Evaluation of the efficacy of a commercially available regimen vs brushing alone on established plaque and gingivitis on adolescents: Study protocol for a randomized, controlled, blind clinical trial.

BACKGROUND: Dental biofilm accumulation and poor personal oral hygiene are known major risk factors for gingivitis and halitosis. However, it is not clear how studies compare the effectiveness of hygiene regimens, associated with outcomes centered on patients. METHODS: A randomized, blind, controlled clinical trial involving 58 participants aged from 12 to 17 years, who search the Department of Pediatric Dentistry of Universidade Metropolitana de Santos, will be conducted. Immediately, the volunteers will be inserted into Group 1 (commercially available hygiene regimen) or Group 2 (tooth brushing alone). In Group 1, participants will receive Colgate Total 12 toothpastes, Plax mouthwashes and Colgate Ultrasoft toothbrushes, while Group 2 will use Colgate Cavity Protection toothpastes and Colgate Ultrasoft toothbrushes. The interventions will be conducted in the periods of 1, 3, and 6 months after the baseline, when the evaluations will also be performed. Biofilm and halitosis indexes will be evaluated. Data regarding discomfort, satisfaction and the socioeconomic/individual characteristics will also be computed. DISCUSSION: Although toothbrushing has shown positive effects in decreasing biofilm and in gingival health, there is no comparison in the literature of different brushing regimens with halitosis measurement in adolescents. In addition, the effectiveness of these protocols would be confirmed from the acceptability of the volunteers.

Alternative Aging Solutions to Accelerate Resin-Dentin Bond Degradation.

PURPOSE: This study evaluated the effect of aging solutions on the durability of resin-dentin bonds by means of microtensile bond strength (µTBS) and nanoleakage (NL) tests. MATERIALS AND METHODS: The adhesive system Adper Single Bond 2 (3M ESPE) was applied according to the manufacturer's instructions to the flattened occlusal surface of 40 extracted human molars. After bonding, teeth were sectioned to obtain bonded sticks (0.8 mm2 area) which were tested in tension immediately or after different storage periods (1 week, 1 month, or 6 months). Bonded sticks were kept immersed in 5 different solutions: 1) distilled water (DW); 2) 99.9% propionic acid (PA); 3) 99% acetic acid (AA); 4) 75% ethanol (ET), and 5) mineral oil (MO). To determine NL, bonded sticks from each experimental condition were immersed in silver nitrate and analyzed by SEM. Data were analyzed by two-way repeated measure ANOVA and Tukey's test (α=0.05). RESULTS: Faster degradation of bond strength (1 week) could be seen for AA and ET (p<0.05) in comparison with DW. Specimens stored in PA and DW showed bond strengths significantly reduced after one and six months, respectively (p<0.05). No degradation of the resin-dentin bond strengths was observed for specimens stored in MO (p>0.05). Nanoleakage increased for all groups except MO after storage. CONCLUSION: Propionic acid, acetic acid, and ethanol can be used as alternative aging solutions to more quickly obtain results on the bond resistance to degradation.

A new universal simplified adhesive: 36-Month randomized double-blind clinical trial.

STATEMENT OF THE PROBLEM: It is still debatable which technique should be used with universal adhesives, either etch-and-rinse (wet or dry) or self-etch strategy (with or without selective enamel etching). PURPOSE OF THE STUDY: To evaluate the 36-month clinical performance of Scotchbond Universal Adhesive (SU, 3M ESPE) in non-carious cervical lesions (NCCLs) using two evaluation criteria. METHODS/MATERIALS: Thirty-nine patients participated in this study. Two-hundred restorations were assigned to four groups: ERm: etch-and-rinse+moist dentin; ERd: etch-and-rinse+dry dentin; Set: selective enamel etching; and SE: self-etch. The same composite resin was inserted for all restorations in up to 3 increments. The restorations were evaluated at baseline and at 6-, 18-, and 36-months using both the FDI and the USPHS criteria. Statistical analyses were performed with Friedman repeated measures ANOVA by rank and McNemar test for significance in each pair (α=0.05). RESULTS: Eight restorations (ERm: 1; ERd: 1; Set: 1 and SE: 5) were lost after 36 months, but only significant for SE when compared with baseline (p=0.02 for either criteria). Marginal staining occurred in 6.8% of the restorations (groups ERm, ERd, and Set) and 17.5% of the restorations (group SE), with significant difference for each group when compared with baseline using the FDI criteria (p<0.04), while statistical significance was reached only for SE when compared with baseline using the USPHS criteria (p<0.03). Twenty-eight and 49 restorations were scored as bravo for marginal adaptation using the USPHS and FDI criteria, respectively, with significant difference for each group when compared with baseline (p<0.05). CONCLUSIONS: While there was no statistical difference among bonding strategies when a universal adhesive was used, there were signs of degradation when the universal adhesive was applied in SE mode. The FDI criteria remain more sensitive than the USPHS criteria, especially for the criteria marginal staining and marginal adaptation.

Randomized clinical trial of four adhesion strategies in cervical lesions: 12-month results.

The aim of this study was to evaluate the 6- and 12-month clinical performance of four adhesion strategies from the same manufacturer (Kerr) in non-carious cervical lesions (NCCLs) using two evaluation criteria. Thirty-five patients, with at least four NCCLs each, participated in this study. After samplesize calculation, 180 restorations were assigned to one of the following groups: OFL (Optibond FL), OSP (Optibond Solo Plus), XTR (Optibond XTR), and AIO (Optibond All-In-One). The composite resin Filtek Supreme Ultra (3M ESPE) was placed incrementally. The restorations were evaluated at baseline, after 6 months, and after 12 months, using both the FDI and the USPHS-modified criteria. Statistical analyses were performed with Friedman repeated measures, ANOVA by rank, and the McNemar test for significance in each pair (α=0.05). Six restorations (2 for OFL, 1 for OSP, 2 for XTR, and 1 for AIO) were lost at 12 months (P>0.05 for both evaluation criteria). Marginal staining was observed in seven restorations using the FDI criteria (P>0.05) and three restorations using the USPHSmodified criteria (P>0.05). Eight restorations (2 for OSP, 3 for XTR, and 3 for AIO) were classified as Bravo for marginal adaptation using the USPHSmodified criteria (P>0.05). However, 62 restorations (14 for OFL, 12 for OSP, 15 for XTR, and 21 for AIO) were classified as Bravo using the FDI criteria (P>0.05). The four adhesion strategies showed similar clinical retention at 6 and 12 months. The FDI evaluation criteria tend to be more sensitive than the USPHS-modified criteria.

In-office bleaching with a two- and seven-day intervals between clinical sessions: A randomized clinical trial on tooth sensitivity.

OBJECTIVES: In-office bleaching is usually performed in 2-3 sessions with one-week interval. The impact of shorter interval times on tooth sensitivity has not been evaluated. This study aimed to compare the absolute risk of tooth sensitivity (TS) and colour change after in-office bleaching with a two- and seven-day intervals between sessions. METHODS: We selected for this randomized, single-blind study, 40 patients with colour C2 or darker. We performed two bleaching sessions with a 35% hydrogen peroxide gel with either a 1-week or 2-day interval. We recorded the TS up to 48 h with a VAS scale and the colour at baseline and 30 days after bleaching with a value-oriented shade guide and a spectrophotometer. The risk and intensity of TS were compared with the Fisher's exact test and two-way repeated measures ANOVA. Colour change (ΔSGU and ΔE) were evaluated by Student's t-test (alpha=5%). RESULTS: Approximately 60% of the participants reported TS (65% and 55% for the 7 and 2-day groups). A significant whitening of approximately 6 shade guide units was detected for both groups. No difference was detected between groups. CONCLUSIONS: The reduction of the interval between bleaching sessions from seven to two days reduced the treatment time without increasing the bleaching-induced TS (clinicaltrials.gov identifier: NCT1959789). CLINICAL SIGNIFICANCE: In-office bleaching with a 2-day interval did not increase the risk and intensity of bleaching-induced tooth sensitivity.

Simplificando la adhesión con un sistema adhesivo universal: reporte de casos / Clinical application of a new universal adhesive system: case reports

Los sistemas adhesivos tienden a ser cada vez más simplificados y versátiles. Hasta el presente, el clínico todavía debe elegir entre adhesivos autoacondicionantes o convencionales. Objetivo: mostrar la aplicación clínica de un nuevo sistema adhesivo considerado universal, debido a que puede ser usado como adhesivo autoacondicionante o como uno convencional. Caso clínico: fueron realizadas restauraciones cervicales en lesiones no cariosas con varias posibilidades de utilización de un nuevo adhesivo (Scotchbond(TM) Universal, 3M Espe), aplicando el ácido fosfórico en toda la cavidad y dejando la dentina seca o húmeda, o aplicando el ácido fosfórico solamente en el esmalte, o aplicando sólo el adhesivo sin grabado previo con ácido fosfórico. Después de restaurar con resina compuesta, todos los casos fueron evaluados clínicamente en el inicio del tratamiento y a los 6 meses. Conclusión: los resultados demostraron un excelente desempeño clínico de este nuevo sistema adhesivo, utilizado con cualquiera de las distintas técnicas clínicas propuestas. No obstante, deben realizarse estudios de larga duración en un mayor número de casos clínicos, a fin de comprobar los resultados aquí presentados (AU)

Simplificando la adhesión con un sistema adhesivo universal: reporte de casos / Clinical application of a new universal adhesive system: case reports

Los sistemas adhesivos tienden a ser cada vez más simplificados y versátiles. Hasta el presente, el clínico todavía debe elegir entre adhesivos autoacondicionantes o convencionales. Objetivo: mostrar la aplicación clínica de un nuevo sistema adhesivo considerado universal, debido a que puede ser usado como adhesivo autoacondicionante o como uno convencional. Caso clínico: fueron realizadas restauraciones cervicales en lesiones no cariosas con varias posibilidades de utilización de un nuevo adhesivo (Scotchbond(TM) Universal, 3M Espe), aplicando el ácido fosfórico en toda la cavidad y dejando la dentina seca o húmeda, o aplicando el ácido fosfórico solamente en el esmalte, o aplicando sólo el adhesivo sin grabado previo con ácido fosfórico. Después de restaurar con resina compuesta, todos los casos fueron evaluados clínicamente en el inicio del tratamiento y a los 6 meses. Conclusión: los resultados demostraron un excelente desempeño clínico de este nuevo sistema adhesivo, utilizado con cualquiera de las distintas técnicas clínicas propuestas. No obstante, deben realizarse estudios de larga duración en un mayor número de casos clínicos, a fin de comprobar los resultados aquí presentados

A new universal simplified adhesive: 6-month clinical evaluation.

STATEMENT OF THE PROBLEM: Multimode adhesives, which can be used as etch-and-rinse or as self-etch adhesives, have been recently introduced without clinical data to back their use. PURPOSE OF THE STUDY: To evaluate the 6-month clinical performance of Scotchbond Universal Adhesive (SU; 3M ESPE, St. Paul, MN, USA) in noncarious cervical lesions (NCCLs) using two evaluation criteria. METHODS/MATERIALS: Thirty-nine patients participated in this study. Two hundred restorations were assigned to four groups: SU-TEm: etch-and-rinse + moist dentin; SU-TEd: etch-and-rinse + dry dentin; SU-SEet: selective enamel etching; and SU-SE: self-etch. The composite resin Filtek Supreme Ultra (3M ESPE) was placed incrementally. The restorations were evaluated at baseline and after 6 months using both the World Dental Federation (FDI) and the United States Public Health Service (USPHS) criteria. Statistical analyses were performed with Friedman repeated measures analysis of variance by rank and McNemar test for significance in each pair (α = 0.05). RESULTS: Only four restorations (SU-SE: 3 and SU-TEm: 1) were lost after 6 months (p > 0.05 for either criteria). Marginal discoloration occurred in one restoration in the SU-SE group (p > 0.05 for either criteria). Only 2/200 restorations were scored as bravo for marginal adaptation using the USPHS criteria (one for SU-SE and one for SU-SEet, p > 0.05). However, when using the FDI criteria, the percentage of bravo scores for marginal adaptation at 6 months were 32%, 36%, 42%, and 46% for groups SU-TEm, SU-TEd, SU-SEet, and SU-SE, respectively (p > 0.05). CONCLUSIONS: The clinical behavior of the multimode adhesive does not depend on the bonding strategy at 6 months. The FDI evaluation criteria are more sensitive than the USPHS criteria. CLINICAL SIGNIFICANCE: At 6 months, the clinical behavior of the new multimode adhesive Scotchbond Universal was found to be reliable when used in noncarious cervical lesions and may not depend on the bonding strategy employed.

Perioperative use of an anti-inflammatory drug on tooth sensitivity caused by in-office bleaching: a randomized, triple-blind clinical trial.

OBJECTIVES: The aim of this study was to determine the effect of etoricoxib 60 mg on tooth sensitivity (TS) caused by in-office bleaching. MATERIALS AND METHODS: A triple-blind, parallel design, randomized clinical trial was conducted on 30 healthy, young adults who received either a placebo or etoricoxib. The drugs were administered 1 h before the bleaching process and after 24 h. Treatment was performed with 35 % hydrogen peroxide gel. The TS was recorded on three scales: VAS, 0-4, and 0-100. Shade evaluations were performed before and 30 days after bleaching with a visual shade guide and a spectrophotometer. The percentage of patients who reported TS at least once during treatment and the TS intensity were evaluated by Fisher's exact and Mann-Whitney U tests, respectively. Tooth color changes were evaluated by repeated measures ANOVA. RESULTS: There were no significant differences in the percentage of patients with TS, intensity of TS, and color between the groups. CONCLUSIONS AND CLINICAL SIGNIFICANCE: The anti-inflammatory medication etoricoxib 60 mg was unable to reduce the presence and intensity of TS. NCT01300780 (protocol No. 17838/2010).

Apliacação de um novo sistema adesivo universal: relato de caso / Aplication of a new universal adhesive system: case report

Apesar de se tentar com que os adesivos atuais sejam cada vez mais simplificados e versáteis, até o momento o clinico deve optar por adesivos autocondicionantes ou convencionais. O presente relato de caso visa apresentar a aplicação clínica de um novo sistema adesivo considerado universal, pois pode ser usado na técnica autocondicionante ou convencional. Foram realizadas restaurações de lesões cervicais não cariosas com as várias possibilidades de aplicação do adesivo Single Bond Universal, ou seja, aplicando o ácido fosfórico em toda a cavidade e deixando a dentina seca ou úmida; aplicando o ácido fosfórico apenas no esmalte, ou aplicando apenas o adesivo sem a utilização do ácido fosfórico. Após a realização das restaurações com resina composta, estas foram avaliadas inicialmente e após seis meses. Os resultados demonstraram um excelente desempenho clínico quando este novo sistema adesivo foi utilizado em quaisquer das estratégias propostas. Estudos de longa duração e um maior número de casos clínicos devem ser realizados para comprovar os resultados aqui apresentados

In spite of trying to make the current adhesive systems more simplified and versatile, until the moment the clinician should choose self-etch or etch-and-rinse adhesives. This case report aims to present the clinical application of a new adhesive system considered as universal, as it can be used under the self-etch or etch-and-rinse protocols. Caries-free cervical lesions were restored with the different application modes of the adhesive Single Bond Universal, that is, etching the entire cavity leaving dry or moist dentin, enamel etching only or applying the adhesive without etching. After finishing the restoration with resin composite, there were evaluated at baseline and after 6 months. The results demonstrated an excellent clinical behavior when this new adhesive system was used under any protocol proposed. Long term studies and more clinical reports are needed to prove the results here presented

Análise espectrofotométrica e visual do clareamento dental: relato de caso clínico / Spectrophotometric and visual analysis of dental bleaching: clinical case report

O trabalho apresenta descrição de um caso clínico de clareamento dental onde as alterações de cor foram avaliadas através de dois métodos: visual (utilizando escala Vita Clássica) e instrumental (utilizando espectrofotômetro Easyshade). Foi realizado clareamento dental de consultório com peróxido de hidrogênio a 35% Mix One Supreme (Villievie). A cor foi mensurada antes e após a realização do tratamento clareador com os dois métodos. O paciente relatou satisfação com a alteração de cor e esse resultado pôde ser comprovado tanto pela escala de cor quanto pelo espectrofotômetro. A técnica clareadora utilizada mostrou-se eficiente, porém, para resolver completamente o problema estético do paciente foi realizado também fechamento de diastema com resinas compostas fotopolimerizáveis.

Tooth color is considered a complexity phenomenon, influenced by coefficients such as environment illumination conditions, translucence, opacity, light spread, brightness, and structures and morphophysiological processes of sight. The aim of this study was to describe a clinical case of dental bleaching, in which the modifications of color were evaluated by two methods: visual (using Vita Classic scale) and instrumental (using Easyshade spectrophometer). A clinical dental bleaching was performed with hydrogen peroxide at 35% Mix One Supreme (Villievie). The color was measured before and after the bleaching with both methods. The patient reported satisfaction with the color alteration, and that result can be testified both by color scale and spectrophometer. The bleaching technique was very effective, however, in order to solve the esthetic problem completely, diastema was also closed with compound photopolymerizable resin.