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This study aimed to assess the prevalence of use and need for dental prostheses (UNDP) by individuals at age 24 and their life-course determinants. A representative sample (n = 720) of all 5914 births occurring in Pelotas in 1982 were prospectively investigated, and the UNDP were assessed in 2006. Exploratory variables included demographic and socio-economic, oral health, and dental service utilization patterns during the lifecourse. The prevalence of UNDP was 2.1% and 29.7%, respectively. Multivariable Poisson regression analysis showed that low socio-economic status through the life-course [Prevalence Ratio (PR) = 1.56 (95% CI: 1.08-2.26)], lower maternal schooling in childhood [PR 2.79 (1.34-5.79)], no oral hygiene instruction by a dentist at age 15 [PR 1.64 (1.11-2.41)], and caries presence at age 15 (high DMFT tertile) [PR 2.90 (1.98-4.24)] were associated with prosthetic treatment needs. These results support the hypothesis that life-course socio-economic, behavioral, and clinical determinants are associated with the need for dental prostheses. [ABSTRACT FROM AUTHOR]

It is known that stem cells from exfoliated deciduous teeth (SHED) can be induced to differentiate into odontoblasts. However, the nature of dentin-derived morphogenic signals required for dental pulp stem cell differentiation remains unclear. The hypothesis underlying this work is that dentin-derived Bone Morphogenetic Proteins (BMP) are necessary for the differentiation of SHED into odontoblasts. We observed that SHED express markers of odontoblastic differentiation (DSPP, DMP-1, MEPE) when seeded in human tooth slice/scaffolds and cultured in vitro, or implanted subcutaneously into immunodeficient mice. In contrast, SHED cultured in deproteinized tooth slice/scaffolds, or scaffolds without a tooth slice, do not express these markers. SHED express the BMP receptors BMPR-IA, BMPR-IB, and BMPR-II. Notably, blockade of BMP-2 signaling inhibited the expression of markers of odontoblastic differentiation by SHED cultured in tooth slice/ scaffolds. Collectively, this work demonstrates that dentin-derived BMP-2 is required to induce the differentiation of SHED into odontoblasts. [ABSTRACT FROM AUTHOR]

This double-blind randomized clinical trial evaluated the efficacy and safety of two carbamide peroxide concentrations used in at-home vital bleaching. Ninety-two volunteers with a shade mean of C1 or darker for the six maxillary anterior teeth were randomized into two balanced groups (n=46) according to bleaching agent concentration: 10% (CP10) or 16% (CP16) carbamide peroxide. The patients were instructed to use the whitening agent in a tray for two hours once a day for three weeks. Shade evaluations were done with a value-oriented shade guide mad a spectrophotometer at baseline and one week post-bleaching (four-week evaluation). Tooth sensitivity was measured daily using a scale ranging from 0 (no sensitivity) to 4 (severe sensitivity). At the end of the study, the volunteers filled out a questionnaire with seven questions aimed to give their opinion about the adopted treatment regimen. Both carbamide peroxide concentrations resulted in significantly lighter teeth at the four-week evaluation compared to the baseline for all color parameters (p<0.0001) and shade median (p<0.001). There was no significant difference between the two groups in terms of shade change difference with either the spectrophotometer (p=0.1) or the shade guide (p=0.7). Also, no statistically significant difference was found in relation to ΔL* (p=0.7), Δa* and ΔE* (p=0.5). A significant reduction in yellowness (Δb*) was observed for CP16 compared to CP10 (p=0.05) in crude analysis, which disappeared after controlling for b* parameter at baseline. The group treated with CP16 experienced more tooth sensitivity during the first (p=0.02) and third (p=0.01) weeks of treatment compared to the CP10 group. However, no major difference was observed (p=0.09) when the degree of tooth sensitivity between groups was compared. Both 10% and 16% carbamide peroxide concentrations were equally effective and safe for a three-week at-home tooth-bleaching treatment. [ABSTRACT FROM AUTHOR]

Purpose: This in vitro study tested tensile bond strength to enamel and dentin and the flexural modulus of three resin cements. It also determined the influence of these properties on the fracture resistance of teeth restored with ceramic inlays. Materials and Methods: Initially, 10 standard ceramic discs were bonded to enamel using the following resin cements: Enforce (E), RelyX ARC (RX) and Fill Magic Dual Cement (FM). After seven days of storage, the specimens were subjected to tensile forces at a crosshead speed of 0.5 mm/minute until fracture. The enamel was then ground and the ceramic disks were bonded to dentin. The flexural modulus of each type of resin cement was calculated based on the straight-line tension-deformation curve using the three-point flexure method. For resistance to fracture, 40 sound maxillary premolars were randomly divided into four groups (n=10). Three groups were submitted to preparations and restored with ceramic inlays bonded with the same resin cements used during the tensile test (n=10). Intact teeth were used as the control group. The specimens were subjected to compressive axial loading at 0.5 mm/minute using a 10-mm steel ball until fracture. Results: Statistical analysis revealed that, for all cements, the bond strength to enamel was significantly higher (p<0.05) than that obtained in dentin, in both substrates, RX and FM showed higher bond strengths than that obtained for E (p<0.05). In relation to flexural modulus, FM had the lowest and E the highest flexural modulus; whereas, RX differed from the other two (p<0.05). The teeth with inlays that were bonded using RX, and E had a significantly higher (p<0.05) fracture resistance than those where the inlays were bonded with FM but without recovering the resistance observed for the control group (intact teeth). Conclusion: The three resin cements had different mechanical properties. A higher flexural modulus usually resulted in improved resistance to fracture for the ceramically restored teeth. [ABSTRACT FROM AUTHOR]

This study evaluated in vitro and in situ the potential adverse effects of 10% carbamide per oxide on human enamel using microhardness calcium loss and surface morphology analysis. Twenty-four enamel slices (4 mm2) were obtained from recently extracted premolars. The specimens were polished under water-cooling down to 1,200-grade sandpaper. After initial microhardness readings (100g), the specimens were randomly divided into two groups for in situ and in vitro specimens were stored in deionized water and the in situ specimens, included in an intra-oral appliance, were placed in the oral cavity of four volunteers. these cycling sequences took place for 14 days. Upon conclusion of the bleaching treatment, new microhardness readings were performed on all specimens. Calcium dosage was assessed from the bleaching gel collected after initial exposure on day one, then from gel collected between days two and seven and gel collected between day eight and 14 using an atomic absorption spectrophotometer. Surface morphology was observed from two non-treated control specimens and two specimens of each experimental bleached group under SEM evaluation. Statistical analysis (ANOVA and Tukey test) disclosed that specimens bleached in situ showed similar microhardness to unbleached specimens and had statistically higher (p<0.01)hardness than in vitru bleached specimens. The loss if calcium in the vitru conditions. SEM micrographs demonstrated that surface alterations were more pronounced in the in vitro condition. The adverse effects of carbamide peroxide on enamel were evident in specimens bleached in vitro but were not seen in situ. The presence of saliva could prevent the demiralizing effects of bleaching gel in situ. [ABSTRACT FROM AUTHOR]

This study evaluated in vitro the influence of five solutions used to treat cavity preparations on microleakage of amalgam restorations. Seventy-two standard Class V cavities were prepared in buccal and lingual surfaces of 36 recently extracted human third molars. The cervical wall was located in cementum and the occlusal wall was located in enamel. Specimens were randomly divided into six groups (n=12) according to the solution employed to treat the cavities: Group I-2.5% sodium hypochlorite; Group II-Calcium hydroxide solution; Group III-1.23% Acidulated phosphate fluoride; Group IV-2% digluconate of chlorhexidine; Group V-anionic detergent solution (1.25% sodium lauryl sulfate) and Group VI-control group. The solutions were applied for one minute, followed by washing and drying. Two coats of copal varnish were applied in each cavity. The cavities were filled with capsuled amalgam GS-80 (SDI). After finishing and polishing, the specimens were submitted for thermal cycling followed by immersion in methylene blue. Then, the specimens were sectioned and microleakage was evaluated based on a standard ranking under magnification (40x). Data were subjected to statistical analysis using non-parametric tests. Results of the study concluded that leakage was higher in cementum than enamel (p<0.01). The substances employed have no influence on microleakage except for sodium hypochlorite, which increased leakage values in enamel (p<0.05). [ABSTRACT FROM AUTHOR]

This study compared marginal leakage of Class II cavities with gingival margin in cementum using different technique~ Twenty-four recently extracted third molars were used. Proximal standard box cavities were prepared in both mesial and distal surfaces. The gingival margin was located apical to the cemento-enamel junction. All the preparations and restorations were performed by the same operator. Standard cavities were randomly divided into three groups (n=16) and restored as follows: Group 1-light-cured composite resin; Group 2--self-cured composite resin + light-cured composite resin and Group 3-amalgam + light-cured composite resin. After polishing, the teeth were thermocycled and their gingival margins exposed to dye. Specimens were sectioned and leakage scores observed in accordance with a standard ranking. Data were subjected to statistical analysis (Kruskal-Wallis). Results showed that the amalgam/resin composite combination demonstrated the least leakage. [ABSTRACT FROM AUTHOR]

This study evaluated the influence of caries-detection dyes on the in vitro tensile bond strength of adhesive materials to sound dentin. Caries-free human molars were ground to expose superficial dentin. Two dyes (a commercial 0.5% basic fuchsin in propylene glycol and Cari-D-Tect) were applied to sound dentin and rinsed. Subsequently, the dentin was etched with phosphoric acid (35%) and rinsed, leaving a moist dentin surface. The adhesive (Prime & Bond 2.0) was applied in two layers and light cured. A composite (TPH Spectrum), a compomer (Dyract), and a hybrid ionomer (Advance) were used to prepare the bond-strength specimens with a 3-mm-in-diameter bonding area. Control groups were made without use of dyes. Six specimens were prepared for each group. After 24 hours in distilled water, tensile bond strength (MPa) was measured using a testing machine. Analysis of variance was used to evaluate the data. Without dyes, bond strengths of TPH Spectrum and Dyract with Prime and Bond 2.0 were similar and both values were significantly (P < 0.05) higher than that of Advance with Prime & Bond 2.0. Dyes for caries detection reduced the bond strength of TPH Spectrum and Dyract but not Advance when used with Prime and Bond 2.0. [ABSTRACT FROM AUTHOR]

Flávio Fernando Demarco1, Sônia Saeger Meireles2, Hugo Ramalho Sarmento1, Raquel Venâncio Fernandes Dantas1, Tatiana Botero3, Sandra Beatriz Chaves Tarquinio11Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Brazil; 2Department of Operative Dentistry, Federal University of Paraíba, Brazil; 3Cariology, Restorative Science, and Endodontics Department, School of Dentistry, University of Michigan, MI, USAAbstract: This review investigates erosion and abrasion in dental structures undergoing at-home bleaching. Dental erosion is a multifactorial condition that may be idiopathic or caused by a known acid source. Some bleaching agents have a pH lower than the critical level, which can cause changes in the enamel mineral content. Investigations have shown that at-home tooth bleaching with low concentrations of hydrogen or carbamide peroxide have no significant damaging effects on enamel and dentin surface properties. Most studies where erosion was observed were in vitro. Even though the treatment may cause side effects like sensitivity and gingival irritation, these usually disappear at the end of treatment. Considering the literature reviewed, we conclude that tooth bleaching agents based on hydrogen or carbamide peroxide have no clinically significant influence on enamel/dentin mineral loss caused by erosion or abrasion. Furthermore, the treatment is tolerable and safe, and any adverse effects can be easily reversed and controlled.Keywords: peroxide, tooth bleaching, enamel, dentin, erosion, abrasion

O objetivo deste estudo foi monitorar, mensalmente, os níveis de flúor na água de abastecimento público de Pelotas, Rio Grande do Sul, Brasil, bem como verificar a validade da formação de grupos de heterocontrole. Pelotas foi dividida em 16 pontos geográficos, incluindo as três Estações de Tratamento da água e a coleta foi feita de novembro de 1999 a outubro de 2001, em duplicata. Após a coleta, as amostras foram enviadas ao Laboratório de Vigilância Sanitária de Flúor da Universidade do Vale do Itajaí, onde a análise foi feita utilizando-se o método eletrométrico (Orion 920A/Eletrodo Orion 9609). Após 24 meses, 764 unidades amostrais foram coletadas e verificou-se uma inconstância nos resultados, predominando níveis insuficientes de flúor até o primeiro trimestre de 2001, quando houve um significativo aumento no número de unidades amostrais com uma concentração de flúor ideal (0,6-0,9ppmF), porém, há o surgimento de pontos revelando um excesso de fluoretos (> 1ppmF). Os resultados permitiram concluir que o heterocontrole é fundamental para buscar a manutenção de um correto programa de FAAP.

A literature review was conducted to investigate the influence of patient-related factors on restoration survival in posterior permanent teeth as well as to report the methods used to collect these factors. The selection of articles on longitudinal clinical studies investigating the survival of posterior restorations (except full crowns and temporary fillings) and including patient-related factors was performed by applying predefined criteria. The review was organized into two parts, the first describing how patient factors were assessed in the studies (n=45) and the second presenting the statistical significance (n=27) and size of the effect (n=11) of these factors on restoration survival. Patient-related factors mentioned in the studies included age; gender; caries risk; caries activity/severity; decayed, missing, filled teeth; number of restorations; oral hygiene; and bruxism, among others. Sixteen studies included the patient age or age range in the analysis, which was found to be significant in 47% of the studies. Regarding gender, four of 17 reports found a significant effect on survival, showing more failures for men in three studies. The caries risk profile or related variables were included in the analysis of 15 studies, and a significant effect on survival was reported for high-caries-risk individuals (or related variables) in 67% of these studies. Bruxism was also found to influence restoration survival in three of six studies where this variable was investigated. Some issues were found regarding the reporting of methods used to classify patients according to risk and were thoroughly discussed. In view of the information gathered in this review, the assessment of patient factors along with other variables should become part of clinical studies investigating restoration survival, since several of these factors were shown to influence the failure of restorations, regardless of the material type. [ABSTRACT FROM AUTHOR]

This study aimed to systematically review the literature of animal studies to evaluate whether bioactive dentin proteins could improve vital pulp therapy success. The review is reported in accordance with the PRISMA Statement. Two reviewers independently conducted a literature search of seven databases: PubMed (Medline), Lilacs, IBECS, BBO, Web of Science, Scopus and SciELO. Animal experiments in which bioactive dentin proteins were applied directly or indirectly to the pulp tissue were included. Data regarding the characteristics of the proteins evaluated, the delivery systems used and the main findings from each study were tabulated to assess the outcomes of interest (tertiary dentin formation, inflammatory response, intratubular mineralization). After screening, 32 papers were subjected to qualitative analysis. In 75% of the studies, direct pulp capping was performed. Additionally, the most studied proteins were BMP-7, TGF-ß1, and extracted soluble dentin matrix proteins. In conclusion, there is evidence in the literature suggesting that bioactive dentin molecules could enhance tertiary dentin formation with fewer initial inflammatory responses in direct and indirect pulp therapy in animal models. There are potential areas to be explored for novel therapeutic approaches for dental tissue repair and regeneration with bioactive materials. This article is protected by copyright. All rights reserved. [ABSTRACT FROM AUTHOR]

Objective: This randomized clinical trial aimed to compare the 24-months survival of composite restorations in primary molars after partial caries removal (PCR) and total caries removal (TCR).Methods: Forty-eight children aged 3-8 years with at least one molar with a deep carious lesion were included (PCR; n=66; TCR; n=54). For PCR, excavation was stopped when dentine with a leathery consistency was achieved; in the TCR group, total absence of carious tissue was confirmed using a blunt-tipped probe. Pulpotomy was performed in cases of pulp exposure. Success was assessed by modified USPHS criteria with Alpha and Bravo scores recorded as success.Results: Pulp exposure occurred in 1 and 15 of the teeth treated with PCR and TCR respectively (p<0.01). The restorations survival rate after 24 months was 66% (PCR) and 86% (TCR) (p=0.03). When teeth that received pulpotomy were analyzed separately, the survival rate was 92% (p=0.09). PCR performed in occlusoproximal restorations demonstrated the lowest success rate (p=0.002). PCR increases 2.90 times the probability of having a restorative failure compared to TCR (p=0.03), after adjusting for cavity type. When pulp exposure and restoration failure were considered as the outcome, there was no significant difference between the two groups (p=0.10) with success rates of 64% (PCR) and 61% (TCR).Conclusion: Collectively, deciduous teeth submitted to PCR prevented pulp exposure and, consequently, more invasive treatments; otherwise, PCR yielded lower longevity for composite restoration compared to TCR, suggesting that PCR restorations need to be followed over time, especially when multi-surface restorations are involved.Clinical Significance: Composite restorations on carious remaining tissue require monitoring over time, especially those performed in more than one surface. Even if the restorations present shortcomings over the time, the majority of them are subject to repair, allowing more conservative approaches for teeth with deep caries lesions. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to assess the influence of diet in tooth erosion presence in children and adolescents by meta-analysis and meta-regression. Data: Two reviewers independently performed the selection process and the quality of studies was assessed. Sources: Studies published until May 2014 were identified in electronic databases: Pubmed, EBSHost, Scopus, Science direct, Web of Science and Scielo, using keywords. Study selection: Criteria used included: observational studies, tooth erosion and diet, subject age range 8-19 years old, permanent dentition and index. Meta-analysis was performed and in case of heterogeneity a random-effects model was used. Thirteen studies that fulfilled the inclusion criteria were selected. Higher consumption of carbonated drinks (p = 0.001) or acid snacks/sweets (p = 0.01 and for acid fruit juices (p = 0.03)) increased the odds for tooth erosion, while higher intake of milk (p = 0.028) and yogurt (p = 0.002) reduced the erosion occurrence. Heterogeneity was observed in soft drinks, confectionary and snacks and acidic fruit juices models. Methodological issues regarding the questionnaires administration and the inclusion of other variables, such as food groups and tooth brushing, explained partially the heterogeneity observed. Conclusions: Some dietary components (carbonated drinks, acid snacks/sweets and natural acidic fruits juice) increased erosion occurrence while milk and yogurt had a protective effect. Methods to assess diet could influence the homogeneity of the studies and should be considered during the study design. Clinical significance: The method to assess diet should be carefully considered and well conducted as part of the clinical assessment of tooth erosion, since diet could influence the occurrence of tooth erosion. [ABSTRACT FROM AUTHOR]

Background: Dental caries is the main problem oral health and it is not well established in the literature if the enamel defects are a risk factor for its development. Objective: Studies have reported a potential association between developmental defects enamel (DDE) and dental caries occurrence. We investigated the association between DDE and caries in permanent dentition of children and teenagers. Data sources: A systematic review was carried out using four databases (Pubmed, Web of Science, Embase, and Science Direct), which were searched from their earliest records until December 31, 2014. Study selection: Population-based studies assessing differences in dental caries experience according to the presence of enamel defects (and their types) were included. PRISMA guidelines for reporting systematic reviews were followed. Meta-analysis was performed to assess the pooled effect, and meta-regression was carried out to identify heterogeneity sources. From the 2558 initially identified papers, nine studies fulfilled all inclusion criteria after checking the titles, abstracts, references, and complete reading. Seven of them were included in the meta-analysis with random model. Results: A positive association between enamel defects and dental caries was identified; metaanalysis showed that individuals with DDE had higher pooled odds of having dental caries experience [OR 2.21 (95% CI 1.3; 3.54)]. Meta-regression analysis demonstrated that adjustment for sociodemographic factors, countries' socioeconomic status, and bias (quality of studies) explained the high heterogeneity observed. Conclusion: A higher chance of dental caries should be expected among individuals with enamel defects. [ABSTRACT FROM AUTHOR]

Objectives: The main purpose of this systematic review was to estimate the prevalence of dental erosion in permanent teeth of children and adolescents. Methods: An electronic search was performed up to and including March 2014. Eligibility criteria included population-based studies in permanent teeth of children and adolescents aged 8-19-year-old reporting the prevalence or data that allowed the calculation of prevalence rates of tooth erosion. Data collection assessed information regarding geographic location, type of index used for clinical examination, sample size, year of publication, age, examined teeth and tissue exposure. The estimated prevalence of erosive wear was determined, followed by a meta-regression analysis. Results: Twenty-two papers were included in the systematic review. The overall estimated prevalence of tooth erosion was 30.4% (95%IC 23.8-37.0). In the multivariate meta-regression model use of the Tooth Wear Index for clinical examination, studies with sample smaller than 1000 subjects and those conducted in the Middle East and Africa remained associated with higher dental erosion prevalence rates. Conclusions: Our results demonstrated that the estimated prevalence of erosive wear in permanent teeth of children and adolescents is 30.4% with high heterogeneity between studies. Additionally, the correct choice of a clinical index for dental erosion detection and the geographic location play an important role for the large variability of erosive tooth wear in permanent teeth of children and adolescents. Clinical significance: The prevalence of tooth erosion observed in permanent teeth of children and adolescents was considerable high. Our results demonstrated that prevalence rate of erosive wear was influenced by methodological and diagnosis factors. When tooth erosion is assessed, the clinical index should be considered. [ABSTRACT FROM AUTHOR]