Evidence-Based Recommendations for the Oral Health of Patients with Parkinson's Disease.

INTRODUCTION: Patients with Parkinson's disease (PD) present a variety of oral disease that can be worsened by xerostomia and sialorrhea. The patients' physical limitations, for example rigidity and tremor, add to the difficulty of oral care by the general dental surgeon. The objective of the present review was to organize a list of evidence-based recommendations for the oral care of patients with PD. METHODS: A systematic review of the literature was carried out by specialists who selected the relevant papers and created a list of recommendations based upon the literature. RESULTS: Fourteen papers (data reported in 16 articles) were included in this review. Patients with PD had reduced quality of oral health and hygiene, and high prevalence of gingival recession, periodontal disease, dental calculus, tooth decay, tooth mobility and loss, drooling, xerostomia, dysphagia and temporomandibular disorders. Most studies offered class IV evidence, while one paper had class II evidence. CONCLUSION: Patients with PD present poor oral health with conditions that are mostly preventable.

Effect of Camphorquinone Concentration in Physical-Mechanical Properties of Experimental Flowable Resin Composites.

The aim of this study was to evaluate the effect of camphorquinone concentration in physical-mechanical properties of experimental flowable composites in order to find the concentration that results in maximum conversion, balanced mechanical strength, and minimum shrinkage stress. Model composites based on BISGMA/TEGDMA with 70% wt filler loading were prepared containing different concentrations of camphorquinone (CQ) on resin matrix (0.25%, 0.50%, 1%, 1.50%, and 2% by weight). Degree of conversion was determined by FTIR. Surface hardness was assessed before and after 24 h ethanol storage and softening rate was determined. Depth of cure was determined by Knoop hardness evaluation at different depths. Color was assessed by reflectance spectrophotometer, employing the CIE-Lab system. Flexural strength and elastic modulus were determined by a three-point bending test. Shrinkage stress was determined in a Universal Testing Machine in a high compliance system. Data were submitted to ANOVA and Tukey's test (α = 0.05). The increase in CQ concentration caused a significant increase on flexural strength and luminosity of composites. Surface hardness was not affected by the concentration of CQ. Composite containing 0.25% wt CQ showed lower elastic modulus and shrinkage stress when compared to others. Depth of cure was 3 mm for composite containing 1% CQ and 2 mm for the other tested composites. Degree of conversion was inversely correlated with softening rate and directly correlated with elastic modulus and shrinkage stress. In conclusion, CQ concentration affects polymerization characteristics and mechanical strength of composites. The concentration of CQ in flowable composite for optimized polymerization and properties was 1% wt of the resin matrix, which allows adequate balance among degree of conversion, depth of cure, mechanical properties, and color characteristics of these materials.

Caries progression in non-cavitated fissures after infiltrant application: a 3-year follow-up of a randomized controlled clinical trial.

OBJECTIVES: To evaluate the efficacy of a conservative treatment to prevent the progression of caries using an infiltrant on non-cavitated pit and fissures. MATERIAL AND METHODS: This controlled clinical trial selected 23 volunteers with clinically and radiographically non-cavitated occlusal caries among patients presenting a "rather low" to "very high" caries risk. Eighty-six teeth were randomly divided into two experimental groups: teeth receiving a commercial pit-and-fissure sealant (Alpha Seal-DFL) and contralateral teeth receiving Icon infiltrant (DMG). Caries progression was monitored by clinical (laser fluorescence caries detection) and radiographic examination at 12-month intervals over a period of 3 years of monitored caries progression. Probing the sealing materials to detect areas of retention was also used to evaluate marginal integrity. RESULTS: Statistical analysis showed no difference in caries progression using laser fluorescence caries detection when both materials were compared, regardless of the evaluation times (p>0.05). No significance was observed when the marginal sealant integrity of both materials was compared, regardless of the evaluation time (p<0.05). Marginal integrity significantly reduced after 1 year for both materials (p<0.05), but remained stable after 2 and 3 years of evaluation, compared with 1-year results (p>0.05). SEM analysis exhibited a more homogeneous sealing for the infiltrant than obtained by the sealant. CONCLUSIONS: The infiltrant was effective to prevent the caries progression in non-cavitated pit-and-fissures after 3 years of clinical evaluation, comparable with the conventional sealant. The infiltrant also presented better results in terms of caries progression at the 3-year evaluation time using the radiographic analysis.

Caries progression in non-cavitated fissures after infiltrant application: a 3-year follow-up of a randomized controlled clinical trial

Abstract Objectives To evaluate the efficacy of a conservative treatment to prevent the progression of caries using an infiltrant on non-cavitated pit and fissures. Material and Methods This controlled clinical trial selected 23 volunteers with clinically and radiographically non-cavitated occlusal caries among patients presenting a "rather low" to "very high" caries risk. Eighty-six teeth were randomly divided into two experimental groups: teeth receiving a commercial pit-and-fissure sealant (Alpha Seal-DFL) and contralateral teeth receiving Icon infiltrant (DMG). Caries progression was monitored by clinical (laser fluorescence caries detection) and radiographic examination at 12-month intervals over a period of 3 years of monitored caries progression. Probing the sealing materials to detect areas of retention was also used to evaluate marginal integrity. Results Statistical analysis showed no difference in caries progression using laser fluorescence caries detection when both materials were compared, regardless of the evaluation times (p>0.05). No significance was observed when the marginal sealant integrity of both materials was compared, regardless of the evaluation time (p<0.05). Marginal integrity significantly reduced after 1 year for both materials (p<0.05), but remained stable after 2 and 3 years of evaluation, compared with 1-year results (p>0.05). SEM analysis exhibited a more homogeneous sealing for the infiltrant than obtained by the sealant. Conclusions The infiltrant was effective to prevent the caries progression in non-cavitated pit-and-fissures after 3 years of clinical evaluation, comparable with the conventional sealant. The infiltrant also presented better results in terms of caries progression at the 3-year evaluation time using the radiographic analysis.

Randomized, double-blind, placebo-controlled clinical trial on the effects of propolis and chlorhexidine mouthrinses on gingivitis.

OBJECTIVE: The aim of this study was to compare the effects of typified propolis and chlorhexidine mouthrinses on gingival health in a randomized double-blind placebo-controlled clinical trial. MATERIAL AND METHODS: Sixty participants were randomized to 3 mouthrinse study groups: 1) 2% typified propolis (n = 20); 2) 0.12% chlorhexidine (n = 20), and 3) placebo (n = 20). Participants rinsed unsupervised twice a day for 28 days. The Papillary Bleeding Score (PBS) was measured on the mesio-buccal surfaces of all teeth at baseline and 28 days thereafter. Co-variance analysis was employed to compare PBS average values and the number of sites with PBS ≥ 2 among study groups. Sub-group analysis was further applied to participants who were < 40 years-old. RESULTS: The results show efficacy of propolis mouthrinse when comparing before and after treatment protocols significantly for a reduction of mean PBS scores. For younger participants propolis mouthrinse was superior to all groups in reducing mean PBS scores and significant when compared to 0.12% chlorhexidine mouthrinse. CONCLUSION: The efficacy of 2% typified propolis mouthrinse was demonstrated in reducing the levels of gingival inflammation. These results need to be duplicated by other investigators under similar study protocols.

Randomized, double-blind, placebo-controlled clinical trial on the effects of propolis and chlorhexidine mouthrinses on gingivitis / Ensaio clínico duplo-cego randomizado e placebo-controlado dos efeitos de enxaguatórios a base de própolis e clorexidina na saúde gengival, para análise

Objective: The aim of this study was to compare the effects of typified propolis and chlorhexidine mouthrinses on gingival health in a randomized double-blind placebo-controlled clinical trial. Material and Methods: Sixty participants were randomized to 3 mouthrinse study groups: 1) 2% typified propolis (n = 20); 2) 0.12% chlorhexidine (n = 20), and 3) placebo (n = 20). Participants rinsed unsupervised twice a day for 28 days. The Papillary Bleeding Score (PBS) was measured on the mesio-buccal surfaces of all teeth at baseline and 28 days thereafter. Co-variance analysis was employed to compare PBS average values and the number of sites with PBS ≥ 2 among study groups. Sub-group analysis was further applied to participants who were < 40 years-old. Results: The results show efficacy of propolis mouthrinse when comparing before and after treatment protocols significantly for a reduction of mean PBS scores. For younger participants propolis mouthrinse was superior to all groups in reducing mean PBS scores and significant when compared to 0.12% chlorhexidine mouthrinse. Conclusion: The efficacy of 2% typified propolis mouthrinse was demonstrated in reducing the levels of gingival inflammation. These results need to be duplicated by other investigators under similar study protocols.

Objetivos: O propósito deste estudo foi o de comparar os efeitos de enxaguatórios a base de própolis tipificada e clorexidina na saúde gengival, empregando-se um ensaio clínico duplo cego, randomizado, e placebo-controlado. Material e Métodos: Sessenta participantes foram randomizados em 3 grupos de enxaguatórios, a saber: própolis tipificada 2% (n = 20), clorexidina 0,12% (n = 20) e placebo (n = 20). Os participantes bochecharam duas vezes ao dia por 28 dias os respectivos enxaguatórios. Medidas do índice de sangramento papilar (PBS) foram feitas na superfície mésio-bucal de todos os dentes dos participantes no tempo basal e após 28 dias. Análise de co-variância foi empregada permitindo comparações entre os grupos das médias do PBS e do número de sítios ≥ 2. Análise de sub-grupo foi efetuada em participantes com idade < 40 anos. Resultados: Constataram-se os efeitos positivos do enxaguatório de própolis a 2% na reducão da inflamação gingival após uso não supervisionado por 28 dias. Análise no sub-grupo de parcipantes com idade < 40 anos constatou superioridade do enxaguatório de própolis quando comparado com o enxaguatório de clorexidina a 0,12%. Conclusão: Este ensaio clínico demonstrou a eficácia de enxaguatório de própolis tipificada a 2% na redução da inflamação gengival. Estes resultados necessitam ser duplicados por outros investigadores.

Thermo-mechanical degradation of composite restoration photoactivated by modulated methods-a SEM study of marginal and internal gap formation.

OBJECTIVE: To evaluate the influence of thermal-mechanical degradation on superficial and internal gap formation of composite restorations photoactivated using modulated methods. MATERIALS AND METHODS: An experimental composite was prepared using a resin matrix containing 65wt% Bis-GMA and 35wt% TEGDMA. Camphorquinone (0.5wt%) and dimethylaminoethyl-methacrylate (0.5wt%) were dissolved in the resin as a photo-initiator system and 65wt.% silanized glass fillers were added to the matrix. Ground buccal surfaces of bovine lower incisors were used to make 160 preparations (3 mm × 3 mm × 2 mm in depth). An adhesive system (Adper Single Bond 2) was applied and the specimens were assigned into 16 groups (n = 10), according to the photoactivation method [high intensity (HI), low intensity (LI), soft-start (SS) and pulse-delay (PD)] and the degradation protocol [(control/no degradation; thermal cycling (TC); mechanical loading (ML); thermo-mechanical loading (TC+ML)]. Marginal and internal interfaces of bonded restorations were replicated in epoxy resin and analyzed by SEM. Gaps were expressed as a percentage of the total length of the margins. Data were submitted to 2-way ANOVA and Tukey's test (α = 0.05). RESULTS: For the control group no significance was noted among the photoactivation methods. TC had no effect in gap formation. ML and TC+ML increased the incidence of superficial gaps for both HI and SS groups as well as increased the internal gaps for all groups. CONCLUSION: Although photoactivation methods do not influence gap formation at first, composite restoration photoactivated by low intensity or modulated methods showed improved resistance to thermo-mechanical degradation. Mechanical loading is determinant for interfacial degradation of composite restorations, while thermal cycling has no effect on gap formation.

Effects of typified propolis on mutans streptococci and lactobacilli: a randomized clinical trial.

OBJECTIVE: The aim of this study was to determine in a randomized, double-blind, placebo-controlled clinical trial the effects of typified propolis and chlorhexidine rinses on salivary levels of mutans streptococci (MS) and lactobacilli (LACT). METHODS: One hundred patients were screened for salivary levels of MS >100,000 CFUs/mL of saliva. All patients presented with at least one cavitated decayed surface. Sixty patients met entry criteria. Subjects were adults 18-55 years old. After restoration of cavitated lesions patients were randomized to 3 experimental groups: 1) PROP-alcohol-free 2% typified propolis rinse (n = 20); 2) CHX- 0.12% chlorhexidine rinse; 3) PL-placebo mouthrinse. Patients rinsed unsupervised 15 mL of respective rinses twice a day for 1 min for 28 days. Patients were assessed for the salivary levels of MS (Dentocult SM) and LACT (Dentocult LB) at baseline, 7-day, 14-day, and at 28-day visits (experimental effects) and at 45-day visit (residual effects). General linear models were employed to analyze the data. RESULTS: PROP was superior to CHX at 14-day and 28-day visits in suppressing the salivary levels of MS (p < .05). PROP was superior to PL at all visits (p < .01). The residual effects of PROP in suppressing the salivary levels of MS could still be observed at the 45-day visit, where significant differences between PROP and CHX (p < .05), were demonstrated. PROP was significantly superior than CHX in suppressing the levels of salivary LACT at the 28-day visit (p < .05). CONCLUSION: Typified propolis rinse was effective in suppressing cariogenic infections in caries-active patients when compared to existing and placebo therapies.

Effect of photoinitiator concentration on marginal and internal adaptation of experimental composite blends photocured by modulated methods.

OBJECTIVE: The aim of this study was to evaluate the influence of photoinitiator concentration on marginal and internal adaptation of composites photocured by modulated methods. MATERIALS AND METHODS: Composites based on BisGMA/triethylene glycol dimethacrylate and 65 wt% of filler were prepared with different concentrations of camphorquinone/amine (C1-0.5%, C2-1%, C3-1.5%). Cavities were prepared (3 mm × 3 mm × 2 mm) on the buccal surface of 120 bovine incisors and the adhesive system Adper Single Bond 2 was applied following manufactures instruction. Specimens were then distributed according to type of composite (C1, C2, C3) and photoactivation method (high-intensity - 750 mW/cm(2) for 40 s; low intensity - 150 mW/cm(2) for 200 s; soft-start - 150 mW/cm(2) for 10 s + 750 mW/cm(2) for 38 s; pulse-delay - 150 mW/cm(2) for 10 s + 3 min dark + 750 mW/cm(2) for 38 s). Superficial and internal margins were analyzed by scanning electron microscopy, using the epoxy replica technique. The length of gaps was expressed as a percentage of the total length of the margins. Data were submitted to two-way analysis of variance and Tukey's test (α =0.05). RESULTS: Modulated curing methods did not influence gap formation regarding both superficial and internal adaptation. The composite with the lower initiator concentration (C1) presented higher gap formation when compared with those with higher concentrations (C2 and C3). CONCLUSION: Modulated photoactivation methods did not reduce gap formation for the experimental composite restorations evaluated. However, higher photoinitiator concentrations promote better marginal seal.

Effects of typified propolis on mutans streptococci and lactobacilli: a randomized clinical trial / Efeitos da própolis tipificada nos estreptococcos do grupo mutans e lactobacilos: ensaio clínico randomizado

Objective: The aim of this study was to determine in a randomized, double-blind, placebo-controlled clinical trial the effects of typified propolis and chlorhexidine rinses on salivary levels of mutans streptococci (MS) and lactobacilli (LACT). Methods: One hundred patients were screened for salivary levels of MS >100,000 CFUs/mL of saliva. All patients presented with at least one cavitated decayed surface. Sixty patients met entry criteria. Subjects were adults 18-55 years old. After restoration of cavitated lesions patients were randomized to 3 experimental groups:1) PROP-alcohol-free 2% typified propolis rinse (n= 20); 2) CHX- 0.12% chlorhexidine rinse; 3) PLplacebo mouthrinse. Patients rinsed unsupervised 15 mL of respective rinses twice a day for 1 min for 28 days. Patients were assessed for the salivary levels of MS (Dentocult SM) and LACT (Dentocult LB) at baseline, 7-day, 14-day, and at 28-day visits (experimental effects) and at 45-day visit (residual effects). General linear models were employed to analyze the data. Results: PROP was superior to CHX at 14-day and 28-day visits in suppressing the salivary levels of MS (p < .05). PROP was superior to PL at all visits (p < .01). The residual effects of PROP in suppressing the salivary levels of MS could still be observed at the 45-day visit, where significant differences between PROP and CHX (p < .05), were demonstrated. PROP was significantly superior than CHX in suppressing the levels of salivary LACT at the 28-day visit (p < .05). Conclusion: Typified propolis rinse was effective in suppressing cariogenic infections in caries-active patients when compared to existing and placebo therapies.

Objetivo: O objetivo deste estudo foi determinar, em um estudo randomizado, duplo-cego, placebo-controlado os efeitos da própolis tipificada e clorexidina sobre os níveis salivares de estreptococos do grupo mutans (EM) e lactobacilos (LACT). Métodos: Cem pacientes foram selecionados para níveis salivares de MS > 100.000 UFC/mL de saliva. Todos os pacientes apresentaram pelo menos uma superfície cariada com cavitação. Sessenta pacientes preencheram os critérios de inclusão. Os indivíduos eram adultos com 18-55 anos de idade. Após a restauração das lesões cavitadas, os pacientes foram randomizados para três grupos experimentais: 1) PROP- bochecho livre de álcool de 2% de própolis tipificada (n = 20), 2) CHX- bochecho de clorexidina 0,12%, 3) PL- bochecho placebo. Os participantes bochecharam sem supervisão 15 mL dos enxaguatórios duas vezes por dia, durante 1 minuto, durante 28 dias. Os pacientes foram avaliados para os níveis salivares de MS (Dentocult SM) e LACT (Dentocult LB) na linha de base, e após 7 dias, 14 dias, 28 dias (efeitos experimentais) e 45 dias (efeitos residuais). Modelos lineares foram utilizados para analisar os dados. Resultados: PROP foi superior ao CHX nas visitas de 14 dias e de 28 dias na supressão dos níveis salivares de SM (p < 0,05). PROP foi superior ao PL em todas as visitas (p < 0,01). Os efeitos residuais de PROP na supressão dos níveis salivares de MS ainda foi observado na visita de 45 dias, onde diferenças significativas entre PROP e CHX (p < 0,05) foram demonstradas. PROP foi significativamente superior a CHX na supressão dos níveis salivares de LACT na visita de 28 dias (p < 0,05). Conclusão: O enxaguatório de própolis tipificada foi eficaz na supressão de infecções cariogênicas em pacientes com atividade de cárie quando comparado a terapias existentes e ao placebo

Comparative study of bond strength to human and bovine dentine at three different depths / Estudo comparativo da resistência adesiva à dentina humana e bovina em três diferentes profundidades

The aim of this study was to compare the bond strength to three different depths of remaining human and bovine dentin, through shear bond strength test, and to establish a possible relationship among the depths of the substrates to contribute for the replacement of human dentin in bond strength tests. Forty-eight human teeth (H) and forty-eight bovine teeth (B), freshly extracted, stored in distilled water and frozen at -18 ° C for at most four weeks were used in this study. 240-, 400-, 600- and 800-grit sandpapers were used to expose the dentin and standardize the smear layer at 0.5, 1.0 and 2.0mm of dentin thickness. Scotchbond Multi-Purpose Plus adhesive system was used following the manufacturer’s instructions, on a standardized area of 4mm, followed by the incrementally application of Z100 resin composite (3M). The shear bond test was performed in the Instron Universal machine at cross-head speed of 0.5mm/min. Statistical analysis was performed by ANOVA (p <0.05). There were significant differences in bond strength between H and B teeth, with the highest values for H teeth. There was a significant difference in bond strength to the depths analyzed but there was similarity in behavior between H (0.5mm) and B (2mm) substrates. Bovine substrate can be used for laboratory studies of bond strength as indicative of the initial performance of new products, although the differences related to human substrate should be observed.

O objetivo do presente estudo foi comparar a resistência adesiva da dentina humana e bovina em três diferentes espessuras de remanescente, frente ao teste de cisalhamento, a fim de estabelecer uma possível relação de profundidade entre os substratos visando contribuir para a substituição da dentina humana em testes de adesão. Empregaram-se 48 dentes humanos (H) e 48 dentes bovinos (B), recém-extraídos, armazenados em água destilada e congelados a –18°C, por no máximo quatro semanas. Foram utilizadas lixas de granulação 240, 400, 600 e 800, para expor a dentina e padronizar a smear layer, com espessura de dentina de 0,5, 1,0 e 2,0mm. O sistema adesivo Scotchbond Multi-Uso Plus foi utilizado seguindo instruções do fabricante, em uma área padronizada de 4mm, seguido da aplicação incremental da resina Z100 (3M). O ensaio de cisalhamento foi realizado em máquina Instron Universal à velocidade de 0,5mm/min. Foi realizada análise estatística pelo teste ANOVA a dois critérios (p < 0,05). Houve diferença significativa entre a resistência adesiva em dentes H e B, sendo os maiores valores para H; houve diferença significativa de resistência para as profundidades analisadas; houve semelhança de comportamento entre os substratos H 0,5mm e B 2mm. O substrato B pode ser empregado em estudos laboratoriais de resistência adesiva como indicativos da performance inicial de novos produtos, observando-se as diferenças existentes entre eles.

Microtensile bond strength test and failure analysis to assess bonding characteristics of different adhesion approaches to ground versus unground enamel.

This study evaluated the bonding characteristics to ground and unground enamel obtained with different strategies. For this purpose, 24 sound third-molars were bisected mesiodistally to obtain tooth halves. A flat enamel area was delimited in the tooth sections, which were randomly distributed into 8 groups (n=6), according to the enamel condition (ground and unground) and adhesive system (Adper Single Bond 2 - SB2; Adper Prompt L-Pop - PLP; Adper Prompt - AD; Clearfil SE Bond - SE). Each system was applied according manufacturers' instructions and a 6-mm-high resin composite "crown" was incrementally built up on bonded surfaces. Hourglass-shaped specimens with 0.8 mm(2) cross-section were produced. Microtensile bond strength (µTBS) was recorded and the failure patterns were classified. Results were analyzed by two-way ANOVA and Tukey's test (α=0.05). There were no statistically significant differences among the µTBS values of SB2, PLP and AD (p>0.05). SE values were significantly lower (p0.05). There was prevalence of cohesive failure within enamel, adhesive system and resin composite for SB2. The self-etch systems produced higher incidence of cohesive failures in the adhesive system. Enamel condition did not determine significant differences on bonding characteristics for the same bonding system. In conclusion, the bonding systems evaluated in this study resulted in specific µTBS and failure patterns due to the particular interaction with enamel.

Estudo in vivo do manchamento dental causado pela ingestão de café associada ao clareamento profissional / In vivo study of dental discoloration caused by coffee ingestion associated within-office dental bleaching

Objective: The present study aims to verify the effectiveness of in-office dental bleaching using 35% hydrogen peroxide in patients with or without a habit of consuming coffee at least three times per day at different time intervals (pre-bleaching or baseline;48 hours post-bleaching or start; and 90 days post-bleaching or recall). Methods and Material - Forty patients with superior and inferior vital teeth from canine to canine participated in this study. The optical measurements with SpectroShade Microspectrophotometer (MHT, Verona, Italy) determined the pre-bleaching status (baselinemeasurement), the status at 48 hours post-bleaching (start measurement), and thestatus at 90 days post-bleaching (recall measurement). The Delta E (ΔE) value was determined, and the difference between the pre- and post-bleaching luminosity was used as an indicator of the degree of chromogenic alteration. The patients were divided into four groups according to the presence or absence of a coffee ingestion habit and according to different post-bleaching time intervals. These data were analyzed by ANOVA and in case of significant differences the mean values were compared usingthe Tukey test (p < 0.05). Results and Conclusions - In conclusion, it was possible to confirm that professional dental bleaching is an effective technique that can be usedboth in patients who drink and do not drink coffee. However, the maintainability of this treatment was significantly reduced in the group of patients who habitually drink coffee within a period of only 90 days

Objetivos: O presente estudo visa verificar a efetividade do clareamento dental profissional utilizando o peróxido de hidrogênio a 35% em pacientes com e sem o hábito de ingestão de café por pelo menos três vezes ao dia em diferentes intervalosde tempo (pré-clareamento ou baseline; 48 horas pós-clareamento ou start; e 90 diaspós-clareamento ou recall). Material e Métodos - Quarenta pacientes com dentes naturais inferiores e superiores participaram deste estudo. As tomadas de cor com o espectrofotômetro SpectroShade (MHT, Verona, Itália) determinaram a condição pré clareamento(medição baseline), a condição em 48 horas pós-clareamento (medição start),e a condição após 90 dias (medição recall). O valor de Delta E (ΔE) foi determinado, e a diferença entre a luminosidade na condição pré e pós-clareamentos foram utilizadas como o indicador do grau de alteração cromatogênica. Os pacientes foram divididos em quatro grupos de acordo com a presença ou ausência de hábitos de ingestão de café e dos diferentes períodos pós-clareamento. Os dados foram analisados via ANOVA e, quando necessário, os valores médios foram comparados utilizando o teste de Tukeya 5% de significância (p < 0.05). Resultados e Conclusões - Como conclusão foi possível confirmar que clareamento dental profissional é uma técnica efetiva e que pode ser utilizada tanto em pacientes que ingerem como nos que não ingerem café. Contudo, a durabilidade deste tratamento clareador é significativamente reduzida no grupo de pacientes que habitualmente bebem café dentro de um período relativamente curto, ou seja, de apenas 90 dias

Microtensile bond strength test and failure analysis to assess bonding characteristics of different adhesion approaches to ground versus unground enamel

This study evaluated the bonding characteristics to ground and unground enamel obtained with different strategies. For this purpose, 24 sound third-molars were bisected mesiodistally to obtain tooth halves. A flat enamel area was delimited in the tooth sections, which were randomly distributed into 8 groups (n=6), according to the enamel condition (ground and unground) and adhesive system (Adper Single Bond 2 - SB2; Adper Prompt L-Pop - PLP; Adper Prompt - AD; Clearfil SE Bond - SE). Each system was applied according manufacturers' instructions and a 6-mm-high resin composite "crown" was incrementally built up on bonded surfaces. Hourglass-shaped specimens with 0.8 mm² cross-section were produced. Microtensile bond strength (μTBS) was recorded and the failure patterns were classified. Results were analyzed by two-way ANOVA and Tukey's test (α=0.05). There were no statistically significant differences among the μTBS values of SB2, PLP and AD (p>0.05). SE values were significantly lower (p0.05). There was prevalence of cohesive failure within enamel, adhesive system and resin composite for SB2. The self-etch systems produced higher incidence of cohesive failures in the adhesive system. Enamel condition did not determine significant differences on bonding characteristics for the same bonding system. In conclusion, the bonding systems evaluated in this study resulted in specific μTBS and failure patterns due to the particular interaction with enamel.

Este estudo avaliou a união ao esmalte íntegro e desgastado obtida com diferentes estratégias. Para tanto, 24 terceiros molares hígidos foram seccionados ao meio. Um plano de esmalte foi delimitado nos fragmentos de dente, aleatoriamente distribuídos em 8 grupos (n=6) conforme a condição do esmalte (íntegro ou desgastado) e o adesivo (Adper Single Bond 2: SB2; Adper Prompt L-Pop: PLP; Adper Prompt: AD; Clearfil SE Bond: SE). Estes foram aplicados seguindo recomendações dos fabricantes e uma "coroa" de compósito (altura - 6 mm) incrementalmente construída. Espécimes (ampulheta/secção transversal - 0,8 mm²) foram confeccionados. O ensaio de resistência da união à micro-tração (RUµT) foi realizado e os padrões de fratura classificadas. Os resultados analisados pela ANOVA (dois fatores) e teste de Tukey (α=0,05). Os valores de RUµT do SB2, PLP e AD não foram significativamente diferentes entre si (p>0,05); SE foi inferior (p0,05). Houve prevalência de fratura no esmalte, adesivo e compósito no SB2. Nos adesivos autocondicionantes, predominou a fratura no adesivo. A condição do esmalte não influenciou significativamente as características da união, considerando o mesmo adesivo. Em conclusão, os adesivos apresentaram RUµT e padrões de fratura específicos, devido a forma de interação com o esmalte.

Two-year clinical evaluation of self-etching adhesives in posterior restorations.

PURPOSE: To evaluate the 2-year clinical performance of three self-etching adhesives and one etch-and-rinse adhesive (control) in posterior composite restorations. MATERIALS AND METHODS: Upon approval by the Institutional Review Board, 121 restorations were inserted in 38 subjects. The adhesives were applied as per manufacturers' instructions. Preparations were restored with a nanofilled composite resin (Filtek Supreme, 3M ESPE) and evaluated at baseline, 6 months, 1 year, and 2 years. Statistical analyses included the McNemar and the Mann-Whitney non-parametric tests (p < 0.05). RESULTS: At 2 years, 91 out of 121 restorations were evaluated using the USPHS modified criteria. The number of alpha ratings decreased significantly from baseline to 2 years for Adper Prompt L-Pop, Clearfil S3 Bond, and iBond in the categories color match, marginal staining, and marginal adaptation. For One-Step Plus, only marginal staining was significantly worse at 2 years than at baseline. Postoperative sensitivity to air improved significantly for One-Step Plus at 2 years, but this improvement was already detected at 1 year. When the 2-year evaluation criteria were pooled by pairs of adhesives, One-Step Plus resulted in a significantly greater number of alfa ratings for marginal adaptation than the other three adhesives. On the other hand, iBond resulted in a significantly lower number of alfa ratings than any of the other 3 adhesives for color match and marginal staining. Adper Prompt L-Pop, Clearfil S3 Bond, and One-Step Plus resulted in a statistically similar number of alfa ratings for marginal staining and color match. There were no significant differences in any of the evaluation criteria between Clearfil S3 Bond and Adper Prompt L-Pop. CONCLUSION: Only One-Step Plus, the etch-and-rinse adhesive, resulted in good marginal adaptation at 2 years. One of the self-etching adhesives, iBond, resulted in unacceptable clinical performance.

Conhecimento do cirurgião dentista da cidade de São Paulo quanto à prevenção da cárie dental e uso de gomas de mascar / Knowledge of dentists about dental caries prevention and chewing gum in São Paulo city

Os autores desenvolveram uma pesquisa de opinião entre 100 cirurgiões dentistas através da aplicação de um questionário contendo dezesseis perguntas relacionadas com hábitos preventivos. Procurou-se distribuir os questionários de forma a atingir em proporções iguais regiões de variados níveis socioeconômicos na grande São Paulo. Após a tabulação dos dados constatou-se que embora o nível de informação do profissional em alguns aspectos preventivos seja bom, apenas a metade dos grupos pesquisados conhecem os benefícios das gomas de mascar "sugar free" como alternativa aos métodos de higienização convencionais.

One-year clinical performance of self-etch adhesives in posterior restorations.

PURPOSE: To evaluate the 1-year clinical performance of three self-etching adhesives (Adper Prompt L-Pop, Clearfil S3 Bond, iBond) in posterior composite restorations using one etch&rinse adhesive (One-Step Plus) as control. METHODS: Upon approval by the Institutional Review Board, 121 restorations were inserted in 38 subjects. The adhesives were applied as per manufacturers' instructions. Preparations were restored with a nanofilled resin composite (Filtek Supreme) and evaluated at baseline, 6 months, and 1 year. Statistical analyses included the Chi-square distribution with the McNemar non-parametric test (P < 0.05). RESULTS: At 1 year, 111 restorations in 35 subjects were evaluated using the USPHS modified criteria. No significant changes were observed for the etch&rinse adhesive One-Step Plus. At 1 year the number of Alfa ratings decreased significantly for Clearfil S3 Bond and for iBond in the categories color match, marginal staining, and marginal adaptation. For Adper Prompt L-Pop, marginal adaptation at 1 year was significantly worse than at baseline. Postoperative sensitivity to air improved significantly for Adper Prompt L-Pop, Clearfil S3 Bond, and iBond. When the evaluation criteria were paired at 1 year, iBond resulted in a significantly lower number of Alfa ratings than any of the other adhesives for color match, marginal staining, and marginal adaptation. One-Step Plus resulted in a greater number of Alfa ratings for marginal adaptation than either Adper Prompt L-Pop or Clearfil S3 Bond. Marginal adaptation was significantly better for Clearfil S3 Bond than for Adper Prompt L-Pop. The post-operative sensitivity measured at 1 year for Adper Prompt L-Pop was statistically better than that for One-Step Plus.

Density and diameter of dentinal tubules in etched and non-etched bovine dentine examined by scanning electron microscopy.

Bovine teeth have been widely used in studies focusing adhesion to dentine over the last years. However, little is known about main structural aspects of bovine dentine, especially regarding density and diameter of its tubules. Thirty bovine incisors were randomly divided into two groups. In group I, teeth were cross-sectioned at three depths: outer, middle and inner. The dentinal surfaces were etched with 35% phosphoric acid for 90s. In group II, the teeth were fractured at the same three depths. All the specimens were processed and examined in a Jeol 6100 SEM. Fifteen micrographs from each depth were obtained for the two groups at a magnification of 2500x. To determine the diameter of the dentinal tubules, the LEICA Q500 MC software was used. All the results were statistically processed in the EXCEL software. The dentinal tubules were wider at the outer regions (GI: 5.21+/-0.64microm; GII: 2.30+/-0.09microm) than that at the inner regions (GI: 2.71+/-0.72microm; GII: 1.77+/-0.06microm). Tubular density was higher at the inner regions (50310+/-11178tubules/mm(2)) than that at the outer regions (18772+/-2951tubules/mm(2)). In addition, the peritubular dentine was wider at the outer depth than at the inner one. Our results showed that bovine dentine possesses some structural aspects different from those previously reported for human dentine, mainly related to the diameter of dentinal tubules and to the thickness of peritubular dentine at the several depths.

Estudo comparativo ao microscópio de luz da morfologia das dentinas bovina e humana / Comparative study by light microscopic of the morphology of human and bovine dentin

A disponibilidade de dentes humanos para pesquisa científica tem diminuído muito. As Comissões de Bioética estão cada vez mais exigentes em relação ao uso desses dentes nestas pesquisas. Dentes bovinos têm sido utilizados como substitutos, de forma aleatória, sem que se defina se as características dessa dentina são semelhantes à humana. Os objetivos deste trabalho foram, portanto, o de estudar aspectos micromorfológicos da dentina bovina, a fim de normalizar o uso de dentes bovinos, substituindo dentes humanos em pesquisas científicas e embasar novos estudos comparativos, uma vez que a literatura apresenta poucos estudos aprofundados sobre o assunto. Dentes bovinos foram fixados em formal tamponado a 10%. Foram preparadas lâminas pelas técnicas de desgaste e de descalcificação; estas foram coradas por HematoxilinaJEosina e Tricrômico de Masson. Concluiu-se que: dentina bovina apresenta maior número de túbulos dentinários/área próximo à polpa e menor número próximo ao esmalte, semelhante à dentina humana; maior diâmetro nas proximidades do esmalte e menor diâmetro nas proximidades da polpa, ao contrário da dentina humana; a distribuição da dentina intertubular bovina próxima à polpa não foi uniforme ao longo do dente. Considerando estas conclusões, especialmente a que mostra maior diâmetro dos túbulos dentinários próximo ao esmalte, na dentina bovina, é razoável supor alterações em pesquisas que utilizam essa dentina em substituição à dentina humana. Outros estudos devem ser realizados para complementar esses achados.

Clinical performance of a self-etching adhesive at 18 months.

PURPOSE: To test the null hypothesis that beveling and/or etching enamel would not affect the 18-month clinical performance of the self-etching adhesive Clearfil SE Bond (CSEB) in noncarious cervical lesions (NCCL). METHODS: With Institutional Review Board approval, 34 patients were enrolled in this study. A total of 120 NCCL was selected and assigned to four groups: (1) CSEB was applied without any cavity preparation; (2) CSEB was applied after beveling enamel; (3) CSEB was applied after etching enamel for 15 seconds with 35% phosphoric acid; (4) CSEB was applied after beveling and etching enamel. A microfilled composite resin was used for all restorations. RESULTS: At 6 months after initial placement, 120 restorations (a 100% recall rate) were evaluated. At 18 months, 87 restorations (a 72.5% recall rate) were available for evaluation. A survival rate of 100% was measured for all groups at both 6 and 18 months. Sensitivity to air decreased significantly only for Group 3 (no bevel+acid etch) from baseline to 18 months without statistical changes from 6 months to 18 months. None of the other parameters resulted in significant differences for any of the four groups. However, when data were pooled, both the overall marginal discoloration and the overall marginal adaptation were significantly worse at 18 months than at baseline, while sensitivity to air decreased significantly from baseline to 18 months. The 18-month survival rate of the self-etching adhesive Clearfil SE Bond was not improved by enamel bevel or by enamel etching. Both overall marginal adaptation and overall marginal discoloration were worse at 18 months than at baseline. .