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Introdução: os enxaguantes bucais clareadores tem sido muito utilizados, porém sua eficiência e efeitos colaterais trazem questionamentos. Objetivo: este ensaio clínico teve como objetivo avaliar se o enxaguante bucal clareador, contendo peróxido de hidrogênio a 1,5%, apresenta ação clareadora e se há algum efeito secundário na cavidade bucal. Metodologia: foram selecionados 10 voluntários com idade média de 21,5 anos, submetidos a avaliação da cor dos dentes com auxílio do espectrômetro em 3 momentos: inicial; com 15 e com 30 dias de uso do enxaguante. A avaliação dos efeitos colaterais foi realizada a partir da coleta de saliva estimulada em 4 momentos: antes e depois ao primeiro uso do produto, com 15 e com 30 dias, e realizadas as análises laboratoriais: fluxo salivar; pH; quantidade de Streptococcus mutans e de Lactobacillus. A normalidade dos dados foi verificada pelo teste de Shapiro-Wilk, comparação de cor pelo teste t dependente, comparação dos microrganismos pelos testes ANOVA de medidas repetida e Tukey. Resultados: as análises de cor dos dentes não evidenciaram nenhuma alteração significativa em nenhum dos tempos investigados. No fluxo salivar, pH e Lactobacillus não houveram alterações significativas. Na quantidade de Streptococcus mutans notou-se um aumento significativo quando comparado os valores após o primeiro uso e com 30 dias. Conclusão: a solução de enxague bucal contendo peróxido de hidrogênio a 1,5% não apresentou alteração significativa na coloração dos dentes e nenhum efeito colateral significativo na atividade cariogênica de acordo com os testes e períodos avaliados.

Introduction: whitening mouthwashes have been widely used, but their efficiency and side effects raise questions. Objective: this clinical trial aimed to assess whether the bleaching mouthwash, containing 1.5% hydrogen peroxide, has a bleaching action and whether there are any side effects in the oral cavity. Methods: 10 volunteers were selected, with a mean age of 21.5 years, who underwent tooth color evaluation with the aid of a spectrometer in 3 moments: initial; with 15 and 30 days of using the washes. The evaluation of side effects was performed from the collection of stimulated saliva in 4 moments: before and after the first use of the product, at 15 and 30 days, and laboratory analyzes were carried out: salivary flow; pH; the number of Streptococcus mutans and Lactobacillus. Normal distribution was verified with Shapiro-Wilk test, comparisons of color were performed with t-test, comparisons of the microorganisms were performed with repeated measures ANOVA and Tukey tests. Results: the analysis did not show any significant changes in any of the investigated times. There were no significant changes in the salivary flow, pH and Lactobacillus. The number of Streptococcus mutans, was noted a significant increase when comparing the values after the first use and with 30 days. Conclusion: the mouthwash containing 1.5% hydrogen peroxide was not shown any significant alterations in the color teeth. There were not significant collateral effects on the cariogenic activity according to the tests and periods evaluated.

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STATEMENT OF PROBLEM: Redesigned mixing tips, promising less impression material waste, have been marketed. However, whether their use adversely affects the dimensional stability and detail reproduction of the impression material is unclear. PURPOSE: The purpose of this in vitro study was to evaluate the dimensional stability, detail reproduction, and material waste of different polyvinyl siloxane impression materials (regular and light-body) mixed with 2 different mixing tips (MIXPAC T-Mixer mixing tip and MIXPAC helical mixing tip). MATERIAL AND METHODS: Six different polyvinyl siloxane impression materials were used in 2 different consistencies: Virtual Monophase and Virtual Light Body (Ivoclar Vivadent AG), Express XT Regular and Express XT Light Body (3M ESPE), and Panasil initial contact Regular and Panasil initial contact Light (Kettenbach). The polyvinyl siloxane impression materials were mixed with 2 different mixing tips: conventional helical and T-Mixer (n=10). The specimens were prepared in a metal matrix as per specification #19 of the American National Standards Institute/American Dental Association (ANSI/ADA) and International Organization for Standardization (ISO) 4823:2015. The materials were mixed with both mixing tips as per the manufacturer's instructions, inserted into a perforated custom tray on the matrix, and allowed to polymerize completely. The dimensional stability was calculated based on the measurement of the reproduction of lines engraved in the metal matrix. Detail reproduction was evaluated through analysis of continuity and reproducibility of those lines, immediately, 7 days, and 14 days after polymerization. Material waste was assessed by the difference between the initial (before mixing) and final weight (after complete polymerization) of both mixing tips. The data on dimensional stability and detail reproduction among the materials were submitted to the Kruskal-Wallis test, followed by the Student-Newman-Keuls test (α=.05). Comparison between the mixing tips was carried out with the Mann-Whitney test (α=.05), while the comparison among the periods of analysis (immediate, 7 days, and 14 days) was carried out with the Friedman test (α=.05). The data on material waste between the mixing tips were submitted to 1-way ANOVA, followed by the Tukey honestly significant difference tests (α=.05). RESULTS: The T-Mixer mixing tip resulted in reduced material waste. For dimensional stability, Virtual Light mixed with T-Mixer resulted in lower dimensional change (0.53 ±0.58%) compared with the helical mixing tip (1.09 ±0.43%). Among the materials, Panasil Light presented higher values of dimensional change at immediate and 7-day analysis when mixed with T-Mixer tip with a statistical difference compared with Express Light, Virtual Light, and Panasil Regular (P<.05). In general, both mixing tips provided similar results in all periods of analysis (P>.05) for qualitative analysis of detail reproduction. CONCLUSIONS: The T-Mixer tip resulted in less material waste compared with the helical mixing tip. In general, light-body materials showed higher dimensional stability when the T-Mixer tip was used compared with the conventional tip. In general, reduced detail reproduction was observed after periods longer than 7 days after impression making.

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This study evaluated the decomposition rate (DR), pH, enamel color alteration (DE) and whiteness index (DWI) promoted by at-home and in-office bleaching. Enamel surface was submitted to (n=10): at-home (10%, 15%, 20% carbamide peroxide - CP, 6% hydrogen peroxide -HP) and three 35% HP agents with light irradiation (LED, laser, and halogen) or no treatment (control). The DR and pH of agents were measured after 0, 2, 4, 6 and 8 h (at-home) or after 5, 15, 20, 30 and 40 min (in-office). Color parameters (L*, a*, b*, DE, DWI) were determined at baseline and after bleaching. DR, pH, L*, a*, b* data were analyzed by one-way (at-home) or two-way (in-office) repeated measures ANOVA and Tukey test. DE and DWI, by one-way (at-home) or two-way (in-office) ANOVA and Tukey test. DR of at-home agents was similar after 6 and 8 h (p>0.05), with pH close to neutral (6.5 to 6.9, CP) or acid 5.9 (6% HP). From 4 to 8 h, DE was higher for 15% and 20% CP compared with 10% CP (p<0.05). After 40 min, DR of 35% HP agents was similar and all exhibited significant DE in one application (p<0.05), regardless light irradiation. DWI indicated whitening effect with no differences among groups (p>0.05). One 35% HP showed alkaline pH, and the others, pH < 5.5. At-home agents could be applied for 2 h (15%, 20% CP, 6% HP) and 4 h (10% CP) and the in-office agents, up to 40 min in one application, without light.

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Abstract This study evaluated the decomposition rate (DR), pH, enamel color alteration (DE) and whiteness index (DWI) promoted by at-home and in-office bleaching. Enamel surface was submitted to (n=10): at-home (10%, 15%, 20% carbamide peroxide - CP, 6% hydrogen peroxide -HP) and three 35% HP agents with light irradiation (LED, laser, and halogen) or no treatment (control). The DR and pH of agents were measured after 0, 2, 4, 6 and 8 h (at-home) or after 5, 15, 20, 30 and 40 min (in-office). Color parameters (L*, a*, b*, DE, DWI) were determined at baseline and after bleaching. DR, pH, L*, a*, b* data were analyzed by one-way (at-home) or two-way (in-office) repeated measures ANOVA and Tukey test. DE and DWI, by one-way (at-home) or two-way (in-office) ANOVA and Tukey test. DR of at-home agents was similar after 6 and 8 h (p>0.05), with pH close to neutral (6.5 to 6.9, CP) or acid 5.9 (6% HP). From 4 to 8 h, DE was higher for 15% and 20% CP compared with 10% CP (p<0.05). After 40 min, DR of 35% HP agents was similar and all exhibited significant DE in one application (p<0.05), regardless light irradiation. DWI indicated whitening effect with no differences among groups (p>0.05). One 35% HP showed alkaline pH, and the others, pH < 5.5. At-home agents could be applied for 2 h (15%, 20% CP, 6% HP) and 4 h (10% CP) and the in-office agents, up to 40 min in one application, without light.

Resumo Este estudo avaliou a taxa de decomposição (DR), pH, alteração da cor do esmalte (∆E) e índice de clareamento (DWI) promovido por agentes clareadores caseiros e de consultório. A superfície do esmalte foi submetida a (n=10): agentes caseiros (10%, 15%, 20% de peróxido de carbamida - CP e 6% de peróxido de hidrogênio - HP) e três agentes a base de HP a 35% comirradiação por luz (LED, laser e halógena) ou sem tratamento (controle). A DR e pH dos agentes foi mensurada após 0, 2, 4, 6 e 8h (agentes caseiros) e após 5, 15, 20, 30 e 40 min (agentes de consultório). Parâmetros de cor (L*, a*, b*, DE e DWI) foram determinados inicialmente e após clareamento. Os dados da DR, pH, L*, a*, b* foram analisados por ANOVA um fator (agentes caseiros) ou dois fatores (agentes de consultório) de medidas repetidas e teste Tukey. ΔE e DWI por ANOVA um fator (agentes caseiros) e dois fatores (agentes de consultório) e teste Tukey. A DR dos agentes clareadores caseiros foi similar após 6 e 8 h (p>0.05), com pH próximo ao neutro (6,5 a 6,9 - CP) ou ácido (5,9- HP 6%). De 4 a 8 h, a ∆E foi maior para CP 15% e 20% comparado ao CP 10% (p<0.05). Após 40 min, a DR dos agentes HP 35% foi similar e todos exibiram ∆E significante em uma aplicação (p<0.05), independente da aplicação de luz. DWI indicou efeito clareador, sem diferenças entre os grupos (p>0.05). Um agente HP 35% exibiu pH alcalino, e os outros, pH<5.5. Os agentes clareadores caseiros poderiam ser aplicados por 2 h (15%, 20% CP e 6% HP) e 4 h (CP 10%), e os agentes clareadores de consultório, até 40 min em uma aplicação, sem luz.

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Objective: The at-home bleaching technique leads to the intimate contact of the bleaching gel with gingival tissues, so this study evaluated the immediate inflammatory response, through the edemogenic test, induced by at-home bleaching gels of 10% carbamide peroxide with different desensitizing agents, the quantification of hydrogen peroxide released and bleaching gels pH. Material and Methods: Forty-eight rats were divided into groups (n=12): CTRL-control group, WP-Whiteness Perfect 10% (FGM Produtos Odontológicos, Joinville, SC, Brazil), OPA-Opalescence 10% (Ultradent Products Inc., South Jordan, IT, USA), and PB-Power Bleaching (BM4, Palhoça, SC, Brazil). For the edemogenic test, all rats received an intravenous injection of Evan's Blue; after 30 min, 0.2 mL of each bleaching gels was injected into the subcutaneous tissue of the rats, and the results of the vascular permeability were assessed after 3 and 6h. The amount of HP released and pH of each product was also determined. Data were submitted to statistical test (p <0.05 ). Results: At 3h, the PB showed higher vascular permeability than the other groups. At 6h, the PB produced similar vascular permeability than WHI, and higher than OPA and CTRL groups. The OPA group had a higher vascular permeability at 6h compared to 3h; there is no difference in other groups. The PB group had higher HP concentrations than the other groups. Conclusion: In general, the PB caused a more considerable amount of inflammatory edema and higher amount of HP released. This results suggesting that these bleaching gels cause greater aggression in soft gingival tissues that eventually ends up in contact with bleaching products. (AU)

Objetivo: A técnica de clareamento domiciliar leva ao contato íntimo do gel clareador com tecidos gengivais, assim, este estudo avaliou a resposta inflamatória imediata, através do teste edemogênico, induzido por gel de clareamento caseiro à base de peróxido de carbamida a 10% com diferentes agentes dessensibilizantes, a quantificação de peróxido de hidrogênio liberado e o pH dos géis branqueadores. Material e Métodos: Quarenta e oito ratos foram divididos em 4 grupos (n = 12): grupocontrole CTRL, WP-Whiteness Perfect 10% (FGM Produtos Odontológicos, Joinville, SC, Brasil), OPA-Opalescence 10% (Ultradent Products Inc., South Jordan, IT, EUA) e PB-Power Bleaching (BM4, Palhoça, SC, Brasil). Para o teste edemogênico, todos os ratos receberam uma injeção intravenosa de Evan's Blue; após 30 min, 0,2 mL de cada gel clareador foi injetado no tecido subcutâneo dos ratos, e os resultados da permeabilidade vascular foram avaliados após 3 e 6 horas. A quantidade de HP liberada e o pH de cada produto também foram determinados. Os dados foram submetidos ao teste estatístico (P <0,05). Resultados: Às 3h, o PB apresentou maior permeabilidade vascular que os demais grupos. Às 6h, o PB produziu permeabilidade vascular semelhante ao WHI e maior que os grupos OPA e CTRL. O grupo OPA apresentou maior permeabilidade vascular às 6h em relação às 3h; Não existe essa diferença em outros grupos. O grupo PB apresentou maiores concentrações de HP que os demais grupos. Conclusão: Em geral, o PB causou maior quantidade de edema inflamatório e maior quantidade de HP liberado. Estes resultados sugerem que estes géis branqueadores causam maior agressividade nos tecidos gengivais moles que eventualmente acabam em contato com produtos de branqueamento. (AU)

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Excessive gingival display during smile can result in compromised esthetics. This study aims to report a case of excessive gingival display with multiple etiologies treated by means of modified lip repositioning technique associated with esthetic crown lengthening. A 23-year-old female patient, with 5-mm gingival display during smile caused by altered passive eruption and hypermobility of the upper lip, underwent the modified lip repositioning technique associated with gingivectomy followed by flap elevation and ostectomy/osteoplasty. Seven months after the second procedure, the patient had her esthetic complaint solved appearing stable in the observation period. The modified lip repositioning technique is an effective procedure employed to reduce gingival display and when associated with esthetic clinical crown lengthening, can appropriately treat cases of gummy smile.

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In this manuscript, we present a rare case report of giant complex odontoma in the maxillary sinus, where the applied therapy included complete excision of the lesion with a conservative approach. Odontomas are also called benign growth abnormalities or hamartomas. They represent a more common type of odontogenic tumor and are related to various disorders such as bad dental placements, expansion, increased volumetric bone, and no eruption of permanent teeth. Usually they have an asymptomatic evolutionary course. The etiologic factors, although obscure, are related to local trauma, infection, and genetic factor. The structural composition of an odontoma consists of mature dental tissues. Odontomas can be differentiated according to their anatomical presentations: Compound odontoma-clusters of several denticles and complex odontoma-well defined tumefaction mass. The diagnosis can be performed by radiographic examination.

RESUMO

O objetivo do presente estudo foi avaliar o efeito de diferentes tratamentos de superfície sobre a resistência de união de pinos de fibra ao canal radicular. Quarenta e quatro pré-molares inferiores humanos, recém-extraídos, foram instrumentados utilizando-se o sistema rotatório K3®. Os canais foram obturados com guta-percha e cimento Sealapex®. Após preparo para pino, foi realizado um dos quatro seguintes tipos de tratamento de superfície intrarradicular: irrigação com cloreto de sódio (NaCl) a 0,9%, hipoclorito de sódio (NaOCl) a 2,5%, digluconato de clorexidina (CHX) a 2% ou ácido etilenodiaminotetracético (EDTA) a 17%. Pinos de fibra foram cimentados utilizando-se o cimento resinoso RelyX® (Unicem). A partir da parte coronária de cada raiz, foram obtidas três fatias de 1mm de espessura. Foi realizado o teste de cisalhamento por extrusão (Push-out) utilizando uma máquina de ensaios universal a 0,5mm/min. Os dados obtidos foram tabulados e submetidos à análise estatística por meio da análise de variância e do teste de Tukey (p < 0,05). Os resultados mostraram que o tratamento com NaOCl ou EDTA aumentou a resistência de união à dentina, porém sem diferenças do ponto de vista estatístico. Foi possível concluir que a força de união do pino de fibra ao canal radicular não foi significantemente afetada pelo tratamento de superfície com NaOCl a 2,5%, CHX a 2% ou EDTA a 17%.

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BACKGROUND: The aim of this study was to evaluate, by means of pull-out test, the bond strength of fiberglass posts when cemented with different lengths in endodontically treated teeth. MATERIALS AND METHODS: Sixty single-rooted bovine roots were cut in the cementoenamel junction with 21 mm length. They were endodontically treated and randomly divided into three groups (n = 20). Group 1 - Preparation of 2/3 of the remaining roots; Group 2 - Preparation of ½ of the remaining roots and Group 3 - Preparation of » of remaining roots. For all groups it were used posts n = 3 (Exacto, Angelus, Brazil), and cemented with self-etching resin cement (RelyXU200). After cementing posts, the samples were thermocycled (10.000 cycles/5°C and 55°C). The pull-out test was performed on a universal testing machine (EMIC - DL500) and the values obtained were statistically analyzed by analysis of variance (one-factor ANOVA) and multiple comparison test of Tukey, with level of significance of 5%. RESULTS: The mean values ± standard deviation in Newtons (N) were: Group 1 = 120.5 (±42.8) A, Group 2 = 103.1 (±31.2) AB, Group 3 = 41.2 (±22.4) C, P < 0.005. CONCLUSION: The preparation of ½ of remaining root appears to be a viable alternative when 2/3 of the preparation of the remaining root is not possible, but more results are needed for clinical validation.

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Diante do crescente número de pacientes com dentes clareados e da dificuldade dos profissionais em realizar a escolha de cor de materiais restauradores para esses dentes, o objetivo deste estudo foi avaliar o grau de concordância entre os métodos subjetivo e instrumental e entre o acadêmico e o professor na tomada de cor de dentes clareados. Dois pesquisadores duplo-cegos, um acadêmico, e um professor do curso de Odontologia, examinaram 20 pacientes que passaram por clareamento dental recente. Foram feitas tomadas de cor do dente 21, utilizando 3 escalas de cor (Venus, Charisma® e Vita 3D Master) e um aparelho espectrofotométrico (Vita Easyshade). Os dados foram tabulados e submetidos à análise estatística através do teste Kappa. A concordância entre acadêmico e professor foi pequena na tomada de cor de dentes clareados pelo método subjetivo. Já a concordância entre os métodos subjetivo e instrumental foi substancial quando realizada pelo professor e pequena quando realizada pelo acadêmico. Conclui-se que o método instrumental pode ser útil para profissionais menos treinados e que o aperfeiçoamento profissional é essencial para um correto desenvolvimento da acuidade visual na tomada de cor, especialmente para dentes clareados.

In view of the growing number of patients with bleached teeth and the difficulty of professionals to perform the selection of restorative material color for these teeth, the aim of this study was to evaluate the degree of agreement among subjective and instrumental methods and among student and teacher evaluation of the color of bleached teeth. Two double-blind researchers, a student, and a professor of Dentistry, examined 20 patients who underwent recent tooth bleaching procedure. It was accomplished the color selection of tooth 21, using three color scales (Venus®, Charisma® and Vita 3D Master®) and a spectrophotometric appliance (Vita Easyshade®). Data were subjected to statistical analysis using Kappa test. The agreement among academic and teacher was small in color selection of bleached teeth using the subjective method. However, the agreement among subjective and instrumental methods was substantial when held by the teacher and small when performed by student. It can be concluded that the instrumental method may be useful for less trained professionals and professional improvement is essential for a correct development of visual acuity for color selection, especially for bleached teeth.

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