Blue Covarine Toothpaste versus Office Whitening: Which is the Most Effective on Stained Teeth? / Creme Dental de Blue Covarine Versus Clareamento de Consultório: Qual é o Mais Efetivo em Dentes Pigmentados?

Alternative whitening strategies to hydrogen peroxide have been proposed, such as the inclusion of abrasive and/or pigmented particles in the toothpaste. This study compared the whitening effectiveness of a toothpaste containing Blue Covarine (BC) vs. an in-office whitening treatment using 35% hydrogen peroxide (HP) in teeth stained. Bovine incisors blocks (6.0x6.0x2.0 mm) were stained with green tea (GT), orange soda (OS), or red wine (RW). The samples were randomly assigned into 8 groups (n=15), according to the type of staining and whitening treatment: G1 ­ no staining, BC (Control); G2 ­ no staining, HP (Control); G3 ­ GT, BC; G4 ­ GT, HP; G5 ­ OS, BC; G6 ­ OS, HP; G7 ­ RW, BC; G8 ­ RW, HP. Color change (ΔE), luminosity (L*), green-red axis (a*), and blue-yellow axis (b*) were recorded with spectroscopy at T0 ­ baseline, T1 ­ immediately after toothbrushing or in office tooth whitening, and T2 ­ after the conclusion of the treatments. The whiteness index for dentistry (WID) was calculated. Data were analyzed by two-way repeated measured mixed ANOVA and Bonferroni test (α=0.05). HP showed a better whitening performance (ΔE) (p ≤ 0.042). Otherwise, no effects of the whitening agent were observed (p = 1.000). Data from ΔL, Δa, and Δb showed statistically significant differences for experimental groups (p < 0.001). In the WID analysis, BC and HP had similar effects within control and RW groups. In conclusion, blue covarine toothpaste may be a viable option for extrinsically stained teeth. However, for severe staining, HP-based whitening agents proved to be the most effective treatment strategy. (AU)

Estratégias de clareamento alternativas ao peróxido de hidrogênio têm sido propostas, como a inclusão de partículas abrasivas e/ou pigmentadas nos cremes dentais. Este estudo comparou a eficácia clareadora de um creme dental contendo Blue Covarine (BC) com um tratamento de clareamento em consultório com peróxido de hidrogênio a 35% (HP) em dentes pigmentados. Blocos de incisivos bovinos (6,0x6,0x2,0 mm) foram pigmentados com chá verde (GT), refrigerante de laranja (OS) ou vinho tinto (RW). As amostras foram distribuídas aleatoriamente em 8 grupos (n = 15), de acordo com o tipo de pigmento e tratamento clareador: G1 - sem coloração, CB (Controle); G2 - sem coloração, HP (Controle); G3 - GT, BC; G4 - GT, HP; G5 - OS, BC; G6 - SO, HP; G7 - RW, BC; G8 - RW, HP. Mudança de cor (ΔE), luminosidade (L *), eixo verde-vermelho (a*) e eixo azul-amarelo (b*) foram registrados com espectroscopia em T0 - baseline, T1 - imediatamente após a escovação ou clareamento dental em consultório, e T2 - após a conclusão dos tratamentos. O índice de brancura para odontologia (WID) foi calculado. Os dados foram analisados por ANOVA mista de duas vidas para medidas repetidas e teste de Bonferroni (α = 0,05). HP apresentou melhor desempenho de clareamento (ΔE) (p ≤ 0,042). Os dados de ΔL, Δa e Δb mostraram diferenças estatisticamente significativas para os grupos experimentais (p <0,001). Na análise WID, BC e HP tiveram efeitos semelhantes nos grupos controle e RW. Em conclusão, o creme dental covarine azul pode ser uma opção viável para dentes com coloração extrínseca. No entanto, para manchas graves, os agentes de clareamento à base de HP provaram ser a estratégia de tratamento mais eficaz. (AU)

Whitening toothpaste containing activated charcoal, blue covarine, hydrogen peroxide or microbeads: which one is the most effective?

The efficacy of whitening toothpastes is questionable and controversial. Clinicians, patients and researchers have expressed concern with whitening toothpastes due to the risk of wearing the dental structure and the potential for disappointment if the advertised cosmetic results are not achieved. OBJECTIVE: This study compared the whitening performance of toothpastes with different whitening technologies after initial and continued use. MATERIAL AND METHODS: Ninety bovine incisors were stained using a concentrated solution of black tea. They were randomly distributed into 6 groups, according to the toothpaste whitening technology: activated charcoal (B&W), blue covarine (WAD), hydrogen peroxide (LWA), microbeads (Oral B 3D White Perfection - 3DW) and optimized abrasives (XW4D). They were compared to a traditional toothpaste without a whitening agent (TA - control). Specimens underwent a brushing machine with controlled pressure, time and temperature. A calibrated examiner measured the color using a VITA-Classical scale before the first brushing cycle (T0), after the first brushing cycle (TI), and after a brushing cycle that simulates continuous use (TCU). Whitening performance was evaluated by the difference of shades (ΔSGU) between T0-TI and T0-TCU timepoints, using the Kruskal-Wallis and Dunn's non-parametric test. The Wilcoxon test was used to evaluate the cumulative effect (α=0.05). RESULTS: Statistically significant differences were observed between toothpastes in both TI and TCU (p<0.05). The time of use also had a significant effect (p<0.05). CONCLUSION: Only WAD and 3DW showed whitening performance after the first use (TI). The greatest whitening performance after continuous use was obtained by WAD, followed by LWA and 3DW. The use of conventional toothpaste (TA) promotes no tooth whitening. CLINICAL RELEVANCE: Microbead abrasives (3DW) and blue covarine (WAD) were the active technology tested that presented the best global tooth whitening performance.

Color stability of conventional and bulk fill composite resins / Estabilidade cromática de resinas convencionais e resinas bulk fill

ABSTRACT Objective: This study compared the color stability of different dental composite resins after prolonged exposure to a coffee solution. Methods: Sixty-four cylindrical discs (10 mm diameter x 2 mm thickness) were prepared using 8 different dental composite resins (n=8, per group). The specimens were first immersed in artificial saliva for 24 h followed by immersion in a coffee solution for 14 days. The assessment of chromatic variation (ΔE) was performed with the aid of a Vita Easyshade Advanced spectrophotometer (VITA Zahnfabrik, Bad Sackingen, Germany). The color of each specimen was calculated based on the L*, a* and b* coordinates of the CIELab system. Results: Grandio SO had the lowest average chromatic variation (ΔE=7.77) after immersion in coffee solution. Durafill VS, Grandio and Z350 XT (ΔE=8.58; ΔE=9.52; ΔE=10.39, respectively) showed similar chromatic variation, with no statistical difference in relation to Grandio SO. However, the other dental composite resins evaluated showed statistically higher values of ΔE compared to Grandio SO, and Enamel HRi (ΔE=20.56) demonstrated the highest chromatic variation. Conclusion: The Bulk Fill and hybrid composite resins from the same manufacturer (Micerium, Avegno, Italy) showed greater chromatic variation than the other composite resins tested. Grandio SO (Voco, Cuxaven, Germany) had the lowest ΔE variation.

RESUMO Objetivo: Comparar diferentes resinas compostas em relação á estabilidade de cor após exposição prolongada em solução de café. Métodos: Sessenta e quatro discos cilíndricos (10mm x 2mm) foram confeccionados a partir de 8 diferentes marcas comerciais de compósitos (n= 8 por grupo); os espécimes foram imersos em saliva artificial, e posteriormente em café, sendo por conseguinte feita a avaliação da variação cromática (ΔE), utilizando espectrofotômetro Vita Easyshade Advanced (VITA Zahnfabrik, Bad Sackingen, Germany). O padrão de cada espécime foi medido examinando as coordenadas L*, a* e b* do sistema CIELab. Resultados: A resina composta Grandio SO apresentou a menor média de variação cromática (ΔE= 7,77) após a imersão em solução de café. Semelhantemente, a variação cromática das resinas compostas Durafill VS, Grandio e Z350 XT (ΔE=8,58; ΔE=9,52; ΔE=10.39) que não apresentaram diferença estatística. Todavia, as demais resinas compostas avaliadas apresentaram valores estatisticamente maiores de ΔE em relação a resina Grandio SO, sendo que a resina Enamel HRi (ΔE= 20,56) apresentou a maior variação cromática registrada. Conclusão: As resinas da categoria bulk fill e as resinas híbridas produzidas pelo mesmo fabricante (Micerium, Avegno, Itália) tiveram alterações cromáticas superiores às demais resinas testadas sendo que a resina GrandioSO (Voco, Cuxaven, Alemanha) foi a que apresentou menor alteração de ∆E.

Clinical effectiveness of fluorescence, digital images and ICDAS for detecting occlusal caries / Efetividade clínica da fluorescência, imagens digitais e ICDAS na detecção de cárie oclusal

Introduction: The detection of small caries lesions is still a challenge for dental professionals who in their clinical practice have a wide variety of methods to detect caries on occlusal surfaces. Objective: To clinically assess the effectiveness of the Vista Proof fluorescence camera, the Vista Cam digital intraoral micro camera and the International Caries Detection and Assessment System (ICDAS) visual criterion for detecting caries lesions on occlusal surfaces of permanent teeth. Material and method: One hundred and seven posterior teeth from adult patients were examined visually and by means of digital radiographs by an examiner who rated them according to the presence or absence of occlusal caries. The teeth were then assessed by the other examiner using ICDAS, fluorescence and magnified digital images. The effectiveness of the methods was measured based on sensitivity, specificity, positive and negative likelihood ratio. For each method, the Receiver Operating Characteristic (ROC) curve and the Area Under the ROC curve (AUROC) were estimated. Result: There was exceptional discrimination capacity for the intraoral images (AUROC=.93) and the ICDAS (AUROC=.91), with no significant statistical difference between them (z=.35, p=.73). The fluorescence exhibited an acceptable discrimination capacity (AUROC=0.78), although it was lower than the others. The positive likelihood ratio for the fluorescence was only 2.32, compared to 20.58 for the intraoral image and 58.11 for the ICDAS. Conclusion: Both methods and the ICDAS exhibited an adequate clinical performance, although the ICDAS and intraoral image were more effective than the fluorescence.

Introdução: A detecção de pequenas lesões de cárie ainda é um desafio para profissionais da Odontologia, que em sua prática clínica dispõem de uma grande variedade de métodos para detectar cáries nas superfícies oclusais. Objetivo: Avaliar clinicamente a efetividade da câmera de fluorescência Vista Proof, da microcâmera intraoral digital Vista Cam e do critério visual ICDAS (International Caries Detection and Assessment System) para detecção de lesões de cárie nas superfícies oclusais. Material e método: Cento e sete dentes posteriores de pacientes adultos foram examinados visualmente e por meio de radiografias digitais por um examinador que os classificou de acordo com a presença ou ausência de cárie. Os dentes foram então avaliados por outro examinador que utilizou o ICDAS, fluorescência e imagens digitais ampliadas. A efetividade dos métodos foi mensurada por meio da sensibilidade, especificidade, razão de verossimilhança positiva e negativa. Para cada método, a curva ROC (Receiver Operating Characteristic) e a área sob a mesma - AUROC (Area Under the ROC curve) foram estimadas. Resultado: Houve excepcional capacidade discriminante para as imagens intraorais (AUROC=0,93) e para o ICDAS (AUROC=0,91), com diferença estatística não significativa entre eles (z=0,35, p=0,73). A fluorescência apresentou capacidade discriminante aceitável (AUROC=0,78), embora tenha sido menor que os outros. A razão de verossimilhança positiva para a fluorescência foi 2,32, comparado a 20,58 para a imagem intraoral e 58,11 para o ICDAS. Conclusão: Ambos os métodos e o ICDAS exibiram um adequado desempenho clínico, sendo que o ICDAS e a imagem intraoral foram mais efetivos que a fluorescência.

Enhanced bioactive properties of BiodentineTM modified with bioactive glass nanoparticles

Abstract Objective To prepare nanocomposite cements based on the incorporation of bioactive glass nanoparticles (nBGs) into BiodentineTM (BD, Septodent, Saint-Maur-des-Fosses Cedex, France) and to assess their bioactive properties. Material and Methods nBGs were synthesised by the sol-gel method. BD nanocomposites (nBG/BD) were prepared with 1 and 2% nBGs by weight; unmodified BD and GC Fuji IX (GIC, GC Corporation, Tokyo, Japan) were used as references. The in vitro ability of the materials to induce apatite formation was assessed in SBF by X-ray diffraction (XRD), attenuated total reflectance with Fourier transform infrared spectroscopy (ATR-FTIR), and scanning electron microscopy (SEM) with energy dispersive X-ray (EDX) analysis. BD and nBG/BD were also applied to dentine discs for seven days; the morphology and elemental composition of the dentine-cement interface were analysed using SEM-EDX. Results One and two percent nBG/BD composites accelerated apatite formation on the disc surface after short-term immersion in SBF. Apatite was detected on the nBG/BD nanocomposites after three days, compared with seven days for unmodified BD. No apatite formation was detected on the GIC surface. nBG/BD formed a wider interfacial area with dentine than BD, showing blockage of dentine tubules and Si incorporation, suggesting intratubular precipitation. Conclusions The incorporation of nBGs into BD improves its in vitro bioactivity, accelerating the formation of a crystalline apatite layer on its surface after immersion in SBF. Compared with unmodified BD, nBG/BD showed a wider interfacial area with greater Si incorporation and intratubular precipitation of deposits when immersed in SBF.

Does a toothpaste containing blue covarine have any effect on bleached teeth? An in vitro, randomized and blinded study.

The objective of this study was to analyze the effect of bleaching toothpastes, both conventional and those containing the new whitening agent Blue Covarine, on teeth previously bleached by conventional techniques (in-office and at-home). Squared bovine enamel/dentin blocks (6.0 x 6.0 x 2.0 mm) were randomly distributed in 6 groups (n = 15), according to the technique used to bleach them (in-office: HP35%; at-home: PC10%) and the type of bleaching toothpaste (none: control; Blue Covarine containing: BC; and without Blue Covarine: NBC). Experimental groups denominated HP35%, HP35%BC and HP35%NBC received in-office tooth bleaching before toothbrushing, and groups PC10%, PC10%BC and PC10%NBC were subjected to at-home tooth bleaching prior to toothbrushing. After bleaching treatment, groups HP35%BC, PC10%BC, HP35%NBC and PC10%NBC underwent daily tooth brushing in a brushing machine for 3 minutes (150 strokes/min, with a load of 375 g). Tooth color alteration was measured by reflectance spectroscopy (Vita EasyShade, Vident, Brea, CA, USA) at: T0 (baseline) - after in-office or at-home bleaching treatment; T1 - immediately after tooth brushing; T2 - 7 days and T3 - 14 days after tooth brushing. Data was analyzed by repeated measures mixed ANOVA and the Bonferroni post hoc test, with a significance level of 5%. Statistically significant differences were found between different experimental groups, evaluation times and for the interaction between them (p < 0.001). Tooth brushing using either bleaching toothpaste (conventional or with Blue Covarine) showed no color alteration on teeth previously bleached by in-office and at-home tooth bleaching. The use of bleaching toothpastes on previously bleached teeth did not produce a color alteration.

Does a toothpaste containing blue covarine have any effect on bleached teeth? An in vitro, randomized and blinded study

Abstract The objective of this study was to analyze the effect of bleaching toothpastes, both conventional and those containing the new whitening agent Blue Covarine, on teeth previously bleached by conventional techniques (in-office and at-home). Squared bovine enamel/dentin blocks (6.0 x 6.0 x 2.0 mm) were randomly distributed in 6 groups (n = 15), according to the technique used to bleach them (in-office: HP35%; at-home: PC10%) and the type of bleaching toothpaste (none: control; Blue Covarine containing: BC; and without Blue Covarine: NBC). Experimental groups denominated HP35%, HP35%BC and HP35%NBC received in-office tooth bleaching before toothbrushing, and groups PC10%, PC10%BC and PC10%NBC were subjected to at-home tooth bleaching prior to toothbrushing. After bleaching treatment, groups HP35%BC, PC10%BC, HP35%NBC and PC10%NBC underwent daily tooth brushing in a brushing machine for 3 minutes (150 strokes/min, with a load of 375 g). Tooth color alteration was measured by reflectance spectroscopy (Vita EasyShade, Vident, Brea, CA, USA) at: T0 (baseline) - after in-office or at-home bleaching treatment; T1 - immediately after tooth brushing; T2 - 7 days and T3 - 14 days after tooth brushing. Data was analyzed by repeated measures mixed ANOVA and the Bonferroni post hoc test, with a significance level of 5%. Statistically significant differences were found between different experimental groups, evaluation times and for the interaction between them (p < 0.001). Tooth brushing using either bleaching toothpaste (conventional or with Blue Covarine) showed no color alteration on teeth previously bleached by in-office and at-home tooth bleaching. The use of bleaching toothpastes on previously bleached teeth did not produce a color alteration.

Can a bleaching toothpaste containing Blue Covarine demonstrate the same bleaching as conventional techniques? An in vitro, randomized and blinded study

ABSTRACT Objective The purpose of this in vitro study was to compare the efficacy of a bleaching toothpaste containing Blue Covarine vs. conventional tooth bleaching techniques using peroxides (both in-office and at-home). Material and Methods Samples were randomly distributed into five experimental groups (n=15): C - Control; BC – Bleaching toothpaste containing Blue Covarine; WBC – Bleaching toothpaste without Blue Covarine; HP35 - In-office bleaching using 35% hydrogen peroxide; and CP10 – At-home bleaching with 10% carbamide peroxide. The dental bleaching efficacy was determined by the color difference (ΔE), luminosity (ΔL), green-red axis (Δa), and blue-yellow axis (Δb). The CIELab coordinates were recorded with reflectance spectroscopy at different times: T0 - baseline, T1 – immediately after bleaching, T2 - 7 days, T3 - 14 days, and T4 - 21 days after the end of treatments. Data were analyzed by a repeated measures mixed ANOVA and post hoc Bonferroni test, with a significance level of 5%. Results No significant differences were found between the treatment groups C, BC, and WBC. The groups HP35 and CP10 showed significantly higher whitening efficacy than groups C, BC, and WBC. Conclusions There were no significant differences in the whitening efficacy between a Blue Covarine containing toothpaste, a standard whitening toothpaste, and a control. Neither of the whitening toothpastes tested were as effective as in-office or at-home bleaching treatments.

Can a bleaching toothpaste containing Blue Covarine demonstrate the same bleaching as conventional techniques? An in vitro, randomized and blinded study.

OBJECTIVE: The purpose of this in vitro study was to compare the efficacy of a bleaching toothpaste containing Blue Covarine vs. conventional tooth bleaching techniques using peroxides (both in-office and at-home). MATERIAL AND METHODS: Samples were randomly distributed into five experimental groups (n=15): C - Control; BC - Bleaching toothpaste containing Blue Covarine; WBC - Bleaching toothpaste without Blue Covarine; HP35 - In-office bleaching using 35% hydrogen peroxide; and CP10 - At-home bleaching with 10% carbamide peroxide. The dental bleaching efficacy was determined by the color difference (ΔE), luminosity (ΔL), green-red axis (Δa), and blue-yellow axis (Δb). The CIELab coordinates were recorded with reflectance spectroscopy at different times: T0 - baseline, T1 - immediately after bleaching, T2 - 7 days, T3 - 14 days, and T4 - 21 days after the end of treatments. Data were analyzed by a repeated measures mixed ANOVA and post hoc Bonferroni test, with a significance level of 5%. RESULTS: No significant differences were found between the treatment groups C, BC, and WBC. The groups HP35 and CP10 showed significantly higher whitening efficacy than groups C, BC, and WBC. CONCLUSIONS: There were no significant differences in the whitening efficacy between a Blue Covarine containing toothpaste, a standard whitening toothpaste, and a control. Neither of the whitening toothpastes tested were as effective as in-office or at-home bleaching treatments.

Comparación de la fuerza adhesiva de 2 sistemas de cementos de resina en diferentes regiones radiculares en la cementación de postes de fibra / Comparison of bond strength of two resin cement systems in different roots region on the cementation of fiber posts

La causa de fracaso más común de los postes de fibra es su desalojo, principalmente debido a la compleja adhesión dentro del conducto radicular. El principal objetivo de este estudio fue determinar si existe diferencia significativa en la resistencia adhesiva mediante el test push-out en la cementación de postes de fibra con RelyX U-200® (U200) y Core Paste XP® (CPX) en diferentes regiones radiculares. MATERIALES Y MÉTODOS Se seleccionaron 40 premolares, se seccionaron a 15 mm del ápice, fueron tratados endodóncicamente y fueron divididos aleatoriamente en 2 grupos de 20, a los cuales se les cementó un poste de fibra translúcido Exacto® con U200 y CPX. Después de 24 h cada muestra fue seccionada transversalmente a nivel cervical, medio y apical. Fueron sometidas al test de push-out mediante la máquina Tinius Olsen HK5-S para cuantificar la resistencia adhesiva en megapascales. Se utilizó el test Shapiro-Wilk, test de ANOVA de 2 factores y Tukey con un nivel de significación del 95%. RESULTADOS No hubo diferencia significativa de ambos cementos (p = 0,457), pero sí hubo diferencia cuando se comparó el tipo de cemento y la región; CPX presentó valor significativamente mayor en el tercio cervical (p < 0,05), mientras que U200 presentó un valor significativamente mayor en el tercio apical (p < 0,05). CONCLUSIONES No hubo diferencia significativa en el valor de adhesión cuando se comparó solo el factor cemento entre U200 y CXP, sin embargo hubo un mayor valor de CXP a nivel cervical y de U200 a nivel apical.

Loosening is the most common failure of fiber posts, mainly due to complex adhesion within the root canal. The main objective of this study was to determine if significant differences in adhesive resistance, using the push-out test, in the cementation of fiber posts with RelyX U-200® (U200) and Core Paste XP® (CPX) in different root regions. MATERIALS AND METHODS A selection of 40 premolars were sectioned 15 mm from the apex, treated endodontically and then randomly divided in two groups of 20, using an Exacto translucent fiber post with U200 and CPX, respectively. After 24 hours, each sample was sectioned into cervical, middle and apical. The test push-out test was performed using a Tinius Olsen HK5-S machine to quantify the adhesive strength in Mega Pascals. The test Shapiro-Wilk, two-factor Anova and Tukey tests were used with a significance level of 95% RESULTS There were no significant differences between the cements (P = .457) but if there was difference when comparing the type of cement and region. CPX showed a value significantly higher in the cervical third (P < .05), while U200 presented a value significantly higher in the apical third (P < .05). CONCLUSIONS There was no significant difference in the value of the adhesive strength in the comparison between U200 and CXP, however there was a higher value of CXP at cervical and U200 at apical level.

Fracture resistance of endodontically-treated teeth submitted to bleaching treatment with hydrogen peroxide and titanium dioxide nanoparticles photoactivated by LED-laser / Resistência à fratura de dentes tratados endodonticamente submetidos a tratamento clareador com peróxido de hidrogênio e nanopartículas de dióxido de titânio fotoativado por LED-laser

Objective: The aim of this study was evaluate the fracture resistance of endodontically-treated teeth after bleaching treatment using 15% hydrogen peroxide plus titanium dioxide nanoparticles (15HPTiO2) photoactivated by LED-laser, in comparison with protocols using 35% hydrogen peroxide (35HP), 37% carbamide peroxide (37CP) or sodium perborate (SP). Material and method: After endodontic treatment, fifty bovine extracted incisors were divided into five groups (n = 10): G1- without bleaching; G2- 35HP; G3- 37CP; G4- 15HPTiO2 photoactivated by LED-laser and G5- SP. In G2 and G4, the bleaching protocol was applied in 4 sessions, with a 7 day interval between each session. In G3 and G5, the materials were kept in the pulp chamber for 21 days, but replaced every 7 days. After 21 days, the crowns were subjected to compressive load at a cross head speed of 0.5 mm/min, applied at 135° to the long axis of the root using an eletromechanical testing machine, until fracture. The data were submitted to ANOVA and Tukey tests (p = 0.05). Result: The bleaching treatment in endodontically-treated teeth with 15HP plus TiO2 nanoparticles and photoactivated by LED-laser caused reduction of the fracture resistance similarly provided by 35HP, 37CP or SP (p>0.05). All bleaching treatments reduced the fracture resistance compared to unbleached teeth (p<0.05). Conclusion: All bleaching protocols reduced the fracture resistance of endodontically-treated teeth, but there were no differences between each other. .

Objetivo: Avaliar a resistência à fratura de dentes tratados endodonticamente após tratamento clareador usando peroxido de hidrogênio a 15% com nanopartículas de dióxido de titânio (15HPTiO2) fotoativado por LED-laser, em comparação aos protocolos usando peróxido de hidrogênio 35% (35HP), peróxido de carbamida 37% (37CP) ou perborato de sódio (SP). Material e método: Após tratamento endodôntico, 50 incisivos bovinos extraídos foram divididos em 5 grupos (n = 10): G1- sem clareamento; G2- 35HP; G3- 37CP; G4- 15HPTiO2 fotoativado por LED-laser e G5- SP. Nos grupos G2 e G4, o protocolo de clareamento foi aplicado em 4 sessões, com 7 dias de intervalo entre cada sessão. Nos grupos G3 e G5, os materiais foram inseridos na câmara pulpar por 21 dias e trocados a cada 7 dias. Após 21 dias, as coroas foram submetidas à força de compressão com velocidade de 0,5 mm/min, aplicada a 135º em relação ao longo eixo da raiz. empregando máquina de ensaios mecânicos, até a fratura. Os dados foram submetidos aos testes de ANOVA e Tukey (p = 0.05). Resultado: O tratamento clareador em dentes tratados endodonticamente com 15HP e nanopartículas de TiO2 fotoativado por LED-laser proporcionou redução da resistência à fratura semelhante ao 35HP, 37CP ou SP (p>0,05). Todos os tratamentos clareadores reduziram a resistência coronária à fratura quando comparados aos dentes sem tratamento (p<0,05). Conclusão: Todos os protocolos de clareamento reduziram a resistência à fratura dos dentes tratados endodonticamente, sem diferenças estatisticamente significantes entre os grupos. .

Interação multidisciplinar para reabilitação de um dente posterior com sistema IPS E. MAX / Multidisciplinary approach to restore a posterior teeth with IPS e. max system

A Odontologia atual está constantemente aprimorando os tratamentos odontológicos com terapias conservadoras que restabelecem a função, preservando a saúde dos tecidos bucais e a estética. No entanto, as novas terapias também exigem a realização de planos de tratamentos multidisciplinares para obtenção de sucesso clinico e satisfação do paciente. A Periodontia tem ampliado sua abordagem terapêutica para facilitar/possibilitar a realização de tratamentos restauradores, visando à manutenção da integridade dos dentes após o procedimento restaurador. O caso clinico relata um tratamento multidisciplinar envolvendo Dentística, Endodontia e Periodontia, para reabilitação de um elemento unitário posterior afetado por uma lesão de cárie extensa com invasão do espaço biológico. Realizou-se aumento de coroa com osteotomia no dente 36 para recuperar este espaço biológico. Além disso, foi necessária a realização do tratamento endodôntico seguido do procedimento restaurador. Indicou-se realização de uma onlay cerâmica do sistema IPS e.max Press (Ivoclar), devido às exigências mecânicas do caso. O tratamento planejado garantiu função e resistência adequada, preservando os tecidos bucais. Concluiu-se que a abordagem multidisciplinar possibilitou a realização de um tratamento conservador que ofereceu satisfação ao paciente, preservando sua saúde bucal.

Recovering Streptococcus mutans over restorations by the tray technique: a randomized clinical study

AIM: To correlate the tray technique for isolation and counting of Streptococcus mutans over dental restoration with the toothpick technique. METHODS: Forty 18-50-year-old patients of both genders with high cariogenic risk were selected. Inclusion criteria were: occlusal restoration evaluated as alpha, according to the Ryge's criteria (examiner' Cohen-Kappa 0.8) and 2 years old maximum age. Each patient provided a saliva sample (control group S) and two samples of dental biofilm from amalgam or resin-based composite restorations in the same patient, one obtained with the toothpick technique (group TT), and the other from homologous tooth restoration with the tray technique (group TR). This method involves only a direct impression on the occlusal surfaces by a section of a fluoride tray with trypticase yeast extract cysteine sucrose with bacitracin (TYCSB) agar previously prepared and solidified. The samples were incubated at 37 ºC for 48 h and the colony-forming units (CFU) were counted. The results were statistically analyzed with SPSS software using the linear regression method at 95% confidence level. RESULTS: TR was able to isolate S. mutans, and there was a significant positive correlation (r=0.95) with TT. There was no significant correlation between TR and control group S (r=0.47). CONCLUSIONS: TR was able to isolate and count S. mutans from the dental biofilm of dental restorations with a significant correlation with the TT group.

ScanWhite: método objetivo para avaliação do nível de clareamento dentário / ScanWhite: Objective method for dental bleaching level evaluation

Introdução: o clareamento dentários pode ser avaliado por meio de técnicas comparativas subjetivas (visual) ou objetivas (instrumental). Essa última tem se mostrado mais adequado para tal tipo de avaliação. Métodos: a avaliação do sistema foi realizado em laboratório, utilizando-se uma câmara digital, escala de cores Vita Classical e tres diferentes tipos de iluminação. No total, foram realizadas 480 imagens. Em seguida, o software foi avaliado quanto à sua eficiência clínica. Para tal, foi selecionado um caso de microabrasão complementado com clareamento dentário fotoacelerado. Resultados: os testes laboratoriais com diferentes iluminantes apresentaram resultados similares. Clinicamente, foram obsaervados diferentes níveis de clareamento em cada uma das sessões clínicas realizadas. Discussão: os vários métodos objetivos disponíveis atualmente apresentam diferentes graus de imitação na análise da cor de corpos semitranslúcidos (por exemplo, dentes e materiais dentários). Essas estão relacionadas ao posicionamento e ao sistema de cor utilizado (por exemplo, RGB, CYM) por cada equipamento. Portanto, o método proposto apresenta algumas vantagens em relação aos sistemas objetivos, como a ausência da necessidade de manutenção do posicionamento da amostra ou do paciente, algoritmo calibrador e a geração de gráficos e laudos. Conclusões: as comprovações geradas pelo sistema proposto geram maior conforto e segurança durante o tratamento

Introduction: The dental bleaching outcome can be evaluated using subjective (visual) and objective (instrumental) comparative techniques. The latter has demonstrated more suitable results to that kind of evaluation. Methods: The assessment of the proposed system was realized in th laboratory using Vita Classical color pallets, digital camera and three different illuminations. In total, 480 images were acquired. Next, the software was evaluated to check its clinical efficiency.For this, a case of micro-abrasion complemented with photoacelerated dental bleaching was chosen. Results: The laboratorial tests with different illuminants showed similar results. Clinically different levels of dental bleaching were observed in each one of the clinical appointments realized. Discussion: The several objective methods available nowadays present different limitation levels when analysing semitranslucid samples (e.g. teeth and dental materials). These limitations are related with the samples's position and with the color space used by each system (e.g. RGB, CYM). Therefore, the proposed method shows some advantages when compared with the traditional objective methods, such as the absence of position maintenance of the sample or of the patient, calibration algorithm and generation of graphs and reports. Conclusions: The outcomes generated by the proposed system can provide more security both to patient and professional during the treatment

Reabilitação estética multidisciplinar. Parte 2: plástica gengival, preparo do conduto, moldagem e confecção do núcleo metalocerâmico / Multidisciplinary esthetic rehabilitation. Parte 2: gingivoplasty, intraradicular preparation, impression-taking and fabrication of a metal-ceramic core

Tratamento reabilitador estético exige visão ampla durante o diagnóstico, para que se estabeleça correto plano de tratamento, obedecendo-se à ordem correta da realização de cada procedimento. Avaliação dos tecidos periodontais é necessária, não apenas considerando a relação saúde-doença, mas também a relação entre proporção dos dentes e altura do sorriso. Quando a necessidade de se realizar um procedimento periodontal é diagnosticada, este deve ser realizado, considerando-se o tempo de cicatrização e também aspectos protéticos, quando estes estão presentes. Além disso, a confecção de núcleos para reter coroas cerâmicas é uma estratégia que se deve adotar, quando o remanescente dental apresentar-se fragilizado. Este artigo, a segunda parte de três etapas, demostra a sequência de cirurgia plástica gengival, moldagem e confecção de núcleo metalocerâmico

An esthetic rehabilitation treatment should always be accompanied by a periodontal evaluation. In some cases, plastic gingival surgery is required and this procedure must be performed carefully to avoid compromising the overall treatment. Furthermore, the preparation of core for abutment crows is important when the remaining tooth is weakened. The purpose of this paper, the second of a three-part article, is to demonstrate a sequence to perform an esthetic periodontal surgery, impression-taking and metal-ceramic core

Associação de microabrasão e fechamento de distemas com resina composta: relato de caso clínico / Association of microabrasion and diastema closure with composite resin: a case report

Com o avanço das técnicas e materiais restauradores, o cirurgião-dentista tornou-se capaz de solucionar problemas estéticos de forma conservadora. Esse relato de caso descreve a associação das técnicas de microabrasão e fechamento de diastemas com resinas compostas diretas. A paciente do sexo feminino, 16 anos de idade, foi encaminhada pelo ortodontista à clínica de Dentística Restauradora para o fechamento de diastema. Após anamnese e exame clínico detalhado, constatou-se, também, a presença de manchas brancas de fluorose na face vestibular dos dentes anterossuperiores, sendo também proposto o procedimento de microabrasão. Por meio de modelos de estudo da paciente, foi realizado o enceramento diagnóstico, de forma a simular o fechamento dos diastemas. O modelo encerado foi moldado com silicona de condensação para servir como guia de orientação durante os procedimentos restauradores. O tratamento resultou na elevação da autoestima da paciente,pela obtenção de um sorriso mais harmonioso por meio da associação de técnicas estéticas conservadoras.

With the improvements in restorative techniques and materials, the dentist is able to conservatively solve esthetic problems. This case report describes the association of techniques for microabrasion and closure of diastema with direct composite resins. The patient, aged 16, was referred to the restorative dental clinic by the orthodontist for diastema closure. After a detailed clinical examination, it was also noticed the presence of fluorosis white stains on the buccal surface of anterior-superior teeth, and microabrasion treatment was proposed. Through the study cast models of the patient, diagnostic waxing was performed to simulate the closure of diastema. The wax model was cast with condensation silicone to serve as a guideline during the restorative procedures. The treatment resulted in patient's improved self-esteem by obtaining a more harmonious smile through the association of conservative esthetic techniques

Efeitos da aplicação de resina hidrofóbica sobre a resistência deunião de adesivos autocondicionantes de frasco único / Effect of additional hydrofobic layer on the microtensile bond strenght of all-in-one adhesive systems

Introdução: Sabe-se que sistemas adesivos autocondicionantes podem atuar como membranas semipermeáveis, o que pode comprometer a adesão. Objetivo: Buscou-se avaliar os efeitos da aplicação adicional de resina hidrofóbica sobre a resistência de união à microtração de sistemas adesivos autocondicionantes de frasco único sobre dentinabovina. Material e método: Sessenta incisivos bovinos tiveram a face vestibular desgastada até se obter superfície dentinária plana. Foram utilizados os seguintes sistemas adesivos: Clearfil Tri S Bond (CTSB), AdheSE One (ADO) e One Coat 7.0 (OC). Os sistemas adesivos foram testados com (G4, G5, G6) e sem (G1, G2, G3) a aplicação de camada adicional de material hidrofóbico do mesmo fabricante (Clearfil SE Bond, AdheSE e One Coat SE, respectivamente), resultando em seis grupos experimentais (n = 10). Após o procedimento adesivo, resinacomposta Z-350 foi inserida em três incrementos de 1 mm. Todo o procedimento adesivo restaurador foi executado sob pressão pulpar simulada e o teste de microtração foi executado imediatamente após a polimerização da resina composta. Os dados obtidos foram submetidos à ANOVA e ao teste de Tukey (p < 0,05). Resultado: Para todos os adesivos testados, os piores resultados foram observados nos grupos em que a camada adicional de resina hidrofóbica não foi aplicada. Conclusão: A aplicação de camada adicional de material hidrofóbico pode melhorar a resistência de união de sistemas adesivos autocondicionantes de passo único.

Introduction: It is known that self-etching adhesive systems can act as semi-permeable membranes. Objective: Evaluate the effects of additional layer of hydrophobic resin on the microtensile bond strength of self-etching one-bottle adhesives. Material and method: Sixty bovine incisors were used in this study. The facial enamel surfaces of the crowns were abraded with silicon carbide paper to expose flat, mid-coronal dentin surfaces. The following adhesives were used: Clearfil Tri S Bond (CTSB), AdheSE One (ADH) and One Coat 7.0 (OC). Each material was tested with and without applying an additional layer of hydrophobic material from the same manufacturer. Z-350 composite resin was inserted in three 1 mm increments. All adhesive restorative procedure was performed under simulated pulpal pressure and the microtensile test was performed immediately after curing the compositeresin. Data were submitted to ANOVA and Tukey test (p < 0.05). Result: For all adhesives tested, the worst results were observed in groups which the additional layer of hydrophobic resin was not applied. Conclusion: The application of additional layer of hydrophobic material can improve the adhesion of self-etching all-in-one adhesive systems.

A arte de copiar: restauração estética anterior / The art of copy: anterior aesthetic restoration

Atualmente, os pacientes buscam cada vez mais estética, e o profissional deve ser capaz de suprir a necessidade da demanda atual. Para isso, os profissionais devem estar atentos a não somente devolver funcionalidade a seus procedimentos restauradores, mas acima de tudo buscar excelência estética. Entre esses procedimentos, as restaurações adesivas diretas são capazes de mimetizar o que é artificial, tornando as restaurações naturais. Esse artigo tem o objetivo de expor uma sequência clínica, de certa maneira simplificada, em que o profissional conseguiu uma restauração altamente estética.

Evaluation of tooth color after bleaching with and without light-activation / Avaliação da coloração dental após clareamento com e sem ativação por luz

PURPOSE: The use of different light sources as an adjunct to in-office bleaching has been questioned. Thus, the aim of this study was to evaluate the color changes of teeth after application of bleaching techniques with different products, with and without activation by a LED-laser system. METHODS: Twenty-four bovine teeth surfaces were submitted to three bleaching techniques with two commercially available 35 percent hydrogen peroxide bleaching agents (n=8). The specimens were immersed in red wine for 48 h at 37°C and submitted to the bleaching techniques. Color changes were measured before and after staining as well as immediately after and 24 h after the bleaching treatments, with two different methods of color evaluation, software ScanWhite V1.1 and intra-oral spectrophotometer (Vita Easyshade). Data were analyzed by ANOVA and Kruskal-Wallis test. RESULTS: The statistical analysis showed that there was no statistically significant difference at 5 percent of significance level between the different groups, independently of the evaluation time, evaluation methods or the use of LED-laser systems. CONCLUSION: The results suggested that the use of light in the bleaching techniques did not influence the color changes.

OBJETIVO: o uso de diferentes fontes de luz como auxiliar no clareamento de consultório tem sido descrita na literatura.Assim, o objetivo deste estudo foi avaliar as alterações da cor dos dentes após a aplicação de técnicas de clareamento com diferentes produtos, com e sem ativação por um sistema de LED-laser. METODOLOGIA: Vinte-quatro superfícies de dentes bovinos foram submetidas a três técnicas de clareamento com dois agentes clareadores disponíveis comercialmente à base de peróxido de carbamida a 35 por cento (n=8). Os espécimes foram inicialmente imersos em vinho tinto por 48 ha 37°C, e submetidos às técnicas de clareamento. As alterações de cor foram mensuradas antes e após o manchamento, bem como imediatamente e 24 hs após as técnicas de clareamento, por meio de dois diferentes métodos de avaliação da cor: software ScanWhite V1.1 e espectrofotômetro intra-oral Vita Easyshade. Os dados foram analisados pelos testes de ANOVA e Kruskal-Wallis. RESULTADOS: A análise estatística não apontou diferenças significantes entre os diferentes grupos testados, independentemente do período de avaliação, método de avaliação ou uso do sistema LED-laser. CONCLUSÃO: Os resultados sugeriram que o uso da luz não influenciou nas mudanças de cor.

O uso da microabrasão de esmalte como alternativa estética / Using enamel microabrasion as an esthetic alternative

Procedimentos com o objetivo de remover manchas nos dentes têm sido amplamente utilizados para restabelecimento da estética dentária. Dentre esses procedimentos, podem-se citar as técnicas de microabrasão do esmalte, na obtenção de resultados esteticamente mais aceitáveis. O presente artigo demonstra a possibilidade de uso de um agente abrasivo como forma de tratamento estético de manchas brancas...

Procedures to remove tooth staining are increasingly used to restore dental esthetics. One of the techniques that present more esthetically acceptable results is enamel microabrasion. This article demonstrates the possibility of using an abrasive agent as an alternative for the esthetic treatment of white spots...