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ABSTRACT Objective: To investigate whether the dimensions of cavitated dentin carious lesions on the occlusoproximal surfaces of primary teeth could predict the location of cement-enamel junction (CEJ). Material and Methods: Two hundred extracted primary molars were selected and digital images were obtained. The teeth were set in arch models for clinical measurement. The cervical-occlusal (CO) and buccal-lingual/palatal (BL/P) cavities' dimensions were obtained by digital (Image J) and clinical (periodontal millimeter probe) assessments. The cervical margin location was also determined. The thresholds (cut-off points) were determined by sensitivity, specificity and the areas under the receiver operating characteristics curves (Az) for the two methods. Pearson's correlation coefficient was used to investigate the correlation between clinical and digital measurements. Logistic regression analysis was performed to evaluate the association between the dimensions and cervical margin location. Results: There was a strong correlation between methods for all measurements (CO: r=0.90, VL/P: r=0.95). Cavities with BL/P distance higher than 4.5 mm and CO dimension higher than 3.5 mm had a lower chance of presenting the cervical limit above the CEJ, irrespective of the measurement method. Conclusion: CO and VL/P dimensions could be used to predict the CEJ location and, ultimately, as a clinical parameter for restorative decision-making.

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This double-blind, randomized clinical trial aimed to compare the clinical performance and clinical time to restore occluso-proximal cavities in primary molars withbulk-fillresin and conventional resin. A total of 140 class II restorations in primary molars of 65 participants (mean age of 6.7 + 1.5) were placed in two random groups:bulk-filland conventional resin. The restorations were evaluated using FDI criteria at the baseline, 6-month, and one year by a single calibrated examiner, and the clinical restorative time was measured with a digital timer. The success and survival of the restorations were evaluated with Kaplan-Meier graphs. The log-rank test compared the curves. Differences in restorative clinical time were compared using the Mann-Whitney U test. The level of significance was 5%. After one year, 115 restorations were evaluated. The success probability was 88.7% for Filtek Z350 XT and 85.9% for FiltekTM Bulk-fill, and for the survival probability, Filtek Z350 XT presented 90%, and FiltekTM Bulk-fill presented 93.7%. No significant difference was found between the success and survival curves (p=0.62), (p=0.51). The main reason for failure was marginal adaptation.Bulk-fillresin required 30% less time than the conventional resin (p<0.001).Bulk-fillresin presented similar clinical performance to the conventional resin and required less restorative clinical time. It is an option to restore class II lesions of primary molars.

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Abstract This double-blind, randomized clinical trial aimed to compare the clinical performance and clinical time to restore occluso-proximal cavities in primary molars withbulk-fillresin and conventional resin. A total of 140 class II restorations in primary molars of 65 participants (mean age of 6.7 + 1.5) were placed in two random groups:bulk-filland conventional resin. The restorations were evaluated using FDI criteria at the baseline, 6-month, and one year by a single calibrated examiner, and the clinical restorative time was measured with a digital timer. The success and survival of the restorations were evaluated with Kaplan-Meier graphs. The log-rank test compared the curves. Differences in restorative clinical time were compared using the Mann-Whitney U test. The level of significance was 5%. After one year, 115 restorations were evaluated. The success probability was 88.7% for Filtek Z350 XT and 85.9% for FiltekTM Bulk-fill, and for the survival probability, Filtek Z350 XT presented 90%, and FiltekTM Bulk-fill presented 93.7%. No significant difference was found between the success and survival curves (p=0.62), (p=0.51). The main reason for failure was marginal adaptation.Bulk-fillresinrequired 30% less time than the conventional resin (p<0.001).Bulk-fillresin presented similar clinical performance to the conventional resin and required less restorative clinical time. It is an option to restore class II lesions of primary molars.

Resumo Este ensaio clínico randomizado, duplo-cego objetivou comparar a performance clínica e tempo clínico para restaurar cavidades ocluso-proximais em molares decíduos, restauradas com resina bulk-fill e resina convencional. Um total de 140 restaurações classe II em molares decíduos de 65 participantes (média de idade 6.7 + 1.5) foram realizadas dividas em dois grupos randomizados: resina bulk-fill e resina convencional. As restaurações foram avaliadas conforme o critério da FDI no baseline, após 6 meses e 1 ano, por um único examinador calibrado e o tempo clínico restaurador foi mensurado por um cronômetro digital. O sucesso e a sobrevida das restaurações foram avaliados através dos gráficos de Kaplan-Meier. O teste de log-rank comparou as curvas. A diferença no tempo clínico restaurador foi comparada usando o teste U de Mann-Whitney. O nível de significância foi de 5%. Após 1 ano, 115 restaurações foram avaliadas. A probabilidade de sucesso foi de 88,7% para Filtek Z350 XT e 85.9% para FiltekTM Bulk-fill e quanto a probabilidade de sobrevivência, Filtek Z350 XT apresentou 90% e FiltekTM Bulk-fill apresentou 93,7%. Não foi encontrada diferença significativa entre as curvas de sucesso e sobrevida (p=0,62), (p=0,51). A principal causa de falha foi a adaptação marginal. A resina bulk-fill exigiu 30% menos tempo do que a resina convencional (p<0,001). A resina bulk-fill apresentou desempenho clínico semelhante ao da resina convencional e necessitou menor tempo clínico restaurador. Dessa forma, é uma opção para restaurar lesões classe II em molares decíduos.

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Objective: This study investigated the impact of FDI criteria for evaluating restorations on examiners' decision-making compared with their previous personal judgment in primary teeth. Secondly, the possible factors related to changes when using the criteria, including the examiners' experience were explored. Material and Methods: A cross-sectional study in a dental office setting was conducted selecting 27 resin composite restorations placed in primary molars in 11 children. Examinations of the restorations were performed by five undergraduate and five graduate dental students. First, the evaluations were performed based on personal judgment, and 2 weeks later, with FDI criteria. All examiners underwent training to use the FDI criteria after the first evaluation. The consensus of two benchmark examiners was considered to be the reference standard. Initially, a descriptive analysis was performed. Multiple Poisson regressions analyses were used to identify possible associated factors with outcomes - to be less or more invasive based on the FDI criteria than personal judgment. Results: The use of the FDI criteria changed the examiners' decisions in approximately 15% of the cases. Irrespective of examiners' experience, there was a trend of false results (compared to the reference examiners) when a change in the treatment decision was registered by using the FDI criteria. Examiners chose a less invasive option when assessing multi surface restorations with FDI criteria (PR=2.04, 95%CI=1.03-4.05; p=0.04). Examiners who spent more time for evaluation with FDI criteria were more invasive (PR=1.001, 95%CI=1.0001-1.002; p=0.03). Students were more invasive with the FDI criteria when examined children with higher dmf-t (PR=1.16, 95%CI=1.01-1.32; p=0.03). Conclusion: The use of the FDI criteria negatively influenced the restorations' evaluation and treatment decision in primary molars by undergraduate and graduate students.(AU)

Objetivo: Este estudo investigou o impacto dos critérios da FDI para avaliar restaurações na tomade de decisão feita pelos examinadores em comparação ao seu julgamento pessoal prévio em dentes decíduos. Secundariamente, foram explorados os possíveis fatores relacionados com mudanças causadas pelo uso dos critérios, incluindo a experiência dos examinadores. Material e Métodos: Um estudo transversal em ambiente de consultório odontológico foi conduzido selecionando 27 restaurações de resina composta realizado em molares decíduos em 11 crianças. As avaliações das restaurações foram realizadas por cinco estudantes de Graduação e cinco de Pós-graduação em Odontologia. As avaliações foram realizadas com base no julgamento pessoal e, duas semanas depois, com os critérios da FDI. Todos os examinadores foram treinados para utilizar os critérios da FDI após a primeira avaliação. O consenso de dois examinadores "padrão-ouro" foi considerado o padrão de referência. Inicialmente, uma análise descritiva foi realizada. Análises de regressão múltipla de Poisson foram utilizadas para identificar possíveis fatores associados com os desfechos ­ ser mais ou menos invasivo com o uso dos critérios da FDI em relação ao julgamento pessoal. Resultados: A utilização dos critérios do FDI alterou as decisões dos examinadores em aproximadamente 15% dos casos. Independente da experiência dos examinadores, houve uma tendência de resultados falsos (em comparação com os examinadores de referência) quando uma mudança na decisão de tratamento foi registrada usando os critérios da FDI. Os examinadores escolheram uma opção menos invasiva quando avaliaram restaurações envolvendo múltiplas superfícies com os critérios da FDI (RP = 2,04, IC 95% = 1,03-4,05; p = 0,04). Os examinadores que levaram mais tempo para avaliação das restaurações foram mais invasivos com o uso dos critérios da FDI (RP = 1,001, IC 95% = 1,0001-1,0002; p = 0,03). Os alunos foram mais invasivos com o uso dos critérios da FDI quando examinaram crianças com maior experiência de cárie (RP = 1,16, IC 95% = 1,01-1,32; p = 0,03). Conclusão: O uso dos critérios da FDI influenciou negativamente a avaliação das restaurações e decisão de tratamento em dentes decíduos realizada por estudantes de graduação e pós-graduação. (AU)

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Despite composite resins capacity to mimic dental tissues, they can discolor over time. However, there is no information on the effect of prebrushing mouthwashes on the composite resin staining. This study aimed to evaluate the effect of prebrushing mouthwashes on the color stability of three composite resins. Twenty specimens of each resin were prepared: Filtek Z250 (3M ESPE ­S Paul, MN, USA), Charisma (Heraeus Kulzer GmbH - Hanau - Germany) e EvoluX (Dentsply- Petrópolis - Brazil). Groups were randomly divided accord to the treatment: immersion in prebrushing mouthwash (test group) or immersion in deionized water (control group). Test groups were immersed in 10 ml of prebrushing mouthwash Plax Magic (Colgate-Palmolive, São Bernardo do Campo, SP, Brazil) for 60 s three times a day during 35 days following the manufacturer's instructions. Color measurements were performed after 24 h of specimen's preparation and after 7, 14, 21, and 35 days of immersion time. Results showed that prebrushing mouthwash Plax Magic promoted a color change in all the tested materials and evaluation time. The color change was greater in composite resin Charisma, followed by Z250 and EvoluX. Therefore, prebrushing mouthwash promoted a color change in all the materials used. Composite resin Charisma demonstrated less color stability than Filtek Z250 resin and EvoluX resin, which was the most stable. (AU)

Apesar da capacidade das resinas compostas de mimetizar os tecidos dentais, esses materiais podem ter sua cor alterada com o tempo. No entanto, não há informação na literatura sobre o efeito de evidenciadores de placa na estabilidade de cor desses materiais. Este estudo teve por objetivo avaliar o efeito de um evidenciador de placa na estabilidade de cor e três resinas compostas. Para isso, 20 espécimes de cada resina foram preparados: Filtek Z250 (3M ESPE ­S Paul, MN, EUA), Charisma (Heraeus Kulzer GmbH - Hanau - Alemanha) e EvoluX (Dentsply- Petrópolis - Brasil). Os grupos foram aleatoriamente divididos de acordo com o tratamento a ser submetido: imersão no evidenciador de placa (grupo teste) ou imersão em água deionizada (grupo controle). Os grupos teste foram imersos em 10 ml do evidenciador de placa Plax Magic (Colgate Palmolive, São Bernardo do Campo, SP, Brasil) por 60 s três vezes por dia durante 35 dias, de acordo com a orientações de uso do fabricante. As leituras de cor foram feitas após 24 h da preparação dos espécimes e após 7, 14, 21 e 35 dias de imersão. Os resultados mostraram que o evidenciador de placa Plax Magic promoveu alteração de cor em todos os materiais usados e em todos os tempos de leitura. A alteração de cor foi maior na resina Charisma, seguida da Z250 e EvoluX. Portanto, o evidenciador de placa promove alteração de cor em todos os materiais testados. A resina composta Charisma demonstrou menor estabilidade de cor que as resinas Z250 e EvoluX, que, por sua vez, foi a mais estável. (AU)

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OBJECTIVES: This randomized, double-blind clinical trial, , evaluated the behavior of two universal adhesives used in etch-and-rinse (ER) or self-etch (SE) approach in non-carious cervical lesions (NCCLs). METHODS: Two hundred and eleven NCCLs were selected in 54 participants and randomly allocated into four experimental groups: Scotchbond Universal Adhesive - SBU (3M Oral Care) and Prime & Bond Elect - PB (Dentsply Sirona) used in ER and SE modes. Two trained operators placed all resin composite restorations (Filtek Z250, 3M Oral Care). Restorations were evaluated at baseline and after 6 months using both FDI and USPHS modified criteria by a blinded calibrated examiner. Kruskal-Wallis and Mann-Whitney U non-parametric tests were used to compare the restoration failures among experimental groups. RESULTS: Statistically significant differences were found among groups regarding failures (p=0.000 for both FDI and USPHS criteria). PB-SE presented more failures (p<0.05) than other experimental groups. No significant difference was found between any other pair of groups (p>0.05). CONCLUSIONS: The etch and rinse approach affected the clinical performance of Prime and Bond Elect. For this material, the self-etch approach generated lower criteria scores after a six-month follow-up. The bonding strategy did not influence Scotchbond Universal Adhesive clinical performance. (RBR-2GQMVF) CLINICAL SIGNIFICANCE: The clinical behavior of mild universal adhesive Prime & Bond Elect depends on the bonding strategy. The etch-and-rinse approach is recommended for this adhesive system. Scotchbond Universal Adhesive can be used in both bonding strategies without impairing clinical performance.

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Purpose: The purpose of this study was to assess the effect of potassium iodide (KI) after applying silver diamine fluoride (SDF) on the staining of demineralized dentin covered or not by a composite resin layer. Methods: Dentin blocks from 30 bovine incisors were demineralized and randomly allocated in three groups (N equals 10): (1) control (no treatment); (2) treated with SDF; and (3) treated with SDF and KI. Half of the specimens of each group received a composite resin restoration immediately after treatment. A colorimetric evaluation, according to the CIE L*a*b* system, was performed at baseline and after seven, 14, 30, and 60 days. The ΔE data were analyzed using the generalized linear model (Δ equals 0.05). Results: The use of KI immediately after applying SDF decreased the dentin staining at all assessment times. SDF treatment only stained the dentin under composite resin after 60 days. The application of KI reduced the dentin under composite resin staining as ΔE values were similar to the control group even after 60 days. Conclusions: The use of potassium iodide minimizes the darkening of dentin and prevents the staining of the dentin under composite resin restorations in the long-term.

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BACKGROUND: Due to the chemical and morphological differences between primary vs. permanent teeth, the time reduction of the acid etching or acidic primer can result in higher values of bond strength. AIM: To assess through a systematic review and meta-analysis the influence of the reducing etching (acid etching or acidic primer) time on the bond strength of adhesive systems to primary dentin. DESIGN: A systematic search was carried out in 3 databases: PubMed, Web of Science and Scopus. Studies that evaluated the effect of reducing the etching time on the bond strength of adhesive systems to primary dentin were included. Meta-analyses were performed using a random-effects model, with subgroups for etch-and-rinse and self-etching adhesives, with a significance level of P < .05. The risk of bias and heterogeneity between studies (Cochrane and I2 tests) were assessed. RESULTS: Eight studies were included in the systematic review and seven in the meta-analyses. The shortening etching time did not influence the immediate dentin bond strength for etch-and-rinse (Z = 0.07, P = .95) and self-etching adhesives (Z = 0.41, P = .69). After ageing, however, the shorting etching time improved the bond strength for etch-and-rinse adhesives (Z = 2.01, P = .04). All studies presented high bias risk. CONCLUSIONS: Reducing the acid-etching time to primary dentin improves the long-term bond strength to this substrate.

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ABSTRACT Objective: To show the relation between sugar intake in the infant diet and the presence of early childhood caries in a group of preschoolers. Methods: A retrospective analysis of medical records of patients aged 0 to 6 years attended at the Clinic of Babies from 2010 to 2016, at Universidade Federal de Santa Maria. The data analyzed were: patient identification, gender, age, sugar introduction (age and frequency), exclusive breastfeeding, use of a bottle containing sugar, brushing (with or without fluoride) and diagnosis of dental caries through the International Caries Detection and Assessment System. Descriptive analysis showed the characteristics of the sample and comparison analyzes were performed using Fisher and T-Student tests, to verify the relation between individual variables and sugary intake. Results: The average age of the children was 29 months. Of the 86 medical records analyzed, 80.0% of the children ingested sugary foods, and its were part of the eating routine. Only 36 medical records contained information about early childhood caries, in which 86.2% of prevalence was found. There was no statistical difference between sugary diet and other variables (p > 0.05). Conclusion: These results suggest an intense relationship between sugar and early childhood caries. The high frequency of sugar intake is a risk factor for the onset of caries in early childhood, and its insertion in infant feeding may be delayed. Food and hygiene orientation is fundamental in the treatment process as well as family awareness.

RESUMO Objetivo: Mostrar a relação entre a ingestão do açúcar na dieta infantil e a presença da Cárie da Primeira Infância em um grupo de crianças pré-escolares. Métodos: Foi realizada uma análise retrospectiva de prontuários de pacientes de 0 a 6 anos atendidos na Clínica de Bebês entre 2010 a 2016, da Universidade Federal de Santa Maria. Os dados analisados foram: identificação do paciente, sexo, idade, introdução do açúcar (idade e frequência), aleitamento materno exclusivo, uso de mamadeira contendo açúcar, escovação (com ou sem flúor) e diagnóstico de cárie dentária feito através do International Caries Detection and Assessment System. A análise descritiva mostrou as características da amostra e análises comparativas foram realizadas pelos testes de Fisher e T-Student, para verificar a relação entre variáveis individuais e a ingestão de açucares. Resultados: A média de idade das crianças foi de 29 meses. Dos 86 prontuários analisados, 80,0% das crianças ingeriam alimentos açucarados, sendo parte da rotina alimentar. Apenas 36 prontuários continham informações sobre a Cárie da Primeira Infância, nestes foi encontrada uma prevalência de 86,2% da amostra. Não houve diferença estatística entre dieta açucarada e demais variáveis (p > 0,05). Conclusão: Esses resultados sugerem uma intensa relação entre açúcar e Cárie da Primeira Infância. A alta frequência de ingestão de açúcar é um fator de risco para o surgimento da Cárie da Primeira Infância, podendo ser retardada a sua inserção na alimentação infantil. A orientação alimentar e de higienização é fundamental no processo do tratamento assim como a conscientização familiar.

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The aim of this study was to investigate the influence of shortening of etching time for dentin on the restoration survival after selective carious tissue removal in primary molars. This two-arm randomized clinical trial included sixty-two subjects (5-8 year-old) and 100 primary molars presenting moderate dentin carious lesions on occlusal surface. The sample was randomly assigned into groups previously to adhesive application (Adper Single Bond 2; 3M ESPE): etching time recommended by manufacturer (15 s) or reduced (7 s). Resin composite (Filtek Bulk Fill Posterior Restorative; 3M ESPE) was inserted in a single increment for all restorations. Restorations were evaluated at 1, 6, 12, and 18 months using FDI criteria. Survival estimates for restorations' longevity were evaluated with Kaplan-Meier method. Multivariate Cox regression analysis with shared frailty was used to assess the factors associated with failures (p < 0.05). The etching time did not influence the restorations' survival (HR 0.35 95%CI 0.11-1.12; p = 0.06). Mean estimated time of survival was 17.6 months (95%CI, 17.2-17.9). The survival rates at the 18-month follow-up were 75.7% and 91.4% (AFR: 16.9% and 5.7%) when primary dentin was acid etched for 15 and 7 s, respectively (log-rank p = 0.06). In conclusion, the etching time for dentin did not influence the clinical behavior of adhesives restorations. However, there was a tendency for better clinical outcome when using etching time of 7 s.

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