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Background he need of delimiting the bonding area on microshear bond strength (µSBS) test remains an unclear issue. In addition, there are different types of tube to perform the resin composite cylinders on µSBS test. The aim of this study was to evaluate the influence of the adhesive area delimitation and type of tube used to build up specimens for µSBS testing of adhesive systems, to enamel and dentin. Methods 120 bovine incisors were ground to achieve flat buccal enamel (n=60) and dentin (n=60) surfaces. Specimens of each substrate were randomly allocated into 6 groups (n=10) according to the adhesive system-a two-step self-etch (Clearfil SE Bond) and a universal adhesive (Scotchbond Universal Adhesive) applied in the self-etch and etch-and-rinse modes– and type of tube used to build up the specimens: starch and polyethylene. 4 resin composite cylinders (Filtek Z250) were made on each surface; in 2 of them the area delimitation was performed. The specimens were subjected to µSBS test after 24 h of water storage at 37°C. Data were submitted to three-way ANOVA and Tukey’s post hoc tests (α=0.05). Results The delimitation of the adhesive area did not influence on the bond strength to dentin (p=0.349) nor to enamel (p=0.158). The type of tube differently affected the ranking of adhesives in both substrates. Conclusions The delimitation of the adhesive area does not influence on the µSBS to enamel and dentin, irrespective of the tube type used to build up the resin composite specimens. The tube type’s impact on the bond strength depends on the dental substrate and adhesive system.

To systematically review the literature about the antiplaque and antigingivitis efficacy of new and worn manual toothbrushes.Five databases were searched to identify randomized controlled trials, involving adults, comparing the clinical efficacy of new and worn manual toothbrushes. Experimental groups need to have different usage time in changing their manual toothbrush. Two reviewers performed studies selection, data extraction and risk of bias assessment independently. Meta-analyses were performed comparing the toothbrushes after a single use (antiplaque efficacy) and after multiple uses (antiplaque and antigingivitis efficacy).Eight studies were included, totalling 344 individuals. In studies with a single-use design, no statistically difference was found between new and worn toothbrushes for antiplaque efficacy (SMD:-0.39; 95%CI:-0.80 to 0.03). Studies with a multiple-use design showed no statistically difference between groups for the antigingivitis efficacy (MD:-0.10; 95%CI:-0.24 to 0.03). However, higher antiplaque efficacy was demonstrated in new toothbrushes in the studies with a multiple-use design (SMD:-0.75; 95%CI:-1.37 to -0.14). The certainty of the evidence ranged from very low (antiplaque) to low (antigingivitis).New and worn toothbrushes presented similar antiplaque and antigingivitis efficacy. However, further randomized controlled trials, with a lower risk of bias, are needed to enhance the certainty of this evidence.

Objetivo: Avaliar a aderência à publicação de preprints pelos professores dos cursos de pós-graduação em Odontologia, das três Universidades Federais do Estado do Rio Grande do Sul (UFRGS, UFPel e UFSM) (n = 97). Materiais e métodos: Quatro revisores realizaram a busca de publicações em formato preprint, em maio de 2021, nas plataformas MedArxiv e SciELO Preprints, por cada professor incluído. Os mesmos revisores extraíram os dados que foram checados por um quinto revisor. Para a avaliação e comparação das diferentes universidades foi utilizado o teste exato de Fisher, com posterior análise dos resíduos com α corrigido. Para a comparação entre as plataformas foi realizado o teste do Qui-quadrado de Pearson (α = 0,05). Resultados: Os resultados mostraram que 16,5% (n=16) do total de professores incluídos já haviam publicado pelo menos 1 preprint em alguma das duas plataformas, sendo que a UFPel diferiu estatisticamente das outras universidades, apresentando o maior número de aderência seguido pela UFRGS e UFSM (p=0,038). Não houve diferença estatística quanto a comparação das plataformas pesquisadas (p=0,306). Discussão: Os achados demonstram que este formato, mesmo que de forma incipiente, já é uma realidade na área de Odontologia. Conclusão: Os achados deste estudo indicam uma baixa taxa de aderência ao formato de publicação preprint pelos professores dos programas de pós-graduação em Odontologia das universidades públicas do Rio Grande do Sul.

Aim: The publication in preprint format is an interesting open science practice that allows fast outreach to the society of new scientific findings. However, no previous study has investigated how much this practice has been adopted by dental scientists. Therefore, the objective of this study was to evaluate the adherence to the preprint publication format by a sample of Brazilian researchers. Methods: Searches were carried out, in September 2021, on the MedArxiv, OSF, and SciELO preprints platforms, looking for publications in preprint format by all Brazilian researchers of graduate programs in dentistry (n=211) who were productivity fellows in 2021 (PQ). Searches were performed by typing the authors’ full names and the possible variations, as indicated by each author's curriculum, openly available on the Lattes website platform. The data were analyzed through the Friedman test, with the Durbin-Conover post-hoc (α=0.05) in order to compare the three platforms. Spearman's correlation test (α=0.05) was performed to assess the possible correlations between the number of preprints and age, career stage, and the researcher’s scholarship level variables. Results: From the 211 researchers searched, 22 (10.4%) published 1 (one) preprint on at least one platform. A total of 39 published preprints were found at MedArxiv (n=19, 48.7%), SciELO preprints (n=18, 46.2%), and OSF platforms (n=2, 5.1%). There was no difference between the adherence to MedArxiv and SciELO preprints (p = 0.731). However, the OSF platform presented the lowest adherence, statistically differing from MedArxiv (p=0.008) and SciELO preprints platforms (p=0.003). In addition, no correlation was found between the publication of preprints and the researcher's age (p=0.128), career stage (p=0.248), or the researcher's scholarship level (p=0.661). Conclusion: It was possible to observe a low adherence to the preprints publications by Brazilian researchers’ productivity fellows of graduate programs in dentistry.

This review study provides an overview of factors that influence the longevity of all types of direct resin composite restorations.A systematic search was performed in PubMed, Scopus, and Web of Science databases for articles reporting data from primary longitudinal clinical studies on composite longevity published 2011-2021. Prospective or retrospective studies with restorations in permanent dentition, with follow-up periods of at least 5 years were included.In total, 33 articles were included with different study designs, practice settings, datasets, countries of origin, and sample sizes. Annual failure rates of restorations ranged from 0.08% to 6.3%. Survival rates varied between 23% and 97.7%, success rates varied between 43.4% and 98.7%. Secondary caries, fractures, and esthetic compromise were main reasons for failures. Risk factors for reduced restoration durability included patient-level factors (e.g., caries risk, parafunctional habits, number of check-ups per year, socioeconomic status), dentist factors (different operators, operator's experience), and tooth/restoration factors (endodontic treatment, type of tooth, number of restored surfaces). Patient gender and the composite used generally did not influence durability.A number of risk factors are involved in the longevity of composite restorations. Differences between composites play a minor role in durability, assuming that materials and techniques are properly applied by dentists. Patient factors play a major role in longevity. The decision-making process implemented by dentists relative to the diagnosis of aging or failed restorations may also affect the longevity of restorations. Clinicians should treat patients comprehensively and promote a healthy lifestyle to ensure longevity.

This network meta-analysis (NMA) assessed the antiplaque and anti-inflammatory efficacy of different sugar-free chewing gums (SFCG) as adjuncts to toothbrushing.PubMed, Scopus, EMBASE, Web of Science, and CENTRAL databases were searched up to February 2021 to identify randomized controlled trials, involving adults, comparing antiplaque and anti-inflammatory effects of SFCG, with different active ingredients, as adjunctive to mechanical control of biofilm, with a minimum of 7-day of follow-up. Plaque and gingival indexes were assessed. The risk of bias assessment was performed with the RoB 2.0 tool. NMA, and pairwise meta-analyses were performed for both dental plaque and gingival indexes.Twelve studies were included, comprising 850 (antiplaque) and 1459 (gingival inflammation) subjects randomized into 9 interventions: (1) chlorhexidine; (2) chlorhexidine + xylitol (CHX+Xyl); (3) green tea + xylitol (GT+Xyl); (4) magnolia; (5) Lactobacillus reuteri; (6) vitamin C + xylitol; (7) vitamin + carbamide; (8) eucalyptus; and (9) negative control, sorbitol, gum base only, or no chewing gum. No statistically significant differences were detected among SFCG, with different active ingredients, for both antiplaque and anti-inflammatory efficacy (p0.05). However, SFCG with GT+XyL outperformed negative control gums regarding antiplaque efficacy (SMD, - 2.93; 95% CrI, - 0.45 to - 5.38). The SUCRA results showed that SFCG containing GT+Xyl was ranked first, for both antiplaque and anti-inflammatory outcomes.SFCG containing GT+Xyl showed better antiplaque effect over negative controls. However, cautious interpretation is required due to the low number of direct comparisons arms. These shortcomings underscore the need for RCTs with mostly head-to-head comparison that provide more conclusive evidence.There is no robust evidence for the clinical indications of sugar-free chewing gums as adjunct to toothbrushing for the control of biofilm or the treatment of gingivitis.

Objective This study evaluated the effect of resin composite restorations of non-carious cervical lesions (NCCLs) on the occurrence/progression of gingival recession (GR), considering different tooth isolation techniques. Methods A randomized controlled split-mouth and blinded trial was carried out. Patients (n = 38) with at least two NCCLs were included. Before the cervical restoration placement, the NCCLs (181 teeth) were randomly allocated into two treatment groups according to the tooth isolation techniques: cotton roll or rubber dam. Experienced, trained, blinded, and calibrated examiners performed periodontal evaluations at baseline and 5-year follow-up, using a periodontal probe. Restorations were assessed with the FDI criteria. Thirty-two patients (154 teeth) were evaluated at 5 years. The occurrence/progression of GR between baseline and follow-up was considered the primary outcome. The relative risk (RR) and 95 % confidence interval (95 %CI) were calculated by Poisson regression (α Results After 5 year, 31 teeth (13.6 %) presented occurrence/progression of GR. In the multivariate analyses, the occurrence/progression of GR was associated with the use of rubber dam isolation (RR; 95 %CI: 2.65; 1.01–7.00) and a lack of marginal adaptation of the restoration (RR; 95 %CI: 10.98; 2.31–52.30). Toothbrush stiffness, use of abrasive dentifrice, tooth type, and the presence of biofilm or gingivitis did not present a statistically significant higher risk for occurrence/progression of GR. Conclusion The use of rubber dam isolation associated with retraction clamp and the lack of a proper marginal adaptation of the composite restorations are risk indicators for the occurrence/progression of GR in individuals who received a restoration for an NCCL. Clinical significance Isolation with a rubber dam and dental clamps may promote GR in sites with restored NCCLs. Moreover, clinical examinations for lack of marginal adaptations of the restorations may be included in a clinical setting.

Objectives A systematic review was conducted to assess the effects of air-particle abrasion procedures on the mechanical strength and phase transformation of yttria-stabilized tetragonal zirconia polycrystal (Y-TZP). Data This report followed the PRISMA Statement. From 1013 eligible studies, 78 were selected for full-text analysis, from which 37 were excluded. The 41 remaining papers were included for the systematic review; hand-searching yielded three papers. The review comprised a total of 44 studies; 21 were included in the meta-analysis. Sources Searches were performed with no publication year limit through November 2015 in PubMed/MEDLINE, Web of Science (Core Collection) and Scopus databases. Study selection In vitro studies evaluating the effect of air-particle abrasion protocols on the mechanical strength and/or phase transformation of Y-TZP zirconia specimens, immediately or after aging. For the meta-analysis, flexural strength data of air-particle abrasion vs. control (nonabraded) were globally and subgroup analyzed. Subgroup analyses assessed blasting parameters (particle size, pressure, or time duration) and the effect of aging. Statistical analyses were conducted using RevMan 5.1 (Cochrane Collaboration, Copenhagen, Denmark). Comparisons were performed with random-effect models at a 5% significance level. Phase transformation data were included only in the systematic review, as insufficient data were available for meta-analysis. Conclusions Airborne-particle abrasion improved flexural strength of Y-TZP, regardless of abrasion parameters and the presence or lack of aging (p ≤ 0.05). Phase transformation tended to be increased by air abrasion immediately or with up to 2 h of aging. However, after aging for 12 h or more, the abraded Y-TZP showed less monoclinic content than the control.

This study investigated the impact in survival, when repair is seen as failure or not, in anterior composite restorations with a retrospective 15-year follow-up study. Data was collected from patients’ files of a private dental practice, including patients with direct composite restorations placed in anterior teeth (class III, class IV, or veneer) between January 1994 and December 2009. Data were analyzed considering or not repair as failure. Statistical analysis was performed with log rank test, Kaplan–Meier, and Cox regression (p

To systematically review the literature on laboratory studies to determine whether the bond strength of adhesives to primary teeth is similar to that to permanent teeth.This systematic review was conducted according to PRISMA and registered in PROSPERO (CRD42014015160). A comprehensive literature search was conducted considering in vitro studies published up to June 2015 in the PubMed/MEDLINE database, with no limit on year of publication. Two reviewers independently selected papers, extracted data and assessed the risk of bias. From 422 eligible studies, 42 were fully analyzed. Thirty-seven studies were ultimately included in the systematic review and meta-analysis. A global comparison was performed with a random-effects model at a significance level of p0.05, expressed by the difference of means between the groups. The mean bond strengths and standard deviations were tabulated and statistical analyses were conducted in RevMan 5.1 (The Cochrane Collaboration).There was a significant difference between groups, with permanent teeth presenting higher bond strength than primary teeth (p = 0.0005). When the enamel and dentin substrates were considered separately, dentin presented the same trend (p = 0.002), while for enamel there was no significant difference between the dentitions (p = 0.11). The majority of the studies had a high bias risk.Adhesives have higher bond strengths when applied to permanent than to primary teeth. This difference was also valid when the comparison was made between permanent and primary dentin.

This retrospective study aimed to compare the annual failure rate (AFR), reasons for failure and factors influencing survival of posterior and anterior composite restorations placed by undergraduate students. Composite restorations placed by undergraduate students were evaluated. The restorations should be in occlusion, with at least one adjacent tooth; and patients should have been present for check-up, with at least 1 annual recall. The investigation was performed in two separate analysis: 1) dental electronic records of 100 patients (n=333 restorations) were selected to assess factors influencing survival; 2) clinical evaluation of 30 patients by examining restorations (n=123) to assess clinical characteristics and failure type distribution. Data were subjected to Kaplan-Meier method, Log-rank test, Cox regression and Fisher’s Exact test (p

This study aimed to evaluate the microshear bond strength (μSBS) values of adhesive systems to occlusal and proximal dentin submitted to water storage aging

Contains fulltext : 154434.pdf (Publisher’s version ) (Open Access) OBJECTIVES: This study evaluated the caries wall lesion development in different composite-dentin interfaces to investigate if the presence and location of two bonding materials in the gaps influence wall caries lesion development. METHODS: Fourteen volunteers wore a modified occlusal splint containing samples with four different interfaces: perfect bonding/no gap, or with a fixed gap (234+/-30 mum) with either no bonding material, bonding material (Clearfil Protect Bond-PB and Clearfil SE Bond-SE) on dentin or on composite. Eight times a day, the samples were dipped in 20% sucrose solution for 10 min, during 3 weeks. The samples were imaged with microradiography (T-WIM), and lesion depth (LD) and mineral loss (ML) were measured. The data were analysed with paired t-test. RESULTS: The perfect bonding group did not show any caries wall lesion development, whereas all other interfaces did. The interface with bonding on dentin did not show significantly different wall lesion development from the interface with no material. However, when bonding was present on composite, both LD and ML were significantly higher than both other gap conditions (p-values

This in situ study investigated the secondary caries development in dentin in gaps next to composite and amalgam. For 21 days, 14 volunteers wore a modified occlusal splint containing human dentin samples with an average gap of 215 µm (SD = 55 µm) restored with three different materials: Filtek Supreme composite, Clearfil AP-X composite and Tytin amalgam. Eight times a day, the splint with samples was dipped in a 20% sucrose solution for 10 min. Before and after caries development, specimens were imaged with transversal wavelength independent microradiography, and lesion depth (LD) and mineral loss (ML) were calculated. The LD and ML of the three restoration materials were compared within patients using paired t tests (α = 5%). In total 38 composite samples (Filtek n = 19 and AP-X n = 19) and 19 amalgam samples could be used for data analysis. AP-X composite presented the highest mean values of LD and ML of the three restorative materials. Amalgam showed statistically significantly less ML (Δ = 452 µm × vol%) than the combined composite materials (p = 0.036). When comparing amalgam to the separate composite materials, only AP-X composite showed higher ML (Δ = 515 µm × vol%) than amalgam (p = 0.034). Analysis of LD showed the same trends, but these were not statistically significant. In conclusion, amalgam showed reduced secondary caries progression in dentin in gaps compared to composite materials tested in this in situ model.

Aim: This study aimed to evaluate the effect of sodium hypochlorite (NaOCl) pretreatment on bond strength of adhesive systems to different dentin regions. Materials and Methods: Forty human molars were randomly assigned according to different adhesive systems (Adper Single Bond 2; Clearfil SE Bond; Adper SE Plus; G-Bond), pretreatments (control and NaOCl - deproteinization) and dentin regions (proximal, superficial occlusal [SO] and deep occlusal [DO]), n = 5. Cylindrical cavities were performed at the proximal and occlusal surfaces of each sample. For deproteinization, 10% NaOCl was applied on conditioned dentin for 60 s before the adhesive systems application. Two occlusal and one proximal slice were obtained from each sample and submitted to the push-out test. The mode of fracture was analyzed. The data were subjected to three-way ANOVA and Tukey test (P < 0.05). Results: There was statistically significant difference between the adhesive systems (P < 0.01) and dentin regions (P < 0.01); however, the pretreatment did not significantly affect the bond strength values (P > 0.05). The bond strength values were higher for the proximal surface, followed by SO and later by DO, being influenced by the adhesive system. The two-step self-etch adhesive systems presented the highest bond strength results. Conclusion: The deproteinization pretreatment showed similar bonding effectiveness to the conventional adhesive technique. The dentin region plays a rule on the bond strength values.

In order to evaluate the thickness of the hybrid layer and depth of demineralization of dentin surfaces submitted to different treatments, dentin slices from human teeth were divided into two groups: one polished with 60-grit SiC paper and the other with 600-grit SiC paper. The adhesive systems applied were: Adhe SE1, Clearfil SETM Bond, G BondTM and Adper Single BondTM. After treatment, the samples were fractured and prepared and the smear layer, the effect of conditioners, and thickness of the hybrid layer were analyzed by SEM. The adhesive system and smear layer influ- enced thickness of the hybrid layer. The conditioners were more efficient over thin smear layer. A direct correlation was demonstrated between depth of demineralization and thickness of the hybrid layer. The smear layer was able to influence the depth of demineralization and thickness of the hybrid layer; however, for the total-etching adhesive system, thickness of the hybrid layer was independent of the smear layer.

Objectives This study evaluated the effect of the pre-treatment with 2% chlorhexidine digluconate (CHX) as coadjutant in restoration retention of noncarious cervical lesions (NCCL), after 36 months of follow-up. Methods A randomized controlled split-mouth and triple-blind (operators, patients and evaluator) trial was carried out. Patients ( n = 42) with at least two non-carious cervical lesions were included. The teeth with NCCL were randomly assigned to two treatment groups: application of 2% CHX (experimental group) or a placebo solution (control group) for 60 s after acid etching and before the adhesive application. A trained and calibrated examiner evaluated the restorations at baseline (1 week) and at each recall (6, 12, 24 and 36 months) using the FDI criteria. A total of 225 restorations were evaluated after 36-month follow-up. Data were subjected to survival analysis using the Kaplan–Meier method, and the log-rank test was used to evaluate the existence of differences between the survival curves ( α = 0.05). Results The restorations survival rate after 36 months of follow-up was 76.1%. There was no difference in the retention and failure rates between the experimental and the control group ( p = 0.968). There was an increased failure trend when restorations were located subgingival compared to those at the gingival level or supragingival. Conclusion The pre-treatment with 2% chlorhexidine digluconate did not promote further restoration retention of noncarious cervical lesions. Clinical significance The cavity pre-treatment with chlorhexidine for inhibition of hybrid layer degradation does not add any beneficial effect to the clinical performance of restorations.

Objectives This study aimed to systematically review the literature to compare the bond strength values achieved from human and bovine teeth of in vitro studies. Data and source The PubMed/MEDLINE, ISI Web of Science and Scopus electronic databases were searched to select laboratorial studies that evaluated adhesive systems bond strength to human and bovine teeth. No publication year or language restriction was considered. Study selection From 1,285 potentially eligible studies, 15 were selected for full-text analysis, 11 were included in the systematic review and 9 in the meta-analysis. Two authors independently selected the studies, extracted the data and assessed the risk of bias. Mean differences were obtained by comparing bond strength values between human and bovine teeth (overall analysis), and considering enamel and dentin separately (subgroups analysis). Statistical analysis was performed using RevMan5.1, with random effects model, at a significance level of p = 0.05. Results No significant difference was found between human and bovine teeth (p = 0.35), either for enamel (p = 0.07) or for dentin (p = 0.93) substrates. Low to moderate heterogeneity was found on the meta-analysis. All included studies in the systematic review scored between medium and high risk of bias. Conclusions Bovine teeth can be a reliable substitute for human ones on bond strength studies of adhesive systems to both enamel and dentin substrates.

Los sistemas adhesivos son responsables de una union eficaz entre los dientes y la resina, dando como resultado una restauracion durable. Son moleculas organicas bi o multifuncionales que contienen grupos reactivos que interactuan con la dentina y con el monomero de resina de composite. Los sistemas adhesivos se caracterizan por la adhesion humeda, que es el resultado de la presencia de radicales hidrofilicos en sus composiciones, para promover una mejor adherencia y las mejores propiedades de la adhesion. Los sistemas adhesivos pueden utilizar dos estrategias diferentes para interactuar con la estructura dental: Tecnica de grabado total y auto-grabado. Los sistemas de grabado total requiere un acondicionamiento, un lavado y un paso de priming con el fin de permitir la participacion de las fibras de colageno por los monomeros de resina y la formacion de la llamada capa hibrida. El grabado total promueve la limpieza de la dentina, tambien promueve la desmineralizacion superficial y condiciona a las fibrillas de colageno para participar de un mecanismo de interfaz de union diente/sistema adhesivo /material de restauracion. Los sistemas adhesivos autograbantes se caracterizan por la desmineralizacion y la infiltracion de los monomeros de resina de forma simultanea. Esta tecnica es atractiva debido a la sensibilidad reducida asociada a conservar la capa de barro dentinario y tapones de barro dentinario, reduciendo al minimo la posibilidad de contaminacion accidental de la superficie de union con la superficie de la dentina a traves del liquido dentinario trasudado.

Contains fulltext : 172541.pdf (Publisher’s version ) (Closed access) OBJECTIVES: This study aimed to evaluate the dentin wall carious lesion development of different composite-dentin interfaces in the presence of two adhesive bonding materials in the gaps, using a microcosm biofilm model. METHODS: Dentin samples were prepared (10.4mm(2)) and restored with a composite resin using two adhesive systems (etch-and-rinse and self-etch techniques). Different conditions with respect to composite-dentin interfaces were produced with a 200mum gap: failed bonded without ageing or after mechanical ageing, or non-bonded with or without the presence of adhesive material on the dentin wall. For cariogenic challenge, specimens were subjected to a biofilm microcosm model for 14days to create caries-like wall lesions. Before and after caries development, transverse wavelength-independent microradiography images were taken, and lesion depth and mineral loss were measured. Data were analysed with linear regression models (p0.05). CONCLUSION: Different composite-dentin interfaces influence wall lesion development in gaps, with the interfaces submitted to ageing showing less carious protection than those interfaces with the presence of adhesive covering the dentin. CLINICAL SIGNIFICANCE: The presence of adhesive bonding material in the gaps plays a role on the wall caries lesion development.

The aim of this study was to systematically review the literature to assess the effect of grinding on the mechanical properties, structural stability and superficial characteristics of Y-TZP ceramics. The MEDLINE via PubMed and Web of Science (ISI – Web of Knowledge) electronic databases were searched with included peer-reviewed publications in English language and with no publication year limit. From 342 potentially eligible studies, 73 were selected for full-text analysis, 30 were included in the systematic review with 20 considered in the meta-analysis. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias. Statistical analyses were performed using RevMan 5.1, with random effects model, at a significance level of 0.05. A descriptive analysis considering phase transformation, Y-TZP grain size, Vickers hardness, residual stress and aging of all included studies were executed. Four outcomes were considered in the meta-analyses (factor: grinding x as-sintered) in global and subgroups analyses (grinding tool, grit-size and cooling) for flexural strength and roughness (Ra) data. A significant difference (p

Background Occlusal sealants are an effective method for caries prevention, although the effectiveness of different application strategies has not been established yet. Aim This systematic review compared the retention rate of sealants placed on occlusal surfaces following the use of self-etch adhesive systems and traditional acid etching, with or without the application of adhesive system. Design Literature searching was carried out until June 2015 in PubMed/MEDLINE, CENTRAL, and ClinicalTrials databases selecting randomized clinical trials that evaluated self-etch adhesive systems associated with pit and fissure sealants in primary or permanent molars comprising retention as outcome. From 683 potentially eligible studies, 10 were selected for full-text analysis and 5 were included in the meta-analysis. Two reviewers independently selected the studies, extracted the data, and assessed the bias risk. Pooled-effect estimates were obtained by comparing the retention failure rate between groups (self-etch systems vs acid etching with or without adhesive systems). Results Significant difference was found between groups, favoring the control group (prior acid etching) (P < 0.05), which showed lower failure rate in the retention of occlusal sealants. High heterogeneity was found on the meta-analysis. Most trials showed good evidence strength. Conclusions Occlusal sealants applied with self-etch systems show lower retention throughout time than sealants applied in the conventional approach, regardless of the use of adhesive systems.

This systematic review and meta-analysis evaluated the effectiveness of professional topical fluoride application (gels or varnishes) on the reversal treatment of incipient enamel carious lesions in primary or permanent dentition.Literature searching was carried out by the authors in PubMed (MEDLINE), Cochrane Central Register of Controlled Trials, Turning Research Into Practice, and ClinicalTrials.gov to verify the clinical trials available about the outcome. From 754 potentially eligible studies, 21 were selected for full-text analysis, 5 were included for review, and 3 for meta-analysis. The statistical analysis was performed only for studies assessing fluoride varnish; there were insufficient data to perform it for fluoride gel studies. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias. Pooled-effect estimates were expressed as the weighted mean difference between groups.The therapeutic methods ranged considerably regarding the fluoride application protocols. There was a significant trend of effectiveness of fluoride varnish on the reversal of incipient enamel carious lesions (P .05). High heterogeneity was found in the meta-analysis.Fluoride varnish seems to be an effective treatment for the reversal of incipient carious lesions in primary and permanent dentition; however, further clinical trials concerning efficacy of topical fluorides for treating those lesions are still required, mainly regarding the fluoride gel.Considering the scientific evidence on topical fluorides, pediatric dentists can use fluoride varnishes as an adjuvant for the treatment of active white-spot lesions in primary or permanent dentition.

The aim of this study was to evaluate the effect of cariogenic challenge on the microtensile bond strength values (μTBS) of dentin pre-treated with chlorhexidine digluconate (CHX) or sodium hypochlorite (NaOCl). Thirty-six sound molars were selected and randomly assigned to 3 dentin pre-treatments (distilled water - control, 2% CHX and 10% NaOCl) and 4 aging protocols (24h control, biofilm without cariogenic challenge, biofilm with cariogenic challenge, and 18-month water storage). The same etch-and-rinse adhesive system and composite resin were used for all groups (n=30 beams). For the biofilm groups, dental microcosm biofilms originated from saliva of a healthy donor were grown on the samples with a defined medium enriched with mucin, with or without 10% sucrose, according to the group. After the experimental period, the microtensile test was performed. Data were analyzed with ANOVA followed by Tukey test (p

This study aimed to evaluate the effect of chlorhexidine (CHX) application on etched dentin on the 6-month retention of restorations placed on non-carious cervical lesions (NCCLs). A randomized controlled split-mouth and triple blind trial was carried out. Patients (n=42) with at least two non-carious cervical lesions were included. NCCLs were randomly assigned to two groups: control (placebo solution) or test group (2% CHX solution for 60 s after acid etching and before the adhesive application). Class V restorations (n=169) were performed with an etch-and-rinse adhesive system and composite resin by 10 trained operators. A calibrated examiner evaluated the restorations at 1 week (baseline) and at 6 months using the FDI criteria. The primary outcome was retention of the restorations. The analysis of factors associated to failure of restorations was carried out by Fisher's exact test (α=0.05). After 6 months of follow-up, 3.4% (CI 95% 1.3-7.3) of the restorations failed. There was no statistically significant difference between control and CHX (p=0.920). Regarding the cavity variables, deeper (p=0.04), wider (p=0.004) and wedge-shaped (p=0.033) cavities failed more. Both treatments provided acceptable clinical performance of the restorations. The use of CHX as a adjuvant in dentin adhesion did not influence the retention of Class V restorations after 6 months of follow-up.

Objetivo: este estudo teve como objetivo avaliar a posicao e prevalencia de caninos maxilares inclusos bem como a presenca de reabsorcao radicular em dentes adjacentes. Metodos: foram examinadas 372 radiografias panorâmicas, de pacientes entre 13 e 50 anos de idade, realizadas entre os anos de 2008 a 2013 em duas instituicoes de ensino. As radiografias foram examinadas por um unico avaliador, com o auxilio de negatoscopio e lupa com diâmetro de 90 mm e aumento de 2,5 vezes. Os dados foram submetidos a analise estatistica pelo teste Qui-Quadrado (α = 5%). Resultados: foram encontradas um total de 13 radiografias com presenca de caninos superiores inclusos resultando em uma prevalencia de 3,5%. A idade foi um fator que estatisticamente influenciou na presenca de caninos inclusos (p = 0,040), sendo mais prevalente em pacientes com idade de 13-30 anos do que em pacientes com 31-50 anos. A retencao de caninos foi mais prevalente no sexo feminino, porem sem significância estatistica (p = 0,163). A reabsorcao do dente adjacente ocorreu em 15,4% dos casos. Conclusao: A prevalencia de caninos inclusos foi dependente da idade, a qual influenciou a presenca de caninos inclusos, e a posicao mesio-angulada foi predominante em todos os casos.

The purpose of this study was to evaluate the influence of acidogenic challenge on microhardness of enamel adjacent to adhesive restorations in primary and permanent teeth.Occlusal cavities were prepared and immediately restored with two adhesive systems and a composite resin. The specimens were divided into eight groups, according to the type of tooth (primary or permanent), adhesive system (etch-and-rinse or self-etching), and treatment (control or acidogenic challenge). The cariogenic challenge groups were submitted to pH cycling for 10 days. The teeth were prepared for a cross-section microhardness test. Analysis of variance and Tukey's post hoc test were used to analyze the data (α=5 percent).The adhesive systems did not influence the enamel microhardness (P.27). Primary teeth were more susceptible to acidogenic challenge (P=.004). The microhardness values for control groups were statistically similar at different indentation depths (P.05); however, in the acidogenic challenge groups, lower microhardness values were observed in superficial measurements (P.05).Acidogenic challenge negatively influenced the microhardness of the enamel surface adjacent to adhesive restorations. Mineral loss was higher in primary teeth and on the enamel surface.

The aim of this study was to systematically review the literature for in vitro and ex vivo studies that evaluated the effect of matrix metalloproteinase (MMP) inhibitors during the adhesive procedure on the immediate and long-term resin-dentin bond strength. The search was conducted in 6 databases with no publication year or language limits, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. From 1,336 potentially eligible studies, 48 were selected for full-text analysis, and 30 were included for review, with 17 considered in the meta-analysis. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias. Pooled effect estimates were expressed as the weighted mean difference between groups. The most used MMP inhibitor was chlorhexidine (CHX). Immediate bond strength results showed no difference between 2% CHX and control; however, a difference was found between 0.2% CHX and control at baseline. After aging, CHX presented higher bond strength values compared to control groups ( p < .05). However, this was not observed for longer periods of aging. High heterogeneity was found in some comparisons, especially for the water storage aging subgroup. Subgroup analyses showed that self-etching and etch-and-rinse adhesives are benefited by the CHX use. From the studies included, only 1 presented low risk of bias, while the others showed medium or high risk of bias. The use of MMP inhibitors did not affect the immediate bond strength overall, while it influenced the aged bond strength. Aging procedures influenced bond strength values of the dentin adhesion stability.

Contains fulltext : 127602.pdf (Publisher’s version ) (Open Access) This article describes an in vitro fatigue and/or wear simulator enabling controlled application of force, speed, type of liquids and duration, to mimic challenges representative for the human oral environment. The device consists of a container in which a cylinder with specimen holder is placed which drives another cylinder (rod). The rod rotates in an opposite direction to the rotation of the stirring motor, rolling over the specimens mounted in the cylinder. When the rod contacts the specimen a force is applied to mimic processes in the oral environment. The design, working and construction principles of a new device, the Rub&Roll, and some of the possible applications are described Four different application examples are presented: occlusal wear in an low acidic abrasive slurry; combined erosive and abrasive wear of enamel exposed to apple juice or apple pulp; the wear of sealant material in natural teeth in an abrasive slurry; and the influence of mechanical loading cycles on micro tensile bond strength of an adhesive system to dentin Application of the "Rub & Roll" device showed results which are clinically relevant, reproducible and in accordance with existing literature. CONCLUSIONS: The Rub&Roll enables controlled application of chemical and mechanical loading, allowing variation of force, sliding distance, velocity, number of cycles, and frequency, and a combination with erosive and abrasive challenges representative of those in the oral environment.

To evaluate an alternative device using starch tubes to build up resin composite specimens for microshear bond tests.Twenty human molars were selected and sectioned mesiodistally to obtain two sections. The teeth were randomly divided into 4 groups (n = 10) according to the adhesive system - a two-step etch-and-rinse adhesive (Adper Single Bond) and a two-step self-etching adhesive (Clearfil SE Bond) - and the type of tube, starch or polyethylene. The tubes were evaluated under a stereomicroscope at 25X magnification to observe the variation in internal diameter. The resin composite was bonded to flat enamel surfaces using one of the adhesive systems and tube types. After 24 h storage in distilled water, the microshear bond strength (µSBS) was determined and the fracture pattern was analyzed under a stereomicroscope (400X magnification). The microshear bond strength values were subjected to two-way ANOVA. The chi-square test was used to compare pre-test failures and fracture patterns between the groups (p0.05).The type of tube, the adhesive system, and their interaction did not influence the bond strength values (p = 0.062, p = 0.122, and p = 0.301, respectively). No significant differences were observed for pre-test failures or fracture patterns (p = 0.320 and p = 0.561, respectively).Using starch tubes is an alternative to build up composite resin specimens for microshear bond strength testing with the two tested adhesive systems.

Background This systematic review and meta-analysis evaluated the effectiveness of professional topical fluoride application (gels or varnishes) on the reversal treatment of incipient enamel carious lesions in primary or permanent dentition. Methods Literature searching was carried out by the authors in PubMed (MEDLINE), Cochrane Central Register of Controlled Trials, Turning Research Into Practice, and ClinicalTrials.gov to verify the clinical trials available about the outcome. From 754 potentially eligible studies, 21 were selected for full-text analysis, 5 were included for review, and 3 for meta-analysis. The statistical analysis was performed only for studies assessing fluoride varnish; there were insufficient data to perform it for fluoride gel studies. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias. Pooled-effect estimates were expressed as the weighted mean difference between groups. Results The therapeutic methods ranged considerably regarding the fluoride application protocols. There was a significant trend of effectiveness of fluoride varnish on the reversal of incipient enamel carious lesions ( P Conclusions Fluoride varnish seems to be an effective treatment for the reversal of incipient carious lesions in primary and permanent dentition; however, further clinical trials concerning efficacy of topical fluorides for treating those lesions are still required, mainly regarding the fluoride gel. Practical Implications Considering the scientific evidence on topical fluorides, pediatric dentists can use fluoride varnishes as an adjuvant for the treatment of active white-spot lesions in primary or permanent dentition.

Submitted by Fabiano Malheiro (fabianomalheiro22@hotmail.com) on 2013-11-05T16:03:35Z No. of bitstreams: 1 Maximiliano1.pdf: 140097 bytes, checksum: 416955cfa512ca47b309b4c2227fd839 (MD5) Approved for entry into archive by Fabiano Malheiro(fabianomalheiro22@hotmail.com) on 2013-11-05T16:06:56Z (GMT) No. of bitstreams: 1 Maximiliano1.pdf: 140097 bytes, checksum: 416955cfa512ca47b309b4c2227fd839 (MD5) Made available in DSpace on 2013-11-05T16:06:56Z (GMT). No. of bitstreams: 1 Maximiliano1.pdf: 140097 bytes, checksum: 416955cfa512ca47b309b4c2227fd839 (MD5) Previous issue date: 2013-01-01 This trial aimed to evaluate the influence of two educational methods on students’ ability to remove artificial carious dentine. Traditional lecture and lecture plus a live demonstration of artificial carious tissue removal were compared in a blind two parallel-group design. Twenty-six students were randomly divided into two groups, and their skills were evaluated according to the following criteria: time spent on the dentine excavation procedure (in min), students’ perceived confidence in conducting the procedure(graded assessed on a scale from 0 to 10), and the outcome of artificial carious tissue removal, evaluated by measuring the residual dyed artificial carious dentine layer(in lm). Statistical analyses were carried out using a t-test to compare the students’confidence and time spent on the procedure, and a two-way ANOVA was used to compare residual artificial decayed dentine with educational methods and tooth region (incisal, medium, and cervical thirds) as factors. There were no differences between the methods regarding excavation time (P = 0.898) and students’ confidence (P = 0.382). The residual artificial carious dentine results showed that the educational method (P < 0.001) and cavity region (P < 0.001) were statistically significant, as was their interaction (P = 0.040). The lecture plus live demonstration group presented the best results for artificial caries removal. Although there were no differences between the two groups for the cervical region, the best results for the lecture plus live demonstration group was in the other two-thirds of the tooth.

Este estudo avaliou o efeito do desafio erosivo nas propriedades e na estabilidade de união de materiais restauradores ao esmalte e dentina decídua. Duzentos e quarenta molares decíduos foram alocados em 24 grupos, de acordo com substrato - esmalte ou dentina, condição prévia do substrato - hígido ou erodido, material restaurador - resina composta associada ao sistema adesivo - RC, cimento de ionômero de vidro de alta viscosidade - CIVAV, ou modificado por resina - CIVMR, e tratamento após procedimento adesivo - controle (imersão em solução salina/7dias) ou desafio erosivo (imersão em bebida a base de cola por 5 min/3x ao dia/7 dias). Os dentes dos grupos esmalte e dentina erodidos foram submetidos ao desafio erosivo previamente aos procedimentos restauradores. Cânulas de polietileno foram posicionadas sobre superfícies planas dos substratos pré-tratados, para então serem preenchidas por um dos materiais avaliados. Após armazenamento por 24h a 37°C, os espécimes foram submetidos a um dos tratamentos propostos. Metade dos espécimes foi submetida imediatamente ao teste de microcisalhamento e a outra metade após 12 meses de armazenamento em água a 37ºC. Posteriormente, a análise do padrão de fratura foi realizada em estereomicroscópio (400X). Para a análise de resistência à flexão (RF) e rugosidade superficial (RS), trinta corpos de prova foram confeccionados (10x2x1mm). Após armazenamento por 24h, a leitura inicial de RS de dez corpos de prova selecionados aleatoriamente foi obtida. Os corpos de prova foram então imersos em um dos tratamentos propostos - desafio erosivo ou solução salina, para então ser realizada a segunda leitura. Decorrido esta análise, os corpos de prova foram submetidos ao teste de RF (1mm/min). Os valores de resistência de união (RU), bem como de RS e RF obtidos foram submetidos a Análise de Variância e Teste de Tukey (?=5%). Análise de Weibull foi também conduzida considerando os valores de RF. De forma geral, os substratos hígidos resultaram em maiores valores de RU do que os erodidos, com exceção do CIVAV que obteve desempenho similar em ambos substratos. Além disso, o tempo influenciou negativamente a RU somente para os grupos de RC quando da avaliação em dentina. Os demais grupos não apresentaram redução nos valores após 12 meses de armazenamento em água. RC apresentou melhor desempenho adesivo do que os demais materiais avaliados, tanto em 24 horas quanto após 12 meses. O desafio erosivo após o procedimento adesivo apenas influenciou negativamente a RU quando os materiais foram avaliados em dentina erodida. Em relação a RS, menores valores foram obtidos para RC. Além disso, o desafio erosivo influenciou os valores de leitura final, resultando em maior RS para todos os materiais restauradores. Já para a RF, RC demonstrou maiores valores de RF, módulo de Weibull e resistência característica do que os demais materiais. Ademais, o desafio erosivo não afetou estes parâmetros. Em conclusão, o desafio erosivo influencia negativamente a RS e RU a dentina erodida. Os substratos previamente erodidos resultam em pior desempenho da RC e CIVMR. Além disso, o armazenamento em água afeta a estabilidade de união a dentina de RC. This study evaluated the effect of erosive challenge on the properties and bond stability of restorative materials to primary enamel and dentin. Two hundred and forty primary molars were assigned into 24 groups, in according to the substrate - enamel or dentin, the precondition of substrate - sound or eroded, the restorative material - resin composite associated to adhesive system - RC, high-viscous glass ionomer cement- HVGIC or resin-modified glass ionomer cement - RMGIC, e the treatment after restorative procedure - control (immersion in saline solution/7 days) or erosive challenge (immersion in cola-based drink for 5 min/3x per day/7 days). Teeth from the eroded dentin and enamel groups were subjected to erosive challenge prior to bonding procedures. Polyethylene tubes were placed on flat surfaces of the pretreated substrates, and then were filled up with one of evaluated materials. After storage for 24h at 37ºC, the specimens were submitted to one of the proposed treatments. Half of the specimens were immediately submitted to the microshear bond strength test, and the other half after 12 months of water storage at 37ºC. Subsequently, the failures pattern evaluation was performed in stereomicroscopy (400X). For the assessment of flexural strength (FS) and superficial roughness (SR), thirty specimens were built up (10x2x1mm). After storage for 24h, the first reading of SR from ten specimens randomly selected was obtained. Specimens were immersed in one of proposed treatments - erosive challenge or saline solution, to then be performed the second reading. After this assessment, specimens were submitted to FS (1mm/min). The bond strength (BS) values, as well as SR and FS obtained were submitted to analysis of variance and Tukey\'s test (?=5%). Weibull analysis was also performed considering the FS values. Generally, the sound substrates resulted in higher BS values than eroded ones, with exception of the HVGIC that obtained similar performance in both substrates. Furthermore, the storage time negatively influenced the BS values for the RC groups on dentin assessment. The other groups did not show reduction in BS values after 12 months of water storage. RC showed better bonding performance than others evaluated materials, in both at 24 hours as for 12 months at 37ºC. Erosive challenge after bonding procedure only negatively influenced the BS values when the materials were evaluated in eroded dentin. In relation to SR, lower values were obtained to RC. Moreover, erosive challenge affected the second reading, resulting in increased SR for all restorative materials. For FS, RC showed higher values of FS, Weibull modulus and characteristic strength than other materials. Furthermore, immersion in erosive challenge did not affect these parameters. In conclusion, erosive challenge negatively influences SR and BS to eroded dentin. Previously eroded substrate result in the worst performance of RC and RMGIC. Moreover, the water storage affects the bonding stability of RC to dentin.