RESUMO
Objective: To investigate the clinical management of deep occlusal carious lesions in permanent teeth by Brazilian dentists. Material and Methods: This cross-sectional study included a sample of 732 Brazilian dentists who responded to an electronic questionnaire composed of 20 questions addressing socio-demographic information, training and professional activity characteristics, and clinical management of deep carious lesions. Descriptive analysis was performed, considering relative and absolute frequencies and 95% confidence intervals. The association between the dentists' variables of interest (age group, type of higher education institution, years in practice, highest academic degree completed and main sector of professional activity) and the mean number of incorrect answers regarding deep carious lesions management was analyzed by Analysis of Variance (ANOVA), followed by the Bonferroni post-test (p<0.005). Results: Stepwise removal was the strategy pointed out by most dentists (42.8%). However, 16% of the dentists selected nonselective carious tissue removal. Furthermore, 45.6% of the dentists disagreed with maintaining carious tissue over the pulp in deep lesions with a risk of pulpal exposure. When using instruments to remove carious dentine, 17% of the dentists chose a diamond burn while 13% preferred tungsten carbide burs. Dentists who graduated from public institutions had a lower mean of non-conservative decisions than those from private institutions. Dentists with master's or doctoral degrees were more conservative, as well as dentists from public service compared to those from the private sector. Conclusion: The dissemination of conservative approaches in the management of deep carious lesions needs to be strengthened and increasingly based on updated scientific literature.(AU)
Objetivo: Investigar o manejo clínico de lesões cariosas oclusais profundas em dentes permanentes por cirurgiões-dentistas brasileiros. Material e Métodos: Este estudo transversal incluiu uma amostra de 732 dentistas brasileiros que responderam a um questionário eletrônico composto por 20 questões abordando informações sociodemográficas, formação, características da atividade profissional e manejo clínico de lesões cariosas profundas. Foi realizada análise descritiva, considerando frequências relativas e absolutas, e intervalos de confiança de 95%. A associação entre as variáveis de interesse (faixa etária, tipo de instituição de ensino superior, anos de prática, maior titulação acadêmica concluída e principal setor de atividade profissional) dos cirurgiões-dentistas e a média de acertos no manejo de lesões cariosas profundas foi analisada pela Análise de Variância (ANOVA), seguida do pós-teste de Bonferroni (p<0,005). Resultados: A remoção seletiva foi a estratégia apontada pela maioria dos cirurgiões-dentistas (42,8%). No entanto, 16% dos dentistas selecionaram a remoção não seletiva do tecido cariado. Além disso, 45,6% dos dentistas discordaram da manutenção de tecido cariado sobre a polpa em lesões profundas com risco de exposição pulpar. Ao usar instrumentos para remover a dentina cariada, 17% dos dentistas escolheram uma broca diamantada, enquanto 13% preferiram brocas de carboneto de tungstênio. Cirurgiões-dentistas formados em instituições públicas apresentaram menor média de decisões não conservadoras do que os de instituições privadas. Os cirurgiões-dentistas com mestrado ou doutorado foram mais conservadores, assim como os cirurgiões-dentistas do serviço público em relação aos do setor privado. Conclusão: A disseminação de abordagens conservadoras no manejo de lesões cariosas profundas precisa ser fortalecida e cada vez mais baseada em literatura científica atualizada (AU)
Assuntos
Humanos , Cárie Dentária , Capeamento da Polpa Dentária , Odontologia , Odontólogos , Prática Clínica Baseada em EvidênciasRESUMO
CONTEXT: The adhesives clinical effectiveness has been extensively reported for noncarious cervical lesions (NCCLs). However, there is a lack of information about the adhesive systems strategies and their effect on NCCL restoration longevity. AIMS: This study aims to evaluate a 42-month performance of four dentin adhesive systems used for the restorative treatment of NCCLs. SETTINGS AND DESIGN: NCCLs were randomly divided into four groups: (1) Scotchbond multi-purpose (MP); 2: Single bond plus (SB); 3: Scotchbond SE (SE); and 4: Easy bond (EB). SUBJECTS AND METHODS: NCCLs (125) were randomly distributed: (1) MP; (2) SB; (3) SE; and (4) EB and were restored with a nanofilled resin-composite, evaluated along 18-36-42 months. STATISTICAL ANALYSIS USED: Kruskal-Wallis test: Comparison among the adhesive systems in each period. Friedman analysis: Comparison along the periods. Kaplan-Meier: Survival analysis. RESULTS: Baseline and 42-month retention (RET) rates (%) were 100/100 for MP; 100/94.74 for SB; 100/87.5 for SE; and 100/100 for EB. The cumulative failure percentage was 9.52% for MP, 9.52% SB, 15.8% SE, and 10% EB. Restorations survival was not dependent on the used adhesive type. Marginal adaptation (MA) was similar to each group, but EB presented noticeable marginal deterioration. Wear was noticed in the 3-step etch-and-rinse (MP) restorations evaluated after 42 months. For the EB, baseline and 18-month wear evaluation were statistically similar. After 36 and 42 months, wear was also similar for EB. CONCLUSIONS: Adhesive systems showed similar performance within most important adhesive bonding efficiency achievement parameters: RET, MA, interfacial staining, recurrent caries, and postoperative sensitivity evaluated during 42 months.
Assuntos
Colagem Dentária , Cárie Dentária , Resinas Compostas , Cimentos Dentários , Adaptação Marginal Dentária , Materiais Dentários , Restauração Dentária Permanente , Adesivos Dentinários , Humanos , Cimentos de ResinaRESUMO
CONTEXT: Zinc-oxide eugenol (ZOE) is frequently used due to its satisfactory biological response, sedative effect on the pulp, and easy removal. However, literature is very controversial about the influence of the temporary cement-containing eugenol on the bond strength properties. AIMS: This study aims to clarify the literature controversy by evaluating the bond strength of ZOE or ZOE-free applied before bonding procedures and the 7-day resting period after the first session. SETTINGS AND DESIGNS: Twelve recently extracted third molars were randomly divided into three groups: Group 1: Control (without treatment), Group 2: Temp-Bond NE; Group 3: Temp-Bond. SUBJECTS AND METHODS: After temporary restorations, the teeth were immersed in distilled water and stored for 7 days at 37°C. The temporary cement was mechanically removed, and prophylaxis was performed. The adhesive procedures were performed, and a 6-mm-high composite resin block was built. The teeth were immediately stored at 100% relative humidity at 37°C for 24 hours. Specimens with 0.7 (±0.2) mm2 of cross-sectional area were obtained and subjected to a microtensile bond strength (µTBS) test at 1 mm/min until failure. STATISTICAL ANALYSIS USED: Analysis of variance (ANOVA) and Tukey's post hoc test were used for statistical analysis. RESULTS: ZOE or ZOE-free cement did not interfere in the µTBS between resin composite and dentine when used with a two-step-etch-rinse adhesive material, considering 7 days of resting period after the first session, by the ANOVA and Tukey's post hoc test (P < 0.05). CONCLUSIONS: The authors recommend the removal of the temporary cementation at least seven days after the first session and suggest that the clinicians follow-up further studies to use the cement in case its removal is recommended within a longer period.
Assuntos
Colagem Dentária , Cimento de Óxido de Zinco e Eugenol , Resinas Compostas , Cimentos Dentários , Restauração Dentária Temporária , Dentina , Adesivos Dentinários , Eugenol , Teste de Materiais , Cimentos de Resina , Resistência à Tração , ZincoRESUMO
OBJECTIVES: The objective of the present study is to evaluate the effects of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on bleached enamel. MATERIALS AND METHODS: A bleaching agent (35% hydrogen peroxide) was applied, 4 × 8 min on premolar teeth (n = 8). A CPP-ACP paste was applied for 7 days. Prior and post-treatment, microtomography images were obtained and 3D regions of interest (ROIs) were selected, from outer enamel, extending to 110.2-µm depth. CT parameters of structure: thickness (St.Th), separation (St.Sp), and fragmentation index (Fr.I.) were calculated for each (ROI). Data was submitted to paired t tests at a 95% confidence level. The samples were evaluated at 3000 to 100,000 magnification. Quantitative analysis of enamel mineral content was also determined by SEM EDX. RESULTS: There was a significant increase in structure thickness and calcium content. The phosphorus content increased after bleaching. There was also a decreased separation and fragmentation index on the outer enamel to a depth of 56.2 µm (p < 0.05). There were no changes at 110.2-µm depth for the bleaching CPP-ACP association. A covering layer and decreased spaces between the hydroxyapatite crystals appeared around the enamel prisms, 7 days after the CPP-ACP application. CONCLUSIONS: The application of a CPP-ACP provides a compact structure on the enamel's outer surface, for 7 days, due to calcium deposition. CT parameters seem to be a useful tool for mineralizing and remineralizing future studies. CLINICAL RELEVANCE: CPP-ACP neutralizes any adverse effects on enamel surface when applied during a week after bleaching and minimizes any side effects of the bleaching treatment due to a more compact structure.
Assuntos
Caseínas/farmacologia , Esmalte Dentário/efeitos dos fármacos , Esmalte Dentário/ultraestrutura , Clareamento Dental , Remineralização Dentária/métodos , Microtomografia por Raio-X , Humanos , Peróxido de Hidrogênio/farmacologia , Técnicas In Vitro , Microscopia Eletrônica de Varredura , Clareadores Dentários/farmacologiaRESUMO
The aim of this manuscript is to describe 2-year follow-up of a clinical experience with a zirconia-reinforced lithium silicate ceramic for an anterior rehabilitation with single metal-free crowns. The maxillary-central incisor teeth crowns were made by zirconium-reinforced lithium silicate and covered with porcelain were obtained with a digital impression with the intra-oral scanner of the CEREC system as a basis for virtual design, as well as a laminate for the left lateral maxillary incisor, based on a "double scanning" technique. Lithium silicate material seems to be a safe and satisfactory alternative for anterior crowns' rehabilitation.
Assuntos
Coroas , Materiais Dentários , Porcelana Dentária , Compostos de Lítio , Silicatos , Zircônio , Adulto , Planejamento de Prótese Dentária , Feminino , Seguimentos , Humanos , Fatores de TempoRESUMO
The effects of polymerization protocols on water sorption/solubility, the diffusion coefficient (D), the flux (J), and the hardness (KH) of two resin cements were evaluated. The materials were manipulated and divided into three groups (n=6) according to the curing protocol: PA=photoactivation (40 s); DP=delayed photoactivation (10 min self-curing plus 40 s photoactivated); CA=chemical activation. After desiccation, the specimens were weighed, stored in water (37ºC), evaluated over 28-days, and hardness recorded. Chemical activation resulted in lower net water uptake, D, and J for RelyX ARC (RX). For Variolink II (VL), CA yielded equivalent D and lower J; however, photoactivation resulted in lower net water uptake. Hardness of VL was less affected by the water storage, irrespective of the polymerization protocol. Considering the water diffusion parameters, VL demonstrated immediate photoactivation dependence; for RX, a chemical activation. Different polymerization protocols affect the fluid kinetics and the hardness of the resin cements tested.
Assuntos
Dureza , Cura Luminosa de Adesivos Dentários/métodos , Polimerização , Cimentos de Resina/química , Água/química , Análise de Variância , Difusão , Cinética , Teste de Materiais , Microscopia Eletrônica de Varredura , Solubilidade , Espectrometria por Raios XRESUMO
The use of ceramic veneers to restore crowded teeth in the maxilla has been widely discussed in the literature. However, the use of this technique in the mandible has received little attention. Therefore, this case report describes the treatment of crowded mandibular anterior teeth using ceramic veneers. The primary treatment challenge in this region is the reduced tooth structure available for rehabilitation. Proper communication between the clinician and dental technician is required to achieve clinical success. This article presents a straightforward treatment plan and restorative technique that includes both the clinical and laboratory sequences necessary for predictable and stable postoperative outcomes.
Assuntos
Porcelana Dentária , Facetas Dentárias , Estética Dentária , Má Oclusão/reabilitação , Preparo Prostodôntico do Dente , Cimentação , Restauração Dentária Temporária , Técnicos em Prótese Dentária , Odontólogos , Feminino , Humanos , Incisivo , Comunicação Interdisciplinar , Mandíbula , Mastigação , Pessoa de Meia-Idade , Planejamento de Assistência ao PacienteRESUMO
The aim of the present study was to evaluate the fracture resistance of teeth restored with resin composite. Forty-eight maxillary premolar teeth were chosen and randomly divided to six groups: G1 (control): sound teeth; G2: MOD preparation, unrestored; G3: MOD + Adper Single Bond 2/P60; G4: MOD + Adper Easy One/P60; G5: MOD + P90 restorative system; G6: MOD + Adper Easy One/P90 Bond/P90. Specimens were subjected to compressive axial loading (0.5 mm/min). Flexural strength and the modulus of elasticity were also tested (n = 7). The only statistical equivalence with sound teeth was noted for G3 (p < 0.05). Flexural strength and the modulus of elasticity varied among the composites tested (n = 10). The reestablishment of the resistance to fracture in premolars subjected to Class II MOD preparations is restorative-system-dependent. The silorane restorative system is not able to recover the resistance to fracture.
Assuntos
Humanos , Resinas Compostas/química , Restauração Dentária Permanente/métodos , Fraturas dos Dentes , Análise de Variância , Força Compressiva , Análise do Estresse Dentário , Teste de Materiais , Propriedades de SuperfícieRESUMO
The aim of the present study was to evaluate the fracture resistance of teeth restored with resin composite. Forty-eight maxillary premolar teeth were chosen and randomly divided to six groups: G1 (control): sound teeth; G2: MOD preparation, unrestored; G3: MOD + Adper Single Bond 2/P60; G4: MOD + Adper Easy One/P60; G5: MOD + P90 restorative system; G6: MOD + Adper Easy One/P90 Bond/P90. Specimens were subjected to compressive axial loading (0.5 mm/min). Flexural strength and the modulus of elasticity were also tested (n = 7). The only statistical equivalence with sound teeth was noted for G3 (p < 0.05). Flexural strength and the modulus of elasticity varied among the composites tested (n = 10). The reestablishment of the resistance to fracture in premolars subjected to Class II MOD preparations is restorative-system-dependent. The silorane restorative system is not able to recover the resistance to fracture.
Assuntos
Resinas Compostas/química , Restauração Dentária Permanente/métodos , Fraturas dos Dentes , Análise de Variância , Força Compressiva , Análise do Estresse Dentário , Humanos , Teste de Materiais , Propriedades de SuperfícieRESUMO
The aim of this study was to observe the influence of restorative techniques on marginal adaptation and dye penetration around Class V restorations simulating abfraction lesions. Sixty mandibular premolars were divided into six groups (n = 10) using different restorative materials. Cavity preparation presented the gingival wall localized in dentin and the incisal wall in enamel. Replicas of abfraction lesions were obtained and viewed under a stereomicroscope for adaptation assessment. All teeth were subjected to thermocycling and mechanical load cycling and immersed in 0.5% methylene blue dye (pH 7.2) for four hours. The results were tabulated and submitted to Kruskal-Wallis tests, which were significant for the dentin margin with lower microleakage values for primer/Vitremer, followed by Clearfil SE Bond/Durafill VS and Clearfil SE Bond/Z100 in qualitative and quantitative methods (P < 0.05). The enamel margin had no significant difference for microleakage values for all groups. There was no statistically significant difference among the substrates for marginal adaptation. The Spearman coefficient illustrated a direct relation between enamel and dentin for microleakage evaluation (P < 0.0001). The data demonstrated no difference for marginal fit by chi-square test. It can be concluded that all groups had microleakage in different degrees, with the lowest values for resin-modified glass ionomer.