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Objective: To evaluate the retention rate and other clinical criteria of four different restorative techniques for non-carious cervical lesions (NCCLs) after 4 years., Methods: This is a prospective, randomized, double-blind, and split-mouth study evaluating four different adhesion strategies in non-carious cervical lesion restorations: adhesive restorative system (Scotchbond Universal Adhesive/Filtek Z350XT) without (SBU) and with selective enamel acid-etching (E-SBU), resin-modified glass-ionomer cements (Vitremer; RMGIC), and ethylenediaminetetraacetic as acid pretreatment (E-RMGIC). In total, 200 restorations were placed in 50 patients. Good health, no allergies to dental products, adequate oral hygiene were inclusion criteria. Pregnancy, active caries, use of desensitizers/fluoride, orthodontic appliances, and severe bruxism were exclusion criteria. All restorations were scored regarding retention, marginal integrity, marginal discoloration, surface texture, wear, secondary caries, anatomical form, surface staining, color match, and inflammation of gingival tissue marginal adaptation, using modified United States Public Health Service (USPHS) criteria at baseline and after 1, 2, 3 and 4 years. Kruskal-Wallis, Friedman, and Wilcoxon were used (p < 0.05)., Results: In total, 40 patients returned for the follow-up. RMGIC and E-RMGIC presented more alteration in surface texture than SBU and E-SBU. SBU had lower retention at four years than at baseline. Decreased alpha scores for marginal integrity and marginal discoloration were observed for all groups after four years when compared to baseline. Survival curves, related to retention, presented no statistical differences among groups (p = 0.315)., Conclusions: NCCLs restored with ionomer had more reduction in surface luster than resin composite restorations. The use of selective enamel etching promoted less loss of retention for universal adhesive. The increase of initial marginal defects occurred for all types of adhesion strategies., Clinical Relevance: The use of selective enamel etching cause less loss of retention for universal adhesive used in NCCL. Initial marginal defects occur for all types of adhesion strategies after four years., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: This prospective case series aimed to clinically evaluate the bleaching effect, spontaneous tooth sensitivity, and variation in the thermal sensation threshold of different groups of teeth undergoing in-office bleaching., Method and Materials: Ten patients received conventional bleaching treatment: 35% hydrogen peroxide with three bleaching sessions of 45 minutes, evaluating color change (∆E and ∆E00), Whitening Index (WID), and tooth sensitivity (visual analog scale). Thermal stimulus-generating devices were used to simulate sensitivity caused by low temperatures through quantitative sensory tests. Analyses were conducted individually on different teeth groups (n = 20) (mandibular incisors, maxillary incisors, canines, maxillary first premolars)., Results: Regarding color change, mandibular and maxillary incisors did not statistically differ from each other but showed significant difference and greater bleaching potential compared to canines and maxillary first premolars (P = .018). Regarding sensitivity, mandibular and maxillary incisors presented the highest spontaneous sensitivity values (P = .032), while maxillary first premolars did not display painful symptoms, also observed in provoked sensitivity analysis (P = .025)., Conclusions: The general analysis of the results indicates that the tooth type affects the response to the whitening treatment, both in relation to the esthetic benefit and the occurrence of tooth sensitivity. It was observed that mandibular incisors reach the degree of chromatic saturation before canines and premolars, in addition to presenting greater bleaching sensitivity. Personalizing the treatment, based on prior knowledge of the degree of saturation, anatomical factors, and the risk of sensitivity, can provide considerable advantages in the whitening technique.

This study aimed to evaluate the interface of universal adhesive (UA) with bulk-fill resin (BF) and dentin, after endodontic irrigation. The pulp chamber of 96 molars was irrigated with chlorhexidine 2% (CHX) or sodium hypochlorite 5.25% (NaOCl) and restored according to three restorative protocols. Microtensile bond strength (μTBS) and nanoleakage tests were performed after 24 h of thermocycling. Kruskal Wallis, Mann-Whitney and Wilcoxon were performed (p < 0.05). Comparing restorative systems, a difference was found only when irrigated with CHX after 24 h. CHX provided higher μTBS than NaOCl after 24 h for two restorative protocols; after thermocycling, NaOCl provided the greatest μTBS than CHX for one group. Decreased μTBS was observed for all restorative systems when CHX was used after thermocycling. NaOCl demonstrated the highest nanoleakage. The composition of UA influenced the immediate adhesion and sealing to BF when CHX was used; ageing has a deteriorating effect on adhesion and sealing for all restorative systems., (© 2024 Australian Society of Endodontology Inc.)

Objectives: This laboratory study evaluated the influence of the fluorescence intensity of composite resins on additional tooth wear and the presence of restorative material in different dental thirds during the retreatment of direct veneers., Materials and Methods: The crown dimensions of 60 bovine incisors were reduced to 10 × 8 mm. The teeth were classified according to the fluorescence intensity of the composites: low (LOW) (TPH Spectra), medium (MED) (Opallis), and high (HIGH) (Essentia) groups. The teeth were divided according to the removal methods: conventional (CON) and fluorescence-aided identification technique (FIT). The specimens were scanned (T0), received veneer preparation, and scanned again (T1). After restorations, the composites were removed and the teeth were scanned (T2). Measurement assessments between T1 and T2 were performed to determine additional wear, presence of residual areas, and the average between additional wear and the presence of residual areas. Kruskal Wallis, Mann-Whitney, Friedman, 2-way ANOVA, and post-Tukey tests were performed (α < 0.05)., Results: The comparison of composite resins indicated a smaller area of additional wear and greater residue presence in the HIGH group than the LOW group for both techniques in the cervical third. Regarding removal methods, the FIT produced greater additional wear than the CON method for the LOW and MED groups in the middle and cervical thirds. The incisal third exhibited greater additional wear than the other thirds., Conclusions: Composite resins with high fluorescence intensity removed using FIT had less tooth wear. The incisal third was the most affected area for direct veneer removal procedures., Clinical Significance: A FIT has been proposed for composite resin removal; however, the different fluorescence intensities of composite resins can influence tooth wear caused during this procedure., (© 2024 Wiley Periodicals LLC.)

The aim of this clinical, prospective, randomized, and parallel study was to evaluate different in-office treatments for dentin hypersensitivity (DH). One hundred ninety-two teeth with non-cavitated root exposures were treated using different desensitizers: fluoride varnish (Duraphat - FLU); bioactive ceramic solution (Biosilicate - BIOS); universal self-etching adhesive (Single Bond Universal - SBU); bioactive photoactivated varnish (PRG filler - SPRG). The degree of DH was analyzed using a visual analog scale (VAS) and computerized visual scale (CoVAS), before treatments and after 7, 15, and 30 days from the first session. Comparisons among desensitizers were performed using the Kruskal-Wallis and Dunn's tests. Friedman test was used to compare between times (p ≤ 0.05). Comparing desensitizers FLU presented a higher value of DH than BIOS using VAS at 7 days, however, no differences were found using CoVAS analysis. Comparing times, BIOS and SBU showed a reduction in DH after 7 days and SBU showed a reduction at 30 days compared to 7 days using VAS. FLU and SPRG groups reduced DH from 15 days to 30 days using VAS. There was a reduction in DH for FLU, BIOS, and SBU after 7 days and for BIOS this reduction also occurred at 30 days when compared to 15 days using CoVAS. SPRG group showed a reduction from 15 to 30 days. All desensitizers tested were able to reduce the initial sensitivity. The bioactive ceramic solution reduced the DH gradually after 30 days using computerized analysis.

Background: This study aimed to evaluate dentin wear and biological performance of desensitizing materials., Methods: Seventy bovine root dentin blocks were sectioned. Half of the surface of each specimen was untreated (control) and the other half was immersed in EDTA and treated with the following desensitizing materials: placebo varnish (PLA), fluoride varnish (FLU), sodium fluoride (NaF) varnish + sodium trimetaphosphate (TMP), universal adhesive (SBU), S-PRG varnish (SPRG), biosilicate (BIOS), and amelotin solution (AMTN). After application, the specimens were submitted to an erosive-abrasive challenge and the wear analyzed by optical profilometer. Serial dilutions of extracts obtained from the culture medium containing discs impregnated with those desensitizers were applied on fibroblasts and odontoblasts-like cells cultures. Cytotoxicity and production of total protein (TP) by colorimetric assays were determined after 24 h. Data were statistically analyzed using Kruskal-Wallis, Dunn's, One-way ANOVA and Tukey tests (p ≤ 0.05)., Results: No dentin wear was observed only for SBU. The lowest dentin wear was observed for AMTN and TMP. Cell viability was significantly reduced after treatment with undiluted extracts of PLA, FLU, TMP and SBU in fibroblasts and TMP and SBU in odontoblast-like cells. SPRG, BIOS and AMTN were cytocompatible at all dilutions tested. Considering TP results, no statistical difference was observed among the groups and high levels for TP were observed after TMP and FLU treatments., Conclusions: Universal adhesive system may protect dentin with opened tubules from wear after challenge. Extracts of adhesive and fluoride varnishes presented cytotoxic mainly on fibroblasts. The enamel protein may be a future alternative to treat dentin with opened tubules because it may cause low wear under erosive-abrasive challenge with low cytotoxic effects., (© 2024. The Author(s).)

The effectiveness of at-home dental bleaching treatments depends on the time that bleaching products are in contact with the teeth surface and, consequently, on the adequate use of associated custom acetate trays., Objective: This randomized single-blinded trial aimed to analyze if the daily usage time of these products influences the patient's compliance behavior when submitted to monitored at-home dental bleaching. Secondary outcomes were color change and tooth sensitivity., Methodology: Sixty-six volunteers were randomly distributed into three groups (n=22): patients were instructed to use the trays for 2 (G2), 4 (G4), and 8 (G8) hours daily. The daily dental bleaching compliance behavior was measured using a microsensor inserted into the trays. Subjective and objective color evaluation assessments were adopted at baseline (T0), one (T1), two (T2), and three weeks (T3) after the beginning of the bleaching treatment, as well as two weeks after the treatment (T4). Tooth sensitivity was analyzed using the VAS scale, ranging from T1 to T4., Results: G2 showed a greater degree of cooperation than G8 and cooperation was inversely proportional to the recommended usage time. Significantly higher color change was observed in the upper arch for G8 when compared to G2 in subjective analysis, from T1 to T4. There were no statistical differences between the groups in objective analysis., Conclusion: Shorter recommended usage time of the bleaching product may improve the patient's compliance with at-home dental bleaching treatments. However, increased daily usage time may promote better subjective color change. Bleaching sensitivity was more significant in the first week for a longer time of use.

Purpose: This study evaluates the effects of different toothpastes on the nanohardness and chemical compositions of restorative materials and dental surfaces., Methods: Bovine enamel ( n = 72) and dentin ( n = 72) blocks were obtained and restored using RMGIC ( n = 36) or CR ( n = 36) to create the following surfaces: dentin adjacent to RMGIC (DRMGIC), enamel adjacent to RMGIC (ERMGIC), dentin adjacent to CR (DCR), and enamel adjacent to CR (ECR). After restoration, one hemiface of each specimen was coated with an acid-resistant varnish to facilitate the creation of control (C) and eroded (E) sides; the latter were achieved by erosion-abrasion cycles as follows: erosion with 1% citric acid: 5 days, four times for 2 min each day; 1% citric acid/abrasion, two times for 15 s, followed by immersion in a toothpaste slurry for 2 min. Toothpastes without fluoride (WF; n = 12), with sodium fluoride (NaF; n = 12), and with stannous fluoride (SnF 2 ; n = 12) were used for RMGIC or CR. The specimens were analyzed for nanohardness (H), and chemical composition using energy-dispersive X-ray spectroscopy and Raman microscopy. The data were statistically analyzed using two-way repeated measures ANOVA and Tukey's test (α = 0.05)., Results: Lower H values were obtained with NaF for DRMGIC-C, with a statistically significant difference from the H value obtained with WF ( p < 0.05). The calcium and phosphorus concentrations in DCR-E were significantly lower with WF than with the other types of toothpaste ( p < 0.05). Fluoride-containing toothpastes are capable of preserving the main chemical components of the dentin adjacent to the restorative materials under erosive-abrasive conditions.

Objectives: This study investigates the dentin permeability (by hydraulic conductance) and tubule occlusion (by confocal and scanning electron microscopies) of in-office desensitizing materials., Materials and Methods: Bovine dentin blocks were immersed in EDTA to open dentinal tubules. Placebo varnish (PLA), fluoride varnish (FLU), NaF 5% + 5% nanoparticulate sodium trimetaphosphate varnish (TMP), universal adhesive system (SBU), S-PRG filler varnish (SPRG), Biosilicate (BIOS), and amelotin (AMTN) solution were the materials tested. After application, the specimens underwent an erosive-abrasive challenge. Dentin permeability was evaluated at T0 (initial), T1 (after treatment), and T2 (after challenge). Confocal and scanning electron microscopy (SEM) were used to evaluate, respectively, length and number of dentinal tubule occlusions and opened dentinal tubules, after challenge. Permeability and SEM data were analyzed by two-way repeated measures ANOVA and Tukey's tests. Confocal data were analyzed by one-way ANOVA, Tukey's test, and Kruskal-Wallis and Dunn's tests. Spearman and Pearson's correlation tests were also used. Significance level was set at 5%., Results: At T1, the AMTN group showed the lowest permeability value, following the increasing order at T2: AMTN = SBU < BIOS = SPRG < TMP < FLU < PLA. The SBU group had the highest value of occluded dentinal tubule length. The AMTN group presented more occluded dentinal tubules compared to PLA and FLU. AMTN and SBU had the lowest values of opened dentin tubules. Results showed a negative correlation between the analyses., Conclusion: The SBU and AMTN solution were more effective in reducing dentin permeability by occluding dentin tubules., Clinical Relevance: All materials reduced permeability after challenge, except fluoride varnish., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Dentin hypersensitivity (DH) is characterized by rapid, acute pain arising from exposed dental tubules., Aim: the aim of this study was to evaluate the roughness, tubule occlusion, and permeability of eroded dentin brushed with different toothpastes., Materials and Method: ninety bovine teeth were cut into blocks. Thirty hemifaces were protected with varnish and the other sixty were submitted to permeability tests. Specimens were divided into groups according to the dentifrices: without fluoride (WF), sodium fluoride (NaF), and stannous fluoride (SnF2). The blocks were subjected to a 5-day erosive-abrasive protocol. Surface roughness and dentinal tubule occlusion (n=10) were assessed for both control and test hemifaces of the same sample along with permeability analysis (n=20). Two-way RM ANOVA and Tukey's post-hoc test were performed (p≤0.05)., Results: NaF and SnF2 presented higher roughness than WF. The number of open tubules was higher in WF. Permeability was higher in SnF2, but there was no significant difference between WF and NaF., Conclusions: both fluoride toothpastes occluded dentinal tubules and increased roughness. NaF toothpaste promoted greater decrease in dentin permeability., Competing Interests: The authors declare no potential conflicts of interest regarding the research, authorship, and/or publication of this article., (Sociedad Argentina de Investigación Odontológica.)

Objectives: This in vitro study aimed to evaluate the effect of different times and concentrations of hydrofluoric acid etching on the surface of indirect restorative materials obtained from blocks used in CAD-CAM technology., Methods: Specimens (4 mm × 4 mm × 0.8 mm) were obtained for each indirect restorative material: zirconia-reinforced lithium monosilicate ceramic (Celtra Duo), nanoceramic resin (Lava Ultimate), and polymer-infiltrated ceramic network material (Vita Enamic). The materials were submitted to etching with 5% or 10% hydrofluoric acid for 20, 40, 60, or 90 s. A control group for each material was evaluated without any surface treatment, totaling nine experimental groups for each material (n = 10). The specimens were evaluated for surface roughness (R a and R z ), confocal optical microscopy, the contact angle (θ), surface free energy (γs), total free interaction energy (∆G) using a goniometer, and microshear bond strength to resin cement. Specimen images were obtained using scanning electron microscopy, confocal optical microscopy, and atomic force microscopy. Data on the surface roughness, the contact angle, surface free energy, total free interaction energy, and bond strength were subjected to two-way ANOVA and Tukey´s test (α=0.05)., Results: In general, Celtra Duo showed better results after etching with 10% hydrofluoric acid for 40 or 60 s. Lava Ultimate showed better performance after etching with 10% hydrofluoric acid for 20 or 40 s, whereas Vita Enamic showed better results after etching with 5% hydrofluoric acid for 90 s., Conclusion: Each material showed different characteristics after etching with hydrofluoric acid. Knowledge of the proper protocol for each material is essential to ensure improvements in the adhesion process and durability of indirect restorations. In general, Celtra Duo presented mechanical properties superior to those of Lava Ultimate and Vita Enamic., Clinical Significance: Specific etching protocols must be recommended for each indirect material because longer exposure to hydrofluoric acid can jeopardize the surface, thus affecting the mechanical and bond strength properties., Competing Interests: Declaration of Competing Interest The authors have stated explicitly that there are no conflicts of interest in connection with this article., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

This study aims to evaluate in vitro the effect of violet LED when applied directly to dentin tissue pigmented by different substances. We analyzed the chromatic alteration, the bleaching effect and the temperature variation. Hence, 60 bovine dentin tissue discs were divided into five groups: NNatural Pigmentation; T-Black Tea; C-Soluble Coffee; W-Red Wine; B-Equine Blood. Individualized pigmentation protocols were performed and all groups reached the same chromatic change value. Subsequently, we simultaneously performed a bleaching session and measured temperature variation using a K-type thermocouple device. Data on chromatic change (∆E, ∆E00, ∆a, ∆b and ∆L), whitening effect (WID) and temperature variation were subjected to one-way Anova and Tukey's post-test at a 5% significance level. The C group showed the most relevant chromatic change values, similar to the N group, responding positively to the treatment. However, the B group differed from the control group, which showed difficulty to respond to the treatment. Regarding the whitening index, only the W group showed lower results than the others. The B group showed the greatest temperature changes. We conclude that the violet LED offered chromatic change, which generated a bleaching effect. Pigmentations with red wine and blood showed the greatest difficulty to respond to treatment, also promoting a higher temperature rise in teeth pigmented with blood., Competing Interests: Declaration of Competing Interest The authors declare that there are no conflicts of interest regarding the publication of this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Objectives: This randomized, prospective, and split-mouth study aimed to evaluate flowable bulk-fill resin composites in class II restorations, comparing it with a conventional layering technique after 4-year follow-up., Materials and Methods: Fifty-three subjects received three class II restorations according to the restorative systems: conventional microhybrid composite resin (PA - Peak Universal + Amelogen Plus, Ultradent); flowable bulk-fill and nanoparticulate composite resins (ABF - Adper Single Bond 2 + Filtek Bulk Fill Flow + Filtek Z350XT, 3M/Espe); and flowable bulk-fill and microhybrid composite resins, (XST - XP Bond + SDR + TPH3, Dentsply). The clinical performance and interproximal contacts were evaluated. Statistical analyses were performed using the Kaplan-Meier, equality test of two proportions, Friedman, Wilcoxon, Kruskal-Wallis, Mann-Whitney, and Logistic regression analysis tests (alpha = 0.05)., Results: In total, 106 restorations were evaluated at 4 years. Both systems with bulk-fill composites presented higher marginal discoloration than PA. About surface texture, ABF restorative system showed superior bravo scores being statistically similar to XST. Better performance for wear and surface staining was found for XST restorative system. All restorative systems resulted in the decreased interproximal contacts, occurring early for XST., Conclusions: The restorative systems that used flowable bulk-fill resin composites showed satisfactory clinical performance compared with conventional resin composite after 4 years. All restorative systems had decreased proximal contact after 4 years., Clinical Relevance: Initial marginal discoloration was observed in more than 50% of class II restorations performed with restorative systems that used flowable bulk-fill resin composite. All restorative systems had decreased proximal contact strength over time., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objectives: Although bleaching therapy is considered a dose-dependent treatment, the effect of the volume of product used is yet to be studied. This study thus aimed to evaluate the influence of bleaching gel volume on chromatic alteration and postoperative sensitivity., Methodology: Thirty patients were selected and allocated into three groups; the lower canines were analyzed according to the volume of gel used: GI-0.025 mL, GII-0.05 mL, and GIII-0.10 mL. Chromatic alteration analysis was performed using a portable digital spectrophotometer by calculating the ΔE, ΔE00, ΔL*, Δa*, and Δb* values and the whiteness index (W ID ). Spontaneous sensitivity was assessed using a questionnaire, and sensitivity was stimulated by thermo-sensory analysis. Analyses were conducted in five stages: baseline, after 1st, 2nd, and 3rd bleaching sessions, and 14 days after the end. Data were analyzed using the two-way ANOVA test with repeated measures and Tukey's post hoc test (p < 0.05)., Results: It was observed that ΔE, ΔE00, and ΔL* were similar between groups at the end of the bleaching therapy; and the values of Δa*, Δb*, and WID were higher in the GIII group. For sensitivity, it was found that the GI was the one with the lowest values; o GII intermediate values; while the GIII group presents the highest values of spontaneous and stimulated sensitivity., Conclusion: Gel volume influenced the response to bleaching and significantly influenced the spontaneous sensitivity and cold stimulus., Clinical Relevance: The amount of bleaching gel used during therapy is key to both the response to color change and postoperative sensitivity., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

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., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Education and Health Promotion.)

Objectives: To evaluate different restorative techniques for non-carious cervical lesions (NCCLs) and the activity of matrix metalloproteinases (MMPs) in gingival crevicular fluid., Materials and Methods: Two hundred restorations were performed in 50 patients using resin composite restorative system without (I) and with selective enamel conditioning (II) and resin-modified glass-ionomer cement without (III) and with EDTA pretreatment (IV). Gingival crevicular fluid samples were collected in 15 patients. Restorations were evaluated using USPHS criteria at baseline and after 2 years. Percentages of MMP activity were assessed by zymography as a surrogate outcome. Equality tests of two proportions, logistic regression analysis, survival analysis, ANOVA repeated measures, and Fisher tests were used., Results: No differences in clinical performance were found among groups. Group I had lower retention at 2 years than at baseline. Decreased alpha scores for marginal integrity and marginal discoloration were observed for all groups after 2 years. MMP-2 decreased after 1 year, and its activity increased back to the initial level after 2 years, mainly for groups I, II, and III. MMP-9 increased after 1 year, and it was reduced to the initial level after 2 years, mainly for group I., Conclusions: All restorative techniques performed similarly in NCCLs after 2 years with initial marginal defect alterations. MMP-2 reestablished its initial levels after 2 years, and MMP-9 had few alterations over time in crevicular fluid. Clinical relevance The different restorative techniques are equally successful in NCCLs after 2 years of clinical functioning and have similar effects on MMPs present in crevicular fluid., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: To evaluate non-carious cervical lesions (NCCLs) restored with different adhesion strategies., Methodology: This is a prospective, randomized, double-blind, split-mouth study. An adhesive restorative system (Single Bond Universal/Filtek Z350XT - SBU) was evaluated both without and with selective enamel conditioning (E-SBU), resin-modified glass-ionomer cements (Vitremer; RMGIC), and ethylenediaminetetraacetic acid pretreatment (EDTA; E-RMGIC). In total, 200 restorations, placed in 50 patients, were evaluated at baseline and at a 3-year follow-up using the modified United States Public Health Service (USPHS) criteria. Data were analyzed using the two-proportion equality test, multinomial logistic regression, Wilcoxon test, and Kaplan-Meier survival curves., Results: In total, 42 (84%) patients returned for the 3-year follow-up. SBU showed restoration losses statistically different from RMGIC. Retention was also statistically different in SBU between baseline and the 3-year follow-up. Marginal defects and surface texture were statistically significant for all groups in the period studied, except for the surface texture of SBU and the marginal integrity in E-RMGIC. We observed no statistically significant difference in wear, secondary caries, anatomical form, surface staining, and color over time. Recession degree was the only factor to influence retention rates. Cumulative survival (%) was 89, 98, 98, and 95.3, for SBU, SE-SBU, RMGIC, and E-RMGIC, respectively, without significant differences among them. There was a statistically significant difference between survival curves; however, multiple comparison procedures found no statistical differences., Conclusion: Selective enamel etching affected the retention of non-carious cervical restorations. Adhesion using EDTA and resin-modified glass-ionomer cements delayed marginal defects over time. The degree of gingival recession influenced retention rates. Resin composite restorations showed initial marginal defects, and ionomer restorations, reduced surface luster. EDTA pre-treatment followed by resin-modified glass-ionomer cements may be a promising adhesion strategy for NCCL restorations.

The removal of direct composite veneers, when the retreatment is necessary, represents a challenge to the clinician, since the healthy dental structure must be preserved. Thus, the aim of this study was to compare the accuracy provided by different auxiliary devices during retreatment of direct composite veneers. Seventy-five bovine teeth were prepared for direct composite veneers, scanned (T1), and restored. Specimens were divided into 5 groups for retreatment: conventional high-speed handpiece without auxiliary device (WD); high-speed handpiece with a white LED (WL); high-speed handpiece with an UV light (UL); electric motor and multiplier 1/5 handpiece (EM); and conventional high-speed handpiece using magnifying loupe (ML). After retreatments, other scanning was performed (T2). Changes on dental wear or composite residues areas, as well as, the average between wear and presence of residues were measured. Data were submitted to Kruskal-Wallis and Dunn's post-test (p≤ 0.05). There were greater areas of wear for ML, being statistically superior to WD and EM groups. The ML presented smaller residues areas, being statistically lower than the WD and EM groups. Regarding the average between wear and the presence of resin residues, additional wear occurred after re-preparation, regardless of the group. Magnifying loupe promoted greater areas of wear and smaller areas of resin residues than conventional high-speed handpiece and electric motor. Both techniques using light accessories did not differ from other ones., Competing Interests: The authors have declared that no competing interests exist.

Purpose: To evaluate the microhardness, roughness, profilometry and cross-sectional hardness of single increment materials submitted to different challenges., Methods: Thirty-six disks of each material, Filtek Supreme XTE (FT), Filtek One Bulk Fill (BK), Ketac Molar Easy Mix (KT) and Equia Forte + Coat (EQ) were immersed in saliva, pH cycling and Coke for 15 days. Half of each surface was used as its own control. Superficial microhardness, roughness, perfilometry analysis were performed. All samples were sectioned, embedded in acrylic resins, polished and cross-sectional hardness were made. Data were analyzed by ANOVA and Tukey's test (p < 0.05)., Results: The KT presented superficial microhardness superior than EQ. However, in depth, EQ showed superior values. FT, KT suffered the effects of challenges on microhardness values. The highest roughness and wear values were found for KT. RC do not suffer wear. All materials suffered the effects of Coke and pH challenges in depths 10 µm and 60 µm., Conclusion: The single increment restorative material that suffered less action on its surface was the bulk-fill resin. The coat present in the hybrid ionomer was able to resist to the immersion actions. In addition, Coke was the most aggressive challenge.

Objective: The aim of this paper is to present the results of a consensus meeting on the threshold property requirements for the clinical use of conventional glass-ionomer cements (GICs) for restorative indications., Methods: Twenty-one experts on GICs evaluated the results of tests on mechanical and optical properties of 18 different brands of restorative GICs: Bioglass R [B], Chemfil Rock [CR], Equia Forte [EF], Gold Label 2 [GL2], Gold Label 9 [GL9], Glass Ionomer Cement II [GI], Ionglass [IG], Ion Z [IZ], Ionomaster [IM], Ionofil Plus [IP], Ionostar Plus [IS], Ketac Molar Easymix [KM], Magic Glass [MG], Maxxion R [MA], Riva Self Cure [R], Vidrion R [V], Vitro Fil [VF] and Vitro Molar [VM]. All experiments were carried out by a team of researchers from Brazil and England following strict protocols, under the same laboratory conditions throughout, and maintaining data integrity., Results: There was consensus on: determining as primary properties of the material: compressive strength, microhardness, acid erosion and fluoride release, and as secondary properties: contrast ratio and translucency parameter, in order to rank the materials. Seven brands were below the thresholds for restorative indications: IZ, IM, IG, MA, VF, B and MG., Conclusions: Based on the primary properties adopted as being essential for restorative indications, the conventional restorative GICs that met the thresholds and could be considered suitable as long-term restorative materials were: EF, GI, GL9, KM, IP, GL2, IS, CR, V, VM and R. A decision-making process to select the best GIC must also include results from clinical trials., Clinical Significance: This study provides a ranking of GICs that could be considered suitable as long-term restorative materials based on their main properties., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: The purpose of this study was to investigate the effect of a novel dental bleaching technique with Violet LED on enamel color change, bond strength and hybrid layer nanomechanical properties in resin-dentin restoration, and dentin biostability., Methods: A total of 125 bovine incisors were distributed into a control group, violet LED group (LED), and 35 % peroxide hydrogen bleaching gel (BLG) groups (n = 15). Three 45-minute sessions were performed for both bleaching procedures every week. Enamel color change (ΔE, ΔL, and Δb) was determined after every bleaching session. After color analysis, dentin was exposed for the resin-dentin bond strength analysis using microtensile test and evaluation of the nanomechanical properties at the hybrid layer (nanohardness). While half of the specimens were tested immediately, the remaining were evaluated after 10,000 thermal cycles (TC). Thirty additional teeth were used to investigate dentin ultimate tensile strength (UTS) after the bleaching treatments. UTS was evaluated before and after an enzymatic challenge. Two-way repeated measures ANOVA and Tukey's post-test were used for the statistical analysis (α = 0.05)., Results: Enamel bleaching effect was observed in the LED and BLG groups with significant alterations in the ΔE, ΔL, and Δb in the BLG group. No difference was observed in the resin-dentin bond strength among the groups (p > 0.05), however, TC negatively affected the bond strength values for all the groups. Nanomechanical properties ​​remained unchanged when comparing immediate and after TC results (p > 0.05). Bleaching with BLG reduced significantly the dentin UTS, while all groups showed major decrease in UTS after the enzymatic challenge., Conclusions: Although violet LED was able to promote a bleaching effect, less color changes was observed when compared to BLG. None of the bleaching techniques effected the resin-bond strength or the nanomechanics of the hybrid layer. Violet LED did negatively effect dentin biostability as observed for BLG and it may promote less changes to the organic content of dentin., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Objective: This study aimed to evaluate the effects of different toothpastes on the surface wear of enamel, dentin, composite resin (CR), and resin-modified glass ionomer cement (RMGIC), and to perform a topographic analysis of the surfaces, based on representative images generated by atomic force microscopy (AFM) after erosion-abrasion cycles., Methodology: One hundred and forty bovine incisors were collected and divided into two groups: 72 enamel and 72 dentin blocks (4×4 mm). Half of the specimens were restored with CR (Filtek Z350 XT) and the other half with RMGIC (Fuji II LC). Then, samples were submitted to a demineralization cycle (5 days, 4×2 min/day, 1% citric acid, pH 3.2) and exposed to three different toothpastes (2×15 s/day): without fluoride (WF, n=12), sodium fluoride-based (NaF, n=12), and stannous fluoride-based (SnF2, n=12). Surface wear, as well as restoration interfaces wear, were investigated by profilometry of the dental substrates and restorative materials. All representative surfaces underwent AFM analysis. Data were analyzed by two-way analysis of variance and Tukey's tests (α=0.05)., Results: NaF-based toothpaste caused the greater dentin surface wear (p<0.05). Toothpastes affected only enamel-restoration interfaces. AFM analysis showed precipitate formation in dentinal tubules caused by the use of fluoride toothpastes., Conclusions: NaF-based toothpastes had no protective effect on enamel adjacent to CR and RMGIC against erosion-abrasion challenges, nor on dentin adjacent to RMGIC material. SnF2-based toothpastes caused more damage to interfaces between enamel and RMGIC.

Background: To evaluate the bleaching efficacy and post-operative sensitivity of 10 % carbamide peroxide (PC) with or without violet LED (VL)., Methods: Thirty patients were selected and were instructed to perform home bleaching treatment using PC 10 %, for 8 h daily, for 21 days. All patients underwent in-office irradiation of only one hemiarch with VL for 30 min, twice per week for three weeks, totaling six clinical sessions of irradiation. The treatment used for each hemiarch was determined randomly. The analyses were performed at the initial time and 7, 14, and 21 days after the start of treatment and 7 and 14 days after the end of the bleaching treatment. For color analysis, digital spectrophotometry was done using the Visual Analog Scale and cold detection was performed using the thermo-sensory analysis II (TSA II) equipment. The ANOVA-two way with repeated measures and the Tukey test (α = 0.05) were used for the color and cold sensitivity analysis., Results: On analyzing the color change, it was observed that the hemiarch that was irradiated with VL presented the highest values compared with the side that did not receive irradiation. Regarding tooth sensitivity, there was no report of any patient experiencing discomfort during the bleaching protocol. Analysis of the dental thermal sensation threshold showed that the use of VL made the teeth more sensitive., Conclusions: It can be concluded that the VL provided a positive effect on color alteration when used in conjunction with 10 % PC. However, the use of this new protocol made the teeth more sensitive., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Objectives: The purpose of the present prospective and randomized clinical trial was to evaluate the clinical performance of noncarious cervical lesions (NCCLs) restored with different adhesion strategies on the dental substrate., Method and Materials: An adhesive restorative system (Single Bond Universal/ Z350XT) with and without selective enamel conditioning was evaluated, as well as a resin-modified glass-ionomer cement (Vitremer), with and without pretreatment with ethylenediaminetetraacetic acid (EDTA). Two operators placed a total of 200 restorations in 50 patients (four restorations per patient). Data from decayed, missing, and filled teeth (DMFT), visible plaque, and gingival bleeding were collected prior to the restorations and at each evaluation time. All restorations were evaluated using the modified United States Public Health Service (USPHS) evaluation system at baseline, and at 6 and 12 months. Data were analyzed by the Friedman, chi-square, Cochran, Wilcoxon, and multiple logistic regression analysis tests (P ≤ .05)., Results: There was a gradual and significant increase in DMFT with a difference among the three evaluations (P ≤ .001). There was no difference for the Visible Plaque Index over time (P = .28); however, there was a significant reduction in the Gingival Bleeding Index between the baseline and the other evaluations (P ≤ .001). There was no statistically significant difference among groups and periods of evaluations (P > .05). Regarding logistic regression, the model as a whole was statistically significant (P = .034)., Conclusion: The four different adhesion strategies in the NCCL restorations presented similar clinical performance after 1 year of follow-up.

Background: The aim of this study was to analyze bleaching treatment performed with different products, with or without the use of Violet LED., Methods: The color and dental sensitivity of six patients were evaluated as follows: (1)at-home bleaching with 10% Carbamide Peroxide (CP); (2)in-office bleaching with 17.5% Hydrogen Peroxide (HP), and (3)treatment with a placebo gel. All patients, including patients receiving at-home bleaching, received irradiation with violet LED in the office. The right hemiarch was protect with silicone. The color was evaluated using Vita Easyshade digital spectrophotometer and the Vita scale on teeth 13-23. Visual analog scale sensitivity analysis was performed per hemiarch, while the thermal sensation threshold was performed on teeth 11, 13, 21 and 23., Results: Regarding the color change (ΔE) it can be observed that treatment 1, in which 10%CP was used, presented the highest values, followed by treatment 2, in which 17.5%HP was used. Regarding sensitivity, only patients who received 17.5%HP showed moderate sensitivity, and there was no difference between the arches. The analysis of dental thermal sensation threshold showed that there was more dental sensitization between 7 and 14 days and that the use of violet LED made the teeth more sensitive., Conclusions: It was concluded that violet LED enhanced the bleaching effect when used with 10%PC gels, and a discreet effect was seen when used either in conjunction with 17.5%PH or alone. Violet LED had no effect on pain sensation, but increased the detection threshold of thermal changes in the teeth that were irradiated., (Copyright © 2019 Elsevier B.V. All rights reserved.)

The aim of this study was to evaluate influence of protease inhibitors on degradation of sound, sclerotic and caries-affected dentin. Thirty-nine molars were used, thirteen for each dentin condition. Three slices were obtained from each tooth, each one immersed in the following different solutions for 1 h: 1) artificial saliva; 2) 2% chlorhexidine; 3) 0.5% epigallocatechin-gallate (EGCG). After immersion, samples were subjected to enzymatic degradation challenge (collagenase from Clostridium histolyticum). Nanohardness (HIT) and elastic modulus (Er) were measured before and after enzymatic challenge, as well as the ultimate tensile strength (UTS). Results of UTS, HIT and Er tests were submitted to repeated measurements ANOVA and Tukey post-test (α = 0.05). Higher values of UTS were found for sound dentin in control (40.30 ± 21.38 MPa) and 0.5% EGCG (30.05 ± 19.67 MPa) groups. Before degradation, higher values of HIT (0.237 ± 0.062 GPa) and Er (5.58 ± 1.75 GPa) were found for 0.5% EGCG group in caries-affected dentin. After degradation, 2% chlorhexidine group had higher values of HIT and Er for sound (0.134 ± 0.020 GPa and 3.57 ± 0.40 GPa) and sclerotic (0.201 ± 0.048 GPa and 4.30 ± 0.56 GPa) dentin. The 2% chlorhexidine showed best effect increasing HIT and Er, mainly for sclerotic dentin, before/after enzymatic degradation. The 0.5% EGCG showed better effect on HIT and Er in caries-affected dentin, before enzymatic degradation., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

The aim of this study was to evaluate the mechanical resistance of dentin and restorative materials submitted to erosive/abrasive challenges with different dentifrices. The dentin was restored using a resin-modified glass-ionomer (RMGIC) or a composite resin (RC). One hemiface of the sample was protected, and the other was subdivided according to the applied dentifrice (n = 10): without fluoride (SF), sodium fluoride (NaF) and stannous fluoride (SnF). The specimens were submitted to erosive/abrasive cycles, the varnish was removed, and the Martens hardness (HMV) and elastic modulus (Eit) were evaluated. The data were analyzed by repeated two-way ANOVA measurements and Tukey tests (alpha = 0.05). When analyzing the HMV on the test side, there was no influence of the dentifrices in the dentin; however, the orders of NaF < SnF = SF in RC and SnF > NaF = SF in RMGIC were observed. Comparing the treated surfaces, there were no differences in the dentin, and only the SF since CR presented an HMV superior to that of RMGIC. Comparing control and test sides, both dentins obtained a decreased HMV after the erosive/abrasive challenge; for the restorative materials, superior values were found only for SnF in the RMGIC. The Eit values were influenced more by the dentifrices on the test side for the dentin adjacent to the RMGIC, with the lowest values shown for the SF, and for both materials, the highest values were shown for the SnF group. No differences were found when comparing each dentin treated with the same dentifrice; however, the RMGIC presented a superior Eit than the CR when brushed with both dentifrices with a fluoride. Comparing the control and test sides, the same results were obtained for the HMV. The dentifrices showed little influence on the dentin substrate, whereas the dentifrice with SnF enhanced the mechanical properties of the restorative materials, which was more evident in the RMGIC., (Copyright © 2019. Published by Elsevier Ltd.)

Aim: The aim of this study was to evaluate microhardness and color change (ΔE) of composite resins, light cured with different light emission diodes (LEDs) and submitted to artificial accelerated aging (AAA)., Materials and Methods: Two composite resins with lucirin- TPO photoinitiator were selected: Tetric N-Ceram (Ivoclar Vivadent, A1) and Vit-l-escence (Ultradent, WO).A resin with the only camphorquinone photoinitiat or was chosen as a negative control: Filtek Z350XT (3M ESPE, WD). Disc-shaped specimens were prepared (5 mm diameter; 1.5 mm thick) and photopolymerized with an LED with one wavelength (Radii-Cal, SDI) or multiple wavelengths (Valo, Ultradent), for each composite resin (n = 10). Surface microhardness and color evaluations were performed immediately after specimen preparation and after AAA. Microhardness results were analyzed using Kruskal-Wallis and Mann-Whitney tests for multiple comparisons. To compare the evaluation of microhardness at different times, the Wilcoxon test was used. Mean values of ΔE, ΔL, Δa, and Δb were evaluated using two-way analysis of variance (ANOVA), and Tukey test for multiple comparisons (a = 0.05)., Results: Regarding microhardness, a statistically significant difference between the two LEDs was observed for Vit-lescence after AAA. When comparing composite resins that were light-cured with the same device, FiltekZ350XT obtained the greatest microhardness. All groups presented a statistically significant decrease in microhardness from the initial time to the AAA. Regarding ΔE, no statistically significant difference between the two LEDs was observed. When comparing composite resins, FiltekZ350XT showed the highest ΔE values., Conclusion: In general, an LED with multiple wavelengths influenced the microhardness of only one resin containing lucirin-TPO after AAA. The ΔE was more influenced by the composite resin than the LED device., Clinical Significance: The knowledge of composite resin with deficiencies in the polymerization mechanism could contribute to preventing restorations to become more susceptible to color change and reduction of the mechanical strength.

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 (p<0.05). Sound bovine dentin and HCl-pepsin-treated bovine dentin treatments resulted in similar values for both MH and Eit* (p>0.05), but HCl-pepsin-treated bovine dentin and citric acid-treated bovine dentin resulted in lower surface gloss than sound bovine dentin (p<0.05)., Conclusions: The HCl-pepsin protocol modified bovine dentin properties that could be similar to those that occur on human dentin surfaces with erosive lesions.

Objective: The purpose of this clinical report was to describe the detection of fluorescent resin residue after orthodontic bracket debonding with two UV light devices and analyze the surface morphology of enamel after 1 year., Clinical Considerations: A 22-year-old woman had orthodontic brackets removed by a previous dentist; however, resin residue was left on the enamel of the maxillary teeth. After confirming the fluorescent property of the resin, different protocols were used for each half of the maxillary arch. The first method, a black light lens was attached to a light-curing device to detect resin fluorescence, followed by polishing with silicone rubber tips. The second method used a light emitting diode light system attached to and activated by a high-speed handpiece, followed by polishing with discs. Both methods were completed with diamond polishing paste applied with felt discs. Polyvinyl siloxane impressions were made initially, after residue removal, after finishing and after polishing for morphologic analysis. The results were evaluated with photographs and the scanning electron microscope images made of resin casts from the impressions. A follow-up was made after 1 year., Conclusions: Both methods yielded a satisfactory clinical outcome, with a smooth surface, acceptable surface gloss and minimal tooth wear. The use of a UV device that excites fluorescence is recommended for the controlled removal of resin residue on enamel., Clinical Significance: The controlled removal of resin residue from enamel after orthodontic treatment is challenging but can be improved with auxiliary methods for detecting resin residues. This clinical report describes two types of devices that excite fluorescent resins in a more rapid and precise technique to guide the practitioner in the controlled removal of residual resin on teeth., (© 2018 Wiley Periodicals, Inc.)

The purpose of this study was to evaluate the bonding interface between a self-adhesive resin cement to in vitro eroded dentin. Seventy-two third molars were used and divided into two groups: sound dentin and in vitro eroded dentin. The in vitro erosion was performed following a demineralization protocol, in which the specimens were immersed in a demineralizing solution for 2 minutes per cycle and remineralizing solution for 10 minutes per cycle for 9 days. Both groups were submitted to four dentin surface treatments: control group (without any treatment), 2% chlorhexidine, 20% polyacrylic acid, and 0.1 M EDTA (n = 9). Blocks of resin-based composite were bonded with RelyX U200 self-adhesive resin cement applied on the pretreated dentin surfaces. The teeth were sectioned into beams (1mm2) and submitted to microtensile bond strength testing to evaluate the bond strength of self-adhesive resin cement to dentin after 24 hours and 8 months of immersion in artificial saliva. Three specimens of each group were longitudinally cut and evaluated using confocal laser scanning microscopy to analyze the dentin/cement interface. Eroded dentin showed higher bond strength values when compared to sound dentin for the 2% chlorhexidine group (p = 0.03), 24 hours after adhesion. When considering eroded dentin, the 0.1M EDTA group showed higher bond strength values with a statistically significant difference only for the control group (p = 0.002). After 8 months of storage, the present results showed that there was no statistically significant difference between the two substrates for all experimental groups (p>0.05). Analysis of the microscopy confocal showed different types of treatments performed on dentin generally increased tags formation when compared to the control group. The eroded dentin showed a significant increase in density and depth of resinous tags when compared to sound dentin. The storage of samples for 8 months seems to have not caused significant degradation of the adhesive interface., Competing Interests: The authors have declared that no competing interests exist.

Introduction: The standard treatment for locally advanced rectal cancer (RC) consists of neoadjuvant chemoradiation followed by radical surgery. Regardless the extensive use of SUVmax in 18F-FDG PET tumor uptake as representation of tumor glycolytic consumption, there is a trend to apply metabolic volume instead. Thus, the aim of the present study was to evaluate a noninvasive method for tumor segmentation using the 18F-FDG PET imaging in order to predict response to neoadjuvant chemoradiation therapy in patients with rectal cancer., Method: The sample consisted of stage II and III rectal cancer patients undergoing 18F-FDG PET/CT examination before and eight weeks after neoadjuvant therapy. An individualized tumor segmentation methodology was applied to generate tumor volumes (SUV2SD) and compare with standard SUVmax and fixed threshold (SUV40%, SUV50% and SUV60%) pre- and post-therapy. Therapeutic response was assessed in the resected specimens using Dworak's protocol recommendations. Several variables were generated and compared with the histopathological results., Results: Seventeen (17) patients were included and analyzed. Significant differences were observed between responders (Dworak 3 and 4) and non-responders for SUVmax-2 (p<0.01), SUV2SD-2 (p<0.05), SUV40%-2 (p<0.05), SUV50%-2 (p<0.05) and SUV60%-2 (p<0.05). ROC analyses showed significant areas under the curve (p<0.01) for the proposed methodology with sensitivity and specificity varying from 60% to 83% and 73% to 82%, respectively., Conclusion: The present study confirmed the predictive power of the variables using a noninvasive individualized methodology for tumor segmentation based on 18F-FDG PET/CT imaging for response evaluation in patients with rectal cancer after neoadjuvant chemoradiation therapy.

This prospective, randomized, split-mouth clinical trial evaluated the clinical performance of conventional glass ionomer cement (GIC; Riva Self-Cure, SDI), supplied in capsules or in powder/liquid kits and placed in Class I cavities in permanent molars by the Atraumatic Restorative Treatment (ART) approach. A total of 80 restorations were randomly placed in 40 patients aged 11-15 years. Each patient received one restoration with each type of GIC. The restorations were evaluated after periods of 15 days (baseline), 6 months, and 1 year, according to ART criteria. Wilcoxon matched pairs, multivariate logistic regression, and Gehan-Wilcoxon tests were used for statistical analysis. Patients were evaluated after 15 days (n=40), 6 months (n=34), and 1 year (n=29). Encapsulated GICs showed significantly superior clinical performance compared with hand-mixed GICs at baseline (p=0.017), 6 months (p=0.001), and 1 year (p=0.026). For hand-mixed GIC, a statistically significant difference was only observed over the period of baseline to 1 year (p=0.001). Encapsulated GIC presented statistically significant differences for the following periods: 6 months to 1 year (p=0.028) and baseline to 1 year (p=0.002). Encapsulated GIC presented superior cumulative survival rate than hand-mixed GIC over one year. Importantly, both GICs exhibited decreased survival over time. Encapsulated GIC promoted better ART performance, with an annual failure rate of 24%; in contrast, hand-mixed GIC demonstrated a failure rate of 42%.

Purpose: Retrospective study of the effects of anticancer treatment on the brain metabolism of patients diagnosed with rectal cancer based on a large and homogeneous sample of 40 paired F-FDG PET/CT volumes taken from 20 patients. The results are compared to the ones presented by related works to help elucidating the mechanisms of neurotoxicity associated to a decrease in memory, learning and motor skills., Patients and Methods: Twenty patients with rectal adenocarcinoma were scanned before and after neoadjuvant chemoradiation based exclusively on 5-fluorouracil and leucovorin. The sample was non-rigidly registered to a common template to allow for the comparison of regional metabolism. Statistical analysis was based on adjusted paired t-tests., Results: The analysis primarily revealed a statistically significant decrease in the metabolism after neoadjuvant chemotherapy at the hypothalamus, putamen, head of the caudate, globus pallidus, red nucleus, substantia nigra, amygdala, cerebellum and the parahippocampal gyrus. The analysis also revealed smaller regions of increased metabolic activity at the middle temporal gyrus, precuneus of the parietal lobe and cuneus of the occipital lobe., Conclusions: The regions of decreased metabolism detected in the study are related to memory, learning and voluntary movement which is consistent with previous findings based on clinical studies and neuropsychological tests that report impairments on neurocognitive and motor skills associated to these therapies.

Objective: To evaluate four protocols for removal of fluorescent materials after bracket debonding., Materials and Methods: Resin removal from 40 bovine enamel surfaces was performed according to groups (n = 10): conventional (C), white LED (W), LED that evidenced fluorescence (F), and fluorescent lens (FL). The following analyses were performed: sample thickness, superficial area of resin residue, and areas of resin residue or worn enamel in depth. ANOVA and Tukey tests were used to analyze sample thickness (P ≤ .05). Area measurements were analyzed by Kruskal-Wallis and Dunn's tests (P ≤ .05)., Results: The FL group showed the highest reduction in enamel thickness. F group final thickness was similar to that of other groups. The largest superficial areas of resin residue were found for the C and W groups, while the FL group had the greatest removal of resin residue. The C group exhibited the largest area in depth of resin residue. The FL and F groups exhibited the most loss of enamel with the least amount of resin residue; in contrast, the C and W groups presented the fewest areas of worn enamel and the most areas of resin residue., Conclusion: Auxiliary devices were useful for removal of fluorescent residue after bracket debonding.

Aim: The aim of this study was to investigate the association of different degradations on the roughness, gloss, and color changes of microhybrid composites., Materials and Methods: Ten specimens were prepared for Charisma, Amelogen Plus, Point 4, and Opallis resins. Surfaces were polished and baseline measurements of roughness, gloss, and color were recorded. Specimens were then submitted to chemical and mechanical challenges, and the specimens were reevaluated. Roughness and gloss were analyzed by Kruskal -Wallis and Dunn's test (p < 0.05). Color change (ΔE) was analyzed by one-way analysis of variance and Tukey's tests (p < 0.05). The initial and final data were compared using the Wilcoxon test (p < 0.05). Spearman test checked the correlation between the roughness and gloss (p < 0.05)., Results: Regarding surface roughness and gloss, there was no difference between composites before challenges. However, all composites showed a significant increase of roughness after challenges, with highest values for Charisma. The gloss was influenced by challenges, evidencing the best gloss for Point 4. Charisma showed the highest value of color change. There was no correlation between surface roughness and gloss for the initial analysis, and after the challenges., Conclusion: Composites were influenced by association of challenges, and Charisma showed the highest changes for roughness, gloss, and color., Clinical Significance: The type of composite resin influenced the properties of materials, which are surface roughness, gloss, and color change. The dentist should be aware of the performance of different brands, to choose the correct required composite resin for each type of patient or region to be restored.

Abastract This study aimed to evaluate the transenamel and transdentinal penetration of hydrogen peroxide (H202) applied to bovine teeth pigmented with black tea at different intensities. The following groups were formed DW: immersion in distilled water; BT100: immersion in an infusion of 1.6 g of black tea per 100 mL distilled water; BT10: immersion in an infusion of 1.6 g black tea per 10 mL distilled water. All groups were immersed for 6 days. To quantify the penetration of H202, the specimens were placed in artificial pulp chambers (APCs) and subjected to bleaching treatment with 38% H2O2 once per week for 3 weeks. After bleaching treatment, the acetate buffer solution of APCs with peroxidase enzyme was evaluated in a reflection spectrophotometer. The transenamel and transdentinal penetration of H2O2 and the L* values obtained at T1, T2 and T3 were subjected to Kruskal-Wallis and Friedman statistical tests. At T1, the H2O2 diffusion in DW was higher than that in BT100 and BT10. At the other evaluation times, the penetration values in BT100 and BT10 increased and remained similar. The L* values increased significantly in all groups at T1. At T2, the L* values were higher in DW, while the values in BT100 and BT10 were similar to each other. At the end of the experiment, BT10 showed the lowest L* values. The pigmentation level did not affect the penetration of H2O2 through the enamel and dentin and the bleaching agent effectively changed the color of the teeth.

The aim of this study was to evaluate the shear bond strength of resin composite repairs with and without aging of the surface to be repaired, using different adhesive systems and resin composites. Ninety specimens were prepared: 10 for the Control Group (GC - without repair); 40 for Group I (GI - repairs after 7 days) and 40 for Group II (GII - repairs after 180 days). Groups I and II were divided into 4 subgroups of 10 specimens each, according to the adhesive system and composite resin used: A) Adper Scotch Bond Multipurpose + Filtek Z350 XT; B) Adper Single Bond Plus + Filtek Z350 XT; C) Adper Scotch Bond Multipurpose + Esthet-X; D) Adper Single Bond Plus + Esthet-X. The specimens were tested for shear strength in a universal testing machine. The results were analyzed by two-factor one-way ANOVA and Fisher's post hoc tests (alpha=0.05). The control group had better performance than the other groups. There was no significant difference when comparing different adhesive systems and composite resins. Repairs performed at 7 days were better than those performed at 180 days. The composite repairs decreased the mechanical strength of the restoration. Aging of the resin substrate may decrease repair bond strength over time, regardless of the type of adhesive systems and resin composites used., (Sociedad Argentina de Investigación Odontológica.)