp vitality (PDPV) to ensure the success of indirect pulp treatment in primary teeth. A search was carried out in books, theses, dissertations, monographs, printed articles and databases, PubMed, SciELO, and MEDLINE. According to the literature, the success in protecting the dentin-pulp vitality is achieved through an excellent marginal seal, preventing bacterial infiltration in the dentin and controlling the progression of caries. Further clinical studies are needed to evaluate other outcomes after indirect pulp treatment. There isn't a material that has all the desired characteristics for PDPV, and recent studies show that the key to PDPV isn't found in the protective material, but in the restorations marginal sealing, enabling the inactivation of the progression of dental caries.

A dentina e a polpa são consideradas substratos interdependentes, conhecido como complexo dentino-pulpar. Frente a injúrias como cárie e traumatismo, deve-se realizar a proteção desse complexo, baseando-se na inserção de materiais restauradores considerados agentes protetores. Os materiais considerados ideais devem apresentar propriedades como: biocompatibilidade, ser antimicrobiano, ser insolúvel ao meio bucal, ser isolante térmico e elétrico, ter potencial terapêutico e propriedades mecânicas adequadas. Como essas características não são encontradas em todos os materiais, é importante que o cirurgião-dentista conheça as vantagens e as desvantagens daqueles que estão disponíveis comercialmente. O objetivo deste trabalho foi realizar uma revisão crítica da literatura sobre os materiais indicados para proteção indireta da vitalidade dentino-pulpar (PVDP), em dentes decíduos. Para isso, foram pesquisados livros, teses, dissertações, monografias, artigos impressos e das bases de dados, PubMed, SciELO e MEDLINE. De acordo com a literatura, observou-se que a garantia de êxito na proteção da vitalidade dentino-pulpar é alcançada por meio de um ótimo selamento marginal, impedindo a infiltração bacteriana na dentina e controlando a progressão da cárie. São necessários mais estudos clínicos que avaliem outros desfechos após o tratamento indireto da polpa. Não existe um material que possua todas as características desejadas para a PVDP, e estudos recentes demonstram que a chave não se encontra no material protetor, mas sim na vedação marginal das restaurações, propiciando a inativação da progressão da cárie dentária.

Evaluación de la precisión de impresiones sobre implantes usando guía multifuncional en el sistema all-on-four / Accuracy of implant impression using a multifunctional guide in the All-on-Four treatment concept

ABSTRACT Introduction: The passivity of prosthetic components is one of the most important prerequisites in oral implant rehabilitation for maintenance of osseointegration. Objective: Thus, the present study analyzed in vitro the accuracy of different molding techniques in prosthetic rehabilitation on angled implants installed in an anatomical model of a metallic edentulous maxilla. Methods: Laboratory experiment study. A reference metal model of an edentulous maxilla was used. A metal framework was used for the misadaptation assessment. Three groups (n= 10) were compared and impressions were made with vinyl-polysiloxane and casts were obtained with type IV stone: (1) Impression with a metallic open-tray without splinted transfers; (2) Impression with a metallic open-tray and metal splinted transfers; (3) Impression with a multifunctional guide and metal splinted transfers. Misadaptation was assessed with the aid of a stereomicroscope and measuring software. Data were submitted to ANOVA with Welch correction and the Games-Howell post-hoc test with the significance set at 5 percent. Results: Misadaptation (µm) was 110,23 ± 30,94, 37,53 ± 3,92, and 37,69 ± 2,79 for the the groups. Statistically significant differences between impression with a metallic open-tray with and without splinted transfers were observed (p < 0,001). No significant differences between the other types of impression. Conclusions: Impression with a metallic open-tray without splinted transfers and with a multifunctional guide splinted with metal transfers were the most precise methods resulting in higher accuracy in transferred implants(AU)

RESUMEN Introducción: La pasividad de los componentes protésicos es uno de los prerrequisitos más importantes para el mantenimiento de la osteointegración en la rehabilitación oral sobre implantes. Objetivo: Evaluar in vitro la precisión de diferentes técnicas de impresión en rehabilitación sobre implantes inclinados instalados en un modelo anatómico de un maxilar metálico desdentado. Métodos: Estudio de laboratorio de tipo experimental. Se utilizó un modelo metálico de referencia de un maxilar desdentado. Fue utilizada una barra metálica para la evaluación de la desadaptación. Se compararon tres grupos (n = 10), se realizaron impresiones con polivinilsiloxano y se obtuvieron modelos con yeso piedra tipo IV: (1) impresión con una cubeta metálica abierta sin unión de los transferentes; (2) impresión con una cubeta metálica abierta y unión de los transferentes con cilindros metálicos; (3) impresión con una guía multifuncional y unión de los transferentes con cilindros metálicos. La desadaptación se evaluó con la ayuda de un microscopio estereoscópico y un software de medición. Los datos se enviaron a ANOVA con la corrección de Welch y la prueba post-hoc de Games-Howell con la significación establecida en 5 por ciento. Resultados: La desadaptación (µm) fue de 110,23 ± 30,94; 37,53 ± 3,92 y 37,69 ± 2,79 para los grupos, respectivamente. Se observaron diferencias estadísticamente significativas entre la impresión con cubeta abierta metálica con y sin unión de los transferentes (p <0,001). No hubo diferencias significativas entre los otros tipos de impresiones. Conclusiones: La impresión con cubeta abierta metálica sin unión de los transferentes y con una guía multifuncional con unión de los transferentes con cilindros metálicos fueron los métodos más precisos que dieron como resultado una mayor precisión en la transferencia de la posición de los implantes(AU)

Fluoride Release of Giomer and Resin Based Fissure Sealants / Liberación de flúor de sellantes de fosas y fisuras a base de resina y/o ionómero

ABSTRACT Fissure sealants are applied to teeth to prevent caries development. The presence of the fissure sealant creates a protective barrier, which prevents plaque accumulation to the pits and fissure. They have a significant role in preventing pit and fissure caries. The aim of this study was to evaluate the time-dependent fluoride ion release of giomer- and resin-based fissure sealants. Fissure sealants were divided into 4 groups: BeautiSealant (Shofu, Japan), Clinpro Sealant (3M ESPE, USA), Helioseal F (Ivoclar Vivadent, Liechtenstein), Fissurit F (Voco, Germany). Disk shaped samples were prepared for each sealant material tested, and they were transferred into polyethylene vials containing 5 ml of deionized water. Fluoride ion diffusion was determined on days 1,2,3,7,14,21, and 28 (n=7). The fluoride concentration in these samples was analyzed using a pre-calibrated spectrophotometer in parts per million (ppm). These experiments were performed in triplicates at room temperature. ANOVA and Tukey's HSD test were used for statistical analysis. BeautiSealant was released the highest amount of fluoride on day 1 (5.33 ppm), followed by a sudden decrease on the day 2 (2.17ppm). The burst effect was observed only in this group. Clinpro Sealant, Fissurit F and HelioSeal F groups presented fluoride release of 2.69, 2.94 and 2.91 ppm on the first day, respectively, without a significant difference (p>0.05). After the first week, a constant fluoride release level has been reached. The fluoride release for the three resin-based fissure sealants was slightly lower than that for the giomer-based. After the first week, materials exhibited no significant difference and reached a plateau. The usage of a high and prolonged fluoride-releasing fissure sealant material should be considered by clinicians, particularly in patients with caries risk.

RESUMEN Los sellantes de fosas y fisuras se utilizan con el objetivo de prevenir el desarrollo de caries. La presencia del sellante crea una barrera protectora, que evita la acumulación de placa en las fosas y fisuras. Tienen un papel importante en la prevención de la caries. El objetivo de este estudio fue evaluar la liberación de iones fluoruro de los sellantes de fosas y fisuras a base de Ionómeros y resinas. Los sellantes de fosas y fisuras se dividieron en 4 grupos: BeautiSealant (Shofu, Japón), Clinpro Sealant (3M ESPE, EE. UU.), Helioseal F (Ivoclar Vivadent, Liechtenstein), Fissurit F (Voco, Alemania). Se prepararon muestras en forma de disco para cada material, y se transfirieron a viales de polietileno que contenían 5 ml de agua desionizada. La difusión de iones fluoruro se determinó en los días 1,2,3,7,14,21 y 28 (n=7). La concentración de fluoruro en estas muestras se analizó utilizando un espectrofotómetro precalibrado en partes por millón (ppm). Estos experimentos se realizaron por triplicado a temperatura ambiente. ANOVA y la prueba de HSD de Tukey se utilizaron para el análisis estadístico. BeautiSealant liberó la mayor cantidad de fluoruro en el día 1 (5.33 ppm), seguido por una disminución repentina en el día 2 (2.17ppm). Los grupos Clinpro Sealant, Fissurit F y HelioSeal F presentaron una liberación de fluoruro de 2.69, 2.94 y 2.91 ppm el primer día, respectivamente, sin una diferencia significativa (p> 0.05). Posterior a la primera semana, fue alcanzado un nivel constante de liberación de fluoruro. La liberación de flúor para los tres sellantes de fosas y fisuras a base de resina fue ligeramente inferior a la de los Ionómeros. Después de la primera semana, los materiales no mostraron diferencias significativas. Los odontólogos deben considerar el uso de un material sellante de fosas y fisuras que promueva la liberación de flúor a lo largo del tiempo, especialmente en pacientes con riesgo de caries.

Is there a best conventional material for restoring posterior primary teeth? A network meta-analysis

Abstract This study aimed to compare the longevity of different conventional restorative materials placed in posterior primary teeth. This systematic review was conducted following the PRISMA statement and registered in PROSPERO (CRD42016035775). A comprehensive electronic search without date or language restrictions was performed in PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Scopus, Turning Research Into Practice (TRIP) and Clinical Trials databases up to January 2017, selecting randomized clinical trials that assessed the longevity of at least two different conventional restorative materials performed in primary molars. Seventeen studies were included in this systematic review. Pairwise and network meta-analyses were performed and relative risks and 95% confidence intervals (CI) calculated. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias. Restorations of primary molars with conventional glass ionomer cement showed increased risk of failure than compomer, resin-modified glass ionomer cement, amalgam, and composite resin. Risk of bias was low in most studies (45.38% of all items across studies). Pediatric dentists should avoid conventional glass ionomer cement for restoring primary molars.

Avaliação in vitro de infiltração coronária de diferentes cimentos em cavidades complexos / In vitro evaluation of coronal leakage of different sealers in complex cavities

Objetivo: o objetivo do presente estudo foi avaliar in vitro a microin ltração coronária em cavidades complexas seladas com materiais restauradores temporários (MRT). Métodos: as cavidades foram preparadas em 60 pré-molares superiores extraídos de humanos, e os espécimes foram divididos em três grupos, de acordo com o MRT utilizado: G1 = IRM; G2 = Coltosol; G3 = Fill Magic Tempo. Três dentes serviram como controle negativo e não tiveram cavidades preparadas. Antes do selamento das cavidades com o MRT, uma esponja de colágeno foi deixada dentro da câmara pulpar, para avaliação binária da penetração do corante. Dez dentes de cada grupo não foram submetidos à ação de termociclagem e força mecânica oclusal, enquanto outros dez foram submetidos a essas ações. A amostra foi imersa em corante Rodamina B a 0,5% a 37°C, por 7 dias. Resultados: todos os dentes examinados (100%), exceto os controles negativos, apresentaram in ltração pelo corante. Todos os dentes selados com Coltosol (100%) fraturaram após ensaio mecânico, enquanto aqueles com IRM e Fill Magic Tempo mantiveram-se intactos macroscopicamente. A ação ou não das intempéries térmicas e mecânicas não interferiu na penetração do corante nas amostras no presente estudo. Conclusão: nenhum dos materiais testados impediu a in ltração do corante. No entanto, o Coltosol não deve ser indicado para utilização em cavidades complexas onde há incidência de forças mastigatórias, devido ao seu alto índice de fratura.

Propiedades anti-placa dental bacteriana de los principales materiales dentales empleados en consultas estomatológicas / Effect of the main materials used in dental practice against the formation of bacterial dental plaque

Introducción: la placa dental bacteriana y las biopelículas se forman tanto en tejidos dentales duros como en los blandos; constituye la mayor causa de formación de caries dental y de enfermedades periodontales en los pacientes afectados. Objetivo: identificar las propiedades anti-placa dental bacteriana de los materiales dentales más empleados en consultas estomatológicas a través de una revisión bibliográfica. Métodos: se realizó una revisión bibliográfica sobre las propiedades anti-biopelícula de los principales materiales dentales utilizados en consultas estomatológicas. Los criterios de inclusión fueron: las propiedades de inhibición, formación y/o desarrollo de placa dental bacteriana en la superficie de los cementos dentales empleados en endodoncia, cementos dentales de uso frecuente como el óxido de zinc, Policarboxilato e ionómero vítreo; materiales de restauración definitiva como resinas compuestas y aleaciones de plata. Los buscadores de información y plataformas empleados fueron: SciELO, HINARI, y MEDLINE. Se revisaron 21 revistas de impacto relacionadas con el tema. Se obtuvo aproximadamente 899 artículos de los cuales solo 39 fueron incluidos en el estudio. El 52,6 por ciento de los artículos fue de los últimos 5 años. Análisis e integración de los resultados: se expone el mecanismo del efecto y propiedades anti-placa dental bacteriana de algunos cementos dentales, de materiales empleados en endodoncia y de materiales de restauración permanente. Conclusiones: la revisión de la literatura indica que de los materiales dentales que se emplean, las resinas compuestas resultaron ser las que más favorecen la formación de placa dental bacteriana seguidas de la amalgama de plata. Los cementos para tratamientos endodónticos presentaron cualidades favorables para la inhibición de la formación de biopelícula dental y los cementos con compuestos de zinc, pH elevado y liberadores de flúor mostraron cualidades óptimas en la inhibición y no formación de biopelícula(AU)

Introduction: bacterial dental plaque and biofilms are formed in hard and soft dental tissue alike. They are the main cause of dental caries and periodontal disease in the patients affected. Objective: identify the effect of the materials most commonly used in dental practice against the formation of bacterial dental plaque. Methods: a bibliographic review was conducted about the antibiofilm properties of the main materials used in dental practice. The inclusion criteria were the following: inhibitory properties, formation and/or development of bacterial dental plaque on the surface of dental cements used in endodontics, commonly used dental cements such as zinc oxide, polycarboxylate and glass ionomer, permanent restoration materials such as composite resins and silver amalgam. Data were obtained from the search engines and platforms SciELO, HINARI and MEDLINE. A review was conducted of 21 high impact journals dealing with the topic. About 899 papers were obtained, of which only 39 were included in the study. 52.6 percent of the papers had been published in the last five years. Integration of results: a description is provided of the effect of several dental cements, materials used in endodontics and permanent restoration materials against the formation of bacterial dental plaque. Conclusions: according to the bibliographic review conducted, the materials that most commonly enable the formation of bacterial dental plaque are composite resins, followed by silver amalgam. Cements used in endodontic treatment were found to have antifilm properties, whereas cements with zinc compounds, high pH and fluoride releasing capacity exhibited optimal inhibitory and antifilm properties(AU)

Avaliação da rugosidade superficial de diferentes resinas compostas após a realização do acabamento e polimento / Evaluation of the surface roughness of different composites after finishing and polishing

A grande aplicabilidade clínica e a difusão do uso da resina composta geraram uma série de questionamentos sobre as características e o comportamento deste material. Dentre estes, a impossibilidade de formar uma superfície perfeitamente lisa devido aos fatores como o tamanho das partículas e a necessidade de ajustes após a confecção da restauração. Com o intuito de reduzir a rugosidade superficial, diferentes métodos de acabamento e polimento têm sido propostos. Avaliou-se a rugosidade superficial de dois diferentes tipos de resina composta, microparticulada e nanoparticulada, após a realização do acabamento e polimento final. Para isto, foram utilizadas a resina composta microparticulada Durafill VS (Heraeus-Kulzer) e as resinas nanoparticuladas Filtek Z350 XT (3M-ESPE®), Opallis (FGM®) e IPS Empress Direct (Ivoclar Vivadent®). Com essas, foram confeccionados 14 corpos de prova de cada resina composta, submetidos aos mesmos procedimentos de acabamento e polimento, seguindo as seguintes etapas: desgaste com ponta diamantada 2135 F (KG Sorensen®), polimento com a sequência de borrachas abrasivas (Ivoclar Vivadent®) e discos de feltro com pasta diamantada. Cada espécime foi submetida à leitura em rugosímetro para determinação da rugosidade superficial. Os dados obtidos foram submetidos à análise de variância (ANOVA) e teste de Tukey, com nível de significância de 5%. Não houve diferença significativa entre as rugosidades superficiais dos materiais restauradores testados e o sistema de polimento utilizado foi eficaz no aumento da lisura superficial.

The large clinical applicability and propagation of the use of composites have raised many questions about the characteristics and behavior of these materials. Among them is the impossibility of obtaining a perfectly smooth surface, due to factors such as particle size and adjustments required after the restoration is complete. In order to reduce the surface rough-ness, different finishing and polishing methods have been proposed. It was evaluated the surface roughness of two different kinds of composites, microparticle and nanoparticle, after finishing and polishing procedures. For this, we used the microfilled composite, Durafill VS (Heraeus-Kulzer) and nanoparticle composites, Filtek Z350 XT (3M-ESPE), Opallis (FGM), and IPS Empress Direct (Ivoclar Vivadent). Fourteen specimens were fabricated of each composite, and submitted to the same finishing and polishing procedures by following these steps: wear with a Diamond point 2135 F (KG Sorensen), polished with abrasive silicone rubber points sequence (Ivoclar Vivadent), and felt wheels with diamond paste. Each sample was submit¬ted to superficial roughness evaluation using a rugosimeter. Data were submitted to ANOVA statistical analysis and Tukey test at a level of significance of 5%. There were no significant statistically differences between the surface roughness of the tested restorative materials and the polishing system used was effective in increasing surface smoothness.

Anterior composite restorations in clinical practice: findings from a survey with general dental practitioners

Objectives: The aim of this study was to assess technical preferences of general dental practitioners when restoring anterior composite restorations. How the level of clinical experience or post-graduate training infuenced their options was also tested. Material and Methods: A cross-sectional study was performed using a questionnaire with general dental practitioners (GDPs) (n=276) in Southern Brazil. Information regarding post graduation training (specialization, master's or PhD degree) and linical experience (years since completing graduation) were gathered. The options regarding anterior composite restorations (type of composite, adhesive system, light curing unit, polishing procedures and rubber dam use) were collected. Data were submitted to descriptive analysis and associations were tested. Results: Response rate was 68% (187). GDPs selected microhybrid composite (52%) and 2-step total etch adhesive system (77%). LED was the preferred method of activation for 72.8%. Immediate polishing was preferred by 75%, using a combination of techniques. Most of the respondents (74.3%) did not use rubber dam. More experienced clinicians used more halogen lights (p<0.022), performed more light monitoring (p<0.001) and were resistant to use rubber dam (p<0.012). Dentists with post-graduation training used 3-etch-and-rinse system more frequently (p<0.04), usually monitored light intensity (p<0.014) and placed rubber dam more frequently (p<0.044). Conclusions: Hybrid composite, simplifed adhesives, LED units and immediate polishing were preferred by Southern Brazilian dentists for anterior composite restorations. Few dentists used rubber dam to perform composite restorations in anterior teeth. Clinical experience and post-graduation training infuenced the dentists' choices. .

Núcleo metálico fundido X pinos pré-fabricados

A restauração de um dente tratado endodonticamente, com ampla destruição coronária, tem se constituída em um desafio para clínicos e pesquisadores. Os núcleos metálicos fundidos são, há mais de cem anos, a solução mais empregada para recuperação destes dentes...

Métodos químico-mecânicos para a remoção do tecido cariado / Chemical-mechanical methods for the removal of caries

Há algumas décadas, o tratamento da cárie preconizava a remoção dos tecidos cariados baseados em princípios de extensão para prevenção por meio de instrumentos rotatórios de corte e desgaste. Atualmente, novos materiais foram introduzidos no mercado com a utilização de produtos a base de aminoácidos com hidróxido de sódio ou papaína, os quais são indicados para remoção química - mecânica da cárie sem a necessidade de anestesia e equipamentos rotatórios. Esses materiais possibilitam preparos ultraconservadores. Portanto, o objetivo deste trabalho foi discutir, por meio de uma revisão de literatura, a efetividade dos métodos químico-mecânicos para remoção do tecido cariado.

Cementos selladores en endodoncia / Endodontic sealer cements

Los objetivos principales de un tratamiento endodóntico exitoso son la limpieza y conformación adecuadas del conducto radicular y la obturación total del espacio preparado con un material inerte, dimensionalmente estable y biológicamente compatible. Una gran variedad de materiales para rellenar el sistema de conductos han sido utilizados a través de los años. Actualmente, los métodos empleados con mayor frecuencia en la obturación de los conductos radiculares se basan en el uso de conos semisólidos de gutapercha como material base. Sin embargo, este material no sella el conducto por sí solo; por ello, un cemento sellador es necesario para cubrir la dentina y para rellenar las irregularidades y discrepancias entre el material de obturación y las paredes del conducto logrando así el sellado. El cemento sellador debe poseer ciertas características que son determinantes para asegurar el éxito del tratamiento endodóntico. Debido a que el sellador estará en contacto directo con los tejidos periapicales por un tiempo prolongado, su biocompatibilidad es de gran importancia. La toxicidad de un sellador puede retardar la cicatrización de los tejidos periapicales o causar una reacción tisular inflamatoria. Actualmente, existen varios tipos de selladores endodónticos con diferentes composiciones disponibles en el mercado. El propósito de este trabajo de revisión bibliográfica es describir los diferentes tipos de cementos selladores en endodoncia tales como: cementos a base de óxido de zinc-eugenol, a base hidróxido de calcio, a base de resinas, a base de ionómero de vidrio y a base de siliconas, para tenerlo en cuenta a la hora de seleccionar el cemento más adecuado en una determinada situación clínica, La elección de uno u otro dependerá de la adaptación a nuestro objetivo, considerando sus ventajas e inconvenientes.

Zirconium for esthetic rehabilitation: An overview.

The demand for esthetic restorations has resulted in an increased use of dental ceramics for anterior and posterior restorations. A few decades ago, all-ceramic restorations were restricted to treatment in the anterior region, but now all-ceramic restorations can be made anywhere in the dentition. The properties of traditional ceramic materials, however, have limited their use to single crowns; larger restorations have been inadvisable because of insufficient strength. In attempts to meet the requirements for dental materials and improve strength and toughness, several new ceramic materials and techniques have been developed during the past few decades The paper reviews the current literature on dental zirconia with respect to survival, properties, marginal fit, cementation, esthetics and suggests clinical recommendations for their use.

Desproteinização do esmalte associada à técnica de remineralização no clareamento em consultório / Enamel deproteinization associated to remineralization technique on in-office bleaching

Objetivo: avaliar cor, brilho, rugosidade e alterações ultraestruturais do esmalte dental clareado com peróxido de hidrogênio a 35 %, submetido ao tratamento prévio com agente desproteinizante, ou ao tratamento posterior com o agente remineralizador fosforopeptídeo de caseína/fosfato de cálcio amorfo (ACP-CPP). Material e Métodos: Os grupos experimentais foram: GC (controle/consultório): H2O2 a 35 % - 4 sessões de 8 min; GE1 (primer+consultório): NaOCl 5,25 % por 1 min, aplicação do H2O2 a 35 % como no GC; e GE2 (consultório+ACP): GC + ACP-CPP diariamente por 7 dias. Fragmentos contendo esmalte e dentina (n=8), obtidos de dentes bovinos, foram utilizados para avaliar cor, brilho e a rugosidade. Alteração de cor (E), parâmetros L* e b* foram determinados com colorímetro e o brilho superficial com glossímetro antes, imediatamente após (1h), 4 e 7 dias após o tratamento. Parâmetros de rugosidades, Ra, Rt e RSm, foram obtidos com perfilômetro de contato antes, imediatamente após o tratamento e 7 dias após os tratamentos. Os resultados de E, brilho superficial e rugosidade foram avaliados separadamente usando ANOVA 2 fatores e teste de Tukey (p=0,05). Para avaliar a alteração ultraestrutural, dentes pré-molares humanos, seccionados nos sentidos vestibulo-lingual e mesio distal foram observados em microscópio eletrônico de varredura, por emissão de campo, e realizada a quantificação de elementos químicos por EDS. Análise tridimensional da estrutura do esmalte foi realizada por microtomografia computadorizada (micro-CT) com resolução 11,24 m (n=8). Foram realizadas análises dos parâmetros estruturais: espessura estrutural (St.Th.), separação estrutural (St.Sp.) e índice de fragmentação (Fr.I.) antes e após os tratamentos em duas regiões: ROI 1= 56,2 m e ROI 2= 110,2 m, ambas a partir da superfície vestibular. Foi utilizado o teste t pareado para análise estatística de cada parâmetro estrutural. Resultados: Não houve diferença estatística entre os diferentes tratamentos de superfície para E, Ra e RSm. Imediatamente após o clareamento (1h) ocorreu maior aumento do L* e queda do brilho superficial que se manteve por 7 dias. O uso de agente desproteinizante em dentes bovinos não acentuou a redução do brilho do esmalte, mas a aplicação de ACP-CPP acarretou em maior perda brilho e aumento nos valores de rugosidade após 7 dias para Rt. A aplicação do agente desproteinizante previamente ao clareamento em dente humano revelou uma superfície mais lisa, sem alterar os parâmetros estruturais. Há uma maior quantidade de cálcio, formação de um manto de recobrimento após aplicação de ACP-CPP em torno dos prismas de esmalte, aumento de St.Th de 4,1m, menor espaçamento entre os cristais de hidroxiapatita e redução de St.Sp em 0,8 m e de Fr.I em 0,01 no ROI-1 após 7 dias. Conclusão: O uso de agente desproteinizante não altera a cor, brilho e a ultraestrutura inorgânica. A aplicação de ACP-CPP após a técnica de clareamento de consultório não contribui para alteração de cor, mas reduz o brilho e altera a ultraestrutura da porção mais externa do esmalte após 7 dias.

Purpose: To evaluate color, gloss, roughness and ultrastructural changes of enamel bleached with 35% hydrogen peroxide, subjected to previous treatment with deproteinized agent, or later treatment with remineralizing agent casein phosphopeptide-amorphous calcium phosphate (CPP-ACP). Materials and Methods: The experimental groups were: GC (control + in-office): 35% H2O2 - 4 sessions of 8 min; GE1(primer+in-office): 5.25% NaOCl during 1 min before the application of 35% H2O2 as done in GC, and GE2 (in-office+ACP-CPP): GC + ACP-CPP, daily applied during 7 days. Enamel and dentin blocks (n=8), obtained from bovine tooth, were used to evaluate color, gloss and roughness. Color changes (E), L* and b* parameters were done with a colorimeter and surface gloss with a glossimeter, before, immediately after (1h), 4 and 7 days after treatment. Roughness parameters, Ra, RT and Rsm, were done with a contact perfilometer before, immediately after and 7 days after treatments. ANOVA two-way and Tukeys test were performed to evaluate E, gloss and roughness separately (p=0.05). To access human pre-molar ultrastructural changes, teeth were cross-sectioned buccal-lingual and disto-mesio observed by scanning electron microscope, field emission gun, EDS to quantify chemical elements. Enamel three-dimensional images were analysed with microcomputed tomography (micro-CT) with resolution 11,24m (n=8). Structural parameters were analyzed: structural thickness (St.Th.), structural separation (St.Sp.) and fragmentation index (Fr.I.) before and after treatments in two regions of interest:ROI 1= 56,2m and ROI 2= 110,2 m, both from buccal surface. Paired t-test was done for analyses of each structural parameter. Results: There was no statistical difference among surface treatments to E, Ra and Rsm. Immediately after bleaching (1h) occured highest L* increase and decrease of surface gloss which remained until 7 days. Deproteinized agent applied on bovine tooth not emphasized enamel gloss reduction, but the CPP-ACP has resulted in a higher gloss reduction and roughness increase (Rt parameter) after 7 days. Deproteinized agent application previous to in- office bleaching observed a smooth surface, without structural parameters changes. There is a greater calcium quantity, forming a cover mantle after CPP-ACP application around enamel prisms, St.Th increase of 4,1m, less spacing between hydroxyapatite crystals and reductions of St.Sp of 0,8 m and Fr.I of 0,01 on ROI-1 after 7 days. Conclusion: Application of deproteinized agent does not change bovine enamel color, gloss and human enamel inorganic ultrastructure. CPP-ACP application after in-office bleaching does not contribute to color change, but decrease gloss of bovine enamel and change human enamel outermost ultrastructure portion after 7 days.

Quad-helix vs placa removible con tornillo de expansión / Quad-helix vs removable screw plate expansion

La variedad de aparatología para el tratamiento de la mordida cruzada posterior hace con que el Ortodoncista evalúe algunos criterios para su selección y éxito en el tratamiento. El objetivo de este artículo es comparar dos métodos de tratamiento de mordida cruzada posterior en dos casos clínicos tratados con Quad-helix y Placa removible con tornillo de expansión. Podemos concluir que el Quad-helix es el método de tratamiento de primera elección en relación a la placa removible por el corto tiempo de tratamiento, las pocas visitas al ortodoncista, su bajo costo y por la poca colaboración que se necesita del paciente

The different kind of appliances for the treatment of posterior crossbite make that the orthodontist assess some criterions for their selection and success for the treatment. The aim of this paper was to compare two methods of treatment of the posterior crossbite by two case reports treated with Quad-helix and removable plate. Concluding that the Quad-helix is the appliance of first choice in relation of the removable plate for the short time of active treatment, the less visits and chair time, the fewer cost of treatment and the smaller cooperation of the patient

Seal capability of interim post and core crown with temporary cements

The purpose of the present study was to evaluate the in vitro seal capability of interim post and core crown restorations. Eighty teeth were selected and divided into 8 groups. Four experimental groups received interim posts and core crowns. Half of each group was decoronated at the cementum-enamel junction, groups PCCH and PCZO. The other half was sectioned 2 mm coronal to the cementum-enamel junction, groups PCrZO and PCrCH. The interim post and core crowns were luted with Rely X Temp NE, groups PCrZO and PCZO; Hydro C was used for Groups PCrCH and PCCH. The control groups, PC and PCr, received uncoated post and core crowns; groups OTg and OT were left without interim post and core crowns and were totally open. Infiltration was accessed by dye exposure followed by demineralization of the teeth. The length of the infiltration was measured using digital images taken from the specimens. The images were inserted into the Image Tool 3.0 software. Kruskal-Wallis analysis of variance and Dunn's multiple comparison method were used to test for significant differences among test groups (P < .05). Groups PCrZO and PCrCH showed the least dye penetration, followed by groups PCZO and PCCH. Teeth restored with interim post and core crowns will be subject to leakage. Ethics Committee: 095/2008.

Two decades of ART: improving on success through further research

Since the introduction of the Atraumatic Restorative Treatment (ART) approach over twenty years ago, more than 190 research publications have appeared. The last research agenda defining research priorities for ART was published in 1999. The objective of the present work was to review existing research in the context of future research priorities for ART. MATERIAL AND METHODS: An internet survey was conducted amongst those who had published on ART or were known to be working on the ART approach, to solicit their views as to areas of future ART research. Three broad categories were defined, namely: 1. Basic and laboratory research; 2. Clinical research, and, 3. Community, Public Health, Health Services Research. RESULTS: A 31 percent response rate was achieved. The study identified a number of new areas of research as well as areas where additional research is required. These are expressed as recommendations for future ART research. CONCLUSIONS: The ART approach is based on a robust, reliable and ever-growing evidence base concerning its clinical applications which indicates that it is a reliable and quality treatment approach. In common with all other oral health care procedures, targeted applied research is required to improve the oral health care offered.

Consideraciones para la toma de impresión de prótesis sobre implantes / Considerations impression of implant prosthetics

El diseño protésico depende de ciertas condiciones orales y hoy en día el tratamiento con implantes es un recurso terapéutico habitual en el reemplazo de dientes. Existen circunstancias que modifican el desarrollo del tratamiento implantológico y que deben ser evaluadas como son: el espacio entre las arcadas dentales, plano oclusal existente, relación y forma de las arcadas dentales, número y posición de los dientes, entre otras, que determinan la intervención interdisciplinaria del área protésica, implantología y en ocasiones de la ortodoncia para no comprometer el resultado protésico final. Un aspecto importante a considerar es la toma de una correcta impresión para la obtención de un modelo de trabajo que garantice una total precisión en la fabricación de la prótesis con implantes. De esta forma el objetivo fue determinar las consideraciones para la toma de impresión de prótesis con implantes, indicando los tipos de materiales de impresión, sus propiedades, el uso de cubetas individuales. Todo con el propósito de dar a conocer la forma correcta de lograr un resultado Protésico funcional y estético

The prosthetic design depend of the orals conditions, and today the implants treating is a therapeutic and habitual recur in the teeth replace. There are circumstances that modify the implant treating development and that should be evaluated these are: the space between dental arcades, the occlusion, relation and form of the dental arcades, number and position teeth, and others, that determinate the interdisciplinary intervention of the prosthetic area, the implantology, and the orthodontics, for no to compromise the prosthetic result. An important aspect to considerate is the correct impression for to obtain a model works that guarantee a total precision of the prosthesis with implants fabrication. The objective was to determinate the considerations about prosthesis with implants impression, indicating the materials impression types, theirs properties, the individual trays use, with the propose to know the correct form to get a functional and esthetic Prosthetic result

Evolución y tendencias actuales en resinas compuestas / Current trends and evolution on dental composites

La introducción de la tecnología de las resinas compuestas dentro de la odontología restauradora, ha sido una de las contribuciones más significativas para la odontología en los últimos veinte años. Las ventajas de las restauraciones adheridas a la estructura dental, incluyen conservación de tejido dental sano, reducción de la microfiltración, prevención de la sensibilidad postoperatoria, refuerzo de la estructura dental y la transmisión / distribución de las fuerzas masticatorias a través de la interfase adhesiva del diente. A pesar de sus ventajas, las resinas compuestas presentan significativas deficiencias en cuanto a su desempeño, sobre todo lo relacionado con la contracción de polimerización y al estrés que esta produce en la interfase diente - restauración. Actualmente, las mejoras en las formulaciones, el desarrollo de nuevas técnicas de colocación y la optimización de sus propiedades físicas y mecánicas, han hecho la restauración de resina compuesta más confiable y predecible. El objetivo principal de este artículo fue analizar los avances en los materiales de restauración de resina compuesta, a través de una exhaustiva revisión de la literatura, donde se valoraron aspectos tales como: composición, clasificación, propiedades físicas y mecánicas, aspectos de manipulación y tendencias actuales de estos materiales

The introduction of composite-based resin technology to restorative dentistry was one of the most significant contributions to dentistry in the last twenty year. The advantages of bonded restorations include conservation of sound tooth structure, reduction of microleakage, prevention of postoperative sensitivity, tooth reinforcement and the transmission / distribution of functional stress across the bonding interface of the tooth. Today, improvements in formulations, development of new placement techniques and the optimization of physical and mechanicals properties had made the direct composite restoration more reliable and predictable. The main objective of this article was analyzing the advances of resin composites restoration material. Trought an exhaustive literature revision. Valuing aspect as composition, classification, phisycal and mechanical properties, manipulation and current trends of this material.