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Background The management of endodontic infections is a complex challenge, mainly due to the involvement of diverse microorganisms and their by-products. This study aimed to evaluate the efficacy of N-acetylcysteine (NAC), calcium hydroxide (Ca(OH)2), and their combined application as intracanal medications in combating Enterococcus faecalis, Escherichia coli, and lipopolysaccharides (LPS) from E. coli. Methods A total of 60 single-rooted human teeth were carefully selected and divided into six groups. These tooth canals were deliberately exposed to E. faecalis (ATCC 29212) and E. coli (ATCC 25922) to induce biofilm formation. Subsequently, the specimens were treated with NAC, Ca(OH)2, or a combination of both substances. Three samples of the root canals were collected at three moments: the first sample (S1) was to confirm the initial contamination, the second sample (S2) was immediately post-instrumentation, and the third sample (S3) was collected after the use of the intracanal medication. The antimicrobial efficacy of these intracanal medications was assessed by enumerating colony-forming units per milliliter (CFU/mL). In addition to this, the kinetic chromogenic Limulus Amebocyte Lysate (LAL) assay by Lonza was used to quantify LPS from E. coli. Data tested for normality; then, Kruskal-Wallis and Friedman tests were used, and Dunn’s for multiple comparisons. Results The findings of this study showed significant reductions in the microbial load of E. faecalis and E. coli by S3. Notably, there were no statistically significant differences among the treatment groups concerning these microorganisms. However, it was observed that only the combination of NAC and Ca(OH)2 led to a noteworthy decrease in the quantity of E. coli’s LPS after 7-days, demonstrating a statistically significant difference from the other treatment groups. NAC + Ca(OH)2 combination, applied for a duration of 7-days, proved to be more suitable in reducing the presence of E. faecalis, E. coli, and LPS from E. coli within the context of endodontic infections.

Objective: To determine whether there is a lack of diffusion in the knowledge of selective removal of carious tissue (SRCT) and to examine whether cognitive biases influence professionals in their decision to implement SRCT. Additionally, this study seeks to identify whether the lack of knowledge diffusion and cognitive biases act as barriers to the adoption of SRCT in practice. Material and Methods: A series of questions was administered to dental professionals aiming to assess their knowledge of SRCT, their opinions on its use, and whether they incorporated this technique. Some questions were designed to identify potential factors influencing their decision-making process. The data was presented in terms of frequency percentages and analyzed using association tests (p>0.05). Results: Out of 568 respondents, fifty-four individuals (9.5%) were not in favor of SRCT, while eighty-nine did not implement it in their practice. Professionals who were less inclined to use SRCT included those who had not studied it, endodontists, specialists unrelated to dentistry/pediatric/dental clinic, and dentists who had completed their degrees more than four years ago. Cognitive biases, such as outcome bias, overconfidence bias, and bias against new beneficial therapies, were found to be influenced by SRCT knowledge, specialized fields, postgraduate education, and the duration of professional training. Regarding the removal of carious tissue at pulp walls in very deep cavities, 158 respondents answered correctly, while 410 respondents provided incorrect responses. Conclusion: A deficiency in the dissemination of SRCT knowledge was identified. Cognitive biases exerted a significant influence on decision-making concerning the removal of carious tissue. These two findings contribute to the limitation in translating SRCT into clinical practice.

White spot lesions (WSLs) are sites of enamel surface and subsurface demineralization that increases tissue porosity and affects the teeth appearance. The resin infiltration technique proved to be a valid alternative to arrest caries lesion progression and to masking a color change in noncavitated WSLs. Thus, this study aims to report a clinical case of anterior WSLs treated with resin infiltration technique with an 8-year follow-up. The resin infiltration protocol was performed in an 18-year-old female patient presenting WSLs on the maxillary right lateral incisor, left central incisor, and left canine. The protocol followed the manufacturer's recommendations. The patient reported satisfaction with the smile appearance, at the end of the appointment. Infiltrated areas remained unchanged after an 8-year follow-up, showing an acceptable result for the patient's esthetic desires. After 8 years of evaluation, the resin infiltration technique proved to be a resistant and reliable alternative in preventing caries progression and in color masking WSLs.

Background: Nanoparticles such as multi-walled carbon nanotubes present resistance, resilience and biocompatibility with human tissues and could be incorporated into glass ionomer cement materials to improve their characteristics. Therefore, the aim of the present study was to evaluate the effect of multi-walled carbon nanotube (MWCNT) incorporation on different glass ionomer cements’ compressive (σc) and diametral tensile strengths (σt). Methods: Eighty (80) specimens were divided into four groups (N = 20/gr) according to the glass ionomer cement type (conventional and high-viscosity) and the presence or absence of multi-walled carbon nanotubes. Samples were kept in water for 24 h prior to the tests. Data were analyzed using two-way ANOVA and Tukey’s test (p = 0.05). Results: For both σc (p = 0.1739) and σt (p = 0.2183), the glass ionomer cements’ viscosity did not influence the results. The presence of MWCNTs decreased the mean compressive strength values (p = 0.0001) and increased the diametral tensile strength (p = 0.0059). For both conventional and high-viscosity glass ionomer cements, the compressive strength values were higher than the tensile strength data. Conclusions: Regardless of the cement viscosity, the multi-walled carbon nanotube incorporation reduced the compressive strength and increased the tensile strength values.

Aim: This study aimed to evaluate the effect of polymerization with either a monowave (MW) or a polywave (PW) light-curing unit (LCU) on the degree of conversion (DC) and marginal adaptation following thermomechanical aging of an ormocer bulk-fill resin composite (RC) (Admira fusion X-tra Bulk Fill – AB), a methacrylate-based bulk-fill RC (Tetric N-Ceram Bulk Fill – TB) and a conventional RC (Tetric N-Ceram – TC). Methods: DC was assessed in five samples of each RC using Fourier transform infrared spectroscopy. For determination of marginal adaptation, standard preparations were made in 60 bovine incisors, divided into three groups, according to the RC. The bulk-fill RC was inserted in a single increment of 4 mm. In contrast, the conventional RC was inserted in three increments. Marginal gap was evaluated after thermomechanical aging. Data were analyzed using a two-way analysis of variance (ANOVA) and Tukey’s tests for multiple comparisons (α = 0.05). Results: The two-way ANOVA showed a significant effect (p

Abstract Quantification of collagen degradation is an important parameter to evaluate dentin caries for preventive aid. Objectives: Evaluate preventive methods against root collagen degradation by the hydroxyproline assay (HYP) and microradiography technique (MRT). Methodology: Five bovine root dentin blocks were obtained and subjected to an artificial demineralization process by acetate buffer (pH 5) to induce carious lesion formation. Samples were subjected to the following therapeutic treatments: 1) 0.12% chlorhexidine for 1 min, 2) 2% fluoride for 1 min, 3) Nd:YAG Laser (400 μm diameter optical fiber, 10 Hz frequency, 60 mJ/pulse energy, 48 J/cm2 energy density, in noncontact mode for 10 s), 4) deionized water (control) for 1 min, 5) MRT control group (without treatment and removal of collagen). Samples were exposed to degradation by a collagenase enzyme for five days. The enzyme solution was collected, by colorimetry in a spectrophotometer, from the collagen matrix for the hydroxyproline release analysis. The same samples were subjected to an additional two days of demineralization to induce the progression of mineral loss. Samples were analyzed by MRT for the visualization of their degraded areas (estimation of lesion depth and mineral loss). ANOVA was applied to compare hydroxyproline release rates. MRT data were subjected to the Kruskal-Wallis test, followed by the Dunn’s test. Comparisons between the initial five-day and the subsequent two-day demineralization processes were performed by repeated t-test or Wilcoxon (p

Objective: To determine the initial mechanical stabilization of conventional glass ionomer cements (GICs) indicated for the atraumatic restorative treatment (ART) in different storage periods. Material and Methods: Specimens were divided according to the GIC (n=12): IZ - Ion-Z, KM - Ketac Molar Easymix, RS - Riva Self Cure, and GL - Gold Label 9. They were prepared and stored in distilled water. Superficial microhardness (SMH) was evaluated (KHN) in three phases: (A) after 1, (B) 3, and (C) 7 days of storage. Data were submitted to 2-way ANOVA and Tukey tests (α = 5%). Results: The average KHN values for phases A, B, and C were, respectively, 33.05 ± 9.74; 33.21 ± 10.31 and 52.07 ± 11.75 (IZ); 50.35 ± 11.39; 66.05 ± 10.48 and 67.77 ± 13.80 (KM); 89.63 ± 15.59; 71.31 ± 23.86 and 57.70 ± 16.89 (RS); 42.18 ± 9.03; 68.54 ± 6.83 and 57.95 ± 8.24 (GL). Significant differences were observed: GIC, time, and interaction of both (p

Abstract Objective To compare the effectiveness of ART restorations using High Viscosity Glass-ionomer cement (HVGIC) with conventional restorations using resin composite in Class II cavities of permanent teeth, in a 2-year follow-up. Methodology Seventy-seven restorations were made with each restorative material, Equia Fil-GC Corporation (ART restorations) and Z350-3M (conventional restoration), in 54 participants in this parallel and randomized clinical trial. Restorations were evaluated at 6 months, 1 and 2 years using the ART and the modified United States Public Health Service (USPHS) criteria. Chi-square test and Survival Analysis (p

BACKGROUND: The current pandemic associated with SARS-CoV-2 has negatively influenced several activities, including teaching in Operative Dentistry. The aim of this study was to evaluate the influence of knowledge in Operative Dentistry on undergraduate students' perception related to personal life and return to clinical practices classes during pandemic. MATERIALS AND METHODS: The present research was a cross-sectional, observational, and qualitative survey. The 16-item based questionnaire was sent to undergraduate students in 2020, which were divided into two groups, according to the Operative Dentistry knowledge: G1-not started clinical practice; G2-already started or completed clinical practice. Questions were focused on the impact of the pandemic in relation to their personal lives and return to clinical practice classes. Chi-square association test was performed using the SigmaPlot 12.0 software (P ≤ 0.05). RESULTS: The response rate was 55.5% for G1 and 44.4% for G2. Regarding the questions related to personal life, G1 demonstrated higher percentages of fear of contracting the virus during theoretical classes. Same observations were found when students answered about their fear of contracting coronavirus during the clinical practice classes. However, G2 presented the highest agreement responses for the preparedness feeling to return to theoretical classroom, clinical practice classes, and the possibility of applying online learning. CONCLUSIONS: In general, students' knowledge had little influence on perception of personal life. However, students who have more knowledge in operative dentistry presented more security about returning to clinical classes.

Dental implant-supported prosthesis are widely used in oral reconstruction of totally edentulous patients. Nonetheless, one of the most common failures in these cases is caused by overloading from improper occlusion. The aim of this work was to determine if the occlusal scheme influences the biomechanical response in implant-supported dental prostheses. Searches were conduct is several databases (PubMed/MEDLINE, The Cochrane Library, Web of Science, Scopus, LILACS, and Opengrey). We found 632 publications and 521 studies remained after removing duplicates. After applying the inclusion criteria, five studies were used in this systematic review: one clinical trial, one retrospective clinical trial, one in vitro and two in silico. The results show the lack of clinical and laboratory studies about occlusion in implant-supported prostheses. Although there are several studies regarding implant occlusion schemes, there remains a lack of scientific evidence to support that one specific occlusal scheme is superior to another, or to help define the ideal occlusal scheme that improves the clinical outcome. It can be concluded, however, that the proper distribution of loads and the absence of occlusal interferences can increase implant longevity. Thus, more clinical and laboratory studies must be carried out to obtain an occlusal scheme that favors the clinical success of implant rehabilitation.

Abstract Objective: This clinical study sought to evaluate the effectiveness of passive ultrasonic activation (PUA) in eliminating microorganisms in primary endodontic infection (PEI) after instrumentation of root canals using microbiological culture and checkerboard DNA-DNA hybridization. Methodology: Twenty root canals with PEI and apical periodontitis were selected. The root canals were instrumented and then randomly divided into 2 groups, according to the irrigation method: PUA and conventional needle irrigation (CNI). Microbiological samples were collected before instrumentation (S1), after instrumentation (S2) and after irrigation with 17% EDTA (S3). The samples were subjected to anaerobic culture technique and checkerboard DNA-DNA hybridization analysis. Results: A statistically significant difference was found between CNI (23.56%) and PUA (98.37%) regarding the median percentage values for culturable bacteria reduction (p

Introduction: The first clinical sign of a caries lesion which represents mineral loss from the enamel subsurface is white spot lesion. Thus, the use of a resin infiltrant has been cited as a promising treatment, once the resin infiltrant promotes an obstructive effect, hindering the progression of lesions by preventing the diffusion pathways for cariogenic acids. Aim: To evaluate the colour change and surface gloss of white spot lesions after application of unpolished resin infiltrant submitted to toothbrushing, pH cycling and artificial ageing. Materials and Methods: The present in-vitro study was conducted from June 2014 to September 2014. This study was related to the Araçatuba School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil. Fifty Bovine enamel discs were divided into five groups (n=10) white spot lesion (W-control), infiltrated white spot lesion (IW), infiltrated white spot lesion submitted to toothbrushing (IWb), infiltrated white spot lesion submitted to pH cycling (IWc), and infiltrated white spot lesion submitted to artificial ageing (IWa). After the challenges, the specimens were evaluated for colour change using L*a*b*system (CIELAB), and surface gloss analysis was performed using a gloss meter. The data were submitted to oneway ANOVA and Tukey’s test for multiple comparisons (p0.05). All groups receiving resin infiltrant (IW, IWb, IWc, IWa) presented lower surface gloss when compared to W group (p

Abstract Objective The aim of this study was to compare two in vitro erosion protocols, in which one simulates in vivo conditions experienced by patients with gastroesophageal disorders or bulimia (HCl-pepsin protocol), and the other simulates the diet of an individual who consumes a high volume of erosive beverages (citric acid protocol). In addition, the mechanical properties and surface gloss of eroded human dentin were compared with those of sound human dentin. Materials and Methods Blocks of cervical dentin were used: sound human dentin (n=10), human dentin with erosive lesions (n=10), and bovine dentin (n=30). Twenty bovine blocks were subjected to either of two erosion protocols (n=10/protocol). In the first protocol, samples were demineralized using HCl-pepsin solution, then treated with trypsin solution. In the second protocol, samples were demineralized with 2% citric acid. Toothbrushing was performed in both protocols using a toothbrushing machine (15 s with a 150 g load). Ten bovine dentin blocks were not subjected to any erosive treatment. All samples of bovine and human dentin were analyzed to obtain Martens hardness values (MH), elastic modulus (Eit*) and surface gloss. One-way ANOVA and Tukey's test were performed to analyze the data (α=0.05). Results Sound human and eroded human dentin groups showed similar MH and Eit* values (p>0.05); however, sound human dentin showed a higher surface gloss value when compared to eroded human dentin (p0.05), but HCl-pepsin-treated bovine dentin and citric acid-treated bovine dentin resulted in lower surface gloss than sound bovine dentin (p

Introduction: Microorganisms in the cemental canal can lead to the development of periapical lesions and its mechanical removal by means of overinstrumentation may be more favourable for the success of endodontic treatment. However, instrumentation of the apical foramen remains a controversial issue because it can be a traumatic procedure to the periapical tissues. Aim: Considering that post-operative pain is an essential feature of symptomatic periradicular inflammation, this clinical trial evaluated the influence of two different foraminal working lengths on post-operative pain and mechanical allodynia after endodontic treatment completed in single-visit or two-visit. Materials and Methods: Forty eight adult patients indicated for primary endodontic treatment of tooth with asymptomatic apical periodontitis were randomly assigned to 4 groups (n = 12): SV0 – single-visit and instrumentation up to the apical foramen; SV+1 – single-visit and instrumentation 1 mm beyond the apical foramen; TV0 – two-visit and instrumentation up to the apical foramen; TV+1 – two-visit and instrumentation 1 mm beyond the apical foramen. All participants received a visual analog scale to record their assessment of pain at 3 hours to 7 days and data were analysed statistically by Kruskal-Wallis test (α = 5%). For mechanical allodynia evaluation, bite force measurement was performed using a digital gnathodynamometer just before and 7 days after treatment and data were analysed statistically by ANOVA and Tukey’s test (α = 5%). Results: No statistically significant difference was found among the 4 groups in relation to post-operative pain at all time points assessed. Bite force values were significantly higher 7 days after endodontic treatment, indicating that there was a significant reduction of mechanical pain in all groups, with no significant difference among them. Conclusion: All groups exhibited the same rate of post-operative pain at the time points assessed and endodontic treatment effectively increased the mechanical pain thresholds.

Abstract The aim of this study was to evaluate the effect of ethanol on the bond longevity of a universal adhesive system to bovine dentin, under different modes of adhesive application and artificial aging. Bovine dentin was exposed, and the smear layer was standardized by sandpaper polishing. Specimens were randomly divided into 2 groups: ethanol (E) and non-ethanol (N). Groups were subdivided according to adhesive mode of application into etch-and-rinse (Er) and self-etching (S). Resin blocks were built onto the treated surface, and the specimens were stored in deionized water at 37°C for 48 h. Half of the specimens (n = 10) were subjected to thermomechanical aging (A for aged and Na for non-aged). Resin/dentin beams were obtained and subjected to microtensile test in a universal testing machine. Data were analyzed using a three-way ANOVA and Tukey’s tests (α = 5%). There was interaction among the three factors (p=0.0003). The use of ethanol resulted in higher values, except for the Er and Na groups (E_Er_Na = N_Er_Na). The mode of application was similar, except for the N and A groups (N_S_A > N_Er_A). For the A groups, the values were lower, except in the cases using ethanol, in which the results were not affected. The study concluded that the use of ethanol resulted in higher microtensile bond strength values, even after aging. The mode of adhesive application did not influence the results.

The purpose of this study was to evaluate the effect of aging protocols on surface gloss of composites. Cylindrical resin composite specimens (6 mm in diameter, 1 mm thick) were fabricated and divided into three groups (N=60): microfilled (MiFi), nanohybrid (NaHy), and nanofilled (NaFi). Specimens were distributed into four aging subgroups: thermocycling (5° to 55°C, 15,000 cycles); ethanol immersion (15 days); brushing (10,750 cycles); and light aging (216 h). Surface gloss readings (Novo-Curve, Rhopoint TM, England) were performed at baseline (R0) and after every one-third of aging protocols (R1 to R3). Data were submitted to one-way repeated measures ANOVA and Tukey’s test (5%). Overall, surface gloss alterations were detected over time (p

This study aimed to evaluate the effect of beers on the bovine enamel microhardness. Fifty rectangular (1 x 3 x 1 mm-height x width x thickness) enamel specimens were obtained from permanent bovine incisors, and divided into five groups (n = 10) according to the treatment employed: Saliva, Coke, Brahma, Heineken, and Budweiser. Microhardness (Knoop) were obtained before; after 5, 30 and 60 min of immersion in each solution. The data were analyzed using repeated two-way ANOVA and Tukey´s test (p

Background: This study assessed the genotoxic and cytotoxic potential of three different glass ionomer cements used in Orthodontics (Vidrion C, OptiBand, and Band-Lok). Materials and Methods: The tested cements were exposed in vitro to mouse fibroblast cells for 1 h at 37°C. The genotoxicity and cytotoxicity were evaluated by means of the single cell gel (Comet Assay) and the trypan blue exclusion test, respectively. All data were assessed by the Kruskal-Wallis non-parametric test, followed by Dunn′s test. P < 0.05 was considered for statistical significance. Results: Significant statistically differences (P < 0.05) in cytotoxicity were observed for both Vidrion C powder and liquid at the tested concentrations, with exception to the group presenting the lowest powder concentration. OptiBand similarly presented induced cellular death at the highest tested concentration for paste A (P < 0.05). Band-Lok paste B was also able to induce cytotoxicity at the highest tested concentration. Regarding the comet assay, Band-Lok paste B and OptiBand paste A resulted in increased DNA injury (P < 0.05). Conclusion: The obtained results support the thought that some glass ionomer cement components present both genotoxic and cytotoxic effects when in high concentrations. Since DNA damage and cellular death are important events during oncogenesis, this study represents relevant contribution to estimate the real risks induced by these materials upon cellular systems.

There is a clear reported association between social disparity and oral health, for example, between dental caries and malnutrition in children. This fact is detected in several studies, and also found amongst the Brazilian population. However, several efforts have been made to improve the quality of life of the population and to achieve the 2015 Millennium Development Goals. Oral health is a branch to be improved among these goals. The Brazilian experience has been drawing the attention of authorities, insofar as there have been direct improvements in oral health through state oral health programs, and also indirect results by improving the quality of life of the population. Included within the Brazilian oral health programs are the Family Health Program and Smiling Brazil Program. The former is a global healthcare program which involves primary oral healthcare, while the latter is a specialized oral care program. Among the social programs that would indirectly improve oral health are Family Stipend and the Edmond and Lily Safra International Institute of Neuroscience of Natal (ELS-IINN). In conclusion, although oral health problems are related to socioeconomic factors, the implementation of primary oral health programs and programs to improve the population's quality of life may directly or indirectly improve the oral health scenario. This fact is being observed in Brazil, where the oral health policies have changed, and social programs have been implemented.

This case report describes the Indirect Pulp Treatment (IPT) of deep caries lesion in a permanent molar. A 16-year-old male patient reported discomfort associated with thermal stimulation on the permanent mandibular left first molar. The radiographs revealed a deep distal caries lesion, very close to the pulp, absence of radiolucencies in the periapical region, and absence of periodontal space thickening. Pulp sensitivity was confirmed by thermal pulp vitality tests. Based on the main complaint and the clinical and radiographic examinations, the treatment plan was established to preserve pulp vitality. Clinical procedures consisted of removing the infected dentin and lining the caries-affected dentin with calcium hydroxide paste. The tooth was provisionally sealed for approximately 60 days. After this period, tooth vitality was confirmed, the remaining carious dentin was removed, and the tooth was restored. At 4-year follow-up, no clinical or radiographic pathological findings were found.

The purpose of this study was to evaluate the clinical performance of glass ionomer cement (GIC) restorations comparing two minimally invasive methods in permanent teeth after 12 months. Fifty pregnant women (second trimester of pregnancy), mean age 22 ± 5.30 years, were treated by two previously trained operators. The treatment approaches tested were: chemomechanical method (CarisolvTM; MediTeam) and atraumatic restorative treatment (ART). A split-mouth study design was used in which the two treatments were randomly placed in 50 matched pairs of permanent teeth. The chemomechanical method (CM) was the test group and the ART was the control group. The treatments were performed in Public Health Centers. The tested restorative material was a high-strength GIC (Ketac Molar; 3M/ESPE). The restorations were placed according to the ART guidelines. Two calibrated independent examiners evaluated the restorations in accordance with ART criteria. The inter-examiner kappa was 0.97. Data were analyzed using 95% confidence interval on the binomial distribution and Fisher's exact test at 5% significance level. In a 12-month follow-up, 86% of the restorations were evaluated. In the test group (CM), 100% (CI=93.3-100%) of the restorations were considered successful. In the control group (ART) 97.6% (CI=87.4-99.9%) of the restorations were considered successful and 2.4% unsuccessful (marginal defect >0.5 mm). There was no statistically significant difference between the 12-mounth success rate for both groups (Fisher's exact test: P=0.49) and between the two operators (Fisher's exact test: P=1.00). Both minimally invasive methods, chemomechanical method and ART, showed a similar clinical performance after 12 months of follow up.

The aim of this study was to assess the influence of ultrasonic wave propagation on the compressive (CS) and diametral tensile (DTS) strengths of glass ionomer cements (GICs). Three variables were evaluated: conventional GICs, ultrasonic excitation and storage time (1 hour, 24 hours and 7 days). Bovine teeth molds were used for simulating a clinical ultrasonic excitation. The data were submitted to three-way ANOVA and Tukey tests (P < 0.05). All the tested conventional GICs presented an increase in strength from 1 hour to 7 days for CS and DTS. Ultrasonic excitation resulted in a statistically significant increase in the CS, but showed no statistically significant difference in the DTS. Regardless the GICs tested the increase in strength was maturation time-dependent for all groups.

Objectives. To evaluate the influence of different whitening protocols on the efficacy of 35% hydrogen peroxide (HP) tooth whitening and gel pH and concentration. Material and Methods. Eighty-four enamel/dentin discs from bovine incisors were used. The baseline color was measured with a spectrophotometer. Two sessions of in-office whitening with 35% HP were performed under different protocols: G1: 3 applications of HP (10 min each) per session; G2: 1 application of 30 min per session; G3: 1 application of 40 min per session, with no gel replenishment within session for groups 2 and 3. HP titration and pH evaluation at baseline, after 10, 30, and 40 min were also performed. The final color was measured 24 h after the 1st and 2nd whitening sessions. Data were submitted to Repeated Measures ANOVA and Tukey’s test. Results. For color evaluation, no differences were observed among groups after two sessions. HP titration showed no drop on concentration after 10, 30, or 40 min. The pH was 5.54 at baseline and 5.41 after 40 min. Conclusion. Replenishment or extended application time of in-office whitening gel does not affect gel pH and concentration, a fact that supports the similar effectiveness of whitening observed among the tested protocols.

The aim of this study was to investigate the retention rates and effect on occlusal caries incidence of two glass ionomers used as sealants, placed according to the Atraumatic Restorative Treatment (ART) approach, in a high caries-risk community. A total of 150 newly erupted first molars of 42 schoolchildren, between 6-8 years of age were selected. The teeth were divided into two groups: experimental and control groups. In the experimental group, 76 teeth were sealed using Vidrion R-SS White (conventional GIC) and in the control group, 74 teeth were sealed using ChemFlex-Dentsply (high-viscosity conventional GIC). The sealants were applied by one operator following the "press finger technique", described in the ART-WHO manual. Two calibrated independent examiners carried out the evaluation according to the ART criteria. The intra and inter-examiner agreements were 0.84 and 0.81, respectively. Data were submitted to Mann-Whitney and Chi-square tests (pO objetivo deste trabalho foi avaliar o índice de retenção e o efeito na incidência de cárie oclusal de dois selantes ionoméricos realizados pela técnica do Tratamento Restaurador Atraumático (ART) em comunidades com alto índice de cárie. Foram selecionados 150 primeiros molares recém-erupcionados de 42 escolares, entre 6-8 anos de idade. Os dentes foram divididos em dois grupos: experimental e controle. No grupo experimental 76 dentes foram selados com Vidrion R-SSWhite (CIV-convencional) e no grupo controle, 74 dentes foram selados com ChemFlex-Dentsply (CIV-alta viscosidade). Os selantes foram realizados por apenas um operador pela técnica da "pressão digital", descrita no manual de ART da OMS. Dois avaliadores independentes e calibrados segundo os critérios do ART realizaram a avaliação. A concordância intra e inter-examinadores foi de 0,84 e 0,81, respectivamente. Os resultados foram submetidos aos testes Mann-Whitney e Q-quadrado (p

This paper presents a review of the literature on clinical trials with Atraumatic Restorative Treatment. The available scientific literature is encouraging in terms of management of dental caries by this approach, especially for one-surface lesions. The steps of ART are described and the crucial points highlighted. The incorporation of ART into primary health care services, as Family Health Program - PSF, was considered.Este artigo apresenta uma revisão da literatura relacionada a estudos clínicos utilizando o tratamento restaurador atraumático (ART). A literatura científica disponível mostra-se encorajadoura em termos de controle da doença cárie através desta abordagem, especialmente em cavidades de uma superfície. Os passos clínicos da técnica são descritos e pontos de crucial importância enfatizados. A incorporação do tratamento restaurador atraumático em serviços de atenção básica à saúde , como o Programa de Saúde da Família, é considerada.

The aim of this study to evaluate the success rate in one-surface ART restorations placed in permanent molars using a glass ionomer cement especially developed for ART in a community with high caries experience; to evaluate the operator influence on its success, post-operative sensitivity and technique acceptance by patients. Prior to placement of the restorations, the Gingival Bleeding Index, Visible Plaque Index, DMFT, dmft indices and treatment needed were assessed. One hundred and fifty five one-surface restorations were placed in permanent molars of school children, according to the WHO ART manual, 1997. After 6 months, the success rate was verified clinically and by slides. At baseline, the mean DMFT was 2.56 (±1.08) and the mean dmft, 2.53 (±2.33). Operators A and B have placed 102 and 53 ART restorations respectively. The mean time of placement was 16 minutes and 25 seconds to operator A and 14 minutes and 43 seconds to operator B. At 6-month follow up, 152 ART restorations were evaluated and 97.3% were assessed to be successful. Two restorations were excluded from the sample because the ART restorations were replaced by amalgam fillings. Only 4 restorations have failed, in which 2 due to caries, 1 due to fistula presence and the other because the restoration was lost. Four patients reported postoperative sensitivity. At this study period, ART treatment seems to be suitable for its purpose. Further evaluations are necessary to the new glass ionomer cements especially developed for ART technique provided good results at 6-month follow up in a community with high DMFT and dmft indices. The success rate for one-surface cavities in permanent molars was 97.3%, and the studied indices seemed to have no influence in this early evolution period.O objetivo deste estudo foi avaliar o índice de sucesso de restaurações de cavidade de classe I, realizadas em molares permanentes, utilizando-se a técnica do ART e um cimento de ionômero de vidro desenvolvido especialmente para a técnica, em uma comunidade de alto risco à cárie; avaliar a influência do operador no sucesso da técnica e avaliar a sensibilidade pós-operatória e a aceitação da técnica por parte dos pacientes. Antes da realização do tratamento verificou-se o índice de placa visível e o índice de sangramento gengival, CPOD, ceo-d e necessidade de tratamento. Um total de 155 restaurações de uma superfície foram realizadas em molares permanentes de escolares, de acordo com o manual de ART da OMS. Após 6 meses, realizou-se o acompanhamento clínico e por diapositivos. Inicialmente, o CPOD foi de 2,56 ( ±1,08) e o ceod de 2,53 ( ±2,33 ). Os operadores A e B realizaram 102 e 53 restaurações de ART respectivamente. O tempo médio para o tratamento foi de 16 minutos e 25 segundos para A e 14 minutos e 43 segundos para B. Aos seis meses. 152 restaurações foram avaliadas e 97,3% consideradas sucesso. Duas restaurações foram excluídas da amostra pois foram substituídas por amálgama. Somente 4 restaurações falharam, duas por recidiva de cárie, 1 por presença de fistula e a última por perda da restauração. Quatro pacientes relataram sensibilidade pós-operatória. O tratamento ART cumpriu seus objetivos no período analisado. Avaliações futuras são necessárias, especialmente para os cimentos de ionômero de vidro de alta viscosidade, devido aos bons resultados nesta comunidade de alto índice de cárie. O índice de sucesso foi de 97,3% e os índices de cárie parecem não influenciar no sucesso do tratamento.

The aim of this study was to evaluate the performance of two different glass-ionomer cements: a high-density (Ketac Molar - ESPE) and a resin-modified cement (Fuji VIII - GC) using the Atraumatic Restorative Treatment technique to restore multisurface cavities in permanent teeth. A total of 60 ART restorations (30 with each material) were placed in schoolchildren (9-16 years of age) by two operators. After a period of 6 months, two independent examiners evaluated 59 restorations according to the criteria used in previous ART studies. Data were submitted to McNemar and Fischer tests. The success rate of the treatment was 98.3%. One restoration (Ketac Molar) was replaced by another material and was recorded as failure. The success rates of the restorations were 100% and 96.6% for Fuji VIII and Ketac Molar, respectively. There was no statistically significant difference in the restorations success between baseline and 6 months (p>0.05). In the same way, no significant differences were found between materials, cavity types or operators (p>0.05). The ART approach was highly appropriate and effective in restorations involving two or more tooth surfaces, after 6 months. The results showed a promising performance of the ART technique with both materials.O objetivo deste estudo foi avaliar o comportamento de dois cimentos de ionômero de vidro: um de alta viscosidade (Ketac Molar - ESPE) e um modificado por resina (Fuji VIII - GC) em restaurações envolvendo duas ou mais superfícies dentárias, confeccionadas pela técnica do Tratamento Restaurador Atraumático. Sessenta restaurações (30 com cada material) foram inseridas em estudantes (9-16 anos) por dois operadores. Após 6 meses, dois examinadores independentes avaliaram as restaurações de acordo com os critérios utilizados em trabalhos prévios semelhantes. Os dados foram analisados pelos testes de McNemar e Fischer. A porcentagem de sucesso do tratamento foi de 98,3%. Uma restauração (Ketac Molar) foi substituída por outro material e classificada como falha. As porcentagens de sucesso das restaurações foram de 100% e 96,6% para o Fuji VIII e Ketac Molar, respectivamente. Não houve diferença estatisticamente significante no sucesso das restaurações entre o baseline e 6 meses (p>0,05). Da mesma forma, não houve diferença estatística entre os materiais, tipos de cavidade ou entre operadores.(p>0,05). A técnica ART foi altamente apropriada e efetiva em restaurações envolvendo duas ou mais superfícies, após 6 meses. Os resultados mostraram um comportamento promissor com ambos os materiais.

The aim of this study was to compare, in different periods of time, the compressive and diametral tensile strength of a traditional high viscous glass ionomer cement: Fuji IX (GC Corporation), with two new Brazilian GIC's: Vitro-Molar (DFL) and Bioglass R (Biodinamica), all indicated for the Atraumatic Restorative Treatment (ART) technique. Fifteen disk specimens (6.0mm diameter x 3.0mm height) for the diametral tensile strength (DTS) test and fifteen cylindrical specimens (6.0mm diameter x 12.0mm height) for the compressive strength (CS) test were made of each GIC. Specimens were stored in deionized water at 37º C and 100% of humidity in a stove until testing. Five specimens of each GIC were submitted to CS and DTS test in each period, namely 1 hour, 24 hours and 7 days. The specimens were tested in a testing machine (Emic) at a crosshead speed of 1.0mm/min for CS and 0.5mm/min for the DTS test until failure occurred. The data were submitted to two-way ANOVA and Tukey tests (alpha=0.05). The mean CS values ranged from 42.03 to 155.47MPa and means DTS from 5.54 to 13.72 MPa, with test periods from 1h to 7 days. The CS and DTS tests showed no statistically significant difference between Fuji IX and Vitro Molar, except for CS test at 1-hour period. Bioglass R had lowest mean value for CS of the cements tested. In DTS test Bioglass R presented no statistically significant differences when compared with all others tested GICs at 1-hour period and Bioglass R presented no difference at 24-hour and 7-day periods when compared to Vitro-Molar. Further studies to investigate other physical properties such as fracture toughness and wear resistance, as well as chemical composition and biocompatibility, are now needed to better understand the properties of these new Brazilian GIC's.Comparou-se a Resistência à Compressão (RC) e à Tração Diametral (TD) de um cimento de ionômero de vidro de alta viscosidade [Fuji IX (GC Corporation)] e de dois novos cimentos Brasileiros [Vitro Molar (DFL) e Bioglass R (Biodinamica)], recentemente lançados no mercado, ambos indicados para o Tratamento Restaurador Atraumático (ART), em diferentes períodos de tempo. Foram confeccionados quinze corpos-de-prova com 6,0 mm de diâmetro x 3,0 mm de altura para o teste de TD e quinze com 6,0 mm de diâmetro e 12,0 mm de altura para o teste de RC, para cada ionômero a ser testado. Os corpos-de-prova foram armazenados em recipientes plásticos, com água deionizada, e mantidos em estufa a 37ºC e 100% de umidade, até a realização dos testes. Cinco corpos-de-prova de cada material foram submetidos aos testes de TD e RC em cada período de tempo: 1-hora, 24-horas e 7-dias, em uma máquina de testes universal (EMIC - DL 500) a uma velocidade de 1,0 mm/min para RC e 0,5mm/min para TD. Os dados obtidos foram submetidos aos testes ANOVA a dois critérios e Tukey (á=0,05). Os valores médios de RC e TD variaram de 42,03 a 155.47 MPa e de 5,54 a 13,72 MPa, respectivamente para os períodos analisados. O Fuji IX e o Vitro Molar não apresentaram diferenças em relação aos testes de RC e TD, exceto para RC no período de 1-hora. O Bioglass R apresentou os menores valores de RC dos cimentos testados. Na TD o Bioglass R não apresentou diferença em relação aos outros cimentos testados no período de 1-hora e não foi diferente do Vitro-Molar nos períodos de 24-horas e 7-dias. Mais estudos são necessários para avaliar outras propriedades mecânicas desses novos cimentos de ionômero de vidro brasileiros, tais como: tenacidade e desgaste, bem como composição química e biocompatibilidade.

The aim of the present study was to evaluate the clinical performance of two types of ceramics: a slurry-powder ceramic (Duceram Plus, Degussa) - D and a hot-pressed leucite-based glass-ceramic (IPS Empress, Ivoclar Vivadent) - IPS. Eighty-six restorations, 44 IPS and 42 D, were made by one operator. A total of 33 onlays and 53 inlays on twenty-seven premolars and 59 molars were cemented in 35 patients of both sexes, mean age 35 years. All restorations were cemented with the dual-resin cement (Variolink, Ivoclar-Vivadent) under rubber dam and were evaluated at the baseline and after six months, using the modified U.S.P.H.S. criteria for postoperative sensitivity, secondary caries, fracture, color match, marginal discoloration, marginal integrity and surface texture. Additionally radiographs and intraoral photographs were carried out. At baseline 86 restorations were analyzed and all of them received Alfa rating, except for the following that received Bravo rating for postoperative sensitivity - IPS (2.27%); D (7.14%); for color match - IPS (2.27%); D (2.38%) and for surface texture - IPS (2.27%); D (11.90%). After 6 months 100% of the restorations were analyzed and the following received Bravo rating: color match - IPS (4.55%) and D (9.52%); surface texture - IPS (2.27%) and D (11.9%); marginal discoloration - IPS (6.82%) and D (4.76%) and marginal integrity - IPS (4.55%) and D (7.14%). The results were submitted to the Fisher and McNemar Statistical Tests. No significant differences were noticed between the two ceramics. Both ceramics demonstrated satisfactory clinical performance after six months.Este trabalho se propôs a avaliar a performance clínica de dois tipos de cerâmica: IPS Empress, Ivoclar-Vivadent - IPS e Duceram Plus, Degussa - D. Foram realizadas 86 restaurações por apenas um operador, sendo 44 IPS e 42 D. Vinte e sete pré-molares e 59 molares, num total de 33 onlays e 53 inlays, foram cimentadas em 35 pacientes de ambos os sexos, com idade média de 35 anos. A cimentação das restaurações foi realizada com cimento resinoso dual (Variolink, Ivoclar-Vivadent) sob isolamento absoluto e avaliadas no baseline e após 06 meses, mediante o critério U.S.P.H.S. modificado, quanto à sensibilidade pulpar, reincidência de cárie, fratura, reprodução de cor, descoloração marginal, integridade marginal e textura superficial. Adicionalmente foram realizadas radiografias e fotografias. No baseline foi obtida a classificação Bravo nos itens sensibilidade pulpar - IPS (2,27%); D (7,14%); reprodução de cor - IPS (2,27%); D (2,38%) e textura superficial - IPS (2,27%); D (11,90%). Após 06 meses foram analisadas as 86 restaurações, nas quais foi constatada a classificação Bravo para os itens reprodução de cor - IPS (6,82%); D (2,38%); textura superficial - IPS (2,27%); D (9,52%); descoloração marginal - IPS (6,82%); D (4,76%) e integridade de superfície- IPS (4,55%); D (7,14%). Os resultados obtidos foram submetidos ao Teste Estatístico de Fisher e McNemar. Não houve diferença estatisticamente significante entre as cerâmicas. Pode-se concluir que os dois tipos de cerâmica demonstraram uma performance clínica satisfatória após 06 meses.

Objective. To evaluate bacterial growth inhibition, mechanical properties, and compound release rate and stability of copolymers incorporated with anthocyanin (ACY; Vaccinium macrocarpon). Methods. Resin samples were prepared (Bis-GMA/TEGDMA at 70/30 mol%) and incorporated with 2 w/w% of either ACY or chlorhexidine (CHX), except for the control group. Samples were individually immersed in a bacterial culture (Streptococcus mutans) for 24 h. Cell viability (n=3) was assessed by counting the number of colony forming units on replica agar plates. Flexural strength (FS) and elastic modulus (E) were tested on a universal testing machine (n=8). Compound release and chemical stability were evaluated by UV spectrophotometry and 1H NMR (n=3). Data were analyzed by one-way ANOVA and Tukey’s test (α = 0.05). Results. Both compounds inhibited S. mutans growth, with CHX being most effective (P

Introdução Os cimentos de ionômero de vidro (CIV) são materiais com baixa resistência à tração e ao cisalhamento, mostrando-se, portanto, contraindicados para áreas sujeitas às grandes cargas oclusais. Objetivo Avaliar o efeito da incorporação de nanotubos de carbono em CIV por meio de dureza superficial Knoop. Material e método Foram confeccionados 48 espécimes, divididos em quatro grupos, de acordo com o tipo de CIV (n=12) – convencional ou de alta viscosidade, incorporados ou não de nanotubos de carbono (NC) a 2%: (A) Vidrion R; (B) Vidrion R + NC 2%; (C) Vitro Molar, e (D) Vitro Molar + NC 2%. Os espécimes foram preparados utilizando-se seringa Centrix, para inserção do material em moldes plásticos, e armazenados em água deionizada por 24 horas. Após polimento, realizou-se o teste de dureza superficial com penetrador do tipo Knoop. Foram realizadas cinco endentações em cada espécime, distanciadas entre si em 100 µm. Resultado Os valores médios de dureza foram 58,96 ± 8,29 (A), 34,81 ± 5,78 (B), 60,84 ± 4,91 (C) e 41,97 ± 5,45 (D). O teste ANOVA detectou diferenças estatisticamente significantes para os dois parâmetros estudados, tipo de material (p=0,016) e inclusão de NC (p0,05), enquanto os grupos B e D apresentaram diferenças significativas (p

Abstract This double-blind randomized controlled clinical trial evaluated the effectiveness of dentin pretreatment with 100% ethanol (EWBT – ethanol wet bonding technique) and different adhesive protocols in noncarious cervical lesions (NCCL) after 6 months. Patients presenting at least one NCCL were included. NCCLs (n=148) were randomly assigned to 4 groups: NE (Non-EWBT + three-step etch-and-rinse (Scotchbond Multi Purpose, 3M ESPE [MP]), E (EWBT + MP); EB (EWBT + [Bond – third step of MP]), and EU (EWBT + universal adhesive (Single Bond Universal, 3M ESPE). Conventional acid-etching (Condac 37%, FGM) and nanohybrid resin composite (Z350, 3M ESPE) were used. Trained and calibrated examiners (Kappa = 0.61) evaluated the restorations at baseline (7 days) and 6-month recall using the USPHS modified criteria. Data were subjected to Chi square (α = 0.05). Differences in the success rate were found for the treatments (p = 0.003). EB presented the lowest success rate compared with the other groups (p < 0.02). No significant differences were detected among NE, E, and EU (p > 0.49). The survival rates were 97.23%, 97.30%, 78.95%, and 97.30% for NE, E, EB, and EU, respectively. Regarding postoperative sensitivity, a significant reduction was found for groups E (p = 0.027) and EU (p < 0.01) after 6 months. After 6 months, EWBT associated to the hydrophobic adhesive system had the highest failure rate.